code_type,code,description,gross_charge,discounted_cash,min_negotiated,max_negotiated,payer_entries
APR-DRG,001-1,LIVER TRANSPLANT AND/OR INTESTINAL TRANSPLANT,,,24421.32,26081.02,8
APR-DRG,001-2,LIVER TRANSPLANT AND/OR INTESTINAL TRANSPLANT,,,24421.32,26081.02,8
APR-DRG,001-3,LIVER TRANSPLANT AND/OR INTESTINAL TRANSPLANT,,,33925.78,36231.42,8
APR-DRG,001-4,LIVER TRANSPLANT AND/OR INTESTINAL TRANSPLANT,,,80287.29,85743.71,8
APR-DRG,002-1,HEART AND/OR LUNG TRANSPLANT,,,100894.04,107750.92,8
APR-DRG,002-2,HEART AND/OR LUNG TRANSPLANT,,,100894.04,107750.92,8
APR-DRG,002-3,HEART AND/OR LUNG TRANSPLANT,,,100894.04,107750.92,8
APR-DRG,002-4,HEART AND/OR LUNG TRANSPLANT,,,227622.25,243091.73,8
APR-DRG,004-1,TRACHEOSTOMY WITH MV >96 HOURS WITH EXTENSIVE PROCEDURE,,,36192.63,38652.33,8
APR-DRG,004-2,TRACHEOSTOMY WITH MV >96 HOURS WITH EXTENSIVE PROCEDURE,,,36192.63,38652.33,8
APR-DRG,004-3,TRACHEOSTOMY WITH MV >96 HOURS WITH EXTENSIVE PROCEDURE,,,69316.04,74026.84,8
APR-DRG,004-4,TRACHEOSTOMY WITH MV >96 HOURS WITH EXTENSIVE PROCEDURE,,,91477.45,97694.37,8
APR-DRG,005-1,TRACHEOSTOMY WITH MV >96 HOURS WITHOUT EXTENSIVE PROCEDURE,,,28118.74,30029.73,8
APR-DRG,005-2,TRACHEOSTOMY WITH MV >96 HOURS WITHOUT EXTENSIVE PROCEDURE,,,28118.74,30029.73,8
APR-DRG,005-3,TRACHEOSTOMY WITH MV >96 HOURS WITHOUT EXTENSIVE PROCEDURE,,,46737.65,49914.0,8
APR-DRG,005-4,TRACHEOSTOMY WITH MV >96 HOURS WITHOUT EXTENSIVE PROCEDURE,,,64579.62,68968.53,8
APR-DRG,006-1,PANCREAS TRANSPLANT,,,23970.42,25599.48,8
APR-DRG,006-2,PANCREAS TRANSPLANT,,,23970.42,25599.48,8
APR-DRG,006-3,PANCREAS TRANSPLANT,,,23970.42,25599.48,8
APR-DRG,006-4,PANCREAS TRANSPLANT,,,23970.42,25599.48,8
APR-DRG,007-1,ALLOGENEIC BONE MARROW TRANSPLANT,,,76018.73,81185.05,8
APR-DRG,007-2,ALLOGENEIC BONE MARROW TRANSPLANT,,,76018.73,81185.05,8
APR-DRG,007-3,ALLOGENEIC BONE MARROW TRANSPLANT,,,94962.91,101416.7,8
APR-DRG,007-4,ALLOGENEIC BONE MARROW TRANSPLANT,,,194574.39,207797.89,8
APR-DRG,008-1,AUTOLOGOUS BONE MARROW TRANSPLANT,,,34762.85,37125.37,8
APR-DRG,008-2,AUTOLOGOUS BONE MARROW TRANSPLANT,,,34762.85,37125.37,8
APR-DRG,008-3,AUTOLOGOUS BONE MARROW TRANSPLANT,,,57243.35,61133.68,8
APR-DRG,008-4,AUTOLOGOUS BONE MARROW TRANSPLANT,,,76208.34,81387.55,8
APR-DRG,009-1,EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO),,,41306.75,44114.0,8
APR-DRG,009-2,EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO),,,41306.75,44114.0,8
APR-DRG,009-3,EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO),,,41306.75,44114.0,8
APR-DRG,009-4,EXTRACORPOREAL MEMBRANE OXYGENATION (ECMO),,,100732.18,107578.05,8
APR-DRG,011-1,CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES,,,56699.96,60553.35,8
APR-DRG,011-2,CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES,,,56699.96,60553.35,8
APR-DRG,011-3,CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES,,,56699.96,60553.35,8
APR-DRG,011-4,CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES,,,56699.96,60553.35,8
APR-DRG,020-1,OPEN CRANIOTOMY FOR TRAUMA,,,12736.33,13601.91,8
APR-DRG,020-2,OPEN CRANIOTOMY FOR TRAUMA,,,17140.55,18305.44,8
APR-DRG,020-3,OPEN CRANIOTOMY FOR TRAUMA,,,24042.1,25676.02,8
APR-DRG,020-4,OPEN CRANIOTOMY FOR TRAUMA,,,39760.56,42462.74,8
APR-DRG,021-1,OPEN CRANIOTOMY EXCEPT TRAUMA,,,14408.92,15388.16,8
APR-DRG,021-2,OPEN CRANIOTOMY EXCEPT TRAUMA,,,18753.02,20027.5,8
APR-DRG,021-3,OPEN CRANIOTOMY EXCEPT TRAUMA,,,29728.9,31749.31,8
APR-DRG,021-4,OPEN CRANIOTOMY EXCEPT TRAUMA,,,47125.35,50328.05,8
APR-DRG,022-1,VENTRICULAR SHUNT PROCEDURES,,,10921.14,11663.36,8
APR-DRG,022-2,VENTRICULAR SHUNT PROCEDURES,,,12789.51,13658.7,8
APR-DRG,022-3,VENTRICULAR SHUNT PROCEDURES,,,19563.88,20893.47,8
APR-DRG,022-4,VENTRICULAR SHUNT PROCEDURES,,,57536.25,61446.48,8
APR-DRG,023-1,SPINAL PROCEDURES,,,11744.34,12542.5,8
APR-DRG,023-2,SPINAL PROCEDURES,,,18517.16,19775.61,8
APR-DRG,023-3,SPINAL PROCEDURES,,,27471.28,29338.27,8
APR-DRG,023-4,SPINAL PROCEDURES,,,41128.7,43923.86,8
APR-DRG,024-1,OPEN EXTRACRANIAL VASCULAR PROCEDURES,,,6533.88,6977.93,8
APR-DRG,024-2,OPEN EXTRACRANIAL VASCULAR PROCEDURES,,,8096.24,8646.47,8
APR-DRG,024-3,OPEN EXTRACRANIAL VASCULAR PROCEDURES,,,14348.02,15323.13,8
APR-DRG,024-4,OPEN EXTRACRANIAL VASCULAR PROCEDURES,,,28405.47,30335.94,8
APR-DRG,026-1,OTHER NERVOUS SYSTEM AND RELATED PROCEDURES,,,8994.2,9605.45,8
APR-DRG,026-2,OTHER NERVOUS SYSTEM AND RELATED PROCEDURES,,,10949.66,11693.81,8
APR-DRG,026-3,OTHER NERVOUS SYSTEM AND RELATED PROCEDURES,,,17159.82,18326.02,8
APR-DRG,026-4,OTHER NERVOUS SYSTEM AND RELATED PROCEDURES,,,41991.2,44844.98,8
APR-DRG,027-1,OTHER OPEN CRANIOTOMY,,,12752.51,13619.19,8
APR-DRG,027-2,OTHER OPEN CRANIOTOMY,,,15596.68,16656.65,8
APR-DRG,027-3,OTHER OPEN CRANIOTOMY,,,21665.79,23138.23,8
APR-DRG,027-4,OTHER OPEN CRANIOTOMY,,,38897.3,41540.81,8
APR-DRG,029-1,OTHER PERCUTANEOUS INTRACRANIAL PROCEDURES,,,15257.54,16294.47,8
APR-DRG,029-2,OTHER PERCUTANEOUS INTRACRANIAL PROCEDURES,,,18059.32,19286.65,8
APR-DRG,029-3,OTHER PERCUTANEOUS INTRACRANIAL PROCEDURES,,,22092.03,23593.43,8
APR-DRG,029-4,OTHER PERCUTANEOUS INTRACRANIAL PROCEDURES,,,37850.58,40422.95,8
APR-DRG,030-1,PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES,,,16833.01,17977.0,8
APR-DRG,030-2,PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES,,,19167.7,20470.36,8
APR-DRG,030-3,PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES,,,26166.36,27944.65,8
APR-DRG,030-4,PERCUTANEOUS INTRACRANIAL AND EXTRACRANIAL VASCULAR PROCEDURES,,,38941.23,41587.72,8
APR-DRG,040-1,SPINAL DISORDERS AND INJURIES,,,6067.55,6479.91,8
APR-DRG,040-2,SPINAL DISORDERS AND INJURIES,,,12711.66,13575.56,8
APR-DRG,040-3,SPINAL DISORDERS AND INJURIES,,,24738.11,26419.34,8
APR-DRG,040-4,SPINAL DISORDERS AND INJURIES,,,24738.11,26419.34,8
APR-DRG,041-1,NERVOUS SYSTEM MALIGNANCY,,,4983.84,5322.55,8
APR-DRG,041-2,NERVOUS SYSTEM MALIGNANCY,,,5780.83,6173.71,8
APR-DRG,041-3,NERVOUS SYSTEM MALIGNANCY,,,9039.68,9654.03,8
APR-DRG,041-4,NERVOUS SYSTEM MALIGNANCY,,,13511.73,14430.0,8
APR-DRG,042-1,DEGENERATIVE NERVOUS SYSTEM DISORDERS EXCEPT MULTIPLE SCLEROSIS,,,7633.78,8152.58,8
APR-DRG,042-2,DEGENERATIVE NERVOUS SYSTEM DISORDERS EXCEPT MULTIPLE SCLEROSIS,,,7782.54,8311.45,8
APR-DRG,042-3,DEGENERATIVE NERVOUS SYSTEM DISORDERS EXCEPT MULTIPLE SCLEROSIS,,,12061.9,12881.64,8
APR-DRG,042-4,DEGENERATIVE NERVOUS SYSTEM DISORDERS EXCEPT MULTIPLE SCLEROSIS,,,24802.85,26488.48,8
APR-DRG,043-1,"MULTIPLE SCLEROSIS, OTHER DEMYELINATING DISEASE AND INFLAMMATORY NEUROPATHIES",,,5733.04,6122.67,8
APR-DRG,043-2,"MULTIPLE SCLEROSIS, OTHER DEMYELINATING DISEASE AND INFLAMMATORY NEUROPATHIES",,,9319.47,9952.83,8
APR-DRG,043-3,"MULTIPLE SCLEROSIS, OTHER DEMYELINATING DISEASE AND INFLAMMATORY NEUROPATHIES",,,17767.19,18974.67,8
APR-DRG,043-4,"MULTIPLE SCLEROSIS, OTHER DEMYELINATING DISEASE AND INFLAMMATORY NEUROPATHIES",,,34034.47,36347.49,8
APR-DRG,044-1,INTRACRANIAL HEMORRHAGE,,,4472.04,4775.97,8
APR-DRG,044-2,INTRACRANIAL HEMORRHAGE,,,7779.46,8308.16,8
APR-DRG,044-3,INTRACRANIAL HEMORRHAGE,,,11489.21,12270.03,8
APR-DRG,044-4,INTRACRANIAL HEMORRHAGE,,,17701.68,18904.71,8
APR-DRG,045-1,CVA AND PRECEREBRAL OCCLUSION WITH INFARCTION,,,3817.65,4077.11,8
APR-DRG,045-2,CVA AND PRECEREBRAL OCCLUSION WITH INFARCTION,,,6156.2,6574.58,8
APR-DRG,045-3,CVA AND PRECEREBRAL OCCLUSION WITH INFARCTION,,,9509.08,10155.33,8
APR-DRG,045-4,CVA AND PRECEREBRAL OCCLUSION WITH INFARCTION,,,17078.89,18239.6,8
APR-DRG,046-1,NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION,,,4699.43,5018.81,8
APR-DRG,046-2,NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION,,,4999.26,5339.02,8
APR-DRG,046-3,NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION,,,6099.16,6513.66,8
APR-DRG,046-4,NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION,,,6099.16,6513.66,8
APR-DRG,047-1,TRANSIENT ISCHEMIA,,,3083.11,3292.64,8
APR-DRG,047-2,TRANSIENT ISCHEMIA,,,3965.64,4235.15,8
APR-DRG,047-3,TRANSIENT ISCHEMIA,,,7501.2,8010.99,8
APR-DRG,047-4,TRANSIENT ISCHEMIA,,,7501.2,8010.99,8
APR-DRG,048-1,"PERIPHERAL, CRANIAL AND AUTONOMIC NERVE DISORDERS",,,3942.52,4210.46,8
APR-DRG,048-2,"PERIPHERAL, CRANIAL AND AUTONOMIC NERVE DISORDERS",,,5237.43,5593.37,8
APR-DRG,048-3,"PERIPHERAL, CRANIAL AND AUTONOMIC NERVE DISORDERS",,,7709.31,8233.25,8
APR-DRG,048-4,"PERIPHERAL, CRANIAL AND AUTONOMIC NERVE DISORDERS",,,16433.75,17550.61,8
APR-DRG,049-1,BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM,,,6133.85,6550.71,8
APR-DRG,049-2,BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM,,,11877.68,12684.9,8
APR-DRG,049-3,BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM,,,14610.86,15603.83,8
APR-DRG,049-4,BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM,,,29294.95,31285.87,8
APR-DRG,050-1,NON-BACTERIAL INFECTIONS OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS,,,4644.7,4960.36,8
APR-DRG,050-2,NON-BACTERIAL INFECTIONS OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS,,,9539.91,10188.26,8
APR-DRG,050-3,NON-BACTERIAL INFECTIONS OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS,,,17245.38,18417.4,8
APR-DRG,050-4,NON-BACTERIAL INFECTIONS OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS,,,37839.02,40410.6,8
APR-DRG,051-1,VIRAL MENINGITIS,,,3705.9,3957.76,8
APR-DRG,051-2,VIRAL MENINGITIS,,,5070.94,5415.56,8
APR-DRG,051-3,VIRAL MENINGITIS,,,9874.43,10545.51,8
APR-DRG,051-4,VIRAL MENINGITIS,,,9874.43,10545.51,8
APR-DRG,052-1,ALTERATION IN CONSCIOUSNESS,,,3549.43,3790.66,8
APR-DRG,052-2,ALTERATION IN CONSCIOUSNESS,,,4762.63,5086.3,8
APR-DRG,052-3,ALTERATION IN CONSCIOUSNESS,,,7686.96,8209.38,8
APR-DRG,052-4,ALTERATION IN CONSCIOUSNESS,,,16940.93,18092.25,8
APR-DRG,053-1,SEIZURE,,,3784.52,4041.72,8
APR-DRG,053-2,SEIZURE,,,4738.74,5060.79,8
APR-DRG,053-3,SEIZURE,,,6604.79,7053.66,8
APR-DRG,053-4,SEIZURE,,,13468.57,14383.91,8
APR-DRG,054-1,MIGRAINE AND OTHER HEADACHES,,,4061.23,4337.23,8
APR-DRG,054-2,MIGRAINE AND OTHER HEADACHES,,,5278.29,5637.01,8
APR-DRG,054-3,MIGRAINE AND OTHER HEADACHES,,,5763.87,6155.59,8
APR-DRG,054-4,MIGRAINE AND OTHER HEADACHES,,,6985.55,7460.3,8
APR-DRG,055-1,HEAD TRAUMA WITH COMA > 1 HOUR OR HEMORRHAGE,,,3339.0,3565.93,8
APR-DRG,055-2,HEAD TRAUMA WITH COMA > 1 HOUR OR HEMORRHAGE,,,4981.53,5320.08,8
APR-DRG,055-3,HEAD TRAUMA WITH COMA > 1 HOUR OR HEMORRHAGE,,,8914.04,9519.85,8
APR-DRG,055-4,HEAD TRAUMA WITH COMA > 1 HOUR OR HEMORRHAGE,,,15150.4,16180.04,8
APR-DRG,058-1,OTHER DISORDERS OF NERVOUS SYSTEM,,,6385.89,6819.88,8
APR-DRG,058-2,OTHER DISORDERS OF NERVOUS SYSTEM,,,9424.29,10064.78,8
APR-DRG,058-3,OTHER DISORDERS OF NERVOUS SYSTEM,,,13946.45,14894.26,8
APR-DRG,058-4,OTHER DISORDERS OF NERVOUS SYSTEM,,,23721.46,25333.59,8
APR-DRG,059-1,ANOXIC AND OTHER SEVERE BRAIN DAMAGE,,,9983.11,10661.57,8
APR-DRG,059-2,ANOXIC AND OTHER SEVERE BRAIN DAMAGE,,,9983.11,10661.57,8
APR-DRG,059-3,ANOXIC AND OTHER SEVERE BRAIN DAMAGE,,,11609.45,12398.44,8
APR-DRG,059-4,ANOXIC AND OTHER SEVERE BRAIN DAMAGE,,,14680.23,15677.92,8
APR-DRG,073-1,ORBIT AND EYE PROCEDURES,,,7017.93,7494.87,8
APR-DRG,073-2,ORBIT AND EYE PROCEDURES,,,9005.76,9617.81,8
APR-DRG,073-3,ORBIT AND EYE PROCEDURES,,,15461.03,16511.78,8
APR-DRG,073-4,ORBIT AND EYE PROCEDURES,,,30488.89,32560.95,8
APR-DRG,082-1,EYE INFECTIONS AND OTHER EYE DISORDERS,,,4304.79,4597.35,8
APR-DRG,082-2,EYE INFECTIONS AND OTHER EYE DISORDERS,,,5353.82,5717.67,8
APR-DRG,082-3,EYE INFECTIONS AND OTHER EYE DISORDERS,,,7471.15,7978.89,8
APR-DRG,082-4,EYE INFECTIONS AND OTHER EYE DISORDERS,,,13353.72,14261.26,8
APR-DRG,089-1,MAJOR CRANIAL OR FACIAL BONE PROCEDURES,,,14037.4,14991.39,8
APR-DRG,089-2,MAJOR CRANIAL OR FACIAL BONE PROCEDURES,,,16543.2,17667.5,8
APR-DRG,089-3,MAJOR CRANIAL OR FACIAL BONE PROCEDURES,,,27929.13,29827.23,8
APR-DRG,089-4,MAJOR CRANIAL OR FACIAL BONE PROCEDURES,,,39480.78,42163.94,8
APR-DRG,091-1,OTHER MAJOR HEAD AND NECK PROCEDURES,,,9140.65,9761.86,8
APR-DRG,091-2,OTHER MAJOR HEAD AND NECK PROCEDURES,,,18756.1,20030.79,8
APR-DRG,091-3,OTHER MAJOR HEAD AND NECK PROCEDURES,,,27000.34,28835.31,8
APR-DRG,091-4,OTHER MAJOR HEAD AND NECK PROCEDURES,,,51108.73,54582.14,8
APR-DRG,092-1,FACIAL BONE PROCEDURES EXCEPT MAJOR CRANIAL OR FACIAL BONE PROCEDURES,,,8309.75,8874.49,8
APR-DRG,092-2,FACIAL BONE PROCEDURES EXCEPT MAJOR CRANIAL OR FACIAL BONE PROCEDURES,,,9730.3,10391.58,8
APR-DRG,092-3,FACIAL BONE PROCEDURES EXCEPT MAJOR CRANIAL OR FACIAL BONE PROCEDURES,,,17996.89,19219.98,8
APR-DRG,092-4,FACIAL BONE PROCEDURES EXCEPT MAJOR CRANIAL OR FACIAL BONE PROCEDURES,,,25838.01,27594.0,8
APR-DRG,095-1,CLEFT LIP AND PALATE REPAIR,,,7389.45,7891.64,8
APR-DRG,095-2,CLEFT LIP AND PALATE REPAIR,,,9627.78,10282.1,8
APR-DRG,095-3,CLEFT LIP AND PALATE REPAIR,,,10716.12,11444.4,8
APR-DRG,095-4,CLEFT LIP AND PALATE REPAIR,,,10716.12,11444.4,8
APR-DRG,097-1,TONSIL AND ADENOID PROCEDURES,,,5320.67,5682.27,8
APR-DRG,097-2,TONSIL AND ADENOID PROCEDURES,,,6994.8,7470.18,8
APR-DRG,097-3,TONSIL AND ADENOID PROCEDURES,,,15676.85,16742.26,8
APR-DRG,097-4,TONSIL AND ADENOID PROCEDURES,,,15676.85,16742.26,8
APR-DRG,098-1,"OTHER EAR, NOSE, MOUTH, THROAT, CRANIOFACIAL, AND NECK PROCEDURES",,,5736.89,6126.78,8
APR-DRG,098-2,"OTHER EAR, NOSE, MOUTH, THROAT, CRANIOFACIAL, AND NECK PROCEDURES",,,8955.66,9564.3,8
APR-DRG,098-3,"OTHER EAR, NOSE, MOUTH, THROAT, CRANIOFACIAL, AND NECK PROCEDURES",,,14986.99,16005.53,8
APR-DRG,098-4,"OTHER EAR, NOSE, MOUTH, THROAT, CRANIOFACIAL, AND NECK PROCEDURES",,,27609.25,29485.61,8
APR-DRG,110-1,"EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL MALIGNANCIES",,,4639.31,4954.6,8
APR-DRG,110-2,"EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL MALIGNANCIES",,,6307.27,6735.92,8
APR-DRG,110-3,"EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL MALIGNANCIES",,,9652.45,10308.44,8
APR-DRG,110-4,"EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL MALIGNANCIES",,,15525.78,16580.93,8
APR-DRG,111-1,VERTIGO AND OTHER LABYRINTH DISORDERS,,,3787.6,4045.01,8
APR-DRG,111-2,VERTIGO AND OTHER LABYRINTH DISORDERS,,,3941.75,4209.63,8
APR-DRG,111-3,VERTIGO AND OTHER LABYRINTH DISORDERS,,,5108.71,5455.9,8
APR-DRG,111-4,VERTIGO AND OTHER LABYRINTH DISORDERS,,,5108.71,5455.9,8
APR-DRG,113-1,INFECTIONS OF UPPER RESPIRATORY TRACT,,,3096.98,3307.46,8
APR-DRG,113-2,INFECTIONS OF UPPER RESPIRATORY TRACT,,,4169.13,4452.47,8
APR-DRG,113-3,INFECTIONS OF UPPER RESPIRATORY TRACT,,,5974.3,6380.32,8
APR-DRG,113-4,INFECTIONS OF UPPER RESPIRATORY TRACT,,,13297.45,14201.17,8
APR-DRG,114-1,DENTAL DISEASES AND DISORDERS,,,3803.78,4062.29,8
APR-DRG,114-2,DENTAL DISEASES AND DISORDERS,,,7014.07,7490.76,8
APR-DRG,114-3,DENTAL DISEASES AND DISORDERS,,,7014.07,7490.76,8
APR-DRG,114-4,DENTAL DISEASES AND DISORDERS,,,7014.07,7490.76,8
APR-DRG,115-1,"OTHER EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL DIAGNOSES",,,4098.22,4376.74,8
APR-DRG,115-2,"OTHER EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL DIAGNOSES",,,5259.02,5616.42,8
APR-DRG,115-3,"OTHER EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL DIAGNOSES",,,7879.65,8415.17,8
APR-DRG,115-4,"OTHER EAR, NOSE, MOUTH, THROAT AND CRANIAL OR FACIAL DIAGNOSES",,,22398.03,23920.23,8
APR-DRG,120-1,MAJOR RESPIRATORY AND CHEST PROCEDURES,,,12760.99,13628.24,8
APR-DRG,120-2,MAJOR RESPIRATORY AND CHEST PROCEDURES,,,15722.32,16790.83,8
APR-DRG,120-3,MAJOR RESPIRATORY AND CHEST PROCEDURES,,,22992.3,24554.88,8
APR-DRG,120-4,MAJOR RESPIRATORY AND CHEST PROCEDURES,,,46857.89,50042.41,8
APR-DRG,121-1,OTHER RESPIRATORY AND CHEST PROCEDURES,,,10408.58,11115.96,8
APR-DRG,121-2,OTHER RESPIRATORY AND CHEST PROCEDURES,,,12767.16,13634.83,8
APR-DRG,121-3,OTHER RESPIRATORY AND CHEST PROCEDURES,,,20348.53,21731.44,8
APR-DRG,121-4,OTHER RESPIRATORY AND CHEST PROCEDURES,,,34133.89,36453.67,8
APR-DRG,130-1,RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT > 96 HOURS,,,24128.42,25768.22,8
APR-DRG,130-2,RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT > 96 HOURS,,,24128.42,25768.22,8
APR-DRG,130-3,RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT > 96 HOURS,,,31330.57,33459.83,8
APR-DRG,130-4,RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT > 96 HOURS,,,41095.56,43888.46,8
APR-DRG,131-1,CYSTIC FIBROSIS - PULMONARY DISEASE,,,18095.54,19325.34,8
APR-DRG,131-2,CYSTIC FIBROSIS - PULMONARY DISEASE,,,18095.54,19325.34,8
APR-DRG,131-3,CYSTIC FIBROSIS - PULMONARY DISEASE,,,23948.83,25576.42,8
APR-DRG,131-4,CYSTIC FIBROSIS - PULMONARY DISEASE,,,26311.27,28099.41,8
APR-DRG,132-1,BPD AND OTHER CHRONIC RESPIRATORY DISEASES ARISING IN PERINATAL PERIOD,,,5158.04,5508.59,8
APR-DRG,132-2,BPD AND OTHER CHRONIC RESPIRATORY DISEASES ARISING IN PERINATAL PERIOD,,,7037.2,7515.45,8
APR-DRG,132-3,BPD AND OTHER CHRONIC RESPIRATORY DISEASES ARISING IN PERINATAL PERIOD,,,19166.16,20468.71,8
APR-DRG,132-4,BPD AND OTHER CHRONIC RESPIRATORY DISEASES ARISING IN PERINATAL PERIOD,,,35166.73,37556.71,8
APR-DRG,133-1,RESPIRATORY FAILURE,,,5420.88,5789.29,8
APR-DRG,133-2,RESPIRATORY FAILURE,,,5591.98,5972.02,8
APR-DRG,133-3,RESPIRATORY FAILURE,,,8456.97,9031.72,8
APR-DRG,133-4,RESPIRATORY FAILURE,,,13512.5,14430.82,8
APR-DRG,134-1,PULMONARY EMBOLISM,,,3370.6,3599.67,8
APR-DRG,134-2,PULMONARY EMBOLISM,,,4454.32,4757.04,8
APR-DRG,134-3,PULMONARY EMBOLISM,,,7263.81,7757.46,8
APR-DRG,134-4,PULMONARY EMBOLISM,,,12107.37,12930.2,8
APR-DRG,135-1,MAJOR CHEST AND RESPIRATORY TRAUMA,,,3486.22,3723.15,8
APR-DRG,135-2,MAJOR CHEST AND RESPIRATORY TRAUMA,,,4101.31,4380.04,8
APR-DRG,135-3,MAJOR CHEST AND RESPIRATORY TRAUMA,,,6640.25,7091.52,8
APR-DRG,135-4,MAJOR CHEST AND RESPIRATORY TRAUMA,,,9891.39,10563.62,8
APR-DRG,136-1,RESPIRATORY MALIGNANCY,,,5585.05,5964.62,8
APR-DRG,136-2,RESPIRATORY MALIGNANCY,,,5758.47,6149.83,8
APR-DRG,136-3,RESPIRATORY MALIGNANCY,,,8396.85,8967.51,8
APR-DRG,136-4,RESPIRATORY MALIGNANCY,,,13402.28,14313.11,8
APR-DRG,137-1,MAJOR RESPIRATORY INFECTIONS AND INFLAMMATIONS,,,4448.92,4751.27,8
APR-DRG,137-2,MAJOR RESPIRATORY INFECTIONS AND INFLAMMATIONS,,,5831.7,6228.02,8
APR-DRG,137-3,MAJOR RESPIRATORY INFECTIONS AND INFLAMMATIONS,,,6552.38,6997.68,8
APR-DRG,137-4,MAJOR RESPIRATORY INFECTIONS AND INFLAMMATIONS,,,10608.21,11329.15,8
APR-DRG,138-1,BRONCHIOLITIS AND RSV PNEUMONIA,,,3813.03,4072.17,8
APR-DRG,138-2,BRONCHIOLITIS AND RSV PNEUMONIA,,,4965.34,5302.79,8
APR-DRG,138-3,BRONCHIOLITIS AND RSV PNEUMONIA,,,8089.31,8639.07,8
APR-DRG,138-4,BRONCHIOLITIS AND RSV PNEUMONIA,,,16491.56,17612.34,8
APR-DRG,139-1,OTHER PNEUMONIA,,,3376.0,3605.44,8
APR-DRG,139-2,OTHER PNEUMONIA,,,4253.92,4543.02,8
APR-DRG,139-3,OTHER PNEUMONIA,,,5820.91,6216.51,8
APR-DRG,139-4,OTHER PNEUMONIA,,,9623.93,10277.98,8
APR-DRG,140-1,CHRONIC OBSTRUCTIVE PULMONARY DISEASE,,,3826.9,4086.98,8
APR-DRG,140-2,CHRONIC OBSTRUCTIVE PULMONARY DISEASE,,,4386.49,4684.6,8
APR-DRG,140-3,CHRONIC OBSTRUCTIVE PULMONARY DISEASE,,,5144.93,5494.59,8
APR-DRG,140-4,CHRONIC OBSTRUCTIVE PULMONARY DISEASE,,,7539.74,8052.15,8
APR-DRG,141-1,ASTHMA,,,3575.63,3818.64,8
APR-DRG,141-2,ASTHMA,,,4408.84,4708.47,8
APR-DRG,141-3,ASTHMA,,,5583.51,5962.97,8
APR-DRG,141-4,ASTHMA,,,8119.37,8671.17,8
APR-DRG,142-1,INTERSTITIAL AND ALVEOLAR LUNG DISEASES,,,4146.78,4428.6,8
APR-DRG,142-2,INTERSTITIAL AND ALVEOLAR LUNG DISEASES,,,5589.68,5969.56,8
APR-DRG,142-3,INTERSTITIAL AND ALVEOLAR LUNG DISEASES,,,6940.08,7411.73,8
APR-DRG,142-4,INTERSTITIAL AND ALVEOLAR LUNG DISEASES,,,10926.54,11669.12,8
APR-DRG,143-1,"OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES",,,4015.74,4288.66,8
APR-DRG,143-2,"OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES",,,5274.42,5632.88,8
APR-DRG,143-3,"OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES",,,7611.42,8128.7,8
APR-DRG,143-4,"OTHER RESPIRATORY DIAGNOSES EXCEPT SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES",,,12768.7,13636.48,8
APR-DRG,144-1,"RESPIRATORY SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES",,,3718.23,3970.92,8
APR-DRG,144-2,"RESPIRATORY SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES",,,5653.65,6037.88,8
APR-DRG,144-3,"RESPIRATORY SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES",,,7475.77,7983.83,8
APR-DRG,144-4,"RESPIRATORY SIGNS, SYMPTOMS AND MISCELLANEOUS DIAGNOSES",,,11590.18,12377.86,8
APR-DRG,145-1,ACUTE BRONCHITIS AND RELATED SYMPTOMS,,,3379.85,3609.55,8
APR-DRG,145-2,ACUTE BRONCHITIS AND RELATED SYMPTOMS,,,4153.71,4436.0,8
APR-DRG,145-3,ACUTE BRONCHITIS AND RELATED SYMPTOMS,,,6597.85,7046.25,8
APR-DRG,145-4,ACUTE BRONCHITIS AND RELATED SYMPTOMS,,,12091.19,12912.92,8
APR-DRG,160-1,MAJOR CARDIOTHORACIC REPAIR OF HEART ANOMALY,,,27974.6,29875.79,8
APR-DRG,160-2,MAJOR CARDIOTHORACIC REPAIR OF HEART ANOMALY,,,31746.79,33904.34,8
APR-DRG,160-3,MAJOR CARDIOTHORACIC REPAIR OF HEART ANOMALY,,,46032.39,49160.8,8
APR-DRG,160-4,MAJOR CARDIOTHORACIC REPAIR OF HEART ANOMALY,,,112285.37,119916.41,8
APR-DRG,161-1,IMPLANTABLE HEART ASSIST SYSTEMS,,,200302.03,213914.79,8
APR-DRG,161-2,IMPLANTABLE HEART ASSIST SYSTEMS,,,200302.03,213914.79,8
APR-DRG,161-3,IMPLANTABLE HEART ASSIST SYSTEMS,,,200302.03,213914.79,8
APR-DRG,161-4,IMPLANTABLE HEART ASSIST SYSTEMS,,,258812.55,276401.75,8
APR-DRG,162-1,CARDIAC VALVE PROCEDURES WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS,,,23851.71,25472.7,8
APR-DRG,162-2,CARDIAC VALVE PROCEDURES WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS,,,33318.41,35582.77,8
APR-DRG,162-3,CARDIAC VALVE PROCEDURES WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS,,,42886.07,45800.66,8
APR-DRG,162-4,CARDIAC VALVE PROCEDURES WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS,,,59162.59,63183.35,8
APR-DRG,163-1,CARDIAC VALVE PROCEDURES WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS,,,24715.76,26395.47,8
APR-DRG,163-2,CARDIAC VALVE PROCEDURES WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS,,,27245.45,29097.08,8
APR-DRG,163-3,CARDIAC VALVE PROCEDURES WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS,,,35466.57,37876.92,8
APR-DRG,163-4,CARDIAC VALVE PROCEDURES WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS,,,59837.79,63904.43,8
APR-DRG,165-1,CORONARY BYPASS WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS,,,25919.71,27681.25,8
APR-DRG,165-2,CORONARY BYPASS WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS,,,25919.71,27681.25,8
APR-DRG,165-3,CORONARY BYPASS WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS,,,30673.87,32758.51,8
APR-DRG,165-4,CORONARY BYPASS WITH AMI OR COMPLEX PRINCIPAL DIAGNOSIS,,,42811.31,45720.82,8
APR-DRG,166-1,CORONARY BYPASS WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS,,,20892.7,22312.59,8
APR-DRG,166-2,CORONARY BYPASS WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS,,,22159.86,23665.87,8
APR-DRG,166-3,CORONARY BYPASS WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS,,,26880.87,28707.72,8
APR-DRG,166-4,CORONARY BYPASS WITHOUT AMI OR COMPLEX PRINCIPAL DIAGNOSIS,,,39453.03,42134.3,8
APR-DRG,167-1,OTHER CARDIOTHORACIC AND THORACIC CIRCULATORY PROCEDURES,,,18078.59,19307.23,8
APR-DRG,167-2,OTHER CARDIOTHORACIC AND THORACIC CIRCULATORY PROCEDURES,,,19652.51,20988.12,8
APR-DRG,167-3,OTHER CARDIOTHORACIC AND THORACIC CIRCULATORY PROCEDURES,,,30082.68,32127.14,8
APR-DRG,167-4,OTHER CARDIOTHORACIC AND THORACIC CIRCULATORY PROCEDURES,,,47210.14,50418.6,8
APR-DRG,169-1,MAJOR ABDOMINAL VASCULAR PROCEDURES,,,15852.59,16929.95,8
APR-DRG,169-2,MAJOR ABDOMINAL VASCULAR PROCEDURES,,,16593.3,17721.0,8
APR-DRG,169-3,MAJOR ABDOMINAL VASCULAR PROCEDURES,,,25690.8,27436.77,8
APR-DRG,169-4,MAJOR ABDOMINAL VASCULAR PROCEDURES,,,38831.78,41470.84,8
APR-DRG,170-1,"PERMANENT CARDIAC PACEMAKER IMPLANT WITH AMI, HEART FAILURE OR SHOCK",,,17821.93,19033.12,8
APR-DRG,170-2,"PERMANENT CARDIAC PACEMAKER IMPLANT WITH AMI, HEART FAILURE OR SHOCK",,,17821.93,19033.12,8
APR-DRG,170-3,"PERMANENT CARDIAC PACEMAKER IMPLANT WITH AMI, HEART FAILURE OR SHOCK",,,17821.93,19033.12,8
APR-DRG,170-4,"PERMANENT CARDIAC PACEMAKER IMPLANT WITH AMI, HEART FAILURE OR SHOCK",,,17821.93,19033.12,8
APR-DRG,171-1,"PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT AMI, HEART FAILURE OR SHOCK",,,11160.09,11918.54,8
APR-DRG,171-2,"PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT AMI, HEART FAILURE OR SHOCK",,,13343.7,14250.56,8
APR-DRG,171-3,"PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT AMI, HEART FAILURE OR SHOCK",,,16355.13,17466.65,8
APR-DRG,171-4,"PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT AMI, HEART FAILURE OR SHOCK",,,30422.6,32490.15,8
APR-DRG,174-1,PERCUTANEOUS CARDIAC INTERVENTION WITH AMI,,,9305.6,9938.02,8
APR-DRG,174-2,PERCUTANEOUS CARDIAC INTERVENTION WITH AMI,,,10347.69,11050.93,8
APR-DRG,174-3,PERCUTANEOUS CARDIAC INTERVENTION WITH AMI,,,12683.14,13545.1,8
APR-DRG,174-4,PERCUTANEOUS CARDIAC INTERVENTION WITH AMI,,,19480.64,20804.56,8
APR-DRG,175-1,PERCUTANEOUS CARDIAC INTERVENTION WITHOUT AMI,,,10456.36,11166.99,8
APR-DRG,175-2,PERCUTANEOUS CARDIAC INTERVENTION WITHOUT AMI,,,12595.27,13451.26,8
APR-DRG,175-3,PERCUTANEOUS CARDIAC INTERVENTION WITHOUT AMI,,,16594.85,17722.65,8
APR-DRG,175-4,PERCUTANEOUS CARDIAC INTERVENTION WITHOUT AMI,,,27485.93,29353.91,8
APR-DRG,176-1,"INSERTION, REVISION AND REPLACEMENTS OF PACEMAKER AND OTHER CARDIAC DEVICES",,,11890.78,12698.9,8
APR-DRG,176-2,"INSERTION, REVISION AND REPLACEMENTS OF PACEMAKER AND OTHER CARDIAC DEVICES",,,11890.78,12698.9,8
APR-DRG,176-3,"INSERTION, REVISION AND REPLACEMENTS OF PACEMAKER AND OTHER CARDIAC DEVICES",,,27015.76,28851.78,8
APR-DRG,176-4,"INSERTION, REVISION AND REPLACEMENTS OF PACEMAKER AND OTHER CARDIAC DEVICES",,,35003.32,37382.19,8
APR-DRG,177-1,CARDIAC PACEMAKER AND DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT,,,8151.74,8705.74,8
APR-DRG,177-2,CARDIAC PACEMAKER AND DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT,,,8151.74,8705.74,8
APR-DRG,177-3,CARDIAC PACEMAKER AND DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT,,,13309.78,14214.33,8
APR-DRG,177-4,CARDIAC PACEMAKER AND DEFIBRILLATOR REVISION EXCEPT DEVICE REPLACEMENT,,,23766.93,25382.16,8
APR-DRG,178-1,EXTERNAL HEART ASSIST DEVICES,,,41045.46,43834.96,8
APR-DRG,178-2,EXTERNAL HEART ASSIST DEVICES,,,41045.46,43834.96,8
APR-DRG,178-3,EXTERNAL HEART ASSIST DEVICES,,,41045.46,43834.96,8
APR-DRG,178-4,EXTERNAL HEART ASSIST DEVICES,,,69191.95,73894.32,8
APR-DRG,179-1,DEFIBRILLATOR IMPLANTS,,,29210.93,31196.14,8
APR-DRG,179-2,DEFIBRILLATOR IMPLANTS,,,30553.63,32630.09,8
APR-DRG,179-3,DEFIBRILLATOR IMPLANTS,,,34934.73,37308.93,8
APR-DRG,179-4,DEFIBRILLATOR IMPLANTS,,,47521.53,50751.15,8
APR-DRG,180-1,OTHER CIRCULATORY SYSTEM PROCEDURES,,,7815.68,8346.84,8
APR-DRG,180-2,OTHER CIRCULATORY SYSTEM PROCEDURES,,,9538.37,10186.61,8
APR-DRG,180-3,OTHER CIRCULATORY SYSTEM PROCEDURES,,,14041.26,14995.52,8
APR-DRG,180-4,OTHER CIRCULATORY SYSTEM PROCEDURES,,,26487.78,28287.92,8
APR-DRG,181-1,LOWER EXTREMITY VASCULAR PROCEDURES,,,10298.36,10998.25,8
APR-DRG,181-2,LOWER EXTREMITY VASCULAR PROCEDURES,,,14759.62,15762.7,8
APR-DRG,181-3,LOWER EXTREMITY VASCULAR PROCEDURES,,,22778.79,24326.86,8
APR-DRG,181-4,LOWER EXTREMITY VASCULAR PROCEDURES,,,37672.53,40232.8,8
APR-DRG,182-1,OTHER PERIPHERAL VASCULAR AND RELATED PROCEDURES,,,12594.5,13450.44,8
APR-DRG,182-2,OTHER PERIPHERAL VASCULAR AND RELATED PROCEDURES,,,14044.34,14998.81,8
APR-DRG,182-3,OTHER PERIPHERAL VASCULAR AND RELATED PROCEDURES,,,17759.49,18966.44,8
APR-DRG,182-4,OTHER PERIPHERAL VASCULAR AND RELATED PROCEDURES,,,36990.39,39504.3,8
APR-DRG,183-1,PERCUTANEOUS STRUCTURAL CARDIAC PROCEDURES,,,42624.01,45520.78,8
APR-DRG,183-2,PERCUTANEOUS STRUCTURAL CARDIAC PROCEDURES,,,43856.48,46837.02,8
APR-DRG,183-3,PERCUTANEOUS STRUCTURAL CARDIAC PROCEDURES,,,48844.19,52163.69,8
APR-DRG,183-4,PERCUTANEOUS STRUCTURAL CARDIAC PROCEDURES,,,69450.16,74170.07,8
APR-DRG,190-1,ACUTE MYOCARDIAL INFARCTION,,,4063.54,4339.7,8
APR-DRG,190-2,ACUTE MYOCARDIAL INFARCTION,,,5043.96,5386.76,8
APR-DRG,190-3,ACUTE MYOCARDIAL INFARCTION,,,6553.92,6999.33,8
APR-DRG,190-4,ACUTE MYOCARDIAL INFARCTION,,,10515.71,11230.37,8
APR-DRG,191-1,CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE,,,4862.06,5192.5,8
APR-DRG,191-2,CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE,,,5858.68,6256.84,8
APR-DRG,191-3,CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE,,,7861.93,8396.23,8
APR-DRG,191-4,CARDIAC CATHETERIZATION FOR CORONARY ARTERY DISEASE,,,11684.22,12478.29,8
APR-DRG,192-1,CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS,,,5537.26,5913.58,8
APR-DRG,192-2,CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS,,,7229.89,7721.24,8
APR-DRG,192-3,CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS,,,11416.76,12192.65,8
APR-DRG,192-4,CARDIAC CATHETERIZATION FOR OTHER NON-CORONARY CONDITIONS,,,19540.76,20868.77,8
APR-DRG,193-1,ACUTE AND SUBACUTE ENDOCARDITIS,,,5803.95,6198.39,8
APR-DRG,193-2,ACUTE AND SUBACUTE ENDOCARDITIS,,,5908.01,6309.52,8
APR-DRG,193-3,ACUTE AND SUBACUTE ENDOCARDITIS,,,8182.58,8738.68,8
APR-DRG,193-4,ACUTE AND SUBACUTE ENDOCARDITIS,,,13086.26,13975.62,8
APR-DRG,194-1,HEART FAILURE,,,3685.08,3935.53,8
APR-DRG,194-2,HEART FAILURE,,,4812.74,5139.82,8
APR-DRG,194-3,HEART FAILURE,,,6891.52,7359.88,8
APR-DRG,194-4,HEART FAILURE,,,12274.63,13108.83,8
APR-DRG,196-1,CARDIAC ARREST AND SHOCK,,,4576.1,4887.1,8
APR-DRG,196-2,CARDIAC ARREST AND SHOCK,,,4576.1,4887.1,8
APR-DRG,196-3,CARDIAC ARREST AND SHOCK,,,6220.17,6642.9,8
APR-DRG,196-4,CARDIAC ARREST AND SHOCK,,,13964.95,14914.02,8
APR-DRG,197-1,PERIPHERAL AND OTHER VASCULAR DISORDERS,,,3840.78,4101.8,8
APR-DRG,197-2,PERIPHERAL AND OTHER VASCULAR DISORDERS,,,4600.0,4912.62,8
APR-DRG,197-3,PERIPHERAL AND OTHER VASCULAR DISORDERS,,,6074.5,6487.33,8
APR-DRG,197-4,PERIPHERAL AND OTHER VASCULAR DISORDERS,,,13493.23,14410.24,8
APR-DRG,198-1,ANGINA PECTORIS AND CORONARY ATHEROSCLEROSIS,,,2928.95,3128.0,8
APR-DRG,198-2,ANGINA PECTORIS AND CORONARY ATHEROSCLEROSIS,,,3644.23,3891.9,8
APR-DRG,198-3,ANGINA PECTORIS AND CORONARY ATHEROSCLEROSIS,,,5411.63,5779.41,8
APR-DRG,198-4,ANGINA PECTORIS AND CORONARY ATHEROSCLEROSIS,,,11042.93,11793.42,8
APR-DRG,199-1,HYPERTENSION,,,3174.83,3390.6,8
APR-DRG,199-2,HYPERTENSION,,,4159.11,4441.77,8
APR-DRG,199-3,HYPERTENSION,,,5923.43,6325.99,8
APR-DRG,199-4,HYPERTENSION,,,9953.82,10630.29,8
APR-DRG,200-1,CARDIAC STRUCTURAL AND VALVULAR DISORDERS,,,3113.94,3325.56,8
APR-DRG,200-2,CARDIAC STRUCTURAL AND VALVULAR DISORDERS,,,5765.41,6157.24,8
APR-DRG,200-3,CARDIAC STRUCTURAL AND VALVULAR DISORDERS,,,11347.39,12118.57,8
APR-DRG,200-4,CARDIAC STRUCTURAL AND VALVULAR DISORDERS,,,49862.38,53251.09,8
APR-DRG,201-1,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS,,,3228.78,3448.21,8
APR-DRG,201-2,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS,,,3955.62,4224.45,8
APR-DRG,201-3,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS,,,6092.22,6506.26,8
APR-DRG,201-4,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS,,,11828.36,12632.22,8
APR-DRG,203-1,CHEST PAIN,,,2853.42,3047.34,8
APR-DRG,203-2,CHEST PAIN,,,3700.5,3951.99,8
APR-DRG,203-3,CHEST PAIN,,,5595.07,5975.32,8
APR-DRG,203-4,CHEST PAIN,,,6596.32,7044.61,8
APR-DRG,204-1,SYNCOPE AND COLLAPSE,,,3355.97,3584.04,8
APR-DRG,204-2,SYNCOPE AND COLLAPSE,,,4416.55,4716.7,8
APR-DRG,204-3,SYNCOPE AND COLLAPSE,,,6263.34,6689.0,8
APR-DRG,204-4,SYNCOPE AND COLLAPSE,,,7907.4,8444.8,8
APR-DRG,205-1,CARDIOMYOPATHY,,,2802.55,2993.01,8
APR-DRG,205-2,CARDIOMYOPATHY,,,9393.47,10031.86,8
APR-DRG,205-3,CARDIOMYOPATHY,,,9393.47,10031.86,8
APR-DRG,205-4,CARDIOMYOPATHY,,,9393.47,10031.86,8
APR-DRG,206-1,"MALFUNCTION, REACTION, COMPLICATION OF CARDIAC OR VASCULAR DEVICE OR PROCEDURE",,,5621.28,6003.31,8
APR-DRG,206-2,"MALFUNCTION, REACTION, COMPLICATION OF CARDIAC OR VASCULAR DEVICE OR PROCEDURE",,,5621.28,6003.31,8
APR-DRG,206-3,"MALFUNCTION, REACTION, COMPLICATION OF CARDIAC OR VASCULAR DEVICE OR PROCEDURE",,,8198.76,8755.96,8
APR-DRG,206-4,"MALFUNCTION, REACTION, COMPLICATION OF CARDIAC OR VASCULAR DEVICE OR PROCEDURE",,,16402.14,17516.85,8
APR-DRG,207-1,OTHER CIRCULATORY SYSTEM DIAGNOSES,,,3547.89,3789.01,8
APR-DRG,207-2,OTHER CIRCULATORY SYSTEM DIAGNOSES,,,4767.25,5091.24,8
APR-DRG,207-3,OTHER CIRCULATORY SYSTEM DIAGNOSES,,,7199.06,7688.32,8
APR-DRG,207-4,OTHER CIRCULATORY SYSTEM DIAGNOSES,,,19371.95,20688.49,8
APR-DRG,220-1,"MAJOR STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES",,,9975.41,10653.35,8
APR-DRG,220-2,"MAJOR STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES",,,13087.04,13976.45,8
APR-DRG,220-3,"MAJOR STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES",,,21884.69,23372.0,8
APR-DRG,220-4,"MAJOR STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES",,,43941.27,46927.57,8
APR-DRG,222-1,"OTHER STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES",,,5998.96,6406.65,8
APR-DRG,222-2,"OTHER STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES",,,9728.75,10389.93,8
APR-DRG,222-3,"OTHER STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES",,,13345.25,14252.21,8
APR-DRG,222-4,"OTHER STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES",,,27206.14,29055.1,8
APR-DRG,223-1,OTHER SMALL AND LARGE BOWEL PROCEDURES,,,6981.7,7456.19,8
APR-DRG,223-2,OTHER SMALL AND LARGE BOWEL PROCEDURES,,,10820.17,11555.52,8
APR-DRG,223-3,OTHER SMALL AND LARGE BOWEL PROCEDURES,,,16402.91,17517.68,8
APR-DRG,223-4,OTHER SMALL AND LARGE BOWEL PROCEDURES,,,29334.26,31327.85,8
APR-DRG,224-1,PERITONEAL ADHESIOLYSIS,,,8394.54,8965.04,8
APR-DRG,224-2,PERITONEAL ADHESIOLYSIS,,,10450.2,11160.41,8
APR-DRG,224-3,PERITONEAL ADHESIOLYSIS,,,16426.81,17543.2,8
APR-DRG,224-4,PERITONEAL ADHESIOLYSIS,,,31729.84,33886.24,8
APR-DRG,226-1,ANAL AND PERINEAL PROCEDURES,,,5713.0,6101.26,8
APR-DRG,226-2,ANAL AND PERINEAL PROCEDURES,,,6699.59,7154.91,8
APR-DRG,226-3,ANAL AND PERINEAL PROCEDURES,,,13431.57,14344.4,8
APR-DRG,226-4,ANAL AND PERINEAL PROCEDURES,,,13431.57,14344.4,8
APR-DRG,227-1,"HERNIA PROCEDURES EXCEPT INGUINAL, FEMORAL AND UMBILICAL",,,7891.99,8428.34,8
APR-DRG,227-2,"HERNIA PROCEDURES EXCEPT INGUINAL, FEMORAL AND UMBILICAL",,,9963.84,10640.99,8
APR-DRG,227-3,"HERNIA PROCEDURES EXCEPT INGUINAL, FEMORAL AND UMBILICAL",,,13917.16,14862.99,8
APR-DRG,227-4,"HERNIA PROCEDURES EXCEPT INGUINAL, FEMORAL AND UMBILICAL",,,28564.25,30505.51,8
APR-DRG,228-1,"INGUINAL, FEMORAL AND UMBILICAL HERNIA PROCEDURES",,,5246.68,5603.25,8
APR-DRG,228-2,"INGUINAL, FEMORAL AND UMBILICAL HERNIA PROCEDURES",,,7195.98,7685.03,8
APR-DRG,228-3,"INGUINAL, FEMORAL AND UMBILICAL HERNIA PROCEDURES",,,11095.35,11849.4,8
APR-DRG,228-4,"INGUINAL, FEMORAL AND UMBILICAL HERNIA PROCEDURES",,,22449.67,23975.38,8
APR-DRG,229-1,OTHER DIGESTIVE SYSTEM AND ABDOMINAL PROCEDURES,,,6878.41,7345.88,8
APR-DRG,229-2,OTHER DIGESTIVE SYSTEM AND ABDOMINAL PROCEDURES,,,9591.56,10243.41,8
APR-DRG,229-3,OTHER DIGESTIVE SYSTEM AND ABDOMINAL PROCEDURES,,,15558.15,16615.5,8
APR-DRG,229-4,OTHER DIGESTIVE SYSTEM AND ABDOMINAL PROCEDURES,,,35876.62,38314.84,8
APR-DRG,230-1,MAJOR SMALL BOWEL PROCEDURES,,,9167.63,9790.67,8
APR-DRG,230-2,MAJOR SMALL BOWEL PROCEDURES,,,12586.02,13441.38,8
APR-DRG,230-3,MAJOR SMALL BOWEL PROCEDURES,,,20121.15,21488.61,8
APR-DRG,230-4,MAJOR SMALL BOWEL PROCEDURES,,,39870.8,42580.46,8
APR-DRG,231-1,MAJOR LARGE BOWEL PROCEDURES,,,10316.86,11018.01,8
APR-DRG,231-2,MAJOR LARGE BOWEL PROCEDURES,,,12682.37,13544.28,8
APR-DRG,231-3,MAJOR LARGE BOWEL PROCEDURES,,,16840.72,17985.23,8
APR-DRG,231-4,MAJOR LARGE BOWEL PROCEDURES,,,28097.16,30006.68,8
APR-DRG,233-1,APPENDECTOMY WITH COMPLEX PRINCIPAL DIAGNOSIS,,,8861.63,9463.87,8
APR-DRG,233-2,APPENDECTOMY WITH COMPLEX PRINCIPAL DIAGNOSIS,,,10559.65,11277.3,8
APR-DRG,233-3,APPENDECTOMY WITH COMPLEX PRINCIPAL DIAGNOSIS,,,16534.72,17658.44,8
APR-DRG,233-4,APPENDECTOMY WITH COMPLEX PRINCIPAL DIAGNOSIS,,,16534.72,17658.44,8
APR-DRG,234-1,APPENDECTOMY WITHOUT COMPLEX PRINCIPAL DIAGNOSIS,,,5120.27,5468.25,8
APR-DRG,234-2,APPENDECTOMY WITHOUT COMPLEX PRINCIPAL DIAGNOSIS,,,6916.95,7387.04,8
APR-DRG,234-3,APPENDECTOMY WITHOUT COMPLEX PRINCIPAL DIAGNOSIS,,,12905.13,13782.18,8
APR-DRG,234-4,APPENDECTOMY WITHOUT COMPLEX PRINCIPAL DIAGNOSIS,,,12905.13,13782.18,8
APR-DRG,240-1,DIGESTIVE MALIGNANCY,,,5144.93,5494.59,8
APR-DRG,240-2,DIGESTIVE MALIGNANCY,,,6436.76,6874.21,8
APR-DRG,240-3,DIGESTIVE MALIGNANCY,,,8947.19,9555.25,8
APR-DRG,240-4,DIGESTIVE MALIGNANCY,,,16073.8,17166.19,8
APR-DRG,241-1,PEPTIC ULCER AND GASTRITIS,,,4140.61,4422.01,8
APR-DRG,241-2,PEPTIC ULCER AND GASTRITIS,,,5067.86,5412.28,8
APR-DRG,241-3,PEPTIC ULCER AND GASTRITIS,,,7320.08,7817.56,8
APR-DRG,241-4,PEPTIC ULCER AND GASTRITIS,,,14721.85,15722.37,8
APR-DRG,242-1,MAJOR ESOPHAGEAL DISORDERS,,,3706.66,3958.57,8
APR-DRG,242-2,MAJOR ESOPHAGEAL DISORDERS,,,4774.97,5099.48,8
APR-DRG,242-3,MAJOR ESOPHAGEAL DISORDERS,,,6934.68,7405.97,8
APR-DRG,242-4,MAJOR ESOPHAGEAL DISORDERS,,,20441.79,21831.04,8
APR-DRG,243-1,OTHER ESOPHAGEAL DISORDERS,,,4764.17,5087.95,8
APR-DRG,243-2,OTHER ESOPHAGEAL DISORDERS,,,5602.78,5983.55,8
APR-DRG,243-3,OTHER ESOPHAGEAL DISORDERS,,,8551.77,9132.96,8
APR-DRG,243-4,OTHER ESOPHAGEAL DISORDERS,,,13766.08,14701.64,8
APR-DRG,244-1,DIVERTICULITIS AND DIVERTICULOSIS,,,3547.11,3788.18,8
APR-DRG,244-2,DIVERTICULITIS AND DIVERTICULOSIS,,,4345.64,4640.98,8
APR-DRG,244-3,DIVERTICULITIS AND DIVERTICULOSIS,,,6623.29,7073.42,8
APR-DRG,244-4,DIVERTICULITIS AND DIVERTICULOSIS,,,10983.58,11730.04,8
APR-DRG,245-1,INFLAMMATORY BOWEL DISEASE,,,4205.36,4491.16,8
APR-DRG,245-2,INFLAMMATORY BOWEL DISEASE,,,5666.75,6051.87,8
APR-DRG,245-3,INFLAMMATORY BOWEL DISEASE,,,8496.27,9073.69,8
APR-DRG,245-4,INFLAMMATORY BOWEL DISEASE,,,14182.31,15146.15,8
APR-DRG,246-1,GASTROINTESTINAL VASCULAR INSUFFICIENCY,,,4106.7,4385.8,8
APR-DRG,246-2,GASTROINTESTINAL VASCULAR INSUFFICIENCY,,,5380.02,5745.65,8
APR-DRG,246-3,GASTROINTESTINAL VASCULAR INSUFFICIENCY,,,15383.95,16429.46,8
APR-DRG,246-4,GASTROINTESTINAL VASCULAR INSUFFICIENCY,,,15383.95,16429.46,8
APR-DRG,247-1,INTESTINAL OBSTRUCTION,,,3461.56,3696.81,8
APR-DRG,247-2,INTESTINAL OBSTRUCTION,,,4953.79,5290.45,8
APR-DRG,247-3,INTESTINAL OBSTRUCTION,,,7622.99,8141.06,8
APR-DRG,247-4,INTESTINAL OBSTRUCTION,,,15710.75,16778.48,8
APR-DRG,248-1,MAJOR GASTROINTESTINAL AND PERITONEAL INFECTIONS,,,4228.48,4515.85,8
APR-DRG,248-2,MAJOR GASTROINTESTINAL AND PERITONEAL INFECTIONS,,,5416.26,5784.35,8
APR-DRG,248-3,MAJOR GASTROINTESTINAL AND PERITONEAL INFECTIONS,,,8365.25,8933.76,8
APR-DRG,248-4,MAJOR GASTROINTESTINAL AND PERITONEAL INFECTIONS,,,28376.95,30305.48,8
APR-DRG,249-1,"OTHER GASTROENTERITIS, NAUSEA AND VOMITING",,,3879.32,4142.96,8
APR-DRG,249-2,"OTHER GASTROENTERITIS, NAUSEA AND VOMITING",,,4714.85,5035.27,8
APR-DRG,249-3,"OTHER GASTROENTERITIS, NAUSEA AND VOMITING",,,7212.94,7703.14,8
APR-DRG,249-4,"OTHER GASTROENTERITIS, NAUSEA AND VOMITING",,,14210.06,15175.79,8
APR-DRG,251-1,ABDOMINAL PAIN,,,3686.63,3937.18,8
APR-DRG,251-2,ABDOMINAL PAIN,,,4645.48,4961.19,8
APR-DRG,251-3,ABDOMINAL PAIN,,,6674.94,7128.57,8
APR-DRG,251-4,ABDOMINAL PAIN,,,6674.94,7128.57,8
APR-DRG,252-1,"MALFUNCTION, REACTION AND COMPLICATION OF GASTROINTESTINAL DEVICE OR PROCEDURE",,,5182.7,5534.93,8
APR-DRG,252-2,"MALFUNCTION, REACTION AND COMPLICATION OF GASTROINTESTINAL DEVICE OR PROCEDURE",,,6148.49,6566.35,8
APR-DRG,252-3,"MALFUNCTION, REACTION AND COMPLICATION OF GASTROINTESTINAL DEVICE OR PROCEDURE",,,9122.15,9742.11,8
APR-DRG,252-4,"MALFUNCTION, REACTION AND COMPLICATION OF GASTROINTESTINAL DEVICE OR PROCEDURE",,,15173.53,16204.74,8
APR-DRG,253-1,OTHER AND UNSPECIFIED GASTROINTESTINAL HEMORRHAGE,,,3880.09,4143.79,8
APR-DRG,253-2,OTHER AND UNSPECIFIED GASTROINTESTINAL HEMORRHAGE,,,4758.78,5082.19,8
APR-DRG,253-3,OTHER AND UNSPECIFIED GASTROINTESTINAL HEMORRHAGE,,,7288.47,7783.8,8
APR-DRG,253-4,OTHER AND UNSPECIFIED GASTROINTESTINAL HEMORRHAGE,,,13843.93,14784.78,8
APR-DRG,254-1,OTHER DIGESTIVE SYSTEM DIAGNOSES,,,4506.73,4813.02,8
APR-DRG,254-2,OTHER DIGESTIVE SYSTEM DIAGNOSES,,,5555.76,5933.33,8
APR-DRG,254-3,OTHER DIGESTIVE SYSTEM DIAGNOSES,,,8729.05,9322.29,8
APR-DRG,254-4,OTHER DIGESTIVE SYSTEM DIAGNOSES,,,22388.01,23909.52,8
APR-DRG,260-1,"MAJOR PANCREAS, LIVER AND SHUNT PROCEDURES",,,12300.06,13135.99,8
APR-DRG,260-2,"MAJOR PANCREAS, LIVER AND SHUNT PROCEDURES",,,15695.35,16762.02,8
APR-DRG,260-3,"MAJOR PANCREAS, LIVER AND SHUNT PROCEDURES",,,19863.71,21213.68,8
APR-DRG,260-4,"MAJOR PANCREAS, LIVER AND SHUNT PROCEDURES",,,39298.11,41968.85,8
APR-DRG,261-1,MAJOR BILIARY TRACT PROCEDURES,,,9267.83,9897.68,8
APR-DRG,261-2,MAJOR BILIARY TRACT PROCEDURES,,,14311.8,15284.45,8
APR-DRG,261-3,MAJOR BILIARY TRACT PROCEDURES,,,28210.46,30127.68,8
APR-DRG,261-4,MAJOR BILIARY TRACT PROCEDURES,,,28913.41,30878.4,8
APR-DRG,263-1,CHOLECYSTECTOMY,,,6361.23,6793.55,8
APR-DRG,263-2,CHOLECYSTECTOMY,,,8231.13,8790.53,8
APR-DRG,263-3,CHOLECYSTECTOMY,,,10225.13,10920.04,8
APR-DRG,263-4,CHOLECYSTECTOMY,,,19424.37,20744.47,8
APR-DRG,264-1,"OTHER HEPATOBILIARY, PANCREAS AND ABDOMINAL PROCEDURES",,,10175.8,10867.36,8
APR-DRG,264-2,"OTHER HEPATOBILIARY, PANCREAS AND ABDOMINAL PROCEDURES",,,10175.8,10867.36,8
APR-DRG,264-3,"OTHER HEPATOBILIARY, PANCREAS AND ABDOMINAL PROCEDURES",,,15090.28,16115.84,8
APR-DRG,264-4,"OTHER HEPATOBILIARY, PANCREAS AND ABDOMINAL PROCEDURES",,,36174.91,38633.4,8
APR-DRG,279-1,HEPATIC COMA AND OTHER MAJOR ACUTE LIVER DISORDERS,,,3252.68,3473.73,8
APR-DRG,279-2,HEPATIC COMA AND OTHER MAJOR ACUTE LIVER DISORDERS,,,4897.52,5230.36,8
APR-DRG,279-3,HEPATIC COMA AND OTHER MAJOR ACUTE LIVER DISORDERS,,,8151.74,8705.74,8
APR-DRG,279-4,HEPATIC COMA AND OTHER MAJOR ACUTE LIVER DISORDERS,,,16510.06,17632.1,8
APR-DRG,280-1,ALCOHOLIC LIVER DISEASE,,,3473.89,3709.98,8
APR-DRG,280-2,ALCOHOLIC LIVER DISEASE,,,4608.48,4921.68,8
APR-DRG,280-3,ALCOHOLIC LIVER DISEASE,,,7076.5,7557.43,8
APR-DRG,280-4,ALCOHOLIC LIVER DISEASE,,,17027.25,18184.44,8
APR-DRG,281-1,MALIGNANCY OF HEPATOBILIARY SYSTEM AND PANCREAS,,,4519.84,4827.01,8
APR-DRG,281-2,MALIGNANCY OF HEPATOBILIARY SYSTEM AND PANCREAS,,,5736.12,6125.96,8
APR-DRG,281-3,MALIGNANCY OF HEPATOBILIARY SYSTEM AND PANCREAS,,,7593.7,8109.77,8
APR-DRG,281-4,MALIGNANCY OF HEPATOBILIARY SYSTEM AND PANCREAS,,,11033.68,11783.54,8
APR-DRG,282-1,DISORDERS OF PANCREAS EXCEPT MALIGNANCY,,,3544.81,3785.72,8
APR-DRG,282-2,DISORDERS OF PANCREAS EXCEPT MALIGNANCY,,,4567.63,4878.05,8
APR-DRG,282-3,DISORDERS OF PANCREAS EXCEPT MALIGNANCY,,,7259.18,7752.53,8
APR-DRG,282-4,DISORDERS OF PANCREAS EXCEPT MALIGNANCY,,,17887.43,19103.08,8
APR-DRG,283-1,OTHER DISORDERS OF THE LIVER,,,3161.73,3376.6,8
APR-DRG,283-2,OTHER DISORDERS OF THE LIVER,,,4169.13,4452.47,8
APR-DRG,283-3,OTHER DISORDERS OF THE LIVER,,,6775.13,7235.58,8
APR-DRG,283-4,OTHER DISORDERS OF THE LIVER,,,16197.12,17297.9,8
APR-DRG,284-1,DISORDERS OF GALLBLADDER AND BILIARY TRACT,,,3964.87,4234.33,8
APR-DRG,284-2,DISORDERS OF GALLBLADDER AND BILIARY TRACT,,,5367.69,5732.49,8
APR-DRG,284-3,DISORDERS OF GALLBLADDER AND BILIARY TRACT,,,7780.23,8308.98,8
APR-DRG,284-4,DISORDERS OF GALLBLADDER AND BILIARY TRACT,,,17796.48,19005.95,8
APR-DRG,299-1,MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL,,,24916.16,26609.5,8
APR-DRG,299-2,MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL,,,29954.74,31990.5,8
APR-DRG,299-3,MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL,,,40728.66,43496.63,8
APR-DRG,299-4,MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL,,,52085.31,55625.09,8
APR-DRG,300-1,SINGLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL,,,20720.82,22129.03,8
APR-DRG,300-2,SINGLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL,,,26592.6,28399.87,8
APR-DRG,300-3,SINGLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL,,,36694.42,39188.22,8
APR-DRG,300-4,SINGLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL,,,60102.17,64186.78,8
APR-DRG,303-1,DORSAL AND LUMBAR FUSION PROCEDURE FOR CURVATURE OF BACK,,,34584.79,36935.22,8
APR-DRG,303-2,DORSAL AND LUMBAR FUSION PROCEDURE FOR CURVATURE OF BACK,,,43135.03,46066.54,8
APR-DRG,303-3,DORSAL AND LUMBAR FUSION PROCEDURE FOR CURVATURE OF BACK,,,62681.19,66941.07,8
APR-DRG,303-4,DORSAL AND LUMBAR FUSION PROCEDURE FOR CURVATURE OF BACK,,,83570.81,89250.38,8
APR-DRG,304-1,DORSAL AND LUMBAR FUSION PROCEDURE EXCEPT FOR CURVATURE OF BACK,,,21117.77,22552.96,8
APR-DRG,304-2,DORSAL AND LUMBAR FUSION PROCEDURE EXCEPT FOR CURVATURE OF BACK,,,25166.66,26877.02,8
APR-DRG,304-3,DORSAL AND LUMBAR FUSION PROCEDURE EXCEPT FOR CURVATURE OF BACK,,,35898.97,38338.71,8
APR-DRG,304-4,DORSAL AND LUMBAR FUSION PROCEDURE EXCEPT FOR CURVATURE OF BACK,,,49509.37,52874.09,8
APR-DRG,305-1,AMPUTATION OF LOWER LIMB EXCEPT TOES,,,8079.29,8628.37,8
APR-DRG,305-2,AMPUTATION OF LOWER LIMB EXCEPT TOES,,,10162.7,10853.37,8
APR-DRG,305-3,AMPUTATION OF LOWER LIMB EXCEPT TOES,,,14444.37,15426.03,8
APR-DRG,305-4,AMPUTATION OF LOWER LIMB EXCEPT TOES,,,23682.14,25291.61,8
APR-DRG,308-1,HIP AND FEMUR FRACTURE REPAIR,,,9239.31,9867.22,8
APR-DRG,308-2,HIP AND FEMUR FRACTURE REPAIR,,,11712.74,12508.75,8
APR-DRG,308-3,HIP AND FEMUR FRACTURE REPAIR,,,15791.69,16864.91,8
APR-DRG,308-4,HIP AND FEMUR FRACTURE REPAIR,,,25019.44,26719.79,8
APR-DRG,309-1,OTHER SIGNIFICANT HIP AND FEMUR SURGERY,,,10425.54,11134.07,8
APR-DRG,309-2,OTHER SIGNIFICANT HIP AND FEMUR SURGERY,,,13709.83,14641.56,8
APR-DRG,309-3,OTHER SIGNIFICANT HIP AND FEMUR SURGERY,,,18421.58,19673.53,8
APR-DRG,309-4,OTHER SIGNIFICANT HIP AND FEMUR SURGERY,,,28560.4,30501.39,8
APR-DRG,310-1,VERTEBRAL AND INTERVERTEBRAL SPINAL PROCEDURES INCLUDING DISC PROCEDURES,,,7456.5,7963.25,8
APR-DRG,310-2,VERTEBRAL AND INTERVERTEBRAL SPINAL PROCEDURES INCLUDING DISC PROCEDURES,,,12046.48,12865.17,8
APR-DRG,310-3,VERTEBRAL AND INTERVERTEBRAL SPINAL PROCEDURES INCLUDING DISC PROCEDURES,,,15740.82,16810.59,8
APR-DRG,310-4,VERTEBRAL AND INTERVERTEBRAL SPINAL PROCEDURES INCLUDING DISC PROCEDURES,,,26172.53,27951.24,8
APR-DRG,312-1,SKIN GRAFT FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DIAGNOSES,,,10180.43,10872.3,8
APR-DRG,312-2,SKIN GRAFT FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DIAGNOSES,,,14085.96,15043.26,8
APR-DRG,312-3,SKIN GRAFT FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DIAGNOSES,,,22275.47,23789.34,8
APR-DRG,312-4,SKIN GRAFT FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DIAGNOSES,,,45128.27,48195.24,8
APR-DRG,313-1,KNEE AND LOWER LEG PROCEDURES EXCEPT FOOT,,,9364.17,10000.57,8
APR-DRG,313-2,KNEE AND LOWER LEG PROCEDURES EXCEPT FOOT,,,11251.81,12016.5,8
APR-DRG,313-3,KNEE AND LOWER LEG PROCEDURES EXCEPT FOOT,,,16712.0,17847.76,8
APR-DRG,313-4,KNEE AND LOWER LEG PROCEDURES EXCEPT FOOT,,,25226.01,26940.4,8
APR-DRG,314-1,FOOT AND TOE PROCEDURES,,,8332.1,8898.36,8
APR-DRG,314-2,FOOT AND TOE PROCEDURES,,,8350.6,8918.12,8
APR-DRG,314-3,FOOT AND TOE PROCEDURES,,,10372.35,11077.26,8
APR-DRG,314-4,FOOT AND TOE PROCEDURES,,,17081.97,18242.88,8
APR-DRG,315-1,"SHOULDER, UPPER ARM AND FOREARM PROCEDURES EXCEPT JOINT REPLACEMENT",,,5725.34,6114.44,8
APR-DRG,315-2,"SHOULDER, UPPER ARM AND FOREARM PROCEDURES EXCEPT JOINT REPLACEMENT",,,10340.75,11043.52,8
APR-DRG,315-3,"SHOULDER, UPPER ARM AND FOREARM PROCEDURES EXCEPT JOINT REPLACEMENT",,,14555.36,15544.56,8
APR-DRG,315-4,"SHOULDER, UPPER ARM AND FOREARM PROCEDURES EXCEPT JOINT REPLACEMENT",,,24279.5,25929.56,8
APR-DRG,316-1,HAND AND WRIST PROCEDURES,,,5550.36,5927.57,8
APR-DRG,316-2,HAND AND WRIST PROCEDURES,,,7038.74,7517.1,8
APR-DRG,316-3,HAND AND WRIST PROCEDURES,,,11355.09,12126.8,8
APR-DRG,316-4,HAND AND WRIST PROCEDURES,,,17091.22,18252.76,8
APR-DRG,317-1,"TENDON, MUSCLE AND OTHER SOFT TISSUE PROCEDURES",,,6308.04,6736.74,8
APR-DRG,317-2,"TENDON, MUSCLE AND OTHER SOFT TISSUE PROCEDURES",,,8329.02,8895.07,8
APR-DRG,317-3,"TENDON, MUSCLE AND OTHER SOFT TISSUE PROCEDURES",,,12564.44,13418.34,8
APR-DRG,317-4,"TENDON, MUSCLE AND OTHER SOFT TISSUE PROCEDURES",,,25387.1,27112.44,8
APR-DRG,320-1,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE PROCEDURES,,,7824.16,8355.9,8
APR-DRG,320-2,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE PROCEDURES,,,10342.29,11045.17,8
APR-DRG,320-3,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE PROCEDURES,,,14211.6,15177.44,8
APR-DRG,320-4,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE PROCEDURES,,,24864.52,26554.34,8
APR-DRG,321-1,SPINAL FUSION AND OTHER BACK AND NECK PROCEDURES EXCEPT FOR DISC PROCEDURES,,,13151.01,14044.77,8
APR-DRG,321-2,SPINAL FUSION AND OTHER BACK AND NECK PROCEDURES EXCEPT FOR DISC PROCEDURES,,,16563.24,17688.9,8
APR-DRG,321-3,SPINAL FUSION AND OTHER BACK AND NECK PROCEDURES EXCEPT FOR DISC PROCEDURES,,,23514.89,25112.99,8
APR-DRG,321-4,SPINAL FUSION AND OTHER BACK AND NECK PROCEDURES EXCEPT FOR DISC PROCEDURES,,,37412.78,39955.4,8
APR-DRG,322-1,SHOULDER AND ELBOW JOINT REPLACEMENT,,,11833.74,12637.98,8
APR-DRG,322-2,SHOULDER AND ELBOW JOINT REPLACEMENT,,,12539.0,13391.17,8
APR-DRG,322-3,SHOULDER AND ELBOW JOINT REPLACEMENT,,,18511.77,19769.85,8
APR-DRG,322-4,SHOULDER AND ELBOW JOINT REPLACEMENT,,,18511.77,19769.85,8
APR-DRG,323-1,NON-ELECTIVE OR COMPLEX HIP JOINT REPLACEMENT,,,12062.67,12882.46,8
APR-DRG,323-2,NON-ELECTIVE OR COMPLEX HIP JOINT REPLACEMENT,,,14132.98,15093.47,8
APR-DRG,323-3,NON-ELECTIVE OR COMPLEX HIP JOINT REPLACEMENT,,,18901.78,20186.36,8
APR-DRG,323-4,NON-ELECTIVE OR COMPLEX HIP JOINT REPLACEMENT,,,30461.91,32532.14,8
APR-DRG,324-1,ELECTIVE HIP JOINT REPLACEMENT,,,10240.55,10936.51,8
APR-DRG,324-2,ELECTIVE HIP JOINT REPLACEMENT,,,11340.44,12111.15,8
APR-DRG,324-3,ELECTIVE HIP JOINT REPLACEMENT,,,15274.5,16312.57,8
APR-DRG,324-4,ELECTIVE HIP JOINT REPLACEMENT,,,22309.39,23825.56,8
APR-DRG,325-1,NON-ELECTIVE OR COMPLEX KNEE JOINT REPLACEMENT,,,16012.91,17101.16,8
APR-DRG,325-2,NON-ELECTIVE OR COMPLEX KNEE JOINT REPLACEMENT,,,17165.22,18331.79,8
APR-DRG,325-3,NON-ELECTIVE OR COMPLEX KNEE JOINT REPLACEMENT,,,24845.25,26533.76,8
APR-DRG,325-4,NON-ELECTIVE OR COMPLEX KNEE JOINT REPLACEMENT,,,33319.18,35583.59,8
APR-DRG,326-1,ELECTIVE KNEE JOINT REPLACEMENT,,,9921.44,10595.72,8
APR-DRG,326-2,ELECTIVE KNEE JOINT REPLACEMENT,,,11446.81,12224.75,8
APR-DRG,326-3,ELECTIVE KNEE JOINT REPLACEMENT,,,17020.31,18177.03,8
APR-DRG,326-4,ELECTIVE KNEE JOINT REPLACEMENT,,,21803.76,23285.57,8
APR-DRG,340-1,FRACTURE OF FEMUR,,,2874.23,3069.56,8
APR-DRG,340-2,FRACTURE OF FEMUR,,,4165.28,4448.36,8
APR-DRG,340-3,FRACTURE OF FEMUR,,,8072.35,8620.95,8
APR-DRG,340-4,FRACTURE OF FEMUR,,,8072.35,8620.95,8
APR-DRG,341-1,FRACTURE OF PELVIS OR DISLOCATION OF HIP,,,3793.0,4050.77,8
APR-DRG,341-2,FRACTURE OF PELVIS OR DISLOCATION OF HIP,,,4146.01,4427.78,8
APR-DRG,341-3,FRACTURE OF PELVIS OR DISLOCATION OF HIP,,,5050.9,5394.17,8
APR-DRG,341-4,FRACTURE OF PELVIS OR DISLOCATION OF HIP,,,8783.78,9380.73,8
APR-DRG,342-1,"FRACTURES AND DISLOCATIONS EXCEPT FEMUR, PELVIS AND BACK",,,3339.0,3565.93,8
APR-DRG,342-2,"FRACTURES AND DISLOCATIONS EXCEPT FEMUR, PELVIS AND BACK",,,4251.6,4540.55,8
APR-DRG,342-3,"FRACTURES AND DISLOCATIONS EXCEPT FEMUR, PELVIS AND BACK",,,6569.33,7015.79,8
APR-DRG,342-4,"FRACTURES AND DISLOCATIONS EXCEPT FEMUR, PELVIS AND BACK",,,7950.57,8490.9,8
APR-DRG,343-1,MUSCULOSKELETAL MALIGNANCY AND PATHOLOGICAL FRACTURE DUE TO MUSCULOSKELETAL MALIGNANCY,,,6821.38,7284.97,8
APR-DRG,343-2,MUSCULOSKELETAL MALIGNANCY AND PATHOLOGICAL FRACTURE DUE TO MUSCULOSKELETAL MALIGNANCY,,,6844.5,7309.67,8
APR-DRG,343-3,MUSCULOSKELETAL MALIGNANCY AND PATHOLOGICAL FRACTURE DUE TO MUSCULOSKELETAL MALIGNANCY,,,9551.48,10200.61,8
APR-DRG,343-4,MUSCULOSKELETAL MALIGNANCY AND PATHOLOGICAL FRACTURE DUE TO MUSCULOSKELETAL MALIGNANCY,,,15222.08,16256.59,8
APR-DRG,344-1,"OSTEOMYELITIS, SEPTIC ARTHRITIS AND OTHER MUSCULOSKELETAL INFECTIONS",,,5311.42,5672.39,8
APR-DRG,344-2,"OSTEOMYELITIS, SEPTIC ARTHRITIS AND OTHER MUSCULOSKELETAL INFECTIONS",,,6040.58,6451.1,8
APR-DRG,344-3,"OSTEOMYELITIS, SEPTIC ARTHRITIS AND OTHER MUSCULOSKELETAL INFECTIONS",,,8403.02,8974.1,8
APR-DRG,344-4,"OSTEOMYELITIS, SEPTIC ARTHRITIS AND OTHER MUSCULOSKELETAL INFECTIONS",,,11634.12,12424.79,8
APR-DRG,346-1,CONNECTIVE TISSUE DISORDERS,,,6432.91,6870.09,8
APR-DRG,346-2,CONNECTIVE TISSUE DISORDERS,,,8109.34,8660.47,8
APR-DRG,346-3,CONNECTIVE TISSUE DISORDERS,,,13052.35,13939.4,8
APR-DRG,346-4,CONNECTIVE TISSUE DISORDERS,,,26241.12,28024.5,8
APR-DRG,347-1,"OTHER BACK AND NECK DISORDERS, FRACTURES AND INJURIES",,,4162.96,4445.88,8
APR-DRG,347-2,"OTHER BACK AND NECK DISORDERS, FRACTURES AND INJURIES",,,4899.83,5232.83,8
APR-DRG,347-3,"OTHER BACK AND NECK DISORDERS, FRACTURES AND INJURIES",,,6694.97,7149.97,8
APR-DRG,347-4,"OTHER BACK AND NECK DISORDERS, FRACTURES AND INJURIES",,,12531.3,13382.94,8
APR-DRG,349-1,"MALFUNCTION, REACTION, COMPLICATION OF ORTHOPEDIC DEVICE OR PROCEDURE",,,3614.17,3859.79,8
APR-DRG,349-2,"MALFUNCTION, REACTION, COMPLICATION OF ORTHOPEDIC DEVICE OR PROCEDURE",,,5285.99,5645.23,8
APR-DRG,349-3,"MALFUNCTION, REACTION, COMPLICATION OF ORTHOPEDIC DEVICE OR PROCEDURE",,,7755.56,8282.64,8
APR-DRG,349-4,"MALFUNCTION, REACTION, COMPLICATION OF ORTHOPEDIC DEVICE OR PROCEDURE",,,13881.7,14825.12,8
APR-DRG,351-1,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES,,,4019.61,4292.78,8
APR-DRG,351-2,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES,,,4546.81,4855.82,8
APR-DRG,351-3,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES,,,7954.42,8495.01,8
APR-DRG,351-4,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES,,,19423.6,20743.65,8
APR-DRG,361-1,SKIN GRAFT FOR SKIN AND SUBCUTANEOUS TISSUE DIAGNOSES,,,10346.92,11050.11,8
APR-DRG,361-2,SKIN GRAFT FOR SKIN AND SUBCUTANEOUS TISSUE DIAGNOSES,,,13047.72,13934.46,8
APR-DRG,361-3,SKIN GRAFT FOR SKIN AND SUBCUTANEOUS TISSUE DIAGNOSES,,,28010.83,29914.48,8
APR-DRG,361-4,SKIN GRAFT FOR SKIN AND SUBCUTANEOUS TISSUE DIAGNOSES,,,28010.83,29914.48,8
APR-DRG,362-1,MASTECTOMY PROCEDURES,,,9829.72,10497.76,8
APR-DRG,362-2,MASTECTOMY PROCEDURES,,,13574.16,14496.68,8
APR-DRG,362-3,MASTECTOMY PROCEDURES,,,19136.86,20437.43,8
APR-DRG,362-4,MASTECTOMY PROCEDURES,,,19136.86,20437.43,8
APR-DRG,363-1,BREAST PROCEDURES EXCEPT MASTECTOMY,,,5322.22,5683.92,8
APR-DRG,363-2,BREAST PROCEDURES EXCEPT MASTECTOMY,,,12060.35,12879.99,8
APR-DRG,363-3,BREAST PROCEDURES EXCEPT MASTECTOMY,,,19311.06,20623.46,8
APR-DRG,363-4,BREAST PROCEDURES EXCEPT MASTECTOMY,,,19311.06,20623.46,8
APR-DRG,364-1,"OTHER SKIN, SUBCUTANEOUS TISSUE AND RELATED PROCEDURES",,,4880.56,5212.25,8
APR-DRG,364-2,"OTHER SKIN, SUBCUTANEOUS TISSUE AND RELATED PROCEDURES",,,6462.97,6902.2,8
APR-DRG,364-3,"OTHER SKIN, SUBCUTANEOUS TISSUE AND RELATED PROCEDURES",,,10590.48,11310.22,8
APR-DRG,364-4,"OTHER SKIN, SUBCUTANEOUS TISSUE AND RELATED PROCEDURES",,,22609.99,24146.6,8
APR-DRG,380-1,SKIN ULCERS,,,3753.68,4008.79,8
APR-DRG,380-2,SKIN ULCERS,,,4935.29,5270.69,8
APR-DRG,380-3,SKIN ULCERS,,,8035.35,8581.44,8
APR-DRG,380-4,SKIN ULCERS,,,12444.98,13290.75,8
APR-DRG,381-1,MAJOR SKIN DISORDERS,,,4597.68,4910.15,8
APR-DRG,381-2,MAJOR SKIN DISORDERS,,,5817.82,6213.21,8
APR-DRG,381-3,MAJOR SKIN DISORDERS,,,13792.3,14729.64,8
APR-DRG,381-4,MAJOR SKIN DISORDERS,,,13792.3,14729.64,8
APR-DRG,382-1,MALIGNANT BREAST DISORDERS,,,5404.69,5772.0,8
APR-DRG,382-2,MALIGNANT BREAST DISORDERS,,,5404.69,5772.0,8
APR-DRG,382-3,MALIGNANT BREAST DISORDERS,,,7159.75,7646.33,8
APR-DRG,382-4,MALIGNANT BREAST DISORDERS,,,13342.93,14249.73,8
APR-DRG,383-1,CELLULITIS AND OTHER SKIN INFECTIONS,,,3518.59,3757.72,8
APR-DRG,383-2,CELLULITIS AND OTHER SKIN INFECTIONS,,,4581.5,4892.87,8
APR-DRG,383-3,CELLULITIS AND OTHER SKIN INFECTIONS,,,6718.09,7174.66,8
APR-DRG,383-4,CELLULITIS AND OTHER SKIN INFECTIONS,,,12018.73,12835.54,8
APR-DRG,384-1,"CONTUSION, OPEN WOUND AND OTHER TRAUMA TO SKIN AND SUBCUTANEOUS TISSUE",,,3284.28,3507.48,8
APR-DRG,384-2,"CONTUSION, OPEN WOUND AND OTHER TRAUMA TO SKIN AND SUBCUTANEOUS TISSUE",,,4460.49,4763.63,8
APR-DRG,384-3,"CONTUSION, OPEN WOUND AND OTHER TRAUMA TO SKIN AND SUBCUTANEOUS TISSUE",,,7914.34,8452.21,8
APR-DRG,384-4,"CONTUSION, OPEN WOUND AND OTHER TRAUMA TO SKIN AND SUBCUTANEOUS TISSUE",,,10126.48,10814.68,8
APR-DRG,385-1,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST DISORDERS",,,3956.39,4225.28,8
APR-DRG,385-2,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST DISORDERS",,,4970.74,5308.56,8
APR-DRG,385-3,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST DISORDERS",,,7579.05,8094.13,8
APR-DRG,385-4,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST DISORDERS",,,17725.57,18930.22,8
APR-DRG,401-1,ADRENAL PROCEDURES,,,10749.27,11479.8,8
APR-DRG,401-2,ADRENAL PROCEDURES,,,10749.27,11479.8,8
APR-DRG,401-3,ADRENAL PROCEDURES,,,10749.27,11479.8,8
APR-DRG,401-4,ADRENAL PROCEDURES,,,10749.27,11479.8,8
APR-DRG,403-1,PROCEDURES FOR OBESITY,,,8926.37,9533.02,8
APR-DRG,403-2,PROCEDURES FOR OBESITY,,,9877.51,10548.8,8
APR-DRG,403-3,PROCEDURES FOR OBESITY,,,14018.9,14971.64,8
APR-DRG,403-4,PROCEDURES FOR OBESITY,,,27784.99,29673.29,8
APR-DRG,404-1,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES",,,7686.96,8209.38,8
APR-DRG,404-2,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES",,,9838.2,10506.82,8
APR-DRG,404-3,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES",,,16917.8,18067.56,8
APR-DRG,404-4,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES",,,16917.8,18067.56,8
APR-DRG,405-1,"OTHER PROCEDURES FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS",,,9020.41,9633.45,8
APR-DRG,405-2,"OTHER PROCEDURES FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS",,,9499.06,10144.63,8
APR-DRG,405-3,"OTHER PROCEDURES FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS",,,16403.69,17518.5,8
APR-DRG,405-4,"OTHER PROCEDURES FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS",,,37157.65,39682.93,8
APR-DRG,420-1,DIABETES,,,3767.55,4023.6,8
APR-DRG,420-2,DIABETES,,,4020.37,4293.6,8
APR-DRG,420-3,DIABETES,,,5951.94,6356.44,8
APR-DRG,420-4,DIABETES,,,11206.34,11967.93,8
APR-DRG,421-1,"MALNUTRITION, FAILURE TO THRIVE AND OTHER NUTRITIONAL DISORDERS",,,5076.33,5421.33,8
APR-DRG,421-2,"MALNUTRITION, FAILURE TO THRIVE AND OTHER NUTRITIONAL DISORDERS",,,7893.53,8429.98,8
APR-DRG,421-3,"MALNUTRITION, FAILURE TO THRIVE AND OTHER NUTRITIONAL DISORDERS",,,12389.48,13231.48,8
APR-DRG,421-4,"MALNUTRITION, FAILURE TO THRIVE AND OTHER NUTRITIONAL DISORDERS",,,24096.05,25733.64,8
APR-DRG,422-1,HYPOVOLEMIA AND RELATED ELECTROLYTE DISORDERS,,,3433.81,3667.18,8
APR-DRG,422-2,HYPOVOLEMIA AND RELATED ELECTROLYTE DISORDERS,,,4445.84,4747.99,8
APR-DRG,422-3,HYPOVOLEMIA AND RELATED ELECTROLYTE DISORDERS,,,6220.17,6642.9,8
APR-DRG,422-4,HYPOVOLEMIA AND RELATED ELECTROLYTE DISORDERS,,,11984.82,12799.33,8
APR-DRG,423-1,INBORN ERRORS OF METABOLISM,,,6161.59,6580.34,8
APR-DRG,423-2,INBORN ERRORS OF METABOLISM,,,6694.2,7149.14,8
APR-DRG,423-3,INBORN ERRORS OF METABOLISM,,,13965.72,14914.85,8
APR-DRG,423-4,INBORN ERRORS OF METABOLISM,,,13965.72,14914.85,8
APR-DRG,424-1,OTHER ENDOCRINE DISORDERS,,,4320.97,4614.63,8
APR-DRG,424-2,OTHER ENDOCRINE DISORDERS,,,5383.88,5749.78,8
APR-DRG,424-3,OTHER ENDOCRINE DISORDERS,,,9418.12,10058.19,8
APR-DRG,424-4,OTHER ENDOCRINE DISORDERS,,,14649.4,15644.99,8
APR-DRG,425-1,OTHER NON-HYPOVOLEMIC ELECTROLYTE DISORDERS,,,2998.32,3202.09,8
APR-DRG,425-2,OTHER NON-HYPOVOLEMIC ELECTROLYTE DISORDERS,,,4101.31,4380.04,8
APR-DRG,425-3,OTHER NON-HYPOVOLEMIC ELECTROLYTE DISORDERS,,,6180.09,6600.1,8
APR-DRG,425-4,OTHER NON-HYPOVOLEMIC ELECTROLYTE DISORDERS,,,10497.99,11211.44,8
APR-DRG,426-1,NON-HYPOVOLEMIC SODIUM DISORDERS,,,3333.61,3560.16,8
APR-DRG,426-2,NON-HYPOVOLEMIC SODIUM DISORDERS,,,4445.07,4747.16,8
APR-DRG,426-3,NON-HYPOVOLEMIC SODIUM DISORDERS,,,7199.83,7689.14,8
APR-DRG,426-4,NON-HYPOVOLEMIC SODIUM DISORDERS,,,13008.42,13892.48,8
APR-DRG,427-1,THYROID DISORDERS,,,3527.84,3767.6,8
APR-DRG,427-2,THYROID DISORDERS,,,4444.3,4746.34,8
APR-DRG,427-3,THYROID DISORDERS,,,8185.66,8741.96,8
APR-DRG,427-4,THYROID DISORDERS,,,10343.84,11046.82,8
APR-DRG,428-1,GENETIC DISORDERS,,,4926.81,5261.64,8
APR-DRG,428-2,GENETIC DISORDERS,,,7663.07,8183.86,8
APR-DRG,428-3,GENETIC DISORDERS,,,21096.18,22529.9,8
APR-DRG,428-4,GENETIC DISORDERS,,,35778.73,38210.29,8
APR-DRG,440-1,KIDNEY TRANSPLANT,,,16164.75,17263.32,8
APR-DRG,440-2,KIDNEY TRANSPLANT,,,16164.75,17263.32,8
APR-DRG,440-3,KIDNEY TRANSPLANT,,,29459.12,31461.2,8
APR-DRG,440-4,KIDNEY TRANSPLANT,,,29459.12,31461.2,8
APR-DRG,441-1,MAJOR BLADDER PROCEDURES,,,15857.98,16935.71,8
APR-DRG,441-2,MAJOR BLADDER PROCEDURES,,,15857.98,16935.71,8
APR-DRG,441-3,MAJOR BLADDER PROCEDURES,,,21304.29,22752.16,8
APR-DRG,441-4,MAJOR BLADDER PROCEDURES,,,32822.03,35052.66,8
APR-DRG,442-1,KIDNEY AND URINARY TRACT PROCEDURES FOR MALIGNANCY,,,9520.64,10167.67,8
APR-DRG,442-2,KIDNEY AND URINARY TRACT PROCEDURES FOR MALIGNANCY,,,10922.69,11665.01,8
APR-DRG,442-3,KIDNEY AND URINARY TRACT PROCEDURES FOR MALIGNANCY,,,16970.21,18123.52,8
APR-DRG,442-4,KIDNEY AND URINARY TRACT PROCEDURES FOR MALIGNANCY,,,26036.1,27805.55,8
APR-DRG,443-1,KIDNEY AND URINARY TRACT PROCEDURES FOR NON-MALIGNANCY,,,8149.43,8703.28,8
APR-DRG,443-2,KIDNEY AND URINARY TRACT PROCEDURES FOR NON-MALIGNANCY,,,9043.53,9658.14,8
APR-DRG,443-3,KIDNEY AND URINARY TRACT PROCEDURES FOR NON-MALIGNANCY,,,17880.5,19095.68,8
APR-DRG,443-4,KIDNEY AND URINARY TRACT PROCEDURES FOR NON-MALIGNANCY,,,17880.5,19095.68,8
APR-DRG,444-1,RENAL DIALYSIS ACCESS DEVICE PROCEDURES,,,9633.95,10288.69,8
APR-DRG,444-2,RENAL DIALYSIS ACCESS DEVICE PROCEDURES,,,9633.95,10288.69,8
APR-DRG,444-3,RENAL DIALYSIS ACCESS DEVICE PROCEDURES,,,14405.84,15384.88,8
APR-DRG,444-4,RENAL DIALYSIS ACCESS DEVICE PROCEDURES,,,25282.28,27000.49,8
APR-DRG,445-1,OTHER BLADDER PROCEDURES,,,6634.85,7085.76,8
APR-DRG,445-2,OTHER BLADDER PROCEDURES,,,11787.51,12588.6,8
APR-DRG,445-3,OTHER BLADDER PROCEDURES,,,14354.97,15330.55,8
APR-DRG,445-4,OTHER BLADDER PROCEDURES,,,14354.97,15330.55,8
APR-DRG,446-1,URETHRAL AND TRANSURETHRAL PROCEDURES,,,4817.36,5144.76,8
APR-DRG,446-2,URETHRAL AND TRANSURETHRAL PROCEDURES,,,6141.55,6558.94,8
APR-DRG,446-3,URETHRAL AND TRANSURETHRAL PROCEDURES,,,11392.86,12167.13,8
APR-DRG,446-4,URETHRAL AND TRANSURETHRAL PROCEDURES,,,17936.0,19154.95,8
APR-DRG,447-1,"OTHER KIDNEY, URINARY TRACT AND RELATED NON-PERCUTANEOUS PROCEDURES",,,9850.54,10519.99,8
APR-DRG,447-2,"OTHER KIDNEY, URINARY TRACT AND RELATED NON-PERCUTANEOUS PROCEDURES",,,9850.54,10519.99,8
APR-DRG,447-3,"OTHER KIDNEY, URINARY TRACT AND RELATED NON-PERCUTANEOUS PROCEDURES",,,13345.25,14252.21,8
APR-DRG,447-4,"OTHER KIDNEY, URINARY TRACT AND RELATED NON-PERCUTANEOUS PROCEDURES",,,35820.35,38254.74,8
APR-DRG,448-1,"OTHER KIDNEY, URINARY TRACT AND RELATED PERCUTANEOUS PROCEDURES",,,9944.57,10620.41,8
APR-DRG,448-2,"OTHER KIDNEY, URINARY TRACT AND RELATED PERCUTANEOUS PROCEDURES",,,13877.85,14821.0,8
APR-DRG,448-3,"OTHER KIDNEY, URINARY TRACT AND RELATED PERCUTANEOUS PROCEDURES",,,16779.06,17919.39,8
APR-DRG,448-4,"OTHER KIDNEY, URINARY TRACT AND RELATED PERCUTANEOUS PROCEDURES",,,33945.82,36252.82,8
APR-DRG,461-1,KIDNEY AND URINARY TRACT MALIGNANCY,,,6782.07,7242.98,8
APR-DRG,461-2,KIDNEY AND URINARY TRACT MALIGNANCY,,,6782.07,7242.98,8
APR-DRG,461-3,KIDNEY AND URINARY TRACT MALIGNANCY,,,9662.46,10319.13,8
APR-DRG,461-4,KIDNEY AND URINARY TRACT MALIGNANCY,,,9662.46,10319.13,8
APR-DRG,462-1,NEPHRITIS AND NEPHROSIS,,,4189.17,4473.88,8
APR-DRG,462-2,NEPHRITIS AND NEPHROSIS,,,6602.48,7051.19,8
APR-DRG,462-3,NEPHRITIS AND NEPHROSIS,,,13381.47,14290.89,8
APR-DRG,462-4,NEPHRITIS AND NEPHROSIS,,,13381.47,14290.89,8
APR-DRG,463-1,KIDNEY AND URINARY TRACT INFECTIONS,,,3509.34,3747.84,8
APR-DRG,463-2,KIDNEY AND URINARY TRACT INFECTIONS,,,4482.07,4786.67,8
APR-DRG,463-3,KIDNEY AND URINARY TRACT INFECTIONS,,,6576.27,7023.2,8
APR-DRG,463-4,KIDNEY AND URINARY TRACT INFECTIONS,,,10505.7,11219.68,8
APR-DRG,465-1,URINARY STONES AND ACQUIRED UPPER URINARY TRACT OBSTRUCTION,,,3652.71,3900.95,8
APR-DRG,465-2,URINARY STONES AND ACQUIRED UPPER URINARY TRACT OBSTRUCTION,,,4385.72,4683.78,8
APR-DRG,465-3,URINARY STONES AND ACQUIRED UPPER URINARY TRACT OBSTRUCTION,,,7094.24,7576.37,8
APR-DRG,465-4,URINARY STONES AND ACQUIRED UPPER URINARY TRACT OBSTRUCTION,,,14784.28,15789.04,8
APR-DRG,466-1,"MALFUNCTION, REACTION, COMPLICATION OF GENITOURINARY DEVICE OR PROCEDURE",,,3515.51,3754.43,8
APR-DRG,466-2,"MALFUNCTION, REACTION, COMPLICATION OF GENITOURINARY DEVICE OR PROCEDURE",,,4710.22,5030.33,8
APR-DRG,466-3,"MALFUNCTION, REACTION, COMPLICATION OF GENITOURINARY DEVICE OR PROCEDURE",,,6812.9,7275.92,8
APR-DRG,466-4,"MALFUNCTION, REACTION, COMPLICATION OF GENITOURINARY DEVICE OR PROCEDURE",,,10496.45,11209.8,8
APR-DRG,468-1,"OTHER KIDNEY AND URINARY TRACT DIAGNOSES, SIGNS AND SYMPTOMS",,,4086.66,4364.39,8
APR-DRG,468-2,"OTHER KIDNEY AND URINARY TRACT DIAGNOSES, SIGNS AND SYMPTOMS",,,5241.29,5597.49,8
APR-DRG,468-3,"OTHER KIDNEY AND URINARY TRACT DIAGNOSES, SIGNS AND SYMPTOMS",,,7193.66,7682.55,8
APR-DRG,468-4,"OTHER KIDNEY AND URINARY TRACT DIAGNOSES, SIGNS AND SYMPTOMS",,,19444.41,20765.88,8
APR-DRG,469-1,ACUTE KIDNEY INJURY,,,3221.08,3439.99,8
APR-DRG,469-2,ACUTE KIDNEY INJURY,,,4366.45,4663.2,8
APR-DRG,469-3,ACUTE KIDNEY INJURY,,,7639.94,8159.16,8
APR-DRG,469-4,ACUTE KIDNEY INJURY,,,14760.39,15763.53,8
APR-DRG,470-1,CHRONIC KIDNEY DISEASE,,,4916.01,5250.11,8
APR-DRG,470-2,CHRONIC KIDNEY DISEASE,,,4916.01,5250.11,8
APR-DRG,470-3,CHRONIC KIDNEY DISEASE,,,8527.11,9106.63,8
APR-DRG,470-4,CHRONIC KIDNEY DISEASE,,,14520.68,15507.53,8
APR-DRG,482-1,TRANSURETHRAL PROSTATECTOMY,,,5584.28,5963.79,8
APR-DRG,482-2,TRANSURETHRAL PROSTATECTOMY,,,6863.78,7330.25,8
APR-DRG,482-3,TRANSURETHRAL PROSTATECTOMY,,,11391.32,12165.48,8
APR-DRG,482-4,TRANSURETHRAL PROSTATECTOMY,,,11391.32,12165.48,8
APR-DRG,483-1,"PENIS, TESTES AND SCROTAL PROCEDURES",,,5664.44,6049.41,8
APR-DRG,483-2,"PENIS, TESTES AND SCROTAL PROCEDURES",,,8500.9,9078.63,8
APR-DRG,483-3,"PENIS, TESTES AND SCROTAL PROCEDURES",,,15720.0,16788.35,8
APR-DRG,483-4,"PENIS, TESTES AND SCROTAL PROCEDURES",,,15720.0,16788.35,8
APR-DRG,484-1,OTHER MALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES,,,8814.61,9413.66,8
APR-DRG,484-2,OTHER MALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES,,,8814.61,9413.66,8
APR-DRG,484-3,OTHER MALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES,,,11715.82,12512.04,8
APR-DRG,484-4,OTHER MALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES,,,11715.82,12512.04,8
APR-DRG,485-1,PROSTATECTOMY PROCEDURES,,,9624.7,10278.81,8
APR-DRG,485-2,PROSTATECTOMY PROCEDURES,,,11079.15,11832.11,8
APR-DRG,485-3,PROSTATECTOMY PROCEDURES,,,17731.74,18936.81,8
APR-DRG,485-4,PROSTATECTOMY PROCEDURES,,,29242.53,31229.89,8
APR-DRG,500-1,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM",,,6294.17,6721.92,8
APR-DRG,500-2,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM",,,6294.17,6721.92,8
APR-DRG,500-3,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM",,,7481.17,7989.6,8
APR-DRG,500-4,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM",,,7481.17,7989.6,8
APR-DRG,501-1,MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY,,,3305.86,3530.53,8
APR-DRG,501-2,MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY,,,4784.99,5110.18,8
APR-DRG,501-3,MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY,,,7343.2,7842.25,8
APR-DRG,501-4,MALE REPRODUCTIVE SYSTEM DIAGNOSES EXCEPT MALIGNANCY,,,11718.9,12515.33,8
APR-DRG,511-1,UTERINE AND ADNEXA PROCEDURES FOR OVARIAN AND ADNEXAL MALIGNANCY,,,9053.56,9668.85,8
APR-DRG,511-2,UTERINE AND ADNEXA PROCEDURES FOR OVARIAN AND ADNEXAL MALIGNANCY,,,11148.52,11906.19,8
APR-DRG,511-3,UTERINE AND ADNEXA PROCEDURES FOR OVARIAN AND ADNEXAL MALIGNANCY,,,16737.44,17874.93,8
APR-DRG,511-4,UTERINE AND ADNEXA PROCEDURES FOR OVARIAN AND ADNEXAL MALIGNANCY,,,16737.44,17874.93,8
APR-DRG,513-1,UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY EXCEPT LEIOMYOMA,,,6008.98,6417.36,8
APR-DRG,513-2,UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY EXCEPT LEIOMYOMA,,,7148.19,7633.99,8
APR-DRG,513-3,UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY EXCEPT LEIOMYOMA,,,11304.99,12073.29,8
APR-DRG,513-4,UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY EXCEPT LEIOMYOMA,,,14102.91,15061.37,8
APR-DRG,514-1,FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES,,,5062.46,5406.51,8
APR-DRG,514-2,FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES,,,7558.24,8071.91,8
APR-DRG,514-3,FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES,,,7558.24,8071.91,8
APR-DRG,514-4,FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES,,,7558.24,8071.91,8
APR-DRG,517-1,DILATION AND CURETTAGE FOR NON-OBSTETRIC DIAGNOSES,,,4851.27,5180.97,8
APR-DRG,517-2,DILATION AND CURETTAGE FOR NON-OBSTETRIC DIAGNOSES,,,5340.71,5703.68,8
APR-DRG,517-3,DILATION AND CURETTAGE FOR NON-OBSTETRIC DIAGNOSES,,,10391.62,11097.85,8
APR-DRG,517-4,DILATION AND CURETTAGE FOR NON-OBSTETRIC DIAGNOSES,,,10391.62,11097.85,8
APR-DRG,518-1,OTHER FEMALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES,,,5090.98,5436.97,8
APR-DRG,518-2,OTHER FEMALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES,,,7380.2,7881.76,8
APR-DRG,518-3,OTHER FEMALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES,,,13351.41,14258.78,8
APR-DRG,518-4,OTHER FEMALE REPRODUCTIVE SYSTEM AND RELATED PROCEDURES,,,13351.41,14258.78,8
APR-DRG,519-1,UTERINE AND ADNEXA PROCEDURES FOR LEIOMYOMA,,,5992.03,6399.25,8
APR-DRG,519-2,UTERINE AND ADNEXA PROCEDURES FOR LEIOMYOMA,,,7546.68,8059.56,8
APR-DRG,519-3,UTERINE AND ADNEXA PROCEDURES FOR LEIOMYOMA,,,16890.82,18038.74,8
APR-DRG,519-4,UTERINE AND ADNEXA PROCEDURES FOR LEIOMYOMA,,,16890.82,18038.74,8
APR-DRG,530-1,FEMALE REPRODUCTIVE SYSTEM MALIGNANCY,,,4354.12,4650.03,8
APR-DRG,530-2,FEMALE REPRODUCTIVE SYSTEM MALIGNANCY,,,5258.24,5615.6,8
APR-DRG,530-3,FEMALE REPRODUCTIVE SYSTEM MALIGNANCY,,,7830.33,8362.49,8
APR-DRG,530-4,FEMALE REPRODUCTIVE SYSTEM MALIGNANCY,,,15078.73,16103.49,8
APR-DRG,531-1,FEMALE REPRODUCTIVE SYSTEM INFECTIONS,,,3436.89,3670.47,8
APR-DRG,531-2,FEMALE REPRODUCTIVE SYSTEM INFECTIONS,,,4292.45,4584.17,8
APR-DRG,531-3,FEMALE REPRODUCTIVE SYSTEM INFECTIONS,,,8219.56,8778.18,8
APR-DRG,531-4,FEMALE REPRODUCTIVE SYSTEM INFECTIONS,,,8219.56,8778.18,8
APR-DRG,532-1,MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS,,,3466.19,3701.75,8
APR-DRG,532-2,MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS,,,4065.85,4342.17,8
APR-DRG,532-3,MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS,,,5232.8,5588.43,8
APR-DRG,532-4,MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS,,,5232.8,5588.43,8
APR-DRG,539-1,CESAREAN SECTION WITH STERILIZATION,,,5554.22,5931.7,8
APR-DRG,539-2,CESAREAN SECTION WITH STERILIZATION,,,6204.76,6626.44,8
APR-DRG,539-3,CESAREAN SECTION WITH STERILIZATION,,,8759.11,9354.39,8
APR-DRG,539-4,CESAREAN SECTION WITH STERILIZATION,,,15541.19,16597.38,8
APR-DRG,540-1,CESAREAN SECTION WITHOUT STERILIZATION,,,5208.92,5562.92,8
APR-DRG,540-2,CESAREAN SECTION WITHOUT STERILIZATION,,,6347.35,6778.73,8
APR-DRG,540-3,CESAREAN SECTION WITHOUT STERILIZATION,,,7638.41,8157.52,8
APR-DRG,540-4,CESAREAN SECTION WITHOUT STERILIZATION,,,13470.11,14385.56,8
APR-DRG,541-1,VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C,,,5548.83,5925.93,8
APR-DRG,541-2,VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C,,,6022.85,6432.17,8
APR-DRG,541-3,VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C,,,6990.18,7465.24,8
APR-DRG,541-4,VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C,,,8957.97,9566.77,8
APR-DRG,542-1,VAGINAL DELIVERY WITH O.R. PROCEDURE EXCEPT STERILIZATION AND/OR D&C,,,4541.41,4850.05,8
APR-DRG,542-2,VAGINAL DELIVERY WITH O.R. PROCEDURE EXCEPT STERILIZATION AND/OR D&C,,,5141.08,5490.47,8
APR-DRG,542-3,VAGINAL DELIVERY WITH O.R. PROCEDURE EXCEPT STERILIZATION AND/OR D&C,,,6839.11,7303.9,8
APR-DRG,542-4,VAGINAL DELIVERY WITH O.R. PROCEDURE EXCEPT STERILIZATION AND/OR D&C,,,16831.47,17975.35,8
APR-DRG,543-1,"ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY",,,2912.0,3109.9,8
APR-DRG,543-2,"ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY",,,3867.75,4130.61,8
APR-DRG,543-3,"ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY",,,5014.68,5355.48,8
APR-DRG,543-4,"ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY",,,9387.3,10025.27,8
APR-DRG,547-1,ANTEPARTUM WITH O.R. PROCEDURE,,,4788.84,5114.3,8
APR-DRG,547-2,ANTEPARTUM WITH O.R. PROCEDURE,,,6029.78,6439.58,8
APR-DRG,547-3,ANTEPARTUM WITH O.R. PROCEDURE,,,9530.66,10178.38,8
APR-DRG,547-4,ANTEPARTUM WITH O.R. PROCEDURE,,,16311.97,17420.55,8
APR-DRG,548-1,POSTPARTUM AND POST ABORTION DIAGNOSIS WITH O.R. PROCEDURE,,,3186.39,3402.94,8
APR-DRG,548-2,POSTPARTUM AND POST ABORTION DIAGNOSIS WITH O.R. PROCEDURE,,,5349.19,5712.73,8
APR-DRG,548-3,POSTPARTUM AND POST ABORTION DIAGNOSIS WITH O.R. PROCEDURE,,,10707.64,11435.35,8
APR-DRG,548-4,POSTPARTUM AND POST ABORTION DIAGNOSIS WITH O.R. PROCEDURE,,,22095.12,23596.73,8
APR-DRG,560-1,VAGINAL DELIVERY,,,4095.91,4374.27,8
APR-DRG,560-2,VAGINAL DELIVERY,,,4534.48,4842.65,8
APR-DRG,560-3,VAGINAL DELIVERY,,,5491.78,5865.01,8
APR-DRG,560-4,VAGINAL DELIVERY,,,8110.89,8662.12,8
APR-DRG,561-1,POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT PROCEDURE,,,2131.97,2276.86,8
APR-DRG,561-2,POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT PROCEDURE,,,3068.46,3277.0,8
APR-DRG,561-3,POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT PROCEDURE,,,4324.83,4618.75,8
APR-DRG,561-4,POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT PROCEDURE,,,8292.03,8855.56,8
APR-DRG,564-1,"ABORTION WITHOUT D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY",,,2422.55,2587.19,8
APR-DRG,564-2,"ABORTION WITHOUT D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY",,,3191.01,3407.88,8
APR-DRG,564-3,"ABORTION WITHOUT D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY",,,6459.11,6898.08,8
APR-DRG,564-4,"ABORTION WITHOUT D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY",,,6459.11,6898.08,8
APR-DRG,566-1,ANTEPARTUM WITHOUT O.R. PROCEDURE,,,2463.4,2630.82,8
APR-DRG,566-2,ANTEPARTUM WITHOUT O.R. PROCEDURE,,,3174.06,3389.77,8
APR-DRG,566-3,ANTEPARTUM WITHOUT O.R. PROCEDURE,,,3939.44,4207.17,8
APR-DRG,566-4,ANTEPARTUM WITHOUT O.R. PROCEDURE,,,10196.62,10889.59,8
APR-DRG,580-1,"NEONATE, TRANSFERRED < 5 DAYS OLD, NOT BORN HERE",,,2751.68,2938.68,8
APR-DRG,580-2,"NEONATE, TRANSFERRED < 5 DAYS OLD, NOT BORN HERE",,,2986.76,3189.75,8
APR-DRG,580-3,"NEONATE, TRANSFERRED < 5 DAYS OLD, NOT BORN HERE",,,4522.92,4830.3,8
APR-DRG,580-4,"NEONATE, TRANSFERRED < 5 DAYS OLD, NOT BORN HERE",,,4522.92,4830.3,8
APR-DRG,581-1,"NEONATE, TRANSFERRED < 5 DAYS OLD, BORN HERE",,,835.52,892.3,8
APR-DRG,581-2,"NEONATE, TRANSFERRED < 5 DAYS OLD, BORN HERE",,,1206.26,1288.24,8
APR-DRG,581-3,"NEONATE, TRANSFERRED < 5 DAYS OLD, BORN HERE",,,1362.73,1455.34,8
APR-DRG,581-4,"NEONATE, TRANSFERRED < 5 DAYS OLD, BORN HERE",,,1957.0,2090.0,8
APR-DRG,583-1,NEONATE WITH ECMO,,,292530.23,312410.92,8
APR-DRG,583-2,NEONATE WITH ECMO,,,292530.23,312410.92,8
APR-DRG,583-3,NEONATE WITH ECMO,,,307536.5,328437.04,8
APR-DRG,583-4,NEONATE WITH ECMO,,,307536.5,328437.04,8
APR-DRG,588-1,NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE,,,152759.68,163141.41,8
APR-DRG,588-2,NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE,,,152759.68,163141.41,8
APR-DRG,588-3,NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE,,,160596.18,171510.48,8
APR-DRG,588-4,NEONATE BIRTH WEIGHT < 1500 GRAMS WITH MAJOR PROCEDURE,,,317915.79,339521.72,8
APR-DRG,589-1,"NEONATE BIRTH WEIGHT < 500 GRAMS, OR BIRTH WEIGHT 500-999 GRAMS AND GESTATIONAL AGE <24 WEEKS, OR BIRTH WEIGHT 500-749 GRAMS WITH MAJOR ANOMALY OR WITHOUT LIFE SUSTAINING INTERVENTION",,,66067.22,70557.22,8
APR-DRG,589-2,"NEONATE BIRTH WEIGHT < 500 GRAMS, OR BIRTH WEIGHT 500-999 GRAMS AND GESTATIONAL AGE <24 WEEKS, OR BIRTH WEIGHT 500-749 GRAMS WITH MAJOR ANOMALY OR WITHOUT LIFE SUSTAINING INTERVENTION",,,66067.22,70557.22,8
APR-DRG,589-3,"NEONATE BIRTH WEIGHT < 500 GRAMS, OR BIRTH WEIGHT 500-999 GRAMS AND GESTATIONAL AGE <24 WEEKS, OR BIRTH WEIGHT 500-749 GRAMS WITH MAJOR ANOMALY OR WITHOUT LIFE SUSTAINING INTERVENTION",,,69455.56,74175.84,8
APR-DRG,589-4,"NEONATE BIRTH WEIGHT < 500 GRAMS, OR BIRTH WEIGHT 500-999 GRAMS AND GESTATIONAL AGE <24 WEEKS, OR BIRTH WEIGHT 500-749 GRAMS WITH MAJOR ANOMALY OR WITHOUT LIFE SUSTAINING INTERVENTION",,,69455.56,74175.84,8
APR-DRG,591-1,NEONATE BIRTH WEIGHT 500-749 GRAMS WITHOUT MAJOR PROCEDURE,,,57433.74,61337.0,8
APR-DRG,591-2,NEONATE BIRTH WEIGHT 500-749 GRAMS WITHOUT MAJOR PROCEDURE,,,57433.74,61337.0,8
APR-DRG,591-3,NEONATE BIRTH WEIGHT 500-749 GRAMS WITHOUT MAJOR PROCEDURE,,,76130.49,81304.41,8
APR-DRG,591-4,NEONATE BIRTH WEIGHT 500-749 GRAMS WITHOUT MAJOR PROCEDURE,,,137433.54,146773.68,8
APR-DRG,593-1,NEONATE BIRTH WEIGHT 750-999 GRAMS WITHOUT MAJOR PROCEDURE,,,58602.23,62584.91,8
APR-DRG,593-2,NEONATE BIRTH WEIGHT 750-999 GRAMS WITHOUT MAJOR PROCEDURE,,,58602.23,62584.91,8
APR-DRG,593-3,NEONATE BIRTH WEIGHT 750-999 GRAMS WITHOUT MAJOR PROCEDURE,,,92632.84,98928.28,8
APR-DRG,593-4,NEONATE BIRTH WEIGHT 750-999 GRAMS WITHOUT MAJOR PROCEDURE,,,148041.76,158102.85,8
APR-DRG,602-1,NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY,,,35098.14,37483.45,8
APR-DRG,602-2,NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY,,,59934.91,64008.15,8
APR-DRG,602-3,NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY,,,81917.5,87484.71,8
APR-DRG,602-4,NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY,,,101326.45,108212.71,8
APR-DRG,603-1,NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION,,,25395.59,27121.5,8
APR-DRG,603-2,NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION,,,34927.02,37300.7,8
APR-DRG,603-3,NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION,,,58978.38,62986.62,8
APR-DRG,603-4,NEONATE BIRTH WEIGHT 1000-1249 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION,,,58978.38,62986.62,8
APR-DRG,607-1,NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY,,,36574.18,39059.8,8
APR-DRG,607-2,NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY,,,49211.07,52555.51,8
APR-DRG,607-3,NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY,,,70420.57,75206.44,8
APR-DRG,607-4,NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION OR MAJOR ANOMALY,,,100210.36,107020.77,8
APR-DRG,608-1,NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION,,,23181.91,24757.38,8
APR-DRG,608-2,NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION,,,32147.6,34332.39,8
APR-DRG,608-3,NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION,,,49624.99,52997.56,8
APR-DRG,608-4,NEONATE BIRTH WEIGHT 1250-1499 GRAMS WITH OR WITHOUT SIGNIFICANT CONDITION,,,49624.99,52997.56,8
APR-DRG,609-1,NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE,,,78827.45,84184.65,8
APR-DRG,609-2,NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE,,,78827.45,84184.65,8
APR-DRG,609-3,NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE,,,82871.72,88503.78,8
APR-DRG,609-4,NEONATE BIRTH WEIGHT 1500-2499 GRAMS WITH MAJOR PROCEDURE,,,203903.88,217761.42,8
APR-DRG,611-1,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY,,,13424.63,14336.98,8
APR-DRG,611-2,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY,,,31231.15,33353.65,8
APR-DRG,611-3,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY,,,42461.38,45347.1,8
APR-DRG,611-4,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH MAJOR ANOMALY,,,78558.44,83897.36,8
APR-DRG,612-1,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION,,,25650.71,27393.96,8
APR-DRG,612-2,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION,,,37505.28,40054.18,8
APR-DRG,612-3,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION,,,45745.66,48854.59,8
APR-DRG,612-4,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION,,,73435.86,78426.65,8
APR-DRG,613-1,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION,,,14509.89,15496.0,8
APR-DRG,613-2,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION,,,23877.15,25499.87,8
APR-DRG,613-3,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION,,,25102.69,26808.69,8
APR-DRG,613-4,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH CONGENITAL OR PERINATAL INFECTION,,,25102.69,26808.69,8
APR-DRG,614-1,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION,,,11722.76,12519.45,8
APR-DRG,614-2,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION,,,18258.18,19499.03,8
APR-DRG,614-3,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION,,,36959.56,39471.38,8
APR-DRG,614-4,NEONATE BIRTH WEIGHT 1500-1999 GRAMS WITH OR WITHOUT OTHER SIGNIFICANT CONDITION,,,36959.56,39471.38,8
APR-DRG,621-1,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY,,,5598.15,5978.61,8
APR-DRG,621-2,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY,,,16632.6,17762.98,8
APR-DRG,621-3,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY,,,40455.81,43205.24,8
APR-DRG,621-4,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH MAJOR ANOMALY,,,77139.44,82381.93,8
APR-DRG,622-1,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION,,,14852.12,15861.48,8
APR-DRG,622-2,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION,,,23815.48,25434.01,8
APR-DRG,622-3,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION,,,25037.17,26738.72,8
APR-DRG,622-4,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION,,,48891.21,52213.91,8
APR-DRG,623-1,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION,,,10817.09,11552.23,8
APR-DRG,623-2,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION,,,16745.92,17883.99,8
APR-DRG,623-3,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION,,,17605.33,18801.81,8
APR-DRG,623-4,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION,,,17605.33,18801.81,8
APR-DRG,625-1,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION,,,9844.37,10513.4,8
APR-DRG,625-2,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION,,,15081.03,16105.96,8
APR-DRG,625-3,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION,,,15854.12,16931.59,8
APR-DRG,625-4,NEONATE BIRTH WEIGHT 2000-2499 GRAMS WITH OTHER SIGNIFICANT CONDITION,,,15854.12,16931.59,8
APR-DRG,626-1,"NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM",,,2013.27,2150.09,8
APR-DRG,626-2,"NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM",,,2252.98,2406.1,8
APR-DRG,626-3,"NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM",,,7482.7,7991.24,8
APR-DRG,626-4,"NEONATE BIRTH WEIGHT 2000-2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM",,,7482.7,7991.24,8
APR-DRG,630-1,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE,,,57273.42,61165.79,8
APR-DRG,630-2,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE,,,57273.42,61165.79,8
APR-DRG,630-3,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE,,,87408.52,93348.9,8
APR-DRG,630-4,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR CARDIOVASCULAR PROCEDURE,,,197887.18,211335.83,8
APR-DRG,631-1,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER MAJOR PROCEDURE,,,33973.57,36282.46,8
APR-DRG,631-2,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER MAJOR PROCEDURE,,,33973.57,36282.46,8
APR-DRG,631-3,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER MAJOR PROCEDURE,,,66290.74,70795.93,8
APR-DRG,631-4,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER MAJOR PROCEDURE,,,174671.36,186542.22,8
APR-DRG,633-1,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY,,,2320.81,2478.53,8
APR-DRG,633-2,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY,,,9489.81,10134.75,8
APR-DRG,633-3,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY,,,31036.14,33145.39,8
APR-DRG,633-4,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH MAJOR ANOMALY,,,85223.36,91015.24,8
APR-DRG,634-1,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION,,,6213.24,6635.5,8
APR-DRG,634-2,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION,,,12911.3,13788.76,8
APR-DRG,634-3,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION,,,16237.2,17340.7,8
APR-DRG,634-4,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH RESPIRATORY DISTRESS SYNDROME OR OTHER MAJOR RESPIRATORY CONDITION,,,49477.77,52840.34,8
APR-DRG,636-1,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION,,,5692.96,6079.87,8
APR-DRG,636-2,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION,,,7421.05,7925.39,8
APR-DRG,636-3,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION,,,20328.49,21710.04,8
APR-DRG,636-4,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH CONGENITAL OR PERINATAL INFECTION,,,20328.49,21710.04,8
APR-DRG,639-1,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER SIGNIFICANT CONDITION,,,5852.51,6250.26,8
APR-DRG,639-2,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER SIGNIFICANT CONDITION,,,11178.59,11938.3,8
APR-DRG,639-3,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER SIGNIFICANT CONDITION,,,24382.01,26039.04,8
APR-DRG,639-4,NEONATE BIRTH WEIGHT > 2499 GRAMS WITH OTHER SIGNIFICANT CONDITION,,,24382.01,26039.04,8
APR-DRG,640-1,"NEONATE BIRTH WEIGHT > 2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM",,,1555.42,1661.13,8
APR-DRG,640-2,"NEONATE BIRTH WEIGHT > 2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM",,,1894.57,2023.33,8
APR-DRG,640-3,"NEONATE BIRTH WEIGHT > 2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM",,,3613.4,3858.98,8
APR-DRG,640-4,"NEONATE BIRTH WEIGHT > 2499 GRAMS, NORMAL NEWBORN OR NEONATE WITH OTHER PROBLEM",,,3613.4,3858.98,8
APR-DRG,650-1,SPLENIC PROCEDURES,,,9744.17,10406.4,8
APR-DRG,650-2,SPLENIC PROCEDURES,,,12054.96,12874.22,8
APR-DRG,650-3,SPLENIC PROCEDURES,,,19212.4,20518.1,8
APR-DRG,650-4,SPLENIC PROCEDURES,,,19290.25,20601.24,8
APR-DRG,651-1,OTHER PROCEDURES OF BLOOD AND BLOOD-FORMING ORGANS,,,6476.07,6916.2,8
APR-DRG,651-2,OTHER PROCEDURES OF BLOOD AND BLOOD-FORMING ORGANS,,,9541.46,10189.91,8
APR-DRG,651-3,OTHER PROCEDURES OF BLOOD AND BLOOD-FORMING ORGANS,,,13426.95,14339.46,8
APR-DRG,651-4,OTHER PROCEDURES OF BLOOD AND BLOOD-FORMING ORGANS,,,13426.95,14339.46,8
APR-DRG,660-1,MAJOR HEMATOLOGIC OR IMMUNOLOGIC DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION,,,6227.88,6651.14,8
APR-DRG,660-2,MAJOR HEMATOLOGIC OR IMMUNOLOGIC DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION,,,7268.43,7762.4,8
APR-DRG,660-3,MAJOR HEMATOLOGIC OR IMMUNOLOGIC DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION,,,11028.28,11777.78,8
APR-DRG,660-4,MAJOR HEMATOLOGIC OR IMMUNOLOGIC DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION,,,46721.47,49896.72,8
APR-DRG,661-1,COAGULATION AND PLATELET DISORDERS,,,6705.76,7161.5,8
APR-DRG,661-2,COAGULATION AND PLATELET DISORDERS,,,7962.9,8504.07,8
APR-DRG,661-3,COAGULATION AND PLATELET DISORDERS,,,14674.06,15671.33,8
APR-DRG,661-4,COAGULATION AND PLATELET DISORDERS,,,27976.92,29878.27,8
APR-DRG,662-1,SICKLE CELL ANEMIA CRISIS,,,5571.95,5950.63,8
APR-DRG,662-2,SICKLE CELL ANEMIA CRISIS,,,7262.26,7755.81,8
APR-DRG,662-3,SICKLE CELL ANEMIA CRISIS,,,9137.56,9758.56,8
APR-DRG,662-4,SICKLE CELL ANEMIA CRISIS,,,15058.68,16082.09,8
APR-DRG,663-1,OTHER ANEMIA AND DISORDERS OF BLOOD AND BLOOD-FORMING ORGANS,,,3971.04,4240.92,8
APR-DRG,663-2,OTHER ANEMIA AND DISORDERS OF BLOOD AND BLOOD-FORMING ORGANS,,,5022.38,5363.71,8
APR-DRG,663-3,OTHER ANEMIA AND DISORDERS OF BLOOD AND BLOOD-FORMING ORGANS,,,7433.38,7938.56,8
APR-DRG,663-4,OTHER ANEMIA AND DISORDERS OF BLOOD AND BLOOD-FORMING ORGANS,,,13150.24,14043.94,8
APR-DRG,680-1,"MAJOR O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS",,,10144.2,10833.61,8
APR-DRG,680-2,"MAJOR O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS",,,13777.65,14714.0,8
APR-DRG,680-3,"MAJOR O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS",,,23766.16,25381.33,8
APR-DRG,680-4,"MAJOR O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS",,,40493.57,43245.57,8
APR-DRG,681-1,"OTHER  O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS",,,7788.71,8318.04,8
APR-DRG,681-2,"OTHER  O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS",,,12828.83,13700.69,8
APR-DRG,681-3,"OTHER  O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS",,,22689.39,24231.38,8
APR-DRG,681-4,"OTHER  O.R. PROCEDURES FOR LYMPHATIC, HEMATOPOIETIC OR OTHER NEOPLASMS",,,60677.94,64801.68,8
APR-DRG,690-1,ACUTE LEUKEMIA,,,21846.16,23330.85,8
APR-DRG,690-2,ACUTE LEUKEMIA,,,21846.16,23330.85,8
APR-DRG,690-3,ACUTE LEUKEMIA,,,43669.19,46637.0,8
APR-DRG,690-4,ACUTE LEUKEMIA,,,68921.41,73605.39,8
APR-DRG,691-1,"LYMPHOMA, MYELOMA AND NON-ACUTE LEUKEMIA",,,7838.03,8370.71,8
APR-DRG,691-2,"LYMPHOMA, MYELOMA AND NON-ACUTE LEUKEMIA",,,9425.07,10065.61,8
APR-DRG,691-3,"LYMPHOMA, MYELOMA AND NON-ACUTE LEUKEMIA",,,16354.36,17465.82,8
APR-DRG,691-4,"LYMPHOMA, MYELOMA AND NON-ACUTE LEUKEMIA",,,28027.02,29931.77,8
APR-DRG,692-1,RADIOTHERAPY,,,9733.38,10394.87,8
APR-DRG,692-2,RADIOTHERAPY,,,9733.38,10394.87,8
APR-DRG,692-3,RADIOTHERAPY,,,9733.38,10394.87,8
APR-DRG,692-4,RADIOTHERAPY,,,22002.62,23497.95,8
APR-DRG,694-1,LYMPHATIC AND OTHER MALIGNANCIES AND NEOPLASMS OF UNCERTAIN BEHAVIOR,,,4633.14,4948.01,8
APR-DRG,694-2,LYMPHATIC AND OTHER MALIGNANCIES AND NEOPLASMS OF UNCERTAIN BEHAVIOR,,,5321.44,5683.1,8
APR-DRG,694-3,LYMPHATIC AND OTHER MALIGNANCIES AND NEOPLASMS OF UNCERTAIN BEHAVIOR,,,10223.59,10918.4,8
APR-DRG,694-4,LYMPHATIC AND OTHER MALIGNANCIES AND NEOPLASMS OF UNCERTAIN BEHAVIOR,,,18177.24,19412.59,8
APR-DRG,695-1,CHEMOTHERAPY FOR ACUTE LEUKEMIA,,,7613.74,8131.18,8
APR-DRG,695-2,CHEMOTHERAPY FOR ACUTE LEUKEMIA,,,7613.74,8131.18,8
APR-DRG,695-3,CHEMOTHERAPY FOR ACUTE LEUKEMIA,,,20969.78,22394.91,8
APR-DRG,695-4,CHEMOTHERAPY FOR ACUTE LEUKEMIA,,,60331.86,64432.08,8
APR-DRG,696-1,OTHER CHEMOTHERAPY,,,6893.06,7361.52,8
APR-DRG,696-2,OTHER CHEMOTHERAPY,,,9156.06,9778.32,8
APR-DRG,696-3,OTHER CHEMOTHERAPY,,,15902.69,16983.45,8
APR-DRG,696-4,OTHER CHEMOTHERAPY,,,31032.28,33141.27,8
APR-DRG,710-1,INFECTIOUS AND PARASITIC DISEASES INCLUDING HIV WITH O.R. PROCEDURE,,,5617.42,5999.19,8
APR-DRG,710-2,INFECTIOUS AND PARASITIC DISEASES INCLUDING HIV WITH O.R. PROCEDURE,,,8729.83,9323.12,8
APR-DRG,710-3,INFECTIOUS AND PARASITIC DISEASES INCLUDING HIV WITH O.R. PROCEDURE,,,14947.69,15963.55,8
APR-DRG,710-4,INFECTIOUS AND PARASITIC DISEASES INCLUDING HIV WITH O.R. PROCEDURE,,,35463.49,37873.63,8
APR-DRG,711-1,"POST-OPERATIVE, POST-TRAUMA, OTHER DEVICE INFECTIONS WITH O.R. PROCEDURE",,,7664.61,8185.51,8
APR-DRG,711-2,"POST-OPERATIVE, POST-TRAUMA, OTHER DEVICE INFECTIONS WITH O.R. PROCEDURE",,,10203.55,10897.0,8
APR-DRG,711-3,"POST-OPERATIVE, POST-TRAUMA, OTHER DEVICE INFECTIONS WITH O.R. PROCEDURE",,,17593.77,18789.46,8
APR-DRG,711-4,"POST-OPERATIVE, POST-TRAUMA, OTHER DEVICE INFECTIONS WITH O.R. PROCEDURE",,,34594.82,36945.92,8
APR-DRG,720-1,SEPTICEMIA AND DISSEMINATED INFECTIONS,,,3775.27,4031.84,8
APR-DRG,720-2,SEPTICEMIA AND DISSEMINATED INFECTIONS,,,4873.62,5204.84,8
APR-DRG,720-3,SEPTICEMIA AND DISSEMINATED INFECTIONS,,,7746.31,8272.76,8
APR-DRG,720-4,SEPTICEMIA AND DISSEMINATED INFECTIONS,,,15732.34,16801.53,8
APR-DRG,721-1,"POST-OPERATIVE, POST-TRAUMATIC, OTHER DEVICE INFECTIONS",,,4897.52,5230.36,8
APR-DRG,721-2,"POST-OPERATIVE, POST-TRAUMATIC, OTHER DEVICE INFECTIONS",,,5930.36,6333.39,8
APR-DRG,721-3,"POST-OPERATIVE, POST-TRAUMATIC, OTHER DEVICE INFECTIONS",,,9772.69,10436.86,8
APR-DRG,721-4,"POST-OPERATIVE, POST-TRAUMATIC, OTHER DEVICE INFECTIONS",,,18689.04,19959.17,8
APR-DRG,722-1,FEVER AND INFLAMMATORY CONDITIONS,,,3742.12,3996.44,8
APR-DRG,722-2,FEVER AND INFLAMMATORY CONDITIONS,,,4945.31,5281.4,8
APR-DRG,722-3,FEVER AND INFLAMMATORY CONDITIONS,,,7491.95,8001.11,8
APR-DRG,722-4,FEVER AND INFLAMMATORY CONDITIONS,,,11580.16,12367.16,8
APR-DRG,723-1,VIRAL ILLNESS,,,4038.87,4313.35,8
APR-DRG,723-2,VIRAL ILLNESS,,,4768.8,5092.89,8
APR-DRG,723-3,VIRAL ILLNESS,,,12192.16,13020.76,8
APR-DRG,723-4,VIRAL ILLNESS,,,12192.16,13020.76,8
APR-DRG,724-1,OTHER INFECTIOUS AND PARASITIC DISEASES,,,5319.9,5681.45,8
APR-DRG,724-2,OTHER INFECTIOUS AND PARASITIC DISEASES,,,6413.63,6849.51,8
APR-DRG,724-3,OTHER INFECTIOUS AND PARASITIC DISEASES,,,10644.43,11367.84,8
APR-DRG,724-4,OTHER INFECTIOUS AND PARASITIC DISEASES,,,16315.82,17424.66,8
APR-DRG,740-1,MENTAL ILLNESS DIAGNOSIS WITH O.R. PROCEDURE,,,13837.0,14777.38,8
APR-DRG,740-2,MENTAL ILLNESS DIAGNOSIS WITH O.R. PROCEDURE,,,21643.44,23114.36,8
APR-DRG,740-3,MENTAL ILLNESS DIAGNOSIS WITH O.R. PROCEDURE,,,21643.44,23114.36,8
APR-DRG,740-4,MENTAL ILLNESS DIAGNOSIS WITH O.R. PROCEDURE,,,21643.44,23114.36,8
APR-DRG,750-1,SCHIZOPHRENIA AND OTHER SEVERE PSYCHOTIC DISORDERS,,,9725.67,10386.64,8
APR-DRG,750-2,SCHIZOPHRENIA AND OTHER SEVERE PSYCHOTIC DISORDERS,,,9725.67,10386.64,8
APR-DRG,750-3,SCHIZOPHRENIA AND OTHER SEVERE PSYCHOTIC DISORDERS,,,15763.94,16835.28,8
APR-DRG,750-4,SCHIZOPHRENIA AND OTHER SEVERE PSYCHOTIC DISORDERS,,,37067.48,39586.62,8
APR-DRG,751-1,DEPRESSIVE DISORDERS,,,5575.8,5954.74,8
APR-DRG,751-2,DEPRESSIVE DISORDERS,,,6306.49,6735.09,8
APR-DRG,751-3,DEPRESSIVE DISORDERS,,,10296.04,10995.78,8
APR-DRG,751-4,DEPRESSIVE DISORDERS,,,26709.76,28524.99,8
APR-DRG,752-1,PERSONALITY DISORDERS,,,8117.83,8669.53,8
APR-DRG,752-2,PERSONALITY DISORDERS,,,8117.83,8669.53,8
APR-DRG,752-3,PERSONALITY DISORDERS,,,8117.83,8669.53,8
APR-DRG,752-4,PERSONALITY DISORDERS,,,8117.83,8669.53,8
APR-DRG,753-1,BIPOLAR DISORDERS,,,6063.7,6475.8,8
APR-DRG,753-2,BIPOLAR DISORDERS,,,6798.26,7260.28,8
APR-DRG,753-3,BIPOLAR DISORDERS,,,10129.56,10817.97,8
APR-DRG,753-4,BIPOLAR DISORDERS,,,26362.91,28154.57,8
APR-DRG,755-1,ADJUSTMENT DISORDERS,,,6489.95,6931.01,8
APR-DRG,755-2,ADJUSTMENT DISORDERS,,,8649.66,9237.5,8
APR-DRG,755-3,ADJUSTMENT DISORDERS,,,11979.43,12793.56,8
APR-DRG,755-4,ADJUSTMENT DISORDERS,,,11979.43,12793.56,8
APR-DRG,756-1,ACUTE ANXIETY AND STRESS SYNDROMES,,,6658.74,7111.28,8
APR-DRG,756-2,ACUTE ANXIETY AND STRESS SYNDROMES,,,7647.66,8167.4,8
APR-DRG,756-3,ACUTE ANXIETY AND STRESS SYNDROMES,,,8669.71,9258.91,8
APR-DRG,756-4,ACUTE ANXIETY AND STRESS SYNDROMES,,,11167.8,11926.77,8
APR-DRG,757-1,ORGANIC MENTAL HEALTH CONDITIONS AND DISTURBANCES,,,13027.68,13913.05,8
APR-DRG,757-2,ORGANIC MENTAL HEALTH CONDITIONS AND DISTURBANCES,,,15528.08,16583.39,8
APR-DRG,757-3,ORGANIC MENTAL HEALTH CONDITIONS AND DISTURBANCES,,,15528.08,16583.39,8
APR-DRG,757-4,ORGANIC MENTAL HEALTH CONDITIONS AND DISTURBANCES,,,15528.08,16583.39,8
APR-DRG,758-1,DISORDERS OF IMPULSE CONTROL & DEVELOPMENT,,,11997.15,12812.49,8
APR-DRG,758-2,DISORDERS OF IMPULSE CONTROL & DEVELOPMENT,,,17677.79,18879.19,8
APR-DRG,758-3,DISORDERS OF IMPULSE CONTROL & DEVELOPMENT,,,28384.66,30313.71,8
APR-DRG,758-4,DISORDERS OF IMPULSE CONTROL & DEVELOPMENT,,,28602.79,30546.67,8
APR-DRG,759-1,EATING DISORDERS,,,15277.58,16315.86,8
APR-DRG,759-2,EATING DISORDERS,,,15277.58,16315.86,8
APR-DRG,759-3,EATING DISORDERS,,,18651.28,19918.84,8
APR-DRG,759-4,EATING DISORDERS,,,18651.28,19918.84,8
APR-DRG,760-1,OTHER MENTAL HEALTH CONDITIONS AND DISORDERS,,,10427.84,11136.53,8
APR-DRG,760-2,OTHER MENTAL HEALTH CONDITIONS AND DISORDERS,,,11616.39,12405.86,8
APR-DRG,760-3,OTHER MENTAL HEALTH CONDITIONS AND DISORDERS,,,19143.81,20444.84,8
APR-DRG,760-4,OTHER MENTAL HEALTH CONDITIONS AND DISORDERS,,,19143.81,20444.84,8
APR-DRG,761-1,SCHIZOAFFECTIVE DISORDERS,,,11212.5,11974.51,8
APR-DRG,761-2,SCHIZOAFFECTIVE DISORDERS,,,10035.53,10717.55,8
APR-DRG,761-3,SCHIZOAFFECTIVE DISORDERS,,,16703.52,17838.71,8
APR-DRG,761-4,SCHIZOAFFECTIVE DISORDERS,,,19785.09,21129.71,8
APR-DRG,762-1,OBSESSIVE COMPULSIVE DISORDERS,,,12455.0,13301.45,8
APR-DRG,762-2,OBSESSIVE COMPULSIVE DISORDERS,,,11071.45,11823.88,8
APR-DRG,762-3,OBSESSIVE COMPULSIVE DISORDERS,,,18718.33,19990.45,8
APR-DRG,762-4,OBSESSIVE COMPULSIVE DISORDERS,,,18718.33,19990.45,8
APR-DRG,770-1,"DRUG AND ALCOHOL ABUSE OR DEPENDENCE, LEFT AGAINST MEDICAL ADVICE",,,3017.59,3222.67,8
APR-DRG,770-2,"DRUG AND ALCOHOL ABUSE OR DEPENDENCE, LEFT AGAINST MEDICAL ADVICE",,,4103.61,4382.5,8
APR-DRG,770-3,"DRUG AND ALCOHOL ABUSE OR DEPENDENCE, LEFT AGAINST MEDICAL ADVICE",,,7124.29,7608.47,8
APR-DRG,770-4,"DRUG AND ALCOHOL ABUSE OR DEPENDENCE, LEFT AGAINST MEDICAL ADVICE",,,14585.43,15576.67,8
APR-DRG,772-1,ALCOHOL AND DRUG DEPENDENCE WITH REHABILITATION AND/OR DETOXIFICATION THERAPY,,,3682.78,3933.06,8
APR-DRG,772-2,ALCOHOL AND DRUG DEPENDENCE WITH REHABILITATION AND/OR DETOXIFICATION THERAPY,,,3899.36,4164.37,8
APR-DRG,772-3,ALCOHOL AND DRUG DEPENDENCE WITH REHABILITATION AND/OR DETOXIFICATION THERAPY,,,5500.26,5874.07,8
APR-DRG,772-4,ALCOHOL AND DRUG DEPENDENCE WITH REHABILITATION AND/OR DETOXIFICATION THERAPY,,,5500.26,5874.07,8
APR-DRG,773-1,OPIOID ABUSE AND DEPENDENCE,,,4628.51,4943.07,8
APR-DRG,773-2,OPIOID ABUSE AND DEPENDENCE,,,5017.76,5358.77,8
APR-DRG,773-3,OPIOID ABUSE AND DEPENDENCE,,,8858.55,9460.58,8
APR-DRG,773-4,OPIOID ABUSE AND DEPENDENCE,,,17688.57,18890.71,8
APR-DRG,774-1,COCAINE ABUSE AND DEPENDENCE,,,4976.91,5315.15,8
APR-DRG,774-2,COCAINE ABUSE AND DEPENDENCE,,,5287.54,5646.88,8
APR-DRG,774-3,COCAINE ABUSE AND DEPENDENCE,,,8528.65,9108.26,8
APR-DRG,774-4,COCAINE ABUSE AND DEPENDENCE,,,16157.04,17255.1,8
APR-DRG,775-1,ALCOHOL ABUSE AND DEPENDENCE,,,4855.89,5185.91,8
APR-DRG,775-2,ALCOHOL ABUSE AND DEPENDENCE,,,6393.6,6828.12,8
APR-DRG,775-3,ALCOHOL ABUSE AND DEPENDENCE,,,9933.78,10608.9,8
APR-DRG,775-4,ALCOHOL ABUSE AND DEPENDENCE,,,20613.68,22014.61,8
APR-DRG,776-1,OTHER DRUG ABUSE AND DEPENDENCE,,,6674.16,7127.75,8
APR-DRG,776-2,OTHER DRUG ABUSE AND DEPENDENCE,,,6674.16,7127.75,8
APR-DRG,776-3,OTHER DRUG ABUSE AND DEPENDENCE,,,9891.39,10563.62,8
APR-DRG,776-4,OTHER DRUG ABUSE AND DEPENDENCE,,,9891.39,10563.62,8
APR-DRG,792-1,EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT,,,11170.1,11929.24,8
APR-DRG,792-2,EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT,,,12501.24,13350.84,8
APR-DRG,792-3,EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT,,,22276.24,23790.16,8
APR-DRG,792-4,EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT,,,55687.16,59471.72,8
APR-DRG,793-1,MODERATELY EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT,,,7500.43,8010.17,8
APR-DRG,793-2,MODERATELY EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT,,,10612.06,11333.27,8
APR-DRG,793-3,MODERATELY EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT,,,15908.84,16990.03,8
APR-DRG,793-4,MODERATELY EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT,,,26688.18,28501.94,8
APR-DRG,794-1,NON-EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT,,,5874.86,6274.13,8
APR-DRG,794-2,NON-EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT,,,7927.45,8466.21,8
APR-DRG,794-3,NON-EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT,,,12238.41,13070.15,8
APR-DRG,794-4,NON-EXTENSIVE O.R. PROCEDURES FOR OTHER COMPLICATIONS OF TREATMENT,,,24647.16,26322.21,8
APR-DRG,810-1,HEMORRHAGE OR HEMATOMA DUE TO COMPLICATION,,,3708.98,3961.05,8
APR-DRG,810-2,HEMORRHAGE OR HEMATOMA DUE TO COMPLICATION,,,5220.47,5575.26,8
APR-DRG,810-3,HEMORRHAGE OR HEMATOMA DUE TO COMPLICATION,,,8265.05,8826.75,8
APR-DRG,810-4,HEMORRHAGE OR HEMATOMA DUE TO COMPLICATION,,,16281.91,17388.45,8
APR-DRG,811-1,ALLERGIC REACTIONS,,,2950.53,3151.05,8
APR-DRG,811-2,ALLERGIC REACTIONS,,,3739.03,3993.14,8
APR-DRG,811-3,ALLERGIC REACTIONS,,,6440.61,6878.32,8
APR-DRG,811-4,ALLERGIC REACTIONS,,,12024.9,12842.13,8
APR-DRG,812-1,POISONING OF MEDICINAL AGENTS,,,2827.21,3019.35,8
APR-DRG,812-2,POISONING OF MEDICINAL AGENTS,,,3645.78,3893.55,8
APR-DRG,812-3,POISONING OF MEDICINAL AGENTS,,,4867.46,5198.26,8
APR-DRG,812-4,POISONING OF MEDICINAL AGENTS,,,8587.23,9170.83,8
APR-DRG,813-1,OTHER COMPLICATIONS OF TREATMENT,,,4472.82,4776.79,8
APR-DRG,813-2,OTHER COMPLICATIONS OF TREATMENT,,,5480.23,5852.67,8
APR-DRG,813-3,OTHER COMPLICATIONS OF TREATMENT,,,7852.68,8386.36,8
APR-DRG,813-4,OTHER COMPLICATIONS OF TREATMENT,,,13722.15,14654.73,8
APR-DRG,815-1,"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES",,,4118.26,4398.14,8
APR-DRG,815-2,"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES",,,6378.18,6811.65,8
APR-DRG,815-3,"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES",,,12678.52,13540.16,8
APR-DRG,815-4,"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES",,,27952.25,29851.92,8
APR-DRG,816-1,TOXIC EFFECTS OF NON-MEDICINAL SUBSTANCES,,,2935.12,3134.59,8
APR-DRG,816-2,TOXIC EFFECTS OF NON-MEDICINAL SUBSTANCES,,,3984.92,4255.74,8
APR-DRG,816-3,TOXIC EFFECTS OF NON-MEDICINAL SUBSTANCES,,,4741.05,5063.26,8
APR-DRG,816-4,TOXIC EFFECTS OF NON-MEDICINAL SUBSTANCES,,,9097.49,9715.76,8
APR-DRG,817-1,INTENTIONAL SELF-HARM AND ATTEMPTED SUICIDE,,,3452.31,3686.94,8
APR-DRG,817-2,INTENTIONAL SELF-HARM AND ATTEMPTED SUICIDE,,,4670.13,4987.52,8
APR-DRG,817-3,INTENTIONAL SELF-HARM AND ATTEMPTED SUICIDE,,,6063.7,6475.8,8
APR-DRG,817-4,INTENTIONAL SELF-HARM AND ATTEMPTED SUICIDE,,,10248.25,10944.74,8
APR-DRG,841-1,EXTENSIVE THIRD DEGREE BURNS WITH SKIN GRAFT,,,181116.6,193425.5,8
APR-DRG,841-2,EXTENSIVE THIRD DEGREE BURNS WITH SKIN GRAFT,,,181116.6,193425.5,8
APR-DRG,841-3,EXTENSIVE THIRD DEGREE BURNS WITH SKIN GRAFT,,,181116.6,193425.5,8
APR-DRG,841-4,EXTENSIVE THIRD DEGREE BURNS WITH SKIN GRAFT,,,181116.6,193425.5,8
APR-DRG,842-1,BURNS WITH SKIN GRAFT EXCEPT EXTENSIVE THIRD DEGREE BURNS,,,17488.17,18676.69,8
APR-DRG,842-2,BURNS WITH SKIN GRAFT EXCEPT EXTENSIVE THIRD DEGREE BURNS,,,22796.52,24345.79,8
APR-DRG,842-3,BURNS WITH SKIN GRAFT EXCEPT EXTENSIVE THIRD DEGREE BURNS,,,39738.21,42438.87,8
APR-DRG,842-4,BURNS WITH SKIN GRAFT EXCEPT EXTENSIVE THIRD DEGREE BURNS,,,75622.55,80761.95,8
APR-DRG,843-1,EXTENSIVE THIRD DEGREE BURNS WITHOUT SKIN GRAFT,,,6941.62,7413.38,8
APR-DRG,843-2,EXTENSIVE THIRD DEGREE BURNS WITHOUT SKIN GRAFT,,,7180.56,7668.56,8
APR-DRG,843-3,EXTENSIVE THIRD DEGREE BURNS WITHOUT SKIN GRAFT,,,13763.0,14698.35,8
APR-DRG,843-4,EXTENSIVE THIRD DEGREE BURNS WITHOUT SKIN GRAFT,,,13763.0,14698.35,8
APR-DRG,844-1,PARTIAL THICKNESS BURNS WITHOUT SKIN GRAFT,,,4128.28,4408.84,8
APR-DRG,844-2,PARTIAL THICKNESS BURNS WITHOUT SKIN GRAFT,,,7206.77,7696.55,8
APR-DRG,844-3,PARTIAL THICKNESS BURNS WITHOUT SKIN GRAFT,,,10931.94,11674.88,8
APR-DRG,844-4,PARTIAL THICKNESS BURNS WITHOUT SKIN GRAFT,,,10931.94,11674.88,8
APR-DRG,850-1,"PROCEDURE WITH DIAGNOSIS OF REHABILITATION, AFTERCARE OR OTHER CONTACT WITH HEALTH SERVICES",,,13598.83,14523.03,8
APR-DRG,850-2,"PROCEDURE WITH DIAGNOSIS OF REHABILITATION, AFTERCARE OR OTHER CONTACT WITH HEALTH SERVICES",,,17130.53,18294.74,8
APR-DRG,850-3,"PROCEDURE WITH DIAGNOSIS OF REHABILITATION, AFTERCARE OR OTHER CONTACT WITH HEALTH SERVICES",,,33861.03,36162.27,8
APR-DRG,850-4,"PROCEDURE WITH DIAGNOSIS OF REHABILITATION, AFTERCARE OR OTHER CONTACT WITH HEALTH SERVICES",,,86183.75,92040.89,8
APR-DRG,851-1,GENDER RELATED PROCEDURES,,,15333.07,16375.13,8
APR-DRG,851-2,GENDER RELATED PROCEDURES,,,20043.31,21405.47,8
APR-DRG,851-3,GENDER RELATED PROCEDURES,,,26144.78,27921.61,8
APR-DRG,851-4,GENDER RELATED PROCEDURES,,,83405.09,89073.4,8
APR-DRG,860-1,REHABILITATION,,,12737.87,13603.55,8
APR-DRG,860-2,REHABILITATION,,,15723.87,16792.48,8
APR-DRG,860-3,REHABILITATION,,,20377.05,21761.89,8
APR-DRG,860-4,REHABILITATION,,,24696.49,26374.89,8
APR-DRG,861-1,"SIGNS, SYMPTOMS AND OTHER FACTORS INFLUENCING HEALTH STATUS",,,4366.45,4663.2,8
APR-DRG,861-2,"SIGNS, SYMPTOMS AND OTHER FACTORS INFLUENCING HEALTH STATUS",,,5370.01,5734.96,8
APR-DRG,861-3,"SIGNS, SYMPTOMS AND OTHER FACTORS INFLUENCING HEALTH STATUS",,,8685.11,9275.37,8
APR-DRG,861-4,"SIGNS, SYMPTOMS AND OTHER FACTORS INFLUENCING HEALTH STATUS",,,10443.26,11153.0,8
APR-DRG,862-1,OTHER AFTERCARE AND CONVALESCENCE,,,9368.8,10005.51,8
APR-DRG,862-2,OTHER AFTERCARE AND CONVALESCENCE,,,11555.5,12340.82,8
APR-DRG,862-3,OTHER AFTERCARE AND CONVALESCENCE,,,16258.79,17363.75,8
APR-DRG,862-4,OTHER AFTERCARE AND CONVALESCENCE,,,31123.23,33238.4,8
APR-DRG,863-1,NEONATAL AFTERCARE,,,7203.69,7693.26,8
APR-DRG,863-2,NEONATAL AFTERCARE,,,29142.34,31122.88,8
APR-DRG,863-3,NEONATAL AFTERCARE,,,52292.65,55846.52,8
APR-DRG,863-4,NEONATAL AFTERCARE,,,69215.07,73919.01,8
APR-DRG,890-1,HIV WITH MULTIPLE MAJOR HIV RELATED CONDITIONS,,,5581.97,5961.33,8
APR-DRG,890-2,HIV WITH MULTIPLE MAJOR HIV RELATED CONDITIONS,,,5581.97,5961.33,8
APR-DRG,890-3,HIV WITH MULTIPLE MAJOR HIV RELATED CONDITIONS,,,9896.79,10569.38,8
APR-DRG,890-4,HIV WITH MULTIPLE MAJOR HIV RELATED CONDITIONS,,,17438.08,18623.19,8
APR-DRG,894-1,HIV WITH ONE SIGNIFICANT HIV CONDITION OR WITHOUT SIGNIFICANT RELATED CONDITIONS,,,3747.52,4002.21,8
APR-DRG,894-2,HIV WITH ONE SIGNIFICANT HIV CONDITION OR WITHOUT SIGNIFICANT RELATED CONDITIONS,,,5067.09,5411.45,8
APR-DRG,894-3,HIV WITH ONE SIGNIFICANT HIV CONDITION OR WITHOUT SIGNIFICANT RELATED CONDITIONS,,,6936.23,7407.62,8
APR-DRG,894-4,HIV WITH ONE SIGNIFICANT HIV CONDITION OR WITHOUT SIGNIFICANT RELATED CONDITIONS,,,6936.23,7407.62,8
APR-DRG,910-1,CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA,,,11582.47,12369.63,8
APR-DRG,910-2,CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA,,,11582.47,12369.63,8
APR-DRG,910-3,CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA,,,29835.27,31862.91,8
APR-DRG,910-4,CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA,,,49206.45,52550.58,8
APR-DRG,911-1,EXTENSIVE ABDOMINAL OR THORACIC PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA,,,11491.52,12272.5,8
APR-DRG,911-2,EXTENSIVE ABDOMINAL OR THORACIC PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA,,,11491.52,12272.5,8
APR-DRG,911-3,EXTENSIVE ABDOMINAL OR THORACIC PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA,,,15054.83,16077.97,8
APR-DRG,911-4,EXTENSIVE ABDOMINAL OR THORACIC PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA,,,42279.47,45152.83,8
APR-DRG,912-1,MUSCULOSKELETAL AND OTHER PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA,,,12901.28,13778.06,8
APR-DRG,912-2,MUSCULOSKELETAL AND OTHER PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA,,,12901.28,13778.06,8
APR-DRG,912-3,MUSCULOSKELETAL AND OTHER PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA,,,20955.91,22380.09,8
APR-DRG,912-4,MUSCULOSKELETAL AND OTHER PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA,,,38141.17,40733.29,8
APR-DRG,930-1,MULTIPLE SIGNIFICANT TRAUMA WITHOUT O.R. PROCEDURE,,,2914.3,3112.36,8
APR-DRG,930-2,MULTIPLE SIGNIFICANT TRAUMA WITHOUT O.R. PROCEDURE,,,4926.04,5260.82,8
APR-DRG,930-3,MULTIPLE SIGNIFICANT TRAUMA WITHOUT O.R. PROCEDURE,,,7723.96,8248.89,8
APR-DRG,930-4,MULTIPLE SIGNIFICANT TRAUMA WITHOUT O.R. PROCEDURE,,,24170.81,25813.49,8
APR-DRG,950-1,EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,,,11167.02,11925.95,8
APR-DRG,950-2,EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,,,14895.27,15907.57,8
APR-DRG,950-3,EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,,,22903.66,24460.22,8
APR-DRG,950-4,EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,,,54117.08,57794.94,8
APR-DRG,951-1,MODERATELY EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,,,7106.57,7589.54,8
APR-DRG,951-2,MODERATELY EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,,,9069.74,9686.13,8
APR-DRG,951-3,MODERATELY EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,,,16543.2,17667.5,8
APR-DRG,951-4,MODERATELY EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,,,35609.93,38030.03,8
APR-DRG,952-1,NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,,,7116.59,7600.24,8
APR-DRG,952-2,NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,,,7861.16,8395.41,8
APR-DRG,952-3,NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,,,14376.54,15353.59,8
APR-DRG,952-4,NON-EXTENSIVE O.R. PROCEDURE UNRELATED TO PRINCIPAL DIAGNOSIS,,,33296.06,35558.9,8
CDM,0054TOH,CPTR-ASST MUSCSKEL NAVIGJ ORTHO FLUOR IMAGES,118.0,76.7,0.01,486.52,86
CDM,0055TOH,CPTR-ASST MUSCSKEL NAVIGJ ORTHO CT/MRI,730.0,474.5,0.01,730.0,86
CDM,0075TOH,TCAT PLMT XTRC VRT CRTD STENT RS&I PRQ 1ST VSL,3898.0,2533.7,1.1,4107.86,86
CDM,0076TOH,TCAT PLMT XTRC VRT CRTD STENT RS&IPRQ EA VSL,2228.0,1448.2,1.1,2228.0,74
CDM,0084TOH,TEMP PROSTATE URETHRAL STENT,1308.0,850.2,1.1,1308.0,68
CDM,0092TOH,ARTIFIC DISC ADDL,10986.0,7140.9,1.1,10986.0,68
CDM,0098TOH,REVJ TOT DISC ARTHRP ANT APPR CRV EA NTRSPC,11653.0,7574.45,1.1,3060831.65,86
CDM,0100TOH,PLMT SCJNCL RTA PROSTH&PLS&IMPLTJ INTRA-OC RTA,24892.0,16179.8,1.1,24892.0,90
CDM,0101TOH,"EXTRACORP SHOCKWV TX,HI ENRG",180.0,117.0,1.1,1725.52,90
CDM,0106TOH,QUANT SENSORY TEST&INTERPJ/XTR W/TOUCH STIMULI,16.0,10.4,1.1,119.59,90
CDM,0107TOH,VIBRATE QUANT SENSORY TEST,698.0,453.7,1.1,698.0,90
CDM,0110TOH,QUANT SENSORY TEST&INTERPJ/XTR OTHER STIMULI,16.0,10.4,1.1,373.44,90
CDM,0164TOH,RMVL TOT DISC ARTHRP ANT APPR LMBR EA NTRSPC,3885.0,2525.25,1.1,3060831.65,90
CDM,0165TOH,REVJ TOT DISC ARTHRP ANT APPR LMBR EA NTRSPC,4619.0,3002.35,1.1,3060831.65,90
CDM,0184TOH,RECTAL TUMOR EXCISION TRANSANAL ENDOSCOPIC,7239.0,4705.35,1.1,16621.23,90
CDM,01996RVUOH,DAILY ROUNDS; EPIDURAL,193.0,125.45,1.1,497.55,94
CDM,0200TOH,PERQ SAC AGMNTJ UNI W/WO BALO/MCHNL DEV 1/> NDL,6516.0,4235.4,1.1,20863.78,86
CDM,0201TOH,PERQ SAC AGMNTJ BI W/WO BALO/MCHNL DEV 2/> NDLS,12831.0,8340.15,1.1,20863.78,86
CDM,0202TOH,POST VERT ARTHRPLST 1 LU,14574.0,9473.1,1.1,3060831.65,86
CDM,0207TOH,EVAC MEIBOMIAN GLANDS W/HEAT& INTMT PRESSURE,643.0,417.95,1.1,643.0,86
CDM,0213TOH,INJECT PARAVERT FACET JT/NERVE CERV/THORAC 1LVL,593.0,385.45,1.1,2656.95,86
CDM,0216TOH,INJECTION PARAVERT FACET JT/NERVE LMBR/SAC 1LVL,806.0,523.9,1.1,2656.95,86
CDM,0217TOH,INJECTION PARAVERT FACET JT/NERVE LMBR/SAC LVL2,564.0,366.6,1.1,564.58,86
CDM,0218TOH,INJECTION PARAVER FACET JT/NERVE LMBR/SAC 3+LVL,536.0,348.4,1.1,564.58,86
CDM,0232TOH,NJX PLTLT PLASMA W/IMG HARVEST/PREPARATION,750.0,487.5,1.1,1163.18,86
CDM,0232TRVUOH,INJECTION PLATLET RICH PLASMA,750.0,487.5,1.1,1163.18,86
CDM,0236TOH,TRLUML PERIPH ATHRC W/RS&I ABDOM AORTA,4455.0,2895.75,1.1,32085.4,86
CDM,0237TOH,TRLUML PERIPH ATHRC W/RS&I BRCHIOCPHL EA VSL,5843.0,3797.95,1.1,32085.4,86
CDM,0238TOH,TRLUML PERIPHERAL ATHERECTOMY ILIAC ARTERY EA,4299.0,2794.35,1.1,51140.13,86
CDM,0274TOH,PERC LAMINO-/LAMINECTOMY IMAGE GUIDE CERV/THORAC,6687.0,4346.55,1.1,20863.78,86
CDM,0331TOH,MYOCRD SYMPATHETIC INNERVAJ IMG PLNR QUAL&QUANT,390.0,253.5,1.1,4141.53,86
CDM,0332TOH,MYOCRD SYMP INNERVAJ IMG PLNR QUAL&QUANT W/SPECT,390.0,253.5,1.1,4141.53,86
CDM,0332TOH-26,MYOCRD SYMP INNERVAJ IMG PLNR QUAL&QUANT W/SPECT,390.0,253.5,1.1,390.0,68
CDM,0338TOH,TRANSCATH RENAL SYMP DENERV UNI,7571.0,4921.15,1.1,18417.4,86
CDM,0339TOH,TRANSCATH RENAL SYMP DENERV BILAT,8704.0,5657.6,1.1,29389.56,86
CDM,0345TOH,TRANSCATH MITRAL VALVE REPAIR VIA CORONARY SINUS,15436.0,10033.4,1.1,3060831.65,86
CDM,0358TOH,BIA WHOLE BODY COMPOSITION ASSESSMENT W/I&R,67.0,43.55,1.1,85.71,86
CDM,0362TOH,BEHAVIOR ID SUPPORT ASSMT EA 15 MIN TECH TIME,293.0,190.45,1.1,293.0,94
CDM,0373TOH,ADAPT BHV TX PRTCL MODIFICAJ EA 15 MIN TECH TIME,191.0,124.15,1.1,266.89,94
CDM,0395TOH,HDR ELCTR NTRST/NTRCV BRCHTX,7980.0,5187.0,1.1,7980.0,90
CDM,0397TOH,ERCP WITH OPTICAL ENDOMICROSCOPY ADD ON,951.0,618.15,1.1,1293.61,86
CDM,0402TOH,COLLAGEN CROSS-LINKING OF CORNEA MED SEPARATE,3657.0,2377.05,1.1,6813.79,80
CDM,0408TOH,INSJ/RPLC CAR MODULJ SYS PLS GEN TRANSVNS ELTRD,5227.0,3397.55,1.1,95950.11,86
CDM,0409TOH,INSJ/RPLC CARDIAC MODULJ SYS PLS GENERATOR ONLY,2334.0,1517.1,1.1,68747.0,86
CDM,0410TOH,INSJ/RPLC CARDIAC MODULJ SYS ATR ELECTRODE ONLY,2460.0,1599.0,1.1,24778.8,86
CDM,0411TOH,INSJ/RPLC CAR MODULJ SYS VENTR ELECTRODE ONLY,2460.0,1599.0,1.1,24778.8,86
CDM,0412TOH,REMOVAL CARDIAC MODULJ SYS PLS GENERATOR ONLY,1436.0,933.4,1.1,11454.26,86
CDM,0413TOH,REMOVAL CARDIAC MODULJ SYS TRANSVENOUS ELECTRODE,3675.0,2388.75,1.1,11454.26,86
CDM,0414TOH,(2017) RMVL & RPL CARDIAC MODULJ SYS PLS GENERATOR ONLY,2330.0,1514.5,1.1,68747.0,86
CDM,0415TOH,(2017) REPOS CARDIAC MODULJ TRANSVENOUS ELECTRODE,2071.0,1346.15,1.1,2071.0,86
CDM,0416TOH,RELOC SKIN POCKET CARDIAC MODULJ PULSE GENERATOR,2121.0,1378.65,1.1,5320.02,86
CDM,0417TOH,PRGRMG DEVICE EVALUATION CARDIAC MODULJ SYSTEM,872.0,566.8,1.1,872.0,86
CDM,0418TOH,INTERRO DEVICE EVALUATION CARDIAC MODULJ SYSTEM,390.0,253.5,1.1,390.0,86
CDM,0437TOH,IMPLTJ NONBIOL/SYNTH IMPLT FASC RNFCMT ABDL WALL,2128.0,1383.2,1.1,2128.0,86
CDM,0439TOH,MYOCARDIAL PERFUSION ECHO ISCHM/VIABILITY ASSMT,652.0,423.8,1.1,925.3,86
CDM,0440TOH,ABLTJ PERC CRYOABLTJ IMG GDN UXTR/PERPH NERVE,983.0,638.95,1.1,5632.24,86
CDM,0441TOH,ABLTJ PERC CRYOABLTJ IMG GDN LXTR/PERPH NERVE,1107.0,719.55,1.1,5632.24,86
CDM,0442TOH,ABLTJ PERC CRYOABLTJ IMG GDN NRV PLEX/TRNCL NRV,1517.0,986.05,1.1,19428.17,86
CDM,0446TOH,CRTJ SUBQ INSJ IMPLTBL GLUCOSE SENSOR SYS TRAIN,502.0,326.3,1.1,10073.0,128
CDM,0447TOH,(2017) RMVL IMPLTBL GLUCOSE SENSOR SUBQ POCKET VIA INC,536.0,348.4,1.1,584.65,128
CDM,0448TOH,(2017) RMVL INSJ IMPLTBL GLUC SENSOR DIF ANATOMIC SITE,764.0,496.6,1.1,10031.47,128
CDM,0449TOH,INSJ AQUEOUS DRAIN DEV W/O EO RSVR INITIAL DEV,6351.0,4128.15,1.1,15243.78,86
CDM,0474TOH,INSJ ANT SEG AQUEOUS DRG DEV W/IO RSVR,5757.0,3742.05,1.1,5757.0,90
CDM,0483TOH,TMVI W/PROSTHETIC VALVE PERCUTANEOUS APPROACH,11627.0,7557.55,1.1,3060831.65,86
CDM,0484TOH,TMVI W/PROSTHETIC VALVE TRANSTHORACIC EXPOSURE,26564.0,17266.6,1.1,3060831.65,86
CDM,0500FOH,INITIAL PRENATAL CARE VISIT,77.0,50.05,1.1,77.0,68
CDM,0503FOH,POSTPARTUM CARE VISIT,77.0,50.05,1.1,77.0,68
CDM,0505TOH,EV FEMPOP ARTL REVSC TCAT PLMT IV ST GRF & CLSR,11750.0,7637.5,1.1,47987.95,86
CDM,0509TOH,PATTERN ERG W/I&R,160.0,104.0,1.1,160.0,124
CDM,0515TOH,INSERTION WRLS CAR STIMULATOR LV PACG COMPL SYS,13216.0,8590.4,1.1,68747.0,86
CDM,0516TOH,INSERTION WRLS CAR STIMULATOR LV PACG ELTRD ONLY,13216.0,8590.4,1.1,31142.61,86
CDM,0517TOH,INSERTION WRLS CAR STIMULATOR LV PACG BTH COMPNT,13216.0,8590.4,1.1,31142.61,86
CDM,0518TOH,REMOVAL PG WCS LV PACG BATTERY COMPONENT ONLY,2529.0,1643.85,1.1,11454.26,86
CDM,0519TOH,REMOVAL&RPLCMT PG WCS LV PACG BOTH COMPONENTS,2529.0,1643.85,1.1,31142.61,86
CDM,0520TOH,RMVL&RPLCMT PG WCS LV PACG BATTERY COMPNT ONLY,2529.0,1643.85,1.1,31142.61,86
CDM,0521TOH,INTERROG DEV EVAL WRLS CAR STIMULATOR IN PERSON,308.0,200.2,1.1,308.0,86
CDM,0521TOH-26,INTERROG DEV EVAL WRLS CAR STIMULATOR IN PERSON,308.0,200.2,1.1,308.0,86
CDM,0522TOH,PRGRMG DEVICE EVAL WRLS CAR STIMULATOR IN PERSON,403.0,261.95,1.1,403.0,86
CDM,0522TOH-26,PRGRMG DEVICE EVAL WRLS CAR STIMULATOR IN PERSON,403.0,261.95,1.1,403.0,86
CDM,0523TEOH,INTRAPROCEDURAL CORONARY FRACTIONAL FLOW RESERVE (FFR) WITH 3D F,2593.0,1685.45,1.1,7735.57,86
CDM,0523TOH,INTRAPROCEDURAL CORONARY FFP W/3D FUNCJL MAPPING,2593.0,1685.45,1.1,7735.57,86
CDM,0525TOH,INSERTION/REPLACEMENT COMPLETE IIMS,4776.0,3104.4,1.1,31142.61,86
CDM,0526TOH,INSERTION/REPLACEMENT IIMS ELECTRODE ONLY,2412.0,1567.8,1.1,24778.8,86
CDM,0527TOH,INSERTION/REPLACEMENT IIMS IMPLANTABLE MNTR ONLY,2130.0,1384.5,1.1,24778.8,86
CDM,0528TOH,PRGRMG DEVICE EVAL IIMS IN PERSON,276.0,179.4,1.1,276.0,86
CDM,0529TOH,INTERROGATION DEVICE EVAL IIMS IN PERSON,183.0,118.95,1.1,183.0,86
CDM,0530TOH,REMOVAL COMPLETE IIMS INCL IMG S&I,4600.0,2990.0,1.1,11454.26,86
CDM,0531TOH,REMOVAL IIMS ELECTRODE ONLY INCL IMG S&I,3249.0,2111.85,1.1,11454.26,86
CDM,0532TOH,REMOVAL IIMS IMPLANTABLE MNTR ONLY INCL IMG S&I,1351.0,878.15,1.1,11454.26,86
CDM,0543TOH,TRANSAPICAL MV RPR W/TTE PLMT ARTIF CHORDAE TEND,17505.0,11378.25,1.1,3060831.65,86
CDM,0544TOH,TCAT MV ANN RCNSTJ W/IMPL ADJST ANN RCNSTJ DEV,21154.0,13750.1,1.1,3060831.65,86
CDM,0545TOH,TCAT TV ANN RCNSTJ W/IMPL ADJST ANN RCNSTJ DEV,16980.0,11037.0,1.1,3060831.65,86
CDM,0569TOH,TTVR PERCUTANEOUS APPROACH INITIAL PROSTHESIS,11278.0,7330.7,1.1,18286.41,86
CDM,0570TOH,TTVR PERCUTANEOUS APPROACH EACH ADDL PROSTHESIS,11278.0,7330.7,1.1,3060831.65,86
CDM,0571TOH,INSJ/RPLCMT ICDS W/SUBSTERNAL ELECTRODE,9806.0,6373.9,1.1,95950.11,86
CDM,0572TOH,INSJ SUBSTERNAL IMPLANTABLE DEFIBRILLATOR ELTRD,2484.0,1614.6,1.1,24778.8,86
CDM,0573TOH,RMVL SUBSTERNAL IMPLANTABLE DEFIBRILLATOR ELTRD,10278.0,6680.7,1.1,11454.26,86
CDM,0574TOH,REPOS PREV IMPL SS IMPLTBL DFB PACING ELTRD,2835.0,1842.75,1.1,11454.26,86
CDM,0575TOH,PROGRAMMING DEV EVAL ICDS W/SS ELTRD IN PERSON,299.0,194.35,1.1,299.0,86
CDM,0576TOH,INTERROGATION DEV EVAL ICDS W/SS ELTRD IN PERSON,402.0,261.3,1.1,402.0,86
CDM,0577TOH,ELECTROPHYSIOLOGIC EVAL ICDS W/SS ELECTRODE,2414.0,1569.1,1.1,3471.17,86
CDM,0578TOH,REM INTERROG DEV EVAL SS LD ICDS & UP TO 90D PHY/QHP,662.0,430.3,1.1,3060831.65,86
CDM,0579TOH,REM INTERROG DEV EVAL SS LD ICDS & UP TO 90D TECH,643.0,417.95,1.1,643.0,86
CDM,0580TOH,RMVL SUBSTERNAL IMPLTBL DFB PULSE GENERATOR ONLY,1407.0,914.55,1.1,11454.26,86
CDM,0581TOH-26,ABLATION MAL BRST TUMOR PERQ CRTX UNILATERAL,1740.0,1131.0,1.1,1740.0,68
CDM,0581TOH-TC,ABLATION MAL BRST TUMOR PERQ CRTX UNILATERAL,15317.0,9956.05,1.1,15317.0,68
CDM,0582TOH,TRURL ABLTJ MAL PRST8 TISS HI ENERGY WATER VAPOR,4586.0,2980.9,1.1,3060831.65,86
CDM,0583TOH,TYMPANOSTOMY AUTOMATED TUBE DELIVERY SYSTEM,1949.0,1266.85,1.1,4447.63,120
CDM,0586TOH,OPEN ISLET CELL TRANSPLANT,4196.0,2727.4,1.1,3060831.65,86
CDM,0587TOH,PERQ IMPLTJ/RPLCMT ISDNS BLDR DYSF PTN,3473.0,2257.45,1.1,19945.48,86
CDM,0588TOH,REVJ/ OR RMVL PERQ ISDNS BLDR DYSF PTN,2800.0,1820.0,1.1,9923.76,86
CDM,0589TOH,ELEC ALYS SMPL PRGRMG IINS BLDR DYSF PTN 1-3,351.0,228.15,1.1,351.0,86
CDM,0590TOH,ELEC ALYS CPLX PRGRMG IINS BLDR DYSF PTN 4+,654.0,425.1,1.1,654.0,86
CDM,0591TOH,HEALTH &AMP; WELL-BEING COACHING F2F INDIV 1ST ASSMT,195.0,126.75,0.48,3060831.65,86
CDM,0592TOH,HEALTH &AMP; WELL-BEING COACHING F2F INDIV F-UP SESS,195.0,126.75,0.48,3060831.65,86
CDM,0593TOH,HEALTH &AMP; WELL-BEING COACHING FACE TO FACE GROUP,42.0,27.3,0.48,3060831.65,86
CDM,0600TOH,IRE ABLATION 1+TUMORS PER ORGAN W/IMG GDN PERQ,7151.0,4648.15,1.1,30022.29,86
CDM,0601TOH,IRE ABLATION 1+TUMORS PR ORGN W/FLUOR & US GDN OPN,13390.0,8703.5,1.1,30022.29,86
CDM,0613TOH,PERQ TCAT IMPLTJ INTRATRL SEPTAL SHUNT DEVICE,12890.0,8378.5,1.1,3060831.65,86
CDM,0620TOH,ENDOVASCULAR VENOUS ARTERIALIZATION TIBL/PRNL VN,12104.0,7867.6,1.1,84180.56,86
CDM,0621TOH,TRABECULOSTOMY AB INTERNO BY LASER,3772.0,2451.8,1.1,11858.31,86
CDM,0622TOH,TRABECULOSTOMY AB INTERNO LASER W/OPH ENDOSCOPE,3772.0,2451.8,1.1,3060831.65,86
CDM,0627TOH,PERQ NJX ALGC CELL &/PRDCT UNI/BI FLUOR LMBR 1ST,1232.0,800.8,1.1,38384.94,86
CDM,0628TOH,PERQ NJX ALGC CELL &/PRDCT UNI/BI FLUOR LMBR EA,1271.0,826.15,1.1,1271.0,86
CDM,0629TOH,PERQ NJX ALGC CELL&/PRDCT UNI/BI CT LMBR 1ST,1232.0,800.8,1.1,38384.94,86
CDM,0630TOH,PERQ NJX ALGC CELL&/PRDCT UNI/BI CT LMBR EA,1271.0,826.15,1.1,1271.0,86
CDM,0643TOH,TRANSCATHETER L VENTR RESTORATION DEVICE IMPLTJ,15987.0,10391.55,1.1,3060831.65,80
CDM,0644TOH,TCAT RMVL/DEBULK ICAR MASS SUCTION DEVICE PERQ,4358.0,2832.7,1.1,16670.21,86
CDM,0645TOH,TCAT IMPLANTATION CORONARY SINUS REDUCTION DEV,12513.0,8133.45,1.1,51140.13,86
CDM,0646TOH,TTVI/RPLCMT PROSTC VLV PERQ W/R HRT CATH&ANGRPH,16980.0,11037.0,1.1,3060831.65,74
CDM,0649TOH,QUAN MR ALYS TISS COMPOSITION W/MRI,305.0,198.25,1.1,2911.01,86
CDM,0652TOH,EGD FLEXIBLE TRANSNASAL DX W/COLLJ SPEC BR/WA,1037.0,674.05,1.1,5549.59,74
CDM,0653TOH,EGD FLEXIBLE TRANSNASAL W/BIOPSY SINGLE/MULTIPLE,1013.0,658.45,1.1,5549.59,74
CDM,0654TOH,EGD FLEXIBLE TRANSNASAL W/INSJ INTRAL TUBE/CATH,1055.0,685.75,1.1,11169.59,74
CDM,0655TOH,TRANSPERINEAL FOCAL LASER ABLTJ MAL PRST8 TISS,5661.0,3679.65,1.1,10168.64,86
CDM,0656TOH,ANT LUMBAR/TLMBR VRT BODY TETHRG <7VRT SEG,6834.0,4442.1,1.1,12553.16,86
CDM,0659TOH,TCAT INTRA-C NFS SUPERSAT O2 W/PERQ C REVSC AMI,5746.0,3734.9,1.1,3060831.65,86
CDM,0660TOH,IMPLTJ ANT SGM IO NBIODEGRADABLE RX ELUTING SYS,3353.0,2179.45,1.1,3060831.65,86
CDM,0671TOH,INSJ ANT SGM DRG DEV TRAB MW W/O RES&CTRC RMVL1+,6351.0,4128.15,1.1,15243.78,86
CDM,0673TOH,ABLATION B9 THYROID NODULE PERQ LASER W/IMG GDN,1537.0,999.05,1.1,9739.23,86
CDM,0683TOH,PROGRAMMING DEVICE EVALUATION IN PERSON ISDSS,291.0,189.15,1.1,3060831.65,80
CDM,0684TOH,PERIPROCEDURAL DEVICE EVALUATION IN PERSON ISDSS,53.0,34.45,1.1,3060831.65,80
CDM,0685TOH,INTERROGATION DEVICE EVALUATION IN PERSON ISDSS,126.0,81.9,1.1,3060831.65,80
CDM,0686TOH,HISTOTRIPSY MAL HEPATOCELLULAR TISS W/IMG GDN,12176.0,7914.4,1.1,53570.56,86
CDM,0690TOH,QUANTITATIVE US TISS CHARAC I&R W/DX US SM ANAT,54.0,35.1,1.1,348.91,86
CDM,0695TOH,BDY SURF ACTIVATION MAPG PM/CVDFB LEADS TM IMPLT,82.0,53.3,1.1,661.95,86
CDM,0696TOH,BDY SURF ACTIVATION MAPG PM/CVDFB LEADS TM F/UP,82.0,53.3,1.1,661.95,86
CDM,0707TOH,NJX BONE SUB MATRL INTO SUBCHONDRAL BONE DEFECT,966.0,627.9,1.1,9440.12,86
CDM,0710TOH,N-INVAS ARTL PLAQ ALYS DATA PRP QUAN REVIEW I&R,1016.0,660.4,1.1,3060831.65,80
CDM,0713TOH,N-INVAS ARTL PLAQ ALYS DATA REVIEW I&R,1016.0,660.4,1.1,3060831.65,80
CDM,0714TOH,TRANSPERINEAL LASER ABLATION OF BENIGN PROSTATIC HYPERPLASIA INC,4395.0,2856.75,1.1,15090.73,86
CDM,0722TOH,QUAN CT TISS CHARAC W/CT,351.0,228.15,1.1,1992.71,80
CDM,0724TOH,QMRCP W/DX MRI SAME ANATOMY,72.0,46.8,1.1,2911.01,80
CDM,0740TOH,REM AUTON ALG INSULIN DOSE 1ST SETUP& PT EDUCAJ,297.0,193.05,1.1,297.0,86
CDM,0741TOH,REM AUTON ALG NSLN DOS CAL SW DATA COLL TRANSMIS,465.0,302.25,1.1,465.0,86
CDM,0742TOH,AQMBF SPECT W/EXERCISE/RX STRESS & REST,585.0,380.25,1.1,585.0,74
CDM,0743TOH,BONE STRENGTH & FRACTURE RSK CNCRNT VRT FX ASSMT,96.0,62.4,1.1,3060831.65,86
CDM,0744TOH,INSERTION BIOPROSTHETIC VALVE OPEN FEMORAL VEIN,7136.0,4638.4,1.1,16027.4,86
CDM,0745TOH,CAR FCL ABLTJ RADJ ARRHYT N-INVAS LOCLZJ & MAPG,12255.0,7965.75,1.1,3060831.65,86
CDM,0746TOH,CAR FCL ABLTJ RADJ ARRHYT CONV LOCLZJ & MAPG,12255.0,7965.75,1.1,3060831.65,86
CDM,0747TOH,CAR FCL ABLTJ RADJ ARRHYT DLVR RADJ THER,12255.0,7965.75,1.1,3060831.65,86
CDM,0748TOH,NJX STEM CLL PRDCT PERIANAL PERIFISTULAR SFT TIS,997.0,648.05,1.1,3060831.65,86
CDM,0764TOH,ASSTV ALG ECG RSK-BASED ASSMT RELATED CNCRT ECG,298.0,193.7,1.1,3060831.65,86
CDM,0765TOH,ASSTV ALG ECG RSK-BASED ASSMT RELATED PREV ECG,298.0,193.7,1.1,3060831.65,86
CDM,0766TOH,TC MAG STIMJ FCSD LW FRQ EMGNT PLS PN 1ST NERVE,308.0,200.2,1.1,741.48,80
CDM,0767TOH,TC MAG STIMJ FCSD LW FRQ EMGNT PLS PN EA ADD NRV,308.0,200.2,1.1,741.48,80
CDM,0776TOH,THERAPEUTIC INDUCTION OF INTRA-BRAIN HYPOTHERMIA,1906.0,1238.9,1.1,3060831.65,80
CDM,0777TOH,R-T PRESSURE SENSING EPIDURAL GUIDANCE SYSTEM,993.0,645.45,1.1,993.0,86
CDM,0778TOH,SMMG CNCRNT APPL IMU SNR MEAS ROM POST GAIT MUSC,174.0,113.1,1.1,456.09,80
CDM,0779TOH,GI MYOELECTRICAL ACTIVITY STUDY STMCH-COLON I&R,69.0,44.85,1.1,1564.17,86
CDM,0780TOH,INSTLJ FECAL MICROBIOTA SSP RCT NMA LWR GI TRC,603.0,391.95,1.1,603.0,86
CDM,0781TOH,BRNCHSC RF DSTRJ PULM NRV BI MAINSTEM BRONCHI,1177.0,765.05,1.1,3060831.65,80
CDM,0782TOH,BRNCHSC RF DSTRJ PULM NRV UNI MAINSTEM BRONCHUS,1177.0,765.05,1.1,3060831.65,80
CDM,0783TOH,TC AURICULAR NSTIMJ SETUP CALIBRATION &PT EDUCAJ,174.0,113.1,1.1,741.48,86
CDM,0784TOH,INSJ/RPLCMT PERQ ELTRD RA SPI W/INTEGRATED NSTIM,3546.0,2304.9,1.1,39728.72,86
CDM,0785TOH,REVJ/RMVL NSTIM ELTRD RA SPI W/INTEGRATED NSTIM,2574.0,1673.1,1.1,9923.76,86
CDM,0786TOH,INSJ/RPLCMT PERQ ELTRD RA SAC W/INTEGRATED NSTIM,2697.0,1753.05,1.1,39728.72,86
CDM,0787TOH,REVJ/RMVL NSTIM ELTRD RA SAC W/INTEGRATED NSTIM,1047.0,680.55,1.1,9923.76,86
CDM,0788TOH,ELEC ALYS SMPL PRGRMG IINS SP/SAC NRV 1-3 PARAM,388.0,252.2,1.1,388.0,86
CDM,0789TOH,ELEC ALYS CPLX PRGRMG IINS SP/SAC NRV 4+PARAM,397.0,258.05,1.1,397.0,86
CDM,0795TOH,TRANSCATHETER INSERTION OF A PERMANENT DUAL CHAMBER LEADLESS PAC,3867.0,2513.55,1.1,56827.47,74
CDM,0796TOH,TRANSCATHETER INSERTION OF A PERMANENT DUAL CHAMBER LEADLESS PAC,3867.0,2513.55,1.1,56827.47,74
CDM,0797TOH,TRANSCATHETER INSERTION OF A PERMANENT DUAL CHAMBER LEADLESS PAC,3867.0,2513.55,1.1,56827.47,74
CDM,0798TOH,TRANSCATHETER REMOVAL OF PERMANENT DUAL CHAMBER LEADLESS PACEMAK,3257.0,2117.05,1.1,9296.26,74
CDM,0799TOH,TRANSCATHETER REMOVAL OF PERMANENT DUAL CHAMBER LEADLESS PACEMAK,4825.0,3136.25,1.1,9296.26,74
CDM,0800TOH,TRANSCATHETER REMOVAL OF PERMANENT DUAL CHAMBER LEADLESS PACEMAK,4825.0,3136.25,1.1,9296.26,74
CDM,0801TOH,TRANSCATHETER REMOVAL AND REPLACEMENT OF PERMANENT DUAL CHAMBER,3867.0,2513.55,1.1,56827.47,74
CDM,0802TOH,TRANSCATHETER REMOVAL AND REPLACEMENT OF PERMANENT DUAL CHAMBER,3867.0,2513.55,1.1,56827.47,74
CDM,0803TOH,TRANSCATHETER REMOVAL AND REPLACEMENT OF PERMANENT DUAL CHAMBER,3867.0,2513.55,1.1,56827.47,74
CDM,0804TOH,PROGRAMMING DEVICE EVALUATION (IN PERSON) WITH REVIEW AND REPORT,246.0,159.9,1.1,268.52,74
CDM,0804TOH-26,PROGRAMMING DEVICE EVALUATION (IN PERSON) WITH REVIEW AND REPORT,246.0,159.9,1.1,246.0,74
CDM,0805TOH,TCAT SUPR&IVC PROSTC VLV IMPLTJ PERQ FEM VN APPR,2070.0,1345.5,1.1,3060831.65,74
CDM,0806TOH,TCAT SUPR&IVC PROSTC VLV IMPLTJ OPEN FEM VN APPR,2070.0,1345.5,1.1,3060831.65,74
CDM,0811TOH,REM MULTI DAY CPLX UROFLOWMETRY SETUP&PT EDUCAJ,84.0,54.6,1.1,385.69,86
CDM,0812TOH,REM MULTI DAY CPLX UROFLOWMETRY DEV SPLY W/REPRT,84.0,54.6,1.1,110.2,80
CDM,0816TOH,OPEN INSJ/RPLCMT INTEGRATED NSTIMJ SYS PTN SUBQ,2856.0,1856.4,1.1,63800.42,86
CDM,0817TOH,OPEN INSJ/RPLCMT INTEGRATED NSTIMJ SYS PTN SUBF,2192.0,1424.8,1.1,63800.42,82
CDM,0818TOH,REVJ/RMVL INTEGRATED NSTIMJ SYS PTN SUBCUTANEOUS,2529.0,1643.85,1.1,9923.76,86
CDM,0819TOH,REVJ/RMVL INTEGRATED NSTIMJ SYS PTN SUBFASCIAL,2529.0,1643.85,1.1,9923.76,80
CDM,0820TOH,CONT IP MNTR&IVNTJ PSYCHEDELIC MED THERAPY 1ST,1722.0,1119.3,1.1,3060831.65,86
CDM,0821TOH,CONT IP MNTR&IVNTJ PSYCHEDELIC MED THERAPY 2ND,1722.0,1119.3,1.1,1722.0,86
CDM,0822TOH,CONT IP MNTR&IVNTJ PSYCHEDELIC MED THERAPY STAFF,1722.0,1119.3,1.1,1722.0,86
CDM,0823TOH,TCAT INSJ PERM 1CHMBR LDLS PACEMAKER R ATRIAL,3867.0,2513.55,1.1,56827.47,74
CDM,0824TOH,TCAT RMVL PERM 1CHMBR LDLS PACEMAKER R ATRIAL,1557.0,1012.05,1.1,9296.26,74
CDM,0825TOH,TCAT RMVL&RPLCMT PERM 1CHMBR LDLS PM R ATRIAL,2603.0,1691.95,1.1,56827.47,74
CDM,0826TOH,PRGRMG DEV EVAL LDLS PM SINGLE CAR CHAMBER IP,472.0,306.8,1.1,472.0,74
CDM,0826TOH-26,PRGRMG DEV EVAL LDLS PM SINGLE CAR CHAMBER IP,323.0,209.95,1.1,323.0,74
CDM,0826TOH-TC,PRGRMG DEV EVAL LDLS PM SINGLE CAR CHAMBER IP,149.0,96.85,1.1,149.0,74
CDM,0857TOH,OPTO-ACOUSTIC IMG BREAST UNI AUGMNT ALYS&REPRT,787.0,511.55,1.1,787.0,74
CDM,0857TOH-26,OPTO-ACOUSTIC IMG BREAST UNI AUGMNT ALYS&REPRT,362.0,235.3,1.1,362.0,74
CDM,0857TOH-TC,OPTO-ACOUSTIC IMG BREAST UNI AUGMNT ALYS&REPRT,425.0,276.25,1.1,425.0,78
CDM,0866TOH,QUAN MRI ALYS BRAIN WITH DIAGNOSTIC MRI,1237.0,804.05,1.1,1237.0,86
CDM,0866TOH-26,QUAN MRI ALYS BRAIN WITH DIAGNOSTIC MRI,270.0,175.5,1.1,303.3,86
CDM,0866TOH-TC,QUAN MRI ALYS BRAIN WITH DIAGNOSTIC MRI,967.0,628.55,1.1,967.0,90
CDM,0867TOH,TRANSPERINEAL LASER ABLATION OF BENIGN PROSTATE HYPERPLASIA INCL,4725.0,3071.25,1.1,4875.82,86
CDM,0894TOH,CANNULJ LVR ALGRFT PREPJ CONNJ NRMTHRMC PRFU DEV,6094.0,3961.1,1.1,6094.0,86
CDM,0895TOH,CONNJ LVR ALGRFT NRMTHRMC PRFUJ DEV 1ST 4 HOURS,3924.0,2550.6,1.1,3924.0,74
CDM,0896TOH,CONNJ LVR ALGRFT NRMTHRMC PRFUJ DEV EA ADDL HOUR,1666.0,1082.9,1.1,1666.0,74
CDM,0908TOH,OPEN IMPLTJ INT NEUROSTIMULATION SYS VAGUS NERVE,4180.0,2717.0,1.1,4180.0,80
CDM,0909TOH,REPLACEMENT INT NEUROSTIMULATION SYS VAGUS NERVE,5108.0,3320.2,1.1,5108.0,80
CDM,0910TOH,REMOVAL INT NEUROSTIMULATION SYS VAGUS NERVE,4226.0,2746.9,1.1,4226.0,80
CDM,0911TOH,ELEC ALYS INT NSTIMJ SYS VAGUS NRV W/O PRGRMG,163.0,105.95,1.1,163.0,80
CDM,0912TOH,ELEC ALYS INT NSTIMJ SYS VAGUS NRV W/SMPL PRGRMG,363.0,235.95,1.1,363.0,80
CDM,0913TOH,PERQ TCAT THER RX DLVR NTRAC RX BALO 1 MAJ C ART,2708.0,1760.2,1.1,2708.0,82
CDM,0914TOH,PERQ TCAT THER RX DLVR NTRAC RX BALO SEPARATE,2708.0,1760.2,1.1,2708.0,80
CDM,0915TOH,INSJ PERM CCM-D SYS PG&DUAL TRANSVNS ELTRDS/LDS,5227.0,3397.55,1.1,5227.0,80
CDM,0916TOH,INSERTION PERM CCM-D SYSTEM PULSE GENERATOR ONLY,2334.0,1517.1,1.1,2334.0,80
CDM,0917TOH,INSJ PERM CCM-D SYS 1 TRANSVNS LEAD ONLY,2460.0,1599.0,1.1,2460.0,80
CDM,0918TOH,INSJ PERM CCM-D SYS DUAL TRANSVNS LEADS ONLY,2460.0,1599.0,1.1,2460.0,80
CDM,0919TOH,REMOVAL PERM CCM-D SYSTEM PULSE GENERATOR ONLY,1436.0,933.4,1.1,1436.0,80
CDM,0920TOH,RMVL PERM CCM-D SYS 1 TRANSVNS PACING LEAD ONLY,3675.0,2388.75,1.1,3675.0,80
CDM,0921TOH,RMVL PERM CCM-D SYS 1 TRANSVNS DFB LEAD ONLY,3675.0,2388.75,1.1,3675.0,80
CDM,0922TOH,RMVL PERM CCM-D SYS DUAL TRANSVNS LEADS ONLY,3675.0,2388.75,1.1,4461.08,80
CDM,0923TOH,RMVL&RPLCMT PERMANENT CCM-D PULSE GENERATOR ONLY,2330.0,1514.5,1.1,2330.0,80
CDM,0924TOH,REPOSITIONING PREV IMPL CCM-D TRANSVNS ELTRD/LD,2071.0,1346.15,1.1,2071.0,80
CDM,0925TOH,RELOCATION SKIN POCKET IMPLANTED CCM-D PG,2926.0,1901.9,1.1,2926.0,80
CDM,0926TOH,PROGRAMMING DEVICE EVAL IMPL CCM-D SYS IN PERSON,872.0,566.8,1.1,872.0,80
CDM,0927TOH,INTERROG DEV EVAL IMPL CCM-D SYSTEM IN PERSON,511.0,332.15,1.1,511.0,80
CDM,0927TOH-26,INTERROG DEV EVAL IMPL CCM-D SYSTEM IN PERSON,390.0,253.5,1.1,390.0,80
CDM,0927TOH-TC,INTERROG DEV EVAL IMPL CCM-D SYSTEM IN PERSON,121.0,78.65,1.1,121.0,80
CDM,0928TOH,REMOTE INTERROG DEV EVAL CCM-D SYS <90D PHYS/QHP,279.0,181.35,1.1,279.0,80
CDM,0930TOH,ELECTROPHYSIOLOGIC EVAL CCM-D LEADS AT 1ST IMPL,9161.0,5954.65,1.1,9161.0,68
CDM,0930TOH-26,ELECTROPHYSIOLOGIC EVAL CCM-D LEADS AT 1ST IMPL,5227.0,3397.55,1.1,5227.0,80
CDM,0930TOH-TC,ELECTROPHYSIOLOGIC EVAL CCM-D LEADS AT 1ST IMPL,3933.0,2556.45,1.1,3933.0,68
CDM,0931TOH,ELECTROPHYSIOLOGIC EVAL CCM-D LEADS SEPARATE,9161.0,5954.65,1.1,9161.0,68
CDM,0931TOH-26,ELECTROPHYSIOLOGIC EVAL CCM-D LEADS SEPARATE,5227.0,3397.55,1.1,5227.0,80
CDM,0931TOH-TC,ELECTROPHYSIOLOGIC EVAL CCM-D LEADS SEPARATE,3933.0,2556.45,1.1,3933.0,68
CDM,0933TOH,TCAT IMPLT WRLS L ATR PRS SNR L-T L ATR PRS MNTR,2786.0,1810.9,1.1,2786.0,80
CDM,0934TOH,REMOTE MNTR WIRELESS L ATRIAL PRESSURE SNR<30 D,325.0,211.25,1.1,325.0,80
CDM,0935TOH,CYSTO W/RNL PEL SYMPATHETIC DNRVTJ RF ABLTJ BI,3715.0,2414.75,1.1,3715.0,80
CDM,0936TOH,PHOTOBIOMODULATION THERAPY RETINA SINGLE SESSION,28.0,18.2,1.1,1858.16,82
CDM,0937TOH,XTRNL ECG REC>15D<30D REC SCAN ALYS RVW&INTERPJ,256.0,166.4,1.1,857.19,80
CDM,0941TOH,CYSTO FLX INSJ&XPNSJ PROSTATIC URTL SCAFFOLD,762.0,495.3,1.1,762.0,80
CDM,0942TOH,CYSTO FLX RMVL&RPLCMT PROSTATIC URTL SCAFFOLD,1306.0,848.9,1.1,3359.91,80
CDM,0943TOH,CYSTO FLX REMOVAL PROSTATIC URETHRAL SCAFFOLD,1306.0,848.9,1.1,2392.5,80
CDM,0944TOH,3D CONTOUR SIMULAJ TRGT LVR LES&MRGN MICRWV ABLT,93.0,60.45,1.1,801.19,80
CDM,0947TOH,MRGFUS STRTCTC BLD-BRN BARR DISRPJ MBUBB RSN8TR,7488.0,4867.2,1.1,7488.0,68
CDM,0950TOH,PR ABLTJ B9 PRST8 TISSUE TRANSRECTAL HIFU W/US GDN,7092.0,4609.8,1.1,7092.0,80
CDM,0988TOH,OPEN INSJ/RPLCMT INT NSTIMJ SYS PTN SUBQ&SUBF,2192.0,1424.8,1.1,2192.0,68
CDM,0989TOH,REVJ/RMVL INTEGRATED NSTIMJ SYS PTN SUBQ&SUBF,2529.0,1643.85,1.1,2529.0,68
CDM,0990TOH,TRANSCRV INSTLJ BIOD HYDROGEL MATRL INTRAUTERINE,387.0,251.55,1.1,387.0,68
CDM,0991TOH,CYSTO LO-NRG LITHOTRP&ACOUS ACTUATED MICROSPHERE,3200.0,2080.0,1.1,3200.0,68
CDM,0993TOH,N-INVAS ASSMT CAR RSK AUGMNT SW ALYS FAT W/CT,1291.0,839.15,1.1,1291.0,68
CDM,0993TOH-26,N-INVAS ASSMT CAR RSK AUGMNT SW ALYS FAT W/CT,316.0,205.4,1.1,316.0,68
CDM,0993TOH-TC,N-INVAS ASSMT CAR RSK AUGMNT SW ALYS FAT W/CT,975.0,633.75,1.1,975.0,68
CDM,0997TOH,PRECUNEUS MAGNETIC STIMULATION TREATMENT PLNG,584.0,379.6,1.1,584.0,68
CDM,0998TOH,PRECUNEUS MAGNETIC STIMULATION TREATMENT DLVR,584.0,379.6,1.1,584.0,68
CDM,10000OH,INC/DRNG CYST 1 LESION,557.0,362.05,1.1,557.0,68
CDM,10004OH,FINE NEEDLE ASPIRATION BX W/O IMG GDN EA ADDL,320.0,208.0,1.1,320.0,148
CDM,10005OH,FINE NEEDLE ASPIRATION BX W/US GDN 1ST LESION,642.0,417.3,1.1,2050.87,148
CDM,10006OH,FINE NEEDLE ASPIRATION BX W/US GDN EA ADDL,440.0,286.0,1.1,440.0,148
CDM,10007OH,FINE NEEDLE ASPIRATION BX W/FLUORO GDN 1ST LESION,724.0,470.6,1.1,2050.87,148
CDM,10008OH,FINE NEEDLE ASPIRATION BX W/FLUOR GDN EA ADDL,472.0,306.8,1.1,487.76,148
CDM,10009OH,FINE NEEDLE ASPIRATION BX W/CT GDN 1ST LESION,904.0,587.6,1.1,2050.87,148
CDM,10010OH,FINE NEEDLE ASPIRATION BX W/CT GDN EA ADDL,660.0,429.0,1.1,805.33,148
CDM,10011OH,FINE NEEDLE ASPIRATION BX W/MR GDN 1ST LESION,1206.0,783.9,1.1,2050.87,90
CDM,10012OH,FINE NEEDLE ASPIRATION BX W/MR GDN EA ADDL,605.0,393.25,1.1,929.99,90
CDM,10021OH,FINE NEEDLE ASPIRATION BX W/O IMG GDN 1ST LESION,453.0,294.45,1.1,1163.18,148
CDM,10030OH,IMAGE-GUIDED CATHETER FLUID COLLECTION DRAINAGE,1100.0,715.0,1.1,2170.73,148
CDM,10035OH,PERQ SFT TISS LOC DEVICE PLMT 1ST LES W/GDNCE,680.0,442.0,1.1,2050.87,148
CDM,10036OH,PERQ SFT TISS LOC DEVICE PLMT ADD LES W/GDNCE,340.0,221.0,1.1,1024.22,148
CDM,10040OH,ACNE SURGERY,400.0,260.0,1.1,584.65,148
CDM,10040RVU2OH,MILIA EXTRACTION 1-5,250.0,162.5,1.1,584.65,148
CDM,10040RVU3OH,MILIA EXTRACTION EACH ADDTL 10,100.0,65.0,1.1,584.65,148
CDM,10060OH,INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE,537.0,349.05,1.1,584.65,148
CDM,10061OH,INCISION & DRAINAGE ABSCESS COMPLICATED/MULTIPLE,1078.0,700.7,1.1,1163.18,148
CDM,10080OH,INCISION & DRAINAGE PILONIDAL CYST SIMPLE,537.0,349.05,1.1,2050.87,148
CDM,10081OH,INCISION & DRAINAGE PILONIDAL CYST COMPLICATED,1100.0,715.0,1.1,2050.87,148
CDM,10120OH,INCISION & REMOVAL FOREIGN BODY SUBQ TISS SIMPLE,537.0,349.05,1.1,1163.18,148
CDM,10121OH,INCISION & REMOVAL FOREIGN BODY SUBQ TISS COMPL,1206.0,783.9,1.1,4729.25,148
CDM,10140OH,I&D HEMATOMA SEROMA/FLUID COLLECTION,695.0,451.75,1.1,4729.25,148
CDM,10160OH,PUNCTURE ASPIRATION ABSCESS HEMATOMA BULLA/CYST,500.0,325.0,1.1,1163.18,148
CDM,10180OH,INCISION & DRAINAGE COMPLEX PO WOUND INFECTION,920.0,598.0,1.1,8286.13,148
CDM,11000005,ACCOMMODATION PRIVATE ROOM,3018.0,1961.7,1089.2,7687.0,34
CDM,11000010,ACCOMMODATION BARIATRIC ROOM,3018.0,1961.7,1089.2,7687.0,34
CDM,11000015,ACCOMMODATION PRIVATE DELUXE,3353.0,2179.45,1210.1,7687.0,34
CDM,11000030,ACCOMMODATION PRIVATE SUITE,3353.0,2179.45,1210.1,7687.0,34
CDM,11000OH,DBRDMT EXTENSV ECZEMA/INFECT SKN UP 10% BDY SURF,240.0,156.0,1.1,1830.48,148
CDM,11001OH,DBRDMT EXTNSVE ECZEMA/INFECT SKN EA 10% BDY SURF,120.0,78.0,1.1,120.0,148
CDM,11004OH,DBRDMT SKN SUBQ T/M/F NECRO INFCTJ GENT&PR,4320.0,2808.0,1.1,4320.0,144
CDM,11005OH,DBRDMT SKN SUBQ T/M/F NECRO INFCTJ ABDL WALL,5696.0,3702.4,1.1,5696.0,144
CDM,11006OH,DBRDMT SKN SUBQ T/M/F NECRO INFCTJ GENT/ABDL,5240.0,3406.0,1.1,5240.0,144
CDM,11008OH,REMOVAL PROSTHETIC MATRL ABDL WALL FOR INFECTION,2000.0,1300.0,1.1,2000.0,144
CDM,11010OH,DBRDMT W/RMVL FM FX&/DISLC SKIN&SUBQ TISSUS,1844.0,1198.6,1.1,2050.87,148
CDM,11011OH,DBRDMT W/RMVL FM FX&/DISLC SKN SUBQ T/M/F MUSC,2174.0,1413.1,1.1,2174.0,148
CDM,11012OH,DBRDMT FX&/DISLC SUBQ T/M/F BONE,3023.0,1964.95,1.1,8286.13,148
CDM,11042OH,DEBRIDEMENT SUBCUTANEOUS TISSUE 20 SQ CM/<,444.0,288.6,1.1,1163.18,148
CDM,11043OH,DEBRIDEMENT MUSCLE & FASCIA 20 SQ CM/<,1188.0,772.2,1.1,1830.48,148
CDM,11044OH,DEBRIDEMENT BONE MUSCLE &/FASCIA 20 SQ CM/<,1804.0,1172.6,1.1,4729.25,148
CDM,11045OH,DBRDMT SUBCUTANEOUS TISSUE EA ADDL 20 SQ CM,200.0,130.0,1.1,200.0,148
CDM,11046OH,DEBRIDEMENT MUSCLE &/FASCIA EA ADDL 20 SQ CM,412.0,267.8,1.1,412.0,148
CDM,11047OH,DEBRIDEMENT BONE EA ADDL 20 SQ CM/<,720.0,468.0,1.1,720.0,148
CDM,11055OH,PARING/CUTTING BENIGN HYPERKERATOTIC LESION 1,154.0,100.1,1.1,584.65,148
CDM,11056OH,PARING/CUTTING BENIGN HYPERKERATOTIC LESION 2-4,220.0,143.0,1.1,584.65,148
CDM,11057OH,PARING/CUTTING BENIGN HYPERKERATOTIC LESION >4,286.0,185.9,1.1,584.65,148
CDM,11102OH,TANGENTIAL BIOPSY SKIN SINGLE LESION,290.0,188.5,1.1,584.65,148
CDM,11103OH,TANGENTIAL BIOPSY SKIN EA SEP/ADDITIONAL LESION,167.0,108.55,1.1,167.0,148
CDM,11104OH,PUNCH BIOPSY SKIN SINGLE LESION,365.0,237.25,1.1,1163.18,148
CDM,11105OH,PUNCH BIOPSY SKIN EA SEP/ADDITIONAL LESION,198.0,128.7,1.1,198.0,148
CDM,11106OH,INCISIONAL BIOSPY SKIN SINGLE LESION,404.0,262.6,1.1,1830.48,148
CDM,11107OH,INCISIONAL BIOPSY SKIN EA SEP/ADDITIONAL LESION,216.0,140.4,1.1,236.37,148
CDM,11200OH,REMOVAL SKN TAGS MLT FIBRQ TAGS ANY AREA UPW/15,361.0,234.65,1.1,584.65,148
CDM,11200RVU3OH,SKIN TAG REMOVAL 1 - 15,250.0,162.5,1.1,584.65,148
CDM,11201OH,REMOVAL SK TGS MLT FIBRQ TAGS ANY AREA EA 10,128.0,83.2,1.1,128.0,148
CDM,11201RVU1OH,SKIN TAG REMOVAL EA ADDL 10,100.0,65.0,1.1,100.0,148
CDM,11300OH,SHAVING SKIN LESION 1 TRUNK/ARM/LEG DIAM 0.5CM/<,264.0,171.6,1.1,1163.18,148
CDM,11301OH,SHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM 0.6-1.0 CM,396.0,257.4,1.1,584.65,148
CDM,11302OH,SHVG SKN LESION 1 TRUNK/ARM/LEG DIAM 1.1-2.0 CM,462.0,300.3,1.1,584.65,148
CDM,11303OH,SHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM >2.0 CM,550.0,357.5,1.1,1163.18,148
CDM,11305OH,SHAVING SKIN LESION 1 S/N/H/F/G DIAM 0.5 CM/<,352.0,228.8,1.1,584.65,148
CDM,11306OH,SHAVING SKIN LESION 1 S/N/H/F/G DIAM 0.6-1.0 CM,422.0,274.3,1.1,584.65,148
CDM,11307OH,SHAVING SKIN LESION 1 S/N/H/F/G DIAM 1.1-2.0 CM,528.0,343.2,1.1,584.65,148
CDM,11308OH,SHAVING SKIN LESION 1 S/N/H/F/G DIAM >2.0 CM,642.0,417.3,1.1,1163.18,148
CDM,11310OH,SHAVING SKIN LESION 1 F/E/E/N/L/M DIAM 0.5 CM/<,352.0,228.8,1.1,584.65,148
CDM,11311OH,SHVG SKIN LESION 1 F/E/E/N/L/M DIAM 0.6-1.0 CM,484.0,314.6,1.1,584.65,148
CDM,11312OH,SHVG SKIN LESION 1 F/E/E/N/L/M DIAM 1.1-2.0 CM,572.0,371.8,1.1,1163.18,148
CDM,11313OH,SHAVING SKIN LESION 1 F/E/E/N/L/M DIAM >2.0 CM,739.0,480.35,1.1,1163.18,148
CDM,11400OH,"REM LESION TRUNK,ARM, LEG <0.5 CM",360.0,234.0,1.1,2050.87,148
CDM,11400RVU3OH,"REM LESION TRUNK, ARM, LEG <0.5CM",115.0,74.75,1.1,2050.87,148
CDM,11401OH,"REM LESION TRUNK,ARM,LEG 0.6 -1.0CM",563.0,365.95,1.1,1163.18,148
CDM,11401RVU3OH,"REM LESION TRUNK, ARM, LEG 0.6-1.0CM",130.0,84.5,1.1,1163.18,148
CDM,11402OH,"REM LESIO TRUNK,ARM,LEG 1.1 -2.0CM",638.0,414.7,1.1,2050.87,148
CDM,11402RVU3OH,"REM LESIO TRUNK, ARM, LEG 1.1-2.0CM",145.0,94.25,1.1,2050.87,148
CDM,11403OH,"REM LESIO TRUNK,ARM,LEG 2.1-3.0CM",810.0,526.5,1.1,2050.87,148
CDM,11403RVU3OH,"REM LESIO TRUNK, ARM, LEG 2.1-3.0CM",180.0,117.0,1.1,2050.87,148
CDM,11404OH,"REM LESIO TRUNK,ARM,LEG 3.0-4.0CM",928.0,603.2,1.1,4729.25,148
CDM,11404RVU3OH,"REM LESIO TRUNK, ARM, LEG 3.0-4.0CM",205.0,133.25,1.1,4729.25,148
CDM,11406OH,"REM LESION TRUNK,ARM,LEG > 4.0CM",1549.0,1006.85,1.1,4729.25,148
CDM,11406RVU3OH,"REM LESION TRUNK, ARM, LEG >4.0CM",340.0,221.0,1.1,4729.25,148
CDM,11420OH,"REM LESION NEC,HAND,SCAL<0.5CM",453.0,294.45,1.1,4729.25,148
CDM,11420RVU3OH,"REM LESION NEC, HAND, SCAL <0.5CM",115.0,74.75,1.1,4729.25,148
CDM,11421OH,"REM LESION NEC,HND,SCAL 0.6-1.0CM",647.0,420.55,1.1,2050.87,148
CDM,11421RVU3OH,"REM LESION NEC, HND, SCAL 0.6-1.0CM",150.0,97.5,1.1,2050.87,148
CDM,11422OH,"REM LESION NEC,HND,SCAL,FEET,GENITALIA 1.1-2.0CM",739.0,480.35,1.1,4729.25,148
CDM,11422RVU3OH,"REM LESION NEC, HND, SCAL, FEET, GENITALIA 1.1-2.0CM",175.0,113.75,1.1,4729.25,148
CDM,11423OH,"REM LESION NEC,HND,SCAL 2.1-3.0CM",906.0,588.9,1.1,4729.25,148
CDM,11423RVU3OH,"REM LESION NEC, HND, SCAL 2.1-3.0CM",230.0,149.5,1.1,4729.25,148
CDM,11424OH,"REM LESION NEC,HND,SCAL 3.1-4.0CM",1091.0,709.15,1.1,4729.25,148
CDM,11424RVU3OH,"REM LESION NEC, HND, SCAL 3.1-4.0CM",240.0,156.0,1.1,4729.25,148
CDM,11426OH,"REM LESION NECK,HAND,SCAL >4.0CM",1800.0,1170.0,1.1,8286.13,148
CDM,11426RVU3OH,"REM LESION NECK, HAND, SCAL >4.0CM",400.0,260.0,1.1,8286.13,148
CDM,11440OH,"REM LESION FACE,EAR,EYEL <5MM",462.0,300.3,1.1,2050.87,148
CDM,11440RVU3OH,"REM LESION FACE, EAR, EYEL <5MM",115.0,74.75,1.1,2050.87,148
CDM,11441OH,"REM LESION FACE,EAR,EYE 0.6-1CM",673.0,437.45,1.1,2050.87,148
CDM,11441RVU3OH,"REM LESION FACE, EAR, EYE 0.6-1CM",155.0,100.75,1.1,2050.87,148
CDM,11442OH,"REM LESION FACE,EAR,EYE 1.1-2 CM",779.0,506.35,1.1,2050.87,148
CDM,11442RVU3OH,"REM LESION FACE, EAR, EYE 1.1-2CM",175.0,113.75,1.1,2050.87,148
CDM,11443OH,"REM LESION FACE,EAR,EYE 2.1-3 CM",1030.0,669.5,1.1,4729.25,148
CDM,11443RVU3OH,"REM LESION FACE, EAR, EYE 2.1-3CM",230.0,149.5,1.1,4729.25,148
CDM,11444OH,"REM LESION FACE,EAR,EYE 3.1-4 CM",1404.0,912.6,1.1,4729.25,148
CDM,11444RVU4OH,"REM LESION FACE, EAR, EYE 3.1-4CM",305.0,198.25,1.1,4729.25,148
CDM,11446OH,"REM LESION FACE,EAR,EYE >4CM",2112.0,1372.8,1.1,8286.13,148
CDM,11446RVU6OH,"REM LESION FACE, EAR, EYE >4CM",460.0,299.0,1.1,8286.13,148
CDM,11450OH,EXCISION HIDRADENITIS AXILLARY SMPL/INTRM RPR,1288.0,837.2,1.1,8286.13,148
CDM,11451OH,EXCISION HIDRADENITIS AXILLARY COMPLEX REPAIR,1772.0,1151.8,1.1,8286.13,148
CDM,11462OH,EXCISION HIDRADENITIS INGUINAL SMPL/INTRM RPR,1200.0,780.0,1.1,8286.13,148
CDM,11463OH,EXCISION HIDRADENITIS INGUINAL COMPLEX REPAIR,1772.0,1151.8,1.1,8286.13,148
CDM,11470OH,EXCISION H/P/P/U SIMPLE/INTERMEDIATE REPAIR,1496.0,972.4,1.1,8286.13,148
CDM,11471OH,EXCISION H/P/P/U COMPLEX REPAIR,1956.0,1271.4,1.1,8286.13,148
CDM,11600OH,MAL REM LESION 0.5 CM OR LESS,717.0,466.05,1.1,2050.87,148
CDM,11601OH,"MAL LESION TRUNK,ARM,LEG 0.6-1.0CM",911.0,592.15,1.1,2050.87,148
CDM,11602OH,"MAL LESION TRUNK,ARM,LEG 1.1-2.0 CM",999.0,649.35,1.1,1163.18,148
CDM,11603OH,"MAL LESION TRUNK,ARM,LEG 2.1-3.0 CM",1241.0,806.65,1.1,2050.87,148
CDM,11604OH,"MAL LESION TRUNK,ARM,LEG 3.1-4.0 CM",1395.0,906.75,1.1,2050.87,148
CDM,11606OH,EXCISION MALIGNANT LESION TRUNK/ARM/LEG > 4.0 CM,2209.0,1435.85,1.1,4729.25,148
CDM,11620OH,"MAL LESION TRUNK,ARM,LEG<0.5CM",656.0,426.4,1.1,4729.25,148
CDM,11621OH,"MAL LESION NECK,HAND,SCAL 0.6-1CM",832.0,540.8,1.1,2050.87,148
CDM,11622OH,"MAL LESION NECK,HAND,SCAL 1.1-2CM",964.0,626.6,1.1,2050.87,148
CDM,11623OH,"MAL LESION NECK,HAND,SCAL 2.1-3CM",1244.0,808.6,1.1,4729.25,148
CDM,11624OH,"MAL LESION NECK,HAND,SCAL 3.1-4CM",1448.0,941.2,1.1,4729.25,148
CDM,11626OH,EXC SKIN MALIG >4CM REMAINDR BODY,1844.0,1198.6,1.1,8286.13,148
CDM,11640OH,"MAL LESION FACE,EAR,EYEL <5MM",668.0,434.2,1.1,2050.87,148
CDM,11641OH,"MAL LESION FACE,EAR,EYEL 0.6-1CM",868.0,564.2,1.1,2050.87,148
CDM,11642OH,"MAL LESION FACE,EAR,EYEL 1.1-2CM",1048.0,681.2,1.1,2050.87,148
CDM,11643OH,"MAL LESION FACE,EAR,EYEL 2.1-3CM",1368.0,889.2,1.1,4729.25,148
CDM,11644OH,"MAL LESION FACE,EAR,EYEL 3.1-4CM",1736.0,1128.4,1.1,4729.25,148
CDM,11646OH,"MAL LESION FACE,EAR,EYEL >4.0CM",2504.0,1627.6,1.1,8286.13,148
CDM,11719OH,TRIMMING NONDYSTROPHIC NAILS ANY NUMBER,75.0,48.75,1.1,177.54,136
CDM,11720OH,"DEBRIDEMENT OF NAIL(S), 1-5",141.0,91.65,1.1,177.54,148
CDM,11721OH,"DEBRIDEMENT OF NAILS, 6 OR MORE",238.0,154.7,1.1,238.0,148
CDM,11730OH,AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE 1,462.0,300.3,1.1,584.65,148
CDM,11732OH,AVULSION NAIL PLATE PARTIAL/COMP SIMPLE EA ADDL,152.0,98.8,1.1,152.0,148
CDM,11740OH,EVAC. SUBUNGUAL HEMATOMA,148.0,96.2,1.1,373.44,148
CDM,11750OH,EXCISION NAIL MATRIX PERMANENT REMOVAL,695.0,451.75,1.1,1163.18,148
CDM,11755OH,BIOPSY NAIL UNIT SEPARATE PROCEDURE,500.0,325.0,1.1,2050.87,148
CDM,11760OH,"REPAIR OF NAIL BED, SIMPLE",652.0,423.8,1.1,1830.48,148
CDM,11762OH,RECONSTRUC OF NAIL BED W GRAFT,1176.0,764.4,1.1,5320.02,148
CDM,11765OH,WEDGE EXCISION SKIN NAIL FOLD,488.0,317.2,1.1,1163.18,148
CDM,11770OH,EXCISION PILONIDAL CYST/SINUS SIMPLE,1170.0,760.5,1.1,8286.13,148
CDM,11771OH,EXCISION PILONIDAL CYST/SINUS EXTENSIVE,2680.0,1742.0,1.1,8286.13,148
CDM,11772OH,EXCISION PILONIDAL CYST/SINUS COMPLICATED,3234.0,2102.1,1.1,8286.13,148
CDM,11900OH,INJECTION INTRALESIONAL UP TO & INCLUD 7 LESIONS,229.0,148.85,1.1,584.65,148
CDM,11901OH,INJECTION INTRALESIONAL >7 LESIONS,352.0,228.8,1.1,584.65,148
CDM,11920OH,TATTOOING INCL MICROPIGMENTATION 6.0 CM/<,644.0,418.6,1.1,1830.48,148
CDM,11921OH,TATTOOING INCL MICROPIGMENTATION 6.1-20.0 CM,772.0,501.8,1.1,1830.48,148
CDM,11922OH,TATTOOING INCL MICROPIGMENTATION EA 20.0 CM,196.0,127.4,1.1,202.23,148
CDM,11950OH,SUBCUTANEOUS INJECTION FILLING MATERIAL 1 CC/<,336.0,218.4,1.1,584.65,146
CDM,11951OH,SUBCUTANEOUS INJECTION FILLING MATRL 1.1-5.0 CC,476.0,309.4,1.1,1830.48,146
CDM,11952OH,SUBCUTANEOUS INJECTION FILLING MATRL 5.1-10.0CC,676.0,439.4,1.1,1830.48,146
CDM,11954OH,SUBCUTANEOUS INJECTION FILLING MATRL >10.0 CC,740.0,481.0,1.1,1830.48,146
CDM,11960OH,INSERTION TISSUE EXPANDER INCL SBSQ XPNSJ,4596.0,2987.4,1.1,10462.5,144
CDM,11970OH,REPLACEMENT TISSUE EXPANDER W/PERMANENT IMPLANT,3296.0,2142.4,1.1,20863.78,144
CDM,11971OH,REMOVAL TISSUE EXPANDER W/O INSERTION IMPLANT,2808.0,1825.2,1.1,8286.13,144
CDM,11976OH,REMOVAL IMPLANTABLE CONTRACEPTIVE CAPSULES,712.0,462.8,1.1,2050.87,148
CDM,11980OH,SUBCUTANEOUS HORMONE PELLET IMPLANT,440.0,286.0,1.1,1163.18,146
CDM,11981OH,INSERT DRUG IMPLANT DEVICE,502.0,326.3,1.1,502.0,148
CDM,11982OH,REMOVAL NON-BIODEGRADABLE DRUG DELIVERY IMPLANT,590.0,383.5,1.1,1163.18,148
CDM,11983OH,RMVL W/RINSJ NON-BIODEGRADABLE DRUG DLVR IMPLT,840.0,546.0,1.1,1163.18,148
CDM,12000005,ACCOMMODATION SEMI PRIVATE,3675.0,2388.75,1326.31,7687.0,34
CDM,12000115,ACCOMMODATION EMU,3675.0,2388.75,1326.31,7687.0,34
CDM,12001OH,"SIMP REPAIR SCALP,NECK,TRK <2.5CM",370.0,240.5,1.1,584.65,148
CDM,12002OH,"SIMP REPAIR SCALP,NECK,TRK 2.6-7.5CM",502.0,326.3,1.1,584.65,148
CDM,12004OH,"SIMP REPAIR SCALP,NECK,TRK 7.6-12.5CM",634.0,412.1,1.1,634.0,148
CDM,12005OH,"SIMP REPAIR SCALP,NECK,TRK 12.6-20CM",867.0,563.55,1.1,1163.18,148
CDM,12006OH,REPR SUPERF WND BODY 20.1-30,1052.0,683.8,1.1,1163.18,148
CDM,12007OH,REPR SUPERF WND BODY >30CM,1276.0,829.4,1.1,1276.0,148
CDM,12011OH,"SIMP REPAIR FACE,EAR,EYE <2.5CM",471.0,306.15,1.1,584.65,148
CDM,12013OH,"SIMP REPAIR FACE,EAR,EYE 2.6-5CM",537.0,349.05,1.1,584.65,148
CDM,12014OH,"SIMP REPAIR FACE,EAR,EYE 5.1-7.5CM",691.0,449.15,1.1,691.0,148
CDM,12015OH,"SIMP REPAIR FAC,EAR,EYE 7.6-12.5CM",871.0,566.15,1.1,871.0,148
CDM,12016OH,"SIMP REPAIR FAC,EAR,EYE 12.6-20CM",1179.0,766.35,1.1,1179.0,148
CDM,12017OH,SREP F/E/N/L/MM 20.1-30.0CM,1399.0,909.35,1.1,1399.0,144
CDM,12020OH,TX SUPERFICIAL WOUND DEHISCENCE SIMPLE CLOSURE,1175.0,763.75,1.1,1830.48,146
CDM,12021OH,TX SUPERFICIAL WOUND DEHISCENCE W/PACKING,832.0,540.8,1.1,1163.18,146
CDM,12031OH,"INT REPAIR SCALP,AXL,TRUNK <2.5CM",880.0,572.0,1.1,1163.18,148
CDM,12032OH,"INT REPAIR SCALP,AXL,TRUNK 2.6-7.5CM",1109.0,720.85,1.1,1163.18,148
CDM,12034OH,"INT REPAIR SCALP,AXL,TRUNK 7.6-12.5CM",1307.0,849.55,1.1,1307.0,148
CDM,12035OH,"INT REPAIR SCALP,AXL,TRUNK 12.6-20CM",1540.0,1001.0,1.1,1540.0,148
CDM,12036OH,"LAYR CLOS WND TRUNK,ARM,LEG 20.1-30",1861.0,1209.65,1.1,1861.0,148
CDM,12037OH,"LAYR CLOS WND TRUNK,ARM,LEG >30CM",2200.0,1430.0,1.1,5320.02,148
CDM,12041OH,INT REPAIR NECK/HANDS/FEET/XTRNL GENT <2.5CM,924.0,600.6,1.1,1163.18,148
CDM,12042OH,"INT REPAIR NECK,HANDS,FEET, GENIT, 2.6-7.5 CM",1228.0,798.2,1.1,1228.0,148
CDM,12044OH,"INT REPAIR SCALP,NEC,TRK 7.6-12.5CM",1404.0,912.6,1.1,1830.48,148
CDM,12045OH,"INT REPAIR SCALP,NEC,TRK 12.6-20CM",1650.0,1072.5,1.1,1830.48,148
CDM,12046OH,LAYR CLOS WND REST BODY 20.1-30,1892.0,1229.8,1.1,1892.0,148
CDM,12047OH,LAYR CLOS WND REST BODY >30CM,2178.0,1415.7,1.1,5320.02,148
CDM,12051OH,"INT REPAIR FACE,EAR,EYE <2.5CM",1025.0,666.25,1.1,1163.18,148
CDM,12052OH,"INT REPAIR FACE,EAR,EYE 2.6-5CM",1263.0,820.95,1.1,1263.0,148
CDM,12053OH,"INT REPAIR FACE,EAR,EYE 5.1-7.5CM",1395.0,906.75,1.1,1395.0,148
CDM,12054OH,"INT REPAIR FAC,EAR,EYE 7.6-12.5CM",1540.0,1001.0,1.1,1540.0,148
CDM,12055OH,"INT REPAIR FAC,EAR,EYE 12.6-20CM",1980.0,1287.0,1.1,1980.0,148
CDM,12057OH,"LAYR CLOS WND FACE,FACIAL >30CM",2640.0,1716.0,1.1,2640.0,148
CDM,12100010,ACCOMMODATION MED/SURG,3675.0,2388.75,1326.31,7687.0,34
CDM,12200005,ACCOMMODATION OBSTETRICS,2590.0,1683.5,934.73,7687.0,34
CDM,12800015,ACCOMMODATION REHAB SEMI PRIVATE,2590.0,1683.5,934.73,7687.0,39
CDM,13100OH,REPR CMPL WND TRUNK 1.1-2.5CM,1200.0,780.0,1.1,1830.48,148
CDM,13101OH,REPR CMPL WND TRUNK 2.6-7.5CM,1400.0,910.0,1.1,1830.48,148
CDM,13102OH,REPAIR COMPLEX TRUNK EACH ADDITIONAL 5 CM/<,496.0,322.4,1.1,496.0,148
CDM,13120OH,"REPR CMPL WND SCALP,EXTR 1.1-2.5",1292.0,839.8,1.1,1830.48,148
CDM,13121OH,"REPR CMPL WND SCALP,EXTR 2.6-7.5",1600.0,1040.0,1.1,1830.48,148
CDM,13122OH,REPAIR COMPLEX SCALP/ARM/LEG EA ADDL 5 CM/<,576.0,374.4,1.1,576.0,148
CDM,13131OH,"REPR CMPL WND HEAD,FAC,HAND 1.1-2.5",1492.0,969.8,1.1,1492.0,148
CDM,13132OH,"REPR CMPL WND HEAD,FAC,HAND 2.6-7.5",2103.0,1366.95,1.1,2103.0,148
CDM,13133OH,REPAIR COMPLEX F/C/C/M/N/AX/G/H/F EA ADDL 5 CM/<,964.0,626.6,1.1,964.0,148
CDM,13151OH,"REPR CMPL WND LID,NOS,EAR 1.1-2.5",1736.0,1128.4,1.1,1830.48,148
CDM,13152OH,"REPR CMPL WND LID,NOS,EAR 2.5-7.5",2136.0,1388.4,1.1,2136.0,148
CDM,13153OH,REPAIR COMPLX EYELID/NOSE/EAR/LIP EA ADDL 5 CM/<,952.0,618.8,1.1,952.0,148
CDM,13160OH,SECONDARY CLOSURE SURG WOUND/DEHSN EXTSV/COMPLIC,4816.0,3130.4,1.1,5320.02,144
CDM,14000OH,TISSUE REARRAN TRUNK DEF <10SCM,2548.0,1656.2,1.1,5320.02,148
CDM,14001OH,TISSUE REARRAN TRUNK  10.1-30SCM,3512.0,2282.8,1.1,5320.02,148
CDM,14020OH,"TISSUE REARRA SCALP,EXTRE LT 10SCM",2888.0,1877.2,1.1,5320.02,148
CDM,14021OH,"ADJ TISS XFER SCALP,EXTREM 10.1-30",3888.0,2527.2,1.1,5320.02,148
CDM,14040OH,"TISSUE REARR MOUTH,FORE  <10SCM",3440.0,2236.0,1.1,5320.02,148
CDM,14041OH,"TISSUE REARR MOUTH,FORE 10.1-30SCM",4332.0,2815.8,1.1,5320.02,148
CDM,14060OH,"TISSUE REARR LIP,EAR,EYE GT 10 SCM",4061.0,2639.65,1.1,5320.02,148
CDM,14061OH,"TISSUE REARR LIP,EAR,EYE 10.1-30SCM",5051.0,3283.15,1.1,5320.02,148
CDM,14301OH,ATT/R ANY AREA DEFECT 30.1-60SQCM,5060.0,3289.0,1.1,10462.5,148
CDM,14302OH,ATT/R ANY AREA DEFECT EA ADDL 30SQCM OR PART,1641.0,1066.65,1.1,1641.0,144
CDM,14350OH,FILLETED FINGER/TOE FLAP W/PREPJ RECIPIENT SITE,4420.0,2873.0,1.1,5320.02,144
CDM,15002OH,PREP SITE TRUNK/ARM/LEG 1ST 100 SQ CM/1PCT,1606.0,1043.9,1.1,5320.02,148
CDM,15003OH,PREP SITE TRUNK/ARM/LEG ADDL 100 SQ CM/1PCT,320.0,208.0,1.1,320.0,148
CDM,15004OH,PREP SITE F/S/N/H/F/G/M/D GT 1ST 100 SQ CM/1PCT,1832.0,1190.8,1.1,1832.0,148
CDM,15005OH,PREP SITE F/S/N/H/F/G/M/D GT ADDL 100 SQ CM/1PCT,640.0,416.0,1.1,640.0,148
CDM,15011OH,HRV SKIN FOR SKIN CELL SSP AGRFT 1ST 25 SQ CM/<,929.0,603.85,1.1,929.0,84
CDM,15012OH,HRV SKIN FOR SKIN CELL SSP AGRFT EA ADDL 25 SQCM,929.0,603.85,1.1,929.0,84
CDM,15013OH,PREPARATION SKIN CELL SSP AGRFT 1ST 25 SQ CM/<,1696.0,1102.4,1.1,1696.0,84
CDM,15014OH,PREPARATION SKIN CELL SSP AGRFT EA ADDL 25 SQ CM,1696.0,1102.4,1.1,1696.0,84
CDM,15015OH,APPL SKIN CELL SSP AGRFT T/A/L 1ST 480 SQ CM/<,697.0,453.05,1.1,1991.3,84
CDM,15016OH,APPL SKIN CELL SSP AGRFT T/A/L EA ADDL 480 SQ CM,697.0,453.05,1.1,697.0,84
CDM,15017OH,APPL SKN CLL SSP AGRFT F/S/N/H/F/G/M/DGT 1ST 480,850.0,552.5,1.1,2294.28,84
CDM,15018OH,APPL SKN CLL SSP AGRFT F/S/N/H/F/G/M/DGT EA ADDL,850.0,552.5,1.1,850.0,84
CDM,15040OH,HARVEST SKIN TISSUE CLTR SKIN AGRFT 100 CM/<,800.0,520.0,1.1,5320.02,146
CDM,15050OH,PINCH GRAFT 1/MLT SM ULCER TIP/OTH AREA 2CM,2228.0,1448.2,1.1,2228.0,148
CDM,15100OH,SPLIT AGRFT T/A/L 1ST 100 CM/&/1% BDY INFT/CHLD,3960.0,2574.0,1.1,5320.02,148
CDM,15101OH,SPLIT AGRFT T/A/L EA 100 CM/EA 1% BDY INFT/CHLD,688.0,447.2,1.1,688.0,148
CDM,15110OH,EPIDRM AGRFT T/A/L 1ST 100 CM/&/1% BDY INFT/CHLD,4827.0,3137.55,1.1,5320.02,148
CDM,15111OH,EPIDRM AGRFT T/A/L EA 100 CM/EA 1% BDY INFT/CHLD,740.0,481.0,1.1,740.0,148
CDM,15115OH,EPI AUTOGRFT FACE/NCK/HND/FT/GEN <100SQCM,4963.0,3225.95,1.1,5320.02,148
CDM,15116OH,EPIDRM A-GRFT F/N/HF/G ADDL 100 SQ CM/1% BA,1000.0,650.0,1.1,1000.0,148
CDM,15120OH,SPLIT AGRFT F/S/N/H/F/G/M/D GT 1ST 100 CM/</1 %,4060.0,2639.0,1.1,10462.5,148
CDM,15121OH,SPLIT AGRFT F/S/N/H/F/G/M/D GT EA 100 CM/EA 1 %,800.0,520.0,1.1,800.0,148
CDM,15130OH,"DERM AUTOGRFT, TRNK/ARM/LEG <100SQCM",3012.0,1957.8,1.1,5320.02,148
CDM,15131OH,"DERM AUTOGRFT TRNK/ARM/LEG, EA 100SQCM",600.0,390.0,1.1,600.0,148
CDM,15135OH,DERM AUTOGRAFT FACE/NCK/HND/FT/GEN <100SQCM,4412.0,2867.8,1.1,10462.5,148
CDM,15136OH,"DERM AUTOGRAFT FACE/NCK/HND/FT/GEN, EA 100SQCM",600.0,390.0,1.1,600.0,148
CDM,15150OH,CLTR SKIN AUTOGRAFT T/A/L 1ST 25 CM/<,3756.0,2441.4,1.1,5320.02,148
CDM,15151OH,CLTR SKIN AGRFT T/A/L ADDL 1 CM-75 CM,800.0,520.0,1.1,800.0,148
CDM,15152OH,CLTR SKIN AGRFT T/A/L EA 100 CM/EA 1%BODY AREA,1000.0,650.0,1.1,1000.0,148
CDM,15155OH,CLTR SKIN AGRFT F/S/N/H/F/G/M/D GT 1ST 25CM/<,4056.0,2636.4,1.1,10462.5,148
CDM,15156OH,CLTR SKIN AGRFT F/S/N/H/F/G/M/D GT ADDL 1-75CM,1100.0,715.0,1.1,1100.0,148
CDM,15157OH,CLTR SKIN AGRFT F/S/N/H/F/G/M/D GT EA 100 EA,1200.0,780.0,1.1,1200.0,148
CDM,15200OH,FULL GRAFT PROC TRUNK <20 SQCM,3660.0,2379.0,1.1,5320.02,148
CDM,15201OH,FULL GRAFT PROC TRUNK ADD 20 SQCM,581.0,377.65,1.1,581.0,148
CDM,15220OH,"FULL THICKNESS GRAFT SCALP, ARMS LEGS 20 SQ CM OR LESS",3236.0,2103.4,1.1,5320.02,148
CDM,15221OH,"FULL GRAFT PROC SCALP,ARM ADD 20SQCM",476.0,309.4,1.1,476.0,148
CDM,15240OH,SKIN GRAFT HAND <20 SQ CM,4164.0,2706.6,1.1,5320.02,148
CDM,15241OH,SKIN GRAFT HAND ADD'L 20 SCM,818.0,531.7,1.1,818.0,148
CDM,15260OH,SKIN GRAFT NOSE <20 SQ CM,4656.0,3026.4,1.1,5320.02,148
CDM,15261OH,SKIN GRAFT NOSE ADD'L 20SCM,892.0,579.8,1.1,892.0,148
CDM,15271OH,APP SKN SUB GRFT T/A/L AREA/<100SCM /<1ST 25 SCM,660.0,429.0,1.1,5320.02,148
CDM,15272OH,APP SKN SUB GRFT T/A/L AREA/<100SCM EA ADL 25SCM,145.0,94.25,1.1,145.0,148
CDM,15273OH,APP SKN SUB GRFT T/A/L AREA/>100SCM 1ST 100SCM,1400.0,910.0,1.1,10462.5,148
CDM,15274OH,APP SKN SUB GRFT T/A/L AREA/>100SCM ADL 100SCM,320.0,208.0,1.1,320.0,148
CDM,15275OH,SUB GRFT F/S/N/H/F/G/M/D /<100SCM /<1ST 25 SCM,732.0,475.8,1.1,5320.02,148
CDM,15276OH,SUB GRFT F/S/N/H/F/G/M/D /<100SCM EA ADL 25SCM,200.0,130.0,1.1,200.0,148
CDM,15277OH,SUB GRFT F/S/N/H/F/G/M/D />100SCM 1ST 100SCM,1600.0,1040.0,1.1,5320.02,148
CDM,15278OH,SUB GRFT F/S/N/H/F/G/M/D />100SCM ADL 100SCM,400.0,260.0,1.1,400.0,148
CDM,15570OH,FRMJ DIRECT/TUBED PEDICLE W/WO TRANSFER TRUNK,4084.0,2654.6,1.1,5320.02,148
CDM,15572OH,FRMJ DIRECT/TUBE PEDICLE W/WO TR SCALP ARMS/LEGS,4048.0,2631.2,1.1,10462.5,148
CDM,15574OH,FRMJ DIR/TUBE PEDCL W/WOTR FH/CH/CH/M/N/AX/G/H/F,4280.0,2782.0,1.1,5320.02,148
CDM,15576OH,FRMJ DIRECT/TUBED PEDICLE W/WOTR E/N/E/L/NTRORAL,3748.0,2436.2,1.1,5320.02,148
CDM,15600OH,DELAY/SECTN FLAP TRUNK,804.0,522.6,1.1,10462.5,148
CDM,15610OH,"DELAY/SECTN FLAP SCALP,ARM,LEG",1008.0,655.2,1.1,5320.02,148
CDM,15620OH,"DELAY/SECTN FLAP FACE,GENIT,HAND,FT",1500.0,975.0,1.1,5320.02,148
CDM,15630OH,"DELAY/SECTN FLAP LID,NOS,EAR,LIP",1632.0,1060.8,1.1,5320.02,148
CDM,15650OH,TRANSFER SKIN PEDICLE FLAP,1908.0,1240.2,1.1,5320.02,148
CDM,15730OH,MIDFACE FLAP W/PRESERVATION OF VASCULAR PEDICLES,5400.0,3510.0,1.1,10462.5,148
CDM,15731OH,FOREHEAD FLAP W/VASC PEDICLE,5752.0,3738.8,1.1,10462.5,148
CDM,15733OH,MUSC MYOQ/FSCQ FLAP HEAD&NECK W/NAMED VASC PEDCL,6272.0,4076.8,1.1,10462.5,144
CDM,15734OH,MUSC MYOCUTANEOUS/FASCIOCUTANEOUS FLAP TRUNK,9200.0,5980.0,1.1,10462.5,144
CDM,15736OH,MUSC MYOCUTANEOUS/FASCIOCUTANEOUS FLAP UXTR,6816.0,4430.4,1.1,6816.0,144
CDM,15738OH,MUSC MYOCUTANEOUS/FASCIOCUTANEOUS FLAP LXTR,8378.0,5445.7,1.1,10462.5,144
CDM,15740OH,FLAP ISLAND PEDICLE ANATOMIC NAMED AXIAL ARTERY,4720.0,3068.0,1.1,5320.02,148
CDM,15750OH,NEUROVASCULAR PEDICLE GRAFT,5184.0,3369.6,1.1,10462.5,144
CDM,15756OH,FREE MUSC FLAP W MICROVASC ANAST,14776.0,9604.4,1.1,14776.0,144
CDM,15757OH,FREE SKIN FLAP W MICROVASC ANAST,16346.0,10624.9,1.1,16346.0,144
CDM,15758OH,FREE FASCIAL FLAP W/MICROVASCULAR ANASTOMOSIS,14760.0,9594.0,1.1,14760.0,144
CDM,15760OH,GRAFT COMPOSITE W/PRIMARY CLOSURE DONOR AREA,3944.0,2563.6,1.1,5320.02,148
CDM,15769OH,GRAFTING OF AUTOLOGOUS SOFT TISS BY DIRECT EXC,2672.0,1736.8,1.1,10462.5,144
CDM,15769RVU1OH,FAT INJECTIONS FOR BUTTOCK AUGMENT (BBL) - MODERATE,1500.0,975.0,1.1,10462.5,144
CDM,15770OH,"GRAFT,DERMA-FAT-FASCIA",3942.0,2562.3,1.1,10462.5,144
CDM,15771OH,GRAFTING OF AUTOLOGOUS FAT BY LIPO 50 CC OR LESS,2961.0,1924.65,1.1,10462.5,146
CDM,15771RVU1OH,FAT TRANSFER FOR BREAST AUGMENT  50 CC OR LEES- SIMPLE,4500.0,2925.0,1.1,10462.5,146
CDM,15771RVU2OH,FAT TRANSFER FOR BREAST AUGMENT 50 CC OR LESS - MODERATE,4900.0,3185.0,1.1,10462.5,146
CDM,15771RVU3OH,FAT TRNASFER FOR BREAST AUGMENT 50 CC OR LESS - COMPLEX,5200.0,3380.0,1.1,10462.5,146
CDM,15771RVU4OH,FAT INJECTIONS TO BREAST FOR CONTOUR - SIMPLE,2400.0,1560.0,1.1,10462.5,146
CDM,15771RVU5OH,FAT INJECTIONS TO BREAST FOR CONTOUR - MODERATE,3000.0,1950.0,1.1,10462.5,146
CDM,15771RVU6OH,FAT INJECTIONS TO BREAST FOR CONTOUR - COMPLEX,3600.0,2340.0,1.1,10462.5,146
CDM,15772OH,GRAFTING OF AUTOLOGOUS FAT BY LIPO EA ADDL 50 CC,1100.0,715.0,1.1,1100.0,146
CDM,15773OH,GRAFTING OF AUTOLOGOUS FAT BY LIPO 25 CC OR LESS,2732.0,1775.8,1.1,5320.02,146
CDM,15773RVU1OH,FAT INJECTION FACE/NECK INC REVOLVE - MODERATE,990.0,643.5,1.1,5320.02,146
CDM,15774OH,GRAFTING OF AUTOLOGOUS FAT BY LIPO EA ADDL 25 CC,964.0,626.6,1.1,964.0,146
CDM,15775OH,HAIR XPLANT PUNCH GRFT 1-15,1580.0,1027.0,1.1,1580.0,134
CDM,15776OH,HAIR XPLANT PUNCH GRFT >15,2212.0,1437.8,1.1,2212.0,134
CDM,15776RVU1OH,HAIR TRANSPLANT - SIMPLE,5200.0,3380.0,1.1,5200.0,134
CDM,15776RVU2OH,HAIR TRANSPLANT - MODERATE,6500.0,4225.0,1.1,6500.0,134
CDM,15776RVU3OH,HAIR TRANSPLANT - COMPLEX,7200.0,4680.0,1.1,7200.0,134
CDM,15777OH,IMPLNT BIO IMPLNT FOR SOFT TISSUE REINFORCEMENT,1460.0,949.0,1.1,1460.0,144
CDM,15777RVU1OH,ALLODERM MESH PER BREAST,300.0,195.0,1.1,730.01,144
CDM,15778OH,IMPL ABSRB MESH/PRSTH DLYD CLSR DFCT INFCTJ/TRMA,2820.0,1833.0,1.1,2820.0,144
CDM,15780OH,DERMABRAS RX SKIN TOTAL FACE,3492.0,2269.8,1.1,8286.13,134
CDM,15780RVU1OH,MICRODERMABRASION-FACE,125.0,81.25,1.1,8286.13,134
CDM,15781OH,DERMABRAS RX SKIN SGMENT FACE,2008.0,1305.2,1.1,2050.87,136
CDM,15786OH,ABRAS SINGLE LESION,832.0,540.8,1.1,832.0,146
CDM,15787RVU1OH,"SCAR REVISION, ABRASION EA ADDL 4 LESIONS OR LESS",150.0,97.5,1.1,150.0,146
CDM,15788OH,"CHEM PEEL, FACE, EPIDERM",836.0,543.4,1.1,1275.31,134
CDM,15788RVU10OH,MANDELIC,100.0,65.0,1.1,1275.31,134
CDM,15788RVU11OH,HYDRA FACIAL BOOSTER (ADD ON TREATMENT),35.0,22.75,1.1,1275.31,134
CDM,15788RVU12OH,DIAMOND GLOW,175.0,113.75,1.1,1275.31,134
CDM,15788RVU13OH,SIGNATURE FACIAL,100.0,65.0,1.1,1275.31,134
CDM,15788RVU14OH,REJUVENIZE PEEL,185.0,120.25,1.1,1275.31,134
CDM,15788RVU15OH,ADD ON PEEL,50.0,32.5,1.1,1275.31,134
CDM,15788RVU1OH,HYDRAFACIAL,175.0,113.75,1.1,1275.31,134
CDM,15788RVU2OH,GLYCOLIC TRADITIONAL,100.0,65.0,1.1,1275.31,134
CDM,15788RVU3OH,THE ILLUMINIZE PEEL,115.0,74.75,1.1,1275.31,134
CDM,15788RVU4OH,SALICYLIC CLASSIC,125.0,81.25,1.1,1275.31,134
CDM,15788RVU5OH,VITALIZE PEEL,165.0,107.25,1.1,1275.31,134
CDM,15788RVU6OH,THE PERFECT PEEL,250.0,162.5,1.1,1275.31,134
CDM,15788RVU7OH,ENERPEEL EYE & LIP PEEL,100.0,65.0,1.1,1275.31,134
CDM,15788RVU8OH,ENERPEEL NECK & CHEST,100.0,65.0,1.1,1275.31,134
CDM,15788RVU9OH,TEEN ACNE PEEL,60.0,39.0,1.1,1275.31,134
CDM,15789OH,"CHEM PEEL, FACE, DERMAL",1964.0,1276.6,1.1,1964.0,134
CDM,15789RVU1OH,"CHEMICAL PEEL, FACIAL: DERMAL EA. AREA",250.0,162.5,1.1,1830.48,134
CDM,15789RVU2OH,"CHEMICAL PEEL, FACIAL: DERMAL, FULL FACE",700.0,455.0,1.1,1830.48,134
CDM,15792OH,"CHEM PEEL, NONFACIAL EPIDERM",744.0,483.6,1.1,1830.48,134
CDM,15792RVU1OH,BACK TREATMENT/FULL,150.0,97.5,1.1,1830.48,134
CDM,15792RVU2OH,ENERPEEL HANDS,60.0,39.0,1.1,1830.48,134
CDM,15792RVU3OH,BACK TREATMENT/HALF,85.0,55.25,1.1,1830.48,134
CDM,15792RVU4OH,"CHEMICAL PEEL, TCA-NON-FACIAL",250.0,162.5,1.1,1830.48,134
CDM,15793OH,"CHEM PEEL, NONFACIAL DERMAL",1584.0,1029.6,1.1,1584.0,134
CDM,15793RVU1OH,"NON FACIAL, DERMAL (TCA)",250.0,162.5,1.1,1561.51,134
CDM,15819RVU1OH,CERVICOPLASTY - SIMPLE,1855.0,1205.75,1.1,5320.02,76
CDM,15819RVU2OH,CERVICOPLASTY - MODERATE,2350.0,1527.5,1.1,5320.02,76
CDM,15819RVU3OH,CERVICOPLASTY - COMPLEX,2850.0,1852.5,1.1,5320.02,76
CDM,15819RVU4OH,CERVICOPLASTY   (REMOVAL EXCESS NECK SKIN),3000.0,1950.0,1.1,5320.02,76
CDM,15820OH,BLEPHAROPLASTY LOWER LID,2759.0,1793.35,1.1,5320.02,136
CDM,15820RVU1OH,BLEPHAROPLASTY LOWER - SIMPLE,1750.0,1137.5,1.1,5320.02,136
CDM,15820RVU2OH,BLEPHAROPLASTY LOWER - MODERATE,2750.0,1787.5,1.1,5320.02,136
CDM,15820RVU3OH,BLEPHAROPLASTY LOWER - COMPLEX,3250.0,2112.5,1.1,5320.02,136
CDM,15821OH,BLEPHAROPLASTY LOWER EYELID HERNIATED FAT PAD,3010.0,1956.5,1.1,5320.02,134
CDM,15821RVU1OH,BLEPHAROPLASTY LOWER W/ FAT - SIMPLE,1825.0,1186.25,1.1,5320.02,134
CDM,15821RVU2OH,BLEPHAROPLASTY LOWER W/ FAT - MODERATE,2050.0,1332.5,1.1,5320.02,134
CDM,15821RVU3OH,BLEPHAROPLASTY LOWER W/ FAT - COMPLEX,2275.0,1478.75,1.1,5320.02,134
CDM,15821RVU4OH,BLEPHAROPLASTY LOWER PLUS CHEECK - SIMPLE,2000.0,1300.0,1.1,5320.02,134
CDM,15821RVU5OH,BLEPHAROPLASTY LOWER PLUS CHEECK - MODERATE,3000.0,1950.0,1.1,5320.02,134
CDM,15821RVU6OH,BLEPHAROPLASTY LOWER PLUS CHEECK - COMPLEX,4000.0,2600.0,1.1,5320.02,134
CDM,15822OH,BLEPHAROPLASTY UPPER EYELID,2033.0,1321.45,1.1,5320.02,136
CDM,15822RVU1OH,BLEPHAROPLASTY UPPER - SIMPLE,1250.0,812.5,1.1,5320.02,136
CDM,15822RVU2OH,BLEPHAROPLASTY UPPER - MODERATE,1750.0,1137.5,1.1,5320.02,136
CDM,15822RVU3OH,BLEPHAROPLASTY UPPER - COMPLEX,2750.0,1787.5,1.1,5320.02,136
CDM,15823OH,BLEPHAROPLASTY UPPER EYELID W/EXCESSIVE SKIN,2996.0,1947.4,1.1,5320.02,148
CDM,15824OH,RHYTIDECTOMY FOREHEAD,4486.0,2915.9,1.1,5320.02,88
CDM,15824RVUX1OH,FOREHEAD/BROW LIFT - SIMPLE,2400.0,1560.0,1.1,5320.02,88
CDM,15824RVUX2OH,FOREHEAD/BROW LIFT - MODERATE,4700.0,3055.0,1.1,5320.02,88
CDM,15824RVUX3OH,FOREHEAD/BROW LIFT - COMPLEX,7000.0,4550.0,1.1,7000.0,88
CDM,15825OH,RHYTIDECTOMY NECK W/PLATYSMAL TIGHTENING,5845.0,3799.25,1.1,10462.5,88
CDM,15825RVU1OH,NECKLIFT - SIMPLE,5800.0,3770.0,1.1,10462.5,88
CDM,15825RVU2OH,NECKLIFT - MODERATE,7800.0,5070.0,1.1,10462.5,88
CDM,15825RVU3OH,NECKLIFT - COMPLEX,10000.0,6500.0,1.1,10462.5,88
CDM,15825RVU4OH,PLATSYMAPLASTY - SIMPLE,3240.0,2106.0,1.1,10462.5,88
CDM,15825RVU5OH,PLATSYMAPLASTY - MODERATE,3544.0,2303.6,1.1,10462.5,88
CDM,15825RVU6OH,PLATSYMAPLASTY - COMPLEX,3850.0,2502.5,1.1,10462.5,88
CDM,15826OH,RHYTIDECTOMY GLABELLAR FROWN LINES,6105.0,3968.25,1.1,10462.5,88
CDM,15826RVU1OH,BROWLIFT - SIMPLE,1200.0,780.0,1.1,10462.5,88
CDM,15826RVU2OH,BROWLIFT - MODERATE,1450.0,942.5,1.1,10462.5,88
CDM,15826RVU3OH,BROWLIFT - COMPLEX,3500.0,2275.0,1.1,10462.5,88
CDM,15828OH,RHYTIDECTOMY CHEEK CHIN & NECK,8610.0,5596.5,1.1,10462.5,88
CDM,15828RVU1OH,FACELIFT - SIMPLE,7200.0,4680.0,1.1,10462.5,88
CDM,15828RVU2OH,FACELIFT - MODERATE,10500.0,6825.0,1.1,10500.0,88
CDM,15828RVU3OH,FACELIFT - COMPLEX,14500.0,9425.0,1.1,14500.0,88
CDM,15829OH,RHYTIDECTOMY SMAS FLAP,9126.0,5931.9,1.1,10462.5,88
CDM,15829RVU1OH,SMAS FLAP/SHORTSCAR/MINILIFT - SIMPLE,3450.0,2242.5,1.1,10462.5,88
CDM,15829RVU2OH,SMAS FLAP/SHORTSCAR/MINILIFT - MODERATE,5950.0,3867.5,1.1,10462.5,88
CDM,15829RVU3OH,SMAS FLAP/SHORTSCAR/MINILIFT - COMPLEX,8910.0,5791.5,1.1,10462.5,88
CDM,15830OH,EXCISION SKIN ABD INFRAUMBILICAL PANNICULECTOMY,6844.0,4448.6,1.1,19017.99,144
CDM,15830RVU10OH,ABDOMINOPLASTY T - SIMPLE,6400.0,4160.0,1.1,19017.99,144
CDM,15830RVU11OH,ABDOMINIOPLASTY T - MODERATE,6950.0,4517.5,1.1,19017.99,144
CDM,15830RVU12OH,ABDOMINOPLASTY T - COMPLEX,7100.0,4615.0,1.1,19017.99,144
CDM,15830RVU13OH,PANNICULECTOMY ABDMN/INFRAUMBILICAL - SIMPLE,3695.0,2401.75,1.1,19017.99,144
CDM,15830RVU14OH,PANNICULECTOMY ABDMN/INFRAUMBILICAL - MODERATE,4195.0,2726.75,1.1,19017.99,144
CDM,15830RVU15OH,PANNICULECTOMY ABDMN/INFRAUMBILICAL - COMPLEX,4690.0,3048.5,1.1,19017.99,144
CDM,15830RVU1OH,ABDOMINOPLASTY (CIRCUM) - SIMPLE,7150.0,4647.5,1.1,19017.99,144
CDM,15830RVU2OH,ABDOMINIOPLASTY (CIRCUM) - MODERATE,7450.0,4842.5,1.1,19017.99,144
CDM,15830RVU3OH,ABDOMINOPLASTY (CIRCUM) - COMPLEX,8025.0,5216.25,1.1,19017.99,144
CDM,15830RVU4OH,ABDOMINOPLASTY FULL - SIMPLE,4120.0,2678.0,1.1,19017.99,144
CDM,15830RVU5OH,ABDOMINIOPLASTY FULL - MODERATE,5720.0,3718.0,1.1,19017.99,144
CDM,15830RVU6OH,ABDOMINOPLASTY FULL - COMPLEX,6100.0,3965.0,1.1,19017.99,144
CDM,15830RVU7OH,ABDOMINOPLASTY MINI - SIMPLE,3810.0,2476.5,1.1,19017.99,144
CDM,15830RVU8OH,ABDOMINIOPLASTY MINI - MODERATE,4120.0,2678.0,1.1,19017.99,144
CDM,15830RVU9OH,ABDOMINOPLASTY MINI - COMPLEX,4400.0,2860.0,1.1,19017.99,144
CDM,15832OH,EXCISION EXCESSIVE SKIN & SUBQ TISSUE THIGH,5654.0,3675.1,1.1,8286.13,132
CDM,15832RVU1OH,THIGH LIFT - SIMPLE,5805.0,3773.25,1.1,8286.13,132
CDM,15832RVU2OH,THIGH LIFT - MODERATE,6100.0,3965.0,1.1,8286.13,132
CDM,15832RVU3OH,THIGH LIFT - COMPLEX,6500.0,4225.0,1.1,8286.13,132
CDM,15833OH,EXCISION EXCESSIVE SKIN & SUBQ TISSUE LEG,5236.0,3403.4,1.1,8286.13,132
CDM,15834OH,EXCISION EXCESSIVE SKIN & SUBQ TISSUE HIP,4868.0,3164.2,1.1,8286.13,132
CDM,15834RVU1OH,EXCISE EXCESS SKIN HIP - SIMPLE,4013.0,2608.45,1.1,8286.13,132
CDM,15834RVU2OH,EXCISE EXCESS SKIN HIP - MODERATE,4200.0,2730.0,1.1,8286.13,132
CDM,15834RVU3OH,EXCISE EXCESS SKIN HIP - COMPLEX,4400.0,2860.0,1.1,8286.13,132
CDM,15835OH,EXCISION EXCESSIVE SKIN & SUBQ TISSUE BUTTOCK,5196.0,3377.4,1.1,8286.13,132
CDM,15835RVU1OH,"EXCISE EXCESS SKIN, BUTTOCK - SIMPLE",4287.0,2786.55,1.1,8286.13,132
CDM,15835RVU2OH,"EXCISE EXCESS SKIN, BUTTOCK - MODERATE",4400.0,2860.0,1.1,8286.13,132
CDM,15835RVU3OH,"EXCISE EXCESS SKIN, BUTTOCK - COMPLEX",4600.0,2990.0,1.1,8286.13,132
CDM,15836OH,EXCISION EXCESSIVE SKIN & SUBQ TISSUE ARM,4668.0,3034.2,1.1,8286.13,132
CDM,15836RVU1OH,ARMLIFT - SIMPLE,4250.0,2762.5,1.1,8286.13,132
CDM,15836RVU2OH,ARMLIFT - MODERATE,4572.0,2971.8,1.1,8286.13,132
CDM,15836RVU3OH,ARMLIFT - COMPLEX,5150.0,3347.5,1.1,8286.13,132
CDM,15837OH,EXC EXCESSIVE SKIN &SUBQ TISSUE FOREARM/HAND,3820.0,2483.0,1.1,8286.13,136
CDM,15838OH,EXC EXCSV SKIN & SUBQ TISSUE SUBMENTAL FAT PAD,3300.0,2145.0,1.1,8286.13,132
CDM,15838RVU1OH,EXCISION EXCESSIVE SKIN SUBMENTAL FAT PAD - SIMPLE,2271.0,1476.15,1.1,8286.13,132
CDM,15838RVU2OH,EXCISION EXCESSIVE SKIN SUBMENTAL FAT PAD - MODERATE,3100.0,2015.0,1.1,8286.13,132
CDM,15838RVU3OH,EXCISION EXCESSIVE SKIN SUBMENTAL FAT PAD - COMPLEX,3400.0,2210.0,1.1,8286.13,132
CDM,15839OH,EXCISION EXCESSIVE SKIN & SUBQ TISSUE OTHER AREA,4200.0,2730.0,1.1,8286.13,148
CDM,15839RVU1OH,CORRUGATOR EXCISION - SIMPLE,2200.0,1430.0,1.1,8286.13,148
CDM,15839RVU2OH,CORRUGATOR EXCISION - MODERATE,2400.0,1560.0,1.1,8286.13,148
CDM,15839RVU3OH,CORRUGATOR EXCISION - COMPLEX,2600.0,1690.0,1.1,8286.13,148
CDM,15840OH,"GRAFT FACE N PALSY,FREE FASCIA",5996.0,3897.4,1.1,10462.5,144
CDM,15841OH,"GRAFT FACE N PALSY,FREE MUSCLE",10396.0,6757.4,1.1,10462.5,144
CDM,15842OH,GRF FACIAL NRV PALYSS FR MUSCLE FLAP MICROSURG,16404.0,10662.6,1.1,16404.0,144
CDM,15845OH,GRF FACIAL NERVE PARALYSIS REGIONAL MUSCLE TR,5728.0,3723.2,1.1,10462.5,144
CDM,15847OH,"EXCISE EXCESS SKIN TISSUE,ABDOMEN, ADD-ON",5828.0,3788.2,1.1,5828.0,106
CDM,15847RVU1OH,ABDOMINOPLASTY ADD-ON  (INCL FLEUR DE LIS),1000.0,650.0,1.1,2068.22,106
CDM,15851OH,REMOVAL SUTURES/STAPLES REQUIRING ANESTHESIA,440.0,286.0,1.1,5320.02,148
CDM,15852OH,DRESSING CHANGE UNDER ANESTHESIA,344.0,223.6,1.1,1830.48,144
CDM,15853OH,REMOVAL SUTURES OR STAPLES NOT REQUIRING ANESTHESIA,364.0,236.6,1.1,364.0,144
CDM,15854OH,REMOVAL SUTURES & STAPLES NOT REQUIRING ANESTHESIA,337.0,219.05,1.1,337.0,70
CDM,15860OH,TEST FOR BLOOD FLOW IN GRAFT,780.0,507.0,1.1,1163.18,144
CDM,15876OH,"SUCT ASSIS LIPECTOMY,HEAD/NECK",2456.0,1596.4,1.1,10462.5,96
CDM,15876RVU1OH,SUBMENTAL LIPOSUCTION,1710.0,1111.5,1.1,10462.5,96
CDM,15877OH,"SUCT ASSIS LIPECTOMY,TRUNK",4640.0,3016.0,1.1,10462.5,94
CDM,15877RVU1OH,SUCTION ASSISTED LIPECTOMY; TRUNK,3615.0,2349.75,1.1,10462.5,94
CDM,15877RVU2OH,"LIPOSUCTION, HIPS",3615.0,2349.75,1.1,10462.5,94
CDM,15877RVU3OH,LIPOSUCTION ABD - SIMPLE,2850.0,1852.5,1.1,10462.5,94
CDM,15877RVU4OH,LIPOSUCTION ABD - MODERATE,3150.0,2047.5,1.1,10462.5,94
CDM,15877RVU5OH,LIPSUCTION ABD - COMPLEX,3450.0,2242.5,1.1,10462.5,94
CDM,15877RVU6OH,LIPOSUCTION 360 TRUNK - SIMPLE,3742.0,2432.3,1.1,10462.5,94
CDM,15877RVU7OH,LIPOSUCTION 360 TRUNK - MODERATE,4150.0,2697.5,1.1,10462.5,94
CDM,15877RVU8OH,LIPOSUCTION 360 TRUNK - COMLEX,4400.0,2860.0,1.1,10462.5,94
CDM,15877RVUOH,"LIPOSUCTION, STOMACH",3615.0,2349.75,1.1,10462.5,94
CDM,15878OH,"SUCT ASSIS LIPECTOMY,UP EXTREM",4777.0,3105.05,1.1,5320.02,94
CDM,15878RVU1OH,LIPOSUCTION UPPER EXTREM - SIMPLE,3615.0,2349.75,1.1,5320.02,94
CDM,15878RVU2OH,LIPOSUCTION UPPER EXTREM - MODERATE,3825.0,2486.25,1.1,5320.02,94
CDM,15878RVU3OH,LIPOSUCTION UPPER EXTREM - COMPLEX,4000.0,2600.0,1.1,5320.02,94
CDM,15878RVU4OH,LIPOSUCT UPPER EXTREMITY  LYMPH/LIPEDEMA,8500.0,5525.0,1.1,8500.0,94
CDM,15878RVU5OH,LIPOSUCT ARM BILAT LYMPH/LIPEDEMA,15000.0,9750.0,1.1,15000.0,94
CDM,15879OH,"SUCT ASSIS LIPECTOMY,LOW EXTREM",4640.0,3016.0,1.1,10462.5,94
CDM,15879RVU1OH,"LIPOSUCTION, LATERAL THIGHS/HIPS- SIMPLE",2800.0,1820.0,1.1,10462.5,94
CDM,15879RVU2OH,"LIPOSUCTION, LATERAL THIGHS/HIPS - MODERATE",3100.0,2015.0,1.1,10462.5,94
CDM,15879RVU3OH,"LIPOSUCTION, LATERAL THIGHS - COMPLEX",3400.0,2210.0,1.1,10462.5,94
CDM,15879RVU4OH,LIPOSUCT LOWER EXTREMITY LYMPH/LIPEDEMA,11500.0,7475.0,1.1,11500.0,94
CDM,15879RVU5OH,LIPOSUCT LEG BILAT LYMPH/LIPEDEMA,20000.0,13000.0,1.1,20000.0,94
CDM,15879RVUOH,"LIPOSUCTION, THIGHS",3727.0,2422.55,1.1,10462.5,94
CDM,15920OH,EXC COCCYGEAL PR ULC W/COCCYGECTOMY W/PRIM SUTR,3316.0,2155.4,1.1,8286.13,144
CDM,15922OH,EXC COCCYGEAL PR ULC W/COCCYGECTOMY W/FLAP CLSR,4152.0,2698.8,1.1,10462.5,144
CDM,15931OH,EXCISION SACRAL PRESSURE ULCER W/PRIMARY SUTURE,4028.0,2618.2,1.1,8286.13,144
CDM,15933OH,EXC SACRAL PRESSURE ULC W/PRIM SUTR W/OSTECTOMY,4708.0,3060.2,1.1,8286.13,144
CDM,15934OH,EXCISION SACRAL PRESSURE ULCER W/SKIN FLAP CLSR,5472.0,3556.8,1.1,10462.5,144
CDM,15935OH,EXC SACRAL PR ULCER W/SKN FLAP CLSR W/OSTECTOMY,6312.0,4102.8,1.1,10462.5,144
CDM,15936OH,EXC SAC PR ULC PREPJ MUSC/MYOQ FLAP/SKN GRF CLSR,5264.0,3421.6,1.1,5320.02,144
CDM,15937OH,EXC SAC PR ULC PREPJ MUSC/MYOQ FLAP/SKN GRF OSTC,6056.0,3936.4,1.1,6056.0,144
CDM,15940OH,EXC ISCHIAL PRESSURE ULCER W/PRIMARY SUTURE,4080.0,2652.0,1.1,8286.13,144
CDM,15941OH,EXC ISCHIAL PR ULC W/PRIM SUTR W/OSTC ISCHIECT,4964.0,3226.6,1.1,8286.13,144
CDM,15944OH,EXC ISCHIAL PRESSURE ULCER W/SKIN FLAP CLOSURE,4976.0,3234.4,1.1,10462.5,144
CDM,15945OH,EXC ISCHIAL PR ULC W/SKN FLAP CLSR W/OSTECTOMY,5500.0,3575.0,1.1,5500.0,144
CDM,15946OH,EXC ISCHIAL PR ULCER W/OSTC MUSC/MYOQ FLAP/SKIN,9648.0,6271.2,1.1,9648.0,144
CDM,15950OH,EXC TROCHANTERIC PRESSURE ULCER W/PRIMARY SUTR,3212.0,2087.8,1.1,4729.25,144
CDM,15951OH,EXC TRCHNTRIC PR ULCER W/PRIM SUTR W/OSTECTOMY,4632.0,3010.8,1.1,8286.13,144
CDM,15952OH,EXC TROCHANTERIC PR ULCER W/SKIN FLAP CLOSURE,4924.0,3200.6,1.1,5320.02,144
CDM,15953OH,EXC TRCHNTRIC PR ULC W/SKN FLAP CLSR W/OSTECTOMY,5428.0,3528.2,1.1,10462.5,144
CDM,15956OH,EXC TROCHANTERIC PR ULCER MUSC/MYOQ FLAP/SKIN,6716.0,4365.4,1.1,6716.0,144
CDM,15958OH,EXC TRCHNTRIC PR ULC MUSC/MYOQ FLAP/SKIN W/OSTC,6700.0,4355.0,1.1,10462.5,144
CDM,16000OH,"INITIAL TX, FIRST DEGREE BURN, LOCAL TREATMENT",356.0,231.4,1.1,584.65,146
CDM,16020OH,DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ SMALL,312.0,202.8,1.1,584.65,148
CDM,16025OH,DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ MEDIUM,696.0,452.4,1.1,696.0,148
CDM,16030OH,DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ LARGE,832.0,540.8,1.1,1163.18,148
CDM,16035OH,ESCHAROTOMY; INIT INC,1496.0,972.4,1.1,1496.0,144
CDM,16100005,ACCOMMODATION CARE AT HOME,2576.0,1674.4,929.68,2318.4,23
CDM,16400015,ISOLATION,7455.0,4845.75,2690.51,7687.0,34
CDM,17000005,ACCOMMODATION NURSERY,1057.0,687.05,381.47,7687.0,37
CDM,17000OH,"DESTRUCTION, 1ST LESION",268.0,174.2,1.1,584.65,148
CDM,17003OH,"DESTRUC BENIGN/PREMAL,2-14 LESIONS",18.0,11.7,1.1,21.76,148
CDM,17004OH,"DESTRUC BENIGN/PREMAL,>15 LESIONS",603.0,391.95,1.1,1163.18,148
CDM,17100005,ACCOMMODATION NEWBORN - LEVEL I,2382.0,1548.3,859.66,7687.0,37
CDM,17106OH,DESTRUCTION CUTANEOUS VASC PROLIFERATIVE <10CM,1624.0,1055.6,1.1,1624.0,148
CDM,17107OH,"DESTR,CUTAN VASC LESION 10-50SCM",2108.0,1370.2,1.1,2108.0,148
CDM,17107RVU1OH,"LASER, DSTRJ CUTANEOUS VASCULAR LESIONS 10.0-50.0 SQ CM",650.0,422.5,1.1,1830.48,148
CDM,17108OH,DESTRUC CUT/VASC >50 SQ CM,3296.0,2142.4,1.1,5320.02,148
CDM,17108RVU1OH,"LASER, DSTRJ CUTANEOUS VASCULAR LESIONS >50.0 SQ CM",1100.0,715.0,1.1,5320.02,148
CDM,17110OH,DESTRUCTION BENIGN LESIONS UP TO 14,308.0,200.2,1.1,584.65,148
CDM,17110RVU3OH,KERATOSES DESTRUCTION UP TO 14,200.0,130.0,1.1,584.65,148
CDM,17111OH,"DESTRUC FLAT WARTS, 15 OR MORE",427.0,277.55,1.1,584.65,148
CDM,17111RVU3OH,KERATOSES DESTRUCTION 15 OR MORE,250.0,162.5,1.1,584.65,148
CDM,17200005,ACCOMMODATION NEWBORN - LEVEL II,3086.0,2005.9,1113.74,7687.0,37
CDM,17250OH,CHEM CAUTER GRANULAR TISSUE,220.0,143.0,1.1,584.65,148
CDM,17260OH,"DESTR MALIG TRUNK,EXTREM <0.5 CM",422.0,274.3,1.1,584.65,148
CDM,17261OH,"DESTR MALIG TRUNK,EXTREM 0.6-1 CM",537.0,349.05,1.1,584.65,148
CDM,17262OH,"DESTR MALIG TRUNK,EXTREM 1.1-2 CM",717.0,466.05,1.1,717.0,148
CDM,17263OH,"DESTR MALIG TRUNK,EXTREM 2.1-3 CM",810.0,526.5,1.1,810.0,148
CDM,17264OH,"DESTR MALIG TRUNK,EXTREM 3.1-4 CM",876.0,569.4,1.1,1163.18,148
CDM,17266OH,"DESTR MALIG TRUNK,EXTREM >4.0 CM",1052.0,683.8,1.1,1163.18,148
CDM,17270OH,"DESTR MALIG SCAL,NCK,HAND <0.5 CM",548.0,356.2,1.1,584.65,148
CDM,17271OH,"DESTR MALIG SCAL,NCK,HAND 0.6-1 CM",616.0,400.4,1.1,616.0,148
CDM,17272OH,"DESTR MALIG SCAL,NCK,HAND 1.1-2 CM",728.0,473.2,1.1,728.0,148
CDM,17273OH,"DESTR MALIG SCAL,NCK,HAND 2.1-3 CM",840.0,546.0,1.1,1163.18,148
CDM,17274OH,"DESTR MALIG SCAL,NCK,HAND 3.1-4 CM",1056.0,686.4,1.1,1163.18,148
CDM,17276OH,"DESTR MALIG SCAL,NCK,HAND >4 CM",1300.0,845.0,1.1,1300.0,148
CDM,17280OH,DESTRUCTION MALIGNANT LESION F/E/E/N/L/M 0.5CM/<,488.0,317.2,1.1,584.65,148
CDM,17281OH,"DESTR MALIG FACE,NOSE,LIP 0.6-1 CM",708.0,460.2,1.1,1163.18,148
CDM,17282OH,"DESTR MALIG FACE,NOSE,LIP 1.1-2 CM",836.0,543.4,1.1,1163.18,148
CDM,17283OH,"DESTR MALIG FACE,NOSE,LIP 2.1-3 CM",1076.0,699.4,1.1,1163.18,148
CDM,17284OH,"DESTR MALIG FACE,NOSE,LIP 3.1-4 CM",1280.0,832.0,1.1,1830.48,148
CDM,17286OH,"DESTR MALIG FACE,NOSE,LIP >4CM",1792.0,1164.8,1.1,1830.48,148
CDM,17300005,ACCOMMODATION NEWBORN - LEVEL III,5217.0,3391.05,1882.82,11024.0,37
CDM,17311OH,MOHS MICROGRAPHIC H/N/H/F/G 1ST STAGE 5 BLOCKS,2480.0,1612.0,1.1,2480.0,148
CDM,17312OH,MOHS MICROGRAPHIC H/N/H/F/G EACH ADDL STAGE,1320.0,858.0,1.1,1357.88,148
CDM,17313OH,MOHS TRUNK/ARM/LEG 1ST STAGE 5 BLOCKS,2224.0,1445.6,1.1,2224.0,148
CDM,17314OH,MOHS TRUNK/ARM/LEG EA STAGE AFTER 1ST STAGE,1346.0,874.9,1.1,1346.0,148
CDM,17315OH,MOHS TRUNK/ARM/LEG EA ADDL BLOCK ANY STAGE,383.0,248.95,1.1,383.0,148
CDM,17340OH,CRYOTHERAPY CO2 SLUSH LIQUID N2 ACNE,308.0,200.2,1.1,308.0,148
CDM,17360OH,CHEMICAL EXFOLIATION ACNE,584.0,379.6,1.1,584.65,146
CDM,17380OH,ELECTROLYSIS EPILATION EACH 30 MINUTES,111.0,72.15,1.1,1830.48,88
CDM,17400005,ACCOMMODATION NEWBORN - LEVEL IV,7829.0,5088.85,2825.49,11024.0,37
CDM,17999AOH,ONE SYRINGE OF REFYNE,700.0,455.0,0.01,700.0,84
CDM,17999BOH,ONE SYRINGE OF DEFYNE,700.0,455.0,0.01,700.0,84
CDM,17999COH,VOLLURE,700.0,455.0,0.01,700.0,84
CDM,17999EOH,VANQUISH,500.0,325.0,0.01,584.65,84
CDM,17999KOH,RESIDENT CLINIC FILLER,200.0,130.0,0.01,584.65,84
CDM,17999RVU100OH,FAT PAD BIOPSY (COMP CODE 20200),584.0,379.6,0.01,584.65,84
CDM,17999RVU101OH,STERNOHYOID/OMOHYOID ROTNAL MSCLE FLAP RPR ESOPHAGL INJRY (COMP,9200.0,5980.0,0.01,9200.0,84
CDM,17999RVU10OH,IMPLANTATION OF BIO IMPLANT FOR SOFT TISSUE REINF; OTHER AREAS (,1205.0,783.25,0.01,1205.0,84
CDM,17999RVU11OH,INRA THECAL PUMP SUBCUTANEOUS POCKET (COMP CODE 63688),2118.0,1376.7,0.01,2118.0,84
CDM,17999RVU12OH,"FACIAL RESURFACING, LASER (COMP CODE 17108)",3183.0,2068.95,0.01,3183.0,84
CDM,17999RVU13OH,EXTRACTIONS,75.0,48.75,0.01,584.65,84
CDM,17999RVU14OH,DERMABLADING,60.0,39.0,0.01,584.65,84
CDM,17999RVU15OH,ADD ON DERMABLADING,25.0,16.25,0.01,584.65,84
CDM,17999RVU16OH,CUSTOMIZED MASK,15.0,9.75,0.01,584.65,84
CDM,17999RVU17OH,LASER HAIR REMOVAL - SIMPLE,275.0,178.75,0.01,584.65,84
CDM,17999RVU18OH,"LASER HAIR REMOVAL, MODERATE",500.0,325.0,0.01,584.65,84
CDM,17999RVU19OH,LASER HAIR REMOVAL - COMPLEX,750.0,487.5,0.01,750.0,84
CDM,17999RVU20OH,"LASER HAIR REMOVAL, XLARGE AREA",700.0,455.0,0.01,700.0,84
CDM,17999RVU21OH,DERM TECH (COMP CODE 11102),218.0,141.7,0.01,584.65,84
CDM,17999RVU22OH,"NON INVASIVE RADIOFREQUENCY, SMALL (COMP CODE 15781)",1100.0,715.0,0.01,1100.0,84
CDM,17999RVU23OH,"NON INVASIVE RADIOFREQUENCY, LARGE (COMP CODE 15780)",2800.0,1820.0,0.01,2800.0,84
CDM,17999RVU24OH,"NON INVASIVE RADIOFREQUENCY, MEDIUM (COMP CODE 15781)",2500.0,1625.0,0.01,2500.0,84
CDM,17999RVU25OH,"RADIOFREQUENCY MICRONEEDLING, MEDIUM (COMP CODE 15781)",900.0,585.0,0.01,900.0,84
CDM,17999RVU26OH,"RADIOFREQUENCY MICRONEEDLING, LARGE (COMP CODE 15780)",1200.0,780.0,0.01,1200.0,84
CDM,17999RVU27OH,"RADIOFREQUENCY MICRONEEDLING, XLARGE (COMP CODE 15781)",1600.0,1040.0,0.01,1600.0,84
CDM,17999RVU28OH,"MICROFOCUSED ULTRASOUND, LOWER FACE & SUBMENTUM (COMP CODE 15781",2500.0,1625.0,0.01,2500.0,84
CDM,17999RVU29OH,"MICROFOCUSED ULTRASOUND,NECK (COMP CODE 15782)",1800.0,1170.0,0.01,1800.0,84
CDM,17999RVU30OH,"MICROFOCUSED ULTRASOUND, UPPER FACE (COMP CODE 15781)",1500.0,975.0,0.01,1500.0,84
CDM,17999RVU31OH,"MICROFOCUSED ULTRASOUND, FULL FACE & SUBMENTUM (COMP CODE 15780)",3500.0,2275.0,0.01,3500.0,84
CDM,17999RVU32OH,CONTACT RADIOFREQUENCY (COMP CODE 15781),400.0,260.0,0.01,584.65,84
CDM,17999RVU34OH,MICRONEEDLE-REJUV (COMP 15793),450.0,292.5,0.01,584.65,84
CDM,17999RVU35OH,MICRONEEDLE -SCAR (COMP 15793),300.0,195.0,0.01,584.65,84
CDM,17999RVU36OH,MICRONEEDLEN-ACNE (COMP 15793),600.0,390.0,0.01,600.0,84
CDM,17999RVU37OH,COOLSCULPTING CYCLES 1 (COMP 15877),750.0,487.5,0.01,750.0,84
CDM,17999RVU38OH,COOLSCULPTING CYCLES ADV + 1 (COMP 15877),1500.0,975.0,0.01,1500.0,84
CDM,17999RVU39OH,COOLSCULPTING CYCLES 2 (COMP 15877),1500.0,975.0,0.01,1500.0,84
CDM,17999RVU40OH,COOLSCULPTING CYCLES 3 (COMP 15877),2250.0,1462.5,0.01,2250.0,84
CDM,17999RVU41OH,COOLSCULPTING CYCLES 4 (COMP 15877),3000.0,1950.0,0.01,3000.0,84
CDM,17999RVU42OH,COOLSCULPTING CYCLES 5 (COMP 15877),3200.0,2080.0,0.01,3200.0,84
CDM,17999RVU43OH,COOLSCULPTING CYCLES 6 (COMP 15877),3800.0,2470.0,0.01,3800.0,84
CDM,17999RVU44OH,COOLSCULPTING CYCLES 7 (COMP 15877),4200.0,2730.0,0.01,4200.0,84
CDM,17999RVU45OH,COOLSCULPTING CYCLES 8 (COMP 15877),4500.0,2925.0,0.01,4500.0,84
CDM,17999RVU46OH,COOLSCULPTING CYCLES 9 (COMP 15877),4800.0,3120.0,0.01,4800.0,84
CDM,17999RVU47OH,COOLSCULPTING CYCLES 10 (COMP 15877),5000.0,3250.0,0.01,5000.0,84
CDM,17999RVU48OH,COOLSCULPTING CYCLES 11 (COMP 15877),5500.0,3575.0,0.01,5500.0,84
CDM,17999RVU49OH,COOLSCULPTING CYCLES 12 (COMP 15877),6000.0,3900.0,0.01,6000.0,84
CDM,17999RVU50OH,COOLSCULPTING CYCLES 13 (COMP 15877),6500.0,4225.0,0.01,6500.0,84
CDM,17999RVU51OH,COOLSCULPTING CYCLES 14 (COMP 15877),7000.0,4550.0,0.01,7000.0,84
CDM,17999RVU52OH,COOLSCULPTING CYCLES 15 (COMP 15877),7500.0,4875.0,0.01,7500.0,84
CDM,17999RVU53OH,COOLSCULPTING CYCLES ADV + 2 (COMP 15877),2700.0,1755.0,0.01,2700.0,84
CDM,17999RVU54OH,COOLSCULPTING CYCLES ADV + 3 (COMP 15877),3800.0,2470.0,0.01,3800.0,84
CDM,17999RVU55OH,COOLSCULPTING CYCLES ADV + 4 (COMP 15877),4500.0,2925.0,0.01,4500.0,84
CDM,17999RVU56OH,COOLSCULPTING CYCLES ADV + 5 (COMP 15877),5000.0,3250.0,0.01,5000.0,84
CDM,17999RVU57OH,COOLSCULPTING CYCLES ADV + 6 (COMP 15877),6000.0,3900.0,0.01,6000.0,84
CDM,17999RVU58OH,COOLSCULPTING CYCLES ADV + 7 (COMP 15877),7000.0,4550.0,0.01,7000.0,84
CDM,17999RVU5OH,"SUBDERMAL RADIOFREQUENCY, LOWER FACE & NECK SCULPTING (COMP 1578",4375.0,2843.75,0.01,4375.0,84
CDM,17999RVU60OH,LASER VASC & PIGM LESIONS SMALL (COMP CODE 15781),400.0,260.0,0.01,584.65,84
CDM,17999RVU61OH,LASER VASC & PIGM LESIONS FULL FACE/MEDIUM (COMP 15780),600.0,390.0,0.01,600.0,84
CDM,17999RVU62OH,LASER VASC & PIGM LESIONS FACE & NECK/LARGE (COMP 15781),800.0,520.0,0.01,800.0,84
CDM,17999RVU63OH,LASER FRACT NON-ABLATIVE SPOT/PARTIAL FACE (COMP 15781),300.0,195.0,0.01,584.65,84
CDM,17999RVU64OH,LASER FRACT NON-ABLATIVE FULL FACE (COMP 15780),800.0,520.0,0.01,800.0,84
CDM,17999RVU65OH,LASER FRACT NON-ABLATIVE FULL FACE & NECK (COMP 15780),1000.0,650.0,0.01,1000.0,84
CDM,17999RVU66OH,LASER FRACT ABLATIVE SMALL (COMP CODIE 15781),900.0,585.0,0.01,900.0,84
CDM,17999RVU67OH,LASER FRACT ABLATIVE MEDIUM (COMP CODE 15780),2000.0,1300.0,0.01,2000.0,84
CDM,17999RVU68OH,LASER FRACT ABLATIVE LARGE  (COMP CODE 15780),3500.0,2275.0,0.01,3500.0,84
CDM,17999RVU69OH,LASER FRACT ABLAT SINGLE-USE SMALL (COMP CODE 15781),1500.0,975.0,0.01,1500.0,84
CDM,17999RVU6OH,"SUBDERMAL RADIOFREQUENCY, POSTERIOR ARMS, BOTH (COMP 15782)",3125.0,2031.25,0.01,3125.0,84
CDM,17999RVU70OH,LASER FRACT ABLAT SINGLE-USE MEDIUM (COMP CODE 15780),3000.0,1950.0,0.01,3000.0,84
CDM,17999RVU71OH,LASER FRACT ABLAT SINGLE-USE LARGE (COMP CODE 15780),5000.0,3250.0,0.01,5000.0,84
CDM,17999RVU72OH,LASER FRACT NON-ABLAT SINGLE-USE SMALL (COMP CODE 15781),500.0,325.0,0.01,584.65,84
CDM,17999RVU73OH,LASER FRACT NON-ABLAT SINGLE-USE MEDIUM (COMP CODE 15780),800.0,520.0,0.01,800.0,84
CDM,17999RVU74OH,LASER FRACT NON-ABLAT SINGLE-USE LARGE (COMP CODE 15780),1100.0,715.0,0.01,1100.0,84
CDM,17999RVU75OH,MICRONEEDLING SMALL (COMP CODE 15781),250.0,162.5,0.01,584.65,84
CDM,17999RVU76OH,MICRONEEDLING MEDIUM  (COMP CODE 15780),500.0,325.0,0.01,584.65,84
CDM,17999RVU77OH,MICRONEEDLING LARGE (COMP CODE 15780),800.0,520.0,0.01,800.0,84
CDM,17999RVU78OH,PRP & MICRONEEDLING SMALL (COMP CODE 15781 + 0232T),600.0,390.0,0.01,600.0,84
CDM,17999RVU79OH,PRP & MICRONEEDLING MEDIUM (COMP CODE 15780 + 0232T),1100.0,715.0,0.01,1100.0,84
CDM,17999RVU7OH,SUBDERMAL RADIOFREQUENCY ABDOMEN (5X8 AREA) OR UPPER BACK (COMP,1875.0,1218.75,0.01,1875.0,84
CDM,17999RVU80OH,PRP & MICRONEEDLING LARGE (COMP CODE 15780 + 0232T),1300.0,845.0,0.01,1300.0,84
CDM,17999RVU81OH,"TATTOO REMOVAL, LASER (COMP 17110)",259.0,168.35,0.01,584.65,84
CDM,17999RVU82OH,ABDOMINOPLASY W/ FLEUR-DE-LIS W/O PANNICULECTOMY(COMP CODE 15830,7992.0,5194.8,0.01,7992.0,84
CDM,17999RVU83OH,LASER HAIR REMOVAL (COMP 17110),259.0,168.35,0.01,584.65,84
CDM,17999RVU84OH,MICRO-CORING SMALL (COMP CODE 15781),2000.0,1300.0,0.01,2000.0,84
CDM,17999RVU85OH,"MICRO-CORING, MEDIUM (COMP CODE 15781)",3500.0,2275.0,0.01,3500.0,84
CDM,17999RVU86OH,"MICRO-CORING, LARGE - LOWER FACE + NECK (COMP 15780)",4000.0,2600.0,0.01,4000.0,84
CDM,17999RVU87OH,"RADIOFREQUENCY MICRONEEDLING, SMALL (COMP CODE 15781)",800.0,520.0,0.01,800.0,84
CDM,17999RVU88OH,LASER FRACT ABLATIVE LIGHT MODE PARTIAL (COMP CODE 15781),400.0,260.0,0.01,584.65,84
CDM,17999RVU89OH,LASER FRACT ABLATIVE FULL FACE SUPERFICIAL /PARTIAL AGGRESSIVE (,900.0,585.0,0.01,900.0,84
CDM,17999RVU8OH,"SUBDERMAL RADIOFREQUENCY, KNEES, BOTH (COMP 15780)",1250.0,812.5,0.01,1250.0,84
CDM,17999RVU90OH,UMBILICOPLASTY (COMPARABLE CODE 49591),2533.0,1646.45,0.01,2533.0,84
CDM,17999RVU91OH,MICRONEEDLING SCAR (COMP CODE15783),1896.0,1232.4,0.01,1896.0,84
CDM,17999RVU92OH,CERVICOPLASTY (REMOVAL EXCESS NECK SKIN),990.0,643.5,0.01,990.0,84
CDM,17999RVU93OH,WOUND ELECTROCAUTERIZATION/CONTROL OF BLEEDING (COMP 20103),1923.0,1249.95,0.01,1923.0,84
CDM,17999RVU94OH,ELECTROHYDROLIC SHOCKWAVE ENERGY LEVEL 1 SMALL (COMP CODE 15781),800.0,520.0,0.01,800.0,84
CDM,17999RVU95OH,ELECTROHYDROLIC SHOCKWAVE ENERGY LEVEL 2 MEDIUM (COMP CODE 15781,1600.0,1040.0,0.01,1600.0,84
CDM,17999RVU96OH,ELECTROHYDROLIC SHOCKWAVE ENERGY LEVEL 3 LARGE (COMP CODE 15780),2200.0,1430.0,0.01,2200.0,84
CDM,17999RVU97OH,CRYOABLATION ABDOMINAL WALL MASS (COMP CODE 20983),2200.0,1430.0,0.01,2200.0,84
CDM,17999RVU98OH,RADIOFREQUENCY ABLATION SUBCUTANEOUS MASS  (COMP CODE 20982),2808.0,1825.2,0.01,2808.0,84
CDM,17999RVU99OH,CRYOABLATION OF SUBCUTANEOOUS MASS (COMP CODE 20983),2752.0,1788.8,0.01,2752.0,84
CDM,17999RVU9OH,"UNLIST PROC, SKIN, MUCOUS MEMBRANE & SUBCUT TISSUE COMP TO 15777",1205.0,783.25,0.01,1205.0,84
CDM,17999RVUOH,WOUND EXPLORATION,881.0,572.65,0.01,881.0,84
CDM,19000OH,PUNCTURE ASPIRATION CYST BREAST,336.0,218.4,1.1,2050.87,148
CDM,19001OH,PUNCTURE ASPIRATION BREAST EACH ADDITIONAL CYST,168.0,109.2,1.1,168.0,148
CDM,19020OH,MASTOTOMY W/EXPLORATION/DRAINAGE ABSCESS DEEP,1532.0,995.8,1.1,4729.25,148
CDM,19030OH,INJECTION MAMMARY DUCTOGRAM/GALACTOGRAM,612.0,397.8,1.1,612.0,148
CDM,19081OH,BX BREAST W/DEVICE 1ST LESION STEREOTACTIC GUID,1448.0,941.2,1.1,4729.25,148
CDM,19082OH,BX BREAST W/DEVICE ADDL LESION STEREOTACT GUID,726.0,471.9,1.1,1310.21,148
CDM,19083OH,BX BREAST W/DEVICE 1ST LESION ULTRASOUND GUID,1364.0,886.6,1.1,4729.25,148
CDM,19084OH,BX BREAST W/DEVICE ADDL LESION ULTRASOUND GUID,682.0,443.3,1.1,1290.35,148
CDM,19085OH,BX BREAST W/DEVICE 1ST LESION MAGNETIC RES GUID,1602.0,1041.3,1.1,4729.25,148
CDM,19086OH,BX BREAST W/DEVICE ADDL LESION MAGNET RES GUID,801.0,520.65,1.1,2008.62,148
CDM,19100OH,BX BREAST NEEDLE CORE W/O IMAGING GUIDANCE SPX,508.0,330.2,1.1,4729.25,148
CDM,19101OH,BIOPSY BREAST OPEN INCISIONAL,1292.0,839.8,1.1,11117.55,148
CDM,19105OH,ABLTJ CRYOSURGICAL W/US GID EA FIBROADENOMA,1476.0,959.4,1.1,11117.55,146
CDM,19110OH,NIPPLE EXPLORATION,1776.0,1154.4,1.1,11117.55,148
CDM,19112OH,EXCISION LACTIFEROUS DUCT FISTULA,1524.0,990.6,1.1,11117.55,148
CDM,19120OH,EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION,2368.0,1539.2,1.1,11117.55,148
CDM,19125OH,EXC BREAST LES PREOP PLMT RAD MARKER OPEN 1 LES,2944.0,1913.6,1.1,11117.55,148
CDM,19126OH,EXC BRST LES PREOP PLMT RAD MARKER OPN EA ADDL,1172.0,761.8,1.1,1172.0,144
CDM,19281OH,PERQ DEVICE PLACEMENT BREAST LOC 1ST LES W/GDNCE,800.0,520.0,1.1,4729.25,148
CDM,19282OH,PERQ DEVICE PLACEMT BREAST LOC EA LESION W/GDNCE,440.0,286.0,1.1,577.71,148
CDM,19283OH,PERQ BREAST LOC DEVICE PLACEMT 1ST STRTCTC GDNCE,880.0,572.0,1.1,2050.87,148
CDM,19284OH,PERQ BREAST LOC DEVICE PLACEMT EA LESION STRTCTC,440.0,286.0,1.1,645.82,148
CDM,19285OH,PERQ BREAST LOC DEVICE PLACEMT 1ST LESIO US IMAG,748.0,486.2,1.1,2050.87,148
CDM,19286OH,PERQ BREAST LOC DEVICE PLACEMT EACH LES US IMAGE,374.0,243.1,1.1,1020.93,148
CDM,19287OH,PERQ BREAST LOC DEVICE PLACEMT 1ST LESIO MR GUID,1020.0,663.0,1.1,2152.0,148
CDM,19288OH,PERQ BREAST LOC DEVICE PLACEMT ADD LESIO MR GUID,512.0,332.8,1.1,1657.81,148
CDM,19294OH,PREP TUMOR CAVITY IORT W/PARTIAL MASTECTOMY,1200.0,780.0,1.1,1200.0,144
CDM,19296OH,PLMT EXPANDABLE CATH BRST FOLLOWING PRTL MAST,1452.0,943.8,1.1,27493.9,148
CDM,19297OH,PLMT EXPANDABLE CATH BRST CONCURRENT PRTL MAST,688.0,447.2,1.1,688.0,144
CDM,19298OH,PLMT RADTHX BRACHYTX BRST FOLLOWING PRTL MAST,2300.0,1495.0,1.1,19017.99,148
CDM,19300OH,MASTECTOMY FOR GYNECOMASTIA,2124.0,1380.6,1.1,11117.55,148
CDM,19300RVU2OH,GYNECOMASTIA - SIMPLE,1316.0,855.4,1.1,11117.55,148
CDM,19300RVU3OH,GYNECOMASTIA - MODERATE,1525.0,991.25,1.1,11117.55,148
CDM,19300RVU4OH,GYNECOMASTIA - COMPLEX,1750.0,1137.5,1.1,11117.55,148
CDM,19301OH,"MASTECTOMY, PARTIAL",4052.0,2633.8,1.1,11117.55,144
CDM,19302OH,"MASTECTOMY,PARTIAL,  WITH AXILLARY LYMPHADENECTOMY",5596.0,3637.4,1.1,19017.99,144
CDM,19303OH,"MASTECTOMY, SIMPLE, COMPLETE",6000.0,3900.0,1.1,19017.99,144
CDM,19305OH,MAST RAD W/PECTORAL MUSCLES AXILLARY LYMPH NODES,6984.0,4539.6,1.1,6984.0,144
CDM,19306OH,MAST RAD W/PECTORAL MUSC AX INT MAM LYMPH NODES,7252.0,4713.8,1.1,7252.0,144
CDM,19307OH,MAST MODF RAD W/AX LYMPH NOD W/WO PECT/ALIS MIN,7196.0,4677.4,1.1,19017.99,144
CDM,19316OH,MASTOPEXY,4880.0,3172.0,1.1,19017.99,144
CDM,19316RVU1OH,MASTOPEXY - SIMPLE,1476.0,959.4,1.1,19017.99,144
CDM,19316RVU2OH,MASTOPEXY - MODERATE,1575.0,1023.75,1.1,19017.99,144
CDM,19316RVU3OH,MASTOPEXY - COMPLEX,1700.0,1105.0,1.1,19017.99,144
CDM,19318OH,REDUCTION OF LARGE BREAST,7053.0,4584.45,1.1,19017.99,144
CDM,19318RVU1OH,BREAST REDUCTION FEMALE - MODERATE,1820.0,1183.0,1.1,19017.99,144
CDM,19325OH,BREAST AUGMENTATION WITH IMPLANT,3573.0,2322.45,1.1,27493.9,144
CDM,19325RVU1OH,BREAST AUG (SALINE) - SIMPLE,1885.0,1225.25,1.1,27493.9,144
CDM,19325RVU2OH,BREAST AUG (SALINE) - MODERATE,2075.0,1348.75,1.1,27493.9,144
CDM,19325RVU3OH,BREAST AUG (SALINE) - COMPLEX,2250.0,1462.5,1.1,27493.9,144
CDM,19325RVU4OH,BREAST AUG (SILICONE) - SIMPLE,2155.0,1400.75,1.1,27493.9,144
CDM,19325RVU5OH,BREAST AUG (SILICONE) - MODERATE,2355.0,1530.75,1.1,27493.9,144
CDM,19325RVU6OH,BREAST AUG (SILICONE) - COMPLEX,2550.0,1657.5,1.1,27493.9,144
CDM,19325RVU7OH,BREAST AUG (SILICONE) W/ MEDICAL PRO,3768.0,2449.2,1.1,27493.9,144
CDM,19325RVU8OH,BREAST AUG (GEL) - MODERATE,2500.0,1625.0,1.1,27493.9,144
CDM,19328OH,REMOVAL OF BREAST IMPLANT,2976.0,1934.4,1.1,11117.55,144
CDM,19328RVU1OH,BREAST IMPLANT REMOVAL - SIMPLE,2100.0,1365.0,1.1,11117.55,144
CDM,19328RVU2OH,BREAST IMPLANT REMOVAL - MODERATE,2500.0,1625.0,1.1,11117.55,144
CDM,19328RVU3OH,BREAST IMPLANT REMOVAL - COMPLEX,2900.0,1885.0,1.1,11117.55,144
CDM,19330OH,RMVL RUPTURED BREAST IMPLANT W/IMPLANT CONTENTS,3600.0,2340.0,1.1,11117.55,144
CDM,19340OH,INSERTION BREAST IMPLANT SAME DAY OF MASTECTOMY,4192.0,2724.8,1.1,19017.99,144
CDM,19342OH,INSJ/RPLCMT BREAST IMPLANT SEP DAY MASTECTOMY,4611.0,2997.15,1.1,27493.9,144
CDM,19350OH,NIPPLE/AREOLA RECONSTRUCTION,4008.0,2605.2,1.1,11117.55,148
CDM,19355OH,CORRECT INVERTED NIPPLE(S),3408.0,2215.2,1.1,11117.55,146
CDM,19355RVU1OH,INVERTED NIPPPLE CORRECTION,1600.0,1040.0,1.1,11117.55,146
CDM,19357OH,BREAST RECONSTRUC W TISS EXPANDR,6530.0,4244.5,1.1,51394.19,144
CDM,19361OH,BREAST RECONSTRUC W LAT DORSI FLAP,9344.0,6073.6,1.1,9344.0,144
CDM,19364OH,BREAST RECONSTRUC W FREE FLAP,18735.0,12177.75,1.1,18735.0,144
CDM,19367OH,BREAST RECONSTRUCTION SINGLE PEDICLED TRAM FLAP,10720.0,6968.0,1.1,10720.0,144
CDM,19368OH,BREAST RECONSTRUCTION 1PEDICLED TRAM FLAP ANAST,13560.0,8814.0,1.1,13560.0,144
CDM,19369OH,BREAST RECONSTRUCTION BIPEDICLED TRAM FLAP,12524.0,8140.6,1.1,12524.0,144
CDM,19370OH,REVISION PERI-IMPLANT CAPSULE BREAST,4035.0,2622.75,1.1,11117.55,144
CDM,19371OH,PERI-IMPLANT CAPSULECTOMY BREAST COMPLETE,4391.0,2854.15,1.1,11117.55,144
CDM,19380OH,REVISE BREAST RECONSTRUCTION,4915.0,3194.75,1.1,19017.99,144
CDM,19499AOH,TAKEDOWN OF TRAM FLAP,5231.0,3400.15,0.01,11117.55,84
CDM,19499RVU1OH,ENDOSCOPIC MASTECTOMY (COMP CODE 19303),6000.0,3900.0,0.01,11117.55,84
CDM,20100005,"ACCOMMODATION INTESIVE CARE, SURGICAL",8166.0,5307.9,2947.11,7687.0,34
CDM,20100OH,EXPLORATION PENETRATING WOUND SPX NECK,4152.0,2698.8,1.1,4152.0,144
CDM,20101OH,EXPLORATION PENETRATING WOUND SPX CHEST,1292.0,839.8,1.1,5320.02,148
CDM,20102OH,EXPL PENETRATING WOUND SPX ABDOMEN/FLANK/BACK,1592.0,1034.8,1.1,5320.02,148
CDM,20103OH,EXPLORATION PENETRATING WOUND SPX EXTREMITY,2136.0,1388.4,1.1,4729.25,148
CDM,20150OH,EXCISION OF EPIPHYSEAL BAR,5900.0,3835.0,1.1,9440.12,144
CDM,20200005,"ACCOMMODATION INTENSIVE CARE, MEDICAL",8166.0,5307.9,2947.11,7687.0,34
CDM,20200OH,BIOPSY MUSCLE SUPERFICIAL,584.0,379.6,1.1,4729.25,148
CDM,20205OH,DEEP MUSCLE BIOPSY,940.0,611.0,1.1,8286.13,148
CDM,20206OH,BIOPSY MUSCLE PERCUTANEOUS NEEDLE,396.0,257.4,1.1,4729.25,148
CDM,20220OH,"BONE BIOPSY,TROCAR/NEEDLE SUPERF",660.0,429.0,1.1,4729.25,148
CDM,20225OH,"BONE BIOPSY,TROCAR/NEEDLE DEEP",980.0,637.0,1.1,4729.25,148
CDM,20240OH,BIOPSY BONE OPEN SUPERFICIAL,1148.0,746.2,1.1,8286.13,144
CDM,20245OH,BIOPSY BONE OPEN DEEP,2640.0,1716.0,1.1,8286.13,144
CDM,20250OH,BIOPSY VERTEBRAL BODY OPEN THORACIC,2076.0,1349.4,1.1,9440.12,144
CDM,20251OH,BIOPSY VERTEBRAL BODY OPEN LUMBAR/CERVICAL,2288.0,1487.2,1.1,20863.78,144
CDM,20300005,"ACCOMMODATION INTENSIVE CARE, PEDIATRIC",8166.0,5307.9,2947.11,7687.0,34
CDM,20500OH,INJECTION SINUS TRACT THERAPEUTIC SEPARATE PROC,512.0,332.8,1.1,4447.63,148
CDM,20501OH,INJECTION SINUS TRACT DIAGNOSTIC,304.0,197.6,1.1,483.69,148
CDM,20520OH,REMOVAL FOREIGN BODY MUSCLE/TENDON SHEATH SIMPLE,760.0,494.0,1.1,4729.25,148
CDM,20525OH,RMVL FOREIGN BODY MUSCLE/TENDON SHEATH DEEP/COMP,1416.0,920.4,1.1,8286.13,148
CDM,20526OH,INJECTION THERAPEUTIC CARPAL TUNNEL,414.0,269.1,1.1,863.2,148
CDM,20527OH,INJECTION ENZYME PALMAR FASCIAL CORD,400.0,260.0,1.1,863.2,148
CDM,20550OH,INJECTION 1 TENDON SHEATH/LIGAMENT APONEUROSIS,330.0,214.5,1.1,863.2,148
CDM,20551OH,INJECTION SINGLE TENDON ORIGIN/INSERTION,330.0,214.5,1.1,863.2,148
CDM,20552OH,TRIGGER POINT INJECTION MULTI 1-2 MUSCLE GR,290.0,188.5,1.1,863.2,148
CDM,20553OH,TRIGGER POINT INJECTION MULTI 3+ MUSCLE GRP,330.0,214.5,1.1,863.2,148
CDM,20560OH,NEEDLE INSERTION W/O INJECTION 1 OR 2 MUSCLES,141.0,91.65,1.1,141.0,148
CDM,20561OH,NEEDLE INSERTION W/O INJECTION 3 OR MORE MUSCLES,211.0,137.15,1.1,211.0,148
CDM,20600005,ACCOMMODATION ICU - STEP DOWN,6125.0,3981.25,2210.51,7687.0,34
CDM,20600040,ACCOMMODATION ICU,8166.0,5307.9,2947.11,7687.0,34
CDM,20600070,ACCOMMODATION CCU,8166.0,5307.9,2947.11,7687.0,34
CDM,20600OH,ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US,290.0,188.5,1.1,863.2,148
CDM,20604OH,ARTHROCNT ASPIR&/INJ SMALL JT/BURSAW/US REC RPRT,392.0,254.8,1.1,863.2,148
CDM,20605OH,ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US,299.0,194.35,1.1,863.2,148
CDM,20606OH,ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/US,440.0,286.0,1.1,2017.2,148
CDM,20610OH,ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US,348.0,226.2,1.1,863.2,148
CDM,20611OH,ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/US,484.0,314.6,1.1,863.2,148
CDM,20612OH,ASPIRATION&/INJECTION GANGLION CYST ANY LOCATJ,308.0,200.2,1.1,863.2,148
CDM,20615OH,ASPIRATION & INJECTION TREATMENT BONE CYST,932.0,605.8,1.1,2050.87,148
CDM,20650OH,INSERTION WIRE/PIN W/APPL SKELETAL TRACTION SPX,912.0,592.8,1.1,9440.12,148
CDM,20661OH,APPLICATION HALO CRANIAL INCLUDING REMOVAL,2104.0,1367.6,1.1,2104.0,144
CDM,20664OH,APPL HALO 6/> PINS THIN SKULL OSTEOLOGY,4024.0,2615.6,1.1,4024.0,144
CDM,20665OH,REMOVAL TONG/HALO APPLIED BY ANOTHER INDIVIDUAL,544.0,353.6,1.1,1163.18,148
CDM,20670OH,REMOVAL IMPLANT SUPERFICIAL SEPARATE PROCEDURE,788.0,512.2,1.1,4729.25,148
CDM,20680OH,REMOVAL DEEP IMPLANT,2622.0,1704.3,1.1,8286.13,148
CDM,20690OH,APPLICATION UNIPLANE EXTERNAL FIXATION SYSTEM,3512.0,2282.8,1.1,20863.78,144
CDM,20692OH,APPLICATION MULTIPLANE EXTERNAL FIXATION SYSTEM,6508.0,4230.2,1.1,38384.94,144
CDM,20693OH,ADJUSTMENT/REVJ XTRNL FIXATION SYSTEM REQ ANES,2424.0,1575.6,1.1,20863.78,144
CDM,20694OH,REMOVAL EXTERNAL FIXATION SYSTEM UNDER ANES,1712.0,1112.8,1.1,4686.39,148
CDM,20696OH,XTRNL FIXJ W/STEREOTACTIC ADJUSTMENT 1ST & SUBQ,7024.0,4565.6,1.1,54351.12,142
CDM,20697OH,XTRNL FIXJ W/STRTCTC ADJUSTMENT EXCHANGE STRUT,8468.0,5504.2,1.1,8468.0,144
CDM,20700OH,MANUAL PREP AND INSERTION DEEP DRUG DELIVERY DEV,600.0,390.0,1.1,600.0,144
CDM,20701OH,REMOVAL DEEP DRUG DELIVERY DEVICE,497.0,323.05,1.1,497.0,144
CDM,20702OH,MANUAL PREP&AMP;INSJ INTRAMEDULLARY DRUG DLVR DEVICE,1000.0,650.0,1.1,1000.0,144
CDM,20703OH,REMOVAL INTRAMEDULLARY DRUG DELIVERY DEVICE,720.0,468.0,1.1,720.0,144
CDM,20704OH,MANUAL PREP&AMP;INSJ I-ARTIC DRUG DELIVERY DEVICE,1040.0,676.0,1.1,1040.0,144
CDM,20705OH,REMOVAL INTRA-ARTICULAR DRUG DELIVERY DEVICE,860.0,559.0,1.1,860.0,144
CDM,20900OH,BONE GRAFT ANY DONOR AREA MINOR/SMALL,1200.0,780.0,1.1,20863.78,148
CDM,20902OH,BONE GRAFT ANY DONOR AREA MAJOR/LARGE,1832.0,1190.8,1.1,20863.78,144
CDM,20910OH,CARTILAGE GRAFT COSTOCHONDRAL,2212.0,1437.8,1.1,2212.0,144
CDM,20912OH,CARTILAGE GRAFT NASAL SEPTUM,2616.0,1700.4,1.1,10462.5,144
CDM,20920OH,FASCIA LATA GRAFT BY STRIPPER,2204.0,1432.6,1.1,5320.02,144
CDM,20922OH,FASCIA LATA GRAFT INCISION & AREA EXPOSURE,2772.0,1801.8,1.1,5320.02,148
CDM,20924OH,TENDON GRAFT FROM A DISTANCE,2672.0,1736.8,1.1,20863.78,144
CDM,20930OH,ALLOGRAFT FOR SPINE SURGERY ONLY MORSELIZED,767.0,498.55,1.1,767.0,88
CDM,20931OH,ALLOGRAFT FOR SPINE SURGERY ONLY STRUCTURAL,724.0,470.6,1.1,724.0,144
CDM,20932OH,OSTEOARTIUCLAR ALLOGRAFT W/ARTICULAR SURF & BONE,5204.0,3382.6,1.1,5204.0,144
CDM,20933OH,HEMICORTICAL INTERCALARY ALLOGRAFT PARTIAL,4776.0,3104.4,1.1,4776.0,144
CDM,20934OH,INTERCALARY ALLOGRAFT COMPLETE,5200.0,3380.0,1.1,5200.0,144
CDM,20936OH,AUTOGRAFT SPINE SURGERY LOCAL FROM SAME INCISION,1089.0,707.85,1.1,1089.0,88
CDM,20937OH,AUTOGRAFT SPINE SURGERY MORSELIZED SEP INCISION,1116.0,725.4,1.1,1116.0,144
CDM,20938OH,AUTOGRAFT SPINE SURGERY BICORT/TRICORT SEP INC,1208.0,785.2,1.1,1208.0,144
CDM,20939OH,BONE MARROW ASPIRATION BONE GRFG SPI SURG ONLY,464.0,301.6,1.1,464.0,144
CDM,20939RVUOH,BONE MARROW ASPIR BONE GRFG,383.0,248.95,1.1,383.0,144
CDM,20950OH,MNTR INTERSTITIAL FLUID PRESSURE CMPRT SYNDROME,504.0,327.6,1.1,2050.87,148
CDM,20955OH,BONE GRAFT MICROVASCULAR ANASTOMOSIS FIBULA,17714.0,11514.1,1.1,17714.0,144
CDM,20962OH,BONE GRF W/MVASC ANAST OTH/THN ILIAC CREST/METAR,15684.0,10194.6,1.1,15684.0,144
CDM,20969OH,FREE OSTQ FLAP W/MVASC ANAST METAR/GREAT TOE,18172.0,11811.8,1.1,18172.0,144
CDM,20970OH,FREE OSTQ FLAP W/MVASC ANASTOMOSIS ILIAC CREST,17832.0,11590.8,1.1,17832.0,144
CDM,20974OH,ELECTRICAL STIMULATION BONE HEALING NONINVASIVE,248.0,161.2,1.1,281.34,148
CDM,20975OH,ELECTRICAL STIMULATION BONE HEALING INVASIVE,1040.0,676.0,1.1,1040.0,144
CDM,20979OH,LOW INTENSITY US STIMJ BONE HEALING NONINVASIVE,248.0,161.2,1.1,248.0,146
CDM,20982OH,ABLATION BONE TUMOR RF PERQ W/IMG GDN WHEN DONE,2808.0,1825.2,1.1,38384.94,148
CDM,20983OH,ABLATJ BONE TUMOR CRYO PERQ W/IMG GDN WHEN PRFMD,2752.0,1788.8,1.1,20863.78,148
CDM,20985OH,CPTR-ASST SURGICAL NAVIGATION IMAGE-LESS,1000.0,650.0,1.1,1000.0,144
CDM,20999AOH,SHOCK WAVE THERAPY,180.0,117.0,0.01,688.73,84
CDM,20999BOH,BONE MARROW ASPIRATION AND INJECTION,1112.0,722.8,0.01,1112.0,84
CDM,20999COH,ABD EXP & REAPPROXIMATION OF EXTERNAL OBLIQUE APONEUROSIS,6028.0,3918.2,0.01,6028.0,84
CDM,20999DOH,"CORE NEEDLE BIOPSY, FACE (COMP CODE 20206)",357.0,232.05,0.01,688.73,84
CDM,20999FLAPOH,EXPLANTATION OF OSTEOCUTANEOUS FREE FLAP/ HEAD AND NECK (COMP 35,4321.0,2808.65,0.01,4321.0,84
CDM,20999LIPOOH,LIPOGEMS ? AUTOLOGOUS ADIPOSE TISSUE HARVESTING/INJECTION,3500.0,2275.0,0.01,3500.0,84
CDM,20999OH,UNLISTED PROCEDURE MUSCSKELETAL SYSTEM GENERAL,358.0,232.7,0.01,688.73,84
CDM,20999RVU10OH,SKYE PX50 PLACENTAL TISSUE MATRIX (.5CC) WITH PRP,1700.0,1105.0,0.01,1700.0,84
CDM,20999RVU11OH,FLOGRAFT SURGICAL (1.0 ML) (2 M CELLS),3500.0,2275.0,0.01,3500.0,84
CDM,20999RVU12OH,FLOGRAFT SURGICAL WITH PRP,4200.0,2730.0,0.01,4200.0,84
CDM,20999RVU13OH,SKYE PX50 PLACENTAL TISSUE MATRIX (.5 CC),1000.0,650.0,0.01,1000.0,84
CDM,20999RVU14OH,SKYE PX50 PLACENTAL TISSUE MATRIX (1.0 CC),1500.0,975.0,0.01,1500.0,84
CDM,20999RVU15OH,SKYE DX100 PLACENTAL TISSUE MATRIX (1.0 CC),1800.0,1170.0,0.01,1800.0,84
CDM,20999RVU16OH,"MARROW ASPIRATION, PROXIMAL TIBIA (COMP CODE 38222)",619.0,402.35,0.01,688.73,84
CDM,20999RVU17OH,SKYE PX50 PLACENTAL TISSUE MATRIX (1.0CC) WITH PRP,2200.0,1430.0,0.01,2200.0,84
CDM,20999RVU18OH,SKYE DX100 PLACENTAL TISSUE MATRIX (1.0 CC) WITH PRP,2500.0,1625.0,0.01,2500.0,84
CDM,20999RVU1OH,ABDOMINAL INSERTION MESH,2457.0,1597.05,0.01,2457.0,84
CDM,20999RVU22OH,RFA MSK TUMOR (COMP CODE 20982),2808.0,1825.2,0.01,2808.0,84
CDM,20999RVU23OH,RADIOFREQUENCY ABLATION SOFT TISSUE MASS (COMP CODE 20982),2808.0,1825.2,0.01,2808.0,84
CDM,20999RVU24OH,CRYOABLATION OF SOFT TISSUE  MASS (COMP CODE 20983),2752.0,1788.8,0.01,2752.0,84
CDM,20999RVU3OH,CARTILAGE FROM EAR TO EYELID,2439.0,1585.35,0.01,2439.0,84
CDM,20999RVU4OH,LAP COMPONENT SEPARATION,2353.0,1529.45,0.01,2353.0,84
CDM,20999RVU5OH,EAR CARTILAGE GRAFT,2439.0,1585.35,0.01,2439.0,84
CDM,20999RVU6OH,"EXTRACORPOREAL SHOCK WAVE, LOW INTENSITY",150.0,97.5,0.01,688.73,84
CDM,20999RVU7OH,FLOGRAFT CLINICAL (1.0 ML) (750K CELLS),2700.0,1755.0,0.01,2700.0,84
CDM,20999RVU8OH,FLOGRAFT CLINICAL WITH PRP,3200.0,2080.0,0.01,3200.0,84
CDM,20999RVU9OH,FLOGRAFT NEOGENISIS (1.0 ML) (1.2 M CELLS),3200.0,2080.0,0.01,3200.0,84
CDM,20999RVUOH,REVISION OF MESH,2457.0,1597.05,0.01,2457.0,84
CDM,21010OH,ARTHROTOMY TEMPOROMANDIBULAR JOINT,4416.0,2870.4,1.1,9391.15,144
CDM,21011OH,EXCISION TUMOR SOFT TISS FACE/SCALP SUBQ < 2CM,1196.0,777.4,1.1,4729.25,148
CDM,21012OH,EXCISION TUMOR SOFT TISS FACE/SCALP SUBQ 2+CM,1780.0,1157.0,1.1,4729.25,144
CDM,21013OH,EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL < 2CM,2168.0,1409.2,1.1,4729.25,148
CDM,21014OH,EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL 2+CM,2852.0,1853.8,1.1,8286.13,144
CDM,21015OH,RAD RESECTION TUMOR SOFT TISS FACE/SCALP < 2CM,3956.0,2571.4,1.1,8286.13,144
CDM,21016OH,RAD RESECTION TUMOR SOFT TISS FACE/SCALP 2+CM,6104.0,3967.6,1.1,8286.13,144
CDM,21025OH,EXCISION BONE MANDIBLE,4012.0,2607.8,1.1,17080.38,148
CDM,21026OH,EXCISION OF FACIAL BONE(S),2280.0,1482.0,1.1,17080.38,148
CDM,21029OH,REMOVAL CONTOURING BENIGN TUMOR FACIAL BONE,3356.0,2181.4,1.1,9391.15,148
CDM,21030OH,EXC BENIGN TUMOR/CYST MAXL/ZYGOMA ENCL & CURTG,1964.0,1276.6,1.1,17080.38,148
CDM,21031OH,EXCISION TORUS MANDIBULARIS,1320.0,858.0,1.1,9391.15,148
CDM,21032OH,EXCISION MAXILLARY TORUS PALATINUS,1336.0,868.4,1.1,9391.15,148
CDM,21034OH,EXCISION MALIGNANT TUMOR MAXILLA/ZYGOMA,7647.0,4970.55,1.1,17080.38,148
CDM,21040OH,EXCISION BENIGN TUMOR/CYST MANDIBLE ENCL & CURT,1964.0,1276.6,1.1,9391.15,148
CDM,21044OH,EXCISION MALIGNANT TUMOR MANDIBLE,5120.0,3328.0,1.1,17080.38,144
CDM,21045OH,EXCISION MALIGNANT TUMOR MANDIBLE RADICAL,7348.0,4776.2,1.1,7348.0,144
CDM,21046OH,EXC BENIGN TUMOR/CYST MNDBL INTRA-ORAL OSTEOT,5684.0,3694.6,1.1,17080.38,144
CDM,21047OH,EXC B9 TUM/CST MNDBL XTR-ORAL OSTEOT&PRTL MNDB,8028.0,5218.2,1.1,17080.38,144
CDM,21048OH,EXC BENIGN TUMOR/CYST MAXL INTRA-ORAL OSTEOT,5884.0,3824.6,1.1,17080.38,144
CDM,21049OH,EXC B9 TUM/CST MAXL XTR-ORAL OSTEOT&PRTL MAXLC,7728.0,5023.2,1.1,17080.38,144
CDM,21050OH,CONDYLECTOMY TEMPOROMANDIBULAR JOINT SPX,4704.0,3057.6,1.1,17080.38,144
CDM,21060OH,MENISCECTOMY PRTL/COMPL TEMPOROMANDIBULAR JT SPX,4428.0,2878.2,1.1,17080.38,144
CDM,21070OH,CORONOIDECTOMY SEPARATE PROCEDURE,3448.0,2241.2,1.1,17080.38,144
CDM,21073OH,MANIPULATION TMJ THERAPEUTIC REQUIRE ANESTHESIA,1380.0,897.0,1.1,4447.63,146
CDM,21076OH,IMPRESSION&PREPARATION SURG OBTURATOR PROSTHES,5360.0,3484.0,1.1,5360.0,148
CDM,21077OH,IMPRESSION & PREPARATION ORBITAL PROSTHESIS,13480.0,8762.0,1.1,17080.38,148
CDM,21079OH,IMPRESSION & PREPARATION INTERIM OBTURATOR PROST,8924.0,5800.6,1.1,9391.15,148
CDM,21080OH,IMPRESSION & PREPJ DEFINITIVE OBTURATOR PROSTHES,10024.0,6515.6,1.1,10024.0,148
CDM,21081OH,IMPRESSION & PREPJ MANDIBULAR RESECTION PROSTHES,9140.0,5941.0,1.1,17080.38,148
CDM,21082OH,IMPRESSION & PREPJ PALATAL AUGMENTATION PROSTHES,8336.0,5418.4,1.1,9391.15,148
CDM,21083OH,IMPRESSION & PREPARATION PALATAL LIFT PROSTHESIS,7708.0,5010.2,1.1,9391.15,148
CDM,21084OH,IMPRESSION & PREPARATION SPEECH AID PROSTHESIS,8992.0,5844.8,1.1,9391.15,148
CDM,21085OH,IMPRESSION & PREPARATION ORAL SURGICAL SPLINT,3596.0,2337.4,1.1,3596.0,148
CDM,21086OH,IMPRESSION & PREPARATION AURICULAR PROSTHESIS,9952.0,6468.8,1.1,9952.0,148
CDM,21087OH,IMPRESSION & PREPARATION NASAL PROSTHESIS,9952.0,6468.8,1.1,17080.38,148
CDM,21088OH,IMPRESSION & PREPARATION FACIAL PROSTHESIS,7736.0,5028.4,1.1,9976.48,88
CDM,21089OH,UNLISTED MAXILLOFACIAL PROSTHETIC PROCEDURE,1144.0,743.6,0.01,1144.0,84
CDM,21100OH,APPL HALO APPLIANCE MAXILLOFACIAL FIXATION SPX,1892.0,1229.8,1.1,17080.38,148
CDM,21110OH,APPL INTERDENTAL FIXATION DEVICE NON-FX/DISLC,2396.0,1557.4,1.1,4447.63,148
CDM,21116OH,INJECTION TEMPOROMANDIBULAR JOINT ARTHROGRAPHY,324.0,210.6,1.1,724.34,148
CDM,21120OH,GENIOPLASTY AUGMENTATION,2040.0,1326.0,1.1,17080.38,146
CDM,21120RVU1OH,CHIN IMPLANT - SIMPLE,2700.0,1755.0,1.1,17080.38,146
CDM,21120RVU2OH,CHIN IMPLANT - MODERATE,3100.0,2015.0,1.1,17080.38,146
CDM,21120RVU3OH,CHIN IMPLANT - COMPLEX,3300.0,2145.0,1.1,17080.38,146
CDM,21121OH,GENIOPLASTY SLIDING OSTEOTOMY SINGLE PIECE,3436.0,2233.4,1.1,9391.15,148
CDM,21122OH,GENIOPLASTY 2/> SLIDING OSTEOTOMIES,3484.0,2264.6,1.1,17080.38,142
CDM,21122RVU1OH,GENIOPLASTY - SIMPLE,3870.0,2515.5,1.1,17080.38,142
CDM,21122RVU2OH,GENIOPLASTY - MODERATE,4000.0,2600.0,1.1,17080.38,142
CDM,21122RVU3OH,GENIOPLASTY - COMPLEX,4250.0,2762.5,1.1,17080.38,142
CDM,21123OH,GENIOP SLIDING AGMNTJ W/INTERPOSAL BONE GRAFTS,4536.0,2948.4,1.1,9391.15,142
CDM,21125OH,AGMNTJ MNDBLR BODY/ANGLE PROSTHETIC MATERIAL,4320.0,2808.0,1.1,17080.38,148
CDM,21127OH,AGMNTJ MNDBLR BDY/ANGL W/GRF ONLAY/INTERPOSAL,4976.0,3234.4,1.1,17080.38,148
CDM,21137OH,REDUCTION FOREHEAD; CONTOURING ONLY,4096.0,2662.4,1.1,9391.15,144
CDM,21138OH,RDCTJ FHD CNTRG & PROSTHETIC MATRL/BONE GRAFT,5148.0,3346.2,1.1,17080.38,144
CDM,21139OH,RDCTJ FHD CNTRG & SETBACK ANT FRONTAL SINUS WALL,6008.0,3905.2,1.1,17080.38,144
CDM,21141OH,"RECONST FACE,LEFORT I,1 PIECE",7828.0,5088.2,1.1,17080.38,144
CDM,21142OH,"RECONST FACE,LEFORT I,2 PIECES",8112.0,5272.8,1.1,17080.38,144
CDM,21143OH,"RECONST FACE,LEFORT I,3+ PIECES",8420.0,5473.0,1.1,17080.38,144
CDM,21145OH,"RECONST FACE,LEFORT I,1 PIECE+GRFT",9576.0,6224.4,1.1,9576.0,144
CDM,21146OH,"RECONST FACE,LEFORT I,2 PIECES+GRFT",9948.0,6466.2,1.1,9948.0,144
CDM,21147OH,"RECONST FACE,LEFORT I,3+PIECES+GRFT",10588.0,6882.2,1.1,10588.0,144
CDM,21150OH,RCNSTJ MIDFACE LEFORT II ANTERIOR INTRUSION,10384.0,6749.6,1.1,17080.38,144
CDM,21151OH,RCNSTJ MIDFACE LEFORT II W/BONE GRAFTS,11608.0,7545.2,1.1,11608.0,144
CDM,21154OH,RCNSTJ MIDFACE LEFORT III W/O LEFORT I,12516.0,8135.4,1.1,12516.0,144
CDM,21155OH,"RECONST FACE,LEFORT III+LEFORT I",14088.0,9157.2,1.1,14088.0,144
CDM,21159OH,RCNSTJ MIDFACE LEFORT III W/FHD W/O LEFORT I,17256.0,11216.4,1.1,17256.0,144
CDM,21160OH,RCNSTJ MIDFACE LEFORT III W/FHD W/LEFORT I,18876.0,12269.4,1.1,18876.0,144
CDM,21172OH,RCNSTJ SUPERIOR-LATERAL ORBITAL RIM & LOWER FHD,11280.0,7332.0,1.1,17080.38,144
CDM,21175OH,RCNSTJ BIFRONTAL SUPERIOR-LAT ORB RIMS & LWR FHD,13424.0,8725.6,1.1,17080.38,144
CDM,21179OH,RCNSTJ FOREHEAD &/ SUPRAORB RIMS W/ALGRF/PROSTC,9060.0,5889.0,1.1,9060.0,144
CDM,21180OH,RCNSTJ FOREHEAD &/ SUPRAORBITAL RIMS W/AUTOGRAFT,10232.0,6650.8,1.1,10232.0,144
CDM,21181OH,RCNSTJ CONTOURING BENIGN TUMOR CRNL BONES XTRC,4112.0,2672.8,1.1,17080.38,144
CDM,21182OH,RCNSTJ ORBIT/FHD/NASETHMD EXCBONE TUM GRF<40SQCM,13032.0,8470.8,1.1,13032.0,144
CDM,21183OH,RCNSTJ ORBIT/FHD/NASETHMD EXC BONE GRF>40 <80,14280.0,9282.0,1.1,14280.0,144
CDM,21184OH,RCNSTJ ORBIT/FHD/NASETHMD EXC BONE TUM GRF>80SQ,15448.0,10041.2,1.1,15448.0,144
CDM,21188OH,RCNSTJ MDFC OTH/THN LEFORT OSTEOT & BONE GRAFTS,9260.0,6019.0,1.1,9260.0,144
CDM,21193OH,RCNSTJ MNDBLR RAMI HRZNTL/VER/C/L OSTEOT W/O GRF,7560.0,4914.0,1.1,17080.38,144
CDM,21194OH,RCNSTJ MNDBLR RAMI HRZNTL/VER/C/L OSTEOT W/GRAFT,8728.0,5673.2,1.1,17080.38,144
CDM,21195OH,RCNSTJ MNDBLR RAMI&/BODY SGTL SPLT W/O INT RGD,7664.0,4981.6,1.1,17080.38,144
CDM,21196OH,RCNSTJ MNDBLR RAMI&/BDY SGTL SPLT W/INT RGD FI,8332.0,5415.8,1.1,17080.38,144
CDM,21198OH,OSTEOTOMY MANDIBLE SEGMENTAL,6284.0,4084.6,1.1,17080.38,144
CDM,21199OH,OSTEOTOMY MANDIBLE SGMTL W/GENIOGLOSSUS ADVMNT,6692.0,4349.8,1.1,17080.38,144
CDM,2120662OH,NM SALIVARY GLAND IMAGING,1047.0,680.55,1.1,1202.97,142
CDM,2120662OH-25,NM SALIVARY GLAND IMAGING,250.0,162.5,1.1,250.0,70
CDM,2120683OH,NM PET CARDIAC PERF STRESS RB82,495.0,321.75,1.1,495.0,70
CDM,21206OH,OSTEOTOMY MAXILLA SEGMENTAL,6236.0,4053.4,1.1,17080.38,144
CDM,21208OH,OSTEOPLASTY FACIAL BONES AUGMENTATION,4568.0,2969.2,1.1,17080.38,148
CDM,21209OH,OSTEOPLASTY FACIAL BONES REDUCTION,3128.0,2033.2,1.1,17080.38,146
CDM,21210OH,GRAFT BONE NASAL/MAXILLARY/MALAR AREAS,5144.0,3343.6,1.1,17080.38,148
CDM,21210RVU1OH,CHEECK IMPLANT W BONE GRAFT,2000.0,1300.0,1.1,17080.38,148
CDM,21215OH,GRAFT BONE MANDIBLE,4892.0,3179.8,1.1,17080.38,148
CDM,21230OH,GRAFT RIB CRTLG AUTOGENOUS FACE/CHIN/NOSE/EAR,4468.0,2904.2,1.1,17080.38,144
CDM,21230RVU1OH,RHINOPLASTY (RIB) - SIMPLE,5050.0,3282.5,1.1,17080.38,144
CDM,21230RVU2OH,RHINOPLASTY (RIB) - MODERATE,6490.0,4218.5,1.1,17080.38,144
CDM,21230RVU3OH,RHINOPLASTY (RIB) - COMPLEX,7950.0,5167.5,1.1,17080.38,144
CDM,2123247OH,NM SALIVARY GLAND,180.0,117.0,1.1,180.0,126
CDM,21235OH,GRAFT EAR CRTLG AUTOGENOUS NOSE/EAR,3000.0,1950.0,1.1,17080.38,148
CDM,21240OH,ARTHRP TEMPOROMANDIBULAR JOINT W/WO AUTOGRAFT,6428.0,4178.2,1.1,17080.38,144
CDM,21242OH,ARTHROPLASTY TEMPOROMANDIBULAR JT W/ALLOGRAFT,5836.0,3793.4,1.1,17080.38,144
CDM,21243OH,ARTHRP TMPRMAND JOINT W/PROSTHETIC REPLACEMENT,9812.0,6377.8,1.1,54351.12,144
CDM,21244OH,RCNSTJ MNDBL XTRORAL W/TRANSOSTEAL BONE PLATE,5448.0,3541.2,1.1,17080.38,144
CDM,21245OH,RCNSTJ MNDBL/MAXL SUBPRIOSTEAL IMPLANT PARTIAL,5248.0,3411.2,1.1,17080.38,148
CDM,21246OH,RCNSTJ MNDBL/MAXL SUBPRIOSTEAL IMPLANT COMPLETE,5168.0,3359.2,1.1,17080.38,144
CDM,21247OH,RCNSTJ MNDBLR CONDYLE W/BONE CARTLG AUTOGRAFTS,9748.0,6336.2,1.1,9748.0,144
CDM,21248OH,RCNSTJ MANDIBLE/MAXL ENDOSTEAL IMPLANT PARTIAL,5096.0,3312.4,1.1,17080.38,148
CDM,21249OH,RCNSTJ MANDIBLE/MAXL ENDOSTEAL IMPLANT COMPLETE,7508.0,4880.2,1.1,17080.38,148
CDM,21255OH,RCNSTJ ZYGMTC ARCH/GLENOID FOSSA W/BONE CARTLG,7384.0,4799.6,1.1,17080.38,144
CDM,21256OH,RECONSTRUCTION ORBIT W/OSTEOTOMIES & BONE GRAFTS,7770.0,5050.5,1.1,17080.38,144
CDM,21261OH,PERIORBITAL OSTEOTOMIES W/BONE GRAFTS ICRA & XTR,13628.0,8858.2,1.1,17080.38,144
CDM,21267OH,ORBITAL REPOSITIONING W/BONE GRAFTS EXTRACRANIAL,8276.0,5379.4,1.1,17080.38,144
CDM,21268OH,ORBITAL REPOSITIONING W/BONE GRAFTS ICRA & XTRC,10828.0,7038.2,1.1,10828.0,144
CDM,21270OH,MALAR AUGMENTATION PROSTHETIC MATERIAL,4252.0,2763.8,1.1,17080.38,148
CDM,21270RVU1OH,CHEECK IMPLANT W/O BONE GRAFT,2000.0,1300.0,1.1,17080.38,148
CDM,21275OH,SECONDARY REVISION ORBITOCRANIOFACIAL RCNSTJ,4704.0,3057.6,1.1,17080.38,144
CDM,21280OH,MEDIAL CANTHOPEXY SEPARATE PROCEDURE,2852.0,1853.8,1.1,9391.15,142
CDM,21282OH,CANTHOPEXY ;LATERAL,1708.0,1110.2,1.1,9391.15,142
CDM,21282RVU1OH,CANTHOPEXY,1538.0,999.7,1.1,9391.15,142
CDM,21295OH,REDUCTION MASSETER MUSCLE & BONE EXTRAORAL,760.0,494.0,1.1,4447.63,144
CDM,21296OH,REDUCTION MASSETER MUSCLE & BONE INTRAORAL,1912.0,1242.8,1.1,9391.15,144
CDM,21299RVU1OH,"PERSONALIZED, AUTOLOGOUS BONE GRAFT FOR MANDIBULAR RECONSTRUCTIO",7201.0,4680.65,0.01,7201.0,84
CDM,21299RVU2OH,UNLISTED CRANIOFACIAL & MAXILLOFACIAL PROCEDURE,2727.0,1772.55,0.01,2727.0,84
CDM,21299RVU3OH,REMOVAL BY CONTOURING OF BENIGN TUMOR FACIAL BONE (COMP CODE 210,3566.0,2317.9,0.01,3566.0,84
CDM,21299RVU4OH,DAO TRANSORAL MYECTOMY (COMP CODE 21013),2304.0,1497.6,0.01,2304.0,84
CDM,21299RVU5OH,"TRANS-OSTEAL PLATING FOR MANDIBLE RECONSTRUCTION, INTRAORAL, WIT",4904.0,3187.6,0.01,4904.0,84
CDM,21299RVU6OH,COMPLEX SCULPTING & CARVING OF CADAVERIC RIB EAR CARTILAGE FRAME,4022.0,2614.3,0.01,4022.0,84
CDM,21299RVUOH,TRANSCER EXCIS STYLOID PROCESS LIGAMENT (COMP 61605),8438.0,5484.7,0.01,8438.0,84
CDM,21315OH,CLOSED TX NASAL BONE FX W/MNPJ W/O STABILIZATION,422.0,274.3,1.1,4447.63,148
CDM,21320OH,CLOSED TX NASAL BONE FX W/MNPJ W/STABILIZATION,700.0,455.0,1.1,9391.15,148
CDM,21325OH,OPEN TREATMENT NASAL FRACTURE UNCOMPLICATED,1672.0,1086.8,1.1,9391.15,144
CDM,21330OH,OPEN TX NASAL FX COMP W/INT&/XTRNL SKELETAL FI,2316.0,1505.4,1.1,17080.38,144
CDM,21335OH,OPEN TX NASAL FX W/CONCOMITANT OPTX FXD SEPTUM,3608.0,2345.2,1.1,9391.15,144
CDM,21336OH,OPEN TX NASAL SEPTAL FRACTURE W/WO STABILIZATION,2708.0,1760.2,1.1,9440.12,144
CDM,21337OH,CLOSED TX NASAL SEPTAL FRACT W/WO STABILIZATION,1356.0,881.4,1.1,9391.15,146
CDM,21338OH,OPEN TX NASOETHMOID FX W/O EXTERNAL FIXATION,2748.0,1786.2,1.1,17080.38,144
CDM,21339OH,OPEN TX NASOETHMOID FX W/EXTERNAL FIXATION,3400.0,2210.0,1.1,17080.38,144
CDM,21340OH,PERCUTANEOUS TX NASOETHMOID COMPLEX FRACTURE,4596.0,2987.4,1.1,9391.15,144
CDM,21343OH,OPEN TX DEPRESSED FRONTAL SINUS FRACTURE,5728.0,3723.2,1.1,5728.0,144
CDM,21344OH,OPEN TX COMPLICATED FRONTAL SINUS FRACTURE,8628.0,5608.2,1.1,8628.0,144
CDM,21346OH,OPTX NASOMAX CPLX FX LEFT II TYPE W/WIRG & FXJ,4580.0,2977.0,1.1,17080.38,144
CDM,21347OH,OPTX NASOMAX CPLX FX LEFT II TYPE REQ MLT OPN,5412.0,3517.8,1.1,17080.38,144
CDM,21355OH,PERCUTANEOUS TX MALAR AREA FRACTURE,1780.0,1157.0,1.1,9391.15,148
CDM,21356OH,OPEN TX DEPRESSED ZYGOMATIC ARCH FRACTURE,1932.0,1255.8,1.1,17080.38,148
CDM,21360OH,OPEN TX DEPRESSED MALAR FRACTURE,2876.0,1869.4,1.1,17080.38,144
CDM,21365OH,OPEN TX COMP FX MALAR W/INTERNAL FX&MULT SURG,6708.0,4360.2,1.1,17080.38,144
CDM,21366OH,OPEN TX COMP FRACTURE MALAR AREA W/BONE GRAFT,7440.0,4836.0,1.1,17080.38,144
CDM,21385OH,OPEN TX ORBITAL FLOOR BLOWOUT FX TRANSANTRAL,3828.0,2488.2,1.1,17080.38,144
CDM,21386OH,OPEN TX ORBITAL FLOOR BLOWOUT FX PERIORBITAL,3828.0,2488.2,1.1,17080.38,144
CDM,21387OH,OPEN TX ORBITAL FLOOR BLOWOUT FX COMBINED APPR,4044.0,2628.6,1.1,17080.38,144
CDM,21390OH,OPTX ORB FLOOR BLWT FX PRI/BITAL APPR W/ALLPLSTC,4492.0,2919.8,1.1,17080.38,144
CDM,21395OH,OPTX ORB FLOOR BLWT FX PRI/BITAL APPR W/BONE GRF,5880.0,3822.0,1.1,17080.38,144
CDM,21400OH,CLSD TX FX ORBIT EXCEPT BLOWOUT W/O MANIPULATION,600.0,390.0,1.1,1603.96,146
CDM,21406OH,OPEN TX FX ORBIT EXCEPT BLOWOUT W/O IMPLANT,2968.0,1929.2,1.1,17080.38,144
CDM,21407OH,OPEN TX FX ORBIT EXCEPT BLOWOUT W/IMPLANT,3608.0,2345.2,1.1,17080.38,144
CDM,21408OH,OPEN TX FX ORBIT EXCEPT BLOWOUT W/BONE GRAFT,5112.0,3322.8,1.1,17080.38,144
CDM,21421OH,CLOSED TX PALATAL/MAXILLARY FX W/FIXATION/SPLINT,2408.0,1565.2,1.1,9391.15,148
CDM,21422OH,OPEN TREATMENT PALATAL/MAXILLARY FRACTURE,3492.0,2269.8,1.1,17080.38,144
CDM,21423OH,OPEN TX PALATAL/MAXILLARY FX COMP MULTIPLE APPR,4340.0,2821.0,1.1,4340.0,144
CDM,21432OH,OPEN TX CRANIOFACIAL SEP W/WIRING&/INT FIXJ,3528.0,2293.2,1.1,3528.0,144
CDM,21433OH,OPEN TX CRANIOFACIAL SEP COMPLICATED MLT APPR,10516.0,6835.4,1.1,10516.0,144
CDM,21435OH,OPEN TX CRANIOFACIAL SEP COMP W/INT&/XTRNL FIX,8104.0,5267.6,1.1,8104.0,144
CDM,21440OH,CLTX MANDIBULAR/MAXILLARY ALVEOLAR RIDGE FX SPX,1376.0,894.4,1.1,9391.15,148
CDM,21445OH,OPTX MANDIBULAR/MAXILLARY ALVEOLAR RIDGE FX SPX,2504.0,1627.6,1.1,17080.38,148
CDM,21450OH,CLOSED TX MANDIBULAR FRACTURE W/O MANIPULATION,1484.0,964.6,1.1,1995.71,146
CDM,21451OH,CLOSED TX MANDIBULAR FRACTURE W/MANIPULATION,2260.0,1469.0,1.1,4447.63,148
CDM,21453OH,CLOSED TX MANDIBULAR FX W/INTERDENTAL FIXATION,2656.0,1726.4,1.1,17080.38,148
CDM,21454OH,OPEN TX MANDIBULAR FX W/EXTERNAL FIXATION,2944.0,1913.6,1.1,17080.38,144
CDM,21461OH,OPEN TX MANDIBULAR FX W/O INTERDENTAL FIXATION,3724.0,2420.6,1.1,17080.38,148
CDM,21462OH,OPEN TX MANDIBULAR FX W/INTERDENTAL FIXATION,4404.0,2862.6,1.1,17080.38,148
CDM,21465OH,OPEN TREATMENT MANDIBULAR CONDYLAR FRACTURE,5248.0,3411.2,1.1,17080.38,144
CDM,21470OH,OPTX COMP MANDIBULAR FX MLT APPR W/INT FIXATION,7016.0,4560.4,1.1,17080.38,144
CDM,21480OH,CLOSED TX TEMPOROMANDIBULAR DISLOCATION 1ST/SBSQ,268.0,174.2,1.1,688.73,148
CDM,21485OH,CLOSED TX TEMPOROMANDIBULAR DISLC COMP 1ST/SBSQ,1908.0,1240.2,1.1,4447.63,148
CDM,21490OH,OPEN TREATMENT TEMPOROMANDIBULAR DISLOCATION,5180.0,3367.0,1.1,9391.15,144
CDM,21497OH,INTERDENTAL WIRING OTHER THAN FRACTURE,1856.0,1206.4,1.1,4447.63,148
CDM,21499RVU1OH,RESECTION OF HYOID BONE (COMP 60280),1626.0,1056.9,0.01,1626.0,84
CDM,21501OH,I&D DEEP ABSC/HMTMA SOFT TISSUE NECK/THORAX,1592.0,1034.8,1.1,8286.13,148
CDM,21502OH,I&D DP ABSC/HMTMA SOFT TISS NCK/THORAX PRTL RI,3020.0,1963.0,1.1,9440.12,144
CDM,21510OH,INCISION DEEP OPENING BONE CORTEX THORAX,2480.0,1612.0,1.1,2480.0,144
CDM,21550OH,BIOPSY SOFT TISSUE NECK/CHEST,844.0,548.6,1.1,4729.25,148
CDM,21552OH,EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBQ 3+CM,2596.0,1687.4,1.1,8286.13,144
CDM,21554OH,EXC TUMOR SOFT TISSUE NECK/THORAX SUBFASC 5+CM,4452.0,2893.8,1.1,8286.13,144
CDM,21555OH,EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBQ <3CM,1584.0,1029.6,1.1,4729.25,148
CDM,21556OH,EXC TUMOR SOFT TISS NECK/THORAX SUBFASCIAL <5CM,3064.0,1991.6,1.1,8286.13,144
CDM,21557OH,RAD RESECT TUMOR SOFT TISS NECK/ANT THORAX <5CM,5900.0,3835.0,1.1,8286.13,144
CDM,21558OH,RAD RESECT TUMOR SOFT TISS NECK/ANT THORAX 5+CM,8632.0,5610.8,1.1,8632.0,144
CDM,21600OH,EXCISION RIB PARTIAL,2904.0,1887.6,1.1,20863.78,144
CDM,21601OH,EXCISION CHEST WALL TUMOR INCLUDING RIBS,7112.0,4622.8,1.1,8286.13,144
CDM,21602OH,EXCISION CH WAL TUM W/RIB W/O MEDSTNL LYMPHADEC,8876.0,5769.4,1.1,8876.0,144
CDM,21603OH,EXCISION CH WAL TUM W/RIB W/MEDSTNL LYMPHADEC,10068.0,6544.2,1.1,10068.0,144
CDM,21610OH,COSTOTRANSVERSECTOMY SEPARATE PROCEDURE,6364.0,4136.6,1.1,9440.12,144
CDM,21615OH,EXCISION 1ST &/CERVICAL RIB,4180.0,2717.0,1.1,4180.0,144
CDM,21616OH,EXCISION 1ST &/CERVICAL RIB W/SYMPATHECTOMY,5076.0,3299.4,1.1,5076.0,144
CDM,21620OH,OSTECTOMY STERNUM PARTIAL,2912.0,1892.8,1.1,2912.0,144
CDM,21627OH,STERNAL DEBRIDEMENT,2920.0,1898.0,1.1,2920.0,144
CDM,21630OH,RADICAL RESECTN STERNUM,7672.0,4986.8,1.1,7672.0,144
CDM,21685OH,HYOID MYOTOMY AND SUSPENSION,6104.0,3967.6,1.1,17080.38,144
CDM,21700OH,DIVISION SCALENUS ANTICUS W/O RESCJ CERVICAL RIB,2524.0,1640.6,1.1,20863.78,144
CDM,21705OH,DIVISION SCALENUS ANTICUS RESECTION CERVICAL RIB,3968.0,2579.2,1.1,3968.0,144
CDM,21720OH,DIVISION STERNOCLEIDOMASTOID OPEN W/O CAST,2320.0,1508.0,1.1,9440.12,144
CDM,21740OH,REPAIR PECTUS EXCAVATUM/CARINATUM OPEN,7028.0,4568.2,1.1,7028.0,144
CDM,21742OH,REPAIR PECTUS EXCAVATM/CARINATM MINLY W/O THRSC,9670.0,6285.5,1.1,9670.0,106
CDM,21743OH,REPAIR PECTUS EXCAVATM/CARINATM MINLY W/THRSC,10772.0,7001.8,1.1,10772.0,106
CDM,21750OH,CLOSE MEDIAN STERNOTOMY SEP W/WO DEBRIDEMENT SPX,4560.0,2964.0,1.1,4560.0,144
CDM,21811OH,OPEN TX RIB FX W/FIXJ THORACOSCOPIC VIS 1-3 RIBS,4316.0,2805.4,1.1,20863.78,144
CDM,21812OH,OPEN TX RIB FX W/FIXJ THORACOSCOPIC VIS 4-6 RIBS,5200.0,3380.0,1.1,20863.78,144
CDM,21813OH,OPEN TX RIB FX W/FIXJ THORACOSCOPIC VIS 7+ RIBS,7044.0,4578.6,1.1,7044.0,144
CDM,21825OH,OPEN TX STERNUM FRACTURE W/WO SKELETAL FIXATION,3104.0,2017.6,1.1,3104.0,144
CDM,21899AOH,INTRALESIONAL STEROID INJ,419.0,272.35,0.01,713.21,84
CDM,21899BOH,EXPLORE FOR POST-OP WOUND DEHISCENCE/NECK,1313.0,853.45,0.01,1313.0,84
CDM,21899RVU1OH,PECTORALIS MINOR TENDON RELEASE (COMP CODE 23405),2818.0,1831.7,0.01,2818.0,84
CDM,21899RVU2OH,PLATYSMAL MYOTOMY FOR SYNKINESIS/TIGHTNESS FOR FACIAL NERVE SPAS,2105.0,1368.25,0.01,2105.0,84
CDM,21899RVU4OH,STERNAL NONUNION TAKEDOWN (COMP CODE 27470),6171.0,4011.15,0.01,6171.0,84
CDM,21899RVUOH,DEBRIDE NECROTIZING TISS INFECT; NECK,3564.0,2316.6,0.01,3564.0,84
CDM,21920OH,BIOPSY SOFT TISSUE BACK/FLANK SUPERFICIAL,844.0,548.6,1.1,4729.25,148
CDM,21925OH,BIOPSY SOFT TISSUE BACK/FLANK DEEP,1852.0,1203.8,1.1,4729.25,148
CDM,21930OH,EXCISION TUMOR SOFT TISSUE BACK/FLANK SUBQ <3CM,1976.0,1284.4,1.1,4729.25,148
CDM,21931OH,EXCISION TUMOR SOFT TISSUE BACK/FLANK SUBQ 3+CM,2752.0,1788.8,1.1,4729.25,144
CDM,21932OH,EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL <5CM,3928.0,2553.2,1.1,8286.13,144
CDM,21933OH,EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL 5+CM,4452.0,2893.8,1.1,8286.13,144
CDM,21935OH,RAD RESECTION TUMOR SOFT TISSUE BACK/FLANK <5CM,6288.0,4087.2,1.1,8286.13,144
CDM,21936OH,RAD RESECTION TUMOR SOFT TISSUE BACK/FLANK 5+CM,9020.0,5863.0,1.1,9020.0,144
CDM,22010OH,I&D DEEP ABSCESS PST SPINE CRV THRC/CERVICOTHR,5100.0,3315.0,1.1,5100.0,144
CDM,22015OH,I&D DEEP ABSCESS PST SPINE LUMBAR SAC/LUMBOSAC,5056.0,3286.4,1.1,5056.0,144
CDM,22100OH,PRTL EXC PST VRT INTRNSC B1Y LES 1 VRT SGM CRV,4400.0,2860.0,1.1,20863.78,144
CDM,22101OH,PRTL EXC PST VRT INTRNSC B1Y LES 1 VRT SGM THRC,4432.0,2880.8,1.1,20863.78,144
CDM,22102OH,PRTL EXC PST VRT INTRNSC B1Y LES 1 VRT SGM LMBR,4432.0,2880.8,1.1,20863.78,144
CDM,22103OH,PRTL EXC PST VRT INTRNSC B1Y LES 1 VRT SGM EA,936.0,608.4,1.1,936.0,144
CDM,22110OH,PRTL EXC VRT BDY B1Y LES W/O SPI CORD 1 SGM CRV,5600.0,3640.0,1.1,5600.0,144
CDM,22112OH,PRTL EXC VRT BDY B1Y LES W/O SPI CORD 1 SGM THRC,5628.0,3658.2,1.1,5628.0,144
CDM,22114OH,PRTL EXC VRT BDY B1Y LES W/O SPI CORD 1 SGM LMBR,5628.0,3658.2,1.1,5628.0,144
CDM,22116OH,PRTL EXC VRT BDY B1Y LES W/O SPI CORD 1 SGM EA,928.0,603.2,1.1,928.0,144
CDM,22206OH,OSTEOTOMY SPINE POSTERIOR 3 COLUMN THORACIC,14872.0,9666.8,1.1,14872.0,144
CDM,22207OH,OSTEOTOMY SPINE POSTERIOR 3 COLUMN LUMBAR,14672.0,9536.8,1.1,14672.0,144
CDM,22208OH,OSTEOTOMY SPINE POSTERIOR 3 COLUMN EA ADDL SGM,3864.0,2511.6,1.1,3864.0,144
CDM,22210OH,OSTEOTOMY SPINE PST/PSTLAT APPR 1 VRT SGM CRV,10152.0,6598.8,1.1,10152.0,144
CDM,22212OH,OSTEOTOMY SPINE PST/PSTLAT APPR 1 VRT SGM THRC,8396.0,5457.4,1.1,8396.0,144
CDM,22214OH,OSTEOTOMY SPINE PST/PSTLAT APPR 1 VRT SGM LMBR,8408.0,5465.2,1.1,8408.0,144
CDM,22216OH,OSTEOT SPI PST/PSTLAT APPR 1 VRT SGM EA VRT SGM,2653.0,1724.45,1.1,2653.0,144
CDM,22220OH,OSTEOTOMY SPINE W/DSC ANT APPR 1 VRT SGM CRV,9176.0,5964.4,1.1,9176.0,144
CDM,22222OH,OSTEOTOMY SPINE W/DSC ANT APPR 1 VRT SGM THRC,9236.0,6003.4,1.1,9236.0,144
CDM,22224OH,OSTEOTOMY SPINE W/DSC ANT APPR 1 VRT SGM LUMBAR,9236.0,6003.4,1.1,9236.0,144
CDM,22226OH,OSTEOTOMY SPINE W/DSC ANT APPR 1 VRT SGM EA ADDL,2412.0,1567.8,1.1,2412.0,144
CDM,22310OH,CLTX VRT BDY FX W/O MANJ REQ&W/CSTING/BRACING,1380.0,897.0,1.1,1380.0,148
CDM,22315OH,CLTX VRT FX&/DISLC CSTING/BRACING MANJ/TRCJ,4044.0,2628.6,1.1,9440.12,148
CDM,22318OH,OPTX&/RDCTJ ODNTD FX&/DISLC ANT FIXJ W/O GRAFT,9088.0,5907.2,1.1,9088.0,144
CDM,22325OH,OPTX&/RDCTJ VRT FX&/DISLC PST 1 VRT SGM LM,7948.0,5166.2,1.1,7948.0,144
CDM,22326OH,OPTX&/RDCTJ VRT FX&/DISLC PST 1 VRT SGM CR,8336.0,5418.4,1.1,8336.0,144
CDM,22327OH,OPTX&/RDCTJ VRT FX&/DISLC PST 1 VRT SGM TH,8308.0,5400.2,1.1,8308.0,144
CDM,22328OH,OPTX&/RDCTJ VRT FX&/DISLC PST 1 VRT SGM EA,1840.0,1196.0,1.1,1840.0,144
CDM,22505OH,MANIPULATION SPINE W ANESTHESIA,748.0,486.2,1.1,4686.39,144
CDM,22510OH,PERQ VERTEBROPLASTY UNI/BI INJX CERVICOTHORACIC,3160.0,2054.0,1.1,9440.12,148
CDM,22511OH,PERQ VERTEBROPLASTY UNI/BI INJECTION LUMBOSACRAL,2932.0,1905.8,1.1,9440.12,148
CDM,22512OH,VERTEBROPLASTY EACH ADDL CERVICOTHOR/LUMBOSACRAL,1600.0,1040.0,1.1,2471.3,148
CDM,22513AOH,PERQ VERT AGMNTJ CAVITY CRTJ UNI/BI CANNULATION,2851.0,1853.15,1.1,20863.78,148
CDM,22513OH,PERQ VERT AGMNTJ CAVITY CRTJ UNI/BI CANNULATION,3460.0,2249.0,1.1,20863.78,148
CDM,22514OH,PERQ VERT AGMNTJ CAVITY CRTJ UNI/BI CANNULJ LMBR,3196.0,2077.4,1.1,20863.78,148
CDM,22515OH,PERQ VERT AGMNTJ CAVITY CRTJ UNI/BI CANNULJ EACH,1760.0,1144.0,1.1,9838.01,148
CDM,22526OH,"PERC INTRADISC ELECTRO ANNULOPLASTY, SINGLE LEVEL",2340.0,1521.0,1.1,6640.41,114
CDM,22527OH,PERQ INTRDSCL ELECTROTHRM ANNULOPLASTY ADDL LVL,1212.0,787.8,1.1,5443.1,114
CDM,22532OH,ARTHRODESIS LATERAL EXTRACAVITARY THORACIC,10396.0,6757.4,1.1,10396.0,144
CDM,22533OH,ARTHRODESIS LATERAL EXTRACAVITARY LUMBAR,9916.0,6445.4,1.1,9916.0,144
CDM,22534OH,ARTHRODESIS LAT EXTRACAVITARY EA ADDL THRC/LMBR,2396.0,1557.4,1.1,2396.0,144
CDM,22548OH,ARTHRD ANT TRANSORL/XTRORAL C1-C2 W/WO EXC ODNTD,10824.0,7035.6,1.1,10824.0,144
CDM,22551OH,ARTHRD ANT INTERBODY DECOMPRESS CERVICAL BELW C2,11000.0,7150.0,1.1,38384.94,144
CDM,22552OH,ARTHRD ANT INTERDY CERVCL BELW C2 EA ADDL NTRSPC,2600.0,1690.0,1.1,2600.0,144
CDM,22554OH,ARTHRD ANT INTERBODY MIN DSC CRV BELOW C2,7784.0,5059.6,1.1,38384.94,144
CDM,22556OH,ARTHRD ANT INTERBODY MIN DSC THORACIC,9880.0,6422.0,1.1,9880.0,144
CDM,22558OH,ARTHRD ANT INTERBODY MIN DSC LUMBAR,10353.0,6729.45,1.1,10353.0,144
CDM,22585OH,ARTHRD ANT NTRBD MIN DSC EA ADDL INTERSPACE,2429.0,1578.85,1.1,2429.0,144
CDM,22586OH,ARTHRODESIS PRESACRAL INTRBDY W/INSTRUMENT L5/S1,11248.0,7311.2,1.1,11248.0,144
CDM,22590OH,ARTHRODESIS POSTERIOR CRANIOCERVICAL,8704.0,5657.6,1.1,8704.0,144
CDM,22595OH,ARTHRODESIS POSTERIOR ATLAS-AXIS C1-C2,8256.0,5366.4,1.1,8256.0,144
CDM,22600OH,ARTHRD PST/PSTLAT TQ 1NTRSPC CRV BELW C2 SEGMENT,6960.0,4524.0,1.1,6960.0,144
CDM,22610OH,ARTHRODESIS POSTERIOR/PSTLAT TQ 1NTRSPC THORACIC,7603.0,4941.95,1.1,7603.0,144
CDM,22612OH,ARTHRODESIS POSTERIOR/PSTLAT TQ 1NTRSPC LUMBAR,10353.0,6729.45,1.1,54351.12,144
CDM,22614OH,ARTHRODESIS PST/PSTLAT TQ 1NTRSPC EA ADDL NTRSPC,2829.0,1838.85,1.1,2829.0,144
CDM,22630OH,ARTHRODESIS POSTERIOR INTERBODY 1 NTRSPC LUMBAR,9720.0,6318.0,1.1,54351.12,144
CDM,22632OH,ARTHRODESIS POSTERIOR INTERBODY 1 NTRSPC EA ADDL,2297.0,1493.05,1.1,2297.0,144
CDM,22633OH,ARTHRODESIS COMBINED TQ 1NTRSPC LUMBAR,11792.0,7664.8,1.1,54351.12,144
CDM,22634OH,ARTHRODESIS CMBN TQ 1NTRSPC EACH ADDITIONAL,3502.0,2276.3,1.1,3502.0,144
CDM,22800OH,ARTHRODESIS POSTERIOR SPINAL DFRM <6 VRT SGM,8580.0,5577.0,1.1,8580.0,144
CDM,22802OH,ARTHRODESIS POSTERIOR SPINAL DFRM 7-12 VRT SGM,14128.0,9183.2,1.1,14128.0,144
CDM,22804OH,ARTHRODESIS POSTERIOR SPINAL DFRM 13+ VRT SGM,16500.0,10725.0,1.1,16500.0,144
CDM,22808OH,ARTHRODESIS ANTERIOR SPINAL DFRM 2-3 VRT SGM,11004.0,7152.6,1.1,11004.0,144
CDM,22810OH,ARTHRODESIS ANTERIOR SPINAL DFRM 4-7 VRT SGM,12600.0,8190.0,1.1,12600.0,144
CDM,22812OH,ARTHRODESIS ANTERIOR SPINAL DFRM 8+ VRT SGM,13700.0,8905.0,1.1,13700.0,144
CDM,22818OH,"KYPHECTOMY, 1-2 SEGMENTS",13732.0,8925.8,1.1,13732.0,144
CDM,22819OH,"KYPHECTOMY, 3 & MORE SEGMENT",15752.0,10238.8,1.1,15752.0,144
CDM,22830OH,EXPLORATION OF SPINAL FUSION,4937.0,3209.05,1.1,4937.0,144
CDM,22836OH,ANT THORACIC VRT BODY TETHERING <7 VRT SEGMENTS,14080.0,9152.0,1.1,14080.0,142
CDM,22837OH,ANT THORACIC VRT BODY TETHERING 8+ VRT SEGMENTS,15620.0,10153.0,1.1,15620.0,142
CDM,22838OH,REVJ RPLCMT/RMVL THORACIC VRT BODY TETHERING,15840.0,10296.0,1.1,15840.0,142
CDM,22840OH,POSTERIOR NON-SEGMENTAL INSTRUMENTATION,5509.0,3580.85,1.1,5509.0,144
CDM,22841OH,INTERNAL SPINAL FIXATION WIRING SPINOUS PROCESS,2427.0,1577.55,1.1,2427.0,88
CDM,22842OH,POSTERIOR SEGMENTAL INSTRUMENTATION 3-6 VRT SEG,5526.0,3591.9,1.1,5526.0,144
CDM,22843OH,POSTERIOR SEGMENTAL INSTRUMENTATION 7-12 VRT SEG,5914.0,3844.1,1.1,5914.0,144
CDM,22844OH,POSTERIOR SEGMENTAL INSTRUMENTATION 13/> VRT SE,7225.0,4696.25,1.1,7225.0,144
CDM,22845OH,ANTERIOR INSTRUMENTATION 2-3 VERTEBRAL SEGMENTS,5254.0,3415.1,1.1,5254.0,144
CDM,22846OH,ANTERIOR INSTRUMENTATION 4-7 VERTEBRAL SEGMENTS,5456.0,3546.4,1.1,5456.0,144
CDM,22847OH,ANTERIOR INSTRUMENTATION 8/> VERTEBRAL SEGMENTS,6063.0,3940.95,1.1,6063.0,144
CDM,22848OH,PELVIC FIXATION OTHER THAN SACRUM,2636.0,1713.4,1.1,2636.0,144
CDM,22849OH,REINSERTION SPINAL FIXATION DEVICE,8435.0,5482.75,1.1,8435.0,144
CDM,22850OH,REMOVAL POSTERIOR NONSEGMENTAL INSTRUMENTATION,3928.0,2553.2,1.1,3928.0,144
CDM,22852OH,REMOVAL POSTERIOR SEGMENTAL INSTRUMENTATION,3748.0,2436.2,1.1,3748.0,144
CDM,22853OH,INSJ BIOMCHN DEV INTERVERTEBRAL DSC SPC W/ARTHRD,1870.0,1215.5,1.1,1870.0,144
CDM,22854OH,INSJ BIOMCHN DEV VRT CORPECTOMY DEFECT W/ARTHRD,2420.0,1573.0,1.1,2420.0,144
CDM,22855OH,REMOVAL ANTERIOR INSTRUMENTATION,6978.0,4535.7,1.1,6978.0,144
CDM,22856OH,TOTAL DISC ARTHRP ANT DSC 1 INTERSPACE CERVICAL,10582.0,6878.3,1.1,54351.12,144
CDM,22857OH,TOT DISC ARTHRP ANT DSC SINGLE INTERSPACE LUMBAR,10852.0,7053.8,1.1,10852.0,144
CDM,22858OH,TOT DISC ARTHRP ANT APPR DISC 2ND LEVEL CERVICAL,3360.0,2184.0,1.1,3360.0,144
CDM,22859OH,INSJ BIOMCHN DEV NTRVRT DISC SPACE W/O ARTHRD,2420.0,1573.0,1.1,2420.0,144
CDM,22860OH,TOTAL DISC ARTHRP ANT SECOND INTERSPACE LUMBAR,2752.0,1788.8,1.1,2752.0,132
CDM,22861OH,REVJ RPLCMT DISC ARTHROPLASTY ANT 1 NTRSPC CRV,13344.0,8673.6,1.1,13344.0,142
CDM,22862OH,REVJ RPLCMT DISC ARTHROPLASTY ANT 1 NTRSPC LMBR,13052.0,8483.8,1.1,13052.0,130
CDM,22864OH,RMVL DISC ARTHROPLASTY ANT 1 INTERSPACE CERVICAL,11760.0,7644.0,1.1,11760.0,142
CDM,22865OH,RMVL DISC ARTHROPLASTY ANT 1 INTERSPACE LUMBAR,12700.0,8255.0,1.1,12700.0,130
CDM,22867OH,INSJ STABLJ DEV W/DCMPRN LUMBAR SINGLE LEVEL,6000.0,3900.0,1.1,54351.12,142
CDM,22868OH,INSJ STABLJ DEV W/DCMPRN LUMBAR SECOND LEVEL,1600.0,1040.0,1.1,1600.0,142
CDM,22869OH,INSJ STABLJ DEV W/O DCMPRN LUMBAR SINGLE LEVEL,2812.0,1827.8,1.1,38384.94,142
CDM,22870OH,INSJ STABLJ DEV W/O DCMPRN LUMBAR SECOND LEVEL,936.0,608.4,1.1,936.0,142
CDM,22899OH,UNLISTED SPINE SURGERY OR PROCEDURE,661.0,429.65,0.01,889.37,84
CDM,22899RVU1OH,INTRAOSSEOUS DES LUMB/SACRUM,2719.0,1767.35,0.01,2719.0,84
CDM,22899RVU2OH,INTRAOSSEOUS DESTRUCT ADDL,1320.0,858.0,0.01,1320.0,84
CDM,22899RVU7OH,IMAGE GUIDED VERTEBRAL BODY FIDUCIAL MARKER PLCMNT (COMP CODE 22,2845.0,1849.25,0.01,2845.0,84
CDM,22900005,BREAST MILK PROC/STORE/DIST,42.0,27.3,9.16,42.0,58
CDM,22900OH,EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL <5CM,3328.0,2163.2,1.1,8286.13,144
CDM,22901OH,EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL 5+CM,4044.0,2628.6,1.1,8286.13,144
CDM,22902OH,EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ <3CM,1768.0,1149.2,1.1,4729.25,148
CDM,22903OH,EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ 3+CM,2556.0,1661.4,1.1,8286.13,144
CDM,22904OH,RAD RESECTION TUMOR SOFT TISSUE ABDL WALL <5CM,6676.0,4339.4,1.1,8286.13,144
CDM,22905OH,RAD RESECTION TUMOR SOFT TISSUE ABDL WALL 5+CM,8632.0,5610.8,1.1,8632.0,144
CDM,22999AOH,ABDOMINAL WALL / MUSCLE REPAIR,3934.0,2557.1,0.01,3934.0,84
CDM,22999RVU1OH,OPEN REPAIR SPORTS HERNIA (COMP 49505),2627.0,1707.55,0.01,2627.0,84
CDM,22999RVU2OH,EXPLORATORY OF ABDOMEN (COMP CODE 20102),1592.0,1034.8,0.01,1592.0,84
CDM,22999RVU3OH,INCISIONAL BIOPSY OF ABDOM WALL MASS (COMP 21920),696.0,452.4,0.01,696.0,84
CDM,22999RVU4OH,I&D ABDOMINAL WALL HEMATOMA (COMP CODE 26990),3379.0,2196.35,0.01,3379.0,84
CDM,22999RVUOH,REMOVAL OF MESH ABD WALL (COMP 20680),2457.0,1597.05,0.01,2457.0,84
CDM,23000115,ECMO DAILY CARE,1821.0,1183.65,396.98,1821.0,58
CDM,23000OH,REMOVAL SUBDELTOID CALCAREOUS DEPOSITS OPEN,1792.0,1164.8,1.1,8286.13,148
CDM,23020OH,CAPSULAR CONTRACTURE RELEASE,3744.0,2433.6,1.1,9440.12,144
CDM,23030OH,I&D SHOULDER DEEP ABSCESS/HEMATOMA,1388.0,902.2,1.1,8286.13,148
CDM,23031OH,I&D SHOULDER INFECTED BURSA,1116.0,725.4,1.1,8286.13,148
CDM,23035OH,INCISION BONE CORTEX SHOULDER AREA,3664.0,2381.6,1.1,4686.39,144
CDM,23040OH,ARTHROTOMY GLENOHUMERAL JT EXPL/DRG/RMVL FB,4290.0,2788.5,1.1,9440.12,144
CDM,23044OH,ARTHRT ACROMCLAV STRNCLAV JT EXPL/DRG/RMVL FB,3036.0,1973.4,1.1,9440.12,144
CDM,23065OH,BIOPSY SOFT TISSUE SHOULDER SUPERFICIAL,920.0,598.0,1.1,4729.25,148
CDM,23066OH,BIOPSY SOFT TISSUE SHOULDER DEEP,1720.0,1118.0,1.1,8286.13,148
CDM,23071OH,EXCISION TUMOR SOFT TISSUE SHOULDER SUBQ 3+CM,2364.0,1536.6,1.1,4729.25,144
CDM,23073OH,EXC TUMOR SOFT TISSUE SHOULDER SUBFASCIAL 5+CM,4052.0,2633.8,1.1,8286.13,144
CDM,23075OH,EXCISION TUMOR SOFT TISSUE SHOULDER SUBQ <3CM,1684.0,1094.6,1.1,4729.25,148
CDM,23076OH,EXC TUMOR SOFT TISS SHOULDER SUBFASC <5CM,2964.0,1926.6,1.1,8286.13,144
CDM,23077OH,RAD RESECTION TUMOR SOFT TISSUE SHOULDER <5CM,7064.0,4591.6,1.1,8286.13,144
CDM,23078OH,RAD RESECTION TUMOR SOFT TISSUE SHOULDER 5+CM,9020.0,5863.0,1.1,9020.0,144
CDM,23100OH,ARTHROTOMY GLENOHUMERAL JOINT W/BIOPSY,2480.0,1612.0,1.1,9440.12,144
CDM,23101OH,ARTHRT ACROMCLAV/STRNCLAV JT W/BX&/EXC CRTLG,2288.0,1487.2,1.1,9440.12,144
CDM,23105OH,ARTHRT GLENOHUMRL JT W/SYNOVECTOMY W/WO BIOPSY,3392.0,2204.8,1.1,20863.78,144
CDM,23106OH,ARTHRT GLENOHUMRL JT STRNCLAV JT W/SYNVCT W/WOBX,2452.0,1593.8,1.1,9440.12,144
CDM,23107OH,ARTHRT GLENOHMRL JT W/JT EXPL W/WO RMVL LOOSE/FB,3548.0,2306.2,1.1,20863.78,144
CDM,23120OH,CLAVICULECTOMY PARTIAL,3252.0,2113.8,1.1,9440.12,144
CDM,23125OH,CLAVICULECTOMY TOTAL,4242.0,2757.3,1.1,9440.12,144
CDM,23130OH,PARTIAL REPAIR OR REMOVAL OF SHOULDER BONE,3419.0,2222.35,1.1,9440.12,144
CDM,23140OH,EXC/CURTG BONE CYST/BENIGN TUMOR CLAV/SCAPULA,2848.0,1851.2,1.1,9440.12,144
CDM,23146OH,EXC/CURTG BONE CST/B9 TUM CLAV/SCAPULA W/ALGRFT,3232.0,2100.8,1.1,20863.78,144
CDM,23150OH,EXC/CURTG BONE CYST/BENIGN TUMOR PROX HUMERUS,3564.0,2316.6,1.1,9440.12,144
CDM,23155OH,EXC/CURTG BONE CYST/BENIGN TUM PROX HUM W/AGRFT,4344.0,2823.6,1.1,20863.78,144
CDM,23156OH,EXC/CURTG BONE CYST/BENIGN TUM PROX HUM W/ALGRFT,3644.0,2368.6,1.1,20863.78,144
CDM,23170OH,"SEQUESTRECTOMY, CLAVICLE",2884.0,1874.6,1.1,9440.12,144
CDM,23174OH,"SEQUESTRECTOMY,HUMER HEAD-SURG NECK",4020.0,2613.0,1.1,20863.78,144
CDM,23180OH,PARTIAL EXCISION BONE CLAVICLE,3596.0,2337.4,1.1,20863.78,144
CDM,23182OH,PARTIAL EXCISION BONE SCAPULA,3444.0,2238.6,1.1,20863.78,144
CDM,23184OH,PARTIAL EXCISION BONE PROXIMAL HUMERUS,3960.0,2574.0,1.1,20863.78,144
CDM,23190OH,OSTECTOMY SCAPULA PARTIAL,2988.0,1942.2,1.1,9440.12,144
CDM,23195OH,RESECTION HUMERAL HEAD,4144.0,2693.6,1.1,20863.78,144
CDM,23200OH,RAD RESECT CLAVICLE FOR TUMOR,9084.0,5904.6,1.1,9084.0,144
CDM,23210OH,RAD RESECT SCAPULA FOR TUMOR,10884.0,7074.6,1.1,10884.0,144
CDM,23220OH,RADICAL RESECTION BONE TUMOR PROXIMAL HUMERUS,12084.0,7854.6,1.1,12084.0,144
CDM,23330OH,REMOVAL FOREIGN BODY SHOULDER SUBCUTANEOUS,760.0,494.0,1.1,4729.25,148
CDM,23333OH,REMOVAL SHOULDER FOREIGN BODY DEEP SUBFASCIAL/IM,2400.0,1560.0,1.1,8286.13,144
CDM,23334OH,PROSTHESIS REMOVAL HUMERAL/GLENOID COMPONENT,6200.0,4030.0,1.1,8286.13,144
CDM,23335OH,PROSTHESIS REMOVAL HUMERAL AND GLENOID COMPONENT,7600.0,4940.0,1.1,7600.0,144
CDM,23350OH,INJECTION SHOULDER ARTHROGRAPHY/ CT/MRI ARTHG,400.0,260.0,1.1,555.8,148
CDM,23395OH,MUSCLE TRANSFER SHOULDER/UPPER ARM SINGLE,7416.0,4820.4,1.1,20863.78,144
CDM,23397OH,MUSCLE TRANSFER SHOULDER/UPPER ARM MULTIPLE,6704.0,4357.6,1.1,20863.78,144
CDM,23400OH,SCAPULOPEXY,5548.0,3606.2,1.1,20863.78,144
CDM,23405OH,TENOTOMY SHOULDER AREA 1 TENDON,3416.0,2220.4,1.1,20863.78,144
CDM,23406OH,TENOTOMY SHOULDER MULTIPLE THRU SAME INCISION,4404.0,2862.6,1.1,20863.78,144
CDM,23410OH,OPEN REPAIR OF ROTATOR CUFF ACUTE,4556.0,2961.4,1.1,20863.78,144
CDM,23412OH,OPEN REPAIR OF ROTATOR CUFF CHRONIC,4772.0,3101.8,1.1,20863.78,144
CDM,23415OH,CORACOACROMIAL LIGAMENT RELEAS W/WOACROMIOPLASTY,3692.0,2399.8,1.1,20863.78,144
CDM,23420OH,RECONSTRUCTION ROTATOR CUFF AVULSION CHRONIC,5416.0,3520.4,1.1,20863.78,144
CDM,23430OH,TENODESIS LONG TENDON BICEPS,4068.0,2644.2,1.1,20863.78,144
CDM,23440OH,RESECTION/TRANSPLANTATION LONG TENDON BICEPS,4256.0,2766.4,1.1,20863.78,144
CDM,23450OH,CAPSULORRHAPHY ANTERIOR PUTTI-PLATT/MAGNUSON,5480.0,3562.0,1.1,20863.78,144
CDM,23455OH,CAPSULORRHAPHY ANTERIOR W/LABRAL REPAIR,5868.0,3814.2,1.1,20863.78,144
CDM,23460OH,CAPSULORRHAPHY ANTERIOR WITH BONE BLOCK,6961.0,4524.65,1.1,20863.78,144
CDM,23462OH,CAPSULORRHAPHY ANTERIOR W/CORACOID PROCESS TR,6288.0,4087.2,1.1,20863.78,144
CDM,23465OH,CAPSULORRHAPHY GLENOHUMERAL JT PST W/WO BONE BLK,6520.0,4238.0,1.1,20863.78,144
CDM,23466OH,CAPSULORRHAPHY GLENOHUMRL JT MULTI-DIRIONAL INS,6952.0,4518.8,1.1,20863.78,144
CDM,23470OH,ARTHROPLASTY GLENOHUMRL JT HEMIARTHROPLASTY,7156.0,4651.4,1.1,38384.94,144
CDM,23472OH,ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHOULDER,9737.0,6329.05,1.1,54351.12,144
CDM,23473OH,REVIS SHOULDER ARTHRPLSTY HUMERAL/GLENOID COMPNT,10000.0,6500.0,1.1,38384.94,144
CDM,23474OH,REVIS SHOULDER ARTHRPLSTY HUMERAL&GLENOID COMPNT,10884.0,7074.6,1.1,10884.0,144
CDM,23480OH,OSTEOTOMY CLAVICLE W/WO INTERNAL FIXATION,4616.0,3000.4,1.1,20863.78,144
CDM,23485OH,OSTEOTOMY CLAV W/WO INT FIXJ W/BONE GRF NON/MAL,5564.0,3616.6,1.1,38384.94,144
CDM,23490OH,PROPH TX W/WO METHYLMETHACRYLATE CLAVICLE,4864.0,3161.6,1.1,20863.78,144
CDM,23491OH,PROPH TX W/WO METHYLMETHACRYLATE PROX HUMERUS,5816.0,3780.4,1.1,38384.94,144
CDM,23500OH,CLSD TX CLAVICULAR FRACTURE W/O MANIPULATION,972.0,631.8,1.1,972.0,148
CDM,23505OH,CLSD TX CLAVICULAR FRACTURE W/MANIPULATION,1532.0,995.8,1.1,4686.39,148
CDM,23515OH,OPEN TX CLAVICULAR FRACTURE INTERNAL FIXATION,3876.0,2519.4,1.1,20863.78,144
CDM,23520OH,CLSD TX STERNOCLAVICULAR DISLC W/O MANIPULATION,916.0,595.4,1.1,4686.39,146
CDM,23525OH,CLOSED TX STERNOCLAVICULAR DISLC W/MANIPULATION,1516.0,985.4,1.1,1516.0,148
CDM,23530OH,OPEN TX STERNOCLAVICULAR DISLC ACUTE/CHRONIC,2992.0,1944.8,1.1,20863.78,144
CDM,23532OH,OPTX STRNCLAV DISLC ACUTE/CHRONIC W/FASCIAL GRF,3280.0,2132.0,1.1,20863.78,144
CDM,23540OH,CLSD TX ACROMIOCLAVICULAR DISLC W/O MANIPULATION,944.0,613.6,1.1,944.0,146
CDM,23545OH,CLSD TX ACROMIOCLAVICULAR DISLC W/MANIPULATION,1372.0,891.8,1.1,1372.0,148
CDM,23550OH,OPEN TX ACROMIOCLAVICULAR DISLC ACUTE/CHRONIC,3036.0,1973.4,1.1,20863.78,144
CDM,23552OH,OPTX ACROMCLAV DISLC ACUTE/CHRONIC W/FASCIAL GRF,3528.0,2293.2,1.1,20863.78,144
CDM,23570OH,CLOSED TX SCAPULAR FRACTURE W/O MANIPULATION,944.0,613.6,1.1,944.0,148
CDM,23575OH,CLTX SCAPULAR FX W/MANJ W/WO SKELETAL TRACTION,1692.0,1099.8,1.1,4686.39,148
CDM,23585OH,OPEN TX SCAPULAR FX W/INTERNAL FIXATION IF PFRMD,5692.0,3699.8,1.1,20863.78,144
CDM,23600OH,CLTX PROXIMAL HUMERAL FRACTURE W/O MANIPULATION,1200.0,780.0,1.1,1200.0,148
CDM,23605OH,CLTX PROX HUMRL FX W/MANJ W/WO SKELETAL TRACJ,2024.0,1315.6,1.1,4686.39,148
CDM,23615OH,OPEN TREATMENT PROXIMAL HUMERAL FRACTURE,4920.0,3198.0,1.1,38384.94,144
CDM,23616OH,OPEN PROX HUMERAL FRACTURE PROSTHETIC RPLCMT,7348.0,4776.2,1.1,54351.12,144
CDM,23620OH,CLTX GREATER HUMERAL TUBEROSITY FX W/O MANJ,1020.0,663.0,1.1,1020.0,148
CDM,23625OH,CLTX GRTER HUMERAL TUBEROSITY FX W/MANIPULATION,1640.0,1066.0,1.1,4686.39,148
CDM,23630OH,OPEN TREATMENT GRTER HUMERAL TUBEROSITY FRACTURE,4228.0,2748.2,1.1,20863.78,144
CDM,23650OH,CLSD TX SHOULDER DISLC W/MANIPULATION W/O ANES,1553.0,1009.45,1.1,1553.0,148
CDM,23655OH,CLSD TX SHOULDER DISLC W/MANIPULATION REQ ANES,2094.0,1361.1,1.1,4686.39,144
CDM,23660OH,OPEN RX ACUTE SHLDR DISLOC,3064.0,1991.6,1.1,20863.78,144
CDM,23665OH,CLTX SHOULDER DISLC W/FX HUMERAL TUBRST W/MANJ,1864.0,1211.6,1.1,4686.39,148
CDM,23670OH,OPEN TX SHOULDER DISLC W/HUMERAL TUBEROSITY FX,4912.0,3192.8,1.1,20863.78,144
CDM,23675OH,CLTX SHOULDER DISLC W/SURG/ANTMCL NECK FX W/MANJ,2508.0,1630.2,1.1,4686.39,148
CDM,23680OH,OPEN TX SHOULDER DISLOCATION W/NECK FRACTURE,5260.0,3419.0,1.1,38384.94,144
CDM,23700OH,MANJ W/ANES SHOULDER JOINT W/FIXATION APPARATUS,1028.0,668.2,1.1,4686.39,144
CDM,23800OH,ARTHRODESIS GLENOHUMERAL JOINT,5892.0,3829.8,1.1,20863.78,144
CDM,23802OH,ARTHRODESIS GLENOHUMERAL JT W/AUTOGENOUS GRAFT,7368.0,4789.2,1.1,38384.94,144
CDM,23900005,EXTENDED NURSING CARE-PER HOUR,147.0,95.55,32.05,147.0,58
CDM,23900OH,INTERTHORACOSCAPULAR AMPUTATION,8288.0,5387.2,1.1,8288.0,144
CDM,23920OH,DISARTICULATION SHOULDER,6492.0,4219.8,1.1,6492.0,144
CDM,23929RVU10OH,SHOULDER AUGMENTATION W/CEMENT (COMP CODE 22513),3460.0,2249.0,0.01,3460.0,84
CDM,23929RVU1OH,REMOVE CEMENT SPACER,603.0,391.95,0.01,688.73,84
CDM,23929RVU2OH,REPAIR PECTORALIS MAJOR MUSCLE (COMP 29828),2354.0,1530.1,0.01,2354.0,84
CDM,23929RVU3OH,DELTOID REPAIR,3038.0,1974.7,0.01,3038.0,84
CDM,23929RVU4OH,PERCUTANEOUS PINNING OF HUMERUS,2135.0,1387.75,0.01,2135.0,84
CDM,23929RVU7OH,SCAPULOTHORACIC FUSION (COMP 23802),6079.0,3951.35,0.01,6079.0,84
CDM,23929RVUOH,INSERT CEMENT SPACER SHOULDER,4198.0,2728.7,0.01,4198.0,84
CDM,23930OH,I&D UPPER ARM/ELBOW DEEP ABSCESS/HEMATOMA,1196.0,777.4,1.1,8286.13,148
CDM,23931OH,INCISION&DRAINAGE UPPER ARM/ELBOW BURSA,736.0,478.4,1.1,4729.25,148
CDM,23935OH,INC DEEP W/OPENING BONE CORTEX HUMERUS/ELBOW,2552.0,1658.8,1.1,9440.12,144
CDM,24000OH,ARTHRT ELBOW W/EXPLORATION DRAINAGE/REMOVAL FB,2432.0,1580.8,1.1,9440.12,144
CDM,24006OH,ARTHRT ELBOW CAPSULAR EXCISION CAPSULAR RLS SPX,4286.0,2785.9,1.1,9440.12,144
CDM,24065OH,"BX ARM/ELBOW SOFT TISSUE,SUPERFICIAL",852.0,553.8,1.1,4729.25,148
CDM,24066OH,"BX ARM/ELBOW SOFT TISSUE,DEEP",2140.0,1391.0,1.1,8286.13,148
CDM,24071OH,EXC TUMOR SOFT TISSUE UPPER ARM/ELBOW SUBQ 3+CM,2280.0,1482.0,1.1,8286.13,144
CDM,24073OH,EXC TUMOR SOFT TISS UPPER ARM/ELBW SUBFASC 5+CM,4052.0,2633.8,1.1,8286.13,144
CDM,24075OH,EXC TUMOR SOFT TISS UPPER ARM/ELBOW SUBQ <3CM,1866.0,1212.9,1.1,4729.25,148
CDM,24076OH,EXC TUMOR SOFT TISS UPR ARM/ELBOW SUBFASC <5CM,3260.0,2119.0,1.1,8286.13,144
CDM,24077OH,RAD RESECT TUMOR SOFT TISS UPPER ARM/ELBOW <5CM,6288.0,4087.2,1.1,8286.13,144
CDM,24079OH,RAD RESECT TUMOR SOFT TISS UPPER ARM/ELBOW 5+CM,8244.0,5358.6,1.1,8286.13,144
CDM,24101OH,ARTHRT ELBOW W/JNT EXPL W/WOBX W/WORMVL LOOSE/FB,2520.0,1638.0,1.1,9440.12,144
CDM,24102OH,ARTHROTOMY ELBOW W/SYNOVECTOMY,3304.0,2147.6,1.1,9440.12,144
CDM,24105OH,EXCISION OLECRANON BURSA,1512.0,982.8,1.1,9440.12,144
CDM,24110OH,EXCISION/CURTG BONE CYST/BENIGN TUMOR HUMERUS,3032.0,1970.8,1.1,9440.12,144
CDM,24115OH,EXC/CURTG BONE CYST/BENIGN TUMOR HUMERUS W/AGRFT,4048.0,2631.2,1.1,20863.78,144
CDM,24116OH,EXC/CURTG BONE CYST/BENIGN TUM HUMERUS W/ALGRFT,4892.0,3179.8,1.1,20863.78,144
CDM,24120OH,EXC/CURTG BONE CYST/BENIGN TUMOR H/N RDS/OLECRN,2728.0,1773.2,1.1,9440.12,144
CDM,24126OH,EXC/CURTG BONE CST/B9 TUM H/N RDS/OLECRN W/ALGRT,3448.0,2241.2,1.1,20863.78,144
CDM,24130OH,EXCISION RADIAL HEAD,2568.0,1669.2,1.1,9440.12,144
CDM,24134OH,"SEQUESTRECTOMY,MID/DIST HUMERUS",4088.0,2657.2,1.1,20863.78,144
CDM,24140OH,PARTIAL REMOVAL HUMERUS,3820.0,2483.0,1.1,9440.12,144
CDM,24145OH,PARTIAL REMOVAL RADIAL HEAD/NECK,3124.0,2030.6,1.1,20863.78,144
CDM,24147OH,PARTIAL REMOVAL OLECRANNON PROCESS,3136.0,2038.4,1.1,9440.12,144
CDM,24149OH,RAD RESCJ CAPSL TISS&HTRTPC BONE ELBW CONTRCT,7137.0,4639.05,1.1,20863.78,144
CDM,24150OH,RADICAL RESECTION TUMOR SHAFT/DISTAL HUMERUS,9384.0,6099.6,1.1,20863.78,144
CDM,24152OH,RADICAL RESECTION TUMOR RADIAL HEAD/NECK,7996.0,5197.4,1.1,20863.78,144
CDM,24152RVUOH,RADICAL RESEC RADIAL HEAD/NECK,6597.0,4288.05,1.1,20863.78,144
CDM,24155OH,RESECTION ELBOW JOINT ARTHRECTOMY,4836.0,3143.4,1.1,9440.12,144
CDM,24160OH,PROSTHESIS REMOVAL HUMERAL AND ULNAR COMPONENTS,7452.0,4843.8,1.1,9440.12,144
CDM,24164OH,PROSTHESIS REMOVAL RADIAL HEAD,4000.0,2600.0,1.1,9440.12,144
CDM,24200OH,RMVL FOREIGN BODY UPPER ARM/ELBOW SUBCUTANEOUS,724.0,470.6,1.1,4729.25,148
CDM,24201OH,REMOVAL FOREIGN BODY UPPER ARM/ELBOW DEEP,1880.0,1222.0,1.1,8286.13,148
CDM,24220OH,INJECTION FOR ELBOW ARTHROGRAM,524.0,340.6,1.1,648.54,148
CDM,24300OH,MANIPULATION ELBOW W/ANESTH,1616.0,1050.4,1.1,4686.39,144
CDM,24301OH,MUSCLE/TENDON TRANSFER UPPER ARM/ELBOW SINGLE,4152.0,2698.8,1.1,20863.78,144
CDM,24305OH,"ARM/ELBOW TENDON LENGTHEN,SINGLE,EA",3048.0,1981.2,1.1,9440.12,144
CDM,24310OH,"TENOTOMY,ELBOW-SHLDR,SINGL,EACH",2448.0,1591.2,1.1,9440.12,144
CDM,24320OH,"TENOPLASTY,ELB-SHLDR,MUSC XFER,SINGL",4344.0,2823.6,1.1,20863.78,144
CDM,24332OH,"TENOLYSIS, TRICEPS",3164.0,2056.6,1.1,9440.12,144
CDM,24340OH,TENODESIS BICEPS TENDON ELBOW SEPARATE PROCEDURE,3232.0,2100.8,1.1,20863.78,144
CDM,24341OH,REPAIR TENDON/MUSCLE UPPER ARM/ELBOW EA,3796.0,2467.4,1.1,20863.78,144
CDM,24342OH,RINSJ RPTD BICEPS/TRICEPS TDN DSTL W/WO TDN GRF,4344.0,2823.6,1.1,20863.78,144
CDM,24343OH,REPAIR LATERAL COLLATERAL LIGAMENT ELBOW,3664.0,2381.6,1.1,9440.12,144
CDM,24344OH,RCNSTJ LAT COLTRL LIGM ELBOW W/TENDON GRAFT,6084.0,3954.6,1.1,20863.78,144
CDM,24345OH,REPAIR MEDIAL COLLATERAL LIGAMENT ELBOW,3664.0,2381.6,1.1,20863.78,144
CDM,24346OH,RCNSTJ MEDIAL COLTRL LIGM ELBW W/TDN GRF,6084.0,3954.6,1.1,38384.94,144
CDM,24357OH,TENOTOMY ELBOW LATERAL/MEDIAL PERCUTANEOUS,2176.0,1414.4,1.1,9440.12,144
CDM,24358OH,TNOT ELBOW LATERAL/MEDIAL DEBRIDE OPEN,2664.0,1731.6,1.1,9440.12,144
CDM,24359OH,TNOT ELBOW LATERAL/MEDIAL DEBRIDE OPEN TDN RPR,3592.0,2334.8,1.1,9440.12,144
CDM,24360OH,"ARTHROPLASTY,ELBOW,W MEMBRANE",5575.0,3623.75,1.1,20863.78,144
CDM,24361OH,ARTHROPLASTY ELBOW W/DISTAL HUMRL PROSTC RPLCMT,6340.0,4121.0,1.1,54351.12,144
CDM,24362OH,ARTHRP ELBOW W/IMPLT&FSCA LATA LIGAMENT RCNSTJ,6128.0,3983.2,1.1,38384.94,144
CDM,24363OH,ARTHRP ELBOW W/DISTAL HUM&PROX UR PROSTC RPLCM,8800.0,5720.0,1.1,54351.12,144
CDM,24365OH,ARTHROPLASTY RADIAL HEAD,3448.0,2241.2,1.1,38384.94,144
CDM,24366OH,ARTHROPLASTY RADIAL HEAD W/IMPLANT,3744.0,2433.6,1.1,38384.94,144
CDM,24370OH,REVIS ELBOW ARTHRPLSTY HUMERAL/ULNA COMPNT,9420.0,6123.0,1.1,38384.94,144
CDM,24371OH,REVIS ELBOW ARTHRPLSTY HUMERAL&ULNA COMPNT,11000.0,7150.0,1.1,54351.12,144
CDM,24400OH,OSTEOTOMY HUMERUS W/WO INTERNAL FIXATION,4985.0,3240.25,1.1,20863.78,144
CDM,24410OH,MLT OSTEOT W/RELIGNMT IMED ROD HUMERAL SHAFT,6044.0,3928.6,1.1,38384.94,144
CDM,24420OH,OSTEOPLASTY HUMERUS,5492.0,3569.8,1.1,20863.78,144
CDM,24430OH,REPAIR NON/MALUNION HUMERUS W/O GRAFT,6100.0,3965.0,1.1,38384.94,144
CDM,24435OH,REPAIR NON/MALUNION HUMERUS W/ILIAC/OTH AGRFT,5996.0,3897.4,1.1,38384.94,144
CDM,24495OH,DECOMPRESSION FASCT F/ARM W/BRACH ART EXPL,3364.0,2186.6,1.1,20863.78,144
CDM,24498OH,PROPH TX W/WO METHYLMETHACRYLATE HUMERAL SHAFT,4912.0,3192.8,1.1,38384.94,144
CDM,24500OH,CLSD TX HUMERAL SHAFT FRACTURE W/O MANIPULATION,1500.0,975.0,1.1,1500.0,148
CDM,24505OH,CLTX HUMERAL SHFT FX W/MANJ W/WO SKELETAL TRACJ,2156.0,1401.4,1.1,4686.39,148
CDM,24515OH,OPTX HUMERAL SHFT FX W/PLATE/SCREWS W/WOCERCLAGE,4848.0,3151.2,1.1,38384.94,144
CDM,24516OH,TX HUMRAL SHAFT FX W/INSJ IMED IMPLT W/W CERCLGE,4876.0,3169.4,1.1,38384.94,144
CDM,24530OH,CLTX SPRCNDYLR/TRANSCNDYLR HUMERAL FX W/WO MANJ,1476.0,959.4,1.1,1476.0,148
CDM,24535OH,CLTX SPRCNDYLR/TRANSCNDYLR HUMERAL FX W/MANJ,2844.0,1848.6,1.1,4686.39,148
CDM,24538OH,PRQ SKEL FIXJ SPRCNDYLR/TRANSCNDYLR HUMERAL FX,4299.0,2794.35,1.1,20863.78,144
CDM,24545OH,OPEN TX HUMERAL SUPRACONDYLAR FRACTURE W/O XTN,5260.0,3419.0,1.1,38384.94,144
CDM,24546OH,OPEN TX HUMERAL SUPRACONDYLAR FRACTURE W/XTN,5964.0,3876.6,1.1,38384.94,144
CDM,24560OH,CLTX HUMERAL EPICONDYLAR FX MEDIAL/LAT W/O MANJ,1192.0,774.8,1.1,1192.0,148
CDM,24565OH,CLTX HUMERAL EPICONDYLAR FX MEDIAL/LAT W/MANJ,2312.0,1502.8,1.1,4686.39,148
CDM,24566OH,PRQ SKEL FIXJ HUMRL EPCNDYLR FX MEDIAL/LAT MANJ,3624.0,2355.6,1.1,4686.39,144
CDM,24575OH,OPEN TX HUMERAL EPICONDYLAR FRACTURE,3884.0,2524.6,1.1,38384.94,144
CDM,24576OH,CLTX HUMERAL CONDYLAR FX MEDIAL/LAT W/O MANJ,1346.0,874.9,1.1,1346.0,148
CDM,24577OH,CLTX HUMERAL CONDYLAR FX MEDIAL/LATERAL W/MANJ,2644.0,1718.6,1.1,4686.39,148
CDM,24579OH,OPEN TREATMENT HUMERAL CONDYLAR FRACTURE,4576.0,2974.4,1.1,38384.94,144
CDM,24582OH,PRQ SKEL FIXJ HUMRL CNDYLR FX MEDIAL/LAT W/MANJ,4056.0,2636.4,1.1,20863.78,144
CDM,24586OH,OPTX PERIARTICULAR FRACTURE &/DISLOCATION ELBO,6312.0,4102.8,1.1,38384.94,144
CDM,24587OH,OPTX PRIARTICULAR FX&/DISLC ELBW W/IMPLT ARTHR,6316.0,4105.4,1.1,38384.94,144
CDM,24600OH,TREATMENT CLOSED ELBOW DISLOCATION W/O ANES,1748.0,1136.2,1.1,1748.0,148
CDM,24605OH,TREATMENT CLOSED ELBOW DISLOCATION REQ ANES,2256.0,1466.4,1.1,4686.39,144
CDM,24615OH,OPEN TX ACUTE/CHRONIC ELBOW DISLOCATION,3932.0,2555.8,1.1,20863.78,144
CDM,24620OH,CLOSED TX MONTEGGIA FX DISLOCATION ELBOW W/MANJ,2888.0,1877.2,1.1,4686.39,144
CDM,24635OH,OPEN TX MONTEGGIA FRACTURE DISLOCATION ELBOW,3520.0,2288.0,1.1,20863.78,144
CDM,24640OH,CLTX RDL HEAD SUBLXTJ CHLD NURSEMAID ELBW W/MANJ,550.0,357.5,1.1,688.73,148
CDM,24650OH,CLOSED TX RADIAL HEAD/NECK FX W/O MANIPULATION,1016.0,660.4,1.1,1016.0,148
CDM,24655OH,CLOSED TX RADIAL HEAD/NECK FX W/MANIPULATION,2033.0,1321.45,1.1,4686.39,148
CDM,24665OH,OPEN TX RADIAL HEAD/NECK FRACTURE,3344.0,2173.6,1.1,20863.78,144
CDM,24666OH,OPEN TX RADIAL HEAD/NECK FRACTURE PROSTHETIC,3944.0,2563.6,1.1,38384.94,144
CDM,24670OH,CLOSED TX ULNAR FRACTURE PROXIMAL END W/O MANJ,1076.0,699.4,1.1,1076.0,148
CDM,24675OH,CLOSED TX ULNAR FRACTURE PROXIMAL END W/MANJ,1964.0,1276.6,1.1,4686.39,148
CDM,24685OH,OPEN TREATMENT ULNAR FRACTURE PROXIMAL END,3348.0,2176.2,1.1,20863.78,144
CDM,24802OH,ARTHRODESIS ELBOW JOINT W/AUTOGENOUS GRAFT,5728.0,3723.2,1.1,38384.94,144
CDM,24900OH,"AMPUTATN ARM,THRU HUMERUS,PRIM CLOS",4072.0,2646.8,1.1,4072.0,144
CDM,24920OH,AMPUTATE ARM-HUMER; OP CIRCULAR,4052.0,2633.8,1.1,4052.0,144
CDM,24925OH,"AMPUTATN ARM,THRU HUMER,SECOND CL",2920.0,1898.0,1.1,9440.12,144
CDM,24930OH,AMPUTATE ARM-HUMERUS RE-AMPUT,4332.0,2815.8,1.1,4332.0,144
CDM,24935OH,"STUMP ELONGATN,UPPER EXTREM",6580.0,4277.0,1.1,20863.78,144
CDM,24999RVU1OH,ARTHROTOMY W/RMVL EXCHNG ELBOW SPACER,7772.0,5051.8,0.01,7772.0,84
CDM,24999RVU2OH,ORIF OF OCD ELBOW WITH AUTOGRAFT (COMP 27416),4673.0,3037.45,0.01,4673.0,84
CDM,24999RVU3OH,ORIF OF OCD ELBOW WITH DRILLING (COMP 29887),4520.0,2938.0,0.01,4520.0,84
CDM,24999RVU4OH,ORIF OF OCD ELBOW WITH ALLOGRAFT?(COMP 27415),6600.0,4290.0,0.01,6600.0,84
CDM,24999RVU5OH,UPPER ARM COMPARTMENT DECOMPRESSON FASCIOTOMY/RELEASE WITH COMP,3561.0,2314.65,0.01,3561.0,84
CDM,24999RVUOH,INSERT PROSTHETIC ANTIBIOTIC SPACER,7474.0,4858.1,0.01,7474.0,84
CDM,25000065,ATROVENT/1 MG U/D,3.7,2.41,0.81,3.7,60
CDM,25000070,NITRIC OXIDE PER HOUR,131.11,85.22,28.58,131.11,60
CDM,25000090,IPRATROPIUM BROMIDE NON-COMP,3.7,2.41,0.2,11.17,69
CDM,25000105,ALBUTEROL SULFATE INHALATION,92.32,60.01,20.13,92.32,60
CDM,25000115,"ALBUTEROL, UP TO 2.5 MG",4.0,2.6,0.87,4.0,60
CDM,25000120,"ALBUTEROL,INHALATION, UD 1MG",3.0,1.95,0.65,3.0,60
CDM,25000135,ATROPINE SULFATE 0.4MG/ML 1ML,11.25,7.31,2.45,11.25,60
CDM,25000140,ATROPINE SULFATE 1MG/ML 1 ML,9.0,5.85,1.96,9.0,60
CDM,25000155,BETAMETHASONE SOD PHOSP,116.2,75.53,25.33,116.2,60
CDM,25000180,CPD 500 ML,24.0,15.6,5.23,24.0,60
CDM,25000185,DEXAMETHASONE SODIUM PHOSP 4MG,8.1,5.27,1.77,8.1,60
CDM,25000195,EMLA CREAM,6.0,3.9,1.31,6.0,60
CDM,25000210,EPINEPHRINE 2.25%/0.5CC,5.0,3.25,1.09,5.0,60
CDM,25000240,HEPARIN 10ML SODIUM INJ 1000UN,22.54,14.65,4.91,22.54,60
CDM,25000250,HUMIDIFIER 650ML,2.2,1.43,0.48,2.2,60
CDM,25000265,INFANT 4.2% SODIUM BICARBONATE,8.45,5.49,1.84,8.45,60
CDM,25000270,IPRATROPIUM BROMIDE NON-COMP,2.65,1.72,0.58,2.65,60
CDM,25000280,"LEVALBUTEROL INHALATION, UD 05",4.19,2.72,0.91,4.19,60
CDM,25000285,"LEVALBUTEROL NON-COMP, 0.63 MG",24.6,15.99,5.36,24.6,60
CDM,25000290,LIDOCAINE .8% 200CC,7.5,4.88,1.64,7.5,60
CDM,25000305,MANNITOL/ARIDOL KIT,183.46,119.25,39.99,183.46,60
CDM,25000315,MOD. HEMOCON SOLUTION,29.0,18.85,6.32,29.0,60
CDM,25000330,NEOSTIGMINE (0.5 MG/ML) 10 ML,10.55,6.86,2.3,10.55,60
CDM,25000340,NITROGLYCERIN  0.4MG,12.52,8.14,2.73,12.52,60
CDM,25000345,NITROGLYCERIN 50MG/10ML 10ML,17.4,11.31,3.79,17.4,60
CDM,25000365,OMNIPAQUE 240 DYE 50ML,89.0,57.85,19.4,89.0,60
CDM,25000370,PEDS 8.4% SODIUM BICARBONATE,12.25,7.96,2.67,12.25,60
CDM,25000375,PLASMALYTE 1000 ML,6.0,3.9,1.31,6.0,60
CDM,25000385,RESTYLANE,360.0,234.0,78.48,360.0,60
CDM,25000390,SODIUM CHLORIDE .9% IRRIG,12.82,8.33,2.79,12.82,60
CDM,25000400,SOLU-CORTEF 100MG/2ML,9.6,6.24,2.09,9.6,60
CDM,25000405,TEFLON POLYTEF PASTE 7ML,684.0,444.6,149.11,684.0,60
CDM,25000515,LEVALBUTEROL  0.5 MG,13.4,8.71,0.07,13.4,69
CDM,25000525,"ALBUTEROL, UP TO 2.5 MG",4.4,2.86,0.13,11.17,69
CDM,25000535,RACEMIC EPINE 2.25% PER VIAL,2.5,1.63,0.55,60.42,68
CDM,25000635,EPINEPHRINE INJ 0.1MG/ML,7.5,4.88,1.64,7.5,60
CDM,25000645,CLONIDINE 0.3MG TAB,5.36,3.48,1.17,5.36,60
CDM,25000655,SODIUM CHL 0.9% INJ PER VIAL,51.0,33.15,11.12,51.0,60
CDM,25000665,LIDOCAINE 1% 20ML VIAL,3.33,2.16,0.73,3.33,60
CDM,25000675,LEVALBUTEROL N-COMP UNT 0.5 MG,6.0,3.9,1.31,6.0,60
CDM,25000685,NORMAL SALINE INFUS,19.5,12.68,4.25,19.5,60
CDM,25000695,FLUOR-I-STRIP-A.T.,2.3,1.5,0.5,2.3,60
CDM,25000705,HEPATITIS B VACCINE,243.0,157.95,52.97,243.0,60
CDM,25000785,TYLENOL 325MG,4.5,2.93,0.98,4.5,60
CDM,25000815,INJ LIDOCAINE 1%,74.3,48.3,16.2,74.3,60
CDM,25000835,DIACRIOSE OPTHALMIC,19.5,12.68,4.25,19.5,60
CDM,25000845,TETRACAINE OPTH 0.5%,24.1,15.67,5.25,24.1,60
CDM,25000935,SODIUM CITRATE 4%,1.15,0.75,0.25,1.15,60
CDM,25000965,TETANUS TOXOID 0.5ML SYR,172.9,112.39,37.69,172.9,60
CDM,25000995,3000ML NACL,9.34,6.07,2.04,9.34,60
CDM,25000OH,INCISION EXTENSOR TENDON SHEATH WRIST,1420.0,923.0,1.1,4686.39,144
CDM,25001085,ANTIBIOTIC OINTMENT PKT,1.55,1.01,0.34,1.55,60
CDM,25001255,CITRATE DEXTROSE SOLUTION,14.0,9.1,3.05,14.0,58
CDM,25001275,JUVADERM ULTRA PLUS,313.31,203.65,52.18,2266000.0,68
CDM,25001285,RENUVA HYDRATED 3.0,2060.0,1339.0,52.18,2266000.0,68
CDM,25001295,RENUVA HYDRATED 1.5,1040.0,676.0,52.18,2266000.0,68
CDM,25001OH,INCISE FLX TENDN SHEATH WRST,1516.0,985.4,1.1,9440.12,144
CDM,25020OH,DCMPRN FASCT F/ARM&WRST FLXR/XTNSR W/O DBRDMT,2424.0,1575.6,1.1,4686.39,144
CDM,25023OH,DCMPRN FASCT F/ARM&/WRST FLXR/XTNSR W/DBRDMT,5532.0,3595.8,1.1,9440.12,144
CDM,25024OH,DCMPRN FASCT F/ARM&/WRST FLXR&XTNSR W/O DB,4316.0,2805.4,1.1,9440.12,144
CDM,25025OH,DCMPRN FASCT F/ARM&/WRST FLXR&XTNSR DBRDMT,7176.0,4664.4,1.1,7176.0,144
CDM,25028OH,I&D FOREARM&/WRIST DEEP ABSCESS/HEMATOMA,2156.0,1401.4,1.1,9440.12,144
CDM,25031OH,INCISION & DRAINAGE FOREARM&/WRIST BURSA,1704.0,1107.6,1.1,4686.39,144
CDM,25035OH,INCISION DEEP BONE CORTEX FOREARM&/WRIST,3060.0,1989.0,1.1,20863.78,144
CDM,25040OH,ARTHRT RDCRPL/MIDCARPL JT W/EXPL DRG/RMVL FB,3000.0,1950.0,1.1,9440.12,144
CDM,25065OH,BIOPSY SOFT TISSUE FOREARM&/WRIST SUPERFICIAL,816.0,530.4,1.1,4729.25,148
CDM,25066OH,BIOPSY SOFT TISSUE FOREARM&/WRIST DEEP,1708.0,1110.2,1.1,8286.13,144
CDM,25071OH,EXC TUMOR SOFT TISS FOREARM AND/WRIST SUBQ 3+CM,2364.0,1536.6,1.1,4729.25,144
CDM,25073OH,EXC TUMOR SFT TISS FOREARM&//WRIST SUBFASC 3+CM,2852.0,1853.8,1.1,8286.13,144
CDM,25075OH,EXC TUMOR SOFT TISSUE FOREARM &/WRIST SUBQ <3CM,1584.0,1029.6,1.1,4729.25,148
CDM,25076OH,EXC TUMOR SOFT TISS FOREARM&/WRIST SUBFASC <3CM,2696.0,1752.4,1.1,4729.25,144
CDM,25077OH,RAD RESECT TUMOR SOFT TISS FOREARM&/WRIST <3 CM,5172.0,3361.8,1.1,8286.13,144
CDM,25078OH,RAD RESCJ TUM SOFT TISSUE FOREARM&/WRIST 3+CM,7076.0,4599.4,1.1,8286.13,144
CDM,25085OH,CAPSULOTOMY WRIST,2256.0,1466.4,1.1,9440.12,144
CDM,25100OH,ARTHROTOMY WRIST JOINT WITH BIOPSY,1608.0,1045.2,1.1,9440.12,144
CDM,25101OH,ARTHRT WRST W/JT EXPL W/WO BX W/WO RMVL LOOSE/FB,1932.0,1255.8,1.1,9440.12,144
CDM,25105OH,ARTHROTOMY WRIST JOINT WITH SYNOVECTOMY,2408.0,1565.2,1.1,9440.12,144
CDM,25107OH,ARTHROTOMY DSTL RADIOULNAR JOINT RPR CARTILAGE,3080.0,2002.0,1.1,9440.12,144
CDM,25109OH,EXC TENDON FOREARM&/WRIST FLEXOR/EXTENSOR EA,2776.0,1804.4,1.1,9440.12,144
CDM,25110OH,"EXCIS TENDON SHEATH LESN,WRIST/FORE",1616.0,1050.4,1.1,4686.39,144
CDM,25111OH,EXCISION GANGLION WRIST DORSAL/VOLAR PRIMARY,1412.0,917.8,1.1,4686.39,144
CDM,25112OH,EXCISION GANGLION WRIST DORSAL/VOLAR RECURRENT,1868.0,1214.2,1.1,4686.39,144
CDM,25115OH,RAD EXC BURSA SYNVA WRST/F/ARM TDN SHTHS FLXRS,4036.0,2623.4,1.1,4686.39,144
CDM,25116OH,RAD EXC BURSA SYNVA WRST/F/ARM TDN SHTHS XTNSRS,3024.0,1965.6,1.1,9440.12,144
CDM,25118OH,SYNOVECTOMY EXTENSOR TENDON SHTH WRIST 1 CMPRT,1804.0,1172.6,1.1,4686.39,144
CDM,25119OH,SYNVCT XTNSR TDN SHTH WRST 1 RESCJ DSTL ULNA,2484.0,1614.6,1.1,9440.12,144
CDM,25120OH,EXCISION/CURETTAGE CYST/TUMOR RADIUS/ULNA,2508.0,1630.2,1.1,9440.12,144
CDM,25125OH,EXC/CURTG CYST/TUMOR RADIUS/ULNA W/AUTOGRAFT,3068.0,1994.2,1.1,4686.39,144
CDM,25126OH,EXC/CURTG CYST/TUMOR RADIUS/ULNA W/ALLOGRAFT,3096.0,2012.4,1.1,9440.12,144
CDM,25130OH,EXCISION/CURETTAGE CYST/TUMOR CARPAL BONES,2172.0,1411.8,1.1,9440.12,144
CDM,25135OH,EXC/CURTG CYST/TUMOR CARPAL BONES W/AUTOGRAFT,2832.0,1840.8,1.1,20863.78,144
CDM,25136OH,EXC/CURTG CYST/TUMOR CARPAL BONES W/ALLOGRAFT,2456.0,1596.4,1.1,20863.78,144
CDM,25145OH,"SEQUESTRECTOMY,FOREARM/WRIST",2616.0,1700.4,1.1,9440.12,144
CDM,25150OH,"PART REMOVAL BONE,ULNA",2952.0,1918.8,1.1,9440.12,144
CDM,25151OH,"PART REMOVAL BONE,RADIUS",3072.0,1996.8,1.1,9440.12,144
CDM,25170OH,RADICAL RESECTION TUMOR RADIUS OR ULNA,8884.0,5774.6,1.1,20863.78,144
CDM,25210OH,CARPECTOMY 1 BONE,2448.0,1591.2,1.1,9440.12,144
CDM,25215OH,CARPECTOMY ALL BONES PROXIMAL ROW,3256.0,2116.4,1.1,9440.12,144
CDM,25230OH,RADICAL STYLOIDECTOMY SEPARATE PROCEDURE,2148.0,1396.2,1.1,9440.12,144
CDM,25240OH,"EXCIS DISTAL ULNA,PART/COMPLETE",2124.0,1380.6,1.1,9440.12,144
CDM,25246OH,INJECTION FOR WRIST ARTHROGRAM,580.0,377.0,1.1,668.65,148
CDM,25248OH,EXPL W/REMOVAL DEEP FOREIGN BODY FOREARM/WRIST,2124.0,1380.6,1.1,4686.39,144
CDM,25250OH,REMOVAL WRIST PROSTHESIS SEPARATE PROCEDURE,2708.0,1760.2,1.1,4686.39,144
CDM,25251OH,REMOVAL WRIST PROSTH COMPLICATED W/TOTAL WRIST,3928.0,2553.2,1.1,9440.12,144
CDM,25259OH,MANIPULATE WRIST W/ANESTHES,1616.0,1050.4,1.1,4686.39,142
CDM,25260OH,RPR TDN/MUSC FLXR F/ARM&/WRST PRIM 1 EA TDN/MU,3216.0,2090.4,1.1,9440.12,144
CDM,25263OH,RPR TDN/MUSC FLXR F/ARM&/WRIST SEC 1 EA TDN/MUS,3216.0,2090.4,1.1,20863.78,144
CDM,25265OH,RPR TDN/MUSC FLXR F/ARM&/WRISTSEC FR GRF EA,4040.0,2626.0,1.1,9440.12,144
CDM,25270OH,RPR TDN/MUSC XTNSR F/ARM&/WRIST PRIM 1 EA TDN,2468.0,1604.2,1.1,9440.12,144
CDM,25272OH,RPR TDN/MUSC XTNSR F/ARM&/WRIST SEC 1 EA TDN/MU,2884.0,1874.6,1.1,9440.12,144
CDM,25274OH,RPR TDN/MUSC XTNSR F/ARM&/WRST SEC FR GRF EA TDN,3576.0,2324.4,1.1,9440.12,144
CDM,25275OH,RPR TENDON SHEATH EXTENSOR F/ARM&/WRIST W/GRAFT,3584.0,2329.6,1.1,9440.12,144
CDM,25280OH,LNGTH/SHRT FLXR/XTNSR TDN F/ARM&/WRIST 1 EA TDN,2956.0,1921.4,1.1,9440.12,144
CDM,25290OH,TNOT FLXR/XTNSR TENDON FOREARM&/WRIST 1 EA,2172.0,1411.8,1.1,9440.12,144
CDM,25295OH,TNOLS FLXR/XTNSR TENDON FOREARM&/WRIST 1 EA,2688.0,1747.2,1.1,9440.12,144
CDM,25300OH,TENODESIS WRIST FLEXORS FINGERS,3608.0,2345.2,1.1,9440.12,144
CDM,25301OH,TENODESIS WRIST EXTENSORS FINGERS,3436.0,2233.4,1.1,9440.12,144
CDM,25310OH,TDN TRNSPLJ/TR FLXR/XTNSR F/ARM&/WRST 1 EA TDN,3960.0,2574.0,1.1,9440.12,144
CDM,25312OH,TDN TRNSPLJ/TR FLXR/XTNSR F/ARM&/WRST 1/TDN GR,4321.0,2808.65,1.1,9440.12,144
CDM,25315OH,FLEXOR ORIGIN SLIDE FOREARM &/WRIST,4272.0,2776.8,1.1,20863.78,144
CDM,25320OH,CAPSL-RHPHY/RCNSTJ WRST OPN CARPL INS,5100.0,3315.0,1.1,20863.78,144
CDM,25332OH,ARTHRP WRST W/WO INTERPOS W/WO XTRNL/INT FIXJ,4696.0,3052.4,1.1,9440.12,144
CDM,25335OH,CENTRALIZATION WRST ULNA,5356.0,3481.4,1.1,9440.12,144
CDM,25337OH,RCNSTJ STABLJ DSTL U/DSTL JT 2 SOFT TISS STABLJ,4692.0,3049.8,1.1,20863.78,144
CDM,25350OH,"OSTEOTOMY RADIUS,DISTAL THIRD",3636.0,2363.4,1.1,20863.78,144
CDM,25355OH,"OSTEOTOMY RADIUS,PROX/MID THIRD",4212.0,2737.8,1.1,9440.12,144
CDM,25360OH,OSTEOTOMY ULNA,3496.0,2272.4,1.1,20863.78,144
CDM,25365OH,OSTEOTOMY RADIUS/ULNA,5164.0,3356.6,1.1,38384.94,144
CDM,25370OH,MLT OSTEOTOMIES W/RELIGNMT IMED ROD RADIUS/ULNA,5640.0,3666.0,1.1,9440.12,144
CDM,25375OH,MLT OSTEOTOMIES W/RELIGNMT IMED ROD RADIUS&ULNA,5420.0,3523.0,1.1,9440.12,144
CDM,25390OH,OSTEOPLASTY RADIUS/ULNA SHORTENING,4280.0,2782.0,1.1,20863.78,144
CDM,25391OH,OSTEOPLASTY RADIUS/ULNA LENGTHENING W/AUTOGRAFT,5712.0,3712.8,1.1,38384.94,144
CDM,25392OH,OSTEOPLASTY RADIUS & ULNA SHORTENING,5832.0,3790.8,1.1,20863.78,144
CDM,25393OH,OSTEOPLASTY RADIUS&ULNA LENGTHENING W/AUTOGRAF,6624.0,4305.6,1.1,20863.78,144
CDM,25394OH,"OSTEOPLSTY CARPAL, SHORTNING",4340.0,2821.0,1.1,9440.12,144
CDM,25400010,CONTR HOCM 200-249MG 1ML,17.0,11.05,0.21,28.93,68
CDM,25400015,"VISIPAQUE,V-041,PER 1ML",3.48,2.26,0.12,28.93,66
CDM,25400025,OMNIPAQUE 350MGL/ML PLUSPAK OF 150ML,38.4,24.96,0.12,38.4,66
CDM,25400035,350MGL/ML PLUSPAK OF 100ML,19.56,12.71,0.12,28.93,66
CDM,25400045,350MGL/ML PLUSPAK OF 50ML,7.72,5.02,0.12,28.93,66
CDM,25400055,LUMASON 25MG VIAL NDC 00270-7099-16,98.0,63.7,19.64,98.0,69
CDM,25400OH,RPR NONUNION/MALUNION RADIUS/ULNA W/O AUTOGRAFT,4512.0,2932.8,1.1,20863.78,144
CDM,25405OH,RPR NONUNION/MALUNION RADIUS/ULNA W/AUTOGRAFT,6004.0,3902.6,1.1,20863.78,144
CDM,25415OH,RPR NONUNION/MALUNION RADIUS&ULNA W/O AUTOGRAF,5520.0,3588.0,1.1,20863.78,144
CDM,25420OH,RPR NONUNION/MALUNION RADIUS&ULNA W/AUTOGRAFT,6816.0,4430.4,1.1,20863.78,144
CDM,25425OH,FIX DEFECT RAD OR ULNA W AUTOGRFT,5488.0,3567.2,1.1,20863.78,144
CDM,25430OH,VASC PEDICL INTO CARPAL BONE,3884.0,2524.6,1.1,9440.12,144
CDM,25431OH,REP NONUNION CARPAL BONE EA,4356.0,2831.4,1.1,20863.78,144
CDM,25440OH,RPR NONUNION SCAPHOID CARPAL BNE W/WO RDL STYLEC,4272.0,2776.8,1.1,20863.78,144
CDM,25441OH,ARTHROPLASTY W/PROSTHETIC RPLCMT DISTAL RADIUS,5316.0,3455.4,1.1,38384.94,144
CDM,25442OH,ARTHROPLASTY W/PROSTHETIC RPLCMT DISTAL ULNA,4448.0,2891.2,1.1,54351.12,144
CDM,25443OH,ARTHROPLASTY W/PROSTHETIC RPLCMT SCAPHOID CARPAL,4264.0,2771.6,1.1,20863.78,144
CDM,25444OH,ARTHROPLASTY W/PROSTHETIC REPLACEMENT LUNATE,4568.0,2969.2,1.1,38384.94,144
CDM,25445OH,ARTHROPLASTY W/PROSTHETIC REPLACEMENT TRAPEZIUM,3952.0,2568.8,1.1,20863.78,144
CDM,25446OH,ARTHRP W/PROSTC RPLCMT DSTL RDS&PRTL/CARPUS,6920.0,4498.0,1.1,54351.12,144
CDM,25447OH,ARTHRP INTERCARPAL/CARP/MTCRPL JT INTERPOSITION,4200.0,2730.0,1.1,9440.12,144
CDM,25448OH,ARTHRP INTERCARPAL/CARP/MTCRPL JT SUSPENSION,5214.0,3389.1,1.1,5214.0,142
CDM,25449OH,REVJ ARTHRP W/REMOVAL IMPLANT WRIST JOINT,5976.0,3884.4,1.1,20863.78,144
CDM,25450OH,EPIPHYSL ARRST EPIPHYSIOD/STAPLING DSTL RDS/U,3224.0,2095.6,1.1,9440.12,144
CDM,25455OH,EPIPHYSL ARRST EPIPHYSIOD/STAPLING DSTL RDS&ULNA,3884.0,2524.6,1.1,9440.12,144
CDM,25490OH,PROPH TX N/P/PLTWR W/WO METHYLACRYLATE RADIUS,3892.0,2529.8,1.1,20863.78,144
CDM,25491OH,PROPH TX N/P/PLTWR W/WO METHYLMETHACRYLATE ULNA,4060.0,2639.0,1.1,38384.94,144
CDM,25492OH,PROPH TX N/P/PLTWR W/WO METHYLMECRYLATE RAD&UL,5064.0,3291.6,1.1,9440.12,144
CDM,25500065,GADOLINIUM (287) PER ML,4.8,3.12,1.05,28.93,66
CDM,25500OH,CLOSED TX RADIAL SHAFT FRACTURE W/O MANIPULATION,1040.0,676.0,1.1,1040.0,148
CDM,25505OH,CLOSED TX RADIAL SHAFT FRACTURE W/MANIPULATION,2180.0,1417.0,1.1,4686.39,148
CDM,25515OH,OPEN TREATMENT RADIAL SHAFT FRACTURE,3520.0,2288.0,1.1,20863.78,144
CDM,25520OH,CLTX RDL SHFT FX&CLTX DISLC DSTL RAD/ULN JT,2600.0,1690.0,1.1,4686.39,148
CDM,25525OH,OPEN RDL SHAFT FX CLOSED RAD/ULN JT DISLOCATE,4220.0,2743.0,1.1,20863.78,144
CDM,25526OH,OPEN RDL SHAFT FX OPEN RAD/ULN JT DISLOCATE,5260.0,3419.0,1.1,20863.78,144
CDM,25530OH,CLOSED TX ULNAR SHAFT FRACTURE W/O MANIPULATION,896.0,582.4,1.1,925.48,148
CDM,25535OH,CLOSED TX ULNAR SHAFT FRACTURE W/MANIPULATION,2144.0,1393.6,1.1,2144.0,148
CDM,25545OH,OPEN TREATMENT OF ULNAR SHAFT FRACTURE,3176.0,2064.4,1.1,20863.78,144
CDM,25560OH,CLOSED TX RADIAL&ULNAR SHAFT FRACTURES W/O MAN,1036.0,673.4,1.1,1036.0,148
CDM,25565OH,CLOSED TX RADIAL&ULNAR SHAFT FRACTURES W/MANJ,2340.0,1521.0,1.1,4686.39,148
CDM,25574OH,OPEN TX RADIAL&ULNAR SHAFT FX W/FIXJ RADIUS/ULNA,3520.0,2288.0,1.1,20863.78,144
CDM,25575OH,OPEN TX RADIAL&ULNAR SHAFT FX W/FIXJ RADIUS&ULNA,4916.0,3195.4,1.1,20863.78,144
CDM,25600OH,CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O MANJ,1112.0,722.8,1.1,1184.07,148
CDM,25605OH,CLTX DSTL RDL FX/EPIPHYSL SEP W/MANJ WHEN PERF,2500.0,1625.0,1.1,4686.39,148
CDM,25606OH,PERQ SKEL FIXJ DISTAL RADIAL FX/EPIPHYSL SEP,3324.0,2160.6,1.1,9440.12,144
CDM,25607OH,"OPEN RX DISTAL RADIUS FX, EXTRA-ARTICULAR",4206.0,2733.9,1.1,20863.78,144
CDM,25608OH,"OPEN RX DISTAL RADIUS FX, INTRA-ARTICULAR, 2 FRAG",4871.0,3166.15,1.1,20863.78,144
CDM,25609OH,"OPEN RX DISTAL RADIUS FX, INTRA-ARTICULAR, 3+ FRAG",6327.0,4112.55,1.1,20863.78,144
CDM,25622OH,CLOSED TX CARPAL SCAPHOID FRACTURE W/O MANJ,1116.0,725.4,1.1,1116.0,148
CDM,25624OH,CLOSED TX CARPAL SCAPHOID FRACTURE W/MANJ,1908.0,1240.2,1.1,4686.39,148
CDM,25628OH,OPEN TX CARPAL SCAPHOID NAVICULAR FRACTURE,3868.0,2514.2,1.1,20863.78,144
CDM,25630OH,CLTX CARPAL BONE FX W/O MANJ EACH BONE,1333.0,866.45,1.1,1333.0,148
CDM,25635OH,CLTX CARPAL BONE FX W/MANJ EACH BONE,2028.0,1318.2,1.1,4686.39,148
CDM,25645OH,OPEN TX CARPAL BONE FRACTURE OTH/THN SCAPHOID EA,2968.0,1929.2,1.1,9440.12,144
CDM,25650OH,CLOSED TREATMENT ULNAR STYLOID FRACTURE,1292.0,839.8,1.1,1292.0,148
CDM,25651OH,PRQ SKELETAL FIXATION ULNAR STYLOID FRACTURE,2328.0,1513.2,1.1,9440.12,144
CDM,25652OH,OPEN TREATMENT ULNAR STYLOID FRACTURE,3224.0,2095.6,1.1,20863.78,144
CDM,25660OH,CLTX RDCRPL/INTERCARPL DISLC 1/> BONES W/MANJ,1992.0,1294.8,1.1,1992.0,144
CDM,25670OH,OPEN TX RADIOCARPAL/INTERCARPAL DISLC 1/> BONES,3236.0,2103.4,1.1,20863.78,144
CDM,25671OH,PRQ SKELETAL FIXJ DISTAL RADIOULNAR DISLOCATION,2584.0,1679.6,1.1,9440.12,144
CDM,25675OH,CLOSED TX DISTAL RADIOULNAR DISLOCATION W/MANJ,1956.0,1271.4,1.1,1956.0,148
CDM,25676OH,OPEN TX DISTAL RADIOULNAR DISLC ACUTE/CHRONIC,3316.0,2155.4,1.1,20863.78,144
CDM,25680OH,CLTX TRANS-SCAPHOPRILUNAR TYP FX DISLC W/MANJ,2492.0,1619.8,1.1,2492.0,144
CDM,25685OH,OPEN TX TRANS-SCAPHOPERILUNAR FRACTURE DISLC,4036.0,2623.4,1.1,20863.78,144
CDM,25690OH,CLOSED TX LUNATE DISLOCATION W/MANIPULATION,2288.0,1487.2,1.1,4686.39,144
CDM,25695OH,OPEN TREATMENT LUNATE DISLOCATION,3404.0,2212.6,1.1,20863.78,144
CDM,25800040,F NACL .9 1000ML,5.0,3.25,1.09,11.17,75
CDM,25800050,F NACL .9 500ML,13.0,8.45,2.83,13.0,60
CDM,25800575,NORMAL SALINE 1000 CC,6.0,3.9,1.31,11.17,75
CDM,25800580,"INFUSION, NORMAL SALINE 500ML",5.0,3.25,1.09,11.17,75
CDM,25800595,D10 W 1000ML 2B0164,11.0,7.15,2.4,11.0,60
CDM,25800600,D5 .9NS 1000ML 2B1064,11.0,7.15,2.4,11.0,60
CDM,25800605,D5 1/2NS 1000ML,5.0,3.25,1.09,5.0,60
CDM,25800625,"D5 INJ,50ML",3.0,1.95,0.65,3.0,60
CDM,25800630,D5 LR 1000ML,5.0,3.25,1.09,5.0,60
CDM,25800645,DS 1/2 NS 1000ML 2B1074,61.9,40.24,13.49,61.9,60
CDM,25800650,DS 1/2NS 500ML 2B1073Q,12.45,8.09,2.71,12.45,60
CDM,25800655,DS 1/2NS W/20KCL 1000ML B1654,49.45,32.14,10.78,49.45,60
CDM,25800660,DS 1/4NS 1000ML 2B1094,79.68,51.79,17.37,79.68,60
CDM,25800665,DS LR 1000ML 2B2074,61.9,40.24,13.49,61.9,60
CDM,25800670,DS NS .9% 250ML 2B1062,95.87,62.32,20.9,95.87,60
CDM,25800675,DS W 1000ML 2B0064,61.9,40.24,13.49,61.9,60
CDM,25800680,DS W 500ML 2B0063Q,60.16,39.1,13.11,60.16,60
CDM,25800OH,ARTHRODESIS WRIST COMPLETE W/O BONE GRAFT,4431.0,2880.15,1.1,20863.78,144
CDM,25805OH,ARTHRODESIS WRIST W/SLIDING GRAFT,4692.0,3049.8,1.1,20863.78,144
CDM,25810OH,ARTHRODESIS WRIST W/ILIAC/OTHER AUTOGRAFT,4780.0,3107.0,1.1,38384.94,144
CDM,25820OH,ARTHRODESIS WRIST LIMITED W/O BONE GRAFT,3056.0,1986.4,1.1,20863.78,144
CDM,25825OH,ARTHRODESIS WRIST LIMITED W/AUTOGRAFT,3876.0,2519.4,1.1,20863.78,144
CDM,25830OH,ARTHRD DSTL RAD/ULN JT SGMTL RSCJ ULNA W/WO BONE,4352.0,2828.8,1.1,20863.78,144
CDM,25900015,ALPROSTADIL 1.25MCG,493.95,321.07,1.01,493.95,75
CDM,25900040,50ML IV SOLUTION,6.0,3.9,1.31,6.0,60
CDM,25900048,"ALBUTEROL INH KIT,17GM",7.0,4.55,1.53,7.0,60
CDM,25900050,DEL NIDO CARDIOPLEGIA,96.25,62.56,20.98,96.25,60
CDM,25900225,CONRAY 60 DYE 50ML 0953-15,14.0,9.1,3.05,14.0,60
CDM,25900255,"DEXAMETHASONE INJ,4MG/CC,1CC",2.0,1.3,0.44,2.0,60
CDM,25900260,"DEXTROSE 50% LFSH INJ,50CC",6.0,3.9,1.31,6.0,60
CDM,25900305,ESMOLOL 10ML/100MG,70.0,45.5,15.26,70.0,60
CDM,25900360,HEPARIN LOCK NF1310,7.0,4.55,1.53,7.0,60
CDM,25900390,HEXTEND 500 ML,73.0,47.45,15.91,73.0,60
CDM,25900435,INV DISPENSING FEE TIER 2 IV,85.0,55.25,18.53,85.0,60
CDM,25900440,INV DISPENSING FEE TIER 2 ORAL,60.0,39.0,13.08,60.0,60
CDM,25900470,LABETALOL INJ 100MG/20ML,12.0,7.8,2.62,12.0,60
CDM,25900620,LOW DOSE TRIPLE,14.0,9.1,3.05,14.0,60
CDM,25900655,METOPROLOL 5MG/5ML,25.59,16.63,5.58,25.59,60
CDM,25900700,NOREPINEPHRINE 4ML/1MG,40.0,26.0,8.72,40.0,60
CDM,25900820,SODIUM CHLORIDE INJ 0.9% 100CC,5.0,3.25,1.09,5.0,60
CDM,25900825,SODIUM CHORIDE 0.9 INJ 50ML,5.0,3.25,1.09,5.0,60
CDM,25900830,SOLUTION INJ. 100CC & 50CC,3.0,1.95,0.65,3.0,60
CDM,25900835,SOLUTION INJ. 250CC & 150CC,3.0,1.95,0.65,3.0,60
CDM,25900840,"SOLUTION INJ.,500CC & 1000CC",3.0,1.95,0.65,3.0,60
CDM,25900955,WATER INJ 1000ML,3.0,1.95,0.65,3.0,60
CDM,25900OH,AMPUTATION FOREARM THROUGH RADIUS & ULNA,3844.0,2498.6,1.1,3844.0,144
CDM,25905OH,AMP FOREARM THRU RADIUS & ULNA OPEN CIRCULAR,3836.0,2493.4,1.1,3836.0,144
CDM,25909OH,AMP FOREARM THRU RADIUS&ULNA RE-AMPUTATION,3724.0,2420.6,1.1,20863.78,144
CDM,25920OH,DISARTICULATION THROUGH WRIST,3612.0,2347.8,1.1,3612.0,144
CDM,25927OH,AMPUTATION TRANSMETACARPAL,3636.0,2363.4,1.1,3636.0,144
CDM,25929OH,TRANSMETACARPAL AMPUTATION SEC CLOSURE/SCAR REVJ,3128.0,2033.2,1.1,5320.02,144
CDM,25931OH,RE-AMPUTATION TRANSMETACARPAL,3216.0,2090.4,1.1,9440.12,144
CDM,25999RVU1OH,DECOMPRESSION OF THE DISTAL RADIUS (COMP CODE 25035),3060.0,1989.0,0.01,3060.0,84
CDM,25999RVU2OH,RESURFACING OF THE CAPITATE (COMP CODE 25444),4911.0,3192.15,0.01,4911.0,84
CDM,26000000,REFILL SPINE/BRAIN PUMP,2289.0,1487.85,45.54,2289.0,87
CDM,26000005,REFILL SPINE/BRAIN PUMP PHYS,2037.0,1324.05,45.54,2037.0,87
CDM,26000010,IV HYDRATE INIT 31-60MIN,1454.0,945.1,43.43,1454.0,87
CDM,26000050,IV HYDRATE EA ADD HR,318.0,206.7,16.11,452.75,87
CDM,26000090,IV INF INIT UP TO 1 HR,1454.0,945.1,84.89,1454.0,87
CDM,26000130,IV INF SEQ EA ADD HR,318.0,206.7,26.4,452.75,87
CDM,26000170,IV INF SEQ UP TO 1HR,491.0,319.15,37.57,491.0,87
CDM,26000210,IV INF CONCUR THERAPY,762.0,495.3,25.57,762.0,68
CDM,26000250,INJ SQ/IM,491.0,319.15,17.51,491.0,87
CDM,26000265,FILL PORTABLE PUMP,1454.0,945.1,45.54,1454.0,87
CDM,26000275,IRRIG IMP VAD,410.0,266.5,34.52,410.0,87
CDM,26000290,INJ IVPUSH INIT DRUG,1454.0,945.1,45.54,1454.0,87
CDM,26000315,PHLEBOTOMY,889.0,577.85,35.72,889.0,87
CDM,26000330,INJ IVPUSH SEQ NEW DRUG,318.0,206.7,20.23,318.0,87
CDM,26000335,"PROLONGED IV INF, REQ PUMP",1907.0,1239.55,201.23,1907.0,85
CDM,26000370,INJ IV PUSH SEQ SAME DRUG,488.0,317.2,45.54,488.0,66
CDM,26000380,IRRIG DRUG DELIVERY DEVICE,410.0,266.5,34.52,410.0,87
CDM,26000385,THERAPEUTIC IV INFUSION 1ST HR,1454.0,945.1,84.89,1454.0,87
CDM,26000395,THERAP IV INFUSION EA ADDL HR,318.0,206.7,26.4,452.75,87
CDM,26000475,SITZMARKS CAPSULE,103.0,66.95,22.45,103.0,59
CDM,26000485,SC THER INFUSION UP TO 1 HR,1454.0,945.1,185.95,1454.0,87
CDM,26000495,SC THER INFUSION ADDL HR,318.0,206.7,20.29,452.75,87
CDM,26000505,IM/SC INJECTION (MONTHLY),491.0,319.15,17.51,491.0,87
CDM,26000515,INJECTION IV PUSH INIT,1454.0,945.1,45.54,1454.0,87
CDM,26000525,INJ IV PUSH SEQ NEW DRUG,318.0,206.7,20.23,318.0,87
CDM,26000535,IRRIG DRUG DELIVERY DEVICE,410.0,266.5,34.52,410.0,87
CDM,26000545,APPL ON-BODY INJECTOR FOR TIMED SUBQ INJECTION,318.0,206.7,23.69,3174.0,87
CDM,26000575,FILL IMP PUMP SYSTEMIC,1454.0,945.1,45.54,1454.0,87
CDM,26000605,FILL IMP PUMP RESVOIR IV OR IA,1454.0,945.1,45.54,1454.0,87
CDM,26000665,THER/PROPH/DIAG INJ IA,1454.0,945.1,24.16,1454.0,87
CDM,26000805,ADMINISTRATION OF MEDICATION OTHER THAN ORAL AND/OR INJECTABLE,94.0,61.1,19.31,94.0,67
CDM,26000875,EEG CONT REC W/VIDEO BY TECH MIN 8 CHANNELS,1080.0,702.0,135.52,1080.0,85
CDM,26010OH,DRAIN FINGER ABSCESS SIMPLE,700.0,455.0,1.1,1164.4,148
CDM,26011OH,DRAIN FINGER ABSCESS COMPL,986.0,640.9,1.1,4729.25,148
CDM,26020OH,DRAIN HAND TENDON SHEATH,2736.0,1778.4,1.1,9440.12,144
CDM,26025OH,"DRAINAGE PALM BURSA,SINGLE",2032.0,1320.8,1.1,9440.12,144
CDM,26030OH,"DRAINAGE PALM BURSA,MULTIP/COMPLX",2500.0,1625.0,1.1,9440.12,144
CDM,26034OH,INCIS DEEP FINGR/HAND BONE LESN,2652.0,1723.8,1.1,4686.39,144
CDM,26035OH,"DECOMPRESS FINGERS/HAND,INJECT INJ",4548.0,2956.2,1.1,9440.12,144
CDM,26037OH,DECOMPRESS FASCIOTOMY FINGR/HAND,3028.0,1968.2,1.1,9440.12,144
CDM,26040OH,FASCIOTOMY PALMAR PERCUTANEOUS,1384.0,899.6,1.1,4686.39,144
CDM,26045OH,FASCIOTOMY PALMAR OPEN PARTIAL,2292.0,1489.8,1.1,9440.12,144
CDM,26055OH,INCISE FINGER TENDON SHEATH,1368.0,889.2,1.1,4686.39,148
CDM,26060OH,TENOTOMY PERCUTANEOUS SINGLE EACH DIGIT,1164.0,756.6,1.1,4686.39,144
CDM,26070OH,ARTHRT EXPL DRG/RMVL LOOSE/FB CARP/MTCRPL JT,1524.0,990.6,1.1,4686.39,144
CDM,26075OH,ARTHRT EXPL DRG/RMVL LOOSE/FB MTCARPHLNGL JT EA,1564.0,1016.6,1.1,9440.12,144
CDM,26080OH,ARTHRT EXPL DRG/RMVL LOOSE/FB IPHAL JT EA,1788.0,1162.2,1.1,4686.39,144
CDM,26100OH,ARTHROTOMY BIOPSY CARP/MTCRPL JOINT EACH,1516.0,985.4,1.1,9440.12,144
CDM,26105OH,ARTHROTOMY BIOPSY MTCARPHLNGL JOINT EACH,1532.0,995.8,1.1,9440.12,144
CDM,26110OH,ARTHROTOMY BIOPSY INTERPHALANGEAL JOINT EACH,1460.0,949.0,1.1,4686.39,144
CDM,26111OH,EX TUM/VASC MALF SFT TISS HAND/FNGR SUBQ 1.5+CM,2168.0,1409.2,1.1,4729.25,144
CDM,26113OH,EX TUM/VASC MAL SFT TIS HAND/FNGR SUBFSC 1.5+CM,2852.0,1853.8,1.1,4729.25,144
CDM,26115OH,EXC TUM/VASC MAL SFT TISS HAND/FNGR SUBQ <1.5CM,1584.0,1029.6,1.1,4729.25,148
CDM,26116OH,EXC TUM/VAS MAL SFT TIS HAND/FNGR SUBFASC<1.5CM,2696.0,1752.4,1.1,4729.25,144
CDM,26117OH,RAD RESECT TUMOR SOFT TISSUE HAND/FINGER <3CM,4052.0,2633.8,1.1,8286.13,144
CDM,26118OH,RAD RESCJ TUM SOFT TISSUE HAND/FINGER 3 CM/>,5924.0,3850.6,1.1,8286.13,144
CDM,26121OH,FASCT PALM W/WO Z-PLASTY TISSUE REARGMT/SKN GRFT,3092.0,2009.8,1.1,9440.12,144
CDM,26123OH,FASCT PRTL PALMAR 1 DGT PROX IPHAL JT W/WO RPR,4352.0,2828.8,1.1,9440.12,144
CDM,26125OH,FASCT PRTL PALMR ADDL DGT PROX IPHAL JT W/WO RPR,1840.0,1196.0,1.1,1840.0,144
CDM,26130OH,SYNOVECTOMY CARPOMETACARPAL JOINT,2236.0,1453.4,1.1,9440.12,144
CDM,26135OH,SYNVCT MTCARPHLNGL JT W/INTRNSC RLS&XTNSR HOOD,2852.0,1853.8,1.1,9440.12,144
CDM,26140OH,SYNVCT PROX IPHAL JT W/XTNSR RCNSTJ EA IPHAL JT,2536.0,1648.4,1.1,4686.39,144
CDM,26145OH,SYNVCT TDN SHTH RAD FLXR TDN PALM&/FNGR EA TDN,2596.0,1687.4,1.1,4686.39,144
CDM,26160OH,EXC LESION TDN SHTH/JT CAPSL HAND/FNGR,1571.0,1021.15,1.1,4686.39,148
CDM,26170OH,EXCISION TENDON PALM FLEXOR/EXTENSOR SINGLE EACH,1964.0,1276.6,1.1,4686.39,144
CDM,26180OH,EXCISION TENDON FINGER FLEXOR/EXTENSOR EACH,2140.0,1391.0,1.1,4686.39,144
CDM,26185OH,"SESAMOIDECTOMY, THUMB/FINGER",2608.0,1695.2,1.1,4686.39,144
CDM,26200OH,EXCISION/CURETTAGE CYST/TUMOR METACARPAL,2260.0,1469.0,1.1,4686.39,144
CDM,26205OH,EXC/CURETTAGE CYST/TUMOR METACARPAL W/AUTOGRAFT,3172.0,2061.8,1.1,20863.78,144
CDM,26210OH,EXCISION/CURETTAGE CYST/TUMOR PHALANX FINGER,2128.0,1383.2,1.1,4686.39,144
CDM,26215OH,EXC/CURETTAGE CYST/TUMOR PHALANX FINGER W/AGRAFT,2908.0,1890.2,1.1,9440.12,144
CDM,26230OH,"PART REMV BONE,METACARPAL",2588.0,1682.2,1.1,9440.12,144
CDM,26235OH,"PART REMV BONE,PROX/MID PHALANX",2532.0,1645.8,1.1,4686.39,144
CDM,26236OH,"PART REMV BONE,DISTAL PHALANX",2184.0,1419.6,1.1,4686.39,144
CDM,26250OH,RADICAL RESECTION TUMOR METACARPAL,6084.0,3954.6,1.1,9440.12,144
CDM,26260OH,RAD RESECTION TUMOR PROX/MIDDLE PHALANX FINGER,4464.0,2901.6,1.1,9440.12,144
CDM,26262OH,RADICAL RESECTION TUMOR DISTAL PHALANX FINGER,3316.0,2155.4,1.1,4686.39,144
CDM,26320OH,REMOVAL OF IMPLANT FROM HAND/FINGR,1640.0,1066.0,1.1,4729.25,144
CDM,26340OH,MANIPULATION FINGER JOINT UNDER ANES EACH JOINT,1120.0,728.0,1.1,4686.39,142
CDM,26341OH,MANIPLATN PALAR FASCIAL CRD POST INJ SINGLE CORD,364.0,236.6,1.1,688.73,148
CDM,26350OH,RPR/ADVMNT FLXR TDN N/Z/2 W/O FR GRAFT EA TENDON,2484.0,1614.6,1.1,9440.12,144
CDM,26352OH,RPR/ADVMNT FLXR TDN N/Z/2 W/FR GRAFT EA TENDON,3148.0,2046.2,1.1,20863.78,144
CDM,26356OH,RPR/ADVMNT FLXR TDN ZONE 2 W/O FR GRFT EA TENDON,3824.0,2485.6,1.1,9440.12,144
CDM,26357OH,RPR/ADVMNT FLXR TDN ZONE 2 W/O FR GRFT EA TENDON,4400.0,2860.0,1.1,9440.12,144
CDM,26358OH,RPR/ADVMNT FLXR TDN ZONE 2 W/FR GRAFT EA TENDON,5040.0,3276.0,1.1,20863.78,144
CDM,26370OH,RPR/ADVMNT TDN W/NTC SUPFCIS TDN PRIM EA TDN,2912.0,1892.8,1.1,9440.12,144
CDM,26372OH,RPR/ADVMNT TDN W/NTC SUPFCIS TDN W/FREE GRAFT EA,3604.0,2342.6,1.1,20863.78,144
CDM,26373OH,RPR/ADVMNT TDN W/NTC SUPFCIS TDN W/O FREE GRF EA,3364.0,2186.6,1.1,9440.12,144
CDM,26390OH,EXC FLXR TDN W/IMPLTJ SYNTH ROD DLYD TDN GRF H/F,3772.0,2451.8,1.1,20863.78,144
CDM,26392OH,RMVL SYNTH ROD & INSJ FLXR TDN GRF H/F EA ROD,4200.0,2730.0,1.1,20863.78,144
CDM,26410OH,REPAIR EXTENSOR TENDON HAND W/O GRAFT EACH,1908.0,1240.2,1.1,4686.39,144
CDM,26412OH,REPAIR EXTENSOR TENDON HAND W/GRAFT EACH,2592.0,1684.8,1.1,9440.12,144
CDM,26415OH,EXC XTNSR TDN W/IMPLTJ SYNTH ROD DLYD GRF H/F EA,3404.0,2212.6,1.1,9440.12,144
CDM,26416OH,RMVL SYNTH ROD & INSJ XTNSR TDN GRF H/F EA ROD,3824.0,2485.6,1.1,9440.12,144
CDM,26418OH,REPAIR EXTENSOR TENDON FINGER W/O GRAFT EACH,1788.0,1162.2,1.1,4686.39,144
CDM,26420OH,REPAIR EXTENSOR TENDON FINGER W/GRAFT EACH,2776.0,1804.4,1.1,9440.12,144
CDM,26426OH,RPR XTNSR TDN CNTRL SLIP TISS W/LAT BAND EA FNGR,2528.0,1643.2,1.1,9440.12,144
CDM,26428OH,RPR XTNSR TDN CNTRL SLIP SEC W/FR GRFT EA FINGER,2960.0,1924.0,1.1,9440.12,144
CDM,26432OH,CLTX DSTL XTNSR TDN INSJ W/WO PERCUTAN PINNING,1664.0,1081.6,1.1,4686.39,144
CDM,26433OH,REPAIR EXTENSOR TENDON DISTAL INSERTION W/O GRF,1880.0,1222.0,1.1,9440.12,144
CDM,26434OH,REPAIR EXTENSOR TENDON DISTAL INSERTION W/GRAFT,2504.0,1627.6,1.1,9440.12,144
CDM,26437OH,REALIGNMENT EXTENSOR TENDON HAND EACH TENDON,2396.0,1557.4,1.1,9440.12,144
CDM,26440OH,TENOLYSIS FLEXOR TENDON PALM/FINGER EACH TENDON,2064.0,1341.6,1.1,4686.39,144
CDM,26442OH,TENOLYSIS FLEXOR TENDON PALM&FINGER EACH TENDO,4290.0,2788.5,1.1,9440.12,144
CDM,26445OH,TENOLYSIS EXTENSOR TENDON HAND/FINGER EACH,1780.0,1157.0,1.1,9440.12,144
CDM,26449OH,TENOLYSIS CPLX XTNSR TENDON FINGER W/FOREARM EA,3436.0,2233.4,1.1,9440.12,144
CDM,26450OH,"TENOTOMY PALM FLEX,SINGLE,OPEN,EACH",1516.0,985.4,1.1,9440.12,144
CDM,26455OH,"TENOTOMY FINGR FLEX,SINGLE,OPEN,EACH",1504.0,977.6,1.1,4686.39,144
CDM,26460OH,"TENOTOMY HAND EXTEN,SINGLE,OPEN,EACH",1432.0,930.8,1.1,4686.39,144
CDM,26471OH,TENODESIS PROXIMAL INTERPHALANGEAL JOINT EACH,2360.0,1534.0,1.1,9440.12,144
CDM,26474OH,TENODESIS DISTAL JOINT EACH,2196.0,1427.4,1.1,4686.39,144
CDM,26476OH,"TENDON LENGTHENING,EXTEN,HAND/FINGR",2140.0,1391.0,1.1,9440.12,144
CDM,26477OH,"TENDON SHORTENING,EXTEN,HAND/FINGR",2128.0,1383.2,1.1,9440.12,144
CDM,26478OH,"TENDON LENGTHENING,FLEX,HAND/FINGR",2388.0,1552.2,1.1,9440.12,144
CDM,26479OH,"TENDON SHORTENING,FLEX,HAND/FINGR",2364.0,1536.6,1.1,9440.12,144
CDM,26480OH,TR/TRNSPL TDN CARP/MTCRPL HAND W/O FR GRF EA TDN,3600.0,2340.0,1.1,9440.12,144
CDM,26483OH,TENDON TRANSFER TRANSPLANT CARP/MTCRPL GRAFT,3392.0,2204.8,1.1,9440.12,144
CDM,26485OH,TRANSFER/TRANSPLANT TENDON PALMAR W/O GRAFT EACH,3156.0,2051.4,1.1,9440.12,144
CDM,26489OH,TRANSFER/TRANSPLANT TENDON PALMAR W/GRAFT EACH,3944.0,2563.6,1.1,9440.12,144
CDM,26490OH,OPPONENSPLASTY SUPFCIS TDN TR TYP EA TDN,3440.0,2236.0,1.1,9440.12,144
CDM,26492OH,OPPONENSPLASTY TDN TR W/GRF EA TDN,3936.0,2558.4,1.1,9440.12,144
CDM,26494OH,OPPONENSPLASTY HYPOTHENAR MUSC TR,3464.0,2251.6,1.1,9440.12,144
CDM,26496OH,OPPONENSPLASTY OTHER METHODS,3912.0,2542.8,1.1,9440.12,144
CDM,26497OH,TR TDN RESTORE INTRNSC FUNCJ RING&SM FNGR,3904.0,2537.6,1.1,9440.12,144
CDM,26498OH,TR TDN RESTORE INTRNSC FUNCJ ALL 4 FNGRS,5684.0,3694.6,1.1,9440.12,144
CDM,26499OH,CORRECTION CLAW FINGER OTHER METHODS,3668.0,2384.2,1.1,9440.12,144
CDM,26500OH,RCNSTJ TENDON PULLEY EACH W/LOCAL TISSUES SPX,2452.0,1593.8,1.1,20863.78,144
CDM,26502OH,RCNSTJ TDN PULLEY EA TDN W/TDN/FSCAL GRF SPX,2924.0,1900.6,1.1,9440.12,144
CDM,26508OH,RELEASE THENAR MUSCLE,2472.0,1606.8,1.1,9440.12,144
CDM,26510OH,CROSS INTRINSIC TRANSFER EACH TENDON,2240.0,1456.0,1.1,9440.12,144
CDM,26516OH,CAPSULODESIS MTCARPHLNGL JOINT SINGLE DIGIT,2928.0,1903.2,1.1,9440.12,144
CDM,26517OH,CAPSULODESIS MTCARPHLNGL JOINT 2 DIGITS,3632.0,2360.8,1.1,9440.12,144
CDM,26518OH,CAPSULODESIS MTCARPHLNGL JOINT 3/4 DIGITS,3708.0,2410.2,1.1,20863.78,144
CDM,26520OH,CAPSULECTOMY/CAPSULOTOMY MTCARPHLNGL JOINT EACH,2188.0,1422.2,1.1,9440.12,144
CDM,26525OH,CAPSULECTOMY/CAPSULOTOMY IPHAL JOINT EACH,2200.0,1430.0,1.1,4686.39,144
CDM,26530OH,ARTHROPLASTY METACARPOPHALANGEAL JOINT EACH,2752.0,1788.8,1.1,20863.78,144
CDM,26531OH,ARTHRP MTCARPHLNGL JT W/PROSTC IMPLT EA JT,3252.0,2113.8,1.1,20863.78,144
CDM,26535OH,ARTHROPLASTY INTERPHALANGEAL JOINT EACH,2164.0,1406.6,1.1,9440.12,144
CDM,26536OH,ARTHROPLASTY INTERPHALANGEAL JT W/PROSTHETIC EA,2624.0,1705.6,1.1,20863.78,144
CDM,26540OH,RPR COLTRL LIGM MTCARPHLNGL/IPHAL JT,2640.0,1716.0,1.1,9440.12,144
CDM,26541OH,RCNSTJ COLTRL LIGM MTCARPHLNGL 1 W/TDN/FSCAL GRF,3524.0,2290.6,1.1,9440.12,144
CDM,26542OH,RCNSTJ COLTRL LIGM MTCARPHLNGL 1 W/LOCAL TISS,2780.0,1807.0,1.1,9440.12,144
CDM,26545OH,RCNSTJ COLTRL LIGM IPHAL JT 1 W/GRF EA JT,2844.0,1848.6,1.1,9440.12,144
CDM,26546OH,RPR NON-UNION MTCRPL/PHALANX,4332.0,2815.8,1.1,20863.78,144
CDM,26548OH,RPR & RCNSTJ FINGER VOLAR PLATE INTERPHALANGEAL,3288.0,2137.2,1.1,9440.12,144
CDM,26550OH,POLLICIZATION OF DIGIT,8672.0,5636.8,1.1,9440.12,144
CDM,26551OH,TR TOE-TO-HAND W/MVASC ANAST GRT TOE WRP/ARND,19392.0,12604.8,1.1,19392.0,144
CDM,26553OH,TR TOE-TO-HAND W/MVASC ANAST OTH/THN GRT TOE 1,19268.0,12524.2,1.1,19268.0,144
CDM,26554OH,TR TOE-TO-HAND W/MVASC ANAST OTH/THN GRT TOE 2,22804.0,14822.6,1.1,22804.0,144
CDM,26555OH,TR FNGR AXH POS W/O MVASC ANAST,6832.0,4440.8,1.1,20863.78,144
CDM,26556OH,TRANSFER FREE TOE JOINT W/MVASC ANASTOMOSIS,19900.0,12935.0,1.1,19900.0,144
CDM,26560OH,REPAIR SYNDACTYLY EACH SPACE W/SKIN FLAPS,2208.0,1435.2,1.1,4686.39,144
CDM,26561OH,REPAIR SYNDACTYLY EACH SPACE W/SKIN FLAPS&GRAFT,4440.0,2886.0,1.1,9440.12,144
CDM,26562OH,REPAIR SYNDACTYLY EACH SPACE COMPLEX,6672.0,4336.8,1.1,9440.12,144
CDM,26565OH,OSTEOTOMY METACARPAL EACH,2764.0,1796.6,1.1,9440.12,144
CDM,26567OH,OSTEOTOMY PHALANX FINGER EACH,2796.0,1817.4,1.1,9440.12,144
CDM,26568OH,OSTEOPLASTY LENGTHENING METACARPAL/PHALANX,3708.0,2410.2,1.1,20863.78,144
CDM,26580OH,REPAIR CLEFT HAND,7900.0,5135.0,1.1,9440.12,144
CDM,26587OH,RCNSTJ POLYDACTYLOUS DIGIT SOFT TISSUE & BONE,5800.0,3770.0,1.1,9440.12,144
CDM,26590OH,REPAIR MACRODACTYLIA EACH DIGIT,7468.0,4854.2,1.1,7468.0,144
CDM,26591OH,REPAIR INTRINSIC MUSCLES HAND EACH MUSCLE,1487.0,966.55,1.1,9440.12,144
CDM,26593OH,RELEASE INTRINSIC MUSCLES HAND EACH MUSCLE,2200.0,1430.0,1.1,9440.12,144
CDM,26596OH,EXC CONSTRICTING RING FNGR W/MLT Z-PLASTIES,3656.0,2376.4,1.1,9440.12,144
CDM,26600OH,CLTX METACARPAL FX W/O MANIPULATION EACH BONE,1144.0,743.6,1.1,1144.0,148
CDM,26605OH,CLTX METACARPAL FX W/MANIPULATION EACH BONE,1333.0,866.45,1.1,1333.0,148
CDM,26607OH,CLTX METACARPAL FX W/MANJ W/XTRNL FIXJ EA BONE,2192.0,1424.8,1.1,9440.12,144
CDM,26608OH,PRQ SKELETAL FIXJ METACARPAL FX EACH BONE,2220.0,1443.0,1.1,9440.12,144
CDM,26615OH,OPEN TX METACARPAL FRACTURE SINGLE EA BONE,2828.0,1838.2,1.1,9440.12,144
CDM,26641OH,CLTX CARPO/METACARPAL DISLOCATION THUMB W/MANJ,1652.0,1073.8,1.1,1652.0,148
CDM,26645OH,CLTX CARPO/METACARPAL FX DISLC THUMB W/MANJ,1832.0,1190.8,1.1,4686.39,148
CDM,26650OH,PRQ SKELETAL FIX CARPO/METACARPAL FX DISLC THUMB,2140.0,1391.0,1.1,9440.12,144
CDM,26665OH,OPEN TX CARPOMETACARPAL FRACTURE DISLOCATE THUMB,3176.0,2064.4,1.1,9440.12,144
CDM,26670OH,CLTX CARPO/METACARPL DISLC THMB MANJ EA W/O ANES,1532.0,995.8,1.1,1532.0,148
CDM,26675OH,CLTX CARPO/MTCRPL DISLC THUMB MANJ EA JT W/ANES,1932.0,1255.8,1.1,4686.39,148
CDM,26676OH,PRQ SKEL FIXJ CARPO/MTCRPL DISLC THMB MANJ EA JT,2296.0,1492.4,1.1,9440.12,144
CDM,26685OH,OPEN TX CARPOMETACARPAL DISLOCATE NOT THUMB,2828.0,1838.2,1.1,9440.12,144
CDM,26686OH,OPTX CARP/MTCRPL DISLC THMB CPLX MLT/DLYD RDCTJ,3268.0,2124.2,1.1,9440.12,144
CDM,26700OH,CLTX METACARPOPHALANGEAL DISLC W/MANJ W/O ANES,1532.0,995.8,1.1,1532.0,148
CDM,26705OH,CLTX METACARPOPHALANGEAL DISLC W/MANJ W/ANES,1752.0,1138.8,1.1,4686.39,148
CDM,26706OH,PRQ SKEL FIXJ METACARPOPHALANGEAL DISLC W/MANJ,2124.0,1380.6,1.1,9440.12,144
CDM,26715OH,OPEN TREATMENT METACARPOPHALANGEAL DISLOCATION,2812.0,1827.8,1.1,9440.12,144
CDM,26720OH,CLTX PHLNGL FX PROX/MIDDLE PX/F/T W/O MANJ EA,774.0,503.1,1.1,774.0,148
CDM,26725OH,CLTX PHLNGL FX PROX/MIDDLE PX/F/T W/MANJ EA,1531.0,995.15,1.1,1531.0,148
CDM,26727OH,PRQ SKEL FIXJ PHLNGL SHFT FX PROX/MIDDLE PX/F/T,2168.0,1409.2,1.1,9440.12,144
CDM,26735OH,OPEN TX PHALANGEAL SHAFT FRACTURE PROX/MIDDLE EA,2968.0,1929.2,1.1,9440.12,144
CDM,26740OH,CLTX ARTCLR FX INVG MTCRPHLNGL/IPHAL JT W/O MANJ,828.0,538.2,1.1,828.0,148
CDM,26742OH,CLTX ARTCLR FX INVG MTCARPHLNGL/IPHAL JT W/MANJ,1596.0,1037.4,1.1,4686.39,148
CDM,26746OH,OPEN TX ARTICULAR FRACTURE MCP/IP JOINT EA,3920.0,2548.0,1.1,9440.12,144
CDM,26750OH,CLTX DSTL PHLNGL FX FNGR/THMB W/O MANJ EA,720.0,468.0,1.1,720.0,148
CDM,26755OH,CLTX DSTL PHLNGL FX FNGR/THMB W/MANJ EA,1292.0,839.8,1.1,1292.0,148
CDM,26756OH,PRQ SKEL FIXJ DSTL PHLNGL FX FNGR/THMB EA,1832.0,1190.8,1.1,9440.12,144
CDM,26765OH,OPEN TX DISTAL PHALANGEAL FRACTURE EACH,2344.0,1523.6,1.1,9440.12,144
CDM,26770OH,CLTX IPHAL JT DISLC W/MANJ W/O ANES,1260.0,819.0,1.1,1260.0,148
CDM,26775OH,CLTX IPHAL JT DISLC W/MANJ REQ ANES,1560.0,1014.0,1.1,1560.0,148
CDM,26776OH,PRQ SKEL FIXJ IPHAL JT DISLC W/MANJ,1996.0,1297.4,1.1,9440.12,144
CDM,26785OH,OPEN TX INTERPHALANGEAL JOINT DISLOCATION,2640.0,1716.0,1.1,9440.12,144
CDM,26841OH,ARTHRD CARPO/METACARPAL JT THUMB W/WO INT FIXJ,2940.0,1911.0,1.1,20863.78,144
CDM,26842OH,ARTHRD CRP/MTACRPL JT THMB W/WO INT FIXJ W/AGRFT,3396.0,2207.4,1.1,20863.78,144
CDM,26843OH,ARTHRD CARP/MTCRPL JT DGT OTHER THAN THUMB EACH,3112.0,2022.8,1.1,20863.78,144
CDM,26844OH,ARTHRD CARP/MTCRPL JT DGT OTH/THN THMB W/AGRFT,3592.0,2334.8,1.1,20863.78,144
CDM,26850OH,ARTHRODESIS METACARPOPHALANGEAL JT W/WO INT FIXJ,2856.0,1856.4,1.1,20863.78,144
CDM,26852OH,ARTHRODESIS MTCRPL JT W/WO INT FIXJ W/AUTOGRAFT,3484.0,2264.6,1.1,20863.78,144
CDM,26860OH,ARTHRODESIS INTERPHALANGEAL JT W/WO INT FIXJ,1952.0,1268.8,1.1,9440.12,144
CDM,26861OH,ARTHRODESIS IPHAL JT W/WO INT FIXJ EA IPHAL JT,696.0,452.4,1.1,696.0,144
CDM,26862OH,ARTHRODESIS IPHAL JT W/WO INT FIXJ W/AUTOGRAFT,3024.0,1965.6,1.1,9440.12,144
CDM,26863OH,ARTHRODESIS IPHAL JT W/WO INT FIXJ W/AGRFT EA JT,1556.0,1011.4,1.1,1556.0,144
CDM,26910OH,AMP MTCRPL W/FINGER/THUMB W/WO INTEROSS TRANSFER,3116.0,2025.4,1.1,9440.12,144
CDM,26951OH,AMP F/TH 1/2 JT/PHALANX W/NEURECT W/DIR CLSR,2416.0,1570.4,1.1,9440.12,144
CDM,26952OH,AMP F/TH 1/2 JT/PHALANX W/NEURECT LOCAL FLAP,2592.0,1684.8,1.1,9440.12,144
CDM,26989RVU2OH,UNLISTED RADICAL TENOSYNOVECTOMY ECD TENDON (COMP CODE 26145),2758.25,1792.86,0.01,2758.25,84
CDM,26989RVUOH,CLOSED TX OF SESAMOID BONE FRAC IN THE FINGER OR HAND (COMP26600,867.0,563.55,0.01,867.0,84
CDM,26990OH,I&D PELVIS/HIP JT AREA DEEP ABSCESS/HEMATOMA,3180.0,2067.0,1.1,9440.12,144
CDM,26991OH,I&D PELVIS/HIP JOINT AREA INFECTED BURSA,2824.0,1835.6,1.1,4686.39,148
CDM,26992OH,INCISION BONE CORTEX PELVIS&/HIP JOINT,5392.0,3504.8,1.1,5392.0,144
CDM,27000055,LAMINARIA SUPPLY,41.0,26.65,8.94,41.0,59
CDM,27000065,SLING PEDIATRIC MEDIUM,6.9,4.49,1.5,19.65,67
CDM,27000075,SPLINT,32.0,20.8,6.98,32.0,67
CDM,27000095,SPECIAL CASTING MATERIAL,16.0,10.4,3.49,19.65,67
CDM,27000125,DUODERM 4X4,6.0,3.9,1.31,19.65,67
CDM,27000145,GAUZE PADS,3.0,1.95,0.65,19.65,66
CDM,27000215,ACE BANDAGE,8.0,5.2,1.74,19.65,67
CDM,27000235,"SELF-ADHER BAND W>=3"" <5""/YD",25.0,16.25,5.45,25.0,67
CDM,27000245,UNNA BOOT,46.0,29.9,10.03,46.0,59
CDM,27000255,COMPRESSION STOCKING 18-30 MM,64.1,41.67,11.14,64.1,67
CDM,27000265,KNEE HIGH COMPRESS GARMENT 30-,85.0,55.25,18.53,85.0,67
CDM,27000285,THIGH HI COMPRESSION GARMENT30,122.7,79.76,26.75,122.7,67
CDM,27000305,GC STOCKING FULL LNGTH 18-30,5.0,3.25,1.09,67.76,67
CDM,27000355,FOREARM STRAP NON-CUSTOM,34.0,22.1,7.41,34.0,67
CDM,27000385,CAST SUP GAUNTLET PLASTER,25.0,16.25,5.45,25.0,67
CDM,27000395,"FINGER SPLINT, STATIC",46.0,29.9,10.03,46.0,59
CDM,27000405,CRANIAL REMOLDING ORTHOSIS,3200.0,2080.0,697.6,3200.0,59
CDM,27000495,ECMO MONITORING/PER HR,76.0,49.4,16.57,76.0,59
CDM,27000715,"SHOE,POST-OP MALE/MED",9.6,6.24,2.09,9.6,59
CDM,27000805,INCENTIVE SPRIOMETER,7.8,5.07,1.7,7.8,59
CDM,27000835,PREFAB KO W STAYS,118.0,76.7,25.72,118.0,59
CDM,27000845,AMBUL SURG BOOT,46.0,29.9,10.03,46.0,59
CDM,27000855,"POST OP SHOE - DARCO WEDGE, EA",52.0,33.8,11.34,52.0,59
CDM,27000885,"SURGICAL BOOT/SHOE, EA",50.0,32.5,10.9,50.0,59
CDM,27000895,PREFAB KO W CONDYL PADS,172.0,111.8,37.5,172.0,59
CDM,27000OH,TENOTOMY ADDUCTOR HIP PERCUTANEOUS SPX,2296.0,1492.4,1.1,4686.39,144
CDM,27001015,WHFO - PREFAB ELASTIC,30.0,19.5,6.54,30.0,59
CDM,27001025,"SURGICAL BOOT/SHOE, EA",50.0,32.5,10.9,50.0,59
CDM,27001035,"SURGICAL BOOT/SHOE, EA",19.0,12.35,4.14,19.0,59
CDM,27001045,DIGITAL PAD,10.0,6.5,2.18,10.0,59
CDM,27001065,COUDE FOLEY CATHETER,45.0,29.25,9.81,45.0,59
CDM,27001075,CATH INDW FOLEY 2WAY SILI,23.0,14.95,5.01,23.0,59
CDM,27001085,COUDE CATHETER,10.0,6.5,2.18,10.0,59
CDM,27001105,URINARY DRAINAGE BAG,14.0,9.1,3.05,14.0,59
CDM,27001115,URINARY LEG BAG,9.0,5.85,1.96,9.0,59
CDM,27001125,WHFO - PREFAB ELASTIC,30.0,19.5,6.54,30.0,59
CDM,27001135,SPLINT,46.0,29.9,10.03,46.0,59
CDM,27001155,SHORT ARM CAST FIBERGLASS,93.0,60.45,20.27,93.0,59
CDM,27001165,SHORT LEG CAST FIBERGLASS,202.0,131.3,44.04,202.0,59
CDM,27001185,SLINGS,19.0,12.35,4.14,19.0,59
CDM,27001195,KNEE SUPPORT OPEN,27.22,17.69,5.93,27.22,59
CDM,27001205,HINGED KNEE,98.0,63.7,21.36,98.0,59
CDM,27001215,TENNIS ELBOW ORTHOSIS,94.0,61.1,20.49,94.0,59
CDM,27001225,TRU PULL KNEE,150.0,97.5,32.7,150.0,59
CDM,27001235,LONG ARM SPLINT ADULT PLASTER,68.0,44.2,14.82,68.0,59
CDM,27001255,AMBUL SURG BOOT,46.0,29.9,10.03,46.0,59
CDM,27001265,ELASTIC SGL SHOULDER ORTHOSIS,60.0,39.0,13.08,60.0,59
CDM,27001275,POST-OP SHOE EACH,12.0,7.8,2.62,12.0,59
CDM,27001285,ORTHOWEDGE SHOE EACH,46.0,29.9,10.03,46.0,67
CDM,27001305,THERAPEP,31.14,20.24,6.79,31.14,59
CDM,27001315,FOREARM STRAP NON CUSTOM,25.0,16.25,5.45,25.0,59
CDM,27001335,FLOTATION ELBOW PAD,30.0,19.5,6.54,30.0,59
CDM,27001345,WONDERZORBS,33.0,21.45,7.19,33.0,59
CDM,27001355,KNEE BRACE-J,118.0,76.7,25.72,118.0,59
CDM,27001375,PROCELL CASTING LINER/EACH,56.0,36.4,12.21,56.0,59
CDM,27001385,ANKLE SPORT ELASTIC,12.0,7.8,2.62,12.0,59
CDM,27001395,KNEE SUPPORT OPEN,27.22,17.69,5.93,27.22,59
CDM,27001405,KNEE/ DELUXE,33.58,21.83,7.32,33.58,67
CDM,27001445,SHORT LEG SPLINT P FIBERGLASS,73.0,47.45,15.91,73.0,59
CDM,27001455,SHORT LEG SPLINT FIBERGLASS,75.0,48.75,16.35,75.0,59
CDM,27001465,SUPPLIES- GAUNTLET CAST,68.0,44.2,14.82,68.0,59
CDM,27001485,"INDWELLING CATHETER, SPEC TYPE",275.0,178.75,59.95,275.0,59
CDM,27001535,ELASTIC ANKLE SUPPORT BRACE,31.0,20.15,6.76,31.0,59
CDM,27001565,UNNA BOOT,46.0,29.9,10.03,46.0,59
CDM,27001585,SHORT LEG SPLINT FIBERGLASS,75.0,48.75,16.35,75.0,59
CDM,27001595,ELASTIC GARMENT/COVERING,36.0,23.4,7.85,36.0,59
CDM,27001605,WRIST SPLINT-THUMB SPICA,30.0,19.5,6.54,30.0,59
CDM,27001625,KNEE BRACE-J,118.0,76.7,25.72,118.0,59
CDM,27001635,KNEE IMMOBILIZER,118.0,76.7,25.72,118.0,59
CDM,27001655,WRIST SPLINT-THUMB SPICA,30.0,19.5,6.54,30.0,59
CDM,27001665,POST OP SHOE,46.0,29.9,10.03,46.0,59
CDM,27001705,SHORT ARM CAST SUP FBRGL,93.0,60.45,20.27,93.0,59
CDM,27001735,FINGER SPLINT STATIC,46.0,29.9,10.03,46.0,59
CDM,27001755,EO - PREFAB ELASTIC W STAYS,94.0,61.1,20.49,94.0,59
CDM,27001765,DON JOY ELASTIC KNEE SUPPORT,46.0,29.9,10.03,46.0,59
CDM,27001775,CREST PAD WITH ELASTIC,9.0,5.85,1.96,9.0,59
CDM,27001785,BUDIN SPLINT,9.0,5.85,1.96,9.0,59
CDM,27001795,SLING,19.0,12.35,4.14,19.0,59
CDM,27001805,SURGICAL BOOT/SHOE EA,19.0,12.35,4.14,19.0,59
CDM,27001815,EO ELASTIC COUNTER FORCE,50.0,32.5,10.9,50.0,59
CDM,27001825,ELBOW WITH STAYS,30.0,19.5,6.54,30.0,59
CDM,27001835,PADDED ELBOW SUPPORT,19.0,12.35,4.14,19.0,59
CDM,27001855,DH2 PRESSURE RELIEF SHOE,53.0,34.45,11.55,53.0,59
CDM,27001OH,TENOTOMY ADDUCTOR HIP OPEN,2856.0,1856.4,1.1,9440.12,144
CDM,27003125,MEDTRONIC BIOTHERM HEAT EX,412.5,268.13,89.93,412.5,59
CDM,27003OH,TX ADDUXOR SUBQ OPN W/OBTURATOR NEURECTOMY,3124.0,2030.6,1.1,20863.78,144
CDM,27005545,ICEMAN (COLD THERAPY SYSTEM),174.0,113.1,37.93,232.66,67
CDM,27005685,"KIT,ARTHREX TRANSTIBIA,AR1898S",227.5,147.88,49.6,227.5,59
CDM,27005OH,TENOTOMY HIP FLEXOR OPEN SEPARATE PROCEDURE,4028.0,2618.2,1.1,4028.0,144
CDM,27006415,BIS MONITOR ELECTRODE,401.63,261.06,87.56,401.63,59
CDM,27006OH,TENOTOMY ABDUCTORS&/EXTENSOR HIP OPEN SPX,4044.0,2628.6,1.1,9440.12,144
CDM,27007125,WARMING BLANKET,145.0,94.25,31.61,145.0,59
CDM,27007630,W TB CHST,25.0,16.25,5.45,25.0,59
CDM,27009025,PRAFO BOOT/EA.,150.08,97.55,32.72,150.08,59
CDM,27009035,BITE BLOCK,29.52,19.19,6.44,29.52,59
CDM,27009045,THERA-PEP DEVICE,336.4,218.66,73.34,336.4,59
CDM,27009065,POUCHKINS PREEMIE WAFER,6.0,3.9,1.31,6.0,59
CDM,27009075,ADAPT RINGS,8.0,5.2,1.74,8.0,59
CDM,27009085,FOAM PAD 4 X 4,6.0,3.9,1.31,6.0,59
CDM,27009095,POUCHKINS PREEMIE POUCH,6.0,3.9,1.31,6.0,59
CDM,27009105,NU - VALVE,378.0,245.7,82.4,378.0,59
CDM,27009115,MAXIREST K-9 MATTRESS,44.0,28.6,9.59,44.0,59
CDM,27009135,OXYGEN SUBSEQUENT DAY-HOSP,11.98,7.79,2.61,11.98,59
CDM,27009185,MAXIREST K-4 MATTRESS,24.0,15.6,5.23,24.0,59
CDM,27009250,W PREFAB AFO,296.56,192.76,64.65,406.89,72
CDM,27009250_IP,W PREFAB AFO,296.56,192.76,107.95,107.95,1
CDM,27009250_OP,W PREFAB AFO,296.56,192.76,88.67,88.67,1
CDM,27009315,AMBU TUBE CHECK,10.39,6.75,2.27,10.39,59
CDM,27009325,BITE BLOCK,29.52,19.19,6.44,29.52,59
CDM,27009335,CO2 DETECTOR EASY CAP,336.4,218.66,73.34,336.4,59
CDM,27009345,INCENTIVE SPIROMETER,14.44,9.39,3.15,14.44,59
CDM,27009355,MANUAL RESCUSITATION,64.47,41.91,14.05,64.47,59
CDM,27009385,SPACER DEVICE,14.44,9.39,3.15,14.44,59
CDM,27009395,SPACER MASK,14.44,9.39,3.15,14.44,59
CDM,27009415,OXYGEN DEVICE,16.95,11.02,3.7,16.95,59
CDM,27009425,PEAK FLOW,14.44,9.39,3.15,14.44,59
CDM,27009435,PEAK FLOW METER,14.44,9.39,3.15,14.44,59
CDM,27009445,SUCTIONING EQUIPMENT,14.44,9.39,3.15,14.44,59
CDM,27009455,THERA-PEP DEVICE,336.4,218.66,73.34,336.4,59
CDM,27010140,FIBER OPTIC SVO2 SWAN,276.7,179.86,60.32,276.7,59
CDM,27010150,AMT MINI ONE BUTTON,247.5,160.88,53.96,247.5,59
CDM,27010155,BOTOX NEEDLES 27 X 1.5,50.0,32.5,10.9,50.0,59
CDM,27010160,J BRACE,52.2,33.93,11.38,52.2,59
CDM,27010165,PREMIER UROSTOMY-HOLLISTER,4.58,2.98,1.0,4.58,59
CDM,27010170,PED URO-HOLLISTER,3.99,2.59,0.87,3.99,59
CDM,27010175,PULL PEG #302,139.13,90.43,30.33,139.13,59
CDM,27010180,DUAL PORT FEEDING ADAPTER,24.0,15.6,5.23,24.0,59
CDM,27010185,TETHER J-TUBE #319,87.5,56.88,19.08,87.5,59
CDM,27010190,PULL PEG #330,131.25,85.31,28.61,131.25,59
CDM,27010210,DLP VEN 28/36 2STAGE,37.38,24.3,8.15,37.38,59
CDM,27010215,3 LF PUMP SET,49.62,32.25,10.82,49.62,59
CDM,27010455,AMT RPLCMNT GASTRO TUBE,91.88,59.72,20.03,91.88,59
CDM,27010460,IABP DATASCOPE CHARGE,80.91,52.59,17.64,80.91,59
CDM,27010495,BARD ART. 22 FR,22.58,14.68,4.92,22.58,59
CDM,27010500,BARD ART. 26 FR,22.58,14.68,4.92,22.58,59
CDM,27010505,BARD ART. 18 FR,24.92,16.2,5.43,24.92,59
CDM,27010515,RMI FEM 16 FR PERC.,283.76,184.44,61.86,283.76,59
CDM,27010530,1/4 X 1/4 ST,14.8,9.62,3.23,14.8,59
CDM,27010535,PRESSURE DOME,53.3,34.65,11.62,53.3,59
CDM,27010540,3/8 X 3/8 ST,7.48,4.86,1.63,7.48,59
CDM,27010550,1/4 X 1/4 LL,5.45,3.54,1.19,5.45,59
CDM,27010555,3/8 X 3/8 LL,5.45,3.54,1.19,5.45,59
CDM,27010560,3/16 X 1/4 REDUCER,9.0,5.85,1.96,9.0,59
CDM,27010570,1/4 Y,14.8,9.62,3.23,14.8,59
CDM,27010575,3/8 X 1/4 X 3/8 Y,5.84,3.8,1.27,5.84,59
CDM,27010580,1/4 PERF. ADAPTOR,4.64,3.02,1.01,4.64,59
CDM,27010620,ACUCAIR MATT,11.82,7.68,2.58,11.82,59
CDM,27010650,WARMING BLANKET,15.7,10.21,3.42,15.7,59
CDM,27010660,1/4 X 6 VENT TUBING,10.74,6.98,2.34,10.74,59
CDM,27010665,STOMA MEASURING DEVICE - MIC,167.51,108.88,36.52,167.51,59
CDM,27010675,SNAP-LID CONNECTOR CABLE,750.0,487.5,163.5,750.0,59
CDM,27010690,BIS MONITOR ELECTRODE,29.5,19.18,6.43,29.5,59
CDM,27010700,HIGH OUTPUT POUCH CONVATEC,5.99,3.89,1.31,5.99,59
CDM,27010710,"1 3/4"" DURAHES FLEXIFLANGE-CON",5.76,3.74,1.26,5.76,59
CDM,27010740,RMI VEN 22 FR RT CANN,62.8,40.82,13.69,62.8,59
CDM,27010745,DLP PRESSURE SET,62.8,40.82,13.69,62.8,59
CDM,27010755,1/4 FEMALE PERF. ADAPT,6.0,3.9,1.31,6.0,59
CDM,27010760,RMI VEN 22FR STR CANN,62.8,40.82,13.69,62.8,59
CDM,27010765,RMI VENOUS 29/29/29,62.8,40.82,13.69,62.8,59
CDM,27010780,SVENSSON DESCENDING PACK,630.0,409.5,137.34,630.0,59
CDM,27010785,ECMO CIRCUIT MEDTRONIC,1365.0,887.25,297.57,1365.0,59
CDM,27010790,PALL TRANSFUSION FILTER,13.22,8.59,2.88,13.22,59
CDM,27010800,RANDI LINE,19.5,12.68,4.25,19.5,59
CDM,27010805,QUADROX HOLLOW FIBER,1260.0,819.0,274.68,1260.0,59
CDM,27010860,MAC COMPANION,28.0,18.2,6.1,28.0,59
CDM,27010885,"RECUSITATION BAG, ADULT",14.3,9.3,3.12,14.3,59
CDM,27010890,INCENTIVE SPIROMETER,7.8,5.07,1.7,7.8,59
CDM,27010900,EASY PAP CIRCUIT,31.94,20.76,6.96,31.94,59
CDM,27010905,BAIR HUG WARM BLANKET-CARDIAC,14.52,9.44,3.17,14.52,59
CDM,27010920,INCENTIVE SPIROMETER,76.4,49.66,16.66,76.4,59
CDM,27010925,MYOCARDIAL TEMP PROBE,245.0,159.25,53.41,245.0,59
CDM,27010940,POST-OP SHOE MENS LARGE,73.68,47.89,16.06,73.68,59
CDM,27010945,POST-OP SHOE MENS MEDIUM,73.68,47.89,16.06,73.68,59
CDM,27010970,POST-OP SHOE WOMENS LARGE,50.21,32.64,10.95,50.21,59
CDM,27011035,SOMANETICS SENSOR,105.0,68.25,22.89,105.0,59
CDM,27011085,"PAD SET ENERGY, TRANSFER SMALL",975.0,633.75,212.55,975.0,59
CDM,27012115,CONTINUOUS NEBULIZER,63.05,40.98,13.74,63.05,59
CDM,27012365,INCENTIVE SPIROMETER,14.44,9.39,3.15,14.44,59
CDM,27012370,AMBU TUBE CHECK,10.39,6.75,2.27,10.39,59
CDM,27012375,PEAK FLOW METER,14.44,9.39,3.15,14.44,59
CDM,27012435,PEAK FLOW,14.44,9.39,3.15,14.44,59
CDM,27012465,SPACER DEVICE,14.44,9.39,3.15,14.44,59
CDM,27012470,SPACER MASK,14.44,9.39,3.15,14.44,59
CDM,27012475,OXYGEN DEVICE,16.95,11.02,3.7,16.95,59
CDM,27012480,MANUAL RESCUSITATION,64.47,41.91,14.05,64.47,59
CDM,27012485,SUCTIONING EQUIPMENT,14.44,9.39,3.15,14.44,59
CDM,27012490,THERA-PEP DEVICE,336.4,218.66,73.34,336.4,59
CDM,27012495,BITE BLOCK,29.52,19.19,6.44,29.52,59
CDM,27012500,CO2 DETECTOR EASY CAP,336.4,218.66,73.34,336.4,59
CDM,27012510,CLIP-HOLLISTER CO.,4.04,2.63,0.88,4.04,59
CDM,27012520,HOLLISTER PREMIUM POUCH,2.98,1.94,0.65,2.98,59
CDM,27012525,HOLLISTER BELT,6.91,4.49,1.51,6.91,59
CDM,27012530,STOMAHESIVE POWDER CONVATEC,4.76,3.09,1.04,4.76,59
CDM,27012535,HOLLIHESIVE 4X4 HOLLISTER,5.73,3.72,1.25,5.73,59
CDM,27012540,HOLLIHESIVE 8X8 HOLLISTER,12.64,8.22,2.76,12.64,59
CDM,27012545,"1 1/2"" SURFIT FLEXIFLING-CONVT",4.61,3.0,1.0,4.61,59
CDM,27012555,SURFIT DRAINABLE POUCH-CONVATE,8.68,5.64,1.89,8.68,59
CDM,27012560,MENTOR HOSP IRRIGATION SET,62.53,40.64,13.63,62.53,59
CDM,27012565,STOMAHESIVE CONVATEC 4X4,5.97,3.88,1.3,5.97,59
CDM,27012575,SURFIT UROSTOMY POUCH-CONVATEC,3.07,2.0,0.67,3.07,59
CDM,27012585,BABY NIPPLE,1.54,1.0,0.34,1.54,59
CDM,27012595,ILEAL RESERV CATH WEBBER&JUDD,67.2,43.68,14.65,67.2,59
CDM,27012605,"13/4"" DURAHESIV FLNG-FLT CONVA",20.27,13.18,4.42,20.27,59
CDM,27012615,TORBOT CONVERTA POUCH FACEPLAT,38.4,24.96,8.37,38.4,59
CDM,27012620,K-POUCH KIT,194.96,126.72,42.5,194.96,59
CDM,27012625,POST OP UROSTOMY KIT,78.52,51.04,17.12,78.52,59
CDM,27012630,POST OP ILEO/COLOSTOMY KIT,25.86,16.81,5.64,25.86,59
CDM,27012650,"DRESSING,ACE 2""X 5 YD,37023",20.39,13.25,4.45,20.39,59
CDM,27012655,"CATHETER,ANGIOCATH 22GAX1",3.5,2.28,0.76,3.5,59
CDM,27012750,"CATHETER,ANGIOCATH 16GAX1.88",3.5,2.28,0.76,3.5,59
CDM,27012825,"GOWN,SURGEON,DISP,LARGE,9515",5.2,3.38,1.13,5.2,59
CDM,27012850,"CATHETER,ANGIOCATH 16GAX1.16",3.5,2.28,0.76,3.5,59
CDM,27012870,CATH IABP INTRODUCER KIT,251.53,163.49,54.83,251.53,59
CDM,27012940,IABP 25CC 9.5FR,251.97,163.78,54.93,251.97,59
CDM,27012950,IABP 40CC 8FR,1493.76,970.94,325.64,1493.76,59
CDM,27012955,IABP 50 CC 10FR,328.6,213.59,71.63,328.6,59
CDM,27012970,"CATHETER,ANGIOCATH 20GAX1.16",3.5,2.28,0.76,3.5,59
CDM,27012975,SITZ BATH,21.73,14.12,4.74,21.73,59
CDM,27013035,DIALYSIS TRAY,214.32,139.31,46.72,214.32,59
CDM,27013065,"NEBULIZER, 700ML #037-28",63.05,40.98,13.74,63.05,59
CDM,27013115,"CATHETER,ANGIOCATH 24GAX .75",3.5,2.28,0.76,3.5,59
CDM,27013150,"DRESSING,DUODERM EXTRA THIN",6.82,4.43,1.49,6.82,59
CDM,27013175,ZOLL MULTI FUNCTION PADS,21.94,14.26,4.78,21.94,59
CDM,27013210,IABP CATH 9.5FR 40CC,692.81,450.33,151.03,692.81,59
CDM,27013235,"RINGERS INJECTION,1000ML",3.19,2.07,0.7,3.19,59
CDM,27013250,CATH PEZZAR 18 FR,91.56,59.51,19.96,91.56,59
CDM,27013255,ATHLETIC SUPPORT MED,28.04,18.23,6.11,28.04,59
CDM,27013275,THRESHOLD IMPEDENCE DEVICE,164.5,106.93,35.86,164.5,59
CDM,27013290,HOLLISTER NEWBRN POUCHKIN WAFR,3.0,1.95,0.65,3.0,59
CDM,27013305,"CONVATEC-2 1/4"" DURAHES FLNG",7.0,4.55,1.53,7.0,59
CDM,27013325,"2 1/4"" SURFIT FLANGE-CONVATEC",5.0,3.25,1.09,5.0,59
CDM,27013330,HOLLISTER NEWBRN POUCHKN POUCH,3.0,1.95,0.65,3.0,59
CDM,27013335,"HOLLISTER STRAP, SMALL",6.0,3.9,1.31,6.0,59
CDM,27013340,TORBOT BELT,12.29,7.99,2.68,12.29,59
CDM,27013345,MARLEN BELT,7.99,5.19,1.74,7.99,59
CDM,27013350,MARLEN CATH (STR) (MED),16.51,10.73,3.6,16.51,59
CDM,27013355,MARLEN CATH (CRD),16.51,10.73,3.6,16.51,59
CDM,27013360,MARLEN CATH (STR) (SM),16.51,10.73,3.6,16.51,59
CDM,27013365,COLOPLAST FILTER,7.68,4.99,1.67,7.68,59
CDM,27013370,COLOPLAST SKIN BARRIER 8X8,18.28,11.88,3.99,18.28,59
CDM,27013375,LITTLE ONES URO,4.07,2.65,0.89,4.07,59
CDM,27013380,LITTLE ONES DRAIN,3.07,2.0,0.67,3.07,59
CDM,27013385,SURFIT CONVEX INSERT-CONVATEC,2.3,1.5,0.5,2.3,59
CDM,27013390,HOLLISTER LEG BAG,7.0,4.55,1.53,7.0,59
CDM,27013395,HOLLISTER URO ADAPTER,2.61,1.7,0.57,2.61,59
CDM,27013400,MARLEN SHALLOW/DEEP CONVX URO,9.22,5.99,2.01,9.22,59
CDM,27013410,TORBOT MAXI POUCH,4.62,3.0,1.01,4.62,59
CDM,27013415,MARLEN SHAL W/DEEP CONVX DRAIN,47.21,30.69,10.29,47.21,59
CDM,27013420,"HOLLISTER STRAP,MED,LARGE",4.61,3.0,1.0,4.61,59
CDM,27013425,HOLLISTER TUBING,3.07,2.0,0.67,3.07,59
CDM,27013440,CONVATEC IRRIG SLEEVE,4.61,3.0,1.0,4.61,59
CDM,27013460,ACTIVE LIFE DRAINABLE-CONVATEC,3.84,2.5,0.84,3.84,59
CDM,27013465,NEW IMAGE CONVEX FLNG-HOLLISTE,10.0,6.5,2.18,10.0,59
CDM,27013475,NEW IMAGE URO POUCH-HOLLISTER,6.0,3.9,1.31,6.0,59
CDM,27013480,CUSTOM UPPER EXTREM SLEEVE EA,147.0,95.55,32.05,147.0,59
CDM,27013485,TENNIS ELBOW SPLINT,93.0,60.45,20.27,93.0,59
CDM,27013520,CUSTOM UE SLEEVE/GLOVE 1 EA,380.0,247.0,82.84,380.0,59
CDM,27013525,CUSTOM UE SLEEVE/GAUNTLET EA,211.0,137.15,46.0,211.0,59
CDM,27013555,PATELLAR KNEE SUPPORT,87.0,56.55,18.97,87.0,59
CDM,27013565,TENNIS ELBOW SUPPORT,22.0,14.3,4.8,22.0,59
CDM,27013570,SUPPLIES-SHOULDER SPICA,127.26,82.72,27.74,127.26,59
CDM,27013575,SUPPLIES-LONG ARM CAST,90.95,59.12,19.83,90.95,59
CDM,27013580,SUPPLIES-LONG ARM SPLINT,80.0,52.0,17.44,80.0,59
CDM,27013590,SUPPLIES-SHORT ARM CAST,72.0,46.8,15.7,72.0,59
CDM,27013595,SUPPLIES-SHORT ARM SPLINT,65.02,42.26,14.17,65.02,59
CDM,27013605,SUPPLIES-LONG LEG NON-WT BRNG.,74.82,48.63,16.31,74.82,59
CDM,27013615,SUPPLIES-LONG LEG WT. BEARING,142.24,92.46,31.01,142.24,59
CDM,27013620,SUPPLIES-LONG LEG SPLINT,86.92,56.5,18.95,86.92,59
CDM,27013625,SUPPLIES-CYLINDER CAST,101.32,65.86,22.09,101.32,59
CDM,27013630,SUPPLIES-P.T.B. CAST,101.32,65.86,22.09,101.32,59
CDM,27013635,SUPPLIES-SHORT LEG NON-WT BRNG,84.04,54.63,18.32,84.04,59
CDM,27013640,SUPPLIES-SHORT LEG WT BEARING,105.92,68.85,23.09,105.92,59
CDM,27013645,SUPPLIES-SHORT LEG SPLINT,84.04,54.63,18.32,84.04,59
CDM,27013650,SUPPLIES-TOTAL CONTACT CAST,100.46,65.3,21.9,100.46,59
CDM,27013655,SUPPLIES-GELOCAST/UNNABOOT,60.48,39.31,13.18,60.48,59
CDM,27013665,POST OP SHOE,11.82,7.68,2.58,11.82,59
CDM,27013670,SUPPLIES-SHRT LEG/HOT HEEL,127.83,83.09,27.87,127.83,59
CDM,27013720,CUSTOM GLOVE EACH,248.2,161.33,54.11,248.2,59
CDM,27013740,ARM SLEEVE 20-30 MMHG,73.2,47.58,15.96,73.2,59
CDM,27013745,ARM SLEEVE  30-40 MMHG,73.2,47.58,15.96,73.2,59
CDM,27013750,GAUNTLET W/THMB STB 18-21 MMHG,39.9,25.94,8.7,39.9,59
CDM,27013755,GAUNTLET W/FNGR STB 18-21 MMHG,218.2,141.83,47.57,218.2,59
CDM,27013760,GAUNTLET W/ FNGR ST 23-36 MMHG,218.2,141.83,47.57,218.2,59
CDM,27013770,JUZO COMPRESSION BRA,139.8,90.87,30.48,139.8,59
CDM,27013775,SUPPLIES- SPLINT FINGER,46.0,29.9,10.03,46.0,59
CDM,27014065,TEMPORARY PACER,14.64,9.52,3.19,14.64,59
CDM,27014070,PNEUMOTHORAX KIT,146.0,94.9,31.83,146.0,59
CDM,27014100,CORFLO ULTRA  OTW J TUBE,207.0,134.55,45.13,207.0,59
CDM,27014110,"Q-DRAW, SURGE OR BIOMEDICUS CANNULA",525.0,341.25,114.45,525.0,59
CDM,27014115,CARDIOVATIONS QD22FR,624.0,405.6,136.03,624.0,59
CDM,27014120,CARDIOVATIONS ENDOPLEGE,8000.0,5200.0,1744.0,8000.0,59
CDM,27014125,CARDIOVATIONS ENDOVENT,1823.85,1185.5,397.6,1823.85,59
CDM,27014130,MEDTRONIC DLP SUMP,24.0,15.6,5.23,24.0,59
CDM,27014135,MEDTRONIC RMI 24FR,327.45,212.84,71.38,327.45,59
CDM,27014140,MEDTRONIC DLP 11014L,52.0,33.8,11.34,52.0,59
CDM,27014145,MEDTRONIC DLP MC2X,56.0,36.4,12.21,56.0,59
CDM,27014150,BRIDAL NASAL TUBE RETAIN SYS,140.0,91.0,30.52,140.0,59
CDM,27014155,.9% NACL SOLUTION (1L),1.28,0.83,0.28,1.28,59
CDM,27014160,19FR ARTERIAL CANNULA SET,871.5,566.48,189.99,871.5,59
CDM,27014180,AUTO-LOG DISPOSABLES,173.7,112.91,37.87,173.7,59
CDM,27014185,COLLECTION RESERVIOR,53.7,34.91,11.71,53.7,59
CDM,27014190,ROTO FLOW ECMO CIRCUIT,535.5,348.08,116.74,535.5,59
CDM,27014195,ROTO FLOW IMPELLER,258.3,167.9,56.31,258.3,59
CDM,27014200,SOLUTION ANTICOAG ASSEMBLY,20.0,13.0,4.36,20.0,59
CDM,27014205,WASH KIT,100.0,65.0,21.8,100.0,59
CDM,27014215,ENDOTRACHEAL TUBE,63.05,40.98,13.74,63.05,59
CDM,27014220,MANUAL RESUSCITATOR,64.47,41.91,14.05,64.47,59
CDM,27014230,SUCTION EQUIP,14.44,9.39,3.15,14.44,59
CDM,27014240,OXYGEN SUBSEQUENT DAY-HOSP,129.0,83.85,28.12,129.0,59
CDM,27014250,ETCO2,22.0,14.3,4.8,22.0,59
CDM,27014255,STABILTUBE HOLDER,12.84,8.35,2.8,12.84,59
CDM,27014260,"TRACHEOSTOMY TUBE, ANY TYPE",93.0,60.45,20.27,93.0,59
CDM,27014270,THRESHOLD IMPEDENCE DEVICE,164.5,106.93,35.86,164.5,59
CDM,27014275,ESOPHAGEAL DETECTOR DEVICE,7.12,4.63,1.55,7.12,59
CDM,27014280,AVALON / CRESCENT CANNULA,5000.0,3250.0,1090.0,5000.0,59
CDM,27014285,AVALON VASCULAR ACCESS KIT,295.8,192.27,64.48,295.8,59
CDM,27014295,SORIN REVOLUTION CENTRIF,240.0,156.0,52.32,240.0,59
CDM,27014305,TERUMO HEMOCONCENTRATOR,139.4,90.61,30.39,139.4,59
CDM,27014310,IGEL,28.4,18.46,6.19,28.4,59
CDM,27014470,FINGER SPLINTS,8.9,5.79,1.94,8.9,59
CDM,27014475,SUPPLIES - SHORT ARM SPLINT,65.02,42.26,14.17,65.02,59
CDM,27014490,FINGER STACK SPLINT,22.0,14.3,4.8,22.0,59
CDM,27014570,CARDIAC RESUSCITATION,365.31,237.45,79.64,365.31,59
CDM,27014605,SPEC PROCEDURE RM-EQUIP/SUPPLI,347.81,226.08,75.82,347.81,59
CDM,27014625,SP PROC RM/CARDIOVER SUPPLIES,274.87,178.67,59.92,274.87,59
CDM,27014630,SPEC PROCED RM/IABP SUPPLIES,621.34,403.87,135.45,621.34,59
CDM,27014635,SP PROC RM/PERICARD TAP SUPPLI,375.17,243.86,81.79,375.17,59
CDM,27014640,SPEC PROCED RM/SWAN SUPPLIES,750.4,487.76,163.59,750.4,59
CDM,27014645,SP PROC RM/TEMP PACER SUPPLIES,402.52,261.64,87.75,402.52,59
CDM,27014650,OXYGEN DEVICE,16.95,11.02,3.7,16.95,59
CDM,27014655,PEAK FLOW,14.44,9.39,3.15,14.44,59
CDM,27014660,PEAK FLOW METER,14.44,9.39,3.15,14.44,59
CDM,27014665,INCENTIVE SPIROMETER,14.44,9.39,3.15,14.44,59
CDM,27014675,SUCTIONING EQUIPMENT,14.44,9.39,3.15,14.44,59
CDM,27014700,CO2 DETECTOR EASY CAP,336.4,218.66,73.34,336.4,59
CDM,27014720,NASAL AIRWAYS SZ 32,10.39,6.75,2.27,10.39,59
CDM,27014735,MANUAL RESCUSITATION,64.47,41.91,14.05,64.47,59
CDM,27014745,OPTICHAMBER,14.44,9.39,3.15,14.44,59
CDM,27014750,OPTICHAMBER MASK,14.44,9.39,3.15,14.44,59
CDM,27014780,BRIDAL NASAL TUBE,140.0,91.0,30.52,140.0,59
CDM,27014825,MINI LID - COLOPLAST,13.66,8.88,2.98,13.66,59
CDM,27014830,MIDI LID,14.36,9.33,3.13,14.36,59
CDM,27014835,MAXI LID - COLOPLAST,3.08,2.0,0.67,3.08,59
CDM,27014840,SENSURA DRAINABLE - COLOPLAST,3.08,2.0,0.67,3.08,59
CDM,27014845,MINI FISTULA POUCH - COLOPLAST,72.03,46.82,15.7,72.03,59
CDM,27014850,MIDI FISTULA POUCH - COLOPLAST,76.72,49.87,16.72,76.72,59
CDM,27014855,MAXI FISTULA POUCH - COLOPLAST,80.29,52.19,17.5,80.29,59
CDM,27014865,"1 3/4"" DURAHESIVE MOLDABLE",3.74,2.43,0.82,3.74,59
CDM,27014870,"1 3/4"" STOMAHESIVE MOLDABLE",2.82,1.83,0.61,2.82,59
CDM,27014875,"1 3/4"" INVISICLOSE POUCH",2.56,1.66,0.56,2.56,59
CDM,27014880,"2 1/4"" INVISICLOSE POUCH",2.56,1.66,0.56,2.56,59
CDM,27014890,"2 3/4"" INVISICLOSE POUCH",2.18,1.42,0.48,2.18,59
CDM,27014895,PREMIER DRAINABLE FLAT,2.66,1.73,0.58,2.66,59
CDM,27014900,LEG BAG & STRAP SYSTEM,8.44,5.49,1.84,8.44,59
CDM,27014905,NEW IMAGE LOCK-N-ROLL POUCHES,1.36,0.88,0.3,1.36,59
CDM,27014910,FLAT ADAPT BARRIER RING,4.54,2.95,0.99,4.54,59
CDM,27014915,PREMIER CONVEX DRANABLE-PRECUT,2.34,1.52,0.51,2.34,59
CDM,27014920,PREMIER CONVEX-UROSTOMY POUCH,3.14,2.04,0.68,3.14,59
CDM,27014925,NEW IMAGE FLAT FLANGE,2.16,1.4,0.47,2.16,59
CDM,27014930,NEW IMAGE HIGH VOLUME POUCH,4.02,2.61,0.88,4.02,59
CDM,27014935,ONE PIECE HIGH OUTPUT POUCH,14.94,9.71,3.26,14.94,59
CDM,27015310,DVT SLEEVE CALF MEDIUM,12.25,7.96,2.67,12.25,59
CDM,27015320,ALLEVYN 3.5X3.5 DRESSING,4.96,3.22,1.08,4.96,59
CDM,27015470,BRAVA RING 2.0,4.42,2.87,0.96,4.42,59
CDM,27015475,ADHESIVE BRAVA SPRAY,12.56,8.16,2.74,12.56,59
CDM,27015480,UNIVERSAL CATH PORT,10.98,7.14,2.39,10.98,59
CDM,27015485,BRAVA RING 4.2,4.66,3.03,1.02,4.66,59
CDM,27015490,ADHESIVE BRAVA REMOVER,14.92,9.7,3.25,14.92,59
CDM,27015500,PERICARDIOCENTESIS KIT,227.08,147.6,49.5,227.08,59
CDM,27015505,PCA INITIAL SETUP,479.51,311.68,104.53,479.51,59
CDM,27015510,STOMAHESIVE 8X8-CONVATEC,14.36,9.33,3.13,14.36,59
CDM,27015540,ALGIDEX AG,13.94,9.06,3.04,13.94,59
CDM,27015545,TUBIGRIP,52.0,33.8,11.34,52.0,66
CDM,27015550,SLIPPER SOCK,6.48,4.21,1.41,6.48,59
CDM,27015555,DAVIS CATHETER,132.88,86.37,28.97,132.88,59
CDM,27015580,ADAPTER SUR-FIT NATURA 45MM,8.44,5.49,1.84,8.44,59
CDM,27015585,ADAPTER SUR-FIT NATURA 57MM,8.44,5.49,1.84,8.44,59
CDM,27015590,"IRRIGATION SLEEVE 30""2-1/4FLNG",3.85,2.5,0.84,3.85,59
CDM,27015595,IRRIGATION CONE COMBO OSTOMY,19.34,12.57,4.22,19.34,59
CDM,27015650,"2 1/4"" STOMAHESIVE MOLDABLE",2.82,1.83,0.61,2.82,59
CDM,27015655,"2 3/4"" STOMAHESIVE MOLDABLE",2.82,1.83,0.61,2.82,59
CDM,27015670,MERIT INFLATION DEVICE,65.45,42.54,14.27,65.45,59
CDM,27015715,TRNSCTNS MNTR-O2/CO2/DAY,210.0,136.5,45.78,210.0,59
CDM,27015735,HMES,6.0,3.9,1.31,6.0,59
CDM,27015740,TRACH HOLDER,43.0,27.95,9.37,43.0,72
CDM,27015740_IP,TRACH HOLDER,43.0,27.95,15.65,15.65,1
CDM,27015740_OP,TRACH HOLDER,43.0,27.95,12.86,12.86,1
CDM,27015745,MDI SPACER DEVICE NON-VENT PT.,3.67,2.39,0.8,3.67,59
CDM,27015750,MDI SPACER DEVICE VENT PATIENT,3.7,2.41,0.81,3.7,59
CDM,27015755,NRB MASK,10.0,6.5,2.18,10.0,59
CDM,27015760,VENTI MASK,5.0,3.25,1.09,5.0,59
CDM,27015775,NITROGEN GAS PER HOUR,4.07,2.65,0.89,4.07,59
CDM,27015780,HELIOX PER HOUR,14.0,9.1,3.05,14.0,59
CDM,27015785,OXYGEN SUBSEQUENT DAY,11.98,7.79,2.61,11.98,59
CDM,27015895,RMI VEN 24FR RT,62.8,40.82,13.69,62.8,59
CDM,27015900,DLP VEN 28FR RT,62.8,40.82,13.69,62.8,59
CDM,27015910,TRU-PULL BRACE SYSTEM,148.73,96.67,32.42,148.73,59
CDM,27015915,PREFAB ELASTIC ANKLE ORTHOSIS,71.66,46.58,15.62,71.66,59
CDM,27015920,"ELBOW ORTHOSIS,ELASTIC,PREFAB",36.0,23.4,7.85,36.0,59
CDM,27015930,SPLINT,32.0,20.8,6.98,32.0,59
CDM,27016005,STOMA VENT,29.52,19.19,6.44,29.52,59
CDM,27016020,INCENTIVE SPIROMETER-M51,31.57,20.52,6.88,31.57,59
CDM,27016045,HEMOSTATIS CLIP,108.0,70.2,16.97,108.0,67
CDM,27016050,THIGH HI COMPRESSION GARMENT 2,122.7,79.76,11.14,122.7,67
CDM,27016225,ABDOMINAL BINDER,48.0,31.2,10.46,48.0,59
CDM,27016655,HTK,192.0,124.8,41.86,192.0,59
CDM,27016665,UW,310.0,201.5,67.58,310.0,59
CDM,27016675,SPLINT SPLY - SHRT/FOREARM,81.0,52.65,17.66,81.0,59
CDM,27016685,CAST SUP LONG ARM ADULT FBRG,90.95,59.12,19.83,90.95,59
CDM,27016695,"SURGICAL BOOT/SHOE, EA",113.66,73.88,24.78,113.66,59
CDM,27016845,SOL IRR 0.9% NACL VIAFLO 1L,1.72,1.12,0.37,1.72,59
CDM,27016855,CO2 DETECTOR EASY CAP,336.4,218.66,73.34,336.4,59
CDM,27016865,SUCTIONING EQUIPMENT,14.44,9.39,3.15,14.44,59
CDM,27016875,SPACER MASK,14.44,9.39,3.15,14.44,59
CDM,27016885,THERA-PEP DEVICE,336.4,218.66,73.34,336.4,59
CDM,27016895,"TRACHEOSTOMY TUBE, ANY TYPE",71.45,46.44,15.58,71.45,59
CDM,27016905,MANUAL RESCUSITATION,64.47,41.91,14.05,64.47,59
CDM,27016915,AMBU TUBE CHECK,10.39,6.75,2.27,10.39,59
CDM,27016925,BITE BLOCK,29.52,19.19,6.44,29.52,59
CDM,27016935,INCENTIVE SPIROMETER,14.44,9.39,3.15,14.44,59
CDM,27016945,OXYGEN DEVICE,16.95,11.02,3.7,16.95,59
CDM,27016955,PEAK FLOW METER,14.44,9.39,3.15,14.44,59
CDM,27016965,SPACER DEVICE,14.44,9.39,3.15,14.44,59
CDM,27016985,SUPPLIES-SHORT ARM CAST,72.33,47.01,15.77,72.33,59
CDM,27016995,MASIMO SENSOR (PAIR),210.0,136.5,45.78,210.0,59
CDM,27017015,MEDTRONIC MALLEABLE VENT 10FR,82.95,53.92,18.08,82.95,59
CDM,27017025,SUPPLICES DILATOR KIT BOX OF 4,225.57,146.62,49.17,225.57,59
CDM,27017035,FEM VUE SALINE AIR DEVICE,268.5,174.53,58.53,268.5,59
CDM,27017045,FEMVUE SALINE AIR DEVICE/SIS,268.5,174.53,58.53,268.5,59
CDM,27017055,DIAPHRAGM MILEX,68.5,44.53,14.93,68.5,67
CDM,27017075,MARATHON MICROCATH,863.0,560.95,188.13,863.0,67
CDM,27017095,GLIDELIGHT LASER SHEATH,3726.0,2421.9,200.93,3726.0,67
CDM,27017205,SUPPLIES AND MATERIALS,30.0,19.5,6.54,30.0,59
CDM,27017225,RECTO/VAGINAL DILATOR,133.0,86.45,28.99,133.0,59
CDM,27017235,"SURGICAL BOOT/SHOE, EA",46.0,29.9,10.03,46.0,59
CDM,27017245,VERAPAMIL 2.5 MG/ML,7.5,4.88,1.64,7.5,59
CDM,27017285,"SHOE,POST-OP MALE/SM",9.04,5.88,1.97,9.04,59
CDM,27017295,"SHOE,POST-OP FEMALE/SM",9.04,5.88,1.97,9.04,59
CDM,27017305,"SHOE,POST-OP FEMALE/MED",9.04,5.88,1.97,9.04,59
CDM,27017315,"SHOE,POST-OP MALE/MED",9.6,6.24,2.09,9.6,59
CDM,27017325,"SHOE,POST-OP MALE/LG",9.6,6.24,2.09,9.6,59
CDM,27017335,"SHOE,POST-OP FEMALE/LG",9.6,6.24,2.09,9.6,59
CDM,27017395,"GIRDLE,ABOVE KNEE,SM,FG8011S",78.75,51.19,17.17,78.75,59
CDM,27017405,"GIRDLE,ABOVE KNEE,XLG,FG8011XL",78.75,51.19,17.17,78.75,59
CDM,27017415,"GIRDLE,BELOW KNEE,LG,FG8021L",78.75,51.19,17.17,78.75,59
CDM,27017425,"GIRDLE,BELOW KNEE,SM,FG8021S",78.75,51.19,17.17,78.75,59
CDM,27017435,"GIRDLE,BELOW KNEE,XLG,FG8021XL",78.75,51.19,17.17,78.75,59
CDM,27017445,"GIRDLE,BELOW KNEE XXL,LYSONIX",98.0,63.7,21.36,98.0,59
CDM,27017455,CUFF BP SFTCF ADLT LONG 23-33,5.9,3.84,1.29,5.9,59
CDM,27017465,CUFF BP SFTCF ADLT SM 17-25CM,5.7,3.71,1.24,5.7,59
CDM,27017485,"SHORT LEG SPLINT, FIBERGLASS",73.0,47.45,15.91,73.0,67
CDM,27017495,SUPPLIES-SYRINGE TO ADMIN DRUG,9.36,6.08,2.04,19.65,67
CDM,27017505,ELASTIC BANDAGE - ACE,5.0,3.25,1.09,5.0,59
CDM,27017525,SURGICAL BOOT/SHOE EA,19.0,12.35,4.14,19.65,67
CDM,27018695,HELIUM/O2,135.0,87.75,29.43,135.0,59
CDM,27018715,PILL SPLITTER,3.62,2.35,0.79,3.62,59
CDM,27018745,7FR 12IN 3 LUM CATH,32.64,21.22,7.12,32.64,59
CDM,27018765,7FR 12IN 3 LUM CATH,32.64,21.22,7.12,32.64,59
CDM,27018785,XL BINDER ABDOMINAL,42.16,27.4,9.19,42.16,59
CDM,27018795,OSCILLATING DEVICE,66.5,43.23,14.5,66.5,59
CDM,27018815,CHEST VEST,147.0,95.55,32.05,147.0,59
CDM,27018825,UNIVERSAL BINDER ABDOMINAL,12.32,8.01,2.69,12.32,59
CDM,27018835,INFLATION DEVICE,64.22,41.74,14.0,64.22,59
CDM,27018845,CHG BARIATRIC BED 200-500 POUNDS,105.0,68.25,22.89,105.0,59
CDM,27018855,CHG VCP 500 LOW AIR LOSS BED,40.0,26.0,8.72,40.0,59
CDM,27018865,CHG BARIATRIC BED 500-1000 POUNDS??,105.0,68.25,22.89,105.0,59
CDM,27018875,MISTRAL AIR WARMING BLANKETS,30.88,20.07,6.73,30.88,59
CDM,27018885,ELBOW ORTHOSIS PREFAB FIT,45.0,29.25,9.81,45.0,59
CDM,27018935,COMPRESSION SYSTEM BANDAGE,22.22,14.44,4.84,22.22,59
CDM,27018945,2X4 POCKET ADAPTER,1499.0,974.35,326.78,1499.0,58
CDM,27018955,PATIENT PROGRAMMER #3850 HAND HELD,1371.56,891.51,299.0,1371.56,59
CDM,27018965,RIGID DILATOR SIZE P1,225.0,146.25,49.05,225.0,59
CDM,27018975,SILICONE DILATOR SIZE 1,36.0,23.4,7.85,36.0,59
CDM,27018985,SILICONE DILATOR SIZE 2,46.0,29.9,10.03,46.0,59
CDM,27018995,SILICONE DILATOR SIZE 3,58.0,37.7,12.64,58.0,59
CDM,27019005,ENDOSEE TUBING FOR DEVICE,5.7,3.71,1.24,5.7,59
CDM,27019015,SILICONE DILATOR SIZE 4,70.0,45.5,15.26,70.0,59
CDM,27019025,SILICONE DILATOR SIZE 5,80.0,52.0,17.44,80.0,59
CDM,27019035,SILICONE DILATOR SIZE 6,90.0,58.5,19.62,90.0,59
CDM,27019045,DISPOSABLE ENDOSEE DEVICE,225.0,146.25,49.05,225.0,59
CDM,27019055,SILICONE DILATOR SIZE 7,100.0,65.0,21.8,100.0,59
CDM,27019065,RIGID DILATOR SIZE #4,96.25,62.56,20.98,96.25,59
CDM,27019075,"LARGE SET DILATORS (#5,6,7,8)",245.0,159.25,53.41,245.0,59
CDM,27019085,SILICONE DILATOR SIZE 8,110.0,71.5,23.98,110.0,59
CDM,27019095,"PROGRESSIVE SET (#1,3,5,7)",173.25,112.61,37.77,173.25,59
CDM,27019105,RIGID DILATOR SIZE #1,78.75,51.19,17.17,78.75,59
CDM,27019115,RIGID DILATOR SIZE P2,73.5,47.78,16.02,73.5,59
CDM,27019125,RIGID DILATOR SIZE #3,91.0,59.15,19.84,91.0,59
CDM,27019135,"MEDIUM SET DILATORS (#3,4,5,6)",183.75,119.44,40.06,183.75,59
CDM,27019145,FULL SET DILATORS (#1-8),315.0,204.75,68.67,315.0,59
CDM,27019155,RIGID DILATOR SIZE #2,84.0,54.6,18.31,84.0,59
CDM,27019165,"SMALL SET DILATORS (#1,2,3,4)",138.25,89.86,30.14,138.25,59
CDM,27019175,MEDENA CATHETER (STR),15.0,9.75,3.27,15.0,59
CDM,27019185,3M CLOTH ADHESIVE,1.14,0.74,0.25,1.14,59
CDM,27019195,"SUR-FIT ADPTR 2 3/4 NAT""",6.2,4.03,1.35,6.2,59
CDM,27019205,"DURAHESIVE 2 3/4"" 28111096^^MC-TCHG""",3.84,2.5,0.84,3.84,59
CDM,27019215,NASAL AIRWAYS SZ 34,16.0,10.4,3.49,16.0,59
CDM,27019225,CANNULA SIZE 6 6.4MM TRACH,5.62,3.65,1.23,5.62,59
CDM,27019245,8FR 7.5IN CATH DRNGE,90.94,59.11,19.82,90.94,59
CDM,27019255,SECUR STATLK DTSCP,34.68,22.54,7.56,34.68,59
CDM,27019265,PUPILLOMETER SMARGUARD,50.0,32.5,10.9,50.0,59
CDM,27019275,LIDO SMART CARD,285.0,185.25,62.13,285.0,59
CDM,27019295,CATH SUPRAPUBIC/CYSTOSCOPIC,70.87,46.07,15.45,70.87,59
CDM,27019305,INTRO/SHEATH 22FR X 28CM HYDRO COATING,487.5,316.88,106.28,487.5,67
CDM,27019325,OXYGEN DAILY,230.0,149.5,50.14,230.0,59
CDM,27019335,LUNG CLEARANCE DEVICE,69.0,44.85,15.04,69.0,59
CDM,27019355,SUPPLY-BRONCOSCOPE DISPOSABLE,390.0,253.5,85.02,390.0,59
CDM,27019365,EAKIN WASHER - (SM),4.61,3.0,1.0,4.61,59
CDM,27019375,FECAL COLLECTOR 9823,7.37,4.79,1.61,7.37,59
CDM,27019385,COUNTOUR 1 OVAL,3.07,2.0,0.67,3.07,59
CDM,27019395,BELT ADAPTER RING,1.38,0.9,0.3,1.38,59
CDM,27019405,MAXI DRAINABALE POUCH,5.84,3.8,1.27,5.84,59
CDM,27019415,"SURFIT FLEXI NATU 1-3/4""",6.97,4.53,1.52,6.97,59
CDM,27019425,FIRST CHOICE CUSTOM DRAI,6.82,4.43,1.49,6.82,59
CDM,27019435,BELT (CONVATEC),7.68,4.99,1.67,7.68,59
CDM,27019445,DRN TUBE DVC 9780 VERT,8.0,5.2,1.74,8.0,59
CDM,27019455,SKIN PREP WIPES PER 4,3.75,2.44,0.82,3.75,59
CDM,27019465,FIRST CHOICE CONVX DRAIN,5.38,3.5,1.17,5.38,59
CDM,27019475,UNI-SOLVE WIPES PER 4,23.41,15.22,5.1,23.41,59
CDM,27019485,MAXI - DFAD,3.53,2.29,0.77,3.53,59
CDM,27019495,MENTOR IRRIGATION SLEEVE,8.0,5.2,1.74,8.0,59
CDM,27019505,STOMA GUIDE STRIP,16.0,10.4,3.49,16.0,59
CDM,27019515,SURFT FLEX 2-1/4-2-3/4,5.0,3.25,1.09,5.0,59
CDM,27019525,CEMENT,7.68,4.99,1.67,7.68,59
CDM,27019535,FIRST CHOICE CUSTOM URO,6.85,4.45,1.49,6.85,59
CDM,27019545,FIRST CHOICE CONVEX URO,5.38,3.5,1.17,5.38,59
CDM,27019555,URO CUP DEVICE,98.0,63.7,21.36,98.0,59
CDM,27019565,CLIP,5.0,3.25,1.09,5.0,59
CDM,27019575,CONTOUR 1 CUSTOM,4.61,3.0,1.0,4.61,59
CDM,27019585,DUODERM 4X4,8.88,5.77,1.94,8.88,59
CDM,27019595,NEW IMAGE DRAIN POUCH,4.0,2.6,0.87,4.0,59
CDM,27019605,VEST BRONCH PULM HYGIENE-SUPPLY,147.0,95.55,32.05,147.0,59
CDM,27020005,LONG LEG CAST ADULT FIBERGLASS,176.0,114.4,38.37,176.0,59
CDM,27020085,WO - PREFAB ELASTIC,30.0,19.5,6.54,30.0,59
CDM,27020655,IUPC CATH,124.0,80.6,27.03,124.0,59
CDM,27021345,WOUND VAC (PREVENA),3143.0,2042.95,685.17,3143.0,59
CDM,27021565,NASAL PLUG,170.0,110.5,37.06,170.0,59
CDM,27021575,SANE SAEC KIT,31.0,20.15,6.76,31.0,59
CDM,27021695,PROXIMAL DIST 2.7 FR O.D. / 2.4FR X 150CM TREVO PRO 18 MICROCATH,803.0,521.95,175.05,803.0,67
CDM,27021705,KYPHON EXPRESS DIAMOND OSTEO INTRODUCER,600.0,390.0,130.8,600.0,67
CDM,27021715,KYPHON EXPRESS BONE DRILL,693.0,450.45,151.07,693.0,67
CDM,27021725,"PACIFIC PLUS PTA BALLOON CATH, 3.0MM X 20MM, 90CM SHAFT, 0.018IN",262.5,170.63,57.23,262.5,67
CDM,27021775,NEOPRENE SPORT SLEEVE,98.0,63.7,21.36,98.0,59
CDM,27021785,FINGER SPLINT,32.0,20.8,6.98,32.0,59
CDM,27021795,PACIFIC PLUS PTA 3.5MM X 20MM X 130MM BALLOON CATH,262.5,170.63,57.23,262.5,67
CDM,27021905,FOLEY CATH INSERTION TRAY 7100,3.16,2.05,0.69,3.16,59
CDM,27022075,"CAST SUPPLIES, SHORT LEG CAST, ADULT (11 YEARS +), FIBERGLASS",84.78,55.11,16.97,84.78,67
CDM,27022345,BAG HANGER,1.04,0.68,0.23,19.65,67
CDM,27022475,IUP MONITOR SUPPLY,44.0,28.6,9.59,44.0,59
CDM,27022495,VACUUM EXTRACTION SUPPLY,129.0,83.85,28.12,129.0,59
CDM,27022535,COMPRESSION STOCKING XLARGE,108.0,70.2,23.54,108.0,59
CDM,27022545,NEOPRENE ELBOW SUPPORT,22.0,14.3,4.8,22.0,67
CDM,27022595,ONE STEP BUTTON K 18/1.7 PUSH,277.5,180.38,60.5,277.5,59
CDM,27022615,CAST SUPPLIES SHORT LEG SPLINT FIBERGLASS,75.0,48.75,16.35,75.0,67
CDM,27022685,ARM SLING,6.0,3.9,1.31,6.0,59
CDM,27022845,COLOPLAST FISTULA AND WOUND MANAGENENT SYSTEM MAXI,60.81,39.53,13.26,60.81,59
CDM,27022965,CAST SUP LNG LEG SPLNT PED F,58.0,37.7,12.64,58.0,67
CDM,27023025,VALVE INTRODUCER DRYING AID,475.83,309.29,103.73,475.83,59
CDM,27023035,"STANDARD, LARYTUBE 9/36",252.0,163.8,36.52,252.0,67
CDM,27023045,PROVOX LARYBUTTON 12/8,264.0,171.6,36.52,264.0,67
CDM,27023065,"TRACHEOSTOMY TUBE COLLAR/HOLDER, EACH",43.0,27.95,9.37,43.0,59
CDM,27023095,PROVOX LARY BUTTON 12/8,264.0,171.6,31.69,264.0,67
CDM,27023105,PROVX TUBE BRUSH,88.0,57.2,19.18,88.0,59
CDM,27023115,PROVOX BRUSH,92.0,59.8,20.06,92.0,59
CDM,27023125,"TRACHEOSTOMA VALVE, INCLUDING DIAPHRAM, EA",44.0,28.6,9.59,67.76,67
CDM,27023335,FM SYSTEM FITTING FEE,100.0,65.0,21.8,100.0,67
CDM,27023365,"SHIPPING FEE, OVERNIGHT",10.0,6.5,2.18,10.0,59
CDM,27023375,"SHIPPING FEE, USPS",2.0,1.3,0.44,2.0,59
CDM,27023385,CI ACOUSTIC RECEIVER,100.0,65.0,21.8,100.0,67
CDM,27023415,L8621- ZINC AIR BATTERY,8.0,5.2,1.74,42.28,67
CDM,27023425,DIAMOND OSTEO INTRODUCER,693.0,450.45,151.07,693.0,67
CDM,27023435,METATARSAL PADS/DANCE PADS,11.0,7.15,2.4,11.0,59
CDM,27023445,PEDIATRIC EAR MOLD FOR CORRECTION,275.0,178.75,36.52,275.0,67
CDM,27023455,LONG ARM SPLINT  - PEDS,68.0,44.2,14.82,68.0,59
CDM,27023465,SHORT ARM SPLINT - PEDS,41.0,26.65,8.94,41.0,59
CDM,27023475,LONG LEG SPLINT - PEDS,86.0,55.9,18.75,86.0,59
CDM,27023485,SHORT LEG SPLINT - PEDS,58.0,37.7,12.64,58.0,59
CDM,27023495,PTB CAST - PEDS,202.0,131.3,44.04,202.0,59
CDM,27023505,IMPELLA AXILLARY KIT,500.0,325.0,109.0,500.0,59
CDM,27023515,BIOMEDICUS FEM ART CANNULA,703.0,456.95,153.25,703.0,59
CDM,27023525,RAC RETROGRADE,134.75,87.59,29.38,134.75,59
CDM,27023535,"CAST SUPPLIES, SHOULDER CAST, 11 YRS +, PLASTER",72.34,47.02,15.77,72.34,67
CDM,27023545,"CAST SUPPLIES, SHOULDER CAST, 11 YRS+, FIBERGLASS",250.5,162.83,36.52,250.5,67
CDM,27023555,"CAST SUPPLIES, LONG ARM CAST, 11 YRS +, PLASTER",26.68,17.34,5.82,42.28,67
CDM,27023565,"CAST SUPPLIES, LONG ARM CAST, 11 YRS +, FIBERGLASS",26.68,17.34,5.82,26.68,67
CDM,27023575,"CAST SUPPLIES, LONG ARM CAST, PEDS, PLASTER",13.34,8.67,2.91,13.34,67
CDM,27023585,"CAST SUPPLIES, LONG ARM CAST, PEDS, FIBERGLASS",30.0,19.5,6.54,42.28,67
CDM,27023595,"CAST SUPPLIES, SHORT ARM CAST, 11 YRS +, PLASTER",17.82,11.58,3.88,17.82,67
CDM,27023605,"CAST SUPPLIES, SHORT ARM CAST, 11 YRS +, FIBERGLASS",40.08,26.05,8.74,40.08,67
CDM,27023615,"CAST SUPPLIES, SHORT ARM CAST, PEDS, PLASTER",8.88,5.77,1.94,12.9,67
CDM,27023625,"CAST SUPPLIES, SHORT ARM CAST, PEDS, FIBERGLASS",20.08,13.05,4.38,42.28,67
CDM,27023635,"CAST SUPPLIES, GAUNTLET CAST, 11 YRS +, FIBERGLASS",15.0,9.75,3.27,42.28,67
CDM,27023645,"CAST SUPPLIES, GAUNTLET CAST, PEDS, PLASTER",16.24,10.56,3.54,19.65,67
CDM,27023655,"CAST SUPPLIES, GAUNTLET CAST, PEDS, FIBERGLASS",27.34,17.77,5.96,27.34,67
CDM,27023665,"CAST SUPPLIES, LONG ARM SPLINT, 11 YRS +, PLASTER",75.0,48.75,11.14,75.0,67
CDM,27023675,"CAST SUPPLIES, LONG ARM SPLINT, 11 YRS +, FIBERGLASS",29.88,19.42,6.51,29.88,67
CDM,27023685,"CAST SUPPLIES, LONG ARM SPLINT, PEDS, PLASTER",9.4,6.11,2.05,19.65,67
CDM,27023695,"CAST SUPPLIES, LONG ARM SPLINT, PEDS, FIBERGLASS",14.98,9.74,3.27,14.98,67
CDM,27023705,"CAST SUPPLIES, SHORT ARM SPLINT, 11 YRS +, PLASTER",13.88,9.02,3.03,13.88,67
CDM,27023715,"CAST SUPPLIES, SHORT ARM SPLINT, PEDS, PLASTER",6.98,4.54,1.52,19.65,67
CDM,27023725,"CAST SUPPLIES, SHORT ARM SPLINT, PEDS, FIBERGLASS",12.54,8.15,2.73,12.9,67
CDM,27023735,"CAST SUPPLIES, LONG LEG CAST, 11 YRS +, PLASTER",59.5,38.68,12.97,59.5,67
CDM,27023745,"CAST SUPPLIES, LONG LEG CAST, 11 YRS +, FIBERGLASS",156.6,101.79,34.14,156.6,67
CDM,27023755,"CAST SUPPLIES, LONG LEG CAST, PEDS, PLASTER",29.72,19.32,6.48,42.28,67
CDM,27023765,"CAST SUPPLIES, LONG LEG CAST, PEDS, FIBERGLASS",78.3,50.9,17.07,78.3,67
CDM,27023775,"CAST SUPPLIES, LONG LEG CYLINDER CAST, 11 YRS +, PLASTER",55.5,36.08,12.1,55.5,67
CDM,27023785,"CAST SUPPLIES, LONG LEG CYLINDER CAST, 11 YRS +, FIBERGLASS",137.98,89.69,30.08,137.98,67
CDM,27023795,"CAST SUPPLIES, LONG LEG CYLINDER CAST, PEDS,PLASTER",27.74,18.03,6.05,42.28,67
CDM,27023805,"CAST SUPPLIES, LONG LEG CYLINDER CAST, PEDS,FIBERGLASS",69.04,44.88,15.05,69.04,67
CDM,27023815,"CAST SUPPLIES SHORT LEG CAST, 11 YRS +, PLASTER",33.82,21.98,7.37,42.28,67
CDM,27023825,"CAST SUPPLIES, SHORT LEG CAST, PEDS, PLASTER",16.96,11.02,3.7,16.96,67
CDM,27023835,"CAST SUPPLIES, SHORT LEG CAST, PEDS, FIBERGLASS",42.4,27.56,9.24,42.4,67
CDM,27023845,"CAST SUPPLIES, LONG LEG SPLINT, 11 YRS+, PLASTER",41.16,26.75,8.97,42.28,67
CDM,27023855,"CAST SUPPLIES, LONG LEG SPLINT, 11 YRS+, FIBERGLASS",70.26,45.67,15.32,70.26,67
CDM,27023865,"CAST SUPPLIES, LONG LEG SPLINT, PEDS, PLASTER",20.6,13.39,4.49,20.6,67
CDM,27023875,"CAST SUPPLIES, SHORT LEG SPLINT, 11 YRS+, PLASTER",23.9,15.54,5.21,23.9,67
CDM,27023885,"CAST SUPPLIES, SHORT LEG SPLINT, PEDS, PLASTER",11.9,7.74,2.59,19.65,67
CDM,27023895,"CAST SUPPLIES, SHORT LEG SPLINT, PEDS, FIBERGLASS",19.22,12.49,4.19,19.22,67
CDM,27023905,WIERUP 16 FR VENT CANNULA,61.0,39.65,13.3,61.0,59
CDM,27023915,FILTER TRANSFUSION STAND ALONE LEUKOCYTE REDUCTION LATEX FREE,52.22,33.94,11.38,52.22,59
CDM,27023925,RESERVOIR CELL SAVER 5+ 150UM AUTOTRANSFUSION RAISED FILTER COLL,55.18,35.87,12.03,55.18,59
CDM,27023935,CONTAINER TRANSFER PACK C600ML TRANSFUSION COUPLER,85.89,55.83,18.72,85.89,59
CDM,27023945,RESTORE CONTSACT LAYER SILVER,14.38,9.35,3.13,14.38,59
CDM,27023955,ACTICOAT 7 6X6 SHEET,51.24,33.31,11.17,51.24,67
CDM,27023965,MEDIHONEY  PER OZ.,22.94,14.91,5.0,22.94,67
CDM,27023975,ELTA SILVER GEL PER OZ,15.16,9.85,3.3,15.16,67
CDM,27023985,INTERDRY AG SHEET,65.4,42.51,0.07,65.4,67
CDM,27023995,PROGRAN 16 SQ IN OR LESS,15.92,10.35,3.47,15.92,67
CDM,27024005,PROGRAN >16 SQ IN >48 SQ IN,15.92,10.35,3.47,15.92,67
CDM,27024015,PRISMA 16 SQ IN OR LESS,15.92,10.35,3.47,15.92,67
CDM,27024025,PRISMA >16 SQ IN >48 SQ IN,15.92,10.35,3.47,15.92,67
CDM,27024095,LONG ARM SPLINT PEDIATRIC 0-10 YEARS,68.0,44.2,11.14,68.0,67
CDM,27024105,ARCTIC SUN GEL PAD SM/MED/LG,2563.0,1665.95,558.73,2563.0,59
CDM,27024115,ARCTIC SUN GEL PAD UNI,770.0,500.5,167.86,770.0,59
CDM,27024355,"NITROUS OXIDE, (SELF PAY)",75.0,48.75,16.35,75.0,59
CDM,27024365,MEDICAL GRADE CO2 CARTRIDGE,66.66,43.33,14.53,66.66,59
CDM,27024375,HAWKONE CUTTER DRIVER,139.21,90.49,30.35,232.66,67
CDM,27024385,LP DETACHMENT HANDLE,357.0,232.05,77.83,357.0,59
CDM,27024395,CORINDUS GRX CASSETTE,450.0,292.5,98.1,450.0,59
CDM,27024405,ACCESSORY PACK FOR BETA CATH 3.5 SYSTEM,1451.25,943.31,316.37,1451.25,59
CDM,27024515,CAST SUP SHT ARM SPLINT FBRG,25.0,16.25,5.45,25.0,67
CDM,27024625,MOBILE AIR TRANSFER SYSTEM,112.0,72.8,24.42,112.0,59
CDM,27024645,GUARDIAN PROGRAMMER,6068.25,3944.36,1322.88,6068.25,59
CDM,27024655,ANGIASSIST GAS MANAGEMENT AND DELIVERY SYSTEM,166.0,107.9,16.97,166.0,67
CDM,27024665,HIGH FLOW OXYGEN DAILY,345.0,224.25,75.21,345.0,59
CDM,27024685,MEPILEX DRESSING BORDER POST-OP 4X6,50.0,32.5,10.9,50.0,59
CDM,27024695,AMEDA DUAL HYGIENIKIT PLUS WITH MANUAL ADAPTER,50.0,32.5,10.9,50.0,67
CDM,27024725,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, BTE/BTE TIE",1700.0,1105.0,333.06,1700.0,67
CDM,27024735,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, ITC/BTE TIE",1700.0,1105.0,333.06,1700.0,67
CDM,27024745,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, ITE/BTE TIE",1700.0,1105.0,333.06,1700.0,67
CDM,27024755,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, ITC/ITC TIE",1700.0,1105.0,333.06,1700.0,67
CDM,27024765,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, ITE/ITC TIE",1700.0,1105.0,333.06,1700.0,67
CDM,27024775,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, ITE/ITE TIE",1700.0,1105.0,333.06,1700.0,67
CDM,27024785,"HEARING AID, DIGITAL, BINAURAL, BTE TIER 1",1200.0,780.0,261.6,1200.0,67
CDM,27024795,"HEARING AID, DIGITAL, MONAURAL, BTE TIER 1",600.0,390.0,130.8,1491.52,67
CDM,27024805,"HEARING AID, DIGITAL, BINAURAL, CIC TIER 1",1200.0,780.0,261.6,1200.0,67
CDM,27024815,"HEARING AID, DIGITAL, MONAURAL, CIC TIER 1",600.0,390.0,130.8,775.49,67
CDM,27024825,"HEARING AID, CONTRALAT ROUTING DEVICE, MONAURAL, BEHIND THE EAR",600.0,390.0,130.8,1491.52,67
CDM,27024835,"HEARING AID, CONTRALAT ROUTING DEVICE, MONAURAL, IN THE CANAL (I",600.0,390.0,130.8,600.0,67
CDM,27024845,"HEARING AID, CONTRALATERAL ROUTING DEVICE, MONAURAL, IN THE EAR",600.0,390.0,130.8,600.0,67
CDM,27024855,"HEARING AID, DIGITAL, BINAURAL, ITC TIER 1",1200.0,780.0,261.6,1200.0,67
CDM,27024865,"HEARING AID, DIGITAL, MONAURAL, ITC TIER 1",600.0,390.0,130.8,775.49,67
CDM,27024875,"HEARING AID, DIGITAL, BINAURAL, ITE TIER 1",1200.0,780.0,261.6,1200.0,67
CDM,27024885,"HEARING AID, DIGITAL, MONAURAL, ITE TIER 1",600.0,390.0,130.8,1491.52,67
CDM,27024895,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, BTE/BTE TIE",2400.0,1560.0,333.06,2400.0,67
CDM,27024905,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, ITC/BTE TIE",2400.0,1560.0,333.06,2400.0,67
CDM,27024915,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, ITE/BTE TIE",2400.0,1560.0,333.06,2400.0,67
CDM,27024925,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, ITC/ITC TIE",2400.0,1560.0,333.06,2400.0,67
CDM,27024935,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, ITE/ITC TIE",2400.0,1560.0,333.06,2400.0,67
CDM,27024945,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, ITE/ITE TIE",2400.0,1560.0,333.06,2400.0,67
CDM,27024955,"HEARING AID, DIGITAL, BINAURAL, BTE TIER 2",2600.0,1690.0,566.8,2600.0,67
CDM,27024965,"HEARING AID, DIGITAL, MONAURAL, BTE TIER 2",1300.0,845.0,283.4,1491.52,67
CDM,27024975,"HEARING AID, DIGITAL, BINAURAL, CIC TIER 2",2600.0,1690.0,566.8,2600.0,67
CDM,27024985,"HEARING AID, DIGITAL, MONAURAL, CIC TIER 2",1300.0,845.0,283.4,1300.0,67
CDM,27024995,"HEARING AID, CONTRALAT ROUTING DEVICE, MONAURAL, BEHIND THE EAR",1300.0,845.0,283.4,1300.0,67
CDM,27025005,"HEARING AID, CONTRALAT ROUTING DEVICE, MONAURAL, IN THE CANAL (I",1300.0,845.0,283.4,1300.0,67
CDM,27025015,"HEARING AID, CONTRALATERAL ROUTING DEVICE, MONAURAL, IN THE EAR",1300.0,845.0,283.4,1300.0,67
CDM,27025025,"HEARING AID, DIGITAL, BINAURAL, ITC TIER 2",2600.0,1690.0,566.8,2600.0,67
CDM,27025035,"HEARING AID, DIGITAL, MONAURAL, ITC TIER 2",1300.0,845.0,283.4,1300.0,67
CDM,27025045,"HEARING AID, DIGITAL, BINAURAL, ITE TIER 2",2600.0,1690.0,566.8,2600.0,67
CDM,27025055,"HEARING AID, DIGITAL, MONAURAL, ITE TIER 2",1300.0,845.0,283.4,1491.52,67
CDM,27025065,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, BTE/BTE TIE",3200.0,2080.0,333.06,3200.0,67
CDM,27025075,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, ITC/BTE TIE",3200.0,2080.0,333.06,3200.0,67
CDM,27025085,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, ITE/BTE TIE",3200.0,2080.0,333.06,3200.0,67
CDM,27025095,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, ITC/ITC TIE",3200.0,2080.0,333.06,3200.0,67
CDM,27025105,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, ITE/ITC TIE",3200.0,2080.0,333.06,3200.0,67
CDM,27025115,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, ITE/ITE TIE",3200.0,2080.0,333.06,3200.0,67
CDM,27025125,"HEARING AID, DIGITAL, BINAURAL, BTE TIER 3",4200.0,2730.0,669.74,4200.0,67
CDM,27025135,"HEARING AID, DIGITAL, MONAURAL, BTE TIER 3",2100.0,1365.0,457.8,2100.0,67
CDM,27025145,"HEARING AID, DIGITAL, BINAURAL, CIC TIER 3",4200.0,2730.0,669.74,4200.0,67
CDM,27025155,"HEARING AID, DIGITAL, MONAURAL, CIC TIER 3",2100.0,1365.0,457.8,2100.0,67
CDM,27025165,"HEARING AID, CONTRALAT ROUTING DEVICE, MONAURAL, BEHIND THE EAR",2100.0,1365.0,333.06,2100.0,67
CDM,27025175,"HEARING AID, CONTRALAT ROUTING DEVICE, MONAURAL, IN THE CANAL (I",2100.0,1365.0,333.06,2100.0,67
CDM,27025185,"HEARING AID, CONTRALATERAL ROUTING DEVICE, MONAURAL, IN THE EAR",2100.0,1365.0,333.06,2100.0,67
CDM,27025195,"HEARING AID, DIGITAL, BINAURAL, ITC TIER 3",4200.0,2730.0,669.74,4200.0,67
CDM,27025205,"HEARING AID, DIGITAL, MONAURAL, ITC TIER 3",2100.0,1365.0,457.8,2100.0,67
CDM,27025215,"HEARING AID, DIGITAL, BINAURAL, ITE TIER 3",4200.0,2730.0,669.74,4200.0,67
CDM,27025225,"HEARING AID, DIGITAL, MONAURAL, ITE TIER 3",2100.0,1365.0,457.8,2100.0,67
CDM,27025235,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, BTE/BTE TIE",3900.0,2535.0,333.06,3900.0,67
CDM,27025245,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, ITC/BTE TIE",3900.0,2535.0,333.06,3900.0,67
CDM,27025255,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, ITE/BTE TIE",3900.0,2535.0,333.06,3900.0,67
CDM,27025265,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, ITC/ITC TIE",3900.0,2535.0,333.06,3900.0,67
CDM,27025275,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, ITE/ITC TIE",3900.0,2535.0,333.06,3900.0,67
CDM,27025285,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, ITE/ITE TIE",3900.0,2535.0,333.06,3900.0,67
CDM,27025295,"HEARING AID, DIGITAL, BINAURAL, BTE TIER 4",5600.0,3640.0,669.74,5600.0,67
CDM,27025305,"HEARING AID, DIGITAL, MONAURAL, BTE TIER 4",2800.0,1820.0,610.4,2800.0,67
CDM,27025315,"HEARING AID, DIGITAL, BINAURAL, CIC TIER 4",5600.0,3640.0,669.74,5600.0,67
CDM,27025325,"HEARING AID, DIGITAL, MONAURAL, CIC TIER 4",2800.0,1820.0,610.4,2800.0,67
CDM,27025335,"HEARING AID, CONTRALAT ROUTING DEVICE, MONAURAL, BEHIND THE EAR",2800.0,1820.0,333.06,2800.0,67
CDM,27025345,"HEARING AID, CONTRALAT ROUTING DEVICE, MONAURAL, IN THE CANAL (I",2800.0,1820.0,333.06,2800.0,67
CDM,27025355,"HEARING AID, CONTRALATERAL ROUTING DEVICE, MONAURAL, IN THE EAR",2800.0,1820.0,333.06,2800.0,67
CDM,27025365,"HEARING AID, DIGITAL, BINAURAL, ITC TIER 4",5600.0,3640.0,669.74,5600.0,67
CDM,27025375,"HEARING AID, DIGITAL, MONAURAL, ITC TIER 4",2800.0,1820.0,610.4,2800.0,67
CDM,27025385,"HEARING AID, DIGITAL, BINAURAL, ITE TIER 4",5600.0,3640.0,669.74,5600.0,67
CDM,27025395,"HEARING AID, DIGITAL, MONAURAL, ITE TIER 4",2800.0,1820.0,610.4,2800.0,67
CDM,27025585,EMST150 EXPIRATORY MUSCLE STRENGTH TRAINER,88.0,57.2,16.97,88.0,67
CDM,27025595,LIFE SUPPORT FLEX IN ARTERIAL CANNULA SECTION,1050.0,682.5,228.9,1050.0,59
CDM,27025605,LIVER TXPACK,188.0,122.2,40.98,188.0,59
CDM,27025615,LUNG TX EXMO PACK,150.0,97.5,32.7,150.0,59
CDM,27025635,NAUTILUS OXYGENATOR,3600.0,2340.0,784.8,3600.0,59
CDM,27025645,EUROSET OXYGENATOR,2400.0,1560.0,523.2,2400.0,59
CDM,27025655,TANDEM HEART PROTEK SOLO,21000.0,13650.0,4578.0,21000.0,59
CDM,27025665,QUANTUM PROTEK DUO REPLACEMENT,20000.0,13000.0,4360.0,20000.0,59
CDM,27025675,INSERTION KIT PIA V,227.0,147.55,49.49,227.0,59
CDM,27025685,INSERTION KIT PIK A,92.0,59.8,20.06,92.0,59
CDM,27025695,SURGE CANNULA,795.8,517.27,173.48,795.8,59
CDM,27025705,PROTEK DUO INSERTION KIT,1000.0,650.0,218.0,1000.0,59
CDM,27025925,RESEVOIR FRESENIUS CATS AUTOTRANSFUSION COLLECTION,92.26,59.97,20.11,92.26,59
CDM,27025935,FRESENIUS CATS AUTOTRANSFUSION TUBING ASPIRATION ANTICOAGULANT S,51.26,33.32,11.17,51.26,59
CDM,27025945,FRESENIUS CATS ALL DISPOSABLES,256.0,166.4,55.81,256.0,59
CDM,27025955,HEMOCONCENTRATOR PEDI PACK LIVA NOVA,246.0,159.9,53.63,246.0,59
CDM,27025975,CULINARY CONSULT,200.0,130.0,43.6,200.0,59
CDM,27025985,AMBU DISPOSABLE BRONCHOSCOPE,690.0,448.5,150.42,690.0,59
CDM,27025995,SYSTEM CRYO/CUFF IC UNIVERSAL COMPRESSION THERAPY COOLER,174.0,113.1,31.69,174.0,67
CDM,27025OH,FASCIOTOMY HIP/THIGH ANY TYPE,5156.0,3351.4,1.1,5156.0,144
CDM,27027OH,DECOMPRESSION FASCIOTOMY PELVIC COMPARTMENT UNI,5216.0,3390.4,1.1,20863.78,144
CDM,27030OH,ARTHROTOMY HIP W/DRAINAGE,5460.0,3549.0,1.1,5460.0,144
CDM,27033OH,ARTHROTOMY HIP EXPLORATION/REMOVAL FOREIGN BODY,5644.0,3668.6,1.1,20863.78,144
CDM,27036OH,CAPSLCTOMY/CAPSUL HIP W/RLS HIP FLXR MUSC,5752.0,3738.8,1.1,5752.0,144
CDM,27040OH,BIOPSY SOFT TISSUE PELVIS&HIP AREA SUPERFICIAL,1168.0,759.2,1.1,4729.25,148
CDM,27041OH,BIOPSY SOFT TISSUE PELVIS&HIP DEEP/SUBFSCAL/IM,4072.0,2646.8,1.1,4729.25,144
CDM,27043OH,EXCISION TUMOR SOFT TISSUE PELVIS&HIP SUBQ 3+CM,2752.0,1788.8,1.1,8286.13,144
CDM,27045OH,EXC TUMOR SOFT TISSUE PELVIS & HIP SUBFASC 5+CM,4452.0,2893.8,1.1,8286.13,144
CDM,27047OH,EXC TUMOR SOFT TISSUE PELVIS & HIP SUBQ <3CM,2174.0,1413.1,1.1,8286.13,148
CDM,27048OH,EXC TUMOR SOFT TISSUE PELVIS & HIP SUBFASC <5CM,3540.0,2301.0,1.1,8286.13,144
CDM,27049OH,RAD RESECT TUMOR SOFT TISSUE PELVIS & HIP <5 CM,8620.0,5603.0,1.1,8620.0,144
CDM,27050OH,ARTHROTOMY W/BIOPSY SACROILIAC JOINT,1896.0,1232.4,1.1,4686.39,144
CDM,27052OH,ARTHROTOMY W/BIOPSY HIP JOINT,2968.0,1929.2,1.1,4686.39,144
CDM,27054OH,ARTHROTOMY W/SYNOVECTOMY HIP JOINT,3684.0,2394.6,1.1,3684.0,144
CDM,27057OH,DCMPRN FASCIOTOMY PELVIC CMPRT DBRDMT MUSCLE UNI,5964.0,3876.6,1.1,5964.0,144
CDM,27059OH,RAD RESECTION TUMOR SOFT TISS PELVIS&HIP 5+CM,11740.0,7631.0,1.1,11740.0,144
CDM,27060OH,EXCISION ISCHIAL BURSA,2348.0,1526.2,1.1,20863.78,144
CDM,27062OH,EXCISION TROCHANTERIC BURSA/CALCIFICATION,2300.0,1495.0,1.1,9440.12,144
CDM,27065OH,EXCISION BONE CYST/BNIGN TUMOR SUPERFICIAL,2620.0,1703.0,1.1,20863.78,144
CDM,27066OH,EXCISION BONE CYST/BENIGN TUMOR DEEP,4480.0,2912.0,1.1,9440.12,144
CDM,27067OH,EXC B1 CST/B9 TUM W/AGRFT REQ SEP INC,5888.0,3827.2,1.1,20863.78,144
CDM,27070OH,PARTIAL EXCISION SUPERFICIAL PELVIS,4624.0,3005.6,1.1,4624.0,144
CDM,27071OH,PARTIAL EXCISION DEEP PELVIS,5452.0,3543.8,1.1,5452.0,144
CDM,27075OH,RAD RESCT TUMOR WING OF ILIUM 1 PUBIC/ISCHIAL,13084.0,8504.6,1.1,13084.0,144
CDM,27076OH,RAD RESCT TUMOR ILIUM ACETABULUM BOTH PUBIC,16084.0,10454.6,1.1,16084.0,144
CDM,27077OH,RADICAL RESCTION TUMOR INNOMINATE BONE TOTAL,18084.0,11754.6,1.1,18084.0,144
CDM,27078OH,RAD RESCT TUMOR ISCHIAL TUBEROSITY&GRT TRCHNTR,12884.0,8374.6,1.1,12884.0,144
CDM,27080OH,COCCYGECTOMY PRIMARY,2756.0,1791.4,1.1,9440.12,144
CDM,27086OH,RMVL FOREIGN BODY PELVIS/HIP SUBCUTANEOUS TISS,768.0,499.2,1.1,8286.13,148
CDM,27087OH,REMOVAL FOREIGN BODY PELVIS/HIP DEEP,3532.0,2295.8,1.1,9440.12,144
CDM,27090OH,REMOVAL OF HIP PROSTHESIS,4676.0,3039.4,1.1,4676.0,144
CDM,27091OH,RMVL HIP PROSTH COMP W/TOT HIP PROSTH MMA,9740.0,6331.0,1.1,9740.0,144
CDM,27093OH,INJECTION HIP ARTHROGRAPHY W/O ANESTHESIA,520.0,338.0,1.1,791.41,148
CDM,27095OH,INJECTION HIP ARTHROGRAPHY W/ANESTHESIA,600.0,390.0,1.1,1054.08,148
CDM,27096OH,INJECT SI JOINT ARTHRGRPHY&/ANES/STEROID W/IMA,651.0,423.15,1.1,651.0,148
CDM,27097OH,RELEASE/RECESSION HAMSTRING PROXIMAL,3708.0,2410.2,1.1,9440.12,144
CDM,27098OH,ADDUCTOR TRANSFER TO ISCHIUM,4101.0,2665.65,1.1,9440.12,144
CDM,27100015,"PREGNANCY TEST,URINE,3C07-16",2.9,1.89,0.63,2.9,59
CDM,27100025,"SET,MACRODRIP 3 Y-SITES",4.14,2.69,0.9,4.14,59
CDM,27100035,"SET,MICRODRIP 2Y-SITES",4.06,2.64,0.89,4.06,59
CDM,27100605,NON STERILE PENUMBRA SUPPLIES,493.0,320.45,107.47,493.0,59
CDM,27100615,"SUPPORT,ATHLETIC LRG  38-44",8.52,5.54,1.86,8.52,59
CDM,27100645,"PREGNANCY TEST,URINE,3C07-16",2.9,1.89,0.63,2.9,59
CDM,27100665,"SET,MACRODRIP 3 Y-SITES",4.14,2.69,0.9,4.14,59
CDM,27100675,"SET,BURETROL,PED DRIP INJ SITE",2.4,1.56,0.52,2.4,59
CDM,27100715,"SET,MICRODRIP 2Y-SITES",4.06,2.64,0.89,4.06,59
CDM,27100755,"GIRDLE,ABOVE KNEE,LG,FG8011L",78.75,51.19,17.17,78.75,59
CDM,27100765,"GIRDLE,ABOVE KNEE,MED,FG8011M",78.75,51.19,17.17,78.75,59
CDM,27100775,"GIRDLE,BELOW KNEE,MED,FG8021M",78.75,51.19,17.17,78.75,59
CDM,27100915,STAT WRAP 4X4.5  6040,5.0,3.25,1.09,5.0,59
CDM,27100OH,TR XTRNL OBLQ MUSC TRCHNTR W/FSCAL/TDN XTN GRF,4540.0,2951.0,1.1,20863.78,144
CDM,27120OH,ACETABULOPLASTY,7700.0,5005.0,1.1,7700.0,144
CDM,27122OH,ACETABULOPLASTY RESECTION FEMORAL HEAD,6436.0,4183.4,1.1,6436.0,144
CDM,27125OH,HEMIARTHROPLASTY HIP PARTIAL,6656.0,4326.4,1.1,6656.0,144
CDM,27130OH,ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT,8624.0,5605.6,1.1,38384.94,144
CDM,27132OH,CONV PREV HIP TOT HIP ARTHRP W/WO AGRFT/ALGRFT,11304.0,7347.6,1.1,11304.0,144
CDM,27134OH,REVJ TOT HIP ARTHRP BTH W/WO AGRFT/ALGRFT,13323.0,8659.95,1.1,13323.0,144
CDM,27137OH,REVJ TOT HIP ARTHRP ACTBLR W/WO AGRFT/ALGRFT,9988.0,6492.2,1.1,9988.0,144
CDM,27138OH,REVJ TOT HIP ARTHRP FEM ONLY W/WO ALGRFT,10428.0,6778.2,1.1,10428.0,144
CDM,27140OH,OSTEOTOMY&TRANSFER GREATER TROCHANTER SPX,5112.0,3322.8,1.1,5112.0,144
CDM,27146OH,OSTEOTOMY ILIAC ACETABULAR/INNOMINATE BONE,7568.0,4919.2,1.1,7568.0,144
CDM,27147OH,OSTEOTOMY ILIAC ACETABULAR/INNOMINATE HIP RDCTJ,8828.0,5738.2,1.1,8828.0,144
CDM,27151OH,OSTEOTOMY ILIAC ACETABULAR/INNOMINATE FEM OSTEOT,9648.0,6271.2,1.1,9648.0,144
CDM,27156OH,OSTEOT ILIAC ACTBLR/INNOMINATE BONE OSTEOT RDCTJ,10492.0,6819.8,1.1,10492.0,144
CDM,27158OH,OSTEOTOMY PELVIS BILAT,9258.0,6017.7,1.1,9258.0,144
CDM,27161OH,OSTEOTOMY FEMORAL NECK SEPARATE PROCEDURE,7156.0,4651.4,1.1,7156.0,144
CDM,27165OH,OSTEOT INTERTRCHNTRIC/SUBTRCHNTRIC W/INT/XTRNL,8116.0,5275.4,1.1,8116.0,144
CDM,27170OH,B1 GRF FEM H/N INTERTRCHNTRIC/SUBTRCHNTRIC AREA,7044.0,4578.6,1.1,7044.0,144
CDM,27176OH,TX SLP FEM EPIPHYSIS SINGLE/MULTIPL PINNING SITU,5168.0,3359.2,1.1,5168.0,144
CDM,27177OH,OPTX SLP FEM EPIPHYSIS SINGLE/MULT PIN/BONE GRFT,6436.0,4183.4,1.1,6436.0,144
CDM,27178OH,OPTX SLP FEM EPIPHYSIS CLSD MANJ SINGL/MLTPL PIN,5168.0,3359.2,1.1,5168.0,144
CDM,27179OH,OPTX SLP FEM EPIPHYSIS OSTPL FEM NCK HEYMAN PX,5588.0,3632.2,1.1,20863.78,144
CDM,27181OH,OPTX SLP FEM EPIPHYSIS OSTEOT&INT FIXJ,6472.0,4206.8,1.1,6472.0,144
CDM,27185OH,EPIPHYSL ARRST EPIPHYSIOD/STAPLING TRCHNTR FEMUR,3916.0,2545.4,1.1,3916.0,144
CDM,27187OH,PROPH TX N/P/PLTWR W/WO MMA FEM NCK & PROX FEMUR,5692.0,3699.8,1.1,5692.0,144
CDM,27197OH,CLSD TX PELVIC RING FX W/O MANIPULATION,673.0,437.45,1.1,688.73,144
CDM,27198OH,CLSD TX PELVIC RING FX W/MANIPULATION W/ANES,2090.0,1358.5,1.1,2090.0,144
CDM,27200006,GORE DRYSEAL FLEX INTRODUCER/SHEATH DSF 1883,1272.0,826.8,200.93,1272.0,67
CDM,27200016,DIAGNOSTIC IMAGING CATHETER,1125.0,731.25,245.25,1125.0,59
CDM,27200026,"AMPLATZER DELIVERY SYSTEM, 45 DEG",906.0,588.9,197.51,906.0,59
CDM,27200036,GORE DRYSEAL FLEX INTRODUCER/SHEATH DSF 2665,865.5,562.58,188.68,865.5,67
CDM,27200046,ASAHI CORSAIR MICROCATHETER,825.0,536.25,179.85,825.0,59
CDM,27200050,W ACHALASIA BALLOON,284.25,184.76,61.97,284.25,67
CDM,27200056,PTFE COATED GUIDEWIRE,750.0,487.5,163.5,750.0,67
CDM,27200060,W ADAPTER HARMONIC HAND HS DISP,259.0,168.35,56.46,259.0,59
CDM,27200066,TANDEMHEART FEMORAL ARTERIAL CANNULA SET,742.5,482.63,161.87,742.5,59
CDM,27200076,C1725 PTCA CATHETER TIER 1,733.05,476.48,159.8,733.05,67
CDM,27200086,DOUBLE LUMEN INFUSION CATHETER,592.5,385.13,129.17,592.5,59
CDM,27200096,C1887 GUIDING CATHETER TIER 4,506.25,329.06,110.36,506.25,67
CDM,27200106,FEMORAL VENOUS CANNULA W/ CONNECTOR,315.0,204.75,68.67,315.0,59
CDM,27200115,RAPID INF. DEVICE,476.0,309.4,103.77,476.0,67
CDM,27200116,FEMORAL ARTERIAL CANNULA W/ CONNECTOR,225.0,146.25,49.05,225.0,59
CDM,27200125,STERILE SLUSH,33.7,21.91,7.35,33.7,59
CDM,27200126,C1725 PTCA CATHETER TIER 0,195.5,127.08,42.62,232.66,67
CDM,27200135,"BLADE,SURGICAL CLIPPER 4412",19.6,12.74,4.27,19.6,59
CDM,27200136,VASCULAR DILATOR KIT,189.26,123.02,41.26,189.26,59
CDM,27200146,C1887 GUIDING CATHETER TIER 2,175.5,114.08,38.26,232.66,67
CDM,27200156,TORCON NB ADV ANGIO CATH,116.99,76.04,25.5,116.99,59
CDM,27200166,BALLOON WEDGE CATHETER,98.0,63.7,21.36,98.0,59
CDM,27200176,SWAN-GANZ 5 LUMEN CATHETER,85.4,55.51,18.62,232.66,67
CDM,27200186,C1887 GUIDING CATHETER TIER 1,78.0,50.7,17.0,232.66,67
CDM,27200196,"TANDEMHEART PVAD PUMP, SHIP KIT",17550.0,11407.5,3825.9,17550.0,59
CDM,27200205,STRAIGHT TIP CATH,17.0,11.05,3.71,17.0,59
CDM,27200206,DUAL LUMEN CATHETER,8775.0,5703.75,1912.95,8775.0,59
CDM,27200216,"MERIT SHEATH, PLS-1007 CATHETER",54.0,35.1,11.77,232.66,67
CDM,27200225,CAPSULE DELIVERY DEVICE,148.75,96.69,32.43,232.66,67
CDM,27200235,ENDO CLIPS,225.0,146.25,49.05,232.66,67
CDM,27200285,CORDIS SHORT 4 FR OR 5FR,18.2,11.83,3.97,18.2,59
CDM,27200405,ANGIOCATH IV 16GA 5.25 STERILE,29.94,19.46,6.53,29.94,59
CDM,27200406,STRYKER SYNCHRO 2 GUIDEWIRE,751.79,488.66,163.89,751.79,67
CDM,27200415,"CATHETER, HEMODIALYSIS, SHORT",217.0,141.05,47.31,217.0,59
CDM,27200416,PICC 5 FR DOUBLE LUMEN 3CG,533.0,346.45,116.19,533.0,67
CDM,27200426,MIDLINE KIT,268.0,174.2,58.42,268.0,59
CDM,27200436,PICC 5 FR TRIPLE LUMEN 3CG,618.0,401.7,134.72,618.0,67
CDM,27200476,BRAUN SWITCHBACK INFLATION DEVICE,78.0,50.7,17.0,78.0,59
CDM,27200556,"DISPOSABLE 4F PV LOOP CATHETER, NO LUMEN AND 12 ELECTRODES WITH",2093.0,1360.45,200.93,2093.0,67
CDM,27200566,DISPOSABLE 7F PV LOOP CATHETER WITH 0.025 INCH LUMEN AND 12 ELEC,2012.0,1307.8,200.93,2012.0,67
CDM,27200580,W BALLOON CATH COOK G31236,1712.13,1112.88,200.93,1712.13,67
CDM,27200776,BRAUN ATRIOSEPTOSTOMY BALLOON CATHETER,627.0,407.55,136.69,627.0,59
CDM,27200786,COEFF PERCUT TRANSL VALVULOPLASTY CATHETER,682.97,443.93,148.89,682.97,59
CDM,27200856,ACIST CVI ANGIO TOUCH,36.0,23.4,7.85,36.0,59
CDM,27200866,EDWARDS SAPIEN 3 PULMONIC SYSTEM 29 MM,56025.0,36416.25,12213.45,56025.0,59
CDM,27200876,PICC 4FR SINGLE LUMEN 3CG,444.0,288.6,96.79,444.0,67
CDM,27200896,LIVA NOVA RT ANGLE VENOUS CANNULA EACH RV-41024,45.5,29.58,9.92,45.5,59
CDM,27200906,MEDTRONIC EOPA CANNULA EACH #77424,87.5,56.88,19.08,87.5,59
CDM,27200916,MEDTRONIC DLP ARTERIAL CANNULA EACH #77010,136.5,88.73,29.76,136.5,59
CDM,27200926,MEDTRONIC INSERTION KIT EACH #96553,133.0,86.45,28.99,133.0,59
CDM,27200936,EDWARDS FEMORAL ARTERIAL CANNULA EACH #FEMII016A,225.0,146.25,49.05,225.0,59
CDM,27200946,MEDTRONIC CORTIVA VENOUS CANNULA EACH #CB96835-012,420.0,273.0,91.56,420.0,59
CDM,27200956,ABBOTT CENTRIMAG BLOOD PUMP #102953,17010.0,11056.5,3708.18,17010.0,59
CDM,27200966,ABBOTT PEDIMAG BLOOD PUMP #201-90052,13500.0,8775.0,2943.0,13500.0,59
CDM,27200976,AVALON VV DOUBLE LUMEN CANNULA #10013,3525.0,2291.25,768.45,3525.0,59
CDM,27200986,MEDTRONIC NEX GEN CANNULA EACH #96820-108,427.5,277.88,93.2,427.5,59
CDM,27200996,MEDTRONIC PEDIATRIC VAD PACK #CB11M73R2,120.75,78.49,26.32,120.75,59
CDM,27200OH,CLOSED TREATMENT COCCYGEAL FRACTURE,768.0,499.2,1.1,768.0,146
CDM,27201006,BOSTON SCIENTIFIC OCCLUSION DEVICE COILS 2MM,1332.0,865.8,290.38,1332.0,59
CDM,27201016,BOSTON SCIENTIFIC OCCLUSION DEVICE COILS  3MM X 12 CM,1482.0,963.3,323.08,1482.0,59
CDM,27201026,BOSTON SCIENTIFIC EVEROLIMUS ELUTING STENT,975.0,633.75,212.55,975.0,59
CDM,27201086,BOSTON SCIENTIFIC EMBOLD FIBERED COILS 5X15,1482.0,963.3,323.08,1482.0,59
CDM,27201096,BOSTON SCIENTIFIC EMBOLD FIBERED COILS 10X50,1686.15,1096.0,367.58,1686.15,59
CDM,27201106,BOSTON SCIENTIFIC EMBOLD FIBERED COILS 10X30,1686.15,1096.0,367.58,1686.15,59
CDM,27201116,BOSTON SCIENTIFIC EMBOLD FIBERED COILS 8X20,1482.0,963.3,323.08,1482.0,59
CDM,27201136,BARD PTV DILATION BALLOON,1125.0,731.25,200.93,1125.0,67
CDM,27201146,LEUKOCYTE REDUCTION RBC FILTER,33.64,21.87,7.33,33.64,59
CDM,27201156,PERIPHERAL IVL CATHETER,4657.5,3027.38,200.93,4657.5,67
CDM,27201175,"5 FIBERWIRE SUTURE,W/NEEDLE",54.0,35.1,11.77,54.0,59
CDM,27201216,MERIT MEDICAL PULM ARTERY PRESSURE MONITORING CATHETER 5-7 FR,73.41,47.72,16.0,73.41,59
CDM,27201556,ARROWGUARD BLUE PLUS CATHETER,267.0,173.55,58.21,267.0,67
CDM,27201616,"HEMOCONCENTRATOR, DHF 0.6 W/36",158.0,102.7,34.44,158.0,59
CDM,27201646,CANNULA ARTERIAL 20FR DILATOR,105.0,68.25,22.89,105.0,59
CDM,27201676,"AUTOLOG/SEQUESTRA, RESERVIOR",98.0,63.7,21.36,98.0,59
CDM,27201686,"AUTOLOG, WASH KIT, 135ML BOWL",162.0,105.3,35.32,162.0,59
CDM,27201826,BIPAL BIOPSY FORCEP,233.0,151.45,50.79,233.0,59
CDM,27201886,PTS SIZING BALLOON CATHETER,593.0,385.45,129.27,593.0,59
CDM,27201896,DRYSEAL FLEX INTRODUCER SHEATH,880.0,572.0,191.84,880.0,67
CDM,27201916,BARD DILATION BALLOON VALVULOPLASTY CATHETER,1620.0,1053.0,200.93,1620.0,67
CDM,27201936,EXD-001,1018.5,662.03,222.03,1018.5,59
CDM,27201946,HEX TORQUE WRENCH,675.0,438.75,147.15,675.0,59
CDM,27201956,EXD BATTERY,87.5,56.88,19.08,87.5,59
CDM,27202086,CHOICE  FLOPPY GUIDEWIRE W/ICE COATING .014 IN X 182 CM,111.48,72.46,24.3,111.48,59
CDM,27202126,GLIDECATH COBRA 2  CATHETER,90.56,58.86,19.74,232.66,67
CDM,27202146,BRAUN WEDGE PRESSURE BALLOON FLOTATION CATH,84.0,54.6,18.31,84.0,59
CDM,27202156,ENSITE SURFACE ELECTRODE KIT,8100.0,5265.0,1765.8,8100.0,59
CDM,27202166,MAPPING CATHETER WITH TRUEREF TECHNOLOGY,2928.0,1903.2,200.93,2928.0,67
CDM,27202176,TORQUE DEVICE,50.0,32.5,10.9,50.0,59
CDM,27202186,TRANSEPTAL GUIDING SHEATH,323.0,209.95,70.41,323.0,59
CDM,27202196,TRIEVER24 THROMBECTOMY CATHETER,13500.0,8775.0,200.93,13500.0,67
CDM,27202206,CLOTTRIEVER CATHETER,7425.0,4826.25,200.93,7425.0,67
CDM,27202216,INARI PROTRIEVE SHEATH,5400.0,3510.0,200.93,5400.0,67
CDM,27202226,CLOT RETRIEVER SHEATH,2025.0,1316.25,200.93,2025.0,67
CDM,27202246,BALLOON TRAPPING CATH,300.0,195.0,65.4,300.0,59
CDM,27202306,EDWARDS SEPTOSTOMY BALLOON CATHETER,1151.28,748.33,250.98,1151.28,59
CDM,27202316,BARD PTA BALLOON DILATION CATHETER 5 MM X4 CM,330.0,214.5,71.94,330.0,67
CDM,27202326,BARD PTA BALLOON DILATION CATHETER  7 MM X2 CM,247.5,160.88,53.96,247.5,67
CDM,27202396,ICU MEDICAL ARTERIAL LINE CATHETER,79.61,51.75,17.35,79.61,59
CDM,27202416,BOSTON SCIENTIFIC EMBOLD FIBERED COILS 2X4,1332.0,865.8,200.93,1332.0,67
CDM,27202420,W CATH DRNG 10FR/14FR 25CM,102.87,66.87,22.43,232.66,67
CDM,27202426,BOSTON SCIENTIFIC EMBOLD FIBERED COILS 2X6,1332.0,865.8,200.93,1332.0,67
CDM,27202436,BOSTON SCIENTIFIC EMBOLD FIBERED COILS 3X6,1332.0,865.8,200.93,1332.0,67
CDM,27202446,BOSTON SCIENTIFIC EMBOLD FIBERED COILS 3X12,1482.0,963.3,200.93,1482.0,67
CDM,27202456,BOSTON SCIENTIFIC EMBOLD FIBERED COILS 4X8,1332.0,865.8,200.93,1332.0,67
CDM,27202466,BOSTON SCIENTIFIC EMBOLD FIBERED COILS 4X15,1482.0,963.3,200.93,1482.0,67
CDM,27202476,BOSTON SCIENTIFIC EMBOLD FIBERED COILS 5X8,1332.0,865.8,200.93,1332.0,67
CDM,27202486,BOSTON SCIENTIFIC EMBOLD FIBERED COILS 6X10,1482.0,963.3,200.93,1482.0,67
CDM,27202496,BOSTON SCIENTIFIC EMBOLD FIBERED COILS 6X20,1482.0,963.3,200.93,1482.0,67
CDM,27202500,W CATH 7FR DUAL F/TRAY V-CUFF,255.57,166.12,55.71,255.57,67
CDM,27202506,BOSTON SCIENTIFIC EMBOLD FIBERED COILS 10X20,1482.0,963.3,200.93,1482.0,67
CDM,27202510,W CATH ABL NAV DS,1554.34,1010.32,200.93,1554.34,67
CDM,27202516,BOSTON SCIENTIFIC EMBOLD FIBERED COILS 12X20,1482.0,963.3,200.93,1482.0,67
CDM,27202526,BOSTON SCIENTIFIC EMBOLD FIBERED COILS 12X30,1686.15,1096.0,200.93,1686.15,67
CDM,27202536,BOSTON SCIENTIFIC EMBOLD FIBERED COILS 12X50,1686.15,1096.0,200.93,1686.15,67
CDM,27202546,BOSTON SCIENTIFIC EMBOLD FIBERED COILS 14X20,1482.0,963.3,200.93,1482.0,67
CDM,27202556,BOSTON SCIENTIFIC EMBOLD FIBERED COILS 14X30,1686.15,1096.0,200.93,1686.15,67
CDM,27202560,W CATH ACUNAV ULTRASOUND,2565.0,1667.25,200.93,2565.0,67
CDM,27202566,BOSTON SCIENTIFIC EMBOLD FIBERED COILS 14X50,1686.15,1096.0,200.93,1686.15,67
CDM,27202570,W CATH ANG SURPAS,473.47,307.76,103.22,473.47,67
CDM,27202576,BOSTON SCIENTIFIC EMBOLD FIBERED COILS 18X50,1686.15,1096.0,200.93,1686.15,67
CDM,27202586,BOSTON SCIENTIFIC EMBOLD FIBERED COILS 20X50,1686.15,1096.0,200.93,1686.15,67
CDM,27202596,BOSTON SCIENTIFIC EMBOLD FIBERED COILS 22X60,1686.15,1096.0,200.93,1686.15,67
CDM,27202600,W CATH ANGIO XFEEDER 120CM,420.49,273.32,91.67,420.49,67
CDM,27202606,BOSTON SCIENTIFIC EMBOLD FIBERED COILS 32X60,1686.15,1096.0,200.93,1686.15,67
CDM,27202656,WORLEY HEMOSTATIC SAFESHEATH 9FR X 40CM,630.0,409.5,137.34,630.0,67
CDM,27202690,W CATH ATHR TRANSLUM DIREC,1223.0,794.95,200.93,1223.0,67
CDM,27202700,W CATH ATLANTS SR,1102.21,716.44,200.93,1102.21,67
CDM,27202736,W DEV CLOSR VASC 6/7 FR MYNX,1050.0,682.5,228.9,1050.0,59
CDM,27202746,AMPLATZER?DUCT OCCLUDER II,6945.75,4514.74,1514.17,6945.75,59
CDM,27202756,AMPLATZER SIZING BALLOON CATHETER,465.0,302.25,101.37,465.0,59
CDM,27202766,AMPLATZER SEPTAL OCCLUDER,10763.55,6996.31,200.93,10763.55,67
CDM,27202856,DESTINO STEERABLE GUIDING SHEATH 6.5 FR,1498.5,974.03,200.93,1498.5,67
CDM,27202866,CONCERTO PGLA EMBOL COIL,750.0,487.5,163.5,750.0,59
CDM,27202916,PREVALON MAT,113.75,73.94,24.8,113.75,59
CDM,27202OH,OPEN TREATMENT COCCYGEAL FRACTURE,3216.0,2090.4,1.1,9440.12,144
CDM,27203066,TRANSEPTAL SHEATH AND WIRE-BAYLIS,1387.5,901.88,302.48,1387.5,59
CDM,27203076,ANGIODYNAMICS MED COMP MST KIT,239.75,155.84,52.27,239.75,59
CDM,27203086,ONO RETRIEVAL DEVICE,14523.3,9440.15,3166.08,14523.3,59
CDM,27203096,BOTOX CHEMODEVERVATION NEEDLE,95.38,62.0,20.79,95.38,59
CDM,27203106,STENT GRASPER,119.11,77.42,25.97,119.11,59
CDM,27203176,AVEIR LEADLESS DUAL PM INTRODUCER/SHEATH,6150.0,3997.5,200.93,6150.0,67
CDM,27203406,"CATH, BALLOON DIL NON-VASC C1726 1200",2400.0,1560.0,200.93,2400.0,67
CDM,27203420,W CATH DIAG STEERABLE ORBITER,1238.0,804.7,200.93,1238.0,67
CDM,27203596,AMBU DISPOSABLE FLEXIBLE CYSTOSCOPE,250.0,162.5,54.5,250.0,59
CDM,27203606,INDIRECT CALORIMETRY SUPPLY,55.68,36.19,12.14,55.68,59
CDM,27203646,HELIX LOCKING TOOL,50.0,32.5,10.9,50.0,59
CDM,27203726,"CATH, GUIDE C1887 161",322.0,209.3,70.2,322.0,67
CDM,27203996,AGILIS HISPRO SLITTER,70.0,45.5,15.26,232.66,67
CDM,27204056,FARAWAVE ELECTROPHYSIOLOGY ABLATION PFA CATHETER,16900.0,10985.0,200.93,16900.0,67
CDM,27204066,FARAPULSE ELECTROPHYSIOLOGY ABLATION CABLE,400.0,260.0,87.2,400.0,59
CDM,27204076,FARADRIVE ELECTROPHYSIOLOGICAL ABLATION STEERABLE SHEATH,2600.0,1690.0,200.93,2600.0,67
CDM,27204116,JETI ALL IN ONE NON-STERILE KIT,880.0,572.0,191.84,880.0,59
CDM,27204186,MEDTRONIC FLEXCATH CONTOUR STEERABLE SHEATH,4360.0,2834.0,200.93,4360.0,67
CDM,27204196,MEDTRONIC PULSESELECT PFA LOOP CATHETER,19500.0,12675.0,200.93,19500.0,67
CDM,27204206,MEDTRONIC PULSESELECT PFA CATHETER INTERFACE CABLE,1050.0,682.5,228.9,1050.0,59
CDM,27204216,PREVALON MATS,128.0,83.2,27.9,128.0,59
CDM,27204246,PRECISION POINT KIT,530.0,344.5,115.54,530.0,59
CDM,27204306,AERIN STYLUS,1900.0,1235.0,200.93,1900.0,67
CDM,27204326,POSISEP X,280.0,182.0,61.04,280.0,59
CDM,27204430,W CATH NON-BRAIDED,39.0,25.35,8.5,39.0,59
CDM,27204436,AGENT DCB,16950.0,11017.5,200.93,16950.0,74
CDM,27204436_IP,AGENT DCB,16950.0,11017.5,9288.6,9288.6,1
CDM,27204436_OP,AGENT DCB,16950.0,11017.5,7356.3,7356.3,1
CDM,27204440,W CATH NON-BRAIDED PIGTL FLUSH,39.0,25.35,8.5,39.0,59
CDM,27204546,SHILEY UNCUFFED,111.21,72.29,24.24,111.21,67
CDM,27204556,SHILEY CUFFED,123.59,80.33,26.94,123.59,67
CDM,27204566,SHILEY XLT CUFFED,110.01,71.51,23.98,110.01,67
CDM,27204576,SHILEY XLT UNCUFFED,110.01,71.51,23.98,110.01,67
CDM,27204586,TRACOE COMFORT UNCUFFED,247.5,160.88,36.52,247.5,67
CDM,27204596,TRACOE 304 UNCUFFED,77.82,50.58,16.96,77.82,67
CDM,27204606,TRACOE 314 UNCUFFED,106.09,68.96,23.13,106.09,67
CDM,27204616,TRACOE 301 CUFFED,79.45,51.64,17.32,79.45,67
CDM,27204626,TRACOE  303 UNCUFFED,73.41,47.72,16.0,73.41,67
CDM,27204636,TRACOE 313 UNCUFFED,106.94,69.51,23.31,106.94,67
CDM,27204646,HOOD TRACHEAL T TUBE STOMA STENT,295.86,192.31,31.69,295.86,67
CDM,27204656,HOOD STOMA STENT STRAIGHT,239.42,155.62,31.69,239.42,67
CDM,27204666,HOOD STOMA STENT CURVED,250.27,162.68,31.69,250.27,67
CDM,27204676,HOOD SPECIAL STRAIGHT STOMA STENT,438.17,284.81,31.69,438.17,67
CDM,27204686,HOOD SPECIAL CURVED STOMA STENT,512.76,333.29,31.69,512.76,67
CDM,27204766,"ASAHI HYDROPHILIC COATED SPRING COIL GUIDE WIRE, 1.5J CE, 0.35IN",80.0,52.0,17.44,232.66,67
CDM,27204876,CENTURION VASECTOMY SET,108.0,70.2,16.97,108.0,67
CDM,27204886,TRAY TRIALYSIS CATH DIALYSIS SHORT TERM,380.0,247.0,82.84,380.0,67
CDM,27204896,VERSACROSS ACCESS KIT,1850.0,1202.5,200.93,1850.0,67
CDM,27204906,KIT J STANDARD NARROW WIDE STYLET CLIP ON TOOL,128.0,83.2,27.9,128.0,59
CDM,27204916,FORCEPS BIPAL 7FR 2.2MM 104CM BIOPSY STR TIP FEM ART,350.0,227.5,76.3,350.0,59
CDM,27204926,KIT ARTERIAL RADIAL 20G X 8CM SAC CUSTOM,64.0,41.6,13.95,232.66,67
CDM,27204936,OSCAR PERIPHERAL MULTIFUNCT CATH,1240.0,806.0,200.93,1240.0,67
CDM,27204946,GUIDEWIRE .035IN ANGLE HYDROPHILIC VASC STIFF,70.0,45.5,15.26,232.66,67
CDM,27204956,TELEMARK MICROCATH PERCU SINGLE LUM,780.0,507.0,170.04,780.0,67
CDM,27204966,SHOCKWAVE L6 IVL CATH,6900.0,4485.0,200.93,6900.0,67
CDM,27204976,LAUNCHER CATHETER IMA,96.0,62.4,20.93,232.66,67
CDM,27204986,M1128 RADIATION SHIELD STRL DRAPE KIT,110.0,71.5,23.98,110.0,59
CDM,27204996,GUIDEWIRE VASC VC CONN FARADRIVE,1990.0,1293.5,200.93,1990.0,67
CDM,27205006,CPS AIM SLITTABLE INNER CATH,342.0,222.3,74.56,342.0,67
CDM,27205016,CPS DIRECT VASC GUIDE CATH,360.0,234.0,78.48,360.0,67
CDM,27205026,BASIXSKY INFLATION DEVICE,120.0,78.0,26.16,120.0,59
CDM,27205056,SHOCKWAVE E8 IVL CATHETER,9400.0,6110.0,200.93,9400.0,67
CDM,27205086,SHOCKWAVE E8 IVL CATHETER,14100.0,9165.0,3073.8,14100.0,59
CDM,27205136,OSCAR PERIPHERAL MULTIFUNCT CATH,1228.5,798.53,200.93,1228.5,67
CDM,27205140,W CATH URET,15.46,10.05,3.37,232.66,67
CDM,27205146,CATHETER SWAN-GANZ 7FR 110CM 4 LUMEN THERMODILUTION,53.9,35.04,11.75,53.9,59
CDM,27205156,FOCAL CATH TO GEN STERILE CBL,710.0,461.5,154.78,710.0,59
CDM,27205166,KIT STYLET ASSORTED 75CM UNIVERSAL J STRAIGHT REPOSITION CLIP ON,142.5,92.63,31.07,142.5,59
CDM,27205176,SELECTRA VASCULAR GUIDE-CATHETER,426.0,276.9,92.87,426.0,67
CDM,27205186,CELSIUS CARDIAC RADIO-FREQUECY ABLATION SYSTEM CATHETER,1378.0,895.7,200.93,1378.0,67
CDM,27205196,SUTURE SLEEVE,90.0,58.5,19.62,90.0,59
CDM,27205206,OPN NC 4.0 MM X 15 MM / 35 ATM / 6F SUPER HP PTCA BALLOON,2000.0,1300.0,436.0,2000.0,59
CDM,27205216,OPTICROSS HD CORONARY IMAGING CATHETERS,1406.5,914.23,200.93,1406.5,67
CDM,27205226,CATHETER TYSHAK II 8FR 18MM STANDARD MICROTHIN LOW PROFILE 100CM,1051.34,683.37,200.93,1051.34,67
CDM,27205236,IS4/DF4 ADA,94.0,61.1,20.49,94.0,59
CDM,27205286,OSCAR PERIPHERAL MULTIFUNCT CATH,1228.5,798.53,200.93,1228.5,67
CDM,27205296,PALADIN CAROTID PTA BALLOON SYSTEM WITH INTEGRATED EMBOLIC PROTE,2400.0,1560.0,200.93,2400.0,67
CDM,27205306,ENSITE PATIENT REFERENCE SENSOR,4800.0,3120.0,1046.4,4800.0,59
CDM,27205316,"CLOTTRIEVER CATHETER, VARIABLE LENGTHTHROMBECTOMY SUCTION CATHET",13000.0,8450.0,200.93,13000.0,67
CDM,27205326,"ATLAS PTA BALLOON DILATATIONCATHETER, LARGE DIAMETER",470.0,305.5,102.46,470.0,67
CDM,27205336,KIT 8.5FR 4IN INTRODUCER CUSTOM SHEATH PERCUTANEOUS,182.7,118.76,39.83,232.66,67
CDM,27205346,CATHETER R2P METACROSS BALLOON DILATATION RAPID EXCHANGE,520.0,338.0,113.36,520.0,67
CDM,27205356,CHECK-FLO PERFORMER INTRODUCER,193.64,125.87,42.21,232.66,67
CDM,27205366,AMULET STEERABLE DELIVERY SHEATH,2000.0,1300.0,200.93,2000.0,67
CDM,27205376,QDOT MICRO CATHETER,7162.0,4655.3,200.93,7162.0,67
CDM,27205386,"SWAM-GANZ THERMODILUTION VENOUS INFUSION PORT CATHETER, STANDARD",85.4,55.51,18.62,85.4,59
CDM,27205390,W CATHETER MAMMOSITE,56.0,36.4,12.21,232.66,67
CDM,27205406,EMERGE PTCA DILATATION CATHETER,110.0,71.5,23.98,232.66,67
CDM,27205416,OPTICROSS HD CORONARY IMAGING CATHETERS,1406.5,914.23,200.93,1406.5,67
CDM,27205446,AURYON ATHERECTOMY CATHETER EXIMO HYDROPHILIC COATED 4001,5590.0,3633.5,200.93,5590.0,67
CDM,27205456,AURYON ATHERECTOMY CATHETER EXIMO HYDROPHILIC COATED  4002,5590.0,3633.5,200.93,5590.0,67
CDM,27205466,NITREX PERIPHERAL VASCULAR GUIDEWIRE,220.0,143.0,47.96,232.66,67
CDM,27205476,"CATH, EP, 19 OR FEW ELECT, T34",3400.0,2210.0,200.93,3400.0,67
CDM,27205486,GUIDEWIRE POWERTURN,142.0,92.3,30.96,232.66,67
CDM,27205496,JADE PTA BALLOON DILATATION CATHETER PERCUTANEOUS TRANSLUMINAL A,270.0,175.5,58.86,270.0,67
CDM,27205556,BERMAN ANGIOGRAPHIC BALLOON CATHETER,204.0,132.6,44.47,232.66,67
CDM,27205566,"ADROIT GUIDING CATHETER, JL 3.5, SINGLE USE",74.0,48.1,16.13,232.66,67
CDM,27205576,FLOWTRIEVER PRICE PROCEDURE,22000.0,14300.0,4796.0,22000.0,59
CDM,27205616,THROMBECTOMY EMBOLECTOMY DEVICE EKOS+KIT,13570.0,8820.5,200.93,13570.0,67
CDM,27205626,CATHETER ADROIT TRUELUMEN 6FR .072IN AMPLATZ LEFT .75 CURVE BLUE,64.0,41.6,13.95,232.66,67
CDM,27205636,CATHETER EXIMO ATHERECTOMY 2MM - HYDROPHILIC COATED,5590.0,3633.5,200.93,5590.0,67
CDM,27205646,CHARGER OTW PTA BALLOON DILATATION CATHETER,220.0,143.0,47.96,232.66,67
CDM,27205696,PACLITAXEL-COATED PTA BALLOON CATHETER,2590.0,1683.5,200.93,2590.0,67
CDM,27205706,DCB 018 IPU06015020P D6.0 L150 UL0200,3080.0,2002.0,200.93,3080.0,67
CDM,27205716,RETRIEVAL CATHETER WITH PEEL AWAY SHEATH,19260.0,12519.0,200.93,19260.0,67
CDM,27205726,CATHETER ADROIT TRUELUMEN 6FR .072IN JUDKINS RIGHT 4 CURVE BLUE,74.0,48.1,16.13,232.66,67
CDM,27205736,CLEANER15 ROTATIONAL THROMBECTOMY SYSTEM,1992.0,1294.8,200.93,1992.0,67
CDM,27205746,"R2P CROSSTELLA RX PTA BALLOON, 200CM, 2MM X 100MM",520.0,338.0,113.36,520.0,67
CDM,27205756,"R2P CROSSTELLA RX PTA BALLOON, 200CM, 3MM X 100MM",520.0,338.0,113.36,520.0,67
CDM,27205766,"R2P CROSSTELLA RX PTA BALLOON, 200CM, 6MM X 150MM",520.0,338.0,113.36,520.0,67
CDM,27205770,W CLP WR ROTABLDR,20.5,13.33,4.47,232.66,67
CDM,27205776,CATHETER?CAT6X W/SONIC + LIGHTNING BOLT,15280.0,9932.0,200.93,15280.0,67
CDM,27205786,B BRAUN SET MULTI-SNARE RETRIEVAL SNARE CATHETER,553.56,359.81,120.68,553.56,67
CDM,27205796,"FREEZOR MAX 3, MEDIUM BLUE, CARDIAC CRYOABLATION CATH",3800.0,2470.0,200.93,3800.0,67
CDM,27205806,FARAWAVE 2.0 CATHETER,16900.0,10985.0,200.93,16900.0,67
CDM,27205816,PROGREAT MICROCATHETER SYSTEM,760.0,494.0,165.68,760.0,67
CDM,27205856,DRYSEAL FLEX INTRODUCER SHEATH,1154.0,750.1,200.93,1154.0,67
CDM,27205866,GORE DRYSEAL FLEX INTRODUCER SHEATH,2790.0,1813.5,200.93,2790.0,67
CDM,27205876,SPHERE-9 CATHETER,22000.0,14300.0,4796.0,22000.0,59
CDM,27205886,TUBING SET  HEXAFLOW,2000.0,1300.0,436.0,2000.0,59
CDM,27205896,CABLE EXTENSION,4000.0,2600.0,872.0,4000.0,59
CDM,27205906,PATCH LOCATION REF,10000.0,6500.0,2180.0,10000.0,59
CDM,27205916,SLITTABLE OUTER GUIDE CATHETER,360.0,234.0,78.48,360.0,67
CDM,27205926,FARAWAVE 2.0 NAV CATHETER,16900.0,10985.0,200.93,16900.0,67
CDM,27205936,FARAWAVE 2.0 NAV CATHETER,16900.0,10985.0,200.93,16900.0,67
CDM,27205966,"HALO SINGLE LOOP SNARE KIT 4F, 5MM X 20CM",74.0,48.1,16.13,232.66,67
CDM,27205976,BASIXSKY,80.0,52.0,17.44,80.0,59
CDM,27205986,NUVISION ICE CATHETER,6400.0,4160.0,200.93,6400.0,67
CDM,27205996,CATHETER VISIONS PV 8.5FR .035IN,1900.0,1235.0,414.2,1900.0,59
CDM,27206006,GUIDEWIRE HI-TORQUE SUPRA CORE,140.0,91.0,30.52,232.66,67
CDM,27206016,PULSED FIELD ABLATION CATHETER,16900.0,10985.0,3684.2,16900.0,59
CDM,27206026,CATHETER CONNECTION CABLE,400.0,260.0,87.2,400.0,59
CDM,27206036,ASSERT-IQ EL+ INSERTABLE CARDIAC MONITOR 49X9.4X4.4MM,7000.0,4550.0,1526.0,7000.0,59
CDM,27206046,"ADROIT GUIDING CATHETER, IM, SINGLE USE",74.0,48.1,16.13,232.66,67
CDM,27206056,CD LEYCOM PV CATHETER LIST WITH ELECTRODE SPACING,2980.0,1937.0,649.64,2980.0,59
CDM,27206066,CATHETER ADROIT TRUELUMEN 6FR .072IN AL1 CURVE BLUE YELLOW STAIN,74.0,48.1,16.13,232.66,67
CDM,27206075,"PROBE,ESOPHAGEAL,90072",6.24,4.06,1.36,6.24,59
CDM,27206076,CATHETER ADROIT TRUELUMEN 6FR .072IN AMPLATZ RIGHT 1 CURVE BLUE,74.0,48.1,16.13,232.66,67
CDM,27206086,DILATOR 14FR TAPER PLASTIC 70CM SURGICAL SHEATH LATEX SEPTUM,176.0,114.4,38.37,176.0,59
CDM,27206096,CATH GUIDE 100CM7FR LAUNCH AL.75 CURVE CORONARY NYLON LARGE LUME,78.0,50.7,17.0,232.66,67
CDM,27206136,ENDOFORM DRESSING,70.24,45.66,11.14,70.24,67
CDM,27206186,MEDPOR NOSTRIL RETAINER,250.0,162.5,54.5,250.0,67
CDM,27206196,"RECOR MEDICAL PARADISE RDN CATHETER(S), INTRAVASCULAR FOR RENAL",40000.0,26000.0,200.93,40000.0,67
CDM,27206206,HRAM 10 CHANNEL CATH,520.0,338.0,113.36,520.0,59
CDM,27206216,ARM 4 CHANNEL CATH,145.0,94.25,31.61,145.0,59
CDM,27206220,W DEV RETRIEV INS,683.0,443.95,148.89,683.0,67
CDM,27206226,ATRIEVE? VASCULAR SNARE KIT 6F,490.0,318.5,106.82,490.0,67
CDM,27206236,JETI? 6F CATHETER KIT,7480.0,4862.0,200.93,7480.0,67
CDM,27206316,ANGIOSCULPT EVO RX PTCA SCORING BALLOON CATHETER WITH HYDROPHILI,1660.0,1079.0,200.93,1660.0,67
CDM,27206346,AURYON ATHERECTOMY CATHETER,6000.0,3900.0,200.93,6000.0,67
CDM,27206356,R2P DESTINATION SLENDER GUIDING SHEATH,568.0,369.2,123.82,568.0,67
CDM,27206366,JAVELIN PERIPHERAL IVL CATHETER,9400.0,6110.0,2049.2,9400.0,59
CDM,27206376,ASAHI CROSSWALK STRAIGHT,330.0,214.5,71.94,330.0,67
CDM,27206386,VIPERWIRE GUIDEWIRE,300.0,195.0,65.4,300.0,67
CDM,27206396,CATHETER BERMAN  ANGIOGRAPHIC 2 LUMEN BALLOON SYRINGE,204.0,132.6,44.47,232.66,67
CDM,27206406,GLIDECATH HYDROPHYLIC COATED CATHETER,103.5,67.28,22.56,232.66,67
CDM,27206416,CATHETER ARMADA  BALLOON DILATATION OTW ACCEPTS,158.0,102.7,34.44,232.66,67
CDM,27206426,CPS LOCATOR 3D DELIVERY CATHETER AND DILATOR,360.0,234.0,78.48,360.0,67
CDM,27206436,TRUSTEER ACCESS SHEATH DILATOR,3000.0,1950.0,654.0,3000.0,59
CDM,27206446,R2P NAVICROSS CATHETER,830.0,539.5,180.94,830.0,67
CDM,27206456,FMD PERIPHERAL GUIDEWIRE,470.0,305.5,102.46,470.0,67
CDM,27206486,ARROWG+ARD BLUE (R) MAC (TM) TWO-LUMEN CENTRAL VENOUS ACCESS KIT,162.92,105.9,35.52,232.66,67
CDM,27206496,"LS SHEATH, PIGTAIL-DILATOR, STRAIGHT DILATOR, AMPLATZ WIRE",2000.0,1300.0,436.0,2000.0,59
CDM,27206516,IMPELLA FLEX RP SMART ASST,50000.0,32500.0,10900.0,50000.0,59
CDM,27206536,GEN 2 SMART TIP 190,700.0,455.0,152.6,700.0,67
CDM,27206546,CLEANER VAC? - 18F OD X 115CM ASPIRATION CATHETER WITH HANDPIECE,16000.0,10400.0,200.93,16000.0,67
CDM,27206556,ASAHI SILVERWAY,60.0,39.0,13.08,232.66,67
CDM,27206566,CLEANER VAC? ASPIRATION CANISTER,11000.0,7150.0,2398.0,11000.0,59
CDM,27206576,DOT PROV 4FR DL MAX 3CG,479.5,311.68,104.53,479.5,67
CDM,27206586,MST BASIC SET 2.6FR DL 50CM (CATH ONLY),294.0,191.1,64.09,294.0,67
CDM,27206596,VASCU-PICC MAX BARRIER 2.6FR DL 50CM,484.0,314.6,105.51,484.0,67
CDM,27206606,CATH PWRPICC PROVENA MAX 3FR SL,1054.14,685.19,200.93,1054.14,67
CDM,27206616,MAX BARRIER 3FR SL SPT,480.06,312.04,104.65,480.06,67
CDM,27206736,SAPPHIRE PRO II BALLOON CORNARY DILATATION CATHETER,170.0,110.5,37.06,232.66,67
CDM,27206746,SAPPHIRE NC 24 CORONARY DILATATION CATHETER,170.0,110.5,37.06,232.66,67
CDM,27206756,R2P METACROSS RX PTA BALLOON DILATATION CATHETER,520.0,338.0,113.36,520.0,67
CDM,27206766,"RX PTA BALLOON DILATATION CATHETER 5FR, 3MM X 40MM X 200CM",520.0,338.0,113.36,520.0,67
CDM,27206776,SAPPHIRE NC 24 CORONARY DILATATION CATHETER,170.0,110.5,37.06,232.66,67
CDM,27206786,"TOURGUIDE STEERABLE SHEATH, 6.5F",1150.0,747.5,200.93,1150.0,67
CDM,27206826,GORE MOLDING & OCCULSION BALLOON 4CM X 90CM,918.0,596.7,200.12,918.0,67
CDM,27206856,RUNTHROUGH NS CORONARY GUIDEWIRE,130.0,84.5,28.34,232.66,67
CDM,27206866,"STYLET NEEDLE?MOND RVOT STYLET, NORMAL RADIUS SOFT AND FIRM STYL",136.0,88.4,29.65,136.0,59
CDM,27206876,AGILIS? NXT STEERABLE INTRODUCER DUAL-REACH,2600.0,1690.0,200.93,2600.0,67
CDM,27206896,GUIDEWIRE 135,270.0,175.5,58.86,270.0,67
CDM,27206906,CATHETER VISTA BRITE TIP TRUELUMEN 7FR .078IN RENAL DOUBLE CURVE,119.4,77.61,26.03,232.66,67
CDM,27206936,TELEPORT CONTROL MICROCATHETER,1100.0,715.0,200.93,1100.0,67
CDM,27206946,TELEPORT MICROCATHETER,1100.0,715.0,200.93,1100.0,67
CDM,27206956,OSCAR PERIPHERAL MULTIFUNCTIONAL CATHETER,999.8,649.87,200.93,999.8,67
CDM,27206966,"CATHETER, DIAGNOSTIC 101",202.0,131.3,44.04,202.0,59
CDM,27206976,SYMPLICITY SPYRAL CATH RDN016,32000.0,20800.0,200.93,32000.0,67
CDM,27206986,CLEANER VAC THROMBECTOMY SYSTEM,16500.0,10725.0,200.93,16500.0,67
CDM,27206996,EGGPACK DISPOSABLE,434.0,282.1,94.61,434.0,59
CDM,27207006,BRITE TIP,50.22,32.64,10.95,232.66,67
CDM,27207016,DESTINATION PERIPHERAL GUIDING SHEATH,163.24,106.11,35.59,232.66,67
CDM,27207046,EZ GUIDE AORTIC CANNULA,152.0,98.8,33.14,152.0,59
CDM,27207056,PEDIATRIC EUROSET OXYGENATOR,2200.0,1430.0,479.6,2200.0,59
CDM,27207066,ADULT EUROSET OXYGENATOR,2200.0,1430.0,479.6,2200.0,59
CDM,27207076,SURGE LIFE SUPPORT VENOUS ECMO CANNULA,794.0,516.1,173.09,794.0,59
CDM,27207086,PRESSURE TRANDUCERS,560.0,364.0,122.08,560.0,59
CDM,27207096,MC3 OPUS INSERTION KIT GUIDEWIRE,300.0,195.0,65.4,300.0,59
CDM,27207106,ENDOSCOPE SINGLE USE IE DISPOSABLE URINARY TRACT IMAGING ILLUMIN,25.0,16.25,5.45,232.66,67
CDM,27207126,R2P CROSSTELLA RX PTA BALLOON,520.0,338.0,113.36,520.0,67
CDM,27207136,LIGHTNING FLASH CATHETER 115CM HTORQ ASPIRATION TUBING 6F CATHET,19300.0,12545.0,200.93,19300.0,67
CDM,27207146,CATHETER NAVICROSS HYDROPHILIC STAINLESS STEEL 150CM ANGIOGRAPHI,390.0,253.5,85.02,390.0,67
CDM,27207156,"ADVISOR HD GRID X, SENSOR ENABLED, HIGH DENSITY MAPPING CATHETER",5248.0,3411.2,200.93,5248.0,67
CDM,27207166,SOFT ANGLED RADIFOCUS GLIDEWIRE,142.0,92.3,30.96,232.66,67
CDM,27207176,TELEFLEX RINGER PTCA PERFUSION BALLOON,6200.0,4030.0,200.93,6200.0,67
CDM,27207196,NEVERTOUCH FRS KIT 21G,584.0,379.6,127.31,584.0,59
CDM,27207206,EVLT TUBING 4 METER INFILATRATON PUMP LASER,59.0,38.35,12.86,59.0,59
CDM,27207256,AGILIS NXT STEERABLE INTRODUCER 13FR MEDIUM CURL,2600.0,1690.0,200.93,2600.0,67
CDM,27207306,ARROW PSI KIT 8.5FR 4IN INTRODUCER,194.0,126.1,42.29,232.66,67
CDM,27207316,CABLE 6FT PACING TEMPORARY DISPOSABLE,50.0,32.5,10.9,50.0,59
CDM,27207326,GUIDEWIRE MINAMO,150.0,97.5,32.7,232.66,67
CDM,27207336,US RANGER DILATATION CATHETER BALLOON,3890.0,2528.5,200.93,3890.0,67
CDM,27207346,CATHETER LAUNCHER,78.0,50.7,17.0,232.66,67
CDM,27207356,SUBLIME MICROCATHETER,760.0,494.0,165.68,760.0,67
CDM,27207366,MEDTRONICTM ROTATABLE CONNECTOR,640.0,416.0,139.52,640.0,59
CDM,27207376,SSPC NXT PLUS WITH DELIVERY CATHETER AND DILATOR,700.0,455.0,152.6,700.0,67
CDM,27207386,VARIPULSE BI-DIRECTIONAL CATHETER,12346.0,8024.9,200.93,12346.0,67
CDM,27207396,"VERSACROSS RF WIRE, PIGTAIL, D0 SHEATH",3300.0,2145.0,200.93,3300.0,67
CDM,27207406,"VERSACROSS CONNECT RF WIRE, PIGTAIL, D0 TRANSSEPTAL DILATOR",1990.0,1293.5,200.93,1990.0,67
CDM,27207416,LAUNCHER GUIDING CATHETER,78.0,50.7,17.0,232.66,67
CDM,27207426,TYSHAK II BALLOON DILATATION CATH,1101.8,716.17,200.93,1101.8,67
CDM,27207436,VISTA BRITE TIP GUIDING CATHETER,74.0,48.1,16.13,232.66,67
CDM,27207446,"VISTA BRITE TIP GUIDING CATHETER, JUDKINS RIGHT CORONARY",74.0,48.1,16.13,232.66,67
CDM,27207456,US RANGER DILATATION CATHETER BALLOON,5790.0,3763.5,200.93,5790.0,67
CDM,27207466,DEVICE CATHETER FIXATION TRAPPER EXCHANGE,500.0,325.0,109.0,500.0,67
CDM,27207476,SUBLIME MICROCATHETER,760.0,494.0,165.68,760.0,67
CDM,27207486,SUBLIME RADIAL ACCESS GUIDING SHEATH,600.0,390.0,130.8,600.0,67
CDM,27207496,SUBLIME RADIAL ACCESS PTA BALLOON DILATATION CATHETER,594.0,386.1,129.49,594.0,67
CDM,27207506,PANNUS RETRACTOR CZ-PPR-XL,150.0,97.5,32.7,150.0,59
CDM,27207536,ELEMENT VASCULAR ACCESS SYSTEM,1800.0,1170.0,200.93,1800.0,67
CDM,27207546,GLIDEWIRE CARDIAC/PERIPHERAL VASCULAR GUIDEWIRE,142.0,92.3,30.96,232.66,67
CDM,27207556,DRUG-COATED BALLOON CATHETER,2580.0,1677.0,200.93,2580.0,67
CDM,27207566,SPUR PERIPHERAL RETRIEVABLE STENT SYSTEM,7990.0,5193.5,200.93,7990.0,67
CDM,27207586,VENTRAX DELIVERY SYSTEM,2000.0,1300.0,436.0,2000.0,59
CDM,27207596,PINNACLE DESTINATION GUIDING SHEATH,192.0,124.8,41.86,232.66,67
CDM,27207606,CROSPERIO RX PTA BALLOON DILATATION CATHETER,580.0,377.0,126.44,580.0,67
CDM,27207616,KIT DENALI SNARE 2 SHEATH RETRIEVAL,900.0,585.0,196.2,900.0,67
CDM,27207626,"SPEX LP SHAPEABLE SUPPORT CATHETER, US",320.0,208.0,69.76,320.0,67
CDM,27207666,BSW NUVISION,6400.0,4160.0,200.93,6400.0,67
CDM,27207676,WORLEY VEIN SELECTOR STD CURVE,248.0,161.2,54.06,248.0,67
CDM,27207686,WORLEY LVI SYSTEM RENAL 5.5F,840.0,546.0,183.12,840.0,59
CDM,27207696,WORLEY ADVANCED CSG STANDARD,630.0,409.5,137.34,630.0,67
CDM,27207706,STRYKER MATS,123.0,79.95,26.81,123.0,59
CDM,27207716,VARIPULSE INTERFACE CABLE,1374.0,893.1,299.53,1374.0,59
CDM,27207726,CARDINAL PERIPHERAL VASCULAR PACK,150.0,97.5,32.7,150.0,59
CDM,27207736,CARDINAL PACK SURGICAL CUSTOM ANGIOGRAPHY,84.0,54.6,18.31,84.0,59
CDM,27207746,CATH ART 7.5FR THRMDIL,54.0,35.1,11.77,232.66,67
CDM,27207756,MULTIFLEX PENTALUMEN 7FR,96.0,62.4,20.93,96.0,59
CDM,27207766,KIT MAC ARROWG+ARD BLUE ARROW ADVANCER 9FR,272.0,176.8,59.3,272.0,67
CDM,27207776,SUPREME QUAD CRD-2 4FR,278.0,180.7,60.6,278.0,67
CDM,27207786,AMPLATZER SIZING BALLOON II 24MM X 70CM,682.0,443.3,148.68,682.0,59
CDM,27207976,QUELIMMUNE HUD,7500.0,4875.0,1635.0,7500.0,59
CDM,27208230,W EMBLIC PRTCTN RX ACCNT SYS,1755.0,1140.75,200.93,1755.0,67
CDM,27208990,W GDNG INTRDCR FAST CTH 60CM,240.0,156.0,52.32,240.0,67
CDM,27209020,W GDNG SHTH STRGHT CRSS-CUT VLV,179.0,116.35,39.02,232.66,67
CDM,27209340,W GINTRO EP IC FC,69.0,44.85,15.04,232.66,67
CDM,27209845,DIFFICULT AIRWAY KIT,116.42,75.67,25.38,116.42,59
CDM,27209895,ESOPHAGEAL STETHOSCOPE,5.88,3.82,1.28,5.88,59
CDM,27209915,GLIDESCOPE BLADE DISP,28.58,18.58,6.23,28.58,59
CDM,27210005,LMA - DISPOSABLE,27.0,17.55,5.89,27.0,59
CDM,27210045,OTHER NERVE BLOCK KIT,43.14,28.04,9.4,43.14,59
CDM,27210075,PROBE COVERS SURGICAL,29.0,18.85,6.32,29.0,59
CDM,27212035,F/G 5FR CONE TIP URET CATHR,23.6,15.34,5.14,23.6,59
CDM,27212405,NEB AERO RAINDROP TEE SM VOL,1.58,1.03,0.34,1.58,59
CDM,27212600,W NDL BRACHYTHRPY,174.0,113.1,37.93,232.66,67
CDM,27212910OH,W NDLE ECHOTIP DISPOSABLE CHIBA,318.0,206.7,1.1,318.0,70
CDM,27213010,W NEEDLE CRYO SEEDNET ICEROD EA,2430.0,1579.5,200.93,2430.0,67
CDM,27213035,NDL PORT 1IN 20GA + HUBER,85.37,55.49,18.61,85.37,59
CDM,27213045,KIT DRSG CHNG CUST,4.76,3.09,1.04,4.76,59
CDM,27214430,W PROGRAM PT INTERSTIM 3031A,1335.0,867.75,200.93,1335.0,67
CDM,27214555,LIVER BIOPSY RTPS 100,746.7,485.36,162.78,746.7,59
CDM,27214565,"DIAMOND, COURIER",366.96,238.52,80.0,366.96,59
CDM,27214635,COOK VASC RETRIEVAL FORCE,176.6,114.79,38.5,176.6,59
CDM,27214645,CORDIS GUIDING CATHETER,243.13,158.03,53.0,243.13,59
CDM,27214665,ENVOY GUIDING CATHETER 6F,460.53,299.34,100.4,460.53,59
CDM,27214675,LABS 200 LIVER BIOPSY SET,721.18,468.77,157.22,721.18,59
CDM,27214685,MICROVENA 4MM GOOSENECK SNARE,400.89,260.58,87.39,400.89,59
CDM,27214695,MICROVENA 25MM SNARE,555.68,361.19,121.14,555.68,59
CDM,27214705,CORDIS TRANSIT MICROCATH,565.53,367.59,123.29,565.53,59
CDM,27214715,US CATHETER W/RADEOPAQUE TIP,217.59,141.43,47.43,217.59,59
CDM,27214745,REPAIR KIT FOR HICKMAN,107.7,70.01,23.48,107.7,59
CDM,27214755,COIL PUSHER (401216),347.27,225.73,75.7,347.27,59
CDM,27214765,CONNECTING CABLE SET FOR GDC,260.96,169.62,56.89,260.96,59
CDM,27214775,MOTOR DRIVE UNIT,160.74,104.48,35.04,160.74,59
CDM,27214785,INFLATION DEVICE,49.6,32.24,10.81,49.6,59
CDM,27214795,VPI URETERAL BRUSH BX SET,76.35,49.63,16.64,76.35,59
CDM,27214825,MICROPUNCTURE SHEATH SET,45.28,29.43,9.87,45.28,59
CDM,27214835,GASTROSTOMY SET,190.22,123.64,41.47,190.22,59
CDM,27214845,ANCHOR SUTURE SET,81.98,53.29,17.87,81.98,59
CDM,27214855,GLIDECATHETERS,89.1,57.92,19.42,89.1,59
CDM,27214895,SYMMETRY BALLOON,241.11,156.72,52.56,241.11,59
CDM,27214945,MICROCATHETER PROWLER 10 & 14,214.14,139.19,46.68,214.14,59
CDM,27214975,RANGER BALLOON,587.95,382.17,128.17,587.95,59
CDM,27214985,LE MAITRE STENT GUIDE,18.37,11.94,4.0,18.37,59
CDM,27215025,ANGIOFLUSH FLUID MGT/COLL BAG,144.01,93.61,31.39,144.01,59
CDM,27215035,TUOHY Y CONNECTOR,40.64,26.42,8.86,40.64,59
CDM,27215055,TRANSGASTRIC JEJUNAL TUBE,268.66,174.63,58.57,268.66,59
CDM,27215115,LUMBAR DRAINAGE KIT,114.57,74.47,24.98,114.57,59
CDM,27215145,D-STAT FLOWABLE HEMOSTAT,99.34,64.57,21.66,99.34,59
CDM,27215195,CATHETER ACCESS PORT KIT,400.89,260.58,87.39,400.89,59
CDM,27215215,BIOPSY FORCEPS,254.89,165.68,55.57,254.89,59
CDM,27215285,TRANSJUGULAR BIOPSY NEEDLE,355.46,231.05,77.49,355.46,59
CDM,27215295,ENDOTRACHEAL TUBE,63.05,40.98,13.74,63.05,59
CDM,27215305,DOUBLE LUMEN ENDOTRACHEAL TUBE,29.52,19.19,6.44,29.52,59
CDM,27215465,LMA NON-DISPOSABLE,29.52,19.19,6.44,29.52,59
CDM,27215605,ANGIODYNAMICS 6FR CATH,36.74,23.88,8.01,36.74,59
CDM,27215635,KYPHON INTRODUCER TOOL KIT,1628.0,1058.2,354.9,1628.0,59
CDM,27215675,MARINE PLOYMERTECH SYVEK PATCH,205.0,133.25,44.69,205.0,59
CDM,27215685,ALLIGATOR DEVICE,3375.0,2193.75,735.75,3375.0,59
CDM,27215735,CARDINAL HEALTH TRAY,383.24,249.11,83.55,383.24,59
CDM,27215865,ANG-DYN THERMODILUTION CATHETE,142.92,92.9,31.16,142.92,59
CDM,27215875,COOK TRANS-JUG LIVER ACCESS,959.0,623.35,209.06,959.0,59
CDM,27215895,KYPHON KPT-1502 FIRST FX KIT,8777.0,5705.05,1913.39,8777.0,59
CDM,27215915,ROSS MODIFIED TRANSSEPTAL NDL,142.92,92.9,31.16,142.92,59
CDM,27215955,COOK G361236HASKAL TIP ACCESS,828.75,538.69,180.67,828.75,59
CDM,27215985,SUROS ATEC HANDPIECE NEEDLE,231.61,150.55,50.49,231.61,59
CDM,27215OH,OPTX ILIAC TUBRST AVLS/WING FX FIXJ IF PRFRMD,4180.0,2717.0,1.1,4180.0,112
CDM,27216065,COOK NEFF ACCESS KIT W/COATING,126.07,81.95,27.48,126.07,59
CDM,27216075,GUIDANT EMBOLIC PROTECT SYSTEM,3974.0,2583.1,866.33,3974.0,59
CDM,27216135,TOPICAL SKIN ADHESIVE,40.24,26.16,8.77,40.24,59
CDM,27216195,BACTSEAL EVD CATHETER SET,660.0,429.0,143.88,660.0,59
CDM,27216205,NEURON SELECT CATHETER,1425.0,926.25,310.65,1425.0,59
CDM,27216225,CELERO CORE BIOPSY DEVICE,338.0,219.7,73.68,338.0,59
CDM,27216255,PENUMBRA ASPIRATION TUBING,525.0,341.25,114.45,525.0,59
CDM,27216285,PENUMBRA REPERFUSION CATH,2267.0,1473.55,494.21,2267.0,59
CDM,27216295,CUSTOM WASTEBAG KIT,73.41,47.72,16.0,73.41,59
CDM,27216315,BILIARY DRAINAGE KIT,170.29,110.69,37.12,170.29,59
CDM,27216325,NEPHROSTOMY DRAINAGE KIT,93.62,60.85,20.41,93.62,59
CDM,27216345,US CLIP SENOREX GEL MARK,143.5,93.28,31.28,143.5,59
CDM,27216355,US ULTRA CLIP RIBN/WING SHAPE,131.25,85.31,28.61,232.66,67
CDM,27216375,COOL TIP RF CLUSTER TIP PROBE,2362.5,1535.63,515.03,2362.5,59
CDM,27216385,COOL TIP RF PROBE,1788.75,1162.69,389.95,1788.75,59
CDM,27216395,DETACHMENT HANDLE AND CATH,1395.0,906.75,304.11,1395.0,59
CDM,27216405,STRYKER DETACHMENT SYSTEM,292.5,190.13,63.77,292.5,59
CDM,27216515,POWERWIRE RADIOFREQ GUIDEWIRE,5000.0,3250.0,1090.0,5000.0,59
CDM,27216535,TREVO PRO SYSTEM STRYKER,8971.09,5831.21,1955.7,8971.09,59
CDM,27216545,PLEURX VACUUM BOTTLE,66.5,43.23,14.5,66.5,59
CDM,27216555,GASTROINTESTINAL ANCHOR SET,190.31,123.7,41.49,190.31,59
CDM,27216565,CAPNOFLEX 1F ORL/NSL CANNULA,14.48,9.41,3.16,14.48,59
CDM,27216575,CAPNOFLX 1R NSL C02 SMPL CANN,17.72,11.52,3.86,17.72,59
CDM,27216635,ENDOTRACHEAL TUBE,63.05,40.98,13.74,63.05,59
CDM,27216655,LMA DISPOSABLE,29.52,19.19,6.44,29.52,59
CDM,27216OH,PERQ SKELETAL FIXATION PST PELVIC BONE FX&/DIS,6292.0,4089.8,1.1,6292.0,112
CDM,27217595,NEUROMUSCULAR STIM NEEDLE,311.49,202.47,67.9,311.49,59
CDM,27217605,IMPLANTED PUMP REFILL KIT,46.0,29.9,10.03,46.0,59
CDM,27217615,CELL SAVER TRANSFER,97.5,63.38,21.26,97.5,59
CDM,27217635,ESOPHAGEAL STETHOSCOPE,5.88,3.82,1.28,5.88,59
CDM,27217645,CONTINUOUS PA CATHETER,337.5,219.38,73.58,337.5,59
CDM,27217655,RMI FEM 20 FR PERC.,257.99,167.69,56.24,257.99,59
CDM,27217665,6 FT. 3/8 TUBING,63.0,40.95,13.73,63.0,59
CDM,27217675,AXIOM VEN 28 FR.,226.5,147.23,49.38,226.5,59
CDM,27217685,RMI VEN 32 FR,55.62,36.15,12.13,55.62,59
CDM,27217705,"CHEST DRAIN 3/8"" X 6"" TUBING",44.0,28.6,9.59,44.0,59
CDM,27217715,RACZ CATH,517.02,336.06,112.71,517.02,59
CDM,27217725,RACZ RK NEEDLE,196.96,128.02,42.94,196.96,59
CDM,27217735,"SMK NEEDLE 2""",300.0,195.0,65.4,300.0,59
CDM,27217745,"SMK NEEDLE 5""",300.0,195.0,65.4,300.0,59
CDM,27217775,22 GAUGE BEADED NEEDLE,22.06,14.34,4.81,22.06,59
CDM,27217785,ARGYLE ART. 21 FR,352.93,229.4,76.94,352.93,59
CDM,27217795,RMI FEM 18 FR PERC.,371.49,241.47,80.98,371.49,59
CDM,27217805,RMI FEM PIK A,84.89,55.18,18.51,84.89,59
CDM,27217815,DLP VEN 28FR,37.38,24.3,8.15,37.38,59
CDM,27217825,DLP VEN 24FR,38.94,25.31,8.49,38.94,59
CDM,27217845,RMI VEN 18 FR PERC,297.0,193.05,64.75,297.0,59
CDM,27217855,RMI VEN 20 FR PERC,297.0,193.05,64.75,297.0,59
CDM,27217865,RMI VEN 28 FR PERC,297.0,193.05,64.75,297.0,59
CDM,27217875,RMI VEN PIK V,84.89,55.18,18.51,84.89,59
CDM,27217885,RMI VEN OPT GUIDE,30.0,19.5,6.54,30.0,59
CDM,27217895,GAS FILTER,20.48,13.31,4.46,20.48,59
CDM,27217915,SAMPLE COUPLER,12.24,7.96,2.67,12.24,59
CDM,27217925,PURGE LINES,18.0,11.7,3.92,18.0,59
CDM,27217935,RAPID PRIME,24.6,15.99,5.36,24.6,59
CDM,27217955,1/4 X 3/8 REDUCER,9.72,6.32,2.12,9.72,59
CDM,27217975,3/8 Y,8.0,5.2,1.74,8.0,59
CDM,27217995,WORD CATHETER,1.31,0.85,0.29,1.31,59
CDM,27217OH,OPTX ANT PELVIC BONE FX&/DISLC INT FIXJ IF PFR,6446.0,4189.9,1.1,6446.0,112
CDM,27218005,"6"" SPINAL NEEDLE",9.02,5.86,1.97,9.02,59
CDM,27218035,"17 G 3 1/2"" TUOHY EPI NEEDLE",158.95,103.32,34.65,158.95,59
CDM,27218055,BLOOD WARMING CASSETTE,26.26,17.07,5.72,26.26,59
CDM,27218065,CARDIAC OUTPUT KIT,25.0,16.25,5.45,25.0,59
CDM,27218075,G TUBES,67.7,44.01,14.76,67.7,59
CDM,27218085,CVP KIT DOUBLE LUMEN 7 FR,41.66,27.08,9.08,41.66,59
CDM,27218105,CVP KIT MULTI LUMEN 7 FR,41.66,27.08,9.08,41.66,59
CDM,27218115,LEVEL ONE SET: D60,72.54,47.15,15.81,72.54,59
CDM,27218125,LEVEL ONE SET: D100,113.31,73.65,24.7,113.31,59
CDM,27218135,LMA - DISPOSABLE,27.0,17.55,5.89,27.0,59
CDM,27218145,MEAN ART LINE KIT,11.62,7.55,2.53,11.62,59
CDM,27218155,SWAN-GANZ CATHETER 7.5 FR,40.98,26.64,8.93,40.98,59
CDM,27218165,TRIFURCATED ART LINE KIT,17.32,11.26,3.78,17.32,59
CDM,27218175,RAPID INFUSION PACK,1840.03,1196.02,401.13,1840.03,59
CDM,27218185,MICROLARYNGEAL TRACH TUBE,20.32,13.21,4.43,20.32,59
CDM,27218195,REINFORCED TRACH TUBE,19.42,12.62,4.23,19.42,59
CDM,27218205,SHINOBI GUIDE WIRE,179.28,116.53,39.08,179.28,59
CDM,27218215,HEPCON/HMS,28.0,18.2,6.1,28.0,59
CDM,27218225,MANNITOL FILTER .22,3.22,2.09,0.7,3.22,59
CDM,27218235,12 FR 3 LUMEN (AK-12123H),119.54,77.7,26.06,119.54,59
CDM,27218245,SPINAL DRAINAGE TRAY,242.55,157.66,52.88,242.55,59
CDM,27218255,SPINAL DRAINAGE BAG,66.0,42.9,14.39,66.0,59
CDM,27218265,BRONCHIAL BLOCKER,225.0,146.25,49.05,225.0,59
CDM,27218305,AQUACEL HYDROFIBER DRESSING 6X,8.0,5.2,1.74,8.0,59
CDM,27218315,INTRATHECAL CATH KIT,206.58,134.28,45.03,206.58,59
CDM,27218325,AIRWAY EXCHANGE CATHETER,87.5,56.88,19.08,87.5,59
CDM,27218345,ARNDT BRONCHIAL BLOCKER,197.75,128.54,43.11,197.75,59
CDM,27218355,CARMEDA ARTERIAL CANNULA,160.13,104.08,34.91,160.13,59
CDM,27218365,"SMK NEEDLE 6""",337.5,219.38,73.58,337.5,59
CDM,27218375,GILL VENT,21.52,13.99,4.69,21.52,59
CDM,27218385,HEPARIN FREE PA CATHETER,39.66,25.78,8.65,39.66,59
CDM,27218395,CANNULA VENOUS PERC FR 15-23CM,200.7,130.46,43.75,200.7,59
CDM,27218415,DLP VENOUS CANNULA,58.0,37.7,12.64,58.0,59
CDM,27218435,CARDIO ALEGIA BATCHES,11.33,7.36,2.47,11.33,59
CDM,27218575,"INTRODUCER KIT, 9FR, MAC",119.51,77.68,26.05,119.51,59
CDM,27218585,DLP VEN 28FR FEM,218.75,142.19,47.69,218.75,59
CDM,27218625,SLIC CATHETER SINGLE LUMENT,5.72,3.72,1.25,5.72,59
CDM,27218635,GUIDEWIRE,27.0,17.55,5.89,27.0,59
CDM,27218655,RAPID INFUSION CATH SET,24.0,15.6,5.23,24.0,59
CDM,27218715,ENDOBRONCHIAL DBL LUMEN TUBE,89.06,57.89,19.42,89.06,59
CDM,27218725,ARTERIAL LINE KIT,18.6,12.09,4.05,18.6,59
CDM,27218735,CVP KIT - 16GA 3 LUMEN,41.66,27.08,9.08,41.66,59
CDM,27218755,"CVP KIT, TRIPLE LUMEN 5.5FR",65.54,42.6,14.29,65.54,59
CDM,27218765,SWAN GANZ KIT INTRODUCER,39.68,25.79,8.65,39.68,59
CDM,27218775,QUAD LINE KIT-SPECTRAMED,24.86,16.16,5.42,24.86,59
CDM,27218785,INTRODUCER KIT 9FR,238.48,155.01,51.99,238.48,59
CDM,27218795,BELMONT FLUID SYSTEM KIT,316.64,205.82,69.03,316.64,59
CDM,27218915,CATH RETENT/FOLEY 5CC 24 FR,11.0,7.15,2.4,11.0,59
CDM,27218OH,OPTX POST PEL BONE FX&/DISLC INT FIXJ IF PFRMD,8372.0,5441.8,1.1,8372.0,112
CDM,27219025,"CATHETER, INTRATHECAL, #8709",742.5,482.63,161.87,742.5,59
CDM,27219035,OFF PUMP PLEGIA (NAVIA),99.07,64.4,21.6,99.07,59
CDM,27219045,DIFFICULT AIRWAY KIT,116.42,75.67,25.38,116.42,59
CDM,27219105,SET PCA PUMP PERIPHERAL 560112,6.14,3.99,1.34,6.14,59
CDM,27219345,CONTIPLEX STIMULATING NEEDLE,238.52,155.04,52.0,238.52,59
CDM,27219355,CONTIPLEX STIMULATING NEEDLE,84.34,54.82,18.39,84.34,59
CDM,27219895,SURGICELL HEMOSTAT 2 X 3,112.0,72.8,24.42,112.0,59
CDM,27219955,FEMORAL ARTERIAL LINE KIT,38.76,25.19,8.45,38.76,59
CDM,27219965,"KIT, TUNNELER/CONNECTOR FU245",288.0,187.2,62.78,288.0,59
CDM,27219975,LATEX-FREE PA CATHETER,375.0,243.75,81.75,375.0,59
CDM,27219980,W CATH ABLATION EZ STEER NAV,60.0,39.0,13.08,232.66,67
CDM,27220015,SPINAL NEEDLE 4.75 IN,26.0,16.9,5.67,26.0,59
CDM,27220025,SPINAL NEEDLE 3.5 IN,21.76,14.14,4.74,21.76,59
CDM,27220035,CDS DISPOSABLE SET,250.0,162.5,54.5,250.0,59
CDM,27220185,OTHER NERVE BLOCK KIT,43.14,28.04,9.4,43.14,59
CDM,27220205,CONTINUOUS CATHETER BLOCK KIT,107.35,69.78,23.4,107.35,59
CDM,27220215,PARAVERTEBRAL BLOCK KIT,37.0,24.05,8.07,37.0,59
CDM,27220225,SPINAL PRESSURE MONITORING KIT,280.5,182.33,61.15,280.5,59
CDM,27220485,"HI FLOW O2 SETUP, ANY TYP",64.75,42.09,14.12,64.75,59
CDM,27220555,LMA DISPOSABLE,29.52,19.19,6.44,29.52,59
CDM,27220865,ENDOTRACHEAL TUBE,63.05,40.98,13.74,63.05,59
CDM,27220970,W CATH ANG 135CM CROSSBOSS,1417.5,921.38,200.93,1417.5,67
CDM,27220OH,CLTX ACETABULUM HIP/SOCKT FX W/O MANJ,2420.0,1573.0,1.1,2420.0,148
CDM,27221165,"GAUZE PACK I000 1/4"" X 5YD",82.95,53.92,18.08,82.95,59
CDM,27221200,W CATH EP 6FR 110CM 2-10-2MM,1665.0,1082.25,200.93,1665.0,67
CDM,27221285,SPINAL TRAY-22 GAUGE,21.5,13.98,4.69,21.5,59
CDM,27221300,W CATH GUID EP FINECROSS,900.0,585.0,196.2,900.0,67
CDM,27221335,SPINAL TRAY-WHITACRE,23.76,15.44,5.18,23.76,59
CDM,27221355,PENROSE DRAIN 91802,37.63,24.46,8.2,37.63,59
CDM,27221395,NEEDLE SPINAL 25 #5180,10.39,6.75,2.27,10.39,59
CDM,27221455,EPIDURAL KIT B BRAUN,41.2,26.78,8.98,41.2,59
CDM,27221595,AQUACEL SILVER 4X4,22.0,14.3,4.8,22.0,59
CDM,27221645,"HUBER NEEDLE 22X.75"" #604210",2.82,1.83,0.61,2.82,59
CDM,27221675,SPYGLASS DIRECT VISUAL PROBE,530.0,344.5,115.54,530.0,59
CDM,27221685,SPYGLASS DELIVERY CATHETER,975.0,633.75,212.55,975.0,59
CDM,27221695,SPYBITE BIOPSY FORCEP,525.0,341.25,114.45,525.0,59
CDM,27221705,INTRADUCTAL LITHOTRIPSY FIBER,442.0,287.3,96.36,442.0,59
CDM,27221715,STRYKER INTRODUCER W/STYLET,1050.0,682.5,228.9,1050.0,59
CDM,27221725,SINERGY RFA SIJ KIT,362.85,235.85,79.1,362.85,59
CDM,27221735,ENDOCLAMP AORTIC CATH,7400.0,4810.0,1613.2,7400.0,59
CDM,27221745,PICC LINE KIT,247.5,160.88,53.96,247.5,59
CDM,27221755,PROBE COVERS SURGICAL,33.0,21.45,7.19,33.0,59
CDM,27221765,SURG-TIP TRANSDUCERS COVERS,33.0,21.45,7.19,33.0,59
CDM,27221785,"SPRINGWIRE 0.18""",7.82,5.08,1.7,7.82,59
CDM,27221795,"SPRINGWIRE 0.21""",7.16,4.65,1.56,7.16,59
CDM,27221805,"BABYWIRE 0.12"" BY 18 CM",24.4,15.86,5.32,24.4,59
CDM,27221815,PIC NEEDLE,42.0,27.3,9.16,42.0,59
CDM,27221825,MICROINTRODUCER KIT,165.0,107.25,35.97,165.0,59
CDM,27221835,"HI FLOW O2 SETUP, ANY TYP",64.75,42.09,14.12,64.75,59
CDM,27221855,BRIDAL NASAL TUBE,131.0,85.15,28.56,131.0,59
CDM,27221865,"CORTRAK 10 FR FEED TUBE - 43""",120.0,78.0,26.16,120.0,59
CDM,27221875,"CORTRAK 10 FR FEED TUBE - 55""",120.0,78.0,26.16,120.0,59
CDM,27221885,"CORTRAK 8 FR FEED TUBE -43""",120.0,78.0,26.16,120.0,59
CDM,27221915,MEDTRONIC ANTENNA RESTORE,136.5,88.73,29.76,136.5,59
CDM,27221935,AEROSOL CLOUD ENHANCER,10.92,7.1,2.38,10.92,59
CDM,27221945,BAIR HUGGER - LITHOTOMY,35.1,22.82,7.65,35.1,59
CDM,27221955,CENTRAL LINE DRAPE,5.98,3.89,1.3,5.98,59
CDM,27221965,GLIDESCOPE BLADE DISP,28.58,18.58,6.23,28.58,59
CDM,27221975,MICROPUNCTURE INTRO SET,61.25,39.81,13.35,61.25,59
CDM,27221995,RACZ RK NEEDLE,196.96,128.02,42.94,196.96,59
CDM,27222005,UNIBLOCKER BRONCHIAL BLOCKER,218.75,142.19,47.69,218.75,59
CDM,27222015,HEMO CLIP,245.0,159.25,53.41,245.0,59
CDM,27222025,LIGATION BAND,277.5,180.38,60.5,277.5,59
CDM,27222035,NEEDLE KNIFE,240.0,156.0,52.32,240.0,59
CDM,27222045,"INTRODUCER, BOUGIE 15FR",9.02,5.86,1.97,9.02,59
CDM,27222055,EPIDURAL KIT ARROW,40.0,26.0,8.72,40.0,59
CDM,27222065,RFA LUMBAR COOLED KIT,1125.0,731.25,245.25,1125.0,59
CDM,27222075,RFA THORACIC COOLED KIT,1125.0,731.25,245.25,1125.0,59
CDM,27222085,BAIR HUGGER-FULL BODY,50.0,32.5,10.9,50.0,59
CDM,27222095,SLIC CATHETER 3 LUMEN MAC,33.0,21.45,7.19,33.0,59
CDM,27222105,BAIR HUGGER CARDIAC STERILE,50.28,32.68,10.96,50.28,59
CDM,27222115,A-LINE ADD-ON KIT,12.9,8.39,2.81,12.9,59
CDM,27222125,COOK AIRWAY EXC CATH 8-19 FR,75.0,48.75,16.35,75.0,59
CDM,27222135,RACZ CATH,517.02,336.06,112.71,517.02,59
CDM,27222145,RACZ RK NEEDLE,196.96,128.02,42.94,196.96,59
CDM,27222155,LMA SUPREME 3,26.44,17.19,5.76,26.44,59
CDM,27222185,HEATED CIRCUIT,10.97,7.13,2.39,10.97,59
CDM,27222195,BLANKET WARMING -  SPINAL,26.23,17.05,5.72,26.23,59
CDM,27222205,EDWARDS AOR ART STRT,432.0,280.8,94.18,432.0,59
CDM,27222215,EDWARDS AOR ART ANGLD,432.0,280.8,94.18,432.0,59
CDM,27222225,LMA 4 FLEXIBLE,37.0,24.05,8.07,37.0,59
CDM,27222235,DLP VEN 22 FR STR,26.0,16.9,5.67,26.0,59
CDM,27222245,"FINGER SPLINT, STATIC",46.0,29.9,10.03,46.0,59
CDM,27222275,COHEN ENDOBRONCH BLOCKER 9.0FR,262.5,170.63,57.23,262.5,59
CDM,27222295,TIP BONE CLEANING,173.67,112.89,37.86,173.67,59
CDM,27222305,SUCTION IRRIGATOR HAND PIECE,259.25,168.51,56.52,259.25,59
CDM,27222315,PAJUNK SONOTAP CANN 21GA,30.0,19.5,6.54,30.0,59
CDM,27222355,SCS POCKET ADAPTOR,742.5,482.63,161.87,742.5,59
CDM,27222385,AINTREE INTUBATION CATHETER,77.0,50.05,16.79,77.0,59
CDM,27222395,AIRWAY EXCHANGE CATHETER,77.0,50.05,16.79,77.0,59
CDM,27222405,SORIN LG6 FILTER PACK,239.75,155.84,52.27,239.75,59
CDM,27222415,AERONEB NEBULIZER,70.0,45.5,15.26,70.0,59
CDM,27222435,"PROBE COVER, GNRL 15 X 122CM",132.0,85.8,28.78,132.0,59
CDM,27222445,DILATOR SYRINGE,231.0,150.15,50.36,231.0,59
CDM,27222455,INJECTOR NEEDLE,218.75,142.19,47.69,218.75,59
CDM,27222465,PEDIATRIC ECMO PACK,2963.25,1926.11,645.99,2963.25,59
CDM,27222475,ADULT ECMO PACK,684.0,444.6,149.11,684.0,59
CDM,27222485,ROTAFLOW PUMPHEAD,486.0,315.9,105.95,486.0,59
CDM,27222505,ADULT QUADROX OXYGENATOR,1613.25,1048.61,351.69,1613.25,59
CDM,27222575,4 X 4 GENTLE DRESSING,5.98,3.89,1.3,5.98,59
CDM,27222595,MCGRATH MAC BLADE SZ4,16.0,10.4,3.49,16.0,59
CDM,27222615,ENDOSCOPIC SCISSORS 2.8 MM,851.29,553.34,185.58,851.29,59
CDM,27222625,RAT TOOTH FORCEPS,688.25,447.36,150.04,688.25,59
CDM,27222645,EMBOL-X CANNULA,885.26,575.42,192.99,885.26,59
CDM,27222655,MILD KIT,2835.0,1842.75,200.93,2835.0,74
CDM,27222655_IP,MILD KIT,2835.0,1842.75,1553.58,1553.58,1
CDM,27222655_OP,MILD KIT,2835.0,1842.75,1230.39,1230.39,1
CDM,27222685,TRAY PROC HEMODIALYSIS NO CATH,84.0,54.6,18.31,84.0,59
CDM,27222705,MEDTRONIC ANCHOR SEAL,217.0,141.05,47.31,217.0,59
CDM,27222715,THERAPY MANAGER MEDTRONICS,1125.0,731.25,245.25,1125.0,59
CDM,27222735,GI DOPLLER PROBE,239.75,155.84,52.27,239.75,59
CDM,27222745,PRISMA MATRIX 4.34 DRESSING,64.56,41.96,14.07,64.56,59
CDM,27222805,"CORTRAK 8 FR FEEDING TUBE - 43""",63.36,41.18,13.81,63.36,59
CDM,27222845,SPRINGWIRE GUIDE MARKED,9.52,6.19,2.08,9.52,59
CDM,27222855,INTRODUCER SHORT 8/5 FR,12.96,8.42,2.83,12.96,59
CDM,27222875,HI FLOW O2 SETUP ANY TYPE,64.75,42.09,14.12,64.75,59
CDM,27222905,IABP INSERT KIT,218.75,142.19,47.69,218.75,59
CDM,27222935,PACER CABLE,20.0,13.0,4.36,20.0,59
CDM,27222955,HEMCON PATCH,58.2,37.83,12.69,58.2,59
CDM,27222995,VAPOTHERM CANNULA,171.5,111.48,37.39,171.5,59
CDM,27222OH,CLTX ACETABULM HIP/SOCKT FX MANJ W/WO SKEL TRACJ,5644.0,3668.6,1.1,5644.0,144
CDM,27223075,EAKIN FISTULA POUCH,19.66,12.78,4.29,19.66,59
CDM,27223095,IABP CATHETER,1425.0,926.25,310.65,1425.0,59
CDM,27223120,PACING WIRE,420.0,273.0,91.56,420.0,59
CDM,27223125,6FR SHORT SHEATH,54.0,35.1,11.77,54.0,59
CDM,27223135,6FR LONG SHEATH,120.0,78.0,26.16,120.0,59
CDM,27223245,VESSEL DILATOR,23.0,14.95,5.01,23.0,59
CDM,27223295,FEM-O-STOP,149.0,96.85,32.48,149.0,59
CDM,27223350,W KIT TRANSJUGULAR LIVER BIOPSY,850.0,552.5,185.3,850.0,59
CDM,27223365,PEEL AWAY INTRODUCER,600.0,390.0,130.8,600.0,59
CDM,27223375,DILATOR SHEATH SET,450.0,292.5,98.1,450.0,67
CDM,27223415,PIN VISE,135.0,87.75,29.43,135.0,59
CDM,27223435,STYLET WIRES(.013 & .015),86.0,55.9,18.75,86.0,59
CDM,27223445,BYRD WORK STATION,1150.5,747.83,200.93,1150.5,67
CDM,27223455,PRE-LOADED HELICAL BASKET,601.8,391.17,131.19,601.8,59
CDM,27223465,TIP DEFLECTING WIRE GUIDE,217.83,141.59,47.49,217.83,59
CDM,27223475,EXTRACTION GRIP,487.5,316.88,106.28,487.5,67
CDM,27223485,LOCKING STYLET,79.0,51.35,17.22,232.66,67
CDM,27223535,ART  MEAN INSERT KIT (ARROW),392.18,254.92,85.5,392.18,59
CDM,27223565,PERICARDIOCENTESIS TRAY,131.25,85.31,28.61,131.25,59
CDM,27223575,PERICARDIOCENTESIS TRAY,202.0,131.3,44.04,202.0,59
CDM,27223595,SCIMED GUIDEWIRE,205.93,133.85,44.89,205.93,59
CDM,27223605,MULLINS INTRODUCER,133.26,86.62,29.05,133.26,59
CDM,27223615,TRANSEPTAC INTRODUCER,236.25,153.56,51.5,236.25,59
CDM,27223630,W CATH INPACT ADMIRAL DCB/DEB,2580.0,1677.0,200.93,2580.0,67
CDM,27223635,USCI PEDS NIH,176.86,114.96,38.56,176.86,59
CDM,27223675,CATH COOK PIGTAIL-DIAGNOSTIC,44.0,28.6,9.59,44.0,59
CDM,27223775,MICROVENA SNARE,453.0,294.45,98.75,453.0,59
CDM,27223855,BIOPTOME-REUSEABLE,675.0,438.75,147.15,675.0,59
CDM,27223865,SCIMED ROTA WIRE,245.0,159.25,53.41,245.0,59
CDM,27223875,CORDIS STABILIZER WIRE (180),259.58,168.73,56.59,259.58,59
CDM,27223895,TORAY BALLOON,2970.0,1930.5,647.46,2970.0,59
CDM,27223915,ACS INDEFLATOR,96.69,62.85,21.08,96.69,59
CDM,27223935,CORDIS REFLEX,23.97,15.58,5.23,23.97,59
CDM,27223945,ANGIOJET CATHETER,2862.0,1860.3,623.92,2862.0,59
CDM,27223965,CONNECTOR CABLE(NEW),603.0,391.95,131.45,603.0,59
CDM,27223985,BLAZER II TEMP RFA(NEW),1226.67,797.34,267.41,1226.67,59
CDM,27224005,STEERABLE CONNECTORS(NEW),122.5,79.63,26.71,122.5,59
CDM,27224055,ARROW TEMPORARY BALLOON,133.0,86.45,28.99,232.66,67
CDM,27224075,LASER CATHETER,2565.0,1667.25,200.93,2565.0,67
CDM,27224085,CURVED INNER FEMORAL SHEATH,173.25,112.61,37.77,173.25,59
CDM,27224135,NEEDLE EYE SNARE(FEM),975.0,633.75,212.55,975.0,59
CDM,27224145,BROCKENBROUGH NEEDLE,263.0,170.95,57.33,263.0,59
CDM,27224165,RADI-WIRE,936.0,608.4,204.05,936.0,59
CDM,27224195,LLD STYLET,61.98,40.29,13.51,61.98,59
CDM,27224255,CARTO REFERENCE PATCH,1425.0,926.25,200.93,1425.0,67
CDM,27224295,"CHILI CONNECTOR CABLE, NEW",347.0,225.55,75.65,347.0,59
CDM,27224315,SYVEK CLOSURE PATCH,88.0,57.2,19.18,88.0,59
CDM,27224325,AMPLATZER SIZING BALLOON,375.0,243.75,81.75,375.0,59
CDM,27224335,AMPLATZER DELIVERY SYSTEM,13136.0,8538.4,2863.65,13136.0,59
CDM,27224345,AMPLATZER WIRE,242.27,157.48,52.81,242.27,59
CDM,27224365,OUTER SHEATH,40.0,26.0,8.72,40.0,59
CDM,27224375,TORAY GUIDE WIRE,450.0,292.5,98.1,450.0,59
CDM,27224395,EP GUIDE WIRE,166.25,108.06,36.24,166.25,59
CDM,27224405,THERMISTOR ABLATION CATHETER,928.5,603.53,202.41,928.5,59
CDM,27224415,RE-USED CCF CABLE,42.32,27.51,9.23,42.32,59
CDM,27224425,LEAD EXTENDER,512.0,332.8,111.62,512.0,67
CDM,27224455,10 PIN CONNECTOR CABLE,166.25,108.06,36.24,166.25,59
CDM,27224465,EP MALLINCKRODT WIRE,217.83,141.59,47.49,217.83,59
CDM,27224475,LEAD STYLET,166.25,108.06,36.24,166.25,59
CDM,27224535,CABLE,42.0,27.3,9.16,42.0,59
CDM,27224605,ESI SURFACE ELECTRODE PATCH,1425.0,926.25,310.65,1425.0,59
CDM,27224615,MICRO CATH W/ DISTAL MARKER,832.0,540.8,181.38,832.0,59
CDM,27224675,DRAWTEX 2X2,9.48,6.16,2.07,9.48,59
CDM,27224685,DRAWTEX 4X39 ROLLS,9.32,6.06,2.03,19.65,67
CDM,27224705,ONE TIE COMPRESSION COIL,300.0,195.0,65.4,300.0,59
CDM,27224775,J&J HC CATH 7FR PIG HIGH FLO,17.0,11.05,3.71,17.0,59
CDM,27224795,MEDI-TECH 4F/5F COBRA CATHETER,99.89,64.93,21.78,99.89,59
CDM,27224805,DAIG 4F BIPOLAR PACING,70.07,45.55,15.28,232.66,67
CDM,27224825,"COOK HI-PRESSURE TUBING,G09435",11.22,7.29,2.45,11.22,59
CDM,27224835,ABBOTT LAB CARDIAC OUTPUT,18.6,12.09,4.05,18.6,59
CDM,27224865,MERIT 4FR JL 1.5 CATHETER,26.69,17.35,5.82,26.69,59
CDM,27224885,FEHLING INST BIOPTOME; 1.6X510,516.0,335.4,112.49,516.0,59
CDM,27224915,ARROW WEDGE CATH,74.97,48.73,16.34,74.97,59
CDM,27224925,ARROW BERMAN CATH,111.0,72.15,24.2,111.0,59
CDM,27224935,ARROW THERMO CATH,155.75,101.24,33.95,155.75,59
CDM,27224965,BRAUN SEPTOSTOMY CATH,348.0,226.2,75.86,348.0,59
CDM,27224985,BRAUN MULTI TRACK CATH,64.0,41.6,13.95,64.0,59
CDM,27224995,MALLINCKRODT FLEXT/50228 GWIRE,143.5,93.28,31.28,143.5,59
CDM,27225005,"COOK ST FLUSH; 4FR, 5FR",43.0,27.95,9.37,43.0,59
CDM,27225015,COOK 4FR JR,28.0,18.2,6.1,28.0,59
CDM,27225025,COOK 5FR JR,28.0,18.2,6.1,28.0,59
CDM,27225035,COOK 5FR JL,38.68,25.14,8.43,38.68,59
CDM,27225055,COOK BIOPSY FORCEPS 3/120 CM,506.81,329.43,110.48,506.81,59
CDM,27225065,COOK BIOPSY FORCEPS 5.2/60,506.81,329.43,110.48,506.81,59
CDM,27225075,COOK BIOPSY FORCEPS 5.2/120,506.81,329.43,110.48,506.81,59
CDM,27225155,MEDTRONIC NIH CATH 5FR/50CM,160.23,104.15,34.93,160.23,59
CDM,27225165,MEDTRONIC NIH CATH 5FR/80CM,160.23,104.15,34.93,160.23,59
CDM,27225175,MEDTRONIC NIH CATH 6FR/80CM,160.23,104.15,34.93,160.23,59
CDM,27225185,MEDTRONIC NIH CATH 7FR/100CM,68.69,44.65,14.97,68.69,59
CDM,27225195,MEDTRONIC NIH CATH 8FR/100CM,68.69,44.65,14.97,68.69,59
CDM,27225205,MEDTRONIC GL CATH 6FR/80CM,160.23,104.15,34.93,160.23,59
CDM,27225215,MEDTRONIC GL CATH 7FR/100CM,87.5,56.88,19.08,87.5,59
CDM,27225245,MICROVENA SNARE 2-7MM,589.02,382.86,128.41,589.02,59
CDM,27225255,MICROVENA SNARE 25MM,412.5,268.13,89.93,412.5,59
CDM,27225265,MICROVENA SNARE 35MM,412.5,268.13,89.93,412.5,59
CDM,27225295,NMT BALLOON,589.02,382.86,128.41,589.02,59
CDM,27225315,MEDITECH NON-TAPER ANG GLIDE C,99.89,64.93,21.78,99.89,59
CDM,27225325,MEDITECH CUTTING BALLOON,1200.0,780.0,261.6,1200.0,59
CDM,27225345,ST. JUDE DIAG SHEATH,38.0,24.7,8.28,38.0,59
CDM,27225375,CORDIS BIOPTOME; 7F 50CM,277.5,180.38,60.5,277.5,59
CDM,27225385,VESSEL DILATORS,8.0,5.2,1.74,8.0,59
CDM,27225395,MYOCARDIAL BX TRAY,56.89,36.98,12.4,56.89,59
CDM,27225405,PERICARDIOCENTESIS TRAY,193.0,125.45,42.07,193.0,59
CDM,27225435,FEMORAL-DISPOSABLE TRAY,77.6,50.44,16.92,77.6,59
CDM,27225455,CORDIS 6FR/J1 534-620T,17.0,11.05,3.71,17.0,59
CDM,27225495,BRAUN GALAXY PULLBACK SLED,61.25,39.81,13.35,61.25,59
CDM,27225505,NAMIC PARTY PACK,77.0,50.05,16.79,77.0,59
CDM,27225535,CORDIS NEONATAL CATH,57.5,37.38,12.54,57.5,59
CDM,27225565,MERIT VERTEBRAL CATH,22.0,14.3,4.8,22.0,59
CDM,27225595,CORDIS 4FR/JL 538-420,23.0,14.95,5.01,23.0,59
CDM,27225605,CORDIS 4FR/JR 538-421,26.69,17.35,5.82,26.69,59
CDM,27225615,CORDIS 4FR/PIG 538-450S,27.0,17.55,5.89,27.0,59
CDM,27225625,CORDIS 5FR/JL,17.0,11.05,3.71,17.0,59
CDM,27225635,CORDIS 5FR/JR,17.0,11.05,3.71,17.0,59
CDM,27225665,BOSTON SCIENTIFIC V18-300 CONT,148.31,96.4,32.33,148.31,59
CDM,27225705,BOSTON SCIENTIFIC CONTROL SYRI,10.3,6.7,2.25,10.3,59
CDM,27225715,CORDIS SAVVY BALLOON,451.7,293.61,98.47,451.7,59
CDM,27225725,CORDIS POWERFLEX P3,225.0,146.25,49.05,225.0,59
CDM,27225745,CORDIS OPTA PRO BALLOON,225.0,146.25,49.05,225.0,59
CDM,27225805,MEDITECH GL CATH 4FR/100CM STR,154.0,100.1,33.57,154.0,59
CDM,27225815,NU-MED SIZING BALLOON,315.0,204.75,68.67,315.0,59
CDM,27225875,"COOK NTR CATH; 4FR, 5FR",36.0,23.4,7.85,36.0,59
CDM,27225975,FORGEIN BODY NET STNDRD,87.5,56.88,19.08,87.5,59
CDM,27225985,FORCEP BIOPSY OVAL W/NEEDLE,157.5,102.38,34.34,157.5,59
CDM,27226005,TZ MED TRANSEPTAL NEEDLE,225.0,146.25,49.05,225.0,59
CDM,27226015,BALLOON DILATOR ALL SIZES,220.0,143.0,47.96,220.0,59
CDM,27226025,"CLIPS, RESOLUTION",232.5,151.13,50.69,232.5,59
CDM,27226035,LIGATING DEVICE POLLYLOOP,166.25,108.06,36.24,166.25,59
CDM,27226045,"SNARE MINI, STNDRD, JUMBO",45.8,29.77,9.98,45.8,59
CDM,27226085,5FR DL PICC LINE CATH,129.48,84.16,28.23,129.48,59
CDM,27226125,SV-8 0.018X300CM GUIDEWIRE,197.75,128.54,43.11,197.75,59
CDM,27226165,11FR X 10CM .035,16.0,10.4,3.49,16.0,59
CDM,27226175,014 VASCULAR WIRE SOLUTIONS,49.0,31.85,10.68,49.0,59
CDM,27226215,7FR TORQUEVIEW 180 DEGRE CURVE,1104.0,717.6,240.67,1104.0,59
CDM,27226285,SINGLE LUMEN PICC 4FR OR 5FR,166.25,108.06,36.24,166.25,59
CDM,27226305,BBRAUN 5FR SING LUM PICC,126.0,81.9,27.47,126.0,59
CDM,27226315,NAVA CATHETER,285.0,185.25,62.13,285.0,59
CDM,27226345,MEDTRONIC NIH CATH 6FR/50CM,160.23,104.15,34.93,160.23,59
CDM,27226355,PROGREAT 2.8F,412.5,268.13,89.93,412.5,59
CDM,27226365,TERMUMO GLIDEWIRE 018X260,175.0,113.75,38.15,175.0,59
CDM,27226435,ST JUDE STEER INTR SHEATH,1350.0,877.5,294.3,1350.0,59
CDM,27226445,MREYE .038/5MMX3CM OR 8CM,113.75,73.94,24.8,113.75,59
CDM,27226455,CORDIS .032 X 260CM,12.0,7.8,2.62,12.0,59
CDM,27226525,TERUMO 5FR-9FR,15.0,9.75,3.27,15.0,59
CDM,27226535,TRUTORQUE 035/300,120.75,78.49,26.32,120.75,59
CDM,27226545,TRUTORQUE 035/150,96.25,62.56,20.98,96.25,59
CDM,27226585,CORDIS 5FR AL 1.0,17.0,11.05,3.71,17.0,59
CDM,27226675,MERIT 5FR 7CM INTRO SHEATH,72.98,47.44,15.91,72.98,59
CDM,27226755,MEDRAD 150ML MRKV SYRINGE,8.2,5.33,1.79,8.2,59
CDM,27226765,MERIT MAESTRO MCROCATH,525.0,341.25,114.45,525.0,59
CDM,27226815,SPRING WIRE .030X145CM,70.0,45.5,15.26,70.0,59
CDM,27226825,SPR SHTH INTRODUC ALL SZS,87.5,56.88,19.08,87.5,59
CDM,27226835,MNGS JL1 CATH ALL SIZES,218.75,142.19,47.69,218.75,59
CDM,27226845,MNGS MP CATH ALL SIZES,218.75,142.19,47.69,218.75,59
CDM,27226865,MNGS COBRA CATH ALL SIZES,218.75,142.19,47.69,218.75,59
CDM,27226875,MNGS PIGTL CATH ALL SIZES,218.75,142.19,47.69,218.75,59
CDM,27226885,MNGS JR1 CATH ALL SIZES,218.75,142.19,47.69,218.75,59
CDM,27226895,MNGS JB1 CATH ALL SIZES,218.75,142.19,47.69,218.75,59
CDM,27226905,COPILOT GD WIRE ACC KIT,68.0,44.2,14.82,68.0,59
CDM,27226955,CEREBRAL SLIP CATH BEA ANGIO,65.4,42.51,14.26,65.4,59
CDM,27226965,6FR WOV CORON CATH,68.69,44.65,14.97,68.69,59
CDM,27226975,PROTRACK MCROCATH,270.0,175.5,58.86,270.0,59
CDM,27226985,"THRMO 7FR, 4 LM, 110CM CATH",64.05,41.63,13.96,64.05,59
CDM,27226OH,OPTX PST/ANT ACTBLR WALL FX W/INT FIXJ,6228.0,4048.2,1.1,6228.0,144
CDM,27227015,ADLT MULTIFUNC DEFIB PADS,38.28,24.88,8.35,38.28,59
CDM,27227025,VESSEL DILATOR,19.8,12.87,4.32,19.8,59
CDM,27227045,CONN CVR FOR ACUSON ULTR CATH,15.0,9.75,3.27,15.0,59
CDM,27227075,MULTI SNARE SET 20MMX125CM,397.5,258.38,86.66,397.5,59
CDM,27227095,BAIR TEMP BLKT ADULT,48.96,31.82,10.67,48.96,59
CDM,27227105,BAIR TEMP BLKT INFANT,25.34,16.47,5.52,25.34,59
CDM,27227125,DISPOSABLE CHIBA NEEDLE,25.0,16.25,5.45,25.0,59
CDM,27227135,MULTI SNARE ST 10MMX125CM,337.5,219.38,73.58,337.5,59
CDM,27227145,SITE-RITE PROBE SHEATH KIT,10.3,6.7,2.25,10.3,59
CDM,27227175,VASCULAR RETRIEVAL FORCEPS,408.37,265.44,89.02,408.37,59
CDM,27227195,VSI GDEWR STNLS STEL 100CM,68.25,44.36,14.88,68.25,59
CDM,27227215,CHCKFLO INTRO LRG 14FRX30CM,78.75,51.19,17.17,78.75,59
CDM,27227225,15.2X244CM SURGI TIP INOP COV,29.38,19.1,6.4,29.38,59
CDM,27227235,BAIR TEMP BLKT PEDIATRIC,28.84,18.75,6.29,28.84,59
CDM,27227265,TERUMO GLIDEWIRE .035X260CM,81.55,53.01,17.78,81.55,59
CDM,27227275,NAMIC 4 VALVE KIT W/TRNSDC,50.0,32.5,10.9,50.0,59
CDM,27227295,CIVCO DRAPE W/NEOGARD TIP,27.5,17.88,6.0,27.5,59
CDM,27227305,MP/PICC KIT CENTURION MEDICAL,22.2,14.43,4.84,22.2,59
CDM,27227315,ACCESS GDWR INSERT TOOL,20.0,13.0,4.36,20.0,59
CDM,27227325,ABBOTT GDWIRE PTCA STRAIGHT,122.5,79.63,26.71,122.5,59
CDM,27227335,CENTURION INFT PICC DRESS KIT,22.0,14.3,4.8,22.0,59
CDM,27227445,BELMONT RID TUBING SET,323.37,210.19,70.49,323.37,59
CDM,27227455,MAN INFLATED RETROGRADE,70.0,45.5,15.26,70.0,59
CDM,27227465,NON AR4 PLEGIA SET,86.94,56.51,18.95,86.94,59
CDM,27227485,ARTERIAL MEAN LINE,42.38,27.55,9.24,42.38,59
CDM,27227495,STERILE WATER FOR IRRIGATION,16.59,10.78,3.62,16.59,59
CDM,27227505,STERILE WATER FOR INJ (SWFI),7.5,4.88,1.64,7.5,59
CDM,27227515,PROTEGE STENT 6-10MMX80CM,1242.0,807.3,200.93,1242.0,67
CDM,27227525,PEDS QUADROX OXYGENATOR,2430.0,1579.5,529.74,2430.0,59
CDM,27227545,165CM OVESCO SYSTEM  12/6T,718.5,467.03,156.63,718.5,59
CDM,27227555,220CM OVESCO SYSTEM  12/6T,729.0,473.85,158.92,729.0,59
CDM,27227565,DRAWTEX 4X39 ROLLS,86.61,56.3,18.88,86.61,59
CDM,27227575,DRAWTEX 3X3,20.14,13.09,4.39,20.14,67
CDM,27227585,KYPHON XPANDER SYRINGE,210.0,136.5,45.78,210.0,59
CDM,27227595,KYPHON HV-R BONE CEMENT MIXER,262.5,170.63,57.23,262.5,59
CDM,27227605,KYPHON XPANDER BONE TAMP,1462.5,950.63,318.83,1462.5,59
CDM,27227615,SIZE 3 KYPHON BONE FILLER,126.0,81.9,27.47,126.0,59
CDM,27227625,MEDTRONIC TUNNELLER,171.5,111.48,37.39,171.5,59
CDM,27227635,ASCENDA INTRA CATHETER 86 CM,1350.0,877.5,294.3,1350.0,59
CDM,27227645,18FR ATRIAL VENT CATHETER,50.0,32.5,10.9,50.0,59
CDM,27227655,EMBOL-X FILTER,337.5,219.38,73.58,337.5,59
CDM,27227665,EMBOL-X SHEATH,472.5,307.13,103.01,472.5,59
CDM,27227675,21/24 FR FLEX AORTIC CANNULA,38.0,24.7,8.28,38.0,59
CDM,27227685,24 FR ANGLED AORTIC CANNULA,38.0,24.7,8.28,38.0,59
CDM,27227695,CELL SAVER LEUKOCYTE FILTER,55.36,35.98,12.07,55.36,59
CDM,27227705,LOWER LEG PERFUSION CANNULA,36.4,23.66,7.94,36.4,59
CDM,27227715,PRUITT CATHETER,705.0,458.25,153.69,705.0,59
CDM,27227725,ACCESSORY KITS 3550-29,210.0,136.5,45.78,210.0,59
CDM,27227735,"ACCESSORY KIT, 3550-02",87.5,56.88,19.08,87.5,59
CDM,27227745,MEDTRONIC CATHETER 8780,1350.0,877.5,294.3,1350.0,59
CDM,27227765,CARDIOHELP HLS ADVANCED SET,25000.0,16250.0,5450.0,25000.0,59
CDM,27227825,MEDI-TECH TERUMO GW ANGLE,100.8,65.52,21.97,100.8,59
CDM,27227835,6FR PROGLIDE SUTURE W/TRIM,250.5,162.83,54.61,250.5,59
CDM,27227845,STRYKER DX IMAG CATH 8-10FR,1087.5,706.88,237.08,1087.5,59
CDM,27227855,GUIDEWIRE BOS SCI .018X300CM,191.19,124.27,41.68,191.19,59
CDM,27227865,MICRO ELITE HV INTRO SET,56.0,36.4,12.21,56.0,59
CDM,27227875,NOVASURE DEVICE,1517.4,986.31,330.79,1517.4,59
CDM,27227OH,OPTX ACTBLR FX INVG ANT/PST 1 COLUMN/FX W/INT,10164.0,6606.6,1.1,10164.0,144
CDM,27228275,EVIVA 12 GAUGE STX BX DEVICE,310.07,201.55,67.6,310.07,59
CDM,27228285,DETACHMENT CABLE SET,166.25,108.06,36.24,166.25,59
CDM,27228295,COVIDIEN APPOLLO ONYX DEL CATH,2693.25,1750.61,587.13,2693.25,59
CDM,27228305,ENDOTRACHEAL TUBE,63.05,40.98,13.74,63.05,59
CDM,27228315,"HI FLOW O2 SETUP, ANY TYP",64.75,42.09,14.12,64.75,59
CDM,27228335,HEMO LOOP,151.81,98.68,33.09,151.81,59
CDM,27228675,PWR BONE MARROW BX NEEDLE102MM,258.0,167.7,56.24,258.0,67
CDM,27228805,CARDIOTOMY RESERVOIR,550.35,357.73,119.98,550.35,59
CDM,27228815,"CONNECTORS, ANY",30.44,19.79,6.64,30.44,59
CDM,27228825,ARGYLE CANNULA,42.0,27.3,9.16,42.0,59
CDM,27228835,ENDO RETURN 21FR,657.0,427.05,143.23,657.0,59
CDM,27228845,EMR  KIT,286.5,186.23,62.46,286.5,59
CDM,27228855,4 X 4 AG GENTLE DRESSING,15.32,9.96,3.34,15.32,59
CDM,27228865,SWAN GANZ THERMO,74.0,48.1,16.13,74.0,59
CDM,27228905,"CATHETER,LUBRI-SIL,14FR",6.84,4.45,1.49,6.84,59
CDM,27228965,"CATHETER,FOLEY 10FR 3CC PEDS",13.24,8.61,2.89,13.24,59
CDM,27228OH,OPTX ACTBLR FX INVG ANT&POST 2 COLUMNS FX W/INT,11732.0,7625.8,1.1,11732.0,144
CDM,27229045,OXYSENSOR PEDS/ADULT D20/D25,18.0,11.7,3.92,18.0,59
CDM,27229055,OXYSENSOR NEO/INFANT I20/N25,23.4,15.21,5.1,23.4,59
CDM,27229165,"PLUG,CATHETER,#0414L BARD",2.92,1.9,0.64,2.92,59
CDM,27229295,"KIT,NEB W/ADAPTOR,1000ML",6.08,3.95,1.33,6.08,59
CDM,27229335,"ELECTRODE,BIS MONITOR,1860100",25.0,16.25,5.45,25.0,59
CDM,27229355,"AIRWAY,NASAL",15.98,10.39,3.48,15.98,59
CDM,27229365,"AIRWAY,ORAL",3.22,2.09,0.7,3.22,59
CDM,27229395,"STOCKING,HUNTLEIGH,LG #DVT20",59.5,38.68,12.97,59.5,59
CDM,27229415,COAGCHEK PLUS CHARGE,32.0,20.8,6.98,32.0,59
CDM,27229485,"AIRWAY,NASOPHARYNGEAL,1507528",6.0,3.9,1.31,6.0,59
CDM,27229495,"SLEEVE,COMPRESS,SCD,LG,9789",64.0,41.6,13.95,64.0,59
CDM,27229505,"SLEEVE,COMPRESS,SCD,MED,9529",33.0,21.45,7.19,33.0,59
CDM,27229515,"SLEEVE,EXPRESS,SCD,XLG,9790",104.13,67.68,22.7,104.13,59
CDM,27229665,CUFF BP SFTCF CHILD 12-19CM,5.8,3.77,1.26,5.8,59
CDM,27229685,ATHLETIC SUPPORT MED,28.04,18.23,6.11,28.04,59
CDM,27229695,"SNSR,INF LNCS INF-L,OXMTR 1861",18.87,12.27,4.11,18.87,59
CDM,27229705,"SNSR,PED LNCS PDTX OXMTR,1860",14.28,9.28,3.11,14.28,59
CDM,27229715,"SNSR,LNCS ADTX SPO2",14.28,9.28,3.11,14.28,59
CDM,27229725,"BLADE,SURGICAL CLIPPER 4412",19.6,12.74,4.27,19.6,59
CDM,27229735,"BRA,SPORT,SZ:34 #6014-34",10.0,6.5,2.18,10.0,59
CDM,27229745,"BRA,SPORT,SZ:36 #6014-36",10.0,6.5,2.18,10.0,59
CDM,27229755,"BRA,SPORT,SZ:38 #6014-38",10.0,6.5,2.18,10.0,59
CDM,27229765,"BRA,SPORT,SZ:40 #6014-40",10.0,6.5,2.18,10.0,59
CDM,27229775,"BRA,SPORT,SZ:42 #6014-42",10.0,6.5,2.18,10.0,59
CDM,27229785,"BRA,SPORT,SZ:44 #6014-44",8.2,5.33,1.79,8.2,59
CDM,27229795,"BRA,SPORT,SZ:46 #6014-46",10.0,6.5,2.18,10.0,59
CDM,27229805,"BRA,SPORT,SZ:48 #6014-48",10.0,6.5,2.18,10.0,59
CDM,27229835,OXYGEN THERAPY,21.84,14.2,4.76,21.84,59
CDM,27229855,PROWLER MICROCATHETER,585.55,380.61,127.65,585.55,67
CDM,27229865,"CATH, BALLOON C1725 160",355.37,230.99,77.47,355.37,67
CDM,27229875,BALLOON OPTA LP,355.7,231.21,77.54,355.7,67
CDM,27229885,GUIDANT AGILTRAC BALLOON CATH,147.22,95.69,32.09,232.66,67
CDM,27229895,SIZING CATH,227.27,147.73,49.54,232.66,67
CDM,27229905,COOK BALLOON MENCINI DOUBLE,565.0,367.25,123.17,565.0,67
CDM,27229915,BARD CONQUEST BALLOON,310.0,201.5,67.58,310.0,67
CDM,27229925,COOK 6.5 FR. SLIP CATH 125CM,247.0,160.55,53.85,247.0,67
CDM,27229935,ATLAS BALLOON CATHETER,367.5,238.88,80.12,367.5,67
CDM,27229945,ATLAS BALLOON CATHETER,383.24,249.11,83.55,383.24,67
CDM,27229955,COOK SLIP-CATH # 280522,137.0,89.05,29.87,232.66,67
CDM,27229965,BOSTON SCIENTIFIC CUTTING CATH,1160.0,754.0,200.93,1160.0,67
CDM,27229975,BOSTON SCIENTIFIC BALLOON CATH,2551.0,1658.15,200.93,2551.0,67
CDM,27229985,TRANSLUM ANGIOPL - CATH,238.0,154.7,51.88,238.0,67
CDM,27229995,DAX MICRO CATHER,1492.5,970.13,200.93,1492.5,67
CDM,27230005,OCCLUSION BALLOON MICRO VEN,1755.0,1140.75,200.93,1755.0,67
CDM,27230015,OCCLUSION BAL STRYKER SSC0305,1917.34,1246.27,200.93,1917.34,67
CDM,27230025,OCCLUSION BAL SSC0407 SRC0410,1816.43,1180.68,200.93,1816.43,67
CDM,27230035,TRANSLUM ANGIOPL NON-LSR CATH,285.0,185.25,62.13,285.0,67
CDM,27230045,ACS BALLOON LEVEL I,375.0,243.75,81.75,375.0,67
CDM,27230055,CORDIS BALLOON LEVEL I,760.0,494.0,165.68,760.0,67
CDM,27230065,MEDITECH SYMMETRY,900.0,585.0,196.2,900.0,67
CDM,27230075,"MEDTRONIC ""D"" BALLOON",201.0,130.65,43.82,232.66,67
CDM,27230085,CONQUEST BALLOON CATHETER,337.5,219.38,73.58,337.5,67
CDM,27230095,BRAUN Z-MED II BALLOON 15X3,1154.0,750.1,200.93,1154.0,67
CDM,27230105,BRAUN Z-MED II BALLOON 5X2-10X,412.5,268.13,89.93,412.5,67
CDM,27230115,BRAUN Z-MED II BALLOON 22X4-25,675.0,438.75,147.15,675.0,67
CDM,27230125,BRAUN TYSHAK BALLOON 6X3-10X3,631.88,410.72,137.75,631.88,67
CDM,27230135,BRAUN TYSHAK II BALLOON 5X2-25,726.77,472.4,158.44,726.77,67
CDM,27230145,BARD; ATLAS BALLOON CATH,897.0,583.05,195.55,897.0,67
CDM,27230155,B-BRAUN MINI GHOST BALLOON,528.0,343.2,115.1,528.0,67
CDM,27230165,BOS SCIENTFIC BALLON,330.0,214.5,71.94,330.0,67
CDM,27230175,HALO 360 BALLOON,525.0,341.25,114.45,525.0,67
CDM,27230185,TTS BALLOON DILATOR,144.37,93.84,31.47,232.66,67
CDM,27230195,ACLASIA BALLOON DILATOR,661.5,429.98,144.21,661.5,67
CDM,27230205,COUDE TIP URETHRAL BALLOON,85.68,55.69,18.68,232.66,67
CDM,27230215,CRE WIREGUIDED DILATOR,337.5,219.38,73.58,337.5,67
CDM,27230225,NON-VAS BALLON DILAT CATH,2307.89,1500.13,200.93,2307.89,67
CDM,27230245,PLEURX DRAINAGE CATHETER,690.0,448.5,150.42,690.0,67
CDM,27230255,8FR PERICARDIOCENT PROC KIT,258.0,167.7,56.24,258.0,67
CDM,27230265,PLEURAL DRAINAGE CATHETER,359.0,233.35,78.26,359.0,67
CDM,27230275,QUADRAPOLAR EP CATH,900.0,585.0,196.2,900.0,67
CDM,27230285,STEEROCATH OCTAPOLAR(NEW),418.5,272.03,91.23,418.5,67
CDM,27230295,TAP/DEFLECTABLE MAPPING CATH,501.0,325.65,109.22,501.0,67
CDM,27230305,CARTO NAVIS STAR CATHETER,3375.0,2193.75,200.93,3375.0,67
CDM,27230315,MIDLINE CATHETER,115.0,74.75,25.07,232.66,67
CDM,27230325,CATH CVP 3-LUMEN 7FR CK-15703,18.05,11.73,3.93,232.66,67
CDM,27230335,PICC CATHETER,178.0,115.7,38.8,232.66,67
CDM,27230345,MIDLINE INFUSION CATH,1200.0,780.0,200.93,1200.0,67
CDM,27230375,C1753 TIER 1 OCT OR IVUS CATHETER,1088.0,707.2,200.93,1088.0,67
CDM,27230385,C1753 TIER 2 OCT OR IVUS CATHETER,3240.0,2106.0,200.93,3240.0,67
CDM,27230395,BOS SCI ATLANTIS CORONARY CATH,960.0,624.0,200.93,960.0,67
CDM,27230405,ACUNAV V10FR 3D ULTSND CATH,4725.0,3071.25,200.93,4725.0,67
CDM,27230415,FOGARTY CATHETER,406.54,264.25,88.63,406.54,67
CDM,27230425,ARROW TREROTOLA FR BASKET CATH,864.25,561.76,188.41,864.25,67
CDM,27230435,THROMBECT/EMBOLECTOMY CATH,2693.0,1750.45,200.93,2693.0,67
CDM,27230445,THROMBECT/EMBOLECTMY CATH,2180.0,1417.0,200.93,2180.0,67
CDM,27230455,THROMBECT/EMBOLECTMY CATH,1050.0,682.5,200.93,1050.0,67
CDM,27230465,THROMBECT/EMBOLECTMY CATH,2626.0,1706.9,200.93,2626.0,67
CDM,27230475,THROMBECT/EMBOLECTOMY CATH,927.0,602.55,200.93,927.0,67
CDM,27230485,THROMBECT/EMBOLECTOMY CATH,4035.0,2622.75,200.93,4035.0,67
CDM,27230495,10 FR PRONTO EXTRACTION CATH,1192.5,775.13,200.93,1192.5,67
CDM,27230505,SOLTR THROMB EMBO EV3 DVC,8320.05,5408.03,200.93,8320.05,67
CDM,27230515,C1757 TIER 2 THROMBECTOMY CATH,2336.0,1518.4,200.93,2336.0,67
CDM,27230525,C1757 TIER 1 THROMBECTOMY CATH,750.0,487.5,163.5,750.0,67
CDM,27230535,ACUNAV ICE CATHETER,2565.0,1667.25,200.93,2565.0,67
CDM,27230545,GUIDE WIRE,73.15,47.55,15.95,232.66,67
CDM,27230555,INFUSSION WIRE .035,402.17,261.41,87.67,402.17,67
CDM,27230565,GLIDEWIRE GOLD,431.83,280.69,94.14,431.83,67
CDM,27230575,TRANSEND GUIDEWIRE,364.46,236.9,79.45,364.46,67
CDM,27230585,INSTINCT GUIDEWIRE,240.46,156.3,52.42,240.46,67
CDM,27230595,TAD II GUIDEWIRES,249.0,161.85,54.28,249.0,67
CDM,27230605,NITREX GUIDE WIRE .018,131.26,85.32,28.61,232.66,67
CDM,27230615,COPE NT .018 60 CM GUIDE WIRE,53.88,35.02,11.75,232.66,67
CDM,27230625,.035 TIP DEFLECTOR GUIDE WIRE,147.0,95.55,32.05,232.66,67
CDM,27230635,GLIDEWIRES 035 038X260CM,80.08,52.05,17.46,232.66,67
CDM,27230645,"SS GLIDEWIRES 035,038",81.49,52.97,17.76,232.66,67
CDM,27230655,GLIDEWIRES,61.03,39.67,13.3,232.66,67
CDM,27230665,AMPLATZ SS GUIDEWIRE .035 .038,79.81,51.88,17.4,232.66,67
CDM,27230675,PLATINUM PLUS LT GUIDEWIRE,86.09,55.96,18.77,232.66,67
CDM,27230685,V-.018 CONTROL GUIDE WIRE,220.13,143.08,47.99,232.66,67
CDM,27230695,CHOICE GUIDEWIRE 014X300CM,667.87,434.12,145.6,667.87,67
CDM,27230705,MAILMAN GUIDEWIRE,258.98,168.34,56.46,258.98,67
CDM,27230715,PRECISION VASCULAR SYNCHRO-35,741.0,481.65,161.54,741.0,67
CDM,27230725,MIRAGE GUIDEWIRE .008,517.83,336.59,112.89,517.83,67
CDM,27230735,LUNDERQUIST - RING TORQUE,164.0,106.6,35.75,232.66,67
CDM,27230745,X-CELERATOR EXCHANGE GUIDEWIRE,413.33,268.66,90.11,413.33,67
CDM,27230755,GUIDE WIRE,1688.0,1097.2,200.93,1688.0,67
CDM,27230765,GUIDE WIRE .035,88.97,57.83,19.4,232.66,67
CDM,27230775,GUIDE WIRE,59.2,38.48,12.91,232.66,67
CDM,27230785,CM WHOLEY STRAIGHT GUIDE WIRE,151.76,98.64,33.08,232.66,67
CDM,27230795,CM WHOLEY J GUIDE WIRE,223.0,144.95,48.61,232.66,67
CDM,27230805,GUIDEWIRE C1769 40,267.88,174.12,58.4,267.88,67
CDM,27230815,LUBRIGUIDE COATED GUIDEWIRE,85.68,55.69,18.68,232.66,67
CDM,27230825,TERUMO GOLD TIP 70 DEGREE,237.11,154.12,51.69,237.11,67
CDM,27230835,"COOK AES CURVED .025""X260CM GW",68.95,44.82,15.03,232.66,67
CDM,27230845,AMPLATZ SS WIRE ST,85.63,55.66,18.67,232.66,67
CDM,27230855,COOK GUIDE WIRES .018/80 ST,35.02,22.76,7.63,232.66,67
CDM,27230865,COOK GUIDE WIRES .021/260 ST,48.14,31.29,10.49,232.66,67
CDM,27230875,COOK GUIDE WIRES .025/145 ST,22.1,14.37,4.82,232.66,67
CDM,27230885,COOK GUIDE WIRES .025/260 ST,43.78,28.46,9.54,232.66,67
CDM,27230895,COOK GUIDE WIRES .032/260 J,43.34,28.17,9.45,232.66,67
CDM,27230905,COOK GUIDE WIRES .035/260 ST,35.7,23.21,7.78,232.66,67
CDM,27230915,COOK GUIDE WIRES .035/260 J,39.94,25.96,8.71,232.66,67
CDM,27230925,COOK DEFLECTING WIRE .035/145,86.28,56.08,18.81,232.66,67
CDM,27230935,GUIDANT ACS WIRE,148.75,96.69,32.43,232.66,67
CDM,27230945,VASCULAR SOLUTIONS WIRE 018/40,42.0,27.3,9.16,232.66,67
CDM,27230955,ARROW GUIDEWIRE 6FX24CM,48.0,31.2,10.46,232.66,67
CDM,27230965,COOK GW FOR MULLINS INTRO,94.0,61.1,20.49,232.66,67
CDM,27230975,B BRAUN MICRO GUIDEWIRE 4F,28.0,18.2,6.1,232.66,67
CDM,27230985,GDWIRE THRUWAY 18X30CM,166.25,108.06,36.24,232.66,67
CDM,27230995,GUIDE WIRE,139.65,90.77,30.44,232.66,67
CDM,27230OH,CLTX FEM FX PROX END NCK W/O MANJ,2324.0,1510.6,1.1,2324.0,148
CDM,27231005,"GUIDEWIRE,APTUS ENDOSTAPL SYS",1485.0,965.25,200.93,1485.0,67
CDM,27231015,GUNTHER TULIP RETRIEVAL SET,643.0,417.95,140.17,643.0,67
CDM,27231025,RET DEV INSERTABLE,2020.0,1313.0,200.93,2020.0,67
CDM,27231035,EON PATIENT PROGRAMMER 3851,2964.38,1926.85,200.93,2964.38,67
CDM,27231045,PWR BN MARROW BX CMP TRAY152MM,193.0,125.45,42.07,232.66,67
CDM,27231055,FILTER WIRE (EPD),2943.61,1913.35,200.93,2943.61,67
CDM,27231065,C1885 TIER 1 LASER CATHETER,3780.0,2457.0,200.93,3780.0,67
CDM,27231075,RENEGADE MICROCATHETER,723.0,469.95,157.61,723.0,67
CDM,27231085,EXCEL 14 MICROCATHETER,1131.0,735.15,200.93,1131.0,67
CDM,27231095,SHUTTLE GUIDING CATHETER,293.15,190.55,63.91,293.15,67
CDM,27231105,RENEGADE HI-FLOW MICROCATHETER,383.15,249.05,83.53,383.15,67
CDM,27231115,COOK 7FR GUIDING CATHETER,248.34,161.42,54.14,248.34,67
CDM,27231125,MICROCATH EXCELSIOR SL-10,1161.37,754.89,200.93,1161.37,67
CDM,27231135,6FR SHUTTLE SELECT 90 CM,321.25,208.81,70.03,321.25,67
CDM,27231145,CONCENTRIC MERCI MICROCATHETER,1326.0,861.9,200.93,1326.0,67
CDM,27231155,EXCELSIOR SL-10 PRESHAPED CATH,1246.87,810.47,200.93,1246.87,67
CDM,27231165,TERUMO MICROCATHETER,1231.0,800.15,200.93,1231.0,67
CDM,27231175,NEURON DEL CATHERTER PENUMBRA,675.0,438.75,147.15,675.0,67
CDM,27231185,"CATHETER, GUIDING",1020.0,663.0,200.93,1020.0,67
CDM,27231195,RENEGADE HI-FLOW FATHOM SYSTEM,924.0,600.6,200.93,924.0,67
CDM,27231205,ECHELON 14 MICROCATH,969.0,629.85,200.93,969.0,67
CDM,27231215,JUDKINS RT 6FRX100CM DX CATH,34.0,22.1,7.41,232.66,67
CDM,27231225,SCIMED DIAGNOSTIC CATH,390.0,253.5,85.02,390.0,67
CDM,27231235,SCIMED GUIDE CATH,91.0,59.15,19.84,232.66,67
CDM,27231245,6-8 FR CORDIS CATHETER,68.49,44.52,14.93,232.66,67
CDM,27231255,5 FR MEDI-DYNE CATH-DIAGNOSTIC,30.46,19.8,6.64,232.66,67
CDM,27231265,TRANSIT CATHETER,850.5,552.83,185.41,850.5,67
CDM,27231275,CORDIS 4F IM CATHETER,26.69,17.35,5.82,232.66,67
CDM,27231285,COOK PIGTAIL;3-7 FR,41.06,26.69,8.95,232.66,67
CDM,27231295,COOK 4FR JL 1.5 - 4.0,28.0,18.2,6.1,232.66,67
CDM,27231305,MEDITECH ST GLIDE CATH,142.0,92.3,30.96,232.66,67
CDM,27231315,CORDIS CORONARY GUIDE CATH 6FR,91.88,59.72,20.03,232.66,67
CDM,27231325,COOK .035 ROSEN WIRE,38.24,24.86,8.34,232.66,67
CDM,27231335,HIGH FLOW MICROCATHETER,3712.5,2413.13,200.93,3712.5,67
CDM,27231355,COOK CURVED PEEL AWAY INTRODUC,217.83,141.59,47.49,232.66,67
CDM,27231365,CK FLOW BLUE MULLINS SHEATH,78.22,50.84,17.05,232.66,67
CDM,27231375,CHECK FLOW SHEATH 30 & 45 CM,95.59,62.13,20.84,232.66,67
CDM,27231385,INTRODUCER SHEATHS 25CM,25.99,16.89,5.67,232.66,67
CDM,27231395,BRITE TIP SHEATH,91.0,59.15,19.84,232.66,67
CDM,27231405,"BRITE TIP SHEATH 6F,7F,8FX35CM",39.35,25.58,8.58,232.66,67
CDM,27231415,"BRITE TIP SHEATH 7F,9FX45CM",101.99,66.29,22.23,232.66,67
CDM,27231425,"CORDIS BRT TIP SHEATH 23CM,35C",86.83,56.44,18.93,232.66,67
CDM,27231435,CORDIS BRITE TIP SHEATH 50CM,63.54,41.3,13.85,232.66,67
CDM,27231445,BALKIN SHEATHS,111.31,72.35,24.27,232.66,67
CDM,27231455,"CHECK-FLO 10 FR, 45CM INTRODUC",199.0,129.35,43.38,232.66,67
CDM,27231465,TRANS-SEPTAL INTRODUCER,375.0,243.75,81.75,375.0,67
CDM,27231475,SAFE SHEATH,675.0,438.75,147.15,675.0,67
CDM,27231485,ARROW 35CM SHEATHS,174.13,113.18,37.96,232.66,67
CDM,27231495,CVP 8.5 FR INTRODUCER,47.04,30.58,10.25,232.66,67
CDM,27231505,CVP 7.5 FR INTRODUCER,84.0,54.6,18.31,232.66,67
CDM,27231515,PERCUTANEOUS SHEATH CK02000,43.87,28.52,9.56,232.66,67
CDM,27231525,INTRO/SHEATH NON-LASER,55.0,35.75,11.99,232.66,67
CDM,27231535,SCIMED ADVANCER,1500.0,975.0,200.93,1500.0,67
CDM,27231545,COOK; 10F 30 CM SHEATH,1820.25,1183.16,200.93,1820.25,67
CDM,27231555,COOK 8FR/63 MULLINS,90.37,58.74,19.7,232.66,67
CDM,27231565,"COOK 10FR/63, 12 OR 14FR/75 MU",151.31,98.35,32.99,232.66,67
CDM,27231575,COOK 11/75 MULLINS,131.64,85.57,28.7,232.66,67
CDM,27231585,CORDIS AVANTI SHEATH,17.0,11.05,3.71,232.66,67
CDM,27231595,COOK; 7F/8F 30CM/80CM SHEATH,68.95,44.82,15.03,232.66,67
CDM,27231605,COOK; 12F 40CM SHEATH,126.44,82.19,27.56,232.66,67
CDM,27231615,COOK 16F INTRODUCER SHEATH,331.31,215.35,72.23,331.31,67
CDM,27231625,ARROW INTRODUCER; 6F X 24 CM,81.2,52.78,17.7,232.66,67
CDM,27231635,COOK FLEXOR SHEATH; 6X30,117.0,76.05,25.51,232.66,67
CDM,27231645,COOK INTRODUCER 10.0-38-75-RB,94.0,61.1,20.49,232.66,67
CDM,27231655,B BRAUN 4F MICRO INTRO SHEATH,28.0,18.2,6.1,232.66,67
CDM,27231665,CHCKFLO INTRO PERFORM SET,143.5,93.28,31.28,232.66,67
CDM,27231685,CRYOABLATION PROBE,3195.0,2076.75,200.93,3195.0,67
CDM,27231695,HYPER GLIDE OCC BALLOON,1385.1,900.32,200.93,1385.1,67
CDM,27231705,HALO 360 CATHATER,1688.0,1097.2,200.93,1688.0,67
CDM,27231715,CRYOABATION STRAIGHT CATH,750.0,487.5,163.5,750.0,67
CDM,27231725,HALO 90 CATHETER,1125.0,731.25,200.93,1125.0,67
CDM,27231735,CHILI COOLED CATHETER,2135.08,1387.8,200.93,2135.08,67
CDM,27231765,"TRAY,SPINAL,SPROTTE 24G",227.42,147.82,49.58,227.42,59
CDM,27231775,"TRAY,NERVE BLOCK NB100 BRAUN",18.14,11.79,3.95,18.14,59
CDM,27231785,RAE E.T.T.,19.0,12.35,4.14,19.0,59
CDM,27231795,"TUBE,ENDOTRACHEAL",64.75,42.09,14.12,64.75,59
CDM,27231805,"PROBE,ESOPHAGEAL,90072",6.24,4.06,1.36,6.24,59
CDM,27231845,"AIRWAY,MICROPHARYNGEAL,SUN MED",5.7,3.71,1.24,5.7,59
CDM,27231875,"AIRWAY,NASOPHARYNGEAL,1507530",6.0,3.9,1.31,6.0,59
CDM,27231885,"NEEDLE,BLOCK,AB-21090-SS",17.8,11.57,3.88,17.8,59
CDM,27231895,"LMA,DISPOSABLE,SZ3,125030",17.0,11.05,3.71,17.0,59
CDM,27231905,"LMA,DISPOSABLE,SZ4,125040",17.0,11.05,3.71,17.0,59
CDM,27231915,"LMA,DISPOSABLE,SZ5,125050",17.0,11.05,3.71,17.0,59
CDM,27231935,BIS SENSOR STRIPS,29.8,19.37,6.5,29.8,59
CDM,27231945,BLANKET BAIR FULL,48.96,31.82,10.67,48.96,59
CDM,27231955,ELEC MULTIFUNCTION DEFIB/PACE,32.17,20.91,7.01,32.17,59
CDM,27231965,LMA DISP SUPREME SIZE 3,26.42,17.17,5.76,26.42,59
CDM,27231975,LMA DISP SUPREME SIZE 4,26.42,17.17,5.76,26.42,59
CDM,27231985,LMA DISP SUPREME SIZE 5,26.42,17.17,5.76,26.42,59
CDM,27231995,SYRINGE 60CC LUER/LOCK,25.54,16.6,5.57,25.54,59
CDM,27232005,TRACH TUB 5.0 LASER SHIELD CUF,224.0,145.6,48.83,224.0,59
CDM,27232015,TRACH TUB REINF CUFF MURPH 7.5,36.62,23.8,7.98,36.62,59
CDM,27232215,GEN DIAGNOSTIC CATH TIER 1,27.0,17.55,5.89,27.0,59
CDM,27232235,TRACH STD MONT,261.0,169.65,56.9,261.0,59
CDM,27232265,MISC EP SUPPLY TIER 1,60.0,39.0,13.08,60.0,59
CDM,27232275,ZOLL ELECTRODE,74.0,48.1,16.13,74.0,59
CDM,27232285,SLEEVE/SLEEVE ACCESSORY TIER 1,54.0,35.1,11.77,54.0,59
CDM,27232295,IRRIGATION TUBING SET,105.0,68.25,22.89,105.0,59
CDM,27232305,AQUACEL SURGICAL DRESSING,55.0,35.75,11.99,55.0,59
CDM,27232315,3/8 X 1/2 REDUCER,16.0,10.4,3.49,16.0,59
CDM,27232320,C1725 BALLOONS TIER 6,1620.0,1053.0,200.93,1620.0,67
CDM,27232325,CONNECTOR,15.32,9.96,3.34,15.32,59
CDM,27232330,C1725 BALLOONS TIER 5,1425.0,926.25,200.93,1425.0,67
CDM,27232335,ECMO TUBING PACK W/OUT OXY,500.0,325.0,109.0,500.0,59
CDM,27232340,C1725 BALLOONS TIER 4,967.0,628.55,200.93,967.0,67
CDM,27232345,ECMO TUBING PACK W/OXY,4100.0,2665.0,893.8,4100.0,59
CDM,27232350,"CATH, BALLOON C1725 175",474.0,308.1,103.33,474.0,67
CDM,27232355,FEMORAL VENOUS CANNULA,350.27,227.68,76.36,350.27,59
CDM,27232360,C1724 ATHERECTOMY TIER 2,5123.0,3329.95,200.93,5123.0,67
CDM,27232365,FEMORAL ARTERIAL CANNULA,304.0,197.6,66.27,304.0,59
CDM,27232370,IN PACT ADMIRAL DCB BALLOON,1958.0,1272.7,200.93,1958.0,67
CDM,27232375,BICAVAL SVC/IVC CANNULA,72.0,46.8,15.7,72.0,59
CDM,27232380,GLIDE OR GUIDE CATH TIER 3,1275.0,828.75,200.93,1275.0,67
CDM,27232385,TWO STAGE VENOUS CANNULA,36.0,23.4,7.85,36.0,59
CDM,27232390,GLIDE OR GUIDE CATH TIER 1,584.0,379.6,127.31,584.0,67
CDM,27232395,THORACOTOMY AVR CANNULA,576.4,374.66,125.66,576.4,59
CDM,27232400,GLIDE OR GUIDE CATH TIER 2,743.0,482.95,161.97,743.0,67
CDM,27232405,ARTERIAL AORTIC CANNULA,100.0,65.0,21.8,100.0,59
CDM,27232410,TAG DRY SEAL SHEATH,488.0,317.2,106.38,488.0,59
CDM,27232415,SVENSSON VENT,35.12,22.83,7.66,35.12,59
CDM,27232420,22 FR ANGIO VAC CANNULA,17550.0,11407.5,3825.9,17550.0,59
CDM,27232425,JOHNSTON VENT,50.2,32.63,10.94,50.2,59
CDM,27232430,C1894 SHEATH/INTRODUCER TIER 3,255.0,165.75,55.59,255.0,67
CDM,27232435,NAVIA CARDIOPLEGIA SET,37.0,24.05,8.07,37.0,59
CDM,27232440,C1894 SHEATH/INTRODUCER TIER 5,621.0,403.65,135.38,621.0,67
CDM,27232445,SHEATH GENERIC TIER 3,409.0,265.85,89.16,409.0,59
CDM,27232450,C1894 SHEATH/INTRODUCER TIER 2,167.0,108.55,36.41,232.66,67
CDM,27232455,SWAN GANZ BERMAN,92.0,59.8,20.06,232.66,67
CDM,27232460,C1894 SHEATH/INTRODUCER TIER 0,52.0,33.8,11.34,232.66,67
CDM,27232465,ARTERIAL LINE KIT,39.92,25.95,8.7,39.92,59
CDM,27232470,C1766 INTRODUCER TIER 2,1200.0,780.0,200.93,1200.0,67
CDM,27232475,CUTTING BALLOON,241.93,157.25,52.74,241.93,67
CDM,27232480,C1894 SHEATH/INTRODUCER TIER 1,111.0,72.15,24.2,232.66,67
CDM,27232485,C1714 ARTHERECTOMY CATH,4043.0,2627.95,200.93,4043.0,67
CDM,27232490,C1894 SHEATH/INTRODUCER TIER 4,332.0,215.8,72.38,332.0,67
CDM,27232495,BRACHYTX SEED ADMIN SET,5197.5,3378.38,200.93,5197.5,67
CDM,27232500,PENUMBRA THROMBECTOMY CATHETER,4037.0,2624.05,880.07,4037.0,59
CDM,27232505,ROTAGLIDE LUBRICANT,155.0,100.75,33.79,155.0,59
CDM,27232510,PENUMBRA MAX CANISTER,548.0,356.2,119.46,548.0,59
CDM,27232515,4FR MICROPUNCTURE,79.0,51.35,17.22,232.66,67
CDM,27232520,PENUMBRA SEPARATOR,2693.0,1750.45,587.07,2693.0,59
CDM,27232525,C1725 BALLOONS TIER 2,239.0,155.35,52.1,239.0,67
CDM,27232530,PENUMBRA ASPIRATION TUBING,615.0,399.75,134.07,615.0,59
CDM,27232535,LUTONIX DRUG COATED BALLOON,2092.0,1359.8,200.93,2092.0,67
CDM,27232540,GEN DIAGNOSTIC CATH TIER 3,180.0,117.0,39.24,180.0,59
CDM,27232545,.014 GUIDEWIRES,228.0,148.2,49.7,232.66,67
CDM,27232550,J GUIDE WIRE: LONG,131.25,85.31,28.61,232.66,67
CDM,27232555,EKOSONIC MACH 4 BALLOONS,3031.0,1970.15,200.93,3031.0,67
CDM,27232560,"LIVEWIRE HEX, OCT, DECA(NEW)",1400.31,910.2,200.93,1400.31,67
CDM,27232565,VASCUTAPE RADIOPAQUE STRIP,78.0,50.7,17.0,78.0,59
CDM,27232570,CORDIS LASSO CATHETER,1451.25,943.31,200.93,1451.25,67
CDM,27232575,3.5 FR B-RAIL CATH,5198.0,3378.7,200.93,5198.0,67
CDM,27232580,RPM MAPPING CATHETER,1306.95,849.52,200.93,1306.95,67
CDM,27232585,GUIDEZILLA GUIDE EXT CATH,750.0,487.5,163.5,750.0,67
CDM,27232590,WRENCH/ACCESSORY KITS TIER 2,83.0,53.95,18.09,83.0,59
CDM,27232595,CUSTOM MYOCARDIAL PACK,65.0,42.25,14.17,65.0,59
CDM,27232600,.014 PIGGYBACK WIRE CONVERTER,353.0,229.45,76.95,353.0,59
CDM,27232605,XXL BALLOON,300.0,195.0,65.4,300.0,67
CDM,27232615,8.5FR AGILIS INTRODUCER,870.0,565.5,189.66,870.0,67
CDM,27232620,CONTROL VALVE,55.0,35.75,11.99,55.0,59
CDM,27232625,"SHEATH, AVANTI OR PINNACLE",51.0,33.15,11.12,232.66,67
CDM,27232630,ELECTROSURG DISSECTION DEVICE,92.0,59.8,20.06,92.0,59
CDM,27232635,PORT PLUG OR CAP,128.0,83.2,27.9,128.0,59
CDM,27232640,ST JUDE FIXATION/STYLET KITS,166.0,107.9,36.19,166.0,59
CDM,27232645,MINI STICK OR CHECK-FLO INTRO,113.0,73.45,24.63,232.66,67
CDM,27232650,C1733 EVOLUTION  SHEATH SET,2018.25,1311.86,200.93,2018.25,67
CDM,27232655,C1769 EP GUIDEWIRE TIER I,60.0,39.0,13.08,232.66,67
CDM,27232660,SPACING LASSO,866.0,562.9,188.79,866.0,59
CDM,27232665,C1769 EP GUIDEWIRE TIER III,229.5,149.18,50.03,232.66,67
CDM,27232670,ANTIBAC DEFIB MESH,1493.0,970.45,325.47,1493.0,59
CDM,27232675,AQUACEL SURGICAL DRESSING,55.0,35.75,11.99,55.0,59
CDM,27232680,GLIDE OR GUIDE CATH TIER 1,91.0,59.15,19.84,232.66,67
CDM,27232685,FIRMAP PACING CATH,6615.0,4299.75,200.93,6615.0,67
CDM,27232690,TACTICATH ABLATION CATHETER,2970.0,1930.5,200.93,2970.0,67
CDM,27232695,2.6M COOLING POINT TUBING,175.0,113.75,38.15,232.66,67
CDM,27232700,C1733 ABLATION CATH TIER I,1275.0,828.75,200.93,1275.0,67
CDM,27232705,C1733 ABLATION CATH TIER II,3240.0,2106.0,200.93,3240.0,67
CDM,27232715,C1733 ABLATION CATH TIER III,5670.0,3685.5,200.93,5670.0,67
CDM,27232720,C2630 ABLAT CATH TIER I,1418.0,921.7,200.93,1418.0,67
CDM,27232725,C2630 ABLAT CATH TIER II,2228.0,1448.2,200.93,2228.0,67
CDM,27232730,C1887 DIAG CATH EP TIER III,746.0,484.9,162.63,746.0,67
CDM,27232735,ZOLL ELECTRODE,74.0,48.1,16.13,74.0,59
CDM,27232740,IRRIGATION TUBING SET,105.0,68.25,22.89,105.0,59
CDM,27232745,WATCHMAN ACCESS CAP 1-3 UNITS,1350.0,877.5,294.3,1350.0,59
CDM,27232750,WATCHMAN ACCESS CAP EA ADD,1350.0,877.5,294.3,1350.0,59
CDM,27232755,STEERABLE CATHETER ACCESS KIT,1782.0,1158.3,388.48,1782.0,59
CDM,27232760,THERMO ABLAT CATH TIER I,1200.0,780.0,200.93,1200.0,67
CDM,27232765,THERMO ABLAT CATH TIER II,2700.0,1755.0,200.93,2700.0,67
CDM,27232770,THERMO ABLAT CATH TIER 4,4334.0,2817.1,200.93,4334.0,67
CDM,27232775,MISC EP SUPPLY TIER 1,60.0,39.0,13.08,60.0,59
CDM,27232780,MISC EP SUPPLY TIER 2,180.25,117.16,39.29,180.25,59
CDM,27232785,ADAPTER TIER 1,175.0,113.75,38.15,175.0,59
CDM,27232790,IMPLANT/CONNECT TOOL TIER 0,30.0,19.5,6.54,30.0,59
CDM,27232795,SLITTER TOOL,90.0,58.5,19.62,90.0,59
CDM,27232800,C1773 STYLET,771.0,501.15,168.08,771.0,67
CDM,27232805,C1893  INTRODUCER/GUIDER 1,270.0,175.5,58.86,270.0,67
CDM,27232810,IMPLANT/CONNECT TOOL TIER 3,1350.0,877.5,294.3,1350.0,59
CDM,27232815,WRENCH/ACCESSORY KITS TIER 1,46.0,29.9,10.03,46.0,59
CDM,27232820,C1894 SHEATH TIER 2,318.0,206.7,69.32,318.0,67
CDM,27232825,C1894 SHEATH TIER 3,975.0,633.75,200.93,975.0,67
CDM,27232830,SENSATION PLUS INSERTION KIT,250.0,162.5,54.5,250.0,59
CDM,27232835,C1766 BI-DIRECTIONAL INTROD,1782.0,1158.3,200.93,1782.0,67
CDM,27232840,C1730 EP CATH W/CON TIER I,713.0,463.45,155.43,713.0,67
CDM,27232845,C1731 EP CATH WITH ELECTR 3,2099.0,1364.35,200.93,2099.0,67
CDM,27232850,SLEEVE/SLEEVE ACCESSORY TIER 2,210.0,136.5,45.78,210.0,59
CDM,27232855,SLEEVE/SLEEVE ACCESSORY TIER 1,54.0,35.1,11.77,54.0,59
CDM,27232865,BIPOLAR SEALER,713.0,463.45,155.43,713.0,59
CDM,27232870,C1730 EP CATH W/CON TIER 0,243.0,157.95,52.97,243.0,67
CDM,27232875,C1887 DIAG CATH EP TIER I,276.0,179.4,60.17,276.0,67
CDM,27232880,C1887 DIAG CATH EP TIER II,375.0,243.75,81.75,375.0,67
CDM,27232885,IABP CATH & KIT,1425.0,926.25,310.65,1425.0,59
CDM,27232890,C1757 EMBOLECTOMY DEVICE,675.0,438.75,147.15,675.0,67
CDM,27232895,C1725 BALLOONS TIER I,192.5,125.13,41.97,232.66,67
CDM,27232900,MISC EP SUPPLY TIER 3,300.0,195.0,65.4,300.0,59
CDM,27232905,C1773 SNARE TIER 1,413.0,268.45,90.03,413.0,67
CDM,27232910,C1773 LEAD LOCKING DEVICE,788.0,512.2,171.78,788.0,67
CDM,27232915,C1725 BALLOONS TIER 2,201.0,130.65,43.82,232.66,67
CDM,27232920,C1725 BALLOONS TIER 1,123.0,79.95,26.81,232.66,67
CDM,27232930,DEXTERITY STEERABLE INTRODUCER,2018.0,1311.7,200.93,2018.0,67
CDM,27232940,IMPLANT/CONNECT TOOL TIER 1,300.0,195.0,65.4,300.0,59
CDM,27232950,IMPLANT/CONNECT TOOL TIER 2,637.0,414.05,138.87,637.0,59
CDM,27232960,TUNNELING TOOL FOR DEFIB LEAD,575.0,373.75,125.35,575.0,59
CDM,27232970,C1887 DIAG CATH EP TIER 0,15.5,10.08,3.38,232.66,67
CDM,27232980,PACEMAKER ADAPTER KIT TIER I,287.0,186.55,62.57,287.0,67
CDM,27232990,LONG PEEL AWAY INTROD TIER II,202.0,131.3,44.04,232.66,67
CDM,27232OH,CLTX FEM FX PROX END NCK W/MANJ W/WO SKEL TRACJ,4688.0,3047.2,1.1,4688.0,144
CDM,27233005,RADIAL ARTERY CATH KIT AK4220,32.0,20.8,6.98,32.0,59
CDM,27233015,RESTORE WITH SILVER,16.87,10.97,3.68,16.87,59
CDM,27233025,SLITTER TOOL,90.0,58.5,19.62,90.0,59
CDM,27233035,ROTAGLIDE LUBRICANT,155.0,100.75,33.79,155.0,59
CDM,27233040,IMPLANT/CONNECT TOOL TIER 1,300.0,195.0,65.4,300.0,59
CDM,27233055,WRENCH/ACCESSORY KITS TIER 1,46.0,29.9,10.03,46.0,59
CDM,27233065,SLEEVE/SLEEVE ACCESSORY TIER 2,210.0,136.5,45.78,210.0,59
CDM,27233075,2.6M COOLING POINT TUBING,175.0,113.75,38.15,175.0,59
CDM,27233085,ROTAGLIDE LUBRICANT,155.0,100.75,33.79,155.0,59
CDM,27233095,IMPLANT/CONNECT TOOL TIER 1,300.0,195.0,65.4,300.0,59
CDM,27233115,WRENCH/ACCESSORY KITS TIER 1,46.0,29.9,10.03,46.0,59
CDM,27233125,SLEEVE/SLEEVE ACCESSORY TIER 2,210.0,136.5,45.78,210.0,59
CDM,27233135,C1725 BALLOONS TIER 5,1425.0,926.25,200.93,1425.0,67
CDM,27233145,C1730 EP CATH W/CON TIER 0,243.0,157.95,52.97,243.0,67
CDM,27233155,C1730 EP CATH W/CON TIER I,713.0,463.45,155.43,713.0,67
CDM,27233165,C1731 EP CATH WITH ELECTR 3,2099.0,1364.35,200.93,2099.0,67
CDM,27233175,THERMO ABLAT CATH TIER 4,4334.0,2817.1,200.93,4334.0,67
CDM,27233185,C1766 BI-DIRECTIONAL INTROD,1782.0,1158.3,200.93,1782.0,67
CDM,27233195,C1769 EP GUIDEWIRE TIER III,229.5,149.18,50.03,232.66,67
CDM,27233205,C1773 LEAD LOCKING DEVICE,788.0,512.2,171.78,788.0,67
CDM,27233215,GLIDE OR GUIDE CATH TIER 2,743.0,482.95,161.97,743.0,67
CDM,27233225,C1887 DIAG CATH EP TIER 0,15.5,10.08,3.38,232.66,67
CDM,27233235,C1887 DIAG CATH EP TIER III,746.0,484.9,162.63,746.0,67
CDM,27233245,GLIDE OR GUIDE CATH TIER 1,584.0,379.6,127.31,584.0,67
CDM,27233255,C1887 DIAG CATH EP TIER 0,15.5,10.08,3.38,232.66,67
CDM,27233265,C1887 DIAG CATH EP TIER III,746.0,484.9,162.63,746.0,67
CDM,27233275,GLIDE OR GUIDE CATH TIER 1,584.0,379.6,127.31,584.0,67
CDM,27233285,C1894 SHEATH/INTRODUCER TIER 0,52.0,33.8,11.34,232.66,67
CDM,27233295,C1894 SHEATH/INTRODUCER TIER 2,167.0,108.55,36.41,232.66,67
CDM,27233305,C1894 SHEATH TIER 2,318.0,206.7,69.32,318.0,67
CDM,27233315,TACTICATH ABLATION CATHETER,2970.0,1930.5,200.93,2970.0,67
CDM,27233335,SPINAL BLOCK KIT A4144-25,42.02,27.31,9.16,42.02,59
CDM,27233345,"1"" CONVEX-IT WAFER",3.91,2.54,0.85,3.91,59
CDM,27233455,SENSURA CX LT,3.86,2.51,0.84,3.86,59
CDM,27233465,SENSURA URO POUCH,1.96,1.27,0.43,1.96,59
CDM,27233475,SENSURA POST-OP 100MM,9.86,6.41,2.15,9.86,59
CDM,27233485,7.5FR 40CC CATH IAB W/STAT,1392.2,904.93,303.5,1392.2,59
CDM,27233495,14FR 15-20CM .035IN CATH SET,157.5,102.38,34.34,157.5,59
CDM,27233505,COMPRESSION SLEEVE-SM,30.14,19.59,6.57,30.14,59
CDM,27233515,SOFIA MICROCATHETER,3098.0,2013.7,200.93,3098.0,67
CDM,27233525,EAKIN-TEARDROP,42.92,27.9,9.36,42.92,59
CDM,27233545,OST POUCH EAKIN 9.7 X 6.3,36.26,23.57,7.9,36.26,59
CDM,27233555,SENSURA POUCH,1.51,0.98,0.33,1.51,59
CDM,27233565,SINGLE SHOT BLOCK KIT NB400,50.0,32.5,10.9,50.0,59
CDM,27233575,CONT BLOCK CATH KIT ASK-19600,92.75,60.29,20.22,92.75,59
CDM,27233585,BASIX TOUCH INF DEVICE,58.0,37.7,12.64,58.0,59
CDM,27233595,HEMCOM WOUND DRESSING,40.8,26.52,8.89,40.8,59
CDM,27233625,"1 1/8"" CONVEX-IT WAFER",3.91,2.54,0.85,3.91,59
CDM,27233635,POWER INJECTABLE PICC ONLY,96.25,62.56,20.98,96.25,59
CDM,27233645,SHERLOCK 3CG WIRE,176.75,114.89,38.53,176.75,59
CDM,27233665,BARD PICC/SHERLOCK 5FR DOUBLE,145.0,94.25,31.61,232.66,67
CDM,27233725,NEVRO PATIENT REMOTE KIT,945.0,614.25,206.01,945.0,59
CDM,27233735,NEVRO CHARGER KIT,1485.0,965.25,323.73,1485.0,59
CDM,27233745,CATH HEPARIN,74.73,48.57,16.29,74.73,59
CDM,27233755,PROMETRA TUNNELER,158.0,102.7,34.44,158.0,59
CDM,27233765,ST JUDE SWIFT LOCK ANCHOR 1192,240.0,156.0,52.32,240.0,59
CDM,27233775,MEDTRONIC 8596SC CATH KIT,600.0,390.0,130.8,600.0,59
CDM,27233785,BARD PICC/SHERLOCK 4FR SINGLE,113.75,73.94,24.8,232.66,67
CDM,27233815,MERIT 4FR PIGTAIL 70CM,26.04,16.93,5.68,26.04,59
CDM,27233825,HEALTH SPAN INTRO/SHEATH,1125.0,731.25,245.25,1125.0,59
CDM,27233835,BRAUN TYSHAK BALLOON 10X8,631.88,410.72,137.75,631.88,67
CDM,27233845,ATLAS GOLD OTW DIL 20-24MMX120CM,48.0,31.2,10.46,232.66,67
CDM,27233855,ASAHI INTERVENT WIRE,148.0,96.2,32.26,148.0,59
CDM,27233865,COOK INTRO SHTH 22F 65CM,454.0,295.1,98.97,454.0,59
CDM,27233875,CHECK-FLO INTRO SET 20-24FRX40-65CM,489.78,318.36,106.77,489.78,59
CDM,27233885,BAYLIS NRG TRANS NEEDLE,727.5,472.88,158.6,727.5,59
CDM,27233895,BRK TRANSEPTL NDL 19GAX56CM,262.5,170.63,57.23,262.5,59
CDM,27233915,AGA AMPLATZER OCC DEVICE,1425.0,926.25,310.65,1425.0,59
CDM,27233930,TERUMO TORQUE DVC 010/038,131.25,85.31,28.61,131.25,59
CDM,27233935,AQUILEX TUBE SET,140.0,91.0,30.52,140.0,59
CDM,27233945,MYOSURE LITE DISPOSABLE,771.0,501.15,168.08,771.0,59
CDM,27233955,COOK GUIDE WIRES .018/260 ST,52.52,34.14,11.45,232.66,67
CDM,27233965,MESALT 6X6 DRESSING,1.63,1.06,0.36,19.65,67
CDM,27233995,"PRECISION, PT PRGM KIT#5500",1314.0,854.1,200.93,1314.0,67
CDM,27234005,SUTURELESS PUMP CONNECTOR REVISION KIT,225.0,146.25,49.05,225.0,59
CDM,27234015,MEDTRONIC CATH DISP 38CM,171.5,111.48,37.39,171.5,65
CDM,27234015_IP,MEDTRONIC CATH DISP 38CM,171.5,111.48,62.43,62.43,1
CDM,27234015_OP,MEDTRONIC CATH DISP 38CM,171.5,111.48,51.28,51.28,1
CDM,27234025,BS MODEL SC-4395-70 KIT,225.75,146.74,49.21,225.75,59
CDM,27234035,SYNCHROMED REFILL KIT 8551,84.0,54.6,18.31,84.0,59
CDM,27234075,C1769 WIRES TIER II,292.5,190.13,63.77,292.5,67
CDM,27234115,GEN DIAGNOSTIC CATH TIER 2,96.0,62.4,20.93,96.0,59
CDM,27234125,EMBO COIL PUSHER,285.0,185.25,62.13,285.0,59
CDM,27234135,MILEX MEDIIUM 80MMX20MM VAGINAL-RECTAL DILATORS -SET OF 4,246.33,160.11,53.7,246.33,59
CDM,27234145,ABSORBABLE ANTIBACTERIAL ENVELOPE LARGE,1492.5,970.13,325.37,1492.5,59
CDM,27234155,DUO-DERM DRESSING 6X6 (1),8.0,5.2,1.74,8.0,59
CDM,27234165,EAKIN 6.9 X 4.3,19.66,12.78,4.29,19.66,59
CDM,27234185,INTROSYTE INTRODUCER SHEATH 26GAX 1.9CM,46.3,30.1,10.09,232.66,67
CDM,27234195,EAKIN DIAMOND,12.81,8.33,2.79,12.81,59
CDM,27234205,8FR 50CC CATH IAB W/STAT,1397.13,908.13,304.57,1397.13,59
CDM,27234215,4X 30 OCCLUSION BALLOON,47.74,31.03,10.41,47.74,59
CDM,27234225,ACUNAV DIAGNOSTIC US CATH,1972.0,1281.8,429.9,1972.0,59
CDM,27234235,ARISTA ABSORBABOE HEMOSTAT,323.0,209.95,70.41,323.0,59
CDM,27234245,GEL BLOCK 10X EMBO PLEDGETS,70.0,45.5,15.26,70.0,59
CDM,27234255,ELECTRODE,236.25,153.56,51.5,236.25,59
CDM,27234265,GENERIC SHEATH TIER 1,96.25,62.56,20.98,96.25,59
CDM,27234275,OCCLUSION BALLOON CATHETER,380.73,247.47,83.0,380.73,59
CDM,27234285,GASTROJEJUNOSTOMY SET,372.0,241.8,81.1,372.0,59
CDM,27234295,GUIDEWIRE WHOLEY HI-TORQUE,275.3,178.95,60.02,275.3,59
CDM,27234305,FIRM CONNORS GUIDEWIRE 300CM,500.14,325.09,109.03,500.14,59
CDM,27234325,28MM X 6CM BALLOON Z MED,998.3,648.9,200.93,998.3,67
CDM,27234335,HRTSTART PED MLTIFUN ELEC PADS,40.8,26.52,8.89,40.8,59
CDM,27234345,MNGS JL1.5 CATH ALL SIZES,218.75,142.19,47.69,232.66,67
CDM,27234355,ABOT GW HI-TORQ BAL HVYWT,131.25,85.31,28.61,232.66,67
CDM,27234365,PENUMBRA REPERFUSION CATH,3861.0,2509.65,841.7,3861.0,59
CDM,27234375,STRYKER AXS DSTL ACC CATH,3037.5,1974.38,200.93,3037.5,67
CDM,27234385,VENTRIC NEURO PREP KIT,280.5,182.33,61.15,280.5,59
CDM,27234395,CELLO BALLOON GUIDE CATH 8FR X 102CM,1765.8,1147.77,200.93,1765.8,67
CDM,27234405,"BALLOON,SHAFT,STERLING MONORAIL BALLOON DILATATION CATH 135CM 5M",495.0,321.75,107.91,495.0,67
CDM,27234415,"HEADWAY 27 MICROCATH 156CM W/HYDROPHILIC COATIN,6CM STRAIGHT SHA",1406.25,914.06,200.93,1406.25,67
CDM,27234425,REPERFUSION 3 MAX CATH & PENUMBRA HI-FLOW ASPIRATION TUBING,3043.57,1978.32,663.5,3043.57,59
CDM,27234475,CATH GUID .035IN 4.8-3.7FR 90,1313.13,853.53,200.93,1313.13,67
CDM,27234485,CATH ANG 5FR 20CM 70CM .035IN,237.5,154.38,51.78,237.5,59
CDM,27234495,CATH ANG 5FR 100CM .035IN PGTL,1620.0,1053.0,353.16,1620.0,59
CDM,27234505,DIL SRG AMPLTZ TFE ST 30CM 16,1620.0,1053.0,200.93,1620.0,67
CDM,27234515,DIL VASC 5FR 20CM HYDRPHLC,22.0,14.3,4.8,232.66,67
CDM,27235OH,PRQ SKEL FIXJ FEMORAL FX PROX END NECK,5200.0,3380.0,1.1,20863.78,144
CDM,27236OH,OPTX FEM FX PROX END NCK INT FIXJ/PROSTC RPLCMT,7044.0,4578.6,1.1,7044.0,144
CDM,27238OH,CLTX INTER/PERI/SUBTROCHANTERIC FEM FX W/O MANJ,2300.0,1495.0,1.1,4686.39,144
CDM,27239805,CHECK FLO ASSEM ADAPTOR,15.5,10.08,3.38,15.5,59
CDM,27239815,B BRAUN NUCLEUS X BAL CATH,1313.13,853.53,200.93,1313.13,67
CDM,27239825,CENTRIMAG BLOOD PUMP CAT#102953,25200.0,16380.0,5493.6,25200.0,59
CDM,27239835,CENTRIMAG 34F DRAINAGE CANNULA KIT CAT#201-50067,1620.0,1053.0,353.16,1620.0,59
CDM,27239845,CENTRIMAG 24F RETURN CANNULA KIT CAT#201-50065,1620.0,1053.0,353.16,1620.0,59
CDM,27239895,MEDRAD ENDORECTAL IMAGE COIL BPX15-INSRT,258.0,167.7,56.24,258.0,67
CDM,27239905,EMPRINT THERMO PERC ANT PROBE,4313.25,2803.61,940.29,4313.25,59
CDM,27239915,WOUND CLOSURE,10.0,6.5,2.18,10.0,59
CDM,27239975,LEAD PACE 52CM 6.2FR-7FR,637.5,414.38,138.98,637.5,59
CDM,27239985,LEAD PACE 58CM 6.2FR-7FR,637.5,414.38,138.98,637.5,59
CDM,27239995,INTRO SHEALTH 7FR .092IN 13CM,54.0,35.1,11.77,54.0,59
CDM,27240005,SCISSORS HOT SHEARS DA VINCI S/SI,480.0,312.0,104.64,480.0,59
CDM,27240015,SENSURA FLAT WAFER,1.82,1.18,0.4,1.82,59
CDM,27240025,SENSURA FLAT POUCH EZ CL,2.02,1.31,0.44,2.02,59
CDM,27240035,"SENSURA CXLT CTF 1 1/4""",9.42,6.12,2.05,9.42,59
CDM,27240115,BIOFEEDBACK DISPOSABLE 2 CHANNEL CATHETER,562.5,365.63,122.63,562.5,59
CDM,27240125,GEN DIAGNOSTIC CATH TIER 5,1087.5,706.88,237.08,1087.5,59
CDM,27240135,AORTIC DIL CATH TIER I,937.5,609.38,200.93,937.5,67
CDM,27240145,WOUND CARE/SUTURE TIER 2,123.0,79.95,26.81,123.0,59
CDM,27240155,ESOPHAGEAL RETRACTOR,548.0,356.2,119.46,548.0,59
CDM,27240185,GEN DIAGNOSTIC CATH TIER X,2740.0,1781.0,597.32,2740.0,59
CDM,27240215,TRU-FIX DEV SECUR FIX DISC ADH DRSG KT TFK10,32.5,21.13,7.09,32.5,59
CDM,27240275,YUEH CENTESIS CATH NEEDLE 5F 7CM 19G,42.0,27.3,9.16,42.0,59
CDM,27240415,GUIDEWIRE C1769 38,81.49,52.97,17.76,232.66,67
CDM,27240465,PACK SURGICAL FEMORAL ANGIO TRANSJUGULAR SAN29MACCR,130.0,84.5,28.34,130.0,59
CDM,27240555,FLEXIMA 8F 25CM APD REGULAR PIGTAIL,139.0,90.35,30.3,139.0,59
CDM,27240565,REGULAR FLEXIMA NEPHROSTOMY 12F  25MM,328.0,213.2,71.5,328.0,67
CDM,27240655,FLEXIMA BILIARY RO 8F 35CM REG,142.0,92.3,30.96,142.0,59
CDM,27240OH,CLTX INTR/PERI/SBTRCHNTC FEMORAL FX W/MANJ,5524.0,3590.6,1.1,5524.0,144
CDM,27241065,POWERPORT PORT ISP GROSHONG 8FR TITANIUM CUSTOM CP00003,375.0,243.75,81.75,375.0,59
CDM,27241605,GLIDE OR GUIDE CATH,91.0,59.15,19.84,232.66,67
CDM,27241625,COOK RAABE SHEATH,80.0,52.0,17.44,232.66,67
CDM,27241635,STRYKER - VEREPORT CEMENT CANNULA 11 G,110.0,71.5,23.98,110.0,59
CDM,27241645,STRYKER - 11 G HAND DRILL,91.0,59.15,19.84,91.0,59
CDM,27241655,IVAS INFLATABLE VERATABLE AUGMENTATION SYSTEM,1590.3,1033.7,346.69,1590.3,59
CDM,27241665,KIVA ULTRA FLEX CEMENT NEEDLE,375.0,243.75,81.75,375.0,59
CDM,27241675,HEARTSPAN TRANSEPTAL NEEDLE,255.0,165.75,55.59,255.0,59
CDM,27242545,GUIDEWIRE HI-TORQUE BALANCE MIDDLEWEIGHT UNIVERSAL II .014IN STR,177.5,115.38,38.7,232.66,67
CDM,27243625,B BRAUN BIB BALLOON STENT PLACEMENT CATH 26-30 X 4-5,1328.4,863.46,200.93,1328.4,67
CDM,27243635,BARR SKN 4.5X4.5IN 7/8IN 1.75 CX FLANGE,14.93,9.7,3.25,14.93,59
CDM,27243645,BELT MIO 40IN MD (15BELTS/BOX),36.61,23.8,7.98,36.61,59
CDM,27243655,BELT MIO 61IN XL (15 BELTS/BOX),46.68,30.34,10.18,46.68,59
CDM,27243665,POUCH DRN SOFT CTF TO 1-5/16,21.66,14.08,4.72,21.66,59
CDM,27243675,POUCH DRN SOFT CTF TO 1-11/16,21.66,14.08,4.72,21.66,59
CDM,27243685,POUCH DRN LIGHT 1-3/8 PRECUT,21.66,14.08,4.72,21.66,59
CDM,27243695,POUCH DRN LIGHT 1-1/2 PRECUT,21.66,14.08,4.72,21.66,59
CDM,27243705,POUCH DRN LIGHT 13/16 PRECUT,21.66,14.08,4.72,21.66,59
CDM,27243715,POUCH DRN LIGHT 1-1/8 PRECUT,21.66,14.08,4.72,21.66,59
CDM,27243725,POUCH DRN DEEP 1-3/8 PRECUT,21.66,14.08,4.72,21.66,59
CDM,27243735,POUCH DRN DEEP 1-1/2 PRECUT,21.66,14.08,4.72,21.66,59
CDM,27243745,POUCH DRN DEEP 13/16 PRECUT,21.66,14.08,4.72,21.66,59
CDM,27243755,POUCH DRN DEEP 1-1/8 PRECUT,21.66,14.08,4.72,21.66,59
CDM,27243765,POUCH URO SOFT CTF TO 1-5/16,25.22,16.39,5.5,25.22,59
CDM,27243775,POUCH URO SOFT? CTF TO 2IN,25.22,16.39,5.5,25.22,59
CDM,27243785,POUCH URO LIGHT CTF TO 1-5/16,25.22,16.39,5.5,25.22,59
CDM,27243795,POUCH URO LIGHT CTF TO 1-11/16,25.22,16.39,5.5,25.22,59
CDM,27243805,POUCH URO DEEP CTF 5/8-1-5/16,25.22,16.39,5.5,25.22,59
CDM,27243815,POUCH URO DEEP CTF 5/8-1-11/16,25.22,16.39,5.5,25.22,59
CDM,27243825,POUCH OST REPL FLTR DOOR REPL,9.66,6.28,2.11,9.66,59
CDM,27243835,"BARR CERAPLUS 44MM 1 3/4"" CONVEX",8.78,5.71,1.91,8.78,59
CDM,27243845,"BARR CERAPLUS 57MM 2 1/4"" CONVEX",8.78,5.71,1.91,8.78,59
CDM,27243855,"BARR CERAPLUS 70MM 2 3/4"" CONVEX",8.78,5.71,1.91,8.78,59
CDM,27243865,STRYKER KYPHO 10G/11G-10MM/15MM/20MM IVAS SYSTEM KIT,4773.6,3102.84,1040.64,4773.6,59
CDM,27243875,"STRYKER KYPHO 10G/11G, IVAS ACCESS CANULA",546.0,354.9,119.03,546.0,59
CDM,27243885,STRYKER KYPHO 10G/11G CURETTE,776.88,504.97,169.36,776.88,59
CDM,27243895,STRYKER KYPHO 10G/11G IVAS VERTEPORT CEMENT CANULA,1524.33,990.81,332.3,1524.33,59
CDM,27243905,STRYKER KYPHO CURVED NEEDLE,810.0,526.5,176.58,810.0,59
CDM,27243915,STRYKER KYPHO 10G/11G IVAS BONE BIOPSY KIT,728.91,473.79,158.9,728.91,59
CDM,27244045,CLIP/TISSUE MARKER,110.0,71.5,23.98,232.66,67
CDM,27244655,SUPPLY-BIPAP MASK XL,86.0,55.9,18.75,86.0,59
CDM,27244725,SUTURE ETHILON 5-0 P3,29.5,19.18,6.43,29.5,59
CDM,27244735,SUTURE PACK,57.2,37.18,12.47,57.2,59
CDM,27244745,SUTURE PROLENE 4-0 PRE-4,21.72,14.12,4.73,21.72,59
CDM,27244755,SUTURE PROLENE 5-0 P3,7.3,4.75,1.59,7.3,59
CDM,27244765,SUTURE PROLENE 5-0 PRE-3,31.5,20.48,6.87,31.5,59
CDM,27244OH,TX INTER/PR/SUBTRCHNTRIC FEMORAL FX SCREW IMPLT,7272.0,4726.8,1.1,7272.0,144
CDM,27245275,FOLEY DRAINAGE CATH,27.0,17.55,5.89,232.66,67
CDM,27245OH,TX INTER/PR/SUBTRCHNTRIC FEM FX IMED IMPLTSCREW,7272.0,4726.8,1.1,7272.0,144
CDM,27246OH,CLTX GREATER TROCHANTERIC FX W/O MANJ,1932.0,1255.8,1.1,1932.0,148
CDM,27248OH,OPEN TREATMENT GREATER TROCHANTERIC FRACTURE,4312.0,2802.8,1.1,4312.0,144
CDM,27250505,ACCUSTICK SYSTEM,138.0,89.7,30.08,138.0,59
CDM,27250815,PLEURIX DRAINAGE SYSTEM,92.75,60.29,20.22,92.75,67
CDM,27250825,COOK GUID WIRES .021/145 ST,27.62,17.95,6.02,232.66,67
CDM,27250835,CORDIS SLALOM BALLON,495.0,321.75,107.91,495.0,59
CDM,27250845,G120289 NMARQ PVI SYSTEM NCT01824394,3037.5,1974.38,200.93,3037.5,67
CDM,27250OH,CLTX HIP DISLOCATION TRAUMATIC W/O ANESTHESIA,1681.0,1092.65,1.1,1681.0,144
CDM,27252095,ICESPHERE 1.5 NEEDLE,2278.8,1481.22,200.93,2278.8,67
CDM,27252105,ICEROD PLUS 1.5 NEEDLE,2278.8,1481.22,200.93,2278.8,67
CDM,27252115,ICE EDGE 2.4 NEEDLE,2551.5,1658.48,200.93,2551.5,67
CDM,27252125,ICEROD PLUS 1.5 CX HELIUM FREE NDLE,2461.05,1599.68,536.51,2461.05,59
CDM,27252135,ICE PEARL 2.1 CX HELIUM FREE NDLE,3200.0,2080.0,200.93,3200.0,67
CDM,27252145,ICE FORCE 2.1 CX HELIUM FREE NDLE,2916.0,1895.4,200.93,2916.0,67
CDM,27252395,LACERATION TRAY PLASTIC,36.0,23.4,7.85,36.0,59
CDM,27252525,MYOSURE LITE,140.0,91.0,30.52,140.0,59
CDM,27252OH,CLTX HIP DISLOCATION TRAUMATIC REQ ANESTHESIA,4853.0,3154.45,1.1,4853.0,144
CDM,27253145,WHOLEY .035/260 GW,105.0,68.25,22.89,232.66,67
CDM,27253275,X LARGE BINDER,18.31,11.9,3.99,18.31,59
CDM,27253285,LARGE BINDER,6.17,4.01,1.35,6.17,59
CDM,27253295,POUCH URO ULTRACLEAR 44 MM 1-3/4 HOLLISTER,7.29,4.74,1.59,7.29,59
CDM,27253305,POUCH URO ULTRACLEAR 57MM HOLLISTER,7.29,4.74,1.59,7.29,59
CDM,27253315,POUCH URO ULTRACLEAR 70 MM 2-3/4 HOLLISTER,7.29,4.74,1.59,7.29,59
CDM,27253OH,OPTX HIP DISLOCATION TRAUMATIC W/O INTERNAL FIXJ,5432.0,3530.8,1.1,5432.0,144
CDM,27254755,CHLOROGUARD KIT W/PICC,389.82,253.38,84.98,389.82,67
CDM,27254785,DOMEBORO ASTR PWDR SOLUTN ALUMINUM SULFATE,1.26,0.82,0.27,1.26,59
CDM,27254OH,OPTX HIP DISLC TRAUMTC W/ACTBLR WALL&FEM HEAD,7576.0,4924.4,1.1,7576.0,144
CDM,27255225,HME CASSETTES,166.25,108.06,16.97,166.25,67
CDM,27255235,9/55 LARY TUBES,215.25,139.91,36.52,215.25,67
CDM,27255245,PROVOX TUBE HOLDERS,42.0,27.3,9.16,42.0,67
CDM,27255255,C1887 DIAG CATH EP TIER 4,1493.0,970.45,200.93,1493.0,67
CDM,27255265,C1887 DIAG CATH EP TIER 5,2025.0,1316.25,200.93,2025.0,67
CDM,27255275,C1887 DIAG CATH EP TIER 6,3240.0,2106.0,200.93,3240.0,67
CDM,27255285,S DRVR NDL LRG SUTURE CT DVNC XI,360.0,234.0,78.48,360.0,59
CDM,27255295,S CAUTERY PERM HOOK DVNC XI,300.0,195.0,65.4,300.0,59
CDM,27255305,PACING PA CATHETER,300.0,195.0,65.4,300.0,59
CDM,27255315,S APPLIER DA VINCI S/SI ENDOWRIST 8MM 45- D LRG POLY 55.9CM 2.4C,28.0,18.2,6.1,28.0,59
CDM,27255325,S APPL CLP LARGE DVNC XI,28.0,18.2,6.1,28.0,59
CDM,27255335,S SHEARS DA VINCI S/SI ENDOWRIST HARMONIC ACE 8MM CURVE SURGICAL,96.25,62.56,20.98,96.25,59
CDM,27255345,S SHR ESU HARM DVNC 8MM CRV,97.48,63.36,21.25,97.48,59
CDM,27255355,S FORCEPS MARYLAND BIPOLAR,236.25,153.56,51.5,236.25,59
CDM,27255365,S STPL EWRST STAPLER 45 DVNC XI,210.0,136.5,45.78,210.0,59
CDM,27255375,S FORCEPS DA VINCI S/SI ENDOWRIST DEBAKEY 8MM 30- D MED 54.6CM 1,277.5,180.38,60.5,277.5,59
CDM,27255385,S FORCEPS DA VINCI S/SI ENDOWRIST CADIERE 8MM LAP FINGERTIP CTRL,300.0,195.0,65.4,300.0,59
CDM,27255395,S HOOK DA VINCI S/SI ENDOWRIST 8MM 55.2CM 1.6CM LAPAROSCOPIC CAU,300.0,195.0,65.4,300.0,59
CDM,27255405,S ELECTRD DA VINCI S/SI ENDOWRIST 8MM MONOPOL CAUTERY SPATULA PE,300.0,195.0,65.4,300.0,59
CDM,27255415,S GRASPER DA VINCI S/SI ENDOWRIST 8MM 56.7CM LAP 2 FENESTRATE,300.0,195.0,65.4,300.0,59
CDM,27255425,S DRIVE DA VINCI S/SI ENDOWRIST 8MM 30- D LRG 54.4CM 49.3CM NDL,330.0,214.5,71.94,330.0,59
CDM,27255435,S FORCEPS PROGRASP DA VINCI S/SI ENDOWRIST 8MM 38- D 56.2CM 2.8C,330.0,214.5,71.94,330.0,59
CDM,27255445,S FORCEPS DA VINCI S/SI ENDOWRIST RESANO 8MM 30- D MED 54.5CM 1.,330.0,214.5,71.94,330.0,59
CDM,27255455,S DRIVER MEGA DA VINCI S/SI ENDOWRIST 8MM 30- D 54.7CM 1.3CM NEE,330.0,214.5,71.94,330.0,59
CDM,27255465,S DRVR NDL LRG 1X31.5CM DVNC XI,330.0,214.5,71.94,330.0,59
CDM,27255475,S FRCP PRGRSP 2.8X33.53 DVNC XI,330.0,214.5,71.94,330.0,59
CDM,27255485,S GRSP TIP-UP FENES DVNC XI,330.0,214.5,71.94,330.0,59
CDM,27255495,S DRIVER DA VINCI S/SI ENDOWRIST 5MM 30- D 55.1CM .9CM NEEDLE,322.5,209.63,70.31,322.5,59
CDM,27255505,S ELECTRD DA VINCI S/SI ENDOWRIST 5MM 56.7CM 1.3CM MONOPOL CAUTE,334.65,217.52,72.95,334.65,59
CDM,27255515,S DISSECTOR DA VINCI S/SI ENDOWRIST MARYLAND 5MM 30- D 56.1CM 2.,322.5,209.63,70.31,322.5,59
CDM,27255525,S DRIVE SUTURECUT DA VINCI S/SI ENDOWRIST 8MM 30- D LRG 54.5CM 1,360.0,234.0,78.48,360.0,59
CDM,27255535,S DRIVE SUTURECUT ENDOWRIST 8MM 23- D MEG 49.7CM 1.4CM NEEDLE RO,360.0,234.0,78.48,360.0,59
CDM,27255545,S RETRACT ENDOWRIST DA VINCI S/SI GRAPTOR SML ENDOSCOPIC GRASP,360.0,234.0,78.48,360.0,59
CDM,27255555,S SCISSORS DA VINCI S/SI ENDOWRIST 5MM 30- D MED CURVE 55.6CM 1.,375.0,243.75,81.75,375.0,59
CDM,27255565,S FORCEPS DA VINCI S/SI ENDOWRIST MARYLAND 8MM 45 D 55.8CM 2CM L,405.0,263.25,88.29,405.0,59
CDM,27255575,S FORCEPS DA VINCI S/SI ENDOWRIST 8MM 45- D MED 55.9CM 2.1CM LAP,1358.0,882.7,296.04,1358.0,59
CDM,27255585,S FRCP MRYLND BPLR DVNC XI,405.0,263.25,88.29,405.0,59
CDM,27255595,S FRCP BPLR FENES DVNC XI,405.0,263.25,88.29,405.0,59
CDM,27255605,S FORCEPS DA VINCI S/SI ENDOWRIST PK 8MM 70- D 55.4CM 2CM LAP,435.0,282.75,94.83,435.0,59
CDM,27255615,S RETRACTOR DA VINCI S/SI ENDOWRIST 8MM 60- D 58.2CM 4.8CM LAP,442.5,287.63,96.47,442.5,59
CDM,27255625,S CAUTERY HOT SHEARS MCS DVNC XI,480.0,312.0,104.64,480.0,59
CDM,27255635,S GRASP DA VINCI S/SI ENDOWRIST SCHERTEL 5MM 30- D 56.6CM 3.2CM,322.5,209.63,70.31,322.5,59
CDM,27255645,IVAS HAND DRILL 10GA,117.0,76.05,25.51,117.0,59
CDM,27255655,VERTAPLEX HV / AUTOPLEX SYSTEM KIT W/O NEEDLES,1482.0,963.3,323.08,1482.0,59
CDM,27255665,"SPECIALTY RECHARGEABLE SURGICAL CLIPPER BLADE ASSEMBLY, SINGLE U",16.0,10.4,3.49,16.0,59
CDM,27255675,"EQUALIZER OCCLUSION BALLOON CATHETER,33MM, 7FR X 100CM",372.0,241.8,81.1,372.0,59
CDM,27255685,CELLO BALLOON GUIDE CATHETER 8FR X 102CM,1308.0,850.2,200.93,1308.0,67
CDM,27255695,IMAGE 2 ANGIO CATH BERN TIP BRAID-TORQ CEREB 038?MX G-WIRE 5FR X,21.0,13.65,4.58,21.0,59
CDM,27255705,"I.D. FLEXNECK EXXTENDED CATHETER 5.1MM O.D. X 3.5MM, ADULT",784.5,509.93,171.02,784.5,59
CDM,27255715,SIZE 2 KYPHX EXPRESS BONE FILLER DEVICE,91.0,59.15,19.84,91.0,59
CDM,27255725,CUSTOM AGB MAC 2-L C V ACCESS KIT FOR USE WITH 8 - 8.5 FR. CATHE,121.0,78.65,26.38,232.66,67
CDM,27255735,"AMT BRIDLE NASAL TUBE RETAINING SYSTEM 10FR, TEAL",131.0,85.15,28.56,131.0,59
CDM,27255745,G-JET LOW PROFILE GASTRIC-JEJUNAL ENTERAL TUBE 16FR X 1.5CM X 45,637.5,414.38,138.98,637.5,59
CDM,27255755,"MIC-KEY LOW-PROFILE GASTRO FEEDING TB/KIT, 20 FR, 3.0 CM, 5ML BA",179.0,116.35,39.02,179.0,59
CDM,27255765,"MIC-KEY FEEDING TUBE ACC 12?,EXT SET W/ SECUR-LOK RT ANGLE, 2 PO",19.0,12.35,4.14,19.0,59
CDM,27255775,"INQWIRE DIAG G-WIRE 0.025IN X 150CM, FIXED-CORE PTFE COATED, 3MM",16.5,10.73,3.6,232.66,67
CDM,27255785,"ANGIOJET ULTRA THROMBECTORY POWER PULSE KIT, US",68.0,44.2,14.82,68.0,59
CDM,27255795,"SUPER SHEATH 12FR X 11CM ?, INTRO SHEATH WITHOUT WIRE",15.0,9.75,3.27,232.66,67
CDM,27255805,"GALT PTFE MICRO-ACCESS TEARAWAY INTRO, W/0.018"" WIRE 11 FR? X 10",32.0,20.8,6.98,32.0,59
CDM,27255815,"ARROW JACC PRESSURE INJECTABLE KIT 5.5FR X 20CM, SINGLE LUMEN",376.0,244.4,81.97,376.0,59
CDM,27255825,VIRTUTRAX INSTRUMENT NAVIGATOR,79.0,51.35,17.22,79.0,59
CDM,27255835,AMPLATZER VASCULAR PLUG 4 4MM X 10MM,1380.0,897.0,300.84,1380.0,59
CDM,27255845,SCEPTER XC X-TRA COMPLIANT OCCLUSION BALLOON CATH 4.0MM X 11MM,2226.0,1446.9,200.93,2226.0,67
CDM,27255855,BRIDGE OCCLUSION BALLOON CATHETER 90CM,1275.0,828.75,277.95,1275.0,59
CDM,27255865,"EPIC VAS STNT, 12MM X 60MM, 75CM SELF-EXPD, NITINOL, .035IN MAX",1087.5,706.88,200.93,1087.5,67
CDM,27255875,BRIDGE PREP KIT,397.5,258.38,86.66,397.5,59
CDM,27255885,INDIGO WIRE 200CM SEPARATOR 3,1162.5,755.63,253.43,1162.5,59
CDM,27255895,"INDIGO REPERF 4.1FR PROX X 150CM ASPIR CATH 3, STRGHT TIP, COMPA",1714.5,1114.43,373.76,1714.5,59
CDM,27255905,"MEDTRONIC KYPHON V OSTEO INTRODUCER TROCAR 13GA , BEVEL KIT",1350.0,877.5,294.3,1350.0,59
CDM,27255915,"ETRAX NEEDLE REPLACEMENT KITS16GA X 18GA X 15CM , TROCAR TIP, ST",79.0,51.35,17.22,79.0,59
CDM,27255925,ACE REPERFUSION CATH & PENUMBRA HI-FLOW ASPIRATION TUBING,3861.0,2509.65,200.93,3861.0,67
CDM,27255935,"AXS CATALYST DISTAL ACCESS CATHETER, 6FR X 132CM",3037.5,1974.38,662.18,3037.5,59
CDM,27255945,ACE 68 REPERFUSION CATHETER 5MAX AND HI-FLOW ASPIRATION TUBING,3827.0,2487.55,834.29,3827.0,59
CDM,27255955,DBL  IPAS VALVE ASPIRATOR,51.5,33.48,11.23,51.5,59
CDM,27255965,SEMI RIGID CANNULAE 6MM,21.0,13.65,4.58,21.0,59
CDM,27255975,SEMI RIGID CANNULAE 8MM,21.0,13.65,4.58,21.0,59
CDM,27256675,MERIT SWIFTNINJA SNCM125,3240.0,2106.0,200.93,3240.0,67
CDM,27256765,"BOSTON SCIENTIFIC 2.0MM X 12MM BALLOON, EMERGE OTW PTCA CATHETER",330.0,214.5,71.94,330.0,59
CDM,27256775,MISC EP SUPPLY TIER 4,675.0,438.75,147.15,675.0,59
CDM,27256785,MISC EP SUPPLY TIER 5,960.0,624.0,209.28,960.0,59
CDM,27256795,C2628 OCCLUSION BALLOON TIER 2,593.0,385.45,129.27,593.0,67
CDM,27256805,THORATEC ACCESSORIES KIT,238.0,154.7,51.88,238.0,59
CDM,27256815,QUICK ACCESS NDL HOLDER,200.0,130.0,43.6,200.0,59
CDM,27256835,RADIAL-FEM ANGIOGRAPHY SHEET,70.0,45.5,15.26,70.0,59
CDM,27256845,C1726 VALVULOPLASTY BALLOON,938.0,609.7,200.93,938.0,67
CDM,27256855,C1757 TIER 3 THROMBECTOMY CATH,3800.0,2470.0,200.93,3800.0,67
CDM,27256865,TERUMO MEDICAL CORP 4FR X 123CM GLIDECATH HYDRO CATH,90.56,58.86,19.74,232.66,67
CDM,27256875,TERUMO GLIDE WIRE GT 0.018 X 180CM STANDARD,253.5,164.78,55.26,253.5,67
CDM,27256OH,TX SPONTAN HIP DISLC ABDCT SPLNT/TRCJ W/O ANES,1712.0,1112.8,1.1,1712.0,148
CDM,27257985,DOVER SILICONE FOLEY CATH 3CC BALLOON 8FR/17IN,8.4,5.46,1.83,8.4,59
CDM,27257OH,TX SPON HIP DISLC ABDCT SPLNT/TRCJ W/MANJ ANES,2152.0,1398.8,1.1,4686.39,144
CDM,27258OH,OPTX SPON HIP DISLC RPLCMT FEM HEAD ACTBLM,6472.0,4206.8,1.1,6472.0,144
CDM,27259OH,OPTX SPON HIP DISLC RPLCMT FEM HEAD ACTBLM SHRT,9304.0,6047.6,1.1,9304.0,144
CDM,27261005,"PROX ?2.3FR / 1.9FR DIS X 150CM, PROWLER 14 MICROCATH, 50CM, 45",1053.0,684.45,200.93,1053.0,67
CDM,27261015,"PROX ?2.3FR / 1.9FR DIS X 150CM, PROWLER 14 MICROCATH, 50CM, J C",1053.0,684.45,200.93,1053.0,67
CDM,27261025,"WORKING LENGTH REPERFUSION CATH, 3.4FR X 150CM, .032IN MAX G/W",2267.0,1473.55,200.93,2267.0,67
CDM,27261035,"NAVIEN DIST INTRACRAN SUPPT CATH, 6FR X?0.072IN X 105CM, 8CM 25",763.0,495.95,166.33,763.0,59
CDM,27261045,"NEURON MAX 088 SELECT CATHETER, SIM, 6FR X 125CM",219.0,142.35,47.74,219.0,59
CDM,27261055,"CRAGG-MCNAMARA VALV INFUS CATH, 5FR X 135CM, 50CM INFUS,.038IN M",206.5,134.23,45.02,232.66,67
CDM,27261065,"ACCUSTICK II W/RO MARK INTRO SYS, W/0.038 SS J-TIP & 0.018  NITI",138.0,89.7,30.08,232.66,67
CDM,27261075,BECKER EXTERNAL DRAINAGE SYSTEM (EDMS) GS TUBING SMARTSITES,185.5,120.58,40.44,185.5,59
CDM,27261085,STONE REMOVAL SET (BSM-200),900.0,585.0,196.2,900.0,67
CDM,27261095,DOC GUIDE WIRE EXTENSION (EA),145.0,94.25,31.61,145.0,59
CDM,27261105,"FLOWGUARD VALVED PEELABLE INTRODUCER KIT, 16FR (VP-100)",70.0,45.5,15.26,70.0,59
CDM,27261115,"VAN ANDEL ILIAC & FEMORAL DILATATION CATHETER, 5FR X 80CM",36.0,23.4,7.85,36.0,59
CDM,27261125,"AMPLATZ ANCHOR PERCUFLEX CATH W/LOCKING MALECOT, 8 FR X 30 CM",133.0,86.45,28.99,232.66,67
CDM,27261135,"PERICARDIOCENTESIS PROCEDURE KIT, HIGH-FLOW STRAIGHT CATHETER, 6",131.0,85.15,28.56,232.66,67
CDM,27261145,"IVAS INFLATABLE VERTEBRAL AUGMENTATION SYSTEM KIT, 10GA 15MM",1591.0,1034.15,346.84,1591.0,59
CDM,27261155,"CORFLO NASOINTESTINAL ENDOSCOPICALLY PLACED FEEDING TUBES, 12FR",106.0,68.9,23.11,106.0,59
CDM,27261165,"CADENCE PRECISION INJECTOR, THREADED SYRINGE, BALLOON, 1ML",166.0,107.9,36.19,166.0,59
CDM,27261175,"G-JET LOW PROFILE GASTRIC-JEJUNAL ENTERAL TUBE, 16FR X 2CM X 30C",637.5,414.38,138.98,637.5,59
CDM,27261185,"VERTEPORT CEMENT CANNULA, 10GA",105.5,68.58,23.0,105.5,59
CDM,27261195,"IVAS CURETTE, 10GA",747.0,485.55,162.85,747.0,59
CDM,27261205,"SILICONE MALECOT NEPHROSTOMY CATHETER, 10 FR X 20CM",65.0,42.25,14.17,232.66,67
CDM,27261215,PROMETRA PTC 12860,1050.0,682.5,228.9,1050.0,59
CDM,27261225,DISPOSABLE CPAP SUPPLY,102.0,66.3,22.24,102.0,59
CDM,27261245,PEP DEVICE SUPPLY,25.8,16.77,5.62,25.8,59
CDM,27261275,GLIDE OR GUIDE CATH TIER 4,3308.0,2150.2,200.93,3308.0,67
CDM,27261285,GLIDE OR GUIDE CATH TIER 5,12622.5,8204.63,200.93,12622.5,67
CDM,27261295,C1773 SNARE TIER 3,2558.0,1662.7,200.93,2558.0,67
CDM,27261305,GEN LUBRICANT TIER 1,112.0,72.8,24.42,112.0,59
CDM,27261325,STARTER GUIDEWIRE .035IN X 260CM BEN/STR/PTFE/15,41.5,26.98,9.05,232.66,67
CDM,27261335,"BENTSON CEREBRAL GDWR 0.035"" X 260CM COATED",44.0,28.6,9.59,232.66,67
CDM,27261345,ROADRUNNER WIRE GUIDE (RFSPC-35-145),59.0,38.35,12.86,232.66,67
CDM,27261355,"ROADRUNNER PC GUIDEWIRE, FIRM (RPC-35-260)",61.0,39.65,13.3,232.66,67
CDM,27261365,"SYNCHRO-10 MICROFAB NITINOL GUIDEWIRE 0.010IN X 300CM,55CM",838.0,544.7,182.68,838.0,67
CDM,27261375,TRAXCESS HYDROPHILIC GUIDEWIRE 0.014IN,506.0,328.9,110.31,506.0,67
CDM,27261385,"SYNCHRO-10 MICROFAB NITINOL GUIDEWIRE 0.010IN X 200CM,55CM",709.0,460.85,154.56,709.0,67
CDM,27261395,PEEL-AWAY INTRODUCER SET (PLVW-18.0-38-30),152.0,98.8,33.14,232.66,67
CDM,27261405,"MIC-KEY JEJUNAL FEEDING TUBE 14 FR, 2.0CM,5ML BALLOON",265.5,172.58,57.88,265.5,59
CDM,27261415,CHAIT TRPDR TM PED CECOSTOMY CATH SET (TDCS-100),208.0,135.2,45.34,232.66,67
CDM,27261425,"NAVARRE UNIV DRNG CATH W/NITINOL 6FR, LOCKING PIGTAIL",517.5,336.38,112.82,517.5,67
CDM,27261435,ULTRATHANE AMPLZ UNIV DRN CATH 14.0FR (ULT14.0-38-50-P-6S-PIG),228.0,148.2,49.7,228.0,59
CDM,27261445,ULTRATHANE PIGTAIL DRNG CATH (ULT8.5-38-50-P-6S-AUDC-PIG),259.0,168.35,56.46,259.0,59
CDM,27261455,AMPLATZ UNIVERSAL DRAINAGE CATHETER,228.0,148.2,49.7,228.0,59
CDM,27261465,CHAIT TRPDR PED CECOSTOMY CATH SET 10.2FR X 24CM,212.0,137.8,46.22,232.66,67
CDM,27261475,SILICONE BILIARY CATH W/LUER LOCK,186.0,120.9,40.55,186.0,59
CDM,27261485,"PWRLN PWR INJ CVC, CATH TIP DUAL LUMEN CATH",390.0,253.5,85.02,390.0,67
CDM,27261495,"PWRLN PWR INJ CVC, CATH TIP, TRIPLE LUMEN CATH",450.0,292.5,98.1,450.0,67
CDM,27261505,"RENEGADE HI FLO MICROCATH 135/10 CM, 3FR",588.5,382.53,128.29,588.5,67
CDM,27261515,AMPLATZ GOOSE NECK MICROSNARE KIT 2MM LOOP CATH,885.0,575.25,192.93,885.0,67
CDM,27261525,B/H/L CATH RPR KITS 9.6 FR(1.6MM I.D.) SINGLE LUMEN (WHT CNTR),217.0,141.05,47.31,217.0,59
CDM,27261535,B/H/L CATH RPR KIT (ALL FR SZ EXCEPT 13.5FR) DUAL & TRPL LUMEN,229.0,148.85,49.92,229.0,59
CDM,27261545,B/H/L CATH RPR KIT 9 & 10FR DUAL LUMEN (RED & WHT CNTR),255.5,166.08,55.7,255.5,59
CDM,27261555,B/H/L CATH RPR KIT 12.5FR TRIPLE LUMEN (R/W/B CNTR),300.0,195.0,65.4,300.0,59
CDM,27261565,CATH REPAIR KIT W/CONNECTORS,227.5,147.88,49.6,227.5,59
CDM,27261575,KYPHX XPNDR INFLAT SYRING-CANADA HOSP USE CAT#A08E,210.0,136.5,45.78,210.0,59
CDM,27261585,"FUSION CYTOLOGY BRUSH, 1.5CM FILIFORM TIP",145.0,94.25,31.61,145.0,59
CDM,27261595,NITINOL PLTNM TIP GW (MPIS-501-10.0-SC-NT-SST) INTROD SET,79.0,51.35,17.22,232.66,67
CDM,27261605,PROWLER 14 MICROCATH STRAIGHT MAX GUIDEWIRE,975.0,633.75,200.93,975.0,67
CDM,27261615,VASCUTAPE RADIOPAQUE MARKING TAPE W/MM (20 STRPS/BX),81.0,52.65,17.66,81.0,59
CDM,27261625,G-JET LOW PROFILE GASTRIC-JEJUNAL ENTERAL TUBE,637.5,414.38,138.98,637.5,59
CDM,27261635,JEJUNAL FEEDING KIT,512.0,332.8,111.62,512.0,59
CDM,27261645,"MEDTRONIC (EDM) LUMBCATH 80CM, OPENTIP, BARIUM IMPREGNATED",227.0,147.55,49.49,227.0,59
CDM,27261655,"MEDTRONIC EXT DRAIN + MONITORING LUMBAR DRAINAGE KIT, OPEN TIP",252.0,163.8,54.94,252.0,59
CDM,27261665,BECKER 27761 STOP BCNDLESS PATLN 24,238.0,154.7,51.88,238.0,59
CDM,27261675,D-STAT MODEL 4000 VASCULAR FLOWABLE,191.0,124.15,41.64,191.0,59
CDM,27261685,RENAL ACCESS AND BIOPSY SET (RABS-100),660.0,429.0,143.88,660.0,59
CDM,27261695,ANGIOFLOW THERMODILUTION CATH 6FR X 35CM,344.0,223.6,74.99,344.0,59
CDM,27261705,ACE REPERFUSION CATH 5MAX,3334.5,2167.43,200.93,3334.5,67
CDM,27261715,AXS CATALYST DISTAL ACCESS CATHETER 5FR X 115CM,1957.5,1272.38,426.74,1957.5,59
CDM,27261725,"PROWLER 27 MICROCATH, STRAIGHT",1327.5,862.88,200.93,1327.5,67
CDM,27261735,"PROWLER SELECT LP ES / PROWLER PLUS 45CM MICROCATH, STRAIGHT",975.0,633.75,200.93,975.0,67
CDM,27261745,"PROWLER SELECT PLUS MICROCATH, 5CM, 45 DEG",1053.0,684.45,200.93,1053.0,67
CDM,27261755,"PROWLER SELECT PLUS MICROCATH, 5CM, STRAIGHT",907.5,589.88,197.84,907.5,67
CDM,27261765,"TYSHAK II BALLOON DILATATION CATH, 1.5 ATM, 25MM X 4 CM BALLOON",693.0,450.45,151.07,693.0,67
CDM,27261775,"Z-MED BALLOON CATH, 20MM X 4CM BALLOON",805.5,523.58,175.6,805.5,67
CDM,27261785,"Z-MED II BALLOON CATH, 8 ATM 16MM X 4CM BALLOON",802.0,521.3,174.84,802.0,67
CDM,27261795,"CODA BALLOON CATH, 0.035IN GUIDE 9FR X120 CM 32/30 BALLOON",592.5,385.13,129.17,592.5,67
CDM,27261805,"ATLAS PTA DILATATION CATH, 6.5 FR X 75 CM SHAFT, 14MM BALLON",367.5,238.88,80.12,367.5,67
CDM,27261815,"ATHEROTOME, 6 MM DIA. PERIPHERAL CUTTING BALLOON",1198.5,779.03,200.93,1198.5,67
CDM,27261825,HICKMAN SINGLE LUMEN CATHETER W/O VITACUFF  4.2 FR,203.0,131.95,44.25,232.66,67
CDM,27261835,BROVIAC/HICKMAN/LEONARD CATH/ 7 FR DUAL LUMEN PED CATH,222.0,144.3,48.4,232.66,67
CDM,27261845,ANGIOJET ZELANTEDVT THROMBECTOMY SYSTEM 8FR X 105CM,3800.0,2470.0,200.93,3800.0,67
CDM,27261855,TRANSEND EX GUIDEWIRE,620.0,403.0,135.16,620.0,67
CDM,27261865,AGILITY 16 STEERABLE GUIDEWIRE,412.5,268.13,89.93,412.5,67
CDM,27261875,"FATHOM STEERABLE GUIDEWIRE 0.016""",510.0,331.5,111.18,510.0,67
CDM,27261885,RENEGADE FIBER BRAID MICROCATH W/HYDRO PASS 150/10CM & 130/20CM,637.5,414.38,138.98,637.5,67
CDM,27261895,"RENEGADE HI-FLO MICROCATHETER, 105/10 CM, 3 FR",588.5,382.53,128.29,588.5,67
CDM,27261905,"RENEGADE STC 18 MICROCATH W/ RO MARKER, ANGLED 105CM",723.0,469.95,157.61,723.0,67
CDM,27261915,"RENEGADE STC 18 MICROCATH W/ RO MARKER, STRAIGHT",693.0,450.45,151.07,693.0,67
CDM,27261925,"RENEGADE STC 18 MICROCATH W/ RO MARKER, ANGLED 150CM",688.0,447.2,149.98,688.0,67
CDM,27261935,"RENEGADE FIBER BRAIDED MICROCATH W/HYDRO PASS, 150CM 20CM DISTAL",637.5,414.38,138.98,637.5,67
CDM,27261945,"RENEGADE HI-FLO MICROCATH 150CM X 10CM, STRAIGHT TIP",588.5,382.53,128.29,588.5,67
CDM,27261955,NEURON DELIVERY CATHETER,1027.5,667.88,200.93,1027.5,67
CDM,27261965,"SUREFIRE PRECISION INFUSION SYSTEM 0.025IN X 120CM, MICROCATH",3915.0,2544.75,853.47,3915.0,59
CDM,27261975,CHECK-FLO PERFORMER INTRODUCER SET (RCFW-14.0-38-45-RB),257.0,167.05,56.03,257.0,67
CDM,27261985,CHECK-FLO PERFORMER INTRODUCER SET (RCFW-16.0P-38-45-RB),143.5,93.28,31.28,232.66,67
CDM,27261995,SHEATH SET (VSSW-4.0-18-NPAS-100),185.5,120.58,40.44,232.66,67
CDM,272620115,IRRISEPT,140.0,91.0,30.52,140.0,59
CDM,27262055,"WALLSTENT GI GUIDEWIRE, SUPER STIFF 0.035IN X 500CM",178.0,115.7,38.8,232.66,67
CDM,27262215,EXTERNAL URETHRAL CLAMP,10.0,6.5,2.18,10.0,59
CDM,27262225,FOAM DRG <=16 SQ IN W/BORDER,4.96,3.22,1.08,4.96,59
CDM,27262245,JUZO VELCRO WRAP CALF,77.0,50.05,16.79,77.0,67
CDM,27262255,JUZO VELCRO WRAP FOOT,40.0,26.0,8.72,40.0,67
CDM,27262265,GENERIC OCCLUSION BALLOON TIER 1,1275.0,828.75,277.95,1275.0,59
CDM,27262275,RFA SIJ COOLED KIT,1125.0,731.25,245.25,1125.0,59
CDM,27262285,RFA CERVICAL COOLED KIT,1125.0,731.25,245.25,1125.0,59
CDM,27262295,RFA TRANSDISCAL COOLED KIT,1492.5,970.13,325.37,1492.5,59
CDM,27262305,BIOPINCE FULL CORE BIOPSY INST 18GA 10CM BX/5,292.5,190.13,16.97,292.5,67
CDM,27262315,BIOPINCE FULL CORE BIOPSY INSTR 18GA 15CM BX/5,292.5,190.13,16.97,292.5,67
CDM,27262325,FULL CORE BIOPSY INSTRUMENT CA/5,292.5,190.13,16.97,292.5,67
CDM,27262335,TRAY PROCEDURE PARACENTESIS BX/5,615.0,399.75,16.97,615.0,67
CDM,27262345,TRAY THORCNTS 16CM 6FR SFCNTS CA/10,851.4,553.41,16.97,851.4,67
CDM,27262355,TRAY BIOPSY PROCEDURE CA/20,457.8,297.57,16.97,457.8,67
CDM,27262365,SAFE-T-CENTESIS DRUG-FREE TRAY 6FX16CM BX/10,735.9,478.34,160.43,735.9,67
CDM,27262505,CHEST DRAINAGE SYSTEM,143.6,93.34,31.3,143.6,59
CDM,27262515,PRESSURE WIRE GEN-X-GUIDE MOUNTED SEN 0.14X175CM,900.0,585.0,196.2,900.0,67
CDM,27265OH,CLTX POST HIP ARTHRP DISLC W/O ANES,2096.0,1362.4,1.1,2096.0,142
CDM,27266OH,CLTX POST HIP ARTHRP DISLC REQ ANES,3112.0,2022.8,1.1,4686.39,144
CDM,27267OH,CLOSED TX FEMORAL FRACTURE PROX HEAD W/O MANJ,2200.0,1430.0,1.1,9440.12,144
CDM,27268OH,CLOSED TX FEMORAL FRACTURE PROX HEAD W/MANJ,2848.0,1851.2,1.1,2848.0,144
CDM,27269OH,OPEN TX FEMORAL FRACTURE PROXIMAL END HEAD,7556.0,4911.4,1.1,7556.0,144
CDM,27270015,SUPPLY-OSCILLATOR,563.0,365.95,122.73,563.0,59
CDM,27270065,NN SUPPLY-NAVA CATHETERS,297.0,193.05,64.75,297.0,59
CDM,27270075,NN SUPPLY-DSISP IPV CIRCUIT,201.0,130.65,43.82,201.0,59
CDM,27270225,BOSTON SCI MAV MONO PTCA CATH 4.5MM X 20CM,192.0,124.8,41.86,192.0,59
CDM,27270235,BOSTON SCI EMERG MONO PTCA CATH 2.5-2.50MM X 15-20MM,192.0,124.8,41.86,192.0,59
CDM,27270245,ABBOTT MUL VIS CORO STENT SYS 3.5MM X 23MM,570.0,370.5,124.26,570.0,59
CDM,27270255,INTRODUCER KCFW 4.0-18/3545 RB-ANLO,75.25,48.91,16.4,232.66,67
CDM,27270265,CTO RECANALIZATION CATHETER???,305.35,198.48,66.57,305.35,67
CDM,27270285,BOS SCI MUSTANG OVER THE WIRE PTA BALLOON CATH,270.0,175.5,58.86,270.0,67
CDM,27270305,BOS SCI SYNERGY MONORAIL 4.00MMX20MM COR STENT,1485.0,965.25,200.93,1485.0,67
CDM,27270315,ABB XIENCE ALPINE CORO SNT 4.0X18,2241.0,1456.65,200.93,2241.0,74
CDM,27270315_IP,ABB XIENCE ALPINE CORO SNT 4.0X18,2241.0,1456.65,1228.07,1228.07,1
CDM,27270315_OP,ABB XIENCE ALPINE CORO SNT 4.0X18,2241.0,1456.65,972.59,972.59,1
CDM,27270325,COOK GUIDE WIRES.021/80 ST,30.2,19.63,6.58,232.66,67
CDM,27270335,PRO-PADZ MULTI FUNC ELECTRODES,87.59,56.93,19.09,87.59,59
CDM,27270345,EVERCROSS DILATION CATHETER 9MMX40MM,192.5,125.13,41.97,232.66,67
CDM,27270395,G160219 ARCTIC FRONT ADVANCE CARDIAC CRYOABLATION CATHETER,4200.0,2730.0,915.6,4200.0,59
CDM,27270405,PENUMBRA INDIGO SUCTION IRRIGATION,547.5,355.88,119.36,547.5,59
CDM,27271025,BOSTON SCI HORNET STRAIGHT TIP 014/300CM,227.5,147.88,49.6,227.5,59
CDM,27271035,"ABBOT ASAHI CONF PRO 12, 014IN/ 180CM GUIDE WIRE",210.0,136.5,45.78,232.66,67
CDM,27271045,"ASAHI ASTATO 30 300, 018IN/300CM GUIDE WIRE",247.5,160.88,53.96,247.5,67
CDM,27271935,MAMMO TISSUE CLIPS,110.0,71.5,23.98,110.0,59
CDM,27272435,US BRST CLIP,218.0,141.7,47.52,232.66,67
CDM,27274615,TR BAND RADIAL ARTERY COMPRESSION DEVICE,96.0,62.4,20.93,96.0,59
CDM,27274625,GUIDEWIRE C1769 40,100.0,65.0,21.8,232.66,67
CDM,27275OH,MANIPULATION HIP JOINT W ANESTHESIA,928.0,603.2,1.1,4686.39,144
CDM,27278OH,ARTHRD SI JT PRQ W/PLMT IARTIC IMPLT WO TFXJ DEV,3458.0,2247.7,1.1,54351.12,146
CDM,27279855,"EXPRESS DRAINAGE SET, CAT",56.0,36.4,12.21,56.0,59
CDM,27279OH,ARTHRODESIS SI JOINT PERCUTANEOUS/MIN INVASIVE,4852.0,3153.8,1.1,54351.12,144
CDM,27280175,"PENETRATION 22MM, 18 GUAGE X 10CM",55.4,36.01,12.08,55.4,59
CDM,27280185,"PENETRATION 22MM, 18 GA X 16CM",55.4,36.01,12.08,232.66,67
CDM,27280195,"PENETRATION 22MM, 18 GUAGE X 20CM",55.32,35.96,12.06,232.66,67
CDM,27280215,COAXIAL QUICK CORE NEEDLE BX SET QCS-20-9.0-10T,73.96,48.07,16.12,73.96,59
CDM,27280235,"CATH, BALLOON C1725 180",450.0,292.5,98.1,450.0,67
CDM,27280245,"CATH, BALLOON C1725 85",213.0,138.45,46.43,232.66,67
CDM,27280255,"CATH, BALLOON C1725 60",150.0,97.5,32.7,232.66,67
CDM,27280265,GUIDEWIRE C1769 53,133.0,86.45,28.99,232.66,67
CDM,27280405,CIRCUMCISION SUPPLIES,37.8,24.57,8.24,37.8,59
CDM,27280575,DISPOSABLE DRAINAGE BAG,16.0,10.4,3.49,16.0,59
CDM,27280585,COOK 5FR X 90CM ANSEL O FLEXOR CH FLO INTO SHEATH,175.0,113.75,38.15,175.0,59
CDM,27280595,METRONIC INSTANT COIL DETACHER,81.55,53.01,17.78,81.55,59
CDM,27280735,NIPPLE SHIELD ALL SIZES,10.08,6.55,2.2,10.08,59
CDM,27280775,SANE SAEC KIT,36.0,23.4,7.85,36.0,59
CDM,27280785,SANE DFSA KIT,12.0,7.8,2.62,12.0,59
CDM,27280875,GRSP LAPSCP BOWEL DVNC S/SI,322.5,209.63,70.31,322.5,59
CDM,27280885,SCIS LAPSCP 8MM DVNC EWRST,292.5,190.13,63.77,292.5,59
CDM,27280895,DISECT BPLR EWRST 8MM CRV CAUT,405.0,263.25,88.29,405.0,59
CDM,27280OH,ARTHRODESIS SI JT OPN W/OBTAINING B1 GRF INSTRMJ,8000.0,5200.0,1.1,8000.0,144
CDM,27281615,ARMADA 18 PTA CATHETER SZ 2X2 THRU 6X4,127.5,82.88,27.8,232.66,67
CDM,27282835,SNAP VAC,296.15,192.5,64.56,296.15,59
CDM,27282OH,ARTHRODESIS SYMPHYSIS PUBIS W/OBTAINING GRAFT,4740.0,3081.0,1.1,4740.0,144
CDM,27283025,BALLOON BOSTON EMERGE,192.5,125.13,41.97,232.66,67
CDM,27283215,CERVICAL RIPENING BALLOON,113.0,73.45,24.63,113.0,59
CDM,27283225,MONICA NOVII ELECTRODES,84.0,54.6,18.31,84.0,59
CDM,27283705,CRE BALLOON DILATOR,298.5,194.03,65.07,298.5,59
CDM,27284225,PEDS HIGH FLOW OXYGEN SET-UP (NOT VAPOTHERM),166.63,108.31,36.33,166.63,59
CDM,27284235,METANEB CIRCUIT,148.75,96.69,32.43,148.75,59
CDM,27284825,MEDTRONIC J SLEEVE,19.0,12.35,4.14,19.0,59
CDM,27284835,"MEDTRONIC LINQ II, ACTUAL RECORDER",6270.75,4075.99,200.93,6270.75,67
CDM,27284845,EXOFIN GLUE,20.0,13.0,4.36,20.0,59
CDM,27284855,AQUACEL DRESSING,94.45,61.39,20.59,94.45,59
CDM,27284865,"CARDINAL, LOOP PAC, SAN29LPCCC",53.26,34.62,11.61,53.26,59
CDM,27284875,"COVIDEN, VALLEYLAB, CAUTERY PENCIL",5.78,3.76,1.26,5.78,59
CDM,27284885,MEDTRONIC SAFETY CABLE 5587,135.45,88.04,29.53,135.45,59
CDM,27284895,"BOSTON SCIENTIFIC INGEVITY MRI, 7740, ACTUAL LEAD",510.0,331.5,111.18,510.0,67
CDM,27284905,"CARDINAL, SAN29PCCCJ PAC",89.93,58.45,19.6,89.93,59
CDM,27284915,"REMINGTON MEDICAL, PA-801 CABLE",32.0,20.8,6.98,32.0,59
CDM,27284925,"MERIT SHEATH, PLS-1007 CATHETER",54.0,35.1,11.77,232.66,67
CDM,27284935,TANDEM LUNG KIT,30138.75,19590.19,6570.25,30138.75,59
CDM,27284945,RANDEM HEART PROTEK DUO KIT,27438.75,17835.19,5981.65,27438.75,59
CDM,27285195,CATHETER ESOPHAGEAL BALLOON,103.72,67.42,22.61,103.72,59
CDM,27285435,ICEFORCE 2.1 CX 90 DEG CRYO NEEDLE,2160.0,1404.0,200.93,2160.0,67
CDM,27285445,ICEROD CX 90 DEG CRYO NEEDLE,1823.0,1184.95,200.93,1823.0,67
CDM,27285815,MISC CATH SUPPLY TIER 1,143.0,92.95,31.17,143.0,59
CDM,27285875,ZOLL PROPADZ MULTI-FUNCTION ELECTRODES ADULT,73.66,47.88,16.06,73.66,59
CDM,27285885,"MERIT, CONTRAST INJ. TUBING AIRLESS ROTATING ADAPTER",11.64,7.57,2.54,232.66,67
CDM,27285895,"MERIT, DIAG. ULTRA HIGH FLOW PIGTAIL CATH, 10 SIDE PORTS",22.0,14.3,4.8,232.66,67
CDM,27285905,"MEDTRONIC, PACEMAKER ADAPTA DUAL CHAMBER, SMALL",3780.0,2457.0,200.93,3780.0,67
CDM,27285915,MEDTRONIC RESOLUTE ONYX 4.5X15MM CORONARY STENT SYSTEM,1350.0,877.5,200.93,1350.0,67
CDM,27285925,"ABBOTT, NC TREK, CORONARY DILATION CATH 4.5X15MM",148.75,96.69,32.43,232.66,67
CDM,27285935,"BOSTON SCIENTIFIC 185CM FORTE GUIDE WIRE MOD SUPPORT, FLOPPY",130.66,84.93,28.48,130.66,59
CDM,27285945,MEDTRONIC/5FRX65CM/NIH CARDIO - MARKER,68.25,44.36,14.88,68.25,59
CDM,27285955,MEDTRONIC/5FRX80CM/NIH CARDIO - MARKER,68.25,44.36,14.88,232.66,67
CDM,27285965,BOSTON SCIENTIFIC/FORTE 014/300CM MOD SUPPORT GUIDE WIRE,113.75,73.94,24.8,232.66,67
CDM,27285975,BOSTON SCIENTIFIC/FORTE 014/185CM MOD SUPPORT GUIDE WIRE,113.75,73.94,24.8,232.66,67
CDM,27285985,"EV3/012X18, BABYWIRE, DOUBLE ENDED NITINOL GUIDEWIRE",24.4,15.86,5.32,24.4,59
CDM,27285995,"3M CENTRAL LINE KIT, INFANT",20.08,13.05,4.38,20.08,59
CDM,27286005,"BARD 3FR POWERPICC SV BASIC, SL",244.35,158.83,53.27,244.35,67
CDM,27286015,ABBOTT HI-TORQUE FLOPPY II GUIDE WIRE .014IN/STRAIGHT,124.25,80.76,27.09,124.25,59
CDM,27286025,ANGIODYNAMICS CUSTOMNAMIC CONVENIENCE KIT 5 VALVE WITH DT,76.14,49.49,16.6,76.14,59
CDM,27286035,"ANGIODYNAMICS PERCEPTOR DT DISP TRANSDUCER, W/SC",19.5,12.68,4.25,232.66,67
CDM,27286045,ARROW INT. PEDS TWO-LUMEN CENTRAL VENOUS CATH KIT W/BLUE FLEX TI,88.8,57.72,19.36,88.8,59
CDM,27286065,"ABBOTT 5CMX18CM, RX HERCULINK ELITE .014 BILIARY STENT SYSTEM",825.0,536.25,179.85,825.0,67
CDM,27286095,"ARROW 3FR X 4CM VSI MICRO-HV SHEATH W/HYDROPHILIC COATING, GOLD",85.75,55.74,18.69,232.66,67
CDM,27286105,ARROW 6FR VSI MICRO DE-CLOT HV INTRODUCER KIT,78.75,51.19,17.17,232.66,67
CDM,27286115,ARROW 4FR X 5.5CM VSI MICRO-HV SHEATH W/HYDROPHILC COATING W/ SS,78.75,51.19,17.17,232.66,67
CDM,27286125,"5FR X 40CM VSI DE-CLOT MICRO-HV INTRODUCER KIT, NITINOL, SS",78.75,51.19,17.17,232.66,67
CDM,27286135,"ARROW 130CMX0.018 VSI GUIDEWIRE, NITINOL MANDREL/PLATINUM SOFT T",75.25,48.91,16.4,232.66,67
CDM,27286145,"ARROW 4FR X 40CM VSI MICRO-ACCESS TEARAWAY INTRODUCER KIT, NITIN",74.0,48.1,16.13,232.66,67
CDM,27286155,"ARROW 4FRX40CMX0.018IN MICRO-INTRODUCER, NITINOL PLATINUM, SOFT",37.9,24.64,8.26,232.66,67
CDM,27286165,ARROW 8FR GUARDIAN II NOCLICK HEMOSTASIS VALVE W/ GUIDEWIRE TOOL,34.0,22.1,7.41,34.0,59
CDM,27286175,"ARROW 21GA X 4CM VARI-LASE FLEX ACCESS NEEDLE, SMOOTH TIP",6.5,4.23,1.42,6.5,59
CDM,27286185,"ARROW 4FR X 40CM, 5FR X 10CM VSI MICRO-ACC TEARAWAY SHEATH/DILAT",6.3,4.1,1.37,6.3,59
CDM,27286195,"ATRIUM MEDICAL EXPRESS DRY-SEAL CHEST DRAIN, SINGLE COLLECTION",57.64,37.47,12.57,232.66,67
CDM,27286205,"B BRAUN 5FRX14CMTEAR-AWAY INTRO SHEATHKIT, 18GNEEDLE, .038"" SS G",64.64,42.02,14.09,64.64,59
CDM,27286215,"BARD MEDICAL STATLOCK PICC PLUS, SLIDING POST, CRESCENT",8.06,5.24,1.76,8.06,59
CDM,27286225,"BARD MEDICAL STATLOCK PICC PLUS TRICOT ANCHOR PAD, SLIDING POSTS",7.6,4.94,1.66,7.6,59
CDM,27286235,BAYLIS GROUNDING PAD,24.0,15.6,5.23,232.66,67
CDM,27286245,"BD INF. 26GA 1.9 FRX50 CM SINGLE LMN, BD FIRST PICC CATHETER ONL",73.5,47.78,16.02,232.66,67
CDM,27286255,BECTON DICKINSON 26GA X 1.9CM INTROSYTE-N PRECISION INTRODUCER,51.6,33.54,11.25,51.6,59
CDM,27286265,BECTON DICKINSON 22GA X 8TW CHIBATYPE NEEDLE (BX/10),10.22,6.64,2.23,10.22,59
CDM,27286295,BOSTON SCI 185CM FORTE GUIDEWIRE/MOD SUP/FLOPPY/STRT TIP W/MARKE,130.65,84.92,28.48,130.65,59
CDM,27286305,"CARDINAL 82 X 124"" CONV TIB FEMORAL ANGIO DRAPE/DUAL 6""CIRC FENE",8.26,5.37,1.8,8.26,59
CDM,27286335,CENTURION NICU PICC/BROVIAC DRESSING TRAY,7.4,4.81,1.61,7.4,59
CDM,27286345,CHEMENCE 1ML EXOFIN HIGH VISCOSITY TISSUE ADHESIVE,20.0,13.0,4.36,20.0,59
CDM,27286355,"CONMED PADPRO 2603 MINI PEDS MULTI FUNCTION ELECTRODE, PINK",48.0,31.2,10.46,48.0,59
CDM,27286365,CONVATEC 9CM X 15CM AQUACEL AG SURGICAL COVER DRESSING,53.96,35.07,11.76,232.66,67
CDM,27286375,"COOK 7FR X 110 CM, FLEXOR TUOHY-BORST SIDEARM INTRODUCER",175.0,113.75,38.15,232.66,67
CDM,27286385,COOK CHECK-FLO PERFORMER INTRODUCER SET (RCFW-18.0P-38-85-RB),169.75,110.34,37.01,232.66,67
CDM,27286395,"COOK CHECK-FLO INTRODUCER SET, MULLINS(RCFW-10.0-38-85-RB-MTS)",152.25,98.96,33.19,232.66,67
CDM,27286405,"COOK CHECK-FLO INTRODUCER SET, MULLINS(RCFW-11.0-38-85-RB-MTS)",152.25,98.96,33.19,232.66,67
CDM,27286415,"COOK 4FRX90CM, FLEXOR CHECK-FLO INTRO, ANSEL, ACCEPTS .018/.035G",140.0,91.0,30.52,140.0,59
CDM,27286425,COOK 15CMX10MM MREYE EMBO COIL/0.038IN MAX(IMWCE-38-15-10),118.13,76.78,25.75,118.13,59
CDM,27286435,"COOK 12CM X 12MM MREYE EMBO COIL, 0.038IN MAX(IMWCE-38-12-12)",113.75,73.94,24.8,232.66,67
CDM,27286445,"COOK 5FR X 55CM FLEXOR ANSEL GUIDING SHEATH, MULTIPURPOSE",96.25,62.56,20.98,232.66,67
CDM,27286455,"COOK 7FRX63M, CHECK-FLO INTRODUCER, MULLINS, RB TIP, W/O WIRE",80.5,52.33,17.55,232.66,67
CDM,27286465,"COOK 5 FR X 45 CM, FLEXOR CHECK-FLO INTRODUCER, ANSEL",75.25,48.91,16.4,232.66,67
CDM,27286475,"COOK 5FRX45CM, FLEXOR CHECK-FLO INTRODUCER, ANSEL 2",75.25,48.91,16.4,232.66,67
CDM,27286485,"COOK 12FRX13CM, CHECK-FLO INTRO, LG VALVE, INC .038IN STRT 3MM J",71.3,46.35,15.54,232.66,67
CDM,27286495,"COOK 14FRX13CM, CHECK-FLO INTRO, LG VALVE, INC.038IN STRT 3MM J",74.0,48.1,16.13,232.66,67
CDM,27286505,"COOK 0.021"" X 145CM STRAIGHT FIXED CORE GUIDEWIRE (SF-21-145)",67.9,44.14,14.8,67.9,59
CDM,27286515,COOK 21GAX7CM ONE-PART PERC ENTRY THINWALL NEEDLE W/BASEPLATE,26.6,17.29,5.8,232.66,67
CDM,27286525,COOK 0.035INX180CM LUNDER EXTRA STIFF WIRE GUIDE (TSMG-35-180-4-,21.58,14.03,4.7,21.58,59
CDM,27286535,COOK22GA X 20CM DISPOSABLE CHIBA NEEDLE,15.06,9.79,3.28,15.06,59
CDM,27286545,COOKPERCUTANEOUS ENTRY NEEDLE (SDN-18-5.0),5.6,3.64,1.22,5.6,59
CDM,27286555,"COOPERSURGICAL 10INX16IN TRANSWARMER, INF TRANS MATTRESS, DISP",50.44,32.79,11.0,232.66,67
CDM,27286565,"CORDIS 5FRX100CM LVB TIP GUIDING CATH, AMPLATZ COR, AL 2 LBT, .0",74.0,48.1,16.13,232.66,67
CDM,27286575,"CORDIS 5FRX100CM LVB TIP GUIDING CATH, AMPLATZ COR, AR 2 LBT, .0",74.0,48.1,16.13,232.66,67
CDM,27286585,"CORDIS 9FR X 98CM VB TIP GUIDING CATH, MULTIPURPOSE, MPA 1, .098",74.0,48.1,16.13,232.66,67
CDM,27286595,"CORDIS 6FRX100CM VB TIP GUIDE CATH, AMPLATZ LEFT COR, AL .75, .0",74.0,48.1,16.13,232.66,67
CDM,27286605,"CORDIS 6FRX100CM VB TIP GUIDE CATH, AMPLATZ LEFT COR, AL 1, .070",74.0,48.1,16.13,232.66,67
CDM,27286615,"CORDIS 5FRX35CM, BRITE TIP INTERVEN SHEATH, 0.035IN MAX GWIRE (E",50.22,32.64,10.95,232.66,67
CDM,27286625,"CORDIS 4FRX100CM INFINITI TL DIAGCATH, SRC, FEMORAL /THRULUMEN",23.0,14.95,5.01,232.66,67
CDM,27286635,"CORDIS 4FRX5.5CM, AVANTI SHEATH INTRO, W/ 0.035IN GUIDEWIRE",18.2,11.83,3.97,232.66,67
CDM,27286645,"CORDIS 5FRX5.5CM, AVANTI SHEATH INTRO, W/ 0.035IN GUIDEWIRE",18.2,11.83,3.97,232.66,67
CDM,27286655,"CORDIS 5FRX100CM INF TL DIAG CATH, JUDKINS L COR, JL 5, FEM SEL,",15.5,10.08,3.38,232.66,67
CDM,27286665,"CORDIS 5FRX100CM INF TL DIAG CATH, AMPLATZ, AR 1 MOD, FEM SEL",15.5,10.08,3.38,232.66,67
CDM,27286675,"CORDIS 6FRX100CM INF TL DIAG CATH, JUDKINS L COR, JL 5, FEM SEL,",15.5,10.08,3.38,232.66,67
CDM,27286685,"CORDIS 6FRX100CM INF TL DIAG CATH, INTERNAL MAM, IM, FEM SEL",15.5,10.08,3.38,232.66,67
CDM,27286695,"CORDIS 4FRX100CM INF TL DIAG CATH, MULTIPURPOSE, MPA 2, FEM SEL,",15.5,10.08,3.38,232.66,67
CDM,27286705,"CORDIS 4FRX100CM INFINITI TL DIAG CATH, AMPLATZ, AR MOD, FEM SEL",15.5,10.08,3.38,232.66,67
CDM,27286715,"CORDIS 4FRX100CM INFTLDIAGCATH,FEMSEL, WILLIAMS RIGHT/NO TORQUE",15.5,10.08,3.38,15.5,59
CDM,27286725,"COVIDEN REM POLYHESIVE II INF PT ELECTRODE, SINGLE USE, 2.7 M CO",10.64,6.92,2.32,10.64,59
CDM,27286735,"COVIDEN ELECTROSURGICAL PENCIL, HANDSWITCHING, 10 FT CORD",5.78,3.76,1.26,5.78,59
CDM,27286745,COVIDEN ADULT REM POLYHESIVE II PT RET ELECTRODE W/9 FT CORD,5.6,3.64,1.22,5.6,59
CDM,27286755,"COVIDEN ARGYLE UMB CATH INSERTTRAY W/FINETIPFORCEPS,W/OCATH",76.51,49.73,16.68,76.51,59
CDM,27286765,"COVIDEN8FRX17IN, 100% SILICONE FOLEY CATH, 3CC BALLOON, 2-WAY, P",8.4,5.46,1.83,8.4,59
CDM,27286775,"COVIDEN 10FRX17IN,100% SILICONE FOLEY CATH, 3CC BALLOON, 2-WAY,",8.4,5.46,1.83,8.4,59
CDM,27286785,"COVIDEN12FRX17IN, 5CC BALLOON, 2-WAY, 100 % SILICONE FOLEY CATHE",5.74,3.73,1.25,5.74,59
CDM,27286795,"COVIDEN14 FRX17IN, 5CC BALLOON, 2-WAY, 100 % SILICONE FOLEY CATH",5.74,3.73,1.25,5.74,59
CDM,27286835,"COVIDEN 18"" BIOSYN SUTURE, 4-0, UNDYED, P-12 PREM NEEDLE, REVCUT",5.64,3.67,1.23,5.64,59
CDM,27286855,"ETHICON 2.5CM DISK W/4.0MM HOLE, BIOPATCH PROTECT DRESSW/CHG",11.54,7.5,2.52,11.54,59
CDM,27286865,"ETHICON 1.9CM DISK W/1.5 MM CENTER HOLE, BIOPATCH PROTECT DRESS",11.54,7.5,2.52,11.54,59
CDM,27286875,"ETHICON 2.5CM DISK W/ 7MM CENTER HOLE, BIOPATCH PROTECTIVE DRESS",11.54,7.5,2.52,11.54,59
CDM,27286885,ETHICON TAPE UMBILICAL COTTON 1/8 X 36,10.88,7.07,2.37,10.88,59
CDM,27286895,ETHICON SUTURE ETHIBOND XTRA 3-0 SH 30 INCH,9.5,6.18,2.07,232.66,67
CDM,27286905,"GALT MED 5FR X 5.5CM  MA HEM VALVE INTRO KIT, W/ GUIDE WIRE, SOF",56.0,36.4,12.21,232.66,67
CDM,27286915,"GALT MED 6FR X 5.5CM M-A HEM VALVE INTRO KIT, W/ GUIDE WIRE, SOF",56.0,36.4,12.21,232.66,67
CDM,27286925,"GALT MED 3FR X 3CM MICROSLIDE INTRO SHEATH SET, .008IN GWIRE",46.3,30.1,10.09,232.66,67
CDM,27286935,"GALT MED 4FR X 5CM M-A TEARAWAY SHEATH/DILATOR INTRO SET, 0.018I",36.8,23.92,8.02,232.66,67
CDM,27286945,"GALT MED 4.5FR X 5CM TEARAWAY SHEATH/DILATOR INTRO SET, 0.018IN",32.0,20.8,6.98,232.66,67
CDM,27286955,"GALT MED 5FRX5CMTEARAWAY SHEATH/DILATOR INTRO SET, 0.018IN MAX",32.0,20.8,6.98,232.66,67
CDM,27286965,"GALT MED 5.5FR X 5CMTEARAWAY SHEATH/DILATOR INTRO SET, 0.018IN M",32.0,20.8,6.98,32.0,59
CDM,27286975,HEART SYNC PED RADIOTRANS MULTIFUNCT DEFIB ELECTRODES W/ZOLL CON,25.8,16.77,5.62,232.66,67
CDM,27286985,"ICU MED 7FR,4 LUMEN,110CM THERMODIL CATH HEP-COAT MULTIFLEX, LAT",59.76,38.84,13.03,59.76,59
CDM,27286995,"ICU MED THERMOSET, CO-SET, FOR USE WITH IN-LINE PROBE",20.1,13.07,4.38,232.66,67
CDM,27287005,"MEDTRONIC5FRX100CM LAUNCH GUIDING CATH, AMPLATZ RIGHT 1.0, 0.058",68.25,44.36,14.88,232.66,67
CDM,27287015,"MEDTRONIC 5FRX100CM LAUNCH GUIDING CATH, JUDKINS LEFT 3.0, 0.058",68.25,44.36,14.88,68.25,59
CDM,27287025,MEDTRONIC STERILE SLEEVE,19.0,12.35,4.14,232.66,67
CDM,27287035,"MERIT 6FR PERICARDIOCENTESIS KIT, HIGH-FLOW PIGTAIL CATH",166.16,108.0,36.22,232.66,67
CDM,27287045,"MERIT 4FRX65CM SOFTOUCH PED DIAG CATH, 2 BAND PIGTAIL",112.0,72.8,24.42,232.66,67
CDM,27287055,"MERIT 4F X 65CM, PED-PIG-VSC-2B PERFORMA 0.035",112.0,72.8,24.42,232.66,67
CDM,27287065,"MERIT 4FX7CM PRELUDE HYDROPHILIC SHEATH INTRO 0.018""X40CM",98.0,63.7,21.36,98.0,59
CDM,27287075,MERIT5FR PRELUDE  I DEAL,98.0,63.7,21.36,232.66,67
CDM,27287085,MERIT 6 FR SHEATH INTRODUCER,98.0,63.7,21.36,232.66,67
CDM,27287095,MERIT 5FR X 11CM PRELUDE IDEAL HYDROPHILIC SHEATH INTRO,91.0,59.15,19.84,232.66,67
CDM,27287105,MERIT 6FR X 11CM PRELUDE IDEAL HYDROPHILIC SHEATH INTRO,91.0,59.15,19.84,232.66,67
CDM,27287115,MERIT 7FR /11CM SHEATH INTRODUCER,91.0,59.15,19.84,232.66,67
CDM,27287125,"MERIT 3FR X 40CM PERFORMA PED DIAGCATH, PIGTAIL, 4 SIDE PORTS,TE",73.5,47.78,16.02,232.66,67
CDM,27287135,"MERIT 6.5FR2.1MMX20CM,GREEN,4 HOLES,STRT,RESOLVE NO-LOCK DRAIN C",70.0,45.5,15.26,232.66,67
CDM,27287145,"MERIT 0.038INX260CM INQWIRE AMPLATZ DIAG GWIRE, STRT SHORT TIP",70.0,45.5,15.26,232.66,67
CDM,27287155,"MERIT 5FX4CM PRELUDE SHORT SHEATH INTRODUCER, GRAY, 0.46MMX40CM",65.9,42.84,14.37,232.66,67
CDM,27287165,MERIT 7FRX13CM CLASSIC SHEATH SPLIT HEMOSTAT INTRODUCER SYSTEM,54.0,35.1,11.77,232.66,67
CDM,27287175,MERIT 7FRX13CM PRELUDE SNAP SPLIT HEMOSTAT INTRODUCER SYSTEM,54.0,35.1,11.77,232.66,67
CDM,27287185,"MERIT 0.035INX180CM INQWIRE DIAG GWIRE, FIXED-CORE PTFE COATED,",50.4,32.76,10.99,50.4,59
CDM,27287195,"MERIT 4FX10CM MAK, ECHO-ENHANCED 4CM NEEDLE KIT,0.46MMX40CM",50.0,32.5,10.9,232.66,67
CDM,27287205,"MERIT 5FRX65CM IMPRESS DIAG PERIPH CATH, STRT FLUSH, 10 SP",50.0,32.5,10.9,232.66,67
CDM,27287215,"MERIT 4FR PERFORMA DIAGNOSTIC CATHETER, MULTIPURPOSE BUMPER TIP",46.0,29.9,10.03,232.66,67
CDM,27287225,"MERIT 4FRX65CM IMPRESS DIAG PERIPH CATH, STRT FLUSH, 10 SPS",44.0,28.6,9.59,232.66,67
CDM,27287235,"MERIT 4FRX90CM IMPRESS DIAG PERIPH CATH, STRT FLUSH, 10 SPS",44.0,28.6,9.59,232.66,67
CDM,27287245,"MERIT 0.035INX260CM INQWIRE DIAG GWIRE, FIXED-CORE, 1.5MM J ROSE",40.2,26.13,8.76,232.66,67
CDM,27287255,"MERIT 5FRX90CM IMPRESS DIAG PERIP CATH, STRT FLUSH, 10 SPS, NON-",22.0,14.3,4.8,232.66,67
CDM,27287265,"MERIT 5FRX65CM PERFORMA DIAG CATH,HIGHFLOWPIGTAIL,10 SIDE PORTS",22.0,14.3,4.8,232.66,67
CDM,27287275,"MERIT 5FRX90CM PERFORMA DIAG CATH,HIGH FLOW PIGTAIL, 10 SPS",22.0,14.3,4.8,232.66,67
CDM,27287285,"MERIT 4FRX80CM PERFORMA DIAG CATH, PIGTAIL FLUSH, 10 SPS, NON-BR",22.0,14.3,4.8,232.66,67
CDM,27287295,"MERIT 0.035INX260CM INQWIRE DIAG GWIRE, FIXED-CORE, 3MM J-TIP",21.0,13.65,4.58,232.66,67
CDM,27287305,"MERIT 0.035INX150CM INQWIRE DIAG GWIRE, FIXED-CORE, 3MM J-TIP FI",20.5,13.33,4.47,232.66,67
CDM,27287315,"MERIT 0.035INX150CM INQWIRE DIAG GWIRE, FIX-CORE HEP COATED, STR",17.2,11.18,3.75,232.66,67
CDM,27287325,"MERIT 6FRX100CM PERFORMA DIAG CATH, JR4.0, 1.9CMTIP, 0.038IN MAX",17.0,11.05,3.71,232.66,67
CDM,27287335,"MERIT 6FR X 125CM PERFORMA DIAG CATH, A2, 5.8CM TIP, 2 SPS",17.0,11.05,3.71,232.66,67
CDM,27287345,"MERIT 6FRX110CM PERFORMA DIAG CATH, STRT CARD PIGTAIL, 8.0CM TIP",126.0,81.9,27.47,232.66,67
CDM,27287355,"MERIT 5FRX100CM PERFORMA DIAG CATH, JL6.0 HIGH FLOW, 2.5CM TIP",17.0,11.05,3.71,17.0,59
CDM,27287365,"MERIT HEMOSTASIS VALVE ADAPTER, UP TO 8F",13.0,8.45,2.83,13.0,59
CDM,27287375,"MERIT 48IN 1200 PSI CONTRAST INJ TUBING, POLYURETHANE",11.64,7.57,2.54,232.66,67
CDM,27287385,"MERIT 5FRX0.035IN PERFORMA ANGIO CATH, RAD, BRAIDED, VERT MOD .1",9.2,5.98,2.01,9.2,59
CDM,27287465,"NONIN PURELIGHT PULSE OXIMETER SENSOR, INFANT",18.0,11.7,3.92,232.66,67
CDM,27287475,OSCOR 6FR /10MM/100CM VENOS OCCLUSION BALLOON CATHETER,112.0,72.8,24.42,112.0,59
CDM,27287485,REMINGTON 2.5M DISP SURG CABLE W/ 2MM TOUCHPROOF/GATOR CLIP,32.0,20.8,6.98,32.0,59
CDM,27287505,"TERMO 4FRX120CM GLIDECATH HYDROPHYLIC COATED CATH, ANGLED TIP",90.56,58.86,19.74,90.56,59
CDM,27287515,ZOLL PEDI-PADZ SOLID GEL RADIOLUCENT PEDIATRIC MF ELECTRODE,15.74,10.23,3.43,15.74,59
CDM,27287525,MEDTRONIC J SLEEVE,19.0,12.35,4.14,232.66,67
CDM,27287535,"MEDTRONIC LINQ II, ACTUAL RECORDER",6270.75,4075.99,1367.02,6270.75,59
CDM,27287545,EXOFIN GLUE,20.0,13.0,4.36,20.0,59
CDM,27287555,AQUACEL DRESSING,94.45,61.39,20.59,94.45,59
CDM,27287565,"CARDINAL, LOOP PAC, SAN29LPCCC",53.26,34.62,11.61,53.26,59
CDM,27287575,"COVIDEN, VALLEYLAB, CAUTERY PENCIL",5.78,3.76,1.26,5.78,59
CDM,27287585,MEDTRONIC SAFETY CABLE 5587,135.45,88.04,29.53,232.66,67
CDM,27287595,"BOSTON SCIENTIFIC INGEVITY MRI, 7740, ACTUAL LEAD",510.0,331.5,111.18,510.0,59
CDM,27287605,"CARDINAL, SAN29PCCCJ PAC",89.93,58.45,19.6,89.93,59
CDM,27287615,"REMINGTON MEDICAL, PA-801 CABLE",32.0,20.8,6.98,232.66,67
CDM,27287625,"MERIT SHEATH, PLS-1007 CATHETER",54.0,35.1,11.77,54.0,59
CDM,27288155,KIT CATH ACCSS PORT PROMETRA 11824,98.0,63.7,21.36,98.0,59
CDM,27288165,KIT REFILL PROMETRA 11825,48.0,31.2,10.46,48.0,59
CDM,27288175,CATH TUNNELER KIT PROMETRA,158.0,102.7,34.44,158.0,59
CDM,27288185,TUNNELER ANS 1120,105.0,68.25,22.89,105.0,59
CDM,27288195,KIT NRSTM NDL ANCHR ACCK101X,300.0,195.0,65.4,300.0,59
CDM,27288205,KIT NRSTM TUNNELR ACCK30XX,300.0,195.0,65.4,300.0,59
CDM,27288215,KIT NRSTM CABLE SNSA ACCK4000,400.0,260.0,87.2,400.0,59
CDM,27288225,KIT TORQ WRENCH ACCK6006,300.0,195.0,65.4,300.0,59
CDM,27288235,KIT STYLET 30-70CM ACCK8012-X0,300.0,195.0,65.4,300.0,59
CDM,27288245,IPG TEMPLATE KIT,300.0,195.0,65.4,300.0,59
CDM,27288255,KIT TRIAL MX ADPT NVRO ACCK9050,300.0,195.0,65.4,300.0,59
CDM,27288265,KIT INTLS PRGRMR 9774X,862.5,560.63,188.03,862.5,67
CDM,27288275,KIT INTLS PRGRM RCHRG 9775X,1552.5,1009.13,338.45,1552.5,59
CDM,27288285,ADPT LD PCKT 1X4 74001,615.0,399.75,134.07,615.0,59
CDM,27288295,ADPT LD 2X4 PCKT 74002,1185.0,770.25,258.33,1185.0,59
CDM,27288305,ENVELOPE TYRX NMRM61XX,1492.5,970.13,325.37,1492.5,59
CDM,27288315,KIT NRSTM 14GA CRV TIP NDL 355014,66.5,43.23,14.5,66.5,59
CDM,27288325,KIT STIM BOOT ANCHR NRMSCLR 355024,71.75,46.64,15.64,71.75,59
CDM,27288335,KIT NRSTM 14GA TUO NDL SYR 355028,80.5,52.33,17.55,80.5,59
CDM,27288345,KIT NRSTM RSTR PLG CLS BT 355029,253.75,164.94,55.32,253.75,59
CDM,27288355,KIT NRSTM ANCHR ADPT 38CM 355038,131.25,85.31,28.61,131.25,59
CDM,27288365,KIT NRSTM ACC EXT PASS 365538,157.5,102.38,34.34,157.5,59
CDM,27288375,KIT NRSTM 63CM 6.5FR PERC 3550-63,131.25,85.31,28.61,131.25,59
CDM,27288395,PRGMR NRSTM ACTIVA PT ANT EXT 37092,117.25,76.21,25.56,117.25,59
CDM,27288405,CATH INT THCL 2 PC 878X,1350.0,877.5,200.93,1350.0,67
CDM,27288415,CATH INT THCL SUTLS PMP CONN 8731SC,967.5,628.88,200.93,967.5,67
CDM,27288425,KIT ACC 2 ATTACH CLLT SPNL SEG 8782,742.5,482.63,161.87,742.5,59
CDM,27288435,KIT ACC 2 ATTACH CLLT PMP SEG 8784,675.0,438.75,147.15,675.0,59
CDM,27288445,CATH INT THCL PROX SPNL KT PMP 8596SC,600.0,390.0,130.8,600.0,67
CDM,27288455,CATH INT THCL DIST SPNL KT REV 8598,450.0,292.5,98.1,450.0,67
CDM,27288465,PRGMR NRSTM SNCHR 2 HNDHLD 8835,1125.0,731.25,245.25,1125.0,59
CDM,27288475,KIT INT THCL PMP SUTLS CONN 8578,225.0,146.25,49.05,225.0,59
CDM,27288485,PASS SRG ONQ PNBSTR CATH 8591-XX,171.5,111.48,37.39,171.5,59
CDM,27288495,KIT INF DCRN PCH SNCHR DRG 8590-1,148.75,96.69,32.43,148.75,59
CDM,27288505,KIT ACC 2 ATTACH CLLT CATH 8785,270.0,175.5,58.86,270.0,59
CDM,27288515,COILED LEAD BLANK KIT,300.0,195.0,65.4,300.0,59
CDM,27288525,CONTROLLER PATIENT THERAPY 12860,1050.0,682.5,228.9,1050.0,59
CDM,27290215,URETHRAL DILATOR SET - COOK,289.58,188.23,63.13,289.58,59
CDM,27290225,MALE URETHRAL DILATION BALLOON CATH.,152.33,99.01,33.21,232.66,67
CDM,27290635,"BOSTON SCI 3MMX8MM - 4.5MMX28MM, 144CM REBEL BARE METAL STENT SY",1012.5,658.13,200.93,1012.5,67
CDM,27290675,"2.6FR X 150CM CXI SUPPORT CATHETER, ANGL",247.5,160.88,53.96,247.5,67
CDM,27290685,HI-TORQUE WHISPER MS GUIDE WIRE W/HYDROC,124.25,80.76,27.09,232.66,67
CDM,27290695,6FR HAWKONE DIRECTIONAL ATHERECTOMY SYST,4313.25,2803.61,200.93,4313.25,67
CDM,27290705,12FR X 30CM AMPLATZ ANCHOR PERCUFLEX CA,132.56,86.16,28.9,132.56,59
CDM,27290715,"6.0MM X 20MM BALLOON, 90CM SHAFT, PACIFI",262.5,170.63,57.23,262.5,67
CDM,27290725,MAP-IT SHROUDED DECA EXTENSION CABLE,227.0,147.55,49.49,227.0,59
CDM,27290735,FEM-O-STOP GOLD FEMORAL COMPRESSION DEVICE,192.99,125.44,42.07,192.99,59
CDM,27290745,90CM BRIDGE OCCLUSION BALLOON CATHETER,975.0,633.75,200.93,975.0,67
CDM,27290755,6FR GUIDEZILLA II GUIDE EXTENSION CATH,600.0,390.0,130.8,600.0,67
CDM,27290765,0.018IN X 300CM HI-TORQUE COMMAND ST GUIDE,267.88,174.12,58.4,267.88,67
CDM,27290795,COOK FUHMAN PLEURAL/PNEUMOPERICARDIAL DRAINAGE SET,150.73,97.97,32.86,150.73,59
CDM,27290805,"ABBOTT/ OMNILINK,7.0MM X 16MM X135CM STENT SYSTEM",1620.0,1053.0,200.93,1620.0,67
CDM,27290975,ABBOTT VASCULAR CLOSURE DEVICE,322.5,209.63,70.31,322.5,67
CDM,27290985,MEDTRONIC 52CM DF-1 UNIPOLAR ENDOCARDIAL SVC CORONARY SINUS LEAD,1275.0,828.75,200.93,1275.0,67
CDM,27290995,MEDTRONIC TUNNELING TOOL FOR MEDTRONIC LEAD MODEL 6996,574.5,373.43,125.24,574.5,59
CDM,27290OH,INTERPELVIABDOMINAL AMPUTATION,9820.0,6383.0,1.1,9820.0,144
CDM,27291005,MEDTRONIC SELECTSITES STEERABLE DEFLECTING GUIDING CATH FOR 69CM,304.5,197.93,66.38,304.5,67
CDM,27291015,MEDTRONIC 52CM UNIPOLAR ENDOCARDIAL SVC LEAD,1275.0,828.75,200.93,1275.0,67
CDM,27291025,"MEDTRONIC 32CM EPI MYOCARDIAL PACING LEAD, SUTURELESS SCREW IN",637.5,414.38,138.98,637.5,67
CDM,27291085,SCIS MONOPOLAR CURVED 430004,555.0,360.75,120.99,555.0,59
CDM,27291095,SCIS MONOPOLAR CAUTERY 430007,318.0,206.7,69.32,318.0,59
CDM,27291105,FRCP MARYLAND BIPOLAR 430010,517.5,336.38,112.82,517.5,59
CDM,27291115,FRCP FENESTRATED BIPOLAR 430011,517.5,336.38,112.82,517.5,59
CDM,27291125,DRIV LG NEED 430006,465.0,302.25,101.37,465.0,59
CDM,27291135,FRCP CADIERE  430009,412.5,268.13,89.93,412.5,59
CDM,27291145,INST SHEATH 430012,375.0,243.75,81.75,375.0,59
CDM,27291155,MED-LG CLIP APP HEM-O-LOK 430005,70.0,45.5,15.26,70.0,59
CDM,27291165,MCS TIP 430035,210.0,136.5,45.78,210.0,59
CDM,27291175,TIP ESU 5MM CAUT RBTC HK DVNC 400156,148.75,96.69,32.43,148.75,59
CDM,27291185,TIP ESU 5MM DVNC EWRST RBTC HK 400160,148.75,96.69,32.43,148.75,59
CDM,27291195,INST SHEATH 430012,60.0,39.0,13.08,60.0,59
CDM,27291205,CAMERA SHEATH 430020,105.0,68.25,22.89,105.0,59
CDM,27291215,DRAPE INST ARM 430013,622.5,404.63,135.71,622.5,59
CDM,27291225,KIT C.6.6.6 25 MM X 100 MM 463568,270.0,175.5,58.86,270.0,59
CDM,27291985,BOSTON SCIENTIFIC/PERIPH VASC/FIBER BRAID MICROCATH W/ HYDRO PAS,637.5,414.38,138.98,637.5,67
CDM,27291995,ABBOTT/HERCULINK/EXPANDING BILLARY STENT/5MM X 12MM? 135CM ELITE,825.0,536.25,179.85,825.0,67
CDM,27292005,ABBOTT/TREKRX CORONARY DILATION CATH/4.0MM X 15MM,148.75,96.69,32.43,232.66,67
CDM,27292015,MEDTRONIC MULLINS INTRO SHEATH 8FR W/HEMO VALVE 59CM- 67CM,148.75,96.69,32.43,232.66,67
CDM,27292025,B-BRAUN COEFFICIENT 12X2,527.85,343.1,115.07,527.85,59
CDM,27292275,D'VILL LONG LENGTH INTRODUCER SET/ 14 FR. X 85 CM,328.5,213.53,71.61,328.5,67
CDM,27292285,D'VILL LONG LENGTH INTRODUCER SET /12 FR. X 85  CM,328.5,213.53,71.61,328.5,67
CDM,27292295,"TERUMO, CORONARY MICRO GUIDE CATHETER/ 1.8 FR X130 CM",600.0,390.0,130.8,600.0,67
CDM,27292305,ABBOT/TREK  CORONARY DILATION CATHETER/3.50X15X145CM,148.75,96.69,32.43,232.66,67
CDM,27292315,ABBOT/TREK CORONARY DILATION CATHETER/3.0X15X145 CM,148.75,96.69,32.43,232.66,67
CDM,27292610,CORVOCET BX SYSTEM,110.0,71.5,23.98,110.0,59
CDM,27292645,"BOSTON SCIENTIFIC FORTE GUIDEWIRE, MOD SUPPORT, FLOPPY, ST TIP,",122.15,79.4,26.63,232.66,67
CDM,27292655,MEDTRONIC ADJUSTABLE SPLITTER,61.25,39.81,13.35,61.25,59
CDM,27292665,"MEDTRONIC ACUMEN C315 LEAD DELIVERY GUIDING CATHER, J SHAPED",660.0,429.0,143.88,660.0,67
CDM,27292675,"MEDTRONIC AZURE XT, DR, SURESCAN",5940.0,3861.0,200.93,5940.0,67
CDM,27292685,CORDIS PALMAZ BLUE TRANSHEPATIC BILIARY STENT 80CM LENGTH,1260.0,819.0,200.93,1260.0,67
CDM,27292705,"REBEL CORONARY PLAT CHROMIUM BARE METAL STENT SYS 3MMX8MM, 144 C",750.0,487.5,163.5,750.0,67
CDM,27293125,"SHOCKWAVE LITHOPLASTY PERIPHERAL BALLOON OTW, 6F",3712.5,2413.13,200.93,3712.5,67
CDM,27293135,"SHOCKWAVE LITHOPLASTY PERIPHERAL OTW BALLOON CATHETER, 7F",3712.5,2413.13,200.93,3712.5,67
CDM,27293155,PTNS KIT,96.25,62.56,20.98,96.25,59
CDM,27293175,"ASAHI, GLADIUS, GUIDEWIRE, 014X200CM, PPW14R100S",201.25,130.81,43.87,232.66,67
CDM,27293205,ARGON PRESSURE MANIFOLD,56.0,36.4,12.21,56.0,59
CDM,27293215,"MERIT INQWIRE DIAGNOSTIC GUIDEWIRE, FIXED CORE, SUPER STIFF",63.44,41.24,13.83,232.66,67
CDM,27293225,"MEDTRONIC WOVEN CORONARY CATH, HI VOL NIH, W/CARDIO MARKER IMAGE",68.25,44.36,14.88,232.66,67
CDM,27293235,BECTON DICKINSON PLEURX PLEURAL EFFUSION DRAINAGE KIT,80.1,52.07,17.46,80.1,59
CDM,27293245,"ASAHI PROWATER PTCA GUIDEWIRE, STRAIGHT, 0.014X300 CM",122.5,79.63,26.71,232.66,67
CDM,27293265,"CORIDS PWRFLX PICC DUAL LUMEN BALL DIL CATH 5MMX2CM BALL, 5FR,11",192.5,125.13,41.97,232.66,67
CDM,27293275,"BARD POWER PICC DUAL LUMEN NITINOL GW, 5FR, RADSTIC MICROINTRODU",213.57,138.82,46.56,232.66,67
CDM,27293285,BARD 4 FR POWER PICC DUAL LUMEN,227.5,147.88,49.6,232.66,67
CDM,27293295,"BARD POWER PICC SV CATHETIR IR TRAY, SINGLE LUMEN, NITINOL,3FRX7",229.25,149.01,49.98,232.66,67
CDM,27293305,"BAYLIS BMC CATHETER CONNECTOR CABLE FOR NYKANEN RFP CATH, 10 FT",225.0,146.25,49.05,225.0,59
CDM,27293315,"BARD DORADO PTA DILATION BALLOON CATHETER, 4MMX2CM, 5FRX80CM",247.5,160.88,53.96,247.5,67
CDM,27293325,"TERUMO ANGIO SEAL VIP PLATFORM CLOSURE DEVICE, 8 FR",262.5,170.63,57.23,262.5,59
CDM,27293335,"GORE DRYSEAL FLEX INTRODUCER SHEATH, 22FR X33CM",355.5,231.08,77.5,355.5,67
CDM,27293345,"BRAUN MULTISNARE SET, 15MM X125 CM",484.43,314.88,105.61,484.43,59
CDM,27293355,"BRAUN COEFFECIENT PTV DILATION CATH, 11MMX3CM BALL,3.5FR SHAFT X",627.45,407.84,136.78,627.45,67
CDM,27293365,"BAYLIS NRG RF TRANSEPTAL NEEDLE, CURVE 0, 56CMX32IN",727.5,472.88,158.6,727.5,59
CDM,27293375,"GORE DRYSEAL FLEX INTRODUCER SHEATH, 26 FR X 65 CM",865.5,562.58,188.68,865.5,67
CDM,27293385,"MEDTRONIC 6 F PROT?G? GPS, NITINOL STENT, 9MMX30MMX120CM",900.0,585.0,196.2,900.0,67
CDM,27293395,"MEDTRONIC INTRASTENT LD MAX BILIARY STENT, UNMOUNTED,12MMX26MM",937.5,609.38,200.93,937.5,67
CDM,27293405,"PENUMBRA LANTERN DELIVERY MICROCATH, 0.025OMX135CM 45 DEGREE TIP",975.0,633.75,200.93,975.0,67
CDM,27293415,"BRAUN TYSHAK II BALLON DILATION CATH, 10MMX4CM BALLOON,5FRX90CM",1026.75,667.39,200.93,1026.75,67
CDM,27293425,"BRAUN TYSHAK II BALLON DILATION CATH,8MMX6CM BALLOON,4FRX70CM SH",1155.02,750.76,200.93,1155.02,67
CDM,27293435,"BARD VIDA BAV BALLOON VALVULOPLASTY CATHETER 22MMX4CM,100CM SHAF",1260.0,819.0,200.93,1260.0,67
CDM,27293445,"BRAUN BIB DILATION CATHETER,10MMX3.5CM INNER,20MMX4CM OUTER 8 FR",1285.5,835.58,200.93,1285.5,67
CDM,27293455,"NUMED BIB DILATION CATH,5MMX3CM INNER,10MMX4MM OUTER, 8 FR SHAFT",1285.5,835.58,200.93,1285.5,67
CDM,27293465,OSCOR DESTINO TWIST STEERABLE GUIDING SHEATH,1425.0,926.25,200.93,1425.0,67
CDM,27293475,MEDTRONIC MVP MICRO VASCULAR PLUG MECHANICAL DETACHMENT 13MM,2288.25,1487.36,498.84,2288.25,59
CDM,27293485,BRAUN COVERED CP STENT 1.6 CM,7222.5,4694.63,200.93,7222.5,67
CDM,27293495,"MEDTRONIC SELECT SURE PACEMAKER LEAD, MODEL 3830",675.0,438.75,147.15,675.0,67
CDM,27293725,COOK PARK BLADE SEPTOPLASTY CATHETER 5.7 FRX68.5CM 9.4 MM BLADE,2084.0,1354.6,200.93,2084.0,67
CDM,27293755,PAD ELECTRODES,54.0,35.1,11.77,54.0,59
CDM,27293765,CORTICAL BIPOLAR PROBES,583.5,379.28,127.2,583.5,59
CDM,27293785,CS CATH DELIVERY SYSTEM,906.0,588.9,197.51,906.0,59
CDM,27293865,INFUSION CATHETER,206.5,134.23,45.02,232.66,67
CDM,27293875,INTRACRANIAL CATHETER RFX072-105-08MP,847.88,551.12,184.84,847.88,67
CDM,27293885,C1769 WIRES TIER III,225.0,146.25,49.05,232.66,67
CDM,27293895,ARROW SHEATH/DILATOR,133.35,86.68,29.07,232.66,67
CDM,27293905,NEUROVASCULAR COIL 4MM X 10CM,2531.25,1645.31,551.81,2531.25,59
CDM,27293915,COIL DETATCHMENT HANDLE,357.0,232.05,77.83,357.0,59
CDM,27293955,"CORDIS/SABER PTA BALLOON DILATION CATHETER,5MMX20MM, 4 FR, 150 C",393.75,255.94,85.84,393.75,67
CDM,27293995,SIDE BY SIDE BIPOLAR STIMULATOR,201.25,130.81,43.87,201.25,59
CDM,27294005,STAINLESS STEEL GRID 4 X 12,3624.74,2356.08,790.19,3624.74,59
CDM,27294035,VENTRIC EXT DRAIN SET,35.0,22.75,7.63,35.0,59
CDM,27294045,COOK 5FR. VAN ANDEL CATHETER,24.23,15.75,5.28,24.23,59
CDM,27294055,"BONE DRILL,COUNTER,300-1900",241.38,156.9,52.62,241.38,59
CDM,27294095,RETTRACT RETRROUND TOUGH,375.0,243.75,81.75,375.0,59
CDM,27294115,HEMOSPRAY,1977.75,1285.54,200.93,1977.75,67
CDM,27294145,C1757 TIER 11 TROMBECTOMY CATH,12150.0,7897.5,200.93,12150.0,67
CDM,27294205,CIRCA S-CATH,8100.0,5265.0,1765.8,8100.0,59
CDM,27294215,IPA 7MM SEMI RIGID CANNULAE,21.0,13.65,4.58,21.0,59
CDM,27294245,SUPPLY - MINI-BAL CATHETER,88.68,57.64,19.33,88.68,59
CDM,27294255,RADIAL COMPRESSION BAND 25,63.0,40.95,13.73,63.0,59
CDM,27294285,"COOK, FLIPPER-DELIVERY MECHANISM",179.73,116.82,39.18,179.73,59
CDM,27294325,"GORE, 27MM CARDIOFORM ASD SEPTAL OCCLUDER",10679.85,6941.9,200.93,10679.85,67
CDM,27294365,BAYLIS RADIOFREQUENCY WIRE,1275.0,828.75,277.95,1275.0,59
CDM,27294375,BAYLIS ELECTROSURGERY CONNECTOR CABLE,225.0,146.25,49.05,225.0,59
CDM,27294385,BAYLIS LEAD CABLE,375.0,243.75,81.75,375.0,59
CDM,27294395,BAYLIS TRANSEPTAL NEEDLE 71 CM,705.0,458.25,153.69,705.0,59
CDM,27294435,MIFI OI ABLATION CATHETER CABLE,630.0,409.5,137.34,630.0,67
CDM,27294465,CAST SUPPLIES SHORT ARM SPLINT ADULT,81.0,52.65,17.66,81.0,59
CDM,27294485,SET CELL SAVER ELITE 21.5IN 26.5IN 11.75X16.5IN 21X72IN AUTOTRAN,96.25,62.56,20.98,96.25,59
CDM,27294495,SET CELL SAVER ELITE 21.5IN 26.5IN 11.75X16.5IN 21X72IN AUTOTRAN,96.25,62.56,20.98,96.25,59
CDM,27294505,SET CELL SAVER ELITE 21.5IN 26.5IN 11.75X16.5IN 21X72IN AUTOTRAN,99.75,64.84,21.75,99.75,59
CDM,27294515,ALLEVYN FOAM 5X5,36.56,23.76,7.97,36.56,67
CDM,27294585,EP UMBILICAL CABLE,1200.0,780.0,261.6,1200.0,59
CDM,27294595,BOSTON SCIENTIFIC TAKERU PTCA BALLOON CATHETER,229.25,149.01,49.98,232.66,67
CDM,27294845,ABBOTT/AMPLATZER TORQVUE,1487.7,967.01,324.32,1487.7,59
CDM,27294855,ABBOTT PICCOLO DUCT OCCLUDER,13068.0,8494.2,2848.82,13068.0,59
CDM,27294865,INQWIRE AMPLATZ SHORT TAPER 0.035 X 260CM,87.5,56.88,19.08,232.66,67
CDM,27294875,RADIOFREQUENCY PROBE (BOX OF 5),8505.0,5528.25,1854.09,8505.0,59
CDM,27294885,ACCESS INSTRUMENTS (BOX OF 5),12690.0,8248.5,2766.42,12690.0,59
CDM,27294895,ADDITIONAL LEVEL ACCESS INSTRUMENTS (BOX OF 5),4725.0,3071.25,1030.05,4725.0,59
CDM,27294905,RADIOFREQUENCY PROBE,5967.0,3878.55,1300.81,5967.0,59
CDM,27294915,ACCESS INSTRUMENTS,2538.0,1649.7,553.28,2538.0,59
CDM,27294925,ADDITIONAL LEVEL ACCESS INSTRUMENTS,1050.0,682.5,228.9,1050.0,59
CDM,27294935,"RADIOFREQUENCY GENERATOR, PURCHASE",40500.0,26325.0,8829.0,40500.0,59
CDM,27294945,"RADIOFREQUENCY GENERATOR, MONTHLY RENTAL",1350.0,877.5,294.3,1350.0,59
CDM,27294955,"RADIOFREQUENCY GENERATOR, PROCEDURE RENTAL",412.5,268.13,89.93,412.5,59
CDM,27294965,INTRACEPT INTRAOSSEOUS RADIOFREQUENCY PROBE,8505.0,5528.25,1854.09,8505.0,59
CDM,27294975,TERUMO AZUR CX 18 DETACHABLE COIL,1425.0,926.25,310.65,1425.0,59
CDM,27294985,TERUMO AZUR 18 DETACHABLE HELICAL HYDROCOIL,1360.43,884.28,296.57,1360.43,59
CDM,27294995,TERUMO AZUR DETACHABLE CONTROLLER,286.5,186.23,62.46,286.5,59
CDM,27295045,COOK DILATOR-G52834,269.18,174.97,58.68,269.18,59
CDM,27295055,COOK ROADRUNNER EXCHANGE GUIDEWIRE 0.018X300 CM,171.5,111.48,37.39,232.66,67
CDM,27295065,TABLO CARTRIDGE,120.0,78.0,26.16,120.0,59
CDM,27295115,GORE DRYSEAL FLEX INTRODUCER/SHEATH DSF 1633,268.5,174.53,58.53,268.5,67
CDM,27295125,GORE DRYSEAL FLEX INTRODUCER/SHEATH DSF 1833,322.5,209.63,70.31,322.5,67
CDM,27295445,KIT ABLT RHYTHMIA LOC REF PTCH,960.0,624.0,209.28,960.0,59
CDM,27295595,URODYNAMIC CATH ? 7FS ? SINGLE SENSOR,59.0,38.35,12.86,59.0,59
CDM,27295605,URODYNAMIC CATH ? 7FS ? ABDOMINAL CATHETER,51.0,33.15,11.12,51.0,59
CDM,27295615,URODYNAMIC ? PUMP TUBING SET,25.52,16.59,5.56,25.52,59
CDM,27295625,SHREDDED EMG LEAD SET,63.0,40.95,13.73,63.0,59
CDM,27295635,MEDTRONIC IN PACT PACLITAXEL PTA BALLOON CATH,1603.8,1042.47,200.93,1603.8,67
CDM,27295645,"BRAUN COVERED MOUNTED  STENT, 8 ZIG",9720.0,6318.0,200.93,9720.0,67
CDM,27295655,"BRAUN COVERED MOUNTED  STENT, 10 ZIG",11002.5,7151.63,200.93,11002.5,67
CDM,27295715,EDWARDS SAPIEN 3 ULTRA 26 MM TRANSCATHER HEART VALVE,43875.0,28518.75,9564.75,43875.0,59
CDM,27295725,B. BRAUN DVILL MODEL DV 1265 HEMOSTATIS INTRODUCER SET,348.0,226.2,75.86,348.0,67
CDM,27295735,MERITRANS DTX PLUS MANIFOLD,67.3,43.75,14.67,67.3,59
CDM,27295775,CORDIS 8MMX2CM SLALOM PTA BALLOON DILATION CATHETER,348.0,226.2,75.86,348.0,67
CDM,27295785,BRAUN COVERED MOUNTED CP STENT 10 ZIG X 6.0 CM,11542.5,7502.63,200.93,11542.5,67
CDM,27295795,BRAUN COVERED MOUNTED CP STENT 10 ZIG X 5.5 CM,11205.0,7283.25,200.93,11205.0,67
CDM,27295805,BRAUN COVERED MOUNTED CP STENT 8 ZIG X 6.0 CM,9922.5,6449.63,200.93,9922.5,67
CDM,27295835,"WIRE,GUIDE,PRESSURE,185,STR,VERRATA",1012.5,658.13,200.93,1012.5,67
CDM,27295845,COOK LUNDERQUIST EXTRASTIFF GUIDEWIRE 7.5MM CURVE,177.89,115.63,38.78,232.66,67
CDM,27295855,POLYMEM WIC SILVER ROPE WOUND FILLER,25.0,16.25,5.45,25.0,67
CDM,27295865,MEDTRONIC CAPSURE FIX PACING LEAD,607.5,394.88,132.44,607.5,67
CDM,27295895,INFANT MATTRESS WARMER MEDLINE,23.76,15.44,5.18,23.76,59
CDM,27295965,SET OXIRIS HEMOFILTER PRISMA,347.1,225.62,75.67,347.1,59
CDM,27295OH,DISARTICULATION OF HIP,7864.0,5111.6,1.1,7864.0,144
CDM,27296365,INTRO SHTH 8.5FR 71CM GUID,1664.0,1081.6,200.93,1664.0,67
CDM,27296535,NUDEL STENT 14MMX3.4,10289.7,6688.31,2243.15,10289.7,59
CDM,27296545,NUDEL STENT  X3.9,10567.8,6869.07,2303.78,10567.8,59
CDM,27296705,CATH MICRO MAMBA FLEX 135,900.0,585.0,196.2,900.0,67
CDM,27297335,"PATIENT PROGRAMMER, WAVEWRITER SPINAL CORD STIMULATOR",900.0,585.0,196.2,900.0,67
CDM,27297365,EVIVA STEREO DEVICE,450.0,292.5,16.97,450.0,67
CDM,27297375,STEREO BIOPSY TRAY,22.0,14.3,4.8,22.0,67
CDM,27297385,US BIOPSY TRAY,76.35,49.63,16.64,76.35,67
CDM,27297395,BARD MARQUEE US BIOPSY DEVICE,187.5,121.88,16.97,187.5,67
CDM,27297405,BARD MARQUEE US BIOPSY DEVICE W/GUIDE,91.0,59.15,16.97,91.0,67
CDM,27297415,JADA SYSTEM DEVICE,2988.0,1942.2,651.38,2988.0,59
CDM,27297445,UNIFUSE INFUSION CATHETER,179.38,116.6,39.1,179.38,59
CDM,27297455,BOSTON SCI SYNERGY OTW CORONARY STENT SYSTEM,1485.0,965.25,323.73,1485.0,59
CDM,27297465,HARMONY TPV 22,44550.0,28957.5,9711.9,44550.0,59
CDM,27297475,HARMONY TPV 25,44550.0,28957.5,9711.9,44550.0,59
CDM,27297485,HARMONY DELIVERY CATHETER SYSTEM,11475.0,7458.75,2501.55,11475.0,59
CDM,27297535,POWERGLIDE MIDLINE FULL KIT,191.0,124.15,41.64,232.66,67
CDM,27297545,POWERGLIDE MIDLINE BASIC KIT,118.0,76.7,25.72,232.66,67
CDM,27297565,SHOCKWAVE C2 IVL CATHETER,7050.0,4582.5,200.93,7050.0,67
CDM,27297695,SIZER BRST  RE-STRL   MSZ-XXX,50.0,32.5,10.9,50.0,59
CDM,27297705,INQUIRY DECAPOLAR STEERABLE EP CATH,450.0,292.5,98.1,450.0,67
CDM,27297785,HAEMONETICS LIPIGUARD SB1E,57.86,37.61,12.61,57.86,59
CDM,27297805,CATH TACTI SEN EN 8FR D C 115CM ABLA C FORCE,3972.0,2581.8,200.93,3972.0,67
CDM,27298025,"ENDOSCOPE, SINGLE USE, DISPOSABLE",3995.5,2597.08,200.93,3995.5,67
CDM,27298855,PLASMABLADE,375.0,243.75,81.75,375.0,59
CDM,27299235,"COOK STENT, BILIARY BALLOON",1312.0,852.8,200.93,1312.0,67
CDM,27299275,BARD HALO ONE GUIDING SHEATH,465.0,302.25,101.37,465.0,67
CDM,27299395,BECKTON DTXPLUS TRANSDUCER KIT,86.0,55.9,18.75,86.0,59
CDM,27299405,MERIT DTXPLUS TRANSDUCER KIT,86.0,55.9,18.75,86.0,59
CDM,27299415,MERIT MANIFOLD VALVE KIT,67.0,43.55,14.61,67.0,59
CDM,27299465,"6FR X 100CM ADROIT GUIDING CATHETER, XB 3.5, .072IN ID",74.0,48.1,16.13,232.66,67
CDM,27299485,ANGIOVAC CIRCUIT W/BUBBLE TRAP,2025.0,1316.25,441.45,2025.0,59
CDM,27299545,BARD VIDA TRUE FLOW VALVULOPASTY PERFUSION CATHETHER,1958.0,1272.7,200.93,1958.0,67
CDM,27299595,EDWARDS ARTERIAL CATH TRUE C  TIP SWAN GANZ,184.0,119.6,40.11,184.0,59
CDM,27299605,EDWARDS ARTERIAL CATH TRUE WAVE 2 LUMEN,220.0,143.0,47.96,232.66,67
CDM,27299645,MERIT THERMAL DILUTION CATHETER,196.0,127.4,42.73,196.0,59
CDM,27299795,PRESSURE ALARM ADAPTER CABLE,173.25,112.61,37.77,173.25,59
CDM,27299805,DIAGNOSTIC CABLE,292.5,190.13,63.77,292.5,59
CDM,27299815,CATHETER INTERFACE CABLE,600.0,390.0,130.8,600.0,59
CDM,27299825,MARINR MC 7FR 2/5/2 EP CATHETER,915.0,594.75,199.47,915.0,67
CDM,27299835,PATIENT REFERENCE SENSOR,1050.0,682.5,228.9,1050.0,59
CDM,27299845,"LARGE ACCESS TRANSSEPTAL DILATOR W/ GUIDEWIRE, RF WIRE, DISPERSI",1417.5,921.38,309.02,1417.5,59
CDM,27299855,VASCULARIZED TISSUE POCKET,1462.5,950.63,318.83,1462.5,59
CDM,27299865,DUODECAPOLAR DIAGNOSTIC CATHETER WITH GUIDEWIRE,1606.5,1044.23,350.22,1606.5,59
CDM,27299875,CARDIOVASCULAR DEVICE POCKET XXL,1620.0,1053.0,353.16,1620.0,59
CDM,27299885,FIXED EP ELECTRODE CATHETER,2025.0,1316.25,441.45,2025.0,59
CDM,27299895,C2630 ABLAT CATH TIER III,3476.25,2259.56,200.93,3476.25,67
CDM,27299905,INTRO SHEATH 12FR 65 CM,3476.25,2259.56,757.82,3476.25,59
CDM,27299915,HEX IMPACT SCREW EXTRACTOR,3476.25,2259.56,757.82,3476.25,59
CDM,27299925,"INTRODUCER SHEATH, INTEGRATED DILATOR/TRANSSEPTAL NEEDLE",3476.25,2259.56,757.82,3476.25,59
CDM,27299935,INTRODUCER SHEATH WITH DILATOR,3476.25,2259.56,757.82,3476.25,59
CDM,27299945,MIDSHAFT ULNA PLT X-RAY TEMPLATE,5265.0,3422.25,1147.77,5265.0,59
CDM,27299955,"ICE CATHETER, INTRACARDIAC AND INTRA-LUMINAL VISUALIZATION",4590.0,2983.5,1000.62,4590.0,59
CDM,27299965,CORONARY IVL CATHETER,7050.0,4582.5,200.93,7050.0,67
CDM,27299975,C1724 ROTATIONAL ATHERECTOMY CATHETER TIER 1,2355.75,1531.24,200.93,2355.75,67
CDM,27299985,DRUG COATED BALLOON CATHETER,1748.25,1136.36,381.12,1748.25,59
CDM,27299995,C1725 PTCA CATHETER TIER 2,1404.71,913.06,200.93,1404.71,67
CDM,27299AOH,FASCIAL TRANSFER TO REPAIR OF THE ABDUCTOR TENDON,3746.0,2434.9,0.01,3746.0,84
CDM,27299OH,PELVIS/HIP JOINT SURGERY UNLISTED,2751.0,1788.15,0.01,2751.0,84
CDM,27299RVU10OH,"UNLISTED PROC, PELVIS OR HIP JOINT COMPARED TO 27000",914.0,594.1,0.01,914.0,84
CDM,27299RVU11OH,ABDUCTOR ANCHOR RECONSTRUCTION (COMP CODE 27100),4880.0,3172.0,0.01,4880.0,84
CDM,27299RVU12OH,OPEN PX TO RPR ABDUCTOR MUSCULATURE TO TUMOR PROSTHESIS (COMP CO,4101.0,2665.65,0.01,4101.0,84
CDM,27299RVU13OH,PROPHYLACTIC FIXATION PELVIS/ACETABULUM (27227),9148.0,5946.2,0.01,9148.0,84
CDM,27299RVU14OH,CT GUIDED ACETABULOPLASTY (COMP CODE 22511),2639.0,1715.35,0.01,2639.0,84
CDM,27299RVU15OH,POSTERIOR CAPSULAR RECONSTRUCTION (COMP CODE 27100),4540.0,2951.0,0.01,4540.0,84
CDM,27299RVU1OH,CORE DECOMPRESSION-HIP,1961.0,1274.65,0.01,1961.0,84
CDM,27299RVU3OH,GLUTEUS MEDIUS/MINIMUS REPAIR (COMP CODE 27385),2458.0,1597.7,0.01,2458.0,84
CDM,27299RVU4OH,SUTURE OF ABDUCTOR TENDON (COMP CODE 27385),3085.0,2005.25,0.01,3085.0,84
CDM,27299RVU5OH,OPEN TROCH FLIP OSTEOTOMY,4217.0,2741.05,0.01,4217.0,84
CDM,27299RVU6OH,"UNLIST PROC, PELVIS OR HIP JOINT COMPARED TO 27000",914.0,594.1,0.01,914.0,84
CDM,27299RVU7OH,OPEN HIP LABRAL REPAIR (COMP 27120),6353.0,4129.45,0.01,6353.0,84
CDM,27299RVU9OH,UNLISTED PROC; OPEN TREATMENT TOTAL HIP REPLACEMENT DISLOCATION,2501.0,1625.65,0.01,2501.0,84
CDM,27299RVUOH,ARTHOTOMY REMOVAL/EXCHANGE HIP SPACER,8036.0,5223.4,0.01,8036.0,84
CDM,27300005,GC STOCKING CSTM W/ THUMB STUB,80.2,52.13,11.14,80.2,67
CDM,27300015,GLUCOSE MONITOR PURCHASE,1850.0,1202.5,403.3,1850.0,67
CDM,27300020,TAKE HOME BIOPSY KIT,140.25,91.16,30.57,140.25,59
CDM,27300025,IONTOPATCH,10.0,6.5,2.18,10.0,59
CDM,27300030,EMERGENCY KIT,34.79,22.61,7.58,34.79,59
CDM,27300050,CERVICAL ROLL,19.0,12.35,4.14,19.0,59
CDM,27300065,LUMBAR ROLL,18.0,11.7,3.92,18.0,59
CDM,27300100,EARLY COMPLIANCE LUMBAR ROLL,16.0,10.4,3.49,16.0,59
CDM,27300105,HEEL LIFT,9.0,5.85,1.96,9.0,59
CDM,27300115,LUMBAR D SECTION ROLL,29.0,18.85,6.32,29.0,59
CDM,27300125,SI LOC BELT,54.0,35.1,11.77,54.0,59
CDM,27300130,EMERGENCY REPAIR KIT,34.79,22.61,7.58,34.79,59
CDM,27300155,GAUNTLET W/THMB STB 23-36 MMHG,39.9,25.94,8.7,39.9,67
CDM,27300165,RESISTIVE SPORT CORDS,25.0,16.25,5.45,25.0,59
CDM,27300175,KNEE SLEEVES,157.8,102.57,34.4,157.8,59
CDM,27300185,METACARPAL SPLINT,30.5,19.83,6.65,30.5,59
CDM,27300195,SPLINT COCK-UP WRIST,99.3,64.55,21.65,99.3,59
CDM,27300205,TENNIS ELBOW BRACE,99.3,64.55,21.65,99.3,59
CDM,27300215,WRIST SPLINT,97.3,63.25,21.21,97.3,59
CDM,27300225,SPLINT THUMB SPICA,142.5,92.63,16.97,142.5,67
CDM,27300255,LUMBAR ROLL FIRM DENSITY,23.0,14.95,5.01,23.0,59
CDM,27301OH,I&D DEEP ABSC BURSA/HEMATOMA THIGH/KNEE REGION,2712.0,1762.8,1.1,8286.13,148
CDM,27303OH,INC DEEP W/OPNG BONE CORTEX FEMUR/KNEE,3452.0,2243.8,1.1,3452.0,144
CDM,27305OH,"FASCIOTOMY,ILIOTIBIAL,OPEN",2472.0,1606.8,1.1,9440.12,144
CDM,27306OH,TENOTOMY PRQ ADDUCTOR/HAMSTRING 1 TENDON SPX,1896.0,1232.4,1.1,9440.12,144
CDM,27307OH,TENOTOMY PRQ ADDUCTOR/HAMSTRING MULTIPLE TENDON,2424.0,1575.6,1.1,9440.12,144
CDM,27310OH,ARTHRT KNE W/EXPL DRG/RMVL FB,4000.0,2600.0,1.1,9440.12,144
CDM,27323OH,BIOPSY SOFT TISSUE THIGH/KNEE AREA SUPERFICIAL,932.0,605.8,1.1,4729.25,148
CDM,27324OH,BIOPSY SOFT TISSUE THIGH/KNEE AREA DEEP,2016.0,1310.4,1.1,8286.13,144
CDM,27325OH,"NEURECTOMY, HAMSTRING MUSCLE",2880.0,1872.0,1.1,5632.24,144
CDM,27326OH,"NEURECTOMY, POPLITEAL (GASTROCNEMIUS)",2588.0,1682.2,1.1,5632.24,144
CDM,27327OH,EXCISION TUMOR SOFT TISSUE THIGH/KNEE SUBQ <3CM,1584.0,1029.6,1.1,4729.25,148
CDM,27328OH,EXC TUMOR SOFT TISSUE THIGH/KNEE SUBFASC <5CM,3540.0,2301.0,1.1,8286.13,144
CDM,27329OH,RAD RESECT TUMOR SOFT TISSUE THIGH/KNEE <5CM,6288.0,4087.2,1.1,8286.13,144
CDM,27330OH,ARTHROTOMY KNEE W/SYNOVIAL BIOPSY ONLY,2044.0,1328.6,1.1,9440.12,144
CDM,27331OH,ARTHRT KNE W/JT EXPL BX/RMVL LOOSE/FB,2408.0,1565.2,1.1,9440.12,144
CDM,27332OH,ARTHRT W/EXC SEMILUNAR CRTLG KNEE MEDIAL/LAT,3384.0,2199.6,1.1,9440.12,144
CDM,27333OH,ARTHRT W/EXC SEMILUNAR CRTLG KNEE MEDIAL&LAT,3020.0,1963.0,1.1,9440.12,144
CDM,27334OH,ARTHROTOMY W/SYNOVECTOMY KNEE ANTERIOR/POSTERIOR,3676.0,2389.4,1.1,9440.12,144
CDM,27335OH,ARTHRT W/SYNVCT KNE ANT&POST W/POP AREA,4220.0,2743.0,1.1,20863.78,144
CDM,27337OH,EXCISON TUMOR SOFT TISSUE THIGH/KNEE SUBQ 3+CM,2364.0,1536.6,1.1,8286.13,144
CDM,27339OH,EXC TUMOR SOFT TISSUE THIGH/KNEE SUBFASC 5+CM,4452.0,2893.8,1.1,8286.13,144
CDM,27340OH,EXCISION PREPATELLAR BURSA,1728.0,1123.2,1.1,9440.12,144
CDM,27345OH,EXCISION SYNOVIAL CYST POPLITEAL SPACE,2436.0,1583.4,1.1,9440.12,144
CDM,27347OH,EXCISION LESION MENISCUS/CAPSULE KNEE,2692.0,1749.8,1.1,9440.12,144
CDM,27350OH,PATELLECTOMY/HEMIPATELLECTOMY,3464.0,2251.6,1.1,20863.78,144
CDM,27355OH,EXCISION/CURETTAGE CYST/TUMOR FEMUR,3200.0,2080.0,1.1,9440.12,144
CDM,27356OH,EXCISION/CURETTAGE CYST/TUMOR FEMUR W/ALLOGRAFT,4036.0,2623.4,1.1,38384.94,144
CDM,27357OH,EXCISION/CURETTAGE CYST/TUMOR FEMUR W/AUTOGRAFT,4464.0,2901.6,1.1,20863.78,144
CDM,27358OH,EXCISION/CURETTAGE CYST/TUMOR FEMUR INT FIXATION,1892.0,1229.8,1.1,1892.0,144
CDM,27360OH,PRTL EXC BONE FEMUR PROX TIBIA&/FIBULA,4584.0,2979.6,1.1,9440.12,144
CDM,27364OH,RAD RESECTION TUMOR SOFT TISSUE THIGH/KNEE 5+CM,9796.0,6367.4,1.1,9796.0,144
CDM,27365OH,"RAD RESEC TUMOR,FEMUR OR KNEE",12884.0,8374.6,1.1,12884.0,144
CDM,27369OH,NJX PX CNTRST KNE ARTHG CONTRST ENHNCD CT/MRI KNE,308.0,200.2,1.1,624.58,148
CDM,27372OH,"REMV FOREIGN BODY,KNEE/THIGH,DEEP",2084.0,1354.6,1.1,8286.13,148
CDM,27380OH,SUTURE INFRAPATELLAR TENDON PRIMARY,2980.0,1937.0,1.1,20863.78,144
CDM,27381OH,SUTR INFRAPATELLAR TDN 2 RCNSTJ W/FSCAL/TDN GRF,4304.0,2797.6,1.1,20863.78,144
CDM,27385OH,SUTURE QUADRICEPS/HAMSTRING RUPTURE PRIMARY,3049.0,1981.85,1.1,20863.78,144
CDM,27386OH,SUTR QUADRICEPS/HAMSTRING MUSC RPT RCNSTJ,4452.0,2893.8,1.1,20863.78,144
CDM,27390OH,TENOTOMY OPEN HAMSTRING KNEE HIP SINGLE TENDON,2212.0,1437.8,1.1,9440.12,144
CDM,27391OH,TENOTOMY OPN HAMSTRING KNEE HIP MULTIPLE 1 LEG,2996.0,1947.4,1.1,9440.12,144
CDM,27392OH,TENOTOMY OPEN HAMSTRING KNEE HIP MULTIPLE BI,3852.0,2503.8,1.1,9440.12,144
CDM,27393OH,"LENGTHEN HAMSTR TENDON,SINGLE",2900.0,1885.0,1.1,20863.78,144
CDM,27394OH,"LENGTHEN HAMSTR TENDON,MULTI,ONE LEG",3868.0,2514.2,1.1,20863.78,144
CDM,27395OH,"LENGTHEN HAMSTR TENDON,MULTI,2 LEGS",5386.0,3500.9,1.1,9440.12,144
CDM,27396OH,TRANSPLANT/TRANSFER THIGH XTNSR TO FLXR 1 TENDON,3260.0,2119.0,1.1,20863.78,144
CDM,27397OH,TRANSPLANT/TRANSFER THIGH XTNSR TO FLXR MULT TDN,5064.0,3291.6,1.1,20863.78,144
CDM,27400010,W AFO CUSTOM PLASTIC,992.0,644.8,216.26,992.0,72
CDM,27400010_IP,W AFO CUSTOM PLASTIC,992.0,644.8,361.09,361.09,1
CDM,27400010_OP,W AFO CUSTOM PLASTIC,992.0,644.8,296.61,296.61,1
CDM,27400020,W AIRCAST FP ANKL-FT W/WO JNTS,382.0,248.3,83.28,382.0,72
CDM,27400020_IP,W AIRCAST FP ANKL-FT W/WO JNTS,382.0,248.3,139.05,139.05,1
CDM,27400020_OP,W AIRCAST FP ANKL-FT W/WO JNTS,382.0,248.3,114.22,114.22,1
CDM,27400045,"RUBBER PESSARY, ANY TYPE",109.0,70.85,11.14,109.0,72
CDM,27400045_IP,"RUBBER PESSARY, ANY TYPE",109.0,70.85,39.68,39.68,1
CDM,27400045_OP,"RUBBER PESSARY, ANY TYPE",109.0,70.85,32.59,32.59,1
CDM,27400050,W BRACE ACL T-ROM KO ADJ JNT,600.0,390.0,130.8,600.0,72
CDM,27400050_IP,W BRACE ACL T-ROM KO ADJ JNT,600.0,390.0,218.4,218.4,1
CDM,27400050_OP,W BRACE ACL T-ROM KO ADJ JNT,600.0,390.0,179.4,179.4,1
CDM,27400055,"PESSARY, NON RUBBER",115.0,74.75,25.07,115.0,73
CDM,27400055_IP,"PESSARY, NON RUBBER",115.0,74.75,41.86,41.86,1
CDM,27400055_OP,"PESSARY, NON RUBBER",115.0,74.75,34.39,34.39,1
CDM,27400060,W BRACE ELBOW ROM,140.0,91.0,30.52,775.49,72
CDM,27400060_IP,W BRACE ELBOW ROM,140.0,91.0,49.85,49.85,1
CDM,27400060_OP,W BRACE ELBOW ROM,140.0,91.0,40.95,40.95,1
CDM,27400070,W BRACE FEMUR FX,1897.0,1233.05,413.55,1897.0,73
CDM,27400070_IP,W BRACE FEMUR FX,1897.0,1233.05,1039.56,1039.56,1
CDM,27400070_OP,W BRACE FEMUR FX,1897.0,1233.05,823.3,823.3,1
CDM,27400075,CERVICAL FOAM COLLAR,47.0,30.55,10.25,47.0,72
CDM,27400075_IP,CERVICAL FOAM COLLAR,47.0,30.55,17.11,17.11,1
CDM,27400075_OP,CERVICAL FOAM COLLAR,47.0,30.55,14.05,14.05,1
CDM,27400080,W BRACE HUMERUS FX,147.0,95.55,32.05,147.0,72
CDM,27400080_IP,W BRACE HUMERUS FX,147.0,95.55,53.51,53.51,1
CDM,27400080_OP,W BRACE HUMERUS FX,147.0,95.55,43.95,43.95,1
CDM,27400085,CERVICAL SEMI-RIGID ADJUSTABLE,70.46,45.8,15.36,19595.16,72
CDM,27400085_IP,CERVICAL SEMI-RIGID ADJUSTABLE,70.46,45.8,25.65,25.65,1
CDM,27400085_OP,CERVICAL SEMI-RIGID ADJUSTABLE,70.46,45.8,21.07,21.07,1
CDM,27400105,C.O. SEMIRIGID THERMAPLASTIC,166.72,108.37,36.34,166.72,72
CDM,27400105_IP,C.O. SEMIRIGID THERMAPLASTIC,166.72,108.37,60.69,60.69,1
CDM,27400105_OP,C.O. SEMIRIGID THERMAPLASTIC,166.72,108.37,49.85,49.85,1
CDM,27400110,W BRACE TLSO TRPLN CTRL HYPRTSN,476.56,309.76,103.89,980.32,72
CDM,27400110_IP,W BRACE TLSO TRPLN CTRL HYPRTSN,476.56,309.76,173.47,173.47,1
CDM,27400110_OP,W BRACE TLSO TRPLN CTRL HYPRTSN,476.56,309.76,142.49,142.49,1
CDM,27400120,WHO PREFAB WRIST W/O JOINTS,83.75,54.44,18.26,83.75,72
CDM,27400120_IP,WHO PREFAB WRIST W/O JOINTS,83.75,54.44,24.39,24.39,1
CDM,27400120_OP,WHO PREFAB WRIST W/O JOINTS,83.75,54.44,20.03,20.03,1
CDM,27400135,THORA TLC II LVAD PNEUM LD 5FT,408.24,265.36,89.0,408.24,72
CDM,27400135_IP,THORA TLC II LVAD PNEUM LD 5FT,408.24,265.36,148.6,148.6,1
CDM,27400135_OP,THORA TLC II LVAD PNEUM LD 5FT,408.24,265.36,122.06,122.06,1
CDM,27400155,"HEARTMATE POWER BASE UNIT,1240",1985.98,1290.89,432.94,1985.98,73
CDM,27400155_IP,"HEARTMATE POWER BASE UNIT,1240",1985.98,1290.89,1088.32,1088.32,1
CDM,27400155_OP,"HEARTMATE POWER BASE UNIT,1240",1985.98,1290.89,861.92,861.92,1
CDM,27400160,W KO W/ ADJ FLEX/EXT ROTAT CUS,843.0,547.95,183.77,1491.52,72
CDM,27400160_IP,W KO W/ ADJ FLEX/EXT ROTAT CUS,843.0,547.95,306.85,306.85,1
CDM,27400160_OP,W KO W/ ADJ FLEX/EXT ROTAT CUS,843.0,547.95,252.06,252.06,1
CDM,27400170,W LINER BRACE,95.58,62.13,20.84,95.58,72
CDM,27400170_IP,W LINER BRACE,95.58,62.13,34.79,34.79,1
CDM,27400170_OP,W LINER BRACE,95.58,62.13,28.58,28.58,1
CDM,27400180,W LUMBAR ORTHOSIS CORSET,145.0,94.25,31.61,145.0,72
CDM,27400180_IP,W LUMBAR ORTHOSIS CORSET,145.0,94.25,52.78,52.78,1
CDM,27400180_OP,W LUMBAR ORTHOSIS CORSET,145.0,94.25,43.36,43.36,1
CDM,27400185,SIO FLEX PELVISACRAL PREFAB,101.49,65.97,22.12,101.49,72
CDM,27400185_IP,SIO FLEX PELVISACRAL PREFAB,101.49,65.97,36.94,36.94,1
CDM,27400185_OP,SIO FLEX PELVISACRAL PREFAB,101.49,65.97,30.35,30.35,1
CDM,27400210,W ORTHOSIS ANK/FT STATIC,204.0,132.6,44.47,204.0,72
CDM,27400210_IP,W ORTHOSIS ANK/FT STATIC,204.0,132.6,72.07,72.07,1
CDM,27400210_OP,W ORTHOSIS ANK/FT STATIC,204.0,132.6,59.2,59.2,1
CDM,27400220,W ORTHOSIS HIP POSTOP,1103.0,716.95,240.45,1103.0,72
CDM,27400220_IP,W ORTHOSIS HIP POSTOP,1103.0,716.95,401.49,401.49,1
CDM,27400220_OP,W ORTHOSIS HIP POSTOP,1103.0,716.95,329.8,329.8,1
CDM,27400225,BOG BACK BRACE,413.0,268.45,58.52,413.0,72
CDM,27400225_IP,BOG BACK BRACE,413.0,268.45,150.33,150.33,1
CDM,27400225_OP,BOG BACK BRACE,413.0,268.45,123.49,123.49,1
CDM,27400240,WHFO PREFAB W/O JOINTS,147.0,95.55,32.05,406.89,72
CDM,27400240_IP,WHFO PREFAB W/O JOINTS,147.0,95.55,53.51,53.51,1
CDM,27400240_OP,WHFO PREFAB W/O JOINTS,147.0,95.55,43.95,43.95,1
CDM,27400250,W PREFAB WHFO WO JNTS,267.87,174.12,58.4,406.89,72
CDM,27400250_IP,W PREFAB WHFO WO JNTS,267.87,174.12,97.5,97.5,1
CDM,27400250_OP,W PREFAB WHFO WO JNTS,267.87,174.12,80.09,80.09,1
CDM,27400270,W SHRINKER PROST BELOW KNEE,54.98,35.74,11.99,54.98,72
CDM,27400270_IP,W SHRINKER PROST BELOW KNEE,54.98,35.74,20.01,20.01,1
CDM,27400270_OP,W SHRINKER PROST BELOW KNEE,54.98,35.74,16.44,16.44,1
CDM,27400285,HALO AMB VEST,3146.25,2045.06,685.88,3146.25,65
CDM,27400285_IP,HALO AMB VEST,3146.25,2045.06,1724.15,1724.15,1
CDM,27400285_OP,HALO AMB VEST,3146.25,2045.06,1365.47,1365.47,1
CDM,27400290,W STRAP PAD VARUS/VALGUS T,72.55,47.16,15.82,72.55,72
CDM,27400290_IP,W STRAP PAD VARUS/VALGUS T,72.55,47.16,26.41,26.41,1
CDM,27400290_OP,W STRAP PAD VARUS/VALGUS T,72.55,47.16,21.69,21.69,1
CDM,27400300,W TLSO 2PC PL SHELL W LINER,2415.0,1569.75,526.47,2415.0,65
CDM,27400300_IP,W TLSO 2PC PL SHELL W LINER,2415.0,1569.75,1323.42,1323.42,1
CDM,27400300_OP,W TLSO 2PC PL SHELL W LINER,2415.0,1569.75,1048.11,1048.11,1
CDM,27400315,"PROTECTIVE BODY SOCK, EACH",79.66,51.78,17.37,79.66,72
CDM,27400315_IP,"PROTECTIVE BODY SOCK, EACH",79.66,51.78,29.0,29.0,1
CDM,27400315_OP,"PROTECTIVE BODY SOCK, EACH",79.66,51.78,23.82,23.82,1
CDM,27400340,W TUBE TRACH UNCUF W/DIC,77.0,50.05,16.79,77.0,72
CDM,27400340_IP,W TUBE TRACH UNCUF W/DIC,77.0,50.05,28.03,28.03,1
CDM,27400340_OP,W TUBE TRACH UNCUF W/DIC,77.0,50.05,23.02,23.02,1
CDM,27400345,TLSO CUSTOM SCOLI,2106.44,1369.19,459.2,2106.44,73
CDM,27400345_IP,TLSO CUSTOM SCOLI,2106.44,1369.19,1154.33,1154.33,1
CDM,27400345_OP,TLSO CUSTOM SCOLI,2106.44,1369.19,914.19,914.19,1
CDM,27400355,LAT THORAC EXT ADDTN,287.99,187.19,62.78,406.89,72
CDM,27400355_IP,LAT THORAC EXT ADDTN,287.99,187.19,104.83,104.83,1
CDM,27400355_OP,LAT THORAC EXT ADDTN,287.99,187.19,86.11,86.11,1
CDM,27400360,W VALVE TRACH PASSY MUIR,121.63,79.06,26.52,121.63,72
CDM,27400360_IP,W VALVE TRACH PASSY MUIR,121.63,79.06,44.27,44.27,1
CDM,27400360_OP,W VALVE TRACH PASSY MUIR,121.63,79.06,36.37,36.37,1
CDM,27400375,TLSO LO PROFILE LUMB PAD,107.06,69.59,23.34,107.06,72
CDM,27400375_IP,TLSO LO PROFILE LUMB PAD,107.06,69.59,38.97,38.97,1
CDM,27400375_OP,TLSO LO PROFILE LUMB PAD,107.06,69.59,32.01,32.01,1
CDM,27400390,W COLLAR CERV ADJ BAR THRC FRM,726.48,472.21,158.37,726.48,72
CDM,27400390_IP,W COLLAR CERV ADJ BAR THRC FRM,726.48,472.21,264.44,264.44,1
CDM,27400390_OP,W COLLAR CERV ADJ BAR THRC FRM,726.48,472.21,217.22,217.22,1
CDM,27400415,LAT TROCHANT PAD ADDTN,91.46,59.45,19.94,91.46,72
CDM,27400415_IP,LAT TROCHANT PAD ADDTN,91.46,59.45,33.29,33.29,1
CDM,27400415_OP,LAT TROCHANT PAD ADDTN,91.46,59.45,27.35,27.35,1
CDM,27400425,HMII MODULAR BELT LGE,637.5,414.38,58.52,637.5,72
CDM,27400425_IP,HMII MODULAR BELT LGE,637.5,414.38,232.05,232.05,1
CDM,27400425_OP,HMII MODULAR BELT LGE,637.5,414.38,190.61,190.61,1
CDM,27400440,W LINER INTERFACE AK SOFT,103.4,67.21,22.54,103.4,72
CDM,27400440_IP,W LINER INTERFACE AK SOFT,103.4,67.21,37.64,37.64,1
CDM,27400440_OP,W LINER INTERFACE AK SOFT,103.4,67.21,30.92,30.92,1
CDM,27400445,HO PAVLIK HARNESS,238.0,154.7,51.88,238.0,72
CDM,27400445_IP,HO PAVLIK HARNESS,238.0,154.7,86.63,86.63,1
CDM,27400445_OP,HO PAVLIK HARNESS,238.0,154.7,71.16,71.16,1
CDM,27400450,W BRACE LSO SAG-CORONL PNL PRFB,210.0,136.5,45.78,775.49,72
CDM,27400450_IP,W BRACE LSO SAG-CORONL PNL PRFB,210.0,136.5,76.44,76.44,1
CDM,27400450_OP,W BRACE LSO SAG-CORONL PNL PRFB,210.0,136.5,62.79,62.79,1
CDM,27400455,HO ILFELD TYPE,290.28,188.68,63.28,406.89,72
CDM,27400455_IP,HO ILFELD TYPE,290.28,188.68,105.66,105.66,1
CDM,27400455_OP,HO ILFELD TYPE,290.28,188.68,86.79,86.79,1
CDM,27400460,W BRACE CYBERTECH PREMIUM PLUS,1207.15,784.65,263.16,1207.15,72
CDM,27400460_IP,W BRACE CYBERTECH PREMIUM PLUS,1207.15,784.65,439.4,439.4,1
CDM,27400460_OP,W BRACE CYBERTECH PREMIUM PLUS,1207.15,784.65,360.94,360.94,1
CDM,27400470,W BRACE CYBERTECH SPINE FLEX PLUS,180.0,117.0,39.24,980.32,72
CDM,27400470_IP,W BRACE CYBERTECH SPINE FLEX PLUS,180.0,117.0,65.52,65.52,1
CDM,27400470_OP,W BRACE CYBERTECH SPINE FLEX PLUS,180.0,117.0,53.82,53.82,1
CDM,27400475,"HO PLASTIC,CUSTOM FITTED",212.71,138.26,46.37,212.71,72
CDM,27400475_IP,"HO PLASTIC,CUSTOM FITTED",212.71,138.26,77.43,77.43,1
CDM,27400475_OP,"HO PLASTIC,CUSTOM FITTED",212.71,138.26,63.6,63.6,1
CDM,27400490,W A.L. EXT PCC HIP JNT,459.29,298.54,91.28,459.29,72
CDM,27400490_IP,W A.L. EXT PCC HIP JNT,459.29,298.54,167.18,167.18,1
CDM,27400490_OP,W A.L. EXT PCC HIP JNT,459.29,298.54,137.33,137.33,1
CDM,27400505,PREFAB ELASTIC KO W JNTS,175.0,113.75,38.15,175.0,72
CDM,27400505_IP,PREFAB ELASTIC KO W JNTS,175.0,113.75,63.7,63.7,1
CDM,27400505_OP,PREFAB ELASTIC KO W JNTS,175.0,113.75,52.33,52.33,1
CDM,27400510,EO PREFAB W ADJ LOCK JNTS,548.0,356.2,119.46,980.32,72
CDM,27400510_IP,EO PREFAB W ADJ LOCK JNTS,548.0,356.2,89.18,89.18,1
CDM,27400510_OP,EO PREFAB W ADJ LOCK JNTS,548.0,356.2,73.26,73.26,1
CDM,27400515,PLAYMAKER KNEE BRACE,324.0,210.6,58.52,324.0,72
CDM,27400515_IP,PLAYMAKER KNEE BRACE,324.0,210.6,135.06,135.06,1
CDM,27400515_OP,PLAYMAKER KNEE BRACE,324.0,210.6,110.94,110.94,1
CDM,27400525,PREFAB CANVAS KO IMMOBILIZER,155.0,100.75,31.69,155.0,72
CDM,27400525_IP,PREFAB CANVAS KO IMMOBILIZER,155.0,100.75,56.42,56.42,1
CDM,27400525_OP,PREFAB CANVAS KO IMMOBILIZER,155.0,100.75,46.35,46.35,1
CDM,27400565,KO SINGLE UPRIGHT CUSTOM FIT,263.0,170.95,57.33,1491.52,72
CDM,27400565_IP,KO SINGLE UPRIGHT CUSTOM FIT,263.0,170.95,95.73,95.73,1
CDM,27400565_OP,KO SINGLE UPRIGHT CUSTOM FIT,263.0,170.95,78.64,78.64,1
CDM,27400575,"KO DBL UPRIGHT ADJ, CUSTOM FAB",1377.25,895.21,300.24,1377.25,73
CDM,27400575_IP,"KO DBL UPRIGHT ADJ, CUSTOM FAB",1377.25,895.21,754.73,754.73,1
CDM,27400575_OP,"KO DBL UPRIGHT ADJ, CUSTOM FAB",1377.25,895.21,597.73,597.73,1
CDM,27400595,AFO ANKLE GAUNTLET,142.0,92.3,30.96,142.0,72
CDM,27400595_IP,AFO ANKLE GAUNTLET,142.0,92.3,51.69,51.69,1
CDM,27400595_OP,AFO ANKLE GAUNTLET,142.0,92.3,42.46,42.46,1
CDM,27400605,CUSTOM MOLDED ANKLE GAUNTLET,531.32,345.36,115.83,531.32,72
CDM,27400605_IP,CUSTOM MOLDED ANKLE GAUNTLET,531.32,345.36,193.4,193.4,1
CDM,27400605_OP,CUSTOM MOLDED ANKLE GAUNTLET,531.32,345.36,158.86,158.86,1
CDM,27400615,AFO AIR CAST,124.0,80.6,27.03,124.0,72
CDM,27400615_IP,AFO AIR CAST,124.0,80.6,45.14,45.14,1
CDM,27400615_OP,AFO AIR CAST,124.0,80.6,37.08,37.08,1
CDM,27400625,"AFO, SUPRAMALLEOLAR W/STRAPS",662.35,430.53,144.39,662.35,72
CDM,27400625_IP,"AFO, SUPRAMALLEOLAR W/STRAPS",662.35,430.53,241.1,241.1,1
CDM,27400625_OP,"AFO, SUPRAMALLEOLAR W/STRAPS",662.35,430.53,198.04,198.04,1
CDM,27400630,"W BTTRY BCKUP,PKT CTRL,HM 106128",600.0,390.0,130.8,1491.52,72
CDM,27400630_IP,"W BTTRY BCKUP,PKT CTRL,HM 106128",600.0,390.0,218.4,218.4,1
CDM,27400630_OP,"W BTTRY BCKUP,PKT CTRL,HM 106128",600.0,390.0,179.4,179.4,1
CDM,27400635,"AFO,RIGID,ANTERIOR,CRB, PREFAB",1050.4,682.76,228.99,1491.52,72
CDM,27400635_IP,"AFO,RIGID,ANTERIOR,CRB, PREFAB",1050.4,682.76,382.35,382.35,1
CDM,27400635_OP,"AFO,RIGID,ANTERIOR,CRB, PREFAB",1050.4,682.76,314.07,314.07,1
CDM,27400645,AFO CUSTOM MADE DFA,573.21,372.59,124.96,573.21,72
CDM,27400645_IP,AFO CUSTOM MADE DFA,573.21,372.59,208.65,208.65,1
CDM,27400645_OP,AFO CUSTOM MADE DFA,573.21,372.59,171.39,171.39,1
CDM,27400655,CUSTOM PLASTIC AFO,1321.27,858.83,288.04,1321.27,72
CDM,27400655_IP,CUSTOM PLASTIC AFO,1321.27,858.83,724.06,724.06,1
CDM,27400655_OP,CUSTOM PLASTIC AFO,1321.27,858.83,573.43,573.43,1
CDM,27400665,PREFAB SPIRAL AFO,988.56,642.56,215.51,1491.52,72
CDM,27400665_IP,PREFAB SPIRAL AFO,988.56,642.56,359.84,359.84,1
CDM,27400665_OP,PREFAB SPIRAL AFO,988.56,642.56,295.58,295.58,1
CDM,27400675,AFO PLASTIC/JOINTS,1045.0,679.25,227.81,1491.52,72
CDM,27400675_IP,AFO PLASTIC/JOINTS,1045.0,679.25,380.38,380.38,1
CDM,27400675_OP,AFO PLASTIC/JOINTS,1045.0,679.25,312.46,312.46,1
CDM,27400685,PREFAB AFO W ANKLE JNT,551.76,358.64,120.28,551.76,72
CDM,27400685_IP,PREFAB AFO W ANKLE JNT,551.76,358.64,200.84,200.84,1
CDM,27400685_OP,PREFAB AFO W ANKLE JNT,551.76,358.64,164.98,164.98,1
CDM,27400695,CUSTOM SGL BAR AFO,652.0,423.8,142.14,980.32,72
CDM,27400695_IP,CUSTOM SGL BAR AFO,652.0,423.8,237.33,237.33,1
CDM,27400695_OP,CUSTOM SGL BAR AFO,652.0,423.8,194.95,194.95,1
CDM,27400700,RATCHET LOCK KNEE EXTENSION,168.74,109.68,36.79,168.74,72
CDM,27400700_IP,RATCHET LOCK KNEE EXTENSION,168.74,109.68,61.42,61.42,1
CDM,27400700_OP,RATCHET LOCK KNEE EXTENSION,168.74,109.68,50.45,50.45,1
CDM,27400705,AFO METAL DBL UPRIGHT,655.0,425.75,142.79,655.0,72
CDM,27400705_IP,AFO METAL DBL UPRIGHT,655.0,425.75,238.42,238.42,1
CDM,27400705_OP,AFO METAL DBL UPRIGHT,655.0,425.75,195.85,195.85,1
CDM,27400710,THIGH WT. BEAR ISCHIAL,1351.56,878.51,294.64,1351.56,72
CDM,27400710_IP,THIGH WT. BEAR ISCHIAL,1351.56,878.51,740.65,740.65,1
CDM,27400710_OP,THIGH WT. BEAR ISCHIAL,1351.56,878.51,586.58,586.58,1
CDM,27400750,HEAVY DUTY HIP JT,2294.28,1491.28,91.28,2294.28,73
CDM,27400750_IP,HEAVY DUTY HIP JT,2294.28,1491.28,1257.27,1257.27,1
CDM,27400750_OP,HEAVY DUTY HIP JT,2294.28,1491.28,995.72,995.72,1
CDM,27400755,KAFO PLASTIC 2-JOINTS,2182.28,1418.48,475.74,2182.28,65
CDM,27400755_IP,KAFO PLASTIC 2-JOINTS,2182.28,1418.48,1195.89,1195.89,1
CDM,27400755_OP,KAFO PLASTIC 2-JOINTS,2182.28,1418.48,947.11,947.11,1
CDM,27400765,KAFO PLASTIC 1-JOINT,1952.0,1268.8,425.54,1952.0,73
CDM,27400765_IP,KAFO PLASTIC 1-JOINT,1952.0,1268.8,1069.7,1069.7,1
CDM,27400765_OP,KAFO PLASTIC 1-JOINT,1952.0,1268.8,847.17,847.17,1
CDM,27400780,NEOPRENE KNEE SUPPORT,153.79,99.96,33.53,153.79,72
CDM,27400780_IP,NEOPRENE KNEE SUPPORT,153.79,99.96,55.98,55.98,1
CDM,27400780_OP,NEOPRENE KNEE SUPPORT,153.79,99.96,45.98,45.98,1
CDM,27400790,GROWTH EXTENSION BARS,66.87,43.47,14.58,66.87,72
CDM,27400790_IP,GROWTH EXTENSION BARS,66.87,43.47,24.34,24.34,1
CDM,27400790_OP,GROWTH EXTENSION BARS,66.87,43.47,19.99,19.99,1
CDM,27400795,PREFAB SOFT CUSTOM FX ORTHOSIS,828.0,538.2,180.5,828.0,72
CDM,27400795_IP,PREFAB SOFT CUSTOM FX ORTHOSIS,828.0,538.2,301.39,301.39,1
CDM,27400795_OP,PREFAB SOFT CUSTOM FX ORTHOSIS,828.0,538.2,247.57,247.57,1
CDM,27400805,PREFAB AFO TIBIAL FX ORTHOSIS,1264.0,821.6,275.55,1491.52,72
CDM,27400805_IP,PREFAB AFO TIBIAL FX ORTHOSIS,1264.0,821.6,692.67,692.67,1
CDM,27400805_OP,PREFAB AFO TIBIAL FX ORTHOSIS,1264.0,821.6,548.58,548.58,1
CDM,27400810,NON-CORSVE FIN PER BAR,74.49,48.42,16.24,74.49,72
CDM,27400810_IP,NON-CORSVE FIN PER BAR,74.49,48.42,27.11,27.11,1
CDM,27400810_OP,NON-CORSVE FIN PER BAR,74.49,48.42,22.27,22.27,1
CDM,27400820,DROP LOCK RETAINER,35.33,22.96,7.7,42.28,72
CDM,27400820_IP,DROP LOCK RETAINER,35.33,22.96,12.86,12.86,1
CDM,27400820_OP,DROP LOCK RETAINER,35.33,22.96,10.56,10.56,1
CDM,27400825,PREFAB SEMI-RIGID KAFO FEM FX,1356.47,881.71,295.71,1356.47,72
CDM,27400825_IP,PREFAB SEMI-RIGID KAFO FEM FX,1356.47,881.71,743.35,743.35,1
CDM,27400825_OP,PREFAB SEMI-RIGID KAFO FEM FX,1356.47,881.71,588.71,588.71,1
CDM,27400830,KNEE CONTROL FULL KNEECAP,96.51,62.73,21.04,96.51,72
CDM,27400830_IP,KNEE CONTROL FULL KNEECAP,96.51,62.73,35.13,35.13,1
CDM,27400830_OP,KNEE CONTROL FULL KNEECAP,96.51,62.73,28.86,28.86,1
CDM,27400835,PLASTIC FOOTPLATE,156.05,101.43,34.02,156.05,72
CDM,27400835_IP,PLASTIC FOOTPLATE,156.05,101.43,56.8,56.8,1
CDM,27400835_OP,PLASTIC FOOTPLATE,156.05,101.43,46.66,46.66,1
CDM,27400840,VAR/VAL KNEE CAP,101.0,65.65,22.02,101.0,72
CDM,27400840_IP,VAR/VAL KNEE CAP,101.0,65.65,36.76,36.76,1
CDM,27400840_OP,VAR/VAL KNEE CAP,101.0,65.65,30.2,30.2,1
CDM,27400850,KNEE CONTROL CONDYLAR PAD,96.12,62.48,20.95,96.12,72
CDM,27400850_IP,KNEE CONTROL CONDYLAR PAD,96.12,62.48,34.99,34.99,1
CDM,27400850_OP,KNEE CONTROL CONDYLAR PAD,96.12,62.48,28.74,28.74,1
CDM,27400855,INTEGRITY FRX WALKER BRACE,115.0,74.75,25.07,115.0,72
CDM,27400855_IP,INTEGRITY FRX WALKER BRACE,115.0,74.75,41.86,41.86,1
CDM,27400855_OP,INTEGRITY FRX WALKER BRACE,115.0,74.75,34.39,34.39,1
CDM,27400860,SOCK TIBIAL FX,50.77,33.0,11.07,50.77,72
CDM,27400860_IP,SOCK TIBIAL FX,50.77,33.0,18.48,18.48,1
CDM,27400860_OP,SOCK TIBIAL FX,50.77,33.0,15.18,15.18,1
CDM,27400865,ADJ MOTION KNEE JNT ADDTN,181.31,117.85,39.53,181.31,72
CDM,27400865_IP,ADJ MOTION KNEE JNT ADDTN,181.31,117.85,66.0,66.0,1
CDM,27400865_OP,ADJ MOTION KNEE JNT ADDTN,181.31,117.85,54.21,54.21,1
CDM,27400895,P.F. DFA PLANTAR,73.94,48.06,16.12,73.94,72
CDM,27400895_IP,P.F. DFA PLANTAR,73.94,48.06,26.91,26.91,1
CDM,27400895_OP,P.F. DFA PLANTAR,73.94,48.06,22.11,22.11,1
CDM,27400905,DFA PF ASST/RST,95.25,61.91,20.76,95.25,72
CDM,27400905_IP,DFA PF ASST/RST,95.25,61.91,34.67,34.67,1
CDM,27400905_OP,DFA PF ASST/RST,95.25,61.91,28.48,28.48,1
CDM,27400915,SPLIT STIRRUP AND PLAT,112.61,73.2,24.55,112.61,72
CDM,27400915_IP,SPLIT STIRRUP AND PLAT,112.61,73.2,40.99,40.99,1
CDM,27400915_OP,SPLIT STIRRUP AND PLAT,112.61,73.2,33.67,33.67,1
CDM,27400945,REINFORCED SOLID STIRRUP,220.64,143.42,48.1,406.89,72
CDM,27400945_IP,REINFORCED SOLID STIRRUP,220.64,143.42,80.31,80.31,1
CDM,27400945_OP,REINFORCED SOLID STIRRUP,220.64,143.42,65.97,65.97,1
CDM,27400955,LONG TONGUE STIRRUP,158.21,102.84,34.49,158.21,72
CDM,27400955_IP,LONG TONGUE STIRRUP,158.21,102.84,57.59,57.59,1
CDM,27400955_OP,LONG TONGUE STIRRUP,158.21,102.84,47.3,47.3,1
CDM,27400965,VARUG/VALGUS PLASTIC CORRECT,153.44,99.74,33.45,153.44,72
CDM,27400965_IP,VARUG/VALGUS PLASTIC CORRECT,153.44,99.74,55.85,55.85,1
CDM,27400965_OP,VARUG/VALGUS PLASTIC CORRECT,153.44,99.74,45.88,45.88,1
CDM,27400970,SOCK FEMORAL FX,71.2,46.28,15.52,71.2,72
CDM,27400970_IP,SOCK FEMORAL FX,71.2,46.28,25.92,25.92,1
CDM,27400970_OP,SOCK FEMORAL FX,71.2,46.28,21.29,21.29,1
CDM,27400980,TORSION MECHANISM KNEE/ANKLE,160.0,104.0,34.88,980.32,72
CDM,27400980_IP,TORSION MECHANISM KNEE/ANKLE,160.0,104.0,58.24,58.24,1
CDM,27400980_OP,TORSION MECHANISM KNEE/ANKLE,160.0,104.0,47.84,47.84,1
CDM,27400985,NONMOLDED LACER CUST ORTHOSIS,432.17,280.91,94.21,980.32,72
CDM,27400985_IP,NONMOLDED LACER CUST ORTHOSIS,432.17,280.91,157.31,157.31,1
CDM,27400985_OP,NONMOLDED LACER CUST ORTHOSIS,432.17,280.91,129.22,129.22,1
CDM,27400990,MISC LOWER EXTREMITY ORTHOSIS,189.0,122.85,16.97,189.0,72
CDM,27400990_IP,MISC LOWER EXTREMITY ORTHOSIS,189.0,122.85,68.8,68.8,1
CDM,27400990_OP,MISC LOWER EXTREMITY ORTHOSIS,189.0,122.85,56.51,56.51,1
CDM,27400995,UCBL MOLDED,369.76,240.34,80.61,369.76,72
CDM,27400995_IP,UCBL MOLDED,369.76,240.34,134.59,134.59,1
CDM,27400995_OP,UCBL MOLDED,369.76,240.34,110.56,110.56,1
CDM,27400OH,TRANSFER TENDON/MUSCLE HAMSTRINGS FEMUR,3732.0,2425.8,1.1,20863.78,144
CDM,27401000,"FOOT INS SPENCO MODEL, EA",8.48,5.51,1.85,67.76,72
CDM,27401000_IP,"FOOT INS SPENCO MODEL, EA",8.48,5.51,3.09,3.09,1
CDM,27401000_OP,"FOOT INS SPENCO MODEL, EA",8.48,5.51,2.54,2.54,1
CDM,27401005,PLASTAZOTE INSERT MOLD(ORTHO F,190.1,123.57,41.44,190.1,72
CDM,27401005_IP,PLASTAZOTE INSERT MOLD(ORTHO F,190.1,123.57,69.2,69.2,1
CDM,27401005_OP,PLASTAZOTE INSERT MOLD(ORTHO F,190.1,123.57,56.84,56.84,1
CDM,27401015,MOLDED LONG ARCH ORTH,461.0,299.65,58.52,461.0,72
CDM,27401015_IP,MOLDED LONG ARCH ORTH,461.0,299.65,167.8,167.8,1
CDM,27401015_OP,MOLDED LONG ARCH ORTH,461.0,299.65,137.84,137.84,1
CDM,27401020,MOLDED LONG ARCH MET,120.0,78.0,26.16,406.89,72
CDM,27401020_IP,MOLDED LONG ARCH MET,120.0,78.0,43.68,43.68,1
CDM,27401020_OP,MOLDED LONG ARCH MET,120.0,78.0,35.88,35.88,1
CDM,27401025,SHOE INSERT GRAPHITE,83.04,53.98,18.1,83.04,72
CDM,27401025_IP,SHOE INSERT GRAPHITE,83.04,53.98,30.23,30.23,1
CDM,27401025_OP,SHOE INSERT GRAPHITE,83.04,53.98,24.83,24.83,1
CDM,27401030,"HI STRNGTH LTWT FT INSERT,EA",98.0,63.7,21.36,98.0,72
CDM,27401030_IP,"HI STRNGTH LTWT FT INSERT,EA",98.0,63.7,35.67,35.67,1
CDM,27401030_OP,"HI STRNGTH LTWT FT INSERT,EA",98.0,63.7,29.3,29.3,1
CDM,27401040,"PREMOLD LONGIT FOOT ARCH,EA",51.0,33.15,11.12,51.0,72
CDM,27401040_IP,"PREMOLD LONGIT FOOT ARCH,EA",51.0,33.15,18.56,18.56,1
CDM,27401040_OP,"PREMOLD LONGIT FOOT ARCH,EA",51.0,33.15,15.25,15.25,1
CDM,27401045,HALLUS VALGUS NT DYN SPLINT,53.0,34.45,11.55,53.0,72
CDM,27401045_IP,HALLUS VALGUS NT DYN SPLINT,53.0,34.45,19.29,19.29,1
CDM,27401045_OP,HALLUS VALGUS NT DYN SPLINT,53.0,34.45,15.85,15.85,1
CDM,27401050,DENNIS-BROWNE BAR RT,104.79,68.11,22.84,104.79,72
CDM,27401050_IP,DENNIS-BROWNE BAR RT,104.79,68.11,38.14,38.14,1
CDM,27401050_OP,DENNIS-BROWNE BAR RT,104.79,68.11,31.33,31.33,1
CDM,27401055,DENNIS-BROWNE BAR CP,95.82,62.28,20.89,95.82,72
CDM,27401055_IP,DENNIS-BROWNE BAR CP,95.82,62.28,34.88,34.88,1
CDM,27401055_OP,DENNIS-BROWNE BAR CP,95.82,62.28,28.65,28.65,1
CDM,27401060,FOOT PLASTIC HEEL STABILIZER,8.82,5.73,1.92,36.7,72
CDM,27401060_IP,FOOT PLASTIC HEEL STABILIZER,8.82,5.73,3.21,3.21,1
CDM,27401060_OP,FOOT PLASTIC HEEL STABILIZER,8.82,5.73,2.64,2.64,1
CDM,27401075,JR ORTH SHOE W SUPIN/PRONATOR,59.8,38.87,13.04,59.8,72
CDM,27401075_IP,JR ORTH SHOE W SUPIN/PRONATOR,59.8,38.87,21.77,21.77,1
CDM,27401075_OP,JR ORTH SHOE W SUPIN/PRONATOR,59.8,38.87,17.88,17.88,1
CDM,27401080,ORTH SHOE INFANT HIGHTOP EACH,46.0,29.9,10.03,46.0,72
CDM,27401080_IP,ORTH SHOE INFANT HIGHTOP EACH,46.0,29.9,16.74,16.74,1
CDM,27401080_OP,ORTH SHOE INFANT HIGHTOP EACH,46.0,29.9,13.75,13.75,1
CDM,27401100,"WOMENS DEPTH SHOE, EACH",82.0,53.3,17.88,82.0,72
CDM,27401100_IP,"WOMENS DEPTH SHOE, EACH",82.0,53.3,29.85,29.85,1
CDM,27401100_OP,"WOMENS DEPTH SHOE, EACH",82.0,53.3,24.52,24.52,1
CDM,27401115,"MENS DEPTH SHOE, EACH",85.0,55.25,18.53,85.0,72
CDM,27401115_IP,"MENS DEPTH SHOE, EACH",85.0,55.25,30.94,30.94,1
CDM,27401115_OP,"MENS DEPTH SHOE, EACH",85.0,55.25,25.42,25.42,1
CDM,27401120,"MENS HT DEPTH SHOES, EA",87.0,56.55,18.97,87.0,72
CDM,27401120_IP,"MENS HT DEPTH SHOES, EA",87.0,56.55,31.67,31.67,1
CDM,27401120_OP,"MENS HT DEPTH SHOES, EA",87.0,56.55,26.01,26.01,1
CDM,27401125,WOMEN'S OXFORD SHOE W BRACE,79.53,51.69,17.34,79.53,72
CDM,27401125_IP,WOMEN'S OXFORD SHOE W BRACE,79.53,51.69,28.95,28.95,1
CDM,27401125_OP,WOMEN'S OXFORD SHOE W BRACE,79.53,51.69,23.78,23.78,1
CDM,27401130,MENS SHOE-PART OF BRACE,86.88,56.47,18.94,86.88,72
CDM,27401130_IP,MENS SHOE-PART OF BRACE,86.88,56.47,31.62,31.62,1
CDM,27401130_OP,MENS SHOE-PART OF BRACE,86.88,56.47,25.98,25.98,1
CDM,27401135,CUSTOM DEPTH SHOES,365.0,237.25,31.69,365.0,72
CDM,27401135_IP,CUSTOM DEPTH SHOES,365.0,237.25,132.86,132.86,1
CDM,27401135_OP,CUSTOM DEPTH SHOES,365.0,237.25,109.14,109.14,1
CDM,27401155,SPLIT SIZE SHOES,91.0,59.15,19.84,91.0,72
CDM,27401155_IP,SPLIT SIZE SHOES,91.0,59.15,33.12,33.12,1
CDM,27401155_OP,SPLIT SIZE SHOES,91.0,59.15,27.21,27.21,1
CDM,27401160,CUSTOM FIT SANDAL,65.0,42.25,14.17,65.0,66
CDM,27401165,LIFT FULL FOOT/PER INCH,61.38,39.9,13.38,61.38,72
CDM,27401165_IP,LIFT FULL FOOT/PER INCH,61.38,39.9,22.34,22.34,1
CDM,27401165_OP,LIFT FULL FOOT/PER INCH,61.38,39.9,18.35,18.35,1
CDM,27401170,LIFT-NEOPRENE/PER INCH,95.82,62.28,20.89,95.82,72
CDM,27401170_IP,LIFT-NEOPRENE/PER INCH,95.82,62.28,34.88,34.88,1
CDM,27401170_OP,LIFT-NEOPRENE/PER INCH,95.82,62.28,28.65,28.65,1
CDM,27401175,ACCOMMODATIVE HEEL PAD,68.08,44.25,11.14,68.08,72
CDM,27401175_IP,ACCOMMODATIVE HEEL PAD,68.08,44.25,24.78,24.78,1
CDM,27401175_OP,ACCOMMODATIVE HEEL PAD,68.08,44.25,20.36,20.36,1
CDM,27401180,LIFT-INSIDE/1/2 INCH,85.0,55.25,18.53,85.0,72
CDM,27401180_IP,LIFT-INSIDE/1/2 INCH,85.0,55.25,30.94,30.94,1
CDM,27401180_OP,LIFT-INSIDE/1/2 INCH,85.0,55.25,25.42,25.42,1
CDM,27401185,"HEEL LIFT, PER INCH",18.0,11.7,3.92,42.28,72
CDM,27401185_IP,"HEEL LIFT, PER INCH",18.0,11.7,6.55,6.55,1
CDM,27401185_OP,"HEEL LIFT, PER INCH",18.0,11.7,5.38,5.38,1
CDM,27401195,HEEL WEDGE,40.0,26.0,8.72,40.0,72
CDM,27401195_IP,HEEL WEDGE,40.0,26.0,14.56,14.56,1
CDM,27401195_OP,HEEL WEDGE,40.0,26.0,11.96,11.96,1
CDM,27401200,"SOLE WEDGE, BETWEEN SOLE",58.0,37.7,12.64,58.0,72
CDM,27401200_IP,"SOLE WEDGE, BETWEEN SOLE",58.0,37.7,21.11,21.11,1
CDM,27401200_OP,"SOLE WEDGE, BETWEEN SOLE",58.0,37.7,17.34,17.34,1
CDM,27401210,OUTFLARE WEDGE,58.0,37.7,12.64,58.0,72
CDM,27401210_IP,OUTFLARE WEDGE,58.0,37.7,21.11,21.11,1
CDM,27401210_OP,OUTFLARE WEDGE,58.0,37.7,17.34,17.34,1
CDM,27401215,"METATARSAL BAR WEDGE, ROCKER",48.0,31.2,10.46,48.0,72
CDM,27401215_IP,"METATARSAL BAR WEDGE, ROCKER",48.0,31.2,17.47,17.47,1
CDM,27401215_OP,"METATARSAL BAR WEDGE, ROCKER",48.0,31.2,14.35,14.35,1
CDM,27401220,"HEEL, COUNTER, PLASTIC REINF",145.0,94.25,31.61,145.0,72
CDM,27401220_IP,"HEEL, COUNTER, PLASTIC REINF",145.0,94.25,52.78,52.78,1
CDM,27401220_OP,"HEEL, COUNTER, PLASTIC REINF",145.0,94.25,43.36,43.36,1
CDM,27401225,"HEEL, SACH CUSHION TYPE",125.0,81.25,27.25,125.0,72
CDM,27401225_IP,"HEEL, SACH CUSHION TYPE",125.0,81.25,45.5,45.5,1
CDM,27401225_OP,"HEEL, SACH CUSHION TYPE",125.0,81.25,37.38,37.38,1
CDM,27401230,SHOE INSERT,72.33,47.01,15.77,72.33,72
CDM,27401230_IP,SHOE INSERT,72.33,47.01,26.33,26.33,1
CDM,27401230_OP,SHOE INSERT,72.33,47.01,21.63,21.63,1
CDM,27401235,"HEEL, PAD AND DEPRESSION SPUR",51.0,33.15,11.12,51.0,72
CDM,27401235_IP,"HEEL, PAD AND DEPRESSION SPUR",51.0,33.15,18.56,18.56,1
CDM,27401235_OP,"HEEL, PAD AND DEPRESSION SPUR",51.0,33.15,15.25,15.25,1
CDM,27401240,HEEL PAD,55.0,35.75,11.99,55.0,72
CDM,27401240_IP,HEEL PAD,55.0,35.75,20.02,20.02,1
CDM,27401240_OP,HEEL PAD,55.0,35.75,16.45,16.45,1
CDM,27401245,FULL SOLE,60.0,39.0,13.08,60.0,72
CDM,27401245_IP,FULL SOLE,60.0,39.0,21.84,21.84,1
CDM,27401245_OP,FULL SOLE,60.0,39.0,17.94,17.94,1
CDM,27401265,TRANSFER NEW CALIPER PLATE,89.8,58.37,19.58,89.8,72
CDM,27401265_IP,TRANSFER NEW CALIPER PLATE,89.8,58.37,32.69,32.69,1
CDM,27401265_OP,TRANSFER NEW CALIPER PLATE,89.8,58.37,26.85,26.85,1
CDM,27401270,TRANS EXIST STIRRUP,143.0,92.95,31.17,143.0,72
CDM,27401270_IP,TRANS EXIST STIRRUP,143.0,92.95,52.05,52.05,1
CDM,27401270_OP,TRANS EXIST STIRRUP,143.0,92.95,42.76,42.76,1
CDM,27401275,TRANSFER NEW SOLID STIRRUP,118.27,76.88,25.78,118.27,72
CDM,27401275_IP,TRANSFER NEW SOLID STIRRUP,118.27,76.88,43.05,43.05,1
CDM,27401275_OP,TRANSFER NEW SOLID STIRRUP,118.27,76.88,35.36,35.36,1
CDM,27401280,SO-PREFAB FIG OF 8 RESTRAINER,18.0,11.7,3.92,36.7,72
CDM,27401280_IP,SO-PREFAB FIG OF 8 RESTRAINER,18.0,11.7,6.55,6.55,1
CDM,27401280_OP,SO-PREFAB FIG OF 8 RESTRAINER,18.0,11.7,5.38,5.38,1
CDM,27401285,SO FIG 8 RESTR CANV WEBBING,33.0,21.45,7.19,36.7,72
CDM,27401285_IP,SO FIG 8 RESTR CANV WEBBING,33.0,21.45,12.01,12.01,1
CDM,27401285_OP,SO FIG 8 RESTR CANV WEBBING,33.0,21.45,9.87,9.87,1
CDM,27401290,SO ACROMIOCLAVICULAR PREFAB,510.0,331.5,31.69,510.0,72
CDM,27401290_IP,SO ACROMIOCLAVICULAR PREFAB,510.0,331.5,185.64,185.64,1
CDM,27401290_OP,SO ACROMIOCLAVICULAR PREFAB,510.0,331.5,152.49,152.49,1
CDM,27401300,EO W/O JOINTS CF,375.0,243.75,81.75,406.89,72
CDM,27401300_IP,EO W/O JOINTS CF,375.0,243.75,136.5,136.5,1
CDM,27401300_OP,EO W/O JOINTS CF,375.0,243.75,112.13,112.13,1
CDM,27401315,EO PREFAB RIGID W/O JOINTS,77.4,50.31,16.87,77.4,72
CDM,27401315_IP,EO PREFAB RIGID W/O JOINTS,77.4,50.31,28.17,28.17,1
CDM,27401315_OP,EO PREFAB RIGID W/O JOINTS,77.4,50.31,23.14,23.14,1
CDM,27401320,EO CUSTOM W/WRIST,267.47,173.86,58.31,385.65,72
CDM,27401320_IP,EO CUSTOM W/WRIST,267.47,173.86,97.36,97.36,1
CDM,27401320_OP,EO CUSTOM W/WRIST,267.47,173.86,79.97,79.97,1
CDM,27401335,WHFO CUSTOM W/JOINTS,475.0,308.75,103.55,980.32,72
CDM,27401335_IP,WHFO CUSTOM W/JOINTS,475.0,308.75,172.9,172.9,1
CDM,27401335_OP,WHFO CUSTOM W/JOINTS,475.0,308.75,142.03,142.03,1
CDM,27401340,WHFO CUSTOM RIGID W/OUT JOINTS,363.42,236.22,79.23,363.42,72
CDM,27401340_IP,WHFO CUSTOM RIGID W/OUT JOINTS,363.42,236.22,132.28,132.28,1
CDM,27401340_OP,WHFO CUSTOM RIGID W/OUT JOINTS,363.42,236.22,108.66,108.66,1
CDM,27401350,WHFO - CSTM HINGE WRST/FNGR,300.0,195.0,65.4,775.49,72
CDM,27401350_IP,WHFO - CSTM HINGE WRST/FNGR,300.0,195.0,109.2,109.2,1
CDM,27401350_OP,WHFO - CSTM HINGE WRST/FNGR,300.0,195.0,89.7,89.7,1
CDM,27401355,WHO CUSTOM W/NONTORSION JOINTS,310.0,201.5,67.58,1491.52,72
CDM,27401355_IP,WHO CUSTOM W/NONTORSION JOINTS,310.0,201.5,112.84,112.84,1
CDM,27401355_OP,WHO CUSTOM W/NONTORSION JOINTS,310.0,201.5,92.69,92.69,1
CDM,27401360,WHO CUSTOM W/O JOINTS,443.0,287.95,96.57,980.32,72
CDM,27401360_IP,WHO CUSTOM W/O JOINTS,443.0,287.95,58.24,58.24,1
CDM,27401360_OP,WHO CUSTOM W/O JOINTS,443.0,287.95,47.84,47.84,1
CDM,27401365,WHFO PREFAB FLEXION GLOVE,88.0,57.2,16.97,88.0,72
CDM,27401365_IP,WHFO PREFAB FLEXION GLOVE,88.0,57.2,10.92,10.92,1
CDM,27401365_OP,WHFO PREFAB FLEXION GLOVE,88.0,57.2,8.97,8.97,1
CDM,27401370,HFO CUSTOM W/O JOINTS,200.0,130.0,43.6,406.89,72
CDM,27401370_IP,HFO CUSTOM W/O JOINTS,200.0,130.0,63.7,63.7,1
CDM,27401370_OP,HFO CUSTOM W/O JOINTS,200.0,130.0,52.33,52.33,1
CDM,27401375,PREFAB METACARPL FX ORTHOSIS,113.0,73.45,24.63,113.0,72
CDM,27401375_IP,PREFAB METACARPL FX ORTHOSIS,113.0,73.45,41.13,41.13,1
CDM,27401375_OP,PREFAB METACARPL FX ORTHOSIS,113.0,73.45,33.79,33.79,1
CDM,27401380,HO CUSTOM W/O FINGERS,150.0,97.5,32.7,406.89,72
CDM,27401380_IP,HO CUSTOM W/O FINGERS,150.0,97.5,54.6,54.6,1
CDM,27401380_OP,HO CUSTOM W/O FINGERS,150.0,97.5,44.85,44.85,1
CDM,27401385,HFO CUSTOM W/JOINTS,353.0,229.45,76.95,353.0,72
CDM,27401385_IP,HFO CUSTOM W/JOINTS,353.0,229.45,109.2,109.2,1
CDM,27401385_OP,HFO CUSTOM W/JOINTS,353.0,229.45,89.7,89.7,1
CDM,27401395,HFO PREFAB W/O JOINTS SOFT,51.0,33.15,11.12,51.0,72
CDM,27401395_IP,HFO PREFAB W/O JOINTS SOFT,51.0,33.15,10.92,10.92,1
CDM,27401395_OP,HFO PREFAB W/O JOINTS SOFT,51.0,33.15,8.97,8.97,1
CDM,27401400,FO PREFAB SPRING TENSION FINGER,81.0,52.65,17.66,81.0,72
CDM,27401400_IP,FO PREFAB SPRING TENSION FINGER,81.0,52.65,9.1,9.1,1
CDM,27401400_OP,FO PREFAB SPRING TENSION FINGER,81.0,52.65,7.48,7.48,1
CDM,27401405,FO PREFAB STATIC FINGER,43.0,27.95,9.37,43.0,72
CDM,27401405_IP,FO PREFAB STATIC FINGER,43.0,27.95,9.83,9.83,1
CDM,27401405_OP,FO PREFAB STATIC FINGER,43.0,27.95,8.07,8.07,1
CDM,27401410,HFO PREFAB HINGED W/ JOINTS,97.84,63.6,21.33,97.84,72
CDM,27401410_IP,HFO PREFAB HINGED W/ JOINTS,97.84,63.6,35.61,35.61,1
CDM,27401410_OP,HFO PREFAB HINGED W/ JOINTS,97.84,63.6,29.25,29.25,1
CDM,27401420,WHFO PREFAB W/ JOINTS,107.0,69.55,23.33,406.89,72
CDM,27401420_IP,WHFO PREFAB W/ JOINTS,107.0,69.55,38.95,38.95,1
CDM,27401420_OP,WHFO PREFAB W/ JOINTS,107.0,69.55,31.99,31.99,1
CDM,27401425,FO CUSTOM STATIC FINGER,25.0,16.25,5.45,406.89,72
CDM,27401425_IP,FO CUSTOM STATIC FINGER,25.0,16.25,9.1,9.1,1
CDM,27401425_OP,FO CUSTOM STATIC FINGER,25.0,16.25,7.48,7.48,1
CDM,27401430,"FO CUSTOM STATIC-PROGRESSIVE, DYNAMIC",200.0,130.0,43.6,406.89,72
CDM,27401430_IP,"FO CUSTOM STATIC-PROGRESSIVE, DYNAMIC",200.0,130.0,72.8,72.8,1
CDM,27401430_OP,"FO CUSTOM STATIC-PROGRESSIVE, DYNAMIC",200.0,130.0,59.8,59.8,1
CDM,27401435,QUADRANT SHOULDER BRACE,993.0,645.45,216.47,1491.52,72
CDM,27401435_IP,QUADRANT SHOULDER BRACE,993.0,645.45,361.45,361.45,1
CDM,27401435_OP,QUADRANT SHOULDER BRACE,993.0,645.45,296.91,296.91,1
CDM,27401445,PREFAB SPLNT SHRT ARM FX,240.0,156.0,52.32,980.32,72
CDM,27401445_IP,PREFAB SPLNT SHRT ARM FX,240.0,156.0,87.36,87.36,1
CDM,27401445_OP,PREFAB SPLNT SHRT ARM FX,240.0,156.0,71.76,71.76,1
CDM,27401450,CARPAL FX PREFAB (OT),147.0,95.55,32.05,147.0,72
CDM,27401450_IP,CARPAL FX PREFAB (OT),147.0,95.55,53.51,53.51,1
CDM,27401450_OP,CARPAL FX PREFAB (OT),147.0,95.55,43.95,43.95,1
CDM,27401455,UNLISTED PROC UE ORTHOSIS,74.0,48.1,16.13,74.0,72
CDM,27401455_IP,UNLISTED PROC UE ORTHOSIS,74.0,48.1,26.82,26.82,1
CDM,27401455_OP,UNLISTED PROC UE ORTHOSIS,74.0,48.1,22.03,22.03,1
CDM,27401465,"REPLACE STRAP, ANY ORTHOSIS",25.0,16.25,5.45,36.7,72
CDM,27401465_IP,"REPLACE STRAP, ANY ORTHOSIS",25.0,16.25,9.1,9.1,1
CDM,27401465_OP,"REPLACE STRAP, ANY ORTHOSIS",25.0,16.25,7.48,7.48,1
CDM,27401475,"REPAIR ORTHO LABOR, PER 15 MIN",27.5,17.88,6.0,27.5,72
CDM,27401475_IP,"REPAIR ORTHO LABOR, PER 15 MIN",27.5,17.88,10.01,10.01,1
CDM,27401475_OP,"REPAIR ORTHO LABOR, PER 15 MIN",27.5,17.88,8.22,8.22,1
CDM,27401485,ORTH DEV REPAIR/REPL MINOR P,100.0,65.0,16.97,100.0,72
CDM,27401485_IP,ORTH DEV REPAIR/REPL MINOR P,100.0,65.0,36.4,36.4,1
CDM,27401485_OP,ORTH DEV REPAIR/REPL MINOR P,100.0,65.0,29.9,29.9,1
CDM,27401495,PREFAB ANKLE AIRCAST,97.0,63.05,21.15,97.0,72
CDM,27401495_IP,PREFAB ANKLE AIRCAST,97.0,63.05,35.31,35.31,1
CDM,27401495_OP,PREFAB ANKLE AIRCAST,97.0,63.05,29.0,29.0,1
CDM,27401500,NON-PNEUMATIC WALKING SPLINT,193.0,125.45,42.07,193.0,72
CDM,27401500_IP,NON-PNEUMATIC WALKING SPLINT,193.0,125.45,70.25,70.25,1
CDM,27401500_OP,NON-PNEUMATIC WALKING SPLINT,193.0,125.45,57.71,57.71,1
CDM,27401505,"FOOT DROP SPLINT,RECUMBENT PST",102.0,66.3,22.24,102.0,72
CDM,27401505_IP,"FOOT DROP SPLINT,RECUMBENT PST",102.0,66.3,37.13,37.13,1
CDM,27401505_OP,"FOOT DROP SPLINT,RECUMBENT PST",102.0,66.3,30.5,30.5,1
CDM,27401510,STANDARD CROW,1898.83,1234.24,413.94,1898.83,73
CDM,27401510_IP,STANDARD CROW,1898.83,1234.24,1040.56,1040.56,1
CDM,27401510_OP,STANDARD CROW,1898.83,1234.24,824.09,824.09,1
CDM,27401515,"PARTIAL FOOT,TOE FILLER",676.0,439.4,147.37,676.0,72
CDM,27401515_IP,"PARTIAL FOOT,TOE FILLER",676.0,439.4,246.06,246.06,1
CDM,27401515_OP,"PARTIAL FOOT,TOE FILLER",676.0,439.4,202.12,202.12,1
CDM,27401530,"SYMES ANKLE SOCKET,SACH FOOT",3231.64,2100.57,704.5,3231.64,65
CDM,27401530_IP,"SYMES ANKLE SOCKET,SACH FOOT",3231.64,2100.57,1770.94,1770.94,1
CDM,27401530_OP,"SYMES ANKLE SOCKET,SACH FOOT",3231.64,2100.57,1402.53,1402.53,1
CDM,27401600,BK MOLD SOCKET SACH FT ENDO,3159.81,2053.88,688.84,3159.81,65
CDM,27401600_IP,BK MOLD SOCKET SACH FT ENDO,3159.81,2053.88,1731.58,1731.58,1
CDM,27401600_OP,BK MOLD SOCKET SACH FT ENDO,3159.81,2053.88,1371.36,1371.36,1
CDM,27401605,AK ENDO SACH,4213.48,2738.76,918.54,4213.48,65
CDM,27401605_IP,AK ENDO SACH,4213.48,2738.76,2308.99,2308.99,1
CDM,27401605_OP,AK ENDO SACH,4213.48,2738.76,1828.65,1828.65,1
CDM,27401630,"RIGID DRESSING,BK",557.79,362.56,121.6,980.32,72
CDM,27401630_IP,"RIGID DRESSING,BK",557.79,362.56,203.04,203.04,1
CDM,27401630_OP,"RIGID DRESSING,BK",557.79,362.56,166.78,166.78,1
CDM,27401650,"PREP BK,LAMINATED SOCKET",2416.36,1570.63,526.77,2416.36,65
CDM,27401650_IP,"PREP BK,LAMINATED SOCKET",2416.36,1570.63,1324.17,1324.17,1
CDM,27401650_OP,"PREP BK,LAMINATED SOCKET",2416.36,1570.63,1048.7,1048.7,1
CDM,27401660,4-BAR LINK ABOVE KNEE W/SWING,1990.18,1293.62,433.86,1990.18,73
CDM,27401660_IP,4-BAR LINK ABOVE KNEE W/SWING,1990.18,1293.62,1090.62,1090.62,1
CDM,27401660_OP,4-BAR LINK ABOVE KNEE W/SWING,1990.18,1293.62,863.74,863.74,1
CDM,27401670,TEST SOCKET SYMES,394.06,256.14,85.91,394.06,72
CDM,27401670_IP,TEST SOCKET SYMES,394.06,256.14,143.44,143.44,1
CDM,27401670_OP,TEST SOCKET SYMES,394.06,256.14,117.82,117.82,1
CDM,27401675,"AD'LX,TEST SOCKET,BK",482.0,313.3,91.28,482.0,72
CDM,27401675_IP,"AD'LX,TEST SOCKET,BK",482.0,313.3,175.45,175.45,1
CDM,27401675_OP,"AD'LX,TEST SOCKET,BK",482.0,313.3,144.12,144.12,1
CDM,27401680,AK TEST SOCKET,470.87,306.07,102.65,980.32,72
CDM,27401680_IP,AK TEST SOCKET,470.87,306.07,171.4,171.4,1
CDM,27401680_OP,AK TEST SOCKET,470.87,306.07,140.79,140.79,1
CDM,27401690,"AD'LX,BK ACRYLIC SOCKET",372.65,242.22,81.24,372.65,72
CDM,27401690_IP,"AD'LX,BK ACRYLIC SOCKET",372.65,242.22,135.64,135.64,1
CDM,27401690_OP,"AD'LX,BK ACRYLIC SOCKET",372.65,242.22,111.42,111.42,1
CDM,27401695,"AD'LX AK/KD,ACRYLIC",515.2,334.88,112.31,515.2,72
CDM,27401695_IP,"AD'LX AK/KD,ACRYLIC",515.2,334.88,187.53,187.53,1
CDM,27401695_OP,"AD'LX AK/KD,ACRYLIC",515.2,334.88,154.04,154.04,1
CDM,27401715,"AD'LX,BK TOTAL CONTACT",451.66,293.58,91.28,451.66,72
CDM,27401715_IP,"AD'LX,BK TOTAL CONTACT",451.66,293.58,164.4,164.4,1
CDM,27401715_OP,"AD'LX,BK TOTAL CONTACT",451.66,293.58,135.05,135.05,1
CDM,27401735,BK SUCTION SOCKET,932.74,606.28,203.34,1491.52,72
CDM,27401735_IP,BK SUCTION SOCKET,932.74,606.28,339.52,339.52,1
CDM,27401735_OP,BK SUCTION SOCKET,932.74,606.28,278.89,278.89,1
CDM,27401745,"AD'LX,AK TOTAL CONTACT",572.43,372.08,124.79,572.43,72
CDM,27401745_IP,"AD'LX,AK TOTAL CONTACT",572.43,372.08,208.36,208.36,1
CDM,27401745_OP,"AD'LX,AK TOTAL CONTACT",572.43,372.08,171.16,171.16,1
CDM,27401750,"AD'LX,AK FLEX SOCKET",1848.0,1201.2,402.86,1848.0,73
CDM,27401750_IP,"AD'LX,AK FLEX SOCKET",1848.0,1201.2,1012.7,1012.7,1
CDM,27401750_OP,"AD'LX,AK FLEX SOCKET",1848.0,1201.2,802.03,802.03,1
CDM,27401755,SUCTION SUSP AK/KNEE DISART,607.0,394.55,132.33,607.0,72
CDM,27401755_IP,SUCTION SUSP AK/KNEE DISART,607.0,394.55,220.95,220.95,1
CDM,27401755_OP,SUCTION SUSP AK/KNEE DISART,607.0,394.55,181.49,181.49,1
CDM,27401765,"AD'LX,BK SOFT INSERT",333.87,217.02,72.78,333.87,72
CDM,27401765_IP,"AD'LX,BK SOFT INSERT",333.87,217.02,121.53,121.53,1
CDM,27401765_OP,"AD'LX,BK SOFT INSERT",333.87,217.02,99.83,99.83,1
CDM,27401785,BELOW KNEE CUFF SUSPENSION,90.41,58.77,19.71,90.41,72
CDM,27401785_IP,BELOW KNEE CUFF SUSPENSION,90.41,58.77,32.91,32.91,1
CDM,27401785_OP,BELOW KNEE CUFF SUSPENSION,90.41,58.77,27.03,27.03,1
CDM,27401790,"AD'LX,BK SUPRACOND SUSP",386.0,250.9,84.15,386.0,72
CDM,27401790_IP,"AD'LX,BK SUPRACOND SUSP",386.0,250.9,140.5,140.5,1
CDM,27401790_OP,"AD'LX,BK SUPRACOND SUSP",386.0,250.9,115.41,115.41,1
CDM,27401795,"ADDT LOWER EXTREM,W/LOCK MECH",583.26,379.12,127.15,583.26,72
CDM,27401795_IP,"ADDT LOWER EXTREM,W/LOCK MECH",583.26,379.12,212.31,212.31,1
CDM,27401795_OP,"ADDT LOWER EXTREM,W/LOCK MECH",583.26,379.12,174.39,174.39,1
CDM,27401800,"ADTN TO LE, GEL SOCKET/W/LOCK",926.94,602.51,202.07,1491.52,72
CDM,27401800_IP,"ADTN TO LE, GEL SOCKET/W/LOCK",926.94,602.51,337.41,337.41,1
CDM,27401800_OP,"ADTN TO LE, GEL SOCKET/W/LOCK",926.94,602.51,277.16,277.16,1
CDM,27401810,"ADTN TO LE, GEL SOCK NOT LOCKI",772.46,502.1,168.4,772.46,72
CDM,27401810_IP,"ADTN TO LE, GEL SOCK NOT LOCKI",772.46,502.1,281.18,281.18,1
CDM,27401810_OP,"ADTN TO LE, GEL SOCK NOT LOCKI",772.46,502.1,230.97,230.97,1
CDM,27401815,"ADTN TO LE, FAB CONG TRAUMATIC",1551.38,1008.4,338.2,1551.38,73
CDM,27401815_IP,"ADTN TO LE, FAB CONG TRAUMATIC",1551.38,1008.4,850.16,850.16,1
CDM,27401815_OP,"ADTN TO LE, FAB CONG TRAUMATIC",1551.38,1008.4,673.3,673.3,1
CDM,27401835,BK HEAVY DUTY SUSP SLEEV,260.8,169.52,56.85,260.8,72
CDM,27401835_IP,BK HEAVY DUTY SUSP SLEEV,260.8,169.52,94.93,94.93,1
CDM,27401835_OP,BK HEAVY DUTY SUSP SLEEV,260.8,169.52,77.98,77.98,1
CDM,27401845,"AD'LX, BK, WEB WAIST BELT",72.09,46.86,15.72,72.09,72
CDM,27401845_IP,"AD'LX, BK, WEB WAIST BELT",72.09,46.86,26.24,26.24,1
CDM,27401845_OP,"AD'LX, BK, WEB WAIST BELT",72.09,46.86,21.55,21.55,1
CDM,27401875,REPLACEMENT SOCKET BELOW KNEE,3617.61,2351.45,788.64,3617.61,65
CDM,27401875_IP,REPLACEMENT SOCKET BELOW KNEE,3617.61,2351.45,1982.45,1982.45,1
CDM,27401875_OP,REPLACEMENT SOCKET BELOW KNEE,3617.61,2351.45,1570.04,1570.04,1
CDM,27401880,REPLACE SOCKET ABOVE KNEE,4488.0,2917.2,978.38,4488.0,65
CDM,27401880_IP,REPLACE SOCKET ABOVE KNEE,4488.0,2917.2,2459.42,2459.42,1
CDM,27401880_OP,REPLACE SOCKET ABOVE KNEE,4488.0,2917.2,1947.79,1947.79,1
CDM,27401900,CUSTOM BK COVER,737.62,479.45,160.8,737.62,72
CDM,27401900_IP,CUSTOM BK COVER,737.62,479.45,268.49,268.49,1
CDM,27401900_OP,CUSTOM BK COVER,737.62,479.45,220.55,220.55,1
CDM,27401905,AK CUSTOM COVER,1352.31,879.0,294.8,1352.31,72
CDM,27401905_IP,AK CUSTOM COVER,1352.31,879.0,741.07,741.07,1
CDM,27401905_OP,AK CUSTOM COVER,1352.31,879.0,586.9,586.9,1
CDM,27401935,LOWER LIMB PROS VACUUM PUMP,4719.0,3067.35,1028.74,4719.0,65
CDM,27401935_IP,LOWER LIMB PROS VACUUM PUMP,4719.0,3067.35,2586.01,2586.01,1
CDM,27401935_OP,LOWER LIMB PROS VACUUM PUMP,4719.0,3067.35,2048.05,2048.05,1
CDM,27401950,"AD'ENDO,SAFETY KNEE",696.61,452.8,151.86,696.61,72
CDM,27401950_IP,"AD'ENDO,SAFETY KNEE",696.61,452.8,253.57,253.57,1
CDM,27401950_OP,"AD'ENDO,SAFETY KNEE",696.61,452.8,208.29,208.29,1
CDM,27401970,ENDO KNEE-SHIN FLUID SWG/STA,3475.36,2258.98,757.63,3475.36,65
CDM,27401970_IP,ENDO KNEE-SHIN FLUID SWG/STA,3475.36,2258.98,1904.5,1904.5,1
CDM,27401970_OP,ENDO KNEE-SHIN FLUID SWG/STA,3475.36,2258.98,1508.31,1508.31,1
CDM,27401975,"ADD,ENDOSKELETAL KNEE-SHIN SYS",2113.92,1374.05,460.83,2113.92,73
CDM,27401975_IP,"ADD,ENDOSKELETAL KNEE-SHIN SYS",2113.92,1374.05,1158.43,1158.43,1
CDM,27401975_OP,"ADD,ENDOSKELETAL KNEE-SHIN SYS",2113.92,1374.05,917.44,917.44,1
CDM,27401980,ADD KNEE HYD STANCE EXT,1268.25,824.36,276.48,1268.25,72
CDM,27401980_IP,ADD KNEE HYD STANCE EXT,1268.25,824.36,695.0,695.0,1
CDM,27401980_OP,ADD KNEE HYD STANCE EXT,1268.25,824.36,550.42,550.42,1
CDM,27401985,"AD'ENDO,KNEE EXT ASST",150.0,97.5,32.7,150.0,72
CDM,27401985_IP,"AD'ENDO,KNEE EXT ASST",150.0,97.5,54.6,54.6,1
CDM,27401985_OP,"AD'ENDO,KNEE EXT ASST",150.0,97.5,44.85,44.85,1
CDM,27401995,"ADD, LE, ENDO, SWING STANCE",28312.43,18403.08,1030.0,28312.43,73
CDM,27401995_IP,"ADD, LE, ENDO, SWING STANCE",28312.43,18403.08,15515.21,15515.21,1
CDM,27401995_OP,"ADD, LE, ENDO, SWING STANCE",28312.43,18403.08,12287.59,12287.59,1
CDM,27402000,"AD'ENDO,BK ALIGN SYS",424.68,276.04,92.58,980.32,72
CDM,27402000_IP,"AD'ENDO,BK ALIGN SYS",424.68,276.04,154.58,154.58,1
CDM,27402000_OP,"AD'ENDO,BK ALIGN SYS",424.68,276.04,126.98,126.98,1
CDM,27402005,"AD'ENDO,AK/HD ALIGN SYS",622.15,404.4,135.63,622.15,72
CDM,27402005_IP,"AD'ENDO,AK/HD ALIGN SYS",622.15,404.4,226.46,226.46,1
CDM,27402005_OP,"AD'ENDO,AK/HD ALIGN SYS",622.15,404.4,186.02,186.02,1
CDM,27402015,ABOVE KNEE MANUAL LOCK,400.0,260.0,87.2,980.32,72
CDM,27402015_IP,ABOVE KNEE MANUAL LOCK,400.0,260.0,145.6,145.6,1
CDM,27402015_OP,ABOVE KNEE MANUAL LOCK,400.0,260.0,119.6,119.6,1
CDM,27402020,"AD'ENDO,BK ULTRA LIGHT",747.0,485.55,162.85,747.0,72
CDM,27402020_IP,"AD'ENDO,BK ULTRA LIGHT",747.0,485.55,271.91,271.91,1
CDM,27402020_OP,"AD'ENDO,BK ULTRA LIGHT",747.0,485.55,223.35,223.35,1
CDM,27402025,"AD'ENDO,AK ULTRA LIGHT",1087.0,706.55,236.97,1491.52,72
CDM,27402025_IP,"AD'ENDO,AK ULTRA LIGHT",1087.0,706.55,395.67,395.67,1
CDM,27402025_OP,"AD'ENDO,AK ULTRA LIGHT",1087.0,706.55,325.01,325.01,1
CDM,27402035,PROSTHETIC SKIN,689.23,448.0,150.25,689.23,72
CDM,27402035_IP,PROSTHETIC SKIN,689.23,448.0,250.88,250.88,1
CDM,27402035_OP,PROSTHETIC SKIN,689.23,448.0,206.08,206.08,1
CDM,27402045,FLEXIBLE KEEL FOOT,466.66,303.33,101.73,980.32,72
CDM,27402045_IP,FLEXIBLE KEEL FOOT,466.66,303.33,169.86,169.86,1
CDM,27402045_OP,FLEXIBLE KEEL FOOT,466.66,303.33,139.53,139.53,1
CDM,27402055,"LX,ENERGY STORE FOOT",693.15,450.55,151.11,693.15,72
CDM,27402055_IP,"LX,ENERGY STORE FOOT",693.15,450.55,252.31,252.31,1
CDM,27402055_OP,"LX,ENERGY STORE FOOT",693.15,450.55,207.25,207.25,1
CDM,27402060,"LX,MULTI-AXIS FOOT",366.0,237.9,79.79,366.0,72
CDM,27402060_IP,"LX,MULTI-AXIS FOOT",366.0,237.9,133.22,133.22,1
CDM,27402060_OP,"LX,MULTI-AXIS FOOT",366.0,237.9,109.43,109.43,1
CDM,27402065,MULTI-AXIAL ANKLE/FT PROSTH,2940.55,1911.36,641.04,2940.55,65
CDM,27402065_IP,MULTI-AXIAL ANKLE/FT PROSTH,2940.55,1911.36,1611.42,1611.42,1
CDM,27402065_OP,MULTI-AXIAL ANKLE/FT PROSTH,2940.55,1911.36,1276.2,1276.2,1
CDM,27402070,FLEX-WALK SYS LOW EXT PROSTH,4024.33,2615.81,877.3,4024.33,65
CDM,27402070_IP,FLEX-WALK SYS LOW EXT PROSTH,4024.33,2615.81,2205.33,2205.33,1
CDM,27402070_OP,FLEX-WALK SYS LOW EXT PROSTH,4024.33,2615.81,1746.56,1746.56,1
CDM,27402075,ENDOSKELETAL AXIAL ROTATION,758.34,492.92,165.32,758.34,72
CDM,27402075_IP,ENDOSKELETAL AXIAL ROTATION,758.34,492.92,276.04,276.04,1
CDM,27402075_OP,ENDOSKELETAL AXIAL ROTATION,758.34,492.92,226.74,226.74,1
CDM,27402080,MULTI-AXIAL ROTATION UNIT,914.76,594.59,199.42,1491.52,72
CDM,27402080_IP,MULTI-AXIAL ROTATION UNIT,914.76,594.59,332.97,332.97,1
CDM,27402080_OP,MULTI-AXIAL ROTATION UNIT,914.76,594.59,273.51,273.51,1
CDM,27402105,ELB MOLD SOCK FLEX HINGE PAD,2966.76,1928.39,646.75,2966.76,65
CDM,27402105_IP,ELB MOLD SOCK FLEX HINGE PAD,2966.76,1928.39,1625.78,1625.78,1
CDM,27402105_OP,ELB MOLD SOCK FLEX HINGE PAD,2966.76,1928.39,1287.57,1287.57,1
CDM,27402120,DISCONNECT LOCKING WRIST UNI,252.67,164.24,55.08,406.89,72
CDM,27402120_IP,DISCONNECT LOCKING WRIST UNI,252.67,164.24,91.97,91.97,1
CDM,27402120_OP,DISCONNECT LOCKING WRIST UNI,252.67,164.24,75.55,75.55,1
CDM,27402125,LAMINATION COLLAR W/ COUPLIN,218.0,141.7,47.52,218.0,72
CDM,27402125_IP,LAMINATION COLLAR W/ COUPLIN,218.0,141.7,79.35,79.35,1
CDM,27402125_OP,LAMINATION COLLAR W/ COUPLIN,218.0,141.7,65.18,65.18,1
CDM,27402140,HEAVY DUTY CONTROL CABLE,120.9,78.59,26.36,120.9,72
CDM,27402140_IP,HEAVY DUTY CONTROL CABLE,120.9,78.59,44.01,44.01,1
CDM,27402140_OP,HEAVY DUTY CONTROL CABLE,120.9,78.59,36.15,36.15,1
CDM,27402145,HARNESS FIGURE OF 8 SING CON,140.82,91.53,30.7,140.82,72
CDM,27402145_IP,HARNESS FIGURE OF 8 SING CON,140.82,91.53,51.26,51.26,1
CDM,27402145_OP,HARNESS FIGURE OF 8 SING CON,140.82,91.53,42.11,42.11,1
CDM,27402150,TEST SOCK WRIST DISART/BEL E,362.74,235.78,79.08,406.89,72
CDM,27402150_IP,TEST SOCK WRIST DISART/BEL E,362.74,235.78,132.04,132.04,1
CDM,27402150_OP,TEST SOCK WRIST DISART/BEL E,362.74,235.78,108.46,108.46,1
CDM,27402175,FR TYP SOCKET BE/W,655.0,425.75,142.79,655.0,72
CDM,27402175_IP,FR TYP SOCKET BE/W,655.0,425.75,238.42,238.42,1
CDM,27402175_OP,FR TYP SOCKET BE/W,655.0,425.75,195.85,195.85,1
CDM,27402200,TERM DEV MECH HOOK VOL OPEN,494.16,321.2,107.73,980.32,72
CDM,27402200_IP,TERM DEV MECH HOOK VOL OPEN,494.16,321.2,179.87,179.87,1
CDM,27402200_OP,TERM DEV MECH HOOK VOL OPEN,494.16,321.2,147.75,147.75,1
CDM,27402205,TERM DEV MECH HOOK VOL CLOSE,1748.01,1136.21,381.07,1748.01,73
CDM,27402205_IP,TERM DEV MECH HOOK VOL CLOSE,1748.01,1136.21,957.91,957.91,1
CDM,27402205_OP,TERM DEV MECH HOOK VOL CLOSE,1748.01,1136.21,758.64,758.64,1
CDM,27402210,TERM DEV MECH HAND VOL CLOSE,1706.96,1109.52,372.12,1706.96,73
CDM,27402210_IP,TERM DEV MECH HAND VOL CLOSE,1706.96,1109.52,935.41,935.41,1
CDM,27402210_OP,TERM DEV MECH HAND VOL CLOSE,1706.96,1109.52,740.82,740.82,1
CDM,27402215,ELEC HAND IND ART DIGITS,94588.71,61482.66,1030.0,94588.71,73
CDM,27402215_IP,ELEC HAND IND ART DIGITS,94588.71,61482.66,51834.61,51834.61,1
CDM,27402215_OP,ELEC HAND IND ART DIGITS,94588.71,61482.66,41051.5,41051.5,1
CDM,27402220,MICROPROCESSOR CONTROL UPLMB,3512.0,2282.8,765.62,3512.0,65
CDM,27402220_IP,MICROPROCESSOR CONTROL UPLMB,3512.0,2282.8,1924.58,1924.58,1
CDM,27402220_OP,MICROPROCESSOR CONTROL UPLMB,3512.0,2282.8,1524.21,1524.21,1
CDM,27402225,PRODUCTION GLOVE,235.56,153.11,51.35,406.89,72
CDM,27402225_IP,PRODUCTION GLOVE,235.56,153.11,85.74,85.74,1
CDM,27402225_OP,PRODUCTION GLOVE,235.56,153.11,70.43,70.43,1
CDM,27402235,BELOW ELBOW MYOELECTRONIC CT,11759.0,7643.35,1030.0,11759.0,65
CDM,27402235_IP,BELOW ELBOW MYOELECTRONIC CT,11759.0,7643.35,6443.93,6443.93,1
CDM,27402235_OP,BELOW ELBOW MYOELECTRONIC CT,11759.0,7643.35,5103.41,5103.41,1
CDM,27402240,ADULT ELECTRIC HAND,4307.75,2800.04,939.09,4307.75,65
CDM,27402240_IP,ADULT ELECTRIC HAND,4307.75,2800.04,2360.65,2360.65,1
CDM,27402240_OP,ADULT ELECTRIC HAND,4307.75,2800.04,1869.56,1869.56,1
CDM,27402250,"ADD UE PROST BE/WD, ULTLITE",361.47,234.96,78.8,361.47,72
CDM,27402250_IP,"ADD UE PROST BE/WD, ULTLITE",361.47,234.96,131.58,131.58,1
CDM,27402250_OP,"ADD UE PROST BE/WD, ULTLITE",361.47,234.96,108.08,108.08,1
CDM,27402260,ADD UE PROST B/E ACRYLIC,434.33,282.31,91.28,434.33,72
CDM,27402260_IP,ADD UE PROST B/E ACRYLIC,434.33,282.31,158.1,158.1,1
CDM,27402260_OP,ADD UE PROST B/E ACRYLIC,434.33,282.31,129.86,129.86,1
CDM,27402275,PROSTH DEVICE REPL/REPAIR,110.0,71.5,16.97,110.0,72
CDM,27402275_IP,PROSTH DEVICE REPL/REPAIR,110.0,71.5,40.04,40.04,1
CDM,27402275_OP,PROSTH DEVICE REPL/REPAIR,110.0,71.5,32.89,32.89,1
CDM,27402280,REPAIR PROSTH LABOR-15 MIN,27.5,17.88,6.0,27.5,72
CDM,27402280_IP,REPAIR PROSTH LABOR-15 MIN,27.5,17.88,10.01,10.01,1
CDM,27402280_OP,REPAIR PROSTH LABOR-15 MIN,27.5,17.88,8.22,8.22,1
CDM,27402290,VACUUM ERECTION SYSTEM MANUAL,566.0,367.9,123.39,566.0,72
CDM,27402290_IP,VACUUM ERECTION SYSTEM MANUAL,566.0,367.9,206.02,206.02,1
CDM,27402290_OP,VACUUM ERECTION SYSTEM MANUAL,566.0,367.9,169.23,169.23,1
CDM,27402305,SHEATH BK,18.46,12.0,4.02,18.46,72
CDM,27402305_IP,SHEATH BK,18.46,12.0,6.72,6.72,1
CDM,27402305_OP,SHEATH BK,18.46,12.0,5.52,5.52,1
CDM,27402315,"PROSTH SHEATH/SOCK,INCL GEL",88.0,57.2,11.14,88.0,72
CDM,27402315_IP,"PROSTH SHEATH/SOCK,INCL GEL",88.0,57.2,32.03,32.03,1
CDM,27402315_OP,"PROSTH SHEATH/SOCK,INCL GEL",88.0,57.2,26.31,26.31,1
CDM,27402320,WOOL SOCK BK,25.0,16.25,5.45,25.0,72
CDM,27402320_IP,WOOL SOCK BK,25.0,16.25,9.1,9.1,1
CDM,27402320_OP,WOOL SOCK BK,25.0,16.25,7.48,7.48,1
CDM,27402325,WOOL SOCK AK,26.47,17.21,5.77,42.28,72
CDM,27402325_IP,WOOL SOCK AK,26.47,17.21,9.64,9.64,1
CDM,27402325_OP,WOOL SOCK AK,26.47,17.21,7.91,7.91,1
CDM,27402330,SOCK WOOL UPPER LIMB,26.47,17.21,5.77,26.47,72
CDM,27402330_IP,SOCK WOOL UPPER LIMB,26.47,17.21,9.64,9.64,1
CDM,27402330_OP,SOCK WOOL UPPER LIMB,26.47,17.21,7.91,7.91,1
CDM,27402340,SHRINKER AK,78.16,50.8,17.04,78.16,72
CDM,27402340_IP,SHRINKER AK,78.16,50.8,28.45,28.45,1
CDM,27402340_OP,SHRINKER AK,78.16,50.8,23.37,23.37,1
CDM,27402350,STUMP SOCK SINGLE BELOW KNEE,10.0,6.5,2.18,19.65,72
CDM,27402350_IP,STUMP SOCK SINGLE BELOW KNEE,10.0,6.5,3.64,3.64,1
CDM,27402350_OP,STUMP SOCK SINGLE BELOW KNEE,10.0,6.5,2.99,2.99,1
CDM,27402365,TRACHEOSTOMY CARE KIT,43.7,28.41,9.53,43.7,72
CDM,27402365_IP,TRACHEOSTOMY CARE KIT,43.7,28.41,15.91,15.91,1
CDM,27402365_OP,TRACHEOSTOMY CARE KIT,43.7,28.41,13.07,13.07,1
CDM,27402380,SCOLIOSIS BODY JACKET,2028.7,1318.66,442.26,2028.7,73
CDM,27402380_IP,SCOLIOSIS BODY JACKET,2028.7,1318.66,1111.73,1111.73,1
CDM,27402380_OP,SCOLIOSIS BODY JACKET,2028.7,1318.66,880.46,880.46,1
CDM,27402385,UNLIST PROC FOR SPINAL ORTHO,88.0,57.2,16.97,88.0,72
CDM,27402385_IP,UNLIST PROC FOR SPINAL ORTHO,88.0,57.2,32.03,32.03,1
CDM,27402385_OP,UNLIST PROC FOR SPINAL ORTHO,88.0,57.2,26.31,26.31,1
CDM,27402415,NR METATARSAL ARCH SUPPORT EA,35.64,23.17,7.77,42.28,72
CDM,27402415_IP,NR METATARSAL ARCH SUPPORT EA,35.64,23.17,12.97,12.97,1
CDM,27402415_OP,NR METATARSAL ARCH SUPPORT EA,35.64,23.17,10.66,10.66,1
CDM,27402435,HMII SYSTEM DRIVER,7425.0,4826.25,1030.0,19595.16,73
CDM,27402435_IP,HMII SYSTEM DRIVER,7425.0,4826.25,4068.9,4068.9,1
CDM,27402435_OP,HMII SYSTEM DRIVER,7425.0,4826.25,3222.45,3222.45,1
CDM,27402440,HMII DISPLAY MODULE,10530.0,6844.5,1030.0,10530.0,65
CDM,27402440_IP,HMII DISPLAY MODULE,10530.0,6844.5,5770.44,5770.44,1
CDM,27402440_OP,HMII DISPLAY MODULE,10530.0,6844.5,4570.02,4570.02,1
CDM,27402450,HMII 14V LI-ION CLIP SET,1485.0,965.25,323.73,1485.0,73
CDM,27402450_IP,HMII 14V LI-ION CLIP SET,1485.0,965.25,813.78,813.78,1
CDM,27402450_OP,HMII 14V LI-ION CLIP SET,1485.0,965.25,644.49,644.49,1
CDM,27402455,HMII 14V. LI-ION BATTERY EA,1125.0,731.25,245.25,1491.52,72
CDM,27402455_IP,HMII 14V. LI-ION BATTERY EA,1125.0,731.25,409.5,409.5,1
CDM,27402455_OP,HMII 14V. LI-ION BATTERY EA,1125.0,731.25,336.38,336.38,1
CDM,27402460,HEARTWARE AC ADAPTER,2430.0,1579.5,200.93,2430.0,73
CDM,27402460_IP,HEARTWARE AC ADAPTER,2430.0,1579.5,1331.64,1331.64,1
CDM,27402460_OP,HEARTWARE AC ADAPTER,2430.0,1579.5,1054.62,1054.62,1
CDM,27402545,LITE BACK,72.0,46.8,15.7,72.0,72
CDM,27402545_IP,LITE BACK,72.0,46.8,26.21,26.21,1
CDM,27402545_OP,LITE BACK,72.0,46.8,21.53,21.53,1
CDM,27402555,SULLY SHOULDER STABILIZER,510.0,331.5,31.69,510.0,72
CDM,27402555_IP,SULLY SHOULDER STABILIZER,510.0,331.5,185.64,185.64,1
CDM,27402555_OP,SULLY SHOULDER STABILIZER,510.0,331.5,152.49,152.49,1
CDM,27402565,PATELLAR STABILIZING BRACE,175.0,113.75,38.15,175.0,72
CDM,27402565_IP,PATELLAR STABILIZING BRACE,175.0,113.75,63.7,63.7,1
CDM,27402565_OP,PATELLAR STABILIZING BRACE,175.0,113.75,52.33,52.33,1
CDM,27402575,HFO FLEXION GLOVE,80.0,52.0,16.97,80.0,72
CDM,27402575_IP,HFO FLEXION GLOVE,80.0,52.0,29.12,29.12,1
CDM,27402575_OP,HFO FLEXION GLOVE,80.0,52.0,23.92,23.92,1
CDM,27402585,CUSTOM ELBOW HINGE,1440.0,936.0,313.92,1440.0,73
CDM,27402585_IP,CUSTOM ELBOW HINGE,1440.0,936.0,789.12,789.12,1
CDM,27402585_OP,CUSTOM ELBOW HINGE,1440.0,936.0,624.96,624.96,1
CDM,27402595,EWHFO RIGID W/O JNTS CF,453.0,294.45,98.75,775.49,72
CDM,27402595_IP,EWHFO RIGID W/O JNTS CF,453.0,294.45,164.89,164.89,1
CDM,27402595_OP,EWHFO RIGID W/O JNTS CF,453.0,294.45,135.45,135.45,1
CDM,27402725,PEDS TRACH TUBE,218.0,141.7,36.52,218.0,72
CDM,27402725_IP,PEDS TRACH TUBE,218.0,141.7,79.35,79.35,1
CDM,27402725_OP,PEDS TRACH TUBE,218.0,141.7,65.18,65.18,1
CDM,27402730,TRACH-ESOPH VOICE PROS MD IN,329.0,213.85,58.52,329.0,72
CDM,27402730_IP,TRACH-ESOPH VOICE PROS MD IN,329.0,213.85,119.76,119.76,1
CDM,27402730_OP,TRACH-ESOPH VOICE PROS MD IN,329.0,213.85,98.37,98.37,1
CDM,27402750,HMII VEST MED,675.0,438.75,147.15,675.0,72
CDM,27402750_IP,HMII VEST MED,675.0,438.75,245.7,245.7,1
CDM,27402750_OP,HMII VEST MED,675.0,438.75,201.83,201.83,1
CDM,27402755,HMII SHOWER BAG,450.0,292.5,98.1,450.0,72
CDM,27402755_IP,HMII SHOWER BAG,450.0,292.5,163.8,163.8,1
CDM,27402755_OP,HMII SHOWER BAG,450.0,292.5,134.55,134.55,1
CDM,27402825,ALL SHANK FOOT W/VERTICAL LOAD,2708.0,1760.2,590.34,2708.0,65
CDM,27402825_IP,ALL SHANK FOOT W/VERTICAL LOAD,2708.0,1760.2,1483.98,1483.98,1
CDM,27402825_OP,ALL SHANK FOOT W/VERTICAL LOAD,2708.0,1760.2,1175.27,1175.27,1
CDM,27402845,FLEX/EXT WRIST W/WO FRICTION,3034.15,1972.2,661.44,3034.15,65
CDM,27402845_IP,FLEX/EXT WRIST W/WO FRICTION,3034.15,1972.2,1662.71,1662.71,1
CDM,27402845_OP,FLEX/EXT WRIST W/WO FRICTION,3034.15,1972.2,1316.82,1316.82,1
CDM,27402895,TERM DEV AUTO GRASP FEATURE,5423.11,3525.02,1030.0,5423.11,65
CDM,27402895_IP,TERM DEV AUTO GRASP FEATURE,5423.11,3525.02,2971.86,2971.86,1
CDM,27402895_OP,TERM DEV AUTO GRASP FEATURE,5423.11,3525.02,2353.63,2353.63,1
CDM,27403065,SAFE-T-TUBE MONTGOMERY,215.0,139.75,36.52,215.0,72
CDM,27403065_IP,SAFE-T-TUBE MONTGOMERY,215.0,139.75,78.26,78.26,1
CDM,27403065_OP,SAFE-T-TUBE MONTGOMERY,215.0,139.75,64.29,64.29,1
CDM,27403075,SHILEY UN-CUFFED TRACH TUBE,98.0,63.7,21.36,98.0,72
CDM,27403075_IP,SHILEY UN-CUFFED TRACH TUBE,98.0,63.7,35.67,35.67,1
CDM,27403075_OP,SHILEY UN-CUFFED TRACH TUBE,98.0,63.7,29.3,29.3,1
CDM,27403085,SHILEY-FENE TRACHTUBE-M51,97.0,63.05,21.15,97.0,72
CDM,27403085_IP,SHILEY-FENE TRACHTUBE-M51,97.0,63.05,35.31,35.31,1
CDM,27403085_OP,SHILEY-FENE TRACHTUBE-M51,97.0,63.05,29.0,29.0,1
CDM,27403095,COLLAR ECONOMY X-LONG/NARROW,27.0,17.55,5.89,42.28,72
CDM,27403095_IP,COLLAR ECONOMY X-LONG/NARROW,27.0,17.55,9.83,9.83,1
CDM,27403095_OP,COLLAR ECONOMY X-LONG/NARROW,27.0,17.55,8.07,8.07,1
CDM,27403105,"COLLAR, ECONOMY, MEDIUM",9.46,6.15,2.06,42.28,72
CDM,27403105_IP,"COLLAR, ECONOMY, MEDIUM",9.46,6.15,3.44,3.44,1
CDM,27403105_OP,"COLLAR, ECONOMY, MEDIUM",9.46,6.15,2.83,2.83,1
CDM,27403155,PREFAB TLSO TO SCAPULAR SPINE,1170.71,760.96,255.21,1170.71,72
CDM,27403155_IP,PREFAB TLSO TO SCAPULAR SPINE,1170.71,760.96,426.14,426.14,1
CDM,27403155_OP,PREFAB TLSO TO SCAPULAR SPINE,1170.71,760.96,350.04,350.04,1
CDM,27403165,SPIO VEST,348.25,226.36,75.92,775.49,72
CDM,27403165_IP,SPIO VEST,348.25,226.36,126.76,126.76,1
CDM,27403165_OP,SPIO VEST,348.25,226.36,104.13,104.13,1
CDM,27403175,SI STABILIZING BRACE,87.0,56.55,18.97,87.0,72
CDM,27403175_IP,SI STABILIZING BRACE,87.0,56.55,31.67,31.67,1
CDM,27403175_OP,SI STABILIZING BRACE,87.0,56.55,26.01,26.01,1
CDM,27403185,LUMBOSACRAL SUPPORT,30.0,19.5,6.54,36.7,72
CDM,27403185_IP,LUMBOSACRAL SUPPORT,30.0,19.5,10.92,10.92,1
CDM,27403185_OP,LUMBOSACRAL SUPPORT,30.0,19.5,8.97,8.97,1
CDM,27403195,LSO BACK BRACE,655.0,425.75,142.79,980.32,72
CDM,27403195_IP,LSO BACK BRACE,655.0,425.75,82.26,82.26,1
CDM,27403195_OP,LSO BACK BRACE,655.0,425.75,67.57,67.57,1
CDM,27403205,LO SAGITT RIGID PANEL PREFAB,483.33,314.16,105.37,980.32,72
CDM,27403205_IP,LO SAGITT RIGID PANEL PREFAB,483.33,314.16,175.93,175.93,1
CDM,27403205_OP,LO SAGITT RIGID PANEL PREFAB,483.33,314.16,144.52,144.52,1
CDM,27403215,"LSO PREFAB, W/RIGID POST",190.66,123.93,41.56,190.66,72
CDM,27403215_IP,"LSO PREFAB, W/RIGID POST",190.66,123.93,69.4,69.4,1
CDM,27403215_OP,"LSO PREFAB, W/RIGID POST",190.66,123.93,57.01,57.01,1
CDM,27403225,"LSO PREFAB, W/RIG PO/LAT",337.55,219.41,73.59,337.55,72
CDM,27403225_IP,"LSO PREFAB, W/RIG PO/LAT",337.55,219.41,122.87,122.87,1
CDM,27403225_OP,"LSO PREFAB, W/RIG PO/LAT",337.55,219.41,100.93,100.93,1
CDM,27403235,LSO S/C SHELL/PANEL CUSTOM,1231.71,800.61,268.51,1231.71,72
CDM,27403235_IP,LSO S/C SHELL/PANEL CUSTOM,1231.71,800.61,674.98,674.98,1
CDM,27403235_OP,LSO S/C SHELL/PANEL CUSTOM,1231.71,800.61,534.56,534.56,1
CDM,27403245,ABDUCTION SPLINT-PEDIATR,160.0,104.0,34.88,160.0,72
CDM,27403245_IP,ABDUCTION SPLINT-PEDIATR,160.0,104.0,58.24,58.24,1
CDM,27403245_OP,ABDUCTION SPLINT-PEDIATR,160.0,104.0,47.84,47.84,1
CDM,27403255,J BRACE WITH HINGES,41.1,26.72,8.96,67.76,72
CDM,27403255_IP,J BRACE WITH HINGES,41.1,26.72,14.96,14.96,1
CDM,27403255_OP,J BRACE WITH HINGES,41.1,26.72,12.29,12.29,1
CDM,27403265,REACTION BRACE,50.22,32.64,10.95,67.76,72
CDM,27403265_IP,REACTION BRACE,50.22,32.64,18.28,18.28,1
CDM,27403265_OP,REACTION BRACE,50.22,32.64,15.02,15.02,1
CDM,27403275,TRU PULL LITE,146.0,94.9,31.83,146.0,72
CDM,27403275_IP,TRU PULL LITE,146.0,94.9,20.96,20.96,1
CDM,27403275_OP,TRU PULL LITE,146.0,94.9,17.21,17.21,1
CDM,27403285,"LATERAL ""J"" BRACE",92.75,60.29,20.22,92.75,72
CDM,27403285_IP,"LATERAL ""J"" BRACE",92.75,60.29,33.76,33.76,1
CDM,27403285_OP,"LATERAL ""J"" BRACE",92.75,60.29,27.73,27.73,1
CDM,27403295,DELUXE HINGE WRAP AROUND,91.0,59.15,19.84,91.0,72
CDM,27403295_IP,DELUXE HINGE WRAP AROUND,91.0,59.15,33.12,33.12,1
CDM,27403295_OP,DELUXE HINGE WRAP AROUND,91.0,59.15,27.21,27.21,1
CDM,27403305,ECONOMY HINGED KNEE BRACE,69.0,44.85,15.04,69.0,72
CDM,27403305_IP,ECONOMY HINGED KNEE BRACE,69.0,44.85,25.12,25.12,1
CDM,27403305_OP,ECONOMY HINGED KNEE BRACE,69.0,44.85,20.63,20.63,1
CDM,27403315,KO W CONDYL PAD & JNTS,167.28,108.73,36.47,167.28,72
CDM,27403315_IP,KO W CONDYL PAD & JNTS,167.28,108.73,60.89,60.89,1
CDM,27403315_OP,KO W CONDYL PAD & JNTS,167.28,108.73,50.02,50.02,1
CDM,27403325,PREFAB CANVAS KO IMMOBILIZER,134.0,87.1,29.21,134.0,72
CDM,27403325_IP,PREFAB CANVAS KO IMMOBILIZER,134.0,87.1,35.64,35.64,1
CDM,27403325_OP,PREFAB CANVAS KO IMMOBILIZER,134.0,87.1,29.27,29.27,1
CDM,27403355,THROM ADVANCE KNEE,151.0,98.15,32.92,385.65,72
CDM,27403355_IP,THROM ADVANCE KNEE,151.0,98.15,54.96,54.96,1
CDM,27403355_OP,THROM ADVANCE KNEE,151.0,98.15,45.15,45.15,1
CDM,27403365,OPAL KNEE BRACE,893.0,580.45,194.67,1491.52,72
CDM,27403365_IP,OPAL KNEE BRACE,893.0,580.45,325.05,325.05,1
CDM,27403365_OP,OPAL KNEE BRACE,893.0,580.45,267.01,267.01,1
CDM,27403375,KO DONJOY PREFAB,986.01,640.91,214.95,1491.52,72
CDM,27403375_IP,KO DONJOY PREFAB,986.01,640.91,358.91,358.91,1
CDM,27403375_OP,KO DONJOY PREFAB,986.01,640.91,294.82,294.82,1
CDM,27403385,OA KNEE BRACE,1451.0,943.15,316.32,1491.52,73
CDM,27403385_IP,OA KNEE BRACE,1451.0,943.15,795.15,795.15,1
CDM,27403385_OP,OA KNEE BRACE,1451.0,943.15,629.73,629.73,1
CDM,27403395,"ROM KNEE BRACE, COOL",165.38,107.5,36.05,1491.52,72
CDM,27403395_IP,"ROM KNEE BRACE, COOL",165.38,107.5,60.2,60.2,1
CDM,27403395_OP,"ROM KNEE BRACE, COOL",165.38,107.5,49.45,49.45,1
CDM,27403415,OTS BRACE - ACL/PCL,1041.52,676.99,227.05,1491.52,72
CDM,27403415_IP,OTS BRACE - ACL/PCL,1041.52,676.99,379.11,379.11,1
CDM,27403415_OP,OTS BRACE - ACL/PCL,1041.52,676.99,311.41,311.41,1
CDM,27403425,CUSTOM ACL/PCL W/PNEUMATIC KNE,1276.0,829.4,278.17,1276.0,72
CDM,27403425_IP,CUSTOM ACL/PCL W/PNEUMATIC KNE,1276.0,829.4,699.25,699.25,1
CDM,27403425_OP,CUSTOM ACL/PCL W/PNEUMATIC KNE,1276.0,829.4,553.78,553.78,1
CDM,27403435,AIR SPORT/ANKLE BRACE,163.0,105.95,31.69,163.0,72
CDM,27403435_IP,AIR SPORT/ANKLE BRACE,163.0,105.95,29.12,29.12,1
CDM,27403435_OP,AIR SPORT/ANKLE BRACE,163.0,105.95,23.92,23.92,1
CDM,27403445,AFO AIR CAST,132.37,86.04,28.86,132.37,72
CDM,27403445_IP,AFO AIR CAST,132.37,86.04,48.18,48.18,1
CDM,27403445_OP,AFO AIR CAST,132.37,86.04,39.58,39.58,1
CDM,27403455,BLEDSOE BOOT W/ACHILLES WEDGES,134.0,87.1,29.21,134.0,72
CDM,27403455_IP,BLEDSOE BOOT W/ACHILLES WEDGES,134.0,87.1,48.78,48.78,1
CDM,27403455_OP,BLEDSOE BOOT W/ACHILLES WEDGES,134.0,87.1,40.07,40.07,1
CDM,27403465,ACHILLOTRAIN ELASTIC SUPPORT,134.0,87.1,29.21,134.0,72
CDM,27403465_IP,ACHILLOTRAIN ELASTIC SUPPORT,134.0,87.1,48.78,48.78,1
CDM,27403465_OP,ACHILLOTRAIN ELASTIC SUPPORT,134.0,87.1,40.07,40.07,1
CDM,27403475,NIGHT SPLINT,420.0,273.0,91.56,420.0,72
CDM,27403475_IP,NIGHT SPLINT,420.0,273.0,152.88,152.88,1
CDM,27403475_OP,NIGHT SPLINT,420.0,273.0,125.58,125.58,1
CDM,27403485,ASO ANKLE,140.0,91.0,30.52,385.65,72
CDM,27403485_IP,ASO ANKLE,140.0,91.0,50.96,50.96,1
CDM,27403485_OP,ASO ANKLE,140.0,91.0,41.86,41.86,1
CDM,27403495,PEDIATRIC FRACTURE WALKER,78.75,51.19,17.17,385.65,72
CDM,27403495_IP,PEDIATRIC FRACTURE WALKER,78.75,51.19,28.67,28.67,1
CDM,27403495_OP,PEDIATRIC FRACTURE WALKER,78.75,51.19,23.55,23.55,1
CDM,27403505,PROFILE LOW WALKER,76.8,49.92,16.74,1491.52,72
CDM,27403505_IP,PROFILE LOW WALKER,76.8,49.92,27.96,27.96,1
CDM,27403505_OP,PROFILE LOW WALKER,76.8,49.92,22.96,22.96,1
CDM,27403515,PRE TIB SHELL MOLDED,491.91,319.74,107.24,491.91,72
CDM,27403515_IP,PRE TIB SHELL MOLDED,491.91,319.74,179.06,179.06,1
CDM,27403515_OP,PRE TIB SHELL MOLDED,491.91,319.74,147.08,147.08,1
CDM,27403525,B.K. SOCKET MOLD PTB AFO,980.72,637.47,213.8,980.72,72
CDM,27403525_IP,B.K. SOCKET MOLD PTB AFO,980.72,637.47,356.98,356.98,1
CDM,27403525_OP,B.K. SOCKET MOLD PTB AFO,980.72,637.47,293.24,293.24,1
CDM,27403535,"ADD, LE, EXTENDED STEEL SHANK",60.72,39.47,13.24,60.72,72
CDM,27403535_IP,"ADD, LE, EXTENDED STEEL SHANK",60.72,39.47,22.1,22.1,1
CDM,27403535_OP,"ADD, LE, EXTENDED STEEL SHANK",60.72,39.47,18.16,18.16,1
CDM,27403545,DACRO SHOE,46.0,29.9,10.03,46.0,72
CDM,27403545_IP,DACRO SHOE,46.0,29.9,16.74,16.74,1
CDM,27403545_OP,DACRO SHOE,46.0,29.9,13.75,13.75,1
CDM,27403555,HEAVY DUTY JOINT STR,172.97,112.43,37.71,172.97,72
CDM,27403555_IP,HEAVY DUTY JOINT STR,172.97,112.43,62.96,62.96,1
CDM,27403555_OP,HEAVY DUTY JOINT STR,172.97,112.43,51.72,51.72,1
CDM,27403565,SUSPENSION SLEEVE LEXTR ADDTN,143.69,93.4,31.32,143.69,72
CDM,27403565_IP,SUSPENSION SLEEVE LEXTR ADDTN,143.69,93.4,52.3,52.3,1
CDM,27403565_OP,SUSPENSION SLEEVE LEXTR ADDTN,143.69,93.4,42.96,42.96,1
CDM,27403575,DROP LOCK KNEE JNT,102.64,66.72,22.38,102.64,72
CDM,27403575_IP,DROP LOCK KNEE JNT,102.64,66.72,37.36,37.36,1
CDM,27403575_OP,DROP LOCK KNEE JNT,102.64,66.72,30.69,30.69,1
CDM,27403585,DONJOY LATERAL J BRACE,92.75,60.29,20.22,92.75,72
CDM,27403585_IP,DONJOY LATERAL J BRACE,92.75,60.29,33.76,33.76,1
CDM,27403585_OP,DONJOY LATERAL J BRACE,92.75,60.29,27.73,27.73,1
CDM,27403605,PATELLAR TENDON STRAP,27.0,17.55,5.89,27.0,72
CDM,27403605_IP,PATELLAR TENDON STRAP,27.0,17.55,9.83,9.83,1
CDM,27403605_OP,PATELLAR TENDON STRAP,27.0,17.55,8.07,8.07,1
CDM,27403615,AIRHEEL DONJOY,46.0,29.9,10.03,46.0,72
CDM,27403615_IP,AIRHEEL DONJOY,46.0,29.9,16.74,16.74,1
CDM,27403615_OP,AIRHEEL DONJOY,46.0,29.9,13.75,13.75,1
CDM,27403625,DONJOY CROSS STRAP BRACE,39.98,25.99,8.72,39.98,72
CDM,27403625_IP,DONJOY CROSS STRAP BRACE,39.98,25.99,14.55,14.55,1
CDM,27403625_OP,DONJOY CROSS STRAP BRACE,39.98,25.99,11.95,11.95,1
CDM,27403635,CUSTOM FOOT ORTHOTIC/ ORTHOTICS METARSAL SUPPORT,120.0,78.0,26.16,406.89,72
CDM,27403635_IP,CUSTOM FOOT ORTHOTIC/ ORTHOTICS METARSAL SUPPORT,120.0,78.0,43.68,43.68,1
CDM,27403635_OP,CUSTOM FOOT ORTHOTIC/ ORTHOTICS METARSAL SUPPORT,120.0,78.0,35.88,35.88,1
CDM,27403645,"PREMOLD LONGIT FOOT ARCH,EA",55.41,36.02,12.08,55.41,72
CDM,27403645_IP,"PREMOLD LONGIT FOOT ARCH,EA",55.41,36.02,20.17,20.17,1
CDM,27403645_OP,"PREMOLD LONGIT FOOT ARCH,EA",55.41,36.02,16.57,16.57,1
CDM,27403655,PPT MOULDED INSERT EACH,28.0,18.2,6.1,36.7,72
CDM,27403655_IP,PPT MOULDED INSERT EACH,28.0,18.2,10.19,10.19,1
CDM,27403655_OP,PPT MOULDED INSERT EACH,28.0,18.2,8.37,8.37,1
CDM,27403665,UCO SHOE INSERTS,9.0,5.85,1.96,36.7,72
CDM,27403665_IP,UCO SHOE INSERTS,9.0,5.85,3.28,3.28,1
CDM,27403665_OP,UCO SHOE INSERTS,9.0,5.85,2.69,2.69,1
CDM,27403685,FELT HEEL LIFTS,137.0,89.05,29.87,137.0,72
CDM,27403685_IP,FELT HEEL LIFTS,137.0,89.05,3.28,3.28,1
CDM,27403685_OP,FELT HEEL LIFTS,137.0,89.05,2.69,2.69,1
CDM,27403695,HAPADS HEEL LIFT PER INCH,8.0,5.2,1.74,42.28,72
CDM,27403695_IP,HAPADS HEEL LIFT PER INCH,8.0,5.2,2.91,2.91,1
CDM,27403695_OP,HAPADS HEEL LIFT PER INCH,8.0,5.2,2.39,2.39,1
CDM,27403705,"SHOE INSERT, HEALER",15.5,10.08,3.38,36.7,72
CDM,27403705_IP,"SHOE INSERT, HEALER",15.5,10.08,5.64,5.64,1
CDM,27403705_OP,"SHOE INSERT, HEALER",15.5,10.08,4.63,4.63,1
CDM,27403715,CLAVICLE STRAP,139.0,90.35,30.3,139.0,72
CDM,27403715_IP,CLAVICLE STRAP,139.0,90.35,50.6,50.6,1
CDM,27403715_OP,CLAVICLE STRAP,139.0,90.35,41.56,41.56,1
CDM,27403735,EO CUSTOM W/O WRIST,317.0,206.05,69.11,406.89,72
CDM,27403735_IP,EO CUSTOM W/O WRIST,317.0,206.05,97.36,97.36,1
CDM,27403735_OP,EO CUSTOM W/O WRIST,317.0,206.05,79.97,79.97,1
CDM,27403745,EO CUSTOM DBL UPRIGHT ADJ LOCK,1444.0,938.6,314.79,1444.0,73
CDM,27403745_IP,EO CUSTOM DBL UPRIGHT ADJ LOCK,1444.0,938.6,791.31,791.31,1
CDM,27403745_OP,EO CUSTOM DBL UPRIGHT ADJ LOCK,1444.0,938.6,626.7,626.7,1
CDM,27403775,PREFAB WHFO WO JNTS,267.87,174.12,58.4,406.89,72
CDM,27403775_IP,PREFAB WHFO WO JNTS,267.87,174.12,97.5,97.5,1
CDM,27403775_OP,PREFAB WHFO WO JNTS,267.87,174.12,80.09,80.09,1
CDM,27403785,WHFO STATIC,45.0,29.25,9.81,406.89,72
CDM,27403785_IP,WHFO STATIC,45.0,29.25,16.38,16.38,1
CDM,27403785_OP,WHFO STATIC,45.0,29.25,13.46,13.46,1
CDM,27403795,EXOS LONG THUMB SPICA,105.0,68.25,22.89,406.89,72
CDM,27403795_IP,EXOS LONG THUMB SPICA,105.0,68.25,38.22,38.22,1
CDM,27403795_OP,EXOS LONG THUMB SPICA,105.0,68.25,31.4,31.4,1
CDM,27403805,THUMBGUARD,22.0,14.3,4.8,105.69,72
CDM,27403805_IP,THUMBGUARD,22.0,14.3,8.01,8.01,1
CDM,27403805_OP,THUMBGUARD,22.0,14.3,6.58,6.58,1
CDM,27403815,WRIST HAND PLASTIC CAST,141.0,91.65,30.74,141.0,72
CDM,27403815_IP,WRIST HAND PLASTIC CAST,141.0,91.65,51.32,51.32,1
CDM,27403815_OP,WRIST HAND PLASTIC CAST,141.0,91.65,42.16,42.16,1
CDM,27403825,WHFO CUSTOM (OT) - A(EXOS),267.0,173.55,58.21,267.0,72
CDM,27403825_IP,WHFO CUSTOM (OT) - A(EXOS),267.0,173.55,97.19,97.19,1
CDM,27403825_OP,WHFO CUSTOM (OT) - A(EXOS),267.0,173.55,79.83,79.83,1
CDM,27403835,WRIST CUSTOM (OT),72.04,46.83,15.7,980.32,72
CDM,27403835_IP,WRIST CUSTOM (OT),72.04,46.83,26.22,26.22,1
CDM,27403835_OP,WRIST CUSTOM (OT),72.04,46.83,21.54,21.54,1
CDM,27403845,WRIST SPLINT,116.0,75.4,25.29,116.0,72
CDM,27403845_IP,WRIST SPLINT,116.0,75.4,42.22,42.22,1
CDM,27403845_OP,WRIST SPLINT,116.0,75.4,34.68,34.68,1
CDM,27403855,FOREARM SPLINT,30.0,19.5,6.54,36.7,72
CDM,27403855_IP,FOREARM SPLINT,30.0,19.5,10.92,10.92,1
CDM,27403855_OP,FOREARM SPLINT,30.0,19.5,8.97,8.97,1
CDM,27403865,WRIST SPLINT STANDARD,16.0,10.4,3.49,36.7,72
CDM,27403865_IP,WRIST SPLINT STANDARD,16.0,10.4,5.82,5.82,1
CDM,27403865_OP,WRIST SPLINT STANDARD,16.0,10.4,4.78,4.78,1
CDM,27403875,WRIST SUPPORT GEL,36.0,23.4,7.85,36.7,72
CDM,27403875_IP,WRIST SUPPORT GEL,36.0,23.4,13.1,13.1,1
CDM,27403875_OP,WRIST SUPPORT GEL,36.0,23.4,10.76,10.76,1
CDM,27403885,WHO PREFAB NON-FX,46.0,29.9,10.03,46.0,72
CDM,27403885_IP,WHO PREFAB NON-FX,46.0,29.9,16.74,16.74,1
CDM,27403885_OP,WHO PREFAB NON-FX,46.0,29.9,13.75,13.75,1
CDM,27403895,WRIST SPLINT LEFT MED,606.31,394.1,31.69,606.31,72
CDM,27403895_IP,WRIST SPLINT LEFT MED,606.31,394.1,220.7,220.7,1
CDM,27403895_OP,WRIST SPLINT LEFT MED,606.31,394.1,181.29,181.29,1
CDM,27403905,WRIST PREFAB NON FX (OT),30.0,19.5,6.54,36.7,72
CDM,27403905_IP,WRIST PREFAB NON FX (OT),30.0,19.5,10.92,10.92,1
CDM,27403905_OP,WRIST PREFAB NON FX (OT),30.0,19.5,8.97,8.97,1
CDM,27403915,"SPLINT,WRIST,EXOFORM,LEFT,SM",72.0,46.8,15.7,72.0,72
CDM,27403915_IP,"SPLINT,WRIST,EXOFORM,LEFT,SM",72.0,46.8,26.21,26.21,1
CDM,27403915_OP,"SPLINT,WRIST,EXOFORM,LEFT,SM",72.0,46.8,21.53,21.53,1
CDM,27403925,"SPLINT,WRIST,EXOFORM,LEFT,MED",72.0,46.8,15.7,72.0,72
CDM,27403925_IP,"SPLINT,WRIST,EXOFORM,LEFT,MED",72.0,46.8,26.21,26.21,1
CDM,27403925_OP,"SPLINT,WRIST,EXOFORM,LEFT,MED",72.0,46.8,21.53,21.53,1
CDM,27403935,"SPLINT,WRIST,EXOFORM,LEFT,LG",72.0,46.8,15.7,72.0,72
CDM,27403935_IP,"SPLINT,WRIST,EXOFORM,LEFT,LG",72.0,46.8,26.21,26.21,1
CDM,27403935_OP,"SPLINT,WRIST,EXOFORM,LEFT,LG",72.0,46.8,21.53,21.53,1
CDM,27403945,"SPLINT,WRIST,EXOFORM,RIGHT,SM",72.0,46.8,15.7,72.0,72
CDM,27403945_IP,"SPLINT,WRIST,EXOFORM,RIGHT,SM",72.0,46.8,26.21,26.21,1
CDM,27403945_OP,"SPLINT,WRIST,EXOFORM,RIGHT,SM",72.0,46.8,21.53,21.53,1
CDM,27403955,"SPLINT,WRIST,EXOFORM,RIGHT,MED",72.0,46.8,15.7,72.0,72
CDM,27403955_IP,"SPLINT,WRIST,EXOFORM,RIGHT,MED",72.0,46.8,26.21,26.21,1
CDM,27403955_OP,"SPLINT,WRIST,EXOFORM,RIGHT,MED",72.0,46.8,21.53,21.53,1
CDM,27403965,"SPLINT,WRIST,EXOFORM,RIGHT,LG",72.0,46.8,15.7,72.0,72
CDM,27403965_IP,"SPLINT,WRIST,EXOFORM,RIGHT,LG",72.0,46.8,26.21,26.21,1
CDM,27403965_OP,"SPLINT,WRIST,EXOFORM,RIGHT,LG",72.0,46.8,21.53,21.53,1
CDM,27403975,WHFO PREFAB FLEXN GLOVE W ELAS,50.0,32.5,10.9,50.0,72
CDM,27403975_IP,WHFO PREFAB FLEXN GLOVE W ELAS,50.0,32.5,18.2,18.2,1
CDM,27403975_OP,WHFO PREFAB FLEXN GLOVE W ELAS,50.0,32.5,14.95,14.95,1
CDM,27403985,HFO W/O JOINTS CF (EXOS),72.04,46.83,15.7,406.89,72
CDM,27403985_IP,HFO W/O JOINTS CF (EXOS),72.04,46.83,26.22,26.22,1
CDM,27403985_OP,HFO W/O JOINTS CF (EXOS),72.04,46.83,21.54,21.54,1
CDM,27403995,HAND BASED ULNAR/RADIAL BRACE,147.0,95.55,32.05,147.0,72
CDM,27403995_IP,HAND BASED ULNAR/RADIAL BRACE,147.0,95.55,53.51,53.51,1
CDM,27403995_OP,HAND BASED ULNAR/RADIAL BRACE,147.0,95.55,43.95,43.95,1
CDM,27403OH,ARTHROTOMY W/MENISCUS REPAIR KNEE,3448.0,2241.2,1.1,20863.78,144
CDM,27404005,HO W/O JOINTS CF,50.0,32.5,10.9,406.89,72
CDM,27404005_IP,HO W/O JOINTS CF,50.0,32.5,18.2,18.2,1
CDM,27404005_OP,HO W/O JOINTS CF,50.0,32.5,14.95,14.95,1
CDM,27404015,COMFY COOL THUMB SPLINT,47.0,30.55,10.25,47.0,72
CDM,27404015_IP,COMFY COOL THUMB SPLINT,47.0,30.55,17.11,17.11,1
CDM,27404015_OP,COMFY COOL THUMB SPLINT,47.0,30.55,14.05,14.05,1
CDM,27404025,HFO PREFAB W/O JOINTS RIGID,54.0,35.1,11.77,54.0,72
CDM,27404025_IP,HFO PREFAB W/O JOINTS RIGID,54.0,35.1,19.66,19.66,1
CDM,27404025_OP,HFO PREFAB W/O JOINTS RIGID,54.0,35.1,16.15,16.15,1
CDM,27404035,EXOS SHORT THUMB SPICA,70.0,45.5,15.26,70.0,72
CDM,27404035_IP,EXOS SHORT THUMB SPICA,70.0,45.5,25.48,25.48,1
CDM,27404035_OP,EXOS SHORT THUMB SPICA,70.0,45.5,20.93,20.93,1
CDM,27404045,HAND BASED ULNAR/RADIAL BRACE,147.0,95.55,31.69,147.0,72
CDM,27404045_IP,HAND BASED ULNAR/RADIAL BRACE,147.0,95.55,53.51,53.51,1
CDM,27404045_OP,HAND BASED ULNAR/RADIAL BRACE,147.0,95.55,43.95,43.95,1
CDM,27404055,EXOS GUTTER SPLINT,63.0,40.95,13.73,63.0,72
CDM,27404055_IP,EXOS GUTTER SPLINT,63.0,40.95,22.93,22.93,1
CDM,27404055_OP,EXOS GUTTER SPLINT,63.0,40.95,18.84,18.84,1
CDM,27404065,"OT FO, SAFETY PIN, MODIFIED",59.0,38.35,12.86,59.0,72
CDM,27404065_IP,"OT FO, SAFETY PIN, MODIFIED",59.0,38.35,21.48,21.48,1
CDM,27404065_OP,"OT FO, SAFETY PIN, MODIFIED",59.0,38.35,17.64,17.64,1
CDM,27404075,FO STATIC OVAL,13.0,8.45,2.83,42.28,72
CDM,27404075_IP,FO STATIC OVAL,13.0,8.45,4.73,4.73,1
CDM,27404075_OP,FO STATIC OVAL,13.0,8.45,3.89,3.89,1
CDM,27404085,"UE FX ORTHOSIS, HUMERAL",418.0,271.7,91.12,418.0,72
CDM,27404085_IP,"UE FX ORTHOSIS, HUMERAL",418.0,271.7,152.15,152.15,1
CDM,27404085_OP,"UE FX ORTHOSIS, HUMERAL",418.0,271.7,124.98,124.98,1
CDM,27404095,SHRT ARM FX BRACE W/W/OUT BOA,147.0,95.55,32.05,980.32,72
CDM,27404095_IP,SHRT ARM FX BRACE W/W/OUT BOA,147.0,95.55,53.51,53.51,1
CDM,27404095_OP,SHRT ARM FX BRACE W/W/OUT BOA,147.0,95.55,43.95,43.95,1
CDM,27404105,EXOS SHORT ARM FX,128.0,83.2,27.9,980.32,72
CDM,27404105_IP,EXOS SHORT ARM FX,128.0,83.2,46.59,46.59,1
CDM,27404105_OP,EXOS SHORT ARM FX,128.0,83.2,38.27,38.27,1
CDM,27404115,EXOS THUMB SPICA FX,140.0,91.0,30.52,980.32,72
CDM,27404115_IP,EXOS THUMB SPICA FX,140.0,91.0,50.96,50.96,1
CDM,27404115_OP,EXOS THUMB SPICA FX,140.0,91.0,41.86,41.86,1
CDM,27404125,WHO RADIUS/ULNA,50.0,32.5,10.9,980.32,72
CDM,27404125_IP,WHO RADIUS/ULNA,50.0,32.5,18.2,18.2,1
CDM,27404125_OP,WHO RADIUS/ULNA,50.0,32.5,14.95,14.95,1
CDM,27404135,"OT FX ORTHOSIS, RADIUS/ULNAR",30.0,19.5,6.54,980.32,72
CDM,27404135_IP,"OT FX ORTHOSIS, RADIUS/ULNAR",30.0,19.5,10.92,10.92,1
CDM,27404135_OP,"OT FX ORTHOSIS, RADIUS/ULNAR",30.0,19.5,8.97,8.97,1
CDM,27404145,CARPAL FX PREFAB (OT),67.13,43.63,14.63,105.69,72
CDM,27404145_IP,CARPAL FX PREFAB (OT),67.13,43.63,24.44,24.44,1
CDM,27404145_OP,CARPAL FX PREFAB (OT),67.13,43.63,20.07,20.07,1
CDM,27404155,PREFAB SPICA FX BRACE,180.0,117.0,39.24,180.0,72
CDM,27404155_IP,PREFAB SPICA FX BRACE,180.0,117.0,65.52,65.52,1
CDM,27404155_OP,PREFAB SPICA FX BRACE,180.0,117.0,53.82,53.82,1
CDM,27404165,EXOS WRIST BRACE,98.0,63.7,21.36,105.69,72
CDM,27404165_IP,EXOS WRIST BRACE,98.0,63.7,35.67,35.67,1
CDM,27404165_OP,EXOS WRIST BRACE,98.0,63.7,29.3,29.3,1
CDM,27404175,WHO CARPAL FX FIRM/SOFT,50.0,32.5,10.9,105.69,72
CDM,27404175_IP,WHO CARPAL FX FIRM/SOFT,50.0,32.5,18.2,18.2,1
CDM,27404175_OP,WHO CARPAL FX FIRM/SOFT,50.0,32.5,14.95,14.95,1
CDM,27404185,OT FX ORTHOSISWRIST,30.0,19.5,6.54,105.69,72
CDM,27404185_IP,OT FX ORTHOSISWRIST,30.0,19.5,10.92,10.92,1
CDM,27404185_OP,OT FX ORTHOSISWRIST,30.0,19.5,8.97,8.97,1
CDM,27404195,ELBOW SLEEVE,22.0,14.3,4.8,22.0,72
CDM,27404195_IP,ELBOW SLEEVE,22.0,14.3,8.01,8.01,1
CDM,27404195_OP,ELBOW SLEEVE,22.0,14.3,6.58,6.58,1
CDM,27404205,WRIST WRAP,8.0,5.2,1.74,19.65,72
CDM,27404205_IP,WRIST WRAP,8.0,5.2,2.91,2.91,1
CDM,27404205_OP,WRIST WRAP,8.0,5.2,2.39,2.39,1
CDM,27404215,ACTIVE ANKLE,168.0,109.2,36.62,168.0,72
CDM,27404215_IP,ACTIVE ANKLE,168.0,109.2,61.15,61.15,1
CDM,27404215_OP,ACTIVE ANKLE,168.0,109.2,50.23,50.23,1
CDM,27404225,AIR CAST ANKLE,42.1,27.37,9.18,67.76,72
CDM,27404225_IP,AIR CAST ANKLE,42.1,27.37,15.32,15.32,1
CDM,27404225_OP,AIR CAST ANKLE,42.1,27.37,12.59,12.59,1
CDM,27404235,ANKLE BRACE AIR CAST RIGHT,271.58,176.53,58.52,271.58,72
CDM,27404235_IP,ANKLE BRACE AIR CAST RIGHT,271.58,176.53,98.86,98.86,1
CDM,27404235_OP,ANKLE BRACE AIR CAST RIGHT,271.58,176.53,81.2,81.2,1
CDM,27404245,AIRCAST/WALK SPLINT,304.75,198.09,66.44,304.75,72
CDM,27404245_IP,AIRCAST/WALK SPLINT,304.75,198.09,110.93,110.93,1
CDM,27404245_OP,AIRCAST/WALK SPLINT,304.75,198.09,91.12,91.12,1
CDM,27404255,PNEUMATI WALKING BOOT PREFAB,227.0,147.55,49.49,227.0,72
CDM,27404255_IP,PNEUMATI WALKING BOOT PREFAB,227.0,147.55,82.63,82.63,1
CDM,27404255_OP,PNEUMATI WALKING BOOT PREFAB,227.0,147.55,67.87,67.87,1
CDM,27404265,PNEUMATIC FOAM WALKER,828.0,538.2,91.28,828.0,72
CDM,27404265_IP,PNEUMATIC FOAM WALKER,828.0,538.2,301.39,301.39,1
CDM,27404265_OP,PNEUMATIC FOAM WALKER,828.0,538.2,247.57,247.57,1
CDM,27404275,PNEUMATIC DONJOY XP WALKER,125.0,81.25,27.25,125.0,72
CDM,27404275_IP,PNEUMATIC DONJOY XP WALKER,125.0,81.25,45.5,45.5,1
CDM,27404275_OP,PNEUMATIC DONJOY XP WALKER,125.0,81.25,37.38,37.38,1
CDM,27404285,AIRCAST PNEUMATIC WALKER,414.0,269.1,90.25,414.0,72
CDM,27404285_IP,AIRCAST PNEUMATIC WALKER,414.0,269.1,95.0,95.0,1
CDM,27404285_OP,AIRCAST PNEUMATIC WALKER,414.0,269.1,78.04,78.04,1
CDM,27404305,MAXTRAX ANKLE BOOT,57.0,37.05,12.43,67.76,72
CDM,27404305_IP,MAXTRAX ANKLE BOOT,57.0,37.05,20.75,20.75,1
CDM,27404305_OP,MAXTRAX ANKLE BOOT,57.0,37.05,17.04,17.04,1
CDM,27404315,MAXTRAX ANKLE BOOT,45.3,29.45,9.88,67.76,72
CDM,27404315_IP,MAXTRAX ANKLE BOOT,45.3,29.45,16.49,16.49,1
CDM,27404315_OP,MAXTRAX ANKLE BOOT,45.3,29.45,13.54,13.54,1
CDM,27404325,NON-PNEUMATIC WEE WALKER,93.1,60.52,20.3,93.1,72
CDM,27404325_IP,NON-PNEUMATIC WEE WALKER,93.1,60.52,33.89,33.89,1
CDM,27404325_OP,NON-PNEUMATIC WEE WALKER,93.1,60.52,27.84,27.84,1
CDM,27404335,DORSIWEDGE NIGHT SPLINT,68.0,44.2,14.82,68.0,72
CDM,27404335_IP,DORSIWEDGE NIGHT SPLINT,68.0,44.2,24.75,24.75,1
CDM,27404335_OP,DORSIWEDGE NIGHT SPLINT,68.0,44.2,20.33,20.33,1
CDM,27404345,DORSIWEDGE NIGHT SPLINT,62.2,40.43,13.56,62.2,72
CDM,27404345_IP,DORSIWEDGE NIGHT SPLINT,62.2,40.43,22.64,22.64,1
CDM,27404345_OP,DORSIWEDGE NIGHT SPLINT,62.2,40.43,18.6,18.6,1
CDM,27404355,PTB CROW,2879.55,1871.71,627.74,2879.55,73
CDM,27404355_IP,PTB CROW,2879.55,1871.71,1577.99,1577.99,1
CDM,27404355_OP,PTB CROW,2879.55,1871.71,1249.72,1249.72,1
CDM,27404365,CUSTOM GLOVE FOR TERM DEVICE,823.2,535.08,179.46,823.2,72
CDM,27404365_IP,CUSTOM GLOVE FOR TERM DEVICE,823.2,535.08,299.64,299.64,1
CDM,27404365_OP,CUSTOM GLOVE FOR TERM DEVICE,823.2,535.08,246.14,246.14,1
CDM,27404375,TRACH-ESOPH VOICE PROS MD IN,246.0,159.9,53.63,246.0,72
CDM,27404375_IP,TRACH-ESOPH VOICE PROS MD IN,246.0,159.9,89.54,89.54,1
CDM,27404375_OP,TRACH-ESOPH VOICE PROS MD IN,246.0,159.9,73.55,73.55,1
CDM,27404385,TRACH-ESOPH VOICE PROS MD IN,525.0,341.25,58.52,525.0,72
CDM,27404385_IP,TRACH-ESOPH VOICE PROS MD IN,525.0,341.25,191.1,191.1,1
CDM,27404385_OP,TRACH-ESOPH VOICE PROS MD IN,525.0,341.25,156.98,156.98,1
CDM,27404395,TRACH-ESOPH VOICE PROS  IN,419.0,272.35,58.52,419.0,72
CDM,27404395_IP,TRACH-ESOPH VOICE PROS  IN,419.0,272.35,152.52,152.52,1
CDM,27404395_OP,TRACH-ESOPH VOICE PROS  IN,419.0,272.35,125.28,125.28,1
CDM,27404405,"HMII SYSTEM CONTROLLER, 103696",4860.0,3159.0,1030.0,19595.16,73
CDM,27404405_IP,"HMII SYSTEM CONTROLLER, 103696",4860.0,3159.0,2663.28,2663.28,1
CDM,27404405_OP,"HMII SYSTEM CONTROLLER, 103696",4860.0,3159.0,2109.24,2109.24,1
CDM,27404415,"GOGEAR VEST ALL SZ, 1042XX",474.0,308.1,103.33,474.0,72
CDM,27404415_IP,"GOGEAR VEST ALL SZ, 1042XX",474.0,308.1,172.54,172.54,1
CDM,27404415_OP,"GOGEAR VEST ALL SZ, 1042XX",474.0,308.1,141.73,141.73,1
CDM,27404425,"HM SHOWER BAG, 104216/104232",277.5,180.38,60.5,385.65,72
CDM,27404425_IP,"HM SHOWER BAG, 104216/104232",277.5,180.38,101.01,101.01,1
CDM,27404425_OP,"HM SHOWER BAG, 104216/104232",277.5,180.38,82.97,82.97,1
CDM,27404435,"LVAD BATTERY 14V LI-ION, 2465",750.0,487.5,163.5,1491.52,72
CDM,27404435_IP,"LVAD BATTERY 14V LI-ION, 2465",750.0,487.5,273.0,273.0,1
CDM,27404435_OP,"LVAD BATTERY 14V LI-ION, 2465",750.0,487.5,224.25,224.25,1
CDM,27404445,14V LI-ION PATIENT CABLE,1485.0,965.25,200.93,1485.0,73
CDM,27404445_IP,14V LI-ION PATIENT CABLE,1485.0,965.25,813.78,813.78,1
CDM,27404445_OP,14V LI-ION PATIENT CABLE,1485.0,965.25,644.49,644.49,1
CDM,27404455,"LVAD ACCESSORY KIT, 106129",238.0,154.7,51.88,238.0,72
CDM,27404455_IP,"LVAD ACCESSORY KIT, 106129",238.0,154.7,86.63,86.63,1
CDM,27404455_OP,"LVAD ACCESSORY KIT, 106129",238.0,154.7,71.16,71.16,1
CDM,27404465,"TRAVEL CASE, 1260",224.0,145.6,48.83,232.66,72
CDM,27404465_IP,"TRAVEL CASE, 1260",224.0,145.6,81.54,81.54,1
CDM,27404465_OP,"TRAVEL CASE, 1260",224.0,145.6,66.98,66.98,1
CDM,27404475,"GOGEAR BAG, 106449,1042XX",390.0,253.5,85.02,390.0,72
CDM,27404475_IP,"GOGEAR BAG, 106449,1042XX",390.0,253.5,141.96,141.96,1
CDM,27404475_OP,"GOGEAR BAG, 106449,1042XX",390.0,253.5,116.61,116.61,1
CDM,27404485,PRESS ON FRESNELL PRISM,60.0,39.0,13.08,60.0,72
CDM,27404485_IP,PRESS ON FRESNELL PRISM,60.0,39.0,21.84,21.84,1
CDM,27404485_OP,PRESS ON FRESNELL PRISM,60.0,39.0,17.94,17.94,1
CDM,27404495,ABDOMINAL BINDERS,9.22,5.99,2.01,9.22,59
CDM,27404500,HORIZON 637 LSO LUMBAR BRACE,249.0,161.85,54.28,775.49,72
CDM,27404500_IP,HORIZON 637 LSO LUMBAR BRACE,249.0,161.85,90.64,90.64,1
CDM,27404500_OP,HORIZON 637 LSO LUMBAR BRACE,249.0,161.85,74.45,74.45,1
CDM,27405005,STATIC OR DYNAMI AFO PRE CST,89.25,58.01,19.46,89.25,72
CDM,27405005_IP,STATIC OR DYNAMI AFO PRE CST,89.25,58.01,32.49,32.49,1
CDM,27405005_OP,STATIC OR DYNAMI AFO PRE CST,89.25,58.01,26.69,26.69,1
CDM,27405015,RUBBER PESSARY ANY TYPE,58.0,37.7,11.14,58.0,72
CDM,27405015_IP,RUBBER PESSARY ANY TYPE,58.0,37.7,21.11,21.11,1
CDM,27405015_OP,RUBBER PESSARY ANY TYPE,58.0,37.7,17.34,17.34,1
CDM,27405025,NON-OSSEOINTEGRATED SND PROC,6000.0,3900.0,1030.0,6000.0,73
CDM,27405025_IP,NON-OSSEOINTEGRATED SND PROC,6000.0,3900.0,3288.0,3288.0,1
CDM,27405025_OP,NON-OSSEOINTEGRATED SND PROC,6000.0,3900.0,2604.0,2604.0,1
CDM,27405035,DONJOY REACTION KNEE BRACE,84.29,54.79,18.38,84.29,72
CDM,27405035_IP,DONJOY REACTION KNEE BRACE,84.29,54.79,30.68,30.68,1
CDM,27405035_OP,DONJOY REACTION KNEE BRACE,84.29,54.79,25.2,25.2,1
CDM,27405085,HEARTWARE CONTROLLER,8640.0,5616.0,1030.0,8640.0,65
CDM,27405085_IP,HEARTWARE CONTROLLER,8640.0,5616.0,4734.72,4734.72,1
CDM,27405085_OP,HEARTWARE CONTROLLER,8640.0,5616.0,3749.76,3749.76,1
CDM,27405095,"BATTERY HOLSTER, 103479/104234",592.5,385.13,129.17,592.5,72
CDM,27405095_IP,"BATTERY HOLSTER, 103479/104234",592.5,385.13,215.67,215.67,1
CDM,27405095_OP,"BATTERY HOLSTER, 103479/104234",592.5,385.13,177.16,177.16,1
CDM,27405305,SOFTBAND BA,6000.0,3900.0,1030.0,6000.0,73
CDM,27405305_IP,SOFTBAND BA,6000.0,3900.0,3288.0,3288.0,1
CDM,27405305_OP,SOFTBAND BA,6000.0,3900.0,2604.0,2604.0,1
CDM,27405345,"LVAD UNIV BATTER CHGR, 1440",9720.0,6318.0,1030.0,9720.0,65
CDM,27405345_IP,"LVAD UNIV BATTER CHGR, 1440",9720.0,6318.0,5326.56,5326.56,1
CDM,27405345_OP,"LVAD UNIV BATTER CHGR, 1440",9720.0,6318.0,4218.48,4218.48,1
CDM,27405OH,RPR PRIMARY TORN LIGM&/CAPSULE KNEE COLLATERAL,3632.0,2360.8,1.1,20863.78,144
CDM,27406025,FOOT PLASTIC HEEL STABILIZER,117.25,76.21,25.56,117.25,72
CDM,27406025_IP,FOOT PLASTIC HEEL STABILIZER,117.25,76.21,42.68,42.68,1
CDM,27406025_OP,FOOT PLASTIC HEEL STABILIZER,117.25,76.21,35.06,35.06,1
CDM,27406485,SHILEY TRACH TUBE,143.5,93.28,31.28,143.5,72
CDM,27406485_IP,SHILEY TRACH TUBE,143.5,93.28,52.23,52.23,1
CDM,27406485_OP,SHILEY TRACH TUBE,143.5,93.28,42.91,42.91,1
CDM,27406515,LARY BRUSHES,78.75,51.19,16.97,78.75,72
CDM,27406515_IP,LARY BRUSHES,78.75,51.19,28.67,28.67,1
CDM,27406515_OP,LARY BRUSHES,78.75,51.19,23.55,23.55,1
CDM,27406525,PROVOX ACTIVALVE,3015.0,1959.75,58.52,3015.0,73
CDM,27406525_IP,PROVOX ACTIVALVE,3015.0,1959.75,1652.22,1652.22,1
CDM,27406525_OP,PROVOX ACTIVALVE,3015.0,1959.75,1308.51,1308.51,1
CDM,27406605,EHOB BOOT,300.0,195.0,58.52,300.0,72
CDM,27406605_IP,EHOB BOOT,300.0,195.0,109.2,109.2,1
CDM,27406605_OP,EHOB BOOT,300.0,195.0,89.7,89.7,1
CDM,27406625,COMPRESSOGRIP ABOVE KNEE,40.0,26.0,8.72,40.0,72
CDM,27406625_IP,COMPRESSOGRIP ABOVE KNEE,40.0,26.0,14.56,14.56,1
CDM,27406625_OP,COMPRESSOGRIP ABOVE KNEE,40.0,26.0,11.96,11.96,1
CDM,27406635,COMPRESSOGRIP BELOW KNEE,40.0,26.0,8.72,40.0,72
CDM,27406635_IP,COMPRESSOGRIP BELOW KNEE,40.0,26.0,14.56,14.56,1
CDM,27406635_OP,COMPRESSOGRIP BELOW KNEE,40.0,26.0,11.96,11.96,1
CDM,27406685,THUMB SPICA,161.0,104.65,35.1,406.89,72
CDM,27406685_IP,THUMB SPICA,161.0,104.65,58.6,58.6,1
CDM,27406685_OP,THUMB SPICA,161.0,104.65,48.14,48.14,1
CDM,27406725,KNEE / DELUX,33.58,21.83,7.32,33.58,72
CDM,27406725_IP,KNEE / DELUX,33.58,21.83,12.22,12.22,1
CDM,27406725_OP,KNEE / DELUX,33.58,21.83,10.04,10.04,1
CDM,27406865,DYNAMIC COMPRESSION SYSTEM,3500.0,2275.0,16.97,3500.0,73
CDM,27406865_IP,DYNAMIC COMPRESSION SYSTEM,3500.0,2275.0,1918.0,1918.0,1
CDM,27406865_OP,DYNAMIC COMPRESSION SYSTEM,3500.0,2275.0,1519.0,1519.0,1
CDM,27406875,BRACE WRIST HW,240.0,156.0,52.32,406.89,72
CDM,27406875_IP,BRACE WRIST HW,240.0,156.0,87.36,87.36,1
CDM,27406875_OP,BRACE WRIST HW,240.0,156.0,71.76,71.76,1
CDM,27406885,SPLINT THUMB NC,93.0,60.45,20.27,93.0,72
CDM,27406885_IP,SPLINT THUMB NC,93.0,60.45,33.85,33.85,1
CDM,27406885_OP,SPLINT THUMB NC,93.0,60.45,27.81,27.81,1
CDM,27406895,SPLINT WRIST HW,70.0,45.5,15.26,70.0,72
CDM,27406895_IP,SPLINT WRIST HW,70.0,45.5,25.48,25.48,1
CDM,27406895_OP,SPLINT WRIST HW,70.0,45.5,20.93,20.93,1
CDM,27406905,TEEPEE THUMB MS,93.0,60.45,20.27,93.0,72
CDM,27406905_IP,TEEPEE THUMB MS,93.0,60.45,33.85,33.85,1
CDM,27406905_OP,TEEPEE THUMB MS,93.0,60.45,27.81,27.81,1
CDM,27406965,UE PREFAB HUMERAL BRACE,438.0,284.7,91.28,438.0,72
CDM,27406965_IP,UE PREFAB HUMERAL BRACE,438.0,284.7,99.59,99.59,1
CDM,27406965_OP,UE PREFAB HUMERAL BRACE,438.0,284.7,81.81,81.81,1
CDM,27406985,WHO PREFAB RADIUS/ULNA FX,140.0,91.0,30.52,980.32,72
CDM,27406985_IP,WHO PREFAB RADIUS/ULNA FX,140.0,91.0,50.96,50.96,1
CDM,27406985_OP,WHO PREFAB RADIUS/ULNA FX,140.0,91.0,41.86,41.86,1
CDM,27407015,HFO NO JOINTS PREFAB F+Q,47.0,30.55,10.25,47.0,72
CDM,27407015_IP,HFO NO JOINTS PREFAB F+Q,47.0,30.55,17.11,17.11,1
CDM,27407015_OP,HFO NO JOINTS PREFAB F+Q,47.0,30.55,14.05,14.05,1
CDM,27407025,EO PREFAB ELASTIC W METAL JOINTS,123.9,80.54,27.01,123.9,72
CDM,27407025_IP,EO PREFAB ELASTIC W METAL JOINTS,123.9,80.54,45.1,45.1,1
CDM,27407025_OP,EO PREFAB ELASTIC W METAL JOINTS,123.9,80.54,37.05,37.05,1
CDM,27407115,OA REACTION KNEE BRACE,135.0,87.75,29.43,135.0,72
CDM,27407115_IP,OA REACTION KNEE BRACE,135.0,87.75,12.57,12.57,1
CDM,27407115_OP,OA REACTION KNEE BRACE,135.0,87.75,10.32,10.32,1
CDM,27407135,WRIST SPLINT THUMB SPICA,172.0,111.8,16.97,172.0,72
CDM,27407135_IP,WRIST SPLINT THUMB SPICA,172.0,111.8,62.61,62.61,1
CDM,27407135_OP,WRIST SPLINT THUMB SPICA,172.0,111.8,51.43,51.43,1
CDM,27407145,LVAD MOBILE POWER UNIT CAT#107754,10800.0,7020.0,1030.0,10800.0,65
CDM,27407145_IP,LVAD MOBILE POWER UNIT CAT#107754,10800.0,7020.0,5918.4,5918.4,1
CDM,27407145_OP,LVAD MOBILE POWER UNIT CAT#107754,10800.0,7020.0,4687.2,4687.2,1
CDM,27407165,THUMB SPICA,161.0,104.65,35.1,406.89,72
CDM,27407165_IP,THUMB SPICA,161.0,104.65,58.6,58.6,1
CDM,27407165_OP,THUMB SPICA,161.0,104.65,48.14,48.14,1
CDM,27407175,"PROVOX 2 VOICE PROSTHESI, 4.5 MM",570.0,370.5,58.52,570.0,72
CDM,27407175_IP,"PROVOX 2 VOICE PROSTHESI, 4.5 MM",570.0,370.5,207.48,207.48,1
CDM,27407175_OP,"PROVOX 2 VOICE PROSTHESI, 4.5 MM",570.0,370.5,170.43,170.43,1
CDM,27407185,"PROVOX PLUG;  REPLACEMENT ONLY, EACH (INCLUDES PROVOX BRUSH)",78.0,50.7,17.0,78.0,72
CDM,27407185_IP,"PROVOX PLUG;  REPLACEMENT ONLY, EACH (INCLUDES PROVOX BRUSH)",78.0,50.7,28.39,28.39,1
CDM,27407185_OP,"PROVOX PLUG;  REPLACEMENT ONLY, EACH (INCLUDES PROVOX BRUSH)",78.0,50.7,23.32,23.32,1
CDM,27407195,PROVOX FREEHANDS FLEXIVOICE LIGHT,754.0,490.1,58.52,754.0,72
CDM,27407195_IP,PROVOX FREEHANDS FLEXIVOICE LIGHT,754.0,490.1,274.46,274.46,1
CDM,27407195_OP,PROVOX FREEHANDS FLEXIVOICE LIGHT,754.0,490.1,225.45,225.45,1
CDM,27407205,ELECTROLARYNX,550.0,357.5,119.9,1491.52,72
CDM,27407205_IP,ELECTROLARYNX,550.0,357.5,200.2,200.2,1
CDM,27407205_OP,ELECTROLARYNX,550.0,357.5,164.45,164.45,1
CDM,27407215,"BRUSH; REPLACEMENT ONLY,EACH",90.0,58.5,16.97,90.0,72
CDM,27407215_IP,"BRUSH; REPLACEMENT ONLY,EACH",90.0,58.5,32.76,32.76,1
CDM,27407215_OP,"BRUSH; REPLACEMENT ONLY,EACH",90.0,58.5,26.91,26.91,1
CDM,27407235,DONJOY X-ACT ROM ELBOW BRACE,144.15,93.7,31.42,1491.52,72
CDM,27407235_IP,DONJOY X-ACT ROM ELBOW BRACE,144.15,93.7,52.47,52.47,1
CDM,27407235_OP,DONJOY X-ACT ROM ELBOW BRACE,144.15,93.7,43.1,43.1,1
CDM,27407255,TROUBLESHOOTING DEVICE,87.5,56.88,16.97,87.5,72
CDM,27407255_IP,TROUBLESHOOTING DEVICE,87.5,56.88,31.85,31.85,1
CDM,27407255_OP,TROUBLESHOOTING DEVICE,87.5,56.88,26.16,26.16,1
CDM,27407265,LUMBAR ELASTIC SUPPORT,57.0,37.05,12.43,57.0,72
CDM,27407265_IP,LUMBAR ELASTIC SUPPORT,57.0,37.05,20.75,20.75,1
CDM,27407265_OP,LUMBAR ELASTIC SUPPORT,57.0,37.05,17.04,17.04,1
CDM,27407275,VIBRATION GLOVE/IMPACT,30.0,19.5,6.54,36.7,72
CDM,27407275_IP,VIBRATION GLOVE/IMPACT,30.0,19.5,10.92,10.92,1
CDM,27407275_OP,VIBRATION GLOVE/IMPACT,30.0,19.5,8.97,8.97,1
CDM,27407305,HEARTMATE 3 CONTROLLER AND EBB CAT#106531US,7425.0,4826.25,1030.0,19595.16,73
CDM,27407305_IP,HEARTMATE 3 CONTROLLER AND EBB CAT#106531US,7425.0,4826.25,4068.9,4068.9,1
CDM,27407305_OP,HEARTMATE 3 CONTROLLER AND EBB CAT#106531US,7425.0,4826.25,3222.45,3222.45,1
CDM,27407315,HEARTMATE MOBILE POWER UNIT CAT#107754,10800.0,7020.0,1030.0,10800.0,65
CDM,27407315_IP,HEARTMATE MOBILE POWER UNIT CAT#107754,10800.0,7020.0,5918.4,5918.4,1
CDM,27407315_OP,HEARTMATE MOBILE POWER UNIT CAT#107754,10800.0,7020.0,4687.2,4687.2,1
CDM,27407325,HEARTMATE UNIVERSAL BATTERY CHARGER CAT#1440,7776.0,5054.4,1030.0,7776.0,65
CDM,27407325_IP,HEARTMATE UNIVERSAL BATTERY CHARGER CAT#1440,7776.0,5054.4,4261.25,4261.25,1
CDM,27407325_OP,HEARTMATE UNIVERSAL BATTERY CHARGER CAT#1440,7776.0,5054.4,3374.78,3374.78,1
CDM,27407335,HEARTMATE MODULAR CABLE CAT#10652US,6682.0,4343.3,200.93,6682.0,73
CDM,27407335_IP,HEARTMATE MODULAR CABLE CAT#10652US,6682.0,4343.3,3661.74,3661.74,1
CDM,27407335_OP,HEARTMATE MODULAR CABLE CAT#10652US,6682.0,4343.3,2899.99,2899.99,1
CDM,27407345,HEARTMATE TRAVEL CASE CAT#1260,224.0,145.6,48.83,232.66,72
CDM,27407345_IP,HEARTMATE TRAVEL CASE CAT#1260,224.0,145.6,81.54,81.54,1
CDM,27407345_OP,HEARTMATE TRAVEL CASE CAT#1260,224.0,145.6,66.98,66.98,1
CDM,27407355,HEARTMATE 14 VOLT LI-ION BATTERIES SET OF 4 CAT#2465,2700.0,1755.0,588.6,2700.0,73
CDM,27407355_IP,HEARTMATE 14 VOLT LI-ION BATTERIES SET OF 4 CAT#2465,2700.0,1755.0,1479.6,1479.6,1
CDM,27407355_OP,HEARTMATE 14 VOLT LI-ION BATTERIES SET OF 4 CAT#2465,2700.0,1755.0,1171.8,1171.8,1
CDM,27407365,HEARTMATE 14 VOLT LI-ION BATTERY CLIPS SET OF 2 CAT#2865,1320.0,858.0,287.76,1320.0,72
CDM,27407365_IP,HEARTMATE 14 VOLT LI-ION BATTERY CLIPS SET OF 2 CAT#2865,1320.0,858.0,723.36,723.36,1
CDM,27407365_OP,HEARTMATE 14 VOLT LI-ION BATTERY CLIPS SET OF 2 CAT#2865,1320.0,858.0,572.88,572.88,1
CDM,27407375,HEARTMATE BATTERY HOLSTER CAT#104234,474.0,308.1,103.33,474.0,72
CDM,27407375_IP,HEARTMATE BATTERY HOLSTER CAT#104234,474.0,308.1,172.54,172.54,1
CDM,27407375_OP,HEARTMATE BATTERY HOLSTER CAT#104234,474.0,308.1,141.73,141.73,1
CDM,27407385,HEARTMATE GOGEAR CONSOLIDATED BAG L OR R CAT#106449,390.0,253.5,58.52,390.0,72
CDM,27407385_IP,HEARTMATE GOGEAR CONSOLIDATED BAG L OR R CAT#106449,390.0,253.5,141.96,141.96,1
CDM,27407385_OP,HEARTMATE GOGEAR CONSOLIDATED BAG L OR R CAT#106449,390.0,253.5,116.61,116.61,1
CDM,27407395,HEARTMATE SHOWER BAG CAT#104232,675.0,438.75,147.15,675.0,72
CDM,27407395_IP,HEARTMATE SHOWER BAG CAT#104232,675.0,438.75,245.7,245.7,1
CDM,27407395_OP,HEARTMATE SHOWER BAG CAT#104232,675.0,438.75,201.83,201.83,1
CDM,27407405,HEARTMATE STANDALONE BACK-UP BATTERY CAT#106128,750.0,487.5,163.5,1491.52,72
CDM,27407405_IP,HEARTMATE STANDALONE BACK-UP BATTERY CAT#106128,750.0,487.5,273.0,273.0,1
CDM,27407405_OP,HEARTMATE STANDALONE BACK-UP BATTERY CAT#106128,750.0,487.5,224.25,224.25,1
CDM,27407415,HEARTWARE PATIENT PACK CAT#1475,637.5,414.38,138.98,637.5,72
CDM,27407415_IP,HEARTWARE PATIENT PACK CAT#1475,637.5,414.38,232.05,232.05,1
CDM,27407415_OP,HEARTWARE PATIENT PACK CAT#1475,637.5,414.38,190.61,190.61,1
CDM,27407425,HEARTWARE BATTERY CHARGER CAT#1600US,8235.0,5352.75,1030.0,8235.0,65
CDM,27407425_IP,HEARTWARE BATTERY CHARGER CAT#1600US,8235.0,5352.75,4512.78,4512.78,1
CDM,27407425_OP,HEARTWARE BATTERY CHARGER CAT#1600US,8235.0,5352.75,3573.99,3573.99,1
CDM,27407435,HEARTWARE BATTERY CAT#1650DE,1125.0,731.25,245.25,1491.52,72
CDM,27407435_IP,HEARTWARE BATTERY CAT#1650DE,1125.0,731.25,409.5,409.5,1
CDM,27407435_OP,HEARTWARE BATTERY CAT#1650DE,1125.0,731.25,336.38,336.38,1
CDM,27407445,HEARTWARE SHOWER BAG CAT#2000US,450.0,292.5,98.1,450.0,72
CDM,27407445_IP,HEARTWARE SHOWER BAG CAT#2000US,450.0,292.5,163.8,163.8,1
CDM,27407445_OP,HEARTWARE SHOWER BAG CAT#2000US,450.0,292.5,134.55,134.55,1
CDM,27407455,HEARTWARE WAIST PACK 2050US,637.5,414.38,138.98,637.5,72
CDM,27407455_IP,HEARTWARE WAIST PACK 2050US,637.5,414.38,232.05,232.05,1
CDM,27407455_OP,HEARTWARE WAIST PACK 2050US,637.5,414.38,190.61,190.61,1
CDM,27407465,HEARTWARE SHOLDER PACK CAT#2060US,675.0,438.75,147.15,675.0,72
CDM,27407465_IP,HEARTWARE SHOLDER PACK CAT#2060US,675.0,438.75,245.7,245.7,1
CDM,27407465_OP,HEARTWARE SHOLDER PACK CAT#2060US,675.0,438.75,201.83,201.83,1
CDM,27407475,LVAD DRIVELINE CARE KIT PACK MCS (DAILY) CAT#SBA29VACCG,22.84,14.85,4.98,232.66,72
CDM,27407475_IP,LVAD DRIVELINE CARE KIT PACK MCS (DAILY) CAT#SBA29VACCG,22.84,14.85,8.31,8.31,1
CDM,27407475_OP,LVAD DRIVELINE CARE KIT PACK MCS (DAILY) CAT#SBA29VACCG,22.84,14.85,6.83,6.83,1
CDM,27407485,LVAD DRIVELINE CARE KIT PACK MCS (BIWEEKLY) CAT#03-6487,23.94,15.56,5.22,232.66,72
CDM,27407485_IP,LVAD DRIVELINE CARE KIT PACK MCS (BIWEEKLY) CAT#03-6487,23.94,15.56,8.71,8.71,1
CDM,27407485_OP,LVAD DRIVELINE CARE KIT PACK MCS (BIWEEKLY) CAT#03-6487,23.94,15.56,7.16,7.16,1
CDM,27407495,BOSTON SCIENTIFIC MAGIC TORQUE GUIDEWIRE,93.19,60.57,20.32,232.66,72
CDM,27407495_IP,BOSTON SCIENTIFIC MAGIC TORQUE GUIDEWIRE,93.19,60.57,33.92,33.92,1
CDM,27407495_OP,BOSTON SCIENTIFIC MAGIC TORQUE GUIDEWIRE,93.19,60.57,27.86,27.86,1
CDM,27407505,SLING & SWATHE,10.26,6.67,2.24,36.7,72
CDM,27407505_IP,SLING & SWATHE,10.26,6.67,3.73,3.73,1
CDM,27407505_OP,SLING & SWATHE,10.26,6.67,3.07,3.07,1
CDM,27407515,HO PREFAB HAND ORTHOSIS,185.5,120.58,40.44,185.5,72
CDM,27407515_IP,HO PREFAB HAND ORTHOSIS,185.5,120.58,67.52,67.52,1
CDM,27407515_OP,HO PREFAB HAND ORTHOSIS,185.5,120.58,55.46,55.46,1
CDM,27407545,"AUD OSSEO DEV, ABUTMENT",3360.0,2184.0,669.74,3360.0,73
CDM,27407545_IP,"AUD OSSEO DEV, ABUTMENT",3360.0,2184.0,1841.28,1841.28,1
CDM,27407545_OP,"AUD OSSEO DEV, ABUTMENT",3360.0,2184.0,1458.24,1458.24,1
CDM,27407605,FO STATIC FINGER CUSTOM,25.0,16.25,5.45,406.89,72
CDM,27407605_IP,FO STATIC FINGER CUSTOM,25.0,16.25,9.1,9.1,1
CDM,27407605_OP,FO STATIC FINGER CUSTOM,25.0,16.25,7.48,7.48,1
CDM,27407615,"FO STATIC-PROGRESSIVE, DYNAMIC CUSTOM",266.0,172.9,57.99,406.89,72
CDM,27407615_IP,"FO STATIC-PROGRESSIVE, DYNAMIC CUSTOM",266.0,172.9,96.82,96.82,1
CDM,27407615_OP,"FO STATIC-PROGRESSIVE, DYNAMIC CUSTOM",266.0,172.9,79.53,79.53,1
CDM,27407635,LUMBAR ORTHOSIS (LO),285.0,185.25,62.13,980.32,73
CDM,27407655,LUMBOSACRAL ORTHOSIS W/ CHAIRBACK (LSO) - CUSTOM (L0637),356.0,231.4,77.61,775.49,72
CDM,27407655_IP,LUMBOSACRAL ORTHOSIS W/ CHAIRBACK (LSO) - CUSTOM (L0637),356.0,231.4,129.58,129.58,1
CDM,27407655_OP,LUMBOSACRAL ORTHOSIS W/ CHAIRBACK (LSO) - CUSTOM (L0637),356.0,231.4,106.44,106.44,1
CDM,27407OH,REPAIR PRIMARY TORN LIGM&/CAPSULE KNEE CRUCIAT,4340.0,2821.0,1.1,20863.78,144
CDM,27408155,RGP POST GRAFT/SINGLE LENS,225.0,146.25,49.05,225.0,73
CDM,27408165,RGP SPHERE/SINGLE LENS,100.0,65.0,21.8,100.0,73
CDM,27408175,RGP KERATOCONUS/SINGLE LENS,225.0,146.25,49.05,225.0,73
CDM,27408185,RGP TORIC/SINGLE LENS,165.0,107.25,35.97,165.0,73
CDM,27408195,RGP MULTIFOCAL/SINGLE LENS,225.0,146.25,49.05,406.89,73
CDM,27408205,DAILES ACP 90PK,100.0,65.0,21.8,100.0,73
CDM,27408215,BIOFINITY XR,66.0,42.9,14.39,67.76,73
CDM,27408225,BIOTRUE ONE DAY 90 PK,93.0,60.45,20.27,93.0,73
CDM,27408235,ACUVUE 2,57.0,37.05,12.43,67.76,73
CDM,27408245,BIOMEDICS 55 PREMIER,64.0,41.6,13.95,67.76,73
CDM,27408255,CLARITI 1 DAY 90PK,90.0,58.5,19.62,90.0,73
CDM,27408265,MY DAY 90 PK,120.0,78.0,26.16,120.0,73
CDM,27408275,1 DAY ACUVUE MOIST ASTIG 90 PK,147.0,95.55,32.05,406.89,73
CDM,27408285,CLARITI 1 DAY TORIC 30PK,59.0,38.35,12.86,406.89,73
CDM,27408295,PROCLEAR TORIC,113.0,73.45,24.63,406.89,73
CDM,27408305,PROCLEAR TORIC XR 6PK.,200.0,130.0,43.6,406.89,73
CDM,27408315,BIOMEDICS TORIC,75.0,48.75,16.35,406.89,73
CDM,27408325,BIOFINITY TORIC,90.0,58.5,19.62,406.89,73
CDM,27408335,AIR OPTIX HYDRAGYLDE FOR ASTIG.,96.0,62.4,20.93,406.89,73
CDM,27408345,ACUVUE OASYS ASTIGMATISM,60.0,39.0,13.08,406.89,73
CDM,27408355,1 DAY ACUVUE MOIST ASTIG 30 PK,67.0,43.55,14.61,406.89,73
CDM,27408365,DAILIES ACP TORIC  90 PK,136.0,88.4,29.65,406.89,73
CDM,27408375,DAILIES ACP TORIC 30 PACK,53.0,34.45,11.55,406.89,73
CDM,27408385,BIOFINITY TORIC XR,167.0,108.55,36.41,406.89,73
CDM,27408395,DAILIES ACP MULTIF 90PK,157.0,102.05,34.23,406.89,73
CDM,27408405,AIR OPTIX HYDRAGYLDE MULTIFOCAL,147.0,95.55,32.05,406.89,73
CDM,27408415,SOFLENS MULTIFOCAL,116.0,75.4,25.29,406.89,73
CDM,27408425,DAILIES ACP MULTIF 30 PK,64.0,41.6,13.95,406.89,73
CDM,27408435,PROCLEAR MULTIFOCAL TORIC,240.0,156.0,52.32,406.89,73
CDM,27408445,BIOTRUE ONEDAY FOR PRESBYOPIA 30 PK,58.0,37.7,12.64,406.89,73
CDM,27408455,PROCLEAR MULTIFOCAL 6PK,130.0,84.5,28.34,406.89,73
CDM,27408465,CLARITI 1 DAY MF 30PK,60.0,39.0,13.08,406.89,73
CDM,27408475,PROCLEAR 1 DAY MF 90 PK,158.0,102.7,34.44,406.89,73
CDM,27408485,1 DAY ACUVUE M.F. 90 PK,139.0,90.35,30.3,406.89,73
CDM,27408495,CVUE ADV.MULTIFOCAL 6PK,225.0,146.25,49.05,406.89,73
CDM,27408505,BIOFINITY MULTIFOCAL,122.0,79.3,26.6,406.89,73
CDM,27408515,DAILIES TOTAL 1  90 PK,154.0,100.1,33.57,154.0,73
CDM,27408525,ULTRA,73.0,47.45,15.91,73.0,73
CDM,27408535,1-DAY ACUVUE MOIST 30PK,54.0,35.1,11.77,67.76,73
CDM,27408545,DAILIES TOTAL 1  30 PK,59.0,38.35,12.86,67.76,73
CDM,27408555,AIR OPTIX AQUA N& DAY,137.0,89.05,29.87,137.0,73
CDM,27408565,AIR OPTIX COLORS,163.0,105.95,35.53,163.0,73
CDM,27408575,SILSOFT,225.0,146.25,49.05,225.0,73
CDM,27408585,PROCLEAR 1 DAY 90 PK,113.0,73.45,24.63,113.0,73
CDM,27408595,BIOFINITY,66.0,42.9,14.39,406.89,73
CDM,27408605,1-DAY ACUVUE DEFINE 30 PK,59.0,38.35,12.86,67.76,73
CDM,27408615,1-DAY ACUVUE OASYS 90 PK,133.0,86.45,28.99,133.0,73
CDM,27408625,ACUVUE OASYS 24 PK,173.0,112.45,37.71,173.0,73
CDM,27408635,ACUVUE OASYS 12 PK,109.0,70.85,23.76,109.0,73
CDM,27408645,1-DAY ACUVUE MOIST 90 PK,100.0,65.0,21.8,100.0,73
CDM,27408655,FLEXLENS SPH.SILICONE 3PK,120.0,78.0,26.16,120.0,73
CDM,27408665,FLEXLENS SPH.CUSTOM 4PK,165.0,107.25,35.97,165.0,73
CDM,27408675,SYNERGEYES  U.H (SINGLE),350.0,227.5,76.3,385.65,73
CDM,27408685,SYNERGEYES DUE. EXT. PAR,380.0,247.0,82.84,385.65,73
CDM,27408695,SYNERGEYES DUE. PROG. SINGLE,200.0,130.0,43.6,385.65,73
CDM,27408705,SYNERGEYES DUETTE M.F SINGLE,180.0,117.0,39.24,385.65,73
CDM,27408715,SYNERGEYES DUETTE/SINGLE,165.0,107.25,35.97,385.65,73
CDM,27408725,SYNERGEYES A (SINGLE),300.0,195.0,65.4,385.65,73
CDM,27408735,SYNERGEYES A/ANNUAL,450.0,292.5,98.1,450.0,73
CDM,27408745,"SCLERAL LENS,WRNTD/SINGLE LENS",550.0,357.5,119.9,550.0,73
CDM,27408755,SYNERGEYES U.H/ANNUAL,600.0,390.0,130.8,600.0,73
CDM,27408765,SYNERGEYES CLEARCONE SINGLE,450.0,292.5,98.1,450.0,73
CDM,27408775,CUSTOM COLOR,400.0,260.0,16.97,400.0,73
CDM,27408785,CLARITI 1 DAY MF 90PK,134.0,87.1,29.21,406.89,73
CDM,27408795,ULTRA FOR PRESBYOPIA,124.0,80.6,27.03,124.0,73
CDM,27408805,ULTRA MF FOR ASTIGMATISM,185.0,120.25,40.33,406.89,73
CDM,27408825,ACUVUE VITA 6 PK,89.0,57.85,19.4,89.0,73
CDM,27408835,ACUVUE VITA 12 PK,142.0,92.3,30.96,142.0,73
CDM,27408845,ACUVUE VITA  ASTIG. 6 PK,89.0,57.85,19.4,406.89,73
CDM,27408855,CLARITI 1 DAY 30 PK,43.0,27.95,9.37,67.76,73
CDM,27408865,CLARITI 1 DAY TORIC 90 PK,128.0,83.2,27.9,406.89,73
CDM,27408875,PROCLEAR MF XR 6PK,205.0,133.25,44.69,406.89,73
CDM,27408885,MY DAY TORIC 90 PK,163.0,105.95,35.53,406.89,73
CDM,27408895,DAILIES ACP 30 PK,40.0,26.0,8.72,67.76,73
CDM,27408905,DAILIES COLORS 30 PK,51.0,33.15,11.12,67.76,73
CDM,27408915,DAILIES COLORS 90 PK,115.0,74.75,25.07,115.0,73
CDM,27408925,PRECISION 1 30 PK,48.0,31.2,10.46,67.76,73
CDM,27408935,SOFTLENS DAILY 90 PK,100.0,65.0,21.8,100.0,73
CDM,27408945,SOFTLENS - 6 PK,76.0,49.4,16.57,406.89,73
CDM,27408955,INFUSE 90 PK,137.0,89.05,29.87,137.0,73
CDM,27408965,NATURALVUE?SPHERE,60.0,39.0,13.08,67.76,73
CDM,27408975,NATURALVUE? MULTI,100.0,65.0,21.8,406.89,73
CDM,27408985,PRECISION 1 90 PK,103.0,66.95,22.45,103.0,73
CDM,27408995,BIOFINITY TORIC MF 6 PK,177.0,115.05,38.59,406.89,73
CDM,27409005,1 DAY ACUVUE OASYS ASTIG 30 PK,70.0,45.5,15.26,406.89,73
CDM,27409015,MISIGHT CONTACT LENS,475.0,308.75,103.55,475.0,73
CDM,27409025,ALDEN HP TORIC - SINGLE PACK,140.0,91.0,30.52,406.89,73
CDM,27409035,ALDEN HP TORIC - 3 PACK,140.0,91.0,30.52,406.89,73
CDM,27409045,ALDEN HP SPHERE - SINGLE PACK,76.0,49.4,16.57,76.0,73
CDM,27409055,ALDEN HP SPHERE - 3 PACK,76.0,49.4,16.57,76.0,73
CDM,27409065,BIOCOLORS PROSTHETIC,730.0,474.5,58.52,730.0,73
CDM,27409075,BIOCOLORS SPHERE,250.0,162.5,54.5,250.0,73
CDM,27409085,BIOCOLORS TORIC,310.0,201.5,67.58,406.89,73
CDM,27409095,COLOR MATCHING SERVICE,1000.0,650.0,16.97,1000.0,73
CDM,27409105,"INTELLIWAVE  (SINGLE, WRNTD.)",100.0,65.0,21.8,100.0,73
CDM,27409115,"INTELLIWAVE  (3-PK, ONLY NON-WRNTD.)",138.0,89.7,30.08,138.0,73
CDM,27409125,"INTELLIWAVE  TORIC (SINGLE, WRNTD.)",160.0,104.0,34.88,406.89,73
CDM,27409135,"INTELLIWAVE TORIC  (3-PK, ONLY NON-WRNTD.)",192.0,124.8,41.86,406.89,73
CDM,27409145,"INTELLIWAVE MULTI (SINGLE, WRNTD.)",210.0,136.5,45.78,406.89,73
CDM,27409155,"INTELLIWAVE  MULTI (3-PK, ONLY NON-WRNTD.)",240.0,156.0,52.32,406.89,73
CDM,27409165,"INTELLIWAVE  MF TORIC (SINGLE, WRNTD.)",230.0,149.5,50.14,406.89,73
CDM,27409175,"INTELLIWAVE  MF TORIC (3-PK, ONLY NON WTD)",300.0,195.0,65.4,406.89,73
CDM,27409185,SYNERGEYES ID/SINGLE,180.0,117.0,39.24,385.65,73
CDM,27409195,SYNERGEYES ID/ANNUAL,310.0,201.5,67.58,385.65,73
CDM,27409205,SYNERGEYES ID MULTIFOCAL EDOF*/SINGLE,225.0,146.25,49.05,385.65,73
CDM,27409215,SYNERGEYES ID MULTIFOCAL EDOF*/ANNUAL,350.0,227.5,76.3,385.65,73
CDM,27409225,1-DAY ACUVUE OASYS ASTIG 90 PK,167.0,108.55,36.41,406.89,73
CDM,27409235,ACUVUE OASYS MULTIFOCAL,65.0,42.25,14.17,406.89,73
CDM,27409245,MI SIGHT 1-DAY 180 PK,329.0,213.85,58.52,329.0,73
CDM,27409255,PRECISION 1 ONE DAY ASTIG 30 PK,59.0,38.35,12.86,406.89,73
CDM,27409265,PRECISION 1 ONE DAY ASTIG 90 PK,126.0,81.9,27.47,406.89,73
CDM,27409275,1 DAY ACUVUE MOIST  MF 30 PK,89.0,57.85,19.4,406.89,73
CDM,27409285,1 DAY ACUVUE MOIST MF 90 PK,165.0,107.25,35.97,406.89,73
CDM,27409295,BIOTRUE ONE DAY 30PK,38.0,24.7,8.28,67.76,73
CDM,27409305,INFUSE FOR ASTIG 90PK,165.0,107.25,35.97,406.89,73
CDM,27409315,INFUSE MF 90PK,187.0,121.55,40.77,406.89,73
CDM,27409325,ACUVUE OASYS 1-DAY MAX 30 PK,70.0,45.5,15.26,70.0,73
CDM,27409335,ACUVUE OASYS 1-DAY MAX 90 PK,151.0,98.15,32.92,151.0,73
CDM,27409345,ACUVUE OASYS 1-DAY MAX  MULTIFOCAL 30 PK,87.0,56.55,18.97,406.89,73
CDM,27409355,ACUVUE OASYS 1-DAY MAX  MULTIFOCAL 90 PK,195.0,126.75,42.51,406.89,73
CDM,27409365,DAILIES TOTAL 1 FOR ASTIG 30 PK,71.0,46.15,15.48,406.89,73
CDM,27409375,DAILIES TOTAL 1 FOR ASTIG 90 PK,184.0,119.6,40.11,406.89,73
CDM,27409385,MISIGHT 1 DAY 90 PK,165.0,107.25,35.97,165.0,73
CDM,27409395,MY DAY MF 90 PK,182.0,118.3,39.68,406.89,73
CDM,27409405,PRECISION 1 ONE DAY ASTIG 30 PK,60.0,39.0,13.08,406.89,73
CDM,27409415,PRECISION 1 ONE DAY ASTIG 90 PK,130.0,84.5,28.34,406.89,73
CDM,27409425,PROCLEAR SPHERE,91.0,59.15,19.84,91.0,73
CDM,27409435,TOTAL 30  SPHERE 6 PK,76.0,49.4,16.57,76.0,73
CDM,27409445,TOTAL 30 TORIC 6 PK,92.0,59.8,20.06,406.89,73
CDM,27409455,TOTAL 30 MF 6 PK,129.0,83.85,28.12,406.89,73
CDM,27409465,ACUVUE BANDAGE PLANO 6PK,48.0,31.2,10.46,67.76,73
CDM,27409475,PRECISION 7 12 PK,61.0,39.65,13.3,67.76,73
CDM,27409485,PRECISION 7 27 PK,101.0,65.65,22.02,101.0,73
CDM,27409495,PRECISION 7 FOR ASTIG 27PK,126.0,81.9,27.47,406.89,73
CDM,27409505,MISIGHT 1 DAY 180 X 2 (6 MONTH),555.0,360.75,58.52,555.0,73
CDM,27409515,AVAIRA VITALITY 6 PK,50.0,32.5,10.9,67.76,73
CDM,27409525,BIOTRUE ONE DAY FOR ASTIGMATISM (30 PK),48.0,31.2,10.46,406.89,73
CDM,27409535,ULTRA FOR ASTIGMATISM,90.0,58.5,19.62,406.89,73
CDM,27409545,AVAIRA VITALITY TORIC 6 PK,60.0,39.0,13.08,406.89,73
CDM,27409555,DAILIES TOTAL 1 MULTIFOCAL 30 PACK,75.0,48.75,16.35,406.89,73
CDM,27409565,DAILIES TOTAL 1 MULTIFOCAL 90 PACK,197.0,128.05,42.95,406.89,73
CDM,27409575,BIOTRUE ONE DAY FOR ASTIGMATISM (90 PK),127.0,82.55,27.69,406.89,73
CDM,27409585,BIOTRUE ONEDAY FOR PRESBYOPIA (90 PK),149.0,96.85,32.48,406.89,73
CDM,27409595,AIR OPTIX PLUS HYDRAGYLDE,77.0,50.05,16.79,77.0,73
CDM,27409605,BIOFINITY ENERGYS,71.0,46.15,15.48,71.0,73
CDM,27409615,MY DAY 180 PK,212.0,137.8,46.22,212.0,73
CDM,27409625,SYNERGEYES CLEARCONE/ANNUAL,600.0,390.0,130.8,600.0,73
CDM,27409635,SYNERGEYES KC/SINGLE,450.0,292.5,98.1,450.0,73
CDM,27409645,SYNERGEYES PS/SINGLE,375.0,243.75,81.75,385.65,73
CDM,27409655,SYNERGES SCLERAL VS,475.0,308.75,103.55,475.0,73
CDM,27409665,ULTRAHEALTH FC / SINGLE,430.0,279.5,93.74,430.0,73
CDM,27409675,ULTRAHEALTH FC /ANNUAL/PER EYE,600.0,390.0,130.8,600.0,73
CDM,27409685,SYNERGEYES DUE. PROG (.ANNUAL),340.0,221.0,74.12,385.65,73
CDM,27409695,SYNERGEYES DUETTE (ANNUAL),300.0,195.0,65.4,385.65,73
CDM,27409705,SYNERGEYES DUETTE M.F (ANNUAL),340.0,221.0,74.12,385.65,73
CDM,27409715,SYNERGEYES KC (ANNUAL),600.0,390.0,130.8,600.0,73
CDM,27409725,SYNERGEYES PS (ANNUAL),600.0,390.0,130.8,600.0,73
CDM,27409735,RGP ORTHO-K WARRANTED/SINGLE,300.0,195.0,65.4,385.65,73
CDM,27409745,POLISHING/RESURFACING OCULAR PROSTHESIS,99.0,64.35,21.58,99.0,73
CDM,27409755,FRESNEL PRISM PRESS-ON LENS,60.0,39.0,13.08,60.0,73
CDM,27409775,ACUVUE OASYS 1-DAY MAX ASTIG 30 PK,59.0,38.35,12.86,406.89,73
CDM,27409785,ACUVUE OASYS 1-DAY MAX ASTIG MULTIFOCAL 30PK,70.0,45.5,15.26,406.89,73
CDM,27409795,PRECISION 7 FOR ASTIG 12PK,76.0,49.4,16.57,406.89,73
CDM,27409805,"SCLERAL, SPECIALTY, 1 LENS",700.0,455.0,152.6,700.0,73
CDM,27409815,"KNEE ORTHOSIS (KO), SINGLE UPRIGHT CUSTOM FABRICATED",950.0,617.5,207.1,950.0,73
CDM,27409825,CLARITI 1 DAY 180 PK,152.0,98.8,33.14,152.0,73
CDM,27409835,CLARITI 1 DAY MF 3 ADD 30 PK,69.0,44.85,15.04,406.89,73
CDM,27409845,CLARITI 1 DAY MF 3 ADD 90 PK,150.0,97.5,32.7,406.89,73
CDM,27409855,MY DAY ENERGYS 90 PK,140.0,91.0,30.52,140.0,73
CDM,27409865,PRECISION 7 FOR ASTIG 12PK,76.0,49.4,16.57,406.89,73
CDM,27409875,TOTAL 30 MF TORIC 6 PK,163.0,105.95,35.53,406.89,73
CDM,27409OH,RPR 1 TORN LIGM&/CAPSL KNE COLTRL&CRUCIATE,5484.0,3564.6,1.1,20863.78,144
CDM,27412OH,AUTOLOGOUS CHONDROCYTE IMPLANTATION KNEE,9896.0,6432.4,1.1,20863.78,144
CDM,27415OH,OSTEOCHONDRAL KNEE ALLOGRAFT,8000.0,5200.0,1.1,38384.94,144
CDM,27416OH,OSTEOCHONDRAL AUTOGRAFT KNEE OPEN MOSAICPLASTY,5664.0,3681.6,1.1,20863.78,142
CDM,27418OH,ANTERIOR TIBIAL TUBERCLEPLASTY,4640.0,3016.0,1.1,20863.78,144
CDM,27420OH,RCNSTJ DISLOCATING PATELLA,4104.0,2667.6,1.1,20863.78,144
CDM,27422OH,RCNSTJ DISLC PATELLA W/XTNSR RELIGNMT&/MUSC RL,4084.0,2654.6,1.1,20863.78,144
CDM,27424OH,RCNSTJ DISLC PATELLA W/PATELLECTOMY,4096.0,2662.4,1.1,20863.78,144
CDM,27425OH,LATERAL RETINACULAR RELEASE OPEN,2156.0,1401.4,1.1,9440.12,144
CDM,27427OH,LIGAMENTOUS RECONSTRUCTION KNEE EXTRA-ARTICULAR,3916.0,2545.4,1.1,20863.78,144
CDM,27428OH,LIGAMENTOUS RECONSTRUCTION KNEE INTRA-ARTICULAR,6232.0,4050.8,1.1,38384.94,144
CDM,27429OH,LIGMOUS RCNSTJ AGMNTJ KNE INTRA-ARTICULAR XTR,7016.0,4560.4,1.1,38384.94,144
CDM,27430OH,QUADRICEPSPLASTY,4064.0,2641.6,1.1,20863.78,144
CDM,27435OH,CAPSULOTOMY POSTERIOR CAPSULAR RELEASE KNEE,4352.0,2828.8,1.1,9440.12,144
CDM,27437OH,ARTHROPLASTY PATELLA W/O PROSTHESIS,3572.0,2321.8,1.1,20863.78,144
CDM,27438OH,ARTHROPLASTY PATELLA W/PROSTHESIS,4756.0,3091.4,1.1,38384.94,144
CDM,27441OH,ARTHRP KNEE TIBIAL PLATEAU DBRDMT&PRTL SYNVCT,4616.0,3000.4,1.1,38384.94,144
CDM,27442OH,ARTHROPLASTY FEM CONDYLES/TIBIAL PLATEAU KNEE,4948.0,3216.2,1.1,38384.94,144
CDM,27446OH,ARTHRP KNEE CONDYLE&PLATEAU MEDIAL/LAT CMPRT,6852.0,4453.8,1.1,38384.94,144
CDM,27447OH,ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS,7840.0,5096.0,1.1,38384.94,144
CDM,27448OH,OSTEOTOMY FEMUR SHAFT/SUPRACONDYLAR W/O FIXATION,4640.0,3016.0,1.1,4640.0,144
CDM,27450OH,OSTEOTOMY FEMUR SHAFT/SUPRACONDYLAR W/FIXATION,5844.0,3798.6,1.1,5844.0,144
CDM,27454OH,OSTEOT MLT W/RELIGNMT IMED ROD FEM SHFT,7668.0,4984.2,1.1,7668.0,144
CDM,27455OH,OSTEOT PROX TIBIA FIB EXC/OSTEOT BEFORE EPIPHYSL,5344.0,3473.6,1.1,5344.0,144
CDM,27457OH,OSTEOT PROX TIBIA FIB EXC/OSTEOT AFTER EPIPHYSL,5612.0,3647.8,1.1,5612.0,144
CDM,27458OH,OSTEOT FEMUR UNI INSJ XTRNL CTRLD IMED LNGTH DEV,11726.0,7621.9,1.1,11726.0,106
CDM,27465OH,OSTEOPLASTY FEMUR SHORTENING EXCLUDING 64876,7440.0,4836.0,1.1,7440.0,144
CDM,27466OH,OSTEOPLASTY FEMUR LENGTHENING,6912.0,4492.8,1.1,6912.0,144
CDM,27470OH,RPR NON/MAL FEMUR DSTL H/N W/O GRF,6856.0,4456.4,1.1,6856.0,144
CDM,27472OH,RPR NON/MAL FEMUR DSTL H/N W/ILIAC/AUTOG BONE,8237.0,5354.05,1.1,8237.0,144
CDM,27475OH,ARREST EPIPHYSEAL DISTAL FEMUR,3572.0,2321.8,1.1,20863.78,144
CDM,27477OH,ARREST EPIPHYSEAL TIBIA & FIBULA PROXIMAL,4056.0,2636.4,1.1,20863.78,144
CDM,27479OH,ARRST EPIPHYSL CMBN DSTL FEMUR PROX TIBFIB,5264.0,3421.6,1.1,20863.78,144
CDM,27485OH,ARRST HEMIEPIPHYSL DSTL FEMUR/PROX TIBIA/FIBULA,3652.0,2373.8,1.1,20863.78,144
CDM,27486OH,REVJ TOTAL KNEE ARTHRP W/WO ALGRFT 1 COMPONENT,8448.0,5491.2,1.1,8448.0,144
CDM,27487OH,REVJ TOT KNEE ARTHRP FEM&ENTIRE TIBIAL COMPONE,10844.0,7048.6,1.1,10844.0,144
CDM,27488OH,RMVL PROSTH TOT KNEE PROSTH MMA W/WO INSJ SPACER,7040.0,4576.0,1.1,7040.0,144
CDM,27495OH,PROPH TX N/P/PLTWR W/WO METHYLMETHACRYLATE FEMUR,6616.0,4300.4,1.1,6616.0,144
CDM,27496OH,DECOMPRESSION FASCIOTOMY THIGH&/KNEE 1 COMPONENT,2712.0,1762.8,1.1,9440.12,144
CDM,27497OH,DCMPRN FASCT THIGH&/KNEE DBRDMT MUSCLE&/NERVE,3116.0,2025.4,1.1,9440.12,144
CDM,27498OH,DCMPRN FASCIOTOMY THIGH&/KNEE MLT COMPARTMENTS,3464.0,2251.6,1.1,4686.39,144
CDM,27499OH,DCMPRN FASCT THIGH&/KNEE MLT DBRDMT NV MUSC&NRVE,3772.0,2451.8,1.1,20863.78,144
CDM,27500010,W DEFIBRILLATOR CONCERTO,31000.0,20150.0,200.93,31000.0,73
CDM,27500010_IP,W DEFIBRILLATOR CONCERTO,31000.0,20150.0,16988.0,16988.0,1
CDM,27500010_OP,W DEFIBRILLATOR CONCERTO,31000.0,20150.0,13454.0,13454.0,1
CDM,27500030,W ICD CURRENT DR 220736,26000.0,16900.0,200.93,26000.0,73
CDM,27500030_IP,W ICD CURRENT DR 220736,26000.0,16900.0,14248.0,14248.0,1
CDM,27500030_OP,W ICD CURRENT DR 220736,26000.0,16900.0,11284.0,11284.0,1
CDM,27500040,W LD FNLINEII STRX EZ4472/4473,858.0,557.7,187.04,858.0,72
CDM,27500040_IP,W LD FNLINEII STRX EZ4472/4473,858.0,557.7,312.31,312.31,1
CDM,27500040_OP,W LD FNLINEII STRX EZ4472/4473,858.0,557.7,256.54,256.54,1
CDM,27500075,S-ICDR,26000.0,16900.0,200.93,26000.0,73
CDM,27500075_IP,S-ICDR,26000.0,16900.0,14248.0,14248.0,1
CDM,27500075_OP,S-ICDR,26000.0,16900.0,11284.0,11284.0,1
CDM,27500095,"LEAD,DEFIB(ENDOCARD)DUAL COIL",7550.0,4907.5,200.93,7550.0,73
CDM,27500095_IP,"LEAD,DEFIB(ENDOCARD)DUAL COIL",7550.0,4907.5,4137.4,4137.4,1
CDM,27500095_OP,"LEAD,DEFIB(ENDOCARD)DUAL COIL",7550.0,4907.5,3276.7,3276.7,1
CDM,27500105,SUB Q ELECTRODE ICD,8000.0,5200.0,200.93,8000.0,73
CDM,27500105_IP,SUB Q ELECTRODE ICD,8000.0,5200.0,4384.0,4384.0,1
CDM,27500105_OP,SUB Q ELECTRODE ICD,8000.0,5200.0,3472.0,3472.0,1
CDM,27500115,LEAD LT VENT VENOUS TIER III,7760.0,5044.0,200.93,7760.0,73
CDM,27500115_IP,LEAD LT VENT VENOUS TIER III,7760.0,5044.0,4252.48,4252.48,1
CDM,27500115_OP,LEAD LT VENT VENOUS TIER III,7760.0,5044.0,3367.84,3367.84,1
CDM,27500215,LEAD PACEMAKER TIER II,3100.0,2015.0,200.93,3100.0,73
CDM,27500215_IP,LEAD PACEMAKER TIER II,3100.0,2015.0,1698.8,1698.8,1
CDM,27500215_OP,LEAD PACEMAKER TIER II,3100.0,2015.0,1345.4,1345.4,1
CDM,27500225,LEAD PACEMAKER TIER III,5800.0,3770.0,200.93,5800.0,73
CDM,27500225_IP,LEAD PACEMAKER TIER III,5800.0,3770.0,3178.4,3178.4,1
CDM,27500225_OP,LEAD PACEMAKER TIER III,5800.0,3770.0,2517.2,2517.2,1
CDM,27500230,LEAD ICD TIER I,13250.0,8612.5,200.93,13250.0,73
CDM,27500230_IP,LEAD ICD TIER I,13250.0,8612.5,345.8,345.8,1
CDM,27500230_OP,LEAD ICD TIER I,13250.0,8612.5,284.05,284.05,1
CDM,27500235,SUB-Q ICD IMPLANT TIER 2,32000.0,20800.0,200.93,32000.0,73
CDM,27500235_IP,SUB-Q ICD IMPLANT TIER 2,32000.0,20800.0,17536.0,17536.0,1
CDM,27500235_OP,SUB-Q ICD IMPLANT TIER 2,32000.0,20800.0,13888.0,13888.0,1
CDM,27500245,LEAD ICD TIER III,8030.0,5219.5,200.93,8030.0,73
CDM,27500245_IP,LEAD ICD TIER III,8030.0,5219.5,4400.44,4400.44,1
CDM,27500245_OP,LEAD ICD TIER III,8030.0,5219.5,3485.02,3485.02,1
CDM,27500255,PACEMAKER SGL CHAMBER TIER III,7200.0,4680.0,200.93,7200.0,73
CDM,27500255_IP,PACEMAKER SGL CHAMBER TIER III,7200.0,4680.0,3945.6,3945.6,1
CDM,27500255_OP,PACEMAKER SGL CHAMBER TIER III,7200.0,4680.0,3124.8,3124.8,1
CDM,27500265,PACEMAKER DUAL CHMBR TIER III,9354.0,6080.1,200.93,9354.0,73
CDM,27500265_IP,PACEMAKER DUAL CHMBR TIER III,9354.0,6080.1,5125.99,5125.99,1
CDM,27500265_OP,PACEMAKER DUAL CHMBR TIER III,9354.0,6080.1,4059.64,4059.64,1
CDM,27500275,ICD  DUAL CHAMBER TIER II,28500.0,18525.0,200.93,28500.0,73
CDM,27500275_IP,ICD  DUAL CHAMBER TIER II,28500.0,18525.0,15618.0,15618.0,1
CDM,27500275_OP,ICD  DUAL CHAMBER TIER II,28500.0,18525.0,12369.0,12369.0,1
CDM,27500280,ICD SINGLE CHAMBER TIER II,26000.0,16900.0,200.93,26000.0,73
CDM,27500280_IP,ICD SINGLE CHAMBER TIER II,26000.0,16900.0,14248.0,14248.0,1
CDM,27500280_OP,ICD SINGLE CHAMBER TIER II,26000.0,16900.0,11284.0,11284.0,1
CDM,27500285,ICD SINGLE CHAMBER TIER III,36000.0,23400.0,200.93,36000.0,73
CDM,27500285_IP,ICD SINGLE CHAMBER TIER III,36000.0,23400.0,19728.0,19728.0,1
CDM,27500285_OP,ICD SINGLE CHAMBER TIER III,36000.0,23400.0,15624.0,15624.0,1
CDM,27500290,BI V ICD TIER II,40000.0,26000.0,200.93,40000.0,73
CDM,27500290_IP,BI V ICD TIER II,40000.0,26000.0,21920.0,21920.0,1
CDM,27500290_OP,BI V ICD TIER II,40000.0,26000.0,17360.0,17360.0,1
CDM,27500295,LEAD LT VENT VENOUS TIER I,4050.0,2632.5,200.93,4050.0,73
CDM,27500295_IP,LEAD LT VENT VENOUS TIER I,4050.0,2632.5,2219.4,2219.4,1
CDM,27500295_OP,LEAD LT VENT VENOUS TIER I,4050.0,2632.5,1757.7,1757.7,1
CDM,27500300,SUB Q ELECTRODE ICD TIER I,3200.0,2080.0,200.93,3200.0,73
CDM,27500300_IP,SUB Q ELECTRODE ICD TIER I,3200.0,2080.0,1753.6,1753.6,1
CDM,27500300_OP,SUB Q ELECTRODE ICD TIER I,3200.0,2080.0,1388.8,1388.8,1
CDM,27500325,SUB Q ELECTRODE ICD TIER 0,1275.0,828.75,200.93,1275.0,72
CDM,27500325_IP,SUB Q ELECTRODE ICD TIER 0,1275.0,828.75,698.7,698.7,1
CDM,27500325_OP,SUB Q ELECTRODE ICD TIER 0,1275.0,828.75,553.35,553.35,1
CDM,27500335,SUB-Q ICD IMPLANT TIER 1,3400.0,2210.0,200.93,3400.0,73
CDM,27500335_IP,SUB-Q ICD IMPLANT TIER 1,3400.0,2210.0,1863.2,1863.2,1
CDM,27500335_OP,SUB-Q ICD IMPLANT TIER 1,3400.0,2210.0,1475.6,1475.6,1
CDM,27500340,W PACEMAKER ACCENT DR 2110,9354.0,6080.1,200.93,9354.0,73
CDM,27500340_IP,W PACEMAKER ACCENT DR 2110,9354.0,6080.1,5125.99,5125.99,1
CDM,27500340_OP,W PACEMAKER ACCENT DR 2110,9354.0,6080.1,4059.64,4059.64,1
CDM,27500345,PACEMAKER SGL CHAMBER TIER II,6030.0,3919.5,200.93,6030.0,73
CDM,27500345_IP,PACEMAKER SGL CHAMBER TIER II,6030.0,3919.5,3304.44,3304.44,1
CDM,27500345_OP,PACEMAKER SGL CHAMBER TIER II,6030.0,3919.5,2617.02,2617.02,1
CDM,27500355,PACEMAKER DUAL CHAMBR TIER II,15938.0,10359.7,200.93,15938.0,73
CDM,27500355_IP,PACEMAKER DUAL CHAMBR TIER II,15938.0,10359.7,4055.2,4055.2,1
CDM,27500355_OP,PACEMAKER DUAL CHAMBR TIER II,15938.0,10359.7,3211.6,3211.6,1
CDM,27500365,ICD DUAL CHAMBER TIER I,26000.0,16900.0,200.93,26000.0,73
CDM,27500365_IP,ICD DUAL CHAMBER TIER I,26000.0,16900.0,14248.0,14248.0,1
CDM,27500365_OP,ICD DUAL CHAMBER TIER I,26000.0,16900.0,11284.0,11284.0,1
CDM,27500375,PACEMAKER DUAL CHAMBER TIER 0,5800.0,3770.0,200.93,5800.0,73
CDM,27500375_IP,PACEMAKER DUAL CHAMBER TIER 0,5800.0,3770.0,3178.4,3178.4,1
CDM,27500375_OP,PACEMAKER DUAL CHAMBER TIER 0,5800.0,3770.0,2517.2,2517.2,1
CDM,27500405,C1786 PM SGL CHAMBER TIER  5,19000.0,12350.0,200.93,19000.0,73
CDM,27500405_IP,C1786 PM SGL CHAMBER TIER  5,19000.0,12350.0,10412.0,10412.0,1
CDM,27500405_OP,C1786 PM SGL CHAMBER TIER  5,19000.0,12350.0,8246.0,8246.0,1
CDM,27500440,W PM ACCENT SR,5100.0,3315.0,200.93,5100.0,73
CDM,27500440_IP,W PM ACCENT SR,5100.0,3315.0,2794.8,2794.8,1
CDM,27500440_OP,W PM ACCENT SR,5100.0,3315.0,2213.4,2213.4,1
CDM,27500OH,CLOSED TX FEMORAL SHAFT FX W/O MANIPULATION,2520.0,1638.0,1.1,2520.0,148
CDM,27501150,PACEMAKER CONSULTA CRT-P,16000.0,10400.0,200.93,16000.0,73
CDM,27501150_IP,PACEMAKER CONSULTA CRT-P,16000.0,10400.0,8768.0,8768.0,1
CDM,27501150_OP,PACEMAKER CONSULTA CRT-P,16000.0,10400.0,6944.0,6944.0,1
CDM,27501355,"LEAD, AICD, ENDO SINGLE COIL LVL 7",9261.0,6019.65,200.93,9261.0,73
CDM,27501355_IP,"LEAD, AICD, ENDO SINGLE COIL LVL 7",9261.0,6019.65,5075.03,5075.03,1
CDM,27501355_OP,"LEAD, AICD, ENDO SINGLE COIL LVL 7",9261.0,6019.65,4019.27,4019.27,1
CDM,27501485,OPTIMIZER SMART MINI,78000.0,50700.0,200.93,78000.0,73
CDM,27501485_IP,OPTIMIZER SMART MINI,78000.0,50700.0,42744.0,42744.0,1
CDM,27501485_OP,OPTIMIZER SMART MINI,78000.0,50700.0,33852.0,33852.0,1
CDM,27501495,"LEAD, AICD, ENDO SINGLE COIL, T69",6900.0,4485.0,200.93,6900.0,73
CDM,27501495_IP,"LEAD, AICD, ENDO SINGLE COIL, T69",6900.0,4485.0,3781.2,3781.2,1
CDM,27501495_OP,"LEAD, AICD, ENDO SINGLE COIL, T69",6900.0,4485.0,2994.6,2994.6,1
CDM,27501515,AVEIR LEADLESS AR PACEMAKER,37950.0,24667.5,200.93,37950.0,74
CDM,27501525,AVEIR LEADLESS DUAL PACEMAKER,61950.0,40267.5,200.93,61950.0,74
CDM,27501545,AVEIR LEADLESS VENTRICAL PACEMAKER,24000.0,15600.0,200.93,24000.0,74
CDM,27501555,GALLANT VR IMPLANTABLE CARDIOVERTER DEFIBRILLATOR,17250.0,11212.5,200.93,17250.0,74
CDM,27501565,AVEIR DUAL CHAMBER LEADLESS PACEMAKER SYSTEM MFG DR-SYSTEM-AVEIR,61950.0,40267.5,200.93,61950.0,74
CDM,27501575,AVEIR AR LEADLESS PACER SYSTEM MFG AR-SYSTEM-AVEIR,37950.0,24667.5,200.93,37950.0,74
CDM,27501585,AVEIR VR LEADLESS PACER SYSTEM MFG VR-SYSTEM-AVEIR,24000.0,15600.0,200.93,24000.0,74
CDM,27501725,PACEMAKER DUAL CHAMBER TIER I,6174.0,4013.1,200.93,6174.0,73
CDM,27501725_IP,PACEMAKER DUAL CHAMBER TIER I,6174.0,4013.1,3383.35,3383.35,1
CDM,27501725_OP,PACEMAKER DUAL CHAMBER TIER I,6174.0,4013.1,2679.52,2679.52,1
CDM,27501765,C1786 PM SGL CHAMBER TIER III,7200.0,4680.0,200.93,7200.0,73
CDM,27501765_IP,C1786 PM SGL CHAMBER TIER III,7200.0,4680.0,3945.6,3945.6,1
CDM,27501765_OP,C1786 PM SGL CHAMBER TIER III,7200.0,4680.0,3124.8,3124.8,1
CDM,27501775,C1786 PM SGL CHAMBER TIER 4,11000.0,7150.0,200.93,11000.0,73
CDM,27501775_IP,C1786 PM SGL CHAMBER TIER 4,11000.0,7150.0,6028.0,6028.0,1
CDM,27501775_OP,C1786 PM SGL CHAMBER TIER 4,11000.0,7150.0,4774.0,4774.0,1
CDM,27501OH,CLTX SPRCNDYLR/TRNSCNDYLR FEM FX W/O MANJ,2580.0,1677.0,1.1,2580.0,148
CDM,27502OH,CLTX FEM SHFT FX W/MANJ W/WO SKIN/SKELETAL TRACJ,4544.0,2953.6,1.1,4686.39,144
CDM,27503495,LEAD ICD SINGLE COIL LVL 2,5200.0,3380.0,200.93,5200.0,73
CDM,27503495_IP,LEAD ICD SINGLE COIL LVL 2,5200.0,3380.0,2849.6,2849.6,1
CDM,27503495_OP,LEAD ICD SINGLE COIL LVL 2,5200.0,3380.0,2256.8,2256.8,1
CDM,27503585,CRT-D TIER 3,26800.0,17420.0,200.93,26800.0,73
CDM,27503585_IP,CRT-D TIER 3,26800.0,17420.0,14686.4,14686.4,1
CDM,27503585_OP,CRT-D TIER 3,26800.0,17420.0,11631.2,11631.2,1
CDM,27503755,"LEADLESS PACEMAKER, VENT",16000.0,10400.0,200.93,16000.0,73
CDM,27503755_IP,"LEADLESS PACEMAKER, VENT",16000.0,10400.0,8768.0,8768.0,1
CDM,27503755_OP,"LEADLESS PACEMAKER, VENT",16000.0,10400.0,6944.0,6944.0,1
CDM,27503OH,CLTX SPRCNDYLR/TRNSCNDYLR FEM FX W/MANJ,4508.0,2930.2,1.1,4686.39,144
CDM,27504355,"LEADS, ICD",5200.0,3380.0,200.93,5200.0,73
CDM,27504355_IP,"LEADS, ICD",5200.0,3380.0,2849.6,2849.6,1
CDM,27504355_OP,"LEADS, ICD",5200.0,3380.0,2256.8,2256.8,1
CDM,27504385,MICRA AV LEADLESS PACEMAKER,22500.0,14625.0,200.93,22500.0,73
CDM,27504385_IP,MICRA AV LEADLESS PACEMAKER,22500.0,14625.0,12330.0,12330.0,1
CDM,27504385_OP,MICRA AV LEADLESS PACEMAKER,22500.0,14625.0,9765.0,9765.0,1
CDM,27504415,PACEMKR AZURE XT DR MRI,8036.0,5223.4,200.93,8036.0,73
CDM,27504415_IP,PACEMKR AZURE XT DR MRI,8036.0,5223.4,4403.73,4403.73,1
CDM,27504415_OP,PACEMKR AZURE XT DR MRI,8036.0,5223.4,3487.62,3487.62,1
CDM,27505135,COBALT XT QUAD CRT-D (W/ PERFORMA LV LEAD),63150.0,41047.5,200.93,63150.0,74
CDM,27505445,ICD LEAD,4600.0,2990.0,200.93,4600.0,73
CDM,27505445_IP,ICD LEAD,4600.0,2990.0,2520.8,2520.8,1
CDM,27505445_OP,ICD LEAD,4600.0,2990.0,1996.4,1996.4,1
CDM,27505455,ICD SINGLE CHAMBER TIER 0,16980.0,11037.0,200.93,16980.0,73
CDM,27505455_IP,ICD SINGLE CHAMBER TIER 0,16980.0,11037.0,9305.04,9305.04,1
CDM,27505455_OP,ICD SINGLE CHAMBER TIER 0,16980.0,11037.0,7369.32,7369.32,1
CDM,27505495,AVEIR LEADLESS DUAL PACEMAKER,61950.0,40267.5,200.93,61950.0,73
CDM,27505495_IP,AVEIR LEADLESS DUAL PACEMAKER,61950.0,40267.5,22632.4,22632.4,1
CDM,27505495_OP,AVEIR LEADLESS DUAL PACEMAKER,61950.0,40267.5,17924.2,17924.2,1
CDM,27505535,S 275 C1786 ABBOTT AVIER VR LEADLESS,24000.0,15600.0,200.93,24000.0,74
CDM,27505545,MICRA VR LEADLESS PACEMAKER,17500.0,11375.0,200.93,17500.0,73
CDM,27505545_IP,MICRA VR LEADLESS PACEMAKER,17500.0,11375.0,10412.0,10412.0,1
CDM,27505545_OP,MICRA VR LEADLESS PACEMAKER,17500.0,11375.0,8246.0,8246.0,1
CDM,27505595,S 275 C1605 ABBOTT AVIER DR LEADLESS,61950.0,40267.5,200.93,61950.0,74
CDM,27505635,ABBOTT AVERI AR LEADLESS PACEMAKER,37950.0,24667.5,200.93,37950.0,73
CDM,27505635_IP,ABBOTT AVERI AR LEADLESS PACEMAKER,37950.0,24667.5,24660.0,24660.0,1
CDM,27505635_OP,ABBOTT AVERI AR LEADLESS PACEMAKER,37950.0,24667.5,19530.0,19530.0,1
CDM,27505645,S 275 C1786 ABBOTT AVERI AR LEADLESS,37950.0,24667.5,200.93,37950.0,74
CDM,27506005,PAMIRA ICD LEAD,6900.0,4485.0,200.93,6900.0,74
CDM,27506OH,OPTX FEM SHFT FX W/INSJ IMED IMPLT W/WO SCREW,7860.0,5109.0,1.1,7860.0,144
CDM,27507OH,OPTX FEM SHFT FX W/PLATE/SCREWS W/WO CERCLAGE,5792.0,3764.8,1.1,5792.0,144
CDM,27508OH,CLTX FEM FX DSTL END MEDIAL/LAT CONDYLE W/O MANJ,2480.0,1612.0,1.1,2480.0,148
CDM,27509OH,PRQ SKELETAL FIXJ FEMORAL FX DISTAL END,3256.0,2116.4,1.1,20863.78,144
CDM,27510OH,CLTX FEM FX DSTL END MEDIAL/LAT CONDYLE W/MANJ,3920.0,2548.0,1.1,4686.39,144
CDM,27511OH,OPEN TX FEMORAL SUPRACONDYLAR FRACTURE W/O XTN,6648.0,4321.2,1.1,6648.0,144
CDM,27513OH,OPEN TX FEMORAL SUPRACONDYLAR FRACTURE W/XTN,8470.0,5505.5,1.1,8470.0,144
CDM,27514OH,OPEN TX FEMORAL FRACTURE DISTAL MED/LAT CONDYLE,5840.0,3796.0,1.1,5840.0,144
CDM,27516OH,CLTX DISTAL FEMORAL EPIPHYSL SEPARATION W/O MANJ,2236.0,1453.4,1.1,2236.0,148
CDM,27519OH,OPEN TX DISTAL FEMORAL EPIPHYSEAL SEPARATION,5300.0,3445.0,1.1,5300.0,144
CDM,27520OH,CLOSED TX PATELLAR FRACTURE W/O MANIPULATION,1216.0,790.4,1.1,1216.0,148
CDM,27524OH,OPTX PATLLR FX W/INT FIXJ/PATLLC&SOFT TISS RPR,4148.0,2696.2,1.1,20863.78,144
CDM,27530OH,CLTX TIBIAL FX PROXIMAL W/O MANIPULATION,1166.0,757.9,1.1,1166.0,148
CDM,27532OH,CLTX TIBIAL FX PROXIMAL W/WO MANJ W/SKEL TRACJ,3322.0,2159.3,1.1,9440.12,148
CDM,27535OH,OPEN TX TIBIAL FRACTURE PROXIMAL UNICONDYLAR,5364.0,3486.6,1.1,5364.0,144
CDM,27536OH,OPTX TIBIAL FX PROX BICONDYLAR W/WO INT FIXJ,6956.0,4521.4,1.1,6956.0,144
CDM,27538OH,CLTX INTERCONDYLAR SPI&/TUBRST FX KNE W/WO MAN,2036.0,1323.4,1.1,2036.0,148
CDM,27540OH,OPEN TX INTERCONDYLAR SPINE/TUBRST FRACTURE KNEE,4520.0,2938.0,1.1,4520.0,144
CDM,27550OH,CLOSED TX KNEE DISLOCATION W/O ANESTHESIA,2392.0,1554.8,1.1,2392.0,148
CDM,27552OH,CLOSED TX KNEE DISLOCATION W/ANESTHESIA,3272.0,2126.8,1.1,4686.39,144
CDM,27558OH,OPEN TX KNEE DISLOCATION W/REPAIR/RECONSTRUCTION,8092.0,5259.8,1.1,8092.0,144
CDM,27560OH,CLOSED TX PATELLAR DISLOCATION W/O ANESTHESIA,1596.0,1037.4,1.1,1596.0,148
CDM,27562OH,CLOSED TX PATELLAR DISLOCATION W/ANESTHESIA,2392.0,1554.8,1.1,2392.0,144
CDM,27566OH,OPTX PATELLAR DISLC W/WO PRTL/TOT PATELLECTOMY,5084.0,3304.6,1.1,20863.78,144
CDM,27570OH,MANIPULATION KNEE JOINT UNDER GENERAL ANESTHESIA,716.0,465.4,1.1,4686.39,144
CDM,27580OH,ARTHRODESIS KNEE ANY TECHNIQUE,8440.0,5486.0,1.1,8440.0,144
CDM,27590OH,AMPUTATION THIGH THROUGH FEMUR ANY LEVEL,5927.0,3852.55,1.1,5927.0,144
CDM,27592OH,AMPUTATION THIGH THRU FEMUR OPEN CIRCULAR,4392.0,2854.8,1.1,4392.0,144
CDM,27594OH,AMP THIGH THRU FEMUR SEC CLOSURE/SCAR REVISION,2916.0,1895.4,1.1,9440.12,144
CDM,27596OH,AMPUTATION THIGH THROUGH FEMUR RE-AMPUTATION,4516.0,2935.4,1.1,4516.0,144
CDM,27598OH,DISARTICULATION KNEE,4488.0,2917.2,1.1,4488.0,144
CDM,27599RVU10OH,ORIF OF THE OCD LESION FEMORAL CONDYLE,4818.0,3131.7,0.01,4818.0,84
CDM,27599RVU11OH,ANTIBIOTIC ROD FEMUR,6484.0,4214.6,0.01,6484.0,84
CDM,27599RVU12OH,"POLYETHYLENE EXCHANGE- KNEE, ONE COMP",7322.0,4759.3,0.01,7322.0,84
CDM,27599RVU13OH,FEMORAL BONE RECONSTRUCTION W/BONE GRAFT,11126.0,7231.9,0.01,11126.0,84
CDM,27599RVU14OH,PERCUTANEOUS HAMSTRING LENGTHENING (COMP 27393),2175.0,1413.75,0.01,2175.0,84
CDM,27599RVU15OH,ANCHORING FOR FLANK HERNIA REPAIR (COMP 27087),2914.0,1894.1,0.01,2914.0,84
CDM,27599RVU16OH,"UNLISTED PROCEDURE, FEMUR OR KNEE COMPARED TO CPT 27365",8356.0,5431.4,0.01,8356.0,84
CDM,27599RVU18OH,"ORIF OF OCD, KNEE (COMP 20924)",2204.0,1432.6,0.01,2204.0,84
CDM,27599RVU1OH,REPAIR MEDIAL RETINACULUM,1779.0,1156.35,0.01,1779.0,84
CDM,27599RVU20OH,PERCUTANEOUS ULTRASOUND GUIDED TENOTOMY OF LEFT KNEE (COMP TO 24,1795.0,1166.75,0.01,1795.0,84
CDM,27599RVU23OH,STAGE 1 OSSEOINTEGRATION (COMP CODE 27495),7112.0,4622.8,0.01,7112.0,84
CDM,27599RVU24OH,MANIPULATION KNEE JOINT NOT UNDER GENERAL ANESTHESIA (COMP CODE,769.0,499.85,0.01,769.0,84
CDM,27599RVU25OH,"ARTHROPLASTY FEMORAL/FEMUR/PATELLA, KNEE (COMP CODE 27446)",7365.0,4787.25,0.01,7365.0,84
CDM,27599RVU26OH,"ALLOGRAFT STRUT, FEMUR (COMP CODE 27472)",8050.0,5232.5,0.01,8050.0,84
CDM,27599RVU27OH,OPEN REPAIR OF MEDIAL RETINACULUM (COMP CODE 27424),4096.0,2662.4,0.01,4096.0,84
CDM,27599RVU2OH,KNEE SPACER EXCHANGE,1927.0,1252.55,0.01,1927.0,84
CDM,27599RVU3OH,LENGTHEN/SHORTEN TENDON FEMUR/KNEE,2208.0,1435.2,0.01,2208.0,84
CDM,27599RVU4OH,REMOVAL PATELLAR SPUR W/QUAD REPAIR,2767.0,1798.55,0.01,2767.0,84
CDM,27599RVU5OH,"UNLSD PROC,FEMUR/KNEE EXP",3211.0,2087.15,0.01,3211.0,84
CDM,27599RVU6OH,OPEN FIXATION OF OCD,5717.0,3716.05,0.01,5717.0,84
CDM,27599RVU7OH,PATELLA TENDON IMBRICATN,3386.0,2200.9,0.01,3386.0,84
CDM,27599RVU8OH,INSERT FEMUR SPACER,481.0,312.65,0.01,688.73,84
CDM,27599RVU9OH,EXCISION HETEROTROPHIC OSSIFICATION KNEE,3782.0,2458.3,0.01,3782.0,84
CDM,27600115,CRYSTAL LENS,995.0,646.75,200.93,995.0,72
CDM,27600115_IP,CRYSTAL LENS,995.0,646.75,362.18,362.18,1
CDM,27600115_OP,CRYSTAL LENS,995.0,646.75,297.51,297.51,1
CDM,27600125,RESTOR LENS,995.0,646.75,200.93,995.0,72
CDM,27600125_IP,RESTOR LENS,995.0,646.75,362.18,362.18,1
CDM,27600125_OP,RESTOR LENS,995.0,646.75,297.51,297.51,1
CDM,27600135,TORIC LENS,555.0,360.75,120.99,555.0,72
CDM,27600135_IP,TORIC LENS,555.0,360.75,202.02,202.02,1
CDM,27600135_OP,TORIC LENS,555.0,360.75,165.95,165.95,1
CDM,27600335,LENS IOL SYMFONY ZXR00,995.0,646.75,200.93,995.0,72
CDM,27600335_IP,LENS IOL SYMFONY ZXR00,995.0,646.75,362.18,362.18,1
CDM,27600335_OP,LENS IOL SYMFONY ZXR00,995.0,646.75,297.51,297.51,1
CDM,27600345,LENS IOL RESTOR SV25TX,995.0,646.75,200.93,995.0,72
CDM,27600345_IP,LENS IOL RESTOR SV25TX,995.0,646.75,362.18,362.18,1
CDM,27600345_OP,LENS IOL RESTOR SV25TX,995.0,646.75,297.51,297.51,1
CDM,27600355,LENS IOL RESTOR SV25TX,995.0,646.75,200.93,995.0,72
CDM,27600355_IP,LENS IOL RESTOR SV25TX,995.0,646.75,362.18,362.18,1
CDM,27600355_OP,LENS IOL RESTOR SV25TX,995.0,646.75,297.51,297.51,1
CDM,27600375,LENS SYMFONY TORIC ZX225,2350.0,1527.5,200.93,2350.0,73
CDM,27600375_IP,LENS SYMFONY TORIC ZX225,2350.0,1527.5,1287.8,1287.8,1
CDM,27600375_OP,LENS SYMFONY TORIC ZX225,2350.0,1527.5,1019.9,1019.9,1
CDM,27600385,LENS SYMFONY TORIC ZXT,995.0,646.75,200.93,995.0,72
CDM,27600385_IP,LENS SYMFONY TORIC ZXT,995.0,646.75,362.18,362.18,1
CDM,27600385_OP,LENS SYMFONY TORIC ZXT,995.0,646.75,297.51,297.51,1
CDM,27600435,PANOPTIX IOL TFAT00,995.0,646.75,200.93,995.0,72
CDM,27600435_IP,PANOPTIX IOL TFAT00,995.0,646.75,362.18,362.18,1
CDM,27600435_OP,PANOPTIX IOL TFAT00,995.0,646.75,297.51,297.51,1
CDM,27600445,PANOPTIX TORIC IOL TFATX0,995.0,646.75,200.93,995.0,72
CDM,27600445_IP,PANOPTIX TORIC IOL TFATX0,995.0,646.75,362.18,362.18,1
CDM,27600445_OP,PANOPTIX TORIC IOL TFATX0,995.0,646.75,297.51,297.51,1
CDM,27600455,LENS IOL ACRYSOF SA6AT,555.0,360.75,120.99,555.0,72
CDM,27600455_IP,LENS IOL ACRYSOF SA6AT,555.0,360.75,202.02,202.02,1
CDM,27600455_OP,LENS IOL ACRYSOF SA6AT,555.0,360.75,165.95,165.95,1
CDM,27600465,VIVITY DAT,995.0,646.75,200.93,995.0,72
CDM,27600465_IP,VIVITY DAT,995.0,646.75,362.18,362.18,1
CDM,27600465_OP,VIVITY DAT,995.0,646.75,297.51,297.51,1
CDM,27600OH,DECOMPRESS ANT/LAT LEG CMPART,2412.0,1567.8,1.1,9440.12,144
CDM,27601OH,DECOMPRESS POST LEG COMPARTMT,2420.0,1573.0,1.1,9440.12,144
CDM,27602OH,DECOMPRESS ANT/LAT+POST LEG CMPART,3128.0,2033.2,1.1,9440.12,144
CDM,27603OH,INCISION & DRAINAGE LEG/ANKLE ABSCESS/HEMATOMA,2092.0,1359.8,1.1,8286.13,148
CDM,27604OH,INCISION & DRAINAGE LEG/ANKLE INFECTED BURSA,1836.0,1193.4,1.1,9440.12,148
CDM,27605OH,TENOTOMY PRQ ACHILLES TENDON SPX LOCAL ANES,1168.0,759.2,1.1,4686.39,148
CDM,27606OH,TENOTOMY PRQ ACHILLES TENDON SPX GENERAL ANES,1672.0,1086.8,1.1,9440.12,144
CDM,27607OH,INCISION LEG/ANKLE,3448.0,2241.2,1.1,9440.12,144
CDM,27610OH,ARTHROTOMY ANKLE W/EXPL DRAINAGE/REMOVAL FB,3652.0,2373.8,1.1,9440.12,144
CDM,27612OH,ARTHRT PST CAPSUL RLS ANKLE W/WO ACHLL TDN LNGTH,3260.0,2119.0,1.1,9440.12,144
CDM,27613OH,BIOPSY SOFT TISSUE LEG/ANKLE AREA SUPERFICIAL,888.0,577.2,1.1,4729.25,148
CDM,27614OH,BIOPSY SOFT TISSUE LEG/ANKLE AREA DEEP,2320.0,1508.0,1.1,8286.13,148
CDM,27615OH,RAD RESECTION TUMOR SOFT TISSUE LEG/ANKLE <5CM,6288.0,4087.2,1.1,8286.13,144
CDM,27616OH,RAD RESCJ TUM SOFT TISSUE LEG/ANKLE 5+CM,7852.0,5103.8,1.1,8286.13,144
CDM,27618OH,EXC TUMOR SOFT TISSUE LEG/ANKLE SUBQ <3CM,1584.0,1029.6,1.1,4729.25,148
CDM,27619OH,EXC TUMOR SOFT TISSUE LEG/ANKLE SUBFASCIAL <5CM,2764.0,1796.6,1.1,8286.13,144
CDM,27620OH,ARTHRT ANKLE W/EXPL W/WO BX W/WO RMVL LOOSE/FB,2460.0,1599.0,1.1,9440.12,144
CDM,27625OH,ARTHROTOMY W/SYNOVECTOMY ANKLE,3396.0,2207.4,1.1,9440.12,144
CDM,27626OH,ARTHROTOMY W/SYNOVECTOMY ANKLE TENOSYNOVECTOMY,3640.0,2366.0,1.1,9440.12,144
CDM,27630OH,EXCISION LESION TENDON SHEATH/CAPSULE LEG&/ANK,1976.0,1284.4,1.1,9440.12,148
CDM,27632OH,EXCISION TUMOR SOFT TISSUE LEG/ANKLE SUBQ 3+CM,2364.0,1536.6,1.1,8286.13,144
CDM,27634OH,EXC TUMOR SOFT TISSUE LEG/ANKLE SUBFASC 5+CM,4052.0,2633.8,1.1,8286.13,144
CDM,27635OH,EXCISION/CURETTAGE BONE CYST/TUMOR TIBIA/FIBULA,3212.0,2087.8,1.1,9440.12,144
CDM,27637OH,EXC/CURETTAGE CYST/TUMOR TIBIA/FIBULA W/AGRAFT,4124.0,2680.6,1.1,20863.78,144
CDM,27638OH,EXC/CURETTAGE CYST/TUMOR TIBIA/FIBULA W/ALGRAFT,4396.0,2857.4,1.1,20863.78,144
CDM,27640OH,PARTIAL EXCISION BONE TIBIA,4896.0,3182.4,1.1,9440.12,144
CDM,27641OH,PARTIAL EXCISION BONE FIBULA,3936.0,2558.4,1.1,9440.12,144
CDM,27645OH,"RAD RESEC TUMOR,TIBIA",10884.0,7074.6,1.1,10884.0,144
CDM,27646OH,"RAD RESEC TUMOR,FIBULA",9284.0,6034.6,1.1,9284.0,144
CDM,27647OH,RADICAL RESECTION OF TUMOR TALUS OR CALCANEUS,8104.0,5267.6,1.1,9440.12,144
CDM,27648OH,INJECTION ANKLE ARTHROGRAPHY,384.0,249.6,1.1,721.17,148
CDM,27650OH,REPAIR PRIMARY OPEN/PRQ RUPTURED ACHILLES TENDON,3684.0,2394.6,1.1,20863.78,144
CDM,27652OH,RPR PRIMARY OPEN/PRQ RUPTURED ACHILLES W/GRAFT,4312.0,2802.8,1.1,20863.78,144
CDM,27654OH,REPAIR SECONDARY ACHILLES TENDON W/WO GRAFT,4212.0,2737.8,1.1,20863.78,144
CDM,27656OH,REPAIR FASCIAL DEFECT LEG,1884.0,1224.6,1.1,9440.12,148
CDM,27658OH,REPAIR FLEXOR TENDON LEG PRIMARY W/O GRAFT EACH,2048.0,1331.2,1.1,9440.12,144
CDM,27659OH,RPR FLEXOR TENDON LEG SECONDARY W/O GRAFT EACH,2840.0,1846.0,1.1,20863.78,144
CDM,27664OH,RPR EXTENSOR TENDON LEG PRIMARY W/O GRAFT EACH,1892.0,1229.8,1.1,20863.78,144
CDM,27665OH,RPR EXTENSOR TENDON LEG SECONDRY W/WO GRAFT EACH,2228.0,1448.2,1.1,20863.78,144
CDM,27675OH,RPR DISLOC PERONEAL TENDON W/O FIBULAR OSTEOTOMY,2940.0,1911.0,1.1,9440.12,144
CDM,27676OH,REPAIR DISLOCATING PERONEAL TENDON W/FIB OSTEOT,3492.0,2269.8,1.1,20863.78,144
CDM,27680OH,TENOLYSIS FLXR/XTNSR TENDON LEG&/ANKLE 1 EACH,2352.0,1528.8,1.1,9440.12,144
CDM,27681OH,TNOLS FLXR/XTNSR TDN LEG&/ANKLE MLT TDN,2820.0,1833.0,1.1,9440.12,144
CDM,27685OH,"LENGTH/SHORT LEG/ANKL TENDON,SINGLE",2676.0,1739.4,1.1,9440.12,148
CDM,27686OH,"LENGTH/SHORT LEG/ANKL TENDON,MULTI",3100.0,2015.0,1.1,9440.12,144
CDM,27687OH,GASTROCNEMIUS RECESSION,2564.0,1666.6,1.1,9440.12,144
CDM,27690OH,TR/TRNSPL 1 TDN W/MUSC REDIRION/REROUTING SUPFC,3668.0,2384.2,1.1,20863.78,144
CDM,27691OH,TR/TRNSPL 1 TDN W/MUSC REDIRION/REROUTING DP,4196.0,2727.4,1.1,20863.78,144
CDM,27692OH,TR/TRNSPL 1 TDN W/MUSC REDIRION/REROUTING EA TDN,748.0,486.2,1.1,748.0,144
CDM,27695OH,RPR PRIMARY DISRUPTED LIGAMENT ANKLE COLLATERAL,2680.0,1742.0,1.1,20863.78,144
CDM,27696OH,RPR PRIM DISRUPTED LIGM ANKLE BTH COLTRL LIGMS,3432.0,2230.8,1.1,20863.78,144
CDM,27698OH,REPAIR SECONDARY DISRUPTED LIGAMENT ANKLE COLTRL,3844.0,2498.6,1.1,20863.78,144
CDM,27700OH,ARTHROPLASTY ANKLE JOINT,3864.0,2511.6,1.1,20863.78,144
CDM,27702OH,ARTHROPLASTY ANKLE W/IMPLANT,5768.0,3749.2,1.1,54351.12,144
CDM,27703OH,ARTHROPLASTY ANKLE REVISION TOTAL ANKLE,6776.0,4404.4,1.1,6776.0,144
CDM,27704OH,REMOVAL OF ANKLE IMPLANT,3124.0,2030.6,1.1,9440.12,144
CDM,27705OH,OSTEOTOMY TIBIA,4344.0,2823.6,1.1,20863.78,144
CDM,27707OH,OSTEOTOMY FIBULA,1912.0,1242.8,1.1,9440.12,144
CDM,27709OH,OSTEOTOMY TIBIA & FIBULA,6992.0,4544.8,1.1,38384.94,144
CDM,27712OH,OSTEOT MLT W/RELIGNMT IMED ROD,6348.0,4126.2,1.1,6348.0,144
CDM,27713OH,OSTEOT TIBIA UNI INSJ XTRNL CTRLD IMED LNGTH DEV,12320.0,8008.0,1.1,12320.0,106
CDM,27715OH,OSTEOPLASTY TIBIA & FIBULA LENGTHENING/SHORTENIN,6200.0,4030.0,1.1,6200.0,144
CDM,27720OH,REPAIR NONUNION/MALUNION TIBIA W/O GRAFT,4944.0,3213.6,1.1,20863.78,144
CDM,27724OH,RPR NON/MAL TIBIA W/ILIAC/OTH AGRFT,7724.0,5020.6,1.1,7724.0,144
CDM,27725OH,RPR NON/MAL TIBIA SYNOSTOSIS W/FIBULA ANY METH,6964.0,4526.6,1.1,6964.0,144
CDM,27726OH,REPAIR FIBULA NONUNION/MALUNION W/INT FIXATION,5736.0,3728.4,1.1,20863.78,144
CDM,27727OH,REPAIR CONGEN PSEUDOARTHROSIS TIBIA,5936.0,3858.4,1.1,5936.0,144
CDM,27730OH,ARREST EPIPHYSEAL OPEN DISTAL TIBIA,3080.0,2002.0,1.1,9440.12,144
CDM,27732OH,ARREST EPIPHYSEAL OPEN DISTAL FIBULA,2184.0,1419.6,1.1,9440.12,144
CDM,27734OH,ARREST EPIPHYSEAL OPEN DISTAL TIBIA&FIBULA,3532.0,2295.8,1.1,9440.12,144
CDM,27740OH,ARREST EPIPHYSEAL ANY METHOD TIBIA & FIBULA,3844.0,2498.6,1.1,9440.12,144
CDM,27742OH,ARRST EPIPHYSL ANY METH TIBFIB&DSTL FEMUR,4252.0,2763.8,1.1,9440.12,144
CDM,27745OH,PROPH TX N/P/PLTWR W/WO METHYLMETHACRYLATE TIBIA,4196.0,2727.4,1.1,20863.78,144
CDM,27750OH,CLTX TIBIAL SHAFT FX W/O MANIPULATION,1348.0,876.2,1.1,1348.0,148
CDM,27752OH,CLTX TIBIAL SHAFT FX W/MANJ W/WO SKEL TRACJ,2508.0,1630.2,1.1,4686.39,148
CDM,27756OH,PRQ SKELETAL FIXATION TIBIAL SHAFT FRACTURE,2980.0,1937.0,1.1,20863.78,144
CDM,27758OH,OPTX TIBIAL SHFT FX W/PLATE/SCREWS W/WO CERCLAGE,5016.0,3260.4,1.1,38384.94,144
CDM,27759OH,TX TIBL SHFT FX IMED IMPLT W/WO SCREWS&/CERCLA,5780.0,3757.0,1.1,38384.94,144
CDM,27760OH,CLTX MEDIAL MALLEOLUS FX W/O MANIPULATION,1284.0,834.6,1.1,1284.0,148
CDM,27762OH,CLTX MEDIAL MALLS FX W/MANJ W/WO SKN/SKEL TRACJ,2188.0,1422.2,1.1,4686.39,148
CDM,27766OH,OPEN TREATMENT MEDIAL MALLEOLUS FRACTURE,3156.0,2051.4,1.1,20863.78,144
CDM,27767OH,CLOSED TREATMENT PST MALLEOLUS FRACTURE W/O MANJ,1056.0,686.4,1.1,1056.0,148
CDM,27768OH,CLOSED TREATMENT PST MALLEOLUS FRACTURE W/MANJ,2056.0,1336.4,1.1,4686.39,144
CDM,27769OH,OPEN TREATMENT POSTERIOR MALLEOLUS FRACTURE,4056.0,2636.4,1.1,20863.78,144
CDM,27780OH,CLTX PROX FIBULA/SHFT FX W/O MANJ,1132.0,735.8,1.1,1132.0,148
CDM,27781OH,CLTX PROX FIBULA/SHFT FX W/MANJ,1836.0,1193.4,1.1,4686.39,148
CDM,27784OH,OPEN TREATMENT PROXIMAL FIBULA/SHAFT FRACTURE,3868.0,2514.2,1.1,20863.78,144
CDM,27786OH,CLTX DSTL FIBULAR FX LAT MALLS W/O MANJ,1208.0,785.2,1.1,1208.0,148
CDM,27788OH,CLTX DSTL FIBULAR FX LAT MALLS W/MANJ,1856.0,1206.4,1.1,1856.0,148
CDM,27792OH,OPEN TX DISTAL FIBULAR FRACTURE LAT MALLEOLUS,3500.0,2275.0,1.1,20863.78,144
CDM,27800160,W ANCH SUT FASTAK,790.0,513.5,172.22,790.0,73
CDM,27800160_IP,W ANCH SUT FASTAK,790.0,513.5,287.56,287.56,1
CDM,27800160_OP,W ANCH SUT FASTAK,790.0,513.5,236.21,236.21,1
CDM,27800370,W BALLOON ULTRATHIN DIAMOND BS,7996.0,5197.4,200.93,7996.0,74
CDM,27800370_IP,W BALLOON ULTRATHIN DIAMOND BS,7996.0,5197.4,4381.81,4381.81,1
CDM,27800370_OP,W BALLOON ULTRATHIN DIAMOND BS,7996.0,5197.4,3470.26,3470.26,1
CDM,27801025,"PROSTH IMPL, NOS",3000.0,1950.0,200.93,3000.0,74
CDM,27801025_IP,"PROSTH IMPL, NOS",3000.0,1950.0,1644.0,1644.0,1
CDM,27801025_OP,"PROSTH IMPL, NOS",3000.0,1950.0,1302.0,1302.0,1
CDM,27801045,BRACHYTX NON-STR HDR IR-192,750.0,487.5,212.1,750.0,91
CDM,27801045_IP,BRACHYTX NON-STR HDR IR-192,750.0,487.5,273.0,273.0,1
CDM,27801045_OP,BRACHYTX NON-STR HDR IR-192,750.0,487.5,224.25,224.25,1
CDM,27801065,CARDIOSEAL,8941.05,5811.68,200.93,8941.05,74
CDM,27801065_IP,CARDIOSEAL,8941.05,5811.68,4899.7,4899.7,1
CDM,27801065_OP,CARDIOSEAL,8941.05,5811.68,3880.42,3880.42,1
CDM,27801080,W CATH 13.5 FR HICKMAN DIALYSIS,639.62,415.75,139.44,639.62,73
CDM,27801080_IP,W CATH 13.5 FR HICKMAN DIALYSIS,639.62,415.75,232.82,232.82,1
CDM,27801080_OP,W CATH 13.5 FR HICKMAN DIALYSIS,639.62,415.75,191.25,191.25,1
CDM,27801085,"H980006 BRACHYTX,NON-STR,90 TH",33432.0,21730.8,1030.0,33432.0,92
CDM,27801085_IP,"H980006 BRACHYTX,NON-STR,90 TH",33432.0,21730.8,18320.74,18320.74,1
CDM,27801085_OP,"H980006 BRACHYTX,NON-STR,90 TH",33432.0,21730.8,14509.49,14509.49,1
CDM,27801105,BRACHYTX SRC IODINE 125 3-4MCI,176.0,114.4,49.77,3174.78,91
CDM,27801105_IP,BRACHYTX SRC IODINE 125 3-4MCI,176.0,114.4,64.06,64.06,1
CDM,27801105_OP,BRACHYTX SRC IODINE 125 3-4MCI,176.0,114.4,52.62,52.62,1
CDM,27801115,"BRACHYTX, STRANDED, I-125",40.36,26.23,11.41,358.71,91
CDM,27801115_IP,"BRACHYTX, STRANDED, I-125",40.36,26.23,14.69,14.69,1
CDM,27801115_OP,"BRACHYTX, STRANDED, I-125",40.36,26.23,12.07,12.07,1
CDM,27801175,"CATH,BROVIAC/HICKMAN/LEONARD",5980.0,3887.0,200.93,5980.0,74
CDM,27801175_IP,"CATH,BROVIAC/HICKMAN/LEONARD",5980.0,3887.0,3277.04,3277.04,1
CDM,27801175_OP,"CATH,BROVIAC/HICKMAN/LEONARD",5980.0,3887.0,2595.32,2595.32,1
CDM,27801185,QUINTON PERMACATHETER,152.05,98.83,33.15,232.66,73
CDM,27801185_IP,QUINTON PERMACATHETER,152.05,98.83,55.35,55.35,1
CDM,27801185_OP,QUINTON PERMACATHETER,152.05,98.83,45.46,45.46,1
CDM,27801225,SOLESTA,1100.0,715.0,239.8,1275.41,73
CDM,27801225_IP,SOLESTA,1100.0,715.0,400.4,400.4,1
CDM,27801225_OP,SOLESTA,1100.0,715.0,328.9,328.9,1
CDM,27801235,MERIT 5FR JL 3.5,20.0,13.0,4.36,20.0,65
CDM,27801235_IP,MERIT 5FR JL 3.5,20.0,13.0,7.28,7.28,1
CDM,27801235_OP,MERIT 5FR JL 3.5,20.0,13.0,5.98,5.98,1
CDM,27801320,W CATH PORTACATH,894.45,581.39,194.99,894.45,73
CDM,27801320_IP,W CATH PORTACATH,894.45,581.39,325.58,325.58,1
CDM,27801320_OP,W CATH PORTACATH,894.45,581.39,267.44,267.44,1
CDM,27801980,W DEV CLOSR VASC 6/7FR MYNX,1200.0,780.0,200.93,1200.0,73
CDM,27801980_IP,W DEV CLOSR VASC 6/7FR MYNX,1200.0,780.0,436.8,436.8,1
CDM,27801980_OP,W DEV CLOSR VASC 6/7FR MYNX,1200.0,780.0,358.8,358.8,1
CDM,27802030,W DEVICE IPG RESTRE ULTRA 37712,26600.0,17290.0,200.93,26600.0,74
CDM,27802030_IP,W DEVICE IPG RESTRE ULTRA 37712,26600.0,17290.0,14576.8,14576.8,1
CDM,27802030_OP,W DEVICE IPG RESTRE ULTRA 37712,26600.0,17290.0,11544.4,11544.4,1
CDM,27802590,"W EVENT RECORDER,CARDIAC IMPLAN",6320.0,4108.0,200.93,6320.0,74
CDM,27802590_IP,"W EVENT RECORDER,CARDIAC IMPLAN",6320.0,4108.0,3463.36,3463.36,1
CDM,27802590_OP,"W EVENT RECORDER,CARDIAC IMPLAN",6320.0,4108.0,2742.88,2742.88,1
CDM,27802970,W FILTER FEMORAL 65CM,2562.63,1665.71,200.93,2562.63,74
CDM,27802970_IP,W FILTER FEMORAL 65CM,2562.63,1665.71,1404.32,1404.32,1
CDM,27802970_OP,W FILTER FEMORAL 65CM,2562.63,1665.71,1112.18,1112.18,1
CDM,27803110,W GEN INS/IPG CSTM SYNERGY VEST,19110.0,12421.5,200.93,19110.0,74
CDM,27803110_IP,W GEN INS/IPG CSTM SYNERGY VEST,19110.0,12421.5,10472.28,10472.28,1
CDM,27803110_OP,W GEN INS/IPG CSTM SYNERGY VEST,19110.0,12421.5,8293.74,8293.74,1
CDM,27804680,W IMP ANCH MINIRO,737.0,479.05,160.67,737.0,73
CDM,27804680_IP,W IMP ANCH MINIRO,737.0,479.05,268.27,268.27,1
CDM,27804680_OP,W IMP ANCH MINIRO,737.0,479.05,220.36,220.36,1
CDM,27804770,W IMP COLLAGN A/S,699.9,454.94,152.58,1275.41,73
CDM,27804770_IP,W IMP COLLAGN A/S,699.9,454.94,254.76,254.76,1
CDM,27804770_OP,W IMP COLLAGN A/S,699.9,454.94,209.27,209.27,1
CDM,27804850,W IMP LD NSTIM,5975.0,3883.75,200.93,5975.0,74
CDM,27804850_IP,W IMP LD NSTIM,5975.0,3883.75,3274.3,3274.3,1
CDM,27804850_OP,W IMP LD NSTIM,5975.0,3883.75,2593.15,2593.15,1
CDM,27804860,W IMP LD NSTM TST,824.0,535.6,179.63,824.0,73
CDM,27804860_IP,W IMP LD NSTM TST,824.0,535.6,299.94,299.94,1
CDM,27804860_OP,W IMP LD NSTM TST,824.0,535.6,246.38,246.38,1
CDM,27805100,W INJ BULK AGENT COLLAGEN IMP U,529.0,343.85,115.32,1275.41,73
CDM,27805100_IP,W INJ BULK AGENT COLLAGEN IMP U,529.0,343.85,192.63,192.63,1
CDM,27805100_OP,W INJ BULK AGENT COLLAGEN IMP U,529.0,343.85,158.23,158.23,1
CDM,27805110,W INJ BULKING AGENT 1ML MPQ-2.5,711.0,462.15,155.0,1275.41,73
CDM,27805110_IP,W INJ BULKING AGENT 1ML MPQ-2.5,711.0,462.15,258.8,258.8,1
CDM,27805110_OP,W INJ BULKING AGENT 1ML MPQ-2.5,711.0,462.15,212.59,212.59,1
CDM,27805470,W IODINE 1-125 SEEDS NONSTRANDE,11.0,7.15,3.11,358.71,91
CDM,27805470_IP,W IODINE 1-125 SEEDS NONSTRANDE,11.0,7.15,7.88,7.88,1
CDM,27805470_OP,W IODINE 1-125 SEEDS NONSTRANDE,11.0,7.15,6.48,6.48,1
CDM,27805690,W KT STM INTERSTM,915.0,594.75,199.47,915.0,73
CDM,27805690_IP,W KT STM INTERSTM,915.0,594.75,333.06,333.06,1
CDM,27805690_OP,W KT STM INTERSTM,915.0,594.75,273.59,273.59,1
CDM,27807255,MICROVENTION HYDROCOIL,220.18,143.12,48.0,220.18,65
CDM,27807255_IP,MICROVENTION HYDROCOIL,220.18,143.12,80.15,80.15,1
CDM,27807255_OP,MICROVENTION HYDROCOIL,220.18,143.12,65.83,65.83,1
CDM,27807265,BARD GASTROSTOMY TUBE,67.0,43.55,14.61,67.0,65
CDM,27807265_IP,BARD GASTROSTOMY TUBE,67.0,43.55,24.46,24.46,1
CDM,27807265_OP,BARD GASTROSTOMY TUBE,67.0,43.55,20.1,20.1,1
CDM,27807275,MICRUS CORP PC4100412-30,4724.0,3070.6,1029.83,4724.0,66
CDM,27807275_IP,MICRUS CORP PC4100412-30,4724.0,3070.6,2588.75,2588.75,1
CDM,27807275_OP,MICRUS CORP PC4100412-30,4724.0,3070.6,2050.22,2050.22,1
CDM,27807295,MICRUS CORP PC4100626-30,4816.0,3130.4,1030.0,4816.0,66
CDM,27807295_IP,MICRUS CORP PC4100626-30,4816.0,3130.4,2639.17,2639.17,1
CDM,27807295_OP,MICRUS CORP PC4100626-30,4816.0,3130.4,2090.14,2090.14,1
CDM,27807305,MICRUS CORP PC4100730-30,4860.0,3159.0,1030.0,4860.0,66
CDM,27807305_IP,MICRUS CORP PC4100730-30,4860.0,3159.0,2663.28,2663.28,1
CDM,27807305_OP,MICRUS CORP PC4100730-30,4860.0,3159.0,2109.24,2109.24,1
CDM,27807315,MICRUS CORP PC4100829-30,4906.0,3188.9,1030.0,4906.0,66
CDM,27807315_IP,MICRUS CORP PC4100829-30,4906.0,3188.9,2688.49,2688.49,1
CDM,27807315_OP,MICRUS CORP PC4100829-30,4906.0,3188.9,2129.2,2129.2,1
CDM,27807405,GDC 18 COILS 2X4 THRU 3X85,1398.0,908.7,304.76,1398.0,66
CDM,27807405_IP,GDC 18 COILS 2X4 THRU 3X85,1398.0,908.7,766.1,766.1,1
CDM,27807405_OP,GDC 18 COILS 2X4 THRU 3X85,1398.0,908.7,606.73,606.73,1
CDM,27807415,GDC 10 COILS 4X6 - 5X15,1297.52,843.39,282.86,1297.52,65
CDM,27807415_IP,GDC 10 COILS 4X6 - 5X15,1297.52,843.39,711.04,711.04,1
CDM,27807415_OP,GDC 10 COILS 4X6 - 5X15,1297.52,843.39,563.12,563.12,1
CDM,27807425,GDC 18 COILS 4X6 - 5X20,220.18,143.12,48.0,220.18,65
CDM,27807425_IP,GDC 18 COILS 4X6 - 5X20,220.18,143.12,80.15,80.15,1
CDM,27807425_OP,GDC 18 COILS 4X6 - 5X20,220.18,143.12,65.83,65.83,1
CDM,27807435,GDC 10 COILS 6X10 - 9X30,1070.86,696.06,233.45,1070.86,65
CDM,27807435_IP,GDC 10 COILS 6X10 - 9X30,1070.86,696.06,389.79,389.79,1
CDM,27807435_OP,GDC 10 COILS 6X10 - 9X30,1070.86,696.06,320.19,320.19,1
CDM,27807445,GDC 18 COILS 6X20 - 9X30,1098.9,714.29,239.56,1098.9,65
CDM,27807445_IP,GDC 18 COILS 6X20 - 9X30,1098.9,714.29,400.0,400.0,1
CDM,27807445_OP,GDC 18 COILS 6X20 - 9X30,1098.9,714.29,328.57,328.57,1
CDM,27807455,GDC 10 COILS 10X30,1164.65,757.02,253.89,1164.65,65
CDM,27807455_IP,GDC 10 COILS 10X30,1164.65,757.02,423.93,423.93,1
CDM,27807455_OP,GDC 10 COILS 10X30,1164.65,757.02,348.23,348.23,1
CDM,27807465,GDC 18 COILS 10X30 - 14X30,1170.26,760.67,255.12,1170.26,65
CDM,27807465_IP,GDC 18 COILS 10X30 - 14X30,1170.26,760.67,425.97,425.97,1
CDM,27807465_OP,GDC 18 COILS 10X30 - 14X30,1170.26,760.67,349.91,349.91,1
CDM,27807485,GDC 18 COILS 16X30 - 18X30,220.18,143.12,48.0,220.18,65
CDM,27807485_IP,GDC 18 COILS 16X30 - 18X30,220.18,143.12,80.15,80.15,1
CDM,27807485_OP,GDC 18 COILS 16X30 - 18X30,220.18,143.12,65.83,65.83,1
CDM,27807535,"2MM STR, COOK COIL",67.59,43.93,14.73,67.59,65
CDM,27807535_IP,"2MM STR, COOK COIL",67.59,43.93,24.6,24.6,1
CDM,27807535_OP,"2MM STR, COOK COIL",67.59,43.93,20.21,20.21,1
CDM,27807555,CONTOUR EMBOLI,106.56,69.26,23.23,106.56,65
CDM,27807555_IP,CONTOUR EMBOLI,106.56,69.26,38.79,38.79,1
CDM,27807555_OP,CONTOUR EMBOLI,106.56,69.26,31.86,31.86,1
CDM,27807585,"MWCE 38 2X3,4X3,5X5,5X8,5X10",81.58,53.03,17.78,81.58,65
CDM,27807585_IP,"MWCE 38 2X3,4X3,5X5,5X8,5X10",81.58,53.03,29.7,29.7,1
CDM,27807585_OP,"MWCE 38 2X3,4X3,5X5,5X8,5X10",81.58,53.03,24.39,24.39,1
CDM,27807595,MICRUS CORP CSP181300-30,3370.0,2190.5,734.66,3370.0,66
CDM,27807595_IP,MICRUS CORP CSP181300-30,3370.0,2190.5,1846.76,1846.76,1
CDM,27807595_OP,MICRUS CORP CSP181300-30,3370.0,2190.5,1462.58,1462.58,1
CDM,27807605,HILAL COILS 018,68.41,44.47,14.91,68.41,65
CDM,27807605_IP,HILAL COILS 018,68.41,44.47,24.9,24.9,1
CDM,27807605_OP,HILAL COILS 018,68.41,44.47,20.45,20.45,1
CDM,27807645,VORTX COIL - EACH,111.87,72.72,24.39,111.87,65
CDM,27807645_IP,VORTX COIL - EACH,111.87,72.72,40.72,40.72,1
CDM,27807645_OP,VORTX COIL - EACH,111.87,72.72,33.45,33.45,1
CDM,27807655,COOK MARX-COPE GJ TUBE,514.0,334.1,112.05,514.0,65
CDM,27807655_IP,COOK MARX-COPE GJ TUBE,514.0,334.1,187.1,187.1,1
CDM,27807655_OP,COOK MARX-COPE GJ TUBE,514.0,334.1,153.69,153.69,1
CDM,27807665,"LIQUID COIL/10&18/1.5,2.2,5 EA",331.2,215.28,72.2,331.2,65
CDM,27807665_IP,"LIQUID COIL/10&18/1.5,2.2,5 EA",331.2,215.28,120.56,120.56,1
CDM,27807665_OP,"LIQUID COIL/10&18/1.5,2.2,5 EA",331.2,215.28,99.03,99.03,1
CDM,27807675,GROUND PAD,5.0,3.25,1.09,5.0,65
CDM,27807675_IP,GROUND PAD,5.0,3.25,1.82,1.82,1
CDM,27807675_OP,GROUND PAD,5.0,3.25,1.5,1.5,1
CDM,27807685,"LIQUID COIL/10&18/20,30CM EACH",391.91,254.74,85.44,391.91,65
CDM,27807685_IP,"LIQUID COIL/10&18/20,30CM EACH",391.91,254.74,142.66,142.66,1
CDM,27807685_OP,"LIQUID COIL/10&18/20,30CM EACH",391.91,254.74,117.18,117.18,1
CDM,27807735,MICRUS CORP CSP181500-30,3430.0,2229.5,747.74,3430.0,66
CDM,27807735_IP,MICRUS CORP CSP181500-30,3430.0,2229.5,1879.64,1879.64,1
CDM,27807735_OP,MICRUS CORP CSP181500-30,3430.0,2229.5,1488.62,1488.62,1
CDM,27807875,GDC 18 16X30 - 20X30,982.5,638.63,214.19,982.5,65
CDM,27807875_IP,GDC 18 16X30 - 20X30,982.5,638.63,357.63,357.63,1
CDM,27807875_OP,GDC 18 16X30 - 20X30,982.5,638.63,293.77,293.77,1
CDM,27807975,CORDIS-TRUFIL EMBOLIC #631-400,6102.0,3966.3,1030.0,6102.0,66
CDM,27807975_IP,CORDIS-TRUFIL EMBOLIC #631-400,6102.0,3966.3,3343.9,3343.9,1
CDM,27807975_OP,CORDIS-TRUFIL EMBOLIC #631-400,6102.0,3966.3,2648.27,2648.27,1
CDM,27807985,TISSUE MARKER,820.0,533.0,178.76,820.0,73
CDM,27807985_IP,TISSUE MARKER,820.0,533.0,298.48,298.48,1
CDM,27807985_OP,TISSUE MARKER,820.0,533.0,245.18,245.18,1
CDM,27807995,H060003 CORDIS TRUFILL EMB,4988.0,3242.2,1030.0,4988.0,66
CDM,27807995_IP,H060003 CORDIS TRUFILL EMB,4988.0,3242.2,2733.42,2733.42,1
CDM,27807995_OP,H060003 CORDIS TRUFILL EMB,4988.0,3242.2,2164.79,2164.79,1
CDM,27808285,COOK TORNADO COILS 3X2,137.41,89.32,29.96,137.41,65
CDM,27808285_IP,COOK TORNADO COILS 3X2,137.41,89.32,50.02,50.02,1
CDM,27808285_OP,COOK TORNADO COILS 3X2,137.41,89.32,41.09,41.09,1
CDM,27808295,MICROVENTION DETACHABLE COIL,2094.19,1361.22,456.53,2094.19,66
CDM,27808295_IP,MICROVENTION DETACHABLE COIL,2094.19,1361.22,1147.62,1147.62,1
CDM,27808295_OP,MICROVENTION DETACHABLE COIL,2094.19,1361.22,908.88,908.88,1
CDM,27808305,MICROVENTION DETACHABLE COIL,2094.19,1361.22,456.53,2094.19,66
CDM,27808305_IP,MICROVENTION DETACHABLE COIL,2094.19,1361.22,1147.62,1147.62,1
CDM,27808305_OP,MICROVENTION DETACHABLE COIL,2094.19,1361.22,908.88,908.88,1
CDM,27808325,MICROVENTION HYDROCOIL 14,2663.67,1731.39,580.68,2663.67,66
CDM,27808325_IP,MICROVENTION HYDROCOIL 14,2663.67,1731.39,1459.69,1459.69,1
CDM,27808325_OP,MICROVENTION HYDROCOIL 14,2663.67,1731.39,1156.03,1156.03,1
CDM,27808375,MICROVENTION HELICAL COIL,3325.14,2161.34,724.88,3325.14,66
CDM,27808375_IP,MICROVENTION HELICAL COIL,3325.14,2161.34,1822.18,1822.18,1
CDM,27808375_OP,MICROVENTION HELICAL COIL,3325.14,2161.34,1443.11,1443.11,1
CDM,27808385,MICROVENTION HELICAL COIL,5000.0,3250.0,1030.0,5000.0,66
CDM,27808385_IP,MICROVENTION HELICAL COIL,5000.0,3250.0,2740.0,2740.0,1
CDM,27808385_OP,MICROVENTION HELICAL COIL,5000.0,3250.0,2170.0,2170.0,1
CDM,27808425,CPLX 1D MICRO COILS,1507.0,979.55,328.53,1507.0,66
CDM,27808425_IP,CPLX 1D MICRO COILS,1507.0,979.55,825.84,825.84,1
CDM,27808425_OP,CPLX 1D MICRO COILS,1507.0,979.55,654.04,654.04,1
CDM,27808595,HEADWAY MICROCATHETER,938.0,609.7,204.48,938.0,65
CDM,27808595_IP,HEADWAY MICROCATHETER,938.0,609.7,341.25,341.25,1
CDM,27808595_OP,HEADWAY MICROCATHETER,938.0,609.7,280.31,280.31,1
CDM,27808645,HYPERSOFT COIL,2011.0,1307.15,438.4,2011.0,66
CDM,27808645_IP,HYPERSOFT COIL,2011.0,1307.15,1102.03,1102.03,1
CDM,27808645_OP,HYPERSOFT COIL,2011.0,1307.15,872.77,872.77,1
CDM,27808705,MICRUS CORP HELICAL COILS,220.18,143.12,48.0,220.18,65
CDM,27808705_IP,MICRUS CORP HELICAL COILS,220.18,143.12,80.15,80.15,1
CDM,27808705_OP,MICRUS CORP HELICAL COILS,220.18,143.12,65.83,65.83,1
CDM,27808715,MICRUS CORP HELICAL COILS,2705.0,1758.25,589.69,2705.0,66
CDM,27808715_IP,MICRUS CORP HELICAL COILS,2705.0,1758.25,1482.34,1482.34,1
CDM,27808715_OP,MICRUS CORP HELICAL COILS,2705.0,1758.25,1173.97,1173.97,1
CDM,27808735,DELTAPAQ COIL,1997.28,1298.23,435.41,1997.28,66
CDM,27808735_IP,DELTAPAQ COIL,1997.28,1298.23,1094.51,1094.51,1
CDM,27808735_OP,DELTAPAQ COIL,1997.28,1298.23,866.82,866.82,1
CDM,27808745,MICRUSPHERE CERECYTE COIL,2798.04,1818.73,609.97,2798.04,66
CDM,27808745_IP,MICRUSPHERE CERECYTE COIL,2798.04,1818.73,1533.33,1533.33,1
CDM,27808745_OP,MICRUSPHERE CERECYTE COIL,2798.04,1818.73,1214.35,1214.35,1
CDM,27808765,MICRUS CORP SPHERICAL COILS,220.18,143.12,48.0,220.18,65
CDM,27808765_IP,MICRUS CORP SPHERICAL COILS,220.18,143.12,80.15,80.15,1
CDM,27808765_OP,MICRUS CORP SPHERICAL COILS,220.18,143.12,65.83,65.83,1
CDM,27808775,ULTIPAQ CERECYTE COIL,2116.28,1375.58,461.35,2116.28,66
CDM,27808775_IP,ULTIPAQ CERECYTE COIL,2116.28,1375.58,1159.72,1159.72,1
CDM,27808775_OP,ULTIPAQ CERECYTE COIL,2116.28,1375.58,918.47,918.47,1
CDM,27808785,MICRUS CORP FINISHING COILS,220.18,143.12,48.0,220.18,65
CDM,27808785_IP,MICRUS CORP FINISHING COILS,220.18,143.12,80.15,80.15,1
CDM,27808785_OP,MICRUS CORP FINISHING COILS,220.18,143.12,65.83,65.83,1
CDM,27808795,MICRUS CORP FINISHING COILS,220.18,143.12,48.0,220.18,65
CDM,27808795_IP,MICRUS CORP FINISHING COILS,220.18,143.12,80.15,80.15,1
CDM,27808795_OP,MICRUS CORP FINISHING COILS,220.18,143.12,65.83,65.83,1
CDM,27808805,MICRUS CORP FINISHING COILS,220.18,143.12,48.0,220.18,65
CDM,27808805_IP,MICRUS CORP FINISHING COILS,220.18,143.12,80.15,80.15,1
CDM,27808805_OP,MICRUS CORP FINISHING COILS,220.18,143.12,65.83,65.83,1
CDM,27808815,KYPHON C01B CEMENT,459.0,298.35,100.06,459.0,65
CDM,27808815_IP,KYPHON C01B CEMENT,459.0,298.35,167.08,167.08,1
CDM,27808815_OP,KYPHON C01B CEMENT,459.0,298.35,137.24,137.24,1
CDM,27808OH,CLOSED TX BIMALLEOLAR ANKLE FRACTURE W/O MANJ,1212.0,787.8,1.1,1212.0,148
CDM,27809015,BOSTON SCIENTIFIC GDC COIL,3333.0,2166.45,726.59,3333.0,66
CDM,27809015_IP,BOSTON SCIENTIFIC GDC COIL,3333.0,2166.45,1826.48,1826.48,1
CDM,27809015_OP,BOSTON SCIENTIFIC GDC COIL,3333.0,2166.45,1446.52,1446.52,1
CDM,27809035,GUIDANT CAROTID STENT SYSTEM,5769.0,3749.85,1030.0,5769.0,66
CDM,27809035_IP,GUIDANT CAROTID STENT SYSTEM,5769.0,3749.85,3161.41,3161.41,1
CDM,27809035_OP,GUIDANT CAROTID STENT SYSTEM,5769.0,3749.85,2503.75,2503.75,1
CDM,27809095,MICRUS CORP SPH100250,2040.0,1326.0,444.72,2040.0,66
CDM,27809095_IP,MICRUS CORP SPH100250,2040.0,1326.0,1117.92,1117.92,1
CDM,27809095_OP,MICRUS CORP SPH100250,2040.0,1326.0,885.36,885.36,1
CDM,27809270,W PUMP SYNCH II US MKTJUN,24075.0,15648.75,200.93,24075.0,74
CDM,27809270_IP,W PUMP SYNCH II US MKTJUN,24075.0,15648.75,13193.1,13193.1,1
CDM,27809270_OP,W PUMP SYNCH II US MKTJUN,24075.0,15648.75,10448.55,10448.55,1
CDM,27810005,MICRUS CORP SPH100300,2050.0,1332.5,446.9,2050.0,66
CDM,27810005_IP,MICRUS CORP SPH100300,2050.0,1332.5,1123.4,1123.4,1
CDM,27810005_OP,MICRUS CORP SPH100300,2050.0,1332.5,889.7,889.7,1
CDM,27810035,MICRUS CORP SPH100350,2060.0,1339.0,449.08,2060.0,66
CDM,27810035_IP,MICRUS CORP SPH100350,2060.0,1339.0,1128.88,1128.88,1
CDM,27810035_OP,MICRUS CORP SPH100350,2060.0,1339.0,894.04,894.04,1
CDM,27810045,MICRUS CORP SPH100500,2090.0,1358.5,455.62,2090.0,66
CDM,27810045_IP,MICRUS CORP SPH100500,2090.0,1358.5,1145.32,1145.32,1
CDM,27810045_OP,MICRUS CORP SPH100500,2090.0,1358.5,907.06,907.06,1
CDM,27810155,AGA MED - EMBOLIZATION DEVICE,750.0,487.5,163.5,750.0,65
CDM,27810155_IP,AGA MED - EMBOLIZATION DEVICE,750.0,487.5,273.0,273.0,1
CDM,27810155_OP,AGA MED - EMBOLIZATION DEVICE,750.0,487.5,224.25,224.25,1
CDM,27810195,DELTAPLUSH CERECYTE COIL,2433.64,1581.87,530.53,2433.64,66
CDM,27810195_IP,DELTAPLUSH CERECYTE COIL,2433.64,1581.87,1333.63,1333.63,1
CDM,27810195_OP,DELTAPLUSH CERECYTE COIL,2433.64,1581.87,1056.2,1056.2,1
CDM,27810205,"CRCYT HLPQ COIL,3 MM X 8CM",2210.0,1436.5,481.78,2210.0,66
CDM,27810205_IP,"CRCYT HLPQ COIL,3 MM X 8CM",2210.0,1436.5,1211.08,1211.08,1
CDM,27810205_OP,"CRCYT HLPQ COIL,3 MM X 8CM",2210.0,1436.5,959.14,959.14,1
CDM,27810215,"CRCYT HLPQ COIL,4-6 MM X 10CM",2250.0,1462.5,490.5,2250.0,66
CDM,27810215_IP,"CRCYT HLPQ COIL,4-6 MM X 10CM",2250.0,1462.5,1233.0,1233.0,1
CDM,27810215_OP,"CRCYT HLPQ COIL,4-6 MM X 10CM",2250.0,1462.5,976.5,976.5,1
CDM,27810275,PRESIDIO 10MM X 34CM COIL,5420.0,3523.0,1030.0,5420.0,66
CDM,27810275_IP,PRESIDIO 10MM X 34CM COIL,5420.0,3523.0,2970.16,2970.16,1
CDM,27810275_OP,PRESIDIO 10MM X 34CM COIL,5420.0,3523.0,2352.28,2352.28,1
CDM,27810285,PRESIDIO 12MM X 40CM COIL,5600.0,3640.0,1030.0,5600.0,66
CDM,27810285_IP,PRESIDIO 12MM X 40CM COIL,5600.0,3640.0,3068.8,3068.8,1
CDM,27810285_OP,PRESIDIO 12MM X 40CM COIL,5600.0,3640.0,2430.4,2430.4,1
CDM,27810295,PRESIDIO 12MM X 43CM COIL,5690.0,3698.5,1030.0,5690.0,66
CDM,27810295_IP,PRESIDIO 12MM X 43CM COIL,5690.0,3698.5,3118.12,3118.12,1
CDM,27810295_OP,PRESIDIO 12MM X 43CM COIL,5690.0,3698.5,2469.46,2469.46,1
CDM,27810305,PRESIDIO 14MM X 47CM COIL,5810.0,3776.5,1030.0,5810.0,66
CDM,27810305_IP,PRESIDIO 14MM X 47CM COIL,5810.0,3776.5,3183.88,3183.88,1
CDM,27810305_OP,PRESIDIO 14MM X 47CM COIL,5810.0,3776.5,2521.54,2521.54,1
CDM,27810315,PRESIDIO 15MM X 50CM COIL,5900.0,3835.0,1030.0,5900.0,66
CDM,27810315_IP,PRESIDIO 15MM X 50CM COIL,5900.0,3835.0,3233.2,3233.2,1
CDM,27810315_OP,PRESIDIO 15MM X 50CM COIL,5900.0,3835.0,2560.6,2560.6,1
CDM,27810325,PRESIDIO 16MM X 47CM COIL,5810.0,3776.5,1030.0,5810.0,66
CDM,27810325_IP,PRESIDIO 16MM X 47CM COIL,5810.0,3776.5,3183.88,3183.88,1
CDM,27810325_OP,PRESIDIO 16MM X 47CM COIL,5810.0,3776.5,2521.54,2521.54,1
CDM,27810365,PRESIDIO 8MM X 30CM COIL,5300.0,3445.0,1030.0,5300.0,66
CDM,27810365_IP,PRESIDIO 8MM X 30CM COIL,5300.0,3445.0,2904.4,2904.4,1
CDM,27810365_OP,PRESIDIO 8MM X 30CM COIL,5300.0,3445.0,2300.2,2300.2,1
CDM,27810685,MICRUS 2MM X 2.5MM COIL,2207.25,1434.71,481.18,2207.25,66
CDM,27810685_IP,MICRUS 2MM X 2.5MM COIL,2207.25,1434.71,1209.57,1209.57,1
CDM,27810685_OP,MICRUS 2MM X 2.5MM COIL,2207.25,1434.71,957.95,957.95,1
CDM,27810695,MICRUS 12MM X 30CM COIL,2423.25,1575.11,528.27,2423.25,66
CDM,27810695_IP,MICRUS 12MM X 30CM COIL,2423.25,1575.11,1327.94,1327.94,1
CDM,27810695_OP,MICRUS 12MM X 30CM COIL,2423.25,1575.11,1051.69,1051.69,1
CDM,27810715,MICRUS 3MM X 4CM COIL,3320.0,2158.0,723.76,3320.0,66
CDM,27810715_IP,MICRUS 3MM X 4CM COIL,3320.0,2158.0,1819.36,1819.36,1
CDM,27810715_OP,MICRUS 3MM X 4CM COIL,3320.0,2158.0,1440.88,1440.88,1
CDM,27810735,MICRUS 4MM X 4.5CM COIL,3300.0,2145.0,719.4,3300.0,66
CDM,27810735_IP,MICRUS 4MM X 4.5CM COIL,3300.0,2145.0,1808.4,1808.4,1
CDM,27810735_OP,MICRUS 4MM X 4.5CM COIL,3300.0,2145.0,1432.2,1432.2,1
CDM,27810745,MICRUS 4MM X 6CM COIL,3320.0,2158.0,723.76,3320.0,66
CDM,27810745_IP,MICRUS 4MM X 6CM COIL,3320.0,2158.0,1819.36,1819.36,1
CDM,27810745_OP,MICRUS 4MM X 6CM COIL,3320.0,2158.0,1440.88,1440.88,1
CDM,27810755,MICRUS 4MM X 8CM COIL,3350.0,2177.5,730.3,3350.0,66
CDM,27810755_IP,MICRUS 4MM X 8CM COIL,3350.0,2177.5,1835.8,1835.8,1
CDM,27810755_OP,MICRUS 4MM X 8CM COIL,3350.0,2177.5,1453.9,1453.9,1
CDM,27810765,MICRUS 5MM X 7CM COIL,3350.0,2177.5,730.3,3350.0,66
CDM,27810765_IP,MICRUS 5MM X 7CM COIL,3350.0,2177.5,1835.8,1835.8,1
CDM,27810765_OP,MICRUS 5MM X 7CM COIL,3350.0,2177.5,1453.9,1453.9,1
CDM,27810775,MICRUS 5MM X 12CM COIL,3400.0,2210.0,741.2,3400.0,66
CDM,27810775_IP,MICRUS 5MM X 12CM COIL,3400.0,2210.0,1863.2,1863.2,1
CDM,27810775_OP,MICRUS 5MM X 12CM COIL,3400.0,2210.0,1475.6,1475.6,1
CDM,27810785,MICRUS 6MM X 9CM COIL,3390.0,2203.5,739.02,3390.0,66
CDM,27810785_IP,MICRUS 6MM X 9CM COIL,3390.0,2203.5,1857.72,1857.72,1
CDM,27810785_OP,MICRUS 6MM X 9CM COIL,3390.0,2203.5,1471.26,1471.26,1
CDM,27810795,MICRUS 6MM X 15CM COIL,3450.0,2242.5,752.1,3450.0,66
CDM,27810795_IP,MICRUS 6MM X 15CM COIL,3450.0,2242.5,1890.6,1890.6,1
CDM,27810795_OP,MICRUS 6MM X 15CM COIL,3450.0,2242.5,1497.3,1497.3,1
CDM,27810815,MICRUS 7MM X 17CM COIL,3470.0,2255.5,756.46,3470.0,66
CDM,27810815_IP,MICRUS 7MM X 17CM COIL,3470.0,2255.5,1901.56,1901.56,1
CDM,27810815_OP,MICRUS 7MM X 17CM COIL,3470.0,2255.5,1505.98,1505.98,1
CDM,27810835,MICRUS 8MM X 20CM COIL,3490.0,2268.5,760.82,3490.0,66
CDM,27810835_IP,MICRUS 8MM X 20CM COIL,3490.0,2268.5,1912.52,1912.52,1
CDM,27810835_OP,MICRUS 8MM X 20CM COIL,3490.0,2268.5,1514.66,1514.66,1
CDM,27810855,MICRUS 9MM X 22CM COIL,3500.0,2275.0,763.0,3500.0,66
CDM,27810855_IP,MICRUS 9MM X 22CM COIL,3500.0,2275.0,1918.0,1918.0,1
CDM,27810855_OP,MICRUS 9MM X 22CM COIL,3500.0,2275.0,1519.0,1519.0,1
CDM,27810885,MICRUS 11MM X 18CM COIL,3490.0,2268.5,760.82,3490.0,66
CDM,27810885_IP,MICRUS 11MM X 18CM COIL,3490.0,2268.5,1912.52,1912.52,1
CDM,27810885_OP,MICRUS 11MM X 18CM COIL,3490.0,2268.5,1514.66,1514.66,1
CDM,27810915,AZUR DET HYDROCOIL 8 MM X 20CM,1920.0,1248.0,418.56,1920.0,66
CDM,27810915_IP,AZUR DET HYDROCOIL 8 MM X 20CM,1920.0,1248.0,1052.16,1052.16,1
CDM,27810915_OP,AZUR DET HYDROCOIL 8 MM X 20CM,1920.0,1248.0,833.28,833.28,1
CDM,27810925,AZUR DET HYDROCOIL 8 MM X 15CM,1820.0,1183.0,396.76,1820.0,66
CDM,27810925_IP,AZUR DET HYDROCOIL 8 MM X 15CM,1820.0,1183.0,997.36,997.36,1
CDM,27810925_OP,AZUR DET HYDROCOIL 8 MM X 15CM,1820.0,1183.0,789.88,789.88,1
CDM,27810935,AZUR DET HYDROCOIL 4 MM X 10CM,1700.0,1105.0,370.6,1700.0,66
CDM,27810935_IP,AZUR DET HYDROCOIL 4 MM X 10CM,1700.0,1105.0,931.6,931.6,1
CDM,27810935_OP,AZUR DET HYDROCOIL 4 MM X 10CM,1700.0,1105.0,737.8,737.8,1
CDM,27810945,AZUR DETACHMENT CONTROLLER,340.0,221.0,74.12,340.0,65
CDM,27810945_IP,AZUR DETACHMENT CONTROLLER,340.0,221.0,123.76,123.76,1
CDM,27810945_OP,AZUR DETACHMENT CONTROLLER,340.0,221.0,101.66,101.66,1
CDM,27810985,ONYX 18/34 LIQUID EMBOLIC  SYS,4800.0,3120.0,1030.0,4800.0,66
CDM,27810985_IP,ONYX 18/34 LIQUID EMBOLIC  SYS,4800.0,3120.0,2630.4,2630.4,1
CDM,27810985_OP,ONYX 18/34 LIQUID EMBOLIC  SYS,4800.0,3120.0,2083.2,2083.2,1
CDM,27810995,"AZUR COIL  4 X 10, 6 X 10",2505.36,1628.48,546.17,2505.36,66
CDM,27810995_IP,"AZUR COIL  4 X 10, 6 X 10",2505.36,1628.48,1372.94,1372.94,1
CDM,27810995_OP,"AZUR COIL  4 X 10, 6 X 10",2505.36,1628.48,1087.33,1087.33,1
CDM,27810OH,CLOSED TX BIMALLEOLAR ANKLE FRACTURE W/MANJ,2128.0,1383.2,1.1,4686.39,148
CDM,27811005,"AZUR COIL 12X30, 15X30 20X30",3083.52,2004.29,672.21,3083.52,66
CDM,27811005_IP,"AZUR COIL 12X30, 15X30 20X30",3083.52,2004.29,1689.77,1689.77,1
CDM,27811005_OP,"AZUR COIL 12X30, 15X30 20X30",3083.52,2004.29,1338.25,1338.25,1
CDM,27811015,"AZUR COIL 4, 8, 10, 12 X15",2698.08,1753.75,588.18,2698.08,66
CDM,27811015_IP,"AZUR COIL 4, 8, 10, 12 X15",2698.08,1753.75,1478.55,1478.55,1
CDM,27811015_OP,"AZUR COIL 4, 8, 10, 12 X15",2698.08,1753.75,1170.97,1170.97,1
CDM,27811025,AZUR COIL 4MM X 5CM,2312.64,1503.22,504.16,2312.64,66
CDM,27811025_IP,AZUR COIL 4MM X 5CM,2312.64,1503.22,1267.33,1267.33,1
CDM,27811025_OP,AZUR COIL 4MM X 5CM,2312.64,1503.22,1003.69,1003.69,1
CDM,27811035,"AZUR COIL 6X15, 8,10,12,15X20",2890.8,1879.02,630.19,2890.8,66
CDM,27811035_IP,"AZUR COIL 6X15, 8,10,12,15X20",2890.8,1879.02,1584.16,1584.16,1
CDM,27811035_OP,"AZUR COIL 6X15, 8,10,12,15X20",2890.8,1879.02,1254.61,1254.61,1
CDM,27811045,COIL 400 J7CM,4520.0,2938.0,985.36,4520.0,66
CDM,27811045_IP,COIL 400 J7CM,4520.0,2938.0,2476.96,2476.96,1
CDM,27811045_OP,COIL 400 J7CM,4520.0,2938.0,1961.68,1961.68,1
CDM,27812005,COIL 400 COMPL SFT 8MMX30CM 9M,5260.0,3419.0,1030.0,5260.0,66
CDM,27812005_IP,COIL 400 COMPL SFT 8MMX30CM 9M,5260.0,3419.0,2882.48,2882.48,1
CDM,27812005_OP,COIL 400 COMPL SFT 8MMX30CM 9M,5260.0,3419.0,2282.84,2282.84,1
CDM,27812015,COIL 400 COMPL STAND 6MMX15CM,4650.0,3022.5,1013.7,4650.0,66
CDM,27812015_IP,COIL 400 COMPL STAND 6MMX15CM,4650.0,3022.5,2548.2,2548.2,1
CDM,27812015_OP,COIL 400 COMPL STAND 6MMX15CM,4650.0,3022.5,2018.1,2018.1,1
CDM,27812025,COIL 400 CURVE EXT SFT 3MMX6CM,4480.0,2912.0,976.64,4480.0,66
CDM,27812025_IP,COIL 400 CURVE EXT SFT 3MMX6CM,4480.0,2912.0,2455.04,2455.04,1
CDM,27812025_OP,COIL 400 CURVE EXT SFT 3MMX6CM,4480.0,2912.0,1944.32,1944.32,1
CDM,27812035,COIL 400 J 15CM,5240.0,3406.0,1030.0,5240.0,66
CDM,27812035_IP,COIL 400 J 15CM,5240.0,3406.0,2871.52,2871.52,1
CDM,27812035_OP,COIL 400 J 15CM,5240.0,3406.0,2274.16,2274.16,1
CDM,27812045,COIL 400 CURVE EXT SFT 3MMX5CM,4270.0,2775.5,930.86,4270.0,66
CDM,27812045_IP,COIL 400 CURVE EXT SFT 3MMX5CM,4270.0,2775.5,2339.96,2339.96,1
CDM,27812045_OP,COIL 400 CURVE EXT SFT 3MMX5CM,4270.0,2775.5,1853.18,1853.18,1
CDM,27812055,COIL 400 J 10CM,5040.0,3276.0,1030.0,5040.0,66
CDM,27812055_IP,COIL 400 J 10CM,5040.0,3276.0,2761.92,2761.92,1
CDM,27812055_OP,COIL 400 J 10CM,5040.0,3276.0,2187.36,2187.36,1
CDM,27812065,COIL 400 CURVE EXT SFT 2MMX4CM,4060.0,2639.0,885.08,4060.0,66
CDM,27812065_IP,COIL 400 CURVE EXT SFT 2MMX4CM,4060.0,2639.0,2224.88,2224.88,1
CDM,27812065_OP,COIL 400 CURVE EXT SFT 2MMX4CM,4060.0,2639.0,1762.04,1762.04,1
CDM,27812085,COIL 400 SOFT 3MMX6CM 6MMX10CM,4880.0,3172.0,1030.0,4880.0,66
CDM,27812085_IP,COIL 400 SOFT 3MMX6CM 6MMX10CM,4880.0,3172.0,2674.24,2674.24,1
CDM,27812085_OP,COIL 400 SOFT 3MMX6CM 6MMX10CM,4880.0,3172.0,2117.92,2117.92,1
CDM,27812095,COIL 400 COMPLEX STAND 3MMX6CM,4460.0,2899.0,972.28,4460.0,66
CDM,27812095_IP,COIL 400 COMPLEX STAND 3MMX6CM,4460.0,2899.0,2444.08,2444.08,1
CDM,27812095_OP,COIL 400 COMPLEX STAND 3MMX6CM,4460.0,2899.0,1935.64,1935.64,1
CDM,27812770,W STENT AAA BIFUR 22F 36X95MM,3450.04,2242.53,200.93,3450.04,74
CDM,27812770_IP,W STENT AAA BIFUR 22F 36X95MM,3450.04,2242.53,1890.62,1890.62,1
CDM,27812770_OP,W STENT AAA BIFUR 22F 36X95MM,3450.04,2242.53,1497.32,1497.32,1
CDM,27812930,W STENT BILAIRY ZIMMON,93.48,60.76,20.38,232.66,73
CDM,27812930_IP,W STENT BILAIRY ZIMMON,93.48,60.76,34.03,34.03,1
CDM,27812930_OP,W STENT BILAIRY ZIMMON,93.48,60.76,27.95,27.95,1
CDM,27812970,W STENT BRONCHIAL ULTRAFLEX COV,3790.0,2463.5,200.93,3790.0,74
CDM,27812970_IP,W STENT BRONCHIAL ULTRAFLEX COV,3790.0,2463.5,2076.92,2076.92,1
CDM,27812970_OP,W STENT BRONCHIAL ULTRAFLEX COV,3790.0,2463.5,1644.86,1644.86,1
CDM,27813005,COIL 400 COMP SOFT 6MMX15CM 10,5100.0,3315.0,1030.0,5100.0,66
CDM,27813005_IP,COIL 400 COMP SOFT 6MMX15CM 10,5100.0,3315.0,2794.8,2794.8,1
CDM,27813005_OP,COIL 400 COMP SOFT 6MMX15CM 10,5100.0,3315.0,2213.4,2213.4,1
CDM,27813015,COIL 400 COMP STAND 8MMX30CM,5100.0,3315.0,1030.0,5100.0,66
CDM,27813015_IP,COIL 400 COMP STAND 8MMX30CM,5100.0,3315.0,2794.8,2794.8,1
CDM,27813015_OP,COIL 400 COMP STAND 8MMX30CM,5100.0,3315.0,2213.4,2213.4,1
CDM,27813035,COIL COMP STAND 10MMX40,5000.0,3250.0,1030.0,5000.0,66
CDM,27813035_IP,COIL COMP STAND 10MMX40,5000.0,3250.0,2740.0,2740.0,1
CDM,27813035_OP,COIL COMP STAND 10MMX40,5000.0,3250.0,2170.0,2170.0,1
CDM,27813045,PIPELINE EMBOLIZATION DEVICE,24000.0,15600.0,1030.0,24000.0,66
CDM,27813045_IP,PIPELINE EMBOLIZATION DEVICE,24000.0,15600.0,13152.0,13152.0,1
CDM,27813045_OP,PIPELINE EMBOLIZATION DEVICE,24000.0,15600.0,10416.0,10416.0,1
CDM,27813055,STRYKER 360 STANDARD COIL,2880.0,1872.0,627.84,2880.0,66
CDM,27813055_IP,STRYKER 360 STANDARD COIL,2880.0,1872.0,1578.24,1578.24,1
CDM,27813055_OP,STRYKER 360 STANDARD COIL,2880.0,1872.0,1249.92,1249.92,1
CDM,27813065,STRYKER 360 STANDARD COIL,3240.0,2106.0,706.32,3240.0,66
CDM,27813065_IP,STRYKER 360 STANDARD COIL,3240.0,2106.0,1775.52,1775.52,1
CDM,27813065_OP,STRYKER 360 STANDARD COIL,3240.0,2106.0,1406.16,1406.16,1
CDM,27813075,STRYKER 360 SOFT COIL,3060.0,1989.0,667.08,3060.0,66
CDM,27813075_IP,STRYKER 360 SOFT COIL,3060.0,1989.0,1676.88,1676.88,1
CDM,27813075_OP,STRYKER 360 SOFT COIL,3060.0,1989.0,1328.04,1328.04,1
CDM,27813085,STRYKER 360 ULTRA COIL,3240.0,2106.0,706.32,3240.0,66
CDM,27813085_IP,STRYKER 360 ULTRA COIL,3240.0,2106.0,1775.52,1775.52,1
CDM,27813085_OP,STRYKER 360 ULTRA COIL,3240.0,2106.0,1406.16,1406.16,1
CDM,27813095,STRYKER HELICAL ULTRA COIL,2160.0,1404.0,470.88,2160.0,66
CDM,27813095_IP,STRYKER HELICAL ULTRA COIL,2160.0,1404.0,1183.68,1183.68,1
CDM,27813095_OP,STRYKER HELICAL ULTRA COIL,2160.0,1404.0,937.44,937.44,1
CDM,27814005,EV3 3D HELIX COILPC 2 1-10 30,1972.0,1281.8,429.9,1972.0,66
CDM,27814005_IP,EV3 3D HELIX COILPC 2 1-10 30,1972.0,1281.8,1080.66,1080.66,1
CDM,27814005_OP,EV3 3D HELIX COILPC 2 1-10 30,1972.0,1281.8,855.85,855.85,1
CDM,27814065,QUILL GUIDE ASSEMBLY,388.0,252.2,84.58,388.0,65
CDM,27814065_IP,QUILL GUIDE ASSEMBLY,388.0,252.2,141.23,141.23,1
CDM,27814065_OP,QUILL GUIDE ASSEMBLY,388.0,252.2,116.01,116.01,1
CDM,27814075,TITANIUM CATH CONNECTOR,302.0,196.3,65.84,302.0,65
CDM,27814075_IP,TITANIUM CATH CONNECTOR,302.0,196.3,109.93,109.93,1
CDM,27814075_OP,TITANIUM CATH CONNECTOR,302.0,196.3,90.3,90.3,1
CDM,27814OH,OPEN TREATMENT BIMALLEOLAR ANKLE FRACTURE,4248.0,2761.2,1.1,20863.78,144
CDM,27815035,"KIT, EXTENSION #37082-60",2780.0,1807.0,606.04,2780.0,66
CDM,27815035_IP,"KIT, EXTENSION #37082-60",2780.0,1807.0,1523.44,1523.44,1
CDM,27815035_OP,"KIT, EXTENSION #37082-60",2780.0,1807.0,1206.52,1206.52,1
CDM,27815095,4 X 4 STNLESS STEEL SD GRID,1093.14,710.54,238.3,1093.14,65
CDM,27815095_IP,4 X 4 STNLESS STEEL SD GRID,1093.14,710.54,397.9,397.9,1
CDM,27815095_OP,4 X 4 STNLESS STEEL SD GRID,1093.14,710.54,326.85,326.85,1
CDM,27815450,W COIL EMBOL AZUR 4/6MM X 20CM,3110.0,2021.5,200.93,3110.0,74
CDM,27815450_IP,W COIL EMBOL AZUR 4/6MM X 20CM,3110.0,2021.5,1704.28,1704.28,1
CDM,27815450_OP,W COIL EMBOL AZUR 4/6MM X 20CM,3110.0,2021.5,1349.74,1349.74,1
CDM,27815580,W STENT BIL ADVANIX 2 PGTL CRV,257.59,167.43,56.15,257.59,73
CDM,27815580_IP,W STENT BIL ADVANIX 2 PGTL CRV,257.59,167.43,93.76,93.76,1
CDM,27815580_OP,W STENT BIL ADVANIX 2 PGTL CRV,257.59,167.43,77.02,77.02,1
CDM,27816005,2 X 6 STNLESS STEEL SD GRID,811.3,527.35,176.86,811.3,65
CDM,27816005_IP,2 X 6 STNLESS STEEL SD GRID,811.3,527.35,295.31,295.31,1
CDM,27816005_OP,2 X 6 STNLESS STEEL SD GRID,811.3,527.35,242.58,242.58,1
CDM,27816025,1 X 8  STNLESS STEEL SD GRID,461.5,299.98,100.61,461.5,65
CDM,27816025_IP,1 X 8  STNLESS STEEL SD GRID,461.5,299.98,167.99,167.99,1
CDM,27816025_OP,1 X 8  STNLESS STEEL SD GRID,461.5,299.98,137.99,137.99,1
CDM,27816065,INDERMIL GLUE  0.5 GM,52.0,33.8,11.34,52.0,65
CDM,27816065_IP,INDERMIL GLUE  0.5 GM,52.0,33.8,18.93,18.93,1
CDM,27816065_OP,INDERMIL GLUE  0.5 GM,52.0,33.8,15.55,15.55,1
CDM,27816540,W ADPT 25CM Y UNPLR PIN PLG,496.0,322.4,108.13,496.0,73
CDM,27816540_IP,W ADPT 25CM Y UNPLR PIN PLG,496.0,322.4,180.54,180.54,1
CDM,27816540_OP,W ADPT 25CM Y UNPLR PIN PLG,496.0,322.4,148.3,148.3,1
CDM,27816830,W TRAY PROC UNV AVAMAX + VRTBPL,1300.0,845.0,283.4,1300.0,65
CDM,27816830_IP,W TRAY PROC UNV AVAMAX + VRTBPL,1300.0,845.0,712.4,712.4,1
CDM,27816830_OP,W TRAY PROC UNV AVAMAX + VRTBPL,1300.0,845.0,564.2,564.2,1
CDM,27816850,YTTRIUM-90,33432.0,21730.8,1030.0,33432.0,92
CDM,27816850_IP,YTTRIUM-90,33432.0,21730.8,18320.74,18320.74,1
CDM,27816850_OP,YTTRIUM-90,33432.0,21730.8,14509.49,14509.49,1
CDM,27816OH,CLTX TRIMALLEOLAR ANKLE FX W/O MANIPULATION,1351.0,878.15,1.1,1351.0,148
CDM,27817095,AMPLATZER SEPTAL OCCLUDER,26310.0,17101.5,1030.0,26310.0,66
CDM,27817095_IP,AMPLATZER SEPTAL OCCLUDER,26310.0,17101.5,7408.96,7408.96,1
CDM,27817095_OP,AMPLATZER SEPTAL OCCLUDER,26310.0,17101.5,5867.68,5867.68,1
CDM,27817115,TIER 1 EMBOLIZATION COILS DETACHABLE,166.0,107.9,36.19,166.0,65
CDM,27817115_IP,TIER 1 EMBOLIZATION COILS DETACHABLE,166.0,107.9,60.42,60.42,1
CDM,27817115_OP,TIER 1 EMBOLIZATION COILS DETACHABLE,166.0,107.9,49.63,49.63,1
CDM,27817125,AMPLATZER VASCULAR PLUG,1600.0,1040.0,348.8,1600.0,66
CDM,27817125_IP,AMPLATZER VASCULAR PLUG,1600.0,1040.0,876.8,876.8,1
CDM,27817125_OP,AMPLATZER VASCULAR PLUG,1600.0,1040.0,694.4,694.4,1
CDM,27817145,IMPELLA HEART ASSIST DEVICE,44000.0,28600.0,1030.0,44000.0,66
CDM,27817145_IP,IMPELLA HEART ASSIST DEVICE,44000.0,28600.0,24112.0,24112.0,1
CDM,27817145_OP,IMPELLA HEART ASSIST DEVICE,44000.0,28600.0,19096.0,19096.0,1
CDM,27817165,IMPELLA HEART ASSIST DEV 2.5,44000.0,28600.0,1030.0,44000.0,66
CDM,27817165_IP,IMPELLA HEART ASSIST DEV 2.5,44000.0,28600.0,24112.0,24112.0,1
CDM,27817165_OP,IMPELLA HEART ASSIST DEV 2.5,44000.0,28600.0,19096.0,19096.0,1
CDM,27817185,AMPLATZER DUCT OCCLUDER 9MM,5811.75,3777.64,200.93,5811.75,74
CDM,27817185_IP,AMPLATZER DUCT OCCLUDER 9MM,5811.75,3777.64,3184.84,3184.84,1
CDM,27817185_OP,AMPLATZER DUCT OCCLUDER 9MM,5811.75,3777.64,2522.3,2522.3,1
CDM,27817285,CATHETER ACCESSORY KIT 8590-9,285.0,185.25,62.13,285.0,65
CDM,27817285_IP,CATHETER ACCESSORY KIT 8590-9,285.0,185.25,103.74,103.74,1
CDM,27817285_OP,CATHETER ACCESSORY KIT 8590-9,285.0,185.25,85.22,85.22,1
CDM,27817315,15MM-35MM SEPTAL OCCLUDER,13136.0,8538.4,1030.0,13136.0,66
CDM,27817315_IP,15MM-35MM SEPTAL OCCLUDER,13136.0,8538.4,7198.53,7198.53,1
CDM,27817315_OP,15MM-35MM SEPTAL OCCLUDER,13136.0,8538.4,5701.02,5701.02,1
CDM,27817325,CT PICC 4 SL,126.0,81.9,27.47,126.0,65
CDM,27817325_IP,CT PICC 4 SL,126.0,81.9,45.86,45.86,1
CDM,27817325_OP,CT PICC 4 SL,126.0,81.9,37.67,37.67,1
CDM,27817385,BARD VALEO BILIARY STENT,1485.0,965.25,323.73,1485.0,66
CDM,27817385_IP,BARD VALEO BILIARY STENT,1485.0,965.25,813.78,813.78,1
CDM,27817385_OP,BARD VALEO BILIARY STENT,1485.0,965.25,644.49,644.49,1
CDM,27817415,PICC SNGL LMN 3F60CM BARD,120.77,78.5,26.33,120.77,65
CDM,27817415_IP,PICC SNGL LMN 3F60CM BARD,120.77,78.5,43.96,43.96,1
CDM,27817415_OP,PICC SNGL LMN 3F60CM BARD,120.77,78.5,36.11,36.11,1
CDM,27817425,MELODY VALVE,51000.0,33150.0,1030.0,51000.0,66
CDM,27817425_IP,MELODY VALVE,51000.0,33150.0,27948.0,27948.0,1
CDM,27817425_OP,MELODY VALVE,51000.0,33150.0,22134.0,22134.0,1
CDM,27817435,MELODY VALVE DELIVERY SYS,13000.0,8450.0,1030.0,13000.0,66
CDM,27817435_IP,MELODY VALVE DELIVERY SYS,13000.0,8450.0,7124.0,7124.0,1
CDM,27817435_OP,MELODY VALVE DELIVERY SYS,13000.0,8450.0,5642.0,5642.0,1
CDM,27817495,"MREYE EMB COIL 2-4CMX4MM, .038",125.12,81.33,27.28,125.12,65
CDM,27817495_IP,"MREYE EMB COIL 2-4CMX4MM, .038",125.12,81.33,45.54,45.54,1
CDM,27817495_OP,"MREYE EMB COIL 2-4CMX4MM, .038",125.12,81.33,37.41,37.41,1
CDM,27817515,SPANNER PROSTATIC STENT,1150.0,747.5,200.93,1150.0,73
CDM,27817515_IP,SPANNER PROSTATIC STENT,1150.0,747.5,418.6,418.6,1
CDM,27817515_OP,SPANNER PROSTATIC STENT,1150.0,747.5,343.85,343.85,1
CDM,27817525,LC BLUE BEAD EMBOLIC  VE630GS,5121.48,3328.96,1030.0,5121.48,66
CDM,27817525_IP,LC BLUE BEAD EMBOLIC  VE630GS,5121.48,3328.96,2806.57,2806.57,1
CDM,27817525_OP,LC BLUE BEAD EMBOLIC  VE630GS,5121.48,3328.96,2222.72,2222.72,1
CDM,27817535,LC YELLOW BEAD 100-300UM,5121.48,3328.96,1030.0,5121.48,66
CDM,27817535_IP,LC YELLOW BEAD 100-300UM,5121.48,3328.96,2806.57,2806.57,1
CDM,27817535_OP,LC YELLOW BEAD 100-300UM,5121.48,3328.96,2222.72,2222.72,1
CDM,27817650,W IMP TISSUE MARKER BREAST,442.0,287.3,96.36,442.0,73
CDM,27817650_IP,W IMP TISSUE MARKER BREAST,442.0,287.3,298.48,298.48,1
CDM,27817650_OP,W IMP TISSUE MARKER BREAST,442.0,287.3,245.18,245.18,1
CDM,27817785,MEDTRONIC 1X8 LEAD KIT,3908.0,2540.2,851.94,3908.0,66
CDM,27817785_IP,MEDTRONIC 1X8 LEAD KIT,3908.0,2540.2,2141.58,2141.58,1
CDM,27817785_OP,MEDTRONIC 1X8 LEAD KIT,3908.0,2540.2,1696.07,1696.07,1
CDM,27817805,SC-4100 OR CABLE,600.0,390.0,130.8,600.0,65
CDM,27817805_IP,SC-4100 OR CABLE,600.0,390.0,218.4,218.4,1
CDM,27817805_OP,SC-4100 OR CABLE,600.0,390.0,179.4,179.4,1
CDM,27817825,"TORQ WRENCH 4"" KIT 3550-45",110.0,71.5,23.98,110.0,65
CDM,27817825_IP,"TORQ WRENCH 4"" KIT 3550-45",110.0,71.5,40.04,40.04,1
CDM,27817825_OP,"TORQ WRENCH 4"" KIT 3550-45",110.0,71.5,32.89,32.89,1
CDM,27817895,ST. JUDE MULTILEAD TRIAL CABLE,400.0,260.0,87.2,400.0,65
CDM,27817895_IP,ST. JUDE MULTILEAD TRIAL CABLE,400.0,260.0,145.6,145.6,1
CDM,27817895_OP,ST. JUDE MULTILEAD TRIAL CABLE,400.0,260.0,119.6,119.6,1
CDM,27817905,ACCESSORY KIT 3550-63,150.0,97.5,32.7,150.0,65
CDM,27817905_IP,ACCESSORY KIT 3550-63,150.0,97.5,54.6,54.6,1
CDM,27817905_OP,ACCESSORY KIT 3550-63,150.0,97.5,44.85,44.85,1
CDM,27817915,MEDTRONIC RESTORE 97713,18000.0,11700.0,1030.0,18000.0,66
CDM,27817915_IP,MEDTRONIC RESTORE 97713,18000.0,11700.0,9864.0,9864.0,1
CDM,27817915_OP,MEDTRONIC RESTORE 97713,18000.0,11700.0,7812.0,7812.0,1
CDM,27817925,ST JUDE LEAD KIT 90CM LENGTH,2908.0,1890.2,633.94,2908.0,66
CDM,27817925_IP,ST JUDE LEAD KIT 90CM LENGTH,2908.0,1890.2,1593.58,1593.58,1
CDM,27817925_OP,ST JUDE LEAD KIT 90CM LENGTH,2908.0,1890.2,1262.07,1262.07,1
CDM,27817935,MEDTRONIC 1X4 POCKET ADAPTER,820.0,533.0,178.76,820.0,65
CDM,27817935_IP,MEDTRONIC 1X4 POCKET ADAPTER,820.0,533.0,298.48,298.48,1
CDM,27817935_OP,MEDTRONIC 1X4 POCKET ADAPTER,820.0,533.0,245.18,245.18,1
CDM,27817945,MEDTRONIC ACCESSORY KIT 8785,360.0,234.0,78.48,360.0,65
CDM,27817945_IP,MEDTRONIC ACCESSORY KIT 8785,360.0,234.0,131.04,131.04,1
CDM,27817945_OP,MEDTRONIC ACCESSORY KIT 8785,360.0,234.0,107.64,107.64,1
CDM,27817965,PROMETRA INTRATHECAL CATHETER,1540.0,1001.0,200.93,1540.0,74
CDM,27817965_IP,PROMETRA INTRATHECAL CATHETER,1540.0,1001.0,843.92,843.92,1
CDM,27817965_OP,PROMETRA INTRATHECAL CATHETER,1540.0,1001.0,668.36,668.36,1
CDM,27817975,BOSTON SCI PAT. PROG SC-5500,1260.0,819.0,200.93,1260.0,73
CDM,27817975_IP,BOSTON SCI PAT. PROG SC-5500,1260.0,819.0,690.48,690.48,1
CDM,27817975_OP,BOSTON SCI PAT. PROG SC-5500,1260.0,819.0,546.84,546.84,1
CDM,27817980,W STENT URET INLAY OPTIMA,108.5,70.53,23.65,232.66,73
CDM,27817980_IP,W STENT URET INLAY OPTIMA,108.5,70.53,39.49,39.49,1
CDM,27817980_OP,W STENT URET INLAY OPTIMA,108.5,70.53,32.44,32.44,1
CDM,27818055,MICRO VASCULAR PLUG MVP-5 US,3390.0,2203.5,200.93,3390.0,74
CDM,27818055_IP,MICRO VASCULAR PLUG MVP-5 US,3390.0,2203.5,1857.72,1857.72,1
CDM,27818055_OP,MICRO VASCULAR PLUG MVP-5 US,3390.0,2203.5,1471.26,1471.26,1
CDM,27818065,MICRO VASCULAR PLUG MVP-3 US,3000.0,1950.0,654.0,3000.0,66
CDM,27818065_IP,MICRO VASCULAR PLUG MVP-3 US,3000.0,1950.0,1644.0,1644.0,1
CDM,27818065_OP,MICRO VASCULAR PLUG MVP-3 US,3000.0,1950.0,1302.0,1302.0,1
CDM,27818075,CONCERTO DETACH COIL FIBER,937.5,609.38,204.38,937.5,65
CDM,27818075_IP,CONCERTO DETACH COIL FIBER,937.5,609.38,341.25,341.25,1
CDM,27818075_OP,CONCERTO DETACH COIL FIBER,937.5,609.38,280.31,280.31,1
CDM,27818095,MREYE EMB COIL 6CMX4MM,200.0,130.0,43.6,200.0,65
CDM,27818095_IP,MREYE EMB COIL 6CMX4MM,200.0,130.0,72.8,72.8,1
CDM,27818095_OP,MREYE EMB COIL 6CMX4MM,200.0,130.0,59.8,59.8,1
CDM,27818125,GLDWIRE ANG TIP 014X300CM,148.0,96.2,32.26,148.0,65
CDM,27818125_IP,GLDWIRE ANG TIP 014X300CM,148.0,96.2,53.87,53.87,1
CDM,27818125_OP,GLDWIRE ANG TIP 014X300CM,148.0,96.2,44.25,44.25,1
CDM,27818145,B-BRAUN PDA OCCLUDER,3395.0,2206.75,740.11,3395.0,66
CDM,27818145_IP,B-BRAUN PDA OCCLUDER,3395.0,2206.75,1860.46,1860.46,1
CDM,27818145_OP,B-BRAUN PDA OCCLUDER,3395.0,2206.75,1473.43,1473.43,1
CDM,27818185,INTEGRA BMWD PER 1 SQ CM,471.0,306.15,117.73,471.0,76
CDM,27818185_IP,INTEGRA BMWD PER 1 SQ CM,471.0,306.15,171.44,171.44,1
CDM,27818185_OP,INTEGRA BMWD PER 1 SQ CM,471.0,306.15,140.83,140.83,1
CDM,27818285,S 278 C2622,12337.31,8019.25,200.93,12337.31,74
CDM,27818285_IP,S 278 C2622,12337.31,8019.25,6760.85,6760.85,1
CDM,27818285_OP,S 278 C2622,12337.31,8019.25,5354.39,5354.39,1
CDM,27818475,"G010002,STENT32MM,ATRIUM,8600X",3500.0,2275.0,763.0,3500.0,59
CDM,27818475_IP,"G010002,STENT32MM,ATRIUM,8600X",3500.0,2275.0,1918.0,1918.0,1
CDM,27818475_OP,"G010002,STENT32MM,ATRIUM,8600X",3500.0,2275.0,1519.0,1519.0,1
CDM,27818535,XIENCE/BVS PR STENT,2025.0,1316.25,200.93,2025.0,74
CDM,27818535_IP,XIENCE/BVS PR STENT,2025.0,1316.25,1109.7,1109.7,1
CDM,27818535_OP,XIENCE/BVS PR STENT,2025.0,1316.25,878.85,878.85,1
CDM,27818540,BRACHYTX NON-STR HDR IR-192,750.0,487.5,212.1,750.0,91
CDM,27818540_IP,BRACHYTX NON-STR HDR IR-192,750.0,487.5,273.0,273.0,1
CDM,27818540_OP,BRACHYTX NON-STR HDR IR-192,750.0,487.5,224.25,224.25,1
CDM,27818550,IVC FIILTER TIER I,1350.0,877.5,200.93,1350.0,73
CDM,27818550_IP,IVC FIILTER TIER I,1350.0,877.5,739.8,739.8,1
CDM,27818550_OP,IVC FIILTER TIER I,1350.0,877.5,585.9,585.9,1
CDM,27818560,ZILVER DRUG ELUTING STENT,3590.0,2333.5,200.93,3590.0,74
CDM,27818560_IP,ZILVER DRUG ELUTING STENT,3590.0,2333.5,1967.32,1967.32,1
CDM,27818560_OP,ZILVER DRUG ELUTING STENT,3590.0,2333.5,1558.06,1558.06,1
CDM,27818570,C1876 STENT TIER 1,1325.0,861.25,200.93,1325.0,73
CDM,27818570_IP,C1876 STENT TIER 1,1325.0,861.25,726.1,726.1,1
CDM,27818570_OP,C1876 STENT TIER 1,1325.0,861.25,575.05,575.05,1
CDM,27818580,C1876 STENT TIER 0,1150.0,747.5,200.93,1150.0,73
CDM,27818580_IP,C1876 STENT TIER 0,1150.0,747.5,418.6,418.6,1
CDM,27818580_OP,C1876 STENT TIER 0,1150.0,747.5,343.85,343.85,1
CDM,27818590,MITRACLIP 1-5 DEVICES,60000.0,39000.0,1030.0,60000.0,66
CDM,27818590_IP,MITRACLIP 1-5 DEVICES,60000.0,39000.0,32880.0,32880.0,1
CDM,27818590_OP,MITRACLIP 1-5 DEVICES,60000.0,39000.0,26040.0,26040.0,1
CDM,27818655,SYNERGY DRUG ELUDING STENT,2800.0,1820.0,200.93,2800.0,74
CDM,27818655_IP,SYNERGY DRUG ELUDING STENT,2800.0,1820.0,1534.4,1534.4,1
CDM,27818655_OP,SYNERGY DRUG ELUDING STENT,2800.0,1820.0,1215.2,1215.2,1
CDM,27818665,STENT GRAFT HEPARIN COATED,5318.0,3456.7,200.93,5318.0,74
CDM,27818665_IP,STENT GRAFT HEPARIN COATED,5318.0,3456.7,2914.26,2914.26,1
CDM,27818665_OP,STENT GRAFT HEPARIN COATED,5318.0,3456.7,2308.01,2308.01,1
CDM,27818675,"LARIAT, SUTURE DEVICE",9900.0,6435.0,1030.0,9900.0,66
CDM,27818675_IP,"LARIAT, SUTURE DEVICE",9900.0,6435.0,5425.2,5425.2,1
CDM,27818675_OP,"LARIAT, SUTURE DEVICE",9900.0,6435.0,4296.6,4296.6,1
CDM,27818680,WATCHMAN DEVICE CAP 1-3 UNITS,34000.0,22100.0,1030.0,34000.0,66
CDM,27818680_IP,WATCHMAN DEVICE CAP 1-3 UNITS,34000.0,22100.0,18632.0,18632.0,1
CDM,27818680_OP,WATCHMAN DEVICE CAP 1-3 UNITS,34000.0,22100.0,14756.0,14756.0,1
CDM,27818685,WATCHMAN DEVICE CAP EA ADD,34000.0,22100.0,1030.0,34000.0,66
CDM,27818685_IP,WATCHMAN DEVICE CAP EA ADD,34000.0,22100.0,18632.0,18632.0,1
CDM,27818685_OP,WATCHMAN DEVICE CAP EA ADD,34000.0,22100.0,14756.0,14756.0,1
CDM,27818695,C1764 LOOP RECORDER TIER 2,9990.0,6493.5,200.93,9990.0,74
CDM,27818695_IP,C1764 LOOP RECORDER TIER 2,9990.0,6493.5,5474.52,5474.52,1
CDM,27818695_OP,C1764 LOOP RECORDER TIER 2,9990.0,6493.5,4335.66,4335.66,1
CDM,27818700,ANGIOSEAL,350.0,227.5,76.3,350.0,73
CDM,27818700_IP,ANGIOSEAL,350.0,227.5,127.4,127.4,1
CDM,27818700_OP,ANGIOSEAL,350.0,227.5,104.65,104.65,1
CDM,27818705,COBALT STENT,1300.0,845.0,200.93,1300.0,73
CDM,27818705_IP,COBALT STENT,1300.0,845.0,712.4,712.4,1
CDM,27818705_OP,COBALT STENT,1300.0,845.0,564.2,564.2,1
CDM,27818710,C1876 STENT TIER 4,2200.0,1430.0,200.93,2200.0,74
CDM,27818710_IP,C1876 STENT TIER 4,2200.0,1430.0,1205.6,1205.6,1
CDM,27818710_OP,C1876 STENT TIER 4,2200.0,1430.0,954.8,954.8,1
CDM,27818715,DRUG ELUTING STENT,7393.0,4805.45,200.93,7393.0,74
CDM,27818715_IP,DRUG ELUTING STENT,7393.0,4805.45,1424.8,1424.8,1
CDM,27818715_OP,DRUG ELUTING STENT,7393.0,4805.45,1128.4,1128.4,1
CDM,27818720,XIENCE DRUG ELUDING STENT,3150.0,2047.5,200.93,3150.0,74
CDM,27818720_IP,XIENCE DRUG ELUDING STENT,3150.0,2047.5,1726.2,1726.2,1
CDM,27818720_OP,XIENCE DRUG ELUDING STENT,3150.0,2047.5,1367.1,1367.1,1
CDM,27818725,XIENCE/BVS STENT,2025.0,1316.25,200.93,2025.0,74
CDM,27818725_IP,XIENCE/BVS STENT,2025.0,1316.25,1109.7,1109.7,1
CDM,27818725_OP,XIENCE/BVS STENT,2025.0,1316.25,878.85,878.85,1
CDM,27818805,ICAST COVERED STENT,3500.0,2275.0,200.93,3500.0,74
CDM,27818805_IP,ICAST COVERED STENT,3500.0,2275.0,1918.0,1918.0,1
CDM,27818805_OP,ICAST COVERED STENT,3500.0,2275.0,1519.0,1519.0,1
CDM,27818815,"MITRACLIP, EA ADD DEVICE",60000.0,39000.0,1030.0,60000.0,66
CDM,27818815_IP,"MITRACLIP, EA ADD DEVICE",60000.0,39000.0,32880.0,32880.0,1
CDM,27818815_OP,"MITRACLIP, EA ADD DEVICE",60000.0,39000.0,26040.0,26040.0,1
CDM,27818905,C1764 LOOP RECORDER TIER 2,9990.0,6493.5,200.93,9990.0,74
CDM,27818905_IP,C1764 LOOP RECORDER TIER 2,9990.0,6493.5,5474.52,5474.52,1
CDM,27818905_OP,C1764 LOOP RECORDER TIER 2,9990.0,6493.5,4335.66,4335.66,1
CDM,27818915,SYNERGY DRUG ELUDING STENT,2800.0,1820.0,200.93,2800.0,74
CDM,27818915_IP,SYNERGY DRUG ELUDING STENT,2800.0,1820.0,1534.4,1534.4,1
CDM,27818915_OP,SYNERGY DRUG ELUDING STENT,2800.0,1820.0,1215.2,1215.2,1
CDM,27818935,SUBDERMAL NEEDLE ELECTRODES,5.0,3.25,1.09,5.0,65
CDM,27818935_IP,SUBDERMAL NEEDLE ELECTRODES,5.0,3.25,1.82,1.82,1
CDM,27818935_OP,SUBDERMAL NEEDLE ELECTRODES,5.0,3.25,1.5,1.5,1
CDM,27818945,CORKSCREW ELECTRODES,20.0,13.0,4.36,20.0,65
CDM,27818945_IP,CORKSCREW ELECTRODES,20.0,13.0,7.28,7.28,1
CDM,27818945_OP,CORKSCREW ELECTRODES,20.0,13.0,5.98,5.98,1
CDM,27818955,NEVRO BLUE PERC LEAD KIT,2908.0,1890.2,200.93,2908.0,74
CDM,27818955_IP,NEVRO BLUE PERC LEAD KIT,2908.0,1890.2,1593.58,1593.58,1
CDM,27818955_OP,NEVRO BLUE PERC LEAD KIT,2908.0,1890.2,1262.07,1262.07,1
CDM,27818965,MEDTRONIC LEAD KIT 977A275,3158.0,2052.7,200.93,3158.0,74
CDM,27818965_IP,MEDTRONIC LEAD KIT 977A275,3158.0,2052.7,1730.58,1730.58,1
CDM,27818965_OP,MEDTRONIC LEAD KIT 977A275,3158.0,2052.7,1370.57,1370.57,1
CDM,27818975,MEDTRONIC 1X8 LEAD REV KIT,2502.0,1626.3,200.93,2502.0,74
CDM,27818975_IP,MEDTRONIC 1X8 LEAD REV KIT,2502.0,1626.3,1371.1,1371.1,1
CDM,27818975_OP,MEDTRONIC 1X8 LEAD REV KIT,2502.0,1626.3,1085.87,1085.87,1
CDM,27818985,"PUMP,ARROW CONT INFUSION #3000",7889.0,5127.85,200.93,7889.0,74
CDM,27818985_IP,"PUMP,ARROW CONT INFUSION #3000",7889.0,5127.85,4323.17,4323.17,1
CDM,27818985_OP,"PUMP,ARROW CONT INFUSION #3000",7889.0,5127.85,3423.83,3423.83,1
CDM,27818995,PROMETRA CATH TUNNEL 45.7 CM,180.0,117.0,39.24,232.66,73
CDM,27818995_IP,PROMETRA CATH TUNNEL 45.7 CM,180.0,117.0,65.52,65.52,1
CDM,27818995_OP,PROMETRA CATH TUNNEL 45.7 CM,180.0,117.0,53.82,53.82,1
CDM,27818OH,CLTX TRIMALLEOLAR ANKLE FX W/MANIPULATION,2504.0,1627.6,1.1,4686.39,148
CDM,27819005,SC-3400-30 30CM SPLITTER KIT,2970.0,1930.5,200.93,2970.0,74
CDM,27819005_IP,SC-3400-30 30CM SPLITTER KIT,2970.0,1930.5,1627.56,1627.56,1
CDM,27819005_OP,SC-3400-30 30CM SPLITTER KIT,2970.0,1930.5,1288.98,1288.98,1
CDM,27819015,SC-3138-25 25CM EXT KIT,838.0,544.7,182.68,838.0,73
CDM,27819015_IP,SC-3138-25 25CM EXT KIT,838.0,544.7,305.03,305.03,1
CDM,27819015_OP,SC-3138-25 25CM EXT KIT,838.0,544.7,250.56,250.56,1
CDM,27819025,"MEDTRONIC 1X8 EXT 20,40,60CM",383.0,248.95,83.49,383.0,73
CDM,27819025_IP,"MEDTRONIC 1X8 EXT 20,40,60CM",383.0,248.95,139.41,139.41,1
CDM,27819025_OP,"MEDTRONIC 1X8 EXT 20,40,60CM",383.0,248.95,114.52,114.52,1
CDM,27819035,"KIT, ITREL II EXT, #7495-25",990.0,643.5,200.93,990.0,73
CDM,27819035_IP,"KIT, ITREL II EXT, #7495-25",990.0,643.5,360.36,360.36,1
CDM,27819035_OP,"KIT, ITREL II EXT, #7495-25",990.0,643.5,296.01,296.01,1
CDM,27819045,"KIT,EXTENSION #3550-09",390.0,253.5,85.02,390.0,73
CDM,27819045_IP,"KIT,EXTENSION #3550-09",390.0,253.5,141.96,141.96,1
CDM,27819045_OP,"KIT,EXTENSION #3550-09",390.0,253.5,116.61,116.61,1
CDM,27819055,KIT ITREL II EXTENT 7495-40,990.0,643.5,200.93,990.0,73
CDM,27819055_IP,KIT ITREL II EXTENT 7495-40,990.0,643.5,360.36,360.36,1
CDM,27819055_OP,KIT ITREL II EXTENT 7495-40,990.0,643.5,296.01,296.01,1
CDM,27819065,KIT ITREL II EXTENSION 7495-51,990.0,643.5,200.93,990.0,73
CDM,27819065_IP,KIT ITREL II EXTENSION 7495-51,990.0,643.5,360.36,360.36,1
CDM,27819065_OP,KIT ITREL II EXTENSION 7495-51,990.0,643.5,296.01,296.01,1
CDM,27819075,A127 EXTENSION #2342,1621.38,1053.9,200.93,1621.38,74
CDM,27819075_IP,A127 EXTENSION #2342,1621.38,1053.9,888.52,888.52,1
CDM,27819075_OP,A127 EXTENSION #2342,1621.38,1053.9,703.68,703.68,1
CDM,27819085,SCS ACESSORY KIT #1701 ANS,690.63,448.91,150.56,690.63,73
CDM,27819085_IP,SCS ACESSORY KIT #1701 ANS,690.63,448.91,251.39,251.39,1
CDM,27819085_OP,SCS ACESSORY KIT #1701 ANS,690.63,448.91,206.5,206.5,1
CDM,27819095,SC-1140 IPG KIT,19800.0,12870.0,200.93,19800.0,74
CDM,27819095_IP,SC-1140 IPG KIT,19800.0,12870.0,10850.4,10850.4,1
CDM,27819095_OP,SC-1140 IPG KIT,19800.0,12870.0,8593.2,8593.2,1
CDM,27819105,BS PRECISION IPG KIT SC-1132,33000.0,21450.0,200.93,33000.0,74
CDM,27819105_IP,BS PRECISION IPG KIT SC-1132,33000.0,21450.0,18084.0,18084.0,1
CDM,27819105_OP,BS PRECISION IPG KIT SC-1132,33000.0,21450.0,14322.0,14322.0,1
CDM,27819115,BS PRECISION CHARGING SYS KIT,2300.0,1495.0,200.93,2300.0,74
CDM,27819115_IP,BS PRECISION CHARGING SYS KIT,2300.0,1495.0,1260.4,1260.4,1
CDM,27819115_OP,BS PRECISION CHARGING SYS KIT,2300.0,1495.0,998.2,998.2,1
CDM,27819125,BS INTRODUCER SC-4365,180.0,117.0,39.24,232.66,73
CDM,27819125_IP,BS INTRODUCER SC-4365,180.0,117.0,65.52,65.52,1
CDM,27819125_OP,BS INTRODUCER SC-4365,180.0,117.0,53.82,53.82,1
CDM,27819135,BOSTON SCI. IPG SC-1010C,36346.0,23624.9,200.93,36346.0,74
CDM,27819135_IP,BOSTON SCI. IPG SC-1010C,36346.0,23624.9,19917.61,19917.61,1
CDM,27819135_OP,BOSTON SCI. IPG SC-1010C,36346.0,23624.9,15774.16,15774.16,1
CDM,27819145,SC-5532-1 REMOTE CONTROL KIT,1600.0,1040.0,200.93,1600.0,74
CDM,27819145_IP,SC-5532-1 REMOTE CONTROL KIT,1600.0,1040.0,876.8,876.8,1
CDM,27819145_OP,SC-5532-1 REMOTE CONTROL KIT,1600.0,1040.0,694.4,694.4,1
CDM,27819155,SC-5542-1 FREE LINK REMOTE KIT,1260.0,819.0,200.93,1260.0,73
CDM,27819155_IP,SC-5542-1 FREE LINK REMOTE KIT,1260.0,819.0,690.48,690.48,1
CDM,27819155_OP,SC-5542-1 FREE LINK REMOTE KIT,1260.0,819.0,546.84,546.84,1
CDM,27819165,MEDTRONIC MESH POUCH,170.0,110.5,37.06,232.66,73
CDM,27819165_IP,MEDTRONIC MESH POUCH,170.0,110.5,61.88,61.88,1
CDM,27819165_OP,MEDTRONIC MESH POUCH,170.0,110.5,50.83,50.83,1
CDM,27819425,BS MODEL SC-4305 SUTURE SLEEVE,150.0,97.5,32.7,150.0,65
CDM,27819425_IP,BS MODEL SC-4305 SUTURE SLEEVE,150.0,97.5,54.6,54.6,1
CDM,27819425_OP,BS MODEL SC-4305 SUTURE SLEEVE,150.0,97.5,44.85,44.85,1
CDM,27819435,MEDTRONIC SPINAL CATH REV KIT,990.0,643.5,215.82,990.0,65
CDM,27819435_IP,MEDTRONIC SPINAL CATH REV KIT,990.0,643.5,360.36,360.36,1
CDM,27819435_OP,MEDTRONIC SPINAL CATH REV KIT,990.0,643.5,296.01,296.01,1
CDM,27819455,MEDTRONIC TUNNELING PASSER 38,180.0,117.0,39.24,180.0,65
CDM,27819455_IP,MEDTRONIC TUNNELING PASSER 38,180.0,117.0,65.52,65.52,1
CDM,27819455_OP,MEDTRONIC TUNNELING PASSER 38,180.0,117.0,53.82,53.82,1
CDM,27819465,MEDTRONIC SPINAL REV SEGMENT,600.0,390.0,130.8,600.0,65
CDM,27819465_IP,MEDTRONIC SPINAL REV SEGMENT,600.0,390.0,218.4,218.4,1
CDM,27819465_OP,MEDTRONIC SPINAL REV SEGMENT,600.0,390.0,179.4,179.4,1
CDM,27819475,MEDTRONIC TUNNELING TOOL,150.0,97.5,32.7,150.0,65
CDM,27819475_IP,MEDTRONIC TUNNELING TOOL,150.0,97.5,54.6,54.6,1
CDM,27819475_OP,MEDTRONIC TUNNELING TOOL,150.0,97.5,44.85,44.85,1
CDM,27819485,MEDTRONIC TUNNELING PASSER 60,180.0,117.0,39.24,180.0,65
CDM,27819485_IP,MEDTRONIC TUNNELING PASSER 60,180.0,117.0,65.52,65.52,1
CDM,27819485_OP,MEDTRONIC TUNNELING PASSER 60,180.0,117.0,53.82,53.82,1
CDM,27819495,KIVA VCF TREATMENT SYSTEM RT/LT,7192.0,4674.8,1030.0,7192.0,66
CDM,27819495_IP,KIVA VCF TREATMENT SYSTEM RT/LT,7192.0,4674.8,3941.22,3941.22,1
CDM,27819495_OP,KIVA VCF TREATMENT SYSTEM RT/LT,7192.0,4674.8,3121.33,3121.33,1
CDM,27819505,MEDTRONIC CURVE TIP NEEDLE,76.0,49.4,16.57,76.0,65
CDM,27819505_IP,MEDTRONIC CURVE TIP NEEDLE,76.0,49.4,27.66,27.66,1
CDM,27819505_OP,MEDTRONIC CURVE TIP NEEDLE,76.0,49.4,22.72,22.72,1
CDM,27819515,MEDTRONIC BUMPY CONNECTOR,248.0,161.2,54.06,248.0,65
CDM,27819515_IP,MEDTRONIC BUMPY CONNECTOR,248.0,161.2,90.27,90.27,1
CDM,27819515_OP,MEDTRONIC BUMPY CONNECTOR,248.0,161.2,74.15,74.15,1
CDM,27819525,BS SC-1100-02 PRECISION IPG,24300.0,15795.0,1030.0,24300.0,66
CDM,27819525_IP,BS SC-1100-02 PRECISION IPG,24300.0,15795.0,13316.4,13316.4,1
CDM,27819525_OP,BS SC-1100-02 PRECISION IPG,24300.0,15795.0,10546.2,10546.2,1
CDM,27819535,SC-6500-03 PATIENT TRIAL KIT,170.0,110.5,37.06,170.0,65
CDM,27819535_IP,SC-6500-03 PATIENT TRIAL KIT,170.0,110.5,61.88,61.88,1
CDM,27819535_OP,SC-6500-03 PATIENT TRIAL KIT,170.0,110.5,50.83,50.83,1
CDM,27819545,KYPHON T15K OSTEO DEVICE,800.0,520.0,174.4,800.0,65
CDM,27819545_IP,KYPHON T15K OSTEO DEVICE,800.0,520.0,291.2,291.2,1
CDM,27819545_OP,KYPHON T15K OSTEO DEVICE,800.0,520.0,239.2,239.2,1
CDM,27819555,28CM STRAW TUNNEL TOOL SC-4252,600.0,390.0,130.8,600.0,65
CDM,27819555_IP,28CM STRAW TUNNEL TOOL SC-4252,600.0,390.0,218.4,218.4,1
CDM,27819555_OP,28CM STRAW TUNNEL TOOL SC-4252,600.0,390.0,179.4,179.4,1
CDM,27819565,OR CABLE/EXTNS SC-4100A,600.0,390.0,130.8,600.0,65
CDM,27819565_IP,OR CABLE/EXTNS SC-4100A,600.0,390.0,218.4,218.4,1
CDM,27819565_OP,OR CABLE/EXTNS SC-4100A,600.0,390.0,179.4,179.4,1
CDM,27819575,PERC EXT INLINE KIT 3550-05,370.0,240.5,80.66,370.0,65
CDM,27819575_IP,PERC EXT INLINE KIT 3550-05,370.0,240.5,134.68,134.68,1
CDM,27819575_OP,PERC EXT INLINE KIT 3550-05,370.0,240.5,110.63,110.63,1
CDM,27819585,"10CM 4"" INSERT NEEDLE SC-4200",430.0,279.5,93.74,430.0,65
CDM,27819585_IP,"10CM 4"" INSERT NEEDLE SC-4200",430.0,279.5,156.52,156.52,1
CDM,27819585_OP,"10CM 4"" INSERT NEEDLE SC-4200",430.0,279.5,128.57,128.57,1
CDM,27819595,HEX WRENCH SC - 4275,150.0,97.5,32.7,150.0,65
CDM,27819595_IP,HEX WRENCH SC - 4275,150.0,97.5,54.6,54.6,1
CDM,27819595_OP,HEX WRENCH SC - 4275,150.0,97.5,44.85,44.85,1
CDM,27819605,STEER KIT W/CAP SC-4395-50,258.0,167.7,56.24,258.0,65
CDM,27819605_IP,STEER KIT W/CAP SC-4395-50,258.0,167.7,93.91,93.91,1
CDM,27819605_OP,STEER KIT W/CAP SC-4395-50,258.0,167.7,77.14,77.14,1
CDM,27819615,30CM SPLITTER 2X8 KIT BS,2916.0,1895.4,635.69,2916.0,66
CDM,27819615_IP,30CM SPLITTER 2X8 KIT BS,2916.0,1895.4,1597.97,1597.97,1
CDM,27819615_OP,30CM SPLITTER 2X8 KIT BS,2916.0,1895.4,1265.54,1265.54,1
CDM,27819625,MEDTRONIC RECHARABLE NEUROSTIM,27100.0,17615.0,1030.0,27100.0,66
CDM,27819625_IP,MEDTRONIC RECHARABLE NEUROSTIM,27100.0,17615.0,14850.8,14850.8,1
CDM,27819625_OP,MEDTRONIC RECHARABLE NEUROSTIM,27100.0,17615.0,11761.4,11761.4,1
CDM,27819635,RESTORE SENSOR NEUROSTIMULATOR,26600.0,17290.0,1030.0,26600.0,66
CDM,27819635_IP,RESTORE SENSOR NEUROSTIMULATOR,26600.0,17290.0,14576.8,14576.8,1
CDM,27819635_OP,RESTORE SENSOR NEUROSTIMULATOR,26600.0,17290.0,11544.4,11544.4,1
CDM,27819645,MEDTRONIC 6 SURGICAL LEAD,4300.0,2795.0,937.4,4300.0,66
CDM,27819645_IP,MEDTRONIC 6 SURGICAL LEAD,4300.0,2795.0,2356.4,2356.4,1
CDM,27819645_OP,MEDTRONIC 6 SURGICAL LEAD,4300.0,2795.0,1866.2,1866.2,1
CDM,27819655,"PROGRAM, SYNERGY, PATIENT 7435",1990.0,1293.5,433.82,1990.0,66
CDM,27819655_IP,"PROGRAM, SYNERGY, PATIENT 7435",1990.0,1293.5,1090.52,1090.52,1
CDM,27819655_OP,"PROGRAM, SYNERGY, PATIENT 7435",1990.0,1293.5,863.66,863.66,1
CDM,27819665,ANS LEAD EXTENSION 30 CM #3383,1900.0,1235.0,200.93,1900.0,74
CDM,27819665_IP,ANS LEAD EXTENSION 30 CM #3383,1900.0,1235.0,1041.2,1041.2,1
CDM,27819665_OP,ANS LEAD EXTENSION 30 CM #3383,1900.0,1235.0,824.6,824.6,1
CDM,27819675,PRECISION GENERATOR SC#4316,36346.0,23624.9,200.93,36346.0,74
CDM,27819675_IP,PRECISION GENERATOR SC#4316,36346.0,23624.9,19917.61,19917.61,1
CDM,27819675_OP,PRECISION GENERATOR SC#4316,36346.0,23624.9,15774.16,15774.16,1
CDM,27820255,IDC FIBERED OCCL SYS: 36-150 THRU 36-177,778.0,505.7,169.6,778.0,65
CDM,27820255_IP,IDC FIBERED OCCL SYS: 36-150 THRU 36-177,778.0,505.7,283.19,283.19,1
CDM,27820255_OP,IDC FIBERED OCCL SYS: 36-150 THRU 36-177,778.0,505.7,232.62,232.62,1
CDM,27820265,"EPIDURAL NEEDLE, 14 GAUGE 6? (15CM)",65.0,42.25,14.17,65.0,65
CDM,27820265_IP,"EPIDURAL NEEDLE, 14 GAUGE 6? (15CM)",65.0,42.25,23.66,23.66,1
CDM,27820265_OP,"EPIDURAL NEEDLE, 14 GAUGE 6? (15CM)",65.0,42.25,19.44,19.44,1
CDM,27820275,"EXTERNAL PULSE GENERATOR, 2 PORT HEADER",550.0,357.5,119.9,550.0,73
CDM,27820275_IP,"EXTERNAL PULSE GENERATOR, 2 PORT HEADER",550.0,357.5,200.2,200.2,1
CDM,27820275_OP,"EXTERNAL PULSE GENERATOR, 2 PORT HEADER",550.0,357.5,164.45,164.45,1
CDM,27820285,C1874 DRUG ELUT STENT TIER II,5742.0,3732.3,200.93,5742.0,74
CDM,27820285_IP,C1874 DRUG ELUT STENT TIER II,5742.0,3732.3,3146.62,3146.62,1
CDM,27820285_OP,C1874 DRUG ELUT STENT TIER II,5742.0,3732.3,2492.03,2492.03,1
CDM,27820295,IVC FIILTER TIER I,1398.0,908.7,200.93,1398.0,74
CDM,27820295_IP,IVC FIILTER TIER I,1398.0,908.7,766.1,766.1,1
CDM,27820295_OP,IVC FIILTER TIER I,1398.0,908.7,606.73,606.73,1
CDM,27820305,BIONESS STIM ROUTER LEAD KIT,8500.0,5525.0,1030.0,8500.0,66
CDM,27820305_IP,BIONESS STIM ROUTER LEAD KIT,8500.0,5525.0,4658.0,4658.0,1
CDM,27820305_OP,BIONESS STIM ROUTER LEAD KIT,8500.0,5525.0,3689.0,3689.0,1
CDM,27820325,ST.JUDE LEAD DELIVERY,718.0,466.7,156.52,718.0,73
CDM,27820325_IP,ST.JUDE LEAD DELIVERY,718.0,466.7,261.35,261.35,1
CDM,27820325_OP,ST.JUDE LEAD DELIVERY,718.0,466.7,214.68,214.68,1
CDM,27820345,SC-2316-50 INFINION LEAD KIT,6400.0,4160.0,200.93,6400.0,74
CDM,27820345_IP,SC-2316-50 INFINION LEAD KIT,6400.0,4160.0,3507.2,3507.2,1
CDM,27820345_OP,SC-2316-50 INFINION LEAD KIT,6400.0,4160.0,2777.6,2777.6,1
CDM,27820350,SC-2218-70 LINEAR LEAD KIT,2908.0,1890.2,200.93,2908.0,74
CDM,27820350_IP,SC-2218-70 LINEAR LEAD KIT,2908.0,1890.2,1593.58,1593.58,1
CDM,27820350_OP,SC-2218-70 LINEAR LEAD KIT,2908.0,1890.2,1262.07,1262.07,1
CDM,27820365,NEVRO IPG KIT,25300.0,16445.0,1030.0,25300.0,66
CDM,27820365_IP,NEVRO IPG KIT,25300.0,16445.0,13864.4,13864.4,1
CDM,27820365_OP,NEVRO IPG KIT,25300.0,16445.0,10980.2,10980.2,1
CDM,27820375,COOK MREYE EMBOLIZATION COIL,130.0,84.5,28.34,130.0,65
CDM,27820375_IP,COOK MREYE EMBOLIZATION COIL,130.0,84.5,47.32,47.32,1
CDM,27820375_OP,COOK MREYE EMBOLIZATION COIL,130.0,84.5,38.87,38.87,1
CDM,27820385,COOK MREYE COIL 1X2,1995.0,1296.75,434.91,1995.0,66
CDM,27820385_IP,COOK MREYE COIL 1X2,1995.0,1296.75,1093.26,1093.26,1
CDM,27820385_OP,COOK MREYE COIL 1X2,1995.0,1296.75,865.83,865.83,1
CDM,27820395,NIT-OCCLUD PDA DEVICE,3395.0,2206.75,200.93,3395.0,74
CDM,27820395_IP,NIT-OCCLUD PDA DEVICE,3395.0,2206.75,1860.46,1860.46,1
CDM,27820395_OP,NIT-OCCLUD PDA DEVICE,3395.0,2206.75,1473.43,1473.43,1
CDM,27820405,CATH BALLOON ATLAS 12/14,1800.0,1170.0,200.93,1800.0,74
CDM,27820405_IP,CATH BALLOON ATLAS 12/14,1800.0,1170.0,986.4,986.4,1
CDM,27820405_OP,CATH BALLOON ATLAS 12/14,1800.0,1170.0,781.2,781.2,1
CDM,27820415,STRYKER ICAST COVERED STENT,1805.0,1173.25,200.93,1805.0,74
CDM,27820415_IP,STRYKER ICAST COVERED STENT,1805.0,1173.25,989.14,989.14,1
CDM,27820415_OP,STRYKER ICAST COVERED STENT,1805.0,1173.25,783.37,783.37,1
CDM,27820425,SC-4316 CLIK ANCHOR,790.0,513.5,172.22,790.0,73
CDM,27820425_IP,SC-4316 CLIK ANCHOR,790.0,513.5,287.56,287.56,1
CDM,27820425_OP,SC-4316 CLIK ANCHOR,790.0,513.5,236.21,236.21,1
CDM,27820435,BOSTON SCI. TUNNELLING SC-4254,600.0,390.0,130.8,600.0,73
CDM,27820435_IP,BOSTON SCI. TUNNELLING SC-4254,600.0,390.0,218.4,218.4,1
CDM,27820435_OP,BOSTON SCI. TUNNELLING SC-4254,600.0,390.0,179.4,179.4,1
CDM,27820445,MEDTRONIC BI WING 97792,248.0,161.2,54.06,248.0,73
CDM,27820445_IP,MEDTRONIC BI WING 97792,248.0,161.2,90.27,90.27,1
CDM,27820445_OP,MEDTRONIC BI WING 97792,248.0,161.2,74.15,74.15,1
CDM,27820455,ANS RECHARGEABLE IPG,24044.0,15628.6,200.93,24044.0,74
CDM,27820455_IP,ANS RECHARGEABLE IPG,24044.0,15628.6,13176.11,13176.11,1
CDM,27820455_OP,ANS RECHARGEABLE IPG,24044.0,15628.6,10435.1,10435.1,1
CDM,27820465,MEDTRONIC RECHARGEABLE IPG,26288.0,17087.2,200.93,26288.0,74
CDM,27820465_IP,MEDTRONIC RECHARGEABLE IPG,26288.0,17087.2,14405.82,14405.82,1
CDM,27820465_OP,MEDTRONIC RECHARGEABLE IPG,26288.0,17087.2,11408.99,11408.99,1
CDM,27820475,BOSTON NS RECHARGEABLE IPG,27970.0,18180.5,200.93,27970.0,74
CDM,27820475_IP,BOSTON NS RECHARGEABLE IPG,27970.0,18180.5,15327.56,15327.56,1
CDM,27820475_OP,BOSTON NS RECHARGEABLE IPG,27970.0,18180.5,12138.98,12138.98,1
CDM,27820485,ST JUDE ION MINI GENERATOR,24300.0,15795.0,200.93,24300.0,74
CDM,27820485_IP,ST JUDE ION MINI GENERATOR,24300.0,15795.0,13316.4,13316.4,1
CDM,27820485_OP,ST JUDE ION MINI GENERATOR,24300.0,15795.0,10546.2,10546.2,1
CDM,27820495,MEDTRONIC ULTRA GENERATOR,24300.0,15795.0,200.93,24300.0,74
CDM,27820495_IP,MEDTRONIC ULTRA GENERATOR,24300.0,15795.0,13316.4,13316.4,1
CDM,27820495_OP,MEDTRONIC ULTRA GENERATOR,24300.0,15795.0,10546.2,10546.2,1
CDM,27820505,RESTORE SENSOR GENERATOR 37714,26600.0,17290.0,200.93,26600.0,74
CDM,27820505_IP,RESTORE SENSOR GENERATOR 37714,26600.0,17290.0,14576.8,14576.8,1
CDM,27820505_OP,RESTORE SENSOR GENERATOR 37714,26600.0,17290.0,11544.4,11544.4,1
CDM,27820515,MEDTRONICS GENERATOR 97714,27000.0,17550.0,200.93,27000.0,74
CDM,27820515_IP,MEDTRONICS GENERATOR 97714,27000.0,17550.0,14796.0,14796.0,1
CDM,27820515_OP,MEDTRONICS GENERATOR 97714,27000.0,17550.0,11718.0,11718.0,1
CDM,27820525,SJM IPG 16 CHANNEL RECHARGE,25000.0,16250.0,200.93,25000.0,74
CDM,27820525_IP,SJM IPG 16 CHANNEL RECHARGE,25000.0,16250.0,13700.0,13700.0,1
CDM,27820525_OP,SJM IPG 16 CHANNEL RECHARGE,25000.0,16250.0,10850.0,10850.0,1
CDM,27820535,SURESCAN ULTRA IPG 97712,22000.0,14300.0,200.93,22000.0,74
CDM,27820535_IP,SURESCAN ULTRA IPG 97712,22000.0,14300.0,12056.0,12056.0,1
CDM,27820535_OP,SURESCAN ULTRA IPG 97712,22000.0,14300.0,9548.0,9548.0,1
CDM,27820545,ST JUDE CHARGING SYSTEM 3730,1260.0,819.0,200.93,1260.0,73
CDM,27820545_IP,ST JUDE CHARGING SYSTEM 3730,1260.0,819.0,690.48,690.48,1
CDM,27820545_OP,ST JUDE CHARGING SYSTEM 3730,1260.0,819.0,546.84,546.84,1
CDM,27820555,MED CHARGING SYSTEM 97754,3200.0,2080.0,200.93,3200.0,74
CDM,27820555_IP,MED CHARGING SYSTEM 97754,3200.0,2080.0,1753.6,1753.6,1
CDM,27820555_OP,MED CHARGING SYSTEM 97754,3200.0,2080.0,1388.8,1388.8,1
CDM,27820565,PRIMEADVANCED 37702,13365.0,8687.25,200.93,13365.0,74
CDM,27820565_IP,PRIMEADVANCED 37702,13365.0,8687.25,7324.02,7324.02,1
CDM,27820565_OP,PRIMEADVANCED 37702,13365.0,8687.25,5800.41,5800.41,1
CDM,27820575,MEDTRONIC NON-RECHARGEABLE IPG,19316.0,12555.4,200.93,19316.0,74
CDM,27820575_IP,MEDTRONIC NON-RECHARGEABLE IPG,19316.0,12555.4,10585.17,10585.17,1
CDM,27820575_OP,MEDTRONIC NON-RECHARGEABLE IPG,19316.0,12555.4,8383.14,8383.14,1
CDM,27820585,ST. JUDE 16 CHANNEL IPG,19980.0,12987.0,200.93,19980.0,74
CDM,27820585_IP,ST. JUDE 16 CHANNEL IPG,19980.0,12987.0,10949.04,10949.04,1
CDM,27820585_OP,ST. JUDE 16 CHANNEL IPG,19980.0,12987.0,8671.32,8671.32,1
CDM,27820595,1X8 STANDARD LEAD KIT,5975.0,3883.75,200.93,5975.0,74
CDM,27820595_IP,1X8 STANDARD LEAD KIT,5975.0,3883.75,3274.3,3274.3,1
CDM,27820595_OP,1X8 STANDARD LEAD KIT,5975.0,3883.75,2593.15,2593.15,1
CDM,27820605,"ANS OCTRODE LEADKIT, #3186",5015.0,3259.75,200.93,5015.0,74
CDM,27820605_IP,"ANS OCTRODE LEADKIT, #3186",5015.0,3259.75,2748.22,2748.22,1
CDM,27820605_OP,"ANS OCTRODE LEADKIT, #3186",5015.0,3259.75,2176.51,2176.51,1
CDM,27820615,"ANS PERCUT LEAD, 8CHNL #3086",2541.5,1651.98,200.93,2541.5,74
CDM,27820615_IP,"ANS PERCUT LEAD, 8CHNL #3086",2541.5,1651.98,1392.74,1392.74,1
CDM,27820615_OP,"ANS PERCUT LEAD, 8CHNL #3086",2541.5,1651.98,1103.01,1103.01,1
CDM,27820625,"ANS QUATTRODE LEADKIT, #3146",3315.0,2154.75,200.93,3315.0,74
CDM,27820625_IP,"ANS QUATTRODE LEADKIT, #3146",3315.0,2154.75,1816.62,1816.62,1
CDM,27820625_OP,"ANS QUATTRODE LEADKIT, #3146",3315.0,2154.75,1438.71,1438.71,1
CDM,27820635,PRECISION LEAD #2108 50CM,3608.0,2345.2,200.93,3608.0,74
CDM,27820635_IP,PRECISION LEAD #2108 50CM,3608.0,2345.2,1977.18,1977.18,1
CDM,27820635_OP,PRECISION LEAD #2108 50CM,3608.0,2345.2,1565.87,1565.87,1
CDM,27820645,PRECISION LEAD #2108 70CM,3608.0,2345.2,200.93,3608.0,74
CDM,27820645_IP,PRECISION LEAD #2108 70CM,3608.0,2345.2,1977.18,1977.18,1
CDM,27820645_OP,PRECISION LEAD #2108 70CM,3608.0,2345.2,1565.87,1565.87,1
CDM,27820655,PRECISION LEAD EXT #3108 35CM,1312.0,852.8,200.93,1312.0,73
CDM,27820655_IP,PRECISION LEAD EXT #3108 35CM,1312.0,852.8,718.98,718.98,1
CDM,27820655_OP,PRECISION LEAD EXT #3108 35CM,1312.0,852.8,569.41,569.41,1
CDM,27820665,LEAD-OCTAD MEDTRONIC 377730,3980.0,2587.0,200.93,3980.0,74
CDM,27820665_IP,LEAD-OCTAD MEDTRONIC 377730,3980.0,2587.0,2181.04,2181.04,1
CDM,27820665_OP,LEAD-OCTAD MEDTRONIC 377730,3980.0,2587.0,1727.32,1727.32,1
CDM,27820675,BOSTON SCI 70 CM 8 LEAD KIT,2908.0,1890.2,200.93,2908.0,74
CDM,27820675_IP,BOSTON SCI 70 CM 8 LEAD KIT,2908.0,1890.2,1593.58,1593.58,1
CDM,27820675_OP,BOSTON SCI 70 CM 8 LEAD KIT,2908.0,1890.2,1262.07,1262.07,1
CDM,27820685,MEDTRONIC LEAD KIT 977A260,3908.0,2540.2,200.93,3908.0,74
CDM,27820685_IP,MEDTRONIC LEAD KIT 977A260,3908.0,2540.2,2141.58,2141.58,1
CDM,27820685_OP,MEDTRONIC LEAD KIT 977A260,3908.0,2540.2,1696.07,1696.07,1
CDM,27820695,MEDTRONIC LEAD KIT 3777-60,2908.0,1890.2,200.93,2908.0,74
CDM,27820695_IP,MEDTRONIC LEAD KIT 3777-60,2908.0,1890.2,1593.58,1593.58,1
CDM,27820695_OP,MEDTRONIC LEAD KIT 3777-60,2908.0,1890.2,1262.07,1262.07,1
CDM,27820705,MEDTRONIC LEAD TRIAL 977D260,2502.0,1626.3,200.93,2502.0,74
CDM,27820705_IP,MEDTRONIC LEAD TRIAL 977D260,2502.0,1626.3,1371.1,1371.1,1
CDM,27820705_OP,MEDTRONIC LEAD TRIAL 977D260,2502.0,1626.3,1085.87,1085.87,1
CDM,27820715,MEDTRONIC LEAD KIT 977A290,3158.0,2052.7,200.93,3158.0,74
CDM,27820715_IP,MEDTRONIC LEAD KIT 977A290,3158.0,2052.7,1730.58,1730.58,1
CDM,27820715_OP,MEDTRONIC LEAD KIT 977A290,3158.0,2052.7,1370.57,1370.57,1
CDM,27820725,PRIMEADVANCED SURESCAN 97702,19800.0,12870.0,200.93,19800.0,74
CDM,27820725_IP,PRIMEADVANCED SURESCAN 97702,19800.0,12870.0,10850.4,10850.4,1
CDM,27820725_OP,PRIMEADVANCED SURESCAN 97702,19800.0,12870.0,8593.2,8593.2,1
CDM,27820735,SYNCHROMED INF PUMP #8637-40,24075.0,15648.75,200.93,24075.0,74
CDM,27820735_IP,SYNCHROMED INF PUMP #8637-40,24075.0,15648.75,13193.1,13193.1,1
CDM,27820735_OP,SYNCHROMED INF PUMP #8637-40,24075.0,15648.75,10448.55,10448.55,1
CDM,27820745,SYNCHROMED INF PUMP #8637-20,24075.0,15648.75,200.93,24075.0,74
CDM,27820745_IP,SYNCHROMED INF PUMP #8637-20,24075.0,15648.75,13193.1,13193.1,1
CDM,27820745_OP,SYNCHROMED INF PUMP #8637-20,24075.0,15648.75,10448.55,10448.55,1
CDM,27820755,PROMETRA PROGRAMMABLE PUMP,17600.0,11440.0,200.93,17600.0,74
CDM,27820755_IP,PROMETRA PROGRAMMABLE PUMP,17600.0,11440.0,9644.8,9644.8,1
CDM,27820755_OP,PROMETRA PROGRAMMABLE PUMP,17600.0,11440.0,7638.4,7638.4,1
CDM,27820765,"KIT,REVISION #3550-10",580.0,377.0,126.44,580.0,73
CDM,27820765_IP,"KIT,REVISION #3550-10",580.0,377.0,211.12,211.12,1
CDM,27820765_OP,"KIT,REVISION #3550-10",580.0,377.0,173.42,173.42,1
CDM,27820775,"KIT, ACCESSORY, #3550-16",90.0,58.5,19.62,232.66,73
CDM,27820775_IP,"KIT, ACCESSORY, #3550-16",90.0,58.5,32.76,32.76,1
CDM,27820775_OP,"KIT, ACCESSORY, #3550-16",90.0,58.5,26.91,26.91,1
CDM,27820785,MEDTRONIC ACCESS KIT 355531,496.0,322.4,108.13,496.0,73
CDM,27820785_IP,MEDTRONIC ACCESS KIT 355531,496.0,322.4,180.54,180.54,1
CDM,27820785_OP,MEDTRONIC ACCESS KIT 355531,496.0,322.4,148.3,148.3,1
CDM,27820795,ACCESSORY KIT 3550-28,92.0,59.8,20.06,232.66,73
CDM,27820795_IP,ACCESSORY KIT 3550-28,92.0,59.8,33.49,33.49,1
CDM,27820795_OP,ACCESSORY KIT 3550-28,92.0,59.8,27.51,27.51,1
CDM,27820805,MEDTRONIC ACCESSORY 3550-24,82.0,53.3,17.88,232.66,73
CDM,27820805_IP,MEDTRONIC ACCESSORY 3550-24,82.0,53.3,29.85,29.85,1
CDM,27820805_OP,MEDTRONIC ACCESSORY 3550-24,82.0,53.3,24.52,24.52,1
CDM,27820815,BOSTON SCI PAT. PROG SC-5500,1260.0,819.0,200.93,1260.0,73
CDM,27820815_IP,BOSTON SCI PAT. PROG SC-5500,1260.0,819.0,690.48,690.48,1
CDM,27820815_OP,BOSTON SCI PAT. PROG SC-5500,1260.0,819.0,546.84,546.84,1
CDM,27820825,MEDTRONICS PT PROG 97740,1260.0,819.0,200.93,1260.0,73
CDM,27820825_IP,MEDTRONICS PT PROG 97740,1260.0,819.0,690.48,690.48,1
CDM,27820825_OP,MEDTRONICS PT PROG 97740,1260.0,819.0,546.84,546.84,1
CDM,27820835,ST JUDE PATIENT PROGRAMMER,1260.0,819.0,200.93,1260.0,73
CDM,27820835_IP,ST JUDE PATIENT PROGRAMMER,1260.0,819.0,690.48,690.48,1
CDM,27820835_OP,ST JUDE PATIENT PROGRAMMER,1260.0,819.0,546.84,546.84,1
CDM,27820855,AXIUM SLIMTIP TRIAL LEAD KIT 50CM,3490.0,2268.5,200.93,3490.0,74
CDM,27820855_IP,AXIUM SLIMTIP TRIAL LEAD KIT 50CM,3490.0,2268.5,1912.52,1912.52,1
CDM,27820855_OP,AXIUM SLIMTIP TRIAL LEAD KIT 50CM,3490.0,2268.5,1514.66,1514.66,1
CDM,27820865,AXIUM BIG CURVE DELIVERY SHEATH KIT 22CM,1190.0,773.5,259.42,1190.0,65
CDM,27820865_IP,AXIUM BIG CURVE DELIVERY SHEATH KIT 22CM,1190.0,773.5,433.16,433.16,1
CDM,27820865_OP,AXIUM BIG CURVE DELIVERY SHEATH KIT 22CM,1190.0,773.5,355.81,355.81,1
CDM,27820875,AXIUM CONNECTOR CABLE KIT,480.0,312.0,104.64,480.0,65
CDM,27820875_IP,AXIUM CONNECTOR CABLE KIT,480.0,312.0,174.72,174.72,1
CDM,27820875_OP,AXIUM CONNECTOR CABLE KIT,480.0,312.0,143.52,143.52,1
CDM,27820895,"GENESIS XP, IPG # 3609",29314.38,19054.35,200.93,29314.38,74
CDM,27820895_IP,"GENESIS XP, IPG # 3609",29314.38,19054.35,16064.28,16064.28,1
CDM,27820895_OP,"GENESIS XP, IPG # 3609",29314.38,19054.35,12722.44,12722.44,1
CDM,27820935,LEAD NEUROSTIMULATOR C1778 (278),14965.0,9727.25,200.93,14965.0,75
CDM,27820975,IMPLANT NEUROSTIM LEAD TEST KIT C1897 (278),824.0,535.6,179.63,824.0,74
CDM,27821035,CLIK ANCHOR HEXWRENCH SC-4276,150.0,97.5,32.7,232.66,73
CDM,27821035_IP,CLIK ANCHOR HEXWRENCH SC-4276,150.0,97.5,54.6,54.6,1
CDM,27821035_OP,CLIK ANCHOR HEXWRENCH SC-4276,150.0,97.5,44.85,44.85,1
CDM,27821045,CLIK ANCHOR SC-4316,790.0,513.5,172.22,790.0,73
CDM,27821045_IP,CLIK ANCHOR SC-4316,790.0,513.5,287.56,287.56,1
CDM,27821045_OP,CLIK ANCHOR SC-4316,790.0,513.5,236.21,236.21,1
CDM,27821245,MEDTRONIC ON POINT 3987A,3420.0,2223.0,200.93,3420.0,74
CDM,27821245_IP,MEDTRONIC ON POINT 3987A,3420.0,2223.0,1874.16,1874.16,1
CDM,27821245_OP,MEDTRONIC ON POINT 3987A,3420.0,2223.0,1484.28,1484.28,1
CDM,27821265,MEDTRONIC EXT 37083-60,838.0,544.7,182.68,838.0,73
CDM,27821265_IP,MEDTRONIC EXT 37083-60,838.0,544.7,305.03,305.03,1
CDM,27821265_OP,MEDTRONIC EXT 37083-60,838.0,544.7,250.56,250.56,1
CDM,27821285,MEDTRONIC 1X8 TRIAL LEAD,248.0,161.2,54.06,248.0,73
CDM,27821285_IP,MEDTRONIC 1X8 TRIAL LEAD,248.0,161.2,90.27,90.27,1
CDM,27821285_OP,MEDTRONIC 1X8 TRIAL LEAD,248.0,161.2,74.15,74.15,1
CDM,27821295,MEDTRONIC SURESCAN 977A160,3158.0,2052.7,200.93,3158.0,74
CDM,27821295_IP,MEDTRONIC SURESCAN 977A160,3158.0,2052.7,1730.58,1730.58,1
CDM,27821295_OP,MEDTRONIC SURESCAN 977A160,3158.0,2052.7,1370.57,1370.57,1
CDM,27821305,"H110002,B,ARGUS II RETINAL PROS",288116.0,187275.4,200.93,288116.0,74
CDM,27821305_IP,"H110002,B,ARGUS II RETINAL PROS",288116.0,187275.4,157887.57,157887.57,1
CDM,27821305_OP,"H110002,B,ARGUS II RETINAL PROS",288116.0,187275.4,125042.34,125042.34,1
CDM,27821315,RX ACCULINK CAROTID STENT,4018.0,2611.7,200.93,4018.0,74
CDM,27821315_IP,RX ACCULINK CAROTID STENT,4018.0,2611.7,2201.86,2201.86,1
CDM,27821315_OP,RX ACCULINK CAROTID STENT,4018.0,2611.7,1743.81,1743.81,1
CDM,27821325,C1876 STENT TIER 3,1790.0,1163.5,200.93,1790.0,74
CDM,27821325_IP,C1876 STENT TIER 3,1790.0,1163.5,980.92,980.92,1
CDM,27821325_OP,C1876 STENT TIER 3,1790.0,1163.5,776.86,776.86,1
CDM,27821335,MONOPOLAR STIMULATOR PROBE,73.5,47.78,16.02,73.5,65
CDM,27821335_IP,MONOPOLAR STIMULATOR PROBE,73.5,47.78,26.75,26.75,1
CDM,27821335_OP,MONOPOLAR STIMULATOR PROBE,73.5,47.78,21.98,21.98,1
CDM,27821345,BIPOLAR STIMULATOR PROBES,125.0,81.25,27.25,125.0,65
CDM,27821345_IP,BIPOLAR STIMULATOR PROBES,125.0,81.25,45.5,45.5,1
CDM,27821345_OP,BIPOLAR STIMULATOR PROBES,125.0,81.25,37.38,37.38,1
CDM,27821355,CONSENTRIC STIMULATOR PROBE,115.0,74.75,25.07,115.0,65
CDM,27821355_IP,CONSENTRIC STIMULATOR PROBE,115.0,74.75,41.86,41.86,1
CDM,27821355_OP,CONSENTRIC STIMULATOR PROBE,115.0,74.75,34.39,34.39,1
CDM,27821385,1 X 11 STNLESS STEEL SD GRID,604.96,393.22,131.88,604.96,65
CDM,27821385_IP,1 X 11 STNLESS STEEL SD GRID,604.96,393.22,220.21,220.21,1
CDM,27821385_OP,1 X 11 STNLESS STEEL SD GRID,604.96,393.22,180.88,180.88,1
CDM,27821395,1 X 6  STNLESS STEEL SD GRID,320.56,208.36,69.88,320.56,65
CDM,27821395_IP,1 X 6  STNLESS STEEL SD GRID,320.56,208.36,116.68,116.68,1
CDM,27821395_OP,1 X 6  STNLESS STEEL SD GRID,320.56,208.36,95.85,95.85,1
CDM,27822485,"BILIARY STENT, PLASTIC",84.98,55.24,18.53,84.98,65
CDM,27822485_IP,"BILIARY STENT, PLASTIC",84.98,55.24,30.93,30.93,1
CDM,27822485_OP,"BILIARY STENT, PLASTIC",84.98,55.24,25.41,25.41,1
CDM,27822OH,OPEN TX TRIMALLEOLAR ANKLE FX W/O FIXJ PST LIP,4484.0,2914.6,1.1,20863.78,144
CDM,27823OH,OPEN TX TRIMALLEOLAR ANKLE FX W/FIXJ PST LIP,5264.0,3421.6,1.1,20863.78,144
CDM,27824OH,CLTX FX W8 BRG ARTCLR PRTN DSTL TIBIA W/O MANJ,1324.0,860.6,1.1,1324.0,148
CDM,27825OH,CLTX FX W8 BRG ARTCLR PRTN DSTL TIB W/SKEL TRACJ,2676.0,1739.4,1.1,4686.39,148
CDM,27826OH,OPEN TREATMENT FRACTURE DISTAL TIBIA FIBULA,4440.0,2886.0,1.1,20863.78,144
CDM,27827OH,OPEN TREATMENT FRACTURE DISTAL TIBIA ONLY,5916.0,3845.4,1.1,38384.94,144
CDM,27828OH,OPEN TREATMENT FRACTURE DISTAL TIBIA & FIBULA,7372.0,4791.8,1.1,38384.94,144
CDM,27829OH,OPEN TX DISTAL TIBIOFIBULAR JOINT DISRUPTION,3520.0,2288.0,1.1,20863.78,144
CDM,27830OH,CLTX PROX TIBFIB JT DISLC W/O ANES,1584.0,1029.6,1.1,1584.0,148
CDM,27831405,4X40 THRU 7X70 COIL,131.84,85.7,28.74,131.84,65
CDM,27831405_IP,4X40 THRU 7X70 COIL,131.84,85.7,47.99,47.99,1
CDM,27831405_OP,4X40 THRU 7X70 COIL,131.84,85.7,39.42,39.42,1
CDM,27831415,GDC 10+18 3D 6X10 - 8X25,1963.47,1276.26,428.04,1963.47,66
CDM,27831415_IP,GDC 10+18 3D 6X10 - 8X25,1963.47,1276.26,1075.98,1075.98,1
CDM,27831415_OP,GDC 10+18 3D 6X10 - 8X25,1963.47,1276.26,852.15,852.15,1
CDM,27831435,REBEL MONORAIL STENT,1100.0,715.0,239.8,1100.0,65
CDM,27831435_IP,REBEL MONORAIL STENT,1100.0,715.0,400.4,400.4,1
CDM,27831435_OP,REBEL MONORAIL STENT,1100.0,715.0,328.9,328.9,1
CDM,27831475,DELIV DVC 4FRX60CM-5FRX80CM,1104.0,717.6,200.93,1104.0,73
CDM,27831475_IP,DELIV DVC 4FRX60CM-5FRX80CM,1104.0,717.6,401.86,401.86,1
CDM,27831475_OP,DELIV DVC 4FRX60CM-5FRX80CM,1104.0,717.6,330.1,330.1,1
CDM,27831485,ST JUDE AMP OCCLUDER DEVICE 9-PDA2,8200.0,5330.0,200.93,8200.0,74
CDM,27831485_IP,ST JUDE AMP OCCLUDER DEVICE 9-PDA2,8200.0,5330.0,4493.6,4493.6,1
CDM,27831485_OP,ST JUDE AMP OCCLUDER DEVICE 9-PDA2,8200.0,5330.0,3558.8,3558.8,1
CDM,27831515,FIXATE TISSUE BAND DUAL PACK,1580.0,1027.0,344.44,1580.0,66
CDM,27831515_IP,FIXATE TISSUE BAND DUAL PACK,1580.0,1027.0,865.84,865.84,1
CDM,27831515_OP,FIXATE TISSUE BAND DUAL PACK,1580.0,1027.0,685.72,685.72,1
CDM,27831525,ACCESSORY KIT,700.0,455.0,152.6,700.0,65
CDM,27831525_IP,ACCESSORY KIT,700.0,455.0,254.8,254.8,1
CDM,27831525_OP,ACCESSORY KIT,700.0,455.0,209.3,209.3,1
CDM,27831535,PERSONAL THERAPY MANAGER,1500.0,975.0,327.0,1500.0,66
CDM,27831535_IP,PERSONAL THERAPY MANAGER,1500.0,975.0,822.0,822.0,1
CDM,27831535_OP,PERSONAL THERAPY MANAGER,1500.0,975.0,651.0,651.0,1
CDM,27831545,CORNEAL TISSUE,9660.0,6279.0,1842.39,9660.0,66
CDM,27831555,PRE-CUT CORNEA FOR DSAEK,9660.0,6279.0,1842.39,9660.0,66
CDM,27831565,PRE-CUT CORNEA FOR DMEK,9660.0,6279.0,1842.39,9660.0,66
CDM,27832495,SC 2218-50 50CM LEAD KIT,2908.0,1890.2,200.93,2908.0,74
CDM,27832495_IP,SC 2218-50 50CM LEAD KIT,2908.0,1890.2,1593.58,1593.58,1
CDM,27832495_OP,SC 2218-50 50CM LEAD KIT,2908.0,1890.2,1262.07,1262.07,1
CDM,27832515,"VALVE, EDWARDS SAPIEN,THV KIT",43875.0,28518.75,1030.0,43875.0,66
CDM,27832515_IP,"VALVE, EDWARDS SAPIEN,THV KIT",43875.0,28518.75,24043.5,24043.5,1
CDM,27832515_OP,"VALVE, EDWARDS SAPIEN,THV KIT",43875.0,28518.75,19041.75,19041.75,1
CDM,27832555,PROMETRA REFILL KIT 11825,43.0,27.95,9.37,232.66,73
CDM,27832555_IP,PROMETRA REFILL KIT 11825,43.0,27.95,15.65,15.65,1
CDM,27832555_OP,PROMETRA REFILL KIT 11825,43.0,27.95,12.86,12.86,1
CDM,27832565,BS PATIENT PROGRAMMER KIT SC5500-4,1314.0,854.1,200.93,1314.0,73
CDM,27832565_IP,BS PATIENT PROGRAMMER KIT SC5500-4,1314.0,854.1,720.07,720.07,1
CDM,27832565_OP,BS PATIENT PROGRAMMER KIT SC5500-4,1314.0,854.1,570.28,570.28,1
CDM,27832575,SJM 50 SLIM TIP IMPLANT LEAD,3246.0,2109.9,200.93,3246.0,74
CDM,27832575_IP,SJM 50 SLIM TIP IMPLANT LEAD,3246.0,2109.9,1778.81,1778.81,1
CDM,27832575_OP,SJM 50 SLIM TIP IMPLANT LEAD,3246.0,2109.9,1408.76,1408.76,1
CDM,27832585,AXIUM PATIENT PROGRAMMER,2636.0,1713.4,200.93,2636.0,74
CDM,27832585_IP,AXIUM PATIENT PROGRAMMER,2636.0,1713.4,1444.53,1444.53,1
CDM,27832585_OP,AXIUM PATIENT PROGRAMMER,2636.0,1713.4,1144.02,1144.02,1
CDM,27832595,MEDTRONIC ACCESSORY KIT 8590-8,310.0,201.5,67.58,310.0,73
CDM,27832595_IP,MEDTRONIC ACCESSORY KIT 8590-8,310.0,201.5,112.84,112.84,1
CDM,27832595_OP,MEDTRONIC ACCESSORY KIT 8590-8,310.0,201.5,92.69,92.69,1
CDM,27832605,SJM TRIAL LEAD KIT 60 CM,1452.0,943.8,200.93,1452.0,74
CDM,27832605_IP,SJM TRIAL LEAD KIT 60 CM,1452.0,943.8,795.7,795.7,1
CDM,27832605_OP,SJM TRIAL LEAD KIT 60 CM,1452.0,943.8,630.17,630.17,1
CDM,27832615,PRECISION IPG KIT SC1110-02,24300.0,15795.0,200.93,24300.0,74
CDM,27832615_IP,PRECISION IPG KIT SC1110-02,24300.0,15795.0,13316.4,13316.4,1
CDM,27832615_OP,PRECISION IPG KIT SC1110-02,24300.0,15795.0,10546.2,10546.2,1
CDM,27832625,SJM IMPLANTABLE NEUROSTIMULATOR,31449.5,20442.18,200.93,31449.5,74
CDM,27832625_IP,SJM IMPLANTABLE NEUROSTIMULATOR,31449.5,20442.18,17234.33,17234.33,1
CDM,27832625_OP,SJM IMPLANTABLE NEUROSTIMULATOR,31449.5,20442.18,13649.08,13649.08,1
CDM,27832635,MEDTRONIC EXTENSION KIT 37082-40,5320.0,3458.0,200.93,5320.0,74
CDM,27832635_IP,MEDTRONIC EXTENSION KIT 37082-40,5320.0,3458.0,2915.36,2915.36,1
CDM,27832635_OP,MEDTRONIC EXTENSION KIT 37082-40,5320.0,3458.0,2308.88,2308.88,1
CDM,27832645,CARDIOMEMS SENSOR/DELIV SYSTEM,35000.0,22750.0,200.93,35000.0,74
CDM,27832645_IP,CARDIOMEMS SENSOR/DELIV SYSTEM,35000.0,22750.0,19180.0,19180.0,1
CDM,27832645_OP,CARDIOMEMS SENSOR/DELIV SYSTEM,35000.0,22750.0,15190.0,15190.0,1
CDM,27832685,STRYKER-AUTOPLEX SYSTEM WITHOUT NEEDLES,1482.0,963.3,323.08,1482.0,66
CDM,27832685_IP,STRYKER-AUTOPLEX SYSTEM WITHOUT NEEDLES,1482.0,963.3,812.14,812.14,1
CDM,27832685_OP,STRYKER-AUTOPLEX SYSTEM WITHOUT NEEDLES,1482.0,963.3,643.19,643.19,1
CDM,27832695,KIVA VCF TREATMENT SYSTEM ADDTL FX RT/LT,5000.0,3250.0,1030.0,5000.0,66
CDM,27832695_IP,KIVA VCF TREATMENT SYSTEM ADDTL FX RT/LT,5000.0,3250.0,2740.0,2740.0,1
CDM,27832695_OP,KIVA VCF TREATMENT SYSTEM ADDTL FX RT/LT,5000.0,3250.0,2170.0,2170.0,1
CDM,27832705,KIVA PILOT RT/LT,1592.0,1034.8,347.06,1592.0,66
CDM,27832705_IP,KIVA PILOT RT/LT,1592.0,1034.8,872.42,872.42,1
CDM,27832705_OP,KIVA PILOT RT/LT,1592.0,1034.8,690.93,690.93,1
CDM,27832715,GSX 15MM-30MM SEPTAL OCCLUDER DEVICE,13794.0,8966.1,200.93,13794.0,74
CDM,27832715_IP,GSX 15MM-30MM SEPTAL OCCLUDER DEVICE,13794.0,8966.1,7559.11,7559.11,1
CDM,27832715_OP,GSX 15MM-30MM SEPTAL OCCLUDER DEVICE,13794.0,8966.1,5986.6,5986.6,1
CDM,27832OH,OPEN TX PROX TIBFIB JOINT DISLOCATE EXC PROX FIB,4475.0,2908.75,1.1,20863.78,144
CDM,27840015,GEL MARKER,825.0,536.25,179.85,825.0,74
CDM,27840345,MEDTRONIC NC EUPHORA DILATION CATH 4.0-5.0MMX12MM,161.0,104.65,35.1,232.66,73
CDM,27840345_IP,MEDTRONIC NC EUPHORA DILATION CATH 4.0-5.0MMX12MM,161.0,104.65,58.6,58.6,1
CDM,27840345_OP,MEDTRONIC NC EUPHORA DILATION CATH 4.0-5.0MMX12MM,161.0,104.65,48.14,48.14,1
CDM,27840355,GRAFT ST TIS FRZN CADVR 5100-001,896.0,582.4,117.73,896.0,76
CDM,27840355_IP,GRAFT ST TIS FRZN CADVR 5100-001,896.0,582.4,326.14,326.14,1
CDM,27840355_OP,GRAFT ST TIS FRZN CADVR 5100-001,896.0,582.4,267.9,267.9,1
CDM,27840445,"LEAD, NEUROSTIM TRIAL KIT",5275.0,3428.75,200.93,5275.0,74
CDM,27840445_IP,"LEAD, NEUROSTIM TRIAL KIT",5275.0,3428.75,436.8,436.8,1
CDM,27840445_OP,"LEAD, NEUROSTIM TRIAL KIT",5275.0,3428.75,358.8,358.8,1
CDM,27840625,B BRAUN BALLOON MOUNTED COVERED STENTS 1.6-3.4,13100.0,8515.0,200.93,13100.0,74
CDM,27840625_IP,B BRAUN BALLOON MOUNTED COVERED STENTS 1.6-3.4,13100.0,8515.0,7178.8,7178.8,1
CDM,27840625_OP,B BRAUN BALLOON MOUNTED COVERED STENTS 1.6-3.4,13100.0,8515.0,5685.4,5685.4,1
CDM,27840635,B BRAUN BALLOON MOUNTED COVERED STENTS 3.9-4.5V,13500.0,8775.0,200.93,13500.0,74
CDM,27840635_IP,B BRAUN BALLOON MOUNTED COVERED STENTS 3.9-4.5V,13500.0,8775.0,7398.0,7398.0,1
CDM,27840635_OP,B BRAUN BALLOON MOUNTED COVERED STENTS 3.9-4.5V,13500.0,8775.0,5859.0,5859.0,1
CDM,27840OH,CLOSED TX ANKLE DISLOCATION W/O ANESTHESIA,1908.0,1240.2,1.1,1908.0,144
CDM,27842OH,CLTX ANKLE DISLC REQ ANES W/WO PRQ SKEL FIXJ,2584.0,1679.6,1.1,4686.39,144
CDM,27846OH,OPTX ANKLE DISLOCATION W/O REPAIR/INTERNAL FIXJ,4112.0,2672.8,1.1,20863.78,144
CDM,27848OH,OPTX ANKLE DISLOCATION W/REPAIR/INT/XTRNL FIXJ,4672.0,3036.8,1.1,20863.78,144
CDM,27850035,B-BRAUN 12MM X2.2CM COVERED STENT UNMOUNTED,5350.0,3477.5,200.93,5350.0,74
CDM,27850035_IP,B-BRAUN 12MM X2.2CM COVERED STENT UNMOUNTED,5350.0,3477.5,2931.8,2931.8,1
CDM,27850035_OP,B-BRAUN 12MM X2.2CM COVERED STENT UNMOUNTED,5350.0,3477.5,2321.9,2321.9,1
CDM,27850045,"STENT, COATED W/DELIVERY",35.0,22.75,7.63,232.66,73
CDM,27850045_IP,"STENT, COATED W/DELIVERY",35.0,22.75,12.74,12.74,1
CDM,27850045_OP,"STENT, COATED W/DELIVERY",35.0,22.75,10.47,10.47,1
CDM,27850625,CUSTOM FABRICATED LARYNGEAL KEEL,400.0,260.0,16.97,400.0,73
CDM,27850625_IP,CUSTOM FABRICATED LARYNGEAL KEEL,400.0,260.0,145.6,145.6,1
CDM,27850625_OP,CUSTOM FABRICATED LARYNGEAL KEEL,400.0,260.0,119.6,119.6,1
CDM,27850655,"CUSTOM ARROW MULTI-LUMEN PRESS INJ CENTRAL VEN CATH KIT, 8.5FR X",213.0,138.45,46.43,232.66,73
CDM,27850655_IP,"CUSTOM ARROW MULTI-LUMEN PRESS INJ CENTRAL VEN CATH KIT, 8.5FR X",213.0,138.45,77.53,77.53,1
CDM,27850655_OP,"CUSTOM ARROW MULTI-LUMEN PRESS INJ CENTRAL VEN CATH KIT, 8.5FR X",213.0,138.45,63.69,63.69,1
CDM,27850665,"FLUENCY PS ENDOVAS STNT GFT SYST 10MM X 40MM, 9FR X 117CM, 0.035",2632.5,1711.13,200.93,2632.5,74
CDM,27850665_IP,"FLUENCY PS ENDOVAS STNT GFT SYST 10MM X 40MM, 9FR X 117CM, 0.035",2632.5,1711.13,1442.61,1442.61,1
CDM,27850665_OP,"FLUENCY PS ENDOVAS STNT GFT SYST 10MM X 40MM, 9FR X 117CM, 0.035",2632.5,1711.13,1142.51,1142.51,1
CDM,27850685,"HYPERGLIDE OCC BALLOON SYST, 4 MM X 30 MM, 4 MM CATH TIP X 150CM",1411.0,917.15,200.93,1411.0,74
CDM,27850685_IP,"HYPERGLIDE OCC BALLOON SYST, 4 MM X 30 MM, 4 MM CATH TIP X 150CM",1411.0,917.15,773.23,773.23,1
CDM,27850685_OP,"HYPERGLIDE OCC BALLOON SYST, 4 MM X 30 MM, 4 MM CATH TIP X 150CM",1411.0,917.15,612.37,612.37,1
CDM,27850695,"PENUMBRA POD PACKING EMBOLIZATION COIL, 15CM",1485.0,965.25,323.73,1485.0,66
CDM,27850695_IP,"PENUMBRA POD PACKING EMBOLIZATION COIL, 15CM",1485.0,965.25,813.78,813.78,1
CDM,27850695_OP,"PENUMBRA POD PACKING EMBOLIZATION COIL, 15CM",1485.0,965.25,644.49,644.49,1
CDM,27850705,"PENUMBRA POD PACKING EMBOLIZATION COIL, 30CM",1741.5,1131.98,379.65,1741.5,66
CDM,27850705_IP,"PENUMBRA POD PACKING EMBOLIZATION COIL, 30CM",1741.5,1131.98,954.34,954.34,1
CDM,27850705_OP,"PENUMBRA POD PACKING EMBOLIZATION COIL, 30CM",1741.5,1131.98,755.81,755.81,1
CDM,27850715,REPERFUSION CATHETER 3MAX AND PENUMBRA HI-FLOW ASPIRATION TUBING,2781.0,1807.65,606.26,2781.0,66
CDM,27850715_IP,REPERFUSION CATHETER 3MAX AND PENUMBRA HI-FLOW ASPIRATION TUBING,2781.0,1807.65,1523.99,1523.99,1
CDM,27850715_OP,REPERFUSION CATHETER 3MAX AND PENUMBRA HI-FLOW ASPIRATION TUBING,2781.0,1807.65,1206.95,1206.95,1
CDM,27850725,"GIANT-ROEHM B/N VENA CAVA FT FEM APPRO 11FR X 40CM, 12FR .038IN",1958.0,1272.7,200.93,1958.0,74
CDM,27850725_IP,"GIANT-ROEHM B/N VENA CAVA FT FEM APPRO 11FR X 40CM, 12FR .038IN",1958.0,1272.7,1072.98,1072.98,1
CDM,27850725_OP,"GIANT-ROEHM B/N VENA CAVA FT FEM APPRO 11FR X 40CM, 12FR .038IN",1958.0,1272.7,849.77,849.77,1
CDM,27850735,"GIANT-ROEHM B/N VENA CAVA FT JUG APPRO 11FR X 75CM,12FR .038IN M",1958.0,1272.7,200.93,1958.0,74
CDM,27850735_IP,"GIANT-ROEHM B/N VENA CAVA FT JUG APPRO 11FR X 75CM,12FR .038IN M",1958.0,1272.7,1072.98,1072.98,1
CDM,27850735_OP,"GIANT-ROEHM B/N VENA CAVA FT JUG APPRO 11FR X 75CM,12FR .038IN M",1958.0,1272.7,849.77,849.77,1
CDM,27850745,"UNRESTRAIN TAPE 3MM W & 30MM RESTRAIN L,6MM X 6MM HELICAL 0.018",166.0,107.9,36.19,166.0,65
CDM,27850745_IP,"UNRESTRAIN TAPE 3MM W & 30MM RESTRAIN L,6MM X 6MM HELICAL 0.018",166.0,107.9,60.42,60.42,1
CDM,27850745_OP,"UNRESTRAIN TAPE 3MM W & 30MM RESTRAIN L,6MM X 6MM HELICAL 0.018",166.0,107.9,49.63,49.63,1
CDM,27850755,"PRESIDIO SPHERICAL 10 CERECYTE SYS MICROCOIL, 5MM X 17CM",2801.0,1820.65,610.62,2801.0,66
CDM,27850755_IP,"PRESIDIO SPHERICAL 10 CERECYTE SYS MICROCOIL, 5MM X 17CM",2801.0,1820.65,1534.95,1534.95,1
CDM,27850755_OP,"PRESIDIO SPHERICAL 10 CERECYTE SYS MICROCOIL, 5MM X 17CM",2801.0,1820.65,1215.63,1215.63,1
CDM,27850765,"DETACHABLE COIL 12MM X 30CM, GDC-18, 3D SHAPE",1200.0,780.0,261.6,1200.0,65
CDM,27850765_IP,"DETACHABLE COIL 12MM X 30CM, GDC-18, 3D SHAPE",1200.0,780.0,436.8,436.8,1
CDM,27850765_OP,"DETACHABLE COIL 12MM X 30CM, GDC-18, 3D SHAPE",1200.0,780.0,358.8,358.8,1
CDM,27850775,"SOFT 2D STRET-RESIST , 2 MM X 6 CM GDC 10, DETACH COILS",900.0,585.0,196.2,900.0,65
CDM,27850775_IP,"SOFT 2D STRET-RESIST , 2 MM X 6 CM GDC 10, DETACH COILS",900.0,585.0,327.6,327.6,1
CDM,27850775_OP,"SOFT 2D STRET-RESIST , 2 MM X 6 CM GDC 10, DETACH COILS",900.0,585.0,269.1,269.1,1
CDM,27850785,"SOFT 2D STRET-RESIST , 3 MM X 6 CM GDC 10, ?DETACH COILS",1341.0,871.65,292.34,1341.0,65
CDM,27850785_IP,"SOFT 2D STRET-RESIST , 3 MM X 6 CM GDC 10, ?DETACH COILS",1341.0,871.65,734.87,734.87,1
CDM,27850785_OP,"SOFT 2D STRET-RESIST , 3 MM X 6 CM GDC 10, ?DETACH COILS",1341.0,871.65,581.99,581.99,1
CDM,27850795,"SOFT 2D STRET-RESIST, 4 MM X 6 CM GDC 10, DETACH COILS",1297.0,843.05,282.75,1297.0,65
CDM,27850795_IP,"SOFT 2D STRET-RESIST, 4 MM X 6 CM GDC 10, DETACH COILS",1297.0,843.05,710.76,710.76,1
CDM,27850795_OP,"SOFT 2D STRET-RESIST, 4 MM X 6 CM GDC 10, DETACH COILS",1297.0,843.05,562.9,562.9,1
CDM,27850805,"HELICAL 10 HLPQ CERECYTE, 20 MM? X 30 CM",1385.0,900.25,301.93,1385.0,66
CDM,27850805_IP,"HELICAL 10 HLPQ CERECYTE, 20 MM? X 30 CM",1385.0,900.25,758.98,758.98,1
CDM,27850805_OP,"HELICAL 10 HLPQ CERECYTE, 20 MM? X 30 CM",1385.0,900.25,601.09,601.09,1
CDM,27850815,"ULTIPAQ HELICAL 10 FINISHING STRETCH RESIST PLAT MICROCOIL, 2MM",1346.0,874.9,293.43,1346.0,65
CDM,27850815_IP,"ULTIPAQ HELICAL 10 FINISHING STRETCH RESIST PLAT MICROCOIL, 2MM",1346.0,874.9,737.61,737.61,1
CDM,27850815_OP,"ULTIPAQ HELICAL 10 FINISHING STRETCH RESIST PLAT MICROCOIL, 2MM",1346.0,874.9,584.16,584.16,1
CDM,27850825,"ULTIPAQ FINISHING MICROCOILS SR 10, 2MM X 3CM",822.0,534.3,179.2,822.0,65
CDM,27850825_IP,"ULTIPAQ FINISHING MICROCOILS SR 10, 2MM X 3CM",822.0,534.3,299.21,299.21,1
CDM,27850825_OP,"ULTIPAQ FINISHING MICROCOILS SR 10, 2MM X 3CM",822.0,534.3,245.78,245.78,1
CDM,27850835,"ULTIPAQ HELICAL 10 FINISH STRETCH RESIST PLAT MICROCOIL, 2 MM X",1412.0,917.8,307.82,1412.0,66
CDM,27850835_IP,"ULTIPAQ HELICAL 10 FINISH STRETCH RESIST PLAT MICROCOIL, 2 MM X",1412.0,917.8,773.78,773.78,1
CDM,27850835_OP,"ULTIPAQ HELICAL 10 FINISH STRETCH RESIST PLAT MICROCOIL, 2 MM X",1412.0,917.8,612.81,612.81,1
CDM,27850845,"FINISHING SR 10, 4MM X 4CM",1358.0,882.7,296.04,1358.0,65
CDM,27850845_IP,"FINISHING SR 10, 4MM X 4CM",1358.0,882.7,744.18,744.18,1
CDM,27850845_OP,"FINISHING SR 10, 4MM X 4CM",1358.0,882.7,589.37,589.37,1
CDM,27850855,"ULTIPAQ HELICAL 10 FINISH STRETCH RESIST PLAT MICROCOIL, 2 MM X",822.0,534.3,179.2,822.0,65
CDM,27850855_IP,"ULTIPAQ HELICAL 10 FINISH STRETCH RESIST PLAT MICROCOIL, 2 MM X",822.0,534.3,299.21,299.21,1
CDM,27850855_OP,"ULTIPAQ HELICAL 10 FINISH STRETCH RESIST PLAT MICROCOIL, 2 MM X",822.0,534.3,245.78,245.78,1
CDM,27850865,"GDC-18 360, 13MM X 30CM, ?STANDARD, DETACHABLE COIL",1200.0,780.0,261.6,1200.0,65
CDM,27850865_IP,"GDC-18 360, 13MM X 30CM, ?STANDARD, DETACHABLE COIL",1200.0,780.0,436.8,436.8,1
CDM,27850865_OP,"GDC-18 360, 13MM X 30CM, ?STANDARD, DETACHABLE COIL",1200.0,780.0,358.8,358.8,1
CDM,27850875,"MICRUSPHERE SPHERICAL 10 PLATINUM MICROCOIL, 6 MM",1190.0,773.5,259.42,1190.0,65
CDM,27850875_IP,"MICRUSPHERE SPHERICAL 10 PLATINUM MICROCOIL, 6 MM",1190.0,773.5,433.16,433.16,1
CDM,27850875_OP,"MICRUSPHERE SPHERICAL 10 PLATINUM MICROCOIL, 6 MM",1190.0,773.5,355.81,355.81,1
CDM,27850885,"SPHERICAL 10, 7MM X 20CM, MICRUSPHERE ACT MICROCOIL SYST, PLAT",1485.0,965.25,323.73,1485.0,66
CDM,27850885_IP,"SPHERICAL 10, 7MM X 20CM, MICRUSPHERE ACT MICROCOIL SYST, PLAT",1485.0,965.25,813.78,813.78,1
CDM,27850885_OP,"SPHERICAL 10, 7MM X 20CM, MICRUSPHERE ACT MICROCOIL SYST, PLAT",1485.0,965.25,644.49,644.49,1
CDM,27850895,"CASHMERE COMPLEX 2MM X 2.5CM, 14 MICROCOIL SR STRETCH RESISTANT",1502.0,976.3,327.44,1502.0,66
CDM,27850895_IP,"CASHMERE COMPLEX 2MM X 2.5CM, 14 MICROCOIL SR STRETCH RESISTANT",1502.0,976.3,823.1,823.1,1
CDM,27850895_OP,"CASHMERE COMPLEX 2MM X 2.5CM, 14 MICROCOIL SR STRETCH RESISTANT",1502.0,976.3,651.87,651.87,1
CDM,27850905,"CASHMERE COMPLEX ?3MM X 3CM ,14 MICROCOIL SR STRETCH RESISTANT",1472.0,956.8,320.9,1472.0,66
CDM,27850905_IP,"CASHMERE COMPLEX ?3MM X 3CM ,14 MICROCOIL SR STRETCH RESISTANT",1472.0,956.8,806.66,806.66,1
CDM,27850905_OP,"CASHMERE COMPLEX ?3MM X 3CM ,14 MICROCOIL SR STRETCH RESISTANT",1472.0,956.8,638.85,638.85,1
CDM,27850915,"CASHMERE COMPLEX ?4MM X 6CM, 14 MICROCOIL SR STRETCH RESISTANT",1391.0,904.15,303.24,1391.0,66
CDM,27850915_IP,"CASHMERE COMPLEX ?4MM X 6CM, 14 MICROCOIL SR STRETCH RESISTANT",1391.0,904.15,762.27,762.27,1
CDM,27850915_OP,"CASHMERE COMPLEX ?4MM X 6CM, 14 MICROCOIL SR STRETCH RESISTANT",1391.0,904.15,603.69,603.69,1
CDM,27850925,"CASHMERE COMPLEX ?5MM X 7CM, 14 MICROCOIL SR STRETCH RESISTANT",1442.0,937.3,314.36,1442.0,66
CDM,27850925_IP,"CASHMERE COMPLEX ?5MM X 7CM, 14 MICROCOIL SR STRETCH RESISTANT",1442.0,937.3,790.22,790.22,1
CDM,27850925_OP,"CASHMERE COMPLEX ?5MM X 7CM, 14 MICROCOIL SR STRETCH RESISTANT",1442.0,937.3,625.83,625.83,1
CDM,27850935,"CASHMERE COMPLEX 7MM X 11CM, ?14 MICROCOIL SR STRETCH RESISTANT",1408.0,915.2,306.94,1408.0,66
CDM,27850935_IP,"CASHMERE COMPLEX 7MM X 11CM, ?14 MICROCOIL SR STRETCH RESISTANT",1408.0,915.2,771.58,771.58,1
CDM,27850935_OP,"CASHMERE COMPLEX 7MM X 11CM, ?14 MICROCOIL SR STRETCH RESISTANT",1408.0,915.2,611.07,611.07,1
CDM,27850945,"CASHMERE COMPLEX 8MM X 12CM, ?14 MICROCOIL SR STRETCH RESISTANT",1432.0,930.8,312.18,1432.0,66
CDM,27850945_IP,"CASHMERE COMPLEX 8MM X 12CM, ?14 MICROCOIL SR STRETCH RESISTANT",1432.0,930.8,784.74,784.74,1
CDM,27850945_OP,"CASHMERE COMPLEX 8MM X 12CM, ?14 MICROCOIL SR STRETCH RESISTANT",1432.0,930.8,621.49,621.49,1
CDM,27850955,"CASHMERE COMPLEX 9MM X 14CM, ?14 MICROCOIL SR STRETCH RESISTANT",1467.0,953.55,319.81,1467.0,66
CDM,27850955_IP,"CASHMERE COMPLEX 9MM X 14CM, ?14 MICROCOIL SR STRETCH RESISTANT",1467.0,953.55,803.92,803.92,1
CDM,27850955_OP,"CASHMERE COMPLEX 9MM X 14CM, ?14 MICROCOIL SR STRETCH RESISTANT",1467.0,953.55,636.68,636.68,1
CDM,27850965,"CASHMERE COMPLEX COIL, 11MM X 27CM SR STRETCH RESISTANT",1534.0,997.1,334.41,1534.0,66
CDM,27850965_IP,"CASHMERE COMPLEX COIL, 11MM X 27CM SR STRETCH RESISTANT",1534.0,997.1,840.63,840.63,1
CDM,27850965_OP,"CASHMERE COMPLEX COIL, 11MM X 27CM SR STRETCH RESISTANT",1534.0,997.1,665.76,665.76,1
CDM,27850975,"CASHMERE COMPLEX COIL, 12MM X 30CM ?SR STRETCH RESISTANT",1661.0,1079.65,362.1,1661.0,66
CDM,27850975_IP,"CASHMERE COMPLEX COIL, 12MM X 30CM ?SR STRETCH RESISTANT",1661.0,1079.65,910.23,910.23,1
CDM,27850975_OP,"CASHMERE COMPLEX COIL, 12MM X 30CM ?SR STRETCH RESISTANT",1661.0,1079.65,720.87,720.87,1
CDM,27850985,"PRESIDIO 18, 17MM X 50CM COIL",3153.0,2049.45,687.35,3153.0,66
CDM,27850985_IP,"PRESIDIO 18, 17MM X 50CM COIL",3153.0,2049.45,1727.84,1727.84,1
CDM,27850985_OP,"PRESIDIO 18, 17MM X 50CM COIL",3153.0,2049.45,1368.4,1368.4,1
CDM,27850995,"PRESIDIO 18, 20MM X 50CM COIL",3713.0,2413.45,809.43,3713.0,66
CDM,27850995_IP,"PRESIDIO 18, 20MM X 50CM COIL",3713.0,2413.45,2034.72,2034.72,1
CDM,27850995_OP,"PRESIDIO 18, 20MM X 50CM COIL",3713.0,2413.45,1611.44,1611.44,1
CDM,27851005,"PRESIDIO 18, 18MM X 46CM ?CERECTYTE COIL SYSTEM (PRE-RELEASE)",3642.0,2367.3,793.96,3642.0,66
CDM,27851005_IP,"PRESIDIO 18, 18MM X 46CM ?CERECTYTE COIL SYSTEM (PRE-RELEASE)",3642.0,2367.3,1995.82,1995.82,1
CDM,27851005_OP,"PRESIDIO 18, 18MM X 46CM ?CERECTYTE COIL SYSTEM (PRE-RELEASE)",3642.0,2367.3,1580.63,1580.63,1
CDM,27851015,"PRESIDIO 18, 19MM X 50CM ?CERECYTE COIL SYSTEM (PRE-RELEASE)",3713.0,2413.45,809.43,3713.0,66
CDM,27851015_IP,"PRESIDIO 18, 19MM X 50CM ?CERECYTE COIL SYSTEM (PRE-RELEASE)",3713.0,2413.45,2034.72,2034.72,1
CDM,27851015_OP,"PRESIDIO 18, 19MM X 50CM ?CERECYTE COIL SYSTEM (PRE-RELEASE)",3713.0,2413.45,1611.44,1611.44,1
CDM,27851025,"PRESIDIO SPHERICAL 18, 9MM X 33CM ?CERECYTE COIL",3160.0,2054.0,688.88,3160.0,66
CDM,27851025_IP,"PRESIDIO SPHERICAL 18, 9MM X 33CM ?CERECYTE COIL",3160.0,2054.0,1731.68,1731.68,1
CDM,27851025_OP,"PRESIDIO SPHERICAL 18, 9MM X 33CM ?CERECYTE COIL",3160.0,2054.0,1371.44,1371.44,1
CDM,27851035,"COOK-Z STENT, GIANTURCO-ROSCH TRACHEOBRONCH, 20MM X 5CM  SELF-EX",1493.0,970.45,200.93,1493.0,74
CDM,27851035_IP,"COOK-Z STENT, GIANTURCO-ROSCH TRACHEOBRONCH, 20MM X 5CM  SELF-EX",1493.0,970.45,818.16,818.16,1
CDM,27851035_OP,"COOK-Z STENT, GIANTURCO-ROSCH TRACHEOBRONCH, 20MM X 5CM  SELF-EX",1493.0,970.45,647.96,647.96,1
CDM,27851055,CORNEAL IMPLANT INTACS,2290.0,1488.5,333.06,2290.0,74
CDM,27851055_IP,CORNEAL IMPLANT INTACS,2290.0,1488.5,1254.92,1254.92,1
CDM,27851055_OP,CORNEAL IMPLANT INTACS,2290.0,1488.5,993.86,993.86,1
CDM,27852455,H020002- ?NF ATLAS STENT 3.0 X 21MM NO TIP,6155.6,4001.14,200.93,6155.6,74
CDM,27852455_IP,H020002- ?NF ATLAS STENT 3.0 X 21MM NO TIP,6155.6,4001.14,3373.27,3373.27,1
CDM,27852455_OP,H020002- ?NF ATLAS STENT 3.0 X 21MM NO TIP,6155.6,4001.14,2671.53,2671.53,1
CDM,27852465,H020002- ?NF ATLAS STENT 3.0 X 24MM NO TIP,6155.6,4001.14,1030.0,6155.6,66
CDM,27852465_IP,H020002- ?NF ATLAS STENT 3.0 X 24MM NO TIP,6155.6,4001.14,3373.27,3373.27,1
CDM,27852465_OP,H020002- ?NF ATLAS STENT 3.0 X 24MM NO TIP,6155.6,4001.14,2671.53,2671.53,1
CDM,27852475,H020002- ?NF ATLAS STENT 4.0 X 21MM NO TIP,6155.6,4001.14,200.93,6155.6,74
CDM,27852475_IP,H020002- ?NF ATLAS STENT 4.0 X 21MM NO TIP,6155.6,4001.14,3373.27,3373.27,1
CDM,27852475_OP,H020002- ?NF ATLAS STENT 4.0 X 21MM NO TIP,6155.6,4001.14,2671.53,2671.53,1
CDM,27852485,H020002-NF ATLAS STENT 4.0 X 24MM NO TIP,6155.6,4001.14,1030.0,6155.6,66
CDM,27852485_IP,H020002-NF ATLAS STENT 4.0 X 24MM NO TIP,6155.6,4001.14,3373.27,3373.27,1
CDM,27852485_OP,H020002-NF ATLAS STENT 4.0 X 24MM NO TIP,6155.6,4001.14,2671.53,2671.53,1
CDM,27852495,H020002- NF ATLAS STENT 4.5 X 21MM NO TIP,6155.6,4001.14,200.93,6155.6,74
CDM,27852495_IP,H020002- NF ATLAS STENT 4.5 X 21MM NO TIP,6155.6,4001.14,3373.27,3373.27,1
CDM,27852495_OP,H020002- NF ATLAS STENT 4.5 X 21MM NO TIP,6155.6,4001.14,2671.53,2671.53,1
CDM,27852505,H020002- NF ATLAS STENT 4.5 X 30MM NO TIP,6155.6,4001.14,200.93,6155.6,74
CDM,27852505_IP,H020002- NF ATLAS STENT 4.5 X 30MM NO TIP,6155.6,4001.14,3373.27,3373.27,1
CDM,27852505_OP,H020002- NF ATLAS STENT 4.5 X 30MM NO TIP,6155.6,4001.14,2671.53,2671.53,1
CDM,27852515,H020002-NF ATLAS STENT 3.0 X 15MM NO TIP,6155.6,4001.14,200.93,6155.6,74
CDM,27852515_IP,H020002-NF ATLAS STENT 3.0 X 15MM NO TIP,6155.6,4001.14,3373.27,3373.27,1
CDM,27852515_OP,H020002-NF ATLAS STENT 3.0 X 15MM NO TIP,6155.6,4001.14,2671.53,2671.53,1
CDM,27855045,BIOFLO MAX BARRIER 4F SINGLE,520.0,338.0,113.36,520.0,73
CDM,27855045_IP,BIOFLO MAX BARRIER 4F SINGLE,520.0,338.0,189.28,189.28,1
CDM,27855045_OP,BIOFLO MAX BARRIER 4F SINGLE,520.0,338.0,155.48,155.48,1
CDM,27855125,MYNX CLOSURE DEVICE,452.0,293.8,98.54,452.0,74
CDM,27855435,*TULIP VENA CAVA FILTER,1902.0,1236.3,200.93,1902.0,74
CDM,27855435_IP,*TULIP VENA CAVA FILTER,1902.0,1236.3,1042.3,1042.3,1
CDM,27855435_OP,*TULIP VENA CAVA FILTER,1902.0,1236.3,825.47,825.47,1
CDM,27856365,KYLEENA IUD,907.12,589.63,197.75,3323.24,75
CDM,27856375,CI ACOUSTIC SPKR ONLY,300.0,195.0,16.97,300.0,73
CDM,27856375_IP,CI ACOUSTIC SPKR ONLY,300.0,195.0,109.2,109.2,1
CDM,27856375_OP,CI ACOUSTIC SPKR ONLY,300.0,195.0,89.7,89.7,1
CDM,27856385,CI ACOUSTIC COMP KIT,375.0,243.75,16.97,375.0,73
CDM,27856385_IP,CI ACOUSTIC COMP KIT,375.0,243.75,136.5,136.5,1
CDM,27856385_OP,CI ACOUSTIC COMP KIT,375.0,243.75,112.13,112.13,1
CDM,27856495,VIATORR TIPS ENDOPROSTHESIS STENT GRAFT,8358.0,5432.7,200.93,8358.0,74
CDM,27856495_IP,VIATORR TIPS ENDOPROSTHESIS STENT GRAFT,8358.0,5432.7,4580.18,4580.18,1
CDM,27856495_OP,VIATORR TIPS ENDOPROSTHESIS STENT GRAFT,8358.0,5432.7,3627.37,3627.37,1
CDM,27856505,NEUROFORM STENT SYSTEM,10854.0,7055.1,1030.0,10854.0,66
CDM,27856505_IP,NEUROFORM STENT SYSTEM,10854.0,7055.1,5947.99,5947.99,1
CDM,27856505_OP,NEUROFORM STENT SYSTEM,10854.0,7055.1,4710.64,4710.64,1
CDM,27856515,"HYDROPHILIC, SELF-EXPAND, NITINOL, WINGSPAN STENT W/PRE-LOADED O",8964.0,5826.6,1030.0,8964.0,66
CDM,27856515_IP,"HYDROPHILIC, SELF-EXPAND, NITINOL, WINGSPAN STENT W/PRE-LOADED O",8964.0,5826.6,4912.27,4912.27,1
CDM,27856515_OP,"HYDROPHILIC, SELF-EXPAND, NITINOL, WINGSPAN STENT W/PRE-LOADED O",8964.0,5826.6,3890.38,3890.38,1
CDM,27856525,ENTERPRISE VASCULAR RECONSTRUCTION DEVICE,9680.0,6292.0,1030.0,9680.0,66
CDM,27856525_IP,ENTERPRISE VASCULAR RECONSTRUCTION DEVICE,9680.0,6292.0,5304.64,5304.64,1
CDM,27856525_OP,ENTERPRISE VASCULAR RECONSTRUCTION DEVICE,9680.0,6292.0,4201.12,4201.12,1
CDM,27856535,EKOSONIC MACH 4 ENDOVAS DEVICE,4790.0,3113.5,200.93,4790.0,74
CDM,27856535_IP,EKOSONIC MACH 4 ENDOVAS DEVICE,4790.0,3113.5,2624.92,2624.92,1
CDM,27856535_OP,EKOSONIC MACH 4 ENDOVAS DEVICE,4790.0,3113.5,2078.86,2078.86,1
CDM,27856545,INDIGO SEPARATOR 6,2350.0,1527.5,512.3,2350.0,66
CDM,27856545_IP,INDIGO SEPARATOR 6,2350.0,1527.5,1287.8,1287.8,1
CDM,27856545_OP,INDIGO SEPARATOR 6,2350.0,1527.5,1019.9,1019.9,1
CDM,27856555,INDIGO SEPARATOR 8,3950.0,2567.5,861.1,3950.0,66
CDM,27856555_IP,INDIGO SEPARATOR 8,3950.0,2567.5,2164.6,2164.6,1
CDM,27856555_OP,INDIGO SEPARATOR 8,3950.0,2567.5,1714.3,1714.3,1
CDM,27856565,"INDIGO REPERFUSION ASPIRATION CATH 6 135CM, STRAIGHT TIP",3940.0,2561.0,858.92,3940.0,66
CDM,27856565_IP,"INDIGO REPERFUSION ASPIRATION CATH 6 135CM, STRAIGHT TIP",3940.0,2561.0,2159.12,2159.12,1
CDM,27856565_OP,"INDIGO REPERFUSION ASPIRATION CATH 6 135CM, STRAIGHT TIP",3940.0,2561.0,1709.96,1709.96,1
CDM,27856575,"QUINTON PERMCATH DUAL LUMEN DIALYSIS CATH KIT W/ GWIRE, OVAL INT",678.0,440.7,147.8,678.0,73
CDM,27856575_IP,"QUINTON PERMCATH DUAL LUMEN DIALYSIS CATH KIT W/ GWIRE, OVAL INT",678.0,440.7,246.79,246.79,1
CDM,27856575_OP,"QUINTON PERMCATH DUAL LUMEN DIALYSIS CATH KIT W/ GWIRE, OVAL INT",678.0,440.7,202.72,202.72,1
CDM,27856585,HEMOSPLIT DUAL LUMEN CATH 14.5 FR W/AIR GUARD VALVE INTRO (EA),479.0,311.35,104.42,479.0,73
CDM,27856585_IP,HEMOSPLIT DUAL LUMEN CATH 14.5 FR W/AIR GUARD VALVE INTRO (EA),479.0,311.35,174.36,174.36,1
CDM,27856585_OP,HEMOSPLIT DUAL LUMEN CATH 14.5 FR W/AIR GUARD VALVE INTRO (EA),479.0,311.35,143.22,143.22,1
CDM,27856595,"POWERPORT IMPLANTABLE PORT 8FR, GOSHONG VALVED, MICROINTRODUCER",1372.5,892.13,200.93,1372.5,74
CDM,27856595_IP,"POWERPORT IMPLANTABLE PORT 8FR, GOSHONG VALVED, MICROINTRODUCER",1372.5,892.13,752.13,752.13,1
CDM,27856595_OP,"POWERPORT IMPLANTABLE PORT 8FR, GOSHONG VALVED, MICROINTRODUCER",1372.5,892.13,595.67,595.67,1
CDM,27856605,FEMOSTOP GOLD FEMORAL COMPRESS DEVICE (W/OUT HEMO DRESSING),140.0,91.0,30.52,140.0,65
CDM,27856605_IP,FEMOSTOP GOLD FEMORAL COMPRESS DEVICE (W/OUT HEMO DRESSING),140.0,91.0,50.96,50.96,1
CDM,27856605_OP,FEMOSTOP GOLD FEMORAL COMPRESS DEVICE (W/OUT HEMO DRESSING),140.0,91.0,41.86,41.86,1
CDM,27856615,"CHECK-FLO INTRO 12FR X 30CM, LRG VALVE ASSEMBLY, RB TIP",80.5,52.33,17.55,232.66,73
CDM,27856615_IP,"CHECK-FLO INTRO 12FR X 30CM, LRG VALVE ASSEMBLY, RB TIP",80.5,52.33,29.3,29.3,1
CDM,27856615_OP,"CHECK-FLO INTRO 12FR X 30CM, LRG VALVE ASSEMBLY, RB TIP",80.5,52.33,24.07,24.07,1
CDM,27856625,"CHECK-FLO INTRO 14FR X 30CM, LRG VALVE ASSEMBLY, RB TIP",98.0,63.7,21.36,232.66,73
CDM,27856625_IP,"CHECK-FLO INTRO 14FR X 30CM, LRG VALVE ASSEMBLY, RB TIP",98.0,63.7,35.67,35.67,1
CDM,27856625_OP,"CHECK-FLO INTRO 14FR X 30CM, LRG VALVE ASSEMBLY, RB TIP",98.0,63.7,29.3,29.3,1
CDM,27856635,"CHECK-FLO INTRO 16FR X 35CM, LRG VALVE ASSEMBLY, RB TIP",143.5,93.28,31.28,232.66,73
CDM,27856635_IP,"CHECK-FLO INTRO 16FR X 35CM, LRG VALVE ASSEMBLY, RB TIP",143.5,93.28,52.23,52.23,1
CDM,27856635_OP,"CHECK-FLO INTRO 16FR X 35CM, LRG VALVE ASSEMBLY, RB TIP",143.5,93.28,42.91,42.91,1
CDM,27856645,CHECK-FLO PERFORM INTRO SET (RCFW-12.0-38-45-RB),195.0,126.75,42.51,232.66,73
CDM,27856645_IP,CHECK-FLO PERFORM INTRO SET (RCFW-12.0-38-45-RB),195.0,126.75,70.98,70.98,1
CDM,27856645_OP,CHECK-FLO PERFORM INTRO SET (RCFW-12.0-38-45-RB),195.0,126.75,58.31,58.31,1
CDM,27856655,CHECK-FLO PERFORM INTRO SET (RCFW-18.0P-38-40-RB),143.5,93.28,31.28,232.66,73
CDM,27856655_IP,CHECK-FLO PERFORM INTRO SET (RCFW-18.0P-38-40-RB),143.5,93.28,52.23,52.23,1
CDM,27856655_OP,CHECK-FLO PERFORM INTRO SET (RCFW-18.0P-38-40-RB),143.5,93.28,42.91,42.91,1
CDM,27856665,"CHECK-FLO PERFORM INTRO SET, MULLINS (RCFW-6.0-38-48-RB-MTS)",75.0,48.75,16.35,232.66,73
CDM,27856665_IP,"CHECK-FLO PERFORM INTRO SET, MULLINS (RCFW-6.0-38-48-RB-MTS)",75.0,48.75,27.3,27.3,1
CDM,27856665_OP,"CHECK-FLO PERFORM INTRO SET, MULLINS (RCFW-6.0-38-48-RB-MTS)",75.0,48.75,22.43,22.43,1
CDM,27856675,"FAST-CATH 10FR X30CM, 9 FR SNAP LOCK OBTURATOR, 80 CM GUIDEWIRE",80.5,52.33,17.55,232.66,73
CDM,27856675_IP,"FAST-CATH 10FR X30CM, 9 FR SNAP LOCK OBTURATOR, 80 CM GUIDEWIRE",80.5,52.33,29.3,29.3,1
CDM,27856675_OP,"FAST-CATH 10FR X30CM, 9 FR SNAP LOCK OBTURATOR, 80 CM GUIDEWIRE",80.5,52.33,24.07,24.07,1
CDM,27856685,"PROGLIDE SUTURE-MEDIATED CLOSURE SYSTEM, W/KNOT PUSH & 7 SUT TRI",322.5,209.63,70.31,322.5,73
CDM,27856685_IP,"PROGLIDE SUTURE-MEDIATED CLOSURE SYSTEM, W/KNOT PUSH & 7 SUT TRI",322.5,209.63,117.39,117.39,1
CDM,27856685_OP,"PROGLIDE SUTURE-MEDIATED CLOSURE SYSTEM, W/KNOT PUSH & 7 SUT TRI",322.5,209.63,96.43,96.43,1
CDM,27856695,STARCLOSE SE VASCULAR CLOSURE SYSTEM 6 FR X 2.0MM  (EA/1),285.0,185.25,62.13,285.0,73
CDM,27856695_IP,STARCLOSE SE VASCULAR CLOSURE SYSTEM 6 FR X 2.0MM  (EA/1),285.0,185.25,103.74,103.74,1
CDM,27856695_OP,STARCLOSE SE VASCULAR CLOSURE SYSTEM 6 FR X 2.0MM  (EA/1),285.0,185.25,85.22,85.22,1
CDM,27856705,EXOSEAL VASCULAR CLOSURE DEVICE,232.5,151.13,50.69,232.66,73
CDM,27856705_IP,EXOSEAL VASCULAR CLOSURE DEVICE,232.5,151.13,84.63,84.63,1
CDM,27856705_OP,EXOSEAL VASCULAR CLOSURE DEVICE,232.5,151.13,69.52,69.52,1
CDM,27856715,VASCADE VASCULAR CLOSURE SYSTEM DEVICE 5FR,247.5,160.88,53.96,247.5,73
CDM,27856715_IP,VASCADE VASCULAR CLOSURE SYSTEM DEVICE 5FR,247.5,160.88,90.09,90.09,1
CDM,27856715_OP,VASCADE VASCULAR CLOSURE SYSTEM DEVICE 5FR,247.5,160.88,74.0,74.0,1
CDM,27856725,ANGIO-SEAL VIP VASCULAR CLOSURE 6FR (2 BOXES OF 5),256.5,166.73,55.92,256.5,73
CDM,27856725_IP,ANGIO-SEAL VIP VASCULAR CLOSURE 6FR (2 BOXES OF 5),256.5,166.73,93.37,93.37,1
CDM,27856725_OP,ANGIO-SEAL VIP VASCULAR CLOSURE 6FR (2 BOXES OF 5),256.5,166.73,76.69,76.69,1
CDM,27856735,CLOSURE DEVICE,262.5,170.63,57.23,262.5,73
CDM,27856735_IP,CLOSURE DEVICE,262.5,170.63,95.55,95.55,1
CDM,27856735_OP,CLOSURE DEVICE,262.5,170.63,78.49,78.49,1
CDM,27856755,AMPLATZER VASCULAR PLUG 4,1380.0,897.0,300.84,1380.0,66
CDM,27856755_IP,AMPLATZER VASCULAR PLUG 4,1380.0,897.0,756.24,756.24,1
CDM,27856755_OP,AMPLATZER VASCULAR PLUG 4,1380.0,897.0,598.92,598.92,1
CDM,27856765,AMPLATZER VASCULAR PLUG 2,1200.0,780.0,261.6,1200.0,65
CDM,27856765_IP,AMPLATZER VASCULAR PLUG 2,1200.0,780.0,436.8,436.8,1
CDM,27856765_OP,AMPLATZER VASCULAR PLUG 2,1200.0,780.0,358.8,358.8,1
CDM,27856775,"SOFT DETACHABLE COIL, 4 MM X 6 CM GDC 18",1548.0,1006.2,337.46,1548.0,66
CDM,27856775_IP,"SOFT DETACHABLE COIL, 4 MM X 6 CM GDC 18",1548.0,1006.2,848.3,848.3,1
CDM,27856775_OP,"SOFT DETACHABLE COIL, 4 MM X 6 CM GDC 18",1548.0,1006.2,671.83,671.83,1
CDM,27856785,"SOFT DETACHABLE COIL, 5 MM X 12 CM GDC 18",1398.0,908.7,304.76,1398.0,66
CDM,27856785_IP,"SOFT DETACHABLE COIL, 5 MM X 12 CM GDC 18",1398.0,908.7,766.1,766.1,1
CDM,27856785_OP,"SOFT DETACHABLE COIL, 5 MM X 12 CM GDC 18",1398.0,908.7,606.73,606.73,1
CDM,27856795,"DETACHABLE COIL 2D, 5 MM X 20 CM GDC 18",1090.0,708.5,237.62,1090.0,65
CDM,27856795_IP,"DETACHABLE COIL 2D, 5 MM X 20 CM GDC 18",1090.0,708.5,396.76,396.76,1
CDM,27856795_OP,"DETACHABLE COIL 2D, 5 MM X 20 CM GDC 18",1090.0,708.5,325.91,325.91,1
CDM,27856805,CONTOUR PVA EMBO PARTICLES VIAL 45-150 MICRONS,257.0,167.05,56.03,257.0,65
CDM,27856805_IP,CONTOUR PVA EMBO PARTICLES VIAL 45-150 MICRONS,257.0,167.05,93.55,93.55,1
CDM,27856805_OP,CONTOUR PVA EMBO PARTICLES VIAL 45-150 MICRONS,257.0,167.05,76.84,76.84,1
CDM,27856815,CONTOUR PVA EMBO PARTICLES VIAL 150-500 MICRONS,236.0,153.4,51.45,236.0,65
CDM,27856815_IP,CONTOUR PVA EMBO PARTICLES VIAL 150-500 MICRONS,236.0,153.4,85.9,85.9,1
CDM,27856815_OP,CONTOUR PVA EMBO PARTICLES VIAL 150-500 MICRONS,236.0,153.4,70.56,70.56,1
CDM,27856825,CONTOUR PVA EMBO PARTICLES VIAL 500-710 MICRONS,257.0,167.05,56.03,257.0,65
CDM,27856825_IP,CONTOUR PVA EMBO PARTICLES VIAL 500-710 MICRONS,257.0,167.05,93.55,93.55,1
CDM,27856825_OP,CONTOUR PVA EMBO PARTICLES VIAL 500-710 MICRONS,257.0,167.05,76.84,76.84,1
CDM,27856835,"EMBOSPHERE 2 ML PRE-FILLED SYRINGE, 300-500 MICRONS",299.0,194.35,65.18,299.0,65
CDM,27856835_IP,"EMBOSPHERE 2 ML PRE-FILLED SYRINGE, 300-500 MICRONS",299.0,194.35,108.84,108.84,1
CDM,27856835_OP,"EMBOSPHERE 2 ML PRE-FILLED SYRINGE, 300-500 MICRONS",299.0,194.35,89.4,89.4,1
CDM,27856845,"NESTER EMBOLIZATION MICROCOIL 14CM X 3MM, SOFT PLATINUM, 0.018IN",185.0,120.25,40.33,185.0,65
CDM,27856845_IP,"NESTER EMBOLIZATION MICROCOIL 14CM X 3MM, SOFT PLATINUM, 0.018IN",185.0,120.25,67.34,67.34,1
CDM,27856845_OP,"NESTER EMBOLIZATION MICROCOIL 14CM X 3MM, SOFT PLATINUM, 0.018IN",185.0,120.25,55.32,55.32,1
CDM,27856855,"MICROCOILS 0.35IN, 3MM X 14CM EXTENDED EMBOLUS",185.0,120.25,40.33,185.0,65
CDM,27856855_IP,"MICROCOILS 0.35IN, 3MM X 14CM EXTENDED EMBOLUS",185.0,120.25,67.34,67.34,1
CDM,27856855_OP,"MICROCOILS 0.35IN, 3MM X 14CM EXTENDED EMBOLUS",185.0,120.25,55.32,55.32,1
CDM,27856865,"HILAL EMBOLIZ MICRO, STRAIGHT, SOFT PLAT, 0.018IN MAX (SET OF 2)",128.0,83.2,27.9,128.0,65
CDM,27856865_IP,"HILAL EMBOLIZ MICRO, STRAIGHT, SOFT PLAT, 0.018IN MAX (SET OF 2)",128.0,83.2,46.59,46.59,1
CDM,27856865_OP,"HILAL EMBOLIZ MICRO, STRAIGHT, SOFT PLAT, 0.018IN MAX (SET OF 2)",128.0,83.2,38.27,38.27,1
CDM,27856875,"HILAL EMBOLIZ MICRO, SINGLE-CURL, SOFT PLAT, 0.018IN MAX (SET OF",175.0,113.75,38.15,175.0,65
CDM,27856875_IP,"HILAL EMBOLIZ MICRO, SINGLE-CURL, SOFT PLAT, 0.018IN MAX (SET OF",175.0,113.75,63.7,63.7,1
CDM,27856875_OP,"HILAL EMBOLIZ MICRO, SINGLE-CURL, SOFT PLAT, 0.018IN MAX (SET OF",175.0,113.75,52.33,52.33,1
CDM,27856885,VORTX-18 FIBERED PLATINUM COIL,209.0,135.85,45.56,209.0,65
CDM,27856885_IP,VORTX-18 FIBERED PLATINUM COIL,209.0,135.85,76.08,76.08,1
CDM,27856885_OP,VORTX-18 FIBERED PLATINUM COIL,209.0,135.85,62.49,62.49,1
CDM,27856895,"TORNADO EMBOLIZATION MICROCOIL, 0.018IN MAX, 2/3",280.5,182.33,61.15,280.5,65
CDM,27856895_IP,"TORNADO EMBOLIZATION MICROCOIL, 0.018IN MAX, 2/3",280.5,182.33,102.1,102.1,1
CDM,27856895_OP,"TORNADO EMBOLIZATION MICROCOIL, 0.018IN MAX, 2/3",280.5,182.33,83.87,83.87,1
CDM,27856905,"TORNADO EMBOLIZATION MICROCOIL, 0.018IN MAX, 2/4",289.5,188.18,63.11,289.5,65
CDM,27856905_IP,"TORNADO EMBOLIZATION MICROCOIL, 0.018IN MAX, 2/4",289.5,188.18,105.38,105.38,1
CDM,27856905_OP,"TORNADO EMBOLIZATION MICROCOIL, 0.018IN MAX, 2/4",289.5,188.18,86.56,86.56,1
CDM,27856915,"TORNADO EMBOLIZATION MICROCOIL, 0.018IN MAX, 2/5",336.0,218.4,73.25,336.0,65
CDM,27856915_IP,"TORNADO EMBOLIZATION MICROCOIL, 0.018IN MAX, 2/5",336.0,218.4,122.3,122.3,1
CDM,27856915_OP,"TORNADO EMBOLIZATION MICROCOIL, 0.018IN MAX, 2/5",336.0,218.4,100.46,100.46,1
CDM,27856925,"TORNADO EMBOLIZATION MICROCOIL, 0.018IN MAX, 2/6",327.0,212.55,71.29,327.0,65
CDM,27856925_IP,"TORNADO EMBOLIZATION MICROCOIL, 0.018IN MAX, 2/6",327.0,212.55,119.03,119.03,1
CDM,27856925_OP,"TORNADO EMBOLIZATION MICROCOIL, 0.018IN MAX, 2/6",327.0,212.55,97.77,97.77,1
CDM,27856935,"TORNADO EMBOLIZATION MICROCOIL, 0.018IN MAX, 3/7",330.0,214.5,71.94,330.0,65
CDM,27856935_IP,"TORNADO EMBOLIZATION MICROCOIL, 0.018IN MAX, 3/7",330.0,214.5,94.28,94.28,1
CDM,27856935_OP,"TORNADO EMBOLIZATION MICROCOIL, 0.018IN MAX, 3/7",330.0,214.5,77.44,77.44,1
CDM,27856945,"TORNADO EMBOLIZATION MICROCOIL, 0.018IN MAX, 4/3",280.5,182.33,61.15,280.5,65
CDM,27856945_IP,"TORNADO EMBOLIZATION MICROCOIL, 0.018IN MAX, 4/3",280.5,182.33,102.1,102.1,1
CDM,27856945_OP,"TORNADO EMBOLIZATION MICROCOIL, 0.018IN MAX, 4/3",280.5,182.33,83.87,83.87,1
CDM,27856955,"TORNADO EMBOLIZATION MICROCOIL 7CM, PLAT STANDARD, 0.018IN MAX,",193.0,125.45,42.07,193.0,65
CDM,27856955_IP,"TORNADO EMBOLIZATION MICROCOIL 7CM, PLAT STANDARD, 0.018IN MAX,",193.0,125.45,70.25,70.25,1
CDM,27856955_OP,"TORNADO EMBOLIZATION MICROCOIL 7CM, PLAT STANDARD, 0.018IN MAX,",193.0,125.45,57.71,57.71,1
CDM,27856965,"TORNADO EMBOLIZATION MICROCOIL, 0.018IN MAX, 8/4",259.0,168.35,56.46,259.0,65
CDM,27856965_IP,"TORNADO EMBOLIZATION MICROCOIL, 0.018IN MAX, 8/4",259.0,168.35,94.28,94.28,1
CDM,27856965_OP,"TORNADO EMBOLIZATION MICROCOIL, 0.018IN MAX, 8/4",259.0,168.35,77.44,77.44,1
CDM,27856975,"TORNADO EMBOLIZATION MICROCOIL, 0.018IN MAX, 8/5",336.0,218.4,73.25,336.0,65
CDM,27856975_IP,"TORNADO EMBOLIZATION MICROCOIL, 0.018IN MAX, 8/5",336.0,218.4,122.3,122.3,1
CDM,27856975_OP,"TORNADO EMBOLIZATION MICROCOIL, 0.018IN MAX, 8/5",336.0,218.4,100.46,100.46,1
CDM,27856985,"TORNADO EMBOLIZATION MICROCOIL, 0.035IN MAX, 5/8",280.5,182.33,61.15,280.5,65
CDM,27856985_IP,"TORNADO EMBOLIZATION MICROCOIL, 0.035IN MAX, 5/8",280.5,182.33,102.1,102.1,1
CDM,27856985_OP,"TORNADO EMBOLIZATION MICROCOIL, 0.035IN MAX, 5/8",280.5,182.33,83.87,83.87,1
CDM,27856995,HYDROFRAME -10 EMBOLIC COIL SYSTEM 7MM X 15CM,4352.0,2828.8,948.74,4352.0,66
CDM,27856995_IP,HYDROFRAME -10 EMBOLIC COIL SYSTEM 7MM X 15CM,4352.0,2828.8,2384.9,2384.9,1
CDM,27856995_OP,HYDROFRAME -10 EMBOLIC COIL SYSTEM 7MM X 15CM,4352.0,2828.8,1888.77,1888.77,1
CDM,27857005,HYDROFRAME -10 EMBOLIC COIL SYSTEM 8MM X 33CM,4500.0,2925.0,981.0,4500.0,66
CDM,27857005_IP,HYDROFRAME -10 EMBOLIC COIL SYSTEM 8MM X 33CM,4500.0,2925.0,2466.0,2466.0,1
CDM,27857005_OP,HYDROFRAME -10 EMBOLIC COIL SYSTEM 8MM X 33CM,4500.0,2925.0,1953.0,1953.0,1
CDM,27860OH,MANIPULATION ANKLE UNDER GENERAL ANESTHESIA,956.0,621.4,1.1,9440.12,144
CDM,27870015,HYDROFRAME 18-SR EMBOLIC COIL,5431.0,3530.15,1030.0,5431.0,66
CDM,27870015_IP,HYDROFRAME 18-SR EMBOLIC COIL,5431.0,3530.15,2976.19,2976.19,1
CDM,27870015_OP,HYDROFRAME 18-SR EMBOLIC COIL,5431.0,3530.15,2357.05,2357.05,1
CDM,27870025,BARRICADE COIL SYSTEM,892.5,580.13,194.57,892.5,65
CDM,27870025_IP,BARRICADE COIL SYSTEM,892.5,580.13,324.87,324.87,1
CDM,27870025_OP,BARRICADE COIL SYSTEM,892.5,580.13,266.86,266.86,1
CDM,27870035,POD OCCLUSION DEVICE,2567.0,1668.55,559.61,2567.0,66
CDM,27870035_IP,POD OCCLUSION DEVICE,2567.0,1668.55,1406.72,1406.72,1
CDM,27870035_OP,POD OCCLUSION DEVICE,2567.0,1668.55,1114.08,1114.08,1
CDM,27870045,"INTERLOCK -35 FIBERED IDC OCCLUSION SYSTEM, 2D HELICAL COIL",1800.0,1170.0,392.4,1800.0,66
CDM,27870045_IP,"INTERLOCK -35 FIBERED IDC OCCLUSION SYSTEM, 2D HELICAL COIL",1800.0,1170.0,986.4,986.4,1
CDM,27870045_OP,"INTERLOCK -35 FIBERED IDC OCCLUSION SYSTEM, 2D HELICAL COIL",1800.0,1170.0,781.2,781.2,1
CDM,27870065,"BRACHYTHERAPY NON-STRANDED RU106, PER SOURCE",1285.0,835.25,31.82,1285.0,91
CDM,27870065_IP,"BRACHYTHERAPY NON-STRANDED RU106, PER SOURCE",1285.0,835.25,704.18,704.18,1
CDM,27870065_OP,"BRACHYTHERAPY NON-STRANDED RU106, PER SOURCE",1285.0,835.25,557.69,557.69,1
CDM,27870095,AZUR DETACHABLE CONTROLLER,285.0,185.25,62.13,285.0,65
CDM,27870095_IP,AZUR DETACHABLE CONTROLLER,285.0,185.25,103.74,103.74,1
CDM,27870095_OP,AZUR DETACHABLE CONTROLLER,285.0,185.25,85.22,85.22,1
CDM,27870105,"AZUR CX  7,8MM X 24, 28CM DETACHABLE COIL",1162.5,755.63,253.43,1162.5,65
CDM,27870105_IP,"AZUR CX  7,8MM X 24, 28CM DETACHABLE COIL",1162.5,755.63,423.15,423.15,1
CDM,27870105_OP,"AZUR CX  7,8MM X 24, 28CM DETACHABLE COIL",1162.5,755.63,347.59,347.59,1
CDM,27870115,"HELICAL HYDROCOIL, AZUR 18 DETACHABLE COIL 3MM-6MM X 2CM-10CM",1275.0,828.75,277.95,1275.0,65
CDM,27870115_IP,"HELICAL HYDROCOIL, AZUR 18 DETACHABLE COIL 3MM-6MM X 2CM-10CM",1275.0,828.75,698.7,698.7,1
CDM,27870115_OP,"HELICAL HYDROCOIL, AZUR 18 DETACHABLE COIL 3MM-6MM X 2CM-10CM",1275.0,828.75,553.35,553.35,1
CDM,27870125,AZUR CX35 DETACHABLE COIL 8MM X 24CM,1890.0,1228.5,412.02,1890.0,66
CDM,27870125_IP,AZUR CX35 DETACHABLE COIL 8MM X 24CM,1890.0,1228.5,1035.72,1035.72,1
CDM,27870125_OP,AZUR CX35 DETACHABLE COIL 8MM X 24CM,1890.0,1228.5,820.26,820.26,1
CDM,27870135,AZUR DETACHABLE FRAMING COIL 8MM X 24CM,1492.5,970.13,325.37,1492.5,66
CDM,27870135_IP,AZUR DETACHABLE FRAMING COIL 8MM X 24CM,1492.5,970.13,817.89,817.89,1
CDM,27870135_OP,AZUR DETACHABLE FRAMING COIL 8MM X 24CM,1492.5,970.13,647.75,647.75,1
CDM,27870145,TIER 2 EMBOLIZATION COILS DETACHABLE,1830.0,1189.5,398.94,1830.0,66
CDM,27870145_IP,TIER 2 EMBOLIZATION COILS DETACHABLE,1830.0,1189.5,1002.84,1002.84,1
CDM,27870145_OP,TIER 2 EMBOLIZATION COILS DETACHABLE,1830.0,1189.5,794.22,794.22,1
CDM,27870155,TIER 3 EMBOLIZATION COILS DETACHABLE,2800.0,1820.0,610.4,2800.0,66
CDM,27870155_IP,TIER 3 EMBOLIZATION COILS DETACHABLE,2800.0,1820.0,1534.4,1534.4,1
CDM,27870155_OP,TIER 3 EMBOLIZATION COILS DETACHABLE,2800.0,1820.0,1215.2,1215.2,1
CDM,27870165,IMPELLA SUPPLIES,375.0,243.75,81.75,375.0,65
CDM,27870165_IP,IMPELLA SUPPLIES,375.0,243.75,136.5,136.5,1
CDM,27870165_OP,IMPELLA SUPPLIES,375.0,243.75,112.13,112.13,1
CDM,27870175,GEN ENDOPROSTHESIS TIER 1,6574.0,4273.1,1030.0,6574.0,66
CDM,27870175_IP,GEN ENDOPROSTHESIS TIER 1,6574.0,4273.1,3602.55,3602.55,1
CDM,27870175_OP,GEN ENDOPROSTHESIS TIER 1,6574.0,4273.1,2853.12,2853.12,1
CDM,27870185,CHEST TUBE,56.0,36.4,12.21,56.0,65
CDM,27870185_IP,CHEST TUBE,56.0,36.4,20.38,20.38,1
CDM,27870185_OP,CHEST TUBE,56.0,36.4,16.74,16.74,1
CDM,27870205,C1876 STENT TIER 6,3700.0,2405.0,200.93,3700.0,74
CDM,27870205_IP,C1876 STENT TIER 6,3700.0,2405.0,2027.6,2027.6,1
CDM,27870205_OP,C1876 STENT TIER 6,3700.0,2405.0,1605.8,1605.8,1
CDM,27870215,C1876 CAROTID WALLSTENT,3870.0,2515.5,200.93,3870.0,74
CDM,27870215_IP,C1876 CAROTID WALLSTENT,3870.0,2515.5,2120.76,2120.76,1
CDM,27870215_OP,C1876 CAROTID WALLSTENT,3870.0,2515.5,1679.58,1679.58,1
CDM,27870225,PRECISE STENT,3900.0,2535.0,200.93,3900.0,74
CDM,27870225_IP,PRECISE STENT,3900.0,2535.0,2137.2,2137.2,1
CDM,27870225_OP,PRECISE STENT,3900.0,2535.0,1692.6,1692.6,1
CDM,27870235,AMPLATZER DUCT OCCLUDER,3328.0,2163.2,725.5,3328.0,66
CDM,27870235_IP,AMPLATZER DUCT OCCLUDER,3328.0,2163.2,1823.74,1823.74,1
CDM,27870235_OP,AMPLATZER DUCT OCCLUDER,3328.0,2163.2,1444.35,1444.35,1
CDM,27870245,PROSTHETIC IMPLANT DEVICE UROLIFT,1900.0,1235.0,16.97,1900.0,74
CDM,27870245_IP,PROSTHETIC IMPLANT DEVICE UROLIFT,1900.0,1235.0,1041.2,1041.2,1
CDM,27870245_OP,PROSTHETIC IMPLANT DEVICE UROLIFT,1900.0,1235.0,824.6,824.6,1
CDM,27870OH,ARTHRODESIS ANKLE OPEN,6164.0,4006.6,1.1,38384.94,144
CDM,27871365,EQUISTREAM DIALYISIS,930.0,604.5,200.93,930.0,73
CDM,27871365_IP,EQUISTREAM DIALYISIS,930.0,604.5,338.52,338.52,1
CDM,27871365_OP,EQUISTREAM DIALYISIS,930.0,604.5,278.07,278.07,1
CDM,27871425,BIOFLO PICC ON 4F SGL,228.0,148.2,49.7,232.66,73
CDM,27871425_IP,BIOFLO PICC ON 4F SGL,228.0,148.2,82.99,82.99,1
CDM,27871425_OP,BIOFLO PICC ON 4F SGL,228.0,148.2,68.17,68.17,1
CDM,27871905,CONCERTO COIL,1875.0,1218.75,200.93,1875.0,75
CDM,27871955,PROMETRA II CATHETER REVISION KIT,1100.0,715.0,239.8,1100.0,65
CDM,27871955_IP,PROMETRA II CATHETER REVISION KIT,1100.0,715.0,400.4,400.4,1
CDM,27871955_OP,PROMETRA II CATHETER REVISION KIT,1100.0,715.0,328.9,328.9,1
CDM,27871OH,ARTHRODESIS TIBIOFIBULAR JOINT PROXIMAL/DISTAL,3816.0,2480.4,1.1,38384.94,144
CDM,27872635,PENUMBRA OCCL DEVICE 1899,5697.0,3703.05,1030.0,5697.0,67
CDM,27872665,PENUMBRA COIL 1290,3870.0,2515.5,843.66,3870.0,67
CDM,27873255,PULSERIDER STENT VASC T 2.7 - 3.5MM / W8.6MM,12500.0,8125.0,1030.0,12500.0,66
CDM,27873255_IP,PULSERIDER STENT VASC T 2.7 - 3.5MM / W8.6MM,12500.0,8125.0,6850.0,6850.0,1
CDM,27873255_OP,PULSERIDER STENT VASC T 2.7 - 3.5MM / W8.6MM,12500.0,8125.0,5425.0,5425.0,1
CDM,27873265,PULSERIDER STENT VASC T 3.5 - 4.5MM / W8.6MM,12500.0,8125.0,1030.0,12500.0,66
CDM,27873265_IP,PULSERIDER STENT VASC T 3.5 - 4.5MM / W8.6MM,12500.0,8125.0,6850.0,6850.0,1
CDM,27873265_OP,PULSERIDER STENT VASC T 3.5 - 4.5MM / W8.6MM,12500.0,8125.0,5425.0,5425.0,1
CDM,27873275,PULSERIDER STENT VASC T 2.7 - 3.5MM / W10.6MM,12500.0,8125.0,1030.0,12500.0,66
CDM,27873275_IP,PULSERIDER STENT VASC T 2.7 - 3.5MM / W10.6MM,12500.0,8125.0,6850.0,6850.0,1
CDM,27873275_OP,PULSERIDER STENT VASC T 2.7 - 3.5MM / W10.6MM,12500.0,8125.0,5425.0,5425.0,1
CDM,27873285,PULSERIDER STENT VASC T 3.5 - 4.5MM / W10.6MM,12500.0,8125.0,1030.0,12500.0,66
CDM,27873285_IP,PULSERIDER STENT VASC T 3.5 - 4.5MM / W10.6MM,12500.0,8125.0,6850.0,6850.0,1
CDM,27873285_OP,PULSERIDER STENT VASC T 3.5 - 4.5MM / W10.6MM,12500.0,8125.0,5425.0,5425.0,1
CDM,27873295,PULSERIDER STENT VASC Y 2.7 - 3.5MM / W8 6MM,12500.0,8125.0,1030.0,12500.0,66
CDM,27873295_IP,PULSERIDER STENT VASC Y 2.7 - 3.5MM / W8 6MM,12500.0,8125.0,6850.0,6850.0,1
CDM,27873295_OP,PULSERIDER STENT VASC Y 2.7 - 3.5MM / W8 6MM,12500.0,8125.0,5425.0,5425.0,1
CDM,27873305,PULSERIDER STENT VASC Y 3.5 - 4.5MM / W8.6MM,12500.0,8125.0,1030.0,12500.0,66
CDM,27873305_IP,PULSERIDER STENT VASC Y 3.5 - 4.5MM / W8.6MM,12500.0,8125.0,6850.0,6850.0,1
CDM,27873305_OP,PULSERIDER STENT VASC Y 3.5 - 4.5MM / W8.6MM,12500.0,8125.0,5425.0,5425.0,1
CDM,27873315,PULSERIDER STENT VASC Y 2.7 - 3.5MM / W10.6MM,12500.0,8125.0,1030.0,12500.0,66
CDM,27873315_IP,PULSERIDER STENT VASC Y 2.7 - 3.5MM / W10.6MM,12500.0,8125.0,6850.0,6850.0,1
CDM,27873315_OP,PULSERIDER STENT VASC Y 2.7 - 3.5MM / W10.6MM,12500.0,8125.0,5425.0,5425.0,1
CDM,27873325,PULSERIDER STENT VASC Y 3.5 - 4.5MM / W10.6MM,12500.0,8125.0,1030.0,12500.0,66
CDM,27873325_IP,PULSERIDER STENT VASC Y 3.5 - 4.5MM / W10.6MM,12500.0,8125.0,6850.0,6850.0,1
CDM,27873325_OP,PULSERIDER STENT VASC Y 3.5 - 4.5MM / W10.6MM,12500.0,8125.0,5425.0,5425.0,1
CDM,27873965,"STENT, NON-COAT W/DEL C1876 425",1275.0,828.75,200.93,1275.0,73
CDM,27873965_IP,"STENT, NON-COAT W/DEL C1876 425",1275.0,828.75,698.7,698.7,1
CDM,27873965_OP,"STENT, NON-COAT W/DEL C1876 425",1275.0,828.75,553.35,553.35,1
CDM,27873975,"STENT, NON-COAT W/DEL C1876 550",1650.0,1072.5,200.93,1650.0,74
CDM,27873975_IP,"STENT, NON-COAT W/DEL C1876 550",1650.0,1072.5,904.2,904.2,1
CDM,27873975_OP,"STENT, NON-COAT W/DEL C1876 550",1650.0,1072.5,716.1,716.1,1
CDM,27873985,"STENT, NON-COAT W/DEL C1876 375",1125.0,731.25,200.93,1125.0,73
CDM,27873985_IP,"STENT, NON-COAT W/DEL C1876 375",1125.0,731.25,409.5,409.5,1
CDM,27873985_OP,"STENT, NON-COAT W/DEL C1876 375",1125.0,731.25,336.38,336.38,1
CDM,27873995,"STENT, NON-COAT W/DEL C1876 825",2475.0,1608.75,200.93,2475.0,74
CDM,27873995_IP,"STENT, NON-COAT W/DEL C1876 825",2475.0,1608.75,1356.3,1356.3,1
CDM,27873995_OP,"STENT, NON-COAT W/DEL C1876 825",2475.0,1608.75,1074.15,1074.15,1
CDM,27874105,H130005 LVIS JR EXPAND STENT,6800.0,4420.0,1030.0,6800.0,66
CDM,27874105_IP,H130005 LVIS JR EXPAND STENT,6800.0,4420.0,3726.4,3726.4,1
CDM,27874105_OP,H130005 LVIS JR EXPAND STENT,6800.0,4420.0,2951.2,2951.2,1
CDM,27874115,ABBOT HERCULINK RENAL BILIARY STENT 5.0X12X80CM,1540.0,1001.0,200.93,1540.0,74
CDM,27874115_IP,ABBOT HERCULINK RENAL BILIARY STENT 5.0X12X80CM,1540.0,1001.0,843.92,843.92,1
CDM,27874115_OP,ABBOT HERCULINK RENAL BILIARY STENT 5.0X12X80CM,1540.0,1001.0,668.36,668.36,1
CDM,27874695,CERAMENT BONE VOID FILLER 10CC,5448.0,3541.2,200.93,5448.0,74
CDM,27874695_IP,CERAMENT BONE VOID FILLER 10CC,5448.0,3541.2,2985.5,2985.5,1
CDM,27874695_OP,CERAMENT BONE VOID FILLER 10CC,5448.0,3541.2,2364.43,2364.43,1
CDM,27874745,VASCULAR CLOSURE DEVICE,259.5,168.68,56.57,259.5,73
CDM,27874745_IP,VASCULAR CLOSURE DEVICE,259.5,168.68,94.46,94.46,1
CDM,27874745_OP,VASCULAR CLOSURE DEVICE,259.5,168.68,77.59,77.59,1
CDM,27875025,WALLFLEX DUODENAL STENT,4990.0,3243.5,1030.0,4990.0,66
CDM,27875025_IP,WALLFLEX DUODENAL STENT,4990.0,3243.5,2734.52,2734.52,1
CDM,27875025_OP,WALLFLEX DUODENAL STENT,4990.0,3243.5,2165.66,2165.66,1
CDM,27875065,BILIARY WALLFLEX UNCVRD,2999.0,1949.35,653.78,2999.0,66
CDM,27875065_IP,BILIARY WALLFLEX UNCVRD,2999.0,1949.35,1643.45,1643.45,1
CDM,27875065_OP,BILIARY WALLFLEX UNCVRD,2999.0,1949.35,1301.57,1301.57,1
CDM,27875275,"ELECTRODE, NEUROSTIMULATOR L8680 (278)",14965.0,9727.25,333.06,14965.0,74
CDM,27875275_IP,"ELECTRODE, NEUROSTIMULATOR L8680 (278)",14965.0,9727.25,8200.82,8200.82,1
CDM,27875275_OP,"ELECTRODE, NEUROSTIMULATOR L8680 (278)",14965.0,9727.25,6494.81,6494.81,1
CDM,27875295,STENT PROPEL SINUS IMPLANT,1600.0,1040.0,200.93,1600.0,74
CDM,27875295_IP,STENT PROPEL SINUS IMPLANT,1600.0,1040.0,876.8,876.8,1
CDM,27875295_OP,STENT PROPEL SINUS IMPLANT,1600.0,1040.0,694.4,694.4,1
CDM,27875315,C1876 STENT TIER 7,4990.0,3243.5,200.93,4990.0,74
CDM,27875315_IP,C1876 STENT TIER 7,4990.0,3243.5,2734.52,2734.52,1
CDM,27875315_OP,C1876 STENT TIER 7,4990.0,3243.5,2165.66,2165.66,1
CDM,27875325,C1817 STENT TIER 1,11232.0,7300.8,200.93,11232.0,74
CDM,27875325_IP,C1817 STENT TIER 1,11232.0,7300.8,6155.14,6155.14,1
CDM,27875325_OP,C1817 STENT TIER 1,11232.0,7300.8,4874.69,4874.69,1
CDM,27875435,PRECUT CORNEA FOR DALK,10200.0,6630.0,1030.0,10200.0,66
CDM,27875435_IP,PRECUT CORNEA FOR DALK,10200.0,6630.0,5589.6,5589.6,1
CDM,27875435_OP,PRECUT CORNEA FOR DALK,10200.0,6630.0,4426.8,4426.8,1
CDM,27875445,"PUMP INT THCL PROMETRA II,CATH 13827",18000.0,11700.0,200.93,18000.0,74
CDM,27875445_IP,"PUMP INT THCL PROMETRA II,CATH 13827",18000.0,11700.0,9864.0,9864.0,1
CDM,27875445_OP,"PUMP INT THCL PROMETRA II,CATH 13827",18000.0,11700.0,7812.0,7812.0,1
CDM,27875455,PUMP INT THCL PROMETRA II NO CATH 13827,18000.0,11700.0,200.93,18000.0,74
CDM,27875455_IP,PUMP INT THCL PROMETRA II NO CATH 13827,18000.0,11700.0,9864.0,9864.0,1
CDM,27875455_OP,PUMP INT THCL PROMETRA II NO CATH 13827,18000.0,11700.0,7812.0,7812.0,1
CDM,27875465,"CATH INT THCL PROMETRA,PUMP 11823",1540.0,1001.0,200.93,1540.0,74
CDM,27875465_IP,"CATH INT THCL PROMETRA,PUMP 11823",1540.0,1001.0,843.92,843.92,1
CDM,27875465_OP,"CATH INT THCL PROMETRA,PUMP 11823",1540.0,1001.0,668.36,668.36,1
CDM,27875475,CATH INT THCL PROMETRA NO PUMP 11823,1540.0,1001.0,200.93,1540.0,74
CDM,27875475_IP,CATH INT THCL PROMETRA NO PUMP 11823,1540.0,1001.0,843.92,843.92,1
CDM,27875475_OP,CATH INT THCL PROMETRA NO PUMP 11823,1540.0,1001.0,668.36,668.36,1
CDM,27875485,CATH REVISION KIT 11830,1000.0,650.0,200.93,1000.0,73
CDM,27875485_IP,CATH REVISION KIT 11830,1000.0,650.0,364.0,364.0,1
CDM,27875485_OP,CATH REVISION KIT 11830,1000.0,650.0,299.0,299.0,1
CDM,27875495,GNRTR NRSTM IPG KIT NEVRO,25300.0,16445.0,200.93,25300.0,74
CDM,27875495_IP,GNRTR NRSTM IPG KIT NEVRO,25300.0,16445.0,13864.4,13864.4,1
CDM,27875495_OP,GNRTR NRSTM IPG KIT NEVRO,25300.0,16445.0,10980.2,10980.2,1
CDM,27875505,KIT LD EXTN NVRO LEAD2008-XXB,2400.0,1560.0,200.93,2400.0,74
CDM,27875505_IP,KIT LD EXTN NVRO LEAD2008-XXB,2400.0,1560.0,1315.2,1315.2,1
CDM,27875505_OP,KIT LD EXTN NVRO LEAD2008-XXB,2400.0,1560.0,1041.6,1041.6,1
CDM,27875515,PRGRMR KIT NEVRO PTRC1000,1260.0,819.0,200.93,1260.0,73
CDM,27875515_IP,PRGRMR KIT NEVRO PTRC1000,1260.0,819.0,690.48,690.48,1
CDM,27875515_OP,PRGRMR KIT NEVRO PTRC1000,1260.0,819.0,546.84,546.84,1
CDM,27875525,KIT ANCHOR SENZA SCS ACCK5X00,600.0,390.0,130.8,600.0,65
CDM,27875525_IP,KIT ANCHOR SENZA SCS ACCK5X00,600.0,390.0,218.4,218.4,1
CDM,27875525_OP,KIT ANCHOR SENZA SCS ACCK5X00,600.0,390.0,179.4,179.4,1
CDM,27875535,KIT IPG PLG PORT ACCK7000,400.0,260.0,87.2,400.0,65
CDM,27875535_IP,KIT IPG PLG PORT ACCK7000,400.0,260.0,145.6,145.6,1
CDM,27875535_OP,KIT IPG PLG PORT ACCK7000,400.0,260.0,119.6,119.6,1
CDM,27875545,KIT LD ADPT NVRO 20 CM,1600.0,1040.0,200.93,1600.0,74
CDM,27875545_IP,KIT LD ADPT NVRO 20 CM,1600.0,1040.0,876.8,876.8,1
CDM,27875545_OP,KIT LD ADPT NVRO 20 CM,1600.0,1040.0,694.4,694.4,1
CDM,27875555,NRSTM IMP INTELLIS SNSR MRI 97715,23000.0,14950.0,200.93,23000.0,74
CDM,27875555_IP,NRSTM IMP INTELLIS SNSR MRI 97715,23000.0,14950.0,12604.0,12604.0,1
CDM,27875555_OP,NRSTM IMP INTELLIS SNSR MRI 97715,23000.0,14950.0,9982.0,9982.0,1
CDM,27875565,NRSTM IMP PRIME ADV MRI 97702,17000.0,11050.0,200.93,17000.0,74
CDM,27875565_IP,NRSTM IMP PRIME ADV MRI 97702,17000.0,11050.0,9316.0,9316.0,1
CDM,27875565_OP,NRSTM IMP PRIME ADV MRI 97702,17000.0,11050.0,7378.0,7378.0,1
CDM,27875575,NRSTM IMP RESTORE SNSR MRI 97714,23000.0,14950.0,200.93,23000.0,74
CDM,27875575_IP,NRSTM IMP RESTORE SNSR MRI 97714,23000.0,14950.0,12604.0,12604.0,1
CDM,27875575_OP,NRSTM IMP RESTORE SNSR MRI 97714,23000.0,14950.0,9982.0,9982.0,1
CDM,27875585,NRSTM IMP RESTORE ULTRA MRI 97712,21000.0,13650.0,200.93,21000.0,74
CDM,27875585_IP,NRSTM IMP RESTORE ULTRA MRI 97712,21000.0,13650.0,11508.0,11508.0,1
CDM,27875585_OP,NRSTM IMP RESTORE ULTRA MRI 97712,21000.0,13650.0,9114.0,9114.0,1
CDM,27875595,LEAD NRSTM MRI 1X8 60-90CM 977A2XX,3158.0,2052.7,200.93,3158.0,74
CDM,27875595_IP,LEAD NRSTM MRI 1X8 60-90CM 977A2XX,3158.0,2052.7,1730.58,1730.58,1
CDM,27875595_OP,LEAD NRSTM MRI 1X8 60-90CM 977A2XX,3158.0,2052.7,1370.57,1370.57,1
CDM,27875605,LEAD NRSTM MRI 1X8 SC 60-90CM 977Z1XX,3158.0,2052.7,200.93,3158.0,74
CDM,27875605_IP,LEAD NRSTM MRI 1X8 SC 60-90CM 977Z1XX,3158.0,2052.7,1730.58,1730.58,1
CDM,27875605_OP,LEAD NRSTM MRI 1X8 SC 60-90CM 977Z1XX,3158.0,2052.7,1370.57,1370.57,1
CDM,27875615,LEAD NRSTM 45-75CM 3777XX,1800.0,1170.0,200.93,1800.0,74
CDM,27875615_IP,LEAD NRSTM 45-75CM 3777XX,1800.0,1170.0,986.4,986.4,1
CDM,27875615_OP,LEAD NRSTM 45-75CM 3777XX,1800.0,1170.0,781.2,781.2,1
CDM,27875625,LEAD KIT PISCES QUAD PLUS 33-56CM 3888XX,1750.0,1137.5,200.93,1750.0,74
CDM,27875625_IP,LEAD KIT PISCES QUAD PLUS 33-56CM 3888XX,1750.0,1137.5,959.0,959.0,1
CDM,27875625_OP,LEAD KIT PISCES QUAD PLUS 33-56CM 3888XX,1750.0,1137.5,759.5,759.5,1
CDM,27875635,LEAD KIT PISCES QUAD 33-45CM 3487XX,1750.0,1137.5,200.93,1750.0,74
CDM,27875635_IP,LEAD KIT PISCES QUAD 33-45CM 3487XX,1750.0,1137.5,959.0,959.0,1
CDM,27875635_OP,LEAD KIT PISCES QUAD 33-45CM 3487XX,1750.0,1137.5,759.5,759.5,1
CDM,27875645,LEAD NRSTM 60CM TRIAL 1X8 977DX60,1200.0,780.0,200.93,1200.0,73
CDM,27875645_IP,LEAD NRSTM 60CM TRIAL 1X8 977DX60,1200.0,780.0,436.8,436.8,1
CDM,27875645_OP,LEAD NRSTM 60CM TRIAL 1X8 977DX60,1200.0,780.0,358.8,358.8,1
CDM,27875655,KIT INTLS PRGRM EXTRNL 97725,496.0,322.4,108.13,496.0,73
CDM,27875655_IP,KIT INTLS PRGRM EXTRNL 97725,496.0,322.4,180.54,180.54,1
CDM,27875655_OP,KIT INTLS PRGRM EXTRNL 97725,496.0,322.4,148.3,148.3,1
CDM,27875665,KIT NRSTM MULTI TRIAL CABLE 355531,496.0,322.4,108.13,496.0,73
CDM,27875665_IP,KIT NRSTM MULTI TRIAL CABLE 355531,496.0,322.4,180.54,180.54,1
CDM,27875665_OP,KIT NRSTM MULTI TRIAL CABLE 355531,496.0,322.4,148.3,148.3,1
CDM,27875675,NRSTM LD ANCHR INS SEP 9779X,217.0,141.05,47.31,217.0,65
CDM,27875675_IP,NRSTM LD ANCHR INS SEP 9779X,217.0,141.05,78.99,78.99,1
CDM,27875675_OP,NRSTM LD ANCHR INS SEP 9779X,217.0,141.05,64.88,64.88,1
CDM,27875685,NRSTM IMP 60/75CM PSC ZQD SPNL 355027,700.0,455.0,152.6,700.0,73
CDM,27875685_IP,NRSTM IMP 60/75CM PSC ZQD SPNL 355027,700.0,455.0,254.8,254.8,1
CDM,27875685_OP,NRSTM IMP 60/75CM PSC ZQD SPNL 355027,700.0,455.0,209.3,209.3,1
CDM,27875695,NRSTM IMP 30-45CM REV SPNL 355026,582.0,378.3,126.88,582.0,73
CDM,27875695_IP,NRSTM IMP 30-45CM REV SPNL 355026,582.0,378.3,211.85,211.85,1
CDM,27875695_OP,NRSTM IMP 30-45CM REV SPNL 355026,582.0,378.3,174.02,174.02,1
CDM,27875705,KIT NRSTM EXTENSION 3708X-X0,800.0,520.0,174.4,800.0,73
CDM,27875705_IP,KIT NRSTM EXTENSION 3708X-X0,800.0,520.0,291.2,291.2,1
CDM,27875705_OP,KIT NRSTM EXTENSION 3708X-X0,800.0,520.0,239.2,239.2,1
CDM,27875715,KIT EXT NRSTM EXTENSION 37082-X0,1500.0,975.0,200.93,1500.0,74
CDM,27875715_IP,KIT EXT NRSTM EXTENSION 37082-X0,1500.0,975.0,822.0,822.0,1
CDM,27875715_OP,KIT EXT NRSTM EXTENSION 37082-X0,1500.0,975.0,651.0,651.0,1
CDM,27875725,PUMP INT THCL SNCHR 2 DRG 8637-X0,19800.0,12870.0,200.93,19800.0,74
CDM,27875725_IP,PUMP INT THCL SNCHR 2 DRG 8637-X0,19800.0,12870.0,10850.4,10850.4,1
CDM,27875725_OP,PUMP INT THCL SNCHR 2 DRG 8637-X0,19800.0,12870.0,8593.2,8593.2,1
CDM,27875735,LEAD NEVRO LEAD1058-XXB,2908.0,1890.2,200.93,2908.0,74
CDM,27875735_IP,LEAD NEVRO LEAD1058-XXB,2908.0,1890.2,1593.58,1593.58,1
CDM,27875735_OP,LEAD NEVRO LEAD1058-XXB,2908.0,1890.2,1262.07,1262.07,1
CDM,27875745,CHARGER KIT NEVRO CHGR1000,1485.0,965.25,200.93,1485.0,74
CDM,27875745_IP,CHARGER KIT NEVRO CHGR1000,1485.0,965.25,813.78,813.78,1
CDM,27875745_OP,CHARGER KIT NEVRO CHGR1000,1485.0,965.25,644.49,644.49,1
CDM,27876645,GUNTHER TULIP VENA CAVA FILTER SET 65CM,1598.0,1038.7,200.93,1598.0,74
CDM,27876645_IP,GUNTHER TULIP VENA CAVA FILTER SET 65CM,1598.0,1038.7,875.7,875.7,1
CDM,27876645_OP,GUNTHER TULIP VENA CAVA FILTER SET 65CM,1598.0,1038.7,693.53,693.53,1
CDM,27876655,7FR X 60CM CLOSUREFAST CATHETER,2100.0,1365.0,200.93,2100.0,74
CDM,27876655_IP,7FR X 60CM CLOSUREFAST CATHETER,2100.0,1365.0,1150.8,1150.8,1
CDM,27876655_OP,7FR X 60CM CLOSUREFAST CATHETER,2100.0,1365.0,911.4,911.4,1
CDM,27876665,10CC CORTOSS BONE AUGMENTATION CEMENT CA,2594.46,1686.4,565.59,2594.46,66
CDM,27876665_IP,10CC CORTOSS BONE AUGMENTATION CEMENT CA,2594.46,1686.4,1421.76,1421.76,1
CDM,27876665_OP,10CC CORTOSS BONE AUGMENTATION CEMENT CA,2594.46,1686.4,1126.0,1126.0,1
CDM,27876675,"10-8MM X 40MM, TAPERED, XACT CAROTID STENT",3950.0,2567.5,200.93,3950.0,74
CDM,27876675_IP,"10-8MM X 40MM, TAPERED, XACT CAROTID STENT",3950.0,2567.5,2164.6,2164.6,1
CDM,27876675_OP,"10-8MM X 40MM, TAPERED, XACT CAROTID STENT",3950.0,2567.5,1714.3,1714.3,1
CDM,27876685,3.9CM COVERED CP STENT 8 ZIGS .013IN,4300.0,2795.0,200.93,4300.0,74
CDM,27876685_IP,3.9CM COVERED CP STENT 8 ZIGS .013IN,4300.0,2795.0,2356.4,2356.4,1
CDM,27876685_OP,3.9CM COVERED CP STENT 8 ZIGS .013IN,4300.0,2795.0,1866.2,1866.2,1
CDM,27876755,AORTIC TRANSCATHERTER RETROFLEX 3 TRANSFEMORAL VALVE,60000.0,39000.0,1030.0,60000.0,66
CDM,27876755_IP,AORTIC TRANSCATHERTER RETROFLEX 3 TRANSFEMORAL VALVE,60000.0,39000.0,32880.0,32880.0,1
CDM,27876755_OP,AORTIC TRANSCATHERTER RETROFLEX 3 TRANSFEMORAL VALVE,60000.0,39000.0,26040.0,26040.0,1
CDM,27876765,MELODY TRANSCATHETER PULMONARY VALVE,51000.0,33150.0,1030.0,51000.0,66
CDM,27876765_IP,MELODY TRANSCATHETER PULMONARY VALVE,51000.0,33150.0,27948.0,27948.0,1
CDM,27876765_OP,MELODY TRANSCATHETER PULMONARY VALVE,51000.0,33150.0,22134.0,22134.0,1
CDM,27876785,AXIOS STENT W/DELIVERY SYSTEM,10000.0,6500.0,200.93,10000.0,74
CDM,27876785_IP,AXIOS STENT W/DELIVERY SYSTEM,10000.0,6500.0,5480.0,5480.0,1
CDM,27876785_OP,AXIOS STENT W/DELIVERY SYSTEM,10000.0,6500.0,4340.0,4340.0,1
CDM,27876795,CORNEAL TISSUE DSAEK/DMEK,9660.0,6279.0,1842.39,9660.0,66
CDM,27877145,STENT URET OPTIMA 788NNN BRD,108.5,70.53,23.65,232.66,73
CDM,27877145_IP,STENT URET OPTIMA 788NNN BRD,108.5,70.53,39.49,39.49,1
CDM,27877145_OP,STENT URET OPTIMA 788NNN BRD,108.5,70.53,32.44,32.44,1
CDM,27877345,"STENT, NON-COR, TEMP W/DEL SYST C2625 91",274.0,178.1,59.73,274.0,73
CDM,27877345_IP,"STENT, NON-COR, TEMP W/DEL SYST C2625 91",274.0,178.1,66.25,66.25,1
CDM,27877345_OP,"STENT, NON-COR, TEMP W/DEL SYST C2625 91",274.0,178.1,54.42,54.42,1
CDM,27877525,"MEDTRONIC, EV3,CONCERTO COILS, PV-3-8-3D, 3MMX8CM",772.5,502.13,168.41,772.5,65
CDM,27877525_IP,"MEDTRONIC, EV3,CONCERTO COILS, PV-3-8-3D, 3MMX8CM",772.5,502.13,281.19,281.19,1
CDM,27877525_OP,"MEDTRONIC, EV3,CONCERTO COILS, PV-3-8-3D, 3MMX8CM",772.5,502.13,230.98,230.98,1
CDM,27877575,"STENT, XACT (ALL SIZES)",6023.0,3914.95,200.93,6023.0,75
CDM,27877585,"GIANTURCO Z STENT20CM, 25CM OR 30CM",1492.5,970.13,200.93,1492.5,74
CDM,27877585_IP,"GIANTURCO Z STENT20CM, 25CM OR 30CM",1492.5,970.13,817.89,817.89,1
CDM,27877585_OP,"GIANTURCO Z STENT20CM, 25CM OR 30CM",1492.5,970.13,647.75,647.75,1
CDM,27877625,C1874 DRUG ELUT STENT TIER 0,2000.0,1300.0,200.93,2000.0,74
CDM,27877625_IP,C1874 DRUG ELUT STENT TIER 0,2000.0,1300.0,1096.0,1096.0,1
CDM,27877625_OP,C1874 DRUG ELUT STENT TIER 0,2000.0,1300.0,868.0,868.0,1
CDM,27877635,CERECYTE COIL,1826.0,1186.9,398.07,1826.0,66
CDM,27877635_IP,CERECYTE COIL,1826.0,1186.9,1000.65,1000.65,1
CDM,27877635_OP,CERECYTE COIL,1826.0,1186.9,792.48,792.48,1
CDM,27877645,FRAMING COIL 6 MM X 12 CM SPH 10,2110.0,1371.5,459.98,2110.0,66
CDM,27877645_IP,FRAMING COIL 6 MM X 12 CM SPH 10,2110.0,1371.5,1156.28,1156.28,1
CDM,27877645_OP,FRAMING COIL 6 MM X 12 CM SPH 10,2110.0,1371.5,915.74,915.74,1
CDM,27877655,"ENDOGRAFT,VIABAHN,VBH071002",5360.0,3484.0,200.93,5360.0,74
CDM,27877655_IP,"ENDOGRAFT,VIABAHN,VBH071002",5360.0,3484.0,2937.28,2937.28,1
CDM,27877655_OP,"ENDOGRAFT,VIABAHN,VBH071002",5360.0,3484.0,2326.24,2326.24,1
CDM,27877675,MID-BORE VENOUS VASCULAR CLOSURE SYSTEM,321.44,208.94,70.07,321.44,73
CDM,27877675_IP,MID-BORE VENOUS VASCULAR CLOSURE SYSTEM,321.44,208.94,117.0,117.0,1
CDM,27877675_OP,MID-BORE VENOUS VASCULAR CLOSURE SYSTEM,321.44,208.94,96.11,96.11,1
CDM,27877685,C1874 DRUG ELUT STENT TIER VI,16200.0,10530.0,200.93,16200.0,74
CDM,27877685_IP,C1874 DRUG ELUT STENT TIER VI,16200.0,10530.0,8877.6,8877.6,1
CDM,27877685_OP,C1874 DRUG ELUT STENT TIER VI,16200.0,10530.0,7030.8,7030.8,1
CDM,27877695,ANS NON-RECHARGEABLE IPG,19316.0,12555.4,200.93,19316.0,74
CDM,27877695_IP,ANS NON-RECHARGEABLE IPG,19316.0,12555.4,10585.17,10585.17,1
CDM,27877695_OP,ANS NON-RECHARGEABLE IPG,19316.0,12555.4,8383.14,8383.14,1
CDM,27877705,VALVE KIT SAPIEN 3 CERTITUDE,65000.0,42250.0,1030.0,65000.0,66
CDM,27877705_IP,VALVE KIT SAPIEN 3 CERTITUDE,65000.0,42250.0,35620.0,35620.0,1
CDM,27877705_OP,VALVE KIT SAPIEN 3 CERTITUDE,65000.0,42250.0,28210.0,28210.0,1
CDM,27877745,SURPASS FLOWDIVERTER <40MM,25200.0,16380.0,200.93,25200.0,74
CDM,27877745_IP,SURPASS FLOWDIVERTER <40MM,25200.0,16380.0,13809.6,13809.6,1
CDM,27877745_OP,SURPASS FLOWDIVERTER <40MM,25200.0,16380.0,10936.8,10936.8,1
CDM,27877755,SURPASS FLOWDIVERTER >40MM,27600.0,17940.0,200.93,27600.0,74
CDM,27877755_IP,SURPASS FLOWDIVERTER >40MM,27600.0,17940.0,15124.8,15124.8,1
CDM,27877755_OP,SURPASS FLOWDIVERTER >40MM,27600.0,17940.0,11978.4,11978.4,1
CDM,27877765,LVIS JR EXPAND STENT,11890.0,7728.5,200.93,11890.0,74
CDM,27877765_IP,LVIS JR EXPAND STENT,11890.0,7728.5,6515.72,6515.72,1
CDM,27877765_OP,LVIS JR EXPAND STENT,11890.0,7728.5,5160.26,5160.26,1
CDM,27877915,GRAFT MATRISTEM PORCINE URNARY BLADDER EXTRACELLULAR MATRIX PER,12.3,8.0,3.48,183.51,76
CDM,27877915_IP,GRAFT MATRISTEM PORCINE URNARY BLADDER EXTRACELLULAR MATRIX PER,12.3,8.0,4.48,4.48,1
CDM,27877915_OP,GRAFT MATRISTEM PORCINE URNARY BLADDER EXTRACELLULAR MATRIX PER,12.3,8.0,3.68,3.68,1
CDM,27877925,MATRIX ALLODERM SELECT THK.4-2.4MM THICK LARGE CONTOUR PER CM TI,16.13,10.48,4.56,1275.41,84
CDM,27877925_IP,MATRIX ALLODERM SELECT THK.4-2.4MM THICK LARGE CONTOUR PER CM TI,16.13,10.48,5.87,5.87,1
CDM,27877925_OP,MATRIX ALLODERM SELECT THK.4-2.4MM THICK LARGE CONTOUR PER CM TI,16.13,10.48,4.82,4.82,1
CDM,27877935,NEUROFORM ATLAS STENT SYSTEM,12311.2,8002.28,200.93,12311.2,74
CDM,27877935_IP,NEUROFORM ATLAS STENT SYSTEM,12311.2,8002.28,6746.54,6746.54,1
CDM,27877935_OP,NEUROFORM ATLAS STENT SYSTEM,12311.2,8002.28,5343.06,5343.06,1
CDM,27877995,ALLOGRFT 7X10CM DERMAPURE,2450.0,1592.5,117.73,2450.0,77
CDM,27877995_IP,ALLOGRFT 7X10CM DERMAPURE,2450.0,1592.5,1342.6,1342.6,1
CDM,27877995_OP,ALLOGRFT 7X10CM DERMAPURE,2450.0,1592.5,1063.3,1063.3,1
CDM,27878075,ATTAIN STABILITY QUAD MRI SURE SCAN LV LEAD,3940.0,2561.0,200.93,3940.0,74
CDM,27878075_IP,ATTAIN STABILITY QUAD MRI SURE SCAN LV LEAD,3940.0,2561.0,2159.12,2159.12,1
CDM,27878075_OP,ATTAIN STABILITY QUAD MRI SURE SCAN LV LEAD,3940.0,2561.0,1709.96,1709.96,1
CDM,27878085,"H190005,TETHER VERT BODY SYS",11739.0,7630.35,200.93,11739.0,74
CDM,27878085_IP,"H190005,TETHER VERT BODY SYS",11739.0,7630.35,6432.97,6432.97,1
CDM,27878085_OP,"H190005,TETHER VERT BODY SYS",11739.0,7630.35,5094.73,5094.73,1
CDM,27878225,GRFT STRAVIX 2CMX4CM,1900.0,1235.0,117.73,1900.0,77
CDM,27878225_IP,GRFT STRAVIX 2CMX4CM,1900.0,1235.0,1041.2,1041.2,1
CDM,27878225_OP,GRFT STRAVIX 2CMX4CM,1900.0,1235.0,824.6,824.6,1
CDM,27878255,ALLOGRFT 2X3CM DERMAPURE,810.0,526.5,117.73,810.0,76
CDM,27878255_IP,ALLOGRFT 2X3CM DERMAPURE,810.0,526.5,294.84,294.84,1
CDM,27878255_OP,ALLOGRFT 2X3CM DERMAPURE,810.0,526.5,242.19,242.19,1
CDM,27878405,ALLOGRFT 4X6CM DERMAPURE,182.92,118.9,51.73,183.51,76
CDM,27878405_IP,ALLOGRFT 4X6CM DERMAPURE,182.92,118.9,66.58,66.58,1
CDM,27878405_OP,ALLOGRFT 4X6CM DERMAPURE,182.92,118.9,54.69,54.69,1
CDM,27878455,PRQ IMPLTJ NEUROSTIMULATOR ELTRD PERIPHERAL NRV,15600.0,10140.0,200.93,15600.0,74
CDM,27878455_IP,PRQ IMPLTJ NEUROSTIMULATOR ELTRD PERIPHERAL NRV,15600.0,10140.0,8548.8,8548.8,1
CDM,27878455_OP,PRQ IMPLTJ NEUROSTIMULATOR ELTRD PERIPHERAL NRV,15600.0,10140.0,6770.4,6770.4,1
CDM,27878585,IMPLT NROSTM PLS GEN DUA REC,17550.0,11407.5,1030.0,19595.16,74
CDM,27878585_IP,IMPLT NROSTM PLS GEN DUA REC,17550.0,11407.5,9617.4,9617.4,1
CDM,27878585_OP,IMPLT NROSTM PLS GEN DUA REC,17550.0,11407.5,7616.7,7616.7,1
CDM,27878595,SAVI SCOUT REFLECTOT,600.0,390.0,130.8,600.0,73
CDM,27878595_IP,SAVI SCOUT REFLECTOT,600.0,390.0,218.4,218.4,1
CDM,27878595_OP,SAVI SCOUT REFLECTOT,600.0,390.0,179.4,179.4,1
CDM,27878615,SILICONE PIP TOTAL JOINT SYSTEM,1880.0,1222.0,351.41,1880.0,74
CDM,27878615_IP,SILICONE PIP TOTAL JOINT SYSTEM,1880.0,1222.0,1030.24,1030.24,1
CDM,27878615_OP,SILICONE PIP TOTAL JOINT SYSTEM,1880.0,1222.0,815.92,815.92,1
CDM,27878625,"LEAD, WAVEWRITER SPINAL CORD STIMULATOR",2000.0,1300.0,200.93,2000.0,74
CDM,27878625_IP,"LEAD, WAVEWRITER SPINAL CORD STIMULATOR",2000.0,1300.0,1096.0,1096.0,1
CDM,27878625_OP,"LEAD, WAVEWRITER SPINAL CORD STIMULATOR",2000.0,1300.0,868.0,868.0,1
CDM,27878635,"LEAD, WAVEWRITER SPINAL CORD STIMULATOR TEST KIT",5000.0,3250.0,200.93,5000.0,74
CDM,27878635_IP,"LEAD, WAVEWRITER SPINAL CORD STIMULATOR TEST KIT",5000.0,3250.0,2740.0,2740.0,1
CDM,27878635_OP,"LEAD, WAVEWRITER SPINAL CORD STIMULATOR TEST KIT",5000.0,3250.0,2170.0,2170.0,1
CDM,27878645,"GENERATOR, WAVEWRITER SPINAL CORD STIMULATOR",32600.0,21190.0,200.93,32600.0,74
CDM,27878645_IP,"GENERATOR, WAVEWRITER SPINAL CORD STIMULATOR",32600.0,21190.0,17864.8,17864.8,1
CDM,27878645_OP,"GENERATOR, WAVEWRITER SPINAL CORD STIMULATOR",32600.0,21190.0,14148.4,14148.4,1
CDM,27878685,EYELID WEIGHT 0.6 GM,1113.0,723.45,200.93,1113.0,73
CDM,27878685_IP,EYELID WEIGHT 0.6 GM,1113.0,723.45,405.13,405.13,1
CDM,27878685_OP,EYELID WEIGHT 0.6 GM,1113.0,723.45,332.79,332.79,1
CDM,27878695,EYELID WEIGHT 0.8 GM,1152.0,748.8,200.93,1152.0,73
CDM,27878695_IP,EYELID WEIGHT 0.8 GM,1152.0,748.8,419.33,419.33,1
CDM,27878695_OP,EYELID WEIGHT 0.8 GM,1152.0,748.8,344.45,344.45,1
CDM,27878705,EYELID WEIGHT 1.0 GM,1208.0,785.2,200.93,1208.0,73
CDM,27878705_IP,EYELID WEIGHT 1.0 GM,1208.0,785.2,439.71,439.71,1
CDM,27878705_OP,EYELID WEIGHT 1.0 GM,1208.0,785.2,361.19,361.19,1
CDM,27878715,EYELID WEIGHT 1.2 GM,1259.0,818.35,200.93,1259.0,73
CDM,27878715_IP,EYELID WEIGHT 1.2 GM,1259.0,818.35,689.93,689.93,1
CDM,27878715_OP,EYELID WEIGHT 1.2 GM,1259.0,818.35,546.41,546.41,1
CDM,27878725,EYELID WEIGHT 1.4 GM,1301.0,845.65,200.93,1301.0,73
CDM,27878725_IP,EYELID WEIGHT 1.4 GM,1301.0,845.65,712.95,712.95,1
CDM,27878725_OP,EYELID WEIGHT 1.4 GM,1301.0,845.65,564.63,564.63,1
CDM,27878735,EYELID WEIGHT 1.6 GM,1344.0,873.6,200.93,1344.0,73
CDM,27878735_IP,EYELID WEIGHT 1.6 GM,1344.0,873.6,736.51,736.51,1
CDM,27878735_OP,EYELID WEIGHT 1.6 GM,1344.0,873.6,583.3,583.3,1
CDM,27878745,EYELID WEIGHT 1.8 GM,1400.0,910.0,200.93,1400.0,74
CDM,27878745_IP,EYELID WEIGHT 1.8 GM,1400.0,910.0,767.2,767.2,1
CDM,27878745_OP,EYELID WEIGHT 1.8 GM,1400.0,910.0,607.6,607.6,1
CDM,27878755,EYELID WEIGHT 2.0 GM,1451.0,943.15,200.93,1451.0,74
CDM,27878755_IP,EYELID WEIGHT 2.0 GM,1451.0,943.15,795.15,795.15,1
CDM,27878755_OP,EYELID WEIGHT 2.0 GM,1451.0,943.15,629.73,629.73,1
CDM,27878765,EYELID WEIGHT 2.2 GM,1715.0,1114.75,200.93,1715.0,74
CDM,27878765_IP,EYELID WEIGHT 2.2 GM,1715.0,1114.75,939.82,939.82,1
CDM,27878765_OP,EYELID WEIGHT 2.2 GM,1715.0,1114.75,744.31,744.31,1
CDM,27878775,BARD US BIOPSY CLIP,151.25,98.31,32.97,232.66,73
CDM,27878775_IP,BARD US BIOPSY CLIP,151.25,98.31,40.04,40.04,1
CDM,27878775_OP,BARD US BIOPSY CLIP,151.25,98.31,32.89,32.89,1
CDM,27878785,HYDROMARK US BIOPSY CLIP,187.0,121.55,40.77,232.66,73
CDM,27878785_IP,HYDROMARK US BIOPSY CLIP,187.0,121.55,49.5,49.5,1
CDM,27878785_OP,HYDROMARK US BIOPSY CLIP,187.0,121.55,40.66,40.66,1
CDM,27878795,HOLOGIC STEREO BIOPSY CLIP,123.75,80.44,26.98,232.66,73
CDM,27878795_IP,HOLOGIC STEREO BIOPSY CLIP,123.75,80.44,32.76,32.76,1
CDM,27878795_OP,HOLOGIC STEREO BIOPSY CLIP,123.75,80.44,26.91,26.91,1
CDM,27878805,NEEDLE LOC WIRE,45.38,29.5,9.89,232.66,73
CDM,27878805_IP,NEEDLE LOC WIRE,45.38,29.5,12.01,12.01,1
CDM,27878805_OP,NEEDLE LOC WIRE,45.38,29.5,9.87,9.87,1
CDM,27878825,GORE CARDIOFORM SEPTAL OCCLUDER,15822.0,10284.3,1030.0,15822.0,66
CDM,27878825_IP,GORE CARDIOFORM SEPTAL OCCLUDER,15822.0,10284.3,8670.46,8670.46,1
CDM,27878825_OP,GORE CARDIOFORM SEPTAL OCCLUDER,15822.0,10284.3,6866.75,6866.75,1
CDM,27878835,AMNIOFILL HUMAN PLACENTAL TISSUE ALLOGRAFT 250 MG,788.0,512.2,171.78,788.0,65
CDM,27878835_IP,AMNIOFILL HUMAN PLACENTAL TISSUE ALLOGRAFT 250 MG,788.0,512.2,286.83,286.83,1
CDM,27878835_OP,AMNIOFILL HUMAN PLACENTAL TISSUE ALLOGRAFT 250 MG,788.0,512.2,235.61,235.61,1
CDM,27878845,AMNIOFILL HUMAN PLACENTAL TISSUE ALLOGRAFT 500 MG,1418.0,921.7,309.12,1418.0,66
CDM,27878845_IP,AMNIOFILL HUMAN PLACENTAL TISSUE ALLOGRAFT 500 MG,1418.0,921.7,777.06,777.06,1
CDM,27878845_OP,AMNIOFILL HUMAN PLACENTAL TISSUE ALLOGRAFT 500 MG,1418.0,921.7,615.41,615.41,1
CDM,27878945,SILK VOICE INJECTABLE,1350.0,877.5,294.3,1350.0,73
CDM,27878945_IP,SILK VOICE INJECTABLE,1350.0,877.5,739.8,739.8,1
CDM,27878945_OP,SILK VOICE INJECTABLE,1350.0,877.5,585.9,585.9,1
CDM,27879005,ANGIODYNAMICS SCHON XL CATHETER,1087.5,706.88,200.93,1087.5,73
CDM,27879005_IP,ANGIODYNAMICS SCHON XL CATHETER,1087.5,706.88,395.85,395.85,1
CDM,27879005_OP,ANGIODYNAMICS SCHON XL CATHETER,1087.5,706.88,325.16,325.16,1
CDM,27879165,TYRX ANTIBACTERIAL ENVELOPE,1990.0,1293.5,200.93,1990.0,74
CDM,27879165_IP,TYRX ANTIBACTERIAL ENVELOPE,1990.0,1293.5,1090.52,1090.52,1
CDM,27879165_OP,TYRX ANTIBACTERIAL ENVELOPE,1990.0,1293.5,863.66,863.66,1
CDM,27879225,"GALLANT DR ICD, DUAL",22500.0,14625.0,200.93,22500.0,75
CDM,27879235,HARMONY TPV,66000.0,42900.0,1030.0,66000.0,66
CDM,27879235_IP,HARMONY TPV,66000.0,42900.0,36168.0,36168.0,1
CDM,27879235_OP,HARMONY TPV,66000.0,42900.0,28644.0,28644.0,1
CDM,27879265,VAG INSER RECTAL CONTROL SYS,2400.0,1560.0,36.52,2400.0,73
CDM,27879265_IP,VAG INSER RECTAL CONTROL SYS,2400.0,1560.0,1315.2,1315.2,1
CDM,27879265_OP,VAG INSER RECTAL CONTROL SYS,2400.0,1560.0,1041.6,1041.6,1
CDM,27879375,APIFIX MID-C SYSTEM WITH OPTIONAL EXTENDER COMPONENT ROD,44130.0,28684.5,1030.0,44130.0,66
CDM,27879375_IP,APIFIX MID-C SYSTEM WITH OPTIONAL EXTENDER COMPONENT ROD,44130.0,28684.5,24183.24,24183.24,1
CDM,27879375_OP,APIFIX MID-C SYSTEM WITH OPTIONAL EXTENDER COMPONENT ROD,44130.0,28684.5,19152.42,19152.42,1
CDM,27879385,GRAFT MATRISTEM MICROMATRIX PORCINE URINARY BLADDER EXTRACELLULA,2.21,1.44,0.48,2.21,65
CDM,27879385_IP,GRAFT MATRISTEM MICROMATRIX PORCINE URINARY BLADDER EXTRACELLULA,2.21,1.44,0.8,0.8,1
CDM,27879385_OP,GRAFT MATRISTEM MICROMATRIX PORCINE URINARY BLADDER EXTRACELLULA,2.21,1.44,0.66,0.66,1
CDM,27879395,GRAFT MATRISTEM MICROMATRIX PORCINE URINARY BLADDER EXTRACELLULA,2.42,1.57,0.53,2.42,65
CDM,27879395_IP,GRAFT MATRISTEM MICROMATRIX PORCINE URINARY BLADDER EXTRACELLULA,2.42,1.57,0.88,0.88,1
CDM,27879395_OP,GRAFT MATRISTEM MICROMATRIX PORCINE URINARY BLADDER EXTRACELLULA,2.42,1.57,0.72,0.72,1
CDM,27879405,GRAFT MATRISTEM MICROMATRIX PORCINE URINARY BLADDER EXTRACELLULA,2.62,1.7,0.57,2.62,65
CDM,27879405_IP,GRAFT MATRISTEM MICROMATRIX PORCINE URINARY BLADDER EXTRACELLULA,2.62,1.7,0.95,0.95,1
CDM,27879405_OP,GRAFT MATRISTEM MICROMATRIX PORCINE URINARY BLADDER EXTRACELLULA,2.62,1.7,0.78,0.78,1
CDM,27879415,GRAFT MATRISTEM MICROMATRIX PORCINE URINARY BLADDER EXTRACELLULA,2.58,1.68,0.56,2.58,65
CDM,27879415_IP,GRAFT MATRISTEM MICROMATRIX PORCINE URINARY BLADDER EXTRACELLULA,2.58,1.68,0.94,0.94,1
CDM,27879415_OP,GRAFT MATRISTEM MICROMATRIX PORCINE URINARY BLADDER EXTRACELLULA,2.58,1.68,0.77,0.77,1
CDM,27879425,GRAFT MATRISTEM MICROMATRIX 200MG PORCINE URINARY BLADDER EXTRAC,2.62,1.7,0.57,2.62,65
CDM,27879425_IP,GRAFT MATRISTEM MICROMATRIX 200MG PORCINE URINARY BLADDER EXTRAC,2.62,1.7,0.95,0.95,1
CDM,27879425_OP,GRAFT MATRISTEM MICROMATRIX 200MG PORCINE URINARY BLADDER EXTRAC,2.62,1.7,0.78,0.78,1
CDM,27879435,GRAFT MATRISTEM MICROMATRIX PORCINE URINARY BLADDER EXTRACELLULA,2.62,1.7,0.57,2.62,65
CDM,27879435_IP,GRAFT MATRISTEM MICROMATRIX PORCINE URINARY BLADDER EXTRACELLULA,2.62,1.7,0.95,0.95,1
CDM,27879435_OP,GRAFT MATRISTEM MICROMATRIX PORCINE URINARY BLADDER EXTRACELLULA,2.62,1.7,0.78,0.78,1
CDM,27879445,GRAFT MATRISTEM MICROMATRIX 100MG PORCINE URINARY BLADDER EXTRAC,2.58,1.68,0.56,2.58,65
CDM,27879445_IP,GRAFT MATRISTEM MICROMATRIX 100MG PORCINE URINARY BLADDER EXTRAC,2.58,1.68,0.94,0.94,1
CDM,27879445_OP,GRAFT MATRISTEM MICROMATRIX 100MG PORCINE URINARY BLADDER EXTRAC,2.58,1.68,0.77,0.77,1
CDM,27879455,GRAFT MATRISTEM MICROMATRIX 100MG PORCINE URINARY BLADDER EXTRAC,2.62,1.7,0.57,2.62,65
CDM,27879455_IP,GRAFT MATRISTEM MICROMATRIX 100MG PORCINE URINARY BLADDER EXTRAC,2.62,1.7,0.95,0.95,1
CDM,27879455_OP,GRAFT MATRISTEM MICROMATRIX 100MG PORCINE URINARY BLADDER EXTRAC,2.62,1.7,0.78,0.78,1
CDM,27879465,GRAFT MATRISTEM MICROMATRIX 20MG PROCINE URINARY BLADDER EXTRACE,2.7,1.76,0.59,2.7,65
CDM,27879465_IP,GRAFT MATRISTEM MICROMATRIX 20MG PROCINE URINARY BLADDER EXTRACE,2.7,1.76,0.98,0.98,1
CDM,27879465_OP,GRAFT MATRISTEM MICROMATRIX 20MG PROCINE URINARY BLADDER EXTRACE,2.7,1.76,0.81,0.81,1
CDM,27879475,GRAFT MATRISTEM MICROMATRIX PORCINE URINAARY BLADDER EXTRACELLUL,2.95,1.92,0.64,2.95,65
CDM,27879475_IP,GRAFT MATRISTEM MICROMATRIX PORCINE URINAARY BLADDER EXTRACELLUL,2.95,1.92,1.07,1.07,1
CDM,27879475_OP,GRAFT MATRISTEM MICROMATRIX PORCINE URINAARY BLADDER EXTRACELLUL,2.95,1.92,0.88,0.88,1
CDM,27879485,GRAFT MATRISTEM MICROMATRIX SOFT TISSUE POWDER MICRONIZED PARTIC,2.09,1.36,0.46,2.09,65
CDM,27879485_IP,GRAFT MATRISTEM MICROMATRIX SOFT TISSUE POWDER MICRONIZED PARTIC,2.09,1.36,0.76,0.76,1
CDM,27879485_OP,GRAFT MATRISTEM MICROMATRIX SOFT TISSUE POWDER MICRONIZED PARTIC,2.09,1.36,0.62,0.62,1
CDM,27879495,GORE CARDIOFORM ASD OCCLUDER,16302.0,10596.3,200.93,16302.0,74
CDM,27879495_IP,GORE CARDIOFORM ASD OCCLUDER,16302.0,10596.3,8933.5,8933.5,1
CDM,27879495_OP,GORE CARDIOFORM ASD OCCLUDER,16302.0,10596.3,7075.07,7075.07,1
CDM,27879505,AMPLATZER MUSCULAR VSD OCCLUDER,26310.0,17101.5,200.93,26310.0,74
CDM,27879505_IP,AMPLATZER MUSCULAR VSD OCCLUDER,26310.0,17101.5,7408.96,7408.96,1
CDM,27879505_OP,AMPLATZER MUSCULAR VSD OCCLUDER,26310.0,17101.5,5867.68,5867.68,1
CDM,27879515,COVERED CP STENT,11351.64,7378.57,200.93,11351.64,74
CDM,27879515_IP,COVERED CP STENT,11351.64,7378.57,6220.7,6220.7,1
CDM,27879515_OP,COVERED CP STENT,11351.64,7378.57,4926.61,4926.61,1
CDM,27879525,ENDOVASCULAR TACK SYSTEM TIER 1,5590.0,3633.5,1030.0,5590.0,66
CDM,27879525_IP,ENDOVASCULAR TACK SYSTEM TIER 1,5590.0,3633.5,3063.32,3063.32,1
CDM,27879525_OP,ENDOVASCULAR TACK SYSTEM TIER 1,5590.0,3633.5,2426.06,2426.06,1
CDM,27879535,ENDOVASCULAR TACK SYSTEM TIER 2,3990.0,2593.5,869.82,3990.0,66
CDM,27879535_IP,ENDOVASCULAR TACK SYSTEM TIER 2,3990.0,2593.5,2186.52,2186.52,1
CDM,27879535_OP,ENDOVASCULAR TACK SYSTEM TIER 2,3990.0,2593.5,1731.66,1731.66,1
CDM,27879545,"EMBOLIZATION COIL, RUBY",1580.0,1027.0,344.44,1580.0,66
CDM,27879545_IP,"EMBOLIZATION COIL, RUBY",1580.0,1027.0,865.84,865.84,1
CDM,27879545_OP,"EMBOLIZATION COIL, RUBY",1580.0,1027.0,685.72,685.72,1
CDM,27879555,VENOUS VASCULAR CLOSURE SYSTEM,450.0,292.5,98.1,450.0,73
CDM,27879555_IP,VENOUS VASCULAR CLOSURE SYSTEM,450.0,292.5,163.8,163.8,1
CDM,27879555_OP,VENOUS VASCULAR CLOSURE SYSTEM,450.0,292.5,134.55,134.55,1
CDM,27879565,FIBERED PLATINUM COIL,166.0,107.9,36.19,166.0,65
CDM,27879565_IP,FIBERED PLATINUM COIL,166.0,107.9,60.42,60.42,1
CDM,27879565_OP,FIBERED PLATINUM COIL,166.0,107.9,49.63,49.63,1
CDM,27879685,HIGH VOLTAGE SPLITTER/ADAPTOR KIT,5400.0,3510.0,1030.0,5400.0,66
CDM,27879685_IP,HIGH VOLTAGE SPLITTER/ADAPTOR KIT,5400.0,3510.0,2959.2,2959.2,1
CDM,27879685_OP,HIGH VOLTAGE SPLITTER/ADAPTOR KIT,5400.0,3510.0,2343.6,2343.6,1
CDM,27879765,SAPIEN 3 TPV KIT WITH ALTERRA ADAPTIVE PRESTENT,83000.0,53950.0,1030.0,83000.0,66
CDM,27879765_IP,SAPIEN 3 TPV KIT WITH ALTERRA ADAPTIVE PRESTENT,83000.0,53950.0,45484.0,45484.0,1
CDM,27879765_OP,SAPIEN 3 TPV KIT WITH ALTERRA ADAPTIVE PRESTENT,83000.0,53950.0,36022.0,36022.0,1
CDM,27879795,APLIGRAF DS FLM 7.5CM,340.0,221.0,96.15,340.0,76
CDM,27879795_IP,APLIGRAF DS FLM 7.5CM,340.0,221.0,123.76,123.76,1
CDM,27879795_OP,APLIGRAF DS FLM 7.5CM,340.0,221.0,101.66,101.66,1
CDM,27879805,BONE CUBED CANCELLOUS 15CC,11.5,7.48,2.51,1275.41,73
CDM,27879805_IP,BONE CUBED CANCELLOUS 15CC,11.5,7.48,4.19,4.19,1
CDM,27879805_OP,BONE CUBED CANCELLOUS 15CC,11.5,7.48,3.44,3.44,1
CDM,27879815,BONE STAGRAFT 2CC,259.0,168.35,56.46,1275.41,73
CDM,27879815_IP,BONE STAGRAFT 2CC,259.0,168.35,94.28,94.28,1
CDM,27879815_OP,BONE STAGRAFT 2CC,259.0,168.35,77.44,77.44,1
CDM,27879825,BONE STAGRAFT 5CC,243.6,158.34,53.1,1275.41,73
CDM,27879825_IP,BONE STAGRAFT 5CC,243.6,158.34,88.67,88.67,1
CDM,27879825_OP,BONE STAGRAFT 5CC,243.6,158.34,72.84,72.84,1
CDM,27879835,BONE VIVIGEN 10CC,325.0,211.25,70.85,1275.41,73
CDM,27879835_IP,BONE VIVIGEN 10CC,325.0,211.25,118.3,118.3,1
CDM,27879835_OP,BONE VIVIGEN 10CC,325.0,211.25,97.18,97.18,1
CDM,27879845,BONE VIVIGEN 5CC,360.0,234.0,78.48,1275.41,73
CDM,27879845_IP,BONE VIVIGEN 5CC,360.0,234.0,131.04,131.04,1
CDM,27879845_OP,BONE VIVIGEN 5CC,360.0,234.0,107.64,107.64,1
CDM,27879855,BONE VIVIGEN FORMABLE 10CC,390.0,253.5,85.02,1275.41,73
CDM,27879855_IP,BONE VIVIGEN FORMABLE 10CC,390.0,253.5,141.96,141.96,1
CDM,27879855_OP,BONE VIVIGEN FORMABLE 10CC,390.0,253.5,116.61,116.61,1
CDM,27879865,BONE VIVIGEN FORMABLE 5CC,432.0,280.8,94.18,1275.41,73
CDM,27879865_IP,BONE VIVIGEN FORMABLE 5CC,432.0,280.8,157.25,157.25,1
CDM,27879865_OP,BONE VIVIGEN FORMABLE 5CC,432.0,280.8,129.17,129.17,1
CDM,27879875,CONN AXOGUARD 6MM PORCINE 15MM,1889.33,1228.06,411.87,1889.33,74
CDM,27879875_IP,CONN AXOGUARD 6MM PORCINE 15MM,1889.33,1228.06,1035.35,1035.35,1
CDM,27879875_OP,CONN AXOGUARD 6MM PORCINE 15MM,1889.33,1228.06,819.97,819.97,1
CDM,27879885,DRSG BOVINE COLL GLYCOSAMINOGLYCAN 5X4IN,43.11,28.02,12.19,183.51,76
CDM,27879885_IP,DRSG BOVINE COLL GLYCOSAMINOGLYCAN 5X4IN,43.11,28.02,15.69,15.69,1
CDM,27879885_OP,DRSG BOVINE COLL GLYCOSAMINOGLYCAN 5X4IN,43.11,28.02,12.89,12.89,1
CDM,27879895,FILLER BN VOID 5CC DBX ALGRF,119.84,77.9,26.13,1275.41,73
CDM,27879895_IP,FILLER BN VOID 5CC DBX ALGRF,119.84,77.9,43.62,43.62,1
CDM,27879895_OP,FILLER BN VOID 5CC DBX ALGRF,119.84,77.9,35.83,35.83,1
CDM,27879905,FILLER BONE OPTIUM GEL 10CC,80.58,52.38,17.57,1275.41,73
CDM,27879905_IP,FILLER BONE OPTIUM GEL 10CC,80.58,52.38,29.33,29.33,1
CDM,27879905_OP,FILLER BONE OPTIUM GEL 10CC,80.58,52.38,24.09,24.09,1
CDM,27879915,GRAFIX PL PRIME 1.5X2 CM,557.33,362.26,117.73,557.33,76
CDM,27879915_IP,GRAFIX PL PRIME 1.5X2 CM,557.33,362.26,202.87,202.87,1
CDM,27879915_OP,GRAFIX PL PRIME 1.5X2 CM,557.33,362.26,166.64,166.64,1
CDM,27879925,GRAFIX PL PRIME 16MM DISC,470.25,305.66,117.73,470.25,76
CDM,27879925_IP,GRAFIX PL PRIME 16MM DISC,470.25,305.66,171.17,171.17,1
CDM,27879925_OP,GRAFIX PL PRIME 16MM DISC,470.25,305.66,140.6,140.6,1
CDM,27879935,GRAFIX PL PRIME 2X3 CM,348.33,226.41,98.51,348.33,76
CDM,27879935_IP,GRAFIX PL PRIME 2X3 CM,348.33,226.41,126.79,126.79,1
CDM,27879935_OP,GRAFIX PL PRIME 2X3 CM,348.33,226.41,104.15,104.15,1
CDM,27879945,GRAFIX PL PRIME 5X5 CM,223.2,145.08,63.12,223.2,76
CDM,27879945_IP,GRAFIX PL PRIME 5X5 CM,223.2,145.08,81.24,81.24,1
CDM,27879945_OP,GRAFIX PL PRIME 5X5 CM,223.2,145.08,66.74,66.74,1
CDM,27879955,GRAFT BONE OPTECURE 10CC,169.5,110.18,36.95,1275.41,73
CDM,27879955_IP,GRAFT BONE OPTECURE 10CC,169.5,110.18,61.7,61.7,1
CDM,27879955_OP,GRAFT BONE OPTECURE 10CC,169.5,110.18,50.68,50.68,1
CDM,27879965,GRAFT BONE OPTECURE 2CC,208.5,135.53,45.45,1275.41,73
CDM,27879965_IP,GRAFT BONE OPTECURE 2CC,208.5,135.53,75.89,75.89,1
CDM,27879965_OP,GRAFT BONE OPTECURE 2CC,208.5,135.53,62.34,62.34,1
CDM,27879975,GRAFT BONE OPTECURE 5CC,202.2,131.43,44.08,1275.41,73
CDM,27879975_IP,GRAFT BONE OPTECURE 5CC,202.2,131.43,73.6,73.6,1
CDM,27879975_OP,GRAFT BONE OPTECURE 5CC,202.2,131.43,60.46,60.46,1
CDM,27879985,GRAFT BN SUB W50XL10MM THK7MM COMP BN MTRX,344.0,223.6,74.99,1275.41,73
CDM,27879985_IP,GRAFT BN SUB W50XL10MM THK7MM COMP BN MTRX,344.0,223.6,125.22,125.22,1
CDM,27879985_OP,GRAFT BN SUB W50XL10MM THK7MM COMP BN MTRX,344.0,223.6,102.86,102.86,1
CDM,27879995,GRAFT GRAFIX PRIME 2X3CM,308.0,200.2,67.14,1275.41,73
CDM,27879995_IP,GRAFT GRAFIX PRIME 2X3CM,308.0,200.2,112.11,112.11,1
CDM,27879995_OP,GRAFT GRAFIX PRIME 2X3CM,308.0,200.2,92.09,92.09,1
CDM,27880005,GRAFT GRAFIX PRIME PLACENTAL MEMB 4X3CM,236.25,153.56,51.5,1275.41,73
CDM,27880005_IP,GRAFT GRAFIX PRIME PLACENTAL MEMB 4X3CM,236.25,153.56,86.0,86.0,1
CDM,27880005_OP,GRAFT GRAFIX PRIME PLACENTAL MEMB 4X3CM,236.25,153.56,70.64,70.64,1
CDM,27880015,GRAFT GRAFIX PRIME PLACENTAL MEMBR 5X5CM,252.0,163.8,54.94,1275.41,73
CDM,27880015_IP,GRAFT GRAFIX PRIME PLACENTAL MEMBR 5X5CM,252.0,163.8,91.73,91.73,1
CDM,27880015_OP,GRAFT GRAFIX PRIME PLACENTAL MEMBR 5X5CM,252.0,163.8,75.35,75.35,1
CDM,27880025,GRAFT MATRISTEM PORCINE UR BLDDR 10X7CM,29.29,19.04,6.39,29.29,73
CDM,27880025_IP,GRAFT MATRISTEM PORCINE UR BLDDR 10X7CM,29.29,19.04,10.66,10.66,1
CDM,27880025_OP,GRAFT MATRISTEM PORCINE UR BLDDR 10X7CM,29.29,19.04,8.76,8.76,1
CDM,27880035,MTRX TISS 20X16CM ALLODERM THK,54.58,35.48,15.44,1275.41,84
CDM,27880035_IP,MTRX TISS 20X16CM ALLODERM THK,54.58,35.48,19.87,19.87,1
CDM,27880035_OP,MTRX TISS 20X16CM ALLODERM THK,54.58,35.48,16.32,16.32,1
CDM,27880045,SUB BNGF BBTRAUMA VITOSS FOAM 5CC,497.6,323.44,108.48,1275.41,73
CDM,27880045_IP,SUB BNGF BBTRAUMA VITOSS FOAM 5CC,497.6,323.44,181.13,181.13,1
CDM,27880045_OP,SUB BNGF BBTRAUMA VITOSS FOAM 5CC,497.6,323.44,148.78,148.78,1
CDM,27880055,SUB BNGF VITOSS BBTRAUMA FOAM 2.5CC,530.88,345.07,115.73,1275.41,73
CDM,27880055_IP,SUB BNGF VITOSS BBTRAUMA FOAM 2.5CC,530.88,345.07,193.24,193.24,1
CDM,27880055_OP,SUB BNGF VITOSS BBTRAUMA FOAM 2.5CC,530.88,345.07,158.73,158.73,1
CDM,27880065,KERECIS 16 MM,750.0,487.5,117.73,750.0,76
CDM,27880065_IP,KERECIS 16 MM,750.0,487.5,273.0,273.0,1
CDM,27880065_OP,KERECIS 16 MM,750.0,487.5,224.25,224.25,1
CDM,27880075,KERECIS 1.75 X 1.75,796.5,517.73,117.73,796.5,76
CDM,27880075_IP,KERECIS 1.75 X 1.75,796.5,517.73,289.93,289.93,1
CDM,27880075_OP,KERECIS 1.75 X 1.75,796.5,517.73,238.15,238.15,1
CDM,27880085,KERECIS 3 X 3.5 CM,1096.5,712.73,117.73,1096.5,76
CDM,27880085_IP,KERECIS 3 X 3.5 CM,1096.5,712.73,399.13,399.13,1
CDM,27880085_OP,KERECIS 3 X 3.5 CM,1096.5,712.73,327.85,327.85,1
CDM,27880095,KERECIS 3 CM X 3 CM,1574.1,1023.17,117.73,1574.1,77
CDM,27880095_IP,KERECIS 3 CM X 3 CM,1574.1,1023.17,862.61,862.61,1
CDM,27880095_OP,KERECIS 3 CM X 3 CM,1574.1,1023.17,683.16,683.16,1
CDM,27880105,KERECIS 5 CM X 7 CM,1940.63,1261.41,117.73,1940.63,77
CDM,27880105_IP,KERECIS 5 CM X 7 CM,1940.63,1261.41,1063.47,1063.47,1
CDM,27880105_OP,KERECIS 5 CM X 7 CM,1940.63,1261.41,842.23,842.23,1
CDM,27880485,BIOVANCE HUM AMNIO MMBRNE,166.44,108.19,47.07,183.51,76
CDM,27880485_IP,BIOVANCE HUM AMNIO MMBRNE,166.44,108.19,60.58,60.58,1
CDM,27880485_OP,BIOVANCE HUM AMNIO MMBRNE,166.44,108.19,49.77,49.77,1
CDM,27880515,THE GUARDIAN IMD,20500.0,13325.0,200.93,20500.0,74
CDM,27880515_IP,THE GUARDIAN IMD,20500.0,13325.0,11234.0,11234.0,1
CDM,27880515_OP,THE GUARDIAN IMD,20500.0,13325.0,8897.0,8897.0,1
CDM,27880565,MATRIX ALLODERM TISS MED 20X16CM,28.11,18.27,7.95,1275.41,84
CDM,27880565_IP,MATRIX ALLODERM TISS MED 20X16CM,28.11,18.27,10.23,10.23,1
CDM,27880565_OP,MATRIX ALLODERM TISS MED 20X16CM,28.11,18.27,8.4,8.4,1
CDM,27880575,SUB MSTERGRFT CA PHOS COLLAGEN BN GRFT VOID FILLER,60.33,39.21,13.15,1275.41,73
CDM,27880575_IP,SUB MSTERGRFT CA PHOS COLLAGEN BN GRFT VOID FILLER,60.33,39.21,21.96,21.96,1
CDM,27880575_OP,SUB MSTERGRFT CA PHOS COLLAGEN BN GRFT VOID FILLER,60.33,39.21,18.04,18.04,1
CDM,27880585,STRAVIX PL 3X6 CM,173.08,112.5,48.95,183.51,76
CDM,27880585_IP,STRAVIX PL 3X6 CM,173.08,112.5,63.0,63.0,1
CDM,27880585_OP,STRAVIX PL 3X6 CM,173.08,112.5,51.75,51.75,1
CDM,27880595,GRFT NEOX CRYOTEK 1MM 24SQ CM AMNIO UMB CORD,128.96,83.82,36.47,183.51,76
CDM,27880595_IP,GRFT NEOX CRYOTEK 1MM 24SQ CM AMNIO UMB CORD,128.96,83.82,46.94,46.94,1
CDM,27880595_OP,GRFT NEOX CRYOTEK 1MM 24SQ CM AMNIO UMB CORD,128.96,83.82,38.56,38.56,1
CDM,27880605,FLEXHD STRUCTURAL 6CM X 8CM,24.44,15.89,6.91,183.51,76
CDM,27880605_IP,FLEXHD STRUCTURAL 6CM X 8CM,24.44,15.89,8.9,8.9,1
CDM,27880605_OP,FLEXHD STRUCTURAL 6CM X 8CM,24.44,15.89,7.31,7.31,1
CDM,27880615,LAA OCCLUDER DEVICE,34000.0,22100.0,1030.0,34000.0,66
CDM,27880615_IP,LAA OCCLUDER DEVICE,34000.0,22100.0,18632.0,18632.0,1
CDM,27880615_OP,LAA OCCLUDER DEVICE,34000.0,22100.0,14756.0,14756.0,1
CDM,27880645,SPACEOAR HYDROGEL IMPLANTABLE DEVICE,6530.0,4244.5,200.93,6530.0,74
CDM,27880645_IP,SPACEOAR HYDROGEL IMPLANTABLE DEVICE,6530.0,4244.5,3578.44,3578.44,1
CDM,27880645_OP,SPACEOAR HYDROGEL IMPLANTABLE DEVICE,6530.0,4244.5,2834.02,2834.02,1
CDM,27880675,FLEX HD STRUCTURAL 10CMX16CM,24.11,15.67,6.82,183.51,76
CDM,27880675_IP,FLEX HD STRUCTURAL 10CMX16CM,24.11,15.67,8.78,8.78,1
CDM,27880675_OP,FLEX HD STRUCTURAL 10CMX16CM,24.11,15.67,7.21,7.21,1
CDM,27880685,CYTAL WOUND MATRIX 3 LAYER 10X15 CM,21.32,13.86,6.03,183.51,76
CDM,27880685_IP,CYTAL WOUND MATRIX 3 LAYER 10X15 CM,21.32,13.86,7.76,7.76,1
CDM,27880685_OP,CYTAL WOUND MATRIX 3 LAYER 10X15 CM,21.32,13.86,6.37,6.37,1
CDM,27880695,MATRIX TISS 4X2CM GRAFTJACKET NOW THK1-2MM,257.13,167.13,72.72,1275.41,84
CDM,27880695_IP,MATRIX TISS 4X2CM GRAFTJACKET NOW THK1-2MM,257.13,167.13,93.6,93.6,1
CDM,27880695_OP,MATRIX TISS 4X2CM GRAFTJACKET NOW THK1-2MM,257.13,167.13,76.88,76.88,1
CDM,27880705,OMEGA3 SURGICLOSE WND FISH-SKIN 1000MG 19CM2,55.26,35.92,15.63,183.51,76
CDM,27880705_IP,OMEGA3 SURGICLOSE WND FISH-SKIN 1000MG 19CM2,55.26,35.92,20.11,20.11,1
CDM,27880705_OP,OMEGA3 SURGICLOSE WND FISH-SKIN 1000MG 19CM2,55.26,35.92,16.52,16.52,1
CDM,27880715,OMEGA3 SURGICLOSE FISH-SKIN GRFT MESH 2:1 7CM X 10CM,56.39,36.65,15.95,183.51,76
CDM,27880715_IP,OMEGA3 SURGICLOSE FISH-SKIN GRFT MESH 2:1 7CM X 10CM,56.39,36.65,20.53,20.53,1
CDM,27880715_OP,OMEGA3 SURGICLOSE FISH-SKIN GRFT MESH 2:1 7CM X 10CM,56.39,36.65,16.86,16.86,1
CDM,27880745,RESTYLANE (MEDICAL),865.0,562.25,188.57,865.0,65
CDM,27880745_IP,RESTYLANE (MEDICAL),865.0,562.25,314.86,314.86,1
CDM,27880745_OP,RESTYLANE (MEDICAL),865.0,562.25,258.64,258.64,1
CDM,27880865,ITIND DEVICE,5590.0,3633.5,200.93,5590.0,74
CDM,27880865_IP,ITIND DEVICE,5590.0,3633.5,3063.32,3063.32,1
CDM,27880865_OP,ITIND DEVICE,5590.0,3633.5,2426.06,2426.06,1
CDM,27880885,GRAFT EPIFIX  18MM DISC 2.5CM2,456.67,296.84,117.73,456.67,76
CDM,27880885_IP,GRAFT EPIFIX  18MM DISC 2.5CM2,456.67,296.84,166.23,166.23,1
CDM,27880885_OP,GRAFT EPIFIX  18MM DISC 2.5CM2,456.67,296.84,136.54,136.54,1
CDM,27880895,GRAFT EPIFIX  2X4CM 8CM2,321.25,208.81,90.85,321.25,76
CDM,27880895_IP,GRAFT EPIFIX  2X4CM 8CM2,321.25,208.81,116.94,116.94,1
CDM,27880895_OP,GRAFT EPIFIX  2X4CM 8CM2,321.25,208.81,96.05,96.05,1
CDM,27880905,GRAFT EPIFIX 3X4CM 12CM2,381.5,247.98,107.89,381.5,76
CDM,27880905_IP,GRAFT EPIFIX 3X4CM 12CM2,381.5,247.98,138.87,138.87,1
CDM,27880905_OP,GRAFT EPIFIX 3X4CM 12CM2,381.5,247.98,114.07,114.07,1
CDM,27880915,GRAFT EPIFIX 3.5X3.5CM 8SQ CM,298.5,194.03,84.42,298.5,76
CDM,27880915_IP,GRAFT EPIFIX 3.5X3.5CM 8SQ CM,298.5,194.03,108.65,108.65,1
CDM,27880915_OP,GRAFT EPIFIX 3.5X3.5CM 8SQ CM,298.5,194.03,89.25,89.25,1
CDM,27880925,GRAFT EPIFIX 4X4.5CM 10.1SQ CM,258.8,168.22,73.19,258.8,76
CDM,27880925_IP,GRAFT EPIFIX 4X4.5CM 10.1SQ CM,258.8,168.22,94.2,94.2,1
CDM,27880925_OP,GRAFT EPIFIX 4X4.5CM 10.1SQ CM,258.8,168.22,77.38,77.38,1
CDM,27880935,GRAFT ST TIS EPIFIX 14MM AMNIO,299.0,194.35,84.56,299.0,76
CDM,27880935_IP,GRAFT ST TIS EPIFIX 14MM AMNIO,299.0,194.35,108.84,108.84,1
CDM,27880935_OP,GRAFT ST TIS EPIFIX 14MM AMNIO,299.0,194.35,89.4,89.4,1
CDM,27880945,GRAFT EPIFIX 2X2CM 4 SQ CM,492.5,320.13,117.73,492.5,76
CDM,27880945_IP,GRAFT EPIFIX 2X2CM 4 SQ CM,492.5,320.13,179.27,179.27,1
CDM,27880945_OP,GRAFT EPIFIX 2X2CM 4 SQ CM,492.5,320.13,147.26,147.26,1
CDM,27880955,GRAFT EPIFIX 2X3CM 6 SQ CM,381.33,247.86,107.84,381.33,76
CDM,27880955_IP,GRAFT EPIFIX 2X3CM 6 SQ CM,381.33,247.86,138.8,138.8,1
CDM,27880955_OP,GRAFT EPIFIX 2X3CM 6 SQ CM,381.33,247.86,114.02,114.02,1
CDM,27880965,GRAFT ST TIS EPIFIX 16SQ CM,361.88,235.22,102.34,361.88,76
CDM,27880965_IP,GRAFT ST TIS EPIFIX 16SQ CM,361.88,235.22,131.72,131.72,1
CDM,27880965_OP,GRAFT ST TIS EPIFIX 16SQ CM,361.88,235.22,108.2,108.2,1
CDM,27880975,GRAFT ST TIS 6X5CM EPIFIX,366.33,238.11,103.6,366.33,76
CDM,27880975_IP,GRAFT ST TIS 6X5CM EPIFIX,366.33,238.11,133.34,133.34,1
CDM,27880975_OP,GRAFT ST TIS 6X5CM EPIFIX,366.33,238.11,109.53,109.53,1
CDM,27880985,GRAFT EPIFIX 7X7CM 49 SQ CM,516.05,335.43,117.73,516.05,76
CDM,27880985_IP,GRAFT EPIFIX 7X7CM 49 SQ CM,516.05,335.43,136.61,136.61,1
CDM,27880985_OP,GRAFT EPIFIX 7X7CM 49 SQ CM,516.05,335.43,112.22,112.22,1
CDM,27880OH,AMPUTATION LOW LEG THRU TIB/FIB,6148.0,3996.2,1.1,6148.0,144
CDM,27881025,CAPITATION MITRACLIP,60000.0,39000.0,1030.0,60000.0,66
CDM,27881025_IP,CAPITATION MITRACLIP,60000.0,39000.0,32880.0,32880.0,1
CDM,27881025_OP,CAPITATION MITRACLIP,60000.0,39000.0,26040.0,26040.0,1
CDM,27881035,CAPITATION WATCHMAN,34000.0,22100.0,200.93,34000.0,74
CDM,27881035_IP,CAPITATION WATCHMAN,34000.0,22100.0,18632.0,18632.0,1
CDM,27881035_OP,CAPITATION WATCHMAN,34000.0,22100.0,14756.0,14756.0,1
CDM,27881045,CAPITATION TX2 TAA,47000.0,30550.0,200.93,47000.0,74
CDM,27881045_IP,CAPITATION TX2 TAA,47000.0,30550.0,25756.0,25756.0,1
CDM,27881045_OP,CAPITATION TX2 TAA,47000.0,30550.0,20398.0,20398.0,1
CDM,27881055,CAPITATION ZENITH FLEX AAA,19800.0,12870.0,200.93,19800.0,74
CDM,27881055_IP,CAPITATION ZENITH FLEX AAA,19800.0,12870.0,10850.4,10850.4,1
CDM,27881055_OP,CAPITATION ZENITH FLEX AAA,19800.0,12870.0,8593.2,8593.2,1
CDM,27881065,CAPITATION OVATION AAA,19000.0,12350.0,200.93,19000.0,74
CDM,27881065_IP,CAPITATION OVATION AAA,19000.0,12350.0,10412.0,10412.0,1
CDM,27881065_OP,CAPITATION OVATION AAA,19000.0,12350.0,8246.0,8246.0,1
CDM,27881075,CAPITATION CONFORMABLE EXCLUDER AAA,24190.0,15723.5,1030.0,24190.0,66
CDM,27881075_IP,CAPITATION CONFORMABLE EXCLUDER AAA,24190.0,15723.5,13256.12,13256.12,1
CDM,27881075_OP,CAPITATION CONFORMABLE EXCLUDER AAA,24190.0,15723.5,10498.46,10498.46,1
CDM,27881085,CAPITATION CTAG TAA,41790.0,27163.5,1030.0,41790.0,66
CDM,27881085_IP,CAPITATION CTAG TAA,41790.0,27163.5,22900.92,22900.92,1
CDM,27881085_OP,CAPITATION CTAG TAA,41790.0,27163.5,18136.86,18136.86,1
CDM,27881095,CAPITATION EXCLUDER AAA,20500.0,13325.0,1030.0,20500.0,66
CDM,27881095_IP,CAPITATION EXCLUDER AAA,20500.0,13325.0,11234.0,11234.0,1
CDM,27881095_OP,CAPITATION EXCLUDER AAA,20500.0,13325.0,8897.0,8897.0,1
CDM,27881105,CAPITATION AORFIX AAA,21000.0,13650.0,1030.0,21000.0,66
CDM,27881105_IP,CAPITATION AORFIX AAA,21000.0,13650.0,11508.0,11508.0,1
CDM,27881105_OP,CAPITATION AORFIX AAA,21000.0,13650.0,9114.0,9114.0,1
CDM,27881115,CAPITATION ENDURANT AAA,19000.0,12350.0,1030.0,19000.0,66
CDM,27881115_IP,CAPITATION ENDURANT AAA,19000.0,12350.0,10412.0,10412.0,1
CDM,27881115_OP,CAPITATION ENDURANT AAA,19000.0,12350.0,8246.0,8246.0,1
CDM,27881125,"CAPITATION RELAY PRO TAA,M 2-3",34990.0,22743.5,200.93,34990.0,74
CDM,27881125_IP,"CAPITATION RELAY PRO TAA,M 2-3",34990.0,22743.5,19174.52,19174.52,1
CDM,27881125_OP,"CAPITATION RELAY PRO TAA,M 2-3",34990.0,22743.5,15185.66,15185.66,1
CDM,27881135,"CAPITATION RELAY PRO TAA, N 2-3",34990.0,22743.5,200.93,34990.0,74
CDM,27881135_IP,"CAPITATION RELAY PRO TAA, N 2-3",34990.0,22743.5,19174.52,19174.52,1
CDM,27881135_OP,"CAPITATION RELAY PRO TAA, N 2-3",34990.0,22743.5,15185.66,15185.66,1
CDM,27881145,"CAPITATION RELAY PRO TAA,M 4",45990.0,29893.5,200.93,45990.0,74
CDM,27881145_IP,"CAPITATION RELAY PRO TAA,M 4",45990.0,29893.5,25202.52,25202.52,1
CDM,27881145_OP,"CAPITATION RELAY PRO TAA,M 4",45990.0,29893.5,19959.66,19959.66,1
CDM,27881155,"CAPITATION RELAY PRO TAA, N 4",45990.0,29893.5,200.93,45990.0,74
CDM,27881155_IP,"CAPITATION RELAY PRO TAA, N 4",45990.0,29893.5,25202.52,25202.52,1
CDM,27881155_OP,"CAPITATION RELAY PRO TAA, N 4",45990.0,29893.5,19959.66,19959.66,1
CDM,27881165,CAPITATION RELAY TAA,32000.0,20800.0,200.93,32000.0,74
CDM,27881165_IP,CAPITATION RELAY TAA,32000.0,20800.0,17536.0,17536.0,1
CDM,27881165_OP,CAPITATION RELAY TAA,32000.0,20800.0,13888.0,13888.0,1
CDM,27881175,CAPITATION TREO,19000.0,12350.0,1030.0,19000.0,66
CDM,27881175_IP,CAPITATION TREO,19000.0,12350.0,10412.0,10412.0,1
CDM,27881175_OP,CAPITATION TREO,19000.0,12350.0,8246.0,8246.0,1
CDM,27881255,RECOR MEDICAL PARADISE ULTRASOUND RDN PRDS-PPP,40000.0,26000.0,200.93,40000.0,74
CDM,27881255_IP,RECOR MEDICAL PARADISE ULTRASOUND RDN PRDS-PPP,40000.0,26000.0,21920.0,21920.0,1
CDM,27881255_OP,RECOR MEDICAL PARADISE ULTRASOUND RDN PRDS-PPP,40000.0,26000.0,17360.0,17360.0,1
CDM,27881395,"GENERATOR, NEURO NON-RECHARG",51600.0,33540.0,200.93,51600.0,74
CDM,27881395_IP,"GENERATOR, NEURO NON-RECHARG",51600.0,33540.0,28276.8,28276.8,1
CDM,27881395_OP,"GENERATOR, NEURO NON-RECHARG",51600.0,33540.0,22394.4,22394.4,1
CDM,27881645,"BRACHYTHERAPY SOURCE, NON-STRANDED, CESIUM-131, PER SOURCE",161.0,104.65,45.53,3174.78,91
CDM,27881645_IP,"BRACHYTHERAPY SOURCE, NON-STRANDED, CESIUM-131, PER SOURCE",161.0,104.65,58.6,58.6,1
CDM,27881645_OP,"BRACHYTHERAPY SOURCE, NON-STRANDED, CESIUM-131, PER SOURCE",161.0,104.65,48.14,48.14,1
CDM,27881655,"BRACHYTHERAPY SOURCE, STRANDED, CESIUM-131, PER SOURCE",195.0,126.75,55.15,3174.78,91
CDM,27881655_IP,"BRACHYTHERAPY SOURCE, STRANDED, CESIUM-131, PER SOURCE",195.0,126.75,70.98,70.98,1
CDM,27881655_OP,"BRACHYTHERAPY SOURCE, STRANDED, CESIUM-131, PER SOURCE",195.0,126.75,58.31,58.31,1
CDM,27881685,ARMSTRONG MYRINGOTOMY VENT TUBE,29.0,18.85,6.32,29.0,73
CDM,27881685_IP,ARMSTRONG MYRINGOTOMY VENT TUBE,29.0,18.85,10.56,10.56,1
CDM,27881685_OP,ARMSTRONG MYRINGOTOMY VENT TUBE,29.0,18.85,8.67,8.67,1
CDM,27881695,REUTER MYRINGOTOMY VENT TUBE,15.0,9.75,3.27,19.65,73
CDM,27881695_IP,REUTER MYRINGOTOMY VENT TUBE,15.0,9.75,5.46,5.46,1
CDM,27881695_OP,REUTER MYRINGOTOMY VENT TUBE,15.0,9.75,4.49,4.49,1
CDM,27881705,BLUE SILICONE MYRINGOTOMY VENT TUBE,42.0,27.3,9.16,42.0,73
CDM,27881705_IP,BLUE SILICONE MYRINGOTOMY VENT TUBE,42.0,27.3,15.29,15.29,1
CDM,27881705_OP,BLUE SILICONE MYRINGOTOMY VENT TUBE,42.0,27.3,12.56,12.56,1
CDM,27881835,XIENCE SKYPOINT EVEROLIMUS ELUTING STENT SYSTEM,792.0,514.8,172.66,792.0,73
CDM,27881835_IP,XIENCE SKYPOINT EVEROLIMUS ELUTING STENT SYSTEM,792.0,514.8,288.29,288.29,1
CDM,27881835_OP,XIENCE SKYPOINT EVEROLIMUS ELUTING STENT SYSTEM,792.0,514.8,236.81,236.81,1
CDM,27881845,VASCADE MVP XL VENOUS VASC CLOSURE SYS,225.0,146.25,49.05,232.66,73
CDM,27881845_IP,VASCADE MVP XL VENOUS VASC CLOSURE SYS,225.0,146.25,81.9,81.9,1
CDM,27881845_OP,VASCADE MVP XL VENOUS VASC CLOSURE SYS,225.0,146.25,67.28,67.28,1
CDM,27881855,ULTIPACE PACING LEAD,750.0,487.5,163.5,750.0,73
CDM,27881855_IP,ULTIPACE PACING LEAD,750.0,487.5,273.0,273.0,1
CDM,27881855_OP,ULTIPACE PACING LEAD,750.0,487.5,224.25,224.25,1
CDM,27881865,R2P MISAGO STENT,2550.0,1657.5,200.93,2550.0,74
CDM,27881865_IP,R2P MISAGO STENT,2550.0,1657.5,1397.4,1397.4,1
CDM,27881865_OP,R2P MISAGO STENT,2550.0,1657.5,1106.7,1106.7,1
CDM,27881885,NS 100 NEUROSTIMULATOR,9450.0,6142.5,1030.0,9450.0,74
CDM,27881885_IP,NS 100 NEUROSTIMULATOR,9450.0,6142.5,5178.6,5178.6,1
CDM,27881885_OP,NS 100 NEUROSTIMULATOR,9450.0,6142.5,4101.3,4101.3,1
CDM,27881895,BX2 9MMX59MM 7FR 135CM CATH BX2 HEP REDUCED PROFILE,8190.0,5323.5,200.93,8190.0,74
CDM,27881895_IP,BX2 9MMX59MM 7FR 135CM CATH BX2 HEP REDUCED PROFILE,8190.0,5323.5,4488.12,4488.12,1
CDM,27881895_OP,BX2 9MMX59MM 7FR 135CM CATH BX2 HEP REDUCED PROFILE,8190.0,5323.5,3554.46,3554.46,1
CDM,27881915,MICRA VR2 TPS MC2VROS US,28230.0,18349.5,200.93,28230.0,74
CDM,27881915_IP,MICRA VR2 TPS MC2VROS US,28230.0,18349.5,15470.04,15470.04,1
CDM,27881915_OP,MICRA VR2 TPS MC2VROS US,28230.0,18349.5,12251.82,12251.82,1
CDM,27881925,DEVICE VES CLOS MYNX CONTROL VCD 6FR-12FR,350.0,227.5,76.3,350.0,73
CDM,27881925_IP,DEVICE VES CLOS MYNX CONTROL VCD 6FR-12FR,350.0,227.5,127.4,127.4,1
CDM,27881925_OP,DEVICE VES CLOS MYNX CONTROL VCD 6FR-12FR,350.0,227.5,104.65,104.65,1
CDM,27881935,KERECIS PER SQ CM,275.0,178.75,77.77,275.0,77
CDM,27881995,"ARGON VENA CAVA FILTER RETRIEVAL SET, TRIPLE LOOP SNARE",770.0,500.5,167.86,770.0,73
CDM,27881995_IP,"ARGON VENA CAVA FILTER RETRIEVAL SET, TRIPLE LOOP SNARE",770.0,500.5,280.28,280.28,1
CDM,27881995_OP,"ARGON VENA CAVA FILTER RETRIEVAL SET, TRIPLE LOOP SNARE",770.0,500.5,230.23,230.23,1
CDM,27881OH,AMP LEG THRU TIBFIB W/IMMT FITG TQ W/1ST CST,5388.0,3502.2,1.1,5388.0,144
CDM,27882005,STENT ABRE 16MM NITINOL 120MM VENOUS SELF EXPAND,2950.0,1917.5,200.93,2950.0,74
CDM,27882005_IP,STENT ABRE 16MM NITINOL 120MM VENOUS SELF EXPAND,2950.0,1917.5,1616.6,1616.6,1
CDM,27882005_OP,STENT ABRE 16MM NITINOL 120MM VENOUS SELF EXPAND,2950.0,1917.5,1280.3,1280.3,1
CDM,27882015,AGENT DRUG COATED BALLOON,16950.0,11017.5,200.93,16950.0,74
CDM,27882015_IP,AGENT BALLOON CATHETER-DRUG-COATED,16950.0,11017.5,9288.6,9288.6,1
CDM,27882015_OP,AGENT BALLOON CATHETER-DRUG-COATED,16950.0,11017.5,7356.3,7356.3,1
CDM,27882035,GORE VIABAHN VBX BALLOON EXPANDABLE ENDOPROSTHESIS STENT GRAFT,5460.0,3549.0,200.93,5460.0,74
CDM,27882035_IP,GORE VIABAHN VBX BALLOON EXPANDABLE ENDOPROSTHESIS STENT GRAFT,5460.0,3549.0,2992.08,2992.08,1
CDM,27882035_OP,GORE VIABAHN VBX BALLOON EXPANDABLE ENDOPROSTHESIS STENT GRAFT,5460.0,3549.0,2369.64,2369.64,1
CDM,27882045,GORE VIABAHN VBX BALLOON EXPANDABLE ENDOPROSTHESIS STENT GRAFT,5460.0,3549.0,200.93,5460.0,74
CDM,27882045_IP,GORE VIABAHN VBX BALLOON EXPANDABLE ENDOPROSTHESIS STENT GRAFT,5460.0,3549.0,2992.08,2992.08,1
CDM,27882045_OP,GORE VIABAHN VBX BALLOON EXPANDABLE ENDOPROSTHESIS STENT GRAFT,5460.0,3549.0,2369.64,2369.64,1
CDM,27882055,GLIDEPATH LONG-TERM HEMODIALYSIS CATHETER WITH PRELOADED STYLET,600.0,390.0,130.8,600.0,73
CDM,27882055_IP,GLIDEPATH LONG-TERM HEMODIALYSIS CATHETER WITH PRELOADED STYLET,600.0,390.0,218.4,218.4,1
CDM,27882055_OP,GLIDEPATH LONG-TERM HEMODIALYSIS CATHETER WITH PRELOADED STYLET,600.0,390.0,179.4,179.4,1
CDM,27882065,EQUISTREAM LONG-TERM HEMODIALYSIS CATHETER WITH PRELOADED,600.0,390.0,130.8,600.0,73
CDM,27882065_IP,EQUISTREAM LONG-TERM HEMODIALYSIS CATHETER WITH PRELOADED,600.0,390.0,218.4,218.4,1
CDM,27882065_OP,EQUISTREAM LONG-TERM HEMODIALYSIS CATHETER WITH PRELOADED,600.0,390.0,179.4,179.4,1
CDM,27882075,BX2 HEP REDUCED PROFILE BX2 8MMX39MM 7FR 135CM CATH,8190.0,5323.5,200.93,8190.0,74
CDM,27882075_IP,BX2 HEP REDUCED PROFILE BX2 8MMX39MM 7FR 135CM CATH,8190.0,5323.5,4488.12,4488.12,1
CDM,27882075_OP,BX2 HEP REDUCED PROFILE BX2 8MMX39MM 7FR 135CM CATH,8190.0,5323.5,3554.46,3554.46,1
CDM,27882085,ASSERT-IQ EL+ INSERTABLE CARDIAC MONITOR,10500.0,6825.0,200.93,10500.0,74
CDM,27882085_IP,ASSERT-IQ EL+ INSERTABLE CARDIAC MONITOR,10500.0,6825.0,5754.0,5754.0,1
CDM,27882085_OP,ASSERT-IQ EL+ INSERTABLE CARDIAC MONITOR,10500.0,6825.0,4557.0,4557.0,1
CDM,27882105,HF CARDIAC RESYNCHRONIZATION THERAPY DEFIBRILLATOR,29100.0,18915.0,200.93,29100.0,74
CDM,27882105_IP,HF CARDIAC RESYNCHRONIZATION THERAPY DEFIBRILLATOR,29100.0,18915.0,15946.8,15946.8,1
CDM,27882105_OP,HF CARDIAC RESYNCHRONIZATION THERAPY DEFIBRILLATOR,29100.0,18915.0,12629.4,12629.4,1
CDM,27882115,"ADROIT GUIDING CATHETER, IM, SINGLE USE",600.0,390.0,130.8,600.0,73
CDM,27882115_IP,"ADROIT GUIDING CATHETER, IM, SINGLE USE",600.0,390.0,218.4,218.4,1
CDM,27882115_OP,"ADROIT GUIDING CATHETER, IM, SINGLE USE",600.0,390.0,179.4,179.4,1
CDM,27882125,GORE VIABAHN VBX BALLOON EXPANDABLE ENDO,8190.0,5323.5,200.93,8190.0,74
CDM,27882125_IP,GORE VIABAHN VBX BALLOON EXPANDABLE ENDO,8190.0,5323.5,4488.12,4488.12,1
CDM,27882125_OP,GORE VIABAHN VBX BALLOON EXPANDABLE ENDO,8190.0,5323.5,3554.46,3554.46,1
CDM,27882135,DR IMPLANTABLE CARDIOVERTER DEFIBRILLATOR,22500.0,14625.0,200.93,22500.0,74
CDM,27882135_IP,DR IMPLANTABLE CARDIOVERTER DEFIBRILLATOR,22500.0,14625.0,12330.0,12330.0,1
CDM,27882135_OP,DR IMPLANTABLE CARDIOVERTER DEFIBRILLATOR,22500.0,14625.0,9765.0,9765.0,1
CDM,27882145,"HALO? SINGLE LOOP SNARE KIT 4F, 5MM X 20CM",600.0,390.0,130.8,600.0,73
CDM,27882145_IP,"HALO? SINGLE LOOP SNARE KIT 4F, 5MM X 20CM",600.0,390.0,218.4,218.4,1
CDM,27882145_OP,"HALO? SINGLE LOOP SNARE KIT 4F, 5MM X 20CM",600.0,390.0,179.4,179.4,1
CDM,27882175,H230007 AMDS55 HYBRID PROSTHESIS 32MM COLLAR,28900.0,18785.0,1030.0,28900.0,66
CDM,27882175_IP,AMDS55 HYBRID PROSTHESIS 32MM COLLAR,28900.0,18785.0,15837.2,15837.2,1
CDM,27882175_OP,AMDS55 HYBRID PROSTHESIS 32MM COLLAR,28900.0,18785.0,12542.6,12542.6,1
CDM,27882185,H230007 AMDS5540 HYBRID PROSTHESIS 32MM COLLAR,28900.0,18785.0,1030.0,28900.0,66
CDM,27882185_IP,AMDS5540 HYBRID PROSTHESIS 32MM COLLAR,28900.0,18785.0,15837.2,15837.2,1
CDM,27882185_OP,AMDS5540 HYBRID PROSTHESIS 32MM COLLAR,28900.0,18785.0,12542.6,12542.6,1
CDM,27882195,H230007 AMDS40C HYBRID PROSTHESIS 28MM COLLAR,28900.0,18785.0,1030.0,28900.0,66
CDM,27882195_IP,AMDS40C HYBRID PROSTHESIS 28MM COLLAR,28900.0,18785.0,15837.2,15837.2,1
CDM,27882195_OP,AMDS40C HYBRID PROSTHESIS 28MM COLLAR,28900.0,18785.0,12542.6,12542.6,1
CDM,27882205,H230007 AMDS4030C HYBRID PROSTHESIS 28MM COLLAR,28900.0,18785.0,1030.0,28900.0,66
CDM,27882205_IP,AMDS4030C HYBRID PROSTHESIS 28MM COLLAR,28900.0,18785.0,15837.2,15837.2,1
CDM,27882205_OP,AMDS4030C HYBRID PROSTHESIS 28MM COLLAR,28900.0,18785.0,12542.6,12542.6,1
CDM,27882215,TUMARK BIOPSY MARKER,165.0,107.25,35.97,232.66,74
CDM,27882255,ACCUCATH 20G 2.25IN POWER INJECTIBLE,130.0,84.5,28.34,232.66,74
CDM,27882265,ACCUCATH 20G X 2-1/4IN,161.0,104.65,35.1,232.66,74
CDM,27882295,TRUMPET TUBE,84.0,54.6,16.97,84.0,74
CDM,27882305,EBR WISE CRT LEADLESS PACEMAKER SYSTEM MFG M7000,146070.0,94945.5,200.93,146070.0,75
CDM,27882315,GORE EXCLUDER AAA ENDO WITH DELIVERY SYSTEM,22524.0,14640.6,1030.0,22524.0,67
CDM,27882325,RICHARDS T TUBE,64.0,41.6,13.95,64.0,74
CDM,27882335,"ADAPT/EXT, PACING/NEURO LEAD",9450.0,6142.5,200.93,9450.0,75
CDM,27882405,FIDUCIAL MARKER DOUBLE STRANDED,395.0,256.75,86.11,395.0,74
CDM,27882415,FIDUCIAL MARKER SINGLE STRANDED,206.0,133.9,44.91,232.66,74
CDM,27882445,PERCLOSE PROSTYLE SUTURE-MEDIATED CLOSURE AND REPAIR SYSTEM,639.9,415.94,139.5,639.9,74
CDM,27882455,MYNX CONTROL WOUND HYDROGEL DRESSING,525.0,341.25,114.45,525.0,74
CDM,27882465,AZUR CX PERIPHERAL COIL SYSTEM 2MM X 2CM,3927.0,2552.55,856.09,3927.0,67
CDM,27882475,ELUVIA DRUG-ELUTING STENT 7MM X 150MM X 130CM,10497.0,6823.05,200.93,10497.0,75
CDM,27882OH,AMPUTATION LEG THRU TIBIA&FIBULA OPEN CIRCULAR,3916.0,2545.4,1.1,3916.0,144
CDM,27884OH,AMP LEG THRU TIBIA&FIBULA SEC CLOSURE/SCAR REV,3504.0,2277.6,1.1,9440.12,144
CDM,27886OH,AMP LEG THRU TIBIA&FIBULA RE-AMPUTATION,4008.0,2605.2,1.1,4008.0,144
CDM,27888OH,AMP ANKLE-MALLI TIBFIB W/PLSTC CLSR&RESCJ NRV,4148.0,2696.2,1.1,4148.0,144
CDM,27889OH,ANKLE DISARTICULATION,4344.0,2823.6,1.1,20863.78,144
CDM,27892OH,DCMPRN FASCT LEG ANT&/LAT W/DBRDMT MUSC&/NERVE,3176.0,2064.4,1.1,9440.12,144
CDM,27893OH,DCMPRN FASCT LEG PST W/DBRDMT MUSC&/NRV,3160.0,2054.0,1.1,20863.78,144
CDM,27894OH,DCMPRN FASCT LEG ANT&/LAT&PST W/DBRDMT MUS,5068.0,3294.2,1.1,9440.12,144
CDM,27899AOH,TENODESIS; HAMSTRING TENDON TO TIBIA,2666.0,1732.9,0.01,2666.0,84
CDM,27899RVU2OH,HYDRODISSECTION LEG (COMP CODE 20552),281.0,182.65,0.01,688.73,84
CDM,27899RVU3OH,"EXCISION OF ACCESSORY SOLEUS MUSCLE, LEG OR ANKLE AREA (COMP COD",2972.0,1931.8,0.01,2972.0,84
CDM,27899RVU5OH,ASPIRATION OF INTRAMUSCULAR HEMATOMA (COMP CODE 10160),451.0,293.15,0.01,688.73,84
CDM,27899RVU6OH,REPAIR/SUTURE MUSCLE LOWER LEG (COMP CODE 27658),1844.0,1198.6,0.01,1844.0,84
CDM,27899RVUOH,OPEN MICRO FRACTURE ANKLE,4787.0,3111.55,0.01,4787.0,84
CDM,27900105,NOSTRIL RETAINER,250.0,162.5,16.97,250.0,65
CDM,27900105_IP,NOSTRIL RETAINER,250.0,162.5,91.0,91.0,1
CDM,27900105_OP,NOSTRIL RETAINER,250.0,162.5,74.75,74.75,1
CDM,28001OH,INCIS/DRAINAGE BURSA OF FOOT,800.0,520.0,1.1,4729.25,148
CDM,28002OH,I&D BELOW FASCIA FOOT 1 BURSAL SPACE,1116.0,725.4,1.1,4686.39,148
CDM,28003OH,I&D BELOW FASCIA FOOT MULTIPLE AREAS,2112.0,1372.8,1.1,9440.12,148
CDM,28005OH,INCISION BONE CORTEX FOOT,3776.0,2454.4,1.1,9440.12,144
CDM,28008OH,FASCIOTOMY FOOT&/TOE,1836.0,1193.4,1.1,9440.12,148
CDM,28010OH,TENOTOMY PERCUTANEOUS TOE SINGLE TENDON,1188.0,772.2,1.1,4686.39,148
CDM,28011OH,TENOTOMY PERCUTANEOUS TOE MULTIPLE TENDON,1712.0,1112.8,1.1,4686.39,148
CDM,28020OH,ARTHRT W/EXPL DRG/RMVL LOOSE/FB NTRTRSL/TARS JT,2060.0,1339.0,1.1,9440.12,148
CDM,28022OH,ARTHRT W/EXPL DRG/RMVL LOOSE/FB MTTARPHLNGL JT,1924.0,1250.6,1.1,9440.12,148
CDM,28024OH,ARTHRT W/EXPL DRG/RMVL LOOSE/FB IPHAL JT,1808.0,1175.2,1.1,4686.39,148
CDM,28035OH,RELEASE TARSAL TUNNEL,2092.0,1359.8,1.1,5632.24,148
CDM,28039OH,EXCISION TUMOR SOFT TISSUE FOOT/TOE SUBQ 1.5+CM,2168.0,1409.2,1.1,8286.13,148
CDM,28041OH,EXC TUMOR SOFT TISSUE FOOT/TOE SUBFASC 1.5+CM,2852.0,1853.8,1.1,8286.13,144
CDM,28043OH,EXCISION TUMOR SOFT TISSUE FOOT/TOE SUBQ <1.5CM,1584.0,1029.6,1.1,4729.25,148
CDM,28045OH,EXC TUMOR SOFT TISSUE FOOT/TOE SUBFASC <1.5CM,2180.0,1417.0,1.1,8286.13,148
CDM,28046OH,RAD RESECTION TUMOR SOFT TISSUE FOOT/TOE <3CM,4952.0,3218.8,1.1,8286.13,144
CDM,28047OH,RAD RESECTION TUMOR SOFT TISSUE FOOT/TOE 3+CM,6980.0,4537.0,1.1,8286.13,144
CDM,28050OH,ARTHRT W/BX INTERTARSAL/TARSOMETATARSAL JOINT,1756.0,1141.4,1.1,9440.12,148
CDM,28052OH,ARTHRTOMY W/BX METATARSOPHALANGEAL JOINT,1624.0,1055.6,1.1,9440.12,148
CDM,28054OH,ARTHRTOMY W/BX INTERPHALANGEAL JOINT,1428.0,928.2,1.1,9440.12,148
CDM,28055OH,"NEURECTOMY, INTRINSIC MUSCULATURE FOOT",2516.0,1635.4,1.1,5632.24,144
CDM,28060OH,FASCIECTOMY PLANTAR FASCIA PARTIAL SPX,2160.0,1404.0,1.1,9440.12,148
CDM,28062OH,FASCIECTOMY PLANTAR FASCIA RADICAL SPX,2676.0,1739.4,1.1,9440.12,148
CDM,28070OH,SYNVCT INTERTARSAL/TARSOMETATARSAL JT EA SPX,2096.0,1362.4,1.1,20863.78,148
CDM,28072OH,SYNOVECTOMY METATARSOPHALANGEAL JOINT EACH,1888.0,1227.2,1.1,9440.12,148
CDM,28080OH,EXCISION INTERDIGITAL MORTON NEUROMA SINGLE EACH,1944.0,1263.6,1.1,4686.39,148
CDM,28086OH,"SYNOVECTOMY FLEX TENDN SHEATH,FOOT",1968.0,1279.2,1.1,9440.12,148
CDM,28088OH,"SYNOVECTOMY EXTEN TENDN SHEATH,FOOT",1592.0,1034.8,1.1,9440.12,148
CDM,28090OH,EXC LESION TENDON SHEATH/CAPSULE W/SYNVCT FOOT,1820.0,1183.0,1.1,4686.39,148
CDM,28092OH,EXC LESION TENDON SHEATH/CAPSULE W/SYNVCT TOE EA,1512.0,982.8,1.1,4686.39,148
CDM,28100OH,EXCISION/CURETTAGE CYST/TUMOR TALUS/CALCANEUS,2332.0,1515.8,1.1,9440.12,148
CDM,28102OH,EXC/CURTG CST/B9 TUM TALUS/CLCNS W/ILIAC/AGRFT,3168.0,2059.2,1.1,20863.78,144
CDM,28103OH,EXC/CURETTAGE CYST/TUMOR TALUS/CALCANEUS ALGRFT,2668.0,1734.2,1.1,20863.78,144
CDM,28104OH,EXC/CURTG BONE CYST/B9 TUMORTARSAL/METATARSAL,2104.0,1367.6,1.1,9440.12,148
CDM,28106OH,EXC/CURTG CST/B9 TUM TARSAL/METAR W/ILIAC/AGRFT,2940.0,1911.0,1.1,20863.78,144
CDM,28107OH,EXC/CURTG CST/B9 TUM TARSAL/METAR W/ALGRFT,2292.0,1489.8,1.1,20863.78,148
CDM,28108OH,EXC/CURTG CST/B9 TUM PHALANGES FOOT,1720.0,1118.0,1.1,4686.39,148
CDM,28110OH,OSTECTOMY PRTL 5TH METAR HEAD SPX,1688.0,1097.2,1.1,9440.12,148
CDM,28111OH,OSTECTOMY COMPLETE 1ST METATARSAL HEAD,2060.0,1339.0,1.1,9440.12,148
CDM,28112OH,OSTECTOMY COMPLETE OTHER METATARSAL HEAD 2/3/4,1852.0,1203.8,1.1,9440.12,148
CDM,28113OH,OSTECTOMY COMPLETE 5TH METATARSAL HEAD,2444.0,1588.6,1.1,9440.12,148
CDM,28114OH,OSTC COMPL ALL METAR HEADS W/PRTL PROX PHALANGC,4800.0,3120.0,1.1,9440.12,148
CDM,28116OH,OSTECTOMY TARSAL COALITION,3656.0,2376.4,1.1,9440.12,148
CDM,28118OH,OSTECTOMY CALCANEUS,2452.0,1593.8,1.1,9440.12,148
CDM,28119OH,OSTECTOMY CALCANEUS SPUR W/WO PLNTAR FASCIAL RLS,2224.0,1445.6,1.1,9440.12,148
CDM,28120OH,PARTIAL EXCISION BONE TALUS/CALCANEUS,2924.0,1900.6,1.1,9440.12,148
CDM,28122OH,PRTL EXC B1 TARSAL/METAR B1 XCP TALUS/CALCANEUS,2704.0,1757.6,1.1,9440.12,148
CDM,28124OH,PARTICAL EXCISION BONE PHALANX TOE,2000.0,1300.0,1.1,9440.12,148
CDM,28126OH,RESECTION PARTIAL/COMPLETE PHALANGEAL BASE EACH,1456.0,946.4,1.1,9440.12,148
CDM,28130OH,TALECTOMY ASTRAGALECTOMY,3800.0,2470.0,1.1,20863.78,144
CDM,28140OH,METATARSECTOMY,2856.0,1856.4,1.1,9440.12,148
CDM,28150OH,PHALANGECTOMY TOE EACH TOE,1692.0,1099.8,1.1,9440.12,148
CDM,28153OH,RESECTION CONDYLE DISTAL END PHALANX EACH TOE,1520.0,988.0,1.1,9440.12,148
CDM,28160OH,HEMIPHALANGECTOMY/INTERPHALANGEAL JOINT EXC TOE,1552.0,1008.8,1.1,9440.12,148
CDM,28173OH,RADICAL RESECTION TUMOR METATARSAL,5664.0,3681.6,1.1,9440.12,144
CDM,28175OH,RADICAL RESECTION TUMOR PHALANX OR TOE,3316.0,2155.4,1.1,4686.39,144
CDM,28190OH,"REMV FOOT FOREIGN BODY,SUBCUTANEOUS",884.0,574.6,1.1,2050.87,148
CDM,28192OH,"REMV FOOT FOREIGN BODY,DEEP",1912.0,1242.8,1.1,4729.25,148
CDM,28193OH,"REMV FOOT FOREIGN BODY,COMPLEX",2360.0,1534.0,1.1,4729.25,148
CDM,28200OH,RPR TDN FLXR FOOT 1/2 W/O FREE GRAFG EACH TENDON,1896.0,1232.4,1.1,9440.12,148
CDM,28202OH,RPR TENDON FLXR FOOT SEC W/FREE GRAFT EA TENDON,2828.0,1838.2,1.1,20863.78,148
CDM,28208OH,REPAIR TENDON EXTENSOR FOOT 1/2 EACH TENDON,1804.0,1172.6,1.1,9440.12,148
CDM,28210OH,RPR TENDON XTNSR FOOT SEC W/FREE GRAFT EA TENDON,2608.0,1695.2,1.1,20863.78,148
CDM,28220OH,TENOLYSIS FLEXOR FOOT SINGLE TENDON,1868.0,1214.2,1.1,4686.39,148
CDM,28222OH,TENOLYSIS FLEXOR FOOT MULTIPLE TENDONS,2304.0,1497.6,1.1,9440.12,148
CDM,28225OH,TENOLYSIS EXTENSOR FOOT SINGLE TENDON,1512.0,982.8,1.1,9440.12,148
CDM,28226OH,TENOLYSIS EXTENSOR FOOT MULTIPLE TENDON,1868.0,1214.2,1.1,9440.12,148
CDM,28230OH,TX OPN TENDON FLEXOR FOOT SINGLE/MULT TENDON SPX,1744.0,1133.6,1.1,4686.39,148
CDM,28232OH,TX OPEN TENDON FLEXOR TOE 1 TENDON SPX,1404.0,912.6,1.1,4686.39,148
CDM,28234OH,TENOTOMY OPEN EXTENSOR FOOT/TOE EACH TENDON,1416.0,920.4,1.1,4686.39,148
CDM,28238OH,RCNSTJ PST TIBL TDN W/EXC ACCESSORY TARSL NAVCLR,3184.0,2069.6,1.1,20863.78,148
CDM,28240OH,TENOTOMY LENGTHENING/RLS ABDUCTOR HALLUCIS MUSC,1792.0,1164.8,1.1,9440.12,148
CDM,28250OH,DIVISN PLANTAR FASCIA/MUSCLE,2424.0,1575.6,1.1,9440.12,148
CDM,28260OH,"CAPSULOTOMY MIDFOOT JT,MED RELEASE",3276.0,2129.4,1.1,9440.12,148
CDM,28261OH,"CAPSULOTOMY MIDFOOT,TENDN LENGTH",5244.0,3408.6,1.1,5244.0,148
CDM,28262OH,CAPSUL MIDFOOT W/PST TALOTIBL CAPSUL&TDN LNGTH,7572.0,4921.8,1.1,20863.78,148
CDM,28264OH,CAPSULOTOMY MIDTARSAL,4260.0,2769.0,1.1,4686.39,148
CDM,28270OH,CAPSUL MTTARPHLNGL JT W/WO TENORRHAPHY EA JT SPX,1972.0,1281.8,1.1,9440.12,148
CDM,28272OH,CAPSULOTOMY IPHAL JOINT EACH JOINT SPX,1568.0,1019.2,1.1,4686.39,148
CDM,28280OH,SYNDACTYLIZATION TOES,2132.0,1385.8,1.1,9440.12,148
CDM,28285OH,CORRECTION HAMMERTOE,2473.0,1607.45,1.1,9440.12,148
CDM,28286OH,CORRECTION COCK-UP 5TH TOE W/PLASTIC CLOSURE,1880.0,1222.0,1.1,9440.12,148
CDM,28288OH,OSTC PRTL EXOSTC/CONDYLC METAR HEAD,2408.0,1565.2,1.1,9440.12,148
CDM,28289OH,HALLUX RIGIDUS W/CHEILECTOMY 1ST MP JT W/O IMPLT,2760.0,1794.0,1.1,9440.12,148
CDM,28291OH,HALLUX RIGIDUS W/CHEILECTOMY 1ST MP JT W/IMPLT,3524.0,2290.6,1.1,20863.78,148
CDM,28292OH,CORRJ HLX VLGS BNCTY SESMDC RESCJ PROX PHLX BASE,2976.0,1934.4,1.1,9440.12,148
CDM,28295OH,CORRJ HLX VLGS BNCTY SESMDC PROX METAR OSTEOT,3428.0,2228.2,1.1,9440.12,148
CDM,28296OH,CORRJ HLX VLGS BNCTY SESMDC DSTL METAR OSTEOT,3300.0,2145.0,1.1,9440.12,148
CDM,28297OH,CORRJ HLX VLGS BNCTY SESMDC JOINT ARTHRODESIS,3716.0,2415.4,1.1,20863.78,148
CDM,28298OH,CORRJ HLX VLGS BNCTY SESMDC PROX PHLX OSTEOT,3100.0,2015.0,1.1,20863.78,148
CDM,28299OH,CORRJ HLX VLGS BNCTY SESMDC W/DOUBLE OSTEOTOMY,3716.0,2415.4,1.1,20863.78,148
CDM,28300OH,OSTEOTOMY CALCANEUS W/WO INTERNAL FIXATION,3892.0,2529.8,1.1,20863.78,144
CDM,28302OH,OSTEOTOMY TALUS,3896.0,2532.4,1.1,20863.78,144
CDM,28304OH,OSTEOTOMY TARSAL BONES OTH/THN CALCANEUS/TALUS,4140.0,2691.0,1.1,20863.78,148
CDM,28305OH,OSTEOT TARSAL OTH/THN CALCANEUS/TALUS W/AGRFT,4308.0,2800.2,1.1,20863.78,144
CDM,28306OH,OSTEOT W/WO LNGTH SHRT/CORRJ 1ST METAR,2400.0,1560.0,1.1,20863.78,148
CDM,28307OH,OSTEOT W/WO LNGTH SHRT/CORRJ METAR XCP 1ST TOE,2600.0,1690.0,1.1,20863.78,148
CDM,28308OH,OSTEOT W/WO LNGTH SHRT/CORRJ METAR XCP 1ST EA,2192.0,1424.8,1.1,9440.12,148
CDM,28309OH,OSTEOT W/WO LNGTH SHRT/ANGULAR CORRJ METAR MLT,5664.0,3681.6,1.1,20863.78,144
CDM,28310OH,OSTEOT SHRT CORRJ PROX PHALANX 1ST TOE,2228.0,1448.2,1.1,20863.78,148
CDM,28312OH,OSTEOT SHRT CORRJ OTH PHALANGES ANY TOE,1876.0,1219.4,1.1,9440.12,148
CDM,28313OH,RCNSTJ ANGULAR DFRM TOE SOFT TISS PX ONLY,2266.0,1472.9,1.1,9440.12,148
CDM,28315OH,SESAMOIDECTOMY FIRST TOE SPX,2000.0,1300.0,1.1,9440.12,148
CDM,28320OH,REPAIR NONUNION/MALUNION TARSAL BONES,3748.0,2436.2,1.1,38384.94,144
CDM,28322OH,RPR NON/MALUNION METARSAL W/WO BONE GRAFT,3412.0,2217.8,1.1,20863.78,148
CDM,28340OH,RCNSTJ TOE MACRODACTYLY SOFT TISSUE RESECTION,2860.0,1859.0,1.1,9440.12,148
CDM,28341OH,RCNSTJ TOE MACRODACTYLY REQUIRING BONE RESECTION,3488.0,2267.2,1.1,9440.12,148
CDM,28344OH,RECONSTRUCTION TOE POLYDACTYLY,1936.0,1258.4,1.1,9440.12,148
CDM,28345OH,RCNSTJ TOE SYNDACTYLY W/WO SKIN GRAFT EACH WEB,2436.0,1583.4,1.1,4686.39,148
CDM,28360OH,RECONSTRUCT CLEFT FOOT,5968.0,3879.2,1.1,20863.78,144
CDM,28400OH,CLOSED TX CALCANEAL FRACTURE W/O MANIPULATION,924.0,600.6,1.1,924.0,148
CDM,28405OH,CLOSED TX CALCANEAL FRACTURE W/MANIPULATION,1896.0,1232.4,1.1,1896.0,148
CDM,28406OH,PRQ SKELETAL FIXJ CALCANEAL FRACTURE W/MANJ,2624.0,1705.6,1.1,20863.78,144
CDM,28415OH,OPEN TREATMENT CALCANEAL FRACTURE,6476.0,4209.4,1.1,20863.78,144
CDM,28420OH,OPEN TREATMENT CALCANEAL FRACTURE W BONE GRAFT,7008.0,4555.2,1.1,38384.94,144
CDM,28430OH,CLOSED TX TALUS FRACTURE W/O MANIPULATION,888.0,577.2,1.1,888.0,148
CDM,28435OH,CLOSED TX TALUS FRACTURE W/MANIPULATION,1416.0,920.4,1.1,4686.39,148
CDM,28436OH,PRQ SKELETAL FIXATION TALUS FRACTURE W/MANJ,1960.0,1274.0,1.1,20863.78,144
CDM,28445OH,OPEN TREATMENT TALUS FRACTURE,6304.0,4097.6,1.1,20863.78,144
CDM,28446OH,OPEN OSTEOCHONDRAL AUTOGRAFT TALUS,7084.0,4604.6,1.1,20863.78,142
CDM,28450OH,TX TARSAL BONE FX XCP TALUS&CALCN W/O MANJ,893.0,580.45,1.1,893.0,148
CDM,28455OH,TX TARSAL BONE FX XCP TALUS&CALCN W/MANJ,1426.0,926.9,1.1,4686.39,148
CDM,28456OH,PRQ SKEL FIXJ TARSL FX XCP TALUS&CALCNS W/MANJ,1144.0,743.6,1.1,20863.78,144
CDM,28465OH,OPEN TX TARSAL FRACTURE XCP TALUS & CALCANEUS EA,3520.0,2288.0,1.1,20863.78,144
CDM,28470OH,CLOSED TX METATARSAL FRACTURE W/O MANIPULATION,893.0,580.45,1.1,893.0,148
CDM,28475OH,CLTX METAR FX W/MANJ,1204.0,782.6,1.1,1204.0,148
CDM,28476OH,PRQ SKEL FIXJ METAR FX W/MANJ,1440.0,936.0,1.1,9440.12,144
CDM,28485OH,OPEN TREATMENT METATARSAL FRACTURE EACH,2976.0,1934.4,1.1,20863.78,144
CDM,28490OH,CLTX FX GRT TOE PHLX/PHLG W/O MANJ,468.0,304.2,1.1,688.73,148
CDM,28495OH,CLTX FX GRT TOE PHLX/PHLG W/MANJ,672.0,436.8,1.1,688.73,148
CDM,28496OH,PRQ SKEL FIXJ FX GRT TOE PHLX/PHLG W/MANJ,992.0,644.8,1.1,9440.12,148
CDM,28505OH,OPEN TX FRACTURE GREAT TOE/PHALANX/PHALANGES,2976.0,1934.4,1.1,9440.12,148
CDM,28510OH,CLTX FX PHLX/PHLG OTH/THN GRT TOE W/O MANJ,468.0,304.2,1.1,688.73,148
CDM,28515OH,CLTX FX PHLX/PHLG OTH/THN GRT TOE W/MANJ,624.0,405.6,1.1,688.73,148
CDM,28525OH,OPEN TX FRACTURE PHALANX/PHALANGES NOT GREAT TOE,2248.0,1461.2,1.1,9440.12,148
CDM,28530OH,CLOSED TREATMENT SESAMOID FRACTURE,444.0,288.6,1.1,688.73,148
CDM,28531OH,OPEN TX SESAMOID FRACTURE W/WO INTERNAL FIXATION,1028.0,668.2,1.1,20863.78,148
CDM,28540OH,CLTX TARSAL DISLC OTH/THN TALOTARSAL W/O ANES,876.0,569.4,1.1,876.0,148
CDM,28545OH,CLTX TARSAL DISLC OTH/THN TALOTARSAL W/ANES,1040.0,676.0,1.1,9440.12,148
CDM,28546OH,PRQ SKEL FIXJ TARSL DISLC XCP TALOTARSAL W/MANJ,1360.0,884.0,1.1,4686.39,148
CDM,28555OH,OPEN TREATMENT TARSAL BONE DISLOCATION,3860.0,2509.0,1.1,20863.78,148
CDM,28570OH,CLOSED TX TALOTARSAL JOINT DISLC W/O ANES,704.0,457.6,1.1,813.78,148
CDM,28575OH,CLOSED TX TALOTARSAL JOINT DISLOCATION W/ANES,1396.0,907.4,1.1,9440.12,148
CDM,28576OH,PRQ SKEL FIXJ TALOTARSAL JT DISLC W/MANJ,1840.0,1196.0,1.1,20863.78,144
CDM,28585OH,OPEN TREATMENT TALOTARSAL JOINT DISLOCATION,4452.0,2893.8,1.1,20863.78,148
CDM,28600OH,CLOSED TX TARSOMETATARSAL DISLOCATION W/O ANES,808.0,525.2,1.1,808.0,148
CDM,28605OH,CLOSED TX TARSOMETATARSAL DISLOCATION W/ANES,1156.0,751.4,1.1,1187.06,148
CDM,28606OH,PRQ SKEL FIXJ TARS JT DISLC W/MANJ,2036.0,1323.4,1.1,9440.12,144
CDM,28615OH,OPEN TREATMENT TARSOMETATARSAL JOINT DISLOCATION,4280.0,2782.0,1.1,20863.78,144
CDM,28630OH,CLTX METATARSOPHLNGL JT DISLC W/O ANES,700.0,455.0,1.1,700.0,146
CDM,28635OH,CLTX METATARSOPHLNGL JT DISLC REQ ANES,784.0,509.6,1.1,4686.39,148
CDM,28636OH,PRQ SKEL FIXJ METATARSOPHLNGL JT DISLC W/MANJ,1108.0,720.2,1.1,9440.12,148
CDM,28645OH,OPEN TX METATARSOPHALANGEAL JOINT DISLOCATION,2976.0,1934.4,1.1,9440.12,148
CDM,28660OH,CLTX INTERPHALANGEAL JOINT DISLOCATION W/O ANES,512.0,332.8,1.1,688.73,146
CDM,28665OH,CLTX INTERPHALANGEAL JOINT DISLOCATION REQ ANES,788.0,512.2,1.1,788.0,148
CDM,28666OH,PRQ SKEL FIXJ INTERPHALANGEAL JOINT DISLC W/MANJ,1064.0,691.6,1.1,9440.12,144
CDM,28675OH,OPEN TREATMENT INTERPHALANGEAL JOINT DISLOCATION,2248.0,1461.2,1.1,9440.12,148
CDM,28705OH,ARTHRODESIS PANTALAR,8132.0,5285.8,1.1,54351.12,144
CDM,28715OH,ARTHRODESIS TRIPLE,5368.0,3489.2,1.1,38384.94,144
CDM,28725OH,ARTHRODESIS SUBTALAR,4488.0,2917.2,1.1,38384.94,144
CDM,28730OH,ARTHRD MIDTARSL/TARSOMETATARSAL MULT/TRANSVRS,4280.0,2782.0,1.1,38384.94,144
CDM,28735OH,ARTHRD MIDTARSL/TARS MLT/TRANSVRS W/OSTEOT,4892.0,3179.8,1.1,38384.94,144
CDM,28737OH,ARTHRD W/TDN LNGTH&ADVMNT TARSL NVCLR-CUNEIFOR,4412.0,2867.8,1.1,38384.94,144
CDM,28740OH,ARTHRODESIS MIDTARSOMETATARSAL SINGLE JOINT,3716.0,2415.4,1.1,20863.78,148
CDM,28750OH,ARTHRODESIS GREAT TOE METATARSOPHALANGEAL JOINT,3428.0,2228.2,1.1,20863.78,148
CDM,28755OH,ARTHRODESIS GREAT TOE INTERPHALANGEAL JOINT,1952.0,1268.8,1.1,20863.78,148
CDM,28760OH,ARTHRD W/XTNSR HALLUCIS LONGUS TR 1ST METAR NCK,3656.0,2376.4,1.1,20863.78,148
CDM,28800OH,"AMPUTATION FOOT,MIDTARSAL-CHOPART",3516.0,2285.4,1.1,3516.0,144
CDM,28805OH,"AMPUTATION FOOT,TRANSMETATARSAL",5084.0,3304.6,1.1,9440.12,144
CDM,28810OH,"AMPUTATION METATARSAL+TOE,SINGLE",2656.0,1726.4,1.1,9440.12,144
CDM,28820OH,AMPUTATION TOE METATARSOPHALANGEAL JOINT,1544.0,1003.6,1.1,9440.12,148
CDM,28825OH,AMPUTATION TOE INTERPHALANGEAL JOINT,1500.0,975.0,1.1,9440.12,148
CDM,28890OH,ESWT HI NRG PHYS/QHP W/US GDN INVG PLNTAR FASCIA,1380.0,897.0,1.1,4686.39,148
CDM,28899AOH,"ARTHROPLASTY, INTERPOSITION, INTERTARSAL OR TAROMETATARSAL JOINT",3676.0,2389.4,0.01,3676.0,84
CDM,28899OH,FOOT/TOES SURGERY PROC UNLISTED,1870.0,1215.5,0.01,1870.0,84
CDM,28899RVU10OH,"UNLISTED PROCEDURE, FOOT OR TOES  (COMPARISON CODE 27415)",733.0,476.45,0.01,733.0,84
CDM,28899RVU12OH,TALUS DECOMPRESSION W/DRILLING (COMP CODE 28005),4059.0,2638.35,0.01,4059.0,84
CDM,28899RVU13OH,BIOPSY SOFT TISSUE FOOT (COMP 27613),733.0,476.45,0.01,733.0,84
CDM,28899RVU14OH,INTERPOSITION ARTHROPLASTY; FOOT (COMP 28750),2828.0,1838.2,0.01,2828.0,84
CDM,28899RVU16OH,"CORE NEEDLE BIOPSY, FOOT (COMP 10021)",327.0,212.55,0.01,688.73,84
CDM,28899RVU19OH,COMPLETE REMOVAL OF TARSAL BONE (COMP CODE 28130),4085.0,2655.25,0.01,4085.0,84
CDM,28899RVU20OH,ARTHRODESIS INTERPHALANGEAL JOINT LESSER TOE (COMP CODE 28285),2414.0,1569.1,0.01,2414.0,84
CDM,28899RVU21OH,SUBTALAR JOINT?ARTHROEREISIS (COMP CODE 28725),4040.0,2626.0,0.01,4040.0,84
CDM,28899RVU22OH,PERINEURAL TARSAL TUNNEL INJECTION (COMP CODE 64450),330.0,214.5,0.01,688.73,84
CDM,28899RVU6OH,REPAIR LIGAMENT FOOT (COMP CODE 27695),2413.0,1568.45,0.01,2413.0,84
CDM,28899RVU9OH,UNLISTED PLANTAR PLATE REPAIR 2ND METATARSOPHALANGEAL JOINT OF L,1700.0,1105.0,0.01,1700.0,84
CDM,28899TTIOH,TARSAL TUNNEL INJECTION,310.0,201.5,0.01,688.73,84
CDM,29000040,SUPPLIES DRUG INFSN PUMP/CASS,69.75,45.34,15.21,69.75,66
CDM,29000050,OSTOMY/CATH ADHESIVE,10.5,6.83,2.29,19.65,66
CDM,29000055,STOMAHESIVE PAST-CONVATEC,6.7,4.36,1.46,19.65,72
CDM,29000055_IP,STOMAHESIVE PAST-CONVATEC,6.7,4.36,2.44,2.44,1
CDM,29000055_OP,STOMAHESIVE PAST-CONVATEC,6.7,4.36,2.0,2.0,1
CDM,29000065,MEFIX TAPE-MOLNYCKE,8.91,5.79,1.94,19.65,66
CDM,29000070,PINK TAPE-PERMATYPE,3.24,2.11,0.71,19.65,66
CDM,29000080,SPLINT,32.0,20.8,6.98,32.0,66
CDM,29000090,TRANSTRACHEAL O2 CATHETER EACH,207.54,134.9,31.69,207.54,66
CDM,29000095,"PEAK EXPIRE FLOW MTR,HAND HELD",38.0,24.7,8.28,38.0,66
CDM,29000100,SCOOP CATHETER O2 PER FOOT,38.24,24.86,8.34,38.24,66
CDM,29000110,SPACER BAG/RESERVOIR,48.0,31.2,10.46,48.0,66
CDM,29000120,NU-HOPE CATHETER HOLDER,14.0,9.1,3.05,14.0,67
CDM,29000130,DIABETES CUSTOM MOLDED SHOE,296.0,192.4,64.53,406.89,66
CDM,29000155,MULTI DEN INSERT DIRECT FORM,48.0,31.2,10.46,48.0,66
CDM,29000165,HOLLISTER DRAIN COLL #9773(SM),17.43,11.33,3.8,17.43,66
CDM,29000170,MESALT DRESSING (1),2.5,1.63,0.55,19.65,66
CDM,29000175,DUODERM 4X4 EXTRA THIN,11.0,7.15,2.4,19.65,66
CDM,29000180,UNNA BOOT,46.0,29.9,10.03,46.0,66
CDM,29000190,TRACH TUBE NEONATE 3.0MM,90.0,58.5,19.62,90.0,66
CDM,29000200,BIVONA STOMA STENT,94.5,61.43,20.6,94.5,66
CDM,29000205,SOFT PROTECT HELMET PREFAB,385.0,250.25,58.52,385.0,66
CDM,29000220,HARD PROTECT HELMET CUSTOM,1376.0,894.4,16.97,1376.0,66
CDM,29000230,PADS MET U HAPAD,9.0,5.85,1.96,19.65,67
CDM,29000235,ROPE & PULLEY SET,15.5,10.08,3.38,19.65,66
CDM,29000295,ORAL DEVICE/APLIAN CUSFAB,4000.0,2600.0,333.06,4000.0,66
CDM,29000315,SEG PNEUMATIC APPL FULL ARM,108.0,70.2,23.54,980.32,66
CDM,29000325,PNEUMATIC COMPRESSION DEVICE,105.0,68.25,22.89,980.32,66
CDM,29000345,DELUXE HOME TRACTION KIT,631.0,410.15,137.56,631.0,66
CDM,29000370,LIMITED ANKLE MOTION,59.15,38.45,12.89,59.15,66
CDM,29000375,HEEL PAD,38.0,24.7,8.28,38.0,66
CDM,29000380,"ORTHOPEDIC SHOE MODIFY, NOS",83.0,53.95,16.97,83.0,66
CDM,29000385,"REPAIR/REPLACE MINOR PARTS, OR",100.0,65.0,16.97,100.0,66
CDM,29000435,"WALKER,ADJUSTABLE FOLDING",82.0,53.3,17.88,82.0,66
CDM,29000495,TRACH TUBE NEONATE 3.0MM,327.0,212.55,71.29,327.0,58
CDM,29000505,WOUND MANAGER (MED),43.79,28.46,9.55,43.79,66
CDM,29000515,WOUND MANAGER (LG),37.17,24.16,8.1,37.17,66
CDM,29000525,TRUVUE HEEL PROTECTOR,164.0,106.6,16.97,164.0,66
CDM,29000555,CRUTCHES ARM GRIP/PAD EACH,52.27,33.98,11.39,52.27,66
CDM,29000795,ORAL DEV WITHOUT FIX MECH,3000.0,1950.0,333.06,3000.0,66
CDM,29000OH,APPLICATION HALO TYPE BODY CAST,900.0,585.0,1.1,1212.57,148
CDM,29010OH,APPLICATION RISSER JACKET LOCALIZER BODY ONLY,824.0,535.6,1.1,934.35,148
CDM,29046OH,"APPLY BODY CAST,SHLDR-HIP+2 THIGHS",964.0,626.6,1.1,1076.27,148
CDM,29055OH,"APPLY SHOULDER CAST,SPICA",712.0,462.8,1.1,783.62,148
CDM,29065OH,APPLICATION CAST SHOULDER HAND LONG ARM,348.0,226.2,1.1,783.62,148
CDM,29075OH,APPLICATION CAST ELBOW FINGER SHORT ARM,308.0,200.2,1.1,783.62,148
CDM,29085OH,APPLICATION CAST HAND & LOWER FOREARM GAUNTLET,348.0,226.2,1.1,459.15,148
CDM,29086OH,APPLICATION FINGER CAST,248.0,161.2,1.1,459.15,146
CDM,29105OH,APPLICATION LONG ARM SPLINT SHOULDER HAND,320.0,208.0,1.1,459.15,148
CDM,29125OH,APPLICATION SHORT ARM SPLINT FOREARM-HAND STATIC,220.0,143.0,1.1,373.44,148
CDM,29126OH,"APPLY FOREARM SPLINT,DYNAMIC",299.0,194.35,1.1,373.44,148
CDM,29130OH,APPLICATION FINGER SPLINT STATIC,220.0,143.0,1.1,373.44,148
CDM,29131OH,"APPLY FINGER SPLINT,DYNAMIC",242.0,157.3,1.1,242.0,148
CDM,29240OH,STRAPPING SHOULDER,172.0,111.8,1.1,373.44,148
CDM,29260OH,STRAPPING ELBOW OR WRIST,172.0,111.8,1.1,177.54,148
CDM,29280OH,STRAPPING HAND OR FINGER,172.0,111.8,1.1,177.54,146
CDM,29305OH,APPLICATION HIP SPICA CAST 1 LEG,812.0,527.8,1.1,847.3,148
CDM,29325OH,APPL HIP SPICA CAST ONE&ONE-HALF SPICA/BOTH LEGS,928.0,603.2,1.1,935.63,148
CDM,29345OH,APPLICATION LONG LEG CAST THIGH-TOE,560.0,364.0,1.1,783.62,148
CDM,29355OH,APPLICATION LONG LEG CAST WALKER/AMBULATORY TYPE,612.0,397.8,1.1,783.62,148
CDM,29358OH,APPLICATION LONG LEG CAST BRACE,572.0,371.8,1.1,783.62,148
CDM,29365OH,APPLICATION CYLINDER CAST THIGH ANKLE,472.0,306.8,1.1,783.62,148
CDM,29405OH,APPLICATION SHORT LEG CAST BELOW KNEE-TOE,320.0,208.0,1.1,783.62,148
CDM,29425OH,APPLICATION SHORT LEG CAST WALKING/AMBULATORY,320.0,208.0,1.1,783.62,148
CDM,29435OH,APPLICATION PATELLAR TENDON BEARING CAST,472.0,306.8,1.1,783.62,148
CDM,29445OH,APPLICATION RIGID TOTAL CONTACT LEG CAST,712.0,462.8,1.1,783.62,148
CDM,29450OH,APPL CLUBFOOT CAST MOLDING/MANJ LONG/SHORT LEG,915.0,594.75,1.1,915.0,148
CDM,29505OH,APPLICATION LONG LEG SPLINT THIGH ANKLE/TOES,304.0,197.6,1.1,459.15,148
CDM,29515OH,APPLICATION SHORT LEG SPLINT CALF FOOT,321.0,208.65,1.1,459.15,148
CDM,29530OH,STRAPPING KNEE,172.0,111.8,1.1,373.44,148
CDM,29540OH,STRAPPING ANKLE &/FOOT,172.0,111.8,1.1,459.15,148
CDM,29550OH,STRAPPING OF TOES,110.0,71.5,1.1,177.54,148
CDM,29580OH,STRAPPING UNNA BOOT,242.0,157.3,1.1,459.15,148
CDM,29581OH,APPL MLTLAYR COMPRES LEG BELOW KNEE W/ANKLE FOOT,264.0,171.6,1.1,459.15,148
CDM,29584OH,APPL MLTLAYR COMPRES SYS UPARM LWARM HAND&FINGER,140.0,91.0,1.1,459.15,148
CDM,29700OH,REMOVAL/BIVALVING GAUNTLET BOOT/BODY CAST,228.0,148.2,1.1,783.62,146
CDM,29705OH,REMOVAL/BIVALVING FULL ARM/FULL LEG CAST,304.0,197.6,1.1,783.62,146
CDM,29710OH,RMVL/BIVALV SHO/HIP SPICA MINERVA/RISSER JACKET,536.0,348.4,1.1,783.62,146
CDM,29740OH,WEDGING CAST EXCEPT CLUBFOOT CASTS,448.0,291.2,1.1,783.62,146
CDM,29799OH,UNLISTED PROCEDURE CASTING/STRAPPING,229.0,148.85,0.01,459.15,84
CDM,29800OH,ARTHRS TEMPOROMANDIBULR JT DX W/WO SYNVAL BX SPX,2736.0,1778.4,1.1,9440.12,144
CDM,29804OH,ARTHROSCOPY TEMPOROMANDIBULAR JOINT SURGICAL,3548.0,2306.2,1.1,9440.12,144
CDM,29805OH,DIAGNOSTIC ARTHROSCOPY SHOULDER +- SYNOVIAL BX,2412.0,1567.8,1.1,9440.12,144
CDM,29806OH,SURGICAL ARTHROSCOPY SHOULDER CAPSULORRHAPHY,6056.0,3936.4,1.1,20863.78,144
CDM,29807OH,SURGICAL ARTHROSCOPY SHOULDER REPAIR SLAP LESION,5868.0,3814.2,1.1,20863.78,144
CDM,29819OH,SURGICAL ARTHROSCOPY SHOULDER REMOVAL LOOSE/FB,3116.0,2025.4,1.1,9440.12,144
CDM,29820OH,SURGICAL ARTHROSCOPY SHOULDER PRTL SYNOVECTOMY,2884.0,1874.6,1.1,20863.78,144
CDM,29821OH,SURGICAL ARTHROSCOPY SHOULDER COMPL SYNOVECTOMY,3156.0,2051.4,1.1,9440.12,144
CDM,29822OH,SURGICAL ARTHROSCOPY SHOULDER LMTD DBRDMT 1/2,3093.0,2010.45,1.1,9440.12,144
CDM,29823OH,SURGICAL ARTHROSCOPY SHOULDER XTNSV DBRDMT 3+,3511.0,2282.15,1.1,9440.12,144
CDM,29824OH,SURGICAL ARTHROSCOPY SHOULDER DSTL CLAVICULC,3592.0,2334.8,1.1,9440.12,144
CDM,29825OH,SURGICAL ARTHROSCOPY SHOULDER W/LSS&RESCJ ADS,3116.0,2025.4,1.1,9440.12,144
CDM,29826OH,SURGICAL ARTHROSCOPY SHO W/CORACOACRM LIGM RLS,1320.0,858.0,1.1,1320.0,144
CDM,29827OH,SURGICAL ARTHROSCOPY SHOULDER W/ROTATOR CUFF RPR,6236.0,4053.4,1.1,20863.78,144
CDM,29828OH,SURGICAL ARTHROSCOPY SHOULDER BICEPS TENODESIS,5790.0,3763.5,1.1,20863.78,144
CDM,29830OH,ARTHROSCOPY ELBOW DIAG W/WO SYNOVIAL BIOPSY SPX,2352.0,1528.8,1.1,9440.12,144
CDM,29834OH,ARTHROSCOPY ELBOW SURGICAL W/REMOVAL LOOSE/FB,2568.0,1669.2,1.1,9440.12,144
CDM,29835OH,ARTHROSCOPY ELBOW SURGICAL SYNOVECTOMY PARTIAL,2648.0,1721.2,1.1,9440.12,144
CDM,29836OH,ARTHROSCOPY ELBOW SURGICAL SYNOVECTOMY COMPLETE,3088.0,2007.2,1.1,20863.78,144
CDM,29837OH,ARTHROSCOPY ELBOW SURGICAL DEBRIDEMENT LIMITED,2804.0,1822.6,1.1,9440.12,144
CDM,29838OH,ARTHROSCOPY ELBOW SURGICAL DEBRIDEMENT EXTENSIVE,3152.0,2048.8,1.1,9440.12,144
CDM,29840OH,ARTHROSCOPY WRIST DIAG W/WO SYNOVIAL BIOPSY SPX,2272.0,1476.8,1.1,9440.12,144
CDM,29843OH,ARTHROSCOPY WRIST INFECTION LAVAGE&DRAINAGE,2460.0,1599.0,1.1,9440.12,144
CDM,29844OH,ARTHROSCOPY WRIST SURGICAL SYNOVECTOMY PARTIAL,2604.0,1692.6,1.1,9440.12,144
CDM,29845OH,ARTHROSCOPY WRIST SURGICAL SYNOVECTOMY COMPLETE,3076.0,1999.4,1.1,9440.12,144
CDM,29846OH,ARTHRS WRST EXC&/RPR TRIANG FIBROCART&/JOINT,2756.0,1791.4,1.1,9440.12,144
CDM,29847OH,ARTHROSCOPY WRIST SURG INT FIXJ FX/INSTABILITY,2888.0,1877.2,1.1,20863.78,144
CDM,29848OH,NDSC WRST SURG W/RLS TRANSVRS CARPL LIGM,2556.0,1661.4,1.1,4686.39,144
CDM,29850OH,ARTHROSCOPY AID TX SPINE&/FX KNEE W/O FIXJ,3308.0,2150.2,1.1,4686.39,144
CDM,29851OH,ARTHROSCOPY AID TX SPINE&/FX KNEE W/FIXJ,5304.0,3447.6,1.1,5304.0,144
CDM,29855OH,ARTHRS AID TIBIAL FRACTURE PROXIMAL UNICONDYLAR,4304.0,2797.6,1.1,20863.78,144
CDM,29856OH,ARTHRS AID TIBIAL FX PROX UNICONDYLAR BICONDYLAR,5712.0,3712.8,1.1,38384.94,144
CDM,29860OH,ARTHROSCOPY HIP DIAGNOSTIC W/WO SYNOVIAL BYP SPX,3600.0,2340.0,1.1,20863.78,144
CDM,29861OH,ARTHROSCOPY HIP SURGICAL W/REMOVAL LOOSE/FB,4040.0,2626.0,1.1,20863.78,144
CDM,29862OH,ARTHRS HIP DEBRIDEMENT/SHAVING ARTICULAR CRTLG,4468.0,2904.2,1.1,20863.78,144
CDM,29863OH,ARTHROSCOPY HIP SURGICAL W/SYNOVECTOMY,4915.0,3194.75,1.1,9440.12,144
CDM,29866OH,ARTHROSCOPY KNEE OSTEOCHONDRAL AGRFT MOSAICPLAST,5868.0,3814.2,1.1,20863.78,144
CDM,29867OH,ARTHROSCOPY KNEE OSTEOCHONDRAL ALLOGRAFT,7356.0,4781.4,1.1,38384.94,144
CDM,29868OH,ARTHROSCOPY KNEE MENISCAL TRNSPLJ MED/LAT,10040.0,6526.0,1.1,20863.78,144
CDM,2987052OH,DX KNEE ARTHROSCOPY MI EYE,2284.0,1484.6,1.1,2284.0,70
CDM,29870OH,ARTHROSCOPY KNEE DIAGNOSTIC W/WO SYNOVIAL BX SPX,2284.0,1484.6,1.1,9440.12,148
CDM,29871OH,ARTHROSCOPY KNEE INFECTION LAVAGE & DRAINAGE,2944.0,1913.6,1.1,9440.12,144
CDM,29873OH,ARTHRS KNEE W LAT RELEASE,2746.0,1784.9,1.1,9440.12,144
CDM,29874OH,ARTHROSCOPY KNEE REMOVAL LOOSE/FOREIGN BODY,3164.0,2056.6,1.1,9440.12,144
CDM,29875OH,ARTHROSCOPY KNEE SYNOVECTOMY LIMITED SPX,2838.0,1844.7,1.1,9440.12,144
CDM,29876OH,ARTHROSCOPY KNEE SYNOVECTOMY 2/>COMPARTMENTS,3548.0,2306.2,1.1,9440.12,144
CDM,29877OH,ARTHRS KNEE DEBRIDEMENT/SHAVING ARTCLR CRTLG,3652.0,2373.8,1.1,9440.12,144
CDM,29879OH,ARTHRS KNEE ABRASION ARTHRP/MLT DRLG/MICROFX,3596.0,2337.4,1.1,9440.12,144
CDM,29880OH,ARTHRS KNEE W/MENISCECTOMY MED&LAT W/SHAVING,3252.0,2113.8,1.1,9440.12,144
CDM,29881OH,ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG,3093.0,2010.45,1.1,9440.12,144
CDM,29882OH,ARTHROSCOPY KNEE W/MENISCUS RPR MEDIAL/LATERAL,4224.0,2745.6,1.1,9440.12,144
CDM,29883OH,ARTHROSCOPY KNEE W/MENISCUS RPR MEDIAL&LATERAL,4708.0,3060.2,1.1,9440.12,144
CDM,29884OH,ARTHROSCOPY KNEE W/LYSIS ADHESIONS W/WO MANJ SPX,3312.0,2152.8,1.1,9440.12,144
CDM,29885OH,ARTHRS KNEE DRILL OSTEOCHONDRITIS DISSECANS GRFG,4084.0,2654.6,1.1,20863.78,144
CDM,29886OH,ARTHRS KNEE DRILLING OSTEOCHOND DISSECANS LESION,3736.0,2428.4,1.1,9440.12,144
CDM,29887OH,ARTHRS KNEE DRLG OSTEOCHOND DISSECANS INT FIXJ,4064.0,2641.6,1.1,20863.78,144
CDM,29888OH,ARTHRS AIDED ANT CRUCIATE LIGM RPR/AGMNTJ/RCNSTJ,6292.0,4089.8,1.1,20863.78,144
CDM,29889OH,ARTHRS AIDED PST CRUCIATE LIGM RPR/AGMNTJ/RCNSTJ,6964.0,4526.6,1.1,38384.94,144
CDM,29891OH,ARTHRS ANKLE EXC OSTCHNDRL DFCT W/DRLG DFCT,3868.0,2514.2,1.1,9440.12,144
CDM,29892OH,ARTHRS AID RPR LES/TALAR DOME FX/TIBL PLAFOND FX,4108.0,2670.2,1.1,20863.78,144
CDM,29893OH,ENDOSCOPIC PLANTAR FASCIOTOMY,2528.0,1643.2,1.1,9440.12,148
CDM,29894OH,ARTHROSCOPY ANKLE W/REMOVAL LOOSE/FOREIGN BODY,2940.0,1911.0,1.1,9440.12,144
CDM,29895OH,ARTHROSCOPY ANKLE SURGICAL SYNOVECTOMY PARTIAL,2852.0,1853.8,1.1,9440.12,144
CDM,29897OH,ARTHROSCOPY ANKLE SURGICAL DEBRIDEMENT LIMITED,2928.0,1903.2,1.1,9440.12,144
CDM,29898OH,ARTHROSCOPY ANKLE SURGICAL DEBRIDEMENT EXTENSIVE,3736.0,2428.4,1.1,9440.12,144
CDM,29899OH,ARTHRS ANKLE W ARTHRODESIS,6164.0,4006.6,1.1,20863.78,144
CDM,29905OH,ARTHROSCOPY SUBTALAR JOINT WITH SYNOVECTOMY,3672.0,2386.8,1.1,20863.78,144
CDM,29906OH,ARTHROSCOPY SUBTALAR JOINT WITH DEBRIDEMENT,3860.0,2509.0,1.1,9440.12,144
CDM,29907OH,ARTHROSCOPY SUBTALAR JOINT SUBTALAR ARTHRODESIS,4872.0,3166.8,1.1,38384.94,144
CDM,29914OH,ARTHROSCOPY HIP W/FEMOROPLASTY,6455.0,4195.75,1.1,20863.78,144
CDM,29915OH,ARTHROSCOPY HIP W/ACETABULOPLASTY,6000.0,3900.0,1.1,20863.78,144
CDM,29916OH,ARTHROSCOPY HIP W/LABRAL REPAIR,6000.0,3900.0,1.1,20863.78,144
CDM,299999RVU10OH,ARTHROSCOPIC ILIOPSOAS RELEASE (COMP 27036),4745.0,3084.25,0.01,4745.0,84
CDM,29999RVU10OH,EXCISE GANGLION KNEE; SCOPE,2221.0,1443.65,0.01,2221.0,84
CDM,29999RVU11OH,ARTHROSCOPIC GLUTEUS MEDIUS REPAIR,2600.0,1690.0,0.01,2600.0,84
CDM,29999RVU12OH,ARTHR EXC CYCLOP KNEE,4000.0,2600.0,0.01,4000.0,84
CDM,29999RVU13OH,ILIOPSOAS TENDON RELEASE; SCOPE (COMP 27306),2356.0,1531.4,0.01,2356.0,84
CDM,29999RVU14OH,ARTHROSCOPY;PARTIAL REMVAL SCAPULA,1711.0,1112.15,0.01,1711.0,84
CDM,29999RVU15OH,ARTHROSCOPIC REMOVAL GLENOID COMPONENT,2816.0,1830.4,0.01,2816.0,84
CDM,29999RVU16OH,"KNEE DEBRIDEMENT TENDON/MUSCLE, SCOPE",4151.0,2698.15,0.01,4151.0,84
CDM,29999RVU1OH,DEBRIDE LIGAMENTUM TERES; SCOPE,1940.0,1261.0,0.01,1940.0,84
CDM,29999RVU25OH,ARTHROSCOPIC SUPERIOR CAPSULAR RECONSTRUCTION (COMP 29827),5145.0,3344.25,0.01,5145.0,84
CDM,29999RVU26OH,ARTHROSCOPIC TROCHANTERIC BURSECTOMY,1898.0,1233.7,0.01,1898.0,84
CDM,29999RVU27OH,ARTHROSCOPIC TROCHANTERIC BURSECTOMY (COMP CODE 27062),1898.0,1233.7,0.01,1898.0,84
CDM,29999RVU28OH,"UNLISTED PROC, ARTHROSCOPIC ULNAR WAFER PROC (REMOVING APPROX 2M",1752.0,1138.8,0.01,1752.0,84
CDM,29999RVU2OH,ARTHROSCOPY KNEE SUBCHONDROPLAST,4193.0,2725.45,0.01,4193.0,84
CDM,29999RVU31OH,ARTHROSCOPIC REPAIR GREATER TUBEROSITY FRACTURE (COMP TO 29827),5145.0,3344.25,0.01,5145.0,84
CDM,29999RVU37OH,TENOTOMY OF HIP FLEXORS (COMP CODE 27005),4330.0,2814.5,0.01,4330.0,84
CDM,29999RVU38OH,ARTHROSCOPY SHOULDER - BALLOON SPACER IMPLANTATION (COMP CODE 29,3432.0,2230.8,0.01,3432.0,84
CDM,29999RVU39OH,ARTHROSCOPIC REMOVAL OF IMPLANT (COMP CODE 20680),2622.0,1704.3,0.01,2622.0,84
CDM,29999RVU3OH,ARTHRO REMOVAL CALC DEPOS,5591.0,3634.15,0.01,5591.0,84
CDM,29999RVU40OH,ARTHROSCOPIC TENOTOMY (COMP CODE 23405),3416.0,2220.4,0.01,3416.0,84
CDM,29999RVU41OH,ARTHROSCOPIC AC JOINT RECONSTRUCTION (COMP CODE 23462),6288.0,4087.2,0.01,6288.0,84
CDM,29999RVU42OH,ENDOSCOPIC ILIOPSOAS TENDON RELEASE (COMP CODE 29862),4468.0,2904.2,0.01,4468.0,84
CDM,29999RVU43OH,ARTHROSCOPIC EXCISION OF MENISCAL CYST OF THE KNEE (COMP CODE 29,2838.0,1844.7,0.01,2838.0,84
CDM,29999RVU44OH,ARTHROSCOPICALLY AIDED CARPAL DECOMPRESSION/BONE DRILLING (COMP,3060.0,1989.0,0.01,3060.0,84
CDM,29999RVU45OH,ARTHROSCOPIC CORACOPLASTY SHOULDER (COMP CODE 23182),3444.0,2238.6,0.01,3444.0,84
CDM,29999RVU46OH,ARTHROSCOPIC BONE EXCISION WITH GRAFTING (COMP CODE 27360),4584.0,2979.6,0.01,4584.0,84
CDM,29999RVU4OH,ARTHROSCOPY;RELEASE BICEPS TENDONS,2256.0,1466.4,0.01,2256.0,84
CDM,29999RVU5OH,SCOPE HETEROTOPIC OSSIFI EXCISION,4089.0,2657.85,0.01,4089.0,84
CDM,29999RVU6OH,GLENOID FX ; INTERNAL FIXATION SCOPE,4696.0,3052.4,0.01,4696.0,84
CDM,29999RVU7OH,ARTHROSCOPIC MCL RECONSTRUCTION,4821.0,3133.65,0.01,4821.0,84
CDM,29999RVU8OH,ARTHROSCOPIC REMPLISSAGE REPAIR (COMP CODE 29827),5613.0,3648.45,0.01,5613.0,84
CDM,29999RVU9OH,ARTHROSCOPY KNEE MEDIAL RELEASE,3132.0,2035.8,0.01,3132.0,84
CDM,29999RVUOH,ARTHROSCOPIC DENERVATION,927.0,602.55,0.01,927.0,84
CDM,30000015,AV BILL FREEZE CASA,59.0,38.35,4.25,60.05,83
CDM,30000055,COLL CAP BLOOD SPECIMEN,48.0,31.2,2.64,48.0,66
CDM,30000065,COLL BLOOD OFF PICC VENOUS,741.0,481.65,35.72,741.0,86
CDM,30000075,%AMITRIPTYLINE,742.0,482.3,34.82,742.0,84
CDM,30000085,CARBAMAZEPINE FREE,91.0,59.15,6.54,91.0,84
CDM,30000095,%DESIPRAMINE PL,164.0,106.6,34.82,257.48,84
CDM,30000105,%IMIPRAMINE PL,147.0,95.55,34.82,257.48,84
CDM,30000115,%NORTRIPTYLINE,742.0,482.3,34.82,742.0,84
CDM,30000125,TOPIRAMATE,82.0,53.3,5.89,82.0,84
CDM,30000135,VANCOMYCIN,93.0,60.45,6.69,93.0,84
CDM,30000145,%ACTH STIMULATION PANEL,225.0,146.25,16.11,225.0,84
CDM,30000155,ACTH STIM PANEL/21OH ASE,600.0,390.0,27.68,600.0,84
CDM,30000165,ALDOSTERONE SUPPRESSION,866.0,562.9,27.68,866.0,84
CDM,30000185,GNRH STIMULATION,1024.0,665.6,73.29,1024.0,84
CDM,30000195,GROWTH HORMONE STIM,460.0,299.0,27.68,460.0,84
CDM,30000235,PREGNANCY TEST URINE (POINT OF CARE LAB),59.0,38.35,6.37,59.0,84
CDM,30000255,HEMOCULT FECES SCREEN (POINT OF CARE LAB),30.0,19.5,4.31,30.0,84
CDM,30000265,OCCULT BLOOD FECES 1-3 TEST,29.0,18.85,4.23,29.0,84
CDM,30000275,REACTIVE OXYGEN SPECIES,97.0,63.05,6.97,104.92,84
CDM,30000295,BLOOD GAS W CALC O2 SATUR (POINT OF CARE LAB),180.0,117.0,10.43,180.0,84
CDM,30000305,BLOOD GAS PH/PO2/PCO2 W SATUR,544.0,353.6,31.51,544.0,84
CDM,30000315,ADMIN DRUG H PYLORI (POINT OF CARE LAB),54.0,35.1,7.86,60.56,84
CDM,30000335,HCG TEST QUAL,52.0,33.8,7.52,52.0,84
CDM,30000340,"ALPHA-1-ANTITRYPSIN,STOOL",93.0,60.45,6.64,93.0,84
CDM,30000345,COAG TIME ACTIVATED (POINT OF CARE LAB),30.0,19.5,2.1,32.77,84
CDM,30000365,FIBRINOLYSINS SCREEN I&R,107.0,69.55,6.19,107.0,84
CDM,30000390,AMIKACIN ASSAY,104.0,67.6,7.44,104.0,84
CDM,30000405,CMV SCREENING EACH UNIT,80.0,52.0,5.03,80.0,84
CDM,30000425,RBC ANTIB ELUTION,1182.0,768.3,13.39,1182.0,85
CDM,30000435,AGT DIR MONOSPECIF C3,37.0,24.05,2.66,61.39,85
CDM,30000445,ANTIBODY TITER,36.0,23.4,2.56,177.3,85
CDM,30000455,SALVAGED BL PROCESSING EA,5637.0,3664.05,59.33,5637.0,85
CDM,30000465,SPECIAL ANTIGEN SCREEN,44.0,28.6,2.54,373.03,85
CDM,30000475,RBC ANTIGEN TYPING,26.0,16.9,1.89,373.03,85
CDM,30000485,INCUBATION CROSSMATCH,1182.0,768.3,13.39,1182.0,85
CDM,30000495,ELECTRONIC CROSSMATCH,1182.0,768.3,11.81,1182.0,85
CDM,30000535,PREWARM MODIFICATION,169.0,109.85,14.83,169.0,85
CDM,30000545,R E S ABSORP TEST,1182.0,768.3,14.83,1182.0,85
CDM,30000555,TRIPLE ABSORPTION X3,410.0,266.5,14.83,410.0,85
CDM,30000565,SPLITTING BLOOD/BLOOD PRODUCTS EACH UNIT,1182.0,768.3,10.8,1182.0,85
CDM,30000580,TREPONEMA PALLIDUM,91.0,59.15,13.24,91.0,84
CDM,30000595,KRUGER'S TEST,29.0,18.85,2.11,29.0,84
CDM,30000605,SMEAR WET MOUNT,40.0,26.0,5.68,40.0,84
CDM,30000620,CATH COLL SPEC SNGL PATIENT,63.0,40.95,2.64,3443.0,83
CDM,30000625,STREP A ASSAY W/OPTIC,114.0,74.1,16.53,114.0,84
CDM,30000635,BILIRUBIN TOTAL TRANSCUT (POINT OF CARE LAB),35.0,22.75,2.84,35.0,83
CDM,30000645,SWEAT COLLECTION IONTOPHO,369.0,239.85,1.44,369.0,86
CDM,30000665,CULT OOCYTE/EMBRYO<4DAY,5150.0,3347.5,24.85,5150.0,84
CDM,30000685,PREP EMBRYO FOR TRNFER,700.0,455.0,24.85,700.0,84
CDM,30000695,PERCUTANEOUS SPERM ASPIRATION,1010.0,656.5,24.85,1010.0,84
CDM,30000705,CRYOPRESERVATION EMBRYO,2450.0,1592.5,22.63,2450.0,84
CDM,30000715,CRYOPRESERVATION SPERM,540.0,351.0,24.85,540.0,84
CDM,30000725,SPERM WASH FOR INSEMINATI,268.0,174.2,24.85,397.39,84
CDM,30000735,SPERM WASH SECOND INSEM,500.0,325.0,24.85,500.0,84
CDM,30000745,TESTICULAR BIOPSY PREP,1620.0,1053.0,24.85,1620.0,84
CDM,30000755,INSEMINATION OOCYTES,650.0,422.5,24.85,650.0,84
CDM,30000765,EXTN CULT OOCYTE/EMBRYO 4-7D,1400.0,910.0,24.85,1476.35,84
CDM,30000775,OOCYTE FERTILIZATION<=10,2450.0,1592.5,24.85,2450.0,84
CDM,30000785,OOCYTE FERTILIZATION>10,2700.0,1755.0,24.85,2700.0,84
CDM,30000795,BX OOCYTE/EMBRYO<=5EMBRYO,3488.0,2267.2,24.85,3488.0,84
CDM,30000805,BX OOCYTE/EMBRYO>5EMBRYO,3694.0,2401.1,24.85,3694.0,84
CDM,30000810,COLL SPUTUM AEROSOL,1182.0,768.3,6.62,1182.0,86
CDM,30000825,SPERM COUNT/MOTILITY SEMEN,59.0,38.35,4.25,60.05,83
CDM,30000830,COMPATIBILITY TEST ANTIGLOB,1182.0,768.3,15.84,1182.0,85
CDM,30000835,CASA,205.0,133.25,5.95,205.0,83
CDM,30000840,COMPATIBILITY TEST SPIN,1182.0,768.3,14.83,1182.0,85
CDM,30000845,SEMEN ANAL POST VASEC,191.0,124.15,5.95,191.0,83
CDM,30000855,SPERM DIFFERENTIAL,107.0,69.55,7.65,107.0,83
CDM,30000860,COOMBS TEST DIR EA ANTISERUM,37.0,24.05,2.66,61.39,85
CDM,30000865,ANTI SPERM AB TYPING,210.0,136.5,5.27,210.0,83
CDM,30000875,EVAL SPERM HAMSTER TEST,135.0,87.75,8.96,135.0,83
CDM,30000885,EVAL SPERM CERV MUCUS TEST,72.0,46.8,4.88,72.0,83
CDM,30000900,CORTICOSTERONE,155.0,100.75,11.12,155.0,84
CDM,30000905,CITRIC ACID URINE,192.0,124.8,13.73,192.0,84
CDM,30000915,STORAGE SEMEN/SPERM PER YEAR,319.0,207.35,24.85,335.61,84
CDM,30000925,STORAGE/YEAR OOCYTE(S),500.0,325.0,24.85,655.34,84
CDM,30000935,THAW CRYOPRESERVE EMBRYO,1450.0,942.5,24.85,1450.0,84
CDM,30000945,THAW CRYOPRESERVE SPERM/SEMEN,250.0,162.5,24.85,250.0,84
CDM,30000950,*CREATINE KINASE ISOENZYME,92.0,59.8,6.61,92.0,84
CDM,30000965,THAW CRYOPR OOCYTES EA ALIQ,350.0,227.5,24.85,350.0,84
CDM,30000970,*CREATININE BLOOD,35.0,22.75,2.53,35.0,84
CDM,30000975,PERCUTANEOUS SPERM ASPIRATION,378.0,245.7,45.47,378.0,84
CDM,30000995,SPECIMEN ACQUISITION KIT- DD WAIT LIST,49.0,31.85,2.64,49.0,66
CDM,30000OH,DRAINAGE ABSCESS/HEMATOMA NASAL INT APPROACH,592.0,384.8,1.1,886.21,148
CDM,30001005,STAT/AFTER-HOURS REQUEST,144.0,93.6,10.74,144.0,66
CDM,30001075,MATERNAL 8PC DRUG SCREEN,429.0,278.85,31.92,429.0,84
CDM,30001095,LIBRIUM & METABOLITE,742.0,482.3,34.82,742.0,84
CDM,30001115,ITRACONAZOLE,129.0,83.85,18.31,129.0,84
CDM,30001125,%MYPRS MULT ANALYTE ALG,27.0,17.55,5.89,1851898.14,67
CDM,30001165,CANNABANOIDS,742.0,482.3,34.82,742.0,84
CDM,30001175,GM1 ANTIBODY PANEL X2,80.0,52.0,11.53,80.0,84
CDM,30001185,"CV2 AB IGG CBA-IFA SCREEN, SERUM",119.0,77.35,6.91,119.0,84
CDM,30001200,ENCEPH EASTERN,91.0,59.15,6.51,91.0,84
CDM,30001210,ENCEPH WESTERN,91.0,59.15,6.51,91.0,84
CDM,30001220,RBC AG NOT ABO/RH(D) EA,26.0,16.9,1.89,373.03,85
CDM,30001375,I STAT BUN DETERMINATION (POINT OF CARE LAB),27.0,17.55,1.95,27.0,84
CDM,30001450,GAMMAGLOBULIN ASSAY IGE,114.0,74.1,8.13,114.0,84
CDM,30001480,GLUCOSE BLD BY MONIT DEV (POINT OF CARE LAB),23.0,14.95,3.28,23.0,84
CDM,30001490,GLUCAGON,99.0,64.35,7.06,110.02,84
CDM,30001500,GLUCOSE QUANT,27.0,17.55,1.94,27.0,84
CDM,30001530,GONADOTROPIN LH,128.0,83.2,18.52,128.0,84
CDM,30001595,HEMATOCRIT,16.0,10.4,2.31,16.0,84
CDM,30001610,HEMOGLOBIN PLASMA,50.0,32.5,3.61,51.56,84
CDM,30001745,PROTHROMBIN TIME AND INR (POINT OF CARE LAB),30.0,19.5,4.29,30.0,84
CDM,30001750,"IMMUNOASSAY, FECAL OCCULT BLOOD",110.0,71.5,7.86,110.0,84
CDM,30001800,HIV ANTIBODY,61.0,39.65,8.89,61.0,84
CDM,30001820,HIV1 HIV2 SNGL ASSAY AB,95.0,61.75,6.77,95.0,84
CDM,30001855,URINALYSIS (POINT OF CARE LAB),16.0,10.4,2.25,17.31,84
CDM,30001940,B-TUP NATRIURETC PEPTIDE (POINT OF CARE LAB),271.0,176.15,20.86,271.0,84
CDM,30001950,*INFLUENZA A,114.0,74.1,15.92,114.0,84
CDM,30001980,IRRADIATION BLOOD PRODUCT,271.0,176.15,12.38,271.0,85
CDM,30002040,LACTATE(LACTIC ACID),80.0,52.0,11.57,80.0,84
CDM,30002185,POTASSIUM,31.0,20.15,6.76,31.0,58
CDM,30002250,MICROALBUMIN UR SEMI QNT (POINT OF CARE LAB),43.0,27.95,6.23,43.0,84
CDM,30002285,"METHADONE QNT, UR",742.0,482.3,34.82,742.0,84
CDM,30002405,%DAAMPC MDA MDMA,742.0,482.3,34.82,742.0,84
CDM,30002415,%UQNTPP COCAINE,742.0,482.3,34.82,742.0,84
CDM,30002425,%UQNTPP BUPRENORPHINE,742.0,482.3,34.82,742.0,84
CDM,30002510,ANTIDEPRESSANT TRICYCLIC 1/2,742.0,482.3,34.82,742.0,84
CDM,30002515,GQ1B AUTOANTIBODY,119.0,77.35,6.91,119.0,84
CDM,30002525,CRYOPRESERVATION OOCYTE(S),972.0,631.8,24.85,972.0,84
CDM,30002535,STORAGE EMBRYO EA YR,700.0,455.0,24.85,700.0,84
CDM,30002545,FATS URINE,41.0,26.65,2.35,41.0,83
CDM,30002555,"6-MAM CONF, UR",742.0,482.3,34.82,742.0,84
CDM,30002575,SPECIMEN ACQUISITION-KIT - DAILY TESTING,59.0,38.35,2.64,59.0,66
CDM,30002585,ABO TYPRING (FULL),21.0,13.65,1.48,138.46,85
CDM,30002595,%UQNTPP TRAMADOL,742.0,482.3,34.82,742.0,84
CDM,30002605,TRFX MED MISC SCRN,59.0,38.35,4.26,59.0,84
CDM,30002615,TRFX MED FUNGAL SCRN,59.0,38.35,4.26,59.0,84
CDM,30002620,PH BODY FLUID EXCEPT BLD (POINT OF CARE),25.0,16.25,1.77,27.56,84
CDM,30002625,%IOHWC CULTURE,59.0,38.35,4.26,59.0,84
CDM,30002635,"AMINES, VAGINAL FLUID, QUAL",41.0,26.65,5.99,41.0,84
CDM,30002645,%UQNTPP FENTANYL,742.0,482.3,34.82,742.0,84
CDM,30002655,%SENNRO SENSRY NEU IMMX6,119.0,77.35,6.91,119.0,84
CDM,30002660,POOLING BLOOD PLT OR OTHER BLD PRD,1182.0,768.3,13.82,1182.0,85
CDM,30002665,SENMOT IMMUNOASSAY X11,119.0,77.35,6.91,119.0,84
CDM,30002675,RECOMBX MA TA AUTOAB,119.0,77.35,6.91,119.0,84
CDM,30002685,DISCARD CS COLLECT FEE,5637.0,3664.05,59.33,5637.0,85
CDM,30002695,CELL SALVAGE SUPPLY,5637.0,3664.05,59.33,5637.0,85
CDM,30002705,CELL SALVAGE 1 UNIT,5637.0,3664.05,59.33,5637.0,85
CDM,30002710,POTASSIUM BLOOD (POINT OF CARE LAB),33.0,21.45,2.27,33.0,84
CDM,30002715,"5-FLUCYTOSINE, S",129.0,83.85,18.31,129.0,84
CDM,30002725,DTT TREATMENT,410.0,266.5,12.38,410.0,85
CDM,30002741,PRETREAT RBC AB ID DENSITYSEP,1182.0,768.3,17.28,1182.0,85
CDM,30002750,PRETREAT RBC AB ID DRUG,410.0,266.5,12.38,410.0,85
CDM,30002760,PRETREAT SERUM AB ID ABSORP,410.0,266.5,14.83,410.0,85
CDM,30002950,RBC AB ID EA PANL,2482.0,1613.3,18.29,2482.0,85
CDM,30002970,*RBC AB SCREEN EA SERUM,67.0,43.55,3.91,168.05,85
CDM,30003090,RSV IA W DIR OBSERV,90.0,58.5,13.1,90.0,84
CDM,30003150,SODIUM BLOOD (POINT OF CARE LAB),33.0,21.45,2.38,33.0,84
CDM,30003220,SERUM PROCESSING AND STORAGE,59.0,38.35,2.64,59.0,66
CDM,30003240,SYPHILIS TEST QUANT,30.0,19.5,2.18,31.66,84
CDM,30003260,SYPHILIS TEST QUAL,29.0,18.85,2.11,29.0,84
CDM,30003310,TEST SPERM AB,210.0,136.5,5.27,210.0,83
CDM,30003340,THAW FFP EA UNIT,1182.0,768.3,8.35,1182.0,85
CDM,30003440,UA NON-AUTO W/O MICRO (POINT OF CARE LAB),24.0,15.6,3.48,24.0,84
CDM,30003450,URINALYSIS AUTO WO SCPE (POINT OF CARE LAB),16.0,10.4,2.25,17.31,84
CDM,30003500,ROUTINE VENIPUNCTURE,63.0,40.95,2.64,63.0,83
CDM,30003540,VIT B-12,104.0,67.6,8.54,104.0,84
CDM,30007770,RBC AG NOT AB,26.0,16.9,1.89,373.03,85
CDM,30007800,ABO BLOOD TYPING,21.0,13.65,1.48,138.46,85
CDM,30007810,*BLOOD TYPING RH(D),21.0,13.65,1.48,39.3,85
CDM,30007820,AG SCREEN W P,113.0,73.45,6.54,113.0,85
CDM,30007830,CELL COUNT FLUID DIFF COUNT,39.0,25.35,2.72,42.4,83
CDM,30007950,*FAB TITER EA AB,83.0,53.95,5.95,104.69,84
CDM,30007990,RBC AB ELUTION EA ELUTION,1182.0,768.3,13.39,1182.0,85
CDM,30008000,RBC AB ID EA PANL,2482.0,1613.3,18.29,2482.0,85
CDM,30008040,EXAM SYNOVIAL FLUID CRYSTALS,51.0,33.15,3.53,51.0,83
CDM,30008200,LUTEINING HORMONE,128.0,83.2,18.52,128.0,84
CDM,30008250,HIV-1/HIV2 SNG ASSY (POINT OF CARE LAB),95.0,61.75,6.77,95.0,84
CDM,30008420,*RICKETTSIA AB,134.0,87.1,9.56,134.0,84
CDM,30008480,VDRL/RPR QUAL,29.0,18.85,2.11,29.0,84
CDM,30008530,VENIPUNCTURE,63.0,40.95,2.64,63.0,83
CDM,30008700,TEST SPERM AB,210.0,136.5,5.27,210.0,83
CDM,30008770,*SODIUM BLOOD,33.0,21.45,2.38,33.0,84
CDM,30008780,*POTASSIUM SERUM,33.0,21.45,2.27,33.0,84
CDM,30008790,*CALCIUM IONIZED,94.0,61.1,6.75,94.0,84
CDM,30008800,*CHLORIDE,32.0,20.8,2.27,32.0,84
CDM,30008850,*BLOOD TYPING RH(D),21.0,13.65,1.48,39.3,85
CDM,30008930,COOMBS TEST INDIRECT TITER,36.0,23.4,2.56,177.3,85
CDM,30008945,SEMEN CRYOPRESERVATION INITIAL-BW,540.0,351.0,24.85,540.0,84
CDM,30008955,FRUCTOSE QUAL SEMEN,120.0,78.0,8.56,120.0,84
CDM,30008965,SOLID PHASE AB SCRN,67.0,43.55,3.91,168.05,85
CDM,30008975,PLATELET CROSSMATCH,1182.0,768.3,14.83,1182.0,85
CDM,30008985,RETRO AN SPERM COUNT,135.0,87.75,8.96,135.0,83
CDM,30009075,HEP B SURF ANTIG W/REF,71.0,46.15,5.1,71.0,84
CDM,30009095,DEXAMETHAZONE SUP 48HR,1117.0,726.05,64.75,1117.0,84
CDM,30009115,"CRC AB ID, EACH CELL",39.0,25.35,2.83,177.3,85
CDM,30009295,CRC AB ID PANEL,2482.0,1613.3,18.29,2482.0,85
CDM,30009345,HERPES SIMPLEX IGM ABS,99.0,64.35,7.11,99.0,84
CDM,30009355,COOMBS TEST INDIRECT QUAL,39.0,25.35,2.83,177.3,85
CDM,30009395,TESTICULAR BIOPSY PREP,378.0,245.7,45.47,378.0,84
CDM,30009405,STOOL APT TEST,55.0,35.75,3.2,55.0,84
CDM,30009415,OB PANEL,330.0,214.5,19.67,381.89,84
CDM,30009425,PRETREATMENT W/ENZYME,1182.0,768.3,9.94,1182.0,85
CDM,30009455,LAB VENOUS-PH,76.0,49.4,4.4,89.32,84
CDM,30009465,CJD NEURO CSF QUAL,3733.0,2426.45,75.0,3733.0,84
CDM,30009475,SENDOUT ANTIBODY TITER,36.0,23.4,2.56,177.3,85
CDM,30009485,PDGFRA GENE ANALYSIS,2274.0,1478.1,116.49,2274.0,84
CDM,30009495,GIST PDGFRA GENE,2274.0,1478.1,116.49,2274.0,84
CDM,30020165,BLOOD DRAW VENOUS ACCESS DEV,741.0,481.65,35.72,741.0,86
CDM,30020185,"STORAGE (PER YEAR); REPRODUCTIVE TISSUE, TESTICULAR/OVARIAN",489.0,317.85,24.85,489.0,84
CDM,30020195,PAT CROSSMATCH TYPE & SC,67.0,43.55,3.91,168.05,85
CDM,30020205,PAT ABO BLOOD TYPING,21.0,13.65,1.48,138.46,85
CDM,30020215,PAT BLOOD TYPING RH(D),21.0,13.65,1.48,39.3,85
CDM,30020225,PIK3CA GENE ANALYSIS NGS,1896.0,1232.4,109.93,1896.0,84
CDM,30020235,ADD ON PIK3CA NGS,1896.0,1232.4,109.93,1896.0,84
CDM,30020245,HSD3B1 GENOTYPING,324.0,210.6,70.63,1666801.85,67
CDM,30020255,WHIVF BLD TYPE RHD,21.0,13.65,1.48,39.3,85
CDM,30020265,WHIVF BLD BYPE ABO,21.0,13.65,1.48,138.46,85
CDM,30020275,WHIVF RBC AB ACRN,67.0,43.55,3.91,168.05,85
CDM,30020285,WEAK RHD ANLYS UNLISTED,427.0,277.55,83.94,1666801.85,67
CDM,30020295,WKD D AG TYPING,21.0,13.65,1.48,39.3,85
CDM,30020305,RED CELL GENOTYPING,1278.0,830.7,74.08,1988.72,84
CDM,30020315,RCGP UNLISTED MOL PATH,41.0,26.65,8.94,1666801.85,67
CDM,30020325,PARD UNLISTED MOL PATH,437.0,284.05,83.94,1666801.85,67
CDM,30020335,ARCDL HEMOLYSINS/AGG AU,61.0,39.65,4.05,61.0,84
CDM,30020345,ARCDL HEMOLYSINS INCUB,84.0,54.6,5.98,84.0,84
CDM,30020365,CRYOPRESERVATION OF OVARIAN TISSUE,90.0,58.5,8.96,90.0,83
CDM,30020375,PHARMACOGENOMICS CYP3A5,1206.0,783.9,110.13,1206.0,84
CDM,30020385,PHARMACOGENOMICS CYP2C9,1206.0,783.9,69.92,1206.0,84
CDM,30020395,DYPD GENOTYPING,1206.0,783.9,116.49,1206.0,84
CDM,30020405,UGT1A1 GENOTYPING,1615.0,1049.75,93.6,1615.0,84
CDM,30020415,DPYDAO-DYPD GTYP AN ON,1206.0,783.9,116.49,1206.0,84
CDM,30020425,UGT1A1 GENOTYPING ANALYSIS ONLY,1615.0,1049.75,93.6,1615.0,84
CDM,30020485,"CHYLOSCREEN, BF ELECTROPHORESIS, REFLEX",424.0,275.6,20.86,424.0,84
CDM,30020495,OOCYTE IDENTIFICATION FROM FOLLICULAR FLUID,500.0,325.0,24.85,1470.1,84
CDM,30020505,GENOMIC SEQUENCING AHUS1,6121.0,3978.65,672.05,6121.0,84
CDM,30020555,ABSENCE/PRESENCE SPERM (POC) (POINT OF CARE LAB),45.0,29.25,6.5,45.0,84
CDM,30020565,RED CELL GENOTYPING,4968.0,3229.2,173.12,4968.0,84
CDM,30020595,FLT3 ITD MRD ASSAY,2811.0,1827.15,75.0,2811.0,84
CDM,30020605,CHITOTRIOSIDASE,288.0,187.2,18.15,1666801.85,67
CDM,30020615,"SEQUENCING, INFLUENZA PLUS",202.0,131.3,11.69,202.0,84
CDM,30020635,URINE COLLECTION ONLY,25.0,16.25,5.45,25.0,58
CDM,30020OH,"DRAIN ABSCESS/HEMATOMA,NASAL SEPTUM",592.0,384.8,1.1,1603.96,148
CDM,30100010,COMPRE META PANL,73.0,47.45,5.99,73.0,84
CDM,30100015,BMP I STAT ANALYZER,95.0,61.75,9.74,95.0,84
CDM,30100020,LIPID-LIPO PANEL 1,92.0,59.8,13.39,92.0,84
CDM,30100025,BASIC METABOLIC PANEL,58.0,37.7,7.91,58.0,84
CDM,30100030,RENAL FUNC PANL,60.0,39.0,8.68,60.0,84
CDM,30100035,ELECTROLYTE PANEL,48.0,31.2,4.88,48.0,84
CDM,30100040,HEP FUNC PANL,56.0,36.4,4.04,56.0,84
CDM,30100055,DESIPRAMINE PLASMA,153.0,99.45,34.82,257.48,84
CDM,30100065,DOXEPIN/NORDOXEPIN,742.0,482.3,34.82,742.0,84
CDM,30100070,COLUMN CHROM QUANT,157.0,102.05,34.82,257.48,84
CDM,30100085,LIDOCAINE PLASMA,101.0,65.65,7.26,101.0,84
CDM,30100095,NORTRIPTYLINE PLASMA,742.0,482.3,34.82,742.0,84
CDM,30100105,PHENYTOIN FREE PLASMA,95.0,61.75,6.8,95.0,84
CDM,30100115,%FREE PRIMIDONE PLASMA,114.0,74.1,8.19,127.78,84
CDM,30100135,ACTH STIM W/2 TIME PTS,225.0,146.25,16.11,225.0,84
CDM,30100155,GLUCAGON/INSULIN TOLERANC,318.0,206.7,22.75,318.0,84
CDM,30100165,GROWTH HORMONE STIM PEDS,460.0,299.0,27.68,460.0,84
CDM,30100175,GROWTH HORMONE SUPPRESS,892.0,579.8,27.68,892.0,84
CDM,30100195,BILIRUBIN SCREEN URINE,15.0,9.75,1.07,15.0,84
CDM,30100205,BCR/ABL QUANT BLOOD TEST,1131.0,735.15,80.97,1262.54,84
CDM,30100215,P190PCR BLOOD,999.0,649.35,71.52,1115.21,84
CDM,30100225,%UVAHA HVA,1210.0,786.5,70.16,1210.0,84
CDM,30100235,CFSCRN TEST,3841.0,2496.65,109.69,4289.05,84
CDM,30100255,2C19PL TEST,2010.0,1306.5,116.49,2010.0,84
CDM,30100265,2D6 TEST,3111.0,2022.15,109.69,3111.0,84
CDM,30100270,CARBAZEPINE TEGRETOL,101.0,65.65,7.19,101.0,84
CDM,30100275,WARSEN 2C9 TEST,1206.0,783.9,69.92,1206.0,84
CDM,30100290,DIGOXIN ASSAY,92.0,59.8,6.56,92.0,84
CDM,30100295,EGFRCP TEST,2240.0,1456.0,109.69,2240.0,84
CDM,30100310,GENTAMICIN ASSAY,113.0,73.45,8.09,113.0,84
CDM,30100315,PTGENEO TEST,453.0,294.45,26.28,453.0,84
CDM,30100325,FACT V LEIDEN TEST,506.0,328.9,30.18,506.0,84
CDM,30100330,PHENOBARBITAL ASSAY,106.0,68.9,6.12,106.0,84
CDM,30100335,%FRAX FMR 1 TEST,394.0,256.1,22.82,930.61,84
CDM,30100345,HEMDNA TEST,451.0,293.15,32.28,503.27,84
CDM,30100350,PHENYTOIN-DILANTIN,91.0,59.15,6.54,91.0,84
CDM,30100355,ALPHA THALASSEMIA TEST,706.0,458.9,40.9,1397.77,84
CDM,30100365,BCBMD I TEST,1366.0,887.9,97.77,1524.53,84
CDM,30100370,ANALGESICS NON-OPIOID 1 OR 2,742.0,482.3,34.82,742.0,84
CDM,30100375,IGHSB TEST,473.0,307.45,27.42,473.0,84
CDM,30100385,BCBMD II TEST,1192.0,774.8,73.74,1192.0,84
CDM,30100390,THEOPHYLLINE ASSAY,98.0,63.7,6.98,98.0,84
CDM,30100395,RECIPIENT TYPING FOR ENGRAFTMENT MONITORING,1608.0,1045.2,106.2,1608.0,84
CDM,30100400,TOBRAMYCIN ASSAY,111.0,72.15,7.96,111.0,84
CDM,30100405,POST-TX FOLLOW-UP ENGRAFTMENT MONITORING,1431.0,930.15,102.45,1431.0,84
CDM,30100425,JAK2 TEST,632.0,410.8,45.27,632.0,84
CDM,30100435,KRAS GENE,1333.0,866.45,77.3,1333.0,84
CDM,30100445,MTHFR BY PCR TEST,451.0,293.15,26.14,451.0,84
CDM,30100465,MSICCT TEST,2405.0,1563.25,116.49,2405.0,84
CDM,30100475,NPM1 TEST,1701.0,1105.65,98.61,1701.0,84
CDM,30100485,APLPCR RTPCR TEST,1430.0,929.5,102.38,1596.35,84
CDM,30100495,TCBMD II TEST,1442.0,937.3,103.17,1442.0,84
CDM,30100515,T GAMMA TEST,1390.0,903.5,99.5,1390.0,84
CDM,30100525,WARSEN VKORC1 TEST,609.0,395.85,35.28,609.0,84
CDM,30100535,"HLA-A,B,CW,DR,DP-SBT",2384.0,1549.6,116.49,2384.0,84
CDM,30100555,HLA-DP-SBT,853.0,554.45,61.08,853.0,84
CDM,30100560,FE ASSAY,45.0,29.25,3.2,45.0,84
CDM,30100565,PLA 1/2 BY PCR TEST,441.0,286.65,25.58,1608.07,84
CDM,30100590,ALBUMIN SERUM ASSAY,34.0,22.1,4.95,34.0,84
CDM,30100595,BCR/ABL KINASE DOMAIN RT-PCR,1062.0,690.3,83.94,1666801.85,67
CDM,30100600,ALBUMIN URINE/OTHER QUANT,54.0,35.1,3.11,54.0,84
CDM,30100605,ACYLCARN PRO1 QT PLASMA,116.0,75.4,8.33,129.85,84
CDM,30100615,ACTH,266.0,172.9,19.07,266.0,84
CDM,30100620,*MICROALBUMIN URINE QUANT,40.0,26.0,2.86,40.0,84
CDM,30100640,ALKA PHOSPHTA,36.0,23.4,5.18,36.0,84
CDM,30100645,ETHANOL PLASMA,742.0,482.3,34.82,742.0,84
CDM,30100650,ALPHA-FETOPROTEIN SERUM,116.0,75.4,8.28,116.0,84
CDM,30100660,ALT/SGPT,37.0,24.05,5.3,37.0,84
CDM,30100665,ALDOSTERONE,281.0,182.65,20.12,281.0,84
CDM,30100675,%SERPINA1 A1A,93.0,60.45,6.64,93.0,84
CDM,30100685,"AMINES, VAGINAL FLUID",41.0,26.65,5.99,41.0,84
CDM,30100695,AMINO ACID>=6 QUANT EA,116.0,75.4,8.33,129.85,84
CDM,30100710,AMMONIA,101.0,65.65,7.2,101.0,84
CDM,30100715,%UQNTPP AMPHET,742.0,482.3,34.82,742.0,84
CDM,30100725,ANDROSTENEDIONE,202.0,131.3,14.46,202.0,84
CDM,30100735,ANGIOTENSIN CONV ENZYM,101.0,65.65,7.21,101.0,84
CDM,30100745,APOLIPOPROTEIN A1+B X2,146.0,94.9,8.44,146.0,84
CDM,30100750,APOLIPOPROTEIN EA ASSAY,146.0,94.9,8.44,146.0,84
CDM,30100755,PENTOBARBITAL,742.0,482.3,34.82,742.0,84
CDM,30100765,BETA 2 MICROGLOBULIN BLD,112.0,72.8,7.99,112.0,84
CDM,30100770,CA URINE QUANT TIMED,42.0,27.3,2.98,42.0,84
CDM,30100775,BIOTINIDASE ASSAY EA,116.0,75.4,8.33,116.0,84
CDM,30100785,%FGSTRO GSTRC OCCULT BLD,37.0,24.05,5.32,37.0,84
CDM,30100790,AST/SGOT,36.0,23.4,5.18,36.0,84
CDM,30100795,ASSAY IONIZED CA,94.0,61.1,6.75,94.0,84
CDM,30100800,ATOMIC ABSORP SPECTROSCOPY EA,110.0,71.5,7.36,110.0,84
CDM,30100805,CALCULI (STONE) ANALYSIS,89.0,57.85,6.37,89.0,84
CDM,30100810,BARBITURATES,742.0,482.3,34.82,742.0,84
CDM,30100815,CARBOXYHEMOGLOBIN,85.0,55.25,6.08,85.0,84
CDM,30100825,CARNITINE FR & TOT PLASMA,116.0,75.4,8.33,129.85,84
CDM,30100830,BETA 2 MICROGLOBULIN ASSAY,112.0,72.8,7.99,112.0,84
CDM,30100835,CAROTENE,64.0,41.6,4.56,64.0,84
CDM,30100845,CATECHOLAMINE FRACT PL,174.0,113.1,12.47,174.0,84
CDM,30100850,BILIRUBIN TOTAL,35.0,22.75,4.36,35.0,84
CDM,30100855,CERULOPLASMIN LEVEL,74.0,48.1,5.3,74.0,84
CDM,30100860,BILIRUBIN DIR,35.0,22.75,5.02,35.0,84
CDM,30100865,CHEMILUMINESCENT ASSAY,97.0,63.05,6.97,104.92,84
CDM,30100870,OCCULT BLOOD FECES COLORECT,30.0,19.5,4.31,30.0,84
CDM,30100875,ASSAY BLOOD CHLORIDE,32.0,20.8,2.27,32.0,84
CDM,30100880,OCCULT BLOOD FECES 1-3 TEST,29.0,18.85,4.23,29.0,84
CDM,30100885,AMIODARONE,166.0,107.9,9.64,166.0,84
CDM,30100895,CHROMIUM BLOOD,140.0,91.0,10.02,142.17,84
CDM,30100925,CROSS-LINK N-TELOPEPTIDES,129.0,83.85,9.23,129.0,84
CDM,30100935,COPPER BLOOD,86.0,55.9,6.13,95.56,84
CDM,30100940,CALCIUM,36.0,23.4,2.55,36.0,84
CDM,30100945,COPPER URINE,86.0,55.9,6.13,95.56,84
CDM,30100960,PSEUDOCHOLINESTERASE TOTAL,54.0,35.1,3.89,54.0,84
CDM,30100965,LASOSAMIDE,742.0,482.3,34.82,742.0,84
CDM,30100970,CARNITINE TOTAL & FREE QUANT,116.0,75.4,8.33,129.85,84
CDM,30100975,CRYOGLOBULIN QL,45.0,29.25,3.19,49.8,84
CDM,30100980,CO2 BLOOD ASSAY,34.0,22.1,2.41,34.0,84
CDM,30100985,DHEA-S,153.0,99.45,10.98,153.0,84
CDM,30100990,CEA AG,131.0,85.15,9.36,131.0,84
CDM,30100OH,"BIOPSY,INTRANASAL",376.0,244.4,1.1,4447.63,148
CDM,30101005,VIT D 1 25 DIHYDROXY,266.0,172.9,19.01,266.0,84
CDM,30101015,ISOELECTRIC FOCUSING HB,424.0,275.6,20.86,424.0,84
CDM,30101020,*CATECHOLAMINE FRACT ASSAY,174.0,113.1,12.47,174.0,84
CDM,30101025,ERYTHROPOIETIN,130.0,84.5,9.28,130.0,84
CDM,30101035,ESTRADIOL-17B,193.0,125.45,13.8,193.0,84
CDM,30101045,%QUAD4 MARKERS  ESTRIOL,167.0,108.55,11.94,167.0,84
CDM,30101050,CL URINE ASSAY,40.0,26.0,2.48,40.0,84
CDM,30101055,FECAL FAT QUALITATIVE,35.0,22.75,2.52,35.0,84
CDM,30101065,FETAL FIBRONECTIN,444.0,288.6,31.81,444.0,84
CDM,30101070,CL OTHER SOURCE ASSAY,35.0,22.75,2.41,37.65,84
CDM,30101075,FOLIC ACID RBC TEST,122.0,79.3,8.55,122.0,84
CDM,30101080,CHOLESTEROL BLOOD TOTAL,30.0,19.5,4.35,30.0,84
CDM,30101085,%IGG SUBCLASSES X4,55.0,35.75,3.96,55.0,84
CDM,30101095,BLOOD GAS VENOUS (POINT OF CARE LAB),180.0,117.0,10.43,180.0,84
CDM,30101105,BLOOD GAS O2 SATUR ONLY (POINT OF CARE LAB),67.0,43.55,4.31,67.0,84
CDM,30101125,GASTRIN,122.0,79.3,8.71,122.0,84
CDM,30101135,GLUC BLOOD QUANT ASSAY,27.0,17.55,1.94,27.0,84
CDM,30101155,G6PD SCREEN,42.0,27.3,2.99,42.0,84
CDM,30101165,GLUC BLOOD TEST BY DVC (POINT OF CARE LAB),23.0,14.95,3.28,23.0,84
CDM,30101175,GROWTH HORMONE HUMAN,115.0,74.75,8.23,115.0,84
CDM,30101185,HAPTOGLOBIN QUANT,87.0,56.55,6.21,87.0,84
CDM,30101195,H.PYLORI BREATH TEST,465.0,302.25,33.26,465.0,84
CDM,30101205,HEMOGLOBIN FRACT AND QUANT,89.0,57.85,6.36,89.0,84
CDM,30101215,HEMOGLOBIN A2 ASCAA,125.0,81.25,8.48,125.0,84
CDM,30101225,METHEMOGLOBIN QUANT,57.0,37.05,3.62,57.0,84
CDM,30101235,HEMOGLOBIN SERUM (POINT OF CARE LAB),50.0,32.5,3.61,51.56,84
CDM,30101245,HEMOGLOBIN UNSTABLE ASCAA,65.0,42.25,4.18,65.0,84
CDM,30101255,%BRAFBM TEST,1210.0,786.5,70.16,1210.0,84
CDM,30101265,HEMOSIDERIN URINE,33.0,21.45,2.34,33.0,84
CDM,30101275,%HYDROXYINDOLE ACET RANDM,6210.0,4036.5,173.12,6210.0,84
CDM,30101285,CRMSNP TEST,4500.0,2925.0,540.0,4500.0,84
CDM,30101295,%ANCA C+P EIA X2,80.0,52.0,11.53,80.0,84
CDM,30101305,%FLT3 ITD TEST,1142.0,742.3,66.2,1142.0,84
CDM,30101315,INSULIN FREE,89.0,57.85,6.39,99.71,84
CDM,30101325,ASSAY LACTIC ACID,80.0,52.0,11.57,80.0,84
CDM,30101335,%OSHA LEAD,84.0,54.6,12.11,84.0,84
CDM,30101345,L/S RATIO,152.0,98.8,10.86,152.0,84
CDM,30101350,COLLAGEN CROSS LINKS,129.0,83.85,9.23,129.0,84
CDM,30101355,LP (A),99.0,64.35,6.39,99.0,84
CDM,30101365,MANGANESE BLOOD,184.0,119.6,12.15,184.0,84
CDM,30101375,ATMS MASS SPEC QUAL,166.0,107.9,9.64,166.0,84
CDM,30101380,"COPPER, FREE, SERUM OR PLASMA",86.0,55.9,6.13,95.56,84
CDM,30101385,METANEPHRINES URINE,117.0,76.05,8.37,130.46,84
CDM,30101395,%UQNTPP METHADONE,742.0,482.3,34.82,742.0,84
CDM,30101400,CORTISOL TOTAL,112.0,72.8,8.05,112.0,84
CDM,30101405,MUCIN SYNOVIAL FLUID,40.0,26.0,2.9,40.0,84
CDM,30101415,MYOGLOBIN BLOOD,89.0,57.85,6.38,89.0,84
CDM,30101425,KAPPA & LAMBDA SERUM X2,94.0,61.1,6.72,94.0,84
CDM,30101435,NICOTINE/COTININE,742.0,482.3,34.82,742.0,84
CDM,30101445,%AJPWO NIEMANN PICK,324.0,210.6,18.8,324.0,84
CDM,30101455,PRADER-WILLI METH,352.0,228.8,20.43,352.0,84
CDM,30101465,OLIGOCLONAL BAND TEST,189.0,122.85,10.96,189.0,84
CDM,30101475,METHYLMALONIC ACID BL,146.0,94.9,8.48,146.0,84
CDM,30101480,*CREATINE KINASE TOTAL ASSAY,45.0,29.25,6.51,45.0,84
CDM,30101495,OXALATE URINE,100.0,65.0,6.36,100.0,84
CDM,30101500,*CREATINE KINASE MB FRACT,80.0,52.0,5.7,80.0,84
CDM,30101505,CEPLUS TEST,853.0,554.45,61.08,853.0,84
CDM,30101510,*CREATININE OTHER SOURCE ASSAY,36.0,23.4,5.18,36.0,84
CDM,30101515,PROSTATIC ACID PHOS,753.0,489.45,53.89,753.0,84
CDM,30101525,PORPHOBILINOGEN UR SCN,40.0,26.0,2.33,40.0,84
CDM,30101555,POTASSIUM,33.0,21.45,2.27,33.0,84
CDM,30101565,PROGESTERONE,144.0,93.6,10.3,144.0,84
CDM,30101575,PROCALCITONIN,188.0,122.2,13.23,188.0,84
CDM,30101585,PROLACTIN,134.0,87.1,9.57,134.0,84
CDM,30101590,CREATININE CLEARANCE TEST,65.0,42.25,4.67,65.0,84
CDM,30101595,ACETOACETATE,56.0,36.4,8.17,56.0,84
CDM,30101600,*DRUG SCREEN QUAL SNGL,742.0,482.3,34.82,742.0,84
CDM,30101605,PSA FREE,127.0,82.55,9.08,127.0,84
CDM,30101615,PROTEIN ELECTRO.FLUID QT,116.0,75.4,8.33,129.85,84
CDM,30101625,INNER EAR 68KD ANTIBODY,118.0,76.7,8.41,118.0,84
CDM,30101645,ALDOLASE,67.0,43.55,4.8,67.0,84
CDM,30101655,ALPHA-1 ANTITRYPSIN TOTAL,93.0,60.45,6.64,93.0,84
CDM,30101665,ACETYLCHOL REC/BLOCK,100.0,65.0,7.14,100.0,84
CDM,30101670,FERRITIN ASSAY,94.0,61.1,6.73,94.0,84
CDM,30101675,%SEQ2 ALPHA FETOPROTEIN,116.0,75.4,8.28,116.0,84
CDM,30101680,FOLIC ACID SERUM ASSAY,101.0,65.65,7.26,101.0,84
CDM,30101685,RENIN PLASMA,152.0,98.8,10.86,152.0,84
CDM,30101690,GAMMAGLOBULIN ASSAY,64.0,41.6,4.59,64.0,84
CDM,30101695,ASSAY SERUM NA,98.0,63.7,6.85,98.0,84
CDM,30101705,SODIUM FLUID,34.0,22.1,2.4,34.0,84
CDM,30101715,AMINOLEVULINIC ACID (ALA) URINE,114.0,74.1,8.12,114.0,84
CDM,30101725,TESTOSTERONE FREE,176.0,114.4,12.58,176.0,84
CDM,30101745,THYROGLOBULIN,111.0,72.15,7.93,111.0,84
CDM,30101760,BLD GAS PH/PO2/PCO2 W SAT (POINT OF CARE LAB),544.0,353.6,31.51,544.0,84
CDM,30101765,VIT E ALPHA-TOCO TEST,98.0,63.7,7.0,102.87,84
CDM,30101770,GLUCOSE BF,27.0,17.55,1.94,27.0,84
CDM,30101775,ASSAY OF ASCORBIC ACID,68.0,44.2,4.88,68.0,84
CDM,30101785,%T4TFI T4 UPTAKE,45.0,29.25,3.19,45.0,84
CDM,30101795,TROPONIN T,86.0,55.9,4.99,86.0,84
CDM,30101805,"TYROSINE, PLASMA, EA",73.0,47.45,5.14,73.0,84
CDM,30101815,UREA CLEARANCE 24 HR UR,185.0,120.25,13.23,185.0,84
CDM,30101820,GTT 3SPEC,89.0,57.85,12.87,89.0,84
CDM,30101825,UROBILINOGEN SC URINE,42.0,27.3,2.48,42.0,84
CDM,30101830,GTT EA ADD SPEC BEYOND 3,27.0,17.55,3.92,27.0,84
CDM,30101835,CARBOHYDRATE DEF TRANSF,125.0,81.25,8.92,139.04,84
CDM,30101840,GGT ASSAY,50.0,32.5,7.2,50.0,84
CDM,30101845,VIT A (RETINAL) TEST,80.0,52.0,5.73,89.35,84
CDM,30101850,GLYCATED PROTEIN,116.0,75.4,16.76,116.0,84
CDM,30101865,C-PEPTIDE SERUM,144.0,93.6,10.28,144.0,84
CDM,30101870,GONADOTROPIN FSH,128.0,83.2,18.58,128.0,84
CDM,30101875,HCG QUANT SERUM,104.0,67.6,7.44,104.0,84
CDM,30101885,ASSAY HCG,68.0,44.2,3.92,68.0,84
CDM,30101890,HAPTOGLOBIN QUANT ASSAY,87.0,56.55,6.21,87.0,84
CDM,30101895,FECAL WT 24HR WET WEIGHT,158.0,102.7,18.15,1666801.85,67
CDM,30101915,DRUG TEST PRSMV CHEM ANLYZR,429.0,278.85,31.92,429.0,84
CDM,30101935,%PCA3 INTERP REPORT PC,32.0,20.8,2.29,35.18,84
CDM,30101965,%NMRLIP CHOLESTEROL,92.0,59.8,13.39,92.0,84
CDM,30101970,HGB A1C GLYCOSYLATED,67.0,43.55,9.71,67.0,84
CDM,30101975,ETHOSUXIMIDE ZARONTIN,113.0,73.45,8.07,113.0,84
CDM,30101980,HISTAMINE,204.0,132.6,14.58,204.0,84
CDM,30101985,HALOPERIDOL,99.0,64.35,7.07,99.0,84
CDM,30101995,QUINIDINE,101.0,65.65,7.21,101.0,84
CDM,30102000,HOMOCYSTEINE ASSAY,124.0,80.6,8.33,124.0,84
CDM,30102005,DEHYDROEPIANDROSTERONE,174.0,113.1,12.48,174.0,84
CDM,30102025,11-DEOXYCORTISOL,202.0,131.3,14.46,202.0,84
CDM,30102045,DIHYDROTESTOSTERONE,742.0,482.3,34.82,742.0,84
CDM,30102055,*%BO OXI PHOS MUSC MITO X6,304.0,197.6,17.61,304.0,84
CDM,30102065,ELECTROPHORESIS NON-SPEC,424.0,275.6,20.86,424.0,84
CDM,30102095,ESTRIOL SERUM,167.0,108.55,11.94,167.0,84
CDM,30102100,*IMMUNOASSAY NONINF QUANT RIA,127.0,82.55,7.36,127.0,84
CDM,30102105,ESTRONE SERUM,172.0,111.8,22.0,172.0,84
CDM,30102115,ETHYLENE GLYCOL,103.0,66.95,7.36,103.0,84
CDM,30102125,FECAL FAT QUANT FECES,117.0,76.05,8.3,117.0,84
CDM,30102135,FATTY ACIDS NONESTERIFIED,130.0,84.5,7.51,130.0,84
CDM,30102145,PEROXISOMAL PANEL,136.0,88.4,8.92,139.04,84
CDM,30102155,FLUORIDE SERUM,128.0,83.2,9.16,183.29,84
CDM,30102185,GALAC PHOS URIDYL TRANS,145.0,94.25,10.4,162.23,84
CDM,30102195,%NEO GIPO4 URIDYL TRANS,81.0,52.65,4.7,81.0,84
CDM,30102215,%GASTST GASTRIN STIMX4,122.0,79.3,8.74,174.01,84
CDM,30102225,%GASTST GASTRIN,122.0,79.3,8.71,122.0,84
CDM,30102230,IMMUNOASSAY QUANT NOS NONAB,119.0,77.35,6.91,119.0,84
CDM,30102235,GLUCAGON,99.0,64.35,7.06,110.02,84
CDM,30102245,GLUCOSE 6 PHOS DEHYD QT,67.0,43.55,4.79,67.0,84
CDM,30102255,%HCVSUR GLUTTRANS GAMMA,50.0,32.5,7.2,50.0,84
CDM,30102285,F(FETAL) QUAL,55.0,35.75,3.2,55.0,84
CDM,30102295,HEMOGLOBIN PLASMA,50.0,32.5,3.61,51.56,84
CDM,30102315,HOMOCYSTINE UR QNT,124.0,80.6,8.33,124.0,84
CDM,30102325,HOMOVANILLIC ACID (HVA),155.0,100.75,9.56,155.0,84
CDM,30102345,5 HIAA URINE,89.0,57.85,6.37,99.26,84
CDM,30102355,%NEO 17 OH PROGESTERONE,187.0,121.55,13.42,187.0,84
CDM,30102375,%U17K 17KETOSTEROIDS 24UR,88.0,57.2,6.32,88.0,84
CDM,30102395,LACTATE (LACTIC ACID),80.0,52.0,11.57,80.0,84
CDM,30102405,%LDISO LD ISOENZYMES,88.0,57.2,6.32,88.0,84
CDM,30102410,LAC (LD)(LDH),42.0,27.3,2.98,42.0,84
CDM,30102415,"LACTOFERRIN, FECAL",136.0,88.4,9.7,136.0,84
CDM,30102425,HUMAN PLACENTAL LACTOGEN,140.0,91.0,9.99,140.0,84
CDM,30102450,LIPASE ASSAY,48.0,31.2,3.4,48.0,84
CDM,30102455,HDL CHOL SUBFRACTIONS,234.0,152.1,13.54,234.0,84
CDM,30102480,*LIPOPROTEIN MR SPECTROSCOPY,236.0,153.4,15.58,236.0,84
CDM,30102490,HDL CHOLESTEROL DIR ASSAY,57.0,37.05,7.93,57.0,84
CDM,30102500,LDL CHOLESTE,72.0,46.8,10.5,72.0,84
CDM,30102505,MUCOPOLYSACCHARIDES QT,197.0,128.05,11.4,197.0,84
CDM,30102510,MAG ASSAY,46.0,29.9,3.31,46.0,84
CDM,30102515,MYELIN BASIC PROTEIN,119.0,77.35,8.5,119.0,84
CDM,30102525,MYELOPEROXIDASE (MPO),351.0,228.15,20.34,351.0,84
CDM,30102535,NICKEL SERUM,169.0,109.85,12.1,169.0,84
CDM,30102545,NICOTINE AND METAB UR,742.0,482.3,34.82,742.0,84
CDM,30102555,NUCLEOTIDASE-5,77.0,50.05,5.51,77.0,84
CDM,30102565,ORGANIC ACIDS QUANT EA,163.0,105.95,9.44,163.0,84
CDM,30102575,%UORA ORG ACIDS UR QNT,163.0,105.95,9.44,163.0,84
CDM,30102585,"OXYCODONE CONF/QT, URINE",742.0,482.3,34.82,742.0,84
CDM,30102595,OSTEOCALCIN,206.0,133.9,14.74,206.0,84
CDM,30102605,HER-2/NEU SERUM,444.0,288.6,20.86,444.0,84
CDM,30102615,"%SSAT24 PH, UR",25.0,16.25,1.77,27.56,84
CDM,30102635,%NEO PHENYLALANINE,38.0,24.7,2.72,39.14,84
CDM,30102645,ACID PHOSPHATASE TOTL,53.0,34.45,3.65,53.0,84
CDM,30102655,PROSTATIC ACID PHOS,67.0,43.55,4.77,67.0,84
CDM,30102665,%STCATH PHOSPOROUS,33.0,21.45,2.34,33.0,84
CDM,30102680,NATRIURETIC PEPTIDE ASSAY,271.0,176.15,20.86,271.0,84
CDM,30102685,PORPHYRINS URINE,101.0,65.65,7.26,113.27,84
CDM,30102695,PORPHYRINS STOOL,270.0,175.5,15.64,270.0,84
CDM,30102715,PREGNENOLONE SERUM,143.0,92.95,10.21,143.0,84
CDM,30102725,HYDROXYPREGNENELONE-17,157.0,102.05,11.26,157.0,84
CDM,30102755,"PROTEIN TOTAL, OTHER SOURCE",28.0,18.2,1.81,28.0,84
CDM,30102765,PAPP-A,104.0,67.6,7.44,115.95,84
CDM,30102775,PROTEIN ELECT & QUANT,74.0,48.1,5.3,74.0,84
CDM,30102785,PROINSULIN SERUM,184.0,119.6,10.68,184.0,84
CDM,30102795,VITAMIN B6 PLASMA,194.0,126.1,13.88,194.0,84
CDM,30102815,PYRUVATE KINASE,65.0,42.25,4.66,65.0,84
CDM,30102825,SELENIUM BLOOD,176.0,114.4,12.61,176.0,84
CDM,30102855,SOMATOSTATIN,126.0,81.9,9.02,140.77,84
CDM,30102865,%CDG SUGAR CHROMATOGR,269.0,174.85,15.6,269.0,84
CDM,30102885,SUGARS MULT QL EA,38.0,24.7,2.72,38.0,84
CDM,30102895,THIOCYANATE UR RANDOM,80.0,52.0,5.74,80.0,84
CDM,30102905,THYROXINE BIND GLOBULIN,102.0,66.3,7.3,102.0,84
CDM,30102915,%NEO TSH,116.0,75.4,16.8,116.0,84
CDM,30102925,CORTICOSTEROID-BINDING GLOGULIN,124.0,80.6,8.89,124.0,84
CDM,30102935,%HCVSUR ALT (SGPT),37.0,24.05,5.3,37.0,84
CDM,30102945,%VAP TRIGLYCERIDES,40.0,26.0,5.74,40.0,84
CDM,30102965,T3 DIAL FREE,117.0,76.05,8.37,117.0,84
CDM,30102975,REVERSE T3,109.0,70.85,7.78,109.0,84
CDM,30102995,VMA (VANILLYLMANDELIC ACID),107.0,69.55,7.65,119.32,84
CDM,30103005,VIP,244.0,158.6,17.45,272.08,84
CDM,30103015,"COPEPTIN PROAVP, PLASMA",234.0,152.1,16.76,234.0,84
CDM,30103025,VITAMIN K,95.0,61.75,6.78,104.38,84
CDM,30103045,%FIRSCN HCG QUANT,104.0,67.6,7.44,104.0,84
CDM,30103055,C1 ESTERASE INHIBITOR,83.0,53.95,5.92,83.0,84
CDM,30103065,%CEPHAL FLOUR AB X3,83.0,53.95,5.95,83.0,84
CDM,30103095,CANNABINOIDS CONF UR,742.0,482.3,34.82,742.0,84
CDM,30103105,MPL TEST,1278.0,830.7,74.08,1988.72,84
CDM,30103115,KITAML MUTATION ANALYS,2274.0,1478.1,116.49,2274.0,84
CDM,30103155,SEX-HORMONE BIND GLOBULIN,150.0,97.5,10.73,150.0,84
CDM,30103165,INSULIN LIK GR FAC 1,147.0,95.55,10.5,147.0,84
CDM,30103175,AMPHETAMINE CONF URINE,742.0,482.3,34.82,742.0,84
CDM,30103185,COCAINE CONFIRM UR,742.0,482.3,34.82,742.0,84
CDM,30103195,%SERPINA1 GENE ANALYSIS,301.0,195.65,21.56,301.0,84
CDM,30103205,DIF LG BCELL LYMPH SUBTYP,953.0,619.45,83.94,1851898.14,67
CDM,30103215,"TRAMADOL & METAB, QUANT",742.0,482.3,34.82,742.0,84
CDM,30103235,CHIMERISM TEST-STR-3 OR MORE,1799.0,1169.35,116.49,1799.0,84
CDM,30103300,ORGANIC ACID SNGL QUANT,146.0,94.9,8.48,146.0,84
CDM,30103315,DRGTOF TAPENTADOL AND MET,170.0,110.5,34.82,257.48,84
CDM,30103340,OSMOLALITY BLOOD ASSAY,46.0,29.9,3.26,46.0,84
CDM,30103360,OSMOLALITY URINE ASSAY,47.0,30.55,3.37,47.0,84
CDM,30103375,%FLT3M ITD GENE,1142.0,742.3,66.2,1142.0,84
CDM,30103380,PARATHYROID HORMONE ASSAY,285.0,185.25,20.38,285.0,84
CDM,30103385,%FLT3M TKD GENE,573.0,372.45,33.2,573.0,84
CDM,30103420,ANTIPSYCHOTICS NOS 1-3,742.0,482.3,34.82,742.0,84
CDM,30103435,11 DEOXYCORTICOSTERONE,214.0,139.1,15.3,214.0,84
CDM,30103455,%IGA12 IGA SUBCLASS 1&2,55.0,35.75,3.96,55.0,84
CDM,30103460,PHOSPHOROUS ASSAY,33.0,21.45,2.34,33.0,84
CDM,30103480,PHOSPHOROUS URINE ASSAY,40.0,26.0,2.56,40.0,84
CDM,30103500,*PORPHOBILINOGEN URINE QUANT,40.0,26.0,2.33,40.0,84
CDM,30103515,THYROGLOB AB INTERFERENCE,111.0,72.15,7.93,111.0,84
CDM,30103525,URIC ACID BODY FLUID,35.0,22.75,2.34,35.0,84
CDM,30103540,K URINE ASSAY,33.0,21.45,2.13,33.0,84
CDM,30103545,EVEROLIMUS,95.0,61.75,6.78,95.0,84
CDM,30103555,GABAPENTIN,150.0,97.5,8.67,150.0,84
CDM,30103565,MYCOPHENOLIC ACID,125.0,81.25,8.91,125.0,84
CDM,30103575,OXCARBAZEPINE,91.0,59.15,6.54,91.0,84
CDM,30103580,PREALBUMIN ASSAY,101.0,65.65,7.2,101.0,84
CDM,30103585,ZONISAMIDE,91.0,59.15,6.54,91.0,84
CDM,30103595,CRMSNP TEST,4500.0,2925.0,540.0,4500.0,84
CDM,30103605,MGMT TEST,860.0,559.0,49.86,860.0,84
CDM,30103615,PCA3 TEST,1760.0,1144.0,102.02,1760.0,84
CDM,30103625,TGFB2 GENOTYPING LV6,2079.0,1351.35,116.49,2079.0,84
CDM,30103630,PROTEIN TOTAL SERUM ASSAY,25.0,16.25,3.67,25.0,84
CDM,30103635,INSULIN ASSAY,79.0,51.35,5.64,79.0,84
CDM,30103640,*PROTEIN TOTAL URINE ASSAY,25.0,16.25,1.81,25.0,84
CDM,30103645,PHENYLALANINE (PKU) EA,38.0,24.7,2.72,39.14,84
CDM,30103655,CAFFEINE,266.0,172.9,15.43,266.0,84
CDM,30103665,DBMDYS TEST,1925.0,1251.25,111.6,1925.0,84
CDM,30103675,%AJPWO CANVAN,326.0,211.9,18.9,326.0,84
CDM,30103685,%AJPWO BLOOM,271.0,176.15,15.72,271.0,84
CDM,30103690,PROTEIN TOTAL OTHER ASSAY,28.0,18.2,1.81,28.0,84
CDM,30103695,%AJPWO FANCONI,253.0,164.45,14.65,253.0,84
CDM,30103705,CON26 TEST,698.0,453.7,40.45,698.0,84
CDM,30103710,PROTEIN ELECPHRSIS SERUM,74.0,48.1,5.3,74.0,84
CDM,30103715,%AJPWO TAY SACHS,355.0,230.75,51.45,355.0,84
CDM,30103725,%AJPWO FAMILIAL DYSAUTO,271.0,176.15,15.72,271.0,84
CDM,30103735,%NFIB1 COMP ANLYS STR,1608.0,1045.2,106.2,1608.0,84
CDM,30103750,WESTERN BLOT BLOOD OR BODY FL,118.0,76.7,8.41,118.0,84
CDM,30103755,%AJPWO MUCOLIPIDOSIS IV,271.0,176.15,15.72,271.0,84
CDM,30103765,RETT ANALYSIS TEST,3642.0,2367.3,109.69,3642.0,84
CDM,30103775,RETT DUP/DEL TEST,1035.0,672.75,60.0,1035.0,84
CDM,30103785,PTEN ANALYSIS TEST,4140.0,2691.0,173.12,4140.0,84
CDM,30103795,PTEN DUP/DEL TEST,2070.0,1345.5,116.49,2070.0,84
CDM,30103805,PMP22,5233.0,3401.45,173.12,5233.0,84
CDM,30103815,PMP22 TEST,5310.0,3451.5,173.12,5310.0,84
CDM,30103820,PROTOPORPHYRIN RBC QUANT,99.0,64.35,7.08,110.47,84
CDM,30103825,%HLAA29 TEST,513.0,333.45,35.92,513.0,84
CDM,30103835,NARCO1 HLADRB1 TEST,654.0,425.1,45.34,654.0,84
CDM,30103845,%CYP21A2 COMMON VARI,1037.0,674.05,60.13,1728.34,84
CDM,30103855,HEMMIG SCN1A TEST,5839.0,3795.35,173.12,5839.0,84
CDM,30103860,VIT B-2 ASSAY,140.0,91.0,9.99,140.0,84
CDM,30103865,NFIB1 COLA11 COL1A2,13800.0,8970.0,672.05,13800.0,84
CDM,30103875,%ACHFHB ACETYLCHOL,85.0,55.25,5.52,85.0,84
CDM,30103885,AFP AMNIOTIC FLUID,117.0,76.05,8.28,129.17,84
CDM,30103890,NA URINE ASSAY,35.0,22.75,2.4,35.0,84
CDM,30103895,%NEO AMINO ACIDS X3,96.0,62.4,6.85,96.0,84
CDM,30103905,ANGIOTENSIN II,142.0,92.3,10.14,158.03,84
CDM,30103915,POLYCHLOR BIPHENYLS,41.0,26.65,2.97,41.0,84
CDM,30103920,SPECTROPHOTOMETRY NOS,56.0,36.4,3.45,56.0,84
CDM,30103925,%UMUCPO CHONDRO QUANT,142.0,92.3,10.2,159.03,84
CDM,30103935,"SMITH - LEMLI-OPITZ SCREEN, PL",166.0,107.9,9.64,166.0,84
CDM,30103945,CRYOFIBRINOGEN,98.0,63.7,5.66,98.0,84
CDM,30103955,CYANIDE BLOOD,134.0,87.1,9.58,134.0,84
CDM,30103965,MISC SENDOUT CPT 83080,116.0,75.4,8.33,129.85,84
CDM,30103975,PIVKA II,444.0,288.6,20.86,444.0,84
CDM,30104030,TESTOSTERONE TOTAL ASSAY,178.0,115.7,12.75,178.0,84
CDM,30104060,VIT B-1 ASSAY,146.0,94.9,10.48,146.0,84
CDM,30104080,THYROXINE TOTAL ASSAY,47.0,30.55,3.39,47.0,84
CDM,30104090,THYROXINE FREE ASSAY,62.0,40.3,5.11,62.0,84
CDM,30104095,%TADID AMITRIPTYLINE,742.0,482.3,34.82,742.0,84
CDM,30104125,ISOPROPANOL,742.0,482.3,34.82,742.0,84
CDM,30104130,TRIGLYCERIDES ASSAY,40.0,26.0,5.74,40.0,84
CDM,30104135,LSD CONFIRMATION URINE,742.0,482.3,34.82,742.0,84
CDM,30104145,"AMPHETAMINE CONF, UR",742.0,482.3,34.82,742.0,84
CDM,30104150,TRIIODOTHYRONINE TOTAL(TT-3),98.0,63.7,7.0,98.0,84
CDM,30104155,"METHADONE CONFIRM, UR",742.0,482.3,34.82,742.0,84
CDM,30104160,TRIIODOTHYRONINE FREE(FT-3),117.0,76.05,8.37,117.0,84
CDM,30104170,TROPONIN ASSAY QUAL (POINT OF CARE LAB),70.0,45.5,4.04,70.0,84
CDM,30104175,VALPROIC ACID-DEPAKENE,93.0,60.45,6.69,93.0,84
CDM,30104180,BUN,27.0,17.55,1.95,27.0,84
CDM,30104185,VALPROIC ACID FREE,93.0,60.45,6.69,93.0,84
CDM,30104195,LAMOTRIGINE,86.0,55.9,24.32,257.48,84
CDM,30104200,UREA NITROGEN URINE ASSAY,38.0,24.7,2.34,38.0,84
CDM,30104205,LEVETIRACETAM/KEPPRA,91.0,59.15,6.54,91.0,84
CDM,30104215,THERAPEUTIC DRUG LEVEL,129.0,83.85,18.31,129.0,84
CDM,30104220,URIC ACID BLOOD ASSAY,31.0,20.15,4.52,31.0,84
CDM,30104225,HEMOGLOBIN QUAL URINE,27.0,17.55,1.95,27.0,84
CDM,30104230,URIC ACID OTHER SOURCE ASSAY,35.0,22.75,2.34,35.0,84
CDM,30104235,17-OH PROGESTERONE,187.0,121.55,13.42,187.0,84
CDM,30104250,VOLATILES ASSAY,118.0,76.7,7.94,118.0,84
CDM,30104255,%PORPHYRIN SCREEN,92.0,59.8,5.34,92.0,84
CDM,30104265,PSA DIAGNOSTIC,127.0,82.55,10.42,127.0,84
CDM,30104275,PROTEIN ELECTRO.FLUID QT,123.0,79.95,13.62,123.0,84
CDM,30104285,ZINC PROTOPORPHYRINS,99.0,64.35,7.08,110.47,84
CDM,30104295,PYRUVIC ACID CSF,100.0,65.0,5.79,100.0,84
CDM,30104305,SPECIFIC GRAVITY BDY FLD,23.0,14.95,1.31,23.0,84
CDM,30104315,THIOCYANATE,80.0,52.0,5.74,80.0,84
CDM,30104325,%TRAB THYROID STIM IMMUN,351.0,228.15,25.11,351.0,84
CDM,30104335,VMA URINE,107.0,69.55,7.65,119.32,84
CDM,30104345,ZINC BLOOD,79.0,51.35,5.62,87.67,84
CDM,30104355,HCG QUAL FLUID/URINE,59.0,38.35,6.37,59.0,84
CDM,30104365,PSA SCREENING,127.0,82.55,10.42,127.0,84
CDM,30104385,BRWK ACETAMINOPHEN BL,742.0,482.3,34.82,742.0,84
CDM,30104395,ASSAY NONENDOCRINE RECEPTOR,252.0,163.8,18.06,252.0,84
CDM,30104405,CALR EXON 9 MUTATION,839.0,545.35,60.06,839.0,84
CDM,30104415,KIT D816V MUT DETECT,862.0,560.3,49.95,862.0,84
CDM,30104425,MICROALBUMIN; URINE SEMIQUAN,43.0,27.95,6.23,43.0,84
CDM,30104435,LEVAMISOLE,742.0,482.3,34.82,742.0,84
CDM,30104505,%A1APHE A1A PHENOTYPE,100.0,65.0,7.14,100.0,84
CDM,30104515,%2ND TRI AFP,116.0,75.4,8.28,116.0,84
CDM,30104525,AMYLASE,45.0,29.25,6.48,45.0,84
CDM,30104535,STRNGVIL ISTAT CREATININE,35.0,22.75,2.53,35.0,84
CDM,30104545,CRYOGLOBULIN QL,45.0,29.25,3.19,49.8,84
CDM,30104555,GLUCOSE SCRN POST DOSE,33.0,21.45,4.75,33.0,84
CDM,30104565,%LIVFIB GGT,50.0,32.5,7.2,50.0,84
CDM,30104575,%CELCMP TRANSGLUT IGA,80.0,52.0,11.53,80.0,84
CDM,30104585,BRWK PSA DIAGNOSTIC,127.0,82.55,10.42,127.0,84
CDM,30104595,%1ST TRI PAPP-A,104.0,67.6,7.44,115.95,84
CDM,30104605,%1ST TRI HCG QUANT,104.0,67.6,7.44,104.0,84
CDM,30104615,%UQNTPP HEROIN METABOLITE,742.0,482.3,34.82,742.0,84
CDM,30104625,CREATININE UR/FLUID,36.0,23.4,5.18,36.0,84
CDM,30104635,VITAMIN B12 BLOOD,104.0,67.6,8.54,104.0,84
CDM,30104645,PSA FREE,127.0,82.55,9.08,127.0,84
CDM,30104655,%ANEMIA AMINO ADID 2-5 QT,135.0,87.75,8.33,135.0,84
CDM,30104685,JAK2 TEST,632.0,410.8,45.27,632.0,84
CDM,30104705,%CFA VERY LONG CHAIN,136.0,88.4,8.92,139.04,84
CDM,30104715,%CELCMP HLADQ2 TEST,853.0,554.45,61.08,853.0,84
CDM,30104725,GLUCOSE SCRN POST DOSE,45.0,29.25,9.81,45.0,58
CDM,30104735,%CELCMP HLADQ8 TEST,853.0,554.45,61.08,853.0,84
CDM,30104745,%CELCMP GAMMALOBULIN,64.0,41.6,4.59,64.0,84
CDM,30104755,URIC ACID BLOOD,31.0,20.15,4.52,31.0,84
CDM,30104815,GBL MYL NGS 5-50 GENE,5241.0,3406.65,173.12,5241.0,84
CDM,30104825,%A1APHE A1A TOTAL,93.0,60.45,6.64,93.0,84
CDM,30104875,%NASH TRIGLYCERIDES,40.0,26.0,5.74,40.0,84
CDM,30104885,"SULFONYLUREA HYPOGLY, SER",309.0,200.85,34.82,309.0,84
CDM,30104905,MPL MUTATION ANLYS BLD,1278.0,830.7,74.08,1988.72,84
CDM,30104915,POTASSIUM (POINT OF CARE LAB),33.0,21.45,2.27,33.0,84
CDM,30104925,%NGSCOL BRAF,1210.0,786.5,70.16,1210.0,84
CDM,30104935,"%NGSCOL KRAS 12,13",1333.0,866.45,77.3,1333.0,84
CDM,30104945,%KRASGN KRAS EXON2,1333.0,866.45,77.3,1333.0,84
CDM,30104955,%KRASGN KRAS ADD VAR,1333.0,866.45,77.3,1333.0,84
CDM,30104965,%NRASGN GENE ANALYSIS,2041.0,1326.65,116.49,2041.0,84
CDM,30104975,%NGSCOL KRAS 61,1333.0,866.45,77.3,1333.0,84
CDM,30104985,MOPATH PROCEDURE LEVEL 5,1896.0,1232.4,109.93,1896.0,84
CDM,30104995,CFNGS 139 VAR,3841.0,2496.65,109.69,4289.05,84
CDM,30105005,%NASH APOLIPOPROTEIN,146.0,94.9,8.44,146.0,84
CDM,30105015,%NASH BILIRUBIN TOTAL,35.0,22.75,4.36,35.0,84
CDM,30105025,%NASH CHOLESTEROL TOTAL,30.0,19.5,4.35,30.0,84
CDM,30105035,%NASH GLUC QUANT,27.0,17.55,1.94,27.0,84
CDM,30105045,%NASH GGT,50.0,32.5,7.2,50.0,84
CDM,30105055,%NASH HAPTOGLOBIN QNT,87.0,56.55,6.21,87.0,84
CDM,30105065,%NASH NEPHELOMETRY,94.0,61.1,6.72,94.0,84
CDM,30105075,%NASH AST,36.0,23.4,5.18,36.0,84
CDM,30105085,%NASH AST,37.0,24.05,5.3,37.0,84
CDM,30105115,%BCRQL BCR/ABL1 MAJ BRKPT,1131.0,735.15,80.97,1262.54,84
CDM,30105125,%PHI PROST SPEC AG TOT,127.0,82.55,10.42,127.0,84
CDM,30105225,%CELCMP HLADQ8 TEST,853.0,554.45,61.08,853.0,84
CDM,30105255,RESP VIRUS 3-5 TARGETS,984.0,639.6,49.14,984.0,84
CDM,30105265,%LIVFIB APOLIPOPROTEIN,146.0,94.9,8.44,146.0,84
CDM,30105275,%LIVFIB BILIRUBIN,35.0,22.75,4.36,35.0,84
CDM,30105285,%LIVFIB HAPTOGLOBIN QNT,87.0,56.55,6.21,87.0,84
CDM,30105295,%LIVFIB NEPHELOMETRY,94.0,61.1,6.72,94.0,84
CDM,30105305,%LIVFIB ALANINE AMINO,37.0,24.05,5.3,37.0,84
CDM,30105315,TROPONIN I,86.0,55.9,4.99,86.0,84
CDM,30105325,%BCRQL BCR/ABL1 MIN BRKPT,999.0,649.35,71.52,1115.21,84
CDM,30105335,%BCRQL BCR/ABL1 OTH BRKPT,1481.0,962.65,85.85,1481.0,84
CDM,30105345,NT PRO BNP,271.0,176.15,20.86,271.0,84
CDM,30105355,EGFR GENE ANALYSIS,2240.0,1456.0,109.69,2240.0,84
CDM,30105365,MYELOID NGS 5-50 GENE,5241.0,3406.65,173.12,5241.0,84
CDM,30105375,ADMARK PHOS TAU CSF X3,119.0,77.35,6.91,119.0,84
CDM,30105385,MATRIX METALLOPRO-9 MMP-9,119.0,77.35,6.91,119.0,84
CDM,30105415,%BMEMAL W CELL SELECT,1799.0,1169.35,116.49,1799.0,84
CDM,30105425,PAIN PANEL QNT UR,1015.0,659.75,75.43,1015.0,84
CDM,30105435,"HLA-A-B,CW,DR,DQ,DRB345-RSSOP-Q9 VERIF",2791.0,1814.15,109.69,2791.0,84
CDM,30105445,RHD VARIANT ANTIGEN,1278.0,830.7,74.08,1988.72,84
CDM,30105455,HUMAN ERYTHROCYTE AG,1278.0,830.7,74.08,1988.72,84
CDM,30105465,RHCE VARIANT ANTIGEN,1278.0,830.7,74.08,1988.72,84
CDM,30105475,BCR ABL QUAL MPLEX PCR,1170.0,760.5,83.94,1666801.85,67
CDM,30105485,%FLT3 TKD TEST,573.0,372.45,33.2,573.0,84
CDM,30105495,%NGSLUNG HER2,54.0,35.1,11.77,1666801.85,67
CDM,30105505,%NGSLUNG PIK3CA,1896.0,1232.4,109.93,1896.0,84
CDM,30105525,FHHE TEST,2079.0,1351.35,116.49,2079.0,84
CDM,30105535,P53MUT TEST,2079.0,1351.35,116.49,2079.0,84
CDM,30105545,SLC2A1 TEST,2079.0,1351.35,116.49,2079.0,84
CDM,30105555,VON WILLEBRAND TYPE2N,2079.0,1351.35,116.49,2079.0,84
CDM,30105565,FABRY TEST,2079.0,1351.35,116.49,2079.0,84
CDM,30105575,ACTA2 TEST,2079.0,1351.35,116.49,2079.0,84
CDM,30105585,SHOX DNA DX,2079.0,1351.35,116.49,2079.0,84
CDM,30105595,GCH1 TEST,2079.0,1351.35,116.49,2079.0,84
CDM,30105605,MODY3 (TCF2) PT2,1896.0,1232.4,109.93,1896.0,84
CDM,30105615,VASDPL TGFBR1 TEST,2079.0,1351.35,116.49,2079.0,84
CDM,30105635,%CYP21A2 FULL GENE ANA,2079.0,1351.35,116.49,2079.0,84
CDM,30105645,MEN2 FMTC MUT TEST,505.0,328.25,83.94,1666801.85,67
CDM,30105655,CADASL TEST,1952.0,1268.8,113.15,3582.53,84
CDM,30105665,POLG1 TEST,1952.0,1268.8,113.15,3582.53,84
CDM,30105675,HDSNP TEST,4500.0,2925.0,540.0,4500.0,84
CDM,30105685,LDLR TEST,1952.0,1268.8,113.15,3582.53,84
CDM,30105695,HEMMIG ATP1A2,1952.0,1268.8,113.15,3582.53,84
CDM,30105705,SETX TEST,1952.0,1268.8,113.15,3582.53,84
CDM,30105715,CALP3 TEST,1952.0,1268.8,113.15,3582.53,84
CDM,30105725,MFN2 TEST,1952.0,1268.8,113.15,3582.53,84
CDM,30105735,GALACTOSYLCERAMDE,1952.0,1268.8,113.15,3582.53,84
CDM,30105745,MODY2 (GCK),1952.0,1268.8,113.15,3582.53,84
CDM,30105755,MODY1 (HNF4A),1952.0,1268.8,113.15,3582.53,84
CDM,30105765,CLOTTING TEST,30.0,19.5,4.29,30.0,84
CDM,30105775,IMFIX ELECT IGD IGE,154.0,100.1,11.04,154.0,84
CDM,30105785,3 METHYLGLUTACONIC ACID,146.0,94.9,8.48,146.0,84
CDM,30105795,PIPECOLIC ACID SERUM,166.0,107.9,9.64,166.0,84
CDM,30105805,MUSK ANTIBODY,127.0,82.55,7.36,127.0,84
CDM,30105815,MUSCLE MODULATING AB,127.0,82.55,7.36,127.0,84
CDM,30105820,CYSTATIN C,128.0,83.2,7.41,128.0,84
CDM,30105825,GANGLIONIC NACHR ANTIBOD,127.0,82.55,7.36,127.0,84
CDM,30105835,PROCOL TYPEL N TARMINAL,127.0,82.55,7.36,127.0,84
CDM,30105840,ENZYME ACTIVITY NRADIOAC NOS,153.0,99.45,8.92,153.0,84
CDM,30105845,VOLTAGE-GATED CAL IGG AB,127.0,82.55,7.36,127.0,84
CDM,30105855,GANGLIONIC ACHR AUTOAB,127.0,82.55,7.36,127.0,84
CDM,30105860,IMMUNOASSAY,127.0,82.55,7.36,127.0,84
CDM,30105865,MELANOCYTE STIM HORMONE ALP,127.0,82.55,7.36,127.0,84
CDM,30105875,PANCREASTATIN,127.0,82.55,7.36,127.0,84
CDM,30105880,"PORPHOBILINOGEN, QN, RANDOM UR",58.0,37.7,4.17,58.09,84
CDM,30105885,NEURO VG K CHAN ABS MOD,127.0,82.55,7.36,127.0,84
CDM,30105895,MELATONIN,119.0,77.35,6.91,119.0,84
CDM,30105900,PARATHYROID HORMONE ASSAY,285.0,185.25,20.38,285.0,84
CDM,30105905,%MYGRAV ACHR ABX2,127.0,82.55,7.36,127.0,84
CDM,30105910,*PORPHYRINS URINE QUAL,92.0,59.8,5.34,92.0,84
CDM,30105915,%CEPHAL IA/RIA,127.0,82.55,7.36,127.0,84
CDM,30105920,*PROLACTIN ASSAY,134.0,87.1,9.57,134.0,84
CDM,30105925,IGF-II INSULIN LIKE GR,127.0,82.55,7.36,127.0,84
CDM,30105935,VOLTAGE-GATED KCHANNEL AB,127.0,82.55,7.36,127.0,84
CDM,30105945,%LAMBRT IA;QNT RIA X4 MOD,127.0,82.55,7.36,127.0,84
CDM,30105955,21 HYDROXYLASE AB,127.0,82.55,7.36,127.0,84
CDM,30105965,PANCREATIC POLYPE,127.0,82.55,7.36,127.0,84
CDM,30105975,ACETYLCHOL REC MOD,127.0,82.55,7.36,127.0,84
CDM,30105985,IGFBP-3 INSULIN,97.0,63.05,6.97,104.92,84
CDM,30105995,%PARNEO AB BIND X2 MOD,127.0,82.55,7.36,127.0,84
CDM,30106005,IGF BINDING PROTEIN 2,127.0,82.55,7.36,127.0,84
CDM,30106010,LIPOPROTEIN (LP-PLA2) ASSAY,320.0,208.0,18.52,320.0,84
CDM,30106015,TRYPSINOGEN,119.0,77.35,6.91,119.0,84
CDM,30106035,GALACTOSE-1-PHOSPHATE,80.0,52.0,5.69,80.0,84
CDM,30106045,VASC ENDO GROWTH FACT,119.0,77.35,6.91,119.0,84
CDM,30106055,"%CDG MS, MS/MS",166.0,107.9,9.64,166.0,84
CDM,30106060,*MASS SPECTRMTRY QUANT EA,166.0,107.9,9.64,166.0,84
CDM,30106065,"%NCDG MS, MS/MS",166.0,107.9,9.64,166.0,84
CDM,30106075,"ORGANIC ACID, UR",114.0,74.1,8.12,126.71,84
CDM,30106085,VITAMIN B1 PLASMA,146.0,94.9,10.48,146.0,84
CDM,30106095,KINASE TEST,2070.0,1345.5,116.49,2070.0,84
CDM,30106105,MICA GENOTYPING-RSSOP,1278.0,830.7,74.08,1988.72,84
CDM,30106115,MPL TEST,1278.0,830.7,74.08,1988.72,84
CDM,30106125,CEBPA MUT ANALYSIS,1669.0,1084.85,116.49,1669.0,84
CDM,30106135,JAKNON TEST,1278.0,830.7,74.08,1988.72,84
CDM,30106145,%NGSLUNG KRAS 61,1333.0,866.45,77.3,1333.0,84
CDM,30106155,TTR GENOTYPING LV5,1896.0,1232.4,109.93,1896.0,84
CDM,30106165,VWF TSA EXON 28,1278.0,830.7,74.08,1988.72,84
CDM,30106175,DBMDXS TEST,1925.0,1251.25,111.6,1925.0,84
CDM,30106185,GBM ANTIBODY,118.0,76.7,8.41,118.0,84
CDM,30106195,%CEPHAL WESTERN BLOT,118.0,76.7,8.41,118.0,84
CDM,30106215,KITMST TEST,1037.0,674.05,60.13,1728.34,84
CDM,30106225,"CHYMOTRYPSIN, STOOL",56.0,36.4,3.45,56.0,84
CDM,30106235,ADENOSINE DEAMINASE,56.0,36.4,3.45,56.0,84
CDM,30106245,PBG DEAMINASE,56.0,36.4,3.45,56.0,84
CDM,30106255,"BROMIDE, BLOOD",166.0,107.9,9.64,166.0,84
CDM,30106265,PORPHYRINS PLASMA,56.0,36.4,3.45,56.0,84
CDM,30106275,PHOSPHOLIPIDS,56.0,36.4,3.45,56.0,84
CDM,30106285,%MRATIO SPECTROPHOTO,56.0,36.4,3.45,56.0,84
CDM,30106295,PORPHYRINS SERUM TOTAL,56.0,36.4,3.45,56.0,84
CDM,30106305,%ETCMIT SPECTRO X8,56.0,36.4,3.45,56.0,84
CDM,30106315,%ETCMUS SPECTROPHOTO X8,56.0,36.4,3.45,56.0,84
CDM,30106325,%ETCF SPECTROPHOTO X5,56.0,36.4,3.45,56.0,84
CDM,30106335,%MYOENZ SPECTRO X9,56.0,36.4,3.45,56.0,84
CDM,30106365,%BRAFGN BRAF GENE AN,1210.0,786.5,70.16,1210.0,84
CDM,30106375,PURINE&PYRIMIDINE,166.0,107.9,9.64,166.0,84
CDM,30106385,THIOPURINE METHYLT TPMT,153.0,99.45,8.92,153.0,84
CDM,30106395,BILE ACIDS FRACTIONATED,166.0,107.9,9.64,166.0,84
CDM,30106405,N-METHYLHISTAMINE UR,166.0,107.9,9.64,166.0,84
CDM,30106415,IODINE TOTAL URINE,152.0,98.8,10.85,152.0,84
CDM,30106425,PLTHY MASS SPEC QUANT,166.0,107.9,9.64,166.0,84
CDM,30106435,SILVER UR QUANT,166.0,107.9,9.64,166.0,84
CDM,30106445,%UMPSSC QUAL,166.0,107.9,9.64,166.0,84
CDM,30106455,IODIDE SERUM,152.0,98.8,10.85,152.0,84
CDM,30106465,"IODINE, RANDOM URINE",152.0,98.8,10.85,152.0,84
CDM,30106485,SEROTONIN SERUM,214.0,139.1,15.3,214.0,84
CDM,30106495,SEROTONIN WHOLE BLOOD,214.0,139.1,15.3,214.0,84
CDM,30106505,ALLOMAP HTX,2765.0,1797.25,602.77,2765.0,58
CDM,30106535,PLASMIN ACT INHIBITOR AG,119.0,77.35,6.91,119.0,84
CDM,30106545,"PAN.ELASTASE, FECAL",119.0,77.35,6.91,119.0,84
CDM,30106555,ADIPONECTIN,119.0,77.35,6.91,119.0,84
CDM,30106565,ANTI-IGA ANTIBODY,119.0,77.35,6.91,119.0,84
CDM,30106575,ADAMTS13 ANTIBODY,119.0,77.35,6.91,119.0,84
CDM,30106585,INTERLEUKIN 2 RECEPTOR,119.0,77.35,6.91,119.0,84
CDM,30106595,INTERLEUKIN 2,119.0,77.35,6.91,119.0,84
CDM,30106605,GALOP AUTOANTIBODY X2,119.0,77.35,6.91,119.0,84
CDM,30106615,ANTI MULLERIAN HORMONE,119.0,77.35,6.91,119.0,84
CDM,30106625,%MYGRAV STRIATIONAL AB,119.0,77.35,6.91,119.0,84
CDM,30106635,INTERLEUKIN 6,119.0,77.35,6.91,119.0,84
CDM,30106645,INTERLEUKIN 5,119.0,77.35,6.91,119.0,84
CDM,30106655,ALPHA SUBUNIT,97.0,63.05,6.97,104.92,84
CDM,30106660,SEROTONIN ASSAY,214.0,139.1,15.3,214.0,84
CDM,30106665,LEPTIN,119.0,77.35,6.91,119.0,84
CDM,30106675,SULFATIDE AUTOANTIBODYX2,119.0,77.35,6.91,119.0,84
CDM,30106685,ANTI IGE,119.0,77.35,6.91,119.0,84
CDM,30106695,NEURON SPECIFIC ENO CSF,119.0,77.35,6.91,119.0,84
CDM,30106705,%IBDSER SACCH CEREV X2,85.0,55.25,6.05,85.0,84
CDM,30106715,MANNOSE BINDING PROTEIN,119.0,77.35,6.91,119.0,84
CDM,30106725,COLLAGEN TYPE II AB,119.0,77.35,6.91,119.0,84
CDM,30106735,%LAMBRT IMMUNASSY QNT;NOS,119.0,77.35,6.91,119.0,84
CDM,30106740,*THYROXINE TOTAL ASSAY,47.0,30.55,3.39,47.0,84
CDM,30106745,TUMOR NECROSIS SERUM,119.0,77.35,6.91,119.0,84
CDM,30106755,INHIBIN B,119.0,77.35,6.91,119.0,84
CDM,30106765,GLOM BASE MEM AB IGG,80.0,52.0,11.53,80.0,84
CDM,30106775,GM1 TRIAD AUTO AB X4,119.0,77.35,6.91,119.0,84
CDM,30106785,%INHAB IMMUNO QT,119.0,77.35,6.91,119.0,84
CDM,30106795,%PARNEO STRIATIONAL AB,119.0,77.35,6.91,119.0,84
CDM,30106805,%CROHN ELISA X5,119.0,77.35,6.91,119.0,84
CDM,30106815,RIBOSOMAL P PROTEIN IGG,119.0,77.35,6.91,119.0,84
CDM,30106820,LITHIUM ASSAY,46.0,29.9,6.61,46.0,84
CDM,30106825,IBDSGI ELISA X6,119.0,77.35,6.91,119.0,84
CDM,30106835,%CEPLUS IMMUNOASSAY X3,119.0,77.35,6.91,119.0,84
CDM,30106845,GANGLIOSIDE ABS MAYO X6,119.0,77.35,6.91,119.0,84
CDM,30106875,METHYLPARATHIONE BLOOD,166.0,107.9,9.64,166.0,84
CDM,30106885,COQ10 LEUKOCYTES,166.0,107.9,9.64,166.0,84
CDM,30106895,5 METHYLTETRAHYDROFOLATE,166.0,107.9,9.64,166.0,84
CDM,30106905,"SUCCINYLADENOSINE, CSF",166.0,107.9,9.64,166.0,84
CDM,30106910,PROC CHEM UNL,116.0,75.4,8.33,129.85,84
CDM,30106915,PYRIDOXAL 5 PHOSPHATE,166.0,107.9,9.64,166.0,84
CDM,30106925,NEOPTERIN CSF,166.0,107.9,9.64,166.0,84
CDM,30106935,PRO-PREDICT R 6MP X2,166.0,107.9,9.64,166.0,84
CDM,30106945,%UMUCPO CHROMAT QUANT,166.0,107.9,9.64,166.0,84
CDM,30106955,%UDRPAN CHROM QUANT,166.0,107.9,9.64,166.0,84
CDM,30106975,FAMILIAL MEDITERR FEVER,1896.0,1232.4,109.93,1896.0,84
CDM,30106980,TOTAL BILIRUBIN,35.0,22.75,4.36,35.0,84
CDM,30106985,FSHDNA TEST,1896.0,1232.4,109.93,1896.0,84
CDM,30106995,CPT2 TEST,1896.0,1232.4,109.93,1896.0,84
CDM,30107000,CORTISOL FREE,115.0,74.75,8.25,115.0,84
CDM,30107005,TRANSTHYRETIN DNA SQ,1896.0,1232.4,109.93,1896.0,84
CDM,30107015,%PANCPL PRSS1,1896.0,1232.4,109.93,1896.0,84
CDM,30107025,MEN2 TEST,1952.0,1268.8,113.15,3582.53,84
CDM,30107035,XLID TEST,6307.0,4099.55,173.12,6307.0,84
CDM,30107040,VITAMIN NOS,118.0,76.7,6.82,118.0,84
CDM,30107045,BLAU NOD2,2822.0,1834.3,83.94,1666801.85,67
CDM,30107055,COL3 TEST,2808.0,1825.2,83.94,1666801.85,67
CDM,30107065,FBN1DD TEST,2570.0,1670.5,83.94,1666801.85,67
CDM,30107075,MUCKLE TEST,2117.0,1376.05,83.94,1666801.85,67
CDM,30107085,TWINK C100RF2,2020.0,1313.0,83.94,1666801.85,67
CDM,30107095,TRAPS TEST,2001.0,1300.65,83.94,1666801.85,67
CDM,30107105,MVK TEST,1785.0,1160.25,83.94,1666801.85,67
CDM,30107115,SCA17 TEST,945.0,614.25,54.8,2297.92,84
CDM,30107125,SMAD3 TEST,1366.0,887.9,83.94,1666801.85,67
CDM,30107135,MODY4 (IPF1),848.0,551.2,83.94,1666801.85,67
CDM,30107145,SCN6 DNA TEST,1254.0,815.1,83.94,1666801.85,67
CDM,30107155,MTRAT TEST,1042.0,677.3,83.94,1666801.85,67
CDM,30107165,MYD88 L265P MUTATION,950.0,617.5,83.94,1666801.85,67
CDM,30107170,PHENOBARBITAL FREE (UNBOUND),106.0,68.9,6.12,106.0,84
CDM,30107175,CALR EXON 9 MUTATION,940.0,611.0,83.94,1666801.85,67
CDM,30107185,C9ORF72 EXPANSION ASSAY,329.0,213.85,71.72,1666801.85,67
CDM,30107195,MODY5 (UNLISTED),853.0,554.45,83.94,1666801.85,67
CDM,30107205,VASDPL SMAD3 TEST,685.0,445.25,83.94,1666801.85,67
CDM,30107210,ACETAZOLAMIDE,129.0,83.85,18.31,129.0,84
CDM,30107215,VASDPL ACTA2 TEST,685.0,445.25,83.94,1666801.85,67
CDM,30107225,VASDPL COL3A1 TEST,685.0,445.25,83.94,1666801.85,67
CDM,30107230,DRUG SCREEN QUANT CLOZAPINE,139.0,90.35,9.13,139.0,84
CDM,30107235,VASDPL TGFB2 TEST,685.0,445.25,83.94,1666801.85,67
CDM,30107245,DNADEL MT DELETION TEST,427.0,277.55,83.94,1666801.85,67
CDM,30107255,PAX6 TEST,216.0,140.4,47.09,1666801.85,67
CDM,30107265,IBDSGI ATG16L1 TEST,144.0,93.6,31.39,1666801.85,67
CDM,30107275,IBDSGI STAT3 TEST,144.0,93.6,31.39,1666801.85,67
CDM,30107285,IBDSGI NKX23 TEST,144.0,93.6,31.39,1666801.85,67
CDM,30107295,IBDSGI UNLISTED MOL PATH,144.0,93.6,31.39,1666801.85,67
CDM,30107305,%MLH1 UNLISTED PROC,92.0,59.8,20.06,1666801.85,67
CDM,30107325,DYSTONIA DNA TEST,441.0,286.65,25.58,1608.07,84
CDM,30107335,5FU TEST,441.0,286.65,25.58,1608.07,84
CDM,30107345,MCADD TEST,1278.0,830.7,74.08,1988.72,84
CDM,30107355,%IL28B RS12979860 VAR,441.0,286.65,25.58,1608.07,84
CDM,30107360,*AMYLASE ASSAY,45.0,29.25,6.48,45.0,84
CDM,30107365,PAIGEN TEST,441.0,286.65,25.58,1608.07,84
CDM,30107375,GAUCHR TEST,326.0,211.9,47.25,326.0,84
CDM,30107380,ARSENIC,131.0,85.15,9.37,131.0,84
CDM,30107385,%AJPWO GAUCHER,326.0,211.9,47.25,326.0,84
CDM,30107405,EXON28 TEST,1278.0,830.7,74.08,1988.72,84
CDM,30107415,MPLDNA TEST,1278.0,830.7,74.08,1988.72,84
CDM,30107425,YCMICR TEST,1278.0,830.7,74.08,1988.72,84
CDM,30107435,XCISE CPT2 TEST,1278.0,830.7,74.08,1988.72,84
CDM,30107445,XCISE PYGM TEST,1278.0,830.7,74.08,1988.72,84
CDM,30107455,XCISE AMPD1 TEST,1278.0,830.7,74.08,1988.72,84
CDM,30107465,PPTMPT TEST,945.0,614.25,54.8,2297.92,84
CDM,30107475,DM2DNA TEST,945.0,614.25,54.8,2297.92,84
CDM,30107485,LHON TEST,945.0,614.25,54.8,2297.92,84
CDM,30107495,SMADNA TEST,945.0,614.25,54.8,2297.92,84
CDM,30107505,DM1DNA TEST,945.0,614.25,54.8,2297.92,84
CDM,30107515,SCA2 DNA TEST,945.0,614.25,54.8,2297.92,84
CDM,30107525,SCA7 DNA TEST,945.0,614.25,54.8,2297.92,84
CDM,30107535,SCA3 DNA TEST,945.0,614.25,54.8,2297.92,84
CDM,30107545,SCA1 DNA TEST,945.0,614.25,54.8,2297.92,84
CDM,30107550,CHROM QUANT,742.0,482.3,34.82,742.0,84
CDM,30107555,HERPAN TEST,945.0,614.25,54.8,2297.92,84
CDM,30107565,APOALZ TEST,945.0,614.25,54.8,2297.92,84
CDM,30107575,FRIED TEST,945.0,614.25,54.8,2297.92,84
CDM,30107585,DRPLA TEST,945.0,614.25,54.8,2297.92,84
CDM,30107595,HUNTDI TEST,945.0,614.25,54.8,2297.92,84
CDM,30107605,KENEDY TEST,945.0,614.25,54.8,2297.92,84
CDM,30107615,CROHN TEST,945.0,614.25,54.8,2297.92,84
CDM,30107625,APOEG TEST,945.0,614.25,54.8,2297.92,84
CDM,30107635,DNADEL MELAS TEST,6458.0,4197.7,173.12,6458.0,84
CDM,30107645,CFTR TEST,1164.0,756.6,67.5,1164.0,84
CDM,30107655,%PANCPL UNLISTED MOPATH,268.0,174.2,58.42,1666801.85,67
CDM,30107675,TETRAHYDROBIO NECPT CFS,166.0,107.9,9.64,166.0,84
CDM,30107685,COENZYME Q10,166.0,107.9,9.64,166.0,84
CDM,30107705,FLUCONAZOLE SERUM,129.0,83.85,18.31,129.0,84
CDM,30107710,CORTISOL TOTAL,112.0,72.8,8.05,112.0,84
CDM,30107715,KCNJ TEST,1278.0,830.7,74.08,1988.72,84
CDM,30107725,%ADALZ MOL PATH LVL1,945.0,614.25,54.8,2297.92,84
CDM,30107735,"KAPPA FREE, URINE",94.0,61.1,6.72,94.0,84
CDM,30107745,"LAMBDA FREE, URINE",94.0,61.1,6.72,94.0,84
CDM,30107750,*CREATINE KINASE TOTAL ASSAY,45.0,29.25,6.51,45.0,84
CDM,30107755,"KAPLAM, FREE URX2",94.0,61.1,6.72,94.0,84
CDM,30107760,CREATININE OTHER SOURCE,36.0,23.4,5.18,36.0,84
CDM,30107765,%NGSCOL NRAS,2041.0,1326.65,116.49,2041.0,84
CDM,30107775,IDH1 GENE ANALYSIS,1278.0,830.7,74.08,1988.72,84
CDM,30107785,IDH2 GENE ANALYSIS,1278.0,830.7,74.08,1988.72,84
CDM,30107795,%FSII IMMUNO QUANT,119.0,77.35,6.91,119.0,84
CDM,30107805,BENZODIAZEPINES CONF UR,742.0,482.3,34.82,742.0,84
CDM,30107815,GLYBURIDE SERUM,742.0,482.3,34.82,742.0,84
CDM,30107825,LEFLUNOMIDE METABOLITE,129.0,83.85,18.31,129.0,84
CDM,30107835,VASDPL TGFBR2 TEST,2079.0,1351.35,116.49,2079.0,84
CDM,30107845,%FSII CHEMILUMINESCENT,97.0,63.05,6.97,104.92,84
CDM,30107855,LYSO ACID LIPASE ACT,153.0,99.45,8.92,153.0,84
CDM,30107865,"GALACTOSE, QUANT, UR",77.0,50.05,5.53,77.0,84
CDM,30107875,"GLUCOSE RANDOM, UR",27.0,17.55,1.94,27.0,84
CDM,30107880,GLUC BODY FLUID NOT BLOOD,27.0,17.55,1.94,27.0,84
CDM,30107885,"CARBOHYDRATE, UR",38.0,24.7,2.72,38.0,84
CDM,30107895,"BENZO, QUANT, UR",742.0,482.3,34.82,742.0,84
CDM,30107915,FLECAINIDE BLOOD,129.0,83.85,18.31,129.0,84
CDM,30107925,DEXAMETHASONE SERUM,129.0,83.85,18.31,129.0,84
CDM,30107935,SULFONAMIDES,129.0,83.85,18.31,129.0,84
CDM,30107945,VORICONAZOLE,129.0,83.85,18.31,129.0,84
CDM,30107955,POSACONAZOLE,129.0,83.85,18.31,129.0,84
CDM,30107965,%TADID QUANT X4,129.0,83.85,18.31,129.0,84
CDM,30107970,*IMMUNOASSAY NONINF QUAL/SEMI,80.0,52.0,11.53,80.0,84
CDM,30107975,IBUPROFEN,129.0,83.85,18.31,129.0,84
CDM,30107985,MEXILETINE PLASMA,129.0,83.85,18.31,129.0,84
CDM,30107995,PROTRIPTYLINE,129.0,83.85,18.31,129.0,84
CDM,30108005,WARFARIN/COUMADIN CHRM,129.0,83.85,18.31,129.0,84
CDM,30108015,MAPROTILINE HPLC-UV,129.0,83.85,18.31,129.0,84
CDM,30108035,DIGITOXIN,129.0,83.85,18.31,129.0,84
CDM,30108045,PROPOXY CONF,129.0,83.85,18.31,129.0,84
CDM,30108055,PROPAFENONE,129.0,83.85,18.31,129.0,84
CDM,30108075,HLA-B345-SSP-Q9 OR MORE AMPL,853.0,554.45,61.08,853.0,84
CDM,30108140,*IMMUNOASSAY QUANT NOS,119.0,77.35,6.91,119.0,84
CDM,30108145,FREE CORTISOL URINE LCM,115.0,74.75,8.25,115.0,84
CDM,30108155,FREE CORTISOL UR LCM X3,115.0,74.75,8.25,115.0,84
CDM,30108165,%OXPHO1 ENZYME ASSAY X17,153.0,99.45,8.92,153.0,84
CDM,30108175,"ALPHA GALACTOSIDASE, WBC",153.0,99.45,8.92,153.0,84
CDM,30108185,"BETA GALACTOSIDASE, WBC",153.0,99.45,8.92,153.0,84
CDM,30108195,"ARYLSULFATASE A, WBC",153.0,99.45,8.92,153.0,84
CDM,30108205,NEURO CEROID LIPOFUCIN,153.0,99.45,8.92,153.0,84
CDM,30108215,%MYOENZ ENZ ACT X9,153.0,99.45,8.92,153.0,84
CDM,30108225,%ETCF FIBRO ENZ ACT X5,153.0,99.45,8.92,153.0,84
CDM,30108235,%ETCMUS TIS ENZ ACT X8,153.0,99.45,8.92,153.0,84
CDM,30108245,%ETCMIT EMZ ACT X8,153.0,99.45,8.92,153.0,84
CDM,30108255,%OXPHOF ENZ ACT,153.0,99.45,8.92,153.0,84
CDM,30108265,NEURO CEROID LIPO CLN2,153.0,99.45,8.92,153.0,84
CDM,30108275,ALPHA GALACTOS SERUM,153.0,99.45,8.92,153.0,84
CDM,30108285,SIALIC ACID URINE,153.0,99.45,8.92,153.0,84
CDM,30108295,PORPHOBILINOGEN SERUM,153.0,99.45,8.92,153.0,84
CDM,30108305,FATTY ACIDS FREE,130.0,84.5,7.51,130.0,84
CDM,30108315,LONG CHAIN FATTY ACIDS,136.0,88.4,8.92,139.04,84
CDM,30108325,HBSCN1 REFLEX,89.0,57.85,6.36,89.0,84
CDM,30108335,TYSABRI ANTIBODIES,80.0,52.0,11.53,80.0,84
CDM,30108345,IMMUNOASSAY (MYOSPL),80.0,52.0,11.53,80.0,84
CDM,30108355,MAG ANTIBODY IGM,80.0,52.0,11.53,80.0,84
CDM,30108365,%CEPHAL IA QNTNOS NONABX4,119.0,77.35,6.91,119.0,84
CDM,30108375,RNA POLYMER III IGG,80.0,52.0,11.53,80.0,84
CDM,30108385,U3 RNP AB,124.0,80.6,8.86,124.0,84
CDM,30108390,*NEPHELOMETRY ASSAY EA NOS,94.0,61.1,6.72,94.0,84
CDM,30108395,IMMUNOASSAY NONANTIBODY,80.0,52.0,11.53,80.0,84
CDM,30108405,GANGLIOSIDE ABS X2,80.0,52.0,11.53,80.0,84
CDM,30108415,GANGLIOSIDE ABS X6,80.0,52.0,11.53,80.0,84
CDM,30108425,NS6S ANTIBODY,80.0,52.0,11.53,80.0,84
CDM,30108435,%SENMOT IMMUNOASSAY,80.0,52.0,11.53,80.0,84
CDM,30108455,HU AUTOANTIBODY,119.0,77.35,6.91,119.0,84
CDM,30108465,NEOSEN NEURO PARANEO X3,119.0,77.35,6.91,119.0,84
CDM,30108475,%SENNRO IMMUNOASSAY,80.0,52.0,11.53,80.0,84
CDM,30108495,%NGSMEL KIT,2274.0,1478.1,116.49,2274.0,84
CDM,30108505,%NGSMEL NRAS,2041.0,1326.65,116.49,2041.0,84
CDM,30108515,DRB345 INT RESOLUTION,753.0,489.45,53.89,753.0,84
CDM,30108525,%NFIB1 MOL PATH LVL 5,1896.0,1232.4,109.93,1896.0,84
CDM,30108535,MOLECULAR GENE ANALYSIS,292.0,189.8,63.66,1666801.85,67
CDM,30108545,A1A SERPINA1 F & I,360.0,234.0,78.48,1666801.85,67
CDM,30108555,"14.3.3 ETA PROTEIN, SER",119.0,77.35,6.91,119.0,84
CDM,30108565,ETHYL GLUC UR SCRN,429.0,278.85,31.92,429.0,84
CDM,30108685,METHYLMALONIC ACID URINE,146.0,94.9,8.48,146.0,84
CDM,30108695,%ANEMIA ORG ACIDS X2,146.0,94.9,8.48,146.0,84
CDM,30108705,%ANEMIA ORGANIC ADID QT,146.0,94.9,8.48,146.0,84
CDM,30108725,RI AUTOANTIBODY,119.0,77.35,6.91,119.0,84
CDM,30108735,CRMP-5 WB BAND ID,202.0,131.3,11.68,202.0,84
CDM,30108745,%CEPHAL ISLET CELL AB,163.0,105.95,9.77,163.0,84
CDM,30108755,YO AUTOANTIBODY,119.0,77.35,6.91,119.0,84
CDM,30108765,CRMP 5 IGG WEST BLOT CSF,202.0,131.3,11.68,202.0,84
CDM,30108775,%CJD WESTERN BLOT,202.0,131.3,11.68,202.0,84
CDM,30108785,%SEQ1 HCG,104.0,67.6,7.44,104.0,84
CDM,30108795,%SEQ2 HCG QUANT,104.0,67.6,7.44,104.0,84
CDM,30108805,BETA HCG QUANT SERUM,104.0,67.6,7.44,104.0,84
CDM,30108815,HNPP PMP22 FSA TEST,5310.0,3451.5,173.12,5310.0,84
CDM,30108825,B27PCR TEST,513.0,333.45,35.92,513.0,84
CDM,30108845,X C4 ACYLCARNITINE U,116.0,75.4,8.33,129.85,84
CDM,30108855,%ACYLM QUANT,116.0,75.4,8.33,129.85,84
CDM,30108865,ACYLCARNITINES NEONATES,116.0,75.4,8.33,129.85,84
CDM,30108875,%PHAIA PHENOTYPE,100.0,65.0,7.14,100.0,84
CDM,30108885,%ANEMIA  AMINO ACID SGL,159.0,103.35,9.19,159.0,84
CDM,30108895,HOMOCYSTINE UR QNT,159.0,103.35,9.19,159.0,84
CDM,30108905,HPRT,304.0,197.6,17.61,304.0,84
CDM,30108915,%MYOENZ ENZ ACT RADIO,304.0,197.6,17.61,304.0,84
CDM,30108925,%UFLUOR FLUORIDE UR,128.0,83.2,9.16,183.29,84
CDM,30108930,OXYCODONE,742.0,482.3,34.82,742.0,84
CDM,30108935,%CEPLUS GAMMALOBULIN,64.0,41.6,4.59,64.0,84
CDM,30108945,HOMOVANILLIC ACID URINE,155.0,100.75,9.56,155.0,84
CDM,30108955,%VAP ULTRACENRIF LIPOPTN,234.0,152.1,13.54,234.0,84
CDM,30108960,MAGNESIUM RBC,46.0,29.9,3.31,46.0,84
CDM,30108965,RETINOL BINDING PROTEIN,94.0,61.1,6.72,94.0,84
CDM,30108975,PROLACTIN MACROADENOMA,134.0,87.1,9.57,134.0,84
CDM,30108985,FECAL WT 24HR WET WEIGHT,20.0,13.0,4.36,1666801.85,67
CDM,30108995,TEG RESEARCH,29.0,18.85,6.32,1666801.85,67
CDM,30109015,MATRNL TEST,1608.0,1045.2,106.2,1608.0,84
CDM,30109025,POST-TX NO-T-CELL FOLLOW-UP ENGRAFTMENT MONITORING,1431.0,930.15,102.45,1431.0,84
CDM,30109035,"DNA EXTRACT-RSSOP,SSP&SBT-VER",1431.0,930.15,102.45,1431.0,84
CDM,30109045,HNPP PMP22 ANALYSIS TEST,5233.0,3401.45,173.12,5233.0,84
CDM,30109055,T GAMMA TEST,1390.0,903.5,99.5,1390.0,84
CDM,30109065,HLADQ8 TEST,853.0,554.45,61.08,853.0,84
CDM,30109075,HLADQ2 TEST,853.0,554.45,61.08,853.0,84
CDM,30109085,CATHARITIC LAXATIVE UR,742.0,482.3,34.82,742.0,84
CDM,30109095,BLOOD GAS ARTERIAL (POINT OF CARE LAB),180.0,117.0,10.43,180.0,84
CDM,30109175,HEMMIG SCN1A TEST,5839.0,3795.35,173.12,5839.0,84
CDM,30109185,FBN1 TEST,13800.0,8970.0,672.05,13800.0,84
CDM,30109195,COLA12 COL1A1 TEST,13800.0,8970.0,672.05,13800.0,84
CDM,30109205,COLA12 COL1A2 TEST,13800.0,8970.0,672.05,13800.0,84
CDM,30109215,ALPHA 1 ANTRY STOOL,93.0,60.45,6.64,93.0,84
CDM,30109225,A1A CLEARANCE,93.0,60.45,6.64,93.0,84
CDM,30109235,%PHA1A TOTAL,93.0,60.45,6.64,93.0,84
CDM,30109245,ARSENIC HAIR OR NAILS,131.0,85.15,9.37,131.0,84
CDM,30109255,ARSENIC URINE,131.0,85.15,9.37,131.0,84
CDM,30109265,%CADEXR B2-MICROGLOBULIN,112.0,72.8,7.99,112.0,84
CDM,30109275,CARBOHYDRATE DEF TRANSFER,125.0,81.25,8.92,139.04,84
CDM,30109285,CARBOHYDR DEF TRANS PED,125.0,81.25,8.92,139.04,84
CDM,30109295,CATECHOLAMINE FRAC UR,174.0,113.1,12.47,174.0,84
CDM,30109305,TOTAL ANTIOXIDANT CAPACITY,97.0,63.05,6.97,104.92,84
CDM,30109315,IBDSGI CHEMILUM X4,97.0,63.05,6.97,104.92,84
CDM,30109325,"COPPER, TISSUE",86.0,55.9,6.13,95.56,84
CDM,30109335,"CREATINE, URINE",32.0,20.8,2.29,35.18,84
CDM,30109345,SULFONYLUREA HYPO URINE,240.0,156.0,34.82,257.48,84
CDM,30109350,*TESTOSTERONE TOTAL ASSAY,178.0,115.7,12.75,178.0,84
CDM,30109355,"DIURETIC SURVEY, URINE",742.0,482.3,34.82,742.0,84
CDM,30109365,18 HYDROXYCORTICOSTERONE,166.0,107.9,9.64,166.0,84
CDM,30109375,CHOLESTEROL BIO INTERMED,166.0,107.9,9.64,166.0,84
CDM,30109380,CAR AUTOANTIBODY,119.0,77.35,6.91,119.0,84
CDM,30109385,%ANEMIA GCMS ANALYTE QT,166.0,107.9,9.64,166.0,84
CDM,30109390,*CRYSTAL EXAM FLUID/TIS,64.0,41.6,4.59,64.0,84
CDM,30109395,PURINE PROFILE URINARYX2,36.0,23.4,5.18,36.0,84
CDM,30109405,%CADEXR CREATININE,36.0,23.4,5.18,36.0,84
CDM,30109410,AMYLASE,45.0,29.25,6.48,45.0,84
CDM,30109415,%UCAT24 CREATININE,36.0,23.4,5.18,36.0,84
CDM,30109425,%URCAT CREATININE UR,36.0,23.4,5.18,36.0,84
CDM,30109435,%U17K CREATININE,36.0,23.4,5.18,36.0,84
CDM,30109445,%UFLUOR CREATININE,36.0,23.4,5.18,36.0,84
CDM,30109455,%OXPH01 ELECTROPH TECH,424.0,275.6,20.86,424.0,84
CDM,30109460,QUANT SERUM ACETONES/KETONES,56.0,36.4,8.17,56.0,84
CDM,30109465,CHYLOMICRON SCREEN,424.0,275.6,20.86,424.0,84
CDM,30109470,ASSAY FOR CALPROTECTIN FECAL,135.0,87.75,9.7,151.13,84
CDM,30109475,%SEQ2 ESTRIOL,167.0,108.55,11.94,167.0,84
CDM,30109485,ALBUMIN GLYCATED,116.0,75.4,16.76,116.0,84
CDM,30109495,GLYCOPROTEINS,116.0,75.4,16.76,116.0,84
CDM,30109505,TITANIUM SER/PLAS,152.0,98.8,10.85,152.0,84
CDM,30109515,%ACHFHB FETAL HB,55.0,35.75,3.2,55.0,84
CDM,30109525,NMRLIPO PARTICLE QT,236.0,153.4,15.58,236.0,84
CDM,30109535,%STCATH MAGNESIUM,46.0,29.9,3.31,46.0,84
CDM,30109545,MANGANESE URINE,184.0,119.6,12.15,184.0,84
CDM,30109555,%UTXM4 MERCURY,112.0,72.8,8.03,112.0,84
CDM,30109565,MERCURY URINE,112.0,72.8,8.03,112.0,84
CDM,30109575,%UTXM3 MERCURY,112.0,72.8,8.03,112.0,84
CDM,30109585,MYOGLOBIN URINE,89.0,57.85,6.38,89.0,84
CDM,30109595,ALK-P BONE SPECIFIC,102.0,66.3,7.3,102.0,84
CDM,30109600,PTH RELATED PEPTIDE,97.0,63.05,6.97,104.92,84
CDM,30109615,%NCDG SUGAR CHROMATOGR,269.0,174.85,15.6,269.0,84
CDM,30109620,DRGTOF BENZODIAZEPINES1-12,742.0,482.3,34.82,742.0,84
CDM,30109625,TRANSKETOLASE,146.0,94.9,10.48,146.0,84
CDM,30109635,THYROGLOBULIN FLUID,111.0,72.15,7.93,111.0,84
CDM,30109640,ALUM ASSAY,176.0,114.4,12.58,176.0,84
CDM,30109645,VITAMIN B5,118.0,76.7,6.82,118.0,84
CDM,30109655,VITAMIN B7 (BIOTIN),118.0,76.7,6.82,118.0,84
CDM,30109665,PROPYLENE GLYCOL,118.0,76.7,7.94,118.0,84
CDM,30109675,TOLUENE BLOOD,118.0,76.7,7.94,118.0,84
CDM,30109685,BENZENE QT WHOLE BLD,118.0,76.7,7.94,118.0,84
CDM,30109695,COMPLEMENT FACTOR B,83.0,53.95,5.92,83.0,84
CDM,30109705,%ABLQUL BCR/ABL1 MAJ,1131.0,735.15,80.97,1262.54,84
CDM,30109715,%ABLQUL BCR/ABL1 MIN,999.0,649.35,71.52,1115.21,84
CDM,30109725,%ABLQUL BCR/ABL1 OTH,1481.0,962.65,85.85,1481.0,84
CDM,30109735,HUMAN TGB-B1,119.0,77.35,6.91,119.0,84
CDM,30109745,LP-PLA2 ACTIVITY,320.0,208.0,18.52,320.0,84
CDM,30109755,DRGTOF FENTANYL AND METABOLITE,170.0,110.5,34.82,257.48,84
CDM,30109765,CYTOGEN SNP MICROARRAY,4500.0,2925.0,540.0,4500.0,84
CDM,30109775,GROWTH DIFF FACTOR 15,119.0,77.35,6.91,119.0,84
CDM,30109785,PROCAINAMIDE/NAPA,116.0,75.4,8.27,116.0,84
CDM,30109795,%NGSMEL BRAF,1210.0,786.5,70.16,1210.0,84
CDM,30109805,DRB1 HIGH RESOLUTION,853.0,554.45,61.08,853.0,84
CDM,30109825,%NGSMEL BRAF,1210.0,786.5,70.16,1210.0,84
CDM,30109835,BRAF GENE ANALYSIS,1210.0,786.5,70.16,1210.0,84
CDM,30109845,COL3A1 DELETION/DUP ANLS,6210.0,4036.5,173.12,6210.0,84
CDM,30109855,%KITGN KIT TARGET SEQ,2274.0,1478.1,116.49,2274.0,84
CDM,30109860,"TOXIC METAL, QUANT EA",152.0,98.8,10.85,152.0,84
CDM,30109865,HLABC TEST,2785.0,1810.25,109.69,2785.0,84
CDM,30109870,GABITRIL SERUM,187.0,121.55,10.84,187.0,84
CDM,30109875,NARCOLEPSY ASSOC AG,753.0,489.45,53.89,753.0,84
CDM,30109885,HLADR TEST,843.0,547.95,60.36,843.0,84
CDM,30109890,"PH BODY FLUID, NES",25.0,16.25,1.77,27.56,84
CDM,30109895,ACHONDROPLASIA FGFR3,945.0,614.25,54.8,2297.92,84
CDM,30109905,NOD2 GENOTYPING,945.0,614.25,54.8,2297.92,84
CDM,30109915,MELAS TEST,945.0,614.25,54.8,2297.92,84
CDM,30109925,"HBA1_HBA2,DUP_DEL",1896.0,1232.4,109.93,1896.0,84
CDM,30109930,*PRO-PREDICTR METAB,166.0,107.9,9.64,166.0,84
CDM,30109935,BETA GLOBIN SEQUENCING,1896.0,1232.4,109.93,1896.0,84
CDM,30109940,INTERLEUKIN 2 RECEPTOR,252.0,163.8,18.06,252.0,84
CDM,30109945,ACADM TEST,1952.0,1268.8,113.15,3582.53,84
CDM,30109955,HSD1B2 TEST,1896.0,1232.4,109.93,1896.0,84
CDM,30109965,MPZERO TEST,2079.0,1351.35,116.49,2079.0,84
CDM,30109970,CREATININE BLOOD ASSAY,35.0,22.75,2.53,35.0,84
CDM,30109975,NEUFIB TEST,1952.0,1268.8,113.15,3582.53,84
CDM,30109985,MYENGS PANEL NGS,5217.0,3391.05,672.05,6569.1,84
CDM,30109995,ERBB2 GENE ANALYSIS,54.0,35.1,11.77,1666801.85,67
CDM,30110005,MYD88 L265P MUT ANLYS,599.0,389.35,83.94,1666801.85,67
CDM,30110015,RETINAL DYSTROPHY NGS,2916.0,1895.4,83.94,1666801.85,67
CDM,30110020,*CYSTIC FIBROSIS CARRIER SCR,3841.0,2496.65,109.69,4289.05,84
CDM,30110025,BICARONATE URINE,34.0,22.1,2.41,34.0,84
CDM,30110035,CORTISOL PLASMA,112.0,72.8,8.05,112.0,84
CDM,30110045,TRIMETHYLAMINE N-OXIDE,166.0,107.9,9.64,166.0,84
CDM,30110055,%NEUR CHROMAT QN,166.0,107.9,9.64,166.0,84
CDM,30110065,ESTRADIOL TANDEM MASS SP,193.0,125.45,13.8,193.0,84
CDM,30110075,"IMGLB IGG, A, M X3",64.0,41.6,4.59,64.0,84
CDM,30110085,"IMMUNOGLOB D QT, SERUM",64.0,41.6,4.59,64.0,84
CDM,30110095,OXY DISSOC P50 BY HEMOX,92.0,59.8,5.34,92.0,84
CDM,30110105,%NEUR HVA,155.0,100.75,9.56,155.0,84
CDM,30110115,%NEUR 5-HIAA,89.0,57.85,6.37,99.26,84
CDM,30110125,SGPG ANTIBODY IGM,80.0,52.0,11.53,80.0,84
CDM,30110135,ANTI-C1Q AB IGG,80.0,52.0,11.53,80.0,84
CDM,30110145,INTERLEUKIN 4,119.0,77.35,6.91,119.0,84
CDM,30110155,ANTI-HMGCR AUTO AB,80.0,52.0,11.53,80.0,84
CDM,30110165,LIPOPROTEIN ELECTROPHOR,78.0,50.7,5.56,78.0,84
CDM,30110175,%UPURIN MS QUANT X3,166.0,107.9,9.64,166.0,84
CDM,30110185,RFLX IMMUNBLOT PARCSF,202.0,131.3,11.68,202.0,84
CDM,30110190,ALPHA-FETOPROTEIN L3,444.0,288.6,20.86,444.0,84
CDM,30110195,PARA AB WB CSF,202.0,131.3,11.68,202.0,84
CDM,30110205,%OSHA ZPP,99.0,64.35,7.08,110.47,84
CDM,30110215,"ADENOSINE DEAMINASE, PF",56.0,36.4,3.45,56.0,84
CDM,30110220,"TOTAL LIPID FATTY ACID PROFILE, RBC",166.0,107.9,9.64,166.0,84
CDM,30110225,"ADENOSINE DEAMINASE, RBC",56.0,36.4,3.45,56.0,84
CDM,30110235,"ADENOSINE DEAMINASE, SER",56.0,36.4,3.45,56.0,84
CDM,30110240,*SEX HORMONE BINDING GLOBULIN,150.0,97.5,10.73,150.0,84
CDM,30110245,GLYCOMARK,80.0,52.0,5.69,80.0,84
CDM,30110255,UCPEP C PEPTIDE URINE,144.0,93.6,10.28,144.0,84
CDM,30110265,"OXYCODONE SCRN, UR",429.0,278.85,31.92,429.0,84
CDM,30110275,TRAZODONE,742.0,482.3,34.82,742.0,84
CDM,30110285,STRYCHNINE SERUM,742.0,482.3,34.82,742.0,84
CDM,30110295,PAROXETINE SERUM,129.0,83.85,18.31,129.0,84
CDM,30110305,CANVAN TEST,326.0,211.9,18.9,326.0,84
CDM,30110315,%BCRQL BCR/ABL1 MAJ BRKPT,1131.0,735.15,80.97,1262.54,84
CDM,30110380,BLOOD GAS,544.0,353.6,31.51,544.0,84
CDM,30110390,THYROID STIMULATING HORMONE (TSH),116.0,75.4,16.8,116.0,84
CDM,30110400,*FE ASSAY,45.0,29.25,3.2,45.0,84
CDM,30110410,*FE BINDING CAPACITY,60.0,39.0,4.32,60.0,84
CDM,30110440,*GAMMAGLOBULIN ASSAY IGE,114.0,74.1,8.13,114.0,84
CDM,30110470,VITAMIN D 25 HYDROXY,204.0,132.6,16.78,204.0,84
CDM,30110690,*CFTR GENE FULL SEQUENCE,3443.0,2237.95,109.69,3443.0,84
CDM,30110700,*MOPATH PROCEDURE LEVEL 5,1896.0,1232.4,109.93,1896.0,84
CDM,30110710,*UNLISTED MOLECULAR PATHOLOGY,2808.0,1825.2,83.94,1666801.85,67
CDM,30110810,FMR1 GENE DETECTION,394.0,256.1,22.82,930.61,84
CDM,30110820,MOPATH PROCEDURE LEVEL 1,441.0,286.65,25.58,1608.07,84
CDM,30110830,GBA GENE,326.0,211.9,47.25,326.0,84
CDM,30110840,MOPATH PROCEDURE LEVEL 4,1278.0,830.7,74.08,1988.72,84
CDM,30110850,MOPATH PROCEDURE LEVEL 2,945.0,614.25,54.8,2297.92,84
CDM,30110900,HLA I TYPING 1 LOCUS HR,1223.0,794.95,87.53,1223.0,84
CDM,30110960,"HLA ALLELE, EA",1172.0,761.8,67.96,1172.0,84
CDM,30110OH,"EXCISION NOSE POLYP(S),SIMPLE",672.0,436.8,1.1,4447.63,148
CDM,30111040,ALKA PHOSPHTAS ISOENZYME,102.0,66.3,7.3,102.0,84
CDM,30111070,LAC (LD)(LDH),42.0,27.3,2.98,42.0,84
CDM,30111100,*CITRATE ASSAY,192.0,124.8,13.73,192.0,84
CDM,30111110,*OXALATE ASSAY,100.0,65.0,6.36,100.0,84
CDM,30111140,LEAD UR 24HR,84.0,54.6,12.11,84.0,84
CDM,30111150,MERCURY QUANT,112.0,72.8,8.03,112.0,84
CDM,30111160,"CADMIUM, WHOLE BLOOD",163.0,105.95,11.43,163.0,84
CDM,30111170,AMINO ACID SINGL QUANT,159.0,103.35,9.19,159.0,84
CDM,30111270,"HLA-A,B,CW,DR,DQ,DRB345-RSSOP",2775.0,1803.75,109.69,2775.0,84
CDM,30111350,TACROLIMUS ASSAY,95.0,61.75,6.78,95.0,84
CDM,30111360,SIROLIMUS ASSAY,95.0,61.75,6.78,95.0,84
CDM,30111370,CYCLOSPORINE ASSAY,125.0,81.25,8.91,125.0,84
CDM,30111380,HEPATITIS ACUTE PANEL,329.0,213.85,19.67,329.0,84
CDM,30111610,*CFTR GENE INTRON POLY T,1164.0,756.6,67.5,1164.0,84
CDM,30111630,TRANSFERRIN,88.0,57.2,6.3,88.0,84
CDM,30111690,IGH VARI REGIONAL MUTATION,2032.0,1320.8,116.49,2032.0,84
CDM,30111930,SODIUM,33.0,21.45,2.38,33.0,84
CDM,30112440,COCAINE,742.0,482.3,34.82,742.0,84
CDM,30112450,METHADONE,742.0,482.3,34.82,742.0,84
CDM,30112570,PHENCYCLIDINE (PCP),187.0,121.55,34.82,257.48,84
CDM,30112710,ESTROGENS; FRACTIONATED,223.0,144.95,15.95,223.0,84
CDM,30113030,TRICYCLIC & CYCLICALS 6/MORE,742.0,482.3,34.82,742.0,84
CDM,30113150,BLOOD GAS O2 SATUR ONLY,67.0,43.55,4.31,67.0,84
CDM,30113320,HGB; PLASMA,50.0,32.5,3.61,51.56,84
CDM,30113405,%T2BPCR UNLISTED MOLEC,292.0,189.8,34.82,292.0,84
CDM,30113415,"TORSEMIDE, SER/PL",742.0,482.3,34.82,742.0,84
CDM,30113425,%AJPWO BCKDHB,655.0,425.75,38.0,655.0,84
CDM,30113435,%AJPWO G6PC,404.0,262.6,23.4,404.0,84
CDM,30113445,%AJPWO MOL PATH LVL 1,441.0,286.65,25.58,1608.07,84
CDM,30113455,%AJPWO MOL PATH LVL 2,945.0,614.25,54.8,2297.92,84
CDM,30113465,%AJPWO UNLISTED MOL PATH,67.0,43.55,14.61,1666801.85,67
CDM,30113475,CALCITONIN FNA LYMPH ND,185.0,120.25,13.23,185.0,84
CDM,30113485,CORTISOL SERUM RFLX,112.0,72.8,8.05,112.0,84
CDM,30113495,OMEGACHECK,166.0,107.9,9.64,166.0,84
CDM,30113505,"GFR, RENAL FUNCTION",166.0,107.9,9.64,166.0,84
CDM,30113515,OVA1,6189.0,4022.85,173.12,6189.0,84
CDM,30113525,BENZODIAZEPINES1-12,742.0,482.3,34.82,742.0,84
CDM,30113535,GMAPS FATTY ACIDS NONESTERIFIED,130.0,84.5,7.51,130.0,84
CDM,30113615,AMPCQ METHYLENDIOXY%,742.0,482.3,34.82,742.0,84
CDM,30113625,KETAMINE SERUM,742.0,482.3,34.82,742.0,84
CDM,30113635,BENZTROPINE SERUM,742.0,482.3,34.82,742.0,84
CDM,30113645,"DIPHENHYDRAMINE, URINE",742.0,482.3,34.82,742.0,84
CDM,30113655,HYDROCODONE SER%,742.0,482.3,34.82,742.0,84
CDM,30113665,OCCULT BLOOD SCREEN,30.0,19.5,4.31,30.0,84
CDM,30113675,FLUNITRAZEPAM SCREEN UR,429.0,278.85,31.92,429.0,84
CDM,30113685,%BTKMUT MOL PATH LVL7,1952.0,1268.8,113.15,3582.53,84
CDM,30113695,TARGETED B-ALL FUS ANLYS,5241.0,3406.65,173.12,5241.0,84
CDM,30113705,%BTKNUT UNLIST MOL PATH,350.0,227.5,76.3,1666801.85,67
CDM,30113715,MEPHEDRONE MDPV CONF UR,429.0,278.85,31.92,429.0,84
CDM,30113725,"DRUG SCRN, BLD",429.0,278.85,31.92,429.0,84
CDM,30113735,DRUG ABUSE SURVEY UR,429.0,278.85,31.92,429.0,84
CDM,30113745,DRUGS OF ABUSE ORAL FLUID,429.0,278.85,31.92,429.0,84
CDM,30113755,"LSD, UR",429.0,278.85,31.92,429.0,84
CDM,30113765,MECONIUM DRG SCRN 9,429.0,278.85,31.92,429.0,84
CDM,30113775,%DRANCO PRESUMPTIVE DRGS,429.0,278.85,31.92,429.0,84
CDM,30113785,"VOLATILE SCRN, UR",742.0,482.3,34.82,742.0,84
CDM,30113795,DRUG ANALYSIS UR,429.0,278.85,31.92,429.0,84
CDM,30113805,SYNTH CANNABINOID METAB,742.0,482.3,34.82,742.0,84
CDM,30113815,MECONIUM DRG SCRN 5,429.0,278.85,31.92,429.0,84
CDM,30113825,DATE RAPE PANEL,429.0,278.85,31.92,429.0,84
CDM,30113835,DRUGS OF ABUSE 9A SCRN UR,429.0,278.85,31.92,429.0,84
CDM,30113845,MEPHEDRONE MDPV & METHYLONE,429.0,278.85,31.92,429.0,84
CDM,30113855,"DRUG DETECT PNL, UMB CORD",429.0,278.85,31.92,429.0,84
CDM,30113875,IGKPCR TEST,1192.0,774.8,73.74,1192.0,84
CDM,30113885,%EGFRTI TEST,2240.0,1456.0,109.69,2240.0,84
CDM,30113895,%NGSLUNG EGFR,2240.0,1456.0,109.69,2240.0,84
CDM,30113905,IGHPCR TEST,1366.0,887.9,97.77,1524.53,84
CDM,30113915,DNA FINGERPRNT TEST,1608.0,1045.2,106.2,1608.0,84
CDM,30113925,MSI3 TEST,2405.0,1563.25,116.49,2405.0,84
CDM,30113935,TCRB TEST,1442.0,937.3,103.17,1442.0,84
CDM,30113945,BCL2 BY PCR TEST,1037.0,674.05,60.13,1728.34,84
CDM,30113955,T-CELL RECEPTOR DELTA,1037.0,674.05,60.13,1728.34,84
CDM,30113965,%T2BPCR IGH GENE REARR,1366.0,887.9,97.77,1524.53,84
CDM,30113975,IMGENE IGH SB TEST,473.0,307.45,27.42,473.0,84
CDM,30113985,IMGENE TCRB SB TEST,342.0,222.3,24.49,342.0,84
CDM,30113995,TCRBSB TEST,342.0,222.3,24.49,342.0,84
CDM,30114005,GLUCOSE BLOOD REAGENT STRIP (POINT OF CARE LAB),35.0,22.75,5.04,35.0,84
CDM,30114015,"KIT MUT EX 18-11, 17 SEQ",2274.0,1478.1,116.49,2274.0,84
CDM,30114025,KIT D816V MUTATION PCR,862.0,560.3,49.95,862.0,84
CDM,30114035,MLH1 PROMOTER HYPERMETH,1327.0,862.55,76.93,1327.0,84
CDM,30114045,VWF TYPE 2A EX 28,1278.0,830.7,74.08,1988.72,84
CDM,30114055,TTR GENE FULL ANALYSIS,1896.0,1232.4,109.93,1896.0,84
CDM,30114065,VWF2A SEQ 9 EXON REFLEX,2079.0,1351.35,116.49,2079.0,84
CDM,30114075,BLAU SYNDROME,1620.0,1053.0,83.94,1666801.85,67
CDM,30114085,METHAQUALONE GC/MS UR,742.0,482.3,34.82,742.0,84
CDM,30114095,TPMT GENOTYPING ASSAY,945.0,614.25,54.8,2297.92,84
CDM,30114105,MET GENE ANALYSIS,556.0,361.4,83.94,1666801.85,67
CDM,30114115,%FLT3MD TKD VARIANTS,573.0,372.45,33.2,573.0,84
CDM,30114125,FLUOXETINE/NORFLUOXETINE,742.0,482.3,34.82,742.0,84
CDM,30114135,%FLT3MD VARIANTS,1142.0,742.3,66.2,1142.0,84
CDM,30114145,ACETYLCHOLINESTERASE,85.0,55.25,5.52,85.0,84
CDM,30114155,ANTIMONY BLOOD,152.0,98.8,10.85,152.0,84
CDM,30114165,BILE ACIDS TOTAL,118.0,76.7,8.46,118.0,84
CDM,30114175,%CSFPE PROTEIN TOTAL CSF,28.0,18.2,1.81,28.0,84
CDM,30114185,%CSFPE PROT ELEC SCF QT,123.0,79.95,13.62,123.0,84
CDM,30114195,%FSII NEPHELOMETRY EA,94.0,61.1,6.72,94.0,84
CDM,30114205,TESTOSTERONE FR AD MALE,176.0,114.4,12.58,176.0,84
CDM,30114215,GALECTIN-3 SERUM,305.0,198.25,17.7,305.0,84
CDM,30114225,"GALACTOSE QUANT, PLASMA",77.0,50.05,5.53,77.0,84
CDM,30114235,%GMAPS ACYLCARNITINES QL,114.0,74.1,6.85,114.0,84
CDM,30114245,%GMAPS AA MULT QL,96.0,62.4,6.85,96.0,84
CDM,30114255,%GMAPS ANDROSTERONE,176.0,114.4,12.35,176.0,84
CDM,30114265,%GMAPS CARNITINE,116.0,75.4,8.33,129.85,84
CDM,30114275,%GMAPS BILE ACIDS,118.0,76.7,8.46,118.0,84
CDM,30114285,%GMAPS BILIRUBIN TOTAL,35.0,22.75,4.36,35.0,84
CDM,30114295,%GMAPS CHOLESTEROL TOTAL,30.0,19.5,4.35,30.0,84
CDM,30114305,%GMAPS CITRATE,192.0,124.8,13.73,192.0,84
CDM,30114315,%GMAPS CORTISOL TOTAL,112.0,72.8,8.05,112.0,84
CDM,30114325,%GMAPS CREATINE,32.0,20.8,2.29,35.18,84
CDM,30114335,%GMAPS CREATININE BLD,35.0,22.75,2.53,35.0,84
CDM,30114345,%GMAPS VLCHAIN FATTY ACID,136.0,88.4,8.92,139.04,84
CDM,30114355,%GMAPS FOLIC ACID,101.0,65.65,7.26,101.0,84
CDM,30114365,%GMAPS GALACTOSE,77.0,50.05,5.53,77.0,84
CDM,30114375,%GMAPS GLUCOSE QT,27.0,17.55,1.94,27.0,84
CDM,30114385,%GMAPS GLUTATHIONE,107.0,69.55,7.04,107.0,84
CDM,30114395,%GMAPS HVA,155.0,100.75,9.56,155.0,84
CDM,30114405,%GMAPS CATECHOLAMINES,201.0,130.65,12.37,201.0,84
CDM,30114415,%GMAPS COL CHROMOTOG,166.0,107.9,9.64,166.0,84
CDM,30114425,%GMAPS LACTATE,80.0,52.0,11.57,80.0,84
CDM,30114435,%GMAPS MASS SPEC,166.0,107.9,9.64,166.0,84
CDM,30114445,%GMAPS ORGANIC ACIDS QL,114.0,74.1,8.12,126.71,84
CDM,30114455,%GMAPS PHENYLKETONES,27.0,17.55,1.81,27.0,84
CDM,30114465,%GMAPS VIT B-6,194.0,126.1,13.88,194.0,84
CDM,30114475,%GMAPS PYRUVATE,100.0,65.0,5.79,100.0,84
CDM,30114485,%GMAPS VITAMIN B-2,140.0,91.0,9.99,140.0,84
CDM,30114495,%GMAPS SEROTONIN,214.0,139.1,15.3,214.0,84
CDM,30114505,%GMAPS SUGARS QL,38.0,24.7,2.72,38.0,84
CDM,30114515,%GMAPS URIC ACID BLD,31.0,20.15,4.52,31.0,84
CDM,30114525,LINDANE BLOOD,41.0,26.65,2.97,41.0,84
CDM,30114535,%PSEUDOCHOL PHENOTYPE,85.0,55.25,6.05,85.0,84
CDM,30114545,%PHI PROST SPEC AG FREE,127.0,82.55,9.08,127.0,84
CDM,30114555,THYROXIN FREE,62.0,40.3,5.11,62.0,84
CDM,30114565,%OHCREATININE,36.0,23.4,5.18,36.0,84
CDM,30114575,%17-OHCORTICOSTEROIDS,124.0,80.6,8.66,134.89,84
CDM,30114585,"LEUKOTRIENE E4, UR",166.0,107.9,9.64,166.0,84
CDM,30114595,PARA AB WB BND ID,202.0,131.3,11.68,202.0,84
CDM,30114605,INSULIN TOL/GROWTH HORMN,711.0,462.15,27.68,967.46,84
CDM,30114615,OPMD TEST,945.0,614.25,54.8,2297.92,84
CDM,30114625,OBESTY TEST,1278.0,830.7,74.08,1988.72,84
CDM,30114635,ALPHA GLOBIN SEQUENCING,1896.0,1232.4,109.93,1896.0,84
CDM,30114645,POLG2 TEST,1620.0,1053.0,83.94,1666801.85,67
CDM,30114655,SERPINA1 GENOTYPING,756.0,491.4,83.94,1666801.85,67
CDM,30114675,DILTIAZEM,742.0,482.3,34.82,742.0,84
CDM,30114685,MERCAPTOPURINE,742.0,482.3,34.82,742.0,84
CDM,30114695,MITOTANE,742.0,482.3,34.82,742.0,84
CDM,30114705,%UQNTPP CANNABINOID NAT,742.0,482.3,34.82,742.0,84
CDM,30114715,%UQNTPP OPIATE,742.0,482.3,34.82,742.0,84
CDM,30114725,%UQNTPP OPIOIDS 5+,742.0,482.3,34.82,742.0,84
CDM,30114735,%UQNTPP OXYCODONE,742.0,482.3,34.82,742.0,84
CDM,30114785,"PH, BLOOD (POINT OF CARE LAB)",76.0,49.4,4.4,89.32,84
CDM,30115285,ANTI AT1R AB DETERMINATION,80.0,52.0,11.53,80.0,84
CDM,30115295,DPB1 LOCUS HI RES SBT,853.0,554.45,61.08,853.0,84
CDM,30115305,%GMAPS CREATININE UR,36.0,23.4,5.18,36.0,84
CDM,30115315,%GMAPS VIT B-1,146.0,94.9,10.48,146.0,84
CDM,30115325,%GMAPS VIT E,98.0,63.7,7.0,102.87,84
CDM,30115335,%GMAPS TYROSINE,73.0,47.45,5.14,73.0,84
CDM,30115345,%GMAPS UREA NITROGEN,35.0,22.75,2.05,35.0,84
CDM,30115355,%GMAPS UR/URIC ACID,35.0,22.75,2.34,35.0,84
CDM,30115365,%GMAPS VIT A,80.0,52.0,5.73,89.35,84
CDM,30115375,"NITROGEN, TOTAL, FECES",761.0,494.65,18.15,1666801.85,67
CDM,30115385,SP REQUEST SERVICE FEE,62.0,40.3,13.52,1666801.85,67
CDM,30115395,HALOPERIDOL,109.0,70.85,7.19,109.0,84
CDM,30115405,SOTALOL,129.0,83.85,18.31,129.0,84
CDM,30115415,LIPID ASSOC SIALIC ACID,93.0,60.45,6.64,103.46,84
CDM,30115425,CHROMIUM URINE,140.0,91.0,10.02,142.17,84
CDM,30115435,BUPRENORPHINE MEC CONF,742.0,482.3,34.82,742.0,84
CDM,30115445,NEOPTERIN BLD/CSF,119.0,77.35,6.91,119.0,84
CDM,30115455,QUETIAPINE,129.0,83.85,18.31,129.0,84
CDM,30115465,DISOPYRAMIDE NORPACE,129.0,83.85,18.31,129.0,84
CDM,30115475,%5FLUO DPYD MUTATIONS,441.0,286.65,25.58,1608.07,84
CDM,30115485,%5FLUO TYMS MUTATIONS,945.0,614.25,54.8,2297.92,84
CDM,30115495,%5FLUO TEST,216.0,140.4,47.09,1666801.85,67
CDM,30115505,%F2 MS/MS QUANTITATIVE,166.0,107.9,9.64,166.0,84
CDM,30115515,%F2 CREATININE,36.0,23.4,5.18,36.0,84
CDM,30115525,VENLAFAXINE&METABOLITE,129.0,83.85,18.31,129.0,84
CDM,30115535,"%EXKRAS KRAS CODON 12,13",1333.0,866.45,77.3,1333.0,84
CDM,30115545,%EXKRAS KRAS CODON 61,1333.0,866.45,77.3,1333.0,84
CDM,30115555,METHYL ETHYL KETONE URIN,118.0,76.7,7.94,118.0,84
CDM,30115565,XIIIVL TEST,441.0,286.65,25.58,1608.07,84
CDM,30115575,LEUCINE AMINOPEP LAP SER,68.0,44.2,4.52,68.0,84
CDM,30115585,BENZTROPINE SERUM,742.0,482.3,34.82,742.0,84
CDM,30115595,FLUVOXAMINE,742.0,482.3,34.82,742.0,84
CDM,30115605,ANCA - MPO/PR-3 X2,80.0,52.0,11.53,80.0,84
CDM,30115615,MAG AB IGM WB W/REFLEX,118.0,76.7,8.41,118.0,84
CDM,30115625,%GMAPS OXALATE,100.0,65.0,6.36,100.0,84
CDM,30115635,MIDAZOLAM,742.0,482.3,34.82,742.0,84
CDM,30115645,HYPEROXALURIA,166.0,107.9,9.64,166.0,84
CDM,30115655,SILICON SERUM,174.0,113.1,11.62,174.0,84
CDM,30115665,ETHAMBUTOL,129.0,83.85,18.31,129.0,84
CDM,30115675,"ARYLSULFATASE A, URINE",56.0,36.4,3.45,56.0,84
CDM,30115685,TGFB TGFBR1 TEST,2079.0,1351.35,116.49,2079.0,84
CDM,30115695,TGFB TGFBR2 TEST,2079.0,1351.35,116.49,2079.0,84
CDM,30115705,INTERLEUKIN 4,127.0,82.55,7.36,127.0,84
CDM,30115715,DRUG CONFRM PCP,224.0,145.6,34.82,257.48,84
CDM,30115725,%NRAST BY PYROSEQ,2041.0,1326.65,116.49,2041.0,84
CDM,30115735,ANTIMONY URINE,152.0,98.8,10.85,152.0,84
CDM,30115745,CIMETIDINE SERUM,129.0,83.85,18.31,129.0,84
CDM,30115755,KETOROLAC SERUM,742.0,482.3,34.82,742.0,84
CDM,30115765,THYROID CANCER MUT PNL,3423.0,2224.95,109.69,3423.0,84
CDM,30115775,%TYMUT KRAS MUTATION,1333.0,866.45,77.3,1333.0,84
CDM,30115785,%TYMUT NRAS GENE ANLS,2041.0,1326.65,116.49,2041.0,84
CDM,30115795,%TYMUT PAX8/PPAR,945.0,614.25,54.8,2297.92,84
CDM,30115805,%TYMUT NRAS MUTATION,1896.0,1232.4,109.93,1896.0,84
CDM,30115815,MERRF TEST,945.0,614.25,54.8,2297.92,84
CDM,30115825,%TYMUT HRAS MUTATION,1278.0,830.7,74.08,1988.72,84
CDM,30115835,METHAZOLAMIDE SER,742.0,482.3,34.82,742.0,84
CDM,30115845,ELECTROLYTE K BLOOD,33.0,21.45,2.27,33.0,84
CDM,30115855,%GMAPS ASCORBIC ACID,68.0,44.2,4.88,68.0,84
CDM,30115865,DRUG TEST PRSMV INSTRMNT (POINT OF CARE LAB),118.0,76.7,7.18,118.0,84
CDM,30115875,DMD SEQ BILL REFLEX,13800.0,8970.0,672.05,13800.0,84
CDM,30115OH,"EXCISION NOSE POLYP(S),EXTENSIVE",1776.0,1154.4,1.1,9391.15,144
CDM,30116015,HLA I TYPING COMPLETE HR,148.0,96.2,21.42,164.91,83
CDM,30116025,HLA II TYPING 1 LOC HR,853.0,554.45,61.08,853.0,84
CDM,30116035,%IDH12F EXON 4 VAR X2,1278.0,830.7,74.08,1988.72,84
CDM,30116045,UREA CLEARANCE 24 HR UR,50.0,32.5,3.26,50.0,84
CDM,30116145,HEXOSAMINIDASE A & TOTAL X2,116.0,75.4,8.33,129.85,84
CDM,30116155,%NFIB1 UNLISTED,378.0,245.7,82.4,1666801.85,67
CDM,30116275,AIRE TEST,1952.0,1268.8,113.15,3582.53,84
CDM,30116285,MODY4 TEST,1980.0,1287.0,83.94,1666801.85,67
CDM,30116295,T3 UPTAKE,45.0,29.25,3.19,45.0,84
CDM,30117175,%HA1AT SERPINA1 GENE ANLY,301.0,195.65,21.56,301.0,84
CDM,30117185,%HA1AT UNLISTED MOPATH,297.0,193.05,64.75,1666801.85,67
CDM,30117195,DRUG TEST 15-21 CLASSES,1288.0,837.2,75.43,1288.0,84
CDM,30117205,%MULNEU PMP22 GENE ANALYSIS,5233.0,3401.45,173.12,5233.0,84
CDM,30117215,%MULNEU IMMUN QNT NOS NONAB,119.0,77.35,6.91,119.0,84
CDM,30117385,CHSER,140.0,91.0,10.02,142.17,84
CDM,30117395,ATOPIC GAMMAGLOB IGE,114.0,74.1,8.13,114.0,84
CDM,30117405,ATOPIC IMMUNO QNT NONAB,119.0,77.35,6.91,119.0,84
CDM,30117415,"OSMOLALITY, BODY FLUID",46.0,29.9,3.26,46.0,84
CDM,30117425,"OSMOLALITY, STOOL",75.0,48.75,16.35,1666801.85,67
CDM,30117435,"POTASSIUM, BODY FLUID",56.0,36.4,12.21,1666801.85,67
CDM,30117445,"POTASSIUM, STOOL",62.0,40.3,13.52,1666801.85,67
CDM,30117455,"AMPHETAMINE CONF, UR",742.0,482.3,34.82,742.0,84
CDM,30117465,DRGTOF METHYLENEDIOXYAMPHETAMINE,173.0,112.45,34.82,257.48,84
CDM,30117475,OPIBILL OPIATES,742.0,482.3,34.82,742.0,84
CDM,30117485,OPIBILL OXYCODONE,742.0,482.3,34.82,742.0,84
CDM,30117525,FTTESM TESTOSTERONE,178.0,115.7,12.75,178.0,84
CDM,30117535,FTTESM TESTO FR AD MALE,176.0,114.4,12.58,176.0,84
CDM,30117545,SMN1 SMN2 SCRN DIAG,945.0,614.25,54.8,2297.92,84
CDM,30117555,HUMOR1 ASSAY GAMMAG X3,64.0,41.6,4.59,64.0,84
CDM,30117565,HUMOR1 IGG SUBCLASSES X4,55.0,35.75,3.96,55.0,84
CDM,30117595,%IL28B RS8099917 VAR,65.0,42.25,14.17,1666801.85,67
CDM,30117605,%MODY TCF1,1896.0,1232.4,109.93,1896.0,84
CDM,30117615,%MODY HNF1B,2079.0,1351.35,116.49,2079.0,84
CDM,30117625,%MODY HNF1A,2079.0,1351.35,116.49,2079.0,84
CDM,30117635,HEMOQUANT FECAL,270.0,175.5,15.64,270.0,84
CDM,30117645,GENERAL HEALTH PANEL,497.0,323.05,17.36,1666801.85,67
CDM,30117655,MAGNESIUM STOOL,46.0,29.9,3.31,46.0,84
CDM,30117665,VASCULAR DISEASE PANEL,3478.0,2260.7,109.69,3478.0,84
CDM,30117675,%CADEXR CADMIUM X2,163.0,105.95,11.43,163.0,84
CDM,30117685,%UTXM3 ARSENIC,131.0,85.15,9.37,131.0,84
CDM,30117695,%UTXM3 LEAD,84.0,54.6,12.11,84.0,84
CDM,30117705,%UTXM4 ARSENIC,131.0,85.15,9.37,131.0,84
CDM,30117715,%UTXM4 LEAD,84.0,54.6,12.11,84.0,84
CDM,30117725,%UTXM4 CADMIUM,163.0,105.95,11.43,163.0,84
CDM,30117735,BARBITUATES CONF BILL,742.0,482.3,34.82,742.0,84
CDM,30117745,BENZODIAZEPINE CONF BILL,742.0,482.3,34.82,742.0,84
CDM,30117755,PCP CONF BILL,199.0,129.35,34.82,257.48,84
CDM,30117765,"FATTY ACID PROFILE,SER PL",157.0,102.05,34.82,257.48,84
CDM,30117775,ALLOGEN MICA TYPING,1278.0,830.7,74.08,1988.72,84
CDM,30117785,"BROMIDE, SER PL",129.0,83.85,18.31,129.0,84
CDM,30117795,"NGS HLA-A,B,C,DR,DQ,DP,DRB345",2384.0,1549.6,116.49,2384.0,84
CDM,30117805,"KRAS,CONDONS 12 &13, KRAS ADDVAR",1333.0,866.45,77.3,1333.0,84
CDM,30117815,VWD EXON 9 REFLEX,2079.0,1351.35,116.49,2079.0,84
CDM,30117825,HLA B5701,1172.0,761.8,67.96,1172.0,84
CDM,30117835,PITUITARY EVALUATION,3998.0,2598.7,109.69,3998.0,84
CDM,30117845,RFLX IMBLOT PARNEO AIDYSA,202.0,131.3,11.68,202.0,84
CDM,30117855,"HLA-A,B,CW,DR,DQ,DP-NGS-BMT",2384.0,1549.6,116.49,2384.0,84
CDM,30117885,A THALASSEMIA GENE DEL,1397.0,908.05,47.53,1397.0,84
CDM,30117895,DPD 5FU GENOTYPR,1206.0,783.9,116.49,1206.0,84
CDM,30117905,HBA1 HBA2 DEL/DUP,1397.0,908.05,47.53,1397.0,84
CDM,30117915,HBB GENE SEQUENCING,2240.0,1456.0,116.49,2240.0,84
CDM,30117925,IL28B ASSOC VAR 2 SNP,506.0,328.9,73.37,506.0,84
CDM,30117935,5-FLUOROURACIL TOX 5 MUT,1206.0,783.9,116.49,1206.0,84
CDM,30117945,%IDH12 IDH1,1333.0,866.45,116.49,1333.0,84
CDM,30117955,%IDH12 IDH2,2041.0,1326.65,116.49,2041.0,84
CDM,30117965,%PS1SY MOPATH LVL 6,2079.0,1351.35,116.49,2079.0,84
CDM,30117975,%PS1SY UNLISTED MOPATH,713.0,463.45,83.94,1666801.85,67
CDM,30117985,HNPP UNLISTED MOPATH,106.0,68.9,23.11,1666801.85,67
CDM,30117995,MPZERO UNLISTED MOPATH,106.0,68.9,23.11,1666801.85,67
CDM,30117OH,"EXCIS INTRANASAL LESN,INTERN APPRCH",1564.0,1016.6,1.1,9391.15,148
CDM,30118005,PMP22 UNLISTED MOPATH,106.0,68.9,23.11,1666801.85,67
CDM,30118015,TYPE2N UNLISTED MOPATH,106.0,68.9,23.11,1666801.85,67
CDM,30118025,MFN2 UNLISTED MOPATH,106.0,68.9,23.11,1666801.85,67
CDM,30118035,HEMMIG UNLISTED MOPATH,106.0,68.9,23.11,1666801.85,67
CDM,30118045,5FLUO TYMS GENE ANLYS,1206.0,783.9,110.13,1206.0,84
CDM,30118065,5FLUO TYMS GENE ANLYS,1206.0,783.9,110.13,1206.0,84
CDM,30118075,%PANCPL SPINK1,1896.0,1232.4,109.93,1896.0,84
CDM,30118085,%PANCPL MOPATH LVL 6,2079.0,1351.35,116.49,2079.0,84
CDM,30118095,IDH1 GENE ANALYSIS,1333.0,866.45,116.49,1333.0,84
CDM,30118105,IDH2 GENE ANALYISIS,2041.0,1326.65,116.49,2041.0,84
CDM,30118115,%IDHI12 GENE ANALYSIS IDH1,1333.0,866.45,116.49,1333.0,84
CDM,30118125,%IDHI12 GENE ANALYSIS IDH2,2041.0,1326.65,116.49,2041.0,84
CDM,30118135,TPMT GENOTYPE ASSAY,1206.0,783.9,110.13,1206.0,84
CDM,30118145,FLOW SCRN TUBE 1ST MKR,2482.0,1613.3,60.74,2482.0,86
CDM,30118155,LNG550 LUNG CANCER GENE PNL,2409.0,1565.85,109.69,2409.0,84
CDM,30118165,NEWBORN SCREEN,74.0,48.1,4.3,81.02,84
CDM,30118175,DIHYDROTESTOSTERONE,166.0,107.9,9.64,166.0,84
CDM,30118185,%DAOPIC OPIATE,742.0,482.3,34.82,742.0,84
CDM,30118195,"OXYCODONE CONF, ORAL FLD",742.0,482.3,34.82,742.0,84
CDM,30118205,%UTCAQT ANTIDEP CLASS 1-2,742.0,482.3,34.82,742.0,84
CDM,30118215,%UTCAQT TRICYC & CYC 6+,742.0,482.3,34.82,742.0,84
CDM,30118225,%UTCAQT ANTIDEP NOT SPEC,742.0,482.3,34.82,742.0,84
CDM,30118235,THIOPURINE METAB LC-MS/MS,129.0,83.85,18.31,129.0,84
CDM,30118255,"ALCOHOL CONF, UR",742.0,482.3,34.82,742.0,84
CDM,30118265,APOL1 SEQUENCING,383.0,248.95,83.49,1666801.85,67
CDM,30118275,17-HYDROXYPROG QNT TIMED X2,187.0,121.55,13.42,187.0,84
CDM,30118285,GLUTATHIONE TOTAL,107.0,69.55,7.04,107.0,84
CDM,30118295,MATERNAL SCN 1ST TRI,375.0,243.75,21.72,375.0,84
CDM,30118305,MNGS PATHOGEN DX,7250.0,4712.5,83.94,1666801.85,67
CDM,30118315,APOE GENOTYPING ALZHEIMER,945.0,614.25,54.8,2297.92,84
CDM,30118325,%RBCFLP RBC FOLATE,122.0,79.3,8.55,122.0,84
CDM,30118335,RISPERIDONE AND METAB,742.0,482.3,34.82,742.0,84
CDM,30118345,PREGABALIN,742.0,482.3,34.82,742.0,84
CDM,30118355,HSP-70 AB,80.0,52.0,11.53,80.0,84
CDM,30118365,DIGOXIN FREE,92.0,59.8,6.56,92.0,84
CDM,30118375,HLA-B*15:02,1172.0,761.8,67.96,1172.0,84
CDM,30118425,TIN,152.0,98.8,10.85,152.0,84
CDM,30118455,FLT3 TKD TEST,573.0,372.45,33.2,573.0,84
CDM,30118465,CEBPA MUT ANYS MARROW,1669.0,1084.85,116.49,1669.0,84
CDM,30118475,FLT3 TKDM BONE MARROW,573.0,372.45,33.2,573.0,84
CDM,30118485,MYELOPROLIF NEOPL PNL BM,896.0,582.4,83.94,1666801.85,67
CDM,30118495,MYELOPROLIF NEOPL PNL BLD,896.0,582.4,83.94,1666801.85,67
CDM,30118505,NPM1 TEST BONE MARROW,1701.0,1105.65,98.61,1701.0,84
CDM,30118515,DRUG TESTS PRESUMPTIVE,429.0,278.85,31.92,429.0,84
CDM,30118535,ALCOHOLS,742.0,482.3,34.82,742.0,84
CDM,30118545,AMINOLEV ACID DEHYD,153.0,99.45,8.92,153.0,84
CDM,30118555,FLT3 TKDM VARIANTS BM,1142.0,742.3,66.2,1142.0,84
CDM,30118565,HNMNGS HN NGS SEQ PANEL BM,1616.0,1050.4,457.0,6569.1,84
CDM,30118575,HNPNGS HN NGS SEQ PANEL P BLD,1616.0,1050.4,457.0,6569.1,84
CDM,30118645,MYELOMA PROG RISK SIG,2484.0,1614.6,83.94,1851898.14,67
CDM,30118655,OXIDIZED LDL,119.0,77.35,6.91,119.0,84
CDM,30118665,XPANSION INTERPRETER REFL,310.0,201.5,17.96,310.0,84
CDM,30118675,ADANEU THEARP DRG QNT,129.0,83.85,18.31,129.0,84
CDM,30118685,ADANEU CHEMILUMINESCENT,97.0,63.05,6.97,104.92,84
CDM,30118695,IFXNEU THEARP DRG QNT,129.0,83.85,18.31,129.0,84
CDM,30118705,IFXNEU CHEMILUMINESCENT,97.0,63.05,6.97,104.92,84
CDM,30118715,"FAT, FECAL QUAL",35.0,22.75,2.52,35.0,84
CDM,30118725,"BACLOFEN (BACLOF), SKELETAL MUSCLE RELAXANT 1 OR 2",21.0,13.65,5.94,257.48,84
CDM,30118735,LEUK BLD CNCR CHROMOSOME + SNP,1952.0,1268.8,113.15,3582.53,84
CDM,30118745,PROD OF CONCEPTION + SNP,4500.0,2925.0,540.0,4500.0,84
CDM,30118755,BRUCELLA AB TOTAL,62.0,40.3,4.41,68.79,84
CDM,30118765,MARIJUANA METAB UMB CRD QUAL,742.0,482.3,34.82,742.0,84
CDM,30118775,DRUG DET PNL UMB CRD,429.0,278.85,31.92,429.0,84
CDM,30118785,DTOFMP MARIJUANA METAB UMB,742.0,482.3,34.82,742.0,84
CDM,30118795,"NITROGEN, URINE 24 HR",119.0,77.35,6.91,119.0,84
CDM,30118805,ACYLGLYCINES QNT UR,166.0,107.9,9.64,166.0,84
CDM,30118815,UGUANI CHROMOTOGRAPHY,166.0,107.9,9.64,166.0,84
CDM,30118825,UGUANI CREATINE,32.0,20.8,2.29,35.18,84
CDM,30118835,UGUANI CREATINE,36.0,23.4,5.18,36.0,84
CDM,30118845,GUANID CHROMOTOGRAPHY,166.0,107.9,9.64,166.0,84
CDM,30118855,GUANID CREATINE,32.0,20.8,2.29,35.18,84
CDM,30118865,RIBPRO IMMUNO NON AB,80.0,52.0,11.53,80.0,84
CDM,30118945,METHYLPHENIDATE QNT,742.0,482.3,34.82,742.0,84
CDM,30118955,DRG SCRN 9 PANEL,429.0,278.85,31.92,429.0,84
CDM,30118965,DRUG SCREEN AMPHETAMINES 1/2,742.0,482.3,34.82,742.0,84
CDM,30118975,METHYLENEDIOXYAMPHET,742.0,482.3,34.82,742.0,84
CDM,30118985,DRGTOF DRG SCRN BARBITURATES,238.0,154.7,34.82,257.48,84
CDM,30118995,BENZODIAZEPINES1-12,742.0,482.3,34.82,742.0,84
CDM,30118OH,"EXCIS INTRANASAL LESN,EXT APPRCH",3100.0,2015.0,1.1,9391.15,144
CDM,30119005,DRGTOF DRG SCRN BUPRENORPHINE,238.0,154.7,34.82,257.48,84
CDM,30119015,CANNABINOIDS NATURAL,742.0,482.3,34.82,742.0,84
CDM,30119025,DRGTOF DRG SCRN COCAINE,238.0,154.7,34.82,257.48,84
CDM,30119035,DRGTOF DRG SCRN METHADONE,238.0,154.7,34.82,257.48,84
CDM,30119045,OPIATES 1 OR MORE,742.0,482.3,34.82,742.0,84
CDM,30119055,DRG SCRN OXYCODONE,742.0,482.3,34.82,742.0,84
CDM,30119065,DRGTOF PHENCYCLIDINE,238.0,154.7,34.82,257.48,84
CDM,30119075,CSPNL ASPA GENE,326.0,211.9,18.9,326.0,84
CDM,30119085,CSPNL BCKDHB GENE,655.0,425.75,38.0,655.0,84
CDM,30119095,CSPNL BLM GENE,271.0,176.15,15.72,271.0,84
CDM,30119105,CSPNL CFTR GENE COM VARS,3841.0,2496.65,109.69,4289.05,84
CDM,30119115,CSPNL FANCC GENE,253.0,164.45,14.65,253.0,84
CDM,30119125,CSPNL FMR1 GENE DETECTION,394.0,256.1,22.82,930.61,84
CDM,30119135,CSPNL G6PC GENE,404.0,262.6,23.4,404.0,84
CDM,30119145,CSPNL GBA GENE,326.0,211.9,47.25,326.0,84
CDM,30119155,CSPNL HEXA GENE,355.0,230.75,51.45,355.0,84
CDM,30119165,CSPNL IKBKAP GENE,271.0,176.15,15.72,271.0,84
CDM,30119175,CSPNL MCOLN1 GENE,271.0,176.15,15.72,271.0,84
CDM,30119185,CSPNL SMPD1 GENE COMMON VARS,324.0,210.6,18.8,324.0,84
CDM,30119195,CSPNL MOPATH PROC LVL 1,441.0,286.65,25.58,1608.07,84
CDM,30119205,CSPNL MOPATH PROC LVL 2,945.0,614.25,54.8,2297.92,84
CDM,30119215,CSPNL UNLISTED MOPATH,70.0,45.5,15.26,1666801.85,67
CDM,30119225,AJPNL ASPA GENE,326.0,211.9,18.9,326.0,84
CDM,30119235,AJPNL BCKDHB GENE,655.0,425.75,38.0,655.0,84
CDM,30119245,AJPNL BLM GENE,271.0,176.15,15.72,271.0,84
CDM,30119255,AJPNL FANCC GENE,253.0,164.45,14.65,253.0,84
CDM,30119265,AJPNL G6PC GENE,404.0,262.6,23.4,404.0,84
CDM,30119275,AJPNL GBA GENE,326.0,211.9,47.25,326.0,84
CDM,30119285,AJPNL HEXA GENE,355.0,230.75,51.45,355.0,84
CDM,30119295,AJPNL IKBKAP GENE,271.0,176.15,15.72,271.0,84
CDM,30119305,AJPNL MCOLN1 GENE,271.0,176.15,15.72,271.0,84
CDM,30119315,AJPNL SMPD1 GENE COMMON VARS,324.0,210.6,18.8,324.0,84
CDM,30119325,AJPNL MOPATH PROC LVL 1,441.0,286.65,25.58,1608.07,84
CDM,30119335,AJPNL MOPATH PROC LVL 2,945.0,614.25,54.8,2297.92,84
CDM,30119345,AJPNL UNLISTED MOPATH,70.0,45.5,15.26,1666801.85,67
CDM,30119355,TP53MU MOPATH PROC LVL 6,2079.0,1351.35,116.49,2079.0,84
CDM,30119365,LPMNGS TRGTD GENOMIC SEQ ANLYS,5241.0,3406.65,173.12,5241.0,84
CDM,30119375,LPPNGS TRGTD GENOMIC SEQ ANLYS,5241.0,3406.65,173.12,5241.0,84
CDM,30119385,ALLMRW TRGTD GENOMIC SEQ ANLYS,5241.0,3406.65,173.12,5241.0,84
CDM,30119395,ALLPBL TRGTD GENOMIC SEQ ANLYS,5241.0,3406.65,173.12,5241.0,84
CDM,30119405,MYMNGS TRGTD GENOMIC SEQ ANLYS,5241.0,3406.65,173.12,5241.0,84
CDM,30119415,MYPNGS TRGTD GENOMIC SEQ ANLYS,5241.0,3406.65,173.12,5241.0,84
CDM,30119425,5FUDPD DPYD GENE COMMON VARS,1206.0,783.9,116.49,1206.0,84
CDM,30119435,%NFIB1 MOPATH 6,2079.0,1351.35,116.49,2079.0,84
CDM,30119445,LIPOEL LIPID PANEL,92.0,59.8,13.39,92.0,84
CDM,30119455,PROPA DRUG NOS 1-3,742.0,482.3,34.82,742.0,84
CDM,30119465,SOTAL DRUG NOS 1-3,742.0,482.3,34.82,742.0,84
CDM,30119475,ACTIM*ACTIM PROM,677.0,440.05,36.89,677.0,84
CDM,30119485,CF PATHOGENIC VARIANT,3841.0,2496.65,109.69,4289.05,84
CDM,30119495,DIHYDROTESTOSTERONE,202.0,131.3,13.01,202.0,84
CDM,30119515,BENZODIAZEPINES CONF,742.0,482.3,34.82,742.0,84
CDM,30119525,DERMATOMYOSITIS PANEL X6,80.0,52.0,11.53,80.0,84
CDM,30119535,GALACTOCEREBROSIDASE,304.0,197.6,17.61,304.0,84
CDM,30119545,USULFC AMINO AC SNGL QNT,159.0,103.35,9.19,159.0,84
CDM,30119555,UMPSSC MUCOPOLYSACCHARIDE,197.0,128.05,11.4,197.0,84
CDM,30119565,"PIPECOLIC ACID, URINE",166.0,107.9,9.64,166.0,84
CDM,30119575,PHOSPHATIDYLETHANOL,742.0,482.3,34.82,742.0,84
CDM,30119585,PHENCYCLIDINE CONFIRMATION,108.0,70.2,7.2,1666801.85,67
CDM,30119595,THC CONFIRMATION,742.0,482.3,34.82,742.0,84
CDM,30119605,VITAMIN B WHOLE BLOOD,146.0,94.9,10.48,146.0,84
CDM,30119615,TRYPSINOGEN,127.0,82.55,7.36,127.0,84
CDM,30119625,"OREXIN A, SPINAL FLUID (ORXCSF)",127.0,82.55,7.36,127.0,84
CDM,30119635,"ANTI-ALPHA FODRIN AB, IGA",119.0,77.35,6.91,119.0,84
CDM,30119645,"ANTI-ALPHA FODRIN AB, IGG",119.0,77.35,6.91,119.0,84
CDM,30119655,ANIT-ALPHA FODRIN AB X2,119.0,77.35,6.91,119.0,84
CDM,30119665,KAPPA/LAMDA FR LT CH UR,94.0,61.1,6.72,94.0,84
CDM,30119675,CYTOKINE PANEL,119.0,77.35,6.91,119.0,84
CDM,30119685,NY CYCLOSPORINE A,125.0,81.25,8.91,125.0,84
CDM,30119695,NY EVEROLIMUS,95.0,61.75,6.78,95.0,84
CDM,30119705,NY SIROLIMUS,95.0,61.75,6.78,95.0,84
CDM,30119715,NY TACROLIMUS,95.0,61.75,6.78,95.0,84
CDM,30119725,UMUCPO SPECTROPHOTOMETRY,56.0,36.4,3.45,56.0,84
CDM,30119735,CSPNL HGB ELECTROPHORESIS,89.0,57.85,6.36,89.0,84
CDM,30119755,%SSAT24 AMMONIUM,101.0,65.65,7.2,101.0,84
CDM,30119765,%HIRSUT ANDROSTENEDIONE,202.0,131.3,14.46,202.0,84
CDM,30119775,CRYOGLOBULN QI W/REFLX T,45.0,29.25,3.19,49.8,84
CDM,30119785,NEURONAL ABS IGG,80.0,52.0,11.53,80.0,84
CDM,30119795,EOSINOPHIL CATIONIC PROT,119.0,77.35,6.91,119.0,84
CDM,30119805,MANGANESE SERUM,184.0,119.6,12.15,184.0,84
CDM,30119815,ZINC WHOL BLOOD,79.0,51.35,5.62,87.67,84
CDM,30119825,AIDYSA RIA NONAB,127.0,82.55,7.36,127.0,84
CDM,30119835,AIDYSA IMMUNO QNT NOS NONAB,119.0,77.35,6.91,119.0,84
CDM,30119845,ACH RECEPT BIND AB RFLX,127.0,82.55,7.36,127.0,84
CDM,30119865,BTSTFC TESTOSTERONE FR,176.0,114.4,12.58,176.0,84
CDM,30119875,SULFONAMIDES,155.0,100.75,34.82,257.48,84
CDM,30119885,"SSAT24 CALCIUM, UR",42.0,27.3,2.98,42.0,84
CDM,30119895,"SSAT24 CHLORIDE, UR",40.0,26.0,2.48,40.0,84
CDM,30119905,"SSAT24 CITRATE EXCR, UR",192.0,124.8,13.73,192.0,84
CDM,30119915,"SSAT24 CREATININE, UR",36.0,23.4,5.18,36.0,84
CDM,30119925,"SSAT24 MAGNESIUM, UR",46.0,29.9,3.31,46.0,84
CDM,30119935,"SSAT24 OSMOLALITY, UR",47.0,30.55,3.37,47.0,84
CDM,30119945,"SSAT24 OXOLATE, UR",100.0,65.0,6.36,100.0,84
CDM,30119955,"SSAT24 PHOSPHORUS, UR",40.0,26.0,2.56,40.0,84
CDM,30119965,"SSAT24 POTASSIUM, UR",33.0,21.45,2.13,33.0,84
CDM,30119975,"SSAT24 SODIUM, UR",35.0,22.75,2.4,35.0,84
CDM,30119985,"SSAT24 SULFATE, UR",38.0,24.7,2.34,38.0,84
CDM,30119995,SSAT24 UREA NITROGEN,38.0,24.7,2.34,38.0,84
CDM,30120005,"SSAT24 URIC ACID, UR",35.0,22.75,2.34,35.0,84
CDM,30120015,HIRSUT DHEA-SULFATE,153.0,99.45,10.98,153.0,84
CDM,30120025,HIRSUT SHBG,150.0,97.5,10.73,150.0,84
CDM,30120035,HIRSUT TESTOSTERONE TOTAL,178.0,115.7,12.75,178.0,84
CDM,30120215,ACYCLOVIR BLOOD,742.0,482.3,34.82,742.0,84
CDM,30120225,SSAT24 PH,25.0,16.25,1.77,27.56,84
CDM,30120235,UBJP PROTEIN UR,25.0,16.25,1.81,25.0,84
CDM,30120245,UBJP NON SPEC NEPHELOMETRY X2,94.0,61.1,6.72,94.0,84
CDM,30120255,ALPHA-GALACTOSIDASE,153.0,99.45,8.92,153.0,84
CDM,30120265,ADALIMUMAB ACT NEUT AB,266.0,172.9,15.43,266.0,84
CDM,30120275,INFLIXIMAB/BIOSIMILAR ACT NEUT AB,266.0,172.9,15.43,266.0,84
CDM,30120285,POSACONAZOLE,187.0,121.55,10.84,187.0,84
CDM,30120295,LACOSAMIDE,187.0,121.55,10.84,187.0,84
CDM,30120305,VORICONAZOLE,187.0,121.55,10.84,187.0,84
CDM,30120315,BETA HCG QNT TUMOR MKR,106.0,68.9,7.44,106.0,84
CDM,30120325,DILTIAZEM,129.0,83.85,18.31,129.0,84
CDM,30120335,FENTANYL URINE,742.0,482.3,34.82,742.0,84
CDM,30120345,BUPRENOR & METAB QNT UR,742.0,482.3,34.82,742.0,84
CDM,30120355,BUPRENOR & METAB QNT SER/PL,742.0,482.3,34.82,742.0,84
CDM,30120365,SOLUBLE TRANSFERRINE RECEPTOR,252.0,163.8,18.06,252.0,84
CDM,30120375,D2D3 25-OH VITAMIN,204.0,132.6,16.78,204.0,84
CDM,30120385,OPISEC OPIATES 1 OR MORE,742.0,482.3,34.82,742.0,84
CDM,30120395,DRGTOF OPISEC DRG SCRN OXYCODONE,742.0,482.3,34.82,742.0,84
CDM,30120405,DRGTOF ORLOPI OPIATES 1 OR MORE,246.0,159.9,34.82,257.48,84
CDM,30120415,TESTOSTERONE TOTAL ASSAY,178.0,115.7,12.75,178.0,84
CDM,30120425,COLCHICINE LEVEL,742.0,482.3,34.82,742.0,84
CDM,30120435,OPIATE CONFIRMATION UR,742.0,482.3,34.82,742.0,84
CDM,30120445,HYDROXYLASE-21 AB,80.0,52.0,11.53,80.0,84
CDM,30120455,UFLCKL IMMUNO QNT NOS NAB,119.0,77.35,6.91,119.0,84
CDM,30120465,UFLCKL PROTEIN UR,25.0,16.25,1.81,25.0,84
CDM,30120475,HVIIVF ANTI MULLERIAN,266.0,172.9,15.45,266.0,83
CDM,30120485,ASSAY OF GLYCATED PROTEIN,116.0,75.4,16.76,116.0,84
CDM,30120495,CYSTATIN C WITH GFR,128.0,83.2,7.41,128.0,84
CDM,30120505,CHORIONIC GONADOTROPIN ASSAY,52.0,33.8,7.52,52.0,84
CDM,30120515,GOLD SERUM,742.0,482.3,34.82,742.0,84
CDM,30120525,STCATH DEF DRUG NOS,742.0,482.3,34.82,742.0,84
CDM,30120535,"METHYLONE CONF, UR",146.0,94.9,34.82,257.48,84
CDM,30120545,CPEPSP INSULIN SUPPRESSION PANEL,1143.0,742.95,66.72,1143.0,84
CDM,30120555,UC5DC ACYLCARNITINES QUANT,116.0,75.4,8.33,129.85,84
CDM,30120565,UCYS24 AMINO ACIDS QUANT 2-5,135.0,87.75,8.33,135.0,84
CDM,30120575,CPALMT ENZYME CELL ACTIVITY,153.0,99.45,8.92,153.0,84
CDM,30120585,FAOSCM ENZYME CELL ACTIVITY X4,153.0,99.45,8.92,153.0,84
CDM,30120595,FAOACM ENZYME CELL ACTIVITY X8,153.0,99.45,8.92,153.0,84
CDM,30120605,CPALMT ENZYME CELL ACTIVITY RA X2,304.0,197.6,17.61,304.0,84
CDM,30120615,17-HYDROXYPROGESTERONE UR,187.0,121.55,13.42,187.0,84
CDM,30120625,GBMGP IMMUNOASSAY NONANTIBODY,80.0,52.0,11.53,80.0,84
CDM,30120635,ACESTR IMMUNOASSAY NONANTIBODY X2,80.0,52.0,11.53,80.0,84
CDM,30120645,ACETYLCHOL REC MOD,80.0,52.0,11.53,80.0,84
CDM,30120655,ACESTR RIA NONANTIBODY,127.0,82.55,7.36,127.0,84
CDM,30120665,STFRTP ASSAY OF FECES PORPHYRINS,270.0,175.5,15.64,270.0,84
CDM,30120675,CPALMT ASSAY OF PROTEIN OTHER,28.0,18.2,1.81,28.0,84
CDM,30120685,FAOSCM ASSAY OF PROTEIN OTHER,28.0,18.2,1.81,28.0,84
CDM,30120695,FAOACM ASSAY OF PROTEIN OTHER,28.0,18.2,1.81,28.0,84
CDM,30120705,HUWB WESTERN BLOT TEST,118.0,76.7,8.41,118.0,84
CDM,30120715,FAOSCM SPECTROPHOTOMETRY X4,56.0,36.4,3.45,56.0,84
CDM,30120725,FAOACM SPECTROPHOTOMETRY X8,56.0,36.4,3.45,56.0,84
CDM,30120735,USO4 ASSAY OF URINE SULFATE,38.0,24.7,2.34,38.0,84
CDM,30120745,UMHISR COL CHROMOTOGRAPHY,166.0,107.9,9.64,166.0,84
CDM,30120755,UMHISR UR CREATININE,36.0,23.4,5.18,36.0,84
CDM,30120765,DIGITOXIN,742.0,482.3,34.82,742.0,84
CDM,30120775,REFLEX IMMUNOBLOT SER FOR PARNEO,202.0,131.3,11.68,202.0,84
CDM,30120785,BETA-GLUCOSIDASE LEUK,148.0,96.2,10.61,148.0,84
CDM,30120795,"PORPHYRINS, FECAL",270.0,175.5,15.64,270.0,84
CDM,30120805,PBGDEP ENZYME CELL ACT,153.0,99.45,8.92,153.0,84
CDM,30120815,PROMETHEUS ANSER IFX,2129.0,1383.85,18.15,1666801.85,67
CDM,30120825,PROMETHEUS ANSER ADA,2129.0,1383.85,18.15,1666801.85,67
CDM,30120835,PROMETHEUS ANSER VDZ,2129.0,1383.85,18.15,1666801.85,67
CDM,30120845,PROMETHEUS ANSER UST,2129.0,1383.85,18.15,1666801.85,67
CDM,30120855,MCROHN IMM QNT NOS NONAB,119.0,77.35,6.91,119.0,84
CDM,30120865,NEURONAL NUC AB IGG X4,202.0,131.3,11.68,202.0,84
CDM,30120875,AT1R-ANTIBODY-REFERENCE SAMPLE,80.0,52.0,11.53,80.0,84
CDM,30120885,ENCAINIDE,742.0,482.3,34.82,742.0,84
CDM,30120895,PROT WB IMMUNO (MYOSPL),202.0,131.3,11.68,202.0,84
CDM,30120905,DERMYO PROT WB IMMUNO,202.0,131.3,11.68,202.0,84
CDM,30120915,"PLATELET RECIP HLA A,B TYPING",2785.0,1810.25,109.69,2785.0,84
CDM,30120925,BETA-HCG QNT TM CSF,104.0,67.6,7.44,104.0,84
CDM,30120935,FLECAINIDE,129.0,83.85,7.46,129.0,84
CDM,30120945,LEFLUNOMIDE METABOLITE,266.0,172.9,15.43,266.0,84
CDM,30120955,ACETAMINOPHEN BL TEST,129.0,83.85,7.46,129.0,84
CDM,30120965,SALICYLATE,129.0,83.85,7.46,129.0,84
CDM,30120975,AMIODARONE,129.0,83.85,7.46,129.0,84
CDM,30120985,CARBAMAZEPINE-10-11-EPOXI,129.0,83.85,7.46,129.0,84
CDM,30120995,FELBAMATE,129.0,83.85,7.46,129.0,84
CDM,30120OH,EXCISION/SURGICAL PLANING SKIN NOSE RHINOPHYMA,2156.0,1401.4,1.1,9391.15,148
CDM,30121005,RUFINAMIDE,187.0,121.55,10.84,187.0,84
CDM,30121015,METHOTREXATE,266.0,172.9,15.43,266.0,84
CDM,30121025,ITRACONAZOLE,187.0,121.55,10.84,187.0,84
CDM,30121035,GALACTOSE QUANT UR,77.0,50.05,5.53,77.0,84
CDM,30121045,GLUCOSE RANDOM UR,27.0,17.55,1.94,27.0,84
CDM,30121055,ETHANOL PLASMA,119.0,77.35,6.91,119.0,84
CDM,30121065,MCROHN SAA CHEMILUM,97.0,63.05,6.97,104.92,84
CDM,30121075,ANSADA MEAS SER ADA,266.0,172.9,15.43,266.0,84
CDM,30121085,ANSADA MEAS AB ATI,166.0,107.9,9.64,166.0,84
CDM,30121095,ANSIFX MEAS SER ADA,266.0,172.9,15.43,266.0,84
CDM,30121105,ANSIFX MEAS AB ATI,166.0,107.9,9.64,166.0,84
CDM,30121115,ANSVDZ MEAS SER VDZ,266.0,172.9,15.43,266.0,84
CDM,30121125,ANSVDZ MEAS AB ATI,166.0,107.9,9.64,166.0,84
CDM,30121135,ANSUST MEAS SER UST,129.0,83.85,18.31,129.0,84
CDM,30121145,ANSUST MEAS AB ATI,166.0,107.9,9.64,166.0,84
CDM,30121155,ANTI IGE,80.0,52.0,11.53,80.0,84
CDM,30121165,ENCSER RIA NON AB X3,127.0,82.55,7.36,127.0,84
CDM,30121175,"ZINC, UR QNT",79.0,51.35,5.62,87.67,84
CDM,30121185,"MG/LES EVAL, SER",127.0,82.55,7.36,127.0,84
CDM,30121195,MYASTHENIA GRAVIS EVAL,127.0,82.55,7.36,127.0,84
CDM,30121205,"FILM ARRAY, MENINGITIS/ENCEPHALITIS",2876.0,1869.4,49.14,2876.0,84
CDM,30121215,ALLOGEN AUTOANTIBODY,80.0,52.0,11.53,80.0,84
CDM,30121225,"ECULIZUMAB, SERUM",129.0,83.85,18.31,129.0,84
CDM,30121235,BETA HCG QUANT TUMOR MARKER,104.0,67.6,7.44,104.0,84
CDM,30121245,ANTI ALPHA FODRIN AB IGG IGA X2,80.0,52.0,11.53,80.0,84
CDM,30121255,ANTI ALPHA FODRIN AB IGA,80.0,52.0,11.53,80.0,84
CDM,30121265,ANTI ALPHA FODRIN AB IGG,80.0,52.0,11.53,80.0,84
CDM,30121275,CPALMF ENZYME CELL ACTIVITY RA X2,304.0,197.6,17.61,304.0,84
CDM,30121285,CPALMF ENZYME CELL ACTIVITY,153.0,99.45,8.92,153.0,84
CDM,30121295,CPALMF ASSAY OF PROTEIN OTHER,28.0,18.2,1.81,28.0,84
CDM,30121305,ETHAMBUTOL,742.0,482.3,34.82,742.0,84
CDM,30121315,OLANZAPINE,742.0,482.3,34.82,742.0,84
CDM,30121425,ASSAY OF INTERLEUKIN-6 (IL-6),119.0,77.35,6.91,119.0,84
CDM,30121435,IMMUNOGL LT CHNS FR EA,119.0,77.35,6.91,119.0,84
CDM,30121445,ELASTASE PANCREATIC FECAL,158.0,102.7,9.19,158.0,84
CDM,30121455,CYTOKP INTERLEUKIN-6,119.0,77.35,6.91,119.0,84
CDM,30121465,G HYDROXYBUTYRIC,429.0,278.85,31.92,429.0,84
CDM,30121475,SYNTH CANNABINOID METAB,742.0,482.3,34.82,742.0,84
CDM,30121485,SERTRALINE,742.0,482.3,34.82,742.0,84
CDM,30121495,QUETIAPINE,742.0,482.3,34.82,742.0,84
CDM,30121505,MITOTANE,129.0,83.85,18.31,129.0,84
CDM,30121515,MEPHEDRONE MDPV CONF UR,146.0,94.9,34.82,257.48,84
CDM,30121525,UR BARBITURATE CONF RFLX,429.0,278.85,31.92,429.0,84
CDM,30121535,UR BENZODIAZ CONF RFLX,429.0,278.85,31.92,429.0,84
CDM,30121545,UR FLUNITRAZ CONF RFLX,429.0,278.85,31.92,429.0,84
CDM,30121555,UR KETAMINE CONF RFLX,429.0,278.85,31.92,429.0,84
CDM,30121565,UR ALCOHOL CONF RFLX,429.0,278.85,31.92,429.0,84
CDM,30121575,GHB CONF RFLX,742.0,482.3,34.82,742.0,84
CDM,30121585,AMITRIPTYLINE,742.0,482.3,34.82,742.0,84
CDM,30121595,DESIPRAMINE,742.0,482.3,34.82,742.0,84
CDM,30121605,DOXEPIN/NORDOXEPIN,742.0,482.3,34.82,742.0,84
CDM,30121615,IMIPRAMINE,742.0,482.3,34.82,742.0,84
CDM,30121625,NORTRIPTYLINE,742.0,482.3,34.82,742.0,84
CDM,30121635,STCATH ASSAY OF MAGNESIUM,46.0,29.9,3.31,46.0,84
CDM,30121645,MECDRG AMPHETAMINES 5 OR MORE,1015.0,659.75,75.43,1015.0,84
CDM,30121655,MECDRG DRUG SCRN BENZODIAZ 13 OR MORE,1015.0,659.75,75.43,1015.0,84
CDM,30121665,MECDRG OPIOIDS AND OPIATE ANALOGS 5 OR MORE,1015.0,659.75,75.43,1015.0,84
CDM,30121675,DTOFMP GABAPENTIN,1015.0,659.75,75.43,1015.0,84
CDM,30121715,DRGTOF AMPHETAMINES 5 OR MORE,742.0,482.3,34.82,742.0,84
CDM,30121725,DRGTOF DRUG SCRN BENZODIAZ 13 OR MORE,742.0,482.3,34.82,742.0,84
CDM,30121735,DRGTOF OPIOIDS AND OPIATE ANALOGS 5 OR MORE,742.0,482.3,34.82,742.0,84
CDM,30121745,DRGTOF DRUG SCRN GABAPENTIN NON-BLOOD,742.0,482.3,34.82,742.0,84
CDM,30121755,BTSTFC ASSAY OF SEX HORMONE GLOBUL,150.0,97.5,10.73,150.0,84
CDM,30121765,ROM RUPTURE OF FETAL MEMBRANES,677.0,440.05,36.89,677.0,84
CDM,30121775,ACETONE,56.0,36.4,8.17,56.0,84
CDM,30121785,GVHPRE GROWTH STIMULATION GENE 2,522.0,339.3,27.68,522.0,84
CDM,30121795,GVHPRE IMMUNOASSAY QUANT NOS NONAB,119.0,77.35,6.91,119.0,84
CDM,30121805,GVHSYM GROWTH STIMULATION GENE 2,522.0,339.3,27.68,522.0,84
CDM,30121815,GVHSYM IMMUNOASSAY QUANT NOS NONAB,119.0,77.35,6.91,119.0,84
CDM,30121825,GVHPST GROWTH STIMULATION GENE 2,522.0,339.3,27.68,522.0,84
CDM,30121835,GVHPST IMMUNOASSAY QUANT NOS NONAB,119.0,77.35,6.91,119.0,84
CDM,30121845,PLASMA THYMIDINE DETERMINATION,166.0,107.9,9.64,166.0,84
CDM,30121855,"PRIMARY MEMBRANOUS NEPHROPATHY DIAG CASCADE, SER",119.0,77.35,6.91,119.0,84
CDM,30121865,DUPNL DPYD GENE COMMON VARIANTS,1206.0,783.9,116.49,1206.0,84
CDM,30121875,DUPNL UGT1A1 GENE COMMON VARIANTS,1615.0,1049.75,93.6,1615.0,84
CDM,30121885,ANTI-CN-1A (NT5C1A) IBM,80.0,52.0,11.53,80.0,84
CDM,30121975,TPMT ASY THIOPURIN S-MTHYLTRNSFRS,153.0,99.45,8.87,153.0,84
CDM,30121985,"PHOSPHOLIPASE A2 RECEPTOR AB, ELISA, SERUM",119.0,77.35,6.91,119.0,84
CDM,30121995,TRIGLYCERIDES BF W REFLEX TO CHYLOMICRON ELECTROPH,40.0,26.0,5.74,40.0,84
CDM,30122005,"RBC FOLATE (REFLAB ONLY, REQUIRES HCT WITHIN 24 HRS)",122.0,79.3,8.55,122.0,84
CDM,30122035,"LH, PEDIATRIC",128.0,83.2,18.52,128.0,84
CDM,30122045,CLOZAPINE,139.0,90.35,9.13,139.0,84
CDM,30122055,CAHSP ASSAY OF ANDROSTENEDIONE,202.0,131.3,14.46,202.0,84
CDM,30122065,CAHSP DEOXYCORTISOL,202.0,131.3,14.46,202.0,84
CDM,30122075,CAHSP TOTAL CORTISOL,112.0,72.8,8.05,112.0,84
CDM,30122085,CAHSP DEHYDROEPIANDROSTERONE,174.0,113.1,12.48,174.0,84
CDM,30122095,CAHSP ASSAY OF 17-HYDROXYPREGNENO,157.0,102.05,11.26,157.0,84
CDM,30122105,CAHSP ASSAY OF PROGESTERONE,144.0,93.6,10.3,144.0,84
CDM,30122115,CAHSP ASY HYDROXYPROGESTERONE 17-D,187.0,121.55,13.42,187.0,84
CDM,30122125,CAHSP ASSAY OF TOTAL TESTOSTERONE,178.0,115.7,12.75,178.0,84
CDM,30122135,CAHSP DESOXYCORTICOSTERONE,214.0,139.1,15.3,214.0,84
CDM,30122145,"15AGTL - 1,5 ANHYDROGLUCITOL",80.0,52.0,5.69,80.0,84
CDM,30122155,"BENZO, SER PL, QNT RFLX",742.0,482.3,34.82,742.0,84
CDM,30122165,"COCAINE METABOLITE, SER OR PL, QNT RFLX",742.0,482.3,34.82,742.0,84
CDM,30122175,"PCP SER OR PL, QNT RFLX",742.0,482.3,34.82,742.0,84
CDM,30122185,DRG SCRN 9 PANEL SER OR PL,429.0,278.85,31.92,429.0,84
CDM,30122195,"IOHEXOL GLOMERULAR FILTRATION RATE (GFR), PLASMA",166.0,107.9,9.64,166.0,84
CDM,30122205,"PREGABALIN, URINE",32.0,20.8,3.31,1851898.14,67
CDM,30122215,"INFLIXIMAB, SERUM",266.0,172.9,15.43,266.0,84
CDM,30122225,"ADALIMUMAB, SERUM",119.0,77.35,6.91,119.0,84
CDM,30122235,CANNABINOIDS NATURAL,53.0,34.45,5.33,53.0,67
CDM,30122245,"AMMONIUM, 24 HOUR, URINE",101.0,65.65,7.2,101.0,84
CDM,30122255,"AMMONIUM, RANDOM, URINE",101.0,65.65,7.2,101.0,84
CDM,30122265,ASPARAGINASE ENZYME ACTIVITY,153.0,99.45,8.92,153.0,84
CDM,30122275,"MITRAGYNINE (KRATOM), URINE",429.0,278.85,31.92,429.0,84
CDM,30122285,KRATOM (MITRAGYNINE) CONFIRMATION,334.0,217.1,8.21,1851898.14,67
CDM,30122295,ASSAY OF ANTI-MULLERIAN HORMONE,266.0,172.9,15.45,266.0,83
CDM,30122305,"ZINC, URINE QUANTITATIVE",79.0,51.35,5.62,87.67,84
CDM,30122315,NEUROFILAMENT LIGHT (NFL),119.0,77.35,6.91,119.0,84
CDM,30122325,ORGANIC ACID SNGL QUANT-LABCORP,146.0,94.9,8.48,146.0,84
CDM,30122335,"CREATININE, UR (LABCORP PORPHOBILINOGEN, QN, RANDOM UR)",36.0,23.4,5.18,36.0,84
CDM,30122345,UA DIP URINE HCG (POINT OF CARE LAB),52.0,33.8,7.52,52.0,84
CDM,30122365,"ACYLCARNITINES, QUANTIT, P-MAYO",116.0,75.4,8.33,129.85,84
CDM,30122375,"5-HIAA, PLASMA - LABCORP",89.0,57.85,6.37,99.26,84
CDM,30122385,"HYDROXYCHLOROQUINE, BLOOD",129.0,83.85,7.46,129.0,84
CDM,30122395,"CARNITINE, P",116.0,75.4,8.33,129.85,84
CDM,30122405,VENLAFAXINE SERUM/PLASMA - ARUP,36.0,23.4,5.04,1851898.14,67
CDM,30122415,IMMUNOASSAY QUANT NOS NONAB,119.0,77.35,6.91,119.0,84
CDM,30122425,ADIPONECTIN,127.0,82.55,7.36,127.0,84
CDM,30122435,BLOOD GAS MIXED WO O2 SAT,180.0,117.0,10.43,180.0,84
CDM,30122445,"VEDOLIZUMAB QN, S",266.0,172.9,15.43,266.0,84
CDM,30122455,"VEDOLIZUMAB AB, S",97.0,63.05,6.97,104.92,84
CDM,30122465,"USTEKINUMAB QN, S",129.0,83.85,18.31,129.0,84
CDM,30122475,"USTEKINUMAB AB, S",119.0,77.35,6.91,119.0,84
CDM,30122485,ASSAY OF LACTIC ACID,80.0,52.0,11.57,80.0,84
CDM,30122495,"NEURONAL AB (TR/DNER) IGG, SER",202.0,131.3,11.68,202.0,84
CDM,30122505,"NEURONAL NUCLEAR AB (HU) IGG, IB, SERUM",202.0,131.3,11.68,202.0,84
CDM,30122525,"NEURONAL AB (TR/DNER) IGG, CSF",202.0,131.3,11.68,202.0,84
CDM,30122535,MPS ELECTROPHORESIS,424.0,275.6,20.86,424.0,84
CDM,30122545,MUCOPOLYSACCHARIDES MG/MMOL CRT,197.0,128.05,11.4,197.0,84
CDM,30122555,ATLANTIC RESPIRATORY PANEL IGE TOTAL,114.0,74.1,8.13,114.0,84
CDM,30122565,"BULLOUS PEMPHIGOID, BP180 AND BP230, IGG ANTIBODIES",80.0,52.0,11.53,80.0,84
CDM,30122575,CHRONIC VIRAL HEPATITIS NEPHELOMETRY (ARUP),94.0,61.1,6.72,94.0,84
CDM,30122585,"ASPARTATE AMINOTRANSFERASE, FIBROMETER",36.0,23.4,5.18,36.0,84
CDM,30122595,"ALANINE AMINOTRANSFERASE, FIBROMETER",37.0,24.05,5.3,37.0,84
CDM,30122605,"UREA NITROGEN, SERUM, FIBROMETER",27.0,17.55,1.95,27.0,84
CDM,30122615,"GAMMA GLUTAMYL TRANSFERASE, FIBROMETER",50.0,32.5,7.2,50.0,84
CDM,30122625,SENMOT IMMUNOASSAY (ARUP),80.0,52.0,11.53,80.0,84
CDM,30122635,SENNRO IMMUNOASSAY (ARUP),80.0,52.0,11.53,80.0,84
CDM,30122645,INHIBIN B,119.0,77.35,6.91,119.0,84
CDM,30122655,GAUCHER GBA ACTIVITY LEUKOCYTES,153.0,99.45,8.92,153.0,84
CDM,30122665,VITAMIN B3 (NIACIN AND METABOLITES),118.0,76.7,6.82,118.0,84
CDM,30122675,7ALPHAC4,166.0,107.9,9.64,166.0,84
CDM,30122685,PHI PROST SPEC AG TOT,127.0,82.55,10.42,127.0,84
CDM,30122695,ADIPONECTIN,119.0,77.35,6.91,119.0,84
CDM,30122705,DRGTOF OPIATE CONFIRMATION,742.0,482.3,34.82,742.0,84
CDM,30122715,DRGTOF TRAMADOL,742.0,482.3,34.82,742.0,84
CDM,30122725,OPIOIDS AND OPIATE ANALOGS (DRGTOF),742.0,482.3,34.82,742.0,84
CDM,30122735,DRGTOF GABAPENTIN,742.0,482.3,34.82,742.0,84
CDM,30122745,DRGTOF AMPHETAMINES,742.0,482.3,34.82,742.0,84
CDM,30122755,DRGTOF ZOLPIDEM,742.0,482.3,34.82,742.0,84
CDM,30122765,OPIATE CONFIRMATION (MECDRG),64.4,41.86,18.21,257.48,84
CDM,30122775,TRAMADOL (MECDRG),64.4,41.86,18.21,257.48,84
CDM,30122785,OPIOIDS AND OPIATE ANALOGS (MECDRG),64.4,41.86,18.21,257.48,84
CDM,30122795,GABAPENTIN (MECDRG),64.4,41.86,18.21,257.48,84
CDM,30122805,AMPHETAMINES (MECDRG),64.4,41.86,18.21,257.48,84
CDM,30122815,METHYLPHENIDATE (MECDRG),64.4,41.86,18.21,257.48,84
CDM,30122825,ALKALOID DRUGS (MECDRG),64.4,41.86,18.21,257.48,84
CDM,30122835,ZOLPIDEM (MECDRG),64.4,41.86,18.21,257.48,84
CDM,30122845,LORAZEPAM,742.0,482.3,34.82,742.0,84
CDM,30122865,"SYNTHETIC GLUCOCORTICOID SCREEN, URINE",129.0,83.85,18.31,129.0,84
CDM,30122875,CORTISOL,112.0,72.8,8.05,112.0,84
CDM,30122885,"IMMUNOASSAY, LACTOFERRIN, FECAL, QUALITATIVE",136.0,88.4,9.7,136.0,84
CDM,30122895,ARIPIPRAZOLE AND METABOLITE,85.0,55.25,24.04,257.48,84
CDM,30122905,"ANTI-SP100 AND ANTI-GP210 ANTIBODIES, IGG",80.0,52.0,11.53,80.0,84
CDM,30122915,HEX4 GLC4,166.0,107.9,9.64,166.0,84
CDM,30122925,HEX4 CREATININE,36.0,23.4,5.18,36.0,84
CDM,30122935,OXYSTEROLS,166.0,107.9,9.64,166.0,84
CDM,30122945,RUFINAMIDE,187.0,121.55,10.84,187.0,84
CDM,30122955,PREGABALIN,68.0,44.2,19.23,257.48,84
CDM,30122965,ETHOSUXIMIDE LEVEL,113.0,73.45,8.07,113.0,84
CDM,30122975,BRIVARACETAM - QUANTITATIVE ASSAY DRUG,129.0,83.85,18.31,129.0,84
CDM,30122985,PERAMPANEL - QUANTITATIVE ASSAY DRUG,129.0,83.85,18.31,129.0,84
CDM,30122995,DRGTOF OPIOIDS AND OPIATE ANALOGS,53.0,34.45,14.99,257.48,84
CDM,30123005,DRGTOF PROPOXYPHENE,53.0,34.45,14.99,257.48,84
CDM,30123015,DTOFMP BENZODIAZEPINES,53.0,34.45,14.99,257.48,84
CDM,30123025,DTOFMP BUPRENORPHINE,53.0,34.45,14.99,257.48,84
CDM,30123035,DTOFMP COCAINE METABOLITE,53.0,34.45,14.99,257.48,84
CDM,30123045,DTOFMP HYDROCODONE,53.0,34.45,14.99,257.48,84
CDM,30123055,DTOFMP HEROIN METABOLITE,53.0,34.45,14.99,257.48,84
CDM,30123065,DTOFMP OXYCODONE AND METABOLITE,53.0,34.45,14.99,257.48,84
CDM,30123075,DTOFMP OPIOIDS,53.0,34.45,14.99,257.48,84
CDM,30123085,DTOFMP OPIOIDS AND OPIATE ANALOGS,53.0,34.45,14.99,257.48,84
CDM,30123095,DTOFMP MDMA,53.0,34.45,14.99,257.48,84
CDM,30123105,DTOFMP AMPHETAMINES,53.0,34.45,14.99,257.48,84
CDM,30123115,DTOFMP BARBITURATES,53.0,34.45,14.99,257.48,84
CDM,30123125,DTOFMP TAPENTADOL,53.0,34.45,14.99,257.48,84
CDM,30123135,DTOFMP METHADONE,53.0,34.45,14.99,257.48,84
CDM,30123145,DTOFMP PHENCYCLIDINE,53.0,34.45,14.99,257.48,84
CDM,30123155,DTOFMP SEDATIVE HYPNOTICS,53.0,34.45,14.99,257.48,84
CDM,30123165,DTOFMP PROPOXYPHENE,53.0,34.45,14.99,257.48,84
CDM,30123175,DTOFMP MARIJUANA METABOLITE,53.0,34.45,14.99,257.48,84
CDM,30123185,BILE ACIDS TOTAL,118.0,76.7,8.46,118.0,84
CDM,30123195,"PHENOLPHTHALEIN, STOOL",53.0,34.45,14.99,257.48,84
CDM,30123205,MELATONIN,295.0,191.75,34.82,295.0,84
CDM,30123215,MLPTHY CRMP-5 WB,202.0,131.3,11.68,202.0,84
CDM,30123225,"MA2/TA ANTIBODY, IGG SERUM",202.0,131.3,11.68,202.0,84
CDM,30123235,"MA2/TA ANTIBODY, IGG CSF",202.0,131.3,11.68,202.0,84
CDM,30123275,INTERLEUKIN 4,119.0,77.35,6.91,119.0,84
CDM,30123285,CREATININE SERUM (TRPHOS),35.0,22.75,2.53,35.0,84
CDM,30123295,CREATININE URINE (TRPHOS),36.0,23.4,5.18,36.0,84
CDM,30123305,"INORGANIC PHOSPHATE, SERUM (TRPHOS)",33.0,21.45,2.34,33.0,84
CDM,30123315,"INORGANIC PHOSPHATE, URINE (TRPHOS)",40.0,26.0,2.56,40.0,84
CDM,30123325,BETA-AMYLOID; 1-42 (ABETA 42),121.0,78.65,33.64,141.81,76
CDM,30123335,"DIURETIC SURVEY, URINE",739.0,480.35,34.82,739.0,84
CDM,30123345,"SULFONYLUREA HYPOGLYCEMIA PANEL, QUANTITATIVE, URINE",739.0,480.35,34.82,739.0,84
CDM,30123355,HUMAN ANTI-MOUSE AB (HAMA),119.0,77.35,6.91,119.0,84
CDM,30123365,AMPHETAMINES CONF URINE,739.0,480.35,34.82,739.0,84
CDM,30123375,METHYLENEDIOXYAMPHETAMINES CONF URINE,739.0,480.35,34.82,739.0,84
CDM,30123385,PCP CONFIRM URINE,739.0,480.35,34.82,739.0,84
CDM,30123395,FENTANYL URINE,739.0,480.35,34.82,739.0,84
CDM,30123405,"TRAMADOL & METAB, QUANT",739.0,480.35,34.82,739.0,84
CDM,30123415,CANNABINOIDS CONF UR,739.0,480.35,34.82,739.0,84
CDM,30123425,UQNTOX AMPHETAMINES,78.0,50.7,22.06,257.48,84
CDM,30123435,UQNTOX BUPRENORPHINE,78.0,50.7,22.06,257.48,84
CDM,30123445,UQNTOX CANNABINOIDS NATURAL,78.0,50.7,22.06,257.48,84
CDM,30123455,UQNTOX COCCAINE,78.0,50.7,22.06,257.48,84
CDM,30123465,UQNTOX FENTANYL,78.0,50.7,22.06,257.48,84
CDM,30123475,UQNTOX HEROINE METABOLITE,78.0,50.7,22.06,257.48,84
CDM,30123485,UQNTOX METHADONE,78.0,50.7,22.06,257.48,84
CDM,30123495,UQNTOX METHYLENEDIOXYAMPHETAMINES,78.0,50.7,22.06,257.48,84
CDM,30123505,UQNTOX OPIATES,78.0,50.7,22.06,257.48,84
CDM,30123515,UQNTOX OPIOIDS 5+,78.0,50.7,22.06,257.48,84
CDM,30123525,UQNTOX OXYCODONE,78.0,50.7,22.06,257.48,84
CDM,30123535,UQNTOX TRAMADOL,78.0,50.7,22.06,257.48,84
CDM,30123545,UQNTOX PHENCYCLIDINE,78.0,50.7,22.06,257.48,84
CDM,30123555,LYMRFX SERUM ALBUMIN,34.0,22.1,4.95,34.0,84
CDM,30123565,LYMRFX CSF ALBUMIN,54.0,35.1,3.11,54.0,84
CDM,30123575,LYMRFX IGG QUANT,64.0,41.6,4.59,64.0,84
CDM,30123585,3-METHYLGLUTACONIC ACID,146.0,94.9,8.48,146.0,84
CDM,30123595,ALPRAZOLAM,739.0,480.35,34.82,739.0,84
CDM,30123605,DERMATOMYOSITIS PANEL,80.0,52.0,11.53,80.0,84
CDM,30123615,IMMUNOBLOT (POLMYO),202.0,131.3,11.68,202.0,84
CDM,30123625,DTOFMP FENTANYL,53.0,34.45,14.99,257.48,84
CDM,30123635,ANTIBODY IMMUNOASSAY (POLMYO),80.0,52.0,11.53,80.0,84
CDM,30123645,"PT AB, IGG",80.0,52.0,11.53,80.0,84
CDM,30123655,DISACCHARIDASE IN TISSUE,153.0,99.45,8.92,153.0,84
CDM,30123665,OXIDIZED LOW-DENSITY LIPOPROTEIN (OXLDL),72.0,46.8,10.5,72.0,84
CDM,30123675,"TESTOSTERONE, TOTAL, SERUM",178.0,115.7,12.75,178.0,84
CDM,30123685,"TESTOSTERONE, FREE, SERUM",176.0,114.4,12.58,176.0,84
CDM,30123695,ENHANCED LIVER FIBROSIS (ELF) SCORE,1216.0,790.4,116.49,1216.0,83
CDM,30123705,"CXCL9 QUANTITATION, SERUM",119.0,77.35,6.91,119.0,84
CDM,30123715,GLUCOSE QUANT (POINT OF CARE LAB),27.0,17.55,1.94,27.0,84
CDM,30123725,BMP I STAT ANALYZER (POINT OF CARE LAB),95.0,61.75,9.74,95.0,84
CDM,30123735,LIPID-LIPO PANEL 1 (POINT OF CARE LAB),92.0,59.8,13.39,92.0,84
CDM,30123745,ASSAY IONIZED CA (POINT OF CARE LAB),94.0,61.1,6.75,94.0,84
CDM,30123755,BILIRUBIN TOTAL (BACK OFFICE),35.0,22.75,4.36,35.0,84
CDM,30123765,OCCULT BLOOD FECES 1-3 TEST (POINT OF CARE LAB),29.0,18.85,4.23,29.0,84
CDM,30123775,ASSAY LACTIC ACID (POINT OF CARE LAB),80.0,52.0,11.57,80.0,84
CDM,30123785,HGB A1C GLYCOSYLATED (POINT OF CARE LAB),67.0,43.55,9.71,67.0,84
CDM,30123795,"PH BODY FLUID, NES (POINT OF CARE LAB)",25.0,16.25,1.77,27.56,84
CDM,30123805,BLOOD GAS (POINT OF CARE LAB),544.0,353.6,31.51,544.0,84
CDM,30123815,HCG TEST QUAL (POINT OF CARE LAB),52.0,33.8,7.52,52.0,84
CDM,30123835,"DRUG TEST, DEFINITVE, PER DAY?1-7?DRUG CLASSES",742.0,482.3,34.82,742.0,84
CDM,30123845,"DRUG TEST, DEFINITVE, PER DAY?8-14?DRUG CLASSES",1015.0,659.75,75.43,1015.0,84
CDM,30123855,"DRUG TEST, DEFINITVE, PER DAY?15-21 DRUG CLASSES",1288.0,837.2,75.43,1288.0,84
CDM,30123865,"DRUG TEST, DEFINITVE, PER DAY?22 OR MORE DRUG CLASSES",1600.0,1040.0,75.43,1600.0,84
CDM,30123875,URDRG GABAPENTIN,68.0,44.2,19.23,257.48,84
CDM,30123885,URDRG PREGABALIN,68.0,44.2,19.23,257.48,84
CDM,30123895,URDRG BENZODIAZEPINES,68.0,44.2,19.23,257.48,84
CDM,30123905,URDRG BUPRENORPHINE,68.0,44.2,19.23,257.48,84
CDM,30123915,URDRG CANNABINOIDS,68.0,44.2,19.23,257.48,84
CDM,30123925,URDRG FENTANYL,68.0,44.2,19.23,257.48,84
CDM,30123935,URDRG 6-MONOACETYLMORPHINE,68.0,44.2,19.23,257.48,84
CDM,30123945,URDRG KETAMINE AND NORKETAMINE,68.0,44.2,19.23,257.48,84
CDM,30123955,URDRG METHADONE,68.0,44.2,19.23,257.48,84
CDM,30123965,URDRG OPIATES,68.0,44.2,19.23,257.48,84
CDM,30123975,URDRG SKELETAL MUSCLE RELAXANTS,68.0,44.2,19.23,257.48,84
CDM,30123985,URDRG COCAINE,68.0,44.2,19.23,257.48,84
CDM,30123995,URDRG OPIOIDS,68.0,44.2,19.23,257.48,84
CDM,30124005,URDRG OXYCODONE,68.0,44.2,19.23,257.48,84
CDM,30124015,URDRG DRUGS NOT OTHERWISE SPECIFIED,68.0,44.2,19.23,257.48,84
CDM,30124025,URDRG ZOLPIDEM,68.0,44.2,19.23,257.48,84
CDM,30124035,URDRG TRAMADOL,68.0,44.2,19.23,257.48,84
CDM,30124045,"CENOBAMATE (XCOPRI), PLASMA",129.0,83.85,18.31,129.0,84
CDM,30124055,URDRG AMPHETAMINES,68.0,44.2,19.23,257.48,84
CDM,30124065,URDRG METHYLENEDIOXYAMPHETAMINES,68.0,44.2,19.23,257.48,84
CDM,30124625,BENZODIAZEPINES1-12 (MECDRG),64.4,41.86,18.21,257.48,84
CDM,30124635,CARBOXY-THC (MECDRG),64.4,41.86,18.21,257.48,84
CDM,30124645,DRG BUPRENORPHINE (MECDRG),64.4,41.86,18.21,257.48,84
CDM,30124655,DRG COCAINE (MECDRG),64.4,41.86,18.21,257.48,84
CDM,30124665,ORLOPI OPIATES 1 OR MORE (MECDRG),64.4,41.86,18.21,257.48,84
CDM,30124675,OPISEC OXYCODONE (MEDDRG),64.4,41.86,18.21,257.48,84
CDM,30124685,FENTANYL AND METABOLITE (MECDRG),64.4,41.86,18.21,257.48,84
CDM,30124695,METHYLEEDIOXAMPHETAMINE (MECDRG),64.4,41.86,18.21,257.48,84
CDM,30124705,BARBITURATES (MECDRG),64.4,41.86,18.21,257.48,84
CDM,30124715,TAPENTADOL AND MET (MECDRG),64.4,41.86,18.21,257.48,84
CDM,30124725,METHADONE (MECDRG),64.4,41.86,18.21,257.48,84
CDM,30124735,PHENCYCLIDINE (MECDRG),64.4,41.86,18.21,257.48,84
CDM,30124755,LEAD CONCENTRATION,84.0,54.6,12.11,84.0,84
CDM,30124765,CHLORIDE (POINT OF CARE LAB),32.0,20.8,2.27,32.0,84
CDM,30124775,CREATININE BLOOD (POINT OF CARE LAB),35.0,22.75,2.53,35.0,84
CDM,30124785,BLOOD GAS O2 SATUR ONLY (POINT OF CARE LAB),67.0,43.55,4.31,67.0,84
CDM,30124795,CARBOXYHEMOGLOBIN (POINT OF CARE LAB),85.0,55.25,6.08,85.0,84
CDM,30124805,METHEMOGLOBIN QUANT (POINT OF CARE LAB),57.0,37.05,3.62,57.0,84
CDM,30124835,"ANTI-HMGCR ANTIBODY, IGG",97.0,63.05,6.97,104.92,84
CDM,30124845,"ANTI-HMGCR ANTIBODY, IGG",97.0,63.05,6.97,104.92,84
CDM,30124855,PHOSPHOLIPASE A2 RECEPTOR IGG ANTIBODY ELISA,119.0,77.35,6.91,119.0,84
CDM,30124865,GLUC NON GEST TOLERANCE,33.0,21.45,4.75,33.0,84
CDM,30124875,"GLUC, FASTING",27.0,17.55,1.94,27.0,84
CDM,30124885,NEUROFILAMENT LIGHT (NFL),119.0,77.35,33.08,134.88,76
CDM,30124905,"DIPHENHYDRAMINE, SERUM/PLASMA",32.0,20.8,9.05,257.48,84
CDM,30124915,"METOPROLOL, SER/PL",32.0,20.8,9.05,257.48,84
CDM,30124925,RAPID URINE DRUG SCREEN 10-PANEL - MEDTOX,65.0,42.25,14.17,65.0,58
CDM,30124935,RAPID URINE DRUG SCREEN 5-PANEL - MEDTOX,65.0,42.25,14.17,65.0,58
CDM,30124955,URINE DRUG SCREEN 10-PANEL - MEDTOX,50.0,32.5,10.9,50.0,58
CDM,30124OH,EXCISION DERMOID CYST NOSE SIMPLE SUBCUTANEOUS,1280.0,832.0,1.1,4447.63,144
CDM,30125015,URINE DRUG SCREEN 12-PANEL - MEDTOX,95.0,61.75,20.71,95.0,58
CDM,30125025,URINE DRUG SCREEN 4-PANEL (NO THC) - MEDTOX,50.0,32.5,10.9,50.0,58
CDM,30125035,URINE DRUG SCREEN 5-PANEL - MEDTOX,50.0,32.5,10.9,50.0,58
CDM,30125055,URINE DRUG SCREEN 9-PANEL (NO THC) - MEDTOX,50.0,32.5,10.9,50.0,58
CDM,30125065,URINE DRUG SCREEN DOT - MEDTOX,50.0,32.5,10.9,50.0,58
CDM,30125085,URINE DRUG SCREEN CRL WS66 - CRL,95.0,61.75,20.71,95.0,58
CDM,30125105,HAIR DRUG SCREEN 5-PANEL - OMEGA,105.0,68.25,22.89,105.0,58
CDM,30125175,BREATH ALCOHOL TEST - CCAW / WW,30.0,19.5,6.54,30.0,58
CDM,30125205,PTH RELATED PEPTIDE,166.0,107.9,9.64,166.0,84
CDM,30125215,"URDRG STIMULANTS, SYNTHETIC",68.0,44.2,19.23,257.48,84
CDM,30125225,URDRG ALKALOIDS NOS,68.0,44.2,19.23,257.48,84
CDM,30125235,URDRG ASSAY FOR PHENCYCLIDINE,68.0,44.2,19.23,257.48,84
CDM,30125245,"URDRG DRUG SCREENING, TAPENTADOL",68.0,44.2,19.23,257.48,84
CDM,30125OH,EXC DERMOID CYST NOSE COMPLEX UNDER BONE/CRTLG,2920.0,1898.0,1.1,17080.38,144
CDM,30130OH,EXCISION INFERIOR TURBINATE PARTIAL/COMPLETE,1527.0,992.55,1.1,9391.15,144
CDM,30140OH,SUBMUCOUS RESCJ INFERIOR TURBINATE PRTL/COMPL,1320.0,858.0,1.1,9391.15,148
CDM,30150OH,RHINECTOMY PARTIAL,3820.0,2483.0,1.1,17080.38,144
CDM,30160OH,RHINECTOMY TOTAL,3996.0,2597.4,1.1,17080.38,144
CDM,30200005,ANTI PLATELET FACT 4 X2,127.0,82.55,9.07,127.0,84
CDM,30200015,*%ANA,77.0,50.05,5.51,77.0,84
CDM,30200020,*ALLERGEN IGG QUANT/SEMI EA,54.0,35.1,3.13,54.0,84
CDM,30200025,ANTI-STREPTOLYSIN O,50.0,32.5,3.6,50.0,84
CDM,30200030,ALLERGEN IGE QUANT/SEMI EA,36.0,23.4,2.96,36.0,84
CDM,30200035,BETA2 GLYCOPROT IGG/MX2,176.0,114.4,12.57,176.0,84
CDM,30200045,CARDIOLIPIN AB SCREEN,176.0,114.4,12.57,176.0,84
CDM,30200065,%CHEMOTAXIS,110.0,71.5,7.9,123.08,84
CDM,30200070,AB ID LEUKO AB,104.0,67.6,7.44,104.0,84
CDM,30200075,COLD AGGLUTININS,56.0,36.4,3.98,56.0,84
CDM,30200085,C3 COMPLEMENT B1C/B1A,83.0,53.95,5.92,83.0,84
CDM,30200105,COMPLEMENT DEFICIENCY,140.0,91.0,10.04,140.0,84
CDM,30200115,CYCLIC CITRU PEPT ANTI IG,89.0,57.85,6.39,89.0,84
CDM,30200125,DNA ANTIBODY,95.0,61.75,6.79,95.0,84
CDM,30200135,ENA ANY METHOD,124.0,80.6,8.86,124.0,84
CDM,30200145,FLUORESCENT ANTIBODY TITER,83.0,53.95,5.95,104.69,84
CDM,30200155,HEPATITIS B SUR AB QUANT,103.0,66.95,7.4,103.0,84
CDM,30200165,OXIDATIVE METABOLOISM,125.0,81.25,18.09,125.0,84
CDM,30200170,*ANTISTREPTOLYSIN 0 TITER,50.0,32.5,3.6,50.0,84
CDM,30200175,%IMMUNOFIXATION,154.0,100.1,11.04,154.0,84
CDM,30200180,C-REACTIVE PROTEIN,36.0,23.4,5.18,36.0,84
CDM,30200185,"MONOCLONAL PROTEIN,FLUID",203.0,131.95,13.62,203.0,84
CDM,30200190,C-REACTIVE PROTEIN HIGH SENSE,89.0,57.85,6.39,89.0,84
CDM,30200195,%QUAD4 MARKERS INHIBIN,108.0,70.2,7.7,108.0,84
CDM,30200200,*BETA 2 GLYCOPROTEIN I AB EA,176.0,114.4,12.57,176.0,84
CDM,30200205,INSULIN ANTIBODY,148.0,96.2,10.57,148.0,84
CDM,30200215,GAD65 ANTIBODY,163.0,105.95,9.77,163.0,84
CDM,30200225,%RETROVIR LYMPH TRANSF,338.0,219.7,24.21,358.7,84
CDM,30200235,B CELLS TOTAL COUNT,260.0,169.0,18.63,260.0,84
CDM,30200245,%PNH CELL AG,185.0,120.25,13.22,185.0,84
CDM,30200255,NK CELLS TOTAL COUNT,260.0,169.0,18.63,260.0,84
CDM,30200260,"COMPLEMENT AG, EA",83.0,53.95,5.92,83.0,84
CDM,30200265,T CELLS TOTAL COUNT,260.0,169.0,18.63,260.0,84
CDM,30200285,T CELL ABSOLUTE COUNT/RATIO,324.0,210.6,23.2,324.0,84
CDM,30200295,%CD4ABS ABSOLUTE COUNT,185.0,120.25,13.22,185.0,84
CDM,30200310,COMPLEMENT/FUNC ACTIVITY EA,83.0,53.95,5.92,83.0,84
CDM,30200315,PB STEM CELL COUNT,537.0,349.05,28.66,537.0,84
CDM,30200325,THYROID PEROXIDASE AB,100.0,65.0,7.18,100.0,84
CDM,30200335,NITROBLUE TETRAZOLIUM,94.0,61.1,5.62,94.0,84
CDM,30200350,COMPLEMENT FIXATION EA AG,69.0,44.85,4.94,69.0,84
CDM,30200355,CRYPTOCOCCAL ANTIGEN,80.0,52.0,5.03,80.0,84
CDM,30200365,TB GOLD PLUS,428.0,278.2,28.66,428.0,84
CDM,30200375,TEST SKIN CANDIDA,169.0,109.85,8.35,169.0,85
CDM,30200385,"SKIN TEST, UNLISTED ANTIGEN EA",169.0,109.85,8.64,169.0,87
CDM,30200390,*DEOXYRIBONUCLEASE AB,91.0,59.15,6.54,91.0,84
CDM,30200395,TUBERCULOSIS INTRADERMAL (POINT OF CARE LAB),169.0,109.85,13.1,169.0,87
CDM,30200400,DNA AB NATIVE/DOUBLE STRAND,95.0,61.75,6.79,95.0,84
CDM,30200415,ASPERGILLUS ID,104.0,67.6,7.44,105.93,84
CDM,30200425,BLASTOMYCES ID,89.0,57.85,6.37,99.37,84
CDM,30200435,LYME WESTERN BLOT,107.0,69.55,7.65,107.0,84
CDM,30200445,LYME IGG & IGM SERUM,118.0,76.7,8.41,118.0,84
CDM,30200455,COCCIDIOIDES ID,79.0,51.35,5.67,88.34,84
CDM,30200465,CMV IGG ANTIBODY,99.0,64.35,7.11,99.0,84
CDM,30200475,CMV IGM EIA AB,116.0,75.4,8.32,116.0,84
CDM,30200485,EBV-EA IFA,91.0,59.15,6.48,91.0,84
CDM,30200495,EBV-NA IFA,106.0,68.9,7.55,106.0,84
CDM,30200505,EBV-VCA IFA IGG,125.0,81.25,8.96,125.0,84
CDM,30200515,H PYLORI AB,116.0,75.4,7.16,116.0,84
CDM,30200525,%IDM ANTI HTLV I,63.0,40.95,4.14,63.0,84
CDM,30200540,FAB SCREEN E,83.0,53.95,5.95,83.0,84
CDM,30200545,HIV  CONFIRMATION,134.0,87.1,9.56,134.0,84
CDM,30200575,HISTO ID,95.0,61.75,6.17,96.24,84
CDM,30200605,INFLUENZA A+B CF X2,93.0,60.45,6.69,93.0,84
CDM,30200615,LEGIONELLA ANTIBODY,106.0,68.9,7.56,106.0,84
CDM,30200625,MUMPS IGG ANTIBODY,90.0,58.5,6.44,90.0,84
CDM,30200635,MYCOPLASMA IGM AB,91.0,59.15,6.54,91.0,84
CDM,30200645,PARVO B19 AB IGG & IGMX2,104.0,67.6,7.42,104.0,84
CDM,30200655,%IDM CHAGAS,85.0,55.25,6.12,90.01,84
CDM,30200665,RUBELLA IGG SEMI-QUANT,99.0,64.35,7.11,99.0,84
CDM,30200675,MEASLES-RUBEOLA IGG AB,89.0,57.85,6.36,89.0,84
CDM,30200685,TOXOPLAS IGG,99.0,64.35,7.11,99.0,84
CDM,30200695,TOXOPLASMOSIS IGM AB,99.0,64.35,7.11,99.0,84
CDM,30200705,SYPHILIS T PALLIDUM IGG,91.0,59.15,13.24,91.0,84
CDM,30200710,IMMUNOASSY TUMOR CA 15-3,144.0,93.6,10.28,144.0,84
CDM,30200715,VARICELLA ZOSTER IGG AB,89.0,57.85,6.36,89.0,84
CDM,30200725,%CNILE WEST NILE VRS IGM,116.0,75.4,8.32,116.0,84
CDM,30200730,IMMUNOASSY TUMOR CA 19-9,144.0,93.6,10.28,144.0,84
CDM,30200735,%CNILE WEST NILE VRS IGG,99.0,64.35,7.11,110.69,84
CDM,30200740,IMMUNOASSY TUMOR CA 125,144.0,93.6,10.28,144.0,84
CDM,30200750,HTEROPHIL AB SCREEN,36.0,23.4,5.18,36.0,84
CDM,30200755,THYROGLOBULIN AB,110.0,71.5,7.86,110.0,84
CDM,30200765,XM B OR T CYTOTOXIC ALLO-DECEASED,1308.0,850.2,52.25,1308.0,84
CDM,30200770,TUMOR OR OTHER AG QUANT,144.0,93.6,10.28,144.0,84
CDM,30200775,LYMPHOCYTOTOXIC B ABID,543.0,352.95,31.46,543.0,84
CDM,30200785,AB POST TX DSA MONITORING,205.0,133.25,14.66,228.56,84
CDM,30200795,HLA B27 FLOW,178.0,115.7,12.74,178.0,84
CDM,30200805,HLA ABCDR TT UPDATE,400.0,260.0,28.64,400.0,84
CDM,30200815,"HLA-DR,DQ,DR51,52,53 -TYPING DECEASED DONOR",732.0,475.8,42.46,732.0,84
CDM,30200835,FLOW CYTOMETRY XM,59.0,38.35,2.64,59.0,66
CDM,30200840,IMMUNE CMPLX ASSAY,168.0,109.2,12.04,168.0,84
CDM,30200885,*%HEP HBSAG,71.0,46.15,5.1,71.0,84
CDM,30200890,*IMMUNOFIX ELECPHRSIS OTHER,203.0,131.95,13.62,203.0,84
CDM,30200895,HEPATITIS HBSAG CONF,71.0,46.15,5.1,71.0,84
CDM,30200905,AG DETECT NOS IA MULT,83.0,53.95,11.98,83.0,84
CDM,30200920,INHIBIN A,108.0,70.2,7.7,108.0,84
CDM,30200935,TH/TO ANTIBODY,80.0,52.0,11.53,80.0,84
CDM,30200945,HUMAN ANTI-MOUSE AB (HAMA),119.0,77.35,6.91,119.0,84
CDM,30200950,INT FAC AB,104.0,67.6,7.44,104.0,84
CDM,30200955,%IBDSGI C REAC PROTEIN,36.0,23.4,5.18,36.0,84
CDM,30200960,ISLET CELL AB,163.0,105.95,9.77,163.0,84
CDM,30200965,HE4,144.0,93.6,10.28,144.0,84
CDM,30200985,ANTI-IGE RCPTR ANTIBODY,937.0,609.05,28.66,937.0,84
CDM,30200OH,INJECTION TURBINATE THERAPEUTIC,312.0,202.8,1.1,1603.96,148
CDM,30201005,STREPTOZYME TITER,73.0,47.45,5.25,73.0,84
CDM,30201010,*B CELL TOTAL COUNT,260.0,169.0,18.63,260.0,84
CDM,30201015,RHEUMATOID FACTOR QUANT,39.0,25.35,2.8,39.0,84
CDM,30201020,*NATURAL KILLER TOTAL COUNT,260.0,169.0,18.63,260.0,84
CDM,30201030,*T CELL TOTAL COUNT,260.0,169.0,18.63,260.0,84
CDM,30201035,ADENOVIRUS ANTIBODY,89.0,57.85,6.36,89.0,84
CDM,30201045,ASPERGILLUS QUAL OR SEMI-QUANT,104.0,67.6,7.44,105.93,84
CDM,30201050,*T CELL ABSOLUTE COUNT W RATIO,324.0,210.6,23.2,324.0,84
CDM,30201055,STREPTO.PNEUM.X14,89.0,57.85,6.36,89.0,84
CDM,30201065,%FABCSF BLASTOMYCES,89.0,57.85,6.37,99.37,84
CDM,30201070,MICROSOMAL ANTIBODIES EA,100.0,65.0,7.18,100.0,84
CDM,30201075,LYME IGG/IGM IB CSF X2,107.0,69.55,7.65,107.0,84
CDM,30201085,BORELIA BURGDORFERI LYME,118.0,76.7,8.41,118.0,84
CDM,30201095,CAMPY JEJUNI AB IGG,91.0,59.15,6.48,91.0,84
CDM,30201105,CANDIDA IMMUNE COMPLEX,83.0,53.95,5.93,92.43,84
CDM,30201115,%FABCSF COCCIDIODE IGG/M ABS,79.0,51.35,5.67,88.34,84
CDM,30201135,%TORCH AB CMV IGG,99.0,64.35,7.11,99.0,84
CDM,30201145,%TORCHM AB CMV IGM,116.0,75.4,8.32,116.0,84
CDM,30201155,%DIPHTHERIA,105.0,68.25,7.51,105.0,84
CDM,30201165,EHRLICHIA,70.0,45.5,5.02,78.37,84
CDM,30201170,RHEUMATOID FACTOR TEST QUANT,39.0,25.35,2.8,39.0,84
CDM,30201175,GIARDIA LAMBLIA IG/GAM X3,102.0,66.3,7.27,103.03,84
CDM,30201185,"HELMINTH, NES",90.0,58.5,6.42,90.0,84
CDM,30201195,HAEMOPHILUS INFLU B IGG,103.0,66.95,7.4,103.0,84
CDM,30201205,HEPATITIS DELTA AB,118.0,76.7,8.48,118.0,84
CDM,30201215,%PREXP EXP HERPES BL X2,99.0,64.35,7.11,99.0,84
CDM,30201225,HEPATITIS BE ANTIBODY,80.0,52.0,5.71,80.0,84
CDM,30201240,BARTONELLA,70.0,45.5,5.02,78.37,84
CDM,30201245,LEGIONELLA IGM ABS,106.0,68.9,7.56,106.0,84
CDM,30201250,*BRUCELLA AB,62.0,40.3,4.41,68.79,84
CDM,30201255,LEISHMANIASIS,85.0,55.25,6.05,85.0,84
CDM,30201260,CHLAMYDIA,82.0,53.3,5.84,82.0,84
CDM,30201265,LEPTOSPIRA ANTIBODY,112.0,72.8,6.51,112.0,84
CDM,30201275,LISTERIA ANTIBODY,91.0,59.15,6.51,101.56,84
CDM,30201285,MUMPS VIRUS AB IGM,90.0,58.5,6.44,90.0,84
CDM,30201295,MYCOPLASMA AB,91.0,59.15,6.54,91.0,84
CDM,30201305,MISC SENDOUT CPT 86741,91.0,59.15,6.51,91.0,84
CDM,30201310,ARBOVIRUS ST LOUIS,91.0,59.15,6.51,91.0,84
CDM,30201325,MALARIA ANTIBODY IGG,91.0,59.15,6.51,101.56,84
CDM,30201335,ENTAMOEBA HISTO IGG,85.0,55.25,6.12,90.01,84
CDM,30201345,RESPIRATORY SYNCYTIAL AB,110.0,71.5,6.36,110.0,84
CDM,30201355,RUBELLA IGM IFA,99.0,64.35,7.11,99.0,84
CDM,30201365,MEASLES-RUBEOLA IGM AB,89.0,57.85,6.36,89.0,84
CDM,30201375,%TORCH AB TOXOPLS IGG,99.0,64.35,7.11,99.0,84
CDM,30201385,%TORCHM AB TOXOPLS IGM,99.0,64.35,7.11,99.0,84
CDM,30201395,TRICHINELLA IGG AB,87.0,56.55,6.2,87.0,84
CDM,30201405,VARICELLA ZOSTER IGM,89.0,57.85,6.36,89.0,84
CDM,30201410,*AB; HSV II,134.0,87.1,9.56,134.0,84
CDM,30201415,ARBOVIRUS W NILE,116.0,75.4,8.32,116.0,84
CDM,30201425,%ARBOVIRUS W NILE AB IGG,99.0,64.35,7.11,110.69,84
CDM,30201435,%ENDOAB THYRGLOBU AB,110.0,71.5,7.86,110.0,84
CDM,30201450,*INFLUENZA VIRUS AB,93.0,60.45,6.69,93.0,84
CDM,30201460,*LYMPH CHORIOMENINGITIS AB,89.0,57.85,6.36,89.0,84
CDM,30201465,"PT AB, IGG & IGM X2",326.0,211.9,23.08,326.0,66
CDM,30201485,HISTOPLASMA CAPSULA AG,91.0,59.15,5.92,92.38,84
CDM,30201495,NORWALK-LIKE VIRUS AG,83.0,53.95,11.98,83.0,84
CDM,30201515,"IMMUNOASSAY, CAD TITER",111.0,72.15,6.43,111.0,84
CDM,30201525,HIV 1&2 ANTIGEN/ANTIBODY,166.0,107.9,11.89,166.0,84
CDM,30201545,%HSVG12 IGG 2,134.0,87.1,9.56,134.0,84
CDM,30201555,%HSVG12 IGG 1,91.0,59.15,6.51,91.0,84
CDM,30201575,%HEXP HIV 1&2 AG/AB,166.0,107.9,11.89,166.0,84
CDM,30201585,PHOSPHOLIP A2-R AB IGG,83.0,53.95,5.95,83.0,84
CDM,30201595,N-METHYL-D-ASP CSF,83.0,53.95,5.95,83.0,84
CDM,30201605,%ABPA2 IGG TOTAL,54.0,35.1,3.13,54.0,84
CDM,30201615,DNA AB DOUBLE STRANDED,95.0,61.75,6.79,95.0,84
CDM,30201625,SS DNA ANTIBODY IGG,84.0,54.6,5.98,84.0,84
CDM,30201635,BABESIA MICROTI G+M X2,85.0,55.25,6.12,90.01,84
CDM,30201655,%TORC AB RUBELLA IGM,99.0,64.35,7.11,99.0,84
CDM,30201665,%CJD IMMUNO QT,144.0,93.6,10.28,144.0,84
CDM,30201675,N MENINGITIIDIS IGG X4,103.0,66.95,7.4,103.0,84
CDM,30201685,TETANUS TOXOID IGG,103.0,66.95,7.4,103.0,84
CDM,30201695,%HUMOR DIPHTHERIA TOX AB,103.0,66.95,7.4,103.0,84
CDM,30201705,DIPHTHERIA TOXOID IGG,103.0,66.95,7.4,103.0,84
CDM,30201715,%HUMOR TETANUS TOX AB,103.0,66.95,7.4,103.0,84
CDM,30201725,STREP PNEUMO ABS X14,103.0,66.95,7.4,103.0,84
CDM,30201735,PNEUMO ABS SEROTYPES X23,106.0,68.9,28.66,106.0,76
CDM,30201745,"GABA-B-R AB CBA, CSF",83.0,53.95,5.95,104.69,84
CDM,30201755,%ADALZ IMMUNOASSAY QNT,119.0,77.35,6.91,119.0,84
CDM,30201765,ANA BY IFA IGG REFLEX,77.0,50.05,5.51,77.0,84
CDM,30201775,%RHEUMA IMMUNO X2,80.0,52.0,11.53,80.0,84
CDM,30201785,PLATELET AB DETECTION,127.0,82.55,9.07,127.0,84
CDM,30201795,PLATELET ANTIBODY SCRNX4,127.0,82.55,9.07,127.0,84
CDM,30201805,ISLET CELL ANTIBODY,163.0,105.95,9.77,163.0,84
CDM,30201815,GAD65 ANTIBODY,163.0,105.95,9.77,163.0,84
CDM,30201835,%CANDA ALBICAN AB X3,83.0,53.95,5.93,92.43,84
CDM,30201845,%MYPRS UNLISTED IMMUNO,30.0,19.5,6.54,32.25,66
CDM,30201855,BETA 2 GLYC IGG GM GA X3,176.0,114.4,12.57,176.0,84
CDM,30201865,C1Q BINDING ASSAY,168.0,109.2,12.04,168.0,84
CDM,30201875,STREPTOZYME SCREEN,80.0,52.0,5.03,80.0,84
CDM,30201885,"ADENOVIRUS ABS, IGG/IGMX2",89.0,57.85,6.36,89.0,84
CDM,30201895,"ADENOVIRUS ABS, IGM",89.0,57.85,6.36,89.0,84
CDM,30201905,"ADENOVIRUS ABS, IGG",89.0,57.85,6.36,89.0,84
CDM,30201915,%ARBOVIRUS ENCEPH CA-LA X,91.0,59.15,6.51,91.0,84
CDM,30201925,CALIFORNIA ENCEPH X2,91.0,59.15,6.51,91.0,84
CDM,30201935,E EQUINE ENCEPH X2,91.0,59.15,6.51,91.0,84
CDM,30201945,ST LOUS ENCEPH X2,91.0,59.15,6.51,91.0,84
CDM,30201955,W EQUINE ENCEPH X2,91.0,59.15,6.51,91.0,84
CDM,30201965,%TORCHM HSV 1/2 IGM,99.0,64.35,7.11,99.0,84
CDM,30201975,%12IFA HERPES SIMP 2,134.0,87.1,9.56,134.0,84
CDM,30201985,WEST NILE VIRUS IGM,116.0,75.4,8.32,116.0,84
CDM,30201995,WEST NILE VIRUS IGG,99.0,64.35,7.11,110.69,84
CDM,30202005,ALLERGEN IGG EACH,54.0,35.1,3.13,54.0,84
CDM,30202015,ALLERGEN IGE EACH,36.0,23.4,2.96,36.0,84
CDM,30202025,COMPLEMENT C2,83.0,53.95,5.92,83.0,84
CDM,30202035,COMPLEMENT COMP4A,83.0,53.95,5.92,83.0,84
CDM,30202045,COMPLEMENT COMP3A,83.0,53.95,5.92,83.0,84
CDM,30202055,COMPLEMENT FUNCT ACT C8,83.0,53.95,5.92,83.0,84
CDM,30202065,COMP ALTERNATE PATHWAY,140.0,91.0,10.04,140.0,84
CDM,30202075,PM - 1 ANTIBODY,124.0,80.6,8.86,124.0,84
CDM,30202085,ENA (MYOSPL),124.0,80.6,8.86,124.0,84
CDM,30202095,RETICULIN IGA IGG ABS,83.0,53.95,5.95,83.0,84
CDM,30202105,%IBDSER NEUTROPH SP ABS,83.0,53.95,5.95,83.0,84
CDM,30202115,NMDA IGG,83.0,53.95,5.95,83.0,84
CDM,30202120,*IMMUNODIF QUAL EA AB/AG,83.0,53.95,5.92,83.0,84
CDM,30202125,EPIDERMAL ABS & REFLEXX2,83.0,53.95,5.95,83.0,84
CDM,30202135,NMO AQUAPORIN4 IGG CSF,83.0,53.95,5.95,83.0,84
CDM,30202145,NMO AQUAPORIN4 IGG,83.0,53.95,5.95,83.0,84
CDM,30202165,SKELETAL MUSCLE AB SCREEN,83.0,53.95,5.95,83.0,84
CDM,30202175,ADRENAL ANTIBODY,83.0,53.95,5.95,83.0,84
CDM,30202185,ENDOMYSTAL AB IGG,83.0,53.95,5.95,104.69,84
CDM,30202195,PARANEOPLAST ABS CSF X9,83.0,53.95,5.95,83.0,84
CDM,30202205,NMDAG TITER,83.0,53.95,5.95,104.69,84
CDM,30202215,BM2 ABS TITER,83.0,53.95,5.95,104.69,84
CDM,30202225,%PARNEO FLUORESCENT X9,83.0,53.95,5.95,83.0,84
CDM,30202235,INTERCELL SUB AB TITER,83.0,53.95,5.95,104.69,84
CDM,30202245,S-100B PROTEIN,144.0,93.6,10.28,144.0,84
CDM,30202255,AFP CSF TUMOR MARKER,144.0,93.6,10.28,144.0,84
CDM,30202265,%HUMOR PNEUMO IGG X14,103.0,66.95,7.4,103.0,84
CDM,30202275,%ABPA2 ASPERG QUAL OUCHT,83.0,53.95,5.92,83.0,84
CDM,30202285,INHIBIN A,108.0,70.2,7.7,108.0,84
CDM,30202295,NABFERON AB,937.0,609.05,28.66,937.0,84
CDM,30202305,NABFERON AB TITER,937.0,609.05,28.66,937.0,84
CDM,30202315,INFLIX ACT & NEUT AB X2,937.0,609.05,28.66,937.0,84
CDM,30202325,URTICARIA-IND ACTIVITY,937.0,609.05,28.66,937.0,84
CDM,30202335,IMMUNE FUN ASSY ATP,937.0,609.05,28.66,937.0,84
CDM,30202340,ADENOVIRUS AB,89.0,57.85,6.36,89.0,84
CDM,30202345,LPT TO BERYLLIUM,338.0,219.7,24.21,358.7,84
CDM,30202355,LYMPH TRANS TEST,338.0,219.7,24.21,358.7,84
CDM,30202375,TOXIC SHOCK SYNDROME X3,89.0,57.85,6.36,89.0,84
CDM,30202385,LISTERIA ANTIBODY,89.0,57.85,6.36,89.0,84
CDM,30202395,PERTUSSIS/PARAPERT GAM X3,91.0,59.15,6.51,91.0,84
CDM,30202405,B PERTUSSIS AB IGA IB,91.0,59.15,6.51,91.0,84
CDM,30202415,B PERTUSSIS AB IGG IB,91.0,59.15,6.51,91.0,84
CDM,30202425,B PERTUSSIS AB IGM IB,91.0,59.15,6.51,91.0,84
CDM,30202435,BRUCELLA CONFIRM,62.0,40.3,4.41,68.79,84
CDM,30202445,%CIGIM ABS X3,82.0,53.3,5.84,82.0,84
CDM,30202455,CHLAMYDIA AB PANEL X3,82.0,53.3,5.84,82.0,84
CDM,30202465,%CIGIM IGM ABS X3,87.0,56.55,6.26,87.0,84
CDM,30202475,CHLAMYDIA IGM PANEL X3,87.0,56.55,6.26,87.0,84
CDM,30202485,COCCIDIODES IGG/M ABS X2,79.0,51.35,5.67,88.34,84
CDM,30202495,COXIELLA IGG IGM IGA X6,84.0,54.6,5.99,84.0,84
CDM,30202505,COXIELLA BURNETII IGG X2,84.0,54.6,5.99,84.0,84
CDM,30202515,CMV IGG AVIDITY,99.0,64.35,7.11,99.0,84
CDM,30202525,%IDM CMV,99.0,64.35,7.11,99.0,84
CDM,30202535,COXSACKIE A ABS,90.0,58.5,6.43,100.33,84
CDM,30202545,ECHOVIRUS ANTIBODIES X5,90.0,58.5,6.43,100.33,84
CDM,30202555,POLIOVIRUS ANTIBODIES X3,90.0,58.5,6.43,100.33,84
CDM,30202565,EHRLICHIA CHAF IGG/IGMX2,70.0,45.5,5.02,78.37,84
CDM,30202575,"A PHAGO AB, IGG/IGM X2",70.0,45.5,5.02,78.37,84
CDM,30202580,DIPTHERIA TETANUS AB,103.0,66.95,7.4,103.0,84
CDM,30202585,STRONGYLOIDES IGG ABS,90.0,58.5,6.42,90.0,84
CDM,30202595,FILARIASIS ABS IGG4,90.0,58.5,6.42,90.0,84
CDM,30202605,SCHISTOSOMA IGG AB,90.0,58.5,6.42,90.0,84
CDM,30202615,TOXOCARA ANTIBODIES,90.0,58.5,6.42,90.0,84
CDM,30202625,HIV-2 IGG ABS CONFIRM,134.0,87.1,9.56,134.0,84
CDM,30202635,%CSFTOX TOXOPLAS IGG,99.0,64.35,7.11,99.0,84
CDM,30202645,%CSFTOX TOXOPLAS IGM,99.0,64.35,7.11,99.0,84
CDM,30202655,"VZV IGG AB, CSF",89.0,57.85,6.36,89.0,84
CDM,30202665,HERPES VIRUS 6 IGG AB,89.0,57.85,6.36,89.0,84
CDM,30202670,ANTINUCLEAR,83.0,53.95,5.97,83.0,84
CDM,30202675,DENGUE VIRUS IGM AB,89.0,57.85,6.36,89.0,84
CDM,30202685,DENGUE FEVER ABS IGG/M X2,89.0,57.85,6.36,89.0,84
CDM,30202695,HV6 HUMAN IGG/IGM ABSX2,89.0,57.85,6.36,89.0,84
CDM,30202705,HERPESVIRUS 6 IGM AB,89.0,57.85,6.36,89.0,84
CDM,30202715,HERPESVIRUS-7 IGG/M X2,89.0,57.85,6.36,89.0,84
CDM,30202725,DENGUE VIRUS IGG AB,89.0,57.85,6.36,89.0,84
CDM,30202735,HATAVIRUS IGG & IGM,89.0,57.85,6.36,89.0,84
CDM,30202745,PARAINFLU 123ABS IGG/MX3,89.0,57.85,6.36,89.0,84
CDM,30202755,HEPATITIS E IGG/IGM ABX2,89.0,57.85,6.36,89.0,84
CDM,30202765,HTLV I/II ANTIBODY EIA,89.0,57.85,6.36,89.0,84
CDM,30202775,HEPATITIS E IGM,89.0,57.85,6.36,89.0,84
CDM,30202785,HEPATITIS E IGG,89.0,57.85,6.36,89.0,84
CDM,30202795,CHIKUNGUNYA AB W/ REFLEX,89.0,57.85,6.36,89.0,84
CDM,30202805,CHIKUNGUNYA IGM TITER,89.0,57.85,6.36,89.0,84
CDM,30202815,CHIKUNGUNYA IGG TITER,89.0,57.85,6.36,89.0,84
CDM,30202825,XM AUTO UNFRACTIONATED/T CELLS,1308.0,850.2,52.25,1308.0,84
CDM,30202835,XM B CYTOTOXIC AUTO,1308.0,850.2,52.25,1308.0,84
CDM,30202845,XM T CYTOTOXIC AUTO,1308.0,850.2,52.25,1308.0,84
CDM,30202855,XM T CYTOTOXIC ALLO,1308.0,850.2,52.25,1308.0,84
CDM,30202865,XM B CYTOTOXIC ALLO,1308.0,850.2,52.25,1308.0,84
CDM,30202875,HLA-CW TYPING,400.0,260.0,28.64,400.0,84
CDM,30202885,"HLA-A,B,CW - TYPING DECEASED DONOR",400.0,260.0,28.64,400.0,84
CDM,30202895,"HLA-A,B TYPING VERIFICATION",400.0,260.0,28.64,400.0,84
CDM,30202905,XM T & B FLOW AUTO,755.0,490.75,43.8,755.0,84
CDM,30202915,XM T & B FLOW ALLO,755.0,490.75,43.8,755.0,84
CDM,30202925,XM POST-TX DSA MONITORING  CLASS I,2234.0,1452.1,52.25,2234.0,84
CDM,30202935,AB ID & VPRA -CLASS I C1Q,2234.0,1452.1,52.25,2234.0,84
CDM,30202945,XM POST-TX DSA MONITORING  CLASS II,2248.0,1461.2,52.25,2248.0,84
CDM,30202955,AB ID & VPRA-CLAS II LUMINEX-C1Q,2248.0,1461.2,52.25,2248.0,84
CDM,30202965,MYELIN ANTIBODY IGG,83.0,53.95,5.95,83.0,84
CDM,30202975,NMO/AQP4 FACS TITER,83.0,53.95,5.95,104.69,84
CDM,30202985,ZIKA VIRUS IGG,89.0,57.85,6.36,89.0,84
CDM,30202995,ZIKA VIRUS IGM,89.0,57.85,6.36,89.0,84
CDM,30203005,ZIKA VIRUS IGG IGM X2,89.0,57.85,6.36,89.0,84
CDM,30203015,NMO AQUAPORIN 4-IGG FACS,83.0,53.95,5.95,83.0,84
CDM,30203025,%FANA ANA AB,83.0,53.95,5.97,83.0,84
CDM,30203035,"COMPLEMENT C7, FUNC",83.0,53.95,5.92,83.0,84
CDM,30203045,NMDA RECEPTOR AB CBA,83.0,53.95,5.95,83.0,84
CDM,30203055,NMDA-R AB CBA CSF,83.0,53.95,5.95,83.0,84
CDM,30203065,NMDA R AB IFA TITER CSF,83.0,53.95,5.95,104.69,84
CDM,30203075,PLA2R AB IGG TITER,83.0,53.95,5.95,104.69,84
CDM,30203085,IMMUNOFIX ELEC GEL,154.0,100.1,11.04,154.0,84
CDM,30203095,"LYME REFLEX PNL, CSF",118.0,76.7,8.41,118.0,84
CDM,30203105,%FEBAB BRUCCLLA,62.0,40.3,4.41,68.79,84
CDM,30203115,"CANDIDA ABS IGA,G,M X3",83.0,53.95,5.93,92.43,84
CDM,30203125,HIV2 AB CONF SERUM,134.0,87.1,9.56,134.0,84
CDM,30203135,%FEBAB RICKETTSIA X4,134.0,87.1,9.56,134.0,84
CDM,30203145,%FEBAB SALMONELLA  X5,91.0,59.15,6.51,91.0,84
CDM,30203155,HERPESVIR 6 AB IGM TITER,89.0,57.85,6.36,89.0,84
CDM,30204005,BIRD FANCIERS PRECIPITIN,83.0,53.95,5.92,83.0,84
CDM,30204015,LYME DISEASE AB RFLX,107.0,69.55,7.65,107.0,84
CDM,30204025,LRP4 AB TEST,83.0,53.95,5.95,83.0,84
CDM,30204035,TRYPANOSOMA CRUZI AB IGG,85.0,55.25,6.12,90.01,84
CDM,30204045,TRYPANOSOMA CRUZI AB IGM,85.0,55.25,6.12,90.01,84
CDM,30204065,%PNUTCP ALLG SPEC IGE,36.0,23.4,2.96,36.0,84
CDM,30204075,"NA BY IFA, IGG",77.0,50.05,5.51,77.0,84
CDM,30204085,"COMPLEMENT C2, SER",83.0,53.95,5.92,83.0,84
CDM,30204095,COMPLEMENT C1,83.0,53.95,5.92,83.0,84
CDM,30204105,%PHI IMMUNO TUMOR AG,144.0,93.6,10.28,144.0,84
CDM,30204115,LEGIONELLA PNEUMOPHILA AB,106.0,68.9,7.56,106.0,84
CDM,30204125,HIV-1 ANTIBODY EIA SCRN,61.0,39.65,8.89,61.0,84
CDM,30204135,HIV 1&2 ANTIBODY SCREEN,95.0,61.75,6.77,95.0,84
CDM,30204145,POLIOVIRUS ABS NEUTRAL X2,90.0,58.5,6.43,100.33,84
CDM,30204445,TEICHOIC ACID ANTIBODIES,97.0,63.05,6.94,97.0,84
CDM,30204455,COXSACKIE A DIFF AB X6,90.0,58.5,6.43,100.33,84
CDM,30204465,BART QUINTANA ABS X2,70.0,45.5,5.02,78.37,84
CDM,30204475,HETEROPHILE AB TITER,45.0,29.25,3.19,45.0,84
CDM,30204485,"COMPLEMENT C3, SER",83.0,53.95,5.92,83.0,84
CDM,30204495,"COMPLEMENT C4, SER",83.0,53.95,5.92,83.0,84
CDM,30204505,RETICULIN AB IGA TITER,83.0,53.95,5.95,104.69,84
CDM,30204515,PURKINJE AB IGG TITER,83.0,53.95,5.95,104.69,84
CDM,30204525,ANCA TITER,83.0,53.95,5.95,104.69,84
CDM,30204535,STRIATED MUSCLE TITER,83.0,53.95,5.95,104.69,84
CDM,30204545,AMPA RECEPTOR AB CBA,83.0,53.95,5.95,83.0,84
CDM,30204555,C2 COMPLEMENT AG,83.0,53.95,5.92,83.0,84
CDM,30204565,AMPA-R AB CBA CSF,83.0,53.95,5.95,83.0,84
CDM,30204585,%TORCHM AB RUBELLA IGM,99.0,64.35,7.11,99.0,84
CDM,30204595,CASPR2 IGG REFLEX,83.0,53.95,5.95,83.0,84
CDM,30204605,LGI1 IGG,83.0,53.95,5.95,83.0,84
CDM,30204615,%HIVIFA HSV 1 IGM,91.0,59.15,6.51,91.0,84
CDM,30204625,HSV 1 IGM TITER REFLEX,91.0,59.15,6.51,91.0,84
CDM,30204635,HSV 2 IGM TITER REFLEX,134.0,87.1,9.56,134.0,84
CDM,30204645,%HSVIFA HSV 2 IGM,91.0,59.15,6.51,91.0,84
CDM,30204775,"GALAC-ALPHA 1,3-GALAC IGE",124.0,80.6,17.93,124.0,84
CDM,30204785,ZIKA VIRUS IGM,116.0,75.4,16.85,116.0,84
CDM,30204795,ALLG SPEC IGE RECOMB EA,124.0,80.6,17.93,124.0,84
CDM,30204805,NMOA4 AQUAPORIN4 IGG,83.0,53.95,5.95,83.0,84
CDM,30204815,%PNUTCP ALLG IGE RECOMBX5,124.0,80.6,17.93,124.0,84
CDM,30204825,NEURO OPTICA/AQP4 IGG REF,83.0,53.95,5.95,104.69,84
CDM,30204835,ANCA TITER BILL,83.0,53.95,5.95,104.69,84
CDM,30204845,AQUAPORIN4 REC AB IGG CSF,83.0,53.95,5.95,83.0,84
CDM,30204855,SEROTONIN RELEASE LMWH,127.0,82.55,9.07,127.0,84
CDM,30204865,"A FUMIGATUS AB, IGG",104.0,67.6,7.44,105.93,84
CDM,30204885,ALLG SPEC IGE IN HOUSE,124.0,80.6,17.93,124.0,84
CDM,30204895,HLA CLASS II HIGH DEFIN Q,2248.0,1461.2,52.25,2248.0,84
CDM,30204905,MPOA FLUOR AB TITER,83.0,53.95,5.95,104.69,84
CDM,30204915,ASPERGILLUS ID,104.0,67.6,7.44,105.93,84
CDM,30204925,BLASOMYCES DERMATITIDIS AB,89.0,57.85,6.37,99.37,84
CDM,30204935,"COCCIDOIDES AB, CF",79.0,51.35,5.67,88.34,84
CDM,30204945,FUNCF ASPERGILLUS ID,104.0,67.6,7.44,105.93,84
CDM,30204955,FUNCF BLASOMYCES DERMATITIDIS AB,89.0,57.85,6.37,99.37,84
CDM,30204965,FUNCF COCCIDOIDES AB,79.0,51.35,5.67,88.34,84
CDM,30204975,FUNCF HISTOPLASMA AB X2,95.0,61.75,6.17,96.24,84
CDM,30204985,"HISTOPLASMA AB, CF X2",95.0,61.75,6.17,96.24,84
CDM,30204995,BLASTOMYCES D AB RFLX,89.0,57.85,6.37,99.37,84
CDM,30205005,ACHR MODULATING FL RFLX,83.0,53.95,5.95,83.0,84
CDM,30205015,SC5B-9 LEVEL MAC COMPLEX,83.0,53.95,5.92,83.0,84
CDM,30205025,CNSE IMMUNOASSAY TUMOR OT,144.0,93.6,10.28,144.0,84
CDM,30205035,"NEURON SPECIFIC ENOLASE, SER",144.0,93.6,10.28,144.0,84
CDM,30205045,MITOCHONDRIAL ANTIBODY EACH,176.0,114.4,10.18,176.0,84
CDM,30205055,TISSUE TRANSGLUTAMINASE EA,80.0,52.0,4.61,80.0,84
CDM,30205065,GLIADIN ANTIBODY EACH,83.0,53.95,4.61,83.0,84
CDM,30205075,ANTINEUT CYT AB SCR EA,83.0,53.95,4.82,83.0,84
CDM,30205085,ACTIN SMOOTH MUSCLE AB EA,83.0,53.95,4.61,83.0,84
CDM,30205095,CDS1SE AQ4 AB FL CYT EA,260.0,169.0,4.82,260.0,84
CDM,30205105,CDS1SE MOG-IGG1 AB FL EA,260.0,169.0,4.82,260.0,84
CDM,30205115,"MOG AB IGG CBA-IFA SCREEN, SERUM",260.0,169.0,4.82,260.0,84
CDM,30205125,"MOG FACS TITNER, SERUM RFLX",260.0,169.0,4.82,260.0,84
CDM,30205135,NMOA4 FACS ASSAY SERUM,260.0,169.0,4.82,260.0,84
CDM,30205145,NMO/AQP4 FACS SER RFLX,260.0,169.0,4.82,260.0,84
CDM,30205155,VOLTAGE-GATED NA CH AB EA,83.0,53.95,7.36,83.0,84
CDM,30205165,AQPCSF AQ-4 AB EA,83.0,53.95,4.82,83.0,84
CDM,30205175,NMOIFA AQ-4 AB EA,83.0,53.95,4.82,83.0,84
CDM,30205185,IBDSER ANTINEUT CYT AB SCR EA,83.0,53.95,4.82,83.0,84
CDM,30205195,HYPERSENSITIVITY PNEUMONITIS EVALUATION X8,54.0,35.1,3.13,54.0,84
CDM,30205205,"THSD7A AB, S",83.0,53.95,5.95,83.0,84
CDM,30205215,"PLA2R, IMMUNOFLUORESCENCE, S (REFLEX ONLY)",83.0,53.95,5.95,83.0,84
CDM,30205225,CD45RR B CELLS TOTAL COUNT,260.0,169.0,18.63,260.0,84
CDM,30205235,CD45RR NK CELLS TOTAL COUNT,260.0,169.0,18.63,260.0,84
CDM,30205245,CD45RR T CELLS TOTAL COUNT,260.0,169.0,18.63,260.0,84
CDM,30205255,CD45RR T CELL ABSOLUTE COUNT/RATIO,324.0,210.6,23.2,324.0,84
CDM,30205265,CD45RR MONONUCLEAR CELL ANTIGEN X2,185.0,120.25,13.22,185.0,84
CDM,30209980,ENCEPH CALIF LACROSSE,91.0,59.15,6.51,91.0,84
CDM,30210010,CHLAMYDIA IGM,87.0,56.55,6.26,87.0,84
CDM,30210020,BORDETELLA QUAL OR SEMI-QUANT,91.0,59.15,6.51,91.0,84
CDM,30210050,*ALLERG SP IGE;QT OR QUAL,36.0,23.4,2.96,36.0,84
CDM,30210140,*AB ID PLT AB,127.0,82.55,9.07,127.0,84
CDM,30210270,*EXTRACT NUC AG EA AB,124.0,80.6,8.86,124.0,84
CDM,30210400,FAB SCREEN EA AB,83.0,53.95,5.95,83.0,84
CDM,30210560,HETRPHL AB SCRN,36.0,23.4,5.18,36.0,84
CDM,30210750,*PARTCL AGGLUT SCREEN EA,80.0,52.0,5.03,80.0,84
CDM,30210830,*FUNGI AB NOS,85.0,55.25,6.05,85.0,84
CDM,30210850,HISTOPLASMA,95.0,61.75,6.17,96.24,84
CDM,30210890,*AB; SALMONELLA,91.0,59.15,6.51,91.0,84
CDM,30210960,*VIRUS AB NOS,117.0,76.05,8.35,117.0,84
CDM,30211100,*ENTEROVIRUS AB,90.0,58.5,6.43,100.33,84
CDM,30211170,*PHOSPHOLIPID AB,111.0,72.15,7.94,111.0,84
CDM,30211190,*Q FEVER (COXIELLA) AB,84.0,54.6,5.99,84.0,84
CDM,30211230,*AB ID PLT IG ASSAY,86.0,55.9,6.15,95.9,84
CDM,30211280,FRANCISELLA TULARENSIS AB,98.0,63.7,5.66,98.0,84
CDM,30211320,HIV AB CONFIRM/WESTERN BLOT,134.0,87.1,9.56,134.0,84
CDM,30211340,HERPES SIMPLEX TYPE I,91.0,59.15,6.51,91.0,84
CDM,30211420,*H PYLORI AB,116.0,75.4,7.16,116.0,84
CDM,30211510,*HEP C AB,98.0,63.7,14.27,98.0,84
CDM,30211520,*HEP C AB,103.0,66.95,7.4,103.0,84
CDM,30211560,AB PRA FLOW,443.0,287.95,25.68,443.0,84
CDM,30211570,AB ID & VPRA -CLASS I LUMINEX,2234.0,1452.1,52.25,2234.0,84
CDM,30211580,AB ID & VPRA -CLASS II LUMINEX,2248.0,1461.2,52.25,2248.0,84
CDM,30211590,*HLA X-MATCH NON-CYTOTOXIC,755.0,490.75,43.8,755.0,84
CDM,30211620,XM T & B FLOW ALLO- ADD SERUM SAMPLE,252.0,163.8,14.61,252.0,84
CDM,30211680,*HEP B CORE AB TOTAL,83.0,53.95,5.95,83.0,84
CDM,30211690,*HEP B SURFACE AB,74.0,48.1,5.3,74.0,84
CDM,30211700,*HEP C AB,98.0,63.7,14.27,98.0,84
CDM,30211710,"HEP A, HEP A AB IGM",78.0,50.7,5.56,78.0,84
CDM,30211720,HEP B CORE IGM AB,81.0,52.65,5.82,81.0,84
CDM,30211730,HEP A AB TOTAL,85.0,55.25,6.12,85.0,84
CDM,30211740,EIA HIV-1/HIV-2 SCREEN,135.0,87.75,16.64,135.0,84
CDM,30211870,HLA CLASS I&II ANTIBODY QUAL,443.0,287.95,25.68,443.0,84
CDM,30212120,CELL ENUMERATION & ID,1730.0,1124.5,116.49,1730.0,84
CDM,30212405,GABA-B RECEPTOR AB CBA,83.0,53.95,5.95,83.0,84
CDM,30212415,CHROMOGRANIN A,144.0,93.6,10.28,144.0,84
CDM,30212425,ATOPIC ALGN IGE QNT X11,36.0,23.4,2.96,36.0,84
CDM,30212455,HUMOR1 IMMUNASSY INF AG1 X6,103.0,66.95,7.4,103.0,84
CDM,30212465,HUMOR1 IMMUNASSY INF AG2 X6,103.0,66.95,7.4,103.0,84
CDM,30212475,HUMOR1 IMMUNASSY INF AG X4,103.0,66.95,7.4,103.0,84
CDM,30212485,CHROMOGRANIN A,144.0,93.6,10.28,144.0,84
CDM,30212495,ALGN FOOD PANEL IGG X19,54.0,35.1,3.13,54.0,84
CDM,30212505,"ALLERGEN, MILK IGE X4",36.0,23.4,2.96,36.0,84
CDM,30212515,"ALLERGEN, EGG IGE X2",36.0,23.4,2.96,36.0,84
CDM,30212525,"NERUON SPEC ENOLASE, SER",119.0,77.35,6.91,119.0,84
CDM,30212535,NEUROMYELITIS OPT AQP4IGG,83.0,53.95,5.95,104.69,84
CDM,30212545,MOG-IGG1 FACS,83.0,53.95,5.95,83.0,84
CDM,30212555,"MOG FACS TITER, S REF",83.0,53.95,5.95,104.69,84
CDM,30212565,DIPTHERIA TETANUS AB,103.0,66.95,7.4,103.0,84
CDM,30212575,B BURGDO AB IGG IGM X2,107.0,69.55,7.65,107.0,84
CDM,30212635,ANTI NEUT CY AB,83.0,53.95,5.95,83.0,84
CDM,30212645,ADALIMUMAB ACT/NEUT AB,937.0,609.05,28.66,937.0,84
CDM,30212655,HISTO ABS CF+ID CSF X3,95.0,61.75,6.17,96.24,84
CDM,30212665,OVARIAN AB TITER REFLX,83.0,53.95,5.95,104.69,84
CDM,30212675,ASPERGILLUS AB IMDIFF,104.0,67.6,7.44,105.93,84
CDM,30212685,NEUTROPHIL OX BURST BLD,937.0,609.05,28.66,937.0,84
CDM,30212695,CHIKUNGUNYA AB IGG IGM X2,89.0,57.85,6.36,89.0,84
CDM,30212705,POMER4 RPR,29.0,18.85,2.11,29.0,84
CDM,30212715,POMER4 RUBIGG,99.0,64.35,7.11,99.0,84
CDM,30212725,POMER4 HBSAG,71.0,46.15,5.1,71.0,84
CDM,30212735,POMER4 HIV12C,166.0,107.9,11.89,166.0,84
CDM,30212745,HUMAN ERYTHROCYTE AG,4968.0,3229.2,20.31,4968.0,84
CDM,30212765,ADRENAL AB TITER RFLX,83.0,53.95,5.95,104.69,84
CDM,30212775,CJD IMASSAY IA AB QNT,103.0,66.95,7.4,103.0,84
CDM,30212785,COMPLEMENT AH50 FUNC,83.0,53.95,5.92,83.0,84
CDM,30212795,NEISSERIA GONORRHOEA AB T,89.0,57.85,6.36,89.0,84
CDM,30212805,GABA-B-RECEP IFA TITER,83.0,53.95,5.95,104.69,84
CDM,30212815,NMDA-RECEP AB TITER,83.0,53.95,5.95,104.69,84
CDM,30212825,ALGN ORRIS ROOT IGE,36.0,23.4,2.96,36.0,84
CDM,30212835,ALGN CHAETOMIUM GLOB IGE,36.0,23.4,2.96,36.0,84
CDM,30212845,ALGN OCCUPATNL TOBACCO,36.0,23.4,2.96,36.0,84
CDM,30212855,DPPX AB CBA CSF RFLX,83.0,53.95,5.95,83.0,84
CDM,30212865,DPPX AB IFA TITER CSF RFLX,83.0,53.95,5.95,104.69,84
CDM,30212875,DPPX AB IFA CSF RFLX,83.0,53.95,5.95,83.0,84
CDM,30212885,MGLUR1 AB CBA CSF RFLX,83.0,53.95,5.95,83.0,84
CDM,30212895,MGLUR1 AB IFA TITER CSF RFLX,83.0,53.95,5.95,104.69,84
CDM,30212905,MGLUR1 AB IFA CSF RFLX,83.0,53.95,5.95,83.0,84
CDM,30212915,IDM HEP B CORE AB TOTAL,83.0,53.95,5.95,83.0,84
CDM,30212925,IDM HEP C AB,98.0,63.7,14.27,98.0,84
CDM,30212935,TCLACV T CELLS TOTAL CNT,260.0,169.0,18.63,260.0,84
CDM,30212945,TCLACV T CELL ABSOLUTE CT,185.0,120.25,13.22,185.0,84
CDM,30212955,BPHENO MONONUCLEAR AG,185.0,120.25,13.22,185.0,84
CDM,30212965,"GABA-B-R AB CBA, CSF",83.0,53.95,5.95,83.0,84
CDM,30212975,TCELL SUBSETS,185.0,120.25,13.22,185.0,84
CDM,30212985,PARANEOPLSTC AB PANEL X2,83.0,53.95,5.95,83.0,84
CDM,30212995,HETEROPHILE AB W RFLX,36.0,23.4,5.18,36.0,84
CDM,30213005,%UBJP B CELLS COUNT,203.0,131.95,13.62,203.0,84
CDM,30213015,AIDYSA FLUOR AB SCRN,83.0,53.95,5.95,83.0,84
CDM,30213025,AIDYSA ISLET CELL AB,163.0,105.95,9.77,163.0,84
CDM,30213035,AMPHSX &2/3 FLUOR AB SCRN,83.0,53.95,5.95,83.0,84
CDM,30213045,CRMPSX FLUOR AB SCRN,83.0,53.95,5.95,83.0,84
CDM,30213055,DPCBAX FLUOR AB SCRN,83.0,53.95,5.95,83.0,84
CDM,30213065,DPIFAX FLUOR AB TITER,83.0,53.95,5.95,104.69,84
CDM,30213075,PRKTRX & PURK1X/2X FLUOR AB SCRN,83.0,53.95,5.95,83.0,84
CDM,30213085,"DPPX AB IFA, SERUM",83.0,53.95,5.95,83.0,84
CDM,30213095,"MGLUR1 AB CBA, SER",83.0,53.95,5.95,83.0,84
CDM,30213105,"MGLUR1 AB IFA, SER",83.0,53.95,5.95,83.0,84
CDM,30213115,"MGLUR1 AB IFA TITER, SER",83.0,53.95,5.95,104.69,84
CDM,30213125,PANCREASTATIN,144.0,93.6,10.28,144.0,84
CDM,30213135,WHIIVF SYPHILIS TEST,29.0,18.85,2.11,29.0,84
CDM,30213145,WHIIVF HEP C AB,98.0,63.7,14.27,98.0,84
CDM,30213155,WHIIVF HEP B CORE AB TOTA,83.0,53.95,5.95,83.0,84
CDM,30213165,WHIIVF2 RUBELLA IGG SEMI-QUANT,99.0,64.35,7.11,99.0,84
CDM,30213175,WHIIVF2 RUBELLA IGM IFA,99.0,64.35,7.11,99.0,84
CDM,30213185,WHIIVF2 CMV IGG AB,99.0,64.35,7.11,99.0,84
CDM,30213195,WHIIVF2 CMV IGM EIA AB,116.0,75.4,8.32,116.0,84
CDM,30213205,C5COMF COMPLEMENT/FUNCTION ACTIVITY,83.0,53.95,5.92,83.0,84
CDM,30213215,GBMGP FLUORESCENT ANTIBODY SCREEN,83.0,53.95,5.95,83.0,84
CDM,30213225,HUANT FLUORESCENT ANTIBODY SCREEN,83.0,53.95,5.95,83.0,84
CDM,30213235,ACESTR FLUORESCENT ANTIBODY SCREEN,83.0,53.95,5.95,83.0,84
CDM,30213245,GABTTR FLUORESCENT ANTIBODY TITER,83.0,53.95,5.95,104.69,84
CDM,30213255,AMPIFC FLUORESCENT ANTIBODY TITER,83.0,53.95,5.95,104.69,84
CDM,30213265,NANNTR FLUORESCENT ANTIBODY TITER,83.0,53.95,5.95,104.69,84
CDM,30213275,HUTIT FLUORESCENT ANTIBODY TITER,83.0,53.95,5.95,104.69,84
CDM,30213285,COVID19 IGG QUAL BY CIA,291.0,189.15,16.85,291.0,85
CDM,30213295,MCROHN C-REAC PROTEIN HS,89.0,57.85,6.39,89.0,84
CDM,30213305,TULRFX AB AGG RFLX,48.0,31.2,3.45,48.0,84
CDM,30213315,AMPA-RECEP AB TITER,83.0,53.95,5.95,104.69,84
CDM,30213325,"HLA-A,B TYPING",400.0,260.0,28.64,400.0,84
CDM,30213335,"HLA-DR,DQ,DRW TYPING",732.0,475.8,42.46,732.0,84
CDM,30213345,XM T&B FLOW ALLO DECEASED DONOR,755.0,490.75,43.8,755.0,84
CDM,30213355,AB PRA FLOW REPEAT,443.0,287.95,25.68,443.0,84
CDM,30213365,AB ID & VPRA -CLASS I LUMINEX REPEAT,2234.0,1452.1,52.25,2234.0,84
CDM,30213375,AB ID DILUTION - CLASS I LUMINEX,2234.0,1452.1,52.25,2234.0,84
CDM,30213385,AB ID CLASS I PHENO BEADS,2234.0,1452.1,52.25,2234.0,84
CDM,30213395,AB ID & VPRA -CLASS II LUMINEX REPEAT,2248.0,1461.2,52.25,2248.0,84
CDM,30213405,AB ID DILUTION - CLASS II LUMINEX,2248.0,1461.2,52.25,2248.0,84
CDM,30213415,AB ID CLASS II PHENO BEADS,2248.0,1461.2,52.25,2248.0,84
CDM,30213425,CNS DEMYELINATING DIS EVAL SER X2,83.0,53.95,5.95,83.0,84
CDM,30213435,"ALGN FOOD, ALPHA-GAL IGE",124.0,80.6,17.93,124.0,84
CDM,30213455,AB ID CLASS I PHENO BEADS REPEAT,2234.0,1452.1,52.25,2234.0,84
CDM,30213465,AB ID CLASS II PHENO BEADS REPEAT,2248.0,1461.2,52.25,2248.0,84
CDM,30213475,AB ID & VPRA-CLASS I C1Q REPEAT,2234.0,1452.1,52.25,2234.0,84
CDM,30213485,AB ID & VPRA-CLASS II C1Q REPEAT,2248.0,1461.2,52.25,2248.0,84
CDM,30213495,ENCSER FLUORESCENT AB SCRN,83.0,53.95,5.95,83.0,84
CDM,30213505,ENCSER ISLET CELL AB,163.0,105.95,9.77,163.0,84
CDM,30213515,ENCCSF FLUORESCENT AB X21,83.0,53.95,5.95,83.0,84
CDM,30213525,ENCCSF ISLET CELL AB,163.0,105.95,9.77,163.0,84
CDM,30213535,GFAP CBA RFLX,83.0,53.95,5.95,83.0,84
CDM,30213545,GFAP IFA TITER RFLX,83.0,53.95,5.95,104.69,84
CDM,30213555,IGLON5 CBA RFLX,83.0,53.95,5.95,83.0,84
CDM,30213565,IGLON5 IFA TITER RFLX,83.0,53.95,5.95,104.69,84
CDM,30213575,NIF HEAVY CHAIN CBA RFLX,83.0,53.95,5.95,83.0,84
CDM,30213585,NIF IFA TITER RFLX,83.0,53.95,5.95,104.69,84
CDM,30213595,NIF LIGHT CHAIN CBA RFLX,83.0,53.95,5.95,83.0,84
CDM,30213605,ALPHA INTERNEXIN CBA,83.0,53.95,5.95,83.0,84
CDM,30213615,%PARNEO VOLTAGE-GTD CA CHNL ANTB EA,83.0,53.95,7.36,83.0,84
CDM,30213625,ASPERGILLUS FUMIGATUS ANTIBODY IGG,103.0,66.95,7.4,103.0,84
CDM,30213635,WHIIVF SYPHILIS,91.0,59.15,13.24,91.0,84
CDM,30213645,WHIIVF SYPHILIS T PALLIDUM REFLEX,91.0,59.15,13.24,91.0,84
CDM,30213655,PATHOGEN TEST FOR PLTS - LVDS PLTS,410.0,266.5,45.47,410.0,84
CDM,30213665,"AGNTFX - AGNA-1 TITER, SF, REFLEX ONLY",83.0,53.95,5.95,104.69,84
CDM,30213675,"AN1TFX - ANNA-1 TITER, SF, REFLEX ONLY",83.0,53.95,5.95,104.69,84
CDM,30213685,"AN2TFX - ANNA-2 TITER, SF, REFLEX ONLY",83.0,53.95,5.95,104.69,84
CDM,30213695,"AN3TFX - ANNA-3 TITER, SF, REFLEX ONLY",83.0,53.95,5.95,104.69,84
CDM,30213705,"APHCFX - AMPHIPHYSIN AB TITER, SF, REFLEX ONLY",83.0,53.95,5.95,104.69,84
CDM,30213715,"CRMCFX - CRMP-5 IGG TITER, SF, REFLEX ONLY",83.0,53.95,5.95,104.69,84
CDM,30213725,"NCDCFX - NEUROCHONDRIN AB CB ASSAY, SF, REFLEX ONLY",83.0,53.95,5.95,83.0,84
CDM,30213735,"NCTCFX - NEUROCHONDRIN AB TISS IMMFL TITER, SF, REFLEX ONLY",83.0,53.95,5.95,104.69,84
CDM,30213745,"PCA1FX - PCA-1 TITER, SF, REFLEX ONLY",83.0,53.95,5.95,104.69,84
CDM,30213755,"PCA2FX - PCA-2 TITER, SF, REFLEX ONLY",83.0,53.95,5.95,104.69,84
CDM,30213765,"SP7CFX - SEPTIN-7 AB CB ASSAY, SF, REFLEX ONLY",83.0,53.95,5.95,83.0,84
CDM,30213775,"SP7TFX - SEPTIN-7 AB, TISS IMMFL TITER, SF, REFLEX ONLY",83.0,53.95,5.95,104.69,84
CDM,30213785,"AGNTSR - AGNA-1 TITER, SER, REFLEX ONLY",83.0,53.95,5.95,104.69,84
CDM,30213795,"AN1TSR - ANNA-1 TITER, SER, REFLEX ONLY",83.0,53.95,5.95,104.69,84
CDM,30213805,"AN2TSR- ANNA-2 TITER, SER, REFLEX ONLY",83.0,53.95,5.95,104.69,84
CDM,30213815,"AN3TSR - ANNA-3 TITER, SER, REFLEX ONLY",83.0,53.95,5.95,104.69,84
CDM,30213825,"APHTSR - AMPHIPHYSIN AB TITER, SER, REFLEX ONLY",83.0,53.95,5.95,104.69,84
CDM,30213835,"CRMTSR - CRMP-5 NEURONAL IGG TITER, SER, REFLEX ONLY",83.0,53.95,5.95,104.69,84
CDM,30213845,"NCDCSR - NEUROCHONDRIN AB CB ASSAY, SER, REFLEX ONLY",83.0,53.95,5.95,83.0,84
CDM,30213855,"NCDTSR - NEUROCHONDRIN AB, TISS IMMFL TITER, REFLEX ONLY",83.0,53.95,5.95,104.69,84
CDM,30213865,"PC1TSR - PCA-1 TITER, SER, REFLEX ONLY",83.0,53.95,5.95,104.69,84
CDM,30213875,"PC2TSR  - PCA-2 TITER, SER, REFLEX ONLY",83.0,53.95,5.95,104.69,84
CDM,30213885,"SP7CSR - SEPTIN-7 AB CB ASSAY, SER, REFLEX ONLY",83.0,53.95,5.95,83.0,84
CDM,30213895,"SP7TSR - SEPTIN-7 AB, TISS IMMFL TITER, SER, REFLEX ONLY",83.0,53.95,5.95,104.69,84
CDM,30213905,"APBCSR - AP3B2 AB, CB ASSAY, SER, REFLEX ONLY",83.0,53.95,5.95,83.0,84
CDM,30213915,"APBTSR - AP3B2 AB, TISS IMMFL TITER, SER, REFLEX ONLY",83.0,53.95,5.95,104.69,84
CDM,30213925,"BRUCELLA IGG/IGM CONF, REFLEX ONLY",62.0,40.3,4.41,68.79,84
CDM,30213935,"PCCTFX - PCA-TR TITER SF, REFLEX ONLY",83.0,53.95,5.95,104.69,84
CDM,30213945,"PCTTSR - PCATR TITER SER, REFLEX ONLY",83.0,53.95,5.95,104.69,84
CDM,30213955,HUMORAL IMMUNITY PANELS 1/2,103.0,66.95,7.4,103.0,84
CDM,30213995,ZINC TRANSPORTER 8 ANTIBODY,163.0,105.95,9.77,163.0,84
CDM,30214005,C3 NEPHRITIC FACTOR,83.0,53.95,5.92,83.0,84
CDM,30214015,COMPLEMENT FACTOR H,83.0,53.95,5.92,83.0,84
CDM,30214025,COMPLEMENT FACTOR I,83.0,53.95,5.92,83.0,84
CDM,30214035,"ALLERGEN, SESAME SEED RSES I 1 COMPONENT",124.0,80.6,17.93,124.0,84
CDM,30214045,"ALLERGEN, WHEAT, RTRI A OMEGA-5-GLIADIN COMPONENT",124.0,80.6,17.93,124.0,84
CDM,30214055,"ALLERGEN, SESAME SEED WITH COMPONENT REFLEX",36.0,23.4,2.96,36.0,84
CDM,30214065,"ALLERGEN, WHEAT WITH COMPONENT REFLEX",36.0,23.4,2.96,36.0,84
CDM,30214075,"QUANTIFERON-TB GOLD PLUS, BLOOD",428.0,278.2,28.66,428.0,84
CDM,30214085,"ALLERGEN, PAPER WASP COMPONENT IGE",124.0,80.6,17.93,124.0,84
CDM,30214095,"ALLERGEN, HONEY BEE IGE WITH REFLEX TO COMPONENTS",36.0,23.4,2.96,36.0,84
CDM,30214105,"ALLERGEN, YELLOW JACKET (COMMON WASP) IGE WITH REFLEX TO COMPONE",36.0,23.4,2.96,36.0,84
CDM,30214115,"ALLERGEN, PAPER WASP IGE WITH REFLEX TO COMPONENT",36.0,23.4,2.96,36.0,84
CDM,30214125,"ALLERGEN, TOTAL VENOM PANEL IGE WITH REFLEX TO COMPONENTS",36.0,23.4,2.96,36.0,84
CDM,30214135,"ALLERGEN, YELLOW JACKET (COMMON WASP) COMPONENTS IGE",124.0,80.6,17.93,124.0,84
CDM,30214145,ACETYLCHOLINE RECEPTOR MODULATING ANTIBODY,83.0,53.95,4.82,83.0,83
CDM,30214155,ACETYLCHOLINE RECEPTOR (ACHR) BINDING ANTIBODY,127.0,82.55,7.36,127.0,83
CDM,30214165,ACETYLCHOLINE RECEPTOR (ACHR) BLOCKING ANTIBODY,127.0,82.55,7.36,127.0,83
CDM,30214175,"MUSCLE-SPECIFIC KINASE (MUSK) AUTOANTIBODY, SERUM",127.0,82.55,7.36,127.0,83
CDM,30214185,ACETYLCHOLINE RECEPTOR BINDING ANTIBODY,127.0,82.55,7.36,127.0,83
CDM,30214195,ACETYLCHOLINE RECEPTOR BLOCKING ANTIBODY,127.0,82.55,7.36,127.0,83
CDM,30214205,B CELL TOTAL-ARUP,260.0,169.0,18.63,260.0,84
CDM,30214215,BPHENO MONONUCLEAR AG - ARUP,185.0,120.25,13.22,185.0,84
CDM,30214225,PLATELET ANTIBODIES,127.0,82.55,9.07,127.0,84
CDM,30214235,PLATELET ANTIBODIES,127.0,82.55,9.07,127.0,84
CDM,30214245,BAL FCM MARKERS,185.0,120.25,13.22,185.0,84
CDM,30214265,"B CELLS, TOTAL COUNT",260.0,169.0,18.63,260.0,84
CDM,30214275,"CD20 MONONUCLEAR CELL ANTIGEN, QUANT",185.0,120.25,13.22,185.0,84
CDM,30214285,F324-IGE HOP (FOOD),36.0,23.4,2.96,36.0,84
CDM,30214295,LUPINE SEED (LUPINUS ALBUS) IGE,36.0,23.4,2.96,36.0,84
CDM,30214305,CHEESE MOZZARELLA IGE,36.0,23.4,2.96,36.0,84
CDM,30214315,CHEESE PARMESAN IGE,36.0,23.4,2.96,36.0,84
CDM,30214325,CHEESE SWISS IGE,36.0,23.4,2.96,36.0,84
CDM,30214335,"ALLERGEN, FOOD, ASPARAGUS IGE",36.0,23.4,2.96,36.0,84
CDM,30214345,"ALLERGEN, FUNGI/MOLD, B. SPICIFERA IGE",36.0,23.4,2.96,36.0,84
CDM,30214355,"ALLERGEN, FUNGI/MOLD, CURVULARIA LUNATA",36.0,23.4,2.96,36.0,84
CDM,30214365,"PDE10A AB IFA TITER, S",83.0,53.95,5.95,104.69,84
CDM,30214375,"TRIM46 AB CBA, S",83.0,53.95,5.95,83.0,84
CDM,30214385,"TRIM46 AB IFA TITER, S",83.0,53.95,5.95,104.69,84
CDM,30214395,"PDE10A AB IFA TITER, CSF",83.0,53.95,5.95,104.69,84
CDM,30214405,"TRIM46 AB CBA, CSF",83.0,53.95,5.95,83.0,84
CDM,30214415,"TRIM46 AB IFA TITER, CSF",83.0,53.95,5.95,104.69,84
CDM,30214425,GLUTAMIC ACID DECARBOXYLASE ANTIBODY,163.0,105.95,9.77,163.0,84
CDM,30214435,"MOG AB IGG CBA-IFA SCREEN, SERUM",83.0,53.95,4.82,83.0,84
CDM,30214445,"NMO/AQP4 AB IGG CBA-IFA SCREEN, SERUM",83.0,53.95,4.82,83.0,84
CDM,30214455,"FLUORESCENT IMMUNOASSAY SCREEN QUAL, SERUM",83.0,53.95,5.95,83.0,84
CDM,30214465,GLUTAMIC ACID DECARBOXYLASE ANTIBODY CSF,163.0,105.95,9.77,163.0,84
CDM,30214475,"NMO/AQP4 AB IGG CBA-IFA SCREEN, CSF",83.0,53.95,4.82,83.0,84
CDM,30214485,"FLUORESCENT IMMUNOASSAY SCREEN QUAL, CSF",83.0,53.95,5.95,83.0,84
CDM,30214495,"REFLEX MGLUR1 AB IGG CBA-IFA TITER, SERUM",83.0,53.95,5.95,104.69,84
CDM,30214505,"GABA-A RECE$TOR IGG CBA-IFA TITER, SERUM",83.0,53.95,5.95,104.69,84
CDM,30214515,"NEURONAL NUCLEAR AB (ANNA) IFA TITER, IGG",83.0,53.95,5.95,104.69,84
CDM,30214525,"PURKINJE CELL ANTIBODY, TITER",83.0,53.95,5.95,104.69,84
CDM,30214535,"MOG AB IGG TITER BY CBA-IFA, SER",83.0,53.95,5.95,104.69,84
CDM,30214545,"LGI1 AB IGG TITER BY CBA-IFA, SER",83.0,53.95,5.95,104.69,84
CDM,30214555,"GABA-BR AB IGG CBA-IFA TITER, SER",83.0,53.95,5.95,104.69,84
CDM,30214565,"DPPX AB IGG TITER BY CBA-IFA, SER",83.0,53.95,5.95,104.69,84
CDM,30214575,"CASPR2 AB IGG TITER BY CBA-IFA, SER",83.0,53.95,5.95,104.69,84
CDM,30214585,"NEURONAL NUCLEAR ANTIBODY (ANNA) IFA TITER, IGG, CSF",83.0,53.95,5.95,104.69,84
CDM,30214595,"PURKINJE CELL ANTIBODY, TITER, CSF",83.0,53.95,5.95,104.69,84
CDM,30214605,"GABA-BR AB IGG CBA-IFA TITER, CSF",83.0,53.95,5.95,104.69,84
CDM,30214615,"CASPR2 AB IGG CBA-IFA TITER, CSF",83.0,53.95,5.95,104.69,84
CDM,30214625,"LGI1 AB IGG CBA-IFA TITER, CSF",83.0,53.95,5.95,104.69,84
CDM,30214635,"DPPX AB IGG CBA-IFA TITER, CSF",83.0,53.95,5.95,104.69,84
CDM,30214645,"GABA-AR AB IGG CBA-IFA TITER, CSF",83.0,53.95,5.95,104.69,84
CDM,30214655,"MGLUR1 AB IGG CBA-IFA TITER, CSF",83.0,53.95,5.95,104.69,84
CDM,30214665,"NEURONAL NUCLEAR AB (HU) IGG, IB, CSF",202.0,131.3,11.68,202.0,84
CDM,30214675,"ALLERGEN, FOOD, APRICOT",36.0,23.4,2.96,36.0,84
CDM,30214685,"ALLERGEN, INSECT, MOSQUITO, IGE",36.0,23.4,2.96,36.0,84
CDM,30214695,"ALLERGEN, FOOD, NUTMEG IGE",36.0,23.4,2.96,36.0,84
CDM,30214705,"NMO/AQP4 AB IGG CBA-IFA SCREEN, SERUM",83.0,53.95,4.82,83.0,84
CDM,30214715,"MOG AB IGG CBA-IFA SCREEN, SERUM",83.0,53.95,4.82,83.0,84
CDM,30214725,"ALLERGEN, WEED, SAGEBRUSH/WORMWOOD IGE",36.0,23.4,2.96,36.0,84
CDM,30214735,"ALLERGEN, FOOD, SUMMER SQUASH IGE",36.0,23.4,2.96,36.0,84
CDM,30214745,"ALLERGEN, FOOD, SPINACH",36.0,23.4,2.96,36.0,84
CDM,30214755,"ALLERGEN, FOOD, TEA IGE",36.0,23.4,2.96,36.0,84
CDM,30214765,"ALLERGEN, FOOD, TURMERIC IGE",36.0,23.4,2.96,36.0,84
CDM,30214775,"ALLERGEN, FOOD, BLACK OLIVE IGE",36.0,23.4,2.96,36.0,84
CDM,30214785,"ALLERGEN, FOOD, CAULIFLOWER IGE",36.0,23.4,2.96,36.0,84
CDM,30214795,"ALLERGEN, FOOD, GOAT MILK IGE",36.0,23.4,2.96,36.0,84
CDM,30214805,"N. MENINGITIDIS A, C, W-135 AND Y IGG",91.0,59.15,6.51,91.0,84
CDM,30214815,"ALLERGEN, FOOD, GINGER IGE",36.0,23.4,2.96,36.0,84
CDM,30214825,"ALLERGEN, FOOD, LIMA BEAN/WHITE BEAN",36.0,23.4,2.96,36.0,84
CDM,30214835,"ALLERGEN, FOOD, LAMB",36.0,23.4,2.96,36.0,84
CDM,30214845,"ALLERGEN, FOOD, NAVY BEAN IGE",36.0,23.4,2.96,36.0,84
CDM,30214855,"ALLERGEN, FOOD, ANCHOVY IGE",36.0,23.4,2.96,36.0,84
CDM,30214865,"ALLERGEN, FOOD, ANNATTO SEED IGE",36.0,23.4,2.96,36.0,84
CDM,30214875,"ALLERGEN, FOOD, EGGPLANT",36.0,23.4,2.96,36.0,84
CDM,30214885,"ALLERGEN, INSECT, FIRE ANT, IMPORTED",36.0,23.4,2.96,36.0,84
CDM,30214895,"ALLERGEN, FOOD, SARDINE IGE",36.0,23.4,2.96,36.0,84
CDM,30214905,"ALLERGEN, INSECT, BUMBLE BEE VENOM IGE",36.0,23.4,2.96,36.0,84
CDM,30214915,"ALLERGEN, FOOD, CAROB GUM IGE",36.0,23.4,2.96,36.0,84
CDM,30214925,"ALLERGEN, TREE, PALM/QUEEN TREE IGE",36.0,23.4,2.96,36.0,84
CDM,30214935,"HOPS, IGE ALLERGEN",36.0,23.4,2.96,36.0,84
CDM,30214945,"ALLERGEN, REGION 3 SOUTH ATLANTIC RESPIRATORY PANEL IGE",36.0,23.4,2.96,36.0,84
CDM,30214955,PLATELET SURFACE GLYCOPROTEIN EXPRESSION,127.0,82.55,9.07,127.0,84
CDM,30214965,HYPERSENSITIVITY PNEUMO IGE QUANT,36.0,23.4,2.96,36.0,84
CDM,30214975,HYPERSENSITIVITY PNEUMO IGE QUAL,55.0,35.75,3.94,55.0,84
CDM,30214985,HYPERSENSITIVITY PNEUMO IA QUAL,104.0,67.6,7.44,105.93,84
CDM,30214995,HYPERSENSITIVITY PNEUMO ID QUAL,83.0,53.95,5.92,83.0,84
CDM,30215005,%ABPA IMMDIFF QUAL,104.0,67.6,7.44,105.93,84
CDM,30215015,"CV2 ANTIBODY TITER, IGG",83.0,53.95,5.95,104.69,84
CDM,30215025,SENMOT FLUORESCENT ANTIBODY (ARUP),83.0,53.95,5.95,83.0,84
CDM,30215035,SENNRO FLUORESCENT AB (ARUP),83.0,53.95,5.95,83.0,84
CDM,30215045,SPSDEV GAD65 AB,163.0,105.95,9.77,163.0,84
CDM,30215055,SPSDEV FLUORESCENT AB SCREEN,83.0,53.95,5.95,83.0,84
CDM,30215065,SPSDEV GLYCINE RECEPTOR ALPHA1 IGG,252.0,163.8,5.95,252.0,82
CDM,30215075,MLPTHY GAD65 AB,163.0,105.95,9.77,163.0,84
CDM,30215085,MLPTHY FLUORESCENT AB SCREEN,83.0,53.95,5.95,83.0,84
CDM,30215095,MLPTHY NMO/AQP4 FACS,260.0,169.0,4.82,260.0,84
CDM,30215105,MLPTHY MOG FACS,260.0,169.0,4.82,260.0,84
CDM,30215115,LYME IGG CSF,118.0,76.7,8.41,118.0,84
CDM,30215125,LYMRFX BORRELIA ANTIBODY,118.0,76.7,8.41,118.0,84
CDM,30215135,SEMIQUANTITATIVE ANA (DERMYO),77.0,50.05,5.51,77.0,84
CDM,30215145,SEMIQUANTITATIVE ANA (MYOSPL),77.0,50.05,5.51,77.0,84
CDM,30215155,ANA (POLMYO),77.0,50.05,5.51,77.0,84
CDM,30215165,IMMUNOASSAY ENA (POLMYO),124.0,80.6,8.86,124.0,84
CDM,30215175,LYMPHOCYTE ANTIGEN PROLIFERATION,338.0,219.7,24.21,358.7,84
CDM,30215185,COMPLEMENT C9 FUNCTIONAL,83.0,53.95,5.92,83.0,84
CDM,30215195,FLOW CD107A CELL FUNCTION,937.0,609.05,28.66,937.0,84
CDM,30215205,PSTAT5 CELL FUNCTION,937.0,609.05,28.66,937.0,84
CDM,30215215,"LYMPHOCYTE SUBSET 2, CD4 PCT. AND ABSL",185.0,120.25,13.22,185.0,84
CDM,30215225,"PCCA/ANNA BY IFA, SERUM",83.0,53.95,5.95,83.0,84
CDM,30215235,"AMPA RECEPTOR AB IGG TITER, CSF",83.0,53.95,5.95,104.69,84
CDM,30215245,"AMPA RECEPTOR AB IGG TITER, SERUM - REFLEX",83.0,53.95,5.95,104.69,84
CDM,30215255,H PYLORI AB (BACK OFFICE),116.0,75.4,7.16,116.0,84
CDM,30215265,HTEROPHIL AB SCREEN (POINT OF CARE LAB),36.0,23.4,5.18,36.0,84
CDM,30215275,"ALLERGEN, BROMELAIN IGE",124.0,80.6,17.93,124.0,84
CDM,30215285,"SEND-OUT PHOSPHOLIPASE A2 RECEPTOR (PLA2R) ANTIBODY, IGG BY IMMU",83.0,53.95,5.95,83.0,84
CDM,30215295,"PHOSPHOLIPASE RECEPTOR A2 ANTIBODY, IGG TITER",83.0,53.95,5.95,104.69,84
CDM,30215305,TB SKIN TEST,30.0,19.5,6.54,30.0,58
CDM,30215355,TB SKIN TESTING (2-STEP) (RETURN TO CLINIC FOR READING WITHIN 48,60.0,39.0,13.08,60.0,58
CDM,30215365,ALLG SPEC IGE RECOMB EA,124.0,80.6,17.93,124.0,84
CDM,30220OH,INSERTION NASAL SEPTAL PROSTHESIS BUTTON,636.0,413.4,1.1,4447.63,148
CDM,30300OH,REMOVAL FOREIGN BODY INTRANASAL OFFICE PROCEDURE,480.0,312.0,1.1,694.46,148
CDM,30310OH,REMOVAL FOREIGN BODY INTRANASAL GENERAL ANES,804.0,522.6,1.1,9391.15,144
CDM,30400OH,RHINP PRIM LAT&ALAR CRTLGS&/ELVTN NASAL TI,4778.0,3105.7,1.1,17080.38,142
CDM,30400RVU1OH,RHINOPLASTY (TIP) - SIMPLE,5170.0,3360.5,1.1,17080.38,142
CDM,30400RVU2OH,RHINOPLASTY (TIP) - MODERATE,5650.0,3672.5,1.1,17080.38,142
CDM,30400RVU3OH,RHINOPLASTY (TIP) - COMPLEX,6200.0,4030.0,1.1,17080.38,142
CDM,30400RVUOH,RHINOPLASTY REVISION - HNI ONLY,1061.0,689.65,1.1,17080.38,142
CDM,30410OH,RHINP PRIM COMPLETE XTRNL PARTS,5600.0,3640.0,1.1,17080.38,142
CDM,30410RVU1OH,RHINOPLASTY (FULL) - SIMPLE,6340.0,4121.0,1.1,17080.38,142
CDM,30410RVU2OH,RHINOPLASTY (FULL) - MODERATE,8150.0,5297.5,1.1,17080.38,142
CDM,30410RVU3OH,RHINOPLASTY (FULL) - COMPLEX,10000.0,6500.0,1.1,17080.38,142
CDM,30420OH,RHINOPLASTY PRIMARY W/MAJOR SEPTAL REPAIR,6760.0,4394.0,1.1,17080.38,144
CDM,30430OH,RHINOPLASTY SECONDARY MINOR REVISION,3296.0,2142.4,1.1,17080.38,142
CDM,30430RVU1OH,RHINOPLASTY REVISION MINOR - SIMPLE,1500.0,975.0,1.1,17080.38,142
CDM,30430RVU2OH,RHINOPLASTY REVISION MINOR - MODERATE,3000.0,1950.0,1.1,17080.38,142
CDM,30430RVU3OH,RHINOPLASTY REVISION MINOR - COMPLEX,4500.0,2925.0,1.1,17080.38,142
CDM,30435OH,RHINOPLASTY SECONDARY INTERMEDIATE REVISION,5601.0,3640.65,1.1,17080.38,142
CDM,30435RVU1OH,RHINOPLASTY REVISION INTERMEDIATE - SIMPLE,3500.0,2275.0,1.1,17080.38,142
CDM,30435RVU2OH,RHINOPLASTY REVISION INTERMEDIATE - MODERATE,5500.0,3575.0,1.1,17080.38,142
CDM,30435RVU3OH,RHINOPLASTY REVISION INTERMEDIATE - COMPLEX,7500.0,4875.0,1.1,17080.38,142
CDM,30450OH,RHINOPLASTY SECONDARY MAJOR REVISION,7864.0,5111.6,1.1,17080.38,142
CDM,30450RVU1OH,RHINOPLASTY REVISION MAJOR - SIMPLE,7260.0,4719.0,1.1,17080.38,142
CDM,30450RVU2OH,RHINOPLASTY REVISION MAJOR - MODERATE,9500.0,6175.0,1.1,17080.38,142
CDM,30450RVU3OH,RHINOPLASTY REVISION MAJOR - COMPLEX,15500.0,10075.0,1.1,17080.38,142
CDM,30460OH,RHINP DFRM W/COLUM LNGTH TIP ONLY,4128.0,2683.2,1.1,17080.38,144
CDM,30462OH,RHINP DFRM COLUM LNGTH TIP SEPTUM OSTEOT,8112.0,5272.8,1.1,17080.38,144
CDM,30465OH,NASAL VESTIBUL STENOS REPAIR,4944.0,3213.6,1.1,17080.38,144
CDM,30468OH,RPR NSL VLV COLLAPSE SUBQ/SBMCSL LAT WALL IMPLT,1120.0,728.0,1.1,17080.38,148
CDM,30469OH,RPR NSL VLV COLLAPSE LW NRG SUBQ/SBMCSL RMDLG,976.0,634.4,1.1,17080.38,148
CDM,30500020,WBC COUNT MANUAL DIFF,26.0,16.9,1.7,26.0,84
CDM,30500025,BUFFY COAT SEZARY CELL,35.0,22.75,2.03,35.0,84
CDM,30500030,*BLOOD COUNT HCT,16.0,10.4,2.31,16.0,84
CDM,30500040,*BLOOD COUNT HGB,16.0,10.4,2.37,16.0,84
CDM,30500050,CBC AUTO W AUTO DIFF,54.0,35.1,7.77,54.0,84
CDM,30500060,CBC AUTO WO DIFF,45.0,29.25,6.47,45.0,84
CDM,30500065,COAG FACT ASSAY 5,122.0,79.3,8.72,122.0,84
CDM,30500070,MANUAL CELL COUNT EA,30.0,19.5,2.13,30.0,84
CDM,30500075,COAG FACT ASSAY 8,124.0,80.6,8.84,124.0,84
CDM,30500085,VON WILLEBRAND ANTIGEN,158.0,102.7,11.33,158.0,84
CDM,30500090,LEUKO (WBC) COUNT AUTO,18.0,11.7,1.25,18.0,84
CDM,30500095,COAG FACT ASSAY 9,131.0,85.15,9.4,131.0,84
CDM,30500100,COAG FACT ASSAY 10,124.0,80.6,8.84,124.0,84
CDM,30500105,COAG FACT ASSAY 11,124.0,80.6,8.84,124.0,84
CDM,30500110,PLT COUNT AUTO,31.0,20.15,2.21,31.0,84
CDM,30500115,COAG FACTOR ASSAY 13,113.0,73.45,8.07,113.0,84
CDM,30500125,ANTITHROMBIN 3,82.0,53.3,5.85,82.0,84
CDM,30500135,PROTEIN C FUNCTIONAL,95.0,61.75,6.83,95.0,84
CDM,30500145,PROTEIN S FREE,106.0,68.9,7.57,106.0,84
CDM,30500155,APC RESISTANCE,106.0,68.9,7.57,106.0,84
CDM,30500165,%AD13IN FACTR INHIB TEST,89.0,57.85,6.36,99.1,84
CDM,30500185,EUGLOBULIN LYSIS TIME,58.0,37.7,4.15,58.82,84
CDM,30500195,DEGRADATION PRODUCTS,48.0,31.2,3.4,53.05,84
CDM,30500205,COAGULOPATHY INTERPRET,107.0,69.55,6.19,107.0,84
CDM,30500215,%THROMBOGRAPH,163.0,105.95,13.95,163.0,68
CDM,30500225,%AD13AC COAG/FIBFUNC ACT,213.0,138.45,30.86,213.0,84
CDM,30500235,ALPHA 2 ANTIPLASMIN,53.0,34.45,3.8,58.82,84
CDM,30500245,PLASMINOGEN FUNCTIONAL,45.0,29.25,3.22,46.35,84
CDM,30500255,HEINZ BODY STAIN,29.0,18.85,2.07,29.0,84
CDM,30500265,KLEIHAUER BETKE ST,53.0,34.45,3.82,59.61,84
CDM,30500285,IRON STAIN MISC,47.0,30.55,3.19,115.77,84
CDM,30500290,ANTITHROMBIN III AG ASSAY,75.0,48.75,5.34,75.0,84
CDM,30500295,LAP STAIN-LEUK ALK PHOS,59.0,38.35,4.25,66.27,84
CDM,30500305,OSMOTIC FRAG INCUB,92.0,59.8,6.6,92.0,84
CDM,30500315,PLATELET NEUTRALIZATION,124.0,80.6,8.88,124.0,84
CDM,30500325,DILUTE RVVT X2,66.0,42.9,4.73,66.0,84
CDM,30500335,REPTILASE R TIME,68.0,44.2,4.86,68.0,84
CDM,30500345,VISCOSITY BLOOD,81.0,52.65,5.76,81.0,84
CDM,30500375,ASSISTED EMBRYO HATCHING,1050.0,682.5,24.85,1050.0,84
CDM,30500380,ACTIVATED COAGULATION,30.0,19.5,2.1,32.77,84
CDM,30500400,D-DIMER QUANT,70.0,45.5,5.02,70.0,84
CDM,30500405,PREKALLIKREIN FLETCHER,131.0,85.15,9.35,131.0,84
CDM,30500410,FIBRINOGEN,67.0,43.55,4.2,67.0,84
CDM,30500420,FIBRIN AG,100.0,65.0,5.78,100.0,84
CDM,30500450,FIBRIN PLASMINOGEN ACTIVATOR,119.0,77.35,8.49,119.0,84
CDM,30500455,RETICULOCYTE HEMOGLOBIN,38.0,24.7,2.75,38.0,84
CDM,30500475,COAG FACT ASSAY 2,90.0,58.5,6.41,90.0,84
CDM,30500485,VWF MULTIMER,158.0,102.7,11.33,176.68,84
CDM,30500495,COAG FACT ASSAY 12,134.0,87.1,9.56,134.0,84
CDM,30500505,PROTEIN C IMMUNO,83.0,53.95,5.93,87.58,84
CDM,30500515,PROTEIN S TOTAL,80.0,52.0,5.73,89.35,84
CDM,30500525,COAG FACT ASSAY 7,124.0,80.6,8.84,124.0,84
CDM,30500535,CLOT FACTOR VIII VW RISTOCTN,158.0,102.7,11.33,158.0,84
CDM,30500545,BONE MARROW ROUTINE,5637.0,3664.05,11.81,5637.0,87
CDM,30500550,MURAMIDASE,129.0,83.85,8.48,129.0,84
CDM,30500565,CLOTTING TEST (POINT OF CARE LAB),30.0,19.5,4.29,30.0,84
CDM,30500575,SED RATE WESTERGREN,29.0,18.85,4.27,29.0,84
CDM,30500580,*PRO TIME,30.0,19.5,4.29,30.0,84
CDM,30500585,D-DIMER (POINT OF CARE LAB),70.0,45.5,5.02,70.0,84
CDM,30500590,*PRO TIME TEST PLASMA FRACT EA,27.0,17.55,1.95,30.36,84
CDM,30500605,OCCULT BLD IA SCRN,110.0,71.5,7.86,110.0,84
CDM,30500615,OSMOTIC FRAG ERYTHRO,52.0,33.8,3.3,52.0,84
CDM,30500630,SEDIMENTATION RATE AUTO,19.0,12.35,2.7,19.0,84
CDM,30500640,RBC SICKLING REDUC,38.0,24.7,2.72,38.0,84
CDM,30500645,%VWD2N ONE STAGE,124.0,80.6,8.84,124.0,84
CDM,30500655,%VWD2N FACTOR ANTIGEN,158.0,102.7,11.33,158.0,84
CDM,30500670,*PTT PLASMA/WHOLE BLOOD,41.0,26.65,2.97,41.0,84
CDM,30500690,*PTT PLASMA FRACT EA,45.0,29.25,3.19,45.0,84
CDM,30500740,HGB FETAL ROS,65.0,42.25,3.74,90.26,84
CDM,30500770,CLOTTING; HMW KININOGEN ASSAY,131.0,85.15,9.35,145.81,84
CDM,30500780,*BLOOD PLT AGGREGATION EA,172.0,111.8,10.61,172.0,84
CDM,30500830,HEPARIN ASSAY,90.0,58.5,6.46,90.0,84
CDM,30500850,RBC SICKLING REDUC,38.0,24.7,2.72,38.0,84
CDM,30500900,*LEUKO (WBC) COUNT AUTO,18.0,11.7,1.25,18.0,84
CDM,30500970,*PRO TIME,30.0,19.5,4.29,30.0,84
CDM,30501060,RETICULOCYTE COUNT AUTO,28.0,18.2,1.97,28.0,84
CDM,30501100,THROMBIN TIME,40.0,26.0,2.85,40.0,84
CDM,30501110,ANTIXA,90.0,58.5,6.46,90.0,84
CDM,30501220,PRO TIME (POINT OF CARE LAB),30.0,19.5,4.29,30.0,84
CDM,30501360,BLOOD COUNT SPUN MICRO HCT,48.0,31.2,7.0,48.0,84
CDM,30501480,BLOOD COUNT HGB,16.0,10.4,2.37,16.0,84
CDM,30501535,BLEEDING TIME SIMPLATE,33.0,21.45,2.23,66.48,84
CDM,30501545,BLEEDING TIME RATNOFF,33.0,21.45,2.23,66.48,84
CDM,30501555,AVN MANUAL DIFF,26.0,16.9,1.7,26.0,84
CDM,30501655,IMMATURE PLATELET FRACT,247.0,160.55,14.3,247.0,84
CDM,30501685,AUTOMATED RBC COUNT,21.0,13.65,1.49,21.0,84
CDM,30501705,TRANS REACTION EVAL,1182.0,768.3,30.88,1182.0,87
CDM,30501725,LEUKOCYTE ALKALINE PHOSPHATASE,59.0,38.35,4.25,66.27,84
CDM,30501735,HNZBSN HEINZ BOD DIRECT,29.0,18.85,2.07,29.0,84
CDM,30501745,HNZBSN HEINZ BOD INDUCED,47.0,30.55,3.37,47.0,84
CDM,30501755,CSPNL AUTO RBC COUNT,21.0,13.65,1.49,21.0,84
CDM,30501785,EUGLOBULIN LYSIS TIME,58.0,37.7,4.15,58.82,84
CDM,30501795,VISCOSITY SERUM,81.0,52.65,5.76,81.0,84
CDM,30501805,REPTILASE TIME 1:1 MIX BILL,68.0,44.2,4.86,68.0,84
CDM,30501815,PLASMINOGEN ACTIV INHIB AG,119.0,77.35,8.49,119.0,84
CDM,30501825,VWF GPIBM ACTIVITY,213.0,138.45,30.86,213.0,84
CDM,30501835,PLTEMS FIBRINOLYSINS SCREEN I&R,107.0,69.55,6.19,107.0,84
CDM,30501845,MANUAL HEME - PRO TIME,30.0,19.5,4.29,30.0,84
CDM,30501855,MANUAL HEME - PTT PLASMA/WHOLE BLOOD,41.0,26.65,2.97,41.0,84
CDM,30501885,HEXAGOAL PHASE PHOSPHOLIPID NEUTRALIZATION,124.0,80.6,8.88,124.0,84
CDM,30501895,LUPUS ANTICOAG INTERP PANEL,124.0,80.6,8.88,124.0,84
CDM,30501925,ACTIVATED COAGULATION,30.0,19.5,2.1,32.77,84
CDM,30501935,*BLOOD PLT AGGREGATION EA,172.0,111.8,10.61,172.0,84
CDM,30501945,FIBRINOGEN,67.0,43.55,4.2,67.0,84
CDM,30501955,COAGULATION/FIBRINOLYSIS,163.0,105.95,13.95,163.0,68
CDM,30501965,"SMEAR, PARASITEMIA CELL COUNT",30.0,19.5,2.13,30.0,84
CDM,30501975,MANUAL HEME- FIBRINOGEN,67.0,43.55,4.2,67.0,84
CDM,30501985,MANUAL HEME - FIBRINOGEN,67.0,43.55,4.2,67.0,84
CDM,30501995,HEMATOCRIT (POINT OF CARE LAB),16.0,10.4,2.31,16.0,84
CDM,30502005,BLOOD COUNT HCT (POINT OF CARE LAB),16.0,10.4,2.31,16.0,84
CDM,30502015,BLOOD COUNT HGB (POINT OF CARE LAB),16.0,10.4,2.37,16.0,84
CDM,30502025,PRO TIME (POINT OF CARE LAB),30.0,19.5,4.29,30.0,84
CDM,30502035,"CARBOHYDRATE, UR",80.0,52.0,5.69,80.0,84
CDM,30520OH,SEPTOPLASTY/SUBMUCOUS RESECJ W/WO CARTILAGE GRF,2804.0,1822.6,1.1,9391.15,144
CDM,30540OH,"REPAIR CHOANAL ATRESIA,INTRANASAL",3485.0,2265.25,1.1,17080.38,144
CDM,30545OH,"REPAIR CHOANAL ATRESIA,TRANSPALATIN",5113.0,3323.45,1.1,17080.38,144
CDM,30560OH,LYSIS INTRANASAL SYNECHIA,524.0,340.6,1.1,1603.96,148
CDM,30580OH,REPAIR FISTULA OROMAXILLARY,2752.0,1788.8,1.1,17080.38,148
CDM,30600005,"CULTURE, BACTERIAL, STOOL, EACH PLATE",65.0,42.25,4.66,65.0,84
CDM,30600010,"PROCESSING, AFB CONCENTRATION",46.0,29.9,3.3,46.0,84
CDM,30600015,"CULTURE, BACTERIAL, AEROBIC, QUANTITATIVE",68.0,44.2,4.66,68.0,84
CDM,30600025,"CULTURE, BACTERIAL, ANAEROBIC, QUANTITATIVE",67.0,43.55,4.66,67.0,84
CDM,30600030,"CULTURE, BACTERIAL, BLOOD, AEROBIC AND ANAEROBIC",71.0,46.15,5.1,71.0,84
CDM,30600035,"IDENTIFICATION, ANAEROBIC ISOLATE",56.0,36.4,3.99,62.24,84
CDM,30600045,CULT AEROBIC UR QUANT,56.0,36.4,4.0,56.0,84
CDM,30600050,"CULTURE, BACTERIAL, STOOL, SALMONELLA SHIGELLA",65.0,42.25,4.66,65.0,84
CDM,30600055,CULT FUNGI SKIN HAIR NAIL,53.0,34.45,3.8,59.38,84
CDM,30600065,"CULTURE, FUNGAL ISOLATION",58.0,37.7,4.15,58.0,84
CDM,30600075,"CULTURE, FUNGAL ISOLATION, BLOOD",141.0,91.65,8.18,141.0,84
CDM,30600085,"IDENTIFICATION, YEAST",71.0,46.15,5.1,71.0,84
CDM,30600095,"IDENTIFICATION, MOLD",71.0,46.15,5.1,71.0,84
CDM,30600100,"CULTURE, BACTERIAL, AEROBIC",59.0,38.35,4.26,59.0,84
CDM,30600105,"CULTURE, MYCOPLASMA",106.0,68.9,7.6,106.0,84
CDM,30600115,"CULTURE, ACID FAST",75.0,48.75,5.34,75.0,84
CDM,30600155,MICRO ID BY PNA FISH,138.0,89.7,9.9,138.0,84
CDM,30600160,"CULTURE, BACTERIAL, ANAEROBIC",65.0,42.25,4.68,65.0,84
CDM,30600175,ID BY PYROSEQUENCING,53.0,34.45,3.1,53.0,84
CDM,30600180,"IDENTIFICATION, AEROBIC ISOLATE",56.0,36.4,8.08,62.24,84
CDM,30600185,"MACROSCOPIC EXAM, ARTHROPOD",29.0,18.85,2.11,39.45,84
CDM,30600195,"MACROSCOPIC EXAM, PARASITE",30.0,19.5,2.11,32.88,84
CDM,30600205,PINWORM PREP PERIANAL,29.0,18.85,2.11,29.0,84
CDM,30600215,"PROCESSING, TISSUE HOMOGENIZATION",41.0,26.65,2.9,45.32,84
CDM,30600225,"CONCENTRATION AND ID, OVA AND PARASITE",61.0,39.65,4.4,61.0,84
CDM,30600235,SENSITIVITY - DISK PER PLATE,52.0,33.8,3.4,53.16,84
CDM,30600240,"CULTURE, PRESUMPTIVE SCREENING",46.0,29.9,3.27,46.0,84
CDM,30600245,"SUSCEPTIBILITY, ENZYME DETECTION, PER ENZYME",33.0,21.45,2.34,33.0,84
CDM,30600260,CULT/COLONY COUNT QUANT URINE,56.0,36.4,3.98,56.0,84
CDM,30600265,"SMEAR, FUNGAL FLUORESCENT",37.0,24.05,2.66,37.0,84
CDM,30600270,*CULT FUNGI PRES ID OTHER,58.0,37.7,4.15,58.0,84
CDM,30600275,KOH EXAM (POINT OF CARE LAB),29.0,18.85,4.27,29.0,84
CDM,30600285,ENTEROVIRUS CULTURE,180.0,117.0,12.87,180.0,84
CDM,30600295,VIRUS CULTURE W/STAIN,139.0,90.35,9.98,155.51,84
CDM,30600305,HERPES SIMPLEX CULTURE,234.0,152.1,16.72,234.0,84
CDM,30600315,*%DFA ADENO,100.0,65.0,5.92,100.0,84
CDM,30600340,CULT MYCOPLASMA ANY SOURCE,106.0,68.9,7.6,106.0,84
CDM,30600345,PARAINFLUENZA 123 DFA X3,113.0,73.45,6.57,113.0,84
CDM,30600365,VARICELLA ZOSTER DFA,93.0,60.45,5.92,93.0,84
CDM,30600385,HERPES SIMPLEX DFA,83.0,53.95,5.92,83.0,84
CDM,30600395,HEPATITIS BE ANTIGEN,80.0,52.0,5.69,80.0,84
CDM,30600415,"IMMUNOASSAY, ROTAVIRUS",83.0,53.95,5.92,83.0,84
CDM,30600425,%STOOL SHIGA LIKE TOX X2,83.0,53.95,5.92,83.0,84
CDM,30600445,%VAGONA CANDIDA,138.0,89.7,9.9,138.0,84
CDM,30600455,CHLAMYDIA TRACH AMPLIFY,242.0,157.3,19.88,242.0,84
CDM,30600465,"AMPLIFICATION, CLOSTRIDIUM DIFFICILE",257.0,167.05,17.33,257.0,84
CDM,30600475,"QUANTIFICATION, CYTOMEGALOVIRUS",296.0,192.4,21.15,296.0,84
CDM,30600480,"SUSCEPTIBILITY, MULTI-ANTIMICROBIAL",60.0,39.0,4.27,60.0,84
CDM,30600485,ENTEROVIRUS PCR,242.0,157.3,17.33,242.0,84
CDM,30600490,"SMEAR, GRAM STAIN",29.0,18.85,2.11,29.0,84
CDM,30600495,%VAGDNA GARDNERELLA,138.0,89.7,9.9,138.0,84
CDM,30600505,%IDM HBVNAT,242.0,157.3,17.33,242.0,84
CDM,30600515,"QUANTIFICATION, HEPATITIS B VIRUS",296.0,192.4,21.15,296.0,84
CDM,30600525,HEPATITIS C AMPLIFIED PROBE,242.0,157.3,17.33,270.23,84
CDM,30600535,"QUANTIFICATION, HEPATITIS C VIRUS",296.0,192.4,21.15,296.0,84
CDM,30600545,"AMPLIFIED PROBE, HERPES SIMPLEX VIRUS",296.0,192.4,17.33,296.0,84
CDM,30600555,HIV-1 DNA BY PCR,242.0,157.3,17.33,242.0,84
CDM,30600565,"QUANTIFICATION, HIV-1",587.0,381.55,33.62,587.0,84
CDM,30600570,SMEAR WET MOUNT,40.0,26.0,5.68,40.0,84
CDM,30600575,LEGIONELLA PNEUM PCR,242.0,157.3,17.33,242.0,84
CDM,30600580,TISSUE CULTURE,180.0,117.0,12.87,180.0,84
CDM,30600585,ID-PROBE M GORDONAE,138.0,89.7,9.9,138.0,84
CDM,30600595,ID MTB COMPLEX VS NTM,333.0,216.45,19.3,333.0,84
CDM,30600625,GC AMPLIFICATION,242.0,157.3,19.88,242.0,84
CDM,30600635,HPV DNA ASSAY,242.0,157.3,19.1,242.0,84
CDM,30600645,"AMPLIFICATION, STAPHYLOCOCCUS AUREUS",242.0,157.3,17.33,242.0,84
CDM,30600655,"AMPLIFICATION, METHICILLIN RESISTANCE",242.0,157.3,17.33,242.0,84
CDM,30600665,STREP GROUP A AMPLIFICTN,138.0,89.7,9.9,138.0,84
CDM,30600675,"AMPLIFICATION, STREPTOCOCCUS, GROUP B",242.0,157.3,17.33,242.0,84
CDM,30600685,%VAGDNA TRICHOMONAS,138.0,89.7,9.9,138.0,84
CDM,30600695,BORDETELLA PERTUSSIS,242.0,157.3,19.88,242.0,84
CDM,30600705,"QUANTIFICATION, EPSTEIN-BARR VIRUS",296.0,192.4,21.15,309.32,84
CDM,30600715,INFLUENZA OIA (POINT OF CARE LAB),114.0,74.1,15.92,114.0,84
CDM,30600725,RSV DIRECT OPTICAL,90.0,58.5,13.1,90.0,84
CDM,30600730,VIRUS ID NON-IMMUNOLOGIC,234.0,152.1,16.72,234.0,84
CDM,30600735,"GENOTYPE, HEPATITIS C VIRUS",1776.0,1154.4,116.49,1776.0,84
CDM,30600755,%CANDA PART AGG,80.0,52.0,5.03,80.0,84
CDM,30600775,SUSCEPTIBILITY AGAR DIL,33.0,21.45,2.34,33.0,84
CDM,30600810,"IMMUNOASSAY, CLOSTRIDIUM DIFFICILE TOXIN",83.0,53.95,5.92,83.0,84
CDM,30600820,"IMMUNOASSAY, CRYPTOSPORIDIUM",95.0,61.75,5.92,95.0,84
CDM,30600825,BORDETELLA PERTUSS DFA X2,83.0,53.95,5.92,83.0,84
CDM,30600835,HPV DNA 16 18 PCR,242.0,157.3,19.1,242.0,84
CDM,30600840,"IMMUNOASSAY, H. PYLORI",99.0,64.35,7.1,99.0,84
CDM,30600845,%ROTAD ADENOV 40-41,83.0,53.95,5.92,83.0,84
CDM,30600855,ENTAMOEBA HISTOLYT AG,83.0,53.95,5.92,83.0,84
CDM,30600865,HPV DNA PROBE REFLEX,242.0,157.3,19.1,242.0,84
CDM,30600875,TRICHOMONAS VAG AMP,242.0,157.3,19.15,242.0,84
CDM,30600885,FLU A H1N1 PCR,661.0,429.65,49.14,661.0,84
CDM,30600915,HHV-6 PCR,242.0,157.3,17.33,242.0,84
CDM,30600935,LIMULUS AMEBOCYTE LT,111.0,72.15,6.43,111.0,84
CDM,30600945,CYTSEQ NFCT AGT GNTYP ALYS CMV,1776.0,1154.4,49.14,1776.0,84
CDM,30600955,HEPATITIS B GENOTYPING,1776.0,1154.4,49.14,1776.0,84
CDM,30600965,HISTOPLASMA ANTIGEN UR,91.0,59.15,5.92,92.38,84
CDM,30600970,*BARTONELLA DNA AMPL PROBE,242.0,157.3,17.33,242.0,84
CDM,30600975,%E18RP CHLAMYDIA PNEU AMP,242.0,157.3,17.33,789.1,84
CDM,30600980,LYME DISEASE DNA AMPL PROBE,242.0,157.3,17.33,247.11,84
CDM,30600985,"IMMUNOASSAY, GIARDIA",83.0,53.95,5.92,83.0,84
CDM,30600995,%E18RP MYCOPLAS PNEU AMP,242.0,157.3,17.33,242.0,84
CDM,30600OH,REPAIR FISTULA ORONASAL,2464.0,1601.6,1.1,17080.38,148
CDM,30601000,CHLAMYDIA PNEUM DNA AMPL PROB,242.0,157.3,17.33,789.1,84
CDM,30601005,RVP BY PCR,2876.0,1869.4,49.14,2876.0,84
CDM,30601015,HIV ANTIGEN W/HIV ANTIBODIES,90.0,58.5,13.11,98.72,84
CDM,30601020,CMV DNA AMPL PROB,242.0,157.3,17.33,242.0,84
CDM,30601045,HISTOPLASMA ANTIGEN SERUM,91.0,59.15,5.92,92.38,84
CDM,30601055,"HIV-1 RNA QUAL, TMA",242.0,157.3,17.33,242.0,84
CDM,30601070,*HEP C AMP PROBE,242.0,157.3,17.33,270.23,84
CDM,30601085,CLARITHROMYCIN RESIST,242.0,157.3,17.33,242.0,84
CDM,30601095,MISC SENDOUT CPT 88112,369.0,239.85,45.47,369.0,86
CDM,30601105,TRICHOMONAS ANTIGEN,106.0,68.9,15.29,106.0,84
CDM,30601115,DENGUE VIRUS PCR,242.0,157.3,19.88,242.0,84
CDM,30601125,CHIKUNGUNYA BY PCR,242.0,157.3,19.88,242.0,84
CDM,30601150,HIV-2 DNA AMPL PROBE,242.0,157.3,17.33,270.23,84
CDM,30601160,MYCOBACTERIA TB DNA AMPL PROB,288.0,187.2,17.33,288.0,84
CDM,30601180,MYCOPLASMA PNEUM DNA AMPL,242.0,157.3,17.33,242.0,84
CDM,30601205,TISSUE EXAM KOH,29.0,18.85,4.27,29.0,84
CDM,30601215,"AMPLIFICATION, STREPTOCOCCUS, GROUP A",242.0,157.3,33.62,242.0,84
CDM,30601245,INFLUENZA RAPID PCR,984.0,639.6,49.14,984.0,84
CDM,30601255,STREP SCREEN,116.0,75.4,6.72,116.0,84
CDM,30601285,"IDENTIFICATION, NUCLEIC ACID SEQUENCING",796.0,517.4,49.14,796.0,84
CDM,30601295,"IDENTIFICATION, MYCOBACTERIAL",101.0,65.65,5.84,101.0,84
CDM,30601305,RAPID FLU X2,114.0,74.1,15.92,114.0,84
CDM,30601360,EBV BY PCR QUANT CSF,296.0,192.4,21.15,309.32,84
CDM,30601365,FLUPCR RAPID PCR FLU,661.0,429.65,49.14,661.0,84
CDM,30601385,%IOHWC GRAM STAIN,29.0,18.85,2.11,29.0,84
CDM,30601395,ENTEROVIRUS BY PCR,242.0,157.3,17.33,242.0,84
CDM,30601415,"IDENTIFICATION, URINE, PRESUMPTIVE",56.0,36.4,4.0,56.0,84
CDM,30601425,"CULTURE,  BACTERIAL, URINE, QUANTITATIVE",56.0,36.4,3.98,56.0,84
CDM,30601430,STREP ASSAY (POINT OF CARE LAB),114.0,74.1,16.53,114.0,84
CDM,30601435,%TBPPCR MYCOBAC AMP PROB,333.0,216.45,19.3,333.0,84
CDM,30601440,"IMMUNOASSAY, CAD",111.0,72.15,6.43,111.0,84
CDM,30601445,INFLUENZA RSV DETECT,984.0,639.6,49.14,984.0,84
CDM,30601455,INFLUENZA DETECTION,661.0,429.65,49.14,661.0,84
CDM,30601465,STAPH AUREUS AMPLIFICATION,242.0,157.3,19.88,242.0,84
CDM,30601470,%HIVGEN HIV GENOTYPING,1776.0,1154.4,116.49,1776.0,84
CDM,30601475,%IDM W NILE RNA PCR,242.0,157.3,19.88,242.0,84
CDM,30601485,RSV PCR,242.0,157.3,19.88,242.0,84
CDM,30601495,P JIROVECI PCR,242.0,157.3,19.88,242.0,84
CDM,30601505,%E18RP INFECT AGENT AMP,242.0,157.3,19.88,242.0,84
CDM,30601515,%E18GIP INFECT AGAMP X21,242.0,157.3,19.88,242.0,84
CDM,30601520,*HIV PHENOTYPE DNA DRUG EA ADD,180.0,117.0,12.87,180.0,84
CDM,30601525,HPV DNA PROBE SUREPATH,242.0,157.3,19.1,242.0,84
CDM,30601535,"IMMUNOASSAY, PAN-MALARIAL",111.0,72.15,6.43,111.0,84
CDM,30601545,"IMMUNOASSAY, MALARIA P. FALCIPARUM",111.0,72.15,6.43,111.0,84
CDM,30601555,"IMMUNOASSAY, STREP PNEUMONIAE ANTIGEN",111.0,72.15,6.43,111.0,84
CDM,30601565,FUNGI ASSAY FOR B-D GLUC,83.0,53.95,11.98,83.0,84
CDM,30601575,BLASTOMYCES ANTIGEN,83.0,53.95,11.98,83.0,84
CDM,30601595,T VAGINALIS UR MALES,242.0,157.3,19.15,242.0,84
CDM,30601615,STREP SCREEN,116.0,75.4,6.72,116.0,84
CDM,30601625,CMV PCR M4,242.0,157.3,17.33,242.0,84
CDM,30601635,HSV PCR OCULAR FLD,242.0,157.3,17.33,270.23,84
CDM,30601645,HSV 1&2 QT PCR BAL X2,242.0,157.3,17.33,270.23,84
CDM,30601655,HPV DNA HI RISK ANL RECT,242.0,157.3,19.1,242.0,84
CDM,30601665,MTBAM1 AMPLIFICATION,242.0,157.3,19.88,242.0,84
CDM,30601675,%MTBAM1 PROBE PCR,242.0,157.3,19.88,242.0,84
CDM,30601685,HTLV I/II DNA PCR X2,242.0,157.3,19.88,242.0,84
CDM,30601695,WEST NILE VIRU RNA RT,242.0,157.3,19.88,242.0,84
CDM,30601705,TOXOPLASMA PCR,242.0,157.3,19.88,242.0,84
CDM,30601710,ASPERGILLUS GALACT SERUM,83.0,53.95,5.92,92.38,84
CDM,30601715,JC VIRUS DNA PCR,242.0,157.3,19.88,242.0,84
CDM,30601720,*CULT CHLAMYDIA ANY SOURCE,135.0,87.75,9.68,135.0,84
CDM,30601725,VARICELLA ZOSTER PCR,242.0,157.3,19.88,242.0,84
CDM,30601730,*CULT TYPE IF EA ANTISERUM,38.0,24.7,2.75,38.0,84
CDM,30601735,WHIPPLE DNA WHOLE BLD,242.0,157.3,19.88,242.0,84
CDM,30601745,PARVO B19 PLASMA PCR,242.0,157.3,19.88,242.0,84
CDM,30601755,EPSTEIN BARR VIRUS PCR,242.0,157.3,19.88,242.0,84
CDM,30601765,BK VIRUS QUAL URINE,242.0,157.3,19.88,242.0,84
CDM,30601770,CULTURE ANTIGEN DFA,135.0,87.75,9.66,135.0,84
CDM,30601775,WEST NILE VIRUS PCR PLS,242.0,157.3,19.88,242.0,84
CDM,30601785,M HOMINTS PCR,242.0,157.3,19.88,242.0,84
CDM,30601795,HEP D VIRUS PCR,242.0,157.3,19.88,242.0,84
CDM,30601805,OCULAR VZV PCR,242.0,157.3,19.88,242.0,84
CDM,30601815,OCULAR TOXOPL GONDII PCR,242.0,157.3,19.88,242.0,84
CDM,30601825,HUMAN METAPNEUM RT-PCR,242.0,157.3,19.88,242.0,84
CDM,30601835,NOROVIR 1 & 2 DETECT X2,242.0,157.3,19.88,242.0,84
CDM,30601845,JC VIRUS BY PCR,242.0,157.3,19.88,242.0,84
CDM,30601855,BORDETELLA PCR X2,242.0,157.3,19.88,242.0,84
CDM,30601865,UNIVERSAL FUNGAL PCR,484.0,314.6,33.62,484.0,84
CDM,30601870,CULT AEROBIC DEFIN ID EA ISOL,56.0,36.4,8.08,62.24,84
CDM,30601875,%FABPCR INF AG AMP PRBX2,484.0,314.6,33.62,484.0,84
CDM,30601885,%CHROMO CULT AMNIOTIC,1037.0,674.05,60.74,1037.0,83
CDM,30601890,CULT SCREEN ONLY,46.0,29.9,3.27,46.0,84
CDM,30601895,MOLD SUSCEPT 2 DRUG X2,46.0,29.9,3.28,51.09,84
CDM,30601905,AZOLE PANEL X4,46.0,29.9,3.28,51.09,84
CDM,30601915,%HIVPHE ANALYSIS NUCLEIC ACID,3372.0,2191.8,109.69,3372.0,84
CDM,30601925,FUNGAL CULTURE SKIN,53.0,34.45,3.8,59.38,84
CDM,30601935,"CULTURE, FUNGAL ISOLATION, HAIR, SKIN, NAIL",53.0,34.45,3.8,59.38,84
CDM,30601945,"ASPER GALACTOMAN, BAL",83.0,53.95,5.92,92.38,84
CDM,30601955,OCULAR CMV PCR,242.0,157.3,17.33,242.0,84
CDM,30601965,CMV BONE MARROW,242.0,157.3,17.33,242.0,84
CDM,30601975,OCULAR HSV 1&2 PCR X2,242.0,157.3,17.33,270.23,84
CDM,30601985,%AFBPCR MYCOBACT PROBE,333.0,216.45,19.3,333.0,84
CDM,30602000,*SMEAR FLUORESCENT/ACID STAIN,37.0,24.05,2.66,37.0,84
CDM,30602005,BK VIRUS QUANT URINE,296.0,192.4,21.15,309.32,84
CDM,30602015,HERPESVIRUS 7 PCR QUANT,296.0,192.4,21.15,309.32,84
CDM,30602025,ADENOVIRUS PCR QUANT,296.0,192.4,21.15,309.32,84
CDM,30602035,ZIKA RT-PCR,242.0,157.3,19.88,242.0,84
CDM,30602045,STREP SCREEN,116.0,75.4,6.72,116.0,84
CDM,30602055,CMV PCR M4,242.0,157.3,17.33,242.0,84
CDM,30602065,HSV PCR OCULAR FLD,242.0,157.3,17.33,270.23,84
CDM,30602075,HSV 1&2 QT PCR BAL X2,296.0,192.4,21.15,458.88,84
CDM,30602085,HPV DNA HI RISK ANL RECT,242.0,157.3,19.1,242.0,84
CDM,30602095,RSV RAPID PCR,242.0,157.3,19.88,242.0,84
CDM,30602105,RT-QULC ANALYSIS CSF,242.0,157.3,19.88,242.0,84
CDM,30602115,%MTBAM1 PROBE PCR,242.0,157.3,19.88,242.0,84
CDM,30602150,*INFECT AGENT NOS EIA MULT,83.0,53.95,11.98,83.0,84
CDM,30602220,TROFILE CO-RECEPTOR,3154.0,2050.1,16.64,3154.0,66
CDM,30602270,HIV-1 AG EIA,166.0,107.9,9.62,166.0,84
CDM,30602375,RSV EIA,96.0,62.4,5.92,96.0,84
CDM,30602380,*HERPES SIMPLEX DNA AMPL PROBE,242.0,157.3,17.33,270.23,84
CDM,30602430,*INFECT AGENT NOS AMPL PROBE,242.0,157.3,17.33,242.0,84
CDM,30602580,"SMEAR, BLOOD PARASITE",41.0,26.65,2.96,58.34,84
CDM,30605860,*CHLAMYDIA TRACH DNA AMPL PROB,242.0,157.3,19.88,242.0,84
CDM,30605870,*NEISSERIA GONORR DNA AMPL,242.0,157.3,19.88,242.0,84
CDM,30605880,HHV-6A HHV-6B QT PCR,288.0,187.2,20.62,321.49,84
CDM,30605900,GENOSURE INTEGRASE,888.0,577.2,49.14,888.0,84
CDM,30606030,*MYCOBACTERIA AMPLIF NA PROBE,333.0,216.45,19.3,333.0,84
CDM,30606050,*DNA/RNA;MULTI ORG-AMP PR,484.0,314.6,33.62,484.0,84
CDM,30606070,MYCOBACTERIA TB AMPLIFIED PROBE,288.0,187.2,17.33,288.0,84
CDM,30606110,SUSCEPTIBILITY MACROBROTH,46.0,29.9,3.28,51.09,84
CDM,30606120,*HEP B SURFACE AG EIA,71.0,46.15,5.1,71.0,84
CDM,30606220,HIV 1 GENOTYPE RNA REVERSE,1776.0,1154.4,116.49,1776.0,84
CDM,30606300,"PROCESSING, FLUID CONCENTRATION",46.0,29.9,3.3,46.0,84
CDM,30606340,TRICHOMONAS VAGINALIS AMPLIF,242.0,157.3,19.15,242.0,84
CDM,30606470,HPV TYPES 16 & 18 ONLY,280.0,182.0,17.33,280.0,84
CDM,30606480,HIV ANTIGEN W/HIV ANTIBODIES (POINT OF CARE LAB),90.0,58.5,13.11,98.72,84
CDM,30606510,GENOTYPE DNA HIV OTHER REGION,888.0,577.2,49.14,888.0,84
CDM,30606685,UREAPLASMA SPECIES BY PCR,242.0,157.3,19.88,242.0,84
CDM,30606695,%HIVGEN PHENOTYPE,899.0,584.35,49.14,899.0,84
CDM,30606705,HIV I/II POST EXP AG SRN,111.0,72.15,6.43,111.0,84
CDM,30606725,GC DNA PROBE,242.0,157.3,19.88,242.0,84
CDM,30606735,"GIARDIA ANTIGEN, STOOL",83.0,53.95,5.92,83.0,84
CDM,30606745,"QUANTIFICATION, BK VIRUS",296.0,192.4,21.15,309.32,84
CDM,30606755,INFLUENZA A&B MOLECULAR (POINT OF CARE LAB),661.0,429.65,49.14,661.0,84
CDM,30606765,RAPID BACTERIAL VAGINOSIS,84.0,54.6,12.22,84.0,84
CDM,30606925,"AMPLIFICATION, MYCOBACTERIA TUBERCULOSIS",288.0,187.2,17.33,288.0,84
CDM,30606935,%CTNG CTRACH SUREPATH TMA,242.0,157.3,19.88,242.0,84
CDM,30606945,%CTNG NGONORRHAE SUREPATH,242.0,157.3,19.88,242.0,84
CDM,30606955,%HIVPHS PHENO EA ADD X12,180.0,117.0,12.87,180.0,84
CDM,30606965,%HIVPHS PHENO 1-10 DRUGS,3372.0,2191.8,109.69,3372.0,84
CDM,30606975,UREAPLASMA PCR X2,242.0,157.3,19.88,242.0,84
CDM,30606985,%CTNG CTRACH SUREPATH TMA,242.0,157.3,19.88,242.0,84
CDM,30606995,CARBAPENEM RESISTANCE GENE PCR,242.0,157.3,19.88,242.0,84
CDM,30607020,TYPING BY IMMUNOLOGIC METHOD,36.0,23.4,2.56,36.0,84
CDM,30607085,CHLAMYDIATRACH AMP OCULAR,242.0,157.3,19.88,242.0,84
CDM,30607095,NGONORRHOEAE AMP OCULAR,242.0,157.3,19.88,242.0,84
CDM,30607105,%CTNGAO CHLAMYDIA OCULAR,242.0,157.3,19.88,242.0,84
CDM,30607115,%CTNGAO NGONORRHOEAE OCUL,242.0,157.3,19.88,242.0,84
CDM,30607135,CHLAMYDIA DNA PROBE,242.0,157.3,19.88,242.0,84
CDM,30607145,STOOL GASTROINT PNL PCR,2876.0,1869.4,49.14,2876.0,84
CDM,30607155,CYTOCHROME P450 2D6 GENO,3111.0,2022.15,109.69,3111.0,84
CDM,30607205,EHRLICHIA/ANAPLASMA PCR,242.0,157.3,19.88,242.0,84
CDM,30607215,C TRACHOMATIS DFA,83.0,53.95,5.92,83.0,84
CDM,30607225,NFCT AGENT DETECTION GI,885.0,575.25,49.14,885.0,84
CDM,30607235,JC VIRUS QUANT PCR,296.0,192.4,21.15,309.32,84
CDM,30607245,RSV RAPID PCR,484.0,314.6,33.62,484.0,84
CDM,30607255,ZIKA VIRUS RT-PCR,354.0,230.1,17.63,354.0,84
CDM,30607265,"ZIKA VIRUS RT-PCR, UR",354.0,230.1,17.63,354.0,84
CDM,30607275,HERPES TYPING,38.0,24.7,2.75,38.0,84
CDM,30607285,BK VIRUS PCR QUAL BLD,242.0,157.3,19.88,242.0,84
CDM,30607295,MOLD SUSCEPT 3 DRUGS X3,46.0,29.9,3.28,51.09,84
CDM,30607305,MUMPS VIRUS BY PCR,242.0,157.3,19.88,242.0,84
CDM,30607315,GNB BLD CULT ID VERIGENE,138.0,89.7,9.9,138.0,84
CDM,30607325,GPC BLD CULT ID VERIGENE,138.0,89.7,9.9,138.0,84
CDM,30607335,%HSVCUL VIR INNOC TISSUE,180.0,117.0,12.87,180.0,84
CDM,30607345,%HSVCUL VIR INNOC TIS ADD,139.0,90.35,9.98,155.51,84
CDM,30607355,HSV PCR MISC SPEC,242.0,157.3,17.33,270.23,84
CDM,30607365,HCV NS5A DRG RES SEQ,1776.0,1154.4,116.49,1776.0,84
CDM,30607425,"BACTERIAL PCR, DIRECT SPEC",484.0,314.6,33.62,484.0,84
CDM,30607435,ENTEROVIRUS PCR PLASMA,242.0,157.3,17.33,242.0,84
CDM,30607445,CULTURE TYPE IMMUNOLOGIC,36.0,23.4,2.56,36.0,84
CDM,30607455,E COLI AGGL,36.0,23.4,2.56,36.0,84
CDM,30607465,HAEMOPHILUS AGGL,36.0,23.4,2.56,36.0,84
CDM,30607475,SHIGELLA AGGL,36.0,23.4,2.56,36.0,84
CDM,30607485,SALMONELLA AGGL,36.0,23.4,2.56,36.0,84
CDM,30607495,URMPCR DETECT AGENT NOS DNA AMP,242.0,157.3,19.88,242.0,84
CDM,30607525,MTBCSF DET AG NOS DNA AMP,242.0,157.3,19.88,242.0,84
CDM,30607535,ROTAD ADENOV 40-41,83.0,53.95,5.92,83.0,84
CDM,30607545,%ROTAD ROTAVIRUS,83.0,53.95,5.92,83.0,84
CDM,30607575,HEPATITIS D VIRUS QNT PCR,296.0,192.4,21.15,309.32,84
CDM,30607585,IN HOUSE CULT ANTIGEN DFA,135.0,87.75,9.66,135.0,84
CDM,30607595,HEPATITIS E QNT PCR,296.0,192.4,21.15,309.32,84
CDM,30607605,CAMPYLOBACTER AG,83.0,53.95,11.98,83.0,84
CDM,30607615,HBV DRUG RESISTANCE SEQ,1776.0,1154.4,49.14,1776.0,84
CDM,30607625,IDM HIV-1 DNA BY PCR,242.0,157.3,17.33,242.0,84
CDM,30607635,JCV DNA QNT RT-PCR CSF,296.0,192.4,21.15,309.32,84
CDM,30607645,NY BK VIRUS QNT PCR BLD,296.0,192.4,21.15,309.32,84
CDM,30607655,NY CYTOMEG QNT PCR,296.0,192.4,21.15,296.0,84
CDM,30607665,NY EBV QNT PCR,296.0,192.4,21.15,309.32,84
CDM,30607675,C DIFF CYTOTOX CELL ASY,136.0,88.4,9.75,136.0,84
CDM,30607685,HEPATITIS DELTA AG,127.0,82.55,8.1,127.0,84
CDM,30607695,CYTOMEGALOVIRUS,135.0,87.75,9.66,135.0,84
CDM,30607705,MYCOPLASMA GENITALIUM PCR,242.0,157.3,14.04,242.0,84
CDM,30607715,URMPCR MYCOPLAS GENITALIUM AMP,242.0,157.3,14.04,242.0,84
CDM,30607725,"AMPLIFIED PROBE, VARICELLA ZOSTER VIRUS",242.0,157.3,19.88,242.0,84
CDM,30607735,HSV DNA AMP PROBE X2,242.0,157.3,17.33,270.23,84
CDM,30607745,WHIIVF HIV 1&2 AG/AB,166.0,107.9,11.89,166.0,84
CDM,30607755,WHIIVF *%HEP HBSAG,71.0,46.15,5.1,71.0,84
CDM,30607765,WHIIVF CHLAMYDIA TRACH AM,242.0,157.3,19.88,242.0,84
CDM,30607775,WHIIVF GC AMP,242.0,157.3,19.88,242.0,84
CDM,30607785,COVID19 SENDOUT,354.0,230.1,16.64,354.0,85
CDM,30607795,COVID19 INHOUSE,354.0,230.1,16.64,354.0,85
CDM,30607805,RPRAPD CHLAMYDIA PNEU AMP,242.0,157.3,17.33,789.1,84
CDM,30607815,RPRAPD M.PNEUM AMP PRB,242.0,157.3,17.33,242.0,84
CDM,30607825,RPRAPD INFLUENZA RAPID PCR,984.0,639.6,49.14,984.0,84
CDM,30607835,RPRAPD INFECT AGENT NOS AMP,242.0,157.3,19.88,242.0,84
CDM,30607845,COVID19 INHOUSE,354.0,230.1,20.52,354.0,85
CDM,30607855,COVID19 SENDOUT,354.0,230.1,20.52,354.0,85
CDM,30607865,AG DETECT NOS IA MULT,83.0,53.95,11.98,83.0,84
CDM,30607875,ASPERGILLUS DNA QL PCR,242.0,157.3,19.88,242.0,84
CDM,30607885,HPVSFX HPV HIGH-RISK TYPE,242.0,157.3,19.1,242.0,84
CDM,30607935,COVID19 SENDOUT,248.0,161.2,14.37,248.0,85
CDM,30607945,COVID19 INHOUSE,248.0,161.2,14.37,248.0,85
CDM,30607955,"FILM ARRAY, RESPIRATORY 22 TARGETS",2876.0,1869.4,109.69,2876.0,84
CDM,30607965,UCTGC CHLAMYDIA TRACH AMP,242.0,157.3,19.88,242.0,84
CDM,30607975,UCTGC GC AMPLIFICATION,242.0,157.3,19.88,242.0,84
CDM,30608005,SARSCOV2 & INF A&B AMP PRB,984.0,639.6,33.62,984.0,85
CDM,30608025,SARSCOV2 & INF A&B AMP PRB,984.0,639.6,33.62,984.0,85
CDM,30608035,ADENOVIRUS QT RT-PCR,296.0,192.4,21.15,309.32,84
CDM,30608045,BCID DNA/RNA AMP PROBE,242.0,157.3,17.33,242.0,84
CDM,30608065,CNS DNA AMP PROBE TYPE 12-25,2876.0,1869.4,49.14,2876.0,84
CDM,30608075,HIVNGS PHENOTYPE INFECT AGENT DRUG,899.0,584.35,49.14,899.0,84
CDM,30608085,HIVNGS GENOTYPE DNA HIV REVERSE T,1776.0,1154.4,116.49,1776.0,84
CDM,30608095,HIVNGS GENOTYPE DNA/RNA HIV,888.0,577.2,49.14,888.0,84
CDM,30608105,CANDIDA DNA AMP PROBE,242.0,157.3,19.88,242.0,84
CDM,30608115,"SUSCEPTIBILITY, AGAR DILUTION, PER AGENT",33.0,21.45,2.34,33.0,84
CDM,30608125,"SUSCEPTIBILITY, DISK METHOD, PER PLATE",52.0,33.8,3.4,53.16,84
CDM,30608135,CYTOMEGALOVIRUS CMV,242.0,157.3,17.33,242.0,84
CDM,30608145,"IDENTIFICATION, BLOOD PATHOGEN PANEL",1505.0,978.25,49.14,1505.0,84
CDM,30608155,BACTERIAL VAGINOSIS AMPLIFICATION,984.0,639.6,57.05,984.0,84
CDM,30608195,HSVCUL GENETIC VIRUS ISOLATION HSV,234.0,152.1,16.72,234.0,84
CDM,30608205,PCRHSV HSV DNA AMP PROBE X2,242.0,157.3,17.33,270.23,84
CDM,30608215,MYPCRF DETECT AGENT NOS DNA AMP,242.0,157.3,19.88,242.0,84
CDM,30608225,MONKEYPOX VIRUS QUAL PCR,242.0,157.3,19.88,242.0,84
CDM,30608235,MONKEYPOX VIRUS QUAL PCR,354.0,230.1,17.33,1851898.14,83
CDM,30608245,BK VIRUS QUANT URINE,296.0,192.4,21.15,309.32,84
CDM,30608255,LYMPHOGRANULOMA VENEREUM PCR,242.0,157.3,19.88,242.0,84
CDM,30608265,CRYPTOCOCCUS AG DETECTION,111.0,72.15,6.43,111.0,84
CDM,30608275,"AMPLIFICATION, ORTHOPOX VIRUS",354.0,230.1,17.33,1851898.14,83
CDM,30608285,UREAPLASMA SPECIES MOLEC DETEC PCR FLU TIS,242.0,157.3,19.88,242.0,84
CDM,30608305,ADENOVIRUS PCR,242.0,157.3,19.88,242.0,84
CDM,30608315,EHRANA ANAPLSMA PHGCYTOPHLM AMP PRB,242.0,157.3,14.04,242.0,84
CDM,30608325,EHRANA EHRLICHA CHAFFEENSIS AMP PRB,242.0,157.3,14.04,242.0,84
CDM,30608335,"EPSTEIN-BARR VIRUS BY QUALITATIVE PCR, CSF",242.0,157.3,19.88,242.0,84
CDM,30608345,AMBCAN AMPHOTERICIN B/CANDIN SUSCEPTIBILITY PANEL X4,46.0,29.9,3.28,51.09,84
CDM,30608355,CYTSEQ PHENOTYPE INFECT AGENT DRUG,899.0,584.35,49.14,899.0,84
CDM,30608365,"CYTOMEGALOVIRUS (CMV) PCR, AMNIOTIC FLUID",242.0,157.3,17.33,242.0,84
CDM,30608375,"PARVOVIRUS B19 PCR, AMNIOTIC FLUID",242.0,157.3,19.88,242.0,84
CDM,30608385,"TOXOPLASMA GONDII, PCR, AMNIOTIC FLUID",242.0,157.3,19.88,242.0,84
CDM,30608395,"AMPLIFICATION, EXPEDITED, COVID, FLU A/B, RSV",925.0,601.25,33.62,925.0,85
CDM,30608405,"COVID & INFLUENZA A/B & RSV NAAT, ROUTINE",984.0,639.6,33.62,984.0,85
CDM,30608415,HPV SCREEN BY TMA (ARUP),242.0,157.3,19.1,242.0,84
CDM,30608425,HEPATITIS DELTA VIRUS BY QUANTITATIVE PCR,296.0,192.4,17.14,296.0,83
CDM,30608435,HPV GENOTYPE BY TMA (ARUP REFLEX),280.0,182.0,17.33,280.0,84
CDM,30608455,POTASSIUM HYDROXIDE (KOH) PREPS (POC) (POINT OF CARE LAB),40.0,26.0,5.83,40.0,84
CDM,30608465,"HISTOPLASMA GALACTOMANNAN EIA, BAL",91.0,59.15,5.92,92.38,84
CDM,30608475,"HISTOPLASMA GALACTOMANNAN EIA, CSF",91.0,59.15,5.92,92.38,84
CDM,30608485,OIL TEST (SCABIES) (POC) (POINT OF CARE LAB),153.0,99.45,8.96,153.0,84
CDM,30608495,"ACANTHAMOEBA SPECIES DETECTION, PCR",242.0,157.3,19.88,242.0,84
CDM,30608505,MUCORALES BY PCR,242.0,157.3,19.88,242.0,84
CDM,30608515,HHV8 BY QUANTITATIVE PCR,296.0,192.4,21.15,309.32,84
CDM,30608555,"SUSCEPTIBILITY, MULTI-ANTIMICROBIAL VITEK",60.0,39.0,4.27,60.0,84
CDM,30608565,"SUSCEPTIBILITY, MULTI-ANTIMICROBIAL PHOENIX",60.0,39.0,4.27,60.0,84
CDM,30608575,"SUSCEPTIBILITY, MULTI-ANTIMICROBIAL SENSITITRE",60.0,39.0,4.27,60.0,84
CDM,30608585,"PROCESSING, CYTOSPIN",46.0,29.9,3.3,46.0,84
CDM,30608595,"AMPLIFICATION, RIFAMPIN RESISTANCE",242.0,157.3,19.88,242.0,84
CDM,30608605,"IDENTIFICATION, OTHER METHODS",53.0,34.45,3.1,53.0,84
CDM,30608615,"SMEAR, ACID FAST FLUORESCENT",37.0,24.05,2.66,37.0,84
CDM,30608625,"SUSCEPTIBILITY, MULTI-ANTIMICROBIAL AFB",60.0,39.0,4.27,60.0,84
CDM,30608635,PROCESSING AFB REDIGESTION,46.0,29.9,3.3,46.0,84
CDM,30608645,"AMPLIFICATION, RIFAMPIN RESISTANCE",242.0,157.3,19.88,242.0,84
CDM,30608665,HIV-1 RNA,242.0,157.3,17.33,242.0,84
CDM,30608675,HIV-2 RNA,242.0,157.3,17.33,270.23,84
CDM,30608685,COVID-19 MOLECULAR (POINT OF CARE LAB),354.0,230.1,20.52,354.0,85
CDM,30608695,COVID-19 MOLECULAR (POC) & INFLUENZA A&B MOLECULAR (POC),984.0,639.6,33.62,984.0,85
CDM,30608705,RSV RAPID PCR (POINT OF CARE LAB),484.0,314.6,33.62,484.0,84
CDM,30608715,IADNA HPV SEP RPRT HI-RSK TYP&HI-RSK POOLD RSLTS,484.0,314.6,33.62,484.0,82
CDM,30608725,"AMPLIFIED PROBE, PNEUMOCYSTIS JIROVECII",242.0,157.3,33.62,242.0,82
CDM,30608735,"AMPLIFICATION, MYCOBACTERIUM TUBERCULOSIS",530.0,344.5,33.62,530.0,82
CDM,30608745,MTB RIF RES,530.0,344.5,33.62,530.0,82
CDM,30608755,STREP PNEUMO ABS X14,106.0,68.9,28.66,106.0,76
CDM,30608775,"SEQUENCING, INFLUENZA",661.0,429.65,49.14,661.0,84
CDM,30608785,RSV IA W DIR OBSERV (POINT OF CARE LAB),90.0,58.5,13.1,90.0,84
CDM,30608795,"IDENTIFICATION, AEROBIC ISOLATE (POINT OF CARE LAB)",56.0,36.4,8.08,62.24,84
CDM,30608805,PINWORM PREP PERIANAL (POINT OF CARE LAB),29.0,18.85,2.11,29.0,84
CDM,30608815,MEASLES VIRUS QUAL NAAT,242.0,157.3,19.88,242.0,84
CDM,30608835,GROUP A STREP PCR (POINT OF CARE LAB),242.0,157.3,33.62,242.0,84
CDM,30608845,FLUPCR RAPID PCR FLU (POINT OF CARE LAB),661.0,429.65,49.14,661.0,84
CDM,30608855,COVID19 INHOUSE (POINT OF CARE LAB),354.0,230.1,20.52,354.0,85
CDM,30608865,PLASMODIUM SP DIFF PCR X5,242.0,157.3,19.88,242.0,84
CDM,30608875,"GASTROINTESTINAL PANEL, 5 VIRAL TARGETS",885.0,575.25,49.14,885.0,84
CDM,30608915,"SUSCEPTIBILITY, CARBAPENAMASE ENZYME DETECTION, PER ISOLATE",260.0,169.0,1.9,260.0,66
CDM,30608925,"AMPLIFIED PROBE, GC/CT",484.0,314.6,16.64,484.0,76
CDM,30608945,"SHORT TANDEM REPEAT ANALYSIS FOR SPECIMEN IDENTIFICATION, OTHER",484.0,314.6,16.64,484.0,76
CDM,30608955,"ENTEROVIRUS, REAL-TIME PCR, AMNIOTIC FLUID",242.0,157.3,17.33,242.0,84
CDM,30608965,"AMPLIFICATION, STREPTOCOCCUS, GROUP B WITH LIM BROTH",242.0,157.3,17.33,242.0,84
CDM,30620OH,SEPTAL/OTHER INTRANASAL DERMATOPLASTY,2464.0,1601.6,1.1,17080.38,144
CDM,30630OH,REPAIR NASAL SEPTAL PERFORATIONS,2916.0,1895.4,1.1,9391.15,144
CDM,30700005,URINALYSIS NONAUTO W SCPE (POINT OF CARE LAB),28.0,18.2,4.02,28.0,84
CDM,30700010,URINALYSIS AUTO W SCPE,22.0,14.3,3.17,22.0,84
CDM,30700015,N-AUTOM URINALYS WO MICRO (POINT OF CARE LAB),24.0,15.6,3.48,24.0,84
CDM,30700020,URINALYSIS AUTO WO SCPE,16.0,10.4,2.25,17.31,84
CDM,30700025,"URINANALYSIS, QUAL OR SEMI-QUANT",15.0,9.75,1.07,15.0,84
CDM,30700030,PREGNANCY TEST URINE (POINT OF CARE LAB),59.0,38.35,6.37,59.0,84
CDM,30700035,URINALYSIS MICROSCOP ONLY,21.0,13.65,3.05,21.0,84
CDM,30700045,VOL MEASURE TIMED UR OUT,25.0,16.25,1.48,25.0,84
CDM,30700055,URINALYSIS WITH MICRO (POINT OF CARE LAB),22.0,14.3,3.17,22.0,84
CDM,30700065,URINALYSIS ONLY,16.0,10.4,2.25,17.31,84
CDM,30700075,HCG URINE (POINT OF CARE LAB),59.0,38.35,6.37,59.0,84
CDM,30700105,"ADULTERANTS SURVEY, UR",15.0,9.75,1.07,15.0,84
CDM,30700195,URINALYSIS AUTO WO SCPE (POINT OF CARE LAB),16.0,10.4,2.25,17.31,84
CDM,30700205,URINALYSIS MICROSCOP ONLY (POINT OF CARE LAB),21.0,13.65,3.05,21.0,84
CDM,30801OH,ABLTJ SOFT TIS INFERIOR TURBINATES UNI/BI SUPFC,456.0,296.4,1.1,4447.63,148
CDM,30802OH,ABLTJ SOF TISS INF TURBS UNI/BI SUPFC INTRAMURAL,832.0,540.8,1.1,4447.63,148
CDM,30808765,"PROCESSING, THICK SMEAR PREPARATION",46.0,29.9,3.3,46.0,84
CDM,30900025,LAMELLAR BODY COUNT,133.0,86.45,9.34,133.0,84
CDM,30900045,CELL COUNT & DIFF,39.0,25.35,2.72,42.4,83
CDM,30900055,EXAM SYNOVIAL FLUID CRYSTALS,51.0,33.15,3.53,51.0,83
CDM,30900065,EOSINOPHIL SMEAR MISC,40.0,26.0,2.34,40.0,83
CDM,30900295,MISC SENDOUT CPT 83150,155.0,100.75,9.56,155.0,84
CDM,30900355,FECAL LEUKOCYTES,29.0,18.85,2.11,32.88,83
CDM,30900365,HIV 1 HIV 2 SNGL ASSAY AB,95.0,61.75,6.77,95.0,84
CDM,30900375,HIV-1/2 AG/AB COMBO,111.0,72.15,6.43,111.0,84
CDM,30901OH,CONTROL NASAL HEMORRHAGE ANTERIOR SIMPLE,440.0,286.0,1.1,521.9,148
CDM,30903OH,CONTROL NASAL HEMORRHAGE ANTERIOR COMPLEX,678.0,440.7,1.1,814.94,148
CDM,30905OH,CTRL NSL HEMRRG PST NASAL PACKS&/CAUTERY 1ST,867.0,563.55,1.1,1162.67,148
CDM,30906OH,CTRL NSL HEMRRG PST NASAL PACKS&/CAUTERY SUBSQ,1078.0,700.7,1.1,1236.48,148
CDM,30915OH,LIGATION ARTERIES ETHMOIDAL,2976.0,1934.4,1.1,9296.26,144
CDM,30920OH,LIGATION ARTERIES INT MAXILLARY TRANSANTRAL,4902.0,3186.3,1.1,9296.26,144
CDM,30930OH,FRACTURE NASAL INFERIOR TURBINATE THERAPEUTIC,524.0,340.6,1.1,9391.15,144
CDM,30999RVU1OH,EXCISION MIDDLE TURBINATE,1145.0,744.25,0.01,1145.0,84
CDM,30999RVU2OH,NASAL SURGERY PROCEDURE,1194.0,776.1,0.01,1194.0,84
CDM,30999RVU3OH,EXCISION OF MIDDLE TURBINATE (COMP 30130),1145.0,744.25,0.01,1145.0,84
CDM,30999RVU4OH,CRYOABLATION OF NASAL NERVE,1076.0,699.4,0.01,1076.0,84
CDM,30999RVU5OH,BIL REPR NASAL VESTIB STEN W/POLY IMPLNT; LATERA (COMP 31295),1336.0,868.4,0.01,1336.0,84
CDM,30999RVU6OH,UNLISTED PROC; NASAL SURG PROC (COMP TO 30465),4079.0,2651.35,0.01,4079.0,84
CDM,30999RVU7OH,UNLISTED PROC; CRYOABLATION THPY INTRANASAL NERVE(S) MULTIPLE (C,1076.0,699.4,0.01,1076.0,84
CDM,30999RVU8OH,ENDOSCOPIC REMOVAL OF NASAL FOREIGN BODY?(COMP CODE 31238),1165.0,757.25,0.01,1165.0,84
CDM,30999RVUOH,ENDOSCOPIC RESECTION OF NASAL LESION (COMP 30117),1076.0,699.4,0.01,1076.0,84
CDM,31000025,BONE MARROW ROUTINE,5637.0,3664.05,11.81,5637.0,87
CDM,31000045,%CHROMO BLD TISSUE CULT,804.0,522.6,60.74,804.0,83
CDM,31000055,CHROM TISSUE CULT PROCESS,971.0,631.15,60.74,1083.61,83
CDM,31000065,CHROM POC CULTURE PROCESS,1037.0,674.05,60.74,1037.0,83
CDM,31000075,CHROM LEUK BLD CULT PROC,992.0,644.8,60.74,992.0,83
CDM,31000085,%CHROMO SOL TUMOR CULTURE,1018.0,661.7,60.74,1026.15,83
CDM,31000095,%IN VITRO CULT CRYO/STORE,90.0,58.5,8.96,90.0,83
CDM,31000100,SPEC STN GRP II,126.0,81.9,35.63,138.46,86
CDM,31000105,%CHROMO POC KARY 15-20,866.0,562.9,83.94,866.0,83
CDM,31000115,%UROFISH MOLE GEN DNA X4,148.0,96.2,21.42,164.91,83
CDM,31000135,YQHFSH 10-30 CELLS,240.0,156.0,34.81,240.0,83
CDM,31000140,CISH EA PROBE,673.0,437.45,68.5,673.0,86
CDM,31000155,%1221FH HYBRIDIZAT,353.0,229.45,51.19,353.0,83
CDM,31000160,PAP SMR THN PRP,140.0,91.0,15.29,140.0,83
CDM,31000175,%AHTBX PATH LVL V,2482.0,1613.3,68.5,2482.0,86
CDM,31000180,SPEC STN GRP I,207.0,134.55,37.39,207.0,86
CDM,31000185,"SPECIAL STAIN GRP I EA, SEMEN",207.0,134.55,37.39,207.0,86
CDM,31000195,"SPECIAL STAIN GRP II EA, SEMEN",126.0,81.9,35.63,138.46,86
CDM,31000205,%REFMYL IHC REFLEX MY X2,1182.0,768.3,68.5,1182.0,86
CDM,31000215,DIRECT IMMUNOFLUOR-EACH,1182.0,768.3,68.5,1182.0,86
CDM,31000225,%AHTBX ELEC MICR,5637.0,3664.05,68.5,5637.0,86
CDM,31000235,INSITU HYBRID EA PROBE,673.0,437.45,68.5,673.0,86
CDM,31000240,"*SPEC STN GRP II, REV TO 312",126.0,81.9,35.63,138.46,86
CDM,31000245,FISH PLASMA CELL PROBE,2482.0,1613.3,68.5,2482.0,86
CDM,31000265,ATMS MICRODISECTION,519.0,337.35,68.5,519.0,68
CDM,31000275,%MSI3 MICRO DELETION X3,519.0,337.35,37.39,519.0,68
CDM,31000285,PARATHYROID GLAND CRYOPRESERVA,335.0,217.75,45.47,335.0,84
CDM,31000295,CRYOPS WITHDRAW,369.0,239.85,45.47,369.0,84
CDM,31000300,SURGERY PATH GROSS MICRO LEVEL 4,369.0,239.85,37.39,369.0,86
CDM,31000325,"LABCORP CMBP CHROMOSOME ANALYSIS, CHORIONIC VILLUS",1037.0,674.05,60.74,1037.0,83
CDM,31000335,%CHHEMA TISSU CULT BN MAR,992.0,644.8,60.74,992.0,83
CDM,31000345,BMHSNP MOPATH LVL 7,1952.0,1268.8,113.15,3582.53,84
CDM,31000355,%INV16F PROBE X2,148.0,96.2,21.42,164.91,83
CDM,31000360,*MICRODISECTION MANUAL,519.0,337.35,37.39,519.0,68
CDM,31000365,%FSHPCM DNA PROBE,148.0,96.2,21.42,164.91,83
CDM,31000370,INSITU HYBRID EA PROBE,673.0,437.45,68.5,673.0,86
CDM,31000375,%WMS CHROMO HYBRID,240.0,156.0,34.81,240.0,83
CDM,31000385,%FSHPCM ANALY 25-99,292.0,189.8,42.38,292.0,83
CDM,31000390,INSITU HYBRID EA PROBE MAN,2482.0,1613.3,68.5,2482.0,86
CDM,31000395,%CHROMO HEM KAROTYPES,866.0,562.9,83.94,866.0,83
CDM,31000405,%CHHEMA CHROM ANLY 20-25,998.0,648.7,116.49,998.0,83
CDM,31000415,%CVC CHROMOSOME ANALYSIS,1301.0,845.65,116.49,1301.0,83
CDM,31000465,"CHROMOSOME ANAL, KAROTYPE EA",231.0,150.15,33.47,231.0,83
CDM,31000470,IMMUNO H/C EA ADDTL AB STAIN,247.0,160.55,37.39,247.0,68
CDM,31000555,CISH HPV LOW RISK ADTL,935.0,607.75,37.39,935.0,68
CDM,31000580,M/PHMTRC ALYS ISHQUANT/SEMIQ,1182.0,768.3,68.5,1182.0,86
CDM,31000620,INSITU HYBRIDIZATION DUAL,1182.0,768.3,68.5,1182.0,86
CDM,31000670,IMMUNOFLUOR ADDTL,249.0,161.85,1.73,249.0,68
CDM,31000710,INSITU HYBRIDIZATION (FISH),673.0,437.45,68.5,673.0,86
CDM,31000715,FISH ALK NSCLC X2,2482.0,1613.3,68.5,2482.0,86
CDM,31000725,BILIARY TRACT FISH,1182.0,768.3,68.5,1182.0,86
CDM,31000815,REFLEX FISH HER2/D17,1182.0,768.3,68.5,1182.0,86
CDM,31000825,%TBPPCR MACROSE EXAM,49.0,31.85,10.68,65.09,68
CDM,31000835,CHRCON BLD TISSUE CULT,804.0,522.6,60.74,804.0,83
CDM,31000855,CISH EA PROBE MOD,673.0,437.45,68.5,673.0,86
CDM,31000865,CISH KAPPA,673.0,437.45,68.5,673.0,86
CDM,31000875,CISH LAMDA,673.0,437.45,68.5,673.0,86
CDM,31000885,FISH FOR C-MYC (8Q24),673.0,437.45,68.5,673.0,86
CDM,31000895,CISH EACH PROBE,673.0,437.45,68.5,673.0,86
CDM,31000905,CISH FOR EPSTEIN BARR,673.0,437.45,68.5,673.0,86
CDM,31000915,CISH EACH PROBE,673.0,437.45,68.5,673.0,86
CDM,31000OH,LAVAGE CANNULATION MAXILLARY SINUS,480.0,312.0,1.1,713.21,148
CDM,31001005,%ISIGHT TIS CULT AM FLX2,1037.0,674.05,60.74,1037.0,83
CDM,31001015,CELLS PROCESSING AND STORAGE,90.0,58.5,8.96,90.0,83
CDM,31001025,%ISIGHT CHROM AMNIO FLD,1301.0,845.65,116.49,1301.0,83
CDM,31001035,ISIGHT DNA PROBE,148.0,96.2,21.42,164.91,83
CDM,31001085,%CHROMO CULT AMNIOTIC,148.0,96.2,21.42,164.91,83
CDM,31001095,AMLFSH TIS CULT AM FLX2,148.0,96.2,21.42,164.91,83
CDM,31001105,APLFSH PROBE X2,148.0,96.2,21.42,164.91,83
CDM,31001115,FISH FOR BCR/ABL 1 PROBE X2,148.0,96.2,21.42,164.91,83
CDM,31001125,%CLLFSH PROBE X7,148.0,96.2,21.42,164.91,83
CDM,31001135,%FAMLPN PROBE,148.0,96.2,21.42,164.91,83
CDM,31001145,FISH FOR FGFR1 PROBE X2,148.0,96.2,21.42,164.91,83
CDM,31001155,%FSHBLL PROBE X12,148.0,96.2,21.42,164.91,83
CDM,31001165,%FSHPCM DNA PROBE,148.0,96.2,21.42,164.91,83
CDM,31001175,%MLLFSH PROBE X2,148.0,96.2,21.42,164.91,83
CDM,31001185,FISH FOR PDGFRA PROBE X3,148.0,96.2,21.42,164.91,83
CDM,31001195,FISH FOR PDGFRB PROBE X2,148.0,96.2,21.42,164.91,83
CDM,31001205,%RARFSH PROBE X2,148.0,96.2,21.42,164.91,83
CDM,31001215,%FSHMDS PROBE X6,148.0,96.2,21.42,164.91,83
CDM,31001225,%CHROMO CULT AMNIOTIC,148.0,96.2,21.42,164.91,83
CDM,31001235,%ISIGHT TIS CULT AM FLX2,148.0,96.2,21.42,164.91,83
CDM,31001245,YQHFSH DNA PROBE EA X2,148.0,96.2,21.42,164.91,83
CDM,31001255,%CHROMO CULT AMNIOTIC,148.0,96.2,21.42,164.91,83
CDM,31001265,%ISIGHT TIS CULT AM FLX2,148.0,96.2,21.42,164.91,83
CDM,31001275,FHT410 100-300,353.0,229.45,51.19,353.0,83
CDM,31001285,%IGH/CCND1 BM 100-300,353.0,229.45,51.19,353.0,83
CDM,31001295,%IBDSGI IFA FIRST,1182.0,768.3,68.5,1182.0,86
CDM,31001305,%CROHN IFA FIRST,1182.0,768.3,68.5,1182.0,86
CDM,31001315,%PEMGUS IFL FIRST,1182.0,768.3,68.5,1182.0,86
CDM,31001325,%IBDSGI IFA ADDTL,249.0,161.85,1.73,249.0,68
CDM,31001335,%CROHN IFA ADDTL,249.0,161.85,1.73,249.0,68
CDM,31001345,IMMUNOFLUOR MOD ADDTL,249.0,161.85,1.73,249.0,68
CDM,31001355,%PEMGUS IFL ADDTL,249.0,161.85,1.73,249.0,68
CDM,31001365,%ENTERO AB ADDTL X2,249.0,161.85,1.73,249.0,68
CDM,31001375,DNA CONTENT/CELL CYC ANLS,369.0,239.85,45.47,369.0,86
CDM,31001385,%MYCELL 1ST MRK BLOOD,2482.0,1613.3,60.74,2482.0,86
CDM,31001395,%MYCELL EA ADD MRK BLDX5,149.0,96.85,24.28,149.0,68
CDM,31001405,PATHOLOGY LEVEL 3 MOD,369.0,239.85,37.39,369.0,86
CDM,31001415,%MLYFSH FISH IHC FOR IGH,1182.0,768.3,68.5,1182.0,86
CDM,31001425,FISH CUTANE MELANOMA,1182.0,768.3,68.5,1182.0,86
CDM,31001435,FISH T(8;14)(Q24;Q32),1182.0,768.3,68.5,1182.0,86
CDM,31001485,FISH FOR FKHR GENE,1182.0,768.3,68.5,1182.0,86
CDM,31001495,FISH FOR CHOP GENE,1182.0,768.3,68.5,1182.0,86
CDM,31001505,FISH FOR FUS GENE,1182.0,768.3,68.5,1182.0,86
CDM,31001515,REFLEX FISH HER2/D17,1182.0,768.3,68.5,1182.0,86
CDM,31001525,%CCND1F ANALY 100-300,353.0,229.45,51.19,353.0,83
CDM,31001535,%5QFSH ANALY 100-300,353.0,229.45,51.19,353.0,83
CDM,31001545,%AMLFSH ANALY 100-300,353.0,229.45,51.19,353.0,83
CDM,31001555,%APLFSH ANALY 100-300,353.0,229.45,51.19,353.0,83
CDM,31001565,%BCRFSH ANALY 100-300,353.0,229.45,51.19,353.0,83
CDM,31001575,%CLLFSH ANALY 100-300 X3,353.0,229.45,51.19,353.0,83
CDM,31001585,%FAMLPN ANALY 100-300,353.0,229.45,51.19,353.0,83
CDM,31001595,%FGFR1F ANALY 100-300,353.0,229.45,51.19,353.0,83
CDM,31001605,%FSHBLL ANALY 100-300,353.0,229.45,51.19,353.0,83
CDM,31001615,%PCMEXT ANALY 100-300,353.0,229.45,51.19,353.0,83
CDM,31001625,%MLLFSH ANALY 100-300,353.0,229.45,51.19,353.0,83
CDM,31001635,%PDGFRA ANALY 100-300,353.0,229.45,51.19,353.0,83
CDM,31001645,%PDGFRB ANALY 100-300,353.0,229.45,51.19,353.0,83
CDM,31001655,%RARFSH ANALY 100-300,353.0,229.45,51.19,353.0,83
CDM,31001665,%FSHMDS ANALY 100-300 X3,353.0,229.45,51.19,353.0,83
CDM,31001675,%FSHCON ANALY 100-300,353.0,229.45,51.19,353.0,83
CDM,31001685,%FSHPCM ANALY 100-300,353.0,229.45,51.19,353.0,83
CDM,31001695,%BRAF MICRODISECT MAN,353.0,229.45,51.19,353.0,83
CDM,31001705,%EGFRTI MICRODISECT,353.0,229.45,51.19,353.0,83
CDM,31001715,FISH ALK NSCLC,1182.0,768.3,68.5,1182.0,86
CDM,31001725,FISH FOR AGG B CL LYM,1182.0,768.3,68.5,1182.0,86
CDM,31001735,ALK FISH LUNG NSCLC,1182.0,768.3,68.5,1182.0,86
CDM,31001745,FISH CCND1F PARAFFIN,1182.0,768.3,68.5,1182.0,86
CDM,31001765,%BCL6 BM 100-300,353.0,229.45,51.19,353.0,83
CDM,31001775,%IGH/BCL2 BM 100-300,353.0,229.45,51.19,353.0,83
CDM,31001785,%IGH/CCND1 BM 100-300,353.0,229.45,51.19,353.0,83
CDM,31001795,%INV16F ANALY 100-300,353.0,229.45,51.19,353.0,83
CDM,31001805,%MYC(8Q24) BM 100-300,353.0,229.45,51.19,353.0,83
CDM,31001815,%REFMYL IHC REFLEX MY X2,1182.0,768.3,68.5,1182.0,86
CDM,31001825,IMMUNOFL INITIAL MOD PC,1182.0,768.3,68.5,1182.0,86
CDM,31001835,%1221FH PROBE X2,148.0,96.2,21.42,164.91,83
CDM,31001845,FHT410 PROBE X2,148.0,96.2,21.42,164.91,83
CDM,31001855,%BCL6 BM PROBE X2,148.0,96.2,21.42,164.91,83
CDM,31001865,%IGH/CCND1 BM PROBE X2,148.0,96.2,21.42,164.91,83
CDM,31001875,%IGH/BCL2 BM PROBE X2,148.0,96.2,21.42,164.91,83
CDM,31001885,FGFR1 TISSUE X2,2482.0,1613.3,68.5,2482.0,86
CDM,31001895,FISH FOR BIRC3/MALT1,2482.0,1613.3,68.5,2482.0,86
CDM,31001905,FISH FOR BK VIRUS,1182.0,768.3,68.5,1182.0,86
CDM,31001915,%PCMEXT ANALY 25-99,292.0,189.8,42.38,292.0,83
CDM,31001925,CISH HPV HR TC/CISH HPV HR + LR TC X2/CISH HPV LR TC/CISH EBER T,673.0,437.45,68.5,673.0,86
CDM,31001935,%CHRMDS CULT PROC,992.0,644.8,60.74,992.0,83
CDM,31001945,%CHRMDS KARY 15-20,866.0,562.9,83.94,866.0,83
CDM,31001955,%CROHN IFA FIRST,1182.0,768.3,68.5,1182.0,86
CDM,31001965,%PEMGUS IFL FIRST,1182.0,768.3,68.5,1182.0,86
CDM,31002095,%FISH7Q PROBE X2,148.0,96.2,21.42,164.91,83
CDM,31002105,%20Q8FH PROBE X2,148.0,96.2,21.42,164.91,83
CDM,31002115,%BCL2FH PROBE X2,148.0,96.2,21.42,164.91,83
CDM,31002125,%814FSH PROBE X2,148.0,96.2,21.42,164.91,83
CDM,31002135,%FABCFP PROBE X8,148.0,96.2,21.42,164.91,83
CDM,31002145,%BCL2FH ANALY 100-300,353.0,229.45,51.19,353.0,83
CDM,31002155,%814FSH ANALY 100-300,353.0,229.45,51.19,353.0,83
CDM,31002165,%20Q8FH ANALY 100-300,353.0,229.45,51.19,353.0,83
CDM,31002175,%FABCFP ANALY 100-300 X4,353.0,229.45,51.19,353.0,83
CDM,31002185,%FISH7Q ANALY 100-300,353.0,229.45,51.19,353.0,83
CDM,31002195,%HIVPHS PHENOTYPE,899.0,584.35,49.14,899.0,84
CDM,31002205,%HIVPHS GENOTYPE,1776.0,1154.4,116.49,1776.0,84
CDM,31002215,%NRAST MICRODISSECT,519.0,337.35,37.39,519.0,68
CDM,31002225,%IDH12F MICRODISECT TECH,519.0,337.35,37.39,519.0,68
CDM,31002245,WASHING HEMATOPOIETIC CELLS,1749.0,1136.85,376.61,2453.0,84
CDM,31002405,ERBB2 GENE AMP GASTRIC TIS,1182.0,768.3,68.5,1182.0,86
CDM,31002445,GALACTOKINASE ACTIVITY,148.0,96.2,10.61,202.1,84
CDM,31002455,FERN TEST (POINT OF CARE LAB),67.0,43.55,8.96,67.0,84
CDM,31002465,%PMCEXT DNA PROBE X14,148.0,96.2,21.42,164.91,83
CDM,31002555,H&E UNSTAINED SLIDES,335.0,217.75,45.47,335.0,84
CDM,31002595,RHD VARIANT SENDOUT,567.0,368.55,83.94,1666801.85,67
CDM,31002605,FAMILAL MEDITER FEVER SEQ,1896.0,1232.4,109.93,1896.0,84
CDM,31002615,DRPLA DNA TEST,945.0,614.25,54.8,945.0,84
CDM,31002625,SCA1 DNA TEST,945.0,614.25,54.8,945.0,84
CDM,31002635,SCA2 EXPANSION,945.0,614.25,54.8,945.0,84
CDM,31002645,SCA3 DNA TEST,945.0,614.25,54.8,945.0,84
CDM,31002655,SCA7 DNA TEST,945.0,614.25,54.8,945.0,84
CDM,31002665,SCA6 DNA TEST,945.0,614.25,54.8,945.0,84
CDM,31002675,HEMMIG CACNA1A,5839.0,3795.35,173.12,5839.0,84
CDM,31002685,DM2 DNA TEST,945.0,614.25,54.8,945.0,84
CDM,31002695,KENNEDY'S DIS DNA,945.0,614.25,54.8,945.0,84
CDM,31002705,DM1 DNA TEST,945.0,614.25,54.8,945.0,84
CDM,31002715,HUNTINGTON'S DISEASE,945.0,614.25,54.8,945.0,84
CDM,31002725,FRIEDREICH ATAX DNA,945.0,614.25,54.8,945.0,84
CDM,31002735,MYD88 L265P MUT ANLS,1210.0,786.5,70.16,1210.0,84
CDM,31002745,OPMD DNA TEST,945.0,614.25,54.8,945.0,84
CDM,31002755,SMA CARRIER SCRN DIAG,945.0,614.25,54.8,945.0,84
CDM,31002765,SCA17 DNA TEST,945.0,614.25,54.8,945.0,84
CDM,31002775,LIVER FIBRO AND ACTI,498.0,323.7,28.88,498.0,84
CDM,31002805,BTK GENE ANALYISIS,1210.0,786.5,70.16,1210.0,84
CDM,31002815,PLCG2 GENE ANALYSIS,2010.0,1306.5,116.49,2010.0,84
CDM,31002825,DMD SEQUENCING,1863.0,1210.95,83.94,1666801.85,67
CDM,31002835,SARCOMA FUSION NGS PANEL,3438.0,2234.7,109.69,3438.0,84
CDM,31002845,NTRK GENE ANALYSIS,3438.0,2234.7,109.69,3438.0,84
CDM,31002855,MYCNFB DNA PROBE X2,148.0,96.2,21.42,164.91,83
CDM,31002865,MYCNFB INSITU 100-300,353.0,229.45,51.19,353.0,83
CDM,31002875,PAN-SOLID TUMOR NGS,4574.0,2973.1,672.05,6569.1,84
CDM,31002885,TZYGOS STR MKRS SPEC ANALYSIS,1608.0,1045.2,106.2,1608.0,84
CDM,31002895,TZYGOS STR MKRS ADDTL,2103.0,1366.95,116.49,2103.0,84
CDM,31002905,CYTOCHROME P450 2C19,2010.0,1306.5,116.49,2010.0,84
CDM,31002915,CYTOCHROME P450 2D6,3111.0,2022.15,109.69,3111.0,84
CDM,31002925,WRFSEN CYP2C9 GENE VAR,1206.0,783.9,69.92,1206.0,84
CDM,31002935,WRFSEN TPMT GENE VAR,609.0,395.85,35.28,609.0,84
CDM,31002945,GIST BRAF GENE,1210.0,786.5,70.16,1210.0,84
CDM,31002955,GIST KIT GENE,2274.0,1478.1,116.49,2274.0,84
CDM,31002965,GIST NGS GIST,189.0,122.85,41.2,1666801.85,67
CDM,31002975,SHOX DNA DIAGNOSTIC,486.0,315.9,83.94,1666801.85,67
CDM,31002985,HEMATOLOGIC CANCER FUSION,3802.0,2471.3,672.05,6569.1,84
CDM,31003025,CSPNL SMN1 GENE DOS/DEL,945.0,614.25,54.8,945.0,84
CDM,31003035,MATERNIT21 PLUS,5237.0,3404.05,173.12,5237.0,84
CDM,31003045,MATGEN FETAL CHRMOML ANEU,5237.0,3404.05,173.12,5237.0,84
CDM,31003055,MATGEN FETAL CHRMOML MICR,5237.0,3404.05,173.12,5237.0,84
CDM,31003065,MATGEN UNLISTED MOPATH,162.0,105.3,35.32,1666801.85,67
CDM,31003075,PGANTI CYP2C19 GENE COM VAR,2010.0,1306.5,116.49,2010.0,84
CDM,31003085,PGANTI CYP2D6 GENE COM VAR,3111.0,2022.15,109.69,3111.0,84
CDM,31003095,PGPAIN CYP2D6 GENE COM VAR,3111.0,2022.15,109.69,3111.0,84
CDM,31003105,PGXAO CYP2C19 GENE COM VAR,2010.0,1306.5,116.49,2010.0,84
CDM,31003115,PGANTS CYP2C19 GENE COM VAR,2010.0,1306.5,116.49,2010.0,84
CDM,31003125,PGANTS CYP2D6 GENE COM VAR,3111.0,2022.15,109.69,3111.0,84
CDM,31003135,PD-L1 22C3 IHC WITH TPS,1182.0,768.3,68.5,1182.0,86
CDM,31003145,EPI PROCOLON,1325.0,861.25,33.47,1325.0,84
CDM,31003155,CF-CFTR-SEQ,3443.0,2237.95,109.69,3443.0,84
CDM,31003165,BMCHF CYTO NEOPL MICROAR,8004.0,5202.6,464.0,8004.0,84
CDM,31003175,BLLSNP CYTO NEOPL MICROAR,8004.0,5202.6,464.0,8004.0,84
CDM,31003185,BMHSNP CYTO NEOPL MICROAR,8004.0,5202.6,464.0,8004.0,84
CDM,31003195,PIK3CA GENE ANALYSIS NGS,1896.0,1232.4,109.93,1896.0,84
CDM,31003205,ADD ON PIK3CA NGS,1896.0,1232.4,109.93,1896.0,84
CDM,31003215,ASHKENAZI JEWISH DISEASES,16895.0,10981.75,672.05,16895.0,84
CDM,31003225,HNCPPB NGS,1616.0,1050.4,457.0,6569.1,84
CDM,31003235,HNCPBM NGS,1616.0,1050.4,457.0,6569.1,84
CDM,31003245,HLA-B51,879.0,571.35,54.99,879.0,84
CDM,31003255,HS50CY CNCR 50GN CYTO NGS,3126.0,2031.9,109.69,3126.0,84
CDM,31003265,HS50CB 50GN CELL BLK NGS,3126.0,2031.9,109.69,3126.0,84
CDM,31003275,HS50FT 50GN TISSUE NGS,3126.0,2031.9,109.69,3126.0,84
CDM,31003285,DMD SEQUENCING BILL,13800.0,8970.0,672.05,13800.0,84
CDM,31003295,FISH RENAL CELL CARCINOMA PNL,1182.0,768.3,68.5,1182.0,86
CDM,31003305,FISH RENAL CELL CARCINOMA TFE3,1182.0,768.3,68.5,1182.0,86
CDM,31003315,FISH RENAL CELL CARCINOMA TFEB,1182.0,768.3,68.5,1182.0,86
CDM,31003325,ALLO HPC(M) RBC COMP,1749.0,1136.85,376.61,2453.0,84
CDM,31003335,RETTFG MECP2 GENE FULL SEQ,3642.0,2367.3,109.69,3642.0,84
CDM,31003345,RETTFG MECP2 GENE DUP/DELET VARIANT,1035.0,672.75,60.0,1035.0,84
CDM,31003355,CIFAB AB IGG FIRST,1182.0,768.3,68.5,1182.0,86
CDM,31003365,CIFAB AB IGG ADDTL,249.0,161.85,1.73,249.0,68
CDM,31003375,HLA-B58,513.0,333.45,35.92,513.0,84
CDM,31003385,EM PROCESSING AND HOLD,335.0,217.75,45.47,335.0,84
CDM,31003395,EM THICK ONLY,369.0,239.85,37.39,369.0,86
CDM,31003405,CHIMERISM/ENGRAFTMENT ANALY W/COMP TO BASLINE,1431.0,930.15,102.45,1431.0,84
CDM,31003415,STR GENOTYPING,1608.0,1045.2,106.2,1608.0,84
CDM,31003425,"HLA-A,B,C,DR,DQ,DRB345_RT-PCR",2775.0,1803.75,109.69,2775.0,84
CDM,31003435,SOLID ORGAN NGS FEE,2775.0,1803.75,109.69,2775.0,84
CDM,31003445,FISH FOR TP63 TISSUE,1182.0,768.3,68.5,1182.0,86
CDM,31003455,FISH FOR DUSP22-IRF4 TISS,1182.0,768.3,68.5,1182.0,86
CDM,31003465,FISH TP63 DUSP22 PANEL,1182.0,768.3,68.5,1182.0,86
CDM,31003475,JK VARIANT DETERMINATION,540.0,351.0,83.94,1666801.85,67
CDM,31003485,KITPB KIT TARGET SEQ,2274.0,1478.1,116.49,2274.0,84
CDM,31003495,KITPB MUT ANLYS,862.0,560.3,49.95,862.0,84
CDM,31003505,KITBM KIT TARGET SEQ,2274.0,1478.1,116.49,2274.0,84
CDM,31003515,KITBM MUT ANLYS,862.0,560.3,49.95,862.0,84
CDM,31003525,CSF3R MUTATION ANLYS BLD,1278.0,830.7,74.08,1988.72,84
CDM,31003535,CSF3R MUTATION ANLYS BM,1278.0,830.7,74.08,1988.72,84
CDM,31003545,SF3B1 MUTATION ANLYS BLD,1278.0,830.7,74.08,1988.72,84
CDM,31003555,SF3B1 MUTATION ANLYS BM,1278.0,830.7,74.08,1988.72,84
CDM,31003565,HEAD AND NECK NGS,1737.0,1129.05,109.69,2205.57,84
CDM,31003575,SARCOMA FUSION NGS,1737.0,1129.05,491.22,6569.1,84
CDM,31003585,NTRK NGS,1879.0,1221.35,83.94,1666801.85,67
CDM,31003595,HOTSPOT DESMOID NGS,1879.0,1221.35,83.94,1666801.85,67
CDM,31003605,ARC ABO COM ALL DETERMIN,1278.0,830.7,74.08,1988.72,84
CDM,31003615,ARC ABO VARIANTS,1278.0,830.7,74.08,1988.72,84
CDM,31003625,FISH FOR BIRC3/MALT1,1182.0,768.3,68.5,1182.0,86
CDM,31003635,MPL MUTATION ANSYS BLD,1037.0,674.05,60.13,1037.0,84
CDM,31003645,MPL MUTATION ANSYS BM,1037.0,674.05,60.13,1037.0,84
CDM,31003655,JAKNON EX 12-16 SEQ BLD,1278.0,830.7,74.08,1278.0,84
CDM,31003665,JAK2 EX 12-16 MUT DET BLD,1278.0,830.7,74.08,1278.0,84
CDM,31003675,TP53 SOMATIC MUT PROG,4429.0,2878.85,173.12,4429.0,84
CDM,31003685,WRFSEN UNLISTED MOPATH,59.0,38.35,12.86,1666801.85,67
CDM,31003695,SF3B1 MUTATION ANALYS BM,1333.0,866.45,77.3,1333.0,84
CDM,31003705,NTRK NGS,3576.0,2324.4,109.69,3576.0,84
CDM,31003715,SF3B1 MUTATION ANALYS BLD,1333.0,866.45,77.3,1333.0,84
CDM,31003725,190PCR BONE MARROW TEST,999.0,649.35,71.52,1115.21,84
CDM,31003735,BCR/ABL QUANT BONE MARROW,1131.0,735.15,80.97,1262.54,84
CDM,31003745,TCBMDM GENE REARRANGE AMP,1442.0,937.3,103.17,1442.0,84
CDM,31003755,TCBMDM GENE REARRANGE ANAL,1390.0,903.5,99.5,1390.0,84
CDM,31003765,TCBMDO GENE REARRANGE AMP,1442.0,937.3,103.17,1442.0,84
CDM,31003775,TCBMDO GENE REARRANGE ANAL,1390.0,903.5,99.5,1390.0,84
CDM,31003785,BCBMDM LGH REARR HCL,1366.0,887.9,97.77,1524.53,84
CDM,31003795,BCBMDM LGK REARR KLCL,1192.0,774.8,73.74,1192.0,84
CDM,31003805,BCBMDO LGH REARR HCL,1366.0,887.9,97.77,1524.53,84
CDM,31003815,BCBMDO LGK REARR KLCL,1192.0,774.8,73.74,1192.0,84
CDM,31003825,IGHM LGH REARR HCL,1366.0,887.9,97.77,1524.53,84
CDM,31003835,IGHO LGH REARR HCL,1366.0,887.9,97.77,1524.53,84
CDM,31003845,IGKM LGK REARR KLCL,1192.0,774.8,73.74,1192.0,84
CDM,31003855,IGKO LGK REARR KLCL,1192.0,774.8,73.74,1192.0,84
CDM,31003865,TCRBM GENE REARRANGE AMP,1442.0,937.3,103.17,1442.0,84
CDM,31003875,TCRBO GENE REARRANGE AMP,1442.0,937.3,103.17,1442.0,84
CDM,31003885,TCRGM GENE REARRANGE ANAL,1390.0,903.5,99.5,1390.0,84
CDM,31003895,TCRGO GENE REARRANGE ANAL,1390.0,903.5,99.5,1390.0,84
CDM,31003905,MYD88 L265P MUT ANLS BM,1210.0,786.5,70.16,1210.0,84
CDM,31003915,MYD88 L265P MUT ANLS OTH,1210.0,786.5,70.16,1210.0,84
CDM,31003925,ALLPB ALL PANEL NGS BLD,5241.0,3406.65,173.12,5241.0,84
CDM,31003935,ALLBM ALL PANEL NGS BM,5241.0,3406.65,173.12,5241.0,84
CDM,31003945,FLT3 ITD MUT ANSYS BLD,1142.0,742.3,66.2,1142.0,84
CDM,31003955,FLT3 ITD MUT ANSYS BM,1142.0,742.3,66.2,1142.0,84
CDM,31003965,FLT3PB MUT ANSYS BLD,1142.0,742.3,66.2,1142.0,84
CDM,31003975,FLT3PB GENE ANSYS BLD,573.0,372.45,33.2,573.0,84
CDM,31003985,F3MRW MUT ANSYS BM,1142.0,742.3,66.2,1142.0,84
CDM,31003995,F3MRW GENE ANSYS BM,573.0,372.45,33.2,573.0,84
CDM,31004005,1P19Q FISH FOR 1P/19Q,1182.0,768.3,68.5,1182.0,86
CDM,31004015,POCHF PROD CONCEPT+SNP,4500.0,2925.0,540.0,4500.0,84
CDM,31004025,MTHRF 2 VARIANTS,451.0,293.15,26.14,451.0,84
CDM,31004035,EIHC ISH TECH ONLY,673.0,437.45,68.5,673.0,86
CDM,31004045,EIHC EACH ADD AB/BLK,247.0,160.55,37.39,247.0,68
CDM,31004055,EIMMUNOCYTOCHEM TC,1182.0,768.3,68.5,1182.0,86
CDM,31004065,"E IHC QUANTITATIVE, TC",1182.0,768.3,68.5,1182.0,86
CDM,31004075,GISTCY BRAF GENE,1210.0,786.5,70.16,1210.0,84
CDM,31004085,GISTCY KIT GENE,2274.0,1478.1,116.49,2274.0,84
CDM,31004095,GISTCY PDGFRA GENE,2274.0,1478.1,116.49,2274.0,84
CDM,31004105,GISTCY NGS UNLIST MOLEC,189.0,122.85,41.2,1666801.85,67
CDM,31004115,IDH1 COMMON VARIANTS,1333.0,866.45,116.49,1333.0,84
CDM,31004125,IDH2 COMMON VARIANTS,2041.0,1326.65,116.49,2041.0,84
CDM,31004145,LUNG CANCER HOTSPOT CYTO,1992.0,1294.8,109.69,2205.57,84
CDM,31004155,NGSCCY BRAF,1210.0,786.5,70.16,1210.0,84
CDM,31004165,"NGSCCY KRAS 12,13",1333.0,866.45,77.3,1333.0,84
CDM,31004175,NGSCCY KRAS 61,1333.0,866.45,77.3,1333.0,84
CDM,31004185,NGSCCY NRAS,2041.0,1326.65,116.49,2041.0,84
CDM,31004195,NGSMCY BRAF,1210.0,786.5,70.16,1210.0,84
CDM,31004205,NGSMCY KIT,2274.0,1478.1,116.49,2274.0,84
CDM,31004215,NGSMCY NRAS,2041.0,1326.65,116.49,2041.0,84
CDM,31004225,FISH FOR IGH/BCL2 TIS X2,1182.0,768.3,68.5,1182.0,86
CDM,31004235,FISH FOR IGH/CCND1 TIS X2,1182.0,768.3,68.5,1182.0,86
CDM,31004245,CELIAC GLUTEN FREE PANEL X2,853.0,554.45,61.08,853.0,84
CDM,31004255,CSF3RP MUTATION ANANLYSIS BLD,1227.0,797.55,83.94,1666801.85,67
CDM,31004265,CSF3RM MUTATION ANANLYSIS BM,1227.0,797.55,83.94,1666801.85,67
CDM,31004275,CP2C19-CYP2C19 GENOTYPING,2010.0,1306.5,116.49,2010.0,84
CDM,31004285,2C19AO-CYP2C19 GTYP AN ON,2010.0,1306.5,116.49,2010.0,84
CDM,31004295,2D6AO-CYP2D6 GTYP AN ON,3111.0,2022.15,109.69,3111.0,84
CDM,31004305,3B1AO-HSD3B1 GTYP AN ON,324.0,210.6,70.63,1666801.85,67
CDM,31004315,VWFSEQ VON WILLEBRAND DISEASE SEQ,13800.0,8970.0,672.05,13800.0,84
CDM,31004325,CVCYTO CHROMOSOME COUNT ADDITIONAL,186.0,120.9,26.91,186.0,83
CDM,31004335,ISIGHT CYTOGENETICS 25-99,292.0,189.8,42.38,292.0,83
CDM,31004345,FAMCYT CHROMOSOME ANALYSIS AMNIOTIC,1198.0,778.7,116.49,1198.0,83
CDM,31004355,FAMCYT CHROMOSOME COUNT ADDITIONAL,186.0,120.9,26.91,186.0,83
CDM,31004365,PLTEMS ELECTRON MICROSCOPY,5637.0,3664.05,68.5,5637.0,86
CDM,31004375,"CXCR4 MUTATION ANALYSIS, SOMATIC",891.0,579.15,83.94,1666801.85,67
CDM,31004385,HFPNGS HN FUSION NGS PNL BLD,1616.0,1050.4,457.0,6569.1,84
CDM,31004395,HFMNGS HN FUSION NGS PNL BLD,1616.0,1050.4,457.0,6569.1,84
CDM,31004405,HFONGS HN FUSION NGS PNL OTHER,1616.0,1050.4,457.0,6569.1,84
CDM,31004415,HDPNGS ACUTE LEUK NGS PNL BLD,3000.0,1950.0,672.05,6569.1,84
CDM,31004425,HDMNGS ACUTE LEUK NGS PNL BM,3000.0,1950.0,672.05,6569.1,84
CDM,31004435,HDONGS ACUTE LEUK NGS PNL OTHER,3000.0,1950.0,672.05,6569.1,84
CDM,31004445,MYNGSM MYELOID PANEL NGS BM,1616.0,1050.4,457.0,6569.1,84
CDM,31004455,MYNGSP MYELOID PANEL NGS P BLD,1616.0,1050.4,457.0,6569.1,84
CDM,31004465,MYNGSO MYELOID PANEL NGS OTHER,1616.0,1050.4,457.0,6569.1,84
CDM,31004475,LPMNGS CHRONIC LYMPHOPRO NGS BM,1616.0,1050.4,457.0,6569.1,84
CDM,31004485,LPPNGS CHRONIC LYMPHOPRO NGS P BLD,1616.0,1050.4,457.0,6569.1,84
CDM,31004495,LPONGS CHRONIC LYMPHOPRO NGS OTHER,1616.0,1050.4,457.0,6569.1,84
CDM,31004505,HNONGS HN NGS SEQ PANEL OTHER,1616.0,1050.4,457.0,6569.1,84
CDM,31004515,BRAF V600E MUT DETECT BM,1210.0,786.5,70.16,1210.0,84
CDM,31004525,KIT D816V MUT DETECT BLD,862.0,560.3,49.95,862.0,84
CDM,31004535,KIT D816V MUT DETECT BM,862.0,560.3,49.95,862.0,84
CDM,31004545,KIT D816V MUT DETECT OTHER,862.0,560.3,49.95,862.0,84
CDM,31004555,BRAF V600E MUT DETECT OTHER,1210.0,786.5,70.16,1210.0,84
CDM,31004565,CYP2D6 UNLISTED MOLEC PATH,550.0,357.5,83.94,1666801.85,67
CDM,31004575,CYP2D6 REFLX ONLY UNLIST MOLEC PATH,550.0,357.5,83.94,1666801.85,67
CDM,31004585,BRAF V600E MUT DETECT BLOOD,1210.0,786.5,70.16,1210.0,84
CDM,31004595,BMENGS SNP MARKERS SPECIMEN ANAL,1608.0,1045.2,106.2,1608.0,84
CDM,31004605,BMFUNG CHIMERISM ANAL W/CELL SELECT,1799.0,1169.35,116.49,1799.0,84
CDM,31004615,BCRPB BCR/ABL1 GENE MAJOR BP,1131.0,735.15,80.97,1262.54,84
CDM,31004625,BCRPB BCR/ABL1 GENE MINOR BP,999.0,649.35,71.52,1115.21,84
CDM,31004635,BCRBM BCR/ABL1 GENE MAJOR BP,1131.0,735.15,80.97,1262.54,84
CDM,31004645,BCRBM BCR/ABL1 GENE MINOR BP,999.0,649.35,71.52,1115.21,84
CDM,31004655,BM ENGRAFT F/U TEST,1799.0,1169.35,116.49,1799.0,84
CDM,31004665,"TP53 SOMATIC MUT, PROGNOSTIC",2274.0,1478.1,116.49,2274.0,84
CDM,31004675,TISSUE DNA FP FOR MOLAR PREG - IHC SENDOUT,1608.0,1045.2,106.2,1608.0,84
CDM,31004685,CILIARY MOTILITY - EM DIAG,5637.0,3664.05,68.5,5637.0,86
CDM,31004695,"TOPPB TGT ONC NGS, PER BLD",4400.0,2860.0,672.05,6569.1,84
CDM,31004705,"TOPBM TGT ONC NGS, BM",4400.0,2860.0,672.05,6569.1,84
CDM,31004715,"TOPTO TGT ONC NGS, OTH",4400.0,2860.0,672.05,6569.1,84
CDM,31004725,"TOPCY TGT ONC NGS, CYTO",4400.0,2860.0,672.05,6569.1,84
CDM,31004735,NMP1 MUTATION DETECTION BY RT-PCR,1701.0,1105.65,98.61,1701.0,84
CDM,31004745,"PRENATAL SNP MICROARRAY, AMNIOTIC FLUID, CVS",4500.0,2925.0,540.0,4500.0,84
CDM,31004755,UBA1 MUTATION TESTING FOR VEXAS SYNDROME,1278.0,830.7,74.08,1988.72,84
CDM,31004775,PRENATAL QUAD SCREEN,1059.0,688.35,61.4,1059.0,84
CDM,31004785,NARCOLEPSY GENOTYPING (HLADQB1* 06:02),853.0,554.45,61.08,853.0,84
CDM,31004795,HPA-1 GENOTYPING,843.0,547.95,83.94,843.0,84
CDM,31004805,HPA-2 GENOTYPING,843.0,547.95,83.94,843.0,84
CDM,31004815,HPA-3 GENOTYPING,843.0,547.95,83.94,843.0,84
CDM,31004825,HPA-4 GENOTYPING,843.0,547.95,83.94,843.0,84
CDM,31004835,HPA-5 GENOTYPING,843.0,547.95,83.94,843.0,84
CDM,31004845,HPA-6 GENOTYPING,843.0,547.95,83.94,843.0,84
CDM,31004855,HPA-9 GENOTYPING,843.0,547.95,83.94,843.0,84
CDM,31004865,HPA-15 GENOTYPING,843.0,547.95,83.94,843.0,84
CDM,31004875,NEONATAL ALLOIMMUNE THROMBOCYTOPENIA (NAIT)-INITIAL TESTING MATE,2490.0,1618.5,83.94,1666801.85,67
CDM,31004885,HPA-1 GENOTYPING,843.0,547.95,83.94,843.0,84
CDM,31004895,HPA-2 GENOTYPING,843.0,547.95,83.94,843.0,84
CDM,31004905,HPA-3 GENOTYPING,843.0,547.95,83.94,843.0,84
CDM,31004915,HPA-4 GENOTYPING,843.0,547.95,83.94,843.0,84
CDM,31004925,HPA-5 GENOTYPING,843.0,547.95,83.94,843.0,84
CDM,31004935,HPA-6 GENOTYPING,843.0,547.95,83.94,843.0,84
CDM,31004945,HPA-9 GENOTYPING,843.0,547.95,83.94,843.0,84
CDM,31004955,HPA-15 GENOTYPING,843.0,547.95,83.94,843.0,84
CDM,31004965,NEONATAL ALLOIMMUNE THROMBOCYTOPENIA (NAIT)-INITIAL TESTING MATE,2964.0,1926.6,83.94,1666801.85,67
CDM,31004975,NEONATAL ALLOIMMUNE THROMBOCYTOPENIA (NAIT)-INITIAL TESTING MATE,2964.0,1926.6,83.94,1666801.85,67
CDM,31004985,"MORPHOMETRIC ANALYSIS, IN SITU HYBRID (HER2FGAST)",1182.0,768.3,68.5,1182.0,86
CDM,31004995,EGFR GENETIC ANALYSIS,2240.0,1456.0,109.69,2240.0,84
CDM,31005005,EXOME SEQUENCING AHUS1,11950.0,7767.5,672.05,11950.0,84
CDM,31005015,KRAS GENETIC ANALYSIS,1333.0,866.45,77.3,1333.0,84
CDM,31005025,KRAS ADDITIONAL VARIANTS,1333.0,866.45,77.3,1333.0,84
CDM,31005035,ONKOSIGHT ADVANCED CHRONIC LYMPHOID NGS PANEL,5241.0,3406.65,173.12,5241.0,84
CDM,31005045,NPM1 GENE ANALYSIS PB,1701.0,1105.65,98.61,1701.0,84
CDM,31005055,NPM1 GENE ANALYSIS BM,1701.0,1105.65,98.61,1701.0,84
CDM,31005065,NPM1 GENE ANALYSIS OTHER,1701.0,1105.65,98.61,1701.0,84
CDM,31005075,MICROSATELLITE INSTABILITY DET (MSIID),2405.0,1563.25,116.49,2405.0,84
CDM,31005085,%PEMGUS IFL ADDTL,249.0,161.85,1.73,249.0,68
CDM,31005095,"LIVER FIBROSIS, CHRONIC VIRAL HEPATITIS (ARUP)",106.0,68.9,23.11,1851898.14,67
CDM,31005105,POLE DROPLET DIGITAL PCR,378.0,245.7,82.4,1666801.85,67
CDM,31005115,PARD UNLISTED MOL PATH,1278.0,830.7,74.08,1988.72,84
CDM,31005125,IDH1&2-COMMON VARIANTS,1160.0,754.0,83.94,1666801.85,67
CDM,31005135,TARGETED ONCOLOGY PANEL - FINE NEEDLE ASPIRATE,4400.0,2860.0,672.05,6569.1,84
CDM,31005145,IDH1 HOTSPOT VARIANT BM,1333.0,866.45,116.49,1333.0,84
CDM,31005155,IHD2 HOTSPOT VARIANT BM,2041.0,1326.65,116.49,2041.0,84
CDM,31005165,IDH1 HOTSPOT VARIANT PB,1333.0,866.45,116.49,1333.0,84
CDM,31005175,IDH2 HOTSPOT VARIANT PB,2041.0,1326.65,116.49,2041.0,84
CDM,31005185,"HISTIOCYTIC NEOPLASMS, NGS",5241.0,3406.65,173.12,5241.0,84
CDM,31005195,"T-CELL LYMPHOMA, NGS",5241.0,3406.65,173.12,5241.0,84
CDM,31005205,"B-CELL LYMPHOMA, NGS",5241.0,3406.65,173.12,5241.0,84
CDM,31005215,"ACUTE LEUKEMIA RAPID NGS PANEL, BLOOD",3000.0,1950.0,672.05,6569.1,84
CDM,31005225,"ACUTE LEUKEMIA RAPID NGS PANEL, BONE MARROW",3000.0,1950.0,672.05,6569.1,84
CDM,31005275,"TAU, PHOSPHORYLATED (EG, PTAU 181, PTAU 217), EACH",121.0,78.65,23.08,141.81,76
CDM,31005285,"TAU, TOTAL (TTAU)",121.0,78.65,33.64,141.81,76
CDM,31005295,RUNX1-RUNX1T1,945.0,614.25,54.8,2297.92,84
CDM,31005305,CBFB-MYH11 INV(16),945.0,614.25,54.8,2297.92,84
CDM,31005315,MICROBIAL CELL-FREE DNA BY NGS,14671.0,9536.15,13.28,14671.0,84
CDM,31005325,UBA1 MUT DET BY DDPCR BLOOD,1278.0,830.7,74.08,1988.72,84
CDM,31005335,UBA1 MUT DET BY DDPCR BONE MARROW,1278.0,830.7,74.08,1988.72,84
CDM,31005345,UBA1 MUT DET BY DDPCR OTHER,1278.0,830.7,74.08,1988.72,84
CDM,31005355,DNA FINGERPRNT TEST-NGS-GENOTYPING,4128.0,2683.2,83.94,1666801.85,67
CDM,31005365,DNA FINGERPRNT TEST-NGS-FOLLOW UP,4128.0,2683.2,83.94,1666801.85,67
CDM,31005485,TARGETED ONCOLOGY PANEL LOW PURITY,4400.0,2860.0,672.05,6569.1,84
CDM,31005495,FLT3 TKDM BONE MARROW,573.0,372.45,33.2,573.0,84
CDM,31005505,"ISH, QUANT/SEMI QUANT, MULTIPLEX PROBE STAIN",1182.0,768.3,68.5,1182.0,86
CDM,31005515,INTESTINAL TRANSPLANT REJECTION RISK EVALUATION (PLEXIMMUNE),4421.0,2873.65,67.56,4421.0,84
CDM,31005525,CYTOGENOMIC SNP MICROARRAY - FETAL,4500.0,2925.0,540.0,4500.0,84
CDM,31005535,FETAL CELL CONTAMINATION (FCC),1608.0,1045.2,106.2,1608.0,84
CDM,31005545,"TAU, PHOSPHORYLATED (EG, PTAU 181, PTAU 217), EACH",121.0,78.65,23.08,141.81,76
CDM,31005565,BRAF V600E/D AND V600K/R MUTATION DETECTION CIRCULATING TUMOR DN,1335.0,867.75,70.16,1335.0,84
CDM,31005575,"MICROARRAY ANALYSIS, SNP, FORMALIN FIXED PARAFFIN EMBEDDED TISSU",1335.0,867.75,377.54,4279.01,84
CDM,31005585,"MICROARRAY ANALYSIS, POC FFPE",1335.0,867.75,377.54,4279.01,84
CDM,31005595,CALR GENE ANALYSIS,839.0,545.35,60.06,839.0,84
CDM,31005605,"JAK2 GENE ANALYSIS, VAL617PHE VARIANT",632.0,410.8,45.27,632.0,84
CDM,31005615,MPL GENE ANALYSIS,1278.0,830.7,74.08,1278.0,84
CDM,31005625,"JAK2 GENE ANALYSIS, EXONS 12 AND 13",1278.0,830.7,74.08,1278.0,84
CDM,31005635,"STR ANALYSIS FOR MOL PREG, BLD",1608.0,1045.2,106.2,1608.0,84
CDM,31005645,"STR ANALYSIS FOR MOL PREG, OTHER",1608.0,1045.2,106.2,1608.0,84
CDM,31005655,MICORARRAY SNP FFPET,8004.0,5202.6,464.0,8004.0,84
CDM,31005665,"SHORT TANDEM REPEAT ANALYSIS FOR SPECIMEN IDENTIFICATION, BLOOD",1608.0,1045.2,106.2,1608.0,84
CDM,31005675,"SHORT TANDEM REPEAT ANALYSIS FOR SPECIMEN IDENTIFICATION, OTHER",1608.0,1045.2,106.2,1608.0,84
CDM,31005685,BCR-ABL1 KINASE MUT DET SANGER BLD,2070.0,1345.5,116.49,2070.0,84
CDM,31005695,BCR-ABL1 KINASE MUT DET BY SANGER SEQ BM,2070.0,1345.5,116.49,2070.0,84
CDM,31005705,SERPINA1 TARG MUT BY SANGER SEQ,301.0,195.65,21.56,301.0,84
CDM,31005715,UGT1A1 TARG MUT DET BY SANGER,1615.0,1049.75,93.6,1615.0,84
CDM,31005725,UBA1 TARG MUT DET BY SANGER OTHER,1278.0,830.7,74.08,1988.72,84
CDM,31005735,UGTA1 TARG MUT DET BY SANGER BLD,1278.0,830.7,74.08,1988.72,84
CDM,31005745,UBA1 TARG MUT DET BY SANGER BM,1278.0,830.7,74.08,1988.72,84
CDM,31005755,POLE TARG MUT DET BY SANGER,378.0,245.7,82.4,1666801.85,67
CDM,31005765,ONC PAN-TUMOR DNA&RNA NEXT-GENERATION SEQUENCING-CARIS,58339.0,37920.35,208.0,58339.0,77
CDM,31005775,HFE TARGETED MUT BY SANGER SEQ,451.0,293.15,32.28,503.27,84
CDM,31005785,"TP53 SOMATIC MUT, PROGNOSTIC",2274.0,1478.1,116.49,2274.0,84
CDM,31005798,FULL GENE SEQUENCE ANALYSIS OF THE TP53 (TUMOR PROTEIN 53) GENE,4429.0,2878.85,173.12,4429.0,84
CDM,31005805,MATERNAL CELL CONTAMINATION,1608.0,1045.2,106.2,1608.0,84
CDM,31005815,ADDITIONAL CELLS COUNTED,186.0,120.9,26.91,186.0,83
CDM,31005825,INTER FISH ANALYSIS 25-99 CELLS,292.0,189.8,42.38,292.0,83
CDM,31005835,SANGER SEQ DNA BLD,1278.0,830.7,74.08,1988.72,84
CDM,31005845,SANGER SQ DNA BONE MARROW,1278.0,830.7,74.08,1988.72,84
CDM,31005855,SANGER SEQ DNA OTHER,1278.0,830.7,74.08,1988.72,84
CDM,31005865,SANGER SEQ RNA BLD,1278.0,830.7,74.08,1988.72,84
CDM,31005875,SANGER SEQ RNA BONE MARROW,1278.0,830.7,74.08,1988.72,84
CDM,31020OH,SINUSOTOMY MAXILLARY ANTROTOMY INTRANASAL,1228.0,798.2,1.1,9391.15,148
CDM,31030OH,SINUSOTOMY MAXILLARY RAD W/O RMVL ANTROCH POLYPS,2404.0,1562.6,1.1,17080.38,148
CDM,31032OH,SINUSOT MAX ANTRT RAD W/RMVL ANTROCH POLYPS,2676.0,1739.4,1.1,17080.38,144
CDM,31040OH,PTERYGOMAXILLARY FOSSA SURGERY ANY APPROACH,4299.0,2794.35,1.1,17080.38,144
CDM,31050OH,SINUSOTOMY SPHENOID W/WO BIOPSY,2148.0,1396.2,1.1,17080.38,144
CDM,31051OH,SINUSOT SPHENOID W/MUCOSAL STRIPPING/RMVL POLYP,2900.0,1885.0,1.1,17080.38,144
CDM,31070OH,SINUSOTOMY FRONTAL EXTERNAL SIMPLE,1760.0,1144.0,1.1,17080.38,142
CDM,31075OH,SINUSOTOMY FRONTAL TRANSORBITAL UNILATERAL,3804.0,2472.6,1.1,17080.38,144
CDM,31080OH,SINUSOTOMY FRNT OBLITERATIVE W/O FLAP BROW INC,5096.0,3312.4,1.1,17080.38,144
CDM,31081OH,SINUSOT FRNT OBLIT W/O OSTPL FLAP CORONAL INC,5676.0,3689.4,1.1,17080.38,144
CDM,31085OH,SINUSOT FRNT OBLIT W/OSTPL FLAP CORONAL INC,6256.0,4066.4,1.1,17080.38,144
CDM,31086OH,SINUSOT FRNT NONOBLIT W/OSTPL FLAP BROW INC,5744.0,3733.6,1.1,17080.38,144
CDM,31087OH,SINUSOT FRNT NONOBLIT W/OSTPL FLAP CORONAL INC,5828.0,3788.2,1.1,17080.38,144
CDM,31090OH,SINUSOT UNI 3/> PARANSL SINUSES,4915.0,3194.75,1.1,17080.38,144
CDM,31100005,CRYOPRSRV/STRGE HEMATOPOIE CELL,1749.0,1136.85,376.61,2453.0,84
CDM,31100010,CYTPATH NONGYN SMEAR INTERP,271.0,176.15,34.79,271.0,86
CDM,31100015,CYTOLOGY FLUID TP,369.0,239.85,45.47,369.0,86
CDM,31100035,CYTO IMAGER GYN TP DIAG,184.0,119.6,15.29,184.0,83
CDM,31100045,CYTO SECOND PASS ADEQ,147.0,95.55,11.0,147.0,68
CDM,31100065,%CD2 CD3 MONITOR 1ST MARK,2482.0,1613.3,60.74,2482.0,86
CDM,31100075,ADDITIONAL MARKERS,149.0,96.85,24.28,149.0,68
CDM,31100110,CYTPATH SMEAR OTHER,169.0,109.85,22.7,169.0,86
CDM,31100125,STEM CELL PROCESSING,90.0,58.5,8.96,90.0,83
CDM,31100130,CYTPATH SMEAR OTHER W PREP,169.0,109.85,22.7,169.0,86
CDM,31100135,HEMATOPOIETIC THAW,1749.0,1136.85,376.61,2453.0,84
CDM,31100155,CYTOLOGY GYN SC THIN PREP,140.0,91.0,15.29,140.0,83
CDM,31100160,CYTPATH CERV/VAG SCREENING,126.0,81.9,14.03,126.0,83
CDM,31100170,CYTPATH FNA IMMEDIATE EVAL,259.0,168.35,51.11,335.61,86
CDM,31100175,CYTO IMAGER GYN TP SCREEN,184.0,119.6,15.29,184.0,83
CDM,31100180,CYTPATH FNA I&R,369.0,239.85,34.71,369.0,86
CDM,31100185,CYTOLOGY GYN SCREEN,126.0,81.9,15.29,126.0,83
CDM,31100190,"FLOW CYTO, DNA",369.0,239.85,45.47,369.0,86
CDM,31100300,TIS CULT SKIN/BX,971.0,631.15,60.74,1083.61,83
CDM,31100530,CHROMO COUNT ADD,186.0,120.9,26.91,186.0,83
CDM,31100610,"FLOW CYTO, EA ADD MARKER",149.0,96.85,24.28,149.0,68
CDM,31100760,"FLOW CYTO, 1ST MARKER",2482.0,1613.3,60.74,2482.0,86
CDM,31100810,*TIS CULT LYMPHOCYTE,804.0,522.6,60.74,804.0,83
CDM,31101060,*TIS CULT SKIN/BX,971.0,631.15,60.74,1083.61,83
CDM,31101215,BILIARY TRACT MALIG,369.0,239.85,45.47,369.0,86
CDM,31101265,%FCULT CRYOPRESER,90.0,58.5,8.96,90.0,83
CDM,31101285,MISC SENDOUT CPT 88249,1195.0,776.75,116.49,1195.0,83
CDM,31101295,%DGEORG DNA PROBEX2,148.0,96.2,21.42,164.91,83
CDM,31101305,%DGEORG IN SITU HYBRIDIZ,353.0,229.45,51.19,353.0,83
CDM,31101315,%ISIGHT MOL CY 100 - 300,353.0,229.45,51.19,353.0,83
CDM,31101335,CYTOLOGY BRUSHING MOD,271.0,176.15,34.79,271.0,86
CDM,31101345,NEUT OXIDATIVE BURST,153.0,99.45,8.92,153.0,84
CDM,31101355,CYTOLOGY FLUID,271.0,176.15,34.79,271.0,86
CDM,31101365,%PLAFLW FLOW 1ST MARKER,2482.0,1613.3,60.74,2482.0,86
CDM,31101375,%NKFUNC FIRST MARKER,2482.0,1613.3,60.74,2482.0,86
CDM,31101385,%PLAFLW FLW ADD MARKER X5,149.0,96.85,24.28,149.0,68
CDM,31101395,%UTBAS FLW CYT ADD MKR X2,149.0,96.85,24.28,149.0,68
CDM,31101405,%NKFUNC ADDTL MARKERS X2,149.0,96.85,24.28,149.0,68
CDM,31101415,RBCB3 PROTEIN RED,2482.0,1613.3,60.74,2482.0,86
CDM,31101425,%CVID FLW EA ADD MARK X2,149.0,96.85,24.28,149.0,68
CDM,31101435,%ANTIE EA ADD MARKER X2,149.0,96.85,24.28,149.0,68
CDM,31101445,"%MYPRS FLOW CYTOM, ADDTL",149.0,96.85,24.28,149.0,68
CDM,31101455,%BPHENO FLW CYTO EAADDX7,149.0,96.85,24.28,149.0,68
CDM,31101475,%PNH BY FCM 1ST MARK X2,2482.0,1613.3,60.74,2482.0,86
CDM,31101485,%PNH BY FCM ADD MARK X7,149.0,96.85,24.28,149.0,68
CDM,31101495,CYTOLOGY SUREPATH PAP,140.0,91.0,15.29,140.0,83
CDM,31101505,ALLO BM FRZ STORE,90.0,58.5,8.96,90.0,83
CDM,31101515,AUTO BM FRZ STORE,90.0,58.5,8.96,90.0,83
CDM,31101525,%CHROMO AMNIOTIC FL,1301.0,845.65,116.49,1301.0,83
CDM,31101535,%PAX6 PROBE X10,148.0,96.2,21.42,164.91,83
CDM,31101555,%FCULT SKIN CULTURE,971.0,631.15,60.74,1083.61,83
CDM,31101565,%ETCF FIBROBLASTS,971.0,631.15,60.74,1083.61,83
CDM,31101575,%FCULT CRYOPRESER,90.0,58.5,8.96,90.0,83
CDM,31101585,%ETCF CRYOPRESERVE,90.0,58.5,8.96,90.0,83
CDM,31101595,%CVID FLOW FIRST MARKER,2482.0,1613.3,60.74,2482.0,86
CDM,31101615,%NFIB1 TISSUE CULT,804.0,522.6,60.74,804.0,83
CDM,31101625,CORD BLOOD THAW,83.0,53.95,8.96,83.0,83
CDM,31101645,INDIVIDUAL FCM MARKER X1,2482.0,1613.3,60.74,2482.0,86
CDM,31101655,%BAL FCM 1ST MARKER,2482.0,1613.3,60.74,2482.0,86
CDM,31101665,%NUCLEAR TDT BY FCM 1ST MARKER,2482.0,1613.3,60.74,2482.0,86
CDM,31101675,%ACLUK2 1ST MARK,2482.0,1613.3,60.74,2482.0,86
CDM,31101685,%MYELOMA 1ST MARKER,2482.0,1613.3,60.74,2482.0,86
CDM,31101695,%T CELL VBETA 1ST MARKER,2482.0,1613.3,60.74,2482.0,86
CDM,31101705,%SURFACE/CYTO IGM 1ST MARKER,2482.0,1613.3,60.74,2482.0,86
CDM,31101715,%PNH PANEL 1ST MARKER,2482.0,1613.3,60.74,2482.0,86
CDM,31101725,%PLTFLOW CYTO 1ST MARKER,2482.0,1613.3,60.74,2482.0,86
CDM,31101735,%IMMUNE ACT 1ST MARKER,2482.0,1613.3,60.74,2482.0,86
CDM,31101745,%BLYMPHOMA 1ST MARKER,2482.0,1613.3,60.74,2482.0,86
CDM,31101755,%LGLYM 1ST MRK,2482.0,1613.3,60.74,2482.0,86
CDM,31101765,%RLLLIP 1ST MARKER,2482.0,1613.3,60.74,2482.0,86
CDM,31101775,%RLLYMP FC LYMP 1ST MRK,2482.0,1613.3,60.74,2482.0,86
CDM,31101785,%RLLYMP LYMPH MRK ADD X17,149.0,96.85,24.28,149.0,68
CDM,31101795,%ZAP70 ADDTL MARKERS,149.0,96.85,24.28,149.0,68
CDM,31101805,%ZAP70 FIRST MARKER,2482.0,1613.3,60.74,2482.0,86
CDM,31101815,%DGEORG DNA PROBEX2,148.0,96.2,21.42,164.91,83
CDM,31101825,DNA CONTENT/CELL CYC ANLS,369.0,239.85,45.47,369.0,86
CDM,31101835,%MYCELL 1ST MRK BLOOD,2482.0,1613.3,60.74,2482.0,86
CDM,31101845,%MYCELL EA ADD MRK BLDX5,149.0,96.85,24.28,149.0,68
CDM,31101855,%CRMCON CHROMANALY SCELL,1824.0,1185.6,116.49,1824.0,83
CDM,31101915,FIBROBLAST CULTURE MAYO,971.0,631.15,60.74,1083.61,83
CDM,31101925,CVCULT TISSUE CULTURE,971.0,631.15,60.74,1083.61,83
CDM,31101935,CVCULT CRYOPRESERVATN,90.0,58.5,8.96,90.0,83
CDM,31101945,IGH/CCND1 TISSUE CULT BM,992.0,644.8,60.74,992.0,83
CDM,31101955,IGH/CCND1 TISSUE CULT BLD,992.0,644.8,60.74,992.0,83
CDM,31101965,IGH/CCND1 BLD PROBE X2,148.0,96.2,21.42,164.91,83
CDM,31101975,IGH/CCND1 BLD 100-300,353.0,229.45,51.19,353.0,83
CDM,31101985,IGH/BCL2 TISSUE CULT BLD,992.0,644.8,60.74,992.0,83
CDM,31101995,IGH/BCL2 BLD PROBE X2,148.0,96.2,21.42,164.91,83
CDM,31102005,IGH/BCL2 BLD 100-300,353.0,229.45,51.19,353.0,83
CDM,31102015,BCL2 TISSUE CULT BLOOD,992.0,644.8,60.74,992.0,83
CDM,31102025,BCL2 TISSUE CULT BM,992.0,644.8,60.74,992.0,83
CDM,31102035,BCL2 BM PROBE X2,148.0,96.2,21.42,164.91,83
CDM,31102045,BCL2 BM 100-300,353.0,229.45,51.19,353.0,83
CDM,31102055,BCL6 TISSUE CULT BLOOD,992.0,644.8,60.74,992.0,83
CDM,31102065,BCL6 BLD PROBE X2,148.0,96.2,21.42,164.91,83
CDM,31102075,BCL6 BLD 100-300,353.0,229.45,51.19,353.0,83
CDM,31102085,BCL6 TISSUE CULT BM,992.0,644.8,60.74,992.0,83
CDM,31102095,MYCFSH TISSUE CULT BLOOD,992.0,644.8,60.74,992.0,83
CDM,31102105,MYCFSH BLD PROBE X2,148.0,96.2,21.42,164.91,83
CDM,31102115,MYCFSH BLD 100-300,353.0,229.45,51.19,353.0,83
CDM,31102125,MYC TISSUE CULT BM,992.0,644.8,60.74,992.0,83
CDM,31102135,MYC BM PROBE X2,148.0,96.2,21.42,164.91,83
CDM,31102145,814FSH TISSUE CULT BLD,992.0,644.8,60.74,992.0,83
CDM,31102155,IGH/MYC TISSUE CULT BM,992.0,644.8,60.74,992.0,83
CDM,31102165,IGH/MYC BM PROBE X2,148.0,96.2,21.42,164.91,83
CDM,31102175,IGH/MYC BM 100-300,353.0,229.45,51.19,353.0,83
CDM,31102185,CCND1F TISSUE CULT BLOOD,992.0,644.8,60.74,992.0,83
CDM,31102195,CCND1F PROBE BLD X2,148.0,96.2,21.42,164.91,83
CDM,31102205,CCND1F ANALY 100-300 BLD,353.0,229.45,51.19,353.0,83
CDM,31102215,CCND1M TISSUE CULT BM,992.0,644.8,60.74,992.0,83
CDM,31102225,5QFSH TISSUE CULT BLOOD,992.0,644.8,60.74,992.0,83
CDM,31102235,5QFSH PROBE BLD X2,148.0,96.2,21.42,164.91,83
CDM,31102245,5Q TISSUE CULT BM,992.0,644.8,60.74,992.0,83
CDM,31102255,5Q BM PROBE X2,148.0,96.2,21.42,164.91,83
CDM,31102265,5Q BM 100-300,353.0,229.45,51.19,353.0,83
CDM,31102275,FISH7Q TISSUE CULT BLD,992.0,644.8,60.74,992.0,83
CDM,31102285,7Q TISSUE CULT BM,992.0,644.8,60.74,992.0,83
CDM,31102295,7Q BM PROBE X2,148.0,96.2,21.42,164.91,83
CDM,31102305,7Q BM 100-300,353.0,229.45,51.19,353.0,83
CDM,31102315,20Q8 TISSUE CULT BM,992.0,644.8,60.74,992.0,83
CDM,31102325,20Q8 BM PROBE X2,148.0,96.2,21.42,164.91,83
CDM,31102335,20Q8 BM 100-300,353.0,229.45,51.19,353.0,83
CDM,31102345,20Q8 TISSUE CULT BLD,992.0,644.8,60.74,992.0,83
CDM,31102355,1221FH TISSUE CULT BLOOD,992.0,644.8,60.74,992.0,83
CDM,31102365,1221FM TISSUE CULT BM,992.0,644.8,60.74,992.0,83
CDM,31102375,1221FM BM PROBE X2,148.0,96.2,21.42,164.91,83
CDM,31102385,1221FM BM 100-300,353.0,229.45,51.19,353.0,83
CDM,31102395,FGFR1F TISSUE CULT BLOOD,992.0,644.8,60.74,992.0,83
CDM,31102405,FGFR1M TISSUE CULT BM,992.0,644.8,60.74,992.0,83
CDM,31102415,FGFR1M BM PROBE X2,148.0,96.2,21.42,164.91,83
CDM,31102425,FGFR1M BM 100-300,353.0,229.45,51.19,353.0,83
CDM,31102435,TCLACV FLOWCYTO 1ST MKR,2482.0,1613.3,60.74,2482.0,86
CDM,31102445,IGH/BCL2 TISSUE CULT BM,992.0,644.8,60.74,992.0,83
CDM,31102455,PDGFRB TISSUE CULT BLOOD,992.0,644.8,60.74,992.0,83
CDM,31102465,PDGFBM TISSUE CULT BM,992.0,644.8,60.74,992.0,83
CDM,31102475,PDGFBM BM PROBE X2,148.0,96.2,21.42,164.91,83
CDM,31102485,PDGFBM BM 100-300,353.0,229.45,51.19,353.0,83
CDM,31102495,PDGFRA TISSUE CULT BLOOD,992.0,644.8,60.74,992.0,83
CDM,31102505,PDGFAM TISSUE CULT BM,992.0,644.8,60.74,992.0,83
CDM,31102515,PDGFAM BM PROBE X2,148.0,96.2,21.42,164.91,83
CDM,31102525,PDGFAM BM 100-300,353.0,229.45,51.19,353.0,83
CDM,31102535,RARFSH TISSUE CULT BLOOD,992.0,644.8,60.74,992.0,83
CDM,31102545,RARFSM TISSUE CULT BM,992.0,644.8,60.74,992.0,83
CDM,31102555,RARFSM BM PROBE X2,148.0,96.2,21.42,164.91,83
CDM,31102565,RARFSM BM 100-300,353.0,229.45,51.19,353.0,83
CDM,31102575,FHT410 TISSUE CULT BLOOD,992.0,644.8,60.74,992.0,83
CDM,31102585,FT410M TISSUE CULT BM,992.0,644.8,60.74,992.0,83
CDM,31102595,FT410M BM PROBE X2,148.0,96.2,21.42,164.91,83
CDM,31102605,FT410M BM 100-300,353.0,229.45,51.19,353.0,83
CDM,31102615,INV16F TISSUE CULT BLOOD,992.0,644.8,60.74,992.0,83
CDM,31102625,INV16M TISSUE CULT BM,992.0,644.8,60.74,992.0,83
CDM,31102635,INV16M BM PROBE X2,148.0,96.2,21.42,164.91,83
CDM,31102645,INV16M BM 100-300,353.0,229.45,51.19,353.0,83
CDM,31102655,MLLFSH TISSUE CULT BLOOD,992.0,644.8,60.74,992.0,83
CDM,31102665,MLLFBM TISSUE CULT BM,992.0,644.8,60.74,992.0,83
CDM,31102675,MLLFBM BM PROBE X2,148.0,96.2,21.42,164.91,83
CDM,31102685,MLLFBM BM 100-300,353.0,229.45,51.19,353.0,83
CDM,31102695,BCRFSH TISSUE CULT BLOOD,992.0,644.8,60.74,992.0,83
CDM,31102705,BCRFSM TISSUE CULT BM,992.0,644.8,60.74,992.0,83
CDM,31102715,BCRFSM BM PROBE X2,148.0,96.2,21.42,164.91,83
CDM,31102725,BCRFSM BM 100-300,353.0,229.45,51.19,353.0,83
CDM,31102735,FAMLPN TISSUE CULT BLOOD,992.0,644.8,60.74,992.0,83
CDM,31102745,FAMLPM TISSUE CULT BM,992.0,644.8,60.74,992.0,83
CDM,31102755,FAMLPM BM PROBE,148.0,96.2,21.42,164.91,83
CDM,31102765,FAMLPM BM 100-300,353.0,229.45,51.19,353.0,83
CDM,31102775,FSHBLL TISSUE CULT BLOOD,992.0,644.8,60.74,992.0,83
CDM,31102785,FSBLLM TISSUE CULT BM,992.0,644.8,60.74,992.0,83
CDM,31102795,FSBLLM BM PROBE X12,148.0,96.2,21.42,164.91,83
CDM,31102805,FSBLLM BM 100-300,353.0,229.45,51.19,353.0,83
CDM,31102815,FABCFP TISSUE CULT BLOOD,992.0,644.8,60.74,992.0,83
CDM,31102825,FABCBM TISSUE CULT BM,992.0,644.8,60.74,992.0,83
CDM,31102835,FABCBM BM PROBE X8,148.0,96.2,21.42,164.91,83
CDM,31102845,MPNFSH TISSUE CULT BM,992.0,644.8,60.74,992.0,83
CDM,31102855,MPNFSH BM PROBE X9,148.0,96.2,21.42,164.91,83
CDM,31102865,MPNFSH BM 100-300 X4,353.0,229.45,51.19,353.0,83
CDM,31102875,MPNFSM TISSUE CULT BM,992.0,644.8,60.74,992.0,83
CDM,31102885,MPNFSM BM PROBE X9,148.0,96.2,21.42,164.91,83
CDM,31102895,MPNFSM BM 100-300 X4,353.0,229.45,51.19,353.0,83
CDM,31102905,BCRQLM BCR/ABL1 MAJ BRKPT,1131.0,735.15,80.97,1262.54,84
CDM,31102915,BCRQLM BCR/ABL1 MIN BRKPT,999.0,649.35,71.52,1115.21,84
CDM,31102925,BCRQLM BCR/ABL1 OTH BRKPT,1481.0,962.65,85.85,1481.0,84
CDM,31102935,AMLFSH TISSUE CULT BLOOD,992.0,644.8,60.74,992.0,83
CDM,31102945,AMLFBM TISSUE CULT BM,992.0,644.8,60.74,992.0,83
CDM,31102955,AMLFBM BM PROBE X2,148.0,96.2,21.42,164.91,83
CDM,31102965,AMLFBM BM 100-300,353.0,229.45,51.19,353.0,83
CDM,31102975,APLFSH TISSUE CULT BLOOD,992.0,644.8,60.74,992.0,83
CDM,31102985,APLFBM TISSUE CULT BM,992.0,644.8,60.74,992.0,83
CDM,31102995,APLFBM BM PROBE X2,148.0,96.2,21.42,164.91,83
CDM,31103005,APLFBM BM 100-300,353.0,229.45,51.19,353.0,83
CDM,31103015,FSHMDS TISSUE CULT BLOOD,992.0,644.8,60.74,992.0,83
CDM,31103025,FSMDSM TISSUE CULT BM,992.0,644.8,60.74,992.0,83
CDM,31103035,FSMDSM BM PROBE X6,148.0,96.2,21.42,164.91,83
CDM,31103045,FSMDSM BM 100-300 X3,353.0,229.45,51.19,353.0,83
CDM,31103055,CVCYTO CHROMOSOME KARYOTYPE,231.0,150.15,33.47,231.0,83
CDM,31103065,FABCBM BM 100-300 X4,353.0,229.45,51.19,353.0,83
CDM,31103075,CHROMOSOME ANLYS KARY 15-20,866.0,562.9,83.94,866.0,83
CDM,31103085,CHRBLD CHROMO STDY ADD,238.0,154.7,34.43,238.0,83
CDM,31103095,CHRBLL CHROM ANLY 20-25,998.0,648.7,116.49,998.0,83
CDM,31103105,CHROM BM CULT PROC,992.0,644.8,60.74,992.0,83
CDM,31103115,CHRBMH CHROM ANLY 20-25,998.0,648.7,116.49,998.0,83
CDM,31103125,CHRSOL CHROM ANLY 20-25,998.0,648.7,116.49,998.0,83
CDM,31103135,CHROMO NEOPLS TIS CULTURE,1018.0,661.7,60.74,1026.15,83
CDM,31103145,CHRNPT CHROM ANLY 20-25,998.0,648.7,116.49,998.0,83
CDM,31103155,BMCHFX CHROM ANLY 20-25,998.0,648.7,116.49,998.0,83
CDM,31103165,CHRMOS TIS CUL LYMPHOCYTE,804.0,522.6,60.74,804.0,83
CDM,31103175,CHRMOS CHROM ANLS 45,1037.0,674.05,116.49,1037.0,83
CDM,31103185,CELL PROCESSING AND STORAGE,90.0,58.5,8.96,90.0,83
CDM,31103195,POCHF CHROM TIS CUL PROC,971.0,631.15,60.74,1083.61,83
CDM,31103205,POCHF CHR ANLS KARY 15-20,866.0,562.9,83.94,866.0,83
CDM,31103215,CLLFSH TISSUE CULT BLD,992.0,644.8,60.74,992.0,83
CDM,31103225,CHROMS STUDY ADDTL,238.0,154.7,34.43,238.0,83
CDM,31103235,CELL CRYOPRESERVE/STORAGE,90.0,58.5,8.96,90.0,83
CDM,31103245,CPALMF TISSUE CULTURE SKIN/BIOPSY,971.0,631.15,60.74,1083.61,83
CDM,31103255,CPALMF CELL CRYOPRESERVE/STORAGE,90.0,58.5,8.96,90.0,83
CDM,31103265,B CELL CD20 1ST MRK,2482.0,1613.3,60.74,2482.0,86
CDM,31103275,B CELL CD20 ADDTL MRK,149.0,96.85,24.28,149.0,68
CDM,31103285,CHRMDS CHROM ANLY 20-25,998.0,648.7,116.49,998.0,83
CDM,31103295,CHRAML CULT PROC,992.0,644.8,60.74,992.0,83
CDM,31103305,CHRAML CHROM ANLY 20-25,998.0,648.7,116.49,998.0,83
CDM,31103315,FL CYT LAB1243 1ST MKR,2482.0,1613.3,60.74,2482.0,86
CDM,31103325,FLW CYT LYMP WKUP LAB2500,2482.0,1613.3,60.74,2482.0,86
CDM,31103335,CRL2FB PROBE X2,148.0,96.2,21.42,164.91,83
CDM,31103345,CRLF2M ANALY 100-300,353.0,229.45,51.19,353.0,83
CDM,31103355,CRLF2M TISSUE CULT BLOOD,992.0,644.8,60.74,992.0,83
CDM,31103365,CRL2FB PROBE,148.0,96.2,21.42,164.91,83
CDM,31103375,CRL2FB ANALY 100-300,353.0,229.45,51.19,353.0,83
CDM,31103385,CRL2FB TISSUE CULT BLOOD,992.0,644.8,60.74,992.0,83
CDM,31103395,CRIGMP PROBE X4,148.0,96.2,21.42,164.91,83
CDM,31103405,CRIGMP ANALY 100-300 X2,353.0,229.45,51.19,353.0,83
CDM,31103415,CRIGMP TISSUE CULT BLOOD,992.0,644.8,60.74,992.0,83
CDM,31103425,CRIGHM PROBE,148.0,96.2,21.42,164.91,83
CDM,31103435,CRIGHM ANALY 100-300,353.0,229.45,51.19,353.0,83
CDM,31103445,CRIGHM TISSUE CULT BLOOD,992.0,644.8,60.74,992.0,83
CDM,31103455,CRIGHB PROBE,148.0,96.2,21.42,164.91,83
CDM,31103465,CRIGHB ANALY 100-300,353.0,229.45,51.19,353.0,83
CDM,31103475,CRIGHB TISSUE CULT BLOOD,992.0,644.8,60.74,992.0,83
CDM,31103485,CRIGBP PROBE X4,148.0,96.2,21.42,164.91,83
CDM,31103495,CRIGBP ANALY 100-300 X2,353.0,229.45,51.19,353.0,83
CDM,31103505,CRIGBP TISSUE CULT BLOOD,992.0,644.8,60.74,992.0,83
CDM,31103515,ISIGHT CYTOGENETICS 25-99,292.0,189.8,42.38,292.0,83
CDM,31103525,CLLFSM TISSUE CULT BLD,992.0,644.8,60.74,992.0,83
CDM,31103535,CLLFSM PROBE X7,148.0,96.2,21.42,164.91,83
CDM,31103545,CLLFSM ANALY 100-300 X3,353.0,229.45,51.19,353.0,83
CDM,31103555,PAP SMEAR,98.0,63.7,15.29,98.0,86
CDM,31103565,DDIT3 PROBE X2,148.0,96.2,21.42,164.91,83
CDM,31103575,DDIT3 ANALY 100-300,353.0,229.45,51.19,353.0,83
CDM,31103585,PAP AND REFLEX HPV SCREEN- ARUP,140.0,91.0,15.29,140.0,83
CDM,31103595,PAP WITH REFLEX HPV SCREEN-ARUP,140.0,91.0,15.29,140.0,83
CDM,31103605,ALPS FLOW CYTOMETRY,2482.0,1613.3,60.74,2482.0,86
CDM,31103615,ALPS FLOW MARKERS,149.0,96.85,24.28,149.0,68
CDM,31103625,ALPS FLOW INTERP,1947.0,1265.55,45.47,1947.0,68
CDM,31103635,TELOMERE LENGTH MEASUREMENT,369.0,239.85,45.47,369.0,86
CDM,31103645,MAML2 FISH DNA PROBES,148.0,96.2,21.42,164.91,83
CDM,31103655,ADDITIONAL DNA PROBE SET MAYO (IF APPROPRIATE),148.0,96.2,21.42,164.91,83
CDM,31103665,SET 3 DNA PROBES MAYO (IF APPROPRIATE),148.0,96.2,21.42,164.91,83
CDM,31103675,SET 4 DNA PROBES MAYO (IF APPROPRIATE),148.0,96.2,21.42,164.91,83
CDM,31103685,SET 5 DNA PROBES MAYO (IF APPROPRIATE),148.0,96.2,21.42,164.91,83
CDM,31103695,FISH MAYO LESS THAN 25 CELLS (IF APPROPRIATE),292.0,189.8,42.38,292.0,83
CDM,31103705,FISH MAYO 25 TO 99 CELLS (IF APPROPRIATE),292.0,189.8,42.38,292.0,83
CDM,31103715,FISH MAYO GREATER THAN 100 CELLS (IF APPROPRIATE),353.0,229.45,51.19,353.0,83
CDM,31103725,"RET GENE REARRANGEMENTS, FISH",1182.0,768.3,68.5,1182.0,86
CDM,31103735,"I(12P), GERM CELL TUMOR, FISH, TS",148.0,96.2,21.42,164.91,83
CDM,31103745,"ADDITIONAL DNA PROBE SET MAYO (IF APPROPRIATE)-I(12P), GERM CELL",148.0,96.2,21.42,164.91,83
CDM,31103755,"SET 3 DNA PROBES MAYO (IF APPROPRIATE)-I(12P), GERM CELL TUMOR,",148.0,96.2,21.42,164.91,83
CDM,31103765,"SET 4 DNA PROBES MAYO (IF APPROPRIATE)-I(12P), GERM CELL TUMOR,",148.0,96.2,21.42,164.91,83
CDM,31103775,"SET 5 DNA PROBES MAYO (IF APPROPRIATE)-I(12P), GERM CELL TUMOR,",148.0,96.2,21.42,164.91,83
CDM,31103785,"FISH MAYO LESS THAN 25 CELLS (IF APPROPRIATE)-I(12P), GERM CELL",292.0,189.8,42.38,292.0,83
CDM,31103795,"FISH MAYO 25 TO 99 CELLS (IF APPROPRIATE)-I(12P), GERM CELL TUMO",292.0,189.8,42.38,292.0,83
CDM,31103805,"PDGFB (22Q13), FISH, TS",148.0,96.2,21.42,164.91,83
CDM,31103815,"ADDITIONAL DNA PROBE SET MAYO (IF APPROPRIATE)-PDGFB (22Q13), FI",148.0,96.2,21.42,164.91,83
CDM,31103825,"SET 3 DNA PROBES MAYO (IF APPROPRIATE)-PDGFB (22Q13), FISH, TS",148.0,96.2,21.42,164.91,83
CDM,31103835,"SET 4 DNA PROBES MAYO (IF APPROPRIATE)-PDGFB (22Q13), FISH, TS",148.0,96.2,21.42,164.91,83
CDM,31103845,"SET 5 DNA PROBES MAYO (IF APPROPRIATE)-PDGFB (22Q13), FISH, TS",148.0,96.2,21.42,164.91,83
CDM,31103855,"FISH MAYO LESS THAN 25 CELLS (IF APPROPRIATE)-PDGFB (22Q13), FIS",292.0,189.8,42.38,292.0,83
CDM,31103865,"FISH MAYO 25 TO 99 CELLS (IF APPROPRIATE)-PDGFB (22Q13), FISH, T",292.0,189.8,42.38,292.0,83
CDM,31103875,"PLASMA CELL PROLIFERATIVE DISORDER, FISH",148.0,96.2,21.42,164.91,83
CDM,31103885,ADDITIONAL DNA PROBE SET MAYO (IF APPROPRIATE)-PLASMA CELL PROLI,148.0,96.2,21.42,164.91,83
CDM,31103895,SET 3 DNA PROBES MAYO (IF APPROPRIATE)-PLASMA CELL PROLIFERATIVE,148.0,96.2,21.42,164.91,83
CDM,31103905,SET 4 DNA PROBES MAYO (IF APPROPRIATE)-PLASMA CELL PROLIFERATIVE,148.0,96.2,21.42,164.91,83
CDM,31103915,SET 5 DNA PROBES MAYO (IF APPROPRIATE)-PLASMA CELL PROLIFERATIVE,148.0,96.2,21.42,164.91,83
CDM,31103925,FISH MAYO LESS THAN 25 CELLS (IF APPROPRIATE)-PLASMA CELL PROLIF,292.0,189.8,42.38,292.0,83
CDM,31103935,FISH MAYO 25 TO 99 CELLS (IF APPROPRIATE)-PLASMA CELL PROLIFERAT,292.0,189.8,42.38,292.0,83
CDM,31103945,FISH MAYO 100 OR MORE CELLS (IF APPROPRIATE)-PLASMA CELL PROLIFE,353.0,229.45,51.19,353.0,83
CDM,31103955,"PRKACA, REARRANGEMENT, FISH",148.0,96.2,21.42,164.91,83
CDM,31103965,"ADDITIONAL DNA PROBE SET MAYO (IF APPROPRIATE)-PRKACA, REARRANGE",148.0,96.2,21.42,164.91,83
CDM,31103975,"SET 3 DNA PROBES MAYO (IF APPROPRIATE)-PRKACA, REARRANGEMENT, FI",148.0,96.2,21.42,164.91,83
CDM,31103985,"SET 4 DNA PROBES MAYO (IF APPROPRIATE)-PRKACA, REARRANGEMENT, FI",148.0,96.2,21.42,164.91,83
CDM,31103995,"SET 5 DNA PROBES MAYO (IF APPROPRIATE)-PRKACA, REARRANGEMENT, FI",148.0,96.2,21.42,164.91,83
CDM,31104005,"FISH MAYO LESS THAN 25 CELLS (IF APPROPRIATE)-PRKACA, REARRANGEM",292.0,189.8,42.38,292.0,83
CDM,31104015,"FISH MAYO 25 TO 99 CELLS (IF APPROPRIATE)-PRKACA, REARRANGEMENT,",292.0,189.8,42.38,292.0,83
CDM,31104025,"FISH MAYO 100 OR MORE CELLS (IF APPROPRIATE)-PRKACA, REARRANGEME",353.0,229.45,51.19,353.0,83
CDM,31104035,"JAK2 (9P24.1), FISH",148.0,96.2,21.42,164.91,83
CDM,31104045,"ADDITIONAL DNA PROBE SET MAYO (IF APPROPRIATE)-JAK2 (9P24.1), FI",148.0,96.2,21.42,164.91,83
CDM,31104055,"SET 3 DNA PROBES MAYO (IF APPROPRIATE)-JAK2 (9P24.1), FISH",148.0,96.2,21.42,164.91,83
CDM,31104065,"SET 4 DNA PROBES MAYO (IF APPROPRIATE)-JAK2 (9P24.1), FISH",148.0,96.2,21.42,164.91,83
CDM,31104075,"SET 5 DNA PROBES MAYO (IF APPROPRIATE)-JAK2 (9P24.1), FISH",148.0,96.2,21.42,164.91,83
CDM,31104085,"FISH MAYO LESS THAN 25 CELLS (IF APPROPRIATE)-JAK2 (9P24.1), FIS",292.0,189.8,42.38,292.0,83
CDM,31104095,"FISH MAYO 25 TO 99 CELLS (IF APPROPRIATE)-JAK2 (9P24.1), FISH",292.0,189.8,42.38,292.0,83
CDM,31104105,"FISH MAYO 100 OR MORE CELLS (IF APPROPRIATE)-JAK2 (9P24.1), FISH",353.0,229.45,51.19,353.0,83
CDM,31104115,"NR4A3, REARRANGEMENT, FISH",148.0,96.2,21.42,164.91,83
CDM,31104125,"ADDITIONAL DNA PROBE SET MAYO (IF APPROPRIATE)-NR4A3, REARRANGEM",148.0,96.2,21.42,164.91,83
CDM,31104135,"SET 3 DNA PROBES MAYO (IF APPROPRIATE)-NR4A3, REARRANGEMENT, FIS",148.0,96.2,21.42,164.91,83
CDM,31104145,"SET 4 DNA PROBES MAYO (IF APPROPRIATE)-NR4A3, REARRANGEMENT, FIS",148.0,96.2,21.42,164.91,83
CDM,31104155,"SET 5 DNA PROBES MAYO (IF APPROPRIATE)-NR4A3, REARRANGEMENT, FIS",148.0,96.2,21.42,164.91,83
CDM,31104165,"FISH MAYO LESS THAN 25 CELLS (IF APPROPRIATE)-NR4A3, REARRANGEME",292.0,189.8,42.38,292.0,83
CDM,31104175,"FISH MAYO 25 TO 99 CELLS (IF APPROPRIATE)-NR4A3, REARRANGEMENT,",292.0,189.8,42.38,292.0,83
CDM,31104185,"FISH MAYO 100 OR MORE CELLS (IF APPROPRIATE)-NR4A3, REARRANGEMEN",353.0,229.45,51.19,353.0,83
CDM,31104195,"T-LYMPHOBLASTIC LEUKEMIA/LYMPHOMA, FISH",148.0,96.2,21.42,164.91,83
CDM,31104205,ADDITIONAL DNA PROBE SET MAYO (IF APPROPRIATE),148.0,96.2,21.42,164.91,83
CDM,31104215,SET 3 DNA PROBES MAYO (IF APPROPRIATE),148.0,96.2,21.42,164.91,83
CDM,31104225,SET 4 DNA PROBES MAYO (IF APPROPRIATE),148.0,96.2,21.42,164.91,83
CDM,31104235,SET 5 DNA PROBES MAYO (IF APPROPRIATE),148.0,96.2,21.42,164.91,83
CDM,31104245,FISH MAYO LESS THAN 25 CELLS (IF APPROPRIATE),292.0,189.8,42.38,292.0,83
CDM,31104255,FISH MAYO 25 TO 99 CELLS (IF APPROPRIATE),292.0,189.8,42.38,292.0,83
CDM,31104265,FISH MAYO 100 OR MORE CELLS (IF APPROPRIATE),353.0,229.45,51.19,353.0,83
CDM,31104275,"ALK, (2P23), IMT, FISH",148.0,96.2,21.42,164.91,83
CDM,31104285,ADDITIONAL DNA PROBE SET MAYO (IF APPROPRIATE),148.0,96.2,21.42,164.91,83
CDM,31104295,SET 3 DNA PROBES MAYO (IF APPROPRIATE),148.0,96.2,21.42,164.91,83
CDM,31104305,SET 4 DNA PROBES MAYO (IF APPROPRIATE),148.0,96.2,21.42,164.91,83
CDM,31104315,SET 5 DNA PROBES MAYO (IF APPROPRIATE),148.0,96.2,21.42,164.91,83
CDM,31104325,FISH MAYO LESS THAN 25 CELLS (IF APPROPRIATE),292.0,189.8,42.38,292.0,83
CDM,31104335,FISH MAYO 25 TO 99 CELLS (IF APPROPRIATE),292.0,189.8,42.38,292.0,83
CDM,31104345,"FUS (16P11.2), FISH",148.0,96.2,21.42,164.91,83
CDM,31104355,ADDITIONAL DNA PROBE SET MAYO (IF APPROPRIATE),148.0,96.2,21.42,164.91,83
CDM,31104365,SET 3 DNA PROBES MAYO (IF APPROPRIATE),148.0,96.2,21.42,164.91,83
CDM,31104375,SET 4 DNA PROBES MAYO (IF APPROPRIATE),148.0,96.2,21.42,164.91,83
CDM,31104385,SET 5 DNA PROBES MAYO (IF APPROPRIATE),148.0,96.2,21.42,164.91,83
CDM,31104395,FISH MAYO LESS THAN 25 CELLS (IF APPROPRIATE),292.0,189.8,42.38,292.0,83
CDM,31104405,FISH MAYO 25 TO 99 CELLS (IF APPROPRIATE),292.0,189.8,42.38,292.0,83
CDM,31104415,FISH 3Q26 BLD PROBE,148.0,96.2,21.42,164.91,83
CDM,31104425,FISH 3Q26 BLD ANALYSIS,353.0,229.45,51.19,353.0,83
CDM,31104435,FISH3Q36 TISSUE CULT BLOOD,992.0,644.8,60.74,992.0,83
CDM,31104445,FISH 3Q36 BM PROBE,148.0,96.2,21.42,164.91,83
CDM,31104455,FISH 3Q26 BM ANALYSIS,353.0,229.45,51.19,353.0,83
CDM,31104465,FISH 3Q26 TISSUE CULT BM,992.0,644.8,60.74,992.0,83
CDM,31104475,T-CELL ALL FISH 10 PROBE SETS,148.0,96.2,21.42,164.91,83
CDM,31104485,TALLAF FISH 100-300 CELLS,353.0,229.45,51.19,353.0,83
CDM,31104495,T-CELL ALL FISH ADDITIONAL PROBE SET,148.0,96.2,21.42,164.91,83
CDM,31104505,T-CELL ALL FISH 100-300 CELLS ADDITIONAL PROBE SET,353.0,229.45,51.19,353.0,83
CDM,31104515,FLOW TH17,2482.0,1613.3,60.74,2482.0,86
CDM,31104525,FLOW TH17 ADDITIONAL,149.0,96.85,24.28,149.0,68
CDM,31104535,FLOW CD107A,2482.0,1613.3,60.74,2482.0,86
CDM,31104545,FLOW CD107A ADDITIONAL,149.0,96.85,24.28,149.0,68
CDM,31104555,CD52EX FIRST MARKER,2482.0,1613.3,60.74,2482.0,86
CDM,31104565,CD52EX ADDITIONAL MARKERS,149.0,96.85,24.28,149.0,68
CDM,31104575,"KIRFLW FLOW CYTOMETRY; FIRST CELL SURFACE, CYTOPLASMIC OR NUCLEA",2482.0,1613.3,60.74,2482.0,86
CDM,31104585,"KIRFLW FLOW CYTOMETRY; ADDITIONAL CELL SURFACE, CYTOPLASMIC OR N",149.0,96.85,24.28,149.0,68
CDM,31104595,FLOW PERFORIN/GRANZYME B,2482.0,1613.3,60.74,2482.0,86
CDM,31104605,FLOW PERFORIN/GRANZYME B ADDITIONAL,149.0,96.85,24.28,149.0,68
CDM,31104615,FLOW SAP (XLP1) AND XIAP (XLP2),2482.0,1613.3,60.74,2482.0,86
CDM,31104625,FLOW SAP (XLP1) AND XIAP (XLP2) ADDITIONAL,149.0,96.85,24.28,149.0,68
CDM,31104635,FLOW PSTAT5,2482.0,1613.3,60.74,2482.0,86
CDM,31104645,FLOW PSTAT5 ADDITIONAL,149.0,96.85,24.28,149.0,68
CDM,31104765,PAP WITH REFLEX HPV SCREEN-ARUP,184.0,119.6,15.29,184.0,83
CDM,31104775,CHROMOSOME ANALYSIS AMNIOTIC FLUID,1198.0,778.7,116.49,1198.0,83
CDM,31104785,AMNIOTIC FLUID FETAL CELL CULTURE,1037.0,674.05,60.74,1037.0,83
CDM,31104795,REFLEX AMNIOTIC FLUID CULTURE,1037.0,674.05,60.74,1037.0,83
CDM,31104805,"REFLEX COUNT 5, 1 KARYOTYPE",1824.0,1185.6,116.49,1824.0,83
CDM,31104815,CVS FETAL CELL CULTURE,1037.0,674.05,60.74,1037.0,83
CDM,31104825,CHROMOSOME ANALYSIS CVS,1301.0,845.65,116.49,1301.0,83
CDM,31104835,"REFLEX COUNT 5, 1 KARYOTYPE",1824.0,1185.6,116.49,1824.0,83
CDM,31104845,REFLEX AMNIOTIC FLUID CULTURE PROCESSING FEE,1037.0,674.05,60.74,1037.0,83
CDM,31104855,CHROMOSOME FISH PRENATAL,148.0,96.2,21.42,164.91,83
CDM,31104865,CHROMOSOME ANALYSIS AMNIOTIC FLUID,353.0,229.45,51.19,353.0,83
CDM,31104875,MOLECULAR CYTOGENETIC TEST,148.0,96.2,21.42,164.91,83
CDM,31104885,INTERPHASE IN SITU HYBRIDIZATION,353.0,229.45,51.19,353.0,83
CDM,31104895,SEND OUT ROS1 BY FISH,1182.0,768.3,68.5,1182.0,86
CDM,31104905,"SEND OUT ALK GENE REARRANGEMENTS BY FISH, LUNG",1182.0,768.3,68.5,1182.0,86
CDM,31104915,CHROMOSOME AMNIOTIC FLUID,1037.0,674.05,60.74,1037.0,83
CDM,31104925,"CHROMOSOME ANALYSIS 6-12 COLONIES, 1 KARYOTYPE",1198.0,778.7,116.49,1198.0,83
CDM,31104935,CHROMOSOME ANALYSIS ADDITIONAL KARYOTYPE,231.0,150.15,33.47,231.0,83
CDM,31104945,"18, XY AMNIO ANEUPLOID FISH",148.0,96.2,21.42,164.91,83
CDM,31104955,"13, 21 AMNIO ANEUPLOID FISH",148.0,96.2,21.42,164.91,83
CDM,31200005,FISH FOR BLADDER CANCER W/URINARY CYTO,1182.0,768.3,60.74,1182.0,86
CDM,31200010,SURG PATH GROSS ONLY LVL I,169.0,109.85,21.57,169.0,86
CDM,31200015,PATH TOUCH PREP INIT,169.0,109.85,22.7,169.0,86
CDM,31200020,SURG PATH GROSS MICRO LVL II,271.0,176.15,25.83,271.0,86
CDM,31200025,SPECIAL STAIN ON FS,184.0,119.6,37.39,184.0,68
CDM,31200030,SURG PATH GROSS MICRO LVL III,369.0,239.85,37.39,369.0,86
CDM,31200035,OR CONSULTATION,410.0,266.5,34.71,410.0,86
CDM,31200050,TISSUE EXAM BY PATH LVL V,2482.0,1613.3,68.5,2482.0,86
CDM,31200060,TISSUE EXAM BY PATH LVL VI,5637.0,3664.05,68.5,5637.0,86
CDM,31200065,IMMUNOHISTOCHEM QT,1182.0,768.3,68.5,1182.0,86
CDM,31200075,FISH FOR 5Q BIOVIEW X2,2482.0,1613.3,68.5,2482.0,86
CDM,31200080,DECALCIFICATION PROC,106.0,68.9,13.08,106.0,68
CDM,31200085,FISH MYELODYSP MANUAL X6,2482.0,1613.3,68.5,2482.0,86
CDM,31200105,"GLOM BASE AB, IGG IFA",83.0,53.95,5.95,83.0,84
CDM,31200130,HISTOCHEMISTRY FOR ENZYME,5637.0,3664.05,68.5,5637.0,86
CDM,31200145,IHC EA ADDTL AB/BLOCK,247.0,160.55,37.39,247.0,68
CDM,31200155,IHC ADDTL AB PER SLIDE,247.0,160.55,37.39,247.0,68
CDM,31200160,CONSULT SLIDE PREP ELSEWHERE,271.0,176.15,34.71,271.0,86
CDM,31200165,IHC EA MULTIPLEX AB,2482.0,1613.3,68.5,2482.0,86
CDM,31200170,CONSULT SLIDE W PREP,369.0,239.85,34.71,369.0,86
CDM,31200175,CISH ADDTL,935.0,607.75,37.39,935.0,68
CDM,31200180,CONSULT COMPRE DATA REVIEW,1182.0,768.3,34.71,1182.0,86
CDM,31200190,PATH CONSULT OR 1ST BLOCK,1182.0,768.3,34.71,1182.0,86
CDM,31200195,CISH ADDTL PROBE MOD,935.0,607.75,37.39,935.0,68
CDM,31200200,PATH CONSULT OR ADD TIS BLOCK,183.0,118.95,34.71,183.0,68
CDM,31200205,SP BIOPSY PROSTATE,369.0,239.85,37.39,369.0,86
CDM,31200230,IMMUNOHISTOCHEM EA AB,1182.0,768.3,68.5,1182.0,86
CDM,31200235,IHC /SPC EA ADD AB STN,247.0,160.55,37.39,247.0,68
CDM,31200245,"SMEAR, PARASITE SPECIAL STAIN",41.0,26.65,2.96,58.34,84
CDM,31200255,"SMEAR, TRICHROME STAIN",124.0,80.6,8.88,124.0,84
CDM,31200265,FISH EA MULTIPLEX PROBE STAIN PROC,1182.0,768.3,68.5,1182.0,86
CDM,31200275,IMMUNOHISTOCHEM EA AB,1182.0,768.3,68.5,1182.0,86
CDM,31200285,PATH TOUCH PREP EA ADD,183.0,118.95,28.79,183.0,68
CDM,31200290,ELECTRON MICRO DX,5637.0,3664.05,68.5,5637.0,86
CDM,31200295,O/S PATHOL/HYSTOL,126.0,81.9,35.63,138.46,86
CDM,31200305,FISH MORPHOMETRIC ANALYSIS,1182.0,768.3,68.5,1182.0,86
CDM,31200325,DECALCIFICATION MOD,106.0,68.9,13.08,106.0,68
CDM,31200335,PATH TOUCH PREP INIT,5637.0,3664.05,34.71,5637.0,86
CDM,31200350,SPEC STN GRP II,126.0,81.9,35.63,138.46,86
CDM,31200360,SPEC STN GRP II,126.0,81.9,35.63,138.46,86
CDM,31200365,FISH HER-2,1182.0,768.3,68.5,1182.0,86
CDM,31200375,FISH FOR BCL2,1182.0,768.3,68.5,1182.0,86
CDM,31200400,*IMMUNOFLUOR ANTB 1ST STAIN,1182.0,768.3,68.5,1182.0,86
CDM,31200430,IMMUNOFLUOR ANTB 1ST STAIN,1182.0,768.3,68.5,1182.0,86
CDM,31200450,INSITU HYBRID EA PROBE,673.0,437.45,68.5,673.0,86
CDM,31200530,INSITU HYBRID EA PROBE,673.0,437.45,68.5,673.0,86
CDM,31200540,SPECIAL STAIN GROUP 1,207.0,134.55,37.39,207.0,86
CDM,31200600,SURG PATH GROSS MICRO LVL VI MOD,5637.0,3664.05,68.5,5637.0,86
CDM,31200615,FISH FOR ANGIO MYC AMP,1182.0,768.3,68.5,1182.0,86
CDM,31200625,FISH FOR 1P36,1182.0,768.3,68.5,1182.0,86
CDM,31200635,FISH SYT GENE(18Q11),1182.0,768.3,68.5,1182.0,86
CDM,31200645,FISH EWSR1 (22Q12),1182.0,768.3,68.5,1182.0,86
CDM,31200655,FISH FOR EGFR,1182.0,768.3,68.5,1182.0,86
CDM,31200665,FISH FOR 19Q,1182.0,768.3,68.5,1182.0,86
CDM,31200675,FISH FOR ALK TRANS,1182.0,768.3,68.5,1182.0,86
CDM,31200685,FISH FOR MDM2,1182.0,768.3,68.5,1182.0,86
CDM,31200695,FISH C-MYC (8Q24) PRFN,1182.0,768.3,68.5,1182.0,86
CDM,31200705,FISH FOR RET PRFN,1182.0,768.3,68.5,1182.0,86
CDM,31200715,FISH FOR ROS1 PRFN,1182.0,768.3,68.5,1182.0,86
CDM,31200735,FISH T(14;18) FCL,2482.0,1613.3,68.5,2482.0,86
CDM,31200745,FISH T(11;14)MCL X2,2482.0,1613.3,68.5,2482.0,86
CDM,31200755,FISH FOR CLL X5,2482.0,1613.3,68.5,2482.0,86
CDM,31200765,FISH FOR IGHFSH,1182.0,768.3,68.5,1182.0,86
CDM,31200775,FISH MORP EA PRBE MOD,2482.0,1613.3,68.5,2482.0,86
CDM,31200785,ELECTRON MICROSCPY MOD,5637.0,3664.05,68.5,5637.0,86
CDM,31200795,FISH CUTANE MELANOMA,1182.0,768.3,68.5,1182.0,86
CDM,31200805,%REFMYL FISH REFLX,2482.0,1613.3,68.5,2482.0,86
CDM,31200815,%MLYFSH FISH IGH BA X2,2482.0,1613.3,68.5,2482.0,86
CDM,31200825,FISH FOR MALT 1 18Q21,1182.0,768.3,68.5,1182.0,86
CDM,31200835,%OVARAN AB FIRST,1182.0,768.3,68.5,1182.0,86
CDM,31200845,OVARAN AB SCRN W RFLX,83.0,53.95,5.95,83.0,84
CDM,31200895,DYSTROPHIN,153.0,99.45,33.35,170.55,66
CDM,31200905,FISH FOR IGH/MYC/CEP8 TISSUE,1182.0,768.3,68.5,1182.0,86
CDM,31200955,FISH FOR WWTR1/CAMTA1,1182.0,768.3,68.5,1182.0,86
CDM,31200975,BTM FISH REFLEX 1,1182.0,768.3,68.5,1182.0,86
CDM,31200985,BTM FISH REFLEX 2,1182.0,768.3,68.5,1182.0,86
CDM,31200995,BTM FISH REFLEX 3,1182.0,768.3,68.5,1182.0,86
CDM,31200OH,ETHMOIDECTOMY INTRANASAL ANTERIOR,2056.0,1336.4,1.1,17080.38,144
CDM,31201005,BTM FISH REFLEX 4,1182.0,768.3,68.5,1182.0,86
CDM,31201015,BTM FISH REFLEX 5,1182.0,768.3,68.5,1182.0,86
CDM,31201025,BTM FISH REFLEX 6,1182.0,768.3,68.5,1182.0,86
CDM,31201035,FISH FOR RET CYTO BLOCK,1182.0,768.3,68.5,1182.0,86
CDM,31201045,FISH FOR ROS1 CYTO BLOCK,1182.0,768.3,68.5,1182.0,86
CDM,31201055,FISH FOR ALK CYTO BLOCK,1182.0,768.3,68.5,1182.0,86
CDM,31201065,FISH FOR BLADDER CANCER,1182.0,768.3,60.74,1182.0,86
CDM,31201075,QFEVER AB IGG IGM PH I&II,84.0,54.6,5.99,84.0,84
CDM,31201085,QFEVER ABS IGM PH1 RFLX,2482.0,1613.3,68.5,2482.0,86
CDM,31201095,QFEVER ABS IGM PH2 RFLX,2482.0,1613.3,68.5,2482.0,86
CDM,31201105,QFEVER ABS IGG PH1 RFLX,2482.0,1613.3,68.5,2482.0,86
CDM,31201115,QFEVER ABS IGG PH2 RFLX,2482.0,1613.3,68.5,2482.0,86
CDM,31201135,EPATH CONSULT 1-7 SLIDES,271.0,176.15,34.71,271.0,86
CDM,31201145,EPATH CONSULT 8+ SLIDES,271.0,176.15,34.71,271.0,86
CDM,31201155,E SPEC STAIN GP I TECH,207.0,134.55,37.39,207.0,86
CDM,31201165,E SPEC STAIN GRP II TECH,126.0,81.9,35.63,138.46,86
CDM,31201175,SKIN MICRO LVL III,369.0,239.85,37.39,369.0,86
CDM,31201185,SKIN MICRO LEVEL 4,369.0,239.85,37.39,369.0,86
CDM,31201205,"MYCN (N-MYC), FISH",1182.0,768.3,68.5,1182.0,86
CDM,31201215,"MDM2, FISH",1182.0,768.3,68.5,1182.0,86
CDM,31201225,"PD-L1 (SP142) SEMIQUANT IHC, MANUAL",1182.0,768.3,68.5,1182.0,86
CDM,31201235,"PD-L1 (SP263) SEMIQUANT IHC, MANUAL",1182.0,768.3,68.5,1182.0,86
CDM,31201245,"PD-L1 (28-8), SEMIQUANT IHC, MANUAL",1182.0,768.3,68.5,1182.0,86
CDM,31201255,"HER2 AMPLIFICATION, MISCELLANEOUS TUMOR, FISH",1182.0,768.3,68.5,1182.0,86
CDM,31201265,"SLL, FISH",1182.0,768.3,68.5,1182.0,86
CDM,31201275,"ADDITIONAL PROBE SET MAYO (IF APPROPRIATE)-SLL, FISH",1182.0,768.3,68.5,1182.0,86
CDM,31201285,"2 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-SLL, FISH",1182.0,768.3,68.5,1182.0,86
CDM,31201295,"3 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-SLL, FISH",1182.0,768.3,68.5,1182.0,86
CDM,31201305,"4 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-SLL, FISH",1182.0,768.3,68.5,1182.0,86
CDM,31201315,"5 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-SLL, FISH",1182.0,768.3,68.5,1182.0,86
CDM,31201325,"6 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-SLL, FISH",1182.0,768.3,68.5,1182.0,86
CDM,31201335,"7 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-SLL, FISH",1182.0,768.3,68.5,1182.0,86
CDM,31201345,"8 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-SLL, FISH",1182.0,768.3,68.5,1182.0,86
CDM,31201355,"T-CELL LYMPHOMA, FISH",1182.0,768.3,68.5,1182.0,86
CDM,31201365,"ADDITIONAL PROBE SET MAYO (IF APPROPRIATE)-T-CELL LYMPHOMA, FISH",1182.0,768.3,68.5,1182.0,86
CDM,31201375,"2 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-T-CELL LYMPHOMA, F",1182.0,768.3,68.5,1182.0,86
CDM,31201385,"3 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-T-CELL LYMPHOMA, F",1182.0,768.3,68.5,1182.0,86
CDM,31201395,"4 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-T-CELL LYMPHOMA, F",1182.0,768.3,68.5,1182.0,86
CDM,31201405,"5 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-T-CELL LYMPHOMA, F",1182.0,768.3,68.5,1182.0,86
CDM,31201415,"6 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-T-CELL LYMPHOMA, F",1182.0,768.3,68.5,1182.0,86
CDM,31201425,"7 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-T-CELL LYMPHOMA, F",1182.0,768.3,68.5,1182.0,86
CDM,31201435,"8 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-T-CELL LYMPHOMA, F",1182.0,768.3,68.5,1182.0,86
CDM,31201445,"B-CELL LYMPHOMA, FISH, TISSUE",1182.0,768.3,68.5,1182.0,86
CDM,31201455,"ADDITIONAL PROBE SET MAYO (IF APPROPRIATE)-B-CELL LYMPHOMA, FISH",1182.0,768.3,68.5,1182.0,86
CDM,31201465,"2 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-B-CELL LYMPHOMA, F",1182.0,768.3,68.5,1182.0,86
CDM,31201475,"3 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-B-CELL LYMPHOMA, F",1182.0,768.3,68.5,1182.0,86
CDM,31201485,"4 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-B-CELL LYMPHOMA, F",1182.0,768.3,68.5,1182.0,86
CDM,31201495,"5 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-B-CELL LYMPHOMA, F",1182.0,768.3,68.5,1182.0,86
CDM,31201505,"6 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-B-CELL LYMPHOMA, F",1182.0,768.3,68.5,1182.0,86
CDM,31201665,SPEC STN GRP II,126.0,81.9,35.63,138.46,86
CDM,31201OH,ETHMOIDECTOMY INTRANASAL TOTAL,3440.0,2236.0,1.1,4447.63,144
CDM,31205OH,ETHMOIDECTOMY EXTRANASAL TOTAL,4232.0,2750.8,1.1,9391.15,144
CDM,31225OH,MAXILLECTOMY W/O ORBITAL EXENTERATION,10680.0,6942.0,1.1,10680.0,144
CDM,31230OH,MAXILLECTOMY W/ORBITAL EXENTERATION,12328.0,8013.2,1.1,12328.0,144
CDM,31231OH,"NASAL ENDOS,DIAG,UNI/ BILATERAL",484.0,314.6,1.1,623.0,148
CDM,31233OH,"NASAL/SINUS ENDOS,DIAG W/ MAX SI",872.0,566.8,1.1,1190.73,148
CDM,31237OH,NASAL/SINUS NDSC SURG W/BX POLYPECT/DBRDMT SPX,1144.0,743.6,1.1,4949.64,148
CDM,31238OH,NASAL/SINUS NDSC SURG W/CONTROL NASAL HEMRRG,1206.0,783.9,1.1,4949.64,148
CDM,31239OH,NASAL/SINUS NDSC SURG W/DACRYOCSTORHINOSTOMY,3978.0,2585.7,1.1,10921.65,144
CDM,31240OH,NASAL/SINUS NDSC SURG W/CONCHA BULLOSA RESECTION,1148.0,746.2,1.1,4949.64,144
CDM,31241OH,NASAL/SINUS NDSC W/LIG SPHENOPALATINE ARTERY,3520.0,2288.0,1.1,4949.64,144
CDM,31242OH,NASAL/SINUS NDSC DSTRJ RF ABLATION PST NSL NRV,1188.0,772.2,1.1,17080.38,146
CDM,31243OH,NASAL/SINUS NDSC DSTRJ CRYOABLATION PST NSL NRV,1188.0,772.2,1.1,17080.38,146
CDM,31253OH,NASAL/SINUS NDSC TOT W/FRNT SINS EXPL TISS RMVL,3960.0,2574.0,1.1,19960.78,144
CDM,31254OH,NASAL/SINUS NDSC W/PARTIAL ETHMOIDECTOMY,1879.0,1221.35,1.1,19960.78,148
CDM,31255OH,NASAL/SINUS NDSC W/TOTAL ETHOIDECTOMY,2530.0,1644.5,1.1,19960.78,144
CDM,31256OH,NASAL/SINUS ENDOSCOPY W/MAXILLARY ANTROSTOMY,1368.0,889.2,1.1,10921.65,144
CDM,31257OH,NASAL/SINUS NDSC TOTAL WITH SPHENOIDOTOMY,3520.0,2288.0,1.1,19960.78,144
CDM,31259OH,NASAL/SINUS NDSC TOT W/SPHENDT W/SPHEN TISS RMVL,3731.0,2425.15,1.1,19960.78,144
CDM,31267OH,NSL/SINUS NDSC MAX ANTROST W/RMVL TISS MAX SINUS,2059.0,1338.35,1.1,19960.78,144
CDM,31276OH,NASAL/SINUS NDSC W/RMVL TISS FROM FRONTAL SINUS,2970.0,1930.5,1.1,19960.78,144
CDM,31287OH,NASAL/SINUS ENDOSCOPY W/SPHENOIDOTOMY,1540.0,1001.0,1.1,19960.78,144
CDM,31288OH,NSL/SINUS NDSC SPHENDT RMVL TISS SPHENOID SINUS,1640.0,1066.0,1.1,19960.78,144
CDM,31290OH,NASAL/SINUS NDSC RPR CEREBRSP FLUID LEAK ETHMOID,7444.0,4838.6,1.1,7444.0,144
CDM,31291OH,NASAL/SINUS NDSC RPR CEREBSP FLUID LEAK SPHENOID,7824.0,5085.6,1.1,7824.0,144
CDM,31292OH,NASAL/SINUS NDSC SURG MEDIAL/INF ORB WALL DCMPRN,6996.0,4547.4,1.1,19960.78,144
CDM,31293OH,NASAL/SINUS NDSC SURG MEDIAL&INF ORB WALL DCMPRN,6988.0,4542.2,1.1,19960.78,144
CDM,31294OH,NASAL/SINUS NDSC SURG W/OPTIC NERVE DCMPRN,8124.0,5280.6,1.1,19960.78,144
CDM,31295OH,NSL/SINUS NDSC SURG W/DILAT MAXILLARY SINUS,1080.0,702.0,1.1,19960.78,146
CDM,31296OH,NSL/SINUS NDSC SURG W/DILAT FRONTAL SINUS,1364.0,886.6,1.1,19960.78,146
CDM,31297OH,NSL/SINUS NDSC SURG W/DILAT SPHENOID SINUS,976.0,634.4,1.1,19960.78,146
CDM,31298OH,NASAL/SINUS NDSC SURG W/DILATION FRNT&SPHN SINUS,1800.0,1170.0,1.1,19960.78,146
CDM,31299RVU1OH,TREATMENT OF NASOPHARYNGEAL STENOSIS W/ENDOSCOPIC ASSIST (COMP 3,1003.0,651.95,0.01,1003.0,84
CDM,31299RVU2OH,"NASAL ENDOSCOPY, FOREIGN BODY REMOVAL (COMP 31237)",945.0,614.25,0.01,945.0,84
CDM,31299RVU4OH,MAXILLECTOMY; WITHOUT ORBITAL EXENTERATION (COMP 31225),9613.0,6248.45,0.01,9613.0,84
CDM,31299RVUOH,ENDO BILATERAL MOD LOTHROP,8290.0,5388.5,0.01,8290.0,84
CDM,31300OH,LARYNGOTOMY W/RMVL TUMOR/LARYNGOCELE CORDECTOMY,6364.0,4136.6,1.1,9391.15,144
CDM,31360OH,LARYNGECTOMY TOTAL W/O RADICAL NECK DISSECTION,11964.0,7776.6,1.1,11964.0,144
CDM,31365OH,LARYNGECTOMY TOTAL W/RADICAL NECK DISSECTION,15524.0,10090.6,1.1,15524.0,144
CDM,31367OH,LARYNGECTOMY STOT SUPRAGLOTTIC W/O RAD NECK DSJ,12228.0,7948.2,1.1,12228.0,144
CDM,31368OH,LARYNGECTOMY STOT SUPRAGLOTTIC W/RAD NCK DSJ,13676.0,8889.4,1.1,13676.0,144
CDM,31370OH,PARTIAL LARYNGECTOMY HEMILARYGECTOMY HORIZONTAL,11028.0,7168.2,1.1,11028.0,144
CDM,31375OH,PARTIAL LARYNGECTOMY HEMILARYNG LATEROVERTICAL,10428.0,6778.2,1.1,10428.0,144
CDM,31380OH,PARTIAL LARYNGECTOMY HEMILARYNG ANTEROVERTICAL,10228.0,6648.2,1.1,10228.0,144
CDM,31382OH,PARTIAL LARYNG HEMILARYNG ANTERO-LATERO-VERTICAL,11428.0,7428.2,1.1,11428.0,144
CDM,31390OH,PHARYNGOLARYNGECTOMY W/RAD NECK DSJ W/O RCNSTJ,17004.0,11052.6,1.1,17004.0,144
CDM,31395OH,PHARYNGOLARYNGECTOMY W/RAD NECK DSJ W/RCNSTJ,17520.0,11388.0,1.1,17520.0,144
CDM,31400OH,ARYTENOIDECTOMY/ARYTENOIDOPEXY XTRNL APPROACH,4640.0,3016.0,1.1,17080.38,144
CDM,31420OH,EPIGLOTTIDECTOMY,4572.0,2971.8,1.1,17080.38,144
CDM,31500OH,INTUBATION ENDOTRACHEAL EMERGENCY PROCEDURE,1200.0,780.0,1.1,1200.0,144
CDM,31502OH,TRACHEOTOMY TUBE CHANGE PRIOR TO FISTULA TRACT,260.0,169.0,1.1,713.21,144
CDM,31505OH,"LARYNGOSCOPY,INDIRECT,DIAGNOSTIC",244.0,158.6,1.1,578.53,148
CDM,31510OH,"LARYNGOSCOPY,INDIRECT WITH BIOPSY",768.0,499.2,1.1,10921.65,148
CDM,31511OH,"LARYNGOSCOPY,INDIRECT+REMV FOR.BODY",864.0,561.6,1.1,864.0,148
CDM,31515OH,LARYNGOSCOPY W/WO TRACHEOSCOPY ASPIRATION,720.0,468.0,1.1,1190.73,148
CDM,31520OH,LARYNGOSCOPY W/WO TRACHEOSCOPY DX NEWBORN,1024.0,665.6,1.1,1190.73,144
CDM,31525OH,LARYNGOSCOPY W/WO TRACHEOSCOPY DX EXCEPT NEWBORN,1052.0,683.8,1.1,4949.64,148
CDM,31526OH,LARYNGOSCOPY W/WO TRACHEOSCOPY W/MICRO/TELESCOPE,1028.0,668.2,1.1,4949.64,144
CDM,31528OH,LARYNGOSCOPY W/WO TRACHEOSCOPY W/DILATION IN,948.0,616.2,1.1,10921.65,144
CDM,31529OH,LARYNGOSCOPY W/WO TRACHEOSCOPY DILATION SUBSQ,1072.0,696.8,1.1,10921.65,144
CDM,31530OH,LARYNGOSCOPY W/FOREIGN BODY REMOVAL,1352.0,878.8,1.1,4949.64,144
CDM,31531OH,LARYNGOSCOPY FOREIGN BODY RMVL MICRO/TELESCOPE,1432.0,930.8,1.1,10921.65,144
CDM,31535OH,LARYNGOSCOPY DIRECT OPERATIVE W/BIOPSY,1264.0,821.6,1.1,10921.65,144
CDM,31536OH,LARYNGOSCOPY W/BIOPSY MICROSCOPE/TELESCOPE,1420.0,923.0,1.1,10921.65,144
CDM,31540OH,LARYNGOSCOPY EXC TUM&/STRIPPING CORDS/EPIGLOTT,1648.0,1071.2,1.1,10921.65,144
CDM,31541OH,LARGSC EXC TUM&/STRPG CORDS/EPIGL MCRSCP/TLSCP,1808.0,1175.2,1.1,10921.65,144
CDM,31545OH,LARGSC MICRO/TELESCOPE RMVL LES VOCAL CORD FLAP,2772.0,1801.8,1.1,10921.65,144
CDM,31551OH,LARYNGOPLASTY LARYNGEAL STEN W/O STENT < 12 YRS,8600.0,5590.0,1.1,17080.38,144
CDM,31552OH,LARYNGOPLASTY LARYNGEAL STEN W/O STENT 12 YRS >,8200.0,5330.0,1.1,17080.38,144
CDM,31553OH,LARYNGOPLASTY LARYNGEAL STEN W/STENT < 12 YRS,8800.0,5720.0,1.1,17080.38,144
CDM,31554OH,LARYNGOPLASTY LARYNGEAL STEN W/STENT 12 YRS >,8800.0,5720.0,1.1,17080.38,144
CDM,31560OH,LARYNGOSCOPY DIRECT OPERATIVE W/ARYTENOIDECTOMY,2398.0,1558.7,1.1,19960.78,144
CDM,31561OH,LARGSC ARYTENOIDECTOMY MICROSCOPE/TELESCOPE,2396.0,1557.4,1.1,19960.78,144
CDM,31570OH,LARYNGOSCOPE INJECTION VOCAL CORD THERAPEUTIC,1544.0,1003.6,1.1,10921.65,148
CDM,31571OH,LARGSC W/NJX VOCAL CORD THER W/MICRO/TELESCOPE,1704.0,1107.6,1.1,10921.65,144
CDM,31572OH,LARYNGOSCOPY FLEXIBLE ABLATJ DESTJ LESION(S) UNI,1324.0,860.6,1.1,10921.65,148
CDM,31573OH,LARYNGOSCOPY FLEXIBLE THERAPEUTIC INJECTION UNI,972.0,631.8,1.1,4949.64,148
CDM,31574OH,LARYNGOSCOPY FLEXIBLE W/INJECTION AGMNTJ UNI,972.0,631.8,1.1,4949.64,148
CDM,31575OH,LARYNGOSCOPY FLEXIBLE DIAGNOSTIC,414.0,269.1,1.1,578.53,148
CDM,31576OH,LARYNGOSCOPY FLEXIBLE W/BIOPSY(IES),756.0,491.4,1.1,4949.64,148
CDM,31578OH,LARYNGOSCOPY FLEXIBLE RMVL LESION(S) NON-LASER,972.0,631.8,1.1,10921.65,148
CDM,31579OH,LARYNGOSCOPY FLX/RGD TELESCOPIC W/STROBOSCOPY,827.0,537.55,1.1,1190.73,148
CDM,31580OH,LARYNGOPLASTY LARYN WEB W/KEEL STENT INSERTION,5840.0,3796.0,1.1,17080.38,144
CDM,31584OH,LARYNGOPLASTY W/OPEN REDUCTION FRACTURE W/TRACHS,7032.0,4570.8,1.1,17080.38,144
CDM,31587OH,LARYNGOPLASTY CRICOID SPLIT W/O GRAFT PLACEMENT,6108.0,3970.2,1.1,17080.38,144
CDM,31590OH,LARYNGEAL REINNERVATION NEUROMUSCULAR PEDICLE,3140.0,2041.0,1.1,17080.38,144
CDM,31591OH,LARYNGOPLASTY MEDIALIZATION UNLIATERAL,5424.0,3525.6,1.1,17080.38,144
CDM,31592OH,CRICOTRACHEAL RESECTION,10000.0,6500.0,1.1,17080.38,144
CDM,31599OH,UNLISTED PROCEDURE LARYNX,1641.0,1066.65,0.01,1641.0,84
CDM,31599RVU10OH,DL WITH LASER RESURFACING OF SUBGLOTTIC SKIN GRAFT (COMP 31536),1172.0,761.8,0.01,1580.23,84
CDM,31599RVU11OH,CHONDROLARYNGOPLASTY (TRACHEAL SHAVE/REDUCTION) (COMP 31591),3491.0,2269.15,0.01,3491.0,84
CDM,31599RVU12OH,ENDOSCOPIC LARYNGOPLASTY W/ INDWELLING KEEL OR STENT (COMP 31580,4689.0,3047.85,0.01,4689.0,84
CDM,31599RVU13OH,"LARYNGOSCOPY DIRECT, DIAGNOSTIC, FETUS (COMP 31520)",845.0,549.25,0.01,1580.23,84
CDM,31599RVU14OH,ESOPHAGOSCOPY WITH ESOPHAGEAL STENT (COMP CODE 43212),1445.0,939.25,0.01,1580.23,84
CDM,31599RVU15OH,UNLISTED ENDOSCOPIC LARYNGOPLASTY WITH PLACEMENT OF POSTERIOR CR,7741.0,5031.65,0.01,7741.0,84
CDM,31599RVU1OH,MICRODRCT LARYN W VOCAL CORDOTOMY (COMP CODE 31541),1836.0,1193.4,0.01,1836.0,84
CDM,31599RVU2OH,DL W LYSIS OF DENSE INTERARYTENOID SCAR (COMP 31561),2079.0,1351.35,0.01,2079.0,84
CDM,31599RVU3OH,NECK EXPLR W RMVL LARYNX IMPLANT (COMP 35800),2597.0,1688.05,0.01,2597.0,84
CDM,31599RVU4OH,MICR DL W/PRT EXC SUPRAGLOTTIC LARYNX (COMP 31300),3772.0,2451.8,0.01,3772.0,84
CDM,31599RVU5OH,LASER LARYNGOSCOPIC CORDECTOMY,4336.0,2818.4,0.01,4336.0,84
CDM,31599RVU7OH,LARYNGOSCOP LSR SUPRALOTTIC LARYNGECTOM (COMP 31367),7727.0,5022.55,0.01,7727.0,84
CDM,31599RVU8OH,LARYNGOPHARYNGECTMY W LEVEL 6 NODE DISS,14760.0,9594.0,0.01,14760.0,84
CDM,31599RVU9OH,DIRECT LARYNGOSCOPY WITH LYSIS LARYNGEAL STENOSIS (COMP 31541),1492.0,969.8,0.01,1580.23,84
CDM,31599RVUOH,DL W/ LYSIS OF LARYNGEAL STENOSIS (COMP 31541),1491.0,969.15,0.01,1580.23,84
CDM,31600OH,"TRACHEOSTOMY, PLANNED",2446.0,1589.9,1.1,9391.15,144
CDM,31601OH,"TRACHEOSTOMY, <2 Y/O",3200.0,2080.0,1.1,17080.38,144
CDM,31603OH,TRACHEOSTOMY EMERGENCY PROCEDURE TRANSTRACHEAL,2400.0,1560.0,1.1,4447.63,144
CDM,31605OH,TRACHEOSTOMY EMERGENCY CRICOTHYROID MEMBRANE,2580.0,1677.0,1.1,2580.0,144
CDM,31610OH,TRACHEOSTOMY FENESTRATION W/SKIN FLAPS,4800.0,3120.0,1.1,17080.38,144
CDM,31611OH,CONSTJ TRACHEOESOPHGL FSTL&INSJ SP PROSTH,2400.0,1560.0,1.1,9391.15,144
CDM,31613OH,TRACHEOSTOMA REVJ SMPL W/O FLAP ROTATION,1884.0,1224.6,1.1,9391.15,144
CDM,31614OH,TRACHEOSTOMA REVJ CPLX W/FLAP ROTATION,3452.0,2243.8,1.1,17080.38,144
CDM,31615OH,TRACHEOBRNCHSC THRU EST TRACHS INC,810.0,526.5,1.1,1603.96,148
CDM,31622OH,BRNCHSC INCL FLUOR GDNCE DX W/CELL WASHG SPX,1113.0,723.45,1.1,4949.64,148
CDM,31622OH-22,BRNCHSC INCL FLUOR GDNCE DX W/CELL WASHG SPX,1113.0,723.45,1.1,1113.0,70
CDM,31623OH,BRNCHSC BRUSHING/PROTECTED BRUSHINGS,1157.0,752.05,1.1,4949.64,148
CDM,31624OH,BRNCHSC W/BRNCL ALVEOLAR LAVAGE,1157.0,752.05,1.1,4949.64,148
CDM,31625OH,BRONCHOSCOPY BRONCHIAL/ENDOBRNCL BX 1+ SITES,1368.0,889.2,1.1,4949.64,148
CDM,31626OH,BRONCHOSCOPY W/PLMT FIDUCIAL MARKERS SINGLE/MULT,1564.0,1016.6,1.1,19960.78,148
CDM,31627OH,BRNCHSC W/CPTR-ASST IMAGE-GUIDED NAVIGATION,800.0,520.0,1.1,3502.07,148
CDM,31628OH,BRONCHOSCOPY W/TRANSBRONCHIAL LUNG BX 1 LOBE,1562.0,1015.3,1.1,10921.65,148
CDM,31629OH,BRONCHOSCOPY NEEDLE BX TRACHEA MAIN STEM&/BRON,1650.0,1072.5,1.1,10921.65,148
CDM,31630OH,BRNCHSC W/TRACHEAL/BRONCHIAL DILAT/CLSD RDCTJ FX,1524.0,990.6,1.1,10921.65,144
CDM,31631OH,BRONCHOSCOPY W/PLACEMENT TRACHEAL STENT,1744.0,1133.6,1.1,19960.78,144
CDM,31632OH,BRONCHOSCOPY W/TRANSBRONCHIAL LUNG BX EACH LOBE,412.0,267.8,1.1,412.0,148
CDM,31633OH,BRONCHOSCOPY W/TRANSBRONCL NDL ASPIR BX EA LOBE,528.0,343.2,1.1,528.0,148
CDM,31634OH,BRONCHOSCOPY BALLOON OCCLUSION,1500.0,975.0,1.1,19960.78,146
CDM,31635OH,BRONCHOSCOPY W/REMOVAL FOREIGN BODY,1505.0,978.25,1.1,4949.64,148
CDM,31636OH,BRNCHSC W/PLACEMENT BRNCL STENT 1ST BRONCHUS,1720.0,1118.0,1.1,19960.78,144
CDM,31637OH,BRONCHOSCOPY EACH MAJOR BRONCHUS STENTED,632.0,410.8,1.1,632.0,144
CDM,31638OH,BRNCHSC REVJ TRACHEAL/BRNCL STENT INS PREV SESS,1952.0,1268.8,1.1,19960.78,144
CDM,31640OH,BRONCHOSCOPY W/EXCISION TUMOR,1972.0,1281.8,1.1,10921.65,144
CDM,31641OH,BRNCHSC W/DSTRJ TUM RELIEF STENOSIS OTH/THN EXC,2008.0,1305.2,1.1,10921.65,144
CDM,31643OH,BRNCHSC W/PLMT CATH INTRCV RADIOELMNT APPL,1396.0,907.4,1.1,4949.64,144
CDM,31645OH,BRONCHOSCOPY W/THER ASPIR TRACHBRNCL TREE 1ST,1267.0,823.55,1.1,4949.64,148
CDM,31646OH,BRONCHOSCOPY W/THER ASPIR TRACHBRNCL TREE SBSQ,1223.0,794.95,1.1,1223.0,144
CDM,31647OH,BRNCHSC OCCLUSION&INSERT BRONCH VALVE INIT LOBE,1660.0,1079.0,1.1,19960.78,142
CDM,31648OH,BRNCHSC REMOVAL BRONCHIAL VALVE INITIAL,1580.0,1027.0,1.1,10921.65,142
CDM,31649OH,BRNCHSC REMOVAL BRONCHIAL VALVE EA ADDL,576.0,374.4,1.1,4949.64,142
CDM,31651OH,BRNCHSC OCCLUSION&INSERT BRONCH VALVE ADDL LOBE,632.0,410.8,1.1,632.0,142
CDM,31652OH,BRNCHSC EBUS GUIDED SAMPL 1/2 NODE STATION/STRUX,1962.0,1275.3,1.1,10921.65,148
CDM,31653OH,BRNCHSC EBUS GUIDED SAMPL 3/> NODE STATION/STRUX,2182.0,1418.3,1.1,10921.65,148
CDM,31654OH,BRNSCHSC TNDSC EBUS DX/TX INTERVENTION PERPH LES,560.0,364.0,1.1,560.0,148
CDM,31660OH,BRONCHOSCOPIC THERMOPLASTY ONE LOBE,1600.0,1040.0,1.1,19960.78,142
CDM,31661OH,BRONCHOSCOPIC THERMOPLASTY 2/> LOBES,1700.0,1105.0,1.1,19960.78,142
CDM,31720OH,"CATHETER ASPIRATN,NASOTRACH",424.0,275.6,1.1,621.38,144
CDM,31730OH,TTRACH INTRO NDL WIRE DIL/STENT/TUBE O2 THER,1140.0,741.0,1.1,4949.64,148
CDM,31750OH,TRACHEOPLASTY CERVICAL,6772.0,4401.8,1.1,17080.38,144
CDM,31760OH,TRACHEOPLASTY INTRATHORACIC,9392.0,6104.8,1.1,9392.0,144
CDM,31766OH,CARINAL RECONSTRUCTION,12668.0,8234.2,1.1,12668.0,144
CDM,31770OH,BRONCHOPLASTY GRAFT REPAIR,9416.0,6120.4,1.1,9416.0,144
CDM,31775OH,BRONCHOPLASTY EXCISION STENOSIS & ANASTOMOSIS,9836.0,6393.4,1.1,9836.0,144
CDM,31780OH,EXCISION TRACHEAL STENOSIS&ANASTOMOSIS CERVICA,7936.0,5158.4,1.1,7936.0,144
CDM,31781OH,EXC TRACHEAL STENOSIS&ANAST CERVICOTHORACIC,9940.0,6461.0,1.1,9940.0,144
CDM,31785OH,EXCISION TRACHEAL TUMOR/CARCINOMA CERVICAL,7340.0,4771.0,1.1,17080.38,144
CDM,31786OH,EXCISION TRACHEAL TUMOR/CARCINOMA THORACIC,10168.0,6609.2,1.1,10168.0,144
CDM,31800OH,SUTURE TRACHEAL WOUND/INJURY CERVICAL,3272.0,2126.8,1.1,3272.0,144
CDM,31805OH,SUTURE TRACHEAL WOUND/INJURY INTRATHORACIC,5368.0,3489.2,1.1,5368.0,144
CDM,31820OH,SURG CLSR TRACHEOSTOMY/FISTULA W/O PLASTIC RPR,1856.0,1206.4,1.1,9391.15,148
CDM,31825OH,SURG CLSR TRACHEOSTOMY/FISTULA W/PLASTIC RPR,2828.0,1838.2,1.1,9391.15,148
CDM,31830OH,REVISE TRACHEOSTOMY SCAR,1848.0,1201.2,1.1,9391.15,148
CDM,31899AOH,DL W/LYSIS OF TRACHEAL STENOSIS (COMP 31541),1628.0,1058.2,0.01,1628.0,84
CDM,31899RVU1OH,CONTROL HEMORRHAGE FROM TRACHEOSTOMA (COMP 31613),1165.0,757.25,0.01,1165.0,84
CDM,31899RVU2OH,UNLISTED PROC; TRACHEOSTOMY TUBE EXCHANGE FOLLOWING ESTABLISHED,215.0,139.75,0.01,578.53,84
CDM,31899RVUOH,"UNLIST PROC, TRACHEA, BRONCHI COMPARED TO 31613",2002.0,1301.3,0.01,2002.0,84
CDM,32000020,RADIOLOGIC EXAMINATION EYE DETECT FOREIGN BODY,608.0,395.2,43.5,81865.9,87
CDM,32000030,RADIOLOGIC EXAMINATION MANDIPLE PRTL <4 VIEWS,608.0,395.2,52.43,81947.72,87
CDM,32000035,RADIOLOGIC EXAMINATION TEETH 1 VIEW,608.0,395.2,16.66,82181.53,87
CDM,32000040,RADIOLOG EXAM MANDIBLE COMPL MINIMUM 4 VIEWS,734.0,477.1,56.78,81959.42,87
CDM,32000045,RADIOLOGIC EXAM TEETH COMPLETE FULL MOUTH,1668.0,1084.2,56.78,82204.91,87
CDM,32000050,RADIOLOGIC EXAM MASTOIDS < 3 VIEWS PER SIDE,734.0,477.1,51.49,81971.1,87
CDM,32000060,RADEX MASTOIDS COMPL MINIMUM 3 VIEWS PR SIDE,734.0,477.1,56.78,81982.8,87
CDM,32000065,CEPHALOGRAM ORTHODONTIC,608.0,395.2,21.06,82239.98,87
CDM,32000075,ORTHOPANTOGRAM,608.0,395.2,23.08,82245.82,87
CDM,32000080,RADEX FACIAL BONES < 3 VIEWS,608.0,395.2,42.45,81994.48,87
CDM,32000085,RADEX SPINE LUMBOSACRAL ONLY BENDING 2/3 VIEWS,734.0,477.1,54.34,84309.13,87
CDM,32000090,RADEX FACIAL BONES COMPLETE MINIMUM 3 VIEWS,734.0,477.1,56.78,82006.18,87
CDM,32000095,RADEX UPPER EXTREMITY INFANT MINIMUM 2 VIEWS,734.0,477.1,41.93,85445.41,87
CDM,32000100,RADEX NASAL BONES COMPLETE MINIMUM 3 VIEWS,608.0,395.2,50.66,82017.86,87
CDM,32000115,RADEX LOWER EXTREMITY INFANT MINIMUM 2 VIEWS,608.0,395.2,41.93,86029.91,87
CDM,32000120,RADEX ORBITS COMPLETE MINIMUM 4 VIEWS,734.0,477.1,56.78,82064.62,87
CDM,32000130,RADEX SINUSES PARANASAL <3 VIEWS,608.0,395.2,43.14,82076.32,87
CDM,32000140,RADEX SINUSES PARANASAL COMPL MINIMUM 3 VIEWS,608.0,395.2,50.11,82088.01,87
CDM,32000145,THERAPEUTIC ENEMA RDCTJ INTUSSUSCEPTION/OBSTRCJ,1228.0,798.2,142.61,86837.7,87
CDM,32000150,RADIOLOGIC EXAMINATION SELLA TURCICA,608.0,395.2,43.53,82111.39,87
CDM,32000160,RADIOLOGIC EXAMINATION SKULL 4< VIEWS,734.0,477.1,48.67,82123.08,87
CDM,32000170,RADIOLOGIC EXAM SKULL COMPLETE MINIMUM 4 VIEWS,734.0,477.1,56.78,82134.77,87
CDM,32000180,RADEX TEMPOROMANDBLE JT OPN & CLSD MOUTH UNILAT,608.0,395.2,46.32,82214.26,87
CDM,32000190,RADEX TEMPOROMANDBLE JT OPN & CLSD MOUTH BILAT,608.0,395.2,56.78,82216.6,87
CDM,32000200,RADIOLOGIC EXAMINATION NECK SOFT TISSUE,608.0,395.2,41.62,82251.67,87
CDM,32000215,LYMPHANGIOGRAPHY PELVIC/ABDOMINAL BILATERAL RS&I,21718.0,14116.7,992.07,88619.28,85
CDM,32000220,RADIOLOGIC EXAMINATION SALIVARY GLAND CALCULUS,608.0,395.2,50.49,82275.05,87
CDM,32000225,VENOGRAPHY CAVAL SUPERIOR SERIALOGRAPHY RS&I,10719.0,6967.35,150.76,10719.0,87
CDM,32000230,SIALOGRAPHY RS&I,1668.0,1084.2,142.61,82286.74,87
CDM,32000250,RADEX RIBS UNILATERAL 2 VIEWS,608.0,395.2,48.7,83116.74,87
CDM,32000260,RADEX RIBS UNI W/POSTEROANT CH MINIMUM 3 VIEWS,734.0,477.1,56.14,83117.9,87
CDM,32000270,RADEX RIBS BILATERAL 3 VIEWS,734.0,477.1,56.78,83128.43,87
CDM,32000280,RADEX RIBS BI W/POSTEROANT CH MINIMUM 4 VIEWS,734.0,477.1,56.78,83129.6,87
CDM,32000290,RADEX STERNUM MINIMUM 2 VIEWS,608.0,395.2,44.69,83140.12,87
CDM,32000300,RADEX STERNOCLAVICULAR JT/JTS MINIMUM 3 VIEWS,608.0,395.2,55.28,83151.81,87
CDM,32000320,RADEX SPINE 1 VIEW SPECIFY LEVEL,608.0,395.2,31.82,84192.23,87
CDM,32000330,RADEX SPINE CERVICAL 2 OR 3 VIEWS,608.0,395.2,52.93,84215.61,87
CDM,32000340,RADEX SPINE CERVICAL 4 OR 5 VIEWS,734.0,477.1,56.78,84227.3,87
CDM,32000350,RADEX SPINE CERVICAL 6 OR MORE VIEWS,734.0,477.1,56.78,84229.63,87
CDM,32000370,RADEX SPINE THORACIC 2 VIEWS,734.0,477.1,43.75,84250.68,87
CDM,32000380,RADEX SPINE THORACIC 3 VIEWS,734.0,477.1,52.82,84253.01,87
CDM,32000385,RADIOLOGIC EXAMINATION OSSEOUS SURVEY INFANT,734.0,477.1,56.78,90102.75,87
CDM,32000390,RADEX SPINE THORACIC MINIMUM 4 VIEWS,734.0,477.1,56.78,84255.36,87
CDM,32000400,RADEX SPINE THORACOLUMBAR JUNCTION MIN 2 VIEWS,608.0,395.2,45.99,84262.37,87
CDM,32000420,RADEX SPINE LUMBOSACRAL 2/3 VIEWS,734.0,477.1,53.4,84285.75,87
CDM,32000425,AORTOGRAPHY THORACIC SERIALOGRAPHY RS&I,37299.0,24244.35,153.87,37299.0,87
CDM,32000430,RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS,734.0,477.1,56.78,84297.44,87
CDM,32000440,RADEX SPINE LUMBSCRL COMPL W/BENDING VIEWS MIN 6,734.0,477.1,56.78,84302.12,87
CDM,32000450,RADIOLOGIC EXAMINATION PELVIS 1/2 VIEWS,734.0,477.1,37.03,84367.58,87
CDM,32000455,US VASC ACCESS SITS VSL PATENCY NDL ENTRY,266.0,172.9,49.6,89940.25,68
CDM,32000460,RADIOLOGIC EXAM PELVIS COMPL MINIMUM 3 VIEWS,734.0,477.1,56.36,84390.96,87
CDM,32000470,RADIOLOGIC EXAMINATION SACROILIAC JNTS <3 VIEWS,734.0,477.1,44.55,84402.65,87
CDM,32000480,RADIOLOGIC EXAM SACROILIAC JOINTS 3/MORE VIEWS,734.0,477.1,52.35,84404.99,87
CDM,32000490,RADEX SACRUM & COCCYX MINIMUM 2 VIEWS,608.0,395.2,43.61,84426.03,87
CDM,32000500,MYELOGRAPHY CERVICAL RS&I,5451.0,3543.15,145.89,84449.41,87
CDM,32000510,MYELOGRAPHY THORACIC RS&I,5451.0,3543.15,138.59,84466.95,87
CDM,32000530,MYELOGRAPY LUMBOSACRAL RS&I,5451.0,3543.15,143.11,84478.63,87
CDM,32000535,RADIOLOGIC EXAMINATION KNEE 1/2 VIEWS,608.0,395.2,46.07,85992.5,87
CDM,32000550,MYELOGRAPY 2/MORE REGIONS RS&I,5451.0,3543.15,175.82,84484.48,87
CDM,32000575,DXA BONE DENSITY STUDY AXIAL SKELETON,734.0,477.1,71.03,90113.27,79
CDM,32000590,DISKOGRAPY LUMBAR RS&I,13474.0,8758.1,146.4,84513.71,87
CDM,32000600,RADEX CLAVICLE COMPLETE,608.0,395.2,43.72,85337.86,87
CDM,32000610,RADEX SCAPULA COMPLETE,734.0,477.1,31.39,85349.55,87
CDM,32000620,RADEX SHOULDER 1 VIEW,608.0,395.2,28.32,85361.24,87
CDM,32000630,RADEX SHOULDER COMPLETE MINIMUM 2 VIEWS,608.0,395.2,46.79,85372.93,87
CDM,32000640,RADEX A-C JOINTS BI W/WO WEIGHTED DISTRCJ,608.0,395.2,38.33,85396.31,87
CDM,32000650,RADEX HUMERUS MINIMUM 2 VIEWS,608.0,395.2,42.78,85408.0,87
CDM,32000660,RADEX ELBOW 2 VIEWS,608.0,395.2,39.02,85419.69,87
CDM,32000665,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 1 VW,608.0,395.2,56.72,84263.53,87
CDM,32000670,RADEX ELBOW COMPLETE MINIMUM 3 VIEWS,608.0,395.2,44.08,85431.38,87
CDM,32000675,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 2/3 VW,734.0,477.1,56.78,84264.71,87
CDM,32000680,RADEX FOREARM 2 VIEWS,608.0,395.2,39.02,85443.07,87
CDM,32000685,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 4/5 VW,734.0,477.1,56.78,84265.88,87
CDM,32000690,RADEX WRIST 2 VIEWS,608.0,395.2,45.6,85454.76,87
CDM,32000695,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 6/> VW,734.0,477.1,56.78,84267.04,87
CDM,32000700,RADEX WRIST COMPLETE MINIMUM 3 VIEWS,608.0,395.2,55.83,85466.45,87
CDM,32000710,RADEX HAND 2 VIEWS,734.0,477.1,42.31,85478.14,87
CDM,32000715,RADEX HIP UNILATERAL WITH PELVIS 1 VIEW,608.0,395.2,43.97,85923.53,87
CDM,32000720,RADEX HAND MINIMUM 3 VIEWS,608.0,395.2,50.19,85489.83,87
CDM,32000725,RADEX HIP UNILATERAL WITH PELVIS 2-3 VIEWS,608.0,395.2,56.78,85924.71,87
CDM,32000730,RADEX FINGR MINIMUM 2 VIEWS,608.0,395.2,52.04,85501.52,87
CDM,32000735,RADEX HIP UNILATERAL WITH PELVIS MINIMUM 4 VIEWS,734.0,477.1,56.78,85925.87,87
CDM,32000745,RADEX HIPS BILATERAL WITH PELVIS 2 VIEWS,734.0,477.1,55.28,85946.91,87
CDM,32000755,RADEX HIPS BILATERAL WITH PELVIS 3-4 VIEWS,734.0,477.1,56.78,85948.09,87
CDM,32000765,RADEX HIPS BILATERAL WITH PELVIS MINIMUM 5 VIEWS,734.0,477.1,56.78,85949.25,87
CDM,32000775,RADIOLOGIC EXAMINATION FEMUR 1 VIEW,608.0,395.2,39.02,85981.99,87
CDM,32000780,RADIOLOGIC EXAMINATION FEMUR 1 VIEW,608.0,395.2,39.02,85981.99,87
CDM,32000785,RADIOLOGIC EXAMINATION FEMUR MINIMUM 2 VIEWS,608.0,395.2,47.73,85983.15,87
CDM,32000790,RADIOLOGIC EXAMINATION KNEE 1/2 VIEWS,608.0,395.2,46.07,85992.5,87
CDM,32000800,RADIOLOGIC EXAMINATION KNEE 3 VIEWS,608.0,395.2,55.25,85994.85,87
CDM,32000805,INTRALUMINAL DILATION STRICTURES&/OBSTRCJS RS&I,894.0,581.1,79.56,894.0,66
CDM,32000810,RADIOLOGIC EXAM KNEE COMPLETE 4/MORE VIEWS,734.0,477.1,56.78,85997.18,87
CDM,32000820,RADIOLOGIC EXAM BOTH KNEES STANDING ANTEROPOST,608.0,395.2,54.06,85998.35,87
CDM,32000830,RADIOLOGIC EXAMINATION TIBIA & FIBULA 2 VIEWS,608.0,395.2,42.31,86027.58,87
CDM,32000840,RADIOLOGIC EXAMINATION ANKLE 2 VIEWS,608.0,395.2,43.25,86039.26,87
CDM,32000850,RADEX ANKLE COMPLETE MINIMUM 3 VIEWS,608.0,395.2,49.25,86050.96,87
CDM,32000860,RADIOLOGIC EXAMINATION FOOT 2 VIEWS,608.0,395.2,38.08,86062.65,87
CDM,32000870,RADEX FOOT COMPLETE MINIMUM 3 VIEWS,608.0,395.2,45.96,86074.34,87
CDM,32000880,RADEX CALCANEUS MINIMUM 2 VIEWS,608.0,395.2,38.08,86097.72,87
CDM,32000890,RADEX TOE MINIMUM 2 VIEWS,608.0,395.2,39.35,86109.41,87
CDM,32000920,RADIOLOGIC EXAM COMPLETE ACUTE ABDOMEN SERIES,734.0,477.1,56.78,86532.59,87
CDM,32000930,PERITONEOGRAM RS&I,3783.0,2458.95,142.61,86728.99,85
CDM,32000940,RADIOLOGIC EXAM ESOPHAGUS SINGLE CONTRAST STUDY,1228.0,798.2,56.78,86764.05,87
CDM,32000950,RADIOLOGIC EXAM SWALLOW FUNCTION CONTRAST STUDY,1228.0,798.2,142.61,86775.75,87
CDM,32000960,RADIOLOGIC EXAM UPR GI TRC SINGLE CONTRAST STUDY,1228.0,798.2,142.61,86787.43,87
CDM,32001010,RADIOLOGIC EXAM SMALL INT SINGLE CONTRAST STUDY,1228.0,798.2,142.61,86799.13,87
CDM,32001015,RADIOLOGIC EXAM PHRNX&/CRV ESOPH CONTRAST STUDY,1228.0,798.2,56.78,86752.37,87
CDM,32001020,RADIOLOGIC EXAM SMALL INT DOUBLE CONTRAST STUDY,1228.0,798.2,142.61,86800.29,87
CDM,32001030,RADIOLOGIC EXAM COLON SINGLE CONTRAST STUDY,1228.0,798.2,142.61,86822.51,87
CDM,32001040,RADIOLOGIC EXAM COLON DOUBLE CONTRAST STUDY,1228.0,798.2,142.61,86834.19,87
CDM,32001050,CHOLANGIOGRAPHY&/PANCREATOGRAPHY NTRAOP RS&I,1101.0,715.65,51.87,1101.0,66
CDM,32001060,CHOLANGIO&/PANCREATOGRAPHY ADDL SET INTRAOP RS,214.0,139.1,31.11,214.0,66
CDM,32001110,CMBN NDSC CATHJ BILIARY&PNCRTC DUCTAL SYS RS&I,927.0,602.55,112.68,927.0,66
CDM,32001120,INTRO LONG GI TUBE W/MULT FLUORO & IMAGES RS&I,632.0,410.8,77.68,632.0,66
CDM,32001130,PERCUTANEOUS PLACEMENT ENTEROCLYSIS TUBE RS&I,427.0,277.55,93.09,427.0,66
CDM,32001150,PRQ TRANSHEPATC DILAT BILIARY DUCT STRICTRE RS&I,1645.0,1069.25,112.68,1645.0,66
CDM,32001160,UROGRAPHY IV W/WO KUB W/WO TOMOGRAPHY,1228.0,798.2,142.61,86974.47,87
CDM,32001180,UROGRAPHY RETROGRADE WITH/WO KUB,2464.0,1601.6,103.39,86997.85,87
CDM,32001190,ANTEGRADE UROGRAPHY RADIOLOGICAL SUPVJ & INTERPJ,2464.0,1601.6,142.61,87003.7,87
CDM,32001200,CYSTOGRAPHY MINIMUM 3 VIEWS RS&I,2464.0,1601.6,53.9,87009.55,87
CDM,32001210,URETHROCYSTOGRAPHY RETROGRADE RS&I,1668.0,1084.2,142.61,87032.93,85
CDM,32001220,URETHROCYSTOGRAPHY VOIDING RS&I,1668.0,1084.2,142.41,87038.77,87
CDM,32001240,RADEX RENAL CYST STUDY TRANSLUMBAR RS&I,3783.0,2458.95,142.61,87056.31,85
CDM,32001270,DILATION URETERS/URETHRA RS&I,14135.0,9187.75,112.68,87073.84,87
CDM,32001280,HYSTEROSALPINGOGRAPHY RS&I,1668.0,1084.2,125.03,87371.94,87
CDM,32001290,TRANSCERVICAL CATHJ FALLOPIAN TUBE RS&I,419.0,272.35,88.69,419.0,66
CDM,32001300,PERINEOGRAM,1668.0,1084.2,142.61,87412.86,85
CDM,32001320,ANGIOGRAPHY VISCERAL SLCTV/SUPRASLCTV RS&I,37299.0,24244.35,211.81,37299.0,87
CDM,32001330,LYMPHANGIOGRAPHY PELVIC/ABDOMINAL UNILAT RS&I,21718.0,14116.7,654.66,88616.93,85
CDM,32001340,SHUNTOGRAM INDWELLING NONVASCULAR SHUNT RS&I,734.0,477.1,95.38,88621.61,87
CDM,32001350,SPLENOPORTOGRAPY RS&I,21718.0,14116.7,654.66,21718.0,85
CDM,32001360,VENOGRAPHY EXTREMITY UNILATERAL RS&I,10719.0,6967.35,137.67,10719.0,87
CDM,32001390,VENOGRAPHY EXTREMITY BILATERAL RS&I,10719.0,6967.35,167.71,10719.0,87
CDM,32001420,VENOGRAPHY CAVAL INFERIOR SERIALOGRAPHY RS&I,21718.0,14116.7,143.9,21718.0,87
CDM,32001450,VENOGRAPHY RENAL UNILATERAL SELECTIVE RS&I,21718.0,14116.7,152.56,21718.0,87
CDM,32001460,VENOGRAPHY RENAL BILATERAL SELECTIVE RS&I,21718.0,14116.7,185.8,21718.0,87
CDM,32001470,VENOGRAPHY ADRENAL UNILATERAL SELECTIVE RS&I,21718.0,14116.7,166.06,21718.0,87
CDM,32001490,VENOGRAPHY VENOUS SINUS/JUGULAR CATH RS&I,21718.0,14116.7,161.02,21718.0,87
CDM,32001510,VENOGRAPHY SUPERIOR SAGITTAL SINUS RS&I,21718.0,14116.7,201.02,21718.0,87
CDM,32001540,PRQ TRANSHEPATC PORTOGRAPY HEMODYN EVAL RS&I,21718.0,14116.7,172.95,21718.0,87
CDM,32001550,PRQ TRANSHEPATC PORTOGRAPY W/O HEMODYN EVL INTRP,21718.0,14116.7,174.36,21718.0,87
CDM,32001560,HEPATC VNGRPH WDG/FR HEMODYN EVAL RS&I,21718.0,14116.7,158.49,21718.0,87
CDM,32001570,HEPATC VNGRPH WDG/FR W/O HEMODYN EVAL RS&I,21718.0,14116.7,159.71,21718.0,87
CDM,32001580,VENOUS SAMPLING THRU CATH W/WO ANGIOGRAPHY RS&,37299.0,24244.35,140.08,37299.0,87
CDM,32001590,TRANSCATHETER EMBOLIZATION ANY METH RS&I,3113.0,2023.45,112.68,3113.0,67
CDM,32001620,MECHANICAL RMVL PERICATHETER OBSTR MATRL RS&I,720.0,468.0,112.68,720.0,68
CDM,32001630,MECHANICAL RMVL INTRALUMINAL OBSTR MATRL RS&I,419.0,272.35,91.34,419.0,68
CDM,32001800,TRANSCATHETER BIOPSY RS&I,3670.0,2385.5,112.68,3670.0,66
CDM,32001850,CHANGE PRQ TUBE/DRAINAGE CATH W CONTRAST RS&I,1051.0,683.15,112.68,88826.19,68
CDM,32001860,RADIOLOGICAL GUIDANCE PRQ DRG W/PLMT CATH RS&I,2127.0,1382.55,112.68,88832.03,68
CDM,32001910,FLUOROSCOPY UP TO 1 HOUR PHYSICIAN/QHP TIME,1668.0,1084.2,55.71,88844.89,87
CDM,32001950,RADEX FROM NOSE RECTUM FOREIGN BODY 1 VIEW CHLD,608.0,395.2,38.8,88856.59,87
CDM,32001960,RADEX ABSCESS/FISTULA/SINUS TRACT RS&I,3783.0,2458.95,76.75,88938.41,87
CDM,32001980,RADIOLOGICAL EXAMINATION SURGICAL SPECIMEN,3783.0,2458.95,29.1,88959.46,87
CDM,32001990,RADEX 1 PLNE BODY SECTION OTH/THN W/UROGRAPY,734.0,477.1,56.78,88961.79,87
CDM,32002000,CINERADIOGRAPY/VIDRADIOGRAPY XCPT WHERE SPEC,734.0,477.1,56.78,88985.17,87
CDM,32002020,PROC XR UNLISTD,201.0,130.65,55.88,409.57,85
CDM,32002030,FLUORO CENTRAL VENOUS ACCESS DEV PLACEMENT,823.0,534.95,112.68,823.0,68
CDM,32002050,FLUOROSCOPIC GUIDANCE NEEDLE PLACEMENT ADD ON,838.0,544.7,112.68,838.0,68
CDM,32002070,FLUOR NEEDLE/CATH SPINE/PARASPINAL DX/THER ADDON,996.0,647.4,112.68,996.0,68
CDM,32002110,MAMMARY DUCTOGRAM OR GALACTOGRAM SINGLE,1668.0,1084.2,71.31,1668.0,87
CDM,32002120,MAMMARY DUCTOGRAM OR GALACTOGRAM MULTIPLE,1668.0,1084.2,91.94,1668.0,87
CDM,32002130,MANUAL APPL STRESS PFRMD PHYS/QHP JOINT FILMS,608.0,395.2,71.03,90096.91,87
CDM,32002140,BONE AGE STUDIES,734.0,477.1,33.89,90098.07,87
CDM,32002150,BONE LENGTH STUDIES,734.0,477.1,56.78,90099.24,87
CDM,32002160,RADIOLOGIC EXAMINATION OSSEOUS SURVEY LIMITED,734.0,477.1,56.78,90100.42,87
CDM,32002170,RADIOLOGIC EXAMINATION OSSEOUS SURVEY COMPL,734.0,477.1,95.38,90101.58,87
CDM,32002180,JOINT SURVEY SINGLE VIEW 2 OR MORE JOINTS,734.0,477.1,56.78,90103.92,87
CDM,32002190,DXA BONE DENSITY STUDY 1/> SITES AXIAL SKEL,734.0,477.1,52.21,90107.43,79
CDM,32002240,DXA BONE DENSITY STUDY 1/>SITES APPENDICLR SKEL,608.0,395.2,41.87,90108.59,79
CDM,32002260,XR DEXA WHOLE BODY COMPOSITION,734.0,477.1,56.78,734.0,85
CDM,32002270,RADIOLOGIC EXAM UPR GI TRC DOUBLE CONTRAST STUDY,1228.0,798.2,142.61,86794.45,87
CDM,32002290,DXA BONE DENSITY STUDY AXIAL SKELETON,734.0,477.1,71.03,90113.27,79
CDM,32002300,VERTEBRAL FRACTURE ASSESSMENT VIA DXA,608.0,395.2,45.02,90114.45,79
CDM,32002320,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 1 VW,608.0,395.2,56.72,84263.53,87
CDM,32002330,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 2/3 VW,734.0,477.1,56.78,84264.71,87
CDM,32002370,RADEX HIP UNILATERAL WITH PELVIS 1 VIEW,608.0,395.2,43.97,85923.53,87
CDM,32002380,RADEX HIP UNILATERAL WITH PELVIS 2-3 VIEWS,608.0,395.2,56.78,85924.71,87
CDM,32002485,ANGRPH CATH F-UP STD TCAT OTHER THAN THROMBYLSIS,21718.0,14116.7,360.53,21718.0,86
CDM,32002525,US GUIDANCE NEEDLE PLACEMENT IMG S&I,863.0,560.95,73.26,89946.11,68
CDM,32002545,ENDOSCOPIC CATHJ BILIARY DUCTAL SYSTEM RS&I,436.0,283.4,95.05,436.0,66
CDM,32002705,ENDOSCOPIC CATHJ PANCREATIC DUCTAL SYS RS&I,757.0,492.05,112.68,757.0,66
CDM,32002735,BRONCHOGRAPHY,249.0,161.85,56.78,409.57,85
CDM,32002745,UROGRAPHY INFUSION DRIP &/BOLUS TECHNIQUE,1228.0,798.2,142.61,86986.17,87
CDM,32002925,RADEX WRIST COMPLETE MINIMUM 3 VIEWS,608.0,395.2,55.83,85466.45,87
CDM,32003165,RADIOLOGIC EXAM KNEE COMPLETE 4/MORE VIEWS,734.0,477.1,56.78,85997.18,87
CDM,32003365,RADIOLOGIC EXAM KNEE COMPLETE 4/MORE VIEWS,734.0,477.1,56.78,85997.18,87
CDM,32004105,RADIOLOGIC EXAMINATION KNEE 3 VIEWS,608.0,395.2,55.25,85994.85,87
CDM,32004405,VASOGRAPY VESICULOGRAPY/EPIDIDYMOGRAPY RS&I,1668.0,1084.2,132.46,87021.23,87
CDM,32004415,RADIOLOG EXAM MANDIBLE COMPL MINIMUM 4 VIEWS,734.0,477.1,56.78,81959.42,87
CDM,32004425,RADEX STERNUM MINIMUM 2 VIEWS,608.0,395.2,44.69,83140.12,87
CDM,32004435,RADEX HUMERUS MINIMUM 2 VIEWS,608.0,395.2,42.78,85408.0,87
CDM,32004445,RADEX ELBOW 2 VIEWS,608.0,395.2,39.02,85419.69,87
CDM,32004455,RADEX WRIST 2 VIEWS,608.0,395.2,45.6,85454.76,87
CDM,32004465,RADEX FINGR MINIMUM 2 VIEWS,608.0,395.2,52.04,85501.52,87
CDM,32004475,RADIOLOGIC EXAMINATION TIBIA & FIBULA 2 VIEWS,608.0,395.2,42.31,86027.58,87
CDM,32004485,RADIOLOGIC EXAMINATION ANKLE 2 VIEWS,608.0,395.2,43.25,86039.26,87
CDM,32004625,RADIOLOGIC EXAM ABDOMEN 1 VIEW,608.0,395.2,40.21,86527.92,87
CDM,32004635,RADIOLOGIC EXAM ABDOMEN 2 VIEWS,734.0,477.1,48.59,86529.08,87
CDM,32004645,RADIOLOGIC EXAM ABDOMEN 3+ VIEWS,734.0,477.1,56.78,86531.42,87
CDM,32004685,RADIOLOGIC EXAM TEETH PRTL EXAM < FULL MOUTH,1668.0,1084.2,55.0,82193.22,87
CDM,32004695,CPLX DYNAMIC PHARYNGEAL&SP EVAL C/V REC,1668.0,1084.2,132.56,82264.53,87
CDM,32004705,RADIOLOGIC EXAM CHEST 2 VIEWS,608.0,395.2,44.47,83053.61,87
CDM,32004795,PERITONEOGRAM RS&I,3783.0,2458.95,142.61,86728.99,85
CDM,32004845,CORPORA CAVERNOSOGRAPY RS&I,734.0,477.1,95.38,87027.08,85
CDM,32004855,ANATOMIC MODEL 3D PRINTED 1ST COMPNT ANTMC STRUX,238.0,154.7,53.07,281.79,85
CDM,32004865,ANATOMIC MODEL 3D PRINTED EA ADDL COMPONENT,126.0,81.9,27.47,126.0,66
CDM,32004875,ANATOMIC GUIDE 3D PRINTED 1ST ANATOMIC GUIDE,238.0,154.7,53.07,281.79,85
CDM,32004885,ANATOMIC GUIDE 3D PRINTED EA ADDL ANATOMIC GUIDE,64.0,41.6,13.95,100.53,66
CDM,32004895,RADIOLOGIC EXAM ESOPHAGUS DOUBLE CONTRAST STUDY,1228.0,798.2,142.61,86765.22,87
CDM,32004905,RADIOLOGIC SMALL INTESTINE FOLLOW-THROUGH STUDY,795.0,516.75,105.58,86796.78,68
CDM,32004915,UNLISTED FLUOROSCOPIC PROCEDURE,308.0,200.2,56.78,409.57,85
CDM,32004925,LYMPHANGIOGRAPHY EXTREMITY ONLY BILATERAL RS&I,10719.0,6967.35,654.66,88614.6,85
CDM,32004935,ICG LYMPHANGIOGRAPHY,2464.0,1601.6,81.99,2464.0,84
CDM,32004945,"VENOGRAPHY, PULM, SEL. RADIOLOGICAL SUPV & INTERP (COMP CODE 757",19680.0,12792.0,56.78,19680.0,85
CDM,32004955,TBS DXA/OTHER IMG CALCULATION W/I&R FX RISK,309.0,200.85,53.8,309.0,61
CDM,32004965,TBS TECHL PREP&TRANSMIS DATA ALYS PFRMD ELSEWHR,608.0,395.2,3.47,608.0,79
CDM,32004975,TBS TECHNICAL CALCULATION ONLY,608.0,395.2,38.23,608.0,79
CDM,32004985,TBS INTERPRETATION & REPORT FX RISK BY OTHER QHP,102.0,66.3,12.85,469.67,69
CDM,32005005,LYMPHANGIOGRAPHY EXTREMITY ONLY UNILAT RS&I,4266.0,2772.9,545.0,88612.26,85
CDM,32005085,OPTO-ACOUSTIC IMG BREAST UNI AUGMNT ALYS&REPRT,425.0,276.25,95.38,530.3,84
CDM,32005095,ENDOVASCULAR REPAIR OF TRANSVERSE AORTIC ARCH; INVOLVING COVERAG,2496.0,1622.4,56.78,2496.0,85
CDM,32005105,ENDOVASCULAR REPAIR OF ASCENDING AORTA; RS&I (COMP TO 75957),2132.0,1385.8,56.78,2132.0,85
CDM,32005115,CT ABDOMEN W/O SCREENING,734.0,477.1,56.78,734.0,85
CDM,32005125,3D RENDERING LIVER (DONOR) S&I,1436.0,933.4,56.78,1436.0,85
CDM,32005135,UNLISTED PROC; SPY ELITE EVAL OF INTESTINE,2773.0,1802.45,56.78,2773.0,85
CDM,32005145,"VENOGRAPHY, PULM, SEL. RADIOLOGICAL SUPV.&INTERP",21718.0,14116.7,56.78,21718.0,85
CDM,32005155,UNLISTED DXA BODY COMPOSITION STUDY,734.0,477.1,56.78,734.0,85
CDM,32005165,LYMPHANGIOGRAPHY OF FACE & NECK,10719.0,6967.35,56.78,10719.0,85
CDM,32005175,ANGIOGRAM ITA (INFERIOR THYROID ARTERY) (COMP CODE 75710),19680.0,12792.0,56.78,19680.0,85
CDM,32005185,VENOGRAM VENOUS MALFORMATION (COMP CODE 75774),3872.0,2516.8,56.78,3872.0,85
CDM,32005195,VENOGRAM PARASPINAL VEIN (COMP CODE 75705),33929.0,22053.85,56.78,33929.0,85
CDM,32005205,VENOGRAM PERIUTERINE VEIN (COMP CODE 75736),33929.0,22053.85,56.78,33929.0,85
CDM,32005215,VENOGRAM AZYGOS VEIN (COMP COMP CODE 75705),33929.0,22053.85,56.78,33929.0,85
CDM,32005225,VENOGRAM GASTRIC VEIN (COMP CODE 75891),19680.0,12792.0,56.78,19680.0,85
CDM,32005235,VENOGRAM GONADAL VEIN (COMP CODE 75831),19680.0,12792.0,56.78,19680.0,85
CDM,32005245,VENOGRAM IMV (INFERIOR MESENTERIC VEIN) (COMP CODE 75891),19680.0,12792.0,56.78,19680.0,85
CDM,32005255,VENOGRAM SUPERIOR  MESENTERIC VEIN (COMP CODE 75891),21718.0,14116.7,56.78,21718.0,85
CDM,32005265,CONDYLAR EMISSRAY VENOGRAM (COMP CODE 75860),21718.0,14116.7,56.78,21718.0,85
CDM,32005275,VENOGRAM PARAVERTEBRAL VEIN (COMP CODE 75705),37299.0,24244.35,56.78,37299.0,85
CDM,32005285,"VENOGRAM, INFERIOR PETROSAL SINUS (COMP CODE 75870)",21718.0,14116.7,56.78,21718.0,85
CDM,32005295,VENOGRAM FACIAL VLM (VENOLYTIC MALFORMATION) (COMP CODE 75860),21718.0,14116.7,56.78,21718.0,85
CDM,32005305,VENOGRAM ILIOLUMBAR VEIN (COMP CODE 75705),37299.0,24244.35,56.78,37299.0,85
CDM,32005315,VENOGRAM VERTEBRAL VEIN (COMP CODE 75705),37299.0,24244.35,56.78,37299.0,85
CDM,32005325,VENOGRAM SPLENIC VEIN (COMP CODE 75891),21718.0,14116.7,56.78,21718.0,85
CDM,32005335,VENOGRAM SEGMENTAL VEIN (COMP CODE 75705),37299.0,24244.35,56.78,37299.0,85
CDM,32005345,VENOGRAM VENOLYMPHATIC MALFORMATION (COMP CODE 75774),4182.0,2718.3,56.78,4182.0,85
CDM,32005355,VENOGRAM GASTRODUODENAL SHUNT (COMP CODE 75891),21718.0,14116.7,56.78,21718.0,85
CDM,32005365,VENOGRAM SAPHENOUS VEIN (COMP CODE 75820),10719.0,6967.35,56.78,10719.0,85
CDM,32005375,VENOGRAM CARDINAL VARIX (COMP CODE 75891),21718.0,14116.7,56.78,21718.0,85
CDM,32005385,RADIOLOGICAL EXAMINATION SURGICAL SPECIMEN,3783.0,2458.95,29.1,88959.46,87
CDM,32005395,COR ANGIO W/ FLOW RESRV,27869.0,18114.85,1947.82,27869.0,66
CDM,32035OH,"THORACOSTOMY,RIB RESECT,EMPYEMA",4516.0,2935.4,1.1,4516.0,144
CDM,32036OH,"THORACOSTOMY,OPEN DRAIN/EMPYEMA",4920.0,3198.0,1.1,4920.0,144
CDM,32096OH,THORACTOMY W/DX BX LUNG INFILTRATE UNILATERAL,5500.0,3575.0,1.1,5500.0,144
CDM,32097OH,THORACTOMY W/DX BX LUNG NODULE/MASS UNILATERAL,5500.0,3575.0,1.1,5500.0,144
CDM,32098OH,THORACOTOMY W/BIOPSY OF PLEURA,5164.0,3356.6,1.1,5164.0,144
CDM,32100OH,THORACOTOMY WITH EXPLORATION,5500.0,3575.0,1.1,5500.0,144
CDM,32110OH,THORCOM CTRL TRAUMTC HEMRRG&/RPR LNG TEAR,10112.0,6572.8,1.1,10112.0,144
CDM,32120OH,"THORACOTOMY,POSTOP COMPLICATNS",5756.0,3741.4,1.1,5756.0,144
CDM,32124OH,THORACOTOMY OPN INTRAPLEURAL PNEUMONOLYSIS,6180.0,4017.0,1.1,6180.0,144
CDM,32140OH,"THORACOTOMY,CYST REMOVAL",6664.0,4331.6,1.1,6664.0,144
CDM,32141OH,THORACOTOMY W/RESECTION BULLAE,10872.0,7066.8,1.1,10872.0,144
CDM,32150OH,THORCOM W/RMVL INTRAPLEURAL FB/FIBRIN DEP,6728.0,4373.2,1.1,6728.0,144
CDM,32151OH,THORCOM W/RMVL IPUL FB,6776.0,4404.4,1.1,6776.0,144
CDM,32160OH,THORACOTOMY W/CARDIAC MASSAGE,5240.0,3406.0,1.1,5240.0,144
CDM,32200010,RADEX SHOULDER ARTHROGRAPHY RS&I,2464.0,1601.6,142.61,85384.62,87
CDM,32200015,RADEX ELBOW ARTHROGRAPHY RS&I,2464.0,1601.6,131.62,85437.22,87
CDM,32200025,RADEX WRIST ARTHROGRAPHY RS&I,2464.0,1601.6,142.61,85472.3,87
CDM,32200035,RADIOLOGIC EXAM KNEE ARTHROGRAPHY RS&I,2464.0,1601.6,142.61,86015.88,87
CDM,32200040,RADEX HIP ARTHROGRAPHY RS&I,2464.0,1601.6,142.61,85951.59,87
CDM,32200080,RADEX ANKLE ARTHROGRAPHY RS&I,2464.0,1601.6,142.61,86056.8,87
CDM,32200OH,PNEUMONOSTOMY W/OPEN DRAINAGE ABSCESS/CYST,7472.0,4856.8,1.1,7472.0,144
CDM,32215OH,PLEURAL SCARIFICATION REPEAT PNEUMOTHORAX,5220.0,3393.0,1.1,5220.0,144
CDM,32220OH,DECORTICATION PULMONARY TOTAL SEPARATE PROCEDURE,10660.0,6929.0,1.1,10660.0,144
CDM,32225OH,DECORTICATION PULMONARY PARTIAL SEPARATE PROC,6700.0,4355.0,1.1,6700.0,144
CDM,32300010,AORTOGRAPHY THORACIC W/O SERIALOGRAPHY RS&I,21718.0,14116.7,247.71,21718.0,87
CDM,32300015,ANGIOGRAPHY ADRENAL UNILATERAL SLCTV RS&I,21718.0,14116.7,201.06,21718.0,87
CDM,32300020,AORTOGRAPHY THORACIC SERIALOGRAPHY RS&I,37299.0,24244.35,153.87,37299.0,87
CDM,32300025,ANGRPH PULMONARY NONSLCTV CATH/VEN NJX RS&I,21718.0,14116.7,174.75,21718.0,87
CDM,32300030,AORTOGRAPHY ABDOMINAL SERIALOGRAPHY RS&I,21718.0,14116.7,155.99,21718.0,87
CDM,32300050,AORTOGRAPHY ABDL BI ILIOFEM LOW EXTREM CATH RS&I,21718.0,14116.7,192.31,21718.0,87
CDM,32300200,ANGIOGRAPHY SPINAL SELECTIVE RS&I,37299.0,24244.35,315.5,37299.0,87
CDM,32300210,ANGIOGRAPHY EXTREMITY UNILATERAL RS&I,21718.0,14116.7,185.09,21718.0,87
CDM,32300230,ANGIOGRAPHY EXTREMITY BILATERAL RS&I,21718.0,14116.7,201.1,21718.0,87
CDM,32300310,ANGIOGRAPHY ADRENAL BILATERAL SLCTV RS&I,21718.0,14116.7,226.27,21718.0,87
CDM,32300320,ANGIOGRAPHY PELVIC SLCTV/SUPRASLCTV RS&I,37299.0,24244.35,186.1,37299.0,87
CDM,32300330,ANGIOGRAPHY PULMONARY UNILATERAL SLCTV RS&I,21718.0,14116.7,165.26,21718.0,87
CDM,32300340,ANGIOGRAPHY PULMONARY BILATERAL SLCTV RS&I,21718.0,14116.7,185.47,21718.0,87
CDM,32300370,ANGRPH SLCTV EA VSL STUDIED AFTER BASIC XM RS&I,4182.0,2718.3,122.14,4182.0,68
CDM,32300400,ANGRPH CATH F-UP STD TCAT OTHER THAN THROMBYLSIS,21718.0,14116.7,360.53,21718.0,86
CDM,32300405,"PURACOL PLUS 4 1/4 "" X 4 1/2 """,31.0,20.15,6.76,31.0,66
CDM,32300410,ANGIO ILIAC ARTERY W CATH,6890.0,4478.5,14.91,6890.0,68
CDM,32300420,ANGIOGRAPHY INTERNAL MAMMARY RS&I,21718.0,14116.7,216.07,21718.0,87
CDM,32300445,TRANSCATHETER EMBOLIZATION ANY METH RS&I,3113.0,2023.45,112.68,3113.0,67
CDM,32300515,"SIM ANGRM W/ PRSR-GEN CATH (ONE-WAY VALVE, INTERMIT OCCLUDING) I",30915.0,20094.75,2523.55,30915.0,76
CDM,32310OH,PLEURECTOMY PARIETAL SEPARATE PROCEDURE,6112.0,3972.8,1.1,6112.0,144
CDM,32320OH,DECORTICATION & PARIETAL PLEURECTOMY,10900.0,7085.0,1.1,10900.0,144
CDM,32400080,RADIOLOGIC EXAM CHEST SINGLE VIEW,608.0,395.2,33.63,83052.44,87
CDM,32400090,RADIOLOGIC EXAM CHEST 2 VIEWS,608.0,395.2,44.47,83053.61,87
CDM,32400100,RADIOLOGIC EXAM CHEST 3 VIEWS,608.0,395.2,55.75,83054.78,87
CDM,32400105,RADIOLOGIC EXAM CHEST SINGLE VIEW,608.0,395.2,33.63,83052.44,87
CDM,32400110,RADIOLOGIC EXAM CHEST 4+ VIEWS,734.0,477.1,56.78,83055.95,87
CDM,32400115,RADIOLOGIC EXAM CHEST 2 VIEWS,608.0,395.2,44.47,83053.61,87
CDM,32400120,RADIOLOGIC EXAM ABDOMEN 1 VIEW,608.0,395.2,40.21,86527.92,87
CDM,32400125,RADIOLOGIC EXAM CHEST 3 VIEWS,608.0,395.2,55.75,83054.78,87
CDM,32400130,RADIOLOGIC EXAM ABDOMEN 2 VIEWS,734.0,477.1,48.59,86529.08,87
CDM,32400135,RADIOLOGIC EXAM CHEST 4+ VIEWS,734.0,477.1,56.78,83055.95,87
CDM,32400140,RADIOLOGIC EXAM ABDOMEN 3+ VIEWS,734.0,477.1,56.78,86531.42,87
CDM,32400185,"X-RAY, CHEST, 2 VIEWS",105.0,68.25,22.89,105.0,58
CDM,32400OH,BIOPSY PLEURA PERCUTANEOUS NEEDLE,704.0,457.6,1.1,4729.25,148
CDM,32408OH,CORE NEEDLE BX LUNG/MEDIASTINUM PERQ W/IMG,1399.0,909.35,1.1,4729.25,148
CDM,32440OH,REMOVAL OF LUNG PNEUMONECTOMY,10912.0,7092.8,1.1,10912.0,144
CDM,32442OH,REMOVAL LUNG PNEUMONECTOMY RESXN SGMNT TRACHEA,22588.0,14682.2,1.1,22588.0,144
CDM,32445OH,REMOVAL LUNG PNEUMONECTOMY EXTRAPLEURAL,25536.0,16598.4,1.1,25536.0,144
CDM,32480OH,RMVL LUNG OTHER THAN PNEUMONECTOMY 1 LOBE LOBECT,10328.0,6713.2,1.1,10328.0,144
CDM,32482OH,RMVL LUNG OTHER THAN PNEUMONECT 2 LOBES BILOBEC,10976.0,7134.4,1.1,10976.0,144
CDM,32484OH,RMVL LUNG OTHER THAN PNEUMONECT 1 SEGMENTECTOMY,10152.0,6598.8,1.1,10152.0,144
CDM,32486OH,RMVL LUNG XCP TOT PNEUMONECTOMY SLEEVE LOBECTOMY,17152.0,11148.8,1.1,17152.0,144
CDM,32488OH,RMVL LUNG OTHER/THAN PNUMEC COMPLETION PNUMEC,17196.0,11177.4,1.1,17196.0,144
CDM,32491OH,RMVL LUNG OTH/THN PNUMEC RESXN-PLCTJ EMPHY LUNG,10096.0,6562.4,1.1,10096.0,130
CDM,32501OH,RESCJ&BRONCHOPLASTY PFRMD TM LOBEC/SGMECTOMY,1872.0,1216.8,1.1,1872.0,144
CDM,32503OH,RESCJ APICAL LUNG TUMOR W/O CHEST WALL RCNSTJ,12696.0,8252.4,1.1,12696.0,144
CDM,32504OH,RESCJ APICAL LUNG TUMOR W/CHEST WALL RCNSTJ,14616.0,9500.4,1.1,14616.0,144
CDM,32505OH,THORACOTOMY W/THERAPEUTIC WEDGE RESEXN INITIAL,6300.0,4095.0,1.1,6300.0,144
CDM,32506OH,THORACOTOMY W/THERAP WEDGE RESEXN ADDL IPSILATRL,1200.0,780.0,1.1,1200.0,144
CDM,32507OH,THORACOTOMY W/DX WEDGE RESEXN &ANTOM LUNG RESEXN,1200.0,780.0,1.1,1200.0,144
CDM,32540OH,EXTRAPLEURAL ENUCLEATION EMPYEMA EMPYEMECTOMY,12140.0,7891.0,1.1,12140.0,144
CDM,32550OH,INSERTION INDWELLING TUNNELED PLEURAL CATHETER,1568.0,1019.2,1.1,10089.06,148
CDM,32551OH,TUBE THORACOSTOMY INCLUDES WATER SEAL,1216.0,790.4,1.1,4671.09,144
CDM,32552OH,RMVL NDWELLG TUN PLEURAL CATH W/CUFF,1012.0,657.8,1.1,1833.54,148
CDM,32553OH,PLMT NTRSTL DEV RADJ THX GID PRQ INTRATHRC 1/MLT,1562.0,1015.3,1.1,4040.52,148
CDM,32554OH,THORACENTESIS NEEDLE/CATH PLEURA W/O IMAGING,801.0,520.65,1.1,1833.54,148
CDM,32555OH,THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING,999.0,649.35,1.1,1833.54,148
CDM,32556OH,PERQ DRAINAGE PLEURA INSERT CATH W/O IMAGING,1100.0,715.0,1.1,5549.59,148
CDM,32557OH,PERQ DRAINAGE PLEURA INSERT CATH W/IMAGING,1373.0,892.45,1.1,4671.09,148
CDM,32560OH,INSTLJ VIA CHEST TUBE/CATH AGENT FOR PLEURODESIS,616.0,400.4,1.1,1833.54,148
CDM,32561OH,INSTLJ VIA CH TUBE/CATH AGENT FBRNLYSIS 1ST DAY,556.0,361.4,1.1,1833.54,148
CDM,32562OH,INSTLJ CH TUBE/CATH AGENT FBRNLYSIS SBSQ DAY,496.0,322.4,1.1,1833.54,148
CDM,32601OH,THORSC DX LUNGS/PERICAR/MED/PLEURAL SPACE W/O BX,2200.0,1430.0,1.1,16829.38,144
CDM,32604OH,THORACOSCOPY DX PERICARDIAL SAC W/BIOPSY SPX,3508.0,2280.2,1.1,30022.29,144
CDM,32606OH,THORACOSCOPY DX MEDIASTINAL SPACE W/BIOPSY SPX,3356.0,2181.4,1.1,16829.38,144
CDM,32607OH,THORACOSCOPY W/DX BX OF LUNG INFILTRATE UNILATRL,2200.0,1430.0,1.1,30022.29,144
CDM,32608OH,THORACOSCOPY W/DX BX OF LUNG NODULES UNILATRL,2736.0,1778.4,1.1,30022.29,144
CDM,32609OH,THORACOSCOPY WITH BIOPSYIES OF PLEURA,1832.0,1190.8,1.1,16829.38,144
CDM,32650OH,THORACOSCOPY SURG W PLEURODESIS,4332.0,2815.8,1.1,4332.0,144
CDM,32651OH,THORACOSCOPY SURG PART PULM DECORT,7512.0,4882.8,1.1,7512.0,144
CDM,32652OH,THRSC TOT PULM DCRTCTJ INTRAPLEURAL PNEUMONOLSS,11652.0,7573.8,1.1,11652.0,144
CDM,32653OH,THORACOSCOPY RMVL INTRAPLEURAL FB/FIBRIN DEPOSIT,7268.0,4724.2,1.1,7268.0,144
CDM,32654OH,THORACOSCOPY CONTROL TRAUMATIC HEMORRHAGE,8208.0,5335.2,1.1,8208.0,144
CDM,32655OH,THORACOSCOPY W/RESECTION BULLAE W/WO PLEURAL PX,6468.0,4204.2,1.1,6468.0,144
CDM,32656OH,THORACOSCOPY SURG PART PLEURECTOMY,5304.0,3447.6,1.1,5304.0,144
CDM,32658OH,THORACOSCOPY W/RMVL CLOT/FB FROM PERICARDIAL SAC,4684.0,3044.6,1.1,4684.0,144
CDM,32659OH,THRSC CRTJ PRCRD WINDOW/PRTL RESCJ PRCRD SAC,4776.0,3104.4,1.1,4776.0,144
CDM,32661OH,THORACOSCOPY W/EXC PERICARDIAL CYST TUMOR/MASS,5332.0,3465.8,1.1,5332.0,144
CDM,32662OH,THORACOSCOPY W/EXC MEDIASTINAL CYST TUMOR/MASS,5996.0,3897.4,1.1,5996.0,144
CDM,32663OH,THORACOSCOPY W/LOBECTOMY SINGLE LOBE,9856.0,6406.4,1.1,9856.0,144
CDM,32664OH,THORACOSCOPY W/THORACIC SYMPATHECTOMY,6283.0,4083.95,1.1,6283.0,144
CDM,32665OH,THORACOSCOPY W/ESOPHAGOMYOTOMY HELLER TYPE,8612.0,5597.8,1.1,8612.0,144
CDM,32666OH,THORACOSCOPY W/THERA WEDGE RESEXN INITIAL UNILAT,5800.0,3770.0,1.1,5800.0,144
CDM,32667OH,THORACOSCOPY W/THERA WEDGE RESEXN ADDL IPSILATRL,1200.0,780.0,1.1,1200.0,144
CDM,32668OH,THORACOSCOPY W/DX WEDGE RESEXN ANATO LUNG RESEXN,1200.0,780.0,1.1,1200.0,144
CDM,32669OH,THORACOSCOPY W/SEGMENTECTOMY,9412.0,6117.8,1.1,9412.0,144
CDM,32670OH,THORACOSCOPY W/BILOBECTOMY,11408.0,7415.2,1.1,11408.0,144
CDM,32671OH,THORACOSCOPY W/PNEUMONECTOMY,12768.0,8299.2,1.1,12768.0,144
CDM,32672OH,THORACOSCOPY W/RESEXN-PLICAJ EMPHYSEMA LUNG UNIL,10800.0,7020.0,1.1,10800.0,144
CDM,32673OH,THORACOSCOPY RESEXN THYMUS UNI/BILATERAL,8452.0,5493.8,1.1,8452.0,144
CDM,32674OH,THORCOSCPY W/MEDIASTINL &REGIONL LYMPHADENECTOMY,1648.0,1071.2,1.1,1648.0,144
CDM,32701OH,THORAX STEREOTACTIC RADIATION TARGET W/TX COURSE,1672.0,1086.8,1.1,1672.0,142
CDM,32800OH,REPAIR LUNG HERNIA THROUGH CHEST WALL,6284.0,4084.6,1.1,6284.0,144
CDM,32810OH,CLSR CH WALL FLWG OPN FLAP DRG EMPYEMA,5980.0,3887.0,1.1,5980.0,144
CDM,32815OH,OPEN CLOSURE MAJOR BRONCHIAL FISTULA,20012.0,13007.8,1.1,20012.0,144
CDM,32820OH,MAJOR RECONSTRUCTION CHEST WALL POSTTRAUMATIC,9004.0,5852.6,1.1,9004.0,144
CDM,32851OH,LUNG TRANSPLANT 1 W/O CARDIOPULMONARY BYPASS,23856.0,15506.4,1.1,23856.0,144
CDM,32852OH,LUNG TRANSPLANT 1 W/CARDIOPULMONARY BYPASS,26200.0,17030.0,1.1,26200.0,144
CDM,32853OH,LUNG TRANSPLANT 2 W/O CARDIOPULMONARY BYPASS,33792.0,21964.8,1.1,33792.0,144
CDM,32854OH,LUNG TRANSPLANT 2 W/CARDIOPULMONARY BYPASS,36000.0,23400.0,1.1,36000.0,144
CDM,32855OH,BKBENCH PREPJ CADAVER DONOR LUNG ALLOGRAFT UNI,6133.0,3986.45,1.1,6133.0,104
CDM,32856OH,BKBENCH PREPJ CADAVER DONOR LUNG ALLOGRAFT BI,9101.0,5915.65,1.1,9101.0,104
CDM,32900000,RADIOLOGIC EXAM SACROILIAC JOINTS 3/MORE VIEWS,734.0,477.1,52.35,84404.99,87
CDM,32900005,PROC XR UNLISTD,354.0,230.1,56.78,409.57,85
CDM,32900015,MEDICAL PHYSICS DOSE EVAL RADIATION EXPOS W/RPRT,3661.0,2379.65,105.71,3661.0,87
CDM,32900OH,RESECTION RIBS EXTRAPLEURAL ALL STAGES,9524.0,6190.6,1.1,9524.0,144
CDM,32905OH,THORACOPLASTY SCHEDE TYPE/EXTRAPLEURAL,9316.0,6055.4,1.1,9316.0,144
CDM,32906OH,THORACOP SCHEDE TYP/XTRPLEURAL CLSR BRNCPLR FSTL,11720.0,7618.0,1.1,11720.0,144
CDM,32940OH,PNEUMONOLYSIS XTRPRIOSTEAL W/FILLING/PACKING PX,8536.0,5548.4,1.1,8536.0,144
CDM,32994OH,ABLATION THER 1+ PULM TUMORS PERQ CRYOABLATION,3612.0,2347.8,1.1,30022.29,148
CDM,32997OH,TOTAL LUNG LAVAGE (UNILATERAL),2924.0,1900.6,1.1,2924.0,144
CDM,32998OH,ABLATION THER 1+ PULM TUMORS PERQ RADIOFREQUENCY,3612.0,2347.8,1.1,16829.38,148
CDM,32999AOH,THORACOTOMY FOR DELIVERY OF AN ENDOVASCULAR PROSTHESIS,5157.0,3352.05,0.01,5157.0,84
CDM,32999OH,UNLISTED PROCEDURE LUNGS & PLEURA,1165.0,757.25,0.01,1833.54,84
CDM,32999RVU1OH,REVISE/DEBRIDE CLAGETT WINDOW NO CLOSURE,1532.0,995.8,0.01,1833.54,84
CDM,32999RVU3OH,IMAGE GUIDED CHEST TUBE EXCHANGE REPOSITION (COMP CODE 49423),628.0,408.2,0.01,1833.54,84
CDM,32999RVU4OH,IMAGE GUIDED LUNG LOCALIZATION (COMP CODE 32553),1562.0,1015.3,0.01,1833.54,84
CDM,32999RVUOH,LUNG CRYOABLATION,2363.0,1535.95,0.01,2363.0,84
CDM,32999TUBEOH,CHEST TUBE EXCHANGE,802.0,521.3,0.01,1833.54,84
CDM,33016OH,PERICARDIOCENTESIS W/IMG GUIDANCE WHEN PERFORMED,1760.0,1144.0,1.1,4671.09,144
CDM,33017OH,PERQ PRCRD DRG 6YR+ W/O CONGENITAL CAR ANOMALY,2033.0,1321.45,1.1,2033.0,144
CDM,33018OH,PERQ PRCRD DRG 0-5YR/ANY AGE W/CGEN CAR ANOMALY,2160.0,1404.0,1.1,2160.0,144
CDM,33019OH,PERQ PERICARDIAL DRG W/INSJ NDWELLG CATH W/CT,1888.0,1227.2,1.1,1888.0,144
CDM,33020OH,PERICARDIOTOMY REMOVAL CLOT/FOREIGN BODY PRIMARY,5724.0,3720.6,1.1,5724.0,144
CDM,33025OH,CRTJ PERICARDIAL WINDOW/PRTL RESECJ W/DRG/BX,5808.0,3775.2,1.1,5808.0,144
CDM,33030OH,PRICARDIECTOMY STOT/COMPL W/O CARDPULM BYPASS,14400.0,9360.0,1.1,14400.0,144
CDM,33031OH,PRICARDIECTOMY STOT/COMPL W/CARDPULM BYPASS,18000.0,11700.0,1.1,18000.0,144
CDM,33050OH,RESECTION PERICARDIAL CYST/TUMOR,6788.0,4412.2,1.1,6788.0,144
CDM,33100015,CHEMOTX NJX SUBARACHND/INTRAVENTR RSVR 1/MULT,2289.0,1487.85,45.54,2289.0,86
CDM,33100020,CHEMOTX ADMN CNS REQ SPINAL PUNCTURE,2289.0,1487.85,90.61,2289.0,86
CDM,33100025,CHEMOTHERAPY ADMINISTRATION INTRALESIONAL </7,491.0,319.15,32.3,491.0,86
CDM,33100030,CHEMOTX ADMN IV PUSH TQ 1/1ST SBST/DRUG,2289.0,1487.85,45.54,2289.0,86
CDM,33100035,CHEMOTHERAPY ADMINISTRATION INTRALESIONAL >7,1454.0,945.1,45.54,1454.0,86
CDM,33100040,CHEMOTX ADMN IV PUSH TQ EA SBST/DRUG,491.0,319.15,45.54,491.0,86
CDM,33100050,CHEMOTX ADMN SUBQ/IM NON-HORMONAL ANTI-NEO,491.0,319.15,45.54,491.0,86
CDM,33100060,CHEMOTX ADMN SUBQ/IM HORMONAL ANTI-NEO,491.0,319.15,45.54,491.0,86
CDM,33100070,CHEMOTHERAPY ADMIN INTRA-ARTERIAL PUSH TQ,2289.0,1487.85,45.54,2289.0,86
CDM,33100100,CHEMOTX ADMN SUBQ/IM HORMONAL ANTI-NEO,491.0,319.15,45.54,491.0,86
CDM,33100110,CHEMOTX ADMN SUBQ/IM NON-HORMONAL ANTI-NEO,491.0,319.15,45.54,491.0,86
CDM,33100115,CHEMOTHERAPY ADMINISTRATION INTRALESIONAL </7,491.0,319.15,32.3,491.0,86
CDM,33120OH,EXC INTRACARDIAC TUMOR RESCJ CARDIOPULMONARY BYP,15380.0,9997.0,1.1,15380.0,144
CDM,33130OH,RESECTION EXTERNAL CARDIAC TUMOR,9668.0,6284.2,1.1,9668.0,144
CDM,33140OH,TRANSMYOCARDIAL LASER REVASCULAR THORACOTOMY SPX,11336.0,7368.4,1.1,11336.0,144
CDM,33141OH,TRANSMYOCRD LASER REVSC PFRMD TM OTH OPN CAR PX,1016.0,660.4,1.1,1016.0,144
CDM,33202OH,"INSERT EPICARDIAL ELECTRODE, OPEN",5808.0,3775.2,1.1,5808.0,144
CDM,33203OH,INSERT EPICARD ELTRD ENDO,5588.0,3632.2,1.1,5588.0,144
CDM,33206OH,INS NEW/RPLCMT PRM PACEMAKR W/TRANS ELTRD ATRIAL,3142.0,2042.3,1.1,31142.61,144
CDM,33207OH,INS NEW/RPLC PRM PACEMAKER W/TRANSV ELTRD VENTR,3120.0,2028.0,1.1,31142.61,144
CDM,33208OH,INS NEW/RPLCMT PRM PM W/TRANSV ELTRD ATRIAL&VENT,3408.0,2215.2,1.1,31142.61,144
CDM,33210OH,INSJ/RPLCMT TEMP TRANSVNS 1CHMBR ELTRD/PM CATH,1342.0,872.3,1.1,24778.8,144
CDM,33211OH,INSJ/RPLCMT TEMP TRANSVNS 2CHMBR PACG ELTRDS SPX,1256.0,816.4,1.1,24778.8,144
CDM,33212OH,INS PM PLS GEN W/EXIST SINGLE LEAD,2004.0,1302.6,1.1,24778.8,144
CDM,33213OH,INS PACEMAKER PULSE GEN ONLY W/EXIST DUAL LEADS,2112.0,1372.8,1.1,31142.61,144
CDM,33214OH,UPG PACEMAKER SYS CONVERT 1CHMBR SYS 2CHMBR SYS,3036.0,1973.4,1.1,31142.61,144
CDM,33215OH,RPSG PREV IMPLTED PM/DFB R ATR/R VENTR ELECTRODE,1968.0,1279.2,1.1,9296.26,144
CDM,33216OH,INSJ 1 TRANSVNS ELTRD PERM PACEMAKER/IMPLTBL DFB,2248.0,1461.2,1.1,24778.8,144
CDM,33217OH,INSJ 2 TRANSVNS ELTRD PERM PACEMAKER/IMPLTBL DFB,2236.0,1453.4,1.1,24778.8,144
CDM,33218OH,RPR 1 TRANSVNS ELTRD PRM PM/PACING IMPLNTBL DFB,2328.0,1513.2,1.1,11454.26,144
CDM,33220OH,RPR 2 TRANSVNS ELECTRODES PRM PM/IMPLANTABLE DFB,2360.0,1534.0,1.1,11454.26,144
CDM,33221OH,INS PACEMAKER PULSE GEN ONLY W/EXIST MULT LEADS,2220.0,1443.0,1.1,56827.47,144
CDM,33222OH,RELOCATION OF SKIN POCKET FOR PACEMAKER,1940.0,1261.0,1.1,5320.02,144
CDM,33223OH,RELOCATE SKIN POCKET IMPLANTABLE DEFIBRILLATOR,2520.0,1638.0,1.1,5320.02,144
CDM,33224OH,INSJ ELTRD CAR VEN SYS ATTCH PREV PM/DFB PLS GEN,3616.0,2350.4,1.1,31142.61,144
CDM,33225OH,INSJ ELTRD CAR VEN SYS TM INSJ DFB/PM PLS GEN,3332.0,2165.8,1.1,3332.0,144
CDM,33226OH,RPSG PREV IMPLTED CAR VEN SYS L VENTR ELTRD,3472.0,2256.8,1.1,9296.26,144
CDM,33227OH,REMVL PERM PM PLSE GEN W/REPL PLSE GEN SNGL LEAD,2100.0,1365.0,1.1,24778.8,144
CDM,33228OH,REMVL PERM PM PLS GEN W/REPL PLSE GEN 2 LEAD SYS,2208.0,1435.2,1.1,31142.61,144
CDM,33229OH,REMVL PERM PM PLS GEN W/REPL PLSE GEN MULT LEAD,2316.0,1505.4,1.1,56827.47,144
CDM,33230OH,INS PACNG CVDFB PLS GEN ONLY W/EXIST DUAL LEADS,2428.0,1578.2,1.1,68747.0,144
CDM,33231OH,INS PACNG CVDFB PLS GEN ONLY W/EXIST MULTI LEADS,2536.0,1648.4,1.1,95950.11,144
CDM,33233OH,REMOVAL PERMANENT PACEMAKER PULSE GENERATOR ONLY,1256.0,816.4,1.1,24778.8,144
CDM,33234OH,RMVL TRANSVNS PM ELTRD 1 LEAD SYS ATR/VENTR,3064.0,1991.6,1.1,11454.26,144
CDM,33235OH,RMVL TRANSVNS PM ELTRD DUAL LEAD SYS,3960.0,2574.0,1.1,11454.26,144
CDM,33236OH,RMVL PRM EPICAR PM&ELTRDS THORCOM 1 LEAD SYS,5092.0,3309.8,1.1,5092.0,144
CDM,33237OH,RMVL PRM EPICAR PM&ELTRDS THORCOM DUAL LEAD SY,5536.0,3598.4,1.1,5536.0,144
CDM,33238OH,RMVL PRM TRANSVENOUS ELECTRODE THORACOTOMY,6160.0,4004.0,1.1,6160.0,144
CDM,33240OH,INSJ IMPLNTBL DEFIB PULSE GEN W/1 EXISTING LD,2320.0,1508.0,1.1,68747.0,144
CDM,33241OH,REMOVAL IMPLANTABLE DEFIB PULSE GENERATOR ONLY,1216.0,790.4,1.1,11454.26,144
CDM,33243OH,RMVL 1/DUAL CHAMBER DEFIB ELECTRODE BY THORACOM,9428.0,6128.2,1.1,9428.0,144
CDM,33244OH,RMVL1/DUAL CHMBR IMPLTBL DFB ELTRD TRANSVNS XTRJ,5496.0,3572.4,1.1,11454.26,144
CDM,33249OH,INSJ/RPLCMT PERM DFB W/TRNSVNS LDS 1/DUAL CHMBR,6565.0,4267.25,1.1,95950.11,144
CDM,33250OH,ABLATION ARRHYTHMOGENIC FOCI/PATHWAY W/O BYPASS,10360.0,6734.0,1.1,10360.0,144
CDM,33251OH,ABLATION ARRHYTHMOGENIC FOCI/PATHWAY W/BYPASS,11568.0,7519.2,1.1,11568.0,144
CDM,33254OH,ABLATION & RECONSTRUCTION ATRIA LIMITED,9484.0,6164.6,1.1,9484.0,144
CDM,33255OH,ABLATION & RCNSTJ ATRIA EXTNSV W/O BYPASS,11616.0,7550.4,1.1,11616.0,144
CDM,33256OH,ABLATION & RCNSTJ ATRIA EXTNSV W/BYPASS,13960.0,9074.0,1.1,13960.0,144
CDM,33257OH,ATRIA ABLATE & RCNSTJ W/OTHER PROCEDURE LIMITE,3852.0,2503.8,1.1,3852.0,144
CDM,33258OH,ATRIA ABLTJ & RCNSTJ W/OTHER PX EXTENSIV W/O BYP,4400.0,2860.0,1.1,4400.0,144
CDM,33259OH,ATRIA ABLTJ & RCNSTJ W/OTHER PX EXTEN W/BYPASS,5656.0,3676.4,1.1,5656.0,144
CDM,33261OH,OPRATIVE ABLTJ VENTR ARRHYTHMOGENIC FOC W/BYPASS,11568.0,7519.2,1.1,11568.0,144
CDM,33262OH,REM PAC CVDFB PLSE GEN &REPL PLSE GEN SNGL LEAD,2324.0,1510.6,1.1,68747.0,144
CDM,33263OH,REM PAC CVDFB PLSE GEN &REPL PLSE GEN DUAL LEAD,2432.0,1580.8,1.1,68747.0,144
CDM,33264OH,REM PAC CVDFB PLS GEN &REPL PLSE GEN MULTI LEAD,2540.0,1651.0,1.1,95950.11,144
CDM,33265OH,NDSC ABLATION & RCNSTJ ATRIA LIMITED W/O BYPAS,9484.0,6164.6,1.1,9484.0,144
CDM,33266OH,NDSC ABLATION & RCNSTJ ATRIA EXTEN W/O BYPASS,13216.0,8590.4,1.1,13216.0,144
CDM,33267OH,EXCLUSION LEFT ATRIAL APPENDAGE OPEN ANY METHOD,7400.0,4810.0,1.1,7400.0,144
CDM,33268OH,EXCLUSION LAA OPEN TM STRNT/THRCM ANY METHOD,1000.0,650.0,1.1,1000.0,144
CDM,33269OH,EXCLUSION L ATR APPENDAGE THORACOSCOPIC ANY METH,5724.0,3720.6,1.1,5724.0,144
CDM,33270OH,INS/RPLCMNT PERM SUBQ IMPLTBL DFB W/SUBQ ELTRD,4004.0,2602.6,1.1,95950.11,144
CDM,33271OH,INSJ OF SUBQ IMPLANTABLE DEFIBRILLATOR ELECTRODE,3000.0,1950.0,1.1,24778.8,144
CDM,33272OH,RMVL OF SUBQ IMPLANTABLE DEFIBRILLATOR ELECTRODE,2385.0,1550.25,1.1,11454.26,144
CDM,33273OH,REPOS PREVIOUSLY IMPLANTED SUBQ IMPLANTABLE DFB,2600.0,1690.0,1.1,11454.26,144
CDM,33274OH,TCAT INSJ/RPL PERM LEADLESS PACEMAKER RV W/IMG,3432.0,2230.8,1.1,56827.47,144
CDM,33275OH,TCAT REMOVAL PERM LEADLESS PM RIGHT VENTR W/IMG,3436.0,2233.4,1.1,9296.26,144
CDM,33285OH,INSERTION SUBQ CARDIAC RHYTHM MONITOR W/PRGRMG,673.0,437.45,1.1,24778.8,148
CDM,33286OH,REMOVAL SUBCUTANEOUS CARDIAC RHYTHM MONITOR,600.0,390.0,1.1,2050.87,148
CDM,33289OH,TCAT IMPL WRLS P-ART PRS SNR L-T HEMODYN MNTR,2400.0,1560.0,1.1,84765.21,142
CDM,33300010,THER RAD SIMULAJ-AIDED FIELD SETTING SIMPLE,916.0,595.4,105.71,916.0,87
CDM,33300020,THER RAD SIMULAJ-AIDED FIELD SETTING INTERMED,2526.0,1641.9,320.56,2526.0,87
CDM,33300030,THER RAD SIMULAJ-AIDED FIELD SETTING COMPLEX,2526.0,1641.9,320.56,2526.0,87
CDM,33300040,3-D RADIOTHERAPY PLAN DOSE-VOLUME HISTOGRAMS,9441.0,6136.65,623.34,9441.0,87
CDM,33300050,BASIC RADIATION DOSIMETRY CALCULATION,916.0,595.4,85.09,916.0,87
CDM,33300060,NTSTY MODUL RADTHX PLN DOSE-VOL HISTOS,9441.0,6136.65,771.49,9441.0,87
CDM,33300085,MLC IMRT DESIGN & CONSTRUCTION PER IMRT PLAN,2526.0,1641.9,320.56,2526.0,87
CDM,33300100,SPEC TELETHX PORT PLN PARTS HEMIBDY TOT BDY,2526.0,1641.9,121.12,2526.0,87
CDM,33300105,RADIATION DELIVERY STEREOTACTIC CRANIAL COBALT,52747.0,34285.55,4012.14,116265.0,85
CDM,33300110,SPEC DOSIM ONLY PRESCRIBED TREATING PHYS,916.0,595.4,80.65,916.0,87
CDM,33300120,TX DEVICES DESIGN & CONSTRUCTION SIMPLE,916.0,595.4,49.65,916.0,87
CDM,33300125,INTRAOP RADIAJ TX DELIVER XRAY SINGLE TX SESSION,52747.0,34285.55,989.77,52747.0,85
CDM,33300130,TX DEVICES DESIGN & CONSTRUCTION INTERMEDIATE,916.0,595.4,105.71,916.0,87
CDM,33300135,INTRAOP RADIAJ TX DELIVER ELECTRONS SNGL TX SESS,52747.0,34285.55,989.77,52747.0,85
CDM,33300140,TX DEVICES DESIGN & CONSTRUCTION COMPLEX,2526.0,1641.9,162.81,2526.0,87
CDM,33300145,HYPERTHERMIA EXTERNAL GENERATED SUPERFICIAL,1815.0,1179.75,136.52,1815.0,87
CDM,33300150,CONTINUING MEDICAL PHYSICS CONSLTJ PR WK,916.0,595.4,105.71,916.0,87
CDM,33300160,SPEC MEDICAL RADJ PHYSICS CONSLTJ,916.0,595.4,105.71,916.0,87
CDM,33300170,RADIATION DELIVERY STEREOTACTIC CRANIAL LINEAR,52747.0,34285.55,1337.65,116265.0,87
CDM,33300230,RADIATION TX DELIVERY 1 MEV >= INTERMEDIATE,3388.0,2202.2,136.52,3388.0,86
CDM,33300235,INTERSTITIAL RADIATION SOURCE APPLIC COMPLEX,4787.0,3111.55,622.02,4787.0,87
CDM,33300270,RADIATION TREATMENT DELIVERY 1 MEV >= COMPLEX,4855.0,3155.75,136.52,4855.0,86
CDM,33300295,STEREOTACTIC BODY RADIATION DELIVERY,12116.0,7875.4,989.77,12116.0,87
CDM,33300310,THERAPEUTIC RADIOLOGY PORT IMAGES(S),483.0,313.95,20.86,483.0,67
CDM,33300325,RP THER RADIOLBLD MONOCLONAL ANTIBODY IV INFUS,1546.0,1004.9,199.49,1546.0,87
CDM,33300335,RESPIRATORY MOTION MANAGEMENT SIMULATION,2981.0,1937.65,105.71,2981.0,68
CDM,33300345,TELETHX ISODOSE PLN SMPL W/DOSIMETRY CALCULATION,2526.0,1641.9,105.71,2526.0,87
CDM,33300350,SPECIAL TREATMENT PROCEDURE,3991.0,2594.15,176.88,3991.0,87
CDM,33300355,TELETHX ISODOSE PLN CPLX W/BASIC DOSIMETRY,2526.0,1641.9,320.56,2526.0,87
CDM,33300365,BRACHYTX ISODOSE PLN SMPL W/DOSIMETRY CAL,2526.0,1641.9,105.71,2526.0,87
CDM,33300375,BRACHYTX ISODOSE PLN INTERMED W/DOSIMETRY CAL,2526.0,1641.9,320.56,2526.0,87
CDM,33300385,BRACHYTX ISODOSE PLN CPLX W/DOSIMETRY CAL,2526.0,1641.9,320.56,2526.0,87
CDM,33300415,GUIDANCE FOR LOCLZJ TARGET VOL FOR RADJ TX DLVR,392.0,254.8,48.14,392.0,67
CDM,33300425,RADIATION TREATMENT DELIVERY 1 MEV >= SIMPLE,897.0,583.05,96.53,897.0,86
CDM,33300435,RADIATION TX DELIVERY 1 MEV >= INTERMEDIATE,3388.0,2202.2,136.52,3388.0,86
CDM,33300445,HDR RDNCL NTRSTL/INTRCAV BRACHYTX 1 CHANNEL,4787.0,3111.55,358.52,4787.0,87
CDM,33300455,HDR RDNCL NTRSTL/INTRCAV BRACHYTX 2-12 CHANNEL,4787.0,3111.55,622.02,4787.0,87
CDM,33300465,HDR RDNCL NTRSTL/INTRCAV BRACHYTX >12 CHANNELS,4787.0,3111.55,622.02,4787.0,87
CDM,33300470,RADIATION TREATMENT DELIVERY 1 MEV >= SIMPLE,897.0,583.05,96.53,897.0,86
CDM,33300475,INTERSTITIAL RADIATION LDR,741.0,481.65,96.53,741.0,85
CDM,33300535,HDR RDNCL SKN SURF BRACHYTX LES </2CM/1 CHAN,1815.0,1179.75,233.15,1815.0,87
CDM,33300545,INTERSTITIAL DEV PLMT RADIATION THERAPY 1/MLT,6294.0,4091.1,212.99,6294.0,86
CDM,33300555,HDR RDNCL SK SRF BRCHYTX LES >2CM&2CHAN/MLT LES,1815.0,1179.75,233.15,1815.0,87
CDM,33300575,RESEARCH LINAC 60 MINUTES,4320.0,2808.0,169.91,3065999.97,67
CDM,33300595,RESEARCH PLANNING,2160.0,1404.0,105.71,2160.0,85
CDM,33300615,STEREOTACTIC BODY RADIATION DELIVERY,12116.0,7875.4,989.77,12116.0,87
CDM,33300625,THERAPEUTIC RADIOLOGY TX PLANNING COMPLEX,1135.0,737.75,105.71,1135.0,69
CDM,33300OH,REPAIR CARDIAC WOUND W/O BYPASS,17988.0,11692.2,1.1,17988.0,144
CDM,33305OH,REPAIR CARDIAC WOUND W/CARDIOPULMONARY BYPASS,30772.0,20001.8,1.1,30772.0,144
CDM,33310OH,CARDIOT EXPL W/RMVL FB ATR/VENTR THRMB W/O BYP,8136.0,5288.4,1.1,8136.0,144
CDM,33315OH,CARDIOT EXPL RMVL FB ATR/VENTR THRMB CARD BYP,14000.0,9100.0,1.1,14000.0,144
CDM,33320OH,SUTR RPR AORTA/GRT VSL W/O SHUNT/CARD BYP,7416.0,4820.4,1.1,7416.0,144
CDM,33321OH,SUTR RPR AORTA/GREAT VESSEL W/SHUNT BYPASS,8324.0,5410.6,1.1,8324.0,144
CDM,33322OH,SUTURE REPAIR AORTA/GREAT VESSEL W/BYPASS,9768.0,6349.2,1.1,9768.0,144
CDM,33330OH,INSJ GRAFT AORTA/GREAT VESSEL W/O SHUNT/BYPASS,10116.0,6575.4,1.1,10116.0,144
CDM,33335OH,INSJ GRAFT AORTA/GREAT VESSEL W/BYPASS,13564.0,8816.6,1.1,13564.0,144
CDM,33340OH,PERQ CLSR TCAT L ATR APNDGE W/ENDOCARDIAL IMPLNT,6160.0,4004.0,1.1,6160.0,142
CDM,33361OH,REPLACE AORTIC VALVE PERQ FEMORAL ARTRY APPROACH,9887.0,6426.55,1.1,9887.0,144
CDM,33362OH,REPLACE AORTIC VALVE OPENFEMORAL ARTERY APPROACH,9816.0,6380.4,1.1,9816.0,144
CDM,33363OH,REPLACE AORTIC VALVE OPEN AXILLRY ARTRY APPROACH,10188.0,6622.2,1.1,10188.0,144
CDM,33364OH,REPLACE AORTIC VALVE OPEN ILIAC ARTERY APPROACH,10388.0,6752.2,1.1,10388.0,144
CDM,33365OH,REPLACE AORTIC VALVE OPEN TRANSAORTIC APPROACH,10636.0,6913.4,1.1,10636.0,144
CDM,33366OH,TRANSCATHETER TRANSAPICAL REPLACEMT AORTIC VALVE,12914.0,8394.1,1.1,12914.0,144
CDM,33367OH,REPLACE AORTIC VALVE W/BYP PRQ ART/VENOUS APPRCH,4752.0,3088.8,1.1,4752.0,144
CDM,33368OH,REPLACE AORTIC VALVE W/BYP OPEN ART/VENOUS APRCH,5756.0,3741.4,1.1,5756.0,144
CDM,33369OH,REPLACE AORTA VALVE W/BYP CNTRL ART/VENOUS APRCH,7600.0,4940.0,1.1,7600.0,144
CDM,33370OH,TRANSCATHETER PLACEMENT&SBSQ REMOVAL CEPD PERQ,1000.0,650.0,1.1,1000.0,144
CDM,33390OH,VALVULOPLASTY AORTIC VALVE OPEN CARD BYP SIMPLE,14000.0,9100.0,1.1,14000.0,144
CDM,33391OH,(2017) VALVULOPLASTY AORTIC VALVE OPEN CARD BYP COMPLEX,16600.0,10790.0,1.1,16600.0,144
CDM,33404OH,CONSTRUCTION APICAL-AORTIC CONDUIT,12548.0,8156.2,1.1,12548.0,144
CDM,33405OH,RPLCMT PROST AORTIC VALVE OPEN XCP HOMOGRF/STENT,18181.0,11817.65,1.1,18181.0,144
CDM,33406OH,RPLCMT AORTIC VALVE OPN ALLOGRAFT VALVE FREEHAND,21072.0,13696.8,1.1,21072.0,144
CDM,33410OH,RPLCMT AORTIC VALVE OPN W/STENTLESS TISSUE VALVE,20420.0,13273.0,1.1,20420.0,144
CDM,33411OH,RPLCMT AORTIC VALVE ANNULUS ENLGMENT NONC SINUS,24828.0,16138.2,1.1,24828.0,144
CDM,33412OH,REPLACEMENT AORTIC VALVE KONNO PROCEDURE,23600.0,15340.0,1.1,23600.0,144
CDM,33413OH,REPLACEMENT AORTIC&PULMON VALVES ROSS PROCEDUR,23948.0,15566.2,1.1,23948.0,144
CDM,33414OH,RPR VENTR O/F TRC OBSTRCJ PATCH ENLGMENT O/F TRC,15748.0,10236.2,1.1,15748.0,144
CDM,33415OH,RESECTION/INCISION SUBVALVULAR TISSUE,14908.0,9690.2,1.1,14908.0,144
CDM,33416OH,VENTRICULOMYOTOMY-MYECTOMY,14624.0,9505.6,1.1,14624.0,144
CDM,33417OH,AORTOPLASTY SUPRAVALVULAR STENOSIS,11732.0,7625.8,1.1,11732.0,144
CDM,33418OH,TCAT MITRAL VALVE REPAIR INITIAL PROSTHESIS,14190.0,9223.5,1.1,14190.0,142
CDM,33419OH,TCAT MITRAL VALVE REPAIR ADDL PROSTHESIS,3489.0,2267.85,1.1,3489.0,142
CDM,33422OH,VALVOTOMY MITRAL VALVE OPEN HEART W/BYPASS,11892.0,7729.8,1.1,11892.0,144
CDM,33425OH,VALVULOPLASTY MITRAL VALVE W/CARDIAC BYPASS,19984.0,12989.6,1.1,19984.0,144
CDM,33426OH,VLVP MITRAL VALVE W/CARD BYP W/PROSTC RING,17312.0,11252.8,1.1,17312.0,144
CDM,33427OH,VLVP MITRAL VALVE W/BYPASS RAD RCNSTJ W/WO RING,17932.0,11655.8,1.1,17932.0,144
CDM,33430OH,REPLACEMENT MITRAL VALVE W/CARDIOPULMONARY BYP,20372.0,13241.8,1.1,20372.0,144
CDM,33440OH,RPLCMT AORTIC VALVE BY TLCJ AUTOL PULM VALVE,25600.0,16640.0,1.1,25600.0,144
CDM,33460OH,VALVECTOMY TRICUSPID VALVE W/CARDIOPULMONARY BYP,17880.0,11622.0,1.1,17880.0,144
CDM,33463OH,VALVULOPLAS TRICUS NO RING INSERT,22832.0,14840.8,1.1,22832.0,144
CDM,33464OH,VALVULOPLAS TRICUS W RING INSERT,17848.0,11601.2,1.1,17848.0,144
CDM,33465OH,REPLACEMENT TRICUSPID VALVE W/CARD BYPASS,20288.0,13187.2,1.1,20288.0,144
CDM,33468OH,TRICUSPID VALVE RPSG&PLCTJ EBSTEIN ANOMALY,18052.0,11733.8,1.1,18052.0,144
CDM,33474OH,VALVOTOMY PULMONARY VALVE OPEN HEART W/BYPASS,15760.0,10244.0,1.1,15760.0,144
CDM,33475OH,"REPLACEMENT, PULMONARY VALVE",16960.0,11024.0,1.1,16960.0,144
CDM,33476OH,R VENTRIC RESCJ INFUND STEN W/WO COMMISSUROTOMY,10628.0,6908.2,1.1,10628.0,144
CDM,33477OH,TCAT PULMONARY VALVE IMPLANTATION PRQ APPROACH,10000.0,6500.0,1.1,10000.0,144
CDM,33478OH,OUTFLOW TRACT AGMNTJ W/WO COMMISSUR/INFUND RESCJ,11016.0,7160.4,1.1,11016.0,144
CDM,33496OH,RPR NON-STRUCT PROSTC VALVE DYSFUNCTION W/BYPASS,11936.0,7758.4,1.1,11936.0,144
CDM,33500000,CHEMOTX ADMN IV NFS TQ UP 1 HR 1/1ST SBST/DRUG,2289.0,1487.85,177.24,2289.0,86
CDM,33500005,CHEMOTX ADMN PERTL CAVITY IMPLANTED PORT/CATH,2289.0,1487.85,25.23,2289.0,86
CDM,33500010,CHEMOTHERAPY ADMN IV INFUSION TQ EA HR,491.0,319.15,36.34,491.0,86
CDM,33500020,CHEMOTX ADMN IV NFS TQ EA SEQL NFS TO 1 HR,491.0,319.15,61.12,491.0,86
CDM,33500025,CHEMOTX ADMN IV PUSH TQ 1/1ST SBST/DRUG,2289.0,1487.85,45.54,2289.0,86
CDM,33500030,CHEMOTX ADMN TQ INIT PROLNG CHEMOTX NFUS PMP,2289.0,1487.85,175.18,2289.0,86
CDM,33500035,CHEMOTX ADMN IV PUSH TQ EA SBST/DRUG,491.0,319.15,45.54,491.0,86
CDM,33500045,CHEMOTHERAPY ADMIN INTRA-ARTERIAL INFUS </1 HR,2289.0,1487.85,198.29,2289.0,86
CDM,33500050,CHEMOTX ADMN TQ INIT PROLNG CHEMOTX NFUS PMP,2289.0,1487.85,175.18,2289.0,86
CDM,33500055,CONCURRENT CHEMO INFUSION UNLISTED,761.0,494.65,41.21,761.0,84
CDM,33500065,CHEMOTX ADMN PLEURAL CAVITY REQ&W/THORACNTS,2289.0,1487.85,152.19,2289.0,86
CDM,33500115,CHEMO EXTEND IV INFUS W/PUMP,2091.0,1359.15,293.81,2091.0,84
CDM,33500145,CHEMOTX ADMN IV NFS TQ UP 1 HR 1/1ST SBST/DRUG,2289.0,1487.85,177.24,2289.0,86
CDM,33500155,CHEMOTX ADMN IV NFS TQ UP 1 HR 1/1ST SBST/DRUG,2289.0,1487.85,177.24,2289.0,86
CDM,33500165,CHEMOTX ADMN IV NFS TQ UP 1 HR 1/1ST SBST/DRUG,2289.0,1487.85,177.24,2289.0,86
CDM,33500175,CHEMOTX ADMN IV NFS TQ UP 1 HR 1/1ST SBST/DRUG,2289.0,1487.85,177.24,2289.0,86
CDM,33500195,CHEMOTHERAPY ADMIN INTRA-ARTERIAL  INFUSION TECHNIQUE >8 HR PRTB,2289.0,1487.85,232.27,2289.0,86
CDM,33500205,CHEMOTHERAPY ADMN INTRAARTERIAL INFUSION EA HR,318.0,206.7,41.21,452.75,86
CDM,33500OH,RPR CORONARY AV/ARTERIOCAR CHMBR FSTL W/BYPASS,11176.0,7264.4,1.1,11176.0,144
CDM,33501OH,RPR CORONARY AV/ARTERIOCAR CHMBR FSTL W/O BYPASS,7804.0,5072.6,1.1,7804.0,144
CDM,33502OH,RPR ANOM CORONARY ART PULM ART ORIGIN LIGATION,8740.0,5681.0,1.1,8740.0,144
CDM,33503OH,RPR ANOM CORONARY ARTERY PULM ART ORIGIN GRAFT,9004.0,5852.6,1.1,9004.0,144
CDM,33504OH,RPR ANOM CORONARY ART PULM ART ORIGIN GRF W/BYP,10184.0,6619.6,1.1,10184.0,144
CDM,33505OH,RPR ANOM CORON ART W/CONSTJ INTRAPULM ART TUNNEL,15360.0,9984.0,1.1,15360.0,144
CDM,33506OH,RPR ANOM CORONARY ART FROM PULM ART TO AORTA,15140.0,9841.0,1.1,15140.0,144
CDM,33507OH,RPR ANOM AORTIC ORIGIN CORONARY ART UNROOF/TLCJ,12560.0,8164.0,1.1,12560.0,144
CDM,33508OH,NDSC SURG W/VIDEO-ASSISTED HARVEST VEIN CABG,124.0,80.6,1.1,124.0,144
CDM,33509OH,ENDOSCOPIC HARVEST UXTR ARTERY 1 SEGMENT CAB PX,1336.0,868.4,1.1,1336.0,144
CDM,33510OH,CORONARY ARTERY BYPASS 1 CORONARY VENOUS GRAFT,13992.0,9094.8,1.1,13992.0,144
CDM,33511OH,CORONARY ARTERY BYPASS 2 CORONARY VENOUS GRAFTS,15380.0,9997.0,1.1,15380.0,144
CDM,33512OH,CORONARY ARTERY BYPASS 3 CORONARY VENOUS GRAFTS,17592.0,11434.8,1.1,17592.0,144
CDM,33513OH,CORONARY ARTERY BYPASS 4 CORONARY VENOUS GRAFTS,18148.0,11796.2,1.1,18148.0,144
CDM,33514OH,CORONARY ARTERY BYPASS 5 CORONARY VENOUS GRAFTS,19232.0,12500.8,1.1,19232.0,144
CDM,33516OH,CORONARY ARTERY BYPASS 6/+ CORONARY VENOUS GRAFT,19904.0,12937.6,1.1,19904.0,144
CDM,33517OH,CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 1 VEIN,1588.0,1032.2,1.1,1588.0,144
CDM,33518OH,CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 2 VEIN,3489.0,2267.85,1.1,3489.0,144
CDM,33519OH,CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 3 VEIN,4616.0,3000.4,1.1,4616.0,144
CDM,33521OH,CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 4 VEIN,5540.0,3601.0,1.1,5540.0,144
CDM,33522OH,CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 5 VEIN,6222.0,4044.3,1.1,6222.0,144
CDM,33523OH,CORONARY ARTERY BYP W/VEIN &ARTERY GRAFT 6 VEIN,7075.0,4598.75,1.1,7075.0,144
CDM,33530OH,ROPRTJ CAB/VALVE PX > 1 MO AFTER ORIGINAL OPERJ,4052.0,2633.8,1.1,4052.0,144
CDM,33533OH,CABG W/ARTERIAL GRAFT SINGLE ARTERIAL GRAFT,14850.0,9652.5,1.1,14850.0,144
CDM,33534OH,"CABG, ARTERIAL, TWO",17547.0,11405.55,1.1,17547.0,144
CDM,33535OH,"CABG, ARTERIAL, THREE",19690.0,12798.5,1.1,19690.0,144
CDM,33536OH,"CABG, ARTERIAL, FOUR+",21309.0,13850.85,1.1,21309.0,144
CDM,33542OH,MYOCARD RESECTN,19284.0,12534.6,1.1,19284.0,144
CDM,33545OH,RPR POSTINFRCJ VENTRICULAR SEPTAL DEFECT,22824.0,14835.6,1.1,22824.0,144
CDM,33548OH,SURG VENTRICULAR RSTRJ PX W/PROSTC PATCH PFRMD,21656.0,14076.4,1.1,21656.0,144
CDM,33572OH,CORONARY ENDARTERCOMY OPEN ANY METHOD,1776.0,1154.4,1.1,1776.0,144
CDM,33600OH,CLOSURE ATRIOVENTRICULAR VALVE SUTURE/PATCH,12124.0,7880.6,1.1,12124.0,144
CDM,33606OH,ANAST PULMONARY ART AORTA DAMUS-KAYE-STANSEL PX,12612.0,8197.8,1.1,12612.0,144
CDM,33608OH,RPR CAR ANOMAL XCP PULM ATRESIA VENTR SEPTL DFCT,14027.0,9117.55,1.1,14027.0,144
CDM,33610OH,RPR CAR ANOMAL SURG ENLGMENT VENTR SEPTL DFCT,12560.0,8164.0,1.1,12560.0,144
CDM,33611OH,RPR 2 OUTLET R VNTRC W/INTRAVENTR TUNNEL RPR,14228.0,9248.2,1.1,14228.0,144
CDM,33612OH,RPR 2 OUTLET R VNTRC RPR R VENTR O/F TRC OBSTRCJ,14628.0,9508.2,1.1,14628.0,144
CDM,33615OH,RPR CAR ANOMAL CLSR SEPTL DFCT SMPL FONTAN PX,14356.0,9331.4,1.1,14356.0,144
CDM,33617OH,RPR COMPLEX CARDIAC ANOMALY MODIFIED FONTAN PX,17200.0,11180.0,1.1,17200.0,144
CDM,33619OH,RPR 1 VNTRC W/O/F OBSTRCJ&AORTIC ARCH HYPOPLAS,19504.0,12677.6,1.1,19504.0,144
CDM,33620OH,APPLICATION RIGHT & LEFT PULMONARY ARTERY BANDS,13200.0,8580.0,1.1,13200.0,144
CDM,33621OH,TRANSTHORACIC CATHETER INSERTION FOR STENT PLMT,6472.0,4206.8,1.1,6472.0,144
CDM,33622OH,RECONSTRUCTION COMPLEX CARDIAC ANOMALY,25600.0,16640.0,1.1,25600.0,144
CDM,33641OH,REPR ASD W BYPASS,11832.0,7690.8,1.1,11832.0,144
CDM,33645OH,DIR/PTCH CLS SINUS VENOSUS W/WO ANOM PUL VEN DRG,12520.0,8138.0,1.1,12520.0,144
CDM,33647OH,RPR ATRIAL & VENTRIC SEPTAL DFCT DIR/PATCH CLS,14520.0,9438.0,1.1,14520.0,144
CDM,33660OH,RPR INCPLT/PRTL AV CANAL W/WO AV VALVE RPR,14005.0,9103.25,1.1,14005.0,144
CDM,33665OH,RPR INTRM/TRANSJ AV CANAL W/WO AV VALVE RPR,13940.0,9061.0,1.1,13940.0,144
CDM,33670OH,RPR COMPL AV CANAL W/WO PROSTC VALVE,16117.0,10476.05,1.1,16117.0,144
CDM,33675OH,CLOSURE MULTIPLE VENTRICULAR SEPTAL DEFECTS,14380.0,9347.0,1.1,14380.0,144
CDM,33676OH,"CLOSE MULTIPLE VSD, WITH RESECTION",14780.0,9607.0,1.1,14780.0,144
CDM,33677OH,"CLOSE MULTIPLE VSD, REMOVE PA BAND",15380.0,9997.0,1.1,15380.0,144
CDM,33681OH,CLSR 1 VENTRICULAR SEPTAL DEFECT W/WO PATCH,14230.0,9249.5,1.1,14230.0,144
CDM,33684OH,CLSR V-SEPTL DFCT W/PULM VLVT/INFUND RESCJ,13748.0,8936.2,1.1,13748.0,144
CDM,33688OH,CLSR V-SEPTAL DFCT W/RMVL P-ART BAND W/WO GUSSET,13900.0,9035.0,1.1,13900.0,144
CDM,33690OH,BANDING PULM ARTERY,8144.0,5293.6,1.1,8144.0,144
CDM,33692OH,COMPL RPR TETRALOGY FALLOT W/O PULM ATRESIA,14460.0,9399.0,1.1,14460.0,144
CDM,33694OH,COMPL RPR T-FALLOT W/O PULM ATRESIA TANULR PATCH,14228.0,9248.2,1.1,14228.0,144
CDM,33697OH,COMPL RPR T-FALLOT W/PULM ATRESIA,15028.0,9768.2,1.1,15028.0,144
CDM,33702OH,RPR SINUS VALSALVA FISTULA,10896.0,7082.4,1.1,10896.0,144
CDM,33710OH,RPR SINUS VALSALVA FISTULA W/RPR V-SEPTAL DEFECT,15000.0,9750.0,1.1,15000.0,144
CDM,33720OH,RPR SINUS VALSALVA ANEURYSM,10904.0,7087.6,1.1,10904.0,144
CDM,33724OH,REPAIR ISOLATED PARTIAL PULM VENOUS RETURN,11052.0,7183.8,1.1,11052.0,144
CDM,33726OH,REPAIR PULMONARY VENOUS STENOSIS,14848.0,9651.2,1.1,14848.0,144
CDM,33730OH,COMPLETE RPR ANOMALOUS PULMONARY VENOUS RETURN,14456.0,9396.4,1.1,14456.0,144
CDM,33732OH,RPR COR TRIATM/SUPVALVR RING RESCJ L ATRIAL MEMB,11584.0,7529.6,1.1,11584.0,144
CDM,33735OH,ATRIAL SEPTECTOMY/SEPTOSTOMY CLOSED HEART,8880.0,5772.0,1.1,8880.0,144
CDM,33736OH,ATR SEPTEC/SEPTOSTOMY OPEN W BYPASS,9728.0,6323.2,1.1,9728.0,144
CDM,33741OH,TAS CONGENITAL CARDIAC ANOMALIES ANY METHOD,5600.0,3640.0,1.1,5600.0,144
CDM,33745OH,TIS CRTJ ST CONGENITAL CARDIAC ANOMAL 1ST SHUNT,8000.0,5200.0,1.1,8000.0,144
CDM,33746OH,TIS CRTJ ST CONGENITAL CARDIAC ANOMAL EA ADDL,3200.0,2080.0,1.1,3200.0,144
CDM,33750OH,SHUNT SUBCLAVIAN PULMONARY ARTERY,8888.0,5777.2,1.1,8888.0,144
CDM,33755OH,SHUNT ASCENDING AORTA PULMONARY ARTERY,9040.0,5876.0,1.1,9040.0,144
CDM,33764OH,SHUNT CENTRAL W/PROSTHETIC GRAFT,9040.0,5876.0,1.1,9040.0,144
CDM,33766OH,SHUNT SUPERIOR VENA CAVA PULMONARY ART 1 LUNG,9428.0,6128.2,1.1,9428.0,144
CDM,33767OH,SHUNT SUPERIOR VENA CAVA PULM ARTERY BOTH LUNGS,10120.0,6578.0,1.1,10120.0,144
CDM,33768OH,ANASTOMOSIS CAVOPULMARY 2ND SUPRIOR VENA CAVA,3200.0,2080.0,1.1,3200.0,144
CDM,33770OH,RPR TRPOS GREAT VSLS W/O ENLGMNT V-SEPTL DFCT,15628.0,10158.2,1.1,15628.0,144
CDM,33771OH,RPR TRPOS GREAT VSLS W/ENLGMNT V-SEPTL DFCT,16252.0,10563.8,1.1,16252.0,144
CDM,33774OH,RPR TRPOS GREAT VSLS ATRIAL BAFFLE PX W/BYPASS,12692.0,8249.8,1.1,12692.0,144
CDM,33775OH,RPR TRPOS GREAT VSLS ATR BAFFLE W/RMVL PULM BAND,13196.0,8577.4,1.1,13196.0,144
CDM,33776OH,RPR TRPOS GRT VSL ATR BAFFLE W/CLSR V-SEPTL DFCT,13900.0,9035.0,1.1,13900.0,144
CDM,33777OH,RPR TRPOS GRT VSL ATR BAFFLE W/BYP SBPULM OBSTRC,13668.0,8884.2,1.1,13668.0,144
CDM,33778OH,RPR TRPOS GRT VESSEL AORTIC PULMONARY ART RCNSTJ,17100.0,11115.0,1.1,17100.0,144
CDM,33779OH,RPR TGV AORTIC PULM ART RCNSTJ W/RMVL PULM BAND,17292.0,11239.8,1.1,17292.0,144
CDM,33780OH,RPR TGV AORTIC P-ART RCNSTJ W/CLSR V-SEPTL DFCT,17560.0,11414.0,1.1,17560.0,144
CDM,33781OH,RPR TGV AORTIC P-ART RCNSTJ RPR SBPULMC OBSTRCJ,16852.0,10953.8,1.1,16852.0,144
CDM,33782OH,A-ROOT TLCJ VSD PULM STNS RPR W/O C OST RIMPLTJ,24032.0,15620.8,1.1,24032.0,144
CDM,33783OH,A-ROOT TLCJ VSD PULM STNS RPR W/ RIMPLTJ C OSTIA,28635.0,18612.75,1.1,28635.0,144
CDM,33786OH,REPAIR TRUNCUS ARTERIOSUS,16748.0,10886.2,1.1,16748.0,144
CDM,33788OH,REIMPLANTATION ANOMALOUS PULMONARY ARTERY,10968.0,7129.2,1.1,10968.0,144
CDM,33800OH,AORTIC SUSPENSN FOR TRACH DECOMPRE,6912.0,4492.8,1.1,6912.0,144
CDM,33802OH,DIVISION ABERRANT VESSEL VASCULAR RING,7348.0,4776.2,1.1,7348.0,144
CDM,33803OH,DIVISION ABERRANT VESSEL W/REANASTOMOSIS,8124.0,5280.6,1.1,8124.0,144
CDM,33814OH,OBLTRJ AORTOPULMONARY SEPTAL DFCT W/CARD BYPASS,10628.0,6908.2,1.1,10628.0,144
CDM,33820OH,REPAIR PATENT DUCTUS ARTERIOSUS LIGATION,6676.0,4339.4,1.1,6676.0,144
CDM,33822OH,RPR PATENT DUXUS ARTERIOSUS DIV UNDER 18 YR,7084.0,4604.6,1.1,7084.0,144
CDM,33840OH,EXC COARCJ AORTA W/WO PDA W/DIRECT ANASTOMOSIS,8536.0,5548.4,1.1,8536.0,144
CDM,33845OH,EXCISION COARCTATION AORTA W/WO PDA W/GRAFT,9172.0,5961.8,1.1,9172.0,144
CDM,33851OH,EXC COARCJ AORTA W/L SUBCLAV ART/PROSTC GUSSET,8792.0,5714.8,1.1,8792.0,144
CDM,33852OH,RPR HYPOPLSTC A-ARCH W/AGRFT/PROSTC W/O BYPASS,9764.0,6346.6,1.1,9764.0,144
CDM,33853OH,RPR HYPOPLSTC A-ARCH W/AGRFT/PROSTC W/BYPASS,13004.0,8452.6,1.1,13004.0,144
CDM,33858OH,AS-AORT GRF W/CARD BYP F/AORTIC DISSECTION,25360.0,16484.0,1.1,25360.0,144
CDM,33859OH,AS-AORT GRF W/CARD BYP F/AORTIC DS OTH/THN DSJ,18052.0,11733.8,1.1,18052.0,144
CDM,33863OH,AS-AORT GRF W/CARD BYP & AORTIC ROOT RPLCMT,23516.0,15285.4,1.1,23516.0,144
CDM,33864OH,ASCENDING AORTA GRF VALVE SPARE ROOT REMODEL,24032.0,15620.8,1.1,24032.0,144
CDM,33866OH,AORTIC HEMIARCH GRAFT W/ISOL & CTRL ARCH VESSELS,7810.0,5076.5,1.1,7810.0,144
CDM,33871OH,TRANSVRS A-ARCH GRF W/CARD BYP PRFD HYPOTHERMIA,24352.0,15828.8,1.1,24352.0,144
CDM,33875OH,DESCENDING THORACIC AORTA GRAFT W/WO BYPASS,20288.0,13187.2,1.1,20288.0,144
CDM,33877OH,RPR THORACOABDOMINAL AORTIC ANEURYS W/WO BYPASS,27612.0,17947.8,1.1,27612.0,144
CDM,33880OH,EVASC RPR DTA COVERAGE ART ORIGIN 1ST ENDOPROSTH,13832.0,8990.8,1.1,13832.0,144
CDM,33881OH,EVASC RPR DTA EXP COVERAGE W/O ART ORIGIN,11832.0,7690.8,1.1,11832.0,144
CDM,33882OH,EVASC RPR TA DPLMNT BRNCHD NDGFT MULTIPIECE SYS,15400.0,10010.0,1.1,15400.0,106
CDM,33883OH,PLMT PROX XTN PROSTH EVASC RPR DTA 1ST XTN,8436.0,5483.4,1.1,8436.0,144
CDM,33886OH,PLMT DSTL XTN PROSTH DLYD AFTER EVASC RPR DTA,7236.0,4703.4,1.1,7236.0,144
CDM,33894OH,EVASC ST RPR COARCJ THRC/AA ACRS MAJ SIDE BRNCH,8039.0,5225.35,1.1,8039.0,144
CDM,33895OH,EVASC ST RPR COARCJ THRC/AA XCRSG MAJ SIDE BRNCH,6398.0,4158.7,1.1,6398.0,144
CDM,33897OH,PERQ TRANSLUMINAL ANGIOPLASTY NATIVE/RECR COA,4324.0,2810.6,1.1,4324.0,144
CDM,33900OH,PERQ P-ART REVSC ST 1ST NML NATIVE CONNJ UNI,4412.0,2867.8,1.1,32085.4,144
CDM,33901OH,PERQ P-ART REVSC ST 1ST NML NATIVE CONNJ BI,5800.0,3770.0,1.1,32085.4,144
CDM,33902OH,PERQ P-ART REVSC ST 1ST ABNOR CONNJ UNILATERAL,5600.0,3640.0,1.1,51140.13,144
CDM,33903OH,PERQ P-ART REVSC ST 1ST ABNORMAL CONNJ BILATERAL,6600.0,4290.0,1.1,32085.4,144
CDM,33904OH,PERQ P-ART REVSC ST EA ADDL VSL/SEP LES NM/ABNL,2212.0,1437.8,1.1,2212.0,144
CDM,33910OH,PULMONARY ARTERY EMBOLECTOMY W/CARD BYPASS,19284.0,12534.6,1.1,19284.0,144
CDM,33915OH,PULMONARY ARTERY EMBOLECTOMY W/O CARD BYPASS,9980.0,6487.0,1.1,9980.0,144
CDM,33916OH,PULMONARY ENDARTERCOMY W/WO EMBOLECTOMY W/BYPASS,31200.0,20280.0,1.1,31200.0,144
CDM,33917OH,RPR PULMONARY ART STENOSIS RCNSTJ W/PATCH/GRAFT,10120.0,6578.0,1.1,10120.0,144
CDM,33920OH,RPR PULMONARY ATRESIA W/CONSTJ/RPLCMT CONDUIT,13096.0,8512.4,1.1,13096.0,144
CDM,33922OH,TRANSECTION PULMONARY ARTERY W/CARD BYPASS,9688.0,6297.2,1.1,9688.0,144
CDM,33924OH,LIG&TKDN SYSIC-TO-PULM ART SHUNT W/CGEN HEART,2196.0,1427.4,1.1,2196.0,144
CDM,33925OH,RPR P-ART ARBORIZJ ANOMAL UNIFCLIZJ W/O BYPASS,12520.0,8138.0,1.1,12520.0,144
CDM,33926OH,RPR P-ART ARBORIZJ ANOMAL UNIFCLIZJ W/BYPASS,17892.0,11629.8,1.1,17892.0,144
CDM,33927OH,IMPLTJ TOTAL RPLCMT HEART SYS W/RCP CARDIECTOMY,19600.0,12740.0,1.1,19600.0,142
CDM,33928OH,REMOVAL & RPLCMT TOTAL RPLCMT HEART SYS,20031.0,13020.15,1.1,3060831.65,88
CDM,33929OH,REMOVAL TOTAL RPLCMT HEART SYS FOR HEART TRNSPL,27438.0,17834.7,1.1,3060831.65,88
CDM,33933OH,BKBENCH PREPJ CADAVER DONOR HEART/LUNG ALLOGRAFT,7415.0,4819.75,1.1,7415.0,104
CDM,33935OH,HEART-LUNG TRNSPL W/RECIPIENT CARDIECTOMY-PNUMEC,36712.0,23862.8,1.1,36712.0,144
CDM,33940OH,DONOR CARDIECTOMY,9815.0,6379.75,1.1,9815.0,82
CDM,33944OH,BKBENCH PREPJ CADAVER DONOR HEART ALLOGRAFT,6741.0,4381.65,1.1,6741.0,104
CDM,33945OH,HEART TRANSPLANT W/WO REC CARDIECTOMY,35800.0,23270.0,1.1,35800.0,144
CDM,33946OH,ECMO/ECLS INITIATION VENO-VENOUS,2640.0,1716.0,1.1,2640.0,144
CDM,33947OH,ECMO/ECLS INITIATION VENO-ARTERIAL,2917.0,1896.05,1.1,2917.0,144
CDM,33948OH,ECMO/ECLS DAILY MANAGEMENT EACH DAY VENO-VENOUS,2081.0,1352.65,1.1,2081.0,144
CDM,33949OH,ECMO/ECLS DAILY MANAGEMENT EA DAY VENO-ARTERIAL,1840.0,1196.0,1.1,1840.0,144
CDM,33951OH,ECMO/ECLS INSJ OF PRPH CANNULA BIRTH-5 YRS PERQ,3260.0,2119.0,1.1,3260.0,144
CDM,33952OH,ECMO/ECLS INSJ OF PRPH CANNULA 6 YRS&OLDER PERQ,3260.0,2119.0,1.1,3260.0,144
CDM,33953OH,ECMO/ECLS INSJ OF PRPH CANNULA BIRTH-5 YRS OPEN,3644.0,2368.6,1.1,3644.0,144
CDM,33954OH,ECMO/ECLS INSJ OF PRPH CANNULA 6 YRS&OLDER OPEN,3644.0,2368.6,1.1,3644.0,144
CDM,33955OH,ECMO/ECLS INSJ OF CENTRAL CANNULA BIRTH-5 YRS,6400.0,4160.0,1.1,6400.0,144
CDM,33956OH,ECMO/ECLS INSJ OF CENTRAL CANNULA 6 YRS & OLDER,6400.0,4160.0,1.1,6400.0,144
CDM,33957OH,ECMO/ECLS REPOS PERIPH CANNULA PERQ BIRTH-5 YRS,1404.0,912.6,1.1,1404.0,144
CDM,33958OH,ECMO/ECLS REPOS PERPH CANNULA PRQ 6 YRS & OLDER,1404.0,912.6,1.1,1404.0,144
CDM,33959OH,ECMO/ECLS REPOS PERPH CANNULA OPEN BIRTH-5 YRS,1788.0,1162.2,1.1,1788.0,144
CDM,33962OH,ECMO/ECLS REPOS PERPH CANNULA OPEN 6 YRS & OLDER,1788.0,1162.2,1.1,1788.0,144
CDM,33963OH,ECMO/ECLS REPOS CENTRAL PERPH CANNULA BIRTH-5YRS,3600.0,2340.0,1.1,3600.0,144
CDM,33964OH,ECMO/ECLS ECLS REPOS CENTRAL CNULA 6YRS & OLDER,3800.0,2470.0,1.1,3800.0,144
CDM,33965OH,ECMO/ECLS RMVL OF PERPH CANNULA PERQ BIRTH-5 YRS,1404.0,912.6,1.1,1404.0,144
CDM,33966OH,ECMO/ECLS RMVL OF PRPH CANNULA PRQ 6 YRS & OLDER,1800.0,1170.0,1.1,1800.0,144
CDM,33967OH,INSERTION INTRA-AORTIC BALLOON ASSIST DEV PERQ,1936.0,1258.4,1.1,1936.0,144
CDM,33968OH,REMOVAL INTRA-AORTIC BALLOON ASSIST DEVICE PRQ,256.0,166.4,1.1,256.0,144
CDM,33969OH,ECMO/ECLS RMVL OF PERPH CANNULA OPEN BIRTH-5 YRS,2088.0,1357.2,1.1,2088.0,144
CDM,33970OH,INSJ INTRA-AORT BALO ASSIST DEV VIA FEM ART OPEN,2696.0,1752.4,1.1,2696.0,144
CDM,33971OH,RMVL I-AORT BALO ASST DEV W/RPR FEM ART W/WO GRF,4796.0,3117.4,1.1,4796.0,144
CDM,33973OH,INSJ I-AORT BALO ASSIST DEV VIA ASCENDING AORTA,3900.0,2535.0,1.1,3900.0,144
CDM,33974OH,RMVL ASCENDING-AORTA BALO DEV W/RPR ASCEND-AORTA,6012.0,3907.8,1.1,6012.0,144
CDM,33975OH,INSJ VENTRIC ASSIST DEV XTRCORP SINGLE VENTRICLE,10000.0,6500.0,1.1,10000.0,144
CDM,33976OH,INSJ VENTRIC ASSIST DEV XTRCORP BIVENTRICULAR,12300.0,7995.0,1.1,12300.0,144
CDM,33977OH,REMOVAL VENTR ASSIST DEVICE XTRCORP 1 VENTRICLE,8344.0,5423.6,1.1,8344.0,144
CDM,33978OH,REMOVAL VENTR ASSIST DEVICE XTRCORP BIVENTR,10000.0,6500.0,1.1,10000.0,144
CDM,33979OH,INSJ VENTR ASSIST DEV IMPLTABLE ICORP 1 VNTRC,15000.0,9750.0,1.1,15000.0,144
CDM,33980OH,RMVL VENTR ASSIST DEV IMPLTABLE ICORP 1 VNTRC,13400.0,8710.0,1.1,13400.0,142
CDM,33981OH,REPLACE XTRA CORP VAD BIVENTRICLE PUMP,6444.0,4188.6,1.1,6444.0,144
CDM,33982OH,PLCMT VAD PMP IMPLTBL ICORP 1 VENTR W/O BYPASS,15144.0,9843.6,1.1,15144.0,144
CDM,33983OH,RPLCMT VAD PMP IMPLTBL ICORP 1 VNTR W/BYPASS,17816.0,11580.4,1.1,17816.0,144
CDM,33984OH,ECMO/ECLS RMVL PRPH CANNULA OPEN 6 YRS & OLDER,2184.0,1419.6,1.1,2184.0,144
CDM,33985OH,ECMO/ECLS REMOVAL OF CENTRAL CANNULA BIRTH-5 YRS,3956.0,2571.4,1.1,3956.0,144
CDM,33986OH,ECMO/ECLS RMVL OF CENTRAL CANNULA 6 YRS & OLDER,4000.0,2600.0,1.1,4000.0,144
CDM,33987OH,ARTERY EXPOS/GRAFT ARTERY PERFUSION ECMO/ECLS,1616.0,1050.4,1.1,1616.0,144
CDM,33988OH,INSERT LEFT HEART VENT BY THORACIC INC ECMO/ECLS,6000.0,3900.0,1.1,6000.0,144
CDM,33989OH,RMVL LEFT HEART VENT BY THORACIC INCIS ECMO/ECLS,3800.0,2470.0,1.1,3800.0,144
CDM,33990OH,INSJ PERQ VAD W/IMAGING ARTERY ACCESS ONLY,2970.0,1930.5,1.1,2970.0,144
CDM,33991OH,INSJ PERQ VAD TRNSPTAL W/IMAGE ART&VENOUS ACCESS,3890.0,2528.5,1.1,3890.0,144
CDM,33992OH,REMOVAL PERQ LEFT HRT VAD ARTL/ARTL&VEN SEP INSJ,1420.0,923.0,1.1,1420.0,144
CDM,33993OH,REPOSITIONING PERQ R/L VAD W/IMG GDN SEP INSJ,1240.0,806.0,1.1,1240.0,144
CDM,33995OH,INSJ PERQ VAD W/RS&I R HEART VENOUS ACCESS ONLY,2700.0,1755.0,1.1,2700.0,144
CDM,33997OH,REMOVAL PERQ R HEART VAD VENOUS CANNULA SEP INSJ,1200.0,780.0,1.1,1200.0,144
CDM,33999AOH,AXILLARY EXPOSURE FOR INSERTION OF VAD,1762.0,1145.3,0.01,1833.54,84
CDM,33999BOH,OPEN AXILLARY INTRA AORTIC BALLON PUMP PLACEMENT,2224.0,1445.6,0.01,2224.0,84
CDM,33999COH,REPAIR ASCENDING AORTA INTRAMURAL HEMATOMA WITH PATCH GRAFT,19912.0,12942.8,0.01,19912.0,84
CDM,33999DOH,REPLACE TRICUSPID VALVE PERQ,8542.0,5552.3,0.01,8542.0,84
CDM,33999EOH,IMPLANT CPNS SYSTEM (COMP TO 33289),2161.0,1404.65,0.01,2161.0,84
CDM,33999FOH,EXPLANT CPNS SYSTEM (COMP TO 33289),2161.0,1404.65,0.01,2161.0,84
CDM,33999OH,UNLISTED CARDIAC SURG PROCEDURE,3722.0,2419.3,0.01,3722.0,84
CDM,33999RVU10OH,"OPEN ANTEGRADE DEPLOYMENT OF ENDOGRAFT, DESCENDING THORACIC AORT",16738.0,10879.7,0.01,16738.0,84
CDM,33999RVU11OH,THROMBECTOMY OF IVC/HEART CHAMBERS BY USE OF ANGIOVAC. (COMP COD,4558.0,2962.7,0.01,4558.0,84
CDM,33999RVU1OH,ANGIOPLASTY LEFT CAROTID,4836.0,3143.4,0.01,4836.0,84
CDM,33999RVU2OH,ATRIAL APPENDAGE LIGATION,8322.0,5409.3,0.01,8322.0,84
CDM,33999RVU3OH,TTVR/ TRANSVENOUS,8054.0,5235.1,0.01,8054.0,84
CDM,33999RVU4OH,TRCATH RPLC MITRAL VALVE,12565.0,8167.25,0.01,12565.0,84
CDM,33999RVU5OH,IMPLANT TOTAL HEART SYSTE,16645.0,10819.25,0.01,16645.0,84
CDM,33999RVU6OH,AORTOPLASTY,21113.0,13723.45,0.01,21113.0,84
CDM,33999RVU7OH,ATRIAL VENTRICULAR BYPASS (COMP CODE 33404),12974.0,8433.1,0.01,12974.0,84
CDM,33999RVU8OH,ENDOVASCULAR REPAIR OF TRANSVERSE THORACIC AORTA (COMP CODE 3388,11411.0,7417.15,0.01,11411.0,84
CDM,33999RVU9OH,VATS LIGATION OF PDA (COMP CODE 33820),5508.0,3580.2,0.01,5508.0,84
CDM,33999RVUOH,REMOVAL INTRACARDIAC CATH,2464.0,1601.6,0.01,2464.0,84
CDM,33999UNL1OH,PERQ TCAT NO-IMPLANT IAS SHUNT CREATION (COMP TO 33741),5041.0,3276.65,0.01,5041.0,84
CDM,34000025,MYOCARDIAL PERFUSION PLANAR 1 STUDY REST/STRESS,9008.0,5855.2,362.64,91712.48,87
CDM,34000035,BRAIN IMAGING MINIMUM 4 STATIC VIEWS,3714.0,2414.1,250.76,91890.17,87
CDM,34000055,KIDNEY IMAGING MORPHOOGY W/VASCULAR FLOW,2773.0,1802.45,285.4,92002.39,87
CDM,34000065,NJX RP LOCLZJ NON-IMG PROBE STUDY INTRAVENOUS,2773.0,1802.45,53.37,92127.48,87
CDM,34000085,RP THERAPY INTRAVENOUS ADMINISTRATION,1546.0,1004.9,128.84,92470.0,87
CDM,34000105,RP LOCLZJ TUM SPECT 1 AREA SINGLE DAY IMAGING,9008.0,5855.2,469.27,92121.64,87
CDM,34000125,RP THERAPY INTRA-ARTERIAL PARTICULATE ADMN,1546.0,1004.9,207.78,92872.14,85
CDM,34001OH,EMBLC/THRMBC CATH CRTD SUBCLA/INNOMINATE ART,7152.0,4648.8,1.1,7152.0,144
CDM,34051OH,EMBLC/THRMBC INNOMINATE SUBCLAVIAN ARTERY,6796.0,4417.4,1.1,6796.0,144
CDM,34100000,THYROID UPTAKE SINGLE/MULTIPLE QUANT MEASUREMENT,2773.0,1802.45,110.95,91196.94,87
CDM,34100005,THYROID IMAGING WITH VASCULAR FLOW,2773.0,1802.45,233.87,91198.11,87
CDM,34100025,THYROID CARCINOMA METASTASES UPTAKE,883.0,573.95,102.22,91206.3,68
CDM,34100035,PARATHYROID IMAGING W/TOMOGRAPHIC SPECT & CT,3714.0,2414.1,311.35,91267.09,87
CDM,34100050,THYROID CARCINOMA METASTASES IMG WHOLE BODY,3714.0,2414.1,311.35,91203.96,87
CDM,34100060,PARATHYROID PLANAR IMAGING,2773.0,1802.45,357.81,91264.75,87
CDM,34100065,SALIVARY GLAND IMAGING SERIAL IMAGES,2773.0,1802.45,138.71,91452.96,87
CDM,34100080,BONE MARROW IMAGING LIMITED AREA,2773.0,1802.45,218.26,91302.16,87
CDM,34100090,BONE MARROW IMAGING MULTIPLE AREAS,2773.0,1802.45,231.39,91303.33,87
CDM,34100100,BONE MARROW IMAGING WHOLE BODY,2773.0,1802.45,307.78,91304.49,87
CDM,34100105,MYOCRD INFARCT AVID PLNR TOMOG SPECT W/WO QUANTJ,3714.0,2414.1,277.35,91731.18,87
CDM,34100110,WHOLE BLOOD VOLUME DETERM PLASMA&RED CELL VOLU,3714.0,2414.1,131.49,91325.54,87
CDM,34100115,CARD BL POOL PLNR MLT STDY WAL MOTN EJECT FRACT,3714.0,2414.1,294.24,91747.55,87
CDM,34100130,LYMPHATICS & LYMPH NODES IMAGING,3714.0,2414.1,433.07,91410.88,87
CDM,34100140,LIVER IMAGING STATIC ONLY,3714.0,2414.1,240.98,91417.89,87
CDM,34100145,PET BRAIN PLAQUE,2700.0,1755.0,311.35,2700.0,85
CDM,34100150,LIVER IMAGING W/VASCULAR FLOW,3714.0,2414.1,266.63,91419.06,87
CDM,34100155,KIDNEY FUNCJ STUDY NON-IMG RADIOISOTOPIC STUDY,2773.0,1802.45,130.66,2773.0,87
CDM,34100170,LIVER & SPLEEN IMAGING STATIC ONLY,2773.0,1802.45,249.46,91434.26,87
CDM,34100190,MYOCARDIAL PERFUSION PLANAR MULTIPLE STUDIES,9008.0,5855.2,532.23,91713.65,87
CDM,34100205,ESOPHAGEAL MOTILITY,2773.0,1802.45,268.52,91484.53,87
CDM,34100210,SALIVARY GLAND FUNCTION STUDY,2773.0,1802.45,136.44,91454.13,87
CDM,34100215,GASTRIC EMPTYNG IMAG STD W/SM BWL TRANSIT,2773.0,1802.45,311.35,91492.7,87
CDM,34100220,GASTROESOPHAGEAL REFLUX STUDY,2773.0,1802.45,303.81,91489.2,87
CDM,34100225,GSTRC EMPTNG IMAG STD W/SM BWL COL TRNST MLT DAY,3714.0,2414.1,311.35,91493.88,87
CDM,34100230,GASTRIC EMPTYING IMAGING STUDY,2773.0,1802.45,311.35,91491.54,87
CDM,34100235,BONE &/JOINT IMAGING LIMITED AREA,2773.0,1802.45,279.07,91533.62,87
CDM,34100245,PULMONARY PERFUSION IMAGING PARTICULATE,2773.0,1802.45,291.58,91860.94,87
CDM,34100250,ACUTE GASTROINTESTINAL BLOOD LOSS IMAGING,2773.0,1802.45,357.81,91507.91,87
CDM,34100255,QUANT DIFF PULM PRFUSION & VENTLAJ W/WO IMAGIN,3714.0,2414.1,370.01,91881.99,87
CDM,34100260,INTESTINE IMAGING,2773.0,1802.45,311.35,91521.94,87
CDM,34100265,KIDNEY IMG MORPHOLOGY VASCULAR FLOW MULTIPLE,3714.0,2414.1,311.35,92011.74,87
CDM,34100270,PERITONEAL-VENOUS SHUNT PATENCY TEST,2773.0,1802.45,311.35,91523.1,87
CDM,34100275,RP LOCLZJ TUM PLNR 1 AREA SINGLE DAY IMAGING,2773.0,1802.45,317.62,92118.13,87
CDM,34100285,SALIVARY GLAND IMAGING,2773.0,1802.45,220.82,91451.79,87
CDM,34100290,BONE &/JOINT IMAGING WHOLE BODY,2773.0,1802.45,311.35,91540.64,87
CDM,34100300,BONE &/JOINT IMAGING 3 PHASE STUDY,2773.0,1802.45,311.35,91551.16,87
CDM,34100320,CARDIAC SHUNT DETECTION,2773.0,1802.45,234.25,91683.25,87
CDM,34100340,MYOCARDIAL SPECT SINGLE STUDY AT REST OR STRESS,9008.0,5855.2,423.21,91710.14,87
CDM,34100350,MYOCARDIAL SPECT MULTIPLE STUDIES,9008.0,5855.2,589.06,91711.31,87
CDM,34100400,CARD BLOOD POOL GATED PLANAR 1 STUDY REST/STRESS,2773.0,1802.45,283.45,91734.69,87
CDM,34100410,CARD BL POOL GATED MLT STDY WAL MOTN EJECT FRACT,2773.0,1802.45,311.35,91735.86,87
CDM,34100420,CARD BL POOL PLANAR 1 STDY WAL MOTN EJECT FRACT,3714.0,2414.1,220.3,91745.21,87
CDM,34100500,BRAIN IMAGING <4 STATIC VIEWS W/VASCULAR FLOW,2773.0,1802.45,270.24,91885.49,87
CDM,34100510,BRAIN IMAGING MIN 4 STATIC VIEWS W VASCULAR FLOW,3714.0,2414.1,311.35,91891.34,87
CDM,34100530,CEREBROSPINAL FLUID FLOW W/O MATL CISTERNOGRAPHY,3714.0,2414.1,414.46,91919.4,87
CDM,34100540,CEREBROSPINAL FLUID FLOW W/O MATL SHUNT EVALTJ,3714.0,2414.1,402.69,91936.93,87
CDM,34100560,CEREBROSPINAL FLUID LEAK DETECTION&LOCALIZATIO,9008.0,5855.2,340.42,91942.78,87
CDM,34100570,KIDNEY IMG MORPHOLOGY VASCULAR FLOW 1 W/O RX,3714.0,2414.1,288.84,92009.41,87
CDM,34100580,KIDNEY IMG MORPHOLOGY VASCULAR FLOW 1 W/RX,3714.0,2414.1,230.55,92010.58,87
CDM,34100610,TESTICULAR IMAGING WITH VASCULAR FLOW,2773.0,1802.45,263.98,92072.53,87
CDM,34100640,RP LOCLZJ TUM PLNR 2+AREA 1+D IMG/1 AREA IMG>2+D,2773.0,1802.45,336.01,92119.29,87
CDM,34100660,RP LOCLZJ TUM PLNR WHOLE BODY SINGLE DAY IMAGING,9008.0,5855.2,378.58,92120.47,87
CDM,34100670,RP LOCLZJ TUM SPECT 1 AREA SINGLE DAY IMAGING,9008.0,5855.2,469.27,92121.64,87
CDM,34100680,RP LOCLZJ TUM PLNR WHOLE BODY 2+ DAYS IMAGING,9008.0,5855.2,513.69,92122.8,87
CDM,34100720,URETERAL REFLUX STUDY RP VOIDING CYSTOGRAM,2773.0,1802.45,288.52,92047.99,87
CDM,34100730,HEPATOBILIARY SYST IMAGING INCLUDING GALLBLADDER,2773.0,1802.45,311.35,91447.12,87
CDM,34100740,HEPATOBIL SYST IMAG INC GB W/PHARMA INTERVENJ,3714.0,2414.1,311.35,91448.28,87
CDM,34100750,PULMONARY VENTILATION IMAGING,2773.0,1802.45,232.72,91859.78,87
CDM,34100760,PULMONARY VENTILATION & PERFUSION IMAGING,3714.0,2414.1,404.17,91863.29,87
CDM,34100770,QUANT DIFFERENTIAL PULM PERFUSION W/WO IMAGING,2773.0,1802.45,248.96,91880.81,87
CDM,34100780,THYROID UPTAKE W/BLOOD FLOW SNGLE/MULT QUAN MEAS,2773.0,1802.45,296.36,91199.29,87
CDM,34100790,PARATHYROID PLANAR IMAGING W/WO SUBTRACTION,2773.0,1802.45,311.35,91265.92,87
CDM,34100885,INJ RADIOACTIVE TRACER FOR ID OF SENTINEL NODE,1607.0,1044.55,37.12,3443.0,86
CDM,34100895,MYOCRD IMG PET METAB EVAL SINGLE STUDY CNCRNT CT,10064.0,6541.6,1352.17,91684.42,77
CDM,34100905,MYOCRD IMG PET PRFUJ 1STD REST/STRESS CNCRNT CT,10064.0,6541.6,1352.17,91685.6,77
CDM,34100915,MYOCRD IMG PET PRFUJ MLT STD RST&STRS CNCRNT CT,15528.0,10093.2,2049.17,91686.76,77
CDM,34100925,MYOCRD IMG PET PRFUJ W/METAB DUAL RADIOTRACER,12768.0,8299.2,1435.79,91687.93,77
CDM,34100935,MYOCRD IMG PET PRFUJ W/METAB 2RTRACER CNCRNT CT,13458.0,8747.7,1776.01,91689.1,77
CDM,34100945,AQMBF PET REST AND PHARMACOLOGIC STRESS,3209.0,2085.85,699.56,3209.0,58
CDM,34100955,RP LOCLZJ TUM SPECT W/CT 1 AREA 1 DAY IMAGING,9008.0,5855.2,587.16,92153.2,87
CDM,34100965,RP LOCLZJ TUM SPECT 2 AREA/SEP ACQUISJ IMG,9008.0,5855.2,873.79,92154.37,87
CDM,34100975,RP LOCLZJ TUM SPECT CT 2AREA/SEP ACQUISJ IMG,10064.0,6541.6,888.71,92155.53,87
CDM,34100985,RADIOPHARMACEUTICAL QUANTIFICATION MEAS 1 AREA,410.0,266.5,89.38,92159.04,68
CDM,34101055,MRI FUSION TO PET (COMP CODE 76376),656.0,426.4,182.37,1909.17,85
CDM,34101OH,EMBLC/THRMBC AX BRACH INNOMINATE SUBCLA ART,4372.0,2841.8,1.1,16027.4,144
CDM,34111OH,EMBLC/THRMBC W/WO CATH RADIAL/ULNAR ART ARM INC,4372.0,2841.8,1.1,16027.4,144
CDM,34151OH,EMBLC/THRMBC RNL CELIAC MESENTRY AORTO-ILIAC ART,10608.0,6895.2,1.1,10608.0,144
CDM,34200010,RP THERAPY ORAL ADMINISTRATION,1546.0,1004.9,126.97,92357.77,87
CDM,34200015,INTERSTITIAL RADIATION SOURCE APPLIC COMPLEX,4787.0,3111.55,622.02,4787.0,87
CDM,34200025,SUPERVISION HANDLING LOADING RADIATION SOURCE,961.0,624.65,24.8,961.0,68
CDM,34200030,RP THERAPY INTRAVENOUS ADMINISTRATION,1546.0,1004.9,128.84,92470.0,87
CDM,34200035,RP THER RADIOLBLD MONOCLONAL ANTIBODY IV INFUS,1546.0,1004.9,199.49,1546.0,87
CDM,34200060,RP THERAPY INTRA-ARTERIAL PARTICULATE ADMN,1546.0,1004.9,207.78,92872.14,85
CDM,34201OH,EMBLC/THRMBC FEMORAL POPLITEAL AORTO-ILIAC ART,7792.0,5064.8,1.1,16027.4,144
CDM,34203OH,EMBLC/THRMBC POPLITEAL-TIBIO-PRONEAL ART LEG INC,7144.0,4643.6,1.1,16027.4,144
CDM,34300005,TC99M TETROFOSMIN/PER DOSE,62.0,40.3,13.52,339.38,63
CDM,34300020,TC99M SESTAMIBI PER DOSE,66.0,42.9,14.39,968.75,63
CDM,34300030,TC99M MEDRONATE<30MCI,56.0,36.4,12.21,149.95,63
CDM,34300035,RADPHARM DX I131 SERUM ALBUMIN,180.0,117.0,39.24,774.73,63
CDM,34300045,NITROGEN N-13 AMMONIA,250.0,162.5,54.5,1581.45,63
CDM,34300050,TC99 PERTECHNET,34.0,22.1,3.76,149.95,63
CDM,34300060,I-123 SODIUM CAP 200 UCI,210.0,136.5,45.78,239.94,63
CDM,34300070,TC99M EXAMETAZIME<25MCI,3128.0,2033.2,129.5,3128.0,80
CDM,34300075,TC99M PYROPHOSPHATE<25MCI,118.0,76.7,25.72,149.95,63
CDM,34300080,I131 DX CAPSL /MCI,180.0,117.0,39.24,203.07,63
CDM,34300090,TC99M MEBROFENIN<15MCI,62.0,40.3,13.52,243.94,63
CDM,34300100,TC99M PENTETATE<25MCI,240.0,156.0,52.32,240.0,63
CDM,34300110,TC99M MAA<10MCI,1092.0,709.8,63.3,1092.0,63
CDM,34300115,TC99M SUCCIMER<10MCI,288.0,187.2,80.06,1392.45,73
CDM,34300120,TC99M SULFUR COLLOID =< 20MCI,200.0,130.0,43.6,1615.51,63
CDM,34300135,RB82<60MCI,800.0,520.0,129.5,972.23,63
CDM,34300150,IN111 DTPA.5MCI,4518.0,2936.7,129.5,4518.0,80
CDM,34300155,IN111 AUTO WBC DIAG/PER DOSE,4928.0,3203.2,129.5,4928.0,80
CDM,34300160,F18 FDG DOSE,250.0,162.5,54.5,897.82,63
CDM,34300170,GA67 CITRTE1MCI,2626.0,1706.9,47.3,2626.0,63
CDM,34300175,SODIUM FLUORIDE F-18 < 30 MCI,217.0,141.05,47.31,563.32,63
CDM,34300180,TC99M BICISATE<25MCI,3766.0,2447.9,129.5,3766.0,80
CDM,34300185,FLORBETAPIR F18 AMYVID,6178.0,4015.7,129.5,6178.0,89
CDM,34300190,TC99 RBC DOSE,350.0,227.5,76.3,350.0,63
CDM,34300200,TC99M MERTIATIDE<15MCI,568.0,369.2,123.82,1651.69,63
CDM,34300210,IND111 PENTETREOTIDE DOSE,10558.0,6862.7,129.5,10558.0,80
CDM,34300220,I-123 MIBG DOSE UP TO 15MCI,8816.0,5730.4,129.5,8816.0,83
CDM,34300240,TC99M FILTERED SULFUR COLLOID,200.0,130.0,43.6,1615.51,63
CDM,34300290,TC99M OXIDRONATE<30MCI,82.0,53.3,17.88,149.95,63
CDM,34300300,TC99M AERO<75MCI,240.0,156.0,38.66,240.0,63
CDM,34300310,IOFLUPANE I-123 UP TO 5 MCI,4537.0,2949.05,129.5,4537.0,80
CDM,34300320,IN111 CAPROMAB<10MCI,4038.0,2624.7,129.5,4038.0,73
CDM,34300330,TC99M CERETEC WBC,2568.0,1669.2,129.5,2568.0,80
CDM,34300340,I-123 CAP PER 1 MCI,210.0,136.5,45.78,331.04,63
CDM,34300350,TC99 TILMANOCEPT DIAG 0.5MCI,1190.0,773.5,129.5,1190.0,63
CDM,34300455,PET SCAN ISOTP UP TO 45MCI,250.0,162.5,54.5,897.82,63
CDM,34300475,"IN-111 PENTETATE, PER 0.5 MCI",4518.0,2936.7,129.5,4518.0,80
CDM,34300495,NETSPOT (GA-68 DOTATATE),152.0,98.8,42.26,152.0,80
CDM,34300505,"AXUMIN FLUCICLOVINE F-18, DIAGNOSTIC, 1 MILLICURE",990.0,643.5,129.5,990.0,80
CDM,34300565,"INDIUM IN-111 OXYQUINOLINE, DIAG, PER 0.5 MCI",5030.0,3269.5,129.5,5030.0,80
CDM,34300575,"TECHNETIUM TC-99M EXAMETAZIME LBLD AUTO WHT BLD CELLS,DIAG,PER S",2568.0,1669.2,129.5,2568.0,80
CDM,34300605,"IODINE I-131 SODIUM IODID SOLUTION, DIAG, PER MCI",180.0,117.0,39.24,180.0,63
CDM,34300665,NON-HEU TC-99M ADD-ON/DOSE,11.0,7.15,3.06,149.95,76
CDM,34300705,"COPPER CU-64, DOTATATE, DIAGNOSTIC, 1 MILLICURIE",2081.0,1352.65,129.5,2081.0,80
CDM,34300715,GA-64 PSMA,2031.0,1320.15,129.5,2471.63,82
CDM,34300735,F-18 PSMA PYLARIFY,745.0,484.25,129.5,1779.35,82
CDM,34300745,"FLUOROESTRADIOL F 18, DIAGNOSTIC, 1 MCI",1534.0,997.1,41.39,1534.0,80
CDM,34300755,GENERIC IOFLUPANE1-123 UP TO 5 MCI,4537.0,2949.05,129.5,4537.0,80
CDM,34300765,"GA-68 GOZETOTIDE, DIAGNOSTIC",1880.0,1222.0,129.5,3040.49,82
CDM,34300775,"GALLIUM GA-68 GOZETOTIDE, DIG (LOCAMETZ), 1 MCI",1648.0,1071.2,129.5,2677.97,82
CDM,34300785,FLUOROESTRADIOL F 18 DIAGNOSTIC 1 MCI,1534.0,997.1,41.39,1534.0,80
CDM,34300805,"FLOTUFOLASTAT F18, DIAGNOSTIC, 1 MILLICURIE",1329.0,863.85,129.5,1416.27,83
CDM,34300815,FLUTEMETAMOL F18 DIAGNOSTIC,8400.0,5460.0,24.99,8400.0,80
CDM,34400005,I131 THERA SOL THERA /MCI,180.0,117.0,20.4,391.19,85
CDM,34400010,I131 THERA CAPSL /MCI,180.0,117.0,21.34,391.19,85
CDM,34400045,RADIUM RA223 DICHLORIDE THER,306.0,198.9,86.54,7510.9,85
CDM,34400085,I-123 SODIUM CAP 100 UCI,210.0,136.5,45.78,239.94,63
CDM,34400095,"LUTETIUM LU 177 DOTATATE, TX",671.0,436.15,186.54,21625.09,85
CDM,34400105,LUTETIUM LU 177 THERAPEAUTIC,99145.0,64444.25,21613.61,99145.0,58
CDM,34400115,"LUTETIUM LU 177 VIPIVOTIDE TETRAXETAN, THERAPEUTIC",512.0,332.8,144.79,21625.09,85
CDM,34401OH,THRMBC DIR/W/CATH VENA CAVA ILIAC VEIN ABDL INC,10608.0,6895.2,1.1,10608.0,144
CDM,34421OH,THRMBC DIR/W/CATH V/C ILIAC FEMPOP VEIN LEG INC,5348.0,3476.2,1.1,9296.26,144
CDM,34451OH,THRMBC DIR/W/CATH V/C ILIAC FEMPOP VEIN ABDL&LEG,11408.0,7415.2,1.1,11408.0,144
CDM,34471OH,THRMBC DIR/W/CATH SUBCLAVIAN VEIN NECK INC,8444.0,5488.6,1.1,8444.0,144
CDM,34490OH,THRMBC DIR/W/CATH AXILL&SUBCLAVIAN VEIN ARM IN,4364.0,2836.6,1.1,9296.26,144
CDM,34502OH,RECONSTRUCTION VENA CAVA ANY METHOD,11228.0,7298.2,1.1,11228.0,144
CDM,34510OH,VENOUS VALVE TRANSPOSITION ANY VEIN DONOR,7964.0,5176.6,1.1,16027.4,144
CDM,34520OH,CROSS-OVER VEIN GRAFT VENOUS SYSTEM,7672.0,4986.8,1.1,16027.4,144
CDM,34530OH,SAPHENOPOPLITEAL VEIN ANASTOMOSIS,7172.0,4661.8,1.1,9296.26,144
CDM,34701OH,EVASC RPR DPLMNT AORTO-AORTIC NDGFT,9484.0,6164.6,1.1,9484.0,144
CDM,34702OH,EVASC RPR DPLMNT AORTO-AORTIC NDGFT RPT,14400.0,9360.0,1.1,14400.0,144
CDM,34703OH,EVASC RPR DPLMNT AORTO-UN-ILIAC NDGFT,10608.0,6895.2,1.1,10608.0,144
CDM,34704OH,EVASC RPR DPLMNT AORTO-UN-ILIAC NDGFT RPT,18000.0,11700.0,1.1,18000.0,144
CDM,34705OH,EVASC RPR DPLMNT AORTO-BI-ILIAC NDGFT,11832.0,7690.8,1.1,11832.0,144
CDM,34706OH,EVASC RPR DPLMNT AORTO-BI-ILIAC NDGFT RPT,18000.0,11700.0,1.1,18000.0,144
CDM,34707OH,EVASC RPR DPLMNT ILIO-ILIAC NDGFT,8912.0,5792.8,1.1,8912.0,144
CDM,34708OH,EVASC RPR DPLMNT ILIO-ILIAC NDGFT RPT,14600.0,9490.0,1.1,14600.0,144
CDM,34709OH,PLACEMENT XTN PROSTH FOR ENDOVASCULAR RPR,2600.0,1690.0,1.1,2600.0,144
CDM,34710OH,DLYD PLACEMENT XTN PROSTH FOR EVASC RPR 1ST VSL,6000.0,3900.0,1.1,6000.0,144
CDM,34711OH,DLYD PLACEMENT XTN PROSTH FOR EVASC RPR EA ADDL,2400.0,1560.0,1.1,2400.0,144
CDM,34712OH,TRANSCATHETER DLVR ENHNCD FIXATION DEVICES RS&I,4800.0,3120.0,1.1,4800.0,144
CDM,34713OH,PERQ ACCESS & CLOSURE FEM ART FOR DELIVERY NDGFT,1000.0,650.0,1.1,1000.0,144
CDM,34714OH,OPN FEM ART EXPOS W/CNDT CRTJ DLVR EVASC PROSTH,2100.0,1365.0,1.1,2100.0,144
CDM,34715OH,OPN AX/SUBCLA ART EXPOS DLVR EVASC PROSTH UNI,2400.0,1560.0,1.1,2400.0,144
CDM,34716OH,OPN AXILLARY/SUBCLAVIAN ART EXPOS W/CNDT CRTJ,2876.0,1869.4,1.1,2876.0,144
CDM,34717OH,EVASC RPR ILIAC ART TM OF A-ILIAC ART NDGFT UNI,3960.0,2574.0,1.1,3960.0,144
CDM,34718OH,EVASC RPR ILIAC ART N/A A-ILIAC ART NDGFT UNI,10560.0,6864.0,1.1,10560.0,144
CDM,34808OH,EVASC PLACEMENT ILIAC ARTERY OCCLUSION DEVICE,1648.0,1071.2,1.1,1648.0,144
CDM,34812OH,OPN FEM ART EXPOS DLVR EVASC PROSTH UNI,1652.0,1073.8,1.1,1652.0,144
CDM,34813OH,PLMT FEM-FEM PROSTC GRF EVASC AORTIC ARYSM RPR,1916.0,1245.4,1.1,1916.0,144
CDM,34820OH,OPN ILIAC ART EXPOS PROSTH/ILIAC OCCLS EVASC UNI,2800.0,1820.0,1.1,2800.0,144
CDM,34830OH,OPN RPR ARYSM RPR ARTL TRAUMA TUBE PROSTH,14092.0,9159.8,1.1,14092.0,144
CDM,34831OH,OPN RPR ARYSM RPR ARTL TRMA AORTOBIILIAC PROSTH,15192.0,9874.8,1.1,15192.0,144
CDM,34832OH,OPN RPR ARYSM RPR ARTL TRMA AORTO-BIFEM PROSTH,15192.0,9874.8,1.1,15192.0,144
CDM,34833OH,OPN ILIAC ART EXPOS CRTJ PROSTH EST CARD BYP,3264.0,2121.6,1.1,3264.0,144
CDM,34834OH,OPN BRACHIAL ARTERY EXPOS DLVR EVASC PROSTH UNI,1166.0,757.9,1.1,1166.0,144
CDM,34839OH,PLNNING PT SPEC FENEST VISCERAL AORTIC GRAFT,3486.0,2265.9,1.1,3060831.65,88
CDM,34841OH,ENDOVASC VISCER AORTA REPAIR FENEST 1 ENDOGRAFT,12429.0,8078.85,1.1,12429.0,104
CDM,34842OH,ENDOVASC VISCER AORTA REPAIR FENEST 2 ENDOGRAFT,16135.0,10487.75,1.1,16135.0,104
CDM,34843OH,ENDOVASC VISCER AORTA REPAIR FENEST 3 ENDOGRAFT,21031.0,13670.15,1.1,21031.0,104
CDM,34844OH,ENDOVASC VISCER AORTA REPR FENEST 4+ ENDOGRAFT,23546.0,15304.9,1.1,23546.0,104
CDM,34845OH,VISCER AND INFRARENAL ABDOM AORTA 1 PROSTHESIS,5546.0,3604.9,1.1,5937.11,104
CDM,34846OH,VISCER AND INFRARENAL ABDOM AORTA 2 PROSTHESIS,8117.0,5276.05,1.1,8157.79,104
CDM,34847OH,VISCER AND INFRARENAL ABDOM AORTA 3 PROSTHESIS,9324.0,6060.6,1.1,10378.47,104
CDM,34848OH,VISCER AND INFRARENAL ABDOM AORTA 4+ PROSTHESIS,11885.0,7725.25,1.1,12599.15,92
CDM,35000015,CT HRT W/O DYE W/CA TEST,608.0,395.2,53.08,608.0,87
CDM,35000025,CT 3D WO POSTPROCESS,566.0,367.9,32.47,566.0,68
CDM,35000105,CT HEART C+ CARDIAC STRUX&MORPH CGEN HRT DS,2464.0,1601.6,159.4,2464.0,87
CDM,35000110,CT GUIDANCE STEREOTACTIC LOCALIZATION,1527.0,992.55,111.4,90026.77,68
CDM,35000115,3D RENDERING W/INTERP & POSTPROCESS SUPERVISION,566.0,367.9,32.47,566.0,68
CDM,35000120,CT GUIDANCE NEEDLE PLACEMENT,2193.0,1425.45,111.4,90027.93,68
CDM,35000125,3D RENDERING W/INTERP&POSTPROC DIFF WORK STATION,1436.0,933.4,86.82,1436.0,68
CDM,35000130,CT GUIDANCE &MONITORING VISC TISS ABLATION,2593.0,1685.45,111.4,2593.0,66
CDM,35000165,RADIOLOGICAL GUIDANCE PRQ DRG W/PLMT CATH RS&I,2127.0,1382.55,112.68,88832.03,68
CDM,35000205,DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX W/CONTRAST,1228.0,798.2,159.4,1228.0,87
CDM,35000315,ABLATION RENAL TUMOR UNILATERAL PERQ CRYOTHERAPY,25651.0,16673.15,534.24,25651.0,87
CDM,35000400,CT LIMITED/LOCALIZED FOLLOW UP STUDY,608.0,395.2,78.83,608.0,87
CDM,35000410,CT HEART CONTRAST EVAL CARDIAC STRUCTURE&MORPH,2464.0,1601.6,159.4,2464.0,87
CDM,35000420,CT HEART C+ CARDIAC STRUX&MORPH CGEN HRT DS,2464.0,1601.6,159.4,2464.0,87
CDM,35000430,CT SOFT TISSUE NECK W/CONTRAST MATERIAL,1228.0,798.2,159.4,82404.81,87
CDM,35000440,CT SOFT TISSUE NECK W/O CONTRAST MATERIAL,734.0,477.1,95.38,82403.64,87
CDM,35000450,CT SOFT TISSUE NECK W/O & W/CONTRAST MATERIAL,1228.0,798.2,159.4,82405.98,87
CDM,35000460,CT CERVICAL SPINE W/O CONTRAST MATERIAL,734.0,477.1,95.38,734.0,87
CDM,35000470,CTA HRT CORNRY ART/BYPASS GRFTS CONTRST 3D POST,2464.0,1601.6,159.4,2464.0,87
CDM,35000480,CT ANGIOGRAPHY NECK W/CONTRAST/NONCONTRAST,1228.0,798.2,159.4,82413.0,87
CDM,35000500,CT CHEST WO SCREENING,99.0,64.35,27.52,409.57,85
CDM,35000510,CT CALCIUM SCORING,65.0,42.25,18.07,409.57,85
CDM,35000575,CT LOWER EXTREMITY W/O CONTRAST MATERIAL,734.0,477.1,95.38,734.0,87
CDM,35000705,LOW DOSE WHOLE BODY CT,10064.0,6541.6,78.83,10064.0,85
CDM,35000785,N-INVAS EST C FFR AUGMNT SW ALYS CTA I&R PHY/QHP,7020.0,4563.0,453.45,7020.0,86
CDM,35000805,QUAN CT TISS CHARAC W/CT,2602.0,1691.3,183.67,2602.0,85
CDM,35000815,QUAN&CHARAC C ATHEROSCLEROTC PLAQ ASSES SEV C DS,6558.0,4262.7,86.82,6558.0,77
CDM,35000825,N-INVAS ASSMT CAR RSK AUGMNT SW ALYS FAT W/CT,975.0,633.75,183.67,975.0,76
CDM,35001OH,DIR RPR ANEURYSM CAROTID-SUBCLAVIAN ARTERY,8324.0,5410.6,1.1,8324.0,144
CDM,35002OH,DIR RPR RUPTD ANEURYSM CAROTID-SUBCLAVIAN ARTERY,8892.0,5779.8,1.1,8892.0,144
CDM,35005OH,DIR RPR ANEURYSM VERTEBRAL ARTERY,7716.0,5015.4,1.1,7716.0,144
CDM,35011OH,DIR RPR ANEURYSM AXIL-BRACHIAL ARM INCISION,7432.0,4830.8,1.1,16027.4,144
CDM,35013OH,DIR RPR RUPTD ANEURYSM AXIL-BRACHIAL ARM INCIS,9292.0,6039.8,1.1,9292.0,144
CDM,35021OH,DIR RPR ANEURYSM INNOMINATE/SUBCLAVIAN ARTERY,8868.0,5764.2,1.1,8868.0,144
CDM,35022OH,DIR RPR RUPTD ANEURYSM INNOMINATE/SUBCLAVIAN,10280.0,6682.0,1.1,10280.0,144
CDM,35045OH,DIR RPR RUPTD ANEURYSM RADIAL/ULNAR ARTERY,7204.0,4682.6,1.1,16027.4,144
CDM,35081OH,DIR RPR ANEURYSM ABDOMINAL AORTA,13412.0,8717.8,1.1,13412.0,144
CDM,35082OH,DIR RPR RUPTD ANEURYSM ABDOMINAL AORTA,16836.0,10943.4,1.1,16836.0,144
CDM,35091OH,DIR RPR ANEURYSM ABDOM AORTA W/VISCERAL VESSELS,14140.0,9191.0,1.1,14140.0,144
CDM,35092OH,DIR RPR RUPTD ANEURSM ABDOM AORTA W/VISCERA VSLS,20388.0,13252.2,1.1,20388.0,144
CDM,35100010,CT HEAD/BRAIN W/O CONTRAST MATERIAL,734.0,477.1,95.38,82356.88,87
CDM,35100020,CT HEAD/BRAIN W/CONTRAST MATERIAL,1228.0,798.2,159.4,82368.57,87
CDM,35100030,CT HEAD/BRAIN W/O & W/CONTRAST MATERIAL,1228.0,798.2,159.4,82380.26,87
CDM,35100040,CT ORBIT SELLA/POST FOSSA/EAR W/O CONTRAST MATRL,734.0,477.1,95.38,82391.95,87
CDM,35100050,CT ORBIT SELLA/POST FOSSA/EAR W/CONTRAST MATRL,1228.0,798.2,159.4,82393.11,87
CDM,35100060,CT ORBIT SELLA/POST FOSSA/EAR W/O & W/CONTR MATR,1228.0,798.2,159.4,82394.29,87
CDM,35100070,CT MAXILLOFACIAL W/O CONTRAST MATERIAL,734.0,477.1,95.38,82398.97,87
CDM,35100080,CT MAXILLOFACIAL W/CONTRAST MATERIAL,1228.0,798.2,159.4,82400.13,87
CDM,35100090,CT MAXILLOFACIAL W/O & W/CONTRAST MATERIAL,1228.0,798.2,159.4,82401.3,87
CDM,35100100,CT ANGIOGRAPHY HEAD W/CONTRAST/NONCONTRAST,1228.0,798.2,159.4,82410.65,87
CDM,35102OH,DIR RPR ANEURYSM ABDOM AORTA W/ILIAC VESSELS,14612.0,9497.8,1.1,14612.0,144
CDM,35103OH,DIR RPR RUPTD ANEURYSM ABDOM AORTA W/ILIAC VSLS,17448.0,11341.2,1.1,17448.0,144
CDM,35111OH,DIR RPR ANEURYSM SPLENIC ARTERY,10512.0,6832.8,1.1,10512.0,144
CDM,35112OH,DIR RPR RUPTD ANEURYSM SPLENIC ARTERY,13028.0,8468.2,1.1,13028.0,144
CDM,35121OH,DIR RPR ANEURYSM HEPATIC/CELIAC/RENAL/MESENTERIC,12608.0,8195.2,1.1,12608.0,144
CDM,35122OH,DIR RPR RUPTD ANEURSM HEPATIC/CELIAC/RENAL/MESEN,15156.0,9851.4,1.1,15156.0,144
CDM,35131OH,DIR RPR ANEURYSM & GRAFT ILIAC ARTERY,10560.0,6864.0,1.1,10560.0,144
CDM,35132OH,DIR RPR RUPTD ANEURYSM & GRAFT ILIAC ARTERY,13028.0,8468.2,1.1,13028.0,144
CDM,35141OH,DIR RPR ANEURYSM & GRAFT COMMON FEMORAL ARTERY,8364.0,5436.6,1.1,8364.0,144
CDM,35142OH,DIR RPR RUPTD ANEURYSM & GRF COMMON FEMORAL ART,10064.0,6541.6,1.1,10064.0,144
CDM,35151OH,DIR RPR ANEURYSM & GRAFT POPLITEAL ARTERY,9488.0,6167.2,1.1,9488.0,144
CDM,35152OH,DIR RPR RUPTD ANEURYSM & GRF POPLITEAL ARTERY,11064.0,7191.6,1.1,11064.0,144
CDM,35180OH,REPAIR CONGENITAL AV FISTULA HEAD & NECK,6040.0,3926.0,1.1,6040.0,144
CDM,35182OH,RPR CONGENITAL AV FISTULA THORAX & ABDOMEN,12684.0,8244.6,1.1,12684.0,144
CDM,35184OH,RPR CONGENITAL AV FISTULA EXTREMITIES,7528.0,4893.2,1.1,9296.26,144
CDM,35188OH,RPR/TRAUMATIC AV FISTULA HEAD & NECK,7200.0,4680.0,1.1,16027.4,144
CDM,35189OH,RPR/TRAUMATIC AV FISTULA THORAX & ABDOMEN,11992.0,7794.8,1.1,11992.0,144
CDM,35190OH,RPR/TRAUMATIC AV FISTULA EXTREMITIES,5368.0,3489.2,1.1,16027.4,144
CDM,35200010,DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX W/O CNTRST,734.0,477.1,95.38,83292.09,87
CDM,35200020,DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX W/CONTRAST,1228.0,798.2,159.4,1228.0,87
CDM,35200025,CT CERVICAL SPINE W/O CONTRAST MATERIAL,734.0,477.1,95.38,734.0,87
CDM,35200030,DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX C-/C+,1228.0,798.2,159.4,1228.0,87
CDM,35200035,CT COLONOGRAPHY SCREENING IMAGE POSTPROCESSING,1668.0,1084.2,183.67,3345.71,85
CDM,35200040,CT ANGIOGRAPHY CHEST W/CONTRAST/NONCONTRAST,1228.0,798.2,159.4,1228.0,87
CDM,35200050,CT CERVICAL SPINE W/CONTRAST MATERIAL,2464.0,1601.6,226.83,2464.0,87
CDM,35200060,CT CERVICAL SPINE W/O &W/CONTRAST MATERIAL,1228.0,798.2,159.4,1228.0,87
CDM,35200065,CT ANGIOGRAPHY ABDOMEN W/CONTRAST/NONCONTRAST,1228.0,798.2,159.4,1228.0,87
CDM,35200070,CT THORACIC SPINE W/O CONTRAST MATERIAL,734.0,477.1,95.38,734.0,87
CDM,35200080,CT THORACIC SPINE W/CONTRAST MATERIAL,1228.0,798.2,159.4,1228.0,87
CDM,35200085,CT COLONOGRPHY DX IMAGE POSTPROCESS W/CONTRAST,1228.0,798.2,159.4,1228.0,87
CDM,35200090,CT THORACIC SPINE W/O & W/CONTRAST MATERIAL,1228.0,798.2,159.4,1228.0,87
CDM,35200095,CT COLONOGRPHY DX IMAGE POSTPROCESS W/O CONTRAST,734.0,477.1,95.38,734.0,87
CDM,35200100,CT LUMBAR SPINE W/O CONTRAST MATERIAL,734.0,477.1,95.38,734.0,87
CDM,35200110,CT LUMBAR SPINE W/CONTRAST MATERIAL,2464.0,1601.6,227.31,2464.0,87
CDM,35200120,CT LUMBAR SPINE W/O & W/CONTRAST MATERIAL,1228.0,798.2,159.4,1228.0,87
CDM,35200130,CT ANGIOGRAPHY PELVIS W/CONTRAST/NONCONTRAST,1228.0,798.2,159.4,1228.0,87
CDM,35200140,CT PELVIS W/O CONTRAST MATERIAL,734.0,477.1,95.38,734.0,87
CDM,35200150,CT PELVIS W/CONTRAST MATERIAL,1228.0,798.2,159.4,1228.0,87
CDM,35200160,CT PELVIS W/O & W/CONTRAST MATERIAL,1228.0,798.2,159.4,1228.0,87
CDM,35200170,CT UPPER EXTREMITY W/O CONTRAST MATERIAL,734.0,477.1,95.38,734.0,87
CDM,35200180,CT UPPER EXTREMITY W/CONTRAST MATERIAL,2464.0,1601.6,272.29,2464.0,87
CDM,35200190,CT UPPER EXTREMITY W/O & W/CONTRAST MATERIAL,1228.0,798.2,159.4,1228.0,87
CDM,35200200,CT ANGIOGRAPHY UPPER EXTREMITY,1228.0,798.2,159.4,1228.0,87
CDM,35200210,CT LOWER EXTREMITY W/O CONTRAST MATERIAL,734.0,477.1,95.38,734.0,87
CDM,35200220,CT LOWER EXTREMITY W/CONTRAST MATERIAL,1228.0,798.2,159.4,1228.0,87
CDM,35200230,CT LOWER EXTREMITY W/O & W/CONTRAST MATRL,1228.0,798.2,159.4,1228.0,87
CDM,35200240,CT ANGIOGRAPHY LOWER EXTREMITY,1228.0,798.2,159.4,1228.0,87
CDM,35200250,CT ABDOMEN W/O CONTRAST MATERIAL,734.0,477.1,95.38,734.0,87
CDM,35200260,CT ABDOMEN W/CONTRAST MATERIAL,1228.0,798.2,159.4,1228.0,87
CDM,35200270,CT ABDOMEN W/O & W/CONTRAST MATERIAL,1228.0,798.2,159.4,1228.0,87
CDM,35200280,CT ANGIOGRAPHY ABDOMEN W/CONTRAST/NONCONTRAST,1228.0,798.2,159.4,1228.0,87
CDM,35200290,CTA ABDL AORTA&BI ILIOFEM W/CONTRAST&POSTP,1228.0,798.2,159.4,1228.0,87
CDM,35200300,CT ABDOMEN & PELVIS W/CONTRAST MATERIAL,2464.0,1601.6,330.06,2464.0,87
CDM,35200310,CT ABDOMEN & PELVIS W/O CONTRAST MATERIAL,1668.0,1084.2,212.58,1668.0,87
CDM,35200320,CT ABDOMEN & PELVIS W/WO CONTRST 1/> BODY RE,2464.0,1601.6,330.06,2464.0,87
CDM,35200330,CT ANGIO ABD&PLVIS CNTRST MTRL W/WO CNTRST IMG,2464.0,1601.6,330.06,2464.0,87
CDM,35200345,COMPUTED TOMOGRAPHY THORAX LW DOSE LNG CA SCR C-,734.0,477.1,95.38,83316.64,87
CDM,35200365,CTA HEAD&NECK C+ W/NONCONTRAST IMG&POST-PXESSING,2459.0,1598.35,330.06,2459.0,77
CDM,35200375,CT CERE PRFUJ ALYS C+ W/CT/CTA SAME ANATOMY,1228.0,798.2,215.05,1228.0,67
CDM,35200385,CT CERE PRFUJ ALYS C+ W/O CT/CTA SAME ANATOMY,1236.0,803.4,165.94,1236.0,77
CDM,35201OH,REPAIR BLOOD VESSEL DIRECT NECK,6772.0,4401.8,1.1,16027.4,144
CDM,35206OH,REPAIR BLOOD VESSEL DIRECT UPPER EXTREMITY,5536.0,3598.4,1.1,9296.26,144
CDM,35207OH,REPAIR BLOOD VESSEL DIRECT HAND FINGER,4376.0,2844.4,1.1,9296.26,144
CDM,35211OH,RPR BLOOD VESSEL DIRECT INTRATHORACIC W/BYPASS,9832.0,6390.8,1.1,9832.0,144
CDM,35216OH,RPR BLOOD VESSEL DIRECT INTRATHORACIC W/O BYPASS,14644.0,9518.6,1.1,14644.0,144
CDM,35221OH,RPR BLOOD VESSEL DIRECT INTRA-ABDOMINAL,10648.0,6921.2,1.1,10648.0,144
CDM,35226OH,RPR BLOOD VESSEL DIRECT LOWER EXTREMITY,6120.0,3978.0,1.1,6120.0,144
CDM,35231OH,REPAIR BLOOD VESSEL W/VEIN GRAFT NECK,8464.0,5501.6,1.1,9296.26,144
CDM,35236OH,REPAIR BLOOD VESSEL W/VEIN GRAFT UPPER EXTREMITY,7208.0,4685.2,1.1,16027.4,144
CDM,35241OH,RPR BLOOD VESSEL VEIN GRAFT INTRATHORACIC W/BYP,10232.0,6650.8,1.1,10232.0,144
CDM,35246OH,RPR BLOOD VESSEL VEIN GRF INTRATHORACIC W/O BYP,11292.0,7339.8,1.1,11292.0,144
CDM,35251OH,REPAIR BLOOD VESSEL VEIN GRAFT INTRA-ABDOMINAL,12764.0,8296.6,1.1,12764.0,144
CDM,35256OH,REPAIR BLOOD VESSEL VEIN GRAFT LOWER EXTREMITY,7624.0,4955.6,1.1,16027.4,144
CDM,35261OH,REPAIR BLOOD VESSEL W/GRAFT OTHER/THAN VEIN NECK,7584.0,4929.6,1.1,9296.26,144
CDM,35266OH,RPR BLOOD VSL GRF OTH/THN VEIN UPPER EXTREMITY,6332.0,4115.8,1.1,16027.4,144
CDM,35271OH,RPR BLOOD VSL GRF OTH/THN VEIN INTRATHRC W/BYP,9832.0,6390.8,1.1,9832.0,144
CDM,35276OH,RPR BLOOD VSL GRF OTH/THN VEIN INTRATHRC W/O BYP,10332.0,6715.8,1.1,10332.0,144
CDM,35281OH,RPR BLVSL W/GRFT OTHER/THAN VEIN INTRA-ABDOMINAL,12024.0,7815.6,1.1,12024.0,144
CDM,35286OH,RPR BLVSL W/GRF OTHER/THAN VEIN LOWER EXTREMITY,6876.0,4469.4,1.1,16027.4,144
CDM,35301OH,TEAEC W/PATCH GRF CAROTID VERTB SUBCLAV NECK INC,8464.0,5501.6,1.1,8464.0,144
CDM,35302OH,TEAEC W/GRAFT SUPERFICIAL FEMORAL ARTERY,8540.0,5551.0,1.1,8540.0,144
CDM,35303OH,TEAEC W/GRAFT POPLITEAL ARTERY,9440.0,6136.0,1.1,9440.0,144
CDM,35304OH,TEAEC W/GRAFT TIBIOPERONEAL TRUNK ARTERY,9840.0,6396.0,1.1,9840.0,144
CDM,35305OH,TEAEC W/GRAFT TIBIAL/PERONEAL ART 1ST VESSEL,9440.0,6136.0,1.1,9440.0,144
CDM,35306OH,TEAEC W/GRAFT EA ADDL TIBIAL/PERONEAL ART,3700.0,2405.0,1.1,3700.0,144
CDM,35311OH,TEAEC W/WO PATCH GRF SUBCLAV INNOM THORACIC INC,11440.0,7436.0,1.1,11440.0,144
CDM,35321OH,TEAEC W/WO PATCH GRF AXILLARY-BRACHIAL,6636.0,4313.4,1.1,16027.4,144
CDM,35331OH,TEAEC W/WO PATCH GRAFT ABDOMINAL AORTA,11088.0,7207.2,1.1,11088.0,144
CDM,35341OH,TEAEC W/WO PATCH GRAFT MESENTERIC CELIAC/RENAL,10484.0,6814.6,1.1,10484.0,144
CDM,35351OH,TEAEC W/WO PATCH GRAFT ILIAC,9844.0,6398.6,1.1,9844.0,144
CDM,35355OH,TEAEC W/WO PATCH GRAFT ILIOFEMORAL,7944.0,5163.6,1.1,7944.0,144
CDM,35361OH,TEAEC W/WO PATCH GRAFT COMBINED AORTOILIAC,12096.0,7862.4,1.1,12096.0,144
CDM,35363OH,TEAEC W/WO PATCH GRAFT COMBINED AORTOILIOFEMORAL,12940.0,8411.0,1.1,12940.0,144
CDM,35371OH,TEAEC W/WO PATCH GRAFT COMMON FEMORAL,6124.0,3980.6,1.1,6124.0,144
CDM,35372OH,TEAEC W/WO PATCH GRAFT DEEP PROFUNDA FEMORAL,7432.0,4830.8,1.1,7432.0,144
CDM,35390OH,ROPRTJ CRTD TEAEC > 1 MO AFTER ORIGINAL OPRATIO,1276.0,829.4,1.1,1276.0,144
CDM,35400OH,ANGIOSCOPY NON-CORONARY VESSEL/GRAFTS THER IVNTJ,1200.0,780.0,1.1,1200.0,144
CDM,35500OH,HARVEST UXTR VEIN 1 SGM LOWER EXTREMITY/CABG PX,2576.0,1674.4,1.1,2576.0,144
CDM,35501OH,BYPASS W/VEIN COMMON-IPSILATERAL CAROTID,11636.0,7563.4,1.1,11636.0,144
CDM,35506OH,BYPASS W/VEIN CAROTID-SUBCLV/SUBCLAVIAN CAROTID,10132.0,6585.8,1.1,10132.0,144
CDM,35508OH,BYPASS W/VEIN CAROTID-VERTEBRAL,10436.0,6783.4,1.1,10436.0,144
CDM,35509OH,BYPASS W/VEIN CAROTID-CONTRALATERAL CAROTID,11236.0,7303.4,1.1,11236.0,144
CDM,35510OH,BYPASS W/VEIN CAROTID-BRACHIAL,9756.0,6341.4,1.1,9756.0,144
CDM,35516OH,BYPASS W/VEIN SUBCLAVIAN-AXILLARY,9684.0,6294.6,1.1,9684.0,144
CDM,35522OH,BYPASS W/VEIN AXILLARY-BRACHIAL,9260.0,6019.0,1.1,9260.0,144
CDM,35523OH,BYPASS W/VEIN BRACHIAL-ULNAR/-RADIAL,9652.0,6273.8,1.1,9652.0,144
CDM,35525OH,BYPASS W/VEIN BRACHIAL-BRACHIAL,8676.0,5639.4,1.1,8676.0,144
CDM,35526OH,BYPASS W/VEIN AORTOSUBCLAV/CAROTID/INNOMINATE,12620.0,8203.0,1.1,12620.0,144
CDM,35531OH,BYPASS W/VEIN AORTOCELIAC/AORTOMESENTERIC,15644.0,10168.6,1.1,15644.0,144
CDM,35533OH,BYPASS W/VEIN AXILLARY-FEMORAL-FEMORAL,11968.0,7779.2,1.1,11968.0,144
CDM,35535OH,BYPASS W/VEIN HEPATORENAL,15252.0,9913.8,1.1,15252.0,144
CDM,35536OH,BYPASS W/VEIN SPLENORENAL,13492.0,8769.8,1.1,13492.0,144
CDM,35537OH,"VEIN BYPASS GRAFT,AORTOILIOFEMORAL",16752.0,10888.8,1.1,16752.0,144
CDM,35538OH,"VEIN BYPASS GRAFT,AORTOBI-ILIAC",18812.0,12227.8,1.1,18812.0,144
CDM,35539OH,"VEIN BYPASS GRAFT,AORTOFEMORAL",17644.0,11468.6,1.1,17644.0,144
CDM,35540OH,"VEIN BYPASS GRAFT,AORTOBIFEMORAL",19732.0,12825.8,1.1,19732.0,144
CDM,35556OH,BYPASS W/VEIN FEMORAL-POPLITEAL,10700.0,6955.0,1.1,10700.0,144
CDM,35558OH,BYPASS W/VEIN FEMORAL-FEMORAL,9252.0,6013.8,1.1,9252.0,144
CDM,35560OH,BYPASS W/VEIN AORTORENAL,13612.0,8847.8,1.1,13612.0,144
CDM,35563OH,BYPASS W/VEIN ILIOILIAC,10448.0,6791.2,1.1,10448.0,144
CDM,35565OH,BYPASS W/VEIN ILIOFEMORAL,10052.0,6533.8,1.1,10052.0,144
CDM,35566OH,BYP FEM-ANT TIBL PST TIBL PRONEAL ART/OTH DSTL,12940.0,8411.0,1.1,12940.0,144
CDM,35570OH,BYP TIBL-TIBL/PRONEAL-TIBL/TIBL/PRONEAL TRK-TIBL,11660.0,7579.0,1.1,11660.0,144
CDM,35571OH,BYP W/VEIN POP-TIBL-PRONEAL ART/OTH DSTL VSL,11229.0,7298.85,1.1,11229.0,144
CDM,35572OH,HARVEST FEMPOP VEIN 1 SGM VASC RCNSTJ PX,2724.0,1770.6,1.1,2724.0,144
CDM,35583OH,IN-SITU VEIN BYPASS FEMORAL-POPLITEAL,11100.0,7215.0,1.1,11100.0,144
CDM,35585OH,IN-SITU FEM-ANT TIBL PST TIBL/PRONEAL ART,12940.0,8411.0,1.1,12940.0,144
CDM,35587OH,IN-SITU VEIN BYP POP-TIBL PRONEAL,10484.0,6814.6,1.1,10484.0,144
CDM,35600OH,OPEN HARVEST UPPER EXTREMITY ART 1 SEGMENT CAB,1580.0,1027.0,1.1,1580.0,144
CDM,35601OH,BYP OTH/THN VEIN COMMON-IPSILATERAL CAROTID,10836.0,7043.4,1.1,10836.0,144
CDM,35602OH,BPG OTH/THN VEIN CAROTID-CONTRALATERAL CAROTID,10353.0,6729.45,1.1,10353.0,106
CDM,35606OH,BYP OTH/THN VEIN CAROTID-SUBCLAVIAN,8984.0,5839.6,1.1,8984.0,144
CDM,35612OH,BYP OTH/THN VEIN SUBCLAVIAN-SUBCLAVIAN,8140.0,5291.0,1.1,8140.0,144
CDM,35616OH,BYP OTH/THN VEIN SUBCLAVIAN-AXILLARY,8728.0,5673.2,1.1,8728.0,144
CDM,35621OH,BYP OTH/THN VEIN AXILLARY-FEMORAL,8412.0,5467.8,1.1,8412.0,144
CDM,35623OH,BYP OTH/THN VEIN AXILLARY-POPLITEAL/-TIBIAL,10368.0,6739.2,1.1,10368.0,144
CDM,35626OH,BYPASS NOT VEIN AORTOSUBCLA/CAROTID/INNOMINATE,11656.0,7576.4,1.1,11656.0,144
CDM,35631OH,BYP OTH/THN VEIN AORTOCELIAC AORTOMSN AORTORNL,14412.0,9367.8,1.1,14412.0,144
CDM,35632OH,BYPASS GRAFT W/OTHER THAN VEIN ILIO-CELIAC,14452.0,9393.8,1.1,14452.0,144
CDM,35633OH,BYPASS GRAFT W/OTHER THAN VEIN ILIO-MESENTERIC,15644.0,10168.6,1.1,15644.0,144
CDM,35634OH,BYPASS GRAFT W/OTHER THAN VEIN ILIORENAL,14132.0,9185.8,1.1,14132.0,144
CDM,35636OH,BYP OTH/THN VEIN SPLENORENAL,12700.0,8255.0,1.1,12700.0,144
CDM,35637OH,"BYPASS GRAFT OTHR,AORTOILIAC",13220.0,8593.0,1.1,13220.0,144
CDM,35638OH,"BYPASS GRAFT OTHR,AORTOBI-ILIAC",13440.0,8736.0,1.1,13440.0,144
CDM,35642OH,BYP OTH/THN VEIN CAROTID-VERTEBRAL,7576.0,4924.4,1.1,7576.0,144
CDM,35645OH,BYP OTH/THN VEIN SUBCLAVIAN-VERTEBRAL,7372.0,4791.8,1.1,7372.0,144
CDM,35646OH,BYP OTH/THN VEIN AORTOBIFEMORAL,13192.0,8574.8,1.1,13192.0,144
CDM,35647OH,BYP OTH/THN VEIN AORTOFEMORAL,11892.0,7729.8,1.1,11892.0,144
CDM,35650OH,BYP OTH/THN VEIN AXILLARY-AXILLARY,8064.0,5241.6,1.1,8064.0,144
CDM,35654OH,BYP OTH/THN VEIN AXILLARY-FEMORAL-FEMORAL,10512.0,6832.8,1.1,10512.0,144
CDM,35656OH,BYP OTH/THN VEIN FEMORAL-POPLITEAL,8188.0,5322.2,1.1,8188.0,144
CDM,35661OH,BYP OTH/THN VEIN FEMORAL-FEMORAL,8140.0,5291.0,1.1,8140.0,144
CDM,35663OH,BYP OTH/THN VEIN ILIOILIAC,9572.0,6221.8,1.1,9572.0,144
CDM,35665OH,BYP OTH/THN VEIN ILIOFEMORAL,8940.0,5811.0,1.1,8940.0,144
CDM,35666OH,BYP OTH/THN VEIN FEM-ANT TIBL PST TIBL/PRONEAL,9464.0,6151.6,1.1,9464.0,144
CDM,35671OH,BYP OTH/THN VEIN POPLITEAL-TIBIAL/-PERONEAL ART,8308.0,5400.2,1.1,8308.0,144
CDM,35681OH,BYPASS COMPOSITE GRAFT PROSTHETIC & VEIN,640.0,416.0,1.1,640.0,144
CDM,35682OH,BYP AUTOG COMPOSIT 2 SEG VEINS FROM 2 LOCATIONS,2876.0,1869.4,1.1,2876.0,144
CDM,35683OH,BYP AUTOG COMPOSIT 3/> SEG FROM 2/> LOCATION,3396.0,2207.4,1.1,3396.0,144
CDM,35685OH,PLMT VEIN PATCH/CUFF DSTL ANAST BYP CONDUIT,1616.0,1050.4,1.1,1616.0,144
CDM,35686OH,CRTJ DSTL ARVEN FSTL LXTR BYP SURG NON-HEMO,1336.0,868.4,1.1,1336.0,144
CDM,35691OH,TRPOS&/RIMPLTJ VERTEBRAL CAROTID ART,7364.0,4786.6,1.1,7364.0,144
CDM,35693OH,TRPOS&/RIMPLTJ VERTEBRAL SUBCLAVIAN ART,6292.0,4089.8,1.1,6292.0,144
CDM,35694OH,TRPOS&/RIMPLTJ SUBCLAVIAN CAROTID ART,7712.0,5012.8,1.1,7712.0,144
CDM,35695OH,TRPOS&/RIMPLTJ CAROTID SUBCLAVIAN ART,8024.0,5215.6,1.1,8024.0,144
CDM,35697OH,RIMPLTJ VISC ART INFRARNL AORTIC PROSTH EA ART,1200.0,780.0,1.1,1200.0,144
CDM,35700OH,ROPRTJ > 1 MO AFTER ORIGINAL OPRATION,1232.0,800.8,1.1,1232.0,144
CDM,35701OH,EXPLORATION N/FLWD SURG NECK ARTERY,3300.0,2145.0,1.1,3300.0,144
CDM,35702OH,EXPLORATION N/FLWD SURG UPPER EXTREMITY ARTERY,2848.0,1851.2,1.1,2848.0,144
CDM,35703OH,EXPLORATION N/FLWD SURG LOWER EXTREMITY ARTERY,3000.0,1950.0,1.1,3000.0,144
CDM,35800OH,EXPL PO HEMRRG THROMBOSIS/INFCTJ NCK,4800.0,3120.0,1.1,4800.0,144
CDM,35820OH,EXPL PO HEMRRG THROMBOSIS/INFCTJ CH,14756.0,9591.4,1.1,14756.0,144
CDM,35840OH,EXPL PO HEMRRG THROMBOSIS/INFCTJ ABD,8300.0,5395.0,1.1,8300.0,144
CDM,35860OH,EXPL PO HEMRRG THROMBOSIS/INFCTJ XTR,6100.0,3965.0,1.1,9296.26,144
CDM,35870OH,RPR GRF-ENTERIC FSTL,9800.0,6370.0,1.1,9800.0,144
CDM,35875OH,THRMBC ARTL/VEN GRF OTH/THN HEMO GRF/FSTL,4288.0,2787.2,1.1,16027.4,144
CDM,35876OH,THRMBC ARTL/VEN GRF XCP HEMO GRF/FSTL W/REVJ GRF,7128.0,4633.2,1.1,16027.4,144
CDM,35879OH,REVJ LXTR ARTL BYP OPN VEIN PATCH ANGIOP,6964.0,4526.6,1.1,16027.4,144
CDM,35881OH,REVJ LXTR ARTL BYP OPN W/SGMTL VEIN INTERPOS,7740.0,5031.0,1.1,16027.4,144
CDM,35883OH,REVJ FEM ANAST BPG GRN OPN W/NONAUTOG PATCH GRF,9260.0,6019.0,1.1,16027.4,144
CDM,35884OH,"REVISE FEMORAL GRAFT, AUTOGENOUS GRAFT",9860.0,6409.0,1.1,16027.4,144
CDM,35900020,CT COLONOGRPHY DX IMAGE POSTPROCESS W/O CONTRAST,734.0,477.1,95.38,734.0,87
CDM,35900040,CT HEART NO CONTRAST QUANT EVAL CORONRY CALCIUM,608.0,395.2,53.08,608.0,87
CDM,35900050,3D RENDERING W/INTERP&POSTPROC DIFF WORK STATION,1436.0,933.4,86.82,1436.0,68
CDM,35900060,3D RENDERING W/INTERP & POSTPROCESS SUPERVISION,566.0,367.9,32.47,566.0,68
CDM,35900070,3D RENDERING W/INTERP&POSTPROC DIFF WORK STATION,1436.0,933.4,86.82,1436.0,68
CDM,35900330,CT CALCIUM SCORING - SELF PAY,608.0,395.2,53.08,608.0,87
CDM,35901OH,"EXCISION, INFEC GRAFT, NECK",3352.0,2178.8,1.1,3352.0,144
CDM,35903OH,"EXCISION, INFEC GRAFT, EXTREMITY",3812.0,2477.8,1.1,9296.26,144
CDM,35905OH,"EXCISION, INFEC GRAFT, THORAX",13408.0,8715.2,1.1,13408.0,144
CDM,35907OH,"EXCISION, INFEC GRAFT, ABDOMEN",14908.0,9690.2,1.1,14908.0,144
CDM,36000015,TCAT PLMT XTRC VRT CRTD STENT RS&I PRQ 1ST VSL,9213.0,5988.45,75.0,12615.0,66
CDM,36000090,INSERTION INDWELLING TUNNELED PLEURAL CATHETER,16234.0,10552.1,239.9,16234.0,87
CDM,36000180,RPLCMT COMPL NON-TUN CVC W/O SUBQ PORT/PMP,8932.0,5805.8,76.69,8932.0,87
CDM,36000210,BRNCHSC W/BRNCL ALVEOLAR LAVAGE,7933.0,5156.45,161.85,7933.0,87
CDM,36000265,IMAGE-GUIDED CATHETER FLUID COLLECTION DRAINAGE,2111.0,1372.15,158.85,12500.0,87
CDM,36000280,SLCTV CATHJ EA 1ST ORD ABDL PEL/LXTR ART BRNCH,3716.0,2415.4,271.6,4628.0,68
CDM,36000285,I&D HEMATOMA SEROMA/FLUID COLLECTION,4861.0,3159.65,143.22,12500.0,87
CDM,36000295,PUNCTURE ASPIRATION ABSCESS HEMATOMA BULLA/CYST,1199.0,779.35,113.6,12500.0,86
CDM,36000305,DEBRIDEMENT SUBCUTANEOUS TISSUE 20 SQ CM/<,1199.0,779.35,71.41,5265.0,87
CDM,36000315,DBRDMT SUBCUTANEOUS TISSUE EA ADDL 20 SQ CM,1729.0,1123.85,29.4,5265.0,69
CDM,36000375,PUNCTURE ASPIRATION CYST BREAST,2111.0,1372.15,48.8,4628.0,86
CDM,36000385,PUNCTURE ASPIRATION BREAST EACH ADDITIONAL CYST,257.0,167.05,24.31,4628.0,68
CDM,36000395,INJECTION MAMMARY DUCTOGRAM/GALACTOGRAM,486.0,315.9,81.99,4628.0,68
CDM,36000455,PROC BREAST UNLISTD,3400.0,2210.0,945.2,6987.0,84
CDM,36000465,BIOPSY MUSCLE PERCUTANEOUS NEEDLE,7453.0,4844.45,66.63,7453.0,87
CDM,36000475,BIOPSY BONE TROCAR/NEEDLE SUPERFICIAL,7453.0,4844.45,101.93,7453.0,87
CDM,36000485,BIOPSY BONE TROCAR/NEEDLE DEEP,7453.0,4844.45,150.85,7453.0,87
CDM,36000495,INJECTION SINUS TRACT THERAPEUTIC SEPARATE PROC,6814.0,4429.1,104.52,12500.0,86
CDM,36000515,INJECTION 1 TENDON SHEATH/LIGAMENT APONEUROSIS,1358.0,882.7,44.63,4628.0,86
CDM,36000525,INJECTION SINGLE TENDON ORIGIN/INSERTION,1358.0,882.7,44.45,4628.0,86
CDM,36000535,INJECTION SINGLE/MLT TRIGGER POINT 1/2 MUSCLES,1358.0,882.7,46.16,4628.0,86
CDM,36000545,ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US,1358.0,882.7,41.36,4628.0,86
CDM,36000555,ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US,1358.0,882.7,42.37,4628.0,86
CDM,36000565,ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US,1358.0,882.7,51.29,4628.0,86
CDM,36000575,ASPIRATION&/INJECTION GANGLION CYST ANY LOCATJ,1358.0,882.7,47.46,4628.0,86
CDM,36000595,APPL CRANIAL TONG/STRTCTC FRAME W/REMOVAL SPX,7362.0,4785.3,280.86,7362.0,86
CDM,36000605,ABLATION BONE TUMOR RF PERQ W/IMG GDN WHEN DONE,59187.0,38471.55,423.4,59187.0,86
CDM,36000615,PROC MUSSKL SYS UNLISTD,2543.0,1652.95,204.59,4628.0,84
CDM,36000625,BIOPSY SOFT TISSUE NECK/THORAX,7453.0,4844.45,177.74,7453.0,87
CDM,36000645,EXCISION TUMOR SOFT TIS BACK/FLANK SUBQ 3 CM/>,7453.0,4844.45,552.06,10364.0,87
CDM,36000715,PERQ INTRDSCL ELECTROTHRM ANNULOPLASTY 1 LEVEL,5573.0,3622.45,1214.91,10364.0,66
CDM,36000725,PERQ INTRDSCL ELECTROTHRM ANNULOPLASTY ADDL LVL,3137.0,2039.05,683.87,10364.0,66
CDM,36000745,EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ <3CM,7453.0,4844.45,399.84,11545.0,87
CDM,36000755,EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ 3 CM/>,13165.0,8557.25,520.48,13165.0,87
CDM,36000775,INJECTION SHOULDER ARTHROGRAPHY/ CT/MRI ARTHG,761.0,494.65,57.51,4628.0,68
CDM,36000785,INJECTION ELBOW ARTHROGRAPHY,442.0,287.3,76.13,4628.0,68
CDM,36000795,INJECTION WRIST ARTHROGRAPHY,637.0,414.05,81.99,4628.0,68
CDM,36000815,INJECTION HIP ARTHROGRAPHY W/O ANESTHESIA,728.0,473.2,77.42,4628.0,68
CDM,36000830,PERFUSION EA ADD 30 MIN,1134.0,737.1,247.21,1134.0,58
CDM,36000840,SURGERY LEVEL 6 EA ADD 30 MIN,6381.0,4147.65,1391.06,6381.0,58
CDM,36000845,INJECTION ANKLE ARTHROGRAPHY,651.0,423.15,57.85,4628.0,68
CDM,36000860,SURGERY LEVEL 2 1ST 30 MIN,4184.0,2719.6,912.11,4184.0,58
CDM,36000870,SURGERY LEVEL 4 1ST 30 MIN,5786.0,3760.9,1261.35,5786.0,58
CDM,36000880,SURGERY LEVEL 5 1ST 30 MIN,5971.0,3881.15,1301.68,5971.0,58
CDM,36000890,SURGERY LEVEL 6 1ST 30 MIN,6381.0,4147.65,1391.06,6381.0,58
CDM,36000895,BRNCHSC W/BRNCL ALVEOLAR LAVAGE,7933.0,5156.45,161.85,7933.0,87
CDM,36000900,SURGERY LEVEL 1 EA ADD 30 MIN,3387.0,2201.55,738.37,3387.0,58
CDM,36000905,BRONCHOSCOPY BRONCHIAL/ENDOBRNCL BX 1+ SITES,7933.0,5156.45,188.63,7933.0,87
CDM,36000910,SURGERY LEVEL 2 EA ADD 30 MIN,3885.0,2525.25,846.93,3885.0,58
CDM,36000915,BRONCHOSCOPY W/TRANSBRONCHIAL LUNG BX 1 LOBE,16960.0,11024.0,213.57,16960.0,87
CDM,36000920,SURGERY LEVEL 3 EA ADD 30 MIN,4734.0,3077.1,1032.01,4734.0,58
CDM,36000930,SURGERY LEVEL 4 EA ADD 30 MIN,5786.0,3760.9,1261.35,5786.0,58
CDM,36000985,BIOPSY PLEURA PERCUTANEOUS NEEDLE,7453.0,4844.45,99.09,7453.0,87
CDM,36000990,SURGERY LEVEL 5 EA ADD 30 MIN,5971.0,3881.15,1301.68,5971.0,58
CDM,36000OH,INTRODUCTION NEEDLE/INTRACATHETER VEIN,72.0,46.8,1.1,99.38,116
CDM,36001000,PERFUSION INIT HOUR,9861.0,6409.65,2149.7,9861.0,58
CDM,36001005,SURGERY LEVEL 2 1ST 30 MIN A 60 PLASTICS,3062.0,1990.3,667.52,3062.0,58
CDM,36001015,SURGERY LEVEL 2 1ST 30 MIN ASC,4184.0,2719.6,912.11,4184.0,58
CDM,36001025,INSERTION INDWELLING TUNNELED PLEURAL CATHETER,16234.0,10552.1,239.9,16234.0,87
CDM,36001030,CELL SAVER EA ADD 15 MIN,152.0,98.8,33.14,152.0,58
CDM,36001035,SURGERY LEVEL 4 1ST 30 MIN A 60 PLASTICS,3731.0,2425.15,813.36,3731.0,58
CDM,36001040,CELL SAVER INIT HOUR,2913.0,1893.45,635.03,2913.0,58
CDM,36001045,RMVL NDWELLG TUNNELED PLEURAL CATHETER W/CUFF,2844.0,1848.6,186.94,12500.0,87
CDM,36001050,SURGERY LEVEL 1 1ST 30 MIN,3394.0,2206.1,739.89,3394.0,58
CDM,36001055,THORACENTESIS NEEDLE/CATH PLEURA W/O IMAGING,2844.0,1848.6,106.42,4628.0,87
CDM,36001065,THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING,2844.0,1848.6,128.29,4628.0,87
CDM,36001075,PERQ DRAINAGE PLEURA INSERT CATH W/O IMAGING,8726.0,5671.9,148.27,8726.0,87
CDM,36001080,SURGERY LEVEL 3 1ST 30 MIN,4734.0,3077.1,1032.01,4734.0,58
CDM,36001085,PERQ DRAINAGE PLEURA INSERT CATH W/IMAGING,7146.0,4644.9,176.17,7146.0,87
CDM,36001095,SURGERY LEVEL 4 1ST 30 MIN ASC,5175.0,3363.75,1128.15,5175.0,58
CDM,36001105,SURGERY LEVEL 5 1ST 30 MIN A 60 PLASTICS,3924.0,2550.6,855.43,3924.0,58
CDM,36001115,ABLATION THER 1+ PULM TUMORS PERQ RADIOFREQUENCY,26838.0,17444.7,515.87,26838.0,86
CDM,36001125,SURGERY LEVEL 5 1ST 30 MIN ASC,5815.0,3779.75,1267.67,5815.0,58
CDM,36001145,INS NEW/RPLCMT PRM PACEMAKR W/TRANS ELTRD ATRIAL,26893.0,17480.45,501.43,26893.0,86
CDM,36001155,INS NEW/RPLC PRM PACEMAKER W/TRANSV ELTRD VENTR,27759.0,18043.35,529.64,27759.0,86
CDM,36001165,INS NEW/RPLCMT PRM PM W/TRANSV ELTRD ATRIAL&VENT,25647.0,16670.55,572.82,25647.0,86
CDM,36001175,INSJ/RPLCMT TEMP TRANSVNS 1CHMBR ELTRD/PM CATH,47587.0,30931.55,181.75,47587.0,86
CDM,36001185,SURGERY LEVEL 1 EA ADD 30 MIN ASC,2499.0,1624.35,544.78,2499.0,58
CDM,36001195,SURGERY LEVEL 1 EA ADD 30 MIN A 60 PLASTICS,1725.0,1121.25,376.05,1725.0,58
CDM,36001205,INS PACEMAKER PULSE GEN ONLY W/EXIST DUAL LEADS,26152.0,16998.8,377.23,26152.0,87
CDM,36001215,UPG PACEMAKER SYS CONVERT 1CHMBR SYS 2CHMBR SYS,25785.0,16760.25,531.35,25785.0,86
CDM,36001225,RPSG PREV IMPLTED PM/DFB R ATR/R VENTR ELECTRODE,18098.0,11763.7,343.28,18098.0,86
CDM,36001235,INSJ 1 TRANSVNS ELTRD PERM PACEMAKER/IMPLTBL DFB,30717.0,19966.05,410.35,30717.0,86
CDM,36001245,INSJ 2 TRANSVNS ELTRD PERM PACEMAKER/IMPLTBL DFB,26791.0,17414.15,408.85,26791.0,86
CDM,36001255,RPR 1 TRANSVNS ELTRD PRM PM/PACING IMPLNTBL DFB,20926.0,13601.9,430.56,20926.0,86
CDM,36001265,RPR 2 TRANSVNS ELECTRODES PRM PM/IMPLANTABLE DFB,20926.0,13601.9,423.74,20926.0,86
CDM,36001275,INS PACEMAKER PULSE GEN ONLY W/EXIST MULT LEADS,45037.0,29274.05,395.81,45037.0,86
CDM,36001285,RELOCATION OF SKIN POCKET FOR PACEMAKER,10518.0,6836.7,379.96,10518.0,87
CDM,36001295,RELOCATE SKIN POCKET IMPLANTABLE DEFIBRILLATOR,10518.0,6836.7,452.22,10518.0,87
CDM,36001305,INSJ ELTRD CAR VEN SYS ATTCH PREV PM/DFB PLS GEN,29510.0,19181.5,562.56,29510.0,86
CDM,36001315,INSJ ELTRD CAR VEN SYS TM INSJ DFB/PM PLS GEN,16614.0,10799.1,505.29,16614.0,68
CDM,36001325,SURGERY LEVEL 2 EA ADD 30 MIN A 60 PLASTICS,3062.0,1990.3,667.52,3062.0,58
CDM,36001335,REMVL PERM PM PLSE GEN W/REPL PLSE GEN SNGL LEAD,21495.0,13971.75,375.19,21495.0,86
CDM,36001345,REMVL PERM PM PLS GEN W/REPL PLSE GEN 2 LEAD SYS,26736.0,17378.4,391.99,26736.0,86
CDM,36001355,REMVL PERM PM PLS GEN W/REPL PLSE GEN MULT LEAD,42964.0,27926.6,410.35,42964.0,86
CDM,36001365,SURGERY LEVEL 3 EA ADD 30 MIN ASC,3831.0,2490.15,835.16,3831.0,58
CDM,36001375,SURGERY LEVEL 3 EA ADD 30 MIN A 60 PLASTICS,3540.0,2301.0,771.72,3540.0,58
CDM,36001385,REMOVAL PERMANENT PACEMAKER PULSE GENERATOR ONLY,47587.0,30931.55,258.34,47587.0,87
CDM,36001395,RMVL TRANSVNS PM ELTRD 1 LEAD SYS ATR/VENTR,20926.0,13601.9,535.42,20926.0,87
CDM,36001405,RMVL TRANSVNS PM ELTRD DUAL LEAD SYS,20926.0,13601.9,705.79,20926.0,86
CDM,36001415,SURGERY LEVEL 4 EA ADD 30 MIN ASC,4297.0,2793.05,936.75,4297.0,58
CDM,36001425,REMOVAL IMPLANTABLE DEFIB PULSE GENERATOR ONLY,20926.0,13601.9,241.58,20926.0,86
CDM,36001435,RMVL1/DUAL CHMBR IMPLTBL DFB ELTRD TRANSVNS XTRJ,20926.0,13601.9,806.19,20926.0,86
CDM,36001445,INSJ/RPLCMT PERM DFB W/TRNSVNS LDS 1/DUAL CHMBR,56044.0,36428.6,1002.33,56044.0,86
CDM,36001455,RMVL IMPLTBL DFB PLSE GEN W/REPL PLSE GEN 1 LEAD,42062.0,27340.3,410.14,42062.0,86
CDM,36001465,RMVL IMPLTBL DFB PLSE GEN W/RPLCMT PLSE GEN 2 LD,40488.0,26317.2,426.74,40488.0,86
CDM,36001475,RMVL IMPLTBL DFB PLS GEN W/RPLCMT PLS GEN MLT LD,52725.0,34271.25,443.36,52725.0,86
CDM,36001505,SURGERY LEVEL 4 EA ADD 30 MIN A 60 PLASTICS,3731.0,2425.15,813.36,3731.0,58
CDM,36001510,BIOPSY MUSCLE PERCUTANEOUS NEEDLE,7453.0,4844.45,66.63,7453.0,87
CDM,36001515,SURGERY LEVEL 5 EA ADD 30 MIN ASC,4966.0,3227.9,1082.59,4966.0,58
CDM,36001525,SURGERY LEVEL 5 EA ADD 30 MIN A 60 PLASTICS,3924.0,2550.6,855.43,3924.0,58
CDM,36001535,SURGERY LEVEL 1 1ST 30 MIN A 60 PLASTICS,1725.0,1121.25,376.05,1725.0,58
CDM,36001545,SURGERY LEVEL 1 1ST 30 MIN ASC,3394.0,2206.1,739.89,3394.0,58
CDM,36001555,SURGERY LEVEL 3 1ST 30 MIN A 60 PLASTICS,3540.0,2301.0,771.72,3540.0,58
CDM,36001565,SURGERY LEVEL 3 1ST 30 MIN ASC,4715.0,3064.75,1027.87,4715.0,58
CDM,36001575,SURGERY LEVEL 6 EA ADD 30 MIN ASC,2766.0,1797.9,602.99,2766.0,58
CDM,36001585,SURGERY LEVEL 6 1ST 30 MIN ASC,2766.0,1797.9,602.99,2766.0,58
CDM,36001595,SURGERY LEVEL 2 EA ADD 30 MIN ASC,3283.0,2133.95,715.69,3283.0,58
CDM,36001605,INSERTION INTRA-AORTIC BALLOON ASSIST DEV PERQ,3138.0,2039.7,289.26,12615.0,68
CDM,36001610,BX/EXC LYMPH NODE NEEDLE SUPERFICIAL,6481.0,4212.65,99.28,6481.0,87
CDM,36001625,INSJ PERQ VAD W/RS&I L HRT ARTERIAL ACCESS ONLY,7901.0,5135.65,402.65,78966.82,68
CDM,36001645,REMOVAL PERQ LEFT HRT VAD ARTL/ARTL&VEN SEP INSJ,4456.0,2896.4,211.92,12615.0,68
CDM,36001825,INTRODUCTION NEEDLE/INTRACATHETER VEIN,246.0,159.9,35.72,4628.0,66
CDM,36001845,NJX PX XTR VNGRPH W/INTRO NDL/INTRACATH,2206.0,1433.9,55.23,4628.0,68
CDM,36001855,INTRO CATHETER SUPERIOR/INFERIOR VENA CAVA,3041.0,1976.65,125.29,4628.0,68
CDM,36001865,SLCTV CATH PLMT VEN SYS 1ST ORDER BRANCH,3601.0,2340.65,180.68,4628.0,68
CDM,36001875,SLCTV CATH PLMT VEN SYS 2ND ORDER/> SLCTV BRANC,3904.0,2537.6,202.68,4628.0,68
CDM,36001895,SLCTV CATHETER PLMT LEFT/RIGHT PULMONARY ARTERY,2775.0,1803.75,173.56,4628.0,68
CDM,36001905,SLCTV CATH PLMT SEGMENTAL/SUBSEGMENTAL PULM ART,3225.0,2096.25,199.93,4628.0,68
CDM,36001925,INTRO OF NEEDLE OR INTRACATHETER UPR/LXTR ARTERY,3657.0,2377.05,102.59,4628.0,68
CDM,36001965,INTRODUCTION CATHETER AORTA,3075.0,1998.75,159.49,4628.0,68
CDM,36001975,SLCTV CATHJ EA 1ST ORD THRC/BRCH/CPHLC BRNCH,7505.0,4878.25,248.76,7505.0,68
CDM,36001985,SLCTV CATHJ 1ST 2ND ORD THRC/BRCH/CPHLC BRNCH,7638.0,4964.7,314.6,7638.0,68
CDM,36001995,SLCTV CATHJ 3RD+ ORD SLCTV THRC/BRCH/CPHLC BRNCH,8125.0,5281.25,357.7,8125.0,68
CDM,36002005,SLCTV CATHJ EA 2ND+ ORD THRC/BRCH/CPHLC BRNCH,990.0,643.5,60.08,4628.0,68
CDM,36002015,NONSLCTV CATH THOR AORTA ANGIO INTR/XTRCRANL ART,18098.0,11763.7,229.65,18098.0,86
CDM,36002025,SLCTV CATH CAROTID/INNOM ART ANGIO XTRCRANL ART,18098.0,11763.7,321.26,18098.0,86
CDM,36002035,SLCTV CATH CAROTID/INNOM ART ANGIO INTRCRANL ART,31083.0,20203.95,386.76,31083.0,86
CDM,36002045,SLCTV CATH INTRNL CAROTID ART ANGIO INTRCRNL ART,31083.0,20203.95,434.69,31083.0,86
CDM,36002050,BIOPSY SALIVARY GLAND NEEDLE,3237.0,2104.05,60.54,4628.0,86
CDM,36002055,SLCTV CATH SUBCLAVIAN ART ANGIO VERTEBRAL ARTERY,18098.0,11763.7,382.64,18098.0,86
CDM,36002065,SLCTV CATH VERTEBRAL ART ANGIO VERTEBRAL ARTERY,31083.0,20203.95,429.92,31083.0,86
CDM,36002075,SLCTV CATH XTRNL CAROTID ANGIO XTRNL CAROTD CIRC,6466.0,4202.9,142.17,6466.0,68
CDM,36002085,SLCTV CATH INTRCRNL BRNCH ANGIO INTRL CAROT/VERT,5846.0,3799.9,299.41,5846.0,68
CDM,36002095,SLCTV CATHJ EA 1ST ORD ABDL PEL/LXTR ART BRNCH,4013.0,2608.45,271.6,4628.0,68
CDM,36002105,SLCTV CATHJ 2ND ORDER ABDL PEL/LXTR ART BRNCH,4525.0,2941.25,288.86,4628.0,68
CDM,36002115,SLCTV CATHJ 3RD+ ORD SLCTV ABDL PEL/LXTR BRNCH,5469.0,3554.85,344.26,5469.0,68
CDM,36002125,SLCTV CATHJ EA 2ND+ ORD ABDL PEL/LXTR ART BRNCH,848.0,551.2,56.29,4628.0,68
CDM,36002135,SLCTV CATH 1STORD W/WO ART PUNCT/FLUORO/S&I UN,18098.0,11763.7,294.94,18098.0,86
CDM,36002145,SLCTV CATH 1STORD W/WO ART PUNCT/FLUOR/S&I BIL,18098.0,11763.7,399.8,18098.0,86
CDM,36002155,SUPSLCTV CATH 2ND+ORD RENAL&ACCESSORY ARTERY/S&I,31083.0,20203.95,413.11,31083.0,86
CDM,36002195,INJECTIONS SCLEROSANT FOR SPIDER VEINS LIM/TRNK,2297.0,1493.05,345.93,12500.0,84
CDM,36002235,PRQ PORTAL VEIN CATHETERIZATION ANY METHOD,1367.0,888.55,298.01,4628.0,68
CDM,36002245,VEN CATHJ SLCTV ORGAN BLD SAMPLING,1660.0,1079.0,208.93,4628.0,68
CDM,36002255,INSJ NON-TUNNELED CENTRAL VENOUS CATH AGE 5 YR/>,18098.0,11763.7,103.42,18098.0,87
CDM,36002265,INSERT TUNNELED CVC W/O SUBQ PORT/PMP AGE <5 YR,31083.0,20203.95,378.01,31083.0,87
CDM,36002275,INSJ TUNNELED CVC W/O SUBQ PORT/PMP AGE 5 YR/>,18098.0,11763.7,301.68,18098.0,87
CDM,36002285,INSJ TUNNELED CTR VAD W/SUBQ PORT AGE 5 YR/>,18098.0,11763.7,385.22,18098.0,87
CDM,36002305,INSJ TUN VAD REQ 2 CATH 2 SITS W/O SUBQ PORT/PMP,18098.0,11763.7,394.46,18098.0,87
CDM,36002325,INSERTION PICC W/O IMG GDN < 5 YR,8932.0,5805.8,114.75,8932.0,87
CDM,36002335,INSERTION PICC W/O IMG GDN 5 YR/>,8932.0,5805.8,112.99,8932.0,87
CDM,36002345,INSJ PRPH CTR VAD W/SUBQ PORT AGE 5 YR/>,18098.0,11763.7,366.73,18098.0,87
CDM,36002355,RPR TUN/NON-TUN CTR VAD CATH W/O SUBQ PORT/PMP,3555.0,2310.75,39.9,5265.0,87
CDM,36002375,RPLCMT CATH CTR VAD SUBQ PORT/PMP,18098.0,11763.7,236.82,18098.0,87
CDM,36002385,RPLCMT COMPL NON-TUN CVC W/O SUBQ PORT/PMP,8932.0,5805.8,76.69,8932.0,87
CDM,36002395,RPLCMT COMPL TUN CVC W/O SUBQ PORT/PMP,18098.0,11763.7,213.76,18098.0,87
CDM,36002405,RPLCMT COMPL TUN CTR VAD W/SUBQ PORT,18098.0,11763.7,332.55,18098.0,87
CDM,36002425,COMPLETE REPLACEMENT PICC RS&I,8932.0,5805.8,68.84,8932.0,87
CDM,36002435,RPLCMT COMPL PRPH CTR VAD W/SUBQ PORT,18098.0,11763.7,343.95,18098.0,87
CDM,36002445,RMVL TUN CVC W/O SUBQ PORT/PMP,3555.0,2310.75,159.64,4628.0,87
CDM,36002455,RMVL TUN CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ,8932.0,5805.8,218.69,8932.0,87
CDM,36002465,DECLOT BY THROMBOLYTIC AGENT IMPLANT DEVICE/CATH,1907.0,1239.55,48.29,12500.0,87
CDM,36002475,MCHNL RMVL PRICATH OBSTR CV DEV VIA VEN ACCESS,18098.0,11763.7,211.54,18098.0,87
CDM,36002485,MCHNL RMVL INTRAL OBSTR CV DEV THRU DEV LUMEN,8932.0,5805.8,52.47,8932.0,87
CDM,36002495,RPSG PREVIOUSLY PLACED CVC UNDER FLUOR GDNCE,8932.0,5805.8,70.06,8932.0,87
CDM,36002505,CNTRST NJX RAD EVAL CTR VAD FLUOR IMG&REPRT,1211.0,787.15,41.63,4628.0,86
CDM,36002515,ARTL CATHJ/CANNULJ MNTR/TRANSFUSION SPX PRQ,1489.0,967.85,56.26,4628.0,68
CDM,36002555,INSJ TRANSVNS INTRAHEPATC PORTOSYSIC SHUNT,17131.0,11135.15,955.36,19077.46,78
CDM,36002565,REVJ TRANSVNS INTRAHEPATIC PORTOSYSTEMIC SHUNT,20388.0,13252.2,438.02,20388.0,86
CDM,36002575,PRIM PRQ TRLUML MCHNL THRMBC N-COR N-ICRA 1ST,50428.0,32778.2,494.11,50428.0,86
CDM,36002595,SEC PRQ TRLUML THRMBC N-CORONARY N-INTRACRANIAL,7031.0,4570.15,283.47,9767.57,68
CDM,36002605,PRQ TRANSLUMINAL MECHANICAL THROMBECTOMY VEIN,29774.0,19353.1,455.96,29774.0,86
CDM,36002615,PRQ TRLUML MCHNL THRMBC VEIN REPEAT TX,18098.0,11763.7,325.89,18098.0,86
CDM,36002625,INS INTRVAS VC FILTR W/WO VAS ACS VSL SELXN RS&I,18379.0,11946.35,255.69,18379.0,86
CDM,36002645,RTRVL INTRVAS VC FILTR W/WO ACS VSL SELXN RS&I,18098.0,11763.7,403.74,18098.0,86
CDM,36002655,PRQ TRANSCATHETER RTRVL INTRVAS FB WITH IMAGING,18098.0,11763.7,349.11,18098.0,86
CDM,36002665,TRANSCATHETER BIOPSY,31083.0,20203.95,253.34,31083.0,86
CDM,36002755,THROMBOLYSIS ARTERIAL INFUSION ICRA RS&I INIT TX,31083.0,20203.95,444.43,31083.0,86
CDM,36002765,THROMBOLYSIS VENOUS INFUSION W/IMAGING INIT TX,18098.0,11763.7,389.45,18098.0,86
CDM,36002775,THROMBOLYSIS ART/VENOUS INFSN W/IMAGE SUBSQ TX,18098.0,11763.7,268.24,18098.0,86
CDM,36002785,CESSATION THROMBOLYTIC THER W/CATHETER REMOVAL,18098.0,11763.7,141.42,18098.0,86
CDM,36002795,TCAT IV STENT CRV CRTD ART EMBOLIC PROTECJ,21468.0,13954.2,1131.85,21468.0,68
CDM,36002805,TCAT IV STENT CRV CRTD ART W/O EMBOLIC PROTECJ,19680.0,12792.0,4290.24,19680.0,66
CDM,36002OH,INJECTION PX PRQ TX EXTREMITY PSEUDOANEURYSM,784.0,509.6,1.1,1833.54,148
CDM,36003025,DIAGNOSTIC BONE MARROW BIOPSIES,6481.0,4212.65,77.81,6481.0,87
CDM,36003035,BX/EXC LYMPH NODE NEEDLE SUPERFICIAL,6481.0,4212.65,99.28,6481.0,87
CDM,36003045,INJECTION PROCEDURE LYMPHANGIOGRAPHY,3757.0,2442.05,81.99,4628.0,68
CDM,36003125,NASO/ORO-GASTRIC TUBE PLMT REQ PHYS&FLUOR GDNCE,1836.0,1193.4,46.57,12500.0,86
CDM,36003145,REPOS NASO/ORO GASTRIC FEEDING TUBE THRU DUO,1119.0,727.35,117.94,4628.0,87
CDM,36003155,ENTEROSCOPY > 2ND PRTN W/PLMT PRQ TUBE,8726.0,5671.9,277.32,8726.0,87
CDM,36003175,INTRODUCTION LONG GI TUBE SEPARATE PROCEDURE,4313.0,2803.45,22.26,12615.0,86
CDM,36003205,BIOPSY LIVER NEEDLE PERCUTANEOUS,7453.0,4844.45,101.93,7453.0,87
CDM,36003235,ABLTJ 1/> LVR TUM PRQ RF,26838.0,17444.7,866.24,26838.0,86
CDM,36003255,CHOLECYSTOSTOMY PRQ W/IMAGING & CATHETER PLMT,16234.0,10552.1,376.66,16234.0,86
CDM,36003325,BILIARY ENDO PRQ T-TUBE DX W/COLLECT SPEC BRUSH,28703.0,18656.95,343.46,28703.0,87
CDM,36003335,BILIARY NDSC PRQ T-TUBE W/BX SINGLE/MULTIPLE,28703.0,18656.95,344.81,28703.0,87
CDM,36003345,BILIARY NDSC PRQ T-TUBE W/DIL DUCT W/O STENT,16234.0,10552.1,410.6,16234.0,87
CDM,36003355,BILIARY NDSC PRQ T-TUBE DILAT STRIX W/STENT,47892.0,31129.8,465.3,47892.0,87
CDM,36003385,PROC BILIARY TRACT UNLISTD,1860.0,1209.0,517.08,12615.0,84
CDM,36003395,BIOPSY PANCREA PERCUTANEOUS NEEDLE,7453.0,4844.45,275.12,7453.0,87
CDM,36003445,ABDOM PARACENTESIS DX/THER W/IMAGING GUIDANCE,4313.0,2803.45,123.62,6112.0,87
CDM,36003465,BX ABDL/RETROPERITONEAL MASS PRQ NEEDLE,7453.0,4844.45,97.23,7453.0,87
CDM,36003485,INJECTION AIR/CONTRAST PERITONEAL CAVITY SPX,325.0,211.25,70.85,4628.0,68
CDM,36003495,INSJ INTRAPERITONEAL CATHETER W/IMG GUID,16234.0,10552.1,234.57,16234.0,87
CDM,36003515,REMOVAL TUNNELED INTRAPERITONEAL CATHETER,14478.0,9410.7,255.04,14478.0,87
CDM,36003525,EXCHNG ABSC/CST DRG CATH RAD GID SPX,8726.0,5671.9,82.63,8726.0,87
CDM,36003535,CNTRST NJX ASSMT ABSC/CST VIA DRG CATH/TUBE SPX,661.0,429.65,43.7,4628.0,68
CDM,36003545,INSERT GASTROSTOMY TUBE PERCUTANEOUS,8726.0,5671.9,238.22,8726.0,87
CDM,36003555,INSERT DUODENOSTOMY/JEJUNOSTOMY TUBE PERQ,8726.0,5671.9,283.46,8726.0,87
CDM,36003565,INSERT CECOSTOMY/OTHER COLONIC TUBE PERCUTANEOUS,5424.0,3525.6,236.95,8326.0,87
CDM,36003575,CONVERT GASTROSTOMY-GASTRO-JEJUNOSTOMY TUBE PERQ,8726.0,5671.9,171.75,8726.0,87
CDM,36003585,REPLACE GASTROSTOMY/CECOSTOMY TUBE PERCUTANEOUS,4313.0,2803.45,76.87,6112.0,86
CDM,36003605,REPLACE DUODENOSTOMY/JEJUNOSTOMY TUBE PERQ,4313.0,2803.45,103.51,6112.0,87
CDM,36003615,REPLACEMENT GASTRO-JEJUNOSTOMY TUBE PERCUTANEOUS,4313.0,2803.45,159.89,6112.0,86
CDM,36003625,OBSTRUCTIVE MATERIAL REMOVAL FROM GI TUBE,4313.0,2803.45,57.13,6112.0,87
CDM,36003635,PLCMT CLIP/WIRE SURG LOC ABD,4669.0,3034.85,461.87,6112.0,84
CDM,36003665,RENAL BIOPSY PRQ TROCAR/NEEDLE,7453.0,4844.45,146.98,7453.0,87
CDM,36003675,RMVL & RPLCMT INTLY DWELLING URETERAL STENT PRQ,9423.0,6124.95,295.47,9423.0,86
CDM,36003685,REMOVAL INDWELLING URETERAL STENT PRQ,9423.0,6124.95,267.34,9423.0,86
CDM,36003715,RMVL & RPLCMT XTRNL ACCESSIBLE NEPHROURTRL CATH,9423.0,6124.95,98.06,9423.0,86
CDM,36003725,RMVL NFROS TUBE REQ FLUORO GUIDANCE,3070.0,1995.5,62.22,4628.0,86
CDM,36003735,ASPIR &/NJX RENAL CYST/PELVIS NEEDLE PRQ,3237.0,2104.05,110.23,4628.0,87
CDM,36003815,ABLATION RENAL TUMOR UNILATERAL PERQ CRYOTHERAPY,25651.0,16673.15,534.24,25651.0,87
CDM,36003825,CHNG URTROST TUBE/XTRNLLY ACCESSIBLE STENT ILEAL,9423.0,6124.95,90.54,9423.0,87
CDM,36003835,CYSTOSTOMY CYSTOTOMY W/DRAINAGE,9423.0,6124.95,344.65,10789.0,87
CDM,36003855,ASPIRATION BLADDER INSERT SUPRAPUBIC CATHETER,9423.0,6124.95,166.65,9423.0,87
CDM,36003865,NJX CSTOGRAPY/VOIDING URETHROCSTOGRAPY,1048.0,681.2,50.79,12615.0,68
CDM,36003875,NJX RETROGRADE URETHROCSTOGRAPY,1335.0,867.75,74.3,12615.0,68
CDM,36003885,INSJ TEMP NDWELLG BLADDER CATHETER SIMPLE,593.0,385.45,30.11,12500.0,86
CDM,36003895,CHANGE CYSTOSTOMY TUBE SIMPLE,1119.0,727.35,49.68,4628.0,86
CDM,36003915,EMG STDS ANAL/URTL SPHNCTR OTH/THN NDL,720.0,468.0,80.17,12500.0,86
CDM,36003925,MEAS POST-VOIDING RESIDUAL URINE&/BLADDER CAP,273.0,177.45,15.69,12500.0,86
CDM,36003935,CYSTOURETHROSCOPY INJ CHEMODENERVATION BLADDER,9423.0,6124.95,196.6,17833.0,87
CDM,36003965,PROC URINARY UNLISTD,1511.0,982.15,214.41,4628.0,84
CDM,36004005,CATH & SALINE/CONTRAST SONOHYSTER/HYSTEROSALPI,831.0,540.15,65.58,4628.0,68
CDM,36004015,TRANSCERV FALLOPIAN TUBE CATH W/WO HYSTOSALPING,14626.0,9506.9,324.41,14626.0,86
CDM,36004025,TAP BLOCK UNILATERAL BY INJECTION(S),1407.0,914.55,67.03,4628.0,68
CDM,36004065,FETAL NONSTRESS TEST,805.0,523.25,59.72,4628.0,86
CDM,36004095,INSERTION CERVICAL DILATOR SEPARATE PROCEDURE,1217.0,791.05,55.12,4628.0,86
CDM,36004185,BIOPSY THYROID PERCUTANEOUS CORE NEEDLE,2814.0,1829.1,88.89,4628.0,86
CDM,36004195,ASPIRATION AND/OR INJECTION THYROID CYST,2814.0,1829.1,56.38,12500.0,87
CDM,36004205,PROC ENDOCRINE UNLISTD,1423.0,924.95,395.59,10592.0,84
CDM,36004215,CISTERNAL/LATERAL C1-C2 PUNCTURE W/O INJ SPX,2037.0,1324.05,92.59,4628.0,87
CDM,36004255,EVASC TEMP BALLOON ARTL OCCLUSION HEAD/NECK,49016.0,31860.4,672.97,49016.0,86
CDM,36004265,TCAT PERMANENT OCCLUSION/EMBOLIZATION PRQ CNS,13704.0,8907.6,1377.5,19077.46,78
CDM,36004275,TCAT PERMANT OCCLUSION/EMBOLIZATION PRQ NON-CNS,52240.0,33956.0,965.96,52240.0,86
CDM,36004285,BALLOON ANGIOPLASTY INTRACRANIAL PERCUTANEOUS,26324.0,17110.6,1615.46,26324.0,68
CDM,36004295,TCAT PLMT IV STENT ICRA W/BALO ANGIOP IF PFRMD,37892.0,24629.8,1741.43,37892.0,68
CDM,36004300,INSERTION TUNNEL INTRAPERITONEAL CATH DIAL OPEN,16234.0,10552.1,262.08,16234.0,87
CDM,36004305,BALLOON DILAT INTRACRANIAL VASOSPASM PRQ INITIAL,26324.0,17110.6,5597.0,26324.0,66
CDM,36004325,PERQ BALO DILA IC VSPSM EA VSL DIFF VASC TER,17075.0,11098.75,3528.0,17075.0,66
CDM,36004345,PRQ ASPIR PULPOSUS/INTERVERTEBRAL DISC/PVRT TISS,4855.0,3155.75,180.62,33436.0,87
CDM,36004355,DIAGNOSTIC LUMBAR SPINAL PUNCTURE,4778.0,3105.7,74.92,4778.0,87
CDM,36004365,THERAPEUTIC SPINAL PUNCTURE DRAINAGE CSF,4778.0,3105.7,109.57,4778.0,87
CDM,36004375,INJECTION EPIDURAL BLOOD/CLOT PATCH,4778.0,3105.7,135.76,4778.0,87
CDM,36004385,INJX/INFUS NEUROLYT SBST EPIDURAL LUMBAR/SACRAL,6143.0,3992.95,167.4,6143.0,87
CDM,36004395,INJECTION PROCEDURE MYELOGRAPHY/CT LUMBAR,1579.0,1026.35,81.99,4628.0,68
CDM,36004445,IMPLTJ REVJ/RPSG ITHCL/EDRL CATH PMP W/O LAM,26151.0,16998.15,467.96,26151.0,87
CDM,36004455,RMVL PREVIOUSLY IMPLTED ITHCL/EDRL CATH,13474.0,8758.1,333.37,13474.0,87
CDM,36004475,IMPLTJ/RPLCMT FS NON-PRGRBL PUMP,35305.0,22948.25,551.28,35305.0,87
CDM,36004485,IMPLTJ/RPLCMT ITHCL/EDRL DRUG NFS PRGRBL PUMP,35293.0,22940.45,453.61,35293.0,87
CDM,36004495,RMVL SUBQ RSVR/PUMP INTRATHECAL/EPIDURAL INFUS,44188.0,28722.2,357.74,44188.0,87
CDM,36004515,PRQ IMPLTJ NSTIM ELECTRODE ARRAY EPIDURAL,25409.0,16515.85,487.54,25409.0,79
CDM,36004535,RMVL SPINAL NSTIM ELTRD PRQ ARRAY INCL FLUOR,13474.0,8758.1,384.14,13474.0,87
CDM,36004555,REVJ INCL RPLCMT NSTIM ELTRD PRQ RA INCL FLUOR,23824.0,15485.6,527.41,23824.0,79
CDM,36004575,INSJ/RPLCMT SPINAL NPG/RCVR POCKET CRTJ&CONNJ,40477.0,26310.05,394.85,40477.0,87
CDM,36004585,REVJ/RMVL IMPL SPI NPG/RCVR DTCH CONNJ ELTRD RA,23729.0,15423.85,365.26,23729.0,87
CDM,36004615,INJECTION AA&/STRD SUPRASCAPULAR NERVE,4778.0,3105.7,64.88,4778.0,87
CDM,36004620,PLC OCCL DVC ARTERY VEIN,838.0,544.7,63.76,12615.0,66
CDM,36004625,INJECTION AA&/STRD INTERCOSTAL NRV SINGLE LVL,4778.0,3105.7,69.56,4778.0,87
CDM,36004645,INJECTION AA&/STRD ILIOINGUINAL IH NERVES,4778.0,3105.7,65.7,4778.0,87
CDM,36004665,INJECTION AA&/STRD PUDENDAL NERVE,6143.0,3992.95,64.29,6143.0,87
CDM,36004675,INJECTION AA&/STRD SCIATIC NERVE W/IMG GDN,4778.0,3105.7,87.62,4778.0,87
CDM,36004705,NJX DX/THER AGT PVRT FACET JT CRV/THRC 1 LEVEL,6143.0,3992.95,123.11,6143.0,87
CDM,36004715,NJX DX/THER AGT PVRT FACET JT CRV/THRC 2ND LEVEL,656.0,426.4,68.6,4628.0,69
CDM,36004725,NJX DX/THER AGT PVRT FACET JT CRV/THRC 2ND LEVEL,656.0,426.4,68.6,4628.0,69
CDM,36004735,NJX DX/THER AGT PVRT FACET JT CRV/THRC 3+ LEVEL,656.0,426.4,69.3,4628.0,69
CDM,36004745,NJX DX/THER AGT PVRT FACET JT LMBR/SAC 1 LEVEL,6143.0,3992.95,105.9,6143.0,87
CDM,36004755,NJX DX/THER AGT PVRT FACET JT LMBR/SAC 1 LEVEL,6143.0,3992.95,105.9,6143.0,87
CDM,36004760,TRLUML PERIPHERAL ATHERECTOMY ILIAC ARTERY EA,38384.0,24949.6,7663.0,38384.0,84
CDM,36004765,NJX DX/THER AGT PVRT FACET JT LMBR/SAC 2ND LEVEL,1737.0,1129.05,59.46,4628.0,69
CDM,36004775,NJX DX/THER AGT PVRT FACET JT LMBR/SAC 2ND LEVEL,1737.0,1129.05,59.46,4628.0,69
CDM,36004785,NJX DX/THER AGT PVRT FACET JT LMBR/SAC 3+ LEVEL,1260.0,819.0,60.89,4628.0,69
CDM,36004795,NJX DX/THER AGT PVRT FACET JT LMBR/SAC 3+ LEVEL,1260.0,819.0,60.89,4628.0,69
CDM,36004815,NJX ANES STELLATE GANGLION CRV SYMPATHETIC,6143.0,3992.95,89.75,6143.0,87
CDM,36004835,INJECTION ANES LMBR/THRC PARAVERTBRL SYMPATHETIC,6143.0,3992.95,98.93,6143.0,87
CDM,36004850,REVSC OPN/PRQ TIB/PERO W/STNT/ATHR/ANGIOP SM VSL,45849.0,29801.85,915.17,45849.0,75
CDM,36004855,PRQ IMPLTJ NEUROSTIMULATOR ELTRD PERIPHERAL NRV,13689.0,8897.85,384.73,13689.0,79
CDM,36004885,POST TIB NEUROSTIMULATION PRQ NEEDLE ELECTRODE,2037.0,1324.05,35.12,5265.0,87
CDM,36004895,OPEN IMPLANTATION NEA PERIPHERAL NERVE,31140.0,20241.0,363.45,31140.0,87
CDM,36004915,REVJ/RMVL PERIPHERAL NEUROSTIMULATOR ELECTRODE,23729.0,15423.85,169.73,23729.0,87
CDM,36004925,INSERTION/RPLCMT PERIPHERAL/GASTRIC NPGR,27892.0,18129.8,343.9,27892.0,87
CDM,36004935,REV/RMV PRPH SAC/GSTRC NPG/RCV DTCH CONN ELTR RA,23729.0,15423.85,267.71,23729.0,87
CDM,36004985,DSTR NROLYTC AGNT PARVERTEB FCT SNGL CRVCL/THORA,13474.0,8758.1,225.83,13474.0,87
CDM,36005005,DSTR NROLYTC AGNT PARVERTEB FCT ADDL CRVCL/THORA,914.0,594.1,78.22,4628.0,69
CDM,36005025,DSTR NROLYTC AGNT PARVERTEB FCT SNGL LMBR/SACRAL,13474.0,8758.1,226.36,13474.0,87
CDM,36005045,DSTR NROLYTC AGNT PARVERTEB FCT ADDL LMBR/SACRAL,3267.0,2123.55,68.6,4628.0,69
CDM,36005085,PARS INTERARTICULARIS INJ,1022.0,664.3,256.95,4628.0,84
CDM,36005165,SIJ INJ - ARTHROGR/ANESTHETIC,2770.0,1800.5,316.55,4628.0,85
CDM,36005175,2ND PERFUSIONIST .25HR,543.0,352.95,118.37,543.0,58
CDM,36005235,AUTOGRAFT (LIVING RELATED),2090.0,1358.5,455.62,2090.0,58
CDM,36005245,BLOCK/LINE PLACEMENT TIME,1740.0,1131.0,379.32,1740.0,58
CDM,36005255,CADAVERIC COLD STORAGE,1671.0,1086.15,364.28,1671.0,58
CDM,36005305,LFT HRT BYPASS PERF INITIAL HR,9671.0,6286.15,2108.28,9671.0,58
CDM,36005315,LFT HRT BYPSS PER EA ADD 30MIN,1117.0,726.05,243.51,1117.0,58
CDM,36005425,PANCREAS,1671.0,1086.15,364.28,1671.0,58
CDM,36005435,PEDIATRIC PERFUSION,20448.0,13291.2,4457.66,20448.0,58
CDM,36005465,PERFUSION PROF SETUP,4720.0,3068.0,1028.96,4720.0,58
CDM,36005485,PERFUSION TECH FEE/HOUR,543.0,352.95,118.37,543.0,58
CDM,36005495,PERFUSIONIST ECMO .25HR,543.0,352.95,118.37,543.0,58
CDM,36005505,PERFUSIONIST HYBRID SUPPORT,543.0,352.95,118.37,543.0,58
CDM,36005515,PERFUSIONIST VAD .25HR,543.0,352.95,118.37,543.0,58
CDM,36005555,PULSATILE PERFUSION,6609.0,4295.85,1440.76,6609.0,58
CDM,36005695,VENO-VENO PERFUSIONIST,1138.0,739.7,248.08,1138.0,58
CDM,36005705,INJECTION AA&/STRD FEMORAL NERVE W/IMG GDN,4778.0,3105.7,81.71,12615.0,86
CDM,36005715,INJECTION AA&/STRD OTHER PERIPHERAL NERVE/BRANCH,4778.0,3105.7,50.31,4778.0,87
CDM,36005745,AUTOGRAFT,244.0,158.6,53.19,244.0,58
CDM,36005750,BRONCHOSCOPY W/PLMT FIDUCIAL MARKERS SINGLE/MULT,31843.0,20697.95,237.4,31843.0,87
CDM,36005765,DERMABRASION TOTAL FACE,8586.0,5580.9,585.62,12615.0,86
CDM,36005775,BX BREAST W/DEVICE ADDL LESION STEREOTACT GUID,2550.0,1657.5,94.46,5265.0,69
CDM,36005785,BX BREAST W/DEVICE 1ST LESION ULTRASOUND GUID,11180.0,7267.0,177.13,11180.0,86
CDM,36005795,BX BREAST W/DEVICE ADDL LESION ULTRASOUND GUID,2629.0,1708.85,88.56,5265.0,69
CDM,36005805,BX BREAST W/DEVICE 1ST LESION MAGNETIC RES GUID,11180.0,7267.0,206.71,11180.0,87
CDM,36005815,BX BREAST W/DEVICE ADDL LESION MAGNET RES GUID,2503.0,1626.95,103.19,5265.0,69
CDM,36005835,PERQ DEVICE PLACEMENT BREAST LOC 1ST LES W/GDNCE,4861.0,3159.65,113.64,6112.0,87
CDM,36005845,PERQ BREAST LOC DEVICE PLACEMT 1ST LESIO US IMAG,2111.0,1372.15,97.51,4628.0,87
CDM,36005855,PERQ BREAST LOC DEVICE PLACEMT EACH LES US IMAGE,2111.0,1372.15,48.93,4628.0,69
CDM,36005865,PERQ BREAST LOC DEVICE PLACEMT 1ST LESIO MR GUID,2111.0,1372.15,144.99,7431.0,87
CDM,36005885,INJECTION SINGLE/MLT TRIGGER POINT 3/> MUSCLES,1358.0,882.7,52.63,4628.0,86
CDM,36005895,ARTHROCNT ASPIR&/INJ SMALL JT/BURSAW/US REC RPRT,1358.0,882.7,53.08,12500.0,87
CDM,36005905,ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/US,3186.0,2070.9,59.85,12500.0,87
CDM,36005915,ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/US,1358.0,882.7,66.5,12500.0,87
CDM,36005925,ABLATJ BONE TUMOR CRYO PERQ W/IMG GDN WHEN PRFMD,32861.0,21359.65,405.52,32861.0,86
CDM,36005935,PERQ VERTEBROPLASTY UNI/BI INJECTION LUMBOSACRAL,14925.0,9701.25,470.4,33436.0,87
CDM,36005945,VERTEBROPLASTY EACH ADDL CERVICOTHOR/LUMBOSACRAL,4501.0,2925.65,237.46,33436.0,69
CDM,36005955,PERQ VERT AGMNTJ CAVITY CRTJ UNI/BI CANNULATION,32861.0,21359.65,578.6,33436.0,87
CDM,36005965,PERQ VERT AGMNTJ CAVITY CRTJ UNI/BI CANNULJ LMBR,32861.0,21359.65,540.23,33436.0,87
CDM,36005975,PERQ VERT AGMNTJ CAVITY CRTJ UNI/BI CANNULJ EACH,10937.0,7109.05,244.44,33436.0,69
CDM,36005985,TENOTOMY ELBOW LATERAL/MEDIAL PERCUTANEOUS,14925.0,9701.25,476.83,14925.0,87
CDM,36005995,EXCISION TUMOR SOFT TISSUE PELVIS&HIP SUBQ 3CM/>,13165.0,8557.25,552.59,13165.0,87
CDM,36005OH,NJX PX XTR VNGRPH W/INTRO NDL/INTRACATH,418.0,271.7,1.1,836.09,148
CDM,36006025,APPLICATION FINGER SPLINT STATIC,593.0,385.45,33.14,12500.0,86
CDM,36006065,INSJ OF SUBQ IMPLANTABLE DEFIBRILLATOR ELECTRODE,19720.0,12818.0,508.72,19720.0,86
CDM,36006075,RMVL OF SUBQ IMPLANTABLE DEFIBRILLATOR ELECTRODE,20926.0,13601.9,386.06,20926.0,86
CDM,36006085,REPOS PREVIOUSLY IMPLANTED SUBQ IMPLANTABLE DFB,20926.0,13601.9,448.76,20926.0,86
CDM,36006095,TCAT MITRAL VALVE REPAIR INITIAL PROSTHESIS,17007.0,11054.55,2012.87,17007.0,68
CDM,36006105,TCAT MITRAL VALVE REPAIR ADDL PROSTHESIS,7874.0,5118.1,473.07,16547.65,68
CDM,36006115,ECMO/ECLS INITIATION VENO-VENOUS,2495.0,1621.75,361.1,12615.0,68
CDM,36006125,ECMO/ECLS INITIATION VENO-ARTERIAL,2757.0,1792.05,397.98,12615.0,68
CDM,36006135,ECMO/ECLS DAILY MANAGEMENT EACH DAY VENO-VENOUS,1967.0,1278.55,284.29,12615.0,68
CDM,36006145,ECMO/ECLS DAILY MANAGEMENT EA DAY VENO-ARTERIAL,1913.0,1243.45,275.04,12615.0,68
CDM,36006155,ECMO/ECLS INSJ OF PRPH CANNULA 6 YRS&OLDER PERQ,2673.0,1737.45,494.05,12615.0,68
CDM,36006165,COLLECT BLOOD FROM IMPLANT VENOUS ACCESS DEVICE,741.0,481.65,35.72,12500.0,86
CDM,36006185,TCATH STENT PLACEMT ANTEGRADE CAROTID/INNOMINATE,15787.0,10261.55,937.52,15787.0,68
CDM,36006205,OPEN/PERQ PLACEMENT INTRAVASCULAR STENT EA ADDL,14042.0,9127.3,242.9,14042.0,68
CDM,36006215,OPEN/PERQ PLACEMENT INTRAVASCULAR STENT SAME 1ST,36934.0,24007.1,352.78,36934.0,86
CDM,36006225,OPEN/PERQ PLACEMENT INTRAVASC STENT SAME EA ADDL,13832.0,8990.8,172.16,13832.0,68
CDM,36006245,VASCULAR EMBOLIZATION OR OCCLUSION VENOUS RS&I,65208.0,42385.2,497.34,65208.0,86
CDM,36006250,SLCTV CATH CAROTID/INNOM ART ANGIO XTRCRANL ART,18098.0,11763.7,321.26,18098.0,86
CDM,36006255,VASCULAR EMBOLIZATION OR OCCLUSION ARTERIAL RS&I,58667.0,38133.55,553.87,58667.0,86
CDM,36006265,VASCULAR EMBOLIZE/OCCLUDE ORGAN TUMOR INFARCT,65208.0,42385.2,657.7,65208.0,86
CDM,36006275,VASCULAR EMBOLIZATION OR OCCLUSION HEMORRHAGE,45626.0,29656.9,771.52,45626.0,86
CDM,36006285,UNLISTED PROCEDURE HEMIC/LYMPH,1423.0,924.95,376.61,4628.0,84
CDM,36006295,BIOPSY SALIVARY GLAND NEEDLE,3237.0,2104.05,60.54,4628.0,86
CDM,36006305,EGD FLEX REMOVAL LESION(S) BY HOT BIOPSY FORCEPS,8726.0,5671.9,197.49,8726.0,87
CDM,36006315,EGD TRANSORAL CONTROL BLEEDING ANY METHOD,8726.0,5671.9,232.25,8726.0,87
CDM,36006325,REPAIR FIST W/PLUG,10711.0,6962.15,786.42,10711.0,84
CDM,36006335,ILEOSCOPY STOMA W/BX SINGLE/MULTIPLE,4313.0,2803.45,86.54,6112.0,87
CDM,36006345,BX ANORECTAL WALL ANAL APPROACH,12615.0,8199.75,368.36,12615.0,87
CDM,36006355,PROCTOSGMDSC RGD DX W/WO COLLJ SPEC BR/WA SPX,4194.0,2726.1,57.12,4628.0,86
CDM,36006375,HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS,4194.0,2726.1,236.61,4628.0,87
CDM,36006405,ABLATION 1/> LIVER TUMOR PERQ CRYOABLATION,47892.0,31129.8,535.95,47892.0,86
CDM,36006415,IMAGE-GUIDE FLUID COLLXN DRAINAGE CATH VISC PERQ,7453.0,4844.45,226.96,10364.0,86
CDM,36006425,IMG-GUIDE FLUID COLLXN DRAINAG CATH PERITON PERQ,7453.0,4844.45,226.96,10364.0,86
CDM,36006445,IMAGE FLUID COLLXN DRAINAG CATH TRANSREC/VAGINAL,7453.0,4844.45,243.13,7453.0,86
CDM,36006455,INSJ TEMP NDWELLG BLADDER CATHETER COMPLICATED,720.0,468.0,49.68,4628.0,86
CDM,36006465,BIOPSY OVARY UNI/BI SEPARATE PROCEDURE,14626.0,9506.9,488.44,14626.0,87
CDM,36006475,MYELOGRAPHY VIA LUMBAR INJECTION RS&I THORACIC,5451.0,3543.15,137.29,7948.0,86
CDM,36006485,MYELOGRAPHY VIA LUMBAR INJECT RS&I LUMBOSACRAL,5451.0,3543.15,135.47,7948.0,86
CDM,36006495,MYELOGRAPHY VIA LUMBAR INJECTION RS&I 2+ REGIONS,5451.0,3543.15,141.19,7948.0,86
CDM,36006525,CHEMODENERVATION ONE EXTREMITY 1-4 MUSCLE,4778.0,3105.7,119.14,12500.0,87
CDM,36006535,LIVER ELASTOGRAPHY W/O IMAG W/I&R,720.0,468.0,0.01,720.0,86
CDM,36006545,TRANSCATHETER RENAL SYMPATH DENERVATION BILAT,12979.0,8436.35,3608.16,12979.0,84
CDM,36006620,BX BREAST W/DEVICE 1ST LESION STEREOTACTIC GUID,11180.0,7267.0,187.9,11180.0,87
CDM,36006655,PERQ SFT TISS LOC DEVICE PLMT 1ST LES W/GDNCE,2111.0,1372.15,96.97,4628.0,86
CDM,36006665,PERQ SFT TISS LOC DEVICE PLMT ADD LES W/GDNCE,617.0,401.05,49.3,4628.0,68
CDM,36006675,INCISION & REMOVAL FOREIGN BODY SUBQ TISS SIMPLE,1199.0,779.35,129.95,12500.0,86
CDM,36006685,DESTRUCTION BENIGN LESIONS UP TO 14,596.0,387.4,80.41,12500.0,86
CDM,36006695,PERQ BREAST LOC DEVICE PLACEMT 1ST STRTCTC GDNCE,2111.0,1372.15,114.37,4628.0,87
CDM,36006705,PERQ BREAST LOC DEVICE PLACEMT EA LESION STRTCTC,2111.0,1372.15,57.53,4628.0,69
CDM,36006715,PERQ BREAST LOC DEVICE PLACEMT ADD LESIO MR GUID,2111.0,1372.15,73.02,4628.0,69
CDM,36006725,INJECTION THERAPEUTIC CARPAL TUNNEL,1358.0,882.7,63.09,4628.0,86
CDM,36006735,ASPIRATION & INJECTION TREATMENT BONE CYST,3237.0,2104.05,182.36,12500.0,86
CDM,36006740,PERQ DEVICE PLACEMT BREAST LOC EA LESION W/GDNCE,4861.0,3159.65,56.97,4861.0,69
CDM,36006745,RMVL FOREIGN BODY UPPER ARM/ELBOW SUBCUTANEOUS,7453.0,4844.45,172.74,12615.0,86
CDM,36006755,INTUBATION ENDOTRACHEAL EMERGENCY PROCEDURE,1068.0,694.2,175.91,4628.0,86
CDM,36006765,BRNCHSC EBUS GUIDED SAMPL 1/2 NODE STATION/STRUX,16960.0,11024.0,266.76,16960.0,87
CDM,36006775,BRNCHSC EBUS GUIDED SAMPL 3/> NODE STATION/STRUX,16960.0,11024.0,295.61,16960.0,87
CDM,36006785,BRNSCHSC TNDSC EBUS DX/TX INTERVENTION PERPH LES,1777.0,1155.05,81.35,4628.0,69
CDM,36006795,TUBE THORACOSTOMY INCLUDES WATER SEAL,7146.0,4644.9,185.81,7146.0,87
CDM,36006805,UNLISTED PROC LUNG/PLEURA,1845.0,1199.25,512.91,12615.0,84
CDM,36006815,INS PM PLS GEN W/EXIST SINGLE LEAD,22737.0,14779.05,362.24,22737.0,87
CDM,36006825,RPSG PREV IMPLTED CAR VEN SYS L VENTR ELTRD,18098.0,11763.7,539.11,18098.0,86
CDM,36006835,INSJ IMPLNTBL DEFIB PULSE GEN W/EXIST DUAL LEADS,42695.0,27751.75,416.46,42695.0,86
CDM,36006840,OPEN/PERQ PLACEMENT INTRAVASCULAR STENT INITIAL,40064.0,26041.6,505.6,40064.0,86
CDM,36006845,TCAT PULMONARY VALVE IMPLANTATION PRQ APPROACH,18215.0,11839.75,1481.09,18215.0,68
CDM,36006855,REPOSITIONING PERQ R/L VAD W/IMG GDN SEP INSJ,2888.0,1877.2,185.46,12615.0,68
CDM,36006865,INJECTION PX PRQ TX EXTREMITY PSEUDOANEURYSM,3555.0,2310.75,120.42,4628.0,86
CDM,36006875,SUPSLCTV CATH 2ND+ORD RENAL&ACCESSORY ARTERY/S&I,18098.0,11763.7,468.13,18098.0,86
CDM,36006885,INSJ NON-TUNNELED CENTRAL VENOUS CATH AGE < 5 Y,18098.0,11763.7,108.87,18098.0,87
CDM,36006895,RPR CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ SIT,8932.0,5805.8,214.41,8932.0,87
CDM,36006905,PRIM PRQ TRLUML MCHNL THRMBC N-COR N-ICRA SBSQ,5539.0,3600.35,186.83,5539.0,68
CDM,36006915,REPSNG INTRVAS VC FILTR W/WO ACS VSL SELXN RS&I,18098.0,11763.7,402.06,18098.0,86
CDM,36006945,INTRAVASCULAR US NONCORONARY RS&I INTIAL VESSEL,6837.0,4444.05,103.53,6837.0,68
CDM,36006955,INTRAVASCULAR US NONCORONARY RS&I ADDL VESSEL,4671.0,3036.15,82.05,4671.0,68
CDM,36006975,DIAGNOSTIC BONE MARROW ASPIRATIONS,6481.0,4212.65,74.5,6481.0,87
CDM,36006995,NJX CHOLANGIO PRQ W/IMG GID RS&I EXISTING ACCESS,16234.0,10552.1,81.86,16234.0,86
CDM,36007005,NJX CHOLANGIO PRQ W/IMG GID RS&I NEW ACCESS,16234.0,10552.1,246.32,16234.0,86
CDM,36007015,PRQ PLMT BILIARY DRG CATH W/IMG GID RS&I EXTERNL,16234.0,10552.1,308.03,16234.0,87
CDM,36007025,PRQ PLMT BILIARY DRG CATH W/IMG GID RS&I INT-EXT,16234.0,10552.1,431.16,16234.0,87
CDM,36007035,CONV EXT BIL DRG CATH TO INT-EXT BIL DRG CATH,16234.0,10552.1,228.91,16234.0,87
CDM,36007045,EXCHANGE BILIARY DRG CATHETER PRQ W/IMG GID RS&I,16234.0,10552.1,154.11,16234.0,86
CDM,36007055,REMOVAL BILIARY DRG CATHETER REQ FLUOR GID RS&I,4313.0,2803.45,111.86,6112.0,86
CDM,36007060,ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/US,3186.0,2070.9,59.85,12500.0,87
CDM,36007065,PLMT BILE DUCT STENT PRQ EXISTING ACCESS,26838.0,17444.7,273.9,26838.0,86
CDM,36007075,PLMT BILE DUCT STENT PRQ NEW ACCESS W/O SEP CATH,26838.0,17444.7,497.52,26838.0,86
CDM,36007085,PLMT BILE DUCT STENT PRQ NEW ACCESS W/SEP CATH,26838.0,17444.7,512.27,26838.0,86
CDM,36007095,PLMT ACCESS THRU BILIARY TREE INTO SMALL BWL NEW,28703.0,18656.95,393.69,28703.0,87
CDM,36007100,PERQ VERTEBROPLASTY UNI/BI INJX CERVICOTHORACIC,14925.0,9701.25,499.97,33436.0,87
CDM,36007105,BALLOON DILAT BILIARY DUCT/AMPULLA PRQ EACH DUCT,4129.0,2683.85,159.58,4628.0,68
CDM,36007115,ENDOLUMINAL BX BILIARY TREE PRQ ANY METH 1/MLT,3810.0,2476.5,167.81,4628.0,68
CDM,36007125,REMOVAL BILIARY DUCT &/GLBLDR CALCULI PERQ RS&I,4661.0,3029.65,183.5,4661.0,68
CDM,36007135,SCLEROTHERAPY FLUID COLLECTION PRQ W/IMG GID,7453.0,4844.45,140.17,11545.0,87
CDM,36007155,NJX PX ANTEGRDE NFROSGRM &/URTRGRM NEW ACCESS,3070.0,1995.5,179.7,5597.0,86
CDM,36007165,NJX PX ANTEGRDE NFROSGRM &/URTRGRM EXSTNG ACESS,3070.0,1995.5,76.45,5597.0,86
CDM,36007175,PLMT NEPHROSTOMY CATH PRQ NEW ACCESS RS&I,9423.0,6124.95,238.53,11545.0,87
CDM,36007185,PLMT NEPHROURETERAL CATH PRQ NEW ACCESS RS&I,15865.0,10312.25,296.09,15865.0,87
CDM,36007195,CONVERT NEPHROSTOMY CATH TO NEPHROURTRL CATH PRQ,9423.0,6124.95,223.64,9423.0,87
CDM,36007200,MYELOGRAPHY VIA LUMBAR INJECTION RS&I CERVICAL,5451.0,3543.15,137.47,7948.0,86
CDM,36007205,EXCHANGE NEPHROSTOMY CATHETER PRQ W/IMG GID RS&I,9423.0,6124.95,115.84,9423.0,87
CDM,36007215,ABLTJ 1/> RENAL TUMOR PRQ UNI RADIOFREQUENCY,26838.0,17444.7,397.94,26838.0,86
CDM,36007225,ENDOLUMINAL BX URTR &/RNL PELVIS NONENDOSCOPIC,604.0,392.6,131.67,6569.77,68
CDM,36007235,PLMT URTRL STENT PRQ PRE-EXISTING NFROS TRACT,15865.0,10312.25,236.69,15865.0,87
CDM,36007245,PLMT URTRL STNT PRQ NEW ACESS W/O SEP NFROS CATH,15865.0,10312.25,308.97,15865.0,87
CDM,36007255,PLMT URTRL STENT PRQ NEW ACCESS W/SEP NFROS CATH,15865.0,10312.25,396.46,15865.0,87
CDM,36007265,URETERAL EMBOLIZATION/OCCLUSION W/IMG GID RS&I,604.0,392.6,131.67,6569.77,68
CDM,36007270,INS/RPLCMNT PERM SUBQ IMPLTBL DFB W/SUBQ ELTRD,52228.0,33948.2,618.21,52228.0,86
CDM,36007275,BALLOON DILAT URETERAL STRICTURE W/IMG GID RS&I,1306.0,848.9,212.27,6569.77,68
CDM,36007285,CYSTO/PYELOSCOPY BX&/FULGURATION PELIVC LESION,23385.0,15200.25,486.04,23385.0,87
CDM,36007295,CISTERNAL/LATERAL C1-C2 PUNCTURE W/INJECTION,2037.0,1324.05,130.26,4628.0,87
CDM,36007305,PERQ BALO DILA IC VSPSM EA VSL SM VASC TER,8352.0,5428.8,1820.74,12615.0,66
CDM,36007315,PERQ ART TRLUML M-THROMBEC &/NFS INTRACRANIAL,11994.0,7796.1,981.03,19185.0,68
CDM,36007325,EVASC INTRACRANIAL PROLNG ADMN RX AGENT ART 1ST,6801.0,4420.65,690.04,12615.0,68
CDM,36007335,EVASC INTRACRANIAL PROLNG ADMN RX AGENT ART ADDL,6241.0,4056.65,295.38,12615.0,68
CDM,36007345,CHEMODERVATE FACIAL/TRIGEM/CERV MUSC MIGRAINE,2037.0,1324.05,142.05,12500.0,87
CDM,36007355,CHEMODENERVATION MUSCLE NECK UNILAT FOR DYSTONIA,2037.0,1324.05,126.43,12500.0,87
CDM,36007365,CHEMODENERVATION 1 EXTREMITY EA ADDL 1-4 MUSCLE,2766.0,1797.9,77.02,4628.0,69
CDM,36007375,CHEMODENERVATION 1 EXTREMITY 5 OR MORE MUSCLES,4778.0,3105.7,129.12,12500.0,87
CDM,36007385,CHEMODENERVATION 1 EXTREMITY EA ADDL 5/> MUSCLES,2229.0,1448.85,88.98,4628.0,69
CDM,36007400,RMVL NDWELLG TUNNELED PLEURAL CATHETER W/CUFF,2844.0,1848.6,186.94,12500.0,87
CDM,36007405,PROLOTHERAPY,392.0,254.8,0.01,392.0,66
CDM,36007425,FASCIECTOMY PLANTAR FASCIA PARTIAL,14925.0,9701.25,432.13,14925.0,87
CDM,36007435,INJ/ASP ECTOPIC PREGNANCY,2158.0,1402.7,172.88,4628.0,84
CDM,36007445,INJECTION AA&/STRD LUMBAR PLEXUS CONT NFS CATH,6143.0,3992.95,80.0,6143.0,87
CDM,36007455,DEST NERVE OTHER PERIPH,1696.0,1102.4,369.73,1696.0,58
CDM,36007465,NJX AA&/STRD TFRML EPI CERVICAL/THORACIC 1 LEVEL,6143.0,3992.95,153.11,6143.0,87
CDM,36007485,DSTRJ NULYT W/WORAD MNTR SUPRIOR HYPOGSTR PLEXUS,6143.0,3992.95,254.07,6143.0,87
CDM,36007550,REPLACE AORTIC VALVE PERQ FEMORAL ARTRY APPROACH,15117.0,9826.05,1377.36,16547.65,68
CDM,36007560,BRNCHSC EBUS GUIDED SAMPL 1/2 NODE STATION/STRUX,16960.0,11024.0,266.76,16960.0,87
CDM,36007570,BRNCHSC EBUS GUIDED SAMPL 3/> NODE STATION/STRUX,16960.0,11024.0,295.61,16960.0,87
CDM,36007600,DIAGNOSTIC BONE MARROW BIOPSIES,6481.0,4212.65,77.81,6481.0,87
CDM,36007630,PERQ SFT TISS LOC DEVICE PLMT 1ST LES W/GDNCE,1448.0,941.2,96.97,4628.0,86
CDM,36007880,NJX PX ANTEGRDE NFROSGRM &/URTRGRM NEW ACCESS,3070.0,1995.5,179.7,5597.0,86
CDM,36008115,LIGATION/BIOPSY TEMPORAL ARTERY,9316.0,6055.4,232.26,9316.0,87
CDM,36008155,PERQ CLSR TCAT L ATR APNDGE W/ENDOCARDIAL IMPLNT,13060.0,8489.0,763.6,16547.65,68
CDM,36008165,INTRO CATH DIALYSIS CIRCUIT DX ANGRPH FLUOR S&I,8932.0,5805.8,195.77,12500.0,87
CDM,36008175,INTRO CATH DIALYSIS CIRCUIT W/TRLUML BALO ANGIOP,32784.0,21309.6,279.82,32784.0,87
CDM,36008185,INTRO CATH DIALYSIS CIRCUIT W/TCAT PLMT IV STENT,32239.0,20955.35,368.44,32239.0,87
CDM,36008195,PERQ THRMBC/NFS DIALYSIS CIRCUIT IMG DX ANGRPH,32784.0,21309.6,428.3,32784.0,87
CDM,36008205,PERQ THRMBC/NFS DIAL CIRCUIT TRLUML BALO ANGIOP,65208.0,42385.2,516.28,65208.0,87
CDM,36008215,PERQ THRMBC/NFS DIAL CIRCUIT TCAT PLMT IV STENT,53185.0,34570.25,596.04,53185.0,87
CDM,36008225,TRLUML BALO ANGIOP CTR DIALYSIS SEG W/IMG S&I,16227.0,10547.55,170.73,16227.0,69
CDM,36008235,STENT PLMT CENTRAL DIAYLSIS SEG PFRMD DIAL CIR,24406.0,15863.9,241.82,24406.0,69
CDM,36008240,TRLML BALO ANGIOP OPEN/PERQ IMG S&I 1ST ART,32784.0,21309.6,404.56,32784.0,87
CDM,36008245,DIALYIS CIRCUIT VASC EMBOLI OCCLS EVASC IMG S&I,22770.0,14800.5,234.01,22770.0,69
CDM,36008255,TRLML BALO ANGIOP OPEN/PERQ IMG S&I 1ST ART,32784.0,21309.6,404.56,32784.0,87
CDM,36008265,TRLML BALO ANGIOP OPEN/PERQ IMG S&I EA ADDL ART,7206.0,4683.9,200.75,10789.0,69
CDM,36008275,TRLML BALO ANGIOP OPEN/PERQ W/IMG S&I 1ST VEIN,32784.0,21309.6,346.14,32784.0,87
CDM,36008285,TRLML BALO ANGIOP OPEN/PERQ W/IMG S&I ADDL VEIN,5404.0,3512.6,169.46,10789.0,69
CDM,36008305,NDSC DCMPRN SPINAL CORD 1 W/LAMOT NTRSPC LUMBAR,49292.0,32039.8,3812.17,49292.0,85
CDM,36008350,NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN,4778.0,3105.7,117.63,4778.0,87
CDM,36008395,CORDOCENTESIS INTRAUTERINE,1217.0,791.05,236.15,12615.0,86
CDM,36008400,LAPAROTOMY ISLET CELL TRANSP,8688.0,5647.2,0.01,12615.0,68
CDM,36008410,LARYNGOSCOPY EXC TUM&/STRIPPING CORDS/EPIGLOTT,16960.0,11024.0,267.22,16960.0,87
CDM,36008420,LARYNGOSCOPY FLEXIBLE ABLATJ DESTJ LESION(S) UNI,16960.0,11024.0,200.24,16960.0,87
CDM,36008425,TCAT PLMT XTRC VRT CRTD STENT RS&IPRQ EA VSL,6300.0,4095.0,75.0,12615.0,66
CDM,36008430,BRONCHOSCOPY BALLOON OCCLUSION,31843.0,20697.95,228.41,31843.0,87
CDM,36008575,ANES PRE-POST OP BLOCK,659.0,428.35,143.66,659.0,58
CDM,36008605,THORACOSCOPY W/BX PLEURA,19238.0,12504.7,4193.88,19238.0,58
CDM,36008855,"CATH UMBILICAL VEIN, DX",129.0,83.85,28.12,129.0,58
CDM,36009205,INJECTION PX DISCOGRPHY EA LVL CERVICAL/THORACIC,1528.0,993.2,81.99,4628.0,68
CDM,36009215,IMPLTJ/RPLCMT ITHCL/EDRL DRUG NFS SUBQ RSVR,34890.0,22678.5,375.14,34890.0,87
CDM,36009235,OPEN IMPLANTATION NEA SACRAL NERVE,18249.0,11861.85,769.27,18249.0,79
CDM,36009255,DSTRJ NEUROLYTIC AGENT PUDENDAL NERVE,6143.0,3992.95,229.36,6143.0,87
CDM,36009275,UNLISTED PROCEDURE SPINE,2412.0,1567.8,204.59,4628.0,84
CDM,36009285,PERQ VERTEBROPLASTY UNI/BI INJX CERVICOTHORACIC,14925.0,9701.25,499.97,33436.0,87
CDM,36009525,INJ PX URETEROGRAPHY/URETEROPYLOGRAPHY CATH,526.0,341.9,59.18,4628.0,68
CDM,36009565,TRLUML PERIPH ATHRC W/RS&I ABDOM AORTA,45362.0,29485.3,3924.0,45362.0,84
CDM,36009625,XTRNL CANNULA DECLTNG SPX W/BALO CATH,31083.0,20203.95,157.59,31083.0,87
CDM,36009635,XTRNL CANNULA DECLTNG SPX W/O BALO CATH,8932.0,5805.8,124.89,8932.0,87
CDM,36009705,INTRO CATHETER RIGHT HEART/MAIN PULMONARY ARTERY,2942.0,1912.3,148.4,4628.0,68
CDM,36009745,EGD PERCUTANEOUS PLACEMENT GASTROSTOMY TUBE,8726.0,5671.9,231.27,8726.0,87
CDM,36009825,EXC NEUROMA CUTAN NRV SURGLY IDENTIFIABLE,13474.0,8758.1,500.41,13474.0,87
CDM,36009835,TRACHEOSTOMA REVJ SMPL W/O FLAP ROTATION,14918.0,9696.7,497.63,14918.0,79
CDM,36009845,LARGSC EXC TUM&/STRPG CORDS/EPIGL MCRSCP/TLSCP,16960.0,11024.0,291.06,16960.0,87
CDM,36009855,PWR BONE MARROW BX NEEDLE 152 MM,146.0,94.9,31.83,232.66,67
CDM,36009905,EVASC RPR DPLMNT AORTO-BI-ILIAC NDGFT,30452.0,19793.8,1759.22,30452.0,69
CDM,36010175,OVARIAN CSTC UNI/BILAT,9068.0,5894.2,1976.82,9068.0,58
CDM,36010445,RMVL PERITONEAL-VENOUS SHUNT,14478.0,9410.7,538.85,14478.0,87
CDM,36010495,INJECTION MUSCULOSKELETAL SYSTEM,343.0,222.95,95.35,4628.0,84
CDM,36010505,DRY NEEDLE TRIGGER POINT INJECTION,343.0,222.95,95.35,4628.0,84
CDM,36010515,INSERT HIS ELECTRODE,2070.0,1345.5,545.0,12615.0,84
CDM,36010645,INTRALESIONAL STEROID INJ,1226.0,796.9,211.91,12615.0,84
CDM,36010675,PROC MATERNITY CARE UNLISTD - IUPC,351.0,228.15,97.58,4628.0,84
CDM,36010755,LARYNGOSCOPY W/WO TRACHEOSCOPY W/MICRO/TELESCOPE,7933.0,5156.45,174.18,7933.0,87
CDM,36010825,REMOVAL SKN TAGS MLT FIBRQ TAGS ANY AREA UPW/15,596.0,387.4,88.41,12500.0,86
CDM,36010965,EXC B9 LESION MRGN XCP SK TG T/A/L 1.1-2.0 CM,2111.0,1372.15,126.78,4628.0,87
CDM,36010975,EXC B9 LESION MRGN XCP SK TG T/A/L 2.1-3.0 CM,2111.0,1372.15,168.13,4628.0,87
CDM,36010OH,INTRO. OF CATH SUP/INF VENA CAVA,872.0,566.8,1.1,1768.67,148
CDM,36011155,BLADDER INSTILLATION ANTICARCINOGENIC AGENT,3070.0,1995.5,51.01,4628.0,86
CDM,36011365,BIOPSY SOFT TISSUE THIGH/KNEE AREA SUPERFICIAL,7453.0,4844.45,195.73,7453.0,87
CDM,36011375,EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 1.1-2.0CM,4861.0,3159.65,154.63,4861.0,87
CDM,36011435,EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 0.6-1.0CM,2111.0,1372.15,123.15,4628.0,87
CDM,36011445,EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 0.5 CM/<,4861.0,3159.65,95.4,4861.0,86
CDM,36011465,INSERTION INTRAUTERINE DEVICE IUD,502.0,326.3,68.6,12500.0,66
CDM,36011585,REMOVAL INTRAUTERINE DEVICE IUD,1399.0,909.35,68.6,4628.0,86
CDM,36011595,TRANSPERINEAL PLMT NDL/CATHS PROSTATE RADJ INSJ,23385.0,15200.25,898.67,33436.0,87
CDM,36011715,EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION,11488.0,7467.2,493.27,11488.0,87
CDM,36011775,INS/RPLCMNT PERM SUBQ IMPLTBL DFB W/SUBQ ELTRD,52228.0,33948.2,618.21,52228.0,86
CDM,36011785,INJECTION SINUS TRACT DIAGNOSTIC,1078.0,700.7,42.63,4628.0,68
CDM,36011795,REVJ OPN ARVEN FSTL W/O THRMBC DIAL GRF,31083.0,20203.95,867.35,31083.0,87
CDM,36011895,BILAT  PUDENDAL NRV PULSED RF ABLATION,860.0,559.0,239.08,4628.0,84
CDM,36011OH,SLCTV CATH PLMT VEN SYS 1ST ORDER BRANCH,1256.0,816.4,1.1,2630.86,148
CDM,36012595,EVASC RPR DPLMNT AORTO-AORTIC NDGFT,29773.0,19352.45,1425.15,29773.0,69
CDM,36012605,EVASC RPR DPLMNT AORTO-AORTIC NDGFT RPT,6478.0,4210.7,1412.2,19185.0,69
CDM,36012615,EVASC RPR DPLMNT AORTO-UN-ILIAC NDGFT,15837.0,10294.05,1582.61,19185.0,69
CDM,36012625,EVASC RPR DPLMNT AORTO-UN-ILIAC NDGFT RPT,15837.0,10294.05,2601.25,19185.0,69
CDM,36012645,EVASC RPR DPLMNT AORTO-BI-ILIAC NDGFT RPT,15837.0,10294.05,2631.45,19185.0,69
CDM,36012655,EVASC RPR DPLMNT ILIO-ILIAC NDGFT,15837.0,10294.05,1341.45,17833.0,69
CDM,36012665,EVASC RPR DPLMNT ILIO-ILIAC NDGFT RPT,15837.0,10294.05,2121.49,17833.0,69
CDM,36012675,PLACEMENT XTN PROSTH FOR ENDOVASCULAR RPR,10262.0,6670.3,372.16,12094.67,69
CDM,36012685,DLYD PLACEMENT XTN PROSTH FOR EVASC RPR 1ST VSL,10262.0,6670.3,919.32,12094.67,69
CDM,36012695,DLYD PLACEMENT XTN PROSTH FOR EVASC RPR EA ADDL,10262.0,6670.3,341.31,12094.67,69
CDM,36012705,TRANSCATHETER DLVR ENHNCD FIXATION DEVICES RS&I,10262.0,6670.3,752.5,12094.67,69
CDM,36012715,PERQ ACCESS & CLOSURE FEM ART FOR DELIVERY NDGFT,9640.0,6266.0,142.54,12094.67,68
CDM,36012725,OPN FEM ART EXPOS W/CNDT CRTJ DLVR EVASC PROSTH,18660.0,12129.0,313.51,18660.0,68
CDM,36012775,ENDOVEN ABLTI THER CHEM ADHESIVE 1ST VEIN,31083.0,20203.95,205.64,31083.0,87
CDM,36012785,ENDOVEN ABLTI THER CHEM ADHESIVE SBSQ VEIN,3640.0,2366.0,102.64,5265.0,69
CDM,36012795,TMVI W/PROSTHETIC VALVE PERCUTANEOUS APPROACH,15044.0,9778.6,3279.59,16547.65,66
CDM,36012805,TMVI W/PROSTHETIC VALVE TRANSTHORACIC EXPOSURE,15043.0,9777.95,3279.37,16547.65,66
CDM,36012815,ABLATION THER 1+ PULM TUMORS PERQ CRYOABLATION,26695.0,17351.75,516.21,26695.0,87
CDM,36012825,ENDOVEN ABLTI THER CHEM ADHESIVE 1ST VEIN,31083.0,20203.95,205.64,31083.0,87
CDM,36012835,ENDOVEN ABLTI THER CHEM ADHESIVE SBSQ VEIN,3640.0,2366.0,102.64,5265.0,69
CDM,36012845,DIAGNOSTIC BONE MARROW BIOPSIES & ASPIRATIONS,11448.0,7441.2,84.63,11448.0,87
CDM,36012945,EVASC RPR DPLMNT ILIO-ILIAC NDGFT,15837.0,10294.05,1341.45,17833.0,69
CDM,36012OH,SLCTV CATH PLMT VEN SYS 2ND ORDER/> SLCTV BRANC,1404.0,912.6,1.1,2728.28,148
CDM,36013075,INSJ IMPLNTBL DEFIB PULSE GEN W/EXIST MULTILEADS,65538.0,42599.7,443.03,65538.0,86
CDM,36013085,INSJ IMPLNTBL DEFIB PULSE GEN W/1 EXISTING LD,50000.0,32500.0,400.37,50000.0,86
CDM,36013115,OPN FEM ART EXPOS DLVR EVASC PROSTH UNI,18660.0,12129.0,238.8,18660.0,68
CDM,36013135,EVASC PLACEMENT ILIAC ARTERY OCCLUSION DEVICE,26743.0,17382.95,234.84,26743.0,68
CDM,36013215,INJECTION AA&/STRD INTERCOSTAL NRV EA ADDL LVL,6143.0,3992.95,29.38,6143.0,87
CDM,36013235,NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN,6143.0,3992.95,98.33,6143.0,87
CDM,36013265,NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN,6143.0,3992.95,110.21,6143.0,87
CDM,36013325,NJX DX/THER SBST INTRLMNR CRV/THRC W/O IMG GDN,4778.0,3105.7,115.52,4778.0,87
CDM,36013345,NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN,4778.0,3105.7,117.63,4778.0,87
CDM,36013355,TAP BLOCK BILATERAL BY INJECTION(S),1407.0,914.55,78.32,4628.0,68
CDM,36013375,CEMENTOPLASTY-HIP,5072.0,3296.8,204.59,5072.0,84
CDM,36013765,NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL,6143.0,3992.95,129.97,6143.0,87
CDM,36013945,I&D HEMATOMA,3786.0,2460.9,825.35,3786.0,58
CDM,36013OH,INTRO CATHETER RIGHT HEART/MAIN PULMONARY ARTERY,1008.0,655.2,1.1,2561.67,148
CDM,36014235,EMBLC/THRMBC AX BRACH INNOMINATE SUBCLA ART,31082.0,20203.3,687.3,31082.0,86
CDM,36014255,CATHJ UMBILICAL VEIN DX/THER NB,129.0,83.85,28.12,12615.0,68
CDM,36014535,OVARIAN CYSTECTOMY UNI/BI,22708.0,14760.2,878.18,22708.0,87
CDM,36014655,"UNLISTED PROCEDURE, VASCULAR INJECTION",500.0,325.0,109.0,12615.0,66
CDM,36014735,BONE MARROW HARVEST TRANSPLANTATION AUTOLOGOUS,18741.0,12181.65,210.07,18741.0,86
CDM,36014815,TEAEC W/GRAFT SUPERFICIAL FEMORAL ARTERY,26191.0,17024.15,1289.7,26191.0,68
CDM,36014885,REMOVAL INTRA-AORTIC BALLOON ASSIST DEVICE PRQ,1387.0,901.55,38.26,12235.0,68
CDM,36014915,CT BIOPSY ADRENAL,740.0,481.0,205.72,10592.0,84
CDM,36014OH,SLCTV CATHETER PLMT LEFT/RIGHT PULMONARY ARTERY,1329.0,863.85,1.1,2567.0,148
CDM,36015245,OPEN/PERQ PLACEMENT INTRAVASCULAR STENT INITIAL,40064.0,26041.6,505.6,40064.0,86
CDM,36015255,NJX PX ANTEGRDE NFROSGRM &/URTRGRM EXSTNG ACESS,3070.0,1995.5,76.45,5597.0,86
CDM,36015265,EXCHANGE NEPHROSTOMY CATHETER PRQ W/IMG GID RS&I,9423.0,6124.95,115.84,9423.0,87
CDM,36015435,ANOSC RMVL 1 TUM POLYP/OTH LES SNARE TQ,4194.0,2726.1,94.7,6112.0,87
CDM,36015575,TEAEC W/WO PATCH GRAFT DEEP PROFUNDA FEMORAL,27821.0,18083.65,1126.97,27821.0,78
CDM,36015775,URETERONEOCYSTOSTOMY ANAST 1 URETER BLADDER,6857.0,4457.05,1302.37,12615.0,68
CDM,36015865,SALPINGECTOMY COMPLETE/PARTIAL UNI/BI SPX,4019.0,2612.35,876.14,10651.0,69
CDM,36015OH,SLCTV CATH PLMT SEGMENTAL/SUBSEGMENTAL PULM ART,1404.0,912.6,1.1,2780.62,148
CDM,36016325,ENDOVEN ABLTJ INCMPTNT VEIN XTR RF 1ST VEIN,18098.0,11763.7,317.89,33436.0,87
CDM,36016355,CYSTO W/INSERT URETERAL STENT,15865.0,10312.25,182.47,15865.0,87
CDM,36016515,ANOSCOPY ABLATION LESION,12615.0,8199.75,106.89,12615.0,79
CDM,36016525,CHANGE CYSTOSTOMY TUBE COMPLICATED,3070.0,1995.5,94.16,4628.0,87
CDM,36016585,REPLACE AORTIC VALVE PERQ FEMORAL ARTRY APPROACH,15117.0,9826.05,1377.36,16547.65,68
CDM,36016605,PUNCTURE SHUNT TUBE/RESERVOIR ASPIRATION/INJ PX,4778.0,3105.7,64.85,4778.0,87
CDM,36016745,NJX PX CNTRST KNE ARTHG CNTRST ENHNCD CT/MRI KNE,782.0,508.3,45.81,4628.0,68
CDM,36016755,INSERTION PICC W/RS&I < 5 YR,3555.0,2310.75,100.2,5597.0,87
CDM,36016765,INSERTION PICC W/RS&I 5 YR/>,8932.0,5805.8,97.86,8932.0,87
CDM,36016775,PERQ DILATION XST TRC ENDOUROLOGIC PX W/IMG,15865.0,10312.25,178.5,15865.0,87
CDM,36016785,PERQ DILATION XST TRC NEW ACCESS RENAL COLTJ SYS,15865.0,10312.25,297.63,15865.0,87
CDM,36016815,EXCISION INFECTED GRAFT EXTREMITY,18098.0,11763.7,646.01,18098.0,86
CDM,36016845,REMOVAL COMPLETE IIMS INCL IMG S&I,14557.0,9462.05,3007.01,14557.0,84
CDM,36016855,REMOVAL IIMS ELECTRODE ONLY INCL IMG S&I,14557.0,9462.05,806.19,14557.0,84
CDM,36016865,REMOVAL IIMS IMPLANTABLE MNTR ONLY INCL IMG S&I,14557.0,9462.05,3007.01,14557.0,84
CDM,36016905,TRURL DSTRJ PRST8 TISS RF WV THERMOTHERAPY,15865.0,10312.25,448.17,15865.0,86
CDM,36016945,NJX PX CNTRST KNE ARTHG CNTRST ENHNCD CT/MRI KNE,782.0,508.3,45.81,4628.0,68
CDM,36016955,INSERTION PICC W/RS&I < 5 YR,3555.0,2310.75,100.2,5597.0,87
CDM,36016965,INSERTION PICC W/RS&I 5 YR/>,8932.0,5805.8,97.86,8932.0,87
CDM,36016975,TRURL DSTRJ PRST8 TISS RF WV THERMOTHERAPY,15865.0,10312.25,448.17,15865.0,86
CDM,36017015,INSERTION WRLS CAR STIMULATOR LV PACG COMPL SYS,27833.0,18091.45,6021.0,27833.0,84
CDM,36017025,INSERTION WRLS CAR STIMULATOR LV PACG ELTRD ONLY,16020.0,10413.0,806.19,33436.0,85
CDM,36017035,INSERTION WRLS CAR STIMULATOR LV PACG BTH COMPNT,10800.0,7020.0,3002.4,33436.0,85
CDM,36017045,REMOVAL PG WCS LV PACG BATTERY COMPONENT ONLY,14557.0,9462.05,3007.01,14557.0,84
CDM,36017055,REMOVAL&RPLCMT PG WCS LV PACG BOTH COMPONENTS,41861.0,27209.65,6021.0,41861.0,84
CDM,36017065,RMVL&RPLCMT PG WCS LV PACG BATTERY COMPNT ONLY,18264.0,11871.6,5077.39,25280.05,84
CDM,36017075,INSERTION/REPLACEMENT COMPLETE IIMS,14990.0,9743.5,3924.0,20045.35,84
CDM,36017085,INSERTION/REPLACEMENT IIMS ELECTRODE ONLY,10838.0,7044.7,806.19,33436.0,85
CDM,36017095,INSERTION/REPLACEMENT IIMS IMPLANTABLE MNTR ONLY,33104.0,21517.6,3924.0,33436.0,85
CDM,36017115,PLC OF ENDOBRONCHIAL BLOCKER,969.0,629.85,171.85,4628.0,84
CDM,36017125,INDUCED ABORT 1/> VAG SUPP DLVR FETUS D&C &/EVAC,2895.0,1881.75,577.68,6112.0,69
CDM,36017205,INSERTION SUBQ CARDIAC RHYTHM MONITOR W/PRGRMG,14571.0,9471.15,96.22,14571.0,86
CDM,36017215,REMOVAL SUBCUTANEOUS CARDIAC RHYTHM MONITOR,4046.0,2629.9,94.71,4628.0,86
CDM,36017265,TCAT INSJ/RPL PERM LEADLESS PACEMAKER RV W/IMG,38008.0,24705.2,526.96,38008.0,86
CDM,36017275,TCAT REMOVAL PERM LEADLESS PM RIGHT VENTR W/IMG,18098.0,11763.7,563.73,18098.0,86
CDM,36017285,INSERTION SUBQ CARDIAC RHYTHM MONITOR W/PRGRMG,14571.0,9471.15,96.22,14571.0,86
CDM,36017295,REMOVAL SUBCUTANEOUS CARDIAC RHYTHM MONITOR,4046.0,2629.9,94.71,4628.0,86
CDM,36017315,FINE NEEDLE ASPIRATION BX W/US GDN 1ST LESION,3237.0,2104.05,84.23,4628.0,87
CDM,36017325,FINE NEEDLE ASPIRATION BX W/US GDN EA ADDL,942.0,612.3,58.24,4628.0,69
CDM,36017335,FINE NEEDLE ASPIRATION BX W/CT GDN 1ST LESION,3237.0,2104.05,127.26,4628.0,87
CDM,36017375,PUNCH BIOPSY SKIN SINGLE LESION,1199.0,779.35,50.78,12500.0,87
CDM,36017395,INCISIONAL BIOPSY SKIN SINGLE LESION,1836.0,1193.4,61.62,4628.0,87
CDM,36017445,TRIGEMINAL BALLOON COMPRESSION,3276.0,2129.4,256.95,4628.0,84
CDM,36017485,NJX DX/THER SBST INTRLMNR CRV/THRC W/IMG GDN,4778.0,3105.7,126.25,4778.0,87
CDM,36017525,INS TUNNEL CVAD W SUB Q PORT < 5,7158.0,4652.7,1560.44,7158.0,58
CDM,36017535,INJECTION AA&/STRD GREATER OCCIPITAL NERVE,2037.0,1324.05,58.85,4628.0,87
CDM,36017545,RPR HYPOSPADIAS COMPLCTJS DSJ & URTP FLAP/GRF,23385.0,15200.25,1186.68,23385.0,87
CDM,36017555,REPLACE TRICUSPID VALVE PERQ,12960.0,8424.0,545.0,12960.0,84
CDM,36017635,PERCUTANEOUS CRYOABLATION ABDOMEN,8123.0,5279.95,461.87,8123.0,84
CDM,36017865,INJECTION PROCEDURE SPLENOPORTOGRAPY,3430.0,2229.5,81.99,4628.0,68
CDM,36017905,TTVR PERCUTANEOUS APPROACH INITIAL PROSTHESIS,15117.0,9826.05,3295.51,16547.65,66
CDM,36017915,TTVR PERCUTANEOUS APPROACH EACH ADDL PROSTHESIS,7874.0,5118.1,1716.53,16547.65,66
CDM,36017925,INSJ/RPLCMT ICDS W/SUBSTERNAL ELECTRODE,46823.0,30434.95,7663.0,46823.0,84
CDM,36017935,INSJ SUBSTERNAL IMPLANTABLE DEFIBRILLATOR ELTRD,33104.0,21517.6,806.19,33104.0,84
CDM,36017945,RMVL SUBSTERNAL IMPLANTABLE DEFIBRILLATOR ELTRD,14557.0,9462.05,806.19,14557.0,84
CDM,36017955,REPOS PREV IMPL SS IMPLTBL DFB PACING ELTRD,14557.0,9462.05,806.19,14557.0,84
CDM,36017965,RMVL SUBSTERNAL IMPLTBL DFB PULSE GENERATOR ONLY,14557.0,9462.05,806.19,14557.0,84
CDM,36017975,ABLATION MAL BRST TUMOR PERQ CRTX UNILATERAL,15317.0,9956.05,1031.8,15317.0,84
CDM,36017985,TRURL ABLTJ MAL PRST8 TISS HI ENERGY WATER VAPOR,6764.0,4396.6,1880.39,13730.23,76
CDM,36017995,REVJ/ OR RMVL PERQ ISDNS BLDR DYSF PTN,13756.0,8941.4,284.76,13756.0,85
CDM,36018005,NEEDLE INSERTION W/O INJECTION 1 OR 2 MUSCLES,113.0,73.45,17.49,12500.0,86
CDM,36018015,NEEDLE INSERTION W/O INJECTION 3 OR MORE MUSCLES,113.0,73.45,22.7,12500.0,86
CDM,36018025,PERICARDIOCENTESIS W/IMG GUIDANCE WHEN PERFORMED,8932.0,5805.8,262.68,11545.0,87
CDM,36018035,PERQ PRCRD DRG 6YR+ W/O CONGENITAL CAR ANOMALY,5413.0,3518.45,275.54,12615.0,68
CDM,36018045,PERQ PRCRD DRG 0-5YR/ANY AGE W/CGEN CAR ANOMALY,5314.0,3454.1,322.62,12615.0,68
CDM,36018055,PERQ PERICARDIAL DRG W/INSJ NDWELLG CATH W/CT,5314.0,3454.1,243.0,12615.0,68
CDM,36018065,EVASC RPR ILIAC ART TM OF A-ILIAC ART NDGFT UNI,34625.0,22506.25,512.22,34625.0,68
CDM,36018105,DIAGNOSTIC LUMBAR SPINAL PUNCTURE W/FLUOR OR CT,4778.0,3105.7,99.72,4778.0,87
CDM,36018115,THERAPEUTIC SPINAL PNXR DRAINAGE CSF W/FLUOR/CT,4778.0,3105.7,121.65,4778.0,87
CDM,36018125,INJECTION AA&/STRD NERVES NRVTG SI JOINT W/IMG,4778.0,3105.7,96.29,4778.0,87
CDM,36018135,INJECTION AA&/STRD GENICULAR NRV BRANCHES W/IMG,4778.0,3105.7,97.17,4778.0,87
CDM,36018145,DESTRUCTION NEUROLYTIC AGT GENICULAR NERVE W/IMG,13474.0,8758.1,173.61,13474.0,87
CDM,36018155,RADIOFREQUENCY ABLTJ NRV NRVTG SI JT W/IMG GDN,13474.0,8758.1,230.6,13474.0,87
CDM,36018175,EVASC RPR ILIAC ART N/A A-ILIAC ART NDGFT UNI,31502.0,20476.3,1423.77,31502.0,68
CDM,36018185,PERQ PRCRD DRG 0-5YR/ANY AGE W/CGEN CAR ANOMALY,5314.0,3454.1,322.62,12615.0,68
CDM,36018195,PERQ PERICARDIAL DRG W/INSJ NDWELLG CATH W/CT,5314.0,3454.1,243.0,12615.0,68
CDM,36018205,TTVR PERCUTANEOUS APPROACH INITIAL PROSTHESIS,15117.0,9826.05,3295.51,16547.65,66
CDM,36018215,TTVR PERCUTANEOUS APPROACH EACH ADDL PROSTHESIS,7874.0,5118.1,1716.53,16547.65,66
CDM,36018225,PERICARDIOCENTESIS W/IMG GUIDANCE WHEN PERFORMED,8932.0,5805.8,262.68,11545.0,87
CDM,36018235,INJ ANESTHETIC AGENT PHRENIC NERVE UNIL,597.0,388.05,165.97,4628.0,84
CDM,36018245,BLOCK CERVICAL PLEXUS,659.0,428.35,183.2,4628.0,84
CDM,36018255,INJ ANESTHETIC AGENT PHRENIC NERVE BIL,1194.0,776.1,256.95,4628.0,84
CDM,36018265,INSTLJ VIA CHEST TUBE/CATH AGENT FOR PLEURODESIS,2844.0,1848.6,90.77,5265.0,87
CDM,36018305,DISRUPTION-FIBRIN SHEATH W/BALLOON,3448.0,2241.2,545.0,4628.0,85
CDM,36018355,REVASC ENDOV W/IVL INCL ANGIOPLASTY,65208.0,42385.2,2523.55,65208.0,84
CDM,36018365,REVASC ENDOV W/IVL W/STENT INCL ANGIOPLASTY,37311.0,24252.15,3924.0,37311.0,84
CDM,36018375,REVASC ENDOV W/IVL W/ATHERECTOMY INCL ANGIOPLASTY,103251.0,67113.15,3924.0,103251.0,84
CDM,36018385,REVASC ENDOV W/IVL W/STENT-ATHER INCL ANGIOPLASTY,34461.0,22399.65,7663.0,34461.0,84
CDM,36018415,PERITONEAL DIALYSIS CATHETER REVISION,7269.0,4724.85,461.87,7269.0,84
CDM,36018435,RPR NSL VLV COLLAPSE SUBQ/SBMCSL LAT WALL IMPLT,27212.0,17687.8,187.89,27212.0,87
CDM,36018445,ENDOVASCULAR VENOUS ARTERIALIZATION TIBL/PRNL VN,28378.0,18445.7,6021.0,45838.5,85
CDM,36018455,CORE NEEDLE BX LUNG/MEDIASTINUM PERQ W/IMG,7453.0,4844.45,178.29,11545.0,87
CDM,36018475,TIS CRTJ ST CONGENITAL CARDIAC ANOMAL 1ST SHUNT,5119.0,3327.35,1115.94,16547.65,68
CDM,36018485,TIS CRTJ ST CONGENITAL CARDIAC ANOMAL EA ADDL,3430.0,2229.5,476.6,16547.65,68
CDM,36018495,INSJ PERQ VAD W/RS&I R HEART VENOUS ACCESS ONLY,7664.0,4981.6,402.8,78966.82,68
CDM,36018515,PERQ NJX ALGC CELL &/PRDCT UNI/BI FLUOR LMBR 1ST,10021.0,6513.65,2602.0,33436.0,85
CDM,36018525,PERQ NJX ALGC CELL &/PRDCT UNI/BI FLUOR LMBR EA,885.0,575.25,192.93,4628.0,66
CDM,36018535,PERQ NJX ALGC CELL&/PRDCT UNI/BI CT LMBR 1ST,4869.0,3164.85,1353.58,33436.0,85
CDM,36018555,"REVASC ENDOV, OPEN OR PERC, TIBIAL/PERONEAL ARTERY(IES), W/IVL,",26829.0,17438.85,3924.0,26829.0,84
CDM,36018565,"REVASC ENDOV, OPEN OR PERC,  TIBIAL/PERONEAL ARTERY(IES); W/IVL,",46149.0,29996.85,6021.0,46149.0,84
CDM,36018575,"REVASC ENDOV, OPEN OR PERC, TIBIAL/PERONEAL ARTERY(IES); W/IVL A",36344.0,23623.6,6021.0,36344.0,84
CDM,36018585,"REVASC ENDOV, OPEN OR PERC, TIBIAL/PERONEAL ARTERY(IES); W/IVL A",38839.0,25245.35,6021.0,38839.0,84
CDM,36018595,INJECTION AA&/STRD TRIGEMINAL NERVE EACH BRANCH,2037.0,1324.05,58.81,4628.0,87
CDM,36018605,NJX AA&/STRD TFRML EPI CERVICAL/THORACIC EA ADDL,1361.0,884.65,71.67,4628.0,69
CDM,36018615,INJECTION ANES SUPERIOR HYPOGASTRIC PLEXUS,6143.0,3992.95,149.1,6143.0,87
CDM,36018625,INJX ANES CELIAC PLEXUS W/WO RADIOLOGIC MONITRNG,6143.0,3992.95,110.86,6143.0,87
CDM,36018635,CANNULATION THORACIC DUCT,7147.0,4645.55,331.61,12615.0,68
CDM,36018645,TRANSRECTAL ABLTJ MAL PRST8 TISSUE HIFU W/US,42537.0,27649.05,1149.88,42537.0,87
CDM,36018665,PARATHYROIDECTOMY/EXPLORATION PARATHYROIDS,23663.0,15380.95,1112.21,23663.0,87
CDM,36018705,CARDIAC SURGERY PROCEDURE THROMBECTOMY,6564.0,4266.6,545.0,12615.0,84
CDM,36018725,MARS THERAPY (COMP 90945),1301.0,845.65,361.68,12615.0,84
CDM,36018735,PERQ NJX ALGC CELL&/PRDCT UNI/BI CT LMBR EA,885.0,575.25,192.93,4628.0,66
CDM,36018755,TRANSCATHETER TRANSAPICAL REPLACEMT AORTIC VALVE,29787.0,19361.55,1789.59,29787.0,68
CDM,36018845,IMPL OI IMPLT SKULL MAG TC ATTACHMENT ESP<100,51467.0,33453.55,685.19,51467.0,87
CDM,36018855,RPLCMT OI IMPLT SKULL MAG TC ATTACHMENT ESP<100,51467.0,33453.55,709.8,51467.0,87
CDM,36018865,REMOVAL OI IMPLT SKULL PERQ ATTACHMENT ESP,12978.0,8435.7,524.44,12978.0,86
CDM,36018875,REMOVAL ENTIRE OI IMPLT SKL MAG TC ATTCH ESP<100,12978.0,8435.7,586.2,12978.0,86
CDM,36018885,XCAPSL CTRC RMVL INSJ IO LENS PRSTH CPLX INSJ 1+,23735.0,15427.75,921.6,23735.0,86
CDM,36018895,XCAPSL CTRC RMVL INSJ IO LENS PROSTH INSJ 1+,23735.0,15427.75,738.94,23735.0,86
CDM,36018905,INSJ RX ELUTING IMPLT PUNCTAL DILAT LAC CANAL EA,10732.0,6975.8,35.46,10732.0,87
CDM,36018915,TRANSCATHETER PLACEMENT&SBSQ REMOVAL CEPD PERQ,3134.0,2037.1,149.1,16547.65,68
CDM,36019025,"MRGHIFU, OTHER  THAN UTERINE LEIOMYOMATA",88781.0,57707.65,2029.97,88781.0,77
CDM,36019035,THYR RF ABAL W/US (COMP 47382),23750.0,15437.5,2262.59,23750.0,84
CDM,36019045,"TRANSCATHETER TRICUSPID VALVE REPAIR,PERCUTANEOUS APPROACH; INIT",17007.0,11054.55,3707.53,17007.0,66
CDM,36019055,THERMAL DSTRJ INTRAOSSEOUS BVN 1ST 2 LMBR/SAC,44799.0,29119.35,477.35,44799.0,87
CDM,36019115,JOINT REDUCTION/MANIPULATION,1696.0,1102.4,369.73,1696.0,58
CDM,36019345,ART BYPASS CAROTID-SUBCLAVIAN,28437.0,18484.05,1098.89,28437.0,68
CDM,36019365,VISC & INFRAREN ABD 1 PROSTH,31502.0,20476.3,6867.44,31502.0,66
CDM,36019375,VISC & INFRAREN ABD 2 PROSTH,34625.0,22506.25,7548.25,34625.0,66
CDM,36019385,VISC & INFRAREN ABD 3 PROSTH,37750.0,24537.5,7778.0,37750.0,66
CDM,36019395,"EMBO/THROM FEM/POP, AORTAILIAC ART",31082.0,20203.3,1180.3,31082.0,86
CDM,36019415,ART BYP FEMORAL-FEMORAL,21164.0,13756.6,1247.91,21164.0,68
CDM,36019465,ARTVEN ANAST OPN UPR ARM BASLILIC VEN TRANS,31083.0,20203.95,838.29,31083.0,87
CDM,36019475,TAVR OPEN FEMORAL APPROACH,28437.0,18484.05,1500.23,28437.0,68
CDM,36019825,PECTO-INTERCOSTAL NERVE BLOCK (COMP 64450),4270.0,2775.5,256.95,4628.0,84
CDM,36019865,EMBO/THROM POP/TIBIO/PERONEAL ART,31082.0,20203.3,1095.2,31082.0,86
CDM,36019875,"INJ SCLEROSING SOLUTION, SINGLE VEIN",2297.0,1493.05,43.96,12500.0,86
CDM,36019925,"OPN BRACH ART EXPOS PROS, UNLAT",19786.0,12860.9,150.47,19786.0,68
CDM,36019935,REPAIR BLOOD VESSEL UPPER EXT,18098.0,11763.7,913.47,18098.0,86
CDM,36019955,VISC & INFRAREN ABD 4+ PROSTH,16400.0,10660.0,3575.2,16400.0,66
CDM,36020015,BYP OTH/THN VEIN CAROTID-VERTEBRAL,16506.0,10728.9,1098.89,16506.0,68
CDM,36020045,RPR BLOOD VESSEL DIRECT LOWER EXTREMITY,4046.0,2629.9,610.39,7966.0,86
CDM,36020085,ABLTJ PERC CRYOABLTJ IMG GDN NRV PLEX/TRNCL NRV,12145.0,7894.25,3278.0,12145.0,84
CDM,36020115,AS-AORT GRF W/CARD BYP F/AORTIC DISSECTION,16506.0,10728.9,2623.14,16506.0,68
CDM,36020135,TAVR TRANSAORTIC APPROACH,40822.0,26534.3,1626.0,40822.0,68
CDM,36020145,PERQ P-ART REVSC ST 1ST NML NATIVE CONNJ BI,65208.0,42385.2,864.19,65208.0,86
CDM,36020155,PERQ P-ART REVSC ST 1ST NML NATIVE CONNJ UNI,65208.0,42385.2,657.03,65208.0,86
CDM,36020165,PERQ P-ART REVSC ST 1ST ABNOR CONNJ UNILATERAL,103251.0,67113.15,834.23,103251.0,86
CDM,36020175,PERQ P-ART REVSC ST 1ST ABNORMAL CONNJ BILATERAL,65208.0,42385.2,983.89,65208.0,86
CDM,36020195,PERQ AV FISTULA CREATION UXTR SINGLE ACCESS,103251.0,67113.15,418.33,103251.0,86
CDM,36020205,PERQ AV FISTULA CREATION UXTR SEP ACCESS SITES,103251.0,67113.15,534.44,103251.0,86
CDM,36020235,TENOTOMY PERCUTANEOUS SINGLE EACH DIGIT,7362.0,4785.3,306.01,7362.0,87
CDM,36020265,REVJ OPN ARVEN FSTL W/THRMBC DIAL GRF,31083.0,20203.95,927.83,31083.0,87
CDM,36020285,IRE ABLATION 1+TUMORS PER ORGAN W/IMG GDN PERQ,18149.0,11796.85,2029.97,30070.59,85
CDM,36020305,SHOULDER SURG PROC UNLISTED (COMP CODE 20982),10131.0,6585.15,204.59,10131.0,84
CDM,36020315,FEMUR/KNEE SURG UNLISTED(COMP CODE 20982),10131.0,6585.15,204.59,10131.0,84
CDM,36024015,TRANSCERVICAL ABLATION UTERINE FIBROID RF,34016.0,22110.4,465.03,34016.0,86
CDM,36024025,INSJ/RPLCMT PERQ ELTRD RA SPI W/INTEGRATED NSTIM,49881.0,32422.65,3924.0,49881.0,76
CDM,36024035,REVJ/RMVL NSTIM ELTRD RA SPI W/INTEGRATED NSTIM,13756.0,8941.4,2167.75,13756.0,84
CDM,36024045,INSJ/RPLCMT PERQ ELTRD RA SAC W/INTEGRATED NSTIM,51916.0,33745.4,3924.0,51916.0,69
CDM,36024055,REVJ/RMVL NSTIM ELTRD RA SAC W/INTEGRATED NSTIM,13756.0,8941.4,2167.75,13756.0,84
CDM,36024065,ENDOVEN ABLTJ INCMPTNT VEIN XTR LASER 1ST VEIN,18098.0,11763.7,319.28,33436.0,87
CDM,36024075,OPEN INSERTION OR REPLACEMENT OF INTEGRATED NEUROSTIMULATION SYS,15277.0,9930.05,0.01,36683.4,85
CDM,36024085,EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 3.1-4.0CM,4861.0,3159.65,204.53,6112.0,87
CDM,36024105,PLMT NTRSTL DEV RADJ THX GID PRQ INTRATHRC 1/MLT,6294.0,4091.1,205.6,8326.0,86
CDM,36024125,PLACEMENT OF INTERSTITIAL DEVICE(S) FOR RADIATION,7867.0,5113.55,0.01,12615.0,84
CDM,36024135,INTRAVERTEBRAL BODY FRACTURE AUGMENTATION WITH IMPLANT,16475.0,10708.75,200.93,16475.0,74
CDM,36024135_IP,INTRAVERTEBRAL BODY FRACTURE AUGMENTATION WITH IMPLANT,16475.0,10708.75,9028.3,9028.3,1
CDM,36024135_OP,INTRAVERTEBRAL BODY FRACTURE AUGMENTATION WITH IMPLANT,16475.0,10708.75,7150.15,7150.15,1
CDM,36024145,RNFA IMPELLA SUPPORT .25HR,543.0,352.95,118.37,543.0,58
CDM,36024165,BYP OTH/THN VEIN SUBCLAVIAN-SUBCLAVIAN,4718.0,3066.7,1028.52,12615.0,68
CDM,36024185,HISTOTRIPSY MAL HEPATOCELLULAR TISS W/IMG GDN,70002.0,45501.3,0.01,70002.0,85
CDM,36024195,LOOP REVISION,3924.0,2550.6,545.0,12615.0,84
CDM,36024345,ABLTJ 1/+THYROID NODULE 1 LOBE/ISTHMUS PERQ RF,6481.0,4212.65,361.87,10364.0,84
CDM,36024365,MRGFUS STEREOTACTIC ABLATION TARGET INTRACRANIAL,86045.0,55929.25,3924.0,86045.0,75
CDM,36024385,ELEC ALYS INT NSTIMJ SYS VAGUS NRV W/SMPL PRGRMG,298.0,193.7,82.84,298.0,76
CDM,36024435,REVJ/RMVL PROSTHETIC VAGINAL GRAFT VAGINAL APP,14626.0,9506.9,567.16,33436.0,87
CDM,36024445,DISE DYN EVAL SLEEP DISORDERED BREATHING FLX DX,7933.0,5156.45,107.64,12500.0,87
CDM,36024455,CRTJ PERICARDIAL WINDOW/PRTL RESECJ W/DRG/BX,8900.0,5785.0,920.67,12615.0,68
CDM,36024505,INJECT EVALUATE PREVIOUS PERITONEAL-VENOUS SHUNT,766.0,497.9,48.46,4628.0,68
CDM,36024515,PHOTODYNAMIC THERAPY BY ENDOSCOPIC APPLICATION OF LIGHT,119.0,77.35,25.94,12615.0,68
CDM,36024525,TOTAL ABDOMINAL HYSTERECT W/WO RMVL TUBE OVARY,4618.0,3001.7,1006.72,10201.0,68
CDM,36024535,STOT/TOT HYSTERECTOMY AFTER CESAREAN DELIVERY,4190.0,2723.5,0.01,12615.0,68
CDM,36024545,MICRODISSECTION TESTICULAR SPERM EXTRACTION (54522),13287.0,8636.55,214.41,13287.0,84
CDM,36024565,IMAGE GUIDED VERTEBRAL BODY FIDUCIAL MARKER PLCMNT (COMP CODE 22,13324.0,8660.6,204.59,13324.0,84
CDM,36024575,REVJ COLOSTOMY SMPL RLS SUPFC SCAR SPX,16840.0,10946.0,743.68,16840.0,87
CDM,36024585,REVJ ILEOSTOMY SIMPLE RLS SUPERFICIAL SCAR SPX,16840.0,10946.0,704.44,16840.0,87
CDM,36024595,CT GUIDED ACETABULOPLASTY (COMP CODE 22511),13324.0,8660.6,204.59,13324.0,84
CDM,36024615,IMAGE GUIDED CHEST TUBE EXCHANGE REPOSITION (COMP CODE 49423),7833.0,5091.45,545.0,12615.0,84
CDM,36024625,CRYOABLATION ABDOMINAL WALL MASS (COMP CODE 20983),29447.0,19140.55,168.79,29447.0,84
CDM,36024635,IMAGE GUIDED - CRYOABLATION OF ADRENAL GLAND (COMP CODE 50593),39232.0,25500.8,2262.59,39232.0,84
CDM,36024645,DIRECT PUNCTURE JUGULAR VEIN (COMP CODE 36005),2043.0,1327.95,399.48,12615.0,66
CDM,36024655,RF ABLATION BILIARY TRACT (COMP CODE 47556),42370.0,27540.5,786.42,42370.0,84
CDM,36024665,PLCMNT RETRO NEPHROURETERAL CATHETER (COMP CODE 50688),9423.0,6124.95,214.41,9423.0,84
CDM,36024685,RFA MSK TUMOR (COMP CODE 20982),59187.0,38471.55,204.59,59187.0,84
CDM,36024695,IMPAR GANGLION COCCYGEAL NEUROLYSIS (COMP CODE 64680),6143.0,3992.95,256.95,6143.0,84
CDM,36024705,REPOSITION PERITONEAL DIALYSIS CATH (COMP CODE 36597),8932.0,5805.8,461.87,8932.0,84
CDM,36024715,SHOULDER AUGMENTATION W/CEMENT (COMP CODE 22513),32861.0,21359.65,204.59,32861.0,84
CDM,36024725,PERCUTANEOUS HEPATIC PERFUSION DELIVERY OF INTRA-ARTERIAL HIGH D,1489.0,967.85,413.94,4628.0,85
CDM,36024735,PREOP WIRE LOCALIZATION INTRAPERITONEAL (COMP CODE 49411),6294.0,4091.1,461.87,6294.0,84
CDM,36024745,MICROWAVE ABLATION ADRENAL GLAND (COMP CODE 50592),26838.0,17444.7,2262.59,26838.0,84
CDM,36024755,VAGINAL CUFF BIOPSY (COMP CODE 57100),4005.0,2603.25,172.88,4628.0,84
CDM,36024765,RADIOFREQUENCY ABLATION SOFT TISSUE MASS (COMP CODE 20982),59187.0,38471.55,204.59,59187.0,84
CDM,36024775,RADIOFREQUENCY ABLATION SUBCUTANEOUS MASS  (COMP CODE 20982),59187.0,38471.55,168.79,59187.0,84
CDM,36024785,RADIOFREQUENCY ABLATION INTRA ABDOMINAL MASS (COMP CODE 50592),26838.0,17444.7,461.87,26838.0,84
CDM,36024795,CRYOABLATION OF INTRA ABDOMINAL MASS (COMP CODE 50593),25651.0,16673.15,461.87,25651.0,84
CDM,36024805,CRYOABLATION OF SUBCUTANEOOUS MASS (COMP CODE 20983),32861.0,21359.65,168.79,32861.0,84
CDM,36024815,CRYOABLATION OF SOFT TISSUE  MASS (COMP CODE 20983),32861.0,21359.65,204.59,32861.0,84
CDM,36024825,FIBRIN SHEATH DISRUPTION W/BALLOON (COMP CODE 36595),18098.0,11763.7,545.0,18098.0,85
CDM,36024835,SELECTIVE EXTERNAL CAROTID ANGIOGRAPHY (COMP CODE 36227),6466.0,4202.9,545.0,6466.0,85
CDM,36024845,FAT PAD BIOPSY (COMP CODE 20200),7453.0,4844.45,168.79,7453.0,84
CDM,36024855,VASCULAR EMBOLIZATION WITH PRESSURE-GENERATING CATHETER,35000.0,22750.0,5616.0,35000.0,84
CDM,36024865,SPINAL ACCESSORY NERVE BLOCK (COMP CODE 64405),2037.0,1324.05,256.95,4628.0,84
CDM,36024875,PERINEURAL TARSAL TUNNEL INJECTION (COMP CODE 64450),4778.0,3105.7,204.59,4778.0,84
CDM,36024885,RADIOFREQUENCY ABLATION PARATHYROID ADENOMA (COMP CODE 20982),59187.0,38471.55,2262.59,59187.0,84
CDM,36024895,SUPRA PUBIC CATHETER REPOSITION (COMP CODE 36597),8932.0,5805.8,214.41,8932.0,84
CDM,36024905,CRYOABLATION AVM (COMP CODE 20983),32861.0,21359.65,545.0,32861.0,85
CDM,36024915,VENOUS SINUS TEST BALLOON OCCLUSION (COMP CODE 61623),49016.0,31860.4,545.0,49016.0,85
CDM,36024925,IMAGE GUIDED LUNG LOCALIZATION (COMP CODE 32553),6294.0,4091.1,545.0,12615.0,84
CDM,36024935,BILAT MIDDLE MENINGEAL ARTERY LIDOCAINE INFUSION (COMP CODE 6165,6801.0,4420.65,545.0,6801.0,85
CDM,36024945,INJECTION HEPATIC ARTERY INFUSION PUMP (COMP CODE 36598),1211.0,787.15,264.0,12615.0,66
CDM,36024955,IMAGE GUIDED REPOSITION G-TUBE (COMP CODE 43761),1119.0,727.35,311.08,6112.0,84
CDM,36024965,"INCISION AND DRAINAGE HEMATOMA, VAGINAL OB/POSTPARTUM",3866.0,2512.9,200.78,6112.0,87
CDM,36024985,TEAEC W/WO PATCH GRAFT ILIOFEMORAL,6658.0,4327.7,1189.82,12615.0,68
CDM,36024995,CLTX POST HIP ARTHRP DISLC REQ ANES,6616.0,4300.4,676.52,6616.0,87
CDM,36025005,BIOPSY PROSTATE TRANSRECTAL ULTRASOUND-GUIDED,16566.0,10767.9,177.34,16566.0,77
CDM,36025015,BX PROSTATE TRANSRECTAL US GID W/MRI FUS GDN 1ST,16566.0,10767.9,222.58,16566.0,77
CDM,36025025,BX PROSTATE TRANSPERINEAL ULTRASOUND-GUIDED,16566.0,10767.9,213.31,16566.0,77
CDM,36025035,BX PROSTATE TRANSPERINEAL US GID W/MRI FUS GDN 1,16566.0,10767.9,247.74,16566.0,77
CDM,36025045,BX PROSTATE TRANSRECTAL MRI-US GID TRGT LES 1ST,16566.0,10767.9,176.34,16566.0,77
CDM,36025055,BX PROSTATE TPRNL MRI-US GID TRGT LES 1ST,16566.0,10767.9,206.26,16566.0,77
CDM,36025065,BX PROSTATE IN-BORE CT/MRI BX ADDL TRGT LES 1ST,25198.0,16378.7,247.31,25198.0,77
CDM,36025075,BX PROSTATE IN-BORE CT/MRI TRGT LES ONLY 1ST,25198.0,16378.7,224.69,25198.0,77
CDM,36025085,BX PROSTATE EA ADDL MRI-US FUSION/IN-BORE CT/MRI,25198.0,16378.7,63.01,25198.0,67
CDM,36025115,ABLATION IRE LIVER 1+ TUMORS W/IMG GDN PERQ,49956.0,32471.4,569.26,49956.0,77
CDM,36025125,PELVIC EXAMINATION W/ANESTHESIA OTHER THAN LOCAL,14626.0,9506.9,68.6,14626.0,87
CDM,36025135,BILIARY ENDOSCOPY PRQ VIA T-TUBE W/RMVL CALCULUS,16234.0,10552.1,528.93,16234.0,87
CDM,36025145,EV FEMPOP ARTL REVSC TCAT PLMT IV ST GRF & CLSR,47177.0,30665.05,3924.0,47177.0,84
CDM,36025155,OOPHORECTOMY PARTIAL/TOTAL UNI/BI,22708.0,14760.2,636.59,22708.0,69
CDM,36100010,DIAGNOSTIC BONE MARROW ASPIRATIONS,6481.0,4212.65,74.5,6481.0,87
CDM,36100045,INSJ/RPLCMT SPINAL NPG/RCVR POCKET CRTJ&CONNJ,40477.0,26310.05,394.85,40477.0,87
CDM,36100050,NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL,6143.0,3992.95,129.97,6143.0,87
CDM,36100055,NJX AA&/STRD TFRML EPI LUMBAR/SACRAL EA ADDL,1482.0,963.3,59.46,4628.0,69
CDM,36100065,FINE NEEDLE ASPIRATION BX W/O IMG GDN 1ST LESION,1838.0,1194.7,61.22,12500.0,86
CDM,36100075,INJECTION HIP ARTHROGRAPHY W/ANESTHESIA,873.0,567.45,81.99,4628.0,68
CDM,36100105,CONTRAST INJECTION PERQ RADIOLOGIC EVAL GI TUBE,1112.0,722.8,35.08,12500.0,86
CDM,36100125,REMOVE INT DWELL URETERAL STENT TRANSURETHRAL,9423.0,6124.95,189.94,9423.0,87
CDM,36100135,NJX VISUALIZATION ILEAL CONDUIT&/URETEROPYELOG,999.0,649.35,80.52,4628.0,68
CDM,36100175,CHANGE CYSTOSTOMY TUBE COMPLICATED,3070.0,1995.5,94.16,4628.0,87
CDM,36100255,PERQ SAC AGMNTJ UNI W/WO BALO/MCHNL DEV 1/> NDL,18899.0,12284.35,3812.17,18899.0,84
CDM,36100265,PERQ SAC AGMNTJ BI W/WO BALO/MCHNL DEV 2/> NDLS,28575.0,18573.75,3812.17,28575.0,84
CDM,36100275,EXTERNAL CAROTID ART ONLY UNI,4133.0,2686.45,545.0,4628.0,85
CDM,36100285,INSERTION PERITONEAL-VENOUS SHUNT,11705.0,7608.25,918.85,11705.0,69
CDM,36100375,EVASC RPR DTA COVERAGE ART ORIGIN 1ST ENDOPROSTH,12591.0,8184.15,1640.54,12615.0,68
CDM,36100435,INJECTION PX DISCOGRAPHY EACH LEVEL LUMBAR,2103.0,1366.95,81.99,4628.0,68
CDM,36100565,INJECT SI JOINT ARTHRGRPHY&/ANES/STEROID W/IMA,1928.0,1253.2,97.13,12500.0,69
CDM,36100805,BONE MARROW ASPIRATION BONE GRFG SPI SURG ONLY,840.0,546.0,79.33,10799.44,69
CDM,36100825,INJECTION SINUS TRACT DIAGNOSTIC,1078.0,700.7,42.63,4628.0,68
CDM,36100855,FINE NEEDLE ASPIRATION BX W/US GDN 1ST LESION,3237.0,2104.05,84.23,4628.0,87
CDM,36100865,FINE NEEDLE ASPIRATION BX W/US GDN EA ADDL,942.0,612.3,58.24,4628.0,69
CDM,36100875,FINE NEEDLE ASPIRATION BX W/FLUOR GDN 1ST LESION,3237.0,2104.05,106.31,4628.0,87
CDM,36100885,FINE NEEDLE ASPIRATION BX W/FLUOR GDN EA ADDL,725.0,471.25,64.29,4628.0,69
CDM,36100895,FINE NEEDLE ASPIRATION BX W/CT GDN 1ST LESION,3237.0,2104.05,127.26,4628.0,87
CDM,36100905,FINE NEEDLE ASPIRATION BX W/CT GDN EA ADDL,1471.0,956.15,89.86,4628.0,69
CDM,36100915,FINE NEEDLE ASPIRATION BX W/MR GDN 1ST LESION,3237.0,2104.05,384.69,4628.0,85
CDM,36100925,FINE NEEDLE ASPIRATION BX W/MR GDN EA ADDL,1456.0,946.4,317.41,4628.0,67
CDM,36100935,TCAT INSJ/RPL PERM LEADLESS PACEMAKER RV W/IMG,38008.0,24705.2,526.96,38008.0,86
CDM,36100945,TCAT REMOVAL PERM LEADLESS PM RIGHT VENTR W/IMG,18098.0,11763.7,563.73,18098.0,86
CDM,36100955,INSERTION SUBQ CARDIAC RHYTHM MONITOR W/PRGRMG,14571.0,9471.15,96.22,14571.0,86
CDM,36100965,REMOVAL SUBCUTANEOUS CARDIAC RHYTHM MONITOR,4046.0,2629.9,94.71,4628.0,86
CDM,36100975,DEBRIDEMENT OPEN WOUND 20 SQ CM/<,914.0,594.1,43.12,4628.0,86
CDM,36100OH,INTRO NEEDLE/INTRACATH CAROTID/VERTEBRAL ARTERY,1208.0,785.2,1.1,1850.45,148
CDM,36101005,INSJ/RPLCMT ICDS W/SUBSTERNAL ELECTRODE,46823.0,30434.95,7663.0,46823.0,84
CDM,36101015,INSJ SUBSTERNAL IMPLANTABLE DEFIBRILLATOR ELTRD,33104.0,21517.6,806.19,33104.0,84
CDM,36101025,RMVL SUBSTERNAL IMPLANTABLE DEFIBRILLATOR ELTRD,14557.0,9462.05,806.19,14557.0,84
CDM,36101035,RMVL SUBSTERNAL IMPLTBL DFB PULSE GENERATOR ONLY,14557.0,9462.05,806.19,14557.0,84
CDM,36101045,PERCUTANEOUS IMPLANTATION/REPLACEMENT ISDNS PTN,7752.0,5038.8,284.76,7752.0,85
CDM,36101055,PERICARDIOCENTESIS W/IMG GUIDANCE WHEN PERFORMED,8932.0,5805.8,262.68,11545.0,87
CDM,36101065,PERQ PRCRD DRG 6YR+ W/O CONGENITAL CAR ANOMALY,5413.0,3518.45,275.54,12615.0,68
CDM,36101075,DIAGNOSTIC LUMBAR SPINAL PUNCTURE W/FLUOR OR CT,4778.0,3105.7,99.72,4778.0,87
CDM,36101085,THERAPEUTIC SPINAL PNXR DRAINAGE CSF W/FLUOR/CT,4778.0,3105.7,121.65,4778.0,87
CDM,36101095,INJECTION AA&/STRD NERVES NRVTG SI JOINT W/IMG,4778.0,3105.7,96.29,4778.0,87
CDM,36101105,DESTRUCTION NEUROLYTIC AGT GENICULAR NERVE W/IMG,13474.0,8758.1,173.61,13474.0,87
CDM,36101175,MINOR SURGERY LEVEL 1 1ST 30 MIN,3394.0,2206.1,739.89,3394.0,58
CDM,36101185,MINOR SURGERY LEVEL 1 EA ADD 30 MIN,3387.0,2201.55,738.37,3387.0,58
CDM,36101195,MINOR SURGERY LEVEL 2 1ST 30 MIN,4184.0,2719.6,912.11,4184.0,58
CDM,36101205,MINOR SURGERY LEVEL 2 EA ADD 30 MIN,3885.0,2525.25,846.93,3885.0,58
CDM,36101215,MINOR SURGERY LEVEL 3 1ST 30 MIN,4734.0,3077.1,1032.01,4734.0,58
CDM,36101225,MINOR SURGERY LEVEL 3 EA ADD 30 MIN,4734.0,3077.1,1032.01,4734.0,58
CDM,36140OH,INTRO OF NEEDLE OR INTRACATHETER UPR/LXTR ARTERY,704.0,457.6,1.1,1662.37,148
CDM,36160OH,INTRO NEEDLE/INTRACATH AORTIC TRANSLUMBAR,1008.0,655.2,1.1,1838.92,148
CDM,36200OH,INTRODUCTION CATHETER AORTA,1108.0,720.2,1.1,1941.85,148
CDM,36215OH,SLCTV CATHJ EA 1ST ORD THRC/BRCH/CPHLC BRNCH,1835.0,1192.75,1.1,3374.16,148
CDM,36216OH,SLCTV CATHJ 1ST 2ND ORD THRC/BRCH/CPHLC BRNCH,2108.0,1370.2,1.1,3486.01,148
CDM,36217OH,SLCTV CATHJ 3RD+ ORD SLCTV THRC/BRCH/CPHLC BRNCH,2516.0,1635.4,1.1,5808.33,148
CDM,36218OH,SLCTV CATHJ EA 2ND+ ORD THRC/BRCH/CPHLC BRNCH,404.0,262.6,1.1,680.09,148
CDM,36221OH,NONSLCTV CATH THOR AORTA ANGIO INTR/XTRCRANL ART,1568.0,1019.2,1.1,9296.26,148
CDM,36222OH,SLCTV CATH CAROTID/INNOM ART ANGIO XTRCRANL ART,2323.0,1509.95,1.1,9296.26,148
CDM,36223OH,SLCTV CATH CAROTID/INNOM ART ANGIO INTRCRANL ART,2530.0,1644.5,1.1,16027.4,148
CDM,36224OH,SLCTV CATH INTRNL CAROTID ART ANGIO INTRCRNL ART,2750.0,1787.5,1.1,16027.4,148
CDM,36225OH,SLCTV CATH SUBCLAVIAN ART ANGIO VERTEBRAL ARTERY,2530.0,1644.5,1.1,9296.26,148
CDM,36226OH,SLCTV CATH VERTEBRAL ART ANGIO VERTEBRAL ARTERY,2750.0,1787.5,1.1,16027.4,148
CDM,36227OH,SLCTV CATH XTRNL CAROTID ANGIO XTRNL CAROTD CIRC,920.0,598.0,1.1,920.0,148
CDM,36228OH,SLCTV CATH INTRCRNL BRNCH ANGIO INTRL CAROT/VERT,1700.0,1105.0,1.1,4106.01,148
CDM,36245OH,SLCTV CATHJ EA 1ST ORD ABDL PEL/LXTR ART BRNCH,1860.0,1209.0,1.1,4056.8,148
CDM,36246OH,SLCTV CATHJ 2ND ORDER ABDL PEL/LXTR ART BRNCH,2008.0,1305.2,1.1,2743.97,148
CDM,36247OH,SLCTV CATHJ 3RD+ ORD SLCTV ABDL PEL/LXTR BRNCH,2658.0,1727.7,1.1,4647.37,148
CDM,36248OH,SLCTV CATHJ EA 2ND+ ORD ABDL PEL/LXTR ART BRNCH,404.0,262.6,1.1,404.0,148
CDM,36251OH,SLCTV CATH 1STORD W/WO ART PUNCT/FLUORO/S&I UNI,2244.0,1458.6,1.1,9296.26,148
CDM,36252OH,SLCTV CATH 1STORD W/WO ART PUNCT/FLUOR/S&I BILAT,2966.0,1927.9,1.1,9296.26,148
CDM,36253OH,SUPSLCTV CATH 2ND+ORD RENL&ACCES ARTERY/S&I UNI,3212.0,2087.8,1.1,16027.4,148
CDM,36254OH,SUPSLCTV CATH 2ND+ORD RENL&ACCES ARTER/S&I BILAT,3160.0,2054.0,1.1,9296.26,148
CDM,36260OH,INSJ IMPLANTABLE INTRA-ARTERIAL INFUSION PUM,3964.0,2576.6,1.1,16027.4,144
CDM,36261OH,REVIS IMPLANT INTRA-ART INFUS PUMP,2252.0,1463.8,1.1,11454.26,144
CDM,36262OH,REMOV IMPLANT INTRA-ART INFUS PUMP,1644.0,1068.6,1.1,11454.26,144
CDM,36299OH,VESSEL INJECTION PROCEDURE UNLISTED,345.0,224.25,0.01,345.0,84
CDM,36299RVU1OH,INJECTION FOR EGD W/ ECHO TIP (COMP CODE 36481),2232.0,1450.8,0.01,2232.0,84
CDM,36299RVU2OH,DIRECT PUNCTURE JUGULAR VEIN (COMP CODE 36005),409.0,265.85,0.01,409.0,84
CDM,36299RVU3OH,INJECTION HEPATIC ARTERY INFUSION PUMP (COMP CODE 36598),296.0,192.4,0.01,296.0,84
CDM,36400OH,"VENIPUNC <3 Y/O,FEM,JUG,SAG SINUS",152.0,98.8,1.1,152.0,146
CDM,36405OH,"VENIPUNC <3 Y/O, SCALP",124.0,80.6,1.1,124.0,146
CDM,36406OH,"VENIPUNC <3 Y/O, OTHER",72.0,46.8,1.1,72.0,146
CDM,36410EXOH,"VENIPUNC NEED PHYS SKILL,DX OR RX",79.0,51.35,1.1,79.0,146
CDM,36410OH,VNPNXR 3 YEARS/> PHYS/QHP SKILL,79.0,51.35,1.1,79.0,146
CDM,36415OH,COLLECTION VENOUS BLOOD VENIPUNCTURE,40.0,26.0,1.1,40.0,92
CDM,36416OH,COLLECTION CAPILLARY BLOOD,31.0,20.15,1.1,31.0,100
CDM,36420OH,VENOUS CUTDOWN <1 Y/O,404.0,262.6,1.1,404.0,144
CDM,36425OH,VENOUS CUTDOWN >1 Y/O,304.0,197.6,1.1,1163.18,144
CDM,36430OH,TRANSFUSION BLOOD/BLOOD COMPONENTS,1057.0,687.05,1.1,1267.25,144
CDM,36450OH,"EXCHANGE TRANSFUSION, NEWBORN",1400.0,910.0,1.1,1400.0,144
CDM,36455OH,EXCHNG TRANSFUSION BLOOD OTHER/THAN NEW BORN,972.0,631.8,1.1,1267.25,144
CDM,36460OH,TRANSFUSION INTRAUTERINE FETAL,2632.0,1710.8,1.1,2632.0,144
CDM,36465OH,NJX NONCMPND SCLEROSANT SINGLE INCMPTNT VEIN,940.0,611.0,1.1,5320.02,148
CDM,36466OH,NJX NONCMPND SCLEROSANT MULTIPLE INCMPTNT VEINS,1200.0,780.0,1.1,5320.02,148
CDM,36468OH,INJECTIONS SCLEROSANT FOR SPIDER VEINS LIM/TRNK,257.0,167.05,1.1,1163.18,84
CDM,36468RVU1OH,SPIDER VEINS-LOW-COSMETIC,200.0,130.0,1.1,1163.18,84
CDM,36468RVU2OH,SPIDER VEINS-MODERATE-COSMETIC ONLY,300.0,195.0,1.1,1163.18,84
CDM,36468RVU3OH,SPIDER VEINS EXTENSIVE-COSMETIC ONLY,500.0,325.0,1.1,1163.18,84
CDM,36468RVU4OH,INJECTION(S); SPIDER VEIN,100.0,65.0,1.1,1163.18,84
CDM,36470OH,INJECTION SCLEROSANT SINGLE INCMPTNT VEIN,300.0,195.0,1.1,1163.18,148
CDM,36471OH,INJECTION SCLEROSANT MULTIPLE INCMPTNT VEINS,660.0,429.0,1.1,1163.18,148
CDM,36473OH,ENDOVEN ABLTJ INCMPTNT VEIN MCHNCHEM 1ST VEIN,1400.0,910.0,1.1,9296.26,146
CDM,36474OH,ENDOVEN ABLTJ INCMPTNT VEIN MCHNCHEM SBSQ VEINS,700.0,455.0,1.1,869.36,146
CDM,36475OH,ENDOVEN ABLTJ INCMPTNT VEIN XTR RF 1ST VEIN,2120.0,1378.0,1.1,9296.26,148
CDM,36478OH,ENDOVEN ABLTJ INCMPTNT VEIN XTR LASER 1ST VEIN,2332.0,1515.8,1.1,9296.26,148
CDM,36479OH,ENDOVEN ABLTJ INCMPTNT VEIN XTR LASER 2ND+ VEINS,1166.0,757.9,1.1,1166.0,148
CDM,36481OH,PRQ PORTAL VEIN CATHETERIZATION ANY METHOD,2692.0,1749.8,1.1,5834.94,148
CDM,36482OH,ENDOVEN ABLTI THER CHEM ADHESIVE 1ST VEIN,1400.0,910.0,1.1,16027.4,146
CDM,36483OH,ENDOVEN ABLTI THER CHEM ADHESIVE SBSQ VEIN,700.0,455.0,1.1,700.0,146
CDM,36500OH,VEN CATHJ SLCTV ORGAN BLD SAMPLING,1404.0,912.6,1.1,1404.0,144
CDM,36510OH,CATHJ UMBILICAL VEIN DX/THER NB,436.0,283.4,1.1,436.0,148
CDM,36511OH,THR APHERESIS WHITE BLD CELL,880.0,572.0,1.1,4475.18,144
CDM,36512OH,THR APHERESIS RED BLOOD CELL,880.0,572.0,1.1,4475.18,144
CDM,36513OH,THERAPEU APHERESIS PLATELETS,880.0,572.0,1.1,1267.25,144
CDM,36514OH,THERAPEUTIC APHERESIS PLASMA,796.0,517.4,1.1,4475.18,148
CDM,36516OH,THER APHERESIS W/EXTRACORPOREAL IMMUNOADSORPTION,686.0,445.9,1.1,13495.95,148
CDM,36522OH,PHOTOPHERESIS EXTRACORPOREAL,770.0,500.5,1.1,13495.95,148
CDM,36555OH,INSJ NON-TUNNELED CENTRAL VENOUS CATH AGE < 5 Y,849.0,551.85,1.1,9296.26,148
CDM,36556OH,INSJ NON-TUNNELED CENTRAL VENOUS CATH AGE 5 YR/>,770.0,500.5,1.1,9296.26,148
CDM,36557OH,INSERT TUNNELED CVC W/O SUBQ PORT/PMP AGE <5 YR,2152.0,1398.8,1.1,16027.4,148
CDM,36558OH,INSJ TUNNELED CVC W/O SUBQ PORT/PMP AGE 5 YR/>,2020.0,1313.0,1.1,9296.26,148
CDM,36560OH,INSJ TUNNELED CTR VAD W/SUBQ PORT UNDER 5 YR,2658.0,1727.7,1.1,9296.26,148
CDM,36561OH,INSJ TUNNELED CTR VAD W/SUBQ PORT AGE 5 YR/>,2548.0,1656.2,1.1,9296.26,148
CDM,36563OH,INSJ TUNNELED CTR VAD W/SUBQ PUMP,2636.0,1713.4,1.1,16027.4,148
CDM,36565EXOH,"CV CATH INSERT,TUNNELED W/PUMP",1931.0,1255.15,1.1,9296.26,148
CDM,36565OH,INSJ TUN VAD REQ 2 CATH 2 SITS W/O SUBQ PORT/PMP,2548.0,1656.2,1.1,9296.26,148
CDM,36566OH,INSJ TUN VAD REQ 2 CATH 2 SITS W/SUBQ PORT,2768.0,1799.2,1.1,16027.4,148
CDM,36568OH,INSERTION PICC W/O IMG GDN < 5 YR,928.0,603.2,1.1,4671.09,144
CDM,36569OH,INSERTION PICC W/O IMG GDN 5 YR/>,836.0,543.4,1.1,4671.09,144
CDM,36570OH,INSJ PRPH CTR VAD W/SUBQ PORT UNDER 5 YR,2248.0,1461.2,1.1,9296.26,148
CDM,36571OH,INSJ PRPH CTR VAD W/SUBQ PORT AGE 5 YR/>,2240.0,1456.0,1.1,9296.26,148
CDM,36572AOH,INSERTION PICC W/RS&I < 5 YR,867.0,563.55,1.1,1833.54,148
CDM,36572OH,INSERTION PICC W/RS&I < 5YR,801.0,520.65,1.1,1833.54,148
CDM,36573OH,INSERTION PICC W/RS&I 5 YR >,748.0,486.2,1.1,4671.09,148
CDM,36573PEDSOH,"INSERTION PICC LINE, AGE 5 AND OLDER",892.0,579.8,1.1,4671.09,148
CDM,36575OH,RPR TUN/NON-TUN CTR VAD CATH W/O SUBQ PORT/PMP,268.0,174.2,1.1,1833.54,148
CDM,36576OH,RPR CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ SIT,1196.0,777.4,1.1,4671.09,148
CDM,36578OH,RPLCMT CATH CTR VAD SUBQ PORT/PMP,1316.0,855.4,1.1,9296.26,148
CDM,36580EXOH,REPL NON-TUN CVC SAME ACCESS,432.0,280.8,1.1,4671.09,148
CDM,36580OH,RPLCMT COMPL NON-TUN CVC W/O SUBQ PORT/PMP,576.0,374.4,1.1,4671.09,148
CDM,36581OH,RPLCMT COMPL TUN CVC W/O SUBQ PORT/PMP,1292.0,839.8,1.1,9296.26,148
CDM,36582OH,RPLCMT COMPL TUN CTR VAD W/SUBQ PORT,1996.0,1297.4,1.1,9296.26,148
CDM,36584OH,COMPLETE REPLACEMENT PICC RS&I,480.0,312.0,1.1,4671.09,148
CDM,36585OH,RPLCMT COMPL PRPH CTR VAD W/SUBQ PORT,1836.0,1193.4,1.1,9296.26,148
CDM,36589OH,RMVL TUN CVC W/O SUBQ PORT/PMP,1003.0,651.95,1.1,1833.54,148
CDM,36590OH,RMVL TUN CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ,1364.0,886.6,1.1,4671.09,148
CDM,36591OH,COLLECT BLOOD FROM IMPLANT VENOUS ACCESS DEVICE,36.0,23.4,1.1,373.44,142
CDM,36592OH,COLLECT BLOOD FROM CATHETER VENOUS NOS,59.0,38.35,1.1,373.44,142
CDM,36593OH,DECLOT BY THROMBOLYTIC AGENT IMPLANT DEVICE/CATH,512.0,332.8,1.1,988.7,144
CDM,36595OH,MCHNL RMVL PRICATH OBSTR CV DEV VIA VEN ACCESS,1436.0,933.4,1.1,9296.26,148
CDM,36596OH,MCHNL RMVL INTRAL OBSTR CV DEV THRU DEV LUMEN,300.0,195.0,1.1,4671.09,148
CDM,36597OH,RPSG PREVIOUSLY PLACED CVC UNDER FLUOR GDNCE,484.0,314.6,1.1,4671.09,148
CDM,36598OH,CNTRST NJX RAD EVAL CTR VAD FLUOR IMG&REPRT,296.0,192.4,1.1,624.44,148
CDM,36599OH,DUMMY PROC NAME,1898.0,1233.7,1.1,1898.0,70
CDM,36600OH,ARTERIAL PUNCTURE WITHDRAWAL BLOOD DX,128.0,83.2,1.1,373.44,148
CDM,36620OH,ARTL CATHJ/CANNULJ MNTR/TRANSFUSION SPX PRQ,440.0,286.0,1.1,440.0,144
CDM,36625OH,ARTL CATHJ/CANNULJ MNTR/TRANSFUSION SPX CUTDOWN,844.0,548.6,1.1,844.0,144
CDM,36660OH,CATHETERIZATION UMBILICAL NEWBORN ART DX/THERAPY,560.0,364.0,1.1,560.0,144
CDM,36680OH,PLACEMENT OF NEEDLE FOR INTRAOSSEOUS INFUSION,528.0,343.2,1.1,1163.18,144
CDM,36800OH,INSJ CANNULA HEMO OTH PURPOSE SPX VEIN VEIN,1069.0,694.85,1.1,16027.4,144
CDM,36810OH,INSJ CANNULA HEMO OTH PURPOSE SPX ARVEN XTRNL,1584.0,1029.6,1.1,9296.26,144
CDM,36815OH,INSJ CANNULA HEMO OTH SPX ARVEN XTRNL REVJ/CLSR,1048.0,681.2,1.1,16027.4,144
CDM,36818OH,ARVEN ANAST OPN UPR ARM CEPHALIC VEIN TRPOS,4956.0,3221.4,1.1,16027.4,144
CDM,36819OH,ARVEN ANAST OPN UPR ARM BASILIC VEIN TRPOS,5316.0,3455.4,1.1,16027.4,144
CDM,36820OH,ARVEN ANAST OPN F/ARM VEIN TRPOS,5228.0,3398.2,1.1,16027.4,144
CDM,36821OH,ARTERIOVENOUS ANASTOMOSIS OPEN DIRECT,4760.0,3094.0,1.1,9296.26,144
CDM,36823OH,INSJ CNULA ISLTD XC-CIRCJ REG CHEMOTX XTR RMVL,9192.0,5974.8,1.1,9192.0,142
CDM,36825OH,CRTJ ARVEN FSTL XCP DIR ARVEN ANAST AUTOG GRF,5668.0,3684.2,1.1,16027.4,144
CDM,36830OH,CRTJ ARVEN FSTL XCP DIR ARVEN ANAST NONAUTOG GRF,4812.0,3127.8,1.1,16027.4,144
CDM,36831OH,THRMBC OPN ARVEN FSTL W/O REVJ DIAL GRF,4400.0,2860.0,1.1,16027.4,144
CDM,36832OH,REVJ OPN ARVEN FSTL W/O THRMBC DIAL GRF,5400.0,3510.0,1.1,16027.4,144
CDM,36833OH,REVJ OPN ARVEN FSTL W/THRMBC DIAL GRF,5800.0,3770.0,1.1,16027.4,144
CDM,36836OH,PERQ AV FISTULA CREATION UXTR SINGLE ACCESS,2880.0,1872.0,1.1,51140.13,146
CDM,36837OH,PERQ AV FISTULA CREATION UXTR SEP ACCESS SITES,3720.0,2418.0,1.1,51140.13,146
CDM,36838OH,DSTL REVSC&INTERVAL LIG UXTR HEMO ACCESS,8676.0,5639.4,1.1,16027.4,144
CDM,36861OH,XTRNL CANNULA DECLTNG SPX W/BALO CATH,1008.0,655.2,1.1,16027.4,144
CDM,36901OH,INTRO CATH DIALYSIS CIRCUIT DX ANGRPH FLUOR S&I,1344.0,873.6,1.1,4671.09,148
CDM,36902OH,INTRO CATH DIALYSIS CIRCUIT W/TRLUML BALO ANGIOP,1932.0,1255.8,1.1,16670.21,148
CDM,36903OH,INTRO CATH DIALYSIS CIRCUIT W/TCAT PLMT IV STENT,2556.0,1661.4,1.1,32085.4,148
CDM,36904OH,PERQ THRMBC/NFS DIALYSIS CIRCUIT IMG DX ANGRPH,3000.0,1950.0,1.1,16670.21,148
CDM,36905OH,PERQ THRMBC/NFS DIAL CIRCUIT TRLUML BALO ANGIOP,3600.0,2340.0,1.1,32085.4,148
CDM,36906OH,PERQ THRMBC/NFS DIAL CIRCUIT TCAT PLMT IV STENT,4168.0,2709.2,1.1,51140.13,148
CDM,36907OH,(2017) TRLUML BALO ANGIOP CTR DIALYSIS SEG W/IMG S&I,1200.0,780.0,1.1,1985.46,148
CDM,36908OH,STENT PLMT CENTRAL DIAYLSIS SEG PFRMD DIAL CIR,1700.0,1105.0,1.1,4731.95,148
CDM,36909OH,DIALYIS CIRCUIT VASC EMBOLI OCCLS EVASC IMG S&I,1648.0,1071.2,1.1,6373.59,148
CDM,37000025,ANESTHESIA-.25 HOURS,897.0,583.05,195.55,897.0,58
CDM,37000035,ANESTHESIA-.50 HOURS,1300.0,845.0,283.4,1300.0,58
CDM,37000045,ANESTHESIA-.75 HOURS,1507.0,979.55,328.53,1507.0,58
CDM,37000055,ANESTHESIA-1.00 HOURS,1709.0,1110.85,372.56,1709.0,58
CDM,37000065,ANESTHESIA-1.25 HOURS,1912.0,1242.8,416.82,1912.0,58
CDM,37000075,ANESTHESIA-1.50 HOURS,2114.0,1374.1,460.85,2114.0,58
CDM,37000085,ANESTHESIA-1.75 HOURS,2321.0,1508.65,505.98,2321.0,58
CDM,37000095,ANESTHESIA-2.00 HOURS,2520.0,1638.0,549.36,2520.0,58
CDM,37000105,ANESTHESIA-2.50 HOURS,2940.0,1911.0,640.92,2940.0,58
CDM,37000115,ANESTHESIA-2.75 HOURS,3156.0,2051.4,688.01,3156.0,58
CDM,37000125,ANESTHESIA-3.00 HOURS,3346.0,2174.9,729.43,3346.0,58
CDM,37000135,ANESTHESIA-3.25 HOURS,3552.0,2308.8,774.34,3552.0,58
CDM,37000145,ANESTHESIA-3.75 HOURS,3957.0,2572.05,862.63,3957.0,58
CDM,37000155,ANESTHESIA-4.00 HOURS,3990.0,2593.5,869.82,3990.0,58
CDM,37000165,ANESTHESIA-4.25 HOURS,4032.0,2620.8,878.98,4032.0,58
CDM,37000170,ANES-PARAVERT BLOCK 15MIN,324.0,210.6,70.63,324.0,58
CDM,37000175,ANESTHESIA-4.50 HOURS,4067.0,2643.55,886.61,4067.0,58
CDM,37000180,ANES-GENERAL 15MIN,413.0,268.45,90.03,413.0,58
CDM,37000185,ANESTHESIA-4.75 HOURS,4147.0,2695.55,904.05,4147.0,58
CDM,37000190,ANES-MAC 15MIN,456.0,296.4,99.41,456.0,58
CDM,37000195,ANESTHESIA-5.00 HOURS,4180.0,2717.0,911.24,4180.0,58
CDM,37000200,ANES-SP-EPI COMBO 15MIN,327.0,212.55,71.29,327.0,58
CDM,37000205,ANESTHESIA-5.25 HOURS,4667.0,3033.55,1017.41,4667.0,58
CDM,37000210,ANES-BIER BLOCK 15MIN,324.0,210.6,70.63,324.0,58
CDM,37000215,ANESTHESIA-5.50 HOURS,4712.0,3062.8,1027.22,4712.0,58
CDM,37000220,ANES-REGIONAL BLOCK 15MIN,381.0,247.65,83.06,381.0,58
CDM,37000225,ANESTHESIA-5.75 HOURS,4881.0,3172.65,1064.06,4881.0,58
CDM,37000235,ANESTHESIA-6.00 HOURS,5246.0,3409.9,1143.63,5246.0,58
CDM,37000245,ANESTHESIA-6.25 HOURS,5491.0,3569.15,1197.04,5491.0,58
CDM,37000255,ANESTHESIA-6.50 HOURS,5681.0,3692.65,1238.46,5681.0,58
CDM,37000265,ANESTHESIA-6.75 HOURS,5862.0,3810.3,1277.92,5862.0,58
CDM,37000270,ANES-EPIDURAL 15MIN,301.0,195.65,65.62,301.0,58
CDM,37000275,ANESTHESIA-7.25 HOURS,6353.0,4129.45,1384.95,6353.0,58
CDM,37000280,ANES-SPINAL 15MIN,339.0,220.35,73.9,339.0,58
CDM,37000285,ANESTHESIA-7.50 HOURS,6520.0,4238.0,1421.36,6520.0,58
CDM,37000290,MODERATE SEDATION FOR ENDOSCOPY,701.0,455.65,14.86,701.0,68
CDM,37000295,ANESTHESIA-7.75 HOURS,6746.0,4384.9,1470.63,6746.0,58
CDM,37000305,ANESTHESIA-8.00 HOURS,6962.0,4525.3,1517.72,6962.0,58
CDM,37000315,ANESTHESIA-8.25 HOURS,7214.0,4689.1,1572.65,7214.0,58
CDM,37000325,ANESTHESIA-8.50 HOURS,7462.0,4850.3,1626.72,7462.0,58
CDM,37000335,ANESTHESIA-8.75 HOURS,7676.0,4989.4,1673.37,7676.0,58
CDM,37000345,ANESTHESIA-9.00 HOURS,7911.0,5142.15,1724.6,7911.0,58
CDM,37000355,ANESTHESIA-9.25 HOURS,8156.0,5301.4,1778.01,8156.0,58
CDM,37000365,ANESTHESIA-9.50 HOURS,8266.0,5372.9,1801.99,8266.0,58
CDM,37000375,ANESTHESIA-9.75 HOURS,8662.0,5630.3,1888.32,8662.0,58
CDM,37000385,ANESTHESIA-10.00 HOURS,8910.0,5791.5,1942.38,8910.0,58
CDM,37000395,ANESTHESIA-10.25 HOURS,9153.0,5949.45,1995.35,9153.0,58
CDM,37000405,ANESTHESIA-10.75 HOURS,9656.0,6276.4,2105.01,9656.0,58
CDM,37000415,ANESTHESIA-11.00 HOURS,9890.0,6428.5,2156.02,9890.0,58
CDM,37000425,ANESTHESIA-11.50 HOURS,10394.0,6756.1,2265.89,10394.0,58
CDM,37000435,ANESTHESIA-11.75 HOURS,10639.0,6915.35,2319.3,10639.0,58
CDM,37000445,ANESTHESIA-12.00 HOURS,11065.0,7192.25,2412.17,11065.0,58
CDM,37000455,ANESTHESIA-12.25 HOURS,11135.0,7237.75,2427.43,11135.0,58
CDM,37000465,ANESTHESIA-12.50 HOURS,11662.0,7580.3,2542.32,11662.0,58
CDM,37000475,ANESTHESIA-12.75 HOURS,11764.0,7646.6,2564.55,11764.0,58
CDM,37000485,ANESTHESIA-13.00 HOURS,11884.0,7724.6,2590.71,11884.0,58
CDM,37000495,ANESTHESIA-13.25 HOURS,12463.0,8100.95,2716.93,12463.0,58
CDM,37000505,ANESTHESIA-13.50 HOURS,12564.0,8166.6,2738.95,12564.0,58
CDM,37000515,ANESTHESIA-13.75 HOURS,12664.0,8231.6,2760.75,12664.0,58
CDM,37000525,ANESTHESIA-14.00 HOURS,12862.0,8360.3,2803.92,12862.0,58
CDM,37000535,ANESTHESIA-14.25 HOURS,13113.0,8523.45,2858.63,13113.0,58
CDM,37000545,ANESTHESIA-14.50 HOURS,13374.0,8693.1,2915.53,13374.0,58
CDM,37000555,ANESTHESIA-15.00 HOURS,13864.0,9011.6,3022.35,13864.0,58
CDM,37000565,ANESTHESIA-15.25 HOURS,14122.0,9179.3,3078.6,14122.0,58
CDM,37000575,ANESTHESIA-15.50 HOURS,15742.0,10232.3,3431.76,15742.0,58
CDM,37000585,ANESTHESIA-15.75 HOURS,15860.0,10309.0,3457.48,15860.0,58
CDM,37000595,ANESTHESIA-16.00 HOURS,16062.0,10440.3,3501.52,16062.0,58
CDM,37000605,ANESTHESIA-16.25 HOURS,17062.0,11090.3,3719.52,17062.0,58
CDM,37000615,ANESTHESIA-16.50 HOURS,18066.0,11742.9,3938.39,18066.0,58
CDM,37000625,ANESTHESIA-16.75 HOURS,18355.0,11930.75,4001.39,18355.0,58
CDM,37000635,ANESTHESIA-17.00 HOURS,18553.0,12059.45,4044.55,18553.0,58
CDM,37000645,ANESTHESIA-17.25 HOURS,18949.0,12316.85,4130.88,18949.0,58
CDM,37000655,ANESTHESIA-17.50 HOURS,19357.0,12582.05,4219.83,19357.0,58
CDM,37000665,ANESTHESIA-17.75 HOURS,19620.0,12753.0,4277.16,19620.0,58
CDM,37000675,ANESTHESIA-18.00 HOURS,19921.0,12948.65,4342.78,19921.0,58
CDM,37000685,ANESTHESIA-18.25 HOURS,20207.0,13134.55,4405.13,20207.0,58
CDM,37000695,ANESTHESIA-18.50 HOURS,20506.0,13328.9,4470.31,20506.0,58
CDM,37000705,ANESTHESIA-18.75 HOURS,20964.0,13626.6,4570.15,20964.0,58
CDM,37000715,ANESTHESIA-19.25 HOURS,21394.0,13906.1,4663.89,21394.0,58
CDM,37000725,ANESTHESIA-19.50 HOURS,21683.0,14093.95,4726.89,21683.0,58
CDM,37000735,ANESTHESIA-19.75 HOURS,21982.0,14288.3,4792.08,21982.0,58
CDM,37000745,ANESTHESIA-2.25 HOURS,2744.0,1783.6,598.19,2744.0,58
CDM,37000755,ANESTHESIA-3.50 HOURS,3759.0,2443.35,819.46,3759.0,58
CDM,37000765,ANESTHESIA-7.00 HOURS,6112.0,3972.8,1332.42,6112.0,58
CDM,37000775,ANESTHESIA-10.50 HOURS,9388.0,6102.2,2046.58,9388.0,58
CDM,37000785,ANESTHESIA-11.25 HOURS,10141.0,6591.65,2210.74,10141.0,58
CDM,37000795,ANESTHESIA-14.75 HOURS,13463.0,8750.95,2934.93,13463.0,58
CDM,37000805,ANESTHESIA-19.00 HOURS,21091.0,13709.15,4597.84,21091.0,58
CDM,37000815,ANESTHESIA-21.00 HOURS,23394.0,15206.1,5099.89,23394.0,58
CDM,37000825,ANESTHESIA 20.00 HOURS,22262.0,14470.3,4853.12,22262.0,58
CDM,37000835,ANESTHESIA 20.25 HOURS,22372.0,14541.8,4877.1,22372.0,58
CDM,37000845,ANESTHESIA 20.50 HOURS,22829.0,14838.85,4976.72,22829.0,58
CDM,37000855,ANESTHESIA 20.75 HOURS,23108.0,15020.2,5037.54,23108.0,58
CDM,37000865,ANESTHESIA 21.25 HOURS,23683.0,15393.95,5162.89,23683.0,58
CDM,37000875,ANESTHESIA 22.50 HOURS,24855.0,16155.75,5418.39,24855.0,58
CDM,37000885,ANESTHESIA 22.75 HOURS,25183.0,16368.95,5489.89,25183.0,58
CDM,37000895,ANESTHESIA 23.00 HOURS,25159.0,16353.35,5484.66,25159.0,58
CDM,37000905,ANESTHESIA 23.25 HOURS,25178.0,16365.7,5488.8,25178.0,58
CDM,37000915,ANESTHESIA 23.50 HOURS,25199.0,16379.35,5493.38,25199.0,58
CDM,37000925,ANESTHESIA 23.75 HOURS,25217.0,16391.05,5497.31,25217.0,58
CDM,37000935,ANESTHESIA 24.00 HOURS,25235.0,16402.75,5501.23,25235.0,58
CDM,37000945,ANESTHESIA-21.50 HOURS,23777.0,15455.05,5183.39,23777.0,58
CDM,37000975,ANESTHESIA-22.25 HOURS,24688.0,16047.2,5381.98,24688.0,58
CDM,37000985,MORIBUND NO SURVIV W/O OPER P5,54.0,35.1,11.77,54.0,58
CDM,37000995,SEVERE SYSTEMIC DISEASE P4,35.0,22.75,7.63,35.0,58
CDM,37001005,SEVERE SYSTEMIC DISEASE P3,22.0,14.3,4.8,22.0,58
CDM,37001015,ANESTHESIA-2.25 HOURS,2744.0,1783.6,598.19,2744.0,58
CDM,37001025,ANESTHESIA-3.50 HOURS,3759.0,2443.35,819.46,3759.0,58
CDM,37001125,ANESTHESIA-18.50 HOURS,20506.0,13328.9,4470.31,20506.0,58
CDM,37001135,ANESTHESIA-19.75 HOURS,21982.0,14288.3,4792.08,21982.0,58
CDM,37001145,ANESTHESIA 20.25 HOURS,22372.0,14541.8,4877.1,22372.0,58
CDM,37001155,ANESTHESIA 20.50 HOURS,22829.0,14838.85,4976.72,22829.0,58
CDM,37001165,ANESTHESIA 20.75 HOURS,23108.0,15020.2,5037.54,23108.0,58
CDM,37001175,ANESTHESIA 21.25 HOURS,23683.0,15393.95,5162.89,23683.0,58
CDM,37001185,ANESTHESIA 22.50 HOURS,24855.0,16155.75,5418.39,24855.0,58
CDM,37001195,ANESTHESIA 23.00 HOURS,25159.0,16353.35,5484.66,25159.0,58
CDM,37001205,ANESTHESIA-21.75 HOURS,23759.0,15443.35,5179.46,23759.0,58
CDM,37001215,ANESTHESIA-22.00 HOURS,24528.0,15943.2,5347.1,24528.0,58
CDM,37001225,MOD SED SAME PHYS/QHP INITIAL 15 MINS <5 YRS,1169.0,759.85,29.16,1169.0,68
CDM,37001235,MOD SED SAME PHYS/QHP INITIAL 15 MINS 5/> YRS,701.0,455.65,14.86,701.0,68
CDM,37001245,MOD SED SAME PHYS/QHP EACH ADDL 15 MINS,276.0,179.4,15.87,276.0,68
CDM,37001255,MOD SED OTHER PHYS/QHP INITIAL 15 MINS 5/> YRS,584.0,379.6,96.48,584.0,68
CDM,37001265,MOD SED OTHER PHYS/QHP EACH ADDL 15 MINS,276.0,179.4,60.17,276.0,68
CDM,37001275,MOD SED OTHER PHYS/QHP INITIAL 15 MINS <5 YRS,717.0,466.05,109.43,717.0,68
CDM,37001295,MOD SED SAME PHYS/QHP INITIAL 15 MINS 5/> YRS,701.0,455.65,14.86,701.0,68
CDM,37001305,MOD SED SAME PHYS/QHP EACH ADDL 15 MINS,276.0,179.4,15.87,276.0,68
CDM,37001325,MOD SEDAT ENDO SERVICE >5 YRS,701.0,455.65,6.92,701.0,68
CDM,37001355,ANES-OB EPIDURAL CONT/1 HOUR,298.0,193.7,64.96,298.0,58
CDM,37140OH,VENOUS ANASTOMOSIS OPEN PORTOCAVAL,16000.0,10400.0,1.1,16000.0,144
CDM,37145OH,VENOUS ANASTOMOSIS OPEN RENOPORTAL,14800.0,9620.0,1.1,14800.0,144
CDM,37160OH,VENOUS ANASTOMOSIS OPEN CAVAL-MESENTERIC,15200.0,9880.0,1.1,15200.0,144
CDM,37180OH,VENOUS ANASTOMOSIS OPEN SPLENORENAL PROXIMAL,14600.0,9490.0,1.1,14600.0,144
CDM,37181OH,VENOUS ANASTOMOSIS OPEN SPLENORENAL DISTAL,16000.0,10400.0,1.1,16000.0,144
CDM,37182OH,INSJ TRANSVNS INTRAHEPATC PORTOSYSIC SHUNT,6788.0,4412.2,1.1,6788.0,144
CDM,37183OH,REVJ TRANSVNS INTRAHEPATIC PORTOSYSTEMIC SHUNT,3096.0,2012.4,1.1,19490.23,148
CDM,37184OH,PRIM PRQ TRLUML MCHNL THRMBC N-COR N-ICRA 1ST,3700.0,2405.0,1.1,51140.13,148
CDM,37185OH,PRIM PRQ TRLUML MCHNL THRMBC N-COR N-ICRA SBSQ,1443.0,937.95,1.1,1601.1,148
CDM,37186OH,SEC PRQ TRLUML THRMBC N-CORONARY N-INTRACRANIAL,2165.0,1407.25,1.1,3981.77,148
CDM,37187OH,PRQ TRANSLUMINAL MECHANICAL THROMBECTOMY VEIN,3423.0,2224.95,1.1,32085.4,148
CDM,37188OH,PRQ TRLUML MCHNL THRMBC VEIN REPEAT TX,2402.0,1561.3,1.1,9296.26,148
CDM,37191OH,INS INTRVAS VC FILTR W/WO VAS ACS VSL SELXN RS&I,1962.0,1275.3,1.1,16027.4,148
CDM,37192OH,REPSNG INTRVAS VC FILTR W/WO ACS VSL SELXN RS&I,2840.0,1846.0,1.1,9296.26,148
CDM,37193OH,RTRVL INTRVAS VC FILTR W/WO ACS VSL SELXN RS&I,2840.0,1846.0,1.1,9296.26,148
CDM,37195OH,THROMBOLYSIS CEREBRAL IV INFUSION,2075.0,1348.75,1.1,2075.0,106
CDM,37197OH,PRQ TRANSCATHETER RTRVL INTRVAS FB WITH IMAGING,2658.0,1727.7,1.1,9296.26,148
CDM,37200OH,TRANSVASCULAR BIOPSY,1820.0,1183.0,1.1,16027.4,144
CDM,37211OH,THROMBOLYSIS ARTERIAL INFUSION W/IMAGING INIT TX,3100.0,2015.0,1.1,16027.4,144
CDM,37212OH,THROMBOLYSIS VENOUS INFUSION W/IMAGING INIT TX,2724.0,1770.6,1.1,9296.26,144
CDM,37213OH,THROMBOLYSIS ART/VENOUS INFSN W/IMAGE SUBSQ TX,1900.0,1235.0,1.1,9296.26,144
CDM,37214OH,CESSATION THROMBOLYTIC THRPY W/CATHETER REMOVAL,1096.0,712.4,1.1,9296.26,144
CDM,37215OH,TCAT IV STENT CRV CRTD ART EMBOLIC PROTECJ,7810.0,5076.5,1.1,7810.0,144
CDM,37216OH,TCAT IV STENT CRV CRTD ART W/O EMBOLIC PROTECJ,7192.0,4674.8,1.1,7192.0,100
CDM,37217OH,TCATH STENT PLACEMT RETROGRAD CAROTID/INNOMINATE,8152.0,5298.8,1.1,8152.0,144
CDM,37218OH,TCATH STENT PLACEMT ANTEGRADE CAROTID/INNOMINATE,5900.0,3835.0,1.1,5900.0,144
CDM,37236OH,OPEN/PERQ PLACEMENT INTRAVASCULAR STENT INITIAL,3500.0,2275.0,1.1,32085.4,148
CDM,37237OH,OPEN/PERQ PLACEMENT INTRAVASCULAR STENT EA ADDL,1700.0,1105.0,1.1,4216.95,148
CDM,37238OH,OPEN/PERQ PLACEMENT INTRAVASCULAR STENT SAME 1ST,2658.0,1727.7,1.1,32085.4,148
CDM,37239OH,OPEN/PERQ PLACEMENT INTRAVASC STENT SAME EA ADDL,1307.0,849.55,1.1,5558.32,148
CDM,37241OH,VASCULAR EMBOLIZATION OR OCCLUSION VENOUS RS&I,3850.0,2502.5,1.1,32085.4,148
CDM,37242OH,VASCULAR EMBOLIZATION OR OCCLUSION ARTERIAL RS&I,4312.0,2802.8,1.1,51140.13,148
CDM,37243OH,VASCULAR EMBOLIZE/OCCLUDE ORGAN TUMOR INFARCT,5166.0,3357.9,1.1,32085.4,148
CDM,37244OH,VASCULAR EMBOLIZATION OR OCCLUSION HEMORRHAGE,6050.0,3932.5,1.1,32085.4,148
CDM,37246OH,TRLML BALO ANGIOP OPEN/PERQ IMG S&I 1ST ART,3080.0,2002.0,1.1,16670.21,148
CDM,37247OH,TRLML BALO ANGIOP OPEN/PERQ IMG S&I EA ADDL ART,1540.0,1001.0,1.1,1859.65,148
CDM,37248OH,TRLML BALO ANGIOP OPEN/PERQ W/IMG S&I 1ST VEIN,2640.0,1716.0,1.1,16670.21,148
CDM,37249OH,TRLML BALO ANGIOP OPEN/PERQ W/IMG S&I ADDL VEIN,1307.0,849.55,1.1,1455.57,148
CDM,37252OH,INTRAVASCULAR US NONCORONARY RS&I INTIAL VESSEL,792.0,514.8,1.1,3173.0,148
CDM,37253OH,INTRAVASCULAR US NONCORONARY RS&I ADDL VESSEL,634.0,412.1,1.1,634.0,148
CDM,37254OH,REVSC EVASC IVT ANGIOP UNI SF LES 1ST VSL,3212.0,2087.8,1.1,5352.46,106
CDM,37255OH,REVSC EVASC IVT ANGIOP UNI SF LES EA ADDL VSL,1320.0,858.0,1.1,1330.47,106
CDM,37256OH,REVSC EVASC IVT ANGIOP UNI CPLX LES 1ST VSL,4730.0,3074.5,1.1,6300.24,106
CDM,37257OH,REVSC EVASC IVT ANGIOP UNI CPLX LES EA ADDL VSL,1712.0,1112.8,1.1,1712.0,106
CDM,37258OH,REVSC EVASC IVT ST PLMT UNI SF LES 1ST VSL,3850.0,2502.5,1.1,9158.51,106
CDM,37259OH,REVSC EVASC IVT ST PLMT UNI SF LES EA ADDL VSL,1760.0,1144.0,1.1,3111.79,106
CDM,37260OH,REVSC EVASC IVT ST PLMT UNI CPLX LES 1ST VSL,5584.0,3629.6,1.1,21594.73,106
CDM,37261OH,REVSC EVASC IVT ST PLMT UNI CPLX LES EA ADDL VSL,1870.0,1215.5,1.1,8598.53,106
CDM,37262OH,INTRAVASCULAR LITHOTRIPSY IVT WITHIN SAME ARTERY,1320.0,858.0,1.1,8704.67,106
CDM,37263OH,REVSC EVASC FPVT ANGIOP UNI SF LES 1ST VSL,3410.0,2216.5,1.1,13897.95,106
CDM,37264OH,REVSC EVASC FPVT ANGIOP UNI SF LES EA ADDL VSL,1320.0,858.0,1.1,5587.38,106
CDM,37265OH,REVSC EVASC FPVT ANGIOP UNI CPLX LES 1ST VSL,4620.0,3003.0,1.1,17485.88,106
CDM,37266OH,REVSC EVASC FPVT ANGIOP UNI CPLX LES EA ADDL VSL,1760.0,1144.0,1.1,6253.42,106
CDM,37267OH,REVSC EVASC FPVT ST PLMT UNI SF LES 1ST VSL,3850.0,2502.5,1.1,13346.71,106
CDM,37268OH,REVSC EVASC FPVT ST PLMT UNI SF LES EA ADDL VSL,1641.0,1066.65,1.1,8589.11,106
CDM,37269OH,REVSC EVASC FPVT ST PLMT UNI CPLX LES 1ST VSL,6490.0,4218.5,1.1,29553.87,106
CDM,37270OH,REVSC EVASC FPVT ST PLMT UNI CPLX LES EA ADD VSL,2200.0,1430.0,1.1,8948.16,106
CDM,37271OH,REVSC EVASC FPVT ATHRC UNI SF LES 1ST VSL,3960.0,2574.0,1.1,26968.52,106
CDM,37272OH,REVSC EVASC FPVT ATHRC UNI SF LES EA ADDL VSL,1760.0,1144.0,1.1,5988.71,106
CDM,37273OH,REVSC EVASC FPVT ATHRC UNI CPLX LES 1ST VSL,5557.0,3612.05,1.1,33789.35,106
CDM,37274OH,REVSC EVASC FPVT ATHRC UNI CPLX LES EA ADDL VSL,2420.0,1573.0,1.1,6385.7,106
CDM,37275OH,REVSC EVASC FPVT ST ATHRC UNI SF LES 1ST VSL,4840.0,3146.0,1.1,26261.02,106
CDM,37276OH,REVSC EVASC FPVT ST ATHRC UNI SF LES EA ADDL VSL,1870.0,1215.5,1.1,8845.13,106
CDM,37277OH,REVSC EVASC FPVT ST ATHRC UNI CPLX LES 1ST VSL,6600.0,4290.0,1.1,39393.32,106
CDM,37278OH,REVSC EVSC FPVT ST ATHRC UNI CPLX LES EA ADD VSL,2640.0,1716.0,1.1,9920.87,106
CDM,37279OH,INTRAVASCULAR LITHOTRIPSY FPVT W/IN SAME ARTERY,1760.0,1144.0,1.1,11836.32,106
CDM,37280OH,REVSC EVASC TPVT ANGIOP UNI SF LES 1ST VSL,4312.0,2802.8,1.1,6968.99,106
CDM,37281OH,REVSC EVASC TPVT ANGIOP UNI SF LES EA ADDL VSL,1320.0,858.0,1.1,1905.16,106
CDM,37282OH,REVSC EVASC TPVT ANGIOP UNI CPLX LES 1ST VSL,5416.0,3520.4,1.1,15649.09,106
CDM,37283OH,REVSC EVASC TPVT ANGIOP UNI CPLX LES EA ADDL VSL,1874.0,1218.1,1.1,2241.8,106
CDM,37284OH,REVSC EVASC TPVT ST PLMT UNI SF LES 1ST VSL,4400.0,2860.0,1.1,14434.33,106
CDM,37285OH,REVSC EVASC TPVT ST PLMT UNI SF LES EA ADDL VSL,1470.0,955.5,1.1,7128.51,106
CDM,37286OH,REVSC EVASC TPVT ST PLMT UNI CPLX LES 1ST VSL,5922.0,3849.3,1.1,26517.23,106
CDM,37287OH,REVSC EVASC TPVT ST PLMT UNI CPLX LES EA ADD VSL,2200.0,1430.0,1.1,12622.23,106
CDM,37288OH,REVSC EVASC TPVT ATHRC UNI SF LES 1ST VSL,5940.0,3861.0,1.1,19976.47,106
CDM,37289OH,REVSC EVASC TPVT ATHRC UNI SF LES EA ADDL VSL,2090.0,1358.5,1.1,2395.26,106
CDM,37290OH,REVSC EVASC TPVT ATHRC UNI CPLX LES 1ST VSL,7480.0,4862.0,1.1,27265.34,106
CDM,37291OH,REVSC EVASC TPVT ATHRC UNI CPLX LES EA ADDL VSL,2860.0,1859.0,1.1,2860.0,106
CDM,37292OH,REVSC EVASC TPVT ST ATHRC UNI SF LES 1ST VSL,6600.0,4290.0,1.1,26188.08,106
CDM,37293OH,REVSC EVASC TPVT ST ATHRC UNI SF LES EA ADDL VSL,2860.0,1859.0,1.1,8996.19,106
CDM,37294OH,REVSC EVASC TPVT ST ATHRC UNI CPLX LES 1ST VSL,7920.0,5148.0,1.1,38855.89,106
CDM,37295OH,REVSC EVSC TPVT ST ATHRC UNI CPLX LES EA ADD VSL,3590.0,2333.5,1.1,15355.63,106
CDM,37296OH,REVSC EVASC IMVT ANGIOP UNI SF LES 1ST VSL,4840.0,3146.0,1.1,7836.72,106
CDM,37297OH,REVSC EVASC IMVT ANGIOP UNI SF LES EA ADDL VSL,1760.0,1144.0,1.1,2150.48,106
CDM,37298OH,REVSC EVASC IMVT ANGIOP UNI CPLX LES 1ST VSL,6028.0,3918.2,1.1,8824.76,106
CDM,37299OH,REVSC EVASC IMVT ANGIOP UNI CPLX LES EA ADDL VSL,2200.0,1430.0,1.1,2339.39,106
CDM,37400010,ACUPUNCTURE 1/> NDLS W/ELEC STIMJ 1ST 15 MIN,33.0,21.45,9.17,45.47,86
CDM,37400015,ACUPUNCTURE 1/> NDLS W/ESTIM EACH ADDL 15 MIN,33.0,21.45,7.19,36.64,68
CDM,37501OH,UNLISTED VASCULAR ENDOSCOPY PROCEDURE,109.0,70.85,0.01,1833.54,96
CDM,37565OH,LIGATION INTERNAL JUGULAR VEIN,4820.0,3133.0,1.1,9296.26,144
CDM,37600OH,LIGATION EXTERNAL CAROTID ARTERY,4968.0,3229.2,1.1,9296.26,144
CDM,37605OH,LIGATION INTERNAL/COMMON CAROTID ARTERY,5712.0,3712.8,1.1,9296.26,144
CDM,37607OH,LIG/BANDING ANGIOACCESS ARTERIOVENOUS FISTULA,2500.0,1625.0,1.1,9296.26,144
CDM,37609OH,LIGATION/BIOPSY TEMPORAL ARTERY,1220.0,793.0,1.1,4729.25,148
CDM,37615OH,LIGATION MAJOR ARTERY NECK,3120.0,2028.0,1.1,9296.26,144
CDM,37616OH,LIGATION MAJOR ARTERY CHEST,7588.0,4932.2,1.1,7588.0,144
CDM,37617OH,LIGATION MAJOR ARTERY ABDOMEN,9516.0,6185.4,1.1,9516.0,144
CDM,37618OH,LIGATION MAJOR ARTERY EXTREMITY,2412.0,1567.8,1.1,2412.0,144
CDM,37619OH,LIGATION OF INFERIOR VENA CAVA,12000.0,7800.0,1.1,16027.4,144
CDM,37650OH,LIGATION OF FEMORAL VEIN,3396.0,2207.4,1.1,9296.26,144
CDM,37660OH,LIGATION OF COMMON ILIAC VEIN,8912.0,5792.8,1.1,8912.0,144
CDM,37700OH,LIG&DIV LONG SAPH VEIN SAPHFEM JUNCT/INTERRUPJ,1528.0,993.2,1.1,9296.26,144
CDM,37718OH,LIGJ DIVJ & STRIPPING SHORT SAPHENOUS VEIN,2852.0,1853.8,1.1,9296.26,144
CDM,37722OH,LIGJ DIVJ&STRIP LONG SAPH SAPHFEM JUNCT KNE/BELW,3590.0,2333.5,1.1,9296.26,144
CDM,37735OH,LIGJ & DIVJ RADICAL STRIP LONG/SHORT SAPHENOUS,4360.0,2834.0,1.1,9296.26,144
CDM,37760OH,LIG PRFRATR VEIN SUBFSCAL RAD INCL SKN GRF 1 LEG,4312.0,2802.8,1.1,9296.26,144
CDM,37761OH,LIG PRFRATR VEIN SUBFSCAL OPEN INCL US GID 1 LEG,3652.0,2373.8,1.1,9296.26,144
CDM,37765OH,STAB PHLEBT VARICOSE VEINS 1 XTR 10-20 STAB INCS,2112.0,1372.8,1.1,9296.26,148
CDM,37766OH,STAB PHLEBT VARICOSE VEINS 1 XTR > 20 INCS,2640.0,1716.0,1.1,9296.26,148
CDM,37780OH,LIGJ & DIV SHORT SAPH VEIN SAPHENOPOP JUNCT SPX,1572.0,1021.8,1.1,9296.26,144
CDM,37785OH,LIGJ DIVJ &/EXCJ VARICOSE VEIN CLUSTER 1 LEG,1729.0,1123.85,1.1,9296.26,148
CDM,37799AOH,TRANSCATH RENAL DENERVATN,761.0,494.65,0.01,2283.59,84
CDM,37799BOH,"CREATION OF AVF, PERCUTANEOUS USING MAGNETIC-GUIDED ARTERIAL AND",2288.0,1487.2,0.01,2288.0,84
CDM,37799NORVUOH,UNLISTED PROCEDURE VASCULAR SURGERY,784.0,509.6,0.01,2283.59,84
CDM,37799OH,UNLISTED PROCEDURE VASCULAR SURGERY,862.0,560.3,0.01,2283.59,84
CDM,37799RVU10OH,EXCISION OF VEIN (COMP CODE 35206),3121.0,2028.65,0.01,3121.0,84
CDM,37799RVU11OH,PORTAL/HEPATIC VEIN THROMBECTOMY (COMP CODE 34401),4339.0,2820.35,0.01,4339.0,84
CDM,37799RVU12OH,RESECTION VENOUS ANEURYSM,4531.0,2945.15,0.01,4531.0,84
CDM,37799RVU14OH,EXCISION /LIGATION ABDOMINAL VEINS (COMP CODE 35221),11314.0,7354.1,0.01,11314.0,84
CDM,37799RVU15OH,VENA CAVA RESECTION WITH RECONSTRUCTION (COMP 34502),11116.0,7225.4,0.01,11116.0,84
CDM,37799RVU16OH,THROMBECTOMY HEPATIC ARTERY ANASTOMOSIS,9244.0,6008.6,0.01,9244.0,84
CDM,37799RVU17OH,ENDOVASC REPR ASCENDING THORACIC AORTA,21965.0,14277.25,0.01,21965.0,84
CDM,37799RVU18OH,UNLISTED VASC PROCEDURE,21965.0,14277.25,0.01,21965.0,84
CDM,37799RVU19OH,"SPLENECTOMY,GASTROESOPHAGEAL DEVASCULARIZ",9883.0,6423.95,0.01,9883.0,84
CDM,37799RVU20OH,FENESTRATED ENDOGRAFT MAIN BODY 1 EXT,12158.0,7902.7,0.01,12158.0,84
CDM,37799RVU21OH,FENESTRATED MN BODY 4 EXT,18412.0,11967.8,0.01,18412.0,84
CDM,37799RVU26OH,CAROTID TO CAROTID TRANSPOSITION (COMP CODE 35695),6620.0,4303.0,0.01,6620.0,84
CDM,37799RVU27OH,REPAIR AORTOENTERIC FISTULA (COMP 35189),14676.0,9539.4,0.01,14676.0,84
CDM,37799RVU28OH,SUPERCHARGE COLONIC CONDUIT W/MVA (COMP 15757),6130.0,3984.5,0.01,6130.0,84
CDM,37799RVU29OH,"CATH. OF UMBILICAL VEIN FOR DIAGNOSIS OR THERAPY, FETUS (COMP 36",461.0,299.65,0.01,2283.59,84
CDM,37799RVU2OH,STAB PHLEB VARICOSE LESS THAN 10,2289.0,1487.85,0.01,2289.0,84
CDM,37799RVU30OH,"BYPASS GRAFT, WITH OTHER THAN VEIN; CAROTID-AXILLARY (COMP CODE",7412.0,4817.8,0.01,7412.0,84
CDM,37799RVU31OH,EXTRACORPOREAL CARBO DIOXIDE REMOVAL (COMP 33958),1274.0,828.1,0.01,2283.59,84
CDM,37799RVU32OH,"BYPASS GRAFT, WITH OTHER THAN VEIN; AXILLARY-BRACHIAL (COMP TO 3",9954.0,6470.1,0.01,9954.0,84
CDM,37799RVU33OH,AORTIC ARTERIAL JUMP GRAFT (COMP CODE 47147),2521.0,1638.65,0.01,2521.0,84
CDM,37799RVU34OH,CREATION OF MESORENAL SHUNT (SUP MESENTERIC VEIN TO RENAL VEIN),14401.0,9360.65,0.01,14401.0,84
CDM,37799RVU35OH,EXCISION OF INTERNAL JUGULAR VEIN TUMOR THROMBUS (COMP CODE 3447,7600.0,4940.0,0.01,7600.0,84
CDM,37799RVU36OH,PERCUTANEOUS HEPATIC PERFUSION DELIVERY OF INTRA-ARTERIAL HIGH D,440.0,286.0,0.01,2283.59,84
CDM,37799RVU37OH,FIBRIN SHEATH DISRUPTION W/BALLOON (COMP CODE 36595),1436.0,933.4,0.01,2283.59,84
CDM,37799RVU38OH,SELECTIVE EXTERNAL CAROTID ANGIOGRAPHY (COMP CODE 36227),920.0,598.0,0.01,2283.59,84
CDM,37799RVU39OH,CRYOABLATION AVM (COMP CODE 20983),2752.0,1788.8,0.01,2752.0,84
CDM,37799RVU3OH,"LIGATION, AV FISTULA",1052.0,683.8,0.01,2283.59,84
CDM,37799RVU40OH,VENOUS SINUS TEST BALLOON OCCLUSION (COMP CODE 61623),3980.0,2587.0,0.01,3980.0,84
CDM,37799RVU41OH,BILAT MIDDLE MENINGEAL ARTERY LIDOCAINE INFUSION (COMP CODE 6165,4000.0,2600.0,0.01,4000.0,84
CDM,37799RVU42OH,"EXPLORATION OF VEIN, NOT FOLLOWED BY SURGICAL REPAIR (COMP CODE",2848.0,1851.2,0.01,2848.0,84
CDM,37799RVU4OH,EXCISION OF GRAFT (COMP 35907),13418.0,8721.7,0.01,13418.0,84
CDM,37799RVU6OH,STAB INCISION UNDER 10 (COMP CODE 37765),2289.0,1487.85,0.01,2289.0,84
CDM,37799RVU8OH,RELEASE MEDIAN LIGAMENT,4937.0,3209.05,0.01,4937.0,84
CDM,38100OH,SPLENECTOMY TOTAL SEPARATE PROCEDURE,7820.0,5083.0,1.1,7820.0,144
CDM,38101OH,SPLENECTOMY PARTIAL SEPARATE PROCEDURE,7820.0,5083.0,1.1,7820.0,144
CDM,38102OH,SPLENC TOT EN BLOC EXTNSV DS CONJUNCT W/OTH PX,1916.0,1245.4,1.1,1916.0,144
CDM,38115OH,RPR RPTD SPLEEN SPLENORRHAPHY W/WO PRTL SPLENECT,8752.0,5688.8,1.1,8752.0,144
CDM,38120OH,"LAPAROSCOPY, SURGICAL, SPLENECTOMY",6828.0,4438.2,1.1,30022.29,144
CDM,38129OH,"UNLISTED LAPAROSCOPY PROCEDURE, SPL",3856.0,2506.4,0.01,16829.38,84
CDM,38129RVUOH,"UNLIST LAP PROC, SPLEEN COMPARED TO 47300",6585.0,4280.25,0.01,16829.38,84
CDM,38200OH,INJECTION PROCEDURE SPLENOPORTOGRAPY,1056.0,686.4,1.1,1056.0,144
CDM,38205OH,BLD-DRV HEMATOP PROGEN CELL HRVG TRNSPLJ ALGNC,660.0,429.0,1.1,660.0,142
CDM,38206OH,BLD-DRV HEMATOP PROGEN CELL HRVG TRNSPLJ AUTOL,660.0,429.0,1.1,4475.18,144
CDM,38207OH,TRNSPL PREPJ HEMATOP PROGEN CELLS CRYOPRSRV STOR,356.0,231.4,1.1,1267.25,98
CDM,38209OH,TRNSP PREP HMATOP PROG THAW PREV HRV WSH PER DNR,96.0,62.4,1.1,1267.25,98
CDM,38210OH,TRNSPL PREPJ HEMATOP PROGEN DEPLJ IN HRV T-CELL,628.0,408.2,1.1,1267.25,98
CDM,38212OH,TRNSPL PREPJ HEMATOP PROGEN RED BLD CELL RMVL,376.0,244.4,1.1,1267.25,98
CDM,38214OH,TRNSPL PREPJ HEMATOP PROGEN PLSM VOL DEPLJ,324.0,210.6,1.1,1267.25,98
CDM,38215OH,TRNSPL PREPJ HEMATOP PROGEN CONCENTRATION PLSM,376.0,244.4,1.1,1267.25,98
CDM,38220OH,DIAGNOSTIC BONE MARROW ASPIRATIONS,480.0,312.0,1.1,4729.25,148
CDM,38221OH,DIAGNOSTIC BONE MARROW BIOPSIES,512.0,332.8,1.1,4729.25,148
CDM,38222OH,DIAGNOSTIC BONE MARROW BIOPSIES & ASPIRATIONS,634.0,412.1,1.1,8286.13,148
CDM,38225OH,CAR-T THERAPY HRVG BLD-DRV T LYMPHCYT PR DAY,854.0,555.1,1.1,854.0,106
CDM,38226OH,CAR-T THERAPY PREPJ BLD-DRV T LYMPHCYT F/TRNS,348.0,226.2,1.1,348.0,106
CDM,38227OH,CAR-T THERAPY RECEIPT & PREPJ CAR-T CELLS F/ADMN,352.0,228.8,1.1,4330.51,106
CDM,38228OH,CAR-T THERAPY AUTOL CAR-T CELL ADMINISTRATION,1320.0,858.0,1.1,1449.2,144
CDM,38230OH,BONE MARROW HARVEST TRANSPLANTATION ALLOGENEIC,1400.0,910.0,1.1,4475.18,142
CDM,38232OH,BONE MARROW HARVEST TRANSPLANTATION AUTOLOGOUS,1400.0,910.0,1.1,13495.95,144
CDM,38240OH,TRNSPLJ ALLOGENEIC HEMATOPOIETIC CELLS PER DONOR,1760.0,1144.0,1.1,159374.03,144
CDM,38241OH,TRNSPLJ AUTOLOGOUS HEMATOPOIETIC CELLS PER DONOR,1320.0,858.0,1.1,4475.18,144
CDM,38242OH,ALLOGENEIC LYMPHOCYTE INFUSIONS,928.0,603.2,1.1,4475.18,144
CDM,38243OH,TRNSPLJ HEMATOPOIETIC CELL BOOST,852.0,553.8,1.1,4475.18,142
CDM,38300OH,DRG LYMPH NODE ABSC/LYMPHADENITIS SMPL,944.0,613.6,1.1,8286.13,148
CDM,38305OH,DRG LYMPH NODE ABSC/LYMPHADENITIS EXTNSV,2672.0,1736.8,1.1,8286.13,144
CDM,38308OH,LYMPHANGIOTOMY/OTH OPRATIONS LYMPHATIC CHANNELS,2724.0,1770.6,1.1,11117.55,144
CDM,38380OH,SUTR&/LIG THORACIC DUCT CERVICAL APPROACH,3384.0,2199.6,1.1,3384.0,144
CDM,38381OH,SUTR&/LIG THORACIC DUCT THORACIC APPROACH,5352.0,3478.8,1.1,5352.0,144
CDM,38382OH,SUTR&/LIG THORACIC DUCT ABDOMINAL APPROACH,4260.0,2769.0,1.1,4260.0,144
CDM,38500OH,BX/EXC LYMPH NODE OPEN SUPERFICIAL,1516.0,985.4,1.1,11117.55,148
CDM,38505OH,BX/EXC LYMPH NODE NEEDLE SUPERFICIAL,636.0,413.4,1.1,4729.25,148
CDM,38510OH,BX/EXC LYMPH NODE OPEN DEEP CERVICAL NODE,2696.0,1752.4,1.1,11117.55,148
CDM,38520OH,BX/EXC LYMPH NODE OPN DP CRV NODE W/EXC FAT PAD,2812.0,1827.8,1.1,11117.55,144
CDM,38525OH,BX/EXC LYMPH NODE OPEN DEEP AXILLARY NODE,2572.0,1671.8,1.1,11117.55,144
CDM,38530OH,BX/EXC LYMPH NODE OPEN INT MAMMARY NODE,3336.0,2168.4,1.1,11117.55,144
CDM,38531OH,OPEN BIOPSY/EXCISION INGUINOFEMORAL NODES,2696.0,1752.4,1.1,11117.55,144
CDM,38542OH,DISSECTION DEEP JUGULAR NODE,3180.0,2067.0,1.1,16829.38,144
CDM,38550OH,EXC CSTIC HYGROMA AX/CRV W/O DP NEUROVASC DSJ,2844.0,1848.6,1.1,11117.55,144
CDM,38555OH,EXC CSTIC HYGROMA AX/CRV W/DP NEUROVASC DSJ,6236.0,4053.4,1.1,19017.99,144
CDM,38562OH,LMTD LMPHADEC STAGING SPX PEL&PARA-AORTIC,4424.0,2875.6,1.1,4424.0,144
CDM,38564OH,LMTD LMPHADEC STAGING SPX RPR AORTIC&/SPLENIC,4552.0,2958.8,1.1,4552.0,144
CDM,38570OH,LAPS SURG RETROPERITONEAL LYMPH NODE BX 1/MLT,3736.0,2428.4,1.1,16829.38,144
CDM,38571OH,LAPS SURG BILATERAL TOTAL PELVIC LMPHADECTOMY,5280.0,3432.0,1.1,30022.29,144
CDM,38572OH,LAPS BI TOT PEL LMPHADEC & PRI-AORTIC LYMPH BX 1,6240.0,4056.0,1.1,30022.29,144
CDM,38573OH,LAPS W/BI TOT PEL LMPHADEC & OMNTC LYMPH BX,8000.0,5200.0,1.1,30022.29,144
CDM,38589RVU1OH,"UNLISTED LAPAROSCOPY PROCEDURE, LYMPHATIC SYSTEM (COMPARISON COD",3167.0,2058.55,0.01,16829.38,84
CDM,38589RVU3OH,"UNLIST LAP PROC, LYMPHATIC SYSTEM COMPARED TO 38747",1610.0,1046.5,0.01,16829.38,84
CDM,38589RVU4OH,"UNLISTED LAPAROSCOPY PROCEDURE, LYMPHATIC SYSTEM (COMPARISON COD",340.0,221.0,0.01,16829.38,84
CDM,38589RVU5OH,UNLISTED PROC; LAP INGUINAL LYMPH NODE DISSECTION (COMPARED TO 3,4495.0,2921.75,0.01,16829.38,84
CDM,38589RVU6OH,LAP ROBOTIC RETROPERITONEAL LYMPHADENECTOMY COMP 38780,7016.0,4560.4,0.01,16829.38,84
CDM,38589RVUOH,LAPAROSCOPIC LYMPHANDECTOMY,1360.0,884.0,0.01,16829.38,84
CDM,38700OH,SUPRAHYOID LYMPHADENECTOMY,5124.0,3330.6,1.1,19017.99,144
CDM,38720OH,CERVICAL LYMPHADENECTOMY,8780.0,5707.0,1.1,19017.99,144
CDM,38724OH,CERVICAL LYMPHADEC MODIFIED RADICAL NECK DSJ,9580.0,6227.0,1.1,9580.0,144
CDM,38740OH,AXILLARY LYMPHADENECTOMY SUPERFICIAL,4280.0,2782.0,1.1,16829.38,144
CDM,38745OH,AXILLARY LYMPHADENECTOMY COMPLETE,5548.0,3606.2,1.1,16829.38,144
CDM,38746OH,THORCOM THRC W/MEDSTNL & REGIONAL LMPHADEC,1648.0,1071.2,1.1,1648.0,144
CDM,38747OH,ABDL LMPHADEC REG CELIAC GSTR PORTAL PRIPNCRTC,1952.0,1268.8,1.1,1952.0,144
CDM,38760OH,INGUINOFEM LMPHADEC SUPFC W/CLOQUETS NODE SPX,5448.0,3541.2,1.1,19017.99,144
CDM,38765OH,INGUINOFEM LMPHADEC SUPFC W/PEL LMPHADEC,8764.0,5696.6,1.1,8764.0,144
CDM,38770OH,PEL LMPHADEC W/XTRNL ILIAC HYPOGSTR&OBTURATOR,5624.0,3655.6,1.1,5624.0,144
CDM,38780OH,RPR TABDL LMPHADEC EXTNSV W/PEL AORTIC&RNL,7080.0,4602.0,1.1,7080.0,144
CDM,38790OH,INJECTION PROCEDURE LYMPHANGIOGRAPHY,568.0,369.2,1.1,568.0,144
CDM,38792OH,INJ RADIOACTIVE TRACER FOR ID OF SENTINEL NODE,260.0,169.0,1.1,1202.97,148
CDM,38794OH,CANNULATION THORACIC DUCT,1848.0,1201.2,1.1,1848.0,144
CDM,38900OH,INTRAOP SENTINEL LYMPH NODE ID W/DYE INJECTION,1000.0,650.0,1.1,1000.0,144
CDM,38999ALLOOH,ALLOGENEIC INFUSION ALLO 715 (COMP 0540T),4333.0,2816.45,0.01,4333.0,84
CDM,38999NKXOH,ALLOGENEIC ADMINISTRATION NKX 101 (COMP 0537T),1522.0,989.3,0.01,1522.0,84
CDM,38999PBSCOH,ALLOGENEIC INFUSION PBSC 1490 (COMP 0540T),4333.0,2816.45,0.01,4333.0,84
CDM,38999RVU10OH,LNVA - MICROSURGERY,14750.0,9587.5,0.01,14750.0,84
CDM,38999RVU11OH,"LVA/LVB MICROSURGERY - PREVENTATIVE (COMP 35206, 38308, 69990)",4000.0,2600.0,0.01,4000.0,84
CDM,38999RVU12OH,"LVA/LVB MICROSURGERY - THERAPEUTIC (COMP 35206, 38308, 69990)",20000.0,13000.0,0.01,20000.0,84
CDM,38999RVU13OH,ICG LYMPHOGRAPHY,469.0,304.85,0.01,1267.25,84
CDM,38999RVU14OH,UNLISTED MAGTRACE INJECTION ADMINISTRATION (COMP CODE 38900),1063.0,690.95,0.01,1267.25,84
CDM,38999RVU2OH,EXCISION PENILE LYMPHEDEMA,12429.0,8078.85,0.01,12429.0,84
CDM,38999RVU3OH,"UNLISTED PROCEDURE, HEMIC OR LYMPHATIC SYSTEM (COMPARISON CODE 3",410.0,266.5,0.01,1267.25,84
CDM,38999RVU4OH,"THERAPEUTIC LVA (COMP 35206, 38308, 69990)",7956.0,5171.4,0.01,7956.0,84
CDM,38999RVU6OH,"IMMEDIATE LVA (COMP 35206, 38308, 69990)",4774.0,3103.1,0.01,4774.0,84
CDM,38999RVU7OH,RESEARCH IMMUNE EFFECTOR CELL COLLECTION FOR AUTO AND ALLO (COMP,1281.0,832.65,0.01,1281.0,84
CDM,38999RVU8OH,RESEARCH IMMUNE EFFECTOR CELL (IEC) INFUSION (COMP 96413),650.0,422.5,0.01,1267.25,84
CDM,38999RVU9OH,RESEARCH CAR T ALLOGENEIC COLLECTION (COMP 0537T),1281.0,832.65,0.01,1281.0,84
CDM,39000010,WHOLE BLOOD TXFUS PER UNIT,1553.0,1009.45,175.8,1553.0,84
CDM,39000020,CRYOPRECIPITATE EA UNIT,439.0,285.35,54.51,439.0,84
CDM,39000040,RBC LR EA UNIT,1256.0,816.4,164.64,1256.0,84
CDM,39000050,FFP SNGL DONOR WITHIN 8 HR,582.0,378.3,72.81,582.0,84
CDM,39000070,RBC EA UNIT,996.0,647.4,124.3,996.0,84
CDM,39000090,PLT LR EA UNIT,868.0,564.2,116.59,868.0,84
CDM,39000100,PLT PHERESIS LR EA UNIT,3361.0,2184.65,342.99,3361.0,84
CDM,39000120,RBC LR IRRAD EA UNIT,1765.0,1147.25,209.08,1765.0,84
CDM,39000125,SPLIT UNIT,978.0,635.7,131.45,978.0,84
CDM,39000150,PLTS PHERESIS PER UNIT,2740.0,1781.0,286.1,2740.0,84
CDM,39000195,RED CELLS WASHED EA UNIT,2738.0,1779.7,341.31,2738.0,84
CDM,39000255,PLTS PHERESIS LEUKOR IRR,4662.0,3030.3,342.99,4662.0,84
CDM,39000305,PLTS PHERESIS LEUKOR HLA,5365.0,3487.25,342.99,5365.0,84
CDM,39000385,RBC IRRADIATED EACH UNIT,1030.0,669.5,134.48,1030.0,84
CDM,39000395,GRANUL LEUK 1U TRANSFUSED,6884.0,4474.6,342.99,6884.0,66
CDM,39000405,RED CELL FROZ/THAW 1 UNIT,4511.0,2932.15,209.08,4511.0,84
CDM,39000455,PLATELET RICH PLASMA UNIT,3846.0,2499.9,209.08,3846.0,84
CDM,39000465,PLATELETS IRRADIATED EA UNIT,937.0,609.05,121.43,937.0,84
CDM,39000475,PLATELETS LEUKORED IRRAD EA UNIT,1417.0,921.05,175.56,1417.0,84
CDM,39000485,PLATELET PHERESIS IRRAD EA UNIT,4055.0,2635.75,342.99,4055.0,84
CDM,39000495,PLASMA CRYOPRECIPITATE REDUCED EA UNIT,1016.0,660.4,62.96,1016.0,84
CDM,39000505,WH BLD OR RBC L/R CMV NEG EA UNIT,1188.0,772.2,140.37,1188.0,84
CDM,39000515,PLT PHER IRR L/R CMV NEG EA UNIT,3169.0,2059.85,342.99,3169.0,84
CDM,39000525,RBC L/R IRR CMV NEG EA UNIT,1538.0,999.7,206.6,1538.0,84
CDM,39000535,FR FRZ PLASMA FRZN 8-24 HOURS EA UNIT,491.0,319.15,65.9,491.0,84
CDM,39000545,FR FRZ PLASMA DONOR RETESTED EA UNIT,338.0,219.7,45.36,338.0,84
CDM,39000555,PLASMA SNGL DONOR PATHOGEN REDUCED FRZN EACH UNIT,2018.0,1311.7,209.08,2018.0,84
CDM,39000565,PLT PHER PATH-RED EA,4052.0,2633.8,342.99,4052.0,84
CDM,39000575,CONVALESCENT PLASMA,491.0,319.15,65.9,491.0,84
CDM,39000655,RED CELL LEUKOREDUCED DEGLYCEROLIZED IRRADIATED,3349.0,2176.85,209.08,3349.0,84
CDM,39000OH,MEDIAST W/EXPL DRG RMVL FB/BX CRV APPR,3028.0,1968.2,1.1,3028.0,144
CDM,39010OH,MEDIAST W/EXPL DRG RMVL FB/BX TTHRC APPR,5276.0,3429.4,1.1,5276.0,144
CDM,39100000,TXFUS BLOOD/BLOOD COMPONENT,2514.0,1634.1,58.82,4392.0,87
CDM,39100010,TRANSFUSION BLOOD OR BLOOD COMPONENTS,2514.0,1634.1,58.82,4392.0,87
CDM,39100015,EXCHNG TRANSFUSION BLOOD OTHER/THAN NEW BORN,2514.0,1634.1,145.96,3443.0,86
CDM,39100020,TRANSFUSION BLOOD OR BLOOD COMPONENT - PACU,2514.0,1634.1,58.82,4392.0,87
CDM,39200OH,RESECTION OF MEDIASTINAL CYST,6036.0,3923.4,1.1,6036.0,144
CDM,39220OH,RESECTION MEDIASTINAL TUMOR,7820.0,5083.0,1.1,7820.0,144
CDM,39401OH,MEDIASTINOSCOPY INCLUDES MEDIASTINAL MASS BIOPSY,2176.0,1414.4,1.1,16829.38,144
CDM,39402OH,MEDIASTINOSCOPY WITH LYMPH NODE BIOPSY/IES,2900.0,1885.0,1.1,16829.38,144
CDM,39501OH,REPAIR LACERATION DIAPHRAGM ANY APPROACH,5592.0,3634.8,1.1,5592.0,144
CDM,39503OH,RPR NEONATAL DIPHRG HERNIA W/WO CHEST TUBE INSJ,43564.0,28316.6,1.1,43564.0,144
CDM,39540OH,RPR DIPHRG HRNA OTH/THN NEONATAL TRAUMTC AQT,5828.0,3788.2,1.1,5828.0,144
CDM,39541OH,RPR DIPHRG HRNA OTH/THN NEONATAL TRAUMTC CHRNC,6300.0,4095.0,1.1,6300.0,144
CDM,39545OH,IMBRICATION DIAPHRAGM EVENTRATION,5868.0,3814.2,1.1,5868.0,144
CDM,39560OH,RESCJ DIAPHRAGM W/SIMPLE REPAIR,5224.0,3395.6,1.1,5224.0,144
CDM,39561OH,RESCJ DIAPHRAGM W/COMPLEX REPAIR,7996.0,5197.4,1.1,7996.0,144
CDM,39599RVU1OH,VATS PLICATION OF DIAPHRAGM (COMP CODE 39545),4841.0,3146.65,0.01,3061000.0,84
CDM,39599RVU2OH,UNLISTED PROC; LAP DIAPHRAGM RESECTION (COMP TO 39560),5224.0,3395.6,0.01,3061000.0,84
CDM,39599RVU3OH,"UNLISTED PROC, LAPAROSCOPIC REPAIR OF DIAPHRAGMATIC HERNIA (NON-",4808.0,3125.2,0.01,3061000.0,84
CDM,39599RVU4OH,LAP OR ROBOTIC REPAIR OF DIAPHRAGMATIC HERNIA; CHRONIC (COMP COD,5671.0,3686.15,0.01,3061000.0,84
CDM,39599RVU6OH,UNLISTED THORACOSCOPIC REPAIR CONGENITAL DIAPHRAGMATIC HERNIA-NE,43564.0,28316.6,0.01,3061000.0,84
CDM,40000145,CPTRIZD OPH DX IMG PST SGM UNI/BI RTA OCT ANGRPH,1432.0,930.8,47.73,1432.0,84
CDM,40100005,DIGITAL BREAST TOMOSYNTHESIS UNILATERAL,111.0,72.15,24.2,462.83,67
CDM,40100015,DIGITAL BREAST TOMOSYNTHESIS BILATERAL,134.0,87.1,29.21,591.75,67
CDM,40100045,DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI,563.0,365.95,51.83,563.0,86
CDM,40100055,DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI,706.0,458.9,51.83,706.0,86
CDM,40100070,DIGITAL BREAST TOMOSYNTHESIS UNILATERAL,111.0,72.15,24.2,462.83,67
CDM,40100080,DIGITAL BREAST TOMOSYNTHESIS BILATERAL,134.0,87.1,29.21,591.75,67
CDM,40200010,3D RENDERING W/INTERP & POSTPROCESS SUPERVISION,566.0,367.9,32.47,566.0,68
CDM,40200015,ECHOENCEPHALOGRAPHY REAL TIME IMAGING,734.0,477.1,95.38,89436.42,87
CDM,40200020,US SOFT TISSUE HEAD & NECK REAL TIME IMGE DOCM,734.0,477.1,95.38,89471.48,87
CDM,40200025,OPHTHALMIC US DX B-SCAN&QUAN A-SCAN SM PT ENCTR,889.0,577.85,88.54,89441.09,87
CDM,40200030,US CHEST REAL TIME W/IMAGE DOCUMENTATION,734.0,477.1,72.73,89550.98,87
CDM,40200045,OPHTHALMIC US DX B-SCAN W/WO NON-QUAN A-SCAN,734.0,477.1,60.95,89443.43,87
CDM,40200050,US ABDOMINAL REAL TIME W/IMAGE DOCUMENTATION,734.0,477.1,95.38,89663.2,87
CDM,40200055,DX OPHTHALMIC US ANT SEGMENT IMMERSION UNI/BI,734.0,477.1,95.38,89444.59,87
CDM,40200060,US ABDOMINAL REAL TIME W/IMAGE LIMITED,734.0,477.1,95.38,89669.04,87
CDM,40200065,OPHTHALMIC US DX CORNEAL PACHYMETRY UNI/BI,169.0,109.85,13.87,89445.77,87
CDM,40200070,US RETROPERITONEAL REAL TIME W/IMAGE COMPLETE,734.0,477.1,95.38,89745.04,87
CDM,40200075,OPHTHALMIC BIOMETRY US ECHOGRAPY A-SCAN,734.0,477.1,60.82,89448.1,87
CDM,40200080,US RETROPERITONEAL REAL TIME W/IMAGE LIMITED,734.0,477.1,76.6,89750.88,87
CDM,40200085,OPH BMTRY US ECHOGRAPY A-SCAN IO LENS PWR CAL,734.0,477.1,89.36,89451.61,87
CDM,40200090,US TRNSPLNT KIDNEY REAL TIME W/IMAGE DOCMTN,734.0,477.1,95.38,89752.05,87
CDM,40200095,ULTRASOUND SPINAL CANAL & CONTENTS,734.0,477.1,95.38,89780.1,87
CDM,40200100,US PREGNANT UTERUS 14 WK TRANSABDL 1/1ST GESTAT,734.0,477.1,95.38,89781.27,87
CDM,40200105,US PREG UTERUS 14 WK TRANSABDL EACH GESTATION,711.0,462.15,67.32,89782.45,68
CDM,40200110,US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION,734.0,477.1,95.38,89785.94,87
CDM,40200115,US PREG UTERUS W/DETAIL FETAL ANAT 1ST GESTATION,1668.0,1084.2,116.89,89792.96,87
CDM,40200120,US PREG UTERUS > 1ST TRIMESTER ABDL EA GESTATIO,711.0,462.15,111.5,89791.8,68
CDM,40200125,US PREG UTERUS DETAIL FETAL ANAT EXAM EA GESTAT,654.0,425.1,116.89,89794.13,68
CDM,40200130,US PREGNANT UTERUS LIMITED 1/> FETUSES,734.0,477.1,95.38,89797.64,87
CDM,40200135,US FETAL NUCHAL TRANSLUCENCY 1ST GESTATION,734.0,477.1,95.38,89795.3,87
CDM,40200140,US PREG UTERUS REAL TIME W/IMAGE DCMTN TRANSVAG,734.0,477.1,95.38,89799.97,87
CDM,40200145,US FETAL NUCHAL TRANSLUCENCY EA ADDL GESTATION,426.0,276.9,78.5,89796.47,68
CDM,40200150,US TRANSVAGINAL,734.0,477.1,95.38,89815.18,87
CDM,40200160,SALINE INFUS SONOHYSTEROGRAPHY W/COLOR DOPPLER,1668.0,1084.2,150.27,89816.34,87
CDM,40200165,US PREG UTERUS REAL TIME F/U TRNSABDL PER FETUS,734.0,477.1,95.38,89798.81,87
CDM,40200170,US PELVIC NONOBSTETRIC REAL-TIME IMAGE COMPLETE,734.0,477.1,95.38,89845.57,87
CDM,40200175,FETAL BIOPHYSICAL PROFILE NON-STRESS TESTING,734.0,477.1,95.38,89801.15,87
CDM,40200180,US PELVIC NONOBSTETRIC IMAGE DCMTN LIMITED/F/U,734.0,477.1,63.2,89846.73,87
CDM,40200185,FETAL BIOPHYSICAL PROFILE W/O NON-STRESS TESTING,734.0,477.1,95.38,89802.32,87
CDM,40200190,US SCROTUM & CONTENTS,734.0,477.1,95.38,89861.94,87
CDM,40200195,DOPPLER VELOCIMETRY FETAL UMBILICAL ARTERY,734.0,477.1,56.91,89803.48,87
CDM,40200200,US TRANSRECTAL,734.0,477.1,95.38,89864.27,87
CDM,40200205,DOPPLER VELOCIMETRY FETAL MIDDLE CEREBRAL ART,734.0,477.1,95.38,89804.65,87
CDM,40200210,US TRANSRCT PRSTATE VOL BRACHYTX PLNNING SPX,734.0,477.1,95.38,89865.44,87
CDM,40200215,ECHO FETAL CARDIOVASC W/WO M-MODE RECORDING,3783.0,2458.95,116.89,89809.32,87
CDM,40200220,US COMPL JOINT R-T W/IMAGE DOCUMENTATION,734.0,477.1,68.54,89874.79,87
CDM,40200225,ECHO FETAL CARDIOVASC W/WO M-MODE REPEAT STD,1668.0,1084.2,116.89,89810.5,87
CDM,40200240,US CMPRN RPR ARTL PSEUDOARYSM/ARVEN FSTL,2149.0,1396.85,112.68,89939.09,87
CDM,40200245,DOPPLER ECHO FETAL PULS SPECTRAL F/U/REPEAT,734.0,477.1,61.89,89812.83,87
CDM,40200250,US VASC ACCESS SITS VSL PATENCY NDL ENTRY,266.0,172.9,49.6,89940.25,68
CDM,40200265,US INFT HIPS R-T IMG DYNAMIC REQ PHYS/QHP MANJ,608.0,395.2,78.83,89879.47,87
CDM,40200270,US &MNTR PARENCHYMAL TISSUE ABLATION,698.0,453.7,93.21,698.0,66
CDM,40200280,US GUIDANCE NEEDLE PLACEMENT IMG S&I,863.0,560.95,73.26,89946.11,68
CDM,40200295,US GUIDANCE AMNIOCENTESIS IMG S&I,366.0,237.9,34.68,89950.78,68
CDM,40200300,ULTRASONIC GUIDANCE INTRAOPERATIVE,843.0,547.95,93.21,843.0,66
CDM,40200305,US GUIDANCE ASPIRATION OVA IMG S&I,207.0,134.55,34.68,89953.12,68
CDM,40200320,US LMTD JOINT/OTH NONVASC XTR STRUX R-T W/IMG,734.0,477.1,29.1,89875.97,87
CDM,40200325,US GUIDANCE INTERSTITIAL RADIOELMENT APPLICATION,1192.0,774.8,61.73,89972.99,69
CDM,40200330,US UNLISTED SOFT TISSUE,323.0,209.95,78.83,409.57,85
CDM,40200355,US BREAST UNI REAL TIME WITH IMAGE COMPLETE,734.0,477.1,95.38,89594.23,87
CDM,40200360,US BREAST UNI REAL TIME WITH IMAGE COMPLETE,734.0,477.1,95.38,89594.23,87
CDM,40200365,US BREAST UNI REAL TIME WITH IMAGE LIMITED,608.0,395.2,78.83,89595.4,87
CDM,40200370,US BREAST UNI REAL TIME WITH IMAGE LIMITED,608.0,395.2,78.83,89595.4,87
CDM,40200395,US GUIDANCE CHORIONIC VILLUS SAMPLING IMG S&I,239.0,155.35,52.1,239.0,66
CDM,40200425,US ABDOMINAL AORTA REAL TIME SCREEN STUDY AAA,734.0,477.1,95.38,89670.22,87
CDM,40200445,RADIOLOGICAL GUIDANCE PRQ DRG W/PLMT CATH RS&I,2127.0,1382.55,112.68,88832.03,68
CDM,40201025,US GUIDANCE NEEDLE PLACEMENT IMG S&I,863.0,560.95,73.26,89946.11,68
CDM,40201055,US INFT HIPS R-T IMG LMTD STATIC PHYS/QHP MANJ,608.0,395.2,78.83,89880.64,87
CDM,40201075,US INFT HIPS R-T IMG LMTD STATIC PHYS/QHP MANJ,608.0,395.2,78.83,89880.64,87
CDM,40201085,US GUIDANCE NEEDLE PLACEMENT IMG S&I,863.0,560.95,73.26,89946.11,68
CDM,40201095,US GUIDANCE NEEDLE PLACEMENT IMG S&I,863.0,560.95,73.26,89946.11,68
CDM,40201105,US MICROBUBBLE  CONTR CHARACTER (NON-CARDIAC) INITIAL LESION,637.0,414.05,138.87,637.0,58
CDM,40201115,ULTRASOUND TRGT DYNAMIC MICROBUBBLE EA ADDL LES,766.0,497.9,143.11,89989.36,68
CDM,40201125,ULTRASOUND ELASTOGRAPHY FIRST TARGET LESION,734.0,477.1,95.38,89992.87,87
CDM,40201135,ULTRASOUND ELASTOGRAPHY EA ADDL TAGET LESION,1030.0,669.5,80.3,89994.03,68
CDM,40201145,ULTRASOUND ELASTOGRAPHY PARENCHYMA,734.0,477.1,95.38,89991.69,87
CDM,40201155,ULTRASOUND TRGT DYNAMIC MICROBUBBLE 1ST LESION,1228.0,798.2,150.27,89988.19,87
CDM,40201165,ULTRASOUND TRGT DYNAMIC MICROBUBBLE EA ADDL LES,766.0,497.9,143.11,89989.36,68
CDM,40201175,ULTRASOUND ELASTOGRAPHY PARENCHYMA,734.0,477.1,95.38,89991.69,87
CDM,40201185,ULTRASOUND ELASTOGRAPHY FIRST TARGET LESION,734.0,477.1,95.38,89992.87,87
CDM,40201195,USE EA ADDL TARGET LESION,1030.0,669.5,80.3,89994.03,68
CDM,40201205,LIVER ELASTOGRAPHY W/O IMAG W/I&R,720.0,468.0,40.35,720.0,86
CDM,40201255,US NRV&ACC STRUX 1 XTR COMPRE W/IMG PR EXTREMITY,734.0,477.1,91.23,734.0,87
CDM,40201265,QUANTITATIVE US TISS CHARAC I&R W/DX US SM ANAT,108.0,70.2,23.54,113.14,66
CDM,40300005,SCREENING DIGITAL BREAST TOMOSYNTHESIS BI,140.0,91.0,38.92,90087.56,85
CDM,40300025,SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD,609.0,395.85,51.83,609.0,86
CDM,40300040,SCREENING DIGITAL BREAST TOMOSYNTHESIS BI,140.0,91.0,38.92,90087.56,85
CDM,40400005,PET IMAGING SKULL BASE TO MID-THIGH,10064.0,6541.6,1352.17,92132.15,77
CDM,40400010,MYOCRD IMG PET METAB EVAL SINGLE STUDY,9008.0,5855.2,1210.23,91719.5,77
CDM,40400015,PET IMAGING WHOLE BODY,10064.0,6541.6,1352.17,92133.32,77
CDM,40400020,MYOCRD IMG PET PRFUJ SINGLE STUDY REST/STRESS,10064.0,6541.6,1352.17,91756.9,77
CDM,40400025,PET IMAGING LIMITED AREA CHEST HEAD/NECK,9008.0,5855.2,1210.23,92130.99,77
CDM,40400030,MYOCRD IMG PET PRFUJ MULTIPLE STUDY REST&STRESS,10064.0,6541.6,1352.17,91758.07,77
CDM,40400035,PET IMAGING LIMITED AREA CHEST HEAD/NECK,9008.0,5855.2,1210.23,92130.99,77
CDM,40400040,BRAIN IMAGING PET METABOLIC EVALUATION,10064.0,6541.6,1352.17,91893.68,77
CDM,40400045,PET IMAGING CT FOR ATTENUATION LIMITED AREA,10064.0,6541.6,1352.17,92134.5,77
CDM,40400055,PET IMAGING CT ATTENUATION SKULL BASE MID-THIGH,10064.0,6541.6,1352.17,92135.66,77
CDM,40400065,PET IMAGING FOR CT ATTENUATION WHOLE BODY,10064.0,6541.6,1352.17,92136.83,77
CDM,40400140,PET IMAGING CT ATTENUATION SKULL BASE MID-THIGH,10064.0,6541.6,1352.17,92135.66,77
CDM,40400170,PET IMAGING FOR CT ATTENUATION WHOLE BODY,10064.0,6541.6,1352.17,92136.83,77
CDM,40400200,PET IMAGING CT FOR ATTENUATION LIMITED AREA,10064.0,6541.6,1352.17,92134.5,77
CDM,40400210,PET IMAGING CT ATTENUATION SKULL BASE MID-THIGH,10064.0,6541.6,1352.17,92135.66,77
CDM,40400220,PET IMAGING FOR CT ATTENUATION WHOLE BODY,10064.0,6541.6,1352.17,92136.83,77
CDM,40400230,PET IMAGING CT FOR ATTENUATION LIMITED AREA,10064.0,6541.6,1352.17,92134.5,77
CDM,40490OH,BIOPSY OF LIP,488.0,317.2,1.1,713.21,148
CDM,40500OH,VERMILIONECTOMY LIP SHV W/MUCOSAL ADVMNT,1788.0,1162.2,1.1,9391.15,148
CDM,40510OH,EXC LIP TRANSVRS WEDGE EXC W/PRIM CLSR,1928.0,1253.2,1.1,9391.15,148
CDM,40520OH,EXC LIP V-EXC W/PRIM DIR LINR CLSR,1916.0,1245.4,1.1,9391.15,148
CDM,40525OH,EXC LIP FULL THKNS RCNSTJ W/LOCAL FLAP,3088.0,2007.2,1.1,9391.15,144
CDM,40527OH,EXC LIP FULL THKNS RCNSTJ W/CROSS LIP FLAP,3728.0,2423.2,1.1,17080.38,144
CDM,40530OH,RESCJ LIP > ONE-FOURTH W/O RCNSTJ,2216.0,1440.4,1.1,9391.15,148
CDM,40650OH,RPR LIP FULL THICKNESS VERMILION ONLY,1512.0,982.8,1.1,1603.96,148
CDM,40652OH,RPR LIP FULL THICKNESS HALF/< VERTICAL HEIGHT,1772.0,1151.8,1.1,1772.0,148
CDM,40654OH,RPR LIP FULL THKNS >ONE-HALF VERT HEIGHT/COMPLE,2192.0,1424.8,1.1,4447.63,148
CDM,40700OH,PLSTC RPR CL LIP/NSL DFRM PRIM PRTL/COMPL UNI,5668.0,3684.2,1.1,17080.38,144
CDM,40701OH,PLSTC RPR CL LIP/NSL DFRM PRIM BI 1 STG PX,6892.0,4479.8,1.1,17080.38,144
CDM,40702OH,PLSTC RPR CL LIP/NSL DFRM PRIM BI 1 2 STGS,5708.0,3710.2,1.1,17080.38,144
CDM,40720OH,PLSTC RPR CL LIP/NSL DFRM SEC RECRTJ DFCT & RECL,6477.0,4210.05,1.1,9391.15,144
CDM,40761OH,PLSTC RPR CL LIP/NSL DFRM W/CROSS LIP PEDCL FLAP,6336.0,4118.4,1.1,17080.38,144
CDM,40799RVU1OH,LIP LIFT UPPER (COMP 11444 + 13132),2525.0,1641.25,0.01,2525.0,84
CDM,40800OH,DRG ABSC CST HMTMA VESTIBULE MOUTH SMPL,492.0,319.8,1.1,2050.87,148
CDM,40801OH,DRG ABSC CST HMTMA VESTIBULE MOUTH COMP,1052.0,683.8,1.1,1603.96,148
CDM,40804OH,RMVL EMBEDDED FB VESTIBULE MOUTH SMPL,520.0,338.0,1.1,2644.7,148
CDM,40805OH,RMVL EMBEDDED FB VESTIBULE MOUTH COMP,1116.0,725.4,1.1,1603.96,148
CDM,40806OH,INCISION LABIAL FRENUM FRENOTOMY,124.0,80.6,1.1,1603.96,146
CDM,40808OH,"BIOPSY, MOUTH, VESTIBULE",420.0,273.0,1.1,1603.96,148
CDM,40810OH,EXC LES MUCOSA & SBMCSL VESTIBULE MOUTH W/O RPR,544.0,353.6,1.1,9391.15,148
CDM,40812OH,EXC LESION MUCOSA & SBMCSL VESTIBULE SMPL RPR,948.0,616.2,1.1,4447.63,148
CDM,40814OH,EXC LESION MUCOSA & SBMCSL VESTIBULE CPLX RPR,1408.0,915.2,1.1,9391.15,148
CDM,40816OH,EXC LESION MUCOSA&SBMCSL VESTIBULE CPLX EXC MUSC,1508.0,980.2,1.1,9391.15,148
CDM,40818OH,EXC MUCOSA VESTIBULE MOUTH AS DON GRF,1132.0,735.8,1.1,1603.96,148
CDM,40819OH,EXC FRENUM LABIAL/BUCCAL,1004.0,652.6,1.1,4447.63,148
CDM,40820OH,DSTRJ LES/SCAR VESTIBULE MOUTH PHYSICAL METHS,536.0,348.4,1.1,9391.15,148
CDM,40830OH,CLOSURE LACERATION VESTIBULE MOUTH 2.5 CM/<,728.0,473.2,1.1,749.84,148
CDM,40831OH,CLOSURE LACERATION VESTIBULE MOUTH > 2.5 CM/CPL,1028.0,668.2,1.1,1603.96,148
CDM,40840OH,VESTIBULOPLASTY ANTERIOR,3660.0,2379.0,1.1,17080.38,148
CDM,40842OH,VESTIBULOPLASTY POSTERIOR UNILATERAL,3660.0,2379.0,1.1,17080.38,148
CDM,40843OH,VESTIBULOPLASTY POSTERIOR BILATERAL,5116.0,3325.4,1.1,17080.38,148
CDM,40844OH,VESTIBULOPLASTY ENTIRE ARCH,6720.0,4368.0,1.1,17080.38,148
CDM,40845OH,VESTIBULOPLASTY CPLX W/RIDGE XTN MUSC RPSG,7744.0,5033.6,1.1,17080.38,148
CDM,40899RVU1OH,LYSIS OF SCAR RMT FOR CORRECTION OF TRISMUS (COMP 40814),1162.0,755.3,0.01,1162.0,84
CDM,40899RVU2OH,TRANSORAL MYECTOMY OF DEPRESSOR ANGULI ORIS MUSCLE (COMP CODE 21,2168.0,1409.2,0.01,2168.0,84
CDM,40900000,3D RENDERING W/INTERP & POSTPROCESS SUPERVISION,566.0,367.9,32.47,566.0,68
CDM,40900005,3D RENDERING W/INTERP&POSTPROC DIFF WORK STATION,1436.0,933.4,86.82,1436.0,68
CDM,40900015,MRI-TRUS FUSION-GUIDED PROSTRATE BIOPSY,1231.0,800.15,78.83,1231.0,85
CDM,41000005,RT MONITORING TRANSPORT,486.0,315.9,64.98,486.0,84
CDM,41000020,CATHETER ASPIRATION NASOTRACHEAL SPX,936.0,608.4,61.8,4392.0,87
CDM,41000025,PROC RESP FUNC GROUP,157.0,102.05,18.04,157.0,86
CDM,41000030,ARTERIAL PUNCTURE WITHDRAWAL BLOOD DX,741.0,481.65,18.03,2453.0,86
CDM,41000035,HOME CARE INSTRUCTION,124.0,80.6,27.03,124.0,58
CDM,41000040,CARDIOPULMONARY RESUSCITATION,1791.0,1164.15,204.28,1791.0,86
CDM,41000050,VENTILATION ASSIST & MGMT INPATIENT 1ST DAY,3041.0,1976.65,117.24,3041.0,86
CDM,41000060,VENTILATION ASSIST & MGMT INPATIENT EA SBSQ DA,3041.0,1976.65,80.81,3041.0,86
CDM,41000070,PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT,936.0,608.4,10.99,936.0,86
CDM,41000095,PATIENT EDUC PULM/RESP,76.0,49.4,16.57,76.0,58
CDM,41000105,PATIENT TRANSPORT-INTERNAL,189.0,122.85,41.2,189.0,58
CDM,41000110,PENTAMIDINE AERSL INHALATION PNEUMOCYSTIS/PROPH,936.0,608.4,64.98,936.0,84
CDM,41000115,RT DAILY ASSESSMENT,483.0,313.95,64.98,483.0,84
CDM,41000120,CONTINUOUS INHALATION TREATMENT 1ST HR,593.0,385.45,64.98,593.0,86
CDM,41000130,CONTINUOUS INHALATION TREATMENT EA ADDL HR,162.0,105.3,22.74,162.0,68
CDM,41000140,CPAP VENTILATION CPAP INITIATION&MGMT,936.0,608.4,44.23,936.0,86
CDM,41000155,RESPIRATORY THERAPY EVAL-HOSP,359.0,233.35,64.98,359.0,84
CDM,41000160,DEMO&/EVAL OF PT UTILIZ AERSL GEN/NEB/INHLR/IP,936.0,608.4,24.8,936.0,86
CDM,41000210,MANJ CH WALL FACILITATE LNG FUNCJ 1 DEMO&/EVAL,593.0,385.45,34.67,593.0,86
CDM,41000215,PROC RESP OTHER 1-1 15MIN,98.0,63.7,14.28,98.0,86
CDM,41000220,MANJ CHEST WALL FACILITATE LUNG FUNCTION SUBSQ,593.0,385.45,54.59,593.0,86
CDM,41000230,PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT,936.0,608.4,10.99,936.0,86
CDM,41000425,MECHANICAL CHEST WALL OSCILLATION LUNG FUNCTION,936.0,608.4,28.56,936.0,86
CDM,41000435,CAR SEAT/BED TEST INFT THRU 12 MO 60 MIN,181.0,117.65,28.16,181.0,86
CDM,41000515,RESPIRATORY ASSIST,97.0,63.05,21.15,97.0,58
CDM,41000605,DEMO&/EVAL OF PT UTILIZ AERSL GEN/NEB/INHLR/IP,936.0,608.4,24.8,936.0,86
CDM,41000695,DEMO&/EVAL OF PT UTILIZ AERSL GEN/NEB/INHLR/IP,936.0,608.4,24.8,936.0,86
CDM,41000795,SPUTUM COLLECTION,1182.0,768.3,6.62,1182.0,86
CDM,41000825,VITAL CAPACITY TOTAL SEPARATE PROCEDURE,720.0,468.0,64.98,720.0,84
CDM,41000835,NONINVASIVE EAR/PULSE OXIMETRY SINGLE DETER,348.0,226.2,3.47,348.0,68
CDM,41000845,NONINVASIVE EAR/PULSE OXIMETRY MULTIPLE DETER,348.0,226.2,5.35,348.0,68
CDM,41000855,INTUBATION ENDOTRACHEAL EMERGENCY PROCEDURE,1068.0,694.2,175.91,3443.0,86
CDM,41000865,ARTL CATHJ/CANNULJ MNTR/TRANSFUSION SPX PRQ,1489.0,967.85,56.26,3443.0,68
CDM,41000875,CARDIOPULMONARY RESUSCITATION,1791.0,1164.15,204.28,1791.0,86
CDM,41000915,NONINVASIVE EAR/PULSE OXIMETRY OVERNIGHT MONITOR,720.0,468.0,34.38,720.0,86
CDM,41000OH,INTRAORAL I&D TONGUE/FLOOR LINGUAL,540.0,351.0,1.1,1603.96,148
CDM,41001005,DELIVERY/BIRTHING ROOM RESUSCITATION,4515.0,2934.75,171.1,4515.0,87
CDM,41001045,DELIVERY/BIRTHING ROOM RESUSCITATION,4515.0,2934.75,171.1,4515.0,86
CDM,41001055,UNLISTED PULMONARY SERVICE (RESPIRATORY EVALUATION),332.0,215.8,64.98,332.0,84
CDM,41001135,DAILY PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT,2901.0,1885.65,10.99,2901.0,86
CDM,41001145,RESPIRATOR FIT TEST,35.0,22.75,7.63,35.0,58
CDM,41001155,OSHA RESPIRATOR QUESTIONNAIRE REVIEW,35.0,22.75,7.63,35.0,58
CDM,41001165,RESPIRATOR MEDICAL EVALUATION,35.0,22.75,7.63,35.0,58
CDM,41005OH,INTRAORAL I&D TONGUE/FLOOR SUBLNGL SUPFC,524.0,340.6,1.1,788.54,148
CDM,41006OH,INTRAORAL I&D TONGUE/FLOOR SUBLNGL DP SPRMLHYD,1336.0,868.4,1.1,4447.63,148
CDM,41007OH,INTRAORAL I&D TONGUE/FLOOR SUBMENTAL SPACE,1280.0,832.0,1.1,4447.63,148
CDM,41008OH,INTRAORAL I&D TONGUE/FLOOR SUBMNDBLR SPACE,1384.0,899.6,1.1,9391.15,148
CDM,41009OH,INTRAORAL I&D TONGUE/FLOOR MASTICATOR SPACE,1632.0,1060.8,1.1,1632.0,148
CDM,41010OH,INCISION LINGUAL FRENUM FRENOTOMY,444.0,288.6,1.1,4447.63,148
CDM,41015OH,XTRORAL I&D ABSC CST/HMTMA FLOOR MOUTH SUBLNGL,1632.0,1060.8,1.1,1632.0,148
CDM,41016OH,XTRORAL I&D ABSC CST/HMTMA FLOOR MOUTH SUBMENT,1676.0,1089.4,1.1,17080.38,148
CDM,41017OH,XTRORAL I&D ABSC CST/HMTMA FLOOR MOUTH SUBMNDB,1676.0,1089.4,1.1,9391.15,148
CDM,41018OH,XTRORAL I&D FLOOR MASTICATOR SPACE,2088.0,1357.2,1.1,4447.63,148
CDM,41100OH,BIOPSY TONGUE ANTERIOR 2/3,568.0,369.2,1.1,1603.96,148
CDM,41105OH,"BIOPSY TONGUE,POSTER 1/3",588.0,382.2,1.1,9391.15,148
CDM,41108OH,"BIOPSY, MOUTH, FLOOR",484.0,314.6,1.1,4729.25,148
CDM,41110OH,EXCISION LESION TONGUE W/O CLOSURE,624.0,405.6,1.1,9391.15,148
CDM,41112OH,EXC LESION TONGUE W/CLSR ANTERIOR TWO-THIRDS,1132.0,735.8,1.1,9391.15,148
CDM,41113OH,EXC LESION TONGUE W/CLSR POSTERIOR ONE-THIRD,1316.0,855.4,1.1,9391.15,148
CDM,41114OH,EXC LESION TONGUE W/CLSR W/LOCAL TONGUE FLAP,3528.0,2293.2,1.1,9391.15,144
CDM,41115OH,EXCISION OF LINGUAL FRENUM (FRENECTOMY),716.0,465.4,1.1,4447.63,148
CDM,41116OH,EXCISION LESION FLOOR MOUTH,1008.0,655.2,1.1,9391.15,148
CDM,41120OH,GLOSSECTOMY <ONE-HALF TONGUE,4902.0,3186.3,1.1,17080.38,144
CDM,41130OH,GLOSSECTOMY HEMIGLOSSECTOMY,6296.0,4092.4,1.1,6296.0,144
CDM,41135OH,GLOSSECTOMY PRTL W/UNI RADICAL NECK DSJ,12056.0,7836.4,1.1,12056.0,144
CDM,41140OH,GLSSC COMPL/TOT W/WOTRACHS W/O RAD NECK DSJ,11660.0,7579.0,1.1,11660.0,144
CDM,41145OH,GLSSC COMPL/TOT W/WO TRACHS W/UNI RAD NECK DSJ,15172.0,9861.8,1.1,15172.0,144
CDM,41150OH,GLSSC COMPOSIT W/RESCJ FLOOR & MANDIBULAR RESCJ,11944.0,7763.6,1.1,11944.0,144
CDM,41153OH,GLSSC COMPOSIT RESCJ FLOOR SUPRAHYOID NCK DSJ,13436.0,8733.4,1.1,13436.0,144
CDM,41155OH,GLSSC COMPOSIT RESCJ FLR MNDBLR RESCJ & RAD NECK,17720.0,11518.0,1.1,17720.0,144
CDM,41250OH,"REPAIR TONGUE LACER,<2.5CM",784.0,509.6,1.1,1163.18,148
CDM,41251OH,"REPAIR TONGUE LACER,POST 1/3",928.0,603.2,1.1,1052.35,148
CDM,41252OH,"REPAIR TONGUE LACER,2.6CM+/COMPLX",1208.0,785.2,1.1,1208.0,148
CDM,41520OH,FRENOPLASTY SURG REVJ FRENUM EG W/Z-PLASTY,1132.0,735.8,1.1,9391.15,148
CDM,41530OH,SUBMUCOSAL ABLTJ TONGUE RF 1/> SITES PR SESSION,1400.0,910.0,1.1,9391.15,146
CDM,41599AOH,TONGUE ADVANCEMENT (COMP 15733),5645.0,3669.25,0.01,5645.0,84
CDM,41599RVUOH,LASER DESTRUCTION/TONGUE LESION (COMP 41110),515.0,334.75,0.01,713.21,84
CDM,41800OH,DRG ABSC CST HMTMA FROM DENTOALVEOLAR STRUXS,508.0,330.2,1.1,955.6,148
CDM,41805OH,RMVL EMBEDDED FB FROM DENTALVLR STRUXS SOFT TISS,536.0,348.4,1.1,4447.63,148
CDM,41806OH,RMVL EMBEDDED FB FROM DENTOALVEOLAR STRUXS BONE,1116.0,725.4,1.1,4447.63,148
CDM,41820OH,GINGIVECTOMY EXC GINGIVA EACH QUADRANT,1372.0,891.8,1.1,9391.15,90
CDM,41821OH,OPRCULECTOMY EXC PRICORONAL TISSUE,282.0,183.3,1.1,4447.63,90
CDM,41822OH,EXC FIBROUS TUBEROSITIES DENTOALVEOLAR STRUXS,964.0,626.6,1.1,4447.63,148
CDM,41823OH,EXC OSS TUBEROSITIES DENTOALVEOLAR STRUXS,1508.0,980.2,1.1,17080.38,148
CDM,41825OH,EXC LESION/TUMOR DENTOALVEOLAR STRUX W/O RPR,564.0,366.6,1.1,9391.15,148
CDM,41826OH,EXC LESION/TUMOR DENTOALVEOLAR STRUX W/SMPL RPR,1060.0,689.0,1.1,9391.15,148
CDM,41827OH,EXC LESION/TUMOR DENTALVEOLAR STRUX W/CMPLX RPR,1685.0,1095.25,1.1,17080.38,148
CDM,41828OH,EXC HYPRPLSTC ALVEOLAR MUCOSA EA QUADRANT SPEC,1256.0,816.4,1.1,4447.63,136
CDM,41830OH,ALVEOLECTOMY W/CURTG OSTEITIS/SEQUESTRECTOMY,1380.0,897.0,1.1,9391.15,136
CDM,41850OH,DESTRUCTION LESION DENTOALVEOLAR STRUCTURES,625.0,406.25,1.1,4447.63,90
CDM,41870OH,PERIODONTAL MUCOSAL GRAFTING,1563.0,1015.95,1.1,4447.63,88
CDM,41872OH,GINGIVOPLASTY EACH QUADRANT SPECIFY,1204.0,782.6,1.1,9391.15,136
CDM,41874OH,ALVEOLOPLASTY EACH QUADRANT SPECIFY,1404.0,912.6,1.1,9391.15,136
CDM,41899AOH,COMPLICATED FULL BONY EXTRACTION (COMP D7241),750.0,487.5,0.01,750.0,84
CDM,41899BOH,FULL BONY IMPACTION EXTRACTION (COMP D7240),600.0,390.0,0.01,713.21,84
CDM,41899COH,PARTIAL BONY IMPACTION EXTRACTION (COMP D7230),550.0,357.5,0.01,713.21,84
CDM,41899DOH,REMOVE RESIDUAL ROOT (COMP D7250),400.0,260.0,0.01,713.21,84
CDM,41899EOH,SIMPLE EXTRACTION ERUPTED TOOTH (COMP D7140),300.0,195.0,0.01,713.21,84
CDM,41899FOH,SOFT TISSUE IMPACTION EXTRACTION (COMP D7220),500.0,325.0,0.01,713.21,84
CDM,41899GOH,SURGICAL EXTRACTION ERUPTED TOOTH (COMP D7210),400.0,260.0,0.01,713.21,84
CDM,41899RVU1OH,"EXTRACT IMPACTED TOOTH, SURGICAL; W/BONY EXTRACTION (COMP D7240)",500.0,325.0,0.01,713.21,84
CDM,41899RVU2OH,"EXTRACT IMPACTED TOOTH, SURGICAL; SOFT TISSUE ONLY (COMP D7220)",300.0,195.0,0.01,713.21,84
CDM,41899RVU3OH,"EXTRACT IMPACTED TOOTH, SURGICAL; SIMPLE REMOVAL (COMP D7140)",200.0,130.0,0.01,713.21,84
CDM,41899RVU4OH,SCLEROTHERAPY TO THE ORAL CAVITY (COMP CODE 36470),300.0,195.0,0.01,713.21,84
CDM,42000020,THERA EXER 1,258.0,167.7,37.06,258.0,86
CDM,42000030,NEURMSCL THERAPY 15MIN,261.0,169.65,41.24,261.0,86
CDM,42000035,STRAPPING SHOULDER,593.0,385.45,21.71,2453.0,86
CDM,42000040,GAIT TRAINING THERAPY 15M,228.0,148.2,31.09,228.0,86
CDM,42000050,THERA ACTIVITY DIR 15MIN,274.0,178.1,44.62,274.0,86
CDM,42000060,TX WOUND<=20CM,914.0,594.1,43.12,3443.0,86
CDM,42000070,TX WOUND>21CM,746.0,484.9,29.21,3443.0,68
CDM,42000080,EDUC HOME MGMT EA 15MIN GP,274.0,178.1,31.09,274.0,86
CDM,42000095,APPLICATION CYLINDER CAST THIGH ANKLE,1222.0,794.3,100.27,2453.0,86
CDM,42000145,STRAPPING ANKLE &/FOOT,726.0,471.9,21.37,2453.0,86
CDM,42000165,BIOFDBK TRAIN ANY METHOD GP,319.0,207.35,23.22,319.0,85
CDM,42000185,WC/WH INITIAL PER 15 MIN,106.0,68.9,23.11,106.0,58
CDM,42000195,CANALITH REPOSITIONING PROCEDURE,240.0,156.0,41.92,240.0,85
CDM,42000205,DEVELOPMENTAL SCREEN W/SCORING & DOC STD INSTRM,316.0,205.4,68.89,316.0,66
CDM,42000235,APPLY TRACTION MECH GP,194.0,126.1,18.14,194.0,86
CDM,42000255,VASOPNEUMATIC DVC GP,203.0,131.95,14.7,203.0,86
CDM,42000265,WHIRLPOOL GP,179.0,116.35,20.16,179.0,86
CDM,42000275,ELECTR STIM 15MIN GP,239.0,155.35,18.49,239.0,86
CDM,42000280,PT IONTOPHORESIS 15MIN GP,189.0,122.85,23.82,189.0,86
CDM,42000285,US 15MIN GP,174.0,113.1,17.59,174.0,86
CDM,42000290,HUBBARD 15MIN GP,232.0,150.8,45.89,232.0,86
CDM,42000295,THERA EXER 15MIN,258.0,167.7,37.06,258.0,86
CDM,42000300,THER PX 1/> AREAS EACH 15 MINUTES MASSAGE,202.0,131.3,31.09,202.0,86
CDM,42000305,MANUAL THERAPY 15MIN GP,241.0,156.65,34.41,241.0,86
CDM,42000335,PT/OT WORK CONDITION,1004.0,652.6,31.09,1004.0,67
CDM,42000355,NEGATIVE PRESSURE WOUND THERAPY DME </= 50 SQ CM,914.0,594.1,30.08,914.0,86
CDM,42000360,NEGATIVE PRESSURE WOUND THERAPY DME >50 SQ CM,1838.0,1194.7,32.95,1838.0,86
CDM,42000365,PHYSICAL PERFORMANCE TEST/MEAS W/REPRT EA 15 MIN,272.0,176.8,42.65,272.0,86
CDM,42000385,SKIN FOLD BODY,27.0,17.55,5.89,4341999.96,67
CDM,42000390,ELECTR STIM UNATTEND,145.0,94.25,14.7,145.0,85
CDM,42000405,PT WK CNDITIONNG PER 15 MIN,242.0,157.3,52.76,242.0,58
CDM,42000425,THER PX 1/> AREAS EACH 15 MIN AQUA THER W/XERSS,326.0,211.9,46.13,326.0,86
CDM,42000445,P.T. COMMUNITY REINTEG 15 MIN,176.0,114.4,40.05,176.0,86
CDM,42000465,APPLICATION LONG LEG SPLINT THIGH ANKLE/TOES,726.0,471.9,56.47,2453.0,86
CDM,42000475,APPLICATION SHORT LEG CAST BELOW KNEE-TOE,1222.0,794.3,68.51,2453.0,86
CDM,42000485,APPLICATION SHORT LEG SPLINT CALF FOOT,726.0,471.9,56.47,2453.0,86
CDM,42000515,PT DEVELOPMENTAL TEST/LMTD,316.0,205.4,68.89,316.0,66
CDM,42000535,MANUAL THERAPY TQS 1/> REGIONS EACH 15 MINUTES,241.0,156.65,34.41,241.0,86
CDM,42000545,THER PX 1/> AREAS EACH 15 MIN NEUROMUSC REEDUCA,261.0,169.65,41.24,261.0,86
CDM,42000555,THER PX 1/> AREAS EA 15 MIN GAIT TRAING W/STAIR,228.0,148.2,31.09,228.0,86
CDM,42000565,"PT THERAPEUT PROC/EXER, 15 MIN",258.0,167.7,37.06,258.0,86
CDM,42000585,THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN,274.0,178.1,44.62,274.0,86
CDM,42000615,PT SENSORY INTEGRATIVE TCH/15M,188.0,122.2,52.26,188.0,85
CDM,42000800,STRAP UNNA BOOT GP,726.0,471.9,31.54,2453.0,86
CDM,42000805,WRAP MULT LAYER VENOUS COMP,726.0,471.9,32.95,2453.0,86
CDM,42000810,CANALITH REPOSITIONING PROCEDURE,240.0,156.0,41.92,240.0,85
CDM,42000815,ELECTRICAL STIM. UNATTENDED,177.0,115.05,31.09,177.0,67
CDM,42000820,WHIRLPOOL GP,179.0,116.35,20.16,179.0,86
CDM,42000825,APPL MODALITY 1/> AREAS ELEC STIMJ EA 15 MIN,239.0,155.35,18.49,239.0,86
CDM,42000830,APPL MODALITY 1/> AREAS ULTRASOUND EA 15 MIN,174.0,113.1,17.59,174.0,86
CDM,42000835,MANUAL THERAPY TQS 1/> REGIONS EACH 15 MINUTES,241.0,156.65,34.41,241.0,86
CDM,42000840,GROUP THERAPY GP,234.0,152.1,22.65,234.0,86
CDM,42000845,WHEELCHAIR MGMT EA 15 MIN,254.0,165.1,39.57,254.0,86
CDM,42000850,RMVL WOUND FB GP,914.0,594.1,173.69,2453.0,84
CDM,42000855,"NEG PRESS WOUND TX, < 50 CM",914.0,594.1,30.08,914.0,86
CDM,42000860,"NEG PRESS WOUND TX, > 50 CM",1838.0,1194.7,32.95,1838.0,86
CDM,42000865,TEST PHYSCL PERF EA 15MIN GP,272.0,176.8,42.65,272.0,86
CDM,42000870,ASSTV TECHNOL ASSMT DIR CNTCT W/REPRT EA 15 MIN,296.0,192.4,48.65,296.0,85
CDM,42000875,ORTHO MGMT EXT/TRUNK 15MN GP,295.0,191.75,60.21,295.0,85
CDM,42000880,PROSTHTIC TRAINING EXT 15M GP,270.0,175.5,52.32,270.0,85
CDM,42000890,LOW FREQUENCY NON-THERMAL ULTRASOUND PER DAY,914.0,594.1,21.86,914.0,86
CDM,42000895,WND CARE UNATT ELECT STIM 15M,147.0,95.55,14.52,215.66,85
CDM,42000905,NEG PRESSURE WOUND THERAPY NON DME >50 SQ CM,1838.0,1194.7,28.29,1838.0,86
CDM,42000925,AQUATIC THERAPY 15MIN GP,326.0,211.9,46.13,326.0,86
CDM,42000935,NEG PRESSURE WOUND THERAPY NON DME </= 50 SQ CM,1838.0,1194.7,24.7,1838.0,86
CDM,42000985,APPLICATION MODALITY 1/> AREAS INFRARED,48.0,31.2,8.45,48.0,86
CDM,42000OH,DRAINAGE ABSCESS PALATE/UVULA,512.0,332.8,1.1,713.21,148
CDM,42001075,PARAFFIN,166.0,107.9,7.04,166.0,86
CDM,42001085,APPL MODALITY 1/> AREAS CONTRAST BATHS EA 15 MIN,126.0,81.9,17.37,126.0,86
CDM,42001095,WORK HARDENING (ADDL HR),503.0,326.95,31.09,503.0,67
CDM,42001195,WC/WH EA ADDITIONAL PER 15 MIN,100.0,65.0,21.8,100.0,58
CDM,42001255,"CONTRAST BATH, EA 15 MIN",126.0,81.9,17.37,126.0,86
CDM,42001435,ORTH/PROS MGMT EA 15 MIN GP,320.0,208.0,66.46,320.0,85
CDM,42001505,PREP F/U 45 MIN,80.0,52.0,17.44,80.0,58
CDM,42001515,AQUATICS,11.0,7.15,2.4,4341999.96,67
CDM,42001525,HYDROSTATIS WEIGH,59.0,38.35,12.86,4341999.96,67
CDM,42001535,SKIN FOLD BODY,25.0,16.25,5.45,4341999.96,67
CDM,42001545,EXERCISE 30 MINS,30.0,19.5,6.54,4341999.96,67
CDM,42001555,EXERCISE 60 MINS,60.0,39.0,13.08,4341999.96,67
CDM,42001565,STRENGTH TESTING EVAL,140.0,91.0,30.52,4341999.96,67
CDM,42001575,PERFORMANCE EVAL,220.0,143.0,31.09,4341999.96,67
CDM,42001585,METABOLIC INITIAL ASSESSMENT,75.0,48.75,16.35,4341999.96,67
CDM,42001595,METABOLIC INITIAL RMR,125.0,81.25,27.25,4341999.96,67
CDM,42001605,METABOLIC RE-TEST,54.0,35.1,11.77,4341999.96,67
CDM,42001615,LACTATE TEST,216.0,140.4,31.09,4341999.96,67
CDM,42001625,GENERAL EXERCISE EVAL,113.0,73.45,24.63,469.67,66
CDM,42001635,PREP EVALUATION,27.0,17.55,5.89,4341999.96,67
CDM,42001645,DEVLOPMENT TEST INTERPT&REP,425.0,276.25,16.16,425.0,86
CDM,42001655,DEVEL TST PHYS/QHP 1ST HR,1080.0,702.0,121.73,1080.0,86
CDM,42001665,DEVEL TST PHYS/QHP EA ADDL,302.0,196.3,64.36,302.0,68
CDM,42001675,NEUROELTRD STIM POST TIBIAL,2037.0,1324.05,35.12,5265.0,87
CDM,42001725,PT COMBINED WORK CONDITIONING PER 15 MIN,207.0,134.55,45.13,207.0,58
CDM,42001745,"REMOTE MONITORING, INITIAL SUPPLY",257.0,167.05,32.72,257.0,78
CDM,42001755,REMOTE MONITORING 20 MIN,72.0,46.8,15.7,72.0,60
CDM,42001775,INITIAL ASSESSMENT,125.0,81.25,27.25,4341999.96,67
CDM,42001815,REMOTE MONITORING EDUCATION AND SET UP,889.0,577.85,27.62,889.0,86
CDM,42001825,BFB TRAING W/EMG &/MANOMETRY 1ST 15 MIN CNTCT,267.0,173.55,52.06,267.0,85
CDM,42001835,BFB TRAING W/EMG&/MANOMETRY EA ADDL 15 MIN CNTCT,267.0,173.55,29.16,267.0,85
CDM,42001845,THER IVNTJ COG FUNCJ CNTCT 1ST 15 MINUTES,205.0,133.25,28.08,205.0,85
CDM,42001855,THER IVNTJ COG FUNCJ CNTCT EA ADDL 15 MINUTES,205.0,133.25,26.54,205.0,85
CDM,42001865,REMOTE PHYSIOLOGIC MONITORING EA ADDL 20 MIN MO,68.0,44.2,14.82,68.0,60
CDM,42001875,BFB TRAING W/EMG &/MANOMETRY 1ST 15 MIN CNTCT,267.0,173.55,52.06,267.0,85
CDM,42001885,BFB TRAING W/EMG&/MANOMETRY EA ADDL 15 MIN CNTCT,267.0,173.55,29.16,267.0,85
CDM,42001895,NEEDLE INSERTION W/O INJECTION 1 OR 2 MUSCLES,113.0,73.45,17.49,3443.0,86
CDM,42001905,NEEDLE INSERTION W/O INJECTION 3 OR MORE MUSCLES,113.0,73.45,22.7,3443.0,86
CDM,42001915,TRUST- PT EVAL,560.0,364.0,122.08,560.0,58
CDM,42001925,TRUST- PT TREATMENT,451.0,293.15,98.32,451.0,58
CDM,42001935,TRUST-BALANCE AND DUAL TASK,934.0,607.1,203.61,934.0,58
CDM,42001945,TRUST- COGNITIVE ASSEMENT / ELECTRONIC,158.0,102.7,34.44,158.0,58
CDM,42002025,TRUST-NUTRITION,532.0,345.8,115.98,532.0,58
CDM,42002035,TRUST-COGNITION SNAP SHOT,217.0,141.05,47.31,217.0,58
CDM,42002045,VV THERAPEUTIC EXERCISE PT (97110),258.0,167.7,37.06,258.0,86
CDM,42002055,VV NEUROMUSCULAR EDUCATION PT (97112),261.0,169.65,41.24,261.0,86
CDM,42002065,VV GAIT TRAINING THERAPY  (97116),228.0,148.2,31.09,228.0,86
CDM,42002075,VV EVALUATION LOW COMPLEXITY  (97161),605.0,393.25,93.19,605.0,85
CDM,42002085,VV EVALUATION MODERATE COMPLEXITY  (97162),605.0,393.25,93.19,605.0,85
CDM,42002095,VV EVALUATION HIGH COMPLEXITY (97163),605.0,393.25,93.19,605.0,85
CDM,42002105,VV THERAPEUTIC ACTIVITIES (97530),274.0,178.1,44.62,274.0,86
CDM,42002125,VV SELF-CARE HOME MANAGEMENT  PT (97535),274.0,178.1,31.09,274.0,86
CDM,42002135,LOW INTENSITY ESWT CORPUS CAVERNOSUM LOW ENERGY,973.0,632.45,49.68,3443.0,84
CDM,42002145,PT CAREGIVER TRAINING STRATEGIES&TQ 1ST 30 MINUTES,887.0,576.55,39.1,887.0,85
CDM,42002155,PT CAREGIVER TRAINING STRATEGIES&TQ EA ADDL 15 MIN,887.0,576.55,30.26,887.0,85
CDM,42002185,RTM DEV SPLY DATA MUSCSKEL SYS 2-15 D IN 30D PD,263.0,170.95,35.31,263.0,69
CDM,42002195,REMOTE THERAPEUTIC MNTR 1ST SET-UP&PT EDUCAJ EQP,593.0,385.45,27.62,593.0,86
CDM,42002205,REM THER MNTR DEV SPLY DATA MUSCSKEL SYS EA 30 D,172.0,111.8,32.72,172.0,78
CDM,42002215,REMOTE THER MNTR TX MGMT PHYS/QHP 1ST 20 MIN,72.0,46.8,20.02,72.0,70
CDM,42002225,REMOTE THER MNTR TX MGMT PHYS/QHP EA ADDL 20 MIN,72.0,46.8,20.02,72.0,70
CDM,42002235,APPLICATION CAST SHOULDER HAND LONG ARM,1222.0,794.3,78.39,2453.0,86
CDM,42002245,APPLICATION CAST ELBOW FINGER SHORT ARM,1222.0,794.3,72.22,2453.0,86
CDM,42100005,THERA EXER EA 15 MINS,258.0,167.7,37.06,258.0,86
CDM,42100015,MIST WOUND ULTRASOUND,914.0,594.1,21.86,914.0,86
CDM,42100025,PREP ASSESSMENT,119.0,77.35,25.94,4341999.96,67
CDM,42100035,PREP 30 MIN,60.0,39.0,13.08,4341999.96,67
CDM,42100045,PREP 60 MIN,100.0,65.0,21.8,4341999.96,67
CDM,42100055,PERFORMANCE EXERCISE 30 MIN,30.0,19.5,6.54,4341999.96,67
CDM,42100065,PERFORMANCE EXERCISE 60 MIN,60.0,39.0,13.08,4341999.96,67
CDM,42100075,FOLLOW UP / GROUP CHARGE,25.0,16.25,5.45,4341999.96,67
CDM,42100085,GOLF PERFORMANCE,110.0,71.5,23.98,4341999.96,67
CDM,42100095,JUMP RIGHT,110.0,71.5,23.98,4341999.96,67
CDM,42100105,MATCH FIT  SOCCER,110.0,71.5,23.98,4341999.96,67
CDM,42100115,RUN SMART,110.0,71.5,23.98,4341999.96,67
CDM,42100125,SKATING,110.0,71.5,23.98,4341999.96,67
CDM,42100135,THROW RIGHT FITNESS TRAINING,110.0,71.5,23.98,4341999.96,67
CDM,42100145,TRAIN RIGHT,110.0,71.5,23.98,4341999.96,67
CDM,42100155,VIDEO ANALYSIS SPORTS HEALTH,80.0,52.0,17.44,4341999.96,67
CDM,42100165,PERFORMANCE EXERCISE 45 MINUTES,45.0,29.25,9.81,4341999.96,67
CDM,42100185,THER IVNTJ COG FUNCJ CNTCT 1ST 15 MINUTES,205.0,133.25,28.08,205.0,85
CDM,42100195,THER IVNTJ COG FUNCJ CNTCT EA ADDL 15 MINUTES,205.0,133.25,26.54,205.0,85
CDM,42100205,ALTER G 30 MIN,30.0,19.5,6.54,4341999.96,67
CDM,42100215,ALTER G 45 MIN,45.0,29.25,9.81,4341999.96,67
CDM,42100225,EXERCISE 45 MIN,45.0,29.25,9.81,4341999.96,67
CDM,42100235,DANCE PERFORMANCE INITIAL,110.0,71.5,23.98,4341999.96,67
CDM,42100245,FUNCTIONAL EXERCISE GROUP,20.0,13.0,4.36,4341999.96,67
CDM,42100255,THERAPEUTIC YOGA (COMP 9800715),75.0,48.75,16.35,4341999.96,67
CDM,42100265,MASSAGE THERAPY (COMP 97799RVU),90.0,58.5,19.62,4341999.96,67
CDM,42100275,MANUAL LYMPH DRAINAGE (MLD) (COMP 97799A),75.0,48.75,16.35,4341999.96,67
CDM,42100285,REIKI THERAPY (COMP 9800342),60.0,39.0,13.08,4341999.96,67
CDM,42100295,HERBAL THERAPY NEW (COMP 9800341),150.0,97.5,31.09,4341999.96,67
CDM,42100305,HERBAL THERAPY EST (COMP 9800340),75.0,48.75,16.35,4341999.96,67
CDM,42100OH,BIOPSY PALATE UVULA,598.0,388.7,1.1,4447.63,148
CDM,42104OH,EXC LESION PALATE UVULA W/O CLOSURE,676.0,439.4,1.1,9391.15,148
CDM,42106OH,EXC LESION PALATE UVULA W/SMPL PRIM CLOSURE,860.0,559.0,1.1,9391.15,148
CDM,42107OH,EXC LESION PALATE UVULA W/LOCAL FLAP CLOSURE,1824.0,1185.6,1.1,17080.38,148
CDM,42120OH,RESCJ PALATE/EXTENSIVE RESCJ LESION,4744.0,3083.6,1.1,17080.38,144
CDM,42140OH,UVULECTOMY EXCISION UVULA,680.0,442.0,1.1,9391.15,148
CDM,42145OH,PALATOPHAYNGOPLASTY,3912.0,2542.8,1.1,17080.38,144
CDM,42160OH,DSTRJ LESION PALATE/UVULA THERMAL CRYO/CHEM,740.0,481.0,1.1,9391.15,148
CDM,42180OH,REPAIR PALATE LACER <2CM,1020.0,663.0,1.1,1603.96,148
CDM,42182OH,REPAIR PALATE LACER 2+CM OR COMPLX,1548.0,1006.2,1.1,17080.38,148
CDM,42200OH,PALATOP CL PALATE SOFT&/HARD PALATE ONLY,5012.0,3257.8,1.1,17080.38,144
CDM,42205OH,PALATOPLASTY W/CLSR ALVEOLAR RIDGE SOFT TISSUE,5464.0,3551.6,1.1,9391.15,144
CDM,42210OH,PALATOP CLSR ALVEOLAR RIDGE GRF ALVEOLAR RIDGE,6012.0,3907.8,1.1,17080.38,144
CDM,42215OH,PALATOPLASTY CLEFT PALATE MAJOR REVJ,3596.0,2337.4,1.1,17080.38,144
CDM,42220OH,PALATOPLASTY CLEFT PALATE SEC LNGTH PX,2864.0,1861.6,1.1,17080.38,144
CDM,42225OH,PALATOP CL PALATE ATTACHMENT PHARYNGEAL FLAP,3908.0,2540.2,1.1,17080.38,144
CDM,42226OH,LENGTHENING PALATE+PHARY FLAP,4140.0,2691.0,1.1,17080.38,144
CDM,42227OH,LENGTHENING PALATE+ISLAND FLAP,3960.0,2574.0,1.1,17080.38,144
CDM,42235OH,REPAIR ANTER PALATE W VOMER FLAP,3204.0,2082.6,1.1,17080.38,144
CDM,42260OH,REPAIR NASOLABIAL FISTULA,4088.0,2657.2,1.1,17080.38,148
CDM,42281OH,INSJ PIN-RETAINED PALATAL PROSTHESIS,792.0,514.8,1.1,17080.38,148
CDM,42299RVU1OH,PALATAL RECONSTRUCTION NOT FOR CLEFT PALATE (COMP 42200),4135.0,2687.75,0.01,4135.0,84
CDM,42299RVUOH,SOMNOPLASTY -REPEAT TREATMENT,350.0,227.5,0.01,713.21,84
CDM,42300OH,"DRAIN ABSCESS PAROTID,SIMPLE",792.0,514.8,1.1,4447.63,148
CDM,42305OH,"DRAIN ABSCESS PAROTID,COMPLIC",2524.0,1640.6,1.1,9391.15,144
CDM,42310OH,"DRAIN ABSC-SUBMAX,SUBLING-INTRAORAL",644.0,418.6,1.1,1603.96,148
CDM,42320OH,DRAIN ABSC-SUBMAX-EXTERNAL,960.0,624.0,1.1,1603.96,148
CDM,42330OH,SIALOT SUBMNDBLR SUBLNGL/PRTD UNCOMP INTRAORAL,904.0,587.6,1.1,9391.15,148
CDM,42335OH,SIALOLITHOTOMY SUBMNDBLR SUBMAX COMP INTRAORAL,1364.0,886.6,1.1,9391.15,148
CDM,42340OH,SIALOLITHOTOMY PRTD XTRORAL/COMP INTRAORAL,1888.0,1227.2,1.1,9391.15,148
CDM,42400010,PHYSICAL THERAPY EVALUATION LOW COMPLEX 20 MINS,605.0,393.25,93.19,605.0,85
CDM,42400015,THERAPEUTIC EXERCISES EA 15MIN,258.0,167.7,37.06,258.0,86
CDM,42400025,MANUAL THERAPY TQS 1/> REGIONS EACH 15 MINUTES,241.0,156.65,34.41,241.0,86
CDM,42400035,PT EVAL - LOW,605.0,393.25,93.19,605.0,85
CDM,42400045,PT EVAL - MOD,605.0,393.25,93.19,605.0,85
CDM,42400055,PT EVAL - HIGH,605.0,393.25,93.19,605.0,85
CDM,42400065,PT RE-EVAL,383.0,248.95,86.04,383.0,85
CDM,42400OH,"BIOPSY SALIVARY GLAND,NEEDLE",343.0,222.95,1.1,2050.87,148
CDM,42405OH,BIOPSY SALIVARY GLAND INCISIONAL,1336.0,868.4,1.1,4447.63,148
CDM,42408OH,EXC SUBLINGUAL SALIVARY CYST RANULA,1864.0,1211.6,1.1,9391.15,148
CDM,42409OH,MARSUPIALIZATION SUBLNGL SALIVARY CST RANULA,1164.0,756.6,1.1,9391.15,148
CDM,42410OH,EXC PRTD TUM/PRTD GLND LAT LOBE W/O NRV DSJ,3828.0,2488.2,1.1,17080.38,144
CDM,42415OH,EXC PRTD TUM/PRTD GLND LAT DSJ&PRSRV FACIAL NR,6864.0,4461.6,1.1,17080.38,144
CDM,42420OH,EXC PRTD TUM/PRTD GLND TOT DSJ&PRSRV FACIAL NR,7812.0,5077.8,1.1,17080.38,144
CDM,42425OH,EXCISION PAROTID TUMOR/GLAND TOTAL EN BLOC RMVL,5368.0,3489.2,1.1,17080.38,144
CDM,42426OH,EXC PRTD TUM/PRTD GLND TOT W/UNI RAD NCK DSJ,9064.0,5891.6,1.1,9064.0,144
CDM,42440OH,EXCISION SUBMANDIBULAR SUBMAXILLARY GLAND,2702.0,1756.3,1.1,17080.38,144
CDM,42450OH,EXCISION SUBLINGUAL GLAND,1896.0,1232.4,1.1,17080.38,148
CDM,42500OH,PLSTC RPR SALIVARY DUX SIALODOCHOPLASTY PRIM,1768.0,1149.2,1.1,17080.38,148
CDM,42505OH,PLSTC RPR SALIVARY DUX SIALODOCHOPLASTY SEC/COMP,2528.0,1643.2,1.1,17080.38,148
CDM,42507OH,PAROTID DUCT DIVERSION BILATERAL WILKE PX,2500.0,1625.0,1.1,17080.38,144
CDM,42510OH,PAROTID DUCT DVRJ BILATERAL WITH LIG BOTH DUCTS,3340.0,2171.0,1.1,9391.15,144
CDM,42550OH,INJECTION PROCEDURE SIALOGRAPHY,500.0,325.0,1.1,515.65,148
CDM,42600OH,CLOSURE OF SALIVARY FISTULA,1976.0,1284.4,1.1,9391.15,148
CDM,42650OH,DILATION OF SALIVARY DUCT,308.0,200.2,1.1,4447.63,148
CDM,42660OH,DILAT&CATHJ SALIVARY DUCT W/WO INJECTION,452.0,293.8,1.1,1603.96,148
CDM,42665OH,LIGATION SALIVARY DUCT INTRAORAL,1052.0,683.8,1.1,9391.15,148
CDM,42699RVU1OH,SIALOENDOSCOPY W SALIVARY DUCT STONE EXTRACTION (COMP 31255),2473.0,1607.45,0.01,2473.0,84
CDM,42699RVU2OH,SIALOENDOSCOPY W HYDRO/MECHANICAL DILATION (COMP 31254),1485.0,965.25,0.01,1485.0,84
CDM,42699RVUOH,IMPLNT ALLODERM/PAROTIDCTMY WOUND BED,1204.0,782.6,0.01,1204.0,84
CDM,42700OH,"I & D ABSCESS, PERITONSILLAR",668.0,434.2,1.1,713.21,148
CDM,42720OH,I&D ABSC RTRPHRNGL/PARAPHARYNGEAL INTRAORAL,2524.0,1640.6,1.1,9391.15,148
CDM,42725OH,I&D ABSC RTRPHRNGL/PARAPHARYNGEAL XTRNL APPR,4964.0,3226.6,1.1,17080.38,144
CDM,42800OH,BIOPSY OROPHARYNX,576.0,374.4,1.1,4447.63,148
CDM,42804OH,"BIOPSY NASOPHARYNX,SIMPLE",516.0,335.4,1.1,9391.15,148
CDM,42806OH,BX NASOPHARYNX SURVEY UNKNOWN PRIMARY LESION,652.0,423.8,1.1,9391.15,148
CDM,42808OH,EXCISION/DESTRUCTION LESION PHARYNX ANY METHOD,940.0,611.0,1.1,9391.15,148
CDM,42809OH,REMOVE PHARYNX FOREIGN BODY,744.0,483.6,1.1,1163.18,148
CDM,42810OH,EXC BRANCHIAL CLEFT CYST CONFINED SKN&SUBQ TIS,1352.0,878.8,1.1,9391.15,148
CDM,42815OH,EXC BRANCHIAL CLEFT CYST BELOW SUBQ TISS&/PHRYNX,2924.0,1900.6,1.1,17080.38,144
CDM,42820OH,TONSILLECTOMY & ADENOIDECTOMY <AGE 12,1688.0,1097.2,1.1,17080.38,144
CDM,42821OH,TONSILLECTOMY & ADENOIDECTOMY AGE 12/>,1744.0,1133.6,1.1,9391.15,144
CDM,42825OH,TONSILLECTOMY PRIMARY/SECONDARY <AGE 12,1404.0,912.6,1.1,17080.38,144
CDM,42826OH,TONSILLECTOMY PRIMARY/SECONDARY AGE 12/>,1380.0,897.0,1.1,9391.15,144
CDM,42830OH,ADENOIDECTOMY PRIMARY <AGE 12,1060.0,689.0,1.1,9391.15,144
CDM,42831OH,ADENOIDECTOMY PRIMARY AGE 12/>,1124.0,730.6,1.1,9391.15,144
CDM,42835OH,ADENOIDECTOMY SECONDARY<AGE 12,952.0,618.8,1.1,9391.15,144
CDM,42836OH,ADENOIDECTOMY SECONDARY AGE 12/>,1304.0,847.6,1.1,9391.15,144
CDM,42842OH,RADICAL RESECTION TONSIL W/O CLOSURE,4892.0,3179.8,1.1,17080.38,144
CDM,42844OH,RADICAL RESCJ TONSIL CLOSURE W/LOCAL FLAP,7112.0,4622.8,1.1,17080.38,144
CDM,42845OH,RADICAL RESCJ TONSIL CLOSURE W/OTHER FLAP,13024.0,8465.6,1.1,13024.0,144
CDM,42860OH,EXCISION OF TONSIL TAGS,920.0,598.0,1.1,9391.15,144
CDM,42870OH,EXC/DSTRJ LINGUAL TONSIL ANY METHOD SPX,2208.0,1435.2,1.1,17080.38,144
CDM,42890OH,LIMITED PHARYNGECTOMY,7652.0,4973.8,1.1,17080.38,144
CDM,42892OH,RESCJ LAT PHRNGL WALL/PYRIFORM SINUS DIR CLSR,10412.0,6767.8,1.1,17080.38,144
CDM,42894OH,RESCJ PHRNGL WALL CLSR W/FLP OR FLP W/MVASC ANAS,13568.0,8819.2,1.1,13568.0,144
CDM,42900000,WORK HARDENING/CONDITIONING 1ST 2 HR,1004.0,652.6,31.09,1004.0,67
CDM,42900005,EMPLOYEE MASSAGE (COMP 99499RVU1),75.0,48.75,16.35,79.59,66
CDM,42900OH,SUTURE PHARYNX WOUND/INJURY,2116.0,1375.4,1.1,4447.63,144
CDM,42950OH,PHARYNGOPLASTY PLSTC/RCNSTV OPRATION PHARYNX,3308.0,2150.2,1.1,17080.38,144
CDM,42953OH,PHARYNGOESOPHAGEAL REPAIR,3780.0,2457.0,1.1,3780.0,144
CDM,42955OH,PHARYNGOSTOMY FSTLJ PHARYNX XTRNL FEEDING,3204.0,2082.6,1.1,4447.63,144
CDM,42960OH,CONTROL OROPHARYNGEAL HEMORRHAGE SIMPLE,952.0,618.8,1.1,1603.96,144
CDM,42961OH,CTRL OROPHARYNGEAL HEMORRHAGE COMP REQ HOSPITJ,2308.0,1500.2,1.1,2308.0,144
CDM,42962OH,CTRL OROPHARYNGEAL HEMORRHAGE W/SEC SURG IVNTJ,3256.0,2116.4,1.1,9391.15,144
CDM,42970OH,CTRL NASOPHARYNGEAL HEMRRG SMPL W/PST NSL PACKS,2328.0,1513.2,1.1,2328.0,144
CDM,42972OH,CTRL NASOPHARYNGEAL HEMORRHAGE W/SEC SURG IVNTJ,3036.0,1973.4,1.1,9391.15,144
CDM,42975OH,DISE DYN EVAL SLEEP DISORDERED BREATHING FLX DX,695.0,451.75,1.1,4949.64,142
CDM,42999AOH,DL W/LYSIS OF PHARYNG/HYPOPHARYNG STENOSIS (COMP 42950),2978.0,1935.7,0.01,2978.0,84
CDM,42999RVU1OH,NASOPHARYNGOSOCOPY W/BX NASOPHARYNX (COMP CODE 31237),1030.0,669.5,0.01,1030.0,84
CDM,42999RVU2OH,ALLODERM RECONSTRUCT PHARYNX,1205.0,783.25,0.01,1205.0,84
CDM,42999RVU3OH,EXCISION OF TONSIL LESION (COMP 42808),776.0,504.4,0.01,776.0,84
CDM,42999RVU4OH,INJECTION OF FILLER INTO PHARYNGEAL WALL (COMP CODE 31574),803.0,521.95,0.01,803.0,84
CDM,42999RVUOH,ENDO CAUTERY OF PIRIFOM SINUS TRACT,776.0,504.4,0.01,776.0,84
CDM,43000015,APPLICATION LONG ARM SPLINT SHOULDER HAND,726.0,471.9,48.61,2453.0,86
CDM,43000020,APPLICATION SHORT ARM SPLINT FOREARM-HAND STATIC,593.0,385.45,49.26,2453.0,86
CDM,43000025,APPLICATION FINGER SPLINT DYNAMIC,273.0,177.45,39.55,2453.0,86
CDM,43000050,DEVELOPMENTAL TEST LIMITED,316.0,205.4,68.89,316.0,66
CDM,43000075,APPL MODALITY 1/> AREAS ELEC STIMJ UNATTENDED,177.0,115.05,31.09,177.0,67
CDM,43000080,PARAFFIN BATH GO,166.0,107.9,7.04,166.0,86
CDM,43000095,IONTOPHORESIS 15MIN GO,189.0,122.85,23.82,189.0,86
CDM,43000105,US 15MIN GO,174.0,113.1,17.59,174.0,86
CDM,43000110,THERA EXER 15MIN GO,258.0,167.7,37.06,258.0,86
CDM,43000140,THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN,274.0,178.1,44.62,274.0,86
CDM,43000160,WORK HARDENING INIT 2HR GO,1004.0,652.6,31.09,1004.0,67
CDM,43000170,DEBRIDEMENT OPEN WOUND EACH ADDITIONAL 20 SQ CM,746.0,484.9,29.21,3443.0,68
CDM,43000205,WND CARE UNATT ELECT STIM 15M,147.0,95.55,14.52,215.66,85
CDM,43000325,OT WK CNDITIONNG PER 15 MIN,242.0,157.3,52.76,242.0,58
CDM,43000375,APPLICATION CAST SHOULDER HAND LONG ARM,1222.0,794.3,78.39,2453.0,86
CDM,43000385,APPLICATION CAST ELBOW FINGER SHORT ARM,1222.0,794.3,72.22,2453.0,86
CDM,43000395,APPLICATION LONG ARM SPLINT SHOULDER HAND,726.0,471.9,48.61,2453.0,86
CDM,43000405,APPLICATION SHORT ARM SPLINT FOREARM-HAND STATIC,593.0,385.45,49.26,2453.0,86
CDM,43000415,APPLICATION FINGER SPLINT STATIC,593.0,385.45,33.14,2453.0,86
CDM,43000425,DEVELOPMENTAL SCREEN W/SCORING & DOC STD INSTRM,316.0,205.4,68.89,316.0,66
CDM,43000435,THERA FUNC ACTIVITIES 15M,274.0,178.1,44.62,274.0,86
CDM,43000445,EVAL ORAL&PHARYNGEAL SWLNG FUNCJ,570.0,370.5,70.74,570.0,85
CDM,43000465,OT WHEELCHAIR MANAGEMENT 15 MI,254.0,165.1,39.57,254.0,86
CDM,43000485,OT THERAPEUT PROC/EXER 15 MIN,258.0,167.7,37.06,258.0,86
CDM,43000495,OT ELECTRICAL STIMULATION 15 M,239.0,155.35,18.49,239.0,86
CDM,43000500,THERA EXER 15MIN,258.0,167.7,37.06,258.0,86
CDM,43000510,NEURMSCL THERAPY 15MIN,261.0,169.65,41.24,261.0,86
CDM,43000520,MANUAL THERAPY 15MIN,241.0,156.65,34.41,241.0,86
CDM,43000530,THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN,274.0,178.1,44.62,274.0,86
CDM,43000545,TX SWALLOWING DYSFUNCTION&/ORAL FUNCJ FEEDING,664.0,431.6,85.08,664.0,86
CDM,43000550,SENSORY INTEGRATN EA 15M,188.0,122.2,52.26,188.0,85
CDM,43000560,EDUC HOME MGMT EA 15MIN GO,274.0,178.1,31.09,274.0,86
CDM,43000575,THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN,274.0,178.1,44.62,274.0,86
CDM,43000580,WHEELCHAIR MGMT EA 15 MIN,254.0,165.1,39.57,254.0,86
CDM,43000675,OT COMMUNITY REINTEGRATION/15M,176.0,114.4,40.05,176.0,86
CDM,43000685,UNLISTED PHYSICAL MED/REHAB SERV,280.0,182.0,31.09,4341999.96,67
CDM,43000780,WHIRLPOOL GO,179.0,116.35,20.16,179.0,86
CDM,43000785,APPL MODALITY 1/> AREAS ELEC STIMJ EA 15 MIN,239.0,155.35,18.49,239.0,86
CDM,43000790,GROUP THERAPY GO,234.0,152.1,22.65,234.0,86
CDM,43000795,DEBRIDEMENT OPEN WOUND 20 SQ CM/<,914.0,594.1,43.12,3443.0,86
CDM,43000800,TEST PHYSCL PERF EA 15MIN GO,272.0,176.8,42.65,272.0,86
CDM,43000805,ORTHO MGMT EXT/TRUNK 15MN GO,295.0,191.75,60.21,295.0,85
CDM,43000810,PROSTHTIC TRAINING EXT 15M GO,270.0,175.5,52.32,270.0,85
CDM,43000820,WND CARE UNATT ELECT STIM 15M,147.0,95.55,14.52,215.66,85
CDM,43000825,COGNITIVE TEST BY HC PRO,662.0,430.3,129.95,662.0,85
CDM,43000845,WC/WH EA ADDTL HR,503.0,326.95,31.09,503.0,67
CDM,43000875,DRIVER ON ROAD PER 60 MINS,100.0,65.0,21.8,4341999.96,67
CDM,43000925,JOBST COMPRESSION UT,203.0,131.95,14.7,203.0,86
CDM,43000965,WC/WH INITIAL PER 15 MIN,106.0,68.9,23.11,106.0,58
CDM,43000975,WC/WH EA ADDITIONAL PER 15 MIN,100.0,65.0,21.8,100.0,58
CDM,43000995,"CONTRAST BATH, EA 15 MIN",126.0,81.9,17.37,126.0,86
CDM,43001045,ELEC STIM - UNAT,177.0,115.05,31.09,177.0,67
CDM,43001065,BIOFDBK TRAIN ANY METHOD GO,319.0,207.35,23.22,319.0,85
CDM,43001205,ORTH/PROS MGMT EA 15 MIN GO,320.0,208.0,66.46,320.0,85
CDM,43001265,DEVLOPMENT TEST INTERPT&REP,425.0,276.25,16.16,425.0,86
CDM,43001275,DEVEL TST PHYS/QHP 1ST HR,1080.0,702.0,121.73,1080.0,86
CDM,43001285,DEVEL TST PHYS/QHP EA ADDL,302.0,196.3,64.36,302.0,68
CDM,43001335,OT COMBINED WORK CONDITIONING PER 15 MIN,207.0,134.55,45.13,207.0,58
CDM,43001345,THER IVNTJ COG FUNCJ CNTCT 1ST 15 MINUTES,205.0,133.25,28.08,205.0,85
CDM,43001355,THER IVNTJ COG FUNCJ CNTCT EA ADDL 15 MINUTES,205.0,133.25,26.54,205.0,85
CDM,43001465,VV THERAPEUTIC EXERCISE  OT (97110),258.0,167.7,37.06,258.0,86
CDM,43001475,VV NEUROMUSCULAR EDUCATION  OT (97112),261.0,169.65,41.24,261.0,86
CDM,43001485,VV EVALUATION LOW COMPLEXITY (97165),674.0,438.1,128.09,674.0,85
CDM,43001495,VV EVALUATION MODERATE COMPLEXITY (97166),674.0,438.1,128.09,674.0,85
CDM,43001505,VV EVALUATION HIGH COMPLEXITY (97167),674.0,438.1,128.09,674.0,85
CDM,43001515,VV SELF-CARE HOME MANAGEMENT OT (97535),274.0,178.1,31.09,274.0,86
CDM,43001525,VV THERAPEUTIC ACTIVITY OT (97530),274.0,178.1,44.62,274.0,86
CDM,43001605,OT CAREGIVER TRAINING STRATEGIES&TQ 1ST 30 MINUTES,887.0,576.55,39.1,887.0,85
CDM,43001615,OT CAREGIVER TRAINING STRATEGIES&TQ EA ADDL 15 MIN,887.0,576.55,30.26,887.0,85
CDM,43001655,RTM TX MGMT 1 R-T IA COMUNICAJ CAL MO 1ST 10 MIN,593.0,385.45,16.43,593.0,69
CDM,43001665,RTM TX MGMT 1 R-T IA COMUNICAJ CAL MO 1ST 10 MIN,172.0,111.8,16.43,172.0,69
CDM,43001675,REMOTE THER MNTR TX MGMT PHYS/QHP 1ST 20 MIN,72.0,46.8,20.02,72.0,70
CDM,43001685,REMOTE THER MNTR TX MGMT PHYS/QHP EA ADDL 20 MIN,72.0,46.8,20.02,72.0,70
CDM,43030OH,CRICOPHAYNGEAL MYOTOMY,3196.0,2077.4,1.1,17080.38,144
CDM,43045OH,ESOPHAGOTOMY THORACIC APPR W/RMVL FB,8752.0,5688.8,1.1,8752.0,144
CDM,43100000,THER IVNTJ COG FUNCJ CNTCT 1ST 15 MINUTES,205.0,133.25,28.08,205.0,85
CDM,43100010,THER IVNTJ COG FUNCJ CNTCT EA ADDL 15 MINUTES,205.0,133.25,26.54,205.0,85
CDM,43100OH,EXC LESION ESOPHOGUS W/PRIM RPR CERVICAL APPR,3864.0,2511.6,1.1,3864.0,144
CDM,43101OH,EXC LESION ESOPHAGUS W/PRIM RPR THRC/ABDL APPR,6828.0,4438.2,1.1,6828.0,144
CDM,43107OH,TOT ESOPHAGECTOMY W/O THORCOM W/WO PYLOROPLASTY,20820.0,13533.0,1.1,20820.0,144
CDM,43108OH,TOT ESOPHG W/O THORCOM COLON NTRPSTJ/INT RCNSTJ,33148.0,21546.2,1.1,33148.0,144
CDM,43112OH,TOTAL ESOPHAGECTOMY W/THORCOM W/WO PYLORPLASTY,24800.0,16120.0,1.1,24800.0,144
CDM,43113OH,TOT ESOPHG W/THORCOM W/COLON NTRPSTJ/INT RCNSTJ,32024.0,20815.6,1.1,32024.0,144
CDM,43116OH,PRTL ESOPHAGECTOMY CERVICAL W/FREE INTSTINAL GRF,37196.0,24177.4,1.1,37196.0,144
CDM,43117OH,PRTL ESOPHECT DSTL W/WO PROX GASTRECT/PYLORPLSTY,23000.0,14950.0,1.1,23000.0,144
CDM,43118OH,PRTL ESOPH DSTL W/WO PROX GASTRC W/COLON NTRPSTJ,26828.0,17438.2,1.1,26828.0,144
CDM,43121OH,PRTL ESOPHAGEC W/WO PROX GASTREC/PYLOROPLASTY,20572.0,13371.8,1.1,20572.0,144
CDM,43122OH,PRTL ESOPHG THORACOABD W/WO PROXGASTREC/PYLOROPL,17672.0,11486.8,1.1,17672.0,144
CDM,43123OH,PRTL ESPHG THORACOABDL/ABDL APPR NTRPSTJ/RCNSTJ,33248.0,21611.2,1.1,33248.0,144
CDM,43124OH,TOT/PRTL ESPHG W/O RCNSTJ W/CRV ESOPHAGOSTOMY,27636.0,17963.4,1.1,27636.0,144
CDM,43130OH,DIVERTICULECTOMY HYPOPHARYNX/ESOPH CRV APPR,5513.0,3583.45,1.1,17080.38,144
CDM,43135OH,DIVERTICULECTOMY HYPOPHARYNX/ESOPH THRC APPR,10468.0,6804.2,1.1,10468.0,144
CDM,43180OH,ESOPHAGOSCP RIG TRANSORAL HYPOPHARYNX CRV ESOPH,3612.0,2347.8,1.1,17080.38,144
CDM,43191OH,ESOPHAGOSCOPY RIGID TRANSORAL DIAGNOSTIC BRUSH,996.0,647.4,1.1,5549.59,144
CDM,43192OH,ESOPHAGOSCOPY RIGID TRANSORAL INJ SUBMUCOSAL,1116.0,725.4,1.1,5549.59,144
CDM,43193OH,ESOPHAGOSCOPY RIGID TRANSORAL WITH BIOPSY,1116.0,725.4,1.1,5549.59,144
CDM,43194OH,ESOPHAGOSCOPY RIG TRANSORAL REMOVAL FOREIGN BODY,1404.0,912.6,1.1,5549.59,144
CDM,43195OH,ESOPHAGOSCOPY RIGID TRANSORAL BALLOON DILATION,1228.0,798.2,1.1,11169.59,144
CDM,43196OH,ESOPHAGOSCOPY RIG TRANSORAL GUIDE WIRE DILATION,1324.0,860.6,1.1,5549.59,144
CDM,43197OH,ESOPHAGOSCOPY FLEXIBLE TRANSNASAL DIAGNOSTIC,608.0,395.2,1.1,2644.7,148
CDM,43198OH,ESOPHAGOSCOPY FLEXIBLE TRANSNASAL WITH BIOPSY,728.0,473.2,1.1,2644.7,148
CDM,43200OH,ESOPHAGOSCOPY FLEXIBLE TRANSORAL DIAGNOSTIC,625.0,406.25,1.1,2644.7,148
CDM,43201OH,ESOPHAGOSCOPY FLEXIBLE TRANSORAL W SUBMUCOUS INJ,688.0,447.2,1.1,5549.59,148
CDM,43202OH,ESOPHAGOSCOPY FLEXIBLE TRANSORAL WITH BIOPSY,688.0,447.2,1.1,5549.59,148
CDM,43204OH,ESOPHAGOSCOPY FLEX TRANSORAL INJECTION VARICES,932.0,605.8,1.1,5549.59,144
CDM,43205OH,ESPHGOSCOPY FLEX W/BAND LIGATION ESOPHGL VARICES,976.0,634.4,1.1,5549.59,144
CDM,43206OH,ESOPHAGOSCOPY TRANSORAL W/OPTICAL ENDOMICROSCOPY,916.0,595.4,1.1,5549.59,146
CDM,43210OH,EGD PARTIAL/COMPL ESOPHAGOGASTRIC FUNDOPLASTY,3100.0,2015.0,1.1,30022.29,144
CDM,43211OH,ESOPHAGOSCOPY FLEXIBLE TRANSORAL MUCOSAL RESEXN,1680.0,1092.0,1.1,5549.59,144
CDM,43212OH,ESOPHAGOSCOPY TRANSORAL STENT PLACEMENT,1360.0,884.0,1.1,16621.23,144
CDM,43213OH,ESOPHAGOSCOPY RETROGRADE DILATE BALLOON/OTHER,1852.0,1203.8,1.1,5549.59,148
CDM,43214OH,ESOPHAGOSCOPY DILATE ESOPHAGUS BALLOON 30 MM,1360.0,884.0,1.1,5549.59,144
CDM,43215OH,ESOPHAGOSCOPY FLEXIBLE REMOVAL FOREIGN BODY,976.0,634.4,1.1,5549.59,148
CDM,43216OH,ESPHAGOSCOPY FLEX LESION REMOVAL HOT BX FORCEPS,920.0,598.0,1.1,5549.59,148
CDM,43217OH,ESOPHAGOSCOPY FLEXIB LESION REMOVAL TUMOR SNARE,1120.0,728.0,1.1,5549.59,148
CDM,43220OH,ESOPHAGOSCOPY FLEX BALLOON DILAT <30 MM DIAM,800.0,520.0,1.1,5549.59,148
CDM,43226OH,ESOPHAGOSCOPY FLEXIBLE GUIDE WIRE DILATION,896.0,582.4,1.1,5549.59,148
CDM,43227OH,ESOPHAGOSCOPY FLEXIBLE W/BLEEDING CONTROL,1156.0,751.4,1.1,5549.59,148
CDM,43229OH,ESOPHAGOSCOPY FLEX TRANSORAL LESION ABLATION,1396.0,907.4,1.1,11169.59,148
CDM,43231OH,ESOPHAGOSCOPY FLEXIBLE TRANSORAL ULTRASOUND EXAM,1120.0,728.0,1.1,5549.59,144
CDM,43232OH,ESOPHAGOSCOPY INTRA/TRANSMURAL NEEDLE ASPIRAT/BX,1436.0,933.4,1.1,5549.59,144
CDM,43233OH,EGD ESOPHAGUS BALLOON DILATION 30 MM OR LARGER,1628.0,1058.2,1.1,5549.59,144
CDM,43235OH,ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC,836.0,543.4,1.1,2644.7,148
CDM,43236OH,ESOPHAGOGASTRODUODENOSCOPY SUBMUCOSAL INJECTION,1052.0,683.8,1.1,2644.7,148
CDM,43237OH,ESOPHAGOGASTRODUODENOSCOPY US SCOPE W/ADJ STRXRS,1527.0,992.55,1.1,5549.59,144
CDM,43238OH,EGD INTRMURAL US NEEDLE ASPIRATE/BIOPSY ESOPHAGS,1830.0,1189.5,1.1,5549.59,144
CDM,43239OH,EGD TRANSORAL BIOPSY SINGLE/MULTIPLE,1052.0,683.8,1.1,2644.7,148
CDM,43240OH,EGD TRANSORAL TRANSMURAL DRAINAGE PSEUDOCYST,3146.0,2044.9,1.1,16621.23,144
CDM,43241OH,EGD INTRALUMINAL TUBE/CATHETER INSERTION,1096.0,712.4,1.1,5549.59,144
CDM,43242OH,EGD INTRMURAL NEEDLE ASPIR/BIOP ALTERED ANATOMY,2081.0,1352.65,1.1,5549.59,144
CDM,43243OH,EGD INJECTION SCLEROSIS ESOPHGL/GASTRIC VARICES,1879.0,1221.35,1.1,5549.59,144
CDM,43244OH,EGD BAND LIGATION ESOPHGEAL/GASTRIC VARICES,1936.0,1258.4,1.1,5549.59,144
CDM,43245OH,EGD DILATION GASTRIC/DUODENAL STRICTURE,1355.0,880.75,1.1,5549.59,148
CDM,43246OH,EGD PERCUTANEOUS PLACEMENT GASTROSTOMY TUBE,1566.0,1017.9,1.1,5549.59,144
CDM,43247OH,EGD FLEXIBLE FOREIGN BODY REMOVAL,1368.0,889.2,1.1,2644.7,148
CDM,43248OH,EGD INSERT GUIDE WIRE DILATOR PASSAGE ESOPHAGUS,1280.0,832.0,1.1,2644.7,148
CDM,43249OH,EGD BALLOON DILATION ESOPHAGUS <30 MM DIAM,1175.0,763.75,1.1,5549.59,148
CDM,43250OH,EGD FLEX REMOVAL LESION(S) BY HOT BIOPSY FORCEPS,1307.0,849.55,1.1,5549.59,148
CDM,43251OH,EGD REMOVAL TUMOR POLYP/OTHER LESION SNARE TECH,1527.0,992.55,1.1,5549.59,148
CDM,43252OH,EGD FLEX TRANSORAL W/OPTICAL ENDOMICROSCOPY,1302.0,846.3,1.1,5549.59,146
CDM,43253OH,EGD US GUIDED TRANSMURAL INJXN/FIDUCIAL MARKER,2081.0,1352.65,1.1,5549.59,144
CDM,43254OH,EGD TRANSORAL ENDOSCOPIC MUCOSAL RESECTION,2143.0,1392.95,1.1,5549.59,144
CDM,43255OH,"EGD WITH CONTROL OF BLEED,",1566.0,1017.9,1.1,5549.59,148
CDM,43257OH,EGD DELIVER THERMAL ENERGY SPHNCTR/CARDIA GERD,1660.0,1079.0,1.1,11169.59,144
CDM,43259OH,EDG US EXAM SURGICAL ALTER STOM DUODENUM/JEJUNUM,1616.0,1050.4,1.1,5549.59,144
CDM,43260OH,ERCP DX COLLECTION SPECIMEN BRUSHING/WASHING,2340.0,1521.0,1.1,11169.59,144
CDM,43261OH,ERCP W/BIOPSY SINGLE/MULTIPLE,2460.0,1599.0,1.1,11169.59,144
CDM,43262OH,ERCP W/SPHINCTEROTOMY/PAPILLOTOMY,2600.0,1690.0,1.1,11169.59,144
CDM,43263OH,ERCP W/PRESSURE MEASUREMENT SPHINCTER OF ODDI,2600.0,1690.0,1.1,5549.59,144
CDM,43264OH,ERCP REMOVE CALCULI/DEBRIS BILIARY/PANCREAS DUCT,2917.0,1896.05,1.1,11169.59,144
CDM,43265OH,ERCP DESTRUCTION/LITHOTRIPSY CALCULI ANY METHOD,3489.0,2267.85,1.1,16621.23,144
CDM,43266OH,EGD ENDOSCOPIC STENT PLACEMENT W/WIRE& DILATION,1568.0,1019.2,1.1,16621.23,144
CDM,43270OH,EGD ABLATE TUMOR POLYP/LESION W/DILATION& WIRE,1604.0,1042.6,1.1,5549.59,148
CDM,43273OH,ENDOSCOPIC PAPILLA CANNULATION BILE/PANCREATIC,896.0,582.4,1.1,896.0,144
CDM,43274OH,ERCP STENT PLACEMENT BILIARY/PANCREATIC DUCT,3731.0,2425.15,1.1,16621.23,144
CDM,43275OH,ERCP REMOVE FOREIGN BODY/STENT BILIARY/PANC DUCT,3018.0,1961.7,1.1,5549.59,144
CDM,43276OH,ERCP BILIARY/PANC DUCT STENT EXCHANGE W/DIL&WIRE,3890.0,2528.5,1.1,16621.23,144
CDM,43277OH,ERCP BALLOON DILATE BILIARY/PANC DUCT/AMPULLA EA,2760.0,1794.0,1.1,11169.59,144
CDM,43278OH,ERCP TUMOR/POLYP/LESION ABLATION W/DILATION&WIRE,3168.0,2059.2,1.1,11169.59,144
CDM,43279OH,LAPS ESOPHAGOMYOTOMY W/FUNDOPLASTY IF PERFORMED,8840.0,5746.0,1.1,8840.0,144
CDM,43280OH,LAPS SURG ESOPG/GSTR FUNDOPLASTY,7240.0,4706.0,1.1,30022.29,144
CDM,43281OH,LAPS RPR PARAESPHGL HRNA INCL FUNDPLSTY W/O MESH,10640.0,6916.0,1.1,30022.29,144
CDM,43282OH,LAPS RPR PARAESPHGL HRNA INCL FUNDPLSTY W/MESH,12040.0,7826.0,1.1,30022.29,144
CDM,43283OH,LAPS ESOPHAGEAL LENGTHENING ADDL,1298.0,843.7,1.1,1298.0,144
CDM,43284OH,LAPS ESOPHGL SPHNCTR AGMNTJ PLMT DEV CRRPL,4052.0,2633.8,1.1,30022.29,142
CDM,43285OH,REMOVAL ESOPHAGEAL SPHINCTER AGMNTJ DEVICE,4188.0,2722.2,1.1,16829.38,142
CDM,43286OH,ESOPHAGECTOMY TOTAL NEAR TOTAL W/LAPS MOBLJ,22000.0,14300.0,1.1,22000.0,144
CDM,43287OH,ESOPHAGECTOMY DISTAL 2/3 W/LAPAROSCOPIC MOBLJ,25200.0,16380.0,1.1,25200.0,144
CDM,43288OH,ESOPHAGECTOMY TOTAL NEAR TOTAL W/THRSC MOBLJ,26568.0,17269.2,1.1,26568.0,144
CDM,43289OH,UNLISTED LAPAROSCOPIC PROCEDURE ESOPHAGUS,9667.0,6283.55,0.01,16829.38,84
CDM,43289RVU2OH,UNLISTED LAP ESOPHAGOPLASTY FOR CONGENITAL DEFECT (COMP CODE 433,22708.0,14760.2,0.01,22708.0,84
CDM,43289RVU3OH,"UNLISTED LAP RESECTION, ESOPHAGEAL DUPLICATION CYST (COMP CODE 4",7340.0,4771.0,0.01,16829.38,84
CDM,43290OH,EGD FLX TRNSORL W/DPLMNT NTRGSTR BARIATRIC BALO,1244.0,808.6,1.1,8898.47,146
CDM,43291OH,EGD FLX TRNSORL W/RMVL NTRGSTR BARIATRIC BALO,1120.0,728.0,1.1,2644.7,146
CDM,43300OH,ESPHGP CRV APPR W/O RPR TRACHEOESOPHGL FSTL,3732.0,2425.8,1.1,3732.0,144
CDM,43305OH,ESPHGP CRV APPR W/RPR TRACHEOESOPHGL FSTL,7240.0,4706.0,1.1,7240.0,144
CDM,43310OH,ESPHGP THRC APPR W/O RPR TRACHEOESOPHGL FSTL,10504.0,6827.6,1.1,10504.0,144
CDM,43312OH,ESPHGP THRC APPR W/RPR TRACHEOESOPHGL FSTL,11700.0,7605.0,1.1,11700.0,144
CDM,43313OH,ESPHGP CGEN DFCT THRC APPR W/O RPR FSTL,19380.0,12597.0,1.1,19380.0,144
CDM,43314OH,ESPHGP CGEN DFCT THRC APPR W/RPR FSTL,21372.0,13891.8,1.1,21372.0,144
CDM,43320OH,EGST W/WO VAGOTOMY&PYLOROPLASTY TABDL/TTHRC AP,9324.0,6060.6,1.1,9324.0,144
CDM,43325OH,ESOPG/GSTR FUNDOPLASTY W/FUNDIC PATCH,9040.0,5876.0,1.1,9040.0,144
CDM,43327OH,ESOPG/GSTR FUNDOPLASTY W/LAPT,5340.0,3471.0,1.1,5340.0,144
CDM,43328OH,ESOPG/GSTR FUNDOPLASTY W/THORCOM,7964.0,5176.6,1.1,7964.0,144
CDM,43330OH,ESOPHAGOMYOTOMY HELLER TYPE ABDOMINAL APPROACH,8876.0,5769.4,1.1,8876.0,144
CDM,43331OH,ESOPHAGOMYOTOMY HELLER TYPE THORACIC APPROACH,9224.0,5995.6,1.1,9224.0,144
CDM,43332OH,RPR PARAESOPH HIATAL HERNIA W/LAPT W/O MESH,7848.0,5101.2,1.1,7848.0,144
CDM,43333OH,LAPT RPR PARAESOPH HIATAL HERNIA W/ MESH,8584.0,5579.6,1.1,8584.0,144
CDM,43334OH,RPR PARAESOPH HIATAL HERNIA W/THORCOM W/O MESH,8848.0,5751.2,1.1,8848.0,144
CDM,43335OH,RPR PARAESOPH HIATAL HERNIA W/THORCOM W/MESH,9588.0,6232.2,1.1,9588.0,144
CDM,43336OH,RPR PARAESOPH HIATAL HERNIA THORCOABDOM W/O MESH,10324.0,6710.6,1.1,10324.0,144
CDM,43337OH,RPR PARAESOPH HIATAL HERNIA THORCOABDOM W/MESH,11060.0,7189.0,1.1,11060.0,144
CDM,43338OH,ESOPHAGUS LENGTHENING,884.0,574.6,1.1,884.0,144
CDM,43340OH,ESOPHAGOJEJUNOSTOMY W/O TOT GSTRCT ABDL APPR,9196.0,5977.4,1.1,9196.0,144
CDM,43341OH,ESOPHAGOJEJUNOSTOMY W/O TOT GSTRCT THRC APPR,9692.0,6299.8,1.1,9692.0,144
CDM,43351OH,ESOPHAGOSTOMY FSTLJ ESOPH XTRNL THRC APPR,8820.0,5733.0,1.1,8820.0,144
CDM,43352OH,ESOPHAGOSTOMY FSTLJ ESOPH XTRNL CRV APPR,7124.0,4630.6,1.1,7124.0,144
CDM,43360OH,GI RCNSTJ PREV ESPHG/EXCLUSION W/STOMACH,16044.0,10428.6,1.1,16044.0,144
CDM,43361OH,GI RCNSTJ PREV ESPHG/EXCLUSION W/COLON SM INT,18272.0,11876.8,1.1,18272.0,144
CDM,43400035,OT EVAL - LOW,674.0,438.1,128.09,674.0,85
CDM,43400045,OT EVAL - MOD,674.0,438.1,128.09,674.0,85
CDM,43400055,OT EVAL - HIGH,674.0,438.1,128.09,674.0,85
CDM,43400065,OCCUPATIONAL THER RE-EVAL EST PLAN CARE 30 MINS,383.0,248.95,87.28,383.0,85
CDM,43400OH,LIGATION DIRECT ESOPHAGEAL VARICES,10240.0,6656.0,1.1,10240.0,144
CDM,43405OH,LIG/STAPLING G-ESOP JUNCT PRE-ESOPHGL PRF8J,9892.0,6429.8,1.1,9892.0,144
CDM,43410OH,SUTR ESOPHGL WND/INJ CRV APPR,6564.0,4266.6,1.1,6564.0,144
CDM,43415OH,SUTR ESOPHGL WND/INJ TTHRC/TABDL APPR,17952.0,11668.8,1.1,17952.0,144
CDM,43420OH,CLSR ESOPHAGOSTOMY/FSTL CRV APPR,6712.0,4362.8,1.1,9391.15,144
CDM,43425OH,CLSR ESOPHAGOSTOMY/FSTL TTHRC/TABDL APPR,10016.0,6510.4,1.1,10016.0,144
CDM,43450OH,DILATION ESOPH UNGUIDED SOUND/BOUGIE 1/MULT PASS,563.0,365.95,1.1,2644.7,148
CDM,43453OH,DILATION ESOPHAGUS GUIDE WIRE,564.0,366.6,1.1,5549.59,148
CDM,43460OH,ESOPG/GSTR TAMPONADE W/BALO SENGSTAKEN TYPE,1516.0,985.4,1.1,1516.0,142
CDM,43496OH,"FREE JEJUNUM XFER,MICROVASC ANAST",5238.0,3404.7,1.1,7178.05,104
CDM,43497OH,TRANSORAL LOWER ESOPHAGEAL MYOTOMY,5316.0,3455.4,1.1,16621.23,142
CDM,43499RVU11OH,ENDOSCOPIC SUBMUCOSAL DISSECTION OF  ESOPHAGUS - (COMP CODE 4304,9299.0,6044.35,0.01,9299.0,84
CDM,43499RVU12OH,UNLISTED MIN INVASIVE FOKER - ANASTOMOSIS (COMP CODE 43313),20591.0,13384.15,0.01,20591.0,84
CDM,43499RVU14OH,UNLISTED MIN INVASIVE FOKER - STRETCHING (COMP CODE 43425),10642.0,6917.3,0.01,10642.0,84
CDM,43499RVU16OH,"ENDOVAC, ESOPH; EGD (COMP 43235, 97605)",990.0,643.5,0.01,2644.7,84
CDM,43499RVU17OH,"ENDOVAC, ESOPH; ENTEROSCOPY W/ILEUM (COMP 44376, 97605)",2092.0,1359.8,0.01,2644.7,84
CDM,43499RVU18OH,THORACOSCOPY W/ LIGATION OF TRACHEOESOPH FISTULA & REP OF ESOPHA,19235.0,12502.75,0.01,19235.0,84
CDM,43499RVU1OH,ZENKERS DIVERTICULOPEXY,4135.0,2687.75,0.01,4135.0,84
CDM,43499RVU2OH,PERORAL ENDOSCOPIC MYOTOMY,9116.0,5925.4,0.01,9116.0,84
CDM,43499RVU4OH,ESD ESOPHAGUS (COMP 43211),5300.0,3445.0,0.01,5300.0,84
CDM,43499RVU5OH,UNLISTED PROC; ORAL ENDOSCOPIC MYOTOMY (COMP TO 43279),7957.0,5172.05,0.01,7957.0,84
CDM,43499RVU6OH,EGD REPAIR ESOPHAGEAL PERFORATION W/HEMOCLIPS (COMP 43235),742.0,482.3,0.01,2644.7,84
CDM,43499RVU7OH,"ENDOVAC, ESOPH; ENTEROSCOPY (COMP 44360, 97605)",1134.0,737.1,0.01,2644.7,84
CDM,43499RVUOH,ENDOSCOPIC CRICOPHARYNGEAL MYOTOMY,2637.0,1714.05,0.01,2644.7,84
CDM,43500OH,GASTROTOMY W/EXPLORATION/FOREIGN BODY REMOVAL,5116.0,3325.4,1.1,5116.0,144
CDM,43501OH,GASTROTOMY W/SUTURE REPAIR BLEEDING ULCER,9040.0,5876.0,1.1,9040.0,144
CDM,43520OH,PYLOROMYOTOMY CUTTING PYLORIC MUSC,4516.0,2935.4,1.1,4516.0,144
CDM,43605OH,"BIOPSY OF STOMACH,BY LAPAROTOMY",5488.0,3567.2,1.1,5488.0,144
CDM,43610OH,EXC LOCAL ULCER/BENIGN TUMOR STOMACH,6536.0,4248.4,1.1,6536.0,144
CDM,43611OH,EXC LOCAL MALIGNANT TUMOR STOMACH,8152.0,5298.8,1.1,8152.0,144
CDM,43620OH,GSTRCT TOT W/ESOPHAGOENTEROSTOMY,13616.0,8850.4,1.1,13616.0,144
CDM,43621OH,GSTRCT TOT W/ROUX-EN-Y RCNSTJ,15812.0,10277.8,1.1,15812.0,144
CDM,43622OH,GSTRCT TOT W/FRMJ INTSTINAL POUCH ANY TYPE,16012.0,10407.8,1.1,16012.0,144
CDM,43631OH,GSTRCT PRTL DSTL W/GASTRODUODENOSTOMY,9804.0,6372.6,1.1,9804.0,144
CDM,43632OH,GSTRCT PRTL DSTL W/GASTROJEJUNOSTOMY,14056.0,9136.4,1.1,14056.0,144
CDM,43633OH,GSTRCT PRTL DSTL W/ROUX-EN-Y RCNSTJ,13256.0,8616.4,1.1,13256.0,144
CDM,43634OH,GSTRCT PRTL DSTL W/FRMJ INTSTINAL POUCH,14656.0,9526.4,1.1,14656.0,144
CDM,43635OH,VAGOTOMY PFRMD W/PRTL DSTL GSTRCT,824.0,535.6,1.1,824.0,144
CDM,43640OH,VGTMY W/PYLORPLSTY W/WO GASTROST TRUNCAL/SLCTV,7824.0,5085.6,1.1,7824.0,144
CDM,43644OH,LAPS GSTR RSTCV PX W/BYP ROUX-EN-Y LIMB <150 CM,12936.0,8408.4,1.1,12936.0,144
CDM,43645OH,LAPS GSTR RSTCV PX W/BYP&SM INT RCNSTJ,12612.0,8197.8,1.1,12612.0,144
CDM,43647OH,LAP IMPLANT/ REPLACE GASTRIC NEUROSTIM ANTRUM,1499.0,974.35,1.1,39728.72,106
CDM,43648OH,LAP REVISE/REMOVE GASTRIC NEUROSTIM ANTRUM,1543.0,1002.95,1.1,30022.29,104
CDM,43651OH,LAPS SURG TRNSXJ VAGUS NRV TRUNCAL,4052.0,2633.8,1.1,16829.38,144
CDM,43652OH,LAPS SURG TRNSXJ VAGUS NRV SLCTV/HILY SLCTV,4852.0,3153.8,1.1,16829.38,144
CDM,43653OH,LAPS SURG GASTROSTOMY W/O CONSTJ GSTR TUBE SPX,3392.0,2204.8,1.1,16829.38,144
CDM,43659AGRVU4OH,"UNLISTED LAPAROSCOPY PROCEDURE, STOMACH (COMPARISON CODE 43631)",4260.0,2769.0,0.01,16829.38,84
CDM,43659AGRVU8OH,"UNLIST LAP PROC, STOMACH COMPARED TO 43820",7435.0,4832.75,0.01,16829.38,84
CDM,43659OH,UNLISTED LAPAROSCOPIC PROCEDURE STOMACH,12030.0,7819.5,0.01,16829.38,84
CDM,43659RVU10OH,LAP GASTRIC RESTRICTION,8373.0,5442.45,0.01,16829.38,84
CDM,43659RVU11OH,ESO/GASTRECTOMY W RY ESO/JEJUNOSTOMY,14637.0,9514.05,0.01,16829.38,84
CDM,43659RVU12OH,LAPAROSCOPIC TOTAL GASTRECTOMY W/ROUX-EN Y ANASTOMOSIS (COMPARIS,13045.0,8479.25,0.01,16829.38,84
CDM,43659RVU13OH,UNLISTED LAPAROSCOPIC PYLOROPLASTY (COMPARED TO 43800),5092.0,3309.8,0.01,16829.38,84
CDM,43659RVU14OH,"UNLIST LAP PROC, STOMACH COMPARED TO 43633",12030.0,7819.5,0.01,16829.38,84
CDM,43659RVU15OH,"UNLISTED LAPAROSCOPY PROCEDURE, STOMACH (COMPARISON CODE 43840)",7534.0,4897.1,0.01,16829.38,84
CDM,43659RVU16OH,"LAPAROSCOPIC GASTROJEJUNOSTOMY, WITHOUT VAGOTOMY (COMP 43820)",7435.0,4832.75,0.01,16829.38,84
CDM,43659RVU18OH,LAPAROSCOPIC EXCISION MALIGNANT TUMOR OF STOMACH (COMP 43611),7398.0,4808.7,0.01,16829.38,84
CDM,43659RVU19OH,"UNLISTED LAPAROSCOPY PROCEDURE, STOMACH (COMPARISON CODE 44680)",6520.0,4238.0,0.01,16829.38,84
CDM,43659RVU1OH,UNLISTED LAPAROSCOPY STOMACH,3879.0,2521.35,0.01,16829.38,84
CDM,43659RVU20OH,LAPAROSCOPIC EXCISION ULCER OR BENIGN TUMOR STOMACH (COMP CODE 4,7026.0,4566.9,0.01,16829.38,84
CDM,43659RVU22OH,"UNLISTED PROC, LAP DISTAL GASTRECTOMY W/GASTROJEJUNOSTOMY (COMP",12756.0,8291.4,0.01,16829.38,84
CDM,43659RVU23OH,LAP EXC. OF GASTRIC TUMOR (COMP 43610),5113.0,3323.45,0.01,16829.38,84
CDM,43659RVU24OH,LAP GASTROTOMY (COMP 43500),4221.0,2743.65,0.01,16829.38,84
CDM,43659RVU25OH,LAP REPAIR GASTRIC FISTULA (COMP 43880),9000.0,5850.0,0.01,16829.38,84
CDM,43659RVU26OH,LAP DUODENAL SWITCH PROCEDURE (COMP 43845),10659.0,6928.35,0.01,16829.38,84
CDM,43659RVU27OH,LAP PARTIAL GASTRECTOMY W RNY RECONSTRUC (COMP 43633),10936.0,7108.4,0.01,16829.38,84
CDM,43659RVU28OH,LAPAROSCOPIC GASTROPEXY WITH LAP RPR PARAESOPH HIATAL HERNIA W/,3747.0,2435.55,0.01,16829.38,84
CDM,43659RVU32OH,UNLISTED PROC; LAPARSCOPIC REVISION ROUX-EN-Y GASTRIC BYPASS GAS,10808.0,7025.2,0.01,16829.38,84
CDM,43659RVU33OH,LAPAROSCOPIC REVISION GASTROJEJUNAL ANASTOMOSIS W/EXCISION GASTR,9204.0,5982.6,0.01,16829.38,84
CDM,43659RVU36OH,UNLISTED LAPAROSCOPIC PROCEDURE STOMACH (COMP CODE 43843),9120.0,5928.0,0.01,16829.38,84
CDM,43659RVU38OH,LAPAROSCOPIC GASTROPEXY (COMP CODE 43338),950.0,617.5,0.01,16829.38,84
CDM,43659RVU39OH,LAPAROSCOPIC PYLOROMYOTOMY (COMP CODE 43520),4854.0,3155.1,0.01,16829.38,84
CDM,43659RVU3OH,LAPAROSCOPIC PYLOROPLASTY,4484.0,2914.6,0.01,16829.38,84
CDM,43659RVU40OH,LAPAROSCOPIC PARTIAL GASTRECTOMY FOR EXCISION OF GASTROCUTANEOUS,8713.0,5663.45,0.01,16829.38,84
CDM,43659RVU41OH,LAP TOTAL GASTRECTOMY W/RESECTION OF THE GASTROJEJUNOSTOMY (COMP,13616.0,8850.4,0.01,16829.38,84
CDM,43659RVU4OH,LAP. OVERSEW GASTR ULCER,5247.0,3410.55,0.01,16829.38,84
CDM,43659RVU5OH,LAP PARTIAL GASTRECTOMY (COMP CODE 43611),5069.0,3294.85,0.01,16829.38,84
CDM,43659RVU6OH,"LAP, GASTROJEJUNOSTOMY (COMP 43820)",6115.0,3974.75,0.01,16829.38,84
CDM,43659RVU7OH,LAP REVISION GASTROJEJUNOSTOMY (COMP 43860),6423.0,4174.95,0.01,16829.38,84
CDM,43659RVU8OH,LAP GASTRECT W/ROUX-EN-Y,9340.0,6071.0,0.01,16829.38,84
CDM,43659RVUOH,LAPAROSCOPIC PYLOROMYOTOMY (COMP 43800),3728.0,2423.2,0.01,16829.38,84
CDM,43752OH,NASO/ORO-GASTRIC TUBE PLMT REQ PHYS&FLUOR GDNCE,356.0,231.4,1.1,1163.18,132
CDM,43753OH,GASTRIC TUBE PLMT W/ASPIR & LAVAGE,180.0,117.0,1.1,915.24,144
CDM,43754OH,GASTRIC TUBE DX PLMT W/ASPIR 1 SPECIMEN,180.0,117.0,1.1,915.24,148
CDM,43755OH,GASTRIC TUBE DX PLMT W/ASPIR MULT SPECIMENS,376.0,244.4,1.1,680.24,148
CDM,43757OH,DUODENAL TUBE DX PLMT W/IMG GID MULT SPECIMEN,504.0,327.6,1.1,2644.7,148
CDM,43761OH,REPOS NASO/ORO GASTRIC FEEDING TUBE THRU DUO,884.0,574.6,1.1,884.0,148
CDM,43762OH,PERQ REPLACEMENT GTUBE NOT REQ REVJ GSTRST TRC,330.0,214.5,1.1,760.58,148
CDM,43763OH,PERQ REPLACEMENT GTUBE REQ REVJ GSTRST TRC,564.0,366.6,1.1,1132.92,148
CDM,43770OH,LAPS GASTRIC RESTRICTIVE PROCEDURE PLACE DEVICE,7200.0,4680.0,1.1,30022.29,144
CDM,43771OH,LAPS GASTRIC RESTRICTIVE PX REVISION DEVICE,8316.0,5405.4,1.1,8316.0,144
CDM,43772OH,LAPS GASTRIC RESTRICTIVE PX REMOVE DEVICE,6280.0,4082.0,1.1,11169.59,144
CDM,43773OH,LAPS GASTRIC RESTRICTIVE PX REMOVE&RPLCMT DEVICE,8316.0,5405.4,1.1,16829.38,144
CDM,43774OH,LAPS GASTRIC RESTRICTIVE PX REMOVE DEVICE & PORT,6304.0,4097.6,1.1,11169.59,144
CDM,43775OH,LAPS GSTRC RSTRICTIV PX LONGITUDINAL GASTRECTOMY,8967.0,5828.55,1.1,8967.0,144
CDM,43800OH,PYLOROPLASTY,6172.0,4011.8,1.1,6172.0,144
CDM,43810OH,GASTRODUODENOSTOMY,6752.0,4388.8,1.1,6752.0,144
CDM,43820OH,GASTROJEJUNOSTOMY W/O VAGOTOMY,9012.0,5857.8,1.1,9012.0,144
CDM,43825OH,GASTROJEJUNOSTOMY+VAGOTOMY,8704.0,5657.6,1.1,8704.0,144
CDM,43830OH,GASTROSTOMY OPN W/O CONSTJ GSTR TUBE SPX,4340.0,2821.0,1.1,5549.59,144
CDM,43831OH,GASTROSTOMY OPN NEONATAL FEEDING,3396.0,2207.4,1.1,3396.0,144
CDM,43832OH,GASTROSTOMY OPN W/CONSTJ GSTR TUBE,6936.0,4508.4,1.1,6936.0,144
CDM,43840OH,GASTRORRHAPHY SUTR PRF8 DUOL/GSTR ULCER WND/INJ,9132.0,5935.8,1.1,9132.0,144
CDM,43842OH,GASTRIC RSTCV W/O BYP VERTICAL-BANDED GASTROPLY,8412.0,5467.8,1.1,8412.0,112
CDM,43843OH,GSTR RSTCV W/O BYP OTH/THN VER-BANDED GSTP,8484.0,5514.6,1.1,8484.0,144
CDM,43845OH,GASTRIC RSTCV W/PRTL GASTRECTOMY 50-100 CM,13320.0,8658.0,1.1,13320.0,142
CDM,43846OH,GASTRIC RSTCV W/BYP W/SHORT LIMB 150 CM/<,10964.0,7126.6,1.1,10964.0,144
CDM,43847OH,GASTRIC RSTCV W/BYP W/SM INT RCNSTJ LIMIT ABSRPJ,12112.0,7872.8,1.1,12112.0,144
CDM,43848OH,REVISION OPEN GASTRIC RESTRICTIVE PX NOT DEVICE,13100.0,8515.0,1.1,13100.0,144
CDM,43860OH,REVJ GSTR/JJ ANAST W/RCNSTJ W/O VGTMY,11156.0,7251.4,1.1,11156.0,144
CDM,43865OH,REVJ GSTR/JJ ANAST W/RCNSTJ W/VGTMY,11620.0,7553.0,1.1,11620.0,144
CDM,43870OH,"CLOSURE OF GASTROSTOMY,SURGICAL",4576.0,2974.4,1.1,11169.59,144
CDM,43880OH,CLOSURE GASTROCOLIC FISTULA,10872.0,7066.8,1.1,10872.0,144
CDM,43881OH,OPEN IMPLANT/ REPLACE GASTRIC NEUROSTIM ANTRUM,5340.0,3471.0,1.1,5340.0,104
CDM,43882OH,REVISION/RMVL GASTRIC NSTIM ELTRDE ANTRUM OPEN,1772.0,1151.8,1.1,1910.06,104
CDM,43886OH,GSTR RSTCV PX OPN REVJ SUBQ PORT COMPONENT ONLY,1856.0,1206.4,1.1,10462.5,144
CDM,43887OH,GSTR RSTCV PX OPN RMVL SUBQ PORT COMPONENT ONLY,1728.0,1123.2,1.1,5320.02,144
CDM,43888OH,GSTR RSTCV OPN RMVL & RPLCMT SUBQ PORT,2576.0,1674.4,1.1,10462.5,144
CDM,43889OH,GSTR RSTCV PX TRNSORL ESG W/ARGON PLASMA COAGJ,5526.0,3591.9,1.1,5526.0,106
CDM,43999RVU10OH,"PARTIAL GATRECTOMY, PROXIMAL (COMP 43610)",8533.0,5546.45,0.01,8533.0,84
CDM,43999RVU11OH,ENDOSCOPIC PYLOROMYOTOMY (COMP 43520),4700.0,3055.0,0.01,4700.0,84
CDM,43999RVU12OH,EGD W SUTURE OF GASTROCUTANEOUS FISTULA (COMP 43255),1364.0,886.6,0.01,2644.7,84
CDM,43999RVU13OH,ENDO GASTRIC BYPASS REVISON (COMP 43860),9200.0,5980.0,0.01,9200.0,84
CDM,43999RVU14OH,ENDOSCOPIC SLEEVE GASTROPLASTY (COMP 43843),8900.0,5785.0,0.01,8900.0,84
CDM,43999RVU15OH,OPEN GASTROPEXY (COMP TO 44680),5927.0,3852.55,0.01,5927.0,84
CDM,43999RVU16OH,EGD W/ GASTRO/GASTRIC FISTULA REPAIR (COMP CODE 44650),8290.0,5388.5,0.01,8290.0,84
CDM,43999RVU17OH,EGD W/ APSPIRATION THERAPY (COMP CODE 43753),149.0,96.85,0.01,2644.7,84
CDM,43999RVU18OH,EGD W/ SUTURE REPAIR OF LG INTESTINE  (COMP CODE 44604),5993.0,3895.45,0.01,5993.0,84
CDM,43999RVU19OH,EGD W/ SUTURE REPAIR OF STOMACH (COMP CODE 43840),7534.0,4897.1,0.01,7534.0,84
CDM,43999RVU1OH,REMOVAL OF GASTROSTOMY TUBE,315.0,204.75,0.01,2644.7,84
CDM,43999RVU20OH,EGD W/ INTRAGASTRIC BALLOON PLACEMENT (COMP 43843),6999.0,4549.35,0.01,6999.0,84
CDM,43999RVU21OH,ENDOSCOPIC WOUND VAC PLACEMENT (COMP CODE 43235 & 97605),1122.0,729.3,0.01,2644.7,84
CDM,43999RVU22OH,TRANS ORAL GASTRIC OUTLET REDUCTION TORE (COMP CODE 43771),7485.0,4865.25,0.01,7485.0,84
CDM,43999RVU23OH,BAND FLUID REMOVAL (COMP CODE 49082),149.0,96.85,1.1,2644.7,148
CDM,43999RVU24OH,ENDOSCOPIC SUBMUCOSAL DISSECTION OF STOMACH - (COMP CODE 43611),8662.0,5630.3,0.01,8662.0,84
CDM,43999RVU25OH,OPEN GASTRIC BAND REMOVAL (COMP CODE 43774),6776.0,4404.4,0.01,6776.0,84
CDM,43999RVU26OH,CENTRAL GASTRECTOMY WITH GASTROGASTROSTOMY (COMP 43631),8824.0,5735.6,0.01,8824.0,84
CDM,43999RVU27OH,"ENDOVAC, STOMACH; ENTEROSCOPY (COMP 44360, 97605)",1134.0,737.1,0.01,2644.7,84
CDM,43999RVU28OH,"ENDOVAC, STOMACH; ENTEROSCOPY W/ILEUM (COMP 44376, 97605)",2092.0,1359.8,0.01,2644.7,84
CDM,43999RVU29OH,"LIGATION OF GASTRIC VARIED, OPEN (COMP CODE 43244)",1893.0,1230.45,0.01,2644.7,84
CDM,43999RVU2OH,LAPAROSCOPIC PYLOROPLASTY,6333.0,4116.45,0.01,6333.0,84
CDM,43999RVU30OH,IMAGE GUIDED REPOSITION G-TUBE (COMP CODE 43761),884.0,574.6,0.01,2644.7,84
CDM,43999RVU31OH,SLEEVE GASTRECTOMY TO SINGLE ANASTOMOSIS DUODENAL SWITCH (SADIS),13320.0,8658.0,0.01,13320.0,84
CDM,43999RVU32OH,TRANSNASAL EGD W/REMOVAL OF FOREIGN BODY (COMP 43247),1368.0,889.2,0.01,2644.7,84
CDM,43999RVU3OH,"LAP, REVISION NISSEN FUNDOPLASTY (COMP 43280)",7240.0,4706.0,0.01,7240.0,84
CDM,43999RVU4OH,EXC GASTROCUTANEOUS FISTULA (COMP 44640),4221.0,2743.65,0.01,4221.0,84
CDM,43999RVU5OH,"UNLISTED PROCEDURE, STOMACH (COMPARISON CODE 43880)",9866.0,6412.9,0.01,9866.0,84
CDM,43999RVU6OH,"UNLISTED PROCEDURE, STOMACH COMPARED TO CPT 43520",3726.0,2421.9,0.01,3726.0,84
CDM,43999RVU7OH,PARTIAL GASTRECTOMY (COMP CODE 43610),2880.0,1872.0,0.01,2880.0,84
CDM,43999RVU9OH,ESD STOMACH (COMP 43254),5300.0,3445.0,0.01,5300.0,84
CDM,43999X1OH,ADJUSTMENT OF GASTRIC BAND,67.0,43.55,0.01,2644.7,84
CDM,44000015,TX SPEECH LANGUAGE VOICE COMMJ AUDITRY 2/>INDIV,283.0,183.95,30.03,283.0,86
CDM,44000040,EVAL ORAL&PHARYNGEAL SWLNG FUNCJ,570.0,370.5,70.74,570.0,85
CDM,44000065,STANDARDIZED COGNITIVE PERFORMANCE TESTING,662.0,430.3,129.95,662.0,85
CDM,44000080,ASSESS APHASIA PER HR,480.0,312.0,124.17,480.0,85
CDM,44000090,SPEECH/HEARING THERAPY INDIV,473.0,307.45,70.74,473.0,86
CDM,44000125,RX SP-GENRATJ AUGMNT&COMUNICAJ DEV 1ST HR,1420.0,923.0,70.74,1420.0,85
CDM,44000155,TX SPEECH LANG VOICE COMMJ &/AUDITORY PROC IND,473.0,307.45,70.74,473.0,86
CDM,44000160,TREAT SWALLOWING DYSFUNCTION,664.0,431.6,85.08,664.0,86
CDM,44000165,SLT-SPEECH/LANGUAG THERAPY GRP,283.0,183.95,30.03,283.0,86
CDM,44000225,SLT-THERA SVC COM DEV PRG MOD,629.0,408.85,85.08,629.0,85
CDM,44000265,BEHAV QUAL ANLYS VOICE MO,544.0,353.6,70.74,544.0,85
CDM,44000405,EVAL RX N-SP-GEN AUGMT ALT COMMUN DEV ADD 30 MIN,268.0,174.2,58.42,268.0,66
CDM,44000410,BEHAVIORAL & QUALIT ANALYSIS VOICE AND RESONANCE,544.0,353.6,70.74,544.0,85
CDM,44000435,"SLT-DEVELOPMENTAL TEST,LIM",316.0,205.4,68.89,316.0,66
CDM,44000500,LARYNGOSCOPY FLX/RGD TELESCOPIC W/STROBOSCOPY,1786.0,1160.9,133.1,4392.0,87
CDM,44000505,TX SPEECH LANGUAGE VOICE COMMJ AUDITRY 2/>INDIV,283.0,183.95,30.03,283.0,86
CDM,44000510,FIT PROSTHTIC VOICE DVC 440,636.0,413.4,70.74,636.0,85
CDM,44000515,EVAL ORAL&PHARYNGEAL SWLNG FUNCJ,570.0,370.5,70.74,570.0,85
CDM,44000520,MOTION FLUOR EVAL SWLNG FUNCJ C/V REC,829.0,538.85,113.53,829.0,85
CDM,44000525,FEES W CINE OR VIDEO,1084.0,704.6,74.78,1084.0,85
CDM,44000530,COGNITIVE TEST BY HCPRO GN,662.0,430.3,129.95,662.0,85
CDM,44000550,"SENSORY INTEGRATION, EA 1",188.0,122.2,52.26,188.0,85
CDM,44000555,UNLISTED ENT PROCED/SERVICE,174.0,113.1,22.7,174.0,84
CDM,44000585,LARYNGEAL FUNCTION STUDIES,516.0,335.4,44.77,528.46,87
CDM,44000705,DEVEL TST PHYS/QHP 1ST HR,1080.0,702.0,121.73,1080.0,86
CDM,44000715,DEVEL TST PHYS/QHP EA ADDL,302.0,196.3,64.36,302.0,68
CDM,44000755,THER IVNTJ COG FUNCJ CNTCT 1ST 15 MINUTES,205.0,133.25,28.08,205.0,85
CDM,44000765,THER IVNTJ COG FUNCJ CNTCT EA ADDL 15 MINUTES,205.0,133.25,26.54,205.0,85
CDM,44000885,VV SPEECH THERAPY (92507),473.0,307.45,70.74,473.0,86
CDM,44000895,VV FLUENCY EVAL (92521),593.0,385.45,70.74,593.0,85
CDM,44000905,VV SOUND PRODUCTION EVALUATION (92522),573.0,372.45,70.74,573.0,85
CDM,44000915,VV SPEECH SOUND LANGUAGE COMPREHENSIVE EVAL (92523),1002.0,651.3,70.74,1002.0,85
CDM,44000925,VV VOICE EVAL (92524),544.0,353.6,70.74,544.0,85
CDM,44000935,SLT CAREGIVER TRAINING STRATEGIES&TQ 1ST 30 MINUTES,887.0,576.55,39.1,887.0,85
CDM,44000945,SLT CAREGIVER TRAINING STRATEGIES&TQ EA ADDL 15 MIN,887.0,576.55,30.26,887.0,85
CDM,44000955,SLT GROUP CAREGIVER TRAINING STRATEGIES & TECHNIQUE,887.0,576.55,13.13,887.0,85
CDM,44000985,REMOTE THERAPEUTIC MNTR 1ST SET-UP&PT EDUCAJ EQ,593.0,385.45,27.62,593.0,86
CDM,44000995,REM THER MNTR DEV SPLY DATA MUSCSKEL SYS EA 30 D,172.0,111.8,32.72,172.0,78
CDM,44001005,REMOTE THER MNTR TX MGMT PHYS/QHP 1ST 20 MIN,72.0,46.8,20.02,72.0,70
CDM,44001015,REMOTE THER MNTR TX MGMT PHYS/QHP EA ADDL 20 MIN,72.0,46.8,20.02,72.0,70
CDM,44001025,AUDIOGRAM,28.0,18.2,6.1,28.0,58
CDM,44005OH,ENTEROLSS FRING INTSTINAL ADHESION SPX,7384.0,4799.6,1.1,7384.0,144
CDM,44010OH,"DUODENOTOMY FOR EXPLOR,BX,FB REMOV",5704.0,3707.6,1.1,5704.0,144
CDM,44015OH,TUBE/NEEDLE CATH JEJUNOSTOMY ANY METHOD,1048.0,681.2,1.1,1048.0,144
CDM,44020OH,ENTEROTOMY SM INT OTH/THN DUO EXPL BX/FB RMVL,6488.0,4217.2,1.1,6488.0,144
CDM,44021OH,ENTEROTOMY SM INT OTH/THN DUO DCMPRN,6524.0,4240.6,1.1,6524.0,144
CDM,44025OH,COLOTOMY EXPLORATION/BIOPSY/FOREIGN BODY REMOVAL,6604.0,4292.6,1.1,6604.0,144
CDM,44050OH,RDCTJ VOLVULUS INTUSSUSCEPTION INT HRNA LAPT,6208.0,4035.2,1.1,6208.0,144
CDM,44055OH,CORRJ MALROTATION BANDS&/RDCTJ VOLVULUS,10252.0,6663.8,1.1,10252.0,144
CDM,44100000,TX SPEECH LANG VOICE COMMJ &/AUDITORY PROC IND,473.0,307.45,70.74,473.0,86
CDM,44100065,THER IVNTJ COG FUNCJ CNTCT 1ST 15 MINUTES,205.0,133.25,28.08,205.0,85
CDM,44100075,THER IVNTJ COG FUNCJ CNTCT EA ADDL 15 MINUTES,205.0,133.25,26.54,205.0,85
CDM,44110OH,EXC 1/> SMALL/LARGE LESIONS INTESTINE ENTEROTOM,5616.0,3650.4,1.1,5616.0,144
CDM,44111OH,EXC 1/> SM/LG LESIONS INTESTNE MULT ENTEROTOMIE,6608.0,4295.2,1.1,6608.0,144
CDM,44120OH,ENTRC RESCJ SMALL INTESTINE 1 RESCJ & ANAST,8328.0,5413.2,1.1,8328.0,144
CDM,44121OH,ENTERECTOMY RESCJ SMALL INTESTINE EA RESCJ & ANA,1776.0,1154.4,1.1,1776.0,144
CDM,44125OH,ENTERECTOMY RESCJ SMALL INTESTINE W/ENTEROSTOMY,8813.0,5728.45,1.1,8813.0,144
CDM,44126OH,ENTRC RESCJ ATRESIA RESCJ & ANAST W/O TAPRING,16892.0,10979.8,1.1,16892.0,144
CDM,44127OH,ENTRC RESCJ ATRESIA RESCJ & ANAST SGM W/TAPRING,19720.0,12818.0,1.1,19720.0,144
CDM,44128OH,ENTRC RESCJ ATRESIA EA RESCJ & ANASTOMOSIS,1776.0,1154.4,1.1,1776.0,144
CDM,44130OH,ENTEROENTEROST ANAST INT W/WO CUTAN NTRSTM SPX,8844.0,5748.6,1.1,8844.0,144
CDM,44132OH,DONOR ENTERECTOMY OPEN CADAVER DONOR,15830.0,10289.5,1.1,3060831.65,82
CDM,44135OH,INTESTINAL ALLOTRANSPLANTATION CADAVER DONOR,35266.0,22922.9,1.1,58893.64,84
CDM,44136OH,INTESTINAL ALLOTRANSPLANTATION LIVING DONOR,35821.0,23283.65,1.1,3060831.65,82
CDM,44137OH,RMVL TRNSPLED INTESTINAL ALLOGRAFT COMPL,14032.0,9120.8,1.1,3060831.65,88
CDM,44139OH,MOBLJ SPLENIC FLXR PFRMD CONJUNCT W/PRTL COLCT,892.0,579.8,1.1,892.0,144
CDM,44140OH,COLECTOMY PARTIAL W/ANASTOMOSIS,9036.0,5873.4,1.1,9036.0,144
CDM,44141OH,COLECTOMY PRTL W/SKIN LEVEL CECOST/COLOSTOMY,11964.0,7776.6,1.1,11964.0,144
CDM,44143OH,COLECTOMY PRTL W/END COLOSTOMY & CLSR DSTL SGMT,11116.0,7225.4,1.1,11116.0,144
CDM,44144OH,COLECTOMY PRTL W/COLOST/ILEOST & MUCOFISTULA,11964.0,7776.6,1.1,11964.0,144
CDM,44145OH,COLECTOMY PRTL W/COLOPROCTOSTOMY,11432.0,7430.8,1.1,11432.0,144
CDM,44146OH,COLECTOMY PRTL W/COLOPROCTOSTOMY & COLOSTOMY,14120.0,9178.0,1.1,14120.0,144
CDM,44147OH,COLECTOMY PRTL ABDOMINAL & TRANSANAL APPROACH,13476.0,8759.4,1.1,13476.0,144
CDM,44150OH,COLCT TOT ABDL W/O PRCTECT W/ILEOST/ILEOPXTS,12072.0,7846.8,1.1,12072.0,144
CDM,44151OH,COLCT TOT ABDL W/O PRCTECT W/CONTINENT ILEOST,13968.0,9079.2,1.1,13968.0,144
CDM,44155OH,COLECTOMY TOT ABDL W/PROCTECTOMY W/ILEOSTOMY,13768.0,8949.2,1.1,13768.0,144
CDM,44156OH,COLECTOMY TOT ABDL W/PROCTECTOMY W/CONTNT ILEOST,14968.0,9729.2,1.1,14968.0,144
CDM,44157OH,COLECTOMY TOT ABD W/PROCTECTOMY ILEOANAL ANAST,14280.0,9282.0,1.1,14280.0,144
CDM,44158OH,COLCT TTL ABD W/PRCTECT ILEOANAL ANAST & RSVR,14680.0,9542.0,1.1,14680.0,144
CDM,44160OH,COLECTOMY PRTL W/RMVL TERMINAL ILEUM & ILEOCOLOS,8356.0,5431.4,1.1,8356.0,144
CDM,44180OH,LAPAROSCOPY ENTEROLYSIS SEPARATE PROCEDURE,6108.0,3970.2,1.1,16829.38,144
CDM,44186OH,LAPAROSCOPY SURGICAL JEJUNOSTOMY,4152.0,2698.8,1.1,16829.38,144
CDM,44187OH,LAPAROSCOPY SURG ILEOSTOMY/JEJUNOSTOMY NON-TUBE,6960.0,4524.0,1.1,6960.0,144
CDM,44188OH,LAPAROSCOPY SURG COLOSTOMY/SKN LVL CECOSTOMY,7740.0,5031.0,1.1,7740.0,144
CDM,44202OH,LAPS ENTERECT RESCJ 1 SMALL INTEST RESCJ & ANA,9356.0,6081.4,1.1,9356.0,144
CDM,44203OH,LAPAROSCOPY SMALL INTESTINE RESCJ & ANASTOMOSIS,1776.0,1154.4,1.1,1776.0,144
CDM,44204OH,LAPAROSCOPY COLECTOMY PARTIAL W/ANASTOMOSIS,10568.0,6869.2,1.1,10568.0,144
CDM,44205OH,LAPS COLECTOMY PRTL W/RMVL TERMINAL ILEUM,10098.0,6563.7,1.1,10098.0,144
CDM,44206OH,LAPS COLECTOMY PRTL W/END CLST & CLSR DSTL SGM,11916.0,7745.4,1.1,11916.0,144
CDM,44207OH,LAPS COLECTOMY PRTL W/COLOPXTSTMY LW ANAST,14045.0,9129.25,1.1,14045.0,144
CDM,44208OH,LAPS COLECTMY PRTL W/COLOPXTSTMY LW ANAST W/CLST,14956.0,9721.4,1.1,14956.0,144
CDM,44210OH,LAPS COLECTOMY TOT W/O PRCTECT W/ILEOST/ILEOPXTS,12036.0,7823.4,1.1,12036.0,144
CDM,44211OH,LAPS COLCT TTL ABD W/PRCTECT ILEOANAL ANASTOMSIS,14832.0,9640.8,1.1,14832.0,144
CDM,44212OH,LAPS COLECTOMY ABDL W/PROCTECTOMY W/ILEOSTOMY,13832.0,8990.8,1.1,13832.0,144
CDM,44213OH,LAPS MOBLJ SPLENIC FLXR PFRMD W/PRTL COLECTOMY,1400.0,910.0,1.1,1400.0,144
CDM,44227OH,LAPS CLSR NTRSTM LG/SM INT W/RESCJ & ANASTOMOSIS,11448.0,7441.2,1.1,11448.0,144
CDM,44238AGRVU3OH,"UNLIST LAP PROC, INTEST (EXC RECTUM) COMPARED TO 44050",5122.0,3329.3,0.01,16829.38,96
CDM,44238AOH,"LX PROCTOSIGMOID, CAA, ILEOSTOMY",10949.0,7116.85,0.01,16829.38,96
CDM,44238OH,UNLISTED LAPAROSCOPY PX INTESTINE XCP RECTUM,8026.0,5216.9,0.01,16829.38,96
CDM,44238RVU10OH,LAP EXCISION OF LARGE BOWEL LESION(S) (COMP 44110),3791.0,2464.15,0.01,16829.38,96
CDM,44238RVU11OH,LX EXCISION OF MECKEL'S DIVERTICULUM (COMP CODE 44800),4226.0,2746.9,0.01,16829.38,96
CDM,44238RVU12OH,LAP EXCISION OF SMALL BOWEL LESION(S),3791.0,2464.15,0.01,16829.38,96
CDM,44238RVU13OH,LAP EXCISION SM BOWEL LESION,3861.0,2509.65,0.01,16829.38,96
CDM,44238RVU14OH,"LAP SUTURE OF SM INTESTINE, SINGLE (COMP 44602)",4495.0,2921.75,0.01,16829.38,96
CDM,44238RVU15OH,"UNLISTED LAPAROSCOPIC PROCEDURE, INTESTINE (EXCEPT RECTUM)  (COM",2120.0,1378.0,0.01,16829.38,96
CDM,44238RVU16OH,"UNLIST LAP PROC, INTEST (EXC RECTUM) COMPARED TO 44050",5634.0,3662.1,0.01,16829.38,96
CDM,44238RVU17OH,"UNLIST LAP PROC, INTESTINE (EXCEPT RECTUM) (COMP CODE 44144)",9721.0,6318.65,0.01,16829.38,96
CDM,44238RVU18OH,LAP REPAIR ENTEROCUTANEOUS FISTULA (COMP 44640),9684.0,6294.6,0.01,16829.38,96
CDM,44238RVU19OH,"LAP REDUCE VOLVULUS,INTUSS,INTERNAL HERNIA (COMP 44050)",5122.0,3329.3,0.01,16829.38,96
CDM,44238RVU1OH,LAPAROSCOPIC STRICTUROPLASTY (COMP 44615),6538.0,4249.7,0.01,16829.38,96
CDM,44238RVU20OH,LAP CLOSURE OF ILEOSIGMOID FISTULA (COMP 44650),5656.0,3676.4,0.01,16829.38,96
CDM,44238RVU21OH,"LAP SUTURE OF LG INTESTINE, SINGLE/MULT (COMP 44604)",5857.0,3807.05,0.01,16829.38,96
CDM,44238RVU22OH,UNLISTED PROC; LAP REVISION OF ILEOSTOMY; COMPLICATED (COMP TO 4,17632.0,11460.8,0.01,17632.0,96
CDM,44238RVU23OH,"UNLISTED PROC, LAP REPAIR OF DUODENAL PERFORATION (COMP TO 44602",10506.0,6828.9,0.01,16829.38,96
CDM,44238RVU24OH,UNLISTED LAPAROSCOPIC COMPLETION PROCTECTOMY WITH ILEOANAL POUCH,14118.5,9177.03,0.01,16829.38,96
CDM,44238RVU25OH,STRONG PROCEDURE FOR TX OF SMA SYNDROME (COMP 44180),14118.5,9177.03,0.01,16829.38,96
CDM,44238RVU26OH,UNLISTED LAPAROSCOPIC DUODENODUODENOSTOMY (COMP CODE 44126),17948.0,11666.2,0.01,17948.0,96
CDM,44238RVU27OH,SUTURE OF MESENTERY (SEPARATE PROCEDURE) (COMP CODE 44850),5147.0,3345.55,0.01,16829.38,96
CDM,44238RVU28OH,LAP CLOSURE OF ENTEROVESICAL FISTULA W/O RESECTION (COMP 44660),10281.0,6682.65,1.1,10281.0,144
CDM,44238RVU29OH,LAPAROSCOPIC BRAUN ENTEROENTEROSTOMY (COMP 44130),9507.0,6179.55,0.01,16829.38,96
CDM,44238RVU2OH,LX CLOSE ENTEROENTERIC FI,7718.0,5016.7,0.01,16829.38,96
CDM,44238RVU30OH,LAP EXCISION OF CECUM W/O ANASTOMOSIS (COMP 44110),6037.0,3924.05,0.01,16829.38,96
CDM,44238RVU31OH,LAP REVISION COLOSTOMY W/RPR PARACOLOSTOMY HERNIA (COMP 44346),5035.0,3272.75,0.01,16829.38,96
CDM,44238RVU32OH,LAPAROSCOPIC EXCISION SMALL BOWEL LESION/S (COMP 44110),6037.0,3924.05,0.01,16829.38,96
CDM,44238RVU33OH,LAPAROSCOPIC PARTIAL COLECTOMY WITHOUT ANASTOMOSIS (COMP CODE 44,11360.0,7384.0,0.01,16829.38,96
CDM,44238RVU34OH,UNLISTED LAP LADDS PROCEDURE (COMP CODE 44055),9227.0,5997.55,0.01,16829.38,96
CDM,44238RVU35OH,LAPAROSCOPIC ILEOCOLOSTOMY PEXY (COMP 44312),3395.0,2206.75,0.01,16829.38,96
CDM,44238RVU36OH,LAP GRAHAM PATCH INTESTINE (COMP 43840),8219.0,5342.35,0.01,16829.38,96
CDM,44238RVU37OH,LAPAROSCOPIC REMOVAL OF FOREIGN BODY; SMALL INTESTINE (COMP 4402,5840.0,3796.0,0.01,16829.38,96
CDM,44238RVU38OH,LAP REVISION OF ILEAL POUCH W/ RESECTION (COMP 46712),13123.0,8529.95,0.01,16829.38,96
CDM,44238RVU39OH,LAPAROSCOPIC CECOPEXY (COMP CODE 44680),6466.0,4202.9,0.01,16829.38,96
CDM,44238RVU3OH,LAPARSCOPIC CLOSURE ENTEROCOLIC FISTULA (COMP 44650),10096.0,6562.4,0.01,16829.38,96
CDM,44238RVU40OH,LAP COLECTOMY W/REMOVAL OF TI; NO ANASTOMOSIS W/ STOMA (COMP 442,10725.0,6971.25,0.01,16829.38,96
CDM,44238RVU4OH,LAP/MALROTATION OF BOWEL,8044.0,5228.6,0.01,16829.38,96
CDM,44238RVU5OH,LX REDUCT BOWEL OBSTRUCT,4524.0,2940.6,0.01,16829.38,96
CDM,44238RVU6OH,LX TAKEDOWN OF COLOVESICLE FIST W/RESECT (COMP CODE 44661),10664.0,6931.6,0.01,16829.38,96
CDM,44238RVU7OH,LAP DUODENODUODENOSTOMY,11274.0,7328.1,0.01,16829.38,96
CDM,44238RVU8OH,LAPAROSCOPIC APPENDICOSTOMY,2779.0,1806.35,0.01,16829.38,96
CDM,44238RVU9OH,LAPAROSCOPIC; MECKELS DIVERTICULECTOMY,4226.0,2746.9,0.01,16829.38,96
CDM,44238RVUOH,LAPAROSCOPIC ENTEROENTEROSTOMY,5243.0,3407.95,0.01,16829.38,96
CDM,44300OH,PLACEMENT ENTEROSTOMY/CECOSTOMY TUBE OPEN,5500.0,3575.0,1.1,5500.0,144
CDM,44310OH,"ILEOSTOMY/JEJUNOSTOMY,NONTUBE",7740.0,5031.0,1.1,7740.0,144
CDM,44312OH,REVJ ILEOSTOMY SIMPLE RLS SUPERFICIAL SCAR SPX,3772.0,2451.8,1.1,10462.5,144
CDM,44314OH,REVJ ILEOSTOMY COMPLIC RCNSTJ IN-DEPTH SPX,6696.0,4352.4,1.1,6696.0,144
CDM,44316OH,CONTINENT ILEOSTOMY KOCK PROCEDURE SPX,9436.0,6133.4,1.1,9436.0,144
CDM,44320OH,COLOSTOMY/SKIN LEVEL CECOSTOMY,7964.0,5176.6,1.1,7964.0,144
CDM,44322OH,COLOSTOMY/SKN LVL CECOSTOMY W/MULT BXS SPX,5328.0,3463.2,1.1,5328.0,144
CDM,44340OH,REVJ COLOSTOMY SMPL RLS SUPFC SCAR SPX,3712.0,2412.8,1.1,10462.5,144
CDM,44345OH,REVJ COLOSTOMY COMP RCNSTJ IN-DEPTH SPX,6888.0,4477.2,1.1,6888.0,144
CDM,44346OH,REVJ COLOSTOMY W/RPR PARACLST HERNIA SPX,7852.0,5103.8,1.1,7852.0,144
CDM,44360OH,ENDOSCOPY UPPER SMALL INTESTINE,996.0,647.4,1.1,5549.59,144
CDM,44361OH,ENDOSCOPY UPPER SMALL INTESTINE W/BIOPSY,1108.0,720.2,1.1,5549.59,144
CDM,44363OH,ENTEROSCOPY > 2ND PRTN W/RMVL FOREIGN BODY,1356.0,881.4,1.1,5549.59,144
CDM,44364OH,ENTEROSCOPY > 2ND PRTN W/RMVL LESION SNARE,1452.0,943.8,1.1,5549.59,144
CDM,44365OH,ENTEROSCOPY > 2ND PRTN W/RMVL LESION CAUTERY,1284.0,834.6,1.1,5549.59,144
CDM,44366OH,ENTEROSCOPY > 2ND PRTN W/CONTROL BLEEDING,1720.0,1118.0,1.1,5549.59,144
CDM,44369OH,ENTEROSCOPY > 2ND PRTN ABLTJ LESION,1764.0,1146.6,1.1,5549.59,144
CDM,44370OH,ENTEROSCOPY > 2ND PRTN TNDSC STENT PLMT,1876.0,1219.4,1.1,16621.23,144
CDM,44372OH,ENTEROSCOPY > 2ND PRTN W/PLMT PRQ TUBE,1720.0,1118.0,1.1,5549.59,144
CDM,44373OH,ENTEROSCOPY > 2ND PRTN CONV GSTRST TUBE,1356.0,881.4,1.1,5549.59,144
CDM,44376OH,ENTEROSC >2ND PRTN W/ILEUM W/WO COLLJ SPEC SPX,2060.0,1339.0,1.1,5549.59,144
CDM,44377OH,ENTEROSC >2ND PRTN W/ILEUM W/BX SINGLE/MULTIPLE,2168.0,1409.2,1.1,5549.59,144
CDM,44378OH,ENTEROSCOPY > 2ND PRTN ILEUM CONTROL BLEEDING,2808.0,1825.2,1.1,5549.59,144
CDM,44379OH,ENTEROSCOPY > 2ND PRTN W/ILEUM W/STENT PLMT,2944.0,1913.6,1.1,16621.23,144
CDM,44380OH,ILEOSCOPY THRU STOMA DX W/COLLJ SPEC WHEN PRFMD,348.0,226.2,1.1,2644.7,148
CDM,44381OH,ILEOSCOPY STOMA W/BALLOON DILATION,552.0,358.8,1.1,5549.59,136
CDM,44382OH,ILEOSCOPY STOMA W/BX SINGLE/MULTIPLE,468.0,304.2,1.1,2644.7,148
CDM,44384OH,ILEOSCOPY STOMA W/PLMT OF ENDOSCOPIC STENT,1140.0,741.0,1.1,5549.59,132
CDM,44385OH,NDSC EVAL INTSTINAL POUCH DX W/COLLJ SPEC SPX,528.0,343.2,1.1,2666.13,148
CDM,44386OH,NDSC EVAL INTSTINAL POUCH W/BX SINGLE/MULTIPLE,660.0,429.0,1.1,2666.13,148
CDM,44388OH,COLONOSCOPY STOMA DX INCLUDING COLLJ SPEC SPX,1088.0,707.2,1.1,2666.13,148
CDM,44389OH,COLONOSCOPY STOMA W/BIOPSY SINGLE/MULTIPLE,1329.0,863.85,1.1,3440.56,148
CDM,44390OH,COLONOSCOPY STOMA W/RMVL FOREIGN BODY,1496.0,972.4,1.1,2666.13,148
CDM,44391OH,COLONOSCOPY STOMA CONTROL BLEEDING,1648.0,1071.2,1.1,3440.56,148
CDM,44392OH,COLONOSCOPY STOMA RMVL LES BY HOT BIOPSY FORCEPS,1412.0,917.8,1.1,3440.56,148
CDM,44394OH,COLONOSCOPY STOMA W/RMVL TUM POLYP/OTH LES SNARE,1612.0,1047.8,1.1,3440.56,148
CDM,44400005,SWALLOW EVAL FUNC FLUORO GN,829.0,538.85,113.53,829.0,85
CDM,44400030,EVALUATE SWALLOWING FUNCTION,570.0,370.5,70.74,570.0,85
CDM,44400040,EVALUATION OF SPEECH FLUENCY (STUTTER CLUTTER),549.0,356.85,70.74,549.0,85
CDM,44400045,EVAL OF SPEECH PRODUCTION,573.0,372.45,70.74,573.0,85
CDM,44400050,EVALUATION OF SPEECH SOUND PRODUCTION ARTICULATE,573.0,372.45,70.74,573.0,85
CDM,44400055,EVAL SPEECH SOUND PRODUCT LANGUAGE COMPREHENSION,1002.0,651.3,70.74,1002.0,85
CDM,44400060,EVAL SPEECH SOUND LANG COMPREH,1002.0,651.3,70.74,1002.0,85
CDM,44400065,BEHAVIORAL & QUALIT ANALYSIS VOICE AND RESONANCE,544.0,353.6,70.74,544.0,85
CDM,44400075,EVAL OF SPEECH FLUENCY,593.0,385.45,70.74,593.0,85
CDM,44400135,PROC ENT UNLISTD 444,174.0,113.1,22.7,174.0,84
CDM,44400145,EVAL SPCH - GEN DEV 1 HR,1420.0,923.0,70.74,1420.0,85
CDM,44400155,EVAL SPCH - GEN DEV 30 MN,172.0,111.8,47.82,172.0,85
CDM,44401OH,COLONOSCOPY STOMA ABLATION LESION,1736.0,1128.4,1.1,7924.73,148
CDM,44402OH,COLONOSCOPY STOMA W/ENDOSCOPIC STENT PLCMT,1880.0,1222.0,1.1,16621.23,144
CDM,44403OH,COLONOSCOPY STOMA W/ENDOSCOPIC MUCOSAL RESCJ,2200.0,1430.0,1.1,3440.56,132
CDM,44404OH,COLONOSCOPY STOMA W/SUBMUCOSAL INJECTION,1208.0,785.2,1.1,3440.56,136
CDM,44405OH,COLONOSCOPY STOMA W/BALLOON DILATION,1292.0,839.8,1.1,3440.56,136
CDM,44406OH,COLONOSCOPY STOMA W/ENDOSCOPIC ULTRASOUND EXAM,1640.0,1066.0,1.1,3440.56,132
CDM,44407OH,COLONOSCOPY STOMA W/US GID NDL ASPIR/BX,1984.0,1289.6,1.1,3440.56,132
CDM,44408OH,COLONOSCOPY THROUGH STOMA WITH DECOMPRESSION,1656.0,1076.4,1.1,2666.13,144
CDM,44500OH,INTRODUCTION LONG GI TUBE SEPARATE PROCEDURE,172.0,111.8,1.1,2644.7,144
CDM,44602OH,ENTERORRHAPHY SINGLE PERFORATION,9888.0,6427.2,1.1,9888.0,144
CDM,44603OH,ENTERORRHAPHY MULTIPLE PERFORATIONS,11264.0,7321.6,1.1,11264.0,144
CDM,44604OH,SUTR LG INTESTINE 1/MULT PERFORAT W/O COLOSTOMY,7264.0,4721.6,1.1,7264.0,144
CDM,44605OH,SUTR LG INTESTINE 1/MULT PERFORAT W/COLOSTOMY,8832.0,5740.8,1.1,8832.0,144
CDM,44615OH,INTSTINAL STRICTUROPLASTY W/WO DILAT OBSTRCJ,7264.0,4721.6,1.1,7264.0,144
CDM,44620OH,CLOSURE ENTEROSTOMY LG/SMALL INTESTINE,6349.0,4126.85,1.1,6349.0,144
CDM,44625OH,CLSR NTRSTM LG/SM RESCJ & ANAST OTH/THN CLRCT,6912.0,4492.8,1.1,6912.0,144
CDM,44626OH,CLSR NTRSTM LG/SM RESCJ & COLORECTAL ANASTOMOSIS,11160.0,7254.0,1.1,11160.0,144
CDM,44640OH,CLOSURE INTESTINAL CUTANEOUS FISTULA,9680.0,6292.0,1.1,9680.0,144
CDM,44650OH,CLSR ENTEROENTERIC/ENTEROCOLIC FSTL,10048.0,6531.2,1.1,10048.0,144
CDM,44660OH,CLSR ENTEROVES FSTL W/O INTSTINAL/BLADDER RESCJ,9564.0,6216.6,1.1,9564.0,144
CDM,44661OH,CLSR ENTEROVES FSTL W/INTESTINE&/BLADDER RESCJ,10940.0,7111.0,1.1,10940.0,144
CDM,44680OH,INTESTINAL PLICATION SEPARATE PROCEDURE,7184.0,4669.6,1.1,7184.0,144
CDM,44700OH,EXCLUSION SM INT FROM PELVIS MESH/PROSTH/TISS,6992.0,4544.8,1.1,6992.0,144
CDM,44701OH,INTRAOPERATIVE COLONIC LAVAGE,1240.0,806.0,1.1,1240.0,144
CDM,44705OH,PREPARE FECAL MICROBIOTA FOR INSTILLATION,568.0,369.2,1.1,568.0,114
CDM,44715OH,BKBENCH PREP CADAVER/LIVING DONOR INTESTINE,2673.0,1737.45,1.1,4462.94,88
CDM,44720OH,BKBENCH RCNSTJ INT ALGRFT VEN ANAST EA,2000.0,1300.0,1.1,2000.0,142
CDM,44721OH,BKBENCH RCNSTJ INT ALGRFT ARTL ANAST EA,2800.0,1820.0,1.1,2800.0,142
CDM,44799RVU13OH,ESD SMALL INTESTINE (COMP 44364),5300.0,3445.0,0.01,5300.0,84
CDM,44799RVU14OH,POUCHOSCOPY W/INJECTION (COMP 44386),482.0,313.3,0.01,2644.7,84
CDM,44799RVU15OH,POUCHOSCOPY WITH DILATION (COMP 44386),624.0,405.6,0.01,2644.7,84
CDM,44799RVU16OH,POUCHOSCOPY W/STRICTUROTOMY/FISTULOTOMY (COMP 44386),705.0,458.25,0.01,2644.7,84
CDM,44799RVU17OH,POUCHOSCOPY W/HOT BIOPSY (COMP 44386),772.0,501.8,0.01,2644.7,84
CDM,44799RVU18OH,POUCHOSCOPY W/SNARE (COMP 44386),772.0,501.8,0.01,2644.7,84
CDM,44799RVU19OH,PANCREAS PRESERVING DUODENECTOMY (COMP 48153),16193.0,10525.45,0.01,16193.0,84
CDM,44799RVU1OH,SMALL BAE WITH DILATION,1069.0,694.85,0.01,2644.7,84
CDM,44799RVU20OH,REPAIR DUODENAL FISTULA (COMP 44650),4409.0,2865.85,0.01,4409.0,84
CDM,44799RVU21OH,POUCHOSCOPY W/STRICTUROTOMY & INJECTION (COMP 44386),705.0,458.25,0.01,2644.7,84
CDM,44799RVU22OH,POUCHOSCOPY W/HOT BIOPSY & INJECTION (COMP 44386),965.0,627.25,0.01,2644.7,84
CDM,44799RVU23OH,POUCHOSCOPY W/ HOT BIOPSY & DILATION (COMP 44386),965.0,627.25,0.01,2644.7,84
CDM,44799RVU24OH,POUCHOSCOPY W/SNARE & INJECTION (COMP 44386),965.0,627.25,0.01,2644.7,84
CDM,44799RVU25OH,POUCHOSCOPY W/SNARE & DILATION (COMP 44386),965.0,627.25,0.01,2644.7,84
CDM,44799RVU26OH,ILEOSCOPY WITH ABLATION VIA STOMA (COMP CODE 44401),1833.0,1191.45,0.01,2644.7,84
CDM,44799RVU27OH,RETROGRADE SMALL INTESTINE ENTEROSCOPY W/BIOPSY (COMP 44377),1818.0,1181.7,0.01,2644.7,84
CDM,44799RVU28OH,RETROGRADE ENTEROSCOPY W/CONTROL OF BLEEDING (COMP 44378),2346.0,1524.9,0.01,2644.7,84
CDM,44799RVU29OH,ENTEROSCOPY W/DILATION (COMP CODE 43249),874.0,568.1,0.01,2644.7,84
CDM,44799RVU2OH,SERIAL TRANSVERSE ENTEROPLASTY (COMP 44603),11986.0,7790.9,0.01,11986.0,84
CDM,44799RVU30OH,ENTEROSCOPY W/SUBMUCOSAL INJECTION (COMP CODE 43236),881.0,572.65,0.01,2644.7,84
CDM,44799RVU31OH,BAE W/ENDOSCOPIC MUCOSAL RESECTION (COMP CODE 43254),1638.0,1064.7,0.01,2644.7,84
CDM,44799RVU32OH,POUCHOSCOPY WITH FOREIGN BODY REMOVAL (COMP 45332),590.0,383.5,0.01,2644.7,84
CDM,44799RVU33OH,"LOWER BAE, RETROGRADE, W/O FLUORO (COMP 45378)",1079.0,701.35,0.01,2644.7,84
CDM,44799RVU34OH,RETROGRADE ENTEROSCOPY SUBMUCOSAL INJECTION (COMP 45381),1189.0,772.85,0.01,2644.7,84
CDM,44799RVU35OH,ENDOSCOPIC SUBMUCOSAL DISSECTION OF SMALL INSTESTINE - (COMP COD,9941.0,6461.65,0.01,9941.0,84
CDM,44799RVU36OH,CORRECTION OF GUT MALROTATION (EG. KAREEM'S PROCEDURE) - (COMP C,11020.0,7163.0,0.01,11020.0,84
CDM,44799RVU37OH,LAPAROSCOPIC OVERSEW OF SMALL BOWEL ANASTOMOSIS (COMP 44620),6204.0,4032.6,1.1,6204.0,144
CDM,44799RVU38OH,ILEOSCOPY W/ CONTROL OF BLEEDING THROUGH THE STOMA (COMP 44378),3018.0,1961.7,0.01,3018.0,84
CDM,44799RVU39OH,"ENDOVAC, SMALL INT; ENTEROSCOPY (COMP 44360, 97605)",1134.0,737.1,0.01,2644.7,84
CDM,44799RVU3OH,NON-CONG SM BOWEL TAPERING PROC,6610.0,4296.5,0.01,6610.0,84
CDM,44799RVU40OH,"ENDOVAC, SMALL INT; ENTEROSCOPY W/ILEUM (COMP 44376, 97605)",2092.0,1359.8,0.01,2644.7,84
CDM,44799RVU41OH,"ENDOVAC, SMALL INT; EGD (COMP 43235, 97605)",990.0,643.5,0.01,2644.7,84
CDM,44799RVU42OH,"ENDOVAC, SMALL INT; POUCHOSCOPY (COMP 44385, 97605)",2203.0,1431.95,0.01,2644.7,84
CDM,44799RVU43OH,POUCHOSCOPY W/ STENT PLACEMENT (COMP 44402),1693.0,1100.45,0.01,2644.7,84
CDM,44799RVU44OH,EGD THROUGH ARTIFICIAL STOMA (COMP 44369),1588.0,1032.2,0.01,2644.7,84
CDM,44799RVU45OH,SMALL INTESTINE MYRIAD COLLAGEN MATRIX IMPLANT (COMP 15777),1315.0,854.75,0.01,2644.7,84
CDM,44799RVU46OH,RETROGRADE ENTEROSCOPY W/DILATION (COMP 45386),1659.0,1078.35,0.01,2644.7,84
CDM,44799RVU47OH,EGD W/ CLIPPING OF INTESTINAL FISTULA (COMP 43255),1566.0,1017.9,0.01,2644.7,84
CDM,44799RVU48OH,POUCHOSCOPY W/DECOMPRESSION (COMP 45393),2059.0,1338.35,0.01,2644.7,84
CDM,44799RVU49OH,REVISION OF JEJUNOSTOMY (COMP 44314),6696.0,4352.4,0.01,6696.0,84
CDM,44799RVU4OH,REVISION OF ANASTOMOSIS (COMP 44125),8624.0,5605.6,0.01,8624.0,84
CDM,44799RVU5OH,REVISION JEJUNOJEJUNOSTOMY,5769.0,3749.85,0.01,5769.0,84
CDM,44799RVU6OH,"UNLIST PROC, SMALL INTESTINE COMPARED TO 44110",4633.0,3011.45,0.01,4633.0,84
CDM,44799RVU8OH,"UNLISTED PROCEDURE, SMALL INTESTINE COMPARED TO 44394",1373.0,892.45,0.01,2644.7,84
CDM,44799RVU9OH,"UNLISTED PROCEDURE, SMALL INTESTINE COMPARED TO 43236",881.0,572.65,0.01,2644.7,84
CDM,44799RVUOH,SMALL BOWEL BAE W/ SUBMUCO INJECTION,1300.0,845.0,0.01,2644.7,84
CDM,44800OH,EXC MECKEL'S DIVERTICULUM/OMPHALOMESENTERIC DUCT,4820.0,3133.0,1.1,4820.0,144
CDM,44820OH,EXCISION LESION MESENTERY SEPARATE PROCEDURE,5492.0,3569.8,1.1,5492.0,144
CDM,44850OH,SUTURE MESENTERY SEPARATE PROCEDURE,4844.0,3148.6,1.1,4844.0,144
CDM,44899RVUOH,"UNLISTED PROCEDURE, MECKEL'S DIVERTICULUM AND THE MESENTERY (COM",4943.0,3212.95,0.01,3061000.0,84
CDM,44900OH,INCISION AND DRAINAGE APPENDICEAL ABSCESS OPEN,5028.0,3268.2,1.1,5028.0,144
CDM,44950OH,APPENDECTOMY,4240.0,2756.0,1.1,22063.69,144
CDM,44955OH,APPENDEC INDICATED PURPOSE OTH MAJOR PX NOT SPX,612.0,397.8,1.1,612.0,144
CDM,44960OH,APPENDEC RPTD APPENDIX ABSC/PRITONITIS,5800.0,3770.0,1.1,5800.0,144
CDM,44970OH,LAPAROSCOPIC APPENDECTOMY,3780.0,2457.0,1.1,16829.38,144
CDM,44979AGRVUOH,"UNLISTED LAPAROSCOPY PROCEDURE, APPENDIX",519.0,337.35,0.01,16829.38,84
CDM,44979NORVUOH,"UNLISTED LAPAROSCOPY PROCEDURE, APP",519.0,337.35,0.01,16829.38,84
CDM,44979OH,UNLISTED LAPAROSCOPY PROCEDURE APPENDIX,571.0,371.15,0.01,16829.38,84
CDM,44979RVU1OH,UNLISTED PROC; LAP DRAINAGE OF APPENDICEAL ABSCESS W/DEBRIDEMENT,4526.0,2941.9,0.01,16829.38,84
CDM,44979RVU2OH,LAPAROSCOPIC APPENDICOLOSTOMY (COMP 44188),6386.0,4150.9,0.01,16829.38,84
CDM,44979RVU3OH,OPEN APPENDICOSTOMY (COMP 44188),6386.0,4150.9,0.01,16829.38,84
CDM,44979RVUOH,LAP APPENDECTOMY AT TIME OTHER SURGERY (COMP CODE 44955),519.0,337.35,0.01,16829.38,84
CDM,44999OH,DUMMY PROC NAME,1280.0,832.0,1.1,1280.0,70
CDM,45000000,FINE NEEDLE ASPIRATION BX W/O IMG GDN 1ST LESION,1838.0,1194.7,61.22,3443.0,86
CDM,45000005,INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE,596.0,387.4,127.84,3443.0,86
CDM,45000010,INCISION & DRAINAGE ABSCESS COMPLICATED/MULTIPLE,1199.0,779.35,168.79,4392.0,87
CDM,45000015,INCISION & DRAINAGE PILONIDAL CYST SIMPLE,2111.0,1372.15,130.31,3443.0,86
CDM,45000020,TEMPORARY TRANSCUTANEOUS PACING,3763.0,2445.95,1.48,3763.0,86
CDM,45000025,INCISION & DRAINAGE PILONIDAL CYST COMPLICATED,2111.0,1372.15,206.85,4392.0,87
CDM,45000030,CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL,3763.0,2445.95,126.78,3763.0,86
CDM,45000035,INCISION & REMOVAL FOREIGN BODY SUBQ TISS SIMPLE,1199.0,779.35,129.95,3443.0,86
CDM,45000040,CARDIOVERSION ELECTIVE ARRHYTHMIA INTERNAL SPX,3763.0,2445.95,274.07,3763.0,86
CDM,45000055,I&D HEMATOMA SEROMA/FLUID COLLECTION,4861.0,3159.65,143.22,4861.0,87
CDM,45000060,ANOGENITAL XM MAGNIFY CHILD/SUSPECT TRAUMA W IMG,1157.0,752.05,68.73,1157.0,86
CDM,45000065,PUNCTURE ASPIRATION ABSCESS HEMATOMA BULLA/CYST,1199.0,779.35,113.6,3443.0,86
CDM,45000070,IPECAC/SIMILAR ADMN EMESIS&OBS STOMACH EMPTIED,184.0,119.6,33.56,184.0,68
CDM,45000075,INCISION & DRAINAGE COMPLEX PO WOUND INFECTION,8586.0,5580.9,213.37,8586.0,87
CDM,45000080,EMERGENCY DEPARTMENT VISIT MAY NOT REQ PHYS/QHP,608.0,395.2,14.86,1962.0,87
CDM,45000090,EMERGENCY DEPARTMENT VISIT STRAIGHTFORWARD MDM,1093.0,710.45,54.67,1962.0,87
CDM,45000100,EMERGENCY DEPARTMENT VISIT LOW MDM,1911.0,1242.15,68.73,3196.0,87
CDM,45000110,EMERGENCY DEPARTMENT VISIT MODERATE MDM,2938.0,1909.7,68.73,3196.0,87
CDM,45000115,DEBRIDEMENT SUBCUTANEOUS TISSUE 20 SQ CM/<,1199.0,779.35,71.41,5265.0,87
CDM,45000120,EMERGENCY DEPARTMENT VISIT HIGH MDM,4230.0,2749.5,68.73,3807.0,87
CDM,45000130,CRITICAL CARE ILL/INJURED PATIENT INIT 30-74 MIN,5814.0,3779.1,68.73,5232.6,87
CDM,45000135,DEBRIDEMENT BONE MUSCLE &/FASCIA 20 SQ CM/<,4861.0,3159.65,261.27,5265.0,87
CDM,45000140,CRITICAL CARE ILL/INJURED PATIENT ADDL 30 MIN,2487.0,1616.55,68.73,3005.0,69
CDM,45000145,PARING/CUTTING BENIGN HYPERKERATOTIC LESION 1,596.0,387.4,19.01,3443.0,86
CDM,45000150,VAGINAL DELIVERY ONLY,12718.0,8266.7,931.5,12718.0,86
CDM,45000185,REMOVAL SKN TAGS MLT FIBRQ TAGS ANY AREA UPW/15,596.0,387.4,88.41,3443.0,86
CDM,45000215,TRIMMING NONDYSTROPHIC NAILS ANY NUMBER,178.0,115.7,9.41,2453.0,86
CDM,45000235,AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE 1,596.0,387.4,47.68,3443.0,86
CDM,45000245,AVULSION NAIL PLATE PARTIAL/COMP SIMPLE EA ADDL,536.0,348.4,20.87,3443.0,68
CDM,45000255,EVACUATION SUBUNGUAL HEMATOMA,387.0,251.55,40.37,3443.0,86
CDM,45000260,BLEPHAROTOMY DRAINAGE ABSCESS EYELID,1375.0,893.75,129.34,3443.0,86
CDM,45000265,EXCISION NAIL MATRIX PERMANENT REMOVAL,1199.0,779.35,120.28,3443.0,86
CDM,45000275,REPAIR NAIL BED,1836.0,1193.4,47.68,3443.0,86
CDM,45000280,REMOVAL FB EYE CONJUNCTIVAL SUPERFICIAL,593.0,385.45,32.6,2453.0,86
CDM,45000285,WEDGE EXCISION SKIN NAIL FOLD,1199.0,779.35,47.68,3443.0,86
CDM,45000295,SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.5CM/<,596.0,387.4,55.78,3443.0,86
CDM,45000305,SMPL REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.6-7.5CM,596.0,387.4,73.19,2453.0,86
CDM,45000315,SMPL RPR SCALP/NECK/AX/GENIT/TRUNK 12.6-20.0CM,1199.0,779.35,116.2,5265.0,87
CDM,45000345,SIMPLE REPAIR F/E/E/N/L/M 2.5CM/<,596.0,387.4,69.14,2453.0,86
CDM,45000355,SIMPLE REPAIR F/E/E/N/L/M 2.6CM-5.0 CM,596.0,387.4,72.06,2453.0,86
CDM,45000365,SIMPLE REPAIR F/E/E/N/L/M 5.1CM-7.5 CM,596.0,387.4,92.88,4392.0,87
CDM,45000375,SIMPLE REPAIR F/E/E/N/L/M 7.6CM-12.5 CM,596.0,387.4,116.53,4392.0,87
CDM,45000395,TX SUPERFICIAL WOUND DEHISCENCE SIMPLE CLOSURE,1836.0,1193.4,220.7,4392.0,87
CDM,45000415,REPAIR INTERMEDIATE S/A/T/E 2.5 CM/<,1199.0,779.35,166.32,3443.0,86
CDM,45000425,REPAIR INTERMEDIATE S/A/T/E 2.6-7.5 CM,1199.0,779.35,207.0,4392.0,87
CDM,45000435,REPAIR INTERMEDIATE S/A/T/E 7.6-12.5 CM,1199.0,779.35,227.17,5265.0,87
CDM,45000445,REPAIR INTERMEDIATE S/A/T/E 12.6-20.0CM,1199.0,779.35,239.13,5265.0,87
CDM,45000465,REPAIR INTERMEDIATE N/H/F/XTRNL GENT 2.5CM/<,1199.0,779.35,163.16,3443.0,86
CDM,45000475,REPAIR INTERMEDIATE N/H/F/XTRNL GENT 2.6-7.5 CM,1199.0,779.35,213.65,4392.0,87
CDM,45000485,REPAIR INTERMEDIATE N/H/F/XTRNL GENT 7.6-12.5CM,1836.0,1193.4,239.13,5265.0,87
CDM,45000495,REPAIR INTERMEDIATE F/E/E/N/L&/MUC 2.5 CM/<,1199.0,779.35,187.01,3443.0,86
CDM,45000505,REPAIR INTERMEDIATE F/E/E/N/L&/MUC 2.6-5.0 CM,1199.0,779.35,218.75,4392.0,87
CDM,45000510,INSJ NON-NDWELLG BLADDER CATHETER,593.0,385.45,29.4,3443.0,86
CDM,45000515,REPAIR INTERMEDIATE F/E/E/N/L&/MUC 5.1-7.5 CM,1199.0,779.35,237.4,4392.0,87
CDM,45000520,INSJ TEMP NDWELLG BLADDER CATHETER SIMPLE,593.0,385.45,30.11,3443.0,86
CDM,45000525,REPAIR INTERMEDIATE F/E/E/N/L&/MUC 7.6-12.5 CM,1199.0,779.35,239.13,5265.0,87
CDM,45000540,MEAS POST-VOIDING RESIDUAL URINE&/BLADDER CAP,273.0,177.45,15.69,273.0,86
CDM,45000585,REPAIR COMPLEX F/C/C/M/N/AX/G/H/F 1.1-2.5 CM,1199.0,779.35,262.85,5265.0,87
CDM,45000595,REPAIR COMPLEX F/C/C/M/N/AX/G/H/F 2.6-7.5 CM,1836.0,1193.4,326.45,7813.0,87
CDM,45000625,REPAIR COMPLEX EYELID/NOSE/EAR/LIP 1.1-2.5 CM,1836.0,1193.4,301.17,7813.0,87
CDM,45000635,REPAIR COMPLEX EYELID/NOSE/EAR/LIP 2.6-7.5 CM,1836.0,1193.4,361.9,7813.0,87
CDM,45000655,INITIAL TX 1ST DEGREE BURN LOCAL TX,596.0,387.4,54.89,2453.0,86
CDM,45000665,DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ SMALL,596.0,387.4,67.22,3443.0,86
CDM,45000675,DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ MEDIUM,596.0,387.4,128.56,5265.0,87
CDM,45000685,DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ LARGE,1199.0,779.35,153.02,5265.0,87
CDM,45000695,CHEMICAL CAUTERIZATION OF GRANULATION TISSUE,596.0,387.4,43.62,3443.0,86
CDM,45000705,MASTOTOMY W/EXPLORATION/DRAINAGE ABSCESS DEEP,4861.0,3159.65,378.79,5265.0,87
CDM,45000725,INJECTION SINGLE/MLT TRIGGER POINT 1/2 MUSCLES,1358.0,882.7,46.16,3443.0,86
CDM,45000735,ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US,1358.0,882.7,41.36,3443.0,86
CDM,45000745,ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US,1358.0,882.7,42.37,3443.0,86
CDM,45000755,ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US,1358.0,882.7,51.29,3443.0,86
CDM,45000800,DRAINAGE EXTERNAL EAR ABSCESS/HEMATOMA SIMPLE,2814.0,1829.1,107.64,3443.0,86
CDM,45000805,APPL INTERDENTAL FIXATION DEVICE NON-FX/DISLC,6814.0,4429.1,886.67,6814.0,87
CDM,45000845,CLOSED TX TEMPOROMANDIBULAR DISLOCATION 1ST/SBSQ,1103.0,716.95,38.71,4392.0,87
CDM,45000855,INTERDENTAL WIRING OTHER THAN FRACTURE,6814.0,4429.1,744.87,6814.0,87
CDM,45000885,CLTX PROX HUMRL FX W/MANJ W/WO SKELETAL TRACJ,7362.0,4785.3,295.11,7362.0,87
CDM,45000905,CLSD TX SHOULDER DISLC W/MANIPULATION W/O ANES,1103.0,716.95,204.59,4392.0,87
CDM,45000915,CLTX SHOULDER DISLC W/FX HUMERAL TUBRST W/MANJ,7362.0,4785.3,295.11,7362.0,87
CDM,45000935,INCISION&DRAINAGE UPPER ARM/ELBOW BURSA,7453.0,4844.45,198.34,7453.0,87
CDM,45000945,CLTX HUMERAL SHFT FX W/MANJ W/WO SKELETAL TRACJ,7362.0,4785.3,295.11,7362.0,87
CDM,45000965,TREATMENT CLOSED ELBOW DISLOCATION W/O ANES,1103.0,716.95,204.59,4392.0,87
CDM,45000975,CLOSED TX MONTEGGIA FX DISLOCATION ELBOW W/MANJ,7362.0,4785.3,295.11,7362.0,87
CDM,45000985,CLTX RDL HEAD SUBLXTJ CHLD NURSEMAID ELBW W/MANJ,1103.0,716.95,92.65,2453.0,86
CDM,45000995,CLOSED TX RADIAL HEAD/NECK FX W/MANIPULATION,7362.0,4785.3,295.11,7362.0,87
CDM,45000OH,TRANSRECTAL DRAINAGE OF PELVIC ABSCESS,2520.0,1638.0,1.1,3440.56,144
CDM,45001040,APPLICATION SHORT LEG SPLINT CALF FOOT,726.0,471.9,56.47,2453.0,86
CDM,45001050,INTUBATION ENDOTRACHEAL EMERGENCY PROCEDURE,1068.0,694.2,175.91,3443.0,86
CDM,45001065,CLOSED TX RADIAL&ULNAR SHAFT FRACTURES W/MANJ,7362.0,4785.3,295.11,7362.0,87
CDM,45001085,CLTX DSTL RDL FX/EPIPHYSL SEP W/MANJ WHEN PERF,7362.0,4785.3,295.11,7813.0,87
CDM,45001095,CLOSED TREATMENT ULNAR STYLOID FRACTURE,1103.0,716.95,204.59,2453.0,86
CDM,45001220,APPLICATION SHORT ARM SPLINT FOREARM-HAND STATIC,593.0,385.45,49.26,2453.0,86
CDM,45001230,APPLICATION FINGER SPLINT STATIC,593.0,385.45,33.14,2453.0,86
CDM,45001340,APPLICATION LONG LEG SPLINT THIGH ANKLE/TOES,726.0,471.9,56.47,2453.0,86
CDM,45001410,I&D ISCHIORECTAL&/PERIRECTAL ABSCESS SPX,5424.0,3525.6,513.72,7813.0,87
CDM,45001640,COLLECTION CAPILLARY BLOOD SPECIMEN,48.0,31.2,2.64,48.0,66
CDM,45001660,COLLECT BLOOD FROM IMPLANT VENOUS ACCESS DEVICE,741.0,481.65,35.72,741.0,86
CDM,45001700,INSJ TUNNELED CVC W/O SUBQ PORT/PMP AGE 5 YR/>,18098.0,11763.7,301.68,18098.0,87
CDM,45001720,DRG ABSC CST HMTMA FROM DENTOALVEOLAR STRUXS,593.0,385.45,107.64,4392.0,87
CDM,45001740,COLLECTION VENOUS BLOOD VENIPUNCTURE,63.0,40.95,2.64,63.0,83
CDM,45001905,INTRAORAL I&D TONGUE/FLOOR SUBMNDBLR SPACE,14918.0,9696.7,301.29,14918.0,87
CDM,45001915,CLOSED TX RADIAL SHAFT FRACTURE W/MANIPULATION,7362.0,4785.3,295.11,7362.0,87
CDM,45001925,TX TARSAL BONE FX XCP TALUS&CALCN W/MANJ,7362.0,4785.3,276.94,7362.0,87
CDM,45001935,EXPLORATION PENETRATING WOUND SPX EXTREMITY,7453.0,4844.45,239.13,7453.0,86
CDM,45001945,CLOSED TX PALATAL/MAXILLARY FX W/FIXATION/SPLINT,14918.0,9696.7,655.7,14918.0,87
CDM,45001955,REMOVAL FOREIGN BODY FOOT DEEP,7453.0,4844.45,372.49,7453.0,87
CDM,45001965,RPR/ADVMNT FLXR TDN N/Z/2 W/O FR GRAFT EA TENDON,14925.0,9701.25,962.29,14925.0,87
CDM,45001975,RMVL FOREIGN BODY UPPER ARM/ELBOW SUBCUTANEOUS,7453.0,4844.45,172.74,7453.0,86
CDM,45001985,TWIST DRILL HOLE EVAC&/DRG SUBDURAL HEMATOMA,13323.0,8659.95,1146.33,13323.0,68
CDM,45001995,INTRAORAL I&D TONGUE/FLOOR SUBMENTAL SPACE,6814.0,4429.1,258.99,6814.0,87
CDM,45002005,CLOSED TX DISTAL RADIOULNAR DISLOCATION W/MANJ,1103.0,716.95,204.59,4392.0,87
CDM,45002015,DRAINAGE FINGER ABSCESS SIMPLE,914.0,594.1,168.79,2453.0,86
CDM,45002025,DRAINAGE FINGER ABSCESS COMPLICATED,7453.0,4844.45,225.79,7453.0,87
CDM,45002045,REPAIR EXTENSOR TENDON HAND W/O GRAFT EACH,7362.0,4785.3,781.67,7813.0,87
CDM,45002065,CLTX METACARPAL FX W/MANIPULATION EACH BONE,1103.0,716.95,204.59,5265.0,87
CDM,45002075,CLTX CARPO/METACARPAL FX DISLC THUMB W/MANJ,7362.0,4785.3,295.11,7362.0,87
CDM,45002085,CLTX CARPO/METACARPL DISLC THMB MANJ EA W/O ANES,1103.0,716.95,204.59,4392.0,87
CDM,45002095,CLTX METACARPOPHALANGEAL DISLC W/MANJ W/O ANES,1103.0,716.95,204.59,4392.0,87
CDM,45002330,SMPL RPR SCALP/NECK/AX/GENIT/TRUNK 20.1-30.0CM,1199.0,779.35,141.42,5265.0,87
CDM,45002700,CLTX FX PHLX/PHLG OTH/THN GRT TOE W/MANJ,1103.0,716.95,186.73,4392.0,87
CDM,45002860,INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE,596.0,387.4,127.84,3443.0,86
CDM,45002950,CLSD TX SHOULDER DISLC W/MANIPULATION REQ ANES,7362.0,4785.3,512.04,7362.0,87
CDM,45003005,CLTX PHLNGL FX PROX/MIDDLE PX/F/T W/MANJ EA,1103.0,716.95,204.59,7813.0,87
CDM,45003015,CLTX ARTCLR FX INVG MTCARPHLNGL/IPHAL JT W/MANJ,7362.0,4785.3,295.11,7362.0,87
CDM,45003025,CLTX DSTL PHLNGL FX FNGR/THMB W/MANJ EA,1103.0,716.95,204.59,4392.0,87
CDM,45003055,CLTX IPHAL JT DISLC W/MANJ W/O ANES,1103.0,716.95,204.59,4392.0,87
CDM,45003075,AMP F/TH 1/2 JT/PHALANX W/NEURECT W/DIR CLSR,14925.0,9701.25,904.91,14925.0,87
CDM,45003090,CLOSED TX RADIAL HEAD/NECK FX W/O MANIPULATION,1103.0,716.95,204.59,3443.0,86
CDM,45003140,CLTX HUMERAL EPICONDYLAR FX MEDIAL/LAT W/O MANJ,1103.0,716.95,204.59,4392.0,87
CDM,45003660,CLOSED TX RADIAL&ULNAR SHAFT FRACTURES W/MANJ,7362.0,4785.3,295.11,7362.0,87
CDM,45003690,CLTX CARPAL BONE FX W/O MANJ EACH BONE,1103.0,716.95,204.59,3443.0,86
CDM,45004005,CLTX HIP DISLOCATION TRAUMATIC W/O ANESTHESIA,1103.0,716.95,204.59,4392.0,87
CDM,45004015,CLTX POST HIP ARTHRP DISLC W/O ANES,1103.0,716.95,204.59,4392.0,87
CDM,45004035,CLTX FEM SHFT FX W/MANJ W/WO SKIN/SKELETAL TRACJ,7362.0,4785.3,295.11,7362.0,87
CDM,45004055,CLTX FEM FX DSTL END MEDIAL/LAT CONDYLE W/MANJ,7362.0,4785.3,295.11,7362.0,87
CDM,45004075,CLOSED TX KNEE DISLOCATION W/O ANESTHESIA,1103.0,716.95,204.59,4392.0,87
CDM,45004085,CLOSED TX PATELLAR DISLOCATION W/O ANESTHESIA,1103.0,716.95,204.59,4392.0,87
CDM,45004095,CLTX TIBIAL SHAFT FX W/MANJ W/WO SKEL TRACJ,7362.0,4785.3,295.11,7362.0,87
CDM,45004105,CLTX MEDIAL MALLS FX W/MANJ W/WO SKN/SKEL TRACJ,7362.0,4785.3,295.11,7362.0,87
CDM,45004125,CLTX DSTL FIBULAR FX LAT MALLS W/MANJ,1103.0,716.95,204.59,4392.0,87
CDM,45004225,CLOSED TX BIMALLEOLAR ANKLE FRACTURE W/MANJ,7362.0,4785.3,295.11,7362.0,87
CDM,45004335,CLTX TRIMALLEOLAR ANKLE FX W/MANIPULATION,7362.0,4785.3,295.11,7362.0,87
CDM,45004355,CLOSED TX ANKLE DISLOCATION W/O ANESTHESIA,1103.0,716.95,204.59,4392.0,87
CDM,45004365,REMOVAL FOREIGN BODY FOOT SUBCUTANEOUS,3237.0,2104.05,160.76,4392.0,87
CDM,45004385,CLOSED TX TALUS FRACTURE W/MANIPULATION,7362.0,4785.3,295.11,7362.0,87
CDM,45004415,CLTX METAR FX W/MANJ,1103.0,716.95,204.59,4392.0,87
CDM,45004435,CLTX FX PHLX/PHLG OTH/THN GRT TOE W/MANJ,1103.0,716.95,186.73,4392.0,87
CDM,45004445,CLTX METATARSOPHLNGL JT DISLC W/O ANES,1103.0,716.95,137.97,4392.0,87
CDM,45004455,CLTX INTERPHALANGEAL JOINT DISLOCATION W/O ANES,1103.0,716.95,115.66,4392.0,87
CDM,45004485,APPLICATION CAST HAND & LOWER FOREARM GAUNTLET,726.0,471.9,77.24,2453.0,86
CDM,45004495,APPLICATION LONG ARM SPLINT SHOULDER HAND,726.0,471.9,48.61,2453.0,86
CDM,45004505,APPLICATION SHORT ARM SPLINT FOREARM-HAND STATIC,593.0,385.45,49.26,2453.0,86
CDM,45004515,APPLICATION SHORT ARM SPLINT DYNAMIC,593.0,385.45,56.42,2453.0,86
CDM,45004525,APPLICATION FINGER SPLINT STATIC,593.0,385.45,33.14,2453.0,86
CDM,45004545,STRAPPING SHOULDER,593.0,385.45,21.71,2453.0,86
CDM,45004605,APPLICATION SHORT LEG CAST WALKING/AMBULATORY,1222.0,794.3,64.21,2453.0,86
CDM,45004615,APPLICATION LONG LEG SPLINT THIGH ANKLE/TOES,726.0,471.9,56.47,2453.0,86
CDM,45004625,APPLICATION SHORT LEG SPLINT CALF FOOT,726.0,471.9,56.47,2453.0,86
CDM,45004675,REMOVAL/BIVALVING FULL ARM/FULL LEG CAST,1222.0,794.3,51.92,2453.0,86
CDM,45004715,DRAINAGE ABSCESS/HEMATOMA NASAL SEPTUM,2343.0,1522.95,138.54,4392.0,87
CDM,45004725,REMOVAL FOREIGN BODY INTRANASAL OFFICE PROCEDURE,593.0,385.45,107.64,2453.0,86
CDM,45004735,CONTROL NASAL HEMORRHAGE ANTERIOR SIMPLE,593.0,385.45,65.29,3443.0,86
CDM,45004745,CONTROL NASAL HEMORRHAGE ANTERIOR COMPLEX,593.0,385.45,91.33,4392.0,87
CDM,45004755,CTRL NSL HEMRRG PST NASAL PACKS&/CAUTERY 1ST,593.0,385.45,107.64,4392.0,87
CDM,45004765,CTRL NSL HEMRRG PST NASAL PACKS&/CAUTERY SUBSQ,1068.0,694.2,107.64,4392.0,87
CDM,45004775,NASAL ENDOSCOPY DIAGNOSTIC UNI/BI SPX,893.0,580.45,71.14,4392.0,87
CDM,45004805,NASAL/SINUS NDSC SURG W/CONTROL NASAL HEMRRG,7933.0,5156.45,185.77,7933.0,87
CDM,45004815,INTUBATION ENDOTRACHEAL EMERGENCY PROCEDURE,1068.0,694.2,175.91,3443.0,86
CDM,45004825,TRACHEOTOMY TUBE CHANGE PRIOR TO FISTULA TRACT,1068.0,694.2,40.15,3443.0,86
CDM,45004845,LARYNGOSCOPY W/WO TRACHEOSCOPY DX EXCEPT NEWBORN,7933.0,5156.45,177.23,7933.0,87
CDM,45004875,LARYNGOSCOPY FLEXIBLE DIAGNOSTIC,893.0,580.45,76.23,4337.0,86
CDM,45004915,TRACHEOBRNCHSC THRU EST TRACHS INC,2343.0,1522.95,130.21,4392.0,87
CDM,45004925,CATHETER ASPIRATION NASOTRACHEAL SPX,936.0,608.4,61.8,4392.0,87
CDM,45004955,TUBE THORACOSTOMY INCLUDES WATER SEAL,7146.0,4644.9,185.81,7146.0,87
CDM,45004965,THORACENTESIS NEEDLE/CATH PLEURA W/O IMAGING,2844.0,1848.6,106.42,4392.0,87
CDM,45004975,THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING,2844.0,1848.6,128.29,4392.0,87
CDM,45005015,REPAIR BLOOD VESSEL DIRECT HAND FINGER,18098.0,11763.7,847.46,18098.0,87
CDM,45005045,INTRODUCTION NEEDLE/INTRACATHETER VEIN,246.0,159.9,35.72,246.0,66
CDM,45005055,VNPNXR 3 YEARS/> PHYS/QHP SKILL,222.0,144.3,10.81,222.0,68
CDM,45005075,INSJ NON-TUNNELED CENTRAL VENOUS CATH AGE 5 YR/>,18098.0,11763.7,103.42,18098.0,87
CDM,45005085,INSERTION PICC W/O IMG GDN 5 YR/>,8932.0,5805.8,112.99,8932.0,87
CDM,45005145,COLLECT BLOOD FROM IMPLANT VENOUS ACCESS DEVICE,741.0,481.65,35.72,741.0,86
CDM,45005185,COLLECT BLOOD FROM CATHETER VENOUS NOS,741.0,481.65,35.72,741.0,86
CDM,45005195,DECLOT BY THROMBOLYTIC AGENT IMPLANT DEVICE/CATH,1907.0,1239.55,48.29,4392.0,87
CDM,45005205,ARTERIAL PUNCTURE WITHDRAWAL BLOOD DX,741.0,481.65,18.03,2453.0,86
CDM,45005225,ARTL CATHJ/CANNULJ MNTR/TRANSFUSION SPX PRQ,1489.0,967.85,56.26,3443.0,68
CDM,45005235,PLACEMENT NEEDLE INTRAOSSEOUS INFUSION,2294.0,1491.1,74.59,3443.0,86
CDM,45005255,THROMBOLYSIS CEREBRAL IV INFUSION,1907.0,1239.55,277.57,2453.0,84
CDM,45005295,RPR LIP FULL THICKNESS VERMILION ONLY,2343.0,1522.95,107.64,7813.0,87
CDM,45005305,RPR LIP FULL THICKNESS HALF/< VERTICAL HEIGHT,2343.0,1522.95,107.64,7813.0,87
CDM,45005315,RPR LIP FULL THKNS >ONE-HALF VERT HEIGHT/COMPLE,6814.0,4429.1,484.54,7813.0,87
CDM,45005325,DRG ABSC CST HMTMA VESTIBULE MOUTH SMPL,3237.0,2104.05,148.98,4392.0,87
CDM,45005335,DRG ABSC CST HMTMA VESTIBULE MOUTH COMP,2343.0,1522.95,234.41,5265.0,87
CDM,45005365,CLOSURE LACERATION VESTIBULE MOUTH > 2.5 CM/CPL,2343.0,1522.95,240.75,4392.0,87
CDM,45005385,XTRORAL I&D ABSC CST/HMTMA FLOOR MOUTH SUBMENT,27212.0,17687.8,406.82,27212.0,87
CDM,45005395,RPR LAC 2.5 CM/< MOUTH&/ANT TWO-THIRDS TONG,1836.0,1193.4,107.64,5265.0,87
CDM,45005415,DRG ABSC CST HMTMA FROM DENTOALVEOLAR STRUXS,593.0,385.45,107.64,4392.0,87
CDM,45005425,DRAINAGE ABSCESS PALATE UVULA,1068.0,694.2,107.64,5265.0,87
CDM,45005445,I&D ABSCESS PERITONSILLAR,1068.0,694.2,107.64,4392.0,87
CDM,45005465,CONTROL OROPHARYNGEAL HEMORRHAGE SIMPLE,2343.0,1522.95,182.45,4392.0,87
CDM,45005505,EGD FLEXIBLE FOREIGN BODY REMOVAL,4313.0,2803.45,205.04,5265.0,87
CDM,45005575,I&D ISCHIORECTAL&/PERIRECTAL ABSCESS SPX,5424.0,3525.6,513.72,7813.0,87
CDM,45005585,I&D PERIANAL ABSCESS SUPERFICIAL,4194.0,2726.1,123.77,4392.0,87
CDM,45005595,INCISION THROMBOSED HEMORRHOID EXTERNAL,1119.0,727.35,130.98,3443.0,86
CDM,45005645,ABDOM PARACENTESIS DX/THER W/O IMAGING GUIDANCE,4313.0,2803.45,89.92,5265.0,87
CDM,45005655,ABDOM PARACENTESIS DX/THER W/IMAGING GUIDANCE,4313.0,2803.45,123.62,5265.0,87
CDM,45005685,REPLACE DUODENOSTOMY/JEJUNOSTOMY TUBE PERQ,4313.0,2803.45,103.51,5265.0,87
CDM,45005725,ASPIRATION BLADDER INSERT SUPRAPUBIC CATHETER,9423.0,6124.95,166.65,9423.0,87
CDM,45005735,BLDR IRRIGATION SMPL LAVAGE &/INSTLJ,1119.0,727.35,35.12,3443.0,86
CDM,45005745,INSJ NON-NDWELLG BLADDER CATHETER,593.0,385.45,29.4,3443.0,86
CDM,45005755,INSJ TEMP NDWELLG BLADDER CATHETER SIMPLE,593.0,385.45,30.11,3443.0,86
CDM,45005765,INSJ TEMP NDWELLG BLADDER CATHETER COMPLICATED,720.0,468.0,49.68,3443.0,86
CDM,45005775,CHANGE CYSTOSTOMY TUBE SIMPLE,1119.0,727.35,49.68,3443.0,86
CDM,45005785,CYSTOURETHROSCOPY,3070.0,1995.5,93.98,4392.0,87
CDM,45005795,CYSTO W/IRRIG & EVAC MULTPLE OBSTRUCTING CLOTS,15865.0,10312.25,334.61,15865.0,87
CDM,45005805,CYSTO BLADDER W/URETERAL CATHETERIZATION,9423.0,6124.95,155.93,9423.0,87
CDM,45005815,CYSTO CALIBRATION DILAT URTL STRIX/STENOSIS,9423.0,6124.95,178.25,9423.0,87
CDM,45005855,IRRIGATION CORPORA CAVERNOSA PRIAPISM,1119.0,727.35,49.68,4392.0,87
CDM,45005865,NJX C/P/A CAVERNOSA W/PHARMACOLOGIC AGT,1119.0,727.35,49.68,2453.0,86
CDM,45005895,FORESKN MANJ W/LSS PREPUTIAL ADS&STRETCHING,1119.0,727.35,66.98,4392.0,87
CDM,45005995,DRAINAGE SCROTAL WALL ABSCESS,7453.0,4844.45,202.86,7453.0,87
CDM,45005OH,I&D SUBMUCOSAL ABSCESS RECTUM,808.0,525.2,1.1,3440.56,148
CDM,45006005,I&D VULVA/PERINEAL ABSCESS,1399.0,909.35,68.6,4392.0,87
CDM,45006015,I&D OF BARTHOLINS GLAND ABSCESS,925.0,601.25,68.6,4392.0,87
CDM,45006045,INTRO ANY HEMOSTATIC AGENT/PACK VAG HEMRRG SPX,925.0,601.25,132.3,4392.0,87
CDM,45006055,COLPORRHAPHY SUTURE INJURY VAGINA,14626.0,9506.9,373.3,14626.0,87
CDM,45006065,BIOPSY CERVIX SINGLE/MULT/EXCISION OF LESION SPX,4005.0,2603.25,86.32,4392.0,87
CDM,45006085,ENDOMETRIAL BX W/WO ENDOCERVIX BX W/O DILAT SPX,925.0,601.25,72.23,3443.0,86
CDM,45006095,REMOVAL INTRAUTERINE DEVICE IUD,1399.0,909.35,68.6,3443.0,86
CDM,45006105,VAGINAL DELIVERY ONLY,12718.0,8266.7,931.5,12718.0,86
CDM,45006135,PUNCTURE SHUNT TUBE/RESERVOIR ASPIRATION/INJ PX,4778.0,3105.7,64.85,4778.0,87
CDM,45006145,TWIST DRILL HOLE IMPLT VENTRICULAR CATH/DEVICE,8667.0,5633.55,394.09,8667.0,68
CDM,45006165,RPLCMT/REVJ CSF SHUNT VALVE/CATH SHUNT SYS,44188.0,28722.2,1069.93,44188.0,87
CDM,45006175,REPRGRMG PROGRAMMABLE CEREBROSPINAL SHUNT,2069.0,1344.85,22.84,5265.0,87
CDM,45006185,DIAGNOSTIC LUMBAR SPINAL PUNCTURE,4778.0,3105.7,74.92,4778.0,87
CDM,45006195,THERAPEUTIC SPINAL PUNCTURE DRAINAGE CSF,4778.0,3105.7,109.57,4778.0,87
CDM,45006205,INJECTION EPIDURAL BLOOD/CLOT PATCH,4778.0,3105.7,135.76,4778.0,87
CDM,45006265,INJECTION AA&/STRD TRIGEMINAL NERVE EACH BRANCH,2037.0,1324.05,58.81,4392.0,87
CDM,45006285,INJECTION AA&/STRD GREATER OCCIPITAL NERVE,2037.0,1324.05,58.85,4392.0,87
CDM,45006295,INJECTION AA&/STRD FEM NRV CONT NFS CATH IMG GDN,6143.0,3992.95,93.64,6143.0,87
CDM,45006305,INJECTION AA&/STRD OTHER PERIPHERAL NERVE/BRANCH,4778.0,3105.7,50.31,4778.0,87
CDM,45006315,REMOVAL FB EYE CONJUNCTIVAL SUPERFICIAL,593.0,385.45,32.6,2453.0,86
CDM,45006335,RMVL FB XTRNL EYE CORNEAL W/O SLIT LAMP,1836.0,1193.4,48.64,2453.0,86
CDM,45006345,RMVL FB XTRNL EYE CORNEAL W/SLIT LAMP,593.0,385.45,48.64,2453.0,86
CDM,45006385,BLEPHAROTOMY DRAINAGE ABSCESS EYELID,1375.0,893.75,129.34,3443.0,86
CDM,45006395,CANTHOTOMY SEPARATE PROCEDURE,10732.0,6975.8,128.18,10732.0,87
CDM,45006415,SUTR WND EYELID/MARGIN/TARSUS/CONJUNC FULL THICK,10732.0,6975.8,472.66,10732.0,87
CDM,45006425,PROBE LACRIMAL CANALICULI W/WO IRRIGATION,1375.0,893.75,133.95,3443.0,86
CDM,45006435,DRAINAGE EXTERNAL EAR ABSCESS/HEMATOMA SIMPLE,2814.0,1829.1,107.64,3443.0,86
CDM,45006445,DRAINAGE EXTERNAL EAR ABSCESS/HEMATOMA CMPLX,6481.0,4212.65,180.8,6481.0,87
CDM,45006455,DRAINAGE EXTERNAL AUDITORY CANAL ABSCESS,2814.0,1829.1,107.64,3443.0,86
CDM,45006465,REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT,238.0,154.7,36.18,3443.0,86
CDM,45006485,NASOPHARYNGOSCOPY W/ENDOSCOPE SPX,777.0,505.05,42.75,3443.0,86
CDM,45006495,CARDIOPULMONARY RESUSCITATION,1791.0,1164.15,204.28,1791.0,86
CDM,45006525,THERAPEUTIC PROPHYLACTIC/DX INJECTION SUBQ/IM,491.0,319.15,17.51,491.0,87
CDM,45006585,DILAT URETHRAL STRIX DILATOR MALE 1ST,1119.0,727.35,49.68,3443.0,86
CDM,45006595,RMVL FB XTRNL AUDITORY CANAL W/O ANES,516.0,335.4,53.47,2453.0,86
CDM,45006655,SHAVING SKIN LESION 1 S/N/H/F/G DIAM 0.5 CM/<,596.0,387.4,44.99,2453.0,86
CDM,45006665,SHAVING SKIN LESION 1 S/N/H/F/G DIAM 1.1-2.0 CM,596.0,387.4,69.89,2453.0,86
CDM,45006675,EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 1.1-2.0CM,2111.0,1372.15,164.41,4392.0,87
CDM,45006685,SIMPLE RPR SCALP/NECK/AX/GENIT/TRUNK 7.6-12.5CM,596.0,387.4,91.51,4392.0,87
CDM,45006705,CLTX HUMERAL EPICONDYLAR FX MEDIAL/LAT W/MANJ,7362.0,4785.3,295.11,7362.0,87
CDM,45006715,CLOSED TX LUNATE DISLOCATION W/MANIPULATION,7362.0,4785.3,295.11,7362.0,87
CDM,45006725,CLOSED TX TALOTARSAL JOINT DISLC W/O ANES,1103.0,716.95,204.59,4392.0,87
CDM,45006735,LARYNGOSCOPY W/WO TRACHEOSCOPY ASPIRATION,1786.0,1160.9,129.25,4392.0,87
CDM,45006745,RPLCMT CATH CTR VAD SUBQ PORT/PMP,18098.0,11763.7,236.82,18098.0,87
CDM,45006765,I&D EPIDIDYMIS TSTIS&/SCROTAL SPACE,9423.0,6124.95,253.94,9423.0,87
CDM,45006775,INJECTION AA&/STRD BRACHIAL PLEXUS,6143.0,3992.95,89.94,6143.0,87
CDM,45006785,INJECTION AA&/STRD SCIATIC NRV CONT NFS CATH IMG,6143.0,3992.95,97.68,6143.0,87
CDM,45006795,INJECTION AA&/STRD FEMORAL NERVE,4778.0,3105.7,81.71,4778.0,86
CDM,45006835,TYMPANOSTOMY LOCAL/TOPICAL ANESTHESIA,2037.0,1324.05,107.64,7431.0,86
CDM,45006935,TX SUPERFICIAL WOUND DEHISCENCE W/PACKING,1199.0,779.35,164.42,4392.0,87
CDM,45006945,REPAIR COMPLEX SCALP/ARM/LEG 2.6-7.5 CM,1836.0,1193.4,278.55,7813.0,87
CDM,45006955,REMOVAL FOREIGN BODY MUSCLE/TENDON SHEATH SIMPLE,7453.0,4844.45,176.01,7453.0,87
CDM,45006965,CLOSED TX NASAL SEPTAL FRACT W/WO STABILIZATION,14918.0,9696.7,295.11,14918.0,87
CDM,45006975,CLTX MANDIBULAR/MAXILLARY ALVEOLAR RIDGE FX SPX,14918.0,9696.7,809.01,14918.0,86
CDM,45006985,CLTX SCAPULAR FX W/MANJ W/WO SKELETAL TRACTION,7362.0,4785.3,295.11,7362.0,87
CDM,45006995,CLTX SPRCNDYLR/TRANSCNDYLR HUMERAL FX W/MANJ,7362.0,4785.3,295.11,7362.0,87
CDM,45007005,CLOSED TX CARPAL SCAPHOID FRACTURE W/MANJ,7362.0,4785.3,295.11,7362.0,87
CDM,45007015,CLTX TIBIAL FX PROXIMAL W/WO MANJ W/SKEL TRACJ,14925.0,9701.25,295.11,14925.0,87
CDM,45007025,CLTX INTERPHALANGEAL JOINT DISLOCATION REQ ANES,1222.0,794.3,152.34,4392.0,87
CDM,45007035,REMOVAL/BIVALVING GAUNTLET BOOT/BODY CAST,1222.0,794.3,38.61,2453.0,86
CDM,45007045,NASAL/SINUS NDSC SURG W/BX POLYPECT/DBRDMT SPX,7933.0,5156.45,177.82,7933.0,87
CDM,45007055,LARYNGOSCOPY INDIRECT DIAGNOSTIC SPX,893.0,580.45,55.88,2453.0,86
CDM,45007065,LARYNGOSCOPY FLX RMVL FOREIGN BODY(S),1786.0,1160.9,151.89,5265.0,87
CDM,45007075,THORACOTOMY W/CARDIAC MASSAGE,5901.0,3835.65,954.74,13132.0,68
CDM,45007085,RPR BLOOD VESSEL DIRECT LOWER EXTREMITY,4046.0,2629.9,610.39,7966.0,86
CDM,45007095,COMPLETE REPLACEMENT PICC RS&I,8932.0,5805.8,68.84,8932.0,87
CDM,45007105,RMVL TUN CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ,8932.0,5805.8,218.69,8932.0,87
CDM,45007115,THROMBOLYSIS VENOUS INFUSION W/IMAGING INIT TX,18098.0,11763.7,389.45,18098.0,86
CDM,45007125,RMVL EMBEDDED FB VESTIBULE MOUTH SMPL,4313.0,2803.45,143.08,4392.0,87
CDM,45007135,CLOSURE LACERATION VESTIBULE MOUTH 2.5 CM/<,1068.0,694.2,107.64,2453.0,86
CDM,45007145,NASO/ORO-GASTRIC TUBE PLMT REQ PHYS&FLUOR GDNCE,1836.0,1193.4,46.57,4337.0,86
CDM,45007155,GASTRIC INTUBATJ & ASPIRAJ W/PHYS SKILL/LAVAGE,1432.0,930.8,26.72,3443.0,86
CDM,45007165,EXC THROMBOSED HEMORRHOID XTRNL,5424.0,3525.6,133.69,5424.0,87
CDM,45007175,ANOSCOPY DX W/COLLJ SPEC BR/WA SPX WHEN PRFRMD,593.0,385.45,49.87,3443.0,86
CDM,45007185,CHANGE CYSTOSTOMY TUBE COMPLICATED,3070.0,1995.5,94.16,4392.0,87
CDM,45007195,MEAS POST-VOIDING RESIDUAL URINE&/BLADDER CAP,273.0,177.45,15.69,273.0,86
CDM,45007205,CYSTO W/SIMPLE REMOVAL STONE & STENT,9423.0,6124.95,176.99,9423.0,87
CDM,45007215,FIT&INSJ PESSARY/OTH INTRAVAGINAL SUPPORT DEVI,925.0,601.25,53.11,2453.0,86
CDM,45007225,VENTRICULAR PUNCTURE PREVIOUS BURR HOLE W/O NJX,6143.0,3992.95,125.91,6143.0,87
CDM,45007235,REMOVAL EMBEDDED FOREIGN BODY EYELID,1375.0,893.75,127.71,3443.0,86
CDM,45008760,CLTX TIBIAL FX PROXIMAL W/O MANIPULATION,1103.0,716.95,204.59,4392.0,87
CDM,45008770,CLTX TIBIAL SHAFT FX W/O MANIPULATION,1103.0,716.95,204.59,4392.0,87
CDM,45008780,CLOSED TX TALUS FRACTURE W/O MANIPULATION,1103.0,716.95,204.59,4392.0,87
CDM,45008790,CLTX PROX FIBULA/SHFT FX W/O MANJ,1103.0,716.95,204.59,4392.0,87
CDM,45008850,CLTX METACARPAL FX W/MANIPULATION EACH BONE,1103.0,716.95,204.59,5265.0,87
CDM,45008860,CLTX MEDIAL MALLEOLUS FX W/O MANIPULATION,1103.0,716.95,204.59,4392.0,87
CDM,45008870,CLTX FX W8 BRG ARTCLR PRTN DSTL TIBIA W/O MANJ,1103.0,716.95,204.59,4392.0,87
CDM,45008880,CLOSED TX CALCANEAL FRACTURE W/O MANIPULATION,1103.0,716.95,204.59,4392.0,87
CDM,45008950,CLOSED TX BIMALLEOLAR ANKLE FRACTURE W/O MANJ,1103.0,716.95,204.59,4392.0,87
CDM,45009980,AMP F/TH 1/2 JT/PHALANX W/NEURECT W/DIR CLSR,14925.0,9701.25,904.91,14925.0,87
CDM,45010020,CLTX POST HIP ARTHRP DISLC W/O ANES,1103.0,716.95,204.59,4392.0,87
CDM,45010050,CLTX TRIMALLEOLAR ANKLE FX W/MANIPULATION,7362.0,4785.3,295.11,7362.0,87
CDM,45010070,TX TARSAL BONE FX XCP TALUS&CALCN W/O MANJ,1103.0,716.95,204.59,4392.0,87
CDM,45010120,EMERGENCY DEPARTMENT VISIT MODERATE MDM,2938.0,1909.7,68.73,3196.0,87
CDM,45010140,CRITICAL CARE ILL/INJURED PATIENT INIT 30-74 MIN,5814.0,3779.1,68.73,5232.6,87
CDM,45010150,DEBRIDEMENT OPEN WOUND EACH ADDITIONAL 20 SQ CM,746.0,484.9,29.21,3443.0,68
CDM,45010160,DEBRIDEMENT OPEN WOUND 20 SQ CM/<,914.0,594.1,43.12,3443.0,86
CDM,45010180,CLTX POST HIP ARTHRP DISLC REQ ANES,7362.0,4785.3,676.52,7362.0,87
CDM,45010270,OFFICE/OUTPATIENT EST PT MAY NOT REQ PHYS/QHP,150.0,97.5,10.63,150.0,68
CDM,45010280,OPHTHALMIC US DX QUANTITATIVE A-SCAN ONLY,734.0,477.1,72.76,89442.26,87
CDM,45010290,OPHTHALMIC US DX B-SCAN W/WO NON-QUAN A-SCAN,734.0,477.1,60.95,89443.43,87
CDM,45010320,STRAIGHT CATH - SPECIMEN COLLECTION,63.0,40.95,2.64,3443.0,83
CDM,45010325,CLSD TX SHOULDER DISLC W/MANIPULATION REQ ANES,7362.0,4785.3,512.04,7362.0,87
CDM,45010345,CLTX POST HIP ARTHRP DISLC REQ ANES,7362.0,4785.3,676.52,7362.0,87
CDM,45010365,CLTX DSTL FIBULAR FX LAT MALLS W/O MANJ,1103.0,716.95,204.59,4392.0,87
CDM,45010395,DRAINAGE ABSCESS/HEMATOMA NASAL INT APPROACH,1068.0,694.2,107.64,4392.0,87
CDM,45010405,LARYNGOSCOPY FLX/RGD TELESCOPIC W/STROBOSCOPY,1786.0,1160.9,133.1,4392.0,87
CDM,45010415,THORACOTOMY WITH EXPLORATION,2510.0,1631.5,547.18,13132.0,68
CDM,45010425,INJECTION PX PRQ TX EXTREMITY PSEUDOANEURYSM,3555.0,2310.75,120.42,3555.0,86
CDM,45010465,INJECTION AA&/STRD BRACH PLEX CONT NFS CATH IMG,6143.0,3992.95,100.19,6143.0,87
CDM,45010475,RMVL FB XTRNL EYE CORNEAL W/O SLIT LAMP,1836.0,1193.4,48.64,2453.0,86
CDM,45010525,CLSD TX SHOULDER DISLC W/MANIPULATION REQ ANES,7362.0,4785.3,512.04,7362.0,87
CDM,45010535,CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O MANJ,1103.0,716.95,204.59,3443.0,86
CDM,45010545,CLTX POST HIP ARTHRP DISLC REQ ANES,7362.0,4785.3,676.52,7362.0,87
CDM,45010555,CLTX DSTL FIBULAR FX LAT MALLS W/O MANJ,1103.0,716.95,204.59,4392.0,87
CDM,45010565,CLTX FX GRT TOE PHLX/PHLG W/MANJ,1103.0,716.95,193.21,4392.0,87
CDM,45010585,LARYNGOSCOPY FLEXIBLE W/BIOPSY(IES),7933.0,5156.45,132.9,7933.0,87
CDM,45010595,LARYNGOSCOPY FLX/RGD TELESCOPIC W/STROBOSCOPY,1786.0,1160.9,133.1,4392.0,87
CDM,45010615,INJECTION PX PRQ TX EXTREMITY PSEUDOANEURYSM,3555.0,2310.75,120.42,3555.0,86
CDM,45010635,RMVL TUN CVC W/O SUBQ PORT/PMP,3555.0,2310.75,159.64,4392.0,87
CDM,45010645,"UNLISTED PROCEDURE, LIPS",382.0,248.3,106.2,1087.99,84
CDM,45010655,BIOPSY OROPHARYNX,6814.0,4429.1,131.28,6814.0,87
CDM,45010665,REMOVAL FOREIGN BODY PHARYNX,1836.0,1193.4,107.64,3443.0,86
CDM,45010675,ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC,4313.0,2803.45,143.26,4392.0,87
CDM,45010685,EGD TRANSORAL BIOPSY SINGLE/MULTIPLE,4313.0,2803.45,160.83,5265.0,87
CDM,45010695,PERITONEAL LAVAGE W/WO IMAGING GUIDANCE,4313.0,2803.45,122.53,5265.0,87
CDM,45010705,EXCHANGE NEPHROSTOMY CATHETER PRQ W/IMG GID RS&I,9423.0,6124.95,115.84,9423.0,87
CDM,45010715,CYSTO/URETERO W/LITHOTRIPSY &INDWELL STENT INSRT,23385.0,15200.25,484.62,23385.0,87
CDM,45010735,SUTR WND EYELID/MARGIN/TARSUS/CONJUNC PRTL THICK,10732.0,6975.8,255.58,10732.0,87
CDM,45010755,XTRORAL I&D ABSC CST/HMTMA FLOOR MOUTH SUBMNDB,14918.0,9696.7,401.34,14918.0,87
CDM,45010765,LIGATION/BIOPSY TEMPORAL ARTERY,9316.0,6055.4,232.26,9316.0,87
CDM,45010775,INSJ TUNNELED CVC W/O SUBQ PORT/PMP AGE 5 YR/>,18098.0,11763.7,301.68,18098.0,87
CDM,45010785,RPR LIP FULL THICKNESS HALF/< VERTICAL HEIGHT,2343.0,1522.95,107.64,7813.0,87
CDM,45010795,ARTHRT EXPL DRG/RMVL LOOSE/FB IPHAL JT EA,7362.0,4785.3,485.42,10789.0,87
CDM,45010805,INSJ TUNNELED CVC W/O SUBQ PORT/PMP AGE 5 YR/>,18098.0,11763.7,301.68,18098.0,87
CDM,45010815,TX TARSAL BONE FX XCP TALUS&CALCN W/MANJ,7362.0,4785.3,276.94,7362.0,87
CDM,45010825,CLTX IPHAL JT DISLC W/MANJ REQ ANES,1222.0,794.3,232.99,5265.0,87
CDM,45010845,TWIST DRILL HOLE EVAC&/DRG SUBDURAL HEMATOMA,13323.0,8659.95,1146.33,13323.0,68
CDM,45010905,OPEN TX ARTICULAR FRACTURE MCP/IP JOINT EA,14925.0,9701.25,840.79,14925.0,87
CDM,45010915,REMOVAL FOREIGN BODY INTRANASAL GENERAL ANES,14918.0,9696.7,244.33,14918.0,87
CDM,45011005,EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM/<,2111.0,1372.15,97.21,3443.0,86
CDM,45011085,EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M 0.5CM/<,2111.0,1372.15,126.48,4337.0,86
CDM,45011165,CLTX CARPO/METACARPAL DISLOCATION THUMB W/MANJ,1103.0,716.95,204.59,4392.0,87
CDM,45011175,CLTX TARSAL DISLC OTH/THN TALOTARSAL W/O ANES,1103.0,716.95,204.59,4392.0,87
CDM,45011185,REPAIR BLOOD VESSEL DIRECT UPPER EXTREMITY,18098.0,11763.7,913.47,18098.0,86
CDM,45011205,TRANSFUSION BLOOD/BLOOD COMPONENTS,2514.0,1634.1,58.82,4392.0,87
CDM,45011295,CYSTOSTOMY CYSTOTOMY W/DRAINAGE,9423.0,6124.95,344.65,10789.0,87
CDM,45011305,DRG OF SKENE'S GLAND ABSCESS OR CYST,9423.0,6124.95,188.85,9423.0,86
CDM,45011315,TX INCOMPLETE ABORTION ANY TRIMESTER SURGICAL,12718.0,8266.7,353.19,13821.0,87
CDM,45011325,INJECTION AA&/STRD INTERCOSTAL NRV EA ADDL LVL,6143.0,3992.95,29.38,6143.0,87
CDM,45011345,REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT,238.0,154.7,22.27,3443.0,86
CDM,45011355,US ABDOMINAL REAL TIME W/IMAGE LIMITED,734.0,477.1,95.38,89669.04,87
CDM,45011365,US PELVIC NONOBSTETRIC IMAGE DCMTN LIMITED/F/U,734.0,477.1,63.2,89846.73,87
CDM,45011535,INCISION & DRAINAGE ABSCESS COMPLICATED/MULTIPLE,1199.0,779.35,168.79,4392.0,87
CDM,45011575,CLTX DSTL PHLNGL FX FNGR/THMB W/O MANJ EA,1103.0,716.95,204.59,4392.0,87
CDM,45011585,CLTX METACARPAL FX W/O MANIPULATION EACH BONE,1103.0,716.95,204.59,2453.0,86
CDM,45011595,CLTX FX GRT TOE PHLX/PHLG W/O MANJ,1103.0,716.95,164.43,4392.0,87
CDM,45011605,INCISION & REMOVAL FOREIGN BODY SUBQ TISS COMPL,4861.0,3159.65,215.11,5265.0,87
CDM,45011615,DBRDMT W/RMVL FM FX&/DISLC SKIN&SUBQ TISSUS,2111.0,1372.15,239.13,5265.0,87
CDM,45011625,DBRDMT FX&/DISLC SUBQ T/M/F BONE,8586.0,5580.9,460.64,8586.0,87
CDM,45011635,DEBRIDEMENT MUSCLE & FASCIA 20 SQ CM/<,1836.0,1193.4,178.27,5265.0,87
CDM,45011645,DEBRIDEMENT NAIL ANY METHOD 1-5,178.0,115.7,17.51,3443.0,86
CDM,45011655,EXCISION PILONIDAL CYST/SINUS SIMPLE,8586.0,5580.9,219.96,8586.0,87
CDM,45011665,SMPL RPR SCALP/NECK/AX/GENIT/TRUNK 20.1-30.0CM,1199.0,779.35,141.42,5265.0,87
CDM,45011675,SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK >30.0CM,596.0,387.4,165.69,5265.0,87
CDM,45011685,SIMPLE REPAIR F/E/E/N/L/M 12.6CM-20.0 CM,1199.0,779.35,157.64,5265.0,87
CDM,45011695,SIMPLE REPAIR F/E/E/N/L/M 20.1CM-30.0 CM,1199.0,779.35,186.25,5265.0,87
CDM,45011705,SIMPLE REPAIR F/E/E/N/L/M >30.0 CM,596.0,387.4,165.69,5265.0,87
CDM,45011715,REPAIR INTERMEDIATE S/A/T/E 20.1-30.0 CM,1836.0,1193.4,239.13,5265.0,87
CDM,45011725,REPAIR INTERMEDIATE S/A/T/E >30.0 CM,5488.0,3567.2,239.13,5488.0,87
CDM,45011735,REPAIR INTERMEDIATE N/H/F/XTRNL GENT 12.6-20 CM,1836.0,1193.4,239.13,5265.0,87
CDM,45011745,RPR INTERMEDIATE N/H/F/XTRNL GENT 20.1-30.0 CM,1836.0,1193.4,239.13,5265.0,87
CDM,45011755,REPAIR INTERMEDIATE N/H/F/XTRNL GENT >30.0 CM,5488.0,3567.2,239.13,5488.0,87
CDM,45011765,REPAIR INTERMEDIATE F/E/E/N/L&/MUC 12.6-20.0CM,1199.0,779.35,239.13,5265.0,87
CDM,45011775,REPAIR INTERMEDIATE F/E/E/N/L&/MUC 20.1-30.0CM,1199.0,779.35,239.13,5265.0,87
CDM,45011785,REPAIR INTERMEDIATE F/E/E/N/L&/MUC >30.0 CM,1199.0,779.35,239.13,5265.0,87
CDM,45011795,REPAIR COMPLEX TRUNK 1.1-2.5 CM,1836.0,1193.4,218.87,5265.0,87
CDM,45011805,REPAIR COMPLEX TRUNK 2.6-7.5 CM,1836.0,1193.4,266.43,7813.0,87
CDM,45011815,REPAIR COMPLEX TRUNK EACH ADDITIONAL 5 CM/<,314.0,204.1,68.45,4392.0,69
CDM,45011825,REPAIR COMPLEX SCALP/ARM/LEG 1.1-2.5 CM,1836.0,1193.4,250.54,5265.0,87
CDM,45011835,REPAIR COMPLEX SCALP/ARM/LEG EA ADDL 5 CM/<,726.0,471.9,88.95,4392.0,69
CDM,45011845,REPAIR COMPLEX F/C/C/M/N/AX/G/H/F EA ADDL 5 CM/<,1159.0,753.35,135.31,4392.0,69
CDM,45011855,REPAIR COMPLX EYELID/NOSE/EAR/LIP EA ADDL 5 CM/<,603.0,391.95,131.45,7813.0,69
CDM,45011865,DESTRUCTION PREMALIGNANT LESION 1ST,596.0,387.4,60.52,3443.0,86
CDM,45011875,CHEMICAL CAUTERIZATION OF GRANULATION TISSUE,596.0,387.4,43.62,3443.0,86
CDM,45011885,UNLISTED PROC SKIN MM & SQ TISS,25.0,16.25,6.95,3443.0,84
CDM,45011895,EXPLORATION PENETRATING WOUND SPX CHEST,8414.0,5469.1,247.45,8414.0,86
CDM,45011905,INJECTION 1 TENDON SHEATH/LIGAMENT APONEUROSIS,1358.0,882.7,44.63,3443.0,86
CDM,45011915,INJECTION SINGLE TENDON ORIGIN/INSERTION,1358.0,882.7,44.45,3443.0,86
CDM,45011925,INJECTION SINGLE/MLT TRIGGER POINT 3/> MUSCLES,1358.0,882.7,52.63,3443.0,86
CDM,45011935,ASPIRATION&/INJECTION GANGLION CYST ANY LOCATJ,1358.0,882.7,47.46,3443.0,86
CDM,45011945,INSERTION WIRE/PIN W/APPL SKELETAL TRACTION SPX,14925.0,9701.25,196.12,14925.0,87
CDM,45011955,REMOVAL IMPLANT SUPERFICIAL SEPARATE PROCEDURE,7453.0,4844.45,174.23,7453.0,87
CDM,45011975,CLOSED TX NASAL BONE FX W/MNPJ W/O STABILIZATION,6814.0,4429.1,68.18,6814.0,87
CDM,45011995,CLSD TX CLAVICULAR FRACTURE W/O MANIPULATION,1103.0,716.95,204.59,4392.0,87
CDM,45012005,CLSD TX CLAVICULAR FRACTURE W/MANIPULATION,7362.0,4785.3,295.11,7362.0,87
CDM,45012015,CLSD TX STERNOCLAVICULAR DISLC W/O MANIPULATION,7362.0,4785.3,295.11,7362.0,87
CDM,45012025,CLSD TX ACROMIOCLAVICULAR DISLC W/O MANIPULATION,1103.0,716.95,204.59,4392.0,87
CDM,45012035,CLSD TX ACROMIOCLAVICULAR DISLC W/MANIPULATION,1103.0,716.95,204.59,4392.0,87
CDM,45012045,CLTX PROXIMAL HUMERAL FRACTURE W/O MANIPULATION,1103.0,716.95,204.59,3443.0,86
CDM,45012055,REMOVAL FOREIGN BODY UPPER ARM/ELBOW DEEP,13165.0,8557.25,485.18,13165.0,87
CDM,45012065,CLSD TX HUMERAL SHAFT FRACTURE W/O MANIPULATION,1103.0,716.95,204.59,4392.0,87
CDM,45012075,CLTX SPRCNDYLR/TRANSCNDYLR HUMERAL FX W/WO MANJ,1103.0,716.95,204.59,4392.0,87
CDM,45012085,CLTX HUMERAL EPICONDYLAR FX MEDIAL/LAT W/O MANJ,1103.0,716.95,204.59,4392.0,87
CDM,45012095,CLTX HUMERAL CONDYLAR FX MEDIAL/LAT W/O MANJ,1103.0,716.95,204.59,4392.0,87
CDM,45012105,CLTX HUMERAL CONDYLAR FX MEDIAL/LATERAL W/MANJ,7362.0,4785.3,295.11,7362.0,87
CDM,45012115,TREATMENT CLOSED ELBOW DISLOCATION REQ ANES,7362.0,4785.3,593.85,7362.0,87
CDM,45012125,CLOSED TX ULNAR FRACTURE PROXIMAL END W/O MANJ,1103.0,716.95,204.59,4392.0,87
CDM,45012135,CLOSED TX ULNAR FRACTURE PROXIMAL END W/MANJ,7362.0,4785.3,295.11,7362.0,87
CDM,45012145,EXPL W/REMOVAL DEEP FOREIGN BODY FOREARM/WRIST,7362.0,4785.3,497.23,7362.0,87
CDM,45012155,RPR TDN/MUSC FLXR F/ARM&/WRST PRIM 1 EA TDN/MU,14925.0,9701.25,731.43,14925.0,87
CDM,45012165,CLOSED TX RADIAL SHAFT FRACTURE W/O MANIPULATION,1103.0,716.95,204.59,3443.0,86
CDM,45012185,CLOSED TX ULNAR SHAFT FRACTURE W/O MANIPULATION,1103.0,716.95,204.59,3443.0,86
CDM,45012195,CLOSED TX ULNAR SHAFT FRACTURE W/MANIPULATION,1103.0,716.95,204.59,4392.0,87
CDM,45012205,CLOSED TX RADIAL&ULNAR SHAFT FRACTURES W/O MAN,1103.0,716.95,204.59,3443.0,86
CDM,45012235,CLOSED TX CARPAL SCAPHOID FRACTURE W/O MANJ,1103.0,716.95,204.59,2453.0,86
CDM,45012245,CLOSED TX CARPAL SCAPHOID FRACTURE W/MANJ,7362.0,4785.3,295.11,7362.0,87
CDM,45012255,CLTX CARPAL BONE FX W/O MANJ EACH BONE,1103.0,716.95,204.59,3443.0,86
CDM,45012265,CLTX CARPAL BONE FX W/MANJ EACH BONE,7362.0,4785.3,295.11,7362.0,87
CDM,45012275,CLOSED TREATMENT ULNAR STYLOID FRACTURE,1103.0,716.95,204.59,2453.0,86
CDM,45012285,UNLISTED PROCEDURE FOREARM OR WRIST,400.0,260.0,111.2,3443.0,84
CDM,45012295,REPAIR EXTENSOR TENDON FINGER W/O GRAFT EACH,7362.0,4785.3,820.98,10789.0,87
CDM,45012305,CLTX CARPO/METACARPAL FX DISLC THUMB W/MANJ,7362.0,4785.3,295.11,7362.0,87
CDM,45012335,CLTX PHLNGL FX PROX/MIDDLE PX/F/T W/O MANJ EA,1103.0,716.95,204.59,5265.0,87
CDM,45012345,CLTX ARTCLR FX INVG MTCRPHLNGL/IPHAL JT W/O MANJ,1103.0,716.95,204.59,4392.0,87
CDM,45012355,OPEN TX DISTAL PHALANGEAL FRACTURE EACH,14925.0,9701.25,604.54,14925.0,87
CDM,45012365,OPEN TX INTERPHALANGEAL JOINT DISLOCATION,14925.0,9701.25,646.94,14925.0,87
CDM,45012375,AMP F/TH 1/2 JT/PHALANX W/NEURECT LOCAL FLAP,14925.0,9701.25,855.5,14925.0,87
CDM,45012385,UNLISTED PROCEDURE HANDS OR FINGERS,400.0,260.0,111.2,3443.0,84
CDM,45012395,RMVL FOREIGN BODY PELVIS/HIP SUBCUTANEOUS TISS,13165.0,8557.25,208.46,13165.0,87
CDM,45012405,REMOVAL FOREIGN BODY PELVIS/HIP DEEP,14925.0,9701.25,726.25,14925.0,87
CDM,45012415,CLTX FEM FX PROX END NCK W/MANJ W/WO SKEL TRACJ,4873.0,3167.45,295.11,5265.0,79
CDM,45012425,CLTX HIP DISLOCATION TRAUMATIC REQ ANESTHESIA,7362.0,4785.3,824.67,7362.0,87
CDM,45012435,TX SPONTAN HIP DISLC ABDCT SPLNT/TRCJ W/O ANES,1103.0,716.95,204.59,4392.0,87
CDM,45012445,TX SPON HIP DISLC ABDCT SPLNT/TRCJ W/MANJ ANES,7362.0,4785.3,408.15,7813.0,87
CDM,45012455,REMOVAL FOREIGN BODY DEEP THIGH/KNEE,13165.0,8557.25,475.77,25635.0,87
CDM,45012465,ARREST EPIPHYSEAL DISTAL FEMUR,32861.0,21359.65,762.83,32861.0,86
CDM,45012475,CLTX SPRCNDYLR/TRNSCNDYLR FEM FX W/MANJ,7362.0,4785.3,295.11,7813.0,87
CDM,45012485,CLTX FEM FX DSTL END MEDIAL/LAT CONDYLE W/O MANJ,1103.0,716.95,204.59,4392.0,87
CDM,45012495,CLOSED TX PATELLAR FRACTURE W/O MANIPULATION,1103.0,716.95,204.59,4392.0,87
CDM,45012505,CLTX TIBIAL FX PROXIMAL W/O MANIPULATION,1103.0,716.95,204.59,4392.0,87
CDM,45012515,CLOSED TX PATELLAR DISLOCATION W/ANESTHESIA,1103.0,716.95,204.59,4392.0,87
CDM,45012525,CLTX TIBIAL SHAFT FX W/O MANIPULATION,1103.0,716.95,204.59,4392.0,87
CDM,45012535,CLTX MEDIAL MALLEOLUS FX W/O MANIPULATION,1103.0,716.95,204.59,4392.0,87
CDM,45012545,CLOSED TREATMENT PST MALLEOLUS FRACTURE W/MANJ,7362.0,4785.3,295.11,7362.0,87
CDM,45012555,CLTX PROX FIBULA/SHFT FX W/O MANJ,1103.0,716.95,204.59,4392.0,87
CDM,45012565,CLTX PROX FIBULA/SHFT FX W/MANJ,7362.0,4785.3,295.11,7362.0,87
CDM,45012575,CLOSED TX BIMALLEOLAR ANKLE FRACTURE W/O MANJ,1103.0,716.95,204.59,4392.0,87
CDM,45012585,CLTX TRIMALLEOLAR ANKLE FX W/O MANIPULATION,1103.0,716.95,204.59,4392.0,87
CDM,45012595,CLTX FX W8 BRG ARTCLR PRTN DSTL TIBIA W/O MANJ,1103.0,716.95,204.59,4392.0,87
CDM,45012605,CLTX FX W8 BRG ARTCLR PRTN DSTL TIB W/SKEL TRACJ,7362.0,4785.3,295.11,7362.0,87
CDM,45012615,UNLISTED PROCEDURE LEG OR ANKLE,400.0,260.0,111.2,3443.0,84
CDM,45012635,REMOVAL FOREIGN BODY FOOT COMPLICATED,7453.0,4844.45,437.63,10789.0,87
CDM,45012645,CLOSED TX CALCANEAL FRACTURE W/O MANIPULATION,1103.0,716.95,204.59,4392.0,87
CDM,45012655,CLOSED TX TALUS FRACTURE W/O MANIPULATION,1103.0,716.95,204.59,4392.0,87
CDM,45012665,TX TARSAL BONE FX XCP TALUS&CALCN W/O MANJ,1103.0,716.95,204.59,4392.0,87
CDM,45012675,CLOSED TX METATARSAL FRACTURE W/O MANIPULATION,1103.0,716.95,204.59,4392.0,87
CDM,45012685,CLTX FX PHLX/PHLG OTH/THN GRT TOE W/O MANJ,1103.0,716.95,159.36,4392.0,87
CDM,45012695,CLOSED TX TALOTARSAL JOINT DISLOCATION W/ANES,14925.0,9701.25,433.23,14925.0,87
CDM,45012705,CLOSED TX TARSOMETATARSAL DISLOCATION W/O ANES,1103.0,716.95,200.83,4392.0,87
CDM,45012725,APPLICATION CAST SHOULDER HAND LONG ARM,1222.0,794.3,78.39,2453.0,86
CDM,45012735,APPLICATION CAST ELBOW FINGER SHORT ARM,1222.0,794.3,72.22,2453.0,86
CDM,45012745,APPLICATION SHORT ARM SPLINT FOREARM-HAND STATIC,593.0,385.45,49.26,2453.0,86
CDM,45012755,APPLICATION FINGER SPLINT STATIC,593.0,385.45,33.14,2453.0,86
CDM,45012765,APPLICATION FINGER SPLINT DYNAMIC,273.0,177.45,39.55,2453.0,86
CDM,45012775,STRAPPING THORAX,726.0,471.9,21.71,2453.0,86
CDM,45012785,STRAPPING SHOULDER,593.0,385.45,21.71,2453.0,86
CDM,45012795,STRAPPING ELBOW/WRIST,273.0,177.45,21.9,2453.0,86
CDM,45012805,STRAPPING HAND/FINGER,273.0,177.45,22.98,2453.0,86
CDM,45012815,APPLICATION LONG LEG CAST THIGH-TOE,1222.0,794.3,105.3,3443.0,86
CDM,45012825,APPLICATION SHORT LEG CAST BELOW KNEE-TOE,1222.0,794.3,68.51,2453.0,86
CDM,45012835,APPLICATION PATELLAR TENDON BEARING CAST,1222.0,794.3,99.03,2453.0,86
CDM,45012845,APPLICATION RIGID TOTAL CONTACT LEG CAST,1222.0,794.3,105.3,2453.0,86
CDM,45012855,APPLICATION LONG LEG SPLINT THIGH ANKLE/TOES,726.0,471.9,56.47,2453.0,86
CDM,45012865,APPLICATION SHORT LEG SPLINT CALF FOOT,726.0,471.9,56.47,2453.0,86
CDM,45012875,STRAPPING KNEE,593.0,385.45,21.71,2453.0,86
CDM,45012885,STRAPPING ANKLE &/FOOT,726.0,471.9,21.37,2453.0,86
CDM,45012895,STRAPPING TOES,273.0,177.45,13.46,2453.0,86
CDM,45012905,STRAPPING UNNA BOOT,726.0,471.9,31.54,2453.0,86
CDM,45012915,REMOVAL/BIVALVING GAUNTLET BOOT/BODY CAST,1222.0,794.3,38.61,2453.0,86
CDM,45012925,REMOVAL/BIVALVING FULL ARM/FULL LEG CAST,1222.0,794.3,51.92,2453.0,86
CDM,45012935,UNLISTED PROCEDURE CASTING OR STRAPPING,270.0,175.5,56.47,270.0,84
CDM,45012945,UNLISTED PROCEDURE NOSE,926.0,601.9,211.91,3443.0,84
CDM,45012955,LARYNGOSCOPY INDIRECT W/REMOVAL FOREIGN BODY,893.0,580.45,107.64,5265.0,87
CDM,45012965,TRACHEOSTOMY EMERGENCY PROCEDURE TRANSTRACHEAL,6814.0,4429.1,363.13,6814.0,79
CDM,45012975,TRACHEOSTOMY EMERGENCY CRICOTHYROID MEMBRANE,1068.0,694.2,211.91,3443.0,78
CDM,45012985,UNLISTED PROCEDURE TRACHEA BRONCHI,292.0,189.8,81.18,3443.0,84
CDM,45012995,THORCOM CTRL TRAUMTC HEMRRG&/RPR LNG TEAR,10508.0,6830.2,1739.98,13132.0,68
CDM,45013005,PERICARDIOTOMY REMOVAL CLOT/FOREIGN BODY PRIMARY,6216.0,4040.4,978.66,13132.0,68
CDM,45013015,REPAIR CARDIAC WOUND W/O BYPASS,18695.0,12151.75,2867.24,18695.0,68
CDM,45013025,INTRODUCTION NEEDLE/INTRACATHETER VEIN,246.0,159.9,35.72,246.0,66
CDM,45013035,VNPNXR <3 YEARS PHY/QHP SKILL FEMRAL/JUGLAR VEIN,158.0,102.7,2.64,158.0,68
CDM,45013045,VNPNXR <3 YEARS PHYS/QHP SKILL SCALP VEIN,129.0,83.85,2.64,129.0,68
CDM,45013055,VNPNXR <3 YEARS PHYS/QHP SKILL OTHER VEIN,129.0,83.85,2.64,129.0,68
CDM,45013065,VNPNXR 3 YEARS/> PHYS/QHP SKILL,222.0,144.3,10.81,222.0,68
CDM,45013075,VENIPUNCTURE CUTDOWN UNDER AGE 1 YR,741.0,481.65,35.72,3443.0,86
CDM,45013085,VENIPUNCTURE CUTDOWN AGE 1 YR/>,2294.0,1491.1,35.72,3443.0,86
CDM,45013095,INSJ NON-TUNNELED CENTRAL VENOUS CATH AGE < 5 Y,18098.0,11763.7,108.87,18098.0,87
CDM,45013105,RPR TUN/NON-TUN CTR VAD CATH W/O SUBQ PORT/PMP,3555.0,2310.75,39.9,5265.0,87
CDM,45013115,RPR CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ SIT,8932.0,5805.8,214.41,8932.0,87
CDM,45013125,RPLCMT COMPL NON-TUN CVC W/O SUBQ PORT/PMP,8932.0,5805.8,76.69,8932.0,87
CDM,45013135,RPLCMT COMPL TUN CVC W/O SUBQ PORT/PMP,18098.0,11763.7,213.76,18098.0,87
CDM,45013145,COLLECT BLOOD FROM CATHETER VENOUS NOS,741.0,481.65,35.72,741.0,86
CDM,45013155,UNLISTED VASC PROCEDURE,8607.0,5594.55,545.0,8607.0,85
CDM,45013165,RMVL EMBEDDED FB VESTIBULE MOUTH COMP,2343.0,1522.95,230.37,5265.0,87
CDM,45013175,RPR LAC 2.5 CM/< PST ONE-THIRD TONGUE,1068.0,694.2,107.64,5265.0,87
CDM,45013185,RPR LAC TONGUE FLOOR MOUTH > 2.6 CM/CPLX,1068.0,694.2,107.64,5265.0,87
CDM,45013195,REPAIR LACERATION PALATE </2 CM,2343.0,1522.95,209.64,4392.0,87
CDM,45013205,REPAIR LACERATION PALATE >2 CM/COMPLEX,27212.0,17687.8,288.11,27212.0,87
CDM,45013215,UNLISTED PROCEDURE PALATE UVULA,248.0,161.2,68.94,1573.0,84
CDM,45013225,CTRL NASOPHARYNGEAL HEMRRG SMPL W/PST NSL PACKS,1068.0,694.2,107.64,3443.0,86
CDM,45013235,I&D SUBMUCOSAL ABSCESS RECTUM,5424.0,3525.6,199.41,5424.0,87
CDM,45013245,UNLISTED PROCEDURE RECTUM,4599.0,2989.35,792.91,4599.0,84
CDM,45013255,ANOSCOPY W/RMVL FOREIGN BODY,4194.0,2726.1,100.5,4392.0,87
CDM,45013265,UNLISTED PROCEDURE ABD PERITONEUM,4669.0,3034.85,461.87,4669.0,84
CDM,45013275,ASPIRATION BLADDER NEEDLE,1119.0,727.35,45.42,3443.0,86
CDM,45013285,UNLISTED PROCEDURE MALE GENITAL SYSTEM,1736.0,1128.4,214.41,4337.0,84
CDM,45013295,UNLISTED PROCEDURE FEMALE GENITAL SYS,2158.0,1402.7,172.88,3443.0,84
CDM,45013305,DELIVERY PLACENTA SEPARATE PROCEDURE,12718.0,8266.7,108.18,12718.0,86
CDM,45013315,RMVL FB XTRNL EYE EMBED SCJNCL/SCLERAL NONPERFOR,1836.0,1193.4,40.07,2453.0,86
CDM,45013325,RMVL FB INTRAOCULAR ANT CHAMBER EYE/LENS,10491.0,6819.15,381.15,10491.0,87
CDM,45013335,RMVL CORNEAL EPITHELIUM W/WO CHEMOCAUTERIZATION,4455.0,2895.75,76.26,4455.0,86
CDM,45013345,UNLISTED PROCEDURE ANT SEG OF EYE,3941.0,2561.65,381.15,3941.0,84
CDM,45013355,UNLISTED PROCEDURE ORBIT,1200.0,780.0,198.21,1200.0,84
CDM,45013365,OPHTHALMIC US DX QUANTITATIVE A-SCAN ONLY,734.0,477.1,72.76,89442.26,87
CDM,45013375,OPHTHALMIC US DX B-SCAN W/WO NON-QUAN A-SCAN,734.0,477.1,60.95,89443.43,87
CDM,45013385,OFFICE/OUTPATIENT EST PT MAY NOT REQ PHYS/QHP,150.0,97.5,10.63,150.0,68
CDM,45014615,CLOSED TX RADIAL HEAD/NECK FX W/O MANIPULATION,1103.0,716.95,204.59,3443.0,86
CDM,45014625,CLTX GREATER HUMERAL TUBEROSITY FX W/O MANJ,1103.0,716.95,204.59,3443.0,86
CDM,45014665,ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/US,3186.0,2070.9,59.85,4392.0,87
CDM,45014695,CLSD TX FX ORBIT EXCEPT BLOWOUT W/O MANIPULATION,2343.0,1522.95,219.21,5265.0,87
CDM,45014705,CLOSED TREATMENT STERNUM FRACTURE,1103.0,716.95,193.39,4392.0,87
CDM,45014725,INTRAORAL I&D TONGUE/FLOOR SUBLNGL SUPFC,1068.0,694.2,107.64,4392.0,87
CDM,45014765,FETAL NONSTRESS TEST,805.0,523.25,59.72,805.0,86
CDM,45014795,OSTEOPATHIC MANIPULATIVE TX 1-2 BODY REGIONS,76.0,49.4,20.43,76.0,86
CDM,45014815,INTRAORAL I&D TONGUE/FLOOR LINGUAL,2343.0,1522.95,128.26,3443.0,86
CDM,45014825,CLTX PROX TIBFIB JT DISLC W/O ANES,1103.0,716.95,204.59,4392.0,87
CDM,45014835,INJECTION INTRALESIONAL UP TO & INCLUD 7 LESIONS,596.0,387.4,32.16,3443.0,86
CDM,45014845,DUP-SCAN LXTR ART/ARTL BPGS UNI/LMTD STUDY,611.0,397.15,95.38,611.0,86
CDM,45014855,STREP A ASSAY W/OPTIC,114.0,74.1,16.53,114.0,84
CDM,45014865,ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/US,1358.0,882.7,66.5,4392.0,87
CDM,45014875,CLTX RDCRPL/INTERCARPL DISLC 1/> BONES W/MANJ,1103.0,716.95,204.59,4392.0,87
CDM,45014885,MNTR INTERSTITIAL FLUID PRESSURE CMPRT SYNDROME,3237.0,2104.05,103.02,3443.0,86
CDM,45014895,CLOSED TREATMENT PST MALLEOLUS FRACTURE W/O MANJ,1103.0,716.95,204.59,4392.0,87
CDM,45014905,NEGATIVE PRESSURE WOUND THERAPY DME </= 50 SQ CM,914.0,594.1,30.08,914.0,86
CDM,45014925,INTRAORAL I&D TONGUE/FLOOR MASTICATOR SPACE,2343.0,1522.95,326.31,4392.0,87
CDM,45014935,CANALITH REPOSITIONING PROCEDURE,240.0,156.0,41.92,240.0,85
CDM,45014955,CLOSED TX OF MANDIBULAR FRACTURE W/O MANIPULATION,2343.0,1522.95,295.11,7813.0,87
CDM,45014965,CLOSED TX FEMORAL SHAFT FX W/O MANIPULATION,1103.0,716.95,204.59,4392.0,87
CDM,45014975,CLTX GREATER TROCHANTERIC FX W/O MANJ,1103.0,716.95,204.59,4392.0,87
CDM,45014985,INJECTION AA&/STRD PUDENDAL NERVE,6143.0,3992.95,64.29,6143.0,87
CDM,45014995,CLTX INTERCONDYLAR SPI&/TUBRST FX KNE W/WO MAN,1103.0,716.95,204.59,4392.0,87
CDM,45015055,CLTX INTR/PERI/SBTRCHNTC FEMORAL FX W/MANJ,1820.0,1183.0,295.11,5265.0,79
CDM,45015085,CLOSED TX SCAPULAR FRACTURE W/O MANIPULATION,1103.0,716.95,204.59,4392.0,87
CDM,45015095,CLTX FEM FX PROX END NCK W/O MANJ,1103.0,716.95,204.59,4392.0,87
CDM,45015105,HYMENOTOMY SIMPLE INCISION,14626.0,9506.9,54.13,14626.0,87
CDM,45015125,OSTEOPATHIC MANIPULATIVE TX 1-2 BODY REGIONS,76.0,49.4,20.43,76.0,86
CDM,45015135,ARTHROPLASTY INTERPHALANGEAL JOINT EACH,14925.0,9701.25,516.72,14925.0,87
CDM,45015175,INTERROG DEV EVAL PM/LDLS PM PHYS/QHP IN PERSON,214.0,139.1,22.84,214.0,86
CDM,45015185,PERQ REPLACEMENT GTUBE NOT REQ REVJ GSTRST TRC,1119.0,727.35,44.67,4392.0,87
CDM,45015195,PERQ REPLACEMENT GTUBE REQ REVJ GSTRST TRC,1119.0,727.35,103.67,4392.0,87
CDM,45015205,CLTX ACETABULUM HIP/SOCKT FX W/O MANJ,1103.0,716.95,204.59,7813.0,87
CDM,45015215,CLTX INTER/PERI/SUBTROCHANTERIC FEM FX W/O MANJ,7362.0,4785.3,295.11,7362.0,87
CDM,45015225,EXC B9 LESION MRGN XCP SK TG T/A/L 0.6-1.0 CM,1199.0,779.35,117.6,3443.0,86
CDM,45015235,CLOSED TREATMENT SESAMOID FRACTURE,1103.0,716.95,132.87,4392.0,87
CDM,45015245,CLTX GRTER HUMERAL TUBEROSITY FX W/MANIPULATION,7362.0,4785.3,295.11,7362.0,87
CDM,45015255,INSJ/RPLCMT TEMP TRANSVNS 1CHMBR ELTRD/PM CATH,47587.0,30931.55,181.75,47587.0,86
CDM,45015265,OSTEOPATHIC MANIPULATIVE TX 3-4 BODY REGIONS,76.0,49.4,20.43,107.33,87
CDM,45015275,EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 0.5 CM/<,4861.0,3159.65,95.4,4861.0,86
CDM,45015285,REMOVAL NON-BIODEGRADABLE DRUG DELIVERY IMPLANT,1197.0,778.05,82.32,3443.0,86
CDM,45015295,PARACENTSIS ANT CHAMB EYE ASPIR AQUEOUS SPX,10491.0,6819.15,95.36,10491.0,87
CDM,45015305,IRRIGAJ IMPLNTD VENOUS ACCESS DRUG DELIVERY SYST,410.0,266.5,34.52,410.0,86
CDM,45015315,CLTX VRT BDY FX W/O MANJ REQ&W/CSTING/BRACING,1103.0,716.95,204.59,4392.0,87
CDM,45015325,CLOSED TREATMENT COCCYGEAL FRACTURE,1103.0,716.95,204.59,4392.0,87
CDM,45015345,NASPHARSCOPY INJ PHARYNX,3434.0,2232.1,211.91,3443.0,84
CDM,45015355,REMOVAL RESIDUAL ROOT,302.0,196.3,83.96,13821.0,85
CDM,45015365,BRNCHSC INCL FLUOR GDNCE DX W/CELL WASHG SPX,7933.0,5156.45,158.8,7933.0,87
CDM,45015385,TX MISSED ABORTION FIRST TRIMESTER SURGICAL,12718.0,8266.7,433.87,13821.0,87
CDM,45015395,DBRDMT SUBCUTANEOUS TISSUE EA ADDL 20 SQ CM,1729.0,1123.85,29.4,5265.0,69
CDM,45015415,INJECTION AA&/STRD AXILLARY NERVE W/IMG GDN,6143.0,3992.95,81.82,6143.0,87
CDM,45015445,PERICARDIOCENTESIS W/IMG GUIDANCE WHEN PERFORMED,8932.0,5805.8,262.68,8932.0,87
CDM,45015455,PERQ PRCRD DRG 6YR+ W/O CONGENITAL CAR ANOMALY,5413.0,3518.45,275.54,11132.0,68
CDM,45015465,PERQ PRCRD DRG 0-5YR/ANY AGE W/CGEN CAR ANOMALY,5314.0,3454.1,322.62,8413.0,69
CDM,45015485,NEEDLE INSERTION W/O INJECTION 3 OR MORE MUSCLES,113.0,73.45,22.7,3443.0,86
CDM,45015495,PUNCH BIOPSY SKIN SINGLE LESION,1199.0,779.35,50.78,4392.0,87
CDM,45015505,INJECTION AA&/STRD SUPRASCAPULAR NERVE,4778.0,3105.7,64.88,4778.0,87
CDM,45015515,LARYNGOSCOPY W/FOREIGN BODY REMOVAL,7933.0,5156.45,223.45,7933.0,87
CDM,45015525,NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 2 LEVEL,741.0,481.65,97.71,741.0,86
CDM,45015565,PVB THORACIC CONT CATHETER INFUSION W/IMG GID,4778.0,3105.7,105.59,4778.0,87
CDM,45015575,CLTX SPRCNDYLR/TRNSCNDYLR FEM FX W/O MANJ,1103.0,716.95,204.59,5265.0,87
CDM,45015585,MYOMECTOMY 1-4 MYOMAS 250 GM/< VAGINAL APPR,14626.0,9506.9,631.78,14626.0,87
CDM,45015595,ELECT ANALYS IMPLT ITHCL/EDRL PUMP W/REPRGRMG,2069.0,1344.85,39.55,4337.0,86
CDM,45015605,EXC B9 LESION MRGN XCP SK TG T/A/L 1.1-2.0 CM,2111.0,1372.15,126.78,4392.0,87
CDM,45015615,DRAINAGE TENDON SHEATH DIGIT&/PALM EACH,14925.0,9701.25,653.65,14925.0,87
CDM,45015625,DEBRIDEMENT MUSCLE &/FASCIA EA ADDL 20 SQ CM,2452.0,1593.8,62.14,5265.0,69
CDM,45015635,CLOSED TX CALCANEAL FRACTURE W/MANIPULATION,1103.0,716.95,204.59,5265.0,87
CDM,45015645,PUNCTURE ASPIRATION CYST BREAST,2111.0,1372.15,48.8,3443.0,86
CDM,45015655,REMOVAL FOREIGN BODY SHOULDER SUBCUTANEOUS,7453.0,4844.45,207.24,7453.0,87
CDM,45015665,I&D THYROGLOSSAL DUCT CYST INFECTED,5925.0,3851.25,182.91,5925.0,87
CDM,45015675,RMVL NDWELLG TUNNELED PLEURAL CATHETER W/CUFF,2844.0,1848.6,186.94,4392.0,87
CDM,45015685,ELECT ANLYS IMPLT ITHCL/EDRL PMP W/O REPRG/REFIL,2069.0,1344.85,28.74,4337.0,86
CDM,45015695,PERQ DRAINAGE PLEURA INSERT CATH W/O IMAGING,8726.0,5671.9,148.27,8726.0,87
CDM,45015705,CLOSED TX FEMORAL FRACTURE PROX HEAD W/O MANJ,14925.0,9701.25,295.11,14925.0,87
CDM,45015715,INJECTION AA&/STRD SCIATIC NERVE,4778.0,3105.7,87.62,4778.0,87
CDM,45015725,CURETTAGE POSTPARTUM,12718.0,8266.7,214.1,12718.0,87
CDM,45015735,BURR HOLE IMPLANT VENTRICULAR CATH/OTHER DEVICE,4561.0,2964.65,459.95,5831.66,68
CDM,45015745,CLSD TX PELVIC RING FX W/O MANIPULATION,1103.0,716.95,152.61,4392.0,87
CDM,45015765,EPISIOTOMY/VAG RPR OTH/THN ATTENDING,12718.0,8266.7,173.64,12718.0,86
CDM,45015775,CHEMOTX ADMN SUBQ/IM NON-HORMONAL ANTI-NEO,491.0,319.15,45.54,491.0,86
CDM,45015795,CLTX ACETABULM HIP/SOCKT FX MANJ W/WO SKEL TRACJ,531.0,345.15,147.62,3443.0,78
CDM,45016535,PUNCH BIOPSY SKIN EA SEP/ADDITIONAL LESION,184.0,119.6,27.96,4392.0,69
CDM,45016545,THORACIC FASCIAL PLANE BLOCK UNI INJECTION,4336.0,2818.4,84.26,4336.0,67
CDM,45016565,INJ ANES SPHENOPALATINE GANGLION,2037.0,1324.05,118.89,3443.0,86
CDM,45016575,ARTHROCNT ASPIR&/INJ SMALL JT/BURSAW/US REC RPRT,1358.0,882.7,53.08,4392.0,87
CDM,45016585,CLTX RDL SHFT FX&CLTX DISLC DSTL RAD/ULN JT,7362.0,4785.3,295.11,7362.0,87
CDM,45016615,LOWER XTR FASCIAL PLANE BLOCK UNI INJECTION,753.0,489.45,75.31,3443.0,67
CDM,45016625,CRTJ PERICARDIAL WINDOW/PRTL RESECJ W/DRG/BX,8900.0,5785.0,920.67,13132.0,68
CDM,45016635,TRAUMA CAT 1 - NO NOTIFICATION,4227.0,2747.55,921.49,4227.0,58
CDM,45016645,TRAUMA CAT 2 - NO NOTIFICATION,4227.0,2747.55,921.49,4227.0,58
CDM,45016655,TRAUMA CAT 3 - NO NOTIFICATION,4227.0,2747.55,921.49,4227.0,58
CDM,45020OH,I&D DP SUPRALEVATOR PELVIRCT/RETRORCT ABSC,3424.0,2225.6,1.1,8188.18,144
CDM,45100OH,BX ANORECTAL WALL ANAL APPROACH,1616.0,1050.4,1.1,8188.18,144
CDM,45108OH,ANORECTAL MYOMECTOMY,2048.0,1331.2,1.1,8188.18,144
CDM,45110OH,PRCTECT COMPL CMBN ABDOMINOPRNL W/CLST,12304.0,7997.6,1.1,12304.0,144
CDM,45111OH,PRCTECT PRTL RESCJ RECTUM TABDL APPR,7204.0,4682.6,1.1,7204.0,144
CDM,45112OH,PRCTECT CMBN ABDOMINOPRNL PULL-THRU PX,13272.0,8626.8,1.1,13272.0,144
CDM,45113OH,PRCTECT PRTL W/MUCOSEC ILEOANAL ANAST RSVR,13288.0,8637.2,1.1,13288.0,144
CDM,45114OH,PRCTECT PRTL W/ANAST ABDL & TRANSSAC APPROACH,12316.0,8005.4,1.1,12316.0,144
CDM,45116OH,PRCTECT PRTL W/ANAST TRANSSAC APPR ONLY,11088.0,7207.2,1.1,11088.0,144
CDM,45119OH,PRCTECT CMBN PULL-THRU W/RSVR W/NTRSTM,13392.0,8704.8,1.1,13392.0,144
CDM,45120OH,PRCTECT COMPL W/PULL-THRU PX & ANASTOMOSIS,10560.0,6864.0,1.1,10560.0,144
CDM,45121OH,PRCTECT COMPL W/STOT/TOT COLCT W/MLT BXS,11632.0,7560.8,1.1,11632.0,144
CDM,45123OH,PRCTECT PRTL W/O ANAST PRNL APPR,7544.0,4903.6,1.1,7544.0,144
CDM,45126OH,PELVIC EXENTERATION COLORECTAL MALIGNANCY,19640.0,12766.0,1.1,19640.0,144
CDM,45130OH,EXC RCT PROCIDENTIA W/ANAST PERINEAL APPROACH,7400.0,4810.0,1.1,7400.0,144
CDM,45136OH,EXC ILEOANAL RESVR W/ILEOSTMY,12328.0,8013.2,1.1,12328.0,144
CDM,45150OH,DIVISION STRICTURE RECTUM,2340.0,1521.0,1.1,3440.56,144
CDM,45160OH,EXC RCT TUM PROCTOTOMY TRANSSAC/TRANSCOCCYGEAL,6532.0,4245.8,1.1,8188.18,144
CDM,45171OH,EXC RCT TUM NOT INCL MUSCULARIS PROPRIA,3252.0,2113.8,1.1,8188.18,144
CDM,45172OH,EXC RCT TUM INCL MUSCULARIS PROPRIA,4852.0,3153.8,1.1,8188.18,144
CDM,45190OH,DESTRUCTION RECTAL TUMOR TRANSANAL APPROACH,4168.0,2709.2,1.1,8188.18,144
CDM,45300OH,PROCTOSGMDSC RGD DX W/WO COLLJ SPEC BR/WA SPX,320.0,208.0,1.1,2666.13,148
CDM,45303OH,PROCTOSGMDSC RIGID W/DILATION,560.0,364.0,1.1,3440.56,148
CDM,45305OH,PROCTOSGMDSC RIGID W/BX SINGLE/MULTIPLE,460.0,299.0,1.1,3440.56,148
CDM,45307OH,PROCTOSGMDSC RIGID W/RMVL FOREIGN BODY,640.0,416.0,1.1,8188.18,148
CDM,45308OH,PROCTOSGMDSC RIGID RMVL 1 LESION CAUTERY,520.0,338.0,1.1,8188.18,148
CDM,45309OH,PROCTOSGMDSC RIGID RMVL 1 LESION SNARE TQ,560.0,364.0,1.1,3440.56,148
CDM,45315OH,PROCTOSGMDSC RIGID RMVL MULT TUMOR CAUTERY/SNARE,680.0,442.0,1.1,3440.56,148
CDM,45317OH,PROCTOSGMDSC RIGID CONTROL BLEEDING,760.0,494.0,1.1,3440.56,148
CDM,45320OH,PROCTOSGMDSC RIGID ABLATION LESION,672.0,436.8,1.1,8188.18,148
CDM,45321OH,PROCTOSGMDSC RIGID DCMPRN VOLVULUS,660.0,429.0,1.1,8188.18,144
CDM,45330OH,SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA IF PFRMD,370.0,240.5,1.1,2666.13,148
CDM,45331OH,SIGMOIDOSCOPY FLX W/BIOPSY SINGLE/MULTIPLE,502.0,326.3,1.1,2666.13,148
CDM,45332OH,SIGMOIDOSCOPY FLX W/RMVL FOREIGN BODY,774.0,503.1,1.1,3440.56,148
CDM,45333OH,SIGMOIDOSCOPY FLX W/RMVL TUMOR BY HOT BX FORCEPS,682.0,443.3,1.1,2666.13,148
CDM,45334OH,SIGMOIDOSCOPY FLX CONTROL BLEEDING,880.0,572.0,1.1,3440.56,148
CDM,45335OH,SGMDSC FLX DIRED SBMCSL NJX ANY SBST,458.0,297.7,1.1,2666.13,148
CDM,45337OH,SGMDSC FLX W/DCMPRN W/PLMT DCMPRN TUBE,924.0,600.6,1.1,2666.13,144
CDM,45338OH,SGMDSC FLX RMVL TUM POLYP/OTH LES SNARE TQ,902.0,586.3,1.1,3440.56,148
CDM,45340OH,SIGMOIDOSCOPY FLX TNDSC BALO DILAT,550.0,357.5,1.1,3440.56,148
CDM,45341OH,SIGMOIDOSCOPY FLX NDSC US XM,933.0,606.45,1.1,2666.13,144
CDM,45342OH,SIGMOIDOSCOPY FLX TNDSC US GID NDL ASPIR/BX,1311.0,852.15,1.1,3440.56,144
CDM,45346OH,SIGMOIDOSCOPY FLX ABLATION TUMOR POLYP/OTH LES,1236.0,803.4,1.1,7646.0,148
CDM,45347OH,SIGMOIDOSCOPY W/PLACEMENT OF STENT,1197.0,778.05,1.1,16621.23,144
CDM,45349OH,SGMDSC FLX WITH ENDOSCOPIC MUCOSAL RESECTION,1549.0,1006.85,1.1,8188.18,132
CDM,45350OH,SIGMOIDOSCOPY FLX WITH WITH BAND LIGATION(S),739.0,480.35,1.1,3440.56,136
CDM,45378OH,COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD,1434.0,932.1,1.1,2666.13,148
CDM,45379OH,COLONOSCOPY FLX W/REMOVAL OF FOREIGN BODY(S),1883.0,1223.95,1.1,3440.56,148
CDM,45380OH,COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE,1566.0,1017.9,1.1,3440.56,148
CDM,45381OH,COLSC FLX WITH DIRECTED SUBMUCOSAL NJX ANY SBST,1566.0,1017.9,1.1,3440.56,148
CDM,45382OH,COLSC FLEXIBLE W/CONTROL BLEEDING ANY METHOD,1864.0,1211.6,1.1,3440.56,148
CDM,45384OH,COLSC FLX W/REMOVAL LESION BY HOT BX FORCEPS,1628.0,1058.2,1.1,3440.56,148
CDM,45385OH,COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ,2011.0,1307.15,1.1,3440.56,148
CDM,45386OH,COLSC FLEXIBLE W/TRANSENDOSCOPIC BALLOON DILAT,1659.0,1078.35,1.1,3440.56,148
CDM,45388OH,COLONOSCOPY FLX ABLATION TUMOR POLYP/OTHER LES,2147.0,1395.55,1.1,8196.83,148
CDM,45389OH,COLONOSCOPY FLX WITH ENDOSCOPIC STENT PLACEMENT,2096.0,1362.4,1.1,16621.23,144
CDM,45390OH,COLONOSCOPY FLX W/ENDOSCOPIC MUCOSAL RESECTION,2416.0,1570.4,1.1,8188.18,144
CDM,45391OH,COLSC FLX W/NDSC US XM RCTM ET AL LMTD&ADJ STRUX,1856.0,1206.4,1.1,3440.56,144
CDM,45392OH,COLSC FLX W/US GUID NDL ASPIR/BX W/US RCTM ET AL,2200.0,1430.0,1.1,3440.56,144
CDM,45393OH,COLONOSCOPY FLEXIBLE WITH DECOMPRESSION,2059.0,1338.35,1.1,3440.56,144
CDM,45395OH,LAPS PROCTECTOMY ABDOMINOPERINEAL W/COLOSTOMY,13200.0,8580.0,1.1,13200.0,144
CDM,45397OH,LAPS PROCTECTOMY COMBINED PULL-THRU W/RESERVOIR,14600.0,9490.0,1.1,14600.0,144
CDM,45398OH,COLONOSCOPY FLEXIBLE WITH BAND LIGATION(S),1680.0,1092.0,1.1,3440.56,148
CDM,45399OH,UNLISTED PROCEDURE COLON,13185.0,8570.25,0.01,13185.0,84
CDM,45399RVU10OH,"ENDOVAC, COLON; COLONOSCOPY VIA STOMA (COMP 45388, 97605)",2336.0,1518.4,0.01,2666.13,84
CDM,45399RVU11OH,OPEN RESECTION OF CECUM W/O ANASTOMOSIS (COMP 44110),5055.0,3285.75,0.01,5055.0,84
CDM,45399RVU12OH,SERIAL TRANVERSE COLOPLASTY (COMP 44604),6538.0,4249.7,0.01,6538.0,84
CDM,45399RVU2OH,ESD COLON (COMP 45390),5300.0,3445.0,0.01,5300.0,84
CDM,45399RVU3OH,EXCISION OF LESION. STOMA WITHOUT SCOPE (COMP 44382),620.0,403.0,0.01,2666.13,84
CDM,45399RVU4OH,DILATION OF COLOSTOMY (COMP 57800),254.0,165.1,0.01,2666.13,84
CDM,45399RVU5OH,ENDOSCOPIC SUBMUCOSAL DISSECTION OF COLON - (COMP CODE 44204),11229.0,7298.85,0.01,11229.0,84
CDM,45399RVU6OH,ENDOSCOPIC DEFECT CLOSURE (COMP CODE 44604),7808.0,5075.2,0.01,7808.0,84
CDM,45399RVU7OH,EDOSCOPIC STRICTUROTOMY (COMP 46700),4218.0,2741.7,0.01,4218.0,84
CDM,45399RVU8OH,"ENDOVAC, COLON; FLEX-SIG (COMP 45330, 97605)",599.0,389.35,0.01,2666.13,84
CDM,45399RVU9OH,"ENDOVAC, COLON; COLONOSCOPY (COMP 45378, 97605)",1639.0,1065.35,0.01,2666.13,84
CDM,45400OH,LAPAROSCOPY PROCTOPEXY PROLAPSE,7776.0,5054.4,1.1,7776.0,144
CDM,45402OH,LAPAROSCOPY PROCTOPEXY PROLAPSE SIGMOID RESCJ,10604.0,6892.6,1.1,10604.0,144
CDM,45499RVU1OH,LX COMP. PROC. IPAA +-ILEOSTOMY (COMP CODE 44211),9768.0,6349.2,0.01,16829.38,84
CDM,45499RVU2OH,LAP EXCISION  RETRORECTAL MASS/TUMOR (COMP 45172),6239.0,4055.35,0.01,16829.38,84
CDM,45499RVU3OH,LAPAROSCOPIC ABDOMINAL PERINEAL EXCISION OF ILEAL J POUCH (COMP,13099.0,8514.35,0.01,16829.38,84
CDM,45499RVU4OH,UNLISTED LAP SWENSON PROCEDURE (COMP CODE 45120),11220.0,7293.0,0.01,16829.38,84
CDM,45499RVU5OH,LAP PARTIAL PROCTECTOMY (COMP 45111),7744.0,5033.6,0.01,16829.38,84
CDM,45499RVU6OH,LAP COMPLETE PROCTECTOMY W/WO COLOANAL ANASTOMOSIS (COMP 45112),14267.0,9273.55,0.01,16829.38,84
CDM,45500OH,PROCTOPLASTY STENOSIS,3092.0,2009.8,1.1,8188.18,144
CDM,45505OH,PROCTOPLASTY PROLAPSE MUCOUS MEMBRANE,3344.0,2173.6,1.1,8188.18,144
CDM,45520OH,PERIRECTAL INJ SCLEROSING SOLUTION PROLAPSE,220.0,143.0,1.1,2666.13,148
CDM,45540OH,PROCTOPEXY ABDOMINAL APPROACH,7248.0,4711.2,1.1,7248.0,144
CDM,45541OH,PROCTOPEXY PERINEAL APPROACH,5940.0,3861.0,1.1,8188.18,144
CDM,45550OH,PROCTOPEXY W/SIGMOID RESCJ ABDL APPR,9920.0,6448.0,1.1,9920.0,144
CDM,45560OH,REPAIR RECTOCELE SEPARATE PROCEDURE,4600.0,2990.0,1.1,8188.18,144
CDM,45562OH,EXPL RPR & PRESACRAL DRG RECTAL INJURY,7192.0,4674.8,1.1,7192.0,144
CDM,45563OH,EXPL RPR & PRESACRAL DRG RECTAL INJ W/COLOSTOMY,10552.0,6858.8,1.1,10552.0,144
CDM,45600000,CHART PREP/NO CHARGE,11.0,7.15,2.4,79.59,66
CDM,45800OH,CLOSURE RECTOVESICAL FISTULA,8124.0,5280.6,1.1,8124.0,144
CDM,45805OH,CLSR RECTOVESICAL FISTULA W/COLOSTOMY,9328.0,6063.2,1.1,9328.0,144
CDM,45820OH,CLOSURE RECTOURETHRAL FISTULA,8148.0,5296.2,1.1,8148.0,144
CDM,45825OH,CLOSURE RECTOURETHRAL FISTULA W/COLOSTOMY,9668.0,6284.2,1.1,9668.0,144
CDM,45900OH,RDCTJ PROCIDENTIA UNDER ANES SEPARATE PROCEDURE,1196.0,777.4,1.1,2666.13,144
CDM,45905OH,DILAT ANAL SPHNCTR SPX UNDER ANES OTH/THN LOCAL,940.0,611.0,1.1,3440.56,144
CDM,45910OH,DILAT RCT STRIX SPX UNDER ANES OTH/THN LOCAL,1140.0,741.0,1.1,3440.56,144
CDM,45915OH,RMVL FECAL IMPACTION/FB SPX UNDER ANES,1276.0,829.4,1.1,3440.56,148
CDM,45990OH,ANRCT XM SURG REQ ANES GENERAL SPI/EDRL DX,720.0,468.0,1.1,8188.18,144
CDM,45999NORVUOH,RECTUM SURGERY PROCEDURE UNLISTED,5300.0,3445.0,0.01,5300.0,84
CDM,45999RVU1OH,ESD RECTUM (COMP 45390),5300.0,3445.0,0.01,5300.0,84
CDM,45999RVU2OH,TRANSANAL RPR COLOANAL ANASTOMOSIS (COMP 45505),2397.0,1558.05,0.01,2666.13,84
CDM,45999RVU3OH,SECOND STAGE PULL-THROUGH(TURNBULL)PROCEDURE (COMP 45505),911.0,592.15,0.01,2666.13,84
CDM,45999RVU4OH,"ENDOVAC, RECTUM; COLONOSCOPY VIA STOMA (COMP 44388, 97605)",1217.0,791.05,0.01,2666.13,84
CDM,45999RVU5OH,"ENDOVAC, RECTUM; COLONOSCOPY (COMP 45378, 97605)",1639.0,1065.35,0.01,2666.13,84
CDM,45999RVU6OH,"ENDOVAC, RECTUM; FLEX-SIG (COMP 45330, 97605)",599.0,389.35,0.01,2666.13,84
CDM,45999RVU7OH,"OPEN REPAIR OF RECTAL FISTULA WO ANASTOMOSIS, TRANS-PERINEAL APP",6484.0,4214.6,0.01,6484.0,84
CDM,45999RVU8OH,REVISION/REDO POUCH AP APPROACH W/W/O STOMA (COMP 46712),13123.0,8529.95,0.01,13123.0,84
CDM,45999RVUOH,REV ILEOANAL RES W/W/O ST (COMP 45113),14000.0,9100.0,0.01,14000.0,84
CDM,46000000,NONINVASIVE EAR/PULSE OXIMETRY SINGLE DETER,348.0,226.2,3.47,348.0,68
CDM,46000010,SPMTRY W/VC EXPIRATORY FLO W/WO MXML VOL VNTJ,720.0,468.0,36.09,720.0,87
CDM,46000020,BRNCDILAT RSPSE SPMTRY PRE&POST-BRNCDILAT ADMN,1432.0,930.8,51.99,1432.0,87
CDM,46000025,BRNCSPSM PROVOCATION EVAL MLT SPMTRY W/ADMN AGT,1432.0,930.8,81.08,1432.0,87
CDM,46000030,NONINVASIVE EAR/PULSE OXIMETRY SINGLE DETER,348.0,226.2,3.47,348.0,68
CDM,46000035,VITAL CAPACITY TOTAL SEPARATE PROCEDURE,720.0,468.0,64.98,720.0,85
CDM,46000040,NONINVASIVE EAR/PULSE OXIMETRY MULTIPLE DETER,348.0,226.2,5.35,348.0,68
CDM,46000055,HIGH ALTITUDE SIMULATJ TEST W/PHYS INTERP&REPORT,593.0,385.45,64.98,593.0,87
CDM,46000060,NONINVASIVE EAR/PULSE OXIMETRY OVERNIGHT MONITOR,720.0,468.0,34.38,720.0,87
CDM,46000065,HIGH ALTITUDE SIMULATJ W/PHYS I&R W/O2 TITRATION,593.0,385.45,64.98,593.0,87
CDM,46000080,UNLSTD CAR SEAT STY,113.0,73.45,31.41,321.47,85
CDM,46000085,CARDIOPULMONARY EXERCISE TESTING,1432.0,930.8,127.97,1432.0,87
CDM,46000090,NITRIC OXIDE EXPIRED GAS DETERMINATION,118.0,76.7,26.5,118.0,87
CDM,46000095,MANJ CHEST WALL FACILITATE LUNG FUNCTION SUBSQ,593.0,385.45,54.59,593.0,87
CDM,46000100,O2 UPTK EXP GAS ALYS W/CO2 OUTPUT % O2 XTRC,1432.0,930.8,64.61,1432.0,87
CDM,46000110,PLETHYSMOGRAPHY LUNG VOLUMES W/WO AIRWAY RESIST,1432.0,930.8,75.23,1432.0,87
CDM,46000115,GAS DILUT/WASHOUT LUNG VOL W/WO DISTRIB VENT&V,720.0,468.0,59.54,720.0,87
CDM,46000120,AIRWAY RESISTANCE BY OSCILLOMETRY,720.0,468.0,59.07,720.0,87
CDM,46000125,CO DIFFUSING CAPACITY,605.0,393.25,64.98,605.0,68
CDM,46000145,NONINVASIVE EAR/PULSE OXIMETRY SINGLE DETER,348.0,226.2,3.47,348.0,68
CDM,46000155,CAR SEAT CHALLENGE,110.0,71.5,30.58,321.47,85
CDM,46000165,NONINVASIVE EAR/PULSE OXIMETRY MULTIPLE DETER,348.0,226.2,5.35,348.0,68
CDM,46000205,MAX BREATHING CAPACITY MAXIMAL VOLUNTARY VENTJ,273.0,177.45,20.02,273.0,87
CDM,46000215,INHLJ BRNCL CHALLENGE TSTG W/HISTAM/METHACHOL,1592.0,1034.8,48.76,1592.0,79
CDM,46000265,THERAPEUTIC PROCEDURES GROUP 2/> INDIVIDUALS,157.0,102.05,18.04,157.0,87
CDM,46000285,XERS TST BRNCSPSM PRE&POST SPMTRY&PLS OX W/ECG,593.0,385.45,64.98,593.0,87
CDM,46000295,PULMONARY STRESS TESTING,593.0,385.45,42.21,593.0,87
CDM,46001045,XERS TST BRNCSPSM PRE&POST SPMTRY&PLS OX WO /ECG,273.0,177.45,53.07,273.0,87
CDM,46001055,PATIENT-INITIATED SPIROMETRIC RECORDING,1432.0,930.8,44.82,1432.0,87
CDM,46001085,BREATHING RESPONSE TO HYPOXIA,720.0,468.0,64.98,720.0,87
CDM,46001095,"OXYGEN UPTAKE, EXPIRED GAS ANALYSIS; CO2 OUTPUT",1432.0,930.8,64.61,1432.0,87
CDM,46001125,RTM DEV SPLY DATA RESPIR SYS 2-15 DAYS IN 30D PD,263.0,170.95,35.31,263.0,69
CDM,46001135,PULMONARY FUNCTION TEST,60.0,39.0,13.08,60.0,58
CDM,46020OH,PLACEMENT OF SETON,818.0,531.7,1.1,8188.18,144
CDM,46030OH,REMOVAL ANAL SETON OTHER MARKER,592.0,384.8,1.1,3440.56,148
CDM,46040OH,I&D ISCHIORECTAL&/PERIRECTAL ABSCESS SPX,2148.0,1396.2,1.1,3440.56,148
CDM,46045OH,I&D INTRAMURAL IM/ABSC TRANSANAL ANES,2348.0,1526.2,1.1,8188.18,144
CDM,46050OH,"I/D PERIANAL ABSCESS, SUPERFICIAL",546.0,354.9,1.1,2666.13,148
CDM,46060OH,I&D ISCHIORCT/INTRAMURAL ABSC W/WO SETON,2548.0,1656.2,1.1,8188.18,144
CDM,46080OH,SPHINCTEROTOMY ANAL DIVISION SPHINCTER SPX,1008.0,655.2,1.1,8188.18,148
CDM,46083OH,INCISION THROMBOSED HEMORRHOID EXTERNAL,580.0,377.0,1.1,719.34,148
CDM,46200OH,FISSURECTOMY INCL SPHINCTEROTOMY WHEN PERFORMED,1436.0,933.4,1.1,8188.18,148
CDM,46220OH,EXCISION SINGLE EXTERNAL PAPILLA OR TAG ANUS,644.0,418.6,1.1,3440.56,148
CDM,46221OH,HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS,944.0,613.6,1.1,2666.13,148
CDM,46230OH,EXCISION MULTIPLE EXTERNAL PAPILLAE/TAGS ANUS,1048.0,681.2,1.1,8188.18,148
CDM,46250OH,HEMORRHOIDECTOMY XTRNL 2/> COLUMN/GROUP,1700.0,1105.0,1.1,8188.18,148
CDM,46255OH,HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP,1984.0,1289.6,1.1,8188.18,148
CDM,46255URVUOH,HEMORRHOIDECTOMY (COMP CODE 46255),627.0,407.55,1.1,8188.18,148
CDM,46257OH,HEMORRHOID NTRNL & XTRNL 1 COLUMN W/FISSURECTO,2304.0,1497.6,1.1,8188.18,144
CDM,46258OH,HRHC 1 COL/GRP W/FSTULECTMY INCL FSSRECTOMY,2564.0,1666.6,1.1,8188.18,144
CDM,46260OH,HEMORRHOIDECTOMY INT & XTRNL 2/> COLUMN/GRO,2692.0,1749.8,1.1,8188.18,144
CDM,46261OH,HRHC NTRNL & XTRNL 2/> COLUMN/GROUP W/FISSU,3104.0,2017.6,1.1,8188.18,144
CDM,46262OH,HRHC 2/> COL/GRP W/FSTULECTMY INCL FSSRECTMY,3164.0,2056.6,1.1,8188.18,144
CDM,46270OH,SURG TX ANAL FISTULA SUBQ,1968.0,1279.2,1.1,8188.18,148
CDM,46275OH,SURG TX ANAL FISTULA INTERSPHINCTERIC,2168.0,1409.2,1.1,8188.18,148
CDM,46280OH,TX ANAL FSTL TRANS/SUPRA/XTRASPHNCTRC INCL SETON,2556.0,1661.4,1.1,8188.18,144
CDM,46285OH,SURG TX ANAL FISTULA 2ND STAGE,2168.0,1409.2,1.1,8188.18,148
CDM,46288OH,CLSR ANAL FSTL W/RCT ADVMNT FLAP,3124.0,2030.6,1.1,8188.18,144
CDM,46320OH,EXC THROMBOSED HEMORRHOID XTRNL,656.0,426.4,1.1,3440.56,148
CDM,46500OH,INJECTION SCLEROSING SOLUTION HEMORRHOIDS,696.0,452.4,1.1,2666.13,148
CDM,46505OH,CHEMODENERVATION INTERNAL ANAL SPHINCTER,1272.0,826.8,1.1,3440.56,148
CDM,46600OH,ANOSCOPY DX W/COLLJ SPEC BR/WA SPX WHEN PRFRMD,242.0,157.3,1.1,402.04,148
CDM,46601OH,ANOSCOPY DX W/HRA &CHEM AGNTS ENHANCEMENT,640.0,416.0,1.1,640.0,136
CDM,46604OH,ANOSCOPY W/DILATION,412.0,267.8,1.1,3440.56,148
CDM,46606OH,ANOSCOPY W/BX SINGLE/MULTIPLE,528.0,343.2,1.1,3440.56,148
CDM,46607OH,ANOSCOPY DX W/HRA &CHEM AGNTS ENHANCEMENT W/BX,968.0,629.2,1.1,3440.56,136
CDM,46608OH,"ANOSCOPY,REMOVE FOREIGN BODY",520.0,338.0,1.1,2666.13,148
CDM,46610OH,ANOSCOPY W/RMVL LESION CAUTERY,512.0,332.8,1.1,8188.18,148
CDM,46611OH,ANOSC RMVL 1 TUM POLYP/OTH LES SNARE TQ,520.0,338.0,1.1,2666.13,148
CDM,46612OH,ANOSC RMVL MULT TUMORS CAUTERY/SNARE,600.0,390.0,1.1,8188.18,148
CDM,46614OH,"ANOSCOPY,CONTROL BLEEDING",400.0,260.0,1.1,3440.56,148
CDM,46615OH,"ANOSCOPY,ABLATE LESION",600.0,390.0,1.1,8188.18,148
CDM,46700OH,ANOPLASTY PLASTIC OPERATION STRICTURE ADULT,3924.0,2550.6,1.1,8188.18,144
CDM,46705OH,ANOPLASTY PLASTIC OPERATION STRICTURE INFANT,2972.0,1931.8,1.1,2972.0,144
CDM,46706OH,REPAIR ANAL FISTULA W/FIBRIN GLUE,976.0,634.4,1.1,8188.18,144
CDM,46707OH,RPR ANORECTAL FISTULA W/ PLUG,2556.0,1661.4,1.1,8188.18,144
CDM,46710OH,RPR ILEOANAL POUCH FSTL/POUCH ADVMNT TPRNL APPR,6856.0,4456.4,1.1,6856.0,144
CDM,46712OH,RPR ILEOANAL POUCH FSTL/POUCH ADVMNT CMBN APPR,14580.0,9477.0,1.1,14580.0,144
CDM,46715OH,RPR LW IMPERFORATE ANUS W/ANOPRNL FSTL CUT-BK,3048.0,1981.2,1.1,3048.0,144
CDM,46716OH,RPR LW IMPERFORATE ANUS W/TRPOS FISTULA,7016.0,4560.4,1.1,7016.0,144
CDM,46730OH,RPR HI IMPRF ANUS W/O FSTL PRNL/SACROPRNL APPR,12260.0,7969.0,1.1,12260.0,144
CDM,46735OH,RPR HI IMPRF ANUS W/O FISTULA CMBN APPR,14456.0,9396.4,1.1,14456.0,144
CDM,46740OH,RPR HI IMPRF ANUS W/FSTL PRNL/SACROPRNL APPR,13560.0,8814.0,1.1,13560.0,144
CDM,46742OH,RPR HI IMPRF ANUS W/FSTL TABDL & SACROPRNL,16056.0,10436.4,1.1,16056.0,144
CDM,46744OH,RPR CLOACAL ANOMALY SACROPERINEAL,23576.0,15324.4,1.1,23576.0,144
CDM,46746OH,RPR CLOACAL ANOMALY CMBN ABDL&SACROPRNL,26176.0,17014.4,1.1,26176.0,144
CDM,46750OH,SPHNCTROP ANAL INCONTINENCE/PROLAPSE ADULT,4860.0,3159.0,1.1,8188.18,144
CDM,46751OH,SPHNCTROP ANAL INCONTINENCE/PROLAPSE CHLD,3720.0,2418.0,1.1,3720.0,144
CDM,46753OH,GRAFT THIERSCH RCT INCONTINENCE &/PROLAPSE,3556.0,2311.4,1.1,8188.18,144
CDM,46754OH,RMVL THIERSCH WIRE/SUTURE ANAL CANAL,1204.0,782.6,1.1,8188.18,148
CDM,46760OH,SPHINCTEROPLASTY ANAL MUSCLE TRANSPLANT,6980.0,4537.0,1.1,8188.18,144
CDM,46761OH,SPHNCTROP ANAL LEVATOR MUSC IMBRCJ,6116.0,3975.4,1.1,8188.18,144
CDM,46900OH,DSTRJ LESION ANUS SIMPLE CHEMICAL,764.0,496.6,1.1,1163.18,148
CDM,46910OH,DSTRJ LESION ANUS SMPL ELTRDSICCATION,764.0,496.6,1.1,5320.02,148
CDM,46916OH,DSTRJ LESION ANUS SIMPLE CRYOSURGERY,764.0,496.6,1.1,882.76,148
CDM,46917OH,DSTRJ LESION ANUS SIMPLE LASER SURG,764.0,496.6,1.1,8188.18,148
CDM,46922OH,DSTRJ LESION ANUS SIMPLE SURG EXCISION,764.0,496.6,1.1,8188.18,148
CDM,46924OH,DSTRJ LESION ANUS EXTENSIVE,1124.0,730.6,1.1,8188.18,148
CDM,46930OH,DESTRUCTION INTERNAL HEMORRHOID THERMAL ENERGY,644.0,418.6,1.1,3440.56,148
CDM,46940OH,CURTG/CAUT ANAL FISSURE W/DILAT SPHNCTR SPX 1ST,940.0,611.0,1.1,8188.18,148
CDM,46942OH,CURTG/CAUT ANAL FISSURE W/DILAT SPHNCTR SPX SBSQ,828.0,538.2,1.1,2666.13,148
CDM,46945OH,INT HRHC BY LIGATION SINGLE HROID W/O IMG GDN,1476.0,959.4,1.1,8188.18,144
CDM,46946OH,INT HRHC BY LIGATION 2+ HROID W/O IMG GDN,1800.0,1170.0,1.1,8188.18,144
CDM,46947OH,HEMORRHOIDOPEXY BY STAPLING,2228.0,1448.2,1.1,8188.18,144
CDM,46948OH,INT HRHC TRANSANAL HROID DARTLZJ 2+ W/US GDN,2228.0,1448.2,1.1,8188.18,144
CDM,46999RVU10OH,"UNLIST PROC, ANUS COMPARED TO 45100",1333.0,866.45,0.01,2666.13,84
CDM,46999RVU11OH,POST OP CONTROL OF BLEEDING ANUS (COMP 46945),746.0,484.9,0.01,2666.13,84
CDM,46999RVU12OH,"UNLISTED PROC; TRANSANAL HEMORRHOIDAL DEARTERIALIZATION, SINGLE",1838.0,1194.7,0.01,2666.13,84
CDM,46999RVU13OH,SUBMUCOSAL ANAL INJECTION FOR INFLAMMATION/PAIN (COMP CODE 46505,1367.0,888.55,0.01,2666.13,84
CDM,46999RVU14OH,"REPAIR, CLOSURE OF ANAL FISTULA-OTHER THAN GLUE (COMP 46706)",1049.0,681.85,0.01,2666.13,84
CDM,46999RVU15OH,"HEMORRHOIDECTOMY, EXTERNAL, SINGLE COLUMN (COMP 46255)",1786.0,1160.9,0.01,2666.13,84
CDM,46999RVU16OH,POST OP CONTROL OF BLEEDING-ANUS (COMP CODE 46614),361.0,234.65,0.01,2666.13,84
CDM,46999RVU17OH,EXPLANATION OF ARTIFICIAL BOWEL SPHINCTER (COMP 53446),3968.0,2579.2,0.01,3968.0,84
CDM,46999RVU18OH,"ANOSCOPY W/SUBMUCOSAL INJECTION, ANY SUBSTANCE (COMP 45381)",1566.0,1017.9,0.01,2666.13,84
CDM,46999RVU19OH,LAP ASSISTED CLOACA REPAIR (COMP 46748),27852.0,18103.8,0.01,27852.0,84
CDM,46999RVU1OH,POST OP CONTROL OF BLEEDING,781.0,507.65,0.01,2666.13,84
CDM,46999RVU2OH,"INJECTION ANAL MUCOSA, SOLESTA",1049.0,681.85,0.01,2666.13,84
CDM,46999RVU3OH,"HEMORROIDECTOMY, EXTERNAL, SINGLE (COMP CODE 46220)",1402.0,911.3,0.01,2666.13,84
CDM,46999RVU4OH,ANUSECTOMY,2599.0,1689.35,0.01,2666.13,84
CDM,46999RVU5OH,MUCOSCETOMY,2683.0,1743.95,0.01,2683.0,84
CDM,46999RVU7OH,REPAIR OF ENTEROANAL FIST,5634.0,3662.1,0.01,5634.0,84
CDM,46999RVU9OH,"UNLIST PROC, ANUS COMPARED TO 46947",1838.0,1194.7,0.01,2666.13,84
CDM,46999RVUOH,ANAL BIOPSY (COMP 45100),363.0,235.95,0.01,2666.13,84
CDM,47000030,ANALYSIS COCHLEAR IMPLT PT <7 YR PRGRMG,626.0,406.9,22.84,626.0,86
CDM,47000035,ANALYSIS COCHLEAR IMPLT PT <7 YR SBSQ REPRGRMG,626.0,406.9,22.84,626.0,86
CDM,47000040,ANALYSIS COCHLEAR IMPLT 7 YR/> PRGRMG,626.0,406.9,22.84,626.0,86
CDM,47000045,ANALYSIS COCHLEAR IMPLT 7 YR/> SBSQ REPRGRMG,626.0,406.9,22.84,626.0,86
CDM,47000255,AUDIOMETRY EVAL & SPEECH RECOG,626.0,406.9,35.94,626.0,86
CDM,47000275,TYMPANOMETRY,157.0,102.05,11.98,157.0,86
CDM,47000355,"DISPENSING FEE, MONAURAL HEARING AID, ANY TYPE",300.0,195.0,40.0,300.0,66
CDM,47000365,"DISPENSING FEE, BINAURAL",300.0,195.0,40.0,300.0,66
CDM,47000375,"DISPENSING FEE, CONTRALATERAL, MONAURAL",300.0,195.0,40.0,300.0,66
CDM,47000385,"DISPENSING FEE, CONTRALATERAL ROUTING SYSTEM, BINAURAL",300.0,195.0,40.0,300.0,66
CDM,47000395,"FITTING FEE, HAT",108.0,70.2,22.7,124.64,84
CDM,47000405,BONE CONDUCTION DEVICE EVAL,108.0,70.2,22.7,124.64,84
CDM,47000415,BONE CONDUCTION FITTING FEE,540.0,351.0,22.7,540.0,84
CDM,47000425,BONE CONDUCTION CHECK,108.0,70.2,22.7,124.64,84
CDM,47000535,SPONTANEOUS NYSTAGMUS STUDY,1048.0,681.2,40.0,1048.0,66
CDM,47000545,EVALUATION HEARING AID CANDIDACY 1ST 30 MINUTES,313.0,203.45,40.0,313.0,66
CDM,47000555,EVALUATION HEARING AID CANDIDACY EA ADDL 15 MIN,157.0,102.05,34.23,157.0,66
CDM,47000565,HEARING AID SELECTION SERVICES 1ST 30 MINUTES,313.0,203.45,40.0,313.0,66
CDM,47000575,HEARING AID SELECTION SERVICES EA ADDL 15 MIN,157.0,102.05,34.23,157.0,66
CDM,47000585,HEARING AID FITTING SERVICES 1ST 60 MINUTES,626.0,406.9,40.0,626.0,66
CDM,47000595,HEARING AID FITTING SERVICES EA ADDL 15 MINUTES,157.0,102.05,34.23,157.0,66
CDM,47000605,HEARING AID POST-FITTING F-UP SVC 1ST 30 MINUTES,313.0,203.45,40.0,313.0,66
CDM,47000615,HEARING AID POST-FITTING F-UP SVC EA ADDL 15 MIN,157.0,102.05,34.23,157.0,66
CDM,47000625,BEHAVIORAL VERIFICATION OF AMPLIFICATION,626.0,406.9,40.0,626.0,66
CDM,47000635,HEARING AID MEAS VERIF W/PROBE MICROPHONE,626.0,406.9,40.0,626.0,66
CDM,47000645,HEARING DEVICE VERIFICATION ELECTROACOUSTIC ALYS,626.0,406.9,40.0,626.0,66
CDM,47000655,HEARING ASSISTIVE DEVICE SUPPL TECH FITTING SVC,626.0,406.9,40.0,626.0,66
CDM,47000OH,BIOPSY LIVER NEEDLE PERCUTANEOUS,660.0,429.0,1.1,4729.25,148
CDM,47001OH,BX LVR NDL DONE PURPOSE TM OTH MAJOR PX,836.0,543.4,1.1,836.0,144
CDM,47010OH,HEPATOTOMY OPEN DRAINAGE ABSCESS/CYST 1/2 STAGES,7760.0,5044.0,1.1,7760.0,144
CDM,47015OH,LAPT W/ASPIR &/NJX HEPATC PARASITIC CYST/ABSCESS,7400.0,4810.0,1.1,7400.0,144
CDM,47100000,BINOCULAR MICROSCOPY SEPARATE DX PROCEDURE,93.0,60.45,10.63,93.0,68
CDM,47100015,SPONTANEOUS NYSTAGMUS TEST,516.0,335.4,31.65,516.0,86
CDM,47100020,POSITIONAL NYSTAGMUS TEST,516.0,335.4,36.71,516.0,86
CDM,47100035,OPTOKINETIC NYSTAGMUS TEST,720.0,468.0,22.14,720.0,86
CDM,47100040,OSCILLATING TRACKING TEST,1432.0,930.8,20.81,1432.0,86
CDM,47100045,SINUSOIDAL VERTICAL AXIS ROTATIONAL TESTING,720.0,468.0,121.73,720.0,86
CDM,47100060,TYMP & REFLEX THRESH,626.0,406.9,27.65,626.0,86
CDM,47100065,SCREENING TEST PURE TONE AIR ONLY,64.0,41.6,13.95,64.0,66
CDM,47100070,AUDIOMETRY THRESHOLD TEST,516.0,335.4,40.0,516.0,86
CDM,47100075,AUDIOMETRY AIR AND BONE,626.0,406.9,64.56,626.0,86
CDM,47100080,SPEECH AUDIOMETRY THRESHOLD,238.0,154.7,40.0,238.0,86
CDM,47100085,SPEECH RECEPTION THRESHOLD,238.0,154.7,40.0,238.0,86
CDM,47100090,COMPRE AUDIOMETRY THRESHOLD EVAL SP RECOGNIJ,626.0,406.9,35.94,626.0,86
CDM,47100100,STENGER TEST PURE TONE,238.0,154.7,29.32,238.0,86
CDM,47100105,TYMPANOMETRY,157.0,102.05,11.98,157.0,86
CDM,47100115,ACOUSTIC IMMIT TEST TYMPANOM/ACOUST REFLX/DECAY,626.0,406.9,33.08,626.0,86
CDM,47100135,VISUAL REINFORCEMENT AUDIOMETRY,626.0,406.9,41.37,626.0,86
CDM,47100140,AUDIOMETRY CONDITION PLAY,626.0,406.9,121.73,626.0,86
CDM,47100145,SELECT PICTURE AUDIOMETRY,238.0,154.7,40.0,238.0,86
CDM,47100150,ELECTROCOCHLEOGRAPHY,626.0,406.9,121.73,626.0,86
CDM,47100155,TEST EVOKED AUDITORY LTD,1246.0,809.9,27.14,1246.0,86
CDM,47100160,TEST EVOKED AUDITORY COMPR,1246.0,809.9,42.27,1246.0,86
CDM,47100175,EVAL AUD REHAB STATUS,626.0,406.9,70.74,626.0,86
CDM,47100180,EVAL AUD FUNCJ CAND/PO SURG IMPLT DEV EA ADDL 15,76.0,49.4,16.57,81.91,68
CDM,47100185,PROC ENT UNLISTD 471,11.0,7.15,3.06,124.64,84
CDM,47100200,BASIC VESTIBULAR EVAL,626.0,406.9,132.51,626.0,86
CDM,47100205,CALORIC VEST TEST BITHERMAL,626.0,406.9,50.03,626.0,86
CDM,47100215,CALORIC VEST TEST MONOTHERMAL,626.0,406.9,27.49,626.0,86
CDM,47100225,TONE DECAY TEST,157.0,102.05,34.79,157.0,86
CDM,47100235,ACOUSTIC REFLEX THRESHOLD,157.0,102.05,17.56,157.0,86
CDM,47100245,STENGER TEST SPEECH,2122.0,1379.3,30.73,2122.0,86
CDM,47100255,CANALITH REPOSITIONING PROCEDURE,240.0,156.0,41.92,240.0,85
CDM,47100295,BRIEF SPEECH SCREEN EVAL,319.0,207.35,22.7,319.0,84
CDM,47100325,VIDEO HEAD IMPULSE TEST,319.0,207.35,22.7,319.0,84
CDM,47100335,DYNAMIC VISUAL ACUITY TESTING,319.0,207.35,22.7,319.0,84
CDM,47100345,MODF CLINICAL TEST SENS INTERACTION BALANCE,625.0,406.25,22.7,625.0,84
CDM,47100355,EVOKED OTOACOUSTIC EMISSIONS SCREEN AUTO ANALYS,186.0,120.9,40.0,186.0,66
CDM,47100485,FISTULA,170.0,110.5,22.7,170.0,84
CDM,47100495,VEMP,268.0,174.2,22.7,268.0,84
CDM,47100505,NECK NYSTAGMUS TEST,170.0,110.5,22.7,170.0,84
CDM,47100545,TESTING VHIT & MCTSIB,944.0,613.6,22.7,944.0,84
CDM,47100555,"TESTING VHIT,DVAT,MCTSIB",1263.0,820.95,22.7,1263.0,84
CDM,47100565,TESTING VHIT & DVAT,637.0,414.05,22.7,637.0,84
CDM,47100575,"TESTING VEMP,VHIT,MCTSIB",1212.0,787.8,22.7,1212.0,84
CDM,47100585,"TESTING VEMP,VHIT,DVAT,MCTSIB",1530.0,994.5,22.7,1530.0,84
CDM,47100595,TESTING VEMP & VHIT,586.0,380.9,22.7,586.0,84
CDM,47100605,TESTING VEMP & MCTSIB,893.0,580.45,22.7,893.0,84
CDM,47100615,CDP-SOT 6 CONDITIONS W/INTERPRETATION & REPORT,593.0,385.45,58.62,593.0,86
CDM,47100625,CDP-SOT 6 CONDITIONS W/I&R W/MCT & ADT,593.0,385.45,80.04,593.0,86
CDM,47100635,CERVICAL VEMP TESTING W/I&R,626.0,406.9,46.92,626.0,86
CDM,47100645,OCULAR VEMP TESTING W/I&R,626.0,406.9,47.64,626.0,86
CDM,47100655,CERVICAL & OCULAR VEMP TESTING W/I&R,1246.0,809.9,70.91,1246.0,86
CDM,47100665,AEP SCR AUDITORY POTENTIAL W/STIMULI AUTO ALYS,631.0,410.15,40.0,631.0,66
CDM,47100675,AEP HEARING STATUS DETER BROADBAND STIMULI I&R,1246.0,809.9,103.52,1246.0,86
CDM,47100685,AEP THRESHOLD ESTIMATION MLT FREQUENCIES I&R,1246.0,809.9,134.62,1246.0,86
CDM,47100695,AEP NEURODIAGNOSTIC INTERPRETATION AND REPORT,1246.0,809.9,102.77,1246.0,86
CDM,47100705,SPEECH IN NOISE TEST (COMP 92556),64.0,41.6,17.79,124.64,84
CDM,47100715,"BAI / OSSEO HRG DEVICE ANALYSIS, PROGRAM & VERIFICATION, 1ST 6OM",626.0,406.9,22.84,626.0,86
CDM,47100725,"BAI / OSSEO HRG DEVICE ANALYSIS, PROGRAM & VERIFICATION, EACH AD",156.0,101.4,19.73,156.0,68
CDM,47100OH,WEDGE BIOPSY OF LIVER,5164.0,3356.6,1.1,5164.0,144
CDM,47120OH,HEPATECTOMY RESCJ PARTIAL LOBECTOMY,15604.0,10142.6,1.1,15604.0,144
CDM,47122OH,HEPATECTOMY RESCJ TRISEGMENTECTOMY,23792.0,15464.8,1.1,23792.0,144
CDM,47125OH,HEPATECTOMY RESCJ TOTAL LEFT LOBECTOMY,21216.0,13790.4,1.1,21216.0,144
CDM,47130OH,HEPATECTOMY RESCJ TOTAL RIGHT LOBECTOMY,22876.0,14869.4,1.1,22876.0,144
CDM,47133OH,DONOR HEPATECTOMY CADAVER DONOR,15830.0,10289.5,1.1,15830.0,82
CDM,47135OH,LVR ALTRNSPLJ ORTHOTOPIC PRTL/WHL DON ANY AGE,39600.0,25740.0,1.1,39600.0,144
CDM,47140OH,DONOR HEPATECTOMY LIVING DONOR SEG II & III,23760.0,15444.0,1.1,23760.0,142
CDM,47141OH,DONOR HEPATECTOMY LIVING DONOR SEG II III & IV,28600.0,18590.0,1.1,28600.0,142
CDM,47142OH,DONOR HEPATECTOMY LIVING DONOR SEG V VI VII &VI,31776.0,20654.4,1.1,31776.0,142
CDM,47143OH,BKBENCH PREP CADAVER DONOR,2673.0,1737.45,1.1,2673.0,104
CDM,47144OH,BKBENCH PREPJ CADAVER WHOLE LIVER GRF I&IV VII,2875.0,1868.75,1.1,2875.0,104
CDM,47145OH,BKBENCH PREPJ CADAVER DONOR WHL LVR GRF I&V VI,3046.0,1979.9,1.1,3046.0,104
CDM,47146OH,BKBENCH RCNSTJ LVR GRF VENOUS ANAST EA,2400.0,1560.0,1.1,2400.0,142
CDM,47147OH,BKBENCH RCNSTJ LVR GRF ARTL ANAST EA,2800.0,1820.0,1.1,2800.0,142
CDM,47200000,AUDITORY REHABILITATION PRELINGUAL HEARING LOSS,268.0,174.2,31.09,268.0,66
CDM,47200005,AUDITORY REHABILITATION POSTLINGUAL HEARING LOSS,329.0,213.85,31.09,329.0,66
CDM,47300OH,MARSUPIALIZE LIVER CYST/ABSCESS,7256.0,4716.4,1.1,7256.0,144
CDM,47350OH,MGMT LVR HEMRRG SMPL SUTR LVR WND/INJ,8996.0,5847.4,1.1,8996.0,144
CDM,47360OH,MGMT LVR HEMRRG CPLX SUTR WND/INJ,12524.0,8140.6,1.1,12524.0,144
CDM,47361OH,MGMT LVR HEMRRG EXPL WND DBRDMT COAGJ/SUTR,21040.0,13676.0,1.1,21040.0,144
CDM,47362OH,MGMT LVR HEMRRG RE-EXPL WND RMVL PACKING,9416.0,6120.4,1.1,9416.0,144
CDM,47370OH,LAPS SURG ABLTJ 1/> LVR TUM RF,8320.0,5408.0,1.1,30022.29,144
CDM,47371OH,LAPS SURG ABLTJ 1 > LVR TUM CRYOSURG,8320.0,5408.0,1.1,30022.29,144
CDM,47379AGRVU1OH,"UNLISTED LAPAROSCOPIC PROCEDURE, LIVER (COMPARISON CODE 47120)",5610.0,3646.5,0.01,16829.38,84
CDM,47379RVU10OH,"UNLISTED LAPAROSCOPIC PROCEDURE, LIVER (COMPARISON CODE 47100)",4260.0,2769.0,0.01,16829.38,84
CDM,47379RVU11OH,"UNLISTED LAPAROSCOPIC PROCEDURE, LIVER (COMPARISON CODE 47001)",312.0,202.8,0.01,16829.38,84
CDM,47379RVU12OH,"UNLISTED LAPAROSCOPIC PROCEDURE, LIVER (COMPARISON CODE 47000)",310.0,201.5,0.01,16829.38,84
CDM,47379RVU13OH,LAP LT LOBECTOMY LIVER (COMP 47125),22197.0,14428.05,0.01,22197.0,84
CDM,47379RVU14OH,LAP EXCISION LIVER CYST (COMP 47010),6057.0,3937.05,0.01,16829.38,84
CDM,47379RVU15OH,LAP. DONOR HEPATECTOMY -LEFT LIVING DONOR SEG II III & IV (COMP,47190.0,30673.5,0.01,47190.0,84
CDM,47379RVU16OH,"LAP DONOR HEPATECTOMY - RIGHT LIVING DONOR SEG V, VI, VII & VIII",52502.0,34126.3,0.01,52502.0,84
CDM,47379RVU17OH,LAPAROSCOPIC PARTIAL HEPATIC LOBECTOMY W/ PARTIAL HEPATIC LOBECT,12873.0,8367.45,0.01,16829.38,84
CDM,47379RVU18OH,SURGERY PERFORMED LAPAROSCOPY TOTAL RIGHT HEPATIC LOBECTOMY (COM,20760.0,13494.0,0.01,20760.0,84
CDM,47379RVU19OH,LAPRO DONOR HEPATECTOMY LIVING DONOR LT SEG II & III (47140),25542.0,16602.3,0.01,25542.0,84
CDM,47379RVU1OH,LAPAROSCOPIC LIVER BIOPSY (COMP 47001),2765.0,1797.25,0.01,16829.38,84
CDM,47379RVU20OH,LAPAROSCOPIC POSTOPERATIVE LIVER HEMORRHAGE(COMP CODE 47361),22618.0,14701.7,0.01,22618.0,84
CDM,47379RVU2OH,LAP MARSUPIALIZATION HEPATIC CYST (COMP CODE 47300),5333.0,3466.45,0.01,16829.38,84
CDM,47379RVU3OH,LAPAROSCOPIC EXC. OF CYSTIC LIVER LESION,6244.0,4058.6,0.01,16829.38,84
CDM,47379RVU4OH,"LAPAROSCOPE PROCEDURE, LI",9979.0,6486.35,0.01,16829.38,84
CDM,47379RVU5OH,LAP RT LOBECTOMY LIVER,22197.0,14428.05,0.01,22197.0,84
CDM,47379RVU7OH,"UNLISTED LAPAROSCOPIC PROCEDURE, LIVER (COMPARISON CODE 47010)",6402.0,4161.3,0.01,16829.38,84
CDM,47379RVUOH,LAP UNROOFING OF LIVER CYST(S),1159.0,753.35,0.01,16829.38,84
CDM,47380OH,ABLTJ OPN 1/> LVR TUM RF,9824.0,6385.6,1.1,9824.0,144
CDM,47382OH,ABLTJ 1/> LVR TUM PRQ RF,5988.0,3892.2,1.1,16829.38,148
CDM,47383OH,ABLATION 1/> LIVER TUMOR PERQ CRYOABLATION,3552.0,2308.8,1.1,30022.29,148
CDM,47384OH,ABLATION IRE LIVER 1+ TUMORS W/IMG GDN PERQ,3045.0,1979.25,1.1,3045.0,106
CDM,47399RVU1OH,DESTRUCTION/FULGURATION LIVER LESION(S) (COMP 44005),6718.0,4366.7,0.01,6718.0,84
CDM,47399RVU2OH,EXC OF HEPATIC HEMANGIOMA,9705.0,6308.25,0.01,9705.0,84
CDM,47399RVU3OH,MARS THERAPY (COMP 90945),511.0,332.15,0.01,2050.87,84
CDM,47399RVU4OH,FLUSHING OF LIVER IN SITU (COMP 47146),2400.0,1560.0,0.01,2400.0,84
CDM,47399RVUOH,EXC HEPATIC LESION,4260.0,2769.0,0.01,4260.0,84
CDM,47400OH,HEPATCOTOMY/HEPATCOSTOMY W/EXPL DRG/RMVL ST1,14544.0,9453.6,1.1,14544.0,144
CDM,47420OH,CHOLEDOCHOT/OST W/O SPHNCTROTOMY/SPHNCTROP,9693.0,6300.45,1.1,9693.0,144
CDM,47425OH,CHOLEDOCHOT/OST W/SPHNCTROTOMY/SPHNCTROP,8924.0,5800.6,1.1,8924.0,144
CDM,47460OH,TRANSDUOL SPHINCTEROT/PLASTY W/WO RMVL CALCULUS,8208.0,5335.2,1.1,8208.0,144
CDM,47480OH,CHOLECSTOT/CHOLECSTOST W/EXPL DRG/RMVL ST1 SPX,5300.0,3445.0,1.1,5300.0,144
CDM,47490OH,CHOLECYSTOSTOMY PRQ W/IMAGING & CATHETER PLMT,2094.0,1361.1,1.1,10089.06,144
CDM,47531OH,NJX CHOLANGIO PRQ W/IMG GID RS&I EXISTING ACCESS,572.0,371.8,1.1,10089.06,148
CDM,47532OH,NJX CHOLANGIO PRQ W/IMG GID RS&I NEW ACCESS,1870.0,1215.5,1.1,10089.06,148
CDM,47533OH,PRQ PLMT BILIARY DRG CATH W/IMG GID RS&I EXTERNL,2367.0,1538.55,1.1,10089.06,148
CDM,47534OH,PRQ PLMT BILIARY DRG CATH W/IMG GID RS&I INT-EXT,3344.0,2173.6,1.1,10089.06,148
CDM,47535OH,CONV EXT BIL DRG CATH TO INT-EXT BIL DRG CATH,1738.0,1129.7,1.1,10089.06,148
CDM,47536OH,EXCHANGE BILIARY DRG CATHETER PRQ W/IMG GID RS&I,1148.0,746.2,1.1,10089.06,148
CDM,47537OH,REMOVAL BILIARY DRG CATHETER REQ FLUOR GID RS&I,810.0,526.5,1.1,2644.7,148
CDM,47538OH,PLMT BILE DUCT STENT PRQ EXISTING ACCESS,2090.0,1358.5,1.1,16829.38,148
CDM,47539OH,PLMT BILE DUCT STENT PRQ NEW ACCESS W/O SEP CATH,3500.0,2275.0,1.1,16829.38,148
CDM,47540OH,PLMT BILE DUCT STENT PRQ NEW ACCESS W/SEP CATH,3612.0,2347.8,1.1,16829.38,148
CDM,47541OH,PLMT ACCESS THRU BILIARY TREE INTO SMALL BWL NEW,2700.0,1755.0,1.1,22063.69,148
CDM,47542OH,BALLOON DILAT BILIARY DUCT/AMPULLA PRQ EACH DUCT,1140.0,741.0,1.1,1686.44,148
CDM,47543OH,ENDOLUMINAL BX BILIARY TREE PRQ ANY METH SNG/MLT,1200.0,780.0,1.1,1332.14,148
CDM,47544OH,REMOVAL BILIARY DUCT &/GLBLDR CALCULI PERQ RS&I,1443.0,937.95,1.1,2813.77,148
CDM,47550OH,BILIARY NDSC INTRAOPERATIVE,1208.0,785.2,1.1,1208.0,144
CDM,47552OH,BILIARY ENDO PRQ T-TUBE DX W/COLLECT SPEC BRUSH,2412.0,1567.8,1.1,22063.69,144
CDM,47553OH,BILIARY NDSC PRQ T-TUBE W/BX SINGLE/MULTIPLE,2536.0,1648.4,1.1,22063.69,144
CDM,47554OH,BILIARY ENDOSCOPY PRQ VIA T-TUBE W/RMVL CALCULUS,3620.0,2353.0,1.1,30022.29,144
CDM,47555OH,BILIARY NDSC PRQ T-TUBE W/DIL DUCT W/O STENT,3020.0,1963.0,1.1,10089.06,144
CDM,47556OH,BILIARY NDSC PRQ T-TUBE DILAT STRIX W/STENT,3420.0,2223.0,1.1,30022.29,144
CDM,47562OH,LAPAROSCOPY SURG CHOLECYSTECTOMY,4188.0,2722.2,1.1,16829.38,144
CDM,47563OH,LAPS SURG CHOLECYSTECTOMY W/CHOLANGIOGRAPHY,4588.0,2982.2,1.1,16829.38,144
CDM,47564OH,LAPS SURG CHOLECSTC W/EXPL COMMON DUCT,7200.0,4680.0,1.1,30022.29,144
CDM,47570OH,LAPAROSCOPY SURG CHOLECYSTOENETEROSTOMY,5024.0,3265.6,1.1,5024.0,144
CDM,47579AOH,LAPAROSCOPIC CHOLEYSTOSTOMY TUBE PLACEMENT,4373.0,2842.45,0.01,16829.38,84
CDM,47579RVU1OH,"UNLISTED PROC, LAP COMMON BILE DUCT EXPLORATION (COMP CODE 47420",7270.0,4725.5,0.01,16829.38,84
CDM,47579RVU3OH,UNLISTED PROC; LAP REPAIR OF COMMON BILE DUCT INJURY. (COMP TO 4,8146.0,5294.9,0.01,16829.38,84
CDM,47579RVU7OH,LAP RESECTION OF CHOLEDOCHAL CYST (COMP CODE 47715),9159.0,5953.35,1.1,9159.0,144
CDM,47579RVU8OH,LAP PORTOENTEROSTOMY (COMP CODE 47701),11492.0,7469.8,0.01,16829.38,84
CDM,47579RVUOH,LAP RESECTION EXTRA BILE DUCT,6070.0,3945.5,0.01,16829.38,84
CDM,47600OH,CHOLECYSTECTOMY,6992.0,4544.8,1.1,6992.0,144
CDM,47605OH,CHOLECYSTECTOMY W/CHOLANGIOGRAPHY,7392.0,4804.8,1.1,7392.0,144
CDM,47610OH,CHOLECYSTECTOMY W/EXPLORATION COMMON DUCT,8368.0,5439.2,1.1,8368.0,144
CDM,47612OH,CHOLECYSTECTOMY EXPL DUCT CHOLEDOCHOENTEROSTOMY,8484.0,5514.6,1.1,8484.0,144
CDM,47620OH,CHOLECSTC EXPL DUX SPHNCTROTOMY/SPHNCTROP,9228.0,5998.2,1.1,9228.0,144
CDM,47700OH,EXPLOR CONG ATRESIA BILE DUCTS,6600.0,4290.0,1.1,6600.0,144
CDM,47701OH,PORTOENETEROSTOMY,11492.0,7469.8,1.1,11492.0,144
CDM,47711OH,EXC BILE DUX TUM W/WO PRIM RPR XTRHEPATC,10360.0,6734.0,1.1,10360.0,144
CDM,47712OH,EXC BILE DUX TUM W/WO PRIM RPR INTRAHEPATC,13488.0,8767.2,1.1,13488.0,144
CDM,47715OH,EXCISION OF CHOLEDOCHAL CYST,8620.0,5603.0,1.1,8620.0,144
CDM,47720OH,CHOLECYSTOENTEROSTOMY; DIRECT,7336.0,4768.4,1.1,7336.0,144
CDM,47740OH,CHOLECYSTOENTEROSTOMY+ROUX-EN-Y,8492.0,5519.8,1.1,8492.0,144
CDM,47741OH,CHOLECYSTOENTER+ROUX-EN-Y+GASTROENT,9684.0,6294.6,1.1,9684.0,144
CDM,47760OH,ANAST EXTRAHEP DUCT TO GI TRACT,15328.0,9963.2,1.1,15328.0,144
CDM,47765OH,ANAST INTRAHEP DUCT TO GI TRACT,20876.0,13569.4,1.1,20876.0,144
CDM,47780OH,"ANAST,ROUX-EN-Y,EXTRAHEP TO GI TRCT",16928.0,11003.2,1.1,16928.0,144
CDM,47785OH,"ANAST,ROUX-EN-Y,INTRAHEP TO GI TRCT",22476.0,14609.4,1.1,22476.0,144
CDM,47800OH,RCNSTJ PLSTC BILIARY DUCTS W/END-TO-END ANAST,10468.0,6804.2,1.1,10468.0,144
CDM,47801OH,PLACEMENT CHOLEDOCHAL STENT,7040.0,4576.0,1.1,7040.0,144
CDM,47900445,SHARED ACUPUNT MED APPT (COMP 9800346),50.0,32.5,10.9,79.59,66
CDM,47900455,TAI CHI (COMP 9800833),75.0,48.75,16.35,79.59,66
CDM,47900465,WELLNESS YOGA - (GROUP) (COMP 9800929),10.0,6.5,2.18,79.59,66
CDM,47900475,WELLNESS YOGA EHP (COMP 9800939),30.0,19.5,6.54,79.59,66
CDM,47900485,CHAIR MASSAGE (OH),25.0,16.25,5.45,79.59,66
CDM,47900OH,SUTURE EXTRAHEPATIC BILE DUCT PRE-EXIST INJURY,8976.0,5834.4,1.1,8976.0,144
CDM,47999RVU1OH,BILIARY FISTULA TRACT CLOSURE,2492.0,1619.8,0.01,2644.7,84
CDM,47999RVU2OH,BILE DUCT RECONSTRUCTION (COMP CODE 47760),16477.0,10710.05,0.01,16477.0,84
CDM,47999RVU3OH,REVISION BILIARY ANAST,12646.0,8219.9,0.01,12646.0,84
CDM,47999RVU5OH,"UNLISTED PROCEDURE, BILIARY TRACT (COMPARISON CODE 47900)",9537.0,6199.05,0.01,9537.0,84
CDM,47999RVU6OH,T TUBE PLACEMENT OPEN (COMP 47900),5521.0,3588.65,0.01,5521.0,84
CDM,47999RVU7OH,ERCP W/CONTROL OF BLEED (COMP CODE 44378),2278.0,1480.7,0.01,2644.7,84
CDM,47999RVU8OH,ERCP W/ SUBMUCOSAL INJECTION (TATTOOING) (COMP 43236),1028.0,668.2,0.01,2644.7,84
CDM,47999RVU9OH,RF ABLATION BILIARY TRACT (COMP CODE 47556),3079.0,2001.35,0.01,3079.0,84
CDM,48000050,PRGRMG DEV EVAL 1 LEAD PM/LDLS PM 1 CAR CHMBR IP,214.0,139.1,22.84,214.0,87
CDM,48000055,PRQ TRLUML CORONARY ANGIOPLASTY ONE ART/BRANCH,32784.0,21309.6,497.76,32784.0,87
CDM,48000060,PROGRAM EVAL IMPLANTABLE IN PERSN DUAL LD PACER,214.0,139.1,22.84,214.0,87
CDM,48000065,PRQ TRLUML CORONARY ANGIO/ATHERECT ONE ART/BRNCH,30204.0,19632.6,603.68,30204.0,87
CDM,48000070,PROGRAM EVAL IMPLANTABLE IN PRSN MULTI LD PACER,214.0,139.1,22.84,214.0,87
CDM,48000080,PRGRMNG DEV EVAL IMPLANTABLE IN PERSN 1 LD DFB,214.0,139.1,22.84,214.0,87
CDM,48000085,PRQ TRLUML CORONRY STENT/ATH/ANGIO ONE ART/BRNCH,45214.0,29389.1,711.68,45214.0,86
CDM,48000090,PRGRMG EVAL IMPLANTABLE IN PRSN DUAL LEAD DFB,214.0,139.1,22.84,214.0,87
CDM,48000100,PRGRMG EVAL IMPLANTABLE IN PERSON MULTI LEAD DFB,214.0,139.1,22.84,214.0,87
CDM,48000110,PRGRMG DEV EVAL SCRMS PHYS/QHP IN PERSON,214.0,139.1,22.84,214.0,87
CDM,48000120,INTERROG DEV EVAL PM/LDLS PM PHYS/QHP IN PERSON,214.0,139.1,22.84,214.0,87
CDM,48000130,INTERROG EVAL F2F 1/DUAL/MLT LEADS IMPLTBL DFB,214.0,139.1,22.84,214.0,87
CDM,48000145,PERI-PX DEV EVAL PM/LDLS PM PHYS/QHP IN PERSON,302.0,196.3,22.84,302.0,68
CDM,48000150,INTERROG DEV EVAL SCRMS PHYS/QHP IN PERSON,141.0,91.65,22.7,141.0,87
CDM,48000155,PERI-PX DEV EVAL & PROG SING/DUAL/MULTI LEAD DFB,339.0,220.35,22.84,339.0,68
CDM,48000165,INTERROG DEV EVAL ICPMS PHYS/QHP IN PERSON,214.0,139.1,22.84,214.0,87
CDM,48000170,ECHO TRANSTHORC R-T 2D W/WO M-MODE REC F-UP/LMTD,1390.0,903.5,132.12,1390.0,87
CDM,48000175,TRANSTELEPHONIC RHYTHM STRIP PACEMAKER EVAL,214.0,139.1,22.84,214.0,87
CDM,48000185,REM INTERROG PM/LDLS PM/IDS <90 D TECH REVIEW,214.0,139.1,22.84,214.0,87
CDM,48000205,ECHO TRANSESOPHAG R-T 2D W/PRB IMG ACQUISJ I&R,3153.0,2049.45,303.35,3153.0,87
CDM,48000240,BUNDLE OF HIS RECORDING,20747.0,13485.55,1560.06,20747.0,85
CDM,48000245,ECHO TTHRC R-T 2D W/WO M-MODE REST&STRS CONT ECG,3153.0,2049.45,304.97,3153.0,87
CDM,48000250,INTRA-VENTRIC&/ATRIAL MAPG TACHYCARD W/CATH MA,5963.0,3875.95,1299.93,14036.41,66
CDM,48000265,MEDICATION ADMIN & HEMODYNAMIC MEASURMENT,4530.0,2944.5,45.54,4530.0,68
CDM,48000270,COMPRE ELECTROPHYSIOLOGIC W/O ARRHYT INDUCTION,43632.0,28360.8,1560.06,43632.0,85
CDM,48000275,INSERTION FLOW DIRECTED CATHETER FOR MONITORING,8932.0,5805.8,112.04,10260.0,87
CDM,48000280,COMPRE ELECTROPHYSIOLOGIC ARRHYTHMIA INDUCTION,43632.0,28360.8,1560.06,43632.0,85
CDM,48000290,COMPRE ELECTROPHYSIOL XM W/LEFT ATRIAL PACNG/REC,14588.0,9482.2,1560.06,14588.0,66
CDM,48000300,COMPRE ELECTROPHYSIOL XM W/LEFT VENTR PACNG/REC,10514.0,6834.1,1560.06,10514.0,66
CDM,48000305,ELECTRONIC ANALYSIS ANTITACHY PACEMAKER SYSTEM,1724.0,1120.6,92.64,1724.0,87
CDM,48000310,PROGRAMMED STIMJ & PACG AFTER IV DRUG NFS,9664.0,6281.6,1560.06,9664.0,66
CDM,48000315,INTERROGATION VAD IN PRSON W/PHYS/QHP ANALYSIS,528.0,343.2,22.84,528.0,87
CDM,48000335,2DTTE W CONTR LTD,2053.0,1334.45,330.06,2053.0,85
CDM,48000340,EPHYS EVAL PACG CVDFB LDS W/TSTG OF PULSE GEN,3938.0,2559.7,858.48,9402.0,66
CDM,48000350,EPHYS EVAL PACG CVDFB PRGRMG/REPRGRMG PARAMETERS,6980.0,4537.0,394.62,9402.0,87
CDM,48000355,2D TTE W CONTR STRESS,4543.0,2952.95,353.35,4543.0,85
CDM,48000360,ICAR CATHETER ABLATION ATRIOVENTR NODE FUNCTION,22091.0,14359.15,633.97,22091.0,86
CDM,48000365,STRESS ECHO W/CONTRAST,4543.0,2952.95,353.35,4543.0,85
CDM,48000375,COUNTERPULSE EXTRNL EA TX,516.0,335.4,86.64,516.0,87
CDM,48000390,CARDIOVASCULAR FUNCTION EVAL W/TILT TABLE W/MNTR,3051.0,1983.15,108.55,3051.0,87
CDM,48000395,PRGRMG DEV EVAL IMPLANTABLE SUBQ LEAD DFB SYSTEM,214.0,139.1,22.84,214.0,87
CDM,48000405,INTERROGATION EVAL F2F IMPLANT SUBQ LEAD DEFIB,214.0,139.1,22.84,214.0,87
CDM,48000415,EPHYS EVAL SUBQ IMPLANTABLE DEFIBRILLATOR,5773.0,3752.45,241.51,5773.0,68
CDM,48000485,CARDIAC CHARGES TRANSFERRED SOUTH POINTE,271.0,176.15,59.08,271.0,58
CDM,48000495,CARDIAC CHARGES TRANSFERRED FRM LUTHERAN,125.0,81.25,27.25,125.0,58
CDM,48000515,INTERROGATION EVAL IN PERSON WR DEFIBRILLATOR,214.0,139.1,22.84,214.0,87
CDM,48000525,COMPRE ELECTROPHYSIOL XM W/LEFT VENTR PACNG/REC,10514.0,6834.1,1560.06,10514.0,66
CDM,48000535,CARDIOMEMS IMPLANTSENSOR,2592.0,1684.8,23.5,2592.0,85
CDM,48000565,ILIAC REVASC,6504.0,4227.6,1417.87,6504.0,58
CDM,48000575,CPR,1365.0,887.25,297.57,1365.0,58
CDM,48000OH,PLACE DRAIN PERIPANCREATIC ACUTE PANCREATITIS,12780.0,8307.0,1.1,12780.0,144
CDM,48008870,CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL,3763.0,2445.95,126.78,3763.0,87
CDM,48008900,ECHO TRANSTHORC R-T 2D W/WO M-MODE REC F-UP/LMTD,1390.0,903.5,132.12,1390.0,87
CDM,48008920,COMPRE EP EVAL ABLTJ 3D MAPG TX SVT,78627.0,51107.55,911.02,78627.0,87
CDM,48008930,COMPRE EP EVAL ABLTJ 3D MAPG TX VT,74805.0,48623.25,1098.33,74805.0,87
CDM,48008940,ICAR CATHETER ABLATION ARRHYTHMIA ADD ON,6877.0,4470.05,333.89,14036.41,68
CDM,48008950,COMPRE EP EVAL ABLTJ ATR FIB PULM VEIN ISOLATION,69628.0,45258.2,1032.83,69628.0,87
CDM,48008960,ABLATE L/R ATRIAL FIBRIL W/ISOLATED PULM VEIN,6667.0,4333.55,333.89,14036.41,68
CDM,48011995,EPHYS EVAL PACG CVDFB LDS W/TSTG OF PULSE GEN,3938.0,2559.7,858.48,9402.0,66
CDM,48012055,PRGRMG EVAL IMPLANTABLE IN PERSON MULTI LEAD DFB,214.0,139.1,22.84,214.0,87
CDM,48012105,PERIPHERAL ARTERIAL DISEASE REHAB PER SESSION,342.0,222.3,20.39,342.0,87
CDM,48012455,INTRACARDIAC ELECTROPHYSIOLOGIC 3D MAPPING,13342.0,8672.3,317.27,13342.0,68
CDM,48012465,INTRACARD ECHOCARD W/THER/DX IVNTJ INCL IMG S&I,6873.0,4467.45,353.35,6873.0,66
CDM,48012505,TCAT INSJ/RPL PERM LEADLESS PACEMAKER RV W/IMG,38008.0,24705.2,526.96,40101.16,87
CDM,48012515,TCAT REMOVAL PERM LEADLESS PM RIGHT VENTR W/IMG,18098.0,11763.7,563.73,18098.0,87
CDM,48012525,INSERTION SUBQ CARDIAC RHYTHM MONITOR W/PRGRMG,14571.0,9471.15,96.22,17484.36,87
CDM,48012535,REMOVAL SUBCUTANEOUS CARDIAC RHYTHM MONITOR,4046.0,2629.9,94.71,4046.0,87
CDM,48012545,TCAT IMPL WRLS P-ART PRS SNR L-T HEMODYN MNTR,38626.0,25106.9,367.28,59815.74,87
CDM,48012555,INTERROG DEV EVAL WRLS CAR STIMULATOR IN PERSON,98.0,63.7,22.7,98.0,85
CDM,48012565,PRGRMG DEVICE EVAL WRLS CAR STIMULATOR IN PERSON,149.0,96.85,22.84,149.0,85
CDM,48012585,PRGRMG DEVICE EVAL IIMS IN PERSON,149.0,96.85,22.84,149.0,85
CDM,48012595,INTERROGATION DEVICE EVAL IIMS IN PERSON,149.0,96.85,22.84,149.0,85
CDM,48012615,REM INTERROG ICPMS <30 D PHYS/QHP,214.0,139.1,32.72,214.0,79
CDM,48012625,INSJ/RPLCMT ICDS W/SUBSTERNAL ELECTRODE,46823.0,30434.95,7710.0,67707.32,85
CDM,48012635,INSJ SUBSTERNAL IMPLANTABLE DEFIBRILLATOR ELTRD,33104.0,21517.6,806.19,33104.0,85
CDM,48012645,RMVL SUBSTERNAL IMPLANTABLE DEFIBRILLATOR ELTRD,14557.0,9462.05,806.19,14557.0,85
CDM,48012655,REPOS PREV IMPL SS IMPLTBL DFB PACING ELTRD,14557.0,9462.05,806.19,14557.0,85
CDM,48012675,INTERROGATION DEV EVAL ICDS W/SS ELTRD IN PERSON,149.0,96.85,22.84,149.0,85
CDM,48012685,ELECTROPHYSIOLOGIC EVAL ICDS W/SS ELECTRODE,4856.0,3156.4,1032.51,4856.0,85
CDM,48012705,REM INTERROG DEV EVAL SS LD ICDS < 90D TECH,149.0,96.85,22.84,149.0,85
CDM,48012715,RMVL SUBSTERNAL IMPLTBL DFB PULSE GENERATOR ONLY,14557.0,9462.05,806.19,14557.0,85
CDM,48012725,ATRIAL BALLOON OSTOMY,182.0,118.3,23.5,321.47,85
CDM,48012805,RMVL OF SUBQ IMPLANTABLE DEFIBRILLATOR ELECTRODE,20926.0,13601.9,386.06,20926.0,87
CDM,48012885,PROCAINAMIDE INFUSION CHALLENGE,3823.0,2484.95,23.5,3823.0,85
CDM,48012895,TCAT INSJ/RPL PERM LEADLESS PACEMAKER RA W/IMG (COMP TO 33274),37901.0,24635.65,545.0,37901.0,85
CDM,48012905,CAR FCL ABLTJ RADJ ARRHYT DLVR RADJ THER,55185.0,35870.25,12030.33,3065831.37,67
CDM,48012915,CAR FCL ABLTJ RADJ ARRHYT N-INVAS LOCLZJ & MAPG,55185.0,35870.25,12030.33,3065831.37,67
CDM,48012925,CAR FCL ABLTJ RADJ ARRHYT CONV LOCLZJ & MAPG,55185.0,35870.25,12030.33,3065831.37,67
CDM,48012935,TRANSCATHETER INSERTION OF A PERMANENT DUAL CHAMBER LEADLESS PAC,28973.0,18832.45,6303.75,40101.16,85
CDM,48012945,TRANSCATHETER INSERTION OF A PERMANENT DUAL CHAMBER LEADLESS PAC,25738.0,16729.7,6021.0,40101.16,85
CDM,48012955,TRANSCATHETER INSERTION OF A PERMANENT DUAL CHAMBER LEADLESS PAC,22742.0,14782.3,6021.0,40101.16,85
CDM,48012965,TRANSCATHETER REMOVAL OF PERMANENT DUAL CHAMBER LEADLESS PACEMAK,12590.0,8183.5,2765.32,12590.0,85
CDM,48012975,TRANSCATHETER REMOVAL OF PERMANENT DUAL CHAMBER LEADLESS PACEMAK,12590.0,8183.5,2765.32,12590.0,85
CDM,48012985,TRANSCATHETER REMOVAL OF PERMANENT DUAL CHAMBER LEADLESS PACEMAK,12590.0,8183.5,2765.32,12590.0,85
CDM,48012995,TRANSCATHETER REMOVAL AND REPLACEMENT OF PERMANENT DUAL CHAMBER,28973.0,18832.45,6303.75,40101.16,85
CDM,48013005,TRANSCATHETER REMOVAL AND REPLACEMENT OF PERMANENT DUAL CHAMBER,22742.0,14782.3,6303.75,40101.16,85
CDM,48013015,TRANSCATHETER REMOVAL AND REPLACEMENT OF PERMANENT DUAL CHAMBER,22742.0,14782.3,6303.75,40101.16,85
CDM,48013025,PROGRAMMING DEVICE EVALUATION (IN PERSON) WITH REVIEW AND REPORT,149.0,96.85,22.84,149.0,85
CDM,48013035,PRGRMG DEV EVAL LDLS PM SINGLE CAR CHAMBER IP,149.0,96.85,22.84,149.0,85
CDM,48013045,TCAT INSJ PERM 1CHMBR LDLS PACEMAKER R ATRIAL,22742.0,14782.3,6303.75,40101.16,85
CDM,48013055,TCAT RMVL PERM 1CHMBR LDLS PACEMAKER R ATRIAL,12590.0,8183.5,2765.32,12590.0,85
CDM,48013065,TCAT RMVL&RPLCMT PERM 1CHMBR LDLS PM R ATRIAL,22742.0,14782.3,6303.75,40101.16,85
CDM,48013075,TRANSCATHETER RENAL SYMPATH DENERVATION UNILAT,22806.0,14823.9,4958.66,22806.0,85
CDM,48013085,TRANSCATHETER RENAL SYMPATH DENERVATION BILAT,12979.0,8436.35,3608.16,12979.0,85
CDM,48013095,REM INTERROG SCRMS <30 D PHYS/QHP,214.0,139.1,32.72,214.0,79
CDM,48013175,REMOTE MNTR WIRELESS P-ART PRS SNR UP TO 30 D,214.0,139.1,34.57,214.0,78
CDM,48013185,ISOPROTERENOL CHALLENGE FOR PVC INDUCTION ONLY (COMP CODE 93623),9664.0,6281.6,23.5,9664.0,85
CDM,48013195,INTERROG EVAL CRTD SINS BAT MODULJ SYS IP W/,907.0,589.55,22.84,907.0,77
CDM,48013205,INTERROG EVAL CRTD SINS BAT MODULJ SYS IP WO,907.0,589.55,22.84,907.0,77
CDM,48020OH,REMOVAL OF PANCREATIC STONE,7636.0,4963.4,1.1,7636.0,144
CDM,48100010,PRQ TRANSLUMINAL CORONARY MECHANICL THROMBECTOMY,3821.0,2483.65,104.77,6797.55,68
CDM,48100040,ENDOLUMINAL CORONARY IVUS OCT I&R INITIAL VESSEL,5062.0,3290.3,112.68,5062.0,66
CDM,48100045,LAA LARIAT,10454.0,6795.1,23.5,10454.0,84
CDM,48100050,ENDOLUMINAL CORONARY IVUS OCT I&R ADDL VESSEL,3905.0,2538.25,112.68,4628.0,66
CDM,48100140,INSERTION FLOW DIRECTED CATHETER FOR MONITORING,8932.0,5805.8,112.04,10260.0,86
CDM,48100160,ENDOMYOCARDIAL BIOPSY,18098.0,11763.7,794.04,18098.0,86
CDM,48100185,RMVL TUN CVC W/O SUBQ PORT/PMP,3555.0,2310.75,159.64,4628.0,87
CDM,48100245,OPEN/PERQ PLACEMENT INTRAVASCULAR STENT INITIAL,40064.0,26041.6,505.6,40064.0,86
CDM,48100255,OPEN/PERQ PLACEMENT INTRAVASCULAR STENT SAME 1ST,36934.0,24007.1,352.78,36934.0,86
CDM,48100265,OPEN/PERQ PLACEMENT INTRAVASC STENT SAME EA ADDL,13832.0,8990.8,172.16,13832.0,68
CDM,48100305,PRQ BALLOON VALVULOPLASTY AORTIC VALVE,20959.0,13623.35,1475.42,20959.0,86
CDM,48100315,PRQ BALLOON VALVULOPLASTY MITRAL VALVE,36015.0,23409.75,1523.72,36015.0,86
CDM,48100320,RIGHT VENTRICULAR RECORDING,6980.0,4537.0,1032.51,6980.0,84
CDM,48100325,PRQ BALLOON VALVULOPLASTY PULMONARY VALVE,65208.0,42385.2,1214.37,65208.0,86
CDM,48100340,INTRAVENTRICULAR PACING,43632.0,28360.8,1560.06,43632.0,84
CDM,48100350,INTRACARDIAC ELECTROPHYSIOLOGIC 3D MAPPING,13342.0,8672.3,317.27,13342.0,68
CDM,48100370,INTRACARD ECHOCARD W/THER/DX IVNTJ INCL IMG S&I,6873.0,4467.45,353.35,6873.0,66
CDM,48100375,PRQ TRLUML PULMONARY ART BALLOON ANGIOP 1 VSL,65208.0,42385.2,712.38,65208.0,86
CDM,48100385,PRQ TRLUML PULMONARY ART BALLOON ANGIOP EA VSL,5794.0,3766.1,355.12,37117.0,68
CDM,48100395,PHYSIOLOGIC EXERCISE STUDY & HEMODYNAMIC MEASU,2831.0,1840.15,108.55,4628.0,68
CDM,48100585,PRQ TCAT CLSR CGEN INTRATRL COMUNICAJ W/IMPLT,33856.0,22006.4,1083.76,33856.0,86
CDM,48100595,PRQ TCAT CLSR CGEN VENTR SEPTAL DFCT W/IMPLT,42240.0,27456.0,1467.77,42240.0,86
CDM,48100615,INTRA-ATRIAL RECORDING,43632.0,28360.8,1560.06,43632.0,84
CDM,48100635,INDUCTION ARRHYTHMIA ELECTRICAL PACING,6980.0,4537.0,1032.51,10201.0,84
CDM,48100645,CLSR PDA,8608.0,5595.2,23.5,8608.0,84
CDM,48100650,RIGHT HEART CATH O2 SATURATION & CARDIAC OUTPUT,18494.0,12021.1,1096.87,18494.0,86
CDM,48100655,PERC DES W/ ANGIO SINGLE MAJOR,41649.0,27071.85,5870.61,41649.0,84
CDM,48100660,L HRT CATH W/NJX L VENTRICULOGRAPHY IMG S&I,18494.0,12021.1,1117.68,18494.0,86
CDM,48100665,PERC DES W/ANGIO ADDTL BRANCH,18602.0,12091.3,2602.0,18602.0,66
CDM,48100670,R & L HRT CATH W/NJX L VENTRICULOG IMG S&I,18494.0,12021.1,1422.14,18494.0,86
CDM,48100675,PERC DES/ATHER/ANGIO 1 MAJ ART,44697.0,29053.05,5870.61,44697.0,84
CDM,48100680,CATH PLACEMENT & NJX CORONARY ART ANGIO IMG S&I,18494.0,12021.1,1125.32,18494.0,86
CDM,48100685,PERC DES/ ATHER/ANGIO ADDTL BR,14577.0,9475.05,3177.79,14577.0,66
CDM,48100690,CATH PLMT & NJX CORONARY ART/GRFT ANGIO IMG S&I,18494.0,12021.1,1252.38,18494.0,86
CDM,48100695,PERC DES REVASC CABG 1 VSL,42588.0,27682.2,5870.61,42588.0,84
CDM,48100700,CATH PLMT R HRT & ARTS W/NJX & ANGIO IMG S&I,18494.0,12021.1,1396.76,18494.0,86
CDM,48100705,PERC DES  REVASC CABG ADDTL BR,18602.0,12091.3,4055.24,18602.0,66
CDM,48100710,CATH PLMT R HRT/ARTS/GRFTS W/NJX& ANGIO IMG S&I,18494.0,12021.1,1520.96,18494.0,86
CDM,48100715,PERC DES REVASC W/AMI 1 VSL,33050.0,21482.5,5870.61,33050.0,66
CDM,48100720,CATH PLMT L HRT & ARTS W/NJX & ANGIO IMG S&I,18494.0,12021.1,1290.31,18494.0,86
CDM,48100725,PERC DES REVASC CTO SINGLE VSL,51254.0,33315.1,5870.61,51254.0,84
CDM,48100730,CATH PLMT L HRT/ARTS/GRFTS WNJX & ANGIO IMG S&I,18494.0,12021.1,1384.05,18494.0,86
CDM,48100740,R & L HRT CATH WINJX HRT ART& L VENTR IMG,18494.0,12021.1,1534.32,18494.0,86
CDM,48100750,R& L HRT CATH W/INJEC HRT ART/GRFT& L VENT I,18494.0,12021.1,1692.58,18494.0,86
CDM,48100760,LEFT HEART CATH BY TRANSEPTAL PUNCTURE,9493.0,6170.45,226.65,10260.0,68
CDM,48100770,MEDICATION ADMIN & HEMODYNAMIC MEASURMENT,4530.0,2944.5,45.54,4628.0,68
CDM,48100840,NJX SEL L VENT/ATRIAL ANGIO HRT CATH W/S&I,4226.0,2746.9,29.96,11132.0,68
CDM,48100850,NJX SEL R VENT/ATRIAL ANGIO HRT CATH W/S&I,4028.0,2618.2,29.58,11132.0,68
CDM,48100860,NJX SUPRAVALV AORTOG HRT CATH W/S&I,4586.0,2980.9,41.64,11132.0,68
CDM,48100870,NJX DRG C-CATHJ NSLCTV P-ART ANGIOGRAPHY,4539.0,2950.35,52.45,11132.0,68
CDM,48100885,NJX PX XTR VNGRPH W/INTRO NDL/INTRACATH,2206.0,1433.9,55.23,4628.0,68
CDM,48100895,INTRO CATHETER SUPERIOR/INFERIOR VENA CAVA,3041.0,1976.65,125.29,4628.0,68
CDM,48100905,SLCTV CATH PLMT VEN SYS 1ST ORDER BRANCH,3601.0,2340.65,180.68,4628.0,68
CDM,48100925,INTRO CATHETER RIGHT HEART/MAIN PULMONARY ARTERY,2942.0,1912.3,148.4,4628.0,68
CDM,48100935,SLCTV CATHETER PLMT LEFT/RIGHT PULMONARY ARTERY,2775.0,1803.75,173.56,4628.0,68
CDM,48100955,INTRODUCTION CATHETER AORTA,3075.0,1998.75,159.49,4628.0,68
CDM,48100OH,OPEN BIOPSY OF PANCREAS,5784.0,3759.6,1.1,5784.0,144
CDM,48101015,SLCTV CATHJ 2ND ORDER ABDL PEL/LXTR ART BRNCH,4525.0,2941.25,288.86,4628.0,68
CDM,48101035,INSJ NON-TUNNELED CENTRAL VENOUS CATH AGE 5 YR/>,18098.0,11763.7,103.42,18098.0,87
CDM,48101065,INSERTION PICC W/O IMG GDN < 5 YR,8932.0,5805.8,114.75,8932.0,87
CDM,48101075,PRQ TRANSCATHETER RTRVL INTRVAS FB WITH IMAGING,18098.0,11763.7,349.11,18098.0,86
CDM,48101085,PERCUTAN TRANSCATH CLOSURE PAT DUCT ARTERIOSUS,51285.0,33335.25,733.72,51285.0,86
CDM,48101095,INTRA-ATRIAL PACING,43632.0,28360.8,1560.06,43632.0,84
CDM,48101105,PLACEMENT OF OCCLUSIVE DEVICE,838.0,544.7,63.76,4628.0,66
CDM,48101115,TCAT PULMONARY VALVE IMPLANTATION PRQ APPROACH,18215.0,11839.75,1481.09,18215.0,68
CDM,48101125,VASCULAR EMBOLIZATION OR OCCLUSION ARTERIAL RS&I,58667.0,38133.55,553.87,58667.0,86
CDM,48101130,IV DOP VEL&/OR PRESS C/FLO RSRV MEAS 1ST VSL,4625.0,3006.25,992.07,4628.0,66
CDM,48101135,TCAT PLACEMENT RADJ DLVR DEV SBSQ C IV BRACHYTX,12877.0,8370.05,178.69,12877.0,68
CDM,48101140,IV DOP VEL&/OR PRESS C/FLO RSRV MEAS ADDL VSL,4750.0,3087.5,992.07,4750.0,66
CDM,48101145,SLCTV CATHJ 3RD+ ORD SLCTV THRC/BRCH/CPHLC BRNCH,8125.0,5281.25,357.7,8125.0,68
CDM,48101195,INJECTION PROCEDURE DURING CARDIAC CATHETERIZATION,5592.0,3634.8,61.09,11132.0,68
CDM,48101315,OPEN/PERQ PLACE STENT EA ADD,14042.0,9127.3,242.9,14042.0,68
CDM,48101325,INJ CONGENITAL CARD CATH,5341.0,3471.65,58.8,11132.0,68
CDM,48101335,INJ HRT CONGNTL ART/GRFT,5592.0,3634.8,61.09,11132.0,68
CDM,48101510,PRQ BM REVASC CABG 1 VSL,44674.0,29038.1,673.42,44674.0,86
CDM,48102260,CLSR ASD TX CATH W IMP,33856.0,22006.4,1083.76,33856.0,86
CDM,48102295,REPLACE PICC SAME ACCESS VL,8932.0,5805.8,68.84,8932.0,87
CDM,48102355,PERC PARAVALVULAR LEAK,5400.0,3510.0,23.5,5400.0,84
CDM,48102365,PRQ CARDIAC ANGIOPLAST 1 ART,32784.0,21309.6,497.76,32784.0,86
CDM,48102385,PRQ CARDIAC ANGIO/ARTHRECT 1 ART,30204.0,19632.6,603.68,30204.0,86
CDM,48102405,PRQ CARDIAC STENT W/ANGIO 1 VSL,42281.0,27482.65,596.27,42281.0,86
CDM,48102445,PRQ CARD REVASC MI 1 VSL,33050.0,21482.5,758.22,33050.0,68
CDM,48102455,PRQ DES REVASC CHRONIC 1VSL,38342.0,24922.3,799.28,38342.0,86
CDM,48102485,PERQ TRANSCATH CLS PARAVALVR LEAK 1 MITRAL VALVE,61383.0,39898.95,1249.05,61383.0,86
CDM,48102495,PERQ TRANSCATH CLS PARAVALVR LEAK 1 AORTIC VALVE,65306.0,42448.9,1031.93,65306.0,86
CDM,48102505,PERQ TRANSCATH CLS PARAVALVR LEAK EACH OCCLS DEV,3374.0,2193.1,452.31,16547.65,68
CDM,48102515,INSJ/RPLC CAR MODULJ SYS PLS GEN TRANSVNS ELTRD,28932.0,18805.8,6303.75,32665.91,84
CDM,48102525,INSJ/RPLC CARDIAC MODULJ SYS PLS GENERATOR ONLY,8664.0,5631.6,2408.59,25280.05,84
CDM,48102535,INSJ/RPLC CARDIAC MODULJ SYS ATR ELECTRODE ONLY,33104.0,21517.6,806.19,33104.0,84
CDM,48102545,INSJ/RPLC CAR MODULJ SYS VENTR ELECTRODE ONLY,33104.0,21517.6,806.19,33104.0,84
CDM,48102555,REMOVAL CARDIAC MODULJ SYS PLS GENERATOR ONLY,14557.0,9462.05,3007.01,14557.0,84
CDM,48102565,REMOVAL CARDIAC MODULJ SYS TRANSVENOUS ELECTRODE,14557.0,9462.05,806.19,14557.0,84
CDM,48102575,RMVL & RPL CARDIAC MODULJ SYS PLS GENERATOR ONLY,32367.0,21038.55,7710.0,32367.0,84
CDM,48102585,REPOS CARDIAC MODULJ TRANSVENOUS ELECTRODE,2473.0,1607.45,545.0,10260.0,84
CDM,48102595,RELOC SKIN POCKET CARDIAC MODULJ PULSE GENERATOR,7317.0,4756.05,806.19,7317.0,84
CDM,48102605,PRGRMG DEVICE EVALUATION CARDIAC MODULJ SYSTEM,149.0,96.85,22.84,149.0,84
CDM,48102615,INTERRO DEVICE EVALUATION CARDIAC MODULJ SYSTEM,149.0,96.85,22.84,149.0,84
CDM,48102625,MYOCARDIAL PERFUSION ECHO ISCHM/VIABILITY ASSMT,3228.0,2098.2,353.35,3228.0,66
CDM,48102705,INSJ/RPLCMT TEMP TRANSVNS 1CHMBR ELTRD/PM CATH,47587.0,30931.55,181.75,47587.0,86
CDM,48102715,INSERTION INTRA-AORTIC BALLOON ASSIST DEV PERQ,3138.0,2039.7,289.26,12235.0,68
CDM,48102765,PERC DES REVASC CTO ADDTL VESSEL,33050.0,21482.5,4132.0,33050.0,66
CDM,48102775,INS NEW/RPLC PRM PACEMAKER W/TRANSV ELTRD VENTR,27759.0,18043.35,529.64,27759.0,86
CDM,48102785,NONSLCTV CATH THOR AORTA ANGIO INTR/XTRCRANL ART,18098.0,11763.7,229.65,18098.0,86
CDM,48102805,PERCUTANEOUS TRANSCATHETER SEPTAL REDUCTION THER,5821.0,3783.65,822.53,16547.65,68
CDM,48102815,TRICUSPID VALVULOPLASTY,11824.0,7685.6,23.5,11824.0,84
CDM,48102825,TRLUML PERIPH ATHRC W/RS&I BRCHIOCPHL EA VSL,20304.0,13197.6,5616.0,20304.0,84
CDM,48102835,PDA BALLOON OCCLUSION,9088.0,5907.2,23.5,9088.0,84
CDM,48102865,FRACT FLOW RES-UNL-STANDALONE,4070.0,2645.5,23.5,4628.0,84
CDM,48102OH,BIOPSY PANCREA PERCUTANEOUS NEEDLE,1880.0,1222.0,1.1,4729.25,148
CDM,48103045,INTRAVASC US-STANDALONE,3827.0,2487.55,23.5,4628.0,84
CDM,48103055,REMOVAL INTRA-AORTIC BALLOON ASSIST DEVICE PRQ,1387.0,901.55,38.26,12235.0,68
CDM,48103065,SLCTV CATH 1STORD W/WO ART PUNCT/FLUORO/S&I UN,18098.0,11763.7,294.94,18098.0,86
CDM,48103075,SLCTV CATH 1STORD W/WO ART PUNCT/FLUOR/S&I BIL,18098.0,11763.7,399.8,18098.0,86
CDM,48103085,INSERTION PICC W/RS&I 5 YR/>,8932.0,5805.8,97.86,8932.0,87
CDM,48103105,IFR STANDALONE-ADD'L VESSEL,2848.0,1851.2,23.5,4628.0,84
CDM,48103115,INSJ/RPLCMT ICDS W/SUBSTERNAL ELECTRODE,46823.0,30434.95,7710.0,46823.0,84
CDM,48103125,INSJ SUBSTERNAL IMPLANTABLE DEFIBRILLATOR ELTRD,33104.0,21517.6,806.19,33104.0,84
CDM,48103135,REPOS PREV IMPL SS IMPLTBL DFB PACING ELTRD,14557.0,9462.05,806.19,14557.0,84
CDM,48103145,RMVL SUBSTERNAL IMPLTBL DFB PULSE GENERATOR ONLY,14557.0,9462.05,806.19,14557.0,84
CDM,48103155,PERICARDIOCENTESIS W/IMG GUIDANCE WHEN PERFORMED,8932.0,5805.8,262.68,8932.0,87
CDM,48103165,PERQ PRCRD DRG 6YR+ W/O CONGENITAL CAR ANOMALY,5413.0,3518.45,275.54,11132.0,68
CDM,48103175,PERQ PRCRD DRG 0-5YR/ANY AGE W/CGEN CAR ANOMALY,5314.0,3454.1,322.62,11132.0,68
CDM,48103185,PERQ PERICARDIAL DRG W/INSJ NDWELLG CATH W/CT,5314.0,3454.1,243.0,11132.0,68
CDM,48103195,SLCTV CATHJ EA 1ST ORD THRC/BRCH/CPHLC BRNCH,7505.0,4878.25,248.76,7505.0,68
CDM,48103205,BLIND INTERATRIAL SHUNT IDE,100628.0,65408.2,8413.0,100628.0,84
CDM,48103215,ENDOVASCULAR VENOUS ARTERIALIZATION TIBL/PRNL VN,28378.0,18445.7,6021.0,45838.5,85
CDM,48103225,NON-BLIND INTERATRIAL SHUNT,158128.0,102783.2,8413.0,158128.0,84
CDM,48103255,THROMBOLYSIS VENOUS INFUSION W/IMAGING INIT TX,18098.0,11763.7,389.45,18098.0,86
CDM,48103265,THROMBOLYSIS ART/VENOUS INFSN W/IMAGE SUBSQ TX,18098.0,11763.7,268.24,18098.0,86
CDM,48103275,CESSATION THROMBOLYTIC THER W/CATHETER REMOVAL,18098.0,11763.7,141.42,18098.0,86
CDM,48103285,RPLCMT COMPL TUN CVC W/O SUBQ PORT/PMP,18098.0,11763.7,213.76,18098.0,87
CDM,48103295,INS NEW/RPLCMT PRM PACEMAKR W/TRANS ELTRD ATRIAL,26893.0,17480.45,501.43,26893.0,86
CDM,48103305,INS NEW/RPLCMT PRM PM W/TRANSV ELTRD ATRIAL&VENT,25647.0,16670.55,572.82,25647.0,86
CDM,48103315,RPSG PREV IMPLTED PM/DFB R ATR/R VENTR ELECTRODE,18098.0,11763.7,343.28,18098.0,86
CDM,48103325,INSJ 1 TRANSVNS ELTRD PERM PACEMAKER/IMPLTBL DFB,30717.0,19966.05,410.35,30717.0,86
CDM,48103335,INSJ ELTRD CAR VEN SYS ATTCH PREV PM/DFB PLS GEN,29510.0,19181.5,562.56,29510.0,86
CDM,48103345,INSJ ELTRD CAR VEN SYS TM INSJ DFB/PM PLS GEN,16614.0,10799.1,505.29,16614.0,68
CDM,48103355,REMVL PERM PM PLSE GEN W/REPL PLSE GEN SNGL LEAD,21495.0,13971.75,375.19,21495.0,86
CDM,48103365,REMVL PERM PM PLS GEN W/REPL PLSE GEN 2 LEAD SYS,26736.0,17378.4,391.99,26736.0,86
CDM,48103375,REMVL PERM PM PLS GEN W/REPL PLSE GEN MULT LEAD,42964.0,27926.6,410.35,42964.0,86
CDM,48103385,REMOVAL PERMANENT PACEMAKER PULSE GENERATOR ONLY,47587.0,30931.55,258.34,47587.0,87
CDM,48103395,RMVL TRANSVNS PM ELTRD 1 LEAD SYS ATR/VENTR,20926.0,13601.9,535.42,20926.0,87
CDM,48103405,RMVL TRANSVNS PM ELTRD DUAL LEAD SYS,20926.0,13601.9,705.79,20926.0,86
CDM,48103415,REMOVAL IMPLANTABLE DEFIB PULSE GENERATOR ONLY,20926.0,13601.9,241.58,20926.0,86
CDM,48103425,RMVL1/DUAL CHMBR IMPLTBL DFB ELTRD TRANSVNS XTRJ,20926.0,13601.9,806.19,20926.0,86
CDM,48103435,INSJ/RPLCMT PERM DFB W/TRNSVNS LDS 1/DUAL CHMBR,56044.0,36428.6,1002.33,56044.0,86
CDM,48103445,RMVL IMPLTBL DFB PLSE GEN W/REPL PLSE GEN 1 LEAD,42062.0,27340.3,410.14,42062.0,86
CDM,48103455,RMVL IMPLTBL DFB PLSE GEN W/RPLCMT PLSE GEN 2 LD,40488.0,26317.2,426.74,40488.0,86
CDM,48103465,RMVL IMPLTBL DFB PLS GEN W/RPLCMT PLS GEN MLT LD,52725.0,34271.25,443.36,52725.0,86
CDM,48103475,INSERT HIS ELECTRODE,2070.0,1345.5,545.0,4628.0,84
CDM,48103485,SLCTV CATH CAROTID/INNOM ART ANGIO XTRCRANL ART,18098.0,11763.7,321.26,18098.0,86
CDM,48103495,SLCTV CATH CAROTID/INNOM ART ANGIO INTRCRANL ART,31083.0,20203.95,386.76,31083.0,86
CDM,48103515,SLCTV CATH SUBCLAVIAN ART ANGIO VERTEBRAL ARTERY,18098.0,11763.7,382.64,18098.0,86
CDM,48103555,INTRO CATH DIALYSIS CIRCUIT DX ANGRPH FLUOR S&I,8932.0,5805.8,195.77,8932.0,87
CDM,48103565,INTRO CATH DIALYSIS CIRCUIT W/TRLUML BALO ANGIOP,32784.0,21309.6,279.82,32784.0,87
CDM,48103575,INTRO CATH DIALYSIS CIRCUIT W/TCAT PLMT IV STENT,32239.0,20955.35,368.44,32239.0,87
CDM,48103585,PERQ THRMBC/NFS DIALYSIS CIRCUIT IMG DX ANGRPH,32784.0,21309.6,428.3,32784.0,87
CDM,48103595,PERQ THRMBC/NFS DIAL CIRCUIT TRLUML BALO ANGIOP,65208.0,42385.2,516.28,65208.0,87
CDM,48103605,PERQ THRMBC/NFS DIAL CIRCUIT TCAT PLMT IV STENT,53185.0,34570.25,596.04,53185.0,87
CDM,48103615,TRLUML BALO ANGIOP CTR DIALYSIS SEG W/IMG S&I,16227.0,10547.55,170.73,16227.0,69
CDM,48103625,STENT PLMT CENTRAL DIAYLSIS SEG PFRMD DIAL CIR,24406.0,15863.9,241.82,24406.0,69
CDM,48103635,DIALYIS CIRCUIT VASC EMBOLI OCCLS EVASC IMG S&I,22770.0,14800.5,234.01,22770.0,69
CDM,48103745,VASCULAR EMBOLIZATION OR OCCLUSION VENOUS RS&I,65208.0,42385.2,497.34,65208.0,86
CDM,48103775,TRLML BALO ANGIOP OPEN/PERQ IMG S&I 1ST ART,32784.0,21309.6,404.56,32784.0,87
CDM,48103785,TRLML BALO ANGIOP OPEN/PERQ W/IMG S&I 1ST VEIN,32784.0,21309.6,346.14,32784.0,87
CDM,48103795,TRLML BALO ANGIOP OPEN/PERQ W/IMG S&I ADDL VEIN,5404.0,3512.6,169.46,10789.0,69
CDM,48103805,INTRAVASCULAR US NONCORONARY RS&I INTIAL VESSEL,6837.0,4444.05,103.53,6837.0,68
CDM,48103815,INTRAVASCULAR US NONCORONARY RS&I ADDL VESSEL,4671.0,3036.15,82.05,4671.0,68
CDM,48103835,TCAT IMPLANTATION CORONARY SINUS REDUCTION DEV,40022.0,26014.3,5870.61,40022.0,84
CDM,48103845,TAS CONGENITAL CARDIAC ANOMALIES ANY METHOD,5635.0,3662.75,834.23,16547.65,68
CDM,48103895,R HRT CATH CHD W/IMG CATH TRGT ZONE NML NT CONNJ,18494.0,12021.1,1947.82,18494.0,84
CDM,48103905,R HRT CATH CHD W/IMG CATH TRGT ZON ABNL NT CONNJ,18494.0,12021.1,1947.82,18494.0,84
CDM,48103915,L HRT CATH CHD IMG CATH TRGT ZON NML/ABNL NT CNJ,18494.0,12021.1,1947.82,18494.0,84
CDM,48103925,R&L HRT CATH CHD IMG CATH TRGT ZONE NML NT CONNJ,18494.0,12021.1,1947.82,18494.0,84
CDM,48103935,R&L HRT CATH CHD IMG CATH TRGT ZON ABNL NT CONNJ,18494.0,12021.1,1947.82,18494.0,84
CDM,48103945,CAR OUTP MEAS DRG CAR CATH EVAL CGEN HRT DEFECT,673.0,437.45,81.99,4628.0,66
CDM,48103985,TRANSCATHETER PLACEMENT&SBSQ REMOVAL CEPD PERQ,3134.0,2037.1,149.1,16547.65,68
CDM,48103995,TCAT RMVL/DEBULK ICAR MASS SUCTION DEVICE PERQ,22806.0,14823.9,4958.66,22806.0,84
CDM,48104005,TCAT TV ANN RCNSTJ W/IMPL ADJST ANN RCNSTJ DEV,17007.0,11054.55,3707.53,17007.0,66
CDM,48104025,EVASC ST RPR COARCJ THRC/AA ACRS MAJ SIDE BRNCH,5119.0,3327.35,1088.8,12094.67,68
CDM,48104035,EVASC ST RPR COARCJ THRC/AA XCRSG MAJ SIDE BRNCH,22779.0,14806.35,866.74,22779.0,68
CDM,48104045,PERQ TRANSLUMINAL ANGIOPLASTY NATIVE/RECR COA,6728.0,4373.2,644.17,8711.0,68
CDM,48104065,TCAT INTRA-C NFS SUPERSAT O2 W/PERQ C REVSC AMI,18339.0,11920.35,3997.9,18339.0,66
CDM,48104085,IMPLANT CPNS SYSTEM,7373.0,4792.45,545.0,7373.0,84
CDM,48104095,EXPLANT CPNS SYSTEM,5530.0,3594.5,545.0,5530.0,84
CDM,48104105,"TRANSCATHETER TRICUSPID VALVE REPAIR,PERCUTANEOUS APPROACH; INIT",17007.0,11054.55,3707.53,17007.0,66
CDM,48104115,INSERTION WRLS CAR STIMULATOR LV PACG COMPL SYS,27833.0,18091.45,6021.0,27833.0,84
CDM,48104125,CARDIOVASCULAR PROCEDURE,1145.0,744.25,23.5,4628.0,84
CDM,48104135,TIS CRTJ ST CONGENITAL CARDIAC ANOMAL 1ST SHUNT,5119.0,3327.35,1115.94,16547.65,68
CDM,48104175,IVL W/ANGIOPLASTY,65208.0,42385.2,2523.55,65208.0,84
CDM,48104185,IVL & STENT W/ANGIOPLASTY,37311.0,24252.15,4672.17,37311.0,84
CDM,48104195,IVL & ATHERECTOMY W/ANGIOPLASTY,103251.0,67113.15,4672.17,103251.0,84
CDM,48104205,IVL STENT  ATHERECTOMY W/ANGIOPLASTY,34461.0,22399.65,8050.0,34461.0,84
CDM,48104215,TRANSCATH MITRAL VALVE REPAIR VIA CORONARY SINUS,15747.0,10235.55,3432.85,16547.65,66
CDM,48104275,NJX DRG C-CATHJ SLCTV P-ART ANGIOGRAPHY BI,17189.0,11172.85,73.64,17189.0,68
CDM,48104285,NJX DRG C-CATHJ SLCTV P-ART ANGIOGRAPHY UNI,12902.0,8386.3,44.52,12902.0,68
CDM,48104315,NJX DRG C-CATHJ SLCTV PULM VEN ANGIOGRAPHY,1367.0,888.55,81.4,4628.0,68
CDM,48104325,NJX DRG C-CATHJ SLCTV PULM ANGRPH MAPCA CHD EA,4623.0,3004.95,81.99,4628.0,68
CDM,48104335,SUBCLAVIAN TRANS-CAROTID TAVR,17587.0,11431.55,545.0,17587.0,84
CDM,48104345,INSERTION/REPLACEMENT COMPLETE IIMS,14990.0,9743.5,4167.22,20045.35,84
CDM,48104355,INSERTION/REPLACEMENT IIMS ELECTRODE ONLY,10838.0,7044.7,806.19,33436.0,85
CDM,48104365,INSERTION/REPLACEMENT IIMS IMPLANTABLE MNTR ONLY,33104.0,21517.6,6021.0,33436.0,85
CDM,48104375,REMOVAL COMPLETE IIMS INCL IMG S&I,14557.0,9462.05,3007.01,14557.0,84
CDM,48104385,REMOVAL IIMS ELECTRODE ONLY INCL IMG S&I,14557.0,9462.05,806.19,14557.0,84
CDM,48104395,REMOVAL IIMS IMPLANTABLE MNTR ONLY INCL IMG S&I,14557.0,9462.05,3007.01,14557.0,84
CDM,48104405,STAND ALONE INTRACARDIAC ECHO,5892.0,3829.8,23.5,5892.0,84
CDM,48104425,INSERTION PICC W/RS&I < 5 YR,3555.0,2310.75,774.99,3555.0,58
CDM,48104435,PERQ TCAT NO-IMPLANT IAS SHUNT CREATION (COMP TO 33741),5218.0,3391.7,545.0,5218.0,84
CDM,48104455,PRQ COR ASPIR THROMBECT ONLY (COMP TO 92973),3538.0,2299.7,23.5,4628.0,84
CDM,48104465,TRANSCATHETER L VENTR RESTORATION DEVICE IMPLTJ,17007.0,11054.55,3707.53,17007.0,66
CDM,48104475,VENOGRAPHY CHD AZYGOS/HEMIAZYGOS VENOUS SYSTEM,59541.0,38701.65,63.87,59541.0,68
CDM,48104485,VENOGRAPHY CHD CORONARY SINUS,59541.0,38701.65,82.14,59541.0,68
CDM,48104495,VENOGRAPHY CHD VENOVENOUS COLTRL AT/ABOVE HRT,59541.0,38701.65,119.49,59541.0,68
CDM,48104505,VENOGRAPHY CHD VENOVENOUS COLLATERAL BELOW HEART,59541.0,38701.65,120.49,59541.0,68
CDM,48104515,PERCUTANEOUS TRANSLUMINAL CORONARY LITHOTRIPSY,5062.0,3290.3,168.72,6797.55,68
CDM,48104525,VENOGRAPHY CHD ANOMALOUS/PERSISTENT SVC NT DRG,59541.0,38701.65,67.73,59541.0,68
CDM,48104535,INSTANTANEOUS WAVE-FREE RATIO (IFR) 1 VESSEL (COMP CODE 93571),3964.0,2576.6,23.5,4628.0,84
CDM,48104545,"INSTANTANEOUS WAVE-FREE RATIO (IFR) 2 VESSEL (COMP CODE 93571,93",7193.0,4675.45,23.5,7193.0,84
CDM,48104555,"INSTANTANEOUS WAVE-FREE RATIO (IFR) 3 VESSEL (COMP CODE 93571, 9",10422.0,6774.3,23.5,10422.0,84
CDM,48104595,INTRAPROCEDURAL CORONARY FRACTIONAL FLOW RESERVE (FFR) WITH 3D F,17254.0,11215.1,405.62,17254.0,66
CDM,48104625,"STAND ALONE IVUS, ADD'L VESSEL (COMP TO 92979)",465.0,302.25,23.5,4628.0,84
CDM,48104645,"REVASC ENDOV, OPEN OR PERC, TIBIAL/PERONEAL ARTERY(IES), W/IVL,",26829.0,17438.85,4672.17,26829.0,84
CDM,48104655,"REVASC ENDOV, OPEN OR PERC,  TIBIAL/PERONEAL ARTERY(IES); W/IVL,",46149.0,29996.85,6021.0,46149.0,84
CDM,48104665,"REVASC ENDOV, OPEN OR PERC, TIBIAL/PERONEAL ARTERY(IES); W/IVL A",36344.0,23623.6,6021.0,36344.0,84
CDM,48104675,"REVASC ENDOV, OPEN OR PERC, TIBIAL/PERONEAL ARTERY(IES); W/IVL A",38839.0,25245.35,6021.0,38839.0,84
CDM,48104685,TCAT SUPR&IVC PROSTC VLV IMPLTJ PERQ FEM VN APPR,29430.0,19129.5,6415.74,29430.0,66
CDM,48104705,PERQ TCAT THER RX DLVR NTRAC RX BALO 1 MAJ C ART PERQ TCAT THER,22806.0,14823.9,5285.54,22806.0,83
CDM,48104715,PERQ TCAT THER RX DLVR NTRAC RX BALO SEPARATE,12526.0,8141.9,2602.0,12526.0,66
CDM,48104725,INSERTION OF ENDOVASCULAR IVC FLOW REGULATOR DEVICE (COMP CODE 3,28274.0,18378.1,545.0,28274.0,85
CDM,48104735,TCAT IMPLANT OF IVC MONITORING DEVICE (COMP TO 33289),33676.0,21889.4,545.0,33676.0,84
CDM,48104745,"ENDOVASCULAR ATHERECTOMY/ANGIOPLASTY, OPEN/PERQ, ILIAC VEIN (COM",45849.0,29801.85,545.0,45849.0,85
CDM,48104765,PERQ TCAT PLMT NTRAC ST 2+LES 2+ST 2+C SEGMENTS,129228.0,83998.2,697.79,129228.0,77
CDM,48104775,PERQ TRLUML REVSC CHRNC TOT OCCLS 1 ANTGRD&RTRGR,81380.0,52897.0,872.42,81380.0,77
CDM,48104785,REVSC EVASC FPVT ANGIOP UNI CPLX LES EA ADDL VSL,33435.0,21732.75,235.31,33435.0,67
CDM,48104795,REVSC EVASC FPVT ST PLMT UNI SF LES 1ST VSL,67817.0,44081.05,518.83,67817.0,77
CDM,48104805,REVSC EVASC FPVT ST PLMT UNI SF LES EA ADDL VSL,67817.0,44081.05,219.62,67817.0,67
CDM,48104815,REVSC EVASC FPVT ST PLMT UNI CPLX LES 1ST VSL,67817.0,44081.05,872.26,67817.0,77
CDM,48104825,REVSC EVASC FPVT ST PLMT UNI CPLX LES EA ADD VSL,67817.0,44081.05,294.65,67817.0,67
CDM,48104835,REVSC EVASC FPVT ATHRC UNI SF LES 1ST VSL,107690.0,69998.5,534.67,107690.0,77
CDM,48104845,REVSC EVASC FPVT ATHRC UNI SF LES EA ADDL VSL,107690.0,69998.5,235.99,107690.0,67
CDM,48104855,REVSC EVASC FPVT ATHRC UNI CPLX LES 1ST VSL,107690.0,69998.5,748.88,107690.0,77
CDM,48104865,REVSC EVASC FPVT ATHRC UNI CPLX LES EA ADDL VSL,107690.0,69998.5,324.87,107690.0,67
CDM,48104875,REVSC EVASC FPVT ST ATHRC UNI SF LES 1ST VSL,107690.0,69998.5,650.67,107690.0,77
CDM,48104885,REVSC EVASC FPVT ST ATHRC UNI SF LES EA ADDL VSL,107690.0,69998.5,250.18,107690.0,67
CDM,48104895,REVSC EVASC FPVT ST ATHRC UNI CPLX LES 1ST VSL,107690.0,69998.5,885.42,107690.0,77
CDM,48104905,REVSC EVSC FPVT ST ATHRC UNI CPLX LES EA ADD VSL,107690.0,69998.5,352.49,107690.0,67
CDM,48104925,REVSC EVASC TPVT ANGIOP UNI SF LES 1ST VSL,67817.0,44081.05,579.39,67817.0,77
CDM,48104935,REVSC EVASC TPVT ANGIOP UNI SF LES EA ADDL VSL,67817.0,44081.05,175.61,67817.0,67
CDM,48104945,REVSC EVASC TPVT ANGIOP UNI CPLX LES 1ST VSL,67817.0,44081.05,727.03,67817.0,77
CDM,48104955,REVSC EVASC TPVT ANGIOP UNI CPLX LES EA ADDL VSL,67817.0,44081.05,249.77,67817.0,67
CDM,48104965,REVSC EVASC TPVT ST PLMT UNI SF LES 1ST VSL,107690.0,69998.5,597.41,107690.0,77
CDM,48104975,REVSC EVASC TPVT ST PLMT UNI SF LES EA ADDL VSL,107690.0,69998.5,198.2,107690.0,67
CDM,48104985,REVSC EVASC TPVT ST PLMT UNI CPLX LES 1ST VSL,107690.0,69998.5,802.01,107690.0,77
CDM,48104995,REVSC EVASC TPVT ST PLMT UNI CPLX LES EA ADD VSL,107690.0,69998.5,297.44,107690.0,67
CDM,48105005,REVSC EVASC TPVT ATHRC UNI SF LES 1ST VSL,107690.0,69998.5,796.58,107690.0,77
CDM,48105015,REVSC EVASC TPVT ATHRC UNI SF LES EA ADDL VSL,107690.0,69998.5,280.4,107690.0,67
CDM,48105025,REVSC EVASC TPVT ATHRC UNI CPLX LES 1ST VSL,107690.0,69998.5,1002.27,107690.0,77
CDM,48105035,REVSC EVASC TPVT ATHRC UNI CPLX LES EA ADDL VSL,107690.0,69998.5,383.23,107690.0,67
CDM,48105045,REVSC EVASC TPVT ST ATHRC UNI SF LES 1ST VSL,107690.0,69998.5,888.93,107690.0,77
CDM,48105055,REVSC EVASC TPVT ST ATHRC UNI SF LES EA ADDL VSL,107690.0,69998.5,389.45,107690.0,67
CDM,48105065,REVSC EVASC TPVT ST ATHRC UNI CPLX LES 1ST VSL,107690.0,69998.5,1065.75,107690.0,77
CDM,48105075,REVSC EVSC TPVT ST ATHRC UNI CPLX LES EA ADD VSL,107690.0,69998.5,489.93,107690.0,67
CDM,48105085,REVSC EVASC IMVT ANGIOP UNI SF LES 1ST VSL,67817.0,44081.05,649.64,67817.0,77
CDM,48105095,REVSC EVASC IMVT ANGIOP UNI SF LES EA ADDL VSL,67817.0,44081.05,234.39,67817.0,67
CDM,48105105,REVSC EVASC IMVT ANGIOP UNI CPLX LES 1ST VSL,67817.0,44081.05,805.48,67817.0,77
CDM,48105115,REVSC EVASC IMVT ANGIOP UNI CPLX LES EA ADDL VSL,67817.0,44081.05,292.61,67817.0,67
CDM,48105125,REVSC EVASC IVT ANGIOP UNI SF LES 1ST VSL,33435.0,21732.75,434.21,33435.0,77
CDM,48105135,REVSC EVASC IVT ANGIOP UNI SF LES EA ADDL VSL,33435.0,21732.75,176.18,33435.0,67
CDM,48105145,REVSC EVASC IVT ANGIOP UNI CPLX LES 1ST VSL,33435.0,21732.75,637.07,33435.0,77
CDM,48105155,REVSC EVASC IVT ANGIOP UNI CPLX LES EA ADDL VSL,33435.0,21732.75,228.19,33435.0,67
CDM,48105165,REVSC EVASC IVT ST PLMT UNI SF LES 1ST VSL,67817.0,44081.05,518.47,67817.0,77
CDM,48105175,REVSC EVASC IVT ST PLMT UNI SF LES EA ADDL VSL,67817.0,44081.05,234.45,67817.0,67
CDM,48105185,REVSC EVASC IVT ST PLMT UNI CPLX LES 1ST VSL,67817.0,44081.05,750.06,67817.0,77
CDM,48105195,REVSC EVASC IVT ST PLMT UNI CPLX LES EA ADDL VSL,67817.0,44081.05,249.15,67817.0,67
CDM,48105205,INTRAVASCULAR LITHOTRIPSY IVT WITHIN SAME ARTERY,5062.0,3290.3,178.07,5062.0,67
CDM,48105215,REVSC EVASC FPVT ANGIOP UNI SF LES 1ST VSL,33435.0,21732.75,460.38,33435.0,77
CDM,48105225,REVSC EVASC FPVT ANGIOP UNI SF LES EA ADDL VSL,33435.0,21732.75,176.7,33435.0,67
CDM,48105235,REVSC EVASC FPVT ANGIOP UNI CPLX LES 1ST VSL,33435.0,21732.75,622.93,33435.0,77
CDM,48105265,INITIAL OPEN IMPLANTATION BAT MODULATION SYSTEM,180002.0,117001.3,707.75,180002.0,77
CDM,48105275,REVISION/RPLCMT BAT MODULATION SYSTEM LEAD ONLY,14287.0,9286.55,805.9,14287.0,77
CDM,48105285,REVISION/RPLCMT BAT MODULATION SYSTEM PG ONLY,31526.0,20491.9,537.35,32113.14,77
CDM,48105OH,RESECJ/DBRDMT PANCREAS NECROTIZING PANCREATITIS,19704.0,12807.6,1.1,19704.0,144
CDM,48120OH,EXCISION OF PANCREAS LESION,7364.0,4786.6,1.1,7364.0,144
CDM,48140OH,PNCRTECT DSTL STOT W/O PNCRTCOJEJUNOSTOMY,10528.0,6843.2,1.1,10528.0,144
CDM,48145OH,PNCRTECT DSTL STOT W/PNCRTCOJEJUNOSTOMY,10956.0,7121.4,1.1,10956.0,144
CDM,48146OH,PNCRTECT DSTL NR-TOT W/PRSRV DUO CHLD-TYP PX,12240.0,7956.0,1.1,12240.0,144
CDM,48148OH,EXCISION AMPULLA VATER,8156.0,5301.4,1.1,8156.0,144
CDM,48150OH,PNCRTECT PROX STOT W/PANCREATOJEJUNOSTOMY,21136.0,13738.4,1.1,21136.0,144
CDM,48152OH,PNCRTECT WHIPPLE W/O PANCREATOJEJUNOSTOMY,19460.0,12649.0,1.1,19460.0,144
CDM,48153OH,PNCRTECT W/PANCREATOJEJUNOSTOMY,21116.0,13725.4,1.1,21116.0,144
CDM,48154OH,PNCRTECT PROX STOT W/O PANCREATOJEJUNOSTOMY,19552.0,12708.8,1.1,19552.0,144
CDM,48155OH,PANCREATECTOMY TOTAL,11780.0,7657.0,1.1,11780.0,144
CDM,48160OH,PANCREATECTOMY W/TRNSPLJ PANCREAS/ISLET CELLS,13636.0,8863.4,1.1,13636.0,88
CDM,48200000,ERGONOVINE PROVOCATION TST,2294.0,1491.1,108.55,2294.0,86
CDM,48200005,MICROVOLT T-WAVE ASSESS VENTRICULAR ARRHYTHMIAS,900.0,585.0,86.64,900.0,86
CDM,48200010,CV STRS TST XERS&/OR RX CONT ECG TRCG ONLY,1791.0,1164.15,52.52,1791.0,86
CDM,48300000,ECHO FETAL CARDIOVASC W/WO M-MODE RECORDING,3783.0,2458.95,116.89,3783.0,87
CDM,48300005,DOPPLER ECHO FETAL SPECTRAL DISPLAY COMPLETE,734.0,477.1,91.45,734.0,87
CDM,48300010,ECHO TRANSTHORAC R-T 2D W/WO M-MODE REC COMP,1390.0,903.5,180.66,1390.0,87
CDM,48300015,COMPLETE TTHRC ECHO CONGENITAL CARDIAC ANOMALY,3153.0,2049.45,292.91,3153.0,87
CDM,48300020,ECHO TRANSESOPHAG R-T 2D W/PRB IMG ACQUISJ I&R,3153.0,2049.45,303.35,3153.0,87
CDM,48300025,F-UP/LIMITED TTHRC ECHO CONGENITAL CAR ANOMALY,3153.0,2049.45,209.3,3153.0,87
CDM,48300030,DOP ECHOCARD COLOR FLOW VELOCITY MAPPING,1066.0,692.9,32.12,1066.0,68
CDM,48300035,ECHO TRANSTHORC R-T 2D W/WO M-MODE REC F-UP/LMTD,1390.0,903.5,132.12,1390.0,87
CDM,48300040,ECHO TTHRC R-T 2D M-MODE COMPL SPEC&COLR D W/O CONTRAST,3153.0,2049.45,258.45,3153.0,87
CDM,48300045,ECHO TRANSESOPHAG CONGEN PROBE PLCMT IMGNG I&R,3153.0,2049.45,353.35,3153.0,85
CDM,48300065,ECHO TRANSESOPHAG MONTR CARDIAC PUMP FUNCTJ,3153.0,2049.45,353.35,3153.0,85
CDM,48300070,DOPPLER ECHOCARD PULSE WAVE W/SPECTRAL DISPLAY,1333.0,866.45,66.68,1333.0,68
CDM,48300075,DOP ECHOCARD PULSE WAVE W/SPECTRAL F-UP/LMTD STD,600.0,390.0,33.31,600.0,68
CDM,48300080,ECHO TTHRC R-T 2D W/WO M-MODE COMPLETE REST&ST,3153.0,2049.45,243.23,3153.0,87
CDM,48300090,ECHO TEE GUID TCAT ICAR/VESSEL STRUCTURAL INTVN,4048.0,2631.2,264.67,4048.0,68
CDM,48300095,"TTE W/DOPPLER, COMPLETE W/CONT",4543.0,2952.95,353.35,4543.0,85
CDM,48300105,ECHO TEE GUID TCAT ICAR/VESSEL STRUCTURAL INTVN,4048.0,2631.2,264.67,4048.0,68
CDM,48300205,ECHO 2D W/CONTRAST,4543.0,2952.95,353.35,4543.0,85
CDM,48300215,TEE W/CONTRAST 2D,4543.0,2952.95,353.35,4543.0,85
CDM,48300225,TEE W/CONTRAST CONGENITAL ANOMALIES,4543.0,2952.95,353.35,4543.0,85
CDM,48300235,TTE CONGENITAL ANOMALIES W/CONTRAST,4543.0,2952.95,353.35,4543.0,85
CDM,48300245,"TTE CONGENITAL ANOMALIES, LIMITED W/CONTRAST",4543.0,2952.95,353.35,4543.0,85
CDM,48300255,TEE FOR MONITORING W/CONTRAST,4543.0,2952.95,353.35,4543.0,85
CDM,48300265,ECHO TRANSESOPHAG R-T 2D IMG ACQUISJ I&R ONLY,2237.0,1454.05,292.37,2237.0,68
CDM,48300275,ECHO TTHRC R-T 2D W/WOM-MODE COMPL SPEC&COLR D,3153.0,2049.45,258.45,3153.0,87
CDM,48300305,MYOCRD STRAIN IMG SPECKLE TRCK ASSMT MYOCRD MECH,69.0,44.85,13.67,409.15,68
CDM,48300315,HOSPITAL MYOCRD STRAIN,69.0,44.85,13.67,409.15,68
CDM,48300325,3D ECHO IMG&PST-PXESSING TEE/TTE CGEN CAR ANOMAL,518.0,336.7,28.49,518.0,68
CDM,48308900,ECHO TRANSTHORC R-T 2D W/WO M-MODE REC F-UP/LMTD,1390.0,903.5,132.12,1390.0,87
CDM,48510OH,EXTERNAL DRAINAGE PSEUDOCYST OF PANCREAS OPEN,6876.0,4469.4,1.1,6876.0,144
CDM,48520OH,INT ANAST PANCREATIC CYST GI TRACT DIRECT,7260.0,4719.0,1.1,7260.0,144
CDM,48540OH,INT ANAST PANCREATIC CYST GI TRACT ROUX-EN-Y,8776.0,5704.4,1.1,8776.0,144
CDM,48545OH,PANCREATORRHAPHY INJURY,8892.0,5779.8,1.1,8892.0,144
CDM,48547OH,DUOL EXCLUSION W/GASTROJEJUNOSTOMY PNCRTC INJ,12152.0,7898.8,1.1,12152.0,144
CDM,48548OH,PANCREATICOJEJUNOSTOMY SIDE-TO-SIDE ANAST,11236.0,7303.4,1.1,11236.0,144
CDM,48551OH,BKBENCH PREPJ CADAVER DONOR PANCREAS ALLOGRAFT,4958.0,3222.7,1.1,4958.0,104
CDM,48552OH,BKBENCH RCNSTJ CDVR PNCRS ALGRFT VEN ANAST EA,1720.0,1118.0,1.1,1720.0,142
CDM,48554OH,TRANSPLANT ALLOGRAFT PANCREAS,15120.0,9828.0,1.1,15120.0,144
CDM,48556OH,REMOVAL ALLOGRAFT PANCREAS,7788.0,5062.2,1.1,7788.0,144
CDM,48900005,PRE 3D MDL W/CCTA AND/OR MRI,5850.0,3802.5,453.45,5850.0,84
CDM,48999RVU10OH,PANCREAS STONE SHOCK WAVE LITHOTRIPSY (COMP 50590),3224.0,2095.6,0.01,3224.0,84
CDM,48999RVU11OH,"UNLISTED PROC, LAP PANCREATICODUODENECTOMY W/DISTAL GASTRECTOMY",19181.0,12467.65,0.01,19181.0,84
CDM,48999RVU12OH,UNLISTED PROC; ENDOSCOPIC DEBRIDEMENT OF PANCREATIC PSEUDOCYST (,2327.0,1512.55,0.01,2327.0,84
CDM,48999RVU13OH,ABLATION PANCREATIC TUMOR (COMP 47380),6626.0,4306.9,0.01,6626.0,84
CDM,48999RVU14OH,LAP PANCREAS DEBRIDEMENT (COMP 48105),16256.0,10566.4,0.01,16256.0,84
CDM,48999RVU15OH,LAP ENUCLEATION PANCREAS LESION (COMP 48120),6075.0,3948.75,0.01,6075.0,84
CDM,48999RVU16OH,PANCREAS RESECTION FREY PROCEDURE (COMP 48145),9064.0,5891.6,0.01,9064.0,84
CDM,48999RVU17OH,ISLET AUTOLOGOUS CELL TRANSPLANT (COMP 36260),4510.0,2931.5,0.01,4510.0,84
CDM,48999RVU19OH,LAPAROSCOPIC PYLORUS PRESERVING PANCREATICODUODENECTOMY (COMP CO,22699.0,14754.35,0.01,22699.0,84
CDM,48999RVU1OH,LAP REMOVAL PANCREAS W/OR W/O SPLENECTOM,10857.0,7057.05,0.01,10857.0,84
CDM,48999RVU2OH,LAP REMOVAL PANCREAS W/OR W/O SPLENECTOM (COMP CODE 48140),10857.0,7057.05,0.01,10857.0,84
CDM,48999RVU3OH,PANCREATECTOMY CENTRAL,6719.0,4367.35,0.01,6719.0,84
CDM,48999RVU4OH,LAPAROSCOPIC WHIPPLE,21776.0,14154.4,0.01,21776.0,84
CDM,48999RVU5OH,UNLISTED LAP DEBRIDEMENT OF PANCREATIC CYST (COMP CODE 48105),16010.0,10406.5,0.01,16010.0,84
CDM,48999RVUOH,EGD-PSEUDOCYST NECROSECTOMY (COMP 48105),21189.0,13772.85,0.01,21189.0,84
CDM,49000005,EXCISION PILONIDAL CYST/SINUS SIMPLE,8586.0,5580.9,219.96,8586.0,87
CDM,49000050,I&D ISCHIORCT/INTRAMURAL ABSC W/WO SETON,12615.0,8199.75,589.38,12615.0,87
CDM,49000060,ANOSCOPY W/RMVL LESION CAUTERY,12615.0,8199.75,95.32,12615.0,79
CDM,49000070,INJECTION PEYRONIE DISEASE,1119.0,727.35,0.01,2351.0,87
CDM,49000075,NJX C/P/A CAVERNOSA W/PHARMACOLOGIC AGT,1119.0,727.35,49.68,12500.0,86
CDM,49000095,INJECTION AA&/STRD GREATER OCCIPITAL NERVE,2037.0,1324.05,58.85,4628.0,87
CDM,49000OH,EXPLORATORY LAPAROTOMY CELIOTOMY W/WO BIOPSY SPX,5016.0,3260.4,1.1,5016.0,144
CDM,49002OH,REOPENING RECENT LAPAROTOMY,7052.0,4583.8,1.1,7052.0,144
CDM,49005115,TRNSPLJ AUTOLOGOUS HEMATOPOIETIC CELLS PER DONOR,6557.0,4262.05,197.79,10651.0,86
CDM,49005165,TRURL DSTRJ PRST8 TISS RF WV THERMOTHERAPY,15865.0,10312.25,448.17,15865.0,86
CDM,49005175,FINE NEEDLE ASPIRATION BX W/O IMG GDN EA ADDL,1017.0,661.05,48.23,4628.0,69
CDM,49005185,FINE NEEDLE ASPIRATION BX W/US GDN 1ST LESION,3237.0,2104.05,84.23,4628.0,87
CDM,49005195,FINE NEEDLE ASPIRATION BX W/US GDN EA ADDL,942.0,612.3,58.24,4628.0,69
CDM,49005205,FINE NEEDLE ASPIRATION BX W/FLUOR GDN 1ST LESION,3237.0,2104.05,106.31,4628.0,87
CDM,49005215,FINE NEEDLE ASPIRATION BX W/FLUOR GDN EA ADDL,725.0,471.25,64.29,4628.0,69
CDM,49005225,FINE NEEDLE ASPIRATION BX W/CT GDN 1ST LESION,3237.0,2104.05,127.26,4628.0,87
CDM,49005235,FINE NEEDLE ASPIRATION BX W/CT GDN EA ADDL,1471.0,956.15,89.86,4628.0,69
CDM,49005245,FINE NEEDLE ASPIRATION BX W/MR GDN 1ST LESION,3237.0,2104.05,384.69,4628.0,85
CDM,49005255,FINE NEEDLE ASPIRATION BX W/MR GDN EA ADDL,1456.0,946.4,317.41,4628.0,67
CDM,49005265,TANGENTIAL BIOPSY SKIN SINGLE LESION,596.0,387.4,40.28,12500.0,87
CDM,49005275,TANGENTIAL BIOPSY SKIN EA SEP/ADDITIONAL LESION,159.0,103.35,23.54,4628.0,69
CDM,49005285,PUNCH BIOPSY SKIN SINGLE LESION,1199.0,779.35,50.78,12500.0,87
CDM,49005295,PUNCH BIOPSY SKIN EA SEP/ADDITIONAL LESION,184.0,119.6,27.96,4628.0,69
CDM,49005305,INCISIONAL BIOPSY SKIN SINGLE LESION,1836.0,1193.4,61.62,4628.0,87
CDM,49005315,INCISIONAL BIOPSY SKIN EA SEP/ADDITIONAL LESION,283.0,183.95,33.35,4628.0,69
CDM,49005325,PERQ DILATION XST TRC ENDOUROLOGIC PX W/IMG,15865.0,10312.25,178.5,15865.0,87
CDM,49005335,PERQ DILATION XST TRC NEW ACCESS RENAL COLTJ SYS,15865.0,10312.25,297.63,15865.0,87
CDM,49005375,INSJ/RPLCMT ICDS W/SUBSTERNAL ELECTRODE,46823.0,30434.95,7663.0,46823.0,84
CDM,49005385,INSJ SUBSTERNAL IMPLANTABLE DEFIBRILLATOR ELTRD,33104.0,21517.6,806.19,33104.0,84
CDM,49005395,RMVL SUBSTERNAL IMPLANTABLE DEFIBRILLATOR ELTRD,14557.0,9462.05,806.19,14557.0,84
CDM,49005405,REPOS PREV IMPL SS IMPLTBL DFB PACING ELTRD,14557.0,9462.05,806.19,14557.0,84
CDM,49005415,RMVL SUBSTERNAL IMPLTBL DFB PULSE GENERATOR ONLY,14557.0,9462.05,806.19,14557.0,84
CDM,49005425,ABLATION MAL BRST TUMOR PERQ CRTX UNILATERAL,15317.0,9956.05,1031.8,15317.0,84
CDM,49005435,TRURL ABLTJ MAL PRST8 TISS HI ENERGY WATER VAPOR,6764.0,4396.6,1880.39,13730.23,76
CDM,49005455,PERCUTANEOUS IMPLANTATION/REPLACEMENT ISDNS PTN,7752.0,5038.8,284.76,7752.0,85
CDM,49005465,REVISION OR REMOVAL ISDNS POSTERIOR TIBIAL NRV,13756.0,8941.4,284.76,13756.0,85
CDM,49005475,ELEC ALYS SMPL PRGRMG IINS PTN 1-3 PARAMETERS,367.0,238.55,0.01,367.0,84
CDM,49005485,ELEC ALYS CPLX PRGRMG IINS BLDR DYSF PTN 4+,367.0,238.55,0.01,367.0,84
CDM,49005545,NEEDLE INSERTION W/O INJECTION 1 OR 2 MUSCLES,113.0,73.45,17.49,12500.0,86
CDM,49005555,NEEDLE INSERTION W/O INJECTION 3 OR MORE MUSCLES,113.0,73.45,22.7,12500.0,86
CDM,49005565,MANUAL PREP AND INSERTION DEEP DRUG DELIVERY DEV,259.0,168.35,56.46,4628.0,68
CDM,49005575,REMOVAL DEEP DRUG DELIVERY DEVICE,632.0,410.8,70.72,4628.0,68
CDM,49005585,MANUAL PREP&INSJ INTRAMEDULLARY DRUG DLVR DEVICE,259.0,168.35,56.46,4628.0,68
CDM,49005595,REMOVAL INTRAMEDULLARY DRUG DELIVERY DEVICE,632.0,410.8,79.74,4628.0,68
CDM,49005605,MANUAL PREP&INSJ I-ARTIC DRUG DELIVERY DEVICE,259.0,168.35,56.46,4628.0,68
CDM,49005615,REMOVAL INTRA-ARTICULAR DRUG DELIVERY DEVICE,632.0,410.8,79.74,4628.0,68
CDM,49005625,PERICARDIOCENTESIS W/IMG GUIDANCE WHEN PERFORMED,8932.0,5805.8,262.68,11545.0,87
CDM,49005645,DIAGNOSTIC LUMBAR SPINAL PUNCTURE W/FLUOR OR CT,4778.0,3105.7,99.72,4778.0,87
CDM,49005655,THERAPEUTIC SPINAL PNXR DRAINAGE CSF W/FLUOR/CT,4778.0,3105.7,121.65,4778.0,87
CDM,49005665,INJECTION AA&/STRD NERVES NRVTG SI JOINT W/IMG,4778.0,3105.7,96.29,4778.0,87
CDM,49005675,INJECTION AA&/STRD GENICULAR NRV BRANCHES W/IMG,4778.0,3105.7,97.17,4778.0,87
CDM,49005685,DESTRUCTION NEUROLYTIC AGT GENICULAR NERVE W/IMG,13474.0,8758.1,173.61,13474.0,87
CDM,49005695,RADIOFREQUENCY ABLTJ NRV NRVTG SI JT W/IMG GDN,13474.0,8758.1,230.6,13474.0,87
CDM,49005725,MYOCRD IMG PET METAB EVAL SINGLE STUDY CNCRNT CT,10064.0,6541.6,0.01,10064.0,77
CDM,49005735,MYOCRD IMG PET PRFUJ 1STD REST/STRESS CNCRNT CT,10064.0,6541.6,0.01,10064.0,77
CDM,49005745,MYOCRD IMG PET PRFUJ MLT STD RST&STRS CNCRNT CT,15528.0,10093.2,0.01,15528.0,77
CDM,49005755,MYOCRD IMG PET PRFUJ W/METAB DUAL RADIOTRACER,12768.0,8299.2,0.01,12768.0,77
CDM,49005765,MYOCRD IMG PET PRFUJ W/METAB 2RTRACER CNCRNT CT,13458.0,8747.7,0.01,13458.0,77
CDM,49005775,RP LOCLZJ TUM SPECT W/CT 1 AREA 1 DAY IMAGING,9008.0,5855.2,0.01,9008.0,87
CDM,49005785,RP LOCLZJ TUM SPECT 2 AREA/SEP ACQUISJ IMG,9008.0,5855.2,0.01,9008.0,87
CDM,49005795,RP LOCLZJ TUM SPECT CT 2AREA/SEP ACQUISJ IMG,10064.0,6541.6,0.01,10064.0,87
CDM,49005805,DUPLEX SCAN ARTL INFL&VEN O/F HEMO COMPL BI STD,1390.0,903.5,0.01,1390.0,86
CDM,49005815,DUPLEX SCAN ARTL INFL&VEN O/F HEMO COMPL UNI STD,611.0,397.15,0.01,611.0,86
CDM,49005835,SURG NASOPHARYNGOSCOPY DILAT EUSTACHIAN TUBE BI,23663.0,15380.95,268.91,23663.0,87
CDM,49005845,PERQ NJX ALGC CELL &/PRDCT UNI/BI FLUOR LMBR 1ST,10021.0,6513.65,2602.0,33436.0,85
CDM,49005885,RPR NSL VLV COLLAPSE SUBQ/SBMCSL LAT WALL IMPLT,27212.0,17687.8,187.89,27212.0,87
CDM,49005895,TRANSRECTAL ABLTJ MAL PRST8 TISSUE HIFU W/US,42537.0,27649.05,1149.88,42537.0,87
CDM,49005915,SURG NASOPHARYNGOSCOPY DILAT EUSTACHIAN TUBE UNI,23663.0,15380.95,193.13,23663.0,87
CDM,49005945,"REVASC ENDOV, OPEN OR PERC, TIBIAL/PERONEAL ARTERY(IES), W/IVL,",26829.0,17438.85,3924.0,26829.0,84
CDM,49005955,"REVASC ENDOV, OPEN OR PERC,  TIBIAL/PERONEAL ARTERY(IES); W/IVL,",46149.0,29996.85,6021.0,46149.0,84
CDM,49005965,"REVASC ENDOV, OPEN OR PERC, TIBIAL/PERONEAL ARTERY(IES); W/IVL A",36344.0,23623.6,6021.0,36344.0,84
CDM,49005975,"REVASC ENDOV, OPEN OR PERC, TIBIAL/PERONEAL ARTERY(IES); W/IVL A",38839.0,25245.35,6021.0,38839.0,84
CDM,49006035,DISE DYN EVAL SLEEP DISORDERED BREATHING FLX DX,7933.0,5156.45,107.64,12500.0,87
CDM,49006125,NJX BONE SUB MATRL INTO SUBCHONDRAL BONE DEFECT,12978.0,8435.7,174.77,12978.0,84
CDM,49006135,PERQ P-ART REVSC ST 1ST NML NATIVE CONNJ UNI,65208.0,42385.2,657.03,65208.0,86
CDM,49006145,PERQ P-ART REVSC ST 1ST NML NATIVE CONNJ BI,65208.0,42385.2,864.19,65208.0,86
CDM,49006235,PERQ P-ART REVSC ST 1ST ABNOR CONNJ UNILATERAL,103251.0,67113.15,834.23,103251.0,86
CDM,49006345,PERQ P-ART REVSC ST 1ST ABNORMAL CONNJ BILATERAL,65208.0,42385.2,983.89,65208.0,86
CDM,49006355,PERQ AV FISTULA CREATION UXTR SINGLE ACCESS,103251.0,67113.15,418.33,103251.0,86
CDM,49006365,PERQ AV FISTULA CREATION UXTR SEP ACCESS SITES,103251.0,67113.15,534.44,103251.0,86
CDM,49007225,PTCA W/ IVUS OR OCT,41751.0,27138.15,5870.61,41751.0,66
CDM,49007235,COR ANGIO W/ FFR & 3D MAP,23119.0,15027.35,1947.82,23119.0,66
CDM,49007245,PCTA W/ COR LITHOTRIP,47343.0,30772.95,5870.61,47343.0,66
CDM,49010OH,EXPL RETROPERITONEUM W/WO BX SPX,6424.0,4175.6,1.1,6424.0,144
CDM,49013OH,PREPERITONEAL PEL PACK F/HEMRRG ASSOC PEL TRMA,3340.0,2171.0,1.1,3340.0,144
CDM,49014OH,REEXPL PEL WND W/RMVL PREPERITONEAL PEL PACKING,2692.0,1749.8,1.1,2692.0,144
CDM,49020OH,DRG PERITONEAL ABSCESS/LOCAL PERITONITIS OPEN,10668.0,6934.2,1.1,10668.0,144
CDM,49040OH,DRAINAGE SUBDIAPHRAGMATIC/SUBPHREN ABSCESS OPEN,6608.0,4295.2,1.1,6608.0,144
CDM,49060OH,DRAINAGE OF RETROPERITONEAL ABSCESS OPEN,7412.0,4817.8,1.1,7412.0,144
CDM,49062OH,DRG XTRAPERITONEAL LYMPHOCELE PERITON CAVITY OPN,4888.0,3177.2,1.1,4888.0,144
CDM,49082OH,ABDOM PARACENTESIS DX/THER W/O IMAGING GUIDANCE,546.0,354.9,1.1,2644.7,148
CDM,49083OH,ABDOM PARACENTESIS DX/THER W IMAGING GUIDANCE,880.0,572.0,1.1,2644.7,148
CDM,49084OH,PERITONEAL LAVAGE W/WO IMAGING GUIDANCE,880.0,572.0,1.1,2644.7,144
CDM,49180OH,BX ABDL/RPR MASS PRQ NDL,761.0,494.65,1.1,4729.25,148
CDM,49185OH,SCLEROTHERAPY FLUID COLLECTION PRQ W/IMG GID,940.0,611.0,1.1,4729.25,148
CDM,49186OH,OPEN EXC/DSTRJ INTRA-ABDL TUMOR/CST 5 CM OR LESS,9680.0,6292.0,1.1,9680.0,142
CDM,49187OH,OPEN EXC/DSTRJ INTRA-ABDL TUMOR/CST 5.1-10 CM,12606.0,8193.9,1.1,12606.0,142
CDM,49188OH,OPEN EXC/DSTRJ INTRA-ABDL TUMOR/CST 10.1-20 CM,14960.0,9724.0,1.1,14960.0,142
CDM,49189OH,OPEN EXC/DSTRJ INTRA-ABDL TUMOR/CST 20.1-30 CM,17600.0,11440.0,1.1,17600.0,142
CDM,49190OH,OPEN EXC/DSTRJ INTRA-ABDL TUMOR/CYST >30 CM,22000.0,14300.0,1.1,22000.0,142
CDM,49215OH,EXCISE PRESACRAL/SACRAL TUMOR,15124.0,9830.6,1.1,15124.0,144
CDM,49250OH,UMBILECTOMY OMPHALECTOMY EXC UMBILICUS SPX,3604.0,2342.6,1.1,10089.06,144
CDM,49255OH,OMNTC EPIPLOECTOMY RESCJ OMENTUM SPX,5024.0,3265.6,1.1,5024.0,144
CDM,49320OH,LAPS ABD PRTM&OMENTUM DX W/WO SPEC BR/WA SPX,2262.0,1470.3,1.1,16829.38,144
CDM,49321OH,L'SCOPE W/BIOPSY SINGLE/MULTIPLE,2176.0,1414.4,1.1,16829.38,144
CDM,49322OH,L'SCOPE CAVITY/CYST SINGLE/MULTIPLE,2404.0,1562.6,1.1,16829.38,144
CDM,49323OH,L'SCOPE W/DRNG  LYMPHOCELE TO PERIT,4092.0,2659.8,1.1,16829.38,144
CDM,49324OH,LAPS INSERTION TUNNELED INTRAPERITONEAL CATHETER,2528.0,1643.2,1.1,16829.38,144
CDM,49325OH,LAPS W/REVISION INTRAPERITONEAL CATHETER,2728.0,1773.2,1.1,16829.38,144
CDM,49326OH,LAPAROSCOPY W/OMENTOPEXY,1400.0,910.0,1.1,1400.0,144
CDM,49327OH,LAPS W/INSERTION NTRSTL DEV W/IMG GID 1+,952.0,618.8,1.1,952.0,144
CDM,49329AGRVU2OH,"UNLISTED LAPAROSCOPY PROCEDURE, ABDOMEN, PERITONEUM AND OMENTUM",4670.0,3035.5,0.01,16829.38,84
CDM,49329RVU10OH,"UNLISTED LAP REMOVAL FOREIGN BODY , ABD (COMP CODE 49402)",3018.0,1961.7,0.01,16829.38,84
CDM,49329RVU11OH,"LAP LYSIS ADHESIONS,PERITONEAL (COMP CODE 44180)",5013.0,3258.45,0.01,16829.38,84
CDM,49329RVU12OH,LAP. REM. PANCREAS W/WO SPLEEN,3341.0,2171.65,0.01,16829.38,84
CDM,49329RVU13OH,LX EXCISION OF RETROPERITONEAL TUMOR (COMP 49203),5541.0,3601.65,0.01,16829.38,84
CDM,49329RVU14OH,LAP DRAINAGE OF ABD ABSCESS (COMP 49020),3987.0,2591.55,0.01,16829.38,84
CDM,49329RVU15OH,LAPAROSCOPIC CREATION OF MYOFASCIAL CUTANEOUS MUSCLE FLAPS (COMP,7163.0,4655.95,0.01,16829.38,84
CDM,49329RVU16OH,"UNLISTED LAPAROSCOPY, ABDOMEN, PERITONEUM AND OMENTUM (COMP CODE",2374.0,1543.1,0.01,16829.38,84
CDM,49329RVU17OH,"UNLISTED LAPAROSCOPY PROCEDURE, ABDOMEN, PERITONEUM AND OMENTUM",8623.0,5604.95,0.01,16829.38,84
CDM,49329RVU19OH,"UNLISTED LAPAROSCOPY PROCEDURE, ABDOMEN, PERITONEUM AND OMENTUM",7307.0,4749.55,0.01,16829.38,84
CDM,49329RVU1OH,LAP RMVL FOREIGN IN OMENTUM/ABDOMEN,1779.0,1156.35,0.01,16829.38,84
CDM,49329RVU20OH,"UNLISTED LAPAROSCOPY PROCEDURE, ABDOMEN, PERITONEUM AND OMENTUM",5024.0,3265.6,0.01,16829.38,84
CDM,49329RVU22OH,LAP RELEASE MEDIAN ARCUATE LIGAMENT (COMP 49320),2185.0,1420.25,0.01,16829.38,84
CDM,49329RVU23OH,POST OP LAP EXPLOR & CONTROL HEMORRHAGE ABD (COMP TO 35840),4557.0,2962.05,0.01,16829.38,84
CDM,49329RVU24OH,LAPAROSCOPIC PERITONEAL DIALYSIS CATH REMOVAL (COMP TO 49422),2152.0,1398.8,0.01,16829.38,84
CDM,49329RVU25OH,LAPAROSCOPIC ABDOMINAL MESH REMOVAL (COMP TO 20680),1967.0,1278.55,0.01,16829.38,84
CDM,49329RVU26OH,LAPAROSCOPIC RELEASE OF MEDIAN ARCUATE LIGAMENT (MALS PROC) (COM,5883.0,3823.95,0.01,16829.38,84
CDM,49329RVU27OH,LAPAROPSCOPIC URACHAL CYST EXCISION (COMP CODE 39545),6235.0,4052.75,0.01,16829.38,84
CDM,49329RVU28OH,"LAP EXCISION ABD, PERITONEUM, OMENTUM 5CM OR LESS (COMP 49186)",9460.0,6149.0,0.01,16829.38,84
CDM,49329RVU29OH,"LAP,EXCISION ABD, PERITONEUM, OMENTUM 5.1-10CM (COMP 49187)",12320.0,8008.0,0.01,16829.38,84
CDM,49329RVU2OH,LAPAROSCOPIC EVACUATION HEMATOMA (COMP 49002),1967.0,1278.55,0.01,16829.38,84
CDM,49329RVU30OH,"LAP EXCISION ABD, PERITONEUM, OMENTUM 10.1-20CM (COMP 49188)",14620.0,9503.0,0.01,16829.38,84
CDM,49329RVU31OH,"LAP EXCISION ABD, PERITONEUM, OMENTUM 20.1-30CM (COMP 49189)",17200.0,11180.0,0.01,17200.0,84
CDM,49329RVU32OH,"LAP EXCISION ABD, PERITONEUM, OMENTUM GREATER THAN 30CM (COMP 49",21500.0,13975.0,0.01,21500.0,84
CDM,49329RVU33OH,LAP EXCISION OF A PRESACRAL SINUS(FISTULA) TRACT/ABSCESS (COMP 4,15124.0,9830.6,0.01,16829.38,84
CDM,49329RVU3OH,LAPROSCOPIC OMENTAL FLAP INTRA-ABDOMINAL (COMP CODE 49905),3294.0,2141.1,0.01,16829.38,84
CDM,49329RVU4OH,LAPAR,2640.0,1716.0,0.01,16829.38,84
CDM,49329RVU5OH,LAP EXPLORATION FOR POST OP HEMORRHAGE,3190.0,2073.5,0.01,16829.38,84
CDM,49329RVU6OH,LAP EXCISION ABDOMINAL WALL TUMOR,4932.0,3205.8,0.01,16829.38,84
CDM,49329RVU7OH,LAP RMV/REVSION VETRICULOPERITONEL SHUNT,4574.0,2973.1,0.01,16829.38,84
CDM,49329RVU8OH,LX EXCISION OF RETROPERITONEAL TUMOR,5541.0,3601.65,0.01,16829.38,84
CDM,49329RVU9OH,LAPAROSCOPIC EXCISION OMENTUM (49255),3501.0,2275.65,0.01,16829.38,84
CDM,49400OH,INJECTION AIR/CONTRAST PERITONEAL CAVITY SPX,752.0,488.8,1.1,752.0,148
CDM,49402OH,REMOVAL PERITONEAL FOREIGN BODY FROM CAVITY,5636.0,3663.4,1.1,10089.06,144
CDM,49405OH,IMAGE-GUIDE FLUID COLLXN DRAINAGE CATH VISC PERQ,1600.0,1040.0,1.1,4729.25,148
CDM,49406OH,IMG-GUIDE FLUID COLLXN DRAINAG CATH PERITON PERQ,1760.0,1144.0,1.1,4729.25,148
CDM,49407OH,IMAGE FLUID COLLXN DRAINAG CATH TRANSREC/VAGINAL,1700.0,1105.0,1.1,4729.25,148
CDM,49411OH,INTERSTITIAL DEV PLMT RADIATION THERAPY 1/MLT,1428.0,928.2,1.1,4040.52,148
CDM,49412OH,PLMT INTRSTL DEV OPN W/IMG GID 1+,600.0,390.0,1.1,600.0,144
CDM,49418OH,INSJ INTRAPERITONEAL CATHETER W/IMG GID,1584.0,1029.6,1.1,10089.06,148
CDM,49419OH,INSERTION TUNNEL INTRAPERITONEAL CATH SUBQ PORT,2832.0,1840.8,1.1,16027.4,144
CDM,49421OH,INSERTION TUNNEL INTRAPERITONEAL CATH DIAL OPEN,1684.0,1094.6,1.1,10089.06,144
CDM,49422OH,REMOVAL TUNNELED INTRAPERITONEAL CATHETER,1760.0,1144.0,1.1,9296.26,144
CDM,49423OH,EXCHNG ABSC/CST DRG CATH RAD GID SPX,642.0,417.3,1.1,5549.59,148
CDM,49424OH,CNTRST NJX ASSMT ABSC/CST VIA DRG CATH/TUBE SPX,304.0,197.6,1.1,614.25,148
CDM,49426OH,REVIS PERITONEAL-VENOUS SHUNT,4164.0,2706.6,1.1,10089.06,144
CDM,49427OH,INJECT EVALUATE PREVIOUS PERITONEAL-VENOUS SHUNT,392.0,254.8,1.1,392.0,144
CDM,49428OH,LIGATION OF ABD-VENOUS SHUNT,2748.0,1786.2,1.1,2748.0,144
CDM,49429OH,RMVL PERITONEAL-VENOUS SHUNT,2976.0,1934.4,1.1,9296.26,144
CDM,49435OH,INSERT SUBQ EXTENSION INTRAPERITONEAL CATH,900.0,585.0,1.1,900.0,144
CDM,49436OH,DELAYED CREATION EXIT SITE EMBEDDED CATHETER,1088.0,707.2,1.1,5549.59,148
CDM,49440OH,INSERT GASTROSTOMY TUBE PERCUTANEOUS,1729.0,1123.85,1.1,5549.59,148
CDM,49441OH,INSERT DUODENOSTOMY/JEJUNOSTOMY TUBE PERQ,1808.0,1175.2,1.1,5549.59,148
CDM,49442OH,INSERT CECOSTOMY/OTHER COLONIC TUBE PERCUTANEOUS,1500.0,975.0,1.1,3440.56,148
CDM,49446OH,CONVERT GASTROSTOMY-GASTRO-JEJUNOSTOMY TUBE PERQ,1224.0,795.6,1.1,5549.59,148
CDM,49450OH,REPLACE GASTROSTOMY/CECOSTOMY TUBE PERCUTANEOUS,544.0,353.6,1.1,2644.7,148
CDM,49451OH,REPLACE DUODENOSTOMY/JEJUNOSTOMY TUBE PERQ,736.0,478.4,1.1,2644.7,148
CDM,49452OH,REPLACEMENT GASTRO-JEJUNOSTOMY TUBE PERCUTANEOUS,1144.0,743.6,1.1,2644.7,148
CDM,49460OH,OBSTRUCTIVE MATERIAL REMOVAL FROM GI TUBE,384.0,249.6,1.1,2644.7,148
CDM,49465OH,CONTRAST INJECTION PERQ RADIOLOGIC EVAL GI TUBE,248.0,161.2,1.1,713.21,148
CDM,49491OH,RPR 1ST INGUN HRNA PRETERM INFT RDC,5012.0,3257.8,1.1,16829.38,144
CDM,49492OH,RPR 1ST INGUN HRNA PRETERM INFT INCARCERATED,6172.0,4011.8,1.1,10089.06,144
CDM,49495OH,RPR 1ST INGUN HRNA FULL TERM INFT <6 MO RDC,2480.0,1612.0,1.1,10089.06,144
CDM,49496OH,RPR 1ST INGUN HRNA FULL TERM INFT <6 MO INCARCER,3768.0,2449.2,1.1,10089.06,144
CDM,49500OH,RPR 1ST INGUN HRNA AGE 6 MO-5 YRS REDUCIBLE,2336.0,1518.4,1.1,22063.69,144
CDM,49501OH,RPR 1ST INGUN HRNA AGE 6 MO-5 YRS INCARCERATED,3744.0,2433.6,1.1,10089.06,144
CDM,49505OH,RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE,3184.0,2069.6,1.1,10089.06,144
CDM,49507OH,RPR 1ST INGUN HRNA AGE 5 YRS/> INCARCERATED,3636.0,2363.4,1.1,10089.06,144
CDM,49520OH,RPR RECRT INGUINAL HERNIA ANY AGE REDUCIBLE,3996.0,2597.4,1.1,10089.06,144
CDM,49521OH,RPR RECRT INGUN HERNIA ANY AGE INCARCERATED,4592.0,2984.8,1.1,22063.69,144
CDM,49525OH,RPR INGUN HERNIA SLIDING ANY AGE,3572.0,2321.8,1.1,10089.06,144
CDM,49540OH,REPAIR LUMBAR HERNIA,4296.0,2792.4,1.1,16829.38,144
CDM,49550OH,RPR 1ST FEM HRNA ANY AGE REDUCIBLE,3596.0,2337.4,1.1,10089.06,144
CDM,49553OH,RPR 1ST FEM HERNIA ANY AGE INCARCERATED,3968.0,2579.2,1.1,10089.06,144
CDM,49555OH,RPR RECRT FEM HERNIA REDUCIBLE,3756.0,2441.4,1.1,10089.06,144
CDM,49557OH,RPR RECRT FEM HRNA INCARCERATED,4648.0,3021.2,1.1,10089.06,144
CDM,49591OH,RPR AA HERNIA 1ST < 3 CM REDUCIBLE,2622.0,1704.3,1.1,10089.06,144
CDM,49592OH,RPR AA HERNIA 1ST < 3 CM NCRC8/STRANGULATED,3722.0,2419.3,1.1,16829.38,144
CDM,49593OH,RPR AA HERNIA 1ST 3-10 CM REDUCIBLE,4514.0,2934.1,1.1,10089.06,144
CDM,49594OH,RPR AA HERNIA 1ST 3-10 CM NCRC8/STRANGULATED,5922.0,3849.3,1.1,16829.38,144
CDM,49595OH,RPR AA HERNIA 1ST > 10 CM REDUCIBLE,6134.0,3987.1,1.1,10089.06,144
CDM,49596OH,RPR AA HERNIA 1ST > 10 CM NCRC8/STRANGULATED,8215.0,5339.75,1.1,8215.0,144
CDM,49600OH,RPR SMALL OMPHALOCELE W/PRIMARY CLOSURE,4620.0,3003.0,1.1,10089.06,144
CDM,49605OH,RPR LG OMPHALOCELE/GASTROSCHISIS W/WO PROSTH,34836.0,22643.4,1.1,34836.0,144
CDM,49606OH,RPR LG OMPHALOCELE/GASTROSCHISIS RMVL PROSTH,7600.0,4940.0,1.1,7600.0,144
CDM,49611OH,RPR OMPHALOCELE GROSS TYP OPRATION 2ND STG,3736.0,2428.4,1.1,3736.0,144
CDM,49613OH,RPR AA HERNIA RECR < 3 CM REDUCIBLE,2968.0,1929.2,1.1,10089.06,144
CDM,49614OH,RPR AA HERNIA RECR < 3 CM NCRC8/STRANGULATED,4100.0,2665.0,1.1,16829.38,144
CDM,49615OH,RPR AA HERNIA RECR 3-10 CM REDUCIBLE,4584.0,2979.6,1.1,10089.06,144
CDM,49616OH,RPR AA HERNIA RECR 3-10 CM NCRC8/STRANGULATED,6842.0,4447.3,1.1,6842.0,144
CDM,49617OH,RPR AA HERNIA RECR > 10 CM REDUCIBLE,6412.0,4167.8,1.1,6412.0,144
CDM,49618OH,RPR AA HERNIA RECR > 10 CM NCRC8/STRANGULATED,9068.0,5894.2,1.1,9068.0,144
CDM,49621OH,RPR PARASTOMAL HERNIA 1ST/RECR REDUCIBLE,5480.0,3562.0,1.1,5480.0,144
CDM,49622OH,RPR PARASTOMAL HRNA 1ST/RECR NCRC8/STRANGULATED,6824.0,4435.6,1.1,6824.0,144
CDM,49623OH,RMVL NONINFCT MESH/PROSTH AA/PARASTOMAL HRNA RPR,1500.0,975.0,1.1,1500.0,144
CDM,49650OH,LAPAROSCOPY SURG RPR INITIAL INGUINAL HERNIA,2544.0,1653.6,1.1,16829.38,144
CDM,49651OH,LAPS SURG RPR RECURRENT INGUINAL HERNIA,3352.0,2178.8,1.1,16829.38,144
CDM,49659OH,UNLISTED LAPS PX HRNAP HERNIORRHAPHY HERNIOTOMY,3264.0,2121.6,0.01,16829.38,84
CDM,49659RVU10OH,LAPAROSCOPIC CONGENITAL HERNIA REPAIR W/ MESH (COMP 43282),10837.0,7044.05,0.01,16829.38,84
CDM,49659RVU1OH,REPAIR INTERNAL HERNIA,6583.0,4278.95,0.01,16829.38,84
CDM,49659RVU3OH,LAP. REPAIR PARAESOPHAGEAL HERNIA,3696.0,2402.4,0.01,16829.38,84
CDM,49659RVU4OH,LAP. PERISTOMAL HERNIA REPAIR,5160.0,3354.0,0.01,16829.38,84
CDM,49659RVU5OH,"UNLISTED LAPAROSCOPY PROCEDURE, HERNIOPLASTY, HERNIORRHAPHY, HER",1680.0,1092.0,0.01,16829.38,84
CDM,49659RVU6OH,LAP REPAIR OF FEMORAL HERNIA (COMP 49550),3827.0,2487.55,0.01,16829.38,84
CDM,49659RVU7OH,LAP REPAIR INITIAL FEMORAL HERNIA; INCAR OR STRANG (COMP CODE 49,3572.0,2321.8,0.01,16829.38,84
CDM,49659RVU8OH,LAPAROSCOPIC REPAIR RECURRENT FEMORAL HERNIA (COMP CODE 49555),3381.0,2197.65,0.01,16829.38,84
CDM,49659RVU9OH,LAP REPAIR OF ACUTE TRAUMATIC DIAPHRAGMATIC HERNIA (COMP 39540),6265.0,4072.25,0.01,16829.38,84
CDM,49659RVUOH,LAP INCAR INGUINAL HERNIA REPAIR,3413.0,2218.45,0.01,16829.38,84
CDM,49900OH,SEC ABDOMINAL WALL SUTURE EVISCERATION/DEHSN,4964.0,3226.6,1.1,4964.0,144
CDM,49904OH,OMENTAL FLAP EXTRA-ABDOMINAL,8940.0,5811.0,1.1,8940.0,144
CDM,49905OH,OMENTAL FLAP INTRA-ABDOMINAL,2616.0,1700.4,1.1,2616.0,144
CDM,49906OH,"FREE OMENTAL FLAP,MICROVASC ANAST",3043.0,1977.95,1.1,5241.27,88
CDM,49999AOH,DRAINAGE SUBHEPATIC ABSCESS,8801.0,5720.65,0.01,8801.0,84
CDM,49999RVU11OH,UNLISTED PROC OPEN DRAINAGE OF INTRA ABD FLUID (COMP CODE 49062),4888.0,3177.2,0.01,4888.0,84
CDM,49999RVU12OH,"UNLISTED PROCEDURE, ABDOMEN, PERITONEUM & OMENTUM COMPARED TO 44",5588.0,3632.2,0.01,5588.0,84
CDM,49999RVU14OH,MESENTERIC OR OMENTUM BIOPSY (COMP 49000),3111.0,2022.15,0.01,3111.0,84
CDM,49999RVU15OH,OBTRUATOR HERNIA (COMP 49550),2967.0,1928.55,0.01,2967.0,84
CDM,49999RVU16OH,"OMENTAL FLAP, LAPARCOCOPIC (COMP CODE 49905)",2812.0,1827.8,0.01,2812.0,84
CDM,49999RVU17OH,EXPL OF GROIN WOUND W/ RELEASE OF SCAR FORMATION (COMP CODE 3584,7471.0,4856.15,0.01,7471.0,84
CDM,49999RVU18OH,CORE NEEDLE BIOPSY ABDOMEN/PERITONEUM/OMENTUM AT TIME OF OTHER P,818.0,531.7,0.01,2644.7,84
CDM,49999RVU19OH,PERCUTANEOUS CRYOABLATION ABDOMEN (COMP CODE 32994),3251.0,2113.15,0.01,3251.0,84
CDM,49999RVU1OH,INCISION FOR EXPLORATION ABDOMEN WOUND,813.0,528.45,0.01,2644.7,84
CDM,49999RVU20OH,REPOSITION PERITONEAL DIALYSIS CATH (COMP CODE 36597),484.0,314.6,0.01,2644.7,84
CDM,49999RVU21OH,PREOP WIRE LOCALIZATION INTRAPERITONEAL (COMP CODE 49411),1428.0,928.2,0.01,2644.7,84
CDM,49999RVU22OH,RADIOFREQUENCY ABLATION INTRA ABDOMINAL MASS (COMP CODE 50592),2620.0,1703.0,0.01,2644.7,84
CDM,49999RVU23OH,CRYOABLATION OF INTRA ABDOMINAL MASS (COMP CODE 50593),3552.0,2308.8,0.01,3552.0,84
CDM,49999RVU2OH,LYMPHO SCLEROSIS VIA CATH,1199.0,779.35,0.01,2644.7,84
CDM,49999RVU3OH,"REMOVAL FOREIGN BODY, ABD WALL (COMP CODE 11008)",3152.0,2048.8,0.01,3152.0,84
CDM,49999RVU5OH,"ALLODER,PERMACOL, SURGISIS MESH",2556.0,1661.4,0.01,2644.7,84
CDM,49999RVU6OH,RMVL F.B. ABDOMEN DEEP,3152.0,2048.8,0.01,3152.0,84
CDM,49999RVU7OH,LAP OMENTAL FLAP INTRA-ABDOMN,4005.0,2603.25,0.01,4005.0,84
CDM,49999RVU8OH,ABDOMEN SURGERY PROCEDURE,570.0,370.5,0.01,2644.7,84
CDM,49999RVU9OH,REPAIR HERNIA PERINEAL (COMP 44050),3934.0,2557.1,0.01,3934.0,84
CDM,50010OH,RNL EXPL X NECESSITATING OTH SPEC PX,4912.0,3192.8,1.1,4912.0,144
CDM,50011981OH,INSERT DRUG IMPLANT DEVICE,387.0,251.55,1.1,387.0,148
CDM,50020OH,"ABCESS DRAINAGE,RENAL/PERIRENA",7232.0,4700.8,1.1,7232.0,144
CDM,50040OH,NEPHROSTOMY/NEPHROTOMY W/DRAINAGE,6672.0,4336.8,1.1,6672.0,144
CDM,50060OH,NEPHROLITHOTOMY REMOVAL STAGE 1,8380.0,5447.0,1.1,8380.0,144
CDM,50065OH,NEPHROLITHOTOMY SECONDARY FOR CALCULUS,8928.0,5803.2,1.1,8928.0,144
CDM,50075OH,NEPHROLITHOTOMY RMVL LG STAGHORN STAGE 1,10836.0,7043.4,1.1,10836.0,144
CDM,50080OH,PERQ NL/PL LITHOTRP SIMPLE UP TO 2 CM 1 LOCATION,5460.0,3549.0,1.1,26866.4,144
CDM,50081OH,PERQ NL/PL LITHOTRP COMPLEX >2 CM MLT LOCATIONS,9200.0,5980.0,1.1,26866.4,144
CDM,50120OH,EXPLOR RENAL PELVIS,6884.0,4474.6,1.1,6884.0,144
CDM,50125OH,PYELOTOMY W/DRAINAGE PYELOSTOMY,7128.0,4633.2,1.1,7128.0,144
CDM,50130OH,PYELOTOMY W/REMOVAL CALCULUS,7528.0,4893.2,1.1,7528.0,144
CDM,50200OH,RENAL BIOPSY PRQ TROCAR/NEEDLE,1047.0,680.55,1.1,4729.25,148
CDM,50205OH,RENAL BIOPSY SURG EXPOSURE KIDNEY,4916.0,3195.4,1.1,4916.0,144
CDM,50220OH,NEPHRECTOMY W/PRTL URETERECTOMY W/OPEN RIB RESCJ,7472.0,4856.8,1.1,7472.0,144
CDM,50225OH,NEPHRECTOMY W/PRTL URETERECT OPN RIB RESCJ COMPL,8752.0,5688.8,1.1,8752.0,144
CDM,50230OH,NEPHRECTOMY W/PRTL URETERECT OPEN RIB RESCJ RAD,9524.0,6190.6,1.1,9524.0,144
CDM,50234OH,NEPHRECTOMY W/TOT URETERECT&BLDR CUFF SAME INC,10582.0,6878.3,1.1,10582.0,144
CDM,50236OH,NEPHRECTOMY TOT URETEREC&BLDR CUFF SEPAR INCISN,10776.0,7004.4,1.1,10776.0,144
CDM,50240OH,NEPHRECTOMY PARTIAL,9684.0,6294.6,1.1,9684.0,144
CDM,50250OH,OPEN ABLATION RENAL MASS CRYOSURG ULTRASOUND,8888.0,5777.2,1.1,8888.0,144
CDM,50280OH,EXCIS/UNROOF RENAL CYST,6836.0,4443.4,1.1,6836.0,144
CDM,50290OH,EXCISION PERINEPHRIC CYST,6460.0,4199.0,1.1,6460.0,144
CDM,50320OH,"LIVING DONOR NEPHRECTOMY, OPEN",8972.0,5831.8,1.1,8972.0,142
CDM,50323OH,BKBENCH PREPJ CADAVER DONOR RENAL ALLOGRAFT,1136.0,738.4,1.1,1136.0,104
CDM,50325OH,BKBENCH PREPJ LIVING RENAL DONOR ALLOGRAFT,1136.0,738.4,1.1,1136.0,104
CDM,50327OH,BKBENCH RCNSTJ RENAL ALGRFT VENOUS ANAST EA,1760.0,1144.0,1.1,1760.0,142
CDM,50328OH,BKBENCH RCNSTJ RENAL ALLOGRAFT ARTERIAL ANAST EA,1400.0,910.0,1.1,1400.0,142
CDM,50329OH,BKBENCH RCNSTJ ALGRFT URETERAL ANAST EA,1336.0,868.4,1.1,1336.0,142
CDM,50340OH,RECIPIENT NEPHRECTOMY SEPARATE PROCEDURE,6178.0,4015.7,1.1,6178.0,144
CDM,50360OH,RENAL ALLOTRANSPLANTATION W/ GRAFT W/O RECIPIENT NEPHRECTOMY,17547.0,11405.55,1.1,17547.0,144
CDM,50365OH,"RENAL ALLOTRANSPLANTATION, IMPLANTATION OF GRAFT; WITH RECIPIENT",18452.0,11993.8,1.1,18452.0,144
CDM,50370OH,RMVL TRNSPLED RENAL ALLOGRAFT,7552.0,4908.8,1.1,7552.0,144
CDM,50380OH,RENAL AUTOTRNSPLJ REIMPLANTATION KIDNEY,12044.0,7828.6,1.1,12044.0,144
CDM,50382OH,RMVL & RPLCMT INTLY DWELLING URETERAL STENT PRQ,2100.0,1365.0,1.1,5941.4,148
CDM,50384OH,REMOVAL INDWELLING URETERAL STENT PRQ,1900.0,1235.0,1.1,5941.4,148
CDM,50385OH,REMOVE & REPLACE INDWELL URETERAL STENT TRURTHRL,1676.0,1089.4,1.1,5941.4,148
CDM,50386OH,REMOVE INT DWELL URETERAL STENT TRANSURETHRAL,1220.0,793.0,1.1,5941.4,148
CDM,50387OH,RMVL & RPLCMT XTRNL ACCESSIBLE NEPHROURTRL CATH,700.0,455.0,1.1,5941.4,148
CDM,50389OH,RMVL NFROS TUBE REQ FLUORO GUIDANCE,484.0,314.6,1.1,1992.71,148
CDM,50390OH,ASPIR &/NJX RENAL CYST/PELVIS NEEDLE PRQ,784.0,509.6,1.1,2050.87,144
CDM,50391OH,INSTLJ THER AGENT RENAL PELVIS&/URETER VIA TUB,784.0,509.6,1.1,784.0,148
CDM,50396OH,MANOMETRIC STDS THRU TUBE/NDWELLG URTRL CATH,836.0,543.4,1.1,1992.71,144
CDM,50400OH,PYELOPLASTY SIMPLE,9359.0,6083.35,1.1,9359.0,144
CDM,50405OH,PYELOPLASTY COMPLICATED,11378.0,7395.7,1.1,11378.0,144
CDM,50430OH,NJX PX ANTEGRDE NFROSGRM &/URTRGRM NEW ACCESS,1160.0,754.0,1.1,2124.29,148
CDM,50431OH,NJX PX ANTEGRDE NFROSGRM &/URTRGRM EXSTNG ACESS,440.0,286.0,1.1,1992.71,148
CDM,50432OH,PLMT NEPHROSTOMY CATH PRQ NEW ACCESS RS&I,1600.0,1040.0,1.1,5941.4,148
CDM,50433OH,PLMT NEPHROURETERAL CATH PRQ NEW ACCESS RS&I,2020.0,1313.0,1.1,10168.64,148
CDM,50434OH,CONVERT NEPHROSTOMY CATH TO NEPHROURTRL CATH PRQ,1500.0,975.0,1.1,5941.4,148
CDM,50435OH,EXCHANGE NEPHROSTOMY CATHETER PRQ W/IMG GID RS&I,801.0,520.65,1.1,5941.4,148
CDM,50436OH,PERQ DILATION XST TRC ENDOUROLOGIC PX W/IMG,1112.0,722.8,1.1,10168.64,144
CDM,50437OH,PERQ DILATION XST TRC NEW ACCESS RENAL COLTJ SYS,1940.0,1261.0,1.1,10168.64,144
CDM,50500OH,NEPHRORRHAPHY SUTURE KIDNEY WOUND/INJURY,8488.0,5517.2,1.1,8488.0,144
CDM,50520OH,CLOSURE NEPHROCUTANEOUS/PYELOCUTANEOUS FISTULA,7552.0,4908.8,1.1,7552.0,144
CDM,50525OH,CLSR NEPHROVISCERAL FISTULA W/VISC RPR ABDL APPR,9756.0,6341.4,1.1,9756.0,144
CDM,50540OH,SYMPHYSIOTOMY HORSESHOE KDN W/WO PLOP UNI/BI,8440.0,5486.0,1.1,8440.0,144
CDM,50541OH,LAPAROSCOPY SURG ABLATION RENAL CYSTS,6744.0,4383.6,1.1,30022.29,144
CDM,50542OH,LAPS ABLTJ RENAL MASS LESION W/INTRAOP US,8544.0,5553.6,1.1,30022.29,144
CDM,50543OH,LAPAROSC PARTIAL NEPHRECTOMY,10964.0,7126.6,1.1,30022.29,144
CDM,50544OH,"LAPAROSCOPY, SURGICAL; PYELOPLASTY",9348.0,6076.2,1.1,30022.29,144
CDM,50545OH,LAPAROSCOPY RADICAL NEPHRECTOMY,10024.0,6515.6,1.1,10024.0,144
CDM,50546OH,LAPAROSCOPY NEPHRECTOMY W/PARTIAL URETERECT,8748.0,5686.2,1.1,8748.0,144
CDM,50547OH,LAPAROSCOPY DONOR NEPHRECTOMY LIVING DONOR,10536.0,6848.4,1.1,10536.0,142
CDM,50548OH,LAPAROSCOPY NEPHRECTOMY W/TOTAL URETERECTOMY,10144.0,6593.6,1.1,10144.0,144
CDM,50549RVU10OH,LAPAROSCOPIC RENAL AUTOTRANSPLANTATION (COMP CODE 50380),10840.0,7046.0,0.01,16829.38,84
CDM,50549RVU11OH,LAPAROSCOPIC URETEROPLASTY (COMP CODE 50700),6009.0,3905.85,0.01,16829.38,84
CDM,50549RVU12OH,LAPAROSCOPIC RENAL CYST EXCISION (COMP CODE 50280),6836.0,4443.4,0.01,16829.38,84
CDM,50549RVU1OH,LAPAROSCOPIC PYELOLITHOTOMY (COMP 50130),7689.0,4997.85,0.01,16829.38,84
CDM,50549RVU2OH,"LAPAROSCOPE PROC, RENAL (COMP CODE 50365)",18452.0,11993.8,0.01,18452.0,84
CDM,50549RVU3OH,LAP RENAL AUTOTXP REIMPL,12047.0,7830.55,0.01,16829.38,84
CDM,50549RVU4OH,LX REMOVAL URETER W/ PART BLADDER CUFF,7553.0,4909.45,0.01,16829.38,84
CDM,50549RVU5OH,LX URETEROURETEROSTOMY,7553.0,4909.45,0.01,16829.38,84
CDM,50549RVU6OH,"LAPAROSCOPE PROC, URETER",7553.0,4909.45,0.01,16829.38,84
CDM,50549RVU7OH,LAPAROSCOPIC URETEROLYSIS,7553.0,4909.45,0.01,16829.38,84
CDM,50549RVU8OH,LX ILEAL CONDUIT,7553.0,4909.45,0.01,16829.38,84
CDM,50549RVU9OH,"UNLISTED LAPAROSCOPY PROCEDURE, RENAL (COMP CODE 50234)",10341.0,6721.65,0.01,16829.38,84
CDM,50549RVUOH,LAPAROSCOPIC CALICEAL DIVERTICULECTOMY,7520.0,4888.0,0.01,16829.38,84
CDM,50551OH,RENAL ENDOSCOPY NEPHROSTOMY W/WO IRRIGATION,2236.0,1453.4,1.1,15090.73,148
CDM,50553OH,RENAL NDSC NEPHROST W/URETERAL CATH W/WO DILA,2392.0,1554.8,1.1,15090.73,148
CDM,50555OH,RENAL NDSC NEPHROS/PYELOSTOMY BIOPSY,2608.0,1695.2,1.1,26866.4,148
CDM,50557OH,RENAL NDSC NEPHROS/PYELOSTOMY FULG&/INC W/WO BI,2644.0,1718.6,1.1,26866.4,148
CDM,50561OH,RENAL NDSC NEPHROS/PYELOSTOMY RMVL FB/CALCULUS,3032.0,1970.8,1.1,15090.73,148
CDM,50562OH,RENAL NDSC NEPHROS/PYELOSTOMY RESCJ TUMOR,4360.0,2834.0,1.1,26866.4,144
CDM,50570OH,RENAL NDSC NEPHROTOMY W/WO IRRIGATION,3812.0,2477.8,1.1,10168.64,144
CDM,50572OH,RNL NDSC NFROT W/URTRL CATHJ W/WO DILAT URETER,4132.0,2685.8,1.1,4132.0,144
CDM,50574OH,RENAL NDSC NEPHROTOMY W/BIOPSY,4400.0,2860.0,1.1,10168.64,144
CDM,50575OH,RNL NDSC NFROT/PLOT W/ENDOPYELOTOMY,5584.0,3629.6,1.1,15090.73,144
CDM,50576OH,RNL NDSC NFROT FULGURATION &/INCISION W/WO BX,4388.0,2852.2,1.1,26866.4,144
CDM,50580OH,RNL NDSC NFROT/PLOT W/RMVL FB/CALCULUS,4736.0,3078.4,1.1,15090.73,144
CDM,50590OH,LITHOTRIPSY XTRCORP SHOCK WAVE,3908.0,2540.2,1.1,10168.64,148
CDM,50592OH,ABLTJ 1/> RENAL TUMOR PRQ UNI RADIOFREQUENCY,2620.0,1703.0,1.1,16829.38,148
CDM,50593OH,ABLATION RENAL TUMOR UNILATERAL PERQ CRYOTHERAPY,3552.0,2308.8,1.1,30022.29,148
CDM,50600OH,URTROTOMY W/EXPL/DRG SEPARATE PROCEDURE,6868.0,4464.2,1.1,6868.0,144
CDM,50605OH,URETEROTOMY INSERTION INDWELLING STENT ALL TYPES,6716.0,4365.4,1.1,6716.0,144
CDM,50606OH,ENDOLUMINAL BX URTR &/RNL PELVIS NONENDOSCOPIC,1264.0,821.6,1.1,1638.58,148
CDM,50610OH,URTROLITHOTOMY UPPER ONE-THIRD URETER,6900.0,4485.0,1.1,6900.0,144
CDM,50620OH,URTROLITHOTOMY MIDDLE ONE-THIRD URETER,6572.0,4271.8,1.1,6572.0,144
CDM,50630OH,URTROLITHOTOMY LOWER ONE-THIRD URETER,6484.0,4214.6,1.1,6484.0,144
CDM,50650OH,URETRECECTOMY W/BLADDER CUFF SEPARATE PROCEDURE,8281.0,5382.65,1.1,8281.0,144
CDM,50660OH,URETERECTOMY TOT ECTOPIC URETER CMBN APPR,8408.0,5465.2,1.1,8408.0,144
CDM,50684OH,INJ PX URETEROGRAPHY/URETEROPYLOGRAPHY CATH,304.0,197.6,1.1,428.36,148
CDM,50688OH,CHNG URTROST TUBE/XTRNLLY ACCESSIBLE STENT ILEAL,480.0,312.0,1.1,5941.4,144
CDM,50690OH,NJX VISUALIZATION ILEAL CONDUIT&/URETEROPYELOG,464.0,301.6,1.1,464.0,148
CDM,50693OH,PLMT URTRL STENT PRQ PRE-EXISTING NFROS TRACT,1584.0,1029.6,1.1,10168.64,148
CDM,50694OH,PLMT URTRL STNT PRQ NEW ACESS W/O SEP NFROS CATH,2100.0,1365.0,1.1,10168.64,148
CDM,50695OH,PLMT URTRL STENT PRQ NEW ACCESS W/SEP NFROS CATH,2720.0,1768.0,1.1,10168.64,148
CDM,50700OH,URETEROPLASTY PLASTIC OPERATION URETER,6676.0,4339.4,1.1,6676.0,144
CDM,50705OH,URETERAL EMBOLIZATION/OCCLUSION W/IMG GID RS&I,1612.0,1047.8,1.1,6157.2,148
CDM,50706OH,BALLOON DILAT URETERAL STRICTURE W/IMG GID RS&I,1520.0,988.0,1.1,2823.28,148
CDM,50715OH,URETEROLYSIS W/WORPSG URETER RETROPERIT FIBROSIS,8256.0,5366.4,1.1,8256.0,144
CDM,50725OH,URTROLSS RETROCAVAL URTR W/REANAST,8080.0,5252.0,1.1,8080.0,144
CDM,50727OH,REVJ URINARY-CUTANEOUS ANASTAMOSIS,3312.0,2152.8,1.1,10168.64,144
CDM,50728OH,REVJ UR-CUTAN ANAST RPR FSCAL DFCT & HERNIA,4872.0,3166.8,1.1,4872.0,144
CDM,50740OH,URETEROPYELOSTOMY ANAST URETER RENAL PELVIS,8028.0,5218.2,1.1,8028.0,144
CDM,50750OH,URETEROCALYCOSTOMY ANAST URETER RENAL CALYX,8488.0,5517.2,1.1,8488.0,144
CDM,50760OH,URETEROURETEROSTOMY,8028.0,5218.2,1.1,8028.0,144
CDM,50770OH,TRANSURETEROURETEROSTOMY ANAST URETER CLAT URTR,8488.0,5517.2,1.1,8488.0,144
CDM,50780OH,URETERONEOCYSTOSTOMY ANAST 1 URETER BLADDER,8778.0,5705.7,1.1,8778.0,144
CDM,50782OH,URETERONEOCYSTOSTOMY ANAST DUPLICATE URETER BLDR,7864.0,5111.6,1.1,7864.0,144
CDM,50783OH,URETERONEOCYSTOSTOMY W/URETERAL TAILORING,8280.0,5382.0,1.1,8280.0,144
CDM,50785OH,URTRONEOCSTOST W/VESICO-PSOAS HITCH/BLDR FLAP,8892.0,5779.8,1.1,8892.0,144
CDM,50800OH,URETEROENTEROSTOMY ANAST URETER INTESTINE,7220.0,4693.0,1.1,7220.0,144
CDM,50810OH,URETEROSIGMOIDOSTOMY W/SIGMOID BLADDER & COLOSTO,9044.0,5878.6,1.1,9044.0,144
CDM,50815OH,URETEROCOLON CONDUIT INTESTINE ANASTOMOSIS,8904.0,5787.6,1.1,8904.0,144
CDM,50820OH,URETEROILEAL CONDUIT W/INTESTINE ANASTOMOSIS,9628.0,6258.2,1.1,9628.0,144
CDM,50825OH,CONTINENT DVRJ W/INT ANAST ANY SGM SM&/LG INTSTN,12272.0,7976.8,1.1,12272.0,144
CDM,50830OH,URINARY UN-DIVERSION,13508.0,8780.2,1.1,13508.0,144
CDM,50840OH,RPLCMT ALL/PART URETER INTESTINE SGM W/ANAST,8956.0,5821.4,1.1,8956.0,144
CDM,50845OH,CUTANANEOUS APPENDICO-VESICOSTOMY,8984.0,5839.6,1.1,8984.0,144
CDM,50860OH,URETEROSTOMY TRANSPLANTATION URETER SKIN,6832.0,4440.8,1.1,6832.0,144
CDM,50900OH,URETERORRHAPHY SUTURE URETER SEPARATE PROCEDURE,6016.0,3910.4,1.1,6016.0,144
CDM,50920OH,CLOSURE URETEROCUTANEOUS FISTULA,6324.0,4110.6,1.1,6324.0,144
CDM,50930OH,CLOSURE URETEROCUTANEOUS FISTULA W/VISC RPR,8076.0,5249.4,1.1,8076.0,144
CDM,50940OH,DELIGATION OF URETER,6372.0,4141.8,1.1,6372.0,144
CDM,50945OH,"LAPAROSCOPY, SURGICAL, URETEROLITHO",7188.0,4672.2,1.1,16829.38,144
CDM,50947OH,LAPS URTRONEOCSTOST W/CSTSC&URTRL STENT PLMT,11343.0,7372.95,1.1,30022.29,144
CDM,50948OH,LAPS URTRONEOCSTOST W/O CSTSC&URTRL STENT PLMT,10481.0,6812.65,1.1,30022.29,144
CDM,50949OH,UNLISTED LAPAROSCOPY PROCEDURE URETER,8308.0,5400.2,0.01,16829.38,84
CDM,50949RVU1OH,LAP URETEROURETEROSTOMY (COMP 50760),7553.0,4909.45,0.01,16829.38,84
CDM,50949RVU2OH,LAPAROSCOPIC URETEROLYSIS (COMP 50715),7431.0,4830.15,0.01,16829.38,84
CDM,50949RVU3OH,LAP ILEAL CONDUIT (COMP 50820),7553.0,4909.45,0.01,16829.38,84
CDM,50949RVU4OH,LAPAROSCOPIC URINARY UNDIVERSION (COMP 50830),13848.0,9001.2,0.01,16829.38,84
CDM,50949RVU5OH,LAPAROSCOPIC DISSECTION'S OF THE URETER AND REIMPLANTATION INTO,9558.0,6212.7,0.01,16829.38,84
CDM,50949RVU6OH,LAPAROSCOPIC URETERECTOMY WITH BLADDER CUFF (COMP CODE 50650),8093.0,5260.45,0.01,16829.38,84
CDM,50949RVU7OH,LAPAROSCOPIC URETEROCALICOSTOMY (COMP CODE 50750),8488.0,5517.2,0.01,16829.38,84
CDM,50951OH,URETERAL ENDOSCOPY VIA URETEROSTOMY,2332.0,1515.8,1.1,10168.64,148
CDM,50953OH,URETERAL ENDOSCOPY VIA URETEROST W/WO DIL URETER,2492.0,1619.8,1.1,10168.64,148
CDM,50955OH,URETERAL ENDOSCOPY VIA URETEROSTOMY W/BIOPSY,2696.0,1752.4,1.1,15090.73,148
CDM,50957OH,URETERAL ENDOSCOPY W/DEST&/INC W/WO BIOPSY,2712.0,1762.8,1.1,15090.73,148
CDM,50961OH,URETERAL ENDOSCOPY VIA URETEROST W/RMVL FB/STONE,2416.0,1570.4,1.1,15090.73,148
CDM,50970OH,URETERAL ENDOSCOPY VIA URETEROTOMY W/O IMAGING,2852.0,1853.8,1.1,10168.64,144
CDM,50972OH,NDSC URETEROTOMY URTRL CATHJ W/WO DILAT URETER,2752.0,1788.8,1.1,10168.64,144
CDM,50974OH,URETER ENDO&BX/URETEROTOMY,3664.0,2381.6,1.1,15090.73,144
CDM,50976OH,URETERAL ENDOSC VIA URETEROT W/DEST&/INC W/WO BX,3612.0,2347.8,1.1,15090.73,144
CDM,50980OH,NDSC URETEROTOMY RMVL FB/CALCULUS,2736.0,1778.4,1.1,15090.73,144
CDM,51000000,OPHTH MEDICAL XM&EVAL INTERMEDIATE NEW PT,593.0,385.45,0.01,593.0,87
CDM,51000005,OPHTH MEDICAL XM&EVAL COMPRE NEW PT 1/> VST,593.0,385.45,0.01,593.0,87
CDM,51000015,OPHTH MEDICAL XM&EVAL INTERMEDIATE ESTAB PT,593.0,385.45,0.01,593.0,87
CDM,51000020,OFFICE/OUTPATIENT EST PT MAY NOT REQ PHYS/QHP,150.0,97.5,0.01,150.0,69
CDM,51000025,OPHTH MEDICAL XM&EVAL COMPRHNSV ESTAB PT 1/>,593.0,385.45,0.01,593.0,87
CDM,51000035,GONIOSCOPY SEPARATE PROCEDURE,593.0,385.45,0.01,593.0,87
CDM,51000170,INITIAL PREVENTIVE MEDICINE NEW PATIENT <1YEAR,99.0,64.35,0.01,99.0,67
CDM,51000175,INITIAL PREVENTIVE MEDICINE NEW PT AGE 1-4 YRS,108.0,70.2,0.01,108.0,67
CDM,51000180,INITIAL PREVENTIVE MEDICINE NEW PT AGE 5-11 YRS,154.0,100.1,0.01,154.0,67
CDM,51000185,INITIAL PREVENTIVE MEDICINE NEW PT AGE 12-17 YR,186.0,120.9,0.01,186.0,67
CDM,51000190,INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS,184.0,119.6,0.01,184.0,67
CDM,51000195,INITIAL PREVENTIVE MEDICINE NEW PATIENT 40-64YRS,254.0,165.1,0.01,254.0,67
CDM,51000200,INITIAL PREVENTIVE MEDICINE NEW PATIENT 65YRS&>,291.0,189.15,0.01,291.0,67
CDM,51000205,PERIODIC PREVENTIVE MED ESTABLISHED PATIENT <1Y,144.0,93.6,0.01,144.0,67
CDM,51000210,PERIODIC PREVENTIVE MED EST PATIENT 1-4YRS,153.0,99.45,0.01,153.0,67
CDM,51000215,PERIODIC PREVENTIVE MED EST PATIENT 5-11YRS,185.0,120.25,0.01,185.0,67
CDM,51000220,PERIODIC PREVENTIVE MED EST PATIENT 12-17YRS,211.0,137.15,0.01,211.0,67
CDM,51000225,PERIODIC PREVENTIVE MED EST PATIENT 18-39 YRS,313.0,203.45,0.01,313.0,67
CDM,51000230,PERIODIC PREVENTIVE MED EST PATIENT 40-64YRS,230.0,149.5,0.01,230.0,67
CDM,51000235,PERIODIC PREVENTIVE MED EST PATIENT 65YRS& OLDER,243.0,157.95,0.01,243.0,67
CDM,51000240,PREVENT MED COUNSEL&/RISK FACTOR REDJ SPX 15 MIN,124.0,80.6,0.01,124.0,67
CDM,51000245,PREVENT MED COUNSEL&/RISK FACTOR REDJ SPX 30 MIN,222.0,144.3,0.01,222.0,67
CDM,51000255,PREV MED COUNSEL & RISK FACTOR REDJ GRP SPX 60 M,151.0,98.15,0.01,151.0,67
CDM,51000265,TRANSJ CARE MGMT MOD MDM F2F 14 CAL D DISCHARGE,889.0,577.85,0.01,889.0,87
CDM,51000270,TRANSJ CARE MGMT HIGH MDM F2F 7 CAL D DISCHARGE,889.0,577.85,0.01,889.0,87
CDM,51000280,"CA SCRNING, PELV & BRST EXAM",370.0,240.5,0.01,370.0,87
CDM,51000285,INIT FOOT EXAM PT LOPS,515.0,334.75,0.01,515.0,87
CDM,51000290,FOLLOWUP EVAL FOOT PT LOP,515.0,334.75,0.01,515.0,87
CDM,51000295,DEMONSTRATE USE HOME INR MON,515.0,334.75,0.01,515.0,87
CDM,51000300,INIT PREVENTIVE EXAM NEW,515.0,334.75,0.01,515.0,87
CDM,51000305,PPPS INITIAL VISIT,203.0,131.95,0.01,242.59,86
CDM,51000310,PPPS SUBSEQ VISIT,189.0,122.85,0.01,190.53,86
CDM,51000355,DSTRJ LESION ANUS SIMPLE SURG EXCISION,12615.0,8199.75,0.01,12615.0,87
CDM,51000365,PRQ IMPLTJ NEUROSTIM ELTRD SACRAL NRVE W/IMAGING,24426.0,15876.9,0.01,24426.0,79
CDM,51000375,PREVENT MED COUNSEL&/RISK FACTOR REDJ SPX 45 MIN,337.0,219.05,0.01,337.0,67
CDM,51000385,PREVENT MED COUNSEL&/RISK FACTOR REDJ SPX 60 MIN,448.0,291.2,0.01,448.0,67
CDM,51000395,WORK RELATED/MED DBLT XM OTH/THN TREATING PHYS,224.0,145.6,0.01,224.0,67
CDM,51000405,OFFICE/OUTPATIENT ESTABLISHED SF MDM 10-19 MIN,150.0,97.5,0.01,150.0,69
CDM,51000410,OFFICE/OUTPATIENT ESTABLISHED LOW MDM 20-29 MIN,150.0,97.5,0.01,150.0,69
CDM,51000415,OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30-39 MIN,187.0,121.55,0.01,187.0,69
CDM,51000420,OFFICE/OUTPATIENT ESTABLISHED HIGH MDM 40-54 MIN,240.0,156.0,0.01,240.0,69
CDM,51000495,CHRONIC CARE MGMT SVCS STAFF 1ST 20 MIN CAL MO,638.0,414.7,0.01,638.0,79
CDM,51000505,OFFICE/OUTPATIENT EST PT MAY NOT REQ PHYS/QHP,150.0,97.5,0.01,150.0,69
CDM,51000515,OFFICE/OUTPATIENT EST PT MAY NOT REQ PHYS/QHP,150.0,97.5,0.01,150.0,69
CDM,51000585,ETN OUTPATINET > 135 MIN,515.0,334.75,0.01,515.0,85
CDM,51000785,PT-FOCUSED HLTH RISK ASSMT SCORE DOC STND INSTRM,89.0,57.85,0.01,89.0,87
CDM,51000795,CAREGIVER HLTH RISK ASSMT SCORE DOC STND INSTRM,89.0,57.85,0.01,89.0,87
CDM,51001025,OFFICE/OUTPATIENT EST PT MAY NOT REQ PHYS/QHP,150.0,97.5,0.01,150.0,69
CDM,51001065,OFFICE/OUTPATIENT NEW LOW MDM 30-44 MINUTES,139.0,90.35,0.01,141.11,69
CDM,51001075,OFFICE/OUTPATIENT NEW MODERATE MDM 45-59 MINUTES,174.0,113.1,0.01,211.15,69
CDM,51001095,OFFICE/OUTPATIENT EST PT MAY NOT REQ PHYS/QHP,150.0,97.5,0.01,150.0,69
CDM,51001175,OFFICE/OP CONSLTJ NEW/EST PT MOD MDM 40 MINUTES,147.0,95.55,0.01,147.0,67
CDM,51001235,OFFICE VISIT,515.0,334.75,0.01,515.0,85
CDM,51001305,ADVANCE CARE PLANNING FIRST 30 MINS,638.0,414.7,0.01,638.0,87
CDM,51001315,ADVANCE CARE PLANNING EA ADDL 30 MINS,98.0,63.7,0.01,98.0,69
CDM,51001345,"PREOP SERVICE LVRS, 16 DAYS",2122.0,1379.3,0.01,2122.0,85
CDM,51001355,"PREOP SERVICE LVRS, 10-15 DAYS",1246.0,809.9,0.01,1246.0,85
CDM,51001365,"PREOP SERVICE LVRS, 1-9 DAYS",2122.0,1379.3,0.01,2122.0,85
CDM,51001375,"POSTOP SERVICE LVRS, MIN 6 DAYS",2122.0,1379.3,0.01,2122.0,85
CDM,51001385,HEALTH & WELL-BEING COACHING F2F INDIV 1ST ASSMT,92.0,59.8,0.01,92.0,67
CDM,51001395,HEALTH & WELL-BEING COACHING F2F INDIV F-UP SESS,92.0,59.8,0.01,92.0,67
CDM,51001405,HEALTH & WELL-BEING COACHING FACE TO FACE GROUP,89.0,57.85,0.01,89.0,67
CDM,51001475,REMOTE PHYSIOLOGIC MONITORING EA ADDL 20 MIN MO,68.0,44.2,0.01,68.0,61
CDM,51001485,SELF-MEAS BP PT EDUCAJ/TRAING & DEV CALIBRATION,169.0,109.85,0.01,169.0,87
CDM,51001545,CHRONIC CARE MGMT SVC STAF EA ADDL 20 MIN CAL MO,247.0,160.55,0.01,247.0,61
CDM,51001555,TELEHEALTH ORIGINATING SITE FEE (W/ PO MODIFIER),43.0,27.95,0.01,43.0,67
CDM,51001625,CHRONIC CARE MGMT SVC PHYS EA ADDL 30 MIN CAL MO,68.0,44.2,0.01,68.0,61
CDM,51001635,SUBCUTANEOUS INJECTION FILLING MATRL >10.0 CC,1836.0,1193.4,0.01,2453.0,87
CDM,51001825,DEPRESSION SCREEN ANNUAL,119.0,77.35,0.01,119.0,87
CDM,51001845,MLT FAM GROUP BHV MGMT/MODIFICAJ TRAING 1ST 60,245.0,159.25,0.01,245.0,86
CDM,51001855,MLT FAM GROUP BHV MGMT/MODIFICAJ TRAING EA ADDL,59.0,38.35,0.01,152.57,86
CDM,51001865,ANNUAL ALCOHOL SCREEN 15 MIN,206.0,133.9,0.01,206.0,87
CDM,51001875,BRIEF ALCOHOL MISUSE COUNSEL,638.0,414.7,0.01,638.0,87
CDM,51001885,HIGH INTEN BEH COUNS STD 30M,638.0,414.7,0.01,638.0,87
CDM,51001895,INTENS BEHAVE THER CARDIO DX,206.0,133.9,0.01,206.0,87
CDM,51001905,BEHAVIOR COUNSEL OBESITY 15M,638.0,414.7,0.01,638.0,87
CDM,51001925,CAREGIVER TRAINING STRATEGIES&TQ 1ST 30 MINUTES,887.0,576.55,0.01,887.0,86
CDM,51001935,CAREGIVER TRAINING STRATEGIES&TQ EA ADDL 15 MIN,887.0,576.55,0.01,887.0,86
CDM,51001945,GROUP CAREGIVER TRAINING STRATEGIES & TECHNIQUE,887.0,576.55,0.01,887.0,86
CDM,51001985,SLT GROUP CAREGIVER TRAINING STRATEGIES & TECHNIQUE?,887.0,576.55,0.01,887.0,86
CDM,51001995,PT/OT CAREGIVER TRAINING STRATEGIES&TQ 1ST 30 MINUTES,887.0,576.55,0.01,887.0,86
CDM,51002005,PT/OT CAREGIVER TRAINING STRATEGIES&TQ EA ADDL 15 MIN,887.0,576.55,0.01,887.0,86
CDM,51002675,MED GENETICS&GENETIC COUNSELING SVCS EACH 30 MIN,280.0,182.0,0.01,280.0,67
CDM,51002705,MCHNL SCLP COOL CAP SPLY HEAD MEAS FITG&EDUCAJ,10008.0,6505.2,0.01,10008.0,78
CDM,51002715,MCHNL SCLP COOL HAIR PREPJ CAP PLMT THER&PRECOOL,12078.0,7850.7,0.01,12078.0,68
CDM,51002725,MCHNL SCLP COOL AFTER CHEMO EACH 30 MINUTES,3020.0,1963.0,0.01,3020.0,68
CDM,51002735,SCREENING DARK ADAPTATION MEASUREMENT W/I&R,1836.0,1193.4,0.01,1836.0,67
CDM,51002745,REM MNTR PHYSIOL PARAM DEV SPLY W/REC 2-15 DAYS,263.0,170.95,0.01,263.0,70
CDM,51002755,RPM TX MGMT 1 R-T IA COMUNICAJ CAL MO 1ST 10 MIN,244.0,158.6,0.01,244.0,60
CDM,51002765,RTM DEV SPLY DATA CBT 2-15 DAYS IN 30 D PD,263.0,170.95,0.01,263.0,69
CDM,51002785,DOT PHYSICAL EXAM,110.0,71.5,0.01,110.0,59
CDM,51002825,PRE-PLACEMENT EXAM,65.0,42.25,0.01,65.0,59
CDM,51002835,PHYSICAL EXAM,65.0,42.25,0.01,65.0,59
CDM,51002845,RETURN TO WORK EXAM,65.0,42.25,0.01,65.0,59
CDM,51020OH,CYSTOTOMY/CYSTOSTOMY FULG&/INSJ RADACT MATRL,3076.0,1999.4,1.1,10168.64,144
CDM,51040OH,CYSTOSTOMY CYSTOTOMY W/DRAINAGE,1796.0,1167.4,1.1,5941.4,144
CDM,51045OH,CYSTOTOMY W/INSJ URETERAL CATH/STENT SPX,3124.0,2030.6,1.1,5941.4,144
CDM,51050OH,CYSTOLITHOTOMY CYSTOTOMY W/RMVL CALCULUS,3188.0,2072.2,1.1,15090.73,144
CDM,51060OH,TRANSVESICAL URETEROLITHOTOMY,3980.0,2587.0,1.1,5941.4,144
CDM,51065OH,CYSTOTOMY W/CALCULUS BASKET XTRJ&/FRAGMENTATIO,3980.0,2587.0,1.1,10168.64,144
CDM,51080OH,DRG PRIVESICAL/PREVESICAL SPACE ABSC,2684.0,1744.6,1.1,8286.13,144
CDM,51100OH,ASPIRATION BLADDER NEEDLE,312.0,202.8,1.1,719.34,148
CDM,51101OH,ASPIRATION BLADDER TROCAR/INTRACATHETER,408.0,265.2,1.1,3048.76,148
CDM,51102OH,ASPIRATION BLADDER INSERT SUPRAPUBIC CATHETER,1080.0,702.0,1.1,5941.4,148
CDM,51500OH,EXC URACHAL CYST/SINUS W/WO UMBILICAL HERNIA RPR,4420.0,2873.0,1.1,16829.38,144
CDM,51520OH,CYSTOTOMY SIMPLE EXCISION VESICAL NECK,4084.0,2654.6,1.1,10168.64,144
CDM,51525OH,CYSTOTOMY EXCISE BLADDER DIVERTICULUM 1/MULTIPLE,6168.0,4009.2,1.1,6168.0,144
CDM,51530OH,"CYSTOTOMY,EXCIS BLADDER TUMOR",5484.0,3564.6,1.1,5484.0,144
CDM,51535OH,CYSTOTOMY EXCISE/INCISE/REPAIR URETEROCELE,5560.0,3614.0,1.1,10168.64,144
CDM,51550OH,CYSTECTOMY PARTIAL SIMPLE,6892.0,4479.8,1.1,6892.0,144
CDM,51555OH,CYSTECTOMY PARTIAL COMPLICATED,9272.0,6026.8,1.1,9272.0,144
CDM,51565OH,CSTC PRTL W/RIMPLTJ URTR IN BLDR URTRONEOCSTOST,9472.0,6156.8,1.1,9472.0,144
CDM,51570OH,CYSTECTOMY COMPLETE SEPARATE PROCEDURE,10984.0,7139.6,1.1,10984.0,144
CDM,51575OH,CYSTECTOMY W/BI PELVIC LYMPHADENECTOMY,13672.0,8886.8,1.1,13672.0,144
CDM,51580OH,CYSTECTOMY W/URETEROSIGMOIDOSTOMY W/NODES,15563.0,10115.95,1.1,15563.0,144
CDM,51585OH,CYSTECTOMY W/URETEROSIGMOID BI PELV LYMPH NODES,17442.0,11337.3,1.1,17442.0,144
CDM,51590OH,CSTC COMPL W/URTROILEAL CONDUIT/BLDR W/INT ANAST,14532.0,9445.8,1.1,14532.0,144
CDM,51595OH,CSTC COMPL W/CONDUIT/SIGMOID BLDR PEL LMPHADEC,16528.0,10743.2,1.1,16528.0,144
CDM,51596OH,CSTC COMPL W/CONTINENT DVRJ OPN NEOBLDR,17704.0,11507.6,1.1,17704.0,144
CDM,51597OH,PELVIC EXENTERATION COMPLETE MALIGNANCY,17144.0,11143.6,1.1,17144.0,144
CDM,51600OH,NJX CSTOGRAPY/VOIDING URETHROCSTOGRAPY,352.0,228.8,1.1,713.39,148
CDM,51610OH,NJX RETROGRADE URETHROCSTOGRAPY,420.0,273.0,1.1,437.27,148
CDM,51700OH,BLDR IRRIGATION SMPL LAVAGE &/INSTLJ,264.0,171.6,1.1,719.34,148
CDM,51701OH,INSJ NON-NDWELLG BLADDER CATHETER,220.0,143.0,1.1,373.44,148
CDM,51702OH,INSJ TEMP NDWELLG BLADDER CATHETER SIMPLE,220.0,143.0,1.1,373.44,148
CDM,51703OH,INSJ TEMP NDWELLG BLADDER CATHETER COMPLICATED,588.0,382.2,1.1,588.0,148
CDM,51705OH,CHANGE CYSTOSTOMY TUBE SIMPLE,360.0,234.0,1.1,719.34,148
CDM,51710OH,CHANGE CYSTOSTOMY TUBE COMPLICATED,540.0,351.0,1.1,1992.71,148
CDM,51715OH,NDSC NJX IMPLT MATRL URT&/BLDR NCK,1492.0,969.8,1.1,10168.64,148
CDM,51720OH,BLADDER INSTILLATION ANTICARCINOGENIC AGENT,383.0,248.95,1.1,1992.71,148
CDM,51721OH,INSJ TRURL ABLTJ TRNSDCR DLVR THRM US PRST8 TISS,1782.0,1158.3,1.1,1832.21,144
CDM,51725OH,"CYSTOMETROGRAM, SIMPLE",1783.0,1158.95,1.1,1783.0,144
CDM,51725OH-26,"CYSTOMETROGRAM, SIMPLE",664.0,431.6,1.1,664.0,126
CDM,51726OH,BLADDER PRESSURE MEASUREMENT DURING FILLING,1871.0,1216.15,1.1,1871.0,144
CDM,51726OH-26,BLADDER PRESSURE MEASUREMENT DURING FILLING,752.0,488.8,1.1,752.0,126
CDM,51727OH,COMPLEX CYSTOMETROGRAM URETHRAL PRESS PROFILE,3914.0,2544.1,1.1,3914.0,144
CDM,51727OH-26,COMPLEX CYSTOMETROGRAM URETHRAL PRESS PROFILE,844.0,548.6,1.1,844.0,126
CDM,51728OH,COMPLEX CYSTOMETROGRAM VOIDING PRESSURE STUDIES,3998.0,2598.7,1.1,3998.0,144
CDM,51728OH-26,COMPLEX CYSTOMETROGRAM VOIDING PRESSURE STUDIES,928.0,603.2,1.1,928.0,126
CDM,51729OH,COMPLX CYSTOMETRO W/VOID PRESS&URETHRAL PROFILE,4174.0,2713.1,1.1,4174.0,144
CDM,51729OH-26,COMPLX CYSTOMETRO W/VOID PRESS&URETHRAL PROFILE,1104.0,717.6,1.1,1104.0,126
CDM,51736OH,SIMPLE UROFLOMETRY,661.0,429.65,1.1,661.0,144
CDM,51736OH-26,SIMPLE UROFLOMETRY,68.0,44.2,1.1,68.0,126
CDM,51741OH,COMPLEX UROFLOMETRY,1500.0,975.0,1.1,1500.0,144
CDM,51741OH-26,COMPLEX UROFLOMETRY,68.0,44.2,1.1,68.0,126
CDM,51772OH,URETHRAL PRESSURE PROFILE,530.0,344.5,1.1,530.0,70
CDM,51784OH,EMG STDS ANAL/URTL SPHNCTR OTH/THN NDL,1050.0,682.5,1.1,1050.0,144
CDM,51784OH-26,EMG STDS ANAL/URTL SPHNCTR OTH/THN NDL,330.0,214.5,1.1,330.0,126
CDM,51784OH-TC,EMG STDS ANAL/URTL SPHNCTR OTH/THN NDL,720.0,468.0,1.1,720.0,126
CDM,51785OH,NDL EMG STDS EMG ANAL/URTL SPHNCTR ANY TQ,1792.0,1164.8,1.1,1792.0,144
CDM,51785OH-26,NDL EMG STDS EMG ANAL/URTL SPHNCTR ANY TQ,673.0,437.45,1.1,673.0,126
CDM,51792OH,STIMULUS EVOKED RESPONSE,713.0,463.45,1.1,884.07,144
CDM,51792OH-26,STIMULUS EVOKED RESPONSE,440.0,286.0,1.1,440.0,126
CDM,51797OH,VOID PRESSURE STUDIES INTRAABDOMINAL,1487.0,966.55,1.1,1487.0,144
CDM,51797OH-26,VOID PRESSURE STUDIES INTRAABDOMINAL,352.0,228.8,1.1,352.0,126
CDM,51798OH,MEAS POST-VOIDING RESIDUAL URINE&/BLADDER CAP,42.0,27.3,1.1,177.54,144
CDM,51800OH,CSTOPLASTY/CSTOURTP PLSTC ANY,7556.0,4911.4,1.1,7556.0,144
CDM,51820OH,CSTOURTP W/UNI/BI URTRONEOCSTOST,7836.0,5093.4,1.1,7836.0,144
CDM,51840OH,ANT VESICOURETHROPEXY/URETHROPEXY SMPL,4544.0,2953.6,1.1,4544.0,144
CDM,51841OH,ANT VESICOURETHROPEXY/URETHROPEXY COMP,5472.0,3556.8,1.1,5472.0,144
CDM,51845OH,ABDOMINO-VAG VESICAL NCK SSP W/WO NDSC CTRL,4060.0,2639.0,1.1,14506.08,144
CDM,51860OH,CYSTORRHAPHY SUTR BLDR WND INJ/RPT SIMPLE,5040.0,3276.0,1.1,26866.4,144
CDM,51865OH,CYSTORRHAPHY SUTR BLDR WND INJ/RPT COMPLICATED,6320.0,4108.0,1.1,6320.0,144
CDM,51880OH,CLOSE CYSTOSTOMY,3148.0,2046.2,1.1,10168.64,144
CDM,51900005,"EXTRACORPOREAL SHOCK WAVE, LOW INTENSITY",150.0,97.5,0.01,3443.0,85
CDM,51900OH,CLSR VESICOVAGINAL FISTUL AABDL APPROACH,5852.0,3803.8,1.1,5852.0,144
CDM,51920OH,CLOSURE VESICOUTERINE FISTULA,5364.0,3486.6,1.1,5364.0,144
CDM,51940OH,CLOSURE EXSTROPHY BLADDER,12264.0,7971.6,1.1,12264.0,144
CDM,51960OH,ENTEROCYSTOPLASTY W/INTESTINAL ANASTOMOSIS,11176.0,7264.4,1.1,11176.0,144
CDM,51980OH,CUTANEOUS VESICOSTOMY,5028.0,3268.2,1.1,5028.0,144
CDM,51990OH,LAPAROSCOPY URETHRAL SUSPENSION STRESS INCONT,5344.0,3473.6,1.1,16829.38,144
CDM,51992OH,"LAPAROSCOPY, SURGICAL; SLING OPERAT",5948.0,3866.2,1.1,16829.38,144
CDM,51999RVU10OH,LAP CYSTECTOMY W/ PELVIC LYMPHADENECTOMY (COMP 51575),18052.0,11733.8,0.01,18052.0,84
CDM,51999RVU11OH,LAPAROSCOPIC DIVERTICULECTOMY (COMP 51525),4306.0,2798.9,0.01,16829.38,84
CDM,51999RVU12OH,LAP CYSTOPLASTY OR CYSTOURETHROPLASTY (COMP 51800),6568.0,4269.2,0.01,16829.38,84
CDM,51999RVU13OH,"UNLISTED LAPAROSCOPY PROCEDURE, BLADDER",5311.0,3452.15,0.01,16829.38,84
CDM,51999RVU14OH,"UNLISTED LAPAROSCOPY PROCEDURE, BLADDER",13188.0,8572.2,0.01,16829.38,84
CDM,51999RVU15OH,UNLISTED PROC; LAPAROSCOPIC PARTICAL CYSTECTOMY (COMP TO 51550),6255.0,4065.75,0.01,16829.38,84
CDM,51999RVU16OH,"EXCISION OF URACHAL CYST OR SINUS, W/WO UMBILICAL HERNIA REPAIR",4420.0,2873.0,0.01,16829.38,84
CDM,51999RVU17OH,"STONE REMOVAL FROM BLADDER, LAPAROSCOPIC APPROACH WITH ROBOTIC A",3427.0,2227.55,0.01,16829.38,84
CDM,51999RVU18OH,"LAPAROSCOPIC CLOSURE OF VESICOVAGINAL FISTULA, ABDOMINAL APPROAC",6290.0,4088.5,0.01,16829.38,84
CDM,51999RVU19OH,UNLISTED LAPAROSCOPIC PROCEDURE BLADDER (COMP CODE 51590),15621.0,10153.65,0.01,16829.38,84
CDM,51999RVU1OH,LAPARSCOP URETERCTOMY,7764.0,5046.6,0.01,16829.38,84
CDM,51999RVU20OH,LAPAROSCOPIC ANTERIOR VAGINECTOMY (COMP CODE 57106),3225.0,2096.25,0.01,16829.38,84
CDM,51999RVU2OH,LAP REPAIR BLADDER REPAIR (COMP 51860),5198.0,3378.7,0.01,16829.38,84
CDM,51999RVU3OH,LAPAROSCOPY PARTIAL CYSTECTOMY (COMP 51555),14126.0,9181.9,0.01,16829.38,84
CDM,51999RVU5OH,LAPAROSCOPIC CYSTECTOMY (COMP 51570),15839.0,10295.35,0.01,16829.38,84
CDM,51999RVU6OH,ROBOTIC CYSTECTOMY W/ CONDUIT & PELVIC LYMPHADENECTOMY (COMP 515,37762.0,24545.3,0.01,37762.0,84
CDM,51999RVU7OH,ROBOTIC (LAP) CYSTECTOMY W/ NEOBLADDER URINARY DIVERSION (COMP 5,41039.0,26675.35,0.01,41039.0,84
CDM,51999RVU8OH,ROBOTIC (LAP) PELVIC EXENTERATION (COMP 51597),37500.0,24375.0,0.01,37500.0,84
CDM,51999RVU9OH,ROBOTIC (LAP) PELVIC EXENTERATION W/ NEOBLADDER (COMP 51597),42500.0,27625.0,0.01,42500.0,84
CDM,51999RVUOH,LAPAROSCOPIC BLADDER REPAIR,4641.0,3016.65,0.01,16829.38,84
CDM,52000OH,CYSTOURETHROSCOPY,673.0,437.45,1.1,1992.71,148
CDM,52001OH,CYSTO W/IRRIG & EVAC MULTPLE OBSTRUCTING CLOTS,2176.0,1414.4,1.1,10168.64,148
CDM,52005OH,CYSTO BLADDER W/URETERAL CATHETERIZATION,1043.0,677.95,1.1,5941.4,148
CDM,52007OH,CYSTO W/URTRL CATHJ BRUSH BX URTR&/RENAL PELVIS,1208.0,785.2,1.1,10168.64,148
CDM,52010OH,CYSTO W/EJACULATORY DUCT CATHETERIZATION,1208.0,785.2,1.1,1992.71,148
CDM,52204OH,"CYSTOURETHROSCOPY,BIOPSY",1036.0,673.4,1.1,5941.4,148
CDM,52214OH,CYSTO W/DESTRUCTION OF LESIONS,1400.0,910.0,1.1,10168.64,148
CDM,52224OH,CYSTO W/REMOVAL OF LESIONS MINOR <0.5CM,1620.0,1053.0,1.1,10168.64,148
CDM,52234OH,CYSTO W/REMOVAL OF TUMORS SMALL,1848.0,1201.2,1.1,10168.64,144
CDM,52235OH,CYSTOURETHROSCOPY W/DEST &/RMVL MED BLADDER TUM,2176.0,1414.4,1.1,10168.64,144
CDM,52240OH,CYSTOURETHROSCOPY W/DEST &/RMVL TUMOR LARGE,3300.0,2145.0,1.1,15090.73,144
CDM,52250OH,CYSTOURETHROSCOPY INSJ RADIOACT SBST W/WOBX/FULG,1796.0,1167.4,1.1,10168.64,144
CDM,52260OH,CYSTOURETHROSCOPY W/DIL BLADDER GENERAL ANESTH,1564.0,1016.6,1.1,5941.4,144
CDM,52265OH,"CYSTOSCOPY,DIL BLADDER,LOCAL ANESTH",1176.0,764.4,1.1,5941.4,148
CDM,52270OH,"CYSTOSCOPY,INTERN URETHROTOMY,FEMALE",1344.0,873.6,1.1,5941.4,148
CDM,52275OH,"CYSTOSCOPY,INTERN URETHROTOMY,MALE",1876.0,1219.4,1.1,5941.4,148
CDM,52276OH,CYSTOURETHROSCOPY W/INTERNAL URETHROTOMY MALE,1996.0,1297.4,1.1,5941.4,144
CDM,52277OH,"CYSTOSCOPY,RESEC EXTERN SPHINCTER",2464.0,1601.6,1.1,10168.64,144
CDM,52281OH,CYSTO CALIBRATION DILAT URTL STRIX/STENOSIS,1210.0,786.5,1.1,5941.4,148
CDM,52282OH,CYSTOURETHROSCOPY INSERTION PERM URETHRAL STENT,2556.0,1661.4,1.1,10168.64,144
CDM,52283OH,"CYSTOSCOPY,STEROID INJ,STRICTURE",1492.0,969.8,1.1,5941.4,148
CDM,52284OH,CYSTO W/DILAT RX BALO CATH URTL STRIX/STEN MALE,1364.0,886.6,1.1,15090.73,146
CDM,52285OH,"CYSTOSCOPY,RX FEMALE URETHRAL SYND",1440.0,936.0,1.1,1992.71,148
CDM,52287OH,CYSTOURETHROSCOPY INJ CHEMODENERVATION BLADDER,1280.0,832.0,1.1,5941.4,148
CDM,52290OH,CYSTOURETHROSCOPY W/URETERAL MEATOTOMY UNI/BI,1832.0,1190.8,1.1,5941.4,144
CDM,52300OH,CYSTO W/RESCJ/FULG ORTHOPIC URETEROCELE UNI/BI,2120.0,1378.0,1.1,10168.64,144
CDM,52301OH,CYSTO W/RESECJ ECTOPIC URETEROCELE UNI/BI,2200.0,1430.0,1.1,10168.64,144
CDM,52305OH,CYSTO INC/RESCJ ORIFICE BLDR DIVERTICULUM 1/MLT,2120.0,1378.0,1.1,15090.73,144
CDM,52310OH,CYSTO W/SIMPLE REMOVAL STONE & STENT,1124.0,730.6,1.1,5941.4,148
CDM,52315OH,CYSTO W/COMPLEX REMOVAL STONE & STENT,2080.0,1352.0,1.1,5941.4,148
CDM,52317OH,LITHOLAPAXY SMPL/SM <2.5 CM,2684.0,1744.6,1.1,10168.64,148
CDM,52318OH,LITHOLAPAXY COMP/LG > 2.5 CM,3672.0,2386.8,1.1,10168.64,144
CDM,52320OH,CYSTOURETHROSCOPY W/RMVL URETERAL CALCULUS,1876.0,1219.4,1.1,10168.64,144
CDM,52325OH,CYSTO FRAGMENTATION URETERAL STONE,2460.0,1599.0,1.1,15090.73,144
CDM,52327OH,CYSTO W/SUBURTRIC NJX IMPLT MATRL,2072.0,1346.8,1.1,15090.73,144
CDM,52330OH,CYSTO MANJ W/O RMVL URETERAL STONE,2012.0,1307.8,1.1,10168.64,148
CDM,52332OH,CYSTO W/INSERT URETERAL STENT,1128.0,733.2,1.1,10168.64,148
CDM,52334OH,CYSTO INSJ URTRL GD WIRE PRQ NFROS RTRGR,1483.0,963.95,1.1,10168.64,144
CDM,52341OH,CYSTO W/URETER STRICTURE TX,2140.0,1391.0,1.1,10168.64,144
CDM,52342OH,CYSTO W/TX URETEROPELVIC JUNCTION STRICTURE,2340.0,1521.0,1.1,10168.64,144
CDM,52343OH,CYSTO W/TX INTRA-RENAL STRICTURE,2620.0,1703.0,1.1,10168.64,144
CDM,52344OH,CYSTO W/URTROSCOPY W/TX URETERAL STRICTURE,2820.0,1833.0,1.1,10168.64,144
CDM,52345OH,CYSTO W/URTROSCOPY W/TX URTROPEL JUNCT STRIX,3020.0,1963.0,1.1,10168.64,144
CDM,52346OH,CYSTO W/URTROSCOPY W/TX INTRA-RENAL STRICTURE,3432.0,2230.8,1.1,15090.73,144
CDM,52351OH,CYSTO W/URTROSCOPY&/PYELOSCOPY DX,2530.0,1644.5,1.1,10168.64,144
CDM,52352OH,CYSTO W/URETEROSCOPY W/RMVL/MANJ STONES,2700.0,1755.0,1.1,10168.64,144
CDM,52353OH,CYSTO W/URETEROSCOPY W/LITHOTRIPSY,3000.0,1950.0,1.1,15090.73,144
CDM,52354OH,CYSTO/PYELOSCOPY BX&/FULGURATION PELIVC LESION,3200.0,2080.0,1.1,15090.73,144
CDM,52355OH,CYSTO/PYELOSCOPY RESCJ PELVIC TUMOR,3600.0,2340.0,1.1,15090.73,144
CDM,52356OH,CYSTO/URETERO W/LITHOTRIPSY &INDWELL STENT INSRT,3200.0,2080.0,1.1,15090.73,144
CDM,52400OH,CYSTO INC FULG/RESCJ URTL VALVES/FOLDS,3476.0,2259.4,1.1,10168.64,144
CDM,52402OH,CSTO W/TRURL RESCJ/INC EJACULATORY DUXS,2108.0,1370.2,1.1,10168.64,144
CDM,52441OH,CYSTO INSERTION TRANSPROSTATIC IMPLANT SINGLE,1760.0,1144.0,1.1,4235.95,148
CDM,52442OH,CYSTO INSERTION TRANSPROSTATIC IMPLANT EA ADDL,444.0,288.6,1.1,2874.53,148
CDM,52443OH,CYSTO 1ST TRURL ANT PRST8 COMIS NONRX BALO CATH,1593.0,1035.45,1.1,15055.51,106
CDM,52450OH,TRANSURETHRAL INCISION OF PROSTATE,3112.0,2022.8,1.1,10168.64,144
CDM,52500OH,TRANSURETHRAL RESEC BLADDER NECK,3256.0,2116.4,1.1,10168.64,144
CDM,52597OH,TRURL ROBOTIC-ASSISTED WATERJET RESECTION PRST8,4510.0,2931.5,1.1,4510.0,106
CDM,52601OH,TRURL ELECTROSURG RESCJ PROSTATE BLEED COMPLETE,5790.0,3763.5,1.1,15090.73,144
CDM,52630OH,TRURL RESCJ RESIDUAL/REGROWTH OBSTR PRSTATE TISS,2620.0,1703.0,1.1,15090.73,144
CDM,52640OH,TRURL RESCJ POSTOP BLADDER NECK CONTRACTURE,1916.0,1245.4,1.1,10168.64,144
CDM,52648OH,LASER VAPORIZATION OF PROSTATE FOR URINE FLOW,4860.0,3159.0,1.1,15090.73,148
CDM,52649OH,LASER ENUCLEATION PROSTATE W/MORCELLATION,5824.0,3785.6,1.1,15090.73,144
CDM,52700OH,TRURL DRAINAGE PROSTATIC ABSCESS,2996.0,1947.4,1.1,10168.64,144
CDM,53000000,OSTEOPATHIC MANIPULATIVE TX 1-2 BODY REGIONS,76.0,49.4,20.43,76.0,86
CDM,53000005,OSTEOPATHIC MANIPULATIVE TX 3-4 BODY REGIONS,76.0,49.4,20.43,107.33,87
CDM,53000010,OSTEOPATHIC MANIPULATIVE TX 5-6 BODY REGIONS,76.0,49.4,20.43,107.33,87
CDM,53000015,OSTEOPATHIC MANIPULATIVE TX 7-8 BODY REGIONS,76.0,49.4,20.43,107.33,87
CDM,53000025,OSTEOPATHIC MANIPULATIVE TX 9-10 BODY REGIONS,76.0,49.4,20.43,107.33,87
CDM,53000OH,URTT/URTS XTRNL SPX PENDULOUS URETHRA,932.0,605.8,1.1,5941.4,144
CDM,53010OH,URETHROTOMY/URETHROSTOMY XT SPX PERINEAL URETHRA,1780.0,1157.0,1.1,15090.73,144
CDM,53020OH,MEATOTOMY CUTTING MEATUS SPX EXCEPT INFANT,708.0,460.2,1.1,5941.4,144
CDM,53025OH,MEATOTOMY CUTTING MEATUS SPX INFANT,452.0,293.8,1.1,5941.4,144
CDM,53040OH,DRAINAGE DEEP PERIURETHRAL ABSCESS,2620.0,1703.0,1.1,10168.64,144
CDM,53060OH,DRG OF SKENE'S GLAND ABSCESS OR CYST,1072.0,696.8,1.1,5941.4,148
CDM,53085OH,DRG PERINEAL URINARY XTRVASATION COMPLIC,4472.0,2906.8,1.1,5941.4,144
CDM,53200OH,BIOPSY OF URETHRA,1036.0,673.4,1.1,5941.4,148
CDM,53210OH,URETHRECTOMY TOT W/CYSTOST FEMALE,5488.0,3567.2,1.1,10168.64,144
CDM,53215OH,URETHRECTOMY TOT W/CYSTOST MALE,6740.0,4381.0,1.1,15090.73,144
CDM,53220OH,EXC/FULGURATION CARCINOMA URETHRA,3052.0,1983.8,1.1,10168.64,144
CDM,53230OH,EXC URETHRAL DIVERTICULUM SPX FEMALE,4176.0,2714.4,1.1,15090.73,144
CDM,53235OH,EXC URETHRAL DIVERTICULUM SPX MALE,4396.0,2857.4,1.1,15090.73,144
CDM,53240OH,MARSUPIALIZATION URTL DIVERTICULUM MALE/FEMALE,2832.0,1840.8,1.1,10168.64,144
CDM,53250OH,EXCISION OF BULBOURETHRAL GLAND,2608.0,1695.2,1.1,10168.64,144
CDM,53260OH,EXC/FULGURATION URETHRAL POLYP DSTL URETHRA,1212.0,787.8,1.1,10168.64,148
CDM,53265OH,EXC/FULGURATION URETHRAL CARUNCLE,1268.0,824.2,1.1,5941.4,148
CDM,53270OH,EXCISION OR FULGURATION SKENES GLANDS,1256.0,816.4,1.1,10168.64,148
CDM,53275OH,EXCISION/FULGURATION URETHRAL PROLAPSE,1828.0,1188.2,1.1,10168.64,144
CDM,53400OH,URETHROPLASTY 1ST STG FISTULA/DIVERTICULUM/STRIX,5652.0,3673.8,1.1,15090.73,144
CDM,53405OH,URETHROPLASTY 2ND STAGE W/URINARY DIVERSION,6264.0,4071.6,1.1,15090.73,144
CDM,53410OH,URETHROPLASTY 1 STG RECNST MALE ANTERIOR URETHRA,7072.0,4596.8,1.1,15090.73,144
CDM,53415OH,URTP TRANSPUBIC/PRNL 1 STG RCNSTJ/RPR URT,8280.0,5382.0,1.1,8280.0,144
CDM,53420OH,URTP 2-STG RCNSTJ/RPR PROSTAT/URETHRA 1ST STAGE,6068.0,3944.2,1.1,15090.73,144
CDM,53425OH,URTP 2-STG RCNSTJ/RPR PROSTAT/URETHRA 2ND STAGE,6828.0,4438.2,1.1,15090.73,144
CDM,53430OH,URETHROPLASTY RCNSTJ FEMALE URETHRA,6972.0,4531.8,1.1,15090.73,144
CDM,53431OH,URTP W/TUBULARIZATION POST URT&/LWR BLDR,8472.0,5506.8,1.1,15090.73,144
CDM,53440OH,SLING OPRATION CORRJ MALE URINARY INCONTINENCE,5344.0,3473.6,1.1,37439.09,144
CDM,53442OH,RMVL/REVJ SLING MALE URINARY INCONTINENCE,5396.0,3507.4,1.1,15090.73,144
CDM,53444OH,INSERTION TANDEM CUFF,5676.0,3689.4,1.1,58832.42,144
CDM,53445OH,INSJ INFLATABLE URETHRAL/BLADDER NECK SPHINCTER,5200.0,3380.0,1.1,58832.42,144
CDM,53446OH,REMVL INFLATABLE URETHRAL/BLADDER NECK SPHINCTER,4408.0,2865.2,1.1,15090.73,144
CDM,53447OH,RMVL & RPLCMT NFLTL URETHRAL/BLADDER NECK SPHINC,5712.0,3712.8,1.1,58832.42,144
CDM,53448OH,RMVL & RPLCMT NFLTBL NCK SPHNCTR THRU INFCT FLD,9376.0,6094.4,1.1,9376.0,144
CDM,53449OH,RPR NFLTBL URETHRAL/BLADDER NECK SPHINCTER,4224.0,2745.6,1.1,26866.4,142
CDM,53450OH,URETHROMEATOPLASTY W/MUCOSAL ADVANCEMENT,2708.0,1760.2,1.1,10168.64,144
CDM,53453OH,PERIURETHRAL TPRNL ADJTBL BALO CNTNC DEV RMVL EA,5414.0,3519.1,0.01,10168.64,88
CDM,53460OH,URETHROMEATOPLASTY W/PRTL EXC DSTL URTL SGM,3100.0,2015.0,1.1,10168.64,144
CDM,53500OH,URETHROLSS TRVG SEC OPN W/CSTO,5200.0,3380.0,1.1,10168.64,144
CDM,53502OH,URETHRORRHAPHY SUTR URETHRAL WOUND/INJ FEMALE,3304.0,2147.6,1.1,10168.64,144
CDM,53505OH,URETHRORRHAPHY SUTR URETHRAL WOUND/INJ PENILE,3304.0,2147.6,1.1,15090.73,144
CDM,53510OH,URETHRORRHAPHY SUTR URETHRAL WOUND/INJ PERINEAL,4384.0,2849.6,1.1,15090.73,144
CDM,53515OH,URTORR SUTR URETHRAL WND/INJ PROSTATOMEMBRANOUS,5688.0,3697.2,1.1,15090.73,144
CDM,53520OH,CLSR URETHROSTOMY/URETHROQ FSTL MALE SPX,3792.0,2464.8,1.1,15090.73,144
CDM,53600OH,DILAT URETHRAL STRIX DILATOR MALE 1ST,484.0,314.6,1.1,719.34,148
CDM,53601OH,DILAT URETHRAL STRIX DILATOR MALE SBSQ,392.0,254.8,1.1,392.0,148
CDM,53605OH,DILAT URETHRAL STRIX/VESICAL NCK DILAT MALE ANES,512.0,332.8,1.1,10168.64,144
CDM,53620OH,DILAT URETHRAL STRIX FILIFORM & FOLLWR MALE 1ST,648.0,421.2,1.1,1992.71,148
CDM,53621OH,DILAT URETHRAL STRIX FILIFORM & FOLLWR MALE SBSQ,540.0,351.0,1.1,719.34,148
CDM,53660OH,DILAT FEMALE URETHRA W/SUPPOSITORY&/INSTLJ INI,284.0,184.6,1.1,456.09,148
CDM,53661OH,DILAT FEMALE URT W/SUPPOSITORY&/INSTLJ SBSQ,288.0,187.2,1.1,373.44,148
CDM,53665OH,DILAT FEMALE URETHRA GENERAL/CNDJ SPINAL ANES,304.0,197.6,1.1,5941.4,144
CDM,53850OH,TRURL DSTRJ PRSTATE TISS MICROWAVE THERMOTH,2168.0,1409.2,1.1,10168.64,148
CDM,53852OH,TRURL DSTRJ PRSTATE TISS RF THERMOTH,2372.0,1541.8,1.1,10168.64,148
CDM,53854OH,TRURL DSTRJ PRST8 TISS RF WV THERMOTHERAPY,2609.0,1695.85,1.1,10168.64,146
CDM,53855OH,INSERT TEMP PROSTATIC URETH STENT W/MEASUREMENT,656.0,426.4,1.1,5941.4,148
CDM,53865OH,CYSTO INSJ TEMP DEV ISCHMC RMDLG BLDR NECK&PRST8,1364.0,886.6,1.1,9678.82,144
CDM,53866OH,CATHJ RMVL TEMP DEV ISCHMC RMDLG BLDR NECK&PRST8,651.0,423.15,1.1,651.0,144
CDM,53899RVU10OH,LAP URINARY UNDIVERSION,13848.0,9001.2,0.01,13848.0,84
CDM,53899RVU11OH,OPEN NEOBLADDER/UR DIV LAP URETHRA,18258.0,11867.7,0.01,18258.0,84
CDM,53899RVU12OH,DILATATION OF STOMA,922.0,599.3,0.01,922.0,84
CDM,53899RVU15OH,"CALCULUS REMOVAL, URETHRA, VIA INCISION COMP 52315",1716.0,1115.4,0.01,1716.0,84
CDM,53899RVU16OH,ITIND DEVICE REMOVAL SIMPLE (COMP CODE 52310 SIMPLE),1020.0,663.0,0.01,1020.0,84
CDM,53899RVU17OH,ITIND DEVICE INSERTION (COMP CODE 52441),1539.0,1000.35,0.01,1539.0,84
CDM,53899RVU18OH,ITIND DEVICE REMOVAL COMPLICATED (COMP CODE 52315 COMPLICATED),1888.0,1227.2,0.01,1888.0,84
CDM,53899RVU19OH,CYSTO W/URETEROSCOPY W/LITHOTRIPSY (COMP CODE 52353),3225.0,2096.25,0.01,3225.0,84
CDM,53899RVU1OH,LYSIS OF BLADDER,2092.0,1359.8,0.01,2092.0,84
CDM,53899RVU20OH,CYSTO/URETERO W/LITHOTRIPSY &INDWELL STENT INSRT (COMP CODE 5235,3440.0,2236.0,0.01,3440.0,84
CDM,53899RVU21OH,PLCMNT RETRO NEPHROURETERAL CATHETER (COMP CODE 50688),480.0,312.0,0.01,719.34,84
CDM,53899RVU22OH,SUPRA PUBIC CATHETER REPOSITION (COMP CODE 36597),484.0,314.6,0.01,719.34,84
CDM,53899RVU23OH,INJECTION INTO BLADDER LESIONS (NON CHEMODENERVATION) (COMP CODE,1280.0,832.0,0.01,1280.0,84
CDM,53899RVU2OH,URETERAL DILATION,1999.0,1299.35,0.01,1999.0,84
CDM,53899RVU3OH,POUCHOSCOPY STONE REMOVAL,2630.0,1709.5,0.01,2630.0,84
CDM,53899RVU4OH,BLADDER NECK CLOSURE,6429.0,4178.85,0.01,6429.0,84
CDM,53899RVU5OH,LX CYSTOPLASTY OR CYSTOURETHROPLASTY,6568.0,4269.2,0.01,6568.0,84
CDM,53899RVU6OH,LAPAROSCOPIC DIVERTICULECTOMY,4306.0,2798.9,0.01,4306.0,84
CDM,53899RVU7OH,EXCISE PERINEPHRIC TUMOR,6633.0,4311.45,0.01,6633.0,84
CDM,53899RVU8OH,EXCISION OF URETHRAL FISTULA (COMP CODE 46710),6730.0,4374.5,0.01,6730.0,84
CDM,53899RVU9OH,REVISION OF ILEAL CONDUIT,7822.0,5084.3,0.01,7822.0,84
CDM,53899RVUOH,UNLISTED EXCISION OF PERUIRETHRAL CYST,1610.0,1046.5,0.01,1610.0,84
CDM,54000OH,SLITTING PREPUCE DORSAL/LATERAL SPX NEWBORN,636.0,413.4,1.1,10168.64,148
CDM,54001OH,SLITTING PREPUCE DORSAL/LAT SPX XCP NEWBORN,896.0,582.4,1.1,5941.4,148
CDM,54015OH,"INCIS/DRAIN PENIS,DEEP",2144.0,1393.6,1.1,4729.25,144
CDM,54050OH,DSTRJ LESION PENIS SIMPLE CHEMICAL,568.0,369.2,1.1,1163.18,148
CDM,54055OH,DSTRJ LESION PENIS SIMPLE ELECTRODESICCATION,500.0,325.0,1.1,5320.02,148
CDM,54056OH,DSTRJ LESION PENIS SIMPLE CRYOSURGERY,568.0,369.2,1.1,584.65,148
CDM,54057OH,DSTRJ LESION PENIS SIMPLE LASER,516.0,335.4,1.1,5320.02,148
CDM,54060OH,DSTRJ LESION PENIS SIMPLE SURG EXCISION,792.0,514.8,1.1,5320.02,148
CDM,54065OH,DSTRJ LESION PENIS EXTENSIVE,988.0,642.2,1.1,5320.02,148
CDM,54100OH,BIOPSY PENIS SEPARATE PROCEDURE,760.0,494.0,1.1,4729.25,148
CDM,54105OH,"BIOPSY OF PENIS,DEEP STRUCT",1416.0,920.4,1.1,8286.13,148
CDM,54110OH,EXCIS PENILE PLAQUE,4368.0,2839.2,1.1,10168.64,144
CDM,54111OH,"EXCIS PENILE PLAQUE,GRAFT <5CM",5768.0,3749.2,1.1,15090.73,144
CDM,54112OH,"EXCIS PENILE PLAQUE,GRAFT >5CM",6792.0,4414.8,1.1,26866.4,144
CDM,54115OH,REMV FOR.BODY DEEP PENILE TISS,2780.0,1807.0,1.1,8286.13,148
CDM,54120OH,"REMOVAL PENIS,PARTIAL",4404.0,2862.6,1.1,10168.64,144
CDM,54125OH,"REMOVAL PENIS,TOTAL",5824.0,3785.6,1.1,5824.0,144
CDM,54130OH,AMPUTATION PENIS RADW/BI INGUINOFEMORAL LMPHADE,8736.0,5678.4,1.1,8736.0,144
CDM,54135OH,AMPUTATION PENIS RADICAL W/LYMPH NODES,11268.0,7324.2,1.1,11268.0,144
CDM,54150OH,CIRCUMCISION W/CLAMP/OTH DEV W/BLOCK,760.0,494.0,1.1,5941.4,148
CDM,54160OH,CIRCUMCISION NEONATE,1012.0,657.8,1.1,1992.71,148
CDM,54161OH,CIRCUMCISION AGE >28 DAYS,1328.0,863.2,1.1,5941.4,144
CDM,54162OH,LYSIS/EXCISION PENILE POSTCIRCUMCISION ADHESIONS,1328.0,863.2,1.1,5941.4,148
CDM,54163OH,REP INCOMPLETE CIRCUMCISION,1328.0,863.2,1.1,5941.4,144
CDM,54164OH,FRENULOTOMY OF PENIS,1128.0,733.2,1.1,5941.4,144
CDM,54200OH,INJECTION PEYRONIE DISEASE,444.0,288.6,1.1,719.34,148
CDM,54220OH,IRRIGATION CORPORA CAVERNOSA PRIAPISM,968.0,629.2,1.1,968.0,148
CDM,54230OH,INJECTION CORPORA CAVERNOSOGRAPY,536.0,348.4,1.1,536.0,148
CDM,54231OH,DYNAMIC CAVERNOSOMETRY NJX VASOACTIVE DRUGS,898.0,583.7,1.1,898.0,148
CDM,54235OH,NJX C/P/A CAVERNOSA W/PHARMACOLOGIC AGT,476.0,309.4,1.1,719.34,148
CDM,54250OH,NOCTURNAL PENILE TUMESCENCE &/RIGIDITY TEST,2007.0,1304.55,1.1,2007.0,142
CDM,54250OH-26,NOCTURNAL PENILE TUMESCENCE &/RIGIDITY TEST,888.0,577.2,1.1,888.0,126
CDM,54300OH,PENIS STRAIGHTENING CHORDEE,4480.0,2912.0,1.1,10168.64,144
CDM,54304OH,PENIS CORRJ CHORDEE/1ST STAGE HYPOSPADIAS RPR,5312.0,3452.8,1.1,10168.64,144
CDM,54308OH,URETHROPLASTY 2ND STAGE HYPOSPADIAS RPR <3 CM,5048.0,3281.2,1.1,15090.73,144
CDM,54312OH,URETHROPLASTY 2ND STAGE HYPOSPADIAS RPR > 3 CM,5804.0,3772.6,1.1,10168.64,144
CDM,54316OH,URETHROPLASTY 2ND STAGE HYPOSPADIAS RPR SKIN GRF,7220.0,4693.0,1.1,26866.4,144
CDM,54318OH,URETHROPLASTY 3RD STG HYPOSPADIAS RPR RLS PENIS,4972.0,3231.8,1.1,10168.64,144
CDM,54322OH,1 STG DSTL HYPOSPADIAS RPR W/SMPL MEATAL ADVMNT,5592.0,3634.8,1.1,10168.64,144
CDM,54324OH,1 STG DSTL HYPOSPADIAS RPR W/URTP SKIN FLAPS,7020.0,4563.0,1.1,10168.64,144
CDM,54326OH,1 STG DSTL HYPOSPADIAS RPR URTP SKN FLAPS,7489.0,4867.85,1.1,10168.64,144
CDM,54328OH,1 STAGE DSTL HYPOSPADIAS RPR W/EXTENSIVE DSJ,6756.0,4391.4,1.1,10168.64,144
CDM,54332OH,1 STAGE PROX PENILE/PENOSCROTAL HYPOSPADIAS RPR,7348.0,4776.2,1.1,10168.64,144
CDM,54336OH,1 STG PERINEAL HYPOSPADIAS RPR W/GRF&/FLAP,9513.0,6183.45,1.1,10168.64,144
CDM,54340OH,RPR HYPOSPADIAS COMPLCTJS CLSR INC/EXC SIMPLE,3884.0,2524.6,1.1,10168.64,144
CDM,54344OH,RPR HYPOSPADIAS COMPLCTJS MOBLJ FLAPS & URTP,6824.0,4435.6,1.1,26866.4,144
CDM,54348OH,RPR HYPOSPADIAS COMPLCTJS DSJ & URTP FLAP/GRF,7328.0,4763.2,1.1,15090.73,144
CDM,54352OH,REVISION PRIOR HYPOSPADIAS REPAIR DSJ&EXC RCNSTJ,10452.0,6793.8,1.1,15090.73,144
CDM,54360OH,PLASTIC RPR PENIS CORRECT ANGULATION,5112.0,3322.8,1.1,10168.64,144
CDM,54380OH,PLASTIC RPR PENIS EPISPADIAS DSTL SPHNCTR,5672.0,3686.8,1.1,5941.4,144
CDM,54390OH,PLASTIC RPR PENIS EPISPADIAS W/EXSTROPHY BLADDER,9108.0,5920.2,1.1,9108.0,144
CDM,54400OH,INSJ PENILE PROSTHESIS NON-INFLATABLE SEMI-RIGID,3668.0,2384.2,1.1,37439.09,142
CDM,54401OH,INSJ PENILE PROSTHESOS INFLATABLE SELF-CONTAINED,4176.0,2714.4,1.1,58832.42,142
CDM,54405OH,INSJ MULTI-COMPONENT INFLATABLE PENILE PROSTH,5808.0,3775.2,1.1,58832.42,142
CDM,54406OH,RMVL INFLATABLE PENILE PROSTH W/O RPLCMT PROSTH,5156.0,3351.4,1.1,10168.64,144
CDM,54408OH,RPR COMPONENT INFLATABLE PENILE PROSTHESIS,5564.0,3616.6,1.1,15090.73,142
CDM,54410OH,RMVL & RPLCMT INFLATABLE PENILE PROSTH SAME SESS,6072.0,3946.8,1.1,58832.42,142
CDM,54411OH,RMVL & RPLCMT NFLTBL PENILE PROSTH INFECTED FIEL,7340.0,4771.0,1.1,58832.42,142
CDM,54415OH,RMVL NON-NFLTBL/NFLTBL PENILE PROSTH W/O RPLCMT,3552.0,2308.8,1.1,10168.64,144
CDM,54416OH,RMVL & RPLCMT NON-NFLTBL/NFLTBL PENILE PROSTHESI,4832.0,3140.8,1.1,58832.42,142
CDM,54417OH,RMVL & RPLCMT PENILE PROSTHESIS INFECTED FIELD,6440.0,4186.0,1.1,37439.09,142
CDM,54420OH,CORPORA CAVERNOSA-SAPHENOUS VEIN SHUNT UNI/BI,4956.0,3221.4,1.1,10168.64,144
CDM,54430OH,CORPORA CAVERNOSA-CORPUS SPONGIOSUM SHUNT UNI/BI,4424.0,2875.6,1.1,4424.0,144
CDM,54435OH,CORPORA CAVERNOSA-GLANS PENIS FSTLJ PRIAPISM,2724.0,1770.6,1.1,10168.64,144
CDM,54437OH,REPAIR OF TRAUMATIC CORPOREAL TEAR(S),4600.0,2990.0,1.1,10168.64,144
CDM,54440OH,PLASTIC OPERATION PENIS INJURY,5550.0,3607.5,1.1,10168.64,90
CDM,54450OH,FORESKN MANJ W/LSS PREPUTIAL ADS&STRETCHING,448.0,291.2,1.1,719.34,148
CDM,54500OH,BIOPSY TESTIS NEEDLE SEPARATE PROCEDURE,524.0,340.6,1.1,8286.13,144
CDM,54505OH,BIOPSY TESTIS INCISIONAL SEPARATE PROCEDURE,1400.0,910.0,1.1,10168.64,144
CDM,54512OH,EXC XTRPARENCHYMAL LESION TESTIS,3732.0,2425.8,1.1,10168.64,144
CDM,54520OH,ORCHIECTOMY SIMPLE SCROTAL/INGUINAL APPROACH,2332.0,1515.8,1.1,10168.64,144
CDM,54522OH,PARTIAL ORCHIECTOMY,4100.0,2665.0,1.1,10168.64,144
CDM,54530OH,ORCHIECTOMY RADICAL TUMOR INGUINAL APPROACH,3384.0,2199.6,1.1,10089.06,144
CDM,54535OH,ORCHIECTOMY RADICAL TUMOR W/ABDOMINAL EXPL,5276.0,3429.4,1.1,10168.64,144
CDM,54550OH,EXPL UNDESCENDED TSTIS INGUN/SCROTAL AREA,3364.0,2186.6,1.1,10089.06,144
CDM,54560OH,EXPL UNDESCENDED TESTIS W/ABDOMINAL EXPL,4840.0,3146.0,1.1,5941.4,144
CDM,54600OH,RDCTJ TORSION TSTIS W/WO FIXJ CLAT TESTIS,3056.0,1986.4,1.1,10168.64,144
CDM,54620OH,FIXATION CONTRALATERAL TESTIS SEPARATE PROCEDURE,2084.0,1354.6,1.1,10168.64,144
CDM,54640OH,ORCHIOPEXY INGUINAL OR SCROTAL APPROACH,3401.0,2210.65,1.1,10089.06,144
CDM,54650OH,ORCHIOPEXY ABDL APPROACH INTRA-ABDOMINAL TESTIS,5452.0,3543.8,1.1,10089.06,144
CDM,54660OH,INSJ TESTICULAR PROSTH SEPARATE PROCEDURE,2296.0,1492.4,1.1,15090.73,142
CDM,54670OH,SUTURE/REPAIR TESTICULAR INJURY,2660.0,1729.0,1.1,10168.64,144
CDM,54680OH,TRANSPLANTATION TESTIS TO THIGH,5616.0,3650.4,1.1,10168.64,144
CDM,54690OH,"LAPAROSCOPY, SURGICAL; ORCHIECTOMY",4680.0,3042.0,1.1,16829.38,144
CDM,54692OH,LAPAROSCOPY ORCHIOPEXY INTRA-ABDOMINAL TESTIS,5496.0,3572.4,1.1,16829.38,144
CDM,54700OH,I&D EPIDIDYMIS TSTIS&/SCROTAL SPACE,1388.0,902.2,1.1,5941.4,144
CDM,54800OH,"BIOPSY OF EPIDIDYMIS,NEEDLE",932.0,605.8,1.1,4729.25,144
CDM,54830OH,EXCISION LOCAL LESION EPIDIDYMIS,2404.0,1562.6,1.1,10168.64,144
CDM,54840OH,EXCISION SPERMATOCELE W/WO EPIDIDYMECTOMY,2108.0,1370.2,1.1,5941.4,144
CDM,54860OH,EPIDIDYMECTOMY UNILATERAL,2780.0,1807.0,1.1,10168.64,144
CDM,54861OH,EPIDIDYMECTOMY BILATERAL,3880.0,2522.0,1.1,10168.64,144
CDM,54865OH,EXPLORATION OF EPIDIDYMIS W/WO BIOPSY,2539.0,1650.35,1.1,10168.64,144
CDM,54900OH,EPIDIDYMOVASOSTOMY ANAST EPIDIDYMIS UNI,5680.0,3692.0,1.1,5941.4,142
CDM,54901OH,EPIDIDYMOVASOSTOMY ANAST EPIDIDYMIS BI,7640.0,4966.0,1.1,10168.64,142
CDM,55000OH,PNXR ASPIR HYDROCELE TUNICA VAGIS W/WO NJX MED,572.0,371.8,1.1,2050.87,148
CDM,55040OH,EXCISION HYDROCELE UNILATERAL,2180.0,1417.0,1.1,10089.06,144
CDM,55041OH,EXCISION HYDROCELE BILATERAL,3758.0,2442.7,1.1,10089.06,144
CDM,55060OH,RPR TUNICA VAGINALIS HYDROCELE BOTTLE TYPE,2460.0,1599.0,1.1,10168.64,144
CDM,55100OH,DRAINAGE SCROTAL WALL ABSCESS,980.0,637.0,1.1,4729.25,148
CDM,55110OH,EXPLORE SCROTUM,2532.0,1645.8,1.1,10168.64,144
CDM,55120OH,REMOVAL FOREIGN BODY SCROTUM,2288.0,1487.2,1.1,5941.4,144
CDM,55150OH,RESECTION SCROTUM,3256.0,2116.4,1.1,10168.64,144
CDM,55175OH,SCROTOPLASTY SIMPLE,2348.0,1526.2,1.1,10168.64,144
CDM,55180OH,SCROTOPLASTY COMPLICATED,4712.0,3062.8,1.1,15090.73,144
CDM,55200OH,VASOTOMY CANNULIZATION W/WO VAS INC UNI/BI SPX,1820.0,1183.0,1.1,10168.64,148
CDM,55250OH,VASECTOMY UNI/BI SPX W/POSTOP SEMEN EXAMS,1348.0,876.2,1.1,5941.4,148
CDM,55300OH,VASOTOMY VASOGRAMS UNI/BI,1400.0,910.0,1.1,1400.0,144
CDM,55400OH,VASOVASOSTOMY VASOVASORRHAPHY,3788.0,2462.2,1.1,10168.64,142
CDM,55500OH,EXC HYDROCELE SPRMATIC CORD UNI SPX,2488.0,1617.2,1.1,10168.64,144
CDM,55520OH,EXC LESION SPERMATIC CORD SEPARATE PROCEDURE,2664.0,1731.6,1.1,10168.64,144
CDM,55530OH,EXC VARICOCELE/LIGATION SPERMATIC VEINS SPX,2300.0,1495.0,1.1,10168.64,144
CDM,55535OH,EXC VARICOCELE/LIGATION SPERMATIC VEINS ABDL,2876.0,1869.4,1.1,22063.69,144
CDM,55540OH,EXC VARICOCELE/LIGATION VEINS W/HERNIA RPR,3320.0,2158.0,1.1,10089.06,144
CDM,55550OH,LAPS LIGATION SPERMATIC VEINS VARICOCELE,2880.0,1872.0,1.1,16829.38,144
CDM,55559AGRVUOH,"UNLISTED LAPAROSCOY PROCEDURE, SPERMATIC CORD (COMPARISON CODE 5",2664.0,1731.6,0.01,16829.38,84
CDM,55559OH,UNLISTED LAPROSCOPY PROCEDURE SPERMATIC CORD,6868.0,4464.2,0.01,16829.38,84
CDM,55559RVU1OH,LAPAROSCOPIC EXCISION OF SPERMATIC CORD LESION (COMP 55520),2664.0,1731.6,0.01,16829.38,84
CDM,55600OH,VESICULOTOMY,3084.0,2004.6,1.1,5941.4,144
CDM,55650OH,VESICULECTOMY ANY APPROACH,5060.0,3289.0,1.1,5060.0,144
CDM,55680OH,EXCISION MULLERIAN DUCT CYST,2268.0,1474.2,1.1,10168.64,144
CDM,55705OH,BIOPSY PROSTATE INCISIONAL ANY APPROACH,1844.0,1198.6,1.1,10168.64,144
CDM,55706OH,BX PROSTATE STRTCTC SATURATION SAMPLING IMG GID,2512.0,1632.8,1.1,10168.64,144
CDM,55707OH,BIOPSY PROSTATE TRANSRECTAL ULTRASOUND-GUIDED,1157.0,752.05,1.1,1157.0,106
CDM,55708OH,BX PROSTATE TRANSRECTAL US GID W/MRI FUS GDN 1ST,1492.0,969.8,1.1,1492.0,106
CDM,55709OH,BX PROSTATE TRANSPERINEAL ULTRASOUND-GUIDED,1421.0,923.65,1.1,1511.76,106
CDM,55710OH,BX PROSTATE TRANSPERINEAL US GID W/MRI FUS GDN 1,1676.0,1089.4,1.1,1696.55,106
CDM,55711OH,BX PROSTATE TRANSRECTAL MRI-US GID TRGT LES 1ST,1148.0,746.2,1.1,1148.0,106
CDM,55712OH,BX PROSTATE TPRNL MRI-US GID TRGT LES 1ST,1364.0,886.6,1.1,1574.3,106
CDM,55713OH,BX PROSTATE IN-BORE CT/MRI BX ADDL TRGT LES 1ST,1760.0,1144.0,1.1,1983.0,106
CDM,55714OH,BX PROSTATE IN-BORE CT/MRI TRGT LES ONLY 1ST,1593.0,1035.45,1.1,1931.81,106
CDM,55715OH,BX PROSTATE EA ADDL MRI-US FUSION/IN-BORE CT/MRI,462.0,300.3,1.1,462.0,106
CDM,55720OH,PROSTATOTOMY EXTERNAL DRG ABSCESS SIMPLE,3092.0,2009.8,1.1,10168.64,144
CDM,55725OH,PROSTATOTOMY EXTERNAL DRG ABSCESS COMPLICATED,4422.0,2874.3,1.1,10168.64,144
CDM,55801OH,PROSTATECTOMY PERINEAL SUBTOTAL,7920.0,5148.0,1.1,7920.0,144
CDM,55810OH,PROSTATECTOMY PERINEAL RADICAL,9716.0,6315.4,1.1,9716.0,144
CDM,55821OH,PROSTATECTOMY SUPRAPUBIC SUBTOTAL 1/2 STAGES,6072.0,3946.8,1.1,6072.0,144
CDM,55831OH,PROSTATECTOMY RETROPUBIC SUBTOTAL,6240.0,4056.0,1.1,6240.0,144
CDM,55840OH,PROSTATECTOMY RETROPUBIC W/WO NERVE SPARING,8544.0,5553.6,1.1,8544.0,144
CDM,55842OH,PROSTECT RETROPUBIC RAD W/WO NRV SPAR W/LYMPH BX,8544.0,5553.6,1.1,8544.0,144
CDM,55845OH,PROSTECT RETROPUB RAD W/WO NRV SPAR & BI PLV LYM,11079.0,7201.35,1.1,11079.0,144
CDM,55866OH,LAPS PROSTECT RETROPUBIC RAD W/NRV SPARING ROBOT,9882.0,6423.3,1.1,30022.29,144
CDM,55867OH,LAPS SURG PRST8ECT SMPL STOT ROBOTIC ASSISTANCE,7812.0,5077.8,1.1,30022.29,144
CDM,55868OH,LAPS SURG PRST8ECT RPBIC RADICAL W/LYMPH NODE BX,9882.0,6423.3,1.1,9882.0,106
CDM,55869OH,LAPS SURG PRST8ECT RPBIC RAD W/BI PEL LYMPHADEC,12060.0,7839.0,1.1,12060.0,106
CDM,55870OH,ELECTROEJACULATION,1032.0,670.8,1.1,2344.73,134
CDM,55873OH,CRYOSURGICAL ABLATION PROSTATE W/US & MONITORI,5440.0,3536.0,1.1,26866.4,148
CDM,55874OH,TRANSPERINEAL PLMT BIODEGRADABLE MATRL 1/MLT NJX,1212.0,787.8,1.1,15090.73,146
CDM,55875OH,TRANSPERINEAL PLMT NDL/CATHS PROSTATE RADJ INSJ,5384.0,3499.6,1.1,15090.73,144
CDM,55876OH,PLMT INTERSTITIAL DEV RADIAT TX PROSTATE 1/MULT,692.0,449.8,1.1,4040.52,148
CDM,55876SUPOH,PLACE RT DEVICE/MARKER PROS,571.0,371.15,1.1,4040.52,148
CDM,55877OH,ABLATION IRE PRST8 1 OR MORE TUMORS PERCUTANEOUS,5940.0,3861.0,1.1,5940.0,106
CDM,55880OH,TRANSRECTAL ABLTJ MAL PRST8 TISSUE HIFU W/US,7092.0,4609.8,1.1,26866.4,144
CDM,55881OH,ABLATION TRANSURETHRAL PRST8 TISSUE W/THERMAL US,4312.0,2802.8,1.1,28944.23,144
CDM,55882OH,ABLT TRURL PRST8 TIS THRM US INS TRURL US TRNSDC,5060.0,3289.0,1.1,29972.29,144
CDM,55899ARVU10.5OH,HIFU PROCEDURE - HIGH INTENSITY FOCUSED ULTRASOUND (COMP 55873),3326.0,2161.9,0.01,3326.0,84
CDM,55899OH,"GENITAL SURG PROC,MALE UNLISTED",608.0,395.2,0.01,719.34,84
CDM,55899RVU10OH,BURIED PENIS REPAIR,3696.0,2402.4,0.01,3696.0,84
CDM,55899RVU11OH,LIBERATION OF BURIED PENIS,2247.0,1460.55,0.01,2247.0,84
CDM,55899RVU12OH,SECOND STAGE SCROTAL RELEASE,4102.0,2666.3,0.01,4102.0,84
CDM,55899RVU13OH,IMPL TESTIES IN HEMISCROT (COMP CODE 54680),4590.0,2983.5,0.01,4590.0,84
CDM,55899RVU14OH,"DEGLOVING;PLASTIC RPR PENIS,SCRTL SKIN",7676.0,4989.4,0.01,7676.0,84
CDM,55899RVU15OH,"TESTICULAR SPERM EXTRACTION, UNI/BILAT (MICRO TESE)(COMP 54550)",4734.0,3077.1,0.01,4734.0,84
CDM,55899RVU17OH,PERC EPIDIDYMAL SPERM ASPIRATION UNI/BILAT(PESA) (COMP 54505),2300.0,1495.0,0.01,2300.0,84
CDM,55899RVU18OH,ASPIRATION OF SPERMATOCELE (COMP CODE 55000),608.0,395.2,0.01,719.34,84
CDM,55899RVU19OH,FREE FLAP PHALLOPLASTY (COMP CODE 15757),15975.0,10383.75,0.01,15975.0,84
CDM,55899RVU1OH,LAPAROSCOPIC VASECTOMY,2740.0,1781.0,0.01,2740.0,84
CDM,55899RVU20OH,MICRODISSECTION TESTICULAR SPERM EXTRACTION (54522),3691.0,2399.15,0.01,3691.0,84
CDM,55899RVU21OH,LAPAROSCOPIC VESICULECTOMY (COMP CODE 55650),5060.0,3289.0,0.01,5060.0,84
CDM,55899RVU22OH,MICROSCOPIC CREMASTERIC LYSIS (COMP CODE 64722),3434.0,2232.1,0.01,3434.0,84
CDM,55899RVU2OH,ROBOTIC URETEROCALYCOSTOMY,7005.0,4553.25,0.01,7005.0,84
CDM,55899RVU3OH,"EXAM UNDER ANESTHESIA, MALE",520.0,338.0,0.01,719.34,84
CDM,55899RVU4OH,EXAM MALE GENITALIA UNDER ANESTHESIA,578.0,375.7,0.01,719.34,84
CDM,55899RVU5OH,"SEED IMPLANT ""GOLD"" PROSTATE MARKER",851.0,553.15,0.01,851.0,84
CDM,55899RVU6OH,SEMINAL VESICLE BX SINGLE OR MULTI (COMP 55700),1064.0,691.6,0.01,1064.0,84
CDM,55899RVU7OH,DENERVATION MICROSURGICAL SPERM CORD (COMP 55530 & 55520),1849.0,1201.85,0.01,1849.0,84
CDM,55899RVU8OH,EXC FB SCROTAL/GENITALIA,2360.0,1534.0,0.01,2360.0,84
CDM,55899RVU9OH,TESTIC. PROSTH. REMOVAL,3934.0,2557.1,0.01,3934.0,84
CDM,55899RVUOH,FIRST STAGE SCROTAL TUNNELING,5128.0,3333.2,0.01,5128.0,84
CDM,55920OH,PLACEMENT NEEDLE PELVIC ORGAN RADIOELEMENT APPL,3324.0,2160.6,1.1,14506.08,144
CDM,56405OH,I&D VULVA/PERINEAL ABSCESS,596.0,387.4,1.1,936.67,148
CDM,56420OH,I&D OF BARTHOLINS GLAND ABSCESS,576.0,374.4,1.1,620.45,148
CDM,56440OH,MARSUP BARTHOLIN GLAND CYST,1156.0,751.4,1.1,9118.72,144
CDM,56441OH,LYSIS LABIAL ADHESIONS,808.0,525.2,1.1,9118.72,148
CDM,56442OH,"HYMENOTOMY, SIMPLE INCISION",272.0,176.8,1.1,9118.72,144
CDM,56501OH,DESTRUCTION LESIONS VULVA SIMPLE,632.0,410.8,1.1,5320.02,148
CDM,56515OH,DESTRUCTION LESIONS VULVA EXTENSIVE,1355.0,880.75,1.1,5320.02,148
CDM,56605OH,BIOPSY VULVA/PERINEUM 1 LESION SPX,440.0,286.0,1.1,2344.73,148
CDM,56606OH,BIOPSY VULVA/PERINEUM EACH ADDL LESION,220.0,143.0,1.1,220.0,148
CDM,56620OH,VULVECTOMY SIMPLE PARTIAL,3313.0,2153.45,1.1,9118.72,144
CDM,56620RVU1OH,PART SIMPLE REMV VULVA - SIMPLE,1750.0,1137.5,1.1,9118.72,144
CDM,56620RVU2OH,PART SIMPLE REMV VULVA - MODERATE,2100.0,1365.0,1.1,9118.72,144
CDM,56620RVU3OH,PART SIMPLE REMV VULVA - COMPLEX,2400.0,1560.0,1.1,9118.72,144
CDM,56625OH,VULVECTOMY SIMPLE COMPLETE,4259.0,2768.35,1.1,9118.72,144
CDM,56630OH,VULVECTOMY RADICAL PARTIAL,6512.0,4232.8,1.1,6512.0,144
CDM,56631OH,VULVECTOMY RAD PRTL UNI INGUINOFEM LMPHADECTOMY,7596.0,4937.4,1.1,7596.0,144
CDM,56632OH,VULVECTOMY RAD PRTL BI INGUINOFEM LMPHADECTOMY,8744.0,5683.6,1.1,8744.0,144
CDM,56633OH,VULVECTOMY RADICAL COMPLETE,7848.0,5101.2,1.1,7848.0,144
CDM,56634OH,VULVECTOMY RAD COMPL UNI INGUINOFEM LMPHADECTOMY,8264.0,5371.6,1.1,8264.0,144
CDM,56637OH,VULVECTOMY RAD COMPL BI INGUINOFEM LMPHADECTOMY,9900.0,6435.0,1.1,9900.0,144
CDM,56640OH,VULVECTOMY RAD COMPL ILIAC & PELVIC LMPHADECTOMY,9912.0,6442.8,1.1,9912.0,144
CDM,56700OH,PRTL HYMENECTOMY/REVJ HYMENAL RING,1136.0,738.4,1.1,9118.72,144
CDM,56740OH,EXC BARTHOLINS GLAND/CYST,1952.0,1268.8,1.1,9118.72,144
CDM,56800OH,PLASTIC REPAIR INTROITUS,1572.0,1021.8,1.1,9118.72,144
CDM,56805OH,CLITOROPLASTY INTERSEX STATE,8747.0,5685.55,1.1,9118.72,144
CDM,56810OH,PERINEOPLASTY RPR PERINEUM NONOBSTETRICAL SPX,1716.0,1115.4,1.1,9118.72,144
CDM,56820OH,"COLPOSCOPY, VULVA",600.0,390.0,1.1,600.0,148
CDM,56821OH,COLPOSCOPY VULVA W/BIOPSY,820.0,533.0,1.1,936.67,148
CDM,57000OH,COLPOTOMY W/EXPLORATION,1208.0,785.2,1.1,9118.72,144
CDM,57010OH,COLPOTOMY W/DRAINAGE PELVIC ABSCESS,2736.0,1778.4,1.1,9118.72,144
CDM,57020OH,COLPOCENTESIS SEPARATE PROCEDURE,600.0,390.0,1.1,14506.08,148
CDM,57022OH,I&D VAGINAL HEMATOMA OBSTETRICAL/POSTPARTUM,1092.0,709.8,1.1,8286.13,144
CDM,57023OH,I&D VAGINAL HEMATOMA NON-OBSTETRICAL,2072.0,1346.8,1.1,8286.13,144
CDM,57061OH,DESTRUCTION VAGINAL LESIONS SIMPLE,572.0,371.8,1.1,9118.72,148
CDM,57065OH,DESTRUCTION VAGINAL LESIONS EXTENSIVE,1170.0,760.5,1.1,9118.72,148
CDM,57100OH,BIOPSY VAGINAL MUCOSA SIMPLE,480.0,312.0,1.1,2344.73,148
CDM,57105OH,BIOPSY VAGINAL MUCOSA EXTENSIVE,696.0,452.4,1.1,9118.72,148
CDM,57106OH,VAGINECTOMY PARTIAL REMOVAL VAGINAL WALL,3000.0,1950.0,1.1,9118.72,144
CDM,57107OH,VAGINECTOMY PRTL RMVL VAG WALL & PARAVAGINAL T,9824.0,6385.6,1.1,9824.0,144
CDM,57109OH,VAGNC PRTL RMVL VAG WALL W/BI TOT PEL LMPHADEC,11360.0,7384.0,1.1,11360.0,144
CDM,57110OH,VAGINECTOMY COMPLETE REMOVAL VAGINAL WALL,6192.0,4024.8,1.1,6192.0,144
CDM,57111OH,VAGINECTOMY COMPL RMVL VAG WALL & PARAVAG TISS,11360.0,7384.0,1.1,11360.0,144
CDM,57120OH,COLPOCLEISIS LE FORT TYPE,3312.0,2152.8,1.1,14506.08,144
CDM,57130OH,EXCIS VAGINAL SEPTUM,984.0,639.6,1.1,9118.72,148
CDM,57135OH,EXCIS VAGINAL CYST/TUMOR,1080.0,702.0,1.1,9118.72,148
CDM,57150OH,IRRIGATION VAGINA&/APPL MEDICAMENT TX DISEASE,200.0,130.0,1.1,200.0,148
CDM,57155OH,INSERTION UTERINE TANDEM&/VAGINAL OVOIDS,2266.0,1472.9,1.1,14506.08,148
CDM,57156OH,INSERTION VAGINAL RADIATION DEVICE,1076.0,699.4,1.1,1076.0,148
CDM,57160OH,FIT&INSJ PESSARY/OTH INTRAVAGINAL SUPPORT DEVI,356.0,231.4,1.1,581.59,148
CDM,57170OH,DIAPHRAGM/CERVICAL CAP FITTING W/INSTRUCTIONS,364.0,236.6,1.1,581.59,148
CDM,57180OH,INTRO ANY HEMOSTATIC AGENT/PACK VAG HEMRRG SPX,652.0,423.8,1.1,666.37,148
CDM,57200OH,COLPORRHAPHY SUTURE INJURY VAGINA,1768.0,1149.2,1.1,9118.72,144
CDM,57210OH,COLPOPERINEORRHAPHY SUTURE INJ VAGINA&/PERINEU,2284.0,1484.6,1.1,9118.72,144
CDM,57220OH,PLASTIC URETHRAL SPHINCTER VAGINAL APPROACH,1940.0,1261.0,1.1,14506.08,144
CDM,57230OH,PLASTIC REPAIR URETHROCELE,2520.0,1638.0,1.1,9118.72,144
CDM,57240OH,ANTERIOR COLPORRAPHY RPR CYSTOCELE W/CYSTO,4032.0,2620.8,1.1,14506.08,144
CDM,57250OH,POST COLPORRHAPHY RECTOCELE W/WO PERINEORRHAPHY,4435.0,2882.75,1.1,14506.08,144
CDM,57260OH,CMBND ANTERPOST COLPORRAPHY W/CYSTO,5830.0,3789.5,1.1,14506.08,144
CDM,57265OH,CMBND ANTERPOST COLPORRAPHY W/CYSTO W/NTRCL RPR,6000.0,3900.0,1.1,14506.08,144
CDM,57267OH,INSJ MESH/PROSTH PELVIC FLOOR DEFECT EACH SITE,1952.0,1268.8,1.1,1952.0,144
CDM,57268OH,REPAIR ENTEROCELE VAGINAL APPROACH SPX,3028.0,1968.2,1.1,14506.08,144
CDM,57270OH,REPAIR ENTEROCELE ABDOMINAL APPROACH SPX,5468.0,3554.2,1.1,5468.0,144
CDM,57280OH,COLPOPEXY ABDOMINAL APPROACH,6688.0,4347.2,1.1,6688.0,144
CDM,57282OH,COLPOPEXY VAGINAL EXTRAPERITONEAL APPROACH,4652.0,3023.8,1.1,22039.2,144
CDM,57283OH,COLPOPEXY VAGINAL INTRAPERITONEAL APPROACH,4664.0,3031.6,1.1,22039.2,144
CDM,57284OH,PARAVAGINAL DEFECT REPAIR OPEN ABDOMINAL APPR,5732.0,3725.8,1.1,14506.08,144
CDM,57285OH,PARAVAGINAL DEFECT REPAIR VAGINAL APPROACH,4640.0,3016.0,1.1,22039.2,144
CDM,57287OH,RMVL/REVJ SLING STRESS INCONTINENCE,4460.0,2899.0,1.1,9118.72,144
CDM,57288OH,SLING OPER STRES INCONTINENCE,5337.0,3469.05,1.1,14506.08,144
CDM,57289OH,PEREYA PROC+ANTER COLPORRHAPHY,5120.0,3328.0,1.1,22039.2,144
CDM,57291OH,CONSTRUCTION ARTIFICIAL VAGINA W/O GRAFT,3456.0,2246.4,1.1,14506.08,144
CDM,57292OH,CONSTRUCTION ARTIFICIAL VAGINA W/GRAFT,5604.0,3642.6,1.1,14506.08,144
CDM,57295OH,REVJ/RMVL PROSTHETIC VAGINAL GRAFT VAGINAL APP,3128.0,2033.2,1.1,9118.72,144
CDM,57296OH,REVJ W/RMVL PROSTHETIC VAGINAL GRAFT ABDML APPR,6624.0,4305.6,1.1,6624.0,144
CDM,57300OH,CLSR RECTOVAGINAL FISTULA VAGINAL/TRANSANAL APPR,3484.0,2264.6,1.1,9118.72,144
CDM,57305OH,CLSR RECTOVAGINAL FISTULA ABDOMINAL APPROACH,6140.0,3991.0,1.1,6140.0,144
CDM,57307OH,CLSR RECTOVAG FSTL ABDL APPR W/CONCOMITANT CLST,6868.0,4464.2,1.1,6868.0,144
CDM,57308OH,CLSR RECTOVAG FSTL TPRNL PRNL BDY RCNSTJ,4236.0,2753.4,1.1,4236.0,144
CDM,57310OH,CLOSE URETHROVAGINAL FISTULA,3060.0,1989.0,1.1,22039.2,144
CDM,57311OH,CLSR URETHROVAG FSTL W/BULBOCAVERNOSUS TRNSPL,3564.0,2316.6,1.1,3564.0,144
CDM,57320OH,CLOSURE VESICOVAGINAL FISTULA VAGINAL APPROACH,3552.0,2308.8,1.1,14506.08,144
CDM,57330OH,CLSR VESICOVAG FSTL TRANSVESICAL&VAG APPR,5284.0,3434.6,1.1,22039.2,144
CDM,57335OH,VAGINOPLASTY INTERSEX STATE,8008.0,5205.2,1.1,14506.08,144
CDM,57400OH,DILATION VAGINA W/ANESTHESIA OTHER THAN LOCAL,908.0,590.2,1.1,9118.72,144
CDM,57410OH,PELVIC EXAMINATION W/ANESTHESIA OTHER THAN LOCAL,700.0,455.0,1.1,9118.72,144
CDM,57415OH,REMOVAL IMPACTED VAG FB SPX W/ANES OTH/THN LOCAL,996.0,647.4,1.1,9118.72,144
CDM,57420OH,COLPOSCOPY ENTIRE VAGINA W/CERVIX IF PRESENT,640.0,416.0,1.1,936.67,148
CDM,57421OH,COLPOSCOPY ENTIRE VAGINA W/VAGINA/CERVIX BX,880.0,572.0,1.1,2344.73,148
CDM,57423OH,PARAVAGINAL DEFECT REPAIR LAPAROSCOPIC APPROACH,6432.0,4180.8,1.1,30022.29,144
CDM,57425OH,LAPAROSCOPY COLPOPEXY SUSPENSION VAGINAL APEX,6812.0,4427.8,1.1,30022.29,144
CDM,57426OH,REVISION PROSTHETIC VAGINAL GRAFT LAPAROSCOPIC,5720.0,3718.0,1.1,22039.2,144
CDM,57452OH,COLPOSCOPY CERVIX UPPER/ADJACENT VAGINA,600.0,390.0,1.1,600.0,148
CDM,57454OH,COLPOSCOPY CERVIX BX CERVIX & ENDOCRV CURRETAGE,932.0,605.8,1.1,936.67,148
CDM,57455OH,COLPOSCOPY CERVIX UPPR/ADJCNT VAGINA W/CERVIX BX,796.0,517.4,1.1,936.67,148
CDM,57456OH,COLPOSCOPY CERVIX ENDOCERVICAL CURETTAGE,740.0,481.0,1.1,936.67,148
CDM,57460OH,COLPOSCOPY CERVIX VAG LOOP ELTRD BX CERVIX,1132.0,735.8,1.1,9118.72,148
CDM,57461OH,COLPOSCOPY CERVIX VAG ELTRD CONIZATION CERVIX,1372.0,891.8,1.1,9118.72,148
CDM,57465OH,COMPUTER-AIDED MAPG CERVIX UTERI DRG COLPOSCOPY,324.0,210.6,1.1,324.0,148
CDM,57500OH,BIOPSY CERVIX SINGLE/MULT/EXCISION OF LESION SPX,528.0,343.2,1.1,2344.73,148
CDM,57505OH,ENDOCERVICAL CURETTAGE NOT DONE AS PART OF D&C,476.0,309.4,1.1,2344.73,148
CDM,57510OH,CAUTERY CERVIX ELECTRO/THERMAL,760.0,494.0,1.1,9118.72,148
CDM,57511OH,CAUTERY CERVIX CRYOCAUTERY INITIAL/REPEAT,780.0,507.0,1.1,936.67,148
CDM,57513OH,CAUTERY CERVIX LASER ABLATION,780.0,507.0,1.1,9118.72,148
CDM,57520OH,CONIZATION CERVIX W/WO D&C RPR KNIFE/LASER,1644.0,1068.6,1.1,9118.72,148
CDM,57522OH,CONIZATION CERVIX W/WO D&C RPR ELTRD EXC,1468.0,954.2,1.1,9118.72,148
CDM,57530OH,TRACHELECTOMY CERVICECTOMY AMP CERVIX SPX,2108.0,1370.2,1.1,14506.08,144
CDM,57531OH,RAD TRACHELECTOMY W/BI PEL LMPHADEC,11980.0,7787.0,1.1,11980.0,144
CDM,57550OH,EXCISION CERVICAL STUMP VAGINAL APPROACH,2536.0,1648.4,1.1,14506.08,144
CDM,57555OH,EXC CRV STUMP VAG APPR W/ANT &/POST REPAIR,3976.0,2584.4,1.1,14506.08,144
CDM,57558OH,DILATION & CURETTAGE CERVICAL STUMP,688.0,447.2,1.1,9118.72,148
CDM,57700OH,CERCLAGE UTERINE CERVIX NONOBSTETRICAL,1740.0,1131.0,1.1,9118.72,144
CDM,57720OH,TRACHELORRHAPHY PLSTC RPR UTERINE CERVIX VAG,1844.0,1198.6,1.1,9118.72,144
CDM,57800OH,DILATION CERVICAL CANAL INSTRUMENTAL SPX,308.0,200.2,1.1,9118.72,148
CDM,58100OH,ENDOMETRIAL BX W/WO ENDOCERVIX BX W/O DILAT SPX,532.0,345.8,1.1,581.59,148
CDM,58110OH,ENDOMETRIAL BX CONJUNCT W/COLPOSCOPY,308.0,200.2,1.1,308.0,148
CDM,58120OH,DILATION & CURETTAGE DX&/THER NONOBSTETRIC,1436.0,933.4,1.1,9118.72,148
CDM,58140OH,MYOMECTOMY 1-4 MYOMAS W/250 GM/< ABDOMINAL APPR,6316.0,4105.4,1.1,6316.0,144
CDM,58145OH,MYOMECTOMY 1-4 MYOMAS 250 GM/< VAGINAL APPR,3564.0,2316.6,1.1,9118.72,144
CDM,58146OH,MYOMECTOMY 5/> MYOMAS &/>250 GM ABDOMINA,8136.0,5288.4,1.1,8136.0,144
CDM,58150OH,TOTAL ABDOMINAL HYSTERECT W/WO RMVL TUBE OVARY,6924.0,4500.6,1.1,6924.0,144
CDM,58152OH,TOT ABD HYST W/WO RMVL TUBE OVARY W/COLPURETHRXY,8744.0,5683.6,1.1,8744.0,144
CDM,58180OH,SUPRACERVICAL ABDL HYSTER W/WO RMVL TUBE OVARY,6640.0,4316.0,1.1,6640.0,144
CDM,58200OH,TOT ABD HYST W/PARAORTIC & PELVIC LYMPH NODE SAM,9240.0,6006.0,1.1,9240.0,144
CDM,58210OH,RAD ABDL HYSTERECTOMY W/BI PELVIC LMPHADENECTOMY,12364.0,8036.6,1.1,12364.0,144
CDM,58240OH,PEL EXNTJ GYNECOLOGIC MAL,19732.0,12825.8,1.1,19732.0,144
CDM,58260OH,VAGINAL HYSTERECTOMY UTERUS 250 GM/<,5660.0,3679.0,1.1,14506.08,144
CDM,58262OH,VAG HYST 250 GM/< W/RMVL TUBE&/OVARY,6376.0,4144.4,1.1,14506.08,144
CDM,58263OH,VAG HYST 250 GM/< W/RMVL TUBE OVARY W/RPR NTRCL,6892.0,4479.8,1.1,14506.08,144
CDM,58267OH,VAG HYST 250 GM/< W/COLPO-URTCSTOPEXY,7344.0,4773.6,1.1,7344.0,144
CDM,58270OH,VAGINAL HYSTERECTOMY 250 GM/< W/RPR ENTEROCELE,6120.0,3978.0,1.1,14506.08,144
CDM,58275OH,VAGINAL HYSTERECTOMY W/TOT/PRTL VAGINECTOMY,6812.0,4427.8,1.1,6812.0,144
CDM,58280OH,VAG HYSTER W/TOT/PRTL VAGINECT W/RPR ENTEROCELE,7332.0,4765.8,1.1,7332.0,144
CDM,58285OH,VAGINAL HYSTERECTOMY RADICAL SCHAUTA OPERATION,9352.0,6078.8,1.1,9352.0,144
CDM,58290OH,VAGINAL HYSTERECTOMY UTERUS > 250 GM,8108.0,5270.2,1.1,22039.2,144
CDM,58291OH,VAG HYST > 250 GM RMVL TUBE&/OVARY,8824.0,5735.6,1.1,14506.08,144
CDM,58292OH,VAG HYST > 250 GM RMVL TUBE&/OVARY W/RPR ENTRCLE,9340.0,6071.0,1.1,22039.2,144
CDM,58294OH,VAGINAL HYSTERECTOMY >250 GM RPR ENTEROCELE,8620.0,5603.0,1.1,14506.08,144
CDM,58300OH,INSERT INTRAUTERINE DEVICE,444.0,288.6,1.1,444.0,116
CDM,58301OH,REMOVE INTRAUTERINE DEVICE,559.0,363.35,1.1,936.67,148
CDM,58321OH,"ARTIF INSEMINATION,INTRA-CERVICAL",368.0,239.2,1.1,936.67,134
CDM,58322OH,ARTIFIC INSEMINATION INTRAUTERIN,440.0,286.0,1.1,581.59,134
CDM,58323OH,SPERM WASHING FOR ARTIF INSEM,92.0,59.8,1.1,581.59,134
CDM,58340OH,CATH & SALINE/CONTRAST SONOHYSTER/HYSTEROSALPI,387.0,251.55,1.1,803.88,148
CDM,58345OH,TRANSCERV FALLOPIAN TUBE CATH W/WO HYSTOSALPING,1880.0,1222.0,1.1,9118.72,130
CDM,58350OH,CHROMOTUBATION OVIDUCT W/MATERIALS,424.0,275.6,1.1,14506.08,134
CDM,58353OH,ENDOMETRIAL ABLTJ THERMAL W/O HYSTEROSCOPIC GUID,1440.0,936.0,1.1,14506.08,148
CDM,58356OH,ENDOMETRIAL CRYOABLATION W/US & ENDOMETRIAL CR,2564.0,1666.6,1.1,14506.08,148
CDM,58400OH,UTERINE SUSPENSION W/WO SHORTENING LIGAMENTS SPX,2856.0,1856.4,1.1,2856.0,142
CDM,58410OH,UTERINE SUSP W/WO SHORT LIGAMNTS W/SYMPATHECTOMY,5520.0,3588.0,1.1,5520.0,142
CDM,58520OH,HYSTERORRHAPHY REPAIR RUPT UTERUS NONOBSTETRICAL,5392.0,3504.8,1.1,5392.0,144
CDM,58540OH,REVISION OF UTERINE ANOMALY,6284.0,4084.6,1.1,6284.0,144
CDM,58541OH,LAPAROSCOPY SUPRACERVICAL HYSTERECTOMY 250 GM/<,4916.0,3195.4,1.1,30022.29,144
CDM,58542OH,LAPS SUPRACRV HYSTERECT 250 GM/< RMVL TUBE/OVAR,6230.0,4049.5,1.1,30022.29,144
CDM,58543OH,"LAP, SUPRACERVIAL HYSTERECTOMY, >250G",6332.0,4115.8,1.1,30022.29,144
CDM,58544OH,LAPS SUPRACRV HYSTEREC >250 G RMVL TUBE/OVARY,6240.0,4056.0,1.1,30022.29,144
CDM,58545OH,LAPS MYOMECTOMY EXC 1-4 MYOMAS 250 GM/<,6220.0,4043.0,1.1,16829.38,144
CDM,58546OH,LAPS MYOMECTOMY EXC 5/> MYOMAS >250 GRAMS,7976.0,5184.4,1.1,30022.29,144
CDM,58548OH,LAPS W/RAD HYST W/BILAT LMPHADEC RMVL TUBE/OVARY,12652.0,8223.8,1.1,12652.0,144
CDM,58550OH,LAPS VAGINAL HYSTERECTOMY UTERUS 250 GM/<,6040.0,3926.0,1.1,16829.38,144
CDM,58552OH,LAPS W/VAG HYSTERECT 250 GM/&RMVL TUBE&/OVARIES,6764.0,4396.6,1.1,30022.29,144
CDM,58553OH,LAPS W/VAGINAL HYSTERECTOMY > 250 GRAMS,8024.0,5215.6,1.1,30022.29,144
CDM,58554OH,LAPS VAGINAL HYSTERECT > 250 GM RMVL TUBE&/OVAR,9244.0,6008.6,1.1,30022.29,144
CDM,58555OH,"HYSTEROSCOPY, DIAGNOSTIC (SEPARATE",1166.0,757.9,1.1,9118.72,148
CDM,58558OH,HYSTEROSCOPY BX ENDOMETRIUM&/POLYPC W/WO D&C,1835.0,1192.75,1.1,9118.72,148
CDM,58559OH,HYSTEROSCOPY LYSIS INTRAUTERINE ADHESIONS,2080.0,1352.0,1.1,14506.08,144
CDM,58560OH,HYSTEROSCOPY DIV/RESCJ INTRAUTERINE SEPTUM,2300.0,1495.0,1.1,14506.08,144
CDM,58561OH,HYSTEROSCOPY REMOVAL LEIOMYOMATA,2904.0,1887.6,1.1,14506.08,144
CDM,58562OH,HYSTEROSCOPY REMOVAL IMPACTED FOREIGN BODY,1600.0,1040.0,1.1,9118.72,148
CDM,58563OH,HYSTEROSCOPY ENDOMETRIAL ABLATION,1967.0,1278.55,1.1,14506.08,148
CDM,58565OH,HYSTEROSCOPY BI TUBE OCCLUSION W/PERM IMPLNTS,2848.0,1851.2,1.1,14506.08,146
CDM,58570OH,LAPAROSCOPY W TOTAL HYSTERECTOMY UTERUS 250 GM/<,5344.0,3473.6,1.1,30022.29,144
CDM,58571OH,LAPS TOTAL HYSTERECT 250 GM/< W/RMVL TUBE/OVARY,6600.0,4290.0,1.1,30022.29,144
CDM,58572OH,LAPAROSCOPY TOTAL HYSTERECTOMY UTERUS >250 GM,7792.0,5064.8,1.1,30022.29,144
CDM,58573OH,LAPAROSCOPY TOT HYSTERECTOMY >250 G W/TUBE/OVAR,8316.0,5405.4,1.1,30022.29,144
CDM,58575OH,LAPS TOT HYSTERECTOMY RESJ MALIGNANCY W/OMNTC,13040.0,8476.0,1.1,13040.0,144
CDM,58578RVU1OH,UNL PRESACRAL NEURECTOMY,3101.0,2015.65,0.01,16829.38,84
CDM,58578RVU2OH,LAP REPAIR PERFORATED UTERUS,4536.0,2948.4,0.01,16829.38,84
CDM,58578RVU3OH,"UNLISTED LAPAROSCOPY PROCEDURE, UTERUS (COMPARISON CODE 59325)",1474.0,958.1,0.01,16829.38,84
CDM,58578RVU5OH,UNLISTED PROC; ROBOTIC LAPAROSCOPIC TRACHELECTOMY AMPUTATION OF,1739.0,1130.35,0.01,16829.38,84
CDM,58578RVU6OH,UNLISTED LAP REMOVAL OF UTERINE HORN (COMP CODE 58540),5106.0,3318.9,0.01,16829.38,84
CDM,58578RVU7OH,UNLISTED LAPAROSCOPIC HYSTEROTOMY (COMP CODE 59100),5348.0,3476.2,0.01,16829.38,84
CDM,58578RVU8OH,LAPAROSCOPIC ISTHMOCELE REPAIR (COMP CODE 58520),5392.0,3504.8,0.01,16829.38,84
CDM,58578RVU9OH,LAPAROSCOPIC CERVICAL STOMA CREATION (COMP CODE 44187),6960.0,4524.0,0.01,16829.38,84
CDM,58578RVUOH,LAPAROSCOPIC CERCLAGE,1741.0,1131.65,0.01,16829.38,84
CDM,58579OH,"UNLISTED HYSTEROSCOPY PROCEDURE, UT",2776.0,1804.4,0.01,2776.0,84
CDM,58579RVU1OH,UNLISTED HYSTEROSCOPIC ABLATION OF ISTHMOCELE (COMP CODE 58563),1922.0,1249.3,0.01,1922.0,84
CDM,58579RVU2OH,HYSTEROSCOPIC INTRAUTERINE BOTOX INJECTIONS (COMP CODE 52287),1153.0,749.45,0.01,1153.0,84
CDM,58580OH,TRANSCERVICAL ABLATION UTERINE FIBROID RF,3172.0,2061.8,1.1,22039.2,148
CDM,58600OH,LIG/TRNSXJ FLP TUBE ABDL/VAG APPR UNI/BI,2364.0,1536.6,1.1,9118.72,144
CDM,58605OH,LIG/TRNSXJ FLP TUBE ABDL/VAG POSTPARTUM SPX,2112.0,1372.8,1.1,2112.0,144
CDM,58611OH,LIG/TRNSXJ FALOPIAN TUBE CESAREAN DEL/ABDML SURG,638.0,414.7,1.1,638.0,144
CDM,58615OH,OCCLUSION FLP TUBE DEV VAG/SUPRAPUBIC APPR,1576.0,1024.4,1.1,9118.72,144
CDM,58660OH,LAPAROSCOPY W/LYSIS OF ADHESION,4636.0,3013.4,1.1,16829.38,144
CDM,58661OH,LAPAROSCOPY W/RMVL ADNEXAL STRUCTURES,4994.0,3246.1,1.1,16829.38,144
CDM,58661RVU1OH,UNLISTED VNOTES  BILATERAL SALPINGECTOMY (COMP CODE 58661),4121.0,2678.65,1.1,16829.38,144
CDM,58662OH,LAPS FULG/EXC OVARY VISCERA/PERITONEAL SURFACE,4860.0,3159.0,1.1,16829.38,144
CDM,58670OH,LAPAROSCOPY FULGURATION OVIDUCTS,2364.0,1536.6,1.1,16829.38,144
CDM,58671OH,LAPAROSCOPY W/PLMT OCCLUSION DEVICE OVIDUCTS,2364.0,1536.6,1.1,16829.38,144
CDM,58672OH,LAPAROSCOPY FIMBRIOPLASTY,5164.0,3356.6,1.1,16829.38,144
CDM,58673OH,LAPAROSCOPY SALPINGOSTOMY,5616.0,3650.4,1.1,30022.29,144
CDM,58674OH,LAPS ABLTJ UTERINE FIBROIDS W/INTRAOP US GDN,5632.0,3660.8,1.1,30022.29,144
CDM,58679RVU1OH,"UNLISTED PROC, LAPAROSCOPIC BIL OVARIAN TRANSPOSITION (COMP CODE",3970.0,2580.5,0.01,16829.38,84
CDM,58679RVU2OH,UNLISTED LAPAROSCOPIC DETORSION OF OVARY (COMP CODE 49322),2584.0,1679.6,0.01,16829.38,84
CDM,58679RVU3OH,LAPAROSCOPIC TUBAL RE-ANASTOMOSIS (COMP CODE 58750),5631.0,3660.15,0.01,16829.38,84
CDM,58679RVU4OH,LAPAROSCOPIC UTERINE AND OVARIAN TRANSPOSITION (COMP CODE 58571),6600.0,4290.0,0.01,16829.38,84
CDM,58679RVUOH,"UNLISTED LAPAROSCOPY PROCEDURE, OVIDUCT OVARY (COMPARISON CODE 5",1360.0,884.0,0.01,16829.38,84
CDM,58700OH,SALPINGECTOMY COMPLETE/PARTIAL UNI/BI SPX,5180.0,3367.0,1.1,5180.0,144
CDM,58720OH,SALPINGO-OOPHORECTOMY COMPL/PRTL UNI/BI SPX,4864.0,3161.6,1.1,4864.0,144
CDM,58740OH,LYSIS OF ADHESIONS SALPINX/OVARY,5960.0,3874.0,1.1,5960.0,144
CDM,58750OH,TUBOTUBAL ANASTOMOSIS,6256.0,4066.4,1.1,6256.0,130
CDM,58752OH,TUBO-UTERINE IMPLANT,6256.0,4066.4,1.1,6256.0,130
CDM,58760OH,FIMBRIOPLASTY,5572.0,3621.8,1.1,5572.0,130
CDM,58770OH,SALPINGOSTOMY,5908.0,3840.2,1.1,9118.72,132
CDM,58800OH,DRAINAGE OVARIAN CYST UNI/BI SPX VAGINAL APPR,1848.0,1201.2,1.1,9118.72,148
CDM,58805OH,DRAINAGE OVARIAN CYST UNI/BI SPX ABDOMINAL,2568.0,1669.2,1.1,9118.72,144
CDM,58820OH,DRAINAGE OVARIAN ABSCESS VAGINAL APPR OPEN,1880.0,1222.0,1.1,9118.72,144
CDM,58822OH,DRAINAGE OVARIAN ABSCESS ABDOMINAL APPROACH,4724.0,3070.6,1.1,4724.0,144
CDM,58825OH,"TRANSPOSITION, OVARY(S)",4712.0,3062.8,1.1,4712.0,144
CDM,58900OH,BIOPSY OVARY UNI/BI SEPARATE PROCEDURE,2636.0,1713.4,1.1,9118.72,144
CDM,58920OH,WEDGE RESCJ/BISCTJ OVARY UNI/BI,4780.0,3107.0,1.1,22039.2,144
CDM,58925OH,OVARIAN CYSTECTOMY UNI/BI,4972.0,3231.8,1.1,14506.08,144
CDM,58940OH,OOPHORECTOMY PARTIAL/TOTAL UNI/BI,3617.0,2351.05,1.1,3617.0,144
CDM,58943OH,OOPHORECTOMY PRTL/TOT UNI/BI OVARIAN MALIGNANCY,7808.0,5075.2,1.1,7808.0,144
CDM,58950OH,RESCJ OVARIAN/TUBAL/PERITONEAL MALIGNANCY W/BSO,7348.0,4776.2,1.1,7348.0,144
CDM,58951OH,RESCJ PRIM PRTL MAL W/BSO & OMNTC TAH & LMPHAD,9704.0,6307.6,1.1,9704.0,144
CDM,58952OH,RESCJ PRIM PRTL MAL W/BSO & OMNTC RAD DEBULKING,10916.0,7095.4,1.1,10916.0,144
CDM,58953OH,BSO W/OMENTECTOMY TAH&RAD DEBULKING DISSECTION,13652.0,8873.8,1.1,13652.0,144
CDM,58954OH,BSO W/OMENTECTOMY TAH DEBULKING W/LMPHADECTOMY,14852.0,9653.8,1.1,14852.0,144
CDM,58956OH,BSO W/TOT OMENTECTOMY & HYSTERECTOMY MALIGNANC,9120.0,5928.0,1.1,9120.0,144
CDM,58958OH,RESCJ RECR OVR TBL PP UTR MAL OMNTC PEL LMPHADEC,11688.0,7597.2,1.1,11688.0,144
CDM,58960OH,LAPT STG/RESTG OVARIAN TUBAL/PRIM MAL 2ND LOOK,6316.0,4105.4,1.1,6316.0,144
CDM,58970OH,FOLLICLE PUNCTURE OOCYTE RETRIEVAL ANY METHOD,1549.0,1006.85,1.1,2344.73,134
CDM,58974OH,"TRANSFER OF EMBRYO,INTRAUTERINE",1163.0,755.95,1.1,2344.73,88
CDM,58999RVU10OH,LAP PARTIAL VAGINECTOMY,3094.0,2011.1,0.01,3094.0,84
CDM,58999RVU11OH,CHEMODENERVATION VAGINAL MUSCLE (COMP CODE 64646 CHEMODENERV TRU,594.0,386.1,0.01,594.0,84
CDM,58999RVU12OH,"UNLISTED PROC, EXCISION OF VAGINAL CUFF LESION (COMP TO 57135)",891.0,579.15,0.01,891.0,84
CDM,58999RVU14OH,UNLISTED VNOTES BILATERAL SALPINGECTOMY (COMP CODE 58661),4121.0,2678.65,0.01,4121.0,84
CDM,58999RVU15OH,UNLISTED EXCISION GRANULATION TISSUE VAGINA (COMP CODE 57210),1856.0,1206.4,0.01,1856.0,84
CDM,58999RVU16OH,UNLISTED INSERTION FOLEY CATH INTO UTERUS (COMP CODE 51702),213.0,138.45,0.01,581.59,84
CDM,58999RVU17OH,UNLISTED NEEDLE CORE BIOPSY RECTOVAGINAL (COMP CODE 57500),510.0,331.5,0.01,581.59,84
CDM,58999RVU18OH,UNLISTED LAPOROSCOPIC RADICAL PARTIAL VAGINECTOMY (COMP CODE 571,10566.0,6867.9,0.01,10566.0,84
CDM,58999RVU19OH,UNLISTED TRANSVAGINAL REPAIR OF CESAREAN SCAR DEFECT (COMP CODE,3255.0,2115.75,0.01,3255.0,84
CDM,58999RVU1OH,LYSIS OF ADHESIONS OF VAGINAL (COMP CODE 56441),398.0,258.7,0.01,581.59,84
CDM,58999RVU20OH,LAPAROSCOPIC RESECTION OF NEOVAGINA (COMP 57110),6656.0,4326.4,0.01,6656.0,84
CDM,58999RVU21OH,LAPAROSCOPIC UTEROSACRAL LIGAMENT SUSPENSION (COMP CODE 57283),4664.0,3031.6,0.01,4664.0,84
CDM,58999RVU22OH,VAGINAL CUFF BIOPSY (COMP CODE 57100),480.0,312.0,0.01,581.59,84
CDM,58999RVU2OH,UNLISTED VAGINAL CUFF REPAIR (COMP CODE 57200),1602.0,1041.3,0.01,1602.0,84
CDM,58999RVU3OH,UNLISTED VAGINOPLASTY FOR STRICTURE,1813.0,1178.45,0.01,1813.0,84
CDM,58999RVU4OH,UNL LAP RAD TRACHELECTOMY,12374.0,8043.1,0.01,12374.0,84
CDM,58999RVU5OH,LAPAROSCOPIC PARTIAL VAGINECTOMY (COMP CODE 57106),3094.0,2011.1,0.01,3094.0,84
CDM,58999RVU6OH,UNLISTED VULVAR VESTIBULECTOMY,2389.0,1552.85,0.01,2389.0,84
CDM,58999RVU7OH,LUNA,3558.0,2312.7,0.01,3558.0,84
CDM,58999RVU8OH,EXP LAPAROTOMY REPAIR VAG CUFF,5500.0,3575.0,0.01,5500.0,84
CDM,58999RVU9OH,SUPPORT TRIAL,500.0,325.0,0.01,581.59,84
CDM,58999RVUOH,LAPAROSCOPIC REPAIR COLOVAGINAL FISTULA (COMP 57305),3655.0,2375.75,0.01,3655.0,84
CDM,59000OH,AMNIOCENTESIS DIAGNOSIC,520.0,338.0,1.1,2344.73,148
CDM,59001OH,AMNIOCENTESIS THER AMNIOTIC FLUID RDCTJ US GUID,1200.0,780.0,1.1,1200.0,144
CDM,59012OH,CORDOCENTESIS(INTRAUTERINE),1376.0,894.4,1.1,1376.0,144
CDM,59015OH,CHORIONIC VILLUS SAMPLING,880.0,572.0,1.1,2344.73,148
CDM,59020OH,FETAL CONTRACTION STRESS TEST,264.0,171.6,1.1,264.0,126
CDM,59025OH,FETAL NON-STRESS TEST,1038.0,674.7,1.1,1038.0,144
CDM,59025OH-26,FETAL NON-STRESS TEST,233.0,151.45,1.1,233.0,126
CDM,59025OH-TC,FETAL NON-STRESS TEST,805.0,523.25,1.1,805.0,126
CDM,59030OH,FETAL SCALP BLOOD SAMPLING,796.0,517.4,1.1,936.67,144
CDM,59070OH,TRANSABDOMINAL AMNIOINFUSION W/ULTRSND GUIDANCE,2096.0,1362.4,1.1,2096.0,146
CDM,59072OH,FETAL UMBILICAL CORD OCCLUSION W/ULTRSND GUIDNCE,3596.0,2337.4,1.1,3596.0,142
CDM,59074OH,FETAL FLUID DRAINAGE W/ULTRASOUND GUIDANCE,2096.0,1362.4,1.1,2096.0,148
CDM,59076OH,FETAL SHUNT PLACEMENT W/ULTRASOUND GUIDANCE,3596.0,2337.4,1.1,3596.0,144
CDM,59100OH,HYSTEROTOMY ABDOMINAL,5348.0,3476.2,1.1,14506.08,144
CDM,59120OH,TX ECTOPIC PREGNANCY ABDOMINAL/VAGINAL APPR,5068.0,3294.2,1.1,5068.0,144
CDM,59121OH,TX ECTOPIC PREGNANCY W/O SALPING&/OOPHORECTOMY,5096.0,3312.4,1.1,5096.0,144
CDM,59130OH,TX ECTOPIC PREGNANCY ABDL PREGNANCY,6032.0,3920.8,1.1,6032.0,144
CDM,59136OH,TX ECTOPIC PREGNANCY NTRSTL PRTL RESCJ UTER,5700.0,3705.0,1.1,5700.0,144
CDM,59140OH,TX ECTOPIC PREGNANCY CERVICAL W/EVACUATION,2376.0,1544.4,1.1,2376.0,144
CDM,59150OH,LAPS TX ECTOPIC PREG W/O SALPING&/OOPHORECTOMY,4916.0,3195.4,1.1,16829.38,144
CDM,59151OH,LAPS TX ECTOPIC PREG W/SALPING&/OOPHORECTOMY,4844.0,3148.6,1.1,16829.38,144
CDM,59160OH,CURETTAGE POSTPARTUM,1104.0,717.6,1.1,9118.72,148
CDM,59200OH,INSERTION CERVICAL DILATOR SEPARATE PROCEDURE,528.0,343.2,1.1,936.67,148
CDM,59300OH,EPISIOTOMY/VAG RPR OTH/THN ATTENDING,964.0,626.6,1.1,9118.72,148
CDM,59320OH,CERCLAGE CERVIX PREGNANCY VAGINAL,992.0,644.8,1.1,9118.72,144
CDM,59325OH,CERCLAGE CERVIX PREGNANCY ABDOMINAL,1624.0,1055.6,1.1,1624.0,144
CDM,59350OH,HYSTERORRHAPHY RUPTURED UTERUS,1976.0,1284.4,1.1,1976.0,144
CDM,59400OH,OB CARE ANTEPARTUM VAG DLVR & POSTPARTUM,14800.0,9620.0,1.1,14800.0,142
CDM,59409OH,VAGINAL DELIVERY ONLY,6323.0,4109.95,1.1,9118.72,144
CDM,59410OH,VAGINAL DELIVERY ONLY W/POSTPARTUM CARE,8254.0,5365.1,1.1,8254.0,144
CDM,59412OH,EXTERNAL CEPHALIC VERSION W/WO TOCOLYSIS,684.0,444.6,1.1,9118.72,144
CDM,59414OH,DELIVER PLACENTA,644.0,418.6,1.1,9118.72,144
CDM,59425OH,ANTEPARTUM CARE 4-6 VISIT MIDWIFE,3120.0,2028.0,1.1,3120.0,146
CDM,59426OH,ANTEPARTUM CARE ONLY 7 OR > VISITS.,5720.0,3718.0,1.1,5720.0,146
CDM,59430OH,POSTPARTUM CARE ONLY SEPARATE PROCEDURE,1288.0,837.2,1.1,1288.0,148
CDM,59510OH,OB ANTEPARTUM CARE CESAREAN DLVR & POSTPARTUM,16420.0,10673.0,1.1,16420.0,130
CDM,59514OH,CESAREAN DELIVERY ONLY,7097.0,4613.05,1.1,7097.0,144
CDM,59515OH,CESAREAN DELIVERY+POSTPARTUM CARE,10028.0,6518.2,1.1,10028.0,144
CDM,59525OH,STOT/TOT HYSTERECTOMY AFTER CESAREAN DELIVERY,3412.0,2217.8,1.1,3412.0,144
CDM,59610OH,ROUTINE OB CARE VAG DLVRY & POSTPARTUM CARE VB,15484.0,10064.6,1.1,15484.0,130
CDM,59612OH,VAGINAL DELIVERY AFTER CESAREAN DELIVERY,6436.0,4183.4,1.1,9118.72,144
CDM,59614OH,VAGINAL DELIVERY & POSTPARTUM CARE VBAC,8192.0,5324.8,1.1,8192.0,144
CDM,59618OH,ROUTINE OBSTETRICAL CARE ATTEMPTED VBAC,16628.0,10808.2,1.1,16628.0,130
CDM,59620OH,CESAREAN DELIVERY ATTEMPTED VBAC,6664.0,4331.6,1.1,6664.0,142
CDM,59622OH,CESAREAN DLVRY & POSTPARTUM CARE ATTEMPTED VBA,9328.0,6063.2,1.1,9328.0,144
CDM,59812OH,TX INCOMPLETE ABORTION ANY TRIMESTER SURGICAL,1776.0,1154.4,1.1,9118.72,148
CDM,59820OH,TX MISSED ABORTION FIRST TRIMESTER SURGICAL,1936.0,1258.4,1.1,9118.72,148
CDM,59821OH,TX MISSED ABORTION SECOND TRIMESTER SURGICAL,2036.0,1323.4,1.1,9118.72,148
CDM,59830OH,TX SEPTIC ABORTION SURGICAL,2636.0,1713.4,1.1,2636.0,144
CDM,59840OH,INDUCED ABORTION DILATION AND CURETTAGE,1204.0,782.6,1.1,9118.72,148
CDM,59841OH,INDUCED ABORTION DILATION & EVACUATION,2260.0,1469.0,1.1,9118.72,148
CDM,59850OH,INDUCED ABORTION 1/> AMNIOTIC INJX W/D&C/EVACJ,2360.0,1534.0,1.1,2360.0,144
CDM,59851OH,INDUCE ABORT 1/> AMNIOT NJXS DLVR FETUS D&C,2368.0,1539.2,1.1,2368.0,144
CDM,59852OH,INDUCE ABORT 1/> AMNIOT NJXS DLVR FETUS HYSTOTM,3292.0,2139.8,1.1,3292.0,144
CDM,59855OH,INDUCED ABORT 1/> VAG SUPPOSITORIES DLVR FETUS,2572.0,1671.8,1.1,2572.0,144
CDM,59856OH,INDUCED ABORT 1/> VAG SUPP DLVR FETUS D&C &/EVAC,3116.0,2025.4,1.1,3116.0,144
CDM,59857OH,INDUCED ABORT 1/> VAG SUPPOS DLVR FETUS HYSTOT,3732.0,2425.8,1.1,3732.0,144
CDM,59866OH,MULTIFETAL PREGNANCY REDUCTION(S),1596.0,1037.4,1.1,1596.0,132
CDM,59870OH,UTERINE EVACUATION & CURETTAGE HYDATIDIFORM MOLE,2628.0,1708.2,1.1,9118.72,144
CDM,59871OH,REMOVAL CERCLAGE SUTURE UNDER ANESTHESIA,852.0,553.8,1.1,9118.72,144
CDM,59897OH,UNLISTED FETAL INVASIVE PX W/ULTRASOUND,1154.0,750.1,0.01,1154.0,82
CDM,59897RVU1OH,UNLISTED U/S GUIDED FETAL INJECTION (COMP CODE 59850),2142.0,1392.3,0.01,2142.0,82
CDM,59897RVU2OH,UNLISTED HYSTEROSCOPIC RESECTION OF CESAREAN ECTOPIC PREGNANCY (,2052.0,1333.8,0.01,2052.0,82
CDM,59897RVUOH,"OPEN FETAL SURGERY, INCL. HYSTEROTOMY, AMNIO INFUS. US & INTENS.",18150.0,11797.5,0.01,18150.0,82
CDM,59898RVU1OH,UNLISTED LAPAROSCOPIC EXCISION OF CESAREAN SCAR DEFECT ECTOPIC P,6686.0,4345.9,0.01,16829.38,82
CDM,59899RVU1OH,UNLISTED INSERT BAKRI BALLOON POSTPARTUM,1160.0,754.0,0.01,1160.0,84
CDM,59899RVU2OH,"UNLISTED PROCEDURE, MATERNITY CARE AND DELIVERY (COMPARISON CODE",220.0,143.0,0.01,581.59,84
CDM,59899RVU4OH,JADA PROCEDURE (COMP CODE43460),1629.0,1058.85,0.01,1629.0,84
CDM,59899RVUOH,UNLISTED MANUAL UTERINE INVERSION,1630.0,1059.5,0.01,1630.0,84
CDM,60000OH,I&D THYROGLOSSAL DUCT CYST,724.0,470.6,1.1,4447.63,148
CDM,60100OH,BIOPSY THYROID PERCUTANEOUS CORE NEEDLE,624.0,405.6,1.1,2050.87,148
CDM,60200OH,EXC CYST/ADENOMA THYROID/TRANSECTION ISTHMUS,4008.0,2605.2,1.1,16829.38,144
CDM,60210OH,PRTL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY,4492.0,2919.8,1.1,16829.38,144
CDM,60212OH,PRTL THYROID LOBEC UNI W/CONTRATLAT STOT LOBEC,6572.0,4271.8,1.1,16829.38,144
CDM,60220OH,TOTAL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY,4924.0,3200.6,1.1,16829.38,144
CDM,60225OH,TOTAL THYROID LOBEC UNI W/CONTRALAT STOT LOBEC,6508.0,4230.2,1.1,16829.38,144
CDM,60240OH,THYROIDECTOMY TOTAL/COMPLETE,6618.0,4301.7,1.1,16829.38,144
CDM,60252OH,THYROIDECTOMY TOTAL/SUBTOTAL LMTD NECK DISSECT,8804.0,5722.6,1.1,17080.38,144
CDM,60254OH,THYROIDECTOMY TOTAL/SUBTOTAL RAD NECK DISSECT,11368.0,7389.2,1.1,11368.0,144
CDM,60260OH,THYROIDECTOMY RMVL REMAINING TISS FLWG PRTL RMVL,7304.0,4747.6,1.1,17080.38,144
CDM,60270OH,THYROIDECT W/SUBSTERNAL SPLIT/TRANSTHORACIC,9280.0,6032.0,1.1,9280.0,144
CDM,60271OH,THYROIDECTOMY SUBSTERNAL CERVICAL APPROACH,7048.0,4581.2,1.1,17080.38,144
CDM,60280OH,EXCISION THYROGLOSSAL DUCT CYST/SINUS,2464.0,1601.6,1.1,16829.38,144
CDM,60281OH,EXCISION THYROGLOSSAL DUCT CYST/SINUS RECURRENT,3528.0,2293.2,1.1,16829.38,144
CDM,60300OH,ASPIRATION AND/OR INJECTION THYROID CYST,388.0,252.2,1.1,2050.87,148
CDM,60500OH,PARATHYROIDECTOMY/EXPLORATION PARATHYROIDS,6864.0,4461.6,1.1,17080.38,144
CDM,60502OH,PARATHYROIDECTOMY/EXPLOR PARATHYROIDS RE-EXPLOR,8460.0,5499.0,1.1,17080.38,144
CDM,60505OH,PARATHYRDEC/EXPL PARATHYR MEDSTNL STERNAL/TTHRC,9224.0,5995.6,1.1,9224.0,144
CDM,60512OH,PARATHYROID AUTOTRANSPLANTATION ADD-ON,1776.0,1154.4,1.1,1776.0,144
CDM,60520OH,THYMECTOMY PRTL/TOT TRANSCERVICAL APPR SPX,6864.0,4461.6,1.1,17080.38,144
CDM,60521OH,THYMECTOMY PRTL/TOT W/O RAD MEDSTNL DSJ SPX,7672.0,4986.8,1.1,7672.0,144
CDM,60522OH,THYMECTOMY PRTL/TOT RAD MEDSTNL DSJ SPX,9392.0,6104.8,1.1,9392.0,144
CDM,60540OH,ADRENALECTOMY W/EXPL W/WO BX ABDL/LMBR/DRSAL SPX,7929.0,5153.85,1.1,7929.0,144
CDM,60545OH,ADRENALECTOMY EXPL W/EXC RETROPERTINEAL TUMOR,8372.0,5441.8,1.1,8372.0,144
CDM,60600OH,EXC CAROTID BODY TUMOR W/O EXC CAROTID ARTERY,10036.0,6523.4,1.1,10036.0,144
CDM,60605OH,EXC CAROTID BODY TUMOR W EXC CAROTID ARTERY,12784.0,8309.6,1.1,12784.0,144
CDM,60650OH,LAPAROSCOPY ADRENALECTOMY PARTIAL OR COM,8292.0,5389.8,1.1,8292.0,144
CDM,60659OH,"UNLISTED LAPAROSCOPY PROCEDURE, END",6915.0,4494.75,0.01,16829.38,84
CDM,60660OH,ABLTJ 1/+THYROID NODULE 1 LOBE/ISTHMUS PERQ RF,2530.0,1644.5,1.1,8177.87,144
CDM,60661OH,ABLTJ 1/+THYR NDUL ADDL LOBE PERQ RADIOFREQUENCY,1870.0,1215.5,1.1,1870.0,144
CDM,60699RVU1OH,OPEN INCISIONAL BX THYROID (COMP 60200),2174.0,1413.1,0.01,16829.38,84
CDM,60699RVU2OH,OPEN THYROID LOBE BIOPSIES,3479.0,2261.35,0.01,16829.38,84
CDM,60699RVU3OH,CRYOPRESERVATION OF PARATHYROID GLANDS (COMP 60200),3307.0,2149.55,0.01,16829.38,84
CDM,60699RVU6OH,THYR RF ABAL W/US (COMP 47382),5013.0,3258.45,0.01,16829.38,84
CDM,60699RVU7OH,IMAGE GUIDED - CRYOABLATION OF ADRENAL GLAND (COMP CODE 50593),3197.0,2078.05,0.01,16829.38,84
CDM,60699RVU8OH,MICROWAVE ABLATION ADRENAL GLAND (COMP CODE 50592),2620.0,1703.0,0.01,16829.38,84
CDM,60699RVU9OH,RADIOFREQUENCY ABLATION PARATHYROID ADENOMA (COMP CODE 20982),2808.0,1825.2,0.01,16829.38,84
CDM,60699RVUOH,AUTOTRANS OF CRYO TISSUE (COMP CODE 60512),1599.0,1039.35,0.01,16829.38,84
CDM,61000010,MRI PELVIS W/O CONTRAST MATERIAL,1668.0,1084.2,212.58,1668.0,87
CDM,61000020,MRI PELVIS W/CONTRAST MATERIAL,2464.0,1601.6,330.06,2464.0,87
CDM,61000030,CARDIAC MRI W/W/O CONTRAST W/STRESS,5451.0,3543.15,386.08,5451.0,87
CDM,61000040,MRI SPECTROSCOPY,608.0,395.2,78.83,608.0,85
CDM,61000045,MRI PRE- OP MAPPING W/WO CONTR,608.0,395.2,78.83,608.0,85
CDM,61000050,MRI GUIDANCE NEEDLE PLACEMENT RS&I,2053.0,1334.45,52.12,90038.45,68
CDM,61000145,FETAL MRI W/PLACNTL MATRNL PLVC IMG SING/1ST GES,1668.0,1084.2,212.58,1668.0,87
CDM,61000155,FETAL MRI W/PLACNTL MATRNL PLVC IMG EA ADDL GES,1815.0,1179.75,255.48,87340.37,68
CDM,61000165,MRI SPECTROSCOPY,608.0,395.2,78.83,608.0,85
CDM,61000185,MRI BREAST BIL W/ CONTR,5984.0,3889.6,386.08,90071.18,68
CDM,61000365,MRI PROSTATE LIMITED WO IVCON,280.0,182.0,77.84,409.57,85
CDM,61000375,MRI BREAST WITHOUT CONTRAST MATERIAL UNILATERAL,1668.0,1084.2,212.58,90067.68,86
CDM,61000385,MRI BREAST WITHOUT CONTRAST MATERIAL BILATERAL,1668.0,1084.2,212.58,90068.85,86
CDM,61000395,MRI BREAST W/OUT&WITH CONTRAST W/CAD UNILATERAL,4970.0,3230.5,386.08,90070.02,68
CDM,61000405,MRI BREAST BILAT WO/W CONTR,5984.0,3889.6,386.08,90071.18,68
CDM,61000415,MAGNETIC RESONANCE ELASTOGRAPHY,1668.0,1084.2,212.58,89301.98,87
CDM,61000425,MRI BREAST WITHOUT CONTRAST MATERIAL BILATERAL,1668.0,1084.2,212.58,90068.85,86
CDM,61000435,MRI BREAST W/OUT&WITH CONTRAST W/CAD UNILATERAL,4970.0,3230.5,386.08,90070.02,68
CDM,61000445,MRI BREAST WITHOUT&WITH CONTRAST W/CAD BILATERAL,5984.0,3889.6,386.08,90071.18,68
CDM,61000455,MRI CERVICAL LOCALIZATION W IVCON,2651.0,1723.15,78.83,2651.0,85
CDM,61000465,MRI THORACIC LOCALIZATION W IVCON,2651.0,1723.15,78.83,2651.0,85
CDM,61000475,MRI LUMBAR LOCALIZATION W IVCON,280.0,182.0,77.84,409.57,85
CDM,61000485,MRI WHOLE BODY,2530.0,1644.5,551.54,2530.0,58
CDM,61000495,WHOLE BODY MRI,10064.0,6541.6,78.83,10064.0,85
CDM,61000505,QUAN MR ALYS TISS COMPOSITION W/MRI,3802.0,2471.3,255.48,3802.0,85
CDM,61000515,MRI GAMMA KNIFE LOCAL W CONT,2455.0,1595.75,78.83,2455.0,85
CDM,61000665,MRI BREAST LIMITED,225.0,146.25,62.55,409.57,85
CDM,61000675,MRI 3D CAD,1231.0,800.15,78.83,1231.0,85
CDM,61000695,MRI BRAIN LOCALIZATION W IVCON,2651.0,1723.15,78.83,2651.0,85
CDM,61000705,MRI PRE-OP MAPPING W/O CONTRAST,608.0,395.2,78.83,608.0,85
CDM,61000715,MRI PRE-OP MAPPING W/CONTRAST,608.0,395.2,78.83,608.0,85
CDM,61000725,MRI BRAIN W/WO CONTAST PC,2464.0,1601.6,78.83,2464.0,85
CDM,61000735,MMR BRAIN WITH PC,2464.0,1601.6,78.83,2464.0,85
CDM,61000745,MRI BRAIN LOCALIZATION WWO CONT,1929.0,1253.85,78.83,1929.0,85
CDM,61000755,MRI BREAST 3D RENDERING W/INTERP&POSTPROC DIFF WORK STATION,1330.0,864.5,86.82,1330.0,66
CDM,61000OH,SUBDURAL TAP FONTANELLE/SUTUR INFANT UNI/BI INIT,632.0,410.8,1.1,2017.2,144
CDM,61020OH,VENTRICULAR PUNCTURE PREVIOUS BURR HOLE W/O NJX,604.0,392.6,1.1,2656.95,144
CDM,61026OH,VENTRICULAR PUNCTURE PREVIOUS BURR HOLE W/INJ,676.0,439.4,1.1,2017.2,144
CDM,61050OH,CISTERNAL/LATERAL C1-C2 PUNCTURE W/O INJ SPX,604.0,392.6,1.1,863.2,144
CDM,61055OH,CISTERNAL/LATERAL C1-C2 PUNCTURE W/INJECTION,840.0,546.0,1.1,863.2,144
CDM,61070OH,PUNCTURE SHUNT TUBE/RESERVOIR ASPIRATION/INJ PX,392.0,254.8,1.1,2017.2,144
CDM,61100000,MRI BRAIN OPEN INTRACRANIAL PX W/O CONTRAST MATL,3783.0,2458.95,255.48,3783.0,85
CDM,61100005,MRI BRAIN OPEN INTRACRANIAL PX W/CONTRAST MATL,1228.0,798.2,159.4,1228.0,85
CDM,61100010,MRI ORBIT FACE &/NECK W/O CONTRAST,1668.0,1084.2,212.58,1668.0,87
CDM,61100015,MRI BRAIN OPEN INTRACRANIAL PX W/O & W/CONTRAST,1228.0,798.2,159.4,1228.0,85
CDM,61100020,MRI ORBIT FACE & NECK W/CONTRAST MATERIAL,2464.0,1601.6,330.06,2464.0,87
CDM,61100025,MRI BRAIN FUNCTIONAL W/O PHYSICIAN ADMNISTRATION,1668.0,1084.2,212.58,1668.0,87
CDM,61100030,MRI ORBIT FACE & NECK W/O & W/CONTRAST MATRL,2464.0,1601.6,330.06,2464.0,87
CDM,61100040,MRI BRAIN BRAIN STEM W/O CONTRAST MATERIAL,1668.0,1084.2,212.58,1668.0,87
CDM,61100050,MRI BRAIN BRAIN STEM W/CONTRAST MATERIAL,2464.0,1601.6,330.06,2464.0,87
CDM,61100060,MRI BRAIN BRAIN STEM W/O W/CONTRAST MATERIAL,2464.0,1601.6,330.06,2464.0,87
CDM,61100080,MRI BRAIN FUNCTIONAL W/PHYSICIAN ADMNISTRATION,1668.0,1084.2,212.58,1668.0,85
CDM,61100090,MRI BRAIN LOCALIZATION WO CONT,1699.0,1104.35,78.83,1699.0,85
CDM,61105OH,TWIST DRILL HOLE SUBDURAL/VENTRICULAR PUNCTURE,2180.0,1417.0,1.1,2180.0,144
CDM,61107OH,TWIST DRILL HOLE IMPLT VENTRICULAR CATH/DEVICE,1996.0,1297.4,1.1,1996.0,144
CDM,61108OH,TWIST DRILL HOLE EVAC&/DRG SUBDURAL HEMATOMA,4656.0,3026.4,1.1,4656.0,144
CDM,61140OH,BURR HOLE/TREPHINE W/BX BRAIN/INTRACRNIAL LESION,6892.0,4479.8,1.1,6892.0,144
CDM,61150OH,BURR HOLE/TREPHINE W/DRG BRAIN ABSCESS/CYST,7560.0,4914.0,1.1,7560.0,144
CDM,61151OH,BURR HOLE/TREPHINE W/SBSQ TAPPING ICRA ABSC/CST,5396.0,3507.4,1.1,5396.0,144
CDM,61154OH,BURR HOLE W/EVAC&/DRG HEMATOMA XDRL/SDRL,6828.0,4438.2,1.1,6828.0,144
CDM,61156OH,BURR HOLE W/ASPIR HEMATOMA/CYST INTRACEREBRAL,6980.0,4537.0,1.1,6980.0,144
CDM,61200010,MRI SPINAL CANAL CERVICAL W/O CONTRAST MATRL,1668.0,1084.2,212.58,1668.0,87
CDM,61200020,MRI SPINAL CANAL CERVICAL W/CONTRAST MATRL,2464.0,1601.6,330.06,2464.0,87
CDM,61200030,MRI SPINAL CANAL THORACIC W/O CONTRAST MATRL,1668.0,1084.2,212.58,1668.0,87
CDM,61200040,MRI SPINAL CANAL THORACIC W/CONTRAST MATRL,2464.0,1601.6,330.06,2464.0,87
CDM,61200050,MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL,1668.0,1084.2,212.58,1668.0,87
CDM,61200060,MRI SPINAL CANAL LUMBAR W/CONTRAST MATERIAL,2464.0,1601.6,330.06,2464.0,87
CDM,61200070,MRI SPINAL CANAL CERVICAL W/O & W/CONTR MATRL,2464.0,1601.6,330.06,2464.0,87
CDM,61200080,MRI SPINAL CANAL THORACIC W/O & W/CONTR MATRL,2464.0,1601.6,330.06,2464.0,87
CDM,61200090,MRI SPINAL CANAL LUMBAR W/O & W/CONTR MATRL,2464.0,1601.6,330.06,2464.0,87
CDM,61210OH,BURR HOLE IMPLANT VENTRICULAR CATH/OTHER DEVICE,2332.0,1515.8,1.1,2332.0,144
CDM,61215OH,INSJ SUBQ RSVR PUMP/INFUSION SYSTEM VENTRIC CATH,2340.0,1521.0,1.1,19428.17,144
CDM,61250OH,BURR HOLE/TREPHINE SUPRATENTORIAL W/O OTH SURG,4596.0,2987.4,1.1,4596.0,144
CDM,61253OH,BURR HOLE/TREPHINE INFRATENTORIAL UNI/BI,5396.0,3507.4,1.1,5396.0,144
CDM,61304OH,CRANIECTOMY/CRANIOTOMY EXPL SUPRATENTORIAL,9364.0,6086.6,1.1,9364.0,144
CDM,61305OH,CRANIECTOMY/CRANIOTOMY EXPL INFRATENTORIAL,12602.0,8191.3,1.1,12602.0,144
CDM,61312OH,CRANIECTOMY HMTMA SUPRATENTORIAL EXTRA/SUBDURAL,12068.0,7844.2,1.1,12068.0,144
CDM,61313OH,CRANIECTOMY HMTMA SUPRATENTORIAL INTRACEREBRAL,11236.0,7303.4,1.1,11236.0,144
CDM,61314OH,CRANIECTOMY HMTMA INFRATENTORIAL EXTRA/SUBDURAL,10360.0,6734.0,1.1,10360.0,144
CDM,61315OH,CRANIECTOMY HMTMA SUPRATENTORIAL INTRACEREBRAL,11860.0,7709.0,1.1,11860.0,144
CDM,61316OH,INCISION & SUBCUTANEOUS PLMT CRANIAL BONE GRAF,556.0,361.4,1.1,556.0,144
CDM,61320OH,CRANIECTOMY/CRANIOTMY DRG ABSCESS SUPRATENTORIAL,10968.0,7129.2,1.1,10968.0,144
CDM,61321OH,CRANIECTOMY/CRANIOTMY DRG ABSCESS INFRATENTORIAL,12212.0,7937.8,1.1,12212.0,144
CDM,61322OH,CRANIECT/CRANIOT W/WO DURAPLASTY W/O LOBECTOMY,13704.0,8907.6,1.1,13704.0,144
CDM,61323OH,CRANIECT/CRANIOT W/WO DURAPLASTY W/LOBECTOMY,14024.0,9115.6,1.1,14024.0,144
CDM,61330OH,DECOMPRESSION ORBIT ONLY TRANSCRANIAL APPROACH,10120.0,6578.0,1.1,10120.0,144
CDM,61333OH,EXPL ORBIT TRANSCRANIAL APPROACH W/RMVL LESION,11708.0,7610.2,1.1,11708.0,144
CDM,61340OH,SUBTEMPORAL CRANIAL DECOMPRESSION,8044.0,5228.6,1.1,8044.0,144
CDM,61343OH,CRNEC SUBOCCIPITAL CRV LAM DCMPRN MEDULLA & CORD,12744.0,8283.6,1.1,12744.0,144
CDM,61345OH,OTHER CRANIAL DECOMPRESSION POSTERIOR FOSSA,11692.0,7599.8,1.1,11692.0,144
CDM,61400000,MRI PELVIS W/O CONTRAST MATERIAL,1668.0,1084.2,212.58,1668.0,87
CDM,61400005,MRI PELVIS W/CONTRAST MATERIAL,2464.0,1601.6,330.06,2464.0,87
CDM,61400010,MRI TEMPOROMANDIBULAR JOINT,1668.0,1084.2,212.58,1668.0,87
CDM,61400015,3D RENDERING W/INTERP & POSTPROCESS SUPERVISION,566.0,367.9,32.47,566.0,68
CDM,61400020,MRI CHEST W/O CONTRAST MATERIAL,1668.0,1084.2,212.58,1668.0,87
CDM,61400025,3D RENDERING W/INTERP&POSTPROC DIFF WORK STATION,1436.0,933.4,86.82,1436.0,68
CDM,61400030,MRI CHEST W/CONTRAST MATERIAL,5451.0,3543.15,386.08,5451.0,87
CDM,61400040,MRI CHEST W/O & W/CONTRAST MATERIAL,2464.0,1601.6,330.06,2464.0,87
CDM,61400050,MRI PELVIS W/O & W/CONTRAST MATERIAL,2464.0,1601.6,330.06,2464.0,87
CDM,61400055,"MRI BREAST, BILAT W/WO CONTR",1071.0,696.15,297.74,1071.0,84
CDM,61400060,MRI UPPER EXTREMITY OTH THAN JT W/O CONTR MATRL,1668.0,1084.2,212.58,1668.0,87
CDM,61400070,MRI UPPER EXTREMITY OTH THAN JT W/CONTR MATRL,2464.0,1601.6,330.06,2464.0,87
CDM,61400080,MRI UPPER EXTREM OTHER THAN JT W/O & W/CONTRAS,2464.0,1601.6,330.06,2464.0,87
CDM,61400090,MRI ANY JT UPPER EXTREMITY W/O CONTRAST MATRL,1668.0,1084.2,212.58,1668.0,87
CDM,61400100,MRI ANY JT UPPER EXTREMITY W/CONTRAST MATRL,5451.0,3543.15,386.08,5451.0,87
CDM,61400110,MRI ANY JT UPPER EXTREMITY W/O & W/CONTR MATRL,2464.0,1601.6,330.06,2464.0,87
CDM,61400120,MRI LOWER EXTREM OTH/THN JT W/O CONTR MATRL,1668.0,1084.2,212.58,1668.0,87
CDM,61400130,MRI LOWER EXTREM OTH/THN JT W/CONTRAST MATRL,2464.0,1601.6,330.06,2464.0,87
CDM,61400140,MRI LOWER EXTREM OTH/THN JT W/O & W/CONTR MATR,2464.0,1601.6,330.06,2464.0,87
CDM,61400150,MRI ANY JT LOWER EXTREM W/O CONTRAST MATRL,1668.0,1084.2,212.58,1668.0,87
CDM,61400160,MRI ANY JT LOWER EXTREM W/CONTRAST MATERIAL,5451.0,3543.15,386.08,5451.0,87
CDM,61400170,MRI ANY JT LOWER EXTREM W/O & W/CONTRAST MATRL,2464.0,1601.6,330.06,2464.0,87
CDM,61400180,MRI ABDOMEN W/O CONTRAST MATERIAL,1668.0,1084.2,212.58,1668.0,87
CDM,61400190,MRI ABDOMEN W/CONTRAST MATERIAL,2464.0,1601.6,330.06,86719.64,87
CDM,61400200,MRI ABDOMEN W/O & W/CONTRAST MATERIAL,2464.0,1601.6,330.06,86720.8,87
CDM,61400210,CARDIAC MRI MORPHOLOGY & FUNCTION W/O CONTRAST,1668.0,1084.2,212.58,1668.0,87
CDM,61400220,CARDIAC MRI W/O CONTRAST W/STRESS IMAGING,3783.0,2458.95,255.48,3783.0,87
CDM,61400230,CARDIAC MRI W/WO CONTRAST & FURTHER SEQ,2464.0,1601.6,330.06,2464.0,87
CDM,61400240,CARDIAC MRI FOR VELOCITY FLOW MAPPING,566.0,367.9,62.54,88336.37,68
CDM,61400250,3D RENDERING W/INTERP&POSTPROC DIFF WORK STATION,1436.0,933.4,86.82,1436.0,68
CDM,61400365,MAGNETIC RESONANCE ELASTOGRAPHY,1668.0,1084.2,212.58,89301.98,87
CDM,61400375,QMRCP W/DX MRI SAME ANATOMY,3802.0,2471.3,255.48,3802.0,85
CDM,61400385,QUANTITATIVE MRI ANALYSIS OF THE BRAIN,967.0,628.55,212.58,967.0,84
CDM,61400395,MR SAFETY IMPLT ELECTRONICS PREPJ SUPVJ PHYS/QHP,633.0,411.45,85.09,633.0,84
CDM,61400405,MR SAFETY IMPLANT POS&/IMMOBLJ SUPVJ PHYS/QHP,410.0,266.5,55.07,410.0,84
CDM,61400415,MR SAFETY IMPLANT&/FB ASSMT CLIN STAF 1ST 15 MIN,169.0,109.85,15.59,169.0,84
CDM,61400425,MR SAFETY IMPLANT&/FB ASSMT CLIN STAFF EA ADD 30,343.0,222.95,74.77,343.0,67
CDM,61400435,MR SAFETY DETERMINATION PHYSICIAN/OTHER QHP,608.0,395.2,81.63,608.0,84
CDM,61400445,MR SAFETY MED PHYSICS XM CUSTOMIZATION PLNG&MNTR,1668.0,1084.2,86.82,1668.0,84
CDM,61450OH,CRNEC STPL SCTJ COMPRESSION/DCMPRN GANGLION,11076.0,7199.4,1.1,11076.0,144
CDM,61458OH,CRNEC SOPL EXPL/DCMPRN CRNL NRV,11536.0,7498.4,1.1,11536.0,144
CDM,61460OH,CRANIECTOMY SUBOCCIPITAL SECTION 1/> CRANIAL NR,12096.0,7862.4,1.1,12096.0,144
CDM,61500010,MRA HEAD W/O CONTRST MATERIAL,1668.0,1084.2,212.58,1668.0,87
CDM,61500020,MRA HEAD W/CONTRAST MATERIAL,2464.0,1601.6,310.55,2464.0,87
CDM,61500030,MRA HEAD W/O & W/CONTRAST MATERIAL,2464.0,1601.6,310.77,2464.0,87
CDM,61500040,MRA NECK W/O CONTRST MATERIAL,1668.0,1084.2,212.58,1668.0,87
CDM,61500050,MRA NECK W/CONTRAST MATERIAL,2464.0,1601.6,310.77,2464.0,87
CDM,61500060,MRA NECK W/O &W/CONTRAST MATERIAL,2464.0,1601.6,310.77,2464.0,87
CDM,61500OH,CRANIECTOMY W/EXCISION TUMOR/LESION SKULL,7672.0,4986.8,1.1,7672.0,144
CDM,61501OH,CRANIECTOMY OSTEOMYELITIS,6540.0,4251.0,1.1,6540.0,144
CDM,61510OH,CRANIEC TREPHINE BONE FLP BRAIN TUMOR SUPRTENTOR,13565.0,8817.25,1.1,13565.0,144
CDM,61512OH,CRNEC TREPHINE BONE FLAP MENINGIOMA SUPRATENTOR,14856.0,9656.4,1.1,14856.0,144
CDM,61514OH,CRNEC TREPHINE BONE FLAP BRAIN ABSC SUPRATENTOR,10892.0,7079.8,1.1,10892.0,144
CDM,61516OH,CRNEC TREPHINE BONE FLAP FENEST CYST SUPRATENTOR,10632.0,6910.8,1.1,10632.0,144
CDM,61517OH,IMPLTJ BRAIN INTRACAVITARY CHEMOTHERAPY AGENT,552.0,358.8,1.1,552.0,144
CDM,61518OH,CRNEC EXC BRAIN TUMOR INFRATENTORIAL/POST FOSSA,15956.0,10371.4,1.1,15956.0,144
CDM,61519OH,CRNEC EXC TUM INFRATENTOR/POST FOSSA MENINGIOMA,17372.0,11291.8,1.1,17372.0,144
CDM,61520OH,CRNEC TUM INFRATTL/POSTFOSSA CRBLOPNT ANGLE TUM,22836.0,14843.4,1.1,22836.0,144
CDM,61521OH,CRNEC TUM INFRATTL/PFOSSA MIDLINE TUM BASE SKULL,18796.0,12217.4,1.1,18796.0,144
CDM,61522OH,CRNEC INFRATNTORIAL/POST FOSSA EXC BRAIN ABSCESS,12616.0,8200.4,1.1,12616.0,144
CDM,61524OH,CRNEC INFRATNTOR/POSTFOSSA EXC/FENESTRATION CYST,13152.0,8548.8,1.1,13152.0,144
CDM,61526OH,CRNEC TRANSTEMPOR EXC CEREBELLOPONTINE ANGLE TUM,23795.0,15466.75,1.1,23795.0,144
CDM,61530OH,CRNEC EXC CEREBELLOPNTIN ANGLE TUM MID/POSTFOSSA,20046.0,13029.9,1.1,20046.0,144
CDM,61531OH,SUBDURAL IMPLTJ ELECTRODES SEIZURE MONITORING,6564.0,4266.6,1.1,6564.0,144
CDM,61533OH,CRANIOT SUBDURAL IMPLT ELCTRD SEIZURE MONITORING,8584.0,5579.6,1.1,8584.0,144
CDM,61534OH,CRANIOT EPILEPTOGENIC FOC W/O ELECTRCORTICOGRPHY,9204.0,5982.6,1.1,9204.0,144
CDM,61535OH,CRANIOT RMVL EPID/SUBDURL ELCTRD W/O EXC TIS SPX,5260.0,3419.0,1.1,5260.0,144
CDM,61536OH,CRANIOT EPILEPTOGENIC FOCUS W/ELECTROCORTCOGRPHY,15088.0,9807.2,1.1,15088.0,144
CDM,61537OH,CRANIOT TEMPORAL LOBE W/O ELECTROCORTICOGRAPHY,16038.0,10424.7,1.1,16038.0,144
CDM,61538OH,CRANIOT LOBEC TEMPORAL LOBE W/ELECTROCORTCOGRPHY,15780.0,10257.0,1.1,15780.0,144
CDM,61539OH,CRANIOT LOBECTOMY OTH/THN TEMPORAL LOBE W/ECOG,13712.0,8912.8,1.1,13712.0,144
CDM,61540OH,CRANIOT LOBECTOMY OTH/THN TEMPORAL LOBE W/O ECOG,13829.0,8988.85,1.1,13829.0,144
CDM,61541OH,CRANIOTOMY TRANSECTION CORPUS CALLOSUM,13614.0,8849.1,1.1,13614.0,144
CDM,61543OH,CRANIOTOMY PARTIAL/SUBTOTAL HEMISPHERECTOMY,13776.0,8954.4,1.1,13776.0,144
CDM,61544OH,CRANIOTOMY EXCISION/COAGULATION CHOROID PLEXUS,10944.0,7113.6,1.1,10944.0,144
CDM,61545OH,CRANIOTOMY EXCISION CRANIOPHARYNGIOMA,18572.0,12071.8,1.1,18572.0,144
CDM,61546OH,CRANIOT HYPOPHYSEC/EXC PITUITARY TUMOR ICRL APPR,13376.0,8694.4,1.1,13376.0,144
CDM,61548OH,HYPOPHYSEC/EXC PITUITARY TUM TRANSNASAL/SEPTAL,9348.0,6076.2,1.1,9348.0,144
CDM,61550OH,CRANIECTOMY CRANIOSYNOSTOSIS 1 CRANIAL SUTURE,6236.0,4053.4,1.1,6236.0,144
CDM,61552OH,CRANIECT CRANIOSYNOSTOSIS MULT CRANIAL SUTURES,8160.0,5304.0,1.1,8160.0,144
CDM,61556OH,CRANIEC CRANIOSYNOSTOSIS FRONT/PARIET BONE FLAP,9636.0,6263.4,1.1,9636.0,144
CDM,61557OH,CRANIECTOMY CRANIOSYNOSTOSIS BIFRONTAL BONE FLAP,9324.0,6060.6,1.1,9324.0,144
CDM,61558OH,XTN CRANIECT MULTIPLE SUTURE CRANIOSYNOSTOSIS,10600.0,6890.0,1.1,10600.0,144
CDM,61559OH,XTN CRNEC MLT SUTR CRANIOSYNOSTOSIS W/BONE GRAFT,13608.0,8845.2,1.1,13608.0,144
CDM,61563OH,EXC BENIGN TUM CRANIAL BONE W/O OPTIC NRV DCMPRN,11376.0,7394.4,1.1,11376.0,144
CDM,61566OH,CRANIOTOMY SELECTIVE AMYGDALOHIPPOCAMPECTOMY,14278.0,9280.7,1.1,14278.0,144
CDM,61570OH,CRANIECTOMY/CRANIOTOMY EXC FOREIGN BODY BRAIN,10604.0,6892.6,1.1,10604.0,144
CDM,61571OH,CRANIECTOMY/CRANIOTOMY TX PENETRATNG WOUND BRAIN,11368.0,7389.2,1.1,11368.0,144
CDM,61575OH,TRNSRAL SKULL BSE/BR STEM/CORD BX/DCOMPR/EXC LES,14624.0,9505.6,1.1,14624.0,144
CDM,61580OH,CRANIOFACIAL ANT CRANIAL FOSSA W/O ORBITAL EXNTJ,13804.0,8972.6,1.1,13804.0,144
CDM,61581OH,CRANIOFACIAL ANT CRANIAL FOSSA W/ORBITAL EXNTJ,15652.0,10173.8,1.1,15652.0,144
CDM,61582OH,CRANFCL ANT CRANIAL FOSSA UNI/BI CRANIOT/OSTEOT,14056.0,9136.4,1.1,14056.0,144
CDM,61583OH,CRANFCL ANT CRANIAL FOSSA UNI/BIFRNTL ELEV LOBE,15400.0,10010.0,1.1,15400.0,144
CDM,61584OH,ORBITOCRANIAL ANT CRANIAL FOSSA W/O ORBIT EXNTJ,16588.0,10782.2,1.1,16588.0,144
CDM,61585OH,ORBITOCRANIAL ANT CRANIAL FOSSA W/ORBITAL EXNTJ,17028.0,11068.2,1.1,17028.0,144
CDM,61586OH,BICORONAL TRANSZYGMTC&/LEFORT I W/O BONE GRFT,10992.0,7144.8,1.1,10992.0,144
CDM,61590OH,INFRATEMPORAL MID CRANIAL FOSSA W/WO DISARTICLTN,20698.0,13453.7,1.1,20698.0,144
CDM,61591OH,INFRATEMPO MID CRANIAL FOSSA W/WO DCOMPR&/MOBI,20689.0,13447.85,1.1,20689.0,144
CDM,61592OH,ORBITOCRNL APPR MID CRANIAL FOSSA TEMPORAL LOBE,17232.0,11200.8,1.1,17232.0,144
CDM,61595OH,TRANSTEMP APPR POST CRAN FOSSA DCOMPR SINUS/NRV,13496.0,8772.4,1.1,13496.0,144
CDM,61596OH,TRANSCOCHLR POST CRNL FOSSA W/WO MOBIL NRV/ART,15772.0,10251.8,1.1,15772.0,144
CDM,61597OH,TRNSCONDLR POST CRNL FOSSA DCOMPR ART W/WO MOBIL,16328.0,10613.2,1.1,16328.0,144
CDM,61598OH,TRANSPTRSAL POST CRNL FOSSA CLIVUS/FORAMN MAGNUM,14612.0,9497.8,1.1,14612.0,144
CDM,61600000,MRA LWR EXT W CONTR,6006.0,3903.9,247.95,6006.0,69
CDM,61600005,MRA LWR EXT WO CONTR,6006.0,3903.9,247.95,6006.0,69
CDM,61600010,MRA LWR EXT WO/W CONTR,6006.0,3903.9,247.95,6006.0,69
CDM,61600050,MRA LWR EX WO/W,6006.0,3903.9,247.95,6006.0,69
CDM,61600OH,RESCJ/EXC LES BASE ANT CRANIAL FOSSA EXTRADURAL,12004.0,7802.6,1.1,12004.0,144
CDM,61601OH,RESCJ/EXC LES BASE ANT CRNL FOSSA INDRL W/WO GRF,13702.0,8906.3,1.1,13702.0,144
CDM,61605OH,RESCJ/EXC LES INFRATEMPOR FOSSA SPACE APEX XDRL,14331.0,9315.15,1.1,14331.0,144
CDM,61606OH,RESCJ/EXC LES ITPRL FOSSA SPACE APEX IDRL W/RPR,18502.0,12026.3,1.1,18502.0,144
CDM,61607OH,RESCJ/EXC LES PARASELLAR SINUS CLIVUS/MSB XDRL,16372.0,10641.8,1.1,16372.0,144
CDM,61608OH,RESCJ/EXC LES PARASELLAR SINUS CLIVUS/MSB IDRL,18216.0,11840.4,1.1,18216.0,144
CDM,61613OH,OBLTRJ CAROTID ARYSM ARTVEN CAROTID FISTULA DSJ,18012.0,11707.8,1.1,18012.0,144
CDM,61615OH,RESCJ/EXC LES BASE POST CRNL FOSSA JUG FRMN XDRL,14308.0,9300.2,1.1,14308.0,144
CDM,61616OH,RESCJ/EXC LES BASE PCF FORAMEN VRT BODIES IDRL,20566.0,13367.9,1.1,20566.0,144
CDM,61618OH,SECONDARY RPR DURA CSF LEAK FREE TISSUE GRAFT,7476.0,4859.4,1.1,7476.0,144
CDM,61619OH,SEC RPR DURA CSF LEAK LOCAL/REGIONALIZED FLAP,8840.0,5746.0,1.1,8840.0,144
CDM,61623OH,EVASC TEMP BALLOON ARTL OCCLUSION HEAD/NECK,3980.0,2587.0,1.1,32085.4,144
CDM,61624OH,TCAT PERMANENT OCCLUSION/EMBOLIZATION PRQ CNS,8853.0,5754.45,1.1,8853.0,144
CDM,61626OH,TCAT PERMANT OCCLUSION/EMBOLIZATION PRQ NON-CNS,6640.0,4316.0,1.1,32085.4,144
CDM,61630OH,BALLON ANGIOPLASTY  INTRACRANIAL PERCUTANEOUS,8828.0,5738.2,1.1,8828.0,130
CDM,61635OH,TCAT PLMT IV STENT ICRA W/BALO ANGIOP IF PFRMD,9712.0,6312.8,1.1,9712.0,130
CDM,61640OH,BALLOON DILAT INTRACRANIAL VASOSPASM PRQ INITIAL,4928.0,3203.2,1.1,4928.0,98
CDM,61641OH,PERQ BALO DILA IC VSPSM EA VSL SM VASC TER,1732.0,1125.8,1.1,1732.0,98
CDM,61642OH,PERQ BALO DILA IC VSPSM EA VSL DIFF VASC TER,3464.0,2251.6,1.1,3464.0,98
CDM,61645OH,PERQ ART TRLUML M-THROMBEC &/NFS INTRACRANIAL,6600.0,4290.0,1.1,6600.0,144
CDM,61650OH,EVASC INTRACRANIAL PROLNG ADMN RX AGENT ART 1ST,4000.0,2600.0,1.1,4000.0,144
CDM,61651OH,EVASC INTRACRANIAL PROLNG ADMN RX AGENT ART ADDL,1700.0,1105.0,1.1,1700.0,144
CDM,61680OH,INTRACRANIAL ARVEN MALFRMJ SUPRATENTRL SMPL,13020.0,8463.0,1.1,13020.0,144
CDM,61682OH,INTRACRANIAL ARVEN MALFRMJ SUPRATENTRL CMPL,25364.0,16486.6,1.1,25364.0,144
CDM,61684OH,INTRACRANIAL ARVEN MALFRMJ INFRATENTRL SMPL,16656.0,10826.4,1.1,16656.0,144
CDM,61686OH,INTRACRANIAL ARVEN MALFRMJ INFRATENTRL CMPL,27000.0,17550.0,1.1,27000.0,144
CDM,61690OH,INTRACRANIAL ARVEN MALFRMJ DURAL SMPL,12536.0,8148.4,1.1,12536.0,144
CDM,61692OH,INTRACRANIAL ARVEN MALFRMJ DURAL CMPL,21836.0,14193.4,1.1,21836.0,144
CDM,61697OH,COMPLX INTRACRANIAL ARYSM CAROTID CIRCULATION,25360.0,16484.0,1.1,25360.0,144
CDM,61698OH,CPLX INTRACRANIAL ARYSM VERTEBROBASILAR CRCJ,27852.0,18103.8,1.1,27852.0,144
CDM,61700OH,SIMPLE INTRACRANIAL ARYSM CAROTID CIRCULATION,20248.0,13161.2,1.1,20248.0,144
CDM,61702OH,SIMPLE INTRACRANIAL ARYSM VERTEBROBASILAR CRCJ,24016.0,15610.4,1.1,24016.0,144
CDM,61703OH,ICRA CRV APPL OCCLUDING CLAMP CRV CRTD ART,7520.0,4888.0,1.1,7520.0,144
CDM,61705OH,ARYSM VASC MALFRMJ/CRTD-OCCLUSION CRTD ART,15240.0,9906.0,1.1,15240.0,144
CDM,61710OH,ARYSM VASC MALFRMJ IA EMBOLIZATION,12516.0,8135.4,1.1,12516.0,144
CDM,61711OH,ANAST ARTL EXTRACRANIAL-INTRACRANIAL ARTERIES,15292.0,9939.8,1.1,15292.0,144
CDM,61715OH,MRGFUS STEREOTACTIC ABLATION TARGET INTRACRANIAL,8801.0,5720.65,1.1,8801.0,102
CDM,61735OH,CRTJ LES STRTCTC BURR SUBCORTICAL STRUX OTH/THN,9834.0,6392.1,1.1,9834.0,144
CDM,61736OH,LITT LES ICR SINGLE TRAJECTORY 1 SIMPLE LESION,7624.0,4955.6,1.1,7624.0,142
CDM,61737OH,LITT LES ICR MLT TRAJECTORIES MLT/CPLX LESIONS,9068.0,5894.2,1.1,9068.0,142
CDM,61750OH,STEREOTACTIC BX ASPIR/EXC BURR INTRACRANIAL LES,7932.0,5155.8,1.1,7932.0,144
CDM,61751OH,STRTCTC BX ASPIR/EXC BURR ICRA LESION W/CT&I/MR,7516.0,4885.4,1.1,7516.0,144
CDM,61760OH,STRTCTC IMPLTJ ELTRD CEREBRUM SEIZURE MONITORING,8956.0,5821.4,1.1,8956.0,144
CDM,61770OH,STRTCTC LOCLZJ INSJ CATH/PRB PLMT RADJ SRC,9276.0,6029.4,1.1,19428.17,144
CDM,61781OH,STRTCTC CPTR ASSTD PX CRANIAL INTRADURAL,1500.0,975.0,1.1,1500.0,144
CDM,61782OH,STRTCTC CPTR ASSTD PX EXTRADURAL CRANIAL,1399.0,909.35,1.1,1399.0,144
CDM,61783OH,STEREOTACTIC COMPUTER ASSISTED PX SPINAL,1500.0,975.0,1.1,1500.0,144
CDM,61790OH,CREATE LESION STRTCTC PRQ NEUROLYTIC GASSERIAN,4640.0,3016.0,1.1,5632.24,144
CDM,61796OH,STEREOTACTIC RADIOSURGERY 1 SIMPLE CRANIAL LES,5572.0,3621.8,1.1,5572.0,144
CDM,61797OH,STRTCTC RADIOSURGERY EA ADDL CRANIAL LES SIMPLE,1392.0,904.8,1.1,1392.0,144
CDM,61798OH,STEREOTACTIC RADIOSURGERY 1 COMPLEX CRANIAL LES,7940.0,5161.0,1.1,7940.0,144
CDM,61799OH,STRTCTC RADIOSURGERY EA ADDL CRANIAL LES COMPLEX,1924.0,1250.6,1.1,1924.0,144
CDM,61800005,MRA ABD W CONTR,2579.0,1676.35,245.83,2579.0,69
CDM,61800015,MRA ABD WO CONTR,2579.0,1676.35,245.83,2579.0,69
CDM,61800025,MRA ABD WO/W CONTR,2579.0,1676.35,245.83,2579.0,69
CDM,61800035,MRA CHEST W CONTRAST,6274.0,4078.1,246.84,6274.0,69
CDM,61800040,MRA SPINAL CANAL WO/W,3068.0,1994.2,248.56,3068.0,69
CDM,61800045,MRA CHEST WO CONTR,6274.0,4078.1,246.84,6274.0,69
CDM,61800055,MRA CHEST WO/W CONTR,6274.0,4078.1,246.84,6274.0,69
CDM,61800065,MRA PELV W CONTRL,6296.0,4092.4,245.83,6296.0,69
CDM,61800075,MRA PELV WO CONTRL,6296.0,4092.4,245.83,6296.0,69
CDM,61800080,MRA UPPER EXT WO CONT,4288.0,2787.2,238.81,4288.0,69
CDM,61800085,MRA PELV WO/W CONTR,6296.0,4092.4,245.83,6296.0,69
CDM,61800095,"MRA SPINAL CANAL, CONTENTS W/WO CONTRAST MATERIAL",3068.0,1994.2,248.56,3068.0,69
CDM,61800100,MRA CHEST W CON,6274.0,4078.1,246.84,6274.0,69
CDM,61800105,MRA W/CONTRAST SPINAL CANAL,3068.0,1994.2,248.56,3068.0,69
CDM,61800110,MRA CHEST WO,6274.0,4078.1,246.84,6274.0,69
CDM,61800115,MRA W/O CONTRAST SPINAL CANAL,3068.0,1994.2,248.56,3068.0,69
CDM,61800120,MRA CHEST WO/W,6274.0,4078.1,246.84,6274.0,69
CDM,61800125,MRA UPPER EXT W CONT,6296.0,4092.4,238.81,6296.0,69
CDM,61800140,MRA PELV WO CONTR,6296.0,4092.4,245.83,6296.0,69
CDM,61800150,MRA PELV WO/W CONTR,6296.0,4092.4,245.83,6296.0,69
CDM,61800160,MRA ABD W CONT,2579.0,1676.35,245.83,2579.0,69
CDM,61800170,MRA ABD WO CONT,2579.0,1676.35,245.83,2579.0,69
CDM,61800180,MRA ABDOMEN WO/W CONT,2579.0,1676.35,245.83,2579.0,69
CDM,61800190,MRA UPPER EXT WO/W CONT,4288.0,2787.2,238.81,4288.0,69
CDM,61800OH,APPL STRTCTC HEADFRAME STEREOTACTIC RADIOSURGERY,900.0,585.0,1.1,900.0,144
CDM,61860OH,CRNEC/CRX IMPLTJ NSTIM ELTRD CERE CORTICAL,8904.0,5787.6,1.1,8904.0,144
CDM,61863OH,STRTCTC IMPLTJ NSTIM ELTRD W/O RECORD 1ST ARRAY,8284.0,5384.6,1.1,8284.0,144
CDM,61864OH,STRTCTC IMPLTJ NSTIM ELTRD W/O RECORD EA ARRAY,1796.0,1167.4,1.1,1796.0,144
CDM,61867OH,STRTCTC IMPLTJ NSTIM ELTRD W/RECORD 1ST ARRAY,14533.0,9446.45,1.1,14533.0,144
CDM,61868OH,STRTCTC IMPLTJ NSTIM ELTRD W/RECORD EA ARRAY,3480.0,2262.0,1.1,3480.0,144
CDM,61880OH,REVJ/RMVL INTRACRANIAL NEUROSTIMULATOR ELTRDS,2780.0,1807.0,1.1,9923.76,144
CDM,61885OH,INSJ/RPLCMT CRANIAL NEUROSTIM PULSE GENERATOR,2662.0,1730.3,1.1,63800.42,144
CDM,61886OH,INSJ/RPLCMT CRANIAL NEUROSTIM GENER 2/> ELTRDS,4369.0,2839.85,1.1,90562.75,144
CDM,61888OH,REVJ/RMVL NEUROSTIMULATOR PULSE GENERATOR,2092.0,1359.8,1.1,39728.72,144
CDM,61889OH,INSERTION SKULL-MNTD CRANIAL NSTIM PG/RECEIVER,11330.0,7364.5,1.1,11330.0,142
CDM,61891OH,REVJ/RPLCMT SKULL-MNTD CRANIAL NSTIM PG/RECEIVER,4950.0,3217.5,1.1,63800.42,142
CDM,61892OH,REMOVAL SKULL-MNTD CRANIAL NSTIM PG/RCVR W/CRNOP,6600.0,4290.0,1.1,9440.12,142
CDM,62000OH,ELEVATION DEPRESSED SKULL FX SIMPLE EXTRADURAL,5572.0,3621.8,1.1,9391.15,144
CDM,62005OH,ELVTN DEPRS SKL FX COMPOUND/COMMIND XDRL,7052.0,4583.8,1.1,7052.0,144
CDM,62010OH,ELVTN DEPRS SKL FX W/RPR DURA&/DBRDMT BRN,8572.0,5571.8,1.1,8572.0,144
CDM,62100OH,CRX RPR DURAL/CSF LEAK RHINORRHEA/OTORRHEA,10353.0,6729.45,1.1,10353.0,144
CDM,62120OH,RPR ENCEPHALOCELE SKULL VAULT W/CRANIOPLASTY,9836.0,6393.4,1.1,9836.0,144
CDM,62121OH,CRANIOTOMY FOR ENCEPHALOCELE REPAIR SKULL BASE,10133.0,6586.45,1.1,10133.0,144
CDM,62140OH,CRANIOPLASTY SKULL DEFECT </5 CM DIAMETER,5820.0,3783.0,1.1,5820.0,144
CDM,62141OH,CRANIOPLASTY SKULL DEFECT >5 CM DIAMETER,6428.0,4178.2,1.1,6428.0,144
CDM,62142OH,RMVL BONE FLAP/PROSTHETIC PLATE SKULL,4732.0,3075.8,1.1,4732.0,144
CDM,62143OH,RPLCMT BONE FLAP/PROSTHETIC PLATE SKULL,5660.0,3679.0,1.1,5660.0,144
CDM,62145OH,CRANIOPLASTY SKULL DEFECT REPARATIVE BRAIN SURG,8036.0,5223.4,1.1,8036.0,144
CDM,62146OH,CRANIOPLASTY W/AUTOGRAFT </ 5 CM DIAMETER,6912.0,4492.8,1.1,6912.0,144
CDM,62147OH,CRANIOPLASTY W/AUTOGRAFT > 5 CM DIAMETER,8268.0,5374.2,1.1,8268.0,144
CDM,62148OH,INCISE&RETRIEVAL SUBQ CRANIOPLASTY BONE GRAFT,800.0,520.0,1.1,800.0,144
CDM,62160OH,NUNDSC ICRA PLMT/RPLCMT VENTR CATH SHUNT SYS,1200.0,780.0,1.1,1200.0,144
CDM,62161OH,NUNDSC ICRA DSJ ADS FENESTRATION SEPTUM CSTS,8492.0,5519.8,1.1,8492.0,144
CDM,62162OH,NUNDSC ICRA FENESTEXC CYST W/VENTRIC CATH DRG,10720.0,6968.0,1.1,10720.0,144
CDM,62164OH,NEUROENDOSCOPY ICRA W/RETRIEVAL FOREIGN BODY,11772.0,7651.8,1.1,11772.0,144
CDM,62165OH,NUNDSC ICRA EXC PITUITRY TUM TRNSNSL/SPHENOID,9292.0,6039.8,1.1,9292.0,144
CDM,62180OH,VENTRICULO-CISTERNOSTOMY,9032.0,5870.8,1.1,9032.0,144
CDM,62190OH,CRTJ SHUNT SARACH/SDRL-ATR-JUG-AUR,4868.0,3164.2,1.1,4868.0,144
CDM,62192OH,CRTJ SHUNT SARACH/SDRL-PRTL-PLEURAL OTH,5340.0,3471.0,1.1,5340.0,144
CDM,62194OH,RPLCMT/IRRG SUBARACHNOID/SUBDURAL CATHETER,2312.0,1502.8,1.1,5632.24,144
CDM,62200OH,"VENTRICULO-CISTERNOSTOMY,3RD VENT",7716.0,5015.4,1.1,7716.0,144
CDM,62201OH,VENTRICULOCISTERNOSTOMY 3RD VNTRC NEURONDSC,6416.0,4170.4,1.1,6416.0,144
CDM,62220OH,CREATE SHUNT; VENTRIC-ATR JUGUL AURICL,5640.0,3666.0,1.1,5640.0,144
CDM,62223OH,CRTJ SHUNT VENTRICULO-PERITNEAL-PLEURAL TERMINUS,6182.0,4018.3,1.1,6182.0,144
CDM,62225OH,RPLCMT/IRRIGATION VENTRICULAR CATHETER,2724.0,1770.6,1.1,19428.17,144
CDM,62230OH,RPLCMT/REVJ CSF SHUNT VALVE/CATH SHUNT SYS,4572.0,2971.8,1.1,19428.17,144
CDM,62252OH,REPRGRMG PROGRAMMABLE CEREBROSPINAL SHUNT,2395.0,1556.75,1.1,2395.0,144
CDM,62252OH-26,REPRGRMG PROGRAMMABLE CEREBROSPINAL SHUNT,326.0,211.9,1.1,326.0,126
CDM,62256OH,RMVL COMPL CSF SHUNT SYSTEM W/O RPLCMT SHUNT,2952.0,1918.8,1.1,2952.0,144
CDM,62258OH,RMVL COMPLETE CSF SHUNT SYSTEM W/RPLCMT SHUNT,6256.0,4066.4,1.1,6256.0,144
CDM,62263OH,PRQ LYSIS EPIDURAL ADHESIONS MULT SESS 2/> DAYS,2000.0,1300.0,1.1,2656.95,148
CDM,62264OH,PRQ LYSIS EPIDURAL ADHESIONS MULT SESSIONS 1 DAY,1768.0,1149.2,1.1,2656.95,148
CDM,62267OH,PRQ ASPIR PULPOSUS/INTERVERTEBRAL DISC/PVRT TISS,1200.0,780.0,1.1,2050.87,148
CDM,62268OH,PERCUTANEOUS ASPIRATION SPINAL CORD CYST/SYRINX,1892.0,1229.8,1.1,2656.95,144
CDM,62270OH,DIAGNOSTIC LUMBAR SPINAL PUNCTURE,537.0,349.05,1.1,2017.2,148
CDM,62272OH,THERAPEUTIC SPINAL PUNCTURE DRAINAGE CSF,632.0,410.8,1.1,2017.2,148
CDM,62273OH,INJECTION EPIDURAL BLOOD/CLOT PATCH,946.0,614.9,1.1,2017.2,148
CDM,62280OH,INJX/INFUSION NEUROLYTIC SUBSTANCE SUBARACHNOID,1052.0,683.8,1.1,2656.95,148
CDM,62281OH,INJX/INFUS NEUROLYT SUBST EPIDURAL CERV/THORACIC,1064.0,691.6,1.1,2656.95,148
CDM,62282OH,INJX/INFUS NEUROLYT SBST EPIDURAL LUMBAR/SACRAL,1025.0,666.25,1.1,2656.95,148
CDM,62284OH,INJECTION PROCEDURE MYELOGRAPHY/CT LUMBAR,616.0,400.4,1.1,630.91,148
CDM,62287OH,DCMPRN PX PERQ NUCLEUS PULPOSUS 1/MLT LVL LUMBAR,3612.0,2347.8,1.1,5632.24,144
CDM,62290OH,INJECTION PX DISCOGRAPHY EACH LEVEL LUMBAR,1200.0,780.0,1.1,1200.0,148
CDM,62291OH,INJECTION PX DISCOGRPHY EA LVL CERVICAL/THORACIC,1164.0,756.6,1.1,1164.0,148
CDM,62292OH,INJECTION PX CHEMONUCLEOLYSIS 1/MLT LUMBAR,3696.0,2402.4,1.1,5632.24,144
CDM,62300000,COLLAGEN DRESSING <=16 SQ IN,37.0,24.05,8.07,37.0,66
CDM,62300005,COLLAGEN DRSG>6<=48 SQ IN,15.92,10.35,3.47,15.92,66
CDM,62300010,CALCIUM ALGINATE ROPE,11.0,7.15,2.4,19.65,66
CDM,62300015,ALGINATE DRSG >16 <=48 SQ IN,32.0,20.8,6.98,32.0,66
CDM,62300030,RESTORE AG 4X5,16.88,10.97,3.68,19.65,66
CDM,62300040,FOAM DRG >16<=48 SQ IN W/O B,35.0,22.75,7.63,35.0,66
CDM,62300045,DIALYSIS DRESSING CHANGE-INPT.,12.0,7.8,2.62,19.65,66
CDM,62300065,ABSORPT DRG <=16 SQ IN W/O B,5.0,3.25,1.09,19.65,66
CDM,62300070,"LT COMPRES BAND <3""/YD",6.25,4.06,1.36,19.65,66
CDM,62300075,"LT COMPRES BAND >=3"" <5""/YD",10.0,6.5,2.18,19.65,66
CDM,62300080,"HIGH COMPRES BAND W>=3""<5""YD",29.0,18.85,6.32,29.0,66
CDM,62300085,"SELF-ADHER BAND W>=3"" <5""/YD",25.0,16.25,5.45,25.0,66
CDM,62300090,COMPRESSION STOCKING BK20-30,64.1,41.67,11.14,64.1,66
CDM,62300095,COMPRESSION STOCKING BK30-40,64.1,41.67,13.97,64.1,66
CDM,62300100,GC STOCKING THIGHLNGTH 15-20,50.1,32.57,10.92,50.1,66
CDM,62300105,GC STOCKING THIGHLNGTH 30-40,79.06,51.39,17.24,79.06,66
CDM,62300115,TEGADERM FOAM 3 1/2 X 3 1/2,4.5,2.93,0.98,19.65,66
CDM,62300125,RESTORE 4X5,9.38,6.1,2.04,19.65,66
CDM,62300135,ALGINATE DRSG 2X2,11.0,7.15,2.4,19.65,66
CDM,62300145,ALGINATE DRSG 4X4,15.0,9.75,3.27,19.65,66
CDM,62300155,RESTORE AG 4X5,16.88,10.97,3.68,19.65,66
CDM,62300175,10CM X 5 YD SHORT BANDAGE,10.0,6.5,2.18,19.65,66
CDM,62300185,8CM X 5 YD SHORT BANDAGE,10.0,6.5,2.18,19.65,66
CDM,62300195,20-30MMHG KNEE HIGHS,64.1,41.67,11.14,64.1,66
CDM,62300205,15-20MMHG KNEE HIGHS,37.92,24.65,8.27,37.92,66
CDM,62300215,8-15MMHG KNEE HIGHS/ULCER CARE LINERS,23.38,15.2,5.1,23.38,66
CDM,62300225,RELIEF KNEE HIGHS 20-30 MMHG,33.1,21.52,7.22,33.1,66
CDM,62300235,30-40MMHG KNEE HIGHS,64.1,41.67,13.97,64.1,66
CDM,62300245,30-40MMHG KNEE HIGHS/VAIROX/500 SERIES,84.0,54.6,18.31,84.0,66
CDM,62300255,30-40MMHG RELIEF KNEE HIGHS,33.1,21.52,7.22,42.28,66
CDM,62300265,GC STOCKING THIGHLNGTH 15-20,50.1,32.57,10.92,50.1,66
CDM,62300275,GC STOCKING THIGHLNGTH 20-30,79.06,51.39,11.14,79.06,66
CDM,62300285,GC STOCKING WAISTLNGTH,63.18,41.07,13.77,67.76,67
CDM,62300295,GC STOCKING WAISTLNGTH 20-30,99.7,64.81,21.73,99.7,66
CDM,62300305,OASIS WOUND MATRIX,5.72,3.72,1.37,183.51,78
CDM,62300315,OASIS WND MATRIX 3X3.35=10.5CM SQ PER 1 SQ CM,17.34,11.27,4.16,183.51,78
CDM,62300325,OASIS WND MATRIX 3X7=21CM SQ PER 1 SQ CM,15.14,9.84,3.63,183.51,78
CDM,62300335,"PURACOL PLUS 2""X2.25""",25.0,16.25,5.45,25.0,66
CDM,62300345,"PURACOL PLUS AG 2""X2""",20.8,13.52,4.53,20.8,66
CDM,62300355,"FIBRACOL 4""X4.375""",35.0,22.75,7.63,35.0,66
CDM,62300365,CONTACT LAYER <= 16 SQ IN,7.0,4.55,1.53,19.65,66
CDM,62300375,CONTACT LAYER >16<= 48 SQ IN,18.0,11.7,3.92,19.65,66
CDM,62300385,COVADERM PLUS 4X4,1.2,0.78,0.26,19.65,66
CDM,62300415,ALGINATE DRSG 3X3,20.14,13.09,4.39,20.14,66
CDM,62302OH,MYELOGRAPHY VIA LUMBAR INJECTION RS&I CERVICAL,916.0,595.4,1.1,2335.54,148
CDM,62303OH,MYELOGRAPHY VIA LUMBAR INJECTION RS&I THORACIC,916.0,595.4,1.1,2335.54,148
CDM,62304OH,MYELOGRAPHY VIA LUMBAR INJECT RS&I LUMBOSACRAL,900.0,585.0,1.1,2335.54,148
CDM,62305OH,MYELOGRAPHY VIA LUMBAR INJECTION RS&I 2+ REGIONS,940.0,611.0,1.1,2335.54,148
CDM,62320OH,NJX DX/THER SBST INTRLMNR CRV/THRC W/O IMG GDN,792.0,514.8,1.1,2017.2,148
CDM,62321OH,NJX DX/THER SBST INTRLMNR CRV/THRC W/IMG GDN,858.0,557.7,1.1,2017.2,148
CDM,62322OH,NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN,682.0,443.3,1.1,2656.95,148
CDM,62323OH,NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN,792.0,514.8,1.1,2017.2,148
CDM,62324OH,NJX DX/THER SBST INTRLMNR CRV/THRC W/O IMG GDN,832.0,540.8,1.1,2656.95,148
CDM,62325OH,NJX DX/THER SBST INTRLMNR CRV/THRC W/IMG GDN,968.0,629.2,1.1,2656.95,148
CDM,62326OH,NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN,783.0,508.95,1.1,2656.95,148
CDM,62327OH,NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN,836.0,543.4,1.1,2656.95,148
CDM,62328OH,DIAGNOSTIC LUMBAR SPINAL PUNCTURE W/FLUOR OR CT,692.0,449.8,1.1,2017.2,148
CDM,62328OH-TC,DIAGNOSTIC LUMBAR SPINAL PUNCTURE W/FLUOR OR CT,4778.0,3105.7,1.1,4778.0,70
CDM,62329OH,THERAPEUTIC SPINAL PNXR DRAINAGE CSF W/FLUOR/CT,812.0,527.8,1.1,2017.2,148
CDM,62330OH,DCMPRN PERQ PRTL RMVL LIGA FLAVM BI 1NTRSPC LMBR,3520.0,2288.0,1.1,3520.0,106
CDM,62331OH,DCMPRN PRQ PRT RMV LIGA FLAVM BI ADD NTRSPC LMBR,1870.0,1215.5,1.1,1870.0,106
CDM,62350OH,IMPLTJ REVJ/RPSG ITHCL/EDRL CATH PMP W/O LAM,2662.0,1730.3,1.1,19428.17,144
CDM,62351OH,IMPLTJ REVJ/RPSG ITHCL/EDRL CATH W/LAM,4664.0,3031.6,1.1,20863.78,144
CDM,62355OH,RMVL PREVIOUSLY IMPLTED ITHCL/EDRL CATH,1420.0,923.0,1.1,5632.24,144
CDM,62360OH,IMPLTJ/RPLCMT ITHCL/EDRL DRUG NFS SUBQ RSVR,1732.0,1125.8,1.1,52012.51,144
CDM,62361OH,IMPLTJ/RPLCMT FS NON-PRGRBL PUMP,2000.0,1300.0,1.1,52012.51,144
CDM,62362OH,IMPLTJ/RPLCMT ITHCL/EDRL DRUG NFS PRGRBL PUMP,2464.0,1601.6,1.1,52012.51,144
CDM,62365OH,RMVL SUBQ RSVR/PUMP INTRATHECAL/EPIDURAL INFUS,1572.0,1021.8,1.1,19428.17,144
CDM,62367OH,ELECT ANLYS IMPLT ITHCL/EDRL PMP W/O REPRG/REFIL,211.0,137.15,1.1,872.39,146
CDM,62368OH,ELECT ANALYS IMPLT ITHCL/EDRL PUMP W/REPRGRMG,295.0,191.75,1.1,872.39,148
CDM,62369OH,ANAL SP INF PMP W/REPRG&FILL,295.0,191.75,1.1,872.39,148
CDM,62370OH,ELEC ANLYS IMPLT ITHCL/EDRL PMP W/REPR&REF PHYS,396.0,257.4,1.1,872.39,148
CDM,62380OH,NDSC DCMPRN SPINAL CORD 1 W/LAMOT NTRSPC LUMBAR,5916.0,3845.4,1.1,20863.78,90
CDM,62400005,G100247 DGTL BREAST TOMOSYNTH,269.0,174.85,56.78,269.0,86
CDM,62400005_IP,G100247 DGTL BREAST TOMOSYNTH,269.0,174.85,97.92,97.92,1
CDM,62400005_OP,G100247 DGTL BREAST TOMOSYNTH,269.0,174.85,80.43,80.43,1
CDM,62400145,G120028/S003 3D PENUMBRA,3900.0,2535.0,200.93,3900.0,67
CDM,62400145_IP,G120028/S003 3D PENUMBRA,3900.0,2535.0,2137.2,2137.2,1
CDM,62400145_OP,G120028/S003 3D PENUMBRA,3900.0,2535.0,1692.6,1692.6,1
CDM,62400155,G120067 VICTORY CRYO PVAC GLD,4200.0,2730.0,200.93,4200.0,67
CDM,62400155_IP,G120067 VICTORY CRYO PVAC GLD,4200.0,2730.0,2301.6,2301.6,1
CDM,62400155_OP,G120067 VICTORY CRYO PVAC GLD,4200.0,2730.0,1822.8,1822.8,1
CDM,62400165,G120067 VICTORY CRYO PVAC MLTY,1050.0,682.5,200.93,1050.0,67
CDM,62400165_IP,G120067 VICTORY CRYO PVAC MLTY,1050.0,682.5,382.2,382.2,1
CDM,62400165_OP,G120067 VICTORY CRYO PVAC MLTY,1050.0,682.5,313.95,313.95,1
CDM,62400175,G120067 VICTORY CRYO MLTY SPL,1050.0,682.5,200.93,1050.0,67
CDM,62400175_IP,G120067 VICTORY CRYO MLTY SPL,1050.0,682.5,382.2,382.2,1
CDM,62400175_OP,G120067 VICTORY CRYO MLTY SPL,1050.0,682.5,313.95,313.95,1
CDM,62400195,G130222 RELI 4FRT NCT02071173,2600.0,1690.0,200.93,2600.0,67
CDM,62400195_IP,G130222 RELI 4FRT NCT02071173,2600.0,1690.0,1424.8,1424.8,1
CDM,62400195_OP,G130222 RELI 4FRT NCT02071173,2600.0,1690.0,1128.4,1128.4,1
CDM,62400200,G130222 ACUITY LDS NCT02071173,1100.0,715.0,200.93,1100.0,67
CDM,62400200_IP,G130222 ACUITY LDS NCT02071173,1100.0,715.0,400.4,400.4,1
CDM,62400200_OP,G130222 ACUITY LDS NCT02071173,1100.0,715.0,328.9,328.9,1
CDM,62400225,P040012 TPRD STENT W/EPD,4018.0,2611.7,875.92,4018.0,59
CDM,62400225_IP,P040012 TPRD STENT W/EPD,4018.0,2611.7,2201.86,2201.86,1
CDM,62400225_OP,P040012 TPRD STENT W/EPD,4018.0,2611.7,1743.81,1743.81,1
CDM,62400240,G100230 TACTICATH TOCCASTAR,2500.0,1625.0,200.93,2500.0,67
CDM,62400240_IP,G100230 TACTICATH TOCCASTAR,2500.0,1625.0,1370.0,1370.0,1
CDM,62400240_OP,G100230 TACTICATH TOCCASTAR,2500.0,1625.0,1085.0,1085.0,1
CDM,62400390,G070185/S019 GORE SEPTAL OCCL,6439.0,4185.35,1403.7,6439.0,59
CDM,62400390_IP,G070185/S019 GORE SEPTAL OCCL,6439.0,4185.35,3528.57,3528.57,1
CDM,62400390_OP,G070185/S019 GORE SEPTAL OCCL,6439.0,4185.35,2794.53,2794.53,1
CDM,62400465,G110188 LVIS JR EXPAND STENT,6800.0,4420.0,1030.0,6800.0,66
CDM,62400465_IP,G110188 LVIS JR EXPAND STENT,6800.0,4420.0,3726.4,3726.4,1
CDM,62400465_OP,G110188 LVIS JR EXPAND STENT,6800.0,4420.0,2951.2,2951.2,1
CDM,62400475,G110188 LVIS SELF EXPAND STENT,6200.0,4030.0,1030.0,6200.0,66
CDM,62400475_IP,G110188 LVIS SELF EXPAND STENT,6200.0,4030.0,3397.6,3397.6,1
CDM,62400475_OP,G110188 LVIS SELF EXPAND STENT,6200.0,4030.0,2690.8,2690.8,1
CDM,62400615,G110161 GSO ASD DEVICE,6439.0,4185.35,1403.7,6439.0,59
CDM,62400615_IP,G110161 GSO ASD DEVICE,6439.0,4185.35,3528.57,3528.57,1
CDM,62400615_OP,G110161 GSO ASD DEVICE,6439.0,4185.35,2794.53,2794.53,1
CDM,62400635,G120093 SORIN RESPOND ATR LEAD,325.0,211.25,70.85,325.0,67
CDM,62400635_IP,G120093 SORIN RESPOND ATR LEAD,325.0,211.25,118.3,118.3,1
CDM,62400635_OP,G120093 SORIN RESPOND ATR LEAD,325.0,211.25,97.18,97.18,1
CDM,62400645,"G090243, HEARTWARE VENT ASST",77846.0,50599.9,16970.43,77846.0,59
CDM,62400645_IP,"G090243, HEARTWARE VENT ASST",77846.0,50599.9,42659.61,42659.61,1
CDM,62400645_OP,"G090243, HEARTWARE VENT ASST",77846.0,50599.9,33785.16,33785.16,1
CDM,62400655,"G090216/022,EDWARDS SAPIEN XT",25000.0,16250.0,5450.0,25000.0,59
CDM,62400655_IP,"G090216/022,EDWARDS SAPIEN XT",25000.0,16250.0,13700.0,13700.0,1
CDM,62400655_OP,"G090216/022,EDWARDS SAPIEN XT",25000.0,16250.0,10850.0,10850.0,1
CDM,62400675,G110189/A003 INTUITY TRANSFORM,12500.0,8125.0,2725.0,12500.0,59
CDM,62400675_IP,G110189/A003 INTUITY TRANSFORM,12500.0,8125.0,6850.0,6850.0,1
CDM,62400675_OP,G110189/A003 INTUITY TRANSFORM,12500.0,8125.0,5425.0,5425.0,1
CDM,62400685,"G120108/S006 COMMENCE,11000A",8000.0,5200.0,1744.0,8000.0,59
CDM,62400685_IP,"G120108/S006 COMMENCE,11000A",8000.0,5200.0,4384.0,4384.0,1
CDM,62400685_OP,"G120108/S006 COMMENCE,11000A",8000.0,5200.0,3472.0,3472.0,1
CDM,62400695,"G100008 PT RECHARGE KIT,37651",1615.0,1049.75,352.07,1615.0,59
CDM,62400695_IP,"G100008 PT RECHARGE KIT,37651",1615.0,1049.75,885.02,885.02,1
CDM,62400695_OP,"G100008 PT RECHARGE KIT,37651",1615.0,1049.75,700.91,700.91,1
CDM,62400715,"G120160/A002,SALUS TRIAL",28000.0,18200.0,6104.0,28000.0,59
CDM,62400715_IP,"G120160/A002,SALUS TRIAL",28000.0,18200.0,15344.0,15344.0,1
CDM,62400715_OP,"G120160/A002,SALUS TRIAL",28000.0,18200.0,12152.0,12152.0,1
CDM,62400725,"G120053,PERCEVAL S VALVE,SORIN",14500.0,9425.0,3161.0,14500.0,59
CDM,62400725_IP,"G120053,PERCEVAL S VALVE,SORIN",14500.0,9425.0,7946.0,7946.0,1
CDM,62400725_OP,"G120053,PERCEVAL S VALVE,SORIN",14500.0,9425.0,6293.0,6293.0,1
CDM,62400755,"G120263,PORTICO RE-SHEATH TAVR",19100.0,12415.0,4163.8,19100.0,59
CDM,62400755_IP,"G120263,PORTICO RE-SHEATH TAVR",19100.0,12415.0,10466.8,10466.8,1
CDM,62400755_OP,"G120263,PORTICO RE-SHEATH TAVR",19100.0,12415.0,8289.4,8289.4,1
CDM,62400765,"G130005,NELLIX EVAS I,ENDOLGIX",14000.0,9100.0,3052.0,14000.0,59
CDM,62400765_IP,"G130005,NELLIX EVAS I,ENDOLGIX",14000.0,9100.0,7672.0,7672.0,1
CDM,62400765_OP,"G130005,NELLIX EVAS I,ENDOLGIX",14000.0,9100.0,6076.0,6076.0,1
CDM,62400785,"G130038/S1,EXCLUDER CAPITATION",8500.0,5525.0,1853.0,8500.0,59
CDM,62400785_IP,"G130038/S1,EXCLUDER CAPITATION",8500.0,5525.0,4658.0,4658.0,1
CDM,62400785_OP,"G130038/S1,EXCLUDER CAPITATION",8500.0,5525.0,3689.0,3689.0,1
CDM,62400805,G130138 A LEADLESS PACEMAKER,9500.0,6175.0,16.97,9500.0,67
CDM,62400805_IP,G130138 A LEADLESS PACEMAKER,9500.0,6175.0,5206.0,5206.0,1
CDM,62400805_OP,G130138 A LEADLESS PACEMAKER,9500.0,6175.0,4123.0,4123.0,1
CDM,62400835,G130245 MICRA PACEMAKER SYS,9600.0,6240.0,16.97,9600.0,67
CDM,62400835_IP,G130245 MICRA PACEMAKER SYS,9600.0,6240.0,5260.8,5260.8,1
CDM,62400835_OP,G130245 MICRA PACEMAKER SYS,9600.0,6240.0,4166.4,4166.4,1
CDM,62400845,"G000201/S25,STYLE 410 BREAST",1325.0,861.25,16.97,1325.0,67
CDM,62400845_IP,"G000201/S25,STYLE 410 BREAST",1325.0,861.25,726.1,726.1,1
CDM,62400845_OP,"G000201/S25,STYLE 410 BREAST",1325.0,861.25,575.05,575.05,1
CDM,62400855,G110059 ICD FORTIFY ST DR,12850.0,8352.5,200.93,12850.0,67
CDM,62400855_IP,G110059 ICD FORTIFY ST DR,12850.0,8352.5,7041.8,7041.8,1
CDM,62400855_OP,G110059 ICD FORTIFY ST DR,12850.0,8352.5,5576.9,5576.9,1
CDM,62400865,G140039 B EVERA XT DR DDMB1D4,14000.0,9100.0,200.93,14000.0,67
CDM,62400865_IP,G140039 B EVERA XT DR DDMB1D4,14000.0,9100.0,7672.0,7672.0,1
CDM,62400865_OP,G140039 B EVERA XT DR DDMB1D4,14000.0,9100.0,6076.0,6076.0,1
CDM,62400885,G110059 ICD FORTIFY ST SR,9500.0,6175.0,200.93,9500.0,67
CDM,62400885_IP,G110059 ICD FORTIFY ST SR,9500.0,6175.0,5206.0,5206.0,1
CDM,62400885_OP,G110059 ICD FORTIFY ST SR,9500.0,6175.0,4123.0,4123.0,1
CDM,62400895,G140039 B EVERA XT VR DVMB1D4,11000.0,7150.0,200.93,11000.0,67
CDM,62400895_IP,G140039 B EVERA XT VR DVMB1D4,11000.0,7150.0,6028.0,6028.0,1
CDM,62400895_OP,G140039 B EVERA XT VR DVMB1D4,11000.0,7150.0,4774.0,4774.0,1
CDM,62400925,G100008 ACTIVA NEUROSTIM 37601,17200.0,11180.0,200.93,17200.0,67
CDM,62400925_IP,G100008 ACTIVA NEUROSTIM 37601,17200.0,11180.0,9425.6,9425.6,1
CDM,62400925_OP,G100008 ACTIVA NEUROSTIM 37601,17200.0,11180.0,7464.8,7464.8,1
CDM,62400935,"G070235,ACTIVA LEAD,3387S-40",2975.0,1933.75,200.93,2975.0,67
CDM,62400935_IP,"G070235,ACTIVA LEAD,3387S-40",2975.0,1933.75,1630.3,1630.3,1
CDM,62400935_OP,"G070235,ACTIVA LEAD,3387S-40",2975.0,1933.75,1291.15,1291.15,1
CDM,62400945,"G070235,ACTIVA LEAD,3389S-40",3075.0,1998.75,200.93,3075.0,67
CDM,62400945_IP,"G070235,ACTIVA LEAD,3389S-40",3075.0,1998.75,1685.1,1685.1,1
CDM,62400945_OP,"G070235,ACTIVA LEAD,3389S-40",3075.0,1998.75,1334.55,1334.55,1
CDM,62400955,"G100008 ACTIVA PT PROG,37642",900.0,585.0,196.2,900.0,67
CDM,62400955_IP,"G100008 ACTIVA PT PROG,37642",900.0,585.0,327.6,327.6,1
CDM,62400955_OP,"G100008 ACTIVA PT PROG,37642",900.0,585.0,269.1,269.1,1
CDM,62400965,G100008 ACTIVA NEUROSTIM 37612,24000.0,15600.0,200.93,24000.0,67
CDM,62400965_IP,G100008 ACTIVA NEUROSTIM 37612,24000.0,15600.0,13152.0,13152.0,1
CDM,62400965_OP,G100008 ACTIVA NEUROSTIM 37612,24000.0,15600.0,10416.0,10416.0,1
CDM,62400975,"G070235,ACTIVA DBS,37612",24000.0,15600.0,200.93,24000.0,67
CDM,62400975_IP,"G070235,ACTIVA DBS,37612",24000.0,15600.0,13152.0,13152.0,1
CDM,62400975_OP,"G070235,ACTIVA DBS,37612",24000.0,15600.0,10416.0,10416.0,1
CDM,62400985,G120002 BVS/XIENCE STENT,1500.0,975.0,200.93,1500.0,67
CDM,62400985_IP,G120002 BVS/XIENCE STENT,1500.0,975.0,822.0,822.0,1
CDM,62400985_OP,G120002 BVS/XIENCE STENT,1500.0,975.0,651.0,651.0,1
CDM,62400995,"G100200,TREOVANCE W/NAVITEL",9500.0,6175.0,200.93,9500.0,67
CDM,62400995_IP,"G100200,TREOVANCE W/NAVITEL",9500.0,6175.0,5206.0,5206.0,1
CDM,62400995_OP,"G100200,TREOVANCE W/NAVITEL",9500.0,6175.0,4123.0,4123.0,1
CDM,62401035,G120093 SORIN RESPOND CRTD,12300.0,7995.0,200.93,12300.0,67
CDM,62401035_IP,G120093 SORIN RESPOND CRTD,12300.0,7995.0,6740.4,6740.4,1
CDM,62401035_OP,G120093 SORIN RESPOND CRTD,12300.0,7995.0,5338.2,5338.2,1
CDM,62401045,"G100008 ACTIVA EXTEN,37086",695.0,451.75,151.51,695.0,67
CDM,62401045_IP,"G100008 ACTIVA EXTEN,37086",695.0,451.75,252.98,252.98,1
CDM,62401045_OP,"G100008 ACTIVA EXTEN,37086",695.0,451.75,207.81,207.81,1
CDM,62401065,"G980198/S6,ZENITH CUSTOM",6000.0,3900.0,333.06,6000.0,67
CDM,62401065_IP,"G980198/S6,ZENITH CUSTOM",6000.0,3900.0,3288.0,3288.0,1
CDM,62401065_OP,"G980198/S6,ZENITH CUSTOM",6000.0,3900.0,2604.0,2604.0,1
CDM,62401075,"G010002,GREENBERG FENESTRAT",15000.0,9750.0,333.06,15000.0,67
CDM,62401075_IP,"G010002,GREENBERG FENESTRAT",15000.0,9750.0,8220.0,8220.0,1
CDM,62401075_OP,"G010002,GREENBERG FENESTRAT",15000.0,9750.0,6510.0,6510.0,1
CDM,62401095,"G000101/S70,GRAFT,TAA,CUSTOM",10000.0,6500.0,333.06,10000.0,67
CDM,62401095_IP,"G000101/S70,GRAFT,TAA,CUSTOM",10000.0,6500.0,5480.0,5480.0,1
CDM,62401095_OP,"G000101/S70,GRAFT,TAA,CUSTOM",10000.0,6500.0,4340.0,4340.0,1
CDM,62401115,"G130027,VALIANT MONA LSA STNT",15000.0,9750.0,3270.0,15000.0,59
CDM,62401115_IP,"G130027,VALIANT MONA LSA STNT",15000.0,9750.0,8220.0,8220.0,1
CDM,62401115_OP,"G130027,VALIANT MONA LSA STNT",15000.0,9750.0,6510.0,6510.0,1
CDM,62401145,"G090216/022,EDWARDS SAPIEN 3",30000.0,19500.0,6540.0,30000.0,59
CDM,62401145_IP,"G090216/022,EDWARDS SAPIEN 3",30000.0,19500.0,16440.0,16440.0,1
CDM,62401145_OP,"G090216/022,EDWARDS SAPIEN 3",30000.0,19500.0,13020.0,13020.0,1
CDM,62401155,"G120130,MESH 15X25,NCT01746316",10321.0,6708.65,117.73,10321.0,70
CDM,62401155_IP,"G120130,MESH 15X25,NCT01746316",10321.0,6708.65,5655.91,5655.91,1
CDM,62401155_OP,"G120130,MESH 15X25,NCT01746316",10321.0,6708.65,4479.31,4479.31,1
CDM,62401165,"G120130,MESH 6X10,NCT01746316",1768.0,1149.2,117.73,1768.0,70
CDM,62401165_IP,"G120130,MESH 6X10,NCT01746316",1768.0,1149.2,968.86,968.86,1
CDM,62401165_OP,"G120130,MESH 6X10,NCT01746316",1768.0,1149.2,767.31,767.31,1
CDM,62401175,"G120130,MESH 20X40,NCT01746316",22014.0,14309.1,117.73,22014.0,70
CDM,62401175_IP,"G120130,MESH 20X40,NCT01746316",22014.0,14309.1,12063.67,12063.67,1
CDM,62401175_OP,"G120130,MESH 20X40,NCT01746316",22014.0,14309.1,9554.08,9554.08,1
CDM,62401185,"G120130,MESH 10X25,NCT01746316",6881.0,4472.65,117.73,6881.0,70
CDM,62401185_IP,"G120130,MESH 10X25,NCT01746316",6881.0,4472.65,3770.79,3770.79,1
CDM,62401185_OP,"G120130,MESH 10X25,NCT01746316",6881.0,4472.65,2986.35,2986.35,1
CDM,62401195,"G120130,MESH 20X30,NCT01746316",16510.0,10731.5,117.73,16510.0,70
CDM,62401195_IP,"G120130,MESH 20X30,NCT01746316",16510.0,10731.5,9047.48,9047.48,1
CDM,62401195_OP,"G120130,MESH 20X30,NCT01746316",16510.0,10731.5,7165.34,7165.34,1
CDM,62401205,"G120130,MESH 6X6,NCT01746316",1061.0,689.65,117.73,1061.0,70
CDM,62401205_IP,"G120130,MESH 6X6,NCT01746316",1061.0,689.65,386.2,386.2,1
CDM,62401205_OP,"G120130,MESH 6X6,NCT01746316",1061.0,689.65,317.24,317.24,1
CDM,62401215,"G120130,MESH 8X16,NCT01746316",3524.0,2290.6,117.73,3524.0,70
CDM,62401215_IP,"G120130,MESH 8X16,NCT01746316",3524.0,2290.6,1931.15,1931.15,1
CDM,62401215_OP,"G120130,MESH 8X16,NCT01746316",3524.0,2290.6,1529.42,1529.42,1
CDM,62401225,"G120130,MESH 15X30,NCT01746316",12384.0,8049.6,117.73,12384.0,70
CDM,62401225_IP,"G120130,MESH 15X30,NCT01746316",12384.0,8049.6,6786.43,6786.43,1
CDM,62401225_OP,"G120130,MESH 15X30,NCT01746316",12384.0,8049.6,5374.66,5374.66,1
CDM,62401235,"G120130,MESH 20X25,NCT01746316",13760.0,8944.0,117.73,13760.0,70
CDM,62401235_IP,"G120130,MESH 20X25,NCT01746316",13760.0,8944.0,7540.48,7540.48,1
CDM,62401235_OP,"G120130,MESH 20X25,NCT01746316",13760.0,8944.0,5971.84,5971.84,1
CDM,62401245,"G120130,MESH 8X8,NCT01746316",1887.0,1226.55,117.73,1887.0,70
CDM,62401245_IP,"G120130,MESH 8X8,NCT01746316",1887.0,1226.55,1034.08,1034.08,1
CDM,62401245_OP,"G120130,MESH 8X8,NCT01746316",1887.0,1226.55,818.96,818.96,1
CDM,62401255,"G120130,MESH 20X20,NCT01746316",11008.0,7155.2,117.73,11008.0,70
CDM,62401255_IP,"G120130,MESH 20X20,NCT01746316",11008.0,7155.2,6032.38,6032.38,1
CDM,62401255_OP,"G120130,MESH 20X20,NCT01746316",11008.0,7155.2,4777.47,4777.47,1
CDM,62401265,"G120130,MESH 10X20,NCT01746316",5505.0,3578.25,117.73,5505.0,70
CDM,62401265_IP,"G120130,MESH 10X20,NCT01746316",5505.0,3578.25,3016.74,3016.74,1
CDM,62401265_OP,"G120130,MESH 10X20,NCT01746316",5505.0,3578.25,2389.17,2389.17,1
CDM,62401275,"G120130,MESH5.5X10,NCT01746316",981.0,637.65,117.73,981.0,70
CDM,62401275_IP,"G120130,MESH5.5X10,NCT01746316",981.0,637.65,357.08,357.08,1
CDM,62401275_OP,"G120130,MESH5.5X10,NCT01746316",981.0,637.65,293.32,293.32,1
CDM,62401285,"G120130,MESH 6X8,NCT01746316",1324.0,860.6,117.73,1324.0,70
CDM,62401285_IP,"G120130,MESH 6X8,NCT01746316",1324.0,860.6,725.55,725.55,1
CDM,62401285_OP,"G120130,MESH 6X8,NCT01746316",1324.0,860.6,574.62,574.62,1
CDM,62401295,"G120130,MESH 30X30,NCT01746316",21224.0,13795.6,117.73,21224.0,70
CDM,62401295_IP,"G120130,MESH 30X30,NCT01746316",21224.0,13795.6,11630.75,11630.75,1
CDM,62401295_OP,"G120130,MESH 30X30,NCT01746316",21224.0,13795.6,9211.22,9211.22,1
CDM,62401305,"G120130,MESH 6X16,NCT01746316",2643.0,1717.95,117.73,2643.0,70
CDM,62401305_IP,"G120130,MESH 6X16,NCT01746316",2643.0,1717.95,1448.36,1448.36,1
CDM,62401305_OP,"G120130,MESH 6X16,NCT01746316",2643.0,1717.95,1147.06,1147.06,1
CDM,62401315,"G120130,MESH 5X16,NCT01746316",2202.0,1431.3,117.73,2202.0,70
CDM,62401315_IP,"G120130,MESH 5X16,NCT01746316",2202.0,1431.3,1206.7,1206.7,1
CDM,62401315_OP,"G120130,MESH 5X16,NCT01746316",2202.0,1431.3,955.67,955.67,1
CDM,62401325,"G120130,MESH 6X13,NCT01746316",1541.0,1001.65,117.73,1541.0,70
CDM,62401325_IP,"G120130,MESH 6X13,NCT01746316",1541.0,1001.65,844.47,844.47,1
CDM,62401325_OP,"G120130,MESH 6X13,NCT01746316",1541.0,1001.65,668.79,668.79,1
CDM,62401335,"G120130,MESH 16X20,NCT01746316",8807.0,5724.55,117.73,8807.0,70
CDM,62401335_IP,"G120130,MESH 16X20,NCT01746316",8807.0,5724.55,4826.24,4826.24,1
CDM,62401335_OP,"G120130,MESH 16X20,NCT01746316",8807.0,5724.55,3822.24,3822.24,1
CDM,62401345,"G120130,MESH 10X16,NCT01746316",4404.0,2862.6,117.73,4404.0,70
CDM,62401345_IP,"G120130,MESH 10X16,NCT01746316",4404.0,2862.6,2413.39,2413.39,1
CDM,62401345_OP,"G120130,MESH 10X16,NCT01746316",4404.0,2862.6,1911.34,1911.34,1
CDM,62401355,"G120130,MESH 12X12,NCT01746316",108.6,70.59,30.71,183.51,70
CDM,62401355_IP,"G120130,MESH 12X12,NCT01746316",108.6,70.59,39.53,39.53,1
CDM,62401355_OP,"G120130,MESH 12X12,NCT01746316",108.6,70.59,32.47,32.47,1
CDM,62401365,"G120130,MESH 8X15,NCT01746316",2650.0,1722.5,117.73,2650.0,70
CDM,62401365_IP,"G120130,MESH 8X15,NCT01746316",2650.0,1722.5,1452.2,1452.2,1
CDM,62401365_OP,"G120130,MESH 8X15,NCT01746316",2650.0,1722.5,1150.1,1150.1,1
CDM,62401375,"G120130,MESH 25X40,NCT01746316",27517.0,17886.05,117.73,27517.0,70
CDM,62401375_IP,"G120130,MESH 25X40,NCT01746316",27517.0,17886.05,15079.32,15079.32,1
CDM,62401375_OP,"G120130,MESH 25X40,NCT01746316",27517.0,17886.05,11942.38,11942.38,1
CDM,62401385,"G120130,MESH 10X10,NCT01746316",2753.0,1789.45,117.73,2753.0,70
CDM,62401385_IP,"G120130,MESH 10X10,NCT01746316",2753.0,1789.45,1508.64,1508.64,1
CDM,62401385_OP,"G120130,MESH 10X10,NCT01746316",2753.0,1789.45,1194.8,1194.8,1
CDM,62401395,"G140056,PERIGON,NCT02088554",6500.0,4225.0,1417.0,6500.0,59
CDM,62401395_IP,"G140056,PERIGON,NCT02088554",6500.0,4225.0,3562.0,3562.0,1
CDM,62401395_OP,"G140056,PERIGON,NCT02088554",6500.0,4225.0,2821.0,2821.0,1
CDM,62401405,"G140090,REPRISEIII,NCT02202434",25000.0,16250.0,5450.0,25000.0,59
CDM,62401405_IP,"G140090,REPRISEIII,NCT02202434",25000.0,16250.0,13700.0,13700.0,1
CDM,62401405_OP,"G140090,REPRISEIII,NCT02202434",25000.0,16250.0,10850.0,10850.0,1
CDM,62401415,"G140056,PERIGON,NCT02088554",6500.0,4225.0,1417.0,6500.0,59
CDM,62401415_IP,"G140056,PERIGON,NCT02088554",6500.0,4225.0,3562.0,3562.0,1
CDM,62401415_OP,"G140056,PERIGON,NCT02088554",6500.0,4225.0,2821.0,2821.0,1
CDM,62401485,"G140113,HRTMT III,NCT02224755",87500.0,56875.0,19075.0,87500.0,59
CDM,62401485_IP,"G140113,HRTMT III,NCT02224755",87500.0,56875.0,47950.0,47950.0,1
CDM,62401485_OP,"G140113,HRTMT III,NCT02224755",87500.0,56875.0,37975.0,37975.0,1
CDM,62401505,"G010002,STENT,ATRIUM,8600X",1750.0,1137.5,381.5,1750.0,59
CDM,62401505_IP,"G010002,STENT,ATRIUM,8600X",1750.0,1137.5,959.0,959.0,1
CDM,62401505_OP,"G010002,STENT,ATRIUM,8600X",1750.0,1137.5,759.5,759.5,1
CDM,62401525,"G130038/S1,EXCLUDER,ILIAC BRCH",7000.0,4550.0,1526.0,7000.0,59
CDM,62401525_IP,"G130038/S1,EXCLUDER,ILIAC BRCH",7000.0,4550.0,3836.0,3836.0,1
CDM,62401525_OP,"G130038/S1,EXCLUDER,ILIAC BRCH",7000.0,4550.0,3038.0,3038.0,1
CDM,62401535,"G130038/S1,EXCLUDER,INT ILIAC",3500.0,2275.0,763.0,3500.0,59
CDM,62401535_IP,"G130038/S1,EXCLUDER,INT ILIAC",3500.0,2275.0,1918.0,1918.0,1
CDM,62401535_OP,"G130038/S1,EXCLUDER,INT ILIAC",3500.0,2275.0,1519.0,1519.0,1
CDM,62401575,G030240/S001 ACTIVA DBS LEAD,2004.6,1302.99,16.97,2004.6,67
CDM,62401575_IP,G030240/S001 ACTIVA DBS LEAD,2004.6,1302.99,1098.52,1098.52,1
CDM,62401575_OP,G030240/S001 ACTIVA DBS LEAD,2004.6,1302.99,870.0,870.0,1
CDM,62401585,G030240/S001 ACTIVA EXTENSION,595.0,386.75,16.97,595.0,67
CDM,62401585_IP,G030240/S001 ACTIVA EXTENSION,595.0,386.75,216.58,216.58,1
CDM,62401585_OP,G030240/S001 ACTIVA EXTENSION,595.0,386.75,177.91,177.91,1
CDM,62401595,G030240/S001 ACTIVA NEUROSTIM,17095.0,11111.75,16.97,17095.0,67
CDM,62401595_IP,G030240/S001 ACTIVA NEUROSTIM,17095.0,11111.75,9368.06,9368.06,1
CDM,62401595_OP,G030240/S001 ACTIVA NEUROSTIM,17095.0,11111.75,7419.23,7419.23,1
CDM,62401605,G030240/S001 ACTIVA PT PROGMER,660.0,429.0,16.97,660.0,67
CDM,62401605_IP,G030240/S001 ACTIVA PT PROGMER,660.0,429.0,240.24,240.24,1
CDM,62401605_OP,G030240/S001 ACTIVA PT PROGMER,660.0,429.0,197.34,197.34,1
CDM,62401625,"G070235,ACTIVA CONTROLLER,7436",660.0,429.0,143.88,775.49,67
CDM,62401625_IP,"G070235,ACTIVA CONTROLLER,7436",660.0,429.0,240.24,240.24,1
CDM,62401625_OP,"G070235,ACTIVA CONTROLLER,7436",660.0,429.0,197.34,197.34,1
CDM,62401635,"G070235,ACTIVA EXTENSION,7482",595.0,386.75,129.71,595.0,67
CDM,62401635_IP,"G070235,ACTIVA EXTENSION,7482",595.0,386.75,216.58,216.58,1
CDM,62401635_OP,"G070235,ACTIVA EXTENSION,7482",595.0,386.75,177.91,177.91,1
CDM,62401645,"G070235,ACTIVA NEUROSTIM,7426",8545.0,5554.25,200.93,8545.0,67
CDM,62401645_IP,"G070235,ACTIVA NEUROSTIM,7426",8545.0,5554.25,4682.66,4682.66,1
CDM,62401645_OP,"G070235,ACTIVA NEUROSTIM,7426",8545.0,5554.25,3708.53,3708.53,1
CDM,62401665,G100008 ACTIVA LEAD 3387,2975.0,1933.75,648.55,2975.0,59
CDM,62401665_IP,G100008 ACTIVA LEAD 3387,2975.0,1933.75,1630.3,1630.3,1
CDM,62401665_OP,G100008 ACTIVA LEAD 3387,2975.0,1933.75,1291.15,1291.15,1
CDM,62401675,G100008 ACTIVA LEAD 3391,2975.0,1933.75,648.55,2975.0,59
CDM,62401675_IP,G100008 ACTIVA LEAD 3391,2975.0,1933.75,1630.3,1630.3,1
CDM,62401675_OP,G100008 ACTIVA LEAD 3391,2975.0,1933.75,1291.15,1291.15,1
CDM,62401725,G140084 PIPELINE EMBO DEVICE,25800.0,16770.0,5624.4,25800.0,59
CDM,62401725_IP,G140084 PIPELINE EMBO DEVICE,25800.0,16770.0,14138.4,14138.4,1
CDM,62401725_OP,G140084 PIPELINE EMBO DEVICE,25800.0,16770.0,11197.2,11197.2,1
CDM,62401745,H990014 NRSTM IMP 2.4INX2.2IN ENTERRA,16900.0,10985.0,200.93,16900.0,67
CDM,62401745_IP,H990014 NRSTM IMP 2.4INX2.2IN ENTERRA,16900.0,10985.0,9261.2,9261.2,1
CDM,62401745_OP,H990014 NRSTM IMP 2.4INX2.2IN ENTERRA,16900.0,10985.0,7334.6,7334.6,1
CDM,62401755,H990014 LEAD 4351-35CM,2200.0,1430.0,200.93,2200.0,67
CDM,62401755_IP,H990014 LEAD 4351-35CM,2200.0,1430.0,1205.6,1205.6,1
CDM,62401755_OP,H990014 LEAD 4351-35CM,2200.0,1430.0,954.8,954.8,1
CDM,62401785,G150028 TREVO RETRIEVER,8971.0,5831.15,1955.68,8971.0,59
CDM,62401785_IP,G150028 TREVO RETRIEVER,8971.0,5831.15,4916.11,4916.11,1
CDM,62401785_OP,G150028 TREVO RETRIEVER,8971.0,5831.15,3893.41,3893.41,1
CDM,62401795,G150224? THORAFLEX HYBRID DEVICE,14000.0,9100.0,200.93,14000.0,67
CDM,62401795_IP,G150224? THORAFLEX HYBRID DEVICE,14000.0,9100.0,7672.0,7672.0,1
CDM,62401795_OP,G150224? THORAFLEX HYBRID DEVICE,14000.0,9100.0,6076.0,6076.0,1
CDM,62401825,"G140048 IVC FILTER, ALN",725.0,471.25,158.05,725.0,67
CDM,62401825_IP,"G140048 IVC FILTER, ALN",725.0,471.25,263.9,263.9,1
CDM,62401825_OP,"G140048 IVC FILTER, ALN",725.0,471.25,216.78,216.78,1
CDM,62401835,"G140048 IVC FILTER, OPTION",925.0,601.25,200.93,925.0,67
CDM,62401835_IP,"G140048 IVC FILTER, OPTION",925.0,601.25,336.7,336.7,1
CDM,62401835_OP,"G140048 IVC FILTER, OPTION",925.0,601.25,276.58,276.58,1
CDM,62401845,"G140048 IVC FILTER, VENATECH",1474.58,958.48,200.93,1474.58,67
CDM,62401845_IP,"G140048 IVC FILTER, VENATECH",1474.58,958.48,808.07,808.07,1
CDM,62401845_OP,"G140048 IVC FILTER, VENATECH",1474.58,958.48,639.97,639.97,1
CDM,62401855,"G140048 IVC FILTER, DENALI",750.0,487.5,163.5,750.0,67
CDM,62401855_IP,"G140048 IVC FILTER, DENALI",750.0,487.5,273.0,273.0,1
CDM,62401855_OP,"G140048 IVC FILTER, DENALI",750.0,487.5,224.25,224.25,1
CDM,62401865,"G140048 IVC FILTER, GUNTHER-TULIP",699.0,454.35,152.38,699.0,67
CDM,62401865_IP,"G140048 IVC FILTER, GUNTHER-TULIP",699.0,454.35,254.44,254.44,1
CDM,62401865_OP,"G140048 IVC FILTER, GUNTHER-TULIP",699.0,454.35,209.0,209.0,1
CDM,62401875,"G140048 IVC FILTER, OPTEASE",1250.0,812.5,200.93,1250.0,67
CDM,62401875_IP,"G140048 IVC FILTER, OPTEASE",1250.0,812.5,685.0,685.0,1
CDM,62401875_OP,"G140048 IVC FILTER, OPTEASE",1250.0,812.5,542.5,542.5,1
CDM,62401885,"G140048 IVC FILTER, TRAPTEASE",991.0,644.15,200.93,991.0,67
CDM,62401885_IP,"G140048 IVC FILTER, TRAPTEASE",991.0,644.15,360.72,360.72,1
CDM,62401885_OP,"G140048 IVC FILTER, TRAPTEASE",991.0,644.15,296.31,296.31,1
CDM,62401895,"G140048 IVC FILTER, CRUX",950.0,617.5,200.93,950.0,67
CDM,62401895_IP,"G140048 IVC FILTER, CRUX",950.0,617.5,345.8,345.8,1
CDM,62401895_OP,"G140048 IVC FILTER, CRUX",950.0,617.5,284.05,284.05,1
CDM,62401905,"G150251, VALIANT EVO",18000.0,11700.0,3924.0,18000.0,59
CDM,62401905_IP,"G150251, VALIANT EVO",18000.0,11700.0,9864.0,9864.0,1
CDM,62401905_OP,"G150251, VALIANT EVO",18000.0,11700.0,7812.0,7812.0,1
CDM,62401965,G150278 EDWARDS SAPIEN 3 NCT 03003299,30000.0,19500.0,6540.0,30000.0,59
CDM,62401965_IP,G150278 EDWARDS SAPIEN 3 NCT 03003299,30000.0,19500.0,16440.0,16440.0,1
CDM,62401965_OP,G150278 EDWARDS SAPIEN 3 NCT 03003299,30000.0,19500.0,13020.0,13020.0,1
CDM,62402005,GORE CARDIOFORM ASD OCCLUDEER,7175.0,4663.75,200.93,7175.0,67
CDM,62402005_IP,GORE CARDIOFORM ASD OCCLUDEER,7175.0,4663.75,3931.9,3931.9,1
CDM,62402005_OP,GORE CARDIOFORM ASD OCCLUDEER,7175.0,4663.75,3113.95,3113.95,1
CDM,62402015,G150028 DEFUSE 3-SOLITAIRE REVASCULARIZATION DEVICE,8320.05,5408.03,200.93,8320.05,67
CDM,62402015_IP,G150028 DEFUSE 3-SOLITAIRE REVASCULARIZATION DEVICE,8320.05,5408.03,4559.39,4559.39,1
CDM,62402015_OP,G150028 DEFUSE 3-SOLITAIRE REVASCULARIZATION DEVICE,8320.05,5408.03,3610.9,3610.9,1
CDM,62402025,G150028 DEFUSE 3-COVIDIEN MINDFRAME CAPTURE REVASCULARIZATION DE,2693.25,1750.61,587.13,2693.25,59
CDM,62402025_IP,G150028 DEFUSE 3-COVIDIEN MINDFRAME CAPTURE REVASCULARIZATION DE,2693.25,1750.61,1475.9,1475.9,1
CDM,62402025_OP,G150028 DEFUSE 3-COVIDIEN MINDFRAME CAPTURE REVASCULARIZATION DE,2693.25,1750.61,1168.87,1168.87,1
CDM,62402035,"G150028 DEFUSE 3-PENUMBRA SYSTEM SEPARATOR FLEX (026,032,041,054",2970.0,1930.5,200.93,2970.0,67
CDM,62402035_IP,"G150028 DEFUSE 3-PENUMBRA SYSTEM SEPARATOR FLEX (026,032,041,054",2970.0,1930.5,1627.56,1627.56,1
CDM,62402035_OP,"G150028 DEFUSE 3-PENUMBRA SYSTEM SEPARATOR FLEX (026,032,041,054",2970.0,1930.5,1288.98,1288.98,1
CDM,62402045,G150028 DEFUSE 3-PENUMBRA SYSTEM 110 ASPIRATION TUBING,525.0,341.25,114.45,525.0,59
CDM,62402045_IP,G150028 DEFUSE 3-PENUMBRA SYSTEM 110 ASPIRATION TUBING,525.0,341.25,191.1,191.1,1
CDM,62402045_OP,G150028 DEFUSE 3-PENUMBRA SYSTEM 110 ASPIRATION TUBING,525.0,341.25,156.98,156.98,1
CDM,62402055,G150028 DEFUSE 3-PENUMBRA SYSTEM REPERFUSION CATHETER ACE64 & AC,1417.5,921.38,309.02,1417.5,59
CDM,62402055_IP,G150028 DEFUSE 3-PENUMBRA SYSTEM REPERFUSION CATHETER ACE64 & AC,1417.5,921.38,776.79,776.79,1
CDM,62402055_OP,G150028 DEFUSE 3-PENUMBRA SYSTEM REPERFUSION CATHETER ACE64 & AC,1417.5,921.38,615.2,615.2,1
CDM,62402095,"RELAY PRO/NBS,NCT02818972, G040175",15000.0,9750.0,3270.0,15000.0,59
CDM,62402095_IP,"RELAY PRO/NBS,NCT02818972, G040175",15000.0,9750.0,8220.0,8220.0,1
CDM,62402095_OP,"RELAY PRO/NBS,NCT02818972, G040175",15000.0,9750.0,6510.0,6510.0,1
CDM,62402125,"G160226,ELEVATE,NCT02949297",9500.0,6175.0,2071.0,9500.0,59
CDM,62402125_IP,"G160226,ELEVATE,NCT02949297",9500.0,6175.0,5206.0,5206.0,1
CDM,62402125_OP,"G160226,ELEVATE,NCT02949297",9500.0,6175.0,4123.0,4123.0,1
CDM,62402130,"G140113, MOMENTUM 3 CAP, NCT028982955",87500.0,56875.0,19075.0,87500.0,59
CDM,62402130_IP,"G140113, MOMENTUM 3 CAP, NCT028982955",87500.0,56875.0,47950.0,47950.0,1
CDM,62402130_OP,"G140113, MOMENTUM 3 CAP, NCT028982955",87500.0,56875.0,37975.0,37975.0,1
CDM,62402145,"RELAY PRO-D,NCT03033043 G040175",15000.0,9750.0,3270.0,15000.0,59
CDM,62402145_IP,"RELAY PRO-D,NCT03033043 G040175",15000.0,9750.0,8220.0,8220.0,1
CDM,62402145_OP,"RELAY PRO-D,NCT03033043 G040175",15000.0,9750.0,6510.0,6510.0,1
CDM,62402155,"G130120,GORE TAG,NCT 02777593",25000.0,16250.0,5450.0,25000.0,59
CDM,62402155_IP,"G130120,GORE TAG,NCT 02777593",25000.0,16250.0,13700.0,13700.0,1
CDM,62402155_OP,"G130120,GORE TAG,NCT 02777593",25000.0,16250.0,10850.0,10850.0,1
CDM,62402195,G170020 ATTAIN STABILITY QUAD MRI SURE SCAN LV LEAD,1900.0,1235.0,200.93,1900.0,67
CDM,62402195_IP,G170020 ATTAIN STABILITY QUAD MRI SURE SCAN LV LEAD,1900.0,1235.0,1041.2,1041.2,1
CDM,62402195_OP,G170020 ATTAIN STABILITY QUAD MRI SURE SCAN LV LEAD,1900.0,1235.0,824.6,824.6,1
CDM,62402265,"G160246, ACTIVE, NCT03016975",30000.0,19500.0,6540.0,30000.0,59
CDM,62402265_IP,"G160246, ACTIVE, NCT03016975",30000.0,19500.0,16440.0,16440.0,1
CDM,62402265_OP,"G160246, ACTIVE, NCT03016975",30000.0,19500.0,13020.0,13020.0,1
CDM,62404255,"G140230,ARISE,NCT02380716",25000.0,16250.0,5450.0,25000.0,59
CDM,62404255_IP,"G140230,ARISE,NCT02380716",25000.0,16250.0,13700.0,13700.0,1
CDM,62404255_OP,"G140230,ARISE,NCT02380716",25000.0,16250.0,10850.0,10850.0,1
CDM,62404285,"G150057,GORE EXCLUDER,NCT02489539",10250.0,6662.5,2234.5,10250.0,59
CDM,62404285_IP,"G150057,GORE EXCLUDER,NCT02489539",10250.0,6662.5,5617.0,5617.0,1
CDM,62404285_OP,"G150057,GORE EXCLUDER,NCT02489539",10250.0,6662.5,4448.5,4448.5,1
CDM,62404345,G150278 EDWARDS SAPIEN 3 NCT 03003299,30000.0,19500.0,6540.0,30000.0,59
CDM,62404345_IP,G150278 EDWARDS SAPIEN 3 NCT 03003299,30000.0,19500.0,16440.0,16440.0,1
CDM,62404345_OP,G150278 EDWARDS SAPIEN 3 NCT 03003299,30000.0,19500.0,13020.0,13020.0,1
CDM,62404355,G150244 SOLVE CRT/WISE SYSTEM NCT 02922036,25000.0,16250.0,5450.0,25000.0,59
CDM,62404355_IP,G150244 SOLVE CRT/WISE SYSTEM NCT 02922036,25000.0,16250.0,13700.0,13700.0,1
CDM,62404355_OP,G150244 SOLVE CRT/WISE SYSTEM NCT 02922036,25000.0,16250.0,10850.0,10850.0,1
CDM,62404365,NSS-2 BRIDGE 4154852,595.0,386.75,129.71,595.0,59
CDM,62404365_IP,NSS-2 BRIDGE 4154852,595.0,386.75,216.58,216.58,1
CDM,62404365_OP,NSS-2 BRIDGE 4154852,595.0,386.75,177.91,177.91,1
CDM,62404375,"G160223, EMPOWER, NCT 03142152",22500.0,14625.0,4905.0,22500.0,59
CDM,62404375_IP,"G160223, EMPOWER, NCT 03142152",22500.0,14625.0,12330.0,12330.0,1
CDM,62404375_OP,"G160223, EMPOWER, NCT 03142152",22500.0,14625.0,9765.0,9765.0,1
CDM,62404425,"G140178, RESOLUTE ONYX, NCT 03647475",675.0,438.75,147.15,675.0,67
CDM,62404425_IP,"G140178, RESOLUTE ONYX, NCT 03647475",675.0,438.75,245.7,245.7,1
CDM,62404425_OP,"G140178, RESOLUTE ONYX, NCT 03647475",675.0,438.75,201.83,201.83,1
CDM,62404435,"G170258, GUIDE HF, NCT 03387813",15500.0,10075.0,200.93,15500.0,67
CDM,62404435_IP,"G170258, GUIDE HF, NCT 03387813",15500.0,10075.0,8494.0,8494.0,1
CDM,62404435_OP,"G170258, GUIDE HF, NCT 03387813",15500.0,10075.0,6727.0,6727.0,1
CDM,62404455,"G160259, EARLY TAVR, NCT 03042104",30000.0,19500.0,6540.0,30000.0,59
CDM,62404455_IP,"G160259, EARLY TAVR, NCT 03042104",30000.0,19500.0,16440.0,16440.0,1
CDM,62404455_OP,"G160259, EARLY TAVR, NCT 03042104",30000.0,19500.0,13020.0,13020.0,1
CDM,62404465,"G180045, EXCEED, NCT 03517436",32500.0,21125.0,7085.0,32500.0,59
CDM,62404465_IP,"G180045, EXCEED, NCT 03517436",32500.0,21125.0,17810.0,17810.0,1
CDM,62404465_OP,"G180045, EXCEED, NCT 03517436",32500.0,21125.0,14105.0,14105.0,1
CDM,62404475,"G160219, STOP AF FIRST, NCT 03118518",4200.0,2730.0,200.93,4200.0,67
CDM,62404475_IP,"G160219, STOP AF FIRST, NCT 03118518",4200.0,2730.0,2301.6,2301.6,1
CDM,62404475_OP,"G160219, STOP AF FIRST, NCT 03118518",4200.0,2730.0,1822.8,1822.8,1
CDM,62404485,"G180173,B,ATRICURE,NCT03732794",1700.0,1105.0,370.6,1700.0,59
CDM,62404485_IP,"G180173,B,ATRICURE,NCT03732794",1700.0,1105.0,931.6,931.6,1
CDM,62404485_OP,"G180173,B,ATRICURE,NCT03732794",1700.0,1105.0,737.8,737.8,1
CDM,62404515,"G170166, B, PASCAL MITRAL REPAIR SYS",30000.0,19500.0,6540.0,30000.0,59
CDM,62404515_IP,"G170166, B, PASCAL MITRAL REPAIR SYS",30000.0,19500.0,16440.0,16440.0,1
CDM,62404515_OP,"G170166, B, PASCAL MITRAL REPAIR SYS",30000.0,19500.0,13020.0,13020.0,1
CDM,62404525,"G180270, WATCHMAN FLX LAA CLOSURE DEVICE, NCT 03795298",18000.0,11700.0,3924.0,18000.0,59
CDM,62404525_IP,"G180270, WATCHMAN FLX LAA CLOSURE DEVICE, NCT 03795298",18000.0,11700.0,9864.0,9864.0,1
CDM,62404525_OP,"G180270, WATCHMAN FLX LAA CLOSURE DEVICE, NCT 03795298",18000.0,11700.0,7812.0,7812.0,1
CDM,62404595,"G190051, B, ACURATE, NCT 03735667",28000.0,18200.0,6104.0,28000.0,59
CDM,62404595_IP,"G190051, B, ACURATE, NCT 03735667",28000.0,18200.0,15344.0,15344.0,1
CDM,62404595_OP,"G190051, B, ACURATE, NCT 03735667",28000.0,18200.0,12152.0,12152.0,1
CDM,62404605,"G150071, B, TAMBE COMPONENT, NCT 03728985",20000.0,13000.0,4360.0,20000.0,59
CDM,62404605_IP,"G150071, B, TAMBE COMPONENT, NCT 03728985",20000.0,13000.0,10960.0,10960.0,1
CDM,62404605_OP,"G150071, B, TAMBE COMPONENT, NCT 03728985",20000.0,13000.0,8680.0,8680.0,1
CDM,62404615,"G150071, B, TAMBE CAPITATION, NCT 03728985",50000.0,32500.0,10900.0,50000.0,59
CDM,62404615_IP,"G150071, B, TAMBE CAPITATION, NCT 03728985",50000.0,32500.0,27400.0,27400.0,1
CDM,62404615_OP,"G150071, B, TAMBE CAPITATION, NCT 03728985",50000.0,32500.0,21700.0,21700.0,1
CDM,62404625,"G130005/S037, EVAS II, NCT 03298477",7000.0,4550.0,1526.0,7000.0,59
CDM,62404625_IP,"G130005/S037, EVAS II, NCT 03298477",7000.0,4550.0,3836.0,3836.0,1
CDM,62404625_OP,"G130005/S037, EVAS II, NCT 03298477",7000.0,4550.0,3038.0,3038.0,1
CDM,62404655,"EXTRAVASCULAR IMPLANTABLE CARDIOVERTER DEFIBRILLATOR, G190186, N",21710.0,14111.5,4732.78,21710.0,59
CDM,62404655_IP,"EXTRAVASCULAR IMPLANTABLE CARDIOVERTER DEFIBRILLATOR, G190186, N",21710.0,14111.5,11897.08,11897.08,1
CDM,62404655_OP,"EXTRAVASCULAR IMPLANTABLE CARDIOVERTER DEFIBRILLATOR, G190186, N",21710.0,14111.5,9422.14,9422.14,1
CDM,62404665,"EXTRAVASCULAR QUADRIPOLAR LEAD WITH SHAPED PASSIVE FIXATION, G19",6295.0,4091.75,1372.31,6295.0,59
CDM,62404665_IP,"EXTRAVASCULAR QUADRIPOLAR LEAD WITH SHAPED PASSIVE FIXATION, G19",6295.0,4091.75,3449.66,3449.66,1
CDM,62404665_OP,"EXTRAVASCULAR QUADRIPOLAR LEAD WITH SHAPED PASSIVE FIXATION, G19",6295.0,4091.75,2732.03,2732.03,1
CDM,62404675,"STERNAL TUNNELING TOOL, G190186, NCT 04060680",950.0,617.5,207.1,950.0,59
CDM,62404675_IP,"STERNAL TUNNELING TOOL, G190186, NCT 04060680",950.0,617.5,345.8,345.8,1
CDM,62404675_OP,"STERNAL TUNNELING TOOL, G190186, NCT 04060680",950.0,617.5,284.05,284.05,1
CDM,62404685,"TRANVERSE TUNNELING TOOL, G190186, NCT 04060680",950.0,617.5,207.1,950.0,59
CDM,62404685_IP,"TRANVERSE TUNNELING TOOL, G190186, NCT 04060680",950.0,617.5,345.8,345.8,1
CDM,62404685_OP,"TRANVERSE TUNNELING TOOL, G190186, NCT 04060680",950.0,617.5,284.05,284.05,1
CDM,62404695,OSCOR SAFESHEATH II HEMOSTATIC TEARAWAY INTRODUCER SYSTEM WITH I,95.0,61.75,20.71,95.0,59
CDM,62404695_IP,OSCOR SAFESHEATH II HEMOSTATIC TEARAWAY INTRODUCER SYSTEM WITH I,95.0,61.75,34.58,34.58,1
CDM,62404695_OP,OSCOR SAFESHEATH II HEMOSTATIC TEARAWAY INTRODUCER SYSTEM WITH I,95.0,61.75,28.41,28.41,1
CDM,62404715,G190060 FROZEN-AF CRYO-BALLOON CATH MODEL 2315 NCT04133168,4750.0,3087.5,200.93,4750.0,67
CDM,62404715_IP,G190060 FROZEN-AF CRYO-BALLOON CATH MODEL 2315 NCT04133168,4750.0,3087.5,2603.0,2603.0,1
CDM,62404715_OP,G190060 FROZEN-AF CRYO-BALLOON CATH MODEL 2315 NCT04133168,4750.0,3087.5,2061.5,2061.5,1
CDM,62404725,G190060 FROZEN-AF? MAPPING CATHETER MODEL 2317 NCT04133168,900.0,585.0,196.2,900.0,67
CDM,62404725_IP,G190060 FROZEN-AF? MAPPING CATHETER MODEL 2317 NCT04133168,900.0,585.0,327.6,327.6,1
CDM,62404725_OP,G190060 FROZEN-AF? MAPPING CATHETER MODEL 2317 NCT04133168,900.0,585.0,269.1,269.1,1
CDM,62404735,G190060 FROZEN-AF STEERABLE SHEATH MODEL 2316 NCT04133168,1250.0,812.5,200.93,1250.0,67
CDM,62404735_IP,G190060 FROZEN-AF STEERABLE SHEATH MODEL 2316 NCT04133168,1250.0,812.5,685.0,685.0,1
CDM,62404735_OP,G190060 FROZEN-AF STEERABLE SHEATH MODEL 2316 NCT04133168,1250.0,812.5,542.5,542.5,1
CDM,62404745,G190060 FROZEN-AF CRYO-CABLE? MODEL 2318 NCT04133168,150.0,97.5,32.7,150.0,59
CDM,62404745_IP,G190060 FROZEN-AF CRYO-CABLE? MODEL 2318 NCT04133168,150.0,97.5,54.6,54.6,1
CDM,62404745_OP,G190060 FROZEN-AF CRYO-CABLE? MODEL 2318 NCT04133168,150.0,97.5,44.85,44.85,1
CDM,62404755,G190060 FROZEN-AF CATH EXTEN CABLE MODEL 2319 NCT04133168,300.0,195.0,65.4,300.0,59
CDM,62404755_IP,G190060 FROZEN-AF CATH EXTEN CABLE MODEL 2319 NCT04133168,300.0,195.0,109.2,109.2,1
CDM,62404755_OP,G190060 FROZEN-AF CATH EXTEN CABLE MODEL 2319 NCT04133168,300.0,195.0,89.7,89.7,1
CDM,62404765,G190060 FROZEN-AF EP ELECTRIC CABLE MODEL 2320 NCT04133168,300.0,195.0,65.4,300.0,59
CDM,62404765_IP,G190060 FROZEN-AF EP ELECTRIC CABLE MODEL 2320 NCT04133168,300.0,195.0,109.2,109.2,1
CDM,62404765_OP,G190060 FROZEN-AF EP ELECTRIC CABLE MODEL 2320 NCT04133168,300.0,195.0,89.7,89.7,1
CDM,62404775,ALIVE G160013/A001 NCT02931240,25000.0,16250.0,5450.0,25000.0,59
CDM,62404775_IP,ALIVE G160013/A001 NCT02931240,25000.0,16250.0,13700.0,13700.0,1
CDM,62404775_OP,ALIVE G160013/A001 NCT02931240,25000.0,16250.0,10850.0,10850.0,1
CDM,62404785,CHEVAS G130005/S045 NCT04252573,18700.0,12155.0,4076.6,18700.0,59
CDM,62404785_IP,CHEVAS G130005/S045 NCT04252573,18700.0,12155.0,10247.6,10247.6,1
CDM,62404785_OP,CHEVAS G130005/S045 NCT04252573,18700.0,12155.0,8115.8,8115.8,1
CDM,62404795,"TRILUMINATE, NCT03904147, G170118",30000.0,19500.0,6540.0,30000.0,59
CDM,62404795_IP,"TRILUMINATE, NCT03904147, G170118",30000.0,19500.0,16440.0,16440.0,1
CDM,62404795_OP,"TRILUMINATE, NCT03904147, G170118",30000.0,19500.0,13020.0,13020.0,1
CDM,62404805,"G140240,TENDYNE MITRAL VLV SYS, NCT03433274",30000.0,19500.0,6540.0,30000.0,59
CDM,62404805_IP,"G140240,TENDYNE MITRAL VLV SYS, NCT03433274",30000.0,19500.0,16440.0,16440.0,1
CDM,62404805_OP,"G140240,TENDYNE MITRAL VLV SYS, NCT03433274",30000.0,19500.0,13020.0,13020.0,1
CDM,62404895,"G190319 , ONYX 18/34 LIQUID, NCT 04402632",4800.0,3120.0,1046.4,4800.0,59
CDM,62404895_IP,"G190319 , ONYX 18/34 LIQUID, NCT 04402632",4800.0,3120.0,2630.4,2630.4,1
CDM,62404895_OP,"G190319 , ONYX 18/34 LIQUID, NCT 04402632",4800.0,3120.0,2083.2,2083.2,1
CDM,62404915,"G200053, EXCELLENT; EBMBOTRAP II, NCT 03685578",19250.0,12512.5,200.93,19250.0,67
CDM,62404915_IP,"G200053, EXCELLENT; EBMBOTRAP II, NCT 03685578",19250.0,12512.5,10549.0,10549.0,1
CDM,62404915_OP,"G200053, EXCELLENT; EBMBOTRAP II, NCT 03685578",19250.0,12512.5,8354.5,8354.5,1
CDM,62404925,"G200053, EXCELLENT; EMBOTRAP III, NCT 03685578",20265.0,13172.25,200.93,20265.0,67
CDM,62404925_IP,"G200053, EXCELLENT; EMBOTRAP III, NCT 03685578",20265.0,13172.25,11105.22,11105.22,1
CDM,62404925_OP,"G200053, EXCELLENT; EMBOTRAP III, NCT 03685578",20265.0,13172.25,8795.01,8795.01,1
CDM,62404945,"G190069,  EMBOTRAP II, NCT 04167527",19250.0,12512.5,200.93,19250.0,67
CDM,62404945_IP,"G190069,  EMBOTRAP II, NCT 04167527",19250.0,12512.5,10549.0,10549.0,1
CDM,62404945_OP,"G190069,  EMBOTRAP II, NCT 04167527",19250.0,12512.5,8354.5,8354.5,1
CDM,62404955,"G190069, EMBOTRAP III, NCT 04167527",20265.0,13172.25,200.93,20265.0,67
CDM,62404955_IP,"G190069, EMBOTRAP III, NCT 04167527",20265.0,13172.25,11105.22,11105.22,1
CDM,62404955_OP,"G190069, EMBOTRAP III, NCT 04167527",20265.0,13172.25,8795.01,8795.01,1
CDM,62404985,TRISCEND II  G190289/S013  NCT04482062  20-1084,38000.0,24700.0,8284.0,38000.0,59
CDM,62404985_IP,TRISCEND II  G190289/S013  NCT04482062  20-1084,38000.0,24700.0,20824.0,20824.0,1
CDM,62404985_OP,TRISCEND II  G190289/S013  NCT04482062  20-1084,38000.0,24700.0,16492.0,16492.0,1
CDM,62404995,G130138 LEADLESS PACEMAKER NCT 04559945,9500.0,6175.0,200.93,9500.0,67
CDM,62404995_IP,G130138 LEADLESS PACEMAKER NCT 04559945,9500.0,6175.0,5206.0,5206.0,1
CDM,62404995_OP,G130138 LEADLESS PACEMAKER NCT 04559945,9500.0,6175.0,4123.0,4123.0,1
CDM,62405005,MEDTRONIC PVAC GOLD CATHETER PULSED AF-PIVOTAL TRIAL IDE G190272,8600.0,5590.0,200.93,8600.0,67
CDM,62405005_IP,MEDTRONIC PVAC GOLD CATHETER PULSED AF-PIVOTAL TRIAL IDE G190272,8600.0,5590.0,4712.8,4712.8,1
CDM,62405005_OP,MEDTRONIC PVAC GOLD CATHETER PULSED AF-PIVOTAL TRIAL IDE G190272,8600.0,5590.0,3732.4,3732.4,1
CDM,62405015,"CHAMPION AF NCT04394546, G200106",18000.0,11700.0,3924.0,18000.0,59
CDM,62405015_IP,"CHAMPION AF NCT04394546, G200106",18000.0,11700.0,9864.0,9864.0,1
CDM,62405015_OP,"CHAMPION AF NCT04394546, G200106",18000.0,11700.0,7812.0,7812.0,1
CDM,62405035,"G200342, B-SAFER GORETAG/MAIN BODY, NCT04747626",12095.0,7861.75,2636.71,12095.0,59
CDM,62405035_IP,"G200342, B-SAFER GORETAG/MAIN BODY, NCT04747626",12095.0,7861.75,6628.06,6628.06,1
CDM,62405035_OP,"G200342, B-SAFER GORETAG/MAIN BODY, NCT04747626",12095.0,7861.75,5249.23,5249.23,1
CDM,62405045,"G200342, B-SAFER TERUMO RELAY/MAIN BODY, NCT04747626??",10000.0,6500.0,2180.0,10000.0,59
CDM,62405045_IP,"G200342, B-SAFER TERUMO RELAY/MAIN BODY, NCT04747626??",10000.0,6500.0,5480.0,5480.0,1
CDM,62405045_OP,"G200342, B-SAFER TERUMO RELAY/MAIN BODY, NCT04747626??",10000.0,6500.0,4340.0,4340.0,1
CDM,62405055,"G200342, B-SAFER MEDTRONIC ENDURANT/MAIN BODY, NCT04747626??",9975.0,6483.75,2174.55,9975.0,59
CDM,62405055_IP,"G200342, B-SAFER MEDTRONIC ENDURANT/MAIN BODY, NCT04747626??",9975.0,6483.75,5466.3,5466.3,1
CDM,62405055_OP,"G200342, B-SAFER MEDTRONIC ENDURANT/MAIN BODY, NCT04747626??",9975.0,6483.75,4329.15,4329.15,1
CDM,62405065,"G200342, B-SAFER GORETAG/DISTAL, NCT04747626",12095.0,7861.75,2636.71,12095.0,59
CDM,62405065_IP,"G200342, B-SAFER GORETAG/DISTAL, NCT04747626",12095.0,7861.75,6628.06,6628.06,1
CDM,62405065_OP,"G200342, B-SAFER GORETAG/DISTAL, NCT04747626",12095.0,7861.75,5249.23,5249.23,1
CDM,62405075,"G200342, B-SAFER TERUMO RELAY/DISTAL, NCT04747626",10000.0,6500.0,2180.0,10000.0,59
CDM,62405075_IP,"G200342, B-SAFER TERUMO RELAY/DISTAL, NCT04747626",10000.0,6500.0,5480.0,5480.0,1
CDM,62405075_OP,"G200342, B-SAFER TERUMO RELAY/DISTAL, NCT04747626",10000.0,6500.0,4340.0,4340.0,1
CDM,62405085,"G200342, B-SAFER MEDTRONIC ENDURANT/DISTAL, NCT04747626",9975.0,6483.75,2174.55,9975.0,59
CDM,62405085_IP,"G200342, B-SAFER MEDTRONIC ENDURANT/DISTAL, NCT04747626",9975.0,6483.75,5466.3,5466.3,1
CDM,62405085_OP,"G200342, B-SAFER MEDTRONIC ENDURANT/DISTAL, NCT04747626",9975.0,6483.75,4329.15,4329.15,1
CDM,62405095,"G200342, B-SAFER ZENITH ALPHA/DISTAL, NCT04747626",9785.0,6360.25,2133.13,9785.0,59
CDM,62405095_IP,"G200342, B-SAFER ZENITH ALPHA/DISTAL, NCT04747626",9785.0,6360.25,5362.18,5362.18,1
CDM,62405095_OP,"G200342, B-SAFER ZENITH ALPHA/DISTAL, NCT04747626",9785.0,6360.25,4246.69,4246.69,1
CDM,62405105,"G200342, B-SAFER GORE VIABAHN 6/7/8, NCT04747626?",2675.0,1738.75,583.15,2675.0,59
CDM,62405105_IP,"G200342, B-SAFER GORE VIABAHN 6/7/8, NCT04747626?",2675.0,1738.75,1465.9,1465.9,1
CDM,62405105_OP,"G200342, B-SAFER GORE VIABAHN 6/7/8, NCT04747626?",2675.0,1738.75,1160.95,1160.95,1
CDM,62405115,"G200342, B-SAFER GORE VIABAHN 10/11/13, NCT04747626??",3050.0,1982.5,664.9,3050.0,59
CDM,62405115_IP,"G200342, B-SAFER GORE VIABAHN 10/11/13, NCT04747626??",3050.0,1982.5,1671.4,1671.4,1
CDM,62405115_OP,"G200342, B-SAFER GORE VIABAHN 10/11/13, NCT04747626??",3050.0,1982.5,1323.7,1323.7,1
CDM,62405125,"G200342, B-SAFER GORE VIABAHN VBX 19CM, NCT04747626?",2325.0,1511.25,506.85,2325.0,59
CDM,62405125_IP,"G200342, B-SAFER GORE VIABAHN VBX 19CM, NCT04747626?",2325.0,1511.25,1274.1,1274.1,1
CDM,62405125_OP,"G200342, B-SAFER GORE VIABAHN VBX 19CM, NCT04747626?",2325.0,1511.25,1009.05,1009.05,1
CDM,62405135,"G200342, B-SAFER GORE VIABAHN VBX, NCT04747626",2650.0,1722.5,577.7,2650.0,59
CDM,62405135_IP,"G200342, B-SAFER GORE VIABAHN VBX, NCT04747626",2650.0,1722.5,1452.2,1452.2,1
CDM,62405135_OP,"G200342, B-SAFER GORE VIABAHN VBX, NCT04747626",2650.0,1722.5,1150.1,1150.1,1
CDM,62405145,"G200342, B-SAFER ATRIUM ICAST, NCT04747626?",2000.0,1300.0,436.0,2000.0,59
CDM,62405145_IP,"G200342, B-SAFER ATRIUM ICAST, NCT04747626?",2000.0,1300.0,1096.0,1096.0,1
CDM,62405145_OP,"G200342, B-SAFER ATRIUM ICAST, NCT04747626?",2000.0,1300.0,868.0,868.0,1
CDM,62405155,"G200342, B-SAFER BARD FLUENCY PLUS, NCT04747626??",1950.0,1267.5,425.1,1950.0,59
CDM,62405155_IP,"G200342, B-SAFER BARD FLUENCY PLUS, NCT04747626??",1950.0,1267.5,1068.6,1068.6,1
CDM,62405155_OP,"G200342, B-SAFER BARD FLUENCY PLUS, NCT04747626??",1950.0,1267.5,846.3,846.3,1
CDM,62405215,INTELLANAV CATHETER G200215 NEWTON AF NCT04580914,3400.0,2210.0,200.93,3400.0,67
CDM,62405215_IP,INTELLANAV CATHETER G200215 NEWTON AF NCT04580914,3400.0,2210.0,1863.2,1863.2,1
CDM,62405215_OP,INTELLANAV CATHETER G200215 NEWTON AF NCT04580914,3400.0,2210.0,1475.6,1475.6,1
CDM,62405225,INTELLANAV CATH CABLE G200215 NEWTON AF NCT04580914,490.0,318.5,106.82,490.0,67
CDM,62405225_IP,INTELLANAV CATH CABLE G200215 NEWTON AF NCT04580914,490.0,318.5,178.36,178.36,1
CDM,62405225_OP,INTELLANAV CATH CABLE G200215 NEWTON AF NCT04580914,490.0,318.5,146.51,146.51,1
CDM,62405235,"G200275, EXPAND TAVR I EFS, NCT04639258",32500.0,21125.0,7085.0,32500.0,59
CDM,62405235_IP,"G200275, EXPAND TAVR I EFS, NCT04639258",32500.0,21125.0,17810.0,17810.0,1
CDM,62405235_OP,"G200275, EXPAND TAVR I EFS, NCT04639258",32500.0,21125.0,14105.0,14105.0,1
CDM,62405245,G190285 CATALYST?NCT04226547?AMPLATZER AMULET LAA OCCLUDER,12000.0,7800.0,200.93,12000.0,67
CDM,62405245_IP,G190285 CATALYST?NCT04226547?AMPLATZER AMULET LAA OCCLUDER,12000.0,7800.0,6576.0,6576.0,1
CDM,62405245_OP,G190285 CATALYST?NCT04226547?AMPLATZER AMULET LAA OCCLUDER,12000.0,7800.0,5208.0,5208.0,1
CDM,62405255,G170152 ENCIRCLE NCT04153292,35000.0,22750.0,7630.0,35000.0,59
CDM,62405255_IP,G170152 ENCIRCLE NCT04153292,35000.0,22750.0,19180.0,19180.0,1
CDM,62405255_OP,G170152 ENCIRCLE NCT04153292,35000.0,22750.0,15190.0,15190.0,1
CDM,62405265,"G200067, EDWARDS HARPOON MV REPAIR SYSTEM, NCT04375332",25000.0,16250.0,5450.0,25000.0,59
CDM,62405265_IP,"G200067, EDWARDS HARPOON MV REPAIR SYSTEM, NCT04375332",25000.0,16250.0,13700.0,13700.0,1
CDM,62405265_OP,"G200067, EDWARDS HARPOON MV REPAIR SYSTEM, NCT04375332",25000.0,16250.0,10850.0,10850.0,1
CDM,62405295,G190185 CGUARD CAROTID STENT SYSTEM,1800.0,1170.0,200.93,1800.0,67
CDM,62405295_IP,G190185 CGUARD CAROTID STENT SYSTEM,1800.0,1170.0,986.4,986.4,1
CDM,62405295_OP,G190185 CGUARD CAROTID STENT SYSTEM,1800.0,1170.0,781.2,781.2,1
CDM,62405305,"G190185, C-GUARDIANS, NCT04900844",1800.0,1170.0,392.4,1800.0,59
CDM,62405305_IP,"G190185, C-GUARDIANS, NCT04900844",1800.0,1170.0,986.4,986.4,1
CDM,62405305_OP,"G190185, C-GUARDIANS, NCT04900844",1800.0,1170.0,781.2,781.2,1
CDM,62405315,"G200007, PERFORMANCE II, NCT04201132",3900.0,2535.0,850.2,3900.0,59
CDM,62405315_IP,"G200007, PERFORMANCE II, NCT04201132",3900.0,2535.0,2137.2,2137.2,1
CDM,62405315_OP,"G200007, PERFORMANCE II, NCT04201132",3900.0,2535.0,1692.6,1692.6,1
CDM,62405325,"G200342, B-SAFER ZENITH DISSEC/DISTAL NCT04747626",9900.0,6435.0,2158.2,9900.0,59
CDM,62405325_IP,"G200342, B-SAFER ZENITH DISSEC/DISTAL NCT04747626",9900.0,6435.0,5425.2,5425.2,1
CDM,62405325_OP,"G200342, B-SAFER ZENITH DISSEC/DISTAL NCT04747626",9900.0,6435.0,4296.6,4296.6,1
CDM,62405335,"G190069, ENDOVASCULAR THERAPY FOR LOW NIHSS ISCHEMIC STROKES (EN",5500.0,3575.0,1199.0,5500.0,59
CDM,62405335_IP,"G190069, ENDOVASCULAR THERAPY FOR LOW NIHSS ISCHEMIC STROKES (EN",5500.0,3575.0,3014.0,3014.0,1
CDM,62405335_OP,"G190069, ENDOVASCULAR THERAPY FOR LOW NIHSS ISCHEMIC STROKES (EN",5500.0,3575.0,2387.0,2387.0,1
CDM,62405345,"G190212, REPAIR MR, NCT04198870",30000.0,19500.0,6540.0,30000.0,59
CDM,62405345_IP,"G190212, REPAIR MR, NCT04198870",30000.0,19500.0,16440.0,16440.0,1
CDM,62405345_OP,"G190212, REPAIR MR, NCT04198870",30000.0,19500.0,13020.0,13020.0,1
CDM,62405365,G200097 PARADIGM NCT04489823,10000.0,6500.0,200.93,10000.0,67
CDM,62405365_IP,G200097 PARADIGM NCT04489823,10000.0,6500.0,5480.0,5480.0,1
CDM,62405365_OP,G200097 PARADIGM NCT04489823,10000.0,6500.0,4340.0,4340.0,1
CDM,62405375,G210150 NEXT GENERATION ICD LEAD LEADR NCT04863664,4062.0,2640.3,200.93,4062.0,67
CDM,62405375_IP,G210150 NEXT GENERATION ICD LEAD LEADR NCT04863664,4062.0,2640.3,2225.98,2225.98,1
CDM,62405375_OP,G210150 NEXT GENERATION ICD LEAD LEADR NCT04863664,4062.0,2640.3,1762.91,1762.91,1
CDM,62405385,G200319 21-528 MODULARATP NCT04798768  - RETRIEVAL CATHETER,3500.0,2275.0,763.0,3500.0,59
CDM,62405385_IP,G200319 21-528 MODULARATP NCT04798768  - RETRIEVAL CATHETER,3500.0,2275.0,1918.0,1918.0,1
CDM,62405385_OP,G200319 21-528 MODULARATP NCT04798768  - RETRIEVAL CATHETER,3500.0,2275.0,1519.0,1519.0,1
CDM,62405395,G200319 21-528 MODULARATP NCT04798768 - EMBLEM SICD,21000.0,13650.0,200.93,21000.0,67
CDM,62405395_IP,G200319 21-528 MODULARATP NCT04798768 - EMBLEM SICD,21000.0,13650.0,11508.0,11508.0,1
CDM,62405395_OP,G200319 21-528 MODULARATP NCT04798768 - EMBLEM SICD,21000.0,13650.0,9114.0,9114.0,1
CDM,62405405,G200319 21-528 MODULARATP NCT04798768 -  EMPOWER LEADLESS PACEMA,8750.0,5687.5,200.93,8750.0,67
CDM,62405405_IP,G200319 21-528 MODULARATP NCT04798768 -  EMPOWER LEADLESS PACEMA,8750.0,5687.5,4795.0,4795.0,1
CDM,62405405_OP,G200319 21-528 MODULARATP NCT04798768 -  EMPOWER LEADLESS PACEMA,8750.0,5687.5,3797.5,3797.5,1
CDM,62405425,G200342 BARD COVERA STENT  NCT04747626,2225.0,1446.25,200.93,2225.0,67
CDM,62405425_IP,G200342 BARD COVERA STENT  NCT04747626,2225.0,1446.25,1219.3,1219.3,1
CDM,62405425_OP,G200342 BARD COVERA STENT  NCT04747626,2225.0,1446.25,965.65,965.65,1
CDM,62405435,G200342 BARD COVERA FLARED STENT NCT04747626,2300.0,1495.0,200.93,2300.0,67
CDM,62405435_IP,G200342 BARD COVERA FLARED STENT NCT04747626,2300.0,1495.0,1260.4,1260.4,1
CDM,62405435_OP,G200342 BARD COVERA FLARED STENT NCT04747626,2300.0,1495.0,998.2,998.2,1
CDM,62405455,G210214 MITRACLIP (PRIMARY) NCT05051033,30000.0,19500.0,6540.0,30000.0,59
CDM,62405455_IP,G210214 MITRACLIP (PRIMARY) NCT05051033,30000.0,19500.0,16440.0,16440.0,1
CDM,62405455_OP,G210214 MITRACLIP (PRIMARY) NCT05051033,30000.0,19500.0,13020.0,13020.0,1
CDM,62405475,G150035 ALIGN-AR NCT04415047,37500.0,24375.0,8175.0,37500.0,59
CDM,62405475_IP,G150035 ALIGN-AR NCT04415047,37500.0,24375.0,19180.0,19180.0,1
CDM,62405475_OP,G150035 ALIGN-AR NCT04415047,37500.0,24375.0,15190.0,15190.0,1
CDM,62405495,BB16057 CARDIAMP CAS001 NCT02438306,10000.0,6500.0,2180.0,10000.0,59
CDM,62405495_IP,BB16057 CARDIAMP CAS001 NCT02438306,10000.0,6500.0,5480.0,5480.0,1
CDM,62405495_OP,BB16057 CARDIAMP CAS001 NCT02438306,10000.0,6500.0,4340.0,4340.0,1
CDM,62405505,G160196 COSIRA II NEOVASC REDUCER SYSTEM NCT05102019,15000.0,9750.0,3270.0,15000.0,59
CDM,62405505_IP,G160196 COSIRA II NEOVASC REDUCER SYSTEM NCT05102019,15000.0,9750.0,8220.0,8220.0,1
CDM,62405505_OP,G160196 COSIRA II NEOVASC REDUCER SYSTEM NCT05102019,15000.0,9750.0,6510.0,6510.0,1
CDM,62405515,NALU NEUROSTIMULATION SYSTEM FOR PERIPHERAL NERVE STIMULATION (P,8500.0,5525.0,1853.0,8500.0,59
CDM,62405525,G210150 DELIVERY CATHETER (MEDTRONIC) NCT04863664,325.0,211.25,70.85,325.0,67
CDM,62405525_IP,G210150 DELIVERY CATHETER (MEDTRONIC) NCT04863664,325.0,211.25,118.3,118.3,1
CDM,62405525_OP,G210150 DELIVERY CATHETER (MEDTRONIC) NCT04863664,325.0,211.25,97.18,97.18,1
CDM,62405535,G210150 SELECTSITE DEFLECTABLE CATHETER NCT04863664,350.0,227.5,76.3,350.0,67
CDM,62405535_IP,G210150 SELECTSITE DEFLECTABLE CATHETER NCT04863664,350.0,227.5,127.4,127.4,1
CDM,62405535_OP,G210150 SELECTSITE DEFLECTABLE CATHETER NCT04863664,350.0,227.5,104.65,104.65,1
CDM,62405545,G210150 ATTAIN COMMAND SUREVALVE GUIDE CATHETER NCT04863664,212.0,137.8,46.22,232.66,67
CDM,62405545_IP,G210150 ATTAIN COMMAND SUREVALVE GUIDE CATHETER NCT04863664,212.0,137.8,77.17,77.17,1
CDM,62405545_OP,G210150 ATTAIN COMMAND SUREVALVE GUIDE CATHETER NCT04863664,212.0,137.8,63.39,63.39,1
CDM,62405555,G210150 ATTAIN SELECT II SUREVALVE DELIVERY CATHETER SYSTEM NCT0,161.0,104.65,35.1,232.66,67
CDM,62405555_IP,G210150 ATTAIN SELECT II SUREVALVE DELIVERY CATHETER SYSTEM NCT0,161.0,104.65,58.6,58.6,1
CDM,62405555_OP,G210150 ATTAIN SELECT II SUREVALVE DELIVERY CATHETER SYSTEM NCT0,161.0,104.65,48.14,48.14,1
CDM,62405575,G200042 AIM HIGHER OPTIMIZER SMART MINI SYSTEM NCT05064709,26000.0,16900.0,200.93,26000.0,67
CDM,62405575_IP,G200042 AIM HIGHER OPTIMIZER SMART MINI SYSTEM NCT05064709,26000.0,16900.0,14248.0,14248.0,1
CDM,62405575_OP,G200042 AIM HIGHER OPTIMIZER SMART MINI SYSTEM NCT05064709,26000.0,16900.0,11284.0,11284.0,1
CDM,62405665,G190263 EMBOLISE NCT04402632,2500.0,1625.0,545.0,2500.0,59
CDM,62405665_IP,G190263 EMBOLISE NCT04402632,2500.0,1625.0,1370.0,1370.0,1
CDM,62405665_OP,G190263 EMBOLISE NCT04402632,2500.0,1625.0,1085.0,1085.0,1
CDM,62405675,G190084 EVOLVE NCT04195568,14000.0,9100.0,3052.0,14000.0,59
CDM,62405675_IP,G190084 EVOLVE NCT04195568,14000.0,9100.0,7672.0,7672.0,1
CDM,62405675_OP,G190084 EVOLVE NCT04195568,14000.0,9100.0,6076.0,6076.0,1
CDM,62405685,G190319 EMBOLISE  NCT04402632,2500.0,1625.0,545.0,2500.0,59
CDM,62405685_IP,G190319 EMBOLISE  NCT04402632,2500.0,1625.0,1370.0,1370.0,1
CDM,62405685_OP,G190319 EMBOLISE  NCT04402632,2500.0,1625.0,1085.0,1085.0,1
CDM,62405795,G200267; PERIMODIOLAR IMPLANT PERFORMANCE (PIP); NCT04741009,13000.0,8450.0,2834.0,13000.0,59
CDM,62405795_IP,G200267; PERIMODIOLAR IMPLANT PERFORMANCE (PIP); NCT04741009,13000.0,8450.0,7124.0,7124.0,1
CDM,62405795_OP,G200267; PERIMODIOLAR IMPLANT PERFORMANCE (PIP); NCT04741009,13000.0,8450.0,5642.0,5642.0,1
CDM,62405825,G190319 EMBOLISE NCT04402632,2500.0,1625.0,545.0,2500.0,59
CDM,62405825_IP,G190319 EMBOLISE NCT04402632,2500.0,1625.0,1370.0,1370.0,1
CDM,62405825_OP,G190319 EMBOLISE NCT04402632,2500.0,1625.0,1085.0,1085.0,1
CDM,62405835,FARAWAVE PFA BALLOON CATH ADVANTAGE AF NCT05443594 G220079,6500.0,4225.0,200.93,6500.0,67
CDM,62405835_IP,FARAWAVE PFA BALLOON CATH ADVANTAGE AF NCT05443594 G220079,6500.0,4225.0,3562.0,3562.0,1
CDM,62405835_OP,FARAWAVE PFA BALLOON CATH ADVANTAGE AF NCT05443594 G220079,6500.0,4225.0,2821.0,2821.0,1
CDM,62405845,FARADRIVE STEERABLE SHEATH ADVANTAGE AF NCT05443594 G220079,1400.0,910.0,200.93,1400.0,67
CDM,62405845_IP,FARADRIVE STEERABLE SHEATH ADVANTAGE AF NCT05443594 G220079,1400.0,910.0,767.2,767.2,1
CDM,62405845_OP,FARADRIVE STEERABLE SHEATH ADVANTAGE AF NCT05443594 G220079,1400.0,910.0,607.6,607.6,1
CDM,62405855,FARASTAR CATH CONNECTION CABLE ADVANTAGE AF NCT05443594 G220079,850.0,552.5,185.3,850.0,67
CDM,62405855_IP,FARASTAR CATH CONNECTION CABLE ADVANTAGE AF NCT05443594 G220079,850.0,552.5,309.4,309.4,1
CDM,62405855_OP,FARASTAR CATH CONNECTION CABLE ADVANTAGE AF NCT05443594 G220079,850.0,552.5,254.15,254.15,1
CDM,62405865,FARAPOINT PFA POINT CATH ADVANTAGE AF NCT05443594 G220079,10560.0,6864.0,200.93,10560.0,67
CDM,62405865_IP,FARAPOINT PFA POINT CATH ADVANTAGE AF NCT05443594 G220079,10560.0,6864.0,5786.88,5786.88,1
CDM,62405865_OP,FARAPOINT PFA POINT CATH ADVANTAGE AF NCT05443594 G220079,10560.0,6864.0,4583.04,4583.04,1
CDM,62405875,G210285 EXPAND TAVR II NCT05149755,32500.0,21125.0,7085.0,32500.0,59
CDM,62405875_IP,G210285 EXPAND TAVR II NCT05149755,32500.0,21125.0,17810.0,17810.0,1
CDM,62405875_OP,G210285 EXPAND TAVR II NCT05149755,32500.0,21125.0,14105.0,14105.0,1
CDM,62405885,G210327 EDWARDS SAPIEN X4 TRANSCATHETER HEART VALVE SYSTEM NCT05,30000.0,19500.0,6540.0,30000.0,59
CDM,62405885_IP,G210327 EDWARDS SAPIEN X4 TRANSCATHETER HEART VALVE SYSTEM NCT05,30000.0,19500.0,16440.0,16440.0,1
CDM,62405885_OP,G210327 EDWARDS SAPIEN X4 TRANSCATHETER HEART VALVE SYSTEM NCT05,30000.0,19500.0,13020.0,13020.0,1
CDM,62405905,G210218 PERSEVERE NCT05174767,22000.0,14300.0,4796.0,22000.0,59
CDM,62405905_IP,G210218 PERSEVERE NCT05174767,22000.0,14300.0,12056.0,12056.0,1
CDM,62405905_OP,G210218 PERSEVERE NCT05174767,22000.0,14300.0,9548.0,9548.0,1
CDM,62406005,G220275 DURAVR?NCT05182307,25000.0,16250.0,5450.0,25000.0,59
CDM,62406005_IP,G220275 DURAVR?NCT05182307,25000.0,16250.0,13700.0,13700.0,1
CDM,62406005_OP,G220275 DURAVR?NCT05182307,25000.0,16250.0,10850.0,10850.0,1
CDM,62406015,G210214 PASCAL CLASP MITRAL PROLAPSE NCT05051033,30600.0,19890.0,6670.8,30600.0,59
CDM,62406015_IP,G210214 PASCAL CLASP MITRAL PROLAPSE NCT05051033,30600.0,19890.0,16768.8,16768.8,1
CDM,62406015_OP,G210214 PASCAL CLASP MITRAL PROLAPSE NCT05051033,30600.0,19890.0,13280.4,13280.4,1
CDM,62406035,G160013 ALIVE-EA NCT05710042,25000.0,16250.0,5450.0,25000.0,59
CDM,62406035_IP,G160013 ALIVE-EA NCT05710042,25000.0,16250.0,13700.0,13700.0,1
CDM,62406035_OP,G160013 ALIVE-EA NCT05710042,25000.0,16250.0,10850.0,10850.0,1
CDM,62406105,G210308 APEXAV NCT05318092,9000.0,5850.0,200.93,9000.0,67
CDM,62406105_IP,G210308 APEXAV NCT05318092,9000.0,5850.0,4932.0,4932.0,1
CDM,62406105_OP,G210308 APEXAV NCT05318092,9000.0,5850.0,3906.0,3906.0,1
CDM,62406155,G230034 ARISE II ASCENDING STENT NCT05800743,24000.0,15600.0,5232.0,24000.0,59
CDM,62406155_IP,G230034 ARISE II ASCENDING STENT NCT05800743,24000.0,15600.0,13152.0,13152.0,1
CDM,62406155_OP,G230034 ARISE II ASCENDING STENT NCT05800743,24000.0,15600.0,10416.0,10416.0,1
CDM,62406165,G230034 ARISE II AORTIC COMPONENT NCT05800743,27500.0,17875.0,5995.0,27500.0,59
CDM,62406165_IP,G230034 ARISE II AORTIC COMPONENT NCT05800743,27500.0,17875.0,15070.0,15070.0,1
CDM,62406165_OP,G230034 ARISE II AORTIC COMPONENT NCT05800743,27500.0,17875.0,11935.0,11935.0,1
CDM,62406175,G230034 ARISE II SIDE BRANCH COMP NCT05800743,5500.0,3575.0,1199.0,5500.0,59
CDM,62406175_IP,G230034 ARISE II SIDE BRANCH COMP NCT05800743,5500.0,3575.0,3014.0,3014.0,1
CDM,62406175_OP,G230034 ARISE II SIDE BRANCH COMP NCT05800743,5500.0,3575.0,2387.0,2387.0,1
CDM,62406185,G230034 ARISE II TRI-LOBE BLLN CATH NCT05800743,600.0,390.0,130.8,600.0,67
CDM,62406185_IP,G230034 ARISE II TRI-LOBE BLLN CATH NCT05800743,600.0,390.0,218.4,218.4,1
CDM,62406185_OP,G230034 ARISE II TRI-LOBE BLLN CATH NCT05800743,600.0,390.0,179.4,179.4,1
CDM,62406195,G230034 ARISE II CAP PRIMARY ARM NCT05800743,50000.0,32500.0,10900.0,50000.0,59
CDM,62406195_IP,G230034 ARISE II CAP PRIMARY ARM NCT05800743,50000.0,32500.0,27400.0,27400.0,1
CDM,62406195_OP,G230034 ARISE II CAP PRIMARY ARM NCT05800743,50000.0,32500.0,21700.0,21700.0,1
CDM,62406205,G230034 ARISE II CAP SECONDARY ARM NCT05800743,75000.0,48750.0,16350.0,75000.0,59
CDM,62406205_IP,G230034 ARISE II CAP SECONDARY ARM NCT05800743,75000.0,48750.0,41100.0,41100.0,1
CDM,62406205_OP,G230034 ARISE II CAP SECONDARY ARM NCT05800743,75000.0,48750.0,32550.0,32550.0,1
CDM,62406215,G210059 IMPELLA IMPACT NCT05529654,35000.0,22750.0,7630.0,35000.0,59
CDM,62406215_IP,G210059 IMPELLA IMPACT NCT05529654,35000.0,22750.0,19180.0,19180.0,1
CDM,62406215_OP,G210059 IMPELLA IMPACT NCT05529654,35000.0,22750.0,15190.0,15190.0,1
CDM,62406225,G220208 PULSAR NCT05462145,10000.0,6500.0,200.93,10000.0,67
CDM,62406225_IP,G220208 PULSAR NCT05462145,10000.0,6500.0,5480.0,5480.0,1
CDM,62406225_OP,G220208 PULSAR NCT05462145,10000.0,6500.0,4340.0,4340.0,1
CDM,62406235,G230050 LEFT VS LFT RCT NCT05650658,397.0,258.05,86.55,397.0,67
CDM,62406235_IP,G230050 LEFT VS LFT RCT NCT05650658,397.0,258.05,144.51,144.51,1
CDM,62406235_OP,G230050 LEFT VS LFT RCT NCT05650658,397.0,258.05,118.7,118.7,1
CDM,62406245,G230249 AVANT GUARD FARAWAVE ? PFA CATHETER ? NCT06096337,6450.0,4192.5,200.93,6450.0,67
CDM,62406245_IP,G230249 AVANT GUARD FARAWAVE ? PFA CATHETER ? NCT06096337,6450.0,4192.5,3534.6,3534.6,1
CDM,62406245_OP,G230249 AVANT GUARD FARAWAVE ? PFA CATHETER ? NCT06096337,6450.0,4192.5,2799.3,2799.3,1
CDM,62406255,G230249 AVANT GUARD FARAWAVE 2.0? NAV PFA CATHETER ? NCT06096337,8250.0,5362.5,200.93,8250.0,67
CDM,62406255_IP,G230249 AVANT GUARD FARAWAVE 2.0? NAV PFA CATHETER ? NCT06096337,8250.0,5362.5,4521.0,4521.0,1
CDM,62406255_OP,G230249 AVANT GUARD FARAWAVE 2.0? NAV PFA CATHETER ? NCT06096337,8250.0,5362.5,3580.5,3580.5,1
CDM,62406265,G230249 AVANT GUARD FARADRIVE? STEERABLE SHEATH ? NCT06096337,1300.0,845.0,200.93,1300.0,67
CDM,62406265_IP,G230249 AVANT GUARD FARADRIVE? STEERABLE SHEATH ? NCT06096337,1300.0,845.0,712.4,712.4,1
CDM,62406265_OP,G230249 AVANT GUARD FARADRIVE? STEERABLE SHEATH ? NCT06096337,1300.0,845.0,564.2,564.2,1
CDM,62406275,G230249 AVANT GUARD FARASTAR ? CATH CONNECTION CABLE ? NCT060963,200.0,130.0,43.6,232.66,67
CDM,62406275_IP,G230249 AVANT GUARD FARASTAR ? CATH CONNECTION CABLE ? NCT060963,200.0,130.0,72.8,72.8,1
CDM,62406275_OP,G230249 AVANT GUARD FARASTAR ? CATH CONNECTION CABLE ? NCT060963,200.0,130.0,59.8,59.8,1
CDM,62406285,G230249 AVANT GUARD FARASTAR GEN2 ?CATH CONNECTION CABLE ? NCT06,600.0,390.0,130.8,600.0,67
CDM,62406285_IP,G230249 AVANT GUARD FARASTAR GEN2 ?CATH CONNECTION CABLE ? NCT06,600.0,390.0,218.4,218.4,1
CDM,62406285_OP,G230249 AVANT GUARD FARASTAR GEN2 ?CATH CONNECTION CABLE ? NCT06,600.0,390.0,179.4,179.4,1
CDM,62406295,G230015 PERFORMANCE III NEUROGUARD IEP NCT05845710,3900.0,2535.0,850.2,3900.0,59
CDM,62406295_IP,G230015 PERFORMANCE III NEUROGUARD IEP NCT05845710,3900.0,2535.0,2137.2,2137.2,1
CDM,62406295_OP,G230015 PERFORMANCE III NEUROGUARD IEP NCT05845710,3900.0,2535.0,1692.6,1692.6,1
CDM,62406305,G230015 PERFORMANCE III NEUROGUARD ACCESS KIT NCT05845710,2500.0,1625.0,545.0,2500.0,59
CDM,62406305_IP,G230015 PERFORMANCE III NEUROGUARD ACCESS KIT NCT05845710,2500.0,1625.0,1370.0,1370.0,1
CDM,62406305_OP,G230015 PERFORMANCE III NEUROGUARD ACCESS KIT NCT05845710,2500.0,1625.0,1085.0,1085.0,1
CDM,62406335,G210110 ZENITH FEN PLUS ZFEN NCT04875429,14500.0,9425.0,3161.0,14500.0,59
CDM,62406335_IP,G210110 ZENITH FEN PLUS ZFEN NCT04875429,14500.0,9425.0,7946.0,7946.0,1
CDM,62406335_OP,G210110 ZENITH FEN PLUS ZFEN NCT04875429,14500.0,9425.0,6293.0,6293.0,1
CDM,62406345,G210110 ZENITH FEN PLUS UNIBODY NCT04875429,3623.0,2354.95,789.81,3623.0,59
CDM,62406345_IP,G210110 ZENITH FEN PLUS UNIBODY NCT04875429,3623.0,2354.95,1985.4,1985.4,1
CDM,62406345_OP,G210110 ZENITH FEN PLUS UNIBODY NCT04875429,3623.0,2354.95,1572.38,1572.38,1
CDM,62406355,G210110 ZENITH FEN PLUS BGUS NCT04875429,1600.0,1040.0,348.8,1600.0,59
CDM,62406355_IP,G210110 ZENITH FEN PLUS BGUS NCT04875429,1600.0,1040.0,876.8,876.8,1
CDM,62406355_OP,G210110 ZENITH FEN PLUS BGUS NCT04875429,1600.0,1040.0,694.4,694.4,1
CDM,62406375,G230146 ENVISION NAVITOR TAVR SYS NCT05932615,26250.0,17062.5,5722.5,26250.0,59
CDM,62406375_IP,G230146 ENVISION NAVITOR TAVR SYS NCT05932615,26250.0,17062.5,14385.0,14385.0,1
CDM,62406375_OP,G230146 ENVISION NAVITOR TAVR SYS NCT05932615,26250.0,17062.5,11392.5,11392.5,1
CDM,62406385,G230146 ENVISION NAVITOR LOAD SYS NCT05932615,1500.0,975.0,327.0,1500.0,59
CDM,62406385_IP,G230146 ENVISION NAVITOR LOAD SYS NCT05932615,1500.0,975.0,822.0,822.0,1
CDM,62406385_OP,G230146 ENVISION NAVITOR LOAD SYS NCT05932615,1500.0,975.0,651.0,651.0,1
CDM,62406395,G230146 ENVISION FLEXNAV DELIV SYS NCT05932615,500.0,325.0,109.0,500.0,59
CDM,62406395_IP,G230146 ENVISION FLEXNAV DELIV SYS NCT05932615,500.0,325.0,182.0,182.0,1
CDM,62406395_OP,G230146 ENVISION FLEXNAV DELIV SYS NCT05932615,500.0,325.0,149.5,149.5,1
CDM,62406435,G210327 ALLIANCE AVIV NCT 05172973,30000.0,19500.0,6540.0,30000.0,59
CDM,62406435_IP,G210327 ALLIANCE AVIV NCT 05172973,30000.0,19500.0,16440.0,16440.0,1
CDM,62406435_OP,G210327 ALLIANCE AVIV NCT 05172973,30000.0,19500.0,13020.0,13020.0,1
CDM,62406445,"G240065,TRICAV-I,NCT06137807",48500.0,31525.0,10573.0,48500.0,59
CDM,62406445_IP,"G240065,TRICAV-I,NCT06137807",48500.0,31525.0,26578.0,26578.0,1
CDM,62406445_OP,"G240065,TRICAV-I,NCT06137807",48500.0,31525.0,21049.0,21049.0,1
CDM,62406505,G230050 LEFT VS LEFT RCT ULTIPACE NCT05650658,250.0,162.5,54.5,250.0,67
CDM,62406505_IP,G230050 LEFT VS LEFT RCT ULTIPACE NCT05650658,250.0,162.5,91.0,91.0,1
CDM,62406505_OP,G230050 LEFT VS LEFT RCT ULTIPACE NCT05650658,250.0,162.5,74.75,74.75,1
CDM,62406535,G230043 LAAOS4 NCT05963698,17000.0,11050.0,3706.0,17000.0,59
CDM,62406535_IP,G230043 LAAOS4 NCT05963698,17000.0,11050.0,9316.0,9316.0,1
CDM,62406535_OP,G230043 LAAOS4 NCT05963698,17000.0,11050.0,7378.0,7378.0,1
CDM,62406555_IP,G230299 DH3620-C ADMIRE STUDY NCT06456554,,,2886.86,2886.86,1
CDM,62406555_OP,G230299 DH3620-C ADMIRE STUDY NCT06456554,,,2286.31,2286.31,1
CDM,62406565_IP,G230299 DH620-C ADMIRE STUDY NCT06456554,,,2874.81,2874.81,1
CDM,62406565_OP,G230299 DH620-C ADMIRE STUDY NCT06456554,,,2276.76,2276.76,1
CDM,62406575_IP,G230299 UTD1620-C ADMIRE STUDY NCT06456554,,,3106.06,3106.06,1
CDM,62406575_OP,G230299 UTD1620-C ADMIRE STUDY NCT06456554,,,2459.91,2459.91,1
CDM,62406585_IP,G230299 DPI1620-C ADMIRE STUDY NCT06456554,,,2881.38,2881.38,1
CDM,62406585_OP,G230299 DPI1620-C ADMIRE STUDY NCT06456554,,,2281.97,2281.97,1
CDM,62406605,G200342 B-SAFER 5MMX2.5CM VIABAHN STENT,2755.0,1790.75,200.93,2755.0,67
CDM,62406615,G200342 B-SAFER 5MMX29MM VBX VIABAHN STENT,2730.0,1774.5,200.93,2730.0,67
CDM,62406625,G240099 ENTERA SYS 37800,10750.0,6987.5,200.93,10750.0,67
CDM,62406635,G240099 ENTERA LEAD 4531,2625.0,1706.25,200.93,2625.0,67
CDM,62406645,G240020 INNOVATE BRIOVAD IMPLANT KIT NCT06310031,110238.0,71654.7,24031.88,110238.0,59
CDM,62406655,G240020  INNOVATE BRIOVAD PT SUPPORT KIT NCT06310031,20147.0,13095.55,4392.05,20147.0,59
CDM,62406665,G240020  INNOVATE BRIOVAD CONTROLLER W/BATTERY NCT06310031,5853.0,3804.45,1275.95,5853.0,59
CDM,62406675,G240020  INNOVATE BRIOVAD MONITOR KIT NCT06310031,5296.0,3442.4,1154.53,5296.0,59
CDM,62406685,G240242 MIRUS SIEGEL TAVR EFT NCT06680427,35000.0,22750.0,7630.0,35000.0,59
CDM,62406695,G240242 MIRUS SIEGEL TAVR EFT CATHLAB NCT06680427,35000.0,22750.0,7630.0,35000.0,59
CDM,62406705,G240240 SPHERE-9 VT MAP ABL CATH NCT06703489,11000.0,7150.0,200.93,11000.0,67
CDM,62406715,G240240 SPHERE-9 VT CABLE NCT06703489,2000.0,1300.0,436.0,2000.0,59
CDM,62406725,G240240 SPHERE-9 VT RF TUBING NCT06703489,250.0,162.5,54.5,250.0,59
CDM,62406765,G240240 SPHERE-9 VT LOC REF PATCH KIT NCT06703489,312.5,203.13,68.13,312.5,59
CDM,62406775,G240020  INNOVATE BRIOVAD BATTERY KIT NCT06310031,2693.0,1750.45,587.07,2693.0,59
CDM,62406825,G200342 B-SAFER GORE TAG TBE SIDE BRANCH,7800.0,5070.0,1700.4,7800.0,59
CDM,62406835,G240119 TEAM-HF HEARTMATE 3 LVAD NCT06526195,97200.0,63180.0,21189.6,97200.0,59
CDM,62406845,G240119 TEAM-HF CARDIOMEMS NCT06526195,17500.0,11375.0,3815.0,17500.0,59
CDM,62406875,G220093 LEAPPS TRIAL ACH1 NCT05478304,1500.0,975.0,327.0,1500.0,59
CDM,62406885,G220093 LEAPPS TRIAL ACH2 NCT05478304,1150.0,747.5,250.7,1150.0,59
CDM,62406895,G220093 LEAPPS TRIAL ACHV NCT05478304,1800.0,1170.0,392.4,1800.0,59
CDM,62406905,G220093 LEAPPS TRIAL PRO1 NCT05478304,2700.0,1755.0,588.6,2700.0,59
CDM,62406915,G220093 LEAPPS TRIAL PRO2 NCT05478304,3650.0,2372.5,795.7,3650.0,59
CDM,62406925,G220093 LEAPPS TRIAL PROV NCT05478304,5500.0,3575.0,1199.0,5500.0,59
CDM,62406935,G240233 PMEG TREO BIFUR MAIN BODY NCT06657794,7946.0,5164.9,1732.23,7946.0,59
CDM,62406945,G240233 PMEG TREO LEG EXTENSION NCT06657794,4271.0,2776.15,931.08,4271.0,59
CDM,62406955,G240233 PMEG TREO CUFF NCT06657794,4496.0,2922.4,980.13,4496.0,59
CDM,62406965,"G240233 PMEG ICAST STENT 5,6,7X16 NCT06657794",2445.0,1589.25,533.01,2445.0,59
CDM,62406975,"G240233 PMEG ICAST STENT 5,6,7X22 NCT06657794",2545.0,1654.25,554.81,2545.0,59
CDM,62406985,G240233 PMEG ICAST STENT 8X38 NCT06657794,2645.0,1719.25,576.61,2645.0,59
CDM,62406995,G240233 PMEG 4-0 PROLENE SUT NCT06657794,9.46,6.15,2.06,9.46,59
CDM,62407005,G240233 PMEG ENDOVASC SNARE NCT06657794,290.0,188.5,63.22,290.0,59
CDM,62407035,G190128 ALTA VALVE SYSTEM NCT06465745,50000.0,32500.0,10900.0,50000.0,59
CDM,62407065,G250008 ARISE III ASCENDING STENT GRAFT NCT06827990,24000.0,15600.0,5232.0,24000.0,59
CDM,62407075,G250008 ARISE III CAPITATION NCT06827990,50000.0,32500.0,10900.0,50000.0,59
CDM,62407125,G250152 ARTIZEN II NCT07089576,35000.0,22750.0,7630.0,35000.0,59
CDM,62407145,G250226 OPTIMIZE NCT07187115,990.0,643.5,215.82,990.0,59
CDM,62407205,G240279 BOXX-NOAF ISOLATOR SYN ENCOMP CLAMP NCT06989775,5400.0,3510.0,1177.2,5400.0,59
CDM,62407215,G240279 BOXX-NOAF ATRICLIP ACH2 NCT06989775,1150.0,747.5,250.7,1150.0,59
CDM,62407225,G240279 BOXX-NOAF ATRICLIP ACHV NCT06989775,1800.0,1170.0,392.4,1800.0,59
CDM,62407235,G240279 BOXX-NOAF ATRICLIP ACHM NCT06989775,2250.0,1462.5,490.5,2250.0,59
CDM,62407245,G240279 BOXX-NOAF ATRICLIP PRO1 NCT06989775,2700.0,1755.0,588.6,2700.0,59
CDM,62407255,G240279 BOXX-NOAF ATRICLIP PRO2 NCT06989775,3650.0,2372.5,795.7,3650.0,59
CDM,62407265,G240279 BOXX-NOAF ATRICLIP PROV NCT06989775,5500.0,3575.0,1199.0,5500.0,59
CDM,63001OH,LAM W/O FACETEC FORAMOT/DSC 1/2 VRT SGM CRV,7044.0,4578.6,1.1,20863.78,144
CDM,63003OH,LAMINECTOMY W/O FFD 1/2 VERT SEG THORACIC,7096.0,4612.4,1.1,20863.78,144
CDM,63005OH,LAMINECTOMY W/O FFD 1/2 VERT SEG LUMBAR,6572.0,4271.8,1.1,20863.78,144
CDM,63011OH,LAMINECTOMY W/O FFD 1/2 VERT SEG SACRAL,6364.0,4136.6,1.1,20863.78,144
CDM,63012OH,LAMINECTOMY W/RMVL ABNORMAL FACETS LUMBAR,6740.0,4381.0,1.1,20863.78,144
CDM,63015OH,LAMINECTOMY W/O FFD > 2 VERT SEG CERVICAL,8340.0,5421.0,1.1,20863.78,144
CDM,63016OH,LAMINECTOMY W/O FFD > 2 VERT SEG THORACIC,8812.0,5727.8,1.1,20863.78,144
CDM,63017OH,LAMINECTOMY W/O FFD > 2 VERT SEG LUMBAR,6932.0,4505.8,1.1,20863.78,144
CDM,63020OH,LAMNOTMY INCL W/DCMPRSN NRV ROOT 1 INTRSPC CERVC,5964.0,3876.6,1.1,20863.78,144
CDM,63030OH,LAMNOTMY INCL W/DCMPRSN NRV ROOT 1 INTRSPC LUMBR,4800.0,3120.0,1.1,20863.78,144
CDM,63032OH,LAMOT DCMPRN NRV RT RPR ANULR DFCT 1NTRSPC LMBR,1100.0,715.0,1.1,1100.0,106
CDM,63035OH,LAMNOTMY W/DCMPRSN NRV EACH ADDL CRVCL/LMBR,1544.0,1003.6,1.1,1544.0,144
CDM,63040OH,LAMOT PRTL FFD EXC DISC REEXPL 1 NTRSPC CERVICAL,8124.0,5280.6,1.1,20863.78,144
CDM,63042OH,LAMOT PRTL FFD EXC DISC REEXPL 1 NTRSPC LUMBAR,7504.0,4877.6,1.1,20863.78,144
CDM,63043OH,LAMOT PRTL FFD EXC DISC REEXPL 1 NTRSPC EA CRV,4346.0,2824.9,1.1,4346.0,106
CDM,63044OH,LAMOT W/PRTL FFD HRNA8 REEXPL 1 NTRSPC EA LMBR,3744.0,2433.6,1.1,3744.0,106
CDM,63045OH,LAM FACETECTOMY & FORAMOTOMY 1 VRT SGM CERVICAL,7180.0,4667.0,1.1,20863.78,144
CDM,63046OH,LAM FACETECTOMY & FORAMOTOMY 1 VRT SGM THORACIC,7590.0,4933.5,1.1,20863.78,144
CDM,63047OH,LAM FACETECTOMY & FORAMOTOMY 1 VRT SGM LUMBAR,6763.0,4395.95,1.1,20863.78,144
CDM,63048OH,LAM FACETECTOMY&FORAMOT 1 VRT SGM EA ADDL SGM,1527.0,992.55,1.1,1527.0,144
CDM,63050OH,LAMOP CERVICAL W/DCMPRN SPI CORD 2/> VERT SEG,9684.0,6294.6,1.1,9684.0,144
CDM,63051OH,LAMOPLASTY CERVICAL DCMPRN CORD 2/> SEG RCNSTJ,11224.0,7295.6,1.1,11224.0,144
CDM,63052OH,LAM FACETEC/FORAMOT DRG ARTHRD LUMBAR 1 VRT SGM,1700.0,1105.0,1.1,1700.0,142
CDM,63053OH,LAM FACETEC/FORAMOT DRG ARTHRD LMBR EA ADDL SGM,1512.0,982.8,1.1,1512.0,142
CDM,63055OH,TRANSPEDICULAR DCMPRN SPINAL CORD 1 SEG THORACIC,9420.0,6123.0,1.1,20863.78,144
CDM,63056OH,TRANSPEDICULAR DCMPRN SPINAL CORD 1 SEG LUMBAR,8744.0,5683.6,1.1,20863.78,144
CDM,63057OH,TRANSPEDICULAR DCMPRN 1 SEG EA THORACIC/LUMBAR,2100.0,1365.0,1.1,2100.0,144
CDM,63064OH,COSTOVERTEBRAL DCMPRN SPINAL CORD THORACIC 1 SEG,10488.0,6817.2,1.1,20863.78,144
CDM,63066OH,COSTOVERTEBRAL DCMPRN SPINE CORD THORACIC EA SEG,1304.0,847.6,1.1,1304.0,144
CDM,63075OH,DISCECTOMY ANT DCMPRN CORD CERVICAL 1 NTRSPC,7840.0,5096.0,1.1,20863.78,144
CDM,63076OH,DISCECTOMY ANT DCMPRN CORD CERVICAL EA NTRSPC,1616.0,1050.4,1.1,1616.0,144
CDM,63077OH,DISCECTOMY ANT DCMPRN CORD THORACIC 1 NTRSPC,9152.0,5948.8,1.1,9152.0,144
CDM,63078OH,DISCECTOMY ANT DCMPRN CORD THORACIC EA NTRSPC,1312.0,852.8,1.1,1312.0,144
CDM,63081OH,VERTEBRAL CORPECTOMY ANT DCMPRN CERVICAL 1 SEG,10440.0,6786.0,1.1,10440.0,144
CDM,63082OH,VERTEBRAL CORPECTOMY DCMPRN CERVICAL EA SEG,1744.0,1133.6,1.1,1744.0,144
CDM,63085OH,VERTEBRAL CORPECTOMY DCMPRN CORD THORACIC 1 SEG,11788.0,7662.2,1.1,11788.0,144
CDM,63086OH,VERTEBRAL CORPECTOMY DCMPRN CORD THORACIC EA SEG,1276.0,829.4,1.1,1276.0,144
CDM,63087OH,VCRPEC THORACOLMBR DCMPRN LWR THRC/LMBR 1 SEG,15012.0,9757.8,1.1,15012.0,144
CDM,63088OH,VCRPEC THORACOLMBR DCMPRN LWR THRC/LMBR EA SEG,1728.0,1123.2,1.1,1728.0,144
CDM,63090OH,VCRPEC TRANSPRTL/RPR DCMPRN THRC LMBR/SAC 1 SEG,12372.0,8041.8,1.1,12372.0,144
CDM,63091OH,VCRPEC TRANSPRTL/RPR DCMPRN THRC LMBR/SAC EA SEG,1212.0,787.8,1.1,1212.0,144
CDM,63101OH,VERTEB CORPECT LAT XTRCAVITARY DCMPRN THRC 1 SEG,13640.0,8866.0,1.1,13640.0,144
CDM,63102OH,VERTEB CORPECT LAT XTRCAVITARY DCMPRN LMBR 1 SEG,15004.0,9752.6,1.1,15004.0,144
CDM,63103OH,VCRPEC LAT XTRCAVITARY DCMPRN THRC/LMBR EA SEG,2121.0,1378.65,1.1,2121.0,144
CDM,63170OH,LAM W/MYELOTOMY CERVICAL/THORACIC/THORACOLUMBAR,8884.0,5774.6,1.1,8884.0,144
CDM,63172OH,LAM W/DRG INTRMEDULLARY CYST/SYRINX SUBARACHNOID,7904.0,5137.6,1.1,7904.0,144
CDM,63173OH,LAM W/DRG INTRMEDULRY CYST/SYRINX PRTL/PLEURAL,9724.0,6320.6,1.1,9724.0,144
CDM,63190OH,LAMINECTOMY W/RHIZOTOMY > 2 SEGMENTS,7556.0,4911.4,1.1,7556.0,144
CDM,63197OH,LAM W/CORDOTOMY SCTJ SPINOTHALAMIC TRC 1STG THRC,9632.0,6260.8,1.1,9632.0,144
CDM,63200OH,LAMINECTOMY RELEASE TETHERED SPINAL CORD LUMBAR,9434.0,6132.1,1.1,9434.0,144
CDM,63250OH,LAM EXC/OCCLUSION AVM SPINAL CORD CERVICAL,17544.0,11403.6,1.1,17544.0,144
CDM,63251OH,LAM EXC/OCCLUSION AVM SPINAL CORD THORACIC,17856.0,11606.4,1.1,17856.0,144
CDM,63252OH,LAM EXC/OCCLUSION AVM SPI CORD THORACOLUMBAR,17852.0,11603.8,1.1,17852.0,144
CDM,63265OH,LAM EXC/EVAC ISPI LES OTH/THN NEO XDRL CERVICAL,9528.0,6193.2,1.1,20863.78,144
CDM,63266OH,LAM EXC/EVAC ISPI LES OTH/THN NEO XDRL THORACIC,9872.0,6416.8,1.1,20863.78,144
CDM,63267OH,LAM EXC/EVAC ISPI LESION OTH/THN NEO XDRL LUMBAR,7780.0,5057.0,1.1,20863.78,144
CDM,63268OH,LAM EXC/EVAC ISPI LES OTH/THN NEO XDRL SACRAL,8008.0,5205.2,1.1,20863.78,144
CDM,63270OH,LAM EXC ISPI LES OTH/THN NEO IDRL CERVICAL,11920.0,7748.0,1.1,11920.0,144
CDM,63271OH,LAM EXC ISPI LES OTH/THN NEO IDRL THORACIC,11968.0,7779.2,1.1,11968.0,144
CDM,63272OH,LAM EXC ISPI LES OTH/THN NEO IDRL LUMBAR,11000.0,7150.0,1.1,11000.0,144
CDM,63273OH,LAM EXC ISPI LES OTH/THN NEO IDRL SACRAL,10588.0,6882.2,1.1,10588.0,144
CDM,63275OH,LAMINECTOMY BX/EXC ISPI NEO XDRL CERVICAL,10344.0,6723.6,1.1,10344.0,144
CDM,63276OH,LAMINECTOMY BX/EXC ISPI NEO XDRL THORACIC,10276.0,6679.4,1.1,10276.0,144
CDM,63277OH,LAMINECTOMY BX/EXC ISPI NEO XDRL LUMBAR,8956.0,5821.4,1.1,8956.0,144
CDM,63278OH,LAMINECTOMY BX/EXC ISPI NEO XDRL SACRAL,8848.0,5751.2,1.1,8848.0,144
CDM,63280OH,LAM BX/EXC ISPI NEO IDRL XMED CERVICAL,12116.0,7875.4,1.1,12116.0,144
CDM,63281OH,LAM BX/EXC ISPI NEO IDRL XMED THORACIC,11996.0,7797.4,1.1,11996.0,144
CDM,63282OH,LAM BX/EXC ISPI NEO IDRL XMED LUMBAR,11260.0,7319.0,1.1,11260.0,144
CDM,63283OH,LAM BX/EXC ISPI NEO IDRL SACRAL,10704.0,6957.6,1.1,10704.0,144
CDM,63285OH,LAM BX/EXC ISPI NEO IDRL IMED CERVICAL,15220.0,9893.0,1.1,15220.0,144
CDM,63286OH,LAM BX/EXC ISPI NEO IDRL IMED THORACIC,15048.0,9781.2,1.1,15048.0,144
CDM,63287OH,LAM BX/EXC ISPI NEO IDRL IMED THORACOLMBR,16032.0,10420.8,1.1,16032.0,144
CDM,63290OH,LAM BX/EXC ISPI NEO XDRL-IDRL LES ANY LVL,16328.0,10613.2,1.1,16328.0,144
CDM,63295OH,OSTPL RCNSTJ DORSAL SPI ELMNTS FLWG ISPI PX,2100.0,1365.0,1.1,2100.0,144
CDM,63300OH,VCRPEC LES 1 SGM XDRL CERVICAL,10720.0,6968.0,1.1,10720.0,144
CDM,63301OH,VCRPEC LES 1 SGM XDRL THORACIC TTHRC,12628.0,8208.2,1.1,12628.0,144
CDM,63303OH,VCRPEC LES 1 SEG XDRL LMBR/SAC TRANSPRTL/RPR,13420.0,8723.0,1.1,13420.0,144
CDM,63304OH,VERTEBRAL CORPECTOMY EXC LES 1 SEG IDRL CERVICAL,13540.0,8801.0,1.1,13540.0,144
CDM,63305OH,VERTEBRAL CORPECTOMY LES 1 SEG IDRL THRC TTHRC,14496.0,9422.4,1.1,14496.0,144
CDM,63307OH,VCRPEC LES 1 SEG IDRL LMBR/SAC TRANSPRTL/RPR,13984.0,9089.6,1.1,13984.0,144
CDM,63308OH,VERTEBRAL CORPECTOMY EXC INDRL LES EACH SEG,2096.0,1362.4,1.1,2096.0,144
CDM,63600005,RABIES IG INJECTION,2000.0,1300.0,279.94,3329.32,93
CDM,63600015,RABIES IG 150U/ML IM 2ML,2397.0,1558.05,352.44,3329.32,93
CDM,63600025,"RSV-IG, 50 MG-SYNAGIS",4967.0,3228.55,339.68,4967.0,93
CDM,63600030,RHO(D) IMMUNE GLOBULIN INJ,425.8,276.77,92.82,425.8,75
CDM,63600035,D5/0.9NS IV 500ML,16.96,11.02,2.29,16.96,75
CDM,63600050,D5W 500ML,7.5,4.88,1.64,11.17,75
CDM,63600065,PEDI IM 3 DOSE HEP-A VACCINE,88.0,57.2,9.99,88.0,74
CDM,63600070,HEPARIN 1000UNIT/0.9NS 500ML,8.0,5.2,0.31,11.17,75
CDM,63600080,"ISOVUE 300, 100 ML, PER ML",3.48,2.26,0.26,28.93,72
CDM,63600090,"OMNIPAQUE 350, 50 ML, PER ML",3.48,2.26,0.26,28.93,72
CDM,63600105,"IM 3 DOSE HIB, PRP-OMP",108.0,70.2,9.99,108.0,75
CDM,63600115,"HIB, PRP-T",47.0,30.55,9.99,47.0,75
CDM,63600125,H PAPILLOMA VACC 3 DOSE IM,442.0,287.3,16.84,442.0,74
CDM,63600135,FLU VACCINE NO PRESERV 6-35M,22.0,14.3,4.8,27.69,74
CDM,63600145,FLU VACCINE NO PRESERV 0.25 ML,74.7,48.56,9.99,74.7,75
CDM,63600160,W IUD COPPER CONTRACEPTIVE,830.0,539.5,141.84,3114.48,75
CDM,63600165,IIV3 VACCINE SPLIT VIRUS 0.5 ML DOSAGE IM USE,69.7,45.31,9.99,69.7,75
CDM,63600175,FLUMIST VACC NSPR 0.2ML,62.9,40.89,9.99,62.9,75
CDM,63600185,FLU VACC PRSV FREE INC ANTIG,203.3,132.15,9.99,203.3,75
CDM,63600190,W GRFT TISSUE ALLODERM PER SQCM,5356.0,3481.4,66.89,5356.0,86
CDM,63600205,PREVNAR13 PNEUMOCOCCAL VACC IM,814.0,529.1,16.84,814.0,75
CDM,63600210,OMNIPAQUE 350 / 500 ML PER ML,3.48,2.26,0.26,28.93,72
CDM,63600215,"RABIES VACCINE, IM",1491.0,969.15,16.84,1491.0,93
CDM,63600220,W KIT REFILL LIORESAL INTRATHCL,774.15,503.2,174.58,840.33,93
CDM,63600225,ROTOVIRUS VAC ORAL USE,309.0,200.85,16.84,309.0,75
CDM,63600230,ABOBOTULINUMTOXINA 5 UNITS,21.97,14.28,5.27,840.33,93
CDM,63600235,ROTAVIRUS VAC 2 DOSE ORAL,402.0,261.3,9.99,402.0,75
CDM,63600240,BOTULINUM TOX B INJ PER 100U,40.65,26.42,9.76,840.33,93
CDM,63600245,TYPHOID VACC CAP EC,115.0,74.75,9.99,194.04,75
CDM,63600250,INCOBOTULINUMTOXIN A 1 UNIT,15.31,9.95,3.67,840.33,93
CDM,63600255,TYPHOID VI 25MCG/0.5ML SYG,441.0,286.65,9.99,441.0,75
CDM,63600260,CALCIUM GLUCONATE INJ TO 10 ML,7.5,4.88,1.64,11.17,74
CDM,63600265,DTAP-IPV VACC 4-6 YR IM,210.0,136.5,9.99,328.03,75
CDM,63600270,CALCITONIN SALMON 400 UNITS,245.75,159.74,53.57,3329.32,83
CDM,63600275,"DTAP-HIB-IP VACCINE, IM",370.0,240.5,9.99,370.0,75
CDM,63600280,LEUCOVORIN CALCIUM PER 50 MG,67.75,44.04,6.72,67.75,67
CDM,63600285,DTAP IMMUNIZATION,102.0,66.3,9.99,102.0,75
CDM,63600290,INJ MEPIVACAINE PER 10 ML,9.0,5.85,1.96,11.17,75
CDM,63600295,TETANUS-DIPHTHERIA TOXOID PED,222.0,144.3,9.99,222.0,75
CDM,63600300,ANCEF PER 500 MG,17.0,11.05,1.45,17.0,75
CDM,63600320,CEFEPIME HCL INJ 500 MG,36.65,23.82,1.52,36.65,75
CDM,63600330,CEFTRIAXONE PER 250 MG,6.4,4.16,0.81,11.17,75
CDM,63600345,MUMPS RUBELLA MEA,336.0,218.4,9.99,336.0,75
CDM,63600350,CELESTONE IM 3MG,12.81,8.33,2.79,16.15,75
CDM,63600355,MMRV VACCINE,992.0,644.8,9.99,992.0,76
CDM,63600360,"ISOVUE 370, 100 ML, PER ML",3.48,2.26,0.26,28.93,72
CDM,63600365,INACTIVE POLIO VACCINE,151.0,98.15,9.99,151.0,75
CDM,63600370,"OMNIPAQUE 300, 50 ML, PER ML",3.48,2.26,0.26,28.93,72
CDM,63600375,TD VACCINE NO PRSRV >= 7 IM,141.0,91.65,9.99,141.0,75
CDM,63600380,"CEFTAZIDIME, PER 500 MG, INJ",77.26,50.22,2.57,77.26,75
CDM,63600385,TDAP VACCINE >7 IM,170.0,110.5,9.99,170.0,75
CDM,63600390,"OMNIPAQUE 350, 100 ML, PER ML",3.1,2.02,0.26,28.93,72
CDM,63600395,VARICELLA VIRUS VACCINE LIVE,657.0,427.05,16.84,657.0,75
CDM,63600400,CONTR LOCM 300-349 MG/ML,3.48,2.26,0.26,28.93,72
CDM,63600405,"YELLOW FEVER VACCINE, SQ LIVE",648.0,421.2,16.84,648.0,75
CDM,63600420,XIAFLEX PER VIAL,10058.88,6538.27,68.97,10058.88,93
CDM,63600425,PEDIARIX,312.0,202.8,9.99,312.0,75
CDM,63600430,XIAFLEX INJ 0.01 MG,145.79,94.76,34.99,4103.47,93
CDM,63600435,PNEUMOCOCCAL VACCINE 23V,423.0,274.95,9.99,423.0,75
CDM,63600445,MENOMUNE VAC,344.0,223.6,16.84,344.0,74
CDM,63600450,CONTR LOCM 300-349 MG/ML,3.48,2.26,0.26,28.93,72
CDM,63600455,"MENINGOCOCCAL VACCINE, IM",565.0,367.25,16.84,565.0,75
CDM,63600460,CORTICOTROPIN INJ UP TO 40 U,396.99,258.04,86.54,9569.16,74
CDM,63600470,COSYNTROPIN PER 0.25 MG,90.0,58.5,19.62,90.0,75
CDM,63600475,ZOSTAVAX VACC INJ,804.0,522.6,16.84,804.0,74
CDM,63600485,IM DIALYSIS/IMC HEP-B 1ML,258.0,167.7,16.84,340.02,75
CDM,63600490,"DARBEPOETIN ALFA, NON-ESRD",26.82,17.43,2.9,840.33,93
CDM,63600495,IM ADOLES 2D HEP-B VACCINE,139.0,90.35,9.99,161.57,75
CDM,63600505,HEP B/PEDIATRIC/ADOLESCEN,104.0,67.6,9.99,104.0,75
CDM,63600510,"EPOETIN ALFA, NON-ESRD",45.53,29.59,7.53,232.34,93
CDM,63600515,IMMUNIZATION HEPATITIS,258.0,167.7,9.99,258.0,75
CDM,63600520,"ISOVUE 300, 50 ML, PER ML",3.48,2.26,0.26,28.93,72
CDM,63600525,"HEPATITIS B VACCINE, IMMUNOSUP",230.0,149.5,16.84,302.61,75
CDM,63600530,DECITABINE INJECTION,164.56,106.96,1.13,412.04,75
CDM,63600535,IM HEPB-HIB VACCINE,132.0,85.8,9.99,132.0,74
CDM,63600550,INJ DENOSUMAB 1 MG,107.2,69.68,25.19,1559.81,93
CDM,63600555,IOTHALAMATE MEGLUMINE INJ USP 60%,36.1,23.47,0.45,36.1,74
CDM,63600560,"DEPO-MEDROL, 20 MG INJ",6.0,3.9,1.31,19.45,74
CDM,63600570,METHLYPREDNISOLONE 40MG,28.26,18.37,6.16,28.26,74
CDM,63600575,"GAD-BASE MR CONTRAST NOS,1ML",33.0,21.45,2.48,33.0,72
CDM,63600580,"DEPO-MEDROL, 80 MG INJ",22.0,14.3,4.8,42.7,74
CDM,63600585,"INJ MULTIHANCE 20 ML, PER 1ML",22.0,14.3,3.15,28.93,72
CDM,63600595,"GAD-BASE MR CONTRAST NOS,1ML",32.0,20.8,2.56,32.0,72
CDM,63600605,"INJ EOVIST GADOXETATE DISODIUM, PER 1ML",147.0,95.55,24.99,147.0,72
CDM,63600615,INJ GADOFOSVESET TRISODIUM ML,118.0,76.7,24.99,118.0,71
CDM,63600625,GADAVIST GADOBUTROL INJ 0.1ML,2.99,1.94,0.48,28.93,72
CDM,63600640,DEXAMETH SOD INJ TO 1MG,1.99,1.29,0.18,11.17,75
CDM,63600650,"OMNIPAQUE 350, 150 ML, PER ML",3.48,2.26,0.26,28.93,72
CDM,63600655,ABATACEPT INJECTION 10 MG,142.17,92.41,34.12,4103.47,93
CDM,63600660,DILAUDID UP TO 4 MG,28.0,18.2,6.1,28.0,74
CDM,63600670,"OMNIPAQUE 350, 100 ML, PER ML",3.48,2.26,0.26,28.93,72
CDM,63600680,BENADRYL INJECTION TO 50 MG,8.93,5.8,1.25,11.17,75
CDM,63600685,"ISOVUE 300, 200 ML, PER ML",3.48,2.26,0.26,28.93,72
CDM,63600690,DMSP 50ML,2047.75,1331.04,491.46,2047.75,93
CDM,63600700,DOBUTREX INJ PER 250 MG,29.0,18.85,6.32,29.0,75
CDM,63600725,AFLIBERCEPT 40MG/ML,3330.5,2164.83,763.9,3330.5,93
CDM,63600730,"ISOVUE 370, 100 ML, PER ML",3.53,2.29,0.26,28.93,72
CDM,63600745,"ISOVUE 300, 100 ML, PER ML",3.48,2.26,0.26,28.93,72
CDM,63600750,NEUPOGEN 480 MCG INJ PER 1 MCG,3.51,2.28,0.84,465.3,93
CDM,63600755,"OMNIPAQUE 350, 50 ML, PER ML",3.48,2.26,0.26,28.93,72
CDM,63600760,"EMEND-FOSAPREPITANT , 1 MG",4.85,3.15,0.18,60.42,75
CDM,63600765,ALPHA 1 PROTEINASE INHIBITOR,15.61,10.15,3.75,3329.32,93
CDM,63600775,"ALPROSTADIL, PER 1.25MCG",493.95,321.07,1.01,493.95,75
CDM,63600780,IMMUNE GLOBULIN LIQUID 500MG,177.62,115.45,42.63,3329.32,93
CDM,63600790,GAMMAGARD LIQUID INJ 500 MG,210.1,136.57,43.22,4103.47,93
CDM,63600800,"GENTAMICIN 80 MG, INJ",7.5,4.88,1.64,11.17,75
CDM,63600815,AMPICILLIN SODIUM 500 MG,10.71,6.96,1.03,11.17,75
CDM,63600820,INJ GLUCAGON HCL PER 1 MG,618.8,402.22,148.51,618.8,93
CDM,63600835,"HYDRALAZINE HCL, TO 20 MG",40.0,26.0,7.68,40.0,75
CDM,63600840,"INJ GRANISETRON HCL, 100 MCG",15.1,9.82,0.26,15.1,75
CDM,63600845,AZITHROMYCIN 500 MG INJ,27.76,18.04,3.58,27.76,75
CDM,63600870,"INJ, LOVENOX, 10 MG",19.2,12.48,0.93,19.2,75
CDM,63600875,BACLOFEN 50 MCG FOR TRIAL,263.8,171.47,52.18,263.8,75
CDM,63600880,FONDAPARINUX  0.5MG INJ,21.58,14.03,1.44,21.58,75
CDM,63600885,BELIMUMAB INJECTION 10 MG,200.46,130.3,48.11,3329.32,93
CDM,63600890,HYDROCORT NA SUCCIN TO 100MG,10.1,6.57,2.2,50.3,75
CDM,63600895,PENICILLIN G BENZ INJ 100000,15.83,10.29,3.8,164.23,93
CDM,63600900,IBANDRONATE SODIUM INJ 1 MG,527.32,342.76,23.0,527.32,75
CDM,63600905,BOTULINUM TOXIN TYPE A/UNIT,20.85,13.55,5.0,840.33,93
CDM,63600910,INFLIXIMAB INJ 10 MG,420.52,273.34,31.67,1622.37,93
CDM,63600920,"INJ IRON DEXTRAN, 50 MG",35.0,22.75,8.4,164.23,93
CDM,63600925,IRON SUCROSE INJ 1 MG,1.85,1.2,0.4,60.42,75
CDM,63600930,IMUGLUCERASE INJ 400 UNITS,5710.6,3711.89,43.23,8832.81,93
CDM,63600940,INSULIN INJ PER 5 UNITS,104.0,67.6,0.48,104.0,75
CDM,63600950,INTERFERON BETA-1A INJ,3523.6,2290.34,768.14,5908.26,83
CDM,63600955,TORADOL INJ PER 15 MG,55.95,36.37,0.31,55.95,92
CDM,63600970,LEUPROLID ACETATE 11.25 MG,3295.68,2142.19,790.96,4021.62,93
CDM,63600985,"INJ, LEVOFLOXACIN, 250 MG",28.0,18.2,3.78,28.0,75
CDM,63600990,LIDOCAINE HCL INJ FOR IV 10 MG,5.0,3.25,0.09,11.17,74
CDM,63600995,"LINCOMYCIN INJ, TO 300 MG",18.0,11.7,3.92,60.42,75
CDM,63601000,"LORAZEPAM INJ, 2 MG",9.0,5.85,1.96,11.17,75
CDM,63601005,"MANNITOL INJ, 25% IN 50 ML",6.4,4.16,1.4,11.17,74
CDM,63601030,"INJ, MORPHINE SULFATE, TO 10MG",2.13,1.38,0.46,11.17,75
CDM,63601040,TYSABRI 1 MG NATALIZUMAB,74.16,48.2,17.8,5565.45,93
CDM,63601055,INJ OMALIZUMAB 5 MG,151.76,98.64,36.42,3329.32,93
CDM,63601070,ZOFRAN INJ PER 1 MG,1.9,1.24,0.16,11.17,75
CDM,63601075,GNRC PAMIDR DISODIUM PER 30MG,98.2,63.83,19.76,98.2,75
CDM,63601085,"PALONOSETRON HCL INJ, 25 MCG",136.54,88.75,0.62,136.54,75
CDM,63601100,PENICILLIN G TO 600000 UNITS,65.82,42.78,1.37,65.82,75
CDM,63601105,ZOSYN  1 GM/0.125 GM,37.0,24.05,1.91,37.0,75
CDM,63601110,"PENTAMIDINE INH SOL,300MG",207.0,134.55,45.13,207.0,60
CDM,63601120,DESMOPRESSIN ACETATE 1MCG,36.01,23.41,5.42,232.34,83
CDM,63601125,PROGESTERONE INJ PER 50 MG,8.0,5.2,1.25,11.17,75
CDM,63601145,"METOCLOPRAMIDE HCL,<=10 MG",8.0,5.2,1.74,11.17,75
CDM,63601150,LUCENTIS 0.1MG/0.5 MG,1404.2,912.73,65.44,1622.37,93
CDM,63601155,"ZANTAC INJ, 25 MG",3.99,2.59,0.87,17.62,74
CDM,63601165,REGADENOSON INJ 0.1 MG,109.0,70.85,4.69,149.95,75
CDM,63601185,"ROPIVACAINE HCL INJ, 1 MG",45.16,29.35,0.09,45.16,75
CDM,63601190,"INJ, ROMIPLOSTIM, 10 MCG",186.48,121.21,40.65,1622.37,75
CDM,63601195,ROBAXIN UP TO 10 ML,16.0,10.4,3.49,16.0,75
CDM,63601205,"FERRLECIT INJ, 12.5 MG",21.33,13.86,3.87,60.42,75
CDM,63601210,"SOLUMEDROL,  40 MG",7.5,4.88,1.64,13.13,74
CDM,63601220,"TPA INJ, 1 MG",97.72,63.52,23.45,213.93,93
CDM,63601230,SUMATRIPTAN SUCCINATE 6 MG,211.0,137.15,46.0,348.15,75
CDM,63601235,"ZOMETA, ZOLEDRONIC ACID 1 MG",252.2,163.93,8.89,252.2,75
CDM,63601245,RECLAST 1MG,252.2,163.93,8.89,252.2,75
CDM,63601250,THYROTROPIN ALFA 0.9 MG,4871.8,3166.67,1169.23,4871.8,93
CDM,63601255,UNCLASSIFIED DRUG,96.25,62.56,20.98,96.25,60
CDM,63601260,TRIMETHOBENZAMIDE HCL,18.35,11.93,4.0,131.33,75
CDM,63601270,TOBRAMYCIN SULFATE 80MG,7.5,4.88,1.64,11.17,75
CDM,63601275,STRL SALINE SOLN 500 ML=1 UNIT,4.0,2.6,0.87,11.17,75
CDM,63601280,TOCILIZUMAB INJECTION 1 MG,38.86,25.26,5.6,1622.37,93
CDM,63601290,TRIAMCINOLONE A PRS-FREE 1 MG,12.92,8.4,3.1,164.23,85
CDM,63601295,"NRML SALINE SOLUTION, 250 CC",5.0,3.25,1.09,11.17,75
CDM,63601300,TRIAMCINOLONE ACET INJ 10 MG,43.1,28.02,1.3,43.1,75
CDM,63601310,ARISTOSPAN,48.0,31.2,10.46,60.42,75
CDM,63601315,"INFUSION, D-5-W, 1000 CC",7.5,4.88,1.64,11.17,75
CDM,63601330,USTEKINUMAB INJECTION 1 MG,612.92,398.4,133.62,8832.81,83
CDM,63601340,DIAZEPAM INJ TO 5 MG,44.85,29.15,9.64,44.85,75
CDM,63601360,VELAGLUCERASE ALFA 100 UNITS,4861.0,3159.65,367.84,8832.81,93
CDM,63601365,ETONOGESTREL IMPLANT SYSTEM,1851.65,1203.57,403.66,3323.24,75
CDM,63601375,LEVULAN KERASTICK/TUBE,1400.0,910.0,336.0,1400.0,93
CDM,63601390,THIAMINE HCL 100 MG INJ,30.8,20.02,3.16,30.8,75
CDM,63601400,VITAMIN B-12 INJ TO 1000 MCG,8.0,5.2,1.12,11.17,75
CDM,63601415,HYALGAN/SUPARTZ INJ PER DOSE,822.76,534.79,127.69,822.76,75
CDM,63601420,VITAMIN K INJ PER 1 MG,7.5,4.88,1.64,60.42,75
CDM,63601425,EUFLEXXA INJ PER DOSE,234.5,152.43,56.28,259.46,93
CDM,63601435,ORTHOVISC INJ PER DOSE,1152.9,749.39,111.25,1152.9,93
CDM,63601445,SYNVISC OR SYNVISC-ONE 1 MG,93.4,60.71,7.56,465.3,93
CDM,63601450,INJ MAGNESIUM SULFATE/500 MG,7.5,4.88,0.71,11.17,75
CDM,63601455,GEL-ONE PER DOSE,2926.0,1901.9,401.85,2926.0,93
CDM,63601460,INJ POTASSIUM CHLRD PER 2 MEQ,1.06,0.69,0.21,11.17,75
CDM,63601470,PREDNISONE ORAL PER 5 MG,4.0,2.6,0.87,11.17,75
CDM,63601475,METHACHOLINE PER 1 MG,5.88,3.82,1.28,60.42,75
CDM,63601480,INO THERAPY PER DAY,4500.0,2925.0,52.18,4500.0,74
CDM,63601495,"GNRC DOXORUBICIN HCL,10 MG",73.0,47.45,4.87,73.0,67
CDM,63601515,"ARSENIC TRIOXIDE,1 MG",227.3,147.75,7.2,629.95,83
CDM,63601520,"AZACITIDINE INJ, 1MG SDV",27.16,17.65,0.62,412.04,75
CDM,63601530,"INJ, BENDAMUSTINE HCL, 1MG",98.55,64.06,2.04,4103.47,93
CDM,63601535,"INJ BEVACIZUMAB, 10 MG",332.03,215.82,72.7,4103.47,93
CDM,63601540,GNRC BLEOMYCIN SULFT 15 UNITS,174.0,113.1,37.93,174.0,67
CDM,63601545,"INJ BORTEZOMIB, 0.1 MG",230.27,149.68,2.07,1185.36,76
CDM,63601550,ADCETRIS/BRENTUXIMAB PER 50MG,501.91,326.24,120.46,8832.81,93
CDM,63601555,CABAZITAXEL INJECTION 1 MG,693.08,450.5,166.34,5565.45,93
CDM,63601560,"CARBOPLATIN, 50 MG",59.0,38.35,5.13,59.0,67
CDM,63601570,"INJ CETUXIMAB, 10 MG",240.92,156.6,57.82,4103.47,93
CDM,63601575,GNRC CISPLATIN PER 10 MG,38.0,24.7,3.7,38.0,75
CDM,63601585,CYCLOPHOSPHAMIDE 100 MG,15.2,9.88,3.31,629.95,74
CDM,63601595,GENERIC CYTARABINE 100 MG,19.45,12.64,1.46,19.45,75
CDM,63601600,GNRC DACARBAZINE 100 MG INJ,45.24,29.41,7.22,45.24,67
CDM,63601610,DOCETAXEL  1 MG,99.6,64.74,1.14,412.04,75
CDM,63601620,EPIRUBICIN HCL 2 MG INJ,114.77,74.6,3.45,114.77,67
CDM,63601625,HALAVAN 1MG/2ML,454.16,295.2,72.6,3329.32,93
CDM,63601630,GENERIC ETOPOSIDE 10 MG,2.23,1.45,0.49,19.13,75
CDM,63601635,"FLUDARABINE PHOSPHATE, 50 MG",1320.05,858.03,134.15,1320.05,75
CDM,63601640,"5-FU, 500 MG",12.31,8.0,2.68,19.13,75
CDM,63601645,"GEMCITABINE HCL , 200 MG",726.35,472.13,6.17,726.35,75
CDM,63601650,GOSERLIN ACETATE IMPL PER3.6MG,2919.0,1897.35,599.34,2919.0,93
CDM,63601655,"IRINOTECAN, 20 MG",55.73,36.22,3.14,55.73,67
CDM,63601660,"IXABEPILONE INJECTION, 1 MG",327.42,212.82,78.58,4103.47,93
CDM,63601665,GENERIC IFOSFAMIDE PER 1 GM,293.65,190.87,43.48,293.65,67
CDM,63601670,VANTAS IMPLANT 50 MG,14889.0,9677.85,3245.8,14889.0,76
CDM,63601675,INTERFERON ALFA - 2A INJ,77.0,50.05,16.79,2111.65,75
CDM,63601680,INTERFERON ALFA-2B,115.51,75.08,25.18,1559.81,76
CDM,63601685,LEUPROLIDE ACETATE 7.5 MG,4491.83,2919.69,170.77,4491.83,93
CDM,63601690,"METHOTREXATE SODIUM,  50 MG",10.0,6.5,2.18,19.13,75
CDM,63601700,ABRAXANE 1MG,47.96,31.17,8.18,3329.32,93
CDM,63601715,GENERIC MITOMYCIN 5 MG,722.85,469.85,26.1,1185.36,93
CDM,63601730,ARZERRA 10MG,212.7,138.26,51.05,5565.45,93
CDM,63601735,VECTIBIX 10 MG,427.4,277.81,102.58,5653.6,93
CDM,63601740,"INJ PEMTREXED, 10 MG",270.6,175.89,3.59,3329.32,93
CDM,63601765,TORISEL 1 MG,505.94,328.86,20.31,1380.54,93
CDM,63601770,TOPOTECAN INJECTION 0.1 MG,134.29,87.29,2.18,134.29,67
CDM,63601775,"TRASTUZUMAB, 10 MG",398.61,259.1,73.48,4103.47,93
CDM,63601780,VINBLASTINE SULFATE 1 MG,12.69,8.25,2.77,12.69,67
CDM,63601785,VINCRISTINE SULFATE 1 MG,42.25,27.46,9.21,42.25,75
CDM,63601790,VINORELBINE TARTRATE PER 10MG,190.4,123.76,9.52,190.4,67
CDM,63601795,"FULVESTRANT, 25 MG INJ",398.46,259.0,7.51,629.95,83
CDM,63601805,"APLIGRAFT,9978000199",60.22,39.14,14.45,183.51,78
CDM,63601810,"OASIS WOUND MATRIX,8213100015",5.72,3.72,1.37,183.51,78
CDM,63601815,ORAL AZITHROMYCIN  1 GM,57.0,37.05,9.64,60.53,75
CDM,63601820,ONDANSETRON ORAL 1 MG,13.0,8.45,0.02,13.0,75
CDM,63601850,INFLUENZA VACCINE,19.22,12.49,4.19,25.74,74
CDM,63601860,"INJ PERFLUTREN LIP MICROS, ML",547.87,356.12,24.99,547.87,75
CDM,63601890,"ALBUTEROL,INHALATION, UD 1MG",3.0,1.95,0.65,3.0,66
CDM,63601895,ATROVENT/1 MG,3.7,2.41,0.81,3.7,66
CDM,63601910,EPINEPHRINE 2.25%/0.5CC,5.0,3.25,1.09,5.0,66
CDM,63601920,"LEVALBUTEROL INHALATION, UD 05",4.19,2.72,0.91,4.19,66
CDM,63601940,NITRIC OXIDE CHALLENGE/15 MINS,187.5,121.88,40.88,187.5,66
CDM,63601945,NITRIC OXIDE CHALLENGE/PER DAY,4500.0,2925.0,981.0,4500.0,66
CDM,63601955,HEP A/ADULT,308.0,200.2,9.99,308.0,75
CDM,63601960,HEP A/PEDIATRIC ADOLESEN,138.0,89.7,9.99,138.0,75
CDM,63601965,IM ADULT HEPA-HEPB,472.0,306.8,16.84,472.0,75
CDM,63601975,BEVACIZUMAB INJECTION 0.25 MG,9.29,6.04,1.82,60.42,93
CDM,63602005,DEHYDROERGOTAMINE INJ  1 MG,94.24,61.26,20.54,130.14,75
CDM,63602010,OCTREOTIDE DEPOT 1 MG IM INJ,641.65,417.07,154.0,5565.45,93
CDM,63602020,GENERIC MESNA  200 MG,147.07,95.6,2.98,147.07,67
CDM,63602025,LUPRON 1 MG,575.0,373.75,11.02,575.0,68
CDM,63602045,"METHOTREXATE SODIUM,  5 MG",2.0,1.3,0.39,19.13,74
CDM,63602050,INF ALBUMIN 25% 50ML,366.0,237.9,53.07,366.0,86
CDM,63602055,"KYTRIL, 1MG ORAL",134.0,87.1,6.41,134.0,75
CDM,63602085,"OASIS,PORCNE 10X7,8213-0000-09",22.02,14.31,5.28,183.51,78
CDM,63602095,"ULTRAVIST 240, 200-299/ML,1ML",14.42,9.37,0.7,28.93,72
CDM,63602110,FAMOTIDINE 20 MG,11.0,7.15,1.9,60.42,74
CDM,63602135,"OMNIPAQUE 350, 150 ML, PER ML",12.46,8.1,0.26,28.93,72
CDM,63602155,HPV VIRUS VACCINE 9 VAL IM,1106.0,718.9,16.84,1106.0,75
CDM,63602165,FLU VACCINE 4 VALENT NASAL,57.0,37.05,9.99,65.34,75
CDM,63602185,FLU VAC NO PRSV 4 VAL 6-35 M,36.0,23.4,7.85,36.0,75
CDM,63602195,FLU VAC NO PRSV 4 VAL,70.0,45.5,9.99,70.0,75
CDM,63602215,"DOTAREM INJ 0.1ML, 20 ML",2.27,1.48,0.18,28.93,72
CDM,63602235,CERTOLIZUMAB PEGOL INJ 1 MG,33.3,21.65,3.86,3329.32,93
CDM,63602245,INJ DAPTOMYCIN 1 MG,2.3,1.5,0.05,60.42,75
CDM,63602265,PEGLOTICASE INJECTION 1 MG,8362.57,5435.67,2007.02,16514.52,93
CDM,63602275,"INJ, TALIGLUCERACE ALFA 10 U",107.15,69.65,25.72,16514.52,93
CDM,63602285,LEVONORGESTREL - SKYLA 13.5MG,1560.8,1014.52,340.25,2767.14,75
CDM,63602295,INJECTION CARFILZOMIB 1 MG,132.89,86.38,31.89,3329.32,93
CDM,63602305,INJECTION PERTUZUMAB 1 MG,46.61,30.3,11.19,5653.6,93
CDM,63602315,INJ ADO-TRASTUZUMAB EMT 1 MG,133.23,86.6,31.98,5653.6,93
CDM,63602325,FLU VAC NO PRSV 4 VAL 3 YRS+,54.6,35.49,9.99,106.68,74
CDM,63602335,"DOXORUBICIN HCL, LIPID, 10 MG",2607.0,1694.55,104.0,2607.0,93
CDM,63602345,INJ BETA INTERFERON IM 1 MCG,188.64,122.62,41.12,1622.37,83
CDM,63602355,ALLOSKIN PER 1 SQ CM,360.0,234.0,27.65,360.0,78
CDM,63602385,GOLIMUMAB FOR IV USE 1MG,114.65,74.52,11.1,3329.32,93
CDM,63602395,PHARMACY J8499,96.95,63.02,21.14,96.95,74
CDM,63602415,"RHO IG, HUMAN, FULL DOSE, IM",303.0,196.95,66.05,303.0,75
CDM,63602425,NITRIC OXIDE,131.11,85.22,28.58,131.11,60
CDM,63602435,VARICELLA-ZOSTER IG HUMAN IM,15554.0,10110.1,725.74,15554.0,93
CDM,63602445,MENB RP W/OMV VACCINE IM,852.0,553.8,16.84,852.0,75
CDM,63602455,MENB RLP VACCINE IM,604.0,392.6,16.84,604.0,75
CDM,63602465,FLUZONE QUADRIVALENT MDV,67.0,43.55,9.99,67.0,75
CDM,63602485,DTAP-IPV-HIB-HEPB VACCINE IM,526.05,341.93,9.99,804.51,75
CDM,63602505,MENINGOCOCCAL B-BEXSERO VAC,577.0,375.05,9.99,577.0,74
CDM,63602525,"RECLAST INJECTION, 1 MG",806.3,524.1,8.89,806.3,75
CDM,63602535,LEVONORGESTREL IU 52MG 3 YR,1500.0,975.0,327.0,2549.22,75
CDM,63602545,LEVONORGESTREL IU 52MG,1945.25,1264.41,424.06,3323.24,75
CDM,63602555,"ALBUTEROL NON-COMP UNIT, 1 MG",2.0,1.3,0.12,11.17,75
CDM,63602565,VIADUR 65MG,11850.0,7702.5,2583.3,11850.0,75
CDM,63602575,RADIESSE INJECTION 0.1 ML,1063.0,690.95,52.18,1063.0,92
CDM,63602585,APLIGRAF 7.5 CM,77.98,50.69,18.72,183.51,78
CDM,63602595,OASIS BURN MATRIX PER 1 SQ CM,5.72,3.72,1.37,183.51,78
CDM,63602635,GRAFIX PRIME 3CM X 4CM,339.0,220.35,81.36,339.0,78
CDM,63602645,KENALOG 40MG/ML,43.1,28.02,1.3,43.1,75
CDM,63603045,UNCLASSIFIED DRUG,289.0,187.85,63.0,289.0,60
CDM,63603055,ORAL PRESCIP DRUG NON CHEMO NOS,6.5,4.23,1.42,60.42,74
CDM,63603065,MEPOLIZUMAB (NUCALA) PER 1 MG,90.01,58.51,21.6,4103.47,93
CDM,63603085,JAPANESE ENCEPHALITIS VACC IM,1036.0,673.4,16.84,1036.0,75
CDM,63603095,REGITINE INJ TO 5 MG,167.4,108.81,40.18,958.88,93
CDM,63603105,HPV VIRUS VACCINE 9 VAL IM,1106.0,718.9,16.84,1106.0,75
CDM,63603125,BACLOFEN 50MCG/ML SOLUTION,29.0,18.85,6.32,135.68,75
CDM,63603135,"BACLOFEN 2,000MCG/ML INTRTHCL SOLUTION",29.0,18.85,6.96,840.33,93
CDM,63603155,0.25% SENSORCAINE 10 ML,10.85,7.05,2.37,10.85,60
CDM,63603185,IM MORPHINE PRESERVATIVE FREE,28.4,18.46,6.19,60.42,75
CDM,63603195,SOL IV 0.9% NACL 1L VIAFLX LF,19.0,12.35,3.48,19.0,75
CDM,63603225,CNTRST RAD OMPQ 240 100ML,3.48,2.26,0.7,28.93,72
CDM,63603255,"DEMEROL HCL, PER 100MG",10.0,6.5,2.18,18.58,75
CDM,63603265,LUPRON DEPOT,3770.0,2450.5,904.8,4021.62,93
CDM,63603275,ZICONOTIDE 25MCG/ML PRIALT SOLUTION,169.5,110.18,9.04,3329.32,93
CDM,63603285,ZICONOTIDE 100MCG/ML PRIALT SOLUTION,677.98,440.69,9.04,3329.32,93
CDM,63603295,VEDOLIZUMAB (ENTYVIO) 1MG,65.05,42.28,15.61,5565.45,93
CDM,63603305,KENALOG 40 MG /PER 1 CC,43.1,28.02,1.3,43.1,75
CDM,63603315,TESTOPEL 75 MG,202.18,131.42,44.08,202.18,60
CDM,63603325,HEP B IMMUNE GLOBULIN,988.0,642.2,137.82,1622.37,93
CDM,63603345,PREDNISONE ORAL PER 20 MG,2.0,1.3,0.01,11.17,75
CDM,63603355,"INJECTION, RHO D IMMUNE GLOBULIN (HUMAN), (RHOPHYLAC)",63.79,41.46,8.45,164.23,75
CDM,63603375,PREDNISONE IR OR DR ORAL 1MG,4.0,2.6,0.01,11.17,75
CDM,63603385,CCIIV4 VACCINE PRESERVATIVE FREE 0.5 ML IM USE,109.0,70.85,9.99,109.0,75
CDM,63603395,CCK DOSE,320.0,208.0,69.76,320.0,75
CDM,63603425,NIVOLUMAB 100 MG/ 10 ML,26.55,17.26,6.37,5565.45,93
CDM,63603475,DEXAMETHASONE INTRA IMPLANT 0.1 MG,685.68,445.69,164.56,1622.37,93
CDM,63603495,OMNIPAQUE 300MG/ML,3.48,2.26,0.26,28.93,72
CDM,63604055,"ISOVUE 370, 150ML, PER ML",3.3,2.15,0.26,28.93,72
CDM,63604065,"OMNIPAQUE 350, 200ML, PER ML",2.89,1.88,0.26,28.93,72
CDM,63604075,"OMNIPAQUE 300, 75ML, PER ML",3.48,2.26,0.26,28.93,72
CDM,63604185,OASIS WND MATRIX 5X7 PER 1 SQ CM,18.71,12.16,4.49,183.51,78
CDM,63604195,0.25% SENSORCAINE 30 ML VIAL,6.95,4.52,1.52,6.95,60
CDM,63604205,AMINOPHYLLINE 500MG/20ML,7.5,4.88,1.64,23.73,75
CDM,63604215,INFLUENZA VACCINE,74.7,48.56,9.99,74.7,75
CDM,63604225,INJ SULF HEXA LIPID MICROSPH,43.0,27.95,9.37,43.0,75
CDM,63604325,SPINRAZA / NUSINERSEN,168750.0,109687.5,52.18,168750.0,74
CDM,63604335,FLUBLOK TRIVALENT,284.6,184.99,9.99,284.6,75
CDM,63604345,LIDOCAINE 1% 10ML,42.38,27.55,0.09,42.38,74
CDM,63604355,ROPIVICAINE 1% 10ML,41.32,26.86,0.09,41.32,75
CDM,63604365,ROPIVICAINE 0.5 % 10ML,25.85,16.8,0.09,25.85,75
CDM,63604375,BUPIVICAINE 0.5% 10ML,55.7,36.21,12.14,60.42,74
CDM,63604395,OCREVUS 30MG/ML,58501.0,38025.65,52.18,540750.0,74
CDM,63604405,CONTRAST ULTRAVIST 300 PER,3.48,2.26,0.26,28.93,72
CDM,63604425,CONTRAST LOCM 200-299,3.48,2.26,0.7,28.93,72
CDM,63604445,METHYLENE BLUE PER 1ML,23.27,15.13,5.58,28.93,93
CDM,63604465,CONTR LOCM 300-399 MG 1 ML,3.48,2.26,0.26,28.93,72
CDM,63604575,GOSERLIN ACETATE IMPL PER10.8MG,8727.0,5672.55,599.34,8727.0,93
CDM,63604585,PHOTREXA VISCOUS,5700.0,3705.0,1242.6,5700.0,66
CDM,63604605,IIV3 VACCINE SPLIT VIRUS 0.5 ML DOSAGE IM USE,69.7,45.31,9.99,69.7,75
CDM,63604645,HZV VACC RECOMBINANT IM NJX,777.0,505.05,16.84,777.0,75
CDM,63604665,CHOLERA VACCINE LIVE ORAL,734.0,477.1,9.99,734.0,75
CDM,63604675,"INJECTION, HYDROXYPROGESTERONE CAPROATE (MAKENA), 10MG",115.64,75.17,12.08,164.23,82
CDM,63604695,INJ OCRELIZUMAB PER 1 MG (OCREVUS),195.0,126.75,46.8,20935.21,93
CDM,63604705,"DOTAREM INJ 0.1 ML, 15 ML",2.27,1.48,0.18,28.93,72
CDM,63604715,"DOTAREM INJ 0.1 ML, 10 ML",2.27,1.48,0.18,28.93,72
CDM,63604725,OMNIPAQUE 240 / 200 ML,3.48,2.26,0.7,28.93,72
CDM,63604735,OMNIPAQUE 240 / 50 ML,3.48,2.26,0.7,28.93,72
CDM,63604745,OMNIPAQUE 240 / 20 ML,3.48,2.26,0.7,28.93,72
CDM,63604755,OMNIPAQUE 300 / 500 ML,3.48,2.26,0.26,28.93,72
CDM,63604765,OMNIPAQUE 300 / 200 ML,3.48,2.26,0.26,28.93,72
CDM,63604775,OMNIPAQUE 300 / 150 ML,3.48,2.26,0.26,28.93,72
CDM,63604785,OMNIPAQUE 300 / 100 ML,3.48,2.26,0.26,28.93,72
CDM,63604795,VISIPAQUE 320 / 100 ML,3.48,2.26,0.26,28.93,72
CDM,63604905,OMNIPAQUE 300 / 10 ML PER ML,3.48,2.26,0.26,28.93,72
CDM,63604935,NORFLEX-KEFLEX 60 MG,68.5,44.53,9.64,68.5,75
CDM,63604965,DOTAREM 10 MMOL SYRINGE 20ML,2.27,1.48,0.18,28.93,72
CDM,63604975,DOTAREM 7.5 MMOL SYRING 15ML,2.27,1.48,0.18,28.93,72
CDM,63605015,OPTIRAY ?350 -100 ML SYRINGE,2.08,1.35,0.26,28.93,72
CDM,63605025,HEPB VACC 2 DOSE ADULT IM,562.0,365.3,9.99,562.0,75
CDM,63605055,FLUBLOK QUADRIVALENT PFS,233.0,151.45,9.99,233.0,75
CDM,63605065,OMNIPAQUE 300 150 ML,3.48,2.26,0.26,28.93,72
CDM,63605075,OMNIPAQUE 300 50 ML,3.48,2.26,0.76,3.48,66
CDM,63605085,OMNIPAQUE 240  50 ML,3.48,2.26,0.7,28.93,72
CDM,63605325,DRSG EPIFIX PER SQ CM,330.77,215.0,79.38,340.41,78
CDM,63605355,DRSG PURAPLY AM PER SQ CM,119.0,77.35,28.56,227.23,78
CDM,63605425,"INJ., RITUXIMAB, 10 MG",465.97,302.88,74.76,5653.6,93
CDM,63605535,GRAFT EPIFIX 2X2 PER SQ CM,629.94,409.46,117.73,629.94,78
CDM,63605625,RIBOFLAVIN 5'PHOSPHATE OPTH SOLUTION UPTO 3 ML,3130.0,2034.5,9.64,6238.08,75
CDM,63605635,GABLOFEN 1000MCG/ML 20 MG/20ML,442.0,287.3,106.08,840.33,93
CDM,63605645,"INJECTION, RENFLEXIS",271.0,176.15,27.18,1622.37,93
CDM,63605655,VISIPAQUE 320/150 ML,3.48,2.26,0.26,28.93,72
CDM,63605665,"USTEKINUMAB, IV INJECT, 1 MG",44.32,28.81,10.64,5653.6,93
CDM,63605695,"LEXISCAN (REGADENOSON) INJ, 0.1 MG.",197.75,128.54,4.69,197.75,75
CDM,63605705,"EPICORD, PER SQUARE CM",205.0,133.25,49.2,521.87,78
CDM,63605745,GAMMAPLEX INJECTION 500 MG,295.55,192.11,55.01,4103.47,93
CDM,63605765,FLUOCINOLONE 0.18 MG INTRAVITRREAL IMPLANT,1112.0,722.8,266.88,5565.45,93
CDM,63605775,"CEFOTAXIME SODIUM, 1 G",19.11,12.42,4.17,26.81,75
CDM,63605785,GRAFIX PRIME 16MM PER SQ CM,136.46,88.7,32.75,298.31,78
CDM,63605795,INJ ROMOSOZUMAB-AQQG 1 MG,3286.0,2135.9,10.69,3286.0,93
CDM,63605805,GRFT STRAVIX 2CMX2CM,525.0,341.25,117.73,525.0,78
CDM,63605825,AIIV4 VACC INACTIVATED PRSRV FR 0.5ML DOS IM USE,243.0,157.95,9.99,243.0,75
CDM,63605835,"INJECTION, BROLUCIZUMAB-DBLL, 1 MG",1110.17,721.61,266.44,1622.37,93
CDM,63605845,NUSHIELD 1.6 DISC PER SQ CM,296.25,192.56,71.1,296.25,78
CDM,63605855,NUSHIELD 2X3 PER SQ CM,331.25,215.31,79.5,331.25,78
CDM,63605865,NUSHIELD 2X4 PER SQ SM,197.88,128.62,47.49,201.95,78
CDM,63605875,NUSHIELD 3X4 PER SQ CM,229.17,148.96,55.0,229.17,78
CDM,63605885,NUSHIELD 4X4 PER SQ CM,155.86,101.31,37.41,201.95,78
CDM,63605915,BCG LIVE INTRAVESICAL 1MG,711.75,462.64,3.27,711.75,85
CDM,63605935,NUSHIELD 6X6 PER SQ CM,121.05,78.68,29.05,201.95,78
CDM,63605955,NUSHIELD 4X6 PER SQ CM,136.73,88.87,32.82,201.95,78
CDM,63605965,JUVEDERM ULTRA PLUS XC,508.0,330.2,52.18,540750.0,74
CDM,63605975,RESTYLANE LYFT,696.0,452.4,52.18,540750.0,74
CDM,63606115,RESTYLANE,452.0,293.8,52.18,540750.0,74
CDM,63606325,"CYSTO-CONRAY II, PER ML",2.88,1.87,0.13,28.93,74
CDM,63606335,RESTYLANE DEFYNE,1077.0,700.05,52.18,540750.0,74
CDM,63606375,PNEUMOCOCCAL 20-VALENT CONJUGATE VACCINE CODE 90677,1018.0,661.7,16.84,1018.0,75
CDM,63606385,HEP B VACC 3 AG 10 MCG 3 DOSE SCHED FOR IM USE,83.0,53.95,9.99,158.71,75
CDM,63606425,INJ RETACRIT NON_ESRD USE (RETACRIT),39.81,25.88,7.51,465.3,93
CDM,63606445,"MENINGOCOCCAL VACCINE, QUADRIVALENT (MENQUADFI)",617.0,401.05,16.84,617.0,75
CDM,63606495,TICK-BORNE ENCEPH VACC INACTIVATED 0.25ML IM USE,304.0,197.6,16.84,304.0,75
CDM,63606505,TICK-BORNE ENCEPH VACC INACTIVATED 0.5ML IM USE,304.0,197.6,16.84,304.0,75
CDM,63606525,"AFFINITY, 1.5CM X 1.5CM",1149.99,747.49,117.73,1149.99,78
CDM,63606535,"AFFINITY, 2.5CM X 2.5CM",546.42,355.17,117.73,566.2,78
CDM,63606615,"INJ, BIMATOPROST, INTRACAMERAL IMPLANT, 1 MCG (DURYSTA)",702.1,456.37,168.5,1622.37,93
CDM,63606665,AMNIOEXCEL1.5X1.5,614.0,399.1,117.73,614.0,78
CDM,63606675,AMNIOEXCEL 2X3,337.0,219.05,80.88,337.0,78
CDM,63606785,DTAP 5 PERTUSSIS ANTIGENS VACC < 7 YR IM DAPTACEL LATEX FREE,102.0,66.3,9.99,102.0,75
CDM,63606795,"RSV VACCINE, ADJUVANTED (AREXVY)",363.0,235.95,9.99,758.52,75
CDM,63606805,"RSV VACCINE, BIVALENT (ABRYSVO)",1106.0,718.9,9.99,1106.0,75
CDM,63606885,PFIZER-BIONTECH COVID-19 VACCINE (2023-24 SEASON) AGE 6 MO - 4 Y,140.0,91.0,9.99,140.93,75
CDM,63606895,PFIZER-BIONTECH COVID-19 VACCINE (2023-24 SEASON)?AGE 5 YR - 11,278.0,180.7,9.99,278.0,75
CDM,63606905,SARSCOV2 VACC 30MCG/0.3ML TRIS-SUCROSE IM USE,532.7,346.26,9.99,532.7,75
CDM,63606935,DRSG GRAFIX CORE PER SQ CM,533.33,346.66,117.73,533.33,78
CDM,63606975,RSV MONOCLONAL ANTB SEASONAL DOSE 0.5ML IM USE,2080.0,1352.0,453.44,2681.91,75
CDM,63606985,RSV MONOCLONAL ANTB SEASONAL DOSE 1 ML IM USE,2080.0,1352.0,453.44,2080.0,75
CDM,63607035,HEPZATO KIT,1660.0,1079.0,398.4,1812.6,93
CDM,63607055,JYNNEOS VACCINE (MPOX) 0.5 ML,785.7,510.71,0.01,785.7,93
CDM,63607065,SCULPTRA 0.5MG INJECTION,588.0,382.2,1.0,1275.41,93
CDM,63607075,"CHIKUNGUNYA VACCINE, LIVE",990.0,643.5,16.84,990.0,75
CDM,63607175,"INJ MOSUNETUZUMAB-AXGB, 1 MG",2952.7,1919.26,629.15,20935.21,93
CDM,63607185,"INJ, GADOPICLENOL, 1 ML",4.0,2.6,0.87,28.93,72
CDM,63607195,QUTENZA (CAPSAICIN) 8% PATCH,2154.0,1400.1,3.32,2154.0,93
CDM,63607235,"INJ, CYCLOPHOSPHAMD, SANDOZ",15.8,10.27,3.79,629.95,92
CDM,63607245,"CHIKUNGUNYA VACCINE, RECOMBINANT (VIMKUNYA)",991.0,644.15,16.84,991.0,75
CDM,63607255,SARSCOV2 VACCINE 25 MCG/0.25 ML FOR IM USE,465.4,302.51,9.99,465.4,75
CDM,63620OH,STEREOTACTIC RADIOSURGERY 1 SPINAL LESION,6864.0,4461.6,1.1,6864.0,144
CDM,63621OH,STEREOTACTIC RADIOSURGERY EA ADDL SPINAL LESION,1760.0,1144.0,1.1,1760.0,144
CDM,63650OH,PRQ IMPLTJ NSTIM ELECTRODE ARRAY EPIDURAL,3146.0,2044.9,1.1,19945.48,148
CDM,63655OH,LAM IMPLTJ NSTIM ELTRDS PLATE/PADDLE EDRL,4805.0,3123.25,1.1,63800.42,144
CDM,63661OH,RMVL SPINAL NSTIM ELTRD PRQ ARRAY INCL FLUOR,2235.0,1452.75,1.1,5632.24,148
CDM,63662OH,RMVL SPINAL NSTIM ELTRD PLATE/PADDLE INCL FLUOR,4840.0,3146.0,1.1,9923.76,144
CDM,63663OH,REVJ INCL RPLCMT NSTIM ELTRD PRQ RA INCL FLUOR,3410.0,2216.5,1.1,19945.48,148
CDM,63664OH,REVJ INCL RPLCMT NSTIM ELTRD PLT/PDLE INCL FLUOR,5069.0,3294.85,1.1,39728.72,144
CDM,63685OH,INSJ/RPLCMT SPINAL NPG/RCVR POCKET CRTJ&CONNJ,2284.0,1484.6,1.1,90562.75,144
CDM,63688OH,REVJ/RMVL IMPL SPI NPG/RCVR DTCH CONNJ ELTRD RA,1914.0,1244.1,1.1,9923.76,144
CDM,63700OH,"REPR MENINGOCELE,<5CM DIA",6988.0,4542.2,1.1,6988.0,144
CDM,63702OH,"REPR MENINGOCELE,5+CM DIA",7764.0,5046.6,1.1,7764.0,144
CDM,63704OH,"REPR MYELOMENIGOCELE,<5CM DIA",8972.0,5831.8,1.1,8972.0,144
CDM,63706OH,"REPR MYELOMENIGOCELE,5+CM DIA",10140.0,6591.0,1.1,10140.0,144
CDM,63707OH,REPR DURAL/CSF LEAK,5060.0,3289.0,1.1,5060.0,144
CDM,63709OH,REPR DURAL/CSF LEAK W LAMINECTOMY,6260.0,4069.0,1.1,6260.0,144
CDM,63710OH,"DURAL GRAFT REPAIR,SPINE DEFECT",6160.0,4004.0,1.1,6160.0,144
CDM,63740OH,CRTJ SHUNT LMBR SARACH-PRTL-PLEURAL/OTH W/LAM,5052.0,3283.8,1.1,5052.0,144
CDM,63741OH,CRTJ SHUNT LMBR SARACH-PRTL-PLEURAL PRQ X LAM,3648.0,2371.2,1.1,19428.17,144
CDM,63744OH,RPLCMT IRRIGATION/REVJ LUMBOSARACH SHUNT,3576.0,2324.4,1.1,19428.17,144
CDM,63746OH,RMVL ENTIRE LUMBOSARACH SHUNT SYS W/O RPLCMT,2932.0,1905.8,1.1,5632.24,144
CDM,64400OH,INJECTION AA&/STRD TRIGEMINAL NERVE EACH BRANCH,330.0,214.5,1.1,863.2,148
CDM,64405OH,INJECTION AA&/STRD GREATER OCCIPITAL NERVE,414.0,269.1,1.1,863.2,148
CDM,64408OH,INJECTION AA&/STRD VAGUS NERVE,330.0,214.5,1.1,863.2,148
CDM,64415OH,INJECTION AA&/STRD BRACHIAL PLEXUS W/IMG GDN,660.0,429.0,1.1,2656.95,148
CDM,64416OH,INJECTION AA&/STRD BRACH PLEX CONT NFS CATH IMG,792.0,514.8,1.1,2656.95,144
CDM,64417OH,INJECTION AA&/STRD AXILLARY NERVE W/IMG GDN,576.0,374.4,1.1,2656.95,148
CDM,64418OH,INJECTION AA&/STRD SUPRASCAPULAR NERVE,484.0,314.6,1.1,2017.2,148
CDM,64420OH,INJECTION AA&/STRD INTERCOSTAL NRV SINGLE LVL,475.0,308.75,1.1,2017.2,148
CDM,64421OH,INJECTION AA&/STRD INTERCOSTAL NRV EA ADDL LVL,220.0,143.0,1.1,2656.95,148
CDM,64425OH,INJECTION AA&/STRD ILIOINGUINAL IH NERVES,440.0,286.0,1.1,2017.2,148
CDM,64430OH,INJECTION AA&/STRD PUDENDAL NERVE,440.0,286.0,1.1,2656.95,148
CDM,64435OH,INJECTION AA&/STRD PARACERVICAL NERVE,330.0,214.5,1.1,2017.2,148
CDM,64445OH,INJECTION AA&/STRD SCIATIC NERVE W/IMG GDN,612.0,397.8,1.1,2017.2,148
CDM,64446OH,INJECTION AA&/STRD SCIATIC NRV CONT NFS CATH IMG,770.0,500.5,1.1,2656.95,144
CDM,64447OH,INJECTION AA&/STRD FEMORAL NERVE W/IMG GDN,590.0,383.5,1.1,2017.2,148
CDM,64448OH,INJECTION AA&/STRD FEM NRV CONT NFS CATH IMG GDN,739.0,480.35,1.1,2656.95,144
CDM,64449OH,INJECTION AA&/STRD LUMBAR PLEXUS CONT NFS CATH,559.0,363.35,1.1,2656.95,144
CDM,64450OH,INJECTION AA&/STRD OTHER PERIPHERAL NERVE/BRANCH,330.0,214.5,1.1,2017.2,148
CDM,64451OH,INJECTION AA&/STRD NERVES NRVTG SI JOINT W/IMG,669.0,434.85,1.1,2017.2,148
CDM,64454OH,INJECTION AA&/STRD GENICULAR NRV BRANCHES W/IMG,669.0,434.85,1.1,2017.2,148
CDM,64455OH,NJX AA&/STRD PLANTAR COMMON DIGITAL NERVES,330.0,214.5,1.1,863.2,148
CDM,64461OH,PVB THORACIC SINGLE INJECTION SITE W/IMG GID,770.0,500.5,1.1,2017.2,148
CDM,64462OH,PVB THORACIC SECOND & ADDL INJ SITE W/IMG GID,484.0,314.6,1.1,484.0,148
CDM,64463OH,PVB THORACIC CONT CATHETER INFUSION W/IMG GID,836.0,543.4,1.1,2017.2,148
CDM,64466OH,THORACIC FASCIAL PLANE BLOCK UNI INJECTION,660.0,429.0,1.1,660.0,144
CDM,64467OH,THORACIC FASCIAL PLANE BLOCK UNI CONT INFUSION,766.0,497.9,1.1,766.0,144
CDM,64468OH,THORACIC FASCIAL PLANE BLOCK BI INJECTION,735.0,477.75,1.1,735.0,144
CDM,64469OH,THORACIC FASCIAL PLANE BLOCK BI CONT INFUSION,805.0,523.25,1.1,1091.15,144
CDM,64470OH,INJ FACET ANES/STER PARA VERT SINGL,672.0,436.8,1.1,672.0,70
CDM,64472OH,INJ FACET ANES/STER PARA VERT MULTI,469.0,304.85,1.1,469.0,70
CDM,64473OH,LOWER XTR FASCIAL PLANE BLOCK UNI INJECTION,590.0,383.5,1.1,590.0,144
CDM,64474OH,LOWER XTR FASCIAL PLANE BLOCK UNI CONT INFUSION,735.0,477.75,1.1,735.0,144
CDM,64476OH,INJ FACET ANES/STER LS  MULTI,355.0,230.75,1.1,355.0,70
CDM,64479OH,NJX AA&/STRD TFRML EPI CERVICAL/THORACIC 1 LEVEL,1008.0,655.2,1.1,2656.95,148
CDM,64480OH,NJX AA&/STRD TFRML EPI CERVICAL/THORACIC EA ADDL,528.0,343.2,1.1,528.0,148
CDM,64483OH,NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL,836.0,543.4,1.1,2656.95,148
CDM,64484OH,NJX AA&/STRD TFRML EPI LUMBAR/SACRAL EA ADDL,440.0,286.0,1.1,440.0,148
CDM,64486OH,TAP BLOCK UNILATERAL BY INJECTION(S),528.0,343.2,1.1,528.0,148
CDM,64487OH,TAP BLOCK UNILATERAL BY CONTINUOUS INFUSION(S),612.0,397.8,1.1,712.53,148
CDM,64488OH,TAP BLOCK BILATERAL BY INJECTION(S),616.0,400.4,1.1,616.0,148
CDM,64489OH,TAP BLOCK BILATERAL BY CONTINUOUS INFUSION(S),770.0,500.5,1.1,1157.73,148
CDM,64490OH,NJX DX/THER AGT PVRT FACET JT CRV/THRC 1 LEVEL,801.0,520.65,1.1,2656.95,148
CDM,64491OH,NJX DX/THER AGT PVRT FACET JT CRV/THRC 2ND LEVEL,510.0,331.5,1.1,510.0,148
CDM,64492OH,NJX DX/THER AGT PVRT FACET JT CRV/THRC 3+ LEVEL,510.0,331.5,1.1,510.0,148
CDM,64493OH,NJX DX/THER AGT PVRT FACET JT LMBR/SAC 1 LEVEL,669.0,434.85,1.1,2656.95,148
CDM,64494OH,NJX DX/THER AGT PVRT FACET JT LMBR/SAC 2ND LEVEL,440.0,286.0,1.1,440.0,148
CDM,64495OH,NJX DX/THER AGT PVRT FACET JT LMBR/SAC 3+ LEVEL,440.0,286.0,1.1,440.0,148
CDM,64505OH,INJECTION ANES AGENT SPHENOPALATINE GANGLION,598.0,388.7,1.1,863.2,148
CDM,64510OH,NJX ANES STELLATE GANGLION CRV SYMPATHETIC,537.0,349.05,1.1,2656.95,148
CDM,64517OH,INJECTION ANES SUPERIOR HYPOGASTRIC PLEXUS,968.0,629.2,1.1,2656.95,148
CDM,64520OH,INJECTION ANES LMBR/THRC PARAVERTBRL SYMPATHETIC,594.0,386.1,1.1,2656.95,148
CDM,64530OH,INJX ANES CELIAC PLEXUS W/WO RADIOLOGIC MONITRNG,695.0,451.75,1.1,2656.95,148
CDM,64553OH,PRQ IMPLTJ NEUROSTIMULATOR ELTRD CRANIAL NERVE,2452.0,1593.8,1.1,39728.72,148
CDM,64555AOH,PRQ IMPLTJ NEUROSTIMULATOR ELTRD PERIPHERAL NRV (64555),2304.0,1497.6,1.1,19945.48,148
CDM,64555OH,PRQ IMPLTJ NEUROSTIMULATOR ELTRD PERIPHERAL NRV,15993.0,10395.45,1.1,19945.48,148
CDM,64561OH,PRQ IMPLTJ NEUROSTIM ELTRD SACRAL NRVE W/IMAGING,2394.0,1556.1,1.1,19945.48,148
CDM,64566OH,PERC TIB NEUROSTIMULATION PRQ NEEDLE ELECTRODE,264.0,171.6,1.1,863.2,146
CDM,64567OH,PERQ ELEC NRV FIELD STIMJ CRANIAL NRV W/O IMPLTJ,660.0,429.0,1.1,2941.43,106
CDM,64568OH,OPEN IMPLANTATION CRANIAL NERVE NEA & PULSE GEN,3600.0,2340.0,1.1,90562.75,144
CDM,64569OH,REVISION/REPLMT NEUROSTIMLATOR ELTRD CRANIAL NRV,4400.0,2860.0,1.1,39728.72,144
CDM,64570OH,REMOVAL CRNL NRV NSTIM ELTRDS & PULSE GENERATOR,3640.0,2366.0,1.1,19428.17,144
CDM,64575OH,OPEN IMPLANTATION NEA PERIPHERAL NERVE,1768.0,1149.2,1.1,39728.72,144
CDM,64580OH,OPEN IMPLANTATION NEA NEUROMUSCULAR,1676.0,1089.4,1.1,63800.42,144
CDM,64581OH,OPEN IMPLANTATION NEA SACRAL NERVE,5368.0,3489.2,1.1,19945.48,144
CDM,64582OH,OPEN IMPLTJ HPGLSL NRV NSTIM RA PG&RESPIR SENSOR,5600.0,3640.0,1.1,90562.75,142
CDM,64583OH,REVJ/RPLCMT HPGLSL NERVE NSTIM RA PG&RESPIR SNR,5800.0,3770.0,1.1,39728.72,142
CDM,64584OH,REMOVAL HYPOGLOSSAL NERVE NSTIM RA PG&RESPIR SNR,4800.0,3120.0,1.1,19428.17,142
CDM,64585OH,REVJ/RMVL PERIPHERAL NEUROSTIMULATOR ELECTRODE,844.0,548.6,1.1,9923.76,148
CDM,64590OH,INS/RPLC PERPH SAC/GSTRC NPG/RCVR PCKT CRTJ&CONN,2244.0,1458.6,1.1,63800.42,148
CDM,64595OH,REV/RMV PRPH SAC/GSTRC NPG/RCV DTCH CONN ELTR RA,1516.0,985.4,1.1,9923.76,148
CDM,64596OH,INSJ/RPLCMT PERQ ELTRD RA PN W/INT NSTIM 1ST RA,2856.0,1856.4,1.1,39728.72,88
CDM,64597OH,INSJ/RPLCMT PERQ ELTRD RA PN INT NSTIM EA ADD RA,2856.0,1856.4,1.1,2856.0,88
CDM,64598OH,REVISION/REMOVAL NSTIM ELTRD ARRAY PN INT NSTIM,1047.0,680.55,1.1,9923.76,88
CDM,64600OH,DSTRJ TRIGEMINAL NRV SUPRAORB INFRAORB BRANCH,1396.0,907.4,1.1,2656.95,148
CDM,64605OH,DSTRJ NEUROLYTIC TRIGEMINAL NRV 2/3 DIV BRANCH,2260.0,1469.0,1.1,5632.24,148
CDM,64610OH,DSTRJ NEURLYTIC TRIGEM NRV 2/3 DIV RADIO MONITOR,2880.0,1872.0,1.1,5632.24,148
CDM,64611OH,CHEMODENERV PAROTID&SUBMANDIBL SALIVARY GLNDS BI,412.0,267.8,1.1,863.2,148
CDM,64612OH,CHEMODNRVTJ MUSC MUSC INNERVATED FACIAL NRV UNIL,620.0,403.0,1.1,863.2,148
CDM,64615OH,CHEMODERVATE FACIAL/TRIGEM/CERV MUSC MIGRAINE,814.0,529.1,1.1,863.2,148
CDM,64616OH,CHEMODENERVATION MUSCLE NECK UNILAT FOR DYSTONIA,673.0,437.45,1.1,863.2,148
CDM,64617OH,CHEMODENERVATION MUSCLE LARYNX UNILAT W/EMG,836.0,543.4,1.1,2017.2,148
CDM,64620OH,DSTRJ NEUROLYTIC AGENT INTERCOSTAL NERVE,1272.0,826.8,1.1,2656.95,148
CDM,64624OH,DESTRUCTION NEUROLYTIC AGT GENICULAR NERVE W/IMG,1000.0,650.0,1.1,5632.24,148
CDM,64625OH,RADIOFREQUENCY ABLTJ NRV NRVTG SI JT W/IMG GDN,1356.0,881.4,1.1,5632.24,148
CDM,64628OH,THERMAL DSTRJ INTRAOSSEOUS BVN 1ST 2 LMBR/SAC,2860.0,1859.0,1.1,38384.94,142
CDM,64629OH,THERMAL DSTRJ INTRAOSSEOUS BVN EA ADDL LMBR/SAC,1508.0,980.2,1.1,1508.0,142
CDM,64630OH,DSTRJ NEUROLYTIC AGENT PUDENDAL NERVE,1342.0,872.3,1.1,2656.95,148
CDM,64632OH,DEST BY NEUROLYTIC AGENT; PLANTAR COMM DIG NERVE,541.0,351.65,1.1,863.2,148
CDM,64633OH,DSTR NROLYTC AGNT PARVERTEB FCT SNGL CRVCL/THORA,1461.0,949.65,1.1,5632.24,148
CDM,64634OH,DSTR NROLYTC AGNT PARVERTEB FCT ADDL CRVCL/THORA,581.0,377.65,1.1,839.02,148
CDM,64635OH,DSTR NROLYTC AGNT PARVERTEB FCT SNGL LMBR/SACRAL,1461.0,949.65,1.1,5632.24,148
CDM,64636OH,DSTR NROLYTC AGNT PARVERTEB FCT ADDL LMBR/SACRAL,510.0,331.5,1.1,788.06,148
CDM,64640OH,DSTRJ NEUROLYTIC AGENT OTHER PERIPHERAL NERVE,871.0,566.15,1.1,2656.95,148
CDM,64642OH,CHEMODENERVATION ONE EXTREMITY 1-4 MUSCLE,726.0,471.9,1.1,2017.2,148
CDM,64643OH,CHEMODENERVATION 1 EXTREMITY EA ADDL 1-4 MUSCLE,537.0,349.05,1.1,537.0,148
CDM,64644OH,CHEMODENERVATION 1 EXTREMITY 5 OR MORE MUSCLES,801.0,520.65,1.1,2017.2,148
CDM,64645OH,CHEMODENERVATION 1 EXTREMITY EA ADDL 5/> MUSCLES,612.0,397.8,1.1,612.0,148
CDM,64646OH,CHEMODENERVATION OF TRUNK MUSCLE 1-5 MUSCLES,792.0,514.8,1.1,2017.2,148
CDM,64647OH,CHEMODENERVATION OF TRUNK 6 OR MORE MUSCLES,844.0,548.6,1.1,2017.2,148
CDM,64650OH,CHEMODENERVATION ECCRINE GLANDS BOTH AXILLAE,280.0,182.0,1.1,863.2,148
CDM,64653OH,CHEMODENERVATION ECCRINE GLANDS OTH AREA PER DAY,352.0,228.8,1.1,863.2,148
CDM,64654OH,INITIAL OPEN IMPLANTATION BAT MODULATION SYSTEM,4840.0,3146.0,1.1,4840.0,106
CDM,64655OH,REVISION/RPLCMT BAT MODULATION SYSTEM LEAD ONLY,4972.0,3231.8,1.1,4972.0,106
CDM,64656OH,REVISION/RPLCMT BAT MODULATION SYSTEM PG ONLY,3524.0,2290.6,1.1,3524.0,106
CDM,64657OH,REMOVAL BAT MODULATION SYSTEM TOTAL SYSTEM,5337.0,3469.05,1.1,5337.0,106
CDM,64658OH,REMOVAL BAT MODULATION SYSTEM LEAD ONLY,3938.0,2559.7,1.1,3938.0,106
CDM,64659OH,REMOVAL BAT MODULATION SYSTEM PG ONLY,3621.0,2353.65,1.1,3621.0,106
CDM,64680OH,DSTRJ NEUROLYTIC W/WO RAD MONITOR CELIAC PLEXUS,1175.0,763.75,1.1,2656.95,148
CDM,64681OH,DSTRJ NULYT W/WORAD MNTR SUPRIOR HYPOGSTR PLEXUS,1512.0,982.8,1.1,2656.95,148
CDM,64702OH,NEUROPLASTY DIGITAL 1/BOTH SAME DIGIT,2504.0,1627.6,1.1,5632.24,144
CDM,64704OH,NEUROPLASTY NERVE HAND/FOOT,1876.0,1219.4,1.1,5632.24,144
CDM,64708OH,NEURP MAJOR PRPH NRV ARM/LEG OPN OTH/THN SPEC,2544.0,1653.6,1.1,5632.24,144
CDM,64712OH,NEURP MAJOR PRPH NRV OPN ARM/LEG SCIATIC NRV,3228.0,2098.2,1.1,5632.24,144
CDM,64713OH,NEURP MAJOR PRPH NRV OPN ARM/LEG BRACH PLEXUS,4560.0,2964.0,1.1,5632.24,144
CDM,64714OH,NEURP MAJOR PRPH NRV OPN ARM/LEG LMBR PLEXUS,4220.0,2743.0,1.1,5632.24,144
CDM,64716OH,NEUROPLASTY &/TRANSPOSITION CRANIAL NERVE,3076.0,1999.4,1.1,5632.24,144
CDM,64718OH,NEUROPLASTY &/TRANSPOSITION ULNAR NERVE ELBOW,2904.0,1887.6,1.1,5632.24,144
CDM,64719OH,NEUROPLASTY &/TRANSPOSITION ULNAR NERVE WRIST,1988.0,1292.2,1.1,5632.24,144
CDM,64721OH,NEUROPLASTY &/TRANSPOS MEDIAN NRV CARPAL TUNNE,1988.0,1292.2,1.1,5632.24,148
CDM,64722OH,DECOMPRESSION UNSPECIFIED NERVE,1928.0,1253.2,1.1,5632.24,144
CDM,64726OH,DECOMPRESSION PLANTAR DIGITAL NERVE,1708.0,1110.2,1.1,5632.24,144
CDM,64727OH,INTERNAL NEUROLYSIS REQ OPERATING MICROSCOPE,1240.0,806.0,1.1,1240.0,144
CDM,64728OH,DCMPRN MEDIAN NRV AT CARPL TUNL PERQ BALO DILAT,1188.0,772.2,1.1,3441.81,106
CDM,64732OH,TRANSECTION/AVULSION SUPRAORBITAL NERVE,1956.0,1271.4,1.1,5632.24,144
CDM,64734OH,TRANSECTION/AVULSION INFRAORBITAL NERVE,2220.0,1443.0,1.1,5632.24,144
CDM,64736OH,TRANSECT OR AVULSE; MENTAL NERVE,2092.0,1359.8,1.1,5632.24,144
CDM,64738OH,TRANSECTION/AVULSION INF ALVEOLAR NRV W/OSTEO,2544.0,1653.6,1.1,5632.24,144
CDM,64740OH,TRANSECTION/AVULSION LINGUAL NERVE,2488.0,1617.2,1.1,5632.24,144
CDM,64742OH,TRANSECTION/AVULSION FACIAL NRV DIFFERENT/CMPL,2740.0,1781.0,1.1,5632.24,144
CDM,64744OH,TRANSECTION/AVULSION GREATER OCCIPITAL NERVE,2288.0,1487.2,1.1,5632.24,144
CDM,64746OH,TRANSECTION/AVULSION PHRENIC NERVE,2624.0,1705.6,1.1,5632.24,144
CDM,64755OH,TRANSECTION/AVULSION VAGUS NERVES,6020.0,3913.0,1.1,6020.0,144
CDM,64760OH,TRANSECTION/AVULSION VAGUS NERVE ABDOMINAL,3036.0,1973.4,1.1,3036.0,144
CDM,64771OH,TRANSECTION/AVULSION OTH CRANIAL NRV XDRL,3260.0,2119.0,1.1,5632.24,144
CDM,64772OH,TRANSECTION/AVULSION OTH SPINAL NRV XDRL,3136.0,2038.4,1.1,5632.24,144
CDM,64774OH,EXC NEUROMA CUTAN NRV SURGLY IDENTIFIABLE,2320.0,1508.0,1.1,5632.24,144
CDM,64776OH,EXC NEUROMA DIGITAL NERVE 1 OR BOTH SAME DIGIT,2240.0,1456.0,1.1,5632.24,144
CDM,64778OH,"EXCISE DIGITAL NEUROMA,ADDNL DIGIT",1244.0,808.6,1.1,1244.0,144
CDM,64782OH,EXC NEUROMA HAND/FOOT XCP DIGITAL NERVE,2744.0,1783.6,1.1,5632.24,144
CDM,64783OH,EXC NEUROMA HAND/FOOT EA NRV XCP SM DGT,1484.0,964.6,1.1,1484.0,144
CDM,64784OH,EXC NEUROMA MAJOR PERIPHERAL NRV XCP SCIATIC,4248.0,2761.2,1.1,5632.24,144
CDM,64786OH,EXCISE SCIATIC NERVE NEUROMA,6500.0,4225.0,1.1,19428.17,144
CDM,64787OH,IMPLANT NERVE END TO BONE/MUSC,1716.0,1115.4,1.1,1716.0,144
CDM,64788OH,EXC NEUROFIBROMA/NEUROLEMMOMA CUTAN NRV,2096.0,1362.4,1.1,5632.24,144
CDM,64790OH,EXC NEUROFIBROMA/NEUROLEMMOMA MAJOR PRPH NRV,4840.0,3146.0,1.1,5632.24,144
CDM,64792OH,EXC NEUROFIBROMA/NEUROLEMMOMA EXTNSV,6344.0,4123.6,1.1,19428.17,144
CDM,64795OH,BIOPSY OF NERVE,1204.0,782.6,1.1,5632.24,144
CDM,64802OH,"SYMPATHECTOMY,CERVICAL",4148.0,2696.2,1.1,5632.24,144
CDM,64804OH,"SYMPATHECTOMY,CERVICOTHORACIC",6364.0,4136.6,1.1,6364.0,144
CDM,64809OH,"SYMPATHECTOMY,THORACOLUMBAR",5884.0,3824.6,1.1,5884.0,144
CDM,64818OH,"SYMPATHECTOMY,LUMBAR",4536.0,2948.4,1.1,4536.0,144
CDM,64820OH,"SYMPATHECTOMY,DIGITAL ARTERIES",4296.0,2792.4,1.1,5632.24,144
CDM,64821OH,SYMPATHECTOMY RADIAL ARTERY,3732.0,2425.8,1.1,9440.12,144
CDM,64822OH,SYMPATHECTOMY ULNAR ARTERY,3732.0,2425.8,1.1,9440.12,144
CDM,64823OH,SYMPATHECTOMY SUPERFICIAL PALMAR ARCH,4376.0,2844.4,1.1,9440.12,144
CDM,64831OH,SUTURE DIGITAL NERVE HAND/FOOT 1 NERVE,3664.0,2381.6,1.1,5632.24,144
CDM,64832OH,SUTR DIGITAL NRV HAND/FOOT EA DGTAL NRV,2260.0,1469.0,1.1,2260.0,144
CDM,64834OH,SUTURE 1 NERVE HAND/FOOT COMMON SENSORY NERVE,4324.0,2810.6,1.1,19428.17,144
CDM,64835OH,SUTURE 1 NERVE MEDIAN MOTOR THENAR,5161.0,3354.65,1.1,19428.17,144
CDM,64836OH,SUTURE 1 NERVE ULNAR MOTOR,4692.0,3049.8,1.1,19428.17,144
CDM,64837OH,SUTURE EACH ADDITIONAL NERVE HAND/FOOT,2500.0,1625.0,1.1,2500.0,144
CDM,64840OH,SUTURE POSTERIOR TIBIAL NERVE,5608.0,3645.2,1.1,19428.17,144
CDM,64856OH,SUTR PRPH NRV ARM/LEG XCP SCIATIC W/TRPOS,6028.0,3918.2,1.1,19428.17,144
CDM,64857OH,SUTR PRPH NRV ARM/LEG XCP SCIATIC W/O TRPOS,6328.0,4113.2,1.1,19428.17,144
CDM,64858OH,SUTURE SCIATIC NERVE,7128.0,4633.2,1.1,7128.0,144
CDM,64859OH,SUTURE EACH ADDITIONAL PERIPHERAL NERVE,1700.0,1105.0,1.1,1700.0,144
CDM,64861OH,SUTURE BRACHIAL PLEXUS,8356.0,5431.4,1.1,8356.0,144
CDM,64862OH,SUTURE LUMBAR PLEXUS,8436.0,5483.4,1.1,19428.17,144
CDM,64864OH,SUTURE FACIAL NERVE EXTRACRANIAL,5900.0,3835.0,1.1,19428.17,144
CDM,64865OH,SUTURE FACIAL NERVE INFRATEMPORAL W/WO GRAFT,6436.0,4183.4,1.1,19428.17,144
CDM,64866OH,ANAST FACIAL-SPINAL ACCESS,6732.0,4375.8,1.1,6732.0,144
CDM,64868OH,ANAST FACIAL-HYPOGLOSSAL NERVE,5960.0,3874.0,1.1,5960.0,144
CDM,64872OH,"REPR NERVE,SECONDARY/DELAY",796.0,517.4,1.1,796.0,144
CDM,64874OH,"REPR/TRANSPOSE NERVE,SECONADARY",1192.0,774.8,1.1,1192.0,144
CDM,64885OH,"NERVE GRAFT,HEAD/NECK,ONE,=<4CM",7040.0,4576.0,1.1,19428.17,144
CDM,64886OH,"NERVE GRAFT,HEAD/NECK,ONE,>4CM",8328.0,5413.2,1.1,19428.17,144
CDM,64890OH,"NERVE GRAFT,HAND/FOOT,ONE,=<4CM",6496.0,4222.4,1.1,19428.17,144
CDM,64892OH,"NERVE GRAFT,ARM/LEG,ONE,UP TO 4CM",6296.0,4092.4,1.1,19428.17,144
CDM,64893OH,"NERVE GRAFT,ARM/LEG,ONE,>4CM",6748.0,4386.2,1.1,19428.17,144
CDM,64895OH,NRV GR MUL HND/FT TO 4 CM,8156.0,5301.4,1.1,19428.17,144
CDM,64896OH,NERVE GRAFT MULT STR HND/FT; > 4CM,8784.0,5709.6,1.1,19428.17,144
CDM,64897OH,"NERV GRFT,ARM/LEG,MULT,=<4CM",7752.0,5038.8,1.1,19428.17,144
CDM,64898OH,NERVE GRAFT MULTI STR ARM/LEG; > 4 CM,8388.0,5452.2,1.1,19428.17,144
CDM,64901OH,"ADDNL NERVE GRAFT,SINGLE STRAND",4080.0,2652.0,1.1,4080.0,144
CDM,64902OH,"ADDNL NERVE GRAFT,MULTPL STRANDS",4724.0,3070.6,1.1,4724.0,144
CDM,64905OH,"NERVE PEDICLE XFER,FIRST STAGE",6044.0,3928.6,1.1,19428.17,144
CDM,64907OH,"NERVE PEDICLE XFER,SECOND STAGE",8012.0,5207.8,1.1,19428.17,144
CDM,64910OH,NERVE REPAIR W/CONDUIT EACH NERVE,4629.0,3008.85,1.1,19428.17,144
CDM,64911OH,NERVE REPAIR W/AUTOGENOUS VEIN GRAFT EA NERVE,5600.0,3640.0,1.1,19428.17,144
CDM,64912OH,NERVE REPAIR W/NERVE ALLOGRAFT FIRST STRAND,4800.0,3120.0,1.1,19428.17,144
CDM,64913OH,NERVE REPAIR W/NERVE ALLOGRAFT EA ADDL STRAND,1200.0,780.0,1.1,1200.0,144
CDM,64999BOH,TRIGEMINAL BALLOON COMPRESSION,1855.0,1205.75,0.01,1855.0,82
CDM,64999RVU10OH,TRANSMASTOID RPR ENCEPH BY TISS GRFT,6131.0,3985.15,0.01,6131.0,82
CDM,64999RVU11OH,CORE NEEDLE BX INTRACRAN,515.0,334.75,0.01,863.2,82
CDM,64999RVU12OH,NEUROENDO REPAIR CSF LEAK,11909.0,7740.85,0.01,11909.0,82
CDM,64999RVU13OH,NEUROENDO REPAIR OF SKULL BASE ENCEPHALOCELE; UNILAT (COMP 62121,7600.0,4940.0,0.01,7600.0,82
CDM,64999RVU14OH,"NEUROENDOSCOPY, EXPLORATORY/BIOPSY W/O EXCISION OF PITUITARY TUM",7119.0,4627.35,0.01,7119.0,82
CDM,64999RVU15OH,ENDOS TRANSNASAL INTRACRANIAL BIOPSY,8570.0,5570.5,0.01,8570.0,82
CDM,64999RVU16OH,EMS ENCEPHALOMYOSYNANGIOSIS,4941.0,3211.65,0.01,4941.0,82
CDM,64999RVU17OH,SACRAL FUSE W/INSTR S1/S2,9280.0,6032.0,0.01,9280.0,82
CDM,64999RVU18OH,LASER INTERSTITIAL THERMAL THERAPY(LITT,13543.0,8802.95,0.01,13543.0,82
CDM,64999RVU19OH,"ENDOS RESCT SKULL BASE MALIG,PTERGOMAX",23930.0,15554.5,0.01,23930.0,82
CDM,64999RVU1OH,SPINAL HARDWARE INJECTION 1 LEVEL,502.0,326.3,0.01,863.2,82
CDM,64999RVU20OH,ANTER CRANFAC RESECT W ENDOS ASSIS (COMP 61601),21664.0,14081.6,0.01,21664.0,82
CDM,64999RVU21OH,MIDDLE CRANFAC RESECT W/ENDO ASSIST (COMP 61608),26416.0,17170.4,0.01,26416.0,82
CDM,64999RVU22OH,EXTERNAL VENTRICULAR CATH (COMP CODE 61107),1235.0,802.75,0.01,1235.0,82
CDM,64999RVU23OH,ENDOS RESCT TRANSNASAL SKULL BASE TMR,23930.0,15554.5,0.01,23930.0,82
CDM,64999RVU24OH,GANGLION IMPAR BLOCK INJ,419.0,272.35,0.01,863.2,82
CDM,64999RVU25OH,PARS BLOCK INJECTION,502.0,326.3,0.01,863.2,82
CDM,64999RVU26OH,"RFA OTHER (ROOT GANGLION, JOINT, ETC)",864.0,561.6,0.01,864.0,82
CDM,64999RVU27OH,"PULSED RF LUMB/SACR, 1ST LEVEL",1388.0,902.2,0.01,1388.0,82
CDM,64999RVU29OH,FIDUCIAL MARKER PLACEMENT,1798.0,1168.7,0.01,1798.0,82
CDM,64999RVU2OH,REMOVAL OF OMMAYA RESERVOIR,1627.0,1057.55,0.01,1627.0,82
CDM,64999RVU30OH,EXTERNAL VENTRICULAR CATH,1235.0,802.75,0.01,1235.0,82
CDM,64999RVU32OH,EDAS (ENCEPHALO DURO ARTERIO SYNAGIOSIS),5030.0,3269.5,0.01,5030.0,82
CDM,64999RVU33OH,EDAM,9883.0,6423.95,0.01,9883.0,82
CDM,64999RVU34OH,NEUROENDOSCOPY INTRACRANIAL WITH SELLAR RECONSTRUCTION,9688.0,6297.2,0.01,9688.0,82
CDM,64999RVU35OH,SUBTEMP SKULLBASE MID & POST FOSSA TMR (61616),28895.0,18781.75,0.01,28895.0,82
CDM,64999RVU36OH,PERCUTANEOUS GASSERIAN BALLOON DECOMPRESSION (COMP 64605),1855.0,1205.75,0.01,1855.0,82
CDM,64999RVU37OH,ENDOSCOPIC BURR HOLE/TREPHINE W DRAIN OF BRAIN ABSCESS OR CYST (,6204.0,4032.6,0.01,6204.0,82
CDM,64999RVU38OH,ENDOSCOPIC ENDONASAL APPROACH FOR RESECTION OF ORBITAL TUMOR (CO,9659.0,6278.35,0.01,9659.0,82
CDM,64999RVU39OH,REMOVAL OF SEEG ELECTRODES,4340.0,2821.0,0.01,4340.0,82
CDM,64999RVU3OH,AUTOLITT PROCEDURE W/O BIOPSY,12718.0,8266.7,0.01,12718.0,82
CDM,64999RVU40OH,"ENDO ENDONASAL, RESECTN ORB TUMOR; COMPLEX (COMP 61333-22)",12073.75,7847.94,0.01,12073.75,82
CDM,64999RVU41OH,"NEUROENDO REPR, SKULL BASE ENCEPHALOCELE; BIL (COMP 62121-50)",15200.0,9880.0,0.01,15200.0,82
CDM,64999RVU44OH,NERVE WRAPPING (COMP CODE 15271),646.0,419.9,0.01,863.2,82
CDM,64999RVU45OH,"UNLIST PROC, NERVOUS SYSTEM COMPARED TO 64640",863.0,560.95,0.01,863.2,82
CDM,64999RVU46OH,"DSTR NRLYTC AGNT PARAVERT FCT SNGL CERV/THOR, LOW THERM <80* (CO",1267.0,823.55,0.01,1267.0,82
CDM,64999RVU47OH,"DSTR NRLYTC AGNT PARAVERT FCT EA ADDT CERV/THOR, LOW THERM <80*",436.0,283.4,0.01,863.2,82
CDM,64999RVU48OH,"DSTR NRLYTC AGNT PARAVERT FCT SNG LUMB/SACRAL, LOW THERM <80* (C",1247.0,810.55,0.01,1247.0,82
CDM,64999RVU49OH,"DSTR NRLYTC AGNT PARAVERT FCT EA ADDT LUMB/SACRAL, LOW THERM <80",383.0,248.95,0.01,863.2,82
CDM,64999RVU4OH,ENDOS TRANSNASAL INTRACRANIAL BIOPSY (COMP CODE 61570),8570.0,5570.5,0.01,8570.0,82
CDM,64999RVU50OH,"DSTR NRLYTC AGNT OTHER PERIPH NER/BRNCH, LOW THERM <80* (COMP CO",851.0,553.15,0.01,863.2,82
CDM,64999RVU51OH,"CHEMODENERVATION ECCRINE GLANDS, PALM/FOOT (COMP 64650)",281.0,182.65,0.01,863.2,82
CDM,64999RVU52OH,"INJ, ANESTHETIC AGENT; CERVICAL PLEXUS (COMP 64425)",578.0,375.7,0.01,863.2,82
CDM,64999RVU53OH,POST-OPERATIVE INTERCOSTAL NERVE BLOCK (COMP 64809),4854.0,3155.1,0.01,4854.0,82
CDM,64999RVU54OH,"UNLISTED PROC, INJECTION, ANESTHETIC AGENT, CERVICAL PLEXUS (COM",488.0,317.2,0.01,863.2,82
CDM,64999RVU56OH,BOTOX INJECTION INTO PERIVASCULAR TISSUE (CODE 64644),601.0,390.65,0.01,863.2,82
CDM,64999RVU57OH,QUTENZA APPLICATION (COMP 64632),406.0,263.9,0.01,863.2,82
CDM,64999RVU58OH,PECTO-INTERCOSTAL NERVE BLOCK (COMP 64450),566.0,367.9,0.01,863.2,82
CDM,64999RVU5OH,LAP PLACEMENT OF VP SHUNT,3478.0,2260.7,0.01,3478.0,82
CDM,64999RVU60OH,GANGLION OF IMPAR BLOCKADE UNDER FLUOROSCOPIC GUIDANCE (COMP COD,171.0,111.15,0.01,863.2,82
CDM,64999RVU61OH,"ERECTOR SPINAE BLOCKAGE, RIGHT T7 UNDER FLUOROSCOPIC GUIDANCE (C",753.0,489.45,0.01,863.2,82
CDM,64999RVU63OH,SPINAL HARDWARE INJECTION (COMP CODE 64493),646.0,419.9,0.01,863.2,82
CDM,64999RVU69OH,PECS 1 & PECS 2 UNILAT CONTINUOUS INFUSION CATH (COMP CODE 64487,629.0,408.85,0.01,863.2,82
CDM,64999RVU6OH,MASSETER NRV TO FAC NRV ANASTOMOSIS (COMP 64865),4917.0,3196.05,0.01,4917.0,82
CDM,64999RVU72OH,UNLISTED LAPAROSCOPIC PUDENDAL NERVE DECOMPRESSION (COMP CODE 64,4220.0,2743.0,0.01,4220.0,82
CDM,64999RVU7OH,UNLISTED PROCEDURE NERVOUS SYSTEM,12718.0,8266.7,0.01,12718.0,82
CDM,64999RVU80OH,LAPAROSCOPIC NEURECTOMY (COMP CODE 64772),3332.0,2165.8,1.1,5632.24,144
CDM,64999RVU81OH,UNLISTED LAP ILIOINGUINAL AND GENITOFEMORAL NEURECTOMY (COMP COD,3332.0,2165.8,0.01,3332.0,82
CDM,64999RVU82OH,LARYNGEAL REINNERVATION USING CERVICAL NERVE BRANCHES (COMP CODE,6059.0,3938.35,0.01,6059.0,82
CDM,64999RVU83OH,IMPAR GANGLION COCCYGEAL NEUROLYSIS (COMP CODE 64680),1175.0,763.75,0.01,1175.0,82
CDM,64999RVU84OH,SPINAL ACCESSORY NERVE BLOCK (COMP CODE 64405),414.0,269.1,0.01,863.2,82
CDM,64999RVU85OH,TRANSPALATAL APPROACH FOR REMOVAL OF FOREIGN BODY (61575),14624.0,9505.6,0.01,14624.0,82
CDM,64999RVU8OH,ANTER CRANFAC RESECT W/ENDOS ASSIS (COMP CODE 61580),14951.0,9718.15,0.01,14951.0,82
CDM,64999RVU9OH,NEUROENDO REPAIR CSF LEAK (COMP CODE 31291),5518.0,3586.7,0.01,5518.0,82
CDM,64999RVUOH,CONTINUOUS CATHETER TAP BLOCK,597.0,388.05,0.01,863.2,82
CDM,65091OH,EVISCERATION OCULAR CONTENTS W/O IMPLANT,2904.0,1887.6,1.1,11276.72,144
CDM,65093OH,EVISCERATION OCULAR CONTENTS W/IMPLANT,2816.0,1830.4,1.1,11276.72,144
CDM,65101OH,ENUCLEATION OF EYE W/O IMPLANT,3320.0,2158.0,1.1,11276.72,144
CDM,65103OH,ENUCLEATION EYE IMPLT MUSC X ATTACHED IMPLT,3536.0,2298.4,1.1,11276.72,144
CDM,65105OH,ENUCLEATION EYE IMPLT MUSC ATTACHED IMPLT,4369.0,2839.85,1.1,11276.72,144
CDM,65110OH,EXENTERATION ORBIT REMVL ORBITAL CONTENTS ONLY,6280.0,4082.0,1.1,11276.72,144
CDM,65112OH,EXENTERATION ORBIT RMVL ORBIT CONTENTS & BONE,7404.0,4812.6,1.1,11276.72,144
CDM,65114OH,EXNTJ ORBIT RMVL ORB CNTS W/MUSC/MYOQ FLAP,7860.0,5109.0,1.1,11276.72,144
CDM,65125OH,MODIFICAJ OC IMPLT W/PLMT/RPLCMT PEGS SPX,1308.0,850.2,1.1,6813.79,148
CDM,65130OH,INSJ OC IMPLT SEC AFTER EVSC SCLL SHELL,3368.0,2189.2,1.1,11276.72,144
CDM,65140OH,INSJ OC IMPLT AFTER ENCL MUSC ATTACHED,3784.0,2459.6,1.1,11276.72,144
CDM,65150OH,REINSERTION OCULAR IMPLT W/WO CONJUNCTIVAL GRAFT,2572.0,1671.8,1.1,11276.72,144
CDM,65155OH,REINSERTION OCULAR IMPLT RNFCMT &/ ATTACH MUSCLE,4040.0,2626.0,1.1,11276.72,144
CDM,65175OH,REMOVAL OF OCULAR IMPLANT,2960.0,1924.0,1.1,11276.72,144
CDM,65205OH,REMOVAL FB EYE CONJUNCTIVAL SUPERFICIAL,216.0,140.4,1.1,373.44,144
CDM,65210OH,RMVL FB XTRNL EYE EMBED SCJNCL/SCLERAL NONPERFOR,268.0,174.2,1.1,1163.18,148
CDM,65220OH,RMVL FB XTRNL EYE CORNEAL W/O SLIT LAMP,312.0,202.8,1.1,1163.18,148
CDM,65222OH,RMVL FB XTRNL EYE CORNEAL W/SLIT LAMP,370.0,240.5,1.1,373.44,148
CDM,65235OH,RMVL FB INTRAOCULAR ANT CHAMBER EYE/LENS,3604.0,2342.6,1.1,6795.42,144
CDM,65260OH,RMVL FB IO FROM POST SEG MAG XTRJ ANT/POST ROUTE,5016.0,3260.4,1.1,6795.42,144
CDM,65265OH,RMVL FB IO FROM POST SEG NONMAGNETIC XTRJ,5736.0,3728.4,1.1,6795.42,144
CDM,65270OH,RPR LAC CJNC W/WO NONPERFOR LAC SCLERA DIR CLSR,780.0,507.0,1.1,6813.79,148
CDM,65272OH,RPR LAC CJNC MOBLJ& REARGMT W/O HOSPITALIZATION,1848.0,1201.2,1.1,6813.79,148
CDM,65275OH,RPR LAC CORNEA NONPERFOR W/WO RMVL FOREIGN BODY,2516.0,1635.4,1.1,11276.72,148
CDM,65280OH,RPR LAC CORNEA&/SCLERA PERFOR X INVG UVEAL TIS,3640.0,2366.0,1.1,15243.78,144
CDM,65285OH,RPR LAC CORN&/SCLRA PERF W/REPOS/RESCJ UVEAL T,6144.0,3993.6,1.1,15243.78,144
CDM,65286OH,RPR LAC APPL TISSUE GLUE WOUND CORNEA&/SCLERA,2652.0,1723.8,1.1,6795.42,148
CDM,65290OH,RPR WND EXTRAOCULAR MUSCLE TENDON&/TENON CAPSU,2612.0,1697.8,1.1,11276.72,144
CDM,65400OH,EXCISION LESION CORNEA XCP PTERYGIUM,3000.0,1950.0,1.1,3000.0,148
CDM,65410OH,BIOPSY OF CORNEA,588.0,382.2,1.1,6813.79,148
CDM,65420OH,EXCISION/TRANSPOSITION PTERYGIUM W/O GRAFT,1744.0,1133.6,1.1,6813.79,148
CDM,65426OH,EXCISION/TRANSPOSITION PTERYGIUM W/GRAFG,2420.0,1573.0,1.1,6813.79,148
CDM,65430OH,CORNEA SCRAPING DIAGNOSTIC SMEAR &/CULTURE,588.0,382.2,1.1,1163.18,148
CDM,65435OH,RMVL CORNEAL EPITHELIUM W/WO CHEMOCAUTERIZATION,368.0,239.2,1.1,2953.87,148
CDM,65436OH,RMVL CORNEAL EPITHELIUM W/APPL CHELATING AGENT,1928.0,1253.2,1.1,6813.79,148
CDM,65450OH,DSTRJ LESION CRYOTHER PHOTO/THERMOCAUTZATION,1388.0,902.2,1.1,1388.0,148
CDM,65600OH,MULT PUNC ANTER CORNEA,1680.0,1092.0,1.1,6813.79,148
CDM,65710OH,KERATOPLASTY ANTERIOR LAMELLAR,5780.0,3757.0,1.1,15243.78,144
CDM,65730OH,KERATOPLASTY PENTRG EXCEPT APHAKIA/PSEUDOPHAKIA,7194.0,4676.1,1.1,11858.31,144
CDM,65750OH,KERATOPLASTY PENETRAING APHAKIA,6760.0,4394.0,1.1,15243.78,144
CDM,65755OH,KERATOPLASTY PENETRATING PSEUDOPHAKIA,6716.0,4365.4,1.1,11858.31,144
CDM,65756OH,KERATOPLASTY ENDOTHELIAL,7410.0,4816.5,1.1,11858.31,144
CDM,65757OH,BACKBENCH PREPJ CORNEAL ENDOTHELIAL ALLOGRAFT,1284.0,834.6,1.1,1816.12,104
CDM,65770OH,KERATOPROSTHESIS,7896.0,5132.4,1.1,36156.53,144
CDM,65772OH,CRNL RELAXING INC CORRJ INDUCED ASTIGMATISM,2036.0,1323.4,1.1,2953.87,148
CDM,65775OH,CRNL WEDGE RESCJ CORRJ INDUCED ASTIGMATISM,2764.0,1796.6,1.1,6813.79,144
CDM,65778NEOXOH,PLACE AMNIOTIC MEMB OCULAR SURFACE SELF RETAIN,2904.0,1887.6,1.1,4797.44,148
CDM,65778OH,PLACE AMNIOTIC MEMBRA OCULAR SURFACE W/O SUTURES,336.0,218.4,1.1,4797.44,148
CDM,65779OH,PLACE AMNIOTIC MEMBRANE OCULAR SURFACE SUTURED,700.0,455.0,1.1,11276.72,148
CDM,65780OH,OCULAR SURFACE RECONSTRUCTION AMNIOTIC MEMBRANE,2812.0,1827.8,1.1,11276.72,144
CDM,65781OH,OCULAR SURFACE RECONSTRUCTION LIMBAL ALLOGRAFT,7256.0,4716.4,1.1,15243.78,144
CDM,65782OH,OCCULAR SURFACE RECONSTRUCTION LIMBAL AUTOGRAFT,6172.0,4011.8,1.1,11276.72,144
CDM,65785OH,IMPLANTATION INTRASTROMAL CORNEAL RING SEGMENTS,2372.0,1541.8,1.1,11858.31,148
CDM,65800OH,PARACENTSIS ANT CHAMB EYE ASPIR AQUEOUS SPX,673.0,437.45,1.1,6795.42,148
CDM,65810OH,PARACENTSIS ANT CHAM RMVL VITREOUS W/WO AIR INJX,2328.0,1513.2,1.1,6795.42,144
CDM,65815OH,PARACEN ANT CHAM RMVL BLOOD W/WO IRRIG&/AIR IN,2400.0,1560.0,1.1,6795.42,148
CDM,65820OH,GONIOTOMY,3920.0,2548.0,1.1,11858.31,144
CDM,65850OH,TRABECULOTOMY AB EXTERNO,4556.0,2961.4,1.1,6795.42,144
CDM,65855OH,TRABECULOPLASTY BY LASER SURGERY,1320.0,858.0,1.1,1695.79,148
CDM,65860OH,SEVERING ADHESIONS ANTERIOR SEGMENT LASER SPX,1436.0,933.4,1.1,1695.79,148
CDM,65865OH,SEVERING ADS ANT SEG INCAL TQ SPX GONIOSYNECHIAE,2308.0,1500.2,1.1,6795.42,144
CDM,65870OH,SEVERING ADS ANT SEG INCAL SPX ANT SYNECHIAE,2956.0,1921.4,1.1,6795.42,144
CDM,65875OH,SEVERING ADS ANT SEG INCAL SPX POST SYNECHIAE,3124.0,2030.6,1.1,6795.42,144
CDM,65900OH,RMVL EPITHELIAL DOWNGROWTH ANT CHAMBER EYE,5004.0,3252.6,1.1,6795.42,144
CDM,65920OH,RMVL IMPLANTED MATERIAL ANTERIO SEGMENT EYE,3996.0,2597.4,1.1,6795.42,144
CDM,65930OH,RMVL BLOOD CLOT ANTERIOR SEGMENT EYE,3356.0,2181.4,1.1,6795.42,144
CDM,66020OH,"INJECT ANTER CHMBR EYE,AIR/FLUID",656.0,426.4,1.1,6795.42,148
CDM,66030OH,"INJECT ANTER CHMBR EYE,MEDICATN",520.0,338.0,1.1,6795.42,148
CDM,66130OH,"REMOVE EYE LESION,SCLERA",3132.0,2035.8,1.1,6813.79,148
CDM,66160OH,FSTLJ SCLERA SCLERECTOMY PUNCH/SCISSORS IRIDECT,5452.0,3543.8,1.1,6795.42,144
CDM,66170OH,FSTLJ SCLERA GLAUCOMA TRABECULECT AB EXTERNO,5576.0,3624.4,1.1,6795.42,144
CDM,66172OH,FSTLJ SCLERA GLC TRBEC AB EXTERNO SCARRING,5936.0,3858.4,1.1,6795.42,144
CDM,66174OH,TRLUML DILAT AQUEOUS O/F CAN WO RETENTION DEV/ST,3353.0,2179.45,1.1,11858.31,142
CDM,66175OH,TRLUML DILAT AQUEOUS O/F CAN W/RETENTION DEV/ST,3736.0,2428.4,1.1,15243.78,142
CDM,66179OH,AQUEOUS SHUNT EXTRAOCULAR RESERVOIR W/O GRAFT,5600.0,3640.0,1.1,15243.78,144
CDM,66180OH,AQUEOUS SHUNT EXTRAOC EQUAT PLATE RSVR W/GRAFT,6600.0,4290.0,1.1,11858.31,144
CDM,66183OH,INSERT ANTER DRAINAGE DEV W/O EXTRAOC RESERVOIR,5808.0,3775.2,1.1,11858.31,142
CDM,66184OH,REVJ SHUNT EXTRAOCULAR RESERVOIR W/O GRAFT,3832.0,2490.8,1.1,6795.42,144
CDM,66185OH,REVJ AQUEOUS SHUNT EXTRAOCULAR RESERVOIR W/GRAFT,4232.0,2750.8,1.1,6795.42,144
CDM,66225OH,REPAIR SCLERA STAPHYLOMA W GRAFT,5052.0,3283.8,1.1,15243.78,144
CDM,66250OH,REVJ/RPR OPRATIVE WOUND ANTERIOR SEGMENT,2840.0,1846.0,1.1,6813.79,148
CDM,66500OH,IRIDOTOMY STAB INC SPX XCP TRANSFIXION,1532.0,995.8,1.1,6795.42,144
CDM,66505OH,IRIDOTOMY STAB INC SPX TRANSFIXION,1688.0,1097.2,1.1,6795.42,144
CDM,66600OH,IRDEC CRNLSCLRL/CRNL SCTJ RMVL LES,4048.0,2631.2,1.1,11858.31,144
CDM,66605OH,IRDEC CRNLSCLRL/CRNL SCTJ CYCLECTOMY,5688.0,3697.2,1.1,6795.42,144
CDM,66625OH,IRDEC CRNLSCLRL/CRNL SCTJ PRPH GLC SPX,2120.0,1378.0,1.1,6795.42,144
CDM,66630OH,IRDEC CRNLSCLRL/CRNL SCTJ SECTOR GLC SPX,2912.0,1892.8,1.1,6795.42,144
CDM,66635OH,IRDEC CRNLSCLRL/CRNL SCTJ OPTICAL SPX,2948.0,1916.2,1.1,6795.42,144
CDM,66680OH,REPAIR IRIS/CILIARY BODY,3188.0,2072.2,1.1,6795.42,144
CDM,66682OH,SUTURE IRIS CILIARY BODY SPX RETRIEVAL SUTURE,3496.0,2272.4,1.1,6795.42,144
CDM,66683OH,IMPLTJ IRIS PROSTHESIS W/SUTR FIXJ&RPR/RMVL IRIS,4695.0,3051.75,1.1,4695.0,140
CDM,66700OH,CILIARY BODY DESTRUCTION DIATHERMY,2056.0,1336.4,1.1,6795.42,148
CDM,66710OH,CILIARY BODY DSTRJ CYCLOPHOTOCOAG TRANSSCERAL,2056.0,1336.4,1.1,6813.79,148
CDM,66711OH,ECP CILIARY BODY DSTRJ W/O RMVL CRYSTALLINE LENS,2248.0,1461.2,1.1,6795.42,144
CDM,66720OH,CILIARY BODY DESTRUCTION CRYOTHERAPY,1900.0,1235.0,1.1,6813.79,148
CDM,66740OH,CILIARY BODY DESTRUCTION CYCLODIALYSIS,2056.0,1336.4,1.1,6813.79,148
CDM,66761OH,IRIDOTOMY/IRIDECTOMY BY LASER,1320.0,858.0,1.1,1695.79,148
CDM,66762OH,IRIDOPLASTY PHOTOCOAGULATION 1/> SESSIONS,2152.0,1398.8,1.1,2152.0,148
CDM,66770OH,DSTRJ CYST/LESION IRIS/CILIARY BODY,2452.0,1593.8,1.1,2452.0,148
CDM,66820OH,"DISCISSION,2ND CATARACT,INCIS",1604.0,1042.6,1.1,6795.42,144
CDM,66821OH,POST-CATARACT LASER SURGERY,1505.0,978.25,1.1,1695.79,148
CDM,66825OH,REPOSITIONING IO LENS PROSTHESIS REQ INC SPX,3604.0,2342.6,1.1,6795.42,144
CDM,66830OH,RMVL SEC MEMBRANOUS CTRC CORNEO-SCLL SCTJ,3788.0,2462.2,1.1,6795.42,144
CDM,66840OH,RMVL LENS MATERIAL ASPIR TQ 1/> STAGES,3672.0,2386.8,1.1,6795.42,144
CDM,66850OH,RMVL LENS MATERIAL PHACOFRAGMENTATION ASPIR,4220.0,2743.0,1.1,6795.42,144
CDM,66852OH,RMVL LENS MATERIAL PARS PLANA W/WO VITRECTOMY,4564.0,2966.6,1.1,11858.31,144
CDM,66920OH,RMVL LENS MATERIAL INTRACAPSULAR,4052.0,2633.8,1.1,6795.42,144
CDM,66930OH,REMOVAL LENS MATRL INTRACAPSULAR DISLOCATED LENS,4644.0,3018.6,1.1,11858.31,144
CDM,66940OH,REMOVAL LENS MATERIAL EXTRACAPSULAR,4148.0,2696.2,1.1,6795.42,144
CDM,66982OH,XCAPSL CTRC RMVL INSJ IO LENS PROSTH CPLX WO ECP,4510.0,2931.5,1.1,6795.42,144
CDM,66983OH,ICAPSULAR CATARACT XTRJ INSJ IO LENS PRSTH 1 STG,4416.0,2870.4,1.1,6795.42,106
CDM,66984OH,XCAPSL CTRC RMVL INSJ IO LENS PROSTH W/O ECP,3234.0,2102.1,1.1,6795.42,144
CDM,66985OH,INSJ IO LENS PROSTHESIS NOT W/CONCURRENT RMVL,4391.0,2854.15,1.1,6795.42,144
CDM,66986OH,EXCHANGE INTRAOCULAR LENS,4904.0,3187.6,1.1,6795.42,144
CDM,66989OH,XCAPSL CTRC RMVL INSJ IO LENS PRSTH CPLX INSJ 1+,4852.0,3153.8,1.1,15243.78,142
CDM,66991OH,XCAPSL CTRC RMVL INSJ IO LENS PROSTH INSJ 1+,4061.0,2639.65,1.1,15243.78,142
CDM,66999LROH,LRI/NON-SURGICALLY INDUCED,450.0,292.5,0.01,6795.42,84
CDM,66999RVU10OH,ASA ENHANCEMENT 1-2 YEAR,250.0,162.5,0.01,6795.42,84
CDM,66999RVU11OH,BIOPSY CILIARY BODY OR IRIS BIOPSY,485.0,315.25,0.01,6795.42,84
CDM,66999RVU12OH,FEMTOSECOND LASER W/PRESBYOPIA TREATMENT,500.0,325.0,0.01,6795.42,84
CDM,66999RVU13OH,"LASER ASSISTED CORRECTION OF ASTIGMATISM, TORIC LENS",500.0,325.0,0.01,6795.42,84
CDM,66999RVU14OH,ASA ENHANCEMENT 2-3 YEAR,1000.0,650.0,0.01,6795.42,84
CDM,66999RVU15OH,LASIK ENHANCEMENT 2-3 YEARS,1000.0,650.0,0.01,6795.42,84
CDM,66999RVU16OH,"LASER ASSISTED CORRECTION OF ASTIGMATISM, STANDARD LENS",1900.0,1235.0,0.01,6795.42,84
CDM,66999RVU17OH,PLACEMENT AMNIOTIC MEMBRANE USING GLUE,1295.0,841.75,0.01,6795.42,84
CDM,66999RVU18OH,LASIK ENHANCEMENT 3-5 YEARS,1500.0,975.0,0.01,6795.42,84
CDM,66999RVU19OH,FLAP LIFT W/TISSEEL GLUE,1900.0,1235.0,0.01,6795.42,84
CDM,66999RVU1OH,LASER CORREC OF ASTIG,1200.0,780.0,0.01,6795.42,84
CDM,66999RVU20OH,LASIK CUSTOM,2675.0,1738.75,0.01,6795.42,84
CDM,66999RVU21OH,LASIK SMILE,2675.0,1738.75,0.01,6795.42,84
CDM,66999RVU22OH,REFRACTIVE LENS EXCHANGE,4000.0,2600.0,0.01,6795.42,84
CDM,66999RVU23OH,PHAKIC ICL,4500.0,2925.0,0.01,6795.42,84
CDM,66999RVU24OH,INTACS/TERMED/ USE CPT 65875,5445.0,3539.25,0.01,6795.42,84
CDM,66999RVU29OH,"DESTRUCTION ANTERIOR SEGMENT LESION, RADIATION IMPLANT",6719.0,4367.35,0.01,6795.42,84
CDM,66999RVU2OH,AMNIOTIC MEMBRANE W/GLUE,1295.0,841.75,0.01,6795.42,84
CDM,66999RVU32OH,FLAP LIFT W/WO SUTURE,1950.0,1267.5,0.01,6795.42,84
CDM,66999RVU33OH,PRK,2675.0,1738.75,0.01,6795.42,84
CDM,66999RVU34OH,LASIK,2675.0,1738.75,0.01,6795.42,84
CDM,66999RVU35OH,INTRASTROMAL INJ OF MITOMYCIN-C (COMP CODE 66030),553.0,359.45,0.01,6795.42,84
CDM,66999RVU3OH,"EYE SURGERY PROCEDURE, ANT SEGMENT",2928.0,1903.2,0.01,6795.42,84
CDM,66999RVU4OH,FEMTOSECOND LASER,1000.0,650.0,0.01,6795.42,84
CDM,66999RVU6OH,INTRALASE LASER INCISION/PER EYE,200.0,130.0,0.01,6795.42,84
CDM,66999RVU7OH,IMPLANTATION CORNEAL RING SEGMENTS,5282.0,3433.3,0.01,6795.42,84
CDM,66999RVU9OH,LASIK ENHANCEMENT 1-2 YEARS,250.0,162.5,0.01,6795.42,84
CDM,66999RVUOH,SCLERAL BIOPSY,485.0,315.25,0.01,6795.42,84
CDM,67005OH,RMVL VITREOUS ANT APPR PARTIAL REMOVAL,2356.0,1531.4,1.1,6795.42,144
CDM,67010OH,RMVL VITREOUS ANT APPR SUBTOT RMVL MECH VITRECT,2824.0,1835.6,1.1,6795.42,144
CDM,67015OH,ASPIRATION/RELEASE VITREOUS SUBRETINAL/CHOROIDAL,2856.0,1856.4,1.1,6795.42,144
CDM,67025OH,INJ SUBSTITUTE PARS PLANA/LIMBL W/WO ASPIR SPX,3244.0,2108.6,1.1,6795.42,148
CDM,67027OH,IMPLTJ INTRAVITREAL DRUG DLVR SYS RMVL VTS,4648.0,3021.2,1.1,46031.32,144
CDM,67028OH,INTRAVITREAL NJX PHARMACOLOGIC AGT SPX,634.0,412.1,1.1,988.7,148
CDM,67031OH,SEVERING VITREOUS STRANS LASER 1/> STAGES,1788.0,1162.2,1.1,1788.0,148
CDM,67036OH,VITRECTOMY MECHANICAL PARS PLANA,5337.0,3469.05,1.1,11858.31,144
CDM,67039OH,VITRECTOMY MCHNL PARS PLNA FOCAL ENDOLASER PC,5280.0,3432.0,1.1,11858.31,144
CDM,67040OH,VTRECTOMY MCHNL PARS PLNA ENDOLASER PANRTA PC,5800.0,3770.0,1.1,11858.31,144
CDM,67041OH,VITRECTOMY PARS PLANA REMOVE PRERETINAL MEMBRANE,7185.0,4670.25,1.1,11858.31,144
CDM,67042OH,VITRECTOMY PARS PLANA REMOVE INT MEMB RETINA,6532.0,4245.8,1.1,11858.31,144
CDM,67043OH,VITRECTOMY PARS PLANA REMOVE SUBRETINAL MEMBRANE,6960.0,4524.0,1.1,11858.31,144
CDM,67101OH,RPR RETINAL DTCHMNT DRG SUBRETINAL FLUID CRTX,1400.0,910.0,1.1,6795.42,148
CDM,67105OH,RPR RETINAL DTCHMNT DRG SUBRETINAL FLUID PC,1356.0,881.4,1.1,1695.79,148
CDM,67107OH,REPAIR RETINAL DETACHMENT SCLERAL BUCKLING,6400.0,4160.0,1.1,11858.31,144
CDM,67108OH,RPR RETINAL DTCHMNT W/VITRECTOMY ANY METH,7537.0,4899.05,1.1,11858.31,144
CDM,67110OH,RPR RETINAL DTCHMNT INJECTION AIR/OTHER GAS,4100.0,2665.0,1.1,6795.42,148
CDM,67113OH,RPR COMPLEX RETINA DETACH VITRECT &MEMBRANE PEEL,8360.0,5434.0,1.1,15243.78,144
CDM,67120OH,RMVL IMPLNT MATL POSTERIOR SEGMENT EXTRAOCULAR,2840.0,1846.0,1.1,6795.42,148
CDM,67121OH,RMVL IMPLT MATRL POSTERIOR SEGMENT INTRAOCULAR,4900.0,3185.0,1.1,6795.42,144
CDM,67141OH,PROPH RETINAL DTCHMNT W/O DRG CRTX DIATHERMY,1012.0,657.8,1.1,1749.44,148
CDM,67145OH,"PROPHYLAXIS RETINA DETACH,PHOTOCOAG",1113.0,723.45,1.1,1787.79,148
CDM,67208OH,DSTRJ LOCLZD LESION RETINA 1/> SESS CRTX DTHRM,3060.0,1989.0,1.1,3060.0,148
CDM,67210OH,DSTRJ LOCLZD LESION RETINA 1/> SESS PC,2544.0,1653.6,1.1,2544.0,148
CDM,67218OH,DSTRJ LESION RETINA 1/> SESS RADJ IMPLTJ,8958.0,5822.7,1.1,11276.72,144
CDM,67220OH,DSTRJ LESION CHOROID PC 1/> SESS,2544.0,1653.6,1.1,2544.0,148
CDM,67221OH,DSTRJ LESION CHOROID PHOTODYNAMIC THERAPY,1380.0,897.0,1.1,1695.79,148
CDM,67225OH,DSTRJ LESION CHOROID PDT 2ND EYE 1 SESSION,188.0,122.2,1.1,188.0,148
CDM,67227OH,DESTRUCTION RETINOPATHY CRYOTHERAPY DIATHERMY,1400.0,910.0,1.1,11276.72,148
CDM,67228OH,TREATMENT EXTENSIVE RETINOPATHY PHOTOCOAGULATION,1932.0,1255.8,1.1,1932.0,148
CDM,67229OH,EXTENSIVE RETINOPATHY 1/> SESS PRETERM INFANT,7172.0,4661.8,1.1,7172.0,144
CDM,67250OH,SCLERAL REINFORCEMENT SPX W/O GRAFT,3844.0,2498.6,1.1,6813.79,144
CDM,67255OH,SCLERAL REINFORCEMENT SPX W/GRAFT,3352.0,2178.8,1.1,11858.31,144
CDM,67299RVU1OH,CHORIODAL BIOPSY,1468.0,954.2,0.01,6795.42,84
CDM,67299RVU7OH,AUTOLOGOUS RETINAL GRAFT (COMP 67042),6532.0,4245.8,0.01,6795.42,84
CDM,67299RVUOH,GLOBE EXPLORATION,340.0,221.0,0.01,6795.42,84
CDM,67311OH,STRABISMUS RECESSION/RESCJ 1 HRZNTL MUSC,2609.0,1695.85,1.1,6813.79,144
CDM,67312OH,STRABISMUS RECESSION/RESCJ 2 HRZNTL MUSC,3800.0,2470.0,1.1,11276.72,144
CDM,67314OH,STRABISMUS RECESSION/RESCJ 1 VER MUSC,2609.0,1695.85,1.1,6813.79,144
CDM,67316OH,STRABISMUS RECESSION/RESCJ 2/MORE VER MUSC,4124.0,2680.6,1.1,6813.79,144
CDM,67318OH,STRABISMUS ANY SUPERIOR OBLIQUE MUSCLE,3920.0,2548.0,1.1,6813.79,144
CDM,67320OH,TRANSPOSITION PROCEDURE EXTRAOCULAR MUSC,1200.0,780.0,1.1,1200.0,144
CDM,67331OH,"STRABISM SURG,PREV EYE SURG,NOT MUSC",800.0,520.0,1.1,1114.81,144
CDM,67332OH,STRABISMUS SCARRING EO MUSC/RSTCV MYOPATHY,1400.0,910.0,1.1,1400.0,144
CDM,67334OH,STRABISMUS POST FIXJ SUTR TQ W/WO MUSC RECESSION,906.0,588.9,1.1,1100.47,144
CDM,67335OH,PLACEMENT ADJUSTABLE SUTURE STRABISMUS,1292.0,839.8,1.1,1292.0,144
CDM,67340OH,STRABISMUS EXPL&/RPR DETACHED EXTROCULAR MUSC,2000.0,1300.0,1.1,2000.0,144
CDM,67343OH,RLS XTNSV SCAR TISS W/O DETACHING EO MUSC SPX,3388.0,2202.2,1.1,6813.79,144
CDM,67345OH,CHEMODENERVATION EXTRAOCULAR MUSCLE,1324.0,860.6,1.1,1324.0,148
CDM,67346OH,BIOPSY OF EXTRAOCULAR MUSCLE,1148.0,746.2,1.1,11276.72,142
CDM,67400OH,ORBITTMY W/O BN FLP EXP W W/O BX,4480.0,2912.0,1.1,11276.72,144
CDM,67405OH,ORBITTMY W/O BN FLP;W DRAINAGE,3680.0,2392.0,1.1,6813.79,144
CDM,67412OH,ORBITTMY W/O BN FLP W REM LESION,4120.0,2678.0,1.1,6813.79,144
CDM,67413OH,ORBITTMY W/O BN FLP W REM FB,4096.0,2662.4,1.1,6813.79,144
CDM,67414OH,ORBITOTOMY W/O BONE FLAP W/RMVL BONE DCMPRN,7176.0,4664.4,1.1,11276.72,144
CDM,67415OH,FINE NEEDLE ASPIRATION ORBITAL CONTENTS,704.0,457.6,1.1,6813.79,144
CDM,67420OH,ORBITOTOMY BONE FLAP/WINDOW LAT RMVL LESION,8748.0,5686.2,1.1,11276.72,144
CDM,67445OH,ORBITOTOMY BONE FLAP/WINDOW LAT RMVL BONE DCMPRN,7648.0,4971.2,1.1,11276.72,144
CDM,67450OH,ORBITOTOMY BONE FLAP/WINDOW LAT EXPL W/WO BX,6164.0,4006.6,1.1,11276.72,144
CDM,67500OH,"RETROBULBAR INJECT,MEDICATN",472.0,306.8,1.1,850.96,148
CDM,67505OH,"RETROBULBAR INJECT,ALCOHOL",472.0,306.8,1.1,850.96,148
CDM,67515OH,INJECTION MEDICATION/OTHER SUBST TENON CAPSULE,330.0,214.5,1.1,850.96,148
CDM,67516OH,SUPRACHOROIDAL SPACE NJX PHARMACOLOGIC AGENT,673.0,437.45,1.1,988.7,148
CDM,67550OH,ORBITAL IMPLANT INSERTION,4708.0,3060.2,1.1,11276.72,144
CDM,67560OH,ORBITAL IMPLANT REMOVAL/REVISION,4872.0,3166.8,1.1,11276.72,144
CDM,67570OH,OPTIC NERVE DECOMPRESSION,5760.0,3744.0,1.1,11276.72,144
CDM,67700OH,BLEPHAROTOMY DRAINAGE ABSCESS EYELID,560.0,364.0,1.1,1046.33,148
CDM,67710OH,SEVERING TARSORRHAPHY,428.0,278.2,1.1,2953.87,148
CDM,67715OH,CANTHOTOMY SEPARATE PROCEDURE,508.0,330.2,1.1,6813.79,148
CDM,67800OH,"EXCIS CHALAZION,SINGLE",564.0,366.6,1.1,850.96,148
CDM,67801OH,"EXCIS CHALAZION,MULT,SAME LID",764.0,496.6,1.1,2953.87,148
CDM,67805OH,EXCISION CHALAZION MULTIPLE DIFFERENT LIDS,908.0,590.2,1.1,908.0,148
CDM,67808OH,EXC CHALAZION ANES REQ HOSPIZATION SINGLE/MULT,1840.0,1196.0,1.1,6813.79,144
CDM,67810OH,INCISIONAL BIOPSY EYELID SKIN & LID MARGIN,519.0,337.35,1.1,850.96,148
CDM,67820OH,CORRECTION TRICHIASIS EPILATION FORCEPS ONLY,141.0,91.65,1.1,373.44,148
CDM,67825OH,CORRECTION TRICHIASIS EPILATION OTH/THAN FORCEPS,629.0,408.85,1.1,850.96,148
CDM,67830OH,CORRECTION TRICHIASIS INCCISION LID MARGIN,700.0,455.0,1.1,2953.87,148
CDM,67835OH,CORRJ TRICHIASIS INC LID MRGN W/FR MUC MEMB GRF,2280.0,1482.0,1.1,6813.79,144
CDM,67840OH,EXC LESION EYELID W/O CLSR/W/SIMPLE DIR CLOSURE,836.0,543.4,1.1,2953.87,148
CDM,67850OH,DESTRUCTION LESION LID MARGIN </ 1 CM,696.0,452.4,1.1,2953.87,148
CDM,67875OH,TEMP CLOSURE EYELID BY SUTURE,540.0,351.0,1.1,2953.87,148
CDM,67880OH,CONSTJ INTERMARGIN ADHES/TARSORRH/CANTHORRHAPY,2024.0,1315.6,1.1,6813.79,148
CDM,67882OH,CONSTJ INTERMARGIN ADHES/TARSOR/CANTHOR W/TRPOS,2408.0,1565.2,1.1,6813.79,148
CDM,67900OH,REPAIR BROW PTOSIS,3001.0,1950.65,1.1,6813.79,146
CDM,67900RVU1OH,REPAIR BROW PTOSIS - SIMPLE,3600.0,2340.0,1.1,6813.79,146
CDM,67900RVU2OH,REPAIR BROW PTOSIS - MODERATE,3800.0,2470.0,1.1,6813.79,146
CDM,67900RVU3OH,REPAIR BROW PTOSIS - COMPLEX,4500.0,2925.0,1.1,6813.79,146
CDM,67901OH,RPR BLEPHAROPTOSIS FRONTALIS MUSC SUTR/OTH MATRL,3036.0,1973.4,1.1,6813.79,148
CDM,67902OH,RPR BLEPHAROPT FRONTALIS MUSC AUTOL FASCAL SLING,3928.0,2553.2,1.1,11276.72,144
CDM,67903OH,RPR BLEPHAROPTOSIS LEVATOR RESCJ/ADVMNT INTERNAL,2604.0,1692.6,1.1,6813.79,148
CDM,67904OH,RPR BLEPHAROPTOSIS LEVATOR RESCJ/ADVMNT XTRNL,3507.0,2279.55,1.1,6813.79,148
CDM,67906OH,RPR BLEPHAROPTOSIS SUPERIOR RECTUS FASCIAL SLING,2772.0,1801.8,1.1,11276.72,144
CDM,67908OH,RPR BLPOS CONJUNCTIVO-TARSO-MUSC-LEVATOR RESCJ,2332.0,1515.8,1.1,6813.79,148
CDM,67909OH,REDUCTION OVERCORRECTION PTOSIS,2228.0,1448.2,1.1,6813.79,148
CDM,67911OH,CORRECT LID RETRACTION,3000.0,1950.0,1.1,6813.79,144
CDM,67912OH,CORRJ LAGOPHTHALMOS IMPLTJ UPR EYELID LID LOAD,2544.0,1653.6,1.1,6813.79,148
CDM,67914OH,"FIX ECTROPION,SUTURE",1500.0,975.0,1.1,6813.79,148
CDM,67916OH,"FIX ECTROPION,EXCIS TARSAL WEDGE",2192.0,1424.8,1.1,6813.79,148
CDM,67917OH,REPAIR ECTROPION EXTENSIVE,2372.0,1541.8,1.1,6813.79,148
CDM,67921OH,ENTROPION REPAIR/SUTURE,1388.0,902.2,1.1,6813.79,148
CDM,67922OH,"FIX ENTROPION,THERMOCAUT",812.0,527.8,1.1,6813.79,148
CDM,67923OH,"FIX ENTROPION,EXCIS TARSAL WEDGE",2411.0,1567.15,1.1,6813.79,148
CDM,67924OH,REPAIR OF ENTROPION; EXTENSIVE?,2372.0,1541.8,1.1,6813.79,148
CDM,67930OH,SUTR WND EYELID/MARGIN/TARSUS/CONJUNC PRTL THICK,1460.0,949.0,1.1,6813.79,148
CDM,67935OH,SUTR WND EYELID/MARGIN/TARSUS/CONJUNC FULL THICK,2544.0,1653.6,1.1,6813.79,148
CDM,67938OH,"REMOVE EYELID FOREIGN BODY,EMBEDDED",552.0,358.8,1.1,1003.72,148
CDM,67950OH,CANTHOPLASTY LATERAL,2636.0,1713.4,1.1,6813.79,148
CDM,67950RVU1OH,CANTHOPLASTY LATERAL - SIMPLE,1550.0,1007.5,1.1,6813.79,148
CDM,67950RVU2OH,CANTHOPLASTY LATERAL - MODERATE,1850.0,1202.5,1.1,6813.79,148
CDM,67950RVU3OH,CANTHOPLASTY LATERAL - COMPLEX,2100.0,1365.0,1.1,6813.79,148
CDM,67961OH,EXCISION & REPAIR EYELID < ONE-FOURTH LID MARGIN,2344.0,1523.6,1.1,6813.79,148
CDM,67966OH,EXCISION & REPAIR EYELID ONE-FOURTH LID MARGIN,3588.0,2332.2,1.1,6813.79,148
CDM,67971OH,RCNSTJ EYELID FULL THICKNESS </TWO-THIRDS 1 STG,4004.0,2602.6,1.1,6813.79,144
CDM,67973OH,"RECONSTRUC EYELID,TOT LOWER,1 STAGE",5252.0,3413.8,1.1,6813.79,144
CDM,67974OH,"RECONSTRUC EYELID,TOT UPPER,1 STAGE",5240.0,3406.0,1.1,11276.72,144
CDM,67975OH,"RECONSTRUC EYELID,SECOND STAGE",3740.0,2431.0,1.1,6813.79,144
CDM,67999RVU1OH,ENDOSCOPIC BROW PTOSIS (COMP CODE 67900),4500.0,2925.0,0.01,4500.0,84
CDM,67999RVU2OH,REMOVAL OF IMPLANT EYELID (COMP CODE 67938),587.0,381.55,0.01,850.96,84
CDM,67999RVU3OH,FACELIFT - ENDOSCOPIC,2760.0,1794.0,0.01,2760.0,84
CDM,67999RVU4OH,FOREHEAD LIFT - ENDOSCOPIC,3346.0,2174.9,0.01,3346.0,84
CDM,67999RVU5OH,"ORBICULARIS OCULI LATERAL MYECTOMY, UNILATERAL (COMP CODE 15823)",2996.0,1947.4,0.01,2996.0,84
CDM,67999RVUOH,MYECTOMY _EYELID,455.0,295.75,0.01,850.96,84
CDM,68020OH,INCISION CONJUNCTIVA DRAINAGE OF CYST,568.0,369.2,1.1,2953.87,148
CDM,68100OH,BIOPSY OF CONJUNCTIVA,540.0,351.0,1.1,6813.79,148
CDM,68110OH,EXCISION LESION CONJUNCTIVA </1 CM,728.0,473.2,1.1,6813.79,148
CDM,68115OH,EXCISION LESION CONJUNCTIVA > 1 CM,964.0,626.6,1.1,6813.79,148
CDM,68130OH,EXCISION LESION CONJUNCTIVA ADJACENT SCLERA,2040.0,1326.0,1.1,6813.79,148
CDM,68135OH,DESTRUCTION LESION CONJUNCTIVA,756.0,491.4,1.1,6813.79,148
CDM,68200OH,SUBCONJUNCTIVAL INJECTN,196.0,127.4,1.1,1163.18,148
CDM,68320OH,CONJUNCTIVOPLASTY W/GRF/XTNSV REARRANGEMENT,2922.0,1899.3,1.1,6813.79,148
CDM,68325OH,CONJUNCTIVOPLASTY W/BUCCAL MUC MEMB GRAFT,3452.0,2243.8,1.1,11276.72,144
CDM,68326OH,CJP RCNSTJ CUL-DE-SAC BUCCAL GRF/XTNSV REARRGMT,3368.0,2189.2,1.1,11276.72,144
CDM,68328OH,CONJUNCTPL CUL-DE-SAC W/BUCCAL MUC MEMB GRAFT,3780.0,2457.0,1.1,6813.79,144
CDM,68330OH,RPR SYMBLEPHARON CONJUNCTIVOPLASTY W/O GRAFT,2312.0,1502.8,1.1,6795.42,148
CDM,68335OH,RPR SYMBLEPHARON FR GRF CJNC/BUCCAL MUC MEMB,3384.0,2199.6,1.1,11276.72,144
CDM,68340OH,RPR & DIV SYMBLEPHARON W/WO CONFORM/CONTACT LE,1988.0,1292.2,1.1,6813.79,148
CDM,68360OH,"CONJUNC FLAP,BRIDGE/PARTIAL",2068.0,1344.2,1.1,11276.72,148
CDM,68362OH,"CONJUNC FLAP,TOTAL",3444.0,2238.6,1.1,6813.79,144
CDM,68400OH,INCISION DRAINAGE LACRIMAL GLAND,696.0,452.4,1.1,2953.87,148
CDM,68420OH,INCISION DRAINAGE LACRIMAL SAC,940.0,611.0,1.1,6813.79,148
CDM,68440OH,SNIP INCISION LACRIMAL PUNCTUM,396.0,257.4,1.1,850.96,148
CDM,68500OH,EXCISION LACRIMAL GLAND XCPT TUMOR TOTAL,5108.0,3320.2,1.1,11276.72,144
CDM,68505OH,EXCISION LACRIMAL GLAND XCPT TUMOR PRTL,5076.0,3299.4,1.1,11276.72,144
CDM,68510OH,BIOPSY LACRIMAL GLAND,1840.0,1196.0,1.1,6813.79,148
CDM,68520OH,EXCISION LACRIMAL SAC,3512.0,2282.8,1.1,11276.72,144
CDM,68525OH,BIOPSY LACRIMAL SAC,1768.0,1149.2,1.1,6813.79,144
CDM,68530OH,RMVL FB/DACRYOLITH LACRIMAL PASSAGES,1480.0,962.0,1.1,1608.06,148
CDM,68540OH,EXC LACRIMAL GLAND TUMOR FRONTAL APPROACH,4872.0,3166.8,1.1,6813.79,144
CDM,68550OH,EXC LACRIMAL GLAND TUMOR W/OSTEOTOMY,6064.0,3941.6,1.1,11276.72,144
CDM,68700OH,PLASTIC REPAIR CANALICULI,3463.0,2250.95,1.1,6813.79,144
CDM,68705OH,CORRECTION EVERTED PUNCTUM CAUTERY,844.0,548.6,1.1,972.84,148
CDM,68720OH,DACRYOCYSTORHINOSTOMY,4382.0,2848.3,1.1,11276.72,144
CDM,68750OH,CONJUNCTIVORHINOSTOMY INSJ TUBE/STENT,4040.0,2626.0,1.1,11276.72,144
CDM,68760OH,CLSR LACRIMAL PUNCTUM THERMOCAUT LIG/LASER,712.0,462.8,1.1,850.96,148
CDM,68761OH,CLSR LACRIMAL PUNCTUM PLUG EACH,620.0,403.0,1.1,850.96,148
CDM,68770OH,CLOSURE LACRIMAL FISTULA SPX,3316.0,2155.4,1.1,6813.79,144
CDM,68801OH,DILATION LACRIMAL PUNCTUM W/WO IRRGATION,328.0,213.2,1.1,1163.18,148
CDM,68810OH,PROBE NASOLACRIMAL DUCT W/WO IRRIGATION,678.0,440.7,1.1,850.96,148
CDM,68811OH,PROBE NASOLACRIMAL DUCT W/WO IRRIG REQ GEN ANES,766.0,497.9,1.1,6813.79,144
CDM,68815OH,PROBE NASOLACRIMAL DUCT W/WO IRRG INSJ TUBE/STNT,1188.0,772.2,1.1,6813.79,148
CDM,68816OH,PROBE NASOLACRIMAL DUCT WITH CATHETER DILATION,924.0,600.6,1.1,6813.79,148
CDM,68840OH,PROBE LACRIMAL CANALICULI W/WO IRRIGATION,572.0,371.8,1.1,850.96,148
CDM,68841OH,INSJ RX ELUTING IMPLT PUNCTAL DILAT LAC CANAL EA,216.0,140.4,1.1,6813.79,146
CDM,68899RVU1OH,ENDOSCOPIC MARSUPIALIZATION BILAT. NASOLACRIMAL DUCT CYSTS(COMP,1890.0,1228.5,0.01,1890.0,84
CDM,69000OH,DRAINAGE EXTERNAL EAR ABSCESS/HEMATOMA SIMPLE,660.0,429.0,1.1,2050.87,148
CDM,69005OH,DRAINAGE EXTERNAL EAR ABSCESS/HEMATOMA CMPLX,864.0,561.6,1.1,4729.25,148
CDM,69020OH,DRAINAGE EXTERNAL AUDITORY CANAL ABSCESS,612.0,397.8,1.1,2050.87,148
CDM,69090OH,EAR PIERCING,67.0,43.55,1.1,176.73,88
CDM,69090RVU1OH,"EAR PIERCING, BOTH EARS W/EARRINGS",200.0,130.0,1.1,200.0,88
CDM,69090RVUOH,EAR PIERCING,53.0,34.45,1.1,176.73,88
CDM,69100OH,BIOPSY EXTERNAL EAR,324.0,210.6,1.1,713.21,148
CDM,69105OH,BIOPSY EXTERNAL AUDITORY CANAL,374.0,243.1,1.1,4447.63,148
CDM,69110OH,EXCISION EXTERNAL EAR PARTIAL SIMPLE REPAIR,1412.0,917.8,1.1,8286.13,148
CDM,69120OH,EXCISION EXTERNAL EAR COMPLETE AMPUTATION,1656.0,1076.4,1.1,17080.38,144
CDM,69140OH,EXCISION EXOSTOSIS EXTERNAL AUDITORY CANAL,3256.0,2116.4,1.1,17080.38,144
CDM,69145OH,EXCISION SOFT TIS LESION EXTERNAL AUDITORY CANAL,1080.0,702.0,1.1,8286.13,148
CDM,69150OH,RAD EXC XTRNL AUDITORY CANAL LES W/O NCK DSJ,5988.0,3892.2,1.1,17080.38,144
CDM,69200OH,RMVL FB XTRNL AUDITORY CANAL W/O ANES,339.0,220.35,1.1,373.44,148
CDM,69205OH,RMVL FB XTRNL AUDITORY CANAL ANES,532.0,345.8,1.1,4729.25,144
CDM,69209OH,REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT,258.0,167.7,1.1,258.0,144
CDM,69210OH,REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT,268.0,174.2,1.1,268.0,148
CDM,69220OH,"DEBRID MASTOIDECTOM CAVITY,SIMP",332.0,215.8,1.1,584.65,148
CDM,69222OH,"DEBRIDE MASTOID CAVITY,COMPLEX",580.0,377.0,1.1,1603.96,148
CDM,69300OH,OTOPLASTY PROTRUDING EAR W/WO SIZE RDCTJ,2576.0,1674.4,1.1,9391.15,148
CDM,69300RVU1OH,OTOPLASTY - SIMPLE,1115.5,725.08,1.1,9391.15,148
CDM,69300RVU2OH,OTOPLASTY - MODERATE,1215.0,789.75,1.1,9391.15,148
CDM,69300RVU3OH,OTOPLASTY - COMPLEX,1315.0,854.75,1.1,9391.15,148
CDM,69310OH,RECONSTRUCTION EXTERNAL AUDITORY CANAL SPX,4388.0,2852.2,1.1,17080.38,144
CDM,69320OH,RCNSTJ XTRNL AUD CANAL CONGENITAL ATRESIA 1 STG,6872.0,4466.8,1.1,17080.38,144
CDM,69399PEDSOH,PEDIATRIC EAR MOLD FITTING,200.0,130.0,0.01,713.21,84
CDM,69399RVU1OH,REVISION OF OSSEOINTEGRATED BONE ANCHORED IMPANT ABUTMENT (COMP,3164.0,2056.6,0.01,3164.0,84
CDM,69399RVU2OH,ENDOSCOPIC EXTERNAL AUDITORY CANAL (COMP CODE 69200),339.0,220.35,0.01,713.21,84
CDM,69399RVUOH,REMOVE PACKING EAC W GEN ANESTHESIA,390.0,253.5,0.01,713.21,84
CDM,69420OH,MYRINGOTOMY ASPIR&/EUSTACHIAN TUBE NFLTJ,552.0,358.8,1.1,713.21,148
CDM,69421OH,MYRINGOTOMY ASPIR&/EUSTACHIAN TUBE NFLTJ ANES,783.0,508.95,1.1,9391.15,144
CDM,69424OH,VENTILATING TUBE RMVL REQUIRING GENERAL ANES,340.0,221.0,1.1,9391.15,148
CDM,69433OH,TYMPANOSTOMY LOCAL/TOPICAL ANESTHESIA,628.0,408.2,1.1,1603.96,148
CDM,69436OH,TYMPANOSTOMY GENERAL ANESTHESIA,884.0,574.6,1.1,4447.63,144
CDM,69440OH,MIDDLE EAR EXPL THRU POSTAUR/EAR CANAL INC,3084.0,2004.6,1.1,9391.15,144
CDM,69450OH,TYMPANOLYSIS TRANSCANAL,2276.0,1479.4,1.1,9391.15,144
CDM,69501OH,TRANSMASTOID ANTROTOMY,3684.0,2394.6,1.1,17080.38,144
CDM,69502OH,"MASTOIDECTOMY,COMPLETE",5024.0,3265.6,1.1,17080.38,144
CDM,69505OH,"MASTOIDECTOMY,MOD RADICAL",5268.0,3424.2,1.1,17080.38,144
CDM,69511OH,"MASTOIDECTOMY,RADICAL",5480.0,3562.0,1.1,17080.38,144
CDM,69530OH,PETROUS APICECTOMY RADICAL MASTOIDECTOMY,8152.0,5298.8,1.1,17080.38,144
CDM,69535OH,"RESECT TEMPORAL BONE,EXTERN APPRCH",14968.0,9729.2,1.1,14968.0,144
CDM,69540OH,EXCISION AURAL POLYP,500.0,325.0,1.1,4447.63,148
CDM,69550OH,EXCISION AURAL GLOMUS TUMOR TRANSCANAL,4460.0,2899.0,1.1,17080.38,144
CDM,69552OH,EXCISION AURAL GLOMUS TUMOR TRANSMASTOID,7924.0,5150.6,1.1,17080.38,144
CDM,69554OH,EXCISION AURAL GLOMUS TUMOR EXTENDED,14388.0,9352.2,1.1,14388.0,144
CDM,69601OH,REVJ MASTOIDECTOMY RSLTG COMPL MASTOIDECTOMY,5380.0,3497.0,1.1,17080.38,144
CDM,69602OH,REVJ MASTOIDECTOMY RSLTG MODF RAD MSTDC,5504.0,3577.6,1.1,17080.38,144
CDM,69603OH,REVJ MASTOIDECTOMY RSLTG RAD MASTOIDECTOMY,5680.0,3692.0,1.1,17080.38,144
CDM,69604OH,REVJ MASTOIDECTOMY RSLTG TYMPANOPLASTY,5680.0,3692.0,1.1,17080.38,144
CDM,69610OH,TYMPANIC MEMB RPR W/WO PREPJ PERFOR PATCH,1967.0,1278.55,1.1,4447.63,148
CDM,69620OH,MYRINGOPLASTY,2653.0,1724.45,1.1,9391.15,148
CDM,69631OH,TYMPANOPLASTY W/O MASTOIDECT W/O OSSICLE RECNSTJ,4020.0,2613.0,1.1,17080.38,144
CDM,69632OH,TYMPNOPLSTY W/O MSTDC 1ST/REVJ W/OSICLE RECNSTJ,5184.0,3369.6,1.1,17080.38,144
CDM,69633OH,TYMPANOPLASTY W/O MASTOIDEC 1ST/REVJ PROSTH TORP,4924.0,3200.6,1.1,17080.38,144
CDM,69635OH,TYMPP ANTRT/MASTOID W/O OSSICULAR CHAIN RECNSTJ,5404.0,3512.6,1.1,17080.38,144
CDM,69636OH,TYMPP ANTRT/MASTOID W/OSSICULAR CHAIN RECNSTJ,6172.0,4011.8,1.1,17080.38,144
CDM,69637OH,TMPP ANTRT/MASTOIDOTOMY PROSTHESIS TORP,6128.0,3983.2,1.1,17080.38,144
CDM,69641OH,TMPP MASTOIDECTOMY W/O OSSICULAR CHAIN RECNSTJ,5156.0,3351.4,1.1,17080.38,144
CDM,69642OH,TMPP MASTOIDECTOMY W/OSSICULAR CHAIN RECNSTJ,6824.0,4435.6,1.1,17080.38,144
CDM,69643OH,TMPP MASTOIDECT NTC/RCNSTED WALL W/O OCR,6860.0,4459.0,1.1,17080.38,144
CDM,69644OH,TMPP MASTOIDECT NTC/RCNSTED CANAL WALL OCR,6892.0,4479.8,1.1,17080.38,144
CDM,69645OH,TYMPANOPLASTY MASTOIDECTOMY RAD/COMPL W/O OCR,6684.0,4344.6,1.1,17080.38,144
CDM,69646OH,TYMPANOPLASTY MASTOIDECTOMY RAD/COMPL W/OCR,7348.0,4776.2,1.1,17080.38,144
CDM,69660OH,STAPEDECTOMY/STAPEDOTOMY,4812.0,3127.8,1.1,17080.38,144
CDM,69661OH,STAPEDECTOMY/STAPEDOTOMY W/FOOTPLATE DRILL OUT,6368.0,4139.2,1.1,17080.38,144
CDM,69662OH,REVISION STAPEDECTOMY/STAPEDOTOMY,6240.0,4056.0,1.1,17080.38,144
CDM,69666OH,REPAIR OVAL WINDOW FISTULA,3956.0,2571.4,1.1,9391.15,144
CDM,69670OH,MASTOID OBLITERATION,4692.0,3049.8,1.1,17080.38,144
CDM,69705OH,SURG NASOPHARYNGOSCOPY DILAT EUSTACHIAN TUBE UNI,1200.0,780.0,1.1,17080.38,146
CDM,69706OH,SURG NASOPHARYNGOSCOPY DILAT EUSTACHIAN TUBE BI,1708.0,1110.2,1.1,17080.38,146
CDM,69711OH,RMVL/RPR EMGNT BONE CNDJ DEV TEMPORAL BONE,4248.0,2761.2,1.1,9391.15,144
CDM,69714OH,IMPLTJ OI IMPLT SKULL PERQ ATTACHMENT ESP,2939.0,1910.35,1.1,38384.94,144
CDM,69716OH,IMPL OI IMPLT SKULL MAG TC ATTACHMENT ESP<100,3612.0,2347.8,1.1,38384.94,142
CDM,69717OH,RPLCMT OI IMPLT SKULL PERQ ATTACHMENT ESP,3164.0,2056.6,1.1,20863.78,144
CDM,69719OH,RPLCMT OI IMPLT SKULL MAG TC ATTACHMENT ESP<100,4162.0,2705.3,1.1,38384.94,142
CDM,69720OH,DCMPRN FACIAL NRV INTRATEMPORAL LAT GANGLION,5884.0,3824.6,1.1,17080.38,144
CDM,69725OH,DCMPRN NRV INTRATEMPORAL MEDIAL GENICULATE,12162.0,7905.3,1.1,17080.38,144
CDM,69726OH,REMOVAL OI IMPLT SKULL PERQ ATTACHMENT ESP,2544.0,1653.6,1.1,9440.12,142
CDM,69727OH,REMOVAL ENTIRE OI IMPLT SKL MAG TC ATTCH ESP<100,2952.0,1918.8,1.1,9440.12,142
CDM,69728OH,RMVL ENTIRE OI IMPLT SKL MAG TC ATTCH ESP>=100,3400.0,2210.0,1.1,9440.12,144
CDM,69729OH,IMPL OI IMPLT SKULL MAG TC ATTACHMENT ESP>=100,3988.0,2592.2,1.1,38384.94,144
CDM,69730OH,RPLCMT OI IMPLT SKULL MAG TC ATTACHMENT ESP>=100,4100.0,2665.0,1.1,38384.94,144
CDM,69799RVU1OH,BILTRL ET BALLOON DILATN (COMP 68816-50),1528.0,993.2,0.01,1528.0,84
CDM,69799RVU2OH,CATHETER OBLITERATION EUSTACHIAN TUBE,1878.0,1220.7,0.01,1878.0,84
CDM,69799RVU3OH,RPF SSCDS/TRNSCNL W GRAFT,3267.0,2123.55,0.01,3267.0,84
CDM,69799RVU6OH,NASAL ENDOSC W/DILATION OF EUSTACHIAN TUBE; UNILAT (COMP 68816),903.0,586.95,0.01,903.0,84
CDM,69799RVU7OH,SIGMOID RESURFACING W/ SIMPLE MASOIDECTOMY (COMP CODE 69501 AND,2928.0,1903.2,0.01,2928.0,84
CDM,69799RVU8OH,EUSTACHIAN TUBE INJECTION ENDOSCOPIC (COMP CODE 69705),1275.0,828.75,0.01,1275.0,84
CDM,69799RVUOH,REPLACE ABUTMENT FOR BAHA (COMP 20670),591.0,384.15,0.01,713.21,84
CDM,69801OH,LABYRINTHOTOMY TRANSCANAL,906.0,588.9,1.1,4447.63,148
CDM,69805OH,"ENDOLYMPH SAC OPERATN,NO SHUNT",5884.0,3824.6,1.1,17080.38,144
CDM,69806OH,ENDOLYMPH SAC OP W SHUNT,5052.0,3283.8,1.1,17080.38,144
CDM,69905OH,"EXCIS LABYRINTH,TRANSCANAL",4954.0,3220.1,1.1,17080.38,144
CDM,69910OH,EXCIS LABYRINTH W MASTOIDECTOMY,5564.0,3616.6,1.1,17080.38,144
CDM,69915OH,VESTIBULAR NRV SECTION TRANSLABYRINTHINE APPR,9108.0,5920.2,1.1,9391.15,144
CDM,69930OH,COCHLEAR DEVICE IMPLANTATION W/WO MASTOIDECTOMY,7092.0,4609.8,1.1,97802.01,144
CDM,69949RVU1OH,REMOVAL OF COCHLEAR IMPLANT (COMP 69501),3039.0,1975.35,0.01,3039.0,82
CDM,69949RVU2OH,SUPERIOR SEMICIRCULAR CANAL DEHISCENCE REPAIR (COMP 62100),7765.0,5047.25,0.01,7765.0,82
CDM,69949RVUOH,REVISE COCHLEAR IMPLANT (COMP 69930),6383.0,4148.95,0.01,6383.0,82
CDM,69950OH,"VESTIBULAR NERV SECTN,TRANSCRANIAL",11052.0,7183.8,1.1,11052.0,132
CDM,69955OH,TOTAL FACIAL NERVE DECOMPRESSION &/REPAIR,11768.0,7649.2,1.1,17080.38,144
CDM,69960OH,DECOMPRESS INTERN AUDITORY CANAL,12945.0,8414.25,1.1,17080.38,144
CDM,69970OH,"REMOVE TUMOR,TEMPORAL BONE",12964.0,8426.6,1.1,17080.38,144
CDM,69990OH,MICROSURG TQS REQ USE OPERATING MICROSCOPE,1384.0,899.6,1.1,1384.0,144
CDM,70000015,APPLICATION CAST HAND & LOWER FOREARM GAUNTLET,726.0,471.9,77.24,2453.0,86
CDM,70000040,APPLICATION PATELLAR TENDON BEARING CAST,1222.0,794.3,99.03,2453.0,86
CDM,70000045,APPLICATION LONG LEG SPLINT THIGH ANKLE/TOES,726.0,471.9,56.47,2453.0,86
CDM,70000050,WINDOWING CAST,726.0,471.9,49.81,2453.0,86
CDM,70000055,WEDGING CAST EXCEPT CLUBFOOT CASTS,1222.0,794.3,76.45,2453.0,86
CDM,70000060,APPLICATION CYLINDER CAST THIGH ANKLE,1222.0,794.3,100.27,2453.0,86
CDM,70000065,APPLICATION RISSER JACKET LOCALIZER BODY ONLY,1222.0,794.3,105.3,2453.0,86
CDM,70000075,APPLICATION CAST SHOULDER SPICA,1222.0,794.3,105.3,2453.0,86
CDM,70000085,APPLICATION LONG LEG CAST BRACE,1222.0,794.3,105.3,2453.0,86
CDM,70015OH,CISTERNOGRAPHY BRAIN(POS CONTRAST),5927.0,3852.55,1.1,5927.0,142
CDM,70015OH-26,CISTERNOGRAPHY BRAIN(POS CONTRAST),476.0,309.4,1.1,476.0,126
CDM,70015OH-TC,CISTERNOGRAPHY BRAIN(POS CONTRAST),5451.0,3543.15,1.1,5451.0,126
CDM,70030OH,RADIOLOGIC EXAMINATION EYE DETECT FOREIGN BODY,687.0,446.55,1.1,687.0,142
CDM,70030OH-26,RADIOLOGIC EXAMINATION EYE DETECT FOREIGN BODY,79.0,51.35,1.1,79.0,126
CDM,70030OH-TC,RADIOLOGIC EXAMINATION EYE DETECT FOREIGN BODY,608.0,395.2,1.1,608.0,126
CDM,70100OH,RADIOLOGIC EXAMINATION MANDIPLE PRTL <4 VIEWS,680.0,442.0,1.1,680.0,142
CDM,70100OH-26,RADIOLOGIC EXAMINATION MANDIPLE PRTL <4 VIEWS,72.0,46.8,1.1,72.0,126
CDM,70100OH-TC,RADIOLOGIC EXAMINATION MANDIPLE PRTL <4 VIEWS,608.0,395.2,1.1,608.0,126
CDM,70110OH,RADIOLOG EXAM MANDIBLE COMPL MINIMUM 4 VIEWS,834.0,542.1,1.1,834.0,142
CDM,70110OH-26,RADIOLOG EXAM MANDIBLE COMPL MINIMUM 4 VIEWS,100.0,65.0,1.1,100.0,126
CDM,70110OH-TC,RADIOLOG EXAM MANDIBLE COMPL MINIMUM 4 VIEWS,734.0,477.1,1.1,734.0,126
CDM,70120OH,RADIOLOGIC EXAM MASTOIDS < 3 VIEWS PER SIDE,806.0,523.9,1.1,806.0,142
CDM,70120OH-26,RADIOLOGIC EXAM MASTOIDS < 3 VIEWS PER SIDE,72.0,46.8,1.1,72.0,126
CDM,70120OH-TC,RADIOLOGIC EXAM MASTOIDS < 3 VIEWS PER SIDE,734.0,477.1,1.1,734.0,126
CDM,70130OH,RADEX MASTOIDS COMPL MINIMUM 3 VIEWS PR SIDE,884.0,574.6,1.1,884.0,142
CDM,70130OH-26,RADEX MASTOIDS COMPL MINIMUM 3 VIEWS PR SIDE,150.0,97.5,1.1,150.0,126
CDM,70130OH-TC,RADEX MASTOIDS COMPL MINIMUM 3 VIEWS PR SIDE,734.0,477.1,1.1,734.0,126
CDM,70140OH,RADEX FACIAL BONES < 3 VIEWS,684.0,444.6,1.1,684.0,142
CDM,70140OH-26,RADEX FACIAL BONES < 3 VIEWS,76.0,49.4,1.1,76.0,126
CDM,70140OH-TC,RADEX FACIAL BONES < 3 VIEWS,608.0,395.2,1.1,608.0,126
CDM,70150OH,RADEX FACIAL BONES COMPLETE MINIMUM 3 VIEWS,838.0,544.7,1.1,838.0,142
CDM,70150OH-26,RADEX FACIAL BONES COMPLETE MINIMUM 3 VIEWS,104.0,67.6,1.1,104.0,126
CDM,70150OH-TC,RADEX FACIAL BONES COMPLETE MINIMUM 3 VIEWS,734.0,477.1,1.1,734.0,126
CDM,70160OH,RADEX NASAL BONES COMPLETE MINIMUM 3 VIEWS,676.0,439.4,1.1,676.0,142
CDM,70160OH-26,RADEX NASAL BONES COMPLETE MINIMUM 3 VIEWS,68.0,44.2,1.1,68.0,126
CDM,70160OH-TC,RADEX NASAL BONES COMPLETE MINIMUM 3 VIEWS,608.0,395.2,1.1,608.0,126
CDM,70190OH,RADEX OPTIC FORAMINA,692.0,449.8,1.1,692.0,142
CDM,70190OH-26,RADEX OPTIC FORAMINA,84.0,54.6,1.1,84.0,126
CDM,70190OH-TC,RADEX OPTIC FORAMINA,608.0,395.2,1.1,608.0,126
CDM,70200OH,RADEX ORBITS COMPLETE MINIMUM 4 VIEWS,846.0,549.9,1.1,846.0,142
CDM,70200OH-26,RADEX ORBITS COMPLETE MINIMUM 4 VIEWS,112.0,72.8,1.1,112.0,126
CDM,70200OH-TC,RADEX ORBITS COMPLETE MINIMUM 4 VIEWS,734.0,477.1,1.1,734.0,126
CDM,70210OH,RADEX SINUSES PARANASAL <3 VIEWS,676.0,439.4,1.1,676.0,142
CDM,70210OH-26,RADEX SINUSES PARANASAL <3 VIEWS,68.0,44.2,1.1,68.0,126
CDM,70210OH-TC,RADEX SINUSES PARANASAL <3 VIEWS,608.0,395.2,1.1,608.0,126
CDM,70220OH,RADEX SINUSES PARANASAL COMPL MINIMUM 3 VIEWS,705.0,458.25,1.1,705.0,142
CDM,70220OH-26,RADEX SINUSES PARANASAL COMPL MINIMUM 3 VIEWS,97.0,63.05,1.1,97.0,126
CDM,70220OH-TC,RADEX SINUSES PARANASAL COMPL MINIMUM 3 VIEWS,608.0,395.2,1.1,608.0,126
CDM,70240OH,RADIOLOGIC EXAMINATION SELLA TURCICA,684.0,444.6,1.1,684.0,142
CDM,70240OH-26,RADIOLOGIC EXAMINATION SELLA TURCICA,76.0,49.4,1.1,76.0,126
CDM,70240OH-TC,RADIOLOGIC EXAMINATION SELLA TURCICA,608.0,395.2,1.1,608.0,126
CDM,70250OH,RADIOLOGIC EXAMINATION SKULL 4< VIEWS,813.0,528.45,1.1,813.0,142
CDM,70250OH-26,RADIOLOGIC EXAMINATION SKULL 4< VIEWS,79.0,51.35,1.1,79.0,126
CDM,70250OH-TC,RADIOLOGIC EXAMINATION SKULL 4< VIEWS,734.0,477.1,1.1,734.0,126
CDM,70260OH,RADIOLOGIC EXAM SKULL COMPLETE MINIMUM 4 VIEWS,846.0,549.9,1.1,846.0,142
CDM,70260OH-26,RADIOLOGIC EXAM SKULL COMPLETE MINIMUM 4 VIEWS,112.0,72.8,1.1,112.0,126
CDM,70260OH-TC,RADIOLOGIC EXAM SKULL COMPLETE MINIMUM 4 VIEWS,734.0,477.1,1.1,734.0,126
CDM,70300OH,RADIOLOGIC EXAMINATION TEETH 1 VIEW,648.0,421.2,1.1,648.0,142
CDM,70300OH-26,RADIOLOGIC EXAMINATION TEETH 1 VIEW,40.0,26.0,1.1,40.0,126
CDM,70300OH-TC,RADIOLOGIC EXAMINATION TEETH 1 VIEW,608.0,395.2,1.1,608.0,126
CDM,70310OH,RADIOLOGIC EXAM TEETH PRTL EXAM < FULL MOUTH,1738.0,1129.7,1.1,1738.0,142
CDM,70310OH-26,RADIOLOGIC EXAM TEETH PRTL EXAM < FULL MOUTH,70.0,45.5,1.1,70.0,126
CDM,70310OH-TC,RADIOLOGIC EXAM TEETH PRTL EXAM < FULL MOUTH,1668.0,1084.2,1.1,1668.0,126
CDM,70320OH,RADIOLOGIC EXAM TEETH COMPLETE FULL MOUTH,1756.0,1141.4,1.1,1756.0,142
CDM,70320OH-26,RADIOLOGIC EXAM TEETH COMPLETE FULL MOUTH,88.0,57.2,1.1,88.0,126
CDM,70320OH-TC,RADIOLOGIC EXAM TEETH COMPLETE FULL MOUTH,1668.0,1084.2,1.1,1668.0,126
CDM,70328OH,RADEX TEMPOROMANDBLE JT OPN & CLSD MOUTH UNILAT,680.0,442.0,1.1,680.0,142
CDM,70328OH-26,RADEX TEMPOROMANDBLE JT OPN & CLSD MOUTH UNILAT,72.0,46.8,1.1,72.0,126
CDM,70328OH-TC,RADEX TEMPOROMANDBLE JT OPN & CLSD MOUTH UNILAT,608.0,395.2,1.1,608.0,126
CDM,70330OH,RADEX TEMPOROMANDBLE JT OPN & CLSD MOUTH BILAT,704.0,457.6,1.1,704.0,142
CDM,70330OH-26,RADEX TEMPOROMANDBLE JT OPN & CLSD MOUTH BILAT,96.0,62.4,1.1,96.0,126
CDM,70330OH-TC,RADEX TEMPOROMANDBLE JT OPN & CLSD MOUTH BILAT,608.0,395.2,1.1,608.0,126
CDM,70332OH,TEMPOROMANDBLE JT ARTHROGRAPHY RS&I,1884.0,1224.6,1.1,1884.0,142
CDM,70332OH-26,TEMPOROMANDBLE JT ARTHROGRAPHY RS&I,216.0,140.4,1.1,216.0,126
CDM,70332OH-TC,TEMPOROMANDBLE JT ARTHROGRAPHY RS&I,1668.0,1084.2,1.1,1668.0,126
CDM,70336OH,MRI TEMPOROMANDIBULAR JOINT,2260.0,1469.0,1.1,2260.0,142
CDM,70336OH-26,MRI TEMPOROMANDIBULAR JOINT,592.0,384.8,1.1,592.0,126
CDM,70336OH-TC,MRI TEMPOROMANDIBULAR JOINT,1668.0,1084.2,1.1,1668.0,126
CDM,70350OH,CEPHALOGRAM ORTHODONTIC,676.0,439.4,1.1,676.0,142
CDM,70350OH-26,CEPHALOGRAM ORTHODONTIC,68.0,44.2,1.1,68.0,126
CDM,70350OH-TC,CEPHALOGRAM ORTHODONTIC,608.0,395.2,1.1,608.0,126
CDM,70355OH,ORTHOPANTOGRAM,696.0,452.4,1.1,696.0,142
CDM,70355OH-26,ORTHOPANTOGRAM,88.0,57.2,1.1,88.0,126
CDM,70355OH-TC,ORTHOPANTOGRAM,608.0,395.2,1.1,608.0,126
CDM,70360OH,RADIOLOGIC EXAMINATION NECK SOFT TISSUE,687.0,446.55,1.1,687.0,142
CDM,70360OH-26,RADIOLOGIC EXAMINATION NECK SOFT TISSUE,79.0,51.35,1.1,79.0,126
CDM,70360OH-TC,RADIOLOGIC EXAMINATION NECK SOFT TISSUE,608.0,395.2,1.1,608.0,126
CDM,70370OH,RADEX PHARYNX/LARX W/FLUOR&/MAGNIFICATION TQ,736.0,478.4,1.1,736.0,142
CDM,70370OH-26,RADEX PHARYNX/LARX W/FLUOR&/MAGNIFICATION TQ,128.0,83.2,1.1,128.0,126
CDM,70370OH-TC,RADEX PHARYNX/LARX W/FLUOR&/MAGNIFICATION TQ,608.0,395.2,1.1,608.0,126
CDM,70380OH,RADIOLOGIC EXAMINATION SALIVARY GLAND CALCULUS,676.0,439.4,1.1,676.0,142
CDM,70380OH-26,RADIOLOGIC EXAMINATION SALIVARY GLAND CALCULUS,68.0,44.2,1.1,68.0,126
CDM,70380OH-TC,RADIOLOGIC EXAMINATION SALIVARY GLAND CALCULUS,608.0,395.2,1.1,608.0,126
CDM,70390OH,SIALOGRAPHY RS&I,1820.0,1183.0,1.1,1820.0,142
CDM,70390OH-26,SIALOGRAPHY RS&I,152.0,98.8,1.1,152.0,126
CDM,70390OH-TC,SIALOGRAPHY RS&I,1668.0,1084.2,1.1,1668.0,126
CDM,70450OH,CT HEAD/BRAIN W/O CONTRAST MATERIAL,1108.0,720.2,1.1,1108.0,142
CDM,70450OH-26,CT HEAD/BRAIN W/O CONTRAST MATERIAL,374.0,243.1,1.1,374.0,126
CDM,70450OH-TC,CT HEAD/BRAIN W/O CONTRAST MATERIAL,734.0,477.1,1.1,734.0,126
CDM,70460OH,CT HEAD/BRAIN W/CONTRAST MATERIAL,1725.0,1121.25,1.1,1725.0,142
CDM,70460OH-26,CT HEAD/BRAIN W/CONTRAST MATERIAL,497.0,323.05,1.1,497.0,126
CDM,70460OH-TC,CT HEAD/BRAIN W/CONTRAST MATERIAL,1228.0,798.2,1.1,1228.0,126
CDM,70470OH,CT HEAD/BRAIN W/O & W/CONTRAST MATERIAL,1787.0,1161.55,1.1,1787.0,142
CDM,70470OH-26,CT HEAD/BRAIN W/O & W/CONTRAST MATERIAL,559.0,363.35,1.1,559.0,126
CDM,70470OH-TC,CT HEAD/BRAIN W/O & W/CONTRAST MATERIAL,1228.0,798.2,1.1,1228.0,126
CDM,70471OH,CTA HEAD&NECK C+ W/NONCONTRAST IMG&POST-PXESSING,3559.0,2313.35,1.1,3559.0,106
CDM,70471OH-26,CTA HEAD&NECK C+ W/NONCONTRAST IMG&POST-PXESSING,1100.0,715.0,1.1,1100.0,106
CDM,70471OH-TC,CTA HEAD&NECK C+ W/NONCONTRAST IMG&POST-PXESSING,2459.0,1598.35,1.1,2459.0,106
CDM,70472OH,CT CERE PRFUJ ALYS C+ W/CT/CTA SAME ANATOMY,1567.0,1018.55,1.1,1567.0,106
CDM,70472OH-26,CT CERE PRFUJ ALYS C+ W/CT/CTA SAME ANATOMY,339.0,220.35,1.1,339.0,106
CDM,70472OH-TC,CT CERE PRFUJ ALYS C+ W/CT/CTA SAME ANATOMY,1228.0,798.2,1.1,1228.0,106
CDM,70473OH,CT CERE PRFUJ ALYS C+ W/O CT/CTA SAME ANATOMY,1676.0,1089.4,1.1,1676.0,106
CDM,70473OH-26,CT CERE PRFUJ ALYS C+ W/O CT/CTA SAME ANATOMY,440.0,286.0,1.1,440.0,106
CDM,70473OH-TC,CT CERE PRFUJ ALYS C+ W/O CT/CTA SAME ANATOMY,1236.0,803.4,1.1,1236.0,106
CDM,70480OH,CT ORBIT SELLA/POST FOSSA/EAR W/O CONTRAST MATRL,1297.0,843.05,1.1,1297.0,142
CDM,70480OH-26,CT ORBIT SELLA/POST FOSSA/EAR W/O CONTRAST MATRL,563.0,365.95,1.1,563.0,126
CDM,70480OH-TC,CT ORBIT SELLA/POST FOSSA/EAR W/O CONTRAST MATRL,734.0,477.1,1.1,734.0,126
CDM,70481OH,CT ORBIT SELLA/POST FOSSA/EAR W/CONTRAST MATRL,1725.0,1121.25,1.1,1725.0,142
CDM,70481OH-26,CT ORBIT SELLA/POST FOSSA/EAR W/CONTRAST MATRL,497.0,323.05,1.1,497.0,126
CDM,70481OH-TC,CT ORBIT SELLA/POST FOSSA/EAR W/CONTRAST MATRL,1228.0,798.2,1.1,1228.0,126
CDM,70482OH,CT ORBIT SELLA/POST FOSSA/EAR W/O & W/CONTR MATR,1787.0,1161.55,1.1,1787.0,142
CDM,70482OH-26,CT ORBIT SELLA/POST FOSSA/EAR W/O & W/CONTR MATR,559.0,363.35,1.1,559.0,126
CDM,70482OH-TC,CT ORBIT SELLA/POST FOSSA/EAR W/O & W/CONTR MATR,1228.0,798.2,1.1,1228.0,126
CDM,70486OH,CT MAXILLOFACIAL W/O CONTRAST MATERIAL,1108.0,720.2,1.1,1108.0,142
CDM,70486OH-26,CT MAXILLOFACIAL W/O CONTRAST MATERIAL,374.0,243.1,1.1,374.0,126
CDM,70486OH-TC,CT MAXILLOFACIAL W/O CONTRAST MATERIAL,734.0,477.1,1.1,734.0,126
CDM,70487OH,CT MAXILLOFACIAL W/CONTRAST MATERIAL,1725.0,1121.25,1.1,1725.0,142
CDM,70487OH-26,CT MAXILLOFACIAL W/CONTRAST MATERIAL,497.0,323.05,1.1,497.0,126
CDM,70487OH-TC,CT MAXILLOFACIAL W/CONTRAST MATERIAL,1228.0,798.2,1.1,1228.0,126
CDM,70488OH,CT MAXILLOFACIAL W/O & W/CONTRAST MATERIAL,1787.0,1161.55,1.1,1787.0,142
CDM,70488OH-26,CT MAXILLOFACIAL W/O & W/CONTRAST MATERIAL,559.0,363.35,1.1,559.0,126
CDM,70488OH-TC,CT MAXILLOFACIAL W/O & W/CONTRAST MATERIAL,1228.0,798.2,1.1,1228.0,126
CDM,70490OH,CT SOFT TISSUE NECK W/O CONTRAST MATERIAL,1297.0,843.05,1.1,1297.0,142
CDM,70490OH-26,CT SOFT TISSUE NECK W/O CONTRAST MATERIAL,563.0,365.95,1.1,563.0,126
CDM,70490OH-TC,CT SOFT TISSUE NECK W/O CONTRAST MATERIAL,734.0,477.1,1.1,734.0,126
CDM,70491OH,CT SOFT TISSUE NECK W/CONTRAST MATERIAL,1835.0,1192.75,1.1,1835.0,142
CDM,70491OH-26,CT SOFT TISSUE NECK W/CONTRAST MATERIAL,607.0,394.55,1.1,607.0,126
CDM,70491OH-TC,CT SOFT TISSUE NECK W/CONTRAST MATERIAL,1228.0,798.2,1.1,1228.0,126
CDM,70492OH,CT SOFT TISSUE NECK W/O & W/CONTRAST MATERIAL,1941.0,1261.65,1.1,1941.0,142
CDM,70492OH-26,CT SOFT TISSUE NECK W/O & W/CONTRAST MATERIAL,713.0,463.45,1.1,713.0,126
CDM,70492OH-TC,CT SOFT TISSUE NECK W/O & W/CONTRAST MATERIAL,1228.0,798.2,1.1,1228.0,126
CDM,70496OH,CT ANGIOGRAPHY HEAD W/CONTRAST/NONCONTRAST,1998.0,1298.7,1.1,1998.0,142
CDM,70496OH-26,CT ANGIOGRAPHY HEAD W/CONTRAST/NONCONTRAST,770.0,500.5,1.1,770.0,126
CDM,70496OH-TC,CT ANGIOGRAPHY HEAD W/CONTRAST/NONCONTRAST,1228.0,798.2,1.1,1228.0,126
CDM,70498OH,CT ANGIOGRAPHY NECK W/CONTRAST/NONCONTRAST,1998.0,1298.7,1.1,1998.0,142
CDM,70498OH-26,CT ANGIOGRAPHY NECK W/CONTRAST/NONCONTRAST,770.0,500.5,1.1,770.0,126
CDM,70498OH-TC,CT ANGIOGRAPHY NECK W/CONTRAST/NONCONTRAST,1228.0,798.2,1.1,1228.0,126
CDM,70540OH,MRI ORBIT FACE &/NECK W/O CONTRAST,2262.0,1470.3,1.1,2262.0,142
CDM,70540OH-26,MRI ORBIT FACE &/NECK W/O CONTRAST,594.0,386.1,1.1,594.0,126
CDM,70540OH-TC,MRI ORBIT FACE &/NECK W/O CONTRAST,1668.0,1084.2,1.1,1668.0,126
CDM,70542OH,MRI ORBIT FACE & NECK W/CONTRAST MATERIAL,3112.0,2022.8,1.1,3112.0,142
CDM,70542OH-26,MRI ORBIT FACE & NECK W/CONTRAST MATERIAL,648.0,421.2,1.1,648.0,126
CDM,70542OH-TC,MRI ORBIT FACE & NECK W/CONTRAST MATERIAL,2464.0,1601.6,1.1,2464.0,126
CDM,70543OH,MRI ORBIT FACE & NECK W/O & W/CONTRAST MATRL,3324.0,2160.6,1.1,3324.0,142
CDM,70543OH-26,MRI ORBIT FACE & NECK W/O & W/CONTRAST MATRL,860.0,559.0,1.1,860.0,126
CDM,70543OH-TC,MRI ORBIT FACE & NECK W/O & W/CONTRAST MATRL,2464.0,1601.6,1.1,2464.0,126
CDM,70544OH,"MRA, HEAD W/O CONTRAST",2148.0,1396.2,1.1,2148.0,142
CDM,70544OH-26,"MRA, HEAD W/O CONTRAST",480.0,312.0,1.1,480.0,126
CDM,70544OH-TC,"MRA, HEAD W/O CONTRAST",1668.0,1084.2,1.1,1668.0,126
CDM,70545OH,"MRA, HEAD, WITH CONTRAST",2944.0,1913.6,1.1,2944.0,142
CDM,70545OH-26,"MRA, HEAD, WITH CONTRAST",480.0,312.0,1.1,480.0,126
CDM,70545OH-TC,"MRA, HEAD, WITH CONTRAST",2464.0,1601.6,1.1,2464.0,126
CDM,70546OH,MRA; HEAD W & WO CONTRAST,3115.0,2024.75,1.1,3115.0,142
CDM,70546OH-26,MRA; HEAD W & WO CONTRAST,651.0,423.15,1.1,651.0,126
CDM,70546OH-TC,MRA; HEAD W & WO CONTRAST,2464.0,1601.6,1.1,2464.0,126
CDM,70547OH,"MRA, NECK; W/O CONTRAST",2196.0,1427.4,1.1,2196.0,142
CDM,70547OH-26,"MRA, NECK; W/O CONTRAST",528.0,343.2,1.1,528.0,126
CDM,70547OH-TC,"MRA, NECK; W/O CONTRAST",1668.0,1084.2,1.1,1668.0,126
CDM,70548OH,"MRA, NECK; W/CONTRAST",3064.0,1991.6,1.1,3064.0,142
CDM,70548OH-26,"MRA, NECK; W/CONTRAST",600.0,390.0,1.1,600.0,126
CDM,70548OH-TC,"MRA, NECK; W/CONTRAST",2464.0,1601.6,1.1,2464.0,126
CDM,70549OH,"MRA,NECK; W/WO CONTRAST",3184.0,2069.6,1.1,3184.0,142
CDM,70549OH-26,"MRA,NECK; W/WO CONTRAST",720.0,468.0,1.1,720.0,126
CDM,70549OH-TC,"MRA,NECK; W/WO CONTRAST",2464.0,1601.6,1.1,2464.0,126
CDM,70551OH,MRI BRAIN BRAIN STEM W/O CONTRAST MATERIAL,2319.0,1507.35,1.1,2319.0,142
CDM,70551OH-26,MRI BRAIN BRAIN STEM W/O CONTRAST MATERIAL,651.0,423.15,1.1,651.0,126
CDM,70551OH-TC,MRI BRAIN BRAIN STEM W/O CONTRAST MATERIAL,1668.0,1084.2,1.1,1668.0,126
CDM,70552OH,MRI BRAIN BRAIN STEM W/CONTRAST MATERIAL,3247.0,2110.55,1.1,3247.0,142
CDM,70552OH-26,MRI BRAIN BRAIN STEM W/CONTRAST MATERIAL,783.0,508.95,1.1,783.0,126
CDM,70552OH-TC,MRI BRAIN BRAIN STEM W/CONTRAST MATERIAL,2464.0,1601.6,1.1,2464.0,126
CDM,70553OH,MRI BRAIN BRAIN STEM W/O W/CONTRAST MATERIAL,3472.0,2256.8,1.1,3472.0,142
CDM,70553OH-26,MRI BRAIN BRAIN STEM W/O W/CONTRAST MATERIAL,1008.0,655.2,1.1,1008.0,126
CDM,70553OH-TC,MRI BRAIN BRAIN STEM W/O W/CONTRAST MATERIAL,2464.0,1601.6,1.1,2464.0,126
CDM,70554OH,MRI BRAIN FUNCTIONAL W/O PHYSICIAN ADMNISTRATION,2512.0,1632.8,1.1,2512.0,142
CDM,70554OH-26,MRI BRAIN FUNCTIONAL W/O PHYSICIAN ADMNISTRATION,844.0,548.6,1.1,844.0,126
CDM,70554OH-TC,MRI BRAIN FUNCTIONAL W/O PHYSICIAN ADMNISTRATION,1668.0,1084.2,1.1,1668.0,126
CDM,70555OH,MRI BRAIN FUNCTIONAL W/PHYSICIAN ADMNISTRATION,2684.0,1744.6,1.1,2684.0,104
CDM,70555OH-26,MRI BRAIN FUNCTIONAL W/PHYSICIAN ADMNISTRATION,1016.0,660.4,1.1,1016.0,126
CDM,70555OH-TC,MRI BRAIN FUNCTIONAL W/PHYSICIAN ADMNISTRATION,1668.0,1084.2,1.1,1668.0,94
CDM,70557OH,MRI BRAIN OPEN INTRACRANIAL PX W/O CONTRAST MATL,5059.0,3288.35,1.1,5059.0,104
CDM,70557OH-26,MRI BRAIN OPEN INTRACRANIAL PX W/O CONTRAST MATL,1276.0,829.4,1.1,1276.0,126
CDM,70557OH-TC,MRI BRAIN OPEN INTRACRANIAL PX W/O CONTRAST MATL,3783.0,2458.95,1.1,3783.0,94
CDM,70558OH,MRI BRAIN OPEN INTRACRANIAL PX W/CONTRAST MATL,2636.0,1713.4,1.1,2636.0,104
CDM,70558OH-26,MRI BRAIN OPEN INTRACRANIAL PX W/CONTRAST MATL,1408.0,915.2,1.1,1408.0,126
CDM,70558OH-TC,MRI BRAIN OPEN INTRACRANIAL PX W/CONTRAST MATL,1228.0,798.2,1.1,1228.0,94
CDM,70559OH,MRI BRAIN OPEN INTRACRANIAL PX W/O & W/CONTRAST,2508.0,1630.2,1.1,2508.0,104
CDM,70559OH-26,MRI BRAIN OPEN INTRACRANIAL PX W/O & W/CONTRAST,1280.0,832.0,1.1,1280.0,126
CDM,70559OH-TC,MRI BRAIN OPEN INTRACRANIAL PX W/O & W/CONTRAST,1228.0,798.2,1.1,1228.0,94
CDM,71000005,EXT RECOVERY-PER 1/4HR-TO 8HRS,51.0,33.15,11.12,51.0,58
CDM,71000010,PHASE II RECOVERY 1ST 30 MIN,489.0,317.85,106.6,489.0,58
CDM,71000020,PHASE II RECOVERY EA ADD 15 MI,150.0,97.5,32.7,150.0,58
CDM,71000060,PHASE I RECOVERY EA ADD 15 MIN,150.0,97.5,32.7,150.0,58
CDM,71000070,PHASE I RECOVERY 1ST 30 MIN,549.0,356.85,119.68,549.0,58
CDM,71000085,RECOVERY ROOM MILLER PACU ADD'L .50HR,310.0,201.5,67.58,310.0,58
CDM,71000110,PACU 1/2 HR,1102.0,716.3,240.24,1102.0,58
CDM,71000115,RECOVERY TIME EA ADD .25 HRS,147.0,95.55,32.05,147.0,58
CDM,71000120,PACU EA ADD,1102.0,716.3,240.24,1102.0,58
CDM,71000125,O/S RECOVERY ROOM  710,98.0,63.7,21.36,98.0,58
CDM,71000135,PHASE III RECOVERY 1ST 30MIN,548.0,356.2,119.46,548.0,58
CDM,71000145,PHASE III RECOVERY TIME EACH ADD 15MIN,150.0,97.5,32.7,150.0,58
CDM,71000155,EXT RECOVERY-PER 1/4-OVER 8HOURS,6.0,3.9,1.31,6.0,58
CDM,71000395,OB VAG RECOVERY,717.0,466.05,156.31,717.0,58
CDM,71000510,RECOVERY OUTSIDE DELIVERY,360.0,234.0,78.48,360.0,58
CDM,71000865,PACU 15 MINUTES,545.0,354.25,118.81,545.0,58
CDM,71000875,EXTENDED RECOVERY,2218.0,1441.7,483.52,2218.0,58
CDM,71000885,OP-POST IR/CATH/IMAGING RECOVERY,1458.0,947.7,317.84,1458.0,58
CDM,71045OH,RADIOLOGIC EXAM CHEST SINGLE VIEW,687.0,446.55,1.1,687.0,142
CDM,71045OH-26,RADIOLOGIC EXAM CHEST SINGLE VIEW,79.0,51.35,1.1,79.0,126
CDM,71045OH-TC,RADIOLOGIC EXAM CHEST SINGLE VIEW,608.0,395.2,1.1,608.0,126
CDM,71046OH,RADIOLOGIC EXAM CHEST 2 VIEWS,705.0,458.25,1.1,705.0,142
CDM,71046OH-26,RADIOLOGIC EXAM CHEST 2 VIEWS,97.0,63.05,1.1,97.0,126
CDM,71046OH-TC,RADIOLOGIC EXAM CHEST 2 VIEWS,608.0,395.2,1.1,608.0,126
CDM,71047OH,RADIOLOGIC EXAM CHEST 3 VIEWS,727.0,472.55,1.1,727.0,142
CDM,71047OH-26,RADIOLOGIC EXAM CHEST 3 VIEWS,119.0,77.35,1.1,119.0,126
CDM,71047OH-TC,RADIOLOGIC EXAM CHEST 3 VIEWS,608.0,395.2,1.1,608.0,126
CDM,71048OH,RADIOLOGIC EXAM CHEST 4+ VIEWS,870.0,565.5,1.1,870.0,142
CDM,71048OH-26,RADIOLOGIC EXAM CHEST 4+ VIEWS,136.0,88.4,1.1,136.0,126
CDM,71048OH-TC,RADIOLOGIC EXAM CHEST 4+ VIEWS,734.0,477.1,1.1,734.0,126
CDM,71090OH,X-RAY & PACEMAKER INSERTION,196.0,127.4,1.1,196.0,70
CDM,71100OH,RADEX RIBS UNILATERAL 2 VIEWS,696.0,452.4,1.1,696.0,142
CDM,71100OH-26,RADEX RIBS UNILATERAL 2 VIEWS,88.0,57.2,1.1,88.0,126
CDM,71100OH-TC,RADEX RIBS UNILATERAL 2 VIEWS,608.0,395.2,1.1,608.0,126
CDM,71101OH,RADEX RIBS UNI W/POSTEROANT CH MINIMUM 3 VIEWS,842.0,547.3,1.1,842.0,142
CDM,71101OH-26,RADEX RIBS UNI W/POSTEROANT CH MINIMUM 3 VIEWS,108.0,70.2,1.1,108.0,126
CDM,71101OH-TC,RADEX RIBS UNI W/POSTEROANT CH MINIMUM 3 VIEWS,734.0,477.1,1.1,734.0,126
CDM,71110OH,RADEX RIBS BILATERAL 3 VIEWS,862.0,560.3,1.1,862.0,142
CDM,71110OH-26,RADEX RIBS BILATERAL 3 VIEWS,128.0,83.2,1.1,128.0,126
CDM,71110OH-TC,RADEX RIBS BILATERAL 3 VIEWS,734.0,477.1,1.1,734.0,126
CDM,71111OH,RADEX RIBS BI W/POSTEROANT CH MINIMUM 4 VIEWS,862.0,560.3,1.1,862.0,142
CDM,71111OH-26,RADEX RIBS BI W/POSTEROANT CH MINIMUM 4 VIEWS,128.0,83.2,1.1,128.0,126
CDM,71111OH-TC,RADEX RIBS BI W/POSTEROANT CH MINIMUM 4 VIEWS,734.0,477.1,1.1,734.0,126
CDM,71120OH,RADEX STERNUM MINIMUM 2 VIEWS,696.0,452.4,1.1,696.0,142
CDM,71120OH-26,RADEX STERNUM MINIMUM 2 VIEWS,88.0,57.2,1.1,88.0,126
CDM,71120OH-TC,RADEX STERNUM MINIMUM 2 VIEWS,608.0,395.2,1.1,608.0,126
CDM,71130OH,RADEX STERNOCLAVICULAR JT/JTS MINIMUM 3 VIEWS,705.0,458.25,1.1,705.0,142
CDM,71130OH-26,RADEX STERNOCLAVICULAR JT/JTS MINIMUM 3 VIEWS,97.0,63.05,1.1,97.0,126
CDM,71130OH-TC,RADEX STERNOCLAVICULAR JT/JTS MINIMUM 3 VIEWS,608.0,395.2,1.1,608.0,126
CDM,71250OH,DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX W/O CNTRST,1209.0,785.85,1.1,1209.0,142
CDM,71250OH-26,DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX W/O CNTRST,475.0,308.75,1.1,475.0,126
CDM,71250OH-TC,DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX W/O CNTRST,734.0,477.1,1.1,734.0,126
CDM,71260OH,DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX W/CONTRAST,1738.0,1129.7,1.1,1738.0,142
CDM,71260OH-26,DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX W/CONTRAST,510.0,331.5,1.1,510.0,126
CDM,71260OH-TC,DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX W/CONTRAST,1228.0,798.2,1.1,1228.0,126
CDM,71270OH,DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX C-/C+,1778.0,1155.7,1.1,1778.0,142
CDM,71270OH-26,DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX C-/C+,550.0,357.5,1.1,550.0,126
CDM,71270OH-TC,DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX C-/C+,1228.0,798.2,1.1,1228.0,126
CDM,71271OH,COMPUTED TOMOGRAPHY THORAX LW DOSE LNG CA SCR C-,1209.0,785.85,1.1,1209.0,142
CDM,71271OH-26,COMPUTED TOMOGRAPHY THORAX LW DOSE LNG CA SCR C-,475.0,308.75,1.1,475.0,126
CDM,71271OH-TC,COMPUTED TOMOGRAPHY THORAX LW DOSE LNG CA SCR C-,734.0,477.1,1.1,734.0,126
CDM,71275OH,CT ANGIOGRAPHY CHEST W/CONTRAST/NONCONTRAST,2029.0,1318.85,1.1,2029.0,142
CDM,71275OH-26,CT ANGIOGRAPHY CHEST W/CONTRAST/NONCONTRAST,801.0,520.65,1.1,801.0,126
CDM,71275OH-TC,CT ANGIOGRAPHY CHEST W/CONTRAST/NONCONTRAST,1228.0,798.2,1.1,1228.0,126
CDM,71550OH,MRI CHEST W/O CONTRAST MATERIAL,2252.0,1463.8,1.1,2252.0,142
CDM,71550OH-26,MRI CHEST W/O CONTRAST MATERIAL,584.0,379.6,1.1,584.0,126
CDM,71550OH-TC,MRI CHEST W/O CONTRAST MATERIAL,1668.0,1084.2,1.1,1668.0,126
CDM,71551OH,"MRI,CHEST; W/CONTRAST",6143.0,3992.95,1.1,6143.0,142
CDM,71551OH-26,"MRI,CHEST; W/CONTRAST",692.0,449.8,1.1,692.0,126
CDM,71551OH-TC,"MRI,CHEST; W/CONTRAST",5451.0,3543.15,1.1,5451.0,126
CDM,71552OH,MRI CHEST W/O & W/CONTRAST MATERIAL,3368.0,2189.2,1.1,3368.0,142
CDM,71552OH-26,MRI CHEST W/O & W/CONTRAST MATERIAL,904.0,587.6,1.1,904.0,126
CDM,71552OH-TC,MRI CHEST W/O & W/CONTRAST MATERIAL,2464.0,1601.6,1.1,2464.0,126
CDM,7155526OH-26-1,MR ANGIO CHEST (MRA),796.0,517.4,1.1,796.0,126
CDM,7155526OH-26-2,MRA CHEST W/O & W/CONTRAST MATERIAL,796.0,517.4,1.1,796.0,126
CDM,71555COH,MRA CHEST W CONTRAST,7070.0,4595.5,1.1,7070.0,142
CDM,71555COH-26,MRA CHEST W CONTRAST,796.0,517.4,1.1,796.0,126
CDM,71555COH-TC,MRA CHEST W CONTRAST,6274.0,4078.1,1.1,6274.0,126
CDM,71555OH-26,MRA CHEST WITH OR W/O CONT,796.0,517.4,1.1,796.0,126
CDM,71555OH-3,MRA CHEST WITH OR W/O CONT,7070.0,4595.5,1.1,7070.0,142
CDM,71555OH-4,MR ANGIO CHEST (MRA),7070.0,4595.5,1.1,7070.0,142
CDM,71555OH-5,MRA CHEST W/O & W/CONTRAST MATERIAL,7070.0,4595.5,1.1,7070.0,142
CDM,71555OH-TC,MRA CHEST WITH OR W/O CONT,6274.0,4078.1,1.1,6274.0,126
CDM,71555TCOH-TC-6,MR ANGIO CHEST (MRA),6274.0,4078.1,1.1,6274.0,126
CDM,71555TCOH-TC-7,MRA CHEST W/O & W/CONTRAST MATERIAL,6274.0,4078.1,1.1,6274.0,126
CDM,72000000,DELIVERY/BIRTHING ROOM RESUSCITATION,4515.0,2934.75,171.1,4515.0,86
CDM,72000045,DELIVERY OF PLACENTA,8937.0,5809.05,108.18,8937.0,86
CDM,72000095,CESAREAN SECTION SINGLE,7913.0,5143.45,1725.03,7913.0,58
CDM,72000105,CESAREAN SECTION TWINS,8853.0,5754.45,1929.95,8853.0,58
CDM,72000115,CESAREAN SECTION MULTI>2,9168.0,5959.2,1998.62,9168.0,58
CDM,72000375,VAGINAL DELIVERY W/DBL SET-UP,670.0,435.5,146.06,670.0,58
CDM,72000425,FETAL MONITORING LABOR PHYS WRITTEN REPORT,380.0,247.0,58.47,380.0,68
CDM,72000465,FETAL NST TEST,805.0,523.25,59.72,805.0,86
CDM,72000515,FETAL NST TEST,805.0,523.25,59.72,805.0,86
CDM,72000525,TRANSABDOMINAL AMNIOINFUSION W/ULTRSND GUIDANCE,1217.0,791.05,278.32,3443.0,86
CDM,72000535,INSERTION CERVICAL DILATOR SEPARATE PROCEDURE,1217.0,791.05,55.12,3443.0,86
CDM,72001015,FETAL SURG MYELOMENINGO,18649.0,12121.85,2362.56,18649.0,66
CDM,72020OH,RADEX SPINE 1 VIEW SPECIFY LEVEL,672.0,436.8,1.1,672.0,142
CDM,72020OH-26,RADEX SPINE 1 VIEW SPECIFY LEVEL,64.0,41.6,1.1,64.0,126
CDM,72020OH-TC,RADEX SPINE 1 VIEW SPECIFY LEVEL,608.0,395.2,1.1,608.0,126
CDM,72040OH,RADEX SPINE CERVICAL 2 OR 3 VIEWS,705.0,458.25,1.1,705.0,142
CDM,72040OH-26,RADEX SPINE CERVICAL 2 OR 3 VIEWS,97.0,63.05,1.1,97.0,126
CDM,72040OH-TC,RADEX SPINE CERVICAL 2 OR 3 VIEWS,608.0,395.2,1.1,608.0,126
CDM,72050OH,RADEX SPINE CERVICAL 4 OR 5 VIEWS,853.0,554.45,1.1,853.0,142
CDM,72050OH-26,RADEX SPINE CERVICAL 4 OR 5 VIEWS,119.0,77.35,1.1,119.0,126
CDM,72050OH-TC,RADEX SPINE CERVICAL 4 OR 5 VIEWS,734.0,477.1,1.1,734.0,126
CDM,72052OH,RADEX SPINE CERVICAL 6 OR MORE VIEWS,866.0,562.9,1.1,866.0,142
CDM,72052OH-26,RADEX SPINE CERVICAL 6 OR MORE VIEWS,132.0,85.8,1.1,132.0,126
CDM,72052OH-TC,RADEX SPINE CERVICAL 6 OR MORE VIEWS,734.0,477.1,1.1,734.0,126
CDM,72070OH,RADEX SPINE THORACIC 2 VIEWS,822.0,534.3,1.1,822.0,142
CDM,72070OH-26,RADEX SPINE THORACIC 2 VIEWS,88.0,57.2,1.1,88.0,126
CDM,72070OH-TC,RADEX SPINE THORACIC 2 VIEWS,734.0,477.1,1.1,734.0,126
CDM,72072OH,RADEX SPINE THORACIC 3 VIEWS,835.0,542.75,1.1,835.0,142
CDM,72072OH-26,RADEX SPINE THORACIC 3 VIEWS,101.0,65.65,1.1,101.0,126
CDM,72072OH-TC,RADEX SPINE THORACIC 3 VIEWS,734.0,477.1,1.1,734.0,126
CDM,72074OH,RADEX SPINE THORACIC MINIMUM 4 VIEWS,844.0,548.6,1.1,844.0,142
CDM,72074OH-26,RADEX SPINE THORACIC MINIMUM 4 VIEWS,110.0,71.5,1.1,110.0,126
CDM,72074OH-TC,RADEX SPINE THORACIC MINIMUM 4 VIEWS,734.0,477.1,1.1,734.0,126
CDM,72080OH,RADEX SPINE THORACOLUMBAR JUNCTION MIN 2 VIEWS,692.0,449.8,1.1,692.0,142
CDM,72080OH-26,RADEX SPINE THORACOLUMBAR JUNCTION MIN 2 VIEWS,84.0,54.6,1.1,84.0,126
CDM,72080OH-TC,RADEX SPINE THORACOLUMBAR JUNCTION MIN 2 VIEWS,608.0,395.2,1.1,608.0,126
CDM,72081OH,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 1 VW,722.0,469.3,1.1,722.0,142
CDM,72081OH-26,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 1 VW,114.0,74.1,1.1,114.0,126
CDM,72081OH-TC,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 1 VW,608.0,395.2,1.1,608.0,126
CDM,72082OH,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 2/3 VW,870.0,565.5,1.1,870.0,142
CDM,72082OH-26,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 2/3 VW,136.0,88.4,1.1,136.0,126
CDM,72082OH-TC,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 2/3 VW,734.0,477.1,1.1,734.0,126
CDM,72083OH,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 4/5 VW,888.0,577.2,1.1,888.0,142
CDM,72083OH-26,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 4/5 VW,154.0,100.1,1.1,154.0,126
CDM,72083OH-TC,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 4/5 VW,734.0,477.1,1.1,734.0,126
CDM,72084OH,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 6/> VW,914.0,594.1,1.1,914.0,142
CDM,72084OH-26,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 6/> VW,180.0,117.0,1.1,180.0,126
CDM,72084OH-TC,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 6/> VW,734.0,477.1,1.1,734.0,126
CDM,72100OH,RADEX SPINE LUMBOSACRAL 2/3 VIEWS,831.0,540.15,1.1,831.0,142
CDM,72100OH-26,RADEX SPINE LUMBOSACRAL 2/3 VIEWS,97.0,63.05,1.1,97.0,126
CDM,72100OH-TC,RADEX SPINE LUMBOSACRAL 2/3 VIEWS,734.0,477.1,1.1,734.0,126
CDM,72110OH,RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS,848.0,551.2,1.1,848.0,142
CDM,72110OH-26,RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS,114.0,74.1,1.1,114.0,126
CDM,72110OH-TC,RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS,734.0,477.1,1.1,734.0,126
CDM,72114OH,RADEX SPINE LUMBSCRL COMPL W/BENDING VIEWS MIN 6,866.0,562.9,1.1,866.0,142
CDM,72114OH-26,RADEX SPINE LUMBSCRL COMPL W/BENDING VIEWS MIN 6,132.0,85.8,1.1,132.0,126
CDM,72114OH-TC,RADEX SPINE LUMBSCRL COMPL W/BENDING VIEWS MIN 6,734.0,477.1,1.1,734.0,126
CDM,72120OH,RADEX SPINE LUMBOSACRAL ONLY BENDING 2/3 VIEWS,831.0,540.15,1.1,831.0,142
CDM,72120OH-26,RADEX SPINE LUMBOSACRAL ONLY BENDING 2/3 VIEWS,97.0,63.05,1.1,97.0,126
CDM,72120OH-TC,RADEX SPINE LUMBOSACRAL ONLY BENDING 2/3 VIEWS,734.0,477.1,1.1,734.0,126
CDM,72125OH,CT CERVICAL SPINE W/O CONTRAST MATERIAL,1174.0,763.1,1.1,1174.0,142
CDM,72125OH-26,CT CERVICAL SPINE W/O CONTRAST MATERIAL,440.0,286.0,1.1,440.0,126
CDM,72125OH-TC,CT CERVICAL SPINE W/O CONTRAST MATERIAL,734.0,477.1,1.1,734.0,126
CDM,72126OH,CT CERVICAL SPINE W/CONTRAST MATERIAL,2952.0,1918.8,1.1,2952.0,142
CDM,72126OH-26,CT CERVICAL SPINE W/CONTRAST MATERIAL,488.0,317.2,1.1,488.0,126
CDM,72126OH-TC,CT CERVICAL SPINE W/CONTRAST MATERIAL,2464.0,1601.6,1.1,2464.0,126
CDM,72127OH,CT CERVICAL SPINE W/O &W/CONTRAST MATERIAL,1736.0,1128.4,1.1,1736.0,142
CDM,72127OH-26,CT CERVICAL SPINE W/O &W/CONTRAST MATERIAL,508.0,330.2,1.1,508.0,126
CDM,72127OH-TC,CT CERVICAL SPINE W/O &W/CONTRAST MATERIAL,1228.0,798.2,1.1,1228.0,126
CDM,72128OH,CT THORACIC SPINE W/O CONTRAST MATERIAL,1134.0,737.1,1.1,1134.0,142
CDM,72128OH-26,CT THORACIC SPINE W/O CONTRAST MATERIAL,400.0,260.0,1.1,400.0,126
CDM,72128OH-TC,CT THORACIC SPINE W/O CONTRAST MATERIAL,734.0,477.1,1.1,734.0,126
CDM,72129OH,CT THORACIC SPINE W/CONTRAST MATERIAL,1716.0,1115.4,1.1,1716.0,142
CDM,72129OH-26,CT THORACIC SPINE W/CONTRAST MATERIAL,488.0,317.2,1.1,488.0,126
CDM,72129OH-TC,CT THORACIC SPINE W/CONTRAST MATERIAL,1228.0,798.2,1.1,1228.0,126
CDM,72130OH,CT THORACIC SPINE W/O & W/CONTRAST MATERIAL,1736.0,1128.4,1.1,1736.0,142
CDM,72130OH-26,CT THORACIC SPINE W/O & W/CONTRAST MATERIAL,508.0,330.2,1.1,508.0,126
CDM,72130OH-TC,CT THORACIC SPINE W/O & W/CONTRAST MATERIAL,1228.0,798.2,1.1,1228.0,126
CDM,72131OH,CT LUMBAR SPINE W/O CONTRAST MATERIAL,1174.0,763.1,1.1,1174.0,142
CDM,72131OH-26,CT LUMBAR SPINE W/O CONTRAST MATERIAL,440.0,286.0,1.1,440.0,126
CDM,72131OH-TC,CT LUMBAR SPINE W/O CONTRAST MATERIAL,734.0,477.1,1.1,734.0,126
CDM,72132OH,CT LUMBAR SPINE W/CONTRAST MATERIAL,3001.0,1950.65,1.1,3001.0,142
CDM,72132OH-26,CT LUMBAR SPINE W/CONTRAST MATERIAL,537.0,349.05,1.1,537.0,126
CDM,72132OH-TC,CT LUMBAR SPINE W/CONTRAST MATERIAL,2464.0,1601.6,1.1,2464.0,126
CDM,72133OH,CT LUMBAR SPINE W/O & W/CONTRAST MATERIAL,1787.0,1161.55,1.1,1787.0,142
CDM,72133OH-26,CT LUMBAR SPINE W/O & W/CONTRAST MATERIAL,559.0,363.35,1.1,559.0,126
CDM,72133OH-TC,CT LUMBAR SPINE W/O & W/CONTRAST MATERIAL,1228.0,798.2,1.1,1228.0,126
CDM,72141OH,MRI SPINAL CANAL CERVICAL W/O CONTRAST MATRL,2319.0,1507.35,1.1,2319.0,142
CDM,72141OH-26,MRI SPINAL CANAL CERVICAL W/O CONTRAST MATRL,651.0,423.15,1.1,651.0,126
CDM,72141OH-TC,MRI SPINAL CANAL CERVICAL W/O CONTRAST MATRL,1668.0,1084.2,1.1,1668.0,126
CDM,72142OH,MRI SPINAL CANAL CERVICAL W/CONTRAST MATRL,3247.0,2110.55,1.1,3247.0,142
CDM,72142OH-26,MRI SPINAL CANAL CERVICAL W/CONTRAST MATRL,783.0,508.95,1.1,783.0,126
CDM,72142OH-TC,MRI SPINAL CANAL CERVICAL W/CONTRAST MATRL,2464.0,1601.6,1.1,2464.0,126
CDM,72146OH,MRI SPINAL CANAL THORACIC W/O CONTRAST MATRL,2319.0,1507.35,1.1,2319.0,142
CDM,72146OH-26,MRI SPINAL CANAL THORACIC W/O CONTRAST MATRL,651.0,423.15,1.1,651.0,126
CDM,72146OH-TC,MRI SPINAL CANAL THORACIC W/O CONTRAST MATRL,1668.0,1084.2,1.1,1668.0,126
CDM,72147OH,MRI SPINAL CANAL THORACIC W/CONTRAST MATRL,3247.0,2110.55,1.1,3247.0,142
CDM,72147OH-26,MRI SPINAL CANAL THORACIC W/CONTRAST MATRL,783.0,508.95,1.1,783.0,126
CDM,72147OH-TC,MRI SPINAL CANAL THORACIC W/CONTRAST MATRL,2464.0,1601.6,1.1,2464.0,126
CDM,72148OH,MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL,2260.0,1469.0,1.1,2260.0,142
CDM,72148OH-26,MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL,592.0,384.8,1.1,592.0,126
CDM,72148OH-TC,MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL,1668.0,1084.2,1.1,1668.0,126
CDM,72149OH,MRI SPINAL CANAL LUMBAR W/CONTRAST MATERIAL,3176.0,2064.4,1.1,3176.0,142
CDM,72149OH-26,MRI SPINAL CANAL LUMBAR W/CONTRAST MATERIAL,712.0,462.8,1.1,712.0,126
CDM,72149OH-TC,MRI SPINAL CANAL LUMBAR W/CONTRAST MATERIAL,2464.0,1601.6,1.1,2464.0,126
CDM,72156OH,MRI SPINAL CANAL CERVICAL W/O & W/CONTR MATRL,3472.0,2256.8,1.1,3472.0,142
CDM,72156OH-26,MRI SPINAL CANAL CERVICAL W/O & W/CONTR MATRL,1008.0,655.2,1.1,1008.0,126
CDM,72156OH-TC,MRI SPINAL CANAL CERVICAL W/O & W/CONTR MATRL,2464.0,1601.6,1.1,2464.0,126
CDM,72157OH,MRI SPINAL CANAL THORACIC W/O & W/CONTR MATRL,3380.0,2197.0,1.1,3380.0,142
CDM,72157OH-26,MRI SPINAL CANAL THORACIC W/O & W/CONTR MATRL,916.0,595.4,1.1,916.0,126
CDM,72157OH-TC,MRI SPINAL CANAL THORACIC W/O & W/CONTR MATRL,2464.0,1601.6,1.1,2464.0,126
CDM,72158OH,MRI SPINAL CANAL LUMBAR W/O & W/CONTR MATRL,3380.0,2197.0,1.1,3380.0,142
CDM,72158OH-26,MRI SPINAL CANAL LUMBAR W/O & W/CONTR MATRL,916.0,595.4,1.1,916.0,126
CDM,72158OH-TC,MRI SPINAL CANAL LUMBAR W/O & W/CONTR MATRL,2464.0,1601.6,1.1,2464.0,126
CDM,7215926OH,MR ANGIO SPINE (MRA),720.0,468.0,1.1,720.0,126
CDM,72159COH,MRA WO/W CONTRAST SPINAL CANAL,3788.0,2462.2,1.1,3788.0,142
CDM,72159COH-26,MRA WO/W CONTRAST SPINAL CANAL,720.0,468.0,1.1,720.0,126
CDM,72159COH-TC,MRA WO/W CONTRAST SPINAL CANAL,3068.0,1994.2,1.1,3068.0,126
CDM,72159OH-26,MRA SPINE WITH OR W/O CONT,720.0,468.0,1.1,720.0,126
CDM,72159OH-8,MRA SPINE WITH OR W/O CONT,3788.0,2462.2,1.1,3788.0,142
CDM,72159OH-9,MR ANGIO SPINE (MRA),3788.0,2462.2,1.1,3788.0,142
CDM,72159OH-TC,MRA SPINE WITH OR W/O CONT,3068.0,1994.2,1.1,3068.0,126
CDM,72159TCOH,MR ANGIO SPINE (MRA),3068.0,1994.2,1.1,3068.0,126
CDM,72170OH,RADIOLOGIC EXAMINATION PELVIS 1/2 VIEWS,809.0,525.85,1.1,809.0,142
CDM,72170OH-26,RADIOLOGIC EXAMINATION PELVIS 1/2 VIEWS,75.0,48.75,1.1,75.0,126
CDM,72170OH-TC,RADIOLOGIC EXAMINATION PELVIS 1/2 VIEWS,734.0,477.1,1.1,734.0,126
CDM,72190OH,RADIOLOGIC EXAM PELVIS COMPL MINIMUM 3 VIEWS,844.0,548.6,1.1,844.0,142
CDM,72190OH-26,RADIOLOGIC EXAM PELVIS COMPL MINIMUM 3 VIEWS,110.0,71.5,1.1,110.0,126
CDM,72190OH-TC,RADIOLOGIC EXAM PELVIS COMPL MINIMUM 3 VIEWS,734.0,477.1,1.1,734.0,126
CDM,72191OH,CT ANGIOGRAPHY PELVIS W/CONTRAST/NONCONTRAST,1952.0,1268.8,1.1,1952.0,142
CDM,72191OH-26,CT ANGIOGRAPHY PELVIS W/CONTRAST/NONCONTRAST,724.0,470.6,1.1,724.0,126
CDM,72191OH-TC,CT ANGIOGRAPHY PELVIS W/CONTRAST/NONCONTRAST,1228.0,798.2,1.1,1228.0,126
CDM,72192OH,CT PELVIS W/O CONTRAST MATERIAL,1170.0,760.5,1.1,1170.0,142
CDM,72192OH-26,CT PELVIS W/O CONTRAST MATERIAL,436.0,283.4,1.1,436.0,126
CDM,72192OH-TC,CT PELVIS W/O CONTRAST MATERIAL,734.0,477.1,1.1,734.0,126
CDM,72193OH,CT PELVIS W/CONTRAST MATERIAL,1738.0,1129.7,1.1,1738.0,142
CDM,72193OH-26,CT PELVIS W/CONTRAST MATERIAL,510.0,331.5,1.1,510.0,126
CDM,72193OH-TC,CT PELVIS W/CONTRAST MATERIAL,1228.0,798.2,1.1,1228.0,126
CDM,72194OH,CT PELVIS W/O & W/CONTRAST MATERIAL,1765.0,1147.25,1.1,1765.0,142
CDM,72194OH-26,CT PELVIS W/O & W/CONTRAST MATERIAL,537.0,349.05,1.1,537.0,126
CDM,72194OH-TC,CT PELVIS W/O & W/CONTRAST MATERIAL,1228.0,798.2,1.1,1228.0,126
CDM,72195OH,MRI PELVIS W/O CONTRAST MATERIAL,2310.0,1501.5,1.1,2310.0,142
CDM,72195OH-26,MRI PELVIS W/O CONTRAST MATERIAL,642.0,417.3,1.1,642.0,126
CDM,72195OH-TC,MRI PELVIS W/O CONTRAST MATERIAL,1668.0,1084.2,1.1,1668.0,126
CDM,72196OH,MRI PELVIS W/CONTRAST MATERIAL,3225.0,2096.25,1.1,3225.0,142
CDM,72196OH-26,MRI PELVIS W/CONTRAST MATERIAL,761.0,494.65,1.1,761.0,126
CDM,72196OH-TC,MRI PELVIS W/CONTRAST MATERIAL,2464.0,1601.6,1.1,2464.0,126
CDM,72197OH,MRI PELVIS W/O & W/CONTRAST MATERIAL,3432.0,2230.8,1.1,3432.0,142
CDM,72197OH-26,MRI PELVIS W/O & W/CONTRAST MATERIAL,968.0,629.2,1.1,968.0,126
CDM,72197OH-TC,MRI PELVIS W/O & W/CONTRAST MATERIAL,2464.0,1601.6,1.1,2464.0,126
CDM,7219826OH,MRA PELVIS W/WO CONTRAST MATERIAL,792.0,514.8,1.1,792.0,126
CDM,72198BOH,MR ANGIO PELVIS(MRA),7088.0,4607.2,1.1,7088.0,68
CDM,72198BOH-26,MR ANGIO PELVIS(MRA),792.0,514.8,1.1,792.0,68
CDM,72198BOH-TC,MR ANGIO PELVIS(MRA),6296.0,4092.4,1.1,6296.0,72
CDM,72198COH,MRA PELV W CONTRL,7088.0,4607.2,1.1,7088.0,142
CDM,72198COH-26,MRA PELV W CONTRL,792.0,514.8,1.1,792.0,126
CDM,72198COH-TC,MRA PELV W CONTRL,6296.0,4092.4,1.1,6296.0,126
CDM,72198DOH,MRA PELV WO CONTRL,7088.0,4607.2,1.1,7088.0,142
CDM,72198DOH-26,MRA PELV WO CONTRL,792.0,514.8,1.1,792.0,126
CDM,72198DOH-TC,MRA PELV WO CONTRL,6296.0,4092.4,1.1,6296.0,126
CDM,72198OH-10,MRA PELVIS WITH OR W/O CONT,7088.0,4607.2,1.1,7088.0,142
CDM,72198OH-11,MRA PELVIS W/WO CONTRAST MATERIAL,7088.0,4607.2,1.1,7088.0,142
CDM,72198OH-26,MRA PELVIS WITH OR W/O CONT,792.0,514.8,1.1,792.0,126
CDM,72198OH-TC,MRA PELVIS WITH OR W/O CONT,6296.0,4092.4,1.1,6296.0,126
CDM,72198TCOH,MRA PELVIS W/WO CONTRAST MATERIAL,6296.0,4092.4,1.1,6296.0,126
CDM,72200035,VAG DEL SNGL,3778.0,2455.7,823.6,3778.0,58
CDM,72200045,VAG DEL TWINS,4566.0,2967.9,995.39,4566.0,58
CDM,72200095,VAG DEL FETAL DEMISE,2861.0,1859.65,623.7,2861.0,58
CDM,72200115,VAG DEL>=3,6976.0,4534.4,1520.77,6976.0,58
CDM,72200135,TX MISSED ABORTION SECOND TRIMESTER SURGICAL,12718.0,8266.7,430.37,13821.0,87
CDM,72200OH,RADIOLOGIC EXAMINATION SACROILIAC JNTS <3 VIEWS,809.0,525.85,1.1,809.0,142
CDM,72200OH-26,RADIOLOGIC EXAMINATION SACROILIAC JNTS <3 VIEWS,75.0,48.75,1.1,75.0,126
CDM,72200OH-TC,RADIOLOGIC EXAMINATION SACROILIAC JNTS <3 VIEWS,734.0,477.1,1.1,734.0,126
CDM,72202OH,RADIOLOGIC EXAM SACROILIAC JOINTS 3/MORE VIEWS,835.0,542.75,1.1,835.0,142
CDM,72202OH-26,RADIOLOGIC EXAM SACROILIAC JOINTS 3/MORE VIEWS,101.0,65.65,1.1,101.0,126
CDM,72202OH-TC,RADIOLOGIC EXAM SACROILIAC JOINTS 3/MORE VIEWS,734.0,477.1,1.1,734.0,126
CDM,72220OH,RADEX SACRUM & COCCYX MINIMUM 2 VIEWS,676.0,439.4,1.1,676.0,142
CDM,72220OH-26,RADEX SACRUM & COCCYX MINIMUM 2 VIEWS,68.0,44.2,1.1,68.0,126
CDM,72220OH-TC,RADEX SACRUM & COCCYX MINIMUM 2 VIEWS,608.0,395.2,1.1,608.0,126
CDM,72240OH,MYELOGRAPHY CERVICAL RS&I,5815.0,3779.75,1.1,5815.0,142
CDM,72240OH-26,MYELOGRAPHY CERVICAL RS&I,364.0,236.6,1.1,364.0,126
CDM,72240OH-TC,MYELOGRAPHY CERVICAL RS&I,5451.0,3543.15,1.1,5451.0,126
CDM,72255OH,MYELOGRAPHY THORACIC RS&I,5815.0,3779.75,1.1,5815.0,142
CDM,72255OH-26,MYELOGRAPHY THORACIC RS&I,364.0,236.6,1.1,364.0,126
CDM,72255OH-TC,MYELOGRAPHY THORACIC RS&I,5451.0,3543.15,1.1,5451.0,126
CDM,72265OH,MYELOGRAPY LUMBOSACRAL RS&I,5783.0,3758.95,1.1,5783.0,142
CDM,72265OH-26,MYELOGRAPY LUMBOSACRAL RS&I,332.0,215.8,1.1,332.0,126
CDM,72265OH-TC,MYELOGRAPY LUMBOSACRAL RS&I,5451.0,3543.15,1.1,5451.0,126
CDM,72270OH,MYELOGRAPY 2/MORE REGIONS RS&I,5983.0,3888.95,1.1,5983.0,142
CDM,72270OH-26,MYELOGRAPY 2/MORE REGIONS RS&I,532.0,345.8,1.1,532.0,126
CDM,72270OH-TC,MYELOGRAPY 2/MORE REGIONS RS&I,5451.0,3543.15,1.1,5451.0,126
CDM,72285OH,DISKOGRAPY CERVICAL/THORACIC RS&I,13938.0,9059.7,1.1,13938.0,142
CDM,72285OH-26,DISKOGRAPY CERVICAL/THORACIC RS&I,464.0,301.6,1.1,464.0,126
CDM,72285OH-TC,DISKOGRAPY CERVICAL/THORACIC RS&I,13474.0,8758.1,1.1,13474.0,126
CDM,72295OH,DISKOGRAPY LUMBAR RS&I,13806.0,8973.9,1.1,13806.0,142
CDM,72295OH-26,DISKOGRAPY LUMBAR RS&I,332.0,215.8,1.1,332.0,126
CDM,72295OH-TC,DISKOGRAPY LUMBAR RS&I,13474.0,8758.1,1.1,13474.0,126
CDM,73000005,RHYTHM ECG 1-3 LEADS TRACING ONLY W/O I&R,342.0,222.3,8.64,342.0,87
CDM,73000010,EKG TRACING FOR INITIAL PREV,98.0,63.7,8.64,98.0,87
CDM,73000025,SIGNAL AVERAGED ELECTROCARDIOGRAPHY W/WO ECG,342.0,222.3,23.5,342.0,87
CDM,73000035,ECG ROUTINE ECG W/LEAST 12 LDS W/I&R,415.0,269.75,17.77,415.0,69
CDM,73000120,RHYTHM ECG 1-3 LEADS TRACING ONLY W/O I&R,342.0,222.3,8.64,342.0,87
CDM,73000200,ECG ROUTINE ECG W/LEAST 12 LDS TRCG ONLY W/O I&R,342.0,222.3,8.64,342.0,87
CDM,73000235,ECG ROUTINE ECG W/LEAST 12 LDS TRCG ONLY W/O I&R,342.0,222.3,8.64,342.0,87
CDM,73000265,ASSTV ALG ECG RSK-BASED ASSMT RELATED CNCRT ECG,516.0,335.4,23.5,2159881.2,84
CDM,73000275,ASSTV ALG ECG RSK-BASED ASSMT RELATED PREV ECG,516.0,335.4,23.5,2159881.2,84
CDM,73000285,EKG W/INTERPRETATION,70.0,45.5,15.26,70.0,58
CDM,73000OH,RADEX CLAVICLE COMPLETE,672.0,436.8,1.1,672.0,142
CDM,73000OH-26,RADEX CLAVICLE COMPLETE,64.0,41.6,1.1,64.0,126
CDM,73000OH-TC,RADEX CLAVICLE COMPLETE,608.0,395.2,1.1,608.0,126
CDM,73010OH,RADEX SCAPULA COMPLETE,809.0,525.85,1.1,809.0,142
CDM,73010OH-26,RADEX SCAPULA COMPLETE,75.0,48.75,1.1,75.0,126
CDM,73010OH-TC,RADEX SCAPULA COMPLETE,734.0,477.1,1.1,734.0,126
CDM,73020OH,RADEX SHOULDER 1 VIEW,674.0,438.1,1.1,674.0,142
CDM,73020OH-26,RADEX SHOULDER 1 VIEW,66.0,42.9,1.1,66.0,126
CDM,73020OH-TC,RADEX SHOULDER 1 VIEW,608.0,395.2,1.1,608.0,126
CDM,73030OH,RADEX SHOULDER COMPLETE MINIMUM 2 VIEWS,687.0,446.55,1.1,687.0,142
CDM,73030OH-26,RADEX SHOULDER COMPLETE MINIMUM 2 VIEWS,79.0,51.35,1.1,79.0,126
CDM,73030OH-TC,RADEX SHOULDER COMPLETE MINIMUM 2 VIEWS,608.0,395.2,1.1,608.0,126
CDM,73040OH,RADEX SHOULDER ARTHROGRAPHY RS&I,2702.0,1756.3,1.1,2702.0,142
CDM,73040OH-26,RADEX SHOULDER ARTHROGRAPHY RS&I,238.0,154.7,1.1,238.0,126
CDM,73040OH-TC,RADEX SHOULDER ARTHROGRAPHY RS&I,2464.0,1601.6,1.1,2464.0,126
CDM,73050OH,RADEX A-C JOINTS BI W/WO WEIGHTED DISTRCJ,687.0,446.55,1.1,687.0,142
CDM,73050OH-26,RADEX A-C JOINTS BI W/WO WEIGHTED DISTRCJ,79.0,51.35,1.1,79.0,126
CDM,73050OH-TC,RADEX A-C JOINTS BI W/WO WEIGHTED DISTRCJ,608.0,395.2,1.1,608.0,126
CDM,73060OH,RADEX HUMERUS MINIMUM 2 VIEWS,672.0,436.8,1.1,672.0,142
CDM,73060OH-26,RADEX HUMERUS MINIMUM 2 VIEWS,64.0,41.6,1.1,64.0,126
CDM,73060OH-TC,RADEX HUMERUS MINIMUM 2 VIEWS,608.0,395.2,1.1,608.0,126
CDM,73070OH,RADEX ELBOW 2 VIEWS,672.0,436.8,1.1,672.0,142
CDM,73070OH-26,RADEX ELBOW 2 VIEWS,64.0,41.6,1.1,64.0,126
CDM,73070OH-TC,RADEX ELBOW 2 VIEWS,608.0,395.2,1.1,608.0,126
CDM,73080OH,RADEX ELBOW COMPLETE MINIMUM 3 VIEWS,676.0,439.4,1.1,676.0,142
CDM,73080OH-26,RADEX ELBOW COMPLETE MINIMUM 3 VIEWS,68.0,44.2,1.1,68.0,126
CDM,73080OH-TC,RADEX ELBOW COMPLETE MINIMUM 3 VIEWS,608.0,395.2,1.1,608.0,126
CDM,73085OH,RADEX ELBOW ARTHROGRAPHY RS&I,2680.0,1742.0,1.1,2680.0,142
CDM,73085OH-26,RADEX ELBOW ARTHROGRAPHY RS&I,216.0,140.4,1.1,216.0,126
CDM,73085OH-TC,RADEX ELBOW ARTHROGRAPHY RS&I,2464.0,1601.6,1.1,2464.0,126
CDM,73090OH,RADEX FOREARM 2 VIEWS,672.0,436.8,1.1,672.0,142
CDM,73090OH-26,RADEX FOREARM 2 VIEWS,64.0,41.6,1.1,64.0,126
CDM,73090OH-TC,RADEX FOREARM 2 VIEWS,608.0,395.2,1.1,608.0,126
CDM,73092OH,RADEX UPPER EXTREMITY INFANT MINIMUM 2 VIEWS,798.0,518.7,1.1,798.0,142
CDM,73092OH-26,RADEX UPPER EXTREMITY INFANT MINIMUM 2 VIEWS,64.0,41.6,1.1,64.0,126
CDM,73092OH-TC,RADEX UPPER EXTREMITY INFANT MINIMUM 2 VIEWS,734.0,477.1,1.1,734.0,126
CDM,73100010,XTRNL ECG & 48 HR RECORDING,741.0,481.65,25.56,741.0,86
CDM,73100025,EXTERNAL ECG SCANNING ANALYSIS REPORT,342.0,222.3,49.79,342.0,86
CDM,73100030,XTRNL PT ACTIVATED ECG RECORD MONITOR 30 DAYS,214.0,139.1,11.46,214.0,78
CDM,73100035,XTRNL PT ACTIVATED ECG REC DWNLD 30 DAYS,528.0,343.2,83.98,528.0,78
CDM,73100075,EXTERNAL ECG REC>48HR<7D SCANNING ALYS W/REPORT,741.0,481.65,86.64,741.0,86
CDM,73100085,EXTERNAL ECG REC>48HR<7D SCANNING ALYS W/REPORT,741.0,481.65,86.64,741.0,86
CDM,73100105,EXTERNAL ECG REC>7D<15D SCANNING ALYS W/REPORT,741.0,481.65,86.64,741.0,86
CDM,73100125,EXTERNAL ECG REC>48HR<7D RECORDING,226.0,146.9,16.55,226.0,86
CDM,73100135,EXTERNAL ECG REC>7D<15D RECORDING,226.0,146.9,16.55,226.0,86
CDM,73100OH,RADEX WRIST 2 VIEWS,672.0,436.8,1.1,672.0,142
CDM,73100OH-26,RADEX WRIST 2 VIEWS,64.0,41.6,1.1,64.0,126
CDM,73100OH-TC,RADEX WRIST 2 VIEWS,608.0,395.2,1.1,608.0,126
CDM,73110OH,RADEX WRIST COMPLETE MINIMUM 3 VIEWS,683.0,443.95,1.1,683.0,142
CDM,73110OH-26,RADEX WRIST COMPLETE MINIMUM 3 VIEWS,75.0,48.75,1.1,75.0,126
CDM,73110OH-TC,RADEX WRIST COMPLETE MINIMUM 3 VIEWS,608.0,395.2,1.1,608.0,126
CDM,73115OH,RADEX WRIST ARTHROGRAPHY RS&I,2680.0,1742.0,1.1,2680.0,142
CDM,73115OH-26,RADEX WRIST ARTHROGRAPHY RS&I,216.0,140.4,1.1,216.0,126
CDM,73115OH-TC,RADEX WRIST ARTHROGRAPHY RS&I,2464.0,1601.6,1.1,2464.0,126
CDM,73120OH,RADEX HAND 2 VIEWS,798.0,518.7,1.1,798.0,142
CDM,73120OH-26,RADEX HAND 2 VIEWS,64.0,41.6,1.1,64.0,126
CDM,73120OH-TC,RADEX HAND 2 VIEWS,734.0,477.1,1.1,734.0,126
CDM,73130OH,RADEX HAND MINIMUM 3 VIEWS,683.0,443.95,1.1,683.0,142
CDM,73130OH-26,RADEX HAND MINIMUM 3 VIEWS,75.0,48.75,1.1,75.0,126
CDM,73130OH-TC,RADEX HAND MINIMUM 3 VIEWS,608.0,395.2,1.1,608.0,126
CDM,73140OH,RADEX FINGR MINIMUM 2 VIEWS,660.0,429.0,1.1,660.0,142
CDM,73140OH-26,RADEX FINGR MINIMUM 2 VIEWS,52.0,33.8,1.1,52.0,126
CDM,73140OH-TC,RADEX FINGR MINIMUM 2 VIEWS,608.0,395.2,1.1,608.0,126
CDM,73200005,TELEMETRY,289.0,187.85,23.5,289.0,84
CDM,73200010,ACCOMMODATION STEPDOWN/TELE,100.0,65.0,21.8,100.0,58
CDM,73200OH,CT UPPER EXTREMITY W/O CONTRAST MATERIAL,1174.0,763.1,1.1,1174.0,142
CDM,73200OH-26,CT UPPER EXTREMITY W/O CONTRAST MATERIAL,440.0,286.0,1.1,440.0,126
CDM,73200OH-TC,CT UPPER EXTREMITY W/O CONTRAST MATERIAL,734.0,477.1,1.1,734.0,126
CDM,73201OH,CT UPPER EXTREMITY W/CONTRAST MATERIAL,2974.0,1933.1,1.1,2974.0,142
CDM,73201OH-26,CT UPPER EXTREMITY W/CONTRAST MATERIAL,510.0,331.5,1.1,510.0,126
CDM,73201OH-TC,CT UPPER EXTREMITY W/CONTRAST MATERIAL,2464.0,1601.6,1.1,2464.0,126
CDM,73202OH,CT UPPER EXTREMITY W/O & W/CONTRAST MATERIAL,1765.0,1147.25,1.1,1765.0,142
CDM,73202OH-26,CT UPPER EXTREMITY W/O & W/CONTRAST MATERIAL,537.0,349.05,1.1,537.0,126
CDM,73202OH-TC,CT UPPER EXTREMITY W/O & W/CONTRAST MATERIAL,1228.0,798.2,1.1,1228.0,126
CDM,73206OH,CT ANGIOGRAPHY UPPER EXTREMITY,1952.0,1268.8,1.1,1952.0,142
CDM,73206OH-26,CT ANGIOGRAPHY UPPER EXTREMITY,724.0,470.6,1.1,724.0,126
CDM,73206OH-TC,CT ANGIOGRAPHY UPPER EXTREMITY,1228.0,798.2,1.1,1228.0,126
CDM,73218OH,MRI UPPER EXTREMITY OTH THAN JT W/O CONTR MATRL,2208.0,1435.2,1.1,2208.0,142
CDM,73218OH-26,MRI UPPER EXTREMITY OTH THAN JT W/O CONTR MATRL,540.0,351.0,1.1,540.0,126
CDM,73218OH-TC,MRI UPPER EXTREMITY OTH THAN JT W/O CONTR MATRL,1668.0,1084.2,1.1,1668.0,126
CDM,73219OH,MRI UPPER EXTREMITY OTH THAN JT W/CONTR MATRL,3112.0,2022.8,1.1,3112.0,142
CDM,73219OH-26,MRI UPPER EXTREMITY OTH THAN JT W/CONTR MATRL,648.0,421.2,1.1,648.0,126
CDM,73219OH-TC,MRI UPPER EXTREMITY OTH THAN JT W/CONTR MATRL,2464.0,1601.6,1.1,2464.0,126
CDM,73220OH,MRI UPPER EXTREM OTHER THAN JT W/O & W/CONTRAS,3324.0,2160.6,1.1,3324.0,142
CDM,73220OH-26,MRI UPPER EXTREM OTHER THAN JT W/O & W/CONTRAS,860.0,559.0,1.1,860.0,126
CDM,73220OH-TC,MRI UPPER EXTREM OTHER THAN JT W/O & W/CONTRAS,2464.0,1601.6,1.1,2464.0,126
CDM,73221OH,MRI ANY JT UPPER EXTREMITY W/O CONTRAST MATRL,2208.0,1435.2,1.1,2208.0,142
CDM,73221OH-26,MRI ANY JT UPPER EXTREMITY W/O CONTRAST MATRL,540.0,351.0,1.1,540.0,126
CDM,73221OH-TC,MRI ANY JT UPPER EXTREMITY W/O CONTRAST MATRL,1668.0,1084.2,1.1,1668.0,126
CDM,73222OH,MRI ANY JT UPPER EXTREMITY W/CONTRAST MATRL,6099.0,3964.35,1.1,6099.0,142
CDM,73222OH-26,MRI ANY JT UPPER EXTREMITY W/CONTRAST MATRL,648.0,421.2,1.1,648.0,126
CDM,73222OH-TC,MRI ANY JT UPPER EXTREMITY W/CONTRAST MATRL,5451.0,3543.15,1.1,5451.0,126
CDM,73223OH,MRI ANY JT UPPER EXTREMITY W/O & W/CONTR MATRL,3324.0,2160.6,1.1,3324.0,142
CDM,73223OH-26,MRI ANY JT UPPER EXTREMITY W/O & W/CONTR MATRL,860.0,559.0,1.1,860.0,126
CDM,73223OH-TC,MRI ANY JT UPPER EXTREMITY W/O & W/CONTR MATRL,2464.0,1601.6,1.1,2464.0,126
CDM,7322526OH,MR ANGIO UPPER EXTREM,692.0,449.8,1.1,692.0,126
CDM,73225COH,MRA UPPER EXT WO CONT,49880.0,32422.0,1.1,49880.0,142
CDM,73225COH-26,MRA UPPER EXT WO CONT,692.0,449.8,1.1,692.0,126
CDM,73225COH-TC,MRA UPPER EXT WO CONT,4288.0,2787.2,1.1,4288.0,126
CDM,73225OH-12,MRA UPPER EXTREMITY W/WO CONTRAST MATERIAL,4980.0,3237.0,1.1,4980.0,142
CDM,73225OH-13,MR ANGIO UPPER EXTREM,7088.0,4607.2,1.1,7088.0,142
CDM,73225OH-26,MRA UPPER EXTREMITY W/WO CONTRAST MATERIAL,692.0,449.8,1.1,692.0,126
CDM,73225OH-TC,MRA UPPER EXTREMITY W/WO CONTRAST MATERIAL,4288.0,2787.2,1.1,4288.0,126
CDM,73225TCOH,MR ANGIO UPPER EXTREM,6296.0,4092.4,1.1,6296.0,126
CDM,73501OH,RADEX HIP UNILATERAL WITH PELVIS 1 VIEW,687.0,446.55,1.1,687.0,142
CDM,73501OH-26,RADEX HIP UNILATERAL WITH PELVIS 1 VIEW,79.0,51.35,1.1,79.0,126
CDM,73501OH-TC,RADEX HIP UNILATERAL WITH PELVIS 1 VIEW,608.0,395.2,1.1,608.0,126
CDM,73502OH,RADEX HIP UNILATERAL WITH PELVIS 2-3 VIEWS,705.0,458.25,1.1,705.0,142
CDM,73502OH-26,RADEX HIP UNILATERAL WITH PELVIS 2-3 VIEWS,97.0,63.05,1.1,97.0,126
CDM,73502OH-TC,RADEX HIP UNILATERAL WITH PELVIS 2-3 VIEWS,608.0,395.2,1.1,608.0,126
CDM,73503OH,RADEX HIP UNILATERAL WITH PELVIS MINIMUM 4 VIEWS,853.0,554.45,1.1,853.0,142
CDM,73503OH-26,RADEX HIP UNILATERAL WITH PELVIS MINIMUM 4 VIEWS,119.0,77.35,1.1,119.0,126
CDM,73503OH-TC,RADEX HIP UNILATERAL WITH PELVIS MINIMUM 4 VIEWS,734.0,477.1,1.1,734.0,126
CDM,73521OH,RADEX HIPS BILATERAL WITH PELVIS 2 VIEWS,822.0,534.3,1.1,822.0,142
CDM,73521OH-26,RADEX HIPS BILATERAL WITH PELVIS 2 VIEWS,88.0,57.2,1.1,88.0,126
CDM,73521OH-TC,RADEX HIPS BILATERAL WITH PELVIS 2 VIEWS,734.0,477.1,1.1,734.0,126
CDM,73522OH,RADEX HIPS BILATERAL WITH PELVIS 3-4 VIEWS,862.0,560.3,1.1,862.0,142
CDM,73522OH-26,RADEX HIPS BILATERAL WITH PELVIS 3-4 VIEWS,128.0,83.2,1.1,128.0,126
CDM,73522OH-TC,RADEX HIPS BILATERAL WITH PELVIS 3-4 VIEWS,734.0,477.1,1.1,734.0,126
CDM,73523OH,RADEX HIPS BILATERAL WITH PELVIS MINIMUM 5 VIEWS,858.0,557.7,1.1,858.0,142
CDM,73523OH-26,RADEX HIPS BILATERAL WITH PELVIS MINIMUM 5 VIEWS,124.0,80.6,1.1,124.0,126
CDM,73523OH-TC,RADEX HIPS BILATERAL WITH PELVIS MINIMUM 5 VIEWS,734.0,477.1,1.1,734.0,126
CDM,73525OH,RADEX HIP ARTHROGRAPHY RS&I,2680.0,1742.0,1.1,2680.0,142
CDM,73525OH-26,RADEX HIP ARTHROGRAPHY RS&I,216.0,140.4,1.1,216.0,126
CDM,73525OH-TC,RADEX HIP ARTHROGRAPHY RS&I,2464.0,1601.6,1.1,2464.0,126
CDM,73551OH,RADIOLOGIC EXAMINATION FEMUR 1 VIEW,672.0,436.8,1.1,672.0,142
CDM,73551OH-26,RADIOLOGIC EXAMINATION FEMUR 1 VIEW,64.0,41.6,1.1,64.0,126
CDM,73551OH-TC,RADIOLOGIC EXAMINATION FEMUR 1 VIEW,608.0,395.2,1.1,608.0,126
CDM,73552OH,RADIOLOGIC EXAMINATION FEMUR MINIMUM 2 VIEWS,687.0,446.55,1.1,687.0,142
CDM,73552OH-26,RADIOLOGIC EXAMINATION FEMUR MINIMUM 2 VIEWS,79.0,51.35,1.1,79.0,126
CDM,73552OH-TC,RADIOLOGIC EXAMINATION FEMUR MINIMUM 2 VIEWS,608.0,395.2,1.1,608.0,126
CDM,73560OH,RADIOLOGIC EXAMINATION KNEE 1/2 VIEWS,678.0,440.7,1.1,678.0,142
CDM,73560OH-26,RADIOLOGIC EXAMINATION KNEE 1/2 VIEWS,70.0,45.5,1.1,70.0,126
CDM,73560OH-TC,RADIOLOGIC EXAMINATION KNEE 1/2 VIEWS,608.0,395.2,1.1,608.0,126
CDM,73562OH,RADIOLOGIC EXAMINATION KNEE 3 VIEWS,687.0,446.55,1.1,687.0,142
CDM,73562OH-26,RADIOLOGIC EXAMINATION KNEE 3 VIEWS,79.0,51.35,1.1,79.0,126
CDM,73562OH-TC,RADIOLOGIC EXAMINATION KNEE 3 VIEWS,608.0,395.2,1.1,608.0,126
CDM,73564OH,RADIOLOGIC EXAM KNEE COMPLETE 4/MORE VIEWS,831.0,540.15,1.1,831.0,142
CDM,73564OH-26,RADIOLOGIC EXAM KNEE COMPLETE 4/MORE VIEWS,97.0,63.05,1.1,97.0,126
CDM,73564OH-TC,RADIOLOGIC EXAM KNEE COMPLETE 4/MORE VIEWS,734.0,477.1,1.1,734.0,126
CDM,73565OH,RADIOLOGIC EXAM BOTH KNEES STANDING ANTEROPOST,672.0,436.8,1.1,672.0,142
CDM,73565OH-26,RADIOLOGIC EXAM BOTH KNEES STANDING ANTEROPOST,64.0,41.6,1.1,64.0,126
CDM,73565OH-TC,RADIOLOGIC EXAM BOTH KNEES STANDING ANTEROPOST,608.0,395.2,1.1,608.0,126
CDM,73580OH,RADIOLOGIC EXAM KNEE ARTHROGRAPHY RS&I,2724.0,1770.6,1.1,2724.0,142
CDM,73580OH-26,RADIOLOGIC EXAM KNEE ARTHROGRAPHY RS&I,260.0,169.0,1.1,260.0,126
CDM,73580OH-TC,RADIOLOGIC EXAM KNEE ARTHROGRAPHY RS&I,2464.0,1601.6,1.1,2464.0,126
CDM,73590OH,RADIOLOGIC EXAMINATION TIBIA & FIBULA 2 VIEWS,672.0,436.8,1.1,672.0,142
CDM,73590OH-26,RADIOLOGIC EXAMINATION TIBIA & FIBULA 2 VIEWS,64.0,41.6,1.1,64.0,126
CDM,73590OH-TC,RADIOLOGIC EXAMINATION TIBIA & FIBULA 2 VIEWS,608.0,395.2,1.1,608.0,126
CDM,73592OH,RADEX LOWER EXTREMITY INFANT MINIMUM 2 VIEWS,678.0,440.7,1.1,678.0,142
CDM,73592OH-26,RADEX LOWER EXTREMITY INFANT MINIMUM 2 VIEWS,70.0,45.5,1.1,70.0,126
CDM,73592OH-TC,RADEX LOWER EXTREMITY INFANT MINIMUM 2 VIEWS,608.0,395.2,1.1,608.0,126
CDM,73600OH,RADIOLOGIC EXAMINATION ANKLE 2 VIEWS,672.0,436.8,1.1,672.0,142
CDM,73600OH-26,RADIOLOGIC EXAMINATION ANKLE 2 VIEWS,64.0,41.6,1.1,64.0,126
CDM,73600OH-TC,RADIOLOGIC EXAMINATION ANKLE 2 VIEWS,608.0,395.2,1.1,608.0,126
CDM,73610OH,RADEX ANKLE COMPLETE MINIMUM 3 VIEWS,683.0,443.95,1.1,683.0,142
CDM,73610OH-26,RADEX ANKLE COMPLETE MINIMUM 3 VIEWS,75.0,48.75,1.1,75.0,126
CDM,73610OH-TC,RADEX ANKLE COMPLETE MINIMUM 3 VIEWS,608.0,395.2,1.1,608.0,126
CDM,73615OH,RADEX ANKLE ARTHROGRAPHY RS&I,2680.0,1742.0,1.1,2680.0,142
CDM,73615OH-26,RADEX ANKLE ARTHROGRAPHY RS&I,216.0,140.4,1.1,216.0,126
CDM,73615OH-TC,RADEX ANKLE ARTHROGRAPHY RS&I,2464.0,1601.6,1.1,2464.0,126
CDM,73620OH,RADIOLOGIC EXAMINATION FOOT 2 VIEWS,672.0,436.8,1.1,672.0,142
CDM,73620OH-26,RADIOLOGIC EXAMINATION FOOT 2 VIEWS,64.0,41.6,1.1,64.0,126
CDM,73620OH-TC,RADIOLOGIC EXAMINATION FOOT 2 VIEWS,608.0,395.2,1.1,608.0,126
CDM,73630OH,RADEX FOOT COMPLETE MINIMUM 3 VIEWS,683.0,443.95,1.1,683.0,142
CDM,73630OH-26,RADEX FOOT COMPLETE MINIMUM 3 VIEWS,75.0,48.75,1.1,75.0,126
CDM,73630OH-TC,RADEX FOOT COMPLETE MINIMUM 3 VIEWS,608.0,395.2,1.1,608.0,126
CDM,73650OH,RADEX CALCANEUS MINIMUM 2 VIEWS,672.0,436.8,1.1,672.0,142
CDM,73650OH-26,RADEX CALCANEUS MINIMUM 2 VIEWS,64.0,41.6,1.1,64.0,126
CDM,73650OH-TC,RADEX CALCANEUS MINIMUM 2 VIEWS,608.0,395.2,1.1,608.0,126
CDM,73660OH,RADEX TOE MINIMUM 2 VIEWS,660.0,429.0,1.1,660.0,142
CDM,73660OH-26,RADEX TOE MINIMUM 2 VIEWS,52.0,33.8,1.1,52.0,126
CDM,73660OH-TC,RADEX TOE MINIMUM 2 VIEWS,608.0,395.2,1.1,608.0,126
CDM,73700OH,CT LOWER EXTREMITY W/O CONTRAST MATERIAL,1174.0,763.1,1.1,1174.0,142
CDM,73700OH-26,CT LOWER EXTREMITY W/O CONTRAST MATERIAL,440.0,286.0,1.1,440.0,126
CDM,73700OH-TC,CT LOWER EXTREMITY W/O CONTRAST MATERIAL,734.0,477.1,1.1,734.0,126
CDM,73701OH,CT LOWER EXTREMITY W/CONTRAST MATERIAL,1738.0,1129.7,1.1,1738.0,142
CDM,73701OH-26,CT LOWER EXTREMITY W/CONTRAST MATERIAL,510.0,331.5,1.1,510.0,126
CDM,73701OH-TC,CT LOWER EXTREMITY W/CONTRAST MATERIAL,1228.0,798.2,1.1,1228.0,126
CDM,73702OH,CT LOWER EXTREMITY W/O & W/CONTRAST MATRL,1765.0,1147.25,1.1,1765.0,142
CDM,73702OH-26,CT LOWER EXTREMITY W/O & W/CONTRAST MATRL,537.0,349.05,1.1,537.0,126
CDM,73702OH-TC,CT LOWER EXTREMITY W/O & W/CONTRAST MATRL,1228.0,798.2,1.1,1228.0,126
CDM,73706OH,CT ANGIOGRAPHY LOWER EXTREMITY,1988.0,1292.2,1.1,1988.0,142
CDM,73706OH-26,CT ANGIOGRAPHY LOWER EXTREMITY,760.0,494.0,1.1,760.0,126
CDM,73706OH-TC,CT ANGIOGRAPHY LOWER EXTREMITY,1228.0,798.2,1.1,1228.0,126
CDM,73718OH,MRI LOWER EXTREM OTH/THN JT W/O CONTR MATRL,2262.0,1470.3,1.1,2262.0,142
CDM,73718OH-26,MRI LOWER EXTREM OTH/THN JT W/O CONTR MATRL,594.0,386.1,1.1,594.0,126
CDM,73718OH-TC,MRI LOWER EXTREM OTH/THN JT W/O CONTR MATRL,1668.0,1084.2,1.1,1668.0,126
CDM,73719OH,MRI LOWER EXTREM OTH/THN JT W/CONTRAST MATRL,3177.0,2065.05,1.1,3177.0,142
CDM,73719OH-26,MRI LOWER EXTREM OTH/THN JT W/CONTRAST MATRL,713.0,463.45,1.1,713.0,126
CDM,73719OH-TC,MRI LOWER EXTREM OTH/THN JT W/CONTRAST MATRL,2464.0,1601.6,1.1,2464.0,126
CDM,73720OH,MRI LOWER EXTREM OTH/THN JT W/O & W/CONTR MATR,3410.0,2216.5,1.1,3410.0,142
CDM,73720OH-26,MRI LOWER EXTREM OTH/THN JT W/O & W/CONTR MATR,946.0,614.9,1.1,946.0,126
CDM,73720OH-TC,MRI LOWER EXTREM OTH/THN JT W/O & W/CONTR MATR,2464.0,1601.6,1.1,2464.0,126
CDM,73721OH,MRI ANY JT LOWER EXTREM W/O CONTRAST MATRL,2262.0,1470.3,1.1,2262.0,142
CDM,73721OH-26,MRI ANY JT LOWER EXTREM W/O CONTRAST MATRL,594.0,386.1,1.1,594.0,126
CDM,73721OH-TC,MRI ANY JT LOWER EXTREM W/O CONTRAST MATRL,1668.0,1084.2,1.1,1668.0,126
CDM,73722OH,MRI ANY JT LOWER EXTREM W/CONTRAST MATERIAL,6164.0,4006.6,1.1,6164.0,142
CDM,73722OH-26,MRI ANY JT LOWER EXTREM W/CONTRAST MATERIAL,713.0,463.45,1.1,713.0,126
CDM,73722OH-TC,MRI ANY JT LOWER EXTREM W/CONTRAST MATERIAL,5451.0,3543.15,1.1,5451.0,126
CDM,73723OH,MRI ANY JT LOWER EXTREM W/O & W/CONTRAST MATRL,3410.0,2216.5,1.1,3410.0,142
CDM,73723OH-26,MRI ANY JT LOWER EXTREM W/O & W/CONTRAST MATRL,946.0,614.9,1.1,946.0,126
CDM,73723OH-TC,MRI ANY JT LOWER EXTREM W/O & W/CONTRAST MATRL,2464.0,1601.6,1.1,2464.0,126
CDM,7372526OH-26-14,MR ANGIO LOWER EXTREM (MRA),728.0,473.2,1.1,728.0,126
CDM,7372526OH-26-15,MRA LOWER EXTREMITY W/WO CONTRAST MATERIAL,728.0,473.2,1.1,728.0,126
CDM,73725COH,MRA LWR EXT W CONTRL,6734.0,4377.1,1.1,6734.0,142
CDM,73725COH-26,MRA LWR EXT W CONTRL,728.0,473.2,1.1,728.0,126
CDM,73725COH-TC,MRA LWR EXT W CONTRL,6006.0,3903.9,1.1,6006.0,126
CDM,73725OH-16,MRA LWR EXT WITH OR W/O CONT,6734.0,4377.1,1.1,6734.0,142
CDM,73725OH-17,MR ANGIO LOWER EXTREM (MRA),6734.0,4377.1,1.1,6734.0,142
CDM,73725OH-18,MRA LOWER EXTREMITY W/WO CONTRAST MATERIAL,6734.0,4377.1,1.1,6734.0,142
CDM,73725OH-26,MRA LWR EXT WITH OR W/O CONT,728.0,473.2,1.1,728.0,126
CDM,73725OH-TC,MRA LWR EXT WITH OR W/O CONT,6006.0,3903.9,1.1,6006.0,126
CDM,73725TCOH-TC-19,MR ANGIO LOWER EXTREM (MRA),6006.0,3903.9,1.1,6006.0,126
CDM,73725TCOH-TC-20,MRA LOWER EXTREMITY W/WO CONTRAST MATERIAL,6006.0,3903.9,1.1,6006.0,126
CDM,74000000,POLYSOM <6 YRS SLEEP STAGE 4/> ADDL PARAM ATTND,7020.0,4563.0,812.43,7020.0,79
CDM,74000005,POLYSOM <6 YRS SLEEP W/CPAP/BILVL VENT 4/> PARAM,7020.0,4563.0,812.43,7020.0,79
CDM,74000010,MLT SLEEP LATENCY/MAINT OF WAKEFULNESS TSTG,3661.0,2379.65,464.99,3661.0,79
CDM,74000020,SLEEP STD AIRFLOW HRT RATE&O2 SAT EFFORT UNATT,1080.0,702.0,86.32,1080.0,87
CDM,74000025,SLEEP STD REC VNTJ RESPIR ECG/HRT RATE&O2 ATTN,3661.0,2379.65,353.04,3661.0,79
CDM,74000030,POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND,7020.0,4563.0,812.43,7020.0,79
CDM,74000040,POLYSOM 6/>YRS SLEEP W/CPAP 4/> ADDL PARAM ATTND,7020.0,4563.0,812.43,7020.0,79
CDM,74000045,ELECTROCORTICOGRAM SURGERY SPX,2711.0,1762.15,210.99,2765.74,68
CDM,74000050,ELECTROENCEPHALOGRAM EXTEND MONITORING 41-60 MIN,2149.0,1396.85,204.28,2149.0,87
CDM,74000060,EEG EXTENDED MONITORING 61-119 MINUTES,2149.0,1396.85,204.28,2149.0,87
CDM,74000065,FUNCJAL CORT&SUBCORT MAPG PHYS/QHP ATTND INIT HR,7020.0,4563.0,210.99,7020.0,87
CDM,74000070,ELECTROENCEPHALOGRAM W/REC AWAKE&DROWSY,2149.0,1396.85,204.28,2149.0,87
CDM,74000075,FUNCJAL CORT&SUBCORT MAPG PHYS/QHP ATTND ADDL HR,600.0,390.0,130.8,600.0,68
CDM,74000080,ELECTROENCEPHALOGRAM W/REC AWAKE&ASLEEP,2149.0,1396.85,204.28,2149.0,87
CDM,74000085,MAGNETOENCEPHALOGRAPHY SPON BRAIN ACTIVITY,7020.0,4563.0,812.43,7020.0,85
CDM,74000090,ELECTROENCEPHALOGRAM REC COMA/SLEEP ONLY,2149.0,1396.85,204.28,2149.0,87
CDM,74000095,MAGNETOENCEPHALOGRAPY EVOKED FIELDS 1 MODALITY,7020.0,4563.0,812.43,7020.0,85
CDM,74000100,ELECTROENCEPHALOGRAM CERE DEATH EVAL ONLY,3661.0,2379.65,210.99,3661.0,85
CDM,74000115,SLEEP STD AIRFLOW HRT RATE&O2 SAT EFFORT UNATT,1080.0,702.0,86.32,1080.0,87
CDM,74000160,EEG NONINTRACRANIAL SURGERY,1193.0,775.45,210.99,1193.0,68
CDM,74000180,WADA ACTIVATION TEST HEMISPHERIC FUNCTION W/EEG,7020.0,4563.0,210.99,7020.0,87
CDM,74000320,HOME SLEEP TEST/TYPE 3 PORTA,626.0,406.9,86.32,626.0,85
CDM,74000325,MAGNETOENCEPHALOGRAPY EVOKED FIELDS EACH ADDL,4281.0,2782.65,933.26,4281.0,66
CDM,74000335,RNS ECOG REVIEW,740.0,481.0,121.73,740.0,85
CDM,74000395,ECOG IMPLANTED BRAIN NPGT W/REC I&R <30 DAYS,257.0,167.05,32.72,257.0,79
CDM,74000405,ECOG IMPLANTED BRAIN NPGT W/REC I&R <30 DAYS,257.0,167.05,32.72,257.0,79
CDM,74000415,NON-CLINICAL NEURO DIAG RSCH,230.0,149.5,63.94,453.61,85
CDM,74000425,EEG CONT REC W/VIDEO BY TECH MIN 8 CHANNELS,1080.0,702.0,135.52,1080.0,85
CDM,74000435,EEG W/O VIDEO BY TECH 2-12 HR UNMONITORED,2149.0,1396.85,204.28,2149.0,85
CDM,74000445,EEG W/O VIDEO BY TECH 2-12 HR INTERMITTENT MNTR,2149.0,1396.85,204.28,2149.0,85
CDM,74000455,EEG W/O VIDEO BY TECH 2-12HR CONTINUOUS R-T MNTR,2149.0,1396.85,204.28,2149.0,85
CDM,74000465,EEG W/O VID BY TECH EA INCR 12-26HR UNMONITORED,3661.0,2379.65,353.04,3661.0,85
CDM,74000475,EEG W/O VID BY TECH EA INCR 12-26 HR INTMT MNTR,3661.0,2379.65,353.04,3661.0,85
CDM,74000485,EEG W/O VID TECH EA INCR 12-26 HR CONT R-T MNTR,3661.0,2379.65,353.04,3661.0,85
CDM,74000495,VEEG BY TECH 2-12 HOURS UNMONITORED,2149.0,1396.85,204.28,2149.0,85
CDM,74000505,VEEG BY TECH 2-12 HR INTERMITTENT MONITORING,2149.0,1396.85,210.99,2149.0,85
CDM,74000515,VEEG BY TECH 2-12 HR CONTINUOUS R-T MONITORING,3661.0,2379.65,210.99,3661.0,85
CDM,74000525,VEEG BY TECH EA INCR 12-26 HR UNMONITORED,3661.0,2379.65,353.04,3661.0,85
CDM,74000535,VEEG BY TECH EA INCR 12-26 HR INTERMITTENT MNTR,3661.0,2379.65,353.04,3661.0,85
CDM,74000545,VEEG BY TECH EA INCR 12-26 HR CONT R-T MNTR,7020.0,4563.0,695.79,7020.0,85
CDM,74000555,NO SHOW SLEEP STUDY FEE,270.0,175.5,58.86,2159999.98,67
CDM,74000565,UNRETURNED HOME SLEEP STUDY STARTER KIT (EQUIPMENT),4860.0,3159.0,405.62,2159999.98,67
CDM,74000615,ELEC ALYS IMPL S-SCLP CONT BI EEG SYS W/O PRGRMG,544.0,353.6,92.64,544.0,76
CDM,74000625,ELEC ALYS IMPL S-SCLP CONT BI EEG SYS PRGRMG 1ST,389.0,252.85,89.94,389.0,76
CDM,74000655,REM MNTR S-SCLP IMPL CONT BI EEG SYS FITG SET-UP,544.0,353.6,86.64,544.0,76
CDM,74018OH,RADIOLOGIC EXAM ABDOMEN 1 VIEW,687.0,446.55,1.1,687.0,142
CDM,74018OH-26,RADIOLOGIC EXAM ABDOMEN 1 VIEW,79.0,51.35,1.1,79.0,126
CDM,74018OH-TC,RADIOLOGIC EXAM ABDOMEN 1 VIEW,608.0,395.2,1.1,608.0,126
CDM,74019OH,RADIOLOGIC EXAM ABDOMEN 2 VIEWS,835.0,542.75,1.1,835.0,142
CDM,74019OH-26,RADIOLOGIC EXAM ABDOMEN 2 VIEWS,101.0,65.65,1.1,101.0,126
CDM,74019OH-TC,RADIOLOGIC EXAM ABDOMEN 2 VIEWS,734.0,477.1,1.1,734.0,126
CDM,74021OH,RADIOLOGIC EXAM ABDOMEN 3+ VIEWS,853.0,554.45,1.1,853.0,142
CDM,74021OH-26,RADIOLOGIC EXAM ABDOMEN 3+ VIEWS,119.0,77.35,1.1,119.0,126
CDM,74021OH-TC,RADIOLOGIC EXAM ABDOMEN 3+ VIEWS,734.0,477.1,1.1,734.0,126
CDM,74022OH,RADIOLOGIC EXAM COMPLETE ACUTE ABDOMEN SERIES,875.0,568.75,1.1,875.0,142
CDM,74022OH-26,RADIOLOGIC EXAM COMPLETE ACUTE ABDOMEN SERIES,141.0,91.65,1.1,141.0,126
CDM,74022OH-TC,RADIOLOGIC EXAM COMPLETE ACUTE ABDOMEN SERIES,734.0,477.1,1.1,734.0,126
CDM,74150OH,CT ABDOMEN W/O CONTRAST,1258.0,817.7,1.1,1258.0,142
CDM,74150OH-26,CT ABDOMEN W/O CONTRAST,524.0,340.6,1.1,524.0,126
CDM,74150OH-TC,CT ABDOMEN W/O CONTRAST,734.0,477.1,1.1,734.0,126
CDM,74160OH,CT ABDOMEN W/CONTRAST,1787.0,1161.55,1.1,1787.0,142
CDM,74160OH-26,CT ABDOMEN W/CONTRAST,559.0,363.35,1.1,559.0,126
CDM,74160OH-TC,CT ABDOMEN W/CONTRAST,1228.0,798.2,1.1,1228.0,126
CDM,74170OH,CT ABDOMEN W & W/O CONTRAST,1844.0,1198.6,1.1,1844.0,142
CDM,74170OH-26,CT ABDOMEN W & W/O CONTRAST,616.0,400.4,1.1,616.0,126
CDM,74170OH-TC,CT ABDOMEN W & W/O CONTRAST,1228.0,798.2,1.1,1228.0,126
CDM,74174OH,CT ANGIO ABD&PLVIS CNTRST MTRL W/WO CNTRST IMGES,3432.0,2230.8,1.1,3432.0,142
CDM,74174OH-26,CT ANGIO ABD&PLVIS CNTRST MTRL W/WO CNTRST IMGES,968.0,629.2,1.1,968.0,126
CDM,74174OH-TC,CT ANGIO ABD&PLVIS CNTRST MTRL W/WO CNTRST IMGES,2464.0,1601.6,1.1,2464.0,126
CDM,74175OH,CT ANGIOGRAPHY ABDOMEN W/CONTRAST/NONCONTRAST,1956.0,1271.4,1.1,1956.0,142
CDM,74175OH-26,CT ANGIOGRAPHY ABDOMEN W/CONTRAST/NONCONTRAST,728.0,473.2,1.1,728.0,126
CDM,74175OH-TC,CT ANGIOGRAPHY ABDOMEN W/CONTRAST/NONCONTRAST,1228.0,798.2,1.1,1228.0,126
CDM,74176OH,CT ABD & PELVIS W/O CONTRAST,2434.0,1582.1,1.1,2434.0,142
CDM,74176OH-26,CT ABD & PELVIS W/O CONTRAST,766.0,497.9,1.1,766.0,126
CDM,74176OH-TC,CT ABD & PELVIS W/O CONTRAST,1668.0,1084.2,1.1,1668.0,126
CDM,74177OH,CT ABD & PELVIS W/CONTRAST,3265.0,2122.25,1.1,3265.0,142
CDM,74177OH-26,CT ABD & PELVIS W/CONTRAST,801.0,520.65,1.1,801.0,126
CDM,74177OH-TC,CT ABD & PELVIS W/CONTRAST,2464.0,1601.6,1.1,2464.0,126
CDM,74178OH,CT ABD & PELVIS W/WO CONTRST 1+ BODY REGNS,3268.0,2124.2,1.1,3268.0,142
CDM,74178OH-26,CT ABD & PELVIS W/WO CONTRST 1+ BODY REGNS,804.0,522.6,1.1,804.0,126
CDM,74178OH-TC,CT ABD & PELVIS W/WO CONTRST 1+ BODY REGNS,2464.0,1601.6,1.1,2464.0,126
CDM,74181OH,"MRI, ABDOMEN (MRI)",2252.0,1463.8,1.1,2252.0,142
CDM,74181OH-26,"MRI, ABDOMEN (MRI)",584.0,379.6,1.1,584.0,126
CDM,74181OH-TC,"MRI, ABDOMEN (MRI)",1668.0,1084.2,1.1,1668.0,126
CDM,74182OH,MRI ABDOMEN W/CONTRAST MATERIAL,3225.0,2096.25,1.1,3225.0,142
CDM,74182OH-26,MRI ABDOMEN W/CONTRAST MATERIAL,761.0,494.65,1.1,761.0,126
CDM,74182OH-TC,MRI ABDOMEN W/CONTRAST MATERIAL,2464.0,1601.6,1.1,2464.0,126
CDM,74183OH,MRI ABDOMEN W/O & W/CONTRAST MATERIAL,3432.0,2230.8,1.1,3432.0,142
CDM,74183OH-26,MRI ABDOMEN W/O & W/CONTRAST MATERIAL,968.0,629.2,1.1,968.0,126
CDM,74183OH-TC,MRI ABDOMEN W/O & W/CONTRAST MATERIAL,2464.0,1601.6,1.1,2464.0,126
CDM,7418526OH,MR ABDOMINAL AORTA ANGIOGRAM,720.0,468.0,1.1,720.0,126
CDM,74185COH,MRA ABD W CONTR,3299.0,2144.35,1.1,3299.0,142
CDM,74185COH-26,MRA ABD W CONTR,720.0,468.0,1.1,720.0,126
CDM,74185COH-TC,MRA ABD W CONTR,2579.0,1676.35,1.1,2579.0,126
CDM,74185OH-21,MRA ABD WITH OR W/O CONT,3299.0,2144.35,1.1,3299.0,142
CDM,74185OH-22,MR ABDOMINAL AORTA ANGIOGRAM,3299.0,2144.35,1.1,3299.0,142
CDM,74185OH-26,MRA ABD WITH OR W/O CONT,720.0,468.0,1.1,720.0,126
CDM,74185OH-TC,MRA ABD WITH OR W/O CONT,2579.0,1676.35,1.1,2579.0,126
CDM,74185TCOH,MR ABDOMINAL AORTA ANGIOGRAM,2579.0,1676.35,1.1,2579.0,126
CDM,74190OH,X-RAY EXAM OF PERITONEUM,3975.0,2583.75,1.1,3975.0,104
CDM,74190OH-26,X-RAY EXAM OF PERITONEUM,192.0,124.8,1.1,192.0,126
CDM,74190OH-TC,X-RAY EXAM OF PERITONEUM,3783.0,2458.95,1.1,3783.0,94
CDM,74210OH,RADIOLOGIC EXAM PHRNX&/CRV ESOPH CONTRAST STUDY,1464.0,951.6,1.1,1464.0,142
CDM,74210OH-26,RADIOLOGIC EXAM PHRNX&/CRV ESOPH CONTRAST STUDY,236.0,153.4,1.1,236.0,126
CDM,74210OH-TC,RADIOLOGIC EXAM PHRNX&/CRV ESOPH CONTRAST STUDY,1228.0,798.2,1.1,1228.0,126
CDM,74220OH,RADIOLOGIC EXAM ESOPHAGUS SINGLE CONTRAST STUDY,1468.0,954.2,1.1,1468.0,142
CDM,74220OH-26,RADIOLOGIC EXAM ESOPHAGUS SINGLE CONTRAST STUDY,240.0,156.0,1.1,240.0,126
CDM,74220OH-TC,RADIOLOGIC EXAM ESOPHAGUS SINGLE CONTRAST STUDY,1228.0,798.2,1.1,1228.0,126
CDM,74221OH,RADIOLOGIC EXAM ESOPHAGUS DOUBLE CONTRAST STUDY,1508.0,980.2,1.1,1508.0,142
CDM,74221OH-26,RADIOLOGIC EXAM ESOPHAGUS DOUBLE CONTRAST STUDY,280.0,182.0,1.1,280.0,126
CDM,74221OH-TC,RADIOLOGIC EXAM ESOPHAGUS DOUBLE CONTRAST STUDY,1228.0,798.2,1.1,1228.0,126
CDM,74230OH,RADIOLOGIC EXAM SWALLOW FUNCTION CONTRAST STUDY,1440.0,936.0,1.1,1440.0,142
CDM,74230OH-26,RADIOLOGIC EXAM SWALLOW FUNCTION CONTRAST STUDY,212.0,137.8,1.1,212.0,126
CDM,74230OH-TC,RADIOLOGIC EXAM SWALLOW FUNCTION CONTRAST STUDY,1228.0,798.2,1.1,1228.0,126
CDM,74240OH,RADIOLOGIC EXAM UPR GI TRC SINGLE CONTRAST STUDY,1548.0,1006.2,1.1,1548.0,142
CDM,74240OH-26,RADIOLOGIC EXAM UPR GI TRC SINGLE CONTRAST STUDY,320.0,208.0,1.1,320.0,126
CDM,74240OH-TC,RADIOLOGIC EXAM UPR GI TRC SINGLE CONTRAST STUDY,1228.0,798.2,1.1,1228.0,126
CDM,74246OH,RADIOLOGIC EXAM UPR GI TRC DOUBLE CONTRAST STUDY,1588.0,1032.2,1.1,1588.0,142
CDM,74246OH-26,RADIOLOGIC EXAM UPR GI TRC DOUBLE CONTRAST STUDY,360.0,234.0,1.1,360.0,126
CDM,74246OH-TC,RADIOLOGIC EXAM UPR GI TRC DOUBLE CONTRAST STUDY,1228.0,798.2,1.1,1228.0,126
CDM,74248OH,RADIOLOGIC SMALL INTESTINE FOLLOW-THROUGH STUDY,1075.0,698.75,1.1,1075.0,142
CDM,74248OH-26,RADIOLOGIC SMALL INTESTINE FOLLOW-THROUGH STUDY,280.0,182.0,1.1,280.0,126
CDM,74248OH-TC,RADIOLOGIC SMALL INTESTINE FOLLOW-THROUGH STUDY,795.0,516.75,1.1,795.0,126
CDM,74250OH,RADIOLOGIC EXAM SMALL INT SINGLE CONTRAST STUDY,1552.0,1008.8,1.1,1552.0,142
CDM,74250OH-26,RADIOLOGIC EXAM SMALL INT SINGLE CONTRAST STUDY,324.0,210.6,1.1,324.0,126
CDM,74250OH-TC,RADIOLOGIC EXAM SMALL INT SINGLE CONTRAST STUDY,1228.0,798.2,1.1,1228.0,126
CDM,74251OH,RADIOLOGIC EXAM SMALL INT DOUBLE CONTRAST STUDY,1696.0,1102.4,1.1,1696.0,142
CDM,74251OH-26,RADIOLOGIC EXAM SMALL INT DOUBLE CONTRAST STUDY,468.0,304.2,1.1,468.0,126
CDM,74251OH-TC,RADIOLOGIC EXAM SMALL INT DOUBLE CONTRAST STUDY,1228.0,798.2,1.1,1228.0,126
CDM,74261OH,CT COLONOGRPHY DX IMAGE POSTPROCESS W/O CONTRAST,1790.0,1163.5,1.1,1790.0,142
CDM,74261OH-26,CT COLONOGRPHY DX IMAGE POSTPROCESS W/O CONTRAST,1056.0,686.4,1.1,1056.0,126
CDM,74261OH-TC,CT COLONOGRPHY DX IMAGE POSTPROCESS W/O CONTRAST,734.0,477.1,1.1,812.76,126
CDM,74262OH,CT COLONOGRPHY DX IMAGE POSTPROCESS W/CONTRAST,2328.0,1513.2,1.1,2328.0,142
CDM,74262OH-26,CT COLONOGRPHY DX IMAGE POSTPROCESS W/CONTRAST,1100.0,715.0,1.1,1100.0,126
CDM,74262OH-TC,CT COLONOGRPHY DX IMAGE POSTPROCESS W/CONTRAST,1228.0,798.2,1.1,1228.0,126
CDM,74263OH,CT COLONOGRAPHY SCREENING IMAGE POSTPROCESSING,2580.0,1677.0,1.1,2580.0,140
CDM,74263OH-26,CT COLONOGRAPHY SCREENING IMAGE POSTPROCESSING,912.0,592.8,1.1,912.0,126
CDM,74263OH-TC,CT COLONOGRAPHY SCREENING IMAGE POSTPROCESSING,1668.0,1084.2,1.1,1922.76,126
CDM,74270OH,RADIOLOGIC EXAM COLON SINGLE CONTRAST STUDY,1644.0,1068.6,1.1,1644.0,142
CDM,74270OH-26,RADIOLOGIC EXAM COLON SINGLE CONTRAST STUDY,416.0,270.4,1.1,416.0,126
CDM,74270OH-TC,RADIOLOGIC EXAM COLON SINGLE CONTRAST STUDY,1228.0,798.2,1.1,1228.0,126
CDM,74280OH,RADIOLOGIC EXAM COLON DOUBLE CONTRAST STUDY,1732.0,1125.8,1.1,1732.0,142
CDM,74280OH-26,RADIOLOGIC EXAM COLON DOUBLE CONTRAST STUDY,504.0,327.6,1.1,504.0,126
CDM,74280OH-TC,RADIOLOGIC EXAM COLON DOUBLE CONTRAST STUDY,1228.0,798.2,1.1,1228.0,126
CDM,74283OH,THERAPEUTIC ENEMA RDCTJ INTUSSUSCEPTION/OBSTRCJ,2036.0,1323.4,1.1,2036.0,142
CDM,74283OH-26,THERAPEUTIC ENEMA RDCTJ INTUSSUSCEPTION/OBSTRCJ,808.0,525.2,1.1,808.0,126
CDM,74283OH-TC,THERAPEUTIC ENEMA RDCTJ INTUSSUSCEPTION/OBSTRCJ,1228.0,798.2,1.1,1228.0,126
CDM,74300OH,CHOLANGIOGRAPHY&/PANCREATOGRAPHY NTRAOP RS&I,1227.0,797.55,1.1,1227.0,104
CDM,74300OH-26,CHOLANGIOGRAPHY&/PANCREATOGRAPHY NTRAOP RS&I,126.0,81.9,1.1,126.0,126
CDM,74300OH-TC,CHOLANGIOGRAPHY&/PANCREATOGRAPHY NTRAOP RS&I,1101.0,715.65,1.1,1101.0,94
CDM,74301OH,CHOLANGIO&/PANCREATOGRAPHY ADDL SET INTRAOP RS,296.0,192.4,1.1,342.38,104
CDM,74301OH-26,CHOLANGIO&/PANCREATOGRAPHY ADDL SET INTRAOP RS,82.0,53.3,1.1,82.0,126
CDM,74301OH-TC,CHOLANGIO&/PANCREATOGRAPHY ADDL SET INTRAOP RS,214.0,139.1,1.1,307.06,94
CDM,74328OH,ENDOSCOPIC CATHJ BILIARY DUCTAL SYSTEM RS&I,620.0,403.0,1.1,620.0,104
CDM,74328OH-26,ENDOSCOPIC CATHJ BILIARY DUCTAL SYSTEM RS&I,184.0,119.6,1.1,184.0,126
CDM,74328OH-TC,ENDOSCOPIC CATHJ BILIARY DUCTAL SYSTEM RS&I,436.0,283.4,1.1,436.0,94
CDM,74329OH,ENDOSCOPIC CATHJ PANCREATIC DUCTAL SYS RS&I,976.0,634.4,1.1,976.0,104
CDM,74329OH-26,ENDOSCOPIC CATHJ PANCREATIC DUCTAL SYS RS&I,219.0,142.35,1.1,219.0,126
CDM,74329OH-TC,ENDOSCOPIC CATHJ PANCREATIC DUCTAL SYS RS&I,757.0,492.05,1.1,757.0,94
CDM,74330OH,CMBN NDSC CATHJ BILIARY&PNCRTC DUCTAL SYS RS&I,1187.0,771.55,1.1,1187.0,104
CDM,74330OH-26,CMBN NDSC CATHJ BILIARY&PNCRTC DUCTAL SYS RS&I,260.0,169.0,1.1,260.0,126
CDM,74330OH-TC,CMBN NDSC CATHJ BILIARY&PNCRTC DUCTAL SYS RS&I,927.0,602.55,1.1,927.0,94
CDM,74340OH,INTRO LONG GI TUBE W/FLUORO/FILMS,843.0,547.95,1.1,843.0,104
CDM,74340OH-26,INTRO LONG GI TUBE W/FLUORO/FILMS,211.0,137.15,1.1,211.0,126
CDM,74340OH-TC,INTRO LONG GI TUBE W/FLUORO/FILMS,632.0,410.8,1.1,632.0,94
CDM,74355OH,PERCUTANEOUS PLACEMENT ENTEROCLYSIS TUBE RS&I,780.0,507.0,1.1,780.0,104
CDM,74355OH-26,PERCUTANEOUS PLACEMENT ENTEROCLYSIS TUBE RS&I,353.0,229.45,1.1,353.0,126
CDM,74355OH-TC,PERCUTANEOUS PLACEMENT ENTEROCLYSIS TUBE RS&I,427.0,277.55,1.1,427.0,94
CDM,74360OH,INTRALUMINAL DILATION STRICTURES&/OBSTRCJS RS&I,1105.0,718.25,1.1,1105.0,104
CDM,74360OH-26,INTRALUMINAL DILATION STRICTURES&/OBSTRCJS RS&I,211.0,137.15,1.1,211.0,126
CDM,74360OH-TC,INTRALUMINAL DILATION STRICTURES&/OBSTRCJS RS&I,894.0,581.1,1.1,894.0,94
CDM,74363OH,PRQ TRANSHEPATC DILAT BILIARY DUCT STRICTRE RS&I,2054.0,1335.1,1.1,2054.0,104
CDM,74363OH-26,PRQ TRANSHEPATC DILAT BILIARY DUCT STRICTRE RS&I,409.0,265.85,1.1,409.0,126
CDM,74363OH-TC,PRQ TRANSHEPATC DILAT BILIARY DUCT STRICTRE RS&I,1645.0,1069.25,1.1,1645.0,94
CDM,74400OH,UROGRAPHY IV W/WO KUB W/WO TOMOGRAPHY,1444.0,938.6,1.1,1444.0,142
CDM,74400OH-26,UROGRAPHY IV W/WO KUB W/WO TOMOGRAPHY,216.0,140.4,1.1,216.0,126
CDM,74400OH-TC,UROGRAPHY IV W/WO KUB W/WO TOMOGRAPHY,1228.0,798.2,1.1,1228.0,126
CDM,74410OH,UROGRAPHY INFUSION DRIP &/BOLUS TECHNIQUE,1444.0,938.6,1.1,1444.0,142
CDM,74410OH-26,UROGRAPHY INFUSION DRIP &/BOLUS TECHNIQUE,216.0,140.4,1.1,216.0,126
CDM,74410OH-TC,UROGRAPHY INFUSION DRIP &/BOLUS TECHNIQUE,1228.0,798.2,1.1,1228.0,126
CDM,74415OH,UROGRAPHY NFS DRIP &/BOLUS W/NEPHROTOMOGRAPHY,1444.0,938.6,1.1,1444.0,142
CDM,74415OH-26,UROGRAPHY NFS DRIP &/BOLUS W/NEPHROTOMOGRAPHY,216.0,140.4,1.1,216.0,126
CDM,74415OH-TC,UROGRAPHY NFS DRIP &/BOLUS W/NEPHROTOMOGRAPHY,1228.0,798.2,1.1,1228.0,126
CDM,74420OH,UROGRAPHY RETROGRADE WITH/WO KUB,2672.0,1736.8,1.1,2672.0,142
CDM,74420OH-26,UROGRAPHY RETROGRADE WITH/WO KUB,208.0,135.2,1.1,208.0,126
CDM,74420OH-TC,UROGRAPHY RETROGRADE WITH/WO KUB,2464.0,1601.6,1.1,2464.0,126
CDM,74425OH,ANTEGRADE UROGRAPHY RADIOLOGICAL SUPVJ & INTERPJ,2668.0,1734.2,1.1,2668.0,142
CDM,74425OH-26,ANTEGRADE UROGRAPHY RADIOLOGICAL SUPVJ & INTERPJ,204.0,132.6,1.1,204.0,126
CDM,74425OH-TC,ANTEGRADE UROGRAPHY RADIOLOGICAL SUPVJ & INTERPJ,2464.0,1601.6,1.1,2464.0,126
CDM,74430OH,CYSTOGRAPHY MINIMUM 3 VIEWS RS&I,2605.0,1693.25,1.1,2605.0,142
CDM,74430OH-26,CYSTOGRAPHY MINIMUM 3 VIEWS RS&I,141.0,91.65,1.1,141.0,126
CDM,74430OH-TC,CYSTOGRAPHY MINIMUM 3 VIEWS RS&I,2464.0,1601.6,1.1,2464.0,126
CDM,74440OH,XRAY EXAM MALE GENITAL TRACT,1835.0,1192.75,1.1,1835.0,142
CDM,74440OH-26,XRAY EXAM MALE GENITAL TRACT,167.0,108.55,1.1,167.0,126
CDM,74440OH-TC,XRAY EXAM MALE GENITAL TRACT,1668.0,1084.2,1.1,1668.0,126
CDM,74445OH,CORPORA CAVERNOSOGRAPY RS&I,1236.0,803.4,1.1,1236.0,104
CDM,74445OH-26,CORPORA CAVERNOSOGRAPY RS&I,502.0,326.3,1.1,502.0,126
CDM,74445OH-TC,CORPORA CAVERNOSOGRAPY RS&I,734.0,477.1,1.1,734.0,94
CDM,74450OH,URETHROCYSTOGRAPHY RETROGRADE RS&I,1800.0,1170.0,1.1,1800.0,104
CDM,74450OH-26,URETHROCYSTOGRAPHY RETROGRADE RS&I,132.0,85.8,1.1,132.0,126
CDM,74450OH-TC,URETHROCYSTOGRAPHY RETROGRADE RS&I,1668.0,1084.2,1.1,1668.0,94
CDM,74455OH,URETHROCYSTOGRAPHY VOIDING RS&I,1800.0,1170.0,1.1,1800.0,142
CDM,74455OH-26,URETHROCYSTOGRAPHY VOIDING RS&I,132.0,85.8,1.1,132.0,126
CDM,74455OH-TC,URETHROCYSTOGRAPHY VOIDING RS&I,1668.0,1084.2,1.1,1668.0,126
CDM,74470OH,RADEX RENAL CYST STUDY TRANSLUMBAR RS&I,4021.0,2613.65,1.1,4021.0,104
CDM,74470OH-26,RADEX RENAL CYST STUDY TRANSLUMBAR RS&I,238.0,154.7,1.1,238.0,126
CDM,74470OH-TC,RADEX RENAL CYST STUDY TRANSLUMBAR RS&I,3783.0,2458.95,1.1,3783.0,94
CDM,74485OH,DILATION URETERS/URETHRA RS&I,14467.0,9403.55,1.1,14467.0,142
CDM,74485OH-26,DILATION URETERS/URETHRA RS&I,332.0,215.8,1.1,332.0,126
CDM,74485OH-TC,DILATION URETERS/URETHRA RS&I,14135.0,9187.75,1.1,14135.0,126
CDM,74712OH,FETAL MRI W/PLACNTL MATRNL PLVC IMG SING/1ST GES,2868.0,1864.2,1.1,2868.0,142
CDM,74712OH-26,FETAL MRI W/PLACNTL MATRNL PLVC IMG SING/1ST GES,1200.0,780.0,1.1,1200.0,126
CDM,74712OH-TC,FETAL MRI W/PLACNTL MATRNL PLVC IMG SING/1ST GES,1668.0,1084.2,1.1,1668.0,126
CDM,74713OH,FETAL MRI W/PLACNTL MATRNL PLVC IMG EA ADDL GES,2555.0,1660.75,1.1,2555.0,142
CDM,74713OH-26,FETAL MRI W/PLACNTL MATRNL PLVC IMG EA ADDL GES,740.0,481.0,1.1,740.0,126
CDM,74713OH-TC,FETAL MRI W/PLACNTL MATRNL PLVC IMG EA ADDL GES,1815.0,1179.75,1.1,1815.0,126
CDM,74740OH,HYSTEROSALPINGOGRAPHY RS&I,1820.0,1183.0,1.1,1820.0,142
CDM,74740OH-26,HYSTEROSALPINGOGRAPHY RS&I,152.0,98.8,1.1,152.0,126
CDM,74740OH-TC,HYSTEROSALPINGOGRAPHY RS&I,1668.0,1084.2,1.1,1668.0,126
CDM,74742OH,TRANSCERVICAL CATHJ FALLOPIAN TUBE RS&I,663.0,430.95,1.1,663.0,104
CDM,74742OH-26,TRANSCERVICAL CATHJ FALLOPIAN TUBE RS&I,244.0,158.6,1.1,244.0,126
CDM,74742OH-TC,TRANSCERVICAL CATHJ FALLOPIAN TUBE RS&I,419.0,272.35,1.1,536.23,94
CDM,74775OH,X-RAY PERINEOGRAM,1941.0,1261.65,1.1,1941.0,104
CDM,74775OH-26,X-RAY PERINEOGRAM,273.0,177.45,1.1,273.0,126
CDM,74775OH-TC,X-RAY PERINEOGRAM,1668.0,1084.2,1.1,1668.0,94
CDM,75000005,ESOPHAGOSCOPY FLEXIBLE TRANSORAL DIAGNOSTIC,4313.0,2803.45,101.11,6112.0,87
CDM,75000015,ESOPHAGOSCOPY FLEXIBLE TRANSORAL W SUBMUCOUS INJ,8726.0,5671.9,118.81,8726.0,87
CDM,75000025,ESOPHAGOSCOPY FLEXIBLE TRANSORAL WITH BIOPSY,8726.0,5671.9,120.05,8726.0,87
CDM,75000045,ESPHGOSCOPY FLEX W/BAND LIGATION ESOPHGL VARICES,8726.0,5671.9,164.22,8726.0,87
CDM,75000055,ESOPHAGOSCOPY FLEXIBLE REMOVAL FOREIGN BODY,8726.0,5671.9,164.28,8726.0,87
CDM,75000085,ESOPHAGOSCOPY FLEX BALLOON DILAT <30 MM DIAM,8726.0,5671.9,136.63,8726.0,87
CDM,75000095,ESOPHAGOSCOPY FLEXIBLE GUIDE WIRE DILATION,8726.0,5671.9,150.35,8726.0,87
CDM,75000105,ESOPHAGOSCOPY FLEXIBLE W/BLEEDING CONTROL,8726.0,5671.9,191.31,8726.0,87
CDM,75000155,ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC,4313.0,2803.45,143.26,6112.0,87
CDM,75000165,ESOPHAGOGASTRODUODENOSCOPY SUBMUCOSAL INJECTION,4313.0,2803.45,160.83,6112.0,87
CDM,75000175,ESOPHAGOGASTRODUODENOSCOPY US SCOPE W/ADJ STRXRS,8726.0,5671.9,226.85,8726.0,87
CDM,75000185,EGD INTRMURAL US NEEDLE ASPIRATE/BIOPSY ESOPHAGS,8726.0,5671.9,269.14,8726.0,87
CDM,75000195,EGD TRANSORAL BIOPSY SINGLE/MULTIPLE,4313.0,2803.45,160.83,6112.0,87
CDM,75000205,EGD TRANSORAL TRANSMURAL DRAINAGE PSEUDOCYST,27383.0,17798.95,451.96,27383.0,87
CDM,75000215,EGD INTRALUMINAL TUBE/CATHETER INSERTION,8726.0,5671.9,165.33,8726.0,87
CDM,75000225,EGD INTRMURAL NEEDLE ASPIR/BIOP ALTERED ANATOMY,8726.0,5671.9,303.3,8726.0,87
CDM,75000235,EGD INJECTION SCLEROSIS ESOPHGL/GASTRIC VARICES,8726.0,5671.9,274.02,8726.0,87
CDM,75000245,EGD BAND LIGATION ESOPHGEAL/GASTRIC VARICES,8726.0,5671.9,283.7,8726.0,87
CDM,75000255,EGD DILATION GASTRIC/DUODENAL STRICTURE,8726.0,5671.9,203.57,8726.0,87
CDM,75000265,EGD PERCUTANEOUS PLACEMENT GASTROSTOMY TUBE,8726.0,5671.9,231.27,8726.0,87
CDM,75000275,EGD FLEXIBLE FOREIGN BODY REMOVAL,4313.0,2803.45,205.04,6112.0,87
CDM,75000285,EGD INSERT GUIDE WIRE DILATOR PASSAGE ESOPHAGUS,4313.0,2803.45,193.01,6112.0,87
CDM,75000295,EGD BALLOON DILATION ESOPHAGUS <30 MM DIAM,8726.0,5671.9,177.76,8726.0,87
CDM,75000305,EGD FLEX REMOVAL LESION(S) BY HOT BIOPSY FORCEPS,8726.0,5671.9,197.49,8726.0,87
CDM,75000315,EGD REMOVAL TUMOR POLYP/OTHER LESION SNARE TECH,8726.0,5671.9,226.68,8726.0,87
CDM,75000325,EGD TRANSORAL CONTROL BLEEDING ANY METHOD,8726.0,5671.9,232.25,8726.0,87
CDM,75000365,EDG US EXAM SURGICAL ALTER STOM DUODENUM/JEJUNUM,8726.0,5671.9,261.52,8726.0,87
CDM,75000375,ERCP DX COLLECTION SPECIMEN BRUSHING/WASHING,17501.0,11375.65,371.33,17501.0,79
CDM,75000385,ERCP W/BIOPSY SINGLE/MULTIPLE,17501.0,11375.65,390.49,17501.0,79
CDM,75000395,ERCP W/SPHINCTEROTOMY/PAPILLOTOMY,17501.0,11375.65,411.63,17501.0,79
CDM,75000405,ERCP W/PRESSURE MEASUREMENT SPHINCTER OF ODDI,8726.0,5671.9,412.34,8726.0,79
CDM,75000415,ERCP REMOVE CALCULI/DEBRIS BILIARY/PANCREAS DUCT,17501.0,11375.65,419.43,17501.0,79
CDM,75000425,ERCP DESTRUCTION/LITHOTRIPSY CALCULI ANY METHOD,27383.0,17798.95,498.63,27383.0,87
CDM,75000485,ENDOSCOPIC PAPILLA CANNULATION BILE/PANCREATIC,4837.0,3144.05,136.22,10364.0,69
CDM,75000495,DILATION ESOPH UNGUIDED SOUND/BOUGIE 1/MULT PASS,4313.0,2803.45,93.49,6112.0,87
CDM,75000525,NASO/ORO-GASTRIC TUBE PLMT REQ PHYS&FLUOR GDNCE,1836.0,1193.4,46.57,12500.0,86
CDM,75000555,DUODENAL INTUBAT W/IMAG GUIDED MULTIPLE SPECIMEN,4313.0,2803.45,90.17,6112.0,86
CDM,75000615,ENDOSCOPY UPPER SMALL INTESTINE,8726.0,5671.9,166.73,8726.0,87
CDM,75000625,ENDOSCOPY UPPER SMALL INTESTINE W/BIOPSY,8726.0,5671.9,184.01,8726.0,87
CDM,75000645,ENTEROSCOPY > 2ND PRTN W/RMVL LESION SNARE,8726.0,5671.9,236.83,8726.0,87
CDM,75000655,ENTEROSCOPY > 2ND PRTN W/RMVL LESION CAUTERY,8726.0,5671.9,210.93,8726.0,87
CDM,75000665,ENTEROSCOPY > 2ND PRTN W/CONTROL BLEEDING,8726.0,5671.9,277.26,8726.0,87
CDM,75000675,ENTEROSCOPY > 2ND PRTN ABLTJ LESION,8726.0,5671.9,284.2,8726.0,87
CDM,75000690,ENTEROSCOPY > 2ND PRTN W/PLMT PRQ TUBE,8726.0,5671.9,277.32,8726.0,87
CDM,75000695,ENTEROSCOPY > 2ND PRTN CONV GSTRST TUBE,8726.0,5671.9,222.13,8726.0,87
CDM,75000705,ENTEROSC >2ND PRTN W/ILEUM W/WO COLLJ SPEC SPX,8726.0,5671.9,328.32,8726.0,87
CDM,75000715,ENTEROSC >2ND PRTN W/ILEUM W/BX SINGLE/MULTIPLE,8726.0,5671.9,344.4,8726.0,87
CDM,75000725,ENTEROSCOPY > 2ND PRTN ILEUM CONTROL BLEEDING,8726.0,5671.9,443.12,8726.0,87
CDM,75000730,ILEOSCOPY THRU STOMA DX W/COLLJ SPEC WHEN PRFMD,4313.0,2803.45,67.36,6112.0,87
CDM,75000745,ILEOSCOPY THRU STOMA DX W/COLLJ SPEC WHEN PRFMD,4313.0,2803.45,67.36,6112.0,87
CDM,75000755,ILEOSCOPY STOMA W/BX SINGLE/MULTIPLE,4313.0,2803.45,86.54,6112.0,87
CDM,75000765,NDSC EVAL INTSTINAL POUCH DX W/COLLJ SPEC SPX,4194.0,2726.1,85.94,6112.0,87
CDM,75000775,NDSC EVAL INTSTINAL POUCH W/BX SINGLE/MULTIPLE,4194.0,2726.1,104.56,6112.0,87
CDM,75000785,COLONOSCOPY STOMA DX INCLUDING COLLJ SPEC SPX,4194.0,2726.1,181.58,6112.0,87
CDM,75000795,COLONOSCOPY STOMA W/BIOPSY SINGLE/MULTIPLE,5424.0,3525.6,199.48,6112.0,87
CDM,75000805,COLONOSCOPY STOMA RMVL LES BY HOT BIOPSY FORCEPS,5424.0,3525.6,231.23,6112.0,87
CDM,75000825,COLONOSCOPY STOMA W/RMVL TUM POLYP/OTH LES SNARE,5424.0,3525.6,261.07,6112.0,87
CDM,75000835,POUCHOSCOPY W/ NEEDLEKNIFE,8208.0,5335.2,786.42,8208.0,84
CDM,75000845,BX ANORECTAL WALL ANAL APPROACH,12615.0,8199.75,368.36,12615.0,87
CDM,75000855,PROCTOSGMDSC RGD DX W/WO COLLJ SPEC BR/WA SPX,4194.0,2726.1,57.12,4628.0,86
CDM,75000865,PROCTOSGMDSC RIGID W/DILATION,5424.0,3525.6,101.33,6112.0,78
CDM,75000875,PROCTOSGMDSC RIGID W/BX SINGLE/MULTIPLE,5424.0,3525.6,86.47,6112.0,87
CDM,75000885,PROCTOSGMDSC RIGID RMVL 1 LESION CAUTERY,12615.0,8199.75,100.5,12615.0,79
CDM,75000895,PROCTOSGMDSC RIGID RMVL 1 LESION SNARE TQ,5424.0,3525.6,106.22,6112.0,87
CDM,75000905,PROCTOSGMDSC RIGID RMVL MULT TUMOR CAUTERY/SNARE,5424.0,3525.6,123.45,6112.0,87
CDM,75000915,PROCTOSGMDSC RIGID CONTROL BLEEDING,5424.0,3525.6,130.93,6112.0,79
CDM,75000925,SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA IF PFRMD,4194.0,2726.1,67.12,4628.0,86
CDM,75000935,SIGMOIDOSCOPY FLX W/BIOPSY SINGLE/MULTIPLE,4194.0,2726.1,84.87,4628.0,87
CDM,75000945,SIGMOIDOSCOPY FLX W/RMVL FOREIGN BODY,5424.0,3525.6,123.31,6112.0,87
CDM,75000955,SIGMOIDOSCOPY FLX W/RMVL TUMOR BY HOT BX FORCEPS,4194.0,2726.1,110.29,4628.0,87
CDM,75000965,SIGMOIDOSCOPY FLX CONTROL BLEEDING,5424.0,3525.6,137.32,6112.0,87
CDM,75000975,SGMDSC FLX DIRED SBMCSL NJX ANY SBST,4194.0,2726.1,78.79,4628.0,87
CDM,75000985,SGMDSC FLX W/DCMPRN W/PLMT DCMPRN TUBE,4194.0,2726.1,132.03,6112.0,87
CDM,75000995,SGMDSC FLX RMVL TUM POLYP/OTH LES SNARE TQ,5424.0,3525.6,140.73,6112.0,87
CDM,75001015,SIGMOIDOSCOPY FLX TNDSC BALO DILAT,5424.0,3525.6,92.0,6112.0,87
CDM,75001025,SIGMOIDOSCOPY FLX NDSC US XM,4194.0,2726.1,144.94,6112.0,87
CDM,75001055,COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD,4194.0,2726.1,214.53,6112.0,87
CDM,75001075,COLONOSCOPY FLX W/REMOVAL OF FOREIGN BODY(S),5424.0,3525.6,275.92,6112.0,87
CDM,75001095,COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE,5424.0,3525.6,232.45,6112.0,87
CDM,75001105,COLSC FLX WITH DIRECTED SUBMUCOSAL NJX ANY SBST,5424.0,3525.6,232.45,6112.0,87
CDM,75001115,COLSC FLEXIBLE W/CONTROL BLEEDING ANY METHOD,5424.0,3525.6,298.91,6112.0,87
CDM,75001135,COLSC FLX W/REMOVAL LESION BY HOT BX FORCEPS,5424.0,3525.6,263.84,6112.0,87
CDM,75001145,COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ,5424.0,3525.6,294.02,6112.0,87
CDM,75001155,COLSC FLEXIBLE W/TRANSENDOSCOPIC BALLOON DILAT,5424.0,3525.6,245.47,6112.0,87
CDM,75001175,COLSC FLX W/NDSC US XM RCTM ET AL LMTD&ADJ STRUX,5424.0,3525.6,298.08,6112.0,87
CDM,75001235,PLACEMENT SETON,12615.0,8199.75,138.22,12615.0,87
CDM,75001245,REMOVAL ANAL SETON OTHER MARKER,5424.0,3525.6,102.53,6112.0,87
CDM,75001255,I&D ISCHIORECTAL&/PERIRECTAL ABSCESS SPX,5424.0,3525.6,513.72,7813.0,87
CDM,75001275,I&D PERIANAL ABSCESS SUPERFICIAL,4194.0,2726.1,123.77,4628.0,87
CDM,75001325,HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS,4194.0,2726.1,236.61,4628.0,87
CDM,75001335,EXCISION MULTIPLE EXTERNAL PAPILLAE/TAGS ANUS,12615.0,8199.75,205.96,12615.0,87
CDM,75001345,HEMORRHOIDECTOMY XTRNL 2/> COLUMN/GROUP,12615.0,8199.75,386.05,12615.0,87
CDM,75001355,HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP,12615.0,8199.75,428.2,12615.0,87
CDM,75001375,SURG TX ANAL FISTULA INTERSPHINCTERIC,12615.0,8199.75,514.02,12615.0,87
CDM,75001405,EXC THROMBOSED HEMORRHOID XTRNL,5424.0,3525.6,133.69,6112.0,87
CDM,75001435,ANOSCOPY DX W/COLLJ SPEC BR/WA SPX WHEN PRFRMD,593.0,385.45,49.87,12500.0,86
CDM,75001445,ANOSCOPY W/DILATION,5424.0,3525.6,77.96,6112.0,86
CDM,75001455,ANOSCOPY W/BX SINGLE/MULTIPLE,5424.0,3525.6,89.33,6112.0,86
CDM,75001485,ANOSC RMVL 1 TUM POLYP/OTH LES SNARE TQ,4194.0,2726.1,94.7,6112.0,87
CDM,75001495,ANOSCOPY CONTROL BLEEDING,5424.0,3525.6,76.94,7813.0,87
CDM,75001515,DSTRJ LESION ANUS SMPL ELTRDSICCATION,8414.0,5469.1,160.25,8414.0,86
CDM,75001525,DSTRJ LESION ANUS SIMPLE LASER SURG,12615.0,8199.75,150.82,12615.0,87
CDM,75001535,DSTRJ LESION ANUS SIMPLE SURG EXCISION,12615.0,8199.75,163.84,12615.0,87
CDM,75001545,DESTRUCTION INTERNAL HEMORRHOID THERMAL ENERGY,5424.0,3525.6,190.95,8326.0,87
CDM,75001575,INT HRHC BY LIGATION 2+ HROID W/O IMG GDN,12615.0,8199.75,469.72,12615.0,87
CDM,75001585,PROC RM - INJ ANAL SOLESTA,1023.0,664.95,284.39,4628.0,84
CDM,75001625,CONVERT GASTROSTOMY-GASTRO-JEJUNOSTOMY TUBE PERQ,8726.0,5671.9,171.75,8726.0,87
CDM,75001635,REPLACE GASTROSTOMY/CECOSTOMY TUBE PERCUTANEOUS,4313.0,2803.45,76.87,6112.0,86
CDM,75001645,REPLACE DUODENOSTOMY/JEJUNOSTOMY TUBE PERQ,4313.0,2803.45,103.51,6112.0,87
CDM,75001655,REPLACEMENT GASTRO-JEJUNOSTOMY TUBE PERCUTANEOUS,4313.0,2803.45,159.89,6112.0,86
CDM,75001685,ESOPHAGEAL MOTILITY STUDY W/INTERP&RPT,2441.0,1586.65,295.2,4628.0,86
CDM,75001695,ESOPHAGEAL MOTILITY STD W/I&R STIM/PERFUSION,1541.0,1001.65,33.45,4628.0,68
CDM,75001725,GASTROESOPHAG REFLX TEST W/CATH PH ELTRD PLCMT,2441.0,1586.65,256.78,4628.0,86
CDM,75001755,GASTROESOPHAG REFLX TEST W/INTRLUML IMPED ELTRD,1432.0,930.8,204.28,4628.0,86
CDM,75001765,ESOPHGL FUNCJ G-ESOP RFLX IMPD ELTRD PROLNG,2441.0,1586.65,299.41,4628.0,86
CDM,75001795,BREATH HYDROGEN/METHANE TEST,720.0,468.0,36.89,4628.0,86
CDM,75001865,SIGMSCPY FLEX W/WO SPEC,3647.0,2370.55,66.94,4628.0,86
CDM,75001875,"COLON, SCRN HIGH RISK",3647.0,2370.55,214.53,5265.0,87
CDM,75001885,"COLOSCPY, SCRN;  NOT HI RISK",3647.0,2370.55,214.72,5265.0,87
CDM,75001915,PROC RM-EGD PSEUDOCYST NEC,4860.0,3159.0,610.39,4860.0,84
CDM,75001925,EXCISION SINGLE EXTERNAL PAPILLA OR TAG ANUS,5424.0,3525.6,146.24,6112.0,87
CDM,75001935,ESOPHAGOSCP RIG TRANSORAL HYPOPHARYNX CRV ESOPH,27212.0,17687.8,615.47,27212.0,87
CDM,75001945,ESOPHAGOSCOPY RIGID TRANSORAL DIAGNOSTIC BRUSH,8726.0,5671.9,173.38,8726.0,87
CDM,75001955,ESOPHAGOSCOPY RIG TRANSORAL GUIDE WIRE DILATION,8726.0,5671.9,222.04,8726.0,87
CDM,75001965,ESOPHAGOSCOPY TRANSORAL STENT PLACEMENT,27383.0,17798.95,220.19,27383.0,87
CDM,75001975,EGD TRANSORAL ENDOSCOPIC MUCOSAL RESECTION,8726.0,5671.9,312.12,8726.0,87
CDM,75001985,EGD ABLATE TUMOR POLYP/LESION W/DILATION& WIRE,8726.0,5671.9,259.84,8726.0,87
CDM,75001995,ERCP STENT PLACEMENT BILIARY/PANCREATIC DUCT,27383.0,17798.95,532.65,27383.0,87
CDM,75002005,ERCP REMOVE FOREIGN BODY/STENT BILIARY/PANC DUCT,8726.0,5671.9,433.83,10364.0,79
CDM,75002015,ERCP BILIARY/PANC DUCT STENT EXCHANGE W/DIL&WIRE,27383.0,17798.95,554.85,27383.0,87
CDM,75002035,ERCP BALLOON DILATE BILIARY/PANC DUCT/AMPULLA EA,17501.0,11375.65,436.36,17501.0,87
CDM,75002045,ERCP TUMOR/POLYP/LESION ABLATION W/DILATION&WIRE,17501.0,11375.65,498.13,17501.0,87
CDM,75002065,ILEOSCOPY STOMA W/BALLOON DILATION,8726.0,5671.9,99.22,8726.0,87
CDM,75002075,ILEOSCOPY STOMA W/PLMT OF ENDOSCOPIC STENT,8726.0,5671.9,177.92,33436.0,79
CDM,75002085,COLONOSCOPY STOMA ABLATION LESION,5424.0,3525.6,280.34,7948.0,87
CDM,75002105,COLONOSCOPY STOMA W/ENDOSCOPIC STENT PLCMT,27383.0,17798.95,301.98,27383.0,79
CDM,75002115,COLONOSCOPY STOMA W/ENDOSCOPIC MUCOSAL RESCJ,5424.0,3525.6,350.9,7948.0,87
CDM,75002125,COLONOSCOPY STOMA W/SUBMUCOSAL INJECTION,5424.0,3525.6,198.94,7948.0,87
CDM,75002135,COLONOSCOPY STOMA W/BALLOON DILATION,5424.0,3525.6,212.82,7948.0,87
CDM,75002145,COLONOSCOPY STOMA W/ENDOSCOPIC ULTRASOUND EXAM,5424.0,3525.6,265.77,7948.0,87
CDM,75002155,COLONOSCOPY STOMA W/US GID NDL ASPIR/BX,5424.0,3525.6,318.05,7948.0,87
CDM,75002165,COLONOSCOPY THROUGH STOMA WITH DECOMPRESSION,4194.0,2726.1,268.13,7948.0,87
CDM,75002175,SIGMOIDOSCOPY FLX ABLATION TUMOR POLYP/OTH LES,5424.0,3525.6,186.58,7948.0,87
CDM,75002185,SIGMOIDOSCOPY FLX PLACEMENT OF ENDOSCOPIC STENT,27383.0,17798.95,178.84,27383.0,79
CDM,75002195,SGMDSC FLX WITH ENDOSCOPIC MUCOSAL RESECTION,12615.0,8199.75,229.89,12615.0,79
CDM,75002205,SIGMOIDOSCOPY FLX WITH WITH BAND LIGATION(S),5424.0,3525.6,118.05,7948.0,87
CDM,75002215,COLONOSCOPY FLX ABLATION TUMOR POLYP/OTHER LES,5424.0,3525.6,312.84,7948.0,87
CDM,75002225,COLONOSCOPY FLX WITH ENDOSCOPIC STENT PLACEMENT,27383.0,17798.95,333.92,27383.0,79
CDM,75002235,COLONOSCOPY FLX W/ENDOSCOPIC MUCOSAL RESECTION,12615.0,8199.75,383.54,12615.0,79
CDM,75002245,COLONOSCOPY FLEXIBLE WITH DECOMPRESSION,5424.0,3525.6,289.28,7948.0,87
CDM,75002255,COLONOSCOPY FLEXIBLE WITH BAND LIGATION(S),5424.0,3525.6,272.31,7948.0,87
CDM,75002265,ANOSCOPY DX W/HRA &CHEM AGNTS ENHANCEMENT,1836.0,1193.4,110.12,4628.0,86
CDM,75002295,FMT VIA COLONOSCOPY,3647.0,2370.55,82.08,3647.0,86
CDM,75002305,ESOPHAGOSCOPY RETROGRADE DILATE BALLOON/OTHER,8726.0,5671.9,294.14,8726.0,87
CDM,75002385,ERCP WITH OPTICAL ENDOMICROSCOPY ADD ON,4912.0,3192.8,1070.82,4912.0,66
CDM,75002395,EGD PARTIAL/COMPL ESOPHAGOGASTRIC FUNDOPLASTY,47892.0,31129.8,495.05,47892.0,86
CDM,75002405,ESOPHAGOSCOPY FLEXIBLE TRANSORAL ULTRASOUND EXAM,8726.0,5671.9,181.94,8726.0,87
CDM,75002415,INTRAGASTRIC BALLOON INS/REMV,6480.0,4212.0,786.42,6480.0,84
CDM,75002425,REVJ ILEOSTOMY SIMPLE RLS SUPERFICIAL SCAR SPX,16840.0,10946.0,704.44,16840.0,87
CDM,75002435,ENTEROSCOPY > 2ND PRTN W/RMVL FOREIGN BODY,8726.0,5671.9,222.27,8726.0,87
CDM,75002445,COLSC FLX W/US GUID NDL ASPIR/BX W/US RCTM ET AL,5424.0,3525.6,350.56,6112.0,79
CDM,75002455,DILAT ANAL SPHNCTR SPX UNDER ANES OTH/THN LOCAL,5424.0,3525.6,206.06,6112.0,87
CDM,75002465,RMVL FECAL IMPACTION/FB SPX UNDER ANES,5424.0,3525.6,278.04,6112.0,87
CDM,75002475,NJX CHOLANGIO PRQ W/IMG GID RS&I EXISTING ACCESS,16234.0,10552.1,81.86,16234.0,86
CDM,75002485,NJX CHOLANGIO PRQ W/IMG GID RS&I NEW ACCESS,16234.0,10552.1,246.32,16234.0,86
CDM,75002495,CONV EXT BIL DRG CATH TO INT-EXT BIL DRG CATH,16234.0,10552.1,228.91,16234.0,87
CDM,75002505,EXCHANGE BILIARY DRG CATHETER PRQ W/IMG GID RS&I,16234.0,10552.1,154.11,16234.0,86
CDM,75002515,REMOVAL BILIARY DRG CATHETER REQ FLUOR GID RS&I,4313.0,2803.45,111.86,6112.0,86
CDM,75002525,PLMT BILE DUCT STENT PRQ EXISTING ACCESS,26838.0,17444.7,273.9,26838.0,86
CDM,75002535,PLMT BILE DUCT STENT PRQ NEW ACCESS W/O SEP CATH,26838.0,17444.7,497.52,26838.0,86
CDM,75002545,PLMT BILE DUCT STENT PRQ NEW ACCESS W/SEP CATH,26838.0,17444.7,512.27,26838.0,86
CDM,75002555,PLMT ACCESS THRU BILIARY TREE INTO SMALL BWL NEW,28703.0,18656.95,393.69,28703.0,87
CDM,75002565,BALLOON DILAT BILIARY DUCT/AMPULLA PRQ EACH DUCT,4129.0,2683.85,159.58,4628.0,68
CDM,75002575,ENDOLUMINAL BX BILIARY TREE PRQ ANY METH 1/MLT,3810.0,2476.5,167.81,4628.0,68
CDM,75002585,REMOVAL BILIARY DUCT &/GLBLDR CALCULI PERQ RS&I,4661.0,3029.65,183.5,4661.0,68
CDM,75002595,INSERT GASTROSTOMY TUBE PERCUTANEOUS,8726.0,5671.9,238.22,8726.0,87
CDM,75002605,LIVER ELASTOGRAPHY W/O IMAG W/I&R,720.0,468.0,40.35,720.0,86
CDM,75002615,GASTROESOPHAG REFLX TEST W/TELEMTRY PH ELTRD,2441.0,1586.65,299.41,5265.0,87
CDM,75002625,GI TRC IMG INTRALUMINAL ESOPHAGUS-ILEUM W/I&R,4313.0,2803.45,299.41,6112.0,86
CDM,75003370,ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC,4313.0,2803.45,143.26,6112.0,87
CDM,75003480,EGD INJECTION SCLEROSIS ESOPHGL/GASTRIC VARICES,8726.0,5671.9,274.02,8726.0,87
CDM,75003510,EGD REMOVAL TUMOR POLYP/OTHER LESION SNARE TECH,8726.0,5671.9,226.68,8726.0,87
CDM,75003540,EGD INTRALUMINAL TUBE/CATHETER INSERTION,8726.0,5671.9,165.33,8726.0,87
CDM,75003680,ESOPHAGOSCOPY INTRA/TRANSMURAL NEEDLE ASPIRAT/BX,8726.0,5671.9,233.04,8726.0,87
CDM,75003710,GI TRC IMG INTRALUMINAL ESOPHAGUS-ILEUM W/I&R,4313.0,2803.45,299.41,6112.0,86
CDM,75003810,GASTROESOPHAG REFLX TEST W/TELEMTRY PH ELTRD,2441.0,1586.65,299.41,5265.0,87
CDM,75004050,GI TRANSIT & PRES MEAS WIRELESS CAPSULE W/INTERP,4313.0,2803.45,299.41,6112.0,86
CDM,75004070,ELECTROGASTROGRAPHY DX TRANSCUTANEOUS,1432.0,930.8,204.28,4628.0,87
CDM,75004080,PROC GASTROENTERO UNLISTED (COMP 91110),395.0,256.75,109.81,4628.0,84
CDM,75004170,EGD ESOPHAGUS BALLOON DILATION 30 MM OR LARGER,8726.0,5671.9,264.38,8726.0,87
CDM,75004180,EGD US GUIDED TRANSMURAL INJXN/FIDUCIAL MARKER,8726.0,5671.9,303.49,8726.0,87
CDM,75005000,EGD ENDOSCOPIC STENT PLACEMENT W/WIRE& DILATION,27383.0,17798.95,252.16,27383.0,87
CDM,75005230,SIGMOIDOSCOPY FLX WITH WITH BAND LIGATION(S),5424.0,3525.6,118.05,7948.0,87
CDM,75005310,ANOSCOPY DX W/HRA &CHEM AGNTS ENHANCEMENT W/BX,5424.0,3525.6,146.68,7948.0,86
CDM,75005330,ENTEROSCOPY > 2ND PRTN TNDSC STENT PLMT,27383.0,17798.95,308.77,33436.0,87
CDM,75005420,ENTEROSCOPY > 2ND PRTN W/PLMT PRQ TUBE,8726.0,5671.9,277.32,8726.0,87
CDM,75005515,ESOPHAGOSCOPY LESION ABLATE,7716.0,5015.4,1682.09,7716.0,58
CDM,75005615,SIGMSCPY FLEX W/WO SPEC SC,1326.0,861.9,289.07,1326.0,58
CDM,75005655,SIGMSCPY W CONTROL BLOOD SC,3372.0,2191.8,735.1,3372.0,58
CDM,75005665,ENDOSCPY UP GI CONTROL SC,3724.0,2420.6,811.83,3724.0,58
CDM,75010135,ENDOSCPY UP GI BALLOON DI,4452.0,2893.8,970.54,4452.0,58
CDM,75010595,ILEOSCOPY VIA STOMA; DX,1884.0,1224.6,410.71,1884.0,58
CDM,75010655,SIGMSCPY W CONTROL BLOOD,3372.0,2191.8,735.1,3372.0,58
CDM,75010775,TRACH TUBE CHG PRIOR FIST,523.0,339.95,114.01,523.0,58
CDM,75010935,INTRO LONG GI TUBE,4313.0,2803.45,22.26,6112.0,86
CDM,75011345,EGD DELIVER THERMAL ENERGY SPHNCTR/CARDIA GERD,17501.0,11375.65,268.82,17501.0,87
CDM,75011355,ESD ESOPHAGUS,8640.0,5616.0,786.42,8640.0,84
CDM,75011365,ESD STOMACH,8640.0,5616.0,786.42,8640.0,84
CDM,75011375,ESD SMALL INTESTINE,8640.0,5616.0,786.42,8640.0,84
CDM,75011385,ESD COLON,8640.0,5616.0,792.91,8640.0,85
CDM,75011395,ESD RECTUM,8640.0,5616.0,792.91,8640.0,84
CDM,75011405,EGD-PANCREATIC NECROSECTOMY HB,7992.0,5194.8,610.39,7992.0,84
CDM,75011415,EGD/EUS GASTROJAJUNOSTOMY LAMS HB,7560.0,4914.0,786.42,7560.0,84
CDM,75011425,ENDOSCOPIC PYLOROMYOTOMY HB,7560.0,4914.0,786.42,7560.0,84
CDM,75011435,COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD,4194.0,2726.1,214.53,6112.0,87
CDM,75011695,ENDOSCOPY OF BOWEL POUCH,1558.0,1012.7,339.64,1558.0,58
CDM,75011895,CYSTO W/INSERT URETERAL STENT,15865.0,10312.25,182.47,15865.0,87
CDM,75011965,ERCP W SPHINCTEROTOMY/REMOVAL OF CALCULI VIA GASTROSTOMY,2982.0,1938.3,786.42,6112.0,84
CDM,75011975,EGD US GUIDED TRANSMURAL INJXN/FIDUCIAL MARKER,8726.0,5671.9,303.49,8726.0,87
CDM,75011995,GI TRACT IMAGING INTRALUMINAL ESOPHAGUS WI&R,4313.0,2803.45,299.41,6112.0,86
CDM,75012005,ANOSCOPY W/RMVL LESION CAUTERY,12615.0,8199.75,95.32,12615.0,79
CDM,75012105,COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD,4194.0,2726.1,214.53,6112.0,87
CDM,75012115,PERQ REPLACEMENT GTUBE NOT REQ REVJ GSTRST TRC,1119.0,727.35,44.67,4628.0,87
CDM,75012125,PERQ REPLACEMENT GTUBE REQ REVJ GSTRST TRC,1119.0,727.35,103.67,4628.0,87
CDM,75012175,ESOPHAGOSCOPY FLEXIBLE TRANSNASAL DIAGNOSTIC,4313.0,2803.45,90.82,6112.0,87
CDM,75012215,GI LEVEL 1 1ST 30 MIN,3394.0,2206.1,739.89,3394.0,58
CDM,75012225,GI LEVEL 2 1ST 30 MIN,4184.0,2719.6,912.11,4184.0,58
CDM,75012235,GI LEVEL 3 1ST 30 MIN,4715.0,3064.75,1027.87,4715.0,58
CDM,75012245,GI LEVEL 4 1ST 30 MIN,5175.0,3363.75,1128.15,5175.0,58
CDM,75012255,GI LEVEL 5 1ST 30 MIN,5815.0,3779.75,1267.67,5815.0,58
CDM,75012265,GI LEVEL 1 EA ADD 30 MIN,2499.0,1624.35,544.78,2499.0,58
CDM,75012275,GI LEVEL 2 EA ADD 30 MIN,3283.0,2133.95,715.69,3283.0,58
CDM,75012285,GI LEVEL 3 EA ADD 30 MIN,3831.0,2490.15,835.16,3831.0,58
CDM,75012295,GI LEVEL 4 EA ADD 30 MIN,4297.0,2793.05,936.75,4297.0,58
CDM,75012305,GI LEVEL 5 EA ADD 30 MIN,4966.0,3227.9,1082.59,4966.0,58
CDM,75012315,POUCHOSCOPY W/ DILATION (COMP 44386),3762.0,2445.3,786.42,6112.0,84
CDM,75012325,POUCHOSCOPY W/ INJECTION (COMP 44386),3762.0,2445.3,786.42,6112.0,84
CDM,75012335,POUCHOSCOPY W/ STRICTUROTOMY/FISTULOTOMY (COMP 44386),3762.0,2445.3,786.42,6112.0,84
CDM,75012345,POUCHOSCOPY W/ STRICTUROTOMY & INJECTION (COMP 44386),3762.0,2445.3,786.42,6112.0,84
CDM,75012355,POUCHOSCOPY W/ HOT BIOPSY (COMP 44386),3762.0,2445.3,786.42,6112.0,84
CDM,75012365,POUCHOSCOPY W/ HOT BIOPSY & INJECTION (COMP 44386),3762.0,2445.3,786.42,6112.0,84
CDM,75012375,POUCHOSCOPY W/ HOT BIOPSY & DILATION (COMP 44386),3762.0,2445.3,786.42,6112.0,84
CDM,75012385,POUCHOSCOPY W/ SNARE (COMP 44386),3762.0,2445.3,786.42,6112.0,84
CDM,75012395,POUCHOSCOPY W/ SNARE & INJECTION (COMP 44386),3762.0,2445.3,786.42,6112.0,84
CDM,75012405,POUCHOSCOPY W/ SNARE & DILATION (COMP 44386),3762.0,2445.3,786.42,6112.0,84
CDM,75012415,I&D ISCHIORCT/INTRAMURAL ABSC W/WO SETON,12615.0,8199.75,589.38,12615.0,87
CDM,75012435,ELECTROGASTROGRAPHY DX TRANSCUT W/PROVOCTVE TSTG,593.0,385.45,110.82,4628.0,87
CDM,75012445,EGD REPAIR ESOPHAGEAL PERFORATION W/HEMOCLIPS (COMP 43235),3732.0,2425.8,786.42,6112.0,84
CDM,75012455,"UNLISTED PROCEDURE, SMALL INTESTINE (COMP 43236)",2858.0,1857.7,786.42,6112.0,84
CDM,75012475,CHEMODENERVATION INTERNAL ANAL SPHINCTER,5424.0,3525.6,304.4,6112.0,86
CDM,75012485,EGD W SUTURE OF GASTROCUTANEOUS FISTULA (COMP 43255),7833.0,5091.45,786.42,7833.0,84
CDM,75012495,RETROGRADE SMALL INTESTINE ENTEROSCOPY W/BIOPSY (COMP 44377),7833.0,5091.45,786.42,7833.0,84
CDM,75012505,EGD ESOPHAGUS BALLOON DILATION 30 MM OR LARGER,8726.0,5671.9,264.38,8726.0,87
CDM,75012515,RETROGRADE ENTEROSCOPY W/CONTROL OF BLEEDING (COMP 44378),7833.0,5091.45,786.42,7833.0,84
CDM,75012555,ENTEROSCOPY W/DILATION (COMP CODE 43249),7833.0,5091.45,786.42,7833.0,84
CDM,75012565,ENTEROSCOPY W/SUBMUCOSAL INJECTION (COMP CODE 43236),3732.0,2425.8,786.42,6112.0,84
CDM,75012575,BAE W/ENDOSCOPIC MUCOSAL RESECTION (COMP CODE 43254),2517.0,1636.05,699.73,6112.0,84
CDM,75012585,POUCHOSCOPY WITH FOREIGN BODY REMOVAL (COMP 45332),4858.0,3157.7,786.42,6112.0,84
CDM,75012595,ANOSCOPY DX W/HRA &CHEM AGNTS ENHANCEMENT W/BX,5424.0,3525.6,146.68,7948.0,86
CDM,75012615,"LOWER BAE, RETROGRADE, W/O FLUORO (COMP 45378)",3762.0,2445.3,786.42,6112.0,84
CDM,75012625,RETROGRADE ENTEROSCOPY SUBMUCOSAL INJECTION (COMP 45381),4858.0,3157.7,786.42,6112.0,84
CDM,75012635,DILATION OF COLOSTOMY (COMP 57800),2820.0,1833.0,783.96,8326.0,85
CDM,75012645,ENDO GASTRIC BYPASS REVISON (COMP 43860),14904.0,9687.6,786.42,14904.0,84
CDM,75012655,ENDOSCOPIC SLEEVE GASTROPLASTY (COMP 43775),14472.0,9406.8,786.42,14472.0,84
CDM,75012705,GI TRACT IMAGING INTRALUMINAL COLON I&R,4194.0,2726.1,299.41,4194.0,86
CDM,75012715,EGD FLEXIBLE TRANSNASAL W/INSJ INTRAL TUBE/CATH,15218.0,9891.7,780.28,15218.0,85
CDM,75012745,INT HRHC BY LIGATION SINGLE HROID W/O IMG GDN,12615.0,8199.75,424.8,12615.0,86
CDM,75012755,EXCISION OF LESION. STOMA WITHOUT SCOPE (COMP 44382),3732.0,2425.8,792.91,8326.0,85
CDM,75012765,INSTLJ FECAL MICROBIOTA SSP RCT NMA LWR GI TRC,516.0,335.4,110.82,4628.0,84
CDM,75012895,RECTAL SENSATION TONE&COMPLIANCE STUDY,1522.0,989.3,204.28,3443.0,77
CDM,75012905,ANRCT MANO RCT SENSATION&RCT BALO EXPULSION TEST,1754.0,1140.1,353.04,3443.0,77
CDM,75557OH,CARDIAC MRI MORPHOLOGY & FUNCTION W/O CONTRAST,2608.0,1695.2,1.1,2608.0,142
CDM,75557OH-26,CARDIAC MRI MORPHOLOGY & FUNCTION W/O CONTRAST,940.0,611.0,1.1,940.0,126
CDM,75557OH-TC,CARDIAC MRI MORPHOLOGY & FUNCTION W/O CONTRAST,1668.0,1084.2,1.1,1668.0,126
CDM,75559OH,CARDIAC MRI W/O CONTRAST W/STRESS IMAGING,5081.0,3302.65,1.1,5081.0,142
CDM,75559OH-26,CARDIAC MRI W/O CONTRAST W/STRESS IMAGING,1298.0,843.7,1.1,1298.0,126
CDM,75559OH-TC,CARDIAC MRI W/O CONTRAST W/STRESS IMAGING,3783.0,2458.95,1.1,3783.0,126
CDM,75561OH,CARDIAC MRI W/WO CONTRAST & FURTHER SEQ,3608.0,2345.2,1.1,3608.0,142
CDM,75561OH-26,CARDIAC MRI W/WO CONTRAST & FURTHER SEQ,1144.0,743.6,1.1,1144.0,126
CDM,75561OH-TC,CARDIAC MRI W/WO CONTRAST & FURTHER SEQ,2464.0,1601.6,1.1,2464.0,126
CDM,75563OH,CARD MRI W/W/O CON W/STRESS IMAGE,6651.0,4323.15,1.1,6651.0,142
CDM,75563OH-26,CARD MRI W/W/O CON W/STRESS IMAGE,1200.0,780.0,1.1,1200.0,126
CDM,75563OH-TC,CARD MRI W/W/O CON W/STRESS IMAGE,5451.0,3543.15,1.1,5451.0,126
CDM,75565OH,CARDIAC MRI FOR VELOCITY FLOW MAPPING,676.0,439.4,1.1,676.0,142
CDM,75565OH-26,CARDIAC MRI FOR VELOCITY FLOW MAPPING,110.0,71.5,1.1,110.0,126
CDM,75565OH-TC,CARDIAC MRI FOR VELOCITY FLOW MAPPING,566.0,367.9,1.1,566.0,126
CDM,75571AOH,CT CALCIUM SCORING - SELF PAY,840.0,546.0,1.1,840.0,142
CDM,75571AOH-26,CT CALCIUM SCORING - SELF PAY,232.0,150.8,1.1,232.0,126
CDM,75571AOH-TC,CT CALCIUM SCORING - SELF PAY,608.0,395.2,1.1,608.0,126
CDM,75571OH,CT HEART NO CONTRAST QUANT EVAL CORONRY CALCIUM,840.0,546.0,1.1,840.0,142
CDM,75571OH-26,CT HEART NO CONTRAST QUANT EVAL CORONRY CALCIUM,232.0,150.8,1.1,232.0,126
CDM,75571OH-TC,CT HEART NO CONTRAST QUANT EVAL CORONRY CALCIUM,608.0,395.2,1.1,608.0,126
CDM,75572OH,CT HEART CONTRAST EVAL CARDIAC STRUCTURE&MORPH,3164.0,2056.6,1.1,3164.0,142
CDM,75572OH-26,CT HEART CONTRAST EVAL CARDIAC STRUCTURE&MORPH,700.0,455.0,1.1,700.0,126
CDM,75572OH-TC,CT HEART CONTRAST EVAL CARDIAC STRUCTURE&MORPH,2464.0,1601.6,1.1,2464.0,126
CDM,75573OH,CT HEART C+ CARDIAC STRUX&MORPH CGEN HRT DS,3484.0,2264.6,1.1,3484.0,142
CDM,75573OH-26,CT HEART C+ CARDIAC STRUX&MORPH CGEN HRT DS,1020.0,663.0,1.1,1020.0,126
CDM,75573OH-TC,CT HEART C+ CARDIAC STRUX&MORPH CGEN HRT DS,2464.0,1601.6,1.1,2464.0,126
CDM,75574OH,CTA HRT CORNRY ART/BYPASS GRFTS CONTRST 3D POST,3424.0,2225.6,1.1,3424.0,142
CDM,75574OH-26,CTA HRT CORNRY ART/BYPASS GRFTS CONTRST 3D POST,960.0,624.0,1.1,960.0,126
CDM,75574OH-TC,CTA HRT CORNRY ART/BYPASS GRFTS CONTRST 3D POST,2464.0,1601.6,1.1,2464.0,126
CDM,75577OH,QUAN&CHARAC C ATHEROSCLEROTC PLAQ ASSES SEV C DS,6932.0,4505.8,1.1,6932.0,106
CDM,75577OH-26,QUAN&CHARAC C ATHEROSCLEROTC PLAQ ASSES SEV C DS,374.0,243.1,1.1,374.0,106
CDM,75577OH-TC,QUAN&CHARAC C ATHEROSCLEROTC PLAQ ASSES SEV C DS,6558.0,4262.7,1.1,6558.0,106
CDM,75580OH,N-INVAS EST C FFR AUGMNT SW ALYS CTA I&R PHY/QHP,7350.0,4777.5,1.1,7350.0,142
CDM,75580OH-26,N-INVAS EST C FFR AUGMNT SW ALYS CTA I&R PHY/QHP,330.0,214.5,1.1,330.0,126
CDM,75580OH-TC,N-INVAS EST C FFR AUGMNT SW ALYS CTA I&R PHY/QHP,7020.0,4563.0,1.1,7020.0,126
CDM,75600OH,AORTOGRAPHY THORACIC W/O SERIALOGRAPHY RS&I,21914.0,14244.1,1.1,21914.0,142
CDM,75600OH-26,AORTOGRAPHY THORACIC W/O SERIALOGRAPHY RS&I,196.0,127.4,1.1,196.0,126
CDM,75600OH-TC,AORTOGRAPHY THORACIC W/O SERIALOGRAPHY RS&I,21718.0,14116.7,1.1,21718.0,126
CDM,75605OH,AORTOGRAPHY THORACIC SERIALOGRAPHY RS&I,37801.0,24570.65,1.1,37801.0,142
CDM,75605OH-26,AORTOGRAPHY THORACIC SERIALOGRAPHY RS&I,502.0,326.3,1.1,502.0,126
CDM,75605OH-TC,AORTOGRAPHY THORACIC SERIALOGRAPHY RS&I,37299.0,24244.35,1.1,37299.0,126
CDM,75625OH,AORTOGRAPHY ABDOMINAL SERIALOGRAPHY RS&I,22294.0,14491.1,1.1,22294.0,142
CDM,75625OH-26,AORTOGRAPHY ABDOMINAL SERIALOGRAPHY RS&I,576.0,374.4,1.1,576.0,126
CDM,75625OH-TC,AORTOGRAPHY ABDOMINAL SERIALOGRAPHY RS&I,21718.0,14116.7,1.1,21718.0,126
CDM,75630OH,AORTOGRAPHY ABDL BI ILIOFEM LOW EXTREM CATH RS&I,22518.0,14636.7,1.1,22518.0,142
CDM,75630OH-26,AORTOGRAPHY ABDL BI ILIOFEM LOW EXTREM CATH RS&I,800.0,520.0,1.1,800.0,126
CDM,75630OH-TC,AORTOGRAPHY ABDL BI ILIOFEM LOW EXTREM CATH RS&I,21718.0,14116.7,1.1,21718.0,126
CDM,75635OH,CTA ABDL AORTA&BI ILIOFEM W/CONTRAST&POSTP,2188.0,1422.2,1.1,2188.0,142
CDM,75635OH-26,CTA ABDL AORTA&BI ILIOFEM W/CONTRAST&POSTP,960.0,624.0,1.1,960.0,126
CDM,75635OH-TC,CTA ABDL AORTA&BI ILIOFEM W/CONTRAST&POSTP,1228.0,798.2,1.1,1228.0,126
CDM,75705OH,ANGIOGRAPHY SPINAL SELECTIVE RS&I,38171.0,24811.15,1.1,38171.0,142
CDM,75705OH-26,ANGIOGRAPHY SPINAL SELECTIVE RS&I,872.0,566.8,1.1,872.0,126
CDM,75705OH-TC,ANGIOGRAPHY SPINAL SELECTIVE RS&I,37299.0,24244.35,1.1,37299.0,126
CDM,75710OH,ANGIOGRAPHY EXTREMITY UNILATERAL RS&I,22418.0,14571.7,1.1,22418.0,142
CDM,75710OH-26,ANGIOGRAPHY EXTREMITY UNILATERAL RS&I,700.0,455.0,1.1,700.0,126
CDM,75710OH-TC,ANGIOGRAPHY EXTREMITY UNILATERAL RS&I,21718.0,14116.7,1.1,21718.0,126
CDM,75716OH,ANGIOGRAPHY EXTREMITY BILATERAL RS&I,22506.0,14628.9,1.1,22506.0,142
CDM,75716OH-26,ANGIOGRAPHY EXTREMITY BILATERAL RS&I,788.0,512.2,1.1,788.0,126
CDM,75716OH-TC,ANGIOGRAPHY EXTREMITY BILATERAL RS&I,21718.0,14116.7,1.1,21718.0,126
CDM,75726OH,ANGIOGRAPHY VISCERAL SLCTV/SUPRASLCTV RS&I,38119.0,24777.35,1.1,38119.0,142
CDM,75726OH-26,ANGIOGRAPHY VISCERAL SLCTV/SUPRASLCTV RS&I,820.0,533.0,1.1,820.0,126
CDM,75726OH-TC,ANGIOGRAPHY VISCERAL SLCTV/SUPRASLCTV RS&I,37299.0,24244.35,1.1,37299.0,126
CDM,75731OH,ANGIO ADRENAL UNILAT SELECT,22220.0,14443.0,1.1,22220.0,142
CDM,75731OH-26,ANGIO ADRENAL UNILAT SELECT,502.0,326.3,1.1,502.0,126
CDM,75731OH-TC,ANGIO ADRENAL UNILAT SELECT,21718.0,14116.7,1.1,21718.0,126
CDM,75736OH,ANGIOGRAPHY PELVIC SLCTV/SUPRASLCTV RS&I,37755.0,24540.75,1.1,37755.0,142
CDM,75736OH-26,ANGIOGRAPHY PELVIC SLCTV/SUPRASLCTV RS&I,456.0,296.4,1.1,456.0,126
CDM,75736OH-TC,ANGIOGRAPHY PELVIC SLCTV/SUPRASLCTV RS&I,37299.0,24244.35,1.1,37299.0,126
CDM,75741OH,ANGIOGRAPHY PULMONARY UNILATERAL SLCTV RS&I,22242.0,14457.3,1.1,22242.0,142
CDM,75741OH-26,ANGIOGRAPHY PULMONARY UNILATERAL SLCTV RS&I,524.0,340.6,1.1,524.0,126
CDM,75741OH-TC,ANGIOGRAPHY PULMONARY UNILATERAL SLCTV RS&I,21718.0,14116.7,1.1,21718.0,126
CDM,75743OH,ANGIOGRAPHY PULMONARY BILATERAL SLCTV RS&I,22382.0,14548.3,1.1,22382.0,142
CDM,75743OH-26,ANGIOGRAPHY PULMONARY BILATERAL SLCTV RS&I,664.0,431.6,1.1,664.0,126
CDM,75743OH-TC,ANGIOGRAPHY PULMONARY BILATERAL SLCTV RS&I,21718.0,14116.7,1.1,21718.0,126
CDM,75746OH,ANGRPH PULMONARY NONSLCTV CATH/VEN NJX RS&I,22220.0,14443.0,1.1,22220.0,142
CDM,75746OH-26,ANGRPH PULMONARY NONSLCTV CATH/VEN NJX RS&I,502.0,326.3,1.1,502.0,126
CDM,75746OH-TC,ANGRPH PULMONARY NONSLCTV CATH/VEN NJX RS&I,21718.0,14116.7,1.1,21718.0,126
CDM,75756OH,ANGIOGRAPHY INTERNAL MAMMARY RS&I,22174.0,14413.1,1.1,22174.0,142
CDM,75756OH-26,ANGIOGRAPHY INTERNAL MAMMARY RS&I,456.0,296.4,1.1,456.0,126
CDM,75756OH-TC,ANGIOGRAPHY INTERNAL MAMMARY RS&I,21718.0,14116.7,1.1,21718.0,126
CDM,75774OH,ANGRPH SLCTV EA VSL STUDIED AFTER BASIC XM RS&I,4586.0,2980.9,1.1,4586.0,142
CDM,75774OH-26,ANGRPH SLCTV EA VSL STUDIED AFTER BASIC XM RS&I,404.0,262.6,1.1,404.0,126
CDM,75774OH-TC,ANGRPH SLCTV EA VSL STUDIED AFTER BASIC XM RS&I,4182.0,2718.3,1.1,4182.0,126
CDM,75801OH,LYMPHANGIOGRAM EXTREM UNILATER,4590.0,2983.5,1.1,4590.0,104
CDM,75801OH-26,LYMPHANGIOGRAM EXTREM UNILATER,324.0,210.6,1.1,324.0,126
CDM,75801OH-TC,LYMPHANGIOGRAM EXTREM UNILATER,4266.0,2772.9,1.1,4266.0,94
CDM,75803OH,LYMPHANGIO EXTREM BILAT,11234.0,7302.1,1.1,11234.0,104
CDM,75803OH-26,LYMPHANGIO EXTREM BILAT,515.0,334.75,1.1,515.0,126
CDM,75803OH-TC,LYMPHANGIO EXTREM BILAT,10719.0,6967.35,1.1,10719.0,94
CDM,75805OH,LYMPHANGIOGRAPHY PELVIC/ABDOMINAL UNILAT RS&I,22042.0,14327.3,1.1,22042.0,104
CDM,75805OH-26,LYMPHANGIOGRAPHY PELVIC/ABDOMINAL UNILAT RS&I,324.0,210.6,1.1,324.0,126
CDM,75805OH-TC,LYMPHANGIOGRAPHY PELVIC/ABDOMINAL UNILAT RS&I,21718.0,14116.7,1.1,21718.0,94
CDM,75807OH,LYMPHANGIOGRAPHY PELVIC/ABDOMINAL BILATERAL RS&I,22186.0,14420.9,1.1,22186.0,104
CDM,75807OH-26,LYMPHANGIOGRAPHY PELVIC/ABDOMINAL BILATERAL RS&I,468.0,304.2,1.1,468.0,126
CDM,75807OH-TC,LYMPHANGIOGRAPHY PELVIC/ABDOMINAL BILATERAL RS&I,21718.0,14116.7,1.1,21718.0,94
CDM,75809OH,SHUNTOGRAM INDWELLING NONVASCULAR SHUNT RS&I,941.0,611.65,1.1,941.0,142
CDM,75809OH-26,SHUNTOGRAM INDWELLING NONVASCULAR SHUNT RS&I,207.0,134.55,1.1,207.0,126
CDM,75809OH-TC,SHUNTOGRAM INDWELLING NONVASCULAR SHUNT RS&I,734.0,477.1,1.1,734.0,126
CDM,75810OH,SPLENOPORTOGRAM,22174.0,14413.1,1.1,22174.0,104
CDM,75810OH-26,SPLENOPORTOGRAM,456.0,296.4,1.1,456.0,126
CDM,75810OH-TC,SPLENOPORTOGRAM,21718.0,14116.7,1.1,21718.0,94
CDM,75820OH,VENOGRAPHY EXTREMITY UNILATERAL RS&I,11139.0,7240.35,1.1,11139.0,142
CDM,75820OH-26,VENOGRAPHY EXTREMITY UNILATERAL RS&I,420.0,273.0,1.1,420.0,126
CDM,75820OH-TC,VENOGRAPHY EXTREMITY UNILATERAL RS&I,10719.0,6967.35,1.1,10719.0,126
CDM,75822OH,VENOGRAPHY EXTREMITY BILATERAL RS&I,11311.0,7352.15,1.1,11311.0,142
CDM,75822OH-26,VENOGRAPHY EXTREMITY BILATERAL RS&I,592.0,384.8,1.1,592.0,126
CDM,75822OH-TC,VENOGRAPHY EXTREMITY BILATERAL RS&I,10719.0,6967.35,1.1,10719.0,126
CDM,75825OH,VENOGRAPHY CAVAL INFERIOR SERIALOGRAPHY RS&I,22220.0,14443.0,1.1,22220.0,142
CDM,75825OH-26,VENOGRAPHY CAVAL INFERIOR SERIALOGRAPHY RS&I,502.0,326.3,1.1,502.0,126
CDM,75825OH-TC,VENOGRAPHY CAVAL INFERIOR SERIALOGRAPHY RS&I,21718.0,14116.7,1.1,21718.0,126
CDM,75827OH,VENOGRAPHY CAVAL SUPERIOR SERIALOGRAPHY RS&I,11175.0,7263.75,1.1,11175.0,142
CDM,75827OH-26,VENOGRAPHY CAVAL SUPERIOR SERIALOGRAPHY RS&I,456.0,296.4,1.1,456.0,126
CDM,75827OH-TC,VENOGRAPHY CAVAL SUPERIOR SERIALOGRAPHY RS&I,10719.0,6967.35,1.1,10719.0,126
CDM,75831OH,VENOGRAPHY RENAL UNILATERAL SELECTIVE RS&I,22174.0,14413.1,1.1,22174.0,142
CDM,75831OH-26,VENOGRAPHY RENAL UNILATERAL SELECTIVE RS&I,456.0,296.4,1.1,456.0,126
CDM,75831OH-TC,VENOGRAPHY RENAL UNILATERAL SELECTIVE RS&I,21718.0,14116.7,1.1,21718.0,126
CDM,75833OH,VENOGRAPHY RENAL BILATERAL SELECTIVE RS&I,22314.0,14504.1,1.1,22314.0,142
CDM,75833OH-26,VENOGRAPHY RENAL BILATERAL SELECTIVE RS&I,596.0,387.4,1.1,596.0,126
CDM,75833OH-TC,VENOGRAPHY RENAL BILATERAL SELECTIVE RS&I,21718.0,14116.7,1.1,21718.0,126
CDM,75840OH,VENOGRAPHY ADRENAL UNILATERAL SELECTIVE RS&I,22174.0,14413.1,1.1,22174.0,142
CDM,75840OH-26,VENOGRAPHY ADRENAL UNILATERAL SELECTIVE RS&I,456.0,296.4,1.1,456.0,126
CDM,75840OH-TC,VENOGRAPHY ADRENAL UNILATERAL SELECTIVE RS&I,21718.0,14116.7,1.1,21718.0,126
CDM,75860EXOH,VENOGRAM SINUS/JUGULAR,456.0,296.4,1.1,456.0,126
CDM,75860OH,VENOGRAPHY VENOUS SINUS/JUGULAR CATH RS&I,22174.0,14413.1,1.1,22174.0,142
CDM,75860OH-26,VENOGRAPHY VENOUS SINUS/JUGULAR CATH RS&I,456.0,296.4,1.1,456.0,126
CDM,75860OH-TC,VENOGRAPHY VENOUS SINUS/JUGULAR CATH RS&I,21718.0,14116.7,1.1,21718.0,126
CDM,75870OH,VENOGRAPHY SUPERIOR SAGITTAL SINUS RS&I,22220.0,14443.0,1.1,22220.0,142
CDM,75870OH-26,VENOGRAPHY SUPERIOR SAGITTAL SINUS RS&I,502.0,326.3,1.1,502.0,126
CDM,75870OH-TC,VENOGRAPHY SUPERIOR SAGITTAL SINUS RS&I,21718.0,14116.7,1.1,21718.0,126
CDM,75872OH,VENOGRAM EPIDURAL,4768.0,3099.2,1.1,4768.0,142
CDM,75872OH-26,VENOGRAM EPIDURAL,502.0,326.3,1.1,502.0,126
CDM,75872OH-TC,VENOGRAM EPIDURAL,4266.0,2772.9,1.1,4266.0,126
CDM,75880OH,VENOGRAM ORBITAL,4574.0,2973.1,1.1,4574.0,142
CDM,75880OH-26,VENOGRAM ORBITAL,308.0,200.2,1.1,308.0,126
CDM,75880OH-TC,VENOGRAM ORBITAL,4266.0,2772.9,1.1,4266.0,126
CDM,75885OH,PRQ TRANSHEPATC PORTOGRAPY HEMODYN EVAL RS&I,22294.0,14491.1,1.1,22294.0,142
CDM,75885OH-26,PRQ TRANSHEPATC PORTOGRAPY HEMODYN EVAL RS&I,576.0,374.4,1.1,576.0,126
CDM,75885OH-TC,PRQ TRANSHEPATC PORTOGRAPY HEMODYN EVAL RS&I,21718.0,14116.7,1.1,21718.0,126
CDM,75887OH,PRQ TRANSHEPATC PORTOGRAPY W/O HEMODYN EVL INTRP,22294.0,14491.1,1.1,22294.0,142
CDM,75887OH-26,PRQ TRANSHEPATC PORTOGRAPY W/O HEMODYN EVL INTRP,576.0,374.4,1.1,576.0,126
CDM,75887OH-TC,PRQ TRANSHEPATC PORTOGRAPY W/O HEMODYN EVL INTRP,21718.0,14116.7,1.1,21718.0,126
CDM,75889AOH,HEPATC VNGRPH WDG/FR HEMODYN EVAL RS&I (75889A),456.0,296.4,1.1,9296.26,142
CDM,75889OH,HEPATC VNGRPH WDG/FR HEMODYN EVAL RS&I,22174.0,14413.1,1.1,22174.0,142
CDM,75889OH-26,HEPATC VNGRPH WDG/FR HEMODYN EVAL RS&I,456.0,296.4,1.1,456.0,126
CDM,75889OH-TC,HEPATC VNGRPH WDG/FR HEMODYN EVAL RS&I,21718.0,14116.7,1.1,21718.0,126
CDM,75891AOH,HEPATC VNGRPH WDG/FR W/O HEMODYN EVAL RS&I (75891A),456.0,296.4,1.1,9296.26,142
CDM,75891OH,HEPATC VNGRPH WDG/FR W/O HEMODYN EVAL RS&I,22174.0,14413.1,1.1,22174.0,142
CDM,75891OH-26,HEPATC VNGRPH WDG/FR W/O HEMODYN EVAL RS&I,456.0,296.4,1.1,456.0,126
CDM,75891OH-TC,HEPATC VNGRPH WDG/FR W/O HEMODYN EVAL RS&I,21718.0,14116.7,1.1,21718.0,126
CDM,75893OH,VENOUS SAMPLING THRU CATH W/WO ANGIOGRAPHY RS&,37515.0,24384.75,1.1,37515.0,142
CDM,75893OH-26,VENOUS SAMPLING THRU CATH W/WO ANGIOGRAPHY RS&,216.0,140.4,1.1,216.0,126
CDM,75893OH-TC,VENOUS SAMPLING THRU CATH W/WO ANGIOGRAPHY RS&,37299.0,24244.35,1.1,37299.0,126
CDM,75894OH,TRANSCATHETER EMBOLIZATION ANY METH RS&I,3637.0,2364.05,1.1,3637.0,134
CDM,75894OH-26,TRANSCATHETER EMBOLIZATION ANY METH RS&I,524.0,340.6,1.1,524.0,126
CDM,75894OH-TC,TRANSCATHETER EMBOLIZATION ANY METH RS&I,3113.0,2023.45,1.1,3113.0,122
CDM,75898OH,ANGRPH CATH F-UP STD TCAT OTHER THAN THROMBYLSIS,22378.0,14545.7,1.1,22378.0,134
CDM,75898OH-26,ANGRPH CATH F-UP STD TCAT OTHER THAN THROMBYLSIS,660.0,429.0,1.1,660.0,126
CDM,75898OH-TC,ANGRPH CATH F-UP STD TCAT OTHER THAN THROMBYLSIS,21718.0,14116.7,1.1,21718.0,122
CDM,75901OH,MECHANICAL RMVL PERICATHETER OBSTR MATRL RS&I,916.0,595.4,1.1,916.0,142
CDM,75901OH-26,MECHANICAL RMVL PERICATHETER OBSTR MATRL RS&I,196.0,127.4,1.1,196.0,126
CDM,75901OH-TC,MECHANICAL RMVL PERICATHETER OBSTR MATRL RS&I,720.0,468.0,1.1,720.0,126
CDM,75902EXOH,INTRALUMINAL CATH STRIPPING,156.0,101.4,1.1,156.0,126
CDM,75902OH,MECHANICAL RMVL INTRALUMINAL OBSTR MATRL RS&I,575.0,373.75,1.1,575.0,142
CDM,75902OH-26,MECHANICAL RMVL INTRALUMINAL OBSTR MATRL RS&I,156.0,101.4,1.1,156.0,126
CDM,75902OH-TC,MECHANICAL RMVL INTRALUMINAL OBSTR MATRL RS&I,419.0,272.35,1.1,419.0,126
CDM,75970OH,TRANSVASCULAR BIOPSY,4002.0,2601.3,1.1,4002.0,104
CDM,75970OH-26,TRANSVASCULAR BIOPSY,332.0,215.8,1.1,332.0,126
CDM,75970OH-TC,TRANSVASCULAR BIOPSY,3670.0,2385.5,1.1,3670.0,94
CDM,75984OH,CHANGE PRQ TUBE/DRAINAGE CATH W CONTRAST RS&I,1383.0,898.95,1.1,1383.0,142
CDM,75984OH-26,CHANGE PRQ TUBE/DRAINAGE CATH W CONTRAST RS&I,332.0,215.8,1.1,332.0,126
CDM,75984OH-TC,CHANGE PRQ TUBE/DRAINAGE CATH W CONTRAST RS&I,1051.0,683.15,1.1,1051.0,126
CDM,75989OH,RADIOLOGICAL GUIDANCE PRQ DRG W/PLMT CATH RS&I,2603.0,1691.95,1.1,2603.0,142
CDM,75989OH-26,RADIOLOGICAL GUIDANCE PRQ DRG W/PLMT CATH RS&I,476.0,309.4,1.1,476.0,126
CDM,75989OH-TC,RADIOLOGICAL GUIDANCE PRQ DRG W/PLMT CATH RS&I,2127.0,1382.55,1.1,2127.0,126
CDM,76000OH,FLUOROSCOPY UP TO 1 HOUR PHYSICIAN/QHP TIME,1788.0,1162.2,1.1,1788.0,142
CDM,76000OH-26,FLUOROSCOPY UP TO 1 HOUR PHYSICIAN/QHP TIME,120.0,78.0,1.1,120.0,126
CDM,76000OH-TC,FLUOROSCOPY UP TO 1 HOUR PHYSICIAN/QHP TIME,1668.0,1084.2,1.1,1668.0,126
CDM,76003OH,NEEDLE LOCALIZATION BY X-RAY,157.0,102.05,1.1,157.0,70
CDM,76006OH,X-RAY STRESS VIEW,199.0,129.35,1.1,199.0,70
CDM,76010OH,RADEX FROM NOSE RECTUM FOREIGN BODY 1 VIEW CHLD,680.0,442.0,1.1,680.0,142
CDM,76010OH-26,RADEX FROM NOSE RECTUM FOREIGN BODY 1 VIEW CHLD,72.0,46.8,1.1,72.0,126
CDM,76010OH-TC,RADEX FROM NOSE RECTUM FOREIGN BODY 1 VIEW CHLD,608.0,395.2,1.1,608.0,126
CDM,76014OH,MR SAFETY IMPLANT&/FB ASSMT CLIN STAF 1ST 15 MIN,322.0,209.3,1.1,322.0,140
CDM,76014OH-26,MR SAFETY IMPLANT&/FB ASSMT CLIN STAF 1ST 15 MIN,153.0,99.45,1.1,153.0,70
CDM,76014OH-TC,MR SAFETY IMPLANT&/FB ASSMT CLIN STAF 1ST 15 MIN,169.0,109.85,1.1,169.0,70
CDM,76015OH,MR SAFETY IMPLANT&/FB ASSMT CLIN STAFF EA ADD 30,1059.0,688.35,1.1,1059.0,140
CDM,76015OH-26,MR SAFETY IMPLANT&/FB ASSMT CLIN STAFF EA ADD 30,716.0,465.4,1.1,716.0,70
CDM,76015OH-TC,MR SAFETY IMPLANT&/FB ASSMT CLIN STAFF EA ADD 30,343.0,222.95,1.1,343.0,70
CDM,76016OH,MR SAFETY DETERMINATION PHYSICIAN/OTHER QHP,872.0,566.8,1.1,872.0,140
CDM,76016OH-26,MR SAFETY DETERMINATION PHYSICIAN/OTHER QHP,264.0,171.6,1.1,264.0,126
CDM,76016OH-TC,MR SAFETY DETERMINATION PHYSICIAN/OTHER QHP,608.0,395.2,1.1,608.0,126
CDM,76017OH,MR SAFETY MED PHYSICS XM CUSTOMIZATION PLNG&MNTR,2002.0,1301.3,1.1,2002.0,140
CDM,76017OH-26,MR SAFETY MED PHYSICS XM CUSTOMIZATION PLNG&MNTR,334.0,217.1,1.1,334.0,126
CDM,76017OH-TC,MR SAFETY MED PHYSICS XM CUSTOMIZATION PLNG&MNTR,1668.0,1084.2,1.1,1668.0,126
CDM,76018OH,MR SAFETY IMPLT ELECTRONICS PREPJ SUPVJ PHYS/QHP,963.0,625.95,1.1,963.0,140
CDM,76018OH-26,MR SAFETY IMPLT ELECTRONICS PREPJ SUPVJ PHYS/QHP,330.0,214.5,1.1,330.0,126
CDM,76018OH-TC,MR SAFETY IMPLT ELECTRONICS PREPJ SUPVJ PHYS/QHP,633.0,411.45,1.1,633.0,126
CDM,76019OH,MR SAFETY IMPLANT POS&/IMMOBLJ SUPVJ PHYS/QHP,674.0,438.1,1.1,674.0,140
CDM,76019OH-26,MR SAFETY IMPLANT POS&/IMMOBLJ SUPVJ PHYS/QHP,264.0,171.6,1.1,264.0,126
CDM,76019OH-TC,MR SAFETY IMPLANT POS&/IMMOBLJ SUPVJ PHYS/QHP,410.0,266.5,1.1,410.0,126
CDM,76080OH,RADEX ABSCESS/FISTULA/SINUS TRACT RS&I,3999.0,2599.35,1.1,3999.0,142
CDM,76080OH-26,RADEX ABSCESS/FISTULA/SINUS TRACT RS&I,216.0,140.4,1.1,216.0,126
CDM,76080OH-TC,RADEX ABSCESS/FISTULA/SINUS TRACT RS&I,3783.0,2458.95,1.1,3783.0,126
CDM,76098OH,RADIOLOGICAL EXAMINATION SURGICAL SPECIMEN,3907.0,2539.55,1.1,3907.0,142
CDM,76098OH-26,RADIOLOGICAL EXAMINATION SURGICAL SPECIMEN,124.0,80.6,1.1,124.0,126
CDM,76098OH-TC,RADIOLOGICAL EXAMINATION SURGICAL SPECIMEN,3783.0,2458.95,1.1,3783.0,126
CDM,76100010,ARTL CATHJ/CANNULJ MNTR/TRANSFUSION SPX PRQ,1489.0,967.85,0.01,3443.0,68
CDM,76100015,DRG ABSC CST HMTMA FROM DENTOALVEOLAR STRUXS,593.0,385.45,0.01,4392.0,87
CDM,76100020,PULSED RF POPLITEAL NERVE,708.0,460.2,0.01,3443.0,85
CDM,76100055,FINE NEEDLE ASPIRATION BX W/O IMG GDN 1ST LESION,1838.0,1194.7,0.01,12500.0,87
CDM,76100075,ACNE SURGERY,596.0,387.4,0.01,12500.0,87
CDM,76100080,DECLOT BY THROMBOLYTIC AGENT IMPLANT DEVICE/CATH,1907.0,1239.55,0.01,12500.0,87
CDM,76100085,INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE,596.0,387.4,0.01,12500.0,87
CDM,76100095,INCISION & DRAINAGE ABSCESS COMPLICATED/MULTIPLE,1199.0,779.35,0.01,4392.0,87
CDM,76100100,NEGATIVE PRESSURE WOUND THERAPY DME >50 SQ CM,1838.0,1194.7,0.01,1838.0,87
CDM,76100105,INCISION & DRAINAGE PILONIDAL CYST SIMPLE,2111.0,1372.15,0.01,12500.0,87
CDM,76100115,INCISION & DRAINAGE PILONIDAL CYST COMPLICATED,2111.0,1372.15,0.01,12500.0,87
CDM,76100120,OFFICE/OUTPATIENT ESTABLISHED SF MDM 10-19 MIN,150.0,97.5,0.01,150.0,68
CDM,76100125,INCISION & REMOVAL FOREIGN BODY SUBQ TISS SIMPLE,1199.0,779.35,0.01,12500.0,87
CDM,76100135,I&D HEMATOMA SEROMA/FLUID COLLECTION,4861.0,3159.65,0.01,12500.0,87
CDM,76100145,INCISION & DRAINAGE COMPLEX PO WOUND INFECTION,8586.0,5580.9,0.01,8586.0,87
CDM,76100150,ASPIRATION BLADDER INSERT SUPRAPUBIC CATHETER,9423.0,6124.95,0.01,9423.0,87
CDM,76100160,INSJ NON-NDWELLG BLADDER CATHETER,593.0,385.45,0.01,12500.0,87
CDM,76100170,INSJ TEMP NDWELLG BLADDER CATHETER SIMPLE,593.0,385.45,0.01,12500.0,87
CDM,76100180,INSJ TEMP NDWELLG BLADDER CATHETER COMPLICATED,720.0,468.0,0.01,3443.0,87
CDM,76100185,DEBRIDEMENT SUBCUTANEOUS TISSUE 20 SQ CM/<,1199.0,779.35,0.01,5265.0,87
CDM,76100190,MEAS POST-VOIDING RESIDUAL URINE&/BLADDER CAP,273.0,177.45,0.01,12500.0,87
CDM,76100195,DEBRIDEMENT BONE MUSCLE &/FASCIA 20 SQ CM/<,4861.0,3159.65,0.01,5265.0,87
CDM,76100205,DEBRIDEMENT MUSCLE &/FASCIA EA ADDL 20 SQ CM,2452.0,1593.8,0.01,5265.0,69
CDM,76100210,INSERTION PICC W/O IMG GDN 5 YR/>,8932.0,5805.8,0.01,8932.0,87
CDM,76100215,PARING/CUTTING BENIGN HYPERKERATOTIC LESION 1,596.0,387.4,0.01,12500.0,87
CDM,76100220,COMPLETE REPLACEMENT PICC RS&I,8932.0,5805.8,0.01,8932.0,87
CDM,76100225,PARING/CUTTING BENIGN HYPERKERATOTIC LESION >4,596.0,387.4,0.01,12500.0,87
CDM,76100230,DECLOT BY THROMBOLYTIC AGENT IMPLANT DEVICE/CATH,1907.0,1239.55,0.01,12500.0,87
CDM,76100240,COLLECT BLOOD FROM IMPLANT VENOUS ACCESS DEVICE,741.0,481.65,0.01,12500.0,87
CDM,76100245,REMOVAL SK TGS MLT FIBRQ TAGS ANY AREA EA 10,338.0,219.7,0.01,338.0,68
CDM,76100255,SHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM 0.6-1.0 CM,596.0,387.4,0.01,12500.0,87
CDM,76100265,SHVG SKN LESION 1 TRUNK/ARM/LEG DIAM 1.1-2.0 CM,596.0,387.4,0.01,12500.0,87
CDM,76100275,SHAVING SKIN LESION 1 S/N/H/F/G DIAM 0.5 CM/<,596.0,387.4,0.01,12500.0,87
CDM,76100285,SHAVING SKIN LESION 1 S/N/H/F/G DIAM 1.1-2.0 CM,596.0,387.4,0.01,12500.0,87
CDM,76100295,SHAVING SKIN LESION 1 F/E/E/N/L/M DIAM 0.5 CM/<,596.0,387.4,0.01,12500.0,87
CDM,76100305,SHVG SKIN LESION 1 F/E/E/N/L/M DIAM 1.1-2.0 CM,1199.0,779.35,0.01,12500.0,87
CDM,76100315,SHAVING SKIN LESION 1 F/E/E/N/L/M DIAM >2.0 CM,1199.0,779.35,0.01,12500.0,87
CDM,76100320,CYSTOURETHROSCOPY,3070.0,1995.5,0.01,4392.0,87
CDM,76100325,EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM/<,2111.0,1372.15,0.01,3443.0,87
CDM,76100330,EXC B9 LESION MRGN XCP SK TG S/N/H/F/G > 4.0CM,8586.0,5580.9,0.01,8586.0,87
CDM,76100335,EXC B9 LESION MRGN XCP SK TG T/A/L 0.6-1.0 CM,1199.0,779.35,0.01,3443.0,87
CDM,76100340,EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M 0.5CM/<,2111.0,1372.15,0.01,4337.0,87
CDM,76100345,EXC B9 LESION MRGN XCP SK TG T/A/L 1.1-2.0 CM,2111.0,1372.15,0.01,4392.0,87
CDM,76100350,EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 0.6-1.0CM,2111.0,1372.15,0.01,4392.0,87
CDM,76100355,EXC B9 LESION MRGN XCP SK TG T/A/L 2.1-3.0 CM,2111.0,1372.15,0.01,4392.0,87
CDM,76100360,EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 1.1-2.0CM,2111.0,1372.15,0.01,4392.0,87
CDM,76100365,EXC B9 LESION MRGN XCP SK TG T/A/L 3.1-4.0 CM,4861.0,3159.65,0.01,4861.0,87
CDM,76100370,EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 2.1-3.0CM,4861.0,3159.65,0.01,4861.0,87
CDM,76100375,EXC B9 LESION MRGN XCP SK TG T/A/L >4.0 CM,4861.0,3159.65,0.01,5265.0,87
CDM,76100380,EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 3.1-4.0CM,4861.0,3159.65,0.01,4861.0,87
CDM,76100385,EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 0.5 CM/<,4861.0,3159.65,0.01,4861.0,87
CDM,76100390,EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M > 4.0CM,8586.0,5580.9,0.01,8586.0,87
CDM,76100395,EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 0.6-1.0CM,2111.0,1372.15,0.01,4392.0,87
CDM,76100405,EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 1.1-2.0CM,4861.0,3159.65,0.01,4861.0,87
CDM,76100410,THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING,2844.0,1848.6,0.01,4392.0,87
CDM,76100415,EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 2.1-3.0CM,4861.0,3159.65,0.01,4861.0,87
CDM,76100420,EXCISION MAL LESION TRUNK/ARM/LEG 0.5 CM/<,2111.0,1372.15,0.01,3443.0,87
CDM,76100425,EXCISION MAL LESION TRUNK/ARM/LEG 0.6-1.0 CM,2111.0,1372.15,0.01,3443.0,87
CDM,76100430,EXCISION MAL LESION TRUNK/ARM/LEG 1.1-2.0 CM,1199.0,779.35,0.01,4392.0,87
CDM,76100435,EXCISION MAL LESION TRUNK/ARM/LEG 2.1-3.0 CM,2111.0,1372.15,0.01,4392.0,87
CDM,76100440,EXCISION MAL LESION TRUNK/ARM/LEG 3.1-4.0 CM,2111.0,1372.15,0.01,5265.0,87
CDM,76100445,EXCISION MALIGNANT LESION TRUNK/ARM/LEG > 4.0 CM,4861.0,3159.65,0.01,5265.0,87
CDM,76100450,EXCISION MALIGNANT LESION S/N/H/F/G 0.5 CM/<,4861.0,3159.65,0.01,4861.0,87
CDM,76100455,EXCISION MALIGNANT LESION S/N/H/F/G 0.6-1.0 CM,2111.0,1372.15,0.01,3443.0,87
CDM,76100460,EXCISION MALIGNANT LESION S/N/H/F/G 1.1-2.0 CM,2111.0,1372.15,0.01,4392.0,87
CDM,76100465,EXCISION MALIGNANT LESION S/N/H/F/G 2.1-3.0 CM,4861.0,3159.65,0.01,12500.0,87
CDM,76100470,EXCISION MALIGNANT LESION S/N/H/F/G 3.1-4.0 CM,4861.0,3159.65,0.01,5265.0,87
CDM,76100475,EXCISION MALIGNANT LESION S/N/H/F/G >4.0 CM,8586.0,5580.9,0.01,8586.0,87
CDM,76100480,EXCISION MALIGNANT LESION F/E/E/N/L 0.5 CM/<,2111.0,1372.15,0.01,4337.0,87
CDM,76100485,EXCISION MALIGNANT LESION F/E/E/N/L 0.6-1.0 CM,2111.0,1372.15,0.01,4337.0,87
CDM,76100490,EXCISION MALIGNANT LESION F/E/E/N/L 1.1-2.0 CM,2111.0,1372.15,0.01,4392.0,87
CDM,76100495,EXCISION MALIGNANT LESION F/E/E/N/L 2.1-3.0 CM,4861.0,3159.65,0.01,4861.0,87
CDM,76100500,EXCISION MALIGNANT LESION F/E/E/N/L 3.1-4.0 CM,4861.0,3159.65,0.01,5265.0,87
CDM,76100505,EXCISION MALIGNANT LESION F/E/E/N/L >4.0 CM,8586.0,5580.9,0.01,8586.0,87
CDM,76100510,TRIMMING NONDYSTROPHIC NAILS ANY NUMBER,178.0,115.7,0.01,12500.0,87
CDM,76100520,DEBRIDEMENT NAIL ANY METHOD 1-5,178.0,115.7,0.01,12500.0,87
CDM,76100525,DEBRIDEMENT NAIL ANY METHOD 6/>,178.0,115.7,0.01,12500.0,87
CDM,76100530,AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE 1,596.0,387.4,0.01,12500.0,87
CDM,76100535,AVULSION NAIL PLATE PARTIAL/COMP SIMPLE EA ADDL,536.0,348.4,0.01,3443.0,68
CDM,76100540,EVACUATION SUBUNGUAL HEMATOMA,387.0,251.55,0.01,12500.0,87
CDM,76100545,EXCISION NAIL MATRIX PERMANENT REMOVAL,1199.0,779.35,0.01,3443.0,87
CDM,76100550,BIOPSY NAIL UNIT SEPARATE PROCEDURE,2111.0,1372.15,0.01,3443.0,87
CDM,76100560,REPAIR NAIL BED,1836.0,1193.4,0.01,12500.0,87
CDM,76100570,WEDGE EXCISION SKIN NAIL FOLD,1199.0,779.35,0.01,12500.0,87
CDM,76100580,INJECTION INTRALESIONAL UP TO & INCLUD 7 LESIONS,596.0,387.4,0.01,12500.0,87
CDM,76100585,INJECTION INTRALESIONAL >7 LESIONS,596.0,387.4,0.01,12500.0,87
CDM,76100590,TATTOOING INCL MICROPIGMENTATION 6.0 CM/<,1836.0,1193.4,0.01,12500.0,87
CDM,76100595,TATTOOING INCL MICROPIGMENTATION 6.1-20.0 CM,1836.0,1193.4,0.01,12500.0,87
CDM,76100600,TATTOOING INCL MICROPIGMENTATION EA 20.0 CM,285.0,185.25,0.01,3443.0,68
CDM,76100605,SUBCUTANEOUS INJECTION FILLING MATERIAL 1 CC/<,596.0,387.4,0.01,12500.0,87
CDM,76100615,SUBCUTANEOUS INJECTION FILLING MATRL 1.1-5.0 CC,1836.0,1193.4,0.01,12500.0,87
CDM,76100620,SUBCUTANEOUS INJECTION FILLING MATRL >10.0 CC,1836.0,1193.4,0.01,12500.0,87
CDM,76100625,REMOVAL IMPLANTABLE CONTRACEPTIVE CAPSULES,2111.0,1372.15,0.01,3443.0,87
CDM,76100630,SUBCUTANEOUS HORMONE PELLET IMPLANTATION,1197.0,778.05,0.01,12500.0,87
CDM,76100635,INSERTION DRUG DELIVERY IMPLANT,387.0,251.55,0.01,12500.0,87
CDM,76100640,REMOVAL NON-BIODEGRADABLE DRUG DELIVERY IMPLANT,1197.0,778.05,0.01,12500.0,87
CDM,76100645,RMVL W/RINSJ NON-BIODEGRADABLE DRUG DLVR IMPLT,1197.0,778.05,0.01,12500.0,87
CDM,76100650,SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.5CM/<,596.0,387.4,0.01,12500.0,87
CDM,76100655,SMPL REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.6-7.5CM,596.0,387.4,0.01,12500.0,87
CDM,76100660,SIMPLE RPR SCALP/NECK/AX/GENIT/TRUNK 7.6-12.5CM,596.0,387.4,0.01,12500.0,87
CDM,76100670,SIMPLE REPAIR F/E/E/N/L/M 2.5CM/<,596.0,387.4,0.01,12500.0,87
CDM,76100675,SIMPLE REPAIR F/E/E/N/L/M 2.6CM-5.0 CM,596.0,387.4,0.01,12500.0,87
CDM,76100685,REPAIR INTERMEDIATE S/A/T/E 2.5 CM/<,1199.0,779.35,0.01,12500.0,87
CDM,76100690,REPAIR INTERMEDIATE S/A/T/E 2.6-7.5 CM,1199.0,779.35,0.01,12500.0,87
CDM,76100695,REPAIR INTERMEDIATE S/A/T/E 7.6-12.5 CM,1199.0,779.35,0.01,5265.0,87
CDM,76100700,REPAIR INTERMEDIATE S/A/T/E 12.6-20.0CM,1199.0,779.35,0.01,5265.0,87
CDM,76100710,REPAIR INTERMEDIATE N/H/F/XTRNL GENT 2.5CM/<,1199.0,779.35,0.01,12500.0,87
CDM,76100715,REPAIR INTERMEDIATE N/H/F/XTRNL GENT 2.6-7.5 CM,1199.0,779.35,0.01,12500.0,87
CDM,76100720,REPAIR INTERMEDIATE N/H/F/XTRNL GENT 7.6-12.5CM,1836.0,1193.4,0.01,5265.0,87
CDM,76100730,REPAIR INTERMEDIATE F/E/E/N/L&/MUC 2.5 CM/<,1199.0,779.35,0.01,12500.0,87
CDM,76100735,REPAIR INTERMEDIATE F/E/E/N/L&/MUC 2.6-5.0 CM,1199.0,779.35,0.01,12500.0,87
CDM,76100740,REPAIR INTERMEDIATE F/E/E/N/L&/MUC 5.1-7.5 CM,1199.0,779.35,0.01,12500.0,87
CDM,76100750,NEGATIVE PRESSURE WOUND THERAPY DME >50 SQ CM,1838.0,1194.7,0.01,1838.0,87
CDM,76100755,REPAIR COMPLEX TRUNK 1.1-2.5 CM,1836.0,1193.4,0.01,5265.0,87
CDM,76100760,REPAIR COMPLEX TRUNK EACH ADDITIONAL 5 CM/<,314.0,204.1,0.01,4392.0,69
CDM,76100765,REPAIR COMPLEX SCALP/ARM/LEG 1.1-2.5 CM,1836.0,1193.4,0.01,5265.0,87
CDM,76100770,REPAIR COMPLEX SCALP/ARM/LEG 2.6-7.5 CM,1836.0,1193.4,0.01,7813.0,87
CDM,76100775,REPAIR COMPLEX SCALP/ARM/LEG EA ADDL 5 CM/<,726.0,471.9,0.01,4392.0,69
CDM,76100780,REPAIR COMPLEX F/C/C/M/N/AX/G/H/F 1.1-2.5 CM,1199.0,779.35,0.01,5265.0,87
CDM,76100785,REPAIR COMPLEX F/C/C/M/N/AX/G/H/F 2.6-7.5 CM,1836.0,1193.4,0.01,7813.0,87
CDM,76100790,REPAIR COMPLEX F/C/C/M/N/AX/G/H/F EA ADDL 5 CM/<,1159.0,753.35,0.01,4392.0,69
CDM,76100800,REPAIR COMPLEX EYELID/NOSE/EAR/LIP 1.1-2.5 CM,1836.0,1193.4,0.01,7813.0,87
CDM,76100805,REPAIR COMPLEX EYELID/NOSE/EAR/LIP 2.6-7.5 CM,1836.0,1193.4,0.01,7813.0,87
CDM,76100810,ADJACENT TISSUE TRANSFER/REARGMT TRUNK 10 SQCM/<,5488.0,3567.2,0.01,5488.0,87
CDM,76100815,ADJNT TIS TRANSFR/REARRANGE TRUNK 10.1-30.0 SQCM,5488.0,3567.2,0.01,7813.0,87
CDM,76100820,ADJT TIS TRNSFR/REARGMT SCALP/ARM/LEG 10 SQ CM/<,5488.0,3567.2,0.01,7813.0,87
CDM,76100825,ADJT/REARRGMT SCALP/ARM/LEG 10.1-30.0 SQ CM,5488.0,3567.2,0.01,7813.0,87
CDM,76100830,ADJT TIS TRNS/REARGMT F/C/C/M/N/A/G/H/F 10SQCM/<,5488.0,3567.2,0.01,5488.0,87
CDM,76100835,ADJT/REARGMT F/C/C/M/N/AX/G/H/F 10.1-30.0 SQ CM,5488.0,3567.2,0.01,7813.0,87
CDM,76100840,ADJT TIS TRNSFR/REARRGMT E/N/E/L DFCT 10 SQ CM/<,5488.0,3567.2,0.01,7813.0,87
CDM,76100845,ADJT TIS REARGMT EYE/NOSE/EAR/LIP 10.1-30.0 SQCM,5488.0,3567.2,0.01,7813.0,87
CDM,76100850,ADJNT TIS TRNSFR/REARGMT ANY AREA 30.1-60 SQ CM,10983.0,7138.95,0.01,10983.0,87
CDM,76100855,ADJT TIS TRNSFR/REARGMT DEFEC EA ADDL 30 SQCM,3521.0,2288.65,0.01,10789.0,69
CDM,76100860,NEG PRESSURE WOUND THERAPY NON DME </= 50 SQ CM,1838.0,1194.7,0.01,1838.0,87
CDM,76100865,PREP SITE F/S/N/H/F/G/M/D GT 1ST 100 SQ CM/1PCT,1836.0,1193.4,0.01,5265.0,87
CDM,76100870,NEG PRESSURE WOUND THERAPY NON DME >50 SQ CM,1838.0,1194.7,0.01,1838.0,87
CDM,76100885,FTH/GFT FREE W/DIRECT CLOSURE TRUNK 20 CM/<,5488.0,3567.2,0.01,7813.0,87
CDM,76100895,FTH/GFT FREE W/DIRECT CLOSURE S/A/L 20 CM/<,5488.0,3567.2,0.01,5488.0,87
CDM,76100905,FTH/GFT FR W/DIR CLSR F/C/C/M/N/AX/G/H/F 20 CM/<,5488.0,3567.2,0.01,7813.0,87
CDM,76100915,FTH/GFT FREE W/DIRECT CLOSURE N/E/E/L 20 SQ CM/<,5488.0,3567.2,0.01,5488.0,87
CDM,76100920,FTH/GFT FREE W/DIR CLSR N/E/E/L EA 20 SQ CM/<,5488.0,3567.2,0.01,5488.0,69
CDM,76100925,APP SKN SUB GRFT T/A/L AREA/100SQ CM /<1ST 25,5488.0,3567.2,0.01,5488.0,87
CDM,76100930,APP SKN SUB GRFT T/A/L AREA/100SQ CM EA ADL 25SC,5488.0,3567.2,0.01,5488.0,69
CDM,76100935,APP SKN SUBGRFT T/A/L AREA/100SQ CM 1ST 100SQ CM,10983.0,7138.95,0.01,10983.0,87
CDM,76100940,APP SKN SUB GRFT T/A/L AREA>/=100SCM ADL 100SQCM,10983.0,7138.95,0.01,10983.0,69
CDM,76100945,SUB GRFT F/S/N/H/F/G/M/D <100SQ CM 1ST 25 SQ CM,5488.0,3567.2,0.01,5488.0,87
CDM,76100950,SUB GRFT F/S/N/H/F/G/M/D<100SQ CM EA ADDL25SQ CM,5488.0,3567.2,0.01,5488.0,69
CDM,76100OH,RADEX 1 PLNE BODY SECTION OTH/THN W/UROGRAPY,966.0,627.9,1.1,966.0,142
CDM,76100OH-26,RADEX 1 PLNE BODY SECTION OTH/THN W/UROGRAPY,232.0,150.8,1.1,232.0,126
CDM,76100OH-TC,RADEX 1 PLNE BODY SECTION OTH/THN W/UROGRAPY,734.0,477.1,1.1,734.0,126
CDM,76101000,FRMJ DIR/TUBE PEDCL W/WOTR FH/CH/CH/M/N/AX/G/H/F,5488.0,3567.2,0.01,7813.0,87
CDM,76101005,FRMJ DIRECT/TUBED PEDICLE W/WOTR E/N/E/L/NTRORAL,5488.0,3567.2,0.01,7813.0,87
CDM,76101010,DELAY FLAP/SCTJ FLAP EYELIDS NOSE EARS/LIPS,5488.0,3567.2,0.01,7813.0,87
CDM,76101020,FLAP ISLAND PEDICLE ANATOMIC NAMED AXIAL ARTERY,5488.0,3567.2,0.01,5488.0,87
CDM,76101025,GRAFT COMPOSITE W/PRIMARY CLOSURE DONOR AREA,5488.0,3567.2,0.01,5488.0,87
CDM,76101035,DERMABRASION TOTAL FACE,8586.0,5580.9,0.01,8586.0,87
CDM,76101040,DERMABRASION SEGMENTAL FACE,2111.0,1372.15,0.01,2351.0,87
CDM,76101045,DERMABRASION REGIONAL OTHER THAN FACE,8586.0,5580.9,0.01,8586.0,87
CDM,76101050,DERMABRASION SUPERFICIAL ANY SITE,1199.0,779.35,0.01,2351.0,87
CDM,76101055,ABRASION 1 LESION,596.0,387.4,0.01,12500.0,87
CDM,76101060,ABRASION EACH ADDITIONAL 4 LESIONS OR LESS,32.0,20.8,0.01,195.44,68
CDM,76101065,CHEMICAL PEEL FACIAL EPIDERMAL,1199.0,779.35,0.01,12500.0,87
CDM,76101070,CHEMICAL PEEL NONFACIAL EPIDERMAL,1836.0,1193.4,0.01,12500.0,87
CDM,76101105,DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ SMALL,596.0,387.4,0.01,3443.0,87
CDM,76101110,DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ MEDIUM,596.0,387.4,0.01,5265.0,87
CDM,76101120,DESTRUCTION PREMALIGNANT LESION 1ST,596.0,387.4,0.01,12500.0,87
CDM,76101125,DESTRUCTION PREMALIGNANT LESION 2-14 EA,334.0,217.1,0.01,3443.0,68
CDM,76101130,DESTRUCTION PREMALIGNANT LESION 15/>,1199.0,779.35,0.01,3443.0,87
CDM,76101135,DESTRUCTION CUTANEOUS VASC PROLIFERATIVE <10CM,1199.0,779.35,0.01,3443.0,87
CDM,76101140,DSTRJ CUTANEOUS VASCULAR LESIONS 10.0-50.0 SQ CM,1836.0,1193.4,0.01,3443.0,87
CDM,76101145,DSTRJ CUTANEOUS VASCULAR LESIONS >50.0 SQ CM,5488.0,3567.2,0.01,5488.0,87
CDM,76101150,DESTRUCTION BENIGN LESIONS UP TO 14,596.0,387.4,0.01,12500.0,87
CDM,76101155,DESTRUCTION BENIGN LESIONS 15/>,596.0,387.4,0.01,12500.0,87
CDM,76101160,CHEMICAL CAUTERIZATION OF GRANULATION TISSUE,596.0,387.4,0.01,12500.0,87
CDM,76101165,DESTRUCTION MALIGNANT LESION T/A/L 0.5 CM/<,596.0,387.4,0.01,12500.0,87
CDM,76101170,DESTRUCTION MAL LESION TRUNK/ARM/LEG 0.6-1.0 CM,596.0,387.4,0.01,12500.0,87
CDM,76101175,DESTRUCTION MAL LESION TRUNK/ARM/LEG 1.1-2.0CM,596.0,387.4,0.01,12500.0,87
CDM,76101180,DESTRUCTION MAL LESION TRUNK/ARM/LEG 2.1-3.0CM,596.0,387.4,0.01,12500.0,87
CDM,76101185,DESTRUCTION MAL LESION TRUNK/ARM/LEG 3.1-4.0CM,1199.0,779.35,0.01,12500.0,87
CDM,76101190,DESTRUCTION MAL LESION TRUNK/ARM/LEG > 4.0 CM,1199.0,779.35,0.01,4337.0,87
CDM,76101195,DESTRUCTION MALIGNANT LESION S/N/H/F/G 0.5 CM/>,596.0,387.4,0.01,12500.0,87
CDM,76101200,DESTRUCTION MALIGNANT LESION S/N/H/F/G 0.6-1.0CM,596.0,387.4,0.01,12500.0,87
CDM,76101205,DESTRUCTION MALIGNANT LESION S/N/H/F/G 1.1-2.0CM,596.0,387.4,0.01,12500.0,87
CDM,76101215,DESTRUCTION MALIGNANT LESION S/N/H/F/G 2.1-3.0CM,1199.0,779.35,0.01,12500.0,87
CDM,76101225,DSTRJ MAL LESION S/N/H/F/G LESION DIAM > 4.0 CM,1199.0,779.35,0.01,4337.0,87
CDM,76101230,DESTRUCTION MALIGNANT LESION F/E/E/N/L/M 0.5CM/<,596.0,387.4,0.01,12500.0,87
CDM,76101235,DESTRUCTION MAL LESION F/E/E/N/L/M 0.6-1.0CM,596.0,387.4,0.01,12500.0,87
CDM,76101240,DESTRUCTION MAL LESION F/E/E/N/L/M 1.1-2.0CM,596.0,387.4,0.01,12500.0,87
CDM,76101245,DESTRUCTION MAL LESION F/E/E/N/L/M 2.1-3.0CM,1199.0,779.35,0.01,12500.0,87
CDM,76101250,DESTRUCTION MAL LESION F/E/E/N/L/M 3.1-4.0CM,1836.0,1193.4,0.01,3443.0,87
CDM,76101255,DESTRUCTION MAL LESION F/E/E/N/L/M >4.0 CM,1836.0,1193.4,0.01,12500.0,87
CDM,76101260,MOHS MICROGRAPHIC H/N/H/F/G 1ST STAGE 5 BLOCKS,1836.0,1193.4,0.01,4337.0,87
CDM,76101265,MOHS MICROGRAPHIC H/N/H/F/G EACH ADDL STAGE,782.0,508.3,0.01,3443.0,68
CDM,76101270,MOHS TRUNK/ARM/LEG 1ST STAGE 5 BLOCKS,1836.0,1193.4,0.01,4337.0,87
CDM,76101275,MOHS TRUNK/ARM/LEG EA STAGE AFTER 1ST STAGE,782.0,508.3,0.01,3443.0,68
CDM,76101280,MOHS TRUNK/ARM/LEG EA ADDL BLOCK ANY STAGE,692.0,449.8,0.01,3443.0,68
CDM,76101290,LASER PROCEDURE,25.0,16.25,0.01,3443.0,85
CDM,76101295,PUNCTURE ASPIRATION CYST BREAST,2111.0,1372.15,0.01,3443.0,87
CDM,76101300,PUNCTURE ASPIRATION BREAST EACH ADDITIONAL CYST,257.0,167.05,0.01,3443.0,68
CDM,76101305,BIOPSY BREAST OPEN INCISIONAL,11488.0,7467.2,0.01,11488.0,87
CDM,76101315,EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION,11488.0,7467.2,0.01,11488.0,87
CDM,76101340,BIOPSY MUSCLE DEEP,13165.0,8557.25,0.01,13165.0,87
CDM,76101345,BIOPSY MUSCLE PERCUTANEOUS NEEDLE,7453.0,4844.45,0.01,7453.0,87
CDM,76101350,BIOPSY BONE TROCAR/NEEDLE DEEP,7453.0,4844.45,0.01,7453.0,87
CDM,76101360,INJECTION SINUS TRACT DIAGNOSTIC,1078.0,700.7,0.01,3443.0,68
CDM,76101370,INJECTION THERAPEUTIC CARPAL TUNNEL,1358.0,882.7,0.01,3443.0,87
CDM,76101375,INJECTION ENZYME PALMAR FASCIAL CORD,1358.0,882.7,0.01,12500.0,87
CDM,76101380,INJECTION 1 TENDON SHEATH/LIGAMENT APONEUROSIS,1358.0,882.7,0.01,3443.0,87
CDM,76101385,INJECTION SINGLE TENDON ORIGIN/INSERTION,1358.0,882.7,0.01,3443.0,87
CDM,76101390,INJECTION SINGLE/MLT TRIGGER POINT 1/2 MUSCLES,1358.0,882.7,0.01,3443.0,87
CDM,76101395,INJECTION SINGLE/MLT TRIGGER POINT 3/> MUSCLES,1358.0,882.7,0.01,3443.0,87
CDM,76101405,ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US,1358.0,882.7,0.01,3443.0,87
CDM,76101415,ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US,1358.0,882.7,0.01,3443.0,87
CDM,76101420,ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US,1358.0,882.7,0.01,3443.0,87
CDM,76101425,ASPIRATION&/INJECTION GANGLION CYST ANY LOCATJ,1358.0,882.7,0.01,3443.0,87
CDM,76101430,REMOVAL IMPLANT SUPERFICIAL SEPARATE PROCEDURE,7453.0,4844.45,0.01,7453.0,87
CDM,76101435,REMOVAL IMPLANT DEEP,13165.0,8557.25,0.01,13165.0,87
CDM,76101440,MNTR INTERSTITIAL FLUID PRESSURE CMPRT SYNDROME,3237.0,2104.05,0.01,3443.0,87
CDM,76101455,EXCISION TUMOR SOFT TISS FACE/SCALP SUBQ <2CM,7453.0,4844.45,0.01,12500.0,87
CDM,76101460,EXCISION TUMOR SOFT TISS FACE/SCALP SUBQ 2 CM/>,7453.0,4844.45,0.01,7453.0,87
CDM,76101465,EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL 2 CM/>,13165.0,8557.25,0.01,13165.0,87
CDM,76101470,EXCISION TORUS MANDIBULARIS,14918.0,9696.7,0.01,14918.0,87
CDM,76101475,IMPRESSION&PREPARATION SURG OBTURATOR PROSTHES,6814.0,4429.1,0.01,6814.0,87
CDM,76101480,IMPRESSION & PREPARATION ORBITAL PROSTHESIS,27212.0,17687.8,0.01,27212.0,87
CDM,76101485,IMPRESSION & PREPARATION INTERIM OBTURATOR PROST,14918.0,9696.7,0.01,14918.0,87
CDM,76101490,IMPRESSION & PREPJ DEFINITIVE OBTURATOR PROSTHES,14918.0,9696.7,0.01,14918.0,87
CDM,76101495,IMPRESSION & PREPJ MANDIBULAR RESECTION PROSTHES,27212.0,17687.8,0.01,27212.0,87
CDM,76101505,IMPRESSION & PREPJ PALATAL AUGMENTATION PROSTHES,14918.0,9696.7,0.01,14918.0,87
CDM,76101515,IMPRESSION & PREPARATION PALATAL LIFT PROSTHESIS,14918.0,9696.7,0.01,14918.0,87
CDM,76101520,IMPRESSION & PREPARATION ORAL SURGICAL SPLINT,1068.0,694.2,0.01,1573.0,87
CDM,76101525,IMPRESSION & PREPARATION AURICULAR PROSTHESIS,14918.0,9696.7,0.01,14918.0,87
CDM,76101530,IMPRESSION & PREPARATION NASAL PROSTHESIS,27212.0,17687.8,0.01,27212.0,87
CDM,76101540,NASAL STRETCH STENT,269.0,174.85,0.01,1573.0,85
CDM,76101560,GRAFT EAR CRTLG AUTOGENOUS NOSE/EAR,27212.0,17687.8,0.01,27212.0,87
CDM,76101565,RCNSTJ MANDIBLE/MAXL ENDOSTEAL IMPLANT PARTIAL,27212.0,17687.8,0.01,27212.0,87
CDM,76101570,RCNSTJ MANDIBLE/MAXL ENDOSTEAL IMPLANT COMPLETE,27212.0,17687.8,0.01,27212.0,87
CDM,76101580,CLOSED TX NASAL BONE FX W/MNPJ W/O STABILIZATION,6814.0,4429.1,0.01,6814.0,87
CDM,76101585,CLOSED TX NASAL BONE FX W/MNPJ W/STABILIZATION,14918.0,9696.7,0.01,14918.0,87
CDM,76101600,OCCLUSAL ORTHOTIC DVC,302.0,196.3,0.01,2384.51,85
CDM,76101610,BIOPSY SOFT TISSUE NECK/THORAX,7453.0,4844.45,0.01,7453.0,87
CDM,76101615,EXC TUMOR SOFT TIS NECK/ANT THORAX SUBQ 3 CM/>,13165.0,8557.25,0.01,13165.0,87
CDM,76101620,EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBQ <3CM,7453.0,4844.45,0.01,7453.0,87
CDM,76101635,EXCISION TUMOR SOFT TISSUE BACK/FLANK SUBQ <3CM,7453.0,4844.45,0.01,7453.0,87
CDM,76101640,EXCISION TUMOR SOFT TIS BACK/FLANK SUBQ 3 CM/>,7453.0,4844.45,0.01,10364.0,87
CDM,76101645,EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ <3CM,7453.0,4844.45,0.01,11545.0,87
CDM,76101650,EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ 3 CM/>,13165.0,8557.25,0.01,13165.0,87
CDM,76101665,BIOPSY SOFT TISSUE SHOULDER SUPERFICIAL,7453.0,4844.45,0.01,7453.0,87
CDM,76101670,BIOPSY SOFT TISSUE SHOULDER DEEP,13165.0,8557.25,0.01,13165.0,87
CDM,76101675,EXCISION TUMOR SOFT TISSUE SHOULDER SUBQ 3 CM/>,7453.0,4844.45,0.01,10364.0,87
CDM,76101685,EXCISION TUMOR SOFT TISSUE SHOULDER SUBQ <3CM,7453.0,4844.45,0.01,7453.0,87
CDM,76101695,CLSD TX CLAVICULAR FRACTURE W/O MANIPULATION,1103.0,716.95,0.01,4392.0,87
CDM,76101700,CLSD TX ACROMIOCLAVICULAR DISLC W/O MANIPULATION,1103.0,716.95,0.01,4392.0,87
CDM,76101705,CLOSED TX SCAPULAR FRACTURE W/O MANIPULATION,1103.0,716.95,0.01,4392.0,87
CDM,76101710,CLTX PROXIMAL HUMERAL FRACTURE W/O MANIPULATION,1103.0,716.95,0.01,3443.0,87
CDM,76101720,CLTX GREATER HUMERAL TUBEROSITY FX W/O MANJ,1103.0,716.95,0.01,3443.0,87
CDM,76101730,CLSD TX SHOULDER DISLC W/MANIPULATION W/O ANES,1103.0,716.95,0.01,4392.0,87
CDM,76101750,EXC TUMOR SOFT TISSUE UPPER ARM/ELBOW SUBQ 3CM/>,13165.0,8557.25,0.01,13165.0,87
CDM,76101755,EXC TUMOR SOFT TISS UPPER ARM/ELBOW SUBQ <3CM,7453.0,4844.45,0.01,7453.0,87
CDM,76101760,CLSD TX HUMERAL SHAFT FRACTURE W/O MANIPULATION,1103.0,716.95,0.01,4392.0,87
CDM,76101765,CLTX SPRCNDYLR/TRANSCNDYLR HUMERAL FX W/WO MANJ,1103.0,716.95,0.01,4392.0,87
CDM,76101780,CLTX HUMERAL EPICONDYLAR FX MEDIAL/LAT W/O MANJ,1103.0,716.95,0.01,4392.0,87
CDM,76101790,CLTX RDL HEAD SUBLXTJ CHLD NURSEMAID ELBW W/MANJ,1103.0,716.95,0.01,2351.0,87
CDM,76101795,CLOSED TX RADIAL HEAD/NECK FX W/O MANIPULATION,1103.0,716.95,0.01,12500.0,87
CDM,76101800,CLOSED TX RADIAL HEAD/NECK FX W/MANIPULATION,7362.0,4785.3,0.01,7362.0,87
CDM,76101805,CLOSED TX ULNAR FRACTURE PROXIMAL END W/O MANJ,1103.0,716.95,0.01,4392.0,87
CDM,76101815,BIOPSY SOFT TISSUE FOREARM&/WRIST SUPERFICIAL,7453.0,4844.45,0.01,7453.0,87
CDM,76101825,EXC TUMOR SOFT TISS FOREARM AND/WRIST SUBQ 3CM/>,7453.0,4844.45,0.01,10364.0,87
CDM,76101830,EXC TUMOR SOFT TISSUE FOREARM &/WRIST SUBQ <3CM,7453.0,4844.45,0.01,7453.0,87
CDM,76101840,CLOSED TX RADIAL SHAFT FRACTURE W/O MANIPULATION,1103.0,716.95,0.01,12500.0,87
CDM,76101845,CLOSED TX RADIAL SHAFT FRACTURE W/MANIPULATION,7362.0,4785.3,0.01,7362.0,87
CDM,76101850,CLOSED TX ULNAR SHAFT FRACTURE W/O MANIPULATION,1103.0,716.95,0.01,12500.0,87
CDM,76101855,CLOSED TX RADIAL&ULNAR SHAFT FRACTURES W/O MAN,1103.0,716.95,0.01,12500.0,87
CDM,76101860,CLOSED TX RADIAL&ULNAR SHAFT FRACTURES W/MANJ,7362.0,4785.3,0.01,7362.0,87
CDM,76101865,CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O MANJ,1103.0,716.95,0.01,12500.0,87
CDM,76101870,CLTX DSTL RDL FX/EPIPHYSL SEP W/MANJ WHEN PERF,7362.0,4785.3,0.01,7813.0,87
CDM,76101880,CLOSED TX CARPAL SCAPHOID FRACTURE W/O MANJ,1103.0,716.95,0.01,12500.0,87
CDM,76101885,CLTX CARPAL BONE FX W/O MANJ EACH BONE,1103.0,716.95,0.01,12500.0,87
CDM,76101890,CLOSED TREATMENT ULNAR STYLOID FRACTURE,1103.0,716.95,0.01,12500.0,87
CDM,76101895,DRAINAGE FINGER ABSCESS SIMPLE,914.0,594.1,0.01,12500.0,87
CDM,76101900,DRAINAGE FINGER ABSCESS COMPLICATED,7453.0,4844.45,0.01,7453.0,87
CDM,76101910,FASCIOTOMY PALMAR PERCUTANEOUS,7362.0,4785.3,0.01,10789.0,87
CDM,76101915,TENDON SHEATH INCISION,7362.0,4785.3,0.01,7362.0,87
CDM,76101920,MANIPLATN PALAR FASCIAL CRD POST INJ SINGLE CORD,1103.0,716.95,0.01,3443.0,87
CDM,76101930,CLTX METACARPAL FX W/O MANIPULATION EACH BONE,1103.0,716.95,0.01,12500.0,87
CDM,76101940,CLTX METACARPAL FX W/MANIPULATION EACH BONE,1103.0,716.95,0.01,5265.0,87
CDM,76101955,CLTX METACARPOPHALANGEAL DISLC W/MANJ W/O ANES,1103.0,716.95,0.01,12500.0,87
CDM,76101960,CLTX PHLNGL FX PROX/MIDDLE PX/F/T W/O MANJ EA,1103.0,716.95,0.01,12500.0,87
CDM,76101965,CLTX PHLNGL FX PROX/MIDDLE PX/F/T W/MANJ EA,1103.0,716.95,0.01,12500.0,87
CDM,76101975,CLTX ARTCLR FX INVG MTCRPHLNGL/IPHAL JT W/O MANJ,1103.0,716.95,0.01,12500.0,87
CDM,76101985,CLTX DSTL PHLNGL FX FNGR/THMB W/O MANJ EA,1103.0,716.95,0.01,12500.0,87
CDM,76101990,CLTX DSTL PHLNGL FX FNGR/THMB W/MANJ EA,1103.0,716.95,0.01,12500.0,87
CDM,76101995,CLTX IPHAL JT DISLC W/MANJ W/O ANES,1103.0,716.95,0.01,12500.0,87
CDM,76102015,EXC TUMOR SOFT TISSUE PELVIS & HIP SUBQ <3CM,13165.0,8557.25,0.01,13165.0,87
CDM,76102020,INJECTION HIP ARTHROGRAPHY W/O ANESTHESIA,728.0,473.2,0.01,3443.0,68
CDM,76102025,INJECT SI JOINT ARTHRGRPHY&/ANES/STEROID W/IMA,1928.0,1253.2,0.01,12500.0,69
CDM,76102040,CLTX FEM FX PROX END NCK W/O MANJ,1103.0,716.95,0.01,4392.0,87
CDM,76102050,TX SPONTAN HIP DISLC ABDCT SPLNT/TRCJ W/O ANES,1103.0,716.95,0.01,12500.0,87
CDM,76102055,I&D DEEP ABSC BURSA/HEMATOMA THIGH/KNEE REGION,13165.0,8557.25,0.01,13165.0,87
CDM,76102060,BIOPSY SOFT TISSUE THIGH/KNEE AREA SUPERFICIAL,7453.0,4844.45,0.01,7453.0,87
CDM,76102065,BIOPSY SOFT TISSUE THIGH/KNEE AREA DEEP,13165.0,8557.25,0.01,13165.0,87
CDM,76102070,EXCISION TUMOR SOFT TISSUE THIGH/KNEE SUBQ <3CM,7453.0,4844.45,0.01,7453.0,87
CDM,76102075,CLOSED TX FEMORAL SHAFT FX W/O MANIPULATION,1103.0,716.95,0.01,4392.0,87
CDM,76102085,CLTX FEM FX DSTL END MEDIAL/LAT CONDYLE W/O MANJ,1103.0,716.95,0.01,4392.0,87
CDM,76102090,CLOSED TX PATELLAR FRACTURE W/O MANIPULATION,1103.0,716.95,0.01,4392.0,87
CDM,76102095,CLTX TIBIAL FX PROXIMAL W/O MANIPULATION,1103.0,716.95,0.01,4392.0,87
CDM,76102100,CLTX INTERCONDYLAR SPI&/TUBRST FX KNE W/WO MAN,1103.0,716.95,0.01,4392.0,87
CDM,76102105,CLOSED TX PATELLAR DISLOCATION W/O ANESTHESIA,1103.0,716.95,0.01,4392.0,87
CDM,76102110,TENOTOMY PRQ ACHILLES TENDON SPX LOCAL ANES,7362.0,4785.3,0.01,7362.0,87
CDM,76102115,BIOPSY SOFT TISSUE LEG/ANKLE AREA SUPERFICIAL,7453.0,4844.45,0.01,7453.0,87
CDM,76102120,BIOPSY SOFT TISSUE LEG/ANKLE AREA DEEP,13165.0,8557.25,0.01,13165.0,87
CDM,76102130,CLTX TIBIAL SHAFT FX W/O MANIPULATION,1103.0,716.95,0.01,4392.0,87
CDM,76102135,CLTX TIBIAL SHAFT FX W/MANJ W/WO SKEL TRACJ,7362.0,4785.3,0.01,7362.0,87
CDM,76102140,CLTX MEDIAL MALLEOLUS FX W/O MANIPULATION,1103.0,716.95,0.01,4392.0,87
CDM,76102145,CLTX MEDIAL MALLS FX W/MANJ W/WO SKN/SKEL TRACJ,7362.0,4785.3,0.01,7362.0,87
CDM,76102150,CLOSED TREATMENT PST MALLEOLUS FRACTURE W/O MANJ,1103.0,716.95,0.01,4392.0,87
CDM,76102160,CLTX PROX FIBULA/SHFT FX W/O MANJ,1103.0,716.95,0.01,4392.0,87
CDM,76102165,CLTX DSTL FIBULAR FX LAT MALLS W/O MANJ,1103.0,716.95,0.01,4392.0,87
CDM,76102170,CLTX DSTL FIBULAR FX LAT MALLS W/MANJ,1103.0,716.95,0.01,4392.0,87
CDM,76102175,CLOSED TX BIMALLEOLAR ANKLE FRACTURE W/O MANJ,1103.0,716.95,0.01,4392.0,87
CDM,76102180,APPLICATION CAST ELBOW FINGER SHORT ARM,1222.0,794.3,0.01,12500.0,87
CDM,76102185,CLTX FX W8 BRG ARTCLR PRTN DSTL TIBIA W/O MANJ,1103.0,716.95,0.01,4392.0,87
CDM,76102195,REMOVAL FOREIGN BODY FOOT SUBCUTANEOUS,3237.0,2104.05,0.01,4392.0,87
CDM,76102200,REMOVAL FOREIGN BODY FOOT DEEP,7453.0,4844.45,0.01,7453.0,87
CDM,76102205,APPLICATION SHORT ARM SPLINT FOREARM-HAND STATIC,593.0,385.45,0.01,12500.0,87
CDM,76102210,TX OPEN TENDON FLEXOR TOE 1 TENDON SPX,7362.0,4785.3,0.01,7362.0,87
CDM,76102220,CLOSED TX CALCANEAL FRACTURE W/O MANIPULATION,1103.0,716.95,0.01,4392.0,87
CDM,76102225,CLOSED TX TALUS FRACTURE W/O MANIPULATION,1103.0,716.95,0.01,12500.0,87
CDM,76102230,TX TARSAL BONE FX XCP TALUS&CALCN W/O MANJ,1103.0,716.95,0.01,12500.0,87
CDM,76102235,CLOSED TX METATARSAL FRACTURE W/O MANIPULATION,1103.0,716.95,0.01,12500.0,87
CDM,76102240,CLTX FX GRT TOE PHLX/PHLG W/O MANJ,1103.0,716.95,0.01,12500.0,87
CDM,76102245,APPLICATION LONG LEG CAST THIGH-TOE,1222.0,794.3,0.01,12500.0,87
CDM,76102250,CLTX FX PHLX/PHLG OTH/THN GRT TOE W/O MANJ,1103.0,716.95,0.01,12500.0,87
CDM,76102255,CLTX FX PHLX/PHLG OTH/THN GRT TOE W/MANJ,1103.0,716.95,0.01,12500.0,87
CDM,76102260,CLOSED TREATMENT SESAMOID FRACTURE,1103.0,716.95,0.01,12500.0,87
CDM,76102265,APPLICATION SHORT LEG CAST WALKING/AMBULATORY,1222.0,794.3,0.01,12500.0,87
CDM,76102280,APPLICATION RIGID TOTAL CONTACT LEG CAST,1222.0,794.3,0.01,12500.0,87
CDM,76102285,APPL CLUBFOOT CAST MOLDING/MANJ LONG/SHORT LEG,726.0,471.9,0.01,12500.0,87
CDM,76102305,APPLICATION SHORT LEG SPLINT CALF FOOT,726.0,471.9,0.01,12500.0,87
CDM,76102315,STRAPPING ANKLE &/FOOT,726.0,471.9,0.01,12500.0,87
CDM,76102325,STRAPPING TOES,273.0,177.45,0.01,12500.0,87
CDM,76102335,STRAPPING UNNA BOOT,726.0,471.9,0.01,12500.0,87
CDM,76102345,APPL MLTLAYR COMPRES LEG BELOW KNEE W/ANKLE FOOT,726.0,471.9,0.01,12500.0,87
CDM,76102360,DRAINAGE ABSCESS/HEMATOMA NASAL INT APPROACH,1068.0,694.2,0.01,12500.0,87
CDM,76102365,DRAINAGE ABSCESS/HEMATOMA NASAL SEPTUM,2343.0,1522.95,0.01,12500.0,87
CDM,76102370,BIOPSY INTRANASAL,6814.0,4429.1,0.01,6814.0,87
CDM,76102375,EXCISION NASAL POLYP SIMPLE,6814.0,4429.1,0.01,6814.0,87
CDM,76102380,EXCISION/DESTRUCTION INTRANASAL LESION INT APPR,14918.0,9696.7,0.01,14918.0,87
CDM,76102385,EXCISION/SURGICAL PLANING SKIN NOSE RHINOPHYMA,14918.0,9696.7,0.01,14918.0,87
CDM,76102390,INJECTION TURBINATE THERAPEUTIC,2343.0,1522.95,0.01,2351.0,87
CDM,76102400,REMOVAL FOREIGN BODY INTRANASAL OFFICE PROCEDURE,593.0,385.45,0.01,12500.0,87
CDM,76102405,LYSIS INTRANASAL SYNECHIA,2343.0,1522.95,0.01,5265.0,87
CDM,76102410,REPAIR FISTULA OROMAXILLARY,27212.0,17687.8,0.01,27212.0,87
CDM,76102415,ABLTJ SOF TISS INF TURBS UNI/BI SUPFC INTRAMURAL,6814.0,4429.1,0.01,6814.0,87
CDM,76102420,CONTROL NASAL HEMORRHAGE ANTERIOR SIMPLE,593.0,385.45,0.01,12500.0,87
CDM,76102425,CONTROL NASAL HEMORRHAGE ANTERIOR COMPLEX,593.0,385.45,0.01,4392.0,87
CDM,76102430,CTRL NSL HEMRRG PST NASAL PACKS&/CAUTERY 1ST,593.0,385.45,0.01,4392.0,87
CDM,76102435,LAVAGE CANNULATION MAXILLARY SINUS,1068.0,694.2,0.01,12500.0,87
CDM,76102445,NASAL ENDOSCOPY DIAGNOSTIC UNI/BI SPX,893.0,580.45,0.01,12500.0,87
CDM,76102450,NASAL/SINUS ENDOSCOPY DX MAXILLARY SINUSOSCOPY,1786.0,1160.9,0.01,5265.0,87
CDM,76102455,NASAL/SINUS NDSC SURG W/BX POLYPECT/DBRDMT SPX,7933.0,5156.45,0.01,7933.0,87
CDM,76102470,NASAL/SINUS NDSC SURG W/DILATION FRONTAL SINUS,31843.0,20697.95,0.01,31843.0,87
CDM,76102475,INTUBATION ENDOTRACHEAL EMERGENCY PROCEDURE,1068.0,694.2,0.01,3443.0,87
CDM,76102500,LARYNGOSCOPY W/WO TRACHEOSCOPY DX EXCEPT NEWBORN,7933.0,5156.45,0.01,7933.0,87
CDM,76102505,LARYNGOSCOPE INJECTION VOCAL CORD THERAPEUTIC,16960.0,11024.0,0.01,16960.0,87
CDM,76102510,LARGSC W/NJX VOCAL CORD THER W/MICRO/TELESCOPE,16960.0,11024.0,0.01,16960.0,87
CDM,76102515,LARYNGOSCOPY FLEXIBLE DIAGNOSTIC,893.0,580.45,0.01,12500.0,87
CDM,76102520,LARYNGOSCOPY FLX/RGD TELESCOPIC W/STROBOSCOPY,1786.0,1160.9,0.01,4392.0,87
CDM,76102525,LASER VOCAL CORD POLYP,4472.0,2906.8,0.01,4472.0,85
CDM,76102530,TRACHEOBRNCHSC THRU EST TRACHS INC,2343.0,1522.95,0.01,4392.0,87
CDM,76102540,BRNCHSC INCL FLUOR GDNCE DX W/CELL WASHG SPX,7933.0,5156.45,0.01,7933.0,87
CDM,76102550,BRNCHSC BRUSHING/PROTECTED BRUSHINGS,7933.0,5156.45,0.01,7933.0,87
CDM,76102555,BRNCHSC W/BRNCL ALVEOLAR LAVAGE,7933.0,5156.45,0.01,7933.0,87
CDM,76102560,BRONCHOSCOPY BRONCHIAL/ENDOBRNCL BX 1+ SITES,7933.0,5156.45,0.01,7933.0,87
CDM,76102565,BRONCHOSCOPY W/PLMT FIDUCIAL MARKERS SINGLE/MULT,31843.0,20697.95,0.01,31843.0,87
CDM,76102570,BRONCHOSCOPY W/CPTR-ASST IMAGE-GUIDED NAVIGATION,1624.0,1055.6,0.01,3443.0,68
CDM,76102575,BRONCHOSCOPY W/TRANSBRONCHIAL LUNG BX 1 LOBE,16960.0,11024.0,0.01,16960.0,87
CDM,76102580,BRONCHOSCOPY NEEDLE BX TRACHEA MAIN STEM&/BRON,16960.0,11024.0,0.01,16960.0,87
CDM,76102585,BRNCHSC W/TRACHEAL/BRONCHIAL DILAT/CLSD RDCTJ FX,16960.0,11024.0,0.01,16960.0,87
CDM,76102590,BRONCHOSCOPY W/PLACEMENT TRACHEAL STENT,31843.0,20697.95,0.01,31843.0,87
CDM,76102595,BRONCHOSCOPY W/TRANSBRONCHIAL LUNG BX EACH LOBE,1184.0,769.6,0.01,4337.0,68
CDM,76102600,BRONCHOSCOPY W/TRANSBRONCL NDL ASPIR BX EA LOBE,1414.0,919.1,0.01,4337.0,68
CDM,76102605,BRONCHOSCOPY BALLOON OCCLUSION,31843.0,20697.95,0.01,31843.0,87
CDM,76102610,BRONCHOSCOPY W/REMOVAL FOREIGN BODY,7933.0,5156.45,0.01,7933.0,87
CDM,76102635,INSERTION INDWELLING TUNNELED PLEURAL CATHETER,16234.0,10552.1,0.01,16234.0,87
CDM,76102645,RMVL NDWELLG TUNNELED PLEURAL CATHETER W/CUFF,2844.0,1848.6,0.01,12500.0,87
CDM,76102650,THORACENTESIS NEEDLE/CATH PLEURA W/O IMAGING,2844.0,1848.6,0.01,4392.0,87
CDM,76102655,THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING,2844.0,1848.6,0.01,4392.0,87
CDM,76102660,PERQ DRAINAGE PLEURA INSERT CATH W/O IMAGING,8726.0,5671.9,0.01,8726.0,87
CDM,76102665,PERQ DRAINAGE PLEURA INSERT CATH W/IMAGING,7146.0,4644.9,0.01,7146.0,87
CDM,76102700,INTRODUCTION NEEDLE/INTRACATHETER VEIN,246.0,159.9,0.01,246.0,66
CDM,76102705,INJECTION PX PRQ TX EXTREMITY PSEUDOANEURYSM,3555.0,2310.75,0.01,3555.0,87
CDM,76102720,INJECTIONS SCLEROSANT FOR SPIDER VEINS LIM/TRNK,2297.0,1493.05,0.01,12500.0,85
CDM,76102730,INJECTION SCLEROSANT SINGLE INCMPTNT VEIN,2297.0,1493.05,0.01,12500.0,87
CDM,76102740,INJECTION SCLEROSANT MULTIPLE INCMPTNT VEINS,2297.0,1493.05,0.01,12500.0,87
CDM,76102755,ENDOVEN ABLTJ INCMPTNT VEIN XTR LASER 1ST VEIN,18098.0,11763.7,0.01,33436.0,87
CDM,76102760,ENDOVEN ABLTJ INCMPTNT VEIN XTR LASER 2ND+ VEINS,5550.0,3607.5,0.01,33436.0,69
CDM,76102775,INSERTION PICC W/O IMG GDN 5 YR/>,8932.0,5805.8,0.01,8932.0,87
CDM,76102795,COMPLETE REPLACEMENT PICC RS&I,8932.0,5805.8,0.01,8932.0,87
CDM,76102805,RMVL TUN CVC W/O SUBQ PORT/PMP,3555.0,2310.75,0.01,4392.0,87
CDM,76102815,RMVL TUN CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ,8932.0,5805.8,0.01,8932.0,87
CDM,76102825,COLLECT BLOOD FROM IMPLANT VENOUS ACCESS DEVICE,741.0,481.65,0.01,12500.0,87
CDM,76102830,COLLECT BLOOD FROM CATHETER VENOUS NOS,741.0,481.65,0.01,12500.0,87
CDM,76102840,ARTERIAL PUNCTURE WITHDRAWAL BLOOD DX,741.0,481.65,0.01,12500.0,87
CDM,76102850,STAB PHLEBT VARICOSE VEINS 1 XTR 10-20 STAB INCS,18098.0,11763.7,0.01,18098.0,87
CDM,76102855,UNLISTED VASC PROCEDURE,8607.0,5594.55,0.01,8607.0,85
CDM,76102860,BLD-DRV HEMATOP PROGEN CELL HRVG TRNSPLJ AUTOL,6557.0,4262.05,0.01,6557.0,87
CDM,76102885,DIAGNOSTIC BONE MARROW ASPIRATIONS,6481.0,4212.65,0.01,6481.0,87
CDM,76102890,DIAGNOSTIC BONE MARROW BIOPSIES,6481.0,4212.65,0.01,6481.0,87
CDM,76102900,BX/EXC LYMPH NODE NEEDLE SUPERFICIAL,6481.0,4212.65,0.01,6481.0,87
CDM,76102905,BX/EXC LYMPH NODE OPEN DEEP CERVICAL NODE,15317.0,9956.05,0.01,15317.0,87
CDM,76102910,BX/EXC LYMPH NODE OPEN SUPERFICIAL,15317.0,9956.05,0.01,15317.0,87
CDM,76102915,INJ RADIOACTIVE TRACER FOR ID OF SENTINEL NODE,1607.0,1044.55,0.01,3443.0,87
CDM,76102920,BIOPSY OF LIP,1068.0,694.2,0.01,12500.0,87
CDM,76102930,EXC LIP TRANSVRS WEDGE EXC W/PRIM CLSR,14918.0,9696.7,0.01,14918.0,87
CDM,76102935,BIOPSY VESTIBULE MOUTH,2343.0,1522.95,0.01,12500.0,87
CDM,76102940,EXC LES MUCOSA & SBMCSL VESTIBULE MOUTH W/O RPR,14918.0,9696.7,0.01,14918.0,87
CDM,76102945,EXC LESION MUCOSA & SBMCSL VESTIBULE SMPL RPR,6814.0,4429.1,0.01,6814.0,87
CDM,76102955,INTRAORAL I&D TONGUE/FLOOR LINGUAL,2343.0,1522.95,0.01,3443.0,87
CDM,76102965,INCISION LINGUAL FRENUM FRENOTOMY,6814.0,4429.1,0.01,6814.0,87
CDM,76102980,BIOPSY TONGUE ANTERIOR TWO-THIRDS,2343.0,1522.95,0.01,4392.0,87
CDM,76102985,BIOPSY TONGUE POSTERIOR ONE-THIRD,14918.0,9696.7,0.01,14918.0,87
CDM,76102990,BIOPSY FLOOR MOUTH,7453.0,4844.45,0.01,7453.0,87
CDM,76102995,EXCISION LESION TONGUE W/O CLOSURE,14918.0,9696.7,0.01,14918.0,87
CDM,76103000,EXC LESION TONGUE W/CLSR ANTERIOR TWO-THIRDS,14918.0,9696.7,0.01,14918.0,87
CDM,76103005,EXCISION LESION FLOOR MOUTH,14918.0,9696.7,0.01,14918.0,87
CDM,76103020,ALVEOLECTOMY W/CURTG OSTEITIS/SEQUESTRECTOMY,14918.0,9696.7,0.01,14918.0,87
CDM,76103030,ALVEOLOPLASTY EACH QUADRANT SPECIFY,14918.0,9696.7,0.01,14918.0,87
CDM,76103035,REMOVAL RESIDUAL ROOT,302.0,196.3,0.01,13821.0,85
CDM,76103040,BIOPSY PALATE UVULA,6814.0,4429.1,0.01,6814.0,87
CDM,76103045,EXC LESION PALATE UVULA W/O CLOSURE,14918.0,9696.7,0.01,14918.0,87
CDM,76103050,UVULECTOMY EXCISION UVULA,14918.0,9696.7,0.01,14918.0,87
CDM,76103055,"SOMNOPLASTY, PALATE, INIT TX",248.0,161.2,0.01,1573.0,85
CDM,76103060,SIALOT SUBMNDBLR SUBLNGL/PRTD UNCOMP INTRAORAL,14918.0,9696.7,0.01,14918.0,87
CDM,76103065,BIOPSY SALIVARY GLAND NEEDLE,3237.0,2104.05,0.01,3443.0,87
CDM,76103070,BIOPSY SALIVARY GLAND INCISIONAL,6814.0,4429.1,0.01,6814.0,87
CDM,76103075,DILATION SALIVARY DUCT,6814.0,4429.1,0.01,6814.0,87
CDM,76103080,I&D ABSCESS PERITONSILLAR,1068.0,694.2,0.01,4392.0,87
CDM,76103085,BIOPSY OROPHARYNX,6814.0,4429.1,0.01,6814.0,87
CDM,76103090,BIOPSY NASOPHARYNX VISIBLE LESION SIMPLE,14918.0,9696.7,0.01,14918.0,87
CDM,76103095,EXCISION/DESTRUCTION LESION PHARYNX ANY METHOD,14918.0,9696.7,0.01,14918.0,87
CDM,76103100,REMOVAL FOREIGN BODY PHARYNX,1836.0,1193.4,0.01,3443.0,87
CDM,76103110,CTRL OROPHARYNGEAL HEMORRHAGE W/SEC SURG IVNTJ,14918.0,9696.7,0.01,14918.0,87
CDM,76103120,ESOPHAGOSCOPY FLEXIBLE TRANSORAL DIAGNOSTIC,4313.0,2803.45,0.01,4392.0,87
CDM,76103150,GASTRIC BAND ADJ,224.0,145.6,0.01,3484.64,85
CDM,76103155,ENTEROSCOPY > 2ND PRTN W/PLMT PRQ TUBE,8726.0,5671.9,0.01,8726.0,87
CDM,76103160,ENTEROSCOPY > 2ND PRTN CONV GSTRST TUBE,8726.0,5671.9,0.01,8726.0,87
CDM,76103175,SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA IF PFRMD,4194.0,2726.1,0.01,4194.0,87
CDM,76103195,INCISION THROMBOSED HEMORRHOID EXTERNAL,1119.0,727.35,0.01,3443.0,87
CDM,76103200,ANOSCOPY DX W/COLLJ SPEC BR/WA SPX WHEN PRFRMD,593.0,385.45,0.01,12500.0,87
CDM,76103210,DSTRJ LESION ANUS SIMPLE CRYOSURGERY,914.0,594.1,0.01,12500.0,87
CDM,76103215,DSTRJ LESION ANUS EXTENSIVE,12615.0,8199.75,0.01,12615.0,87
CDM,76103220,BIOPSY LIVER NEEDLE PERCUTANEOUS,7453.0,4844.45,0.01,7453.0,87
CDM,76103230,ABDOM PARACENTESIS DX/THER W/O IMAGING GUIDANCE,4313.0,2803.45,0.01,5265.0,87
CDM,76103235,ABDOM PARACENTESIS DX/THER W/IMAGING GUIDANCE,4313.0,2803.45,0.01,5265.0,87
CDM,76103255,CONTRAST INJECTION PERQ RADIOLOGIC EVAL GI TUBE,1112.0,722.8,0.01,12500.0,87
CDM,76103260,LYPHOCELE SCLEROSIS VIA CATH,606.0,393.9,0.01,3443.0,85
CDM,76103265,RENAL BIOPSY PRQ TROCAR/NEEDLE,7453.0,4844.45,0.01,7453.0,87
CDM,76103280,LITHOTRIPSY XTRCORP SHOCK WAVE,15865.0,10312.25,0.01,25635.0,87
CDM,76103290,NJX VISUALIZATION ILEAL CONDUIT&/URETEROPYELOG,999.0,649.35,0.01,3443.0,68
CDM,76103300,ASPIRATION BLADDER INSERT SUPRAPUBIC CATHETER,9423.0,6124.95,0.01,9423.0,87
CDM,76103305,NJX CSTOGRAPY/VOIDING URETHROCSTOGRAPY,1048.0,681.2,0.01,1048.0,68
CDM,76103310,BLDR IRRIGATION SMPL LAVAGE &/INSTLJ,1119.0,727.35,0.01,12500.0,87
CDM,76103315,INSJ NON-NDWELLG BLADDER CATHETER,593.0,385.45,0.01,12500.0,87
CDM,76103320,INSJ TEMP NDWELLG BLADDER CATHETER SIMPLE,593.0,385.45,0.01,12500.0,87
CDM,76103325,INSJ TEMP NDWELLG BLADDER CATHETER COMPLICATED,720.0,468.0,0.01,3443.0,87
CDM,76103330,CHANGE CYSTOSTOMY TUBE SIMPLE,1119.0,727.35,0.01,3443.0,87
CDM,76103335,NDSC NJX IMPLT MATRL URT&/BLDR NCK,15865.0,10312.25,0.01,15865.0,87
CDM,76103340,BLADDER INSTILLATION ANTICARCINOGENIC AGENT,3070.0,1995.5,0.01,3070.0,87
CDM,76103345,SIMPLE CYSTOMETROGRAM,1119.0,727.35,0.01,3443.0,87
CDM,76103350,BLADDER PRESSURE MEASUREMENT DURING FILLING,1119.0,727.35,0.01,4392.0,87
CDM,76103355,COMPLEX CYSTOMETROGRAM URETHRAL PRESS PROFILE,3070.0,1995.5,284.76,4392.0,87
CDM,76103360,COMPLEX CYSTOMETROGRAM VOIDING PRESSURE STUDIES,3070.0,1995.5,0.01,12500.0,87
CDM,76103365,COMPLX CYSTOMETRO W/VOID PRESS & URETHRAL PROFIL,3070.0,1995.5,0.01,12500.0,87
CDM,76103370,COMPLEX UROFLOMETRY,1432.0,930.8,17.48,1432.0,86
CDM,76103375,EMG STDS ANAL/URTL SPHNCTR OTH/THN NDL,720.0,468.0,80.17,720.0,86
CDM,76103380,NDL EMG STDS EMG ANAL/URTL SPHNCTR ANY TQ,1119.0,727.35,0.01,4392.0,87
CDM,76103390,MEAS POST-VOIDING RESIDUAL URINE&/BLADDER CAP,273.0,177.45,0.01,12500.0,87
CDM,76103395,CYSTOURETHROSCOPY,3070.0,1995.5,0.01,4392.0,87
CDM,76103400,CYSTO W/IRRIG & EVAC MULTPLE OBSTRUCTING CLOTS,15865.0,10312.25,0.01,15865.0,87
CDM,76103405,CYSTO BLADDER W/URETERAL CATHETERIZATION,9423.0,6124.95,0.01,9423.0,87
CDM,76103410,CYSTOURETHROSCOPY WITH BIOPSY,9423.0,6124.95,0.01,9423.0,87
CDM,76103415,CYSTO W/DESTRUCTION OF LESIONS,15865.0,10312.25,0.01,15865.0,87
CDM,76103420,CYSTO W/REMOVAL OF LESIONS MINOR <0.5CM,15865.0,10312.25,0.01,15865.0,87
CDM,76103425,CYSTOURETHROSCOPY W/DEST &/RMVL MED BLADDER TUM,15865.0,10312.25,0.01,15865.0,87
CDM,76103435,CYSTO CALIBRATION DILAT URTL STRIX/STENOSIS,9423.0,6124.95,0.01,9423.0,87
CDM,76103440,CYSTOURETHROSCOPY INJ CHEMODENERVATION BLADDER,9423.0,6124.95,0.01,17833.0,87
CDM,76103450,CYSTO W/SIMPLE REMOVAL STONE & STENT,9423.0,6124.95,0.01,9423.0,87
CDM,76103455,CYSTO W/COMPLEX REMOVAL STONE & STENT,9423.0,6124.95,0.01,9423.0,87
CDM,76103465,CYSTO W/INSERT URETERAL STENT,15865.0,10312.25,0.01,15865.0,87
CDM,76103470,CYSTO W/TX URETERAL STRICTURE,15865.0,10312.25,0.01,15865.0,87
CDM,76103480,CYSTO W/URTROSCOPY&/PYELOSCOPY DX,15865.0,10312.25,0.01,15865.0,87
CDM,76103500,MEATOTOMY CUTTING MEATUS SPX EXCEPT INFANT,9423.0,6124.95,0.01,9423.0,87
CDM,76103505,BIOPSY URETHRA,9423.0,6124.95,0.01,9423.0,87
CDM,76103520,DILAT URETHRAL STRIX DILATOR MALE 1ST,1119.0,727.35,0.01,3443.0,87
CDM,76103525,DILAT URETHRAL STRIX DILATOR MALE SBSQ,593.0,385.45,0.01,3443.0,87
CDM,76103530,DILAT URETHRAL STRIX FILIFORM & FOLLWR MALE 1ST,3070.0,1995.5,0.01,3443.0,87
CDM,76103535,DILAT URETHRAL STRIX FILIFORM & FOLLWR MALE SBSQ,1119.0,727.35,0.01,3443.0,87
CDM,76103540,DILAT FEMALE URETHRA W/SUPPOSITORY&/INSTLJ INI,720.0,468.0,0.01,12500.0,87
CDM,76103545,DILAT FEMALE URT W/SUPPOSITORY&/INSTLJ SBSQ,593.0,385.45,0.01,12500.0,87
CDM,76103555,RMVL CORNEAL EPITHELIUM W/APPL CHELATING AGENT,10732.0,6975.8,0.01,12500.0,87
CDM,76103560,INSERT TEMP PROSTATIC URETH STENT W/MEASUREMENT,9423.0,6124.95,0.01,12500.0,87
CDM,76103570,PROC URINARY UNLISTD,1511.0,982.15,0.01,3443.0,85
CDM,76103575,SLITTING PREPUCE DORSAL/LAT SPX XCP NEWBORN,9423.0,6124.95,0.01,9423.0,87
CDM,76103580,DSTRJ LESION PENIS SIMPLE CHEMICAL,1838.0,1194.7,0.01,12500.0,87
CDM,76103585,DSTRJ LESION PENIS SIMPLE ELECTRODESICCATION,8414.0,5469.1,0.01,8414.0,87
CDM,76103590,DSTRJ LESION PENIS SIMPLE CRYOSURGERY,914.0,594.1,0.01,12500.0,87
CDM,76103600,DSTRJ LESION PENIS SIMPLE SURG EXCISION,8414.0,5469.1,0.01,8414.0,87
CDM,76103605,DSTRJ LESION PENIS EXTENSIVE,8414.0,5469.1,0.01,8414.0,87
CDM,76103610,BIOPSY PENIS SEPARATE PROCEDURE,7453.0,4844.45,0.01,7453.0,87
CDM,76103615,CIRCUMCISION W/CLAMP/OTH DEV W/BLOCK,9423.0,6124.95,0.01,9423.0,87
CDM,76103625,CIRCUMCISION AGE >28 DAYS,9423.0,6124.95,0.01,9423.0,87
CDM,76103630,LYSIS/EXCISION PENILE POSTCIRCUMCISION ADHESIONS,9423.0,6124.95,0.01,9423.0,87
CDM,76103635,NJX C/P/A CAVERNOSA W/PHARMACOLOGIC AGT,1119.0,727.35,0.01,12500.0,87
CDM,76103645,FORESKN MANJ W/LSS PREPUTIAL ADS&STRETCHING,1119.0,727.35,0.01,4392.0,87
CDM,76103660,PNXR ASPIR HYDROCELE TUNICA VAGIS W/WO NJX MED,3237.0,2104.05,0.01,12500.0,87
CDM,76103680,VASECTOMY UNI/BI SPX W/POSTOP SEMEN EXAMS,9423.0,6124.95,0.01,9423.0,87
CDM,76103695,PLMT INTERSTITIAL DEV RADIAT TX PROSTATE 1/MULT,6294.0,4091.1,0.01,6294.0,87
CDM,76103705,PESA,1736.0,1128.4,0.01,4337.0,85
CDM,76103710,I&D VULVA/PERINEAL ABSCESS,1399.0,909.35,0.01,4392.0,87
CDM,76103715,I&D OF BARTHOLINS GLAND ABSCESS,925.0,601.25,0.01,4392.0,87
CDM,76103725,DESTRUCTION LESIONS VULVA SIMPLE,8414.0,5469.1,0.01,8414.0,87
CDM,76103730,DESTRUCTION LESIONS VULVA EXTENSIVE,8414.0,5469.1,0.01,8414.0,87
CDM,76103735,BIOPSY VULVA/PERINEUM 1 LESION SPX,4005.0,2603.25,0.01,4392.0,87
CDM,76103740,BIOPSY VULVA/PERINEUM EACH ADDL LESION,784.0,509.6,0.01,3443.0,68
CDM,76103745,COLPOSCOPY VULVA,925.0,601.25,0.01,12500.0,87
CDM,76103750,COLPOSCOPY VULVA W/BIOPSY,1399.0,909.35,0.01,4392.0,87
CDM,76103755,DESTRUCTION VAGINAL LESIONS SIMPLE,14626.0,9506.9,0.01,14626.0,87
CDM,76103760,DESTRUCTION VAGINAL LESIONS EXTENSIVE,14626.0,9506.9,0.01,14626.0,87
CDM,76103765,BIOPSY VAGINAL MUCOSA SIMPLE,4005.0,2603.25,0.01,4392.0,87
CDM,76103775,FIT&INSJ PESSARY/OTH INTRAVAGINAL SUPPORT DEVI,925.0,601.25,0.01,12500.0,87
CDM,76103780,DIAPHRAGM/CERVICAL CAP FITTING W/INSTRUCTIONS,925.0,601.25,0.01,12500.0,87
CDM,76103790,COLPOSCOPY ENTIRE VAGINA W/CERVIX IF PRESENT,1399.0,909.35,0.01,4392.0,87
CDM,76103795,COLPOSCOPY ENTIRE VAGINA W/VAGINA/CERVIX BX,4005.0,2603.25,0.01,4392.0,87
CDM,76103800,COLPOSCOPY CERVIX UPPER/ADJACENT VAGINA,925.0,601.25,0.01,4392.0,87
CDM,76103805,COLPOSCOPY CERVIX BX CERVIX & ENDOCRV CURRETAGE,1399.0,909.35,0.01,4392.0,87
CDM,76103810,COLPOSCOPY CERVIX UPPR/ADJCNT VAGINA W/CERVIX BX,1399.0,909.35,0.01,4392.0,87
CDM,76103815,COLPOSCOPY CERVIX ENDOCERVICAL CURETTAGE,1399.0,909.35,0.01,4392.0,87
CDM,76103820,COLPOSCOPY CERVIX VAG LOOP ELTRD BX CERVIX,14626.0,9506.9,0.01,14626.0,87
CDM,76103825,COLPOSCOPY CERVIX VAG ELTRD CONIZATION CERVIX,14626.0,9506.9,0.01,14626.0,87
CDM,76103830,BIOPSY CERVIX SINGLE/MULT/EXCISION OF LESION SPX,4005.0,2603.25,0.01,4392.0,87
CDM,76103835,ENDOCERVICAL CURETTAGE NOT DONE AS PART OF D&C,4005.0,2603.25,0.01,4392.0,87
CDM,76103840,CAUTERY CERVIX ELECTRO/THERMAL,14626.0,9506.9,0.01,14626.0,87
CDM,76103845,CAUTERY CERVIX CRYOCAUTERY INITIAL/REPEAT,1399.0,909.35,0.01,4392.0,87
CDM,76103850,CONIZATION CERVIX W/WO D&C RPR ELTRD EXC,14626.0,9506.9,0.01,14626.0,87
CDM,76103855,DILATION CERVICAL CANAL INSTRUMENTAL SPX,14626.0,9506.9,0.01,14626.0,87
CDM,76103860,ENDOMETRIAL BX W/WO ENDOCERVIX BX W/O DILAT SPX,925.0,601.25,0.01,12500.0,87
CDM,76103865,ENDOMETRIAL BX CONJUNCT W/COLPOSCOPY,447.0,290.55,0.01,3443.0,68
CDM,76103870,DILATION & CURETTAGE DX&/THER NONOBSTETRIC,14626.0,9506.9,0.01,14626.0,87
CDM,76103875,INSERTION INTRAUTERINE DEVICE IUD,502.0,326.3,0.01,12500.0,67
CDM,76103880,REMOVAL INTRAUTERINE DEVICE IUD,1399.0,909.35,0.01,3443.0,87
CDM,76103885,ARTIFICIAL INSEMINATION INTRA-UTERINE,925.0,601.25,0.01,2351.0,87
CDM,76103895,CATH & SALINE/CONTRAST SONOHYSTER/HYSTEROSALPI,831.0,540.15,0.01,3443.0,68
CDM,76103905,ENDOMETRIAL CRYOABLATION W/US & ENDOMETRIAL CR,22708.0,14760.2,0.01,22708.0,87
CDM,76103910,HYSTEROSCOPY DIAGNOSTIC SEPARATE PROCEDURE,14626.0,9506.9,0.01,14626.0,87
CDM,76103915,HYSTEROSCOPY BX ENDOMETRIUM&/POLYPC W/WO D&C,14626.0,9506.9,0.01,14626.0,87
CDM,76103920,HYSTEROSCOPY LYSIS INTRAUTERINE ADHESIONS,22708.0,14760.2,0.01,22708.0,87
CDM,76103940,HYSTEROSCOPY ENDOMETRIAL ABLATION,22708.0,14760.2,0.01,33436.0,87
CDM,76103945,HYSTEROSCOPY BI TUBE OCCLUSION W/PERM IMPLNTS,22708.0,14760.2,0.01,33436.0,87
CDM,76103950,FOLLICLE PUNCTURE OOCYTE RETRIEVAL ANY METHOD,4005.0,2603.25,0.01,4392.0,87
CDM,76103955,EMBRYO TRANSFER INTRAUTERINE,4005.0,2603.25,0.01,4392.0,85
CDM,76103965,AMNIOCENTESIS DIAGNOSIC,3483.0,2263.95,0.01,3483.0,87
CDM,76103970,AMNIOCENTESIS THER AMNIOTIC FLUID RDCTJ US GUID,1217.0,791.05,0.01,3443.0,87
CDM,76103980,CHORIONIC VILLUS SAMPLING,3483.0,2263.95,0.01,12500.0,87
CDM,76103995,FETAL NONSTRESS TEST,805.0,523.25,59.72,805.0,86
CDM,76104015,INSERTION CERVICAL DILATOR SEPARATE PROCEDURE,1217.0,791.05,0.01,3443.0,87
CDM,76104040,POSTPARTUM CARE ONLY SEPARATE PROCEDURE,255.0,165.75,0.01,3443.0,69
CDM,76104045,TX MISSED ABORTION FIRST TRIMESTER SURGICAL,12718.0,8266.7,0.01,13821.0,87
CDM,76104070,ASPIRATION AND/OR INJECTION THYROID CYST,2814.0,1829.1,0.01,12500.0,87
CDM,76104085,PUNCTURE SHUNT TUBE/RESERVOIR ASPIRATION/INJ PX,4778.0,3105.7,0.01,4778.0,87
CDM,76104090,REPRGRMG PROGRAMMABLE CEREBROSPINAL SHUNT,2069.0,1344.85,0.01,5265.0,87
CDM,76104100,DIAGNOSTIC LUMBAR SPINAL PUNCTURE,4778.0,3105.7,0.01,4778.0,87
CDM,76104105,THERAPEUTIC SPINAL PUNCTURE DRAINAGE CSF,4778.0,3105.7,0.01,4778.0,87
CDM,76104110,INJECTION EPIDURAL BLOOD/CLOT PATCH,4778.0,3105.7,0.01,4778.0,87
CDM,76104115,INJX/INFUS NEUROLYT SUBST EPIDURAL CERV/THORACIC,6143.0,3992.95,0.01,6143.0,87
CDM,76104135,INJECTION PX DISCOGRAPHY EACH LEVEL LUMBAR,2103.0,1366.95,0.01,3443.0,68
CDM,76104185,ELECT ANLYS IMPLT ITHCL/EDRL PMP W/O REPRG/REFIL,2069.0,1344.85,0.01,4337.0,87
CDM,76104190,ELECT ANALYS IMPLT ITHCL/EDRL PUMP W/REPRGRMG,2069.0,1344.85,0.01,4337.0,87
CDM,76104195,ELECT ANLYS IMPLT ITHCL/EDRL PMP W/REPRG&REFIL,2069.0,1344.85,0.01,12500.0,87
CDM,76104200,ELEC ANLYS IMPLT ITHCL/EDRL PMP W/REPR PHYS/QHP,2069.0,1344.85,0.01,12500.0,87
CDM,76104230,INJECTION AA&/STRD TRIGEMINAL NERVE EACH BRANCH,2037.0,1324.05,0.01,4392.0,87
CDM,76104240,INJECTION AA&/STRD GREATER OCCIPITAL NERVE,2037.0,1324.05,0.01,4392.0,87
CDM,76104265,INJECTION AA&/STRD BRACHIAL PLEXUS W/IMG GDN,6143.0,3992.95,0.01,6143.0,87
CDM,76104270,INJECTION AA&/STRD BRACHIAL PLEXUS CONT NFS CATH,6143.0,3992.95,0.01,6143.0,87
CDM,76104280,INJECTION AA&/STRD SUPRASCAPULAR NERVE,4778.0,3105.7,0.01,4778.0,87
CDM,76104285,INJECTION AA&/STRD INTERCOSTAL NRV SINGLE LVL,4778.0,3105.7,0.01,4778.0,87
CDM,76104290,INJECTION AA&/STRD INTERCOSTAL NRV EA ADDL LVL,6143.0,3992.95,0.01,6143.0,87
CDM,76104295,INJECTION AA&/STRD ILIOINGUINAL IH NERVES,4778.0,3105.7,0.01,4778.0,87
CDM,76104300,INJECTION AA&/STRD PUDENDAL NERVE,6143.0,3992.95,0.01,6143.0,87
CDM,76104305,INJECTION AA&/STRD PARACERVICAL NERVE,4778.0,3105.7,0.01,4778.0,87
CDM,76104310,INJECTION AA&/STRD SCIATIC NERVE W/IMG GDN,4778.0,3105.7,0.01,4778.0,87
CDM,76104320,INJECTION AA&/STRD FEMORAL NERVE W/IMG GDN,4778.0,3105.7,0.01,4778.0,87
CDM,76104335,INJECTION AA&/STRD OTHER PERIPHERAL NERVE/BRANCH,4778.0,3105.7,0.01,4778.0,87
CDM,76104340,NJX AA&/STRD PLANTAR COMMON DIGITAL NERVES,2037.0,1324.05,0.01,12500.0,87
CDM,76104345,NJX AA&/STRD TFRML EPI CERVICAL/THORACIC 1 LEVEL,6143.0,3992.95,0.01,6143.0,87
CDM,76104350,NJX AA&/STRD TFRML EPI CERVICAL/THORACIC EA ADDL,1361.0,884.65,0.01,4392.0,69
CDM,76104355,NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL,6143.0,3992.95,0.01,6143.0,87
CDM,76104360,NJX AA&/STRD TFRML EPI LUMBAR/SACRAL EA ADDL,1482.0,963.3,0.01,4392.0,69
CDM,76104365,NJX DX/THER AGT PVRT FACET JT CRV/THRC 1 LEVEL,6143.0,3992.95,0.01,6143.0,87
CDM,76104370,NJX DX/THER AGT PVRT FACET JT CRV/THRC 2ND LEVEL,656.0,426.4,0.01,4392.0,69
CDM,76104375,NJX DX/THER AGT PVRT FACET JT CRV/THRC 3+ LEVEL,656.0,426.4,0.01,4392.0,69
CDM,76104380,NJX DX/THER AGT PVRT FACET JT LMBR/SAC 1 LEVEL,6143.0,3992.95,0.01,6143.0,87
CDM,76104385,NJX DX/THER AGT PVRT FACET JT LMBR/SAC 2ND LEVEL,1737.0,1129.05,0.01,4392.0,69
CDM,76104390,NJX DX/THER AGT PVRT FACET JT LMBR/SAC 3+ LEVEL,1260.0,819.0,0.01,4392.0,69
CDM,76104395,INJECTION ANES AGENT SPHENOPALATINE GANGLION,2037.0,1324.05,0.01,3443.0,87
CDM,76104405,NJX ANES STELLATE GANGLION CRV SYMPATHETIC,6143.0,3992.95,0.01,6143.0,87
CDM,76104410,INJECTION ANES SUPERIOR HYPOGASTRIC PLEXUS,6143.0,3992.95,0.01,6143.0,87
CDM,76104415,INJECTION ANES LMBR/THRC PARAVERTBRL SYMPATHETIC,6143.0,3992.95,0.01,6143.0,87
CDM,76104420,INJX ANES CELIAC PLEXUS W/WO RADIOLOGIC MONITRNG,6143.0,3992.95,0.01,6143.0,87
CDM,76104430,PRQ IMPLTJ NEUROSTIM ELTRD SACRAL NRVE W/IMAGING,24426.0,15876.9,0.01,24426.0,79
CDM,76104435,POST TIB NEUROSTIMULATION PRQ NEEDLE ELECTRODE,2037.0,1324.05,0.01,5265.0,87
CDM,76104440,REVJ/RMVL PERIPHERAL NEUROSTIMULATOR ELECTRODE,23729.0,15423.85,0.01,23729.0,87
CDM,76104455,DSTRJ NEURLYTIC TRIGEM NRV 2/3 DIV RADIO MONITOR,13474.0,8758.1,0.01,13474.0,87
CDM,76104460,CHEMODENERV PAROTID&SUBMANDIBL SALIVARY GLNDS,2037.0,1324.05,0.01,12500.0,87
CDM,76104465,CHEMODNRVTJ MUSC MUSC INNERVATED FACIAL NRV UNIL,2037.0,1324.05,0.01,3443.0,87
CDM,76104480,CHEMODERVATE FACIAL/TRIGEM/CERV MUSC MIGRAINE,2037.0,1324.05,0.01,12500.0,87
CDM,76104485,DSTRJ NEUROLYTIC AGENT INTERCOSTAL NERVE,6143.0,3992.95,0.01,6143.0,87
CDM,76104510,DSTRJ NEUROLYTIC AGENT PUDENDAL NERVE,6143.0,3992.95,0.01,6143.0,87
CDM,76104515,DSTRJ NEUROLYTIC PLANTAR COMMON DIGITAL NERVE,2037.0,1324.05,0.01,12500.0,87
CDM,76104520,DSTR NROLYTC AGNT PARVERTEB FCT SNGL CRVCL/THORA,13474.0,8758.1,0.01,13474.0,87
CDM,76104525,DSTR NROLYTC AGNT PARVERTEB FCT ADDL CRVCL/THORA,914.0,594.1,0.01,4392.0,69
CDM,76104530,DSTR NROLYTC AGNT PARVERTEB FCT SNGL LMBR/SACRAL,13474.0,8758.1,0.01,13474.0,87
CDM,76104535,DSTR NROLYTC AGNT PARVERTEB FCT ADDL LMBR/SACRAL,3267.0,2123.55,0.01,4392.0,69
CDM,76104540,DSTRJ NEUROLYTIC AGENT OTHER PERIPHERAL NERVE,6143.0,3992.95,0.01,6143.0,87
CDM,76104545,CHEMODENERVATION ECCRINE GLANDS BOTH AXILLAE,2037.0,1324.05,0.01,3443.0,87
CDM,76104550,CHEMODENERVATION ECCRINE GLANDS OTH AREA PER DAY,2037.0,1324.05,0.01,3443.0,87
CDM,76104555,DSTRJ NEUROLYTIC W/WO RAD MONITOR CELIAC PLEXUS,6143.0,3992.95,0.01,6143.0,87
CDM,76104560,DSTRJ NULYT W/WORAD MNTR SUPRIOR HYPOGSTR PLEXUS,6143.0,3992.95,0.01,6143.0,87
CDM,76104570,"UNLISTED PROCEDURE, NERVOUS",268.0,174.2,0.01,3443.0,85
CDM,76104575,REMOVAL FB EYE CONJUNCTIVAL SUPERFICIAL,593.0,385.45,0.01,12500.0,87
CDM,76104580,RMVL FB XTRNL EYE EMBED SCJNCL/SCLERAL NONPERFOR,1836.0,1193.4,0.01,12500.0,87
CDM,76104590,RMVL FB XTRNL EYE CORNEAL W/SLIT LAMP,593.0,385.45,0.01,12500.0,87
CDM,76104600,CORNEA SCRAPING DIAGNOSTIC SMEAR &/CULTURE,1836.0,1193.4,0.01,12500.0,87
CDM,76104605,RMVL CORNEAL EPITHELIUM W/WO CHEMOCAUTERIZATION,4455.0,2895.75,0.01,4455.0,87
CDM,76104620,MULTIPLE PUNCTURES ANTERIOR CORNEA,10732.0,6975.8,0.01,10732.0,87
CDM,76104635,PLACE AMNIOTIC MEMBRA OCULAR SURFACE W/O SUTURES,4455.0,2895.75,0.01,13821.0,87
CDM,76104645,PARACENTSIS ANT CHAMB EYE ASPIR AQUEOUS SPX,10491.0,6819.15,0.01,10491.0,87
CDM,76104650,TRABECULOPLASTY BY LASER SURGERY,2524.0,1640.6,0.01,4392.0,87
CDM,76104655,SEVERING ADHESIONS ANTERIOR SEGMENT LASER SPX,2524.0,1640.6,0.01,7966.0,87
CDM,76104660,INJX ANTERIOR CHAMBER EYE AIR/LIQUID SPX,10491.0,6819.15,0.01,10491.0,87
CDM,76104670,REVJ/RPR OPRATIVE WOUND ANTERIOR SEGMENT,10732.0,6975.8,0.01,10732.0,87
CDM,76104675,IRIDOTOMY/IRRIDECTOMY LASER SURG PER SESSION,2524.0,1640.6,0.01,7813.0,87
CDM,76104680,IRIDOPLASTY PHOTOCOAGULATION 1/> SESSIONS,2524.0,1640.6,0.01,3443.0,87
CDM,76104685,POST-CATARACT LASER SURGERY,2524.0,1640.6,0.01,5265.0,87
CDM,76104690,PHOTOTHERAPEUTIC KERATECTOMY,2154.0,1400.1,0.01,2154.0,67
CDM,76104705,ASPIRATION/RELEASE VITREOUS SUBRETINAL/CHOROIDAL,10491.0,6819.15,0.01,10491.0,87
CDM,76104715,INTRAVITREAL NJX PHARMACOLOGIC AGT SPX,1526.0,991.9,0.01,3443.0,87
CDM,76104720,SEVERING VITREOUS STRANS LASER 1/> STAGES,2524.0,1640.6,0.01,5265.0,87
CDM,76104730,PROPH RETINAL DTCHMNT W/O DRG PHOTOCOAGULATION,2524.0,1640.6,0.01,5265.0,87
CDM,76104740,DSTRJ LOCLZD LESION RETINA 1/> SESS PC,2524.0,1640.6,0.01,10651.0,87
CDM,76104745,DSTRJ LESION CHOROID PC 1/> SESS,2524.0,1640.6,0.01,4392.0,87
CDM,76104750,DSTRJ LESION CHOROID PHOTODYNAMIC THERAPY,2524.0,1640.6,0.01,3443.0,87
CDM,76104760,TREATMENT EXTENSIVE RETINOPATHY PHOTOCOAGULATION,2524.0,1640.6,0.01,5265.0,87
CDM,76104775,RETROBULBAR INJECTION MEDICATION SPX,1375.0,893.75,0.01,12500.0,87
CDM,76104780,RETROBULBAR INJECTION ALCOHOL,1375.0,893.75,0.01,3443.0,87
CDM,76104785,INJECTION MEDICATION/OTHER SUBST TENON CAPSULE,1375.0,893.75,0.01,3443.0,87
CDM,76104790,BLEPHAROTOMY DRAINAGE ABSCESS EYELID,1375.0,893.75,0.01,3443.0,87
CDM,76104805,SNIP INCISION LACRIMAL PUNCTUM,1375.0,893.75,0.01,3443.0,87
CDM,76104810,EXCISION CHALAZION SINGLE,1375.0,893.75,0.01,3443.0,87
CDM,76104815,EXCISION CHALAZION MULTIPLE SAME LID,4455.0,2895.75,0.01,4455.0,87
CDM,76104820,EXCISION CHALAZION MULTIPLE DIFFERENT LIDS,1375.0,893.75,0.01,3443.0,87
CDM,76104825,INCISIONAL BIOPSY EYELID SKIN & LID MARGIN,1375.0,893.75,0.01,3443.0,87
CDM,76104830,CORRECTION TRICHIASIS EPILATION FORCEPS ONLY,593.0,385.45,0.01,12500.0,87
CDM,76104835,CORRECTION TRICHIASIS EPILATION OTH/THAN FORCEPS,1375.0,893.75,0.01,2351.0,87
CDM,76104840,EXC LESION EYELID W/O CLSR/W/SIMPLE DIR CLOSURE,4455.0,2895.75,0.01,4455.0,87
CDM,76104845,TEMPORARY CLOSURE EYELIDS SUTURE,4455.0,2895.75,0.01,4455.0,87
CDM,76104850,CONSTJ INTERMARGIN ADHES/TARSORRH/CANTHORRHAPY,10732.0,6975.8,0.01,10732.0,87
CDM,76104855,CORRJ LAGOPHTHALMOS IMPLTJ UPR EYELID LID LOAD,10732.0,6975.8,0.01,10732.0,87
CDM,76104860,REPAIR ECTROPION EXTENSIVE,10732.0,6975.8,0.01,10789.0,87
CDM,76104865,REMOVAL EMBEDDED FOREIGN BODY EYELID,1375.0,893.75,0.01,12500.0,87
CDM,76104875,INCISION CONJUNCTIVA DRAINAGE OF CYST,4455.0,2895.75,0.01,4455.0,87
CDM,76104880,BIOPSY CONJUNCTIVA,10732.0,6975.8,0.01,10732.0,87
CDM,76104885,EXCISION LESION CONJUNCTIVA </1 CM,10732.0,6975.8,0.01,10732.0,87
CDM,76104890,EXCISION LESION CONJUNCTIVA > 1 CM,10732.0,6975.8,0.01,10732.0,87
CDM,76104900,SUBCONJUNCTIVAL INJECTION,1836.0,1193.4,0.01,12500.0,87
CDM,76104910,RMVL FB/DACRYOLITH LACRIMAL PASSAGES,1375.0,893.75,0.01,12500.0,87
CDM,76104915,CLSR LACRIMAL PUNCTUM THERMOCAUT LIG/LASER,1375.0,893.75,0.01,12500.0,87
CDM,76104920,CLSR LACRIMAL PUNCTUM PLUG EACH,1375.0,893.75,0.01,12500.0,87
CDM,76104925,DILATION LACRIMAL PUNCTUM W/WO IRRGATION,1836.0,1193.4,0.01,12500.0,87
CDM,76104930,PROBE NASOLACRIMAL DUCT W/WO IRRIGATION,1375.0,893.75,0.01,4392.0,87
CDM,76104935,PROBE LACRIMAL CANALICULI W/WO IRRIGATION,1375.0,893.75,0.01,12500.0,87
CDM,76104940,DRAINAGE EXTERNAL EAR ABSCESS/HEMATOMA SIMPLE,2814.0,1829.1,0.01,12500.0,87
CDM,76104945,DRAINAGE EXTERNAL EAR ABSCESS/HEMATOMA CMPLX,6481.0,4212.65,0.01,6481.0,87
CDM,76104950,DRAINAGE EXTERNAL AUDITORY CANAL ABSCESS,2814.0,1829.1,0.01,12500.0,87
CDM,76104955,EAR PIERCING,32.0,20.8,0.01,73.83,67
CDM,76104965,BIOPSY EXTERNAL EAR,929.0,603.85,0.01,2351.0,87
CDM,76104970,BIOPSY EXTERNAL AUDITORY CANAL,5925.0,3851.25,0.01,5925.0,87
CDM,76104985,RMVL FB XTRNL AUDITORY CANAL W/O ANES,516.0,335.4,0.01,12500.0,87
CDM,76104990,REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT,238.0,154.7,0.01,12500.0,87
CDM,76104995,DEBRIDEMENT MASTOIDECTOMY CAVITY SIMPLE,795.0,516.75,0.01,12500.0,87
CDM,76105000,DEBRIDEMENT MASTOIDECTOMY CAVITY CMPLX,2037.0,1324.05,0.01,4392.0,87
CDM,76105010,MYRINGOTOMY ASPIR&/EUSTACHIAN TUBE NFLTJ,929.0,603.85,0.01,7431.0,87
CDM,76105020,TYMPANOSTOMY LOCAL/TOPICAL ANESTHESIA,2037.0,1324.05,0.01,7431.0,87
CDM,76105025,TYMPANIC MEMB RPR W/WO PREPJ PERFOR PATCH,5925.0,3851.25,0.01,7431.0,87
CDM,76105035,LABYRINTHOTOMY TRANSCANAL,5925.0,3851.25,0.01,13821.0,87
CDM,76105040,DIALYSIS OTH/THN HEMODIALY REPEAT PHYS/QHP EVALS,5256.0,3416.4,0.01,5256.0,69
CDM,76105050,CARDIOPULMONARY RESUSCITATION,1791.0,1164.15,0.01,1791.0,87
CDM,76105060,IRRIGAJ IMPLNTD VENOUS ACCESS DRUG DELIVERY SYST,410.0,266.5,0.01,410.0,87
CDM,76105065,UNLISTED SPECIAL DERM SERVICE,27.0,17.55,0.01,335.72,85
CDM,76105070,DEBRIDEMENT OPEN WOUND 20 SQ CM/<,914.0,594.1,0.01,3443.0,87
CDM,76105075,DEBRIDEMENT OPEN WOUND EACH ADDITIONAL 20 SQ CM,746.0,484.9,0.01,3443.0,68
CDM,76105080,RMVL DEVITAL TISS N-SLCTV DBRDMT W/O ANES 1 SESS,914.0,594.1,0.01,914.0,85
CDM,76105085,NEGATIVE PRESSURE WOUND THERAPY DME </= 50 SQ CM,914.0,594.1,0.01,914.0,87
CDM,76105125,INJ SACROILIAC JOINT ANES,2770.0,1800.5,0.01,4392.0,85
CDM,76105130,"MEDICARE ONLY, REM IMP EAR WAX",122.0,79.3,0.01,122.0,68
CDM,76105155,INSERTION UTERINE TANDEM&/VAGINAL OVOIDS,22708.0,14760.2,319.02,22708.0,87
CDM,76105165,INSERTION VAGINAL RADIATION DEVICE,1399.0,909.35,0.01,4337.0,87
CDM,76105175,CLTX HUMERAL CONDYLAR FX MEDIAL/LAT W/O MANJ,1103.0,716.95,0.01,4392.0,87
CDM,76105185,CLOSED TX BIMALLEOLAR ANKLE FRACTURE W/MANJ,7362.0,4785.3,0.01,7362.0,87
CDM,76105210,APPLICATION CAST SHOULDER HAND LONG ARM,1222.0,794.3,0.01,12500.0,87
CDM,76105215,APPLICATION CAST HAND & LOWER FOREARM GAUNTLET,726.0,471.9,0.01,12500.0,87
CDM,76105220,APPLICATION LONG ARM SPLINT SHOULDER HAND,726.0,471.9,0.01,12500.0,87
CDM,76105230,APPLICATION FINGER SPLINT STATIC,593.0,385.45,0.01,12500.0,87
CDM,76105240,STRAPPING SHOULDER,593.0,385.45,0.01,12500.0,87
CDM,76105245,STRAPPING HAND/FINGER,273.0,177.45,0.01,12500.0,87
CDM,76105255,APPLICATION LONG LEG CAST WALKER/AMBULATORY TYPE,1222.0,794.3,0.01,12500.0,87
CDM,76105275,APPLICATION SHORT LEG CAST BELOW KNEE-TOE,1222.0,794.3,0.01,12500.0,87
CDM,76105285,EXC OSS TUBEROSITIES DENTOALVEOLAR STRUXS,27212.0,17687.8,0.01,27212.0,87
CDM,76105290,BRNCHSC W/PLACEMENT BRNCL STENT 1ST BRONCHUS,31843.0,20697.95,0.01,31843.0,87
CDM,76105295,BRONCHOSCOPY EACH MAJOR BRONCHUS STENTED,2314.0,1504.1,0.01,4392.0,69
CDM,76105300,BRNCHSC REVJ TRACHEAL/BRNCL STENT INS PREV SESS,31843.0,20697.95,0.01,31843.0,87
CDM,76105305,BRONCHOSCOPY W/EXCISION TUMOR,16960.0,11024.0,0.01,16960.0,87
CDM,76105310,BRNCHSC W/DSTRJ TUM RELIEF STENOSIS OTH/THN EXC,16960.0,11024.0,0.01,16960.0,87
CDM,76105320,BRONCHOSCOPY W/THER ASPIR TRACHBRNCL TREE 1ST,7933.0,5156.45,0.01,7933.0,87
CDM,76105325,BRNCHSC OCCLUSION&INSERT BRONCH VALVE INIT LOBE,31843.0,20697.95,0.01,31843.0,87
CDM,76105335,BRNCHSC REMOVAL BRONCHIAL VALVE INITIAL,16960.0,11024.0,0.01,16960.0,87
CDM,76105340,BRNCHSC REMOVAL BRONCHIAL VALVE EA ADDL,7933.0,5156.45,0.01,7933.0,87
CDM,76105345,BRNCHSC OCCLUSION&INSERT BRONCH VALVE ADDL LOBE,3286.0,2135.9,0.01,11545.0,69
CDM,76105350,BRONCHOSCOPIC THERMOPLASTY ONE LOBE,31843.0,20697.95,0.01,31843.0,87
CDM,76105355,BRONCHOSCOPIC THERMOPLASTY 2/> LOBES,31843.0,20697.95,0.01,31843.0,87
CDM,76105360,CATHETER ASPIRATION NASOTRACHEAL SPX,936.0,608.4,0.01,4392.0,87
CDM,76105365,TTRACH INTRO NDL WIRE DIL/STENT/TUBE O2 THER,7933.0,5156.45,0.01,7933.0,79
CDM,76105370,SURG CLSR TRACHEOSTOMY/FISTULA W/O PLASTIC RPR,14918.0,9696.7,0.01,14918.0,79
CDM,76105395,STAB PHLEBT VARICOSE VEINS 1 XTR > 20 INCS,18098.0,11763.7,0.01,18098.0,87
CDM,76105400,INJECTION SCLEROSING SOLUTION HEMORRHOIDS,4194.0,2726.1,0.01,4194.0,87
CDM,76105405,DSTRJ LESION ANUS SIMPLE CHEMICAL,1838.0,1194.7,0.01,3443.0,87
CDM,76105410,CYSTO W/REMOVAL OF TUMORS SMALL,15865.0,10312.25,0.01,15865.0,87
CDM,76105430,VERMILIONECTOMY LIP SHV W/MUCOSAL ADVMNT,14918.0,9696.7,0.01,14918.0,87
CDM,76105445,TRNSPL PREPJ HEMATOP PROGEN RED BLD CELL RMVL,1749.0,1136.85,0.01,2351.0,85
CDM,76105455,TRNSPL PREPJ HEMATOP PROGEN PLSM VOL DEPLJ,1749.0,1136.85,0.01,2351.0,85
CDM,76105475,INCISION & REMOVAL FOREIGN BODY SUBQ TISS COMPL,4861.0,3159.65,0.01,5265.0,87
CDM,76105505,PUNCTURE ASPIRATION ABSCESS HEMATOMA BULLA/CYST,1199.0,779.35,0.01,12500.0,87
CDM,76105515,DEBRIDEMENT MUSCLE & FASCIA 20 SQ CM/<,1836.0,1193.4,0.01,5265.0,87
CDM,76105525,PARING/CUTTING BENIGN HYPERKERATOTIC LESION 2-4,596.0,387.4,0.01,12500.0,87
CDM,76105535,SHAVING SKIN LESION 1 TRUNK/ARM/LEG DIAM 0.5CM/<,1199.0,779.35,0.01,12500.0,87
CDM,76105545,SHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM >2.0 CM,1199.0,779.35,0.01,12500.0,87
CDM,76105555,SHAVING SKIN LESION 1 S/N/H/F/G DIAM 0.6-1.0 CM,596.0,387.4,0.01,12500.0,87
CDM,76105565,BX BREAST W/DEVICE 1ST LESION ULTRASOUND GUID,11180.0,7267.0,0.01,11180.0,87
CDM,76105575,BX BREAST W/DEVICE ADDL LESION ULTRASOUND GUID,2629.0,1708.85,0.01,5265.0,69
CDM,76105585,ARTHROCNT ASPIR&/INJ SMALL JT/BURSAW/US REC RPRT,1358.0,882.7,0.01,12500.0,87
CDM,76105595,ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/US,3186.0,2070.9,0.01,12500.0,87
CDM,76105605,ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/US,1358.0,882.7,0.01,12500.0,87
CDM,76105615,CLTX VRT BDY FX W/O MANJ REQ&W/CSTING/BRACING,1103.0,716.95,0.01,4392.0,87
CDM,76105625,EXC TUMOR SOFT TISS SHOULDER SUBFASC <5CM,13165.0,8557.25,0.01,13165.0,87
CDM,76105635,INCISION&DRAINAGE UPPER ARM/ELBOW BURSA,7453.0,4844.45,0.01,7453.0,87
CDM,76105645,EXC LESION TDN SHTH/JT CAPSL HAND/FNGR,7362.0,4785.3,0.01,7813.0,87
CDM,76105665,CLOSED TREATMENT COCCYGEAL FRACTURE,1103.0,716.95,0.01,12500.0,87
CDM,76105675,CLTX TRIMALLEOLAR ANKLE FX W/O MANIPULATION,1103.0,716.95,0.01,4392.0,87
CDM,76105685,TENOTOMY PERCUTANEOUS TOE SINGLE TENDON,7362.0,4785.3,0.01,7362.0,87
CDM,76105695,STRAPPING ELBOW/WRIST,273.0,177.45,0.01,12500.0,87
CDM,76105705,DBRDMT EXTENSV ECZEMA/INFECT SKN UP 10% BDY SURF,1836.0,1193.4,0.01,12500.0,87
CDM,76105715,SEPTAL REPOSITIONING,926.0,601.9,0.01,3443.0,85
CDM,76105725,NASAL/SINUS NDSC SURG W/CONTROL NASAL HEMRRG,7933.0,5156.45,0.01,7933.0,87
CDM,76105735,NASAL/SINUS NDSC SURG W/DILATION MAXILLARY SINUS,31843.0,20697.95,0.01,31843.0,87
CDM,76105745,NASAL/SINUS NDSC SURG W/DILATION SPHENOID SINUS,31843.0,20697.95,0.01,31843.0,87
CDM,76105755,LARYNGOSCOPY INDIRECT DIAGNOSTIC SPX,893.0,580.45,0.01,12500.0,87
CDM,76105765,LARYNGOSCOPY FLEXIBLE W/BIOPSY(IES),7933.0,5156.45,0.01,7933.0,87
CDM,76105775,TRACHEOSTOMY PLANNED SEPARATE PROCEDURE,14918.0,9696.7,0.01,14918.0,79
CDM,76105785,CONSTJ TRACHEOESOPHGL FSTL&INSJ SP PROSTH,14918.0,9696.7,0.01,14918.0,79
CDM,76105795,DBRDMT SUBCUTANEOUS TISSUE EA ADDL 20 SQ CM,1729.0,1123.85,0.01,5265.0,69
CDM,76105805,RPR BLOOD VESSEL DIRECT LOWER EXTREMITY,4046.0,2629.9,0.01,7966.0,87
CDM,76105815,LIG/BANDING ANGIOACCESS ARTERIOVENOUS FISTULA,18098.0,11763.7,0.01,18098.0,87
CDM,76105825,LIGJ DIVJ & STRIPPING SHORT SAPHENOUS VEIN,18098.0,11763.7,0.01,18098.0,87
CDM,76105835,LIGJ DIVJ&STRIP LONG SAPH SAPHFEM JUNCT KNE/BELW,18098.0,11763.7,0.01,18098.0,87
CDM,76105845,DRG ABSC CST HMTMA VESTIBULE MOUTH SMPL,3237.0,2104.05,0.01,12500.0,87
CDM,76105855,INCISION LABIAL FRENUM FRENOTOMY,2343.0,1522.95,0.01,12500.0,87
CDM,76105865,DSTRJ LES/SCAR VESTIBULE MOUTH PHYSICAL METHS,14918.0,9696.7,0.01,14918.0,87
CDM,76105875,ILEOSCOPY STOMA W/BALLOON DILATION,8726.0,5671.9,0.01,8726.0,87
CDM,76105885,SIGMOIDOSCOPY FLX WITH WITH BAND LIGATION(S),5424.0,3525.6,0.01,7948.0,87
CDM,76105895,COLONOSCOPY FLEXIBLE WITH BAND LIGATION(S),5424.0,3525.6,0.01,7948.0,87
CDM,76105905,I&D PERIANAL ABSCESS SUPERFICIAL,4194.0,2726.1,0.01,4392.0,87
CDM,76105915,EXCISION SINGLE EXTERNAL PAPILLA OR TAG ANUS,5424.0,3525.6,0.01,5424.0,87
CDM,76105925,HEMORRHOIDECTOMY XTRNL 2/> COLUMN/GROUP,12615.0,8199.75,0.01,12615.0,87
CDM,76105935,EXC THROMBOSED HEMORRHOID XTRNL,5424.0,3525.6,0.01,5424.0,87
CDM,76105955,REMOVAL SKN TAGS MLT FIBRQ TAGS ANY AREA UPW/15,596.0,387.4,0.01,12500.0,87
CDM,76105965,CYSTO INSERTION TRANSPROSTATIC IMPLANT SINGLE,4385.0,2850.25,0.01,7431.0,69
CDM,76105975,PRTL HYMENECTOMY/REVJ HYMENAL RING,14626.0,9506.9,0.01,14626.0,87
CDM,76105985,MYOMECTOMY 1-4 MYOMAS 250 GM/< VAGINAL APPR,14626.0,9506.9,0.01,14626.0,87
CDM,76105995,MULTIFETAL PREGNANCY REDUCTION,1217.0,791.05,0.01,2370.48,87
CDM,76106005,ECTOPIC ASPIRA W/GUIDE,777.0,505.05,0.01,3443.0,85
CDM,76106015,VENTRICULAR PUNCTURE PREVIOUS BURR HOLE W/O NJX,6143.0,3992.95,0.01,6143.0,87
CDM,76106025,TAP BLOCK UNILATERAL BY INJECTION(S),1407.0,914.55,0.01,4337.0,68
CDM,76106035,TAP BLOCK UNILATERAL BY CONTINUOUS INFUSION(S),1407.0,914.55,0.01,4337.0,68
CDM,76106045,TAP BLOCK BILATERAL BY INJECTION(S),1407.0,914.55,0.01,4337.0,68
CDM,76106055,TAP BLOCK BILATERAL BY CONTINUOUS INFUSION(S),1407.0,914.55,0.01,4337.0,68
CDM,76106065,SHAVING SKIN LESION 1 S/N/H/F/G DIAM >2.0 CM,1199.0,779.35,0.01,12500.0,87
CDM,76106075,INS/RPLC PERPH SAC/GSTRC NPG/RCVR PCKT CRTJ&CONN,27892.0,18129.8,0.01,27892.0,87
CDM,76106085,REV/RMV PRPH SAC/GSTRC NPG/RCV DTCH CONN ELTR RA,23729.0,15423.85,0.01,23729.0,87
CDM,76106095,CHEMODENERVATION MUSCLE NECK UNILAT FOR DYSTONIA,2037.0,1324.05,0.01,12500.0,87
CDM,76106105,CHEMODENERVATION MUSCLE LARYNX UNILAT W/EMG,4778.0,3105.7,0.01,12500.0,87
CDM,76106115,CHEMODENERVATION ONE EXTREMITY 1-4 MUSCLE,4778.0,3105.7,0.01,12500.0,87
CDM,76106125,CHEMODENERVATION 1 EXTREMITY EA ADDL 1-4 MUSCLE,2766.0,1797.9,0.01,4392.0,69
CDM,76106135,CHEMODENERVATION 1 EXTREMITY 5 OR MORE MUSCLES,4778.0,3105.7,0.01,12500.0,87
CDM,76106145,CHEMODENERVATION 1 EXTREMITY EA ADDL 5/> MUSCLES,2229.0,1448.85,0.01,4392.0,69
CDM,76106155,CHEMODENERVATION OF TRUNK MUSCLE 1-5 MUSCLES,4778.0,3105.7,0.01,12500.0,87
CDM,76106165,RPR LAC APPL TISSUE GLUE WOUND CORNEA&/SCLERA,10491.0,6819.15,0.01,10491.0,87
CDM,76106175,CORRECTION TRICHIASIS INCCISION LID MARGIN,4455.0,2895.75,0.01,5265.0,87
CDM,76106185,REPAIR BROW PTOSIS,10732.0,6975.8,0.01,10789.0,87
CDM,76106195,PROBE NASOLACRIMAL DUCT W/WO IRRG INSJ TUBE/STNT,10732.0,6975.8,0.01,10732.0,87
CDM,76106205,NEG PRESSURE WOUND THERAPY NON DME </= 50 SQ CM,1838.0,1194.7,0.01,1838.0,87
CDM,76106215,NEG PRESSURE WOUND THERAPY NON DME >50 SQ CM,1838.0,1194.7,0.01,1838.0,87
CDM,76106255,CYSTOURETHRO W/ADDL IMPLANT,11557.0,7512.05,0.01,15448.24,85
CDM,76106265,PROLOTHERAPY,392.0,254.8,0.01,392.0,67
CDM,76106275,SHVG SKIN LESION 1 F/E/E/N/L/M DIAM 0.6-1.0 CM,596.0,387.4,0.01,12500.0,87
CDM,76106285,REPAIR COMPLEX TRUNK 2.6-7.5 CM,1836.0,1193.4,0.01,7813.0,87
CDM,76106295,PREP SITE TRUNK/ARM/LEG 1ST 100 SQ CM/1PCT,5488.0,3567.2,0.01,5488.0,87
CDM,76106305,BX BREAST NEEDLE CORE W/O IMAGING GUIDANCE SPX,4861.0,3159.65,0.01,4861.0,87
CDM,76106315,EXC BENIGN TUMOR/CYST MAXL/ZYGOMA ENCL & CURTG,27212.0,17687.8,0.01,27212.0,87
CDM,76106325,EXCISON TUMOR SOFT TISSUE THIGH/KNEE SUBQ 3 CM/>,13165.0,8557.25,0.01,13165.0,87
CDM,76106335,NJX RETROGRADE URETHROCSTOGRAPY,1335.0,867.75,0.01,1335.0,68
CDM,76106355,NJX PLTLT PLASMA W/IMG HARVEST/PREPARATION,1596.0,1037.4,0.01,3443.0,85
CDM,76106365,IMAGE-GUIDED CATHETER FLUID COLLECTION DRAINAGE,2111.0,1372.15,0.01,12500.0,87
CDM,76106375,DBRDMT EXTNSVE ECZEMA/INFECT SKN EA 10% BDY SURF,299.0,194.35,0.01,3443.0,68
CDM,76106385,EXCISION HIDRADENITIS AXILLARY SMPL/INTRM RPR,8586.0,5580.9,0.01,8586.0,87
CDM,76106395,SIMPLE REPAIR F/E/E/N/L/M 5.1CM-7.5 CM,596.0,387.4,0.01,12500.0,87
CDM,76106405,TX SUPERFICIAL WOUND DEHISCENCE SIMPLE CLOSURE,1836.0,1193.4,0.01,4392.0,87
CDM,76106415,REPAIR INTERMEDIATE F/E/E/N/L&/MUC 7.6-12.5 CM,1199.0,779.35,0.01,5265.0,87
CDM,76106425,REPAIR COMPLX EYELID/NOSE/EAR/LIP EA ADDL 5 CM/<,603.0,391.95,0.01,7813.0,69
CDM,76106435,SPLIT AGRFT T/A/L 1ST 100 CM/&/1% BDY INFT/CHLD,5488.0,3567.2,0.01,5488.0,87
CDM,76106445,SPLIT AGRFT F/S/N/H/F/G/M/D GT 1ST 100 CM/</1 %,10983.0,7138.95,0.01,10983.0,87
CDM,76106455,FTH/GFT FR W/DIR CLSR S/A/L EA ADDL 20 CM/<,5488.0,3567.2,0.01,5488.0,69
CDM,76106465,FTH/GT FR W/DIR CLSR F/C/C/M/N/AX/G/H/F EA20CM/<,5488.0,3567.2,0.01,7813.0,69
CDM,76106475,BLEPHAROPLASTY LOWER EYELID,5488.0,3567.2,0.01,7813.0,87
CDM,76106485,BLEPHAROPLASTY UPPER EYELID,5488.0,3567.2,0.01,7813.0,87
CDM,76106495,INITIAL TX 1ST DEGREE BURN LOCAL TX,596.0,387.4,0.01,12500.0,87
CDM,76106505,DESTRUCTION MALIGNANT LESION S/N/H/F/G 3.1-4.0CM,1199.0,779.35,0.01,3443.0,87
CDM,76106515,PERQ BREAST LOC DEVICE PLACEMT 1ST LESIO US IMAG,2111.0,1372.15,0.01,4392.0,87
CDM,76106525,REMOVAL BREAST BALLOON CATH,130.0,84.5,0.01,6391.95,85
CDM,76106535,BIOPSY BONE OPEN SUPERFICIAL,13165.0,8557.25,0.01,13165.0,87
CDM,76106545,REMOVAL FOREIGN BODY MUSCLE/TENDON SHEATH SIMPLE,7453.0,4844.45,0.01,7453.0,87
CDM,76106555,RMVL FOREIGN BODY MUSCLE/TENDON SHEATH DEEP/COMP,13165.0,8557.25,0.01,13165.0,87
CDM,76106565,EXCISION BENIGN TUMOR/CYST MANDIBLE ENCL & CURT,14918.0,9696.7,0.01,14918.0,87
CDM,76106575,GRAFT BONE NASAL/MAXILLARY/MALAR AREAS,27212.0,17687.8,0.01,27212.0,87
CDM,76106585,GRAFT BONE MANDIBLE,27212.0,17687.8,0.01,27212.0,87
CDM,76106595,CLOSED TX MANDIBULAR FX W/INTERDENTAL FIXATION,27212.0,17687.8,0.01,27212.0,87
CDM,76106605,BIOPSY SOFT TISSUE BACK/FLANK SUPERFICIAL,7453.0,4844.45,0.01,7453.0,87
CDM,76106625,ABDOMINAL FAT PAD BIOPSY,2008.0,1305.2,0.01,3443.0,85
CDM,76106635,CLTX SHOULDER DISLC W/FX HUMERAL TUBRST W/MANJ,7362.0,4785.3,0.01,7362.0,87
CDM,76106645,CLTX SPRCNDYLR/TRANSCNDYLR HUMERAL FX W/MANJ,7362.0,4785.3,0.01,7362.0,87
CDM,76106655,TREATMENT CLOSED ELBOW DISLOCATION W/O ANES,1103.0,716.95,0.01,4392.0,87
CDM,76106665,EXPL W/REMOVAL DEEP FOREIGN BODY FOREARM/WRIST,7362.0,4785.3,0.01,7362.0,87
CDM,76106675,EX TUM/VASC MALF SFT TISS HAND/FNGR SUBQ 1.5CM/>,7453.0,4844.45,0.01,10364.0,87
CDM,76106685,EXC TUM/VASC MAL SFT TISS HAND/FNGR SUBQ <1.5CM,7453.0,4844.45,0.01,7453.0,87
CDM,76106695,CLTX ARTCLR FX INVG MTCARPHLNGL/IPHAL JT W/MANJ,7362.0,4785.3,0.01,7362.0,87
CDM,76106705,BIOPSY SOFT TISSUE PELVIS&HIP AREA SUPERFICIAL,7453.0,4844.45,0.01,7453.0,87
CDM,76106715,CLTX ACETABULUM HIP/SOCKT FX W/O MANJ,1103.0,716.95,0.01,12500.0,87
CDM,76106725,CLTX GREATER TROCHANTERIC FX W/O MANJ,1103.0,716.95,0.01,4392.0,87
CDM,76106735,CLTX SPRCNDYLR/TRNSCNDYLR FEM FX W/O MANJ,1103.0,716.95,0.01,5265.0,87
CDM,76106745,CLTX SPRCNDYLR/TRNSCNDYLR FEM FX W/MANJ,7362.0,4785.3,0.01,7813.0,87
CDM,76106755,EXC TUMOR SOFT TISSUE LEG/ANKLE SUBQ <3CM,7453.0,4844.45,0.01,7453.0,87
CDM,76106765,EXCISION TUMOR SOFT TISSUE LEG/ANKLE SUBQ 3 CM/>,13165.0,8557.25,0.01,13165.0,87
CDM,76106775,CLOSED TX ANKLE DISLOCATION W/O ANESTHESIA,1103.0,716.95,0.01,4392.0,87
CDM,76106785,CLTX FX GRT TOE PHLX/PHLG W/MANJ,1103.0,716.95,0.01,12500.0,87
CDM,76106795,CLTX METATARSOPHLNGL JT DISLC W/O ANES,1103.0,716.95,0.01,12500.0,87
CDM,76106805,CLTX INTERPHALANGEAL JOINT DISLOCATION W/O ANES,1103.0,716.95,0.01,12500.0,87
CDM,76106815,STRAPPING KNEE,593.0,385.45,0.01,12500.0,87
CDM,76106825,NASAL/SINUS NDSC W/PARTIAL ETHMOIDECTOMY,31843.0,20697.95,0.01,31843.0,87
CDM,76106835,INSERT PROPEL SINUS STENT,95.0,61.75,0.01,1087.99,85
CDM,76106845,TRACHEOTOMY TUBE CHANGE PRIOR TO FISTULA TRACT,1068.0,694.2,0.01,3443.0,87
CDM,76106855,BRNCHSC W/PLMT CATH INTRCV RADIOELMNT APPL,7933.0,5156.45,0.01,7933.0,87
CDM,76106865,BRNCHSC EBUS GUIDED SAMPL 1/2 NODE STATION/STRUX,16960.0,11024.0,0.01,16960.0,87
CDM,76106875,BRNCHSC EBUS GUIDED SAMPL 3/> NODE STATION/STRUX,16960.0,11024.0,0.01,16960.0,87
CDM,76106885,BRNSCHSC TNDSC EBUS DX/TX INTERVENTION PERPH LES,1777.0,1155.05,0.01,4392.0,69
CDM,76106895,SURG CLSR TRACHEOSTOMY/FISTULA W/PLASTIC RPR,14918.0,9696.7,0.01,14918.0,79
CDM,76106905,INSTLJ VIA CH TUBE/CATH AGENT FBRNLYSIS 1ST DAY,2844.0,1848.6,0.01,5265.0,87
CDM,76106915,INSTLJ CH TUBE/CATH AGENT FBRNLYSIS SBSQ DAY,2844.0,1848.6,0.01,5265.0,87
CDM,76106925,SLCTV CATH PLMT VEN SYS 1ST ORDER BRANCH,3601.0,2340.65,0.01,3601.0,68
CDM,76106945,VNPNXR 3 YEARS/> PHYS/QHP SKILL,222.0,144.3,0.01,222.0,68
CDM,76106955,INSJ NON-TUNNELED CENTRAL VENOUS CATH AGE 5 YR/>,18098.0,11763.7,0.01,18098.0,87
CDM,76106965,RPR TUN/NON-TUN CTR VAD CATH W/O SUBQ PORT/PMP,3555.0,2310.75,0.01,5265.0,87
CDM,76106975,RESCJ LIP > ONE-FOURTH W/O RCNSTJ,14918.0,9696.7,0.01,14918.0,87
CDM,76106985,PLSTC RPR SALIVARY DUX SIALODOCHOPLASTY PRIM,27212.0,17687.8,0.01,27212.0,87
CDM,76106995,NASPHARSCOPY INJ PHARYNX,3434.0,2232.1,0.01,3443.0,85
CDM,76107005,ESOPHAGOSCOPY FLEXIBLE TRANSORAL WITH BIOPSY,8726.0,5671.9,0.01,8726.0,87
CDM,76107015,IMPLANT OF SPACEOAR,4599.0,2989.35,0.01,4599.0,85
CDM,76107025,I&D ISCHIORECTAL&/PERIRECTAL ABSCESS SPX,5424.0,3525.6,0.01,7813.0,87
CDM,76107035,SCLEROTHERAPY FLUID COLLECTION PRQ W/IMG GID,7453.0,4844.45,0.01,11545.0,87
CDM,76107045,CYSTOURETHROSCOPY W/DIL BLADDER GENERAL ANESTH,9423.0,6124.95,0.01,9423.0,87
CDM,76107065,MARSUPIALIZATION BARTHOLINS GLAND CYST,14626.0,9506.9,0.01,14626.0,87
CDM,76107075,LYSIS LABIAL ADHESIONS,14626.0,9506.9,0.01,14626.0,87
CDM,76107085,COLPOCENTESIS SEPARATE PROCEDURE,22708.0,14760.2,0.01,22708.0,87
CDM,76107095,EXCISION VAGINAL CYST/TUMOR,14626.0,9506.9,0.01,14626.0,87
CDM,76107105,HYSTEROSCOPY DIV/RESCJ INTRAUTERINE SEPTUM,22708.0,14760.2,0.01,22708.0,87
CDM,76107115,NEEDLE CORE BX RECTOVAG,698.0,453.7,0.01,3443.0,85
CDM,76107125,BIOPSY THYROID PERCUTANEOUS CORE NEEDLE,2814.0,1829.1,0.01,3443.0,87
CDM,76107135,INJECTION AA&/STRD SCIATIC NRV CONT NFS CATH IMG,6143.0,3992.95,0.01,6143.0,87
CDM,76107145,PVB THORACIC SINGLE INJECTION SITE W/IMG GID,4778.0,3105.7,0.01,12500.0,87
CDM,76107155,PVB THORACIC SECOND & ADDL INJ SITE W/IMG GID,1322.0,859.3,0.01,4392.0,69
CDM,76107165,PVB THORACIC CONT CATHETER INFUSION W/IMG GID,4778.0,3105.7,0.01,12500.0,87
CDM,76107175,DSTRJ TRIGEMINAL NRV SUPRAORB INFRAORB BRANCH,6143.0,3992.95,0.01,6143.0,87
CDM,76107185,CHEMODENERVATION OF TRUNK 6 OR MORE MUSCLES,4778.0,3105.7,0.01,12500.0,87
CDM,76107195,INJX ANTERIOR CHAMBER EYE MEDICATION SPX,10491.0,6819.15,0.01,10491.0,87
CDM,76107205,RPR RETINAL DTCHMNT INJECTION AIR/OTHER GAS,10491.0,6819.15,0.01,10491.0,87
CDM,76107215,SEVERING TARSORRHAPHY,4455.0,2895.75,0.01,4455.0,87
CDM,76107225,INCISION DRAINAGE LACRIMAL SAC,10732.0,6975.8,0.01,10732.0,87
CDM,76107235,EAR PIERCING,32.0,20.8,0.01,73.83,67
CDM,76107245,REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT,238.0,154.7,0.01,12500.0,87
CDM,76107255,EAR MOLDING INTL VISIT,100.0,65.0,0.01,12500.0,85
CDM,76107265,DEBRID PURULENT MID EAR,302.0,196.3,0.01,3443.0,85
CDM,76107275,CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL,3763.0,2445.95,126.78,3763.0,87
CDM,76107325,CYSTOSCOPY PROSTATIC IMP 1-3,23385.0,15200.25,0.01,23385.0,85
CDM,76107345,EVAC MEIBOMIAN GLNDS AUTO HT& INTMT PRESS UNI,516.0,335.4,0.01,3443.0,85
CDM,76107365,BLEPHAROPLASTY UPPER EYELID W/EXCESSIVE SKIN,5488.0,3567.2,0.01,13821.0,87
CDM,76107375,REPAIR ECTROPION SUTURE,10732.0,6975.8,0.01,10732.0,87
CDM,76107385,PROPH RETINAL DTCHMNT W/O DRG CRTX DIATHERMY,1375.0,893.75,0.01,5265.0,87
CDM,76108015,TUBE THORACOSTOMY INCLUDES WATER SEAL,7146.0,4644.9,0.01,7146.0,87
CDM,76108025,EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 3.1-4.0CM,4861.0,3159.65,0.01,5265.0,87
CDM,76108035,TENOTOMY PERCUTANEOUS TOE MULTIPLE TENDON,7362.0,4785.3,0.01,7813.0,87
CDM,76108045,TRURL DSTRJ PRSTATE TISS RF THERMOTH,15865.0,10312.25,0.01,15865.0,87
CDM,76108055,CYSTOURETHROSCOPY INSERTION PERM URETHRAL STENT,15865.0,10312.25,0.01,33436.0,87
CDM,76108065,EPIDRM AGRFT T/A/L 1ST 100 CM/&/1% BDY INFT/CHLD,5488.0,3567.2,0.01,5488.0,87
CDM,76108105,TENOTOMY ELBOW LATERAL/MEDIAL PERCUTANEOUS,14925.0,9701.25,0.01,14925.0,87
CDM,76108115,EXCISION H/P/P/U SIMPLE/INTERMEDIATE REPAIR,8586.0,5580.9,0.01,8586.0,87
CDM,76108125,TENOTOMY OPEN EXTENSOR FOOT/TOE EACH TENDON,7362.0,4785.3,0.01,7362.0,87
CDM,76108135,ARTHROSCOPY KNEE DIAGNOSTIC W/WO SYNOVIAL BX SPX,14925.0,9701.25,0.01,14925.0,87
CDM,76108145,REPAIR INTERMEDIATE F/E/E/N/L&/MUC 12.6-20.0CM,1199.0,779.35,0.01,5265.0,87
CDM,76108155,RMVL SPINAL NSTIM ELTRD PRQ ARRAY INCL FLUOR,13474.0,8758.1,0.01,13474.0,87
CDM,76108165,TUBE THORACOSTOMY INCLUDES WATER SEAL,7146.0,4644.9,0.01,7146.0,87
CDM,76108195,COLLAGEN CROSS-LINKING OF CORNEA MED SEPARATE,9332.0,6065.8,0.01,9332.0,85
CDM,76108205,CLSD TX PELVIC RING FX W/O MANIPULATION,1103.0,716.95,0.01,4392.0,87
CDM,76108215,LARYNGOSCOPY FLEXIBLE ABLATJ DESTJ LESION(S) UNI,16960.0,11024.0,0.01,16960.0,87
CDM,76108225,LARYNGOSCOPY FLEXIBLE THERAPEUTIC INJECTION UNI,7933.0,5156.45,0.01,11545.0,87
CDM,76108235,LARYNGOSCOPY FLEXIBLE W/INJECTION AGMNTJ UNI,7933.0,5156.45,0.01,11545.0,87
CDM,76108245,ENDOVEN ABLTJ INCMPTNT VEIN MCHNCHEM 1ST VEIN,18098.0,11763.7,0.01,18098.0,87
CDM,76108255,ENDOVEN ABLTJ INCMPTNT VEIN MCHNCHEM SBSQ VEINS,5279.0,3431.35,0.01,5279.0,69
CDM,76108265,NJX DX/THER SBST INTRLMNR CRV/THRC W/O IMG GDN,4778.0,3105.7,0.01,4778.0,87
CDM,76108275,NJX DX/THER SBST INTRLMNR CRV/THRC W/IMG GDN,4778.0,3105.7,0.01,4778.0,87
CDM,76108285,NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN,6143.0,3992.95,0.01,6143.0,87
CDM,76108295,NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN,4778.0,3105.7,0.01,4778.0,87
CDM,76108305,NJX DX/THER SBST INTRLMNR CRV/THRC W/O IMG GDN,6143.0,3992.95,0.01,6143.0,87
CDM,76108315,NJX DX/THER SBST INTRLMNR CRV/THRC W/IMG GDN,6143.0,3992.95,0.01,6143.0,87
CDM,76108325,NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN,6143.0,3992.95,0.01,6143.0,87
CDM,76108335,NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN,6143.0,3992.95,0.01,6143.0,87
CDM,76108345,RCNSTJ EYELID FULL THICKNESS SECOND STAGE,10732.0,6975.8,0.01,10732.0,87
CDM,76108375,SECONDARY CLOSURE SURG WOUND/DEHSN EXTSV/COMPLIC,5488.0,3567.2,0.01,5488.0,87
CDM,76108385,SUB GRFT F/S/N/H/F/G/M/D >/= 100SCM 1ST 100SQ CM,5488.0,3567.2,0.01,5488.0,87
CDM,76108395,SUB GRFT F/S/N/H/F/G/M/D >/= 100SCM ADL 100SQ CM,5488.0,3567.2,0.01,5488.0,69
CDM,76108445,BIOPSY BONE TROCAR/NEEDLE SUPERFICIAL,7453.0,4844.45,0.01,7453.0,87
CDM,76108535,BRONCHOSCOPY W/THER ASPIR TRACHBRNCL TREE SBSQ,1786.0,1160.9,0.01,4392.0,87
CDM,76108635,NJX PX XTR VNGRPH W/INTRO NDL/INTRACATH,2206.0,1433.9,0.01,3443.0,68
CDM,76108645,INTRO CATHETER SUPERIOR/INFERIOR VENA CAVA,3041.0,1976.65,0.01,3443.0,68
CDM,76108655,SLCTV CATH PLMT VEN SYS 2ND ORDER/> SLCTV BRANC,3904.0,2537.6,0.01,3904.0,68
CDM,76108665,SLCTV CATHETER PLMT LEFT/RIGHT PULMONARY ARTERY,2775.0,1803.75,0.01,3443.0,68
CDM,76108675,SLCTV CATH PLMT SEGMENTAL/SUBSEGMENTAL PULM ART,3225.0,2096.25,0.01,3443.0,68
CDM,76108715,SLCTV CATHJ EA 1ST ORD THRC/BRCH/CPHLC BRNCH,7505.0,4878.25,0.01,7505.0,68
CDM,76108725,SLCTV CATHJ 1ST 2ND ORD THRC/BRCH/CPHLC BRNCH,7638.0,4964.7,0.01,7638.0,68
CDM,76108735,SLCTV CATHJ 3RD+ ORD SLCTV THRC/BRCH/CPHLC BRNCH,8125.0,5281.25,0.01,8125.0,68
CDM,76108745,SLCTV CATHJ EA 2ND+ ORD THRC/BRCH/CPHLC BRNCH,990.0,643.5,0.01,4337.0,68
CDM,76108755,SLCTV CATHJ EA 1ST ORD ABDL PEL/LXTR ART BRNCH,4013.0,2608.45,0.01,4337.0,68
CDM,76108765,SLCTV CATHJ 2ND ORDER ABDL PEL/LXTR ART BRNCH,4525.0,2941.25,0.01,4525.0,68
CDM,76108775,SLCTV CATHJ 3RD+ ORD SLCTV ABDL PEL/LXTR BRNCH,5469.0,3554.85,0.01,5469.0,68
CDM,76108785,SLCTV CATHJ EA 2ND+ ORD ABDL PEL/LXTR ART BRNCH,848.0,551.2,0.01,4337.0,68
CDM,76108795,PRQ PORTAL VEIN CATHETERIZATION ANY METHOD,1367.0,888.55,0.01,3443.0,68
CDM,76108805,VEN CATHJ SLCTV ORGAN BLD SAMPLING,1660.0,1079.0,0.01,3443.0,68
CDM,76108815,INSJ TUN VAD REQ 2 CATH 2 SITS W/SUBQ PORT,31083.0,20203.95,0.01,31083.0,87
CDM,76108825,CNTRST NJX RAD EVAL CTR VAD FLUOR IMG&REPRT,1211.0,787.15,0.01,4337.0,87
CDM,76108845,REVJ TRANSVNS INTRAHEPATIC PORTOSYSTEMIC SHUNT,20388.0,13252.2,0.01,20388.0,87
CDM,76108855,PRIM PRQ TRLUML MCHNL THRMBC N-COR N-ICRA 1ST,50428.0,32778.2,0.01,50428.0,87
CDM,76108865,PRIM PRQ TRLUML MCHNL THRMBC N-COR N-ICRA SBSQ,5539.0,3600.35,0.01,5539.0,68
CDM,76108885,PRQ TRANSLUMINAL MECHANICAL THROMBECTOMY VEIN,29774.0,19353.1,0.01,29774.0,87
CDM,76108895,PRQ TRLUML MCHNL THRMBC VEIN REPEAT TX,18098.0,11763.7,0.01,18098.0,87
CDM,76108905,TRANSCATHETER BIOPSY,31083.0,20203.95,0.01,31083.0,87
CDM,76108915,TCAT IV STENT CRV CRTD ART W/O EMBOLIC PROTECJ,19680.0,12792.0,0.01,19680.0,67
CDM,76108925,NASO/ORO-GASTRIC TUBE PLMT REQ PHYS&FLUOR GDNCE,1836.0,1193.4,0.01,12500.0,87
CDM,76108945,CHOLECYSTOSTOMY PRQ W/IMAGING & CATHETER PLMT,16234.0,10552.1,0.01,16234.0,87
CDM,76108955,BILIARY ENDO PRQ T-TUBE DX W/COLLECT SPEC BRUSH,28703.0,18656.95,0.01,28703.0,87
CDM,76108965,BILIARY NDSC PRQ T-TUBE W/BX SINGLE/MULTIPLE,28703.0,18656.95,0.01,28703.0,87
CDM,76108975,BILIARY NDSC PRQ T-TUBE W/DIL DUCT W/O STENT,16234.0,10552.1,0.01,16234.0,87
CDM,76108985,BILIARY NDSC PRQ T-TUBE DILAT STRIX W/STENT,47892.0,31129.8,0.01,47892.0,87
CDM,76109005,CNTRST NJX ASSMT ABSC/CST VIA DRG CATH/TUBE SPX,661.0,429.65,0.01,3443.0,68
CDM,76109015,RMV/RPLC INDW URET BI-S,9423.0,6124.95,0.01,9423.0,87
CDM,76109035,RMV ONLY INDW URET BI-S,9423.0,6124.95,0.01,9423.0,87
CDM,76109055,RMVL NFROS TUBE REQ FLUORO GUIDANCE,3070.0,1995.5,0.01,3443.0,87
CDM,76109085,REFILL&MAINTENANCE PUMP DRUG DLVR SPINAL/BRAIN,2289.0,1487.85,0.01,2289.0,87
CDM,76109095,MEATOTOMY CUTTING MEATUS SPX INFANT,9423.0,6124.95,0.01,9423.0,87
CDM,76109135,OFFICE/OUTPATIENT EST PT MAY NOT REQ PHYS/QHP,150.0,97.5,0.01,150.0,68
CDM,76109275,INJECTION MAMMARY DUCTOGRAM/GALACTOGRAM,486.0,315.9,0.01,3443.0,68
CDM,76109285,MYELOGRAPHY VIA LUMBAR INJECT RS&I LUMBOSACRAL,5451.0,3543.15,0.01,7948.0,87
CDM,76109295,MYELOGRAPHY VIA LUMBAR INJECTION RS&I 2+ REGIONS,5451.0,3543.15,0.01,7948.0,87
CDM,76109305,CISTERNAL/LATERAL C1-C2 PUNCTURE W/INJECTION,2037.0,1324.05,0.01,4392.0,87
CDM,76109315,BX ABDL/RETROPERITONEAL MASS PRQ NEEDLE,7453.0,4844.45,0.01,7453.0,87
CDM,76109325,PERQ BREAST LOC DEVICE PLACEMT 1ST STRTCTC GDNCE,2111.0,1372.15,0.01,4392.0,87
CDM,76109335,PERQ DEVICE PLACEMENT BREAST LOC 1ST LES W/GDNCE,4861.0,3159.65,0.01,4861.0,87
CDM,76109345,PERQ DEVICE PLACEMT BREAST LOC EA LESION W/GDNCE,4861.0,3159.65,0.01,4861.0,69
CDM,76109355,PRQ ASPIR PULPOSUS/INTERVERTEBRAL DISC/PVRT TISS,4855.0,3155.75,0.01,33436.0,87
CDM,76109365,ABLTJ 1/> RENAL TUMOR PRQ UNI RADIOFREQUENCY,26838.0,17444.7,0.01,26838.0,87
CDM,76109375,ABLATION THER 1+ PULM TUMORS PERQ RADIOFREQUENCY,26838.0,17444.7,0.01,26838.0,87
CDM,76109385,BIOPSY PLEURA PERCUTANEOUS NEEDLE,7453.0,4844.45,0.01,7453.0,87
CDM,76109435,DCMPRN FASCT LEG ANT&/LAT COMPARTMENTS ONLY,14925.0,9701.25,0.01,14925.0,87
CDM,76109445,TENOTOMY PRQ ADDUCTOR/HAMSTRING 1 TENDON SPX,14925.0,9701.25,0.01,14925.0,87
CDM,76109455,FOREHEAD FLAP W/PRESERVATION VASCULAR PEDICLE,10983.0,7138.95,0.01,10983.0,87
CDM,76109465,CRNL RELAXING INC CORRJ INDUCED ASTIGMATISM,4455.0,2895.75,0.01,10789.0,87
CDM,76109865,PERQ BREAST LOC DEVICE PLACEMT EA LESION STRTCTC,2111.0,1372.15,0.01,4392.0,69
CDM,76109875,PERQ BREAST LOC DEVICE PLACEMT EACH LES US IMAGE,2111.0,1372.15,0.01,4392.0,69
CDM,76109945,I&D EPIDIDYMIS TSTIS&/SCROTAL SPACE,9423.0,6124.95,0.01,9423.0,87
CDM,76109985,INJECTION AA&/STRD LUMBAR PLEXUS CONT NFS CATH,6143.0,3992.95,0.01,6143.0,87
CDM,76110005,NEG PRESSURE WOUND THERAPY NON DME </= 50 SQ CM,1838.0,1194.7,0.01,1838.0,87
CDM,76110035,IMPLANTATION INTRASTROMAL CORNEAL RING SEGMENTS,18505.0,12028.25,0.01,18505.0,87
CDM,76110345,MYELOGRAPHY VIA LUMBAR INJECTION RS&I CERVICAL,5451.0,3543.15,0.01,7948.0,87
CDM,76110545,EXC/FULGURATION URETHRAL CARUNCLE,9423.0,6124.95,0.01,9423.0,87
CDM,76110555,TENOTOMY SHOULDER AREA 1 TENDON,32861.0,21359.65,0.01,32861.0,87
CDM,76110585,HYSTEROSCOPY REMOVAL IMPACTED FOREIGN BODY,14626.0,9506.9,0.01,14626.0,87
CDM,76110615,TX INCOMPLETE ABORTION ANY TRIMESTER SURGICAL,12718.0,8266.7,0.01,13821.0,87
CDM,76110625,REPAIR INTERMEDIATE N/H/F/XTRNL GENT 12.6-20 CM,1836.0,1193.4,0.01,5265.0,87
CDM,76110635,INSERTION NASAL SEPTAL PROSTHESIS BUTTON,6814.0,4429.1,0.01,7813.0,87
CDM,76110645,TRIM DYSTROPHIC NAIL ANY NUMBER,238.0,154.7,0.01,238.0,87
CDM,76110655,OPHTH XM&EVAL ANES W/WO MANJ GLOBE COMPL,10732.0,6975.8,0.01,10732.0,87
CDM,76110665,FASCIECTOMY PLANTAR FASCIA PARTIAL SPX,14925.0,9701.25,0.01,14925.0,87
CDM,76110675,FASCIOTOMY FOOT&/TOE,14925.0,9701.25,0.01,14925.0,87
CDM,76110685,TENOTOMY ADDUCTOR HIP PERCUTANEOUS SPX,7362.0,4785.3,0.01,7362.0,87
CDM,76110695,TENOTOMY PRQ ADDUCTOR/HAMSTRING MULTIPLE TENDON,14925.0,9701.25,0.01,14925.0,87
CDM,76110715,RPR LAC CJNC W/WO NONPERFOR LAC SCLERA DIR CLSR,10732.0,6975.8,0.01,10732.0,87
CDM,76110725,SUTR WND EYELID/MARGIN/TARSUS/CONJUNC FULL THICK,10732.0,6975.8,0.01,10732.0,87
CDM,76110735,CLTX INTER/PERI/SUBTROCHANTERIC FEM FX W/O MANJ,7362.0,4785.3,0.01,7362.0,87
CDM,76110745,APPLICATION LONG LEG SPLINT THIGH ANKLE/TOES,726.0,471.9,0.01,12500.0,87
CDM,76110755,TYMPANOSTOMY GENERAL ANESTHESIA,5925.0,3851.25,0.01,7813.0,87
CDM,76110765,LARYNGOSCOPY W/WO TRACHEOSCOPY W/DILATION IN,16960.0,11024.0,0.01,16960.0,87
CDM,76110775,LARYNGOSCOPY W/BIOPSY MICROSCOPE/TELESCOPE,16960.0,11024.0,0.01,16960.0,87
CDM,76110785,NEUROPLASTY &/TRANSPOS MEDIAN NRV CARPAL TUNNE,13474.0,8758.1,0.01,13474.0,87
CDM,76110795,CHNG URTROST TUBE/XTRNLLY ACCESSIBLE STENT ILEAL,9423.0,6124.95,0.01,9423.0,87
CDM,76110825,INJECTION AA&/STRD AXILLARY NERVE W/IMG GDN,6143.0,3992.95,0.01,6143.0,87
CDM,76110865,INJECTION EPIDURAL BLOOD/CLOT PATCH,4778.0,3105.7,0.01,4778.0,87
CDM,76110895,INJECTION AA&/STRD GREATER OCCIPITAL NERVE,2037.0,1324.05,0.01,4392.0,87
CDM,76110945,CLTX TRIMALLEOLAR ANKLE FX W/MANIPULATION,7362.0,4785.3,0.01,7362.0,87
CDM,76110955,FLEXIBLE LARYNGOSCOPY WITH APPLICATION OF MITOMYCIN C TECH,2538.0,1649.7,0.01,3443.0,85
CDM,76110965,REVISION TRACHEOSTOMY SCAR,14918.0,9696.7,0.01,14918.0,79
CDM,76110985,INSERTION SPHENOIDAL ELECTRODES EEG PHYS/QHP,868.0,564.2,0.01,868.0,69
CDM,76110995,PARTIAL EXCISION DISTAL PHALANX FINGER,7362.0,4785.3,0.01,7813.0,87
CDM,76111005,ARTERIAL LINE INSERT,1392.0,904.8,0.01,1392.0,58
CDM,76111025,IMPCT TOOTH REMOV SOFT TISS TECH,2000.0,1300.0,0.01,2000.0,84
CDM,76111035,IMPCT TOOTH REMOV PART BONY TECH,2000.0,1300.0,0.01,2000.0,84
CDM,76111045,IMPCT TOOTH REMOV COMP BONY TECH,2000.0,1300.0,0.01,2000.0,84
CDM,76111055,AMP F/TH 1/2 JT/PHALANX W/NEURECT W/DIR CLSR,14925.0,9701.25,0.01,14925.0,87
CDM,76111065,LIGJ DIVJ &/EXCJ VARICOSE VEIN CLUSTER 1 LEG,18098.0,11763.7,0.01,18098.0,87
CDM,76111075,INSERTION INTRA-AORTIC BALLOON ASSIST DEV PERQ,3138.0,2039.7,0.01,7299.08,69
CDM,76111095,INSJ/RPLCMT TEMP TRANSVNS 1CHMBR ELTRD/PM CATH,47587.0,30931.55,0.01,47587.0,87
CDM,76111115,INSERTION FLOW DIRECTED CATHETER FOR MONITORING,8932.0,5805.8,0.01,10260.0,87
CDM,76111125,MOD SED SAME PHYS/QHP INITIAL 15 MINS 5/> YRS,701.0,455.65,0.01,701.0,68
CDM,76111135,MOD SED SAME PHYS/QHP EACH ADDL 15 MINS,276.0,179.4,0.01,276.0,68
CDM,76111155,ECMO/ECLS INITIATION VENO-VENOUS,2495.0,1621.75,0.01,2495.0,69
CDM,76111165,ECMO/ECLS DAILY MANAGEMENT EACH DAY VENO-VENOUS,1967.0,1278.55,0.01,2002.34,69
CDM,76111175,ECMO/ECLS INITIATION VENO-ARTERIAL,2757.0,1792.05,0.01,2757.0,69
CDM,76111185,ECMO/ECLS DAILY MANAGEMENT EA DAY VENO-ARTERIAL,1913.0,1243.45,0.01,2002.34,69
CDM,76111195,INSERTION FLOW DIRECTED CATHETER FOR MONITORING,8932.0,5805.8,0.01,10260.0,87
CDM,76111205,INTERROGATION VAD IN PRSON W/PHYS/QHP ANALYSIS,528.0,343.2,0.01,528.0,87
CDM,76111235,INJECTION PROCEDURE MYELOGRAPHY/CT LUMBAR,1579.0,1026.35,0.01,3443.0,68
CDM,76111255,"APPLICATION OF MODALITY UNSPECIFIED, CONSTANT ATTENDANCE",110.0,71.5,0.01,1759999.98,67
CDM,76111305,FASCT PRTL PALMAR 1 DGT PROX IPHAL JT W/WO RPR,14925.0,9701.25,0.01,14925.0,87
CDM,76111315,TRANSPERINEAL PLMT BIODEGRADABLE MATRL 1/MLT NJX,23385.0,15200.25,0.01,23385.0,87
CDM,76111335,DIAGNOSTIC BONE MARROW BIOPSIES & ASPIRATIONS,11448.0,7441.2,0.01,11448.0,87
CDM,76111345,NASAL/SINUS NDSC SURG W/DILATION FRNT&SPHN SINUS,31843.0,20697.95,0.01,31843.0,87
CDM,76111355,RMVL DEVITAL TISS N-SLCTV DBRDMT W/O ANES 1 SESS,914.0,594.1,0.01,914.0,85
CDM,76111405,IMPRESSION & PREPARATION SPEECH AID PROSTHESIS,14918.0,9696.7,0.01,14918.0,87
CDM,76111415,DEBRIDEMENT PRMLG HYPERKERATOTIC LES W/PDT,596.0,387.4,0.01,3443.0,87
CDM,76111425,ECISION GRANNULATION TISSUE,962.0,625.3,0.01,3443.0,85
CDM,76111435,CYSTO INSERTION TRANSPROSTATIC IMPLANT EA ADDL,8989.0,5842.85,0.01,8989.0,69
CDM,76111445,CT LUNG LOCALIZATION,1845.0,1199.25,0.01,1845.0,85
CDM,76111475,DIAGNOSTIC LUMBAR SPINAL PUNCTURE,4778.0,3105.7,74.92,4778.0,87
CDM,76111485,NJX PX ANTEGRDE NFROSGRM &/URTRGRM EXSTNG ACESS,3070.0,1995.5,0.01,5597.0,87
CDM,76111495,LIG/BANDING ANGIOACCESS ARTERIOVENOUS FISTULA,18098.0,11763.7,0.01,18098.0,87
CDM,76111505,NJX NONCMPND SCLEROSANT SINGLE INCMPTNT VEIN,10518.0,6836.7,0.01,10518.0,87
CDM,76111515,NJX NONCMPND SCLEROSANT MULTIPLE INCMPTNT VEINS,10518.0,6836.7,0.01,10518.0,87
CDM,76111525,TX SUPERFICIAL WOUND DEHISCENCE W/PACKING,1199.0,779.35,0.01,4392.0,87
CDM,76111565,TX MISSED ABORTION SECOND TRIMESTER SURGICAL,12718.0,8266.7,0.01,13821.0,87
CDM,76111625,DESTR RFA/SACROILIAC JOINT/BILAT/COOL METHOD,975.0,633.75,0.01,3443.0,85
CDM,76111635,DESTR PULSED RAD FREQ ABLATION OF PUDENAL NERVE/BILAT,975.0,633.75,0.01,3443.0,85
CDM,76111655,BIOPSY SOFT TISSUE PELVIS&HIP DEEP/SUBFSCAL/IM,7453.0,4844.45,0.01,7453.0,87
CDM,76111725,PRQ IMPLTJ NSTIM ELECTRODE ARRAY EPIDURAL,25409.0,16515.85,0.01,25409.0,79
CDM,76111765,EXCISION EXTERNAL EAR PARTIAL SIMPLE REPAIR,11448.0,7441.2,0.01,11448.0,87
CDM,76111855,INSJ TUNNELED CTR VAD W/SUBQ PORT AGE 5 YR/>,18098.0,11763.7,0.01,18098.0,87
CDM,76111865,TX OPN TENDON FLEXOR FOOT SINGLE/MULT TENDON SPX,7362.0,4785.3,0.01,7362.0,87
CDM,76111905,PLMT NEPHROSTOMY CATH PRQ NEW ACCESS RS&I,9423.0,6124.95,0.01,11545.0,87
CDM,76111995,"EXTRACTION, ERUPTED TOOTH OR EXPOSED ROOT",2000.0,1300.0,0.01,2000.0,84
CDM,76112005,BLOCK BIER EXTREMITY LOWER,518.0,336.7,0.01,3443.0,85
CDM,76112015,ARTHROSCOPY KNEE DIAGNOSTIC W/WO SYNOVIAL BX SPX,14925.0,9701.25,0.01,14925.0,67
CDM,76112025,EXCISION GANGLION WRIST DORSAL/VOLAR PRIMARY,7362.0,4785.3,0.01,7813.0,87
CDM,76112045,AMPUTATION TOE INTERPHALANGEAL JOINT,14833.0,9641.45,0.01,14833.0,87
CDM,76112055,EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL 5 CM/>,13165.0,8557.25,0.01,13165.0,87
CDM,76112085,PERQ VERT AGMNTJ CAVITY CRTJ UNI/BI CANNULATION,32861.0,21359.65,0.01,33436.0,87
CDM,76112095,PERQ VERT AGMNTJ CAVITY CRTJ UNI/BI CANNULJ LMBR,32861.0,21359.65,0.01,33436.0,87
CDM,76112105,PERQ VERT AGMNTJ CAVITY CRTJ UNI/BI CANNULJ EACH,10937.0,7109.05,0.01,33436.0,69
CDM,76112115,LYSIS VAGINAL ADHESIONS,14626.0,9506.9,0.01,14626.0,85
CDM,76112125,DSTRJ LESION PENIS SIMPLE LASER,8414.0,5469.1,0.01,8414.0,87
CDM,76112135,INJ SUBSTITUTE PARS PLANA/LIMBL W/WO ASPIR SPX,10491.0,6819.15,0.01,10491.0,87
CDM,76112155,EXC LESION TENDON SHEATH/CAPSULE W/SYNVCT TOE EA,7362.0,4785.3,0.01,7813.0,87
CDM,76112165,GOLD WEIGHT REMOVAL,265.0,172.25,0.01,488.51,85
CDM,76112185,CLTX DSTL XTNSR TDN INSJ W/WO PERCUTAN PINNING,7362.0,4785.3,0.01,7813.0,87
CDM,76112195,COLONOSCOPY FLX WITH ENDOSCOPIC STENT PLACEMENT,27383.0,17798.95,0.01,27383.0,79
CDM,76112225,INJECTION AA&/STRD VAGUS NERVE,2037.0,1324.05,0.01,4392.0,87
CDM,76112405,COLONOSCOPY STOMA RMVL LES BY HOT BIOPSY FORCEPS,5424.0,3525.6,0.01,5424.0,87
CDM,76112425,VNPNXR <3 YEARS PHYS/QHP SKILL OTHER VEIN,129.0,83.85,0.01,129.0,68
CDM,76112445,POUCHOSCOPY WITH SNARE,916.0,595.4,0.01,916.0,58
CDM,76112475,COLPORRHAPHY SUTURE INJURY VAGINA,14626.0,9506.9,0.01,14626.0,87
CDM,76112485,CONJUCTIVOPLASTY W/ELECTRO SURG.,1096.0,712.4,0.01,1096.0,58
CDM,76112505,RMVL FECAL IMPACTION/FB SPX UNDER ANES,5424.0,3525.6,0.01,5424.0,87
CDM,76112515,ABLTJ PERC CRYOABLTJ IMG GDN LXTR/PERPH NERVE,7811.0,5077.15,0.01,7811.0,85
CDM,76112525,LASIK,1846.0,1199.9,0.01,3907.82,85
CDM,76112535,PHOTOTHERAPEUTIC KERATECTOMY,1846.0,1199.9,0.01,3907.82,85
CDM,76112555,LASIK,2154.0,1400.1,0.01,2154.0,67
CDM,76112565,PHOTOTHERAPEUTIC,2154.0,1400.1,0.01,2154.0,67
CDM,76112595,INJECTION EPIDURAL BLOOD/CLOT PATCH,4778.0,3105.7,0.01,4778.0,87
CDM,76112645,INTRAORAL I&D TONGUE/FLOOR SUBMNDBLR SPACE,14918.0,9696.7,0.01,14918.0,87
CDM,76112655,RMVL EMBEDDED FB VESTIBULE MOUTH SMPL,4313.0,2803.45,0.01,12500.0,87
CDM,76112665,RMVL/REVJ SLING STRESS INCONTINENCE,14626.0,9506.9,0.01,14626.0,87
CDM,76112675,SIGMOIDOSCOPY FLX TNDSC US GID NDL ASPIR/BX,5424.0,3525.6,0.01,5424.0,87
CDM,76112685,CRYOTHERPAY FOR RHINORRHEA,2372.0,1541.8,0.01,3443.0,85
CDM,76112705,CLTX INTERPHALANGEAL JOINT DISLOCATION REQ ANES,1222.0,794.3,0.01,4392.0,87
CDM,76112715,ILEOSCOPY STOMA W/BX SINGLE/MULTIPLE,4313.0,2803.45,0.01,4392.0,87
CDM,76112725,SURG TX ANAL FISTULA SUBQ,12615.0,8199.75,0.01,12615.0,87
CDM,76112745,FINE NEEDLE ASPIRATION BX W/US GDN 1ST LESION,3237.0,2104.05,0.01,4392.0,87
CDM,76112755,FINE NEEDLE ASPIRATION BX W/US GDN EA ADDL,942.0,612.3,0.01,4392.0,69
CDM,76112765,FINE NEEDLE ASPIRATION BX W/CT GDN 1ST LESION,3237.0,2104.05,0.01,4392.0,87
CDM,76112775,FINE NEEDLE ASPIRATION BX W/CT GDN EA ADDL,1471.0,956.15,0.01,4392.0,69
CDM,76112785,PUNCH BIOPSY SKIN SINGLE LESION,1199.0,779.35,0.01,12500.0,87
CDM,76112795,PUNCH BIOPSY SKIN EA SEP/ADDITIONAL LESION,184.0,119.6,0.01,4392.0,69
CDM,76112805,TANGENTIAL BIOPSY SKIN SINGLE LESION,596.0,387.4,0.01,12500.0,87
CDM,76112815,TANGENTIAL BIOPSY SKIN EA SEP/ADDITIONAL LESION,159.0,103.35,0.01,4392.0,69
CDM,76112845,INCISIONAL BIOPSY SKIN SINGLE LESION,1836.0,1193.4,0.01,4392.0,87
CDM,76112855,INCISIONAL BIOPSY SKIN EA SEP/ADDITIONAL LESION,283.0,183.95,0.01,4392.0,69
CDM,76112865,BX PROSTATE STRTCTC SATURATION SAMPLING IMG GID,15865.0,10312.25,0.01,15865.0,87
CDM,76112945,INSJ TUNNELED CVC W/O SUBQ PORT/PMP AGE 5 YR/>,18098.0,11763.7,0.01,18098.0,87
CDM,76112955,NASOPHARYNGOSCOPY W/ENDOSCOPE SPX,777.0,505.05,0.01,3443.0,87
CDM,76112985,TWIST DRILL HOLE IMPLT VENTRICULAR CATH/DEVICE,8667.0,5633.55,0.01,8667.0,69
CDM,76112995,REPAIR INTERMEDIATE F/E/E/N/L&/MUC 2.6-5.0 CM,1199.0,779.35,0.01,12500.0,87
CDM,76113045,EXC HYPRPLSTC ALVEOLAR MUCOSA EA QUADRANT SPEC,6814.0,4429.1,0.01,6814.0,87
CDM,76113065,FINE NEEDLE ASPIRATION BX W/FLUOR GDN 1ST LESION,3237.0,2104.05,0.01,4392.0,87
CDM,76113075,FINE NEEDLE ASPIRATION BX W/FLUOR GDN EA ADDL,725.0,471.25,0.01,4392.0,69
CDM,76113085,FINE NEEDLE ASPIRATION BX W/MR GDN 1ST LESION,3237.0,2104.05,0.01,4392.0,85
CDM,76113095,FINE NEEDLE ASPIRATION BX W/MR GDN EA ADDL,1456.0,946.4,0.01,4392.0,67
CDM,76113105,FINE NEEDLE ASPIRATION BX W/O IMG GDN EA ADDL,1017.0,661.05,0.01,4392.0,69
CDM,76113115,PERQ REPLACEMENT GTUBE NOT REQ REVJ GSTRST TRC,1119.0,727.35,0.01,4392.0,87
CDM,76113125,PROC MATERNITY CARE UNLISTED,379.0,246.35,0.01,4337.0,85
CDM,76113135,RMVL EPITHELIAL DOWNGROWTH ANT CHAMBER EYE,10491.0,6819.15,0.01,13821.0,87
CDM,76113145,UNL REVISION/REMOVE VAGINAL SCAR TISSUE,936.0,608.4,0.01,3443.0,85
CDM,76113155,PERQ SFT TISS LOC DEVICE PLMT 1ST LES W/GDNCE,2111.0,1372.15,0.01,4337.0,87
CDM,76113165,PERQ SFT TISS LOC DEVICE PLMT ADD LES W/GDNCE,617.0,401.05,0.01,3443.0,68
CDM,76113175,ABLATJ BONE TUMOR CRYO PERQ W/IMG GDN WHEN PRFMD,32861.0,21359.65,0.01,32861.0,87
CDM,76113185,INJECTION SHOULDER ARTHROGRAPHY/ CT/MRI ARTHG,761.0,494.65,0.01,3443.0,68
CDM,76113195,INJECTION ELBOW ARTHROGRAPHY,442.0,287.3,0.01,3443.0,68
CDM,76113205,INJECTION WRIST ARTHROGRAPHY,637.0,414.05,0.01,3443.0,68
CDM,76113215,NJX PX CNTRST KNE ARTHG CNTRST ENHNCD CT/MRI KNE,782.0,508.3,0.01,3443.0,68
CDM,76113225,NJX CHOLANGIO PRQ W/IMG GID RS&I EXISTING ACCESS,16234.0,10552.1,0.01,16234.0,87
CDM,76113235,IMAGE-GUIDE FLUID COLLXN DRAINAGE CATH VISC PERQ,7453.0,4844.45,0.01,10364.0,87
CDM,76113245,EXCHNG ABSC/CST DRG CATH RAD GID SPX,8726.0,5671.9,0.01,8726.0,87
CDM,76113255,REPLACE DUODENOSTOMY/JEJUNOSTOMY TUBE PERQ,4313.0,2803.45,0.01,5265.0,87
CDM,76113265,ASPIR &/NJX RENAL CYST/PELVIS NEEDLE PRQ,3237.0,2104.05,0.01,4392.0,87
CDM,76113275,NJX PX ANTEGRDE NFROSGRM &/URTRGRM NEW ACCESS,3070.0,1995.5,0.01,5597.0,87
CDM,76113295,UNL BIOPSY OF STOMA,2101.0,1365.65,0.01,8326.0,85
CDM,76113315,MYELOGRAPHY VIA LUMBAR INJECTION RS&I THORACIC,5451.0,3543.15,0.01,7948.0,87
CDM,76113335,TRURL DSTRJ PRST8 TISS RF WV THERMOTHERAPY,15865.0,10312.25,0.01,15865.0,87
CDM,76113345,BIOPSY SOFT TISSUE UPPER ARM/ELBOW AREA DEEP,13165.0,8557.25,0.01,13165.0,87
CDM,76113355,CYSTO/URETERO W/LITHOTRIPSY &INDWELL STENT INSRT,23385.0,15200.25,0.01,23385.0,87
CDM,76113365,ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US,1358.0,882.7,0.01,3443.0,87
CDM,76113375,CLTX METAR FX W/MANJ,1103.0,716.95,0.01,12500.0,87
CDM,76113385,CYSTO W/URETEROSCOPY W/RMVL/MANJ STONES,15865.0,10312.25,0.01,15865.0,87
CDM,76113395,INTRODUCTION LONG GI TUBE SEPARATE PROCEDURE,4313.0,2803.45,0.01,4313.0,87
CDM,76113405,EXCHANGE NEPHROSTOMY CATHETER PRQ W/IMG GID RS&I,9423.0,6124.95,0.01,9423.0,87
CDM,76113415,APPL MODALITY 1/> AREAS ELEC STIMJ EA 15 MIN,239.0,155.35,0.01,239.0,86
CDM,76113425,APPL MODALITY 1/> AREAS ELEC STIMJ UNATTENDED,177.0,115.05,0.01,177.0,67
CDM,76113435,EGD PERCUTANEOUS PLACEMENT GASTROSTOMY TUBE,8726.0,5671.9,0.01,8726.0,87
CDM,76113445,RMVL IMPLANTED MATERIAL ANTERIO SEGMENT EYE,10491.0,6819.15,0.01,25635.0,87
CDM,76113465,PUNCH BIOPSY SKIN SINGLE LESION,1199.0,779.35,0.01,12500.0,87
CDM,76113485,DRAINAGE PERITON ABSCESS/LOCAL PERITONITIS OPEN,1274.0,828.1,0.01,7813.0,69
CDM,76113495,EXCISION LESION CORNEA XCP PTERYGIUM,4455.0,2895.75,0.01,4455.0,87
CDM,76113505,TARSAL TUNNEL INJECTION,365.0,237.25,0.01,3443.0,85
CDM,76113515,HYMENOTOMY SIMPLE INCISION,14626.0,9506.9,0.01,14626.0,87
CDM,76113535,DRAINAGE SCROTAL WALL ABSCESS,7453.0,4844.45,0.01,7453.0,87
CDM,76113565,PROSTATOTOMY EXTERNAL DRG ABSCESS SIMPLE,15865.0,10312.25,0.01,15865.0,87
CDM,76113575,BIS EXTRACELLULAR FLUID ALYS LYMPHEDEMA ASSMNT,900.0,585.0,0.01,900.0,87
CDM,76113585,CONTROL OROPHARYNGEAL HEMORRHAGE SIMPLE,2343.0,1522.95,0.01,4392.0,87
CDM,76113605,URETERAL ENDOSCOPY VIA URETEROST W/RMVL FB/STONE,23385.0,15200.25,0.01,23385.0,87
CDM,76113615,SMPL RPR SCALP/NECK/AX/GENIT/TRUNK 12.6-20.0CM,1199.0,779.35,0.01,5265.0,87
CDM,76113625,MASTOTOMY W/EXPLORATION/DRAINAGE ABSCESS DEEP,4861.0,3159.65,0.01,5265.0,87
CDM,76113645,PLACE AMNIOTIC MEMBRANE OCULAR SURFACE SUTURED,17347.0,11275.55,0.01,17347.0,87
CDM,76113655,"CORE NEEDLE BIOPSY, FOOT",1236.0,803.4,0.01,3443.0,85
CDM,76113665,BIOPSY VAGINAL MUCOSA EXTENSIVE,14626.0,9506.9,0.01,14626.0,87
CDM,76113675,RPR LIP FULL THKNS >ONE-HALF VERT HEIGHT/COMPLE,6814.0,4429.1,0.01,7813.0,87
CDM,76113685,SUCTION ASSISTED LIPECTOMY LOWER EXTREMITY,10983.0,7138.95,0.01,17833.0,85
CDM,76113695,RMVL EMBEDDED FB FROM DENTALVLR STRUXS SOFT TISS,6814.0,4429.1,0.01,6814.0,87
CDM,76113705,ESOPHAGOSCOPY INTRA/TRANSMURAL NEEDLE ASPIRAT/BX,8726.0,5671.9,0.01,8726.0,87
CDM,76113715,ANAL BIOPSY,2370.0,1540.5,0.01,3443.0,85
CDM,76113725,DESTRUCTION LESION CONJUNCTIVA,10732.0,6975.8,0.01,10732.0,87
CDM,76113735,VAGINAL LASER THERAPY,270.0,175.5,0.01,335.72,85
CDM,76113745,LITHOLAPAXY SMPL/SM <2.5 CM,15865.0,10312.25,0.01,15865.0,87
CDM,76113755,ELEC ALYS CPLX PRGRMG IINS BLDR DYSF PTN 4+,367.0,238.55,0.01,367.0,85
CDM,76113765,NEEDLE INSERTION W/O INJECTION 1 OR 2 MUSCLES,113.0,73.45,0.01,12500.0,87
CDM,76113775,NEEDLE INSERTION W/O INJECTION 3 OR MORE MUSCLES,113.0,73.45,0.01,12500.0,87
CDM,76113785,MANUAL PREP AND INSERTION DEEP DRUG DELIVERY DEV,259.0,168.35,0.01,3443.0,68
CDM,76113795,REMOVAL DEEP DRUG DELIVERY DEVICE,632.0,410.8,0.01,3443.0,68
CDM,76113805,MANUAL PREP&INSJ INTRAMEDULLARY DRUG DLVR DEVICE,259.0,168.35,0.01,3443.0,68
CDM,76113815,REMOVAL INTRAMEDULLARY DRUG DELIVERY DEVICE,632.0,410.8,0.01,3443.0,68
CDM,76113825,MANUAL PREP&INSJ I-ARTIC DRUG DELIVERY DEVICE,259.0,168.35,0.01,3443.0,68
CDM,76113835,REMOVAL INTRA-ARTICULAR DRUG DELIVERY DEVICE,632.0,410.8,0.01,3443.0,68
CDM,76113845,PERICARDIOCENTESIS W/IMG GUIDANCE WHEN PERFORMED,8932.0,5805.8,0.01,11545.0,87
CDM,76113855,DIAGNOSTIC LUMBAR SPINAL PUNCTURE W/FLUOR OR CT,4778.0,3105.7,0.01,4778.0,87
CDM,76113865,THERAPEUTIC SPINAL PNXR DRAINAGE CSF W/FLUOR/CT,4778.0,3105.7,0.01,4778.0,87
CDM,76113875,INJECTION AA&/STRD NERVES NRVTG SI JOINT W/IMG,4778.0,3105.7,0.01,4778.0,87
CDM,76113885,INJECTION AA&/STRD GENICULAR NRV BRANCHES W/IMG,4778.0,3105.7,0.01,4778.0,87
CDM,76113895,DESTRUCTION NEUROLYTIC AGT GENICULAR NERVE W/IMG,13474.0,8758.1,0.01,13474.0,87
CDM,76113905,RADIOFREQUENCY ABLTJ NRV NRVTG SI JT W/IMG GDN,13474.0,8758.1,0.01,13474.0,87
CDM,76113925,TRURL ABLTJ MAL PRST8 TISS HI ENERGY WATER VAPOR,6764.0,4396.6,0.01,1759903.2,77
CDM,76113935,PERQ IMPLTJ/RPLCMT ISDNS BLDR DYSF PTN,7752.0,5038.8,0.01,7752.0,85
CDM,76113945,REVJ/ OR RMVL PERQ ISDNS BLDR DYSF PTN,13756.0,8941.4,0.01,13756.0,85
CDM,76113955,ELEC ALYS SMPL PRGRMG IINS BLDR DYSF PTN 1-3,367.0,238.55,0.01,367.0,85
CDM,76113965,ABLATION MAL BRST TUMOR PERQ CRTX UNILATERAL,15317.0,9956.05,0.01,15317.0,85
CDM,76113975,TYMPANOSTOMY AUTOMATED TUBE DELIVERY SYSTEM,5925.0,3851.25,0.01,7431.0,86
CDM,76113985,NEEDLE INSERTION W/O INJECTION 3 OR MORE MUSCLES,113.0,73.45,0.01,12500.0,87
CDM,76113995,EEG CONT REC W/VIDEO BY TECH MIN 8 CHANNELS,1080.0,702.0,0.01,1080.0,85
CDM,76114005,SOMNOPLASTY-REPEAT TREATMENT,162.0,105.3,0.01,1573.0,85
CDM,76114015,INSERTION PICC W/RS&I 5 YR/>,8932.0,5805.8,0.01,8932.0,87
CDM,76114025,CHANGE CYSTOSTOMY TUBE COMPLICATED,3070.0,1995.5,0.01,4392.0,87
CDM,76114035,SEPTOPLASTY/SUBMUCOUS RESECJ W/WO CARTILAGE GRF,14918.0,9696.7,0.01,14918.0,87
CDM,76114045,FRACTURE NASAL INFERIOR TURBINATE THERAPEUTIC,14918.0,9696.7,0.01,14918.0,87
CDM,76114055,CATHJ UMBILICAL VEIN DX/THER NB,129.0,83.85,0.01,129.0,68
CDM,76114065,CATHETERIZATION UMBILICAL NEWBORN ART DX/THERAPY,252.0,163.8,0.01,252.0,69
CDM,76114075,CLOSED TX OF SESAMOID BONE FRAC IN THE FINGER OR HAND,265.0,172.25,0.01,3443.0,85
CDM,76114085,CHEMODENERVATION VAGINAL MUSCLE,646.0,419.9,0.01,3443.0,85
CDM,76114095,EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL <5CM,13165.0,8557.25,0.01,13165.0,87
CDM,76114105,RMVL SEC MEMBRANOUS CTRC CORNEO-SCLL SCTJ,10491.0,6819.15,0.01,10789.0,87
CDM,76114125,RMVL FB XTRNL EYE CORNEAL W/O SLIT LAMP,1836.0,1193.4,0.01,12500.0,87
CDM,76114155,BRONCHOSCOPY RIGID OR FLEXIBLE W/INJECTION OF CONTRAST MATERIAL,3141.0,2041.65,0.01,3443.0,85
CDM,76114165,CURETTAGE POSTPARTUM,12718.0,8266.7,0.01,12718.0,87
CDM,76114175,EXC TUM/VAS MAL SFT TIS HAND/FNGR SUBFASC<1.5CM,7453.0,4844.45,0.01,7453.0,87
CDM,76114185,ERCP W/CONTROL OF BLEED,3038.0,1974.7,0.01,3038.0,85
CDM,76114195,ILEOSCOPY WITH ABLATION VIA STOMA,2946.0,1914.9,0.01,3443.0,85
CDM,76114205,CLTX HUMERAL SHFT FX W/MANJ W/WO SKELETAL TRACJ,7362.0,4785.3,0.01,7362.0,87
CDM,76114215,SMALL BOWEL BAE W/ SUBMUCO INJECTION,2858.0,1857.7,0.01,3443.0,85
CDM,76114225,ASPIRATION & INJECTION TREATMENT BONE CYST,3237.0,2104.05,0.01,12500.0,87
CDM,76114235,"CORE NEEDLE BIOPSY, FACE (COMP CODE 20206)",6674.0,4338.1,0.01,6674.0,85
CDM,76114245,EXC TUMOR SOFT TISS NECK/THORAX SUBFASCIAL <5CM,13165.0,8557.25,0.01,13165.0,87
CDM,76114255,ESD SMALL INTESTINE (COMP 44364),7833.0,5091.45,0.01,7833.0,85
CDM,76114265,MIDFACE FLAP W/PRESERVATION OF VASCULAR PEDICLES,10983.0,7138.95,0.01,10983.0,87
CDM,76114275,CLOSED TX TEMPOROMANDIBULAR DISLOCATION 1ST/SBSQ,1103.0,716.95,0.01,4392.0,87
CDM,76114285,PHLEBOTOMY THERAPEUTIC SEPARATE PROCEDURE,889.0,577.85,0.01,889.0,87
CDM,76114345,DRAINAGE ABSCESS PALATE UVULA,1068.0,694.2,0.01,5265.0,87
CDM,76114355,INTRO CATH DIALYSIS CIRCUIT W/TRLUML BALO ANGIOP,32784.0,21309.6,0.01,32784.0,87
CDM,76114365,DRAINAGE TENDON SHEATH DIGIT&/PALM EACH,14925.0,9701.25,0.01,14925.0,87
CDM,76114375,J- TUBE REPLACEMENT W/O IMAGING,1699.0,1104.35,0.01,3443.0,85
CDM,76114385,REPAIR INTERMEDIATE S/A/T/E >30.0 CM,5488.0,3567.2,0.01,5488.0,87
CDM,76114395,REPLACE GASTROSTOMY/CECOSTOMY TUBE PERCUTANEOUS,4313.0,2803.45,0.01,4313.0,87
CDM,76114405,EGD FLEXIBLE FOREIGN BODY REMOVAL,4313.0,2803.45,0.01,5265.0,87
CDM,76114415,INJECTION AA&/STRD FEMORAL NERVE CONT NFS CATH,6143.0,3992.95,0.01,6143.0,87
CDM,76114425,REPAIR INTERMEDIATE S/A/T/E 20.1-30.0 CM,1836.0,1193.4,0.01,5265.0,87
CDM,76114435,INJECTION PROCEDURE LYMPHANGIOGRAPHY,3757.0,2442.05,0.01,3757.0,68
CDM,76114455,SEMINAL VESICLE BX SINGLE OR MULTI,3789.0,2462.85,0.01,4337.0,85
CDM,76114465,XTRORAL I&D ABSC CST/HMTMA FLOOR MOUTH SUBMENT,27212.0,17687.8,0.01,27212.0,87
CDM,76114475,EXCISION AURAL POLYP,5925.0,3851.25,0.01,5925.0,87
CDM,76114485,COMPLICATED FULL BONY EXTRACTION,2000.0,1300.0,0.01,2000.0,84
CDM,76114495,REMOVE RESIDUAL ROOT,2000.0,1300.0,0.01,2000.0,84
CDM,76114505,SURGICAL EXTRACTION ERUPTED TOOTH,2000.0,1300.0,0.01,2000.0,84
CDM,76114515,RPR LAC TONGUE FLOOR MOUTH > 2.6 CM/CPLX,1068.0,694.2,0.01,5265.0,87
CDM,76114525,IRRIGATION CORPORA CAVERNOSA PRIAPISM,1119.0,727.35,0.01,4392.0,87
CDM,76114535,EXC FRENUM LABIAL/BUCCAL,6814.0,4429.1,0.01,6814.0,87
CDM,76114555,RPR LAC CJNC MOBLJ& REARGMT W/O HOSPITALIZATION,10732.0,6975.8,0.01,10732.0,87
CDM,76114565,HYSTEROSCOPY REMOVAL LEIOMYOMATA,22708.0,14760.2,0.01,22708.0,87
CDM,76114575,LARYNGOSCOPY EXC TUM&/STRIPPING CORDS/EPIGLOTT,16960.0,11024.0,0.01,16960.0,87
CDM,76114595,EXCISION TENDON PALM FLEXOR/EXTENSOR SINGLE EACH,7362.0,4785.3,0.01,7813.0,87
CDM,76114605,APPL MLTLAYR COMPRES SYS UPARM LWARM HAND&FING,726.0,471.9,0.01,12500.0,87
CDM,76114615,EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL <2CM,7453.0,4844.45,0.01,7453.0,87
CDM,76114625,APPLICATION FINGER SPLINT DYNAMIC,273.0,177.45,0.01,12500.0,87
CDM,76114635,CORE NEEDLE BX LUNG/MEDIASTINUM PERQ W/IMG,7453.0,4844.45,0.01,11545.0,87
CDM,76114645,SURG NASOPHARYNGOSCOPY DILAT EUSTACHIAN TUBE UNI,23663.0,15380.95,0.01,23663.0,87
CDM,76114655,SURG NASOPHARYNGOSCOPY DILAT EUSTACHIAN TUBE BI,23663.0,15380.95,0.01,23663.0,87
CDM,76114665,BIOPSY TESTIS INCISIONAL SEPARATE PROCEDURE,15865.0,10312.25,0.01,15865.0,87
CDM,76114675,INTRA THECAL PUMP SUBCUTANEOUS (COMP 63688),25.0,16.25,0.01,3443.0,85
CDM,76114685,CLOSED TX TARSOMETATARSAL DISLOCATION W/O ANES,1103.0,716.95,0.01,12500.0,87
CDM,76114695,"CALCULUS REMOVAL, URETHRA, VIA INCISION COMP 52315",7763.0,5045.95,0.01,7763.0,85
CDM,76114705,CLOSED TX MONTEGGIA FX DISLOCATION ELBOW W/MANJ,7362.0,4785.3,0.01,7362.0,87
CDM,76114725,EXC LESION TONGUE W/CLSR POSTERIOR ONE-THIRD,14918.0,9696.7,0.01,14918.0,87
CDM,76114735,THERAPEUTIC APHERESIS PLASMA PHERESIS,9426.0,6126.9,0.01,9426.0,87
CDM,76114745,CYSTOURETHROSCOPY W/DEST &/RMVL TUMOR LARGE,23385.0,15200.25,0.01,23385.0,87
CDM,76114755,REMOVAL TUNNELED INTRAPERITONEAL CATHETER,14478.0,9410.7,0.01,14478.0,87
CDM,76114765,RPSG PREVIOUSLY PLACED CVC UNDER FLUOR GDNCE,8932.0,5805.8,0.01,8932.0,87
CDM,76114775,US GUIDANCE NEEDLE PLACEMENT IMG S&I,863.0,560.95,0.01,863.0,68
CDM,76114785,CLOSED TX ULNAR SHAFT FRACTURE W/MANIPULATION,1103.0,716.95,0.01,4392.0,87
CDM,76114795,PARACEN ANT CHAM RMVL BLOOD W/WO IRRIG&/AIR IN,10491.0,6819.15,0.01,10491.0,87
CDM,76114805,CILIARY BODY DSTRJ CYCLOPHOTOCOAG TRANSSCERAL,10732.0,6975.8,0.01,10732.0,87
CDM,76114815,CLTX TIBIAL FX PROXIMAL W/WO MANJ W/SKEL TRACJ,14925.0,9701.25,0.01,14925.0,87
CDM,76114825,EXCISION TUMOR SOFT TISSUE FOOT/TOE SUBQ <1.5CM,7453.0,4844.45,0.01,7453.0,87
CDM,76114835,ABLATION BONE TUMOR RF PERQ W/IMG GDN WHEN DONE,59187.0,38471.55,0.01,59187.0,87
CDM,76114845,PROC MUSSKL SYS UNLISTD,2543.0,1652.95,0.01,3443.0,85
CDM,76114855,ABLATION THER 1+ PULM TUMORS PERQ CRYOABLATION,26695.0,17351.75,0.01,26695.0,87
CDM,76114865,INSJ TUN VAD REQ 2 CATH 2 SITS W/O SUBQ PORT/PMP,18098.0,11763.7,0.01,18098.0,87
CDM,76114875,INSJ PRPH CTR VAD W/SUBQ PORT AGE 5 YR/>,18098.0,11763.7,0.01,18098.0,87
CDM,76114885,RPLCMT COMPL NON-TUN CVC W/O SUBQ PORT/PMP,8932.0,5805.8,0.01,8932.0,87
CDM,76114895,RPLCMT COMPL TUN CVC W/O SUBQ PORT/PMP,18098.0,11763.7,0.01,18098.0,87
CDM,76114905,RPLCMT COMPL TUN CTR VAD W/SUBQ PORT,18098.0,11763.7,0.01,18098.0,87
CDM,76114915,RPSG PREVIOUSLY PLACED CVC UNDER FLUOR GDNCE,8932.0,5805.8,0.01,8932.0,87
CDM,76114925,INSJ CANNULA HEMO OTH PURPOSE SPX VEIN VEIN,31083.0,20203.95,0.01,31083.0,87
CDM,76114935,INS INTRVAS VC FILTR W/WO VAS ACS VSL SELXN RS&I,18379.0,11946.35,0.01,18379.0,87
CDM,76114945,RTRVL INTRVAS VC FILTR W/WO ACS VSL SELXN RS&I,18098.0,11763.7,0.01,18098.0,87
CDM,76114955,THROMBOLYSIS ARTERIAL INFUSION ICRA RS&I INIT TX,31083.0,20203.95,0.01,31083.0,87
CDM,76114965,THROMBOLYSIS ART/VENOUS INFSN W/IMAGE SUBSQ TX,18098.0,11763.7,0.01,18098.0,87
CDM,76114975,CESSATION THROMBOLYTIC THER W/CATHETER REMOVAL,18098.0,11763.7,0.01,18098.0,87
CDM,76114985,LIGATION/BIOPSY TEMPORAL ARTERY,9316.0,6055.4,0.01,9316.0,87
CDM,76115015,EXCISION LINGUAL FRENUM FRENECTOMY,6814.0,4429.1,0.01,6814.0,87
CDM,76115025,INSJ INTRAPERITONEAL CATHETER W/IMG GUID,16234.0,10552.1,0.01,16234.0,87
CDM,76115045,RMVL & RPLCMT XTRNL ACCESSIBLE NEPHROURTRL CATH,9423.0,6124.95,0.01,9423.0,87
CDM,76115055,ABLATION RENAL TUMOR UNILATERAL PERQ CRYOTHERAPY,25651.0,16673.15,0.01,25651.0,87
CDM,76115065,PLMT URTRL STENT PRQ PRE-EXISTING NFROS TRACT,15865.0,10312.25,0.01,15865.0,87
CDM,76115075,PLMT URTRL STNT PRQ NEW ACESS W/O SEP NFROS CATH,15865.0,10312.25,0.01,15865.0,87
CDM,76115085,PLMT URTRL STENT PRQ NEW ACCESS W/SEP NFROS CATH,15865.0,10312.25,0.01,15865.0,87
CDM,76115105,EVASC TEMP BALLOON ARTL OCCLUSION HEAD/NECK,49016.0,31860.4,0.01,49016.0,87
CDM,76115115,TCAT PERMANT OCCLUSION/EMBOLIZATION PRQ NON-CNS,52240.0,33956.0,0.01,52240.0,87
CDM,76115125,DIAGNOSTIC LUMBAR SPINAL PUNCTURE,4778.0,3105.7,0.01,4778.0,87
CDM,76115155,PRQ IMPLTJ NEUROSTIMULATOR ELTRD PERIPHERAL NRV,13689.0,8897.85,0.01,13689.0,79
CDM,76115185,ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC,4313.0,2803.45,0.01,4392.0,87
CDM,76115195,INJECTION OF FILLER INTO PHARYNGEAL WALL (COMP CODE 31574),3022.0,1964.3,0.01,3443.0,85
CDM,76115205,FLAP LIFT W/TISSEEL GLUE,1620.0,1053.0,0.01,3907.82,85
CDM,76115215,"HEMMORRHOIDECTOMY, EXTERNAL SINGLE (COMP 46320)",4858.0,3157.7,0.01,4858.0,85
CDM,76115225,EXCISION BONE MANDIBLE,27212.0,17687.8,0.01,27212.0,87
CDM,76115235,MCHNL RMVL INTRAL OBSTR CV DEV THRU DEV LUMEN,8932.0,5805.8,0.01,8932.0,87
CDM,76115245,"FACIAL RESURFACING, LASER (COMP CODE 17108)",3221.0,2093.65,0.01,3443.0,85
CDM,76115255,DILATATION OF STOMA,1336.0,868.4,0.01,3443.0,85
CDM,76115275,CRANIECTOMY W/EXCISION TUMOR/LESION SKULL,4743.0,3082.95,0.01,4743.0,69
CDM,76115285,TARSAL TUNNEL INJECTION,460.0,299.0,0.01,460.0,58
CDM,76115295,DELAY FLAP/SECTIONING FLAP F/C/C/N/AX/G/H/F,5488.0,3567.2,0.01,10789.0,87
CDM,76115305,BOTOX INJECTION INTO PERIVASCULAR TISSUE (COMP 64644),4270.0,2775.5,0.01,4270.0,85
CDM,76115315,NSL/SINUS NDSC MAX ANTROST W/RMVL TISS MAX SINUS,31843.0,20697.95,0.01,31843.0,87
CDM,76115325,CORRECTION HAMMERTOE,14925.0,9701.25,0.01,14925.0,87
CDM,76115335,NASAL/SINUS ENDOSCOPY W/MAXILLARY ANTROSTOMY,16960.0,11024.0,0.01,16960.0,87
CDM,76115345,LITHOLAPAXY COMP/LG > 2.5 CM,15865.0,10312.25,0.01,15865.0,87
CDM,76115355,"NASAL ENDOSCOPY, FOREIGN BODY REMOVAL (COMP 31237)",1119.0,727.35,0.01,1119.0,85
CDM,76115365,FLAP LIFT W/WO SUTURE,1620.0,1053.0,0.01,3907.82,85
CDM,76115375,EXC TUMOR SOFT TISSUE LEG/ANKLE SUBFASCIAL <5CM,13165.0,8557.25,0.01,13165.0,87
CDM,76115385,RPLCMT OI IMPLT SKULL PERQ ATTACHMENT ESP,28575.0,18573.75,0.01,33436.0,87
CDM,76115395,XTRNL FIXJ W/STRTCTC ADJUSTMENT EXCHANGE STRUT,7362.0,4785.3,0.01,11545.0,87
CDM,76115405,DERM TECH (COMP CODE 11102),413.0,268.45,0.01,3443.0,85
CDM,76115435,SIMPLE REPAIR F/E/E/N/L/M 20.1CM-30.0 CM,1199.0,779.35,0.01,5265.0,87
CDM,76115445,REP INCOMPLETE CIRCUMCISION,9423.0,6124.95,0.01,9423.0,87
CDM,76115455,EGD TRANSORAL BIOPSY SINGLE/MULTIPLE,4313.0,2803.45,0.01,5265.0,87
CDM,76115465,COLPOTOMY W/EXPLORATION,14626.0,9506.9,0.01,14626.0,87
CDM,76115475,EXCISION HIDRADENITIS INGUINAL SMPL/INTRM RPR,8586.0,5580.9,0.01,8586.0,87
CDM,76115505,QUTENZA APPLICATION (COMP 64632),1829.0,1188.85,0.01,3443.0,85
CDM,76115515,"CHEM PEEL, NONFACIAL DERMAL",1199.0,779.35,0.01,12500.0,87
CDM,76115525,PLACEMENT NEEDLE INTRAOSSEOUS INFUSION,2294.0,1491.1,0.01,12500.0,87
CDM,76115535,EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL 5+CM,13165.0,8557.25,0.01,13165.0,87
CDM,76115565,SIALOLITHOTOMY SUBMNDBLR SUBMAX COMP INTRAORAL,14918.0,9696.7,0.01,14918.0,87
CDM,76115575,OSTEOPATHIC MANIPULATION (98928),76.0,49.4,0.01,76.72,87
CDM,76115595,FETAL FLUID DRAINAGE W/ULTRASOUND GUIDANCE,1217.0,791.05,0.01,3443.0,87
CDM,76115605,CLOSED TREATMENT PST MALLEOLUS FRACTURE W/MANJ,7362.0,4785.3,0.01,7362.0,87
CDM,76115625,"BX ARM/ELBOW SOFT TISSUE,SUPERFICIAL",7453.0,4844.45,0.01,7453.0,87
CDM,76115635,INTRO ANY HEMOSTATIC AGENT/PACK VAG HEMRRG SPX,925.0,601.25,0.01,4392.0,87
CDM,76115645,RPLCMT/IRRIGATION VENTRICULAR CATHETER,44188.0,28722.2,0.01,44188.0,87
CDM,76115655,PERQ P-ART REVSC ST 1ST NML NATIVE CONNJ BI,65208.0,42385.2,0.01,65208.0,87
CDM,76115665,PERQ P-ART REVSC ST 1ST ABNOR CONNJ UNILATERAL,103251.0,67113.15,0.01,103251.0,87
CDM,76115675,CLOSED TX NASAL SEPTAL FRACT W/WO STABILIZATION,14918.0,9696.7,0.01,14918.0,87
CDM,76115685,REMOVAL SUTURES/STAPLES NOT REQUIRING ANESTHESIA,751.0,488.15,0.01,3443.0,68
CDM,76115695,REMOVAL SUTURES&STAPLES NOT REQUIRING ANESTHESIA,1355.0,880.75,0.01,3443.0,68
CDM,76115705,RPR NSL VLV COLLAPSE LW NRG SUBQ/SBMCSL RMDLG,27212.0,17687.8,0.01,27212.0,87
CDM,76115715,PERQ P-ART REVSC ST 1ST NML NATIVE CONNJ UNI,65208.0,42385.2,0.01,65208.0,87
CDM,76115725,PERQ P-ART REVSC ST 1ST ABNORMAL CONNJ BILATERAL,65208.0,42385.2,0.01,65208.0,87
CDM,76115735,REPAIR EXTENSOR TENDON HAND W/O GRAFT EACH,7362.0,4785.3,0.01,7813.0,87
CDM,76115745,CORRECTION INVERTED NIPPLES,11488.0,7467.2,0.01,11488.0,87
CDM,76115755,EXCISION HYDROCELE UNILATERAL,16234.0,10552.1,0.01,16234.0,87
CDM,76115765,EXCISION SPERMATOCELE W/WO EPIDIDYMECTOMY,9423.0,6124.95,0.01,10789.0,87
CDM,76115785,LARYNGOSCOPY W/WO TRACHEOSCOPY DILATION SUBSQ,16960.0,11024.0,0.01,16960.0,87
CDM,76115815,"TATTOO REMOVAL, LASER (COMP 17110)",413.0,268.45,0.01,3443.0,85
CDM,76115825,INSJ NON-TUNNELED CENTRAL VENOUS CATH AGE < 5 Y,18098.0,11763.7,0.01,18098.0,87
CDM,76115835,NPWT (WOUND VAT),821.0,533.65,0.01,821.0,58
CDM,76115845,INCISION AND DRAINAGE,690.0,448.5,0.01,690.0,58
CDM,76115855,WOUND DEBRIDEMENT,1379.0,896.35,0.01,1379.0,58
CDM,76115865,APHERESIS,3379.0,2196.35,0.01,3379.0,58
CDM,76115875,TENOTOMY SHOULDER MULTIPLE THRU SAME INCISION,32861.0,21359.65,0.01,32861.0,87
CDM,76115945,BIOPSY BONE OPEN DEEP,13165.0,8557.25,0.01,13165.0,87
CDM,76115955,EXCISION SOFT TISSUE TUMOR SUBFASCIAL ON FINGER = / > 1.5CM (261,7453.0,4844.45,0.01,10364.0,87
CDM,76115985,VESTIBULOPLASTY ANTERIOR,27212.0,17687.8,0.01,27212.0,87
CDM,76115995,EXC LESION/TUMOR DENTOALVEOLAR STRUX W/SMPL RPR,14918.0,9696.7,0.01,14918.0,87
CDM,76116005,REPLACE ABUTMENT FOR BAHA (COMP 20670),1500.0,975.0,0.01,3443.0,85
CDM,76116015,PERIODONTAL MUCOSAL GRAFTING,6814.0,4429.1,0.01,6814.0,85
CDM,76116025,LASER HAIR REMOVAL (COMP 17110),413.0,268.45,0.01,3443.0,85
CDM,76116045,"UNLIST PROC, NERVOUS SYSTEM COMPARED TO 64640",2412.0,1567.8,0.01,3443.0,85
CDM,76116065,EXC LESION PALATE UVULA W/SMPL PRIM CLOSURE,14918.0,9696.7,0.01,14918.0,87
CDM,76116075,ICG LYMPHOGRAPHY,3162.0,2055.3,0.01,3443.0,85
CDM,76116085,INCISION EXTENSOR TENDON SHEATH WRIST,7362.0,4785.3,0.01,7813.0,87
CDM,76116095,REPAIR SYNDACTYLY EACH SPACE W/SKIN FLAPS,7362.0,4785.3,0.01,7362.0,87
CDM,76116105,"SIMP REPAIR FAC,EAR,EYE 7.6-12.5 CM",596.0,387.4,0.01,12500.0,87
CDM,76116115,CIRCUMCISION NEONATE,3070.0,1995.5,0.01,5265.0,87
CDM,76116125,"OSTEOPATHIC MANIP,1-2 BODY REGN",76.0,49.4,0.01,76.0,87
CDM,76116135,MANUAL REDUCTION OF INGUINAL HERNIA (COMP CODE 49505),2866.0,1862.9,0.01,3443.0,85
CDM,76116145,BONE REPLACEMENT GRAFT FOR RIDGE PRESERVATION,2000.0,1300.0,0.01,2384.51,66
CDM,76116155,"GUIDED TISSUE REGENERATION, NATURAL TEETH, PER SITE",2000.0,1300.0,0.01,2000.0,84
CDM,76116165,"GUIDED TISSUE REGENERATION, EDENTULOUS AREA",2000.0,1300.0,0.01,2000.0,66
CDM,76116175,EXC TUMOR SOFT TISSUE SHOULDER SUBFASCIAL 5 CM/>,13165.0,8557.25,0.01,13165.0,87
CDM,76116185,SURGICAL PLACEMENT OF IMPLANT BODY; ENDOSTEAL IMPLANT,2000.0,1300.0,0.01,2000.0,66
CDM,76116195,BONE GRAFT AT TIME OF IMPLANT PLACEMENT,2000.0,1300.0,0.01,2000.0,66
CDM,76116205,"GUIDED TISSUE REGENERATION RESORBABLY BARRIER, PER IMPLANT",2000.0,1300.0,0.01,2000.0,66
CDM,76116215,SURGICAL INDEX-FULLY GUIDED,2000.0,1300.0,0.01,2000.0,66
CDM,76116245,SUPRACHOROIDAL SPACE NJX PHARMACOLOGIC AGENT,1526.0,991.9,0.01,12500.0,87
CDM,76116255,INSTLJ THER AGENT RENAL PELVIS&/URETER VIA TUB,1119.0,727.35,0.01,3443.0,87
CDM,76116265,"UNLIST PROC, PELVIS OR HIP JOINT COMPARED TO 27000",6125.0,3981.25,0.01,6125.0,85
CDM,76116275,FOREIGN BODY REMOVAL (TOOTH) AND I&D (COMP CODE 10061),746.0,484.9,0.01,1087.99,85
CDM,76116285,NASAL/SINUS NDSC DSTRJ RF ABLATION PST NSL NRV,27212.0,17687.8,0.01,27212.0,87
CDM,76116295,REMOVAL OF BREAST IMPLANT,11488.0,7467.2,0.01,11488.0,87
CDM,76116315,PHARYNGOPLASTY PLSTC/RCNSTV OPRATION PHARYNX,27212.0,17687.8,0.01,27212.0,87
CDM,76116325,SLCTV CATH SUBCLAVIAN ART ANGIO VERTEBRAL ARTERY,18098.0,11763.7,0.01,18098.0,87
CDM,76116335,ARTL CATHJ PROLNG NFS THER CHEMOTX CUTDOWN,18098.0,11763.7,0.01,18098.0,87
CDM,76116345,PERQ PRCRD DRG 6YR+ W/O CONGENITAL CAR ANOMALY,5413.0,3518.45,0.01,10260.0,69
CDM,76116355,HYDRODISSECTION LEG (COMP CODE 20552),1220.0,793.0,0.01,3443.0,85
CDM,76116365,INTRASTROMAL INJ OF MITOMYCIN-C (COMP CODE 66030),9592.0,6234.8,0.01,9592.0,85
CDM,76116375,REMOVAL OF IMPLANT FROM HAND/FINGR,7453.0,4844.45,0.01,7453.0,87
CDM,76116385,TRACHEOSTOMY EMERGENCY PROCEDURE TRANSTRACHEAL,6814.0,4429.1,0.01,6814.0,79
CDM,76116395,TRACHEOSTOMY EMERGENCY CRICOTHYROID MEMBRANE,1068.0,694.2,0.01,3443.0,79
CDM,76116405,INSERT TUNNELED CVC W/O SUBQ PORT/PMP AGE <5 YR,31083.0,20203.95,0.01,31083.0,87
CDM,76116415,CONSTJ INTERMARGIN ADHES/TARSOR/CANTHOR W/TRPOS,10732.0,6975.8,0.01,10732.0,87
CDM,76116425,ARTL CATHJ/CANNULJ MNTR/TRANSFUSION SPX CUTDOWN,1489.0,967.85,0.01,1489.0,68
CDM,76116435,VENTRICULAR PUNCTURE PREVIOUS BURR HOLE W/INJ,4778.0,3105.7,0.01,4778.0,87
CDM,76116445,INSJ PRPH CTR VAD W/SUBQ PORT UNDER 5 YR,18098.0,11763.7,0.01,18098.0,87
CDM,76116455,INSJ/RPLCMT TEMP TRANSVNS 2CHMBR PACG ELTRDS SPX,47587.0,30931.55,0.01,47587.0,87
CDM,76116465,INSERTION PICC W/O IMG GDN < 5 YR,8932.0,5805.8,0.01,8932.0,87
CDM,76116475,INSERTION PICC W/RS&I < 5 YR,3555.0,2310.75,0.01,5597.0,87
CDM,76116485,CHEMOTX ADMN CNS REQ SPINAL PUNCTURE,2289.0,1487.85,0.01,2289.0,87
CDM,76116495,CHEMOTX ADMN PLEURAL CAVITY REQ&W/THORACNTS,2289.0,1487.85,0.01,2289.0,87
CDM,76116505,PERQ PRCRD DRG 0-5YR/ANY AGE W/CGEN CAR ANOMALY,5314.0,3454.1,0.01,5314.0,69
CDM,76116515,MAM STEREO BREAST BX FIRST LES,11180.0,7267.0,0.01,11180.0,87
CDM,76116525,CT GD DRAIN PERI/RETROPERI PER,7453.0,4844.45,0.01,10364.0,87
CDM,76116545,ITIND DEVICE REMOVAL SIMPLE (COMP CODE 52310 SIMPLE),7763.0,5045.95,0.01,7763.0,85
CDM,76116555,ITIND DEVICE REMOVAL COMPLICATED (COMP CODE 52315 COMPLICATED),7763.0,5045.95,0.01,7763.0,85
CDM,76116575,CRTJ SUBQ INSJ IMPLTBL GLUCOSE SENSOR SYS TRAIN (0446T),13002.0,8451.3,0.01,13002.0,87
CDM,76116585,RMVL IMPLTBL GLUCOSE SENSOR SUBQ POCKET VIA INC (0447T),645.0,419.25,0.01,645.0,58
CDM,76116595,RMVL INSJ IMPLTBL GLUC SENSOR DIF ANATOMIC SITE (0448T),5927.0,3852.55,0.01,5927.0,58
CDM,76116605,DSTR NEUROLYTIC TRIGEMINAL NRV 2/3 DIV BRANCH (64605),13474.0,8758.1,0.01,13474.0,87
CDM,76116615,PLASTIC REPAIR INTROITUS,14626.0,9506.9,0.01,14626.0,87
CDM,76116625,"ESOPHAGOSCOPY, RIGID, TRANSORAL; WITH BALLOON DILATION (LESS THA",17501.0,11375.65,0.01,17501.0,87
CDM,76116635,EXC LESION MUCOSA & SBMCSL VESTIBULE CPLX RPR,14918.0,9696.7,0.01,14918.0,87
CDM,76116655,REPAIR ENTROPION SUTURE,10732.0,6975.8,0.01,10732.0,87
CDM,76116665,SUBCUTANEOUS INJECTION FILLING MATRL 5.1-10.0CC,1836.0,1193.4,0.01,12500.0,87
CDM,76116675,ASPIRATION OF SPERMATOCELE (COMP CODE 55000),2682.0,1743.3,0.01,4337.0,85
CDM,76116695,ABLTJ PERC CRYOABLTJ IMG GDN UXTR/PERPH NERVE,7811.0,5077.15,0.01,7811.0,85
CDM,76116705,THORACOSCOPY WITH BIOPSIES OF PLEURA,26838.0,17444.7,0.01,26838.0,87
CDM,76116715,MICRONEEDLING SCAR (COMP CODE15783),821.0,533.65,0.01,3443.0,85
CDM,76116735,REMOVAL CRNL NRV NSTIM ELTRDS & PULSE GENERATOR,44188.0,28722.2,0.01,44188.0,87
CDM,76116785,BEDSIDE PERIPHERAL NERVE BLOCK,609.0,395.85,0.01,609.0,58
CDM,76116795,CHEMODENERVATION EXTRAOCULAR MUSCLE (67345),1375.0,893.75,0.01,3443.0,87
CDM,76117035,FRENULOTOMY OF PENIS,9423.0,6124.95,0.01,9423.0,87
CDM,76117045,SMPL RPR SCALP/NECK/AX/GENIT/TRUNK 20.1-30.0CM,1199.0,779.35,0.01,5265.0,87
CDM,76117055,PHOTOBIOMODULATION THERAPY RETINA SINGLE SESSION,48.0,31.2,0.01,229.5,66
CDM,76117065,CYSTO INSJ TEMP DEV ISCHMC RMDLG BLDR NECK&PRST8,33521.0,21788.65,0.01,33521.0,84
CDM,76117075,CATHJ RMVL TEMP DEV ISCHMC RMDLG BLDR NECK&PRST8,1119.0,727.35,0.01,12500.0,84
CDM,76117085,LARGSC ARYTENOIDECTOMY MICROSCOPE/TELESCOPE,31843.0,20697.95,0.01,31843.0,87
CDM,76117095,DBRDMT SKN SUBQ T/M/F NECRO INFCTJ GENT&PR,1138.0,739.7,0.01,1138.0,69
CDM,76117105,INSTILL PHARM RENAL PELVIS,10352.0,6728.8,0.01,10352.0,85
CDM,76117115,EUSTACHIAN TUBE INJECTION ENDOSCOPIC (COMP CODE 69705),16650.0,10822.5,0.01,16650.0,85
CDM,76117125,TULSA DEVICE MANAGEMENT (DONE BY TWO PHYS) INSERT OF TRANSURETHR,2128.0,1383.2,0.01,4337.0,67
CDM,76117135,"TULSA TREATMENT (DONE BY TWO PHYSICIANS) ABLATION PROSTATE TISS,",33629.0,21858.85,0.01,33629.0,67
CDM,76117145,"TULSA COMP PROC (DONE BY SING PHYS)ABL PROSTATE TISS, TRANSURETH",19510.0,12681.5,0.01,19510.0,84
CDM,76117155,EXCISION TROCHANTERIC BURSA/CALCIFICATION,14925.0,9701.25,0.01,14925.0,87
CDM,76117165,LOWER XTR FASCIAL PLANE BLOCK UNI INJECTION,753.0,489.45,0.01,3443.0,67
CDM,76117185,ASPIRATION OF INTRAMUSCULAR HEMATOMA (COMP CODE 10160),821.0,533.65,0.01,3443.0,85
CDM,76117195,VNPNXR <3 YEARS PHY/QHP SKILL FEMRAL/JUGLAR VEIN,158.0,102.7,0.01,158.0,68
CDM,76117205,IMPLTJ INTRAVITREAL DRUG DLVR SYS RMVL VTS,70678.0,45940.7,0.01,70678.0,87
CDM,76117245,VNPNXR <3 YEARS PHYS/QHP SKILL SCALP VEIN,129.0,83.85,0.01,129.0,68
CDM,76117255,"SIMP REPAIR FAC,EAR,EYE 12.6-20CM",1199.0,779.35,0.01,5265.0,87
CDM,76117265,DESTRUCTION LESION DENTOALVEOLAR STRUCTURES,6814.0,4429.1,0.01,6814.0,85
CDM,76117275,DSTRJ LESION PALATE/UVULA THERMAL CRYO/CHEM,14918.0,9696.7,0.01,14918.0,87
CDM,76117285,CLTX METACARPOPHALANGEAL DISLC W/MANJ W/ANES,7362.0,4785.3,0.01,7362.0,87
CDM,76117295,ABLTJ SOFT TIS INFERIOR TURBINATES UNI/BI SUPFC,6814.0,4429.1,0.01,6814.0,87
CDM,76117305,TRANSPERINEAL LASER ABLATION OF BENIGN PROSTATIC HYPERPLASIA INC,20334.0,13217.1,0.01,20334.0,85
CDM,76117315,TRANSPERINEAL LASER ABLATION OF BENIGN PROSTATE HYPERPLASIA INCL,20334.0,13217.1,0.01,20334.0,83
CDM,76117325,TRANSPERINEAL FOCAL LASER ABLATION OF MALIGNANT PROSTATE TISSUE,20334.0,13217.1,0.01,20334.0,85
CDM,76117335,EXCISION PILONIDAL CYST/SINUS SIMPLE,8586.0,5580.9,0.01,8586.0,87
CDM,76117345,LARGSC EXC TUM&/STRPG CORDS/EPIGL MCRSCP/TLSCP,16960.0,11024.0,0.01,16960.0,87
CDM,76117355,ESOPHAGOSCOPY FLEXIBLE TRANSNASAL WITH BIOPSY,4313.0,2803.45,0.01,5597.0,87
CDM,76117365,EXC TUMOR SFT TISS FOREARM&//WRIST SUBFASC 3+CM,13165.0,8557.25,0.01,13165.0,87
CDM,76117375,BEDSIDE PROCEDURE 1ST 30 MIN,3394.0,2206.1,0.01,3394.0,58
CDM,76117385,BEDSIDE PROCEDURE EA ADDL 30 MIN,2499.0,1624.35,0.01,2499.0,58
CDM,76117395,"LARYNGOSCOPY, DIRECT, OPERATIVE, W/OPERATING MICROSCOPE OR TELES",16960.0,11024.0,0.01,16960.0,87
CDM,76117405,TRANSCRV INSTLJ BIOD HYDROGEL MATRL INTRAUTERINE,831.0,540.15,0.01,3443.0,66
CDM,76117415,DRG OF SKENE'S GLAND ABSCESS OR CYST,965.0,627.25,0.01,3443.0,87
CDM,76117425,BIOPSY PROSTATE INCISIONAL ANY APPROACH,15865.0,10312.25,0.01,15865.0,87
CDM,76117435,BIOPSY PROSTATE TRANSRECTAL ULTRASOUND-GUIDED,16566.0,10767.9,0.01,16566.0,77
CDM,76117445,BX PROSTATE TRANSRECTAL US GID W/MRI FUS GDN 1ST,16566.0,10767.9,0.01,16566.0,77
CDM,76117455,BX PROSTATE TRANSPERINEAL ULTRASOUND-GUIDED,16566.0,10767.9,0.01,16566.0,77
CDM,76117465,BX PROSTATE TRANSPERINEAL US GID W/MRI FUS GDN 1,16566.0,10767.9,0.01,16566.0,77
CDM,76117475,BX PROSTATE TRANSRECTAL MRI-US GID TRGT LES 1ST,16566.0,10767.9,0.01,16566.0,77
CDM,76117485,BX PROSTATE TPRNL MRI-US GID TRGT LES 1ST,16566.0,10767.9,0.01,16566.0,77
CDM,76117495,BX PROSTATE IN-BORE CT/MRI BX ADDL TRGT LES 1ST,25198.0,16378.7,0.01,25198.0,77
CDM,76117505,BX PROSTATE IN-BORE CT/MRI TRGT LES ONLY 1ST,25198.0,16378.7,0.01,25198.0,77
CDM,76117515,BX PROSTATE EA ADDL MRI-US FUSION/IN-BORE CT/MRI,25198.0,16378.7,0.01,25198.0,67
CDM,76117525,INJECTION INTO BLADDER LESIONS (NON CHEMODENERVATION) (COMP CODE,9423.0,6124.95,0.01,9423.0,85
CDM,76117535,POLYDACTYL DIIGIT SOFT TISS W/ BONE,15377.0,9995.05,0.01,15377.0,87
CDM,76117545,NASAL/SINUS ENDOSCOPY DX SPHENOID SINUSOSCOPY,7933.0,5156.45,0.01,7933.0,87
CDM,76117555,INSJ TUNNELED CTR VAD W/SUBQ PORT UNDER 5 YR,2658.0,1727.7,0.01,7813.0,87
CDM,76120OH,CINERADIOGRAPY/VIDRADIOGRAPY XCPT WHERE SPEC,886.0,575.9,1.1,886.0,142
CDM,76120OH-26,CINERADIOGRAPY/VIDRADIOGRAPY XCPT WHERE SPEC,152.0,98.8,1.1,152.0,126
CDM,76120OH-TC,CINERADIOGRAPY/VIDRADIOGRAPY XCPT WHERE SPEC,734.0,477.1,1.1,734.0,126
CDM,76140OH,CONSLTJ X-RAY XM MADE ELSEWHERE WRTTN REPRT,1873.0,1217.45,1.1,1873.0,82
CDM,76140OH-26,CONSLTJ X-RAY XM MADE ELSEWHERE WRTTN REPRT,141.0,91.65,1.1,141.0,70
CDM,76140OH-TC,CONSLTJ X-RAY XM MADE ELSEWHERE WRTTN REPRT,1732.0,1125.8,1.1,1732.0,70
CDM,76200080,OBS SVC PER HOUR (13-23 HOURS),38.0,24.7,8.28,16307.0,70
CDM,76200085,CARDIAC - OBS HOSP SVC PER HR  (0-4 HRS),909.0,590.85,198.16,16307.0,70
CDM,76200090,OBS HOSP SVC PER HOUR (5-12 HOURS),70.0,45.5,15.26,16307.0,70
CDM,76200095,CARDIAC - OBS HOSP SVC PER HR (5-12 HRS),241.0,156.65,52.54,16307.0,70
CDM,76200100,OBS HOSP SVC PER HOUR (OVER 23 HRS),87.0,56.55,18.97,16307.0,70
CDM,76200105,CARDIAC - OBS SVC PER HR (13-23 HRS),105.0,68.25,22.89,16307.0,70
CDM,76200295,DIR ADMIT FOR HOSP OBV CARE,2452.0,1593.8,68.73,16307.0,88
CDM,76200335,OBSERVATION PER HR-FIRST HOUR,771.0,501.15,168.08,16307.0,70
CDM,76201235,OBSERVATION PER HR-FIRST HOUR,1011.0,657.15,209.0,16307.0,70
CDM,76201265,OBSERVATION CARVE-OUT PER HR,133.0,86.45,28.99,16307.0,70
CDM,76201275,OBSERV CARVE OUT 60 MINUTES GRP 9,133.0,86.45,28.99,16307.0,70
CDM,76201315,OBSERV CARVE OUT 60 MINUTES GRP 1,133.0,86.45,28.99,16307.0,70
CDM,76201325,OBSERV CARVE OUT GRP 7,133.0,86.45,28.99,16307.0,70
CDM,76201335,OBSERV CARVE OUT GRP 8,133.0,86.45,28.99,16307.0,70
CDM,76201345,OBSERV CARVE OUT 60 MINUTES GRP 2,133.0,86.45,28.99,16307.0,70
CDM,76201355,OBSERV CARVE OUT 60 MINUTES GRP 3,133.0,86.45,28.99,16307.0,70
CDM,76201365,OBSERV CARVE OUT 60 MINUTES GRP 4,133.0,86.45,28.99,16307.0,70
CDM,76201375,OBSERV CARVE OUT 60 MINUTES GRP 5,133.0,86.45,28.99,16307.0,70
CDM,76201385,OBSERV CARVE OUT 60 MINUTES GRP 6,133.0,86.45,28.99,16307.0,70
CDM,76201395,OBSERV CARVE OUT 60 MINUTES GRP 10,133.0,86.45,28.99,16307.0,70
CDM,76376OH,3D RENDERING W/INTERP & POSTPROCESS SUPERVISION,654.0,425.1,1.1,654.0,142
CDM,76376OH-26,3D RENDERING W/INTERP & POSTPROCESS SUPERVISION,88.0,57.2,1.1,88.0,126
CDM,76376OH-TC,3D RENDERING W/INTERP & POSTPROCESS SUPERVISION,566.0,367.9,1.1,566.0,126
CDM,76377OH,3D RENDERING W/INTERP&POSTPROC DIFF WORK STATION,1752.0,1138.8,1.1,1752.0,142
CDM,76377OH-26,3D RENDERING W/INTERP&POSTPROC DIFF WORK STATION,316.0,205.4,1.1,316.0,126
CDM,76377OH-TC,3D RENDERING W/INTERP&POSTPROC DIFF WORK STATION,1436.0,933.4,1.1,1436.0,126
CDM,76380OH,CT LIMITED/LOCALIZED FOLLOW UP STUDY,1000.0,650.0,1.1,1000.0,142
CDM,76380OH-26,CT LIMITED/LOCALIZED FOLLOW UP STUDY,392.0,254.8,1.1,392.0,126
CDM,76380OH-TC,CT LIMITED/LOCALIZED FOLLOW UP STUDY,608.0,395.2,1.1,608.0,126
CDM,76390OH,MRI SPECTROSCOPY,1076.0,699.4,1.1,1282.88,104
CDM,76390OH-26,MRI SPECTROSCOPY,468.0,304.2,1.1,468.0,92
CDM,76390OH-TC,MRI SPECTROSCOPY,608.0,395.2,1.1,1047.38,94
CDM,76391OH,MAGNETIC RESONANCE ELASTOGRAPHY,2152.0,1398.8,1.1,2152.0,142
CDM,76391OH-26,MAGNETIC RESONANCE ELASTOGRAPHY,484.0,314.6,1.1,484.0,126
CDM,76391OH-TC,MAGNETIC RESONANCE ELASTOGRAPHY,1668.0,1084.2,1.1,1668.0,126
CDM,76496OH,"UNLISTED FLUOROSCOPIC PROCEDURE (EG, DIAGNOSTIC, INTERVENTIONAL",406.0,263.9,0.01,406.0,94
CDM,76496OH-26,"UNLISTED FLUOROSCOPIC PROCEDURE (EG, DIAGNOSTIC, INTERVENTIONAL",157.0,102.05,1.1,157.0,70
CDM,76496OH-TC,"UNLISTED FLUOROSCOPIC PROCEDURE (EG, DIAGNOSTIC, INTERVENTIONAL",249.0,161.85,1.1,249.0,72
CDM,76496RVU10OH,CONDYLAR EMISSRAY VENOGRAM (COMP CODE 75860),22174.0,14413.1,0.01,22174.0,94
CDM,76496RVU10OH-26,CONDYLAR EMISSRAY VENOGRAM (COMP CODE 75860),456.0,296.4,1.1,456.0,70
CDM,76496RVU10OH-TC,CONDYLAR EMISSRAY VENOGRAM (COMP CODE 75860),21718.0,14116.7,1.1,21718.0,72
CDM,76496RVU11OH,VENOGRAM PARAVERTEBRAL VEIN (COMP CODE 75705),38171.0,24811.15,0.01,38171.0,94
CDM,76496RVU11OH-26,VENOGRAM PARAVERTEBRAL VEIN (COMP CODE 75705),872.0,566.8,1.1,872.0,70
CDM,76496RVU11OH-TC,VENOGRAM PARAVERTEBRAL VEIN (COMP CODE 75705),37299.0,24244.35,1.1,37299.0,72
CDM,76496RVU12OH,"VENOGRAM, INFERIOR PETROSAL SINUS (COMP CODE 75870)",22220.0,14443.0,0.01,22220.0,94
CDM,76496RVU12OH-26,"VENOGRAM, INFERIOR PETROSAL SINUS (COMP CODE 75870)",502.0,326.3,1.1,502.0,70
CDM,76496RVU12OH-TC,"VENOGRAM, INFERIOR PETROSAL SINUS (COMP CODE 75870)",21718.0,14116.7,1.1,21718.0,72
CDM,76496RVU13OH,VENOGRAM FACIAL VLM (VENOLYTIC MALFORMATION) (COMP CODE 75860),22174.0,14413.1,0.01,22174.0,94
CDM,76496RVU13OH-26,VENOGRAM FACIAL VLM (VENOLYTIC MALFORMATION) (COMP CODE 75860),456.0,296.4,1.1,456.0,70
CDM,76496RVU13OH-TC,VENOGRAM FACIAL VLM (VENOLYTIC MALFORMATION) (COMP CODE 75860),21718.0,14116.7,1.1,21718.0,72
CDM,76496RVU14OH,VENOGRAM ILIOLUMBAR VEIN (COMP CODE 75705),38171.0,24811.15,0.01,38171.0,94
CDM,76496RVU14OH-26,VENOGRAM ILIOLUMBAR VEIN (COMP CODE 75705),872.0,566.8,1.1,872.0,70
CDM,76496RVU14OH-TC,VENOGRAM ILIOLUMBAR VEIN (COMP CODE 75705),37229.0,24198.85,1.1,37229.0,72
CDM,76496RVU15OH,VENOGRAM VERTEBRAL VEIN (COMP CODE 75705),38171.0,24811.15,0.01,38171.0,94
CDM,76496RVU15OH-26,VENOGRAM VERTEBRAL VEIN (COMP CODE 75705),872.0,566.8,1.1,872.0,70
CDM,76496RVU15OH-TC,VENOGRAM VERTEBRAL VEIN (COMP CODE 75705),37299.0,24244.35,1.1,37299.0,72
CDM,76496RVU16OH,VENOGRAM SPLENIC VEIN (COMP CODE 75891),22174.0,14413.1,0.01,22174.0,94
CDM,76496RVU16OH-26,VENOGRAM SPLENIC VEIN (COMP CODE 75891),456.0,296.4,1.1,456.0,70
CDM,76496RVU16OH-TC,VENOGRAM SPLENIC VEIN (COMP CODE 75891),21718.0,14116.7,1.1,21718.0,72
CDM,76496RVU17OH,VENOGRAM SEGMENTAL VEIN (COMP CODE 75705),38171.0,24811.15,0.01,38171.0,94
CDM,76496RVU17OH-26,VENOGRAM SEGMENTAL VEIN (COMP CODE 75705),872.0,566.8,1.1,872.0,70
CDM,76496RVU17OH-TC,VENOGRAM SEGMENTAL VEIN (COMP CODE 75705),37299.0,24244.35,1.1,37299.0,72
CDM,76496RVU18OH,VENOGRAM VENOLYMPHATIC MALFORMATION (COMP CODE 75774),4586.0,2980.9,0.01,4586.0,94
CDM,76496RVU18OH-26,VENOGRAM VENOLYMPHATIC MALFORMATION (COMP CODE 75774),404.0,262.6,1.1,404.0,70
CDM,76496RVU18OH-TC,VENOGRAM VENOLYMPHATIC MALFORMATION (COMP CODE 75774),4182.0,2718.3,1.1,4182.0,72
CDM,76496RVU19OH,VENOGRAM GASTRODUODENAL SHUNT (COMP CODE 75891),22174.0,14413.1,0.01,22174.0,94
CDM,76496RVU19OH-26,VENOGRAM GASTRODUODENAL SHUNT (COMP CODE 75891),456.0,296.4,1.1,456.0,70
CDM,76496RVU19OH-TC,VENOGRAM GASTRODUODENAL SHUNT (COMP CODE 75891),21718.0,14116.7,1.1,21718.0,72
CDM,76496RVU1OH,ANGIOGRAM ITA (INFERIOR THYROID ARTERY) (COMP CODE 75710),20311.0,13202.15,0.01,20311.0,94
CDM,76496RVU1OH-26,ANGIOGRAM ITA (INFERIOR THYROID ARTERY) (COMP CODE 75710),631.0,410.15,1.1,631.0,70
CDM,76496RVU1OH-TC,ANGIOGRAM ITA (INFERIOR THYROID ARTERY) (COMP CODE 75710),19380.0,12597.0,1.1,19380.0,72
CDM,76496RVU20OH,VENOGRAM SAPHENOUS VEIN (COMP CODE 75820),11139.0,7240.35,0.01,11139.0,94
CDM,76496RVU20OH-26,VENOGRAM SAPHENOUS VEIN (COMP CODE 75820),420.0,273.0,1.1,420.0,70
CDM,76496RVU20OH-TC,VENOGRAM SAPHENOUS VEIN (COMP CODE 75820),10719.0,6967.35,1.1,10719.0,72
CDM,76496RVU21OH,VENOGRAM CARDINAL VARIX (COMP CODE 75891),22174.0,14413.1,0.01,22174.0,94
CDM,76496RVU21OH-26,VENOGRAM CARDINAL VARIX (COMP CODE 75891),456.0,296.4,1.1,456.0,70
CDM,76496RVU21OH-TC,VENOGRAM CARDINAL VARIX (COMP CODE 75891),21718.0,14116.7,1.1,21718.0,72
CDM,76496RVU2OH,VENOGRAM VENOUS MALFORMATION (COMP CODE 75774),4236.0,2753.4,0.01,4236.0,94
CDM,76496RVU2OH-26,VENOGRAM VENOUS MALFORMATION (COMP CODE 75774),364.0,236.6,1.1,364.0,70
CDM,76496RVU2OH-TC,VENOGRAM VENOUS MALFORMATION (COMP CODE 75774),3872.0,2516.8,1.1,3872.0,72
CDM,76496RVU3OH,VENOGRAM PARASPINAL VEIN (COMP CODE 75705),34714.0,22564.1,0.01,34714.0,94
CDM,76496RVU3OH-26,VENOGRAM PARASPINAL VEIN (COMP CODE 75705),785.0,510.25,1.1,785.0,70
CDM,76496RVU3OH-TC,VENOGRAM PARASPINAL VEIN (COMP CODE 75705),33929.0,22053.85,1.1,33929.0,72
CDM,76496RVU4OH,VENOGRAM PERIUTERINE VEIN (COMP CODE 75736),34340.0,22321.0,0.01,34340.0,94
CDM,76496RVU4OH-26,VENOGRAM PERIUTERINE VEIN (COMP CODE 75736),411.0,267.15,1.1,411.0,70
CDM,76496RVU4OH-TC,VENOGRAM PERIUTERINE VEIN (COMP CODE 75736),33929.0,22053.85,1.1,33929.0,72
CDM,76496RVU5OH,VENOGRAM AZYGOS VEIN (COMP CODE 75705),34714.0,22564.1,0.01,34714.0,94
CDM,76496RVU5OH-26,VENOGRAM AZYGOS VEIN (COMP CODE 75705),785.0,510.25,1.1,785.0,70
CDM,76496RVU5OH-TC,VENOGRAM AZYGOS VEIN (COMP CODE 75705),33929.0,22053.85,1.1,33929.0,72
CDM,76496RVU6OH,VENOGRAM GASTRIC VEIN (COMP CODE 75891),20091.0,13059.15,0.01,20091.0,94
CDM,76496RVU6OH-26,VENOGRAM GASTRIC VEIN (COMP CODE 75891),411.0,267.15,1.1,411.0,70
CDM,76496RVU6OH-TC,VENOGRAM GASTRIC VEIN (COMP CODE 75891),19680.0,12792.0,1.1,19680.0,72
CDM,76496RVU7OH,VENOGRAM GONADAL VEIN (COMP CODE 75831),20091.0,13059.15,0.01,20091.0,94
CDM,76496RVU7OH-26,VENOGRAM GONADAL VEIN (COMP CODE 75831),411.0,267.15,1.1,411.0,70
CDM,76496RVU7OH-TC,VENOGRAM GONADAL VEIN (COMP CODE 75831),19680.0,12792.0,1.1,19680.0,72
CDM,76496RVU8OH,VENOGRAM IMV (INFERIOR MESENTERIC VEIN) (COMP CODE 75891),20091.0,13059.15,0.01,20091.0,94
CDM,76496RVU8OH-26,VENOGRAM IMV (INFERIOR MESENTERIC VEIN) (COMP CODE 75891),411.0,267.15,1.1,411.0,70
CDM,76496RVU8OH-TC,VENOGRAM IMV (INFERIOR MESENTERIC VEIN) (COMP CODE 75891),19680.0,12792.0,1.1,19680.0,72
CDM,76496RVU9OH,VENOGRAM SUPERIOR  MESENTERIC VEIN (COMP CODE 75891),22174.0,14413.1,0.01,22174.0,94
CDM,76496RVU9OH-26,VENOGRAM SUPERIOR  MESENTERIC VEIN (COMP CODE 75891),456.0,296.4,1.1,456.0,70
CDM,76496RVU9OH-TC,VENOGRAM SUPERIOR  MESENTERIC VEIN (COMP CODE 75891),21718.0,14116.7,1.1,21718.0,72
CDM,76497OH,UNLISTED COMPUTED TOMOGRAPHY PROCEDURE,120.0,78.0,0.01,266.31,94
CDM,76497OH-26,UNLISTED COMPUTED TOMOGRAPHY PROCEDURE,55.0,35.75,1.1,55.0,70
CDM,76497OH-TC,UNLISTED COMPUTED TOMOGRAPHY PROCEDURE,65.0,42.25,1.1,232.12,72
CDM,76497WBOH,LOW DOSE WHOLE BODY CT (COMP CODE 78813),10864.0,7061.6,0.01,10864.0,94
CDM,76497WBOH-26,LOW DOSE WHOLE BODY CT (COMP CODE 78813),800.0,520.0,1.1,800.0,70
CDM,76497WBOH-TC,LOW DOSE WHOLE BODY CT (COMP CODE 78813),10064.0,6541.6,1.1,10064.0,72
CDM,76498AOH,MRI GAMMA KNIFE LOCAL W CONT,3042.0,1977.3,0.01,3042.0,94
CDM,76498AOH-26,MRI GAMMA KNIFE LOCAL W CONT,587.0,381.55,1.1,587.0,70
CDM,76498AOH-TC,MRI GAMMA KNIFE LOCAL W CONT,2455.0,1595.75,1.1,2455.0,72
CDM,76498BOH,MRI BREAST LIMITED,350.0,227.5,0.01,350.0,94
CDM,76498BOH-26,MRI BREAST LIMITED,125.0,81.25,1.1,125.0,70
CDM,76498BOH-TC,MRI BREAST LIMITED,225.0,146.25,1.1,238.77,72
CDM,76498COH,MRI CERVICAL LOCALIZATION W IVCON,3230.0,2099.5,0.01,3230.0,94
CDM,76498COH-26,MRI CERVICAL LOCALIZATION W IVCON,579.0,376.35,1.1,579.0,70
CDM,76498COH-TC,MRI CERVICAL LOCALIZATION W IVCON,2651.0,1723.15,1.1,2651.0,72
CDM,76498DOH,MRI BRAIN LOCALIZATION WO CONT,4018.0,2611.7,0.01,4018.0,94
CDM,76498DOH-26,MRI BRAIN LOCALIZATION WO CONT,2319.0,1507.35,1.1,2319.0,70
CDM,76498DOH-TC,MRI BRAIN LOCALIZATION WO CONT,1699.0,1104.35,1.1,1699.0,72
CDM,76498GOH,MRI BRAIN LOCALIZATION WWO CONT,2685.0,1745.25,0.01,2685.0,94
CDM,76498GOH-26,MRI BRAIN LOCALIZATION WWO CONT,756.0,491.4,1.1,756.0,70
CDM,76498GOH-TC,MRI BRAIN LOCALIZATION WWO CONT,1929.0,1253.85,1.1,1929.0,72
CDM,76498LOH,MRI LUMBAR LOCALIZATION W IVCON,3238.0,2104.7,0.01,3238.0,94
CDM,76498LOH-26,MRI LUMBAR LOCALIZATION W IVCON,587.0,381.55,1.1,587.0,70
CDM,76498LOH-TC,MRI LUMBAR LOCALIZATION W IVCON,2651.0,1723.15,1.1,2651.0,72
CDM,76498OH,UNLISTED MAGNETIC RESONANCE PROCED,1650.0,1072.5,0.01,1650.0,94
CDM,76498POH,MRI PROSTATE LIMITED WO IVCON,350.0,227.5,0.01,350.0,94
CDM,76498POH-26,MRI PROSTATE LIMITED WO IVCON,70.0,45.5,1.1,70.0,70
CDM,76498POH-TC,MRI PROSTATE LIMITED WO IVCON,280.0,182.0,1.1,280.0,72
CDM,76498POM1OH,MRI PRE-OP MAPPING W/CONTRAST,1237.0,804.05,0.01,1237.0,94
CDM,76498POM1OH-26,MRI PRE-OP MAPPING W/CONTRAST,629.0,408.85,1.1,629.0,70
CDM,76498POM1OH-TC,MRI PRE-OP MAPPING W/CONTRAST,608.0,395.2,1.1,608.0,72
CDM,76498POM2OH,MRI PRE-OP MAPPING W/WO CNTRST,1443.0,937.95,0.01,1443.0,94
CDM,76498POM2OH-26,MRI PRE-OP MAPPING W/WO CNTRST,835.0,542.75,1.1,835.0,70
CDM,76498POM2OH-TC,MRI PRE-OP MAPPING W/WO CNTRST,608.0,395.2,1.1,608.0,72
CDM,76498POMOH,MRI PRE-OP MAPPING W/O CONTRST,1131.0,735.15,0.01,1131.0,94
CDM,76498POMOH-26,MRI PRE-OP MAPPING W/O CONTRST,523.0,339.95,1.1,523.0,70
CDM,76498POMOH-TC,MRI PRE-OP MAPPING W/O CONTRST,608.0,395.2,1.1,608.0,72
CDM,76498RVU1OH,MRI BRAIN W/WO CONTRAST PC,3243.0,2107.95,0.01,3243.0,94
CDM,76498RVU1OH-26,MRI BRAIN W/WO CONTRAST PC,779.0,506.35,1.1,779.0,70
CDM,76498RVU1OH-TC,MRI BRAIN W/WO CONTRAST PC,2464.0,1601.6,1.1,2464.0,72
CDM,76498RVU2OH,MRI 3D CAD (COMP CODE 76377),1488.0,967.2,0.01,1488.0,94
CDM,76498RVU2OH-26,MRI 3D CAD (COMP CODE 76377),257.0,167.05,1.1,257.0,70
CDM,76498RVU2OH-TC,MRI 3D CAD (COMP CODE 76377),1231.0,800.15,1.1,1231.0,72
CDM,76498RVU3OH,WHOLE BODY MRI (COMP CODE 78816),10965.0,7127.25,0.01,10965.0,94
CDM,76498RVU3OH-26,WHOLE BODY MRI (COMP CODE 78816),901.0,585.65,1.1,901.0,70
CDM,76498RVU3OH-TC,WHOLE BODY MRI (COMP CODE 78816),10064.0,6541.6,1.1,10064.0,72
CDM,76498RVUOH,MMR BRAIN WITH PC,3051.0,1983.15,0.01,3051.0,94
CDM,76498RVUOH-26,MMR BRAIN WITH PC,587.0,381.55,1.1,587.0,70
CDM,76498RVUOH-TC,MMR BRAIN WITH PC,2464.0,1601.6,1.1,2464.0,72
CDM,76498TOH,MRI THORACIC LOCALIZATION W IVCON,3230.0,2099.5,0.01,3230.0,94
CDM,76498TOH-26,MRI THORACIC LOCALIZATION W IVCON,579.0,376.35,1.1,579.0,70
CDM,76498TOH-TC,MRI THORACIC LOCALIZATION W IVCON,2651.0,1723.15,1.1,2651.0,72
CDM,76499BDOH,BD WHOLE BODY COMPOSITION,819.0,532.35,0.01,819.0,82
CDM,76499BDOH-26,BD WHOLE BODY COMPOSITION,85.0,55.25,0.01,85.0,82
CDM,76499BDOH-TC,BD WHOLE BODY COMPOSITION,734.0,477.1,0.01,734.0,82
CDM,76499OH,UNLISTED DIAGNOSTIC RADIOGRAPHIC PROCEDURE,267.0,173.55,0.01,267.0,82
CDM,76499OH-26,UNLISTED DIAGNOSTIC RADIOGRAPHIC PROCEDURE,66.0,42.9,0.01,66.0,82
CDM,76499OH-TC,UNLISTED DIAGNOSTIC RADIOGRAPHIC PROCEDURE,201.0,130.65,0.01,201.0,82
CDM,76499RVU1OH,3D RENDERING LIVER (DONOR) S&I,2535.0,1647.75,0.01,2535.0,82
CDM,76499RVU1OH-26,3D RENDERING LIVER (DONOR) S&I,1099.0,714.35,0.01,1099.0,82
CDM,76499RVU1OH-TC,3D RENDERING LIVER (DONOR) S&I,1436.0,933.4,0.01,1436.0,82
CDM,76499RVU2OH,UNLISTED PROC; SPY ELITE EVAL OF INTESTINE (COMP TO 78445),2935.0,1907.75,0.01,2935.0,82
CDM,76499RVU2OH-26,UNLISTED PROC; SPY ELITE EVAL OF INTESTINE (COMP TO 78445),162.0,105.3,0.01,162.0,82
CDM,76499RVU2OH-TC,UNLISTED PROC; SPY ELITE EVAL OF INTESTINE (COMP TO 78445),2773.0,1802.45,0.01,2773.0,82
CDM,76499RVU3OH,"VENOGRAPHY, PULM, SEL. RADIOLOGICAL SUPV.&INTERP (COMP CODE 7574",21750.0,14137.5,0.01,21750.0,82
CDM,76499RVU3OH-26,"VENOGRAPHY, PULM, SEL. RADIOLOGICAL SUPV.&INTERP (COMP CODE 7574",32.0,20.8,0.01,32.0,82
CDM,76499RVU3OH-TC,"VENOGRAPHY, PULM, SEL. RADIOLOGICAL SUPV.&INTERP (COMP CODE 7574",21718.0,14116.7,0.01,21718.0,82
CDM,76499RVU4OH,UNLISTED DXA BODY COMPOSITION STUDY (COMP CODE 77080),819.0,532.35,0.01,819.0,82
CDM,76499RVU4OH-26,UNLISTED DXA BODY COMPOSITION STUDY (COMP CODE 77080),85.0,55.25,0.01,85.0,82
CDM,76499RVU4OH-TC,UNLISTED DXA BODY COMPOSITION STUDY (COMP CODE 77080),734.0,477.1,0.01,734.0,82
CDM,76499RVU5OH,ENDOVASCULAR REPAIR OF ASCENDING AORTA; RS&I (COMP TO 75957),2161.0,1404.65,0.01,2161.0,82
CDM,76499RVU6OH,ENDOVASCULAR REPAIR OF TRANSVERSE AORTIC ARCH; INVOLVING COVERAG,3011.0,1957.15,0.01,3011.0,82
CDM,76499RVU7OH,LYMPHANGIOGRAPHY OF FACE & NECK (COMP CODE 75803),11223.0,7294.95,0.01,11223.0,82
CDM,76499RVU7OH-26,LYMPHANGIOGRAPHY OF FACE & NECK (COMP CODE 75803),504.0,327.6,0.01,504.0,82
CDM,76499RVU7OH-TC,LYMPHANGIOGRAPHY OF FACE & NECK (COMP CODE 75803),10719.0,6967.35,0.01,10719.0,82
CDM,76499RVUOH,CT ABDOMEN W/O SCREENING,1258.0,817.7,0.01,1258.0,82
CDM,76499RVUOH-26,CT ABDOMEN W/O SCREENING,524.0,340.6,0.01,524.0,82
CDM,76499RVUOH-TC,CT ABDOMEN W/O SCREENING,734.0,477.1,0.01,734.0,82
CDM,76506OH,ECHOENCEPHALOGRAPHY REAL TIME IMAGING,986.0,640.9,1.1,986.0,142
CDM,76506OH-26,ECHOENCEPHALOGRAPHY REAL TIME IMAGING,252.0,163.8,1.1,252.0,126
CDM,76506OH-TC,ECHOENCEPHALOGRAPHY REAL TIME IMAGING,734.0,477.1,1.1,734.0,126
CDM,76510OH,OPHTHALMIC US DX B-SCAN&QUAN A-SCAN SM PT ENCTR,1197.0,778.05,1.1,1197.0,142
CDM,76510OH-26,OPHTHALMIC US DX B-SCAN&QUAN A-SCAN SM PT ENCTR,308.0,200.2,1.1,308.0,126
CDM,76510OH-TC,OPHTHALMIC US DX B-SCAN&QUAN A-SCAN SM PT ENCTR,889.0,577.85,1.1,889.0,126
CDM,76511OH,OPHTHALMIC US DX QUANTITATIVE A-SCAN ONLY,1016.0,660.4,1.1,1016.0,142
CDM,76511OH-26,OPHTHALMIC US DX QUANTITATIVE A-SCAN ONLY,282.0,183.3,1.1,282.0,126
CDM,76511OH-TC,OPHTHALMIC US DX QUANTITATIVE A-SCAN ONLY,734.0,477.1,1.1,734.0,126
CDM,76512OH,OPHTHALMIC US DX B-SCAN W/WO NON-QUAN A-SCAN,980.0,637.0,1.1,980.0,142
CDM,76512OH-26,OPHTHALMIC US DX B-SCAN W/WO NON-QUAN A-SCAN,246.0,159.9,1.1,246.0,126
CDM,76512OH-TC,OPHTHALMIC US DX B-SCAN W/WO NON-QUAN A-SCAN,734.0,477.1,1.1,734.0,126
CDM,76513OH,DX OPHTHALMIC US ANT SEGMENT IMMERSION UNI/BI,998.0,648.7,1.1,998.0,142
CDM,76513OH-26,DX OPHTHALMIC US ANT SEGMENT IMMERSION UNI/BI,264.0,171.6,1.1,264.0,126
CDM,76513OH-TC,DX OPHTHALMIC US ANT SEGMENT IMMERSION UNI/BI,734.0,477.1,1.1,734.0,126
CDM,76514OH,OPHTHALMIC US DX CORNEAL PACHYMETRY UNI/BI,231.0,150.15,1.1,231.0,142
CDM,76514OH-26,OPHTHALMIC US DX CORNEAL PACHYMETRY UNI/BI,62.0,40.3,1.1,62.0,126
CDM,76514OH-TC,OPHTHALMIC US DX CORNEAL PACHYMETRY UNI/BI,169.0,109.85,1.1,169.0,126
CDM,76516OH,OPHTHALMIC BIOMETRY US ECHOGRAPY A-SCAN,910.0,591.5,1.1,910.0,142
CDM,76516OH-26,OPHTHALMIC BIOMETRY US ECHOGRAPY A-SCAN,176.0,114.4,1.1,176.0,126
CDM,76516OH-TC,OPHTHALMIC BIOMETRY US ECHOGRAPY A-SCAN,734.0,477.1,1.1,734.0,126
CDM,76519OH,OPH BMTRY US ECHOGRAPY A-SCAN IO LENS PWR CAL,950.0,617.5,1.1,950.0,142
CDM,76519OH-26,OPH BMTRY US ECHOGRAPY A-SCAN IO LENS PWR CAL,216.0,140.4,1.1,216.0,126
CDM,76519OH-TC,OPH BMTRY US ECHOGRAPY A-SCAN IO LENS PWR CAL,734.0,477.1,1.1,734.0,126
CDM,76529OH,OPHTHALMIC ULTRASONIC FOREIGN BODY LOCALIZATION,836.0,543.4,1.1,836.0,142
CDM,76529OH-26,OPHTHALMIC ULTRASONIC FOREIGN BODY LOCALIZATION,228.0,148.2,1.1,228.0,126
CDM,76529OH-TC,OPHTHALMIC ULTRASONIC FOREIGN BODY LOCALIZATION,608.0,395.2,1.1,608.0,126
CDM,76536OH,US SOFT TISSUE HEAD & NECK REAL TIME IMGE DOCM,980.0,637.0,1.1,980.0,142
CDM,76536OH-26,US SOFT TISSUE HEAD & NECK REAL TIME IMGE DOCM,246.0,159.9,1.1,246.0,126
CDM,76536OH-TC,US SOFT TISSUE HEAD & NECK REAL TIME IMGE DOCM,734.0,477.1,1.1,734.0,126
CDM,76604OH,US CHEST REAL TIME W/IMAGE DOCUMENTATION,970.0,630.5,1.1,970.0,142
CDM,76604OH-26,US CHEST REAL TIME W/IMAGE DOCUMENTATION,236.0,153.4,1.1,236.0,126
CDM,76604OH-TC,US CHEST REAL TIME W/IMAGE DOCUMENTATION,734.0,477.1,1.1,734.0,126
CDM,76641OH,US BREAST UNI REAL TIME WITH IMAGE COMPLETE,1055.0,685.75,1.1,1055.0,142
CDM,76641OH-26,US BREAST UNI REAL TIME WITH IMAGE COMPLETE,321.0,208.65,1.1,321.0,126
CDM,76641OH-TC,US BREAST UNI REAL TIME WITH IMAGE COMPLETE,734.0,477.1,1.1,734.0,126
CDM,76642OH,US BREAST UNI REAL TIME WITH IMAGE LIMITED,907.0,589.55,1.1,907.0,142
CDM,76642OH-26,US BREAST UNI REAL TIME WITH IMAGE LIMITED,299.0,194.35,1.1,299.0,126
CDM,76642OH-TC,US BREAST UNI REAL TIME WITH IMAGE LIMITED,608.0,395.2,1.1,608.0,126
CDM,76700OH,US ABDOMINAL REAL TIME W/IMAGE DOCUMENTATION,1090.0,708.5,1.1,1090.0,142
CDM,76700OH-26,US ABDOMINAL REAL TIME W/IMAGE DOCUMENTATION,356.0,231.4,1.1,356.0,126
CDM,76700OH-TC,US ABDOMINAL REAL TIME W/IMAGE DOCUMENTATION,734.0,477.1,1.1,734.0,126
CDM,76705OH,US ABDOMINAL REAL TIME W/IMAGE LIMITED,994.0,646.1,1.1,994.0,142
CDM,76705OH-26,US ABDOMINAL REAL TIME W/IMAGE LIMITED,260.0,169.0,1.1,260.0,126
CDM,76705OH-TC,US ABDOMINAL REAL TIME W/IMAGE LIMITED,734.0,477.1,1.1,734.0,126
CDM,76706OH,US ABDOMINAL AORTA REAL TIME SCREEN STUDY AAA,954.0,620.1,1.1,954.0,142
CDM,76706OH-26,US ABDOMINAL AORTA REAL TIME SCREEN STUDY AAA,220.0,143.0,1.1,220.0,114
CDM,76706OH-TC,US ABDOMINAL AORTA REAL TIME SCREEN STUDY AAA,734.0,477.1,1.1,734.0,114
CDM,76770OH,US RETROPERITONEAL REAL TIME W/IMAGE COMPLETE,1060.0,689.0,1.1,1060.0,142
CDM,76770OH-26,US RETROPERITONEAL REAL TIME W/IMAGE COMPLETE,326.0,211.9,1.1,326.0,126
CDM,76770OH-TC,US RETROPERITONEAL REAL TIME W/IMAGE COMPLETE,734.0,477.1,1.1,734.0,126
CDM,76775OH,US RETROPERITONEAL REAL TIME W/IMAGE LIMITED,966.0,627.9,1.1,966.0,142
CDM,76775OH-26,US RETROPERITONEAL REAL TIME W/IMAGE LIMITED,232.0,150.8,1.1,232.0,126
CDM,76775OH-TC,US RETROPERITONEAL REAL TIME W/IMAGE LIMITED,734.0,477.1,1.1,734.0,126
CDM,76776OH,US TRNSPLNT KIDNEY REAL TIME W/IMAGE DOCMTN,1038.0,674.7,1.1,1038.0,142
CDM,76776OH-26,US TRNSPLNT KIDNEY REAL TIME W/IMAGE DOCMTN,304.0,197.6,1.1,304.0,126
CDM,76776OH-TC,US TRNSPLNT KIDNEY REAL TIME W/IMAGE DOCMTN,734.0,477.1,1.1,734.0,126
CDM,76800OH,ULTRASOUND SPINAL CANAL & CONTENTS,1186.0,770.9,1.1,1186.0,142
CDM,76800OH-26,ULTRASOUND SPINAL CANAL & CONTENTS,452.0,293.8,1.1,452.0,126
CDM,76800OH-TC,ULTRASOUND SPINAL CANAL & CONTENTS,734.0,477.1,1.1,734.0,126
CDM,76801OH,US PREGNANT UTERUS 14 WK TRANSABDL 1/1ST GESTAT,1170.0,760.5,1.1,1170.0,142
CDM,76801OH-26,US PREGNANT UTERUS 14 WK TRANSABDL 1/1ST GESTAT,436.0,283.4,1.1,436.0,126
CDM,76801OH-TC,US PREGNANT UTERUS 14 WK TRANSABDL 1/1ST GESTAT,734.0,477.1,1.1,734.0,126
CDM,76802OH,US PREG UTERUS 14 WK TRANSABDL EACH GESTATION,1076.0,699.4,1.1,1076.0,142
CDM,76802OH-26,US PREG UTERUS 14 WK TRANSABDL EACH GESTATION,365.0,237.25,1.1,365.0,126
CDM,76802OH-TC,US PREG UTERUS 14 WK TRANSABDL EACH GESTATION,711.0,462.15,1.1,711.0,126
CDM,76805OH,US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION,1130.0,734.5,1.1,1130.0,142
CDM,76805OH-26,US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION,396.0,257.4,1.1,396.0,126
CDM,76805OH-TC,US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION,734.0,477.1,1.1,734.0,126
CDM,76810OH,US PREG UTERUS > 1ST TRIMESTER ABDL EA GESTATIO,1103.0,716.95,1.1,1103.0,142
CDM,76810OH-26,US PREG UTERUS > 1ST TRIMESTER ABDL EA GESTATIO,392.0,254.8,1.1,392.0,126
CDM,76810OH-TC,US PREG UTERUS > 1ST TRIMESTER ABDL EA GESTATIO,711.0,462.15,1.1,711.0,126
CDM,76811OH,US PREG UTERUS W/DETAIL FETAL ANAT 1ST GESTATION,2428.0,1578.2,1.1,2428.0,142
CDM,76811OH-26,US PREG UTERUS W/DETAIL FETAL ANAT 1ST GESTATION,760.0,494.0,1.1,760.0,126
CDM,76811OH-TC,US PREG UTERUS W/DETAIL FETAL ANAT 1ST GESTATION,1668.0,1084.2,1.1,1668.0,126
CDM,76812OH,US PREG UTERUS DETAIL FETAL ANAT EXAM EA GESTAT,1366.0,887.9,1.1,1366.0,142
CDM,76812OH-26,US PREG UTERUS DETAIL FETAL ANAT EXAM EA GESTAT,712.0,462.8,1.1,712.0,126
CDM,76812OH-TC,US PREG UTERUS DETAIL FETAL ANAT EXAM EA GESTAT,654.0,425.1,1.1,654.0,126
CDM,76813OH,US FETAL NUCHAL TRANSLUCENCY 1ST GESTATION,1206.0,783.9,1.1,1206.0,142
CDM,76813OH-26,US FETAL NUCHAL TRANSLUCENCY 1ST GESTATION,472.0,306.8,1.1,472.0,126
CDM,76813OH-TC,US FETAL NUCHAL TRANSLUCENCY 1ST GESTATION,734.0,477.1,1.1,734.0,126
CDM,76814OH,US FETAL NUCHAL TRANSLUCENCY EA ADDL GESTATION,822.0,534.3,1.1,822.0,142
CDM,76814OH-26,US FETAL NUCHAL TRANSLUCENCY EA ADDL GESTATION,396.0,257.4,1.1,396.0,126
CDM,76814OH-TC,US FETAL NUCHAL TRANSLUCENCY EA ADDL GESTATION,426.0,276.9,1.1,426.0,126
CDM,76815OH,US PREGNANT UTERUS LIMITED 1/> FETUSES,1020.0,663.0,1.1,1020.0,142
CDM,76815OH-26,US PREGNANT UTERUS LIMITED 1/> FETUSES,286.0,185.9,1.1,286.0,126
CDM,76815OH-TC,US PREGNANT UTERUS LIMITED 1/> FETUSES,734.0,477.1,1.1,734.0,126
CDM,76816OH,US PREG UTERUS REAL TIME F/U TRNSABDL PER FETUS,1108.0,720.2,1.1,1108.0,142
CDM,76816OH-26,US PREG UTERUS REAL TIME F/U TRNSABDL PER FETUS,374.0,243.1,1.1,374.0,126
CDM,76816OH-TC,US PREG UTERUS REAL TIME F/U TRNSABDL PER FETUS,734.0,477.1,1.1,734.0,126
CDM,76817OH,US PREG UTERUS REAL TIME W/IMAGE DCMTN TRANSVAG,1034.0,672.1,1.1,1034.0,142
CDM,76817OH-26,US PREG UTERUS REAL TIME W/IMAGE DCMTN TRANSVAG,300.0,195.0,1.1,300.0,126
CDM,76817OH-TC,US PREG UTERUS REAL TIME W/IMAGE DCMTN TRANSVAG,734.0,477.1,1.1,734.0,126
CDM,76818OH,FETAL BIOPHYSICAL PROFILE NON-STRESS TESTING,1154.0,750.1,1.1,1154.0,142
CDM,76818OH-26,FETAL BIOPHYSICAL PROFILE NON-STRESS TESTING,420.0,273.0,1.1,420.0,126
CDM,76818OH-TC,FETAL BIOPHYSICAL PROFILE NON-STRESS TESTING,734.0,477.1,1.1,734.0,126
CDM,76819OH,FETAL BIOPHYSICAL PROFILE W/O NON-STRESS TESTING,1073.0,697.45,1.1,1073.0,142
CDM,76819OH-26,FETAL BIOPHYSICAL PROFILE W/O NON-STRESS TESTING,339.0,220.35,1.1,339.0,126
CDM,76819OH-TC,FETAL BIOPHYSICAL PROFILE W/O NON-STRESS TESTING,734.0,477.1,1.1,734.0,126
CDM,76820OH,DOPPLER VELOCIMETRY FETAL UMBILICAL ARTERY,954.0,620.1,1.1,954.0,142
CDM,76820OH-26,DOPPLER VELOCIMETRY FETAL UMBILICAL ARTERY,220.0,143.0,1.1,220.0,126
CDM,76820OH-TC,DOPPLER VELOCIMETRY FETAL UMBILICAL ARTERY,734.0,477.1,1.1,734.0,126
CDM,76821OH,DOPPLER VELOCIMETRY FETAL MIDDLE CEREBRAL ART,1014.0,659.1,1.1,1014.0,142
CDM,76821OH-26,DOPPLER VELOCIMETRY FETAL MIDDLE CEREBRAL ART,280.0,182.0,1.1,280.0,126
CDM,76821OH-TC,DOPPLER VELOCIMETRY FETAL MIDDLE CEREBRAL ART,734.0,477.1,1.1,734.0,126
CDM,76825OH,ECHO FETAL CARDIOVASC W/WO M-MODE RECORDING,4451.0,2893.15,1.1,4451.0,142
CDM,76825OH-26,ECHO FETAL CARDIOVASC W/WO M-MODE RECORDING,668.0,434.2,1.1,668.0,126
CDM,76825OH-TC,ECHO FETAL CARDIOVASC W/WO M-MODE RECORDING,3783.0,2458.95,1.1,3783.0,126
CDM,76826OH,ECHO FETAL CARDIOVASC W/WO M-MODE REPEAT STD,2033.0,1321.45,1.1,2033.0,142
CDM,76826OH-26,ECHO FETAL CARDIOVASC W/WO M-MODE REPEAT STD,365.0,237.25,1.1,365.0,126
CDM,76826OH-TC,ECHO FETAL CARDIOVASC W/WO M-MODE REPEAT STD,1668.0,1084.2,1.1,1668.0,126
CDM,76827OH,DOPPLER ECHO FETAL SPECTRAL DISPLAY COMPLETE,966.0,627.9,1.1,966.0,142
CDM,76827OH-26,DOPPLER ECHO FETAL SPECTRAL DISPLAY COMPLETE,232.0,150.8,1.1,232.0,126
CDM,76827OH-TC,DOPPLER ECHO FETAL SPECTRAL DISPLAY COMPLETE,734.0,477.1,1.1,734.0,126
CDM,76828OH,DOPPLER ECHO FETAL PULS SPECTRAL F/U/REPEAT,958.0,622.7,1.1,958.0,142
CDM,76828OH-26,DOPPLER ECHO FETAL PULS SPECTRAL F/U/REPEAT,224.0,145.6,1.1,224.0,126
CDM,76828OH-TC,DOPPLER ECHO FETAL PULS SPECTRAL F/U/REPEAT,734.0,477.1,1.1,734.0,126
CDM,76830OH,US TRANSVAGINAL,1038.0,674.7,1.1,1038.0,142
CDM,76830OH-26,US TRANSVAGINAL,304.0,197.6,1.1,304.0,126
CDM,76830OH-TC,US TRANSVAGINAL,734.0,477.1,1.1,734.0,126
CDM,76831OH,SALINE INFUS SONOHYSTEROGRAPHY W/COLOR DOPPLER,1956.0,1271.4,1.1,1956.0,142
CDM,76831OH-26,SALINE INFUS SONOHYSTEROGRAPHY W/COLOR DOPPLER,288.0,187.2,1.1,288.0,126
CDM,76831OH-TC,SALINE INFUS SONOHYSTEROGRAPHY W/COLOR DOPPLER,1668.0,1084.2,1.1,1668.0,126
CDM,76856OH,US PELVIC NONOBSTETRIC REAL-TIME IMAGE COMPLETE,1038.0,674.7,1.1,1038.0,142
CDM,76856OH-26,US PELVIC NONOBSTETRIC REAL-TIME IMAGE COMPLETE,304.0,197.6,1.1,304.0,126
CDM,76856OH-TC,US PELVIC NONOBSTETRIC REAL-TIME IMAGE COMPLETE,734.0,477.1,1.1,734.0,126
CDM,76857OH,US PELVIC NONOBSTETRIC IMAGE DCMTN LIMITED/F/U,934.0,607.1,1.1,934.0,142
CDM,76857OH-26,US PELVIC NONOBSTETRIC IMAGE DCMTN LIMITED/F/U,200.0,130.0,1.1,200.0,126
CDM,76857OH-TC,US PELVIC NONOBSTETRIC IMAGE DCMTN LIMITED/F/U,734.0,477.1,1.1,734.0,126
CDM,76870OH,US SCROTUM & CONTENTS,990.0,643.5,1.1,990.0,142
CDM,76870OH-26,US SCROTUM & CONTENTS,256.0,166.4,1.1,256.0,126
CDM,76870OH-TC,US SCROTUM & CONTENTS,734.0,477.1,1.1,734.0,126
CDM,76872OH,"US, TRANSRECTAL",1010.0,656.5,1.1,1010.0,142
CDM,76872OH-26,"US, TRANSRECTAL",276.0,179.4,1.1,276.0,126
CDM,76872OH-TC,"US, TRANSRECTAL",734.0,477.1,1.1,734.0,126
CDM,76873OH,US TRANSRCT PRSTATE VOL BRACHYTX PLNNING SPX,1416.0,920.4,1.1,1416.0,142
CDM,76873OH-26,US TRANSRCT PRSTATE VOL BRACHYTX PLNNING SPX,682.0,443.3,1.1,682.0,126
CDM,76873OH-TC,US TRANSRCT PRSTATE VOL BRACHYTX PLNNING SPX,734.0,477.1,1.1,734.0,126
CDM,76881OH,US COMPL JOINT R-T W/IMAGE DOCUMENTATION,1130.0,734.5,1.1,1130.0,142
CDM,76881OH-26,US COMPL JOINT R-T W/IMAGE DOCUMENTATION,396.0,257.4,1.1,396.0,126
CDM,76881OH-TC,US COMPL JOINT R-T W/IMAGE DOCUMENTATION,734.0,477.1,1.1,734.0,126
CDM,76882OH,US LMTD JOINT/OTH NONVASC XTR STRUX R-T W/IMG,1038.0,674.7,1.1,1038.0,142
CDM,76882OH-26,US LMTD JOINT/OTH NONVASC XTR STRUX R-T W/IMG,304.0,197.6,1.1,304.0,126
CDM,76882OH-TC,US LMTD JOINT/OTH NONVASC XTR STRUX R-T W/IMG,734.0,477.1,1.1,734.0,126
CDM,76883OH,US NRV&ACC STRUX 1 XTR COMPRE W/IMG PR EXTREMITY,1266.0,822.9,1.1,1266.0,142
CDM,76883OH-26,US NRV&ACC STRUX 1 XTR COMPRE W/IMG PR EXTREMITY,532.0,345.8,1.1,532.0,126
CDM,76883OH-TC,US NRV&ACC STRUX 1 XTR COMPRE W/IMG PR EXTREMITY,734.0,477.1,1.1,734.0,126
CDM,76885OH,US INFT HIPS R-T IMG DYNAMIC REQ PHYS/QHP MANJ,904.0,587.6,1.1,904.0,142
CDM,76885OH-26,US INFT HIPS R-T IMG DYNAMIC REQ PHYS/QHP MANJ,296.0,192.4,1.1,296.0,126
CDM,76885OH-TC,US INFT HIPS R-T IMG DYNAMIC REQ PHYS/QHP MANJ,608.0,395.2,1.1,608.0,126
CDM,76886OH,US INFT HIPS R-T IMG LMTD STATIC PHYS/QHP MANJ,856.0,556.4,1.1,856.0,142
CDM,76886OH-26,US INFT HIPS R-T IMG LMTD STATIC PHYS/QHP MANJ,248.0,161.2,1.1,248.0,126
CDM,76886OH-TC,US INFT HIPS R-T IMG LMTD STATIC PHYS/QHP MANJ,608.0,395.2,1.1,608.0,126
CDM,76936OH,US CMPRN RPR ARTL PSEUDOARYSM/ARVEN FSTL,2945.0,1914.25,1.1,2945.0,142
CDM,76936OH-26,US CMPRN RPR ARTL PSEUDOARYSM/ARVEN FSTL,796.0,517.4,1.1,796.0,126
CDM,76936OH-TC,US CMPRN RPR ARTL PSEUDOARYSM/ARVEN FSTL,2149.0,1396.85,1.1,2149.0,126
CDM,76937OH,US VASC ACCESS SITS VSL PATENCY NDL ENTRY,398.0,258.7,1.1,398.0,142
CDM,76937OH-26,US VASC ACCESS SITS VSL PATENCY NDL ENTRY,132.0,85.8,1.1,132.0,126
CDM,76937OH-TC,US VASC ACCESS SITS VSL PATENCY NDL ENTRY,266.0,172.9,1.1,266.0,126
CDM,76940OH,US &MNTR PARENCHYMAL TISSUE ABLATION,1498.0,973.7,1.1,1498.0,104
CDM,76940OH-26,US &MNTR PARENCHYMAL TISSUE ABLATION,800.0,520.0,1.1,800.0,126
CDM,76940OH-TC,US &MNTR PARENCHYMAL TISSUE ABLATION,698.0,453.7,1.1,698.0,94
CDM,76941OH,US INTRAUTERINE FTL TFUJ/CORDOCNTS IMG S&I,1260.0,819.0,1.1,1260.0,104
CDM,76941OH-26,US INTRAUTERINE FTL TFUJ/CORDOCNTS IMG S&I,536.0,348.4,1.1,536.0,126
CDM,76941OH-TC,US INTRAUTERINE FTL TFUJ/CORDOCNTS IMG S&I,724.0,470.6,1.1,724.0,94
CDM,76942OH,US GUIDANCE NEEDLE PLACEMENT IMG S&I,1158.0,752.7,1.1,1158.0,142
CDM,76942OH-26,US GUIDANCE NEEDLE PLACEMENT IMG S&I,295.0,191.75,1.1,295.0,126
CDM,76942OH-TC,US GUIDANCE NEEDLE PLACEMENT IMG S&I,863.0,560.95,1.1,863.0,126
CDM,76945OH,US GUIDANCE CHORIONIC VILLUS SAMPLING IMG S&I,507.0,329.55,1.1,507.0,104
CDM,76945OH-26,US GUIDANCE CHORIONIC VILLUS SAMPLING IMG S&I,268.0,174.2,1.1,268.0,126
CDM,76945OH-TC,US GUIDANCE CHORIONIC VILLUS SAMPLING IMG S&I,239.0,155.35,1.1,239.0,94
CDM,76946OH,US GUIDANCE AMNIOCENTESIS IMG S&I,518.0,336.7,1.1,518.0,142
CDM,76946OH-26,US GUIDANCE AMNIOCENTESIS IMG S&I,152.0,98.8,1.1,152.0,126
CDM,76946OH-TC,US GUIDANCE AMNIOCENTESIS IMG S&I,366.0,237.9,1.1,366.0,126
CDM,76948OH,US GUIDANCE ASPIRATION OVA IMG S&I,475.0,308.75,1.1,475.0,130
CDM,76948OH-26,US GUIDANCE ASPIRATION OVA IMG S&I,268.0,174.2,1.1,268.0,126
CDM,76948OH-TC,US GUIDANCE ASPIRATION OVA IMG S&I,207.0,134.55,1.1,207.0,126
CDM,76965OH,US GUIDANCE INTERSTITIAL RADIOELMENT APPLICATION,1728.0,1123.2,1.1,1728.0,142
CDM,76965OH-26,US GUIDANCE INTERSTITIAL RADIOELMENT APPLICATION,536.0,348.4,1.1,536.0,126
CDM,76965OH-TC,US GUIDANCE INTERSTITIAL RADIOELMENT APPLICATION,1192.0,774.8,1.1,1192.0,126
CDM,76975OH,GI ENDOSCOPIC US S&I,1992.0,1294.8,1.1,1992.0,104
CDM,76975OH-26,GI ENDOSCOPIC US S&I,324.0,210.6,1.1,324.0,126
CDM,76975OH-TC,GI ENDOSCOPIC US S&I,1668.0,1084.2,1.1,1668.0,94
CDM,76977OH,US BONE DENSITY MEASURE,756.0,491.4,1.1,756.0,142
CDM,76977OH-26,US BONE DENSITY MEASURE,22.0,14.3,1.1,22.0,126
CDM,76977OH-TC,US BONE DENSITY MEASURE,734.0,477.1,1.1,734.0,126
CDM,76978OH,ULTRASOUND TRGT DYNAMIC MICROBUBBLE 1ST LESION,1876.0,1219.4,1.1,1876.0,142
CDM,76978OH-26,ULTRASOUND TRGT DYNAMIC MICROBUBBLE 1ST LESION,648.0,421.2,1.1,648.0,126
CDM,76978OH-TC,ULTRASOUND TRGT DYNAMIC MICROBUBBLE 1ST LESION,1228.0,798.2,1.1,1228.0,126
CDM,76979OH,ULTRASOUND TRGT DYNAMIC MICROBUBBLE EA ADDLT LES,1106.0,718.9,1.1,1106.0,142
CDM,76979OH-26,ULTRASOUND TRGT DYNAMIC MICROBUBBLE EA ADDLT LES,340.0,221.0,1.1,340.0,126
CDM,76979OH-TC,ULTRASOUND TRGT DYNAMIC MICROBUBBLE EA ADDLT LES,766.0,497.9,1.1,766.0,126
CDM,76981OH,ULTRASOUND ELASTOGRAPHY PARENCHYMA,994.0,646.1,1.1,994.0,142
CDM,76981OH-26,ULTRASOUND ELASTOGRAPHY PARENCHYMA,260.0,169.0,1.1,260.0,126
CDM,76981OH-TC,ULTRASOUND ELASTOGRAPHY PARENCHYMA,734.0,477.1,1.1,734.0,126
CDM,76982OH,ULTRASOUND ELASTOGRAPHY FIRST TARGET LESION,970.0,630.5,1.1,970.0,142
CDM,76982OH-26,ULTRASOUND ELASTOGRAPHY FIRST TARGET LESION,236.0,153.4,1.1,236.0,126
CDM,76982OH-TC,ULTRASOUND ELASTOGRAPHY FIRST TARGET LESION,734.0,477.1,1.1,734.0,126
CDM,76983OH,ULTRASOUND ELASTOGRAPHY EA ADDL TARGET LESION,1218.0,791.7,1.1,1218.0,142
CDM,76983OH-26,ULTRASOUND ELASTOGRAPHY EA ADDL TARGET LESION,188.0,122.2,1.1,188.0,126
CDM,76983OH-TC,ULTRASOUND ELASTOGRAPHY EA ADDL TARGET LESION,1030.0,669.5,1.1,1030.0,126
CDM,76998OH,INTRA OP ULTRASONIC GUIDANCE,1243.0,807.95,1.1,1243.0,104
CDM,76998OH-26,INTRA OP ULTRASONIC GUIDANCE,400.0,260.0,1.1,400.0,126
CDM,76998OH-TC,INTRA OP ULTRASONIC GUIDANCE,843.0,547.95,1.1,843.0,92
CDM,77000000,SCREEN CERV/VAG & PELV/BREAST,370.0,240.5,31.51,370.0,86
CDM,77000005,PROSTATE CA SCREENING; DRE,118.0,76.7,10.63,118.0,68
CDM,77000015,BEHAVIOR COUNSEL OBESITY 15M,638.0,414.7,29.41,638.0,86
CDM,77000025,IM ADM THRU 18YR ANY RTE ADDL VAC/TOX COMPT,27.0,17.55,5.89,27.0,68
CDM,77000035,VISIT TO DETERM LDCT ELIG,370.0,240.5,30.87,370.0,86
CDM,77001000,HEP SCREEN HIGH RISK/OTHER,234.0,152.1,28.66,234.0,84
CDM,77001OH,FLUORO CENTRAL VENOUS ACCESS DEV PLACEMENT,990.0,643.5,1.1,990.0,142
CDM,77001OH-26,FLUORO CENTRAL VENOUS ACCESS DEV PLACEMENT,167.0,108.55,1.1,167.0,126
CDM,77001OH-TC,FLUORO CENTRAL VENOUS ACCESS DEV PLACEMENT,823.0,534.95,1.1,823.0,126
CDM,77002OH,FLUOROSCOPIC GUIDANCE NEEDLE PLACEMENT ADD ON,1076.0,699.4,1.1,1076.0,142
CDM,77002OH-26,FLUOROSCOPIC GUIDANCE NEEDLE PLACEMENT ADD ON,238.0,154.7,1.1,238.0,126
CDM,77002OH-TC,FLUOROSCOPIC GUIDANCE NEEDLE PLACEMENT ADD ON,838.0,544.7,1.1,838.0,126
CDM,77003OH,FLUOR NEEDLE/CATH SPINE/PARASPINAL DX/THER ADDON,1260.0,819.0,1.1,1260.0,142
CDM,77003OH-26,FLUOR NEEDLE/CATH SPINE/PARASPINAL DX/THER ADDON,264.0,171.6,1.1,264.0,126
CDM,77003OH-TC,FLUOR NEEDLE/CATH SPINE/PARASPINAL DX/THER ADDON,996.0,647.4,1.1,996.0,126
CDM,77011OH,CT GUIDANCE STEREOTACTIC LOCALIZATION,2011.0,1307.15,1.1,2011.0,142
CDM,77011OH-26,CT GUIDANCE STEREOTACTIC LOCALIZATION,484.0,314.6,1.1,484.0,126
CDM,77011OH-TC,CT GUIDANCE STEREOTACTIC LOCALIZATION,1527.0,992.55,1.1,1527.0,126
CDM,77012OH,CT GUIDANCE NEEDLE PLACEMENT,2793.0,1815.45,1.1,2793.0,142
CDM,77012OH-26,CT GUIDANCE NEEDLE PLACEMENT,600.0,390.0,1.1,600.0,126
CDM,77012OH-TC,CT GUIDANCE NEEDLE PLACEMENT,2193.0,1425.45,1.1,2193.0,126
CDM,77013OH,CT GUIDANCE &MONITORING VISC TISS ABLATION,4189.0,2722.85,1.1,4189.0,104
CDM,77013OH-26,CT GUIDANCE &MONITORING VISC TISS ABLATION,1596.0,1037.4,1.1,1596.0,126
CDM,77013OH-TC,CT GUIDANCE &MONITORING VISC TISS ABLATION,2593.0,1685.45,1.1,2593.0,94
CDM,77021OH,MRI GUIDANCE NEEDLE PLACEMENT RS&I,2653.0,1724.45,1.1,2653.0,142
CDM,77021OH-26,MRI GUIDANCE NEEDLE PLACEMENT RS&I,600.0,390.0,1.1,600.0,126
CDM,77021OH-TC,MRI GUIDANCE NEEDLE PLACEMENT RS&I,2053.0,1334.45,1.1,2053.0,126
CDM,77022OH,MRI GUIDANCE FOR PARENCHYMAL TISSUE ABLATION,3330.0,2164.5,1.1,3330.0,104
CDM,77022OH-26,MRI GUIDANCE FOR PARENCHYMAL TISSUE ABLATION,1696.0,1102.4,1.1,1696.0,126
CDM,77022OH-TC,MRI GUIDANCE FOR PARENCHYMAL TISSUE ABLATION,1634.0,1062.1,1.1,1634.0,94
CDM,77046OH,MRI BREAST WITHOUT CONTRAST MATERIAL UNILATERAL,2306.0,1498.9,1.1,2306.0,142
CDM,77046OH-26,MRI BREAST WITHOUT CONTRAST MATERIAL UNILATERAL,638.0,414.7,1.1,638.0,126
CDM,77046OH-TC,MRI BREAST WITHOUT CONTRAST MATERIAL UNILATERAL,1668.0,1084.2,1.1,1668.0,126
CDM,77047OH,MRI BREAST WITHOUT CONTRAST MATERIAL BILATERAL,2372.0,1541.8,1.1,2372.0,142
CDM,77047OH-26,MRI BREAST WITHOUT CONTRAST MATERIAL BILATERAL,704.0,457.6,1.1,704.0,126
CDM,77047OH-TC,MRI BREAST WITHOUT CONTRAST MATERIAL BILATERAL,1668.0,1084.2,1.1,1668.0,126
CDM,77048OH,MRI BREAST WITHOUT&WITH CONTRAST W/CAD UNILATERAL,5810.0,3776.5,1.1,5810.0,142
CDM,77048OH-26,MRI BREAST WITHOUT&WITH CONTRAST W/CAD UNILATERAL,840.0,546.0,1.1,840.0,126
CDM,77048OH-TC,MRI BREAST WITHOUT&WITH CONTRAST W/CAD UNILATERAL,4970.0,3230.5,1.1,4970.0,126
CDM,77049AOH,MRI BREAST BILAT W CONTR,6904.0,4487.6,1.1,6904.0,142
CDM,77049AOH-26,MRI BREAST BILAT W CONTR,920.0,598.0,1.1,920.0,126
CDM,77049AOH-TC,MRI BREAST BILAT W CONTR,5984.0,3889.6,1.1,5984.0,126
CDM,77049BOH,MRI BREAST BILAT WO/W CONTR,6904.0,4487.6,1.1,6904.0,142
CDM,77049BOH-26,MRI BREAST BILAT WO/W CONTR,920.0,598.0,1.1,920.0,126
CDM,77049BOH-TC,MRI BREAST BILAT WO/W CONTR,5984.0,3889.6,1.1,5984.0,126
CDM,77049OH,MRI BREAST WITHOUT&WITH CONTRAST W/CAD BILATERAL,6904.0,4487.6,1.1,6904.0,142
CDM,77049OH-26,MRI BREAST WITHOUT&WITH CONTRAST W/CAD BILATERAL,920.0,598.0,1.1,920.0,126
CDM,77049OH-TC,MRI BREAST WITHOUT&WITH CONTRAST W/CAD BILATERAL,5984.0,3889.6,1.1,5984.0,126
CDM,77053OH,MAMMARY DUCTOGRAM OR GALACTOGRAM SINGLE,1812.0,1177.8,1.1,1812.0,142
CDM,77053OH-26,MAMMARY DUCTOGRAM OR GALACTOGRAM SINGLE,144.0,93.6,1.1,144.0,126
CDM,77053OH-TC,MAMMARY DUCTOGRAM OR GALACTOGRAM SINGLE,1668.0,1084.2,1.1,1668.0,126
CDM,77054OH,MAMMARY DUCTOGRAM OR GALACTOGRAM MULTIPLE,1848.0,1201.2,1.1,1848.0,142
CDM,77054OH-26,MAMMARY DUCTOGRAM OR GALACTOGRAM MULTIPLE,180.0,117.0,1.1,180.0,126
CDM,77054OH-TC,MAMMARY DUCTOGRAM OR GALACTOGRAM MULTIPLE,1668.0,1084.2,1.1,1668.0,126
CDM,77061OH,DIGITAL BREAST TOMOSYNTHESIS UNILATERAL,171.0,111.15,1.1,332.37,88
CDM,77061OH-26,DIGITAL BREAST TOMOSYNTHESIS UNILATERAL,60.0,39.0,1.1,105.82,76
CDM,77061OH-TC,DIGITAL BREAST TOMOSYNTHESIS UNILATERAL,111.0,72.15,1.1,226.55,78
CDM,77062OH,DIGITAL BREAST TOMOSYNTHESIS BILATERAL,212.0,137.8,1.1,420.63,88
CDM,77062OH-26,DIGITAL BREAST TOMOSYNTHESIS BILATERAL,78.0,50.7,1.1,130.02,76
CDM,77062OH-TC,DIGITAL BREAST TOMOSYNTHESIS BILATERAL,134.0,87.1,1.1,290.61,78
CDM,77063OH,SCREENING DIGITAL BREAST TOMOSYNTHESIS BI,380.0,247.0,1.1,380.0,142
CDM,77063OH-26,SCREENING DIGITAL BREAST TOMOSYNTHESIS BI,240.0,156.0,1.1,240.0,126
CDM,77063OH-TC,SCREENING DIGITAL BREAST TOMOSYNTHESIS BI,140.0,91.0,1.1,140.0,126
CDM,77065OH,DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI,887.0,576.55,1.1,887.0,142
CDM,77065OH-26,DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI,324.0,210.6,1.1,324.0,126
CDM,77065OH-TC,DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI,563.0,365.95,1.1,563.0,126
CDM,77066OH,DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI,1106.0,718.9,1.1,1106.0,142
CDM,77066OH-26,DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI,400.0,260.0,1.1,400.0,126
CDM,77066OH-TC,DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI,706.0,458.9,1.1,706.0,126
CDM,77067OH,SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD,913.0,593.45,1.1,913.0,142
CDM,77067OH-26,SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD,304.0,197.6,1.1,304.0,126
CDM,77067OH-TC,SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD,609.0,395.85,1.1,609.0,126
CDM,77071OH,MANUAL APPL STRESS PFRMD PHYS/QHP JOINT FILMS,180.0,117.0,1.1,266.31,142
CDM,77072OH,BONE AGE STUDIES,810.0,526.5,1.1,810.0,142
CDM,77072OH-26,BONE AGE STUDIES,76.0,49.4,1.1,76.0,126
CDM,77072OH-TC,BONE AGE STUDIES,734.0,477.1,1.1,734.0,126
CDM,77073OH,BONE LENGTH STUDIES,838.0,544.7,1.1,838.0,142
CDM,77073OH-26,BONE LENGTH STUDIES,104.0,67.6,1.1,104.0,126
CDM,77073OH-TC,BONE LENGTH STUDIES,734.0,477.1,1.1,734.0,126
CDM,77074OH,RADIOLOGIC EXAMINATION OSSEOUS SURVEY LIMITED,928.0,603.2,1.1,928.0,142
CDM,77074OH-26,RADIOLOGIC EXAMINATION OSSEOUS SURVEY LIMITED,194.0,126.1,1.1,194.0,126
CDM,77074OH-TC,RADIOLOGIC EXAMINATION OSSEOUS SURVEY LIMITED,734.0,477.1,1.1,734.0,126
CDM,77075OH,RADIOLOGIC EXAMINATION OSSEOUS SURVEY COMPL,976.0,634.4,1.1,976.0,142
CDM,77075OH-26,RADIOLOGIC EXAMINATION OSSEOUS SURVEY COMPL,242.0,157.3,1.1,242.0,126
CDM,77075OH-TC,RADIOLOGIC EXAMINATION OSSEOUS SURVEY COMPL,734.0,477.1,1.1,734.0,126
CDM,77076OH,RADIOLOGIC EXAMINATION OSSEOUS SURVEY INFANT,1014.0,659.1,1.1,1014.0,142
CDM,77076OH-26,RADIOLOGIC EXAMINATION OSSEOUS SURVEY INFANT,280.0,182.0,1.1,280.0,126
CDM,77076OH-TC,RADIOLOGIC EXAMINATION OSSEOUS SURVEY INFANT,734.0,477.1,1.1,734.0,126
CDM,77077OH,JOINT SURVEY SINGLE VIEW 2 OR MORE JOINTS,866.0,562.9,1.1,866.0,142
CDM,77077OH-26,JOINT SURVEY SINGLE VIEW 2 OR MORE JOINTS,132.0,85.8,1.1,132.0,126
CDM,77077OH-TC,JOINT SURVEY SINGLE VIEW 2 OR MORE JOINTS,734.0,477.1,1.1,734.0,126
CDM,77078OH,CT BONE MINERL DENSITY STUDY 1/> SITS AXIAL SKE,708.0,460.2,1.1,708.0,142
CDM,77078OH-26,CT BONE MINERL DENSITY STUDY 1/> SITS AXIAL SKE,100.0,65.0,1.1,100.0,126
CDM,77078OH-TC,CT BONE MINERL DENSITY STUDY 1/> SITS AXIAL SKE,608.0,395.2,1.1,608.0,126
CDM,77080OH,DXA BONE DENSITY STUDY 1/> SITES AXIAL SKEL,822.0,534.3,1.1,822.0,142
CDM,77080OH-26,DXA BONE DENSITY STUDY 1/> SITES AXIAL SKEL,88.0,57.2,1.1,88.0,126
CDM,77080OH-TC,DXA BONE DENSITY STUDY 1/> SITES AXIAL SKEL,734.0,477.1,1.1,734.0,126
CDM,77081OH,DXA BONE DENSITY STUDY 1/>SITES APPENDICLR SKEL,696.0,452.4,1.1,696.0,142
CDM,77081OH-26,DXA BONE DENSITY STUDY 1/>SITES APPENDICLR SKEL,88.0,57.2,1.1,88.0,126
CDM,77081OH-TC,DXA BONE DENSITY STUDY 1/>SITES APPENDICLR SKEL,608.0,395.2,1.1,608.0,126
CDM,77085OH,DXA BONE DENSITY STUDY AXIAL SKELETON,866.0,562.9,1.1,866.0,142
CDM,77085OH-26,DXA BONE DENSITY STUDY AXIAL SKELETON,132.0,85.8,1.1,132.0,126
CDM,77085OH-TC,DXA BONE DENSITY STUDY AXIAL SKELETON,734.0,477.1,1.1,734.0,126
CDM,77086OH,VERTEBRAL FRACTURE ASSESSMENT VIA DXA,683.0,443.95,1.1,683.0,142
CDM,77086OH-26,VERTEBRAL FRACTURE ASSESSMENT VIA DXA,75.0,48.75,1.1,75.0,126
CDM,77086OH-TC,VERTEBRAL FRACTURE ASSESSMENT VIA DXA,608.0,395.2,1.1,608.0,126
CDM,77089OH,TBS DXA/OTHER IMG CALCULATION W/I&R FX RISK,88.0,57.2,1.1,131.82,142
CDM,77090OH,TBS TECHL PREP&TRANSMIS DATA ALYS PFRMD ELSEWHR,474.0,308.1,1.1,474.0,142
CDM,77091OH,TBS TECHNICAL CALCULATION ONLY,158.0,102.7,1.1,266.31,142
CDM,77092OH,TBS INTERPRETATION & REPORT FX RISK BY OTHER QHP,88.0,57.2,1.1,88.0,142
CDM,77100010,ADMIN VACCINE SNGL,214.0,139.1,17.08,214.0,86
CDM,77100015,IMMUNE ADMIN ORAL/NAS 1ST,214.0,139.1,17.08,214.0,86
CDM,77100020,IMM ADMIN ORAL/NASAL ADDL,190.0,123.5,14.98,190.0,68
CDM,77100030,ADMIN VACCINE EA ADD,64.0,41.6,13.95,64.0,68
CDM,77100040,ADMIN VACCINE FLU,214.0,139.1,17.08,214.0,86
CDM,77100045,ADMIN HEPATITIS B VACCINE,185.0,120.25,17.08,185.0,84
CDM,77100050,ADMIN VACCINE PNEUMONIA,214.0,139.1,17.08,214.0,86
CDM,77100065,IMMUNIZ INJ-HEP B VACC ONLY,214.0,139.1,17.08,214.0,86
CDM,77100075,IM ADMIN 1ST/ONLY COMPONENT,70.0,45.5,15.26,70.0,68
CDM,77100125,ADMIN FLU VACCINE,185.0,120.25,17.08,185.0,84
CDM,77100155,ADMIN VAC EA ADD CHILD,64.0,41.6,13.95,64.0,68
CDM,77100165,VFC IM ADMIN 1ST/ONLY THRU 18,21.25,13.81,4.63,30.56,68
CDM,77100355,ADM TOCILIZU COVID-19 1ST,1802.0,1171.3,277.57,1802.0,84
CDM,77100365,ADM TOCILIZU COVID-19 2ND,1802.0,1171.3,277.57,1802.0,84
CDM,77100585,RSV VACCINE PREF SUBUNIT BIVALENT FOR IM USE,33.0,21.45,9.17,74.93,86
CDM,77100625,ADMINISTRATION COVID VACCINE,286.0,185.9,17.08,286.0,82
CDM,77100695,VFC ADMINISTRATION COVID VACCINE,21.25,13.81,5.91,42.29,82
CDM,77100705,"VFC ADMIN BEYFORTUS, W/COUNSELING",21.25,13.81,4.63,39.64,68
CDM,77100725,"ADMIN BEYFORTUS IM INJ, W/ COUNSELING",158.0,102.7,17.08,158.0,68
CDM,77100735,ADMIN BEYFORTUS IM INJ,158.0,102.7,17.08,158.0,68
CDM,77100755,PEMIVIBART INFUSION (IV INFUSION FOR IMMUNE-COMPROMISED COVID-19,1800.0,1170.0,277.57,1800.0,83
CDM,77100765,IMM ADMN SARSCOV2 VACCINE EACH ADDL COMPONENT,286.0,185.9,17.08,286.0,66
CDM,77100775,IMM CNSL PHYS/QHP IMM NOT ADMN SAME DOS 3<10 MIN,70.0,45.5,15.26,100.24,66
CDM,77100785,IMM CNSL PHYS/QHP IMM NOT ADMN SM DOS>10<20 MIN,70.0,45.5,15.26,100.24,66
CDM,77100795,IMM CNSL PHYS/QHP IMM NOT ADMN SAME DOS>20 MIN,70.0,45.5,15.26,100.24,66
CDM,77261OH,THERAPEUTIC RADIOLOGY TX PLANNING SIMPLE,572.0,371.8,1.1,572.0,142
CDM,77262OH,THERAPEUTIC RADIOLOGY TX PLANNING INTERMEDIATE,880.0,572.0,1.1,880.0,142
CDM,77263OH,THERAPEUTIC RADIOLOGY TX PLANNING COMPLEX,1382.0,898.3,1.1,1382.0,142
CDM,77280OH,THER RAD SIMULAJ-AIDED FIELD SETTING SIMPLE,1224.0,795.6,1.1,1224.0,142
CDM,77280OH-26,THER RAD SIMULAJ-AIDED FIELD SETTING SIMPLE,308.0,200.2,1.1,308.0,126
CDM,77280OH-TC,THER RAD SIMULAJ-AIDED FIELD SETTING SIMPLE,916.0,595.4,1.1,916.0,126
CDM,77285OH,THER RAD SIMULAJ-AIDED FIELD SETTING INTERMED,2988.0,1942.2,1.1,2988.0,142
CDM,77285OH-26,THER RAD SIMULAJ-AIDED FIELD SETTING INTERMED,462.0,300.3,1.1,462.0,126
CDM,77285OH-TC,THER RAD SIMULAJ-AIDED FIELD SETTING INTERMED,2526.0,1641.9,1.1,2526.0,126
CDM,77290OH,THER RAD SIMULAJ-AIDED FIELD SETTING COMPLEX,3212.0,2087.8,1.1,3212.0,142
CDM,77290OH-26,THER RAD SIMULAJ-AIDED FIELD SETTING COMPLEX,686.0,445.9,1.1,686.0,126
CDM,77290OH-TC,THER RAD SIMULAJ-AIDED FIELD SETTING COMPLEX,2526.0,1641.9,1.1,2526.0,126
CDM,77293OH,RESPIRATORY MOTION MANAGEMENT SIMULATION,3861.0,2509.65,1.1,3861.0,142
CDM,77293OH-26,RESPIRATORY MOTION MANAGEMENT SIMULATION,880.0,572.0,1.1,880.0,126
CDM,77293OH-TC,RESPIRATORY MOTION MANAGEMENT SIMULATION,2981.0,1937.65,1.1,2981.0,126
CDM,77295OH,3-D RADIOTHERAPY PLAN DOSE-VOLUME HISTOGRAMS,11329.0,7363.85,1.1,11329.0,142
CDM,77295OH-26,3-D RADIOTHERAPY PLAN DOSE-VOLUME HISTOGRAMS,1888.0,1227.2,1.1,1888.0,126
CDM,77295OH-TC,3-D RADIOTHERAPY PLAN DOSE-VOLUME HISTOGRAMS,9441.0,6136.65,1.1,9441.0,126
CDM,77300OH,BASIC RAD DOSIMETRY CALCULATION,1189.0,772.85,1.1,1189.0,142
CDM,77300OH-26,BASIC RAD DOSIMETRY CALCULATION,273.0,177.45,1.1,273.0,126
CDM,77300OH-TC,BASIC RAD DOSIMETRY CALCULATION,916.0,595.4,1.1,916.0,126
CDM,77301OH,NTSTY MODUL RADTHX PLN DOSE-VOL HISTOS,12957.0,8422.05,1.1,12957.0,142
CDM,77301OH-26,NTSTY MODUL RADTHX PLN DOSE-VOL HISTOS,3516.0,2285.4,1.1,3516.0,126
CDM,77301OH-TC,NTSTY MODUL RADTHX PLN DOSE-VOL HISTOS,9441.0,6136.65,1.1,9441.0,126
CDM,77306OH,TELETHX ISODOSE PLN SMPL W/DOSIMETRY CALCULATION,3142.0,2042.3,1.1,3142.0,142
CDM,77306OH-26,TELETHX ISODOSE PLN SMPL W/DOSIMETRY CALCULATION,616.0,400.4,1.1,616.0,126
CDM,77306OH-TC,TELETHX ISODOSE PLN SMPL W/DOSIMETRY CALCULATION,2526.0,1641.9,1.1,2526.0,126
CDM,77307OH,TELETHX ISODOSE PLN CPLX W/BASIC DOSIMETRY,3802.0,2471.3,1.1,3802.0,142
CDM,77307OH-26,TELETHX ISODOSE PLN CPLX W/BASIC DOSIMETRY,1276.0,829.4,1.1,1276.0,126
CDM,77307OH-TC,TELETHX ISODOSE PLN CPLX W/BASIC DOSIMETRY,2526.0,1641.9,1.1,2526.0,126
CDM,77316OH,BRACHYTX ISODOSE PLN SMPL W/DOSIMETRY CAL,3086.0,2005.9,1.1,3086.0,142
CDM,77316OH-26,BRACHYTX ISODOSE PLN SMPL W/DOSIMETRY CAL,560.0,364.0,1.1,560.0,126
CDM,77316OH-TC,BRACHYTX ISODOSE PLN SMPL W/DOSIMETRY CAL,2526.0,1641.9,1.1,2526.0,126
CDM,77317OH,BRACHYTX ISODOSE PLN INTERMED W/DOSIMETRY CAL,3258.0,2117.7,1.1,3258.0,142
CDM,77317OH-26,BRACHYTX ISODOSE PLN INTERMED W/DOSIMETRY CAL,732.0,475.8,1.1,732.0,126
CDM,77317OH-TC,BRACHYTX ISODOSE PLN INTERMED W/DOSIMETRY CAL,2526.0,1641.9,1.1,2526.0,126
CDM,77318OH,BRACHYTX ISODOSE PLN CPLX W/DOSIMETRY CAL,3802.0,2471.3,1.1,3802.0,142
CDM,77318OH-26,BRACHYTX ISODOSE PLN CPLX W/DOSIMETRY CAL,1276.0,829.4,1.1,1276.0,126
CDM,77318OH-TC,BRACHYTX ISODOSE PLN CPLX W/DOSIMETRY CAL,2526.0,1641.9,1.1,2526.0,126
CDM,77321OH,SPEC TELETHX PORT PLN PARTS HEMIBDY TOT BDY,2944.0,1913.6,1.1,2944.0,142
CDM,77321OH-26,SPEC TELETHX PORT PLN PARTS HEMIBDY TOT BDY,418.0,271.7,1.1,418.0,126
CDM,77321OH-TC,SPEC TELETHX PORT PLN PARTS HEMIBDY TOT BDY,2526.0,1641.9,1.1,2526.0,126
CDM,77331OH,SPEC DOSIM ONLY PRESCRIBED TREATING PHYS,1299.0,844.35,1.1,1299.0,142
CDM,77331OH-26,SPEC DOSIM ONLY PRESCRIBED TREATING PHYS,383.0,248.95,1.1,383.0,126
CDM,77331OH-TC,SPEC DOSIM ONLY PRESCRIBED TREATING PHYS,916.0,595.4,1.1,916.0,126
CDM,77332OH,TX DEVICES DESIGN/CONSTR SIMPLE,1114.0,724.1,1.1,1114.0,142
CDM,77332OH-26,TX DEVICES DESIGN/CONSTR SIMPLE,198.0,128.7,1.1,198.0,126
CDM,77332OH-TC,TX DEVICES DESIGN/CONSTR SIMPLE,916.0,595.4,1.1,916.0,126
CDM,77333OH,TX DEVICES DESIGN/CONSTR INTERMED,1246.0,809.9,1.1,1246.0,142
CDM,77333OH-26,TX DEVICES DESIGN/CONSTR INTERMED,330.0,214.5,1.1,330.0,126
CDM,77333OH-TC,TX DEVICES DESIGN/CONSTR INTERMED,916.0,595.4,1.1,916.0,126
CDM,77334OH,TX DEVICES DESIGN/CONSTR COMPLEX,3032.0,1970.8,1.1,3032.0,142
CDM,77334OH-26,TX DEVICES DESIGN/CONSTR COMPLEX,506.0,328.9,1.1,506.0,126
CDM,77334OH-TC,TX DEVICES DESIGN/CONSTR COMPLEX,2526.0,1641.9,1.1,2526.0,126
CDM,77336OH,CONTINUING MEDICAL PHYSICS CONSLTJ PR WK,1091.0,709.15,1.1,1091.0,142
CDM,77338OH,MLC IMRT DESIGN & CONSTRUCTION PER IMRT PLAN,4414.0,2869.1,1.1,4414.0,142
CDM,77338OH-26,MLC IMRT DESIGN & CONSTRUCTION PER IMRT PLAN,1888.0,1227.2,1.1,1888.0,126
CDM,77338OH-TC,MLC IMRT DESIGN & CONSTRUCTION PER IMRT PLAN,2526.0,1641.9,1.1,2526.0,126
CDM,77370OH,SPECIAL RADIATION PHYSICS CONSULT,1131.0,735.15,1.1,1131.0,142
CDM,77373OH,STEREOTACTIC BODY RADIATION DELIVERY,14050.0,9132.5,1.1,14050.0,142
CDM,77387OH,GUIDANCE FOR LOC OF TARGET VOL RADIAJ TX DLVR,299.0,194.35,1.1,336.36,134
CDM,77387OH-26,GUIDANCE FOR LOC OF TARGET VOL RADIAJ TX DLVR,299.0,194.35,1.1,299.0,116
CDM,77399OH,EXTERNAL RADIATION DOSIMETRY,1277.0,830.05,0.01,1277.0,82
CDM,77399OH-26,EXTERNAL RADIATION DOSIMETRY,416.0,270.4,0.01,416.0,82
CDM,77399OH-TC,EXTERNAL RADIATION DOSIMETRY,861.0,559.65,0.01,861.0,82
CDM,77402OH,RADIATION TREATMENT DELIVERY 1 MEV >= SIMPLE,897.0,583.05,1.1,897.0,134
CDM,77407OH,RADIATION TX DELIVERY 1 MEV >= INTERMEDIATE,3388.0,2202.2,1.1,3388.0,134
CDM,77412OH,RADIATION TREATMENT DELIVERY 1 MEV >= COMPLEX,4855.0,3155.75,1.1,4855.0,134
CDM,77417OH,THERAPEUTIC RADIOLOGY PORT IMAGES(S),586.0,380.9,1.1,586.0,114
CDM,77427OH,RADIATION TREATMENT MANAGEMENT 5 TREATMENTS,1483.0,963.95,1.1,1483.0,142
CDM,77431OH,RADIATION THERAPY MGMT 1/2 FRACTIONS ONLY,796.0,517.4,1.1,796.0,142
CDM,77432OH,STERETCTC RADIATION TX MANAGEMENT CRANIAL LESION,3485.0,2265.25,1.1,3485.0,142
CDM,77435OH,STEREOTACTIC BODY RADIATION MANAGEMENT,5223.0,3394.95,1.1,5223.0,142
CDM,77469OH,INTRAOPERATIVE RADIATION TREATMENT MANAGEMENT,2300.0,1495.0,1.1,2300.0,142
CDM,77470OH,SPECIAL TREATMENT PROCEDURE,4884.0,3174.6,1.1,4884.0,142
CDM,77470OH-26,SPECIAL TREATMENT PROCEDURE,893.0,580.45,1.1,893.0,126
CDM,77470OH-TC,SPECIAL TREATMENT PROCEDURE,3991.0,2594.15,1.1,3991.0,126
CDM,77600OH,HYPERTHERMIA EXTERNAL GENERATED SUPERFICIAL,2391.0,1554.15,1.1,2391.0,142
CDM,77600OH-26,HYPERTHERMIA EXTERNAL GENERATED SUPERFICIAL,576.0,374.4,1.1,576.0,126
CDM,77600OH-TC,HYPERTHERMIA EXTERNAL GENERATED SUPERFICIAL,1815.0,1179.75,1.1,1815.0,126
CDM,77605OH,HYPERTHERMIA EXTERNAL GENERATED DEEP,5523.0,3589.95,1.1,5523.0,142
CDM,77605OH-26,HYPERTHERMIA EXTERNAL GENERATED DEEP,736.0,478.4,1.1,736.0,126
CDM,77605OH-TC,HYPERTHERMIA EXTERNAL GENERATED DEEP,4787.0,3111.55,1.1,4787.0,126
CDM,77610OH,HYPERTHERMIA INTERSTITIAL PROBE 1-5,4515.0,2934.75,1.1,4515.0,142
CDM,77610OH-26,HYPERTHERMIA INTERSTITIAL PROBE 1-5,524.0,340.6,1.1,524.0,126
CDM,77610OH-TC,HYPERTHERMIA INTERSTITIAL PROBE 1-5,3991.0,2594.15,1.1,3991.0,126
CDM,77615OH,HYPERTHERMIA INTERSTITIAL PROBE 6+,4727.0,3072.55,1.1,4727.0,142
CDM,77615OH-26,HYPERTHERMIA INTERSTITIAL PROBE 6+,736.0,478.4,1.1,736.0,126
CDM,77615OH-TC,HYPERTHERMIA INTERSTITIAL PROBE 6+,3991.0,2594.15,1.1,3991.0,126
CDM,77620OH,HYPERTHERMIA INTRACAVITARY PROBES,4615.0,2999.75,1.1,4615.0,142
CDM,77620OH-26,HYPERTHERMIA INTRACAVITARY PROBES,624.0,405.6,1.1,624.0,126
CDM,77620OH-TC,HYPERTHERMIA INTRACAVITARY PROBES,3991.0,2594.15,1.1,3991.0,126
CDM,77750OH,INFUSE RADIOACTIVE MATERIALS,3815.0,2479.75,1.1,3815.0,142
CDM,77750OH-26,INFUSE RADIOACTIVE MATERIALS,2000.0,1300.0,1.1,2000.0,126
CDM,77750OH-TC,INFUSE RADIOACTIVE MATERIALS,1815.0,1179.75,1.1,1815.0,126
CDM,77761OH,INTRACAVITARY RADIATION SOURCE APPLIC SIMPLE,5531.0,3595.15,1.1,5531.0,142
CDM,77761OH-26,INTRACAVITARY RADIATION SOURCE APPLIC SIMPLE,1540.0,1001.0,1.1,1540.0,126
CDM,77761OH-TC,INTRACAVITARY RADIATION SOURCE APPLIC SIMPLE,3991.0,2594.15,1.1,3991.0,126
CDM,77763OH,INTRACAVITARY RADIATION SOURCE APPLIC COMPLEX,8251.0,5363.15,1.1,8251.0,142
CDM,77763OH-26,INTRACAVITARY RADIATION SOURCE APPLIC COMPLEX,3464.0,2251.6,1.1,3464.0,126
CDM,77763OH-TC,INTRACAVITARY RADIATION SOURCE APPLIC COMPLEX,4787.0,3111.55,1.1,4787.0,126
CDM,77767OH,HDR RDNCL SKN SURF BRACHYTX LES </2CM/1 CHAN,2235.0,1452.75,1.1,2235.0,142
CDM,77767OH-26,HDR RDNCL SKN SURF BRACHYTX LES </2CM/1 CHAN,420.0,273.0,1.1,420.0,126
CDM,77767OH-TC,HDR RDNCL SKN SURF BRACHYTX LES </2CM/1 CHAN,1815.0,1179.75,1.1,1815.0,126
CDM,77768OH,HDR RDNCL SK SRF BRCHYTX LES >2CM&2CHAN/MLT LES,2375.0,1543.75,1.1,2375.0,142
CDM,77768OH-26,HDR RDNCL SK SRF BRCHYTX LES >2CM&2CHAN/MLT LES,560.0,364.0,1.1,560.0,126
CDM,77768OH-TC,HDR RDNCL SK SRF BRCHYTX LES >2CM&2CHAN/MLT LES,1815.0,1179.75,1.1,1815.0,126
CDM,77770OH,HDR RDNCL NTRSTL/INTRCAV BRACHYTX 1 CHANNEL,5567.0,3618.55,1.1,5567.0,142
CDM,77770OH-26,HDR RDNCL NTRSTL/INTRCAV BRACHYTX 1 CHANNEL,780.0,507.0,1.1,780.0,126
CDM,77770OH-TC,HDR RDNCL NTRSTL/INTRCAV BRACHYTX 1 CHANNEL,4787.0,3111.55,1.1,4787.0,126
CDM,77771OH,HDR RDNCL NTRSTL/INTRCAV BRACHYTX 2-12 CHANNEL,6307.0,4099.55,1.1,6307.0,142
CDM,77771OH-26,HDR RDNCL NTRSTL/INTRCAV BRACHYTX 2-12 CHANNEL,1520.0,988.0,1.1,1520.0,126
CDM,77771OH-TC,HDR RDNCL NTRSTL/INTRCAV BRACHYTX 2-12 CHANNEL,4787.0,3111.55,1.1,4787.0,126
CDM,77772OH,HDR RDNCL NTRSTL/INTRCAV BRACHYTX >12 CHANNELS,6947.0,4515.55,1.1,6947.0,142
CDM,77772OH-26,HDR RDNCL NTRSTL/INTRCAV BRACHYTX >12 CHANNELS,2160.0,1404.0,1.1,2160.0,126
CDM,77772OH-TC,HDR RDNCL NTRSTL/INTRCAV BRACHYTX >12 CHANNELS,4787.0,3111.55,1.1,4787.0,126
CDM,77778OH,INTERSTITIAL RADIATION SOURCE APPLIC COMPLEX,8650.0,5622.5,1.1,8650.0,142
CDM,77778OH-26,INTERSTITIAL RADIATION SOURCE APPLIC COMPLEX,3863.0,2510.95,1.1,3863.0,126
CDM,77778OH-TC,INTERSTITIAL RADIATION SOURCE APPLIC COMPLEX,4787.0,3111.55,1.1,4787.0,126
CDM,77790OH,SUPERVISION HANDLING LOADING RADIATION SOURCE,1407.0,914.55,1.1,1407.0,142
CDM,77790OH-26,SUPERVISION HANDLING LOADING RADIATION SOURCE,446.0,289.9,1.1,446.0,82
CDM,77799OH,UNLISTED PROCEDURE CLINICAL BRACHYTHERAPY,3678.0,2390.7,0.01,3678.0,82
CDM,77799OH-26,UNLISTED PROCEDURE CLINICAL BRACHYTHERAPY,2937.0,1909.05,0.01,2937.0,82
CDM,77799OH-TC,UNLISTED PROCEDURE CLINICAL BRACHYTHERAPY,741.0,481.65,0.01,741.0,82
CDM,78000005,TELEPHONE ASSMT&MGMT SVC NQHP EST PT 5-10 MIN,102.0,66.3,14.49,102.0,85
CDM,78000015,TELEPHONE ASSMT&MGMT SVC NQHP EST PT 11-20 MIN,208.0,135.2,28.26,208.0,85
CDM,78000025,TELEPHONE ASSMT&MGMT SVC NQHP EST PT 21-30 MIN,313.0,203.45,21.85,313.0,85
CDM,78000035,GENETIC COUNSELING VIRTUAL VISIT (SELF PAY),159.0,103.35,34.66,159.0,58
CDM,78000045,"HOPD MNTL HLT, GRP",89.0,57.85,24.74,152.57,84
CDM,78012OH,THYROID UPTAKE SINGLE/MULTIPLE QUANT MEASUREMENT,2849.0,1851.85,1.1,2849.0,142
CDM,78012OH-26,THYROID UPTAKE SINGLE/MULTIPLE QUANT MEASUREMENT,76.0,49.4,1.1,76.0,126
CDM,78012OH-TC,THYROID UPTAKE SINGLE/MULTIPLE QUANT MEASUREMENT,2773.0,1802.45,1.1,2773.0,126
CDM,78013OH,THYROID IMAGING WITH VASCULAR FLOW,2921.0,1898.65,1.1,2921.0,142
CDM,78013OH-26,THYROID IMAGING WITH VASCULAR FLOW,148.0,96.2,1.1,148.0,126
CDM,78013OH-TC,THYROID IMAGING WITH VASCULAR FLOW,2773.0,1802.45,1.1,2773.0,126
CDM,78014OH,THYROID UPTAKE W/BLOOD FLOW SNGLE/MULT QUAN MEAS,2993.0,1945.45,1.1,2993.0,142
CDM,78014OH-26,THYROID UPTAKE W/BLOOD FLOW SNGLE/MULT QUAN MEAS,220.0,143.0,1.1,220.0,126
CDM,78014OH-TC,THYROID UPTAKE W/BLOOD FLOW SNGLE/MULT QUAN MEAS,2773.0,1802.45,1.1,2773.0,126
CDM,78015OH,THYROID CARCINOMA METASTASES IMG LMTD AREA,3041.0,1976.65,1.1,3041.0,142
CDM,78015OH-26,THYROID CARCINOMA METASTASES IMG LMTD AREA,268.0,174.2,1.1,268.0,126
CDM,78015OH-TC,THYROID CARCINOMA METASTASES IMG LMTD AREA,2773.0,1802.45,1.1,2773.0,126
CDM,78018OH,THYROID CARCINOMA METASTASES IMG WHOLE BODY,4058.0,2637.7,1.1,4058.0,142
CDM,78018OH-26,THYROID CARCINOMA METASTASES IMG WHOLE BODY,344.0,223.6,1.1,344.0,126
CDM,78018OH-TC,THYROID CARCINOMA METASTASES IMG WHOLE BODY,3714.0,2414.1,1.1,3714.0,126
CDM,78020OH,THYROID CARCINOMA METASTASES UPTAKE,1123.0,729.95,1.1,1123.0,142
CDM,78020OH-26,THYROID CARCINOMA METASTASES UPTAKE,240.0,156.0,1.1,240.0,126
CDM,78020OH-TC,THYROID CARCINOMA METASTASES UPTAKE,883.0,573.95,1.1,883.0,126
CDM,78070OH,PARATHYROID PLANAR IMAGING,3093.0,2010.45,1.1,3093.0,142
CDM,78070OH-26,PARATHYROID PLANAR IMAGING,320.0,208.0,1.1,320.0,126
CDM,78070OH-TC,PARATHYROID PLANAR IMAGING,2773.0,1802.45,1.1,2773.0,126
CDM,78071OH,PARATHYROID PLANAR IMAGING W/WO SUBTRACTION,3253.0,2114.45,1.1,3253.0,142
CDM,78071OH-26,PARATHYROID PLANAR IMAGING W/WO SUBTRACTION,480.0,312.0,1.1,480.0,126
CDM,78071OH-TC,PARATHYROID PLANAR IMAGING W/WO SUBTRACTION,2773.0,1802.45,1.1,2773.0,126
CDM,78072OH,PARATHYROID IMAGING W/TOMOGRAPHIC SPECT & CT,4354.0,2830.1,1.1,4354.0,142
CDM,78072OH-26,PARATHYROID IMAGING W/TOMOGRAPHIC SPECT & CT,640.0,416.0,1.1,640.0,126
CDM,78072OH-TC,PARATHYROID IMAGING W/TOMOGRAPHIC SPECT & CT,3714.0,2414.1,1.1,3714.0,126
CDM,78075OH,ADRENAL IMAGING CORTEX &/MEDULLA,9304.0,6047.6,1.1,9304.0,142
CDM,78075OH-26,ADRENAL IMAGING CORTEX &/MEDULLA,296.0,192.4,1.1,296.0,126
CDM,78075OH-TC,ADRENAL IMAGING CORTEX &/MEDULLA,9008.0,5855.2,1.1,9008.0,126
CDM,78102OH,"BONE MARROW IMAGING, LTD",2993.0,1945.45,1.1,2993.0,142
CDM,78102OH-26,"BONE MARROW IMAGING, LTD",220.0,143.0,1.1,220.0,126
CDM,78102OH-TC,"BONE MARROW IMAGING, LTD",2773.0,1802.45,1.1,2773.0,126
CDM,78103OH,"BONE MARROW IMAGING, MULT",3073.0,1997.45,1.1,3073.0,142
CDM,78103OH-26,"BONE MARROW IMAGING, MULT",300.0,195.0,1.1,300.0,126
CDM,78103OH-TC,"BONE MARROW IMAGING, MULT",2773.0,1802.45,1.1,2773.0,126
CDM,78104OH,"BONE MARROW IMAGING, BODY",3093.0,2010.45,1.1,3093.0,142
CDM,78104OH-26,"BONE MARROW IMAGING, BODY",320.0,208.0,1.1,320.0,126
CDM,78104OH-TC,"BONE MARROW IMAGING, BODY",2773.0,1802.45,1.1,2773.0,126
CDM,78122OH,WHOLE BLOOD VOLUME DETERM PLASMA&RED CELL VOLU,3894.0,2531.1,1.1,3894.0,142
CDM,78122OH-26,WHOLE BLOOD VOLUME DETERM PLASMA&RED CELL VOLU,180.0,117.0,1.1,180.0,126
CDM,78122OH-TC,WHOLE BLOOD VOLUME DETERM PLASMA&RED CELL VOLU,3714.0,2414.1,1.1,3714.0,126
CDM,78140OH,LABELED RBC SEQUESTRATION DIFFERNTL ORGAN/TISSUE,3017.0,1961.05,1.1,3017.0,142
CDM,78140OH-26,LABELED RBC SEQUESTRATION DIFFERNTL ORGAN/TISSUE,244.0,158.6,1.1,244.0,126
CDM,78140OH-TC,LABELED RBC SEQUESTRATION DIFFERNTL ORGAN/TISSUE,2773.0,1802.45,1.1,2773.0,126
CDM,78195OH,LYMPHATICS & LYMPH NODES IMAGING,4194.0,2726.1,1.1,4194.0,142
CDM,78195OH-26,LYMPHATICS & LYMPH NODES IMAGING,480.0,312.0,1.1,480.0,126
CDM,78195OH-TC,LYMPHATICS & LYMPH NODES IMAGING,3714.0,2414.1,1.1,3714.0,126
CDM,78201OH,LIVER IMAGING STATIC ONLY,3908.0,2540.2,1.1,3908.0,142
CDM,78201OH-26,LIVER IMAGING STATIC ONLY,194.0,126.1,1.1,194.0,126
CDM,78201OH-TC,LIVER IMAGING STATIC ONLY,3714.0,2414.1,1.1,3714.0,126
CDM,78202OH,LIVER IMAGING W/VASCULAR FLOW,3918.0,2546.7,1.1,3918.0,142
CDM,78202OH-26,LIVER IMAGING W/VASCULAR FLOW,204.0,132.6,1.1,204.0,126
CDM,78202OH-TC,LIVER IMAGING W/VASCULAR FLOW,3714.0,2414.1,1.1,3714.0,126
CDM,78215OH,LIVER & SPLEEN IMAGING STATIC ONLY,2969.0,1929.85,1.1,2969.0,142
CDM,78215OH-26,LIVER & SPLEEN IMAGING STATIC ONLY,196.0,127.4,1.1,196.0,126
CDM,78215OH-TC,LIVER & SPLEEN IMAGING STATIC ONLY,2773.0,1802.45,1.1,2773.0,126
CDM,78216OH,LIVER & SPLEEN IMAGING W/VASCULAR FLOW,3001.0,1950.65,1.1,3001.0,142
CDM,78216OH-26,LIVER & SPLEEN IMAGING W/VASCULAR FLOW,228.0,148.2,1.1,228.0,126
CDM,78216OH-TC,LIVER & SPLEEN IMAGING W/VASCULAR FLOW,2773.0,1802.45,1.1,2773.0,126
CDM,78226OH,HEPATOBILIARY SYST IMAGING INCLUDING GALLBLADDER,3069.0,1994.85,1.1,3069.0,142
CDM,78226OH-26,HEPATOBILIARY SYST IMAGING INCLUDING GALLBLADDER,296.0,192.4,1.1,296.0,126
CDM,78226OH-TC,HEPATOBILIARY SYST IMAGING INCLUDING GALLBLADDER,2773.0,1802.45,1.1,2773.0,126
CDM,78227OH,HEPATOBIL SYST IMAG INC GB W/PHARMA INTERVENJ,4110.0,2671.5,1.1,4110.0,142
CDM,78227OH-26,HEPATOBIL SYST IMAG INC GB W/PHARMA INTERVENJ,396.0,257.4,1.1,396.0,126
CDM,78227OH-TC,HEPATOBIL SYST IMAG INC GB W/PHARMA INTERVENJ,3714.0,2414.1,1.1,3714.0,126
CDM,78231OH,SALIVARY GLAND IMAGING SERIAL IMAGES,2981.0,1937.65,1.1,2981.0,142
CDM,78231OH-26,SALIVARY GLAND IMAGING SERIAL IMAGES,208.0,135.2,1.1,208.0,126
CDM,78231OH-TC,SALIVARY GLAND IMAGING SERIAL IMAGES,2773.0,1802.45,1.1,2773.0,126
CDM,78232OH,SALIVARY GLAND FUNCTION STUDY,2980.0,1937.0,1.1,2980.0,142
CDM,78232OH-26,SALIVARY GLAND FUNCTION STUDY,207.0,134.55,1.1,207.0,126
CDM,78232OH-TC,SALIVARY GLAND FUNCTION STUDY,2773.0,1802.45,1.1,2773.0,126
CDM,78258OH,ESOPHAGEAL MOTILITY,3069.0,1994.85,1.1,3069.0,142
CDM,78258OH-26,ESOPHAGEAL MOTILITY,296.0,192.4,1.1,296.0,126
CDM,78258OH-TC,ESOPHAGEAL MOTILITY,2773.0,1802.45,1.1,2773.0,126
CDM,78261OH,GASTRIC MUCOSA IMAGING,3049.0,1981.85,1.1,3049.0,142
CDM,78261OH-26,GASTRIC MUCOSA IMAGING,276.0,179.4,1.1,276.0,126
CDM,78261OH-TC,GASTRIC MUCOSA IMAGING,2773.0,1802.45,1.1,2773.0,126
CDM,78262OH,GASTROESOPHAGEAL REFLUX STUDY,3045.0,1979.25,1.1,3045.0,142
CDM,78262OH-26,GASTROESOPHAGEAL REFLUX STUDY,272.0,176.8,1.1,272.0,126
CDM,78262OH-TC,GASTROESOPHAGEAL REFLUX STUDY,2773.0,1802.45,1.1,2773.0,126
CDM,78264OH,GASTRIC EMPTYING STUDY,3121.0,2028.65,1.1,3121.0,142
CDM,78264OH-26,GASTRIC EMPTYING STUDY,348.0,226.2,1.1,348.0,126
CDM,78264OH-TC,GASTRIC EMPTYING STUDY,2773.0,1802.45,1.1,2773.0,126
CDM,78265OH,GASTRIC EMPTYNG IMAG STD W/SM BWL TRANSIT,3165.0,2057.25,1.1,3165.0,142
CDM,78265OH-26,GASTRIC EMPTYNG IMAG STD W/SM BWL TRANSIT,392.0,254.8,1.1,392.0,126
CDM,78265OH-TC,GASTRIC EMPTYNG IMAG STD W/SM BWL TRANSIT,2773.0,1802.45,1.1,2773.0,126
CDM,78266OH,GSTRC EMPTNG IMAG STD W/SM BWL COL TRNST MLT DAY,4146.0,2694.9,1.1,4146.0,142
CDM,78266OH-26,GSTRC EMPTNG IMAG STD W/SM BWL COL TRNST MLT DAY,432.0,280.8,1.1,432.0,126
CDM,78266OH-TC,GSTRC EMPTNG IMAG STD W/SM BWL COL TRNST MLT DAY,3714.0,2414.1,1.1,3714.0,126
CDM,78278OH,ACUTE GI BLOOD LOSS IMAGING,3169.0,2059.85,1.1,3169.0,142
CDM,78278OH-26,ACUTE GI BLOOD LOSS IMAGING,396.0,257.4,1.1,396.0,126
CDM,78278OH-TC,ACUTE GI BLOOD LOSS IMAGING,2773.0,1802.45,1.1,2773.0,126
CDM,78290OH,INTESTINE IMAGING,3072.0,1996.8,1.1,3072.0,142
CDM,78290OH-26,INTESTINE IMAGING,299.0,194.35,1.1,299.0,126
CDM,78290OH-TC,INTESTINE IMAGING,2773.0,1802.45,1.1,2773.0,126
CDM,78291OH,PERITONEAL-VENOUS SHUNT PATENCY TEST,3125.0,2031.25,1.1,3125.0,142
CDM,78291OH-26,PERITONEAL-VENOUS SHUNT PATENCY TEST,352.0,228.8,1.1,352.0,126
CDM,78291OH-TC,PERITONEAL-VENOUS SHUNT PATENCY TEST,2773.0,1802.45,1.1,2773.0,126
CDM,78300OH,BONE &/JOINT IMAGING LIMITED AREA,3021.0,1963.65,1.1,3021.0,142
CDM,78300OH-26,BONE &/JOINT IMAGING LIMITED AREA,248.0,161.2,1.1,248.0,126
CDM,78300OH-TC,BONE &/JOINT IMAGING LIMITED AREA,2773.0,1802.45,1.1,2773.0,126
CDM,78305OH,BONE &/JOINT IMAGING MULTIPLE AREAS,3105.0,2018.25,1.1,3105.0,142
CDM,78305OH-26,BONE &/JOINT IMAGING MULTIPLE AREAS,332.0,215.8,1.1,332.0,126
CDM,78305OH-TC,BONE &/JOINT IMAGING MULTIPLE AREAS,2773.0,1802.45,1.1,2773.0,126
CDM,78306OH,BONE &/JOINT IMAGING WHOLE BODY,3151.0,2048.15,1.1,3151.0,142
CDM,78306OH-26,BONE &/JOINT IMAGING WHOLE BODY,378.0,245.7,1.1,378.0,126
CDM,78306OH-TC,BONE &/JOINT IMAGING WHOLE BODY,2773.0,1802.45,1.1,2773.0,126
CDM,78315OH,BONE &/JOINT IMAGING 3 PHASE STUDY,3181.0,2067.65,1.1,3181.0,142
CDM,78315OH-26,BONE &/JOINT IMAGING 3 PHASE STUDY,408.0,265.2,1.1,408.0,126
CDM,78315OH-TC,BONE &/JOINT IMAGING 3 PHASE STUDY,2773.0,1802.45,1.1,2773.0,126
CDM,78350OH,"BONE MINERAL, SINGLE PHOTON",2839.0,1845.35,1.1,2839.0,110
CDM,78350OH-26,"BONE MINERAL, SINGLE PHOTON",88.0,57.2,1.1,88.0,98
CDM,78350OH-TC,"BONE MINERAL, SINGLE PHOTON",2751.0,1788.15,1.1,2751.0,98
CDM,78428OH,CARDIAC SHUNT DETECTION,3085.0,2005.25,1.1,3085.0,142
CDM,78428OH-26,CARDIAC SHUNT DETECTION,312.0,202.8,1.1,312.0,126
CDM,78428OH-TC,CARDIAC SHUNT DETECTION,2773.0,1802.45,1.1,2773.0,126
CDM,78429OH,MYOCRD IMG PET METAB EVAL SINGLE STUDY CNCRNT CT,10768.0,6999.2,1.1,10768.0,76
CDM,78429OH-26,MYOCRD IMG PET METAB EVAL SINGLE STUDY CNCRNT CT,704.0,457.6,1.1,704.0,126
CDM,78429OH-TC,MYOCRD IMG PET METAB EVAL SINGLE STUDY CNCRNT CT,10064.0,6541.6,1.1,10064.0,78
CDM,78430OH,MYOCRD IMG PET PRFUJ 1STD REST/STRESS CNCRNT CT,10732.0,6975.8,1.1,10732.0,76
CDM,78430OH-26,MYOCRD IMG PET PRFUJ 1STD REST/STRESS CNCRNT CT,668.0,434.2,1.1,668.0,126
CDM,78430OH-TC,MYOCRD IMG PET PRFUJ 1STD REST/STRESS CNCRNT CT,10064.0,6541.6,1.1,10064.0,78
CDM,78431OH,MYOCRD IMG PET PRFUJ MLT STD RST & STRS CNCRNT CT,16288.0,10587.2,1.1,16288.0,88
CDM,78431OH-26,MYOCRD IMG PET PRFUJ MLT STD RST & STRS CNCRNT CT,760.0,494.0,1.1,760.0,126
CDM,78431OH-TC,MYOCRD IMG PET PRFUJ MLT STD RST & STRS CNCRNT CT,15528.0,10093.2,1.1,15528.0,78
CDM,78432OH,MYOCRD IMG PET PRFUJ W/METAB DUAL RADIOTRACER,13596.0,8837.4,1.1,13596.0,76
CDM,78432OH-26,MYOCRD IMG PET PRFUJ W/METAB DUAL RADIOTRACER,828.0,538.2,1.1,828.0,126
CDM,78432OH-TC,MYOCRD IMG PET PRFUJ W/METAB DUAL RADIOTRACER,12768.0,8299.2,1.1,12768.0,78
CDM,78433OH,MYOCRD IMG PET PRFUJ W/METAB 2RTRACER CNCRNT CT,14362.0,9335.3,1.1,14362.0,76
CDM,78433OH-26,MYOCRD IMG PET PRFUJ W/METAB 2RTRACER CNCRNT CT,904.0,587.6,1.1,904.0,126
CDM,78433OH-TC,MYOCRD IMG PET PRFUJ W/METAB 2RTRACER CNCRNT CT,13458.0,8747.7,1.1,13458.0,78
CDM,78434OH,AQMBF PET REST AND PHARMACOLOGIC STRESS,3461.0,2249.65,1.1,3461.0,76
CDM,78434OH-26,AQMBF PET REST AND PHARMACOLOGIC STRESS,252.0,163.8,1.1,252.0,126
CDM,78434OH-TC,AQMBF PET REST AND PHARMACOLOGIC STRESS,3209.0,2085.85,1.1,3312.0,78
CDM,78451OH,MYOCARDIAL SPECT SINGLE STUDY AT REST OR STRESS,9615.0,6249.75,1.1,9615.0,142
CDM,78451OH-26,MYOCARDIAL SPECT SINGLE STUDY AT REST OR STRESS,607.0,394.55,1.1,607.0,126
CDM,78451OH-TC,MYOCARDIAL SPECT SINGLE STUDY AT REST OR STRESS,9008.0,5855.2,1.1,9008.0,126
CDM,78452OH,MYOCARDIAL SPECT MULTIPLE STUDIES,9721.0,6318.65,1.1,9721.0,142
CDM,78452OH-26,MYOCARDIAL SPECT MULTIPLE STUDIES,713.0,463.45,1.1,713.0,126
CDM,78452OH-TC,MYOCARDIAL SPECT MULTIPLE STUDIES,9008.0,5855.2,1.1,9008.0,126
CDM,78453OH,MYOCARDIAL PERFUSION PLANAR 1 STUDY REST/STRESS,9408.0,6115.2,1.1,9408.0,142
CDM,78453OH-26,MYOCARDIAL PERFUSION PLANAR 1 STUDY REST/STRESS,400.0,260.0,1.1,400.0,126
CDM,78453OH-TC,MYOCARDIAL PERFUSION PLANAR 1 STUDY REST/STRESS,9008.0,5855.2,1.1,9008.0,126
CDM,78454OH,MYOCARDIAL PERFUSION PLANAR MULTIPLE STUDIES,9544.0,6203.6,1.1,9544.0,142
CDM,78454OH-26,MYOCARDIAL PERFUSION PLANAR MULTIPLE STUDIES,536.0,348.4,1.1,536.0,126
CDM,78454OH-TC,MYOCARDIAL PERFUSION PLANAR MULTIPLE STUDIES,9008.0,5855.2,1.1,9008.0,126
CDM,78456OH,ACUTE VENOUS THROMBOSIS IMAGING PEPTIDE,9408.0,6115.2,1.1,9408.0,142
CDM,78456OH-26,ACUTE VENOUS THROMBOSIS IMAGING PEPTIDE,400.0,260.0,1.1,400.0,126
CDM,78456OH-TC,ACUTE VENOUS THROMBOSIS IMAGING PEPTIDE,9008.0,5855.2,1.1,9008.0,126
CDM,78459OH,MYOCRD IMG PET METAB EVAL SINGLE STUDY,9716.0,6315.4,1.1,9716.0,104
CDM,78459OH-26,MYOCRD IMG PET METAB EVAL SINGLE STUDY,708.0,460.2,1.1,708.0,126
CDM,78459OH-TC,MYOCRD IMG PET METAB EVAL SINGLE STUDY,9008.0,5855.2,1.1,9008.0,94
CDM,78466OH,MYOCARDIAL IMAGING INFARCT AVID PLANAR QUAL/QUAN,3049.0,1981.85,1.1,3049.0,142
CDM,78466OH-26,MYOCARDIAL IMAGING INFARCT AVID PLANAR QUAL/QUAN,276.0,179.4,1.1,276.0,126
CDM,78466OH-TC,MYOCARDIAL IMAGING INFARCT AVID PLANAR QUAL/QUAN,2773.0,1802.45,1.1,2773.0,126
CDM,78468OH,MYOCRD IMG INFARCT AVID PLNR EJEC FXJ 1ST PS TQ,4034.0,2622.1,1.1,4034.0,142
CDM,78468OH-26,MYOCRD IMG INFARCT AVID PLNR EJEC FXJ 1ST PS TQ,320.0,208.0,1.1,320.0,126
CDM,78468OH-TC,MYOCRD IMG INFARCT AVID PLNR EJEC FXJ 1ST PS TQ,3714.0,2414.1,1.1,3714.0,126
CDM,78469OH,MYOCRD INFARCT AVID PLNR TOMOG SPECT W/WO QUANTJ,4082.0,2653.3,1.1,4082.0,142
CDM,78469OH-26,MYOCRD INFARCT AVID PLNR TOMOG SPECT W/WO QUANTJ,368.0,239.2,1.1,368.0,126
CDM,78469OH-TC,MYOCRD INFARCT AVID PLNR TOMOG SPECT W/WO QUANTJ,3714.0,2414.1,1.1,3714.0,126
CDM,78472OH,CARD BLOOD POOL GATED PLANAR 1 STUDY REST/STRESS,3165.0,2057.25,1.1,3165.0,142
CDM,78472OH-26,CARD BLOOD POOL GATED PLANAR 1 STUDY REST/STRESS,392.0,254.8,1.1,392.0,126
CDM,78472OH-TC,CARD BLOOD POOL GATED PLANAR 1 STUDY REST/STRESS,2773.0,1802.45,1.1,2773.0,126
CDM,78473OH,CARD BL POOL GATED MLT STDY WAL MOTN EJECT FRACT,3361.0,2184.65,1.1,3361.0,142
CDM,78473OH-26,CARD BL POOL GATED MLT STDY WAL MOTN EJECT FRACT,588.0,382.2,1.1,588.0,126
CDM,78473OH-TC,CARD BL POOL GATED MLT STDY WAL MOTN EJECT FRACT,2773.0,1802.45,1.1,2773.0,126
CDM,78481OH,CARD BL POOL PLANAR 1 STDY WAL MOTN EJECT FRACT,4106.0,2668.9,1.1,4106.0,142
CDM,78481OH-26,CARD BL POOL PLANAR 1 STDY WAL MOTN EJECT FRACT,392.0,254.8,1.1,392.0,126
CDM,78481OH-TC,CARD BL POOL PLANAR 1 STDY WAL MOTN EJECT FRACT,3714.0,2414.1,1.1,3714.0,126
CDM,78483OH,CARD BL POOL PLNR MLT STDY WAL MOTN EJECT FRACT,4302.0,2796.3,1.1,4302.0,142
CDM,78483OH-26,CARD BL POOL PLNR MLT STDY WAL MOTN EJECT FRACT,588.0,382.2,1.1,588.0,126
CDM,78483OH-TC,CARD BL POOL PLNR MLT STDY WAL MOTN EJECT FRACT,3714.0,2414.1,1.1,3714.0,126
CDM,78491OH,MYOCRD IMG PET PRFUJ SINGLE STUDY REST/STRESS,10750.0,6987.5,1.1,10750.0,104
CDM,78491OH-26,MYOCRD IMG PET PRFUJ SINGLE STUDY REST/STRESS,686.0,445.9,1.1,686.0,126
CDM,78491OH-TC,MYOCRD IMG PET PRFUJ SINGLE STUDY REST/STRESS,10064.0,6541.6,1.1,10064.0,94
CDM,78492OH,MYOCRD IMG PET PRFUJ MULTIPLE STUDY REST&STRESS,10784.0,7009.6,1.1,10784.0,104
CDM,78492OH-26,MYOCRD IMG PET PRFUJ MULTIPLE STUDY REST&STRESS,720.0,468.0,1.1,720.0,126
CDM,78492OH-TC,MYOCRD IMG PET PRFUJ MULTIPLE STUDY REST&STRESS,10064.0,6541.6,1.1,10064.0,94
CDM,78496OH,HEART FIRST PASS ADD-ON,864.0,561.6,1.1,864.0,142
CDM,78496OH-26,HEART FIRST PASS ADD-ON,200.0,130.0,1.1,200.0,126
CDM,78496OH-TC,HEART FIRST PASS ADD-ON,664.0,431.6,1.1,664.0,126
CDM,78579OH,PULMONARY VENTILATION IMAGING,2969.0,1929.85,1.1,2969.0,142
CDM,78579OH-26,PULMONARY VENTILATION IMAGING,196.0,127.4,1.1,196.0,126
CDM,78579OH-TC,PULMONARY VENTILATION IMAGING,2773.0,1802.45,1.1,2773.0,126
CDM,78580OH,PULMONARY PERFUSION IMAGING PARTICULATE,3069.0,1994.85,1.1,3069.0,142
CDM,78580OH-26,PULMONARY PERFUSION IMAGING PARTICULATE,296.0,192.4,1.1,296.0,126
CDM,78580OH-TC,PULMONARY PERFUSION IMAGING PARTICULATE,2773.0,1802.45,1.1,2773.0,126
CDM,78582OH,PULMONARY VENTILATION & PERFUSION IMAGING,4142.0,2692.3,1.1,4142.0,142
CDM,78582OH-26,PULMONARY VENTILATION & PERFUSION IMAGING,428.0,278.2,1.1,428.0,126
CDM,78582OH-TC,PULMONARY VENTILATION & PERFUSION IMAGING,3714.0,2414.1,1.1,3714.0,126
CDM,78597OH,QUANT DIFFERENTIAL PULM PERFUSION W/WO IMAGING,3073.0,1997.45,1.1,3073.0,142
CDM,78597OH-26,QUANT DIFFERENTIAL PULM PERFUSION W/WO IMAGING,300.0,195.0,1.1,300.0,126
CDM,78597OH-TC,QUANT DIFFERENTIAL PULM PERFUSION W/WO IMAGING,2773.0,1802.45,1.1,2773.0,126
CDM,78598OH,QUANT DIFF PULM PRFUSION & VENTLAJ W/WO IMAGIN,4054.0,2635.1,1.1,4054.0,142
CDM,78598OH-26,QUANT DIFF PULM PRFUSION & VENTLAJ W/WO IMAGIN,340.0,221.0,1.1,340.0,126
CDM,78598OH-TC,QUANT DIFF PULM PRFUSION & VENTLAJ W/WO IMAGIN,3714.0,2414.1,1.1,3714.0,126
CDM,78601OH,BRAIN IMAGING <4 STATIC VIEWS W/VASCULAR FLOW,2977.0,1935.05,1.1,2977.0,142
CDM,78601OH-26,BRAIN IMAGING <4 STATIC VIEWS W/VASCULAR FLOW,204.0,132.6,1.1,204.0,126
CDM,78601OH-TC,BRAIN IMAGING <4 STATIC VIEWS W/VASCULAR FLOW,2773.0,1802.45,1.1,2773.0,126
CDM,78605OH,"BRAIN IMAGING, COMPLETE",3926.0,2551.9,1.1,3926.0,142
CDM,78605OH-26,"BRAIN IMAGING, COMPLETE",212.0,137.8,1.1,212.0,126
CDM,78605OH-TC,"BRAIN IMAGING, COMPLETE",3714.0,2414.1,1.1,3714.0,126
CDM,78606OH,BRAIN IMAGING MIN 4 STATIC VIEWS W VASCULAR FLOW,3970.0,2580.5,1.1,3970.0,142
CDM,78606OH-26,BRAIN IMAGING MIN 4 STATIC VIEWS W VASCULAR FLOW,256.0,166.4,1.1,256.0,126
CDM,78606OH-TC,BRAIN IMAGING MIN 4 STATIC VIEWS W VASCULAR FLOW,3714.0,2414.1,1.1,3714.0,126
CDM,78608OH,BRAIN IMAGING PET METABOLIC EVALUATION,10664.0,6931.6,1.1,10664.0,104
CDM,78608OH-26,BRAIN IMAGING PET METABOLIC EVALUATION,600.0,390.0,1.1,600.0,126
CDM,78608OH-TC,BRAIN IMAGING PET METABOLIC EVALUATION,10064.0,6541.6,1.1,10064.0,94
CDM,78610OH,"BRAIN IMAGING, VASC FLOW ONLY",3834.0,2492.1,1.1,3834.0,142
CDM,78610OH-26,"BRAIN IMAGING, VASC FLOW ONLY",120.0,78.0,1.1,120.0,126
CDM,78610OH-TC,"BRAIN IMAGING, VASC FLOW ONLY",3714.0,2414.1,1.1,3714.0,126
CDM,78630OH,CEREBROSPINAL FLUID FLOW W/O MATL CISTERNOGRAPHY,3986.0,2590.9,1.1,3986.0,142
CDM,78630OH-26,CEREBROSPINAL FLUID FLOW W/O MATL CISTERNOGRAPHY,272.0,176.8,1.1,272.0,126
CDM,78630OH-TC,CEREBROSPINAL FLUID FLOW W/O MATL CISTERNOGRAPHY,3714.0,2414.1,1.1,3714.0,126
CDM,78645OH,CEREBROSPINAL FLUID FLOW W/O MATL SHUNT EVALTJ,3942.0,2562.3,1.1,3942.0,142
CDM,78645OH-26,CEREBROSPINAL FLUID FLOW W/O MATL SHUNT EVALTJ,228.0,148.2,1.1,228.0,126
CDM,78645OH-TC,CEREBROSPINAL FLUID FLOW W/O MATL SHUNT EVALTJ,3714.0,2414.1,1.1,3714.0,126
CDM,78650OH,CEREBROSPINAL FLUID LEAK DETECTION&LOCALIZATIO,9252.0,6013.8,1.1,9252.0,142
CDM,78650OH-26,CEREBROSPINAL FLUID LEAK DETECTION&LOCALIZATIO,244.0,158.6,1.1,244.0,126
CDM,78650OH-TC,CEREBROSPINAL FLUID LEAK DETECTION&LOCALIZATIO,9008.0,5855.2,1.1,9008.0,126
CDM,78700OH,KIDNEY IMAGING MORPHOLOGY,2953.0,1919.45,1.1,2953.0,142
CDM,78700OH-26,KIDNEY IMAGING MORPHOLOGY,180.0,117.0,1.1,180.0,126
CDM,78700OH-TC,KIDNEY IMAGING MORPHOLOGY,2773.0,1802.45,1.1,2773.0,126
CDM,78701OH,KIDNEY IMAGING MORPHOOGY W/VASCULAR FLOW,2969.0,1929.85,1.1,2969.0,142
CDM,78701OH-26,KIDNEY IMAGING MORPHOOGY W/VASCULAR FLOW,196.0,127.4,1.1,196.0,126
CDM,78701OH-TC,KIDNEY IMAGING MORPHOOGY W/VASCULAR FLOW,2773.0,1802.45,1.1,2773.0,126
CDM,78707OH,KIDNEY IMG MORPHOLOGY VASCULAR FLOW 1 W/O RX,4098.0,2663.7,1.1,4098.0,142
CDM,78707OH-26,KIDNEY IMG MORPHOLOGY VASCULAR FLOW 1 W/O RX,384.0,249.6,1.1,384.0,126
CDM,78707OH-TC,KIDNEY IMG MORPHOLOGY VASCULAR FLOW 1 W/O RX,3714.0,2414.1,1.1,3714.0,126
CDM,78708OH,KIDNEY IMG MORPHOLOGY VASCULAR FLOW 1 W/RX,4198.0,2728.7,1.1,4198.0,142
CDM,78708OH-26,KIDNEY IMG MORPHOLOGY VASCULAR FLOW 1 W/RX,484.0,314.6,1.1,484.0,126
CDM,78708OH-TC,KIDNEY IMG MORPHOLOGY VASCULAR FLOW 1 W/RX,3714.0,2414.1,1.1,3714.0,126
CDM,78709OH,KIDNEY IMG MORPHOLOGY VASCULAR FLOW MULTIPLE,4278.0,2780.7,1.1,4278.0,142
CDM,78709OH-26,KIDNEY IMG MORPHOLOGY VASCULAR FLOW MULTIPLE,564.0,366.6,1.1,564.0,126
CDM,78709OH-TC,KIDNEY IMG MORPHOLOGY VASCULAR FLOW MULTIPLE,3714.0,2414.1,1.1,3714.0,126
CDM,78725OH,KIDNEY FUNCJ STUDY NON-IMG RADIOISOTOPIC STUDY,2925.0,1901.25,1.1,2925.0,142
CDM,78725OH-26,KIDNEY FUNCJ STUDY NON-IMG RADIOISOTOPIC STUDY,152.0,98.8,1.1,152.0,126
CDM,78725OH-TC,KIDNEY FUNCJ STUDY NON-IMG RADIOISOTOPIC STUDY,2773.0,1802.45,1.1,2773.0,126
CDM,78740OH,URETERAL REFLUX STUDY RP VOIDING CYSTOGRAM,3001.0,1950.65,1.1,3001.0,142
CDM,78740OH-26,URETERAL REFLUX STUDY RP VOIDING CYSTOGRAM,228.0,148.2,1.1,228.0,126
CDM,78740OH-TC,URETERAL REFLUX STUDY RP VOIDING CYSTOGRAM,2773.0,1802.45,1.1,2773.0,126
CDM,78761OH,TESTICULAR IMAGING WITH VASCULAR FLOW,3057.0,1987.05,1.1,3057.0,142
CDM,78761OH-26,TESTICULAR IMAGING WITH VASCULAR FLOW,284.0,184.6,1.1,284.0,126
CDM,78761OH-TC,TESTICULAR IMAGING WITH VASCULAR FLOW,2773.0,1802.45,1.1,2773.0,126
CDM,78800OH,RP LOCLZJ TUM PLNR 1 AREA SINGLE DAY IMAGING,3029.0,1968.85,1.1,3029.0,142
CDM,78800OH-26,RP LOCLZJ TUM PLNR 1 AREA SINGLE DAY IMAGING,256.0,166.4,1.1,256.0,126
CDM,78800OH-TC,RP LOCLZJ TUM PLNR 1 AREA SINGLE DAY IMAGING,2773.0,1802.45,1.1,2773.0,126
CDM,78801OH,RP LOCLZJ TUM PLNR 2+AREA 1+D IMG/1 AREA IMG>2+D,3094.0,2011.1,1.1,3094.0,142
CDM,78801OH-26,RP LOCLZJ TUM PLNR 2+AREA 1+D IMG/1 AREA IMG>2+D,321.0,208.65,1.1,321.0,126
CDM,78801OH-TC,RP LOCLZJ TUM PLNR 2+AREA 1+D IMG/1 AREA IMG>2+D,2773.0,1802.45,1.1,2773.0,126
CDM,78802OH,RP LOCLZJ TUM PLNR WHOLE BODY SINGLE DAY IMAGING,9360.0,6084.0,1.1,9360.0,142
CDM,78802OH-26,RP LOCLZJ TUM PLNR WHOLE BODY SINGLE DAY IMAGING,352.0,228.8,1.1,352.0,126
CDM,78802OH-TC,RP LOCLZJ TUM PLNR WHOLE BODY SINGLE DAY IMAGING,9008.0,5855.2,1.1,9008.0,126
CDM,78803OH,RP LOCLZJ TUM SPECT 1 AREA SINGLE DAY IMAGING,9488.0,6167.2,1.1,9488.0,142
CDM,78803OH-26,RP LOCLZJ TUM SPECT 1 AREA SINGLE DAY IMAGING,480.0,312.0,1.1,480.0,126
CDM,78803OH-TC,RP LOCLZJ TUM SPECT 1 AREA SINGLE DAY IMAGING,9008.0,5855.2,1.1,9008.0,126
CDM,78804OH,RP LOCLZJ TUM PLNR WHOLE BODY 2+ DAYS IMAGING,9452.0,6143.8,1.1,9452.0,142
CDM,78804OH-26,RP LOCLZJ TUM PLNR WHOLE BODY 2+ DAYS IMAGING,444.0,288.6,1.1,444.0,126
CDM,78804OH-TC,RP LOCLZJ TUM PLNR WHOLE BODY 2+ DAYS IMAGING,9008.0,5855.2,1.1,9008.0,126
CDM,78808OH,NJX RP LOCLZJ NON-IMG PROBE STUDY INTRAVENOUS,79.0,51.35,1.1,1202.97,142
CDM,78811OH,PET IMAGING LIMITED AREA CHEST HEAD/NECK,9624.0,6255.6,1.1,9624.0,104
CDM,78811OH-26,PET IMAGING LIMITED AREA CHEST HEAD/NECK,616.0,400.4,1.1,616.0,126
CDM,78811OH-TC,PET IMAGING LIMITED AREA CHEST HEAD/NECK,9008.0,5855.2,1.1,9008.0,94
CDM,78812OH,PET IMAGING SKULL BASE TO MID-THIGH,10836.0,7043.4,1.1,10836.0,104
CDM,78812OH-26,PET IMAGING SKULL BASE TO MID-THIGH,772.0,501.8,1.1,772.0,126
CDM,78812OH-TC,PET IMAGING SKULL BASE TO MID-THIGH,10064.0,6541.6,1.1,10064.0,94
CDM,78813OH,PET IMAGE FULL BODY,10864.0,7061.6,1.1,10864.0,104
CDM,78813OH-26,PET IMAGE FULL BODY,800.0,520.0,1.1,800.0,126
CDM,78813OH-TC,PET IMAGE FULL BODY,10064.0,6541.6,1.1,10064.0,94
CDM,78814OH,PET IMAGING CT FOR ATTENUATION LIMITED AREA,10944.0,7113.6,1.1,10944.0,104
CDM,78814OH-26,PET IMAGING CT FOR ATTENUATION LIMITED AREA,880.0,572.0,1.1,880.0,126
CDM,78814OH-TC,PET IMAGING CT FOR ATTENUATION LIMITED AREA,10064.0,6541.6,1.1,10064.0,94
CDM,78815OH,PET IMAGING CT ATTENUATION SKULL BASE MID-THIGH,11040.0,7176.0,1.1,11040.0,104
CDM,78815OH-26,PET IMAGING CT ATTENUATION SKULL BASE MID-THIGH,976.0,634.4,1.1,976.0,126
CDM,78815OH-TC,PET IMAGING CT ATTENUATION SKULL BASE MID-THIGH,10064.0,6541.6,1.1,10064.0,94
CDM,78816OH,PET IMAGING FOR CT ATTENUATION WHOLE BODY,11064.0,7191.6,1.1,11064.0,104
CDM,78816OH-26,PET IMAGING FOR CT ATTENUATION WHOLE BODY,1000.0,650.0,1.1,1000.0,126
CDM,78816OH-TC,PET IMAGING FOR CT ATTENUATION WHOLE BODY,10064.0,6541.6,1.1,10064.0,94
CDM,78830OH,RP LOCLZJ TUM SPECT W/CT 1 AREA 1 DAY IMAGING,9604.0,6242.6,1.1,9604.0,142
CDM,78830OH-26,RP LOCLZJ TUM SPECT W/CT 1 AREA 1 DAY IMAGING,596.0,387.4,1.1,596.0,126
CDM,78830OH-TC,RP LOCLZJ TUM SPECT W/CT 1 AREA 1 DAY IMAGING,9008.0,5855.2,1.1,9008.0,126
CDM,78831OH,RP LOCLZJ TUM SPECT 2 AREA/SEP ACQUISJ IMG,9736.0,6328.4,1.1,9736.0,142
CDM,78831OH-26,RP LOCLZJ TUM SPECT 2 AREA/SEP ACQUISJ IMG,728.0,473.2,1.1,728.0,126
CDM,78831OH-TC,RP LOCLZJ TUM SPECT 2 AREA/SEP ACQUISJ IMG,9008.0,5855.2,1.1,9008.0,126
CDM,78832OH,RP LOCLZJ TUM SPECT CT 2AREA/SEP ACQUISJ IMG,10912.0,7092.8,1.1,10912.0,142
CDM,78832OH-26,RP LOCLZJ TUM SPECT CT 2AREA/SEP ACQUISJ IMG,848.0,551.2,1.1,848.0,126
CDM,78832OH-TC,RP LOCLZJ TUM SPECT CT 2AREA/SEP ACQUISJ IMG,10064.0,6541.6,1.1,10064.0,126
CDM,78835OH,RADIOPHARMACEUTICAL QUANTIFICATION MEAS 1 AREA,598.0,388.7,1.1,598.0,142
CDM,78835OH-26,RADIOPHARMACEUTICAL QUANTIFICATION MEAS 1 AREA,188.0,122.2,1.1,188.0,126
CDM,78835OH-TC,RADIOPHARMACEUTICAL QUANTIFICATION MEAS 1 AREA,410.0,266.5,1.1,410.0,126
CDM,78999OH,UNLISTED MISCELLANEOUS PX DX NUCLEAR MEDICINE,537.0,349.05,0.01,1202.97,82
CDM,78999OH-26,UNLISTED MISCELLANEOUS PX DX NUCLEAR MEDICINE,537.0,349.05,0.01,537.0,82
CDM,78999RVU1OH,MRI FUSION TO PET (COMP CODE 76376),743.0,482.95,0.01,1202.97,82
CDM,78999RVU1OH-26,MRI FUSION TO PET (COMP CODE 76376),87.0,56.55,0.01,87.0,82
CDM,78999RVU1OH-TC,MRI FUSION TO PET (COMP CODE 76376),656.0,426.4,0.01,656.0,82
CDM,79000005,LITHOTRIPSY XTRCORP SHOCK WAVE,15865.0,10312.25,672.27,25635.0,87
CDM,79005OH,RP THERAPY ORAL ADMINISTRATION,2266.0,1472.9,1.1,2266.0,142
CDM,79005OH-26,RP THERAPY ORAL ADMINISTRATION,720.0,468.0,1.1,720.0,126
CDM,79005OH-TC,RP THERAPY ORAL ADMINISTRATION,1546.0,1004.9,1.1,1546.0,126
CDM,79101OH,RP THERAPY INTRAVENOUS ADMINISTRATION,2330.0,1514.5,1.1,2330.0,142
CDM,79101OH-26,RP THERAPY INTRAVENOUS ADMINISTRATION,784.0,509.6,1.1,784.0,126
CDM,79101OH-TC,RP THERAPY INTRAVENOUS ADMINISTRATION,1546.0,1004.9,1.1,1546.0,126
CDM,79200OH,INTRACAVITARY NUCLEAR TREATMNT,2342.0,1522.3,1.1,2342.0,142
CDM,79200OH-26,INTRACAVITARY NUCLEAR TREATMNT,796.0,517.4,1.1,796.0,126
CDM,79200OH-TC,INTRACAVITARY NUCLEAR TREATMNT,1546.0,1004.9,1.1,1546.0,126
CDM,79403OH,RP THER RADIOLBLD MONOCLONAL ANTIBODY IV INFUS,2446.0,1589.9,1.1,2446.0,142
CDM,79403OH-26,RP THER RADIOLBLD MONOCLONAL ANTIBODY IV INFUS,900.0,585.0,1.1,900.0,126
CDM,79403OH-TC,RP THER RADIOLBLD MONOCLONAL ANTIBODY IV INFUS,1546.0,1004.9,1.1,1546.0,126
CDM,79445OH,RP THERAPY INTRA-ARTERIAL PARTICULATE ADMN,2506.0,1628.9,1.1,2506.0,104
CDM,79445OH-26,RP THERAPY INTRA-ARTERIAL PARTICULATE ADMN,960.0,624.0,1.1,960.0,126
CDM,79445OH-TC,RP THERAPY INTRA-ARTERIAL PARTICULATE ADMN,1546.0,1004.9,1.1,1546.0,94
CDM,80047OH,BASIC METABOLIC PANEL WITH CALCIUM IONIZED,95.0,61.75,1.1,95.0,88
CDM,80048OH,BASIC METABOLIC PANEL CALCIUM TOTAL,58.0,37.7,1.1,58.0,88
CDM,80051OH,ELECTROLYTE PANEL,48.0,31.2,1.1,48.0,88
CDM,80053OH,COMPREHENSIVE METABOLIC PANEL,73.0,47.45,1.1,73.0,88
CDM,80061OH,LIPID PANEL,92.0,59.8,1.1,92.0,88
CDM,80069OH,RENAL FUNCT PNL,60.0,39.0,1.1,60.0,88
CDM,80074OH,ACUTE HEPATITIS PANEL,329.0,213.85,1.1,329.0,88
CDM,80076OH,HEPATIC FUNCTION PNL,56.0,36.4,1.1,56.0,88
CDM,80100000,CONTIN AV HEMOFILTRATION CAVH,2938.0,1909.7,102.71,2938.0,86
CDM,80100005,HEMOFILTRATION INPATIENT,1518.0,986.7,330.92,1518.0,58
CDM,80100010,HEMO 1 EVAL IP,4828.0,3138.2,85.0,4828.0,86
CDM,80100011,INTENSIVE CARE IHD,4828.0,3138.2,85.0,4828.0,86
CDM,80100065,CRRT,1560.0,1014.0,340.08,1560.0,58
CDM,80155OH,DRUG SCREEN QUANT CAFFEINE,266.0,172.9,1.1,266.0,88
CDM,80156OH,DRUG ASSAY CARBAMAZEPINE TOTAL,101.0,65.65,1.1,101.0,88
CDM,80157OH,DRUG ASSAY CARBAMAZEPINE FREE,91.0,59.15,1.1,91.0,88
CDM,80158OH,DRUG ASSAY CYCLOSPORINE,125.0,81.25,1.1,125.0,88
CDM,80159OH,DRUG SCREEN QUANT CLOZAPINE,139.0,90.35,1.1,139.0,88
CDM,80162OH,DRUG SCREEN QUANTITATIVE DIGOXIN TOTAL,92.0,59.8,1.1,92.0,88
CDM,80164OH,DRUG ASSAY VALPROIC DIPROPYLACETIC ACID TOTAL,93.0,60.45,1.1,93.0,88
CDM,80165OH,DRUG SCREEN QUANT DIPROPYLACETIC ACID FREE,93.0,60.45,1.1,93.0,88
CDM,80168OH,ETHOSUXIMID/ZARONTIN,113.0,73.45,1.1,113.0,88
CDM,80169OH,DRUG SCREEN QUANT EVEROLIMUS,95.0,61.75,1.1,95.0,88
CDM,80170OH,DRUG SCREEN QUANTITATIVE GENTAMICIN,113.0,73.45,1.1,113.0,88
CDM,80171OH,DRUG SCREEN QUANT GABAPENTIN,150.0,97.5,1.1,150.0,88
CDM,80173OH,DRUG SCREEN QUANTITATIVE HALOPRIDOL,247.0,160.55,1.1,247.0,88
CDM,80175OH,DRUG SCREEN QUAN LAMOTRIGINE,91.0,59.15,1.1,91.0,88
CDM,80176OH,LIDOCAINE BLD,101.0,65.65,1.1,101.0,88
CDM,80177OH,DRUG SCRN QUAN LEVETIRACETAM,91.0,59.15,1.1,91.0,88
CDM,80178OH,DRUG SCREEN QUANTITATIVE LITHIUM,46.0,29.9,1.1,46.0,88
CDM,80180OH,DRUG SCRN QUAN MYCOPHENOLATE,125.0,81.25,1.1,125.0,88
CDM,80183OH,DRUG SCRN QUANT OXCARBAZEPIN,91.0,59.15,1.1,91.0,88
CDM,80184OH,DRUG SCREEN QUANTITATIVE PHENOBARBITAL,106.0,68.9,1.1,106.0,88
CDM,80185OH,DRUG SCREEN QUANTITATIVE PHENYTOIN TOTAL,91.0,59.15,1.1,91.0,88
CDM,80186OH,DRUG SCREEN QUANTITATIVE PHENYTOIN FREE,95.0,61.75,1.1,95.0,88
CDM,80192OH,DRUG SCREEN QUANTITATIVE PROCAINAMIDE METABOLITE,116.0,75.4,1.1,116.0,88
CDM,80194OH,DRUG SCREEN QUANTITATIVE QUINIDINE,101.0,65.65,1.1,101.0,88
CDM,80195OH,DRUG SCREEN QUANTITATIVE SIROLIMUS,95.0,61.75,1.1,95.0,88
CDM,80197OH,DRUG SCREEN QUANTITATIVE TACROLIMUS,95.0,61.75,1.1,95.0,88
CDM,80198OH,DRUG SCREEN QUANTITATIVE THEOPHYLLINE,98.0,63.7,1.1,98.0,88
CDM,80199OH,DRUG SCREEN QUANT TIAGABINE,187.0,121.55,1.1,187.0,88
CDM,80201OH,DRUG SCREEN QUANTITATIVE TOPIRAMATE,82.0,53.3,1.1,82.0,88
CDM,80202OH,DRUG SCREEN QUANTITATIVE VANCOMYCIN,93.0,60.45,1.1,93.0,88
CDM,80203OH,DRUG SCREEN QUANT ZONISAMIDE,91.0,59.15,1.1,91.0,88
CDM,80300000,PERITON DIALYS CAPD PEDS,2938.0,1909.7,102.71,2938.0,86
CDM,80320OH,DRUG SCREEN QUANTITATIVE ALCOHOLS,158.0,102.7,1.1,3060831.65,88
CDM,80321OH,DRUG SCREEN QUANT ALCOHOLS BIOMARKERS 1 OR 2,252.0,163.8,1.1,3060831.65,82
CDM,80323OH,ALKALOIDS NOT OTHERWISE SPECIFIED,334.0,217.1,1.1,3060831.65,88
CDM,80324OH,DRUG SCREEN QUANT AMPHETAMINES 1 OR 2,64.0,41.6,1.1,64.0,88
CDM,80327OH,DRUG SCREEN QUANT ANABOLIC STEROID 1 OR 2,230.0,149.5,1.1,3060831.65,88
CDM,80329OH,DRUG SCREEN ANALGESICS NON-OPIOID 1 OR 2,232.0,150.8,1.1,3060831.65,88
CDM,80331OH,DRUG SCREEN ANALGESICS NON-OPIOID 6 OR MORE,32.0,20.8,1.1,3060831.65,82
CDM,80333OH,ANTIDEPRESSANTS SEROTONERGIC CLASS 3-5,252.0,163.8,1.1,3060831.65,82
CDM,80334OH,ANTIDEPRESSANTS SEROTONERGIC CLASS 6 OR MORE,36.0,23.4,1.1,3060831.65,82
CDM,80339OH,ANTIEPILEPTICS NOT OTHERWISE SPECIFIED 1-3,440.0,286.0,1.1,3060831.65,88
CDM,80341OH,ANTIEPILEPTICS NOT OTHERWISE SPECIFIED 7/MORE,32.0,20.8,1.1,3060831.65,82
CDM,80344OH,ANTIPSYCHOTICS NOT OTHERWISE SPECIFIED 7/MORE,36.0,23.4,1.1,3060831.65,82
CDM,80347OH,DRUG SCREENING BENZODIAZEPINES 13 OR MORE,490.0,318.5,1.1,3060831.65,82
CDM,80348OH,DRUG SCREENING BUPRENORPHINE,28.0,18.2,1.1,3060831.65,82
CDM,80349OH,DRUG SCREENING CANNABINOIDS NATURAL,53.0,34.45,1.1,53.0,88
CDM,80352OH,DRUG SCREENING CANNABINOIDS SYNTHETIC 7/MORE,732.0,475.8,1.1,3060831.65,82
CDM,80353OH,DRUG SCREENING COCAINE,27.0,17.55,1.1,3060831.65,88
CDM,80354OH,DRUG SCREENING FENTANYL,28.0,18.2,1.1,36.94,88
CDM,80355OH,DRUG SCREENING GABAPENTIN NON-BLOOD,32.0,20.8,1.1,3060831.65,88
CDM,80356OH,DRUG SCREENING HEROIN METABOLITE,77.0,50.05,1.1,3060831.65,88
CDM,80358OH,DRUG SCREENING METHADONE,12.0,7.8,1.1,33.67,88
CDM,80360OH,DRUG SCREENING METHYLPHENIDATE,32.0,20.8,1.1,3060831.65,88
CDM,80361OH,DRUG SCREENING OPIATES 1 OR MORE,28.0,18.2,1.1,70.4,88
CDM,80362OH,DRUG SCREENING OPIOIDS AND OPIATE ANALOGS 1 OR 2,476.0,309.4,1.1,3060831.65,88
CDM,80363OH,DRUG SCREENING OPIOIDS AND OPIATE ANALOGS 3 OR 4,28.0,18.2,1.1,3060831.65,82
CDM,80365OH,DRUG SCREENING OXYCODONE,28.0,18.2,1.1,34.34,88
CDM,80366OH,DRUG SCREENING PREGABALIN,32.0,20.8,1.1,3060831.65,88
CDM,80368OH,DRUG SCREENING SEDATIVE HYPNOTICS,36.0,23.4,1.1,36.0,88
CDM,80369OH,DRUG SCREENING SKELETAL MUSCLE RELAXANTS 1 OR 2,276.0,179.4,1.1,3060831.65,88
CDM,80370OH,DRUG SCREENING SKEL MUSCLE RELAXANTS 3 OR MORE,76.0,49.4,1.1,3060831.65,82
CDM,80372OH,DRUG SCREENING TAPENTADOL,38.0,24.7,1.1,52.04,88
CDM,80373OH,DRUG SCREENING TRAMADOL,36.0,23.4,1.1,36.0,88
CDM,80377OH,DRUG/SUBSTANCE DEFINITIVE QUAL/QUANT NOS 7/MORE,32.0,20.8,1.1,3060831.65,88
CDM,80400010,PERITON DIALYS CCPD,2938.0,1909.7,102.71,2938.0,86
CDM,80400OH,ACTH STIMULATION PANEL ADRENAL INSUFFICIENCY,225.0,146.25,1.1,225.0,88
CDM,80402OH,ACTH STIMULATION PANEL 21 HYDROXYLASE DEFICIENCY,600.0,390.0,1.1,600.0,88
CDM,80408OH,ALDOSTERONE SUPPRESS,866.0,562.9,1.1,866.0,88
CDM,80418OH,PITUITARY EVALUATION,3998.0,2598.7,1.1,3998.0,88
CDM,80420OH,DEXAMET SUPR48HUR+BL,1117.0,726.05,1.1,1117.0,88
CDM,80422OH,GLUCAGON TOLERANCE PANEL,318.0,206.7,1.1,318.0,88
CDM,80426OH,GNRH STIMULATION,1024.0,665.6,1.1,1024.0,88
CDM,80428OH,GH STIM PANEL,460.0,299.0,1.1,460.0,88
CDM,80430OH,GROWTH HORMONE SUPRS,892.0,579.8,1.1,892.0,88
CDM,80432OH,INSULIN SUPPRESSION PANEL,1143.0,742.95,1.1,1143.0,88
CDM,80435OH,INSULIN TOLERANCE,711.0,462.15,1.1,711.0,88
CDM,80438OH,TRH STIMULATION BLD,348.0,226.2,1.1,348.0,88
CDM,80503OH,PATH CLIN CONSLTJ SF 5-20,189.0,122.85,1.1,189.0,134
CDM,81000000,VCA ACQUISITION,55000.0,35750.0,11990.0,55000.0,58
CDM,81000OH,URINLS DIP STICK/TABLET REAGNT NON-AUTO MICRSCPY,28.0,18.2,1.1,28.0,88
CDM,81001OH,URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY,22.0,14.3,1.1,22.0,88
CDM,81002OH,URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP,24.0,15.6,1.1,24.0,88
CDM,81003OH,URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY,16.0,10.4,1.1,16.0,88
CDM,81025OH,URINE PREGNANCY TEST VISUAL COLOR CMPRSN METHS,59.0,38.35,1.1,59.0,88
CDM,81050OH,VOLUME MEASUREMENT TIMED COLLECTION EACH,25.0,16.25,1.1,25.0,88
CDM,81100005,ISLET CELL TXPLNT FR PANCREAS,60000.0,39000.0,610.39,60000.0,84
CDM,81100010,LIVER LIVE DONOR AQUISTION FEE,3000.0,1950.0,654.0,3000.0,58
CDM,81100100,ACQUISITION KIDNEY LIVE DONOR,5000.0,3250.0,1090.0,5000.0,58
CDM,81200000,ACQUISITION FEE INTESTINE,273772.0,177951.8,59682.3,273772.0,58
CDM,81200005,ACQUISITION FEE LUNG,174049.0,113131.85,37942.68,174049.0,58
CDM,81200015,ACQUISITION FEE PANCREAS,179133.0,116436.45,39050.99,179133.0,58
CDM,81200100,ACQUISITION FEE LIVER,148908.0,96790.2,32461.94,148908.0,58
CDM,81200110,ACQUISITION KIDNEY CADAVER,81119.0,52727.35,17683.94,81119.0,58
CDM,81200120,ACQUISITION FEE HEART,170388.0,110752.2,37144.58,170388.0,58
CDM,81200130,ACQUISITION FEE CADAVER VASC COMP ALLOGRAFT,37800.0,24570.0,8240.4,37800.0,58
CDM,81200OH,ASPA GENE ANALYSIS COMMON VARIANTS,326.0,211.9,1.1,326.0,88
CDM,81202OH,APC GENE ANALYSIS KNOWN FAMILIAL VARIANTS,1932.0,1255.8,1.1,1932.0,88
CDM,81205OH,BCKDHB GENE ANALYSIS COMMON VARIANTS,655.0,425.75,1.1,655.0,88
CDM,81207OH,BCR/ABL1 MINOR BREAKPNT QUALITATIVE/QUANTITATIVE,999.0,649.35,1.1,999.0,88
CDM,81220OH,CFTR GENE ANALYSIS COMMON VARIANTS,3841.0,2496.65,1.1,3841.0,88
CDM,81223OH,CFTR GENE ANALYSIS FULL GENE SEQUENCE,3443.0,2237.95,1.1,3443.0,88
CDM,81224OH,CFTR GENE ANALYSIS INTRON 8 POLY-T ANALYSIS,1164.0,756.6,1.1,1164.0,88
CDM,81225OH,CYP2C19 GENE ANALYSIS COMMON VARIANTS,2010.0,1306.5,1.1,2010.0,88
CDM,81226OH,CYP2D6 GENE ANALYSIS COMMON VARIANTS,3111.0,2022.15,1.1,3111.0,88
CDM,81229OH,CYTOG ALYS CHRMOML ABNOR CPY NUMBER&SNP VRNT CGH,4182.0,2718.3,1.1,4182.0,88
CDM,81240OH,F2 GENE ANALYSIS 20210G >A VARIANT,453.0,294.45,1.1,453.0,88
CDM,81241OH,F5 COAGULATION FACTOR V ANAL LEIDEN VARIANT,506.0,328.9,1.1,506.0,88
CDM,81243OH,FMR1 GENE ALYS EVAL TO DETECT ABNORMAL ALLELES,394.0,256.1,1.1,394.0,88
CDM,81246OH,FLT3 GENE ANLYS TYROSINE KINASE DOMAIN VARIANTS,573.0,372.45,1.1,573.0,88
CDM,81250OH,G6PC GENE ANALYSIS COMMON VARIANTS,404.0,262.6,1.1,404.0,88
CDM,81251OH,GBA GLUCOSIDASE/BETA/ACID ANAL COMM VARIANTS,326.0,211.9,1.1,326.0,88
CDM,81256OH,HFE HEMOCHROMATOSIS GENE ANAL COMMON VARIANTS,451.0,293.15,1.1,451.0,88
CDM,81257OH,HBA1/HBA2 ANALYSIS FOR COMMON DELETIONS/VARIANT,706.0,458.9,1.1,706.0,88
CDM,81261OH,IGH@ REARRANGE ABNORMAL CLONAL POP AMPLIFIED,1366.0,887.9,1.1,1366.0,88
CDM,81262OH,IGH@ REARRANGE ABNORMAL CLONAL POP DIRECT PROBE,473.0,307.45,1.1,473.0,88
CDM,81263OH,IGH@ VARIABLE REGION SOMATIC MUTATION ANALYSIS,2032.0,1320.8,1.1,2032.0,88
CDM,81265OH,COMPARATIVE ANAL STR MARKERS PATIENT&COMP SPEC,1608.0,1045.2,1.1,1608.0,88
CDM,81267OH,CHIMERISM W/COMP TO BASELINE W/O CELL SELECTION,1431.0,930.15,1.1,1431.0,88
CDM,81270OH,JAK2 GENE ANALYSIS P.VAL617PHE VARIANT,632.0,410.8,1.1,632.0,88
CDM,81272OH,KIT GENE ANALYSIS TARGETED SEQUENCE ANALYSIS,2274.0,1478.1,1.1,2274.0,88
CDM,81287OH,MGMT GENE PROMOTER METHYLATION ANALYSIS,860.0,559.0,1.1,860.0,88
CDM,81291OH,MTHFR GENE ANALYSIS COMMON VARIANTS,451.0,293.15,1.1,451.0,88
CDM,81294OH,MLH1 GENE ANALYSIS DUPLICATION/DELETION VARIANTS,1397.0,908.05,1.1,1397.0,88
CDM,81310OH,NPM1 NUCLEOPHOSMIN GENE ANAL EXON 12 VARIANTS,1701.0,1105.65,1.1,1701.0,88
CDM,81313OH,PCA3/KLK3 PROSTATE SPECIFIC ANTIGEN RATIO,1760.0,1144.0,1.1,1760.0,88
CDM,81315OH,PML/RARALPHA COMMON BREAKPOINTS QUAL/QUANT,1430.0,929.5,1.1,1430.0,88
CDM,81321OH,PTEN GENE ANALYSIS FULL SEQUENCE ANALYSIS,4140.0,2691.0,1.1,4140.0,88
CDM,81323OH,PTEN GENE ANALYSIS DUPLICATION/DELETION VARIANT,2070.0,1345.5,1.1,2070.0,88
CDM,81324OH,PMP22 GENE ANAL DUPLICATION/DELETION ANALYSIS,5233.0,3401.45,1.1,5233.0,88
CDM,81325OH,PMP22 GENE ANALYSIS FULL SEQUENCE ANALYSIS,5310.0,3451.5,1.1,5310.0,88
CDM,81330OH,SMPD1 GENE ANALYSIS COMMON VARIANTS,324.0,210.6,1.1,324.0,88
CDM,81332OH,SERPINA1 GENE ANALYSIS COMMON VARIANTS,301.0,195.65,1.1,301.0,88
CDM,81341OH,TRB@ REARRANGEMENT ANAL DIRECT PROBE METHODOLOGY,342.0,222.3,1.1,342.0,88
CDM,81350OH,UGT1A1 GENE ANALYSIS COMMON VARIANTS,1615.0,1049.75,1.1,1615.0,88
CDM,81372OH,HLA CLASS I TYPING LOW RESOLUTION COMPLETE,2785.0,1810.25,1.1,2785.0,88
CDM,81374OH,HLA I LOW RESOLUTION ONE ANTIGEN EQUIVALENT EACH,513.0,333.45,1.1,513.0,88
CDM,81376OH,HLA CLASS II TYPING LOW RESOLUTION ONE LOCUS EA,843.0,547.95,1.1,843.0,88
CDM,81377OH,HLA II LOW RESOLUTION ONE ANTIGEN EQUIVALENT EA,654.0,425.1,1.1,654.0,88
CDM,81380OH,HLA CLASS I TYPING HIGH RESOLUTION ONE LOCUS EA,1223.0,794.95,1.1,1223.0,88
CDM,81381OH,HLA I TYPING HIGH RESOLUTION 1 ALLELE/ALLELE GRP,1172.0,761.8,1.1,1172.0,88
CDM,81382OH,HLA CLASS II TYPING HIGH RESOLUTION ONE LOCUS EA,853.0,554.45,1.1,853.0,88
CDM,81383OH,HLA II HIGH RESOLUTION 1 ALLELE/ALLELE GROUP,753.0,489.45,1.1,753.0,88
CDM,81400OH,MOLECULAR PATHOLOGY PROCEDURE LEVEL 1,441.0,286.65,1.1,441.0,88
CDM,81406OH,MOLECULAR PATHOLOGY PROCEDURE LEVEL 7,1952.0,1268.8,1.1,1952.0,88
CDM,81420OH,FETAL CHROMOSOMAL ANEUPLOIDY GENOMIC SEQ ANALYS,5237.0,3404.05,1.1,5237.0,88
CDM,81470OH,X-LINKED INTELLECTUAL DBLT GENOMIC SEQ ANALYS,6307.0,4099.55,1.1,6307.0,88
CDM,81500005,TRANSPLT ALLO HCT/DONOR,131220.0,85293.0,267.23,131220.0,86
CDM,81500025,ACTIVATE DONOR SEARCH,2941.0,1911.65,405.62,2941.0,66
CDM,81500035,HARV STEM CELL ALLOGENIC,5800.0,3770.0,93.12,9509.0,68
CDM,81500045,BONE MARROW HARV TRANSPLANT,43127.0,28032.55,222.51,43127.0,86
CDM,81500055,SYPHILIS TEST QUAL,29.0,18.85,2.11,29.0,84
CDM,81500065,CMV AB,99.0,64.35,7.11,99.0,84
CDM,81500075,HTLV I AB,63.0,40.95,4.14,63.0,84
CDM,81500085,HIV 1 HIV 2 SNGL ASSAY AB,95.0,61.75,6.77,95.0,84
CDM,81500095,HEP B CORE AB TOTAL,83.0,53.95,5.95,83.0,84
CDM,81500105,HEP C AB,98.0,63.7,14.27,98.0,84
CDM,81500115,HLA TYPING A/B/C MULT AG,400.0,260.0,28.64,400.0,84
CDM,81500125,HLA TYPING DR/DQ MULT AG,732.0,475.8,42.46,732.0,84
CDM,81500135,HEP B SURFACE AG EIA,71.0,46.15,5.1,71.0,84
CDM,81500145,SPECIMEN TRANSFER,59.0,38.35,2.64,59.0,66
CDM,81500205,THERAPEUTIC APHERESIS WHITE BLOOD CELLS,9426.0,6126.9,123.21,9426.0,86
CDM,81503OH,ONCO (OVARIAN) BIOCHEMICAL ASSAY FIVE PROTEINS,6189.0,4022.85,1.1,6189.0,88
CDM,81900000,ACTIVATE DONOR SEARCH,2941.0,1911.65,405.62,2941.0,66
CDM,81900010,BONE MARROW HARV TRANSPLANT,39932.0,25955.8,222.51,39932.0,86
CDM,81900015,SYPHILIS TEST QUAL,29.0,18.85,2.11,29.0,84
CDM,81900020,CMV AB,99.0,64.35,7.11,99.0,84
CDM,81900025,HTLV I AB,63.0,40.95,4.14,63.0,84
CDM,81900030,HIV 1 HIV 2 SNGL ASSAY AB,95.0,61.75,6.77,95.0,84
CDM,81900035,HEP B CORE AB TOTAL,83.0,53.95,5.95,83.0,84
CDM,81900045,HEP C AB,98.0,63.7,14.27,98.0,84
CDM,81900050,HLA TYPING A/B/C SNGL AG,178.0,115.7,12.74,178.0,84
CDM,81900060,HLA TYPING DR/DQ SNGL AG,208.0,135.2,13.76,208.0,84
CDM,81900065,HLA TYPING DR/DQ MULT AG,732.0,475.8,42.46,732.0,84
CDM,81900075,HEP B SURFACE AG EIA,71.0,46.15,5.1,71.0,84
CDM,81900080,SPECIMEN TRANSFER,59.0,38.35,2.64,59.0,66
CDM,81900095,OFFICE/OP CONSLTJ NEW/EST PT MOD MDM 40 MINUTES,5310.0,3451.5,68.73,5310.0,66
CDM,82000005,UNSCHEDULED DIALYSIS ESRD PT,2799.0,1819.35,373.09,2799.0,84
CDM,82000010,ALBUMIN URINE,43.0,27.95,6.23,43.0,84
CDM,82000020,HEMODIALYSIS,4828.0,3138.2,85.0,4828.0,86
CDM,82010OH,KETONE BODIES SERUM QUANTITATIVE,56.0,36.4,1.1,56.0,88
CDM,82017OH,ACYLCARNITINES QUANTIATIVE EACH SPECIMEN,116.0,75.4,1.1,116.0,88
CDM,82024OH,ADRENOCORTICOTROPIC HORMONE ACTH,266.0,172.9,1.1,266.0,88
CDM,82030OH,ADENOSINE 5-MONOPHOSPHATE CYCLIC,178.0,115.7,1.1,178.0,88
CDM,82040OH,ALBUMIN SERUM PLASMA/WHOLE BLOOD,34.0,22.1,1.1,34.0,88
CDM,82042OH,OTHER SOURCE ALBUMIN QUANTITATIVE EACH SPECIMEN,54.0,35.1,1.1,54.0,88
CDM,82043OH,URINE ALBUMIN QUANTITATIVE,40.0,26.0,1.1,40.0,88
CDM,82044OH,URINE ALBUMIN SEMIQUANTITATIVE,43.0,27.95,1.1,43.0,88
CDM,82045OH,ALBUMIN ISCHEMIA MODIFIED,234.0,152.1,1.1,234.0,88
CDM,82088OH,ASSAY OF ALDOSTERONE,281.0,182.65,1.1,281.0,88
CDM,82100080,ESRD HEMODIALYSIS OP,1544.0,1003.6,336.59,1544.0,66
CDM,82100095,HD SNGL EVAL ESRD (PER TX),4828.0,3138.2,85.0,4828.0,86
CDM,82103OH,ALPHA-1-ANTITRYPSIN; TOTAL,93.0,60.45,1.1,93.0,88
CDM,82105OH,ALPHA-FETOPROTEIN SERUM,116.0,75.4,1.1,116.0,88
CDM,82106OH,ALPHA FETOPROT AFL,117.0,76.05,1.1,117.0,88
CDM,82107OH,AFP-L3 FRACTION ISOFORM & TOTAL AFP W/RATIO,444.0,288.6,1.1,444.0,88
CDM,82127OH,"AMINO ACID, SINGLE QUAL",98.0,63.7,1.1,98.0,88
CDM,82131OH,AMINO ACIDS 1 QUANTITATIVE EACH SPECIMEN,159.0,103.35,1.1,159.0,88
CDM,82136OH,"AMINO ACIDS, 2-5 QUANT",135.0,87.75,1.1,135.0,88
CDM,82139OH,AMINO ACIDS 6/> AMINO ACIDS QUANTITATIVE EA SPE,116.0,75.4,1.1,116.0,88
CDM,82140OH,ASSAY OF AMMONIA,101.0,65.65,1.1,101.0,88
CDM,82150OH,ASSAY OF AMYLASE,45.0,29.25,1.1,45.0,88
CDM,82157OH,ANDROSTENEDIONE BLD,202.0,131.3,1.1,202.0,88
CDM,82163OH,ANGIOTENSIN II,142.0,92.3,1.1,142.0,88
CDM,82172OH,APOLIPOPROTEIN EACH,146.0,94.9,1.1,146.0,88
CDM,82175OH,ASSAY OF ARSENIC,131.0,85.15,1.1,131.0,88
CDM,82180OH,ASSAY OF ASCORBIC ACID BLOOD,68.0,44.2,1.1,68.0,88
CDM,82232OH,BETA-2 MICROGLOBULIN,112.0,72.8,1.1,112.0,88
CDM,82240OH,BILE ACIDS FRACT BLD,183.0,118.95,1.1,183.0,88
CDM,82247OH,BILIRUBIN TOTAL,35.0,22.75,1.1,35.0,88
CDM,82248OH,BILIRUBIN DIRECT,35.0,22.75,1.1,35.0,88
CDM,82261OH,ASSAY BIOTINIDASE,116.0,75.4,1.1,116.0,88
CDM,82270OH,BLOOD OCCULT PEROXIDASE ACTV QUAL FECES 1 DETER,30.0,19.5,1.1,30.0,88
CDM,82271OH,BLOOD OCCULT PEROXIDASE ACTV QUAL OTHER SOURCES,37.0,24.05,1.1,37.0,88
CDM,82272OH,BLOOD OCCULT PEROXIDASE ACTV QUAL FECES 1-3 SPEC,29.0,18.85,1.1,29.0,92
CDM,82274OH,BLOOD OCCULT FECAL HGB DETER IA QUAL FECES 1-3,110.0,71.5,1.1,110.0,88
CDM,82306OH,25 HYDROXY INCLUDES FRACTIONS IF PERFORMED,204.0,132.6,1.1,204.0,88
CDM,82308OH,CALCITONIN BLOOD,185.0,120.25,1.1,185.0,88
CDM,82310OH,CALCIUM; TOTAL,36.0,23.4,1.1,36.0,88
CDM,82330OH,CALCIUM IONIZED BLD,94.0,61.1,1.1,94.0,88
CDM,82340OH,CALCIUM URINE QUANTITATIVE TIMED SPECIMEN,42.0,27.3,1.1,42.0,88
CDM,82365OH,CALCULUS INFRARED SPECTROSCOPY,89.0,57.85,1.1,89.0,88
CDM,82374OH,CARBON DIOXIDE BICARBONATE,34.0,22.1,1.1,34.0,88
CDM,82375OH,CARBOXYHEMOGLOBIN QUANTITATIVE,85.0,55.25,1.1,85.0,88
CDM,82378OH,CARCINOEMBRYONIC ANTIGEN (CEA),131.0,85.15,1.1,131.0,88
CDM,82380OH,CAROTENE BLD,64.0,41.6,1.1,64.0,88
CDM,82384OH,CATECHOLAMINES FRACTIONATED,174.0,113.1,1.1,174.0,88
CDM,82390OH,CERULOPLASMIN BLD,74.0,48.1,1.1,74.0,88
CDM,82397OH,CHEMILUMINESCENT ASSAY,97.0,63.05,1.1,97.0,88
CDM,82415OH,CHLORAMPHENICOL BLD,87.0,56.55,1.1,87.0,88
CDM,82435OH,CHLORIDE BLD,32.0,20.8,1.1,32.0,88
CDM,82436OH,CHLORIDE URINE,40.0,26.0,1.1,40.0,88
CDM,82438OH,CHLORIDE OTHER SOURCE,35.0,22.75,1.1,35.0,88
CDM,82465OH,CHOLESTEROL SERUM/WHOLE BLOOD TOTAL,30.0,19.5,1.1,30.0,88
CDM,82480OH,CHOLINESTERASE; SERUM,54.0,35.1,1.1,54.0,88
CDM,82482OH,CHOLINESTERASE RBC,68.0,44.2,1.1,68.0,88
CDM,82507OH,ASSAY OF CITRATE,192.0,124.8,1.1,192.0,88
CDM,82523OH,COLLAGEN CROSS LINKS ANY METHOD,129.0,83.85,1.1,129.0,88
CDM,82525OH,ASSAY OF COPPER,86.0,55.9,1.1,86.0,88
CDM,82530OH,CORTISOL FREE,115.0,74.75,1.1,115.0,88
CDM,82533OH,CORTISOL; TOTAL,112.0,72.8,1.1,112.0,88
CDM,82540OH,ASSAY CREATINE,32.0,20.8,1.1,32.0,88
CDM,82542OH,COL-CHR/MS NONDRUG ANALYTE NES QUAL/QUAN EA SPEC,166.0,107.9,1.1,166.0,88
CDM,82550OH,CREATINE KINASE TOTAL,45.0,29.25,1.1,45.0,88
CDM,82552OH,CK ISOENZYMES,92.0,59.8,1.1,92.0,88
CDM,82553OH,CREATINE KINASE MB FRACTION ONLY,80.0,52.0,1.1,80.0,88
CDM,82565OH,CREATININE; BLOOD,35.0,22.75,1.1,35.0,88
CDM,82570OH,CREATININE OTHER SOURCE,36.0,23.4,1.1,36.0,88
CDM,82575OH,CREATININE; CLEARANCE,65.0,42.25,1.1,65.0,88
CDM,82585OH,CRYOFIBRINOGEN BLOOD,98.0,63.7,1.1,98.0,88
CDM,82595OH,CRYOGLOBULIN QUALITATIVE/SEMI-QUANTITATIVE,45.0,29.25,1.1,45.0,88
CDM,82600OH,CYANIDE BLD,134.0,87.1,1.1,134.0,88
CDM,82607OH,CYANOCOBALAMIN VITAMIN B-12,104.0,67.6,1.1,104.0,88
CDM,82608OH,CYANOCOBALAMIN VIT B-12 UNSAT BINDING CAPACITY,99.0,64.35,1.1,99.0,88
CDM,82610OH,CYSTATIN C,128.0,83.2,1.1,128.0,88
CDM,82615OH,CYSTINE QUAL UR,66.0,42.9,1.1,66.0,88
CDM,82626OH,DHEA BLOOD,174.0,113.1,1.1,174.0,88
CDM,82627OH,DEHYDROEPIANDROSTERONE-SULFATE,153.0,99.45,1.1,153.0,88
CDM,82634OH,DEOXYCORTISOL-11,202.0,131.3,1.1,202.0,88
CDM,82638OH,PSEUDOCHOLIN PHENOTY,85.0,55.25,1.1,85.0,88
CDM,82652OH,1 25 DIHYDROXY INCLUDES FRACTIONS IF PERFORMED,266.0,172.9,1.1,266.0,88
CDM,82657OH,NZYM ACTIV BLD CELLS/TISS NONRADACT SUBSTRATE EA,153.0,99.45,1.1,153.0,88
CDM,82658OH,NZYM ACTV BLOOD CELLS/TISS RADACT SUBSTRATE EA,304.0,197.6,1.1,304.0,88
CDM,82664OH,ELCTROPHORETIC TECHNIQUE NOT ELSEWHERE SPECIFIED,424.0,275.6,1.1,424.0,88
CDM,82668OH,ASSAY OF ERYTHROPOIETIN,130.0,84.5,1.1,130.0,88
CDM,82670OH,ASSAY OF TOTAL ESTRADIOL,193.0,125.45,1.1,193.0,88
CDM,82671OH,ASSAY OF ESTROGENS FRACTIONATED,223.0,144.95,1.1,223.0,88
CDM,82672OH,ESTROGEN TOTAL,150.0,97.5,1.1,150.0,88
CDM,82677OH,ASSAY OF ESTRIOL,167.0,108.55,1.1,167.0,88
CDM,82679OH,ASSAY OF ESTRONE,172.0,111.8,1.1,172.0,88
CDM,82693OH,ETHYLENE GLYCOL,103.0,66.95,1.1,103.0,88
CDM,82705OH,"FATS/LIPIDS, FECES, QUALITATIVE",35.0,22.75,1.1,35.0,88
CDM,82725OH,FATTY ACIDS NONESTERIFIED,130.0,84.5,1.1,130.0,88
CDM,82726OH,LONG CHAIN FAT ACIDS,136.0,88.4,1.1,136.0,88
CDM,82728OH,ASSAY FERRITIN,94.0,61.1,1.1,94.0,88
CDM,82731OH,FETAL FIBRONECTIN,444.0,288.6,1.1,444.0,88
CDM,82746OH,ASSAY OF FOLIC ACID SERUM,101.0,65.65,1.1,101.0,88
CDM,82747OH,ASSAY OF FOLIC ACID RBC,122.0,79.3,1.1,122.0,88
CDM,82757OH,SEMEN FRUCTOSE QUANT,120.0,78.0,1.1,120.0,88
CDM,82777OH,GALECTIN 3,305.0,198.25,1.1,305.0,88
CDM,82784OH,ASSAY OF GAMMAGLOBULIN IGA IGD IGG IGM EACH,64.0,41.6,1.1,64.0,88
CDM,82785OH,"ASSAY, GAMMAGLOBULIN IGE",114.0,74.1,1.1,114.0,88
CDM,82787OH,GAMMAGLOBULIN IMMUNOGLOBULIN SUBCLASSES,55.0,35.75,1.1,55.0,88
CDM,82803OH,BLOOD GASES ANY COMBINATION PH PCO2 PO2 CO2 HCO3,180.0,117.0,1.1,180.0,88
CDM,82805OH,GASES BLOOD PH DIRECT MEAS XCPT PULSE OXIMITRY,544.0,353.6,1.1,544.0,88
CDM,82820OH,HEMOGLOBIN-OXYGEN AFFINITY,92.0,59.8,1.1,92.0,88
CDM,82900010,UNSCHEDULED DIALYS TX,2799.0,1819.35,373.09,2799.0,84
CDM,82900020,HEMODIALYSIS ONE EVALUATION,4828.0,3138.2,85.0,4828.0,86
CDM,82928OH,GASTRIC RT ANALYSIS,58.0,37.7,1.1,58.0,70
CDM,82930OH,GASTRIC ACID ANALYIS W/PH EACH SPECIMEN,46.0,29.9,1.1,46.0,88
CDM,82941OH,ASSAY OF GASTRIN,122.0,79.3,1.1,122.0,88
CDM,82945OH,GLUCOSE BODY FLUID OTHER THAN BLOOD,27.0,17.55,1.1,27.0,88
CDM,82947OH,GLUCOSE QUANTITATIVE BLOOD XCPT REAGENT STRIP,27.0,17.55,1.1,27.0,88
CDM,82948OH,GLUCOSE BLOOD REAGENT STRIP,35.0,22.75,1.1,58.16,88
CDM,82950OH,GLUCOSE POST GLUCOSE DOSE,33.0,21.45,1.1,33.0,88
CDM,82951OH,GLUCOSE TOLERANCE TEST GTT 3 SPECIMENS,89.0,57.85,1.1,89.0,88
CDM,82952OH,GLUCOSE TOLERANCE EA ADDL BEYOND 3 SPECIMENS,27.0,17.55,1.1,27.0,88
CDM,82955OH,GLUC-6-PHOSPHATE DEHYDROGENASE QUANTITATIVE,67.0,43.55,1.1,67.0,88
CDM,82960OH,GLUC-6-PHOSPHATE DEHYDROGENASE SCREEN,42.0,27.3,1.1,42.0,88
CDM,82962OH,GLUC BLD GLUC MNTR DEV CLEARED FDA SPEC HOME USE,23.0,14.95,1.1,23.0,88
CDM,82977OH,ASSAY OF GLUTAMYLTRASE GAMMA,50.0,32.5,1.1,50.0,88
CDM,82978OH,GLUTATHIONE ASSAY,107.0,69.55,1.1,107.0,88
CDM,82985OH,ASSAY OF GLYCATED PROTEIN,116.0,75.4,1.1,116.0,88
CDM,83000000,PERITONEAL DIALYSIS NON-CAPD,2938.0,1909.7,102.71,2938.0,86
CDM,83001OH,GONADOTROPIN FOLLICLE STIMULATING HORMONE,128.0,83.2,1.1,128.0,88
CDM,83002OH,GONADOTROPIN LUTEINIZING HORMONE,128.0,83.2,1.1,128.0,88
CDM,83003OH,ASSAY OF GROWTH HORMONE HUMAN,115.0,74.75,1.1,115.0,88
CDM,83010OH,ASSAY OF HAPTOGLOBIN QUANTITATIVE,87.0,56.55,1.1,87.0,88
CDM,83013OH,HPYLORI BREATH ANAL UREASE ACT NON-RADACT ISTOPE,465.0,302.25,1.1,465.0,88
CDM,83014OH,HELICOBACTER PYLORI ; DRUG ADMINISTRATION,54.0,35.1,1.1,54.0,88
CDM,83020OH,HEMOGLOBIN FRACTJ/QUANTJ ELECTROPHORESIS,163.0,105.95,1.1,163.0,92
CDM,83020OH-26,HEMOGLOBIN FRACTJ/QUANTJ ELECTROPHORESIS,163.0,105.95,1.1,163.0,126
CDM,83021OH,HEMOGLOBIN FRACTJ/QUANTJ CHROMOTOGRAPHY,125.0,81.25,1.1,125.0,88
CDM,83033OH,HEMOGLOBIN F FETAL QUALITATIVE,55.0,35.75,1.1,55.0,88
CDM,83036OH,HEMOGLOBIN GLYCOSYLATED A1C,67.0,43.55,1.1,67.0,88
CDM,83037OH,HGB GLYCOSYLATED DEVICE CLEARED FDA HOME USE,67.0,43.55,1.1,67.0,88
CDM,83050OH,HEMOGLOBIN METHEMOGLOBIN QUANTITATIVE,57.0,37.05,1.1,57.0,88
CDM,83051OH,ASSAY OF HEMOGLOBIN PLASMA,50.0,32.5,1.1,50.0,88
CDM,83069OH,ASSAY OF HEMOGLOBIN URINE,27.0,17.55,1.1,27.0,88
CDM,83070OH,ASSAY OF HEMOSIDERIN QUAL,33.0,21.45,1.1,33.0,88
CDM,83088OH,ASSAY OF HISTAMINE,204.0,132.6,1.1,204.0,88
CDM,83090OH,ASSAY OF HOMOCYSTEINE,124.0,80.6,1.1,124.0,88
CDM,83497OH,ASSAY OF HYDROXYINDOLACETIC ACID 5-HIAA,89.0,57.85,1.1,89.0,88
CDM,83498OH,ASSAY OF HYDROXYPROGESTERONE 17-D,187.0,121.55,1.1,187.0,88
CDM,83500OH,HYDROXYPROLINE FR UR,156.0,101.4,1.1,156.0,88
CDM,83505OH,HYDROXYPROLINE 24H U,168.0,109.2,1.1,168.0,88
CDM,83525OH,ASSAY OF INSULIN TOTAL,79.0,51.35,1.1,79.0,88
CDM,83527OH,ASSAY OF INSULIN FREE,89.0,57.85,1.1,89.0,88
CDM,83540OH,ASSAY OF IRON,45.0,29.25,1.1,45.0,88
CDM,83550OH,IRON BINDING CAPACITY,60.0,39.0,1.1,60.0,88
CDM,83586OH,KETOSTEROID TOT 24HU,88.0,57.2,1.1,88.0,88
CDM,83593OH,KETOSTEROID FRACT UR,197.0,128.05,1.1,197.0,88
CDM,83605OH,ASSAY OF LACTATE,80.0,52.0,1.1,80.0,88
CDM,83615OH,LACTATE DEHYDROGENASE LDH,42.0,27.3,1.1,42.0,88
CDM,83625OH,LD ISOENZYMES,88.0,57.2,1.1,88.0,88
CDM,83632OH,PLACENTA LACTOGEN BL,140.0,91.0,1.1,140.0,88
CDM,83655OH,ASSAY OF LEAD,84.0,54.6,1.1,84.0,88
CDM,83661OH,L/S RATIO AMNIO FL,152.0,98.8,1.1,152.0,88
CDM,83664OH,FETAL LUNG MATURITY LAMELLAR BODY DENSITY,133.0,86.45,1.1,133.0,88
CDM,83670OH,ASSAY LAP ENZYME,68.0,44.2,1.1,68.0,88
CDM,83690OH,ASSAY OF LIPASE,48.0,31.2,1.1,48.0,88
CDM,83695OH,ASSAY OF LIPOPROTEIN(A),99.0,64.35,1.1,99.0,88
CDM,83698OH,LIPOPROTEIN-ASSOCIATED PHOSPHOLIPASE A2,320.0,208.0,1.1,320.0,88
CDM,83700OH,LIPOPROTEIN BLOOD ELECTROPHORECTIC SEP&QUAN,78.0,50.7,1.1,78.0,88
CDM,83704OH,LIPOPROTEIN BLOOD QUAN NUMBERS & SUBCLASSES,236.0,153.4,1.1,236.0,88
CDM,83718OH,LIPOPROTEIN DIR MEAS HIGH DENSITY CHOLESTEROL,57.0,37.05,1.1,57.0,88
CDM,83721OH,LIPOPROTEIN DIRECT MEASUREMENT LDL CHOLESTEROL,72.0,46.8,1.1,72.0,88
CDM,83735OH,ASSAY OF MAGNESIUM,46.0,29.9,1.1,46.0,88
CDM,83789OH,MASS SPECT&TANDEM MASS SPECT NONDRG ANAL NES EA,166.0,107.9,1.1,166.0,88
CDM,83825OH,ASSAY OF MERCURY QUANTITATIVE,112.0,72.8,1.1,112.0,88
CDM,83857OH,METHEMALBUMIN BLD,74.0,48.1,1.1,74.0,88
CDM,83861OH,MICROFLUID ANALYSIS TEAR OSMOLARITY,155.0,100.75,1.1,155.0,88
CDM,83872OH,ROUTINE SYNOVIAL FL,40.0,26.0,1.1,40.0,88
CDM,83873OH,MYELIN BASIC PROTEIN CEREBROSPINAL FLUID,119.0,77.35,1.1,119.0,88
CDM,83874OH,MYOGLOBIN,89.0,57.85,1.1,89.0,88
CDM,83876OH,MYELOPEROXIDASE MPO,351.0,228.15,1.1,351.0,88
CDM,83880OH,NATRIURETIC PEPTIDE,271.0,176.15,1.1,271.0,88
CDM,83883OH,ASSAY OF NEPHELOMETRY EACH ANALYTE NES,94.0,61.1,1.1,94.0,88
CDM,83916OH,OLIGOCLONAL IMMUNE,189.0,122.85,1.1,189.0,88
CDM,83918OH,METABOLIC COMPLETE U,163.0,105.95,1.1,163.0,88
CDM,83921OH,ORGANIC ACID SINGLE QUANT,146.0,94.9,1.1,146.0,88
CDM,83930OH,ASSAY OF OSMOLALITY BLOOD,46.0,29.9,1.1,46.0,88
CDM,83935OH,ASSAY OF OSMOLALITY URINE,47.0,30.55,1.1,47.0,88
CDM,83937OH,ASSAY OF OSTEOCALCIN,206.0,133.9,1.1,206.0,88
CDM,83945OH,ASSAY OXALATE,100.0,65.0,1.1,100.0,88
CDM,83950OH,ONCOPROTEIN HER-2/NEU,444.0,288.6,1.1,444.0,88
CDM,83970OH,ASSAY OF PARATHORMONE,285.0,185.25,1.1,285.0,88
CDM,83986OH,PH BODY FLUID NOT ELSEWHERE SPECIFIED,25.0,16.25,1.1,25.0,88
CDM,83993OH,ASSAY FOR CALPROTECTIN FECAL,135.0,87.75,1.1,135.0,88
CDM,84000000,PERITONEAL DIALYSIS CAPD,2938.0,1909.7,102.71,2938.0,86
CDM,84060OH,ASSAY ACID PHOSPHATASE,53.0,34.45,1.1,53.0,88
CDM,84075OH,ASSAY OF PHOSPHATASE ALKALINE,36.0,23.4,1.1,36.0,88
CDM,84080OH,ASSAY OF PHOSPHATASE ALKALINE ISOENZYMES,102.0,66.3,1.1,102.0,88
CDM,84100OH,ASSAY OF PHOSPHORUS INORGANIC,33.0,21.45,1.1,33.0,88
CDM,84119OH,PORPHYRIN SCRN RAN U,92.0,59.8,1.1,92.0,88
CDM,84120OH,PORPHYRINS URINE QUANTITATION & FRACTIONATION,101.0,65.65,1.1,101.0,88
CDM,84132OH,POTASSIUM SERUM PLASMA/WHOLE BLOOD,33.0,21.45,1.1,33.0,88
CDM,84133OH,POTASSIUM URINE,33.0,21.45,1.1,33.0,88
CDM,84134OH,PREALBUMIN BLD,101.0,65.65,1.1,101.0,88
CDM,84138OH,PREGNANETRIOL 24HR U,145.0,94.25,1.1,145.0,88
CDM,84140OH,PREGNENOLONE BLOOD,143.0,92.95,1.1,143.0,88
CDM,84143OH,ASSAY/17-HYDROXYPREGNENOLONE,157.0,102.05,1.1,157.0,88
CDM,84144OH,ASSAY OF PROGESTERONE,144.0,93.6,1.1,144.0,88
CDM,84146OH,ASSAY OF PROLACTIN,134.0,87.1,1.1,134.0,88
CDM,84150OH,ASSAY OF PROSTAGLANDIN,288.0,187.2,1.1,288.0,88
CDM,84153OH,ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL,127.0,82.55,1.1,127.0,88
CDM,84154OH,ASSAY OF PROSTATE SPECIFIC ANTIGEN FREE,127.0,82.55,1.1,127.0,88
CDM,84156OH,PROTEIN TOTAL XCPT REFRACTOMETRY URINE,25.0,16.25,1.1,25.0,88
CDM,84157OH,PROTEIN TOTAL XCPT REFRACTOMETRY OTH SRC,28.0,18.2,1.1,28.0,88
CDM,84163OH,PREGNANCY-ASSOCIATED PLASMA PROTEIN-A,104.0,67.6,1.1,104.0,88
CDM,84165OH,PROTEIN ELECTROPHORETIC FRACTJ&QUANTJ SERUM,163.0,105.95,1.1,163.0,92
CDM,84165OH-26,PROTEIN ELECTROPHORETIC FRACTJ&QUANTJ SERUM,163.0,105.95,1.1,163.0,126
CDM,84166OH,PROTEIN ELECTROP FXJ&QUAN OTH FLUS CONCENTRATI,163.0,105.95,1.1,163.0,92
CDM,84166OH-26,PROTEIN ELECTROP FXJ&QUAN OTH FLUS CONCENTRATI,163.0,105.95,1.1,163.0,126
CDM,84181OH,PROTEIN WESTRN BLOT I&R BLOOD/OTHER FLUID,118.0,76.7,1.1,118.0,92
CDM,84182OH,PROTEIN WESTRN BLOT BLOOD/OTH FLU IMMUNOLOGICAL,202.0,131.3,1.1,202.0,92
CDM,84202OH,PROTOPORPHYRIN RBC; QUAN,99.0,64.35,1.1,99.0,88
CDM,84206OH,ASSAY OF PROINSULIN,184.0,119.6,1.1,184.0,88
CDM,84207OH,ASSAY OF PYRIDOXAL PHOSPHATE,194.0,126.1,1.1,194.0,88
CDM,84220OH,PYRUVATE KINASE BLD,65.0,42.25,1.1,65.0,88
CDM,84238OH,RECEPTOR ASSAY NON-ENDOCRINE SPECIFY RECEPTOR,252.0,163.8,1.1,252.0,88
CDM,84244OH,ASSAY OF RENIN,152.0,98.8,1.1,152.0,88
CDM,84252OH,ASSAY OF RIBOFLAVIN-VITAMIN B-2,140.0,91.0,1.1,140.0,88
CDM,84255OH,ASSAY OF SELENIUM,176.0,114.4,1.1,176.0,88
CDM,84260OH,ASSAY OF SEROTONIN,214.0,139.1,1.1,214.0,88
CDM,84270OH,ASSAY OF SEX HORMONE BINDING GLOBULIN,150.0,97.5,1.1,150.0,88
CDM,84285OH,SILICON,174.0,113.1,1.1,174.0,88
CDM,84295OH,SODIUM SERUM PLASMA OR WHOLE BLOOD,33.0,21.45,1.1,33.0,88
CDM,84300OH,ASSAY OF URINE SODIUM,35.0,22.75,1.1,35.0,88
CDM,84302OH,ASSAY OF SODIUM OTHER SOURCE,34.0,22.1,1.1,34.0,88
CDM,84305OH,ASSAY OF SOMATOMEDIN,147.0,95.55,1.1,147.0,88
CDM,84311OH,SPECTROPHOTOMETRY ANALYT NOT ELSEWHERE SPECIFIED,56.0,36.4,1.1,56.0,88
CDM,84315OH,ROUTINE SYNOVIAL FL,23.0,14.95,1.1,23.0,88
CDM,84377OH,SUGARS MONO DI&OLIGOS MLT QUALITATIVE EACH SPE,38.0,24.7,1.1,38.0,88
CDM,84402OH,TESTOSTERONE FREE,176.0,114.4,1.1,176.0,88
CDM,84403OH,ASSAY OF TESTOSTERONE TOTAL,178.0,115.7,1.1,178.0,88
CDM,84425OH,ASSAY OF THIAMINE (VITAMIN B-1),146.0,94.9,1.1,146.0,88
CDM,84432OH,ASSAY OF THYROGLOBULIN,111.0,72.15,1.1,111.0,88
CDM,84436OH,"ASSAY, TOTAL THYROXINE",47.0,30.55,1.1,47.0,88
CDM,84439OH,ASSAY OF FREE THYROXINE,62.0,40.3,1.1,62.0,88
CDM,84442OH,ASSAY OF THYROXINE BINDING GLOBULIN,102.0,66.3,1.1,102.0,88
CDM,84443OH,ASSAY OF THYROID STIMULATING HORMONE TSH,116.0,75.4,1.1,116.0,88
CDM,84445OH,THYROID STIMULATING IMMUNE GLOBULINS TSI,351.0,228.15,1.1,351.0,88
CDM,84446OH,ASSAY OF TOCOPHEROL ALPHA VITAMIN E,98.0,63.7,1.1,98.0,88
CDM,84450OH,TRANSFERASE ASPARTATE AMINO AST SGOT,36.0,23.4,1.1,36.0,88
CDM,84460OH,TRANSFERASE ALANINE AMINO ALT SGPT,37.0,24.05,1.1,37.0,88
CDM,84466OH,ASSAY OF L7383TRANSFERRIN,88.0,57.2,1.1,88.0,88
CDM,84478OH,ASSAY OF TRIGLYCERIDES,40.0,26.0,1.1,40.0,88
CDM,84479OH,THYROID HORM UPTK/THYROID HORMONE BINDING RATIO,45.0,29.25,1.1,45.0,88
CDM,84480OH,ASSAY OF TRIIODOTHYRONINE T3 TOTAL TT3,98.0,63.7,1.1,98.0,88
CDM,84481OH,ASSAY OF TRIIODOTHYRONINE T3 FREE,117.0,76.05,1.1,117.0,88
CDM,84482OH,TRIIODOTHYRONINE T3 REVERSE,109.0,70.85,1.1,109.0,88
CDM,84484OH,ASSAY OF TROPONIN QUANTITATIVE,86.0,55.9,1.1,86.0,88
CDM,84488OH,TEST FECES FOR TRYPSIN,50.0,32.5,1.1,50.0,88
CDM,84520OH,ASSAY OF UREA NITROGEN QUANTITATIVE,27.0,17.55,1.1,27.0,88
CDM,84545OH,UREA-N CLEARANCE TEST,50.0,32.5,1.1,50.0,88
CDM,84550OH,ASSAY OF BLOOD/URIC ACID,31.0,20.15,1.1,31.0,88
CDM,84560OH,ASSAY OF URIC ACID OTHER SOURCE,35.0,22.75,1.1,35.0,88
CDM,84583OH,UROBILINOGEN RND UR,42.0,27.3,1.1,42.0,88
CDM,84586OH,ASSAY OF VASOACTIVE INTESTINAL PEPTIDE,244.0,158.6,1.1,244.0,88
CDM,84588OH,ASSAY OF VASOPRESSIN ANTI-DIURETIC HORMONE,234.0,152.1,1.1,234.0,88
CDM,84590OH,VITAMIN A/RETINOL,80.0,52.0,1.1,80.0,88
CDM,84591OH,ASSAY OF VITAMIN NOT OTHERWISE SPECIFIED,118.0,76.7,1.1,118.0,88
CDM,84620OH,XYLOSE ABSORPTION BLOOD &/OR URINE,89.0,57.85,1.1,89.0,88
CDM,84681OH,ASSAY OF C-PEPTIDE,144.0,93.6,1.1,144.0,88
CDM,84702OH,GONADOTROPIN CHORIONIC QUANTITATIVE,104.0,67.6,1.1,104.0,88
CDM,84703OH,GONADOTROPIN CHORIONIC QUALITATIVE,52.0,33.8,1.1,52.0,88
CDM,85000000,PERITON DIALYS CCPD OP,2938.0,1909.7,102.71,2938.0,86
CDM,85000010,PERITONEAL DIALYSIS CCPD,2938.0,1909.7,102.71,2938.0,86
CDM,85007OH,BLOOD COUNT SMEAR MCRSCP W/MNL DIFRNTL WBC COUNT,26.0,16.9,1.1,26.0,88
CDM,85009OH,BLOOD COUNT MANUAL DIFRNTL WBC COUNT BUFFY COAT,35.0,22.75,1.1,35.0,88
CDM,85013OH,BLOOD COUNT SPUN MICROHEMATOCRIT,48.0,31.2,1.1,48.0,88
CDM,85014OH,BLOOD COUNT HEMATOCRIT,16.0,10.4,1.1,16.0,88
CDM,85018OH,BLOOD COUNT HEMOGLOBIN,16.0,10.4,1.1,16.0,88
CDM,85024OH,AUTOMATED HEMOGRAM,74.0,48.1,1.1,74.0,70
CDM,85025OH,BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC,54.0,35.1,1.1,54.0,88
CDM,85027OH,BLOOD COUNT COMPLETE AUTOMATED,45.0,29.25,1.1,45.0,88
CDM,85032OH,BLOOD COUNT MANUAL CELL COUNT EACH,30.0,19.5,1.1,30.0,88
CDM,85045OH,BLOOD COUNT RETICULOCYTE AUTOMATED,28.0,18.2,1.1,28.0,88
CDM,85046OH,BLOOD COUNT RETICULOCYTES AUTO 1/> CELL MEAS,38.0,24.7,1.1,38.0,88
CDM,85048OH,BLOOD COUNT LEUKOCYTE WBC AUTOMATED,18.0,11.7,1.1,18.0,88
CDM,85049OH,BLOOD COUNT PLATELET AUTOMATED,31.0,20.15,1.1,31.0,88
CDM,85060OH,BLOOD SMEAR PERIPHERAL INTERP PHYS W/WRIT REPORT,198.0,128.7,1.1,198.0,130
CDM,85097OH,BONE MARROW SMEAR INTERPRETATION,414.0,269.1,1.1,2506.96,134
CDM,85100015,ESRD CCPD OP,1301.0,845.65,283.62,1301.0,66
CDM,85210OH,CLOTTING FACTOR II PROTHROMBIN SPECIFIC,90.0,58.5,1.1,90.0,88
CDM,85220OH,CLOTTING FACTOR V ACG/PROACCELERIN LABILE FACTOR,122.0,79.3,1.1,122.0,88
CDM,85230OH,FACTOR VII:C ASSAY,124.0,80.6,1.1,124.0,88
CDM,85240OH,CLOTTING FACTOR VIII AHG 1 STAGE,124.0,80.6,1.1,124.0,88
CDM,85245OH,CLOTTING FACTOR VIII VW FACTOR RISTOCETIN COFACT,158.0,102.7,1.1,158.0,88
CDM,85246OH,CLOTTING FACTOR VIII VW FACTOR ANTIGEN,158.0,102.7,1.1,158.0,88
CDM,85250OH,CLOTTING FACTOR IX PTC/CHRISTMAS,131.0,85.15,1.1,131.0,88
CDM,85260OH,FACTOR X:C ASSAY,124.0,80.6,1.1,124.0,88
CDM,85270OH,CLOTTING FACTOR XI PTA,124.0,80.6,1.1,124.0,88
CDM,85280OH,CLOTTING FACTOR XII HAGEMAN,134.0,87.1,1.1,134.0,88
CDM,85290OH,FACTOR XIII ASSAY,113.0,73.45,1.1,113.0,88
CDM,85300OH,CLOTTING INHIBITORS ANTITHROMBIN III ACTIVITY,82.0,53.3,1.1,82.0,88
CDM,85302OH,CLOTTING INHIBITORS PROTEIN C ANTIGEN,83.0,53.95,1.1,83.0,88
CDM,85303OH,CLOTTING INHIBITOR; PROTEIN C ACTIVITY,95.0,61.75,1.1,95.0,88
CDM,85305OH,CLOTTING INHIBITORS PROTEIN S TOTAL,80.0,52.0,1.1,80.0,88
CDM,85306OH,CLOTTING INHIBITORS PROTEIN S FREE,106.0,68.9,1.1,106.0,88
CDM,85307OH,ACTIVATED PROTEIN C APC RESISTANCE ASSAY,106.0,68.9,1.1,106.0,88
CDM,85347OH,COAGULATION TIME,30.0,19.5,1.1,30.0,88
CDM,85360OH,EUGLOBULIN LYSIS,58.0,37.7,1.1,58.0,88
CDM,85362OH,FIBRIN DGRADJ SPLT PRODUXS AGGLUJ SLIDE SEMIQUAN,48.0,31.2,1.1,48.0,88
CDM,85379OH,FIBRIN DGRADJ PRODUCTS D-DIMER QUANTITATIVE,70.0,45.5,1.1,70.0,88
CDM,85384OH,FIBRINOGEN ACTIVITY,67.0,43.55,1.1,67.0,88
CDM,85385OH,FIBRINOGEN ANTIGEN,100.0,65.0,1.1,100.0,88
CDM,85390OH,FIBRINOLYSINS/COAGULOPATHY SCREEN INTERP&REPOR,107.0,69.55,1.1,107.0,92
CDM,85396OH,COAGJ/FBRNLYS ASSAY WHOLE BLOOD ADDITIVE PER DAY,163.0,105.95,1.1,163.0,130
CDM,85410OH,ALPHA 2 ANTIPLASMIN,53.0,34.45,1.1,53.0,88
CDM,85415OH,FBRNLYC FACTORS&INHIBITORS PLSMNG ACTIVATOR,119.0,77.35,1.1,119.0,88
CDM,85420OH,FIBRINOLYTIC PLASMINOGEN,45.0,29.25,1.1,45.0,88
CDM,85441OH,HEINZ STAIN BLD,29.0,18.85,1.1,29.0,88
CDM,85460OH,HGB/RBCS FETAL FETOMATERNAL HEMRRG DIFRNTL LYSIS,53.0,34.45,1.1,53.0,88
CDM,85461OH,HGB/RBCS FETAL FETOMATERNAL HEMRRG ROSETTE,65.0,42.25,1.1,65.0,88
CDM,85475OH,HAM TEST BLD,61.0,39.65,1.1,61.0,88
CDM,85520OH,HEPARIN ASSAY,90.0,58.5,1.1,90.0,88
CDM,85536OH,IRON STAIN PERIPHERAL BLOOD,47.0,30.55,1.1,47.0,88
CDM,85540OH,WBC ALKALINE PHOSPHATASE COUNT,59.0,38.35,1.1,59.0,88
CDM,85549OH,MURAMIDASE,129.0,83.85,1.1,129.0,88
CDM,85555OH,RBC OSMOTIC FRAGILITY,52.0,33.8,1.1,52.0,88
CDM,85576OH,PLATELET AGGREGATION IN VITRO EACH AGENT,163.0,105.95,1.1,163.0,92
CDM,85576OH-26,PLATELET AGGREGATION IN VITRO EACH AGENT,163.0,105.95,1.1,163.0,126
CDM,85597OH,PHOSPHOLIPID NEUTRALIZATION PLATELET,124.0,80.6,1.1,124.0,88
CDM,85610NORVUOH,PROTHROMBIN TIME,13.0,8.45,1.1,13.0,88
CDM,85610OH,PROTHROMBIN TIME,30.0,19.5,1.1,30.0,88
CDM,85611OH,PROTHROMBIN TIME SUBSTITUTION PLASMA FRCTJ EACH,27.0,17.55,1.1,27.0,88
CDM,85613OH,RUSSELL VIPER VENOM TIME DILUTED,66.0,42.9,1.1,66.0,88
CDM,85635OH,REPTILASE TEST,68.0,44.2,1.1,68.0,88
CDM,85651OH,SEDIMENTATION RATE RBC NON-AUTOMATED,29.0,18.85,1.1,29.0,88
CDM,85652OH,SEDIMENTATION RATE RBC AUTOMATED,19.0,12.35,1.1,19.0,88
CDM,85660OH,SICKLING RBC REDUCTION,38.0,24.7,1.1,38.0,88
CDM,85670OH,THROMBIN TIME,40.0,26.0,1.1,40.0,88
CDM,85730OH,THROMBOPLASTIN TIME PARTIAL PLASMA/WHOLE BLOOD,41.0,26.65,1.1,41.0,88
CDM,85732OH,THROMBOPLASTIN TIME PRTL SUBSTIT PLASMA FRCTJ EA,45.0,29.25,1.1,45.0,88
CDM,85810OH,VISCOSITY,81.0,52.65,1.1,81.0,88
CDM,86001OH,ALLERGEN SPECIFIC IGG QUAN/SEMIQUAN EA ALLERGEN,54.0,35.1,1.1,54.0,88
CDM,86003OH,ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT EACH,36.0,23.4,1.1,36.0,88
CDM,86021OH,ANTIBODY IDENTIFICATION LEUKOCYTE ANTIBODIES,104.0,67.6,1.1,104.0,88
CDM,86022OH,ANTIBODY IDENTIFICATION PLATELET ANTIBODIES,127.0,82.55,1.1,127.0,88
CDM,86036OH,ANTINEUTROPHIL CYTOPLASMIC ANTB SCREEN EA ANTB,83.0,53.95,1.1,83.0,88
CDM,86038OH,ANTINUCLEAR AB (ANA);,83.0,53.95,1.1,83.0,88
CDM,86039OH,ANTINUCLEAR ANTIBODIES ANA TITER,77.0,50.05,1.1,77.0,88
CDM,86060OH,ANTISTREPTOLYSIN O TITER,50.0,32.5,1.1,50.0,88
CDM,86077OH,BLD BANK PHYS SVCS DIFFC CROSS MATCH&/EVAL REP,414.0,269.1,1.1,414.0,134
CDM,86078OH,BLD BANK PHYS SVCS INVSTGJ TFUJ RXN REPRT,414.0,269.1,1.1,498.94,134
CDM,86079OH,BLD BANK PHYS SVCS AUTHJ DEVIJ STANDARD REPRT,414.0,269.1,1.1,414.0,134
CDM,86140OH,C-REACTIVE PROTEIN,36.0,23.4,1.1,36.0,88
CDM,86141OH,C-REACTIVE PROTEIN HIGH SENSITIVITY,89.0,57.85,1.1,89.0,88
CDM,86146OH,BETA 2 GLYCOPROTEIN I ANTIBODY EACH,176.0,114.4,1.1,176.0,88
CDM,86147OH,CARDIOLIPIN ANTIBODY EACH IG CLASS,176.0,114.4,1.1,176.0,88
CDM,86148OH,PHOSPHOLIPID ANTIBODY,111.0,72.15,1.1,111.0,88
CDM,86155OH,NEUTROPHIL ACTIVITY,110.0,71.5,1.1,110.0,88
CDM,86157OH,COLD AGGLUTININ TITER,56.0,36.4,1.1,56.0,88
CDM,86160OH,COMPLEMENT ANTIGEN EACH COMPONENT,83.0,53.95,1.1,83.0,88
CDM,86161OH,COMPLEMENT FUNCTIONAL ACTIVITY EACH COMPONENT,83.0,53.95,1.1,83.0,88
CDM,86162OH,COMPLEMENT; TOT HEMOLYTIC (CH50),140.0,91.0,1.1,140.0,88
CDM,86171OH,"COMPLEMENT FIXATION, EACH",69.0,44.85,1.1,69.0,88
CDM,86200OH,CYCLIC CITRULLINATED PEPTIDE ANTIBODY,89.0,57.85,1.1,89.0,88
CDM,86215OH,DEOXYRIBONUCLEASE ANTIBODY,91.0,59.15,1.1,91.0,88
CDM,86225OH,DNA ANTIBODY NATIVE/DOUBLE STRANDED,95.0,61.75,1.1,95.0,88
CDM,86226OH,DNA SINGLE STRAND AB,84.0,54.6,1.1,84.0,88
CDM,86235OH,EXTRACTABLE NUCLEAR ANTIGEN ANTIBODY ANY METHOD,124.0,80.6,1.1,124.0,88
CDM,86255OH,FLUORESCENT NONNFCT AGT ANTB SCREEN EA ANTIBODY,163.0,105.95,1.1,163.0,92
CDM,86255OH-26,FLUORESCENT NONNFCT AGT ANTB SCREEN EA ANTIBODY,163.0,105.95,1.1,163.0,126
CDM,86256OH,FLUORESCENT NONNFCT AGT ANTB TITER EA ANTIBODY,83.0,53.95,1.1,83.0,92
CDM,86265OH,"FROZEN BLOOD, PREPARATION FOR FREEZING, EACH UNIT INCLUDING PROC",5.0,3.25,1.1,5.0,70
CDM,86300OH,IMMUNOASSAY TUMOR ANTIGEN QUANTITATIVE CA 15-3,144.0,93.6,1.1,144.0,88
CDM,86301OH,IMMUNOASSAY TUMOR ANTIGEN QUANTITATIVE CA 19-9,144.0,93.6,1.1,144.0,88
CDM,86304OH,IMMUNOASSAY TUMOR ANTIGEN QUANTITATIVE CA 125,144.0,93.6,1.1,144.0,88
CDM,86308OH,HETEROPHILE ANTIBODIES SCREEN,36.0,23.4,1.1,36.0,88
CDM,86309OH,HETEROPHILE ANTIBODIES,45.0,29.25,1.1,45.0,88
CDM,86316OH,IMMUNOASSAY TUMOR ANTIGEN QUANTITATIVE,144.0,93.6,1.1,144.0,88
CDM,86317OH,IMMUNOASSAY INFECTIOUS AGENT ANTIBODY QUAN NOS,103.0,66.95,1.1,103.0,88
CDM,86318OH,IA INFECTIOUS AGT ANTIBODY QUAL/SEMIQ 1STEP METH,125.0,81.25,1.1,125.0,88
CDM,86320OH,SERUM IMMUNOELECTROPHORESIS,206.0,133.9,1.1,206.0,126
CDM,86325OH,OTHER IMMUNOELECTROPHORESIS,160.0,104.0,1.1,160.0,126
CDM,86331OH,IMMUNODIFFUSION GEL DIFFUSION QUAL EA AG/ANTBDY,83.0,53.95,1.1,83.0,88
CDM,86334OH,IMMUNOFIX E-PHORESIS SERUM,163.0,105.95,1.1,163.0,92
CDM,86334OH-26,IMMUNOFIX E-PHORESIS SERUM,163.0,105.95,1.1,163.0,126
CDM,86335OH,IMMUNOFIXJ ELECTROPHORESIS OTHER FLUIDS,163.0,105.95,1.1,163.0,92
CDM,86335OH-26,IMMUNOFIXJ ELECTROPHORESIS OTHER FLUIDS,163.0,105.95,1.1,163.0,126
CDM,86336OH,INHIBIN A,108.0,70.2,1.1,108.0,88
CDM,86337OH,INSULIN ANTIBODIES,148.0,96.2,1.1,148.0,88
CDM,86340OH,INTRINSIC FACTOR AB,104.0,67.6,1.1,104.0,88
CDM,86341OH,ISLET CELL AB,163.0,105.95,1.1,163.0,88
CDM,86352OH,CELLULAR FUNCTION ASSAY STIMUL&DETECT BIOMARKE,937.0,609.05,1.1,937.0,88
CDM,86353OH,LYMPHOCYTE TR MITOGEN/AG INDUCED BLASTOGENESIS,338.0,219.7,1.1,338.0,88
CDM,86355OH,B CELLS TOTAL COUNT,260.0,169.0,1.1,260.0,88
CDM,86356OH,MONONUCLEAR CELL ANTIGEN QUANTITATIVE NOS EA,185.0,120.25,1.1,185.0,88
CDM,86357OH,NATURAL KILLER CELLS TOTAL COUNT,260.0,169.0,1.1,260.0,88
CDM,86359OH,T CELLS TOTAL COUNT,260.0,169.0,1.1,260.0,88
CDM,86360OH,T CELLS ABSOLUTE CD4&CD8 COUNT RATIO,324.0,210.6,1.1,324.0,88
CDM,86361OH,T CELLS ABSOLUTE CD4 COUNT,185.0,120.25,1.1,185.0,88
CDM,86367OH,STEM CELLS TOTAL COUNT,537.0,349.05,1.1,537.0,88
CDM,86376OH,MICROSOMAL AB EACH,100.0,65.0,1.1,100.0,88
CDM,86403OH,PARTICLE AGGLUTINATION SCREEN EACH ANTIBODY,80.0,52.0,1.1,80.0,88
CDM,86431OH,RHEUMATOID FACTOR QUANTITATIVE,39.0,25.35,1.1,39.0,88
CDM,86480OH,TB CELL MEDIATED ANTIGN RESPNSE GAMMA INTERFERON,428.0,278.2,1.1,428.0,88
CDM,86485OH,CANDIDA; SKIN TEST BO,52.0,33.8,1.1,85.71,88
CDM,86580OH,SKIN TEST TUBERCULOSIS INTRADERMAL,46.0,29.9,1.1,85.71,130
CDM,86593OH,SYPHILIS TEST QUANTITATIVE,30.0,19.5,1.1,30.0,88
CDM,86602OH,ANTINOMYCES ANTIBODY,70.0,45.5,1.1,70.0,88
CDM,86606OH,ANTIBODY ASPERGILLUS,104.0,67.6,1.1,104.0,88
CDM,86609OH,ANTIBODY BACTERIUM NOT ELSEWHERE SPECIFIED,89.0,57.85,1.1,89.0,88
CDM,86611OH,AB; BARTONELLA,70.0,45.5,1.1,70.0,88
CDM,86612OH,ANTIBODY BLASTOMYCES,89.0,57.85,1.1,89.0,88
CDM,86615OH,ANTIBODY BORDETELLA,91.0,59.15,1.1,91.0,88
CDM,86617OH,ANTIBODY BORRELIA BURGDORFERI CONFIRMATORY TST,107.0,69.55,1.1,107.0,88
CDM,86618OH,ANTIBODY BORRELIA BURGDORFERI LYME DISEASE,118.0,76.7,1.1,118.0,88
CDM,86625OH,"CAMPYLOBACTER, ANTIBODY",91.0,59.15,1.1,91.0,88
CDM,86628OH,ANTIBODY CANDIDA,83.0,53.95,1.1,83.0,88
CDM,86631OH,ANTIBODY CHLAMYDIA,82.0,53.3,1.1,82.0,88
CDM,86632OH,ANTIBODY CHLAMYDIA IGM,87.0,56.55,1.1,87.0,88
CDM,86635OH,ANTIBODY COCCIDIOIDES,79.0,51.35,1.1,79.0,88
CDM,86644OH,ANTIBODY; CYTOMEGALOVIRUS (CMV),99.0,64.35,1.1,99.0,88
CDM,86645OH,ANTIBODY CYTOMEGALOVIRUS CMV IGM,116.0,75.4,1.1,116.0,88
CDM,86648OH,DIPHTHERIA ANTIBODY,105.0,68.25,1.1,105.0,88
CDM,86658OH,ANTIBODY ENTEROVIRUS,90.0,58.5,1.1,90.0,88
CDM,86663OH,ANTIBODY EPSTEIN-BARR EB VIRUS EARLY ANTIGEN EA,91.0,59.15,1.1,91.0,88
CDM,86664OH,ANTIBODY EPSTEIN-BARR EB VIRUS NUCLEAR AG EBNA,106.0,68.9,1.1,106.0,88
CDM,86665OH,ANTIBODY EPSTEIN-BARR EB VIRUS VIRAL CAPSID VCA,125.0,81.25,1.1,125.0,88
CDM,86666OH,AB; ERLICHIA,70.0,45.5,1.1,70.0,88
CDM,86668OH,TULAREMIA AB BLOOD,98.0,63.7,1.1,98.0,88
CDM,86671OH,"FUNGUS, ANTIBODY",85.0,55.25,1.1,85.0,88
CDM,86674OH,GIARDIA LAMBLIA,102.0,66.3,1.1,102.0,88
CDM,86677OH,AB; HELICOBACTER PYLORI,116.0,75.4,1.1,116.0,88
CDM,86682OH,ANTIBODY HELMINTH NOT ELSEWHERE SPECIFIED,90.0,58.5,1.1,90.0,88
CDM,86687OH,ANTIBODY HTLV-I,63.0,40.95,1.1,63.0,88
CDM,86688OH,HTLV-II,97.0,63.05,1.1,97.0,88
CDM,86689OH,ANTIBODY HTLV/HIV ANTIBODY CONFIRMATORY TEST,134.0,87.1,1.1,134.0,88
CDM,86692OH,HEP DELTA AB,118.0,76.7,1.1,118.0,88
CDM,86694OH,ANTIBODY HERPES SMPLX NON-SPECIFIC TYPE TEST,99.0,64.35,1.1,99.0,88
CDM,86695OH,ANTIBODY HERPES SMPLX TYPE 1,91.0,59.15,1.1,91.0,88
CDM,86696OH,AB; HSV TYPE 2,134.0,87.1,1.1,134.0,88
CDM,86698OH,ANTIBODY HISTOPLASMA,95.0,61.75,1.1,95.0,88
CDM,86702OH,HIV-2 AB IGG EIA,93.0,60.45,1.1,93.0,88
CDM,86703OH,ANTIBODY HIV-1&HIV-2 SINGLE RESULT,95.0,61.75,1.1,95.0,88
CDM,86704OH,HEPATITIS B CORE ANTIBODY HBCAB TOTAL,83.0,53.95,1.1,83.0,88
CDM,86705OH,HEPATITIS B CORE ANTIBODY HBCAB IGM ANTIBODY,81.0,52.65,1.1,81.0,88
CDM,86706OH,HEPATITIS B SURF ANTIBODY HBSAB,74.0,48.1,1.1,74.0,88
CDM,86707OH,HEPATITIS BE ANTIBODY HBEAB,80.0,52.0,1.1,80.0,88
CDM,86708OH,HEPATITIS A ANTIBODY HAAB,85.0,55.25,1.1,85.0,88
CDM,86709OH,HEPATITIS ANTIBODY HAAB IGM ANTIBODY,78.0,50.7,1.1,78.0,88
CDM,86717OH,LEISHMANIA,85.0,55.25,1.1,85.0,88
CDM,86720OH,ANTIBODY LEPTOSPIRA,112.0,72.8,1.1,112.0,88
CDM,86727OH,MENINGITIS AB,89.0,57.85,1.1,89.0,88
CDM,86735OH,ANTIBODY MUMPS,90.0,58.5,1.1,90.0,88
CDM,86738OH,AB; MYCOPLASMA,91.0,59.15,1.1,91.0,88
CDM,86741OH,NEISSERIA MENINGITIDIS,91.0,59.15,1.1,91.0,88
CDM,86744OH,NOCARDIA,110.0,71.5,1.1,110.0,88
CDM,86747OH,ANTIBODY PARVOVIRUS,104.0,67.6,1.1,104.0,88
CDM,86753OH,ANTIBODY PROTOZOA NES,85.0,55.25,1.1,85.0,88
CDM,86762OH,ANTIBODY RUBELLA,99.0,64.35,1.1,99.0,88
CDM,86765OH,ANTIBODY RUBEOLA,89.0,57.85,1.1,89.0,88
CDM,86774OH,TETANUS,102.0,66.3,1.1,102.0,88
CDM,86777OH,ANTIBODY TOXOPLASMA,99.0,64.35,1.1,99.0,88
CDM,86778OH,ANTIBODY TOXOPLASMA IGM,99.0,64.35,1.1,99.0,88
CDM,86780OH,TREPONEMA PALLIDUM,91.0,59.15,1.1,91.0,88
CDM,86787OH,ANTIBODY VARICELLA-ZOSTER,89.0,57.85,1.1,89.0,88
CDM,86788OH,ANTIBODY WEST NILE VIRUS IGM,116.0,75.4,1.1,116.0,88
CDM,86789OH,WEST NILE VIRUS ANTIBODY,99.0,64.35,1.1,99.0,88
CDM,86790OH,ANTIBODY VIRUS NOT ELSEWHERE SPECIFIFED,89.0,57.85,1.1,89.0,88
CDM,86800OH,THYROGLOBULIN AB,110.0,71.5,1.1,110.0,88
CDM,86803OH,HEPATITIS C AB TEST,98.0,63.7,1.1,98.0,88
CDM,86804OH,HEP C VIRUS BY RIBA,107.0,69.55,1.1,107.0,88
CDM,86816OH,"HLA TYPING, DR/DQ,SINGLE ANTIGEN",208.0,135.2,1.1,208.0,88
CDM,86826OH,HLA CROSSMATCH NONCYTOTOXIC ADDL SERUM/DILUTION,252.0,163.8,1.1,252.0,88
CDM,86849OH,UNLISTED IMMUNOLOGY,317.0,206.05,0.01,317.0,82
CDM,86850OH,ANTIBODY SCREEN RBC EACH SERUM TECHNIQUE,67.0,43.55,1.1,67.0,88
CDM,86890OH,AUTOLOGOUS BLOOD PROCESS,1182.0,768.3,1.1,1182.0,88
CDM,86900OH,BLOOD TYPING SEROLOGIC ABO,21.0,13.65,1.1,21.0,88
CDM,86901OH,BLOOD TYPING SEROLOGIC RH (D),21.0,13.65,1.1,21.0,88
CDM,86902OH,BLOOD TYPE ANTIGEN DONOR REAGENT SERUM EA,44.0,28.6,1.1,44.0,88
CDM,86905OH,BLOOD TYPING RBC ANTIGENS OTH/THN ABO/RH D EACH,26.0,16.9,1.1,26.0,88
CDM,86920OH,COMPATIBILITY EACH UNIT IMMEDIATE SPIN TECHNIQUE,1182.0,768.3,1.1,1182.0,88
CDM,86921OH,COMPATIBILITY EACH UNIT INCUBATION,1182.0,768.3,1.1,1182.0,88
CDM,86922OH,COMPATIBILITY EACH UNIT ANTIGLOBULIN,1182.0,768.3,1.1,1182.0,88
CDM,86923OH,COMPATIBILITY TEST ELECTRIC,1182.0,768.3,1.1,1182.0,88
CDM,86927OH,FRESH FROZEN PLASMA THAWING EACH UNIT,1182.0,768.3,1.1,1182.0,88
CDM,86931OH,FROZEN BLOOD THAW,1182.0,768.3,1.1,1182.0,88
CDM,86932OH,"FROZEN BLOOD, FREEZE/THAW",271.0,176.15,1.1,271.0,88
CDM,86976OH,"RBC PRETREATMENT,SERUM DILUTN",169.0,109.85,1.1,169.0,88
CDM,86985OH,SPLITTING BLOOD/BLOOD PRODUCTS EACH UNIT,1182.0,768.3,1.1,1182.0,88
CDM,86999RVUOH,TRANSFUSION PLATLET RICH PLASMA INJ,485.0,315.25,0.01,485.0,82
CDM,87015OH,CONCENTRATION INFECTIOUS AGENTS,46.0,29.9,1.1,46.0,88
CDM,87040OH,CULTURE BACTERIAL BLOOD AEROBIC W/ID ISOLATES,71.0,46.15,1.1,71.0,88
CDM,87045OH,CUL BACT STOOL AEROBIC ISOL SALMONELLA&SHIGELL,65.0,42.25,1.1,65.0,88
CDM,87046OH,CUL BACT STOOL AEROBIC ADDL PATHOGENS&ID EA,65.0,42.25,1.1,65.0,88
CDM,87070OH,CUL BACT XCPT URINE BLOOD/STOOL AEROBIC ISOL,59.0,38.35,1.1,59.0,88
CDM,87071OH,CUL BACT QUAN AEROBIC ISOL XCPT UR BLOOD/STOOL,68.0,44.2,1.1,68.0,88
CDM,87073OH,CUL BACT QUAN ANAERC ISOL XCPT UR BLOOD/STOOL,67.0,43.55,1.1,67.0,88
CDM,87075OH,CULTURE BACTERIAL ANY SOURCE ANAEROBIC ISO&ID,65.0,42.25,1.1,65.0,88
CDM,87076OH,CUL BACT ANAEROBIC ADDL METHS DEFINITIVE EA ISOL,56.0,36.4,1.1,56.0,88
CDM,87077OH,CUL BACT AEROBIC ADDL METHS DEFINITIVE EA ISOL,56.0,36.4,1.1,56.0,88
CDM,87081OH,CUL PRSMPTV PTHGNC ORGANISM SCRN W/COLONY ESTIMJ,46.0,29.9,1.1,46.0,88
CDM,87086OH,CULTURE BACTERIAL QUANTTATIVE COLONY COUNT URINE,56.0,36.4,1.1,56.0,88
CDM,87088OH,CULTURE BCT ISOL&PRSMPTV ID ISOLATE EA URINE,56.0,36.4,1.1,56.0,88
CDM,87101OH,CUL FNGI MOLD/YEAST PRSMPTV ID SKN HAIR/NAIL,53.0,34.45,1.1,53.0,88
CDM,87102OH,CULTURE FNGI MOLD/YEAST PRSMPTV OTH XCPT BLOOD,58.0,37.7,1.1,58.0,88
CDM,87103OH,CULTURE FNGI MOLD/YEAST ISOL PRSMPTV ISOL BLOOD,141.0,91.65,1.1,141.0,88
CDM,87106OH,CULTURE FUNGI DEFINITIVE ID EACH ORGANISM YEAST,71.0,46.15,1.1,71.0,88
CDM,87107OH,CULTURE FUNGI DEFINITIVE ID EACH ORGANISM MOLD,71.0,46.15,1.1,71.0,88
CDM,87109OH,MYCOPLASMA CULT,106.0,68.9,1.1,106.0,88
CDM,87118OH,ORG ID AFB,101.0,65.65,1.1,101.0,88
CDM,87150OH,CULTYP NUC ACID AMP PRB CULT/ISOLATE EA ORGNISM,242.0,157.3,1.1,242.0,88
CDM,87158OH,CULTURE TYPING OTHER METHODS,53.0,34.45,1.1,53.0,88
CDM,87168OH,MACROSCOPIC EXAM ARTHROPOD,29.0,18.85,1.1,29.0,88
CDM,87169OH,MACROSCOPIC EXAM PARASITE,30.0,19.5,1.1,30.0,88
CDM,87172OH,PIN WORM PREP,29.0,18.85,1.1,29.0,88
CDM,87176OH,HOMOGENIZATION TISSUE CULTURE,41.0,26.65,1.1,41.0,88
CDM,87177OH,OVA&PARASITES DIRECT SMEARS CONCENTRATION & ID,61.0,39.65,1.1,61.0,88
CDM,87181OH,"ANTIBIOTIC SENS,AGAR DIFFUSN,EA",33.0,21.45,1.1,33.0,88
CDM,87184OH,"ANTIBIOTIC SENS,DISK,EACH",52.0,33.8,1.1,52.0,88
CDM,87185OH,SUSCEPTIBILITY STUDY ANTIMICROBIAL ENZYME DETCJ,33.0,21.45,1.1,33.0,88
CDM,87186OH,SUSCEPTIBLTY STDY ANTIMICRBIAL MICRO/AGAR DILUTJ,60.0,39.0,1.1,60.0,88
CDM,87197OH,SERUM BACTERIA TITER,104.0,67.6,1.1,104.0,88
CDM,87200005,CAR-T THERAPY PREPJ BLD-DRV T LYMPHCYT F/TRNS,348.0,226.2,75.86,2453.0,66
CDM,87205OH,SMR PRIM SRC GRAM/GIEMSA STAIN BCT FUNGI/CELL,29.0,18.85,1.1,29.0,88
CDM,87206OH,SMR PRIM SRC FLUORESCENT&/AFS BCT FNGI PARASIT,37.0,24.05,1.1,37.0,88
CDM,87207OH,"SMEAR, PARASITE SPECIAL STAIN",163.0,105.95,1.1,163.0,92
CDM,87207OH-26,"SMEAR, PARASITE SPECIAL STAIN",163.0,105.95,1.1,163.0,126
CDM,87209OH,SMR PRIM SRC CPLX SPEC STAIN OVA&PARASITS,124.0,80.6,1.1,124.0,88
CDM,87210OH,SMR PRIM SRC WET MOUNT NFCT AGT,40.0,26.0,1.1,40.0,88
CDM,87220OH,TISS KOH SLIDE SAMPS SKN/HR/NLS FNGI/ECTOPARASIT,29.0,18.85,1.1,29.0,88
CDM,87220RVUOH,KOH EXAM,49.0,31.85,1.1,49.0,88
CDM,87253OH,VIRUS TISSUE CULTURE ADDL STDY/ID EACH ISOLATE,139.0,90.35,1.1,139.0,88
CDM,87255OH,VIRUS ID NON-IMMUNOLOGIC OTH/THN CYTOPATHIC,234.0,152.1,1.1,234.0,88
CDM,87265OH,B. PERTUSSIS DFA,83.0,53.95,1.1,83.0,88
CDM,87270OH,C. TRACHOMATIS DFA,83.0,53.95,1.1,83.0,88
CDM,87275OH,IAADI INFLUENZA B VIRUS,85.0,55.25,1.1,85.0,88
CDM,87276OH,"INFLUENZA AG, DFA",111.0,72.15,1.1,111.0,88
CDM,87278OH,LEGIONELLA CULT/DFA,108.0,70.2,1.1,108.0,88
CDM,87290OH,IAADI VARICELLA ZOSTER VIRUS,93.0,60.45,1.1,93.0,88
CDM,87300005,CAR-T THERAPY RECEIPT & PREPJ CAR-T CELLS F/ADMN,352.0,228.8,76.74,2453.0,66
CDM,87300OH,IAADI POLYV MLT ORGANISMS EA POLYV ANTISERUM,83.0,53.95,1.1,83.0,88
CDM,87305OH,IAAD IA ASPERGILLUS,83.0,53.95,1.1,83.0,88
CDM,87324OH,IAAD IA CLOSTRIDIUM DIFFICILE TOXIN,83.0,53.95,1.1,83.0,88
CDM,87328OH,IAAD IA CRYPTOSPORIDIUM,95.0,61.75,1.1,95.0,88
CDM,87329OH,IAAD IA GIARDIA,83.0,53.95,1.1,83.0,88
CDM,87337OH,IAAD IA ENTAMOEBA HISTOLYTICA GRP,83.0,53.95,1.1,83.0,88
CDM,87338OH,IAAD IA HPYLORI STOOL,99.0,64.35,1.1,99.0,88
CDM,87340OH,IAAD IA HEPATITIS B SURFACE ANTIGEN,71.0,46.15,1.1,71.0,88
CDM,87341OH,HEPATITIS B SURFACE AG EIA NEUTRALIZATION,71.0,46.15,1.1,71.0,88
CDM,87350OH,IAAD IA HEPATITIS BE ANTIGEN,80.0,52.0,1.1,80.0,88
CDM,87380OH,HEP DELTA VIRUS AG,127.0,82.55,1.1,127.0,88
CDM,87385OH,IAAD IA HISTOPLASM CAPSULATUM,91.0,59.15,1.1,91.0,88
CDM,87389OH,IAAD EIA HIV-1 AG W/HIV-1&HIV-2 ANTBDY SINGLE,166.0,107.9,1.1,166.0,88
CDM,87400035,CAR-T THERAPY HRVG BLD DRV T LMPHCYT PR DAY,1076.0,699.4,149.22,2453.0,66
CDM,87400055,CAR-T THERAPY AUTOLOGOUS CELL ADMINISTRATION,1327.0,862.55,149.22,2453.0,84
CDM,87400OH,IAAD IA INFLUENZA A/B EACH,97.0,63.05,1.1,97.0,88
CDM,87427OH,IAAD IA SHIGA-LIKE TOXIN,83.0,53.95,1.1,83.0,88
CDM,87430OH,IAAD IA STREPTOCOCCUS GROUP A,116.0,75.4,1.1,116.0,88
CDM,87449OH,IAAD IA NOT OTHERWISE SPECIFIED EACH ORGANISM,83.0,53.95,1.1,83.0,88
CDM,87471OH,"BARTONELLA, DNA, AMP PROBE",242.0,157.3,1.1,242.0,88
CDM,87476OH,IADNA BORRELIA BURGDORFERI AMPLIFIED PROBE TQ,242.0,157.3,1.1,242.0,88
CDM,87480OH,IADNA CANDIDA SPECIES DIRECT PROBE TQ,138.0,89.7,1.1,138.0,88
CDM,87486OH,IADNA CHLAMYDIA PNEUMONIAE AMPLIFIED PROBE TQ,242.0,157.3,1.1,242.0,88
CDM,87490OH,"CHYLMD TRACH, DNA, DIR PROBE",157.0,102.05,1.1,157.0,88
CDM,87491OH,IADNA CHLAMYDIA TRACHOMATIS AMPLIFIED PROBE TQ,242.0,157.3,1.1,242.0,88
CDM,87493OH,INF AGENT DET NUCLEIC ACID CLOSTRIDIUM AMP PROBE,257.0,167.05,1.1,257.0,88
CDM,87496OH,IADNA CYTOMEGALOVIRUS AMPLIFIED PROBE TQ,242.0,157.3,1.1,242.0,88
CDM,87497OH,IADNA CYTOMEGALOVIRUS QUANTIFICATION,296.0,192.4,1.1,296.0,88
CDM,87502OH,INFECTIOUS AGENT DNA/RNA INFLUENZA 1ST 2 TYPES,661.0,429.65,1.1,661.0,88
CDM,87505OH,NFCT AGENT DNA/RNA GASTROINTESTINAL PATHOGEN,885.0,575.25,1.1,885.0,88
CDM,87510OH,IADNA GARDNERELLA VAGINALIS DIRECT PROBE TQ,138.0,89.7,1.1,138.0,88
CDM,87516OH,IADNA HEPATITIS B VIRUS AMPLIFIED PROBE TQ,242.0,157.3,1.1,242.0,88
CDM,87517OH,IADNA HEPATITIS B VIRUS QUANTIFICATION,296.0,192.4,1.1,296.0,88
CDM,87521OH,IADNA HEPATITIS C AMPLIFIED PROBE&REVRSE TRANSCR,242.0,157.3,1.1,242.0,88
CDM,87522OH,IADNA HEPATITIS C QUANT & REVERSE TRANSCRIPTION,296.0,192.4,1.1,296.0,88
CDM,87529OH,IADNA HERPES SOMPLX VIRUS AMPLIFIED PROBE TQ,242.0,157.3,1.1,242.0,88
CDM,87533OH,"HHV-6, DNA, QUANT",288.0,187.2,1.1,288.0,88
CDM,87536OH,IADNA HIV-1 QUANT & REVERSE TRANSCRIPTION,587.0,381.55,1.1,587.0,88
CDM,87538OH,IADNA HIV-2 AMPLIFIED PROBE & REVERSE TRANSCRIPJ,242.0,157.3,1.1,242.0,88
CDM,87541OH,"LEGION PNEUMO, DNA, AMP PROB",242.0,157.3,1.1,242.0,88
CDM,87550OH,IADNA MYCOBACTERIA SPECIES DIRECT PROBE TQ,138.0,89.7,1.1,138.0,88
CDM,87551OH,IADNA MYCOBACTERIA SPECIES AMPLIFIED PROBE TQ,333.0,216.45,1.1,333.0,88
CDM,87555OH,"M.TUBERCULO, DNA, DIR PROBE",185.0,120.25,1.1,185.0,88
CDM,87556OH,IADNA MYCOBACTERIA TUBERCULOSIS AMP PRB,288.0,187.2,1.1,288.0,88
CDM,87560OH,"M.AVIUM-INTRA, DNA, DIR PROB",188.0,122.2,1.1,188.0,88
CDM,87581OH,IADNA MYCOPLSM PNEUMONIAE AMPLIFIED PROBE TQ,242.0,157.3,1.1,242.0,88
CDM,87590OH,"N.GONORRHOEAE, DNA, DIR PROB",185.0,120.25,1.1,185.0,88
CDM,87591OH,IADNA NEISSERIA GONORRHOEAE AMPLIFIED PROBE TQ,242.0,157.3,1.1,242.0,88
CDM,87624OH,IADNA HUMAN PAPILLOMAVIRUS HIGH-RISK TYPES,242.0,157.3,1.1,242.0,88
CDM,87625OH,IADNA HUMAN PAPILLOMAVIRUS TYPES 16 & 18 ONLY,280.0,182.0,1.1,280.0,88
CDM,87631OH,IADNA RESPIRATRY PROBE & REV TRNSCR 3-5 TARGETS,984.0,639.6,1.1,984.0,88
CDM,87633OH,IADNA RESPIRATRY PROBE & REV TRNSCR 12-25 TARGET,2876.0,1869.4,1.1,2876.0,88
CDM,87634OH,IADNA DNA/RNA RSV AMPLIFIED PROBE TECHNIQUE,484.0,314.6,1.1,484.0,88
CDM,87635OH,IADNA SARS-COV-2 COVID-19 AMPLIFIED PROBE TQ,354.0,230.1,1.1,354.0,88
CDM,87636OH,SARSCOV2 & INF A&B AMP PRB,984.0,639.6,1.1,984.0,88
CDM,87637OH,IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ,560.0,364.0,1.1,560.0,88
CDM,87640OH,IADNA S AUREUS AMPLIFIED PROBE TQ,242.0,157.3,1.1,242.0,88
CDM,87650OH,IADNA STREPTOCOCCUS GROUP A DIRECT PROBE TQ,138.0,89.7,1.1,138.0,88
CDM,87651OH,IADNA STREPTOCOCCUS GROUP A AMPLIFIED PROBE TQ,242.0,157.3,1.1,242.0,88
CDM,87651POCOH,STREP A (MOLECULAR),217.0,141.05,1.1,217.0,88
CDM,87653OH,IADNA STREPTOCOCCUS GROUP B AMPLIFIED PROBE TQ,242.0,157.3,1.1,242.0,88
CDM,87660OH,IADNA TRICHOMONAS VAGINALIS DIRECT PROBE TQ,138.0,89.7,1.1,138.0,88
CDM,87661OH,IADNA TRICHOMONAS VAGINALIS AMPLIFIED PROBE TECH,242.0,157.3,1.1,242.0,88
CDM,87797OH,"DETECT AGENT NOS, DNA, DIR",207.0,134.55,1.1,207.0,88
CDM,87801OH,IADNA MULTIPLE ORGANISMS AMPLIFIED PROBE TQ,484.0,314.6,1.1,484.0,88
CDM,87804OH,IAADIADOO INFLUENZA,114.0,74.1,1.1,114.0,88
CDM,87807OH,IAADIADOO RESPIRATORY SYNCTIAL VIRUS,90.0,58.5,1.1,90.0,88
CDM,87808OH,IAADIADOO TRICHOMONAS VAGINALIS,106.0,68.9,1.1,106.0,88
CDM,87880OH,IAADIADOO STREPTOCOCCUS GROUP A,114.0,74.1,1.1,114.0,88
CDM,87900OH,NFCT AGT DRUG SUSCEPT PHENOTYPE PREDICTION,899.0,584.35,1.1,899.0,88
CDM,87901OH,NFCT GEXYP NUCLEIC ACID HIV REV TRNSCR&PROTEAS,1776.0,1154.4,1.1,1776.0,88
CDM,87902OH,NFCT AGNT GENOTYP NUCLEIC ACID HEPATITIS C VIRUS,1776.0,1154.4,1.1,1776.0,88
CDM,87905OH,INFECTIOUS AGENT ENZYMATIC ACTV OTH/THN VIRUS,84.0,54.6,1.1,84.0,88
CDM,87906OH,NFCT GEXYP DNA/RNA HIV 1 OTHER REGION,888.0,577.2,1.1,888.0,88
CDM,87910OH,NFCT AGT GENOTYPE NUCLEIC ACID CYTOMEGALOVIRUS,1776.0,1154.4,1.1,1776.0,88
CDM,88020OH,"AUTOPSY COMPL,W/O CNS",1325.0,861.25,1.1,2754903.06,88
CDM,88100000,ULTRAFILTRATION,2938.0,1909.7,102.71,2938.0,86
CDM,88104OH,CYTP FLU WASHGS/BRUSHINGS XCPT C/V SMRS INTERPJ,246.0,159.9,1.1,246.0,130
CDM,88104OH-26,CYTP FLU WASHGS/BRUSHINGS XCPT C/V SMRS INTERPJ,246.0,159.9,1.1,246.0,126
CDM,88108OH,CYTP CONCENTRATION SMEARS & INTERPRETATION,465.0,302.25,1.1,465.0,130
CDM,88108OH-26,CYTP CONCENTRATION SMEARS & INTERPRETATION,194.0,126.1,1.1,194.0,126
CDM,88112OH,CYTP SLCTV CELL ENHANCEMENT INTERPJ XCPT C/V,246.0,159.9,1.1,246.0,130
CDM,88112OH-26,CYTP SLCTV CELL ENHANCEMENT INTERPJ XCPT C/V,246.0,159.9,1.1,246.0,126
CDM,88120OH,CYTP INSITU HYBRID URINE SPEC 3-5 PROBES EA MNL,528.0,343.2,1.1,1382.33,130
CDM,88120OH-26,CYTP INSITU HYBRID URINE SPEC 3-5 PROBES EA MNL,528.0,343.2,1.1,528.0,126
CDM,88141OH,CYTP CERVICAL/VAGINAL REQ INTERP PHYSICIAN,114.0,74.1,1.1,114.0,130
CDM,88142OH,CYTP CERV/VAG AUTO THIN LAYER PREP MNL SCREEN,140.0,91.0,1.1,140.0,88
CDM,88150OH,CYTP SLIDES C/V MNL SCR UNDER PHYS,126.0,81.9,1.1,126.0,88
CDM,88160OH,CYTP SMRS ANY OTH SRC SCR&INTERPJ,220.0,143.0,1.1,220.0,130
CDM,88160OH-26,CYTP SMRS ANY OTH SRC SCR&INTERPJ,220.0,143.0,1.1,220.0,126
CDM,88161OH,CYTP SMRS ANY OTH SRC PREPJ SCR&INTERPJ,220.0,143.0,1.1,220.0,126
CDM,88162OH,CYTP SMRS ANY OTH SRC EXTND STD > 5 SLIDES,334.0,217.1,1.1,334.0,130
CDM,88172OH,CYTP FINE NDL ASPIRATE IMMT CYTOHIST STD DX 1ST,304.0,197.6,1.1,498.94,130
CDM,88172OH-26,CYTP FINE NDL ASPIRATE IMMT CYTOHIST STD DX 1ST,304.0,197.6,1.1,304.0,126
CDM,88173OH,CYTP EVAL FINE NEEDLE ASPIRATE INTERP & REPORT,612.0,397.8,1.1,612.0,130
CDM,88173OH-26,CYTP EVAL FINE NEEDLE ASPIRATE INTERP & REPORT,612.0,397.8,1.1,612.0,126
CDM,88177OH,CYTP FINE NDL ASPIRATE IMMT CYTOHIST STD EA EVAL,185.0,120.25,1.1,185.0,130
CDM,88177OH-26,CYTP FINE NDL ASPIRATE IMMT CYTOHIST STD EA EVAL,185.0,120.25,1.1,185.0,126
CDM,88180OH,TRANSPLANT ACTIVATE,94.0,61.1,1.1,94.0,70
CDM,88184OH,FLOW CYTOMETRY CELL SURF MARKER TECHL ONLY 1ST,2482.0,1613.3,1.1,2482.0,130
CDM,88185OH,FLOW CYTOMETRY CELL SURF MARKER TECHL ONLY EA,149.0,96.85,1.1,149.0,130
CDM,88187OH,FLOW CYTOMETRY INTERPRETATION 2-8 MARKE,326.0,211.9,1.1,326.0,130
CDM,88188OH,FLOW CYTOMETRY INTERP 9-15 MARKERS,528.0,343.2,1.1,528.0,130
CDM,88189OH,FLOW CYTOMETRY INTERP 16 OR MORE MARKERS,748.0,486.2,1.1,748.0,130
CDM,88230OH,TISS CUL NON-NEO DISORDERS LYMPHOCYTE,804.0,522.6,1.1,804.0,88
CDM,88237OH,TISS CUL NEO DISORDERS BONE MARROW BLOOD CELLS,992.0,644.8,1.1,992.0,88
CDM,88239OH,TISS CUL NEO DISORDERS SOLID TUMOR,1018.0,661.7,1.1,1018.0,88
CDM,88262OH,CHRMSM COUNT 15-20 CLL 2KARYOTYP BANDING,866.0,562.9,1.1,866.0,88
CDM,88271OH,MOLECULAR CYTOGENETICS DNA PROBE EACH,148.0,96.2,1.1,148.0,88
CDM,88272OH,"CYTOGENETICS, 3-5",281.0,182.65,1.1,281.0,88
CDM,88273OH,MOLECULAR CYTOGENETICS CHRMOML ISH 10-30 CLL,240.0,156.0,1.1,240.0,88
CDM,88289OH,CHROMOSOME STUDY: ADDITIONAL,238.0,154.7,1.1,238.0,88
CDM,88291OH,CYTOGENETICS&MOLEC CYTOGENETICS INTERP&REP,229.0,148.85,1.1,229.0,130
CDM,88300OH,LEVEL I SURG PATHOLOGY GROSS EXAMINATION ONLY,35.0,22.75,1.1,85.71,130
CDM,88300OH-26,LEVEL I SURG PATHOLOGY GROSS EXAMINATION ONLY,35.0,22.75,1.1,35.0,126
CDM,88302OH,LEVEL II SURG PATHOLOGY GROSS&MICROSCOPIC EXAM,57.0,37.05,1.1,85.71,130
CDM,88302OH-26,LEVEL II SURG PATHOLOGY GROSS&MICROSCOPIC EXAM,57.0,37.05,1.1,57.0,126
CDM,88304OH,LEVEL III SURG PATHOLOGY GROSS&MICROSCOPIC EXAM,97.0,63.05,1.1,159.17,130
CDM,88304OH-26,LEVEL III SURG PATHOLOGY GROSS&MICROSCOPIC EXAM,97.0,63.05,1.1,97.0,126
CDM,88305OH,LEVEL IV SURG PATHOLOGY GROSS&MICROSCOPIC EXAM,330.0,214.5,1.1,330.0,130
CDM,88305OH-26,LEVEL IV SURG PATHOLOGY GROSS&MICROSCOPIC EXAM,330.0,214.5,1.1,330.0,126
CDM,88307OH,LEVEL V SURG PATHOLOGY GROSS&MICROSCOPIC EXAM,700.0,455.0,1.1,1046.86,130
CDM,88307OH-26,LEVEL V SURG PATHOLOGY GROSS&MICROSCOPIC EXAM,700.0,455.0,1.1,700.0,126
CDM,88307OH-TC,LEVEL V SURG PATHOLOGY GROSS&MICROSCOPIC EXAM,2363.0,1535.95,1.1,2363.0,126
CDM,88309OH,LEVEL VI SURG PATHOLOGY GROSS&MICROSCOPIC EXAM,1232.0,800.8,1.1,2506.96,130
CDM,88309OH-26,LEVEL VI SURG PATHOLOGY GROSS&MICROSCOPIC EXAM,1232.0,800.8,1.1,1232.0,126
CDM,88311OH,DECALCIFICATION PROCEDURE,106.0,68.9,1.1,106.0,130
CDM,88311OH-26,DECALCIFICATION PROCEDURE,106.0,68.9,1.1,106.0,126
CDM,88311OH-TC,DECALCIFICATION PROCEDURE,106.0,68.9,1.1,106.0,126
CDM,88312OH,SPECIAL STAIN GROUP 1 MICROORGANISMS I&R,238.0,154.7,1.1,279.35,130
CDM,88312OH-26,SPECIAL STAIN GROUP 1 MICROORGANISMS I&R,238.0,154.7,1.1,238.0,126
CDM,88312OH-TC,SPECIAL STAIN GROUP 1 MICROORGANISMS I&R,238.0,154.7,1.1,238.0,126
CDM,88313OH,SPCL STN 2 I&R EXCPT MICROORG/ENZYME/IMCYT,106.0,68.9,1.1,206.12,130
CDM,88313OH-26,SPCL STN 2 I&R EXCPT MICROORG/ENZYME/IMCYT,106.0,68.9,1.1,106.0,126
CDM,88313OH-TC,SPCL STN 2 I&R EXCPT MICROORG/ENZYME/IMCYT,126.0,81.9,1.1,177.15,126
CDM,88314OH,SPECIAL STAIN I&R HISTOCHEMICAL W/FROZEN TISSU,198.0,128.7,1.1,208.67,130
CDM,88314OH-26,SPECIAL STAIN I&R HISTOCHEMICAL W/FROZEN TISSU,198.0,128.7,1.1,198.0,126
CDM,88319OH,SPECIAL STAIN I&R GROUP III ENZYME CONSITUENTS,233.0,151.45,1.1,2506.96,130
CDM,88319OH-26,SPECIAL STAIN I&R GROUP III ENZYME CONSITUENTS,5637.0,3664.05,1.1,5637.0,126
CDM,88319OH-TC,SPECIAL STAIN I&R GROUP III ENZYME CONSITUENTS,233.0,151.45,1.1,271.7,126
CDM,88321AOH,EPATH MICROSLIDE CONSULT 1-7,290.0,188.5,1.1,290.0,134
CDM,88321BOH,EPATH MICROSLIDE CONSULT 8+,315.0,204.75,1.1,315.0,134
CDM,88321COH,PATHOUT MICROSLIDE CONSULT,212.0,137.8,1.1,264.79,134
CDM,88321DOH,OCPATH MICROSLIDE CONSULT,212.0,137.8,1.1,264.79,134
CDM,88321OH,CONSLTJ&REPRT SLIDES PREPARED ELSEWHERE,717.0,466.05,1.1,717.0,134
CDM,88321OH-26,CONSLTJ&REPRT SLIDES PREPARED ELSEWHERE,717.0,466.05,1.1,717.0,70
CDM,88323OH,CONSLTJ&REPRT MATERIAL REQUIRING PREPJ SLIDES,805.0,523.25,1.1,805.0,130
CDM,88323OH-26,CONSLTJ&REPRT MATERIAL REQUIRING PREPJ SLIDES,805.0,523.25,1.1,805.0,126
CDM,88325OH,CONSLTJ COMPRE REVIEW REPRT REFERRED MATRL,1254.0,815.1,1.1,1254.0,134
CDM,88329OH,PATHOLOGY CONSULTATION DURING SURGERY,295.0,191.75,1.1,295.0,134
CDM,88331OH,PATH CONSLTJ SURG 1ST BLK FROZEN SCTJ 1 SPEC,524.0,340.6,1.1,524.0,130
CDM,88331OH-26,PATH CONSLTJ SURG 1ST BLK FROZEN SCTJ 1 SPEC,524.0,340.6,1.1,524.0,126
CDM,88332OH,PATH CONSLTJ SURG EA ADDL BLK FROZEN SECTION,260.0,169.0,1.1,260.0,130
CDM,88332OH-26,PATH CONSLTJ SURG EA ADDL BLK FROZEN SECTION,260.0,169.0,1.1,260.0,126
CDM,88333OH,PATH CONSLTJ SURG CYTOLOGIC EXAM INITIAL SITE,528.0,343.2,1.1,2506.96,130
CDM,88333OH-26,PATH CONSLTJ SURG CYTOLOGIC EXAM INITIAL SITE,528.0,343.2,1.1,528.0,126
CDM,88334OH,PATH CONSLTJ SURG CYTOLOGIC EXAM ADDL SITE,321.0,208.65,1.1,321.0,130
CDM,88334OH-26,PATH CONSLTJ SURG CYTOLOGIC EXAM ADDL SITE,321.0,208.65,1.1,321.0,126
CDM,88341OH,IMHISTOCHEM/CYTCHM EA ADDL ANTIBODY SLIDE,246.0,159.9,1.1,246.0,130
CDM,88341OH-26,IMHISTOCHEM/CYTCHM EA ADDL ANTIBODY SLIDE,246.0,159.9,1.1,246.0,126
CDM,88342OH,IMHISTOCHEM/CYTCHM 1ST ANTIBODY STAIN PROCEDURE,308.0,200.2,1.1,498.94,130
CDM,88342OH-26,IMHISTOCHEM/CYTCHM 1ST ANTIBODY STAIN PROCEDURE,308.0,200.2,1.1,308.0,126
CDM,88342OH-TC,IMHISTOCHEM/CYTCHM 1ST ANTIBODY STAIN PROCEDURE,1182.0,768.3,1.1,1182.0,126
CDM,88344OH,IMHISTOCHEM/CYTCHM EA MULTIPLEX ANTIBODY SLIDE,339.0,220.35,1.1,1046.86,130
CDM,88344OH-26,IMHISTOCHEM/CYTCHM EA MULTIPLEX ANTIBODY SLIDE,339.0,220.35,1.1,339.0,126
CDM,88346OH,IMMUNOFLUORESCENCE PER SPEC 1ST SINGL ANTB STAIN,326.0,211.9,1.1,498.94,130
CDM,88346OH-26,IMMUNOFLUORESCENCE PER SPEC 1ST SINGL ANTB STAIN,326.0,211.9,1.1,326.0,126
CDM,88346OH-TC,IMMUNOFLUORESCENCE PER SPEC 1ST SINGL ANTB STAIN,1182.0,768.3,1.1,1182.0,126
CDM,88348OH,ELECTRON MICROSCOPY,664.0,431.6,1.1,2506.96,130
CDM,88348OH-26,ELECTRON MICROSCOPY,664.0,431.6,1.1,664.0,126
CDM,88350OH,IMMUNOFLUORESCENCE PER SPEC ADD SINGL ANTB STAIN,260.0,169.0,1.1,260.0,126
CDM,88360OH,M/PHMTRC ALYS TUMOR IMHCHEM EA ANTIBODY MANUAL,374.0,243.1,1.1,498.94,130
CDM,88360OH-26,M/PHMTRC ALYS TUMOR IMHCHEM EA ANTIBODY MANUAL,374.0,243.1,1.1,374.0,126
CDM,88360OH-TC,M/PHMTRC ALYS TUMOR IMHCHEM EA ANTIBODY MANUAL,1182.0,768.3,1.1,1182.0,126
CDM,88362OH,NERVE TEASING PREPARATIONS,955.0,620.75,1.1,2506.96,130
CDM,88363OH,EXAM & SELECT ARCHIVE TISSUE MOLECULAR ANALYSIS,163.0,105.95,1.1,163.0,134
CDM,88364OH,IN SITU HYBRIDIZATION EA ADDL PROBE STAIN,308.0,200.2,1.1,322.8,130
CDM,88364OH-26,IN SITU HYBRIDIZATION EA ADDL PROBE STAIN,308.0,200.2,1.1,308.0,126
CDM,88364OH-TC,IN SITU HYBRIDIZATION EA ADDL PROBE STAIN,935.0,607.75,1.1,935.0,126
CDM,88365OH,IN SITU HYBRIDIZATION 1ST PROBE STAIN,387.0,251.55,1.1,498.94,130
CDM,88365OH-26,IN SITU HYBRIDIZATION 1ST PROBE STAIN,387.0,251.55,1.1,387.0,126
CDM,88365OH-TC,IN SITU HYBRIDIZATION 1ST PROBE STAIN,673.0,437.45,1.1,673.0,126
CDM,88366OH,IN SITU HYBRIDIZATION EA MULTIPLEX PROBE STAIN,546.0,354.9,1.1,546.0,126
CDM,88368OH,M/PHMTRC ALYS IN SITU HYBRIDIZATION EA PROBE MNL,387.0,251.55,1.1,1046.86,130
CDM,88368OH-26,M/PHMTRC ALYS IN SITU HYBRIDIZATION EA PROBE MNL,387.0,251.55,1.1,387.0,126
CDM,88368OH-TC,M/PHMTRC ALYS IN SITU HYBRIDIZATION EA PROBE MNL,2482.0,1613.3,1.1,2482.0,126
CDM,88371OH,GBM AB/ANTI GBM,153.0,99.45,1.1,153.0,92
CDM,88377OH,M/PHMTRC ALYS ISH QUANT/SEMIQ MNL EACH MULTIPRB,616.0,400.4,1.1,979.48,130
CDM,88377OH-26,M/PHMTRC ALYS ISH QUANT/SEMIQ MNL EACH MULTIPRB,616.0,400.4,1.1,616.0,126
CDM,88377OH-TC,M/PHMTRC ALYS ISH QUANT/SEMIQ MNL EACH MULTIPRB,1182.0,768.3,1.1,1182.0,126
CDM,88381OH,MICRODISSECTION PREP IDENTIFIED TARGET MANUAL,233.0,151.45,1.1,478.66,130
CDM,88381OH-26,MICRODISSECTION PREP IDENTIFIED TARGET MANUAL,233.0,151.45,1.1,233.0,126
CDM,88387OH,MACRO EXAM DISSECT&PREP TISS NONMICRO STD EA,273.0,177.45,1.1,273.0,126
CDM,88720OH,BILIRUBIN TOTAL TRANSCUTANEOUS,35.0,22.75,1.1,35.0,88
CDM,88738OH,HGB QUANT TRANSCUTANEOUS,35.0,22.75,1.1,35.0,88
CDM,88900005,CAVH DIALYSIS OP,2938.0,1909.7,102.71,2938.0,86
CDM,88900015,HEMO 1 EVAL OP,4828.0,3138.2,85.0,4828.0,86
CDM,88900025,CRRT - SINGLE EVALUATION,2938.0,1909.7,102.71,2938.0,86
CDM,89051OH,CELL COUNT MISC BODY FLUIDS W/DIFFERENTIAL COUNT,39.0,25.35,1.1,39.0,88
CDM,89051OH-26,CELL COUNT MISC BODY FLUIDS W/DIFFERENTIAL COUNT,39.0,25.35,1.1,39.0,70
CDM,89060OH,CRYSTAL ID LIGHT MICROSCOPY ALYS TISS/ANY FLUID,163.0,105.95,1.1,163.0,92
CDM,89060OH-26,CRYSTAL ID LIGHT MICROSCOPY ALYS TISS/ANY FLUID,163.0,105.95,1.1,163.0,126
CDM,89125OH,FAT STAIN FECES URINE/RESPIR SECRETIONS,41.0,26.65,1.1,41.0,88
CDM,89130OH,SAMPLE STOMACH CONTENTS,213.0,138.45,1.1,213.0,70
CDM,89190OH,NASAL SMEAR EOSINOPHILS,40.0,26.0,1.1,40.0,88
CDM,89230OH,SWEAT COLLECTION IONTOPHORESIS,154.0,100.1,1.1,159.17,130
CDM,89300OH,SEMEN ALYS PRESENCE&/MOTILITY SPRM HUHNER,68.0,44.2,1.1,68.0,88
CDM,89320OH,SEMEN ANAL VOL/COUNT/MOT,314.0,204.1,1.1,314.0,88
CDM,89321OH,SEMEN ANALYSIS SPERM PRESENCE&/MOTILITY SPRM,209.0,135.85,1.1,209.0,88
CDM,89322OH,SEMEN ANALYSIS STRICT MORPHOLOGIC CRITERIA,107.0,69.55,1.1,107.0,88
CDM,89325OH,SPERM ANTIBODIES,306.0,198.9,1.1,306.0,88
CDM,89329OH,HYPO-OSMOT SWELLING,135.0,87.75,1.1,135.0,88
CDM,89331OH,SPERM EVALUATION RETROGRADE EJACULATION URINE,135.0,87.75,1.1,135.0,88
CDM,89343OH,STORAGE/YEAR; SPERM/SEMEN,207.0,134.55,1.1,498.94,82
CDM,89353OH,THAWING CRYOPRESERVED SPERM/SEMEN EACH ALIQUOT,126.0,81.9,1.1,1211.06,82
CDM,89398OH,UNLISTED REPROD MED LAB PROC,595.0,386.75,0.01,595.0,80
CDM,90000000,PSYCHOTHERAPY COMPLEX INTERACTIVE,153.0,99.45,17.24,153.0,68
CDM,90000005,PSYCHIATRIC DIAGNOSTIC EVALUATION,482.0,313.3,134.0,482.0,86
CDM,90000010,PSYCHIATRIC DIAGNOSTIC EVAL W/MEDICAL SERVICES,482.0,313.3,134.0,482.0,86
CDM,90000025,PSYCHOTHERAPY W/PATIENT 30 MINUTES,482.0,313.3,95.1,482.0,86
CDM,90000030,PSYCHOTHERAPY W/PATIENT 45 MINUTES,482.0,313.3,118.97,482.0,86
CDM,90000035,PSYCHOTHERAPY W/PATIENT 60 MINUTES,482.0,313.3,118.97,482.0,86
CDM,90000040,PSYCHOTHERAPY FOR CRISIS INITIAL 60 MINUTES,482.0,313.3,118.97,482.0,86
CDM,90000045,PSYCHOTHERAPY FOR CRISIS EACH ADDL 30 MINUTES,597.0,388.05,88.93,597.0,68
CDM,90000055,PROC PSYCH UNLISTD,57.0,37.05,15.85,110.12,84
CDM,90000065,MULTIPLE FAMILY GROUP PSYCHOTHERAPY,482.0,313.3,39.33,482.0,86
CDM,90000085,THERAP REPETITIVE TMS TX SUBSEQ DELIVERY & MNG,934.0,607.1,204.28,934.0,84
CDM,90000095,REPET TMS TX SUBSEQ MOTR THRESHLD W/DELIV & MN,934.0,607.1,204.28,934.0,84
CDM,90000105,PHARMACOLOGIC MGMT W/PSYTX,158.0,102.7,10.58,158.0,66
CDM,90000115,TCRANIAL MAGN STIM TX PLAN,934.0,607.1,204.28,934.0,84
CDM,90000155,ASSMT & CARE PLANNING PT W/COGNITIVE IMPAIRMENT,638.0,414.7,41.45,638.0,86
CDM,90000165,CARE MGMT SERVICES BEHAVIORAL HLTH COND 20 MINS,206.0,133.9,24.89,206.0,78
CDM,90000225,CANS ASSESSMENT,192.0,124.8,41.45,192.0,66
CDM,90000225OH,CANS ASSESSMENT,133.0,86.45,1.1,2720889.23,92
CDM,90000235,CRISIS MOBILE RESPONSE,477.0,310.05,103.99,477.0,66
CDM,90000235OH,CRISIS MOBILE RESPONSE,133.0,86.45,1.1,3060831.65,80
CDM,90000245,CRISIS MOBILE RESPONSE FU,140.0,91.0,30.52,140.0,66
CDM,90000245OH,CRISIS MOBILE RESPONSE FU,133.0,86.45,1.1,348.95,80
CDM,90000255,MRSS STABILIZATION SERVICE,35.0,22.75,7.63,183.88,66
CDM,90000255OH,MRSS STABILIZATION SERVICE,133.0,86.45,1.1,3060831.65,80
CDM,90000265,MOD CARE COOR FULL MONTH,415.0,269.75,90.47,415.0,58
CDM,90000265OH,MOD CARE COOR FULL MONTH,133.0,86.45,1.1,3060831.65,80
CDM,90000275,MOD CARE COOR PARTIAL MONTH,208.0,135.2,45.34,208.0,58
CDM,90000275OH,MOD CARE COOR PARTIAL MONTH,133.0,86.45,1.1,3060831.65,80
CDM,90000285,MULTI SYSTEMIC THERAPY FOR JUVENILES (MST),42.0,27.3,9.16,56.29,66
CDM,90000285OH,MULTI SYSTEMIC THERAPY FOR JUVENILES (MST),133.0,86.45,1.1,133.0,80
CDM,90000295,FUNCTIONAL FAMILY THERAPY FOR JUVENILES (FFT),35.0,22.75,7.63,35.0,58
CDM,90000295OH,FUNCTIONAL FAMILY THERAPY FOR JUVENILES (FFT),133.0,86.45,1.1,133.0,80
CDM,90000305,INTENSIVE HOME BASED TREATMENT,38.0,24.7,8.28,38.0,58
CDM,90000305OH,INTENSIVE HOME BASED TREATMENT,133.0,86.45,1.1,133.0,80
CDM,90000315,VIRTUAL PSYCHOTHERAPY FOR CRISIS INITIAL 60 MINUTES,482.0,313.3,118.97,482.0,86
CDM,90000325,VIRTUAL PSYCHOTHERAPY FOR CRISIS EACH ADDL 30 MINUTES,597.0,388.05,88.93,597.0,68
CDM,90000335,PRECUNEUS MAGNETIC STIMULATION TREATMENT PLNG,934.0,607.1,203.61,934.0,66
CDM,90000345,PRECUNEUS MAGNETIC STIMULATION TREATMENT DLVR,934.0,607.1,203.61,934.0,66
CDM,90100000,ELECTROCONVULSIVE THERAPY,1592.0,1034.8,139.72,1592.0,105
CDM,90281OH,IMMUNE GLOBULIN IG HUMAN IM USE,220.0,143.0,1.1,342.83,78
CDM,90371OH,HEPATITIS B IMMUNE GLOBULIN HBIG HUMAN IM,988.0,642.2,1.1,988.0,82
CDM,90375OH,RABIES IMMUNE GLOBULIN RIG HUMAN IM/SUBQ,2000.0,1300.0,1.1,2000.0,82
CDM,90376OH,RABIES IG HEAT-TREATED HUMAN IM/SUBQ,2397.0,1558.05,1.1,2397.0,82
CDM,90378OH,RESPIRATORY SYNCYTIAL VIRUS IG IM 50 MG E,4967.0,3228.55,1.1,5459.79,78
CDM,90380OH,RSV MONOCLONAL ANTB SEASONAL DOSE 0.5ML IM USE,2080.0,1352.0,1.1,2080.0,78
CDM,90381OH,RSV MONOCLONAL ANTB SEASONAL DOSE 1 ML IM USE,2080.0,1352.0,1.1,2080.0,78
CDM,90384OH,RHO(D) IMMUNE GLOBULIN HUMAN FULL-DOSE IM,303.0,196.95,1.1,336.71,78
CDM,90396OH,VARICELLA-ZOSTER IMMUNE GLOBULIN HUMAN IM,935.0,607.75,1.1,6905.62,78
CDM,90460OH,IMADM THROUGH 18YR ANY ROUTE 1ST VAC/TOXOID,96.0,62.4,1.1,96.0,142
CDM,90460VFCOH,VFC IM ADMIN/ONLY THRU 18,21.25,13.81,1.1,74.35,142
CDM,90461OH,IMADM THROUGH 18YR ANY ROUTE EA ADDL VAC/TOXOID,72.0,46.8,1.1,72.0,130
CDM,90470OH,H1N1 INFLUENZA VACC ADMIN W/COUNSELING,62.0,40.3,1.1,62.0,70
CDM,90471OH,IM ADM PRQ ID SUBQ/IM NJXS 1 VACCINE,68.0,44.2,1.1,205.09,142
CDM,90472OH,IM ADM PRQ ID SUBQ/IM NJXS EA VACCINE,60.0,39.0,1.1,60.0,142
CDM,90473OH,IM ADM INTRANSL/ORAL 1 VACCINE,68.0,44.2,1.1,205.09,142
CDM,90474OH,IM ADM INTRANSL/ORAL EA VACCINE,60.0,39.0,1.1,60.0,142
CDM,90480OH,ADMINISTRATION COVID VACCINE (2023-2024),293.0,190.45,1.1,293.0,88
CDM,90480VFCOH,VFC ADMINISTRATION COVID VACCINE,21.25,13.81,1.1,138.2,88
CDM,90481OH,IMM ADMN SARSCOV2 VACCINE EACH ADDL COMPONENT,286.0,185.9,1.1,286.0,68
CDM,90482OH,IMM CNSL PHYS/QHP IMM NOT ADMN SAME DOS 3<10 MIN,106.0,68.9,1.1,106.0,72
CDM,90483OH,IMM CNSL PHYS/QHP IMM NOT ADMN SM DOS>10<20 MIN,220.0,143.0,1.1,220.0,72
CDM,90484OH,IMM CNSL PHYS/QHP IMM NOT ADMN SAME DOS>20 MIN,330.0,214.5,1.1,330.0,72
CDM,90500010,FAM THERAPY W PATIENT DTOX,482.0,313.3,136.31,482.0,88
CDM,90589OH,CHIKUNGUNYA VIRUS VACCINE LIVE FOR IM USE,990.0,643.5,1.1,3060831.65,78
CDM,90593OH,"CHIKUNGUNYA VACCINE, RECOMBINANT (VIMKUNYA)",991.0,644.15,1.1,991.0,74
CDM,90610OH,INITIAL CONSULTATION;EXTENSIVE,77.0,50.05,1.1,77.0,68
CDM,90619OH,"MENINGOCOCCAL VACCINE, QUADRIVALENT (MENQUADFI)",617.0,401.05,1.1,617.0,74
CDM,90620OH,MENB RECOMBINANT PROT W/OUT MEMBR VESIC VACC IM,852.0,553.8,1.1,852.0,78
CDM,90621OH,MENB-FHBP RECOMBNT LIPOPROTEIN VACC 2/3 DOSE IM,604.0,392.6,1.1,658.12,78
CDM,90625OH,CHOLERA VACCINE ADULT 1 DOSE LIVE FOR ORAL USE,734.0,477.1,1.1,1010.13,74
CDM,90626OH,TICK-BORNE ENCEPH VACC INACTIVATED 0.25ML IM USE,304.0,197.6,1.1,3060831.65,78
CDM,90627OH,TICK-BORNE ENCEPH VACC INACTIVATED 0.5ML IM USE,304.0,197.6,1.1,911.34,78
CDM,90632OH,HEPA VACCINE ADULT DOSE FOR INTRAMUSCULAR USE,308.0,200.2,1.1,308.0,82
CDM,90633OH,HEPA VACCINE 2 DOSE SCHEDULE PED/ADOLESC IM USE,138.0,89.7,1.1,138.0,78
CDM,90634OH,HEPA VACCINE 3 DOSE SCHEDULE PED/ADOLESC IM USE,88.0,57.2,1.1,119.38,78
CDM,90636OH,HEPATITIS A & B VACCINE HEPA-HEPB ADULT IM,472.0,306.8,1.1,472.0,78
CDM,90647OH,HIB PRP-OMP VACCINE 3 DOSE SCHEDULE IM USE,108.0,70.2,1.1,108.0,78
CDM,90648OH,HIB PRP-T VACCINE 4 DOSE SCHEDULE IM USE,47.0,30.55,1.1,47.0,78
CDM,90649OH,4VHPV VACCINE 3 DOSE SCHEDULE FOR IM USE,442.0,287.3,1.1,593.83,78
CDM,90651OH,9VHPV VACC 2/3 DOSE SCHED IM USE,1106.0,718.9,1.1,1106.0,78
CDM,90655OH,IIV3 VACC PRESRV FREE 0.25 ML DOSAGE IM USE,22.0,14.3,1.1,122.44,78
CDM,90656OH,IIV3 VACC PRESERVATIVE FREE 0.5 ML DOSAGE IM USE,74.7,48.56,1.1,74.7,82
CDM,90657OH,IIV3 VACCINE SPLIT VIRUS 0.25 ML DOSAGE IM USE,24.0,15.6,1.1,58.16,78
CDM,90658OH,IIV3 VACCINE SPLIT VIRUS 0.5 ML DOSAGE IM USE,69.7,45.31,1.1,69.7,78
CDM,90660OH,LAIV3 VACCINE LIVE FOR INTRANASAL USE,62.9,40.89,1.1,87.35,78
CDM,90662OH,IIV VACCINE PRESERV FREE INCREASED AG CONTENT IM,203.3,132.15,1.1,288.59,82
CDM,90670OH,PCV13 VACCINE FOR INTRAMUSCULAR USE,814.0,529.1,1.1,814.0,82
CDM,90672OH,LAIV4 VACCINE FOR INTRANASAL USE,57.0,37.05,1.1,85.71,82
CDM,90673OH,RIV3 VACCINE PRESERVATIVE FREE FOR IM USE,284.6,184.99,1.1,288.59,78
CDM,90675OH,"RABIES VACCINE, IM",1491.0,969.15,1.1,1491.0,82
CDM,90676OH,"RABIES VACCINE, ID",456.0,296.4,1.1,854.02,78
CDM,90677OH,PCV20 VACCINE FOR INTRAMUSCULAR USE,1018.0,661.7,1.1,1018.0,78
CDM,90678AOH,"RSV VACCINE, BIVALENT (ABRYSVO)",1106.0,718.9,1.1,1106.0,78
CDM,90678OH,RSV VACCINE PREF SUBUNIT BIVALENT FOR IM USE,1106.0,718.9,1.1,1106.0,78
CDM,90679OH,"RSV VACCINE, ADJUVANTED (AREXVY)",363.0,235.95,1.1,1028.5,78
CDM,90680OH,RV5 VACCINE 3 DOSE SCHEDULE LIVE FOR ORAL USE,309.0,200.85,1.1,352.02,78
CDM,90681OH,RV1 VACCINE 2 DOSE SCHEDULE LIVE FOR ORAL USE,402.0,261.3,1.1,495.88,78
CDM,90682OH,RIV4 VACC RECOMBINANT DNA PRSRV ANTIBIO FREE IM,233.0,151.45,1.1,233.0,82
CDM,90685OH,IIV4 VACC PRSRV FREE 0.25 ML DOS FOR IM USE,34.0,22.1,1.1,70.4,78
CDM,90686OH,IIV4 VACC PRESRV FREE 0.5 ML DOS FOR IM USE,70.0,45.5,1.1,70.0,82
CDM,90687OH,IIV4 VACC SPLIT VIRUS 0.25 ML DOS FOR IM USE,33.0,21.45,1.1,33.0,82
CDM,90688OH,IIV4 VACC SPLIT VIRUS 0.5 ML DOS FOR IM USE,67.0,43.55,1.1,67.0,82
CDM,90689OH,IIV4 VACC INACTIVATED PRSRV FR 0.25ML DOS IM USE,44.0,28.6,1.1,52.04,68
CDM,90690OH,"TYPHOID VACCINE, ORAL",115.0,74.75,1.1,351.65,78
CDM,90691OH,TYPHOID VACCINE VI CAPSULAR POLYSACCHARIDE IM,441.0,286.65,1.1,484.6,82
CDM,90696OH,DTAP-IPV VACCINE CHILD 4-6 YRS FOR IM USE,210.0,136.5,1.1,210.0,78
CDM,90697OH,DTAP-IPV-HIB-HEPB VACCINE INTRAMUSCULAR,526.05,341.93,1.1,535.68,78
CDM,90698OH,DTAP-IPV/HIB VACCINE FOR INTRAMUSCULAR USE,370.0,240.5,1.1,375.0,78
CDM,90700AOH,DTAP 5 PERTUSSIS ANTIGENS VACC < 7 YR IM DAPTACEL LATEX FREE,102.0,66.3,1.1,102.0,78
CDM,90700OH,DIPHTH TETANUS TOX ACELL PERTUSSIS VACC<7 YR IM,102.0,66.3,1.1,102.0,78
CDM,90702OH,DT VACCINE YOUNGER THAN 7 YRS FOR IM USE,222.0,144.3,1.1,222.0,74
CDM,90707OH,MEASLES MUMPS RUBELLA VIRUS VACCINE LIVE SUBQ,336.0,218.4,1.1,336.0,78
CDM,90710OH,"MMR+VARICELLA,SQ-COMBINED VACCINE",992.0,644.8,1.1,992.0,78
CDM,90713OH,POLIOVIRUS VACCINE INACTIVATED SUBQ/IM,151.0,98.15,1.1,151.0,78
CDM,90714OH,TD VACCINE PRSRV FREE 7 YRS OR OLDER FOR IM USE,141.0,91.65,1.1,141.0,82
CDM,90715OH,TDAP VACCINE 7 YRS/> IM,170.0,110.5,1.1,170.0,82
CDM,90716OH,VAR VACCINE LIVE FOR SUBCUTANEOUS USE,657.0,427.05,1.1,657.0,78
CDM,90717OH,YELLOW FEVER VACCINE LIVE SUBQ,648.0,421.2,1.1,768.66,78
CDM,90723OH,DTAP-HEPB-IPV VACCINE INTRAMUSCULAR,312.0,202.8,1.1,336.71,78
CDM,90732OH,PPSV23 VACCINE 2 YRS OR OLDER FOR SUBQ/IM USE,423.0,274.95,1.1,423.0,82
CDM,90733OH,MPSV4 VACCINE GROUPS ACYW-135 SUBQ USE,344.0,223.6,1.1,422.42,78
CDM,90734OH,MENACWYD/MENACWY-CRM CONJ VACC GRPS ACWY IM USE,565.0,367.25,1.1,565.0,78
CDM,90736OH,ZOSTER VACCINE HZV LIVE FOR SUBCUTANEOUS USE,804.0,522.6,1.1,808.1,78
CDM,90739OH,HEPB VACCINE ADULT 2 DOSE SCHEDULE FOR IM USE,562.0,365.3,1.1,562.0,82
CDM,90740OH,HEPB VACCINE DIALYSIS/IMMUNSUP PAT 3 DOSE IM,258.0,167.7,1.1,483.39,82
CDM,90743OH,HEPB VACCINE ADOLESCENT 2 DOSE SCHEDULE IM,139.0,90.35,1.1,229.58,78
CDM,90744OH,HEPB VACCINE PED/ADOLESC 3 DOSE SCHEDULE IM,104.0,67.6,1.1,104.0,82
CDM,90746OH,HEPB VACCINE ADULT 3 DOSE SCHEDULE FOR IM USE,258.0,167.7,1.1,258.0,82
CDM,90747OH,HEPB VACCINE DIALYSIS/IMMUNSUP PAT 4 DOSE IM,230.0,149.5,1.1,483.39,82
CDM,90748OH,HIB-HEPB VACCINE FOR INTRAMUSCULAR USE,132.0,85.8,1.1,159.17,78
CDM,90749OH,UNLISTED VACCINE/TOXOID,635.0,412.75,0.01,635.0,80
CDM,90750OH,HZV ZOSTER VACC RECOMBINANT ADJUVANTED IM NJX,777.0,505.05,1.1,777.0,78
CDM,90759OH,HEP B VACC 3 AG 10 MCG 3 DOSE SCHED FOR IM USE,83.0,53.95,1.1,226.51,78
CDM,90760OH,"IV INFUSION, HYDRATION, 1ST HOUR",444.0,288.6,1.1,444.0,68
CDM,90761OH,"IV INFUSION, HYDRATION, EA ADD HOUR",427.0,277.55,1.1,427.0,68
CDM,90765OH,"IV INFUSION, THER/PROPH/DIAG, 1ST HOUR",476.0,309.4,1.1,476.0,68
CDM,90766OH,"IV INFUSION, THER/PROPH/DIAG, EA ADD HOUR",410.0,266.5,1.1,410.0,68
CDM,90767OH,"IV INFUSE, THER/PROPH/DIAG, ADDL SEQ INF, 1ST HR",443.0,287.95,1.1,443.0,68
CDM,90768OH,"IV INFUSION,THER/PROPH/DIAG, CONCURRENT INF",427.0,277.55,1.1,427.0,68
CDM,90775OH,"THER/PROPH/DIAG INJECTION, IV PUSH, EA ADD",277.0,180.05,1.1,277.0,68
CDM,90779OH,UNLISTED THER/PROP/DIAG INJECTION/INFUSION PROC,361.0,234.65,1.1,361.0,68
CDM,90785AOH,PSYCHOTHERAPY COMPLEX INTERACTIVE - VIRTUAL VISIT,145.0,94.25,1.1,145.0,156
CDM,90785OH,PSYCHOTHERAPY COMPLEX INTERACTIVE,145.0,94.25,1.1,145.0,156
CDM,90791OH,PSYCHIATRIC DIAGNOSTIC EVALUATION,1536.0,998.4,1.1,1536.0,154
CDM,90792OH,PSYCHIATRIC DIAGNOSTIC EVAL W/MEDICAL SERVICES,1664.0,1081.6,1.1,1664.0,152
CDM,90832OH,PSYCHOTHERAPY 30 MINUTES PATIENT,744.0,483.6,1.1,744.0,156
CDM,90833OH,PSYCHOTHERAPY PT&/FAMILY W/E&M SRVCS 30 MIN,656.0,426.4,1.1,656.0,152
CDM,90834OH,PSYCHOTHERAPY 45 MINUTES WITH PATIENT,980.0,637.0,1.1,980.0,156
CDM,90836OH,PSYCHOTHERAPY PT&/FAMILY W/E&M SRVCS 45 MIN,832.0,540.8,1.1,832.0,152
CDM,90837OH,PSYCHOTHERAPY 60 MINUTES WITH PATIENT,1452.0,943.8,1.1,1452.0,156
CDM,90838OH,PSYCHOTHERAPY PT&/FAMILY W/E&M SRVCS 60 MIN,1096.0,712.4,1.1,1096.0,152
CDM,90839OH,PSYCHOTHERAPY FOR CRISIS INITIAL 60 MINS,1509.0,980.85,1.1,1509.0,154
CDM,90840OH,PSYCHOTHERAPY FOR CRISIS EACH ADDL 30 MINUTES,722.0,469.3,1.1,722.0,154
CDM,90845OH,MEDICAL PSYCHOANALYSIS,920.0,598.0,1.1,920.0,148
CDM,90846OH,FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS,1052.0,683.8,1.1,1052.0,154
CDM,90847OH,FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS,1096.0,712.4,1.1,1096.0,156
CDM,90849OH,MULTIPLE FAMILY GROUP PSYCHOTHERAPY,260.0,169.0,1.1,465.27,156
CDM,90853OH,GROUP PSYCHOTHERAPY,260.0,169.0,1.1,260.19,156
CDM,90863OH,PHARMACOLOGIC MANAGEMENT W/PSYCHOTHERAPY,192.0,124.8,1.1,192.0,114
CDM,90867OH,REPET TMS TX INITIAL W/MAP/MOTR THRESHLD/DEL&M,584.0,379.6,1.1,1239.34,106
CDM,90868OH,THERAP REPETITIVE TMS TX SUBSEQ DELIVERY & MNG,584.0,379.6,1.1,915.24,106
CDM,90869OH,REPET TMS TX SUBSEQ MOTR THRESHLD W/DELIV & MNGT,584.0,379.6,1.1,1517.59,106
CDM,90870OH,ELECTROCONVULSIVE THERAPY,1000.0,650.0,1.1,1564.17,150
CDM,90875OH,INDIV PSYCHOPHYS BIOFEED TRAIN W/PSYTX 30 MIN,480.0,312.0,1.1,480.0,102
CDM,90876OH,INDIV PSYCHOPHYS BIOFEED TRAIN W/PSYTX 45 MIN,760.0,494.0,1.1,760.0,102
CDM,90880OH,MEDICAL HYPNOTHERAPY,876.0,569.4,1.1,876.0,136
CDM,90882OH,ENVIRONMENTAL IVNTJ MGMT PURPOSES PSYC PT,281.0,182.65,1.1,281.0,88
CDM,90885OH,PSYCHIATRIC EVAL HOSPITAL RECORDS DX PURPOSES,388.0,252.2,1.1,388.0,98
CDM,90887OH,INTERPJ/EXPLNAJ RESULTS PSYCHIATRIC EXAM FAMILY,592.0,384.8,1.1,592.0,104
CDM,90899AOH,UNKEPT APPT,75.0,48.75,0.01,82.65,90
CDM,90899RVUOH,OTHER,230.0,149.5,0.01,230.0,90
CDM,90901OH,"BIOFEEDBACK TRAINING,ANY MODALITY",180.0,117.0,1.1,212.43,142
CDM,90912OH,BFB TRAING W/EMG &AMP;/MANOMETRY 1ST 15 MIN CNTCT,396.0,257.4,1.1,396.0,134
CDM,90913OH,BFB TRAING W/EMG&AMP;/MANOMETRY EA ADDL 15 MIN CNTCT,220.0,143.0,1.1,220.0,134
CDM,90935OH,HEMODIALYSIS PROCEDURE W/ PHYS/QHP EVALUATION,651.0,423.15,1.1,2038.63,144
CDM,90937OH,HEMODIALYSIS PX REPEAT EVAL W/WO REVJ DIALYS RX,928.0,603.2,1.1,928.0,144
CDM,90945OH,DIALYSIS OTHER/THAN HEMODIALYSIS 1 PHYS/QHP EVAL,686.0,445.9,1.1,1291.74,144
CDM,90947OH,DIALYSIS OTH/THN HEMODIALY REPEAT PHYS/QHP EVALS,1008.0,655.2,1.1,1008.0,144
CDM,90951OH,ESRD RELATED SVC MONTHLY & <2 YR OLD 4/> VISITS,9568.0,6219.2,1.1,9568.0,144
CDM,90952OH,ESRD RELATED SVC MONTHLY <2 YR OLD 2/3 VISITS,3790.0,2463.5,1.1,3790.0,106
CDM,90953OH,ESRD RELATED SVC MONTHLY <2 YR OLD 1 VISIT,2370.0,1540.5,1.1,2370.0,106
CDM,90954OH,ESRD RELATED SVC MONTHLY 2-11 YR OLD 4/> VISITS,8344.0,5423.6,1.1,8344.0,144
CDM,90955OH,ESRD RELATED SVC MONTHLY 2-11 YR OLD 2/3 VISITS,4128.0,2683.2,1.1,4128.0,144
CDM,90956OH,ESRD RELATED SVC MONTHLY 2-11 YR OLD 1 VISIT,2656.0,1726.4,1.1,2656.0,144
CDM,90957OH,ESRD RELATED SVC MONTHLY 12-19 YR OLD 4/> VISITS,6184.0,4019.6,1.1,6184.0,144
CDM,90958OH,ESRD RELATED SVC MONTHLY 12-19 YR OLD 2/3 VISITS,3948.0,2566.2,1.1,3948.0,144
CDM,90959OH,ESRD RELATED SVC MONTHLY 12-19 YR OLD 1 VISIT,2476.0,1609.4,1.1,2476.0,144
CDM,90960OH,ESRD RELATED SVC MONTHLY 20&/> YR OLD 4/> VISITS,2708.0,1760.2,1.1,2708.0,144
CDM,90961OH,ESRD RELATED SVC MONTHLY 20/>YR OLD 2/3 VISITS,2208.0,1435.2,1.1,2208.0,144
CDM,90962OH,ESRD RELATED SVC MONTHLY 20&/>YR OLD 1 VISIT,1428.0,928.2,1.1,1428.0,144
CDM,90963OH,ESRD SVC HOME DIALYSIS FULL MONTH <2YR OLD,4836.0,3143.4,1.1,4836.0,144
CDM,90964OH,ESRD SVC HOME DIALYSIS FULL MONTH 2-11 YR OLD,4100.0,2665.0,1.1,4100.0,144
CDM,90965OH,ESRD SVC HOME DIALYSIS FULL MONTH 12-19 YR OLD,3920.0,2548.0,1.1,3920.0,144
CDM,90966OH,ESRD SVC HOME DIALYSIS FULL MONTH 20 YR OLD,2208.0,1435.2,1.1,2208.0,144
CDM,90967OH,ESRD RELATED SVC <FULL MONTH <2 YR OLD,140.0,91.0,1.1,140.0,144
CDM,90968OH,ESRD RELATED SVC <FULL MONTH 2-11 YR OLD,136.0,88.4,1.1,136.0,144
CDM,90969OH,ESRD RELATED SVC <FULL MONTH 12-19 YR OLD,132.0,85.8,1.1,132.0,144
CDM,90970OH,ESRD RELATED SVC <FULL MONTH 20/>YR OLD,72.0,46.8,1.1,72.0,144
CDM,90989OH,DIALYSIS TRAINING PATIENT COMPLETED COURSE,2512.0,1632.8,1.1,2512.0,88
CDM,90993OH,DIALYSIS TRAINING PATIENT PER TRAINING SESSION,534.0,347.1,1.1,534.0,88
CDM,91010OH,ESOPHAGEAL MOTILITY STUDY W/INTERP&RPT,3004.0,1952.6,1.1,3004.0,144
CDM,91010OH-26,ESOPHAGEAL MOTILITY STUDY W/INTERP&RPT,563.0,365.95,1.1,563.0,126
CDM,91010OH-TC,ESOPHAGEAL MOTILITY STUDY W/INTERP&RPT,2441.0,1586.65,1.1,2441.0,126
CDM,91020OH,GASTRIC MOTILITY MANOMETRIC STUDIES,3017.0,1961.05,1.1,3017.0,144
CDM,91020OH-26,GASTRIC MOTILITY MANOMETRIC STUDIES,576.0,374.4,1.1,576.0,126
CDM,91020OH-TC,GASTRIC MOTILITY MANOMETRIC STUDIES,2441.0,1586.65,1.1,2441.0,126
CDM,91022OH,DUODENAL MOTILITY MANOMETRIC STUDY,3017.0,1961.05,1.1,3017.0,144
CDM,91022OH-26,DUODENAL MOTILITY MANOMETRIC STUDY,576.0,374.4,1.1,576.0,126
CDM,91022OH-TC,DUODENAL MOTILITY MANOMETRIC STUDY,2441.0,1586.65,1.1,2441.0,126
CDM,91030OH,ESOPHAGUS ACID PERFUSION TEST ESOPHAGITIS,2805.0,1823.25,1.1,2805.0,144
CDM,91030OH-26,ESOPHAGUS ACID PERFUSION TEST ESOPHAGITIS,364.0,236.6,1.1,364.0,126
CDM,91030OH-TC,ESOPHAGUS ACID PERFUSION TEST ESOPHAGITIS,2441.0,1586.65,1.1,2441.0,126
CDM,91034OH,GASTROESOPHAG REFLX TEST W/CATH PH ELTRD PLCMT,2829.0,1838.85,1.1,2829.0,144
CDM,91034OH-26,GASTROESOPHAG REFLX TEST W/CATH PH ELTRD PLCMT,388.0,252.2,1.1,388.0,126
CDM,91034OH-TC,GASTROESOPHAG REFLX TEST W/CATH PH ELTRD PLCMT,2441.0,1586.65,1.1,2441.0,126
CDM,91035OH,GASTROESOPHAG REFLX TEST W/TELEMTRY PH ELTRD,3141.0,2041.65,1.1,3141.0,144
CDM,91035OH-26,GASTROESOPHAG REFLX TEST W/TELEMTRY PH ELTRD,700.0,455.0,1.1,700.0,126
CDM,91035OH-TC,GASTROESOPHAG REFLX TEST W/TELEMTRY PH ELTRD,2441.0,1586.65,1.1,2441.0,126
CDM,91037OH,GASTROESOPHAG REFLX TEST W/INTRLUML IMPED ELTRD,1820.0,1183.0,1.1,1820.0,144
CDM,91037OH-26,GASTROESOPHAG REFLX TEST W/INTRLUML IMPED ELTRD,388.0,252.2,1.1,388.0,126
CDM,91037OH-TC,GASTROESOPHAG REFLX TEST W/INTRLUML IMPED ELTRD,1432.0,930.8,1.1,1432.0,126
CDM,91038OH,ESOPHGL FUNCJ G-ESOP RFLX IMPD ELTRD PROLNG,2881.0,1872.65,1.1,2881.0,144
CDM,91038OH-26,ESOPHGL FUNCJ G-ESOP RFLX IMPD ELTRD PROLNG,440.0,286.0,1.1,440.0,126
CDM,91038OH-TC,ESOPHGL FUNCJ G-ESOP RFLX IMPD ELTRD PROLNG,2441.0,1586.65,1.1,2441.0,126
CDM,91040OH,ESOPHGL BALO DISTENSION DX STD W/PROVOCATION,2829.0,1838.85,1.1,2829.0,144
CDM,91040OH-26,ESOPHGL BALO DISTENSION DX STD W/PROVOCATION,388.0,252.2,1.1,388.0,126
CDM,91040OH-TC,ESOPHGL BALO DISTENSION DX STD W/PROVOCATION,2441.0,1586.65,1.1,2441.0,126
CDM,91065OH,BREATH HYDROGEN/METHANE TEST,808.0,525.2,1.1,808.0,144
CDM,91065OH-26,BREATH HYDROGEN/METHANE TEST,88.0,57.2,1.1,88.0,126
CDM,91065OH-TC,BREATH HYDROGEN/METHANE TEST,720.0,468.0,1.1,720.0,126
CDM,91110OH,GI TRC IMG INTRALUMINAL ESOPHAGUS-ILEUM W/I&R,5299.0,3444.35,1.1,5299.0,144
CDM,91110OH-26,GI TRC IMG INTRALUMINAL ESOPHAGUS-ILEUM W/I&R,986.0,640.9,1.1,986.0,126
CDM,91110OH-TC,GI TRC IMG INTRALUMINAL ESOPHAGUS-ILEUM W/I&R,4313.0,2803.45,1.1,4313.0,126
CDM,91111OH,GI TRACT IMAGING INTRALUMINAL ESOPHAGUS WI&R,4709.0,3060.85,1.1,4709.0,144
CDM,91111OH-26,GI TRACT IMAGING INTRALUMINAL ESOPHAGUS WI&R,396.0,257.4,1.1,396.0,126
CDM,91111OH-TC,GI TRACT IMAGING INTRALUMINAL ESOPHAGUS WI&R,4313.0,2803.45,1.1,4313.0,126
CDM,91112OH,GI TRANSIT & PRES MEAS WIRELESS CAPSULE W/INTERP,5237.0,3404.05,1.1,5301.67,144
CDM,91112OH-26,GI TRANSIT & PRES MEAS WIRELESS CAPSULE W/INTERP,924.0,600.6,1.1,924.0,126
CDM,91112OH-TC,GI TRANSIT & PRES MEAS WIRELESS CAPSULE W/INTERP,4313.0,2803.45,1.1,4947.61,126
CDM,91113OH,GI TRACT IMAGING INTRALUMINAL COLON I&R,5158.0,3352.7,1.1,5158.0,144
CDM,91113OH-26,GI TRACT IMAGING INTRALUMINAL COLON I&R,964.0,626.6,1.1,964.0,126
CDM,91113OH-TC,GI TRACT IMAGING INTRALUMINAL COLON I&R,4194.0,2726.1,1.1,4194.0,126
CDM,91117OH,COLON MOTILITY STDY MIN 6 HR CONT RECORD W/I&R,980.0,637.0,1.1,980.0,144
CDM,91124OH,RECTAL SENSATION TONE&COMPLIANCE STUDY,2864.0,1861.6,1.1,2864.0,106
CDM,91124OH-26,RECTAL SENSATION TONE&COMPLIANCE STUDY,1342.0,872.3,1.1,1342.0,106
CDM,91124OH-TC,RECTAL SENSATION TONE&COMPLIANCE STUDY,1522.0,989.3,1.1,1542.47,106
CDM,91125OH,ANRCT MANO RCT SENSATION&RCT BALO EXPULSION TEST,2942.0,1912.3,1.1,2942.0,106
CDM,91125OH-26,ANRCT MANO RCT SENSATION&RCT BALO EXPULSION TEST,1188.0,772.2,1.1,1188.0,106
CDM,91125OH-TC,ANRCT MANO RCT SENSATION&RCT BALO EXPULSION TEST,1754.0,1140.1,1.1,1754.0,106
CDM,91132OH,ELECTROGASTROGRAPHY DX TRANSCUTANEOUS,1640.0,1066.0,1.1,1640.0,142
CDM,91132OH-26,ELECTROGASTROGRAPHY DX TRANSCUTANEOUS,208.0,135.2,1.1,208.0,126
CDM,91132OH-TC,ELECTROGASTROGRAPHY DX TRANSCUTANEOUS,1432.0,930.8,1.1,1432.0,126
CDM,91133OH,ELECTROGASTROGRAPHY DX TRANSCUT W/PROVOCTVE TSTG,857.0,557.05,1.1,1508.71,142
CDM,91133OH-26,ELECTROGASTROGRAPHY DX TRANSCUT W/PROVOCTVE TSTG,264.0,171.6,1.1,264.0,126
CDM,91133OH-TC,ELECTROGASTROGRAPHY DX TRANSCUT W/PROVOCTVE TSTG,593.0,385.45,1.1,1397.97,126
CDM,91200055,PARTIAL HOSPITALIZATION SERV,532.0,345.8,115.98,532.0,66
CDM,91200OH,LIVER ELASTOGRAPHY W/O IMAG W/I&R,812.0,527.8,1.1,812.0,144
CDM,91200OH-26,LIVER ELASTOGRAPHY W/O IMAG W/I&R,92.0,59.8,1.1,92.0,126
CDM,91200OH-TC,LIVER ELASTOGRAPHY W/O IMAG W/I&R,720.0,468.0,1.1,720.0,126
CDM,91318OH,PFIZER-BIONTECH COVID-19 VACCINE (2023-24 SEASON) AGE 6 MO - 4 Y,140.0,91.0,1.1,202.03,78
CDM,91319OH,PFIZER-BIONTECH COVID-19 VACCINE (2023-24 SEASON)?AGE 5 YR - 11,278.0,180.7,1.1,278.71,78
CDM,91320OH,SARSCOV2 VACC 30MCG/0.3ML TRIS-SUCROSE IM USE,493.0,320.45,1.1,495.01,78
CDM,91321OH,SARSCOV2 VACCINE 25 MCG/0.25 ML FOR IM USE,465.4,302.51,1.1,465.4,78
CDM,91400000,PSYCHOTHERAPY COMPLEX INTERACTIVE,153.0,99.45,17.24,153.0,68
CDM,91400025,PSYCHOTHERAPY W/PATIENT 30 MINUTES,482.0,313.3,95.1,482.0,86
CDM,91400030,PSYCHOTHERAPY W/PATIENT W/E&M SRVCS 30 MIN,162.0,105.3,35.32,162.0,68
CDM,91400035,PSYCHOTHERAPY W/PATIENT 45 MINUTES,482.0,313.3,118.97,482.0,86
CDM,91400040,PSYCHOTHERAPY W/PATIENT W/E&M SRVCS 45 MIN,189.0,122.85,41.2,189.0,68
CDM,91400045,PSYCHOTHERAPY W/PATIENT 60 MINUTES,482.0,313.3,118.97,482.0,86
CDM,91400050,PSYCHOTHERAPY W/PATIENT W/E&M SRVCS 60 MIN,197.0,128.05,42.95,197.0,68
CDM,91400055,INDIV PSYCHOPHYS BIOFEED TRAIN W/PSYTX 30 MIN,373.0,242.45,81.31,373.0,66
CDM,91400065,INDIV PSYCHOPHYS BIOFEED TRAIN W/PSYTX 45 MIN,445.0,289.25,97.01,445.0,66
CDM,91400125,PSYCHOTHERAPY W/PATIENT 60 MINUTES,482.0,313.3,118.97,482.0,86
CDM,91400205,TEAM CONFERENCE FACE-TO-FACE NONPHYSICIAN,269.0,174.85,21.85,269.0,66
CDM,91400215,TEAM CONFERENCE NON-FACE-TO-FACE NONPHYSICIAN,237.0,154.05,21.85,237.0,66
CDM,91400225,ADAPTIVE BEHAVIOR TX BY PROTOCOL TECH EA 15 MIN,425.0,276.25,77.33,425.0,84
CDM,91400235,ADAPT BHV TX PRTCL MODIFICAJ PHYS/QHP EA 15 MIN,739.0,480.35,138.32,739.0,84
CDM,91400245,HEALTH & WELL-BEING COACHING F2F INDIV 1ST ASSMT,92.0,59.8,20.06,92.0,66
CDM,91400255,HEALTH & WELL-BEING COACHING F2F INDIV F-UP SESS,92.0,59.8,20.06,92.0,66
CDM,91400265,HEALTH BEHAVIOR ASSESSMENT/RE-ASSESSMENT,278.0,180.7,77.28,278.0,86
CDM,91400275,HEALTH BEHAVIOR IVNTJ INDIV F2F 1ST 30 MIN,482.0,313.3,82.51,482.0,86
CDM,91400285,HEALTH BEHAVIOR IVNTJ INDIV F2F EA ADDL 15 MIN,192.0,124.8,27.86,192.0,68
CDM,91400295,CONT IP MNTR&IVNTJ PSYCHEDELIC MED THERAPY 1ST,355.0,230.75,77.39,355.0,66
CDM,91400305,CONT IP MNTR&IVNTJ PSYCHEDELIC MED THERAPY 2ND,355.0,230.75,77.39,355.0,66
CDM,91400315,CONT IP MNTR&IVNTJ PSYCHEDELIC MED THERAPY STAFF,355.0,230.75,77.39,355.0,66
CDM,91500000,GROUP THERAPY,278.0,180.7,33.67,278.0,86
CDM,91500135,PSYCHOTHERAPY COMPLEX INTERACTIVE,153.0,99.45,17.24,153.0,68
CDM,91500155,GROUP ADAPTIVE BHV TX BY PROTOCOL TECH EA 15 MIN,137.0,89.05,24.89,210.73,84
CDM,91500165,GRP ADAPT BHV PRTCL MODIFCAJ PHYS/QHP EA 15 MIN,137.0,89.05,24.89,210.73,84
CDM,91500185,HEALTH & WELL-BEING COACHING FACE TO FACE GROUP,89.0,57.85,19.4,89.0,66
CDM,91500195,HEALTH BEHAVIOR IVNTJ GROUP F2F 1ST 30 MIN,89.0,57.85,12.77,152.57,86
CDM,91500205,HEALTH BEHAVIOR IVNTJ GROUP F2F EA ADDL 15 MIN,89.0,57.85,5.62,89.0,68
CDM,91500225,VIRTUAL VISIT MH IOP GROUP THERAPY,278.0,180.7,33.67,278.0,86
CDM,91600000,FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS,482.0,313.3,134.0,482.0,86
CDM,91600005,FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS,482.0,313.3,134.0,482.0,86
CDM,91600035,MULTIPLE FAMILY GROUP PSYCHOTHERAPY,482.0,313.3,39.33,482.0,86
CDM,91600045,FAMILY ADAPT BHV TX GDN PHYS/QHP EA 15 MIN,137.0,89.05,24.89,210.73,84
CDM,91600055,MULTIPLE FAM GROUP BHV TX GDN PHYS/QHP EA 15 MIN,137.0,89.05,24.89,210.73,84
CDM,91600065,HEALTH BEHAVIOR IVNTJ FAM W/PT F2F 1ST 30 MIN,89.0,57.85,24.74,183.88,86
CDM,91600075,HEALTH BEHAVIOR IVNTJ FAM W/PT F2F EA ADD 15 MIN,89.0,57.85,19.4,89.0,68
CDM,91600085,HEALTH BEHAVIOR IVNTJ FAM W/O PT F2F 1ST 30 MIN,141.0,91.65,30.74,183.88,66
CDM,91600095,HEALTH BEHAVIOR IVNTJ FAM W/O PT F2F EA ADDL 15,70.0,45.5,15.26,73.83,66
CDM,91600105,MLT FAM GROUP BHV MGMT/MODIFICAJ TRAING 1ST 60,245.0,159.25,24.57,245.0,85
CDM,91600115,MLT FAM GROUP BHV MGMT/MODIFICAJ TRAING EA ADDL,59.0,38.35,6.91,152.57,85
CDM,91700015,BIOFEEDBACK TRAINING ANY MODALITY,319.0,207.35,23.22,319.0,85
CDM,91700025,INDIV PSYCHOPHYS BIOFEED TRAIN W/PSYTX 30 MIN,373.0,242.45,81.31,373.0,66
CDM,91700035,INDIV PSYCHOPHYS BIOFEED TRAIN W/PSYTX 45 MIN,445.0,289.25,97.01,445.0,66
CDM,91700045,BFB TRAING W/EMG &/MANOMETRY 1ST 15 MIN CNTCT,267.0,173.55,52.06,267.0,85
CDM,91700055,BFB TRAING W/EMG&/MANOMETRY EA ADDL 15 MIN CNTCT,267.0,173.55,29.16,267.0,85
CDM,91800015,DEVELOPMENTAL SCREEN W/SCORING & DOC STD INSTRM,316.0,205.4,68.89,316.0,66
CDM,91800025,NEUROBEHAVIORAL STATUS XM PHYS/QHP 1ST HOUR,2149.0,1396.85,102.83,2149.0,86
CDM,91800055,BEHAV ASSMT W/SCORE & DOCD/STAND INSTRUMENT,66.0,42.9,6.18,66.0,86
CDM,91800065,STANDARDIZED COGNITIVE PERFORMANCE TESTING,662.0,430.3,129.95,662.0,85
CDM,91800075,DEVELOPMENTAL TST ADMIN PHYS/QHP 1ST HOUR,1080.0,702.0,121.73,1080.0,86
CDM,91800085,DEVELOPMENTAL TST ADMIN PHYS/QHP EA ADDL 30 MIN,302.0,196.3,64.36,302.0,68
CDM,91800095,NEUROBEHAVIORAL STATUS XM PHYS/QHP EA ADDL HOUR,390.0,253.5,85.02,390.0,68
CDM,91800105,PSYCHOLOGICAL TST EVAL SVC PHYS/QHP FIRST HOUR,934.0,607.1,141.65,934.0,86
CDM,91800115,PSYCHOLOGICAL TST EVAL SVC PHYS/QHP EA ADDL HOUR,390.0,253.5,85.02,390.0,68
CDM,91800125,NEUROPSYCHOLOGICAL TST EVAL PHYS/QHP 1ST HOUR,1592.0,1034.8,140.93,1592.0,86
CDM,91800135,NEUROPSYCHOLOGICAL TST EVAL PHYS/QHP EA ADDL HR,390.0,253.5,85.02,390.0,68
CDM,91800145,PSYL/NRPSYCL TST PHYS/QHP 2+ TST 1ST 30 MIN,387.0,251.55,30.41,387.0,86
CDM,91800155,PSYCL/NRPSYCL TST PHYS/QHP 2+ TST EA ADDL 30 MIN,390.0,253.5,24.11,390.0,68
CDM,91800165,PSYCL/NRPSYCL TST TECH 2+ TST 1ST 30 MIN,1197.0,778.05,45.32,1197.0,86
CDM,91800175,PSYCL/NRPSYCL TST TECH 2+ TST EA ADDL 30 MIN,390.0,253.5,45.32,390.0,68
CDM,91800185,PSYCL/NRPSYCL TST ELEC PLATFORM AUTO RESULT,73.0,47.45,3.0,238.95,86
CDM,91800195,BEHAVIOR ID ASSESSMENT BY PHYS/QHP EA 15 MIN,425.0,276.25,77.33,425.0,84
CDM,91800205,BEHAVIOR ID SUPPORT ASSMT BY 1 TECH EA 15 MIN,425.0,276.25,77.33,425.0,84
CDM,91800245,HEALTH BEHAVIOR ASSESSMENT/RE-ASSESSMENT,278.0,180.7,77.28,278.0,86
CDM,91800255,HEALTH BEHAVIOR IVNTJ INDIV F2F 1ST 30 MIN,482.0,313.3,82.51,482.0,86
CDM,91800265,HEALTH BEHAVIOR IVNTJ INDIV F2F EA ADDL 15 MIN,192.0,124.8,27.86,192.0,68
CDM,91800275,HEALTH BEHAVIOR IVNTJ GROUP F2F 1ST 30 MIN,89.0,57.85,12.77,152.57,86
CDM,91800285,HEALTH BEHAVIOR IVNTJ GROUP F2F EA ADDL 15 MIN,89.0,57.85,5.62,89.0,68
CDM,91800295,HEALTH BEHAVIOR IVNTJ FAM W/PT F2F 1ST 30 MIN,89.0,57.85,24.74,183.88,86
CDM,91800305,HEALTH BEHAVIOR IVNTJ FAM W/PT F2F EA ADD 15 MIN,89.0,57.85,19.4,89.0,68
CDM,91800315,HEALTH BEHAVIOR IVNTJ FAM W/O PT F2F 1ST 30 MIN,141.0,91.65,30.74,183.88,66
CDM,91800325,HEALTH BEHAVIOR IVNTJ FAM W/O PT F2F EA ADDL 15,70.0,45.5,15.26,73.83,66
CDM,91800335,THER IVNTJ COG FUNCJ CNTCT 1ST 15 MINUTES,205.0,133.25,28.08,205.0,85
CDM,91800345,THER IVNTJ COG FUNCJ CNTCT EA ADDL 15 MINUTES,205.0,133.25,26.54,205.0,85
CDM,91800355,VIRTUAL BRIEF EMOTIONAL/BEHAV ASSMT,66.0,42.9,6.18,66.0,86
CDM,91800365,PT-FOCUSED HLTH RISK ASSMT SCORE DOC STND INSTRM,89.0,57.85,4.23,89.0,86
CDM,91900000,PRENATAL RISK ASSESSMENT,90.0,58.5,19.62,148.26,66
CDM,91900045,1ST PSYCHIATRIC COLLAB CARE MGMT 1ST 70 MINS,638.0,414.7,77.33,638.0,78
CDM,91900055,SBSQ PSYCHIATRIC COLLAB CARE MGMT 1ST 60 MINS,638.0,414.7,85.75,638.0,78
CDM,92000005,COMPLEX UROFLOMETRY,1432.0,930.8,17.48,1432.0,86
CDM,92000025,VOID PRESSURE STUDIES INTRAABDOMINAL,1135.0,737.75,0.01,3443.0,68
CDM,92000035,NOCTURNAL PENILE TUMESCENCE &/RIGIDITY TEST,1119.0,727.35,49.68,3443.0,86
CDM,92000040,SHORT-LATENCY SOMATOSENS EP STD UPR LIMBS,2149.0,1396.85,204.28,2149.0,86
CDM,92000045,FETAL NONSTRESS TEST,805.0,523.25,59.72,805.0,86
CDM,92000055,DETERMINATION REFRACTIVE STATE,15.0,9.75,3.27,73.83,66
CDM,92000060,SHORT-LATENCY SOMATOSENS EP STD LWR LIMBS,2149.0,1396.85,188.64,2149.0,86
CDM,92000065,GONIOSCOPY SEPARATE PROCEDURE,593.0,385.45,22.49,593.0,86
CDM,92000075,COMPUTERIZED CORNEAL TOPOGRAPHY UNI/BI,273.0,177.45,46.8,273.0,86
CDM,92000080,CTR MOTOR EP STD TRANSCRNL MOTOR STIMJ UPR LIMBS,7020.0,4563.0,320.22,7020.0,86
CDM,92000085,SENSORMOTOR XM W/MLT MEAS OCULAR DEVIJ W/I&R SPX,273.0,177.45,48.64,273.0,86
CDM,92000095,VISUAL FIELD XM UNI/BI W/INTERPRETJ LIMITED EXAM,273.0,177.45,43.12,273.0,86
CDM,92000100,CTR MOTOR EP STD TRANSCRNL MOTOR STIMJ LWR LIMBS,3661.0,2379.65,324.27,3661.0,86
CDM,92000105,VISUAL FIELD XM UNI/BI W/INTERP INTERMED EXAM,273.0,177.45,48.64,273.0,86
CDM,92000115,VISUAL FIELD XM UNI/BI W/INTERP EXTENDED EXAM,593.0,385.45,48.64,593.0,86
CDM,92000120,ORBICULARIS OCULI REFLX ELECTRODIAGNOSTIC TEST,410.0,266.5,48.64,410.0,86
CDM,92000130,ELEC ALYS IMPLT NPGT PHYS/QHP W/O PROGRAMMING,889.0,577.85,21.64,889.0,86
CDM,92000135,CPTRIZED OPH DX IMG ANTERIOR SEGMENT UNI/BI,273.0,177.45,39.16,273.0,86
CDM,92000140,ELEC ALYS IMPLT NPGT SMPL SP/PN NPGT PRGRMG,633.0,411.45,46.77,4392.0,87
CDM,92000145,CPTRIZED OPH DX IMG PST SEGMENT UNI/BI OPTIC NRV,273.0,177.45,40.38,273.0,86
CDM,92000150,ELEC ALYS IMPLT NPGT CPLX SP/PN PRGRMG,633.0,411.45,47.77,633.0,86
CDM,92000155,CPTRIZED OPH DX IMG PST SEGMENT UNI/BI RETINA,273.0,177.45,43.16,273.0,86
CDM,92000175,OPH BMTRY PRTL COHER INTRFRMTRY IO LENS PWR CAL,593.0,385.45,47.73,593.0,86
CDM,92000205,FLUORESCEIN ANGRPH W/MULTIFRAME I&R UNI/BI,1432.0,930.8,198.21,1432.0,86
CDM,92000215,INDOCYANINE-GREEN ANGRPH W/MULTIFRAME I&R UNI/BI,1432.0,930.8,198.21,1432.0,86
CDM,92000225,FUNDUS PHOTOGRAPHY W/INTERPRETATION & REPORT,593.0,385.45,47.2,593.0,86
CDM,92000240,SHORT-LATENCY SOMATOSENS EP STD UPR & LOW LIMB,3661.0,2379.65,391.75,3661.0,86
CDM,92000250,CTR MOTR EP STD TRANSCRNL MOTR STIM UPR&LOW LI,7020.0,4563.0,391.75,7020.0,86
CDM,92000255,COLOR VISION XM EXTENDED ANOMALOSCOPE/EQUIV,273.0,177.45,48.64,273.0,86
CDM,92000260,ELEC ALYS NSTIM PLS GEN GASTRIC INTRAOP W/PRGRMG,460.0,299.0,52.18,460.0,68
CDM,92000270,XTRNL OCULAR PHOTOG W/I&R DOCMT MEDICAL PROGRE,181.0,117.65,31.77,181.0,86
CDM,92000275,ANT SGM IMAGING W/MICROSCOPY ENDOTHELIAL ANALY,593.0,385.45,47.73,593.0,86
CDM,92000285,NASOPHARYNGOSCOPY W/ENDOSCOPE SPX,777.0,505.05,42.75,3443.0,86
CDM,92000290,BIOMPEDANCE-DERIVED PHYSIOLOGIC CV ANALYSIS,741.0,481.65,37.77,741.0,86
CDM,92000295,AMBULATORY BP MNTR W/SW 24 HR+ RECORDING ONLY,741.0,481.65,31.67,741.0,86
CDM,92000305,SPHYGMOCOR/UNLST CV,243.0,157.95,23.5,243.0,84
CDM,92000310,NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 2 LEVEL,741.0,481.65,97.71,741.0,86
CDM,92000315,CONT GLUC MNTR PHYSICIAN/QHP PROVIDED EQUIPMENT,515.0,334.75,86.64,515.0,86
CDM,92000330,TSTG ANS FUNCJ CARDIOVAGAL INNERVAJ PARASYMP,1080.0,702.0,112.56,1080.0,86
CDM,92000335,TSTG ANS FUNCJ VASOMOTOR ADRENERGIC INNERVAJ,889.0,577.85,110.82,889.0,86
CDM,92000340,TESTING AUTONOMIC NERVOUS SYSTEM FUNCTION,889.0,577.85,110.82,889.0,86
CDM,92000345,TSTG ANS FUNCJ PARASYMP&SYMP W/5 MIN PASIVE TILT,2149.0,1396.85,190.73,2149.0,86
CDM,92000350,VISUAL EP TESTING CNS EXCEPT GLAUCOMA W/I&R,2149.0,1396.85,90.5,2149.0,86
CDM,92000370,TEST SELECT & ADMN FUNCTL BRAIN MAP PHYS/QHP,8496.0,5522.4,206.37,8496.0,66
CDM,92000375,WHOLE BODY INTEGUMENTARY PHOTOGRAPHY,176.0,114.4,38.37,469.67,68
CDM,92000380,SCREENING TEST VISUAL ACUITY QUANTITATIVE BILAT,180.0,117.0,39.24,180.0,66
CDM,92000420,XM VIRTUAL - SINGLE INDIVIDUAL,425.0,276.25,16.16,425.0,86
CDM,92000425,VISUAL EP TESTING CNS EXCEPT GLAUCOMA W/I&R,2149.0,1396.85,90.5,2149.0,86
CDM,92000505,CORNEA HYSTERESIS DETERMIN IMPULSE STIMJ UNI/BI,273.0,177.45,16.66,273.0,86
CDM,92000515,SMELL TEST,63.0,40.95,17.51,124.64,84
CDM,92000525,ART PRESS WAVEFORM ANALYS CENTRAL ART PRESSURE,141.0,91.65,20.12,141.0,86
CDM,92000535,AMBULATORY BP MNTR W/SW 24 HR+ SCANNING A/R,741.0,481.65,7.7,741.0,86
CDM,92000575,STIMULUS EVOKED RESPONSE,273.0,177.45,53.07,453.61,86
CDM,92000595,FLUORESCEIN ICG ANGRPH W/MULTIFRAME I&R UNI/BI,1432.0,930.8,198.21,1432.0,86
CDM,92000665,ANT SGM IMAGING W/FLUOROSCEIN ANGIO & I&R,593.0,385.45,47.73,593.0,86
CDM,92000675,BIS EXTRACELLULAR FLUID ALYS LYMPHEDEMA ASSMNT,900.0,585.0,86.64,900.0,86
CDM,92000685,CONT GLUC MONITORING PATIENT PROVIDED EQUIPMENT,238.0,154.7,39.1,238.0,86
CDM,92000705,DUPLEX SCAN EXTRACRANIAL ART UNI/LMTD STUDY,611.0,397.15,95.38,611.0,86
CDM,92000765,MULTIFOCAL ELECTRORETINOGRAPHY W/I&R,720.0,468.0,48.64,720.0,86
CDM,92000775,ELEC ALYS IMPLT SMPL CN NPGT PRGRMG,257.0,167.05,32.72,257.0,86
CDM,92000785,ELEC ALYS IMPLT CPLX CN NPGT PRGRMG,633.0,411.45,57.61,633.0,86
CDM,92000795,FULL FIELD ELECTRORETINOGRAPHY W/I&R,1432.0,930.8,48.64,1432.0,86
CDM,92000805,ELEC ALYS IMPLT SMPL CN NPGT PRGRMG,257.0,167.05,32.72,257.0,86
CDM,92000815,ELEC ALYS IMPLT CPLX CN NPGT PRGRMG,633.0,411.45,57.61,633.0,86
CDM,92000825,ELEC ALYS IMPLT BRN NPGT PRGRMG 1ST 15 MIN,633.0,411.45,56.67,633.0,86
CDM,92000835,ELEC ALYS IMPLT BRN NPGT PRGRMG EA ADDL 15 MIN,359.0,233.35,49.91,359.0,68
CDM,92000845,ELEC ALYS NSTIM GEN GASTRIC SBSQ W/O REPRGRMG,410.0,266.5,20.97,410.0,86
CDM,92000855,ELEC ALYS NSTIM PLS GEN GASTRIC SBSQ W/REPRGRMG,257.0,167.05,22.84,257.0,86
CDM,92000865,ELEC ALYS SMPL PRGRMG IINS BLDR DYSF PTN 1-3,367.0,238.55,83.98,367.0,84
CDM,92000875,ELEC ALYS CPLX PRGRMG IINS BLDR DYSF PTN 4+,367.0,238.55,83.98,367.0,84
CDM,92000895,ELECTRO-OCULOGRAPY W/INTERPRETATION & REPORT,593.0,385.45,48.64,593.0,86
CDM,92000905,PATTERN ELECTRORETINOGRAPHY W/I&R,1246.0,809.9,48.64,1246.0,86
CDM,92000915,IMG RETINA DETCJ/MNTR DS POC AUTO A/R UNI/BI,273.0,177.45,47.73,273.0,86
CDM,92000945,AEP THRESHOLD ESTIMATION MLT FREQUENCIES I&R,1246.0,809.9,134.62,1246.0,86
CDM,92000955,AEP NEURODIAGNOSTIC INTERPRETATION AND REPORT,1246.0,809.9,102.77,1246.0,86
CDM,92000975,DARK ADAPTATION XM W/INTERPRETATION & REPORT,1836.0,1193.4,43.97,1836.0,86
CDM,92001065,INSTRUMENT BASED OCULAR SCR BI W/ONSITE ANALYSIS,154.0,100.1,33.57,154.0,66
CDM,92001085,THER ACTIVATION IMPL PHRENIC NRV STIMULATOR SYS,633.0,411.45,22.84,633.0,86
CDM,92001095,INTERROG&PRGRMG IMPL PHRENIC NRV STIMULATOR SYS,633.0,411.45,22.84,633.0,86
CDM,92001105,INTERROG&PRGRMG IPNSS DURING POLYSOMNOGRAPHY,2069.0,1344.85,22.84,2069.0,86
CDM,92001115,INTERROGATION WITHOUT PROGRAMMING IPNSS,633.0,411.45,22.84,633.0,86
CDM,92001125,ELEC ALYS SMPL PRGRMG IINS SP/SAC NRV 1-3 PARAM,367.0,238.55,83.98,367.0,84
CDM,92001135,ELEC ALYS CPLX PRGRMG IINS SP/SAC NRV 4+PARAM,367.0,238.55,83.98,367.0,84
CDM,92001145,REM MULTI DAY CPLX UROFLOWMETRY SETUP&PT EDUCAJ,515.0,334.75,86.64,515.0,84
CDM,92001155,REM MULTI DAY CPLX UROFLOWMETRY DEV SPLY W/REPRT,626.0,406.9,22.84,626.0,84
CDM,92001185,RISK ASCVD TST ONCE PR 12 MO,370.0,240.5,10.98,370.0,84
CDM,92001195,BIA WHOLE BODY COMPOSITION ASSESSMENT W/I&R,98.0,63.7,22.7,100.32,84
CDM,92001205,VIBRATE QUANT SENSORY TEST,157.0,102.05,34.79,453.61,85
CDM,92001235,LIFT TEST/PHYSICAL ABILITY,45.0,29.25,9.81,45.0,58
CDM,92001255,TITMUS VISION,45.0,29.25,9.81,45.0,58
CDM,92001285,ASCVD RSK MNG CLIN STF PR MO,370.0,240.5,10.98,370.0,76
CDM,92002OH,OPHTH MEDICAL XM&EVAL INTERMEDIATE NEW PT,387.0,251.55,1.1,387.0,148
CDM,92004OH,OPHTH MEDICAL XM&EVAL COMPRE NEW PT 1/> VST,728.0,473.2,1.1,728.0,148
CDM,92012OH,OPHTH MEDICAL XM&EVAL INTERMEDIATE ESTAB PT,368.0,239.2,1.1,385.69,148
CDM,92014OH,OPHTH MEDICAL XM&EVAL COMPRHNSV ESTAB PT 1/>,568.0,369.2,1.1,568.0,148
CDM,92015OH,DETERMINATION REFRACTIVE STATE,65.0,42.25,1.1,65.13,116
CDM,92018OH,OPHTH XM&EVAL ANES W/WO MANJ GLOBE COMPL,1000.0,650.0,1.1,6813.79,144
CDM,92019OH,OPHTH XM&EVAL ANES W/WO MANJ GLOBE LMTD,524.0,340.6,1.1,6813.79,144
CDM,92020OH,GONIOSCOPY SEPARATE PROCEDURE,163.0,105.95,1.1,373.44,148
CDM,92025OH,COMPUTERIZED CORNEAL TOPOGRAPHY UNI/BI,427.0,277.55,1.1,427.0,144
CDM,92025OH-26,COMPUTERIZED CORNEAL TOPOGRAPHY UNI/BI,154.0,100.1,1.1,154.0,126
CDM,92025OH-TC,COMPUTERIZED CORNEAL TOPOGRAPHY UNI/BI,273.0,177.45,1.1,273.0,126
CDM,92060OH,SENSORMOTOR XM W/MLT MEAS OCULAR DEVIJ W/I&R SPX,549.0,356.85,1.1,549.0,144
CDM,92060OH-26,SENSORMOTOR XM W/MLT MEAS OCULAR DEVIJ W/I&R SPX,276.0,179.4,1.1,276.0,126
CDM,92060OH-TC,SENSORMOTOR XM W/MLT MEAS OCULAR DEVIJ W/I&R SPX,273.0,177.45,1.1,273.0,126
CDM,92065OH,ORTHOPTIC TRAINING PERFORMED BY PHYS/OTHER QHP,284.0,184.6,1.1,284.0,142
CDM,92065OH-26,ORTHOPTIC TRAINING PERFORMED BY PHYS/OTHER QHP,284.0,184.6,1.1,284.0,86
CDM,92071OH,FIT CONTACT LENS TX OCULAR SURFACE DISEASE,268.0,174.2,1.1,268.0,148
CDM,92081OH,VISUAL FIELD XM UNI/BI W/INTERPRETJ LIMITED EXAM,405.0,263.25,1.1,405.0,144
CDM,92081OH-26,VISUAL FIELD XM UNI/BI W/INTERPRETJ LIMITED EXAM,132.0,85.8,1.1,132.0,126
CDM,92081OH-TC,VISUAL FIELD XM UNI/BI W/INTERPRETJ LIMITED EXAM,273.0,177.45,1.1,273.0,126
CDM,92082OH,VISUAL FIELD XM UNI/BI W/INTERP INTERMED EXAM,449.0,291.85,1.1,449.0,144
CDM,92082OH-26,VISUAL FIELD XM UNI/BI W/INTERP INTERMED EXAM,176.0,114.4,1.1,176.0,126
CDM,92082OH-TC,VISUAL FIELD XM UNI/BI W/INTERP INTERMED EXAM,273.0,177.45,1.1,273.0,126
CDM,92083OH,VISUAL FIELD XM UNI/BI W/INTERP EXTENDED EXAM,813.0,528.45,1.1,813.0,144
CDM,92083OH-26,VISUAL FIELD XM UNI/BI W/INTERP EXTENDED EXAM,220.0,143.0,1.1,220.0,126
CDM,92083OH-TC,VISUAL FIELD XM UNI/BI W/INTERP EXTENDED EXAM,593.0,385.45,1.1,593.0,126
CDM,92100010,DUPLEX SCAN EXTRACRANIAL ART COMPL BI STUDY,1390.0,903.5,150.27,1390.0,87
CDM,92100020,DUPLEX SCAN EXTRACRANIAL ART UNI/LMTD STUDY,611.0,397.15,95.38,611.0,87
CDM,92100030,TRANSCRANIAL DOPPLER STDY INTRACRANIAL ART COMPL,1390.0,903.5,150.27,1390.0,87
CDM,92100035,PLETHYSMOGRAPHY LUNG VOLUMES W/WO AIRWAY RESIST,1432.0,930.8,75.23,1432.0,87
CDM,92100040,TRANSCRANIAL DOPPLER STDY INTRACRANIAL ART LMTD,611.0,397.15,95.38,611.0,87
CDM,92100045,CAROTID INTIMA MEDIA & CAROTID ATHEROMA EVAL BI,512.0,332.8,97.71,1759903.2,67
CDM,92100060,TRANSCRANIAL DOPPLER INTRACRAN ART EMBOLI DETECT,611.0,397.15,95.38,611.0,87
CDM,92100070,TCD STD ICR ART VEN-ARTL SHNT DETCJ IV MBUBB NJX,611.0,397.15,95.38,611.0,87
CDM,92100080,NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 2 LEVEL,741.0,481.65,97.71,741.0,87
CDM,92100085,PHLEBOTEST EXTREMITY STUDY,154.0,100.1,22.7,154.0,85
CDM,92100090,NON-INVASIVE PHYSIOLOGIC STUDY EXTREMITY 3 LEVLS,900.0,585.0,108.55,900.0,87
CDM,92100095,US PSEUDOANEURYSM,154.0,100.1,22.7,154.0,85
CDM,92100100,N-INVAS PHYSIOLOGIC STD LXTR ART COMPL BI,900.0,585.0,97.71,900.0,87
CDM,92100110,DUP-SCAN LXTR ART/ARTL BPGS COMPL BI STUDY,1390.0,903.5,150.27,1390.0,87
CDM,92100115,DUPLEX SCAN ARTL INFL&VEN O/F HEMO COMPL BI STD,1390.0,903.5,97.71,1390.0,87
CDM,92100120,DUP-SCAN LXTR ART/ARTL BPGS UNI/LMTD STUDY,611.0,397.15,95.38,611.0,87
CDM,92100125,DUPLEX SCAN ARTL INFL&VEN O/F HEMO COMPL UNI STD,611.0,397.15,95.38,611.0,87
CDM,92100130,DUP-SCAN UXTR ART/ARTL BPGS COMPL BI STUDY,1390.0,903.5,97.71,1390.0,87
CDM,92100135,DUPLEX SCAN ARTL INFL&VEN O/F HEMO COMPL BI STD,1390.0,903.5,97.71,1390.0,87
CDM,92100140,DUP-SCAN UXTR ART/ARTL BPGS UNI/LMTD STUDY,611.0,397.15,95.38,611.0,87
CDM,92100145,DUPLEX SCAN ARTL INFL&VEN O/F HEMO COMPL UNI STD,611.0,397.15,95.38,611.0,87
CDM,92100150,DUP SCAN EXT VEIN BILAT,1390.0,903.5,150.27,1390.0,87
CDM,92100155,TECH DUPLEX SCAN COMPL BILATERAL STUDY,1390.0,903.5,150.27,1390.0,87
CDM,92100160,DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY,611.0,397.15,95.38,611.0,87
CDM,92100170,DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN COM,1390.0,903.5,150.27,1390.0,87
CDM,92100175,VASOREACTIVITY STUDY W/TCD ICR ARTERIES COMPLETE,1634.0,1062.1,150.27,1634.0,67
CDM,92100180,DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN LMT,611.0,397.15,95.38,611.0,87
CDM,92100190,DUP-SCAN AORTA IVC ILIAC VASCL/BPGS COMPLETE,1390.0,903.5,150.27,1390.0,87
CDM,92100200,DUP-SCAN AORTA IVC ILIAC VASCL/BPGS UNI/LMTD,611.0,397.15,95.38,611.0,87
CDM,92100205,US TEMPORAL ARTERIES (COMP CODE 93880),1261.0,819.65,22.7,1261.0,85
CDM,92100210,DUP-SCAN ARTL INFL&VEN O/F PEN VSL COMPL,611.0,397.15,95.38,611.0,87
CDM,92100220,DUP-SCAN ARTL INFL&VEN O/F PEN VSL F-UP/LMTD STD,611.0,397.15,93.64,611.0,87
CDM,92100230,DUPLEX SCAN HEMODIALYSIS ACCESS,611.0,397.15,95.38,611.0,87
CDM,92100240,DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN COM,1390.0,903.5,150.27,1390.0,87
CDM,92100250,DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN LMT,611.0,397.15,95.38,611.0,87
CDM,92100OH,SERIAL TONOMETRY SPX W/MLT MEAS INTRAOCULAR PRES,268.0,174.2,1.1,277.87,148
CDM,92132OH,CPTRIZED OPH DX IMG ANTERIOR SEGMENT UNI/BI,401.0,260.65,1.1,401.0,144
CDM,92132OH-26,CPTRIZED OPH DX IMG ANTERIOR SEGMENT UNI/BI,128.0,83.2,1.1,128.0,126
CDM,92132OH-TC,CPTRIZED OPH DX IMG ANTERIOR SEGMENT UNI/BI,273.0,177.45,1.1,273.0,126
CDM,92133OH,CPTRIZED OPH DX IMG PST SEGMENT UNI/BI OPTIC NRV,409.0,265.85,1.1,409.0,144
CDM,92133OH-26,CPTRIZED OPH DX IMG PST SEGMENT UNI/BI OPTIC NRV,136.0,88.4,1.1,136.0,126
CDM,92133OH-TC,CPTRIZED OPH DX IMG PST SEGMENT UNI/BI OPTIC NRV,273.0,177.45,1.1,273.0,126
CDM,92134OH,CPTRIZED OPH DX IMG PST SEGMENT UNI/BI RETINA,414.0,269.1,1.1,414.0,144
CDM,92134OH-26,CPTRIZED OPH DX IMG PST SEGMENT UNI/BI RETINA,141.0,91.65,1.1,141.0,126
CDM,92134OH-TC,CPTRIZED OPH DX IMG PST SEGMENT UNI/BI RETINA,273.0,177.45,1.1,273.0,126
CDM,92136OH,OPH BMTRY PRTL COHER INTRFRMTRY IO LENS PWR CAL,831.0,540.15,1.1,831.0,144
CDM,92136OH-26,OPH BMTRY PRTL COHER INTRFRMTRY IO LENS PWR CAL,238.0,154.7,1.1,238.0,126
CDM,92136OH-TC,OPH BMTRY PRTL COHER INTRFRMTRY IO LENS PWR CAL,593.0,385.45,1.1,593.0,126
CDM,92137OH,CPTRIZD OPH DX IMG PST SGM UNI/BI RTA OCT ANGRPH,1714.0,1114.1,1.1,1714.0,142
CDM,92137OH-26,CPTRIZD OPH DX IMG PST SGM UNI/BI RTA OCT ANGRPH,282.0,183.3,1.1,282.0,126
CDM,92137OH-TC,CPTRIZD OPH DX IMG PST SGM UNI/BI RTA OCT ANGRPH,1432.0,930.8,1.1,1432.0,126
CDM,92145OH,CORNEA HYSTERESIS DETERMIN IMPULSE STIMJ UNI/BI,313.0,203.45,1.1,313.0,142
CDM,92145OH-26,CORNEA HYSTERESIS DETERMIN IMPULSE STIMJ UNI/BI,40.0,26.0,1.1,40.0,126
CDM,92145OH-TC,CORNEA HYSTERESIS DETERMIN IMPULSE STIMJ UNI/BI,273.0,177.45,1.1,273.0,126
CDM,92200005,NEEDLE ELECTROMYOGRAPHY LARYNX,889.0,577.85,110.82,889.0,87
CDM,92200010,NDL EMG 1 XTR W/WO RELATED PARASPINAL AREAS,889.0,577.85,110.82,889.0,87
CDM,92200015,NEEDLE EMG W/1 FIBER ELECTRODE QUAN MEAS JITTER,1080.0,702.0,135.52,1080.0,87
CDM,92200020,NDL EMG 2 XTR W/WO RELATED PARASPINAL AREAS,889.0,577.85,110.82,889.0,87
CDM,92200025,ELECTRICAL STIMULATION GUID W/CHEMODENERVATION,75.0,48.75,16.35,335.02,68
CDM,92200035,NEEDLE EMG GUID W/CHEMODENERVATION,782.0,508.3,102.79,782.0,68
CDM,92200050,NDL EMG 4 XTR W/WO RELATED PARASPINAL AREAS,1080.0,702.0,121.73,1080.0,87
CDM,92200065,TSTG ANS FUNCJ VASOMOTOR ADRENERGIC INNERVAJ,889.0,577.85,110.82,889.0,87
CDM,92200070,NEEDLE ELECTROMYOGRAPHY CRANIAL NRV MUSCLE UNI,2149.0,1396.85,139.79,2149.0,87
CDM,92200095,NEEDLE ELECTROMYOGRAPHY HEMIDIAPHRAGM,1080.0,702.0,121.73,1080.0,87
CDM,92200110,NEEDLE EMG THRC PARASPI MUSC EXCLUDING T1/T12,2149.0,1396.85,129.0,2149.0,87
CDM,92200115,NEEDLE ELECTROMYOGRAPHY CRANIAL NRV MUSCLE BI,2149.0,1396.85,171.83,2149.0,87
CDM,92200120,NEEDLE EMG LMTD STD MUSC 1 XTR/NON-LIMB UNI/BI,889.0,577.85,110.82,889.0,87
CDM,92200125,MOTOR &/SENS NRV CNDJ PRECONF ELTRD ARRAY LIMB,2753.0,1789.45,46.34,2753.0,87
CDM,92200200,NEUROMUSCULAR JUNCT TSTG EA NRV ANY 1 METH,1080.0,702.0,121.73,1080.0,87
CDM,92200210,NERVE CONDUCTION STUDIES 1-2 STUDIES,1080.0,702.0,114.47,1080.0,87
CDM,92200220,NERVE CONDUCTION STUDIES 3-4 STUDIES,2149.0,1396.85,141.98,2149.0,87
CDM,92200230,NERVE CONDUCTION STUDIES 5-6 STUDIES,2149.0,1396.85,170.43,2149.0,87
CDM,92200240,NERVE CONDUCTION STUDIES 7-8 STUDIES,2149.0,1396.85,222.17,2149.0,87
CDM,92200250,NERVE CONDUCTION STUDIES 9-10 STUDIES,3661.0,2379.65,266.86,3661.0,87
CDM,92200260,NERVE CONDUCTION STUDIES 11-12 STUDIES,3661.0,2379.65,310.79,3661.0,87
CDM,92200270,NERVE CONDUCTION STUDIES 13/> STUDIES,3661.0,2379.65,353.04,3661.0,87
CDM,92200290,NEEDLE EMG EA EXTREMITY W/PARASPINL AREA LIMITED,997.0,648.05,82.8,997.0,68
CDM,92200300,NEEDLE EMG EA EXTREMTY W/PARASPINL AREA COMPLETE,1466.0,952.9,125.03,1466.0,68
CDM,92200310,NEEDLE EMG NONEXTREMTY MSCLES W/NERVE CONDUCTION,558.0,362.7,107.88,558.0,68
CDM,92201OH,OPSCPY EXTND RTA DRAWING &AMP; SCL DEPRSN I&AMP;R UNI/BI,176.0,114.4,1.1,177.54,148
CDM,92202OH,OPSCPY EXTND OPTIC NRV/MACULA DRAWING I&AMP;R UNI/BI,114.0,74.1,1.1,177.54,148
CDM,92227OH,REMOTE IMG DX RETINL DIS W/ALYS & REPORT UNI/BI,21.0,13.65,1.1,177.54,142
CDM,92227RVUOH,REMOTE DX RETINAL IMAGING,132.0,85.8,1.1,177.54,142
CDM,92229OH,IMG RETINA DETCJ/MNTR DS POC AUTO A/R UNI/BI,272.0,176.8,1.1,272.0,144
CDM,92230OH,FLUORESCEIN ANGIOSCOPY INTERPRETATION & REPORT,240.0,156.0,1.1,1564.17,148
CDM,92235OH,FLUORESCEIN ANGRPH W/MULTIFRAME I&R UNI/BI,1762.0,1145.3,1.1,1762.0,144
CDM,92235OH-26,FLUORESCEIN ANGRPH W/MULTIFRAME I&R UNI/BI,330.0,214.5,1.1,330.0,126
CDM,92235OH-TC,FLUORESCEIN ANGRPH W/MULTIFRAME I&R UNI/BI,1432.0,930.8,1.1,1432.0,126
CDM,92240OH,INDOCYANINE-GREEN ANGRPH W/MULTIFRAME I&R UNI/BI,1784.0,1159.6,1.1,1784.0,144
CDM,92240OH-26,INDOCYANINE-GREEN ANGRPH W/MULTIFRAME I&R UNI/BI,352.0,228.8,1.1,352.0,126
CDM,92240OH-TC,INDOCYANINE-GREEN ANGRPH W/MULTIFRAME I&R UNI/BI,1432.0,930.8,1.1,1432.0,126
CDM,92242OH,FLUORESCEIN ICG ANGRPH W/MULTIFRAME I&R UNI/BI,1850.0,1202.5,1.1,1850.0,144
CDM,92242OH-26,FLUORESCEIN ICG ANGRPH W/MULTIFRAME I&R UNI/BI,418.0,271.7,1.1,418.0,114
CDM,92242OH-TC,FLUORESCEIN ICG ANGRPH W/MULTIFRAME I&R UNI/BI,1432.0,930.8,1.1,1432.0,114
CDM,92250OH,FUNDUS PHOTOGRAPHY W/INTERPRETATION & REPORT,769.0,499.85,1.1,769.0,144
CDM,92250OH-26,FUNDUS PHOTOGRAPHY W/INTERPRETATION & REPORT,176.0,114.4,1.1,176.0,126
CDM,92250OH-TC,FUNDUS PHOTOGRAPHY W/INTERPRETATION & REPORT,593.0,385.45,1.1,593.0,126
CDM,92260OH,OPHTHALMOSCOPY/DYNAMOMETRY,80.0,52.0,1.1,116.32,148
CDM,92270OH,ELECTRO-OCULOGRAPY W/INTERPRETATION & REPORT,917.0,596.05,1.1,917.0,144
CDM,92270OH-26,ELECTRO-OCULOGRAPY W/INTERPRETATION & REPORT,324.0,210.6,1.1,324.0,126
CDM,92270OH-TC,ELECTRO-OCULOGRAPY W/INTERPRETATION & REPORT,593.0,385.45,1.1,593.0,126
CDM,92273OH,FULL FIELD ELECTRORETINOGRAPHY W/I&R,1736.0,1128.4,1.1,1736.0,144
CDM,92273OH-26,FULL FIELD ELECTRORETINOGRAPHY W/I&R,304.0,197.6,1.1,304.0,126
CDM,92273OH-TC,FULL FIELD ELECTRORETINOGRAPHY W/I&R,1432.0,930.8,1.1,1432.0,126
CDM,92274OH,MULTIFOCAL ELECTRORETINOGRAPHY W/I&R,988.0,642.2,1.1,988.0,144
CDM,92274OH-26,MULTIFOCAL ELECTRORETINOGRAPHY W/I&R,268.0,174.2,1.1,268.0,126
CDM,92274OH-TC,MULTIFOCAL ELECTRORETINOGRAPHY W/I&R,720.0,468.0,1.1,720.0,126
CDM,92283OH,COLOR VISION XM EXTENDED ANOMALOSCOPE/EQUIV,341.0,221.65,1.1,341.0,144
CDM,92283OH-26,COLOR VISION XM EXTENDED ANOMALOSCOPE/EQUIV,68.0,44.2,1.1,68.0,126
CDM,92283OH-TC,COLOR VISION XM EXTENDED ANOMALOSCOPE/EQUIV,273.0,177.45,1.1,273.0,126
CDM,92284OH,DARK ADAPTATION XM W/INTERPRETATION & REPORT,1938.0,1259.7,1.1,1938.0,144
CDM,92284OH-26,DARK ADAPTATION XM W/INTERPRETATION & REPORT,102.0,66.3,1.1,102.0,116
CDM,92285OH,XTRNL OCULAR PHOTOG W/I&R DOCMT MEDICAL PROGRE,203.0,131.95,1.1,203.0,144
CDM,92285OH-26,XTRNL OCULAR PHOTOG W/I&R DOCMT MEDICAL PROGRE,22.0,14.3,1.1,22.0,126
CDM,92285OH-TC,XTRNL OCULAR PHOTOG W/I&R DOCMT MEDICAL PROGRE,181.0,117.65,1.1,181.0,126
CDM,92286OH,ANT SGM IMAGING W/MICROSCOPY ENDOTHELIAL ANALY,769.0,499.85,1.1,769.0,144
CDM,92286OH-26,ANT SGM IMAGING W/MICROSCOPY ENDOTHELIAL ANALY,176.0,114.4,1.1,176.0,126
CDM,92286OH-TC,ANT SGM IMAGING W/MICROSCOPY ENDOTHELIAL ANALY,593.0,385.45,1.1,593.0,126
CDM,92287OH,ANT SGM IMAGING W/FLUOROSCEIN ANGIO & I&R,753.0,489.45,1.1,753.0,144
CDM,92287OH-26,ANT SGM IMAGING W/FLUOROSCEIN ANGIO & I&R,160.0,104.0,1.1,160.0,126
CDM,92287OH-TC,ANT SGM IMAGING W/FLUOROSCEIN ANGIO & I&R,593.0,385.45,1.1,593.0,126
CDM,92288OH,SCREENING DARK ADAPTATION MEASUREMENT W/I&R,75.0,48.75,1.1,75.0,74
CDM,92300000,OBTAINING SCREEN PAP SMEAR,98.0,63.7,15.29,98.0,86
CDM,92310BOH,MONOVISION/MULTIFOCAL REFIT,125.0,81.25,1.1,331.49,114
CDM,92311OH,RX&FITG CONTACT CORNEAL LENS APHAKIA 1 EYE,432.0,280.8,1.1,1163.18,146
CDM,92400000,PERCUTANEOUS TESTS W/ALLERGENIC EXTRACTS,169.0,109.85,4.77,1018.61,78
CDM,92400015,ALLG TSTG PERQ & IC VENOMS IMMED REACT W/I&R,73.0,47.45,4.05,178.84,86
CDM,92400020,ALLG TEST PERQ & IC DRUG/BIOL IMMED REACT W/I&R,165.0,107.25,8.27,178.84,86
CDM,92400025,INTRACUTANEOUS TESTS W/ALLERGENIC EXTRACTS,163.0,105.95,1.48,178.84,86
CDM,92400040,PATCH/APPLICATION TEST SPECIFY NUMBER TESTS,408.0,265.2,6.76,1018.61,78
CDM,92400045,PHOTO PATCH TEST SPECIFY NUMBER TSTS,178.0,115.7,8.37,178.84,86
CDM,92400050,PHOTO TESTS,387.0,251.55,73.2,387.0,78
CDM,92400060,INHLJ BRNCL CHALLENGE TSTG W/HISTAM/METHACHOL,1592.0,1034.8,48.76,1592.0,78
CDM,92400065,INGESTION CHALLENGE TEST INITIAL 120 MINUTES,1592.0,1034.8,87.28,1592.0,86
CDM,92400070,INGESTION CHALLENGE TEST EACH ADDL 60 MINUTES,276.0,179.4,60.17,346.69,68
CDM,92400075,RAPID DESENSITIZATION PROCEDURE EACH HOUR,1197.0,778.05,120.49,1197.0,78
CDM,92499AOH,ORA INTRAOPERATIVE WAVEFRONT ABERROMETRY,200.0,130.0,0.01,200.0,84
CDM,92499RVU1OH,ANNUAL CONTACT LENS CHECK,55.0,35.75,0.01,85.71,84
CDM,92502OH,OTOLARYNGOLOGIC EXAM UNDER GENERAL ANESTHESIA,604.0,392.6,1.1,1603.96,144
CDM,92504OH,BINOCULAR MICROSCOPY SEPARATE DX PROCEDURE,79.0,51.35,1.1,97.4,148
CDM,92507OH,TX SPEECH LANG VOICE COMMJ &/AUDITORY PROC IND,520.0,338.0,1.1,520.0,142
CDM,92508OH,TX SPEECH LANGUAGE VOICE COMMJ AUDITRY 2/>INDIV,132.0,85.8,1.1,132.0,142
CDM,92511OH,NASOPHARYNGOSCOPY W/ENDOSCOPE SPX,268.0,174.2,1.1,578.53,148
CDM,92512OH,NASAL FUNCTION STUDIES,220.0,143.0,1.1,915.24,148
CDM,92516OH,FACIAL NERVE FUNCTION STUDIES,172.0,111.8,1.1,915.24,148
CDM,92517OH,CERVICAL VEMP TESTING W/I&R,320.0,208.0,1.1,456.09,148
CDM,92518OH,OCULAR VEMP TESTING W/I&R,320.0,208.0,1.1,456.09,148
CDM,92519OH,CERVICAL & OCULAR VEMP TESTING W/I&R,480.0,312.0,1.1,915.24,148
CDM,92520OH,LARYNGEAL FUNCTION STUDY,300.0,195.0,1.1,373.44,148
CDM,92521OH,"EVALUATION OF SPEECH FLUENCY (EG, STUTTERING, CLUTTERING)",896.0,582.4,1.1,896.0,142
CDM,92522OH,EVALUATION OF SPEECH SOUND PRODUCTION ARTICULATE,768.0,499.2,1.1,768.0,142
CDM,92523OH,EVAL SPEECH SOUND PRODUCT LANGUAGE COMPREHENSION,1536.0,998.4,1.1,1536.0,142
CDM,92524AOH,GA VOICE CARE EVAL,275.0,178.75,1.1,370.19,142
CDM,92524OH,BEHAVIORAL AND QUALITATIVE ANALYSIS OF VOICE AND RESONANCE,768.0,499.2,1.1,768.0,142
CDM,92526OH,TX SWALLOWING DYSFUNCTION&/ORAL FUNCJ FEEDING,536.0,348.4,1.1,536.0,144
CDM,92531OH,SPONTANEOUS NYSTAGMUS STUDY,150.0,97.5,1.1,150.0,90
CDM,92532OH,POSITIONAL NYSTAGMUS STUDY,215.0,139.75,1.1,215.0,90
CDM,92537OH,CALORIC VESTIBULAR TEST W/REC BI BITHERMAL,890.0,578.5,1.1,890.0,144
CDM,92537OH-26,CALORIC VESTIBULAR TEST W/REC BI BITHERMAL,264.0,171.6,1.1,264.0,126
CDM,92537OH-TC,CALORIC VESTIBULAR TEST W/REC BI BITHERMAL,626.0,406.9,1.1,626.0,126
CDM,92538OH,CALORIC VESTIBULAR TEST W/REC BI MONOTHERMAL,758.0,492.7,1.1,758.0,144
CDM,92538OH-26,CALORIC VESTIBULAR TEST W/REC BI MONOTHERMAL,132.0,85.8,1.1,132.0,126
CDM,92538OH-TC,CALORIC VESTIBULAR TEST W/REC BI MONOTHERMAL,626.0,406.9,1.1,626.0,126
CDM,92540OH,VSTBLR FUNCJ NYSTAG FOVL&PERPH STIMJ OSCIL TRKG,1286.0,835.9,1.1,1286.0,144
CDM,92540OH-26,VSTBLR FUNCJ NYSTAG FOVL&PERPH STIMJ OSCIL TRKG,660.0,429.0,1.1,660.0,126
CDM,92540OH-TC,VSTBLR FUNCJ NYSTAG FOVL&PERPH STIMJ OSCIL TRKG,626.0,406.9,1.1,626.0,126
CDM,92541OH,SPONTANEOUS NYSTAGMUS TEST,692.0,449.8,1.1,692.0,144
CDM,92541OH-26,SPONTANEOUS NYSTAGMUS TEST,176.0,114.4,1.1,176.0,126
CDM,92541OH-TC,SPONTANEOUS NYSTAGMUS TEST,516.0,335.4,1.1,516.0,126
CDM,92542OH,POSITIONAL NYSTAGMUS TEST,727.0,472.55,1.1,727.0,144
CDM,92542OH-26,POSITIONAL NYSTAGMUS TEST,211.0,137.15,1.1,211.0,126
CDM,92542OH-TC,POSITIONAL NYSTAGMUS TEST,516.0,335.4,1.1,516.0,126
CDM,92544OH,OPTKINETIC NYSTAG BIDIR/FOVEAL/PERIPH STIM W/REC,839.0,545.35,1.1,839.0,144
CDM,92544OH-26,OPTKINETIC NYSTAG BIDIR/FOVEAL/PERIPH STIM W/REC,119.0,77.35,1.1,119.0,126
CDM,92544OH-TC,OPTKINETIC NYSTAG BIDIR/FOVEAL/PERIPH STIM W/REC,720.0,468.0,1.1,720.0,126
CDM,92545OH,OSCILLATING TRACKING TEST W/RECORDING,1542.0,1002.3,1.1,1542.0,144
CDM,92545OH-26,OSCILLATING TRACKING TEST W/RECORDING,110.0,71.5,1.1,110.0,126
CDM,92545OH-TC,OSCILLATING TRACKING TEST W/RECORDING,1432.0,930.8,1.1,1432.0,126
CDM,92546OH,SINUSOIDAL VERTICAL AXIS ROTATIONAL TESTING,848.0,551.2,1.1,848.0,144
CDM,92546OH-26,SINUSOIDAL VERTICAL AXIS ROTATIONAL TESTING,128.0,83.2,1.1,128.0,126
CDM,92546OH-TC,SINUSOIDAL VERTICAL AXIS ROTATIONAL TESTING,720.0,468.0,1.1,720.0,126
CDM,92547OH,USE VERTICAL ELECTRODES,187.0,121.55,1.1,187.0,144
CDM,92548OH,CDP-SOT 6 CONDITIONS W/INTERPRETATION & REPORT,861.0,559.65,1.1,861.0,144
CDM,92548OH-26,CDP-SOT 6 CONDITIONS W/INTERPRETATION & REPORT,268.0,174.2,1.1,268.0,126
CDM,92548OH-TC,CDP-SOT 6 CONDITIONS W/INTERPRETATION & REPORT,593.0,385.45,1.1,593.0,126
CDM,92550OH,TYMPANOMETRY AND REFLEX THRESHOLD MEASUREMENTS,154.0,100.1,1.1,456.09,144
CDM,92551OH,SCREENING TEST PURE TONE AIR ONLY,62.0,40.3,1.1,62.0,110
CDM,92552OH,PURE TONE AUDIOMETRY AIR ONLY,127.0,82.55,1.1,373.44,144
CDM,92553OH,PURE TONE AUDIOMETRY AIR & BONE,166.0,107.9,1.1,456.09,144
CDM,92555OH,SPEECH AUDIOMETRY THRESHOLD,84.0,54.6,1.1,177.54,144
CDM,92556OH,SPEECH AUDIOMETRY THRESHOLD SPEECH RECOGNIJ,147.0,95.55,1.1,177.54,144
CDM,92557OH,COMPRE AUDIOMETRY THRESHOLD EVAL SP RECOGNIJ,264.0,171.6,1.1,456.09,148
CDM,92562OH,LOUDNESS BALANCE BINAURAL/MONAURAL,104.0,67.6,1.1,915.24,142
CDM,92563OH,TONE DECAY,98.0,63.7,1.1,116.32,142
CDM,92565OH,PURE TONE STENGER,100.0,65.0,1.1,177.54,142
CDM,92567OH,TYMPANOMETRY,88.0,57.2,1.1,116.32,148
CDM,92568OH,ACOUSTIC REFLEX,116.0,75.4,1.1,116.32,148
CDM,92570AOH,GA VOICE CARE AIT,275.0,178.75,1.1,456.09,148
CDM,92570OH,ACOUSTIC IMMIT TEST TYMPANOM/ACOUST REFLX/DECAY,242.0,157.3,1.1,456.09,148
CDM,92575OH,SENSORINEURAL ACUITY TEST,86.0,55.9,1.1,238.47,142
CDM,92577OH,SPEECH STENGER,144.0,93.6,1.1,1564.17,142
CDM,92579OH,VISUAL REINFORCEMENT AUDIOMETRY,308.0,200.2,1.1,456.09,148
CDM,92582OH,CONDITIONING PLAY AUDIOMETRY,168.0,109.2,1.1,456.09,144
CDM,92583OH,SELECT PICTURE AUDIOMETRY,181.0,117.65,1.1,181.0,142
CDM,92584OH,ELECTROCOCHLEOGRAPHY,440.0,286.0,1.1,456.09,142
CDM,92587OH,DISTORT PRODUCT EVOKED OTOACOUSTIC EMISNS LIMITD,1400.0,910.0,1.1,1400.0,144
CDM,92587OH-26,DISTORT PRODUCT EVOKED OTOACOUSTIC EMISNS LIMITD,154.0,100.1,1.1,154.0,126
CDM,92587OH-TC,DISTORT PRODUCT EVOKED OTOACOUSTIC EMISNS LIMITD,1246.0,809.9,1.1,1246.0,126
CDM,92588OH,DISTRT PROD EVOKD OTOACOUSTIC EMSNS COMP/DX EVAL,1488.0,967.2,1.1,1488.0,144
CDM,92588OH-26,DISTRT PROD EVOKD OTOACOUSTIC EMSNS COMP/DX EVAL,242.0,157.3,1.1,242.0,126
CDM,92588OH-TC,DISTRT PROD EVOKD OTOACOUSTIC EMSNS COMP/DX EVAL,1246.0,809.9,1.1,1246.0,126
CDM,92596OH,EAR PROTECTOR ATTEN MEASURES,121.0,78.65,1.1,234.03,130
CDM,92597OH,EVAL&/FITG VOICE PROSTC DEV SUPLMNT ORAL SPEEC,504.0,327.6,1.1,504.0,142
CDM,92601OH,ANLYS COCHLR IMP < 7 YR W PROG,1012.0,657.8,1.1,1012.0,148
CDM,92602OH,ANLYS COCHLR IMP < 7 YR REPROG,572.0,371.8,1.1,572.0,148
CDM,92603OH,ANLYS COCHLR IMP 7+ YR W PROG,990.0,643.5,1.1,990.0,148
CDM,92604OH,ANLYS COCHLR IMP 7+ YR REPROG,550.0,357.5,1.1,550.0,148
CDM,92605OH,EVAL RX N-SP-GEN AUGMT ALT COMMUN DEV F2F 1ST HR,700.0,455.0,1.1,700.0,102
CDM,92607OH,RX SP-GENRATJ AUGMNT&COMUNICAJ DEV 1ST HR,740.0,481.0,1.1,740.0,142
CDM,92608OH,RX SP-GENRATJ AUGMNT&COMUNICAJ DEV EA 30 MIN,280.0,182.0,1.1,280.0,142
CDM,92609OH,THER SP-GENRATJ DEV PRGRMG&MODIFICAJ,600.0,390.0,1.1,600.0,142
CDM,92610OH,EVAL ORAL&PHARYNGEAL SWLNG FUNCJ,520.0,338.0,1.1,520.0,148
CDM,92611OH,MOTION FLUOR EVAL SWLNG FUNCJ C/V REC,536.0,348.4,1.1,536.0,144
CDM,92612OH,FLEXIBLE ENDOSCOPIC EVAL SWALLOW C/V REC,508.0,330.2,1.1,658.72,148
CDM,92613OH,FLEXIBLE ENDOSCOPIC EVAL SWALLOW C/V REC I&R,312.0,202.8,1.1,312.0,130
CDM,92616OH,FLEXIBLE NDSC EVAL SWLNG&LARYN SENS C/V REC,752.0,488.8,1.1,755.73,148
CDM,92618OH,EVAL RX N-SP-GEN AUGMT ALT COMMUN DEV ADD 30 MIN,260.0,169.0,1.1,260.0,102
CDM,92620OH,EVAL CENTRAL AUDITORY FUNCJ W/REPRT 1ST 60 MIN,600.0,390.0,1.1,600.0,148
CDM,92621OH,EVAL CENTRAL AUDITORY FUNCJ W/REPRT EA 15 MIN,140.0,91.0,1.1,140.0,148
CDM,92622OH,DX ALY PRGRMG&VERIF AUD OI SOUND PROCESSR 1ST 60,550.0,357.5,1.1,550.0,148
CDM,92623OH,DX ALY PRGRMG&VERIF AUD OI SOUND PROCESSR EA ADL,145.0,94.25,1.1,145.0,148
CDM,92625OH,TINNITUS ASSESSMENT,460.0,299.0,1.1,460.0,146
CDM,92626OH,EVAL AUD FUNCJ CAND/PO SURG IMPLT DEV 1ST HR,560.0,364.0,1.1,560.0,148
CDM,92627OH,EVAL AUD FUNCJ CAND/PO SURG IMPLT DEV EA ADDL 15,132.0,85.8,1.1,132.0,148
CDM,92628OH,EVALUATION HEARING AID CANDIDACY 1ST 30 MINUTES,100.0,65.0,1.1,100.0,70
CDM,92630OH,AUDITORY REHABILITATION PRELINGUAL HEARING LOSS,313.0,203.45,1.1,425.86,96
CDM,92631OH,HEARING AID SELECTION SERVICES 1ST 30 MINUTES,100.0,65.0,1.1,100.0,70
CDM,92633OH,AUDITORY REHABILITATION POSTLINGUAL HEARING LOSS,313.0,203.45,1.1,440.78,84
CDM,92634OH,HEARING AID FITTING SERVICES 1ST 60 MINUTES,300.0,195.0,1.1,300.0,70
CDM,92636OH,HEARING AID POST-FITTING F-UP SVC 1ST 30 MINUTES,50.0,32.5,1.1,50.0,70
CDM,92637OH,HEARING AID POST-FITTING F-UP SVC EA ADDL 15 MIN,25.0,16.25,1.1,25.0,70
CDM,92640OH,ANALYSIS W/PRGRMG AUD BRAINSTEM IMPLANT PR HR,704.0,457.6,1.1,704.0,148
CDM,92642OH,HEARING ASSISTIVE DEVICE SUPPL TECH FITTING SVC,100.0,65.0,1.1,100.0,70
CDM,92650OH,AEP SCR AUDITORY POTENTIAL W/STIMULI AUTO ALYS,110.0,71.5,1.1,110.0,108
CDM,92651OH,AEP HEARING STATUS DETER BROADBAND STIMULI I&R,400.0,260.0,1.1,915.24,144
CDM,92652OH,AEP THRESHOLD ESTIMATION MLT FREQUENCIES I&R,600.0,390.0,1.1,915.24,144
CDM,92653OH,AEP NEURODIAGNOSTIC INTERPRETATION AND REPORT,420.0,273.0,1.1,915.24,144
CDM,92700RVU1OH,SPEECH IN NOISE TEST (COMP 92556),163.0,105.95,0.01,163.0,84
CDM,92900025,SANE EVAL,700.0,455.0,152.6,700.0,66
CDM,92900035,SANE EVAL,818.0,531.7,178.32,818.0,58
CDM,92900045,COMPRE CPTR MTN ALYS VIDEO TAPING 3D KINEMATICS,3661.0,2379.65,99.77,3661.0,86
CDM,92900055,PHYS/QHP R&I CPTR MTN ALYS WALK/FUNCJL ACTV REPR,2143.0,1392.95,139.71,2143.0,68
CDM,92920AOH,PTCA + IVUS/OCT,4334.0,2817.1,1.1,16670.21,144
CDM,92920BOH,PTCA + CORONARY LITHOTRIPSY,4334.0,2817.1,1.1,16670.21,144
CDM,92920OH,PRQ TRLUML CORONARY ANGIOPLASTY ONE ART/BRANCH,4334.0,2817.1,1.1,16670.21,144
CDM,92924OH,PRQ TRLUML CORONARY ANGIO/ATHERECT ONE ART/BRNCH,4696.0,3052.4,1.1,32085.4,144
CDM,92928OH,PRQ TRLUML CORONARY STENT W/ANGIO ONE ART/BRNCH,4822.0,3134.3,1.1,32085.4,144
CDM,92930OH,PERQ TCAT PLMT NTRAC ST 2+LES 2+ST 2+C SEGMENTS,5280.0,3432.0,1.1,5280.0,106
CDM,92933OH,PRQ TRLUML CORONRY STENT/ATH/ANGIO ONE ART/BRNCH,5408.0,3515.2,1.1,51140.13,144
CDM,92937OH,PRQ TRLUML CORONARY BYP GRFT REVASC ONE VESSEL,4818.0,3131.7,1.1,32085.4,144
CDM,92941OH,PRQ TRLUML CORONRY TOT OCCLUS REVASC MI ONE VSL,4924.0,3200.6,1.1,4924.0,144
CDM,92943OH,PRQ TRLUML CORONRY CHRONIC OCCLUS REVASC ONE VSL,5416.0,3520.4,1.1,32085.4,144
CDM,92945OH,PERQ TRLUML REVSC CHRNC TOT OCCLS 1 ANTGRD&RTRGR,6600.0,4290.0,1.1,6600.0,106
CDM,92950OH,CARDIO-PULMONARY RESUSCITATION,1760.0,1144.0,1.1,1760.0,148
CDM,92953OH,TEMPORARY TRANSCUTANEOUS PACING,5.0,3.25,0.62,1897.82,144
CDM,92960OH,CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL,880.0,572.0,1.1,1897.82,148
CDM,92961OH,CARDIOVERSION ELECTIVE ARRHYTHMIA INTERNAL SPX,1736.0,1128.4,1.1,1897.82,144
CDM,92970OH,CARDIOASSIST-METH CIRCULATORY ASSIST INTERNAL,1404.0,912.6,1.1,1404.0,144
CDM,92972OH,PERCUTANEOUS TRANSLUMINAL CORONARY LITHOTRIPSY,1307.0,849.55,1.1,1307.0,142
CDM,92973OH,PRQ TRANSLUMINAL CORONARY MECHANICL THROMBECTOMY,1312.0,852.8,1.1,1312.0,144
CDM,92974OH,TCAT PLACEMENT RADJ DLVR DEV SBSQ C IV BRACHYTX,1200.0,780.0,1.1,1200.0,144
CDM,92978OH,ENDOLUMINAL CORONARY IVUS OCT I&R INITIAL VESSEL,5854.0,3805.1,1.1,5854.0,106
CDM,92978OH-26,ENDOLUMINAL CORONARY IVUS OCT I&R INITIAL VESSEL,792.0,514.8,1.1,792.0,126
CDM,92978OH-TC,ENDOLUMINAL CORONARY IVUS OCT I&R INITIAL VESSEL,5062.0,3290.3,1.1,5062.0,90
CDM,92979OH,ENDOLUMINAL CORONARY IVUS OCT I&R ADDL VESSEL,4481.0,2912.65,1.1,4481.0,106
CDM,92979OH-26,ENDOLUMINAL CORONARY IVUS OCT I&R ADDL VESSEL,576.0,374.4,1.1,576.0,126
CDM,92979OH-TC,ENDOLUMINAL CORONARY IVUS OCT I&R ADDL VESSEL,3905.0,2538.25,1.1,3905.0,90
CDM,92986OH,PRQ BALLOON VALVULOPLASTY AORTIC VALVE,9040.0,5876.0,1.1,16670.21,144
CDM,92987OH,PRQ BALLOON VALVULOPLASTY MITRAL VALVE,9352.0,6078.8,1.1,32085.4,144
CDM,92990OH,PRQ BALLOON VALVULOPLASTY PULMONARY VALVE,7308.0,4750.2,1.1,32085.4,144
CDM,92997OH,PRQ TRLUML PULMONARY ART BALLOON ANGIOP 1 VSL,4792.0,3114.8,1.1,32085.4,144
CDM,92998OH,PRQ TRLUML PULMONARY ART BALLOON ANGIOP EA VSL,2396.0,1557.4,1.1,2396.0,144
CDM,93000OH,ECG ROUTINE ECG W/LEAST 12 LDS W/I&R,75.0,48.75,1.1,75.0,144
CDM,93005OH,ECG ROUTINE ECG W/LEAST 12 LDS TRCG ONLY W/O I&R,295.0,191.75,1.1,295.0,144
CDM,93010AOH,EKG INTERPRETATION,56.0,36.4,1.1,56.0,144
CDM,93010OH,ECG ROUTINE ECG W/LEAST 12 LDS I&R ONLY,75.0,48.75,1.1,75.0,144
CDM,93015OH,CV STRS TST XERS&/OR RX CONT ECG W/SI&R,330.0,214.5,1.1,330.0,144
CDM,93016OH,CV STRS TST XERS&/OR RX CONT ECG W/O I&R,198.0,128.7,1.1,198.0,144
CDM,93017OH,CV STRS TST XERS&/OR RX CONT ECG TRCG ONLY,517.0,336.05,1.1,915.24,142
CDM,93018CPSTOH,CONCENTRA PROGRAM STRESS TEST,200.0,130.0,1.1,200.0,144
CDM,93018OH,CV STRS TST XERS&/OR RX CONT ECG I&R ONLY,132.0,85.8,1.1,132.0,144
CDM,93024OH,ERGONOVINE PROVOCATION TST,2809.0,1825.85,1.1,2809.0,144
CDM,93024OH-26,ERGONOVINE PROVOCATION TST,515.0,334.75,1.1,515.0,126
CDM,93024OH-TC,ERGONOVINE PROVOCATION TST,2294.0,1491.1,1.1,2294.0,126
CDM,93025OH,MICROVOLT T-WAVE ASSESS VENTRICULAR ARRHYTHMIAS,1200.0,780.0,1.1,1200.0,144
CDM,93025OH-26,MICROVOLT T-WAVE ASSESS VENTRICULAR ARRHYTHMIAS,300.0,195.0,1.1,300.0,114
CDM,93025OH-TC,MICROVOLT T-WAVE ASSESS VENTRICULAR ARRHYTHMIAS,900.0,585.0,1.1,900.0,114
CDM,93040OH,RHYTHM ECG 1-3 LEADS W/INTERPRETATION & REPORT,60.0,39.0,1.1,60.0,142
CDM,93041OH,RHYTHM ECG 1-3 LEADS TRACING ONLY W/O I&R,72.0,46.8,1.1,177.54,142
CDM,93042AGEXOH,TRANS-TELEPHONIC ARRHYTHMIA MONITORING,20.0,13.0,1.1,23.09,142
CDM,93042OH,RHYTHM ECG 1-3 LEADS INTERPRETATION & REPRT ON,66.0,42.9,1.1,66.0,142
CDM,93050OH,ART PRESS WAVEFORM ANALYS CENTRAL ART PRESSURE,209.0,135.85,1.1,209.0,144
CDM,93050OH-26,ART PRESS WAVEFORM ANALYS CENTRAL ART PRESSURE,68.0,44.2,1.1,68.0,126
CDM,93050OH-TC,ART PRESS WAVEFORM ANALYS CENTRAL ART PRESSURE,141.0,91.65,1.1,141.0,126
CDM,93145OH,INTERROG EVAL CRTD SINS BAT MODULJ SYS IP WO,286.0,185.9,1.1,286.0,106
CDM,93146OH,INTERROG EVAL CRTD SINS BAT MODULJ SYS IP W/,396.0,257.4,1.1,396.0,106
CDM,93150OH,THER ACTIVATION IMPL PHRENIC NRV STIMULATOR SYS,374.0,243.1,1.1,374.0,146
CDM,93151OH,INTERROG&PRGRMG IMPL PHRENIC NRV STIMULATOR SYS,352.0,228.8,1.1,352.0,146
CDM,93152OH,INTERROG&PRGRMG IPNSS DURING POLYSOMNOGRAPHY,801.0,520.65,1.1,872.39,146
CDM,93153OH,INTERROGATION WITHOUT PROGRAMMING IPNSS,189.0,122.85,1.1,281.61,146
CDM,93224OH,XTRNL ECG & 48 HR RECORD SCAN STOR W/R&I,172.0,111.8,1.1,244.68,144
CDM,93225OH,XTRNL ECG & 48 HR RECORDING,357.0,232.05,1.1,373.44,144
CDM,93226OH,EXTERNAL ECG SCANNING ANALYSIS REPORT,750.0,487.5,1.1,750.0,144
CDM,93227OH,XTRNL ECG CONTINUOUS RHYTHM W/I&R UP TO 48 HRS,172.0,111.8,1.1,172.0,144
CDM,93228OH,XTRNL MOBILE CV TELEMETRY W/I&REPORT 30 DAYS,211.0,137.15,1.1,211.0,144
CDM,93242OH,EXTERNAL ECG REC>48HR<7D RECORDING,328.0,213.2,1.1,328.0,144
CDM,93244OH,EXTERNAL ECG REC>48HR<7D REVIEW & INTERPRETATION,200.0,130.0,1.1,200.0,144
CDM,93246OH,EXTERNAL ECG REC>7D<15D RECORDING,328.0,213.2,1.1,328.0,144
CDM,93248OH,EXTERNAL ECG REC>7D<15D REVIEW & INTERPRETATION,242.0,157.3,1.1,242.0,144
CDM,93260OH,PRGRMG DEV EVAL IMPLANTABLE SUBQ LEAD DFB SYSTEM,588.0,382.2,1.1,588.0,142
CDM,93260OH-26,PRGRMG DEV EVAL IMPLANTABLE SUBQ LEAD DFB SYSTEM,374.0,243.1,1.1,374.0,126
CDM,93260OH-TC,PRGRMG DEV EVAL IMPLANTABLE SUBQ LEAD DFB SYSTEM,214.0,139.1,1.1,214.0,126
CDM,93261OH,INTERROGATION EVAL F2F IMPLANT SUBQ LEAD DEFIB,540.0,351.0,1.1,540.0,142
CDM,93261OH-26,INTERROGATION EVAL F2F IMPLANT SUBQ LEAD DEFIB,326.0,211.9,1.1,326.0,126
CDM,93261OH-TC,INTERROGATION EVAL F2F IMPLANT SUBQ LEAD DEFIB,214.0,139.1,1.1,214.0,126
CDM,93264OH,REMOTE MNTR WIRELESS P-ART PRS SNR UP TO 30 D,308.0,200.2,1.1,308.0,146
CDM,93268OH,XTRNL PT ACTIV ECG TRANSMIS W/R&I </30 DAYS,208.0,135.2,1.1,575.22,144
CDM,93270OH,XTRNL PT ACTIVATED ECG RECORD MONITOR 30 DAYS,537.0,349.05,1.1,537.0,144
CDM,93271OH,XTRNL PT ACTIVATED ECG REC DWNLD 30 DAYS,267.0,173.55,1.1,466.82,144
CDM,93272OH,XTRNL PT ACTIVTD ECG DWNLD W/R&I </30 DAYS,208.0,135.2,1.1,208.0,144
CDM,93278OH,SIGNAL AVERAGED ELECTROCARDIOGRAPHY W/WO ECG,442.0,287.3,1.1,442.0,142
CDM,93278OH-26,SIGNAL AVERAGED ELECTROCARDIOGRAPHY W/WO ECG,100.0,65.0,1.1,100.0,126
CDM,93278OH-TC,SIGNAL AVERAGED ELECTROCARDIOGRAPHY W/WO ECG,342.0,222.3,1.1,342.0,126
CDM,93279AGEXOH,PACEMAKER PROGRAMMING SINGLE,260.0,169.0,1.1,260.0,144
CDM,93279OH,PRGRMG DEV EVAL 1 LEAD PM/LDLS PM 1 CAR CHMBR IP,474.0,308.1,1.1,474.0,144
CDM,93279OH-26,PRGRMG DEV EVAL 1 LEAD PM/LDLS PM 1 CAR CHMBR IP,260.0,169.0,1.1,260.0,126
CDM,93279OH-TC,PRGRMG DEV EVAL 1 LEAD PM/LDLS PM 1 CAR CHMBR IP,214.0,139.1,1.1,214.0,126
CDM,93280AGEXOH,PACEMAKER PROGRAMMING DUAL,308.0,200.2,1.1,308.0,144
CDM,93280OH,PROGRAM EVAL IMPLANTABLE IN PERSN DUAL LD PACER,522.0,339.3,1.1,522.0,144
CDM,93280OH-26,PROGRAM EVAL IMPLANTABLE IN PERSN DUAL LD PACER,308.0,200.2,1.1,308.0,126
CDM,93280OH-TC,PROGRAM EVAL IMPLANTABLE IN PERSN DUAL LD PACER,214.0,139.1,1.1,214.0,126
CDM,93281AGEXOH,PACEMAKER PROGRAMMING MULT,374.0,243.1,1.1,374.0,144
CDM,93281OH,PROGRAM EVAL IMPLANTABLE IN PRSN MULTI LD PACER,588.0,382.2,1.1,588.0,144
CDM,93281OH-26,PROGRAM EVAL IMPLANTABLE IN PRSN MULTI LD PACER,374.0,243.1,1.1,374.0,126
CDM,93281OH-TC,PROGRAM EVAL IMPLANTABLE IN PRSN MULTI LD PACER,214.0,139.1,1.1,214.0,126
CDM,93282AGEXOH,DEFIBRILLATOR PROGRAMMING SINGLE,374.0,243.1,1.1,374.0,144
CDM,93282OH,PRGRMNG DEV EVAL IMPLANTABLE IN PERSN 1 LD DFB,588.0,382.2,1.1,588.0,144
CDM,93282OH-26,PRGRMNG DEV EVAL IMPLANTABLE IN PERSN 1 LD DFB,374.0,243.1,1.1,374.0,126
CDM,93282OH-TC,PRGRMNG DEV EVAL IMPLANTABLE IN PERSN 1 LD DFB,214.0,139.1,1.1,214.0,126
CDM,93283AGEXOH,DEFIBRILLATOR PROGRAMMING DUAL,506.0,328.9,1.1,506.0,144
CDM,93283OH,PRGRMG EVAL IMPLANTABLE IN PRSN DUAL LEAD DFB,720.0,468.0,1.1,720.0,144
CDM,93283OH-26,PRGRMG EVAL IMPLANTABLE IN PRSN DUAL LEAD DFB,506.0,328.9,1.1,506.0,126
CDM,93283OH-TC,PRGRMG EVAL IMPLANTABLE IN PRSN DUAL LEAD DFB,214.0,139.1,1.1,214.0,126
CDM,93284AGEXOH,DEFIBRILLATOR PROGRAMMING MULT,550.0,357.5,1.1,550.0,144
CDM,93284OH,PRGRMG EVAL IMPLANTABLE IN PERSON MULTI LEAD DFB,764.0,496.6,1.1,764.0,144
CDM,93284OH-26,PRGRMG EVAL IMPLANTABLE IN PERSON MULTI LEAD DFB,550.0,357.5,1.1,550.0,126
CDM,93284OH-TC,PRGRMG EVAL IMPLANTABLE IN PERSON MULTI LEAD DFB,214.0,139.1,1.1,214.0,126
CDM,93285OH,PRGRMG DEV EVAL SCRMS PHYS/QHP IN PERSON,422.0,274.3,1.1,422.0,144
CDM,93285OH-26,PRGRMG DEV EVAL SCRMS PHYS/QHP IN PERSON,208.0,135.2,1.1,208.0,126
CDM,93285OH-TC,PRGRMG DEV EVAL SCRMS PHYS/QHP IN PERSON,214.0,139.1,1.1,214.0,126
CDM,93286AGEXOH,PACEMAKER PERI PROCEDURAL,132.0,85.8,1.1,150.82,144
CDM,93286OH,PERI-PX DEV EVAL PM/LDLS PM PHYS/QHP IN PERSON,434.0,282.1,1.1,434.0,144
CDM,93286OH-26,PERI-PX DEV EVAL PM/LDLS PM PHYS/QHP IN PERSON,132.0,85.8,1.1,132.0,126
CDM,93286OH-TC,PERI-PX DEV EVAL PM/LDLS PM PHYS/QHP IN PERSON,302.0,196.3,1.1,302.0,126
CDM,93287AGEXOH,DEFIBRILLATOR PERI PROCEDURAL,198.0,128.7,1.1,198.0,144
CDM,93287OH,PERI-PX DEV EVAL & PROG SING/DUAL/MULTI LEAD DFB,537.0,349.05,1.1,537.0,144
CDM,93287OH-26,PERI-PX DEV EVAL & PROG SING/DUAL/MULTI LEAD DFB,198.0,128.7,1.1,198.0,126
CDM,93287OH-TC,PERI-PX DEV EVAL & PROG SING/DUAL/MULTI LEAD DFB,339.0,220.35,1.1,339.0,126
CDM,93288AGEXOH,PACEMAKER INTERROGATION,172.0,111.8,1.1,185.24,144
CDM,93288OH,INTERROG DEV EVAL PM/LDLS PM PHYS/QHP IN PERSON,386.0,250.9,1.1,386.0,144
CDM,93288OH-26,INTERROG DEV EVAL PM/LDLS PM PHYS/QHP IN PERSON,172.0,111.8,1.1,172.0,126
CDM,93288OH-TC,INTERROG DEV EVAL PM/LDLS PM PHYS/QHP IN PERSON,214.0,139.1,1.1,214.0,126
CDM,93289OH,INTERROG EVAL F2F 1/DUAL/MLT LEADS IMPLTBL DFB,544.0,353.6,1.1,544.0,144
CDM,93289OH-26,INTERROG EVAL F2F 1/DUAL/MLT LEADS IMPLTBL DFB,330.0,214.5,1.1,330.0,126
CDM,93289OH-TC,INTERROG EVAL F2F 1/DUAL/MLT LEADS IMPLTBL DFB,214.0,139.1,1.1,214.0,126
CDM,93290AGEXOH,PHYSIOLOGICAL MONITOR INTERROGATION,189.0,122.85,1.1,189.0,144
CDM,93290OH,INTERROG DEV EVAL ICPMS PHYS/QHP IN PERSON,403.0,261.95,1.1,403.0,144
CDM,93290OH-26,INTERROG DEV EVAL ICPMS PHYS/QHP IN PERSON,189.0,122.85,1.1,189.0,126
CDM,93290OH-TC,INTERROG DEV EVAL ICPMS PHYS/QHP IN PERSON,214.0,139.1,1.1,214.0,126
CDM,93291AGEXOH,IMPLANTABLE LOOP RECORDER INTERROGATION,163.0,105.95,1.1,163.26,144
CDM,93291OH,INTERROG DEV EVAL SCRMS PHYS/QHP IN PERSON,304.0,197.6,1.1,304.0,144
CDM,93291OH-26,INTERROG DEV EVAL SCRMS PHYS/QHP IN PERSON,163.0,105.95,1.1,163.0,126
CDM,93291OH-TC,INTERROG DEV EVAL SCRMS PHYS/QHP IN PERSON,141.0,91.65,1.1,141.0,126
CDM,93292AGEXOH,WEARABLE DEFIBRILLATOR INTERROGATION,172.0,111.8,1.1,172.0,144
CDM,93292OH,INTERROGATION EVAL IN PERSON WR DEFIBRILLATOR,386.0,250.9,1.1,386.0,144
CDM,93292OH-26,INTERROGATION EVAL IN PERSON WR DEFIBRILLATOR,172.0,111.8,1.1,172.0,126
CDM,93292OH-TC,INTERROGATION EVAL IN PERSON WR DEFIBRILLATOR,214.0,139.1,1.1,214.0,126
CDM,93293AGEXOH,TELEPHONIC MONITORING,136.0,88.4,1.1,148.78,144
CDM,93293OH,TRANSTELEPHONIC RHYTHM STRIP PACEMAKER EVAL,350.0,227.5,1.1,350.0,144
CDM,93293OH-26,TRANSTELEPHONIC RHYTHM STRIP PACEMAKER EVAL,136.0,88.4,1.1,136.0,126
CDM,93293OH-TC,TRANSTELEPHONIC RHYTHM STRIP PACEMAKER EVAL,214.0,139.1,1.1,214.0,126
CDM,93294OH,REM INTERROG PM/LDLS PM <90 D PHYS/QHP,240.0,156.0,1.1,240.0,144
CDM,93295OH,INTERROGATION EVAL REMOTE </90 D 1/2/MLT LD DFB,326.0,211.9,1.1,326.0,144
CDM,93296AGEXOH,DEFIBRILLATOR HEART RHYTHM DATA PRO CODE,89.0,57.85,1.1,110.2,144
CDM,93297OH,REM INTERROG ICPMS <30 D PHYS/QHP,422.0,274.3,1.1,422.0,144
CDM,93297OH-26,REM INTERROG ICPMS <30 D PHYS/QHP,208.0,135.2,1.1,208.0,114
CDM,93297OH-TC,REM INTERROG ICPMS <30 D PHYS/QHP,214.0,139.1,1.1,214.0,114
CDM,93298OH,REM INTERROG SCRMS <30 D PHYS/QHP,422.0,274.3,1.1,422.0,144
CDM,93298OH-26,REM INTERROG SCRMS <30 D PHYS/QHP,208.0,135.2,1.1,208.0,114
CDM,93298OH-TC,REM INTERROG SCRMS <30 D PHYS/QHP,214.0,139.1,1.1,214.0,114
CDM,93303OH,COMPLETE TTHRC ECHO CONGENITAL CARDIAC ANOMALY,3725.0,2421.25,1.1,3725.0,144
CDM,93303OH-26,COMPLETE TTHRC ECHO CONGENITAL CARDIAC ANOMALY,572.0,371.8,1.1,572.0,126
CDM,93303OH-TC,COMPLETE TTHRC ECHO CONGENITAL CARDIAC ANOMALY,3153.0,2049.45,1.1,3153.0,126
CDM,93304OH,F-UP/LIMITED TTHRC ECHO CONGENITAL CAR ANOMALY,3483.0,2263.95,1.1,3483.0,144
CDM,93304OH-26,F-UP/LIMITED TTHRC ECHO CONGENITAL CAR ANOMALY,330.0,214.5,1.1,330.0,126
CDM,93304OH-TC,F-UP/LIMITED TTHRC ECHO CONGENITAL CAR ANOMALY,3153.0,2049.45,1.1,3153.0,126
CDM,93306OH,ECHO TTHRC R-T 2D W/WOM-MODE COMPL SPEC&COLR D,3795.0,2466.75,1.1,3795.0,144
CDM,93306OH-26,ECHO TTHRC R-T 2D W/WOM-MODE COMPL SPEC&COLR D,642.0,417.3,1.1,642.0,126
CDM,93306OH-TC,ECHO TTHRC R-T 2D W/WOM-MODE COMPL SPEC&COLR D,3153.0,2049.45,1.1,3153.0,126
CDM,93307OH,ECHO TRANSTHORAC R-T 2D W/WO M-MODE REC COMP,1795.0,1166.75,1.1,1795.0,144
CDM,93307OH-26,ECHO TRANSTHORAC R-T 2D W/WO M-MODE REC COMP,405.0,263.25,1.1,405.0,126
CDM,93307OH-TC,ECHO TRANSTHORAC R-T 2D W/WO M-MODE REC COMP,1390.0,903.5,1.1,1390.0,126
CDM,93308OH,ECHO TRANSTHORC R-T 2D W/WO M-MODE REC F-UP/LMTD,1623.0,1054.95,1.1,1623.0,144
CDM,93308OH-26,ECHO TRANSTHORC R-T 2D W/WO M-MODE REC F-UP/LMTD,233.0,151.45,1.1,233.0,126
CDM,93308OH-TC,ECHO TRANSTHORC R-T 2D W/WO M-MODE REC F-UP/LMTD,1390.0,903.5,1.1,1390.0,126
CDM,93312OH,ECHO TRANSESOPHAG R-T 2D W/PRB IMG ACQUISJ I&R,4165.0,2707.25,1.1,4165.0,144
CDM,93312OH-26,ECHO TRANSESOPHAG R-T 2D W/PRB IMG ACQUISJ I&R,1012.0,657.8,1.1,1012.0,126
CDM,93312OH-TC,ECHO TRANSESOPHAG R-T 2D W/PRB IMG ACQUISJ I&R,3153.0,2049.45,1.1,3153.0,126
CDM,93313OH,ECHO R-T 2D W/PROBE PLACEMENT ONLY,114.0,74.1,1.1,1610.09,144
CDM,93314OH,ECHO TRANSESOPHAG R-T 2D IMG ACQUISJ I&R ONLY,3051.0,1983.15,1.1,3051.0,144
CDM,93314OH-26,ECHO TRANSESOPHAG R-T 2D IMG ACQUISJ I&R ONLY,814.0,529.1,1.1,814.0,126
CDM,93314OH-TC,ECHO TRANSESOPHAG R-T 2D IMG ACQUISJ I&R ONLY,2237.0,1454.05,1.1,2237.0,126
CDM,93315OH,ECHO TRANSESOPHAG CONGEN PROBE PLCMT IMGNG I&R,4337.0,2819.05,1.1,4337.0,106
CDM,93315OH-26,ECHO TRANSESOPHAG CONGEN PROBE PLCMT IMGNG I&R,1184.0,769.6,1.1,1184.0,126
CDM,93315OH-TC,ECHO TRANSESOPHAG CONGEN PROBE PLCMT IMGNG I&R,3153.0,2049.45,1.1,3153.0,94
CDM,93316OH,ECHO TRANSESOPHAG CONGEN PROBE PLCMT ONLY,264.0,171.6,1.1,1610.09,144
CDM,93317OH,ECHO TRANSESOPHAG IMAGE ACQUISJ INTERP&REPORT,810.0,526.5,1.1,894.56,106
CDM,93317OH-26,ECHO TRANSESOPHAG IMAGE ACQUISJ INTERP&REPORT,810.0,526.5,1.1,810.0,126
CDM,93317PEDSOH,"ECHO TRANSESOPH,CONG ANOM,ACQ,INTERP",607.2,394.68,1.1,894.56,106
CDM,93318OH,ECHO TRANSESOPHAG MONTR CARDIAC PUMP FUNCTJ,4099.0,2664.35,1.1,4099.0,106
CDM,93318OH-26,ECHO TRANSESOPHAG MONTR CARDIAC PUMP FUNCTJ,946.0,614.9,1.1,946.0,126
CDM,93318OH-TC,ECHO TRANSESOPHAG MONTR CARDIAC PUMP FUNCTJ,3153.0,2049.45,1.1,3153.0,94
CDM,93319OH,ECHO 3D IMG&PST-PXESSING TEE/TTE CGEN CAR ANOMAL,220.0,143.0,1.1,220.0,148
CDM,93320OH,DOPPLER ECHOCARD PULSE WAVE W/SPECTRAL DISPLAY,1500.0,975.0,1.1,1500.0,144
CDM,93320OH-26,DOPPLER ECHOCARD PULSE WAVE W/SPECTRAL DISPLAY,167.0,108.55,1.1,167.0,126
CDM,93320OH-TC,DOPPLER ECHOCARD PULSE WAVE W/SPECTRAL DISPLAY,1333.0,866.45,1.1,1333.0,126
CDM,93321OH,DOP ECHOCARD PULSE WAVE W/SPECTRAL F-UP/LMTD STD,666.0,432.9,1.1,666.0,144
CDM,93321OH-26,DOP ECHOCARD PULSE WAVE W/SPECTRAL F-UP/LMTD STD,66.0,42.9,1.1,66.0,126
CDM,93321OH-TC,DOP ECHOCARD PULSE WAVE W/SPECTRAL F-UP/LMTD STD,600.0,390.0,1.1,600.0,126
CDM,93325OH,DOP ECHOCARD COLOR FLOW VELOCITY MAPPING,1097.0,713.05,1.1,1097.0,144
CDM,93325OH-26,DOP ECHOCARD COLOR FLOW VELOCITY MAPPING,31.0,20.15,1.1,31.0,126
CDM,93325OH-TC,DOP ECHOCARD COLOR FLOW VELOCITY MAPPING,1066.0,692.9,1.1,1066.0,126
CDM,93350OH,ECHO TTHRC R-T 2D W/WO M-MODE COMPLETE REST&ST,3795.0,2466.75,1.1,3795.0,144
CDM,93350OH-26,ECHO TTHRC R-T 2D W/WO M-MODE COMPLETE REST&ST,642.0,417.3,1.1,642.0,126
CDM,93350OH-TC,ECHO TTHRC R-T 2D W/WO M-MODE COMPLETE REST&ST,3153.0,2049.45,1.1,3153.0,126
CDM,93351OH,ECHO TTHRC R-T 2D W/WO M-MODE REST&STRS CONT ECG,3923.0,2549.95,1.1,3923.0,144
CDM,93351OH-26,ECHO TTHRC R-T 2D W/WO M-MODE REST&STRS CONT ECG,770.0,500.5,1.1,770.0,126
CDM,93351OH-TC,ECHO TTHRC R-T 2D W/WO M-MODE REST&STRS CONT ECG,3153.0,2049.45,1.1,3153.0,126
CDM,93352OH,USE OF ECHO CONTRAST AGENT DURING STRESS ECHO,84.0,54.6,1.1,110.16,144
CDM,93355OH,ECHO TEE GUID TCAT ICAR/VESSEL STRUCTURAL INTVN,2050.0,1332.5,1.1,2050.0,144
CDM,93356OH,MYOCRD STRAIN IMG SPECKLE TRCK ASSMT MYOCRD MECH,106.0,68.9,1.1,121.34,148
CDM,93451OH,RIGHT HEART CATH O2 SATURATION & CARDIAC OUTPUT,19581.0,12727.65,1.1,19581.0,144
CDM,93451OH-26,RIGHT HEART CATH O2 SATURATION & CARDIAC OUTPUT,1087.0,706.55,1.1,1087.0,126
CDM,93451OH-TC,RIGHT HEART CATH O2 SATURATION & CARDIAC OUTPUT,18494.0,12021.1,1.1,18494.0,114
CDM,93452OH,L HRT CATH W/NJX L VENTRICULOGRAPHY IMG S&I,20474.0,13308.1,1.1,20474.0,144
CDM,93452OH-26,L HRT CATH W/NJX L VENTRICULOGRAPHY IMG S&I,1980.0,1287.0,1.1,1980.0,126
CDM,93452OH-TC,L HRT CATH W/NJX L VENTRICULOGRAPHY IMG S&I,18494.0,12021.1,1.1,18494.0,114
CDM,93453OH,R & L HRT CATH W/NJX L VENTRICULOG IMG S&I,21130.0,13734.5,1.1,21130.0,144
CDM,93453OH-26,R & L HRT CATH W/NJX L VENTRICULOG IMG S&I,2636.0,1713.4,1.1,2636.0,126
CDM,93453OH-TC,R & L HRT CATH W/NJX L VENTRICULOG IMG S&I,18494.0,12021.1,1.1,18494.0,114
CDM,93454AOH,CORONARY ANGIOGRAPHY + FFR,1998.0,1298.7,1.1,9504.41,144
CDM,93454BOH,CORONARY ANIO + FFR/3D MAPPING (CATHWORKS),1998.0,1298.7,1.1,9504.41,144
CDM,93454OH,CATH PLMT & NJX CORONARY ART ANGIO IMG S&I,20492.0,13319.8,1.1,20492.0,144
CDM,93454OH-26,CATH PLMT & NJX CORONARY ART ANGIO IMG S&I,1998.0,1298.7,1.1,1998.0,126
CDM,93454OH-TC,CATH PLMT & NJX CORONARY ART ANGIO IMG S&I,18494.0,12021.1,1.1,18494.0,114
CDM,93455OH,CATH PLMT & NJX CORONARY ART/GRFT ANGIO IMG S&I,20822.0,13534.3,1.1,20822.0,144
CDM,93455OH-26,CATH PLMT & NJX CORONARY ART/GRFT ANGIO IMG S&I,2328.0,1513.2,1.1,2328.0,126
CDM,93455OH-TC,CATH PLMT & NJX CORONARY ART/GRFT ANGIO IMG S&I,18494.0,12021.1,1.1,18494.0,114
CDM,93456OH,CATH PLMT R HRT & ARTS W/NJX & ANGIO IMG S&I,21090.0,13708.5,1.1,21090.0,144
CDM,93456OH-26,CATH PLMT R HRT & ARTS W/NJX & ANGIO IMG S&I,2596.0,1687.4,1.1,2596.0,126
CDM,93456OH-TC,CATH PLMT R HRT & ARTS W/NJX & ANGIO IMG S&I,18494.0,12021.1,1.1,18494.0,114
CDM,93457OH,CATH PLMT R HRT/ARTS/GRFTS W/NJX&ANGIO IMG S&I,21416.0,13920.4,1.1,21416.0,144
CDM,93457OH-26,CATH PLMT R HRT/ARTS/GRFTS W/NJX&ANGIO IMG S&I,2922.0,1899.3,1.1,2922.0,126
CDM,93457OH-TC,CATH PLMT R HRT/ARTS/GRFTS W/NJX&ANGIO IMG S&I,18494.0,12021.1,1.1,18494.0,114
CDM,93458OH,CATH PLMT L HRT & ARTS W/NJX & ANGIO IMG S&I,20958.0,13622.7,1.1,20958.0,144
CDM,93458OH-26,CATH PLMT L HRT & ARTS W/NJX & ANGIO IMG S&I,2464.0,1601.6,1.1,2464.0,126
CDM,93458OH-TC,CATH PLMT L HRT & ARTS W/NJX & ANGIO IMG S&I,18494.0,12021.1,1.1,18494.0,114
CDM,93459OH,CATH PLMT L HRT/ARTS/GRFTS WNJX & ANGIO IMG S&I,21288.0,13837.2,1.1,21288.0,144
CDM,93459OH-26,CATH PLMT L HRT/ARTS/GRFTS WNJX & ANGIO IMG S&I,2794.0,1816.1,1.1,2794.0,126
CDM,93459OH-TC,CATH PLMT L HRT/ARTS/GRFTS WNJX & ANGIO IMG S&I,18494.0,12021.1,1.1,18494.0,114
CDM,93460OH,R & L HRT CATH WINJX HRT ART& L VENTR IMG,21618.0,14051.7,1.1,21618.0,144
CDM,93460OH-26,R & L HRT CATH WINJX HRT ART& L VENTR IMG,3124.0,2030.6,1.1,3124.0,126
CDM,93460OH-TC,R & L HRT CATH WINJX HRT ART& L VENTR IMG,18494.0,12021.1,1.1,18494.0,114
CDM,93461OH,R& L HRT CATH W/INJEC HRT ART/GRFT& L VENT I,21948.0,14266.2,1.1,21948.0,144
CDM,93461OH-26,R& L HRT CATH W/INJEC HRT ART/GRFT& L VENT I,3454.0,2245.1,1.1,3454.0,126
CDM,93461OH-TC,R& L HRT CATH W/INJEC HRT ART/GRFT& L VENT I,18494.0,12021.1,1.1,18494.0,114
CDM,93462OH,LEFT HEART CATH BY TRANSEPTAL PUNCTURE,1641.0,1066.65,1.1,1641.0,144
CDM,93463OH,MEDICATION ADMIN & HEMODYNAMIC MEASURMENT,880.0,572.0,1.1,880.0,144
CDM,93464OH,PHYSIOLOGIC EXERCISE STUDY & HEMODYNAMIC MEASURE,3551.0,2308.15,1.1,3551.0,144
CDM,93464OH-26,PHYSIOLOGIC EXERCISE STUDY & HEMODYNAMIC MEASURE,720.0,468.0,1.1,720.0,126
CDM,93464OH-TC,PHYSIOLOGIC EXERCISE STUDY & HEMODYNAMIC MEASURE,2831.0,1840.15,1.1,2831.0,126
CDM,93503OH,INSERTION FLOW DIRECTED CATHETER FOR MONITORING,880.0,572.0,1.1,4671.09,144
CDM,93505OH,ENDOMYOCARDIAL BIOPSY,19911.0,12942.15,1.1,19911.0,144
CDM,93505OH-26,ENDOMYOCARDIAL BIOPSY,1813.0,1178.45,1.1,1813.0,126
CDM,93505OH-TC,ENDOMYOCARDIAL BIOPSY,18098.0,11763.7,1.1,18098.0,114
CDM,93563OH,NJX SEL HRT ART CONGENITAL HRT CATH W/S&I,400.0,260.0,1.1,400.0,142
CDM,93564OH,NJX SEL HRT ART/GRFT CONGENITAL HRT CATH W/S&I,412.0,267.8,1.1,412.0,142
CDM,93565OH,NJX SEL L VENT/ATRIAL ANGIO HRT CATH W/S&I,220.0,143.0,1.1,220.0,142
CDM,93566OH,NJX SEL R VENT/ATRIAL ANGIO HRT CATH W/S&I,220.0,143.0,1.1,220.0,142
CDM,93567OH,NJX SUPRAVALV AORTOG HRT CATH W/S&I,308.0,200.2,1.1,308.0,142
CDM,93568OH,NJX DRG C-CATHJ NSLCTV P-ART ANGIOGRAPHY,387.0,251.55,1.1,387.0,142
CDM,93569OH,NJX DRG C-CATHJ SLCTV P-ART ANGIOGRAPHY UNI,343.0,222.95,1.1,343.0,142
CDM,9357152OH,IV DOP VEL&/OR PRESS C/FLO RSRV MEAS 1ST VSL,616.0,400.4,1.1,616.0,68
CDM,93571OH-23,IV DOP VEL&/OR PRESS C/FLO RSRV MEAS 1ST VSL,5232.0,3400.8,1.1,7735.57,104
CDM,93571OH-24,IV DOP VEL&/OR PRESS C/FLO RSRV MEAS 1ST VSL,607.0,394.55,1.1,7735.57,104
CDM,93571OH-26,IV DOP VEL&/OR PRESS C/FLO RSRV MEAS 1ST VSL,607.0,394.55,1.1,607.0,124
CDM,93571OH-TC,IV DOP VEL&/OR PRESS C/FLO RSRV MEAS 1ST VSL,4625.0,3006.25,1.1,4625.0,94
CDM,9357252OH,IV DOP VEL&/OR PRESS C/FLO RSRV MEAS ADDL VSL,492.0,319.8,1.1,492.0,68
CDM,93572OH,IV DOP VEL&/OR PRESS C/FLO RSRV MEAS ADDL VSL,5190.0,3373.5,1.1,7719.15,104
CDM,93572OH-26,IV DOP VEL&/OR PRESS C/FLO RSRV MEAS ADDL VSL,440.0,286.0,1.1,440.0,124
CDM,93572OH-TC,IV DOP VEL&/OR PRESS C/FLO RSRV MEAS ADDL VSL,4750.0,3087.5,1.1,4750.0,94
CDM,93573OH,NJX DRG C-CATHJ SLCTV P-ART ANGIOGRAPHY BI,572.0,371.8,1.1,572.0,142
CDM,93574OH,NJX DRG C-CATHJ SLCTV PULM VEN ANGIOGRAPHY,634.0,412.1,1.1,634.0,142
CDM,93575OH,NJX DRG C-CATHJ SLCTV PULM ANGRPH MAPCA CHD EA,845.0,549.25,1.1,845.0,142
CDM,93580OH,PRQ TCAT CLSR CGEN INTRATRL COMUNICAJ W/IMPLT,7907.0,5139.55,1.1,51140.13,142
CDM,93581OH,PRQ TCAT CLSR CGEN VENTR SEPTAL DFCT W/IMPLT,9756.0,6341.4,1.1,51140.13,142
CDM,93582OH,PERCUTAN TRANSCATH CLOSURE PAT DUCT ARTERIOSUS,4924.0,3200.6,1.1,51140.13,142
CDM,93583OH,PERCUTANEOUS TRANSCATHETER SEPTAL REDUCTION THER,5500.0,3575.0,1.1,5500.0,142
CDM,93584OH,VENOGRAPHY CHD ANOMALOUS/PERSISTENT SVC NT DRG,528.0,343.2,1.1,528.0,142
CDM,93585OH,VENOGRAPHY CHD AZYGOS/HEMIAZYGOS VENOUS SYSTEM,497.0,323.05,1.1,497.0,142
CDM,93586OH,VENOGRAPHY CHD CORONARY SINUS,629.0,408.85,1.1,629.0,142
CDM,93587OH,VENOGRAPHY CHD VENOVENOUS COLTRL AT/ABOVE HRT,928.0,603.2,1.1,928.0,142
CDM,93588OH,VENOGRAPHY CHD VENOVENOUS COLLATERAL BELOW HEART,937.0,609.05,1.1,937.0,142
CDM,93590OH,PERQ TRANSCATH CLS PARAVALVR LEAK 1 MITRAL VALVE,8680.0,5642.0,1.1,51140.13,142
CDM,93591OH,PERQ TRANSCATH CLS PARAVALVR LEAK 1 AORTIC VALVE,7188.0,4672.2,1.1,51140.13,142
CDM,93592OH,PERQ TRANSCATH CLS PARAVALVR LEAK EACH OCCLS DEV,3200.0,2080.0,1.1,3200.0,142
CDM,93593OH,R HRT CATH CHD W/IMG CATH TRGT ZONE NML NT CONNJ,20090.0,13058.5,1.1,20090.0,76
CDM,93593OH-26,R HRT CATH CHD W/IMG CATH TRGT ZONE NML NT CONNJ,1596.0,1037.4,1.1,1596.0,124
CDM,93593OH-TC,R HRT CATH CHD W/IMG CATH TRGT ZONE NML NT CONNJ,18494.0,12021.1,0.03,18494.0,74
CDM,93594OH,R HRT CATH CHD W/IMG CATH TRGT ZON ABNL NT CONNJ,20934.0,13607.1,1.1,20934.0,76
CDM,93594OH-26,R HRT CATH CHD W/IMG CATH TRGT ZON ABNL NT CONNJ,2440.0,1586.0,1.1,2440.0,124
CDM,93594OH-TC,R HRT CATH CHD W/IMG CATH TRGT ZON ABNL NT CONNJ,18494.0,12021.1,0.03,18494.0,74
CDM,93595OH,L HRT CATH CHD IMG CATH TRGT ZON NML/ABNL NT CNJ,21035.0,13672.75,1.1,21035.0,76
CDM,93595OH-26,L HRT CATH CHD IMG CATH TRGT ZON NML/ABNL NT CNJ,2541.0,1651.65,1.1,2541.0,124
CDM,93595OH-TC,L HRT CATH CHD IMG CATH TRGT ZON NML/ABNL NT CNJ,18494.0,12021.1,0.03,18494.0,74
CDM,93596OH,R&L HRT CATH CHD IMG CATH TRGT ZONE NML NT CONNJ,21230.0,13799.5,1.1,21230.0,76
CDM,93596OH-26,R&L HRT CATH CHD IMG CATH TRGT ZONE NML NT CONNJ,2736.0,1778.4,1.1,2736.0,124
CDM,93596OH-TC,R&L HRT CATH CHD IMG CATH TRGT ZONE NML NT CONNJ,18494.0,12021.1,1.1,18494.0,78
CDM,93597OH,R&L HRT CATH CHD IMG CATH TRGT ZON ABNL NT CONNJ,22046.0,14329.9,1.1,22046.0,76
CDM,93597OH-26,R&L HRT CATH CHD IMG CATH TRGT ZON ABNL NT CONNJ,3552.0,2308.8,1.1,3552.0,124
CDM,93597OH-TC,R&L HRT CATH CHD IMG CATH TRGT ZON ABNL NT CONNJ,18494.0,12021.1,1.1,18494.0,78
CDM,93598OH,CAR OUTP MEAS DRG CAR CATH EVAL CGEN HRT DEFECT,1307.0,849.55,1.1,1307.0,76
CDM,93598OH-26,CAR OUTP MEAS DRG CAR CATH EVAL CGEN HRT DEFECT,634.0,412.1,1.1,634.0,124
CDM,93598OH-TC,CAR OUTP MEAS DRG CAR CATH EVAL CGEN HRT DEFECT,673.0,437.45,0.03,673.0,74
CDM,93600OH,BUNDLE OF HIS RECORDING,21680.0,14092.0,1.1,21782.08,104
CDM,93600OH-26,BUNDLE OF HIS RECORDING,933.0,606.45,1.1,933.0,124
CDM,93600OH-TC,BUNDLE OF HIS RECORDING,20747.0,13485.55,1.1,20747.0,94
CDM,93602OH,INTRA-ATRIAL RECORDING,44565.0,28967.25,1.1,44565.0,104
CDM,93602OH-26,INTRA-ATRIAL RECORDING,933.0,606.45,1.1,933.0,124
CDM,93602OH-TC,INTRA-ATRIAL RECORDING,43632.0,28360.8,1.1,43632.0,94
CDM,93603OH,RIGHT VENTRICULAR RECORDING,7913.0,5143.45,1.1,7913.0,104
CDM,93603OH-26,RIGHT VENTRICULAR RECORDING,933.0,606.45,1.1,933.0,124
CDM,93603OH-TC,RIGHT VENTRICULAR RECORDING,6980.0,4537.0,1.1,6980.0,94
CDM,93609OH,INTRA-VENTRIC&/ATRIAL MAPG TACHYCARD W/CATH MA,8140.0,5291.0,1.1,8140.0,104
CDM,93609OH-26,INTRA-VENTRIC&/ATRIAL MAPG TACHYCARD W/CATH MA,2177.0,1415.05,1.1,2177.0,124
CDM,93609OH-TC,INTRA-VENTRIC&/ATRIAL MAPG TACHYCARD W/CATH MA,5963.0,3875.95,1.1,5963.0,94
CDM,93610OH,INTRA-ATRIAL PACING,44961.0,29224.65,1.1,44961.0,104
CDM,93610OH-26,INTRA-ATRIAL PACING,1329.0,863.85,1.1,1329.0,124
CDM,93610OH-TC,INTRA-ATRIAL PACING,43632.0,28360.8,1.1,43632.0,94
CDM,93612OH,INTRAVENTRICULAR PACING,44961.0,29224.65,1.1,44961.0,104
CDM,93612OH-26,INTRAVENTRICULAR PACING,1329.0,863.85,1.1,1329.0,124
CDM,93612OH-TC,INTRAVENTRICULAR PACING,43632.0,28360.8,1.1,43632.0,94
CDM,93613OH,INTRACARDIAC ELECTROPHYSIOLOGIC 3D MAPPING,2092.0,1359.8,1.1,2092.0,142
CDM,93615OH,ESOPHGL REC ATRIAL W/WO VENTRICULAR ELECTROGRAMS,7306.0,4748.9,1.1,7306.0,104
CDM,93615OH-26,ESOPHGL REC ATRIAL W/WO VENTRICULAR ELECTROGRAMS,326.0,211.9,1.1,326.0,124
CDM,93615OH-TC,ESOPHGL REC ATRIAL W/WO VENTRICULAR ELECTROGRAMS,6980.0,4537.0,1.1,6980.0,94
CDM,93616OH,ESOPHGL REC ATRIAL W/WO VENTR ELECTRGRAMS W/PACG,7526.0,4891.9,1.1,7526.0,104
CDM,93616OH-26,ESOPHGL REC ATRIAL W/WO VENTR ELECTRGRAMS W/PACG,546.0,354.9,1.1,546.0,124
CDM,93616OH-TC,ESOPHGL REC ATRIAL W/WO VENTR ELECTRGRAMS W/PACG,6980.0,4537.0,1.1,6980.0,94
CDM,93618OH,INDUCTION ARRHYTHMIA ELECTRICAL PACING,8675.0,5638.75,1.1,8675.0,104
CDM,93618OH-26,INDUCTION ARRHYTHMIA ELECTRICAL PACING,1695.0,1101.75,1.1,1695.0,124
CDM,93618OH-TC,INDUCTION ARRHYTHMIA ELECTRICAL PACING,6980.0,4537.0,1.1,6980.0,94
CDM,93619OH,COMPRE ELECTROPHYSIOLOGIC W/O ARRHYT INDUCTION,46632.0,30310.8,1.1,46632.0,104
CDM,93619OH-26,COMPRE ELECTROPHYSIOLOGIC W/O ARRHYT INDUCTION,3000.0,1950.0,1.1,3000.0,124
CDM,93619OH-TC,COMPRE ELECTROPHYSIOLOGIC W/O ARRHYT INDUCTION,43632.0,28360.8,1.1,43632.0,94
CDM,93620OH,COMPRE ELECTROPHYSIOLOGIC ARRHYTHMIA INDUCTION,48613.0,31598.45,1.1,48613.0,104
CDM,93620OH-26,COMPRE ELECTROPHYSIOLOGIC ARRHYTHMIA INDUCTION,4981.0,3237.65,1.1,4981.0,124
CDM,93620OH-TC,COMPRE ELECTROPHYSIOLOGIC ARRHYTHMIA INDUCTION,43632.0,28360.8,1.1,43632.0,90
CDM,93621OH,COMPRE ELECTROPHYSIOL XM W/LEFT ATRIAL PACNG/REC,15248.0,9911.2,1.1,15248.0,104
CDM,93621OH-26,COMPRE ELECTROPHYSIOL XM W/LEFT ATRIAL PACNG/REC,660.0,429.0,1.1,660.0,124
CDM,93621OH-TC,COMPRE ELECTROPHYSIOL XM W/LEFT ATRIAL PACNG/REC,14588.0,9482.2,1.1,14588.0,94
CDM,93622OH,COMPRE ELECTROPHYSIOL XM W/LEFT VENTR PACNG/REC,11827.0,7687.55,1.1,11827.0,104
CDM,93622OH-26,COMPRE ELECTROPHYSIOL XM W/LEFT VENTR PACNG/REC,1313.0,853.45,1.1,1313.0,124
CDM,93622OH-TC,COMPRE ELECTROPHYSIOL XM W/LEFT VENTR PACNG/REC,10514.0,6834.1,1.1,10514.0,94
CDM,93623OH,PROGRAMMED STIMJ & PACG AFTER IV DRUG NFS,10095.0,6561.75,1.1,10095.0,104
CDM,93623OH-26,PROGRAMMED STIMJ & PACG AFTER IV DRUG NFS,431.0,280.15,1.1,470.33,124
CDM,93623OH-TC,PROGRAMMED STIMJ & PACG AFTER IV DRUG NFS,9664.0,6281.6,1.1,9664.0,94
CDM,93631OH,INTRAOP EPICAR& ENDOCAR PACG& MAPG,27443.0,17837.95,1.1,27443.0,104
CDM,93631OH-26,INTRAOP EPICAR& ENDOCAR PACG& MAPG,3340.0,2171.0,1.1,3340.0,124
CDM,93631OH-TC,INTRAOP EPICAR& ENDOCAR PACG& MAPG,24103.0,15666.95,1.1,24103.0,94
CDM,93640OH,EPHYS EVAL PACG CVDFB LDS INITIAL IMPLAN/REPLACE,4108.0,2670.2,1.1,4108.0,104
CDM,93640OH-26,EPHYS EVAL PACG CVDFB LDS INITIAL IMPLAN/REPLACE,1434.0,932.1,1.1,1434.0,124
CDM,93640OH-TC,EPHYS EVAL PACG CVDFB LDS INITIAL IMPLAN/REPLACE,3549.0,2306.85,1.1,3549.0,94
CDM,93641OH,EPHYS EVAL PACG CVDFB LDS W/TSTG OF PULSE GEN,6433.0,4181.45,1.1,6433.0,104
CDM,93641OH-26,EPHYS EVAL PACG CVDFB LDS W/TSTG OF PULSE GEN,2495.0,1621.75,1.1,2495.0,124
CDM,93641OH-TC,EPHYS EVAL PACG CVDFB LDS W/TSTG OF PULSE GEN,3938.0,2559.7,1.1,3938.0,94
CDM,93642OH,EPHYS EVAL PACG CVDFB PRGRMG/REPRGRMG PARAMETERS,9017.0,5861.05,1.1,9017.0,142
CDM,93642OH-26,EPHYS EVAL PACG CVDFB PRGRMG/REPRGRMG PARAMETERS,2037.0,1324.05,1.1,2037.0,124
CDM,93642OH-TC,EPHYS EVAL PACG CVDFB PRGRMG/REPRGRMG PARAMETERS,6980.0,4537.0,1.1,6980.0,126
CDM,93644OH,EPHYS EVAL SUBQ IMPLANTABLE DEFIBRILLATOR,7111.0,4622.15,1.1,7111.0,140
CDM,93644OH-26,EPHYS EVAL SUBQ IMPLANTABLE DEFIBRILLATOR,1338.0,869.7,1.1,1338.0,124
CDM,93644OH-TC,EPHYS EVAL SUBQ IMPLANTABLE DEFIBRILLATOR,5773.0,3752.45,1.1,5773.0,126
CDM,93650OH,ICAR CATHETER ABLATION ATRIOVENTR NODE FUNCTION,4096.0,2662.4,1.1,21782.08,142
CDM,93653OH,COMPRE EP EVAL ABLTJ 3D MAPG TX SVT,6600.0,4290.0,1.1,69267.37,144
CDM,93654OH,COMPRE EP EVAL ABLTJ 3D MAPG TX VT,7964.0,5176.6,1.1,69267.37,144
CDM,93655OH,ICAR CATHETER ABLATION ARRHYTHMIA ADD ON,2420.0,1573.0,1.1,2420.0,144
CDM,93656OH,COMPRE EP EVAL ABLTJ ATR FIB PULM VEIN ISOLATION,7480.0,4862.0,1.1,69267.37,144
CDM,93657OH,ABLATE L/R ATRIAL FIBRIL W/ ISOLATED PULM VEIN,2420.0,1573.0,1.1,2420.0,144
CDM,93660OH,CARDIOVASCULAR FUNCTION EVAL W/TILT TABLE W/MNTR,3883.0,2523.95,1.1,3883.0,144
CDM,93660OH-26,CARDIOVASCULAR FUNCTION EVAL W/TILT TABLE W/MNTR,832.0,540.8,1.1,832.0,126
CDM,93660OH-TC,CARDIOVASCULAR FUNCTION EVAL W/TILT TABLE W/MNTR,3051.0,1983.15,1.1,3051.0,126
CDM,93662OH,INTRACARD ECHOCARD W/THER/DX IVNTJ INCL IMG S&I,7507.0,4879.55,1.1,7507.0,106
CDM,93662OH-26,INTRACARD ECHOCARD W/THER/DX IVNTJ INCL IMG S&I,634.0,412.1,1.1,634.0,126
CDM,93662OH-TC,INTRACARD ECHOCARD W/THER/DX IVNTJ INCL IMG S&I,6873.0,4467.45,1.1,6873.0,94
CDM,93701OH,BIOMPEDANCE-DERIVED PHYSIOLOGIC CV ANALYSIS,187.0,121.55,1.1,373.44,144
CDM,93702OH,BIS EXTRACELLULAR FLUID ALYS LYMPHEDEMA ASSMNT,895.0,581.75,1.1,895.0,142
CDM,93722OH,PLETHYSMOGRAPHY REPORT,62.0,40.3,1.1,62.0,70
CDM,93724OH,ELECTRONIC ANALYSIS ANTITACHY PACEMAKER SYSTEM,3871.0,2516.15,1.1,3871.0,144
CDM,93724OH-26,ELECTRONIC ANALYSIS ANTITACHY PACEMAKER SYSTEM,2147.0,1395.55,1.1,2147.0,126
CDM,93724OH-TC,ELECTRONIC ANALYSIS ANTITACHY PACEMAKER SYSTEM,1724.0,1120.6,1.1,1724.0,126
CDM,93727OH,ELECTRONIC ANALYSIS OF IMPLANTABLE,283.0,183.95,1.1,283.0,70
CDM,93735OH,"ANALYZE PACER SYS,SINGL+REPROGR",377.0,245.05,1.1,377.0,70
CDM,93741OH,ELECTRONIC ANALYSIS OF PACING CARDI,372.0,241.8,1.1,372.0,70
CDM,93742OH,ELECTRONIC ANALYSIS OF PACING CARDI,411.0,267.15,1.1,411.0,70
CDM,93744OH,ELECTRONIC ANALYSIS OF PACING CARDI,677.0,440.05,1.1,677.0,70
CDM,93745OH,1ST SET-UP & PRGRMG PHYS/QHP OF WEARABLE CVDFB,2015.0,1309.75,1.1,2015.0,104
CDM,93745OH-26,1ST SET-UP & PRGRMG PHYS/QHP OF WEARABLE CVDFB,291.0,189.15,1.1,291.0,92
CDM,93745OH-TC,1ST SET-UP & PRGRMG PHYS/QHP OF WEARABLE CVDFB,1724.0,1120.6,1.1,1724.0,94
CDM,93750OH,INTERROGATION VAD IN PRSON W/PHYSICIAN ANALYSIS,330.0,214.5,1.1,330.0,148
CDM,93784OH,AMBULATORY BP MNTR W/SW 24 HR+ REC SCAN ALYS I&R,167.0,108.55,1.1,167.0,132
CDM,93786OH,AMBULATORY BP MNTR W/SW 24 HR+ RECORDING ONLY,276.0,179.4,1.1,373.44,130
CDM,93790OH,AMBULATORY BP MNTR W/SW 24 HR+ REVIEW W/I&R,167.0,108.55,1.1,167.0,130
CDM,93792OH,PT/CAREGIVER TRAINJ FOR INITIATION HOME INR MNTR,535.0,347.75,1.1,535.0,142
CDM,93793OH,ANTICOAGULANT MGMT FOR PT TAKING WARFARIN,79.0,51.35,1.1,79.0,142
CDM,93798OH,OUTPATIENT CARDIAC REHAB W/CONT ECG MONITORING,112.0,72.8,1.1,385.69,148
CDM,93799AOH,PDA BALLOON OCCLUSION,3284.0,2134.6,0.01,3284.0,84
CDM,93799BOH,PRQ COR ASPIR THROMBECT ONLY (COMP TO 92973),1082.0,703.3,0.01,1082.0,84
CDM,93799COH,"INTRAVASC CORONARY SONO, 1ST VESSEL",594.0,386.1,1.1,594.0,70
CDM,93799RVU10OH,UNLISTED TRICUSPID BALLOON VALVUPLASTY (COMP CODE 33958),1274.0,828.1,0.01,1274.0,84
CDM,93799RVU11OH,"STAND ALONE IVUS, ADD'L VESSEL (COMP TO 92979)",4088.0,2657.2,0.01,4088.0,84
CDM,93799RVU1OH,MELODY TRANSCATH PULM VALVE REPLACEMENT,14905.0,9688.25,0.01,14905.0,84
CDM,93799RVU2OH,VASCULAR SCREENING,180.0,117.0,0.01,456.09,84
CDM,93799RVU3OH,TRICUSPID VALVULOPLASTY,6029.0,3918.85,0.01,6029.0,84
CDM,93799RVU5OH,AORTIC SCALLOP INTENTIONAL LACERATION (BASILICA) (COMP CODE 9298,7315.0,4754.75,0.01,7315.0,84
CDM,93799RVU6OH,FFR WITHOUT CORONARY CATHETERIZATION (COMP 93571),594.0,386.1,0.01,594.0,84
CDM,93799RVU7OH,ATRIAL BALLOON OSTOMY (COMP CODE 33735 ATRIAL SEPTECTOMY OR SEPT,7326.0,4761.9,0.01,7326.0,84
CDM,93799RVU8OH,PERCUTANEOUS ASPIRATION AND OCCLUSION OF ATRIAL HEMATOMA (COMP C,10045.0,6529.25,0.01,10045.0,84
CDM,93799RVU9OH,PERCUTANEOUS TRANSCATHETER CLOSURE OF AQUIRED ASD  (COMP CODE935,10045.0,6529.25,0.01,10045.0,84
CDM,93799RVUOH,LAA FILTER SYSTEM WATCHMAN,19625.0,12756.25,0.01,19625.0,84
CDM,93880OH,DUPLEX SCAN EXTRACRANIAL ART COMPL BI STUDY,1742.0,1132.3,1.1,1742.0,144
CDM,93880OH-26,DUPLEX SCAN EXTRACRANIAL ART COMPL BI STUDY,352.0,228.8,1.1,352.0,126
CDM,93880OH-TC,DUPLEX SCAN EXTRACRANIAL ART COMPL BI STUDY,1390.0,903.5,1.1,1390.0,126
CDM,93882OH,DUPLEX SCAN EXTRACRANIAL ART UNI/LMTD STUDY,811.0,527.15,1.1,811.0,144
CDM,93882OH-26,DUPLEX SCAN EXTRACRANIAL ART UNI/LMTD STUDY,200.0,130.0,1.1,200.0,126
CDM,93882OH-TC,DUPLEX SCAN EXTRACRANIAL ART UNI/LMTD STUDY,611.0,397.15,1.1,611.0,126
CDM,93886OH,TRANSCRANIAL DOPPLER STDY INTRACRANIAL ART COMPL,1750.0,1137.5,1.1,1750.0,144
CDM,93886OH-26,TRANSCRANIAL DOPPLER STDY INTRACRANIAL ART COMPL,360.0,234.0,1.1,360.0,126
CDM,93886OH-TC,TRANSCRANIAL DOPPLER STDY INTRACRANIAL ART COMPL,1390.0,903.5,1.1,1390.0,126
CDM,93888OH,TRANSCRANIAL DOPPLER STDY INTRACRANIAL ART LMTD,932.0,605.8,1.1,932.0,144
CDM,93888OH-26,TRANSCRANIAL DOPPLER STDY INTRACRANIAL ART LMTD,321.0,208.65,1.1,321.0,126
CDM,93888OH-TC,TRANSCRANIAL DOPPLER STDY INTRACRANIAL ART LMTD,611.0,397.15,1.1,611.0,126
CDM,93892OH,TRANSCRANIAL DOPPLER INTRACRAN ART EMBOLI DETECT,1071.0,696.15,1.1,1071.0,144
CDM,93892OH-26,TRANSCRANIAL DOPPLER INTRACRAN ART EMBOLI DETECT,460.0,299.0,1.1,460.0,126
CDM,93892OH-TC,TRANSCRANIAL DOPPLER INTRACRAN ART EMBOLI DETECT,611.0,397.15,1.1,674.24,126
CDM,93893OH,TCD STD ICR ART VEN-ARTL SHNT DETCJ IV MBUBB NJX,1071.0,696.15,1.1,1071.0,144
CDM,93893OH-26,TCD STD ICR ART VEN-ARTL SHNT DETCJ IV MBUBB NJX,460.0,299.0,1.1,460.0,126
CDM,93893OH-TC,TCD STD ICR ART VEN-ARTL SHNT DETCJ IV MBUBB NJX,611.0,397.15,1.1,861.9,126
CDM,93895OH,CAROTID INTIMA MEDIA & CAROTID ATHEROMA EVAL BI,834.0,542.1,1.1,3060831.65,82
CDM,93895OH-26,CAROTID INTIMA MEDIA & CAROTID ATHEROMA EVAL BI,322.0,209.3,1.1,322.0,70
CDM,93895OH-TC,CAROTID INTIMA MEDIA & CAROTID ATHEROMA EVAL BI,512.0,332.8,1.1,512.0,70
CDM,93896OH,VASOREACTIVITY STUDY W/TCD ICR ARTERIES COMPLETE,1990.0,1293.5,1.1,1990.0,142
CDM,93896OH-26,VASOREACTIVITY STUDY W/TCD ICR ARTERIES COMPLETE,356.0,231.4,1.1,356.0,126
CDM,93896OH-TC,VASOREACTIVITY STUDY W/TCD ICR ARTERIES COMPLETE,1634.0,1062.1,1.1,1634.0,126
CDM,93897OH,EMBOLI DETCJ W/O IV MBUBB NJX TCD ICR ART COMPL,1066.0,692.9,1.1,1066.0,142
CDM,93897OH-26,EMBOLI DETCJ W/O IV MBUBB NJX TCD ICR ART COMPL,321.0,208.65,1.1,321.0,126
CDM,93897OH-TC,EMBOLI DETCJ W/O IV MBUBB NJX TCD ICR ART COMPL,745.0,484.25,1.1,745.0,126
CDM,93898OH,VEN-ARTL SHNT DETC IV MBUB NJX TCD ICR ART COMPL,1119.0,727.35,1.1,1119.0,142
CDM,93898OH-26,VEN-ARTL SHNT DETC IV MBUB NJX TCD ICR ART COMPL,374.0,243.1,1.1,374.0,126
CDM,93898OH-TC,VEN-ARTL SHNT DETC IV MBUB NJX TCD ICR ART COMPL,745.0,484.25,1.1,745.0,126
CDM,93922OH,NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 2 LEVEL,851.0,553.15,1.1,851.0,144
CDM,93922OH-26,NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 2 LEVEL,110.0,71.5,1.1,110.0,126
CDM,93922OH-TC,NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 2 LEVEL,741.0,481.65,1.1,741.0,126
CDM,93923OH,NON-INVASIVE PHYSIOLOGIC STUDY EXTREMITY 3 LEVLS,1098.0,713.7,1.1,1098.0,144
CDM,93923OH-26,NON-INVASIVE PHYSIOLOGIC STUDY EXTREMITY 3 LEVLS,198.0,128.7,1.1,198.0,126
CDM,93923OH-TC,NON-INVASIVE PHYSIOLOGIC STUDY EXTREMITY 3 LEVLS,900.0,585.0,1.1,900.0,126
CDM,93924OH,N-INVAS PHYSIOLOGIC STD LXTR ART COMPL BI,1100.0,715.0,1.1,1100.0,144
CDM,93924OH-26,N-INVAS PHYSIOLOGIC STD LXTR ART COMPL BI,200.0,130.0,1.1,200.0,126
CDM,93924OH-TC,N-INVAS PHYSIOLOGIC STD LXTR ART COMPL BI,900.0,585.0,1.1,900.0,126
CDM,93925OH,DUP-SCAN LXTR ART/ARTL BPGS COMPL BI STUDY,1710.0,1111.5,1.1,1710.0,144
CDM,93925OH-26,DUP-SCAN LXTR ART/ARTL BPGS COMPL BI STUDY,320.0,208.0,1.1,320.0,126
CDM,93925OH-TC,DUP-SCAN LXTR ART/ARTL BPGS COMPL BI STUDY,1390.0,903.5,1.1,1390.0,126
CDM,93926OH,DUP-SCAN LXTR ART/ARTL BPGS UNI/LMTD STUDY,811.0,527.15,1.1,811.0,144
CDM,93926OH-26,DUP-SCAN LXTR ART/ARTL BPGS UNI/LMTD STUDY,200.0,130.0,1.1,200.0,126
CDM,93926OH-TC,DUP-SCAN LXTR ART/ARTL BPGS UNI/LMTD STUDY,611.0,397.15,1.1,611.0,126
CDM,93930OH,DUP-SCAN UXTR ART/ARTL BPGS COMPL BI STUDY,1710.0,1111.5,1.1,1710.0,144
CDM,93930OH-26,DUP-SCAN UXTR ART/ARTL BPGS COMPL BI STUDY,320.0,208.0,1.1,320.0,126
CDM,93930OH-TC,DUP-SCAN UXTR ART/ARTL BPGS COMPL BI STUDY,1390.0,903.5,1.1,1390.0,126
CDM,93931OH,DUP-SCAN UXTR ART/ARTL BPGS UNI/LMTD STUDY,811.0,527.15,1.1,811.0,144
CDM,93931OH-26,DUP-SCAN UXTR ART/ARTL BPGS UNI/LMTD STUDY,200.0,130.0,1.1,200.0,126
CDM,93931OH-TC,DUP-SCAN UXTR ART/ARTL BPGS UNI/LMTD STUDY,611.0,397.15,1.1,611.0,126
CDM,93970OH,DUP-SCAN XTR VEINS COMPLETE BILATERAL STUDY,1670.0,1085.5,1.1,1670.0,144
CDM,93970OH-26,DUP-SCAN XTR VEINS COMPLETE BILATERAL STUDY,280.0,182.0,1.1,280.0,126
CDM,93970OH-TC,DUP-SCAN XTR VEINS COMPLETE BILATERAL STUDY,1390.0,903.5,1.1,1390.0,126
CDM,93971OH,DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY,809.0,525.85,1.1,809.0,144
CDM,93971OH-26,DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY,198.0,128.7,1.1,198.0,126
CDM,93971OH-TC,DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY,611.0,397.15,1.1,611.0,126
CDM,93975OH,DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN COM,1900.0,1235.0,1.1,1900.0,144
CDM,93975OH-26,DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN COM,510.0,331.5,1.1,510.0,126
CDM,93975OH-TC,DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN COM,1390.0,903.5,1.1,1390.0,126
CDM,93976OH,DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN LMT,963.0,625.95,1.1,963.0,144
CDM,93976OH-26,DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN LMT,352.0,228.8,1.1,352.0,126
CDM,93976OH-TC,DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN LMT,611.0,397.15,1.1,611.0,126
CDM,93978OH,DUP-SCAN AORTA IVC ILIAC VASCL/BPGS COMPLETE,1742.0,1132.3,1.1,1742.0,144
CDM,93978OH-26,DUP-SCAN AORTA IVC ILIAC VASCL/BPGS COMPLETE,352.0,228.8,1.1,352.0,126
CDM,93978OH-TC,DUP-SCAN AORTA IVC ILIAC VASCL/BPGS COMPLETE,1390.0,903.5,1.1,1390.0,126
CDM,93979OH,DUP-SCAN AORTA IVC ILIAC VASCL/BPGS UNI/LMTD,831.0,540.15,1.1,831.0,144
CDM,93979OH-26,DUP-SCAN AORTA IVC ILIAC VASCL/BPGS UNI/LMTD,220.0,143.0,1.1,220.0,126
CDM,93979OH-TC,DUP-SCAN AORTA IVC ILIAC VASCL/BPGS UNI/LMTD,611.0,397.15,1.1,611.0,126
CDM,93980OH,DUP-SCAN ARTL INFL&VEN O/F PEN VSL COMPL,1111.0,722.15,1.1,1111.0,144
CDM,93980OH-26,DUP-SCAN ARTL INFL&VEN O/F PEN VSL COMPL,500.0,325.0,1.1,500.0,126
CDM,93980OH-TC,DUP-SCAN ARTL INFL&VEN O/F PEN VSL COMPL,611.0,397.15,1.1,611.0,126
CDM,93981OH,DUP-SCAN ARTL INFL&VEN O/F PEN VSL F-UP/LMTD STD,787.0,511.55,1.1,787.0,144
CDM,93981OH-26,DUP-SCAN ARTL INFL&VEN O/F PEN VSL F-UP/LMTD STD,176.0,114.4,1.1,176.0,126
CDM,93981OH-TC,DUP-SCAN ARTL INFL&VEN O/F PEN VSL F-UP/LMTD STD,611.0,397.15,1.1,611.0,126
CDM,93985OH,DUPLEX SCAN ARTL INFL&AMP;VEN O/F HEMO COMPL BI STD,1710.0,1111.5,1.1,1710.0,144
CDM,93985OH-26,DUPLEX SCAN ARTL INFL&AMP;VEN O/F HEMO COMPL BI STD,320.0,208.0,1.1,320.0,126
CDM,93985OH-TC,DUPLEX SCAN ARTL INFL&AMP;VEN O/F HEMO COMPL BI STD,1390.0,903.5,1.1,1390.0,126
CDM,93986OH,DUPLEX SCAN ARTL INFL&AMP;VEN O/F HEMO COMPL UNI STD,811.0,527.15,1.1,811.0,144
CDM,93986OH-26,DUPLEX SCAN ARTL INFL&AMP;VEN O/F HEMO COMPL UNI STD,200.0,130.0,1.1,200.0,126
CDM,93986OH-TC,DUPLEX SCAN ARTL INFL&AMP;VEN O/F HEMO COMPL UNI STD,611.0,397.15,1.1,611.0,126
CDM,93990OH,DUPLEX SCAN HEMODIALYSIS ACCESS,811.0,527.15,1.1,811.0,144
CDM,93990OH-26,DUPLEX SCAN HEMODIALYSIS ACCESS,200.0,130.0,1.1,200.0,126
CDM,93990OH-TC,DUPLEX SCAN HEMODIALYSIS ACCESS,611.0,397.15,1.1,611.0,126
CDM,93998OH,UNLISTED NONINVASIVE VASCULAR DIAGNOSTIC STUDY,139.0,90.35,0.01,139.0,82
CDM,93998RVU1OH,US TEMPORAL ARTERIES (COMP CODE 93880),345.0,224.25,0.01,345.0,82
CDM,94000015,THERAPEUTIC APHERESIS RED BLOOD CELLS,9426.0,6126.9,117.69,9426.0,86
CDM,94000020,THERAPEUTIC APHERESIS PLATELETS,2514.0,1634.1,119.5,4337.0,86
CDM,94000025,THERAPEUTIC APHERESIS PLASMA PHERESIS,9426.0,6126.9,106.06,9426.0,86
CDM,94000035,THER APHERESIS W/EXTRACORPOREAL IMMUNOADSORPTION,26940.0,17511.0,95.4,26940.0,86
CDM,94000040,PHOTOPHERESIS EXTRACORPOREAL,26940.0,17511.0,105.85,26940.0,86
CDM,94000045,TRNSPLJ ALLOGENEIC HEMATOPOIETIC CELLS PER DONOR,131220.0,85293.0,267.23,131220.0,86
CDM,94000055,ALLOGENEIC LYMPHOCYTE INFUSIONS,6557.0,4262.05,140.29,6557.0,86
CDM,94000065,CARDIOPULMONARY RESUSCITATION,1791.0,1164.15,204.28,1791.0,86
CDM,94000070,IMMUNOTHERAPY 1 INJ,138.0,89.7,14.28,138.0,86
CDM,94000075,IMMUNOTHERAPY>=2 INJ,198.0,128.7,17.1,198.0,86
CDM,94000080,ANTIGEN THERAPY SERVICES,138.0,89.7,3.55,138.0,86
CDM,94000085,VENOM INSECT 1 VIAL,138.0,89.7,3.55,138.0,86
CDM,94000090,VENOM MULTIDOSE 2 VIAL,138.0,89.7,3.55,138.0,86
CDM,94000095,VENOM MULTIDOSE 3 VIAL,214.0,139.1,3.55,214.0,86
CDM,94000100,VENOM MULTIDOSE 4 VIAL,214.0,139.1,3.55,214.0,86
CDM,94000105,VENOM MULTIDOSE 5 VIAL,214.0,139.1,3.55,214.0,86
CDM,94000115,PREPJ& ALLERGEN IMMUNOTHERAPY 1/MLT ANTIGEN,124.0,80.6,3.55,124.0,86
CDM,94000120,PREPJ& ANTIGEN ALLERGEN IMMUNOTHERAPY WHL INSE,138.0,89.7,3.55,138.0,86
CDM,94000125,IRRIGAJ IMPLNTD VENOUS ACCESS DRUG DELIVERY SYST,410.0,266.5,34.52,410.0,86
CDM,94000130,PDT DSTR PRMLG LES SKN ILLUM/ACTIVJ PER DAY,596.0,387.4,165.69,596.0,86
CDM,94000140,ACTINOTHERAPY ULTRAVIOLET LIGHT,118.0,76.7,31.09,118.0,86
CDM,94000145,PHOTOCHEMOTX TAR&UVB/PETROLATUM/UVB,178.0,115.7,49.48,178.0,86
CDM,94000150,PHOTOCHEMOTX PSORALENS&ULTRAVIOLET PUVA,178.0,115.7,49.48,178.0,86
CDM,94000160,EXCIMER LASER TX PSORIASIS TOT AREA <250 SQ CM,596.0,387.4,54.84,3443.0,86
CDM,94000165,EXCIMER LASER TX PSORIASIS 250-500 SQ CM,596.0,387.4,61.9,3443.0,86
CDM,94000170,EXCIMER LASER TX PSORIASIS >500 SQ CM,1199.0,779.35,95.45,3443.0,86
CDM,94000180,ACUPUNCTURE 1/> NDLES W/O ELEC STIMJ INIT 15 MIN,33.0,21.45,9.17,39.8,86
CDM,94000185,ACUPUNCTURE 1/> NDLS W/O ESTIM EACH ADDL 15 MIN,33.0,21.45,7.19,36.0,68
CDM,94000190,ACUPUNCTURE 1/> NDLS W/ELEC STIMJ 1ST 15 MIN,33.0,21.45,9.17,45.47,86
CDM,94000195,ACUPUNCTURE 1/> NDLS W/ESTIM EACH ADDL 15 MIN,33.0,21.45,7.19,36.64,68
CDM,94000200,CHIROPRACTIC MANIPULATIVE TX SPINAL 1-2 REGIONS,76.0,49.4,20.43,76.0,86
CDM,94000205,CHIROPRACTIC MANIPULATIVE TX SPINAL 3-4 REGIONS,76.0,49.4,20.43,76.0,86
CDM,94000210,CHIROPRACTIC MANIPULATIVE TX SPINAL 5 REGIONS,76.0,49.4,20.43,76.0,86
CDM,94000215,CHIROPRACTIC MANIPLTV TX EXTRASPINAL 1/> REGION,123.0,79.95,26.81,123.0,66
CDM,94000220,PHLEBOTOMY THERAPEUTIC SEPARATE PROCEDURE,889.0,577.85,35.72,889.0,86
CDM,94000225,WTHH EXERCISE TRAINING,11.0,7.15,2.4,469.67,66
CDM,94000240,ROUTINE FT CARE - PT LOS,795.0,516.75,27.05,795.0,86
CDM,94000255,VITILIGO EXC LASER <250 SQ CM,621.0,403.65,168.79,621.0,84
CDM,94000335,THERAPEUTIC APHERESIS WHITE BLOOD CELLS,9426.0,6126.9,123.21,9426.0,86
CDM,94000345,MCRSCP XM HAIR PLUCK/CLIP FOR CNTS/STRUCT ABNORM,171.0,111.15,8.96,171.0,66
CDM,94000355,UNLISTED SPEC DERM SERVICE,270.0,175.5,75.06,270.0,84
CDM,94000445,BP MONITOR (DEVICE NOT RETURNED),1404.0,912.6,306.07,1404.0,66
CDM,94000455,PDT DSTR PRMLG LES SKN ILLUM/ACTIVJ BY PHYS/QHP,596.0,387.4,165.69,596.0,86
CDM,94000465,DEBRIDEMENT PRMLG HYPERKERATOTIC LES W/PDT,596.0,387.4,165.69,3443.0,86
CDM,94000485,INITIAL EVAL EMPLOYEE FITNESS,60.0,39.0,13.08,469.67,66
CDM,94000495,FOLLOW UP EMPLOYEE FITNESS,11.0,7.15,2.4,469.67,66
CDM,94000505,SPECILAIZED POPULATION EVAL,86.0,55.9,18.75,469.67,66
CDM,94000515,EXERCISE CLASS,11.0,7.15,2.4,469.67,66
CDM,94000535,MINI-BAL RT,424.0,275.6,64.98,424.0,84
CDM,94000545,TRACH ASPIRATION,424.0,275.6,64.98,424.0,84
CDM,94000555,TRNSPLJ AUTOLOGOUS HEMATOPOIETIC CELLS PER DONOR,6557.0,4262.05,197.79,10651.0,86
CDM,94000585,REM THER MNTR DEV SPLY DATA COG BHV THER EA 30 D,112.0,72.8,31.14,112.0,84
CDM,94000595,SCRAMBLER THERAPY,500.0,325.0,121.73,2453.0,84
CDM,94000605,TRANSPLJ HEMATOPOIETIC BOOST CD34+,6557.0,4262.05,135.96,6557.0,87
CDM,94000615,T-CELL DEPLETION OF HARVEST CD34+,1749.0,1136.85,376.61,2453.0,84
CDM,94002OH,VENTILATION ASSIST & MGMT INPATIENT 1ST DAY,876.0,569.4,1.1,1827.42,144
CDM,94003OH,VENTILATION ASSIST & MGMT INPATIENT EA SBSQ DA,603.0,391.95,1.1,1827.42,144
CDM,94004OH,VENTILATION ASSIST & MGMT NURSING FAC PR DAY,400.0,260.0,1.1,400.0,132
CDM,94010OH,SPMTRY W/VC EXPIRATORY FLO W/WO MXML VOL VNTJ,795.0,516.75,1.1,795.0,144
CDM,94010OH-26,SPMTRY W/VC EXPIRATORY FLO W/WO MXML VOL VNTJ,75.0,48.75,1.1,75.0,126
CDM,94010OH-TC,SPMTRY W/VC EXPIRATORY FLO W/WO MXML VOL VNTJ,720.0,468.0,1.1,720.0,126
CDM,94011OH,MEAS SPIROMTRC FORCD EXPIRATORY FLO INFANT-2 YR,700.0,455.0,1.1,700.0,144
CDM,94012OH,MEAS SPIRO FORCD EXP FLO PRE&POST BRONCH INF-2Y,1140.0,741.0,1.1,1140.0,144
CDM,94013OH,MEAS LUNG VOLUMES INFANT OR CHILD THRU 2 YRS,164.0,106.6,1.1,1564.17,144
CDM,94016OH,PATIENT-INITIATED SPIROMETRIC PHYS/QHP R&I ONLY,208.0,135.2,1.1,208.0,144
CDM,94060OH,BRNCDILAT RSPSE SPMTRY PRE&POST-BRNCDILAT ADMN,1529.0,993.85,1.1,1529.0,144
CDM,94060OH-26,BRNCDILAT RSPSE SPMTRY PRE&POST-BRNCDILAT ADMN,97.0,63.05,1.1,97.0,126
CDM,94060OH-TC,BRNCDILAT RSPSE SPMTRY PRE&POST-BRNCDILAT ADMN,1432.0,930.8,1.1,1432.0,126
CDM,94070OH,BRNCSPSM PROVOCATION EVAL MLT SPMTRY W/ADMN AGT,1672.0,1086.8,1.1,1672.0,144
CDM,94070OH-26,BRNCSPSM PROVOCATION EVAL MLT SPMTRY W/ADMN AGT,240.0,156.0,1.1,240.0,126
CDM,94070OH-TC,BRNCSPSM PROVOCATION EVAL MLT SPMTRY W/ADMN AGT,1432.0,930.8,1.1,1432.0,126
CDM,94150OH,VITAL CAPACITY TOTAL SEPARATE PROCEDURE,748.0,486.2,1.1,748.0,112
CDM,94150OH-26,VITAL CAPACITY TOTAL SEPARATE PROCEDURE,28.0,18.2,1.1,28.0,98
CDM,94150OH-TC,VITAL CAPACITY TOTAL SEPARATE PROCEDURE,720.0,468.0,1.1,720.0,98
CDM,94200000,MEDICAL NUTRITION ASSMT&IVNTJ INDIV EACH 15 MI,212.0,137.8,35.63,212.0,85
CDM,94200005,MEDICAL NUTRITION RE-ASSMT&IVNTJ INDIV EA 15 M,180.0,117.0,29.84,180.0,85
CDM,94200010,REHAB CARD PHASE III,6.0,3.9,1.67,156.65,84
CDM,94200015,MEDICAL NUTRITION THERAPY GRP2/ INDIV EA 30 MI,100.0,65.0,16.62,100.0,85
CDM,94200025,EDUCATION&TRAINING PT SELF-MGMT NQHP INDIV PT,126.0,81.9,27.47,126.0,66
CDM,94200030,EDUCATION&TRAINING PT SELF-MGMT NQHP 2-4 PTS,95.0,61.75,20.71,95.0,66
CDM,94200050,TOBACCO USE CESSATION INTERMEDIATE 3-10 MINUTES,89.0,57.85,14.53,89.0,86
CDM,94200055,TOBACCO USE CESSATION INTENSIVE >10 MINUTES,89.0,57.85,24.74,89.0,86
CDM,94200060,EDUCATION&TRAINING PT SELF-MGMT NQHP INDIV PT,126.0,81.9,27.47,126.0,66
CDM,94200075,GENETIC COUNSEL 15 MINS,95.0,61.75,20.71,95.0,66
CDM,94200145,MEDICAL NUTRITION RE-ASSMT&IVNTJ INDIV EA 15 M,180.0,117.0,29.84,180.0,85
CDM,94200185,MGMT DIABETES GROUP 30MIN,121.0,78.65,19.66,121.0,85
CDM,94200225,"NUTRITION THERAPY, REASSES EA 15 MIN",180.0,117.0,29.84,180.0,85
CDM,94200235,NUTRITION GROUP THERAPY,100.0,65.0,16.62,100.0,85
CDM,94200255,"VIRTUAL INITIAL NUTRITION THERAPY, EA. 15M",212.0,137.8,35.63,212.0,85
CDM,94200265,"VIRTUAL REASSESS NUTRITION THERAPY, EA 15 M",180.0,117.0,29.84,180.0,85
CDM,94200275,GRP NUTRITION THERAPY; EA 30M,100.0,65.0,16.62,100.0,85
CDM,94200285,"NUTRITION THERAPY, INITIAL 15 MIN",212.0,137.8,35.63,212.0,85
CDM,94200295,"NUTRITION THERAPY, REASSES EA 15 MIN",180.0,117.0,29.84,180.0,85
CDM,94200305,"VIRTUAL GROUP NUTRITION THERAPY, EA. 30 M",100.0,65.0,16.62,100.0,85
CDM,94200365,PRENATAL CLINIC GROUP,37.0,24.05,8.07,51.72,66
CDM,94200465,PARENTING CLASSES PER SESSION,15.0,9.75,3.27,15.0,58
CDM,94200565,CHILDBIRTH ED PER SESSION,97.0,63.05,21.15,97.0,58
CDM,94200575,DIABETES COUNSELING INDIVIDUAL,177.0,115.05,39.1,177.0,85
CDM,94200605,MEDICAL NUTRITION THERAPY GRP2/ INDIV EA 30 MI,100.0,65.0,16.62,100.0,85
CDM,94200635,INFANT SAFETY CLASS,46.0,29.9,10.03,46.0,58
CDM,94200645,HEALTH COACHING,22.0,14.3,4.8,469.67,66
CDM,94200655,CONT GLUC MONITORING PATIENT PROVIDED EQUIPMENT,238.0,154.7,39.1,238.0,86
CDM,94200985,CHILDBIRTH CLASS,152.0,98.8,33.14,152.0,66
CDM,94200995,PARENTING CLASS,38.0,24.7,8.28,45.28,66
CDM,94200OH,MAX BREATHING CAPACITY MAXIMAL VOLUNTARY VENTJ,293.0,190.45,1.1,293.0,144
CDM,94200OH-26,MAX BREATHING CAPACITY MAXIMAL VOLUNTARY VENTJ,20.0,13.0,1.1,21.96,126
CDM,94200OH-TC,MAX BREATHING CAPACITY MAXIMAL VOLUNTARY VENTJ,273.0,177.45,1.1,273.0,126
CDM,94201005,INFANT SAFETY CLASS,38.0,24.7,8.28,45.28,66
CDM,94201055,VV EDUC SELF MGMT 30MIN INDV,126.0,81.9,27.47,126.0,66
CDM,94201065,"VV MGMT DIABETES GRP 30 MIN, 2-4 PT",95.0,61.75,20.71,95.0,66
CDM,94201075,"VV MGMT DIABETES GRP 30MIN, 5- 8",84.0,54.6,18.31,84.0,66
CDM,94201085,"MGMT DIABETES GRP 30MIN, 5- 8",84.0,54.6,18.31,84.0,66
CDM,94201145,SELF-MEAS BP PT EDUCAJ/TRAING &AMP; DEV CALIBRATION,169.0,109.85,19.92,169.0,86
CDM,94201185,VIRTUAL MGMT DIABETES SNGL 30 MIN,126.0,81.9,27.47,126.0,66
CDM,94201195,VIRTUAL MGMT DIABETES GRP 30 MIN; 2-4 PT,95.0,61.75,20.71,95.0,66
CDM,94201205,VIRTUAL MGMT DIABETES GRP 30 MIN; 5-8 PT,84.0,54.6,18.31,84.0,66
CDM,94201215,"MGMT DIABETES GROUP 30 MIN, 2-4 PT",95.0,61.75,20.71,95.0,66
CDM,94201235,BEHAVIOR COUNSEL OBESITY 15M,638.0,414.7,29.41,638.0,86
CDM,94201265,SUPPLY OF DIGITAL DEVICE,515.0,334.75,39.1,515.0,83
CDM,94201275,MONTHLY TX FOR DMHT 20MINS,515.0,334.75,36.24,515.0,76
CDM,94201285,ADD 20 M OF MONTHLY TX,258.0,167.7,35.38,258.0,59
CDM,94240OH,"LUNG VOLUMES, HELIUM DILUTION",95.0,61.75,1.1,95.0,70
CDM,94300005,REHAB CARD PHASE I,724.0,470.6,10.63,724.0,86
CDM,94300010,REHAB CARD PHASE II,724.0,470.6,10.63,724.0,86
CDM,94300015,CARD REHAB NUTRITION PHASE II,724.0,470.6,10.63,724.0,86
CDM,94300020,REHAB CARD OP DEPT W ECG,724.0,470.6,16.53,724.0,86
CDM,94300025,INTENS CARDIAC REHAB W/EXERC,504.0,327.6,69.16,504.0,86
CDM,94300030,INTENS CARDIAC REHAB NO EXER,504.0,327.6,69.16,504.0,86
CDM,94300055,PR PHASE III REHAB-INTERMED,40.0,26.0,8.72,40.0,58
CDM,94450OH,BREATHING RESPONSE TO HYPOXIA,844.0,548.6,1.1,844.0,144
CDM,94450OH-26,BREATHING RESPONSE TO HYPOXIA,176.0,114.4,1.1,176.0,126
CDM,94450OH-TC,BREATHING RESPONSE TO HYPOXIA,720.0,468.0,1.1,720.0,126
CDM,94452OH,HIGH ALTITUDE SIMULATJ TEST W/PHYS INTERP&REPORT,729.0,473.85,1.1,729.0,142
CDM,94452OH-26,HIGH ALTITUDE SIMULATJ TEST W/PHYS INTERP&REPORT,136.0,88.4,1.1,136.0,126
CDM,94452OH-TC,HIGH ALTITUDE SIMULATJ TEST W/PHYS INTERP&REPORT,593.0,385.45,1.1,593.0,126
CDM,94453OH,HIGH ALTITUDE SIMULATJ W/PHYS I&R W/O2 TITRATION,769.0,499.85,1.1,769.0,142
CDM,94453OH-26,HIGH ALTITUDE SIMULATJ W/PHYS I&R W/O2 TITRATION,176.0,114.4,1.1,176.0,126
CDM,94453OH-TC,HIGH ALTITUDE SIMULATJ W/PHYS I&R W/O2 TITRATION,593.0,385.45,1.1,593.0,126
CDM,94617OH,XERS TST BRNCSPSM PRE&POST SPMTRY&PLS OX W/ECG,901.0,585.65,1.1,901.0,144
CDM,94617OH-26,XERS TST BRNCSPSM PRE&POST SPMTRY&PLS OX W/ECG,308.0,200.2,1.1,308.0,126
CDM,94617OH-TC,XERS TST BRNCSPSM PRE&POST SPMTRY&PLS OX W/ECG,593.0,385.45,1.1,593.0,126
CDM,94618AOH,ADULT - SIX MINUTE WALK,593.0,385.45,1.1,593.0,144
CDM,94618BOH,ADULT - OXIMETRY WITH AMBULATION,593.0,385.45,1.1,593.0,144
CDM,94618BOH-26,ADULT - OXIMETRY WITH AMBULATION,192.0,124.8,1.1,192.0,126
CDM,94618COH,OXYGEN TITRATION-TRANSPLANT,593.0,385.45,1.1,593.0,144
CDM,94618COH-26,OXYGEN TITRATION-TRANSPLANT,192.0,124.8,1.1,192.0,126
CDM,94618OH,PULMONARY STRESS TESTING,785.0,510.25,1.1,785.0,144
CDM,94618OH-26,PULMONARY STRESS TESTING,192.0,124.8,1.1,192.0,126
CDM,94618OH-TC,PULMONARY STRESS TESTING,593.0,385.45,1.1,593.0,126
CDM,94619OH,XERS TST BRNCSPSM PRE&POST SPMTRY&PLS OX WO /ECG,469.0,304.85,1.1,469.0,144
CDM,94619OH-26,XERS TST BRNCSPSM PRE&POST SPMTRY&PLS OX WO /ECG,196.0,127.4,1.1,196.0,126
CDM,94619OH-TC,XERS TST BRNCSPSM PRE&POST SPMTRY&PLS OX WO /ECG,273.0,177.45,1.1,273.0,126
CDM,94621OH,CARDIOPULMONARY EXERCISE TESTING,2000.0,1300.0,1.1,2000.0,144
CDM,94621OH-26,CARDIOPULMONARY EXERCISE TESTING,568.0,369.2,1.1,568.0,126
CDM,94621OH-TC,CARDIOPULMONARY EXERCISE TESTING,1432.0,930.8,1.1,1432.0,126
CDM,94640OH,PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT,154.0,100.1,1.1,621.38,144
CDM,94642OH,PENTAMIDINE AERSL INHALATION PNEUMOCYSTIS/PROPH,359.0,233.35,1.1,621.38,92
CDM,94644OH,"CONTINUOUS INHALATION TX, 1ST HR",121.0,78.65,1.1,373.44,144
CDM,94645OH,"CONTINUOUS INHALATION TX, EACH ADD HR",35.0,22.75,1.1,60.47,144
CDM,94660OH,CPAP VENTILATION CPAP INITIATION&MGMT,304.0,197.6,1.1,621.38,148
CDM,94664OH,DEMO&/EVAL OF PT UTILIZ AERSL GEN/NEB/INHLR/IP,124.0,80.6,1.1,621.38,144
CDM,94667OH,MANJ CH WALL FACILITATE LNG FUNCJ 1 DEMO&/EVAL,197.0,128.05,1.1,373.44,144
CDM,94680OH,O2 UPTK EXP GAS ANALYSIS REST&XERS DIRECT SIMP,824.0,535.6,1.1,824.0,144
CDM,94680OH-26,O2 UPTK EXP GAS ANALYSIS REST&XERS DIRECT SIMP,104.0,67.6,1.1,104.0,126
CDM,94680OH-TC,O2 UPTK EXP GAS ANALYSIS REST&XERS DIRECT SIMP,720.0,468.0,1.1,720.0,126
CDM,94681OH,O2 UPTK EXP GAS ALYS W/CO2 OUTPUT % O2 XTRC,1520.0,988.0,1.1,1520.0,144
CDM,94681OH-26,O2 UPTK EXP GAS ALYS W/CO2 OUTPUT % O2 XTRC,88.0,57.2,1.1,88.0,126
CDM,94681OH-TC,O2 UPTK EXP GAS ALYS W/CO2 OUTPUT % O2 XTRC,1432.0,930.8,1.1,1432.0,126
CDM,94690OH,O2 UPTAKE EXP GAS ANALYSIS REST INDIRECT SPX,301.0,195.65,1.1,301.0,144
CDM,94690OH-26,O2 UPTAKE EXP GAS ANALYSIS REST INDIRECT SPX,28.0,18.2,1.1,28.0,126
CDM,94690OH-TC,O2 UPTAKE EXP GAS ANALYSIS REST INDIRECT SPX,273.0,177.45,1.1,273.0,126
CDM,94720OH,CARBON MONOXIDE DIFFUSING CAPACITY,564.0,366.6,1.1,564.0,70
CDM,94720OH-26,CARBON MONOXIDE DIFFUSING CAPACITY,95.0,61.75,1.1,95.0,70
CDM,94726OH,PLETHYSMOGRAPHY LUNG VOLUMES W/WO AIRWAY RESIST,1546.0,1004.9,1.1,1546.0,144
CDM,94726OH-26,PLETHYSMOGRAPHY LUNG VOLUMES W/WO AIRWAY RESIST,114.0,74.1,1.1,114.0,126
CDM,94726OH-TC,PLETHYSMOGRAPHY LUNG VOLUMES W/WO AIRWAY RESIST,1432.0,930.8,1.1,1432.0,126
CDM,94727OH,GAS DILUT/WASHOUT LUNG VOL W/WO DISTRIB VENT&VOL,834.0,542.1,1.1,834.0,144
CDM,94727OH-26,GAS DILUT/WASHOUT LUNG VOL W/WO DISTRIB VENT&VOL,114.0,74.1,1.1,114.0,126
CDM,94727OH-TC,GAS DILUT/WASHOUT LUNG VOL W/WO DISTRIB VENT&VOL,720.0,468.0,1.1,720.0,126
CDM,94728OH,AIRWAY RESISTANCE BY IMPULSE OSCILLOMETRY,824.0,535.6,1.1,824.0,144
CDM,94728OH-26,AIRWAY RESISTANCE BY IMPULSE OSCILLOMETRY,104.0,67.6,1.1,104.0,126
CDM,94728OH-TC,AIRWAY RESISTANCE BY IMPULSE OSCILLOMETRY,720.0,468.0,1.1,720.0,126
CDM,94729OH,DIFFUSING CAPACITY,681.0,442.65,1.1,681.0,144
CDM,94729OH-26,DIFFUSING CAPACITY,76.0,49.4,1.1,76.0,126
CDM,94729OH-TC,DIFFUSING CAPACITY,605.0,393.25,1.1,605.0,126
CDM,94760OH,NONINVASIVE EAR/PULSE OXIMETRY SINGLE DETER,120.0,78.0,1.1,120.0,130
CDM,94761OH,NONINVASIVE EAR/PULSE OXIMETRY MULTIPLE DETER,198.0,128.7,1.1,198.0,130
CDM,94762OH,NONINVASIVE EAR/PULSE OXIMETRY OVERNIGHT MONITOR,245.0,159.25,1.1,456.09,130
CDM,94772OH,CIRCADIAN RESPIRATRY PATTERN REC 12-24 HR INFANT,2837.0,1844.05,1.1,2837.0,102
CDM,94772OH-26,CIRCADIAN RESPIRATRY PATTERN REC 12-24 HR INFANT,396.0,257.4,1.1,396.0,88
CDM,94772OH-TC,CIRCADIAN RESPIRATRY PATTERN REC 12-24 HR INFANT,2441.0,1586.65,1.1,2441.0,90
CDM,94777OH,PEDIATRIC APNEA MONITOR PHYS/QHP REVIEW,226.0,146.9,1.1,3060831.65,102
CDM,94780OH,CAR SEAT/BED TESTING W/INTERP & REPORT 60 MIN,192.0,124.8,1.1,203.57,146
CDM,94781OH,CAR SEAT/BED TESTNG W/INTERP & REPORT +30MIN,68.0,44.2,1.1,80.26,146
CDM,94800000,UNLSTD PUL REHB PHASE 3,8.0,5.2,2.22,156.65,84
CDM,94800025,PHYS/QHP SVCS OP PULM REHAB WO CONT OXIMTRY MNTR,273.0,177.45,21.8,273.0,86
CDM,94800035,PHYS/QHP SVCS OP PULM REHAB W/CONT OXIMTRY MNTR,273.0,177.45,32.9,273.0,86
CDM,94900005,GROUP HEALTH EDUCATION,17.0,11.05,3.71,51.72,66
CDM,95004OH,PERCUTANEOUS TESTS W/ALLERGENIC EXTRACTS,169.0,109.85,1.1,3048.76,144
CDM,95012OH,NITRIC OXIDE EXPIRED GAS DETERMINATION,71.0,46.15,1.1,116.32,142
CDM,95017OH,ALLG TSTG PERQ & IC VENOMS IMMED REACT W/ I&R,28.0,18.2,1.1,85.71,148
CDM,95018OH,ALLG TEST PERQ & IC DRUG/BIOL IMMED REACT W/ I&R,165.0,107.25,1.1,165.0,148
CDM,95024OH,INTRACUTANEOUS TESTS W/ALLERGENIC EXTRACTS,163.0,105.95,0.62,177.54,148
CDM,95027OH,INTRACUTANEOUS TESTS W/ALLERGENIC XTRCS AIRBORNE,5.0,3.25,1.1,85.71,144
CDM,95028OH,IC TSTS W/ALLGIC XTRCS DLYD TYP RXN W/READING,48.0,31.2,1.1,116.32,144
CDM,95044OH,PATCH TEST(S) SPECIFY NUMBER,408.0,265.2,1.1,3048.76,144
CDM,95052OH,PHOTO PATCH TEST(S) SPECIFY NUM,52.0,33.8,1.1,177.54,144
CDM,95056OH,PHOTOSENSITIVITY TESTS,53.0,34.45,1.1,373.44,144
CDM,95060OH,EYE ALLERGY TESTS,94.0,61.1,1.1,373.44,144
CDM,95065OH,DIRECT NASAL MUCOUS MEMBRANE TEST,126.0,81.9,1.1,126.0,144
CDM,95070OH,INHLJ BRNCL CHALLENGE TSTG W/HISTAM/METHACHOL,527.0,342.55,1.1,1564.17,144
CDM,95076OH,INGESTION CHALLENGE TEST INITIAL 120 MINUTES,660.0,429.0,1.1,1564.17,148
CDM,95079OH,INGESTION CHALLENGE TEST EACH ADDL 60 MINUTES,607.0,394.55,1.1,607.0,148
CDM,95115OH,PROF SVCS ALLG IMMNTX X W/PRV ALLGIC XTRCS 1 NJX,60.0,39.0,1.1,137.75,144
CDM,95117OH,PROF SVCS ALLG IMMNTX X W/PRV ALLGIC XTRCS NJXS,198.0,128.7,1.1,198.0,144
CDM,95144OH,PREPJ& ANTIGEN PRV ALLERGEN IMMUNOTHERAPY 1 DO,24.0,15.6,1.1,137.75,148
CDM,95145OH,PREPJ& ANTIGEN ALLERGEN IMMUNOTHERAPY 1 INSECT,24.0,15.6,1.1,137.75,148
CDM,95146OH,PREPJ& ANTIGEN ALLERGEN IMMUNOTHERAPY 2 INSECT,24.0,15.6,1.1,195.15,148
CDM,95147OH,PREPJ& ANTIGEN ALLERGEN IMMUNOTHERAPY 3 INSECT,24.0,15.6,1.1,205.09,148
CDM,95148OH,PREPJ& ANTIGEN ALLERGEN IMMUNOTHERAPY 4 INSECT,24.0,15.6,1.1,278.42,148
CDM,95149OH,PREPJ& ANTIGEN ALLERGEN IMMUNOTHERAPY 5 INSECT,24.0,15.6,1.1,368.12,148
CDM,95165OH,PREPJ& ALLERGEN IMMUNOTHERAPY 1/MLT ANTIGEN,124.0,80.6,1.1,137.75,148
CDM,95170OH,PREPJ& ANTIGEN ALLERGEN IMMUNOTHERAPY WHL INSE,24.0,15.6,1.1,137.75,148
CDM,95180OH,RAPID DESENSITIZATION PROCEDURE EACH HOUR,804.0,522.6,1.1,1163.18,148
CDM,95249OH,CONT GLUC MONITORING PATIENT PROVIDED EQUIPTMENT,297.0,193.05,1.1,297.0,142
CDM,95250OH,CONT GLUC MNTR PHYSICIAN/QHP PROVIDED EQUIPMENT,393.0,255.45,1.1,464.13,142
CDM,95251OH,CONTINUOUS GLUCOSE MONITORING ANALYSIS I&R,280.0,182.0,1.1,280.0,142
CDM,95700OH,EEG CONT REC W/VIDEO BY TECH MIN 8 CHANNELS,659.0,428.35,1.1,659.0,102
CDM,95705OH,EEG W/O VIDEO BY TECH 2-12 HR UNMONITORED,1396.0,907.4,1.1,1396.0,102
CDM,95708OH,EEG W/O VID BY TECH EA INCR 12-26HR UNMONITORED,1396.0,907.4,1.1,1564.17,102
CDM,95711OH,VEEG BY TECH 2-12 HOURS UNMONITORED,2614.0,1699.1,1.1,2614.0,102
CDM,95712OH,VEEG BY TECH 2-12 HR INTERMITTENT MONITORING,2614.0,1699.1,1.1,2614.0,102
CDM,95713OH,VEEG BY TECH 2-12 HR CONTINUOUS R-T MONITORING,2614.0,1699.1,1.1,2614.0,102
CDM,95714OH,VEEG BY TECH EA INCR 12-26 HR UNMONITORED,2614.0,1699.1,1.1,2614.0,102
CDM,95715OH,VEEG BY TECH EA INCR 12-26 HR INTERMITTENT MNTR,2614.0,1699.1,1.1,2614.0,102
CDM,95716OH,VEEG BY TECH EA INCR 12-26 HR CONT R-T MNTR,2614.0,1699.1,1.1,3048.76,102
CDM,95717OH,EEG PHYS/QHP 2-12 HR WITHOUT VIDEO,880.0,572.0,1.1,880.0,148
CDM,95718OH,EEG PHYS/QHP 2-12 HR WITH VEEG,1100.0,715.0,1.1,1100.0,148
CDM,95719OH,EEG PHYS/QHP EA INCR>12HR<26HR AFTER 24HR WO VID,1320.0,858.0,1.1,1320.0,148
CDM,95720OH,EEG PHYS/QHP EA INCR>12HR<26HR AFTER 24HR W/VEEG,1698.0,1103.7,1.1,1698.0,148
CDM,95721OH,EEG COMPLETE STD PHYS/QHP>36 HR<60 HR W/O VIDEO,1698.0,1103.7,1.1,1698.0,148
CDM,95722OH,EEG COMPLETE STD PHYS/QHP>36 HR<60 HR W/VEEG,2068.0,1344.2,1.1,2068.0,148
CDM,95723OH,EEG COMPLETE STD PHYS/QHP>60 HR<84 HR W/O VIDEO,2090.0,1358.5,1.1,2090.0,148
CDM,95724OH,EEG COMPLETE STD PHYS/QHP>60 HR<84 HR W/VEEG,2640.0,1716.0,1.1,2640.0,148
CDM,95725OH,EEG COMPLETE STD PHYS/QHP&GT;84 HR W/O VID,2376.0,1544.4,1.1,2376.0,148
CDM,95726OH,EEG COMPLETE STD PHYS/QHP&GT;84 HR W/VEEG,3335.0,2167.75,1.1,3335.0,148
CDM,95782OH,POLYSOM <6 YRS SLEEP STAGE 4/> ADDL PARAM ATTND,8164.0,5306.6,1.1,8164.0,144
CDM,95782OH-26,POLYSOM <6 YRS SLEEP STAGE 4/> ADDL PARAM ATTND,1144.0,743.6,1.1,1144.0,126
CDM,95782OH-TC,POLYSOM <6 YRS SLEEP STAGE 4/> ADDL PARAM ATTND,7020.0,4563.0,1.1,7020.0,126
CDM,95783OH,POLYSOM <6 YRS SLEEP W/CPAP/BILVL VENT 4/> PARAM,8265.0,5372.25,1.1,8265.0,144
CDM,95783OH-26,POLYSOM <6 YRS SLEEP W/CPAP/BILVL VENT 4/> PARAM,1245.0,809.25,1.1,1245.0,126
CDM,95783OH-TC,POLYSOM <6 YRS SLEEP W/CPAP/BILVL VENT 4/> PARAM,7020.0,4563.0,1.1,7020.0,126
CDM,95801OH,SLP STDY UNATND W/MIN HRT RATE/O2 SAT/RESP ANAL,750.0,487.5,1.1,750.0,142
CDM,95801OH-26,SLP STDY UNATND W/MIN HRT RATE/O2 SAT/RESP ANAL,340.0,221.0,1.1,340.0,126
CDM,95801OH-TC,SLP STDY UNATND W/MIN HRT RATE/O2 SAT/RESP ANAL,410.0,266.5,1.1,410.0,126
CDM,95803OH,ACTIGRAPHY TESTING RECORDING ANALYSIS I&R,770.0,500.5,1.1,770.0,142
CDM,95803OH-26,ACTIGRAPHY TESTING RECORDING ANALYSIS I&R,360.0,234.0,1.1,360.0,126
CDM,95803OH-TC,ACTIGRAPHY TESTING RECORDING ANALYSIS I&R,410.0,266.5,1.1,410.0,126
CDM,95805OH,MLT SLEEP LATENCY/MAINT OF WAKEFULNESS TSTG,4189.0,2722.85,1.1,4189.0,144
CDM,95805OH-26,MLT SLEEP LATENCY/MAINT OF WAKEFULNESS TSTG,528.0,343.2,1.1,528.0,126
CDM,95805OH-TC,MLT SLEEP LATENCY/MAINT OF WAKEFULNESS TSTG,3661.0,2379.65,1.1,3661.0,126
CDM,95806OH,SLEEP STD AIRFLOW HRT RATE&O2 SAT EFFORT UNATT,1489.0,967.85,1.1,1489.0,142
CDM,95806OH-26,SLEEP STD AIRFLOW HRT RATE&O2 SAT EFFORT UNATT,409.0,265.85,1.1,409.0,126
CDM,95806OH-TC,SLEEP STD AIRFLOW HRT RATE&O2 SAT EFFORT UNATT,1080.0,702.0,1.1,1080.0,126
CDM,95807OH,SLEEP STD REC VNTJ RESPIR ECG/HRT RATE&O2 ATTN,4224.0,2745.6,1.1,4224.0,142
CDM,95807OH-26,SLEEP STD REC VNTJ RESPIR ECG/HRT RATE&O2 ATTN,563.0,365.95,1.1,563.0,126
CDM,95807OH-TC,SLEEP STD REC VNTJ RESPIR ECG/HRT RATE&O2 ATTN,3661.0,2379.65,1.1,3661.0,126
CDM,95808OH,POLYSOM ANY AGE SLEEP STAGE 1-3 ADDL PARAM ATTND,7786.0,5060.9,1.1,7786.0,144
CDM,95808OH-26,POLYSOM ANY AGE SLEEP STAGE 1-3 ADDL PARAM ATTND,766.0,497.9,1.1,766.0,126
CDM,95808OH-TC,POLYSOM ANY AGE SLEEP STAGE 1-3 ADDL PARAM ATTND,7020.0,4563.0,1.1,7020.0,126
CDM,95810OH,POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND,8120.0,5278.0,1.1,8120.0,144
CDM,95810OH-26,POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND,1100.0,715.0,1.1,1100.0,126
CDM,95810OH-TC,POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND,7020.0,4563.0,1.1,7020.0,126
CDM,95811OH,POLYSOM 6/>YRS SLEEP W/CPAP 4/> ADDL PARAM ATTND,8164.0,5306.6,1.1,8164.0,144
CDM,95811OH-26,POLYSOM 6/>YRS SLEEP W/CPAP 4/> ADDL PARAM ATTND,1144.0,743.6,1.1,1144.0,126
CDM,95811OH-TC,POLYSOM 6/>YRS SLEEP W/CPAP 4/> ADDL PARAM ATTND,7020.0,4563.0,1.1,7020.0,126
CDM,95812OH,ELECTROENCEPHALOGRAM EXTEND MONITORING 41-60 MIN,2581.0,1677.65,1.1,2581.0,144
CDM,95812OH-26,ELECTROENCEPHALOGRAM EXTEND MONITORING 41-60 MIN,432.0,280.8,1.1,432.0,126
CDM,95812OH-TC,ELECTROENCEPHALOGRAM EXTEND MONITORING 41-60 MIN,2149.0,1396.85,1.1,2149.0,126
CDM,95813OH,EEG EXTENDED MONITORING 61-119 MINUTES,2801.0,1820.65,1.1,2801.0,144
CDM,95813OH-26,EEG EXTENDED MONITORING 61-119 MINUTES,652.0,423.8,1.1,652.0,126
CDM,95813OH-TC,EEG EXTENDED MONITORING 61-119 MINUTES,2149.0,1396.85,1.1,2149.0,126
CDM,95816OH,ELECTROENCEPHALOGRAM W/REC AWAKE&DROWSY,2624.0,1705.6,1.1,2624.0,144
CDM,95816OH-26,ELECTROENCEPHALOGRAM W/REC AWAKE&DROWSY,475.0,308.75,1.1,475.0,126
CDM,95816OH-TC,ELECTROENCEPHALOGRAM W/REC AWAKE&DROWSY,2149.0,1396.85,1.1,2149.0,126
CDM,95819OH,ELECTROENCEPHALOGRAM W/REC AWAKE&ASLEEP,2624.0,1705.6,1.1,2624.0,144
CDM,95819OH-26,ELECTROENCEPHALOGRAM W/REC AWAKE&ASLEEP,475.0,308.75,1.1,475.0,126
CDM,95819OH-TC,ELECTROENCEPHALOGRAM W/REC AWAKE&ASLEEP,2149.0,1396.85,1.1,2149.0,126
CDM,95822OH,ELECTROENCEPHALOGRAM REC COMA/SLEEP ONLY,2624.0,1705.6,1.1,2624.0,144
CDM,95822OH-26,ELECTROENCEPHALOGRAM REC COMA/SLEEP ONLY,475.0,308.75,1.1,475.0,126
CDM,95822OH-TC,ELECTROENCEPHALOGRAM REC COMA/SLEEP ONLY,2149.0,1396.85,1.1,2149.0,126
CDM,95824OH,ELECTROENCEPHALOGRAM CERE DEATH EVAL ONLY,3957.0,2572.05,1.1,3957.0,104
CDM,95824OH-26,ELECTROENCEPHALOGRAM CERE DEATH EVAL ONLY,296.0,192.4,1.1,296.0,126
CDM,95824OH-TC,ELECTROENCEPHALOGRAM CERE DEATH EVAL ONLY,3661.0,2379.65,1.1,3661.0,94
CDM,95829OH,SURGERY ELECTROCORTICOGRAM,5439.0,3535.35,1.1,5724.75,144
CDM,95829OH-26,SURGERY ELECTROCORTICOGRAM,2728.0,1773.2,1.1,2728.0,126
CDM,95829OH-TC,SURGERY ELECTROCORTICOGRAM,2711.0,1762.15,1.1,4621.21,126
CDM,95830OH,INSERTION SPHENOIDAL ELECTRODES EEG PHYS/QHP,680.0,442.0,1.1,2233.6,146
CDM,95836OH,ECOG IMPLANTED BRAIN NPGT W/REC I&R <30 DAYS,792.0,514.8,1.1,792.0,144
CDM,95857OH,CHOLINESTERASE INHIBITOR CHALLENGE TEST,212.0,137.8,1.1,915.24,148
CDM,95860OH,NDL EMG 1 XTR W/WO RELATED PARASPINAL AREAS,1273.0,827.45,1.1,1273.0,144
CDM,95860OH-26,NDL EMG 1 XTR W/WO RELATED PARASPINAL AREAS,384.0,249.6,1.1,384.0,126
CDM,95860OH-TC,NDL EMG 1 XTR W/WO RELATED PARASPINAL AREAS,889.0,577.85,1.1,889.0,126
CDM,95861OH,NDL EMG 2 XTR W/WO RELATED PARASPINAL AREAS,1505.0,978.25,1.1,1505.0,144
CDM,95861OH-26,NDL EMG 2 XTR W/WO RELATED PARASPINAL AREAS,616.0,400.4,1.1,616.0,126
CDM,95861OH-TC,NDL EMG 2 XTR W/WO RELATED PARASPINAL AREAS,889.0,577.85,1.1,889.0,126
CDM,95863OH,NDL EMG 3 XTR W/WO RELATED PARASPINAL AREAS,1828.0,1188.2,1.1,1828.0,144
CDM,95863OH-26,NDL EMG 3 XTR W/WO RELATED PARASPINAL AREAS,748.0,486.2,1.1,748.0,126
CDM,95863OH-TC,NDL EMG 3 XTR W/WO RELATED PARASPINAL AREAS,1080.0,702.0,1.1,1080.0,126
CDM,95864OH,NDL EMG 4 XTR W/WO RELATED PARASPINAL AREAS,1876.0,1219.4,1.1,1876.0,144
CDM,95864OH-26,NDL EMG 4 XTR W/WO RELATED PARASPINAL AREAS,796.0,517.4,1.1,796.0,126
CDM,95864OH-TC,NDL EMG 4 XTR W/WO RELATED PARASPINAL AREAS,1080.0,702.0,1.1,1080.0,126
CDM,95865OH,NEEDLE ELECTROMYOGRAPHY LARYNX,1517.0,986.05,1.1,1517.0,144
CDM,95865OH-26,NEEDLE ELECTROMYOGRAPHY LARYNX,628.0,408.2,1.1,628.0,126
CDM,95865OH-TC,NEEDLE ELECTROMYOGRAPHY LARYNX,889.0,577.85,1.1,889.0,126
CDM,95866OH,NEEDLE ELECTROMYOGRAPHY HEMIDIAPHRAGM,1580.0,1027.0,1.1,1580.0,144
CDM,95866OH-26,NEEDLE ELECTROMYOGRAPHY HEMIDIAPHRAGM,500.0,325.0,1.1,500.0,126
CDM,95866OH-TC,NEEDLE ELECTROMYOGRAPHY HEMIDIAPHRAGM,1080.0,702.0,1.1,1080.0,126
CDM,95867OH,NEEDLE ELECTROMYOGRAPHY CRANIAL NRV MUSCLE UNI,2465.0,1602.25,1.1,2465.0,144
CDM,95867OH-26,NEEDLE ELECTROMYOGRAPHY CRANIAL NRV MUSCLE UNI,316.0,205.4,1.1,316.0,126
CDM,95867OH-TC,NEEDLE ELECTROMYOGRAPHY CRANIAL NRV MUSCLE UNI,2149.0,1396.85,1.1,2149.0,126
CDM,95868OH,NEEDLE ELECTROMYOGRAPHY CRANIAL NRV MUSCLE BI,2621.0,1703.65,1.1,2621.0,144
CDM,95868OH-26,NEEDLE ELECTROMYOGRAPHY CRANIAL NRV MUSCLE BI,472.0,306.8,1.1,472.0,126
CDM,95868OH-TC,NEEDLE ELECTROMYOGRAPHY CRANIAL NRV MUSCLE BI,2149.0,1396.85,1.1,2149.0,126
CDM,95869OH,NEEDLE EMG THRC PARASPI MUSC EXCLUDING T1/T12,2297.0,1493.05,1.1,2297.0,144
CDM,95869OH-26,NEEDLE EMG THRC PARASPI MUSC EXCLUDING T1/T12,148.0,96.2,1.1,148.0,126
CDM,95869OH-TC,NEEDLE EMG THRC PARASPI MUSC EXCLUDING T1/T12,2149.0,1396.85,1.1,2149.0,126
CDM,95870OH,NEEDLE EMG LMTD STD MUSC 1 XTR/NON-LIMB UNI/BI,1037.0,674.05,1.1,1037.0,144
CDM,95870OH-26,NEEDLE EMG LMTD STD MUSC 1 XTR/NON-LIMB UNI/BI,148.0,96.2,1.1,148.0,126
CDM,95870OH-TC,NEEDLE EMG LMTD STD MUSC 1 XTR/NON-LIMB UNI/BI,889.0,577.85,1.1,889.0,126
CDM,95872OH,NEEDLE EMG W/1 FIBER ELECTRODE QUAN MEAS JITTER,2232.0,1450.8,1.1,2232.0,144
CDM,95872OH-26,NEEDLE EMG W/1 FIBER ELECTRODE QUAN MEAS JITTER,1152.0,748.8,1.1,1152.0,126
CDM,95872OH-TC,NEEDLE EMG W/1 FIBER ELECTRODE QUAN MEAS JITTER,1080.0,702.0,1.1,1080.0,126
CDM,95873OH,ELECTRICAL STIMULATION GUID W/CHEMODENERVATION,238.0,154.7,1.1,238.0,144
CDM,95873OH-26,ELECTRICAL STIMULATION GUID W/CHEMODENERVATION,163.0,105.95,1.1,163.0,126
CDM,95873OH-TC,ELECTRICAL STIMULATION GUID W/CHEMODENERVATION,75.0,48.75,1.1,168.71,126
CDM,95874OH,NEEDLE EMG GUIDANCE FOR CHEMODENERVATION,945.0,614.25,1.1,945.0,144
CDM,95874OH-26,NEEDLE EMG GUIDANCE FOR CHEMODENERVATION,163.0,105.95,1.1,163.0,126
CDM,95874OH-TC,NEEDLE EMG GUIDANCE FOR CHEMODENERVATION,782.0,508.3,1.1,782.0,126
CDM,95875OH,ISCHEMIC LIMB XERS TST SPEC ACQUISJ METAB,1520.0,988.0,1.1,1520.0,142
CDM,95875OH-26,ISCHEMIC LIMB XERS TST SPEC ACQUISJ METAB,440.0,286.0,1.1,440.0,126
CDM,95875OH-TC,ISCHEMIC LIMB XERS TST SPEC ACQUISJ METAB,1080.0,702.0,1.1,1080.0,126
CDM,95885OH,NEEDLE EMG EA EXTREMITY W/PARASPINL AREA LIMITED,1137.0,739.05,1.1,1137.0,144
CDM,95885OH-26,NEEDLE EMG EA EXTREMITY W/PARASPINL AREA LIMITED,140.0,91.0,1.1,140.0,126
CDM,95885OH-TC,NEEDLE EMG EA EXTREMITY W/PARASPINL AREA LIMITED,997.0,648.05,1.1,997.0,126
CDM,95886OH,NEEDLE EMG EA EXTREMTY W/PARASPINL AREA COMPLETE,1844.0,1198.6,1.1,1844.0,144
CDM,95886OH-26,NEEDLE EMG EA EXTREMTY W/PARASPINL AREA COMPLETE,378.0,245.7,1.1,378.0,126
CDM,95886OH-TC,NEEDLE EMG EA EXTREMTY W/PARASPINL AREA COMPLETE,1466.0,952.9,1.1,1466.0,126
CDM,95887OH,NEEDLE EMG NONEXTREMTY MSCLES W/NERVE CONDUCTION,870.0,565.5,1.1,870.0,144
CDM,95887OH-26,NEEDLE EMG NONEXTREMTY MSCLES W/NERVE CONDUCTION,312.0,202.8,1.1,312.0,126
CDM,95887OH-TC,NEEDLE EMG NONEXTREMTY MSCLES W/NERVE CONDUCTION,558.0,362.7,1.1,558.0,126
CDM,95905OH,MOTOR &/SENS NRV CNDJ  PRECONF ELTRD ARRAY LIMB,2773.0,1802.45,1.1,2773.0,144
CDM,95905OH-26,MOTOR &/SENS NRV CNDJ  PRECONF ELTRD ARRAY LIMB,20.0,13.0,1.1,20.0,114
CDM,95905OH-TC,MOTOR &/SENS NRV CNDJ  PRECONF ELTRD ARRAY LIMB,2753.0,1789.45,1.1,2753.0,114
CDM,95907OH,NERVE CONDUCTION STUDIES 1-2 STUDIES,1520.0,988.0,1.1,1520.0,144
CDM,95907OH-26,NERVE CONDUCTION STUDIES 1-2 STUDIES,440.0,286.0,1.1,440.0,126
CDM,95907OH-TC,NERVE CONDUCTION STUDIES 1-2 STUDIES,1080.0,702.0,1.1,1080.0,126
CDM,95908OH,NERVE CONDUCTION STUDIES 3-4 STUDIES,2699.0,1754.35,1.1,2699.0,144
CDM,95908OH-26,NERVE CONDUCTION STUDIES 3-4 STUDIES,550.0,357.5,1.1,550.0,126
CDM,95908OH-TC,NERVE CONDUCTION STUDIES 3-4 STUDIES,2149.0,1396.85,1.1,2149.0,126
CDM,95909OH,NERVE CONDUCTION STUDIES 5-6 STUDIES,2809.0,1825.85,1.1,2809.0,144
CDM,95909OH-26,NERVE CONDUCTION STUDIES 5-6 STUDIES,660.0,429.0,1.1,660.0,126
CDM,95909OH-TC,NERVE CONDUCTION STUDIES 5-6 STUDIES,2149.0,1396.85,1.1,2149.0,126
CDM,95910OH,NERVE CONDUCTION STUDIES 7-8 STUDIES,3029.0,1968.85,1.1,3029.0,144
CDM,95910OH-26,NERVE CONDUCTION STUDIES 7-8 STUDIES,880.0,572.0,1.1,880.0,126
CDM,95910OH-TC,NERVE CONDUCTION STUDIES 7-8 STUDIES,2149.0,1396.85,1.1,2149.0,126
CDM,95911OH,NERVE CONDUCTION STUDIES 9-10 STUDIES,4761.0,3094.65,1.1,4761.0,144
CDM,95911OH-26,NERVE CONDUCTION STUDIES 9-10 STUDIES,1100.0,715.0,1.1,1100.0,126
CDM,95911OH-TC,NERVE CONDUCTION STUDIES 9-10 STUDIES,3661.0,2379.65,1.1,3661.0,126
CDM,95912OH,NERVE CONDUCTION STUDIES 11-12 STUDIES,4981.0,3237.65,1.1,4981.0,144
CDM,95912OH-26,NERVE CONDUCTION STUDIES 11-12 STUDIES,1320.0,858.0,1.1,1320.0,126
CDM,95912OH-TC,NERVE CONDUCTION STUDIES 11-12 STUDIES,3661.0,2379.65,1.1,3661.0,126
CDM,95913OH,NERVE CONDUCTION STUDIES 13/> STUDIES,5227.0,3397.55,1.1,5227.0,144
CDM,95913OH-26,NERVE CONDUCTION STUDIES 13/> STUDIES,1566.0,1017.9,1.1,1566.0,126
CDM,95913OH-TC,NERVE CONDUCTION STUDIES 13/> STUDIES,3661.0,2379.65,1.1,3661.0,126
CDM,95919OH,QUANTITATIVE PUPILLOMETRY PHYS/QHP I&R UNI/BI,961.0,624.65,1.1,961.0,144
CDM,95919OH-26,QUANTITATIVE PUPILLOMETRY PHYS/QHP I&R UNI/BI,72.0,46.8,1.1,72.0,126
CDM,95919OH-TC,QUANTITATIVE PUPILLOMETRY PHYS/QHP I&R UNI/BI,889.0,577.85,1.1,889.0,126
CDM,95921OH,TSTG ANS FUNCJ CARDIOVAGAL INNERVAJ PARASYMP,1440.0,936.0,1.1,1440.0,144
CDM,95921OH-26,TSTG ANS FUNCJ CARDIOVAGAL INNERVAJ PARASYMP,360.0,234.0,1.1,360.0,126
CDM,95921OH-TC,TSTG ANS FUNCJ CARDIOVAGAL INNERVAJ PARASYMP,1080.0,702.0,1.1,1080.0,126
CDM,95922OH,TSTG ANS FUNCJ VASOMOTOR ADRENERGIC INNERVAJ,1273.0,827.45,1.1,1273.0,144
CDM,95922OH-26,TSTG ANS FUNCJ VASOMOTOR ADRENERGIC INNERVAJ,384.0,249.6,1.1,384.0,126
CDM,95922OH-TC,TSTG ANS FUNCJ VASOMOTOR ADRENERGIC INNERVAJ,889.0,577.85,1.1,889.0,126
CDM,95923OH,TESTING AUTONOMIC NERVOUS SYSTEM FUNCTION,1249.0,811.85,1.1,1249.0,142
CDM,95923OH-26,TESTING AUTONOMIC NERVOUS SYSTEM FUNCTION,360.0,234.0,1.1,360.0,126
CDM,95923OH-TC,TESTING AUTONOMIC NERVOUS SYSTEM FUNCTION,889.0,577.85,1.1,889.0,126
CDM,95924OH,TSTG ANS FUNCJ PARASYMP&SYMP W/5 MIN PASIVE TILT,2910.0,1891.5,1.1,2910.0,142
CDM,95924OH-26,TSTG ANS FUNCJ PARASYMP&SYMP W/5 MIN PASIVE TILT,761.0,494.65,1.1,761.0,126
CDM,95924OH-TC,TSTG ANS FUNCJ PARASYMP&SYMP W/5 MIN PASIVE TILT,2149.0,1396.85,1.1,2149.0,126
CDM,95925OH,SHORT-LATENCY SOMATOSENS EP STD UPR LIMBS,2365.0,1537.25,1.1,2365.0,144
CDM,95925OH-26,SHORT-LATENCY SOMATOSENS EP STD UPR LIMBS,216.0,140.4,1.1,216.0,126
CDM,95925OH-TC,SHORT-LATENCY SOMATOSENS EP STD UPR LIMBS,2149.0,1396.85,1.1,2149.0,126
CDM,95926OH,SHORT-LATENCY SOMATOSENS EP STD LWR LIMBS,2365.0,1537.25,1.1,2365.0,144
CDM,95926OH-26,SHORT-LATENCY SOMATOSENS EP STD LWR LIMBS,216.0,140.4,1.1,216.0,126
CDM,95926OH-TC,SHORT-LATENCY SOMATOSENS EP STD LWR LIMBS,2149.0,1396.85,1.1,2149.0,126
CDM,95927OH,SHORT-LATENCY SOMATOSENS EP STD TRNK/HEAD,2365.0,1537.25,1.1,2365.0,144
CDM,95927OH-26,SHORT-LATENCY SOMATOSENS EP STD TRNK/HEAD,216.0,140.4,1.1,216.0,126
CDM,95927OH-TC,SHORT-LATENCY SOMATOSENS EP STD TRNK/HEAD,2149.0,1396.85,1.1,2149.0,126
CDM,95928OH,CTR MOTOR EP STD TRANSCRNL MOTOR STIMJ UPR LIMBS,7620.0,4953.0,1.1,7620.0,144
CDM,95928OH-26,CTR MOTOR EP STD TRANSCRNL MOTOR STIMJ UPR LIMBS,600.0,390.0,1.1,600.0,126
CDM,95928OH-TC,CTR MOTOR EP STD TRANSCRNL MOTOR STIMJ UPR LIMBS,7020.0,4563.0,1.1,7020.0,126
CDM,95929OH,CTR MOTOR EP STD TRANSCRNL MOTOR STIMJ LWR LIMBS,4261.0,2769.65,1.1,4261.0,144
CDM,95929OH-26,CTR MOTOR EP STD TRANSCRNL MOTOR STIMJ LWR LIMBS,600.0,390.0,1.1,600.0,126
CDM,95929OH-TC,CTR MOTOR EP STD TRANSCRNL MOTOR STIMJ LWR LIMBS,3661.0,2379.65,1.1,3661.0,126
CDM,95930OH,VISUAL EP TESTING CNS EXCEPT GLAUCOMA W/I&R,2289.0,1487.85,1.1,2289.0,144
CDM,95930OH-26,VISUAL EP TESTING CNS EXCEPT GLAUCOMA W/I&R,140.0,91.0,1.1,140.0,126
CDM,95930OH-TC,VISUAL EP TESTING CNS EXCEPT GLAUCOMA W/I&R,2149.0,1396.85,1.1,2149.0,126
CDM,95933OH,ORBICULARIS OCULI REFLX ELECTRODIAGNOSTIC TEST,646.0,419.9,1.1,646.0,142
CDM,95933OH-26,ORBICULARIS OCULI REFLX ELECTRODIAGNOSTIC TEST,236.0,153.4,1.1,236.0,126
CDM,95933OH-TC,ORBICULARIS OCULI REFLX ELECTRODIAGNOSTIC TEST,410.0,266.5,1.1,410.0,126
CDM,95937OH,NEUROMUSCULAR JUNCT TSTG EA NRV ANY 1 METH,1340.0,871.0,1.1,1340.0,144
CDM,95937OH-26,NEUROMUSCULAR JUNCT TSTG EA NRV ANY 1 METH,260.0,169.0,1.1,260.0,126
CDM,95937OH-TC,NEUROMUSCULAR JUNCT TSTG EA NRV ANY 1 METH,1080.0,702.0,1.1,1080.0,126
CDM,95938OH,SHORT-LATENCY SOMATOSENS EP STD UPR & LOW LIMBS,4005.0,2603.25,1.1,4005.0,144
CDM,95938OH-26,SHORT-LATENCY SOMATOSENS EP STD UPR & LOW LIMBS,344.0,223.6,1.1,344.0,126
CDM,95938OH-TC,SHORT-LATENCY SOMATOSENS EP STD UPR & LOW LIMBS,3661.0,2379.65,1.1,3661.0,126
CDM,95939OH,CTR MOTR EP STD TRANSCRNL MOTR STIM UPR&LOW LIMB,7920.0,5148.0,1.1,7920.0,144
CDM,95939OH-26,CTR MOTR EP STD TRANSCRNL MOTR STIM UPR&LOW LIMB,900.0,585.0,1.1,900.0,126
CDM,95939OH-TC,CTR MOTR EP STD TRANSCRNL MOTR STIM UPR&LOW LIMB,7020.0,4563.0,1.1,7020.0,126
CDM,95940OH,IONM 1 ON 1 IN OR W/ATTENDANCE EACH 15 MINUTES,264.0,171.6,1.1,264.0,144
CDM,95941OH,IONM REMOTE/NEARBY/>1 PATIENT IN OR PER HOUR,1767.0,1148.55,1.1,1767.0,94
CDM,95955OH,EEG NONINTRACRANIAL SURGERY,1597.0,1038.05,1.1,1597.0,142
CDM,95955OH-26,EEG NONINTRACRANIAL SURGERY,404.0,262.6,1.1,404.0,126
CDM,95955OH-TC,EEG NONINTRACRANIAL SURGERY,1193.0,775.45,1.1,1193.0,126
CDM,95957OH,DIGITAL ANALYSIS ELECTROENCEPHALOGRAM,792.0,514.8,1.1,900.29,144
CDM,95957OH-26,DIGITAL ANALYSIS ELECTROENCEPHALOGRAM,792.0,514.8,1.1,792.0,126
CDM,95958OH,WADA ACTIVATION TEST HEMISPHERIC FUNCTION W/EEG,8716.0,5665.4,1.1,8716.0,144
CDM,95958OH-26,WADA ACTIVATION TEST HEMISPHERIC FUNCTION W/EEG,1696.0,1102.4,1.1,1696.0,126
CDM,95958OH-TC,WADA ACTIVATION TEST HEMISPHERIC FUNCTION W/EEG,7020.0,4563.0,1.1,7020.0,126
CDM,95961OH,FUNCJAL CORT&SUBCORT MAPG PHYS/QHP ATTND INIT HR,8208.0,5335.2,1.1,8208.0,144
CDM,95961OH-26,FUNCJAL CORT&SUBCORT MAPG PHYS/QHP ATTND INIT HR,1188.0,772.2,1.1,1188.0,126
CDM,95961OH-TC,FUNCJAL CORT&SUBCORT MAPG PHYS/QHP ATTND INIT HR,7020.0,4563.0,1.1,7020.0,126
CDM,95962OH,FUNCJAL CORT&SUBCORT MAPG PHYS/QHP ATTND ADDL HR,1884.0,1224.6,1.1,1884.0,144
CDM,95962OH-26,FUNCJAL CORT&SUBCORT MAPG PHYS/QHP ATTND ADDL HR,1284.0,834.6,1.1,1284.0,126
CDM,95962OH-TC,FUNCJAL CORT&SUBCORT MAPG PHYS/QHP ATTND ADDL HR,600.0,390.0,1.1,600.0,126
CDM,95965OH,MAGNETOENCEPHALOGRAPHY SPON BRAIN ACTIVITY,10216.0,6640.4,1.1,10216.0,104
CDM,95965OH-26,MAGNETOENCEPHALOGRAPHY SPON BRAIN ACTIVITY,3196.0,2077.4,1.1,3196.0,126
CDM,95965OH-TC,MAGNETOENCEPHALOGRAPHY SPON BRAIN ACTIVITY,7020.0,4563.0,1.1,7020.0,94
CDM,95966OH,MAGNETOENCEPHALOGRAPY EVOKED FIELDS 1 MODALITY,8616.0,5600.4,1.1,8616.0,104
CDM,95966OH-26,MAGNETOENCEPHALOGRAPY EVOKED FIELDS 1 MODALITY,1596.0,1037.4,1.1,1596.0,126
CDM,95966OH-TC,MAGNETOENCEPHALOGRAPY EVOKED FIELDS 1 MODALITY,7020.0,4563.0,1.1,7020.0,94
CDM,95967OH,MAGNETOENCEPHALOGRAPY EVOKED FIELDS EACH ADDL,5677.0,3690.05,1.1,5677.0,104
CDM,95967OH-26,MAGNETOENCEPHALOGRAPY EVOKED FIELDS EACH ADDL,1396.0,907.4,1.1,1396.0,126
CDM,95967OH-TC,MAGNETOENCEPHALOGRAPY EVOKED FIELDS EACH ADDL,4281.0,2782.65,1.1,4281.0,94
CDM,95970OH,ELEC ALYS IMPLT NPGT PHYS/QHP W/O PROGRAMMING,154.0,100.1,1.1,373.44,148
CDM,95971OH,ELEC ALYS IMPLT NPGT SMPL SP/PN NPGT PRGRMG,343.0,222.95,1.1,343.0,148
CDM,95972OH,ELEC ALYS IMPLT NPGT CPLX SP/PN PRGRMG,352.0,228.8,1.1,352.0,148
CDM,95976OH,ELEC ALYS IMPLT SMPL CN NPGT PRGRMG,321.0,208.65,1.1,321.0,148
CDM,95977OH,ELEC ALYS IMPLT CPLX CN NPGT PRGRMG,388.0,252.2,1.1,388.0,148
CDM,95980OH,ELEC ALYS NSTIM PLS GEN GASTRIC INTRAOP W/PRGRMG,320.0,208.0,1.1,320.0,142
CDM,95981OH,ELEC ALYS NSTIM GEN GASTRIC SBSQ W/O REPRGRMG,120.0,78.0,1.1,177.54,146
CDM,95982OH,ELEC ALYS NSTIM PLS GEN GASTRIC SBSQ W/REPRGRMG,260.0,169.0,1.1,260.0,146
CDM,95983OH,ELEC ALYS IMPLT BRN NPGT PRGRMG 1ST 15 MIN,400.0,260.0,1.1,400.0,148
CDM,95984OH,ELEC ALYS IMPLT BRN NPGT PRGRMG EA ADDL 15 MIN,352.0,228.8,1.1,352.0,148
CDM,95990OH,REFILL&MAINTENANCE PUMP DRUG DLVR SPINAL/BRAIN,217.0,141.05,1.1,988.7,144
CDM,95991OH,RFL&MAIN IMPLT PMP/RSVR DLVR SPI/BRN PHY/QHP,339.0,220.35,1.1,863.2,148
CDM,95992OH,CANALITH REPOSITIONING PROCEDURE,300.0,195.0,1.1,300.0,148
CDM,95999RVU1OH,PUMP TITRATION,1155.0,750.75,0.01,1155.0,84
CDM,96000000,"ECG/REVIEW, INTERPRET ONLY",6.0,3.9,1.31,32.32,60
CDM,96000015,PROLONG CLINCL STAFF SVC,269.0,174.85,12.36,269.0,68
CDM,96000025,PROLONG CLINCL STAFF SVC ADD,269.0,174.85,7.21,269.0,68
CDM,96000OH,COMPRE CPTR MTN ALYS VIDEO TAPING 3D KINEMATICS,720.0,468.0,1.1,1564.17,142
CDM,96004OH,PHYS/QHP R&I CPTR MTN ALYS WALK/FUNCJL ACTV REPR,856.0,556.4,1.1,856.0,142
CDM,96020OH,TEST SELECT & ADMN FUNCTL BRAIN MAP PHYS/QHP,9868.0,6414.2,1.1,9868.0,92
CDM,96020OH-26,TEST SELECT & ADMN FUNCTL BRAIN MAP PHYS/QHP,1372.0,891.8,1.1,1372.0,126
CDM,96020OH-TC,TEST SELECT & ADMN FUNCTL BRAIN MAP PHYS/QHP,8496.0,5522.4,1.1,8496.0,92
CDM,96041OH,MED GENETICS&GENETIC COUNSELING SVCS EACH 30 MIN,650.0,422.5,1.1,650.0,94
CDM,96105OH,ASSESSMENT APHASIA W/INTERP & REPORT PER HOUR,700.0,455.0,1.1,700.0,144
CDM,96110OH,DEVELOPMENTAL SCREEN W/SCORING & DOC STD INSTRM,36.0,23.4,1.1,36.0,112
CDM,96112OH,DEVELOPMENTAL TST ADMIN PHYS/QHP 1ST HOUR,1024.0,665.6,1.1,1024.0,148
CDM,96113OH,DEVELOPMENTAL TST ADMIN PHYS/QHP EA ADDL 30 MIN,464.0,301.6,1.1,464.0,148
CDM,96116OH,NEUROBEHAVIORAL STATUS XM PHYS/QHP 1ST HOUR,744.0,483.6,1.1,915.24,152
CDM,96121OH,NEUROBEHAVIORAL STATUS XM PHYS/QHP EA ADDL HOUR,752.0,488.8,1.1,752.0,150
CDM,96125OH,STANDARDIZED COGNITIVE PERFORMANCE TESTING,680.0,442.0,1.1,680.0,142
CDM,96127DABOH,DEPRESSION SCREENING AUTO BILLING,66.0,42.9,1.1,116.32,142
CDM,96127OH,BEHAV ASSMT W/SCORE & DOCD/STAND INSTRUMENT,66.0,42.9,1.1,116.32,142
CDM,96130OH,PSYCHOLOGICAL TST EVAL SVC PHYS/QHP FIRST HOUR,1126.0,731.9,1.1,1126.0,152
CDM,96131OH,PSYCHOLOGICAL TST EVAL SVC PHYS/QHP EA ADDL HOUR,862.0,560.3,1.1,862.0,152
CDM,96132OH,NEUROPSYCHOLOGICAL TST EVAL PHYS/QHP 1ST HOUR,1126.0,731.9,1.1,1564.17,152
CDM,96133OH,NEUROPSYCHOLOGICAL TST EVAL PHYS/QHP EA ADDL HR,862.0,560.3,1.1,862.0,152
CDM,96136OH,PSYL/NRPSYCL TST PHYS/QHP 2+ TST 1ST 30 MIN,242.0,157.3,1.1,373.44,152
CDM,96137OH,PSYCL/NRPSYCL TST PHYS/QHP 2+ TST EA ADDL 30 MIN,202.0,131.3,1.1,202.0,152
CDM,96138OH,PSYCL/NRPSYCL TST TECH 2+ TST 1ST 30 MIN,788.0,512.2,1.1,1163.18,134
CDM,96139OH,PSYCL/NRPSYCL TST TECH 2+ TST EA ADDL 30 MIN,788.0,512.2,1.1,788.0,132
CDM,96146OH,PSYCL/NRPSYCL TST ELEC PLATFORM AUTO RESULT,203.0,131.95,1.03,203.0,144
CDM,96156OH,HEALTH BEHAVIOR ASSESSMENT/RE-ASSESSMENT,920.0,598.0,1.1,920.0,140
CDM,96158OH,HEALTH BEHAVIOR IVNTJ INDIV F2F 1ST 30 MIN,636.0,413.4,1.1,636.0,140
CDM,96159OH,HEALTH BEHAVIOR IVNTJ INDIV F2F EA ADDL 15 MIN,220.0,143.0,1.1,220.0,140
CDM,96160OH,PT-FOCUSED HLTH RISK ASSMT SCORE DOC STND INSTRM,46.0,29.9,1.1,55.06,142
CDM,96161OH,CAREGIVER HLTH RISK ASSMT SCORE DOC STND INSTRM,89.0,57.85,1.1,89.0,142
CDM,96164OH,HEALTH BEHAVIOR IVNTJ GROUP F2F 1ST 30 MIN,92.0,59.8,1.1,92.0,140
CDM,96165OH,HEALTH BEHAVIOR IVNTJ GROUP F2F EA ADDL 15 MIN,44.0,28.6,1.1,309.0,140
CDM,96167OH,HEALTH BEHAVIOR IVNTJ FAM W/PT F2F 1ST 30 MIN,680.0,442.0,1.1,680.0,140
CDM,96168OH,HEALTH BEHAVIOR IVNTJ FAM W/PT F2F EA ADD 15 MIN,240.0,156.0,1.1,240.0,140
CDM,96170OH,HEALTH BEHAVIOR IVNTJ FAM W/O PT F2F 1ST 30 MIN,600.0,390.0,1.1,600.0,104
CDM,96171OH,HEALTH BEHAVIOR IVNTJ FAM W/O PT F2F EA ADDL 15,216.0,140.4,1.1,216.0,104
CDM,96202OH,MLT FAM GROUP BHV MGMT/MODIFICAJ TRAING 1ST 60,172.0,111.8,1.1,172.0,136
CDM,96203OH,MLT FAM GROUP BHV MGMT/MODIFICAJ TRAING EA ADDL,48.0,31.2,1.1,48.0,132
CDM,96360OH,IV INFUSION HYDRATION INITIAL 31 MIN-1 HOUR,75.0,48.75,1.1,624.44,144
CDM,96361OH,IV INFUSION HYDRATION EACH ADDITIONAL HOUR,40.0,26.0,1.1,137.75,144
CDM,96365OH,IV INFUSION THERAPY/PROPHYLAXIS /DX 1ST TO 1 HR,92.0,59.8,1.1,624.44,144
CDM,96366OH,IV INFUSION THERAPY PROPHYLAXIS/DX EA HOUR,79.0,51.35,1.1,137.75,144
CDM,96367OH,IV INFUSION THER PROPH ADDL SEQUENTIAL TO 1 HR,84.0,54.6,1.1,205.09,144
CDM,96368OH,IV NFS THERAPY PROPHYLAXIS/DX CONCURRENT NFS,75.0,48.75,1.1,75.0,144
CDM,96372OH,THERAPEUTIC PROPHYLACTIC/DX INJECTION SUBQ/IM,491.0,319.15,1.1,491.0,148
CDM,96374OH,THER PROPH/DX NJX IV PUSH SINGLE/1ST SBST/DRUG,79.0,51.35,1.1,624.44,144
CDM,96375OH,THERAPEUTIC INJECTION IV PUSH EACH NEW DRUG,44.0,28.6,1.1,137.75,144
CDM,96376OH,THER PROPH/DX NJX EA SEQL IV PUSH SBST/DRUG FAC,390.0,253.5,1.1,390.0,102
CDM,96377OH,APPL ON-BODY INJECTOR FOR TIMED SUBQ INJECTION,75.0,48.75,1.1,137.75,144
CDM,96380OH,"ADMIN BEYFORTUS IM INJ,W/ COUNSELING",158.0,102.7,1.1,158.0,130
CDM,96380VFCOH,"VFC ADMIN BEYFORTUS IM INJ,W/ COUNSELING",21.25,13.81,1.1,76.65,130
CDM,96381OH,ADMIN BEYFORTUS IM INJ,158.0,102.7,1.1,158.0,130
CDM,96401OH,"CHEMOTHER,NON-HORMONE ANTI-NEOPL, SUB-Q/IM",92.0,59.8,1.1,234.61,144
CDM,96402OH,CHEMOTHER HORMON ANTINEOPL SUB-Q/IM,84.0,54.6,1.1,205.09,144
CDM,96405OH,CHEMOTHERAPY ADMINISTRATION INTRALESIONAL </7,229.0,148.85,1.1,274.11,148
CDM,96406OH,CHEMOTHERAPY ADMINISTRATION INTRALESIONAL >7,352.0,228.8,1.1,624.44,148
CDM,96409OH,"CHEMOTHER, IV PUSH, SNGL DRUG",106.0,68.9,1.1,988.7,144
CDM,96411OH,"CHEMOTHER, IV PUSH,EA ADD DRUG",88.0,57.2,1.1,205.09,144
CDM,96413OH,"CHEMOTHER, IV INFUSION, 1 HR",123.0,79.95,1.1,988.7,144
CDM,96415OH,"CHEMOTHER, IV INFUSION, EA ADD HR",84.0,54.6,1.1,205.09,144
CDM,96416OH,CHEMOTHER PROLONG INFUSE W/PUMP,92.0,59.8,1.1,988.7,144
CDM,96417OH,"CHEMOTHER, IV INFUSE, EACH SEQU INFUS",92.0,59.8,1.1,207.9,144
CDM,96420OH,CHEMOTHERAPY ADMIN INTRA-ARTERIAL PUSH TQ,75.0,48.75,1.1,988.7,144
CDM,96422OH,CHEMOTHERAPY ADMIN INTRA-ARTERIAL INFUS </1 HR,68.0,44.2,1.1,988.7,144
CDM,96440OH,CHEMOTX ADMN PLEURAL CAVITY REQ&W/THORACNTS,848.0,551.2,1.1,2431.21,148
CDM,96446OH,CHEMOTX ADMN PERTL CAVITY IMPLANTED PORT/CATH,163.0,105.95,1.1,988.7,146
CDM,96450OH,CHEMOTX ADMN CNS REQ SPINAL PUNCTURE,612.0,397.8,1.1,988.7,148
CDM,96521OH,"REFILL/MAINT, PORTABLE PUMP",92.0,59.8,1.1,624.44,144
CDM,96522OH,REFILL/MAINT SYSTEMIC PUMP/RESVR,92.0,59.8,1.1,624.44,144
CDM,96523OH,IRRIGAJ IMPLNTD VENOUS ACCESS DRUG DELIVERY SYST,18.0,11.7,1.1,177.54,144
CDM,96542OH,CHEMOTX NJX SUBARACHND/INTRAVENTR RSVR 1/MULT,300.0,195.0,1.1,988.7,148
CDM,96547OH,INTRAOPERATIVE HIPEC PX FIRST 60 MINUTES,2612.0,1697.8,1.1,2612.0,130
CDM,96548OH,INTRAOPERATIVE HIPEC PX EACH ADDL 30 MINUTES,1200.0,780.0,1.1,1649.73,130
CDM,96549RVU1OH,INTRA-OPRATIVE CHEMOTHERAPY INFUSION (COMP 96446),541.0,351.65,0.01,541.0,82
CDM,96549RVU2OH,INTRA-OPERATIVE CHEMOTHERAPY INFUSION (HIPEC) (COMP 96446),611.0,397.15,0.01,611.0,82
CDM,96549RVU4OH,UNLISTED HITEC - HYPERTHERMIC INTRATHORACIC CHEMOTHERAPY (COMP C,764.0,496.6,0.01,764.0,82
CDM,96567OH,PDT DSTR PRMLG LES SKN ILLUM/ACTIVJ PER DAY,441.0,286.65,1.1,584.65,142
CDM,96570OH,PDT NDSC ABL ABNOR TISS VIA ACTIVJ RX 30 MIN,440.0,286.0,1.1,440.0,142
CDM,96571OH,PDT NDSC ABL ABNOR TISS VIA ACTIVJ RX A 15 MIN,220.0,143.0,1.1,220.0,142
CDM,96573OH,PDT DSTR PRMLG LES SKN ILLUM/ACTIVJ BY PHYS/QHP,211.0,137.15,1.1,742.11,142
CDM,96574OH,DEBRIDEMENT PRMLG HYPERKERATOTIC LES W/PDT,444.0,288.6,1.1,911.3,142
CDM,96900OH,ACTINOTHERAPY ULTRAVIOLET LIGHT,92.0,59.8,1.1,116.32,144
CDM,96902OH,MCRSCP XM HAIR PLUCK/CLIP FOR CNTS/STRUCT ABNORM,164.0,106.6,1.1,164.0,102
CDM,96910OH,PHOTOCHEMOTX TAR&UVB/PETROLATUM/UVB,134.0,87.1,1.1,377.31,144
CDM,96912OH,PHOTOCHEMOTX PSORALENS&ULTRAVIOLET PUVA,167.0,108.55,1.1,321.61,144
CDM,96920OH,EXCIMER LASER TX PSORIASIS TOT AREA <250 SQ CM,332.0,215.8,1.1,584.65,148
CDM,96921OH,EXCIMER LASER TX PSORIASIS 250-500 SQ CM,360.0,234.0,1.1,584.65,148
CDM,96922OH,EXCIMER LASER TX PSORIASIS >500 SQ CM,460.0,299.0,1.1,1163.18,148
CDM,96999RVU1OH,VAGINAL LASER THERAPY,250.0,162.5,0.01,584.65,84
CDM,97010OH,APPLICATION MODALITY 1/> AREAS HOT/COLD PACKS,24.0,15.6,1.1,24.0,98
CDM,97012OH,APPL MODALITY 1/> AREAS TRACTION MECHANICAL,100.0,65.0,1.1,100.0,142
CDM,97014OH,APPL MODALITY 1/> AREAS ELEC STIMJ UNATTENDED,72.0,46.8,1.1,72.0,98
CDM,97016OH,APPL MODALITY 1/> AREAS VASOPNEUMATIC DEVICES,72.0,46.8,1.1,72.0,142
CDM,97018OH,APPL MODALITY 1/> AREAS PARAFFIN BATH,24.0,15.6,1.1,24.0,144
CDM,97022OH,APPLICATION MODALITY 1/> AREAS WHIRLPOOL,68.0,44.2,1.1,68.0,142
CDM,97026OH,APPLICATION MODALITY 1/> AREAS INFRARED,26.0,16.9,1.1,26.0,130
CDM,97032OH,APPL MODALITY 1/> AREAS ELEC STIMJ EA 15 MIN,100.0,65.0,1.1,100.0,142
CDM,97033OH,APPL MODALITY 1/> AREAS IONTOPHORESIS EA 15 MIN,104.0,67.6,1.1,104.0,130
CDM,97034OH,APPL MODALITY 1/> AREAS CONTRAST BATHS EA 15 MIN,84.0,54.6,1.1,84.0,142
CDM,97035OH,APPL MODALITY 1/> AREAS ULTRASOUND EA 15 MIN,84.0,54.6,1.1,84.0,142
CDM,97039OH,UNLIST MODALITY SPEC TYPE&TIME CONSTANT ATTEND,179.0,116.35,1.1,3061000.0,82
CDM,97110OH,"THERAPEUTIC EXERCISES RE, EA 15 MIN.",198.0,128.7,1.1,198.0,142
CDM,97112OH,THER PX 1/> AREAS EACH 15 MIN NEUROMUSC REEDUCA,220.0,143.0,1.1,220.0,142
CDM,97113OH,THER PX 1/> AREAS EACH 15 MIN AQUA THER W/XERSS,211.0,137.15,1.1,211.0,142
CDM,97116OH,THER PX 1/> AREAS EA 15 MIN GAIT TRAING W/STAIR,198.0,128.7,1.1,198.0,142
CDM,97124OH,THER PX 1/> AREAS EACH 15 MINUTES MASSAGE,140.0,91.0,1.1,140.0,142
CDM,97129OH,THER IVNTJ COG FUNCJ CNTCT 1ST 15 MINUTES,200.0,130.0,1.1,200.0,146
CDM,97130OH,THER IVNTJ COG FUNCJ CNTCT EA ADDL 15 MINUTES,192.0,124.8,1.1,192.0,142
CDM,97139OH,UNLISTED THERAPEUTIC PROCEDURE SPECIFY,130.0,84.5,1.1,3061000.0,82
CDM,97140OH,MANUAL THERAPY TQS 1/> REGIONS EACH 15 MINUTES,189.0,122.85,1.1,189.0,142
CDM,97150OH,THERAPEUTIC PROCEDURES GROUP 2/> INDIVIDUALS,116.0,75.4,1.1,116.0,142
CDM,97151OH,BEHAVIOR ID ASSESSMENT BY PHYS/QHP EA 15 MIN,119.0,77.35,1.1,294.38,94
CDM,97152OH,BEHAVIOR ID SUPPORT ASSMT BY 1 TECH EA 15 MIN,293.0,190.45,1.1,293.0,94
CDM,97153OH,ADAPTIVE BEHAVIOR TX BY PROTOCOL TECH EA 15 MIN,246.0,159.9,1.1,260.19,94
CDM,97154OH,GROUP ADAPTIVE BHV TX BY PROTOCOL TECH EA 15 MIN,181.0,117.65,1.1,181.0,94
CDM,97155OH,ADAPT BHV TX PRTCL MODIFICAJ PHYS/QHP EA 15 MIN,246.0,159.9,1.1,465.27,94
CDM,97156OH,FAMILY ADAPT BHV TX GDN PHYS/QHP EA 15 MIN,98.0,63.7,1.1,294.38,94
CDM,97157OH,MULTIPLE FAM GROUP BHV TX GDN PHYS/QHP EA 15 MIN,137.0,89.05,1.1,137.0,94
CDM,97158OH,GRP ADAPT BHV PRTCL MODIFCAJ PHYS/QHP EA 15 MIN,75.0,48.75,1.1,82.65,94
CDM,97161OH,PHYSICAL THERAPY EVALUATION LOW COMPLEX 20 MINS,616.0,400.4,1.1,616.0,142
CDM,97162OH,PHYSICAL THERAPY EVALUATION MOD COMPLEX 30 MINS,616.0,400.4,1.1,616.0,142
CDM,97163OH,PHYSICAL THERAPY EVALUATION HIGH COMPLEX 45 MINS,616.0,400.4,1.1,616.0,142
CDM,97164OH,PHYSICAL THERAPY RE-EVAL EST PLAN CARE 20 MINS,384.0,249.6,1.1,384.0,142
CDM,97165OH,OCCUPATIONAL THERAPY EVAL LOW COMPLEX 30 MINS,616.0,400.4,1.1,616.0,142
CDM,97166OH,OCCUPATIONAL THERAPY EVAL MOD COMPLEX 45 MINS,616.0,400.4,1.1,616.0,142
CDM,97167OH,OCCUPATIONAL THERAPY EVAL HIGH COMPLEX 60 MINS,616.0,400.4,1.1,616.0,142
CDM,97168OH,OCCUPATIONAL THER RE-EVAL EST PLAN CARE 30 MINS,384.0,249.6,1.1,384.0,142
CDM,97530OH,THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN,176.0,114.4,1.1,176.0,142
CDM,97533OH,SENSORY INTEGRATIVE TECHNIQUES EACH 15 MINUTES,192.0,124.8,1.1,207.99,142
CDM,97535OH,SELF-CARE/HOME MGMT TRAINING EACH 15 MINUTES,180.0,117.0,1.1,180.0,142
CDM,97537OH,COMMUNITY/WORK REINTEGRATION TRAING EA 15 MIN,192.0,124.8,1.1,192.0,142
CDM,97542OH,WHEELCHAIR MGMT EA 15 MIN,192.0,124.8,1.1,192.0,142
CDM,97545OH,WORK HARDENING/CONDITIONING 1ST 2 HR,319.0,207.35,1.1,336.71,88
CDM,97546OH,WORK HARDENING/CONDITIONING EACH HOUR,129.0,83.85,1.1,168.36,88
CDM,97550OH,CAREGIVER TRAINING STRATEGIES&TQ 1ST 30 MINUTES,440.0,286.0,1.1,440.0,146
CDM,97551OH,CAREGIVER TRAINING STRATEGIES&TQ EA ADDL 15 MIN,238.0,154.7,1.1,238.0,146
CDM,97552OH,GROUP CAREGIVER TRAINING STRATEGIES & TECHNIQUE,101.0,65.65,1.1,101.0,146
CDM,97597OH,DEBRIDEMENT OPEN WOUND 20 SQ CM/<,308.0,200.2,1.1,584.65,148
CDM,97598OH,DEBRIDEMENT OPEN WOUND EACH ADDITIONAL 20 SQ CM,220.0,143.0,1.1,220.0,148
CDM,97602OH,RMVL DEVITAL TISS N-SLCTV DBRDMT W/O ANES 1 SESS,144.0,93.6,1.1,584.65,90
CDM,97605OH,NEGATIVE PRESSURE WOUND THERAPY DME </= 50 SQ CM,242.0,157.3,1.1,584.65,146
CDM,97606OH,NEGATIVE PRESSURE WOUND THERAPY DME >50 SQ CM,264.0,171.6,1.1,1163.18,146
CDM,97607OH,NEG PRESSURE WOUND THERAPY NON DME </= 50 SQ CM,180.0,117.0,1.1,1175.79,146
CDM,97608OH,NEG PRESSURE WOUND THERAPY NON DME >50 SQ CM,202.0,131.3,1.1,1181.12,146
CDM,97610OH,LOW FREQUENCY NON-THERMAL ULTRASOUND PER DAY,160.0,104.0,1.1,1426.64,134
CDM,97750OH,PHYSICAL PERFORMANCE TEST/MEAS W/REPRT EA 15 MIN,180.0,117.0,1.1,180.0,142
CDM,97760OH,ORTHOTICS MGMT & TRAING INITIAL ENCTR EA 15 MINS,200.0,130.0,1.1,200.0,142
CDM,97761OH,PROSTHETICS TRAINING INITIAL ENCTR EA 15 MINS,200.0,130.0,1.1,200.0,142
CDM,97763OH,ORTHOTICS/PROSTH MGMT &/TRAINJ SBSQ ENCTR 15 MIN,192.0,124.8,1.1,192.0,142
CDM,97799AOH,MANUAL LYMPH DRAINAGE (MLD,75.0,48.75,0.01,3061000.0,84
CDM,97799GOLOH,GOLF EVAL W/VIDEO ANALYSIS (MASTERS PKG),323.0,209.95,0.01,3061000.0,84
CDM,97799RVUOH,MASSAGE THERAPY,90.0,58.5,0.01,3061000.0,84
CDM,97799THROH,THROW RIGHT INIT EVAL & VIDEO ANALYSIS,297.0,193.05,0.01,3061000.0,84
CDM,97802OH,MEDICAL NUTRITION ASSMT&IVNTJ INDIV EACH 15 MI,212.0,137.8,1.1,212.0,146
CDM,97803OH,MEDICAL NUTRITION RE-ASSMT&IVNTJ INDIV EA 15 M,180.0,117.0,1.1,180.0,146
CDM,97804OH,MEDICAL NUTRITION THERAPY GRP2/ INDIV EA 30 MI,100.0,65.0,1.1,100.0,146
CDM,97810OH,ACUPUNCTURE 1/> NDLES W/O ELEC STIMJ INIT 15 MIN,76.0,49.4,1.1,128.63,146
CDM,97811OH,ACUPUNCTURE 1/> NDLS W/O ESTIM EACH ADDL 15 MIN,76.0,49.4,1.1,97.67,146
CDM,97813OH,ACUPUNCTURE 1/> NDLS W/ELEC STIMJ 1ST 15 MIN,76.0,49.4,1.1,151.55,146
CDM,97814OH,ACUPUNCTURE 1/> NDLS W/ESTIM EACH ADDL 15 MIN,76.0,49.4,1.1,123.83,146
CDM,9800001OH,CONT. LENS POLISH/PAIR,17.5,11.38,0.01,85.71,84
CDM,9800002OH,POSTAGE AND HANDLING,14.0,9.1,0.01,85.71,84
CDM,9800004OH,POSTAGE & HANDLING/2ND DAY DEL.,20.0,13.0,0.01,85.71,84
CDM,9800005OH,POSTAGE & HANDLING/OVERNIGHT,25.0,16.25,0.01,85.71,84
CDM,9800006OH,RGP POST GRAFT/SINGLE LENS,225.0,146.25,1.1,484.28,90
CDM,9800007OH,RGP SPHERE/SINGLE LENS,100.0,65.0,1.1,484.28,90
CDM,9800008OH,RGP KERATOCONUS/SINGLE LENS,225.0,146.25,1.1,484.28,90
CDM,9800009OH,RGP TORIC/SINGLE LENS,165.0,107.25,1.1,717.78,90
CDM,9800010OH,RGP MULTIFOCAL/SINGLE LENS,225.0,146.25,1.1,826.21,90
CDM,9800011OH,DAILES ACP 90PK,100.0,65.0,1.1,482.55,90
CDM,9800012OH,CLEARSIGHT 1DAY 90PK,69.0,44.85,1.1,482.55,90
CDM,9800013OH,PROCLEAR MONTHLY,77.0,50.05,1.1,482.55,90
CDM,9800014OH,FRESHLOOK COLORS/CB,97.0,63.05,1.1,482.55,90
CDM,9800015OH,BIOFINITY XR,66.0,42.9,1.1,482.55,90
CDM,9800016OH,BIOTRUE ONE DAY 90 PK,93.0,60.45,1.1,482.55,90
CDM,9800017OH,BIOMEDICS 55,30.0,19.5,1.1,482.55,90
CDM,9800018OH,ACUVUE 2,57.0,37.05,1.1,482.55,90
CDM,9800019OH,BIOMEDICS 55 PREMIER,64.0,41.6,1.1,482.55,90
CDM,9800020OH,CLARITI 1 DAY 90PK,90.0,58.5,1.1,482.55,90
CDM,9800021OH,MY DAY 90 PK,120.0,78.0,1.1,482.55,90
CDM,9800022OH,1 DAY ACUVUE MOIST ASTIG 90 PK,147.0,95.55,1.1,955.6,90
CDM,9800023OH,CLARITI 1 DAY TORIC 30PK,59.0,38.35,1.1,955.6,90
CDM,9800024OH,HYDRASOFT TORIC/THIN SIN.,110.0,71.5,1.1,955.6,90
CDM,9800025OH,VERTEX TORIC,50.0,32.5,1.1,955.6,90
CDM,9800026OH,1- DAY AV MOIST ASTIG 720PK,600.0,390.0,1.1,955.6,90
CDM,9800027OH,VERTEX TORIC XR,90.0,58.5,1.1,955.6,90
CDM,9800028OH,HYDRASOFT TORIC/THIN3 PK,110.0,71.5,1.1,955.6,90
CDM,9800029OH,PROCLEAR TORIC,113.0,73.45,1.1,955.6,90
CDM,9800030OH,PROCLEAR TORIC XR 6PK.,200.0,130.0,1.1,955.6,90
CDM,9800031OH,PUREVISION TORIC,65.0,42.25,1.1,955.6,90
CDM,9800032OH,BIOMEDICS TORIC,75.0,48.75,1.1,955.6,90
CDM,9800033OH,AVAIRA TORIC,35.0,22.75,1.1,955.6,90
CDM,9800034OH,BIOFINITY TORIC,90.0,58.5,1.1,955.6,90
CDM,9800035OH,AIR OPTIX AQUA FOR ASTIG.,96.0,62.4,1.1,955.6,90
CDM,9800036OH,ACUVUE OASYS ASTIGMATISM,60.0,39.0,1.1,955.6,90
CDM,9800037OH,1 DAY ACUVUE MOIST ASTIG 30 PK,67.0,43.55,1.1,955.6,90
CDM,9800038OH,CLEARSIGHT 1DAY TORIC30PK,35.0,22.75,1.1,955.6,90
CDM,9800039OH,DAILIES ACP TORIC  90 PK,136.0,88.4,1.1,955.6,90
CDM,9800040OH,DAILIES ACP TORIC 30 PACK,53.0,34.45,1.1,955.6,90
CDM,9800041OH,BIOFINITY TORIC XR,167.0,108.55,1.1,955.6,90
CDM,9800042OH,PROCLEAR 1 DAY MF 30PK,35.0,22.75,1.1,699.32,90
CDM,9800043OH,PUREVISION 2 MULTIFOCAL,81.0,52.65,1.1,699.32,90
CDM,9800044OH,DAILIES ACP MULTIF 90PK,157.0,102.05,1.1,699.32,90
CDM,9800045OH,AIR OPTIX AQUA MULTIFOCAL,147.0,95.55,1.1,699.32,90
CDM,9800046OH,ACUVUE OASYS FOR PRESB.,60.0,39.0,1.1,699.32,90
CDM,9800047OH,SOFLENS MULTIFOCAL,116.0,75.4,1.1,699.32,90
CDM,9800048OH,PUREVISION MULTIFOCAL,65.0,42.25,1.1,699.32,90
CDM,9800049OH,DAILIES ACP MULTIF 30 PK,64.0,41.6,1.1,699.32,90
CDM,9800050OH,PROCLEAR MULTIFOCAL TORIC,240.0,156.0,1.1,699.32,90
CDM,9800051OH,BIOTRUE ONEDAY FOR PRESBYOPIA 30 PK,58.0,37.7,1.1,699.32,90
CDM,9800052OH,PROCLEAR MULTIFOCAL 6PK,130.0,84.5,1.1,699.32,90
CDM,9800053OH,CLARITI 1 DAY MF 30PK,60.0,39.0,1.1,699.32,90
CDM,9800054OH,PROCLEAR 1 DAY MF 90 PK,158.0,102.7,1.1,699.32,90
CDM,9800055OH,1 DAY ACVUE M.F. 30PK,75.0,48.75,1.1,699.32,90
CDM,9800056OH,1 DAY ACUVUE M.F. 90 PK,139.0,90.35,1.1,699.32,90
CDM,9800057OH,CVUE ADV.MULTIFOCAL 6PK,225.0,146.25,1.1,699.32,90
CDM,9800058OH,BIOFINITY MULTIFOCAL,122.0,79.3,1.1,699.32,90
CDM,9800059OH,DAILIES TOTAL 1  90 PK,154.0,100.1,1.1,734.23,90
CDM,9800060OH,ULTRA,73.0,47.45,1.1,734.23,90
CDM,9800061OH,1-DAY ACUVUE MOIST 30PK,54.0,35.1,1.1,734.23,90
CDM,9800062OH,DAILIES TOTAL 1  30 PK,59.0,38.35,1.1,734.23,90
CDM,9800063OH,AIR OPTIX AQUA N& DAY,137.0,89.05,1.1,734.23,90
CDM,9800064OH,AIR OPTIX COLORS,163.0,105.95,1.1,734.23,90
CDM,9800065OH,AIR OPTIX AQUA,50.0,32.5,1.1,734.23,90
CDM,9800066OH,PUREVISION 2,50.0,32.5,1.1,734.23,90
CDM,9800067OH,SILSOFT,225.0,146.25,1.1,734.23,90
CDM,9800068OH,PROCLEAR 1 DAY 90 PK,113.0,73.45,1.1,734.23,90
CDM,9800069OH,BIOFINITY,66.0,42.9,1.1,955.6,90
CDM,9800070OH,AVAIRA,30.0,19.5,1.1,734.23,90
CDM,9800071OH,1-DAY ACUVUE DEFINE 30 PK,59.0,38.35,1.1,734.23,90
CDM,9800072OH,1-DAY ACUVUE MOIST 720 PK,460.0,299.0,1.1,734.23,90
CDM,9800073OH,1-DAY ACUVUE TRUE EYE 720,610.0,396.5,1.1,734.23,90
CDM,9800074OH,1-DAY ACUVUE OASYS 90 PK,133.0,86.45,1.1,734.23,90
CDM,9800075OH,ACUVUE OASYS 24 PK,173.0,112.45,1.1,734.23,90
CDM,9800076OH,ACUVUE OASYS 12 PK,109.0,70.85,1.1,734.23,90
CDM,9800077OH,1-DAY ACUVUE TRUE E.90 PK,135.0,87.75,1.1,734.23,90
CDM,9800078OH,1-DAY ACUVUE MOIST 90 PK,100.0,65.0,1.1,734.23,90
CDM,9800079OH,FLEXLENS SPH.SILICONE 3PK,120.0,78.0,1.1,734.23,90
CDM,9800080OH,FLEXLENS SPH.CUSTOM 4PK,165.0,107.25,1.1,734.23,90
CDM,9800081OH,SYNERGEYES  U.H (SINGLE),350.0,227.5,1.1,2149.61,90
CDM,9800082OH,SYNERGEYES DUE. EXT. PAR,380.0,247.0,1.1,2149.61,90
CDM,9800083OH,SYNERGEYES DUE. PROG. SINGLE,200.0,130.0,1.1,2149.61,90
CDM,9800084OH,SYNERGEYES DUETTE M.F SINGLE,180.0,117.0,1.1,2149.61,90
CDM,9800085OH,SYNERGEYES DUETTE/SINGLE,165.0,107.25,1.1,2149.61,90
CDM,9800086OH,SYNERGEYES A (SINGLE),300.0,195.0,1.1,2149.61,90
CDM,9800087OH,SYNERGEYES A/ANNUAL,450.0,292.5,1.1,2149.61,90
CDM,9800088OH,"SCLERAL LENS,WRNTD/SINGLE LENS",550.0,357.5,1.1,2149.61,90
CDM,9800089OH,SYNERGEYES U.H/ANNUAL,600.0,390.0,1.1,2149.61,90
CDM,9800090OH,SYNERGEYES CLEARCONE SINGLE,450.0,292.5,1.1,2149.61,90
CDM,9800091OH,CUSTOM COLOR,400.0,260.0,0.01,400.0,80
CDM,9800094OH,ACUVUE OASYS 54 PK,218.0,141.7,1.1,734.23,90
CDM,9800095OH,ACUVUE OAYSS FOR ASTIG (ANNUAL 6 PK X4),140.0,91.0,1.1,955.6,90
CDM,9800096OH,CLARITI 1 DAY MF 90PK,134.0,87.1,1.1,699.32,90
CDM,9800097OH,ULTRA FOR PRESBYOPIA,124.0,80.6,1.1,734.23,90
CDM,9800098OH,STANDARD CL EVAL,55.0,35.75,1.1,331.49,114
CDM,9800099OH,APHAKIA REFIT,135.0,87.75,1.1,400.76,146
CDM,98000OH,SYNCHRONOUS AUDIO-VIDEO VISIT NEW SF MDM 15 MIN,372.0,241.8,1.1,372.0,110
CDM,9800100OH,COMPRE. C/L EXAM GAS PERMEABLE,75.0,48.75,1.1,331.49,114
CDM,9800101OH,COMPREHENSIVE C/L EXAM DAILY WEAR,150.0,97.5,1.1,331.49,114
CDM,9800102OH,MULTIFOCAL/SPECIALTY TORIC CONTACT LENS EXAM,205.0,133.25,1.1,331.49,114
CDM,9800103OH,CONACT LENS FIT APHAKIA OU,636.0,413.4,1.1,636.0,146
CDM,9800104OH,"CONTACT LENS FIT APHAKIA, ONE EYE",394.0,256.1,1.1,1163.18,146
CDM,9800105OH,"CONTACT LENS FIT,KERACONUS ONE EYE",379.0,246.35,1.1,379.0,114
CDM,9800106OH,"CONTACT LENS FIT,KERACONUS OU",631.0,410.15,1.1,631.0,114
CDM,9800108OH,CONTACT LENS FOLLOW-UP/CHECK-UP,35.0,22.75,1.1,331.49,114
CDM,9800109OH,DIAGNOSTIC CONTACT LENS FITTING,55.0,35.75,1.1,331.49,114
CDM,9800110OH,KERATOCONUS FIT INITIAL BOTH EYES,788.0,512.2,1.1,788.0,146
CDM,9800111OH,KERATOCONUS FIT INITIAL ONE EYE,788.0,512.2,1.1,788.0,146
CDM,9800112OH,"KERATOCONUS FIT, ANNUAL EXAM NO CHANGE",55.0,35.75,1.1,331.49,114
CDM,9800113OH,"KERATOCONUS, BASIC REFIT",100.0,65.0,1.1,331.49,114
CDM,9800114OH,"KERATOCONUS,MODERATE REFIT>2 F/U VISIT",234.0,152.1,1.1,331.49,114
CDM,9800115OH,"SCLERAL LENS FITTING, BOTH EYES",631.0,410.15,1.1,631.0,146
CDM,9800116OH,"SCLERAL LENS FITTING, ONE EYE",379.0,246.35,1.1,379.0,146
CDM,9800127OH,ONLINE BASIC REVIEW,20.0,13.0,1.1,20.0,68
CDM,9800128OH,ONLINE SIMPLE REVIEW,55.0,35.75,1.1,55.0,68
CDM,9800129OH,ONLINE BASIC TRTMNT PLAN,55.0,35.75,1.1,55.0,68
CDM,9800130OH,ONLINE MODERATE REVIEW,75.0,48.75,1.1,75.0,68
CDM,9800131OH,ONLINE MODERATE PLAN,100.0,65.0,1.1,100.0,68
CDM,9800132OH,ONLINE SIMPLE TRTMNT PLAN,150.0,97.5,1.1,150.0,68
CDM,9800133OH,ONLINE INTERMEDIATE RVW,150.0,97.5,1.1,150.0,68
CDM,9800134OH,ONLINE EXTENSIVE REVIEW,200.0,130.0,1.1,200.0,68
CDM,9800135OH,ONLINE INTERMED TRTMNT PL,250.0,162.5,1.1,250.0,68
CDM,9800136OH,ONLINE COMPLEX REVIEW,300.0,195.0,1.1,300.0,68
CDM,9800137OH,ONLINE EXT TRTMNT PLAN,300.0,195.0,1.1,300.0,68
CDM,9800138OH,ONLINE CMPLX TRTMNT PLAN,200.0,130.0,1.1,200.0,68
CDM,9800139OH,VIRTUAL VISIT 25 MINS,200.0,130.0,1.1,200.0,68
CDM,9800140OH,VIRTUAL VISIT 45 MINS,400.0,260.0,1.1,400.0,68
CDM,9800141OH,VIRTUAL VISIT 60 MINS,550.0,357.5,1.1,550.0,68
CDM,9800143OH,ECC SECOND OPINION ADMIN2,254.0,165.1,1.1,254.0,68
CDM,9800144OH,ECC ADOPTION EVAL ADMIN,209.0,135.85,0.01,2013999.98,80
CDM,9800145OH,ECC WEIGHT MGMT ADMIN,88.0,57.2,0.01,2013999.98,80
CDM,9800146OH,ECC DIABETES/RELATED ADM,88.0,57.2,0.01,2013999.98,80
CDM,9800147OH,ECC CHOLESTEROL/BP MG ADM,88.0,57.2,0.01,2013999.98,80
CDM,9800148OH,ECC SECONDARY PREVENT ADM,88.0,57.2,0.01,2013999.98,80
CDM,9800149OH,ECC NUTRIT SUPP/OTHER ADM,43.0,27.95,0.01,2013999.98,80
CDM,9800150OH,ECC HEALTHY LIFESTYLE ADM,43.0,27.95,0.01,2013999.98,80
CDM,9800151OH,ECC PATHOLOGY ADMIN2,81.0,52.65,1.1,81.0,68
CDM,9800152OH,ECC PRE-ADOPTION 1 ADMIN,254.0,165.1,1.1,254.0,68
CDM,9800153OH,ECC ADOPTION REC RVW ADM,128.0,83.2,1.1,128.0,68
CDM,9800154OH,ECC ADOPT-BLIND REFER/URG,254.0,165.1,1.1,254.0,68
CDM,9800155OH,ECC ADOPT-GEN INFO ADMIN,128.0,83.2,1.1,128.0,68
CDM,9800156OH,ECC ADOPT-ADDTL CHILD ADM,56.0,36.4,1.1,56.0,68
CDM,9800157OH,ECC PLSTC SURG COSM ADMIN,60.0,39.0,1.1,60.0,68
CDM,9800158OH,ECC PLSTC SURG COSM CNSLT,75.0,48.75,0.01,2013999.98,80
CDM,9800159OH,ECC GASTRO DISORDER ADMIN,88.0,57.2,0.01,2013999.98,80
CDM,9800160OH,ECC HEALTHY EATING ADMIN,88.0,57.2,0.01,2013999.98,80
CDM,9800161OH,ECC SPORT NUTRITION ADMIN,88.0,57.2,0.01,2013999.98,80
CDM,9800162OH,ECC VEG DIETS ADMIN,88.0,57.2,0.01,2013999.98,80
CDM,9800163OH,ECC MYCONSULT EMBSY ADMIN,173.0,112.45,1.1,173.0,68
CDM,9800164OH,ECC MYCONSULT REC DOM ADM,245.0,159.25,1.1,245.0,68
CDM,9800165OH,ECC MYCONSULT REC INT ADM,325.0,211.25,1.1,325.0,68
CDM,9800166OH,EVISIT,35.0,22.75,1.1,35.0,68
CDM,9800167OH,ASYNCH EVISIT EXPRESS / ACUTE,20.0,13.0,1.1,20.0,68
CDM,98001OH,SYNCHRONOUS?AUDIO-VIDEO?VISIT NEW?LOW MDM 30 MIN,640.0,416.0,1.1,640.0,110
CDM,9800230OH,BONE DENSITY,822.0,534.3,1.1,822.0,142
CDM,9800236OH,CALCIUM SCORE,740.0,481.0,0.01,740.0,94
CDM,9800256OH,CONTACT LENS EVALUATION,30.0,19.5,1.1,331.49,114
CDM,9800257OH,CONTACT LENS FITTING,90.0,58.5,1.1,331.49,114
CDM,9800258OH,CONTACT LENS REFIT,50.0,32.5,1.1,331.49,114
CDM,9800259OH,REFRACTION,35.0,22.75,1.1,65.13,116
CDM,9800267OH,"NUTRITION THERAPY, INITIAL 15 MIN",212.0,137.8,1.1,212.0,146
CDM,9800268OH,"NUTRITION THERAPY, REASSES EA 15 MIN",180.0,117.0,1.1,180.0,146
CDM,9800269OH,NUTRITION GROUP THERAPY,100.0,65.0,1.1,100.0,146
CDM,9800273OH,ECC NUTRITION (EXT CORP) ADMIN,101.0,65.65,0.01,2013999.98,80
CDM,9800274OH,ECC NUTRITION (CONSUMER) ADMIN,110.0,71.5,0.01,2013999.98,80
CDM,9800275OH,ECC ADOPTION - POST ADOPTION CONSULT ADMIN,254.0,165.1,1.1,254.0,68
CDM,9800276OH,ECC NUTRITION (INT CORP)  ADMIN,88.0,57.2,0.01,2013999.98,80
CDM,9800277OH,ECC NUTRITION (EXT CORP) CLINICAL,124.0,80.6,0.01,2013999.98,80
CDM,9800278OH,ECC NUTRITION (CONSUMER) CLINICAL,135.0,87.75,0.01,2013999.98,80
CDM,9800279OH,ECC ADOPTION - POST ADOPTION CONSULT CLINICAL,311.0,202.15,1.1,311.0,68
CDM,9800280OH,ECC NUTRITION (INT CORP) CLINICAL,107.0,69.55,0.01,2013999.98,80
CDM,9800281OH,ECC SECOND OPINION LEVEL 2 CLINICAL,311.0,202.15,1.1,311.0,68
CDM,9800282OH,ECC PRE-ADOPTION CONSULT-1CHILD CLINICAL,311.0,202.15,1.1,311.0,68
CDM,9800283OH,ECC ADOPTION - RECORD REVIEW CLINICAL,157.0,102.05,1.1,157.0,68
CDM,9800284OH,ECC ADOPTION- BLIND REFERRAL/URGENT REQUEST CLINICAL,311.0,202.15,1.1,311.0,68
CDM,9800285OH,ECC ADOPTION - GENERAL INFORMATION CLINICAL,157.0,102.05,1.1,157.0,68
CDM,9800286OH,ECC ADOPTION - ADDITIONAL CHILD CLINICAL,69.0,44.85,1.1,69.0,68
CDM,9800287OH,ECC PLASTIC SURG COSMETIC- CONSULT CLINICAL,75.0,48.75,1.1,75.0,68
CDM,9800290OH,ECC EMBASSY CONSULT CLINICAL,212.0,137.8,1.1,212.0,68
CDM,9800291OH,ECC SECOND OPINION PATH 2 CLINICAL,99.0,64.35,1.1,99.0,68
CDM,9800292OH,ECC MYCONSULT PATHOLOGY REVIEW CLINICAL,165.0,107.25,1.1,165.0,68
CDM,9800295OH,NEW PATIENT OFFICE VISIT SELF PAY,3000.0,1950.0,0.01,2013999.98,80
CDM,9800298OH,ECC MYCONSULT PATHOLOGY REVIEW ADMIN,135.0,87.75,1.1,135.0,68
CDM,98002OH,SYNCHRONOUS?AUDIO-VIDEO?VISIT NEW?MOD MDM 45 MIN,1040.0,676.0,1.1,1040.0,110
CDM,9800301OH,RENEW GROUP COACHING - MAIN CAMPUS,1020.0,663.0,0.01,2013999.98,80
CDM,9800302OH,RENEW GROUP COACHING - CHAGRIN FALLS,900.0,585.0,0.01,2013999.98,80
CDM,9800303OH,VIDEO HEAD IMPULSE TEST (COMP CODE 92541),172.0,111.8,0.01,172.0,84
CDM,9800306OH,DYNAMIC VISUAL ACUITY TEST,132.0,85.8,0.01,132.0,84
CDM,9800310OH,SHARED NUTRITION NUTRIGENOMICS APPT,50.0,32.5,1.1,50.0,68
CDM,9800311OH,GASTRIC LAP BAND ADJUSTMENT (COMP CODE 36598),56.0,36.4,0.01,2644.7,84
CDM,9800312OH,MODF CLINICAL TEST SENS INTERACTION ON BALANCE,165.0,107.25,0.01,165.0,84
CDM,9800314OH,SMARTPHONE MONITORING 30 DAY,50.0,32.5,0.01,456.09,84
CDM,9800315OH,SMARTPHONE MONITORING CHRONIC,20.0,13.0,0.01,456.09,84
CDM,9800331OH,FISTULA,60.0,39.0,0.01,85.71,84
CDM,9800332OH,VEMP,286.0,185.9,0.01,286.0,84
CDM,9800333OH,NECK NYSTAGMUS,132.0,85.8,0.01,132.0,84
CDM,9800334OH,ECC MYCONSULT RADIOLOGY CLINICAL,165.0,107.25,1.1,165.0,68
CDM,9800335OH,ECC MYCONSULT RADIOLOGY ADMIN,135.0,87.75,1.1,135.0,68
CDM,9800336OH,"DISPENSING FEE, BAHA",500.0,325.0,0.01,500.0,84
CDM,9800339OH,SELF PAY ROUTINE EYE EXAM,150.0,97.5,0.01,3061000.0,80
CDM,9800340OH,HERBAL THERAPY ESTABLISHED,75.0,48.75,0.01,3061000.0,84
CDM,9800341OH,HERBAL THERAPY NEW,150.0,97.5,0.01,3061000.0,84
CDM,9800342OH,REIKI THERAPY,60.0,39.0,0.01,3061000.0,84
CDM,9800343OH,MIND BODY COACHING,50.0,32.5,0.01,2013999.98,80
CDM,9800345OH,EMPLOYEE REIKI,60.0,39.0,0.01,3061000.0,84
CDM,9800346OH,SHARED ACUPUNCTURE MEDICAL APPT,50.0,32.5,0.01,3061000.0,84
CDM,9800347OH,ASSR,283.0,183.95,0.01,283.0,84
CDM,9800349OH,ESD ESOPHAGUS,5300.0,3445.0,0.01,5300.0,84
CDM,9800350OH,ESD STOMACH,5300.0,3445.0,0.01,5300.0,84
CDM,9800351OH,ESD SMALL INTESTINE,5300.0,3445.0,0.01,5300.0,84
CDM,9800352OH,ESD COLON,5300.0,3445.0,0.01,5300.0,84
CDM,9800353OH,ESD RECTUM,5300.0,3445.0,0.01,5300.0,84
CDM,9800354OH,BAI CONSULT,75.0,48.75,0.01,85.71,84
CDM,9800355OH,OSSEINTEGRATED HRG DEVICE EVAL,100.0,65.0,0.01,100.0,84
CDM,9800356OH,EGD-PANCREATIC NECROSECTOMY,4900.0,3185.0,0.01,4900.0,84
CDM,9800357OH,EGD/EUS GASTROJAJUNOSTOMY LAMS (COMP 43266 AND 43237),5000.0,3250.0,0.01,5000.0,84
CDM,9800358OH,ENDOSCOPIC PYLOROMYOTOMY,4700.0,3055.0,0.01,4700.0,84
CDM,98003OH,SYNCHRONOUS?AUDIO-VIDEO?VST NEW?HIGH MDM 60 MIN,1400.0,910.0,1.1,1400.0,98
CDM,9800406OH,NUTRITIONIST PHONE VISIT 30 MIN,100.0,65.0,1.1,100.0,68
CDM,9800407OH,READ VHIT & MCTSIB,297.0,193.05,0.01,297.0,84
CDM,9800408OH,"READ VHIT,DVAT,MCTSIB",429.0,278.85,0.01,429.0,84
CDM,9800409OH,READ VHIT & DVAT,264.0,171.6,0.01,264.0,84
CDM,9800410OH,"READ VEMP,VHIT,MCTSIB",583.0,378.95,0.01,583.0,84
CDM,9800411OH,"READ VEMP,VHIT,DVAT,MCTSIB",715.0,464.75,0.01,715.0,84
CDM,9800412OH,READ VEMP & VHIT,418.0,271.7,0.01,418.0,84
CDM,9800413OH,READ VEMP & MCTSIB,451.0,293.15,0.01,451.0,84
CDM,9800414OH,FLEXIBLE LARYNGOSCOPY W/ APPLICATION OF MITOMYCIN C PROCEDURE,828.0,538.2,0.01,1580.23,84
CDM,9800415OH,ECC MYCONSULT TRIAGE SECOND OPINION CLINICAL,311.0,202.15,1.1,311.0,68
CDM,9800416OH,ECC MYCONSULT TRIAGE SECOND OPINION ADMIN,254.0,165.1,1.1,254.0,68
CDM,9800417OH,ECC MYCONSULT VIGILINT CONSULT CLINICAL,1000.0,650.0,1.1,1000.0,68
CDM,9800418OH,ECC MYCONSULT VIDEO FOLLOW UP CLINICAL,83.0,53.95,1.1,83.0,68
CDM,9800419OH,ECC MYCONSULT VIDEO FOLLOW UP ADMIN,68.0,44.2,1.1,68.0,68
CDM,9800420OH,VIRTUAL VISIT SAMSUNG,59.0,38.35,1.1,59.0,68
CDM,9800421OH,TINNITUS MANAGEMENT CLINIC,300.0,195.0,0.01,300.0,84
CDM,9800423OH,READ VEMP,286.0,185.9,0.01,286.0,84
CDM,9800424OH,CULINARY CONSULT 60 MIN,200.0,130.0,1.1,200.0,68
CDM,9800425OH,ONLINE SAMSUNG URG CARE,59.0,38.35,1.1,59.0,68
CDM,9800427OH,WELLNESS SELF PAY VISIT,1500.0,975.0,1.1,1500.0,68
CDM,9800429OH,WIRELESS ACCESSORY SETUP,125.0,81.25,0.01,125.0,84
CDM,9800441OH,MRI-TRUS FUSION-GUIDED PROSTRATE BIOPSY,1347.0,875.55,0.01,1347.0,94
CDM,9800442OH,"VIRTUAL INITIAL HOSPITAL CARE, E&M (30 MIN)",652.0,423.8,1.1,652.0,146
CDM,9800443OH,VIRTUAL 1ST HOSPITAL IP/OBS CARE MODERATE MDM 55 MINUTES,1040.0,676.0,1.1,1040.0,146
CDM,9800444OH,1ST HOSPITAL IP/OBS CARE HIGH MDM 75 MINUTES,1400.0,910.0,1.1,1400.0,146
CDM,9800445OH,VIRTUAL  SBSQ HOSPITAL IP/OBS CARE SF/LOW MDM 25 MINUTES,400.0,260.0,1.1,400.0,148
CDM,9800446OH,VIRTUAL SBSQ HOSPITAL IP/OBS CARE MOD MDM 35 MINUTES,636.0,413.4,1.1,636.0,148
CDM,9800447OH,VIRTUAL SBSQ HOSPITAL IP/OBS CARE HIGH MDM 50 MINUTES,960.0,624.0,1.1,960.0,148
CDM,9800449OH,IP/OBS CONSLTJ NEW/EST PT SF MDM 35 MINUTES,600.0,390.0,1.1,600.0,116
CDM,9800450OH,VIRTUAL INPATIENT CONSULTATION SERVICES (45 MIN),880.0,572.0,1.1,880.0,116
CDM,9800451OH,IP/OBS CONSLTJ NEW/EST PT MOD MDM 60 MINUTES,1197.0,778.05,1.1,1197.0,116
CDM,9800452OH,IP/OBS CONSLTJ NEW/EST PT HIGH MDM 80 MINUTES,1698.0,1103.7,1.1,1698.0,116
CDM,9800459OH,VIRTUAL VISIT PSYCH DIAGNOSTIC EVAL,1536.0,998.4,1.1,1536.0,154
CDM,9800460OH,VIRTUAL VISIT PSYTX PT&/FAMILY 30 MINS,744.0,483.6,1.1,744.0,156
CDM,9800461OH,VIRTUAL VISIT PSYTX PT&/FAMILY 45 MINS,980.0,637.0,1.1,980.0,156
CDM,9800462OH,VIRTUAL VISIT PSYTX PT&/FAMILY 60 MINS,1452.0,943.8,1.1,1452.0,156
CDM,9800463OH,VIRTUAL VISIT FAMILY PSYTX W/PATIENT,1096.0,712.4,1.1,1096.0,156
CDM,9800464OH,VIRTUAL VISIT GROUP PSYCHOTHERAPY,260.0,169.0,1.1,260.19,156
CDM,9800476OH,OD EST ONLINE E&M LEVEL 1,79.0,51.35,1.1,85.46,152
CDM,9800477OH,OD EST ONLINE E&M LEVEL 2,280.0,182.0,1.1,280.0,152
CDM,9800478OH,OD EST ONLINE E&M LEVEL 3,520.0,338.0,1.1,520.0,152
CDM,9800479OH,OD EST ONLINE E&M LEVEL 4,768.0,499.2,1.1,768.0,152
CDM,9800480OH,OD EST ONLINE E&M LEVEL 5,1120.0,728.0,1.1,1120.0,152
CDM,9800482OH,OD NEW ONLINE E&M LEVEL 2,372.0,241.8,1.1,372.0,152
CDM,9800483OH,OD NEW ONLINE E&M LEVEL 3,640.0,416.0,1.1,640.0,152
CDM,9800484OH,OD NEW ONLINE E&M LEVEL 4,1040.0,676.0,1.1,1040.0,152
CDM,9800485OH,OD NEW ONLINE E&M LEVEL 5,1400.0,910.0,1.1,1400.0,152
CDM,9800489OH,"VIRTUAL VISIT MNT, INITIAL, EA. 15 MIN INCREMENT 97802",212.0,137.8,1.1,212.0,146
CDM,9800490OH,"SCLEROTHERAPY/VARICOSE VEINS, SINGLE VEIN",225.0,146.25,1.1,1163.18,148
CDM,9800491OH,"SCHLEROTHERAPY/VARICOSE VEINS, MULTIPLE VEINS",500.0,325.0,1.1,1163.18,148
CDM,9800492OH,SCLEROTHERAPY/SPIDER VEINS-SINGLE OR MULTIPLE INJECTIONS,350.0,227.5,1.1,1163.18,84
CDM,9800495OH,LAYER CLOSURE OF EAR LOBES,415.0,269.75,1.1,1163.18,148
CDM,9800496OH,LASER RESURFACING/PARTIAL FACE,650.0,422.5,1.1,2050.87,136
CDM,9800497OH,LASER RESURFACING/OTHER THAN FACE,600.0,390.0,1.1,8286.13,134
CDM,9800498OH,LASER CVP LESIONS,300.0,195.0,1.1,1163.18,148
CDM,98004OH,SYNCHRONOUS?AUDIO-VIDEO?VISIT EST?SF MDM 10 MIN,280.0,182.0,1.1,280.0,110
CDM,9800501OH,"EAR PIERCING, BOTH EARS W/EARRINGS",50.0,32.5,1.1,176.73,88
CDM,9800502OH,TATTOO REMOVAL,300.0,195.0,1.1,1489.46,134
CDM,9800503OH,MICRODERMABRASION,300.0,195.0,1.1,1489.46,134
CDM,9800504OH,LASER RESURFACING/SUPERFICIAL,500.0,325.0,1.1,1489.46,134
CDM,9800505OH,"SCAR REVISION, ABRASIVE TECHNIQUE, SINGLE",225.0,146.25,1.1,762.11,146
CDM,9800508OH,READ SPONTANEOUS GAZE TEST,692.0,449.8,1.1,692.0,144
CDM,9800508OH-26,READ SPONTANEOUS GAZE TEST,176.0,114.4,1.1,176.0,126
CDM,9800509OH,READ POSITIONAL (STATIC-DYNAMIC),727.0,472.55,1.1,727.0,144
CDM,9800509OH-26,READ POSITIONAL (STATIC-DYNAMIC),211.0,137.15,1.1,211.0,126
CDM,9800511OH,INTESTINE SURG PROCEDURE UNLISTED,5300.0,3445.0,0.01,16829.38,96
CDM,9800512OH,IMAGING OF CORONARY VESSEL OR GRAFT USING IVUS,594.0,386.1,0.01,594.0,84
CDM,9800513OH,RENUVA 1.5 CC,817.0,531.05,1.1,1830.48,146
CDM,9800514OH,RENUVA 3.0 CC,1619.0,1052.35,1.1,1830.48,146
CDM,9800515OH,VIRTUAL VISIT DIAGNOSTIC EVAL (PSYCHOLOGISTS/THERAPISTS),1536.0,998.4,1.1,1536.0,154
CDM,9800516OH,RENUVA 5.0 CC,2752.0,1788.8,1.1,2752.0,146
CDM,9800525OH,VIRTUAL VISIT DIAGNOSTIC EVAL W/MEDICAL  (PSYCHIATRISTS/MID LEVE,1664.0,1081.6,1.1,1664.0,152
CDM,9800526OH,ULTRA MF FOR ASTIGMATISM,185.0,120.25,1.1,699.32,90
CDM,9800527OH,POSTAGE AND HANDLING E-DOCTOR,10.0,6.5,0.01,85.71,84
CDM,9800528OH,PREP F/U 30 MIN (SELF PAY),60.0,39.0,0.01,3061000.0,84
CDM,9800529OH,PREP F/U 35 MIN (SELF PAY),35.0,22.75,0.01,3061000.0,84
CDM,9800530OH,PREP F/U 45 MIN (SELF PAY),80.0,52.0,0.01,3061000.0,84
CDM,9800531OH,PREP F/U 60 MIN (SELF PAY),100.0,65.0,0.01,3061000.0,84
CDM,9800532OH,ACUVUE VITA 6 PK,89.0,57.85,1.1,734.23,90
CDM,9800533OH,ACUVUE VITA 12 PK,142.0,92.3,1.1,734.23,90
CDM,9800534OH,ACUVUE VITA  ASTIG. 6 PK,89.0,57.85,1.1,955.6,90
CDM,9800535OH,VIRTUAL VISIT INDIVIDUAL PSYCHOTHERAPY 30 (16-37* MIN),744.0,483.6,1.1,744.0,156
CDM,9800536OH,CLARITI 1 DAY 30 PK,43.0,27.95,1.1,734.23,90
CDM,9800537OH,CLARITI 1 DAY TORIC 90 PK,128.0,83.2,1.1,955.6,90
CDM,9800538OH,PROCLEAR MF XR 6PK,205.0,133.25,1.1,699.32,90
CDM,9800540OH,MY DAY TORIC 90 PK,163.0,105.95,1.1,955.6,90
CDM,9800541OH,DAILIES ACP 30 PK,40.0,26.0,1.1,734.23,90
CDM,9800542OH,DAILIES COLORS 30 PK,51.0,33.15,1.1,482.55,90
CDM,9800543OH,DAILIES COLORS 90 PK,115.0,74.75,1.1,482.55,90
CDM,9800544OH,PRECISION 1 30 PK,48.0,31.2,1.1,734.23,90
CDM,9800545OH,VIRTUAL VISIT INDIVIDUAL PSYCHOTHERAPY  45 (38-52* MIN),980.0,637.0,1.1,980.0,156
CDM,9800546OH,PUREVISION 2 HD 6 PK,67.0,43.55,1.1,734.23,90
CDM,9800547OH,PUREVISION 2 FOR ASTIG. 6 PK,67.0,43.55,1.1,955.6,90
CDM,9800548OH,SOFTLENS DAILY 90 PK,100.0,65.0,1.1,482.55,90
CDM,9800549OH,SOFLENS DAILY FOR ASTIG. 30 PK,35.0,22.75,1.1,482.55,90
CDM,9800550OH,SOFTLENS - 6 PK,76.0,49.4,1.1,955.6,90
CDM,9800551OH,INFUSE 90 PK,137.0,89.05,1.1,734.23,90
CDM,9800554OH,PRECISION 1 90 PK,103.0,66.95,1.1,734.23,90
CDM,9800555OH,VIRTUAL VISIT  INDIVIDUAL PSYCHOTHERAPY 60 (53+ *MIN),1452.0,943.8,1.1,1452.0,156
CDM,9800556OH,BIOFINITY TORIC MF 6 PK,177.0,115.05,1.1,699.32,90
CDM,9800565OH,VIRTUAL VISIT E/M + PSYCHOTHERAPY ADD-ON (30 MIN),656.0,426.4,1.1,656.0,152
CDM,9800575OH,VIRTUAL VISIT E/M + PSYCHOTHERAPY ADD-ON (45 MIN),832.0,540.8,1.1,832.0,152
CDM,9800585OH,VIRTUAL VISIT E/M + PSYCHOTHERAPY ADD-ON (60 MIN),1096.0,712.4,1.1,1096.0,152
CDM,9800595OH,VIRTUAL VISIT FAMILY PSYCHOTHERAPY W/O PATIENT,1052.0,683.8,1.1,1052.0,154
CDM,98005OH,SYNCHRONOUS?AUDIO-VIDEO?VISIT EST?LOW MDM 20 MIN,520.0,338.0,1.1,520.0,110
CDM,9800605OH,VIRTUAL VISIT FAMILY PSYCHOTHERAPY WITH PATIENT,1096.0,712.4,1.1,1096.0,156
CDM,9800615OH,COSMETIC EDUCATIONAL VIRTUAL VISIT,200.0,130.0,0.01,200.0,84
CDM,9800625OH,NUTRITIONIST VIRTUAL PHONE NEW ($240.00),240.0,156.0,1.1,240.0,68
CDM,9800635OH,JOINT VENTURE DIGITAL SECOND OPINION,500.0,325.0,1.1,500.0,68
CDM,9800675OH,"VIRTUAL VISIT MNT, RE ASSES, EA. 15 MIN INCREMENT 97803",180.0,117.0,1.1,180.0,146
CDM,9800676OH,TELEPHONE ASSMT&MGMT SVC NQHP EST PT 5-10 MIN,100.0,65.0,1.1,100.0,134
CDM,9800677OH,TELEPHONE ASSMT&MGMT SVC NQHP EST PT 11-20 MIN,200.0,130.0,1.1,200.0,134
CDM,9800678OH,TELEPHONE ASSMT&MGMT SVC NQHP EST PT 21-30 MIN,300.0,195.0,1.1,300.0,134
CDM,9800683OH,VV OFFICE/OP CONSLTJ NEW/EST PT SF MDM 20 MINUTES,475.0,308.75,1.1,475.0,120
CDM,9800684OH,VV OFFICE/OP CONSLTJ NEW/EST PT LOW MDM 30 MINUTES,720.0,468.0,1.1,720.0,120
CDM,9800685OH,VV OFFICE/OP CONSLTJ NEW/EST PT MOD MDM 40 MINUTES,1076.0,699.4,1.1,1076.0,120
CDM,9800686OH,VV OFFICE/OP CONSLTJ NEW/EST PT HIGH MDM 55 MINUTES,1500.0,975.0,1.1,1500.0,120
CDM,9800687OH,E VISIT ONLINE DIGITAL E/M SVC EST PT <7 D 5-10 MINUTES,65.0,42.25,1.1,65.0,144
CDM,9800688OH,E VISIT ONLINE DIGITAL E/M SVC EST PT <7 D 11-20 MINUTES,80.0,52.0,1.1,80.0,144
CDM,9800689OH,E VISIT ONLINE DIGITAL E/M SVC EST PT <7 D 21+ MINUTES,120.0,78.0,1.1,120.0,144
CDM,9800699,VIRTUAL VISIT GROUP THERAPY,278.0,180.7,33.67,278.0,86
CDM,98006OH,SYNCHRONOUS?AUDIO-VIDEO?VISIT EST?MOD MDM 30 MIN,768.0,499.2,1.1,768.0,110
CDM,9800702OH,"VV MNT GROUP, EA. 30 MIN",100.0,65.0,1.1,100.0,146
CDM,9800715OH,THERAPEUTIC YOGA,75.0,48.75,0.01,3061000.0,84
CDM,9800737OH,PULMONARY STRESS TEST (6-MINUTE WALK) INTERP ONLY,192.0,124.8,1.1,373.44,144
CDM,9800737OH-26,PULMONARY STRESS TEST (6-MINUTE WALK) INTERP ONLY,192.0,124.8,1.1,192.0,126
CDM,9800744OH,TMC GROUP VIRTUAL VISIT,200.0,130.0,0.01,200.0,84
CDM,9800745OH,TMC INDIVIDUAL SCREENINGS,100.0,65.0,0.01,100.0,84
CDM,9800746OH,1 DAY ACUVUE OASYS ASTIG 30 PK,70.0,45.5,1.1,955.6,90
CDM,9800748OH,VIRTUAL MGMT DIABETES SNGL 30 MIN,77.0,50.05,1.1,93.26,98
CDM,9800749OH,"VIRTUAL MGMT DIABETES GRP 30 MIN, 2-4 PT",77.0,50.05,1.1,77.0,98
CDM,9800750OH,"VIRTUAL MGMT DIABETES GRP 30 MIN, 5-8 PT",33.0,21.45,1.1,33.28,98
CDM,9800766OH,SKIN EVALUATION,35.0,22.75,0.01,584.65,84
CDM,9800775OH,PROSTHETIC CONTACT LENS,515.0,334.75,1.1,3722.11,90
CDM,9800776OH,JV MULTIDISCIPLINARY BOARD REVIEW,700.0,455.0,1.1,700.0,68
CDM,9800777OH,MISIGHT CONTACT LENS,475.0,308.75,1.1,699.32,90
CDM,9800779OH,ALDEN HP TORIC - SINGLE PACK,140.0,91.0,1.1,955.6,90
CDM,9800780OH,ALDEN HP TORIC - 3 PACK,140.0,91.0,1.1,955.6,90
CDM,9800781OH,ALDEN HP SPHERE - SINGLE PACK,76.0,49.4,1.1,482.55,90
CDM,9800782OH,ALDEN HP SPHERE - 3 PACK,76.0,49.4,1.1,482.55,90
CDM,9800783OH,"PHENOL CHEMICAL PEEL, EACH ADDL AREA",1900.0,1235.0,1.1,1900.0,134
CDM,9800784OH,"PHENOL CHEMICAL PEEL, FULL FACE",3600.0,2340.0,1.1,3600.0,134
CDM,9800789OH,BIOCOLORS PROSTHETIC,730.0,474.5,1.1,730.0,90
CDM,9800790OH,BIOCOLORS SPHERE,250.0,162.5,1.1,482.55,90
CDM,9800791OH,BIOCOLORS TORIC,310.0,201.5,1.1,955.6,90
CDM,9800792OH,COLOR MATCHING SERVICE,1000.0,650.0,0.01,1000.0,80
CDM,9800793OH,"INTELLIWAVE  (SINGLE, WRNTD.)",100.0,65.0,1.1,482.55,90
CDM,9800794OH,"INTELLIWAVE  (3-PK, ONLY NON-WRNTD.)",138.0,89.7,1.1,482.55,90
CDM,9800795OH,"INTELLIWAVE  TORIC (SINGLE, WRNTD.)",160.0,104.0,1.1,955.6,90
CDM,9800796OH,"INTELLIWAVE TORIC  (3-PK, ONLY NON-WRNTD.)",192.0,124.8,1.1,955.6,90
CDM,9800797OH,"INTELLIWAVE MULTI (SINGLE, WRNTD.)",210.0,136.5,1.1,699.32,90
CDM,9800798OH,"INTELLIWAVE  MULTI (3-PK, ONLY NON-WRNTD.)",240.0,156.0,1.1,699.32,90
CDM,9800799OH,"INTELLIWAVE  MF TORIC (SINGLE, WRNTD.)",230.0,149.5,1.1,699.32,90
CDM,98007OH,SYNCHRONOUS AUDIO-VIDEO VST EST HIGH MDM 40 MIN,1040.0,676.0,1.1,1040.0,98
CDM,9800800OH,"INTELLIWAVE  MF TORIC (3-PK, ONLY NON WTD)",300.0,195.0,1.1,699.32,90
CDM,9800801OH,SYNERGEYES ID/SINGLE,180.0,117.0,1.1,2149.61,90
CDM,9800802OH,SYNERGEYES ID/ANNUAL,310.0,201.5,1.1,2149.61,90
CDM,9800803OH,SYNERGEYES ID MULTIFOCAL EDOF*/SINGLE,225.0,146.25,1.1,2149.61,90
CDM,9800804OH,SYNERGEYES ID MULTIFOCAL EDOF*/ANNUAL,350.0,227.5,1.1,2149.61,90
CDM,9800810OH,1-DAY ACUVUE OASYS ASTIG 90 PK,167.0,108.55,1.1,955.6,90
CDM,9800811OH,ACUVUE OASYS MULTIFOCAL,65.0,42.25,1.1,699.32,90
CDM,9800816OH,LASIK SCREENING - EHP,150.0,97.5,0.01,150.0,84
CDM,9800819OH,COCHLEAR IMPLANT REMOTE CHECK,75.0,48.75,0.01,85.71,84
CDM,9800820OH,BAI CHECK,100.0,65.0,0.01,100.0,84
CDM,9800821OH,BAI EVAL,100.0,65.0,0.01,100.0,84
CDM,9800822OH,BAI FITTING,500.0,325.0,0.01,500.0,84
CDM,9800823OH,VIRTUAL PSYTX CRISIS INITIAL 60 MIN,1509.0,980.85,1.1,1509.0,154
CDM,9800824OH,VIRTUAL PSYTX CRISIS EA ADDL 30 MIN,722.0,469.3,1.1,722.0,154
CDM,9800833OH,TAI CHI,75.0,48.75,0.01,3061000.0,84
CDM,9800837OH,DAILIES TOTAL 1 FOR ASTIG 30 PK,57.0,37.05,1.1,955.6,90
CDM,9800838OH,DAILIES TOTAL 1 FOR ASTIG 90 PK,139.0,90.35,1.1,955.6,90
CDM,9800839OH,MI SIGHT 1-DAY 180 PK,329.0,213.85,1.1,734.23,90
CDM,9800840OH,MY DAY MULTI 90 PK,125.0,81.25,1.1,699.32,90
CDM,9800843OH,TOTAL 30 6 PK,73.0,47.45,1.1,734.23,90
CDM,9800844OH,MYCHART MEDICAL ADVICE MESSAGING: ONLINE DIGITAL E/M SVC EAT PT,65.0,42.25,1.1,65.0,144
CDM,9800845OH,MYCHART MEDICAL ADVICE MESSAGING: ONLINE DIGITAL E/M SVC EAT PT,80.0,52.0,1.1,80.0,144
CDM,9800846OH,MYCHART MEDICAL ADVICE MESSAGING: ONLINE DIGITAL E/M SVC EAT PT,120.0,78.0,1.1,120.0,144
CDM,9800871OH,MY CHART MEDICAL ADVICE MESSAGING: QNHP ONLINE DIGITAL E/M SVC E,65.0,42.25,1.1,65.0,130
CDM,9800881OH,MY CHART MEDICAL ADVICE MESSAGING: QNHP ONLINE DIGITAL E/M SVC E,80.0,52.0,1.1,80.0,134
CDM,9800891OH,MY CHART MEDICAL ADVICE MESSAGING: QNHP ONLINE DIGITAL E/M SVC E,120.0,78.0,1.1,120.0,134
CDM,98008OH,SYNCHRONOUS AUDIO-ONLY VISIT NEW SF MDM 15 MIN,360.0,234.0,1.1,360.0,110
CDM,9800911OH,VV?PROLONGED INPATIENT/OBSERVATION EM SVC EA 15 MIN,356.0,231.4,1.1,356.0,104
CDM,9800912OH,VIRTUAL IP/OBS DISCHARGE =/<30 MIN,600.0,390.0,1.1,600.0,148
CDM,9800913OH,VIRTUAL IP/OBS DISCHARGE DAY > 30 MIN,860.0,559.0,1.1,860.0,148
CDM,9800917OH,VIRTUAL PROLONGED OUTPATIENT E/M SERVICE EACH 15 MINUTES,268.0,174.2,1.1,268.0,108
CDM,9800919OH,NON EHP EAT WELL GROUP,100.0,65.0,1.1,100.0,146
CDM,9800929OH,WELLNESS YOGA,60.0,39.0,0.01,3061000.0,84
CDM,9800939OH,WELLNESS YOGA EHP,30.0,19.5,0.01,3061000.0,84
CDM,9800941OH,VV THERAPEUTIC EXERCISE PT (97110),198.0,128.7,1.1,198.0,142
CDM,9800942OH,VV NEUROMUSCULAR EDUCATION PT (97112),220.0,143.0,1.1,220.0,142
CDM,9800943OH,VV GAIT TRAINING THERAPY PT (97116),198.0,128.7,1.1,198.0,142
CDM,9800944OH,VV EVALUATION LOW COMPLEXITY PT (97161),616.0,400.4,1.1,616.0,142
CDM,9800945OH,VV EVALUATION MODERATE COMPLEXITY PT (97162),616.0,400.4,1.1,616.0,142
CDM,9800946OH,VV EVALUATION HIGH COMPLEXITY PT (97163),616.0,400.4,1.1,616.0,142
CDM,9800947OH,VV THERAPEUTIC ACTIVITIES PT (97530),176.0,114.4,1.1,176.0,142
CDM,9800948OH,VV SELF-CARE HOME MANAGEMENT PT (97535),180.0,117.0,1.1,180.0,142
CDM,9800949OH,VV THERAPEUTIC EXERCISE OT (97110),198.0,128.7,1.1,198.0,142
CDM,9800950OH,VV NEUROMUSCULAR EDUCATION OT (97112),220.0,143.0,1.1,220.0,142
CDM,9800951OH,VV EVALUATION LOW COMPLEXITY OT (97161),616.0,400.4,1.1,616.0,142
CDM,9800952OH,VV EVALUATION MODERATE COMPLEXITY OT (97162),616.0,400.4,1.1,616.0,142
CDM,9800953OH,VV EVALUATION HIGH COMPLEXITY OT (97163),616.0,400.4,1.1,616.0,142
CDM,9800954OH,VV SELF-CARE HOME MANAGEMENT OT (97535),180.0,117.0,1.1,180.0,142
CDM,9800955OH,VV SPEECH THERAPY (92507),520.0,338.0,1.1,520.0,142
CDM,9800956OH,VV FLUENCY EVALUATION (92521),896.0,582.4,1.1,896.0,142
CDM,9800957OH,VV SOUND PRODUCTION EVALUATION (92522),768.0,499.2,1.1,768.0,142
CDM,9800958OH,VV SPEECH SOUND LANGUAGE COMPREHENSIVE EVALUATION (92523),1536.0,998.4,1.1,1536.0,142
CDM,9800959OH,VV VOICE EVALUATION (92524),768.0,499.2,1.1,768.0,142
CDM,9800960OH,IMMIGRATION PHYSICAL,175.0,113.75,0.01,3061000.0,80
CDM,9800961OH,VIRTUAL ADVANCE CARE PLANNING FIRST 30 MIN,600.0,390.0,1.1,600.0,146
CDM,9800962OH,VIRTUAL ADVANCE CARE PLANNING EA ADDL 30 MIN,385.0,250.25,1.1,385.0,146
CDM,9800965OH,VV THERAPEUTIC ACTIVITY OT (97530),176.0,114.4,1.1,176.0,142
CDM,9800978OH,US GUIDANCE AND SCLEROTHERAPY,500.0,325.0,1.1,1163.18,84
CDM,9800980OH,JYNNEOS VACCINE (MPOX) 0.5 ML,785.7,510.71,1.1,809.68,78
CDM,9800981OH,VV HEALTH BEHAVIOR ASSESSMENT/RE-ASSESSMENT,920.0,598.0,1.1,920.0,140
CDM,9800982OH,VV HEALTH BEHAVIOR IVNTJ INDIV F2F 1ST 30 MIN,636.0,413.4,1.1,636.0,140
CDM,9800983OH,VV HEALTH BEHAVIOR IVNTJ INDIV F2F EA ADDL 15 MIN,220.0,143.0,1.1,220.0,140
CDM,9800984OH,VV PT-FOCUSED HLTH RISK ASSMT SCORE DOC STND INSTRM,46.0,29.9,1.1,55.06,142
CDM,9800985OH,VV CAREGIVER HLTH RISK ASSMT SCORE DOC STND INSTRM,89.0,57.85,1.1,89.0,142
CDM,9800986OH,VV HEALTH BEHAVIOR IVNTJ GROUP F2F 1ST 30 MIN,92.0,59.8,1.1,92.0,140
CDM,9800987OH,VV HEALTH BEHAVIOR IVNTJ GROUP F2F EA ADDL 15 MIN,44.0,28.6,1.1,309.0,140
CDM,9800988OH,VV HEALTH BEHAVIOR IVNTJ FAM W/PT F2F 1ST 30 MIN,680.0,442.0,1.1,680.0,140
CDM,9800989OH,VV HEALTH BEHAVIOR IVNTJ FAM W/PT F2F EA ADD 15 MIN,240.0,156.0,1.1,240.0,140
CDM,9800990OH,VV HEALTH BEHAVIOR IVNTJ FAM W/O PT F2F 1ST 30 MIN,600.0,390.0,1.1,600.0,104
CDM,9800991OH,VV HEALTH BEHAVIOR IVNTJ FAM W/O PT F2F EA ADDL 15,216.0,140.4,1.1,216.0,104
CDM,9800992OH,VV HOSPITAL IP/OBS CARE SAME DATE SF/LOW MDM 45 MIN (99234),800.0,520.0,1.1,800.0,148
CDM,9800993OH,VV HOSPITAL IP/OBS CARE SAME DATE MOD MDM 70 MIN (99235),1296.0,842.4,1.1,1296.0,148
CDM,9800994OH,VV HOSPITAL IP/OBS CARE SAME DATE HIGH MDM 85 MIN (99236),1720.0,1118.0,1.1,1720.0,148
CDM,9800995OH,1 DAY ACUVUE MOIST  MF 30 PK,89.0,57.85,1.1,699.32,90
CDM,9800996OH,1 DAY ACUVUE MOIST MF 90 PK,165.0,107.25,1.1,699.32,90
CDM,9800997OH,BIOTRUE ONE DAY 30PK,38.0,24.7,1.1,734.23,90
CDM,9800998OH,INFUSE FOR ASTIG 90PK,165.0,107.25,1.1,955.6,90
CDM,9800999OH,INFUSE MF 90PK,187.0,121.55,1.1,699.32,90
CDM,98009OH,SYNCHRONOUS AUDIO-ONLY VISIT NEW LOW MDM 30 MIN,620.0,403.0,1.1,620.0,110
CDM,9801000OH,ACUVUE OASYS 1-DAY MAX 30 PK,70.0,45.5,1.1,734.23,90
CDM,9801001OH,ACUVUE OASYS 1-DAY MAX 90 PK,151.0,98.15,1.1,482.55,90
CDM,9801002OH,ACUVUE OASYS 1-DAY MAX  MULTIFOCAL 30 PK,87.0,56.55,1.1,699.32,90
CDM,9801003OH,ACUVUE OASYS 1-DAY MAX  MULTIFOCAL 90 PK,195.0,126.75,1.1,699.32,90
CDM,9801004OH,DAILIES TOTAL 1 30PK,53.0,34.45,1.1,734.23,90
CDM,9801005OH,DAILIES TOTAL 1 FOR ASTIG 30 PK,71.0,46.15,1.1,955.6,90
CDM,9801006OH,DAILIES TOTAL 1 FOR ASTIG 90 PK,184.0,119.6,1.1,955.6,90
CDM,9801007OH,MISIGHT 1 DAY 90 PK,165.0,107.25,1.1,482.55,90
CDM,9801008OH,MY DAY MF 90 PK,182.0,118.3,1.1,699.32,90
CDM,9801009OH,PRECISION 1 ONE DAY ASTIG 30 PK,60.0,39.0,1.1,955.6,90
CDM,9801010OH,PRECISION 1 ONE DAY ASTIG 90 PK,130.0,84.5,1.1,955.6,90
CDM,9801011OH,PROCLEAR SPHERE,91.0,59.15,1.1,734.23,90
CDM,9801012OH,PROCLEAR 1 DAY MF,137.0,89.05,1.1,699.32,90
CDM,9801013OH,TOTAL 30  SPHERE 6 PK,76.0,49.4,1.1,734.23,90
CDM,9801014OH,TOTAL 30 TORIC 6 PK,92.0,59.8,1.1,955.6,90
CDM,9801015OH,TOTAL 30 MF 6 PK,129.0,83.85,1.1,699.32,90
CDM,9801017OH,UNRETURNED ACTIGRAPHY DEVICE,500.0,325.0,0.01,3061000.0,80
CDM,9801018OH,ONDEMAND SYNCHRONOUS?AUDIO-VIDEO?VISIT NEW?SF MDM 15 MIN,372.0,241.8,1.1,372.0,110
CDM,9801019OH,ONDEMAND SYNCHRONOUS?AUDIO-VIDEO?VISIT NEW?LOW MDM 30 MIN,640.0,416.0,1.1,640.0,110
CDM,9801020OH,ONDEMAND SYNCHRONOUS?AUDIO-VIDEO?VISIT NEW?MOD MDM 45 MIN,1040.0,676.0,1.1,1040.0,110
CDM,9801021OH,ONDEMAND SYNCHRONOUS?AUDIO-VIDEO?VST NEW?HIGH MDM 60 MIN,1400.0,910.0,1.1,1400.0,98
CDM,9801022OH,ONDEMAND SYNCHRONOUS?AUDIO-VIDEO?VISIT EST?SF MDM 10 MIN,280.0,182.0,1.1,280.0,110
CDM,9801023OH,ONDEMAND SYNCHRONOUS?AUDIO-VIDEO?VISIT EST?LOW MDM 20 MIN,520.0,338.0,1.1,520.0,110
CDM,9801024OH,ONDEMAND SYNCHRONOUS?AUDIO-VIDEO?VISIT EST?MOD MDM 30 MIN,768.0,499.2,1.1,768.0,110
CDM,9801025OH,ONDEMAND SYNCHRONOUS?AUDIO-VIDEO?VISIT EST?HIGH MDM 40 MIN,1120.0,728.0,1.1,1120.0,98
CDM,9801027OH,JELMYTO INSTILLATION VIA NEPHROSTOGRAM/URETEROGRAM,1160.0,754.0,1.1,2124.29,148
CDM,9801028OH,"JELMYTO INSTILLATION , ANTEGRADE VIA EXISTING ACCESS",440.0,286.0,1.1,1992.71,148
CDM,9801029OH,JELMYTO INSTILLATION W/O NEPHROSTOGRAM/URETEROGRAM,784.0,509.6,1.1,784.0,148
CDM,9801030OH,"JELMYTO INSTILLATION, RETROGRADE VIA CYSTOURETHROSCOPY",1043.0,677.95,1.1,5941.4,148
CDM,9801031OH,ACUVUE BANDAGE PLANO 6PK,48.0,31.2,1.1,734.23,90
CDM,9801032OH,PRECISION 7 12 PK,61.0,39.65,1.1,734.23,90
CDM,9801033OH,PRECISION 7 27 PK,101.0,65.65,1.1,734.23,90
CDM,9801034OH,PRECISION 7 FOR ASTIG 27PK,126.0,81.9,1.1,955.6,90
CDM,9801035OH,MISIGHT 1 DAY 180 X 2 (6 MONTH),555.0,360.75,1.1,555.0,90
CDM,9801042OH,ACUVUE OASYS 1-DAY MAX ASTIG 30 PK,59.0,38.35,1.1,955.6,90
CDM,9801043OH,ACUVUE OASYS 1-DAY MAX ASTIG MULTIFOCAL 30PK,70.0,45.5,1.1,955.6,90
CDM,9801044OH,PRECISION 7 FOR ASTIG 12PK,76.0,49.4,1.1,955.6,90
CDM,9801045OH,"SCLERAL, SPECIALTY, 1 LENS",700.0,455.0,1.1,2149.61,90
CDM,9801047OH,AUDIOGRAM,28.0,18.2,1.1,28.0,70
CDM,9801051OH,DOT PHYSICAL EXAM,110.0,71.5,1.1,110.0,70
CDM,9801052OH,EKG W/INTERPRETATION,70.0,45.5,1.1,70.0,70
CDM,9801057OH,LIFT TEST/PHYSICAL ABILITY,45.0,29.25,1.1,45.0,70
CDM,9801059OH,PRE-PLACEMENT EXAM,65.0,42.25,1.1,65.0,70
CDM,9801060OH,PHYSICAL EXAM,65.0,42.25,1.1,65.0,70
CDM,9801061OH,PULMONARY FUNCTION TEST,60.0,39.0,1.1,60.0,70
CDM,9801062OH,RESPIRATOR FIT TEST,35.0,22.75,1.1,35.0,70
CDM,9801063OH,OSHA RESPIRATOR QUESTIONNAIRE REVIEW,35.0,22.75,1.1,35.0,70
CDM,9801064OH,RESPIRATOR MEDICAL EVALUATION,35.0,22.75,1.1,35.0,70
CDM,9801065OH,RETURN TO WORK EXAM,65.0,42.25,1.1,65.0,70
CDM,9801068OH,TB SKIN TEST,30.0,19.5,1.1,30.0,70
CDM,9801069OH,TITMUS VISION,45.0,29.25,1.1,45.0,70
CDM,9801070OH,URINE COLLECTION ONLY,25.0,16.25,1.1,25.0,70
CDM,9801073OH,"X-RAY, CHEST, 2 VIEWS",105.0,68.25,1.1,105.0,70
CDM,9801074OH,RAPID URINE DRUG SCREEN 10-PANEL - MEDTOX,65.0,42.25,1.1,65.0,70
CDM,9801075OH,RAPID URINE DRUG SCREEN 5-PANEL - MEDTOX,65.0,42.25,1.1,65.0,70
CDM,9801077OH,URINE DRUG SCREEN 10-PANEL - MEDTOX,50.0,32.5,1.1,50.0,70
CDM,9801083OH,URINE DRUG SCREEN 12-PANEL - MEDTOX,95.0,61.75,1.1,95.0,70
CDM,9801084OH,URINE DRUG SCREEN 4-PANEL (NO THC) - MEDTOX,50.0,32.5,1.1,50.0,70
CDM,9801085OH,URINE DRUG SCREEN 5-PANEL - MEDTOX,50.0,32.5,1.1,50.0,70
CDM,9801087OH,URINE DRUG SCREEN 9-PANEL (NO THC) - MEDTOX,50.0,32.5,1.1,50.0,70
CDM,9801088OH,URINE DRUG SCREEN DOT - MEDTOX,50.0,32.5,1.1,50.0,70
CDM,9801090OH,URINE DRUG SCREEN CRL WS66 - CRL,95.0,61.75,1.1,95.0,70
CDM,9801092OH,HAIR DRUG SCREEN 5-PANEL - OMEGA,105.0,68.25,1.1,105.0,70
CDM,9801099OH,BREATH ALCOHOL TEST - CCAW / WW,30.0,19.5,1.1,30.0,70
CDM,98010OH,SYNCHRONOUS AUDIO-ONLY VISIT NEW MOD MDM 45 MIN,968.0,629.2,1.1,968.0,110
CDM,9801191OH,PRP WITH EXOMES,1250.0,812.5,1.1,1250.0,86
CDM,98011OH,SYNCHRONOUS AUDIO-ONLY VISIT NEW HIGH MDM 60 MIN,1280.0,832.0,1.1,1280.0,98
CDM,9801201OH,TB SKIN TESTING (2-STEP) (RETURN TO CLINIC FOR READING WITHIN 48,60.0,39.0,1.1,60.0,70
CDM,9801204OH,CLARITI 1 DAY 180 PK,152.0,98.8,1.1,734.23,90
CDM,9801205OH,CLARITI 1 DAY MF 3 ADD 30 PK,69.0,44.85,1.1,699.32,90
CDM,9801206OH,CLARITI 1 DAY MF 3 ADD 90 PK,150.0,97.5,1.1,699.32,90
CDM,9801207OH,MY DAY ENERGYS 90 PK,140.0,91.0,1.1,734.23,90
CDM,9801209OH,TOTAL 30 MF TORIC 6 PK,163.0,105.95,1.1,699.32,90
CDM,9801210OH-25,FRESNEL PRISM PRESS-ON LENS,60.0,39.0,1.1,122.86,90
CDM,9801210OH-26,FRESNEL PRISM PRESS-ON LENS,60.0,39.0,1.1,60.0,68
CDM,98012OH,SYNCHRONOUS AUDIO-ONLY VISIT EST SF MDM 10 MIN,260.0,169.0,1.1,260.0,110
CDM,98013OH,SYNCHRONOUS AUDIO-ONLY VISIT EST LOW MDM 20 MIN,480.0,312.0,1.1,480.0,110
CDM,98014OH,SYNCHRONOUS AUDIO-ONLY VISIT EST MOD MDM 30 MIN,700.0,455.0,1.1,700.0,110
CDM,98015OH,SYNCHRONOUS AUDIO-ONLY VISIT EST HIGH MDM 40 MIN,1040.0,676.0,1.1,1040.0,98
CDM,98016OH,BRIEF COMMUNICATION TECH-BSD SVC EST PT 5-10 MIN,132.0,85.8,1.1,132.0,144
CDM,98200005,BPCI ADVANCED IN HOME VISIT,189.0,122.85,41.2,189.0,60
CDM,98925OH,"OSTEOPATHIC MANIP,1-2 BODY REGN",202.0,131.3,1.1,202.0,148
CDM,98926OH,"OSTEOPATHIC MANIP,3-4 BODY REGN",312.0,202.8,1.1,312.0,148
CDM,98927OH,"OSTEOPATHIC MANIP,5-6 BODY REGN",422.0,274.3,1.1,422.0,148
CDM,98928OH,"OSTEOPATHIC MANIP,7-8 BODY REGN",532.0,345.8,1.1,532.0,148
CDM,98929OH,"OSTEOPATHIC MANIP,9-10 BODY REGN",642.0,417.3,1.1,642.0,148
CDM,98940OH,"CHIROPRAC MANIP,SPINAL,1-2 REGIONS",202.0,131.3,1.1,202.0,148
CDM,98941OH,"CHIROPRAC MANIP,SPINAL,3-4 REGIONS",312.0,202.8,1.1,312.0,148
CDM,98942OH,"CHIROPRAC MANIP,SPINAL,5 REGIONS",422.0,274.3,1.1,422.0,148
CDM,98943OH,"CHIROPRAC MANIP,EXTRASPINAL,1+ REGNS",184.0,119.6,1.1,184.0,102
CDM,98960OH,EDUCATION&TRAINING PT SELF-MGMT NQHP INDIV PT,77.0,50.05,1.1,93.26,98
CDM,98961OH,EDUCATION&TRAINING PT SELF-MGMT NQHP 2-4 PTS,77.0,50.05,1.1,77.0,98
CDM,98962OH,EDUCATION&TRAINING PT SELF-MGMT NQHP 5-8 PTS,33.0,21.45,1.1,33.28,98
CDM,98970OH,NQHP OL DIGITAL ASSMT&MGMT EST PT <7 D 5-10 MIN,65.0,42.25,1.1,65.0,130
CDM,98971OH,NQHP OL DIGITAL ASSMT&MGMT EST PT <7 D 11-20 MIN,80.0,52.0,1.1,80.0,134
CDM,98972OH,NQHP OL DIGITAL ASSMT&MGMT EST PT <7 D 21+ MIN,120.0,78.0,1.1,120.0,134
CDM,98978OH,REM THER MNTR DEV SPLY DATA COG BHV THER EA 30 D,258.0,167.7,1.1,258.0,88
CDM,98979OH,RTM TX MGMT 1 R-T IA COMUNICAJ CAL MO 1ST 10 MIN,263.0,170.95,1.1,263.0,106
CDM,98980OH,REMOTE THER MNTR TX MGMT PHYS/QHP 1ST 20 MIN,248.0,161.2,1.1,248.0,146
CDM,98981OH,REMOTE THER MNTR TX MGMT PHYS/QHP EA ADDL 20 MIN,244.0,158.6,1.1,244.0,146
CDM,98985OH,RTM DEV SPLY DATA MUSCSKEL SYS 2-15 D IN 30D PD,59.0,38.35,1.1,131.17,106
CDM,98986OH,RTM DEV SPLY DATA CBT 2-15 DAYS IN 30 D PD,258.0,167.7,1.1,258.0,70
CDM,9899202COH,COSMETIC CONSULTATION,100.0,65.0,1.1,100.0,70
CDM,9899499OH,DOT PHYSICAL,75.0,48.75,0.01,2013999.98,80
CDM,99000155,CONT. LENS POLISH/PAIR,17.5,11.38,4.87,56.32,84
CDM,99000165,POSTAGE AND HANDLING,14.0,9.1,3.89,56.32,84
CDM,99000195,POSTAGE & HANDLING/2ND DAY DEL.,20.0,13.0,5.56,56.32,84
CDM,99000205,POSTAGE & HANDLING/OVERNIGHT,25.0,16.25,6.95,56.32,84
CDM,99000215,POSTAGE AND HANDLING E-DOCTOR,10.0,6.5,2.78,56.32,84
CDM,99000OH,HANDLG&/OR CONVEY OF SPEC FOR TR OFFICE TO LAB,41.0,26.65,1.1,41.0,88
CDM,99001OH,HANDLG&/OR CONVEY OF SPEC FOR TR FROM PT TO LAB,52.0,33.8,1.1,52.0,88
CDM,99002OH,HANDLE/CONVEY/ANY OTH SVC DEVICE FIT PHYS/QHP,60.0,39.0,1.1,60.0,88
CDM,99050OH,SERVICES PROVIDED OFFICE OTH/THN REG SCHED HOURS,143.0,92.95,1.1,143.0,102
CDM,99053OH,"MEDICAL SERVICES 10PM-8AM, 24 HR FAC",110.0,71.5,0.01,110.0,88
CDM,99058OH,SVC PRV EMER BASIS IN OFFICE DISRUPTING SVCS,211.0,137.15,0.01,211.0,88
CDM,99060OH,OUT OF OFFICE EMERG MEDICAL SERVICES,116.0,75.4,0.01,3060831.65,88
CDM,99070COH,ADHESIVE - PROSTHETIC AIDE,17.0,11.05,0.01,73.46,82
CDM,99078OH,PHYS/QHP EDUCATION SVCS RENDERED PTS GRP SETTING,79.0,51.35,1.1,79.0,94
CDM,99080AOH,M3P FINAL REPORT,75.0,48.75,1.1,75.0,82
CDM,99080OH,SPEC REPORTS > USUAL MED COMUNICAJ/STAND RPRTG,119.0,77.35,1.1,119.0,82
CDM,99091OH,COLLJ & INTERPJ PHYSIOL DATA MIN 30 MIN EA 30 D,484.0,314.6,1.1,484.0,132
CDM,99100015,THERAPEUTIC PHLEBOTOMY,889.0,577.85,35.72,889.0,86
CDM,99100OH,ANESTHESIA EXTREME AGE PATIENT UNDER 1 YR/<,136.0,88.4,1.1,138.2,84
CDM,99116OH,ANES COMPLICJ UTILIZATION TOTAL BODY HYPOTHERMIA,133.0,86.45,0.01,133.0,84
CDM,99135OH,ANES COMPLICJ UTILIZATION CONTROLLED HYPOTENSION,136.0,88.4,1.1,691.04,84
CDM,99140OH,ANES COMPLICJ EMERGENCY CONDITIONS SPECIFY,137.0,89.05,1.1,276.42,84
CDM,99151OH,MOD SED SAME PHYS/QHP INITIAL 15 MINS <5 YRS,220.0,143.0,1.1,293.51,148
CDM,99152AOH,MODERATE SEDATION FOR ENDOSCOPY,110.0,71.5,1.1,163.46,148
CDM,99152OH,MOD SED SAME PHYS/QHP INITIAL 15 MINS 5/> YRS,110.0,71.5,1.1,163.46,148
CDM,99153OH,MOD SED SAME PHYS/QHP EACH ADDL 15 MINS,110.0,71.5,1.1,114.75,144
CDM,99155OH,MOD SED OTHER PHYS/QHP INITIAL 15 MINS <5 YRS,760.0,494.0,1.1,1040.28,144
CDM,99156OH,MOD SED OTHER PHYS/QHP INITIAL 15 MINS 5/> YRS,660.0,429.0,1.1,916.19,144
CDM,99157OH,MOD SED OTHER PHYS/QHP EACH ADDL 15 MINS,500.0,325.0,1.1,740.43,144
CDM,99173OH,SCREENING TEST VISUAL ACUITY QUANTITATIVE BILAT,52.0,33.8,1.1,52.0,110
CDM,99177OH,INSTRUMENT BASED OCULAR SCR BI W/ONSITE ANALYSIS,156.0,101.4,1.1,156.0,110
CDM,99183OH,PHYS/QHP ATTN&SUPVJ HYPRBARIC OXYGEN TX/SESSION,844.0,548.6,1.1,844.0,144
CDM,99184OH,INITIAT SELECTIVE HEAD/BODY HYPOTHERMIA NEONATE,1800.0,1170.0,1.1,1800.0,142
CDM,99188OH,APPLICATION TOPICAL FLUORIDE VARNISH BY PHS/QHP,80.0,52.0,1.1,80.0,116
CDM,99195OH,PHLEBOTOMY THERAPEUTIC SEPARATE PROCEDURE,368.0,239.2,1.1,373.44,144
CDM,99199AOH,UNRETURNED HOLTER MONITOR,2032.8,1321.32,0.01,3061000.0,80
CDM,99199BOH,PSYCHEDELIC DOSING SESSION PER HOUR (PI TIME),583.0,378.95,0.01,3061000.0,80
CDM,99199RVU11OH,EXEC HEALTH EXAM PREMIER ESTABLISHED PT,1250.0,812.5,0.01,3061000.0,80
CDM,99199RVU13OH,EXEC HEALTH EXAM INS,939.0,610.35,0.01,3061000.0,80
CDM,99199RVUOH,SMOKING INTERMEDIATE COUNSEL 3-10 MIN,55.0,35.75,0.01,3061000.0,80
CDM,99202OH,OFFICE/OUTPATIENT NEW SF MDM 15 MINUTES,372.0,241.8,1.1,372.0,152
CDM,99203OH,OFFICE/OUTPATIENT NEW LOW MDM 30 MINUTES,640.0,416.0,1.1,640.0,152
CDM,99204OH,OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES,1040.0,676.0,1.1,1040.0,152
CDM,99205OH,OFFICE/OUTPATIENT NEW HIGH MDM 60 MINUTES,1400.0,910.0,1.1,1400.0,152
CDM,99211OH,OFFICE/OUTPATIENT EST PT MAY NOT REQ PHYS/QHP,79.0,51.35,1.1,85.46,152
CDM,99212OH,OFFICE/OUTPATIENT ESTABLISHED SF MDM 10 MIN,280.0,182.0,1.1,280.0,152
CDM,99213CCOH,COSMETIC CLINIC,94.0,61.1,1.1,200.07,152
CDM,99213CPOH,COSMETIC PROCEDURE,218.0,141.7,1.1,218.0,152
CDM,99213OH,OFFICE/OUTPATIENT ESTABLISHED LOW MDM 20 MIN,520.0,338.0,1.1,520.0,152
CDM,99214OH,OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30 MIN,768.0,499.2,1.1,768.0,152
CDM,99215OH,OFFICE/OUTPATIENT ESTABLISHED HIGH MDM 40 MIN,1120.0,728.0,1.1,1120.0,152
CDM,99221AIOH,"INITIAL HOSPITAL CARE, LEVEL I",652.0,423.8,1.1,652.0,146
CDM,99221OH,1ST HOSPITAL IP/OBS CARE SF/LOW MDM 40 MINUTES,652.0,423.8,1.1,652.0,146
CDM,99222OH,1ST HOSPITAL IP/OBS CARE MODERATE MDM 55 MINUTES,1040.0,676.0,1.1,1040.0,146
CDM,99231OH,SBSQ HOSPITAL IP/OBS CARE SF/LOW MDM 25 MINUTES,400.0,260.0,1.1,400.0,148
CDM,99232OH,SBSQ HOSPITAL IP/OBS CARE MOD MDM 35 MINUTES,636.0,413.4,1.1,636.0,148
CDM,99233OH,SBSQ HOSPITAL IP/OBS CARE HIGH MDM 50 MINUTES,960.0,624.0,1.1,960.0,148
CDM,99234OH,HOSPITAL IP/OBS CARE SAME DATE SF/LOW MDM 45 MIN,800.0,520.0,1.1,800.0,148
CDM,99235OH,HOSPITAL IP/OBS CARE SAME DATE MOD MDM 70 MIN,1296.0,842.4,1.1,1296.0,148
CDM,99236OH,HOSPITAL IP/OBS CARE SAME DATE HIGH MDM 85 MIN,1720.0,1118.0,1.1,1720.0,148
CDM,99238OH,HOSPITAL IP/OBS DISCHARGE DAY MGMT 30 MIN/<,600.0,390.0,1.1,600.0,148
CDM,99239OH,HOSPITAL IP/OBS DISCHARGE DAY MGMT > 30 MIN,860.0,559.0,1.1,860.0,148
CDM,99242OH,OFFICE/OP CONSLTJ NEW/EST PT SF MDM 20 MINUTES,475.0,308.75,1.1,475.0,120
CDM,99243OH,OFFICE/OP CONSLTJ NEW/EST PT LOW MDM 30 MINUTES,720.0,468.0,1.1,720.0,120
CDM,99244OH,OFFICE/OP CONSLTJ NEW/EST PT MOD MDM 40 MINUTES,1076.0,699.4,1.1,1076.0,120
CDM,99245OH,OFFICE/OP CONSLTJ NEW/EST PT HIGH MDM 55 MINUTES,1500.0,975.0,1.1,1500.0,120
CDM,99253OH,IP/OBS CONSLTJ NEW/EST PT LOW MDM 45 MINUTES,880.0,572.0,1.1,880.0,116
CDM,99281OH,EMERGENCY DEPARTMENT VISIT MAY NOT REQ PHYS/QHP,110.0,71.5,1.1,187.11,148
CDM,99282OH,EMERGENCY DEPARTMENT VISIT STRAIGHTFORWARD MDM,409.0,265.85,1.1,368.1,148
CDM,99283OH,EMERGENCY DEPARTMENT VISIT LOW MDM,704.0,457.6,1.1,633.6,148
CDM,99284OH,EMERGENCY DEPARTMENT VISIT MODERATE MDM,1206.0,783.9,1.1,1085.4,148
CDM,99285OH,EMERGENCY DEPARTMENT VISIT HIGH MDM,1760.0,1144.0,1.1,1584.0,148
CDM,99288OH,PHYS/QHP DIRECTION EMERGENCY MEDICAL SYSTEMS,427.0,277.55,1.1,427.0,80
CDM,99291OH,CRITICAL CARE ILL/INJURED PATIENT INIT 30-74 MIN,1980.0,1287.0,1.1,1980.0,148
CDM,99292OH,CRITICAL CARE ILL/INJURED PATIENT ADDL 30 MIN,990.0,643.5,1.1,990.0,148
CDM,99295OH,"NEONATAL CRITICAL CARE,INITIAL",3768.0,2449.2,1.1,3768.0,68
CDM,99304OH,INITIAL NURSING FACILITY CARE SF/LOW MDM 25 MIN,600.0,390.0,1.1,600.0,152
CDM,99305OH,INITIAL NURSING FACILITY CARE MOD MDM 35 MINUTES,1000.0,650.0,1.1,1000.0,152
CDM,99306OH,INITIAL NURSING FACILITY CARE HI MDM 50 MINUTES,1400.0,910.0,1.1,1400.0,152
CDM,99307OH,SBSQ NURSING FACILITY CARE SF MDM 10 MINUTES,280.0,182.0,1.1,280.0,152
CDM,99308OH,SBSQ NURSING FACILITY CARE LOW MDM 20 MINUTES,520.0,338.0,1.1,520.0,152
CDM,99309OH,SBSQ NURSING FACILITY CARE MOD MDM 30 MINUTES,768.0,499.2,1.1,768.0,152
CDM,99310OH,SBSQ NURSING FACILITY CARE HIGH MDM 45 MINUTES,1120.0,728.0,1.1,1120.0,152
CDM,99315OH,NURSING FACILITY DSCHRG MGMT 30 MIN/< TOT TIME,600.0,390.0,1.1,600.0,144
CDM,99316OH,NURSING FACILITY DSCHRG MGMT 30 MIN+ TOT TIME,1000.0,650.0,1.1,1000.0,144
CDM,99341OH,HOME/RES VISIT NEW PATIENT SF MDM 15 MINUTES,440.0,286.0,1.1,440.0,148
CDM,99342OH,HOME/RES VISIT NEW PATIENT LOW MDM 30 MINUTES,726.0,471.9,1.1,726.0,148
CDM,99342OSCOH,HOME/RES VISIT NEW PATIENT LOW MDM 30 MINUTES,432.0,280.8,1.1,432.0,148
CDM,99342OSCOH-Z1,HOME/RES VISIT NEW PATIENT LOW MDM 30 MINUTES,432.0,280.8,1.1,432.0,70
CDM,99343OSCOH,"HOME VISIT,NEW PATIENT,LEVEL III",679.0,441.35,1.1,679.0,70
CDM,99343OSCOH-Z1,"HOME VISIT,NEW PATIENT,LEVEL III",679.0,441.35,1.1,679.0,70
CDM,99344OH,HOME/RES VISIT NEW PATIENT MOD MDM 60 MINUTES,1263.0,820.95,1.1,1263.0,144
CDM,99344OSCOH,HOME/RES VISIT NEW PATIENT MOD MDM 60 MINUTES,961.0,624.65,1.1,961.0,144
CDM,99344OSCOH-Z1,HOME/RES VISIT NEW PATIENT MOD MDM 60 MINUTES,961.0,624.65,1.1,961.0,70
CDM,99345OH,HOME/RES VISIT NEW PATIENT HIGH MDM 75 MINUTES,1707.0,1109.55,1.1,1707.0,144
CDM,99345OSCOH,HOME/RES VISIT NEW PATIENT HIGH MDM 75 MINUTES,961.0,624.65,1.1,961.0,144
CDM,99345OSCOH-Z1,HOME/RES VISIT NEW PATIENT HIGH MDM 75 MINUTES,1163.0,755.95,1.1,1163.0,70
CDM,99347OH,HOME/RES VISIT EST PATIENT SF MDM 20 MINUTES,396.0,257.4,1.1,396.0,148
CDM,99347OSCOH,HOME/RES VISIT EST PATIENT SF MDM 20 MINUTES,268.0,174.2,1.1,295.77,148
CDM,99347OSCOH-Z1,HOME/RES VISIT EST PATIENT SF MDM 20 MINUTES,268.0,174.2,1.1,268.0,70
CDM,99348OH,HOME/RES VISIT EST PATIENT LOW MDM 30 MINUTES,660.0,429.0,1.1,660.0,148
CDM,99348OSCOH,HOME/RES VISIT EST PATIENT LOW MDM 30 MINUTES,268.0,174.2,1.1,295.77,148
CDM,99348OSCOH-Z1,HOME/RES VISIT EST PATIENT LOW MDM 30 MINUTES,206.0,133.9,1.1,206.0,70
CDM,99349OH,HOME/RES VISIT EST PATIENT MOD MDM 40 MINUTES,1074.0,698.1,1.1,1074.0,148
CDM,99349OSCOH,HOME/RES VISIT EST PATIENT MOD MDM 40 MINUTES,624.0,405.6,1.1,624.0,148
CDM,99349OSCOH-Z1,HOME/RES VISIT EST PATIENT MOD MDM 40 MINUTES,624.0,405.6,1.1,624.0,70
CDM,99350OH,HOME/RES VISIT EST PATIENT HIGH MDM 60 MINUTES,1584.0,1029.6,1.1,1584.0,144
CDM,99350OSCOH,HOME/RES VISIT EST PATIENT HIGH MDM 60 MINUTES,880.0,572.0,1.1,880.0,144
CDM,99350OSCOH-Z1,HOME/RES VISIT EST PATIENT HIGH MDM 60 MINUTES,880.0,572.0,1.1,880.0,70
CDM,99358OH,PROLONGED E&M SERVICE-1ST HOUR,792.0,514.8,1.1,792.0,102
CDM,99359OH,"PROLONGED SERV,NO CONTCT,EA ADD 1/2",330.0,214.5,1.1,330.0,98
CDM,99360OH,"PHYSICIAN STANDBY SERV,EA 30 MIN",480.0,312.0,1.1,480.0,100
CDM,99366OH,TEAM CONFERENCE FACE-TO-FACE NONPHYSICIAN,328.0,213.2,1.1,328.0,102
CDM,99367OH,TEAM CONFERENCE NON-FACE-TO-FACE PHYSICIAN,440.0,286.0,1.1,440.0,98
CDM,99368OH,TEAM CONFERENCE NON-FACE-TO-FACE NONPHYSICIAN,288.0,187.2,1.1,288.0,98
CDM,99374OH,"HOME HEALTH CARE SUPERV,15-29 MIN",440.0,286.0,1.1,440.0,102
CDM,99375OH,CARE PLAN OVERSIGHT/30-60,692.0,449.8,1.1,692.0,102
CDM,99377OH,"HOSPICE CARE SUPERVISION,15-29 MIN",440.0,286.0,1.1,440.0,102
CDM,99378OH,"HOSPICE CARE SUPERVISION,30+ MIN",692.0,449.8,1.1,692.0,102
CDM,99381OH,"PREVENTIVE VISIT,NEW,INFANT",600.0,390.0,1.1,600.0,116
CDM,99382OH,"PREVENTIVE VISIT,NEW,AGE 1-4",640.0,416.0,1.1,640.0,116
CDM,99383OH,"PREVENTIVE VISIT,NEW,AGE5-11",680.0,442.0,1.1,680.0,118
CDM,99384OH,WELLNESS EXAMS NEW 12-17 YRS,800.0,520.0,1.1,800.0,118
CDM,99385OH,WELLNESS EXAM NEW 18-39 YRS,768.0,499.2,1.1,768.0,118
CDM,99386OH,WELLNESS EXAMS NEW 40-64 YRS,932.0,605.8,1.1,932.0,118
CDM,99387OH,WELLNESS EXAMS NEW 65+ YRS,1000.0,650.0,1.1,1000.0,116
CDM,99391OH,"PREVENTIVE VISIT,EST,INFANT",548.0,356.2,1.1,548.0,116
CDM,99392OH,"PREVENTIVE VISIT,EST,AGE 1-4",600.0,390.0,1.1,600.0,116
CDM,99393OH,"PREVENTIVE VISIT,EST,AGE5-11",600.0,390.0,1.1,600.0,116
CDM,99394OH,"PREVENTIVE VISIT,EST,12-17",680.0,442.0,1.1,680.0,116
CDM,99395OH,WELLNESS EXAMS EST 18-39 YRS,700.0,455.0,1.1,700.0,116
CDM,99396OH,WELLNESS EXAMS EST 40-64 YRS,760.0,494.0,1.1,760.0,116
CDM,99397OH,WELLNESS EXAMS EST 65+ YRS,800.0,520.0,1.1,800.0,116
CDM,99401OH,PREVENT MED COUNSEL&/RISK FACTOR REDJ SPX 15 MIN,192.0,124.8,1.1,192.0,116
CDM,99402OH,PREVENT MED COUNSEL&/RISK FACTOR REDJ SPX 30 MIN,392.0,254.8,1.1,392.0,116
CDM,99403OH,PREVENT MED COUNSEL&/RISK FACTOR REDJ SPX 45 MIN,584.0,379.6,1.1,584.0,114
CDM,99404OH,PREVENT MED COUNSEL&/RISK FACTOR REDJ SPX 60 MIN,780.0,507.0,1.1,780.0,114
CDM,99406OH,TOBACCO USE CESSATION INTERMEDIATE 3-10 MINUTES,96.0,62.4,1.1,96.0,148
CDM,99407OH,TOBACCO USE CESSATION INTENSIVE >10 MINUTES,200.0,130.0,1.1,200.0,148
CDM,99408OH,ALCOHOL/SUBSTANCE SCREEN & INTERVEN 15-30 MIN,260.0,169.0,1.1,260.0,108
CDM,99409OH,ALCOHOL/SUBSTANCE SCREEN & INTERVENTION >30 MIN,520.0,338.0,1.1,520.0,108
CDM,99411OH,PREV MED COUNSEL & RISK FACTOR REDJ GRP SPX 30 M,60.0,39.0,1.1,60.0,100
CDM,99412OH,PREV MED COUNSEL & RISK FACTOR REDJ GRP SPX 60 M,100.0,65.0,1.1,100.0,100
CDM,99415OH,PROLNG CLINCL STAFF SVC DURING O/P E/M 1ST HR,273.0,177.45,1.1,273.0,142
CDM,99416OH,PROLNG CLINCL STAFF SVC DURING O/P E/M EA 30 MIN,273.0,177.45,0.74,273.0,142
CDM,99417OH,PROLONGED OUTPATIENT E/M SERVICE EACH 15 MINUTES,268.0,174.2,1.1,268.0,108
CDM,99418OH,PROLONGED INPATIENT/OBSERVATION EM SVC EA 15 MIN,356.0,231.4,1.1,356.0,104
CDM,99421OH,ONLINE DIGITAL E/M SVC EST PT &LT;7 D 5-10 MINUTES,65.0,42.25,1.1,65.0,144
CDM,99422OH,ONLINE DIGITAL E/M SVC EST PT &LT;7 D 11-20 MINUTES,80.0,52.0,1.1,80.0,144
CDM,99423OH,ONLINE DIGITAL E/M SVC EST PT &LT;7 D 21+ MINUTES,120.0,78.0,1.1,120.0,144
CDM,99424OH,PRINCIPAL CARE MGMT SVC 1ST 30 PHYS/QHP CAL MO,580.0,377.0,1.1,580.0,132
CDM,99425OH,PRINCIPAL CARE MGMT SVC EA ADL 30 PHY/QHP CAL MO,400.0,260.0,1.1,400.0,132
CDM,99426OH,PRINCIPAL CARE MGMT SVC 1ST 30 STAFF CAL MO,400.0,260.0,1.1,400.0,132
CDM,99427OH,PRINCIPAL CARE MGMT SVC EA ADDL 30 STAFF CAL MO,284.0,184.6,1.1,284.0,132
CDM,99429AOH,METABOLIC WEIGHT MANAGEMENT PROGRAM,150.0,97.5,0.01,2013999.98,80
CDM,99429OH,UNLISTED PREVENTIVE MEDICINE SERVICE,103.0,66.95,0.01,2013999.98,80
CDM,99431OH,"INITIAL CARE, NORMAL NEWBORN",408.0,265.2,1.1,408.0,68
CDM,99433OH,"F/U NEWBORN CARE,HOSP,PER DAY",216.0,140.4,1.1,216.0,68
CDM,99435OH,HOSPITAL NB DISCHARGE SAMEDAY,380.0,247.0,1.1,380.0,68
CDM,99436OH,"ATTENDANCE, BIRTH/INITIAL STABILIZE",596.0,387.4,1.1,596.0,68
CDM,99437OH,CHRONIC CARE MGMT SVC PHYS EA ADDL 30 MIN CAL MO,440.0,286.0,1.1,440.0,132
CDM,99439OH,CHRONIC CARE MANAGEMENT SERVICES EA ADDL 20 MIN,280.0,182.0,1.1,280.0,134
CDM,99445OH,REM MNTR PHYSIOL PARAM DEV SPLY W/REC 2-15 DAYS,37.0,24.05,1.1,132.86,106
CDM,99446OH,NTRPROF PHONE/NTRNET/EHR ASSMT&MGMT 5-10 MIN,154.0,100.1,1.1,154.0,142
CDM,99447OH,NTRPROF PHONE/NTRNET/EHR ASSMT&MGMT 11-20 MIN,280.0,182.0,1.1,280.0,142
CDM,99448OH,NTRPROF PHONE/NTRNET/EHR ASSMT&MGMT 21-30 MIN,420.0,273.0,1.1,420.0,142
CDM,99449OH,NTRPROF PHONE/NTRNET/EHR ASSMT&MGMT 31/> MIN,560.0,364.0,1.1,560.0,142
CDM,99450OH,LIFE/DISABILITY EVALUATION,651.0,423.15,1.1,651.0,82
CDM,99451OH,NTRPROF PHONE/NTRNET/EHR ASSMT&MGMT 5/> MIN,280.0,182.0,1.1,280.0,142
CDM,99452OH,NTRPROF PHONE/NTRNET/EHR REFERRAL SVC 30 MIN,280.0,182.0,1.1,280.0,142
CDM,99453OH,REM MNTR PHYSIOL PARAM 1ST SET UP PT EDUCAJ EQP,37.0,24.05,1.1,253.66,144
CDM,99454OH,REM MNTR PHYSIOL PARAM 1ST DEV SUPPLY EA 30 D,118.0,76.7,1.1,132.86,144
CDM,99455OH,WORK RELATED/MED DBLT XM TREATING PHYS,193.0,125.45,1.1,193.0,82
CDM,99456OH,WORK RELATED/MED DBLT XM OTH/THN TREATING PHYS,918.0,596.7,1.1,918.0,82
CDM,99457OH,REMOTE PHYSIOLOGIC MONITORING 20 MIN+ PER MONTH,244.0,158.6,1.1,244.0,148
CDM,99458OH,REMOTE PHYSIOLOGIC MONITORING EA ADDL 20 MIN MO,244.0,158.6,1.1,244.0,148
CDM,99459OH,PELVIC EXAMINATION,53.0,34.45,1.1,53.0,144
CDM,99460OH,1ST HOSP/BIRTHING CENTER CARE PER DAY NML NB,768.0,499.2,1.1,768.0,144
CDM,99461OH,1ST CARE PR DAY NML NB XCPT HOSP/BIRTHING CENTER,504.0,327.6,1.1,504.0,148
CDM,99462OH,SUBQ HOSPITAL CARE PER DAY E/M NORMAL NEWBORN,336.0,218.4,1.1,336.0,144
CDM,99463OH,1ST HOSP/BIRTHING CENTER NB ADMIT & DSCHG SM DAT,852.0,553.8,1.1,852.0,144
CDM,99464OH,ATTN AT DELIVERY 1ST STABILIZATION OF NEWBORN,600.0,390.0,1.1,600.0,144
CDM,99465OH,DELIVERY/BIRTHING ROOM RESUSCITATION,1172.0,761.8,1.1,1248.88,144
CDM,99466OH,CRITICAL CARE INTERFACILITY TRANSPORT 30-74 MIN,1916.0,1245.4,1.1,1916.0,142
CDM,99467OH,CRITICAL CARE INTERFACILITY TRANSPORT EA 30 MIN,960.0,624.0,1.1,960.0,142
CDM,99468OH,1ST INPATIENT CRITICAL CARE PR DAY AGE 28 DAYS/<,8122.0,5279.3,1.1,8122.0,144
CDM,99469OH,SUBQ I/P CRITICAL CARE PR DAY AGE 28 DAYS/<,3516.0,2285.4,1.1,3516.0,144
CDM,99470OH,RPM TX MGMT 1 R-T IA COMUNICAJ CAL MO 1ST 10 MIN,136.0,88.4,1.1,136.0,106
CDM,99471OH,INITIAL PED CRITICAL CARE 29 DAYS THRU 24 MONTHS,7031.0,4570.15,1.1,7031.0,144
CDM,99472OH,SUBSQ PED CRITICAL CARE 29 DAYS THRU 24 MO,3516.0,2285.4,1.1,3516.0,144
CDM,99473OH,SELF-MEAS BP PT EDUCAJ/TRAING & DEV CALIBRATION,221.0,143.65,1.1,221.0,144
CDM,99474OH,SELF-MEAS BP 2 READG 1 MIN APART BID 30 DAY PD,72.0,46.8,1.1,72.0,148
CDM,99475OH,INITIAL PED CRITICAL CARE 2 THRU 5 YEARS,4950.0,3217.5,1.1,4950.0,144
CDM,99476OH,SUBSEQUENT PED CRITICAL CARE 2 THRU 5 YEARS,2970.0,1930.5,1.1,2970.0,144
CDM,99477OH,INITIAL HOSP NEONATE 28 D/< NOT CRITICALLY ILL,3080.0,2002.0,1.1,3080.0,144
CDM,99478OH,SUBSEQUENT INTENSIVE CARE INFANT < 1500 GRAMS,1210.0,786.5,1.1,1210.0,144
CDM,99479OH,SUBSEQUENT INTENSIVE CARE INFANT 1500-2500 GRAMS,1100.0,715.0,1.1,1100.0,144
CDM,99480OH,SUBSEQUENT INTENSIVE CARE INFANT 2501-5000 GRAMS,1056.0,686.4,1.1,1056.0,144
CDM,99483OH,ASSMT & CARE PLANNING PT W/COGNITIVE IMPAIRMENT,1690.0,1098.5,1.1,1690.0,146
CDM,99484OH,CARE MGMT SERVICES BEHAVIORAL HLTH COND 20 MINS,372.0,241.8,1.1,372.0,136
CDM,99485OH,SUPERVISION INTERFACILITY TRANSPORT INIT 30 MIN,660.0,429.0,1.1,660.0,98
CDM,99486OH,SUPERVISION INTERFACILITY TRANSPORT ADDL 30 MIN,572.0,371.8,1.1,572.0,98
CDM,99487OH,COMPLX CHRON CARE COORD W/O PT VST 1ST HR PER MO,724.0,470.6,1.1,724.0,134
CDM,99490OH,CHRONIC CARE MGMT SVCS STAFF 1ST 20 MIN CAL MO,400.0,260.0,1.1,400.0,136
CDM,99491OH,CHRONIC CARE MGMT SVC AT LEAST 30 MIN PER MONTH,600.0,390.0,1.1,600.0,134
CDM,99492OH,1ST PSYCHIATRIC COLLAB CARE MGMT 1ST 70 MINS,827.0,537.55,1.1,827.0,136
CDM,99493OH,SBSQ PSYCHIATRIC COLLAB CARE MGMT 1ST 60 MINS,902.0,586.3,1.1,902.0,136
CDM,99494OH,1ST/SBSQ PSYCH COLLAB CARE MGMT EA ADDL 30 MINS,361.0,234.65,1.1,361.0,136
CDM,99495OH,TRANSJ CARE MGMT MOD MDM F2F 14 CAL D DISCHARGE,1112.0,722.8,1.1,1112.0,134
CDM,99496OH,TRANSJ CARE MGMT HIGH MDM F2F 7 CAL D DISCHARGE,1516.0,985.4,1.1,1516.0,134
CDM,99497OH,ADVANCE CARE PLANNING FIRST 30 MINS,600.0,390.0,1.1,600.0,146
CDM,99498OH,ADVANCE CARE PLANNING EA ADDL 30 MINS,560.0,364.0,1.1,560.0,146
CDM,9949907OH,SPORTS EXAM OR PHYSICAL,35.0,22.75,0.01,2013999.98,80
CDM,99499CEOH,COSMETIC ESTABLISHED,75.0,48.75,0.01,2013999.98,80
CDM,99499COH,COSMETIC CONSULT,250.0,162.5,0.01,2013999.98,80
CDM,99499DOH,COSMETIC ASSESSMENT,99.0,64.35,0.01,2013999.98,80
CDM,99499ROH,EST VIRTUAL VISIT RESEARCH,83.28,54.13,0.01,2013999.98,80
CDM,99499RVU1OH,EMPLOYEE MASSAGE,75.0,48.75,0.01,2013999.98,80
CDM,99499RVU2OH,REASSESMENT NUTRITION THERAPY 61-75 MIN,36.0,23.4,0.01,2013999.98,80
CDM,99499RVU4OH,RESEARCH CHART REVIEW 1,65.0,42.25,0.01,2013999.98,80
CDM,99499RVU7OH,ECC ADOPTION-GENERAL INFO,157.0,102.05,0.01,2013999.98,80
CDM,99499RVU8OH,ECLEVELANDCLINIC SECOND OPINION LEV,311.0,202.15,0.01,2013999.98,80
CDM,99900065,CHARTERED AIR TRANSPORTATION,12500.0,8125.0,2725.0,12500.0,58
CDM,99999BOH,HEALTHCOACH EST OFFICE VISIT 30 MIN,30.0,19.5,1.1,30.0,68
CDM,99999COH,HEALTHCOACH EST PHONE / VIRTUAL VISIT 30 MIN,30.0,19.5,1.1,30.0,68
CDM,99999EOH,HEPATITIS B / HEPLISAV-B,182.0,118.3,1.1,522.03,82
CDM,99999FOH,FLUZONE HIGH DOSE,75.0,48.75,1.1,75.0,68
CDM,99999GOH,TETANUS,62.0,40.3,1.1,62.0,68
CDM,99999HOH,SELF-PAY  INJECTION,33.0,21.45,1.1,33.0,68
CDM,99999IVIOH,IMAGING VIDEO INTERPRETATION,40.0,26.0,1.1,40.0,68
CDM,99999IVR1OH,IMAGING VIDEO REPORT LEVEL 1,20.0,13.0,1.1,20.0,68
CDM,99999IVR2OH,IMAGING VIDEO REPORT LEVEL 2,40.0,26.0,1.1,40.0,68
CDM,99999IVR3OH,IMAGING VIDEO REPORT LEVEL 3,90.0,58.5,1.1,90.0,68
CDM,99999JOH,SELF-PAY ADDITIONAL INJECTION,16.0,10.4,1.1,16.0,68
CDM,99999KOH,PHONE CONSULTS $200,200.0,130.0,1.1,200.0,68
CDM,99999LOH,NUTRIGENOMIX CONSULTS PHONE OR IN PERSON $200,200.0,130.0,1.1,200.0,68
CDM,99999MOH,SHRINGRIX,505.0,328.25,1.1,505.0,68
CDM,99999NUTROH,NUTRIGENOMIX VISIT,95.0,61.75,1.1,95.0,68
CDM,99999OOH,ACUPRESSURE - NEW PATIENT,150.0,97.5,1.1,150.0,68
CDM,99999POH,ACUPRESSURE - ESTABLISHED PATIENT,75.0,48.75,1.1,75.0,68
CDM,99999VIPOH,VIP NUTRITION VISIT,200.0,130.0,1.1,200.0,68
CDM,A36415OH,VENIPUNCTURE,40.0,26.0,1.1,40.0,92
CDM,A4215OH,STERILE NEEDLE,9.0,5.85,0.24,9.0,80
CDM,A4250OH,URINE REAGENT STRIPS/TABLETS,35.0,22.75,1.1,69.1,86
CDM,A4263OH,PERMANENT TEAR DUCT PLUG,14.0,9.1,1.1,78.43,86
CDM,A4264OH,PR INTRATUBAL OCCLUSION DEVICE,3000.0,1950.0,1.1,6709.71,80
CDM,A4266OH,DIAPHRAGM,78.27,50.88,1.1,97.95,80
CDM,A4268OH,FEMALE CONDOM,69.0,44.85,1.1,69.0,80
CDM,A4338OH,INDWELLING CATHETER LATEX,17.0,11.05,1.1,56.38,90
CDM,A4340OH,INDWELLING CATHETER SPECIAL,45.0,29.25,1.1,124.0,90
CDM,A4344OH,CATH INDW FOLEY 2 WAY SILICN,23.0,14.95,1.1,73.56,90
CDM,A4351OH,STRAIGHT TIP URINE CATHETER,2.0,1.3,0.51,7.81,90
CDM,A4352OH,COUDE TIP URINARY CATHETER,10.0,6.5,1.1,25.09,90
CDM,A4356OH,EXT URETH CLMP OR COMPR DVC,10.0,6.5,1.1,209.67,90
CDM,A4357OH,BEDSIDE DRAINAGE BAG,14.0,9.1,1.1,44.6,90
CDM,A4358OH,URINARY LEG BAG,9.0,5.85,1.1,30.48,90
CDM,A4421OH,OSTOMY SUPPLY MISC,23.0,14.95,0.01,23.0,80
CDM,A4452OH,WATERPROOF TAPE,84.04,54.63,0.34,84.04,90
CDM,A4550OH,SURGICAL TRAYS,53.0,34.45,1.1,78.43,86
CDM,A4561OH,"PESSARY RUBBER, ANY TYPE",115.0,74.75,1.1,115.0,90
CDM,A4562OH,"PESSARY, NON RUBBER,ANY TYPE",67.0,43.55,1.1,233.98,90
CDM,A4565OH,SLINGS,19.0,12.35,1.1,35.38,90
CDM,A4570OH,SPLINT,32.0,20.8,1.1,52.04,86
CDM,A4580OH,CAST SUPPLIES (PLASTER),9.0,5.85,1.1,70.4,80
CDM,A4590OH,SPECIAL CASTING MATERIAL,56.0,36.4,1.1,110.2,86
CDM,A4614OH,"PEAK EXPIR FLOW METER,HAND HELD",34.0,22.1,1.1,109.29,90
CDM,A4616OH,SCOOP CATHETER 02 HOSE,6.0,3.9,0.05,6.0,90
CDM,A4625OH,SCOOP CATHETER CLEANING KIT,38.0,24.7,1.1,38.0,90
CDM,A4627OH,AEROCHAMBER SPACER WITH MASK,9.0,5.85,1.1,79.12,86
CDM,A4635OH,UNDERARM CRUTCH PAD,2.0,1.3,0.51,18.37,90
CDM,A4636OH,HANDGRIP FOR CANE ETC,2.0,1.3,0.51,13.79,90
CDM,A4637OH,REPL TIP CANE/CRUTCH/WALKER,3.0,1.95,0.76,8.15,90
CDM,A4648OH,IMPLANTABLE TISSUE MARKER,73.0,47.45,1.1,691.04,80
CDM,A4649OH,SURGICAL SUPPLIES,38.0,24.7,0.01,38.0,80
CDM,A4660OH,SPHYG/BP APP W CUFF AND STET,22.05,14.33,1.1,105.86,86
CDM,A4663OH,DIALYSIS BLOOD PRESSURE CUFF,15.5,10.08,1.1,114.02,86
CDM,A4670OH,"AUTOMATIC BP MONITOR, DIAL",70.5,45.83,1.1,380.07,86
CDM,A50590OH,LITHOTRIPSY,17957.0,11672.05,1.1,17957.0,148
CDM,A51700OH,"BLADDER IRRIGATION,SIMPLE,LAVAGE",843.0,547.95,1.1,843.0,148
CDM,A51701OH,INSJ NON-NDWELLG BLADDER CATHETER,414.0,269.1,1.1,414.0,148
CDM,A51702OH,INSERTION OF TEMP INDWELLING BLADDER CAT,521.0,338.65,1.1,521.0,148
CDM,A51703OH,"INSERTION OF INDWELLING CATH, COMPLEX",896.0,582.4,1.1,896.0,148
CDM,A51705OH,CHANGE CYSTOSTOMY TUBE SIMPLE,1143.0,742.95,1.1,1143.0,148
CDM,A51720OH,BLADDER INSTILLATION,1362.0,885.3,1.1,1992.71,148
CDM,A51726OH,CYSTOMETROGRAM (CMG),1456.0,946.4,1.1,1456.0,144
CDM,A51727OH,CMG W URETHRAL PRESSURE PROFILE,1384.0,899.6,1.1,1992.71,144
CDM,A51728OH,CMG W VPP,1448.0,941.2,1.1,1992.71,144
CDM,A51729OH,CMG W VPS AND UPP,1305.0,848.25,1.1,1992.71,144
CDM,A51741OH,UROFLOWMETRY COMPLEX,619.0,402.35,1.1,915.24,144
CDM,A51798OH,MEASURE OF P/V RESIDUAL,279.0,181.35,1.1,279.0,144
CDM,A52000OH,CYSTOSCOPY,3020.0,1963.0,1.1,3020.0,148
CDM,A52005OH,CYSTO RETROGRADE PYELOGRAM,6616.0,4300.4,1.1,6616.0,148
CDM,A52224OH,CYSTO FULG MINOR TUMOR,4409.0,2865.85,1.1,10168.64,148
CDM,A52235OH,MEDIUM BLADDER TUMORS,6517.0,4236.05,1.1,10168.64,144
CDM,A52240OH,LARGE BLADDER TUMORS,9124.0,5930.6,1.1,15090.73,144
CDM,A52287OH,CYSTOURETHROSCOPY W INJ FOR BLADDER,3143.0,2042.95,1.1,5941.4,148
CDM,A52310OH,CYSTO W/STENT REMOVAL,4036.0,2623.4,1.1,5941.4,148
CDM,A52315OH,CYSTOURETHROSCOPY,5417.0,3521.05,1.1,5941.4,148
CDM,A52317OH,LITHOLAPAXY:CRUSHING & FRAG,9088.0,5907.2,1.1,10168.64,148
CDM,A52332OH,CYSTO W/PLACE DBL J STENT,5653.0,3674.45,1.1,10168.64,148
CDM,A52352OH,CYSTOURETHROSCOPY,7948.0,5166.2,1.1,10168.64,144
CDM,A52450OH,TRANSURETHRAL INSCISION,2567.0,1668.55,1.1,10168.64,144
CDM,A52500OH,TURBN,2751.0,1788.15,1.1,10168.64,144
CDM,A52601OH,TRANSURETH ELECTRO RESECT,4600.0,2990.0,1.1,15090.73,144
CDM,A52648OH,CONTACT LASER VAPORIZATION,4010.0,2606.5,1.1,15090.73,148
CDM,A53600OH,DILATION OF URETHRAL STRICTURE,2030.0,1319.5,1.1,2030.0,148
CDM,A54161OH,CIRCUMCISION,3927.0,2552.55,1.1,5941.4,144
CDM,A54200OH,INJECTION PEYRONIE DISEASE,827.0,537.55,1.1,827.0,148
CDM,A54530OH,"ORCHIECTOMY, RADICAL, INGUINAL APPROACH",7680.0,4992.0,1.1,10089.06,144
CDM,A5507OH,MODIFICATION DIABETIC SHOE,63.47,41.26,1.1,148.78,90
CDM,A5512OH,MULTI DEN INSERT DIRECT FORM,48.0,31.2,1.1,119.17,90
CDM,A55250OH,VASECTOMY SURGERY,2736.0,1778.4,1.1,5941.4,148
CDM,A57288OH,SLING OPERATION FOR SUI,4101.0,2665.65,1.1,14506.08,144
CDM,A6021OH,COLLAGEN DRESSING <=16 SQ IN,37.0,24.05,1.1,96.61,90
CDM,A6022OH,COLLAGEN DRSG>6<=48 SQ IN,170.0,110.5,1.1,170.0,90
CDM,A6025OH,"SILICONE GEL SHEET, EACH",15.0,9.75,1.1,41.46,86
CDM,A6196OH,"ALGINATE DRESS,<16 SQ IN, EACH",11.0,7.15,1.1,33.84,90
CDM,A6197OH,"ALGINATE DRESS,16-48 SQ IN,EACH",83.0,53.95,1.1,83.0,90
CDM,A6207OH,"CONTACT LAYER,16-48 SQ IN, EACH",18.0,11.7,1.1,33.75,90
CDM,A6216OH,"GAUZE,NONIMPREG,<16 SQ IN,NO ADHESIV",6.0,3.9,0.03,6.0,90
CDM,A6218OH,"GAUZE,NONIMPREG,>48 SQ IN,NO ADHESVE",22.0,14.3,0.2,22.0,86
CDM,A6234OH,"HYDROCOLLOID,<16 SQ IN,NO ADHES,EA",8.0,5.2,1.1,30.09,90
CDM,A6237OH,"HYDROCOLLOID,<16 SQ IN,ADHESIVE,EA",9.0,5.85,1.1,36.35,90
CDM,A6242OH,"HYDROGEL,<16 SQ IN,NO ADHESIVE,EA",9.0,5.85,1.1,27.81,90
CDM,A6243OH,"HYDROGEL,16-48 SQ IN,NO ADHESIVE,EA",15.0,9.75,1.1,56.64,90
CDM,A6404OH,"GAUZE,NONIMPREG,STER,>48 SQ IN,EA",6.0,3.9,0.2,8.95,86
CDM,A6443OH,CONFORM BAND N/S W>=3?<5?/YD,8.0,5.2,0.25,8.0,90
CDM,A6446OH,CONFORM BAND S W>=3? <5?/YD,1.5,0.98,0.34,1.79,90
CDM,A6449OH,LT COMPRES BAND >=3? <5?/YD,8.0,5.2,1.1,8.06,90
CDM,A6452OH,HIGH COMPRES BAND W>=3?<5?YD,29.0,18.85,1.1,29.0,90
CDM,A6454OH,SELF-ADHER BAND W>=3? <5?/YD,5.0,3.25,0.7,5.0,90
CDM,A64566OH,PTNS,914.0,594.1,1.1,914.0,146
CDM,A6456OH,ZINC PASTE BAND W >=3?<5?/YD,46.0,29.9,1.1,46.0,90
CDM,A6530OH,COMPRESSION STOCKING BK18-30,30.0,19.5,1.1,115.13,86
CDM,A6533OH,GC STOCKING THIGHLNGTH 18-30,50.0,32.5,1.1,159.17,86
CDM,A6536OH,GC STOCKING FULL LNGTH 18-30,65.0,42.25,1.1,214.27,86
CDM,A6545OH,GRAD COM NON-ELASTIC BK SURG,22.6,14.69,1.1,355.08,90
CDM,A6549OH,G COMPRESSION STOCKING,18.0,11.7,0.01,468.33,80
CDM,A7003OH,NEBULIZER ADMINISTRATION SET,12.0,7.8,1.1,12.0,90
CDM,A7016OH,NEBULIZER DOME & MOUTHPIECE,6.0,3.9,1.1,30.61,90
CDM,A7520OH,TRACH/LARYN TUBE NON-CUFFED,86.0,55.9,1.1,218.16,90
CDM,A7521OH,TRACH/LARYN TUBE CUFFED,85.0,55.25,1.1,216.16,90
CDM,A7524OH,TRACHEOSTOMA STENT/STUD/BTTN,231.0,150.15,1.1,355.71,90
CDM,A76770OH,RENAL ECHOGRAPHY,1883.0,1223.95,1.1,1883.0,142
CDM,A76872OH,GENITALIA ECHOGRAPHY TRANS,1782.0,1158.3,1.1,1782.0,142
CDM,A76942OH,ULTRASONIC GUIDED NEEDLE BX,1425.0,926.25,1.1,1425.0,142
CDM,A81000OH,URINLS DIP STICK/TABLET REAGNT NON-AUTO MICRSCPY,61.0,39.65,1.1,61.0,88
CDM,A81001OH,URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY,88.0,57.2,1.1,88.0,88
CDM,A81002OH,URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP,47.0,30.55,1.1,47.0,88
CDM,A81003OH,URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY,45.0,29.25,1.1,45.0,88
CDM,A9150OH,MISC/EXPER NON-PRESCRIPT DRU,2.0,1.3,0.01,2.0,80
CDM,A9270AOH,ACCOMMODATING LENS WORK UP/NON-COVERED,2182.0,1418.3,0.01,2182.0,80
CDM,A9270BOH,MULTIFOCAL TORIC LENS WORKUP/ NON COVERED,2237.0,1454.05,0.01,2237.0,80
CDM,A9270COH,MULTIFOCAL SPHERICAL LENS WORK UP/NON COVERED,2237.0,1454.05,0.01,2237.0,80
CDM,A9270DOH,SYMFONY TORIC IOL WORK UP/NONCOVERED,2237.0,1454.05,0.01,2237.0,80
CDM,A9270EOH,SYMFONY IOL WORK UP NON-COVERED,2387.0,1551.55,0.01,2387.0,80
CDM,A9270FOH,TORIC IOL WORKUP,1127.0,732.55,0.01,1127.0,80
CDM,A9270GOH,TRIFOCAL IOL WORKUP,2137.0,1389.05,0.01,2137.0,80
CDM,A9284OH,NON-ELECTRONIC SPIROMETER,4.36,2.83,1.1,69.1,80
CDM,A9500OH,"SUPPLY TECHNICIUM SESTAMIBI,PER DOSE",66.0,42.9,1.1,639.82,74
CDM,A9502OH,SUPPLY TECHNICIUM TETROFOSMIN / DOSE,65.0,42.25,1.1,121.08,74
CDM,A9503OH,"SUPPLY TECHNETIUM MEDRONATE,TO 30 MC",62.0,40.3,1.1,62.0,74
CDM,A9508OH,"I131 IODOBENGUATE, DX",9896.0,6432.4,1.1,9896.0,74
CDM,A9509OH,IODINE I-123 SOD IODIDE MIL,210.0,136.5,1.1,3081.68,74
CDM,A9512OH,TECHNETIUMTC99MPERTECHNETATE,34.0,22.1,1.1,34.0,74
CDM,A9513OH,"LUTETIUM LU 177, DOTATATE, THERAPEUTIC, 1 MILLICURIE",106520.0,69238.0,1.1,106520.0,78
CDM,A9516OH,I-123 SODIUM IODIDE CAPSULE,210.0,136.5,1.1,210.0,74
CDM,A9517OH,TH I131 SO IODIDE CAP MILLIC,180.0,117.0,1.1,180.0,74
CDM,A9521OH,TECHNETIUMTC-99M EXAMETAZINE,3128.0,2033.2,1.1,3128.0,74
CDM,A9526OH,"AMMONIA N-13, PER DOSE",250.0,162.5,1.1,510.99,74
CDM,A9528OH,DX I131 SO IODIDE CAP MILLIC,180.0,117.0,1.1,180.0,74
CDM,A9529OH,DX I131 SO IODIDE SOL MILLIC,180.0,117.0,1.1,180.0,74
CDM,A9530OH,TH I131 SO IODIDE SOL MILLIC,180.0,117.0,1.1,180.0,74
CDM,A9537OH,TC99M MEBROFENIN,62.0,40.3,1.1,80.23,74
CDM,A9538OH,"TECHNETIUM TC-99M PYROPHOSPHATE, DIAGNOSTIC",118.0,76.7,1.1,118.0,74
CDM,A9539OH,TC99M PENTETATE,240.0,156.0,1.1,240.0,74
CDM,A9540OH,TC99M MAA,1092.0,709.8,1.1,1092.0,74
CDM,A9541OH,TC99M SULFUR COLLOID,200.0,130.0,1.1,379.67,74
CDM,A9547OH,IN111 OXYQUINOLINE,5030.0,3269.5,1.1,5030.0,74
CDM,A9548OH,IN111 PENTETATE,4518.0,2936.7,1.1,4518.0,74
CDM,A9551OH,TC99M SUCCIMER,288.0,187.2,1.1,970.34,74
CDM,A9552OH,F18 FDG,250.0,162.5,1.1,509.85,74
CDM,A9555OH,RB82 RUBIDIUM,800.0,520.0,1.1,800.0,74
CDM,A9556OH,GA67 GALLIUM,2626.0,1706.9,1.1,2626.0,74
CDM,A9557OH,TC99M BICISATE,3766.0,2447.9,1.1,5206.19,74
CDM,A9560OH,TC99M LABELED RBC,350.0,227.5,1.1,350.0,74
CDM,A9562OH,TC99M MERTIATIDE,568.0,369.2,1.1,1254.2,74
CDM,A9567OH,TECHNETIUM TC-99M AEROSOL,240.0,156.0,1.1,240.0,74
CDM,A9570OH,INDIUM IN-111 AUTO WBC,4928.0,3203.2,1.1,5978.14,74
CDM,A9571OH,INDIUM IN-111 AUTO PLATELET,4928.0,3203.2,1.1,5978.14,74
CDM,A9572OH,INDIUM IN-111 PENTETREOTIDE,10558.0,6862.7,1.1,10558.0,74
CDM,A9573OH,"INJ, GADOPICLENOL, 1 ML",4.0,2.6,1.02,6.3,74
CDM,A9575OH,20 ML DOTAREM INJ 0.1 ML,1.83,1.19,0.12,1.83,78
CDM,A9579OH,INJ OPTIMARK 20ML,15.0,9.75,1.1,15.0,78
CDM,A9580OH,SODIUM FLUORIDE F-18,217.0,141.05,1.1,400.5,74
CDM,A9581OH,INJ EOVIST GADOXETATE DISODIUM PER ML,46.0,29.9,1.1,65.65,78
CDM,A9582OH,PR IODINE I-123 IOBENGUANE,8816.0,5730.4,1.1,8816.0,74
CDM,A9584AOH,GENERIC IOFLUPANE1-123 UP TO 5 MCI,3150.0,2047.5,1.1,3680.64,74
CDM,A9584OH,IODINE I-123 IOFLUPANE,5331.0,3465.15,1.1,5331.0,74
CDM,A9585OH,GADOBUTROL INJECTION,2.99,1.94,0.26,2.99,78
CDM,A9586OH,FLORBETAPIR F18,6543.0,4252.95,1.1,6543.0,74
CDM,A9587OH,GALLIUM GA-68,150.0,97.5,1.1,305.13,78
CDM,A9588OH,FLUCICLOVINE F-18,842.0,547.3,1.1,842.0,74
CDM,A9591OH,FLUOROESTRADIOL F 18 DIAGNOSTIC 1 MCI,11557.0,7512.05,1.1,11557.0,74
CDM,A9592OH,COPPER CU-64 DOTATATE DIAGNOSTIC 1 MCI,7993.0,5195.45,1.1,7993.0,74
CDM,A9595OH,F-18 PSMA PYLARIFY,746.0,484.9,1.1,1775.38,74
CDM,A9606OH,RADIUM RA223 DICHLORIDE THER,303.0,196.95,1.1,644.9,78
CDM,A9607OH,"LUTETIUM LU 177 VIPIVOTIDE TETRAXETAN, THERAPEUTIC",460.0,299.0,1.1,1698.3,74
CDM,A9608OH,"FLOTUFOLASTAT F18, DIAGNOSTIC, 1 MILLICURIE",1329.0,863.85,1.1,1937.61,74
CDM,A96402OH,CHEMO ADMINISTRATION,1128.0,733.2,1.1,1128.0,144
CDM,A9699OH,NOC THERAPEUTIC RADIOPHARM,18025.0,11716.25,0.01,18025.0,80
CDM,A9700OH,ECHOCARDIOGRAPHY CONTRAST,347.2,225.68,1.1,347.2,80
CDM,A9800OH,"GALLIUM GA-68 GOZETOTIDE, DIG (LOCAMETZ), 1 MCI",1648.0,1071.2,1.1,2672.25,74
CDM,A9901OH,DELIVERY/SET UP/DISPENSING,100.0,65.0,0.01,3061000.0,80
CDM,A99202OH,NEW PATIENT VISIT LEVEL II,286.0,185.9,1.1,286.0,152
CDM,A99203OH,NEW PATIENT VISIT LEVEL III,429.0,278.85,1.1,429.0,152
CDM,A99204OH,NEW PATIENT LEVEL COMPLETE,686.0,445.9,1.1,686.0,152
CDM,A99205OH,NEW PATIENT VISIT LEVEL V,716.0,465.4,1.1,716.0,152
CDM,A99211OH,ESTABLISHED PATIENT LEVEL I,177.0,115.05,1.1,177.0,152
CDM,A99212OH,EST PATIENT VISIT LEVEL II,280.0,182.0,1.1,280.0,152
CDM,A99213OH,EST PATIENT VISIT LEVEL III,520.0,338.0,1.1,520.0,152
CDM,A99214OH,ESTABLISHED PATIENT LEVEL IV,515.0,334.75,1.1,515.0,152
CDM,A99215OH,EST PATIENT VISIT LEVEL V,707.0,459.55,1.1,707.0,152
CDM,A99221OH,"INITIAL HOSPITAL CARE,LEVL I",652.0,423.8,1.1,652.0,146
CDM,A99242OH,OFFICE/OP CONSLTJ NEW/EST PT SF MDM 20 MINUTES,319.0,207.35,1.1,319.0,120
CDM,A99243OH,OFFICE/OP CONSLTJ NEW/EST PT LOW MDM 30 MINUTES,449.0,291.85,1.1,449.0,120
CDM,A99245OH,OFFICE/OP CONSLTJ NEW/EST PT HIGH MDM 55 MINUTES,900.0,585.0,1.1,900.0,120
CDM,AA4550OH,SURGICAL TRAY,668.0,434.2,1.1,668.0,86
CDM,AJ9030OH,BCG LIVE INTRAVESICAL INSTILLATION 1 MG,711.75,462.64,1.1,711.75,78
CDM,AJ9217OH,LUPRON,1288.0,837.2,1.1,1288.0,78
CDM,ANE120OH,ELECTIVE COSMETIC ANESTHESIA UNDER AN HOUR,176.0,114.4,1.1,176.0,68
CDM,ANE125OH,ELECTIVE COSMETIC ANESTHESIA HOUR AND ABOVE,87.75,57.04,1.1,87.75,68
CDM,AP9612OH,CATHETERIZATION,63.0,40.95,1.1,63.0,90
CDM,B4082OH,NASOGASTRIC TUBING,23.92,15.55,1.1,49.41,90
CDM,C1767OH,"GENERATOR, NEURO NON-RECHARG",15175.0,9863.75,1.1,15175.0,68
CDM,C1778OH,"LEAD, NEUROSTIMULATOR",2145.0,1394.25,1.1,2145.0,68
CDM,C1787OH,"PATIENT PROGR, NEUROSTIM",1315.0,854.75,1.1,1315.0,68
CDM,C1830OH,POWER BONE MARROW BX NEEDLE,149.0,96.85,1.1,149.0,68
CDM,C1897OH,"LEAD, NEUROSTIM TEST KIT",1095.0,711.75,1.1,1095.0,68
CDM,C2617OH,"STENT, NON-COR, TEM W/O DEL",3289.0,2137.85,1.1,3289.0,68
CDM,C7568OH,COR ANGIO W/FLOW RESRV,3045.0,1979.25,1.1,3045.0,68
CDM,C7569OH,PTCA W/ IVUS OR OCT,5702.0,3706.3,1.1,5702.0,68
CDM,C7570OH,COR ANGIO W/FFR & 3D MAP,2605.0,1693.25,1.1,2605.0,68
CDM,C7571OH,PCTA W/ COR LITHOTRIP,6129.0,3983.85,1.1,6129.0,68
CDM,C9113OH,"INJ PANTOPRAZOLE SODIUM, VIA",82.0,53.3,1.1,82.0,68
CDM,C9257OH,PR BEVACIZUMAB INJECTION,77.0,50.05,1.1,77.0,68
CDM,C9809OH,GEN 2 SMART TIP 190,700.0,455.0,1.1,700.0,68
CDM,C9810OH,COLD THERAPY NON-OPIOID DEV,174.0,113.1,1.1,174.0,68
CDM,C9817OH,CRYPNM CMPRS NONOPIOID DEV,174.0,113.1,1.1,174.0,68
CDM,CEJ3590AOH,JUVEDERM ULTRA .55 CC,600.0,390.0,1.1,600.0,68
CDM,CEJ3590BOH,JUVEDERM ULTRA 1 CC,1200.0,780.0,1.1,1200.0,68
CDM,CEJ3590COH,RESTYLANE  .5 CC,600.0,390.0,1.1,600.0,68
CDM,CEJ3590DOH,RESTYLANE 1 CC SYRINGE,1200.0,780.0,1.1,1200.0,68
CDM,CEJ3590EOH,JUVEDERM VOLBELLA 0.55CC SYRINGE,600.0,390.0,1.1,600.0,68
CDM,CEJ3590FOH,JUVEDERM VOLBELLA 1CC SYRINGE,1200.0,780.0,1.1,1200.0,68
CDM,COSANES105OH,COSMETIC ANES 1 HOUR 45 MINUTES,1351.0,878.15,1.1,1351.0,68
CDM,COSANES120OH,COSMETIC ANES 2 HOURS,1448.0,941.2,1.1,1448.0,68
CDM,COSANES135OH,COSMETIC ANES 2 HOURS 15 MINUTES,1544.0,1003.6,1.1,1544.0,68
CDM,COSANES150OH,COSMETIC ANES 2 HOURS 30 MINUTES,1641.0,1066.65,1.1,1641.0,68
CDM,COSANES165OH,COSMETIC ANES 2 HOURS 45 MINUTES,1737.0,1129.05,1.1,1737.0,68
CDM,COSANES180OH,COSMETIC ANES 3 HOURS,1834.0,1192.1,1.1,1834.0,68
CDM,COSANES195OH,COSMETIC ANES 3 HOURS 15 MINUTES,1930.0,1254.5,1.1,1930.0,68
CDM,COSANES210OH,COSMETIC ANES 3 HOURS 30 MINUTES,2027.0,1317.55,1.1,2027.0,68
CDM,COSANES225OH,COSMETIC ANES 3 HOURS 45 MINUTES,2123.0,1379.95,1.1,2123.0,68
CDM,COSANES240OH,COSMETIC ANES 4 HOURS,2220.0,1443.0,1.1,2220.0,68
CDM,COSANES255OH,COSMETIC ANES 4 HOURS 15 MINUTES,2316.0,1505.4,1.1,2316.0,68
CDM,COSANES270OH,COSMETIC ANES 4 HOURS 30 MINUTES,2413.0,1568.45,1.1,2413.0,68
CDM,COSANES285OH,COSMETIC ANES 4 HOURS 45 MINUTES,2509.0,1630.85,1.1,2509.0,68
CDM,COSANES300OH,COSMETIC ANES 5 HOURS,2606.0,1693.9,1.1,2606.0,68
CDM,COSANES30OH,COSMETIC ANES 30 MINUTES,579.0,376.35,1.1,579.0,68
CDM,COSANES315OH,COSMETIC ANES 5 HOURS 15 MINUTES,2702.0,1756.3,1.1,2702.0,68
CDM,COSANES330OH,COSMETIC ANES 5 HOURS 30 MINUTES,2799.0,1819.35,1.1,2799.0,68
CDM,COSANES345OH,COSMETIC ANES 5 HOURS 45 MINUTES,2895.0,1881.75,1.1,2895.0,68
CDM,COSANES360OH,COSMETIC ANES 6 HOURS,2992.0,1944.8,1.1,2992.0,68
CDM,COSANES375OH,COSMETIC ANES 6 HOURS 15 MINUTES,3088.0,2007.2,1.1,3088.0,68
CDM,COSANES390OH,COSMETIC ANES 6 HOURS 30 MINUTES,3185.0,2070.25,1.1,3185.0,68
CDM,COSANES405OH,COSMETIC ANES 6 HOURS 45 MINUTES,3281.0,2132.65,1.1,3281.0,68
CDM,COSANES420OH,COSMETIC ANES 7 HOURS,3378.0,2195.7,1.1,3378.0,68
CDM,COSANES435OH,COSMETIC ANES 7 HOURS 15 MINUTES,3474.0,2258.1,1.1,3474.0,68
CDM,COSANES450OH,COSMETIC ANES 7 HOURS 30 MINUTES,3571.0,2321.15,1.1,3571.0,68
CDM,COSANES45OH,COSMETIC ANES 45 MINUTES,772.0,501.8,1.1,772.0,68
CDM,COSANES465OH,COSMETIC ANES 7 HOURS 45 MINUTES,3667.0,2383.55,1.1,3667.0,68
CDM,COSANES480OH,COSMETIC ANES 8 HOURS,3764.0,2446.6,1.1,3764.0,68
CDM,COSANES495OH,COSMETIC ANES 8 HOURS 15 MINUTES,3860.0,2509.0,1.1,3860.0,68
CDM,COSANES510OH,COSMETIC ANES 8 HOURS 30 MINUTES,3957.0,2572.05,1.1,3957.0,68
CDM,COSANES525OH,COSMETIC ANES 8 HOURS 45 MINUTES,4053.0,2634.45,1.1,4053.0,68
CDM,COSANES540OH,COSMETIC ANES 9 HOURS,4150.0,2697.5,1.1,4150.0,68
CDM,COSANES555OH,COSMETIC ANES 9 HOURS 15 MINUTES,4247.0,2760.55,1.1,4247.0,68
CDM,COSANES570OH,COSMETIC ANES 9 HOURS 30 MINUTES,4343.0,2822.95,1.1,4343.0,68
CDM,COSANES585OH,COSMETIC ANES 9 HOURS 45 MINUTES,4440.0,2886.0,1.1,4440.0,68
CDM,COSANES600OH,COSMETIC ANES 10 HOURS,4536.0,2948.4,1.1,4536.0,68
CDM,COSANES60OH,COSMETIC ANES 1 HOUR,1062.0,690.3,1.1,1062.0,68
CDM,COSANES75OH,COSMETIC ANES 1 HOUR 15 MINUTES,1158.0,752.7,1.1,1158.0,68
CDM,COSANES90OH,COSMETIC ANES 1 HOUR 30 MINUTES,1258.0,817.7,1.1,1258.0,68
CDM,COSNANES100OH,NON CCF PHYSICIANS COSMETIC CASES,1351.0,878.15,1.1,1351.0,68
CDM,COSOR105,COSMETIC OR 1 HOUR 45 MINUTES,1925.0,1251.25,419.65,1925.0,58
CDM,COSOR120,COSMETIC OR 2 HOURS,2200.0,1430.0,479.6,2200.0,58
CDM,COSOR135,COSMETIC OR 2 HOURS 15 MINUTES,2475.0,1608.75,539.55,2475.0,58
CDM,COSOR150,COSMETIC OR 2 HOURS 30 MINUTES,2750.0,1787.5,599.5,2750.0,58
CDM,COSOR165,COSMETIC OR 2 HOURS 45 MINUTES,3025.0,1966.25,659.45,3025.0,58
CDM,COSOR180,COSMETIC OR 3 HOURS,3300.0,2145.0,719.4,3300.0,58
CDM,COSOR195,COSMETIC OR 3 HOURS 15 MINUTES,3575.0,2323.75,779.35,3575.0,58
CDM,COSOR210,COSMETIC OR 3 HOURS 30 MINUTES,3850.0,2502.5,839.3,3850.0,58
CDM,COSOR225,COSMETIC OR 3 HOURS 45 MINUTES,4125.0,2681.25,899.25,4125.0,58
CDM,COSOR240,COSMETIC OR 4 HOURS,4400.0,2860.0,959.2,4400.0,58
CDM,COSOR255,COSMETIC OR 4 HOURS 15 MINUTES,4675.0,3038.75,1019.15,4675.0,58
CDM,COSOR270,COSMETIC OR 4 HOURS 30 MINUTES,4950.0,3217.5,1079.1,4950.0,58
CDM,COSOR285,COSMETIC OR 4 HOURS 45 MINUTES,5225.0,3396.25,1139.05,5225.0,58
CDM,COSOR30,COSMETIC OR 30 MINUTES,962.0,625.3,209.72,962.0,58
CDM,COSOR300,COSMETIC OR 5 HOURS,5500.0,3575.0,1199.0,5500.0,58
CDM,COSOR315,COSMETIC OR 5 HOURS 15 MINUTES,5775.0,3753.75,1258.95,5775.0,58
CDM,COSOR330,COSMETIC OR 5 HOURS 30 MINUTES - 9 HOURS 30 MINUTES,7837.0,5094.05,1708.47,7837.0,58
CDM,COSOR45,COSMETIC OR 45 MINUTES,1082.0,703.3,235.88,1082.0,58
CDM,COSOR60,COSMETIC OR 1 HOUR,1100.0,715.0,239.8,1100.0,58
CDM,COSOR75,COSMETIC OR 1 HOUR 15 MINUTES,1375.0,893.75,299.75,1375.0,58
CDM,COSOR90,COSMETIC OR 1 HOUR 30 MINUTES,1650.0,1072.5,359.7,1650.0,58
CDM,D0120OH,PERIODIC ORAL EVALUATION - ESTABLISHED PATIENT,95.0,61.75,1.1,95.0,86
CDM,D0140OH,LIMITED ORAL EVALUATION - PROBLEM FOCUSED,125.0,81.25,1.1,145.11,86
CDM,D0145OH,ORAL EVALUATION FOR A PATIENT UNDER THREE YEARS OF AGE AND COUNS,100.0,65.0,1.1,100.0,86
CDM,D0150OH,COMPREHENSIVE ORAL EVALUATION - NEW OR ESTABLISHED PATIENT,160.0,104.0,1.1,424.99,86
CDM,D0160OH,"DETAILED AND EXTENSIVE ORAL EVALUATION - PROBLEM FOCUSED, BY REP",225.0,146.25,1.1,424.99,86
CDM,D0170OH,"RE-EVALUATION - LIMITED, PROBLEM FOCUSED (ESTABLISHED PATIENT; N",115.0,74.75,1.1,424.99,86
CDM,D0180.1OH,ANNUAL PERIDONTAL RECALL,160.0,104.0,1.1,286.78,86
CDM,D0180OH,COMPREHENSIVE PERIODONTAL EVALUATION - NEW OR ESTABLISHED PATIEN,160.0,104.0,1.1,286.78,86
CDM,D0190OH,SCREENING OF A PATIENT,120.0,78.0,1.1,120.0,86
CDM,D0191OH,ASSESSMENT OF A PATIENT,120.0,78.0,1.1,120.0,86
CDM,D0210OH,INTRAORAL - COMPREHENSIVE OF RADIOGRAPHIC IMAGES,200.0,130.0,1.1,279.87,86
CDM,D0220OH,INTRAORAL - PERIAPICAL FIRST RADIOGRAPHIC IMAGE,50.0,32.5,1.1,51.83,86
CDM,D0230OH,INTRAORAL - PERIAPICAL EACH ADDITIONAL RADIOGRAPHIC IMAGE,40.0,26.0,1.1,41.46,86
CDM,D0240OH,INTRAORAL - OCCLUSAL RADIOGRAPHIC IMAGE,50.0,32.5,1.1,79.47,86
CDM,D0250OH,EXTRA-ORAL ? 2D PROJECTION RADIOGRAPHIC IMAGE CREATED USING A ST,80.0,52.0,1.1,107.11,86
CDM,D0251OH,EXTRA-ORAL POSTERIOR DENTAL RADIOGRAPHIC IMAGE,100.0,65.0,1.1,141.67,86
CDM,D0270OH,BITEWING - SINGLE RADIOGRAPHIC IMAGE,45.0,29.25,1.1,55.28,86
CDM,D0272OH,BITEWINGS - TWO RADIOGRAPHIC IMAGES,75.0,48.75,1.1,82.92,86
CDM,D0273OH,BITEWINGS - THREE RADIOGRAPHIC IMAGES,85.0,55.25,1.1,85.0,86
CDM,D0274OH,BITEWINGS - FOUR RADIOGRAPHIC IMAGES,100.0,65.0,1.1,117.48,86
CDM,D0277OH,VERTICAL BITEWINGS - 7 TO 8 RADIOGRAPHIC IMAGES,150.0,97.5,1.1,150.0,86
CDM,D0310OH,DENTAL SALIOGRAPHY,500.0,325.0,1.1,967.45,86
CDM,D0320OH,DENTAL TMJ ARTHROGRAM INCL I,750.0,487.5,1.1,1658.49,86
CDM,D0321OH,"OTHER TEMPOROMANDIBULAR JOINT RADIOGRAPHIC IMAGES, BY REPORT",250.0,162.5,1.1,1658.49,86
CDM,D0322OH,TOMOGRAPHIC SURVEY,650.0,422.5,1.1,1330.25,86
CDM,D0330OH,PANORAMIC RADIOGRAPHIC IMAGE,175.0,113.75,1.1,228.04,86
CDM,D0340OH,"2D CEPHALOMETRIC RADIOGRAPHIC IMAGE ? ACQUISITION, MEASUREMENT A",170.0,110.5,1.1,283.32,86
CDM,D0350OH,2D ORAL/FACIAL PHOTOGRAPHIC IMAGE OBTAINED INTRA-ORALLY OR EXTRA,100.0,65.0,1.1,283.32,86
CDM,D0364OH,CONE BEAM CT CAPTURE AND INTERPRETATION WITH LIMITED FIELD OF VI,350.0,227.5,1.1,524.1,86
CDM,D0365OH,CONE BEAM CT CAPTURE AND INTERPRETATION WITH FIELD OF VIEW OF ON,400.0,260.0,1.1,524.1,86
CDM,D0366OH,CONE BEAM CT CAPTURE AND INTERPRETATION WITH FIELD OF VIEW OF ON,400.0,260.0,1.1,524.1,86
CDM,D0367OH,CONE BEAM CT CAPTURE AND INTERPRETATION WITH FIELD OF VIEW OF BO,400.0,260.0,1.1,524.1,86
CDM,D0368OH,CONE BEAM CT CAPTURE AND INTERPRETATION FOR TMJ SERIES INCLUDING,500.0,325.0,1.1,766.86,86
CDM,D0369OH,MAXILLOFACIAL MRI CAPTURE AND INTERPRETATION,900.0,585.0,1.1,1364.8,86
CDM,D0370OH,MAXILLOFACIAL ULTRASOUND CAPTURE AND INTERPRETATION,650.0,422.5,1.1,650.0,86
CDM,D0371OH,SIALOENDOSCOPY CAPTURE AND INTERPRETATION,650.0,422.5,1.1,650.0,86
CDM,D0372OH,INTRAORAL TOMOSYNTHESIS ? COMPREHENSIVE SERIES OF RADIOGRAPHIC I,250.0,162.5,1.1,338.62,86
CDM,D0373OH,INTRAORAL TOMOSYNTHESIS ? BITEWING RADIOGRAPHIC IMAGE,50.0,32.5,1.1,65.65,86
CDM,D0374OH,INTRAORAL TOMOSYNTHESIS ? PERIAPICAL RADIOGRAPHIC IMAGE,50.0,32.5,1.1,72.56,86
CDM,D0380OH,CONE BEAM CT IMAGE CAPTURE WITH LIMITED FIELD OF VIEW ? LESS THA,400.0,260.0,1.1,418.41,86
CDM,D0381OH,CONE BEAM CT IMAGE CAPTURE WITH FIELD OF VIEW OF ONE FULL DENTAL,400.0,260.0,1.1,418.41,86
CDM,D0382OH,CONE BEAM CT IMAGE CAPTURE WITH FIELD OF VIEW OF ONE FULL DENTAL,400.0,260.0,1.1,418.41,86
CDM,D0383OH,CONE BEAM CT IMAGE CAPTURE WITH FIELD OF VIEW OF BOTH JAWS; WITH,400.0,260.0,1.1,418.41,86
CDM,D0384OH,CONE BEAM CT IMAGE CAPTURE FOR TMJ SERIES INCLUDING TWO OR MORE,500.0,325.0,1.1,611.83,86
CDM,D0385OH,MAXILLOFACIAL MRI IMAGE CAPTURE,700.0,455.0,1.1,991.0,86
CDM,D0386OH,MAXILLOFACIAL ULTRASOUND IMAGE CAPTURE,360.0,234.0,1.1,360.0,86
CDM,D0387OH,INTRAORAL TOMOSYNTHESIS ? COMPREHENSIVE SERIES OF RADIOGRAPHIC I,100.0,65.0,0.01,122.85,86
CDM,D0388OH,INTRAORAL TOMOSYNTHESIS ? BITEWING RADIOGRAPHIC IMAGE ? IMAGE CA,30.0,19.5,0.01,31.0,86
CDM,D0389OH,INTRAORAL TOMOSYNTHESIS ? PERIAPICAL RADIOGRAPHIC IMAGE ? IMAGE,30.0,19.5,0.01,31.0,86
CDM,D0391OH,INTERPRETATION OF DIAGNOSTIC IMAGE BY A PRACTITIONER NOT ASSOCIA,375.0,243.75,1.1,486.59,86
CDM,D0393OH,VIRTUAL TREATMENT SIMULATION USING 3D IMAGE VOLUME OR SURFACE SC,400.0,260.0,1.1,623.76,74
CDM,D0394OH,DIGITAL SUBTRACTION OF TWO OR MORE IMAGES OR IMAGE VOLUMES OF TH,400.0,260.0,1.1,400.0,74
CDM,D0395OH,FUSION OF TWO OR MORE 3D IMAGE VOLUMES OF ONE OR MORE MODALITIES,450.0,292.5,1.1,450.0,74
CDM,D0396OH,PRINTING OF A 3D DENTAL SURFACE SCAN,100.0,65.0,1.1,190.04,86
CDM,D0411OH,HBA1C IN-OFFICE POINT OF SERVICE TESTING,100.0,65.0,1.1,100.0,74
CDM,D0412OH,BLOOD GLUCOSE LEVEL TEST ? IN-OFFICE USING A GLUCOSE METER,100.0,65.0,0.01,100.0,86
CDM,D0414OH,LABORATORY PROCESSING OF MICROBIAL SPECIMEN TO INCLUDE CULTURE A,250.0,162.5,0.01,250.0,86
CDM,D0415OH,COLLECTION OF MICROORGANISMS FOR CULTURE AND SENSITIVITY,270.0,175.5,1.1,270.0,86
CDM,D0416OH,VIRAL CULTURE,200.0,130.0,1.1,200.0,86
CDM,D0417OH,COLLECTION AND PREPERATION OF SALIVA SAMPLE FOR LABORATORY ANALY,275.0,178.75,1.1,275.0,86
CDM,D0418OH,ANALYSIS OF SALIVA SAMPLE - LABORATORY,200.0,130.0,1.1,200.0,86
CDM,D0419OH,ASSESSMENT OF SALIVARY FLOW BY MEASUREMENT,200.0,130.0,1.1,200.0,74
CDM,D0422OH,COLLECTION AND PREPARATION OF GENETIC SAMPLE MATERIAL FOR LABORA,200.0,130.0,1.1,200.0,86
CDM,D0423OH,GENETIC TEST FOR SUSCEPTIBILITY TO DISEASES ? SPECIMEN ANALYSIS,300.0,195.0,1.1,300.0,80
CDM,D0425OH,CARIES SUSCEPTIBILITY TESTS,125.0,81.25,1.1,125.0,86
CDM,D0426OH,"COLLECTION, PREPARATION, AND ANALYSIS OF SALIVA SAMPLE ? POINT-O",200.0,130.0,1.1,200.0,68
CDM,D0431OH,ADJUNCTIVE PRE-DIAGNOSTIC TEST THAT AIDS IN DETECTION OF MUCOSAL,85.0,55.25,1.1,85.0,86
CDM,D0460OH,PULP VITALITY TESTS,75.0,48.75,1.1,89.84,86
CDM,D0461OH,TESTING FOR CRACKED TOOTH,75.0,48.75,1.1,75.0,68
CDM,D0470OH,DIAGNOSTIC CASTS,180.0,117.0,1.1,193.49,86
CDM,D0472OH,"ACCESSION OF TISSUE, GROSS EXAMINATION, PREPARATION AND TRANSMIS",200.0,130.0,1.1,200.0,86
CDM,D0473OH,"ACCESSION OF TISSUE, GROSS AND MICROSCOPIC EXAMINATION, PREPARAT",250.0,162.5,1.1,250.0,86
CDM,D0474OH,"ACCESSION OF TISSUE, GROSS AND MICROSCOPIC EXAMINATION, INCLUDIN",275.0,178.75,1.1,275.0,86
CDM,D0475OH,DECALCIFICATION PROCEDURE,300.0,195.0,1.1,300.0,86
CDM,D0476OH,SPECIAL STAINS FOR MICROORGANISMS,375.0,243.75,1.1,375.0,86
CDM,D0477OH,"SPECIAL STAINS, NOT FOR MICROORGANISMS",400.0,260.0,1.1,400.0,86
CDM,D0478OH,IMMUNOHISTOCHEMICAL STAINS,200.0,130.0,1.1,207.31,86
CDM,D0479OH,"TISSUE IN-SITU HYBRIDIZATION, INCLUDING INTERPRETATION",300.0,195.0,1.1,300.0,86
CDM,D0480OH,"ACCESSION OF EXFOLIATIVE CYTOLOGIC SMEARS, MICROSCOPIC EXAMINATI",200.0,130.0,1.1,200.0,86
CDM,D0482OH,DIRECT IMMUNOFLUORESCENCE,150.0,97.5,1.1,150.0,86
CDM,D0483OH,INDIRECT IMMUNOFLUORESCENCE,175.0,113.75,1.1,175.0,86
CDM,D0484OH,CONSULTATION ON SLIDES PREPARED ELSEWHERE,200.0,130.0,1.1,200.0,86
CDM,D0485OH,"CONSULTATION, INCLUDING PREPARATION OF SLIDES FROM BIOPSY MATERI",400.0,260.0,1.1,400.0,86
CDM,D0486OH,"LABORATORY ACCESSION OF TRANSEPITHELIAL CYTOLOGIC SAMPLE, MICROS",100.0,65.0,1.1,172.76,86
CDM,D0502OH,"OTHER ORAL PATHOLOGY PROCEDURES, BY REPORT",200.0,130.0,0.01,200.0,86
CDM,D0600OH,"NON-IONIZING DIAGNOSTIC PROCEDURE CAPABLE OF QUANTIFYING, MONITO",100.0,65.0,0.01,100.0,80
CDM,D0601OH,"CARIES RISK ASSESSMENT AND DOCUMENTATION, WITH A FINDING OF LOW",100.0,65.0,1.1,100.0,74
CDM,D0602OH,"CARIES RISK ASSESSMENT AND DOCUMENTATION, WITH A FINDING OF MODE",100.0,65.0,1.1,100.0,74
CDM,D0603OH,"CARIES RISK ASSESSMENT AND DOCUMENTATION, WITH A FINDING OF HIGH",100.0,65.0,1.1,100.0,74
CDM,D0801OH,3D INTRAORAL SURFACE SCAN - DIRECT,200.0,130.0,0.01,244.37,86
CDM,D0802OH,DENTAL SURFACE SCAN 3D ? INDIRECT,200.0,130.0,0.01,244.37,86
CDM,D0803OH,FACIAL SURFACE SCAN 3D ? DIRECT,200.0,130.0,0.01,200.0,86
CDM,D0804OH,FACIAL SURFACE SCAN 3D ? INDIRECT,200.0,130.0,0.01,200.0,86
CDM,D0999.1OH,"DIAGNOSTIC WAX UP, PER TOOTH",250.0,162.5,1.1,250.0,68
CDM,D0999OH,"UNSPECIFIED DIAGNOSTIC PROCEDURE, BY REPORT",250.0,162.5,0.01,250.0,80
CDM,D1110.3OH,PROPHYLAXIS-ADULT PARTIAL MOUTH,75.0,48.75,1.1,165.86,86
CDM,D1110OH,PROPHYLAXIS - ADULT,125.0,81.25,1.1,165.86,86
CDM,D1120OH,PROPHYLAXIS - CHILD,100.0,65.0,1.1,114.02,86
CDM,D1206OH,TOPICAL APPLICATION OF FLUORIDE VARNISH,50.0,32.5,1.1,176.21,86
CDM,D1208OH,TOPICAL APPLICATION OF FLUORIDE ? EXCLUDING VARNISH,50.0,32.5,1.1,72.56,86
CDM,D1320OH,TOBACCO COUNSELING FOR THE CONTROL AND PREVENTION OF ORAL DISEAS,30.0,19.5,1.1,93.29,86
CDM,D1351OH,SEALANT - PER TOOTH,75.0,48.75,1.1,103.66,86
CDM,D1353OH,SEALANT REPAIR ? PER TOOTH,75.0,48.75,1.1,107.8,86
CDM,D1354OH,INTERIM CARIES ARRESTING MEDICAMENT APPLICATION ? PER TOOTH,125.0,81.25,1.1,167.45,86
CDM,D1510OH,SPACE MAINTAINER - FIXED - UNILATERAL,450.0,292.5,1.1,670.31,86
CDM,D1516OH,"SPACE MAINTAINER ? FIXED ? BILATERAL, MAXILLARY",500.0,325.0,1.1,1371.71,86
CDM,D1517OH,"SPACE MAINTAINER ? FIXED ? BILATERAL, MANDIBULAR",550.0,357.5,1.1,1371.71,86
CDM,D1520OH,SPACE MAINTAINER - REMOVABLE - UNILATERAL,500.0,325.0,1.1,832.7,86
CDM,D1526OH,"SPACE MAINTAINER ? REMOVABLE ? BILATERAL, MAXILLARY",600.0,390.0,1.1,1285.32,86
CDM,D1527OH,"SPACE MAINTAINER ? REMOVABLE ? BILATERAL, MANDIBULAR",600.0,390.0,1.1,1285.32,86
CDM,D1551OH,RE-CEMENT OR RE-BOND BILATERAL SPACE MAINTAINER - MAXILLARY,150.0,97.5,1.1,179.67,86
CDM,D1552OH,RE-CEMENT OR RE-BOND BILATERAL SPACE MAINTAINER - MANDIBULAR,150.0,97.5,1.1,179.67,86
CDM,D1553OH,RE-CEMENT OR RE-BOND UNILATERAL SPACE MAINTAINER - PER QUADRANT,160.0,104.0,1.1,160.0,86
CDM,D1556OH,REMOVAL OF FIXED UNILATERAL SPACE MAINTAINER - PER QUADRANT,150.0,97.5,1.1,179.67,86
CDM,D1557OH,REMOVAL OF FIXED BILATERAL SPACE MAINTAINER - MAXILLARY,165.0,107.25,1.1,179.67,86
CDM,D1558OH,REMOVAL OF FIXED BILATERAL SPACE MAINTAINER - MANDIBULAR,180.0,117.0,1.1,180.0,86
CDM,D1575OH,DISTAL SHOE SPACE MAINTAINER ? FIXED ? UNILATERAL,520.0,338.0,1.1,863.79,86
CDM,D1720OH,INFLUENZA VACCINE ADMINISTRATION,200.0,130.0,1.1,200.0,68
CDM,D1781OH,VACCINE ADMINISTRATION ? HUMAN PAPILLOMAVIRUS ? DOSE 1,200.0,130.0,0.01,200.0,86
CDM,D1782OH,VACCINE ADMINISTRATION ? HUMAN PAPILLOMAVIRUS ? DOSE 2,200.0,130.0,0.01,200.0,86
CDM,D1783OH,VACCINE ADMINISTRATION ? HUMAN PAPILLOMAVIRUS ? DOSE 3,200.0,130.0,0.01,200.0,86
CDM,D1999OH,"UNSPECIFIED PREVENTIVE PROCEDURE, BY REPORT",160.0,104.0,1.1,160.0,68
CDM,D2140OH,"AMALGAM - ONE SURFACE, PRIMARY OR PERMANENT",200.0,130.0,1.1,231.49,86
CDM,D2150OH,"AMALGAM - TWO SURFACES, PRIMARY OR PERMANENT",280.0,182.0,1.1,300.61,86
CDM,D2160OH,"AMALGAM - THREE SURFACES, PRIMARY OR PERMANENT",350.0,227.5,1.1,362.8,86
CDM,D2161OH,"AMALGAM - FOUR OR MORE SURFACES, PRIMARY OR PERMANENT",400.0,260.0,1.1,442.26,86
CDM,D2330OH,"RESIN-BASED COMPOSITE - ONE SURFACE, ANTERIOR",260.0,169.0,1.1,276.42,86
CDM,D2331OH,"RESIN-BASED COMPOSITE - TWO SURFACES, ANTERIOR",300.0,195.0,1.1,352.43,86
CDM,D2332OH,"RESIN-BASED COMPOSITE - THREE SURFACES, ANTERIOR",350.0,227.5,1.1,428.44,86
CDM,D2335OH,RESIN-BASED COMPOSITE - FOUR OR MORE SURFACES (ANTERIOR),450.0,292.5,1.1,507.91,86
CDM,D2390OH,"RESIN-BASED COMPOSITE CROWN, ANTERIOR",700.0,455.0,1.1,700.0,86
CDM,D2391OH,"RESIN-BASED COMPOSITE - ONE SURFACE, POSTERIOR",275.0,178.75,1.1,310.96,86
CDM,D2392OH,"RESIN-BASED COMPOSITE - TWO SURFACES, POSTERIOR",350.0,227.5,1.1,428.44,86
CDM,D2393OH,"RESIN-BASED COMPOSITE - THREE SURFACES, POSTERIOR",425.0,276.25,1.1,532.1,86
CDM,D2394OH,"RESIN-BASED COMPOSITE - FOUR OR MORE SURFACES, POSTERIOR",500.0,325.0,1.1,532.1,86
CDM,D2510OH,INLAY - METALLIC - ONE SURFACE,1300.0,845.0,1.1,1551.37,86
CDM,D2520OH,INLAY - METALLIC - TWO SURFACES,1400.0,910.0,1.1,1758.69,86
CDM,D2530OH,INLAY - METALLIC - THREE OR MORE SURFACES,1500.0,975.0,1.1,2028.19,86
CDM,D2542OH,ONLAY - METALLIC - TWO SURFACES,2000.0,1300.0,1.1,2073.11,86
CDM,D2543OH,ONLAY - METALLIC - THREE SURFACES,2000.0,1300.0,1.1,2080.02,86
CDM,D2544OH,ONLAY - METALLIC - FOUR OR MORE SURFACES,2000.0,1300.0,1.1,2162.94,86
CDM,D2610OH,INLAY - PORCELAIN/CERAMIC - ONE SURFACE,2000.0,1300.0,1.1,2000.0,86
CDM,D2620OH,INLAY - PORCELAIN/CERAMIC - TWO SURFACES,2000.0,1300.0,1.1,2000.0,86
CDM,D2630OH,INLAY - PORCELAIN/CERAMIC - THREE OR MORE SURFACES,2000.0,1300.0,1.1,2052.38,86
CDM,D2642OH,ONLAY - PORCELAIN/CERAMIC - TWO SURFACES,2000.0,1300.0,1.1,2000.0,86
CDM,D2643OH,ONLAY - PORCELAIN/CERAMIC - THREE SURFACES,2000.0,1300.0,1.1,2149.12,86
CDM,D2644OH,ONLAY - PORCELAIN/CERAMIC - FOUR OR MORE SURFACES,2000.0,1300.0,1.1,2280.42,86
CDM,D2650OH,INLAY - RESIN-BASED COMPOSITE - ONE SURFACE,2000.0,1300.0,1.1,2000.0,86
CDM,D2651OH,INLAY - RESIN-BASED COMPOSITE - TWO SURFACES,2000.0,1300.0,1.1,2000.0,86
CDM,D2652OH,INLAY - RESIN-BASED COMPOSITE - THREE OR MORE SURFACES,2000.0,1300.0,1.1,2000.0,86
CDM,D2662OH,ONLAY - RESIN-BASED COMPOSITE - TWO SURFACES,2000.0,1300.0,1.1,2000.0,86
CDM,D2663OH,ONLAY - RESIN-BASED COMPOSITE - THREE SURFACES,2000.0,1300.0,1.1,2000.0,86
CDM,D2664OH,ONLAY - RESIN-BASED COMPOSITE - FOUR OR MORE SURFACES,2000.0,1300.0,1.1,2055.84,86
CDM,D2710OH,CROWN - RESIN-BASED COMPOSITE (INDIRECT),1400.0,910.0,1.1,1400.0,86
CDM,D2712OH,CROWN - 3/4CROWN RESIN-BASED COMPOSITE (INDIRECT),1400.0,910.0,1.1,1400.0,86
CDM,D2720OH,CROWN - RESIN WITH HIGH NOBLE METAL,1600.0,1040.0,1.1,2280.42,86
CDM,D2721OH,CROWN - RESIN WITH PREDOMINANTLY BASE METAL,1500.0,975.0,1.1,2138.75,86
CDM,D2722OH,CROWN - RESIN WITH NOBLE METAL,1600.0,1040.0,1.1,2183.67,86
CDM,D2740.5OH,CEREC CROWN,1600.0,1040.0,1.1,1600.0,68
CDM,D2740OH,CROWN - PORCELAIN/CERAMIC,1600.0,1040.0,1.1,2342.62,86
CDM,D2750OH,CROWN - PORCELAIN FUSED TO HIGH NOBLE METAL,1675.0,1088.75,1.1,2308.07,86
CDM,D2751OH,CROWN - PORCELAIN FUSED TO PREDOMINANTLY BASE METAL,1525.0,991.25,1.1,2149.12,86
CDM,D2752OH,CROWN - PORCELAIN FUSED TO NOBLE METAL,1650.0,1072.5,1.1,2204.41,86
CDM,D2753OH,CROWN - PORCELAIN FUSED TO TITANIUM AND TITANIUM ALLOYS,1650.0,1072.5,1.1,2501.56,86
CDM,D2780OH,CROWN - 3/4 CAST HIGH NOBLE METAL,1650.0,1072.5,1.1,2073.11,86
CDM,D2781OH,CROWN - 3/4 CAST PREDOMINANTLY BASE METAL,1600.0,1040.0,1.1,2073.11,86
CDM,D2782OH,CROWN - 3/4 CAST NOBLE METAL,1625.0,1056.25,1.1,2073.11,86
CDM,D2783OH,CROWN - 3/4 PORCELAIN/CERAMIC,1625.0,1056.25,1.1,2073.11,86
CDM,D2790OH,CROWN - FULL CAST HIGH NOBLE METAL,1750.0,1137.5,1.1,2228.6,86
CDM,D2791OH,CROWN - FULL CAST PREDOMINANTLY BASE METAL,1625.0,1056.25,1.1,2111.12,86
CDM,D2792OH,CROWN - FULL CAST NOBLE METAL,1675.0,1088.75,1.1,2149.12,86
CDM,D2794OH,CROWN - TITANIUM,1650.0,1072.5,1.1,2149.12,86
CDM,D2799OH,PROVISIONAL CROWN? FURTHER TREATMENT OR COMPLETION OF DIAGNOSIS,600.0,390.0,1.1,2073.11,86
CDM,D2910OH,"RE-CEMENT OR RE-BOND INLAY, ONLAY, VENEER OR PARTIAL COVERAGE RE",175.0,113.75,1.1,200.4,86
CDM,D2915OH,RE-CEMENT OR RE-BOND INDIRECTLY FABRICATED OR PREFABRICATED POST,160.0,104.0,1.1,200.4,86
CDM,D2920OH,RE-CEMENT OR RE-BOND CROWN,180.0,117.0,1.1,207.31,86
CDM,D2921OH,"REATTACHMENT OF TOOTH FRAGMENT, INCISAL EDGE OR CUSP",350.0,227.5,1.1,350.0,74
CDM,D2929OH,PREFABRICATED PORCELAIN/CERAMIC CROWN ? PRIMARY TOOTH,550.0,357.5,1.1,550.0,86
CDM,D2930OH,PREFABRICATED STAINLESS STEEL CROWN - PRIMARY TOOTH,400.0,260.0,1.1,566.65,86
CDM,D2931OH,PREFABRICATED STAINLESS STEEL CROWN - PERMANENT TOOTH,500.0,325.0,1.1,639.21,86
CDM,D2932OH,PREFABRICATED RESIN CROWN,510.0,331.5,1.1,694.49,86
CDM,D2933OH,PREFABRICATED STAINLESS STEEL CROWN WITH RESIN WINDOW,500.0,325.0,1.1,780.87,86
CDM,D2934OH,PREFABRICATED ESTHETIC COATED STAINLESS STEEL CROWN - PRIMARY TO,500.0,325.0,1.1,780.87,86
CDM,D2940OH,PLACEMENT OF INTERIM DIRECT RESTORATION,200.0,130.0,1.1,214.22,86
CDM,D2941OH,INTERIM THERAPEUTIC RESTORATION ? PRIMARY DENTITION,275.0,178.75,1.1,275.0,68
CDM,D2949OH,RESTORATIVE FOUNDATION FOR AN INDIRECT RESTORATION,300.0,195.0,1.1,300.0,74
CDM,D2950OH,"CORE BUILDUP, INCLUDING ANY PINS WHEN REQUIRED",450.0,292.5,1.1,539.01,86
CDM,D2951OH,"PIN RETENTION - PER TOOTH, IN ADDITION TO RESTORATION",100.0,65.0,1.1,114.02,86
CDM,D2952OH,"POST AND CORE IN ADDITION TO CROWN, INDIRECTLY FABRICATED",600.0,390.0,1.1,822.34,86
CDM,D2953OH,EACH ADDITIONAL INDIRECTLY FABRICATED POST - SAME TOOTH,450.0,292.5,1.1,450.0,86
CDM,D2954OH,PREFABRICATED POST AND CORE IN ADDITION TO CROWN,450.0,292.5,1.1,680.67,86
CDM,D2955OH,POST REMOVAL,400.0,260.0,1.1,511.38,86
CDM,D2956OH,REMOVAL OF AN INDIRECT RESTORATION ON A NATURAL TOOTH,300.0,195.0,1.1,300.0,86
CDM,D2957OH,EACH ADDITIONAL PREFABRICATED POST - SAME TOOTH,300.0,195.0,1.1,300.0,86
CDM,D2960OH,LABIAL VENEER (RESIN LAMINATE) - CHAIRSIDE,1000.0,650.0,1.1,1668.85,86
CDM,D2961OH,LABIAL VENEER (RESIN LAMINATE) - LABORATORY,1500.0,975.0,1.1,1869.26,86
CDM,D2962OH,LABIAL VENEER (PORCELAIN LAMINATE) - LABORATORY,1700.0,1105.0,1.1,2031.65,86
CDM,D2971OH,ADDITIONAL PROCEDURES TO CONSTRUCT NEW CROWN UNDER EXISTING PART,425.0,276.25,1.1,483.73,86
CDM,D2975OH,COPING,900.0,585.0,1.1,900.0,86
CDM,D2980OH,CROWN REPAIR NECESSITATED BY RESTORATIVE MATERIAL FAILURE,400.0,260.0,1.1,570.11,86
CDM,D2981OH,INLAY REPAIR NECESSITATED BY RESTORATIVE MATERIAL FAILURE,400.0,260.0,1.1,400.0,80
CDM,D2982OH,ONLAY REPAIR NECESSITATED BY RESTORATIVE MATERIAL FAILURE,400.0,260.0,1.1,400.0,80
CDM,D2983OH,VENEER REPAIR NECESSITATED BY RESTORATIVE MATERIAL FAILURE,430.0,279.5,1.1,430.0,80
CDM,D2989OH,EXCAVATION OF A TOOTH RESULTING IN THE DETERMINATION OF NON-REST,200.0,130.0,1.1,200.0,86
CDM,D2990OH,RESIN INFILTRATION OF INCIPIENT SMOOTH SURFACE LESIONS,50.0,32.5,1.1,214.22,86
CDM,D2991OH,APPLICATION OF HYDROXYAPATITE REGENERATION MEDICAMENT ? PER TOOT,200.0,130.0,1.1,246.24,86
CDM,D2999.11OH,OPALESCENCE 15% 10 DAY NON-CUSTOM,75.0,48.75,0.01,75.0,80
CDM,D2999.12OH,OPALESCENCE 15% 4 DAY NON-CUSTOM,50.0,32.5,0.01,50.0,80
CDM,D2999.13OH,OPALESCENCE 10% 10 DAY NON-CUSTOM,75.0,48.75,0.01,75.0,80
CDM,D2999.14OH,OPALESCENCE 10% 4 DAY NON-CUSTOM,50.0,32.5,0.01,50.0,80
CDM,D2999.2OH,CREST WHITESTRIPS,60.0,39.0,0.01,60.0,80
CDM,D2999.3OH,CUSTOM WHITENING TRAYS - 2 TRAYS,300.0,195.0,0.01,300.0,80
CDM,D2999.4OH,CUSTOM WHITENING TRAYS - 1 TRAY,200.0,130.0,0.01,200.0,80
CDM,D2999.5OH,TOUCH UP KIT 35% - 4 SYRINGES,40.0,26.0,0.01,40.0,80
CDM,D2999.8OH,IN OFFICE WHITENING,350.0,227.5,1.1,350.0,68
CDM,D2999OH,"UNSPECIFIED RESTORATIVE PROCEDURE, BY REPORT",400.0,260.0,0.01,400.0,80
CDM,D3110OH,PULP CAP - DIRECT (EXCLUDING FINAL RESTORATION),125.0,81.25,1.1,141.67,86
CDM,D3120OH,PULP CAP - INDIRECT (EXCLUDING FINAL RESTORATION),125.0,81.25,1.1,125.0,86
CDM,D3220OH,THERAPEUTIC PULPOTOMY (EXCLUDING FINAL RESTORATION) - REMOVAL OF,325.0,211.25,1.1,331.7,86
CDM,D3221OH,"PULPAL DEBRIDEMENT, PRIMARY AND PERMANENT TEETH",350.0,227.5,1.1,350.0,86
CDM,D3222OH,PARTIAL PULPOTOMY FOR APEXOGENESIS - PERMANENT TOOTH WITH INCOMP,425.0,276.25,1.1,425.0,86
CDM,D3230OH,"PULPAL THERAPY (RESORBABLE FILLING) - ANTERIOR, PRIMARY TOOTH (E",400.0,260.0,1.1,604.67,86
CDM,D3240OH,"PULPAL THERAPY (RESORBABLE FILLING) - POSTERIOR, PRIMARY TOOTH (",430.0,279.5,1.1,430.0,86
CDM,D3310OH,"ENDODONTIC THERAPY, ANTERIOR TOOTH (EXCLUDING FINAL RESTORATION)",1100.0,715.0,1.1,1402.8,86
CDM,D3320OH,"ENDODONTIC THERAPY, PREMOLAR TOOTH (EXCLUDING FINAL RESTORATION)",1200.0,780.0,1.1,1710.32,86
CDM,D3330OH,"ENDODONTIC THERAPY, MOLAR TOOTH (EXCLUDING FINAL RESTORATION)",1500.0,975.0,1.1,2211.32,86
CDM,D3331OH,TREATMENT OF ROOT CANAL OBSTRUCTION; NON-SURGICAL ACCESS,900.0,585.0,1.1,900.0,86
CDM,D3332OH,"INCOMPLETE ENDODONTIC THERAPY; INOPERABLE, UNRESTORABLE OR FRACT",600.0,390.0,1.1,1174.77,86
CDM,D3333OH,INTERNAL ROOT REPAIR OF PERFORATION DEFECTS,600.0,390.0,1.1,600.0,86
CDM,D3346OH,RETREATMENT OF PREVIOUS ROOT CANAL THERAPY - ANTERIOR,1300.0,845.0,1.1,1886.52,86
CDM,D3347OH,RETREATMENT OF PREVIOUS ROOT CANAL THERAPY - PREMOLAR,1400.0,910.0,1.1,2225.14,86
CDM,D3348OH,RETREATMENT OF PREVIOUS ROOT CANAL THERAPY - MOLAR,1700.0,1105.0,1.1,2674.32,86
CDM,D3351OH,APEXIFICATION/RECALCIFICATION ? INITIAL VISIT (APICAL CLOSURE /,500.0,325.0,1.1,794.69,86
CDM,D3352OH,APEXIFICATION/RECALCIFICATION ? INTERIM MEDICATION REPLACEMENT,400.0,260.0,1.1,400.0,86
CDM,D3353OH,APEXIFICATION/RECALCIFICATION - FINAL VISIT (INCLUDES COMPLETED,750.0,487.5,1.1,1171.3,86
CDM,D3355OH,PULPAL REGENERATION - INITIAL VISIT,600.0,390.0,1.1,600.0,74
CDM,D3356OH,PULPAL REGENERATION - INTERIM MEDICATION REPLACEMENT,500.0,325.0,1.1,500.0,74
CDM,D3357OH,PULPAL REGENERATION - COMPLETION OF TREATMENT,850.0,552.5,1.1,850.0,74
CDM,D3410OH,APICOECTOMY - ANTERIOR,1100.0,715.0,1.1,1603.21,86
CDM,D3421OH,APICOECTOMY - PREMOLAR (FIRST ROOT),1225.0,796.25,1.1,1751.78,86
CDM,D3425OH,APICOECTOMY - MOLAR (FIRST ROOT),1350.0,877.5,1.1,1979.82,86
CDM,D3426OH,APICOECTOMY (EACH ADDITIONAL ROOT),650.0,422.5,1.1,659.95,86
CDM,D3427OH,PERIRADICULAR SURGERY WITHOUT APICOECTOMY,500.0,325.0,1.1,500.0,68
CDM,D3428OH,BONE GRAFT IN CONJUNCTION WITH PERIRADICULAR SURGERY ? PER TOOTH,575.0,373.75,1.1,575.0,74
CDM,D3429OH,BONE GRAFT IN CONJUNCTION WITH PERIRADICULAR SURGERY ? EACH ADDI,500.0,325.0,1.1,500.0,74
CDM,D3430OH,RETROGRADE FILLING - PER ROOT,430.0,279.5,1.1,483.73,86
CDM,D3431OH,BIOLOGIC MATERIALS TO AID IN SOFT AND OSSEOUS TISSUE REGENERATIO,850.0,552.5,1.1,963.0,74
CDM,D3432OH,"GUIDED TISSUE REGENERATION, RESORBABLE BARRIER, PER SITE, IN CON",575.0,373.75,1.1,1178.4,74
CDM,D3450OH,ROOT AMPUTATION - PER ROOT,600.0,390.0,1.1,984.73,86
CDM,D3460OH,ENDODONTIC ENDOSSEOUS IMPLANT,2000.0,1300.0,1.1,4723.23,86
CDM,D3470OH,INTENTIONAL REIMPLANTATION (INCLUDING NECESSARY SPLINTING),1100.0,715.0,1.1,1962.55,86
CDM,D3471OH,SURGICAL REPAIR OF ROOT RESORPTION - ANTERIOR,900.0,585.0,1.1,2048.93,86
CDM,D3472OH,SURGICAL REPAIR OF ROOT RESORPTION ? PREMOLAR,900.0,585.0,1.1,2366.81,86
CDM,D3473OH,SURGICAL REPAIR OF ROOT RESORPTION ? MOLAR,1000.0,650.0,1.1,2660.49,86
CDM,D3501OH,SURGICAL EXPOSURE OF ROOT SURFACE W/O APICOECTOMY OR REPAIR OF R,900.0,585.0,1.1,1230.05,86
CDM,D3502OH,SURGICAL EXPOSURE OF ROOT SURFACE W/O APICOECTOMY OR REPAIR OF R,900.0,585.0,1.1,1230.05,86
CDM,D3503OH,SURGICAL EXPOSURE OF ROOT SURFACE W/O APICOECTOMY OR REPAIR OF R,900.0,585.0,1.1,1230.05,86
CDM,D3910OH,SURGICAL PROCEDURE FOR ISOLATION OF TOOTH WITH RUBBER DAM,300.0,195.0,1.1,300.0,86
CDM,D3911OH,INTRAORIFICE BARRIER,100.0,65.0,1.1,255.68,80
CDM,D3920OH,"HEMISECTION (INCLUDING ANY ROOT REMOVAL), NOT INCLUDING ROOT CAN",700.0,455.0,1.1,767.05,86
CDM,D3921OH,DECORONATION OR SUBMERGENCE OF AN ERUPTED TOOTH,550.0,357.5,1.1,1005.46,86
CDM,D3950OH,CANAL PREPARATION AND FITTING OF PREFORMED DOWEL OR POST,350.0,227.5,1.1,350.0,86
CDM,D3999OH,"UNSPECIFIED ENDODONTIC PROCEDURE, BY REPORT",500.0,325.0,0.01,500.0,80
CDM,D4210OH,GINGIVECTOMY OR GINGIVOPLASTY - FOUR OR MORE CONTIGUOUS TEETH OR,1000.0,650.0,1.1,1219.68,86
CDM,D4211OH,GINGIVECTOMY OR GINGIVOPLASTY - ONE TO THREE CONTIGUOUS TEETH OR,600.0,390.0,1.1,600.0,86
CDM,D4212OH,GINGIVECTOMY OR GINGIVOPLASTY TO ALLOW ACCESS FOR RESTORATIVE PR,500.0,325.0,1.1,1219.68,86
CDM,D4230OH,ANATOMICAL CROWN EXPOSURE ? FOUR OR MORE CONTIGUOUS TEETH OR TOO,1400.0,910.0,1.1,1641.22,86
CDM,D4231OH,ANATOMICAL CROWN EXPOSURE ? ONE TO THREE TEETH OR TOOTH BOUNDED,900.0,585.0,1.1,1641.22,86
CDM,D4240OH,"GINGIVAL FLAP PROCEDURE, INCLUDING ROOT PLANING - FOUR OR MORE C",1100.0,715.0,1.1,1437.35,86
CDM,D4241OH,"GINGIVAL FLAP PROCEDURE, INCLUDING ROOT PLANING - ONE TO THREE C",900.0,585.0,1.1,1437.35,86
CDM,D4245OH,APICALLY POSITIONED FLAP,800.0,520.0,1.1,1382.07,86
CDM,D4249OH,CLINICAL CROWN LENGTHENING ? HARD TISSUE,1200.0,780.0,1.1,1641.22,86
CDM,D4260OH,OSSEOUS SURGERY (INCLUDING ELEVATION OF A FULL THICKNESS FLAP AN,1500.0,975.0,1.1,2321.88,86
CDM,D4261OH,OSSEOUS SURGERY (INCLUDING ELEVATION OF A FULL THICKNESS FLAP AN,1200.0,780.0,1.1,2321.88,86
CDM,D4263OH,BONE REPLACEMENT GRAFT ? RETAINED NATURAL TOOTH ? FIRST SITE IN,575.0,373.75,1.1,1751.78,86
CDM,D4264OH,BONE REPLACEMENT GRAFT ? RETAINED NATURAL TOOTH ? EACH ADDITIONA,450.0,292.5,1.1,1330.25,86
CDM,D4265OH,BIO MTRLS TO AID SOFT/OS REG,700.0,455.0,1.1,1872.7,86
CDM,D4266OH,"GUIDED TISSUE REGENERATION, NATURAL TEETH - RESORBABLE BARRIER,",500.0,325.0,1.1,1872.7,86
CDM,D4267OH,"GUIDED TISSUE REGENERATION, NATURAL TEETH ? NON-RESORBABLE BARRI",600.0,390.0,1.1,1983.28,86
CDM,D4268OH,"SURGICAL REVISION PROCEDURE, PER TOOTH",800.0,520.0,1.1,800.0,86
CDM,D4270OH,PEDICLE SOFT TISSUE GRAFT PROCEDURE,1100.0,715.0,1.1,1717.23,86
CDM,D4273OH,AUTOGENOUS CONNECTIVE TISSUE GRAFT PROCEDURE (INCLUDING DONOR AN,1300.0,845.0,1.1,1883.08,86
CDM,D4274OH,"MESIAL/DISTAL WEDGE PROCEDURE, SINGLE TOOTH (WHEN NOT PERFORMED",700.0,455.0,1.1,700.0,86
CDM,D4275OH,NON-AUTOGENOUS CONNECTIVE TISSUE GRAFT (INCLUDING RECIPIENT SITE,1450.0,942.5,1.1,1765.6,86
CDM,D4276OH,"COMBINED CONNECTIVE TISSUE AND DOUBLE PEDICLE GRAFT, PER TOOTH",1300.0,845.0,1.1,1883.08,86
CDM,D4277OH,FREE SOFT TISSUE GRAFT PROCEDURE (INCLUDING RECIPIENT AND DONOR,1300.0,845.0,1.1,1790.14,86
CDM,D4278OH,FREE SOFT TISSUE GRAFT PROCEDURE (INCLUDING RECIPIENT AND DONOR,1000.0,650.0,1.1,1765.6,86
CDM,D4283OH,AUTOGENOUS CONNECTIVE TISSUE GRAFT PROCEDURE (INCLUDING DONOR AN,600.0,390.0,1.1,1917.64,86
CDM,D4285OH,NON-AUTOGENOUS CONNECTIVE TISSUE GRAFT PROCEDURE (INCLUDING RECI,650.0,422.5,1.1,1917.64,86
CDM,D4286OH,REMOVAL OF NON-RESORBABLE BARRIER,200.0,130.0,1.1,1803.6,86
CDM,D4320OH,PROVISIONAL SPLINTING - INTRACORONAL,300.0,195.0,1.1,300.0,68
CDM,D4321OH,PROVISIONAL SPLINTING - EXTRACORONAL,300.0,195.0,1.1,300.0,68
CDM,D4322OH,SPLINT ? INTRA-CORONAL; NATURAL TEETH OR PROSTHETIC CROWNS,700.0,455.0,1.1,1060.74,86
CDM,D4323OH,SPLINT ? EXTRA-CORONAL; NATURAL TEETH OR PROSTHETIC CROWNS,675.0,438.75,1.1,929.44,86
CDM,D4341OH,PERIODONTAL SCALING AND ROOT PLANING - FOUR OR MORE TEETH PER QU,350.0,227.5,1.1,480.26,86
CDM,D4342OH,PERIODONTAL SCALING AND ROOT PLANING - ONE TO THREE TEETH PER QU,275.0,178.75,1.1,480.26,86
CDM,D4346OH,SCALING IN PRESENCE OF GENERALIZED MODERATE OR SEVERE GINGIVAL I,250.0,162.5,1.1,536.66,86
CDM,D4355OH,FULL MOUTH DEBRIDEMENT TO ENABLE A COMPREHENSIVE?PERIODONTAL?EVA,230.0,149.5,1.1,317.87,86
CDM,D4381.1OH,LOCAL DELIV ANTIMICRB 1ST SITE,50.0,32.5,1.1,362.8,86
CDM,D4381OH,LOCALIZED DELIVERY OF ANTIMICROBIAL AGENTS VIA A CONTROLLED RELE,85.0,55.25,1.1,362.8,86
CDM,D4910OH,PERIODONTAL MAINTENANCE,180.0,117.0,1.1,286.78,86
CDM,D4920OH,UNSCHEDULED DRESSING CHANGE (BY SOMEONE OTHER THAN TREATING DENT,150.0,97.5,1.1,245.33,86
CDM,D4921OH,GINGIVAL IRRIGATION?WITH A MEDICINAL AGENT?? PER QUADRANT,100.0,65.0,1.1,100.0,74
CDM,D4999OH,"UNSPECIFIED PERIODONTAL PROCEDURE, BY REPORT",250.0,162.5,0.01,250.0,80
CDM,D5110OH,COMPLETE DENTURE - MAXILLARY,3000.0,1950.0,1.1,3000.0,86
CDM,D5120OH,COMPLETE DENTURE - MANDIBULAR,3000.0,1950.0,1.1,3000.0,86
CDM,D5130OH,IMMEDIATE DENTURE - MAXILLARY,3200.0,2080.0,1.1,3200.0,86
CDM,D5140OH,IMMEDIATE DENTURE - MANDIBULAR,3200.0,2080.0,1.1,3200.0,86
CDM,D5211OH,"MAXILLARY PARTIAL DENTURE ? RESIN BASE (INCLUDING, RETENTIVE/CLA",2100.0,1365.0,1.1,2228.6,86
CDM,D5212OH,"MANDIBULAR PARTIAL DENTURE ? RESIN BASE (INCLUDING, RETENTIVE/CL",2100.0,1365.0,1.1,2587.93,86
CDM,D5213OH,MAXILLARY PARTIAL DENTURE - CAST METAL FRAMEWORK WITH RESIN DENT,3000.0,1950.0,1.1,3000.0,86
CDM,D5214OH,MANDIBULAR PARTIAL DENTURE - CAST METAL FRAMEWORK WITH RESIN DEN,3000.0,1950.0,1.1,3000.0,86
CDM,D5221OH,IMMEDIATE MAXILLARY PARTIAL DENTURE ? RESIN BASE (INCLUDING ANY,2100.0,1365.0,1.1,3282.43,86
CDM,D5222OH,IMMEDIATE MANDIBULAR PARTIAL DENTURE ? RESIN BASE (INCLUDING ANY,2100.0,1365.0,1.1,3282.43,86
CDM,D5223OH,IMMEDIATE MAXILLARY PARTIAL DENTURE ? CAST METAL FRAMEWORK WITH,2300.0,1495.0,1.1,4146.22,86
CDM,D5224OH,IMMEDIATE MANDIBULAR PARTIAL DENTURE ? CAST METAL FRAMEWORK WITH,2300.0,1495.0,1.1,4146.22,86
CDM,D5225OH,"MAXILLARY PARTIAL DENTURE - FLEXIBLE BASE (INCLUDING ANY CLASPS,",2100.0,1365.0,1.1,2916.18,86
CDM,D5226OH,MANDIBULAR PARTIAL DENTURE - FLEXIBLE BASE (INCLUDING ANY CLASPS,2100.0,1365.0,1.1,2916.18,86
CDM,D5227OH,IMMEDIATE MAXILLARY PARTIAL DENTURE - FLEXIBLE BASE (INCLUDING A,2000.0,1300.0,1.1,3064.75,86
CDM,D5228OH,IMMEDIATE MANDIBULAR PARTIAL DENTURE - FLEXIBLE BASE (INCLUDING,2000.0,1300.0,1.1,3064.75,86
CDM,D5282OH,REMOVABLE UNILATERAL PARTIAL DENTURE ? ONE PIECE CAST METAL (INC,1500.0,975.0,1.1,1934.9,86
CDM,D5283OH,REMOVABLE UNILATERAL PARTIAL DENTURE ? ONE PIECE CAST METAL (INC,1500.0,975.0,1.1,1934.9,86
CDM,D5284OH,REMOVABLE UNILATERAL PARTIAL DENTURE - 1 PIECE FLEXIBLE BASE (IN,1500.0,975.0,1.1,1820.88,86
CDM,D5286OH,REMOVABLE UNILATERAL PARTIAL DENTURE - 1 PIECE RESIN (INCLUDING,1500.0,975.0,1.1,1820.88,86
CDM,D5410OH,ADJUST COMPLETE DENTURE - MAXILLARY,135.0,87.75,1.1,145.11,86
CDM,D5411OH,ADJUST COMPLETE DENTURE - MANDIBULAR,135.0,87.75,1.1,145.11,86
CDM,D5421OH,ADJUST PARTIAL DENTURE - MAXILLARY,135.0,87.75,1.1,145.11,86
CDM,D5422OH,ADJUST PARTIAL DENTURE - MANDIBULAR,135.0,87.75,1.1,145.11,86
CDM,D5511OH,"REPAIR BROKEN COMPLETE DENTURE BASE, MANDIBULAR",325.0,211.25,1.1,435.35,86
CDM,D5512OH,"REPAIR BROKEN COMPLETE DENTURE BASE, MAXILLARY",325.0,211.25,1.1,435.35,86
CDM,D5520OH,RELACE MISSING OR BROKEN TEETH - COMPLETE DENTURE (PER TOOTH),300.0,195.0,1.1,300.0,86
CDM,D5611OH,"REPAIR RESIN PARTIAL DENTURE BASE, MANDIBULAR",325.0,211.25,1.1,435.35,86
CDM,D5612OH,"REPAIR RESIN PARTIAL DENTURE BASE, MAXILLARY",325.0,211.25,1.1,435.35,86
CDM,D5621OH,"REPAIR CAST PARTIAL FRAMEWORK, MANDIBULAR",425.0,276.25,1.1,611.57,86
CDM,D5622OH,"REPAIR CAST PARTIAL FRAMEWORK, MAXILLARY",425.0,276.25,1.1,611.57,86
CDM,D5630OH,REPAIR OR REPLACE BROKEN RETENTIVE CLASPING MATERIALS ? PER TOOT,400.0,260.0,1.1,411.16,86
CDM,D5640OH,REPLACE MISSING OR BROKEN TEETH - PARTIAL DENTURE (PER TOOTH),300.0,195.0,1.1,300.0,86
CDM,D5650OH,ADD TOOTH TO EXISTING PARTIAL DENTURE (PER TOOTH),350.0,227.5,1.1,362.8,86
CDM,D5660OH,ADD CLASP TO EXISTING PARTIAL DENTURE - PER TOOTH,400.0,260.0,1.1,431.91,86
CDM,D5670OH,REPLACE ALL TEETH AND ACRYLIC ON CAST METAL FRAMEWORK (MAXILLARY,1200.0,780.0,1.1,1200.0,86
CDM,D5671OH,REPLACE ALL TEETH AND ACRYLIC ON CAST METAL FRAMEWORK (MANDIBULA,1200.0,780.0,1.1,1200.0,86
CDM,D5710OH,REBASE COMPLETE MAXILLARY DENTURE,800.0,520.0,1.1,1071.11,86
CDM,D5711OH,REBASE COMPLETE MANDIBULAR DENTURE,800.0,520.0,1.1,1022.73,86
CDM,D5720OH,REBASE MAXILLARY PARTIAL DENTURE,800.0,520.0,1.1,1012.36,86
CDM,D5721OH,REBASE MANDIBULAR PARTIAL DENTURE,800.0,520.0,1.1,1012.36,86
CDM,D5725OH,REBASE HYBRID PROSTHESIS,1100.0,715.0,1.1,1617.03,86
CDM,D5730OH,RELINE COMPLETE MAXILLARY DENTURE (CHAIRSIDE),600.0,390.0,1.1,604.67,86
CDM,D5731OH,RELINE COMPLETE MANDIBULAR DENTURE (CHAIRSIDE),600.0,390.0,1.1,604.67,86
CDM,D5740OH,RELINE MAXILLARY PARTIAL DENTURE (CHAIRSIDE),600.0,390.0,1.1,600.0,86
CDM,D5741OH,RELINE MANDIBULAR PARTIAL DENTURE (CHAIRSIDE),600.0,390.0,1.1,600.0,86
CDM,D5750OH,RELINE COMPLETE MAXILLARY DENTURE (LABORATORY),800.0,520.0,1.1,808.52,86
CDM,D5751OH,RELINE COMPLETE MANDIBULAR DENTURE (LABORATORY),800.0,520.0,1.1,808.52,86
CDM,D5760OH,RELINE MAXILLARY PARTIAL DENTURE (LABORATORY),800.0,520.0,1.1,800.0,86
CDM,D5761OH,RELINE MANDIBULAR PARTIAL DENTURE (LABORATORY),800.0,520.0,1.1,800.0,86
CDM,D5765OH,SOFT LINER FOR COMPLETE OR PARTIAL REMOVABLE DENTURE ? INDIRECT,500.0,325.0,1.1,1098.75,80
CDM,D5810OH,INTERIM COMPLETE DENTURE (MAXILLARY),1000.0,650.0,1.1,1278.41,86
CDM,D5811OH,INTERIM COMPLETE DENTURE (MANDIBULAR),1000.0,650.0,1.1,1371.71,86
CDM,D5820.2OH,ESSIX APPLIANCE - MAXILLARY,300.0,195.0,1.1,988.19,86
CDM,D5820.5OH,INTERIM MAX RPD - COMPLEX,1200.0,780.0,1.1,1200.0,86
CDM,D5820OH,INTERIM PARTIAL DENTURE (MAXILLARY),300.0,195.0,1.1,988.19,86
CDM,D5821.2OH,ESSIX APPLIANCE - MANDIBULAR,300.0,195.0,1.1,1046.92,86
CDM,D5821.5OH,INTERIM MAND RPD - COMPLEX,1200.0,780.0,1.1,1200.0,86
CDM,D5821OH,INTERIM PARTIAL DENTURE (MANDIBULAR),500.0,325.0,1.1,1046.92,86
CDM,D5850OH,"TISSUE CONDITIONING, MAXILLARY",200.0,130.0,1.1,241.86,86
CDM,D5851OH,"TISSUE CONDITIONING, MANDIBULAR",200.0,130.0,1.1,252.23,86
CDM,D5862OH,"PRECISION ATTACHMENT, BY REPORT",400.0,260.0,1.1,1271.51,86
CDM,D5863OH,OVERDENTURE - COMPLETE MAXILLARY - NATURAL TOOTH BORNE,3000.0,1950.0,1.1,3000.0,74
CDM,D5864OH,OVERDENTURE ? PARTIAL MAXILLARY - NATURAL TOOTH BORNE,3000.0,1950.0,1.1,3000.0,74
CDM,D5865OH,OVERDENTURE ? COMPLETE MANDIBULAR - NATURAL TOOTH BORNE,3000.0,1950.0,1.1,3000.0,74
CDM,D5866OH,OVERDENTURE ? PARTIAL MANDIBULAR - NATURAL TOOTH BORNE,3000.0,1950.0,1.1,3000.0,74
CDM,D5867OH,REPLACEMENT OF REPLACEABLE PART OF SEMI-PRECISION OR PRECISION A,500.0,325.0,1.1,500.0,86
CDM,D5875OH,MODIFICATION OF REMOVABLE PROSTHESIS FOLLOWING IMPLANT SURGERY,500.0,325.0,1.1,500.0,86
CDM,D5876OH,ADD METAL SUBSTRUCTURE TO ACRYLIC COMPLETE DENTURE (PER ARCH),1000.0,650.0,0.01,1000.0,86
CDM,D5877OH,DUPLICATION OF COMPLETE DENTURE ? MAXILLARY,1200.0,780.0,1.1,1200.0,68
CDM,D5878OH,DUPLICATION OF COMPLETE DENTURE ? MANDIBULAR,1200.0,780.0,1.1,1200.0,68
CDM,D5899OH,"UNSPECIFIED REMOVABLE PROSTHODONTIC PROCEDURE, BY REPORT",250.0,162.5,0.01,250.0,80
CDM,D5909OH,MAXILLARY GUIDANCE PROSTHESIS WITH GUIDE FLANGE,7500.0,4875.0,1.1,7500.0,68
CDM,D5911OH,FACIAL MOULAGE (SECTIONAL),650.0,422.5,1.1,670.31,86
CDM,D5912OH,FACIAL MOULAGE (COMPLETE),700.0,455.0,1.1,700.0,86
CDM,D5913OH,NASAL PROSTHESIS,8000.0,5200.0,1.1,14100.61,86
CDM,D5914OH,AURICULAR PROSTHESIS,9000.0,5850.0,1.1,14100.61,86
CDM,D5915OH,ORBITAL PROSTHESIS,8500.0,5525.0,1.1,19082.98,86
CDM,D5916OH,OCULAR PROSTHESIS,6000.0,3900.0,1.1,10632.79,86
CDM,D5919OH,FACIAL PROSTHESIS,7500.0,4875.0,1.1,7500.0,80
CDM,D5922OH,NASAL SEPTAL PROSTHESIS,4000.0,2600.0,1.1,5182.77,86
CDM,D5923OH,"OCULAR PROSTHESIS, INTERIM",800.0,520.0,1.1,6075.49,86
CDM,D5924OH,CRANIAL PROSTHESIS,2500.0,1625.0,1.1,5182.77,80
CDM,D5925OH,FACIAL AUGMENTATION IMPLANT PROSTHESIS,2500.0,1625.0,1.1,5182.77,80
CDM,D5926OH,"NASAL PROSTHESIS, REPLACEMENT",1200.0,780.0,1.1,5182.77,86
CDM,D5927OH,"AURICULAR PROSTHESIS, REPLACEMENT",1200.0,780.0,1.1,5182.77,86
CDM,D5928OH,"ORBITAL PROSTHESIS, REPLACEMENT",1200.0,780.0,1.1,5182.77,86
CDM,D5929OH,"FACIAL PROSTHESIS, REPLACEMENT",3000.0,1950.0,1.1,5182.77,80
CDM,D5930OH,MAXILLARY GUIDANCE PROSTHESIS WITHOUT GUIDE FLANGE,7500.0,4875.0,1.1,7500.0,68
CDM,D5931OH,"OBTURATOR PROSTHESIS, SURGICAL",5000.0,3250.0,1.1,7591.04,86
CDM,D5932OH,"OBTURATOR PROSTHESIS, DEFINITIVE",7000.0,4550.0,1.1,14200.81,86
CDM,D5933OH,"OBTURATOR PROSTHESIS, MODIFICATION",850.0,552.5,1.1,1138.69,86
CDM,D5934OH,MANDIBULAR GUIDANCE PROSTHESIS WITH GUIDE FLANGE,5000.0,3250.0,1.1,12943.12,86
CDM,D5935OH,MANDIBULAR GUIDANCE PROSTHESIS WITHOUT GUIDE FLANGE,5000.0,3250.0,1.1,11260.44,86
CDM,D5936OH,"OBTURATOR PROSTHESIS, INTERIM",5000.0,3250.0,1.1,12649.44,86
CDM,D5937OH,TRISMUS APPLIANCE (NOT FOR TMD TREATMENT),1000.0,650.0,1.1,1589.39,86
CDM,D5938OH,"RESECTION PROSTHESIS, MAXILLARY COMPLETE REMOVABLE",7500.0,4875.0,1.1,7500.0,68
CDM,D5939OH,"RESECTION PROSTHESIS, MANDIBULAR COMPLETE REMOVABLE",7500.0,4875.0,1.1,7500.0,68
CDM,D5940OH,"RESECTION PROSTHESIS, MAXILLARY PARTIAL REMOVABLE",7500.0,4875.0,1.1,7500.0,68
CDM,D5941OH,"RESECTION PROSTHESIS, MANDIBULAR PARTIAL REMOVABLE",7500.0,4875.0,1.1,7500.0,68
CDM,D5942OH,"RESECTION PROSTHESIS, MAXILLARY IMPLANT/ABUTMENT SUPPORTED REMOV",7500.0,4875.0,1.1,7500.0,68
CDM,D5943OH,"RESECTION PROSTHESIS, MANDIBULAR IMPLANT/ABUTMENT SUPPORTED REMO",7500.0,4875.0,1.1,7500.0,68
CDM,D5944OH,"RESECTION PROSTHESIS, MAXILLARY IMPLANT/ABUTMENT SUPPORTED REMOV",7500.0,4875.0,1.1,7500.0,68
CDM,D5945OH,"RESECTION PROSTHESIS, MANDIBULAR IMPLANT/ABUTMENT SUPPORTED REMO",7500.0,4875.0,1.1,7500.0,68
CDM,D5946OH,"RESECTION PROSTHESIS, MAXILLARY IMPLANT/ABUTMENT SUPPORTED FIXED",20000.0,13000.0,1.1,20000.0,68
CDM,D5947OH,"RESECTION PROSTHESIS, MANDIBULAR IMPLANT/ABUTMENT SUPPORTED FIXE",20000.0,13000.0,1.1,20000.0,68
CDM,D5948OH,"RESECTION PROSTHESIS, MAXILLARY IMPLANT/ABUTMENT SUPPORTED FIXED",15000.0,9750.0,1.1,15000.0,68
CDM,D5949OH,"RESECTION PROSTHESIS, MANDIBULAR IMPLANT/ABUTMENT SUPPORTED FIXE",15000.0,9750.0,1.1,15000.0,68
CDM,D5951OH,FEEDING AID,1800.0,1170.0,1.1,2278.21,86
CDM,D5952OH,"SPEECH AID PROSTHESIS, PEDIATRIC",4000.0,2600.0,1.1,6709.96,86
CDM,D5953OH,"SPEECH AID PROSTHESIS, ADULT",6000.0,3900.0,1.1,12746.17,86
CDM,D5954OH,PALATAL AUGMENTATION PROSTHESIS,5000.0,3250.0,1.1,11809.82,86
CDM,D5955OH,"PALATAL LIFT PROSTHESIS, DEFINITIVE",5000.0,3250.0,1.1,10925.28,86
CDM,D5958OH,"PALATAL LIFT PROSTHESIS, INTERIM",3000.0,1950.0,1.1,10365.55,86
CDM,D5959OH,"PALATAL LIFT PROSTHESIS, MODIFICATION",1000.0,650.0,1.1,10365.55,86
CDM,D5960OH,"SPEECH AID PROSTHESIS, MODIFICATION",250.0,162.5,1.1,10365.55,86
CDM,D5982OH,SURGICAL STENT FOR SOFT TISSUE HEALING,2000.0,1300.0,1.1,2000.0,86
CDM,D5983OH,RADIATION CARRIER,2000.0,1300.0,1.1,3178.77,86
CDM,D5984OH,RADIATION SHIELD,2000.0,1300.0,1.1,3178.77,86
CDM,D5985OH,RADIATION CONE LOCATOR,1800.0,1170.0,1.1,3178.77,86
CDM,D5986OH,FLUORIDE GEL CARRIER,200.0,130.0,1.1,269.51,86
CDM,D5987OH,COMMISSURE SPLINT,500.0,325.0,1.1,4771.61,86
CDM,D5988OH,SURGICAL SPLINT,800.0,520.0,1.1,5079.12,86
CDM,D5991OH,VESICULOBULLOUS DISEASE MEDICAMENT CARRIER,350.0,227.5,1.1,350.0,86
CDM,D5992OH,"ADJUST MAXILLOFACIAL PROSTHETIC APPLIANCE, BY REPORT",250.0,162.5,1.1,325.71,86
CDM,D5993OH,MAINTENANCE AND CLEANING OF A MAXILLOFACIAL PROSTHESIS (EXTRA- O,250.0,162.5,1.1,577.28,86
CDM,D5999OH,"UNSPECIFIED MAXILLOFACIAL PROSTHESIS, BY REPORT",2000.0,1300.0,0.01,2000.0,80
CDM,D6010OH,SURGICAL PLACEMENT OF IMPLANT BODY: ENDOSTEAL IMPLANT,2500.0,1625.0,1.1,4412.27,86
CDM,D6012OH,SURGICAL PLACEMENT OF INTERIM IMPLANT BODY FOR TRANSITIONAL PROS,500.0,325.0,1.1,4412.27,86
CDM,D6013OH,SURGICAL PLACEMENT OF MINI IMPLANT,1000.0,650.0,1.1,1543.8,74
CDM,D6049OH,SCALING AND DEBRIDEMENT OF A SINGLE IMPLANT W INFLAMMATION/BLEED,75.0,48.75,1.1,75.0,68
CDM,D6050OH,SURGICAL PLACEMENT: TRANSOSTEAL IMPLANT,7000.0,4550.0,1.1,12590.69,86
CDM,D6051OH,PLACEMENT OF INTERIM IMPLANT ABUTMENT,700.0,455.0,1.1,700.0,86
CDM,D6052OH,SEMI-PRECISION ATTACHMENT ABUTMENT,500.0,325.0,1.1,500.0,68
CDM,D6055OH,CONNECTING BAR ? IMPLANT SUPPORTED OR ABUTMENT SUPPORTED,4000.0,2600.0,1.1,4000.0,86
CDM,D6056OH,PREFABRICATED ABUTMENT ? INCLUDES MODIFICATION AND PLACEMENT,900.0,585.0,1.1,1036.55,86
CDM,D6057OH,CUSTOM FABRICATED ABUTMENT ? INCLUDES PLACEMENT,1100.0,715.0,1.1,2936.91,86
CDM,D6058OH,ABUTMENT SUPPORTED PORCELAIN/CERAMIC CROWN,1800.0,1170.0,1.1,4146.22,86
CDM,D6059OH,ABUTMENT SUPPORTED PORCELAIN FUSED TO METAL CROWN (HIGH NOBLE ME,1800.0,1170.0,1.1,4146.22,86
CDM,D6060OH,ABUTMENT SUPPORTED PORCELAIN FUSED TO METAL CROWN (PREDOMINANTLY,1800.0,1170.0,1.1,4491.74,86
CDM,D6061OH,ABUTMENT SUPPORTED PORCELAIN FUSED TO METAL CROWN (NOBLE METAL),1800.0,1170.0,1.1,4491.74,86
CDM,D6062OH,ABUTMENT SUPPORTED CAST METAL CROWN (HIGH NOBLE METAL),1800.0,1170.0,1.1,3437.91,86
CDM,D6063OH,ABUTMENT SUPPORTED CAST METAL CROWN (PREDOMINANTLY BASE METAL),1800.0,1170.0,1.1,1800.0,86
CDM,D6064OH,ABUTMENT SUPPORTED CAST METAL CROWN (NOBLE METAL),1800.0,1170.0,1.1,1800.0,86
CDM,D6065OH,IMPLANT SUPPORTED PORCELAIN/CERAMIC CROWN,2000.0,1300.0,1.1,3455.19,86
CDM,D6066OH,"IMPLANT SUPPORTED PORCELAIN FUSED TO METAL CROWN (TITANIUM, TITA",2000.0,1300.0,1.1,4750.89,86
CDM,D6067OH,"IMPLANT SUPPORTED METAL CROWN (TITANIUM, TITANIUM ALLOY, HIGH NO",2000.0,1300.0,1.1,3109.67,86
CDM,D6068OH,ABUTMENT SUPPORTED RETAINER FOR PORCELAIN/CERAMIC FPD,1800.0,1170.0,1.1,1800.0,86
CDM,D6069OH,ABUTMENT SUPPORTED RETAINER FOR PORCELAIN FUSED TO METAL FPD (HI,1800.0,1170.0,1.1,3627.95,86
CDM,D6070OH,ABUTMENT SUPPORTED RETAINER FOR PORCELAIN FUSED TO METAL FPD (PR,1800.0,1170.0,1.1,2332.25,86
CDM,D6071OH,ABUTMENT SUPPORTED RETAINER FOR PORCELAIN FUSED TO METAL FPD (NO,1800.0,1170.0,1.1,2515.38,86
CDM,D6072OH,ABUTMENT SUPPORTED RETAINER FOR CAST METAL FPD (HIGH NOBLE METAL,1800.0,1170.0,1.1,1800.0,86
CDM,D6073OH,ABUTMENT SUPPORTED RETAINER FOR CAST METAL FPD (PREDOMINANTLY BA,1800.0,1170.0,1.1,1800.0,86
CDM,D6074OH,ABUTMENT SUPPORTED RETAINER FOR CAST METAL FPD (NOBLE METAL),1800.0,1170.0,1.1,1800.0,86
CDM,D6075OH,IMPLANT SUPPORTED RETAINER FOR CERAMIC FPD,2000.0,1300.0,1.1,2000.0,86
CDM,D6076OH,IMPLANT SUPPORTED RETAINER FOR PORCELAIN FUSED TO METAL FPD (TIT,2000.0,1300.0,1.1,2000.0,86
CDM,D6077OH,"IMPLANT SUPPORTED RETAINER FOR CAST METAL FPD (TITANIUM, TITANIU",2000.0,1300.0,1.1,2000.0,86
CDM,D6080OH,IMPLANT MAINTENANCE PROCEDURES WHEN A FULL ARCH FIXED HYBRID PRO,400.0,260.0,1.1,400.0,86
CDM,D6081OH,"SCALING/DEBRIDEMENT OF SINGLE IMPLANT IN PRESENCE OF MUCOSITIS,",250.0,162.5,0.01,306.32,86
CDM,D6082OH,IMPLANT SUPPORTED CROWN - PORCELAIN FUSED TO PREDOMINANTLY BASE,2000.0,1300.0,1.1,3990.74,86
CDM,D6083OH,IMPLANT SUPPORTED CROWN - PORCELAIN FUSED TO NOBLE ALLOYS,2000.0,1300.0,1.1,3990.74,86
CDM,D6084OH,IMPLANT SUPPORTED CROWN - PORCELAIN FUSED TO TITANIUM AND TITANI,2000.0,1300.0,1.1,3990.74,86
CDM,D6085OH,PROVISIONAL IMPLANT CROWN,700.0,455.0,1.1,700.0,86
CDM,D6086OH,IMPLANT SUPPORTED CROWN - PREDOMINANTLY BASE ALLOYS,2000.0,1300.0,1.1,3507.02,86
CDM,D6087OH,IMPLANT SUPPORTED CROWN - NOBLE ALLOYS,2000.0,1300.0,1.1,3507.02,86
CDM,D6088OH,IMPLANT SUPPORTED CROWN - TITANIUM AND TITANIUM ALLOYS,2000.0,1300.0,1.1,3507.02,86
CDM,D6089OH,ACCESSING AND RETORQUING LOOSE IMPLANT SCREW - PER SCREW,200.0,130.0,1.1,233.04,86
CDM,D6090OH,REPAIR OF IMPLANT/ABUTMENT SUPPORTED PROSTHESIS,1000.0,650.0,1.1,2073.11,86
CDM,D6091.1OH,RETENTIVE INSERT CHANGE,100.0,65.0,1.1,539.36,86
CDM,D6091.2OH,PICK UP OF NEW METAL HOUSING,250.0,162.5,1.1,539.36,86
CDM,D6091OH,REPLACEMENT OF SEMI-PRECISION OR PRECISION ATTACHMENT (MALE OR F,500.0,325.0,1.1,539.36,86
CDM,D6092OH,RE-CEMENT OR RE-BOND IMPLANT/ABUTMENT SUPPORTED CROWN,250.0,162.5,1.1,250.0,86
CDM,D6093OH,RE-CEMENT OR RE-BOND IMPLANT/ABUTMENT SUPPORTED FIXED PARTIAL DE,250.0,162.5,1.1,250.0,86
CDM,D6094OH,ABUTMENT SUPPORTED CROWN - (TITANIUM),2000.0,1300.0,1.1,2073.11,86
CDM,D6095OH,"REPAIR IMPLANT ABUTMENT, BY REPORT",900.0,585.0,1.1,900.0,68
CDM,D6096OH,REMOVE BROKEN IMPLANT RETAINING SCREW,1000.0,650.0,1.1,1000.0,86
CDM,D6097OH,ABUTMENT SUPPORTED CROWN - PORCELAIN FUSED TO TITANIUM AND TITAN,2000.0,1300.0,1.1,3911.26,86
CDM,D6098OH,IMPLANT SUPPORTED RETAINER - PORCELAIN FUSED TO PREDOMINANTLY BA,2000.0,1300.0,1.1,3911.26,86
CDM,D6099OH,IMPLANT SUPPORTED RETAINER FOR FPD - PORCELAIN FUSED TO NOBLE AL,2000.0,1300.0,1.1,3990.74,86
CDM,D6100OH,"IMPLANT REMOVAL, BY REPORT",900.0,585.0,1.1,1036.55,86
CDM,D6101OH,DEBRIDEMENT OF A PERI-IMPLANT DEFECT OR DEFECTS SURROUNDING A SI,900.0,585.0,1.1,900.0,86
CDM,D6102OH,DEBRIDEMENT AND OSSEOUS CONTOURING OF A PERI-IMPLANT DEFECT OR D,1100.0,715.0,1.1,2073.11,86
CDM,D6103OH,BONE GRAFT FOR REPAIR OF PERI-IMPLANT DEFECT ? DOES NOT INCLUDE,575.0,373.75,1.1,2073.11,86
CDM,D6104OH,BONE GRAFT AT TIME OF IMPLANT PLACEMENT,575.0,373.75,1.1,2073.11,86
CDM,D6105OH,REMOVAL OF IMPLANT BODY NOT REQUIRING BONE REMOVAL OR FLAP ELEVA,350.0,227.5,0.01,350.0,86
CDM,D6106OH,"GUIDED TISSUE REGENERATION ? RESORBABLE BARRIER, PER IMPLANT",400.0,260.0,1.1,851.76,86
CDM,D6107OH,"GUIDED TISSUE REGENERATION ? NON-RESORBABLE BARRIER, PER IMPLANT",500.0,325.0,1.1,979.8,86
CDM,D6110OH,IMPLANT /ABUTMENT SUPPORTED REMOVABLE DENTURE FOR EDENTULOUS ARC,4000.0,2600.0,1.1,6195.15,86
CDM,D6111OH,IMPLANT /ABUTMENT SUPPORTED REMOVABLE DENTURE FOR EDENTULOUS ARC,4000.0,2600.0,1.1,6195.15,86
CDM,D6112OH,IMPLANT /ABUTMENT SUPPORTED REMOVABLE DENTURE FOR PARTIALLY EDEN,4000.0,2600.0,1.1,6195.15,86
CDM,D6113OH,IMPLANT /ABUTMENT SUPPORTED REMOVABLE DENTURE FOR PARTIALLY EDEN,4000.0,2600.0,1.1,6195.15,86
CDM,D6114OH,IMPLANT /ABUTMENT SUPPORTED FIXED DENTURE FOR EDENTULOUS ARCH ?,20000.0,13000.0,1.1,20000.0,86
CDM,D6115OH,IMPLANT /ABUTMENT SUPPORTED FIXED DENTURE FOR EDENTULOUS ARCH ?,20000.0,13000.0,1.1,20000.0,86
CDM,D6116OH,IMPLANT /ABUTMENT SUPPORTED FIXED DENTURE FOR PARTIALLY EDENTULO,9000.0,5850.0,1.1,9000.0,86
CDM,D6117OH,IMPLANT /ABUTMENT SUPPORTED FIXED DENTURE FOR PARTIALLY EDENTULO,9000.0,5850.0,1.1,9000.0,86
CDM,D6118OH,IMPLANT/ABUTMENT SUPPORTED INTERIM FIXED DENTURE FOR EDENTULOUS,5000.0,3250.0,1.1,5000.0,74
CDM,D6119OH,IMPLANT/ABUTMENT SUPPORTED INTERIM FIXED DENTURE FOR EDENTULOUS,5000.0,3250.0,1.1,5000.0,74
CDM,D6120OH,IMPLANT SUPPORTED RETAINER - PORCELAIN FUSED TO TITANIUM AND TIT,1600.0,1040.0,1.1,3911.26,86
CDM,D6121OH,IMPLANT SUPPORTED RETAINER FOR METAL FPD - PREDOMINANTLY BASE AL,1600.0,1040.0,1.1,3624.49,86
CDM,D6122OH,IMPLANT SUPPORTED RETAINER FOR METAL FPD - NOBLE ALLOYS,1600.0,1040.0,1.1,3914.72,86
CDM,D6123OH,IMPLANT SUPPORTED RETAINER FOR METAL FPD - TITANIUM AND TITANIUM,1600.0,1040.0,1.1,3624.49,86
CDM,D6180OH,IMPLANT MAINTENANCE PROCEDURES WHEN A FULL ARCH FIXED HYBRID PRO,125.0,81.25,1.1,300.61,86
CDM,D6190.1OH,SURGICAL INDEX - NON-GUIDED,350.0,227.5,1.1,2073.11,86
CDM,D6190OH,SURGICAL INDEX - FULLY GUIDED,1000.0,650.0,1.1,2073.11,86
CDM,D6191OH,SEMI-PRECISION ABUTMENT ? PLACEMENT,826.0,536.9,1.1,1129.84,80
CDM,D6193OH,REPLACEMENT OF AN IMPLANT SCREW,150.0,97.5,1.1,632.3,86
CDM,D6194OH,ABUTMENT SUPPORTED RETAINER CROWN FOR FPD (TITANIUM),1600.0,1040.0,1.1,2073.11,86
CDM,D6195OH,ABUTMENT SUPPORTED RETAINER - PORCELAIN FUSED TO TITANIUM AND TI,1600.0,1040.0,1.1,3911.26,86
CDM,D6196OH,REMOVAL OF AN INDIRECT RESTORATION ON AN IMPLANT RETAINED ABUTME,100.0,65.0,1.1,100.0,68
CDM,D6197OH,REPLACEMENT OF RESTORATIVE MATERIAL USED TO CLOSE AN ACCESS OPEN,200.0,130.0,0.01,306.32,86
CDM,D6198OH,REMOVE INTERIM IMPLANT COMPONENT,400.0,260.0,1.1,400.0,86
CDM,D6199.2OH,RESIDENT IMPLANT PROMO,2200.0,1430.0,1.1,2619.04,80
CDM,D6210OH,PONTIC - CAST HIGH NOBLE METAL,1500.0,975.0,1.1,2176.76,86
CDM,D6211OH,PONTIC - CAST PREDOMINANTLY BASE METAL,1500.0,975.0,1.1,2038.56,86
CDM,D6212OH,PONTIC - CAST NOBLE METAL,1500.0,975.0,1.1,2121.48,86
CDM,D6214OH,PONTIC - TITANIUM,1500.0,975.0,1.1,2121.48,86
CDM,D6240OH,PONTIC - PORCELAIN FUSED TO HIGH NOBLE METAL,1500.0,975.0,1.1,2149.12,86
CDM,D6241OH,PONTIC - PORCELAIN FUSED TO PREDOMINANTLY BASE METAL,1500.0,975.0,1.1,1983.28,86
CDM,D6242OH,PONTIC - PORCELAIN FUSED TO NOBLE METAL,1500.0,975.0,1.1,2093.84,86
CDM,D6243OH,PONTIC - PORCELAIN FUSED TO TITANIUM AND TITANIUM ALLOYS,1500.0,975.0,1.1,2501.56,86
CDM,D6245OH,PONTIC - PORCELAIN/CERAMIC,1500.0,975.0,1.1,2073.11,86
CDM,D6250OH,PONTIC - RESIN WITH HIGH NOBLE METAL,1500.0,975.0,1.1,2121.48,86
CDM,D6251OH,PONTIC - RESIN WITH PREDOMINANTLY BASE METAL,1500.0,975.0,1.1,1955.64,86
CDM,D6252OH,PONTIC - RESIN WITH NOBLE METAL,1500.0,975.0,1.1,2017.83,86
CDM,D6253OH,PROVISIONAL PONTIC - FURTHER TREATMENT OR COMPLETION OF DIAGNOSI,500.0,325.0,1.1,2017.83,86
CDM,D6280OH,IMPLANT MAINTENANCE PROCEDURES WHEN A FULL ARCH REMOVABLE IMPLAN,250.0,162.5,1.1,250.0,68
CDM,D6545OH,RETAINER - CAST METAL FOR RESIN BONDED FIXED PROSTHESIS,1200.0,780.0,1.1,1200.0,86
CDM,D6548OH,RETAINER - PORCELAIN/CERAMIC FOR RESIN BONDED FIXED PROSTHESIS,1300.0,845.0,1.1,1300.0,86
CDM,D6549OH,RETAINER ? FOR RESIN BONDED FIXED PROSTHESIS,1300.0,845.0,1.1,2332.25,86
CDM,D6600OH,"RETAINER INLAY - PORCELAIN/CERAMIC, TWO SURFACES",1400.0,910.0,1.1,1872.7,86
CDM,D6601OH,"RETAINER INLAY - PORCELAIN/CERAMIC, THREE OR MORE SURFACES",1500.0,975.0,1.1,2149.12,86
CDM,D6602OH,"RETAINER INLAY - CAST HIGH NOBLE METAL, TWO SURFACES",1400.0,910.0,1.1,1872.7,86
CDM,D6603OH,"RETAINER INLAY - CAST HIGH NOBLE METAL, THREE OR MORE SURFACES",1500.0,975.0,1.1,2149.12,86
CDM,D6604OH,"RETAINER INLAY - CAST PREDOMINANTLY BASE METAL, TWO SURFACES",1400.0,910.0,1.1,1872.7,86
CDM,D6605OH,"RETAINER INLAY - CAST PREDOMINANTLY BASE METAL, THREE OR MORE SU",1500.0,975.0,1.1,2149.12,86
CDM,D6606OH,"RETAINER INLAY - CAST NOBLE METAL, TWO SURFACES",1500.0,975.0,1.1,1872.7,86
CDM,D6607OH,"RETAINER INLAY - CAST NOBLE METAL, THREE OR MORE SURFACES",1600.0,1040.0,1.1,2149.12,86
CDM,D6608OH,"RETAINER ONLAY - PORCELAIN/CERAMIC, TWO SURFACES",1500.0,975.0,1.1,2200.95,86
CDM,D6609OH,"RETAINER ONLAY - PORCELAIN/CERAMIC, THREE OR MORE SURFACES",1600.0,1040.0,1.1,2200.95,86
CDM,D6610OH,"RETAINER ONLAY - CAST HIGH NOBLE METAL, TWO SURFACES",1600.0,1040.0,1.1,2200.95,86
CDM,D6611OH,"RETAINER ONLAY - CAST HIGH NOBLE METAL, THREE OR MORE SURFACES",1600.0,1040.0,1.1,2200.95,86
CDM,D6612OH,"RETAINER ONLAY - CAST PREDOMINANTLY BASE METAL, TWO SURFACES",1500.0,975.0,1.1,2200.95,86
CDM,D6613OH,"RETAINER ONLAY - CAST PREDOMINANTLY BASE METAL, THREE OR MORE SU",1600.0,1040.0,1.1,2200.95,86
CDM,D6614OH,"RETAINER ONLAY - CAST NOBLE METAL, TWO SURFACES",1500.0,975.0,1.1,2200.95,86
CDM,D6615OH,"RETAINER ONLAY - CAST NOBLE METAL, THREE OR MORE SURFACES",1600.0,1040.0,1.1,2200.95,86
CDM,D6624OH,RETAINER INLAY - TITANIUM,1500.0,975.0,1.1,1872.7,86
CDM,D6634OH,RETAINER ONLAY - TITANIUM,1600.0,1040.0,1.1,2200.95,86
CDM,D6710OH,RETAINER CROWN - INDIRECT RESIN BASED COMPOSITE,1500.0,975.0,1.1,2394.44,86
CDM,D6720OH,RETAINER CROWN - RESIN WITH HIGH NOBLE METAL,1600.0,1040.0,1.1,2394.44,86
CDM,D6721OH,RETAINER CROWN - RESIN WITH PREDOMINANTLY BASE METAL,1500.0,975.0,1.1,2270.05,86
CDM,D6722OH,RETAINER CROWN - RESIN WITH NOBLE METAL,1500.0,975.0,1.1,2311.51,86
CDM,D6740OH,RETAINER CROWN - PORCELAIN/CERAMIC,1600.0,1040.0,1.1,2418.63,86
CDM,D6750OH,RETAINER CROWN - PORCELAIN FUSED TO HIGH NOBLE METAL,1600.0,1040.0,1.1,2453.18,86
CDM,D6751OH,RETAINER CROWN - PORCELAIN FUSED TO PREDOMINANTLY BASE METAL,1500.0,975.0,1.1,2287.33,86
CDM,D6752OH,RETAINER CROWN - PORCELAIN FUSED TO NOBLE METAL,1600.0,1040.0,1.1,2342.62,86
CDM,D6753OH,RETAINER CROWN - PORCELAIN FUSED TO TITANIUM AND TITANIUM ALLOYS,1600.0,1040.0,1.1,2501.56,86
CDM,D6780OH,RETAINER CROWN - 3/4 CAST HIGH NOBLE METAL,1600.0,1040.0,1.1,2311.51,86
CDM,D6781OH,RETAINER CROWN - 3/4 CAST PREDOMINANTLY BASE METAL,1600.0,1040.0,1.1,2314.98,86
CDM,D6782OH,RETAINER CROWN - 3/4 CAST NOBLE METAL,1600.0,1040.0,1.1,2314.98,86
CDM,D6783OH,RETAINER CROWN - 3/4 PORCELAIN/CERAMIC,1600.0,1040.0,1.1,2314.98,86
CDM,D6784OH,RETAINER CROWN 3/4 - TITANIUM AND TITANIUM ALLOYS,1600.0,1040.0,1.1,2501.56,86
CDM,D6790OH,RETAINER CROWN - FULL CAST HIGH NOBLE METAL,1600.0,1040.0,1.1,2366.81,86
CDM,D6791OH,RETAINER CROWN - FULL CAST PREDOMINANTLY BASE METAL,1500.0,975.0,1.1,2242.41,86
CDM,D6792OH,RETAINER CROWN - FULL CAST NOBLE METAL,1600.0,1040.0,1.1,2325.33,86
CDM,D6793OH,PROVISIONAL RETAINER CROWN,500.0,325.0,1.1,2270.05,86
CDM,D6794OH,RETAINER CROWN - TITANIUM,1600.0,1040.0,1.1,2270.05,86
CDM,D6920OH,CONNECTOR BAR,1600.0,1040.0,1.1,1600.0,86
CDM,D6930OH,RE-CEMENT OR RE-BOND FIXED PARTIAL DENTURE,250.0,162.5,1.1,286.78,86
CDM,D6940OH,STRESS BREAKER,700.0,455.0,1.1,700.0,86
CDM,D6950OH,PRECISION ATTACHMENT,900.0,585.0,1.1,1271.51,86
CDM,D6980OH,FIXED PARTIAL DENTURE REPAIR NECESSITATED BY RESTORATIVE MATERIA,500.0,325.0,1.1,677.21,86
CDM,D6985OH,PEDIATRIC PARTIAL DENTURE FX,2000.0,1300.0,1.1,2916.18,86
CDM,D6999OH,"UNSPECIFIED FIXED PROSTHODONTIC PROCEDURE, BY REPORT",900.0,585.0,0.01,900.0,80
CDM,D7111OH,"EXTRACTION, CORONAL REMNANTS ? PRIMARY TOOTH",175.0,113.75,1.1,290.24,86
CDM,D7140OH,"EXTRACTION, ERUPTED TOOTH OR EXPOSED ROOT (ELEVATION AND/OR FORC",300.0,195.0,1.1,300.0,86
CDM,D7210OH,"EXTRACTION, ERUPTED TOOTH REQUIRING REMOVAL OF BONE AND/OR SECTI",400.0,260.0,1.1,463.0,86
CDM,D7220OH,REMOVAL OF IMPACTED TOOTH - SOFT TISSUE,500.0,325.0,1.1,580.48,86
CDM,D7230OH,REMOVAL OF IMPACTED TOOTH - PARTIALLY BONY,550.0,357.5,1.1,773.96,86
CDM,D7240OH,REMOVAL OF IMPACTED TOOTH - COMPLETELY BONY,650.0,422.5,1.1,908.72,86
CDM,D7241OH,"REMOVAL OF IMPACTED TOOTH - COMPLETELY BONY, WITH UNUSUAL SURGIC",750.0,487.5,1.1,1143.67,86
CDM,D7250OH,REMOVAL OF RESIDUAL TOOTH ROOTS (CUTTING PROCEDURE),400.0,260.0,1.1,490.63,86
CDM,D7251OH,"CORONECTOMY ? INTENTIONAL PARTIAL TOOTH REMOVAL, IMPACTED TEETH",600.0,390.0,1.1,770.61,86
CDM,D7252OH,PARTIAL EXTRACTION FOR IMMEDIATE IMPLANT PLACEMENT,300.0,195.0,1.1,300.0,74
CDM,D7259OH,NERVE DISSECTION,500.0,325.0,1.1,500.0,68
CDM,D7260OH,OROANTRAL FISTULA CLOSURE,1600.0,1040.0,1.1,4816.53,86
CDM,D7261OH,PRIMARY CLOSURE OF A SINUS PERFORATION,1100.0,715.0,1.1,4720.48,86
CDM,D7270OH,TOOTH REIMPLANTATION AND/OR STABILIZATION OF ACCIDENTALLY EVULSE,800.0,520.0,1.1,998.54,86
CDM,D7272OH,TOOTH TRANSPLANTATION (INCLUDES REIMPLANTATION FROM ONE SITE TO,1000.0,650.0,1.1,1420.08,86
CDM,D7280OH,EXPOSURE OF AN UNERUPTED TOOTH,650.0,422.5,1.1,1095.3,86
CDM,D7282OH,MOBILIZATION OF ERUPTED OR MALPOSITIONED TOOTH TO AID ERUPTION,600.0,390.0,1.1,925.99,86
CDM,D7283OH,PLACEMENT OF DEVICE TO FACILITATE ERUPTION OF IMPACTED TOOTH,600.0,390.0,1.1,925.99,86
CDM,D7284OH,EXCISIONAL BIOPSY OF MINOR SALIVARY GLANDS,600.0,390.0,1.1,1143.67,86
CDM,D7285OH,"INCISIONAL BIOPSY OF ORAL TISSUE-HARD (BONE, TOOTH)",800.0,520.0,1.1,1934.9,86
CDM,D7286OH,INCISIONAL BIOPSY OF ORAL TISSUE-SOFT,500.0,325.0,1.1,794.69,86
CDM,D7287OH,EXFOLIATIVE CYTOLOGICAL SAMPLE COLLECTION,300.0,195.0,1.1,300.0,86
CDM,D7288OH,BRUSH BIOPSY - TRANSEPITHELIAL SAMPLE COLLECTION,300.0,195.0,1.1,1934.9,86
CDM,D7290OH,SURGICAL REPOSITIONING OF TEETH,600.0,390.0,1.1,1339.03,86
CDM,D7291OH,"TRANSSEPTAL FIBEROTOMY/SUPRA CRESTAL FIBEROTOMY, BY REPORT",400.0,260.0,1.1,1036.55,86
CDM,D7292OH,PLACEMENT OF TEMPORARY ANCHORAGE DEVICE [SCREW RETAINED PLATE] R,3900.0,2535.0,1.1,8519.64,86
CDM,D7293OH,PLACEMENT OF TEMPORARY ANCHORAGE DEVICE REQUIRING FLAP; INCLUDES,250.0,162.5,1.1,9005.98,86
CDM,D7294OH,PLACEMENT OF TEMPORARY ANCHORAGE DEVICE WITHOUT FLAP; INCLUDES D,250.0,162.5,1.1,5922.81,86
CDM,D7295OH,HARVEST OF BONE FOR USE IN AUTOGENOUS GRAFTING PROCEDURE,1400.0,910.0,1.1,2272.05,86
CDM,D7296OH,"CORTICOTOMY ? ONE TO THREE TEETH OR TOOTH SPACES, PER QUADRANT",1800.0,1170.0,1.1,1948.1,86
CDM,D7297OH,"CORTICOTOMY ? FOUR OR MORE TEETH OR TOOTH SPACES, PER QUADRANT",1500.0,975.0,1.1,2028.4,86
CDM,D7298OH,"REMOVAL OF TEMPORARY ANCHORAGE DEVICE (SCREW RETAINED PLATE), RE",1000.0,650.0,1.1,1000.0,80
CDM,D7299OH,"REMOVAL OF TEMPORARY ANCHORAGE DEVICE, REQUIRING FLAP",900.0,585.0,1.1,901.81,80
CDM,D7300OH,REMOVAL OF TEMPORARY ANCHORAGE DEVICE WITHOUT FLAP,500.0,325.0,1.1,901.81,80
CDM,D7310OH,ALVEOLOPLASTY IN CONJUNCTION WITH EXTRACTIONS - FOUR OR MORE TEE,500.0,325.0,1.1,542.47,86
CDM,D7311OH,ALVEOLOPLASTY IN CONJUNCTION WITH EXTRACTIONS - ONE TO THREE TEE,400.0,260.0,1.1,542.47,86
CDM,D7320OH,ALVEOLOPLASTY NOT IN CONJUNCTION WITH EXTRACTIONS - FOUR OR MORE,700.0,455.0,1.1,2418.63,86
CDM,D7321OH,ALVEOLOPLASTY NOT IN CONJUNCTION WITH EXTRACTIONS - ONE TO THREE,600.0,390.0,1.1,2418.63,86
CDM,D7340OH,VESTIBULOPLASTY - RIDGE EXTENSION (SECONDARY EPITHELIALIZATION),1800.0,1170.0,1.1,4329.35,86
CDM,D7350OH,"VESTIBULOPLASTY - RIDGE EXTENSION (INCLUDING SOFT TISSUE GRAFTS,",3600.0,2340.0,1.1,13533.95,86
CDM,D7410OH,EXCISION OF BENIGN LESION UP TO 1.25 CM,600.0,390.0,1.1,3006.01,86
CDM,D7411OH,EXCISION OF BENIGN LESION GREATER THAN 1.25 CM,800.0,520.0,1.1,800.0,86
CDM,D7412OH,"EXCISION OF BENIGN LESION, COMPLICATED",1500.0,975.0,1.1,2947.27,86
CDM,D7413OH,EXCISION OF MALIGNANT LESION UP TO 1.25 CM,1000.0,650.0,1.1,3044.02,86
CDM,D7414OH,EXCISION OF MALIGNANT LESION GREATER THAN 1.25 CM,1500.0,975.0,1.1,4733.6,86
CDM,D7415OH,"EXCISION OF MALIGNANT LESION, COMPLICATED",1600.0,1040.0,1.1,4733.6,86
CDM,D7440OH,EXCISION OF MALIGNANT TUMOR - LESION DIAMETER UP TO 1.25 CM,1200.0,780.0,1.1,3044.02,86
CDM,D7441OH,EXCISION OF MALIGNANT TUMOR - LESION DIAMETER GREATER THAN 1.25,2100.0,1365.0,1.1,4733.6,86
CDM,D7450OH,REMOVAL OF BENIGN ODONTOGENIC CYST OR TUMOR - LESION DIAMETER UP,900.0,585.0,1.1,1724.13,86
CDM,D7451OH,REMOVAL OF BENIGN ODONTOGENIC CYST OR TUMOR - LESION DIAMETER GR,1500.0,975.0,1.1,2708.86,86
CDM,D7460OH,REMOVAL OF BENIGN NONODONTOGENIC CYST OR TUMOR - LESION DIAMETER,1000.0,650.0,1.1,1724.13,86
CDM,D7461OH,REMOVAL OF BENIGN NONODONTOGENIC CYST OR TUMOR - LESION DIAMETER,1500.0,975.0,1.1,2777.97,86
CDM,D7471OH,REMOVAL OF LATERAL EXOSTOSIS (MAXILLA OR MANDIBLE),900.0,585.0,1.1,1727.59,86
CDM,D7472OH,REMOVAL OF TORUS PALATINUS,1300.0,845.0,1.1,1727.59,86
CDM,D7473OH,REMOVE TORUS MANDIBULARIS,1300.0,845.0,1.1,1727.59,86
CDM,D7485OH,SURG REDUCT OSSEOUSTUBEROSIT,1100.0,715.0,1.1,2363.34,86
CDM,D7490OH,RADICAL RESECTION OF MAXILLA OR MANDIBLE,9500.0,6175.0,1.1,24431.61,86
CDM,D7509OH,MARSUPIALIZATION OF ODONTOGENIC CYST,750.0,487.5,1.1,1437.35,86
CDM,D7510OH,INCISION AND DRAINAGE OF ABSCESS - INTRAORAL SOFT TISSUE,400.0,260.0,1.1,518.28,86
CDM,D7511OH,INCISION AND DRAINAGE OF ABSCESS - INTRAORAL SOFT TISSUE - COMPL,500.0,325.0,1.1,518.28,86
CDM,D7520OH,INCISION AND DRAINAGE OF ABSCESS - EXTRAORAL SOFT TISSUE,800.0,520.0,1.1,2463.55,86
CDM,D7521OH,INCISION AND DRAINAGE OF ABSCESS - EXTRAORAL SOFT TISSUE - COMPL,800.0,520.0,1.1,2463.55,86
CDM,D7530OH,"REMOVAL OF FOREIGN BODY FROM MUCOSA, SKIN, OR SUBCUTANEOUS ALVEO",500.0,325.0,1.1,887.98,86
CDM,D7540OH,"REMOVAL OF REACTION PRODUCING FOREIGN BODIES, MUSCULOSKELETAL SY",900.0,585.0,1.1,984.73,86
CDM,D7550OH,PARTIAL OSTECTOMY/SEQUESTRECTOMY FOR REMOVAL OF NON-VITAL BONE,500.0,325.0,1.1,615.02,86
CDM,D7560OH,MAXILLARY SINUSOTOMY FOR REMOVAL OF TOOTH FRAGMENT OR FOREIGN BO,2000.0,1300.0,1.1,4871.81,86
CDM,D7670OH,"ALVEOLUS - CLOSED REDUCTION, MAY INCLUDE STABILIZATION OF TEETH",2000.0,1300.0,1.1,3842.16,86
CDM,D7810OH,TMJ OPEN REDUCT-DISLOCATION,6000.0,3900.0,1.1,8665.61,86
CDM,D7820OH,CLOSED REDUCTION OF DISLOCATION,900.0,585.0,1.1,1420.08,86
CDM,D7880OH,"OCCLUSAL ORTHOTIC DEVICE, BY REPORT",1400.0,910.0,1.1,1506.46,86
CDM,D7881OH,OCCLUSAL ORTHOTIC DEVICE ADJUSTMENT,250.0,162.5,1.1,518.28,86
CDM,D7899OH,"UNSPECIFIED TMD THERAPY, BY REPORT",700.0,455.0,0.01,700.0,80
CDM,D7921OH,COLLECTION AND APPLICATION OF AUTOLOGOUS BLOOD CONCENTRATE PRODU,600.0,390.0,1.1,1420.08,86
CDM,D7922OH,PLACEMENT OF INTRA-SOCKET BIOLOGICAL DRESSING TO AID IN HEMOSTAS,150.0,97.5,1.1,324.8,74
CDM,D7939OH,INDEXING FOR OSTEOTOMY USING DYNAMIC ROBOTIC ASSISTED OR DYNAMIC,500.0,325.0,1.1,684.13,80
CDM,D7944OH,BONE CUTTING SEGMENTED,9000.0,5850.0,1.1,16152.99,86
CDM,D7950OH,"OSSEOUS, OSTEOPERIOSTEAL, OR CARTILAGE GRAFT OF THE MANDIBLE OR",3700.0,2405.0,1.1,3700.0,86
CDM,D7951OH,SINUS AUGMENTATION WITH BONE OR BONE SUBSTITUTES VIA A LATERAL O,3900.0,2535.0,1.1,3900.0,86
CDM,D7952OH,SINUS AUGMENTATION VIA A VERTICAL APPROACH,2800.0,1820.0,1.1,2800.0,86
CDM,D7953OH,BONE REPLACEMENT GRAFT FOR RIDGE PRESERVATION - PER SITE,900.0,585.0,1.1,2764.15,86
CDM,D7955OH,REPAIR OF MAXILLOFACIAL SOFT AND/OR HARD TISSUE DEFECT,4000.0,2600.0,1.1,17275.92,86
CDM,D7956OH,"GUIDED TISSUE REGENERATION, EDENTULOUS AREA ? RESORBABLE BARRIER",400.0,260.0,1.1,1803.6,86
CDM,D7957OH,"GUIDED TISSUE REGENERATION, EDENTULOUS AREA ? NON-RESORBABLE BAR",500.0,325.0,1.1,1803.6,86
CDM,D7960OH,FRENULECTOMY - ALSO KNOWN AS FRENECTOMY OR FRENOTOMY - SEPARATE,250.0,162.5,1.1,1136.75,80
CDM,D7961OH,BUCCAL/LABIAL FRENECTOMY (FRENULECTOMY),600.0,390.0,1.1,1057.29,86
CDM,D7962OH,LINGUAL FRENECTOMY (FRENULECTOMY),600.0,390.0,1.1,1057.29,86
CDM,D7970OH,EXCISION OF HYPERPLASTIC TISSUE - PER ARCH,700.0,455.0,1.1,1174.77,86
CDM,D7971OH,EXCISION OF PERICORONAL GINGIVA,400.0,260.0,1.1,400.0,86
CDM,D7972OH,SURGICAL REDUCTION OF FIBROUS TUBEROSITY,1000.0,650.0,1.1,1000.0,86
CDM,D7979OH,NON ? SURGICAL SIALOLITHOTOMY,850.0,552.5,1.1,850.0,74
CDM,D7999OH,"UNSPECIFIED ORAL SURGERY PROCEDURE, BY REPORT",850.0,552.5,0.01,850.0,80
CDM,D8010OH,LIMITED ORTHODONTIC TREATMENT OF THE PRIMARY DENTITION,3500.0,2275.0,1.1,3500.0,86
CDM,D8020OH,LIMITED ORTHODONTIC TREATMENT OF THE TRANSITIONAL DENTITION,3000.0,1950.0,1.1,4837.26,86
CDM,D8080OH,COMPREHENSIVE ORTHODONTIC TREATMENT OF THE ADOLESCENT DENTITION,5500.0,3575.0,1.1,16584.89,86
CDM,D8090.1OH,REFINEMENT ORTHODONTIC TREATMENT OF THE ADULT DENTITION,200.0,130.0,1.1,17275.92,86
CDM,D8090OH,COMPREHENSIVE ORTHODONTIC TREATMENT OF THE ADULT DENTITION,6000.0,3900.0,1.1,17275.92,86
CDM,D8210OH,REMOVABLE APPLIANCE THERAPY,500.0,325.0,1.1,853.88,86
CDM,D8660OH,PRE-ORTHODONTIC TREATMENT EXAMINATION TO MONITOR GROWTH AND DEVE,400.0,260.0,1.1,400.0,86
CDM,D8670OH,PERIODIC ORTHODONTIC TREATMENT VISIT,400.0,260.0,1.1,525.19,86
CDM,D8671OH,PERIODIC ORTHODONTIC TREATMENT VISIT ASSOCIATED WITH ORTHOGNATHI,100.0,65.0,1.1,691.04,86
CDM,D8680.1OH,ORTHODONTIC RETENTION UPPER,250.0,162.5,1.1,1154.03,86
CDM,D8680.2OH,ORTHODONTIC RETENTION LOWER,250.0,162.5,1.1,1154.03,86
CDM,D8680OH,"ORTHODONTIC RETENTION (REMOVAL OF APPLIANCES, CONSTRUCTION AND P",600.0,390.0,1.1,1154.03,86
CDM,D8681OH,REMOVABLE ORTHODONTIC RETAINER ADJUSTMENT,275.0,178.75,1.1,863.79,86
CDM,D8695OH,REMOVAL OF FIXED ORTHODONTIC APPLIANCES FOR REASONS OTHER THAN C,300.0,195.0,1.1,300.0,74
CDM,D8696OH,REPAIR OF ORTHODONTIC APPLIANCE - MAXILLARY,250.0,162.5,1.1,518.28,86
CDM,D8697OH,REPAIR OF ORTHODONTIC APPLIANCE - MANDIBULAR,250.0,162.5,1.1,518.28,86
CDM,D8698OH,RE-CEMENT OR RE-BOND FIXED RETAINER - MAXILLARY,300.0,195.0,1.1,863.79,86
CDM,D8699OH,RE-CEMENT OR RE-BOND FIXED RETAINER - MANDIBULAR,300.0,195.0,1.1,863.79,86
CDM,D8701OH,"REPAIR OF FIXED RETAINER, INCLUDES REATTACHMENT - MAXILLARY",250.0,162.5,1.1,863.79,86
CDM,D8702OH,"REPAIR OF FIXED RETAINER, INCLUDES REATTACHMENT - MANDIBULAR",250.0,162.5,1.1,863.79,86
CDM,D8703OH,REPLACEMENT OF LOST OR BROKEN RETAINER - MAXILLARY,200.0,130.0,1.1,863.79,86
CDM,D8704OH,REPLACEMENT OF LOST OR BROKEN RETAINER - MANDIBULAR,200.0,130.0,1.1,863.79,86
CDM,D8999.1OH,ORTHODONTIC RECORDS,300.0,195.0,0.01,300.0,80
CDM,D8999.2OH,INVISALIGN UPCHARGES,2200.0,1430.0,0.01,2200.0,80
CDM,D8999OH,"UNSPECIFIED ORTHODONTIC PROCEDURE, BY REPORT",600.0,390.0,0.01,600.0,80
CDM,D9110OH,PALLIATIVE TREATMENT OF DENTAL PAIN ??PER VISIT,175.0,113.75,1.1,183.13,86
CDM,D9120OH,FIXED PARTIAL DENTURE SECTIONING,300.0,195.0,1.1,570.11,86
CDM,D9128OH,"PHOTOBIOMODULATION THERAPY - FIRST 15 MINUTE INCREMENT, OR ANY P",250.0,162.5,1.1,250.0,68
CDM,D9129OH,PHOTOBIOMODULATION THERAPY - EACH SUBSEQUENT 15 MINUTE INCREMENT,75.0,48.75,1.1,75.0,68
CDM,D9130OH,TEMPOROMANDIBULAR JOINT DYSFUNCTION ? NON-INVASIVE PHYSICAL THER,300.0,195.0,0.01,300.0,86
CDM,D9210OH,LOCAL ANESTHESIA NOT IN CONJUNCTION WITH OPERATIVE OR SURGICAL P,100.0,65.0,1.1,100.0,86
CDM,D9219OH,"EVALUATION FOR MODERATE SEDATION, DEEP SEDATION OR GENERAL ANEST",150.0,97.5,1.1,150.0,68
CDM,D9222OH,ADMINISTRATION OF DEEP SEDATION/GENERAL ANESTHESIA - FIRST 15 MI,350.0,227.5,1.1,494.09,86
CDM,D9223OH,ADMINISTRATION OF DEEP SEDATION/GENERAL ANESTHESIA ? EACH SUBSEQ,300.0,195.0,1.1,300.0,86
CDM,D9224OH,ADMINISTRATION OF GENERAL ANESTHESIA WITH ADVANCED AIRWAY ? FIRS,500.0,325.0,1.1,500.0,68
CDM,D9225OH,ADMINISTRATION OF GENERAL ANESTHESIA WITH ADVANCED AIRWAY ? EACH,250.0,162.5,1.1,250.0,68
CDM,D9230OH,"INHALATION OF NITROUS OXIDE/ANALGESIA, ANXIOLYSIS",100.0,65.0,1.1,100.2,86
CDM,D9239OH,ADMINISTRATION OF MODERATE SEDATION - INTRAENOUS - FIRST 15 MINU,300.0,195.0,1.1,438.81,86
CDM,D9243OH,ADMINISTRATION OF MODERATE SEDATION - INTRAVENOUS - EACH SUBSEQU,350.0,227.5,1.1,350.0,86
CDM,D9244OH,IN-OFFICE ADMINISTRATION OF MINIMAL SEDATION ? SINGLE DRUG ? ENT,250.0,162.5,1.1,250.0,68
CDM,D9245OH,ADMINISTRATION OF MODERATE SEDATION ? ENTERAL,350.0,227.5,1.1,350.0,68
CDM,D9246OH,ADMINISTRATION OF MODERATE SEDATION ? NON-INTRAVENOUS PARENTERAL,350.0,227.5,1.1,350.0,68
CDM,D9247OH,ADMINISTRATION OF MODERATE SEDATION ? NON-INTRAVENOUS PARENTERAL,300.0,195.0,1.1,300.0,68
CDM,D9310.1OH,CONSULT - DR. KAHN,200.0,130.0,1.1,390.43,86
CDM,D9310OH,CONSULTATION - DIAGNOSTIC SERVICE PROVIDED BY DENTIST OR PHYSICI,200.0,130.0,1.1,390.43,86
CDM,D9311OH,CONSULTATION WITH A MEDICAL HEALTH CARE PROFESSIONAL,250.0,162.5,1.1,290.24,86
CDM,D9420OH,HOSPITAL OR AMBULATORY SURGICAL CENTER CALL,400.0,260.0,1.1,708.31,86
CDM,D9430OH,OFFICE VISIT FOR OBSERVATION (DURING REGULARLY SCHEDULED HOURS),100.0,65.0,1.1,131.3,86
CDM,D9440OH,OFFICE VISIT - AFTER REGULARLY SCHEDULED HOURS,250.0,162.5,1.1,250.0,86
CDM,D9450OH,"CASE PRESENTATION,?SUBSEQUENT TO?DETAILED AND EXTENSIVE TREATMEN",240.0,156.0,1.1,390.43,86
CDM,D9613OH,INFILTRATION OF SUSTAINED RELEASE THERAPEUTIC DRUG ? SINGLE OR M,260.0,169.0,0.01,260.0,86
CDM,D9630OH,DRUGS OR MEDICAMENTS DISPENSED IN THE OFFICE FOR HOME USE,65.0,42.25,1.1,86.39,86
CDM,D9910OH,APPLICATION OF DESENSITIZING MEDICAMENT,75.0,48.75,1.1,82.92,86
CDM,D9911OH,APPLICATION OF DESENSITIZING RESIN FOR CERVICAL AND/OR ROOT SURF,100.0,65.0,1.1,224.59,86
CDM,D9912OH,PRE-VISIT PATIENT SCREENING,180.0,117.0,1.1,1257.69,86
CDM,D9932OH,"CLEANING AND INSPECTION OF REMOVABLE COMPLETE DENTURE, MAXILLARY",125.0,81.25,1.1,224.59,86
CDM,D9933OH,"CLEANING AND INSPECTION OF REMOVABLE COMPLETE DENTURE, MANDIBULA",125.0,81.25,1.1,224.59,86
CDM,D9934OH,"CLEANING AND INSPECTION OF REMOVABLE PARTIAL DENTURE, MAXILLARY",125.0,81.25,1.1,224.59,86
CDM,D9935OH,"CLEANING AND INSPECTION OF REMOVABLE PARTIAL DENTURE, MANDIBULAR",125.0,81.25,1.1,224.59,86
CDM,D9936OH,CLEANING AND INSPECTION OF OCCLUSAL GUARD ? PER APPLIANCE,100.0,65.0,1.1,100.0,68
CDM,D9938OH,FABRICATION OF A CUSTOM REMOVABLE CLEAR PLASTIC TEMPORARY AESTHE,200.0,130.0,1.1,314.43,80
CDM,D9939OH,PLACEMENT OF A CUSTOM REMOVABLE CLEAR PLASTIC TEMPORARY AESTHETI,200.0,130.0,1.1,200.0,74
CDM,D9941.1OH,ATHLETIC TRAUMA SPLINT,100.0,65.0,1.1,293.69,86
CDM,D9941OH,FABRICATION OF ATHLETIC MOUTHGUARD,350.0,227.5,1.1,350.0,86
CDM,D9942OH,REPAIR AND/OR RELINE OF OCCLUSAL GUARD,300.0,195.0,1.1,1364.8,86
CDM,D9943OH,OCCLUSAL GUARD ADJUSTMENT,175.0,113.75,1.1,324.79,86
CDM,D9944.1OH,NIGHTGUARD,1000.0,650.0,1.1,1257.69,86
CDM,D9944.2OH,OCCLSAL GUARD,850.0,552.5,1.1,1257.69,86
CDM,D9944OH,"OCCLUSAL GUARD ? HARD APPLIANCE, FULL ARCH",1600.0,1040.0,1.1,1600.0,86
CDM,D9945OH,"OCCLUSAL GUARD ? SOFT APPLIANCE, FULL ARCH",700.0,455.0,1.1,700.0,86
CDM,D9946.1OH,MINI COMFORT,300.0,195.0,0.01,315.12,86
CDM,D9946OH,"OCCLUSAL GUARD ? HARD APPLIANCE, PARTIAL ARCH",700.0,455.0,0.01,700.0,86
CDM,D9947OH,CUSTOM SLEEP APNEA APPLIANCE FABRICATION AND PLACEMENT,4000.0,2600.0,1.1,4000.0,86
CDM,D9948OH,ADJUSTMENT OF CUSTOM SLEEP APNEA APPLIANCE,150.0,97.5,1.1,1257.69,86
CDM,D9949OH,REPAIR OF CUSTOM SLEEP APNEA APPLIANCE,500.0,325.0,1.1,1257.69,80
CDM,D9951OH,OCCLUSAL ADJUSTMENT - LIMITED,250.0,162.5,1.1,250.0,86
CDM,D9952OH,OCCLUSAL ADJUSTMENT - COMPLETE,900.0,585.0,1.1,1323.34,86
CDM,D9953OH,RELINE CUSTOM SLEEP APNEA APPLIANCE (INDIRECT),400.0,260.0,0.01,400.0,86
CDM,D9954OH,FABRICATION AND DELIVERY OF ORAL APPLIANCE THERAPY (OAT) MORNING,200.0,130.0,1.1,200.0,68
CDM,D9955OH,ORAL APPLIANCE THERAPY (OAT) TITRATION VISIT,150.0,97.5,1.1,150.0,74
CDM,D9959OH,"UNSPECIFIED SLEEP APNEA SERVICES PROCEDURE, BY REPORT",125.0,81.25,1.1,125.0,68
CDM,D9970OH,ENAMEL MICROABRASION,250.0,162.5,1.1,250.0,86
CDM,D9971OH,ODONTOPLASTY 1 - 2 TEETH; INCLUDES REMOVAL OF ENAMEL PROJECTIONS,200.0,130.0,1.1,200.0,86
CDM,D9974OH,INTERNAL BLEACHING - PER TOOTH,350.0,227.5,1.1,350.0,86
CDM,D9975OH,"EXTERNAL BLEACHING FOR HOME APPLICATION, PER ARCH; INCLUDES MATE",400.0,260.0,1.1,400.0,86
CDM,D9986OH,MISSED APPOINTMENT,75.0,48.75,1.1,127.85,80
CDM,D9987OH,CANCELLED APPOINTMENT,75.0,48.75,1.1,127.85,80
CDM,D9990OH,CERTIFIED TRANSLATION OR SIGN-LANGUAGE SERVICES ? PER VISIT,125.0,81.25,0.01,125.0,86
CDM,D9991OH,DENTAL CASE MANAGEMENT ? ADDRESSING APPOINTMENT COMPLIANCE BARRI,125.0,81.25,0.01,125.0,86
CDM,D9992OH,DENTAL CASE MANAGEMENT ? CARE COORDINATION,172.0,111.8,0.01,172.0,86
CDM,D9993OH,DENTAL CASE MANAGEMENT ? MOTIVATIONAL INTERVIEWING,125.0,81.25,0.01,125.0,86
CDM,D9994OH,DENTAL CASE MANAGEMENT ? PATIENT EDUCATION TO IMPROVE ORAL HEALT,100.0,65.0,0.01,100.0,86
CDM,D9995OH,TELEDENTISTRY ? SYNCHRONOUS; REAL-TIME ENCOUNTER,300.0,195.0,1.1,300.0,74
CDM,D9996OH,TELEDENTISTRY ? ASYNCHRONOUS; INFORMATION STORED AND FORWARDED T,175.0,113.75,1.1,175.0,74
CDM,D9997OH,DENTAL CASE MANAGEMENT - PATIENTS WITH SPECIAL HEALTH CARE NEEDS,150.0,97.5,1.1,150.0,74
CDM,D9999OH,"UNSPECIFIED ADJUNCTIVE PROCEDURE, BY REPORT",300.0,195.0,0.01,300.0,80
CDM,E0105OH,"CANE, QUAD OR THREE PRONG",28.05,18.23,1.1,192.84,90
CDM,E0110OH,"CRUTCHES, FOREARM",85.88,55.82,1.1,275.49,90
CDM,E0118OH,CRUTCH SUBSTITUTE,499.0,324.35,1.1,688.73,80
CDM,E0149OH,HEAVY DUTY WHEELED WALKER,290.0,188.5,1.1,737.79,90
CDM,E0155OH,WHEEL ATTACHMENT,15.85,10.3,1.1,88.63,90
CDM,E0163OH,"COMMODE CHAIR, STATIONARY",47.55,30.91,1.1,394.75,90
CDM,E0240OH,BATH/SHOWER CHAIR,38.5,25.03,1.1,241.86,80
CDM,E0241OH,"BATH TUB WALL RAIL, EACH",16.7,10.86,1.1,59.85,86
CDM,E0242OH,"BATH TUB RAIL, FLOOR BASE",37.0,24.05,1.1,174.48,86
CDM,E0243OH,"TOILET RAIL, EACH",35.0,22.75,1.1,107.94,86
CDM,E0244OH,RAISED TOILET SEAT,32.0,20.8,1.1,84.3,86
CDM,E0247OH,TRANS BENCH W/WO COMM OPEN,94.95,61.72,1.1,348.97,86
CDM,E0425OH,"COMPRESSED GAS SYSTEM, PURCHASED",472.0,306.8,1.1,2860.9,86
CDM,E0486OH,ORAL DEVICE/APPLIANCE CUSFAB,4000.0,2600.0,1.1,4664.5,82
CDM,E0570OH,"NEBULIZER, WITH COMPRESSOR",76.85,49.95,1.1,617.44,90
CDM,E0602OH,BREAST PUMP,73.5,47.78,1.1,122.44,90
CDM,E0603OH,ELECTRIC BREAST PUMP,168.0,109.2,1.1,621.93,86
CDM,E0675OH,PNEUMATIC COMPRESSION DEVICE,105.0,68.25,1.1,16863.05,90
CDM,E0860OH,"TRACTION EQUIPMENT, OVERDOOR",58.0,37.7,1.1,162.23,90
CDM,E2603OH,SKIN PROTECT WC CUS WD <22IN,47.0,30.55,1.1,581.37,90
CDM,G0008OH,ADMIN FLU VIRUS VACCINE,68.0,44.2,1.1,205.09,142
CDM,G0009OH,MEDICAR PT ADMIN.PNEUMOCCAL VIR,43.0,27.95,1.1,137.75,90
CDM,G0010OH,HEPATITIS B ADMINIS,99.0,64.35,1.1,137.75,90
CDM,G0101OH,"CERV/VAG CANC SCRN,PELV/BREAST EXAM",198.0,128.7,1.1,260.19,144
CDM,G0102OH,PROSTATE CA SCREENING; DRE,79.0,51.35,1.1,79.0,128
CDM,G0104OH,SCREENING SIGMOIDOSCOPY,370.0,240.5,1.1,2666.13,130
CDM,G0105OH,"COLONOSCOPY, SCREENING, HIGH RISK",1434.0,932.1,1.1,2666.13,130
CDM,G0108OH,"DIAB OUTPT TRAINING INDIV, PER SESSN",396.0,257.4,1.1,396.0,140
CDM,G0109OH,"DIAB TRAIN SERV, GROUP SESSN,INDIVID",110.0,71.5,1.1,110.0,140
CDM,G0117OH,GLAUCOMA SCRN HGH RISK DIREC,198.0,128.7,1.1,206.8,128
CDM,G0121OH,COLONOSCOPY SCRN NOT HIGH RISK,1434.0,932.1,1.1,2666.13,130
CDM,G0127OH,"TRIMMING DYSTROPHIC NAILS,ANY NUMBER",75.0,48.75,1.1,177.54,132
CDM,G0136OH,"ADMINISTRATION OF A STANDARDIZED, EVIDENCE-BASED SOCIAL DETERMIN",79.0,51.35,1.1,82.65,128
CDM,G0168OH,WOUND CLOSURE BY ADHESIVE,136.0,88.4,1.1,401.5,128
CDM,G0179OH,MD RECERTIFICATION HHA PT,198.0,128.7,1.1,198.0,128
CDM,G0180OH,MD CERTIFICATION HHA PATIENT,295.0,191.75,1.1,295.0,128
CDM,G0181OH,HOME HEALTH CARE SUPERVISION,761.0,494.65,1.1,761.0,128
CDM,G0235OH,PET NOT OTHERWISE SPECIFIED,8870.0,5765.5,0.01,8870.0,80
CDM,G0235OH-26,PET NOT OTHERWISE SPECIFIED,643.0,417.95,1.1,643.0,68
CDM,G0235OH-TC,PET NOT OTHERWISE SPECIFIED,8227.0,5347.55,1.1,8227.0,72
CDM,G0245OH,INITIAL FOOT EXAM PT LOPS,387.0,251.55,1.1,387.0,130
CDM,G0246OH,FOLLOWUP EVAL OF FOOT PT LOP,198.0,128.7,1.1,385.69,130
CDM,G0247OH,ROUTINE FOOTCARE PT W LOPS,220.0,143.0,1.1,584.65,130
CDM,G0248OH,DEMONSTRATE USE HOME INR MON,1322.0,859.3,1.1,1322.0,128
CDM,G0249OH,"PROVIDE TEST MATERIAL,EQUIPM",1322.0,859.3,1.1,1322.0,128
CDM,G0250OH,MD REVIEW INTERPRET OF TEST,79.0,51.35,1.1,79.0,128
CDM,G0268OH,REMOVAL OF IMPACTED WAX MD,268.0,174.2,1.1,268.0,128
CDM,G0269OH,OCCLUSIVE DEVICE IN VEIN ART,75.0,48.75,1.1,4273.03,80
CDM,G0270OH,MEDICAL NUTRITION THERAPY; REASSESSMENT,198.0,128.7,1.1,198.0,128
CDM,G0271OH,GROUP MNT 2 OR MORE 30 MINS,110.0,71.5,1.1,110.0,128
CDM,G0278OH,"ILIAC ART ANGIO,CARDIAC CATH",110.0,71.5,1.1,110.0,128
CDM,G0279OH,"TOMOSYNTHESIS, MAMMO",351.0,228.15,1.1,351.0,142
CDM,G0279OH-26,"TOMOSYNTHESIS, MAMMO",264.0,171.6,1.1,264.0,126
CDM,G0279OH-TC,"TOMOSYNTHESIS, MAMMO",87.0,56.55,1.1,89.82,126
CDM,G0289OH,"ARTHRO, LOOSE BODY + CHONDRO",651.0,423.15,1.1,651.0,130
CDM,G0296OH,VISIT TO DETERM LDCT ELIG,229.0,148.85,1.1,260.19,142
CDM,G0310OH,5-15 MINS TIME,78.0,50.7,0.01,3060831.65,80
CDM,G0311OH,16-30 MINS TIME,78.0,50.7,0.01,3060831.65,80
CDM,G0312OH,"AGES UNDER 21, 5-15 MINS TIME",77.0,50.05,0.01,3060831.65,92
CDM,G0313OH,"AGES UNDER 21, 16-30 MINS TIME",117.0,76.05,0.01,3060831.65,92
CDM,G0316OH,PROLONG INPT EVAL ADD15 M,268.0,174.2,1.1,268.0,140
CDM,G0317OH,PROLONG NURSIN FAC EVAL 15M,244.0,158.6,1.1,244.0,140
CDM,G0318OH,PROLONG HOME EVAL ADD 15M,244.0,158.6,1.1,244.0,140
CDM,G0372OH,MD SERVICE REQUIRED FOR PMD,75.0,48.75,1.1,75.0,128
CDM,G0396OH,ALCOHOL/SUBS INTERV 15-30MN,286.0,185.9,1.1,286.0,140
CDM,G0397OH,ALCOHOL/SUBS INTERV >30 MIN,572.0,371.8,1.1,572.0,140
CDM,G0402OH,INITIAL PREVENTIVE EXAM,1144.0,743.6,1.1,1144.0,130
CDM,G0403OH,EKG FOR INITIAL PREVENT EXAM,75.0,48.75,1.1,75.0,130
CDM,G0404OH,EKG TRACING FOR INITIAL PREV,279.0,181.35,1.1,279.0,128
CDM,G0405OH,EKG INTERPRET & REPORT PREVE,75.0,48.75,1.1,75.0,128
CDM,G0406OH,TELEHEALTH FOLLOW-UP INPT CONSULTATION 15 MINS,334.0,217.1,1.1,334.0,140
CDM,G0407OH,TELEHEALTH FOLLOW-UP INPT CONSULTATION 25 MINS,612.0,397.8,1.1,612.0,142
CDM,G0408OH,TELEHEALTH FOLLOW-UP INPT CONSULTATION 35 MINS,880.0,572.0,1.1,880.0,140
CDM,G0412OH,OPEN TX ILIAC SPINE UNI/BIL,4598.0,2988.7,1.1,4598.0,128
CDM,G0413OH,PELVIC RING FRACTURE UNI/BIL,6921.0,4498.65,1.1,20863.78,128
CDM,G0415OH,OPEN TX POST PELVIC FXCTURE,9209.0,5985.85,1.1,9209.0,128
CDM,G0416OH,SAT BIOPSY PROSTATE 1-20 SPC,2879.0,1871.35,1.1,2879.0,128
CDM,G0416OH-26,SAT BIOPSY PROSTATE 1-20 SPC,1440.0,936.0,1.1,1440.0,124
CDM,G0416OH-TC,SAT BIOPSY PROSTATE 1-20 SPC,1439.0,935.35,1.1,1439.0,126
CDM,G0420OH,ED SVC CKD IND PER SESSION,933.0,606.45,1.1,933.0,128
CDM,G0421OH,ED SVC CKD GRP PER SESSION,220.0,143.0,1.1,220.0,128
CDM,G0422OH,PR INTENS CARDIAC REHAB W/EXERC,796.0,517.4,1.1,796.0,128
CDM,G0423OH,PR INTENS CARDIAC REHAB NO EXER,796.0,517.4,1.1,796.0,128
CDM,G0425OH,PR INPT TELEHEALTH CONSULT 30M,845.0,549.25,1.1,845.0,142
CDM,G0426OH,PR INPT TELEHEALTH CONSULT 50M,1148.0,746.2,1.1,1148.0,142
CDM,G0427OH,PR INPT TELEHEALTH CON 70/>M,1698.0,1103.7,1.1,1698.0,140
CDM,G0438OH,"PPPS, INITIAL VISIT",1040.0,676.0,1.1,1040.0,130
CDM,G0439OH,"PPPS, SUBSEQ VISIT",768.0,499.2,1.1,768.0,130
CDM,G0444OH,DEPRESSION SCREEN ANNUAL,79.0,51.35,1.1,82.65,128
CDM,G0446OH,INTENS BEHAVE THER CARDIO DX,264.0,171.6,1.1,264.0,128
CDM,G0447OH,BEHAVIOR COUNSEL OBESITY 15M,264.0,171.6,1.1,264.0,128
CDM,G0452OH,MOLECULAR PATHOLOGY INTERPR,819.0,532.35,1.1,819.0,130
CDM,G0452OH-26,MOLECULAR PATHOLOGY INTERPR,372.0,241.8,1.1,372.0,126
CDM,G0452OH-TC,MOLECULAR PATHOLOGY INTERPR,447.0,290.55,1.1,447.0,114
CDM,G0453OH,CONT INTRAOP NEURO MONITOR,264.0,171.6,1.1,264.0,128
CDM,G0454OH,MD DOCUMENT VISIT BY NPP,79.0,51.35,1.1,133.94,140
CDM,G0455OH,FECAL MICROBIOTA PREP INSTILL,590.0,383.5,1.1,2666.13,128
CDM,G0481OH,DRUG TEST DEF 8-14 CLASSES,651.0,423.15,1.1,651.0,88
CDM,G0498OH,CHEMO EXTEND IV INFUSION W/PUMP,1530.0,994.5,1.1,1530.0,78
CDM,G0500OH,MOD SEDAT ENDO SERVICE >5YRS,44.0,28.6,1.1,179.7,130
CDM,G0506OH,COMP ASSES CARE PLAN CCM SVC,383.0,248.95,1.1,664.19,128
CDM,G0508OH,CRIT CARE TELEHEA CONSULT 60,1760.0,1144.0,1.1,3041.49,128
CDM,G0509OH,CRIT CARE TELEHEA CONSULT 50,1698.0,1103.7,1.1,2875.08,128
CDM,G0537OH,RISK ASCVD TST ONCE PR 12 MO,79.0,51.35,1.1,79.0,126
CDM,G0538OH,ASCVD RSK MNG CLIN STF PR MO,79.0,51.35,1.1,79.0,126
CDM,G0545OH,INFECTIOUS DISEASE CONFIRMED/SUSPECTED INHERENT TO INPATIENT OR,392.0,254.8,1.1,392.0,126
CDM,G0546OH,PHONE/INTERNET EHR ASSESS,154.0,100.1,1.1,154.0,126
CDM,G0547OH,PHONE/INTERNET SVS 11-20 M,308.0,200.2,1.1,308.0,126
CDM,G0548OH,PHONE/INTER SVS 21-30 M,462.0,300.3,1.1,462.0,126
CDM,G0549OH,PHONE/INTER FOR TREAT>31 M,616.0,400.4,1.1,616.0,126
CDM,G0552OH,SUPPLY OF DIGITAL DEVICE,248.0,161.2,1.1,248.0,74
CDM,G0553OH,MONTHLY TX FOR DMHT 20MINS,273.0,177.45,1.1,273.0,114
CDM,G0554OH,ADD 20 M OF MONTHLY TX,268.0,174.2,1.1,268.0,114
CDM,G0556OH,ADV PRIM CARE MGMT LVL 1,110.0,71.5,1.1,110.0,126
CDM,G0557OH,ADV PRIM CARE MGMT LVL 2,339.0,220.35,1.1,339.0,126
CDM,G0558OH,ADV PRIM CARE MGMT LVL 3,735.0,477.75,1.1,735.0,126
CDM,G0559OH,POST-OP FOLLOW-UP PROVIDED BY A DIFFERENT PRACTICE FROM THE SURG,70.0,45.5,1.1,70.0,126
CDM,G0571OH,INTRAOP NERVE CRYOABLATION,598.0,388.7,1.1,598.0,104
CDM,G2010OH,REMOT IMAGE SUBMIT BY PT,79.0,51.35,1.1,133.94,142
CDM,G2211OH,VISIT CPLX INHERENT E&M ASSOC WITH MED CARE SRVC,145.0,94.25,1.1,145.0,128
CDM,G2212OH,PROLONG OUTPT/OFFICE VIS,268.0,174.2,1.1,268.0,140
CDM,G2213OH,INITIAT MED ASSIST TX IN ER,572.0,371.8,1.1,572.0,128
CDM,G8539OH,DOC FUNCT AND CARE PLAN,692.0,449.8,0.01,692.0,80
CDM,G8864OH,PNEUMOCOCCAL VACCINE ADMIN,37.0,24.05,0.01,37.0,80
CDM,G9050OH,ONCOLOGY WORK-UP EVALUATION,24.0,15.6,0.01,24.0,86
CDM,G9051OH,ONCOLOGY TX DECISION-MGMT,24.0,15.6,0.01,3060831.65,86
CDM,G9052OH,ONC SURVEILLANCE FOR DISEASE,24.0,15.6,0.01,3060831.65,86
CDM,G9053OH,ONC EXPECTANT MANAGEMENT PT,24.0,15.6,0.01,3060831.65,86
CDM,G9054OH,ONC SUPERVISION PALLIATIVE,24.0,15.6,0.01,3060831.65,86
CDM,G9055OH,ONC VISIT UNSPECIFIED NOS,24.0,15.6,0.01,3060831.65,86
CDM,G9056OH,ONC PRAC MGMT ADHERES GUIDE,24.0,15.6,0.01,3060831.65,86
CDM,G9057OH,ONC PRACT MGMT DIFFERS TRIAL,24.0,15.6,0.01,3060831.65,86
CDM,G9058OH,ONC PRAC MGMT DISAGREE W/GUI,24.0,15.6,0.01,3060831.65,86
CDM,G9059OH,ONC PRAC MGMT PT OPT ALTERNA,24.0,15.6,0.01,3060831.65,86
CDM,G9060OH,ONC PRAC MGMT DIF PT COMORB,24.0,15.6,0.01,3060831.65,86
CDM,G9061OH,ONC PRAC COND NOADD BY GUIDE,24.0,15.6,0.01,3060831.65,86
CDM,G9062OH,ONC PRAC GUIDE DIFFERS NOS,24.0,15.6,0.01,3060831.65,86
CDM,G9063OH,ONC DX NSCLC STGI NO PROGRES,24.0,15.6,0.01,3060831.65,86
CDM,G9064OH,ONC DX NSCLC STG2 NO PROGRES,24.0,15.6,0.01,3060831.65,86
CDM,G9065OH,ONC DX NSCLC STG3A NO PROGRE,24.0,15.6,0.01,3060831.65,86
CDM,G9066OH,ONC DX NSCLC STG3B-4 METASTA,24.0,15.6,0.01,3060831.65,86
CDM,G9067OH,ONC DX NSCLC DX UNKNOWN NOS,24.0,15.6,0.01,3060831.65,86
CDM,G9068OH,ONC DX SCLC/NSCLC LIMITED,24.0,15.6,0.01,3060831.65,86
CDM,G9069OH,ONC DX SCLC/NSCLC EXT AT DX,24.0,15.6,0.01,3060831.65,86
CDM,G9070OH,ONC DX SCLC/NSCLC EXT UNKNWN,24.0,15.6,0.01,3060831.65,86
CDM,G9071OH,"ONC DX BRST STG1-2B HR,NOPRO",24.0,15.6,0.01,3060831.65,86
CDM,G9072OH,ONC DX BRST STG1-2 NOPROGRES,24.0,15.6,0.01,3060831.65,86
CDM,G9073OH,"ONC DX BRST STG3-HR, NO PRO",24.0,15.6,0.01,3060831.65,86
CDM,G9074OH,ONC DX BRST STG3-NOPROGRESS,24.0,15.6,0.01,3060831.65,86
CDM,G9075OH,ONC DX BRST METASTIC/ RECUR,24.0,15.6,0.01,3060831.65,86
CDM,G9077OH,ONC DX PROSTATE T1NO PROGRES,24.0,15.6,0.01,3060831.65,86
CDM,G9078OH,ONC DX PROSTATE T2NO PROGRES,24.0,15.6,0.01,3060831.65,86
CDM,G9079OH,ONC DX PROSTATE T3B-T4NOPROG,24.0,15.6,0.01,3060831.65,86
CDM,G9080OH,ONC DX PROSTATE W/RISE PSA,24.0,15.6,0.01,3060831.65,86
CDM,G9083OH,ONC DX PROSTATE UNKNOWN NOS,24.0,15.6,0.01,3060831.65,86
CDM,G9084OH,"ONC DX COLON T1-3,N1-2,NO PR",24.0,15.6,0.01,3060831.65,86
CDM,G9085OH,"ONC DX COLON T4, N0 W/O PROG",24.0,15.6,0.01,3060831.65,86
CDM,G9086OH,ONC DX COLON T1-4 NO DX PROG,24.0,15.6,0.01,3060831.65,86
CDM,G9087OH,ONC DX COLON METAS EVID DX,24.0,15.6,0.01,3060831.65,86
CDM,G9088OH,ONC DX COLON METAS NOEVID DX,24.0,15.6,0.01,3060831.65,86
CDM,G9089OH,ONC DX COLON EXTENT UNKNOWN,24.0,15.6,0.01,3060831.65,86
CDM,G9090OH,ONC DX RECTAL T1-2 NO PROGR,24.0,15.6,0.01,3060831.65,86
CDM,G9091OH,ONC DX RECTAL T3 N0 NO PROG,24.0,15.6,0.01,3060831.65,86
CDM,G9092OH,"ONC DX RECTAL T1-3,N1-2NOPRG",24.0,15.6,0.01,3060831.65,86
CDM,G9093OH,"ONC DX RECTAL T4,N,M0 NO PRG",24.0,15.6,0.01,3060831.65,86
CDM,G9094OH,ONC DX RECTAL M1 W/METS PROG,24.0,15.6,0.01,3060831.65,86
CDM,G9095OH,ONC DX RECTAL EXTENT UNKNWN,24.0,15.6,0.01,3060831.65,86
CDM,G9096OH,ONC DX ESOPHAG T1-T3 NOPROG,24.0,15.6,0.01,3060831.65,86
CDM,G9097OH,ONC DX ESOPHAGEAL T4 NO PROG,24.0,15.6,0.01,3060831.65,86
CDM,G9098OH,ONC DX ESOPHAGEAL METS RECUR,24.0,15.6,0.01,3060831.65,86
CDM,G9099OH,ONC DX ESOPHAGEAL UNKNOWN,24.0,15.6,0.01,3060831.65,86
CDM,G9100OH,ONC DX GASTRIC NO RECURRENCE,24.0,15.6,0.01,3060831.65,86
CDM,G9101OH,ONC DX GASTRIC P R1-R2NOPROG,24.0,15.6,0.01,3060831.65,86
CDM,G9102OH,ONC DX GASTRIC UNRESECTABLE,24.0,15.6,0.01,3060831.65,86
CDM,G9103OH,ONC DX GASTRIC RECURRENT,24.0,15.6,0.01,3060831.65,86
CDM,G9104OH,ONC DX GASTRIC UNKNOWN NOS,24.0,15.6,0.01,3060831.65,86
CDM,G9105OH,ONC DX PANCREATC P R0 RES NO,24.0,15.6,0.01,3060831.65,86
CDM,G9106OH,ONC DX PANCREATC P R1/R2 NO,24.0,15.6,0.01,3060831.65,86
CDM,G9107OH,ONC DX PANCREATIC UNRESECTAB,24.0,15.6,0.01,3060831.65,86
CDM,G9108OH,ONC DX PANCREATIC UNKNWN NOS,24.0,15.6,0.01,3060831.65,86
CDM,G9109OH,ONC DX HEAD/NECK T1-T2NO PRG,24.0,15.6,0.01,3060831.65,86
CDM,G9110OH,ONC DX HEAD/NECK T3-4 NOPROG,24.0,15.6,0.01,3060831.65,86
CDM,G9111OH,ONC DX HEAD/NECK M1 METS REC,24.0,15.6,0.01,3060831.65,86
CDM,G9112OH,ONC DX HEAD/NECK EXT UNKNOWN,24.0,15.6,0.01,3060831.65,86
CDM,G9113OH,ONC DX OVARIAN STG1A-B NO PR,24.0,15.6,0.01,3060831.65,86
CDM,G9114OH,ONC DX OVARIAN STG1A-B OR 2,24.0,15.6,0.01,3060831.65,86
CDM,G9115OH,ONC DX OVARIAN STG3/4 NOPROG,24.0,15.6,0.01,3060831.65,86
CDM,G9116OH,ONC DX OVARIAN RECURRENCE,24.0,15.6,0.01,3060831.65,86
CDM,G9117OH,ONC DX OVARIAN UNKNOWN NOS,24.0,15.6,0.01,3060831.65,86
CDM,G9123OH,ONC DX CML CHRONIC PHASE,24.0,15.6,0.01,3060831.65,86
CDM,G9124OH,ONC DX CML ACCELER PHASE,24.0,15.6,0.01,3060831.65,86
CDM,G9125OH,ONC DX CML BLAST PHASE,24.0,15.6,0.01,3060831.65,86
CDM,G9126OH,ONC DX CML REMISSION,24.0,15.6,0.01,3060831.65,86
CDM,G9128OH,ONC DX MULTI MYELOMA STAGE I,24.0,15.6,0.01,3060831.65,86
CDM,G9129OH,ONC DX MULT MYELOMA STG2 HIG,24.0,15.6,0.01,3060831.65,86
CDM,G9130OH,ONC DX MULTI MYELOMA UNKNOWN,24.0,15.6,0.01,3060831.65,86
CDM,G9987OH,BPCI ADVANCED IN HOME VISIT,79.0,51.35,1.1,147.79,128
CDM,H0032OH,MENTAL HEALTH SERVICE PLAN DEVELOPMENT BY NON-PHYSICIAN,692.0,449.8,1.1,692.0,80
CDM,H0049OH,ALCOHOL/DRUG SCREENING,118.0,76.7,1.1,118.0,82
CDM,H0050OH,ALCOHOL/DRUG SERVICE 15 MIN,222.0,144.3,1.1,222.0,82
CDM,H1000OH,PRENATAL CARE ATRISK ASSESSM,281.0,182.65,1.1,281.0,98
CDM,H1001OH,ANTEPARTUM MANAGEMENT,48.0,31.2,1.1,150.23,94
CDM,H1011OH,FAMILY ASSESSMENT,43.0,27.95,1.1,3060831.65,80
CDM,J0120AOH,COSM TETRACYCLINE,500.0,325.0,1.1,500.0,68
CDM,J0178OH,AFLIBERCEPT INJECTION,3330.5,2164.83,1.1,3330.5,78
CDM,J0179OH,"INJECTION, BROLUCIZUMAB-DBLL, 1 MG",1110.17,721.61,1.1,1110.17,74
CDM,J0202OH,"INJECTION, ALEMTUZUMAB",5462.75,3550.79,1.1,7113.76,78
CDM,J0290OH,AMPICILLIN 500 MG INJ,10.71,6.96,0.6,10.71,78
CDM,J0585AOH,BOTOX PER UNIT,14.0,9.1,1.1,18.37,78
CDM,J0585OH,BOTULINUM TOXIN A PER 1 UNIT,20.85,13.55,1.1,20.85,78
CDM,J0586NORVU1OH,DYSPORT 5 UNITS (SP),23.35,15.18,1.1,27.55,78
CDM,J0586OH,ABOBOTULINUMTOXINA,21.97,14.28,1.1,27.55,78
CDM,J0587OH,BOTULINUM TOXIN TYPE B,20.9,13.59,1.1,39.79,78
CDM,J0588AOH,XEOMIN PER UNIT,9.96,6.47,1.1,15.31,78
CDM,J0588OH,INCOBOTULINUMTOXIN A,15.31,9.95,1.1,15.31,78
CDM,J0690OH,CEFAZOLIN SODIUM INJECTION,2.4,1.56,0.61,3.06,78
CDM,J0696OH,CEFTRIAXONE SODIUM INJECTION,6.4,4.16,0.49,6.4,78
CDM,J0702OH,BETAMETHASONE ACET&SOD PHOSP,12.81,8.33,1.1,21.43,78
CDM,J0897OH,DENOSUMAB INJECTION,107.2,69.68,1.1,107.2,78
CDM,J1040OH,METHYLPREDNISOLONE 80 MG INJ,52.75,34.29,1.1,52.75,72
CDM,J1200OH,DIPHENHYDRAMINE HCL INJECTIO,10.9,7.09,0.66,10.9,78
CDM,J1642OH,HEPARIN SODIUM PER 10 U,11.0,7.15,0.01,11.0,78
CDM,J1720OH,HYDROCORTISONE SODIUM SUCC I,31.9,20.74,1.1,55.1,78
CDM,J1815OH,INSULIN INJECTION,5.23,3.4,0.29,5.23,78
CDM,J1885OH,KETOROLAC TROMETHAMINE INJ,2.85,1.85,0.44,2.85,78
CDM,J1941OH,"INJ, FUROSCIX, 20 MG",882.8,573.82,1.1,3060831.65,74
CDM,J1950OH,LEUPROLIDE ACETATE /3.75 MG,1768.0,1149.2,1.1,4790.47,78
CDM,J2360OH,ORPHENADRINE INJ TO 60 MG,55.8,36.27,1.1,55.8,78
CDM,J2405OH,ONDANSETRON HCL INJECTION,46.25,30.06,0.09,46.25,78
CDM,J2426OH,PR PALIPERIDONE PALMITATE INJ,43.2,28.08,1.1,43.2,78
CDM,J2540OH,PENICILLIN G POTASSIUM INJ,46.8,30.42,0.78,46.8,78
CDM,J2545OH,PENTAMIDINE ISETHIONTE/300MG,207.0,134.55,1.1,207.0,78
CDM,J2778OH,RANIBIZUMAB INJECTION,1404.2,912.73,1.1,1404.2,78
CDM,J2785OH,REGADENOSON INJECTION,197.38,128.3,1.1,197.38,78
CDM,J2791OH,RHOPHYLAC INJECTION,63.79,41.46,1.1,63.79,78
CDM,J2805OH,SINCALIDE INJECTION,320.0,208.0,1.1,407.11,78
CDM,J3300OH,TRIAMCINOLONE A INJ PRS-FREE,12.92,8.4,1.1,46.78,78
CDM,J3301AOH,KENALOG 10MG,300.0,195.0,0.87,300.0,78
CDM,J3301OH,KENALOG PER 10MG,40.75,26.49,0.87,40.75,78
CDM,J3420OH,ADMIN VITAMIN B12 INJ,27.25,17.71,0.67,27.25,78
CDM,J3470AOH,HYALURONIDASE,2.0,1.3,0.51,60.75,74
CDM,J3470OH,HYALURONIDASE INJECTION,201.88,131.22,1.1,201.88,74
CDM,J3490AOH,BELOTERO 1.0CC,600.0,390.0,1.1,600.0,68
CDM,J3490BOH,KYBELLA  2CC PER VILE,845.0,549.25,1.1,845.0,68
CDM,J3490COH,PRE-PEN (BENZYPENICILLOYL POLYLYSINE),535.96,348.37,1.1,535.96,68
CDM,J3590AAOH,RESTYLANE GENDER AFFIRMING,800.0,520.0,1.1,800.0,68
CDM,J3590AOH,AVASTIN (BEVACIZUMAB) 1.25 MG,50.0,32.5,1.1,50.0,68
CDM,J3590BOH,JUVADERM VOLBELLA 0.55CC SYRINGE,400.0,260.0,1.1,400.0,68
CDM,J3590COH,JUVADERM VOLBELLA 1CC SYRINGE,725.0,471.25,1.1,725.0,68
CDM,J3590DAXOH,DAXXIFY,9.0,5.85,1.1,9.0,68
CDM,J3590DOH,JUVADERM VOLUMA,800.0,520.0,1.1,800.0,68
CDM,J3590EOH,JUVADERMVOLLURE,700.0,455.0,1.1,700.0,68
CDM,J3590FOH,JUVEDERM ULTRA XC  .55CC,455.0,295.75,1.1,455.0,68
CDM,J3590GOH,JUVEDERM ULTRA  XC 1CC,600.0,390.0,1.1,600.0,68
CDM,J3590HOH,JUVEDERM ULTRA PLUS,600.0,390.0,1.1,600.0,68
CDM,J3590IOH,RENUVA HYDRADTED 1.5 SYRINGE,1125.0,731.25,1.1,1125.0,68
CDM,J3590JOH,RENUVA HYDRADTED 3.0 SYRINGE,2250.0,1462.5,1.1,2250.0,68
CDM,J3590KOH,RESTYLANE  .5CC,400.0,260.0,1.1,400.0,68
CDM,J3590LOH,RESTYLANE 1CC SYRINGE,600.0,390.0,1.1,600.0,68
CDM,J3590MOH,RESTYLANE DEFYNE,700.0,455.0,1.1,700.0,68
CDM,J3590NOH,RESTYLANE KYSSE 1CC SYRINGE,700.0,455.0,1.1,700.0,68
CDM,J3590OH,UNCLASSIFIED BIOLOGICS,50.0,32.5,1.1,50.0,68
CDM,J3590OOH,RESTYLANE LYFT,600.0,390.0,1.1,600.0,68
CDM,J3590POH,RESTYLANE REFYNE,700.0,455.0,1.1,700.0,68
CDM,J3590QOH,RESTYLANE SILK,600.0,390.0,1.1,600.0,68
CDM,J3590ROH,RHA 2 (REVANCE),600.0,390.0,1.1,600.0,68
CDM,J3590SOH,RHA 3 (REVANCE),600.0,390.0,1.1,600.0,68
CDM,J3590TOH,RHA 4 (REVANCE),600.0,390.0,1.1,600.0,68
CDM,J3590UOH,JUVEDERM ULTRA PLUS .55CC,455.0,295.75,1.1,455.0,68
CDM,J3590VOH,RESTYLANE CONTOUR,700.0,455.0,1.1,700.0,68
CDM,J3590WOH,JUVADERM VOLUX XC 1CC,800.0,520.0,1.1,800.0,68
CDM,J3590XOH,RESTYLANE EYELIGHT .5,400.0,260.0,1.1,400.0,68
CDM,J3590YOH,RESTYLANE EYELIGHT 1CC,900.0,585.0,1.1,900.0,68
CDM,J3590ZOH,JUV?DERM SKINVIVE,350.0,227.5,1.1,350.0,68
CDM,J7040OH,NORMAL SALINE SOLUTION INFUS,13.0,8.45,1.1,13.0,78
CDM,J7120OH,RINGERS LACTATE INFUSION,44.0,28.6,1.1,44.0,78
CDM,J7307OH,ETONOGESTREL IMPLANT SYSTEM,1499.0,974.35,1.1,3409.95,74
CDM,J7308OH,AMINOLEVULINIC ACID HCL TOP,290.0,188.5,1.1,1199.91,78
CDM,J7312OH,PR DEXAMETHASONE INTRA IMPLANT,685.69,445.7,1.1,685.69,78
CDM,J7318OH,"HYALURONAN OR DERIVATIVE, DUROLANE, FOR INTRA-ARTICULAR INJECTIO",58.52,38.04,1.1,58.52,78
CDM,J7321OH,HYALGAN/SUPARTZ INJ PER DOSE,830.1,539.57,1.1,830.1,78
CDM,J7323OH,EUFLEXXA INJ PER DOSE,234.5,152.43,1.1,388.75,78
CDM,J7324OH,ORTHOVISC INJ PER DOSE,1152.9,749.39,1.1,1152.9,78
CDM,J7325OH,SYNVISC OR SYNVISC-ONE,102.78,66.81,1.1,102.78,78
CDM,J7326OH,GEL-ONE PER DOSE,3072.0,1996.8,1.1,3072.0,78
CDM,J7328OH,GEL-SYN INJECTION 0.1 MG,7.4,4.81,0.59,7.4,78
CDM,J7351OH,"INJ, BIMATOPROST, INTRACAMERAL IMPLANT, 1 MCG (DURYSTA)",702.1,456.37,1.1,702.1,74
CDM,J7613OH,ALBUTEROL UNIT DOSE,6.0,3.9,0.05,6.0,78
CDM,J7620OH,ALBUTEROL SULFATE .O83% INH,4.45,2.89,0.13,4.45,78
CDM,J8490OH,REGLAN 10 MG TAB,2.0,1.3,0.51,2.0,68
CDM,J8499OH,ORAL PRESCRIP DRUG NON CHEMO,6.5,4.23,1.1,3061000.0,68
CDM,J9030OH,"BCG LIVE INTRAVESICAL INSTILLATION, 1 MG",711.75,462.64,1.1,711.75,78
CDM,J9350BOH,"INJ MOSUNETUZUMAB-AXGB, 1 MG",2952.7,1919.26,1.1,2952.7,74
CDM,K0001OH,STANDARD WHEELCHAIR,200.0,130.0,1.1,2042.7,90
CDM,K1027OH,ORAL DEV WITHOUT FIX MECH,4000.0,2600.0,1.1,3060831.65,70
CDM,L0120OH,"CERVICAL, FLEXIBLE, NON-ADJUSTABLE",52.0,33.8,1.1,104.79,90
CDM,L0172OH,SEMI-RIGID CERVICAL COLLAR,249.0,161.85,1.1,561.19,90
CDM,L0456OH,TLSO FLEX PREFAB,319.0,207.35,1.1,3940.95,90
CDM,L0472OH,TLSO RIGID FRAME HYPEREX PRE,424.0,275.6,1.1,1604.25,90
CDM,L0621OH,SIO FLEX PELVISACRAL PREFAB,102.0,66.3,1.1,244.49,90
CDM,L0625OH,LO FLEXIBL L1-BELOW L5 PRE,33.0,21.45,1.1,143.56,90
CDM,L0626OH,LO SAG STAYS/PANELS PRE-FAB,79.0,51.35,1.1,308.86,90
CDM,L0627OH,LO SAGITT RIGID PANEL PREFAB,249.0,161.85,1.1,1628.64,90
CDM,L0628OH,LO FLEX W/O RIGID STAYS PRE,454.0,295.1,1.1,454.0,90
CDM,L0630OH,LSO POST RIGID PANEL PRE,454.0,295.1,1.1,641.81,90
CDM,L0637OH,LSO SAG-CORONAL PANEL PREFAB,231.0,150.15,1.1,5133.37,90
CDM,L1620OH,HO PAVLIK HARNESS,262.0,170.3,1.1,622.59,90
CDM,L1660OH,"HIP ORTHOSIS,PLASTIC",176.0,114.4,1.1,716.06,90
CDM,L1680OH,HO (RANCHO HIP ACTION TYPE),2379.0,1546.35,1.1,4514.28,90
CDM,L1686OH,HO HIP ABDUCTION TYPE,1854.0,1205.1,1.1,3712.87,90
CDM,L1810OH,KO ELASTIC W/JOINTS,165.0,107.25,1.1,407.92,90
CDM,L1820OH,KO ELAS W/ CONDYLE PADS & JO,295.0,191.75,1.1,563.13,90
CDM,L1830OH,"KO IMMOBILIZER, CANVAS LONGITUDE",33.0,21.45,1.1,255.71,90
CDM,L1832OH,"KO ADJUSTABLE KNEE JOINTS,RIGID",161.0,104.65,1.1,2729.31,90
CDM,L1834OH,"KO W/O KNEE JOINT, MOLDED",1605.0,1043.25,1.1,2876.06,90
CDM,L1840OH,"KO DEROTATION, CUSTOM FABRICATED",1123.0,729.95,1.1,3726.28,90
CDM,L1843OH,KO SINGLE UPRIGHT CUSTOM FIT,839.0,545.35,1.1,3555.38,90
CDM,L1844OH,KO W/ADJ JT ROT CNTRL MOLDED,2070.0,1345.5,1.1,6034.13,90
CDM,L1845OH,"KO DOUBLE UPRIGHT, CUSTOM FITTED",927.0,602.55,1.1,3319.22,90
CDM,L1846OH,"KO DOUBLE UPRIGHT, MOLDED",1404.0,912.6,1.1,4636.16,90
CDM,L1850OH,KO SWEDISH TYPE,435.0,282.75,1.1,846.66,90
CDM,L1902OH,"ASO ANKLE GAUNTLET, CUSTOM FITTED",80.0,52.0,1.1,295.77,90
CDM,L1904OH,"AFO ANKLE GAUNTLET, MOLDED",557.0,362.05,1.1,1788.51,90
CDM,L1906OH,AFO MULTILIGAMENTUS ANKLE SUPPORT,235.0,152.75,1.1,445.58,90
CDM,L1907OH,AFO SUPRAMALLEOLAR CUSTOM,876.0,569.4,1.1,2229.7,90
CDM,L1930OH,AFO PLASTIC,462.0,300.3,1.1,998.24,90
CDM,L1932OH,AFO RIG ANT TIB PREFAB TCF/=,917.0,596.05,1.1,3535.79,90
CDM,L1940OH,AFO MOLDED TO PATIENT MODEL,515.0,334.75,1.1,1929.62,90
CDM,L1945OH,AFO RIGID ANTERIOR TIBIAL SECTION,1933.0,1256.45,1.1,4447.76,90
CDM,L1951OH,AFO SPIRAL PREFABRICATED,980.0,637.0,1.1,3327.66,90
CDM,L1960OH,"AFO POSTERIOR SOLID ANKLE, MOLDED",658.0,427.7,1.1,2456.22,90
CDM,L1970OH,"AFO WITH ANKLE JOINT, MOLDED",715.0,464.75,1.1,2742.52,90
CDM,L1971OH,"AFO W/ANKLE JOINT, PREFAB",154.0,100.1,1.1,1857.44,90
CDM,L1980OH,AFO SINGLE BAR 'BK' ORTHOSIS,717.0,466.05,1.1,1599.88,90
CDM,L1990OH,AFO DOUBLE BAR 'BK' ORTHOSIS,721.0,468.65,1.1,1851.67,90
CDM,L2108OH,"ANKLE, FOOT, ORTHOSIS/IN10",2087.0,1356.55,1.1,4555.35,90
CDM,L2112OH,AFO FRACTURE ORTHOSIS SOFT,911.0,592.15,1.1,1999.06,90
CDM,L2114OH,AFO FRACTURE ORTHOSIS SEMI-RIGID,2145.0,1394.25,1.1,2503.9,90
CDM,L2116OH,AFO FRACTURE ORTHOSIS RIGID,84.0,54.6,1.1,3054.0,90
CDM,L2128OH,KAFO FRACTURE ORTHOSIS,954.0,620.1,1.1,6353.11,90
CDM,L2180OH,ADDN TO FRAC ORTH PLAST SHOE INSRT,229.0,148.85,1.1,525.33,90
CDM,L2184OH,ADDN TO FRAC ORTH LIMIT MOTN KNEE JT,242.0,157.3,1.1,458.95,90
CDM,L2186OH,ADDN TO FRAC ORTH ADJ MOTN KNEE JT,176.0,114.4,1.1,610.4,90
CDM,L2200OH,ADDN TO LOW EXTREM LIMIT ANKLE MOTN,94.0,61.1,1.1,199.09,90
CDM,L2275OH,ADDN TO LOW EXTREM VARUS/VALGUS CORR,229.0,148.85,1.1,516.49,90
CDM,L2280OH,ADDN TO LOW EXTREM MOLD INNER BOOT,601.0,390.65,1.1,2236.89,90
CDM,L2340OH,ADDN TO LOW EXTREM PRETIB SHELL,536.0,348.4,1.1,1655.9,90
CDM,L2350OH,ADDN TO LOW EXTREM PROSTHETIC TYPE,1081.0,702.65,1.1,3301.36,90
CDM,L2624OH,ADDN TO LO EXTR HIP JT ADJ FLEX/EXTN,528.0,343.2,1.1,1546.09,90
CDM,L2795OH,ADDN TO LO EXTR ORTHO KNEE CTRL FULL,166.0,107.9,1.1,324.95,90
CDM,L2800OH,KNEE CAP MEDIAL OR LATERAL P,208.0,135.2,1.1,399.04,90
CDM,L2850OH,ADDN TO LO EXTR ORTHO FEM SOCK,101.0,65.65,1.1,239.69,90
CDM,L3001OH,FOOT INSERT REMOVABLE SPENCO,153.0,99.45,1.1,524.12,90
CDM,L3002OH,FOOT INSERT REMOVABLE PLASTAZOTE,174.0,113.1,1.1,639.93,90
CDM,L3010OH,FOOT INSERT REMOVABLE LONG ARCH SPPT,188.0,122.2,1.1,690.35,90
CDM,L3020OH,FOOT INSERT REMOVABLE LONG/MT SPPT,171.0,111.15,1.1,786.15,90
CDM,L3030OH,FOOT INSERT REMOVABLE FORMED TO PT,114.0,74.1,1.1,302.32,90
CDM,L3040OH,FOOT ARCH SUPPORT REMV LONG,9.0,5.85,1.1,186.52,90
CDM,L3080OH,FOOT ARCH SUPPORT NON-REMV METATAR,35.64,23.17,1.1,125.97,90
CDM,L3100OH,HALLUS-VALGUS NIGHT DYNAMIC SPLINT,53.0,34.45,1.1,171.41,90
CDM,L3170OH,FOOT PLASTIC HEEL STABILIZER,58.0,37.7,1.1,201.54,90
CDM,L3251OH,SHOE SILICONE EA,464.0,301.6,1.1,535.68,86
CDM,L3260OH,AMBULATORY SURGICAL BOOT EAC,46.0,29.9,1.1,48.82,86
CDM,L3334OH,SHOE LIFT,11.0,7.15,1.1,151.09,90
CDM,L3350OH,HEEL WEDGE,4.46,2.9,1.1,90.63,90
CDM,L3430OH,HEEL COUNTER PLASTIC REINFORCED,160.0,104.0,1.1,634.96,90
CDM,L3480OH,HEEL PAD AND DEPRESSION FOR SPUR,23.0,14.95,1.1,246.87,90
CDM,L3485OH,HEEL PAD REMOVABLE FOR SPUR,33.0,21.45,1.1,59.39,86
CDM,L3510OH,SHOE ADDITION INSOLE RUBBER,6.0,3.9,1.1,115.86,90
CDM,L3540OH,SHOE ADDITION SOLE FULL,57.0,37.05,1.1,201.54,90
CDM,L3560OH,SHOE ADDITION TOE TAP HORSESHOE,28.0,18.2,1.1,90.63,90
CDM,L3649OH,UNLISTED PROCEDURE FOR ORTHO SHOES,96.0,62.4,0.01,3061000.0,80
CDM,L3650OH,SHOULDER ORTHOSIS,66.0,42.9,1.1,259.87,90
CDM,L3660OH,"SHLDR ORTHOSIS,ABDUC RESTR,CANVAS",153.0,99.45,1.1,372.64,90
CDM,L3670OH,SHLDR ORTHOSIS ACROMIO/CLAVICULAR,105.0,68.25,1.1,409.96,90
CDM,L3702OH,EO W/O JOINTS CF,413.0,268.45,1.1,1041.32,90
CDM,L3710OH,ELBOW ORTHOSIS WITH METAL JOINTS,184.0,119.6,1.1,514.93,90
CDM,L3730OH,EO DOUBLE UPRIGHT FLEXION ASSIST,1340.0,871.0,1.1,3268.22,90
CDM,L3740OH,EO DOUBLE UPRIGHT ADJUSTABLE LOCK,517.0,336.05,1.1,3874.79,90
CDM,L3760OH,"EO WITHJOINT, PREFABRICATED",119.0,77.35,1.1,1803.51,90
CDM,L3762OH,RIGID EO WO JOINTS,86.0,55.9,1.1,387.71,90
CDM,L3763OH,EWHO RIGID W/O JNTS CF,294.0,191.1,1.1,2698.63,90
CDM,L3806OH,WHFO W/JOINT(S) CUSTOM FAB,523.0,339.95,1.1,1638.0,90
CDM,L3807OH,WHFO W INFLATABLE AIRCHAMBER,147.0,95.55,1.1,901.69,90
CDM,L3808OH,"WHFO, RIGID W/O JOINTS",24.0,15.6,1.1,1284.6,90
CDM,L3809OH,THUMB SPICA,177.0,115.05,1.1,901.69,90
CDM,L3900OH,WHFO DYNAMIC FLEXOR HINGE,330.0,214.5,1.1,5841.79,90
CDM,L3905OH,WHO W/NONTORSION JNT(S) CF,341.0,221.65,1.1,3576.15,90
CDM,L3906OH,WHFO WRIST GAUNTLET,176.0,114.4,1.1,1827.48,90
CDM,L3908OH,WHFO WRIST EXTENSION CONTROL,60.0,39.0,1.1,264.4,90
CDM,L3912OH,WHFO FLEXION GLOVE FINGER CONTROL,88.0,57.2,1.1,379.94,90
CDM,L3913OH,HFO W/O JOINTS CF,193.0,125.45,1.1,976.61,90
CDM,L3917OH,PREFAB METACARPL FX ORTHOSIS,162.0,105.3,1.1,380.79,90
CDM,L3919OH,HO W/O JOINTS CF,165.0,107.25,1.1,976.61,90
CDM,L3921OH,HFO W/JOINT(S) CF,330.0,214.5,1.1,1158.38,90
CDM,L3923OH,HFO W/O JOINTS PF,70.0,45.5,1.1,348.35,90
CDM,L3925OH,FO PIP/DIP WITH JOINT/SPRING,33.0,21.45,1.1,236.88,90
CDM,L3927OH,FO PIP/DIP W/O JOINT/SPRING,14.0,9.1,1.1,126.22,90
CDM,L3929OH,"HFO NONTORSION JOINT, PREFAB",165.0,107.25,1.1,329.38,90
CDM,L3931OH,WHFO NONTORSION JOINT PREFAB,33.0,21.45,1.1,751.88,90
CDM,L3933OH,FO W/O JOINTS CF,183.0,118.95,1.1,769.43,90
CDM,L3960OH,SEWHO ABDUCTION POSITIONING,1092.0,709.8,1.1,2876.16,90
CDM,L3962OH,SEWHO ABDUCTION POSITIONING,907.0,589.55,1.1,2601.3,90
CDM,L3980OH,"UPPER LIMB FX ORTHOSIS, HUMERAL",197.0,128.05,1.1,1395.1,90
CDM,L3982OH,"UPPER LIMB FX ORTHOSIS, RADIUS/ULNA",264.0,171.6,1.1,1416.56,90
CDM,L3984OH,"UPPER LIMB FX ORTHOSIS, WRIST",108.0,70.2,1.1,1247.87,90
CDM,L3999OH,UNLISTED UPPER LIMB ORTHOSIS PROCS,119.0,77.35,0.01,3061000.0,80
CDM,L4002OH,"REPLACE STRAP, ANY ORTHOSIS",28.0,18.2,1.1,186.72,80
CDM,L4210OH,"REPAIR OF ORTHOTIC DEVICE, MINOR",110.0,71.5,1.1,110.0,80
CDM,L4350OH,PNEUMATIC ANKLE CNTRL SPLINT,42.1,27.37,1.1,383.38,90
CDM,L4360OH,PNEUMATIC WALKING SPLINT,382.0,248.3,1.1,1025.88,90
CDM,L4386OH,NON-PNEUM WALK BOOT PREFAB,77.0,50.05,1.1,628.25,90
CDM,L4396OH,ANKLE CONTRACTURE SPLINT,234.0,152.1,1.1,664.95,90
CDM,L4398OH,"FOOT DROP SPLINT,RECUM POSN DEV",102.0,66.3,1.1,306.05,90
CDM,L5000OH,"PARTIAL FOOT, SHOE INSERT",601.0,390.65,1.1,2275.34,90
CDM,L7900OH,VACUUM ERECTION SYSTEM,623.0,404.95,1.1,1741.0,86
CDM,L8000OH,"BREAST PROSTHESIS, MASTECTOMY BRA",70.0,45.5,1.1,168.09,90
CDM,L8210OH,GRAD COMPR STOCK CUSTOM MADE,368.0,239.2,1.1,368.0,68
CDM,L8501OH,TRACHEOSTOMY SPEAKING VALVE,196.0,127.4,1.1,476.82,90
CDM,L8603OH,COLLAGEN IMPLNT URIN TRCT 2.5CC,770.0,500.5,1.1,1728.46,92
CDM,L8606OH,SYNTHETIC IMPLNT URINARY 1ML,436.0,283.4,1.1,815.32,92
CDM,L8699OH,"PROSTHETIC IMPLANT,NOS",701.0,455.65,0.01,701.0,80
CDM,M0076OH,PROLOTHERAPY,185.0,120.25,1.1,198.97,80
CDM,M0201OH,PNE FLU HEPB COV HOME ADMIN,46.0,29.9,1.1,113.26,74
CDM,M0249OH,ADM TOCILIZU COVID-19 1ST,361.0,234.65,1.1,1380.51,78
CDM,M0250OH,ADM TOCILIZU COVID-19 2ND,361.0,234.65,1.1,1380.51,78
CDM,M1072OH,"ROM RAD THERAPY ANAL, PC",11472.0,7456.8,1.1,11472.0,68
CDM,M1073OH,"ROM RAD THERAPY ANAL, TC",67428.0,43828.2,1.1,67428.0,68
CDM,M1074OH,"ROM RAD THERAPY BLADDER, PC",10304.0,6697.6,1.1,10304.0,68
CDM,M1075OH,"ROM RAD THERAPY BLADDER, TC",54154.0,35200.1,1.1,54154.0,68
CDM,M1076OH,"ROM RAD THER BONE METS, PC",5342.0,3472.3,1.1,5342.0,68
CDM,M1077OH,"ROM RAD THER BONE METS, TC",24248.0,15761.2,1.1,24248.0,68
CDM,M1078OH,"ROM RAD THER BRAIN METS, PC",6097.0,3963.05,1.1,6097.0,68
CDM,M1079OH,"ROM RAD THER BRAIN METS, TC",38984.0,25339.6,1.1,38984.0,68
CDM,M1080OH,"ROM RAD THERAPY BREAST, PC",7614.0,4949.1,1.1,7614.0,68
CDM,M1081OH,"ROM RAD THERAPY BREAST, TC",39712.0,25812.8,1.1,39712.0,68
CDM,M1082OH,"ROM RAD THERAPY CERVICAL, PC",11224.0,7295.6,1.1,11224.0,68
CDM,M1083OH,"ROM RAD THERAPY CERVICAL, TC",54252.0,35263.8,1.1,54252.0,68
CDM,M1084OH,"ROM RAD THERAPY CNS, PC",9452.0,6143.8,1.1,9452.0,68
CDM,M1085OH,"ROM RAD THERAPY CNS, TC",59412.0,38617.8,1.1,59412.0,68
CDM,M1086OH,"ROM RAD THER COLORECTAL, PC",9269.0,6024.85,1.1,9269.0,68
CDM,M1087OH,"ROM RAD THER COLORECTAL, TC",48679.0,31641.35,1.1,48679.0,68
CDM,M1088OH,"ROM RAD THER HEAD/NECK, PC",11487.0,7466.55,1.1,11487.0,68
CDM,M1089OH,"ROM RAD THER HEAD/NECK, TC",70144.0,45593.6,1.1,70144.0,68
CDM,M1094OH,"ROM RAD THERAPY LUNG, PC",8246.0,5359.9,1.1,8246.0,68
CDM,M1095OH,"ROM RAD THERAPY LUNG, TC",48030.0,31219.5,1.1,48030.0,68
CDM,M1096OH,"ROM RAD THERAPY LYMPHOMA, PC",6373.0,4142.45,1.1,6373.0,68
CDM,M1097OH,"ROM RAD THERAPY LYMPHOMA, TC",31717.0,20616.05,1.1,31717.0,68
CDM,M1098OH,"ROM RAD THERAPY PANCREAS, PC",9168.0,5959.2,1.1,9168.0,68
CDM,M1099OH,"ROM RAD THERAPY PANCREAS, TC",54386.0,35350.9,1.1,54386.0,68
CDM,M1100OH,"ROM RAD THERAPY PROSTATE, PC",12493.0,8120.45,1.1,12493.0,68
CDM,M1101OH,"ROM RAD THERAPY PROSTATE, TC",81221.0,52793.65,1.1,81221.0,68
CDM,M1102OH,"ROM RAD THERAPY GI, PC",9858.0,6407.7,1.1,9858.0,68
CDM,M1103OH,"ROM RAD THERAPY GI, TC",58634.0,38112.1,1.1,58634.0,68
CDM,M1104OH,"ROM RAD THERAPY UTERUS, PC",10120.0,6578.0,1.1,10120.0,68
CDM,M1105OH,"ROM RAD THERAPY UTERUS, TC",56879.0,36971.35,1.1,56879.0,68
CDM,OITMIXOH,OIT MIXING FEE,100.0,65.0,1.1,100.0,68
CDM,P9010OH,WHOLE BLOOD FOR TRANSFUSION,1553.0,1009.45,1.1,2245.86,86
CDM,P9011OH,BLOOD SPLIT UNIT,978.0,635.7,1.1,978.0,86
CDM,P9012OH,CRYOPRECIPITATE EA UNIT,439.0,285.35,1.1,439.0,80
CDM,P9016OH,"LEUKOCYTE POOR BLOOD, UNIT",1256.0,816.4,1.1,1256.0,80
CDM,P9017OH,ONE DONOR FRESH FROZN PLASMA,582.0,378.3,1.1,582.0,80
CDM,P9019OH,PLATELET CONCENTRATE UNIT,524.0,340.6,1.1,1727.59,80
CDM,P9020OH,PLAELET RICH PLASMA UNIT,3846.0,2499.9,1.1,3846.0,80
CDM,P9021OH,RED BLOOD CELLS UNIT,996.0,647.4,1.1,2245.86,80
CDM,P9022OH,WASHED RED BLOOD CELLS UNIT,2738.0,1779.7,1.1,2738.0,80
CDM,P9031OH,PLATELETS LEUKOCYTES REDUCED,868.0,564.2,1.1,868.0,80
CDM,P9032OH,"PLATELETS, IRRADIATED",937.0,609.05,1.1,937.0,80
CDM,P9033OH,PLATELETS LEUKOREDUCED IRRAD,1417.0,921.05,1.1,1417.0,80
CDM,P9034OH,"PLATELETS, PHERESIS",2740.0,1781.0,1.1,2740.0,80
CDM,P9035OH,PLATELET PHERES LEUKOREDUCED,3361.0,2184.65,1.1,3361.0,80
CDM,P9036OH,PLATELET PHERESIS IRRADIATED,4055.0,2635.75,1.1,4055.0,80
CDM,P9037OH,PLATE PHERES LEUKOREDU IRRAD,4662.0,3030.3,1.1,4662.0,80
CDM,P9038OH,RBC IRRADIATED,1030.0,669.5,1.1,1030.0,80
CDM,P9039OH,RBC DEGLYCEROLIZED,4511.0,2932.15,1.1,4511.0,80
CDM,P9040OH,RBC LEUKOREDUCED IRRADIATED,1765.0,1147.25,1.1,1765.0,80
CDM,P9041OH,"ALBUMIN (HUMAN),5%, 50ML",73.0,47.45,1.1,107.12,86
CDM,P9045OH,ALBUMIN (HUMAN) 5% 250 ML,366.0,237.9,1.1,366.0,86
CDM,P9047OH,"ALBUMIN (HUMAN), 25%, 50ML",366.0,237.9,1.1,366.0,86
CDM,P9050OH,"GRANULOCYTES, PHERESIS UNIT",6884.0,4474.6,1.1,3060831.65,80
CDM,P9052OH,"PLATELETS, HLA-M, L/R, UNIT",5365.0,3487.25,1.1,5365.0,80
CDM,P9060OH,FR FRZ PLASMA DONOR RETESTED,338.0,219.7,1.1,338.0,80
CDM,PKG54405OH,PENILE IMPLANT,42000.0,27300.0,1.1,58832.42,142
CDM,PKG6699FEMTONLOH,FEMTO LASER NO LENS,1900.0,1235.0,1.1,1900.0,68
CDM,PKG76857REIOH,FOLLICULAR US X 5,1325.0,861.25,1.1,1325.0,142
CDM,PKG90867OH,REPET TMS TX INITIAL W/MAP/MOTR THRESHLD/DEL&M,485.0,315.25,1.1,1239.34,106
CDM,PKG90868OH,THERAP REPETITIVE TMS TX SUBSEQ DELIVERY & MNG,485.0,315.25,1.1,915.24,106
CDM,PKG90869OH,REPET TMS TX SUBSEQ MOTR THRESHLD W/DELIV & MN,515.0,334.75,1.1,1517.59,106
CDM,PKGA270TROH,TRULIGN,2900.0,1885.0,1.1,2900.0,68
CDM,PKGA270VFEMTOOH,VIVITY W/FEMTO,3400.0,2210.0,1.1,3400.0,68
CDM,PKGA290ATOH,ACTIVEFOCUS TORIC2.5,2900.0,1885.0,1.1,2900.0,68
CDM,PKGA2970ATFEMTOOH,ACTIVEFOCUS TORIC2.5 WFEMTO,3400.0,2210.0,1.1,3400.0,68
CDM,PKGA2970RFEMTOOH,RESTOR W/FEMTO,3400.0,2210.0,1.1,3400.0,68
CDM,PKGA2970SYFEMTOOH,SYNERGY W/FEMTO,3400.0,2210.0,1.1,3400.0,68
CDM,PKGA2970SYOH,SYNERGY,2900.0,1885.0,1.1,2900.0,68
CDM,PKGA2970TRFEMTOOH,TRULIGN,3400.0,2210.0,1.1,3400.0,68
CDM,PKGA9270CFEMTOOH,CRYSTALENS W/FEMTO,3400.0,2210.0,1.1,3400.0,68
CDM,PKGA9270COH,CRYSTALENS,2900.0,1885.0,1.1,2900.0,68
CDM,PKGA9270PFEMTOOH,PANOPTIX W/FEMTO,2900.0,1885.0,1.1,2900.0,68
CDM,PKGA9270POH,PANOPTIX,2900.0,1885.0,1.1,2900.0,68
CDM,PKGA9270PTFEMTOOH,PANOPTIX TORIC W/FEMTO,3400.0,2210.0,1.1,3400.0,68
CDM,PKGA9270PTOH,PANOPTIX TORIC (INCLUDES CLAREON),2900.0,1885.0,1.1,2900.0,68
CDM,PKGA9270ROH,RESTOR,2900.0,1885.0,1.1,2900.0,68
CDM,PKGA9270RTOH,RESTOR TORIC,2900.0,1885.0,1.1,2900.0,68
CDM,PKGA9270SFEMTOOH,SYMFONY W/FEMTO,3400.0,2210.0,1.1,3400.0,68
CDM,PKGA9270SOH,SYMFONY,2900.0,1885.0,1.1,2900.0,68
CDM,PKGA9270STFEMTOOH,SYMFONY TORIC W/FEMTO,3400.0,2210.0,1.1,3400.0,68
CDM,PKGA9270STOH,SYMFONY TORIC,2900.0,1885.0,1.1,2900.0,68
CDM,PKGA9270SYTFEMTOOH,SYNERGY TORIC W/FEMTO,3400.0,2210.0,1.1,3400.0,68
CDM,PKGA9270SYTOH,SYNERGY TORIC,2900.0,1885.0,1.1,2900.0,68
CDM,PKGA9270TFEMTOOH,TORIC W/FEMTO,1900.0,1235.0,1.1,1900.0,68
CDM,PKGA9270TOH,TORIC? (INC EYHANCE AND CLAREON TORIC),1400.0,910.0,1.1,1400.0,68
CDM,PKGA9270VTOH,VIVITY (TORIC)? (INCLUDES CLAREON),2900.0,1885.0,1.1,2900.0,68
CDM,PKGBARISURGOH,BARIATRIC SURGERY SELF-PAY PACKAGE,25000.0,16250.0,1.1,25000.0,68
CDM,PKGFETALINJEMPOH,FETAL INJECTION EMP,1312.5,853.13,1.1,1312.5,68
CDM,PKGFETALINJOH,FETAL INJECTION,1500.0,975.0,1.1,1500.0,68
CDM,PKGICGOH,ICG PACKAGE,3434.0,2232.1,1.1,3434.0,68
CDM,PKGTERMCONSULTEMPOH,PREGNANCY TERMINATION CONSULT EMP,831.25,540.31,1.1,831.25,68
CDM,PKGTERMCONSULTOH,PREGNANCY TERMINATION CONSULT,950.0,617.5,1.1,950.0,68
CDM,Q0091OH,PAP SMEAR,163.0,105.95,1.1,163.0,130
CDM,Q0115OH,POST-COITAL MUCOUS EXAM,173.0,112.45,1.1,173.0,86
CDM,Q0136OH,NON ESRD EPOETIN ALPHA INJ,36.0,23.4,1.1,36.0,68
CDM,Q0138OH,"FERUMOXYTOL, NON-ESRD",4.0,2.6,0.33,4.0,78
CDM,Q0144OH,"AZITHROMYCIN DIHYDRATE,ORAL,1 GRAM",63.0,40.95,1.1,63.0,74
CDM,Q0162OH,ONDANSETRON ORAL,13.0,8.45,0.01,13.0,78
CDM,Q0163OH,"DIPHENHYDRAMINE HCL,50MG,ORAL",2.0,1.3,0.03,2.0,74
CDM,Q0164OH,"PROCHLORPERAZINE MALEATE,5MG,ORAL",2.0,1.3,0.27,2.0,78
CDM,Q0166OH,"GRANISETRON HYDROCHLORIDE,1MG,ORAL",136.0,88.4,0.76,136.0,78
CDM,Q0167OH,"DRONABINOL,2.5MG,ORAL",12.0,7.8,0.52,12.0,78
CDM,Q0169OH,"PROMETHAZINE HCL,12.5MG,ORAL",2.0,1.3,0.04,2.0,74
CDM,Q0173OH,"TRIMETHOBENZAMIDE HCL,250MG,ORAL",2.0,1.3,0.01,3060831.65,74
CDM,Q0175OH,"PERPHENZAINE,4MG,ORAL",2.0,1.3,0.51,2.0,74
CDM,Q0180OH,"DOLASETRON MESYLATE,100 MG,ORAL",191.0,124.15,1.1,191.0,74
CDM,Q0515OH,SERMORELIN ACETATE INJECTION,4.0,2.6,1.02,3060831.65,74
CDM,Q2004OH,BLADDER CALCULI IRRIG SOL,72.0,46.8,0.07,449.97,74
CDM,Q2009OH,"FOSPHENYTOIN, 50 MG",8.0,5.2,1.1,15.31,74
CDM,Q2026AOH,RADIESSE 0.8CC PER EA. SYRINGE,600.0,390.0,1.1,915.24,68
CDM,Q2026BOH,RADIESSE 1.5CC EA. SYRINGE,800.0,520.0,1.1,915.24,68
CDM,Q2026OH,PR RADIESSE INJECTION,1169.0,759.85,1.1,1169.0,68
CDM,Q2028AOH,SCULPTRA .5MG,800.0,520.0,0.89,800.0,74
CDM,Q2043OH,SIPULEUCEL-T AUTO CD54+,68158.0,44302.7,1.1,163540.05,78
CDM,Q2049OH,IMPORTED LIPODOX INJ,2535.0,1647.75,1.1,2535.0,74
CDM,Q2050OH,DOXORUBICIN INJ 10 MG,2862.0,1860.3,1.1,2862.0,78
CDM,Q3027OH,INJ BETA INTERFERON IM 1 MCG,150.0,97.5,1.1,165.29,78
CDM,Q4003OH,CAST SUP SHOULDER CAST PLSTR,171.0,111.15,1.1,171.0,104
CDM,Q4004OH,CAST SUP SHOULDER CAST FBRGL,254.0,165.1,1.1,499.85,104
CDM,Q4006OH,CAST SUP LONG ARM ADULT FBRG,140.0,91.0,1.1,140.0,104
CDM,Q4007OH,CAST SUP LONG ARM PED PLSTER,98.0,63.7,1.1,98.0,104
CDM,Q4008OH,CAST SUP LONG ARM PED FBRGLS,98.0,63.7,1.1,98.0,104
CDM,Q4009OH,CAST SUP SHT ARM ADULT PLSTR,80.0,52.0,1.1,80.0,104
CDM,Q4010OH,CAST SUP SHT ARM ADULT FBRGL,14.0,9.1,1.1,79.96,104
CDM,Q4011OH,CAST SUP SHT ARM PED PLASTER,42.0,27.3,1.1,42.0,104
CDM,Q4012OH,CAST SUP SHT ARM PED FBRGLAS,80.0,52.0,1.1,80.0,104
CDM,Q4013OH,CAST SUP GAUNTLET PLASTER,28.0,18.2,1.1,64.71,104
CDM,Q4014OH,CAST SUP GAUNTLET FIBERGLASS,102.0,66.3,1.1,109.12,104
CDM,Q4015OH,CAST SUP GAUNTLET PED PLSTER,70.0,45.5,1.1,70.0,104
CDM,Q4016OH,CAST SUP GAUNTLET FBRGLS,70.0,45.5,1.1,70.0,104
CDM,Q4017OH,CAST SUP LNG ARM SPLINT PLST,75.0,48.75,1.1,75.0,104
CDM,Q4018OH,CAST SUP LNG ARM SPLINT FBRG,89.0,57.85,1.1,89.0,104
CDM,Q4019OH,CAST SUP LNG ARM SPLNT PED P,75.0,48.75,1.1,75.0,104
CDM,Q4020OH,CAST SUP LNG ARM SPLNT PED F,75.0,48.75,1.1,75.0,104
CDM,Q4021OH,CAST SUP SHT ARM SPLINT PLST,44.0,28.6,1.1,44.0,104
CDM,Q4022OH,CAST SUP SHT ARM SPLINT FBRG,89.0,57.85,1.1,89.0,104
CDM,Q4023OH,CAST SUP SHT ARM SPLNT PED P,44.0,28.6,1.1,44.0,104
CDM,Q4024OH,CAST SUP SHT ARM SPLNT PED F,45.0,29.25,1.1,45.0,104
CDM,Q4029OH,CAST SUP LONG LEG PLASTER,142.0,92.3,1.1,142.0,104
CDM,Q4030OH,CAST SUP LONG LEG FIBERGLASS,194.0,126.1,1.1,312.49,104
CDM,Q4031OH,CAST SUP LNG LEG PED PLASTER,116.0,75.4,1.1,116.0,104
CDM,Q4032OH,CAST SUP LNG LEG FBRGLS,136.0,88.4,1.1,156.24,104
CDM,Q4034OH,CAST SUP LNG LEG CYLINDER FB,165.0,107.25,1.1,275.35,104
CDM,Q4035OH,CAST SUP LNGLEG CYLNDR PED P,100.0,65.0,1.1,100.0,104
CDM,Q4036OH,CAST SUP LNGLEG CYLNDR PED F,118.0,76.7,1.1,137.76,104
CDM,Q4037OH,CAST SUP SHRT LEG PLASTER,128.0,83.2,1.1,128.0,104
CDM,Q4038OH,CAST SUP SHRT LEG FIBERGLASS,222.0,144.3,1.1,222.0,104
CDM,Q4039OH,CAST SUP SHRT LEG PED PLSTER,83.0,53.95,1.1,83.0,104
CDM,Q4040OH,CAST SUP SHRT LEG PED FBRGLS,128.0,83.2,1.1,128.0,104
CDM,Q4041OH,CAST SUP LNG LEG SPLNT PLSTR,88.0,57.2,1.1,88.0,104
CDM,Q4042OH,CAST SUP LNG LEG SPLNT FBRGL,127.0,82.55,1.1,140.22,104
CDM,Q4043OH,CAST SUP LNG LEG SPLNT PED P,75.0,48.75,1.1,75.0,104
CDM,Q4044OH,CAST SUP LNG LEG SPLNT PED F,64.0,41.6,1.1,70.2,104
CDM,Q4045OH,CAST SUP SHT LEG SPLNT PLSTR,83.0,53.95,1.1,83.0,104
CDM,Q4046OH,CAST SUP SHT LEG SPLNT FBRGL,83.0,53.95,1.1,83.0,104
CDM,Q4047OH,CAST SUP SHT LEG SPLNT PED P,95.0,61.75,1.1,95.0,104
CDM,Q4048OH,CAST SUP SHT LEG SPLNT FIBERGLASS,80.0,52.0,1.1,80.0,104
CDM,Q4049OH,"FINGER SPLINT, STATIC",51.0,33.15,1.1,51.0,92
CDM,Q4050OH,CAST SUPPLIES UNLISTED,31.0,20.15,0.01,3061000.0,80
CDM,Q4051OH,SPLINT SUPPLIES MISC,10.0,6.5,0.01,3061000.0,80
CDM,Q4080OH,ILOPROST INHALATION SOLUTION,93.0,60.45,1.1,93.0,68
CDM,Q4101OH,APLIGRAF SKIN SUB,51.0,33.15,1.1,347.42,110
CDM,Q4102OH,OASIS WOUND MATRIX SKIN SUB,17.0,11.05,1.1,347.42,110
CDM,Q4107OH,GRAFTJACKET SKIN SUB,191.0,124.15,1.1,347.42,108
CDM,Q4121OH,PR THERASKIN,101.0,65.65,1.1,347.42,110
CDM,Q4124OH,OASIS TRI-LAYER WOUND MATRIX,24.0,15.6,1.1,347.42,110
CDM,Q4186OH,"EPIFIX, PER SQ CM",364.0,236.6,1.1,465.27,110
CDM,Q9956OH,"INJ OCTAFLUOROPROPANE MIC,ML",479.0,311.35,1.1,479.0,78
CDM,Q9957OH,"INJ PERFLUTREN LIP MICROS,ML",382.0,248.3,1.1,382.0,78
CDM,Q9965OH,"LOCM 100-199MG/ML IODINE,1ML",14.0,9.1,0.85,14.0,78
CDM,Q9966OH,"LOCM 200-299MG/ML IODINE,1ML",8.0,5.2,0.36,8.0,78
CDM,Q9967OH,LOCM 300-399MG/ML IODINE 1ML,14.0,9.1,0.12,14.0,78
CDM,Q9982OH,FLUTEMETAMOL F18 DIAGNOSTIC,8400.0,5460.0,1.1,8400.0,74
CDM,S0028OH,"INJECTION, FAMOTIDINE, 20 MG",12.0,7.8,0.85,12.0,68
CDM,S0077OH,"INJECTION, CLINDAMYCIN PHOSP, 300 MG",21.0,13.65,1.1,21.0,68
CDM,S0189OH,TESTOSTERONE PELLET 75 MG,212.0,137.8,1.1,235.7,72
CDM,S0190OH,"MIFEPRISTONE, ORAL, 200 MG",103.2,67.08,1.1,134.68,74
CDM,S0191OH,"MISOPROSTOL, ORAL, 200 MCG",3.0,1.95,0.76,30.61,74
CDM,S0265OH,GENETIC COUNSEL 15 MINS,78.0,50.7,1.1,192.84,80
CDM,S0353OH,CANCER TREATMENT PLAN INITIAL,463.0,300.95,1.1,982.58,68
CDM,S0354OH,CANCER TREATMENT PLAN CHANGE,463.0,300.95,1.1,1224.4,68
CDM,S0610OH,"GYN EXAM, NEW PT., ANNUAL",373.0,242.45,1.1,373.0,80
CDM,S0612OH,"GYN EXAM, EST PT., ANNUAL",303.0,196.95,1.1,303.0,80
CDM,S0612RVUOH,PREVENTIVE VISIT,334.0,217.1,1.1,334.0,80
CDM,S0620AOH,"OPHTHALMOLOGICAL EXAM, NEW PT.",176.0,114.4,1.1,204.55,80
CDM,S0620OH,"OPHTHALMOLOGICAL EXAM, NEW PT.",345.0,224.25,1.1,345.0,80
CDM,S0621AOH,"OPHTHALMOLOGICAL EXAM, EST PT.",150.0,97.5,1.1,173.8,80
CDM,S0621OH,"OPHTHALMOLOGICAL EXAM, EST PT.",217.0,141.05,1.1,217.0,80
CDM,S0800OH,LASER IN SITU KERATOMILEUSIS,3529.0,2293.85,1.1,3529.0,80
CDM,S0810OH,PHOTOREFRACTIVE KERATECTOMY,3529.0,2293.85,1.1,3529.0,80
CDM,S0812OH,PHOTOTHERAP KERATECT,2920.0,1898.0,1.1,2920.0,80
CDM,S0812RVUOH,PHOTOTHERAPEUTIC KERATECTOMY,3984.0,2589.6,1.1,3984.0,80
CDM,S2066OH,BREAST GAP FLAP RECONST,21109.0,13720.85,1.1,42854.0,80
CDM,S2067OH,"BREAST ""STACKED"" DIEP/GAP",21109.0,13720.85,1.1,22232.04,80
CDM,S2068OH,BREAST DIEP FLAP RECONSTRUCT,21109.0,13720.85,1.1,54599.06,80
CDM,S2083OH,ADJUSTMENT GASTRIC BAND,72.0,46.8,1.1,356.57,80
CDM,S2118OH,TOTAL HIP RESURFACING,15305.0,9948.25,1.1,15305.0,80
CDM,S2325OH,HIP CORE DECOMPRESSION,2516.0,1635.4,1.1,2696.74,80
CDM,S2404OH,FETAL SURG MYELOMENINGO,18994.0,12346.1,1.1,3060831.65,80
CDM,S2411OH,FETOSCOP LASER THER TTTS,4457.0,2897.05,1.1,13150.06,82
CDM,S2900OH,ROBOTIC SURGICAL SYSTEM,526.0,341.9,0.01,765.25,80
CDM,S5110OH,FAMILY HOMECARE TRAINING 15M,692.0,449.8,1.1,3060831.65,80
CDM,S5150OH,BEHAVIORAL HEALTH RESPITE 15 MIN - 3HR,10.0,6.5,1.1,3060831.65,80
CDM,S5151OH,BEHAVIORAL HEALTH RESPITE PER DIEM 3+HOURS,106.0,68.9,1.1,3060831.65,80
CDM,S8424OH,READY GRADIENT SLEEVE,90.0,58.5,1.1,498.94,80
CDM,S8428OH,READY GRADIENT GAUNTLET,52.0,33.8,1.1,330.59,80
CDM,S8948OH,LOW-LEVEL LASER TRMT 15 MIN,72.0,46.8,1.1,72.0,80
CDM,U0001OH,COVID19,248.0,161.2,1.1,248.0,86
CDM,U0002OH,COVID19,354.0,230.1,1.1,354.0,86
CDM,V2302OH,LENS SPHERE TRIFOCAL 7.12-20,101.0,65.65,1.1,323.68,90
CDM,V2307OH,LENS SPHCY TRIFOCAL 4.25-7/.,187.0,121.55,1.1,301.29,90
CDM,V2309OH,LENS SPHC TRIFOCAL 4.25-7/4.,187.0,121.55,1.1,343.93,90
CDM,V2310OH,LENS SPHC TRIFOCAL 4.25-7/>6,187.0,121.55,1.1,359.24,90
CDM,V2311OH,LENS SPHC TRIFO 7.25-12/.25-,187.0,121.55,1.1,414.79,90
CDM,V2320OH,LENS TRIFOCAL ADD OVER 3.25D,24.0,15.6,1.1,275.73,90
CDM,V2410OH,LENS VARIAB ASPHERICITY SING,48.0,31.2,1.1,405.88,90
CDM,V2430OH,LENS VARIABLE ASPHERICITY BI,48.0,31.2,1.1,429.62,90
CDM,V2499OH,VARIABLE ASPHERICITY LENS,48.0,31.2,0.01,260.19,80
CDM,V2520AOH,AVAIRA VITALITY 6 PK,50.0,32.5,1.1,482.55,90
CDM,V2520OH-27,NATURALVUE?SPHERE?????????????????,60.0,39.0,1.1,482.55,90
CDM,V2520OH-28,CONTACT LENS HYDROPHILIC,36.0,23.4,1.1,482.55,90
CDM,V2521AOH,BIOTRUE ONE DAY FOR ASTIGMATISM (30 PK),48.0,31.2,1.1,48.0,68
CDM,V2521BOH,ULTRA FOR ASTIGMATISM,90.0,58.5,1.1,955.6,90
CDM,V2521COH,AVAIRA VITALITY TORIC 6 PK,60.0,39.0,1.1,955.6,90
CDM,V2521OH,CNTCT LENS HYDROPHILIC TORIC,35.0,22.75,1.1,955.6,90
CDM,V2522AOH,DAILIES TOTAL 1 MULTIFOCAL 30 PACK,75.0,48.75,1.1,699.32,90
CDM,V2522BOH,DAILIES TOTAL 1 MULTIFOCAL 90 PACK,197.0,128.05,1.1,699.32,90
CDM,V2522COH,BIOTRUE ONE DAY FOR ASTIGMATISM (90 PK),127.0,82.55,1.1,699.32,90
CDM,V2522DOH,BIOTRUE ONEDAY FOR PRESBYOPIA (90 PK),149.0,96.85,1.1,699.32,90
CDM,V2522OH,NATURALVUE? MULTI???????????????????,100.0,65.0,1.1,699.32,90
CDM,V2523AOH,AIR OPTIX PLUS HYDRAGYIDE,77.0,50.05,1.1,734.23,90
CDM,V2523BOH,BIOFINITY ENERGYS,71.0,46.15,1.1,734.23,90
CDM,V2523COH,MY DAY 180 PK,212.0,137.8,1.1,734.23,90
CDM,V2523DOH,DAY -1  ACUVUE TRUE EYE 30 PK,64.0,41.6,1.1,734.23,90
CDM,V2531AOH,SYNERGEYES CLEARCONE/ANNUAL,600.0,390.0,1.1,2149.61,90
CDM,V2531BOH,SYNERGEYES KC/SINGLE,450.0,292.5,1.1,2149.61,90
CDM,V2531COH,SYNERGEYES PS/SINGLE,375.0,243.75,1.1,2149.61,90
CDM,V2531DOH,SYNERGES SCLERAL VS,475.0,308.75,1.1,2149.61,90
CDM,V2531EOH,ULTRAHEALTH FC / SINGLE,430.0,279.5,1.1,2149.61,90
CDM,V2531FOH,ULTRAHEALTH FC /ANNUAL/PER EYE,600.0,390.0,1.1,2149.61,90
CDM,V2531GOH,SYNERGEYES DUE. PROG (.ANNUAL),340.0,221.0,1.1,2149.61,90
CDM,V2531HOH,SYNERGEYES DUETTE (ANNUAL),300.0,195.0,1.1,2149.61,90
CDM,V2531IOH,SYNERGEYES DUETTE M.F (ANNUAL),340.0,221.0,1.1,2149.61,90
CDM,V2531JOH,SYNERGEYES KC (ANNUAL),600.0,390.0,1.1,2149.61,90
CDM,V2531KOH,SYNERGEYES PS (ANNUAL),600.0,390.0,1.1,2149.61,90
CDM,V2531LOH,RGP ORTHO-K WARRANTED/SINGLE,300.0,195.0,1.1,2149.61,90
CDM,V2624AOH,POLISHING/RESURFACING OCULAR PROSTHESIS,99.0,64.35,1.1,240.31,90
CDM,V2624OH,POLISHING ARTIFICAL EYE,99.0,64.35,1.1,240.31,90
CDM,V2700OH,BALANCE LENS,37.0,24.05,1.1,177.01,90
CDM,V2718AOH,FRESNEL PRISM PRESS,35.0,22.75,1.1,122.86,90
CDM,V2761OH,MIRROR COATING,41.0,26.65,1.1,42.09,86
CDM,V2787OH,ASTIGMATISM-CORRECT FUNCTION,648.0,421.2,1.1,648.0,80
CDM,V2788OH,PRESBYOPIA-CORRECT FUNCTION,2625.0,1706.25,1.1,2754.9,80
CDM,V36468OH,INJECTION(S) SPIDER VEINS,110.0,71.5,1.1,1163.18,84
CDM,V36470OH,INJECTION THERAPY OF VEIN,114.0,74.1,1.1,1163.18,148
CDM,V36471OH,INJECTION THERAPY OF VEINS,114.0,74.1,1.1,1163.18,148
CDM,V36478OH,ENDOVENOUS LASER 1ST VEIN,650.0,422.5,1.1,9296.26,148
CDM,V36479OH,ENDOVENOUS LASER VEIN ADDON,321.0,208.65,1.1,1021.65,148
CDM,V37700OH,REVISE LEG VEIN,485.0,315.25,1.1,9296.26,144
CDM,V37761OH,LIGATE LEG VEINS OPEN,1100.0,715.0,1.1,9296.26,144
CDM,V37765OH,PHLEB VEINS - EXTREM - TO 20,2112.0,1372.8,1.1,9296.26,148
CDM,V37766OH,PHLEB VEINS - EXTREM 20+,2640.0,1716.0,1.1,9296.26,148
CDM,V37799OH,VASCULAR SURGERY PROCEDURE,110.0,71.5,0.01,2283.59,84
CDM,V5014OH,HEARING AID REPAIR/MODIFYING,332.0,215.8,1.1,612.2,86
CDM,V5160OH,"DISPENSING FEE, BINAURAL",558.0,362.7,1.1,2066.18,86
CDM,V5200OH,CROS HEARING AID DISPENS FEE,351.0,228.15,1.1,1377.45,86
CDM,V5240OH,DISPENSING FEE BICROS,325.0,211.25,1.1,2066.18,86
CDM,V5241OH,"DISPENSING FEE, MONAURAL",325.0,211.25,1.1,1377.45,80
CDM,V5254OH,"HEARING ID, DIGIT, MON, CIC",643.0,417.95,1.1,4146.22,86
CDM,V5255OH,"HEARING AID, DIGIT, MON, ITC",643.0,417.95,1.1,4146.22,86
CDM,V5256OH,"HEARING AID, DIGIT, MON, ITE",694.0,451.1,1.1,4146.22,86
CDM,V5257OH,"HEARING AID, DIGIT, MON, BTE",643.0,417.95,1.1,3673.2,86
CDM,V5261OH,"HEARING AID, DIGIT, BIN, BTE",1867.0,1213.55,1.1,6910.37,86
CDM,V5264OH,EAR MOLD/INSERT,92.0,59.8,1.1,169.3,80
CDM,V5265OH,"EAR MOLD/INSERT, DISP",541.0,351.65,1.1,541.0,80
CDM,V5299OH,"HEARING AID, OTHER:",55.0,35.75,0.01,3061000.0,80
CDM,V5362OH,SPEECH SCREENING,155.0,100.75,1.1,155.0,80
CDM,V76937OH,US GUIDE VASCULAR ACCESS,29.0,18.85,1.1,129.82,142
CDM,V76942OH,ECHO GUIDE FOR BIOPSY,66.0,42.9,1.1,193.59,142
CDM,V93931OH,UPPER EXTREMITY STUDY,200.0,130.0,1.1,401.32,144
CDM,V93970OH,EXTREMITY STUDY,57.0,37.05,1.1,713.21,144
CDM,V93971OH,EXTREMITY STUDY,36.0,23.4,1.1,387.98,144
CDM,V93990OH,DOPPLER FLOW TESTING,228.0,148.2,1.1,418.04,144
CDM,V99202OH,OFFICE/OUTPATIENT VISIT NEW,68.0,44.2,1.1,177.69,152
CDM,V99203OH,OFFICE/OUTPATIENT VISIT NEW,103.0,66.95,1.1,277.03,152
CDM,V99204OH,OFFICE/OUTPATIENT VISIT NEW,175.0,113.75,1.1,412.41,152
CDM,V99212OH,OFFICE/OUTPATIENT VISIT EST,35.0,22.75,1.1,138.61,152
CDM,V99213OH,OFFICE/OUTPATIENT VISIT EST,68.0,44.2,1.1,200.07,152
CDM,V99214OH,OFFICE/OUTPATIENT VISIT EST,106.0,68.9,1.1,283.48,152
CDM,V99215OH,OFFICE/OUTPATIENT VISIT EST,150.0,97.5,1.1,442.72,152
CDM,V99242OH,OFFICE/OP CONSLTJ NEW/EST PT SF MDM 20 MINUTES,100.0,65.0,1.1,186.59,120
CDM,V99243OH,OFFICE/OP CONSLTJ NEW/EST PT LOW MDM 30 MINUTES,140.0,91.0,1.1,282.28,120
CDM,W0710OH,OT/PT WK CNDITIONNG PER 15 MIN,203.0,131.95,1.1,203.0,68
CPT,AUTOTANIP,Cornea - IP,,,21689.0,21689.0,1
CPT,AUTOTANOP,Cornea - OP,,,16020.0,16020.0,1
CPT,AUTOTBM,Autologous/Bone Marrow,,,240500.0,240500.0,1
CPT,CorneaIP,Cornea (Inpatient ),,,26700.0,26700.0,1
CPT,CorneaOP,Cornea (Outpatient),,,19700.0,19700.0,1
CPT,CorniaIP,Cornea (Inpatient ),,,26700.0,26700.0,2
CPT,CorniaOP,Cornea (Outpatient),,,19700.0,19700.0,2
CPT,INTESTONLYA,Intestine Only-Adult,,,485000.0,485000.0,1
CPT,INTESTONLYP,Intestine Only-Pediatric,,,540500.0,540500.0,1
CPT,Intest,Intestine,,,563700.0,563700.0,1
CPT,KIDPANC,Kidney/Pancreas - Adult & Pediatric,,,238302.0,238302.0,1
CPT,MULVISC,Multivisceral - Adult & Pediatric,,,26700.0,26700.0,2
HCPCS,0001A,ADM SARSCOV2 30MCG/0.3ML 1ST,,,44.81,44.81,1
HCPCS,0001A,Adm sarscov2 30mcg/0.3ml 1st,,,17.08,19.78,8
HCPCS,0001F,HEART FAILURE COMPOSITE,,,0.03,0.03,1
HCPCS,0001F,Heart failure composite,,,10.69,12.38,8
HCPCS,0001M,Infectious dis hcv 6 assays,,,2466002.74,2466002.74,1
HCPCS,0001U,HUMAN ERYTHROCYTE AG,4968.0,3229.2,20.31,4968.0,84
HCPCS,0002A,ADM SARSCOV2 30MCG/0.3ML 2ND,,,44.81,44.81,1
HCPCS,0002A,Adm sarscov2 30mcg/0.3ml 2nd,,,17.08,19.78,8
HCPCS,0002M,LIVER DIS 10 ASSAYS W/ASH,,,47.08,1379.32,23
HCPCS,0002M,Liver dis 10 assays w/ash,,,109.69,127.01,8
HCPCS,0002U,ONC CLRCT 3 UR METAB ALG PLP,,,2.2,68.5,25
HCPCS,0002U,Onc clrct 3 ur metab alg plp,,,18.15,21.01,8
HCPCS,0003A,Adm sarscov2 30mcg/0.3ml 3rd,,,17.08,19.78,8
HCPCS,0003M,LIVER DIS 10 ASSAYS W/NASH,,,2.2,1379.32,23
HCPCS,0003M,Liver dis 10 assays w/nash,,,109.69,127.01,8
HCPCS,0003U,ONC OVAR 5 PRTN SER ALG SCOR,,,5.84,2603.0,25
HCPCS,0003U,Onc ovar 5 prtn ser alg scor,,,173.12,200.45,8
HCPCS,0004A,Adm sarscov2 30mcg/0.3ml bst,,,17.08,19.78,8
HCPCS,0004M,SCOLIOSIS DNA ALYS,,,2.5,216.46,23
HCPCS,0004M,Scoliosis dna alys,,,83.94,97.2,8
HCPCS,0005F,OSTEOARTHRITIS COMPOSITE,,,2739849.3,2739849.3,1
HCPCS,0005F,Osteoarthritis composite,,,10.69,12.38,8
HCPCS,0005U,ONCO PRST8 3 GENE UR ALG,,,11.51,2082.4,25
HCPCS,0005U,Onco prst8 3 gene ur alg,,,173.12,200.45,8
HCPCS,0006M,ONC HEP GENE RISK CLASSIFIER,,,150.0,411.0,21
HCPCS,0006M,Onc hep gene risk classifier,,,116.49,134.88,8
HCPCS,0007M,ONC GASTRO 51 GENE NOMOGRAM,,,375.0,1027.5,21
HCPCS,0007M,Onc gastro 51 gene nomogram,,,109.69,127.01,8
HCPCS,0007U,RX TEST PRSMV UR W/DEF CONF,,,80.02,313.54,25
HCPCS,0007U,Rx test prsmv ur w/def conf,,,34.82,40.32,8
HCPCS,0008M,Onc breast risk score,,,2466002.74,2466002.74,1
HCPCS,0008U,HPYLORI DETCJ ABX RSTNC DNA,,,504.0,1638.27,25
HCPCS,0008U,Hpylori detcj abx rstnc dna,,,109.69,127.01,8
HCPCS,0009U,ONC BRST CA ERBB2 AMP/NONAMP,,,55.77,293.18,25
HCPCS,0009U,Onc brst ca erbb2 amp/nonamp,,,83.94,97.2,8
HCPCS,00100,Anes px salivary gland w/bx,,,200.6,232.28,8
HCPCS,00102,Anes px plstc rpr cleft lip,,,200.6,232.28,8
HCPCS,00103,Anes rcnstv px eyelid,,,200.6,232.28,8
HCPCS,00104,Anes electroconvulsive ther,,,200.6,232.28,8
HCPCS,0010U,NFCT DS STRN TYP WHL GEN SEQ,,,7.38,1170.69,25
HCPCS,0010U,Nfct ds strn typ whl gen seq,,,109.69,127.01,8
HCPCS,0011A,ADM SARSCOV2 100MCG/0.5ML1ST,,,44.81,44.81,1
HCPCS,0011A,Adm sarscov2 100mcg/0.5ml1st,,,17.08,19.78,8
HCPCS,0011M,ONC PRST8 CA MRNA 12 GEN ALG,,,3.3,2082.4,25
HCPCS,0011M,Onc prst8 ca mrna 12 gen alg,,,173.12,200.45,8
HCPCS,0011U,RX MNTR LC-MS/MS ORAL FLUID,,,114.43,313.54,25
HCPCS,0011U,Rx mntr lc-ms/ms oral fluid,,,34.82,40.32,8
HCPCS,00120,Anes px ear w/bx nos,,,200.6,232.28,8
HCPCS,00124,Anes px ear otoscopy,,,200.6,232.28,8
HCPCS,00126,Anes px ear tympanotomy,,,200.6,232.28,8
HCPCS,0012A,ADM SARSCOV2 100MCG/0.5ML2ND,,,44.81,44.81,1
HCPCS,0012A,Adm sarscov2 100mcg/0.5ml2nd,,,17.08,19.78,8
HCPCS,0012F,CAP BACTERIAL ASSESS,,,2739849.3,2739849.3,1
HCPCS,0012F,Cap bacterial assess,,,10.69,12.38,8
HCPCS,0012M,ONC MRNA 5 GEN RSK URTHL CA,,,4.5,2082.4,25
HCPCS,0012M,Onc mrna 5 gen rsk urthl ca,,,173.12,200.45,8
HCPCS,0012U,GERMLN DO GENE REARGMT DETCJ,,,504.0,2818.39,3
HCPCS,0012U,Germln do gene reargmt detcj,,,672.05,778.16,8
HCPCS,0013A,Adm sarscov2 100mcg/0.5ml3rd,,,17.08,19.78,8
HCPCS,0013M,ONC MRNA 5 GEN RECR URTHL CA,,,7.95,2082.4,25
HCPCS,0013M,Onc mrna 5 gen recr urthl ca,,,173.12,200.45,8
HCPCS,0013U,ONC SLD ORG NEO GENE REARGMT,,,504.0,2818.39,3
HCPCS,0013U,Onc sld org neo gene reargmt,,,672.05,778.16,8
HCPCS,00140,Anes procedures on eye nos,,,200.6,232.28,8
HCPCS,00142,Anes px on eye lens surgery,,,200.6,232.28,8
HCPCS,00144,Anes px eye corneal trnspl,,,200.6,232.28,8
HCPCS,00145,Anes px eye vitreortnl surg,,,200.6,232.28,8
HCPCS,00147,Anes px on eye iridectomy,,,200.6,232.28,8
HCPCS,00148,Anes px eye ophthalmoscopy,,,200.6,232.28,8
HCPCS,0014A,Fee covid-19 vac 2 res,,,17.08,19.78,8
HCPCS,0014F,COMP PREOP ASSESS CAT SURG,,,2739849.3,2739849.3,1
HCPCS,0014F,Comp preop assess cat surg,,,10.69,12.38,8
HCPCS,0014M,LIVER DS ALYS 3 BMRK SRM ALG,,,132.3,197.4,3
HCPCS,0014M,Liver ds alys 3 bmrk srm alg,,,116.49,134.88,8
HCPCS,0014U,HEM HMTLMF NEO GENE REARGMT,,,504.0,2818.39,3
HCPCS,0014U,Hem hmtlmf neo gene reargmt,,,672.05,778.16,8
HCPCS,0015F,MELAN FOLLOW-UP COMPLETE,,,0.03,0.03,1
HCPCS,0015F,Melan follow-up complete,,,10.69,12.38,8
HCPCS,0015M,ADRNL CORTCL TUM BCHM ASY 25,,,30.9,3576.71,25
HCPCS,0015M,Adrnl cortcl tum bchm asy 25,,,83.94,97.2,8
HCPCS,00160,Anes px nose&sinus nos,,,200.6,232.28,8
HCPCS,00162,Anes px nose&sinus rad surg,,,200.6,232.28,8
HCPCS,00164,Anes px nose&sins bx sft tis,,,200.6,232.28,8
HCPCS,0016M,ONC BLADDER MRNA 219 GEN ALG,,,30.9,9561.59,25
HCPCS,0016M,Onc bladder mrna 219 gen alg,,,83.94,97.2,8
HCPCS,0016U,ONC HMTLMF NEO RNA BCR/ABL1,,,163.96,504.0,25
HCPCS,0016U,Onc hmtlmf neo rna bcr/abl1,,,116.49,134.88,8
HCPCS,00170,Anes intraoral px nos,,,200.6,232.28,8
HCPCS,00172,Anes ntroral px rpr clft pal,,,200.6,232.28,8
HCPCS,00174,Anes ntrorl exc rtrphrng tum,,,200.6,232.28,8
HCPCS,00176,Anes intraoral px rad surg,,,200.6,232.28,8
HCPCS,0017M,ONC DLBCL MRNA 20 GENES ALG,,,30.9,6877.98,25
HCPCS,0017M,Onc dlbcl mrna 20 genes alg,,,672.05,778.16,8
HCPCS,0017U,ONC HMTLMF NEO JAK2 MUT DNA,,,91.66,504.0,25
HCPCS,0017U,Onc hmtlmf neo jak2 mut dna,,,83.94,97.2,8
HCPCS,0018M,TRNSPLJ RNL MEAS CD154+CLL,,,132.3,1755.6,24
HCPCS,0018M,Trnsplj rnl meas cd154+cll,,,52.25,60.5,8
HCPCS,0018U,ONC THYR 10 MICRORNA SEQ ALG,,,3002.09,8225.73,23
HCPCS,0018U,Onc thyr 10 microrna seq alg,,,672.05,778.16,8
HCPCS,00190,Anes px facial b1/skull nos,,,200.6,232.28,8
HCPCS,00192,Anes px fcl b1/skl rad surg,,,200.6,232.28,8
HCPCS,0019M,CV DS PLASMA ALYS PRTN BMRK,,,712.4,1602.9,20
HCPCS,0019M,Cv ds plasma alys prtn bmrk,,,83.94,97.2,8
HCPCS,0019U,ONC RNA TISS PREDICT ALG,,,3675.0,10069.5,23
HCPCS,0019U,Onc rna tiss predict alg,,,672.05,778.16,8
HCPCS,0020M,ONC CNS ALYS 30000 DNA LOCI,,,2500.0,5625.0,15
HCPCS,0020M,Onc cns alys 30000 dna loci,,,83.94,97.2,8
HCPCS,00210,Anes intracranial px nos,,,200.6,232.28,8
HCPCS,00211,Anes icr px crnec/crnot hmtm,,,200.6,232.28,8
HCPCS,00212,Anes icr px subdural taps,,,200.6,232.28,8
HCPCS,00214,Anes icr px burr holes,,,200.6,232.28,8
HCPCS,00215,Anes icr px crnop/elvtn fx,,,200.6,232.28,8
HCPCS,00216,Anes icr px vascular px,,,200.6,232.28,8
HCPCS,00218,Anes icr px in sitting pos,,,200.6,232.28,8
HCPCS,0021A,Adm sarscov2 5x1010vp/.5ml 1,,,17.08,19.78,8
HCPCS,0021U,ONC PRST8 DETCJ 8 AUTOANTB,,,760.0,2082.4,23
HCPCS,0021U,Onc prst8 detcj 8 autoantb,,,173.12,200.45,8
HCPCS,00220,Anes icr px csf shunting px,,,200.6,232.28,8
HCPCS,00222,Anes icr px ecoag icr nrv,,,200.6,232.28,8
HCPCS,0022A,Adm sarscov2 5x1010vp/.5ml 2,,,17.08,19.78,8
HCPCS,0022U,TGSAP NSM LUNG NEO DNA&RNA23,,,1950.0,5343.0,23
HCPCS,0022U,Tgsap nsm lung neo dna&rna23,,,109.69,127.01,8
HCPCS,0023A,Fee covid-19 vac 3 booster,,,17.08,19.78,8
HCPCS,0023U,ONC AML DNA DETCJ/NONDETCJ,,,248.51,680.92,23
HCPCS,0023U,Onc aml dna detcj/nondetcj,,,116.49,134.88,8
HCPCS,0024A,Fee covid-19 vac 3 res,,,17.08,19.78,8
HCPCS,0024U,GLYCA NUC MR SPECTRSC QUAN,,,3.86,93.68,25
HCPCS,0024U,Glyca nuc mr spectrsc quan,,,20.86,24.16,8
HCPCS,0025U,TENOFOVIR LIQ CHROM UR QUAN,,,50.36,235.01,25
HCPCS,0025U,Tenofovir liq chrom ur quan,,,34.82,40.32,8
HCPCS,0026U,ONC THYR DNA&MRNA 112 GENES,,,504.0,9864.0,25
HCPCS,0026U,Onc thyr dna&mrna 112 genes,,,672.05,778.16,8
HCPCS,0027U,JAK2 GENE TRGT SEQ ALYS,,,121.91,504.0,25
HCPCS,0027U,Jak2 gene trgt seq alys,,,83.94,97.2,8
HCPCS,0029U,RX METAB ADVRS TRGT SEQ ALYS,,,440.52,2033.82,25
HCPCS,0029U,Rx metab advrs trgt seq alys,,,173.12,200.45,8
HCPCS,00300,Anes all px integ h/n/ptrunk,,,200.6,232.28,8
HCPCS,0030U,RX METAB WARF TRGT SEQ ALYS,,,90.95,367.52,25
HCPCS,0030U,Rx metab warf trgt seq alys,,,116.49,134.88,8
HCPCS,0031A,Adm sarscov2 vac ad26 .5ml,,,17.08,44.81,9
HCPCS,0031U,CYP1A2 GENE,,,110.13,478.98,25
HCPCS,0031U,Cyp1a2 gene,,,116.49,134.88,8
HCPCS,00320,Anes all px neck nos 1yr/>,,,200.6,232.28,8
HCPCS,00322,Anes all px nck ndl bx thyr,,,200.6,232.28,8
HCPCS,00326,Anes all px larynx&trach<1yr,,,200.6,232.28,8
HCPCS,0032A,Fee covid-19 vac 4 dose 2,,,17.08,19.78,8
HCPCS,0032U,COMT GENE,,,174.81,478.98,25
HCPCS,0032U,Comt gene,,,116.49,134.88,8
HCPCS,0033A,Fee covid-19 vac 4 booster,,,17.08,19.78,8
HCPCS,0033U,HTR2A HTR2C GENES,,,349.62,957.96,12
HCPCS,0033U,Htr2a htr2c genes,,,116.49,134.88,8
HCPCS,0034A,Adm sarscov2 vac ad26 .5ml b,,,17.08,19.78,8
HCPCS,0034U,TPMT NUDT15 GENES,,,10.46,1277.31,25
HCPCS,0034U,Tpmt nudt15 genes,,,109.69,127.01,8
HCPCS,00350,Anes px major vsl neck nos,,,200.6,232.28,8
HCPCS,00352,Anes px maj vsl nck smpl lig,,,200.6,232.28,8
HCPCS,0035U,CJD NEURO CSF QUAL,3733.0,2426.45,75.0,3733.0,84
HCPCS,0036U,XOME TUM & NML SPEC SEQ ALYS,,,4780.0,13097.2,23
HCPCS,0036U,Xome tum & nml spec seq alys,,,672.05,778.16,8
HCPCS,0037U,TRGT GEN SEQ DNA 324 GENES,,,3500.0,9590.0,23
HCPCS,0037U,Trgt gen seq dna 324 genes,,,672.05,778.16,8
HCPCS,0038U,VITAMIN D SRM MICROSAMP QUAN,,,29.6,81.1,23
HCPCS,0038U,Vitamin d srm microsamp quan,,,20.86,24.16,8
HCPCS,0039U,DNA ANTB 2STRAND HI AVIDITY,,,13.74,37.65,23
HCPCS,0039U,Dna antb 2strand hi avidity,,,23.08,26.72,8
HCPCS,00400,Anes integumentary sys nos,,,200.6,232.28,8
HCPCS,00402,Anes integ sys rcnstv breast,,,200.6,232.28,8
HCPCS,00404,Anes integ sys rad/modf brst,,,200.6,232.28,8
HCPCS,00406,Anes integ sys rad brst dsj,,,200.6,232.28,8
HCPCS,0040U,BCR/ABL1 GENE MAJOR BP QUAN,,,409.9,1123.13,23
HCPCS,0040U,Bcr/abl1 gene major bp quan,,,109.69,127.01,8
HCPCS,00410,Anes integ sys conv arrhyt,,,200.6,232.28,8
HCPCS,0041A,Adm sarscov2 5mcg/0.5ml 1st,,,17.08,19.78,8
HCPCS,0041U,B BRGDRFERI ANTB 5 PRTN IGM,,,17.21,47.16,23
HCPCS,0041U,B brgdrferi antb 5 prtn igm,,,23.08,26.72,8
HCPCS,0042A,Adm sarscov2 5mcg/0.5ml 2nd,,,17.08,19.78,8
HCPCS,0042T,Ct perfusion w/contrast cbf,,,393.75,455.92,8
HCPCS,0042U,B BRGDRFERI ANTB 12 PRTN IGG,,,17.21,47.16,23
HCPCS,0042U,B brgdrferi antb 12 prtn igg,,,23.08,26.72,8
HCPCS,0043A,Fee covid-19 vac 5 booster,,,17.08,19.78,8
HCPCS,0043U,TBRF B GRP ANTB 4 PRTN IGM,,,14.86,40.72,23
HCPCS,0043U,Tbrf b grp antb 4 prtn igm,,,23.08,26.72,8
HCPCS,0044A,Adm sarscov2 5mcg/0.5ml bst,,,17.08,19.78,8
HCPCS,0044U,TBRF B GRP ANTB 4 PRTN IGG,,,14.86,40.72,23
HCPCS,0044U,Tbrf b grp antb 4 prtn igg,,,23.08,26.72,8
HCPCS,00450,Anes px clav&scapula nos,,,200.6,232.28,8
HCPCS,00454,Anes px clav&scapula bx clav,,,200.6,232.28,8
HCPCS,0045U,ONC BRST DUX CARC IS 12 GENE,,,3873.0,10612.02,23
HCPCS,0045U,Onc brst dux carc is 12 gene,,,672.05,778.16,8
HCPCS,0046U,FLT3 ITD MRD ASSAY,2811.0,1827.15,75.0,2811.0,84
HCPCS,00470,Anes partial rib rescj nos,,,200.6,232.28,8
HCPCS,00472,Anes prtl rib rescj thoracop,,,200.6,232.28,8
HCPCS,00474,Anes prtl rib rescj rad px,,,200.6,232.28,8
HCPCS,0047U,ONC PRST8 MRNA 17 GENE ALG,,,3873.0,10612.02,23
HCPCS,0047U,Onc prst8 mrna 17 gene alg,,,672.05,778.16,8
HCPCS,0048U,ONC SLD ORG NEO DNA 468 GENE,,,2919.6,7999.7,23
HCPCS,0048U,Onc sld org neo dna 468 gene,,,672.05,778.16,8
HCPCS,0049U,NPM1 GENE ANALYSIS QUAN,,,407.43,1116.36,23
HCPCS,0049U,Npm1 gene analysis quan,,,109.69,127.01,8
HCPCS,00500,Anes all px on esophagus,,,200.6,232.28,8
HCPCS,0050U,TRGT GEN SEQ DNA 194 GENES,,,2916.6,7991.48,23
HCPCS,0050U,Trgt gen seq dna 194 genes,,,672.05,778.16,8
HCPCS,0051A,Adm sarscv2 30mcg trs-sucr 1,,,17.08,19.78,8
HCPCS,0051U,RX MNTR LC-MS/MS UR/BLD 31,,,217.03,530.77,23
HCPCS,0051U,Rx mntr lc-ms/ms ur/bld 31,,,75.43,87.34,8
HCPCS,00520,Anes closed chest px nos,,,200.6,232.28,8
HCPCS,00522,Anes clsd ch px ndl bx pleur,,,200.6,232.28,8
HCPCS,00524,Anes clsd ch px pneumocents,,,200.6,232.28,8
HCPCS,00528,Anes clsd ch mediast&thrc wo,,,200.6,232.28,8
HCPCS,00529,Anes clsd ch mediast&thrc w/,,,200.6,232.28,8
HCPCS,0052A,Adm sarscv2 30mcg trs-sucr 2,,,17.08,19.78,8
HCPCS,0052U,LPOPRTN BLD W/5 MAJ CLASSES,,,33.86,92.78,23
HCPCS,0052U,Lpoprtn bld w/5 maj classes,,,20.86,24.16,8
HCPCS,00530,Anes perm transvns pm insj,,,200.6,232.28,8
HCPCS,00532,Anes access ctr venous crcj,,,200.6,232.28,8
HCPCS,00534,Anes insertion/rplcmt cvdfb,,,200.6,232.28,8
HCPCS,00537,Anes cardiac ep procedures,,,200.6,232.28,8
HCPCS,00539,Anes tracheobronchial rcnstj,,,200.6,232.28,8
HCPCS,0053A,Adm sarscv2 30mcg trs-sucr 3,,,17.08,19.78,8
HCPCS,0053U,ONC PRST8 CA FISH ALYS 4 GEN,,,2274.34,2274.34,1
HCPCS,0053U,Onc prst8 ca fish alys 4 gen,,,672.05,778.16,8
HCPCS,00540,Anes thoracotomy px nos,,,200.6,232.28,8
HCPCS,00541,Anes thrcm px 1 lung vntj,,,200.6,232.28,8
HCPCS,00542,Anes thrcm px decortication,,,200.6,232.28,8
HCPCS,00546,Anes thrcm px pulm rescj,,,200.6,232.28,8
HCPCS,00548,Anes thrcm px trach&bronchi,,,200.6,232.28,8
HCPCS,0054A,Adm sarscv2 30mcg trs-sucr b,,,17.08,19.78,8
HCPCS,0054T,Bone srgry cmptr fluor image,,,86.82,100.53,8
HCPCS,0054T,CPTR-ASST MUSCSKEL NAVIGJ ORTHO FLUOR IMAGES,118.0,76.7,0.01,486.52,86
HCPCS,0054U,RX MNTR 14+ DRUGS & SBSTS,,,166.89,408.15,23
HCPCS,0054U,Rx mntr 14+ drugs & sbsts,,,75.43,87.34,8
HCPCS,00550,Anes for sternal debridement,,,200.6,232.28,8
HCPCS,0055T,Bone srgry cmptr ct/mri imag,,,86.82,100.53,8
HCPCS,0055T,CPTR-ASST MUSCSKEL NAVIGJ ORTHO CT/MRI,730.0,474.5,0.01,730.0,86
HCPCS,0055U,CARD HRT TRNSPL 96 DNA SEQ,,,3240.0,8877.6,23
HCPCS,0055U,Card hrt trnspl 96 dna seq,,,672.05,778.16,8
HCPCS,00560,Anes px heart w/o pump oxtj,,,200.6,232.28,8
HCPCS,00561,Anes px heart w/pump<1 yr,,,200.6,232.28,8
HCPCS,00562,Anes px hrt w/pump age 1yr+,,,200.6,232.28,8
HCPCS,00563,Anes px heart w/pmp crc arst,,,200.6,232.28,8
HCPCS,00566,Anes direct cabg w/o pump,,,200.6,232.28,8
HCPCS,00567,Anes direct cabg w/pump,,,200.6,232.28,8
HCPCS,0056U,HEM AML DNA GENE REARGMT,,,2818.39,2818.39,1
HCPCS,0056U,Hem aml dna gene reargmt,,,672.05,778.16,8
HCPCS,00580,Anes heart/lung transplant,,,200.6,232.28,8
HCPCS,0058T,Cryopreservation ovary tiss,,,24.85,28.78,8
HCPCS,0058U,ONC MERKEL CLL CARC SRM QUAN,,,322.96,884.91,23
HCPCS,0058U,Onc merkel cll carc srm quan,,,116.49,134.88,8
HCPCS,0059U,ONC MERKEL CLL CARC SRM +/-,,,322.96,884.91,23
HCPCS,0059U,Onc merkel cll carc srm +/-,,,116.49,134.88,8
HCPCS,00600,Anes px crv spine&cord nos,,,200.6,232.28,8
HCPCS,00604,Anes px crv spn&cord sitting,,,200.6,232.28,8
HCPCS,0060U,TWN ZYG GEN SEQ ALYS CHRMS2,,,759.05,2079.8,23
HCPCS,0060U,Twn zyg gen seq alys chrms2,,,173.12,200.45,8
HCPCS,0061A,Fee covid-19 vac 7 dose 1,,,17.08,19.78,8
HCPCS,0061U,TC MEAS 5 BMRK SFDI M-S ALYS,,,25.1,68.77,23
HCPCS,0061U,Tc meas 5 bmrk sfdi m-s alys,,,9.22,10.68,8
HCPCS,00620,Anes px thrc spine&cord nos,,,200.6,232.28,8
HCPCS,00625,Anes thrc spine wo 1lng vent,,,200.6,232.28,8
HCPCS,00626,Anes thrc spine w/1 lng vent,,,200.6,232.28,8
HCPCS,0062A,Fee covid-19 vac 7 dose 2,,,17.08,19.78,8
HCPCS,0062U,AI SLE IGG&IGM ALYS 80 BMRK,,,380.72,1043.17,23
HCPCS,0062U,Ai sle igg&igm alys 80 bmrk,,,109.69,127.01,8
HCPCS,00630,Anes px lumbar region nos,,,200.6,232.28,8
HCPCS,00632,Anes px lumbar sympathectomy,,,200.6,232.28,8
HCPCS,00635,Anes dx/ther lumbar pnxr,,,200.6,232.28,8
HCPCS,0063A,Fee covid-19 vac 7 booster,,,17.08,19.78,8
HCPCS,0063U,NEURO AUTISM 32 AMINES ALG,,,750.0,2055.0,23
HCPCS,0063U,Neuro autism 32 amines alg,,,173.12,200.45,8
HCPCS,00640,Anes spine manipulation,,,200.6,232.28,8
HCPCS,0064A,Adm sarscov2 50mcg/0.25mlbst,,,17.08,19.78,8
HCPCS,0064U,ANTB TP TOTAL&RPR IA QUAL,,,31.33,85.84,23
HCPCS,0064U,Antb tp total&rpr ia qual,,,28.66,33.19,8
HCPCS,0065U,SYFLS TST NONTREPONEMAL ANTB,,,18.09,49.57,23
HCPCS,0065U,Syfls tst nontreponemal antb,,,23.08,26.72,8
HCPCS,0066U,PAMG-1 IA CERVICO-VAG FLUID,,,17.13,17.13,1
HCPCS,0066U,Pamg-1 ia cervico-vag fluid,,,18.15,21.01,8
HCPCS,00670,Anes xtnsv sp&spi cord px,,,200.6,232.28,8
HCPCS,0067U,ONC BRST IMHCHEM PRFL 4 BMRK,,,1897.0,5197.78,23
HCPCS,0067U,Onc brst imhchem prfl 4 bmrk,,,672.05,778.16,8
HCPCS,0068U,CANDIDA SPECIES PNL AMP PRB,,,142.63,390.81,23
HCPCS,0068U,Candida species pnl amp prb,,,49.14,56.9,8
HCPCS,0069U,ONC CLRCT MICRORNA MIR-31-3P,,,380.0,1041.2,23
HCPCS,0069U,Onc clrct microrna mir-31-3p,,,109.69,127.01,8
HCPCS,00700,Anes px upr ant abd wall nos,,,200.6,232.28,8
HCPCS,00702,Anes upr ant abd wall lvr bx,,,200.6,232.28,8
HCPCS,0070U,CYP2D6 GEN COM&SLCT RAR VRNT,,,676.37,1853.25,23
HCPCS,0070U,Cyp2d6 gen com&slct rar vrnt,,,173.12,200.45,8
HCPCS,0071A,Adm sarscv2 10mcg trs-sucr 1,,,17.08,19.78,8
HCPCS,0071T,US LEIOMYOMATA ABLATE <200,,,2712.29,8161.83,21
HCPCS,0071T,Us leiomyomata ablate <200,,,3181.01,3683.27,8
HCPCS,0071U,CYP2D6 FULL GENE SEQUENCE,,,600.0,1644.0,23
HCPCS,0071U,Cyp2d6 full gene sequence,,,109.69,127.01,8
HCPCS,0072A,Adm sarscv2 10mcg trs-sucr 2,,,17.08,19.78,8
HCPCS,0072T,FCSD US ABLTJ LEIOMYOM>=200,,,2712.29,8161.83,21
HCPCS,0072T,Fcsd us abltj leiomyom>=200,,,3181.01,3683.27,8
HCPCS,0072U,CYP2D6 GEN CYP2D6-2D7 HYBRID,,,450.91,1235.49,23
HCPCS,0072U,Cyp2d6 gen cyp2d6-2d7 hybrid,,,109.69,127.01,8
HCPCS,00730,Anes px upper pst abdl wall,,,200.6,232.28,8
HCPCS,00731,Anes upr gi ndsc px nos,,,200.6,232.28,8
HCPCS,00732,Anes upr gi ndsc px ercp,,,200.6,232.28,8
HCPCS,0073A,Adm sarscv2 10mcg trs-sucr 3,,,17.08,19.78,8
HCPCS,0073U,CYP2D6 GEN CYP2D7-2D6 HYBRID,,,450.91,1235.49,23
HCPCS,0073U,Cyp2d6 gen cyp2d7-2d6 hybrid,,,109.69,127.01,8
HCPCS,0074A,Adm sarscv2 10mcg trs-sucr b,,,17.08,19.78,8
HCPCS,0074U,CYP2D6 NONDUPLICATED GENE,,,450.91,1235.49,23
HCPCS,0074U,Cyp2d6 nonduplicated gene,,,109.69,127.01,8
HCPCS,00750,Anes hrna rpr upr abd nos,,,200.6,232.28,8
HCPCS,00752,Anes hrna rpr lmbr&vnt&/dehs,,,200.6,232.28,8
HCPCS,00754,Anes hrna rpr omphalocele,,,200.6,232.28,8
HCPCS,00756,Anes hrna rpr diphrg hrna,,,200.6,232.28,8
HCPCS,0075T,TCAT PLMT XTRC VRT CRTD STENT RS&I PRQ 1ST VSL,6555.5,4261.075,1.1,12615.0,152
HCPCS,0075U,CYP2D6 5' GENE DUP/MLT,,,450.91,1235.49,23
HCPCS,0075U,Cyp2d6 5' gene dup/mlt,,,109.69,127.01,8
HCPCS,0076T,TCAT PLMT XTRC VRT CRTD STENT RS&IPRQ EA VSL,4264.0,2771.6,1.1,12615.0,140
HCPCS,0076U,CYP2D6 3' GENE DUP/MLT,,,450.91,1235.49,23
HCPCS,0076U,Cyp2d6 3' gene dup/mlt,,,109.69,127.01,8
HCPCS,00770,Anes px maj abd blood vessel,,,200.6,232.28,8
HCPCS,0077U,IG PARAPROTEIN QUAL BLD/UR,,,43.43,119.0,23
HCPCS,0077U,Ig paraprotein qual bld/ur,,,28.66,33.19,8
HCPCS,0078U,PAIN MGT OPI USE GNOTYP PNL,,,505.18,1235.49,2
HCPCS,0078U,Pain mgt opi use gnotyp pnl,,,109.69,127.01,8
HCPCS,00790,Anes iper upr abd nos,,,200.6,232.28,8
HCPCS,00792,Anes iper upr abd prtl hptc,,,200.6,232.28,8
HCPCS,00794,Anes iper upr abd pncrtect,,,200.6,232.28,8
HCPCS,00796,Anes iper upr abd lvr trnspl,,,200.6,232.28,8
HCPCS,00797,Anes iper upr abd gstr px mo,,,200.6,232.28,8
HCPCS,0079U,CMPRTV DNA ALYS MLT SNPS,,,2739849.3,2739849.3,1
HCPCS,0079U,Cmprtv dna alys mlt snps,,,83.94,97.2,8
HCPCS,00800,Anes px lwr ant abdl wal nos,,,200.6,232.28,8
HCPCS,00802,Anes px lwr abdl wal pannic,,,200.6,232.28,8
HCPCS,0080U,ONC LNG 5 CLIN RSK FACTR ALG,,,3520.0,9644.8,23
HCPCS,0080U,Onc lng 5 clin rsk factr alg,,,672.05,778.16,8
HCPCS,00811,Anes lwr intst ndsc nos,,,200.6,232.28,8
HCPCS,00812,Anes lwr intst scr colsc,,,200.6,232.28,8
HCPCS,00813,Anes upr lwr gi ndsc px,,,200.6,232.28,8
HCPCS,0081A,Adm sarscv2 3mcg trs-sucr 1,,,17.08,19.78,8
HCPCS,00820,Anes px lwr post abdl wall,,,200.6,232.28,8
HCPCS,0082A,Adm sarscv2 3mcg trs-sucr 2,,,17.08,19.78,8
HCPCS,0082U,RX TEST DEF 90+ RX/SBSTS UR,,,246.92,676.56,23
HCPCS,0082U,Rx test def 90+ rx/sbsts ur,,,75.43,87.34,8
HCPCS,00830,Anes hernia rpr lwr abd nos,,,200.6,232.28,8
HCPCS,00832,Anes hernia repair vnt&incal,,,200.6,232.28,8
HCPCS,00834,Anes hernia repair<1 yr age,,,200.6,232.28,8
HCPCS,00836,Anes hrna rpr<37wk brth<50,,,200.6,232.28,8
HCPCS,0083A,Adm sarscv2 3mcg trs-sucr 3,,,17.08,19.78,8
HCPCS,0083U,ONC RSPSE CHEMO CNTRST TOMOG,,,167.35,458.54,23
HCPCS,0083U,Onc rspse chemo cntrst tomog,,,60.74,70.33,8
HCPCS,00840,Anes iper px lower abd nos,,,200.6,232.28,8
HCPCS,00842,Anes iper px amniocentesis,,,200.6,232.28,8
HCPCS,00844,Anes iper px abdmnprnl rescj,,,200.6,232.28,8
HCPCS,00846,Anes iper px rad hystrectomy,,,200.6,232.28,8
HCPCS,00848,Anes iper px pel exentration,,,200.6,232.28,8
HCPCS,0084A,Fee covid-19 vac 9 res,,,17.08,19.78,8
HCPCS,0084T,TEMP PROSTATE URETHRAL STENT,1308.0,850.2,1.1,1308.0,68
HCPCS,0084U,RBC DNA GNOTYP 10 BLD GROUPS,,,228.9,1972.8,25
HCPCS,0084U,Rbc dna gnotyp 10 bld groups,,,173.12,200.45,8
HCPCS,00851,Anes iper px tubal ligation,,,200.6,232.28,8
HCPCS,0085T,Breath test heart reject,,,11.75,13.61,8
HCPCS,0085U,Cdtb&vinculin igg antb ia,,,14.31,14.31,2
HCPCS,00860,Anes xtrprtl px lwr abd nos,,,200.6,232.28,8
HCPCS,00862,Anes xtrprtl lwr abd rnl px,,,200.6,232.28,8
HCPCS,00864,Anes xtrprt lwr abd tot cstc,,,200.6,232.28,8
HCPCS,00865,Anes xtrprt lwr abd prst8ect,,,200.6,232.28,8
HCPCS,00866,Anes xtrprt lw abd adrnlctmy,,,200.6,232.28,8
HCPCS,00868,Anes xtrprtl px rnl transpl,,,200.6,232.28,8
HCPCS,0086U,NFCT DS BACT&FNG ORG ID 6+,,,13.28,548.0,25
HCPCS,0086U,Nfct ds bact&fng org id 6+,,,49.14,56.9,8
HCPCS,00870,Anes xtrprtl cystolithotomy,,,200.6,232.28,8
HCPCS,00872,Anes lithotrp esw water bath,,,200.6,232.28,8
HCPCS,00873,Anes lithotrp esw wo wtr bth,,,200.6,232.28,8
HCPCS,0087U,CRD HRT TRNSPL MRNA 1283 GEN,,,1296.0,8656.81,25
HCPCS,0087U,Crd hrt trnspl mrna 1283 gen,,,672.05,778.16,8
HCPCS,00880,Anes maj lwr abd vessel nos,,,200.6,232.28,8
HCPCS,00882,Anes maj lwr adb vsl ivc lig,,,200.6,232.28,8
HCPCS,0088U,TRNSPLJ KDN ALGRFT REJ 1494,,,208.0,8656.81,25
HCPCS,0088U,Trnsplj kdn algrft rej 1494,,,672.05,778.16,8
HCPCS,0089U,ONC MLNMA PRAME & LINC00518,,,325.33,2082.4,25
HCPCS,0089U,Onc mlnma prame & linc00518,,,173.12,200.45,8
HCPCS,00902,Anes anorectal px,,,200.6,232.28,8
HCPCS,00904,Anes radical perineal px,,,200.6,232.28,8
HCPCS,00906,Anes vulvectomy,,,200.6,232.28,8
HCPCS,00908,Anes perineal prostatectomy,,,200.6,232.28,8
HCPCS,0090U,ONC CUTAN MLNMA MRNA 23 GENE,,,325.33,5343.0,25
HCPCS,0090U,Onc cutan mlnma mrna 23 gene,,,672.05,778.16,8
HCPCS,00910,Anes transurethral px nos,,,200.6,232.28,8
HCPCS,00912,Anes trurl px rescj bldr tum,,,200.6,232.28,8
HCPCS,00914,Anes trurl px rescj prst8,,,200.6,232.28,8
HCPCS,00916,Anes trurl px rescj bleeding,,,200.6,232.28,8
HCPCS,00918,Anes trurl px urtrl cal rmvl,,,200.6,232.28,8
HCPCS,0091A,Adm sarscov2 50 mcg/.5 ml1st,,,17.08,19.78,8
HCPCS,0091U,ONC CLRCT SCR WHL BLD ALG,,,203.55,2739849.3,3
HCPCS,0091U,Onc clrct scr whl bld alg,,,28.66,33.19,8
HCPCS,00920,Anes px male genitalia nos,,,200.6,232.28,8
HCPCS,00921,Anes px male genitalia vasec,,,200.6,232.28,8
HCPCS,00922,Anes px male gent sem ves,,,200.6,232.28,8
HCPCS,00924,Anes male gent undscnd tstis,,,200.6,232.28,8
HCPCS,00926,Anes male gent rad orch ing,,,200.6,232.28,8
HCPCS,00928,Anes male gent rad orch abd,,,200.6,232.28,8
HCPCS,0092A,Adm sarscov2 50 mcg/.5 ml2nd,,,17.08,19.78,8
HCPCS,0092T,ARTIFIC DISC ADDL,10986.0,7140.9,1.1,10986.0,68
HCPCS,0092U,ONC LNG 3 PRTN BMRK PLSM ALG,,,358.8,6817.12,25
HCPCS,0092U,Onc lng 3 prtn bmrk plsm alg,,,672.05,778.16,8
HCPCS,00930,Anes px male gent orchiopexy,,,200.6,232.28,8
HCPCS,00932,Anes male gent compl amp pns,,,200.6,232.28,8
HCPCS,00934,Anes rad amp penis ingun lym,,,200.6,232.28,8
HCPCS,00936,Anes rad amp pns ingun&ilac,,,200.6,232.28,8
HCPCS,00938,Anes insj penile prosthesis,,,200.6,232.28,8
HCPCS,0093A,Adm sarscov2 50 mcg/.5 ml3rd,,,17.08,19.78,8
HCPCS,0093U,RX MNTR 65 COM DRUGS URINE,,,45.77,170.26,25
HCPCS,0093U,Rx mntr 65 com drugs urine,,,34.82,40.32,8
HCPCS,00940,Anes vaginal px nos,,,200.6,232.28,8
HCPCS,00942,Anes vag px clptmy vgnc clpr,,,200.6,232.28,8
HCPCS,00944,Anes vag px vag hysterectomy,,,200.6,232.28,8
HCPCS,00948,Anes vag px crv cerclage,,,200.6,232.28,8
HCPCS,0094A,Adm sarscov2 50 mcg/.5 mlbst,,,17.08,19.78,8
HCPCS,0094U,GENOME RAPID SEQUENCE ALYS,,,846.27,20775.23,25
HCPCS,0094U,Genome rapid sequence alys,,,672.05,778.16,8
HCPCS,00950,Anes vag px culdoscopy,,,200.6,232.28,8
HCPCS,00952,Anes vag px hystsc&/hsg,,,200.6,232.28,8
HCPCS,0095T,RMVL ARTIFIC DISC ADDL CRVCL,,,2739849.3,2739849.3,1
HCPCS,0095T,Rmvl artific disc addl crvcl,,,14056.95,16276.47,8
HCPCS,0095U,EE 2 PRTN BMRK MBP ELISA EST,,,771.98,2115.23,23
HCPCS,0095U,Ee 2 prtn bmrk elisa est,,,173.12,200.45,8
HCPCS,0096U,HPV HI RISK TYPES MALE URINE,,,19.1,96.15,25
HCPCS,0096U,Hpv hi risk types male urine,,,33.62,38.93,8
HCPCS,0097U,Gi pathogen 22 targets,,,49.14,406.73,11
HCPCS,0098T,REV ARTIFIC DISC ADDL,,,2739849.3,2739849.3,1
HCPCS,0098T,REVJ TOT DISC ARTHRP ANT APPR CRV EA NTRSPC,11653.0,7574.45,1.1,3060831.65,86
HCPCS,0098T,Rev artific disc addl,,,14056.95,16276.47,8
HCPCS,0098U,Respir pathogen 14 targets,,,49.14,229.16,10
HCPCS,0099U,Respir pathogen 20 targets,,,49.14,229.16,10
HCPCS,0100T,PLMT SCJNCL RTA PROSTH&PLS&IMPLTJ INTRA-OC RTA,24892.0,16179.8,1.1,24892.0,90
HCPCS,0100T,PROSTH RETINA RECEIVE&GEN,,,7802.81,7802.81,1
HCPCS,0100T,Prosth retina receive&gen,,,2122.76,2457.93,8
HCPCS,0100U,Respir pathogen 21 targets,,,49.14,229.16,10
HCPCS,0101A,Fee covid-19 vac 11 dose 1,,,17.08,19.78,8
HCPCS,0101T,ESW MUSCSKEL SYS NOS,,,204.59,615.65,21
HCPCS,0101T,"EXTRACORP SHOCKWV TX,HI ENRG",180.0,117.0,1.1,1725.52,90
HCPCS,0101T,Esw muscskel sys nos,,,295.11,341.7,8
HCPCS,0101U,HERED COLON CA DO 15 GENES,,,288.84,4778.42,25
HCPCS,0101U,Hered colon ca do 15 genes,,,672.05,778.16,8
HCPCS,0102A,Fee covid-19 vac 11 dose 2,,,17.08,19.78,8
HCPCS,0102T,ESW PHY ANES LAT HMRL EPCNDL,,,2808.13,8450.24,21
HCPCS,0102T,Esw phy anes lat hmrl epcndl,,,3275.28,3792.43,8
HCPCS,0102U,HERED BRST CA RLTD DO 17 GEN,,,288.84,3572.82,25
HCPCS,0102U,Hered brst ca rltd do 17 gen,,,672.05,778.16,8
HCPCS,0103A,Fee covid-19 vac 11 booster,,,17.08,19.78,8
HCPCS,0103U,HERED OVA CA PNL 24 GENES,,,335.33,4778.42,25
HCPCS,0103U,Hered ova ca pnl 24 genes,,,672.05,778.16,8
HCPCS,0104A,Adm sarscov2 5mcg/.5ml as03b,,,17.08,19.78,8
HCPCS,0104U,Hered pan ca pnl 32 genes,,,335.33,335.33,2
HCPCS,0105U,NEPH CKD MULT ECLIA TUM NEC,,,336.26,2603.0,25
HCPCS,0105U,Neph ckd mult eclia tum nec,,,173.12,200.45,8
HCPCS,0106T,QUANT SENSORY TEST&INTERPJ/XTR W/TOUCH STIMULI,16.0,10.4,1.1,119.59,90
HCPCS,0106T,TOUCH QUANT SENSORY TEST,,,34.79,104.7,21
HCPCS,0106T,Touch quant sensory test,,,391.75,453.61,8
HCPCS,0106U,GSTR EMPTG 7 TIMED BRTH SPEC,,,13.63,2396.1,25
HCPCS,0106U,Gstr emptg 7 timed brth spec,,,173.12,200.45,8
HCPCS,0107T,VIBRATE QUANT SENSORY TEST,427.5,277.875,1.1,698.0,175
HCPCS,0107U,C DIFF TOX AG DETCJ IA STOOL,,,5.92,43.84,25
HCPCS,0107U,C diff tox ag detcj ia stool,,,16.64,19.27,8
HCPCS,0108T,COOL QUANT SENSORY TEST,,,53.07,159.69,21
HCPCS,0108T,Cool quant sensory test,,,391.75,453.61,8
HCPCS,0108U,GI BARRETT ESOPH 9 PRTN BMRK,,,336.26,13563.0,25
HCPCS,0108U,Gi barrett esoph 9 prtn bmrk,,,672.05,778.16,8
HCPCS,0109T,HEAT QUANT SENSORY TEST,,,34.79,104.7,21
HCPCS,0109T,Heat quant sensory test,,,391.75,453.61,8
HCPCS,0109U,ID ASPERGILLUS DNA 4 SPECIES,,,5.92,390.81,25
HCPCS,0109U,Id aspergillus dna 4 species,,,49.14,56.9,8
HCPCS,0110T,NOS QUANT SENSORY TEST,,,110.82,333.49,21
HCPCS,0110T,Nos quant sensory test,,,391.75,453.61,8
HCPCS,0110T,QUANT SENSORY TEST&INTERPJ/XTR OTHER STIMULI,16.0,10.4,1.1,373.44,90
HCPCS,0110U,RX MNTR 1+ORAL ONC RX&SBSTS,,,27.11,74.28,25
HCPCS,0110U,Rx mntr 1+oral onc rx&sbsts,,,30.12,34.88,8
HCPCS,01112,Anes bone marrow aspir&/bx,,,200.6,232.28,8
HCPCS,0111A,Adm sarscov2 25mcg/0.25ml1st,,,17.08,19.78,8
HCPCS,0111T,Rbc membranes fatty acids,,,27.68,32.05,8
HCPCS,0111U,ONC COLON CA KRAS&NRAS ALYS,,,77.3,1869.47,25
HCPCS,0111U,Onc colon ca kras&nras alys,,,173.12,200.45,8
HCPCS,01120,Anes px on bony pelvis,,,200.6,232.28,8
HCPCS,0112A,Adm sarscov2 25mcg/0.25ml2nd,,,17.08,19.78,8
HCPCS,0112U,IADI 16S&18S RRNA GENES,,,241.31,975.8,25
HCPCS,0112U,Iadi 16s&18s rrna genes,,,49.14,56.9,8
HCPCS,01130,Anes body cast appl/revj,,,200.6,232.28,8
HCPCS,0113A,Adm sarscov2 25mcg/0.25ml3rd,,,17.08,19.78,8
HCPCS,0113U,ONC PRST8 PCA3&TMPRSS2-ERG,,,304.0,2082.4,25
HCPCS,0113U,Onc prst8 pca3&tmprss2-erg,,,173.12,200.45,8
HCPCS,01140,Anes ntrplvabdmnl amputation,,,200.6,232.28,8
HCPCS,0114U,GI BARRETTS ESOPH VIM&CCNA1,,,33.47,5310.15,25
HCPCS,0114U,Gi barretts esoph vim&ccna1,,,672.05,778.16,8
HCPCS,01150,Anes rad px tumor of pelvis,,,200.6,232.28,8
HCPCS,0115U,RESPIR IADNA 18 VIRAL&2 BACT,,,63.35,754.46,25
HCPCS,0115U,Respir iadna 18 viral&2 bact,,,116.49,134.88,8
HCPCS,01160,Anes clsd px symph pub/si jt,,,200.6,232.28,8
HCPCS,0116U,RX MNTR NZM IA 35+ORAL FLU,,,45.77,676.56,25
HCPCS,0116U,Rx mntr nzm ia 35+oral flu,,,75.43,87.34,8
HCPCS,01170,Anes opn px symph pub/si jt,,,200.6,232.28,8
HCPCS,01173,Anes opn rpr fx disrpj plvs,,,200.6,232.28,8
HCPCS,0117U,PAIN MGMT 11 ENDOGENOUS ANAL,,,840.65,2303.38,25
HCPCS,0117U,Pain mgmt 11 endogenous anal,,,173.12,200.45,8
HCPCS,0118U,TRNSPLJ DON-DRV CLL-FR DNA,,,208.0,7543.91,25
HCPCS,0118U,Trnsplj don-drv cll-fr dna,,,672.05,778.16,8
HCPCS,0119U,CRD CERAMIDES LIQ CHROM PLSM,,,45.77,229.5,25
HCPCS,0119U,Crd ceramides liq chrom plsm,,,36.89,42.71,8
HCPCS,01200,Anes all closed px hip joint,,,200.6,232.28,8
HCPCS,01202,Anes arthroscopic px hip jt,,,200.6,232.28,8
HCPCS,0120U,ONC B CLL LYMPHM MRNA 58 GEN,,,1500.0,6877.98,25
HCPCS,0120U,Onc b cll lymphm mrna 58 gen,,,672.05,778.16,8
HCPCS,01210,Anes open px hip joint nos,,,200.6,232.28,8
HCPCS,01212,Anes open px hip jt disrtcj,,,200.6,232.28,8
HCPCS,01214,Anes open px tot hip arthrp,,,200.6,232.28,8
HCPCS,01215,Anes opn revj tot hip arthrp,,,200.6,232.28,8
HCPCS,0121A,Adm sarscv2 bvl 30mcg/.3ml 1,,,17.08,19.78,8
HCPCS,0121U,SC DIS VCAM-1 WHOLE BLOOD,,,69.92,1395.21,25
HCPCS,0121U,Sc dis vcam-1 whole blood,,,109.69,127.01,8
HCPCS,01220,Anes clsd px upper 2/3 femur,,,200.6,232.28,8
HCPCS,0122U,SC DIS P-SELECTIN WHL BLOOD,,,69.92,1441.87,25
HCPCS,0122U,Sc dis p-selectin whl blood,,,109.69,127.01,8
HCPCS,01230,Anes opn upper 2/3 femur nos,,,200.6,232.28,8
HCPCS,01232,Anes opn px upr 2/3 fem amp,,,200.6,232.28,8
HCPCS,01234,Anes opn upr 2/3 fem rad res,,,200.6,232.28,8
HCPCS,0123U,MCHNL FRAGILITY RBC PRFLG,,,4.25,979.91,25
HCPCS,0123U,Mchnl fragility rbc prflg,,,109.69,127.01,8
HCPCS,0124A,Adm sarscv2 bvl 30mcg/.3ml a,,,17.08,19.78,8
HCPCS,0124U,Ftl cgen abnor 3 analytes,,,22.22,22.22,2
HCPCS,01250,Anes all px nrv musc upr leg,,,200.6,232.28,8
HCPCS,0125U,Ftl cgen abnor prnt comp 5,,,27.81,27.81,2
HCPCS,01260,Anes all px veins upper leg,,,200.6,232.28,8
HCPCS,0126T,Chd risk imt study,,,97.71,113.14,8
HCPCS,0126U,Ftl cgen abnor prnt comp 5 y,,,27.81,27.81,2
HCPCS,01270,Anes px arteries upr leg nos,,,200.6,232.28,8
HCPCS,01272,Anes px art femoral art lig,,,200.6,232.28,8
HCPCS,01274,Anes px art fem art emblc,,,200.6,232.28,8
HCPCS,0127U,Ob pe 3 analytes,,,27.81,27.81,2
HCPCS,0128U,Ob pe 3 analytes y chrmsm,,,27.81,27.81,2
HCPCS,0129U,HERED BRST CA RLTD DO PANEL,,,335.33,3572.82,25
HCPCS,0129U,Hered brst ca rltd do panel,,,672.05,778.16,8
HCPCS,0130U,HERED COLON CA DO MRNA PNL,,,288.84,1602.63,25
HCPCS,0130U,Hered colon ca do mrna pnl,,,109.69,127.01,8
HCPCS,0131U,HERED BRST CA RLTD DO PNL 13,,,335.33,1945.4,12
HCPCS,0131U,Hered brst ca rltd do pnl 13,,,173.12,200.45,8
HCPCS,01320,Anes all px nrv msc kne&/pop,,,200.6,232.28,8
HCPCS,0132U,HERED OVA CA RLTD DO PNL 17,,,335.33,2032.09,12
HCPCS,0132U,Hered ova ca rltd do pnl 17,,,173.12,200.45,8
HCPCS,0133U,HERED PRST8 CA RLTD DO 11,,,335.33,1891.39,25
HCPCS,0133U,Hered prst8 ca rltd do 11,,,173.12,200.45,8
HCPCS,01340,Anes clsd px lower 1/3 femur,,,200.6,232.28,8
HCPCS,0134A,Adm sarscv2 bvl 50mcg/.5ml a,,,17.08,19.78,8
HCPCS,0134U,HERED PAN CA MRNA PNL 18 GEN,,,335.33,2050.59,25
HCPCS,0134U,Hered pan ca mrna pnl 18 gen,,,173.12,200.45,8
HCPCS,0135U,HERED GYN CA MRNA PNL 12 GEN,,,335.33,1919.53,12
HCPCS,0135U,Hered gyn ca mrna pnl 12 gen,,,173.12,200.45,8
HCPCS,01360,Anes open px lower 1/3 femur,,,200.6,232.28,8
HCPCS,0136U,ATM MRNA SEQ ALYS,,,98.11,1116.36,25
HCPCS,0136U,Atm mrna seq alys,,,109.69,127.01,8
HCPCS,0137U,PALB2 MRNA SEQ ALYS,,,282.88,775.09,25
HCPCS,0137U,Palb2 mrna seq alys,,,116.49,134.88,8
HCPCS,01380,Anes all clsd px knee joint,,,200.6,232.28,8
HCPCS,01382,Anes dx arthrs px knee jt,,,200.6,232.28,8
HCPCS,0138U,BRCA1 BRCA2 MRNA SEQ ALYS,,,187.2,1283.22,25
HCPCS,0138U,Brca1 brca2 mrna seq alys,,,109.69,127.01,8
HCPCS,01390,Anes cls px upr tib fib&/pat,,,200.6,232.28,8
HCPCS,01392,Anes opn px upr tib fib&/pat,,,200.6,232.28,8
HCPCS,0139U,NEURO AUSTM MEAS 6 C METABLT,,,336.26,840.27,3
HCPCS,0139U,Neuro austm meas 6 c metablt,,,83.94,97.2,8
HCPCS,01400,Anes opn/arthrs knee jt nos,,,200.6,232.28,8
HCPCS,01402,Anes opn/arth tot kne arthrp,,,200.6,232.28,8
HCPCS,01404,Anes opn/arthrs disrtcj knee,,,200.6,232.28,8
HCPCS,0140U,NFCT DS FUNGI DNA 15 TRGT,,,5.92,429.5,25
HCPCS,0140U,Nfct ds fungi dna 15 trgt,,,33.62,38.93,8
HCPCS,0141A,Adm srscv2 bvl 25mcg/.25ml 1,,,17.08,19.78,8
HCPCS,0141U,NFCT DS BACT&FNG GRAM POS,,,13.28,429.5,25
HCPCS,0141U,Nfct ds bact&fng gram pos,,,49.14,56.9,8
HCPCS,01420,Anes cst appl rmv/rpr kne jt,,,200.6,232.28,8
HCPCS,0142A,Adm srscv2 bvl 25mcg/.25ml 2,,,17.08,19.78,8
HCPCS,0142U,NFCT DS BACT&FNG GRAM NEG,,,13.28,429.5,25
HCPCS,0142U,Nfct ds bact&fng gram neg,,,49.14,56.9,8
HCPCS,01430,Anes px veins knee&pop nos,,,200.6,232.28,8
HCPCS,01432,Anes px vn knee&pop av fstl,,,200.6,232.28,8
HCPCS,0143U,DRUG ASSAY 120+ RX/METABLT,,,31.92,128.2,3
HCPCS,0143U,Drug assay 120+ rx/metablt,,,75.43,87.34,8
HCPCS,01440,Anes px art knee&pop nos,,,200.6,232.28,8
HCPCS,01442,Anes px art knee&pop teaec,,,200.6,232.28,8
HCPCS,01444,Anes px art knee&pop exc&grf,,,200.6,232.28,8
HCPCS,0144A,Adm srscv2 bvl 25mcg/.25ml a,,,17.08,19.78,8
HCPCS,0144U,DRUG ASSAY 160+ RX/METABLT,,,31.92,128.2,3
HCPCS,0144U,Drug assay 160+ rx/metablt,,,75.43,87.34,8
HCPCS,0145U,DRUG ASSAY 65+ RX/METABLT,,,31.92,128.2,3
HCPCS,0145U,Drug assay 65+ rx/metablt,,,34.82,40.32,8
HCPCS,01462,Anes clsd px lower l/a/f,,,200.6,232.28,8
HCPCS,01464,Anes arthrs px ankle&/foot,,,200.6,232.28,8
HCPCS,0146U,DRUG ASSAY 80+ RX/METABLT,,,31.92,128.2,3
HCPCS,0146U,Drug assay 80+ rx/metablt,,,34.82,40.32,8
HCPCS,01470,Anes px nrv msc lw l/a/f nos,,,200.6,232.28,8
HCPCS,01472,Anes rpr rpt achilles tendon,,,200.6,232.28,8
HCPCS,01474,Anes gastrocnemius recession,,,200.6,232.28,8
HCPCS,0147U,DRUG ASSAY 85+ RX/METABLT,,,31.92,128.2,3
HCPCS,0147U,Drug assay 85+ rx/metablt,,,34.82,40.32,8
HCPCS,01480,Anes open px lower l/a/f nos,,,200.6,232.28,8
HCPCS,01482,Anes opn lwr l/a/f rad rescj,,,200.6,232.28,8
HCPCS,01484,Anes opn lw l/a/f oste/ostpl,,,200.6,232.28,8
HCPCS,01486,Anes open total ankle rplcmt,,,200.6,232.28,8
HCPCS,0148U,DRUG ASSAY 100+ RX/METABLT,,,31.92,128.2,3
HCPCS,0148U,Drug assay 100+ rx/metablt,,,34.82,40.32,8
HCPCS,01490,Anes lwr leg cst app rmv/rpr,,,200.6,232.28,8
HCPCS,0149U,DRUG ASSAY 60+ RX/METABLT,,,31.92,128.2,3
HCPCS,0149U,Drug assay 60+ rx/metablt,,,34.82,40.32,8
HCPCS,01500,Anes px art lower leg nos,,,200.6,232.28,8
HCPCS,01502,Anes px art lower leg emblc,,,200.6,232.28,8
HCPCS,0150U,DRUG ASSAY 120+ RX/METABLT,,,31.92,128.2,3
HCPCS,0150U,Drug assay 120+ rx/metablt,,,34.82,40.32,8
HCPCS,0151A,Adm sarscv2 bvl 10mcg/.2ml 1,,,17.08,19.78,8
HCPCS,0151U,Nfct bct/vir resp nfctj 33,,,13.28,214.1,11
HCPCS,01520,Anes px veins lower leg nos,,,200.6,232.28,8
HCPCS,01522,Anes px vn lwr leg ven thrmb,,,200.6,232.28,8
HCPCS,0152U,MICROBIAL CELL-FREE DNA BY NGS,14671.0,9536.15,13.28,14671.0,84
HCPCS,0153U,ONC BREAST MRNA 101 GENES,,,1239.61,8656.81,25
HCPCS,0153U,Onc breast mrna 101 genes,,,109.69,127.01,8
HCPCS,0154A,Adm sarscv2 bvl 10mcg/.2ml a,,,17.08,19.78,8
HCPCS,0154U,ONC URTHL CA RNA FGFR3 GENE,,,109.93,1321.06,25
HCPCS,0154U,Onc urthl ca rna fgfr3 gene,,,109.69,127.01,8
HCPCS,0155U,ONC BRST CA DNA PIK3CA GENE,,,109.93,753.03,25
HCPCS,0155U,Onc brst ca dna pik3ca gene,,,116.49,134.88,8
HCPCS,0156U,COPY NUMBER SEQUENCE ALYS,,,846.27,4767.6,25
HCPCS,0156U,Copy number sequence alys,,,83.94,97.2,8
HCPCS,0157U,APC MRNA SEQ ALYS,,,282.88,775.09,25
HCPCS,0157U,Apc mrna seq alys,,,109.69,127.01,8
HCPCS,0158U,MLH1 MRNA SEQ ALYS,,,282.88,775.09,25
HCPCS,0158U,Mlh1 mrna seq alys,,,83.94,97.2,8
HCPCS,0159U,MSH2 MRNA SEQ ALYS,,,282.88,775.09,25
HCPCS,0159U,Msh2 mrna seq alys,,,83.94,97.2,8
HCPCS,0160U,MSH6 MRNA SEQ ALYS,,,282.88,775.09,25
HCPCS,0160U,Msh6 mrna seq alys,,,83.94,97.2,8
HCPCS,01610,Anes all px nrv musc sho&ax,,,200.6,232.28,8
HCPCS,0161U,PMS2 MRNA SEQ ALYS,,,282.88,775.09,25
HCPCS,0161U,Pms2 mrna seq alys,,,109.69,127.01,8
HCPCS,01620,Anes clsd px shoulder joint,,,200.6,232.28,8
HCPCS,01622,Anes dx arthr px shoulder jt,,,200.6,232.28,8
HCPCS,0162U,HERED COLON CA TRGT MRNA PNL,,,288.84,1333.12,25
HCPCS,0162U,Hered colon ca trgt mrna pnl,,,109.69,127.01,8
HCPCS,01630,Anes opn/arthr px sho jt nos,,,200.6,232.28,8
HCPCS,01634,Anes open/arthrs sho disrtcj,,,200.6,232.28,8
HCPCS,01636,Anes open/arthr ntrthrc amp,,,200.6,232.28,8
HCPCS,01638,Anes opn/arthr tot sho rplcm,,,200.6,232.28,8
HCPCS,0163T,Tot disc arthrp ea addl lmbr,,,14056.95,16276.47,8
HCPCS,0163U,ONC CLRCT SCR 3 PRTN ALG,,,203.55,1070.66,6
HCPCS,0163U,Onc clrct scr 3 prtn alg,,,83.94,97.2,8
HCPCS,0164A,Adm srscv2 bvl 10mcg/0.2ml a,,,17.08,19.78,8
HCPCS,0164T,REMOVE LUMB ARTIF DISC ADDL,,,2739849.3,2739849.3,1
HCPCS,0164T,RMVL TOT DISC ARTHRP ANT APPR LMBR EA NTRSPC,3885.0,2525.25,1.1,3060831.65,90
HCPCS,0164T,Remove lumb artif disc addl,,,14056.95,16276.47,8
HCPCS,0164U,GI IBS IA ANTI-CDTB&VINCULIN,,,6.91,306.93,25
HCPCS,0164U,Gi ibs ia anti-cdtb&vinculin,,,116.49,134.88,8
HCPCS,01650,Anes art sho&ax nos,,,200.6,232.28,8
HCPCS,01652,Anes art sho&ax ax-brch arsm,,,200.6,232.28,8
HCPCS,01654,Anes art sho&ax bypass grf,,,200.6,232.28,8
HCPCS,01656,Anes art sho&ax ax-fem bpg,,,200.6,232.28,8
HCPCS,0165T,REVISE LUMB ARTIF DISC ADDL,,,2739849.3,2739849.3,1
HCPCS,0165T,REVJ TOT DISC ARTHRP ANT APPR LMBR EA NTRSPC,4619.0,3002.35,1.1,3060831.65,90
HCPCS,0165T,Revise lumb artif disc addl,,,14056.95,16276.47,8
HCPCS,0165U,PEANUT ALLG ASMT EPI PRB ALL,,,2.58,1270.7,25
HCPCS,0165U,Peanut allg asmt epi,,,28.66,33.19,8
HCPCS,0166U,LIVER DS 10 BIOCHEM ASY SRM,,,28.88,1379.32,25
HCPCS,0166U,Liver ds 10 biochem asy srm,,,109.69,127.01,8
HCPCS,01670,Anes all px vn shoulder&ax,,,200.6,232.28,8
HCPCS,0167U,CHORNC GONADOTROPIN HCG IA,,,7.44,20.6,4
HCPCS,0167U,Chornc gonadotropin hcg ia,,,22.0,25.48,8
HCPCS,01680,Anes sho cast appl rmvl/rpr,,,200.6,232.28,8
HCPCS,0168U,FTL ANEUPLOIDY DNA SEQ ALYS,,,500.0,850.41,3
HCPCS,0168U,Ftl aneuploidy dna seq alys,,,173.12,200.45,8
HCPCS,0169U,NUDT15&TPMT GENE COM VRNT,,,279.68,1277.31,25
HCPCS,0169U,Nudt15&tpmt gene com vrnt,,,109.69,127.01,8
HCPCS,0170U,NEURO ASD RNA NEXT GEN SEQ,,,336.26,5343.0,25
HCPCS,0170U,Neuro asd rna next gen seq,,,672.05,778.16,8
HCPCS,01710,Anes px nrv musc upr a&e nos,,,200.6,232.28,8
HCPCS,01712,Anes px nrv msc upr a&e tnot,,,200.6,232.28,8
HCPCS,01714,Anes nrv msc upr a&e tnplsty,,,200.6,232.28,8
HCPCS,01716,Anes nrv msc upr a&e tndsis,,,200.6,232.28,8
HCPCS,0171A,Adm sarscv2 bvl 3mcg/0.2ml 1,,,17.08,19.78,8
HCPCS,0171U,TRGT GEN SEQ ALYS PNL DNA 23,,,239.16,4162.22,25
HCPCS,0171U,Trgt gen seq alys pnl dna 23,,,109.69,127.01,8
HCPCS,0172A,Adm sarscv2 bvl 3mcg/0.2ml 2,,,17.08,19.78,8
HCPCS,0172U,ONC SLD TUM ALYS BRCA1 BRCA2,,,1500.0,8302.2,25
HCPCS,0172U,Onc sld tum alys brca1 brca2,,,672.05,778.16,8
HCPCS,01730,Anes clsd px humerus&elbow,,,200.6,232.28,8
HCPCS,01732,Anes dx arthrs px elbow jt,,,200.6,232.28,8
HCPCS,0173A,Adm sarscv2 bvl 3mcg/0.2ml 3,,,17.08,19.78,8
HCPCS,0173U,PSYC GEN ALYS PANEL 14 GENES,,,423.14,1277.31,25
HCPCS,0173U,Psyc gen alys panel 14 genes,,,83.94,97.2,8
HCPCS,01740,Anes opn/arthrs px elbw nos,,,200.6,232.28,8
HCPCS,01742,Anes opn/arthrs elbw osteot,,,200.6,232.28,8
HCPCS,01744,Anes opn/arthrs elbw rpr hum,,,200.6,232.28,8
HCPCS,0174A,Adm sarscv2 bvl 3mcg/0.2ml a,,,17.08,19.78,8
HCPCS,0174T,Cad cxr with interp,,,86.82,100.53,8
HCPCS,0174U,ONC SOLID TUMOR 30 PRTN TRGT,,,1148.4,3576.71,25
HCPCS,0174U,Onc solid tumor 30 prtn trgt,,,83.94,97.2,8
HCPCS,01756,Anes opn/arthrs elbw rad px,,,200.6,232.28,8
HCPCS,01758,Anes opn/arthrs elbw exc cst,,,200.6,232.28,8
HCPCS,0175T,Cad cxr remote,,,86.82,100.53,8
HCPCS,0175U,PSYC GEN ALYS PANEL 15 GENES,,,423.14,3660.89,25
HCPCS,0175U,Psyc gen alys panel 15 genes,,,672.05,778.16,8
HCPCS,01760,Anes opn/arthr elb tot rplct,,,200.6,232.28,8
HCPCS,0176U,CDTB&VINCULIN IGG ANTB IA,,,6.91,175.88,25
HCPCS,0176U,Cdtb&vinculin igg antb ia,,,28.66,33.19,8
HCPCS,01770,Anes px art upr arm&elbw nos,,,200.6,232.28,8
HCPCS,01772,Anes art upr arm&elbw emblc,,,200.6,232.28,8
HCPCS,0177U,ONC BRST CA DNA PIK3CA 11,,,109.93,753.03,25
HCPCS,0177U,Onc brst ca dna pik3ca 11,,,116.49,134.88,8
HCPCS,01780,Anes px vn upr arm&elbw nos,,,200.6,232.28,8
HCPCS,01782,Anes vn upr arm&elbw phlbrpy,,,200.6,232.28,8
HCPCS,0178U,PEANUT ALLG ASMT EPI CLIN RX,,,2.58,1260.02,25
HCPCS,0178U,Peanut allg asmt epi clin rx,,,23.08,26.72,8
HCPCS,0179U,ONC NONSM CLL LNG CA ALYS 23,,,1148.4,5324.4,25
HCPCS,0179U,Onc nonsm cll lng ca alys 23,,,83.94,97.2,8
HCPCS,0180U,ABO GNOTYP ABO 7 EXONS,,,228.9,753.03,25
HCPCS,0180U,Abo gnotyp abo 7 exons,,,83.94,97.2,8
HCPCS,01810,Anes px nrv musc f/arm wrst,,,200.6,232.28,8
HCPCS,0181U,CO GNOTYP AQP1 EXON 1,,,185.2,507.45,25
HCPCS,0181U,Co gnotyp aqp1 exon 1,,,116.49,134.88,8
HCPCS,01820,Anes clsd px rds u/w/h bones,,,200.6,232.28,8
HCPCS,01829,Anes dx arthroscopic px wrst,,,200.6,232.28,8
HCPCS,0182U,CROM GNOTYP CD55 EXONS 1-10,,,228.9,825.7,25
HCPCS,0182U,Crom gnotyp cd55 exons 1-10,,,116.49,134.88,8
HCPCS,01830,Anes arthr/ndsc wrst/hnd nos,,,200.6,232.28,8
HCPCS,01832,Anes arthr/ndsc tot wrst rpl,,,200.6,232.28,8
HCPCS,0183U,DI GNOTYP SLC4A1 EXON 19,,,185.2,507.45,25
HCPCS,0183U,Di gnotyp slc4a1 exon 19,,,116.49,134.88,8
HCPCS,01840,Anes art f/arm wrst&hnd nos,,,200.6,232.28,8
HCPCS,01842,Anes art farm wrst&hnd emblc,,,200.6,232.28,8
HCPCS,01844,Anes vasc shunt/shunt revj,,,200.6,232.28,8
HCPCS,0184T,EXC RECTAL TUMOR ENDOSCOPIC,,,4944.41,14878.72,21
HCPCS,0184T,Exc rectal tumor endoscopic,,,1836.64,2126.64,8
HCPCS,0184T,RECTAL TUMOR EXCISION TRANSANAL ENDOSCOPIC,7239.0,4705.35,1.1,16621.23,90
HCPCS,0184U,DO GNOTYP ART4 EXON 2,,,185.2,507.45,25
HCPCS,0184U,Do gnotyp art4 exon 2,,,116.49,134.88,8
HCPCS,01850,Anes vein f/arm wrst&hnd nos,,,200.6,232.28,8
HCPCS,01852,Anes px vn f/arm phlbrrhaphy,,,200.6,232.28,8
HCPCS,0185U,FUT1 GNOTYP FUT1 EXON 4,,,185.2,507.45,25
HCPCS,0185U,Fut1 gnotyp fut1 exon 4,,,116.49,134.88,8
HCPCS,01860,Anes forearm wrist/hand cast,,,200.6,232.28,8
HCPCS,0186U,FUT2 GNOTYP FUT2 EXON 2,,,185.2,507.45,25
HCPCS,0186U,Fut2 gnotyp fut2 exon 2,,,116.49,134.88,8
HCPCS,0187U,FY GNOTYP ACKR1 EXONS 1-2,,,228.9,753.03,25
HCPCS,0187U,Fy gnotyp ackr1 exons 1-2,,,116.49,134.88,8
HCPCS,0188U,GE GNOTYP GYPC EXONS 1-4,,,228.9,753.03,25
HCPCS,0188U,Ge gnotyp gypc exons 1-4,,,116.49,134.88,8
HCPCS,0189U,GYPA GNOTYP NTRNS 1 5 EXON 2,,,228.9,753.03,25
HCPCS,0189U,Gypa gnotyp ntrns 1 5 exon 2,,,116.49,134.88,8
HCPCS,0190U,GYPB GNOTYP NTRNS 1 5 SEUX 3,,,228.9,753.03,25
HCPCS,0190U,Gypb gnotyp ntrns 1 5 seux 3,,,116.49,134.88,8
HCPCS,01916,Anes dx arteriography/vngrph,,,200.6,232.28,8
HCPCS,0191T,Insert ant segment drain int,,,2420.84,2803.08,8
HCPCS,0191U,IN GNOTYP CD44 EXONS 2 3 6,,,228.9,753.03,25
HCPCS,0191U,In gnotyp cd44 exons 2 3 6,,,116.49,134.88,8
HCPCS,01920,Anes cardiac catheterization,,,200.6,232.28,8
HCPCS,01922,Anes n-invas img/radj ther,,,200.6,232.28,8
HCPCS,01924,Anes ther ivntl rad artl nos,,,200.6,232.28,8
HCPCS,01925,Anes ivntl rad artl crtd/c,,,200.6,232.28,8
HCPCS,01926,Anes ivntl rad icr icar/aort,,,200.6,232.28,8
HCPCS,0192U,JK GNOTYP SLC14A1 EXON 9,,,228.9,753.03,25
HCPCS,0192U,Jk gnotyp slc14a1 exon 9,,,116.49,134.88,8
HCPCS,01930,Anes ther ivntl rad ven nos,,,200.6,232.28,8
HCPCS,01931,Anes ivnt rad ntrhpt/prt crc,,,200.6,232.28,8
HCPCS,01932,Anes th ivnt rad ntrthrc/jug,,,200.6,232.28,8
HCPCS,01933,Anes ther ivntl rad px icr,,,200.6,232.28,8
HCPCS,01935,Anesth perc img dx sp proc,,,200.6,232.28,8
HCPCS,01936,Anesth perc img tx sp proc,,,200.6,232.28,8
HCPCS,01937,Anes drg/aspir crv/thrc,,,200.6,232.28,8
HCPCS,01938,Anes drg/aspir lmbr/sac,,,200.6,232.28,8
HCPCS,01939,Anes nulyt agt crv/thrc,,,200.6,232.28,8
HCPCS,0193U,JR GNOTYP ABCG2 EXONS 2-26,,,228.9,775.09,25
HCPCS,0193U,Jr gnotyp abcg2 exons 2-26,,,116.49,134.88,8
HCPCS,01940,Anes nulyt agt lmbr/sac,,,200.6,232.28,8
HCPCS,01941,Anes neuromd/ntrvrt crv/thrc,,,200.6,232.28,8
HCPCS,01942,Anes neuromd/ntrvrt lmbr/sac,,,200.6,232.28,8
HCPCS,0194U,KEL GNOTYP KEL EXON 8,,,185.2,507.45,25
HCPCS,0194U,Kel gnotyp kel exon 8,,,116.49,134.88,8
HCPCS,01951,Anes 2&3 burn less 4 % tbsa,,,200.6,232.28,8
HCPCS,01952,Anes 2&3 burn 4-9% tbsa,,,200.6,232.28,8
HCPCS,01953,Anes 2&3 burn ea add 9% tbsa,,,200.6,232.28,8
HCPCS,01958,Anes xtrnl cephalic version,,,200.6,232.28,8
HCPCS,0195U,KLF1 TARGETED SEQUENCING,,,131.8,1028.19,25
HCPCS,0195U,Klf1 targeted sequencing,,,109.69,127.01,8
HCPCS,01960,Anes vaginal delivery only,,,200.6,232.28,8
HCPCS,01961,Anes cesarean delivery only,,,200.6,232.28,8
HCPCS,01962,Anes urgent hysterectomy,,,200.6,232.28,8
HCPCS,01963,Anes cesarean hysterectomy,,,200.6,232.28,8
HCPCS,01965,Anes incompl/missed ab px,,,200.6,232.28,8
HCPCS,01966,Anes induced abortion px,,,200.6,232.28,8
HCPCS,01967,Neuraxl lbr anes vag dlvr,,,200.6,232.28,8
HCPCS,01968,Anes/analg cs dlvr neuraxial,,,200.6,232.28,8
HCPCS,01969,Anes c hyst flwg neuraxial,,,200.6,232.28,8
HCPCS,0196U,LU GNOTYP BCAM EXON 3,,,185.2,507.45,25
HCPCS,0196U,Lu gnotyp bcam exon 3,,,116.49,134.88,8
HCPCS,0197U,LW GNOTYP ICAM4 EXON 1,,,185.2,507.45,25
HCPCS,0197U,Lw gnotyp icam4 exon 1,,,116.49,134.88,8
HCPCS,0198T,OCULAR BLOOD FLOW MEASURE,,,110.82,333.49,21
HCPCS,0198T,Ocular blood flow measure,,,48.64,56.32,8
HCPCS,0198U,RHD&RHCE GNTYP RHD1-10&RHCE5,,,228.9,775.09,25
HCPCS,0198U,Rhd&rhce gntyp rhd1-10&rhce5,,,116.49,134.88,8
HCPCS,01990,Physiol support hrvg organs,,,200.6,232.28,8
HCPCS,01991,Anes dx/ther nrv blk&inj oth,,,200.6,232.28,8
HCPCS,01992,Anes dx/ther nrv blk&inj prn,,,200.6,232.28,8
HCPCS,01996,DAILY ROUNDS; EPIDURAL,193.0,125.45,1.1,497.55,94
HCPCS,01996,Dly hosp mgmt edrl rx admin,,,200.6,232.28,8
HCPCS,01999,Unlisted anes procedure,,,200.6,232.28,8
HCPCS,0199U,SC GNOTYP ERMAP EXONS 4 12,,,228.9,753.03,25
HCPCS,0199U,Sc gnotyp ermap exons 4 12,,,116.49,134.88,8
HCPCS,0200T,PERQ SAC AGMNTJ UNI W/WO BALO/MCHNL DEV 1/> NDL,12707.5,8259.875,1.1,20863.78,170
HCPCS,0200U,XK GNOTYP XK EXONS 1-3,,,228.9,753.03,25
HCPCS,0200U,Xk gnotyp xk exons 1-3,,,116.49,134.88,8
HCPCS,0201T,PERQ SAC AGMNTJ BI W/WO BALO/MCHNL DEV 2/> NDLS,20703.0,13456.95,1.1,28575.0,170
HCPCS,0201U,YT GNOTYP ACHE EXON 2,,,185.2,507.45,25
HCPCS,0201U,Yt gnotyp ache exon 2,,,116.49,134.88,8
HCPCS,0202T,POST VERT ARTHRPLST 1 LU,14574.0,9473.1,1.1,3060831.65,86
HCPCS,0202T,POST VERT ARTHRPLST 1 LUMBAR,,,12146.38,2739849.3,13
HCPCS,0202T,Post vert arthrplst 1 lumbar,,,3812.17,4414.09,8
HCPCS,0202U,"FILM ARRAY, RESPIRATORY 22 TARGETS",2876.0,1869.4,109.69,2876.0,84
HCPCS,0203U,AI IBD MRNA XPRSN PRFL 17,,,336.26,2082.4,25
HCPCS,0203U,Ai ibd mrna xprsn prfl 17,,,173.12,200.45,8
HCPCS,0204U,ONC THYR MRNA XPRSN ALYS 593,,,1440.0,7999.7,4
HCPCS,0204U,Onc thyr mrna xprsn alys 593,,,672.05,778.16,8
HCPCS,0205U,OPH AMD ALYS 3 GENE VARIANTS,,,47.0,128.78,25
HCPCS,0205U,Oph amd alys 3 gene variants,,,83.94,97.2,8
HCPCS,0206U,NEURO ALZHEIMER CELL AGGREGJ,,,336.26,6070.2,25
HCPCS,0206U,Neuro alzheimer cell aggregj,,,83.94,97.2,8
HCPCS,0207T,EVAC MEIBOMIAN GLANDS W/HEAT& INTMT PRESSURE,643.0,417.95,1.1,643.0,86
HCPCS,0207T,EVAC MEIBOMIAN GLNDS AUTO HT& INTMT PRESS UNI,516.0,335.4,0.01,3443.0,85
HCPCS,0207U,NEURO ALZHEIMER QUAN IMAGING,,,168.13,1150.2,5
HCPCS,0207U,Neuro alzheimer quan imaging,,,116.49,134.88,8
HCPCS,0208T,AUDIOMETRY AIR ONLY,,,34.79,104.7,21
HCPCS,0208T,Audiometry air only,,,40.0,46.32,8
HCPCS,0208U,ONC MTC MRNA XPRSN ALYS 108,,,1440.0,1440.0,2
HCPCS,0208U,Onc mtc mrna xprsn alys 108,,,109.69,127.01,8
HCPCS,0209T,AUDIOMETRY AIR & BONE,,,34.79,104.7,21
HCPCS,0209T,Audiometry air & bone,,,40.0,46.32,8
HCPCS,0209U,CYTOG CONST ALYS INTERROG,,,540.0,2156.79,25
HCPCS,0209U,Cytog const alys interrog,,,83.94,97.2,8
HCPCS,0210T,SPEECH AUDIOMETRY THRESHOLD,,,34.79,104.7,21
HCPCS,0210T,Speech audiometry threshold,,,40.0,46.32,8
HCPCS,0210U,SYPHILIS TST ANTB IA QUAN,,,2.11,51.05,25
HCPCS,0210U,Syphilis tst antb ia quan,,,23.08,26.72,8
HCPCS,0211T,SPEECH AUDIOM THRESH & RECOG,,,34.79,104.7,21
HCPCS,0211T,Speech audiom thresh & recog,,,40.0,46.32,8
HCPCS,0211U,ONC PAN-TUMOR DNA&RNA NEXT-GENERATION SEQUENCING-CARIS,58339.0,37920.35,208.0,58339.0,77
HCPCS,0212T,COMPRE AUDIOMETRY EVALUATION,,,121.73,407.79,21
HCPCS,0212T,Compre audiometry evaluation,,,40.0,46.32,8
HCPCS,0212U,RARE DS GEN DNA ALYS PROBAND,,,66.2,15002.05,25
HCPCS,0212U,Rare ds gen dna alys proband,,,83.94,97.2,8
HCPCS,0213T,INJECT PARAVERT FACET JT/NERVE CERV/THORAC 1LVL,593.0,385.45,1.1,2656.95,86
HCPCS,0213T,NJX PARAVERT W/US CER/THOR,,,790.76,2379.55,21
HCPCS,0213T,Njx paravert w/us cer/thor,,,565.54,654.83,8
HCPCS,0213U,RARE DS GEN DNA ALYS EA COMP,,,33.2,7425.26,25
HCPCS,0213U,Rare ds gen dna alys ea comp,,,83.94,97.2,8
HCPCS,0214T,Njx paravert w/us cer/thor,,,565.54,654.83,8
HCPCS,0214U,RARE DS XOM DNA ALYS PROBAND,,,1912.0,14315.4,25
HCPCS,0214U,Rare ds xom dna alys proband,,,672.05,778.16,8
HCPCS,0215T,Njx paravert w/us cer/thor,,,565.54,654.83,8
HCPCS,0215U,RARE DS XOM DNA ALYS EA COMP,,,2574.65,7054.54,25
HCPCS,0215U,Rare ds xom dna alys ea comp,,,672.05,778.16,8
HCPCS,0216T,INJECTION PARAVERT FACET JT/NERVE LMBR/SAC 1LVL,806.0,523.9,1.1,2656.95,86
HCPCS,0216T,NJX PARAVERT W/US LUMB/SAC,,,790.76,2379.55,21
HCPCS,0216T,Njx paravert w/us lumb/sac,,,565.54,654.83,8
HCPCS,0216U,NEURO INH ATAXIA DNA 12 COM,,,514.8,4211.43,25
HCPCS,0216U,Neuro inh ataxia dna 12 com,,,83.94,97.2,8
HCPCS,0217T,INJECTION PARAVERT FACET JT/NERVE LMBR/SAC LVL2,564.0,366.6,1.1,564.58,86
HCPCS,0217T,Njx paravert w/us lumb/sac,,,565.54,654.83,8
HCPCS,0217U,NEURO INH ATAXIA DNA 51 GENE,,,514.8,6023.48,25
HCPCS,0217U,Neuro inh ataxia dna 51 gene,,,83.94,97.2,8
HCPCS,0218T,INJECTION PARAVER FACET JT/NERVE LMBR/SAC 3+LVL,536.0,348.4,1.1,564.58,86
HCPCS,0218T,Njx paravert w/us lumb/sac,,,565.54,654.83,8
HCPCS,0218U,NEURO MUSC DYS DMD SEQ ALYS,,,800.0,6244.46,25
HCPCS,0218U,Neuro musc dys dmd seq alys,,,672.05,778.16,8
HCPCS,0219T,PLMT POST FACET IMPLT CERV,,,12146.38,2739849.3,13
HCPCS,0219T,Plmt post facet implt cerv,,,14056.95,16276.47,8
HCPCS,0219U,NFCT AGT HIV GNRJ SEQ ALYS,,,255.08,1986.5,25
HCPCS,0219U,Nfct agt hiv gnrj seq alys,,,28.66,33.19,8
HCPCS,0220T,PLMT POST FACET IMPLT THOR,,,12146.38,2739849.3,13
HCPCS,0220T,Plmt post facet implt thor,,,9326.79,10799.44,8
HCPCS,0220U,ONC BRST CA AI ASSMT 12 FEAT,,,60.59,1935.13,25
HCPCS,0220U,Onc brst ca ai assmt 12 feat,,,45.47,52.65,8
HCPCS,0221T,PLMT POST FACET IMPLT LUMB,,,6206.54,18676.74,21
HCPCS,0221T,Plmt post facet implt lumb,,,3812.17,4414.09,8
HCPCS,0221U,ABO GNOTYP NEXT GNRJ SEQ ABO,,,228.9,753.03,25
HCPCS,0221U,Abo gnotyp next gnrj seq abo,,,83.94,97.2,8
HCPCS,0222T,Plmt post facet implt addl,,,3812.17,4414.09,8
HCPCS,0222U,RHD&RHCE GNTYP NEXT GNRJ SEQ,,,228.9,775.09,25
HCPCS,0222U,Rhd&rhce gntyp next gnrj seq,,,83.94,97.2,8
HCPCS,0223U,NFCT DS 22 TRGT SARS-COV-2,,,166.71,1141.98,25
HCPCS,0223U,Nfct ds 22 trgt sars-cov-2,,,49.14,56.9,8
HCPCS,0224U,ANTIBODY SARS-COV-2 TITER(S),,,20.57,140.92,26
HCPCS,0224U,Antibody sars-cov-2 titer(s),,,33.62,38.93,8
HCPCS,0225U,NFCT DS DNA&RNA 21 SARSCOV2,,,166.71,1141.98,25
HCPCS,0225U,Nfct ds dna&rna 21 sarscov2,,,49.14,56.9,8
HCPCS,0226U,SVNT SARSCOV2 ELISA PLSM SRM,,,16.91,115.85,26
HCPCS,0226U,Svnt sarscov2 elisa plsm srm,,,28.66,33.19,8
HCPCS,0227U,RX ASY PRSMV 30+RX/METABLT,,,31.92,170.26,25
HCPCS,0227U,Rx asy prsmv 30+rx/metablt,,,34.82,40.32,8
HCPCS,0228T,Njx tfrml eprl w/us cer/thor,,,565.54,654.83,8
HCPCS,0228U,ONC PRST8 MA MOLEC PRFL ALG,,,173.03,474.1,24
HCPCS,0228U,Onc prst8 ma molec prfl alg,,,109.69,127.01,8
HCPCS,0229T,Njx tfrml eprl w/us cer/thor,,,565.54,654.83,8
HCPCS,0229U,BCAT1&IKZF1 PRMTR MTHLN ALYS,,,33.47,1052.16,25
HCPCS,0229U,Bcat1&ikzf1 prmtr mthyln aly,,,109.69,127.01,8
HCPCS,0230T,Njx tfrml eprl w/us lumb/sac,,,565.54,654.83,8
HCPCS,0230U,AR FULL SEQUENCE ANALYSIS,,,120.54,825.7,25
HCPCS,0230U,Ar full sequence analysis,,,116.49,134.88,8
HCPCS,0231T,Njx tfrml eprl w/us lumb/sac,,,565.54,654.83,8
HCPCS,0231U,CACNA1A FULL GENE ANALYSIS,,,338.51,2318.78,25
HCPCS,0231U,Cacna1a full gene analysis,,,173.12,200.45,8
HCPCS,0232T,INJECTION PLATLET RICH PLASMA,750.0,487.5,1.1,1163.18,86
HCPCS,0232T,NJX PLTLT PLASMA W/IMG HARVEST/PREPARATION,1173.0,762.45,0.01,3443.0,171
HCPCS,0232T,PRP WITH EXOMES,1250.0,812.5,1.1,1250.0,86
HCPCS,0232U,CSTB FULL GENE ANALYSIS,,,109.93,753.03,25
HCPCS,0232U,Cstb full gene analysis,,,116.49,134.88,8
HCPCS,0233U,FXN GENE ANALYSIS,,,109.93,753.03,25
HCPCS,0233U,Fxn gene analysis,,,116.49,134.88,8
HCPCS,0234T,TRLUML PERIP ATHRC RENAL ART,,,9544.11,28720.16,21
HCPCS,0234T,Trluml perip athrc renal art,,,10445.39,12094.67,8
HCPCS,0234U,MECP2 FULL GENE ANALYSIS,,,211.15,1446.36,25
HCPCS,0234U,Mecp2 full gene analysis,,,109.69,127.01,8
HCPCS,0235T,TRLUML PERIP ATHRC VISCERAL,,,2739849.3,2739849.3,1
HCPCS,0235T,Trluml perip athrc visceral,,,4672.17,5409.88,8
HCPCS,0235U,PTEN FULL GENE ANALYSIS,,,240.0,1644.0,25
HCPCS,0235U,Pten full gene analysis,,,109.69,127.01,8
HCPCS,0236T,TRLUML PERIPH ATHRC W/RS&I ABDOM AORTA,24908.5,16190.525,1.1,45362.0,170
HCPCS,0236U,SMN1&SMN2 FULL GENE ANALYSIS,,,120.54,1651.4,25
HCPCS,0236U,Smn1&smn2 full gene analysis,,,173.12,200.45,8
HCPCS,0237T,TRLUML PERIPH ATHRC W/RS&I BRCHIOCPHL EA VSL,13073.5,8497.775,1.1,32085.4,170
HCPCS,0237U,CAR ION CHNLPTHY GEN SEQ PNL,,,288.84,1602.63,25
HCPCS,0237U,Car ion chnlpthy gen seq pnl,,,109.69,127.01,8
HCPCS,0238T,TRLUML PERIPHERAL ATHERECTOMY ILIAC ARTERY EA,21341.5,13871.974999999999,1.1,51140.13,170
HCPCS,0238U,ONC LNCH SYN GEN DNA SEQ ALY,,,288.84,1602.63,25
HCPCS,0238U,Onc lnch syn gen dna seq aly,,,109.69,127.01,8
HCPCS,0239U,TRGT GEN SEQ ALYS PNL 311+,,,239.16,9590.0,25
HCPCS,0239U,Trgt gen seq alys pnl 311+,,,672.05,778.16,8
HCPCS,0240U,NFCT DS VIR RESP RNA 3 TRGT,,,57.05,390.81,13
HCPCS,0240U,Nfct ds vir resp rna 3 trgt,,,33.62,38.93,8
HCPCS,0241U,NFCT DS VIR RESP RNA 4 TRGT,,,57.05,390.81,13
HCPCS,0241U,Nfct ds vir resp rna 4 trgt,,,33.62,38.93,8
HCPCS,0242U,TRGT GEN SEQ ALYS PNL 55-74,,,5000.0,13700.0,23
HCPCS,0242U,Trgt gen seq alys pnl 55-74,,,672.05,778.16,8
HCPCS,0243U,OB PE BIOCHEM ASSAY PGF ALG,,,64.41,176.48,23
HCPCS,0243U,Ob pe biochem assay pgf alg,,,83.94,97.2,8
HCPCS,0244U,ONC SOLID ORGN DNA 257 GENES,,,3500.0,9590.0,23
HCPCS,0244U,Onc solid orgn dna 257 genes,,,109.69,127.01,8
HCPCS,0245U,ONC THYR MUT ALYS 10 GEN&37,,,1266.07,3469.03,22
HCPCS,0245U,Onc thyr mut alys 10 gen&37,,,109.69,127.01,8
HCPCS,0246U,RBC DNA GNOTYP 16 BLD GROUPS,,,720.0,1972.8,23
HCPCS,0246U,Rbc dna gnotyp 16 bld groups,,,173.12,200.45,8
HCPCS,0247U,OB PRTRM BRTH IBP4 SHBG MEAS,,,750.0,2055.0,23
HCPCS,0247U,Ob prtrm brth ibp4 shbg meas,,,18.15,21.01,8
HCPCS,0248U,ONC SPHRD CELL CUL 12 RX PNL,,,800.0,8312.78,24
HCPCS,0248U,Onc sphrd cell cul 12 rx pnl,,,109.69,127.01,8
HCPCS,0249U,ONC BRST ALYS 32 PHSPRTN ALG,,,1549.2,6080.42,24
HCPCS,0249U,Onc brst alys 32 phsprtn alg,,,109.69,127.01,8
HCPCS,0250U,ONC SLD ORG NEO DNA 505 GENE,,,1167.84,7999.7,25
HCPCS,0250U,Onc sld org neo dna 505 gene,,,672.05,778.16,8
HCPCS,0251U,HEPCIDIN-25 ELISA SERUM/PLSM,,,5.67,47.32,25
HCPCS,0251U,Hepcidin-25 elisa serum/plsm,,,18.15,21.01,8
HCPCS,0252U,FTL ANEUPLOIDY STR ALYS DNA,,,572.5,2079.8,24
HCPCS,0252U,Ftl aneuploidy str alys dna,,,109.69,127.01,8
HCPCS,0253T,INSERT AQUEOUS DRAIN DEVICE,,,3527.34,4301.59,20
HCPCS,0253T,Insert aqueous drain device,,,2420.84,2803.08,8
HCPCS,0253U,RPRDTVE MED RNA GEN PRFL 238,,,645.0,8656.81,24
HCPCS,0253U,Rprdtve med rna gen prfl 238,,,109.69,127.01,8
HCPCS,0254U,REPRDTVE MED ALYS 24 CHRMSM,,,645.0,2079.8,24
HCPCS,0254U,Reprdtve med alys 24 chrmsm,,,109.69,127.01,8
HCPCS,0255U,ANDROLOGY INFERTILITY ASSMT,,,4.41,86.58,24
HCPCS,0255U,Andrology infertility assmt,,,24.85,28.78,8
HCPCS,0256U,TMA/TMAO PRFL LCMS/MS UR ALG,,,9.64,438.26,24
HCPCS,0256U,Tma/tmao prfl lcms/ms ur alg,,,83.94,97.2,8
HCPCS,0257U,VLCAD LEUK NZM ACTV WHL BLD,,,8.92,1952.17,24
HCPCS,0257U,Vlcad leuk nzm actv whl bld,,,18.15,21.01,8
HCPCS,0258U,AI PSOR MRNA 50-100 GEN ALG,,,1500.0,10069.5,25
HCPCS,0258U,Ai psor mrna 50-100 gen alg,,,83.94,97.2,8
HCPCS,0259U,NEPH CKD NUC MRS MEAS GFR,,,4.97,144.43,25
HCPCS,0259U,Neph ckd nuc mrs meas gfr,,,20.86,24.16,8
HCPCS,0260U,RARE DS ID OPT GENOME MAPG,,,66.38,3462.07,24
HCPCS,0260U,Rare ds id opt genome mapg,,,83.94,97.2,8
HCPCS,0261U,ONC CLRCT CA IMG ALYS W/AI,,,203.55,13563.0,25
HCPCS,0261U,Onc clrct ca img alys w/ai,,,83.94,97.2,8
HCPCS,0262U,ONC SLD TUM RT-PCR 7 GEN,,,1148.4,8768.0,24
HCPCS,0262U,Onc sld tum rt-pcr 7 gen,,,83.94,97.2,8
HCPCS,0263T,IM B1 MRW CEL THER CMPL,,,4014.88,12081.59,21
HCPCS,0263T,Im b1 mrw cel ther cmpl,,,1729.41,2002.47,8
HCPCS,0263U,NEURO ASD MEAS 16 C METBLT,,,336.26,2055.0,25
HCPCS,0263U,Neuro asd meas 16 c metblt,,,173.12,200.45,8
HCPCS,0264T,IM B1 MRW CEL THER XCL HRVST,,,4014.88,12081.59,21
HCPCS,0264T,Im b1 mrw cel ther xcl hrvst,,,1729.41,2002.47,8
HCPCS,0264U,RARE DS ID OPT GENOME MAPG,,,7.49,3462.07,24
HCPCS,0264U,Rare ds id opt genome mapg,,,83.94,97.2,8
HCPCS,0265T,IM B1 MRW CEL THER HRVST ONL,,,4014.88,12081.59,21
HCPCS,0265T,Im b1 mrw cel ther hrvst onl,,,1729.41,2002.47,8
HCPCS,0265U,RAR DO WHL GN&MTCDRL DNA ALS,,,1702.85,15003.69,24
HCPCS,0265U,Rar do whl gn&mtcdrl dna als,,,83.94,97.2,8
HCPCS,0266T,IMPLT/RPL CRTD SNS DEV TOTAL,,,40974.76,123301.37,9
HCPCS,0266T,Implt/rpl crtd sns dev total,,,19174.95,22202.58,8
HCPCS,0266U,UNXPL CNST HRTBL DO GN XPRSN,,,7.49,8768.0,24
HCPCS,0266U,Unxpl cnst hrtbl do gn xprsn,,,83.94,97.2,8
HCPCS,0267T,IMPLT/RPL CRTD SNS DEV LEAD,,,2951.88,8882.81,9
HCPCS,0267T,Implt/rpl crtd sns dev lead,,,2167.75,2510.02,8
HCPCS,0267U,RARE DO ID OPT GEN MAPG&SEQ,,,426.88,18465.76,24
HCPCS,0267U,Rare do id opt gen mapg&seq,,,83.94,97.2,8
HCPCS,0268T,IMPLT/RPL CRTD SNS DEV GEN,,,26939.5,81066.43,9
HCPCS,0268T,Implt/rpl crtd sns dev gen,,,19174.95,22202.58,8
HCPCS,0268U,HEM AHUS GEN SEQ ALYS 15 GEN,,,113.15,1666.39,24
HCPCS,0268U,Hem ahus gen seq alys 15 gen,,,83.94,97.2,8
HCPCS,0269T,REV/REMVL CRTD SNS DEV TOTAL,,,5779.17,17390.7,9
HCPCS,0269T,Rev/remvl crtd sns dev total,,,2167.75,2510.02,8
HCPCS,0269U,HEM AUT DM CGEN TRMBCTPNA 22,,,109.93,1666.39,24
HCPCS,0269U,Hem aut dm cgen trmbctpna 22,,,83.94,97.2,8
HCPCS,0270T,REV/REMVL CRTD SNS DEV LEAD,,,2951.88,8882.81,9
HCPCS,0270T,Rev/remvl crtd sns dev lead,,,2167.75,2510.02,8
HCPCS,0270U,HEM CGEN COAGJ DO 20 GENES,,,344.63,1666.39,24
HCPCS,0270U,Hem cgen coagj do 20 genes,,,83.94,97.2,8
HCPCS,0271T,REV/REMVL CRTD SNS DEV GEN,,,2951.88,8882.81,9
HCPCS,0271T,Rev/remvl crtd sns dev gen,,,2167.75,2510.02,8
HCPCS,0271U,HEM CGEN NEUTROPENIA 24 GEN,,,456.58,1666.39,24
HCPCS,0271U,Hem cgen neutropenia 24 gen,,,83.94,97.2,8
HCPCS,0272T,INTERROGATE CRTD SNS DEV,,,135.52,407.79,9
HCPCS,0272T,Interrogate crtd sns dev,,,22.84,26.44,8
HCPCS,0272U,HEM GENETIC BLD DO 60 GENES,,,372.11,1666.39,24
HCPCS,0272U,Hem genetic bld do 60 genes,,,83.94,97.2,8
HCPCS,0273T,INTERROGATE CRTD SNS W/PGRMG,,,135.52,407.79,9
HCPCS,0273T,Interrogate crtd sns w/pgrmg,,,22.84,26.44,8
HCPCS,0273U,HEM GEN HYPRFIBRNLYSIS 9 GEN,,,25.58,1666.39,24
HCPCS,0273U,Hem gen hyprfibrnlysis 8 gen,,,83.94,97.2,8
HCPCS,0274T,PERC LAMINO-/LAMINECTOMY IMAGE GUIDE CERV/THORAC,6687.0,4346.55,1.1,20863.78,86
HCPCS,0274T,PRQ LAMOT/LAM DCMPR CRV/THRC,,,6206.54,18676.74,21
HCPCS,0274T,Prq lamot/lam dcmpr crv/thrc,,,3812.17,4414.09,8
HCPCS,0274U,HEM GEN PLTLT DO 62 GENES,,,111.54,1666.39,24
HCPCS,0274U,Hem gen pltlt do 62 genes,,,83.94,97.2,8
HCPCS,0275T,PERQ LAMOT/LAM LUMBAR,,,6206.54,18676.74,10
HCPCS,0275T,Perq lamot/lam lumbar,,,3812.17,4414.09,8
HCPCS,0275U,HEM HEPRN NDUC TRMBCTPNA SRM,,,9.07,50.33,25
HCPCS,0275U,Hem heprn nduc trmbctpna srm,,,9.71,11.24,8
HCPCS,0276U,HEM INH THROMBOCYTOPENIA 42,,,9.07,6709.05,24
HCPCS,0276U,Hem inh thrombocytopenia 42,,,83.94,97.2,8
HCPCS,0277U,HEM GEN PLTLT FUNCJ DO 40,,,109.93,1666.39,24
HCPCS,0277U,Hem gen pltlt funcj do 40,,,83.94,97.2,8
HCPCS,0278T,SCRAMBLER THERAPY,500.0,325.0,121.73,2453.0,84
HCPCS,0278U,HEM GEN THROMBOSIS 14 GENES,,,569.26,1666.39,24
HCPCS,0278U,Hem gen thrombosis 14 genes,,,83.94,97.2,8
HCPCS,0279U,HEM VW FACTOR&CLGN III BNDG,,,6.91,31.59,25
HCPCS,0279U,Hem vw factor&clgn iii bndg,,,9.71,11.24,8
HCPCS,0280U,HEM VW FACTOR&CLGN IV BNDG,,,6.91,47.32,25
HCPCS,0280U,Hem vw factor&clgn iv bndg,,,9.71,11.24,8
HCPCS,0281U,HEM VWD PROPEPTIDE AG LVL,,,6.91,47.32,25
HCPCS,0281U,Hem vwd propeptide ag lvl,,,9.71,11.24,8
HCPCS,0282U,RED CELL GENOTYPING,4968.0,3229.2,173.12,4968.0,84
HCPCS,0283U,VW FACTOR TYPE 2B EVAL PLSM,,,9.35,50.42,25
HCPCS,0283U,Vw factor type 2b eval plsm,,,9.71,11.24,8
HCPCS,0284U,VW FACTOR TYPE 2N EVAL PLSM,,,11.33,47.32,25
HCPCS,0284U,Vw factor type 2n eval plsm,,,9.71,11.24,8
HCPCS,0285U,ONC DS PROG&RSPSE MNTR RADJ,,,11.33,1214.67,24
HCPCS,0285U,Onc ds prog&rspse mntr radj,,,83.94,97.2,8
HCPCS,0286U,CEP72 NUDT15&TPMT GENE ALYS,,,134.13,367.52,24
HCPCS,0286U,Cep72 nudt15&tpmt gene alys,,,116.49,134.88,8
HCPCS,0287U,ONC THYR DNA&MRNA 112 GENES,,,1440.0,9864.0,24
HCPCS,0287U,Onc thyr dna&mrna 112 genes,,,672.05,778.16,8
HCPCS,0288U,ONC LUNG MRNA QUAN PCR 11&3,,,1148.4,10612.02,24
HCPCS,0288U,Onc lung mrna quan pcr 11&3,,,672.05,778.16,8
HCPCS,0289U,NEURO ALZHEIMER MRNA 24 GEN,,,168.13,2082.4,24
HCPCS,0289U,Neuro alzheimer mrna 24 gen,,,173.12,200.45,8
HCPCS,0290T,Laser inc for pkp/lkp recip,,,2774.75,3212.87,8
HCPCS,0290U,PAIN MGMT MRNA GEN XPRSN 36,,,760.0,2082.4,24
HCPCS,0290U,Pain mgmt mrna gen xprsn 36,,,173.12,200.45,8
HCPCS,0291U,PSYC MOOD DO MRNA 144 GENES,,,423.14,4808.7,24
HCPCS,0291U,Psyc mood do mrna 144 genes,,,672.05,778.16,8
HCPCS,0292U,PSYC STRS DO MRNA 72 GENES,,,423.14,4808.7,24
HCPCS,0292U,Psyc strs do mrna 72 genes,,,672.05,778.16,8
HCPCS,0293U,PSYC SUICIDAL IDEA MRNA 54,,,423.14,2082.4,24
HCPCS,0293U,Psyc suicidal idea mrna 54,,,173.12,200.45,8
HCPCS,0294U,LNGVTY&MRTLTY RSK MRNA 18GEN,,,1140.0,2082.4,5
HCPCS,0294U,Lngvty&mrtlty rsk mrna 18gen,,,173.12,200.45,8
HCPCS,0295T,Ext ecg complete,,,86.64,100.32,8
HCPCS,0295U,ONC BRST DUX CARC 7 PROTEINS,,,1549.2,14891.9,24
HCPCS,0295U,Onc brst dux carc 7 proteins,,,672.05,778.16,8
HCPCS,0296T,Ext ecg recording,,,86.64,100.32,8
HCPCS,0296U,ONC ORL&/OROP CA 20 MLC FEAT,,,1440.0,5343.0,24
HCPCS,0296U,Onc orl&/orop ca 20 mlc feat,,,672.05,778.16,8
HCPCS,0297T,Ext ecg scan w/report,,,86.64,100.32,8
HCPCS,0297U,ONC PAN TUM WHL GEN SEQ DNA,,,208.0,7999.7,24
HCPCS,0297U,Onc pan tum whl gen seq dna,,,672.05,778.16,8
HCPCS,0298T,Ext ecg review and interp,,,86.64,100.32,8
HCPCS,0298U,ONC PAN TUM WHL TRNS SEQ RNA,,,208.0,7999.7,24
HCPCS,0298U,Onc pan tum whl trns seq rna,,,672.05,778.16,8
HCPCS,0299U,ONC PAN TUM WHL GEN OPT MAPG,,,208.0,5105.22,24
HCPCS,0299U,Onc pan tum whl gen opt mapg,,,83.94,97.2,8
HCPCS,0300U,ONC PAN TUM WHL GEN SEQ&OPT,,,208.0,11461.78,24
HCPCS,0300U,Onc pan tum whl gen seq&opt,,,83.94,97.2,8
HCPCS,0301U,IADNA BARTONELLA DDPCR,,,205.82,719.85,24
HCPCS,0301U,Iadna bartonella ddpcr,,,33.62,38.93,8
HCPCS,0302U,IADNA BRTNLA DDPCR FLWG LIQ,,,205.82,990.15,24
HCPCS,0302U,Iadna brtnla ddpcr flwg liq,,,33.62,38.93,8
HCPCS,0303U,HEM RBC ADS WHL BLD HYPOXIC,,,12.34,6032.44,24
HCPCS,0303U,Hem rbc ads whl bld hypoxic,,,8.48,9.82,8
HCPCS,0304U,HEM RBC ADS WHL BLD NORMOXIC,,,12.34,5687.69,24
HCPCS,0304U,Hem rbc ads whl bld normoxic,,,8.48,9.82,8
HCPCS,0305U,HEM RBC FNCLTY&DFRM SHR STRS,,,12.34,1815.47,24
HCPCS,0305U,Hem rbc fnclty&dfrm shr strs,,,8.48,9.82,8
HCPCS,0306U,ONC MRD NXT-GNRJ ALYS 1ST,,,239.16,10626.95,24
HCPCS,0306U,Onc mrd nxt-gnrj alys 1st,,,83.94,97.2,8
HCPCS,0307U,ONC MRD NXT-GNRJ ALYS SBSQ,,,239.16,2176.9,24
HCPCS,0307U,Onc mrd nxt-gnrj alys sbsq,,,83.94,97.2,8
HCPCS,0308T,INSJ OCULAR TELESCOPE PROSTH,,,15051.58,45293.27,21
HCPCS,0308T,Insj ocular telescope prosth,,,2420.84,2803.08,8
HCPCS,0308U,CRD CAD ALYS 3 PRTN 3 PARAM,,,45.77,1070.66,24
HCPCS,0308U,Crd cad alys 3 prtn 3 param,,,83.94,97.2,8
HCPCS,0309U,CRD CV DS ALY 4 PRTN PLM ALG,,,45.77,1070.66,24
HCPCS,0309U,Crd cv ds aly 4 prtn plm alg,,,83.94,97.2,8
HCPCS,0310U,PED VSCLTS KD ALYS 3 BMRKS,,,6.39,1070.66,24
HCPCS,0310U,Ped vsclts kd alys 3 bmrks,,,83.94,97.2,8
HCPCS,0311U,NFCT DS BCT QUAN ANTMCRB SC,,,8.08,22.14,24
HCPCS,0311U,Nfct ds bct quan antmcrb sc,,,16.64,19.27,8
HCPCS,0312T,Laps impltj nstim vagus,,,19174.95,22202.58,8
HCPCS,0312U,AI DS SLE ALYS 8 IGG AUTOANT,,,336.26,2303.38,24
HCPCS,0312U,Ai ds sle alys 8 igg autoant,,,173.12,200.45,8
HCPCS,0313T,Laps rmvl nstim array vagus,,,2167.75,2510.02,8
HCPCS,0313U,ONC PNCRS DNA&MRNA SEQ 74,,,1440.0,9864.0,24
HCPCS,0313U,Onc pncrs dna&mrna seq 74,,,672.05,778.16,8
HCPCS,0314T,Laps rmvl vgl arry&pls gen,,,2167.75,2510.02,8
HCPCS,0314U,ONC CUTAN MLNMA MRNA 35 GENE,,,1549.2,5343.0,24
HCPCS,0314U,Onc cutan mlnma mrna 35 gene,,,672.05,778.16,8
HCPCS,0315T,Rmvl vagus nerve pls gen,,,2167.75,2510.02,8
HCPCS,0315U,ONC CUTAN SQ CLL CA MRNA 40,,,1549.2,23290.0,24
HCPCS,0315U,Onc cutan sq cll ca mrna 40,,,672.05,778.16,8
HCPCS,0316T,Replc vagus nerve pls gen,,,19174.95,22202.58,8
HCPCS,0316U,B BRGDRFERI LYME DS OSPA EVL,,,7.65,51.13,24
HCPCS,0316U,B brgdrferi lyme ds ospa evl,,,16.64,19.27,8
HCPCS,0317T,Elec alys vagus nrv pls gen,,,22.84,26.44,8
HCPCS,0317U,ONC LUNG CA 4-PRB FISH ASSAY,,,304.0,5562.2,24
HCPCS,0317U,Onc lung ca 4-prb fish assay,,,672.05,778.16,8
HCPCS,0318U,PED WHL GEN MTHYLTN ALYS 50+,,,33.2,4851.12,24
HCPCS,0318U,Ped whl gen mthyltn alys 50+,,,83.94,97.2,8
HCPCS,0319U,NEPH RNA PRETRNSPL PERPH BLD,,,208.0,7261.0,24
HCPCS,0319U,Neph rna pretrnspl perph bld,,,83.94,97.2,8
HCPCS,0320U,NEPH RNA PSTTRNSPL PERPH BLD,,,208.0,7261.0,24
HCPCS,0320U,Neph rna psttrnspl perph bld,,,83.94,97.2,8
HCPCS,0321U,IADNA GU PTHGN 20BCT&FNG ORG,,,257.13,1739.46,24
HCPCS,0321U,Iadna gu pthgn 20bct&fng org,,,109.69,127.01,8
HCPCS,0322U,NEURO ASD MEAS 14 ACYL CARN,,,336.26,2055.0,24
HCPCS,0322U,Neuro asd meas 14 acyl carn,,,173.12,200.45,8
HCPCS,0323U,IADNA CNS PTHGN NEXT GEN SEQ,,,21.15,5825.79,24
HCPCS,0323U,Iadna cns pthgn next gen seq,,,672.05,778.16,8
HCPCS,0324U,ONC OVAR SPHRD CELL 4 RX PNL,,,239.16,239.16,2
HCPCS,0324U,Onc ovar sphrd cell 4 rx pnl,,,672.05,778.16,8
HCPCS,0325U,ONC OVAR SPHRD CELL PARP,,,239.16,239.16,2
HCPCS,0325U,Onc ovar sphrd cell parp,,,672.05,778.16,8
HCPCS,0326U,TRGT GEN SEQ ALYS PNL 83+,,,2000.0,13700.0,24
HCPCS,0326U,Trgt gen seq alys pnl 83+,,,83.94,97.2,8
HCPCS,0327U,FTL ANEUPLOIDY TRSMY DNA SEQ,,,500.0,2178.3,24
HCPCS,0327U,Ftl aneuploidy trsmy dna seq,,,173.12,200.45,8
HCPCS,0328U,DRUG ASSAY 120+ RX&METABLT,,,31.92,313.54,24
HCPCS,0328U,Drug assay 120+ rx&metablt,,,34.82,40.32,8
HCPCS,0329T,MNTR IO PRESS 24HRS/> UNI/BI,,,2739849.3,2739849.3,1
HCPCS,0329T,Mntr io press 24hrs/> uni/bi,,,48.64,56.32,8
HCPCS,0329U,ONC NEO XOME&TRNS SEQ ALYS,,,325.33,9420.07,24
HCPCS,0329U,Onc neo xome&trns seq alys,,,83.94,97.2,8
HCPCS,0330T,TEAR FILM IMG UNI/BI W/I&R,,,34.79,104.7,21
HCPCS,0330T,Tear film img uni/bi w/i&r,,,86.82,100.53,8
HCPCS,0330U,IADNA VAG PTHGN PANEL 27 ORG,,,17.33,1141.98,24
HCPCS,0330U,Iadna vag pthgn panel 27 org,,,33.62,38.93,8
HCPCS,0331T,HEART SYMP IMAGE PLNR,,,1210.23,3707.03,21
HCPCS,0331T,Heart symp image plnr,,,888.71,1029.03,8
HCPCS,0331T,MYOCRD SYMPATHETIC INNERVAJ IMG PLNR QUAL&QUANT,390.0,253.5,1.1,4141.53,86
HCPCS,0331U,ONC HL NEO OPT GEN MAPPING,,,208.0,5105.22,24
HCPCS,0331U,Onc hl neo opt gen mapping,,,83.94,97.2,8
HCPCS,0332T,HEART SYMP IMAGE PLNR SPECT,,,1210.23,3707.03,21
HCPCS,0332T,Heart symp image plnr spect,,,888.71,1029.03,8
HCPCS,0332T,MYOCRD SYMP INNERVAJ IMG PLNR QUAL&QUANT W/SPECT,390.0,253.5,1.1,4141.53,154
HCPCS,0332U,ONC PAN TUM GEN PRFLG 8 DNA,,,1142.06,3129.24,24
HCPCS,0332U,Onc pan tum gen prflg 8 dna,,,83.94,97.2,8
HCPCS,0333T,VISUAL EP SCR ACUITY AUTO,,,2739849.3,2739849.3,1
HCPCS,0333T,Visual ep scr acuity auto,,,391.75,453.61,8
HCPCS,0333U,ONC LVR SURVEILANC HCC CFDNA,,,662.32,2000.0,24
HCPCS,0333U,Onc lvr surveilanc hcc cfdna,,,83.94,97.2,8
HCPCS,0334U,ONC SLD ORGN TGSA DNA 84/+,,,1167.84,2739849.3,23
HCPCS,0334U,Onc sld orgn tgsa dna 84/+,,,672.05,778.16,8
HCPCS,0335T,INSJ SINUS TARSI IMPLANT,,,6206.54,18676.74,21
HCPCS,0335T,Insj sinus tarsi implant,,,1754.89,2031.98,8
HCPCS,0335U,RARE DS WHL GEN SEQ FETAL,,,66.2,14315.4,24
HCPCS,0335U,Rare ds whl gen seq feta,,,672.05,778.16,8
HCPCS,0336U,RARE DS WHL GEN SEQ BLD/SLV,,,33.2,7054.54,24
HCPCS,0336U,Rare ds whl gen seq bld/slv,,,672.05,778.16,8
HCPCS,0337U,ONC PLSM CELL DO&MYELOMA ID,,,121.34,6671.9,24
HCPCS,0337U,Onc plsm cell do&myeloma id,,,83.94,97.2,8
HCPCS,0338T,TRANSCATH RENAL SYMP DENERV UNI,7571.0,4921.15,1.1,18417.4,86
HCPCS,0338T,TRANSCATHETER RENAL SYMPATH DENERVATION UNILAT,22806.0,14823.9,4958.66,22806.0,85
HCPCS,0338U,ONC SLD TUM CRCG TUM CL SLCT,,,121.34,6671.9,24
HCPCS,0338U,Onc sld tum crcg tum cl slct,,,83.94,97.2,8
HCPCS,0339T,TRANSCATH RENAL SYMP DENERV BILAT,8704.0,5657.6,1.1,29389.56,86
HCPCS,0339T,TRANSCATHETER RENAL SYMPATH DENERVATION BILAT,12979.0,8436.35,3608.16,12979.0,169
HCPCS,0339U,ONC PRST8 MRNA HOXC6 & DLX1,,,304.0,2082.4,24
HCPCS,0339U,Onc prst8 mrna hoxc6 & dlx1,,,173.12,200.45,8
HCPCS,0340U,ONC PAN CA ALYS MRD PLASMA,,,335.33,9836.6,25
HCPCS,0340U,Onc pan ca alys mrd plasma,,,83.94,97.2,8
HCPCS,0341U,FTL ANEUP DNA SEQ CMPR ALYS,,,500.0,5206.55,24
HCPCS,0341U,Ftl aneup dna seq cmpr alys,,,83.94,97.2,8
HCPCS,0342T,THXP APHERESIS W/HDL DELIP,,,4014.88,12081.59,21
HCPCS,0342T,Thxp apheresis w/hdl delip,,,1729.41,2002.47,8
HCPCS,0342U,ONC PNCRTC CA MULT IA ECLIA,,,10.28,2457.78,5
HCPCS,0342U,Onc pncrtc ca mult ia eclia,,,173.12,200.45,8
HCPCS,0343U,ONC PRST8 XOM ALY 442 SNCRNA,,,200.0,2082.4,24
HCPCS,0343U,Onc prst8 xom aly 442 sncrna,,,173.12,200.45,8
HCPCS,0344U,HEP NAFLD SEMIQ EVL 28 LIPID,,,201.36,2170.55,24
HCPCS,0344U,Hep nafld semiq evl 28 lipid,,,83.94,97.2,8
HCPCS,0345T,TRANSCATH MITRAL VALVE REPAIR VIA CORONARY SINUS,15591.5,10134.474999999999,1.1,3060831.65,152
HCPCS,0345U,PSYC GENOM ALYS PNL 15 GEN,,,423.14,3660.89,24
HCPCS,0345U,Psyc genom alys pnl 15 gen,,,672.05,778.16,8
HCPCS,0346U,BETA AMYL A?40&A?42 LC-MS/MS,,,45.77,255.53,3
HCPCS,0346U,Beta amyl ab40&ab42 lc-ms/ms,,,18.15,21.01,8
HCPCS,0347T,INS BONE DEVICE FOR RSA,,,53.07,159.69,21
HCPCS,0347T,Ins bone device for rsa,,,251.58,291.3,8
HCPCS,0347U,RX METAB/PCX DNA 16 GEN ALYS,,,699.2,3660.89,24
HCPCS,0347U,Rx metab/pcx dna 16 gen alys,,,672.05,778.16,8
HCPCS,0348T,RSA SPINE EXAM,,,95.38,551.66,23
HCPCS,0348T,Rsa spine exam,,,56.78,65.75,8
HCPCS,0348U,RX METAB/PCX DNA 25 GEN ALYS,,,699.2,2033.82,24
HCPCS,0348U,Rx metab/pcx dna 25 gen alys,,,173.12,200.45,8
HCPCS,0349T,RSA UPPER EXTR EXAM,,,95.38,551.66,23
HCPCS,0349T,Rsa upper extr exam,,,56.78,65.75,8
HCPCS,0349U,RX METAB/PCX DNA 27GEN RX IA,,,699.2,2033.82,24
HCPCS,0349U,Rx metab/pcx dna 27gen rx ia,,,173.12,200.45,8
HCPCS,0350T,RSA LOWER EXTR EXAM,,,78.83,409.57,23
HCPCS,0350T,Rsa lower extr exam,,,56.78,65.75,8
HCPCS,0350U,RX METAB/PCX DNA 27 GEN ALYS,,,699.2,3660.89,24
HCPCS,0350U,Rx metab/pcx dna 27 gen alys,,,672.05,778.16,8
HCPCS,0351T,Intraop oct brst/node spec,,,86.82,100.53,8
HCPCS,0351U,NFCT DS BCT/VIRAL TRAIL IP10,,,57.05,713.77,24
HCPCS,0351U,Nfct ds bct/viral trail ip10,,,83.94,97.2,8
HCPCS,0352T,OCT BRST/NODE I&R PER SPEC,,,2185.7,2739849.3,3
HCPCS,0352T,Oct brst/node i&r per spec,,,86.82,100.53,8
HCPCS,0352U,NFCT DS BV&VAGINITIS AMP PRB,,,57.05,390.81,3
HCPCS,0352U,Nfct ds bv&vaginitis amp prb,,,33.62,38.93,8
HCPCS,0353T,Intraop oct breast cavity,,,86.82,100.53,8
HCPCS,0353U,IADNA CHLMYD&GONORR AMP PRB,,,17.33,192.29,3
HCPCS,0353U,Iadna chlmyd&gonorr amp prb,,,16.64,19.27,8
HCPCS,0354T,OCT BREAST SURG CAVITY I&R,,,2185.7,2739849.3,3
HCPCS,0354T,Oct breast surg cavity i&r,,,86.82,100.53,8
HCPCS,0354U,HPV HI RSK QUAL MRNA E6/E7,,,19.1,96.15,3
HCPCS,0354U,Hpv hi rsk qual mrna e6/e7,,,33.62,38.93,8
HCPCS,0355T,Gi tract capsule endoscopy,,,299.41,346.69,8
HCPCS,0355U,APOL1 RISK VARIANTS,,,137.0,375.38,24
HCPCS,0355U,Apol1 risk variants,,,83.94,97.2,8
HCPCS,0356T,Insrt drug device for iop,,,48.64,56.32,8
HCPCS,0356U,ONC OROP/ANAL 17 DNA DDPCR,,,1440.0,2739849.3,24
HCPCS,0356U,Onc orop/anal 17 dna ddpcr,,,83.94,97.2,8
HCPCS,0357U,ONC MLNMA AI QUAN ALYS 142,,,1500.0,1500.0,2
HCPCS,0357U,Onc mlnma ai quan alys 142,,,116.49,134.88,8
HCPCS,0358T,BIA WHOLE BODY COMPOSITION ASSESSMENT W/I&R,82.5,53.625,1.1,100.32,170
HCPCS,0358U,NEURO ALYS ß-AMYL 1-42&1-40,,,168.13,713.77,24
HCPCS,0358U,Neuro alys b-amyl 1-42&1-40,,,116.49,134.88,8
HCPCS,0359U,ONC PRST8 CA ALYS ALL PSA,,,304.0,2082.4,24
HCPCS,0359U,Onc prst8 ca alys all psa,,,18.15,21.01,8
HCPCS,0360U,ONC LUNG ELISA 7 AUTOANT ALG,,,358.8,2303.38,24
HCPCS,0360U,Onc lung elisa 7 autoant alg,,,83.94,97.2,8
HCPCS,0361U,NEURFLMNT LT CHN DIG IA QUAN,,,6.91,2739849.3,10
HCPCS,0361U,Neurflmnt lt chn dig ia quan,,,16.64,19.27,8
HCPCS,0362T,BEHAVIOR ID SUPPORT ASSMT EA 15 MIN TECH TIME,293.0,190.45,1.1,293.0,94
HCPCS,0362T,BHV ID SUPRT ASSMT EA 15 MIN,,,24.89,74.91,21
HCPCS,0362T,Bhv id suprt assmt ea 15 min,,,197.35,228.51,8
HCPCS,0362U,ONC PAP THYR CA RNA 82&10,,,82.92,9864.0,24
HCPCS,0362U,Onc pap thyr ca rna 82&10,,,83.94,97.2,8
HCPCS,0363U,ONC URTHL MRNA 5 GEN ALG,,,200.0,2082.4,24
HCPCS,0363U,Onc urthl mrna 5 gen alg,,,83.94,97.2,8
HCPCS,0364U,ONC HL NEO GEN SEQ ALYS ALG,,,80.97,2739849.3,23
HCPCS,0364U,Onc hl neo gen seq alys alg,,,83.94,97.2,8
HCPCS,0365U,ONC BLDR 10 UR HRBR URTHL CA,,,358.8,2457.78,24
HCPCS,0365U,Onc bldr 10 ur hrbr urthl ca,,,83.94,97.2,8
HCPCS,0366U,ONC BLDR 10 PRB RECR BLDR CA,,,358.8,2457.78,24
HCPCS,0366U,Onc bldr 10 prb recr bldr ca,,,83.94,97.2,8
HCPCS,0367U,ONC BLDR 10 FLWG TRURL RESCJ,,,358.8,2471.97,24
HCPCS,0367U,Onc bldr 10 flwg trurl rescj,,,83.94,97.2,8
HCPCS,0368U,ONC CLRCT CA MUT&MTHYLTN MRK,,,625.17,2739849.3,5
HCPCS,0368U,Onc clrct ca mut&mthyltn mrk,,,83.94,97.2,8
HCPCS,0369U,IADNA GI PTHGN 31 ORG&21 ARG,,,205.82,1141.98,11
HCPCS,0369U,Iadna gi pthgn 31 org&21 arg,,,49.14,56.9,8
HCPCS,0370U,IADNA SURG WND PTHGN 34&21,,,17.33,1141.98,11
HCPCS,0370U,Iadna surg wnd pthgn 34&21,,,49.14,56.9,8
HCPCS,0371U,IADNA GU PTHGN SEMIQ DNA16&1,,,17.33,1141.98,24
HCPCS,0371U,Iadna gu pthgn semiq dna16&1,,,49.14,56.9,8
HCPCS,0372U,NFCT DS GU PTHGN ARG DETCJ,,,17.33,1141.98,24
HCPCS,0372U,Nfct ds gu pthgn arg detcj,,,33.62,38.93,8
HCPCS,0373T,ADAPT BHV TX EA 15 MIN,,,24.89,74.91,21
HCPCS,0373T,ADAPT BHV TX PRTCL MODIFICAJ EA 15 MIN TECH TIME,191.0,124.15,1.1,266.89,94
HCPCS,0373T,Adapt bhv tx ea 15 min,,,197.35,228.51,8
HCPCS,0373U,IADNA RSP TR NFCT 17 8 13&16,,,17.33,1141.98,11
HCPCS,0373U,Iadna rsp tr nfct 17 8 13&16,,,33.62,38.93,8
HCPCS,0374U,IADNA GU PTHGN 21 ORG&21ARG,,,17.33,1141.98,11
HCPCS,0374U,Iadna gu pthgn 21 org&21arg,,,49.14,56.9,8
HCPCS,0375U,ONC OVRN BCHM ASY 7 PRTN ALG,,,358.8,2457.78,24
HCPCS,0375U,Onc ovrn bchm asy 7 prtn alg,,,83.94,97.2,8
HCPCS,0376T,Insert ant segment drain int,,,2420.84,2803.08,8
HCPCS,0376U,ONC PRST8 CA IMG ALYS 128,,,200.0,1935.13,24
HCPCS,0376U,Onc prst8 ca img alys 128,,,83.94,97.2,8
HCPCS,0377U,CV DS QUAN ADVSRM/PLSM LPRTN,,,15.58,130.37,24
HCPCS,0377U,Cv ds quan advsrm/plsm lprtn,,,83.94,97.2,8
HCPCS,0378T,VISUAL FIELD ASSMNT REV/RPRT,,,2739849.3,2739849.3,1
HCPCS,0378U,RFC1 REPEAT XPNSJ VRNT ALYS,,,45.77,375.38,24
HCPCS,0378U,Rfc1 repeat xpnsj vrnt alys,,,83.94,97.2,8
HCPCS,0379T,VIS FIELD ASSMNT TECH SUPPT,,,34.79,104.7,21
HCPCS,0379U,TGSAP SL OR NEO DNA523&RNA55,,,303.81,2739849.3,23
HCPCS,0379U,Tgsap sl or neo dna523&rna55,,,83.94,97.2,8
HCPCS,0380U,RX METB ADVRS TRGT SQ ALY 20,,,699.2,1141.98,3
HCPCS,0380U,Rx metb advrs trgt sq aly 20,,,83.94,97.2,8
HCPCS,0381T,Ext h rate epi sz 14 days,,,86.64,100.32,8
HCPCS,0381U,MAPLE SYRUP UR DS MNTR QUAN,,,38.0,2739849.3,23
HCPCS,0381U,Maple syrup ur ds mntr quan,,,83.94,97.2,8
HCPCS,0382T,Ext h rate sz 14 day ri only,,,86.64,100.32,8
HCPCS,0382U,HYPRPHENYLALNINMIA MNTR QUAN,,,45.77,2739849.3,23
HCPCS,0382U,Hyprphenylalninmia mntr quan,,,83.94,97.2,8
HCPCS,0383U,TYROSINEMIA TYP I MNTR QUAN,,,45.77,2739849.3,23
HCPCS,0383U,Tyrosinemia typ i mntr quan,,,83.94,97.2,8
HCPCS,0384U,NEPH CKD RSK HI STG KDN DS,,,4.97,2055.0,24
HCPCS,0384U,Neph ckd rsk hi stg kdn ds,,,83.94,97.2,8
HCPCS,0385U,NEPH CKD ALG RSK DBTC KDN DS,,,4.97,1070.66,24
HCPCS,0385U,Neph ckd alg rsk dbtc kdn ds,,,83.94,97.2,8
HCPCS,0386U,GI BARRETT ESOPH MTHYLTN ALY,,,336.26,336.26,2
HCPCS,0386U,Gi barrett esoph mthyltn aly,,,83.94,97.2,8
HCPCS,0387U,ONC MLNMA AMBRA1&AMLO,,,948.5,2598.89,22
HCPCS,0387U,Onc mlnma ambra1&amlo,,,83.94,97.2,8
HCPCS,0388U,ONC NONSM CLL LNG CA 37 GEN,,,3500.0,2739849.3,21
HCPCS,0388U,Onc nonsm cll lng ca 37 gen,,,83.94,97.2,8
HCPCS,0389U,PED FBRL KD IFI27&MCEMP1 RNA,,,70.2,2739849.3,21
HCPCS,0389U,Ped fbrl kd ifi27&mcemp1 rna,,,83.94,97.2,8
HCPCS,0390U,OB PE KDR ENG&RBP4 IA ALG,,,64.41,176.48,22
HCPCS,0390U,Ob pe kdr eng&rbp4 ia alg,,,83.94,97.2,8
HCPCS,0391U,ONC SLD TUM DNA&RNA 437 GEN,,,3600.0,9864.0,22
HCPCS,0391U,Onc sld tum dna&rna 437 gen,,,83.94,97.2,8
HCPCS,0392U,RX METAB GEN-RX IA 16 GENES,,,1336.09,3660.89,22
HCPCS,0392U,Rx metab genrx ia 16 genes,,,83.94,97.2,8
HCPCS,0393U,NEU PRKSN MSFL a-SYNCLN PRTN,,,540.99,1482.31,22
HCPCS,0393U,Neu prksn msfl a-syncln prtn,,,83.94,97.2,8
HCPCS,0394T,HDR ELCTRNC SKN SURF BRCHYTX,,,233.15,701.6,9
HCPCS,0394T,Hdr elctrnc skn surf brchytx,,,136.52,158.07,8
HCPCS,0394U,PFAS 16 PFAS COMPND LC MS/MS,,,198.74,544.55,22
HCPCS,0394U,Pfas 16 pfas compnd lc ms/ms,,,18.15,21.01,8
HCPCS,0395T,HDR ELCTR NTRST/NTRCV BRCHTX,7980.0,5187.0,1.1,7980.0,111
HCPCS,0395T,Hdr elctr ntrst/ntrcv brchtx,,,358.52,415.13,8
HCPCS,0395U,ONC LNG MULTIOMICS PLSM ALG,,,797.45,2739849.3,21
HCPCS,0395U,Onc lng multiomics plsm alg,,,83.94,97.2,8
HCPCS,0396T,Intraop kinetic balnce sensr,,,2483.09,2875.16,8
HCPCS,0396U,OB PREIMPLTJ TST 300000 DNA,,,2739849.3,2739849.3,1
HCPCS,0396U,Ob preimpltj tst 300000 dna,,,83.94,97.2,8
HCPCS,0397T,ERCP WITH OPTICAL ENDOMICROSCOPY ADD ON,2931.5,1905.4750000000001,1.1,4912.0,152
HCPCS,0397U,Onc nonsm cll lng ca 109,,,83.94,97.2,8
HCPCS,0398T,MRGFUS STRTCTC LES ABLTJ,,,11817.85,35562.32,2
HCPCS,0398U,GI BARET ESPH DNA MTHYLN ALY,,,1755.0,2739849.3,21
HCPCS,0398U,Gi baret esph dna mthyln aly,,,83.94,97.2,8
HCPCS,0399U,NEURO CERE FOLATE DEFNCY SRM,,,300.0,2739849.3,21
HCPCS,0399U,Neuro cere folate defncy srm,,,83.94,97.2,8
HCPCS,0400T,Mltispectrl digital les alys,,,9.22,10.68,8
HCPCS,0400U,OB XPND CAR SCR 145 GENES,,,2185.32,2739849.3,3
HCPCS,0400U,Ob xpnd car scr 145 genes,,,83.94,97.2,8
HCPCS,0401T,Mltispectrl digital les alys,,,9.22,10.68,8
HCPCS,0401U,CRD C HRT DS 9 GEN 12 VRNTS,,,489.68,2739849.3,21
HCPCS,0401U,Crd c hrt ds 9 gen 12 vrnts,,,83.94,97.2,8
HCPCS,0402T,COLLAGEN CROSS-LINKING OF CORNEA MED SEPARATE,6494.5,4221.425,0.01,9332.0,165
HCPCS,0402U,NFCT AGT STI MULT AMP PRB TQ,,,142.63,390.81,22
HCPCS,0402U,Nfct agt sti mult amp prb tq,,,16.64,19.27,8
HCPCS,0403T,DIABETES PREV STANDARD CURR,,,534.3,534.3,1
HCPCS,0403T,Diabetes prev standard curr,,,44.67,51.72,8
HCPCS,0403U,ONC PRST8 MRNA 18 GEN 1ST UR,,,760.0,2082.4,22
HCPCS,0403U,Onc prst8 mrna 18 gen 1st ur,,,83.94,97.2,8
HCPCS,0404T,Trnscrv uterin fibroid abltj,,,5500.26,6368.73,8
HCPCS,0404U,ONC BRST SEMIQ MEAS THYM KN,,,322.96,884.91,22
HCPCS,0404U,Onc brst semiq meas thym kn,,,83.94,97.2,8
HCPCS,0405T,Ovrsght xtrcorp liv asst pat,,,405.62,469.67,8
HCPCS,0405U,ONC PNCRTC 59 MTHLTN BLK MRK,,,1770.48,4851.12,22
HCPCS,0405U,Onc pncrtc 59 mthltn blk mrk,,,83.94,97.2,8
HCPCS,0406U,ONC LUNG FLOW CYTMTRY 5 MRK,,,760.0,2082.4,22
HCPCS,0406U,Onc lung flow cytmtry 5 mrk,,,83.94,97.2,8
HCPCS,0407U,NEPH DBTC CKD MULT ECLIA ALG,,,950.0,2603.0,22
HCPCS,0407U,Neph dbtc ckd mult eclia alg,,,83.94,97.2,8
HCPCS,0408T,INSJ/RPLC CAR MODULJ SYS PLS GEN TRANSVNS ELTRD,17079.5,11101.675,1.1,95950.11,170
HCPCS,0408U,IAAD BLK AC WV BSNSR SARSCV2,,,14.13,2739849.3,21
HCPCS,0408U,Iaad blk ac wv bsnsr sarscv2,,,33.62,38.93,8
HCPCS,0409T,INSJ/RPLC CARDIAC MODULJ SYS PLS GENERATOR ONLY,5499.0,3574.3500000000004,1.1,68747.0,170
HCPCS,0409U,ONC SLD TUM DNA 80 & RNA 36,,,2919.6,7999.7,22
HCPCS,0409U,Onc sld tum dna 80 & rna 36,,,83.94,97.2,8
HCPCS,0410T,INSJ/RPLC CARDIAC MODULJ SYS ATR ELECTRODE ONLY,17782.0,11558.3,1.1,33104.0,170
HCPCS,0410U,ONC PNCRTC DNA WHL GN SEQ 5-,,,1160.0,3178.4,22
HCPCS,0410U,Onc pncrtc dna whl gn seq 5-,,,83.94,97.2,8
HCPCS,0411T,INSJ/RPLC CAR MODULJ SYS VENTR ELECTRODE ONLY,17782.0,11558.3,1.1,33104.0,170
HCPCS,0411U,PSYC GENOM ALYS PNL 15 GEN,,,1336.09,3660.89,22
HCPCS,0411U,Psyc genom alys pnl 15 gen,,,672.05,778.16,8
HCPCS,0412T,REMOVAL CARDIAC MODULJ SYS PLS GENERATOR ONLY,7996.5,5197.724999999999,1.1,14557.0,170
HCPCS,0412U,BETA AMYLOID Aß42/40 IMPRCIP,,,750.0,2739849.3,21
HCPCS,0412U,Beta amyloid ab42/40 imprcip,,,18.15,21.01,8
HCPCS,0413T,REMOVAL CARDIAC MODULJ SYS TRANSVENOUS ELECTRODE,9116.0,5925.4,1.1,14557.0,170
HCPCS,0413U,ONC HL NEO OPT GEN MAPG DNA,,,1263.53,3462.07,22
HCPCS,0413U,Onc hl neo opt gen mapg dna,,,83.94,97.2,8
HCPCS,0414T,(2017) RMVL & RPL CARDIAC MODULJ SYS PLS GENERATOR ONLY,2330.0,1514.5,1.1,68747.0,86
HCPCS,0414T,RMVL & RPL CARDIAC MODULJ SYS PLS GENERATOR ONLY,32367.0,21038.55,7710.0,32367.0,84
HCPCS,0414U,ONC LNG AUG ALG ALY WHL SLD8,,,706.25,1935.13,22
HCPCS,0414U,Onc lng aug alg aly whl sld8,,,83.94,97.2,8
HCPCS,0415T,(2017) REPOS CARDIAC MODULJ TRANSVENOUS ELECTRODE,2071.0,1346.15,1.1,2071.0,86
HCPCS,0415T,REPOS CARDIAC MODULJ TRANSVENOUS ELECTRODE,2473.0,1607.45,545.0,10260.0,84
HCPCS,0415U,CV DS ACS BLD ALG 5 YR SCORE,,,390.75,1070.66,22
HCPCS,0415U,Cv ds acs bld alg 5 yr score,,,83.94,97.2,8
HCPCS,0416T,RELOC SKIN POCKET CARDIAC MODULJ PULSE GENERATOR,4719.0,3067.3500000000004,1.1,7317.0,170
HCPCS,0416U,IADNA GU PTHGN 20BCT&FNG ORG,,,1141.98,1141.98,1
HCPCS,0416U,Iadna gu pthgn 20bct&fng org,,,83.94,97.2,8
HCPCS,0417T,PRGRMG DEVICE EVALUATION CARDIAC MODULJ SYSTEM,510.5,331.825,1.1,872.0,170
HCPCS,0417U,RARE DS ALYS 335 NUC GENES,,,2842.53,2739849.3,21
HCPCS,0417U,Rare ds alys 335 nuc genes,,,83.94,97.2,8
HCPCS,0418T,INTERRO DEVICE EVALUATION CARDIAC MODULJ SYSTEM,269.5,175.175,1.1,390.0,170
HCPCS,0418U,ONC BRST AUG ALG ALY WHL SL8,,,706.25,1935.13,22
HCPCS,0418U,Onc brst aug alg aly whl sl8,,,45.47,52.65,8
HCPCS,0419T,DSTRJ NEUROFIBROMA XTNSV,,,544.87,1639.62,21
HCPCS,0419T,Dstrj neurofibroma xtnsv,,,168.79,195.44,8
HCPCS,0419U,NRPSYC GEN SEQ VRNT ALY 13,,,1336.09,3660.89,22
HCPCS,0419U,Nrpsyc gen seq vrnt aly 13,,,83.94,97.2,8
HCPCS,0420T,DSTRJ NEUROFIBROMA XTNSV,,,544.87,1639.62,21
HCPCS,0420T,Dstrj neurofibroma xtnsv,,,168.79,195.44,8
HCPCS,0420U,ONC URTHL MRNA XPRSN 6 SNP,,,200.0,2739849.3,16
HCPCS,0420U,Onc urthl mrna xprsn 6 snp,,,83.94,97.2,8
HCPCS,0421T,WATERJET PROSTATE ABLTJ CMPL,,,7992.18,24050.1,11
HCPCS,0421T,Waterjet prostate abltj cmpl,,,3284.72,3803.36,8
HCPCS,0421U,ONC CLRCT SCR SGL AMP 8 RNA,,,203.55,2739849.3,5
HCPCS,0421U,Onc clrct scr sgl amp 8 rna,,,83.94,97.2,8
HCPCS,0422T,TACTILE BREAST IMG UNI/BI,,,78.83,409.57,23
HCPCS,0422T,Tactile breast img uni/bi,,,51.83,60.02,8
HCPCS,0422U,ONC PAN SOLID TUM ALYS DNA,,,11.33,2739849.3,16
HCPCS,0422U,Onc pan solid tum alys dna,,,83.94,97.2,8
HCPCS,0423T,Assay secretory type ii pla2,,,20.86,24.16,8
HCPCS,0423U,PSYC GENOMIC ALYS PNL 26 GEN,,,416.78,2739849.3,23
HCPCS,0423U,Psyc genomic alys pnl 26 gen,,,83.94,97.2,8
HCPCS,0424T,Insj/rplc nstim apnea compl,,,19174.95,22202.58,8
HCPCS,0424U,ONC PRST8 XOM ALYS 53 SNCRNA,,,200.0,2739849.3,23
HCPCS,0424U,Onc prst8 xom alys 53 sncrna,,,83.94,97.2,8
HCPCS,0425U,GENOM RPD SEQ ALYS EA CMPRTR,,,846.27,2739849.3,16
HCPCS,0425U,Genom rpd seq alys ea cmprtr,,,83.94,97.2,8
HCPCS,0426U,GENOME ULTRA-RAPID SEQ ALYS,,,846.27,2739849.3,16
HCPCS,0426U,Genome ultra-rapid seq alys,,,83.94,97.2,8
HCPCS,0427T,Insj/rplc nstim apnea pls gn,,,19174.95,22202.58,8
HCPCS,0427U,MONOCYTE DSTRBJ WDTH WHL BLD,,,4.48,2739849.3,23
HCPCS,0427U,Monocyte dstrbj wdth whl bld,,,8.48,9.82,8
HCPCS,0428T,Rmvl nstim apnea pls gen,,,2167.75,2510.02,8
HCPCS,0428U,ONC BRST CTDNA ALYS 56/> GEN,,,1239.61,2739849.3,3
HCPCS,0428U,Onc brst ctdna alys 56/> gen,,,83.94,97.2,8
HCPCS,0429T,Rmvl nstim apnea sen ld,,,2167.75,2510.02,8
HCPCS,0429U,HPV OROP SWAB 14 HI-RISK TYP,,,19.1,2739849.3,23
HCPCS,0429U,Hpv orop swab 14 hi-risk typ,,,33.62,38.93,8
HCPCS,0430T,Rmvl nstim apnea stimj ld,,,2167.75,2510.02,8
HCPCS,0430U,GI MALABS AAT CALPRO PNCRTC,,,7.06,2739849.3,23
HCPCS,0430U,Gi malabs aat calpro pncrtc,,,18.15,21.01,8
HCPCS,0431T,Rmvl/rplc nstim apnea pls gn,,,19174.95,22202.58,8
HCPCS,0431U,SPSDEV GLYCINE RECEPTOR ALPHA1 IGG,252.0,163.8,5.95,252.0,82
HCPCS,0432T,Repos nstim apnea stimj ld,,,2167.75,2510.02,8
HCPCS,0432U,KLHL11 ANTB SR/CSF ASY QUAL,,,5.95,2739849.3,23
HCPCS,0432U,Klhl11 antb sr/csf asy qual,,,18.15,21.01,8
HCPCS,0433T,Repos nstim apnea sensing ld,,,2167.75,2510.02,8
HCPCS,0433U,ONC PRST8 5 DNA REG MRK PCR,,,304.0,2739849.3,23
HCPCS,0433U,Onc prst8 5 dna reg mrk pcr,,,83.94,97.2,8
HCPCS,0434T,Interro eval npgs apnea,,,22.84,26.44,8
HCPCS,0434U,RX METAB ADVRS VRNT ALYS 25,,,416.78,2739849.3,23
HCPCS,0434U,Rx metab advrs vrnt alys 25,,,83.94,97.2,8
HCPCS,0435T,Prgrmg eval npgs apnea 1 ses,,,22.84,26.44,8
HCPCS,0435U,ONC CHEMO RX CYTOX CSC 14 RX,,,7.46,2739849.3,23
HCPCS,0435U,Onc chemo rx cytox csc 14 rx,,,18.31,21.2,8
HCPCS,0436T,Prgrmg eval npgs apnea study,,,22.84,26.44,8
HCPCS,0436U,ONC LNG PLSM ALYS 388 PRTN,,,699.2,2739849.3,16
HCPCS,0436U,Onc lng plsm alys 388 prtn,,,83.94,97.2,8
HCPCS,0437T,IMPLTJ NONBIOL/SYNTH IMPLT FASC RNFCMT ABDL WALL,2128.0,1383.2,1.1,2128.0,86
HCPCS,0437T,Impltj synth rnfcmt abdl wal,,,3392.26,3927.88,8
HCPCS,0437U,PSYC ANXIETY DO MRNA 15 BMRK,,,423.14,2739849.3,23
HCPCS,0437U,Psyc anxiety do mrna 15 bmrk,,,83.94,97.2,8
HCPCS,0438U,RX METAB ADVRS VRNT ALYS 33,,,416.78,2739849.3,23
HCPCS,0438U,Rx metab advrs vrnt alys 33,,,83.94,97.2,8
HCPCS,0439T,MYOCARDIAL PERFUSION ECHO ISCHM/VIABILITY ASSMT,1940.0,1261.0,1.1,3228.0,152
HCPCS,0439U,CRD CHD DNA ALYS 5 SNP 3 DNA,,,854.0,1921.5,13
HCPCS,0439U,Crd chd dna alys 5 snp 3 dna,,,83.94,97.2,8
HCPCS,0440T,ABLTJ PERC CRYOABLTJ IMG GDN UXTR/PERPH NERVE,4397.0,2858.0499999999997,0.01,7811.0,171
HCPCS,0440U,CRD CHD DNA ALYS 10 SNP 6DNA,,,854.0,1921.5,13
HCPCS,0440U,Crd chd dna alys 10 snp 6dna,,,83.94,97.2,8
HCPCS,0441T,ABLTJ PERC CRYOABLTJ IMG GDN LXTR/PERPH NERVE,4459.0,2898.35,0.01,7811.0,171
HCPCS,0441U,NFCT DS BCT FNGL/VIRAL SEMIQ,,,444.08,999.18,13
HCPCS,0441U,Nfct ds bct fngl/viral semiq,,,83.94,97.2,8
HCPCS,0442T,ABLTJ PERC CRYOABLTJ IMG GDN NRV PLEX/TRNCL NRV,6831.0,4440.15,1.1,19428.17,170
HCPCS,0442U,NFCT DS RESPIR NFCTJ MXA&CRP,,,41.38,93.11,20
HCPCS,0442U,Nfct ds respir nfctj mxa&crp,,,83.94,97.2,8
HCPCS,0443T,R-t spctrl alys prst8 tiss,,,37.39,43.3,8
HCPCS,0443U,NEURFLMNT LT CHN ULTRSENS IA,,,116.23,261.53,13
HCPCS,0443U,Neurflmnt lt chn ultrsens ia,,,16.64,19.27,8
HCPCS,0444T,1st plmt drug elut oc ins,,,45.54,52.73,8
HCPCS,0444U,ONC SLD ORGN NEO TGSAP 361,,,2919.6,6569.1,20
HCPCS,0444U,Onc sld orgn neo tgsap 361,,,83.94,97.2,8
HCPCS,0445T,Sbsqt plmt drug elut oc ins,,,45.54,52.73,8
HCPCS,0445U,ABETA42 & PTAU181 ECLIA CSF,,,260.5,586.13,20
HCPCS,0445U,Abeta42 & ptau181 eclia csf,,,83.94,97.2,8
HCPCS,0446T,CRTJ SUBQ INSJ IMPLTBL GLUCOSE SENSOR SYS TRAIN,502.0,326.3,1.1,10073.0,128
HCPCS,0446T,CRTJ SUBQ INSJ IMPLTBL GLUCOSE SENSOR SYS TRAIN (0446T),13002.0,8451.3,0.01,13002.0,87
HCPCS,0446U,AI DS SLE ALYS 10 CYTOKINE,,,840.65,1891.47,20
HCPCS,0446U,Ai ds sle alys 10 cytokine,,,83.94,97.2,8
HCPCS,0447T,(2017) RMVL IMPLTBL GLUCOSE SENSOR SUBQ POCKET VIA INC,536.0,348.4,1.1,584.65,128
HCPCS,0447T,RMVL IMPLTBL GLUCOSE SENSOR,,,173.69,208.8,20
HCPCS,0447T,Rmvl impltbl glucose sensor,,,168.79,195.44,8
HCPCS,0447U,AI DS SLE ALYS 11 CYTOKINE,,,840.65,1891.47,20
HCPCS,0447U,Ai ds sle alys 11 cytokine,,,83.94,97.2,8
HCPCS,0448T,(2017) RMVL INSJ IMPLTBL GLUC SENSOR DIF ANATOMIC SITE,764.0,496.6,1.1,10031.47,128
HCPCS,0448T,REMVL INSJ IMPLTBL GLUC SENS,,,1582.09,4329.65,20
HCPCS,0448T,Remvl insj impltbl gluc sens,,,389.36,450.84,8
HCPCS,0448U,Onc lng&cln ca dna qual ngs,,,83.94,97.2,8
HCPCS,0449T,INSJ AQUEOUS DRAIN DEV 1ST,,,4534.31,5537.8,20
HCPCS,0449T,INSJ AQUEOUS DRAIN DEV W/O EO RSVR INITIAL DEV,6351.0,4128.15,1.1,15243.78,86
HCPCS,0449T,Insj aqueous drain dev 1st,,,2420.84,2803.08,8
HCPCS,0449U,CAR SCR SEV INH COND 5 GENES,,,2737.32,4105.98,2
HCPCS,0449U,Car scr sev inh cond 5 genes,,,83.94,97.2,8
HCPCS,0450T,Insj aqueous drain dev each,,,2420.84,2803.08,8
HCPCS,0450U,ONC MM LC-MS/MS MONOC P-PRTN,,,43.43,65.15,7
HCPCS,0450U,Onc mm lc-ms/ms monoc p-prtn,,,83.94,97.2,8
HCPCS,0451T,Insj/rplcmt aortic ventr sys,,,68198.62,78966.82,8
HCPCS,0451U,ONC MM LC-MS/MS PEP ION QUAN,,,43.43,65.15,7
HCPCS,0451U,Onc mm lc-ms/ms pep ion quan,,,83.94,97.2,8
HCPCS,0452T,Insj/rplcmt dev vasc seal,,,68198.62,78966.82,8
HCPCS,0452U,ONC BLDR MTHYL PENK LTE-QMSP,,,192.0,432.0,20
HCPCS,0452U,Onc bldr mthyl penk lte-qmsp,,,83.94,97.2,8
HCPCS,0453T,Insj/rplcmt mech-elec ntrfce,,,68198.62,78966.82,8
HCPCS,0453U,ONC CLRCT CA CFDNA QPCR ASY,,,192.0,432.0,20
HCPCS,0453U,Onc clrct ca cfdna qpcr asy,,,83.94,97.2,8
HCPCS,0454T,Insj/rplcmt subq electrode,,,68198.62,78966.82,8
HCPCS,0454U,RARE DS ID OPT GENOME MAPG,,,1263.53,2842.95,20
HCPCS,0454U,Rare ds id opt genome mapg,,,83.94,97.2,8
HCPCS,0455T,Remvl aortic ventr cmpl sys,,,3007.01,3481.8,8
HCPCS,0455U,NFCT AGT STI MULT AMP PRB UR,,,142.63,320.93,20
HCPCS,0455U,Nfct agt sti mult amp prb ur,,,16.64,19.27,8
HCPCS,0456T,Remvl aortic dev vasc seal,,,3007.01,3481.8,8
HCPCS,0456U,Ai ra ngs 19 genes anti-ccp,,,83.94,97.2,8
HCPCS,0457T,Remvl mech-elec skin ntrfce,,,3007.01,3481.8,8
HCPCS,0457U,PFAS 9 CMPND LC-MS/MS PLS/SR,,,198.74,447.17,20
HCPCS,0457U,Pfas 9 cmpnd lcms/ms pls/sr,,,18.15,21.01,8
HCPCS,0458T,Remvl subq electrode,,,806.19,933.48,8
HCPCS,0458U,ONC BRST CA S100 A8&A9 ELISA,,,260.5,586.13,20
HCPCS,0458U,Onc brst ca s100 a8&a9 elisa,,,83.94,97.2,8
HCPCS,0459T,Relocaj rplcmt aortic ventr,,,68198.62,78966.82,8
HCPCS,0459U,ABETA42 & TTAU ECLIA CSF,,,260.5,586.13,20
HCPCS,0459U,Abeta42 & ttau eclia csf,,,83.94,97.2,8
HCPCS,0460T,Repos aortic ventr dev eltrd,,,806.19,933.48,8
HCPCS,0460U,ONC WHL BLD/BUCC RTPCR 24GEN,,,917.08,2063.43,13
HCPCS,0460U,Onc whl bld/bucc rtpcr 24gen,,,83.94,97.2,8
HCPCS,0461T,Repos aortic contrpulsj dev,,,3007.01,3481.8,8
HCPCS,0461U,ONC RXGENOM ALYS RTPCR 24GEN,,,917.08,2063.43,13
HCPCS,0461U,Onc rxgenom alys rtpcr 24gen,,,83.94,97.2,8
HCPCS,0462T,Prgrmg eval aortic ventr sys,,,22.84,26.44,8
HCPCS,0462U,MELATONIN LVL TST SLP STD7/9,,,17.27,38.87,20
HCPCS,0462U,Melatonin lvl tst slp std7/9,,,83.94,97.2,8
HCPCS,0463T,Interrog aortic ventr sys,,,22.84,26.44,8
HCPCS,0463U,ONC CRVX MRNA GENXPRSN 14BMK,,,760.0,1710.0,13
HCPCS,0463U,Onc crvx mrna genxprsn 14bmk,,,83.94,97.2,8
HCPCS,0464T,VISUAL EP TEST FOR GLAUCOMA,,,121.73,407.79,21
HCPCS,0464T,Visual ep test for glaucoma,,,48.64,56.32,8
HCPCS,0464U,ONC CLRCT SCR QRTSA DNA MRK,,,591.92,1331.82,14
HCPCS,0464U,Onc clrct scr qrtsa dna mrk,,,83.94,97.2,8
HCPCS,0465T,Supchrdl njx rx w/o supply,,,45.54,52.73,8
HCPCS,0465U,ONC URTHL CARC DNA QMSP 2GEN,,,1938.01,4360.53,20
HCPCS,0465U,Onc urthl carc dna qmsp 2gen,,,83.94,97.2,8
HCPCS,0466T,Insj ch wal respir eltrd/ra,,,19174.95,22202.58,8
HCPCS,0466U,CRD CAD DNA GWAS 564856 SNP,,,345.43,777.23,13
HCPCS,0466U,Crd cad dna gwas 564856 snp,,,83.94,97.2,8
HCPCS,0467T,Revj/rplmnt ch respir eltrd,,,2167.75,2510.02,8
HCPCS,0467U,ONC BLDR DNA NGS 60GEN&ANEUP,,,1519.06,3417.89,20
HCPCS,0467U,Onc bldr dna ngs 60gen&aneup,,,83.94,97.2,8
HCPCS,0468T,Rmvl ch wal respir eltrd/ra,,,2167.75,2510.02,8
HCPCS,0468U,HEP NASH MIR-34A5P A2M YKL40,,,251.7,566.33,20
HCPCS,0468U,Hep nash mir34a5p a2m ykl40,,,83.94,97.2,8
HCPCS,0469T,RTA POLARIZE SCAN OC SCR BI,,,2739849.3,2739849.3,1
HCPCS,0469T,Rta polarize scan oc scr bi,,,47.73,55.26,8
HCPCS,0469U,RARE DS WHL GEN SEQ FTL SAMP,,,1197.94,2695.37,20
HCPCS,0469U,Rare ds whl gen seq ftl samp,,,83.94,97.2,8
HCPCS,0470T,Oct skn img acquisj i&r 1st,,,71.45,82.73,8
HCPCS,0470U,ONC OROP DETCJ MRD 8 DNA HPV,,,597.91,1345.31,13
HCPCS,0470U,Onc orop detcj mrd 8 dna hpv,,,83.94,97.2,8
HCPCS,0471T,Oct skn img acquisj i&r addl,,,71.45,82.73,8
HCPCS,0471U,ONC CLRC CA 35 VRN KRAS&NRAS,,,760.0,1710.0,20
HCPCS,0471U,Onc clrc ca 35 vrn kras&nras,,,83.94,97.2,8
HCPCS,0472T,PRGRMG IO RTA ELTRD RA,,,259.13,779.78,21
HCPCS,0472T,Prgrmg io rta eltrd ra,,,22.84,26.44,8
HCPCS,0472U,CA VI PSP&SP1 ANTB SJÖGREN,,,27.9,62.78,13
HCPCS,0472U,Ca vi psp&sp1 antb sjogren,,,83.94,97.2,8
HCPCS,0473T,REPRGRMG IO RTA ELTRD RA,,,83.98,252.71,21
HCPCS,0473T,Reprgrmg io rta eltrd ra,,,22.84,26.44,8
HCPCS,0473U,ONC SLD TUM BLD/SLV 648 GENE,,,4500.0,10125.0,20
HCPCS,0473U,Onc sld tum bld/slv 648 gene,,,83.94,97.2,8
HCPCS,0474T,INSJ ANT SEG AQUEOUS DRG DEV W/IO RSVR,5757.0,3742.05,1.1,5757.0,90
HCPCS,0474T,Insj aqueous drg dev io rsvr,,,2420.84,2803.08,8
HCPCS,0474U,HERED PAN CA GSAP 88GENE NGS,,,1303.95,2933.9,20
HCPCS,0474U,Hered pan ca gsap 88gene ngs,,,83.94,97.2,8
HCPCS,0475T,Rec ftl car sgl 3 ch i&r,,,23.5,27.21,8
HCPCS,0475U,HERED PRST8 CA GSAP 23 GENES,,,1303.95,2933.9,20
HCPCS,0475U,Hered prst8 ca gsap 23 genes,,,83.94,97.2,8
HCPCS,0476T,Rec ftl car sgl elec tr data,,,23.5,27.21,8
HCPCS,0476U,RX METAB PSYC 14GEN&CYP2D6,,,416.78,937.76,20
HCPCS,0476U,Rx metab psyc 14gen&cyp2d6,,,173.12,200.45,8
HCPCS,0477T,Rec ftl car sgl xrtj alys,,,23.5,27.21,8
HCPCS,0477U,RX METAB PSY 14&CYP2D6 GN-RX,,,416.78,937.76,20
HCPCS,0477U,Rx metab psy 14&cyp2d6 gn-rx,,,173.12,200.45,8
HCPCS,0478T,Rec ftl car 3 ch rev i&r,,,23.5,27.21,8
HCPCS,0478U,ONC NSCLC DNA&RNA DPCR 9GENS,,,552.99,1244.24,13
HCPCS,0478U,Onc nsclc dna&rna dpcr 9gens,,,83.94,97.2,8
HCPCS,0479T,FXJL ABL LSR 1ST 100 SQ CM,,,544.87,769.14,20
HCPCS,0479T,Fxjl abl lsr 1st 100 sq cm,,,239.13,276.89,8
HCPCS,0479U,TAU PHOSPHORYLATED PTAU217,,,17.27,38.87,20
HCPCS,0479U,Tau phosphorylated ptau217,,,83.94,97.2,8
HCPCS,0480T,Fxjl abl lsr ea addl 100sqcm,,,239.13,276.89,8
HCPCS,0480U,NFCT DS CSF METAG NGS ALYS,,,2126.2,4783.95,20
HCPCS,0480U,Nfct ds csf metag ngs alys,,,83.94,97.2,8
HCPCS,0481T,NJX AUTOL WBC CONCENTRATE,,,345.67,1040.19,21
HCPCS,0481T,Njx autol wbc concentrate,,,453.96,525.64,8
HCPCS,0481U,IDH1 IDH2&TERT PROMOTER NGS,,,674.24,1517.04,20
HCPCS,0481U,Idh1 idh2&tert promoter ngs,,,83.94,97.2,8
HCPCS,0482U,OB PE BIOCHEM ASY SFLT1&PLGF,,,128.82,289.85,20
HCPCS,0482U,Ob pe biochem asy sflt1&plgf,,,83.94,97.2,8
HCPCS,0483T,TMVI W/PROSTHETIC VALVE PERCUTANEOUS APPROACH,13335.5,8668.075,1.1,3060831.65,152
HCPCS,0483U,NFCT DS NG GYRA S91F PT MUT,,,35.09,78.96,13
HCPCS,0483U,Nfct ds ng gyra s91f pt mut,,,16.64,19.27,8
HCPCS,0484T,TMVI W/PROSTHETIC VALVE TRANSTHORACIC EXPOSURE,20803.5,13522.275,1.1,3060831.65,152
HCPCS,0484U,NFCT DS MGEN 23S RRNA PT MUT,,,35.09,78.96,13
HCPCS,0484U,Nfct ds mgen 23s rrna pt mut,,,16.64,19.27,8
HCPCS,0485T,OCT MID EAR I&R UNILATERAL,,,34.79,104.7,21
HCPCS,0485T,Oct mid ear i&r unilateral,,,40.0,46.32,8
HCPCS,0485U,ONC SOL TUM CFDNA&RNA NGS GM,,,3649.48,8211.33,13
HCPCS,0485U,Onc sol tum cfdna&rna ngs gm,,,83.94,97.2,8
HCPCS,0486T,OCT MID EAR I&R BILATERAL,,,34.79,104.7,21
HCPCS,0486T,Oct mid ear i&r bilateral,,,40.0,46.32,8
HCPCS,0486U,ONC PAN SOL TUM NGS CFCTDNA,,,1644.25,3699.57,13
HCPCS,0486U,Onc pan sol tum ngs cfctdna,,,83.94,97.2,8
HCPCS,0487T,Trvg biomchn mapg w/reprt,,,97.71,113.14,8
HCPCS,0487U,ONC SOL TUM CFCDNA TGSAP 84,,,2919.6,6569.1,20
HCPCS,0487U,Onc sol tum cfcdna tgsap 84,,,83.94,97.2,8
HCPCS,0488T,DIABETES PREV ONLINE/ELEC,,,2739849.3,2739849.3,1
HCPCS,0488U,OB FETAL AG NIPT CFDNA ALYS,,,1138.58,1707.87,2
HCPCS,0488U,Ob fetal ag nipt cfdna alys,,,83.94,97.2,8
HCPCS,0489T,REGN CELL TX SCLDR HANDS,,,2739849.3,2739849.3,1
HCPCS,0489T,Regn cell tx scldr hands,,,453.96,525.64,8
HCPCS,0489U,OB SGNIPT CFDNA SEQ ALYS 1+,,,2595.65,2595.65,1
HCPCS,0489U,Ob sgnipt cfdna seq alys 1+,,,83.94,97.2,8
HCPCS,0490T,REGN CELL TX SCLDR H MLT INJ,,,2739849.3,2739849.3,1
HCPCS,0490T,Regn cell tx scldr h mlt inj,,,453.96,525.64,8
HCPCS,0490U,ONC CUTAN/UVEAL MLNMA CD146,,,2435.0,5478.75,20
HCPCS,0490U,Onc cutan/uveal mlnma cd146,,,83.94,97.2,8
HCPCS,0491T,Abl lsr opn wnd 1st 20 sqcm,,,239.13,276.89,8
HCPCS,0491U,ONC SOL TUM CTC SLCT ER PRTN,,,2435.0,5478.75,20
HCPCS,0491U,Onc sol tum ctc slct er prtn,,,83.94,97.2,8
HCPCS,0492T,Abl lsr opn wnd addl 20 sqcm,,,239.13,276.89,8
HCPCS,0492U,ONC SOL TUM CTC SLCTN PD-L1,,,2435.0,5478.75,20
HCPCS,0492U,Onc sol tum ctc slctn pd-l1,,,83.94,97.2,8
HCPCS,0493T,Cntc near ifr spectrsc wound,,,86.82,100.53,8
HCPCS,0493U,TRNSPL MED QUAN DD-CFDNA NGS,,,2753.25,6194.82,20
HCPCS,0493U,Trnspl med quan dd-cfdna ngs,,,672.05,778.16,8
HCPCS,0494T,PREP & CANNULJ CDVR DON LUNG,,,2739849.3,2739849.3,1
HCPCS,0494T,Prep & cannulj cdvr don lung,,,1229.51,1423.64,8
HCPCS,0494U,RBC AG FTL RHD GENE ALYS NGS,,,759.05,1707.87,20
HCPCS,0494U,Rbc ag ftl rhd gene alys ngs,,,83.94,97.2,8
HCPCS,0495T,MNTR CDVR DON LNG 1ST 2 HRS,,,2739849.3,2739849.3,1
HCPCS,0495T,Mntr cdvr don lng 1st 2 hrs,,,1229.51,1423.64,8
HCPCS,0495U,ONC PRST8 ALYS CRCG PLSM PRT,,,760.0,1710.0,20
HCPCS,0495U,Onc prst8 alys crcg plsm prt,,,83.94,97.2,8
HCPCS,0496T,MNTR CDVR DON LNG EA ADDL HR,,,2739849.3,2739849.3,1
HCPCS,0496T,Mntr cdvr don lng ea addl hr,,,1229.51,1423.64,8
HCPCS,0496U,ONC CLRCT CFDNA 8/7 GENES,,,485.86,1093.19,13
HCPCS,0496U,Onc clrct cfdna 8/7 genes,,,116.49,134.88,8
HCPCS,0497T,Xtrnl pt act ecg in-off conn,,,23.5,27.21,8
HCPCS,0497U,ONC PRST8 MRNA RT-PCR 6GENES,,,3873.0,8714.25,20
HCPCS,0497U,Onc prst8 mrna rt-pcr 6genes,,,83.94,97.2,8
HCPCS,0498T,Xtrnl pt act ecg r&i pr 30 d,,,23.5,27.21,8
HCPCS,0498U,ONC CLRCT NGS MUT DETC 43GEN,,,1345.31,3026.96,13
HCPCS,0498U,Onc clrct ngs mut detc 43gen,,,83.94,97.2,8
HCPCS,0499T,Cysto f/urtl strix/stenosis,,,2111.89,2445.34,8
HCPCS,0499U,ONC CLRCT&LNG DNA NGS 8GENES,,,597.91,1345.31,20
HCPCS,0499U,Onc clrct&lng dna ngs 8genes,,,83.94,97.2,8
HCPCS,0500F,INITIAL PRENATAL CARE VISIT,77.0,50.05,1.1,171.66,69
HCPCS,0500F,Initial prenatal care visit,,,10.69,12.38,8
HCPCS,0500T,HPV 5+ HI RISK HPV TYPES,,,15.21,2739849.3,3
HCPCS,0500T,Hpv 5+ hi risk hpv types,,,16.64,19.27,8
HCPCS,0500U,AUTOINFLAM DS VEXAS SYND DNA,,,175.4,394.65,20
HCPCS,0500U,Autoinflam ds vexas synd dna,,,83.94,97.2,8
HCPCS,0501F,PRENATAL FLOW SHEET,,,0.03,0.03,1
HCPCS,0501F,Prenatal flow sheet,,,10.69,12.38,8
HCPCS,0501T,Cor ffr derived cor cta data,,,453.45,525.05,8
HCPCS,0501U,ONC CLRC BLD QUAN MEAS CFDNA,,,432.0,432.0,1
HCPCS,0501U,Onc clrc bld quan meas cfdna,,,83.94,97.2,8
HCPCS,0502F,SUBSEQUENT PRENATAL CARE,,,0.03,0.03,1
HCPCS,0502F,Subsequent prenatal care,,,10.69,12.38,8
HCPCS,0502T,Cor ffr data prep & transmis,,,86.82,100.53,8
HCPCS,0502U,HPV E6/E7 MRK HI-RSK TYP CRV,,,35.09,78.96,20
HCPCS,0502U,Hpv e6/e7 mrk hi-rsk typ crv,,,83.94,97.2,8
HCPCS,0503F,POSTPARTUM CARE VISIT,77.0,50.05,1.1,171.66,69
HCPCS,0503F,Postpartum care visit,,,10.69,12.38,8
HCPCS,0503T,Cor ffr alys gnrj ffr mdl,,,453.45,525.05,8
HCPCS,0503U,NEURO ALZ DS ßAMYL&TAU PRTN,,,750.0,1687.5,20
HCPCS,0503U,Neuro alz ds bamyl&tau prtn,,,83.94,97.2,8
HCPCS,0504T,Cor ffr data review i&r,,,86.82,100.53,8
HCPCS,0504U,NFCT DS UTI ID 17 PATH ORGS,,,416.78,937.76,20
HCPCS,0504U,Nfct ds uti id 17 path orgs,,,49.14,56.9,8
HCPCS,0505F,HEMODIALYSIS PLAN DOCD,,,2739849.3,2739849.3,1
HCPCS,0505F,Hemodialysis plan docd,,,10.69,12.38,8
HCPCS,0505T,EV FEMPOP ARTL REVSC TCAT PLMT IV ST GRF & CLSR,29463.5,19151.275,1.1,47987.95,170
HCPCS,0505U,NFCT DS VAG INFCTJ ID 32ORGS,,,679.77,1529.49,20
HCPCS,0505U,Nfct ds vag infctj id 32orgs,,,16.64,19.27,8
HCPCS,0506T,MAC PGMT OPT DNS MEAS HFP,,,53.07,159.69,21
HCPCS,0506T,Mac pgmt opt dns meas hfp,,,47.73,55.26,8
HCPCS,0506U,GI BARRETTS ESOPHGL CELL 89,,,1938.01,4360.53,20
HCPCS,0506U,Gi barretts esophgl cell 89,,,83.94,97.2,8
HCPCS,0507F,PERITON DIALYSIS PLAN DOCD,,,2739849.3,2739849.3,1
HCPCS,0507F,Periton dialysis plan docd,,,10.69,12.38,8
HCPCS,0507T,NEAR IFR 2IMG MIBMN GLND I&R,,,53.07,159.69,21
HCPCS,0507T,Near ifr 2img mibmn glnd i&r,,,47.73,55.26,8
HCPCS,0507U,ONC OVR DNA WHOLE GEN W/5HMC,,,1160.0,2610.0,20
HCPCS,0507U,Onc ovr dna whole gen w/5hmc,,,83.94,97.2,8
HCPCS,0508U,Trnsplj med dd-cfdna 40 snps,,,83.94,97.2,8
HCPCS,0509F,URINE INCON PLAN DOCD,,,0.03,0.03,1
HCPCS,0509F,Urine incon plan docd,,,10.69,12.38,8
HCPCS,0509T,PATTERN ELECTRORETINOGRAPHY W/I&R,1246.0,809.9,48.64,1246.0,86
HCPCS,0509T,PATTERN ERG W/I&R,160.0,104.0,1.1,160.0,124
HCPCS,0509U,Trnsplj med dd-cfdna<12 snps,,,83.94,97.2,8
HCPCS,0510T,RMVL SINUS TARSI IMPLANT,,,2808.13,8450.24,21
HCPCS,0510T,Rmvl sinus tarsi implant,,,1754.89,2031.98,8
HCPCS,0510U,ONC PNCRTC CA ALG ALYS 16GEN,,,473.91,1066.31,13
HCPCS,0510U,Onc pncrtc ca alg alys 16gen,,,83.94,97.2,8
HCPCS,0511T,RMVL&RINSJ SINUS TARSI IMPLT,,,6206.54,18676.74,21
HCPCS,0511T,Rmvl&rinsj sinus tarsi implt,,,4090.38,4736.23,8
HCPCS,0511U,ONC SOL TUM 3DMICROENVIR 36+,,,3033.86,6826.19,20
HCPCS,0511U,Onc sol tum 3dmicroenvir 36+,,,83.94,97.2,8
HCPCS,0512T,ESW INTEG WND HLG 1ST WND,,,173.69,522.66,21
HCPCS,0512T,Esw integ wnd hlg 1st wnd,,,239.13,276.89,8
HCPCS,0512U,ONC PRST8 ALYS DGTZ IMG MSI,,,706.25,1589.07,20
HCPCS,0512U,Onc prst8 alys dgtz img msi,,,83.94,97.2,8
HCPCS,0513F,ELEV BP PLAN OF CARE DOCD,,,2739849.3,2739849.3,1
HCPCS,0513F,Elev bp plan of care docd,,,10.69,12.38,8
HCPCS,0513T,Esw integ wnd hlg ea addl,,,239.13,276.89,8
HCPCS,0513U,ONC PRST8 ALG ALYS MSI&HRD,,,706.25,1589.07,20
HCPCS,0513U,Onc prst8 alg alys msi&hrd,,,83.94,97.2,8
HCPCS,0514F,CARE PLAN HGB DOCD ESA PT,,,2739849.3,2739849.3,1
HCPCS,0514F,Care plan hgb docd esa pt,,,10.69,12.38,8
HCPCS,0514T,Intraop vis axis id pt fixj,,,48.64,56.32,8
HCPCS,0514U,GI IBD IA QUAN DETER ADL LVL,,,38.57,86.79,20
HCPCS,0514U,Gi ibd ia quan deter adl lvl,,,18.31,21.2,8
HCPCS,0515T,INSERTION WRLS CAR STIMULATOR LV PACG COMPL SYS,20524.5,13340.925,1.1,68747.0,254
HCPCS,0515U,GI IBD IA QUAN DETER IFX LVL,,,38.57,86.79,20
HCPCS,0515U,Gi ibd ia quan deter ifx lvl,,,18.31,21.2,8
HCPCS,0516F,ANEMIA PLAN OF CARE DOCD,,,2739849.3,2739849.3,1
HCPCS,0516F,Anemia plan of care docd,,,10.69,12.38,8
HCPCS,0516T,INSERTION WRLS CAR STIMULATOR LV PACG ELTRD ONLY,14618.0,9501.7,1.1,33436.0,171
HCPCS,0516U,RX METAB RXGENOMIC GNOTYP 40,,,416.78,937.76,20
HCPCS,0516U,Rx metab rxgenomic gnotyp 40,,,83.94,97.2,8
HCPCS,0517F,GLAUCOMA PLAN OF CARE DOCD,,,0.03,0.03,1
HCPCS,0517F,Glaucoma plan of care docd,,,10.69,12.38,8
HCPCS,0517T,INSERTION WRLS CAR STIMULATOR LV PACG BTH COMPNT,12008.0,7805.2,1.1,33436.0,171
HCPCS,0517U,THER RX MNTR 80+ PSYACTIV RX,,,246.92,555.57,20
HCPCS,0517U,Ther rx mntr 80+ psyactiv rx,,,18.31,21.2,8
HCPCS,0518F,FALL PLAN OF CARE DOCD,,,0.03,0.03,1
HCPCS,0518F,Fall plan of care docd,,,10.69,12.38,8
HCPCS,0518T,REMOVAL PG WCS LV PACG BATTERY COMPONENT ONLY,8543.0,5552.95,1.1,14557.0,170
HCPCS,0518U,THER RX MNTR 90+ PN&MTL HLTH,,,246.92,555.57,20
HCPCS,0518U,Ther rx mntr 90+ pn&mtl hlth,,,18.31,21.2,8
HCPCS,0519F,PLAND CHEMO DOCD B/4 TXMNT,,,2739849.3,2739849.3,1
HCPCS,0519F,Pland chemo docd b/4 txmnt,,,10.69,12.38,8
HCPCS,0519T,REMOVAL&RPLCMT PG WCS LV PACG BOTH COMPONENTS,22195.0,14426.75,1.1,41861.0,170
HCPCS,0519U,THER RX MNTR MEDS P/D/A 110+,,,246.92,555.57,20
HCPCS,0519U,Ther rx mntr meds p/d/a 110+,,,18.31,21.2,8
HCPCS,0520F,RAD DOS LIMTS B/4 3D RAD,,,2739849.3,2739849.3,1
HCPCS,0520F,Rad dos limts b/4 3d rad,,,10.69,12.38,8
HCPCS,0520T,RMVL&RPLCMT PG WCS LV PACG BATTERY COMPNT ONLY,10396.5,6757.725,1.1,31142.61,170
HCPCS,0520U,THER RX MNTR 200+ RX/SBSTS,,,246.92,555.57,20
HCPCS,0520U,Ther rx mntr 200+ rx/sbsts,,,18.31,21.2,8
HCPCS,0521F,PLAN OF CARE 4 PAIN DOCD,,,0.03,0.03,1
HCPCS,0521F,Plan of care 4 pain docd,,,10.69,12.38,8
HCPCS,0521T,INTERROG DEV EVAL WRLS CAR STIMULATOR IN PERSON,203.0,131.95,1.1,308.0,257
HCPCS,0521U,RF IGA&IGM CCP ANTB SR-A IA,,,51.8,116.55,13
HCPCS,0521U,Rf iga&igm ccp antb sr-a ia,,,83.94,97.2,8
HCPCS,0522T,PRGRMG DEVICE EVAL WRLS CAR STIMULATOR IN PERSON,276.0,179.39999999999998,1.1,403.0,257
HCPCS,0522U,CA VI PSP&SP1 ANTB CL SEMIQL,,,260.5,586.13,13
HCPCS,0522U,Ca vi psp&sp1 antb cl semiql,,,83.94,97.2,8
HCPCS,0523T,INTRAPROCEDURAL CORONARY FFP W/3D FUNCJL MAPPING,2593.0,1685.45,1.1,7735.57,86
HCPCS,0523T,INTRAPROCEDURAL CORONARY FRACTIONAL FLOW RESERVE (FFR) WITH 3D F,9923.5,6450.275000000001,1.1,17254.0,152
HCPCS,0523U,ONC SOLTUM DNA NGS SNV 22GEN,,,1352.09,3042.21,13
HCPCS,0523U,Onc soltum dna ngs snv 22gen,,,83.94,97.2,8
HCPCS,0524T,EV CATH DIR CHEM ABLTJ W/IMG,,,2765.32,8321.41,21
HCPCS,0524T,Ev cath dir chem abltj w/img,,,2140.36,2478.31,8
HCPCS,0524U,OB PE SFLT-1/PLGF IA SRM/PLS,,,128.82,289.85,13
HCPCS,0524U,Ob pe sflt-1/plgf ia srm/pls,,,83.94,97.2,8
HCPCS,0525F,INITIAL VISIT FOR EPISODE,,,2739849.3,2739849.3,1
HCPCS,0525F,Initial visit for episode,,,10.69,12.38,8
HCPCS,0525T,INSERTION/REPLACEMENT COMPLETE IIMS,9883.0,6423.95,1.1,31142.61,254
HCPCS,0525U,ONC SPHRD CELL CUL 11-RX PNL,,,3033.86,6826.19,13
HCPCS,0525U,Onc sphrd cell cul 11-rx pnl,,,83.94,97.2,8
HCPCS,0526F,SUBS VISIT FOR EPISODE,,,2739849.3,2739849.3,1
HCPCS,0526F,Subs visit for episode,,,10.69,12.38,8
HCPCS,0526T,INSERTION/REPLACEMENT IIMS ELECTRODE ONLY,6625.0,4306.25,1.1,33436.0,256
HCPCS,0526U,Nefro rnl trnspl quan cxcl10,,,83.94,97.2,8
HCPCS,0527T,INSERTION/REPLACEMENT IIMS IMPLANTABLE MNTR ONLY,17617.0,11451.05,1.1,33436.0,256
HCPCS,0527U,HSV 1&2 VZV AMP PRB TQ PTHGN,,,142.63,320.93,13
HCPCS,0527U,Hsv 1&2 vzv amp prb tq pthgn,,,16.64,19.27,8
HCPCS,0528F,RCMND FLW-UP 10 YRS DOCD,,,2739849.3,2739849.3,1
HCPCS,0528F,Rcmnd flw-up 10 yrs docd,,,10.69,12.38,8
HCPCS,0528T,PRGRMG DEVICE EVAL IIMS IN PERSON,212.5,138.125,1.1,276.0,171
HCPCS,0528U,LRT IAD 18BCT/8VIR&7ARG RNA,,,634.84,1428.39,13
HCPCS,0528U,Lrt iad 18bct/8vir&7arg rna,,,16.64,19.27,8
HCPCS,0529F,INTRVL 3/>YR PTS CLNSCP DOCD,,,2739849.3,2739849.3,1
HCPCS,0529F,Intrvl 3/>yr pts clnscp docd,,,10.69,12.38,8
HCPCS,0529T,INTERROGATION DEVICE EVAL IIMS IN PERSON,166.0,107.9,1.1,183.0,171
HCPCS,0529U,Hem vte snp f2&f5 gen leiden,,,83.94,97.2,8
HCPCS,0530T,REMOVAL COMPLETE IIMS INCL IMG S&I,9578.5,6226.025,1.1,14557.0,254
HCPCS,0530U,ONC PAN-SOL TUM CTDNA 77 GEN,,,2919.6,6569.1,13
HCPCS,0530U,Onc pan-sol tum ctdna 77 gen,,,83.94,97.2,8
HCPCS,0531T,REMOVAL IIMS ELECTRODE ONLY INCL IMG S&I,8903.0,5786.95,1.1,14557.0,254
HCPCS,0531U,Nfct ds afb&inv fng 673orgs,,,83.94,97.2,8
HCPCS,0532T,REMOVAL IIMS IMPLANTABLE MNTR ONLY INCL IMG S&I,7954.0,5170.099999999999,1.1,14557.0,254
HCPCS,0532U,RARE DS WHLGEN&MITOCHDRL DNA,,,5031.2,11320.2,13
HCPCS,0532U,Rare ds whlgen&mitochdrl dna,,,83.94,97.2,8
HCPCS,0533T,Cont rec mvmt do 6-10 days,,,86.64,100.32,8
HCPCS,0533U,RX METAB ADVRS GNOTYP 16GENS,,,416.78,937.76,13
HCPCS,0533U,Rx metab advrs gnotyp 16gens,,,83.94,97.2,8
HCPCS,0534T,Cont rec mvmt do setup&train,,,39.1,45.28,8
HCPCS,0534U,Onc prst8 mirna snp 32 vrnt,,,83.94,97.2,8
HCPCS,0535F,DYSPNEA MNGMNT PLAN DOCD,,,2739849.3,2739849.3,1
HCPCS,0535F,Dyspnea mngmnt plan docd,,,10.69,12.38,8
HCPCS,0535T,Cont rec mvmt do reprt cnfig,,,86.64,100.32,8
HCPCS,0535U,PFAS LC-MS/MS PLSM/SRM QUAN,,,62.14,139.82,13
HCPCS,0535U,Pfas lc-ms/ms plsm/srm quan,,,18.15,21.01,8
HCPCS,0536T,Cont rec mvmt do dl w/i&r,,,86.64,100.32,8
HCPCS,0536U,RBCAG FTL RHD PCR ALYS EXON4,,,192.0,432.0,13
HCPCS,0536U,Rbcag ftl rhd pcr alys exon4,,,83.94,97.2,8
HCPCS,0537T,BLD DRV T LYMPHCYT CAR-T CLL,,,2739849.3,2739849.3,1
HCPCS,0537T,Bld drv t lymphcyt car-t cll,,,149.22,172.78,8
HCPCS,0537U,ONC CLRCT CA CFDNA >2500 DMR,,,1495.0,3363.75,13
HCPCS,0537U,Onc clrct ca cfdna >2500 dmr,,,83.94,97.2,8
HCPCS,0538T,BLD DRV T LYMPHCYT PREP TRNS,,,2739849.3,2739849.3,1
HCPCS,0538T,Bld drv t lymphcyt prep trns,,,149.22,172.78,8
HCPCS,0538U,ONC SOL TUM NGTS FFPE 600GEN,,,2989.55,6726.5,13
HCPCS,0538U,Onc sol tum ngts ffpe 600gen,,,83.94,97.2,8
HCPCS,0539T,RECEIPT&PREP CAR-T CLL ADMN,,,2739849.3,2739849.3,1
HCPCS,0539T,Receipt&prep car-t cll admn,,,149.22,172.78,8
HCPCS,0539U,ONC SOL TUMOR CFCTDNA 152GEN,,,3288.51,7399.16,13
HCPCS,0539U,Onc sol tumor cfctdna 152gen,,,83.94,97.2,8
HCPCS,0540F,GLUCO MNGMNT PLAN DOCD,,,2739849.3,2739849.3,1
HCPCS,0540F,Gluco mngmnt plan docd,,,10.69,12.38,8
HCPCS,0540T,CAR-T CLL ADMN AUTOLOGOUS,,,293.81,884.14,2
HCPCS,0540T,Car-t cll admn autologous,,,149.22,172.78,8
HCPCS,0540U,TRNSPLJ MED QUAN DD-CFDNA,,,2753.25,6194.82,13
HCPCS,0540U,Trnsplj med quan dd-cfdna,,,83.94,97.2,8
HCPCS,0541T,MYOCARDIAL IMAGING MCG,,,353.04,1399.26,21
HCPCS,0541T,Myocardial imaging mcg,,,255.48,295.82,8
HCPCS,0541U,Cv ds hdl rct cec lc-ms/ms 5,,,83.94,97.2,8
HCPCS,0542T,MYOCARDIAL IMAGING MCG I&R,,,2739849.3,2739849.3,1
HCPCS,0542T,Myocardial imaging mcg i&r,,,255.48,295.82,8
HCPCS,0542U,Nefro renal trnspl ur nmr 84,,,83.94,97.2,8
HCPCS,0543T,TA MV RPR W/ARTIF CHORD TEND,,,2739849.3,2739849.3,1
HCPCS,0543T,TRANSAPICAL MV RPR W/TTE PLMT ARTIF CHORDAE TEND,17505.0,11378.25,1.1,3060831.65,86
HCPCS,0543T,Ta mv rpr w/artif chord tend,,,14291.15,16547.65,8
HCPCS,0543U,ONC SOL TUM NGS DNA 517 GENS,,,2989.55,6726.5,13
HCPCS,0543U,Onc sol tum ngs dna 517 gens,,,83.94,97.2,8
HCPCS,0544T,TCAT MV ANN RCNSTJ W/IMPL ADJST ANN RCNSTJ DEV,21154.0,13750.1,1.1,3060831.65,86
HCPCS,0544T,TCAT MV ANNULUS RCNSTJ,,,2739849.3,2739849.3,1
HCPCS,0544T,Tcat mv annulus rcnstj,,,14291.15,16547.65,8
HCPCS,0544U,Nefro trnsp mntr 48vrnt dpcr,,,83.94,97.2,8
HCPCS,0545F,FOLLOW UP CARE PLAN MDD DOCD,,,0.03,0.03,1
HCPCS,0545F,Follow up care plan mdd docd,,,10.69,12.38,8
HCPCS,0545T,TCAT TV ANN RCNSTJ W/IMPL ADJST ANN RCNSTJ DEV,16993.5,11045.775,1.1,3060831.65,152
HCPCS,0545U,ACHR ANTB ID IMFLUOR LIVECLL,,,37.73,84.9,13
HCPCS,0545U,Achr antb id imfluor livecll,,,23.08,26.72,8
HCPCS,0546T,Rf spectrsc ntraop mrgn asmt,,,86.82,100.53,8
HCPCS,0546U,LDNS LRP4 ANTB IMFLR LIVECLL,,,37.73,84.9,13
HCPCS,0546U,Ldns lrp4 antb imflr livecll,,,23.08,26.72,8
HCPCS,0547T,B1 MATRL QUAL TST MCRIND TIB,,,591.95,2739849.3,3
HCPCS,0547U,NEURFLMNT LT CHN CLEIA PLSM,,,116.23,261.53,13
HCPCS,0547U,Neurflmnt lt chn cleia plsm,,,16.64,19.27,8
HCPCS,0548T,Tprnl balo cntnc dev bi,,,3635.15,4209.12,8
HCPCS,0548U,GFAP CLEIA PLASMA,,,116.23,261.53,13
HCPCS,0548U,Gfap cleia plasma,,,16.64,19.27,8
HCPCS,0549T,Tprnl balo cntnc dev uni,,,2111.89,2445.34,8
HCPCS,0549U,ONC URTHL DNA MTHYLTD RT PCR,,,760.0,1710.0,13
HCPCS,0549U,Onc urthl dna mthyltd rt pcr,,,83.94,97.2,8
HCPCS,0550F,CYTOPATH REPORT NONGYN SPCMN,,,129.47,129.47,1
HCPCS,0550F,Cytopath report nongyn spcmn,,,10.69,12.38,8
HCPCS,0550T,Tprnl balo cntnc dev rmvl ea,,,2111.89,2445.34,8
HCPCS,0550U,Onc prst8 elisa tot&free psa,,,18.15,21.01,8
HCPCS,0551F,CYTOPATH REPORT NON ROUTINE,,,2739849.3,2739849.3,1
HCPCS,0551F,Cytopath report non routine,,,10.69,12.38,8
HCPCS,0551T,Tprnl balo cntnc dev adjmt,,,284.76,329.73,8
HCPCS,0551U,Tp ptau217 ult dgt prtn detj,,,83.94,97.2,8
HCPCS,0552T,LOW-LEVEL LASER THERAPY,,,61.65,61.65,1
HCPCS,0552T,Low-level laser therapy,,,31.09,36.0,8
HCPCS,0552U,Repr med pga gdo te bx locus,,,83.94,97.2,8
HCPCS,0553T,PERQ TCAT ILIAC ANAST IMPLT,,,2739849.3,2739849.3,1
HCPCS,0553T,Perq tcat iliac anast implt,,,8435.63,9767.57,8
HCPCS,0553U,REPR MED PGA EMBRY TE STRUX,,,759.05,1707.87,13
HCPCS,0553U,Repr med pga embry te strux,,,83.94,97.2,8
HCPCS,0554T,B1 STR & FX RSK ANALYSIS,,,85.57,2739849.3,3
HCPCS,0554U,REPR MED PGA 24CHRM TE BX QC,,,759.05,1707.87,13
HCPCS,0554U,Repr med pga 24chrm te bx qc,,,83.94,97.2,8
HCPCS,0555F,SYMPTOM MGMNT PLAN CARE DOCD,,,2739849.3,2739849.3,1
HCPCS,0555F,Symptom mgmnt plan care docd,,,10.69,12.38,8
HCPCS,0555T,B1 STR&FX RSK TRANSMIS DATA,,,22.7,124.9,23
HCPCS,0555T,B1 str&fx rsk transmis data,,,86.82,100.53,8
HCPCS,0555U,REPR MED PGA EMBRYONIC TE QC,,,759.05,1707.87,13
HCPCS,0555U,Repr med pga embryonic te qc,,,83.94,97.2,8
HCPCS,0556F,PLAN CARE LIPID CONTROL DOCD,,,0.03,0.03,1
HCPCS,0556F,Plan care lipid control docd,,,10.69,12.38,8
HCPCS,0556T,B1 STR & FX RSK ASSESSMENT,,,212.58,1165.03,23
HCPCS,0556U,NFCT DS P-S DNA&RNA 12 TRGTS,,,142.63,320.93,13
HCPCS,0556U,Nfct ds p-s dna&rna 12 trgts,,,83.94,97.2,8
HCPCS,0557F,PLAN CAREMNG ANGNL SYMPTDOCD,,,2739849.3,2739849.3,1
HCPCS,0557F,Plan caremng angnl symptdocd,,,10.69,12.38,8
HCPCS,0557T,B1 STR & FX RSK I&R,,,21.2,2739849.3,3
HCPCS,0557T,B1 str & fx rsk i&r,,,405.62,469.67,8
HCPCS,0557U,NFCT DS BV DNA MRK VAG FLUID,,,262.99,591.74,13
HCPCS,0557U,Nfct ds bv dna mrk vag fluid,,,83.94,97.2,8
HCPCS,0558T,CT SCAN F/BIOMCHN CT ALYS,,,78.83,409.57,23
HCPCS,0558T,Ct scan f/biomchn ct alys,,,71.45,82.73,8
HCPCS,0558U,ONC CLRCT ELISA BF7 AG SERUM,,,20.81,46.83,13
HCPCS,0558U,Onc clrct elisa bf7 ag serum,,,83.94,97.2,8
HCPCS,0559T,ANATOMIC MODEL 3D PRINTED 1ST COMPNT ANTMC STRUX,238.0,154.7,53.07,281.79,85
HCPCS,0559U,ONC BRS QUAN ELISA BF9AG SRM,,,20.81,46.83,13
HCPCS,0559U,Onc brs quan elisa bf9ag srm,,,83.94,97.2,8
HCPCS,0560T,ANATOMIC MODEL 3D PRINTED EA ADDL COMPONENT,126.0,81.9,27.47,126.0,66
HCPCS,0560U,ONC MRD GSA CFDNA BASELINE,,,3878.45,8726.52,13
HCPCS,0560U,Onc mrd gsa cfdna baseline,,,83.94,97.2,8
HCPCS,0561T,ANATOMIC GUIDE 3D PRINTED 1ST ANATOMIC GUIDE,238.0,154.7,53.07,281.79,85
HCPCS,0561U,ONC MRD GSA CFDNA SUBSEQUENT,,,794.49,1787.61,13
HCPCS,0561U,Onc mrd gsa cfdna subsequent,,,83.94,97.2,8
HCPCS,0562T,ANATOMIC GUIDE 3D PRINTED EA ADDL ANATOMIC GUIDE,64.0,41.6,13.95,100.53,66
HCPCS,0562U,ONC SOL TUM TGSA 33GENS SNVS,,,597.91,1345.31,13
HCPCS,0562U,Onc sol tum tgsa 33gens snvs,,,83.94,97.2,8
HCPCS,0563T,EVAC MEIBOMIAN GLND HEAT BI,,,53.07,159.69,21
HCPCS,0563T,Evac meibomian glnd heat bi,,,48.64,56.32,8
HCPCS,0563U,NFCT DS PTHGN-SNA 11VIR&4BCT,,,416.78,937.76,13
HCPCS,0563U,Nfct ds pthgn-sna 11vir&4bct,,,83.94,97.2,8
HCPCS,0564T,ONC CHEMO RX CYTOTOX CSC 14,,,47.01,231.78,4
HCPCS,0564T,Onc chemo rx cytotox csc 14,,,18.31,21.2,8
HCPCS,0564U,NFCT DS PTHGN-SNA 10VIR&4BCT,,,416.78,937.76,13
HCPCS,0564U,Nfct ds pthgn-sna 10vir&4bct,,,83.94,97.2,8
HCPCS,0565T,AUTOL CELL IMPLT ADPS HRVG,,,2739849.3,2739849.3,1
HCPCS,0565T,Autol cell implt adps hrvg,,,251.58,291.3,8
HCPCS,0565U,ONC HCC NGS DETC 6626EPIGALT,,,1160.0,2610.0,13
HCPCS,0565U,Onc hcc ngs detc 6626epigalt,,,83.94,97.2,8
HCPCS,0566T,Autol cell implt adps njx,,,174.77,202.37,8
HCPCS,0566U,ONC LNG QPCR-BSD ALYS 13DMRS,,,416.78,937.76,13
HCPCS,0566U,Onc lng qpcr-bsd alys 13dmrs,,,83.94,97.2,8
HCPCS,0567T,PERM FLP TUBE OCCLS W/IMPLT,,,2739849.3,2739849.3,1
HCPCS,0567T,Perm flp tube occls w/implt,,,1703.89,1972.93,8
HCPCS,0567U,RARE DS WHL GEN SEQ SRS&LRS,,,5031.2,11320.2,13
HCPCS,0567U,Rare ds whl gen seq srs&lrs,,,83.94,97.2,8
HCPCS,0568T,INTRO MIX SALINE&AIR F/SSG,,,2739849.3,2739849.3,1
HCPCS,0568T,Intro mix saline&air f/ssg,,,112.68,130.47,8
HCPCS,0568U,NEUROL DEMENTIA BAMYL PTAU,,,897.0,2018.25,13
HCPCS,0568U,Neurol dementia bamyl ptau,,,83.94,97.2,8
HCPCS,0569T,TTVR PERCUTANEOUS APPROACH INITIAL PROSTHESIS,13197.5,8578.375,1.1,18286.41,218
HCPCS,0569U,Onc sol tum ngs tmm>20000dmr,,,83.94,97.2,8
HCPCS,0570T,TTVR PERCUTANEOUS APPROACH EACH ADDL PROSTHESIS,9576.0,6224.4,1.1,3060831.65,218
HCPCS,0570U,NEUROL TBI ALYS GFAP&UCH-L1,,,260.5,586.13,13
HCPCS,0570U,Neurol tbi alys gfap&uch-l1,,,83.94,97.2,8
HCPCS,0571T,INSJ/RPLCMT ICDS W/SUBSTERNAL ELECTRODE,28314.5,18404.425,1.1,95950.11,507
HCPCS,0571U,ONC SOL TUM DNA80&RNA10G NGS,,,2919.6,6569.1,13
HCPCS,0571U,Onc sol tum dna80&rna10g ngs,,,83.94,97.2,8
HCPCS,0572T,INSJ SUBSTERNAL IMPLANTABLE DEFIBRILLATOR ELTRD,17794.0,11566.099999999999,1.1,33104.0,507
HCPCS,0572U,Onc prst8 httl qfish whl bld,,,83.94,97.2,8
HCPCS,0573T,RMVL SUBSTERNAL IMPLANTABLE DEFIBRILLATOR ELTRD,12417.5,8071.375,1.1,14557.0,423
HCPCS,0573U,Onc pancreas 3bmrk pclf alg,,,83.94,97.2,8
HCPCS,0574T,REPOS PREV IMPL SS IMPLTBL DFB PACING ELTRD,8696.0,5652.4,1.1,14557.0,423
HCPCS,0574U,Mtb cfp-10 serum/plsm lc-ms,,,33.62,38.93,8
HCPCS,0575F,HIV RNA PLAN CARE DOCD,,,2739849.3,2739849.3,1
HCPCS,0575F,Hiv rna plan care docd,,,10.69,12.38,8
HCPCS,0575T,PRGRMG DEV EVAL ICDS SS IP,,,32.72,98.45,21
HCPCS,0575T,PROGRAMMING DEV EVAL ICDS W/SS ELTRD IN PERSON,299.0,194.35,1.1,299.0,86
HCPCS,0575T,Prgrmg dev eval icds ss ip,,,22.84,26.44,8
HCPCS,0575U,TRNSPLJ MED LAR RTPCR 4GENES,,,380.0,855.0,13
HCPCS,0575U,Trnsplj med lar rtpcr 4genes,,,83.94,97.2,8
HCPCS,0576T,INTERROGATION DEV EVAL ICDS W/SS ELTRD IN PERSON,275.5,179.075,1.1,402.0,171
HCPCS,0576U,TRNSPLJ MED LAR QUAN DDCFDNA,,,3240.0,7290.0,13
HCPCS,0576U,Trnsplj med lar quan ddcfdna,,,83.94,97.2,8
HCPCS,0577T,ELECTROPHYSIOLOGIC EVAL ICDS W/SS ELECTRODE,3635.0,2362.75,1.1,4856.0,171
HCPCS,0577U,ONC OVR SERUM ALYS 39 GPS,,,246.92,555.57,13
HCPCS,0577U,Onc ovr serum alys 39 gps,,,83.94,97.2,8
HCPCS,0578T,REM INTERROG DEV EVAL SS LD ICDS & UP TO 90D PHY/QHP,662.0,430.3,1.1,3060831.65,86
HCPCS,0578T,REM INTERROG DEV ICDS PHYS,,,2739849.3,2739849.3,1
HCPCS,0578T,Rem interrog dev icds phys,,,22.84,26.44,8
HCPCS,0578U,ONC CUTAN MLN RNA QPCR 10GEN,,,3873.0,8714.25,13
HCPCS,0578U,Onc cutan mln rna qpcr 10gen,,,83.94,97.2,8
HCPCS,0579T,REM INTERROG DEV EVAL SS LD ICDS & UP TO 90D TECH,643.0,417.95,1.1,643.0,86
HCPCS,0579T,REM INTERROG DEV EVAL SS LD ICDS < 90D TECH,149.0,96.85,22.84,149.0,85
HCPCS,0579U,NFRO DBTC CKD ELISA APOA4,,,390.75,879.2,13
HCPCS,0579U,Nfro dbtc ckd elisa apoa4,,,83.94,97.2,8
HCPCS,0580F,MULTIDISCIPLINARY CARE PLAN,,,2739849.3,2739849.3,1
HCPCS,0580F,Multidisciplinary care plan,,,10.69,12.38,8
HCPCS,0580T,RMVL SUBSTERNAL IMPLTBL DFB PULSE GENERATOR ONLY,7982.0,5188.299999999999,1.1,14557.0,507
HCPCS,0580U,BBRGDRFERI LD ANTB DETCJ 31,,,17.21,38.73,13
HCPCS,0580U,Bbrgdrferi ld antb detcj 31,,,23.08,26.72,8
HCPCS,0581F,PT TRNSFRD FROM ANESTH TO CC,,,2739849.3,2739849.3,1
HCPCS,0581F,Pt trnsfrd from anesth to cc,,,10.69,12.38,8
HCPCS,0581T,ABLATION MAL BRST TUMOR PERQ CRTX UNILATERAL,8528.5,5543.525,0.01,15317.0,389
HCPCS,0581U,TRNSPL MED ANTB NOHLA 39TRGT,,,325.8,733.05,13
HCPCS,0581U,Trnspl med antb nohla 39trgt,,,67.56,78.23,8
HCPCS,0582F,NO TRNSFR FROM ANESTH TO CC,,,2739849.3,2739849.3,1
HCPCS,0582F,No trnsfr from anesth to cc,,,10.69,12.38,8
HCPCS,0582T,TRURL ABLTJ MAL PRST8 TISS HI ENERGY WATER VAPOR,5675.0,3688.75,0.01,3060831.65,315
HCPCS,0582U,RARE DS RPD WHLGEN DNA VRNTS,,,7582.2,17059.95,13
HCPCS,0582U,Rare ds rpd whlgen dna vrnts,,,83.94,97.2,8
HCPCS,0583F,TRANSFER CARE CHECKLIST USED,,,2739849.3,2739849.3,1
HCPCS,0583F,Transfer care checklist used,,,10.69,12.38,8
HCPCS,0583T,TYMPANOSTOMY AUTOMATED TUBE DELIVERY SYSTEM,3937.0,2559.05,0.01,7431.0,206
HCPCS,0583U,RARE DS RPD WHLGEN CMPTR DNA,,,3791.1,8529.98,13
HCPCS,0583U,Rare ds rpd whlgen cmptr dna,,,83.94,97.2,8
HCPCS,0584F,NO TRANSFERCARE CHKLIST USED,,,2739849.3,2739849.3,1
HCPCS,0584F,No transfercare chklist used,,,10.69,12.38,8
HCPCS,0584T,PERQ ISLET CELL TRANSPLANT,,,2739849.3,2739849.3,1
HCPCS,0584T,Perq islet cell transplant,,,3471.98,4020.19,8
HCPCS,0584U,NEURO CSF PRION PRTN QUAL,,,540.99,1217.24,13
HCPCS,0584U,Neuro csf prion prtn qual,,,83.94,97.2,8
HCPCS,0585T,LAPS ISLET CELL TRANSPLANT,,,2739849.3,2739849.3,1
HCPCS,0585T,Laps islet cell transplant,,,3471.98,4020.19,8
HCPCS,0585U,TGSAP SO NEO CFDNA 521 GENES,,,2919.6,6569.1,13
HCPCS,0585U,Tgsap so neo cfdna 521 genes,,,83.94,97.2,8
HCPCS,0586T,OPEN ISLET CELL TRANSPLANT,4196.0,2727.4,1.1,3060831.65,87
HCPCS,0586T,Open islet cell transplant,,,3471.98,4020.19,8
HCPCS,0586U,ONC MRNA GEN XPRSN 216 GENES,,,2919.6,6569.1,13
HCPCS,0586U,Onc mrna gen xprsn 216 genes,,,83.94,97.2,8
HCPCS,0587T,PERCUTANEOUS IMPLANTATION/REPLACEMENT ISDNS PTN,7752.0,5038.8,284.76,7752.0,170
HCPCS,0587T,PERQ IMPLTJ/RPLCMT ISDNS BLDR DYSF PTN,5612.5,3648.125,0.01,19945.48,171
HCPCS,0587U,THER RX MNTR 60-150RX&METABL,,,114.43,257.48,13
HCPCS,0587U,Ther rx mntr 60150rx&metabl,,,18.31,21.2,8
HCPCS,0588T,REVISION OR REMOVAL ISDNS POSTERIOR TIBIAL NRV,13756.0,8941.4,284.76,13756.0,85
HCPCS,0588T,REVJ/ OR RMVL PERQ ISDNS BLDR DYSF PTN,8278.0,5380.7,0.01,13756.0,256
HCPCS,0588U,NFCT DS BCT/VIR 32GENES MRNA,,,760.0,1710.0,13
HCPCS,0588U,Nfct ds bct/vir 32genes mrna,,,83.94,97.2,8
HCPCS,0589T,ELEC ALYS SMPL PRGRMG IINS BLDR DYSF PTN 1-3,359.0,233.35000000000002,0.01,367.0,255
HCPCS,0589T,ELEC ALYS SMPL PRGRMG IINS PTN 1-3 PARAMETERS,367.0,238.55,0.01,367.0,84
HCPCS,0589U,PFAS24CMPND HI-PERF LC-MS/MS,,,198.74,447.17,13
HCPCS,0589U,Pfas24cmpnd hiperf lc-ms/ms,,,18.15,21.01,8
HCPCS,0590T,ELEC ALYS CPLX PRGRMG IINS BLDR DYSF PTN 4+,510.5,331.82500000000005,0.01,654.0,339
HCPCS,0590U,Nfct ds bct&fngl dna 44 orgs,,,49.14,56.9,8
HCPCS,0591T,HEALTH & WELL-BEING COACHING F2F INDIV 1ST ASSMT,92.0,59.8,0.01,92.0,133
HCPCS,0591T,HEALTH &AMP; WELL-BEING COACHING F2F INDIV 1ST ASSMT,195.0,126.75,0.48,3060831.65,86
HCPCS,0591U,ONC PRST8 CA 3PRTNS PLSM SRM,,,760.0,1710.0,13
HCPCS,0591U,Onc prst8 ca 3prtns plsm srm,,,83.94,97.2,8
HCPCS,0592T,HEALTH & WELL-BEING COACHING F2F INDIV F-UP SESS,92.0,59.8,0.01,92.0,133
HCPCS,0592T,HEALTH &AMP; WELL-BEING COACHING F2F INDIV F-UP SESS,195.0,126.75,0.48,3060831.65,86
HCPCS,0592U,ONC HL NEO DNA TGS 417 GENES,,,2919.6,6569.1,13
HCPCS,0592U,Onc hl neo dna tgs 417 genes,,,83.94,97.2,8
HCPCS,0593T,HEALTH & WELL-BEING COACHING FACE TO FACE GROUP,89.0,57.85,0.01,89.0,133
HCPCS,0593T,HEALTH &AMP; WELL-BEING COACHING FACE TO FACE GROUP,42.0,27.3,0.48,3060831.65,86
HCPCS,0593U,NFCT DS GU PTHGN DNA 46TRGT,,,634.84,1428.39,13
HCPCS,0593U,Nfct ds gu pthgn dna 46trgt,,,49.14,56.9,8
HCPCS,0594T,OSTEOT HUM XTRNL LNGTH DEV,,,6206.54,18676.74,21
HCPCS,0594T,Osteot hum xtrnl lngth dev,,,3275.28,3792.43,8
HCPCS,0594U,Nfct ds sepsis pncrtc spc,,,49.14,56.9,8
HCPCS,0595U,NFCT DS TFP VCTRBRN&ZOONOTIC,,,262.99,591.74,13
HCPCS,0595U,Nfct ds tfp vctrbrn&zoonotic,,,49.14,56.9,8
HCPCS,0596T,TEMP FML IU VLV-PMP 1ST INSJ,,,592.63,725.67,20
HCPCS,0596T,Temp fml iu vlv-pmp 1st insj,,,284.76,329.73,8
HCPCS,0596U,Neuro alzds plsm 3dstnct isp,,,18.15,21.01,8
HCPCS,0597T,TEMP FML IU VALVE-PMP RPLCMT,,,592.63,725.67,20
HCPCS,0597T,Temp fml iu valve-pmp rplcmt,,,284.76,329.73,8
HCPCS,0597U,Onc breast rna xprsn 329gens,,,83.94,97.2,8
HCPCS,0598T,R-T FLUOR WOUND IMG 1ST SITE,,,204.28,1338.77,23
HCPCS,0598T,R-t fluor wound img 1st site,,,86.82,100.53,8
HCPCS,0598U,GI IBS IGG ANTB 18FOOD ITEMS,,,300.0,675.0,13
HCPCS,0598U,Gi ibs igg antb 18food items,,,83.94,97.2,8
HCPCS,0599T,R-t fluor wound img ea addl,,,86.82,100.53,8
HCPCS,0599U,ONC PNCRTC CA MULT IA SERUM,,,897.0,2018.25,13
HCPCS,0599U,Onc pncrtc ca mult ia serum,,,83.94,97.2,8
HCPCS,0600T,IRE ABLATION 1+TUMORS PER ORGAN W/IMG GDN PERQ,12650.0,8222.5,1.1,30070.59,171
HCPCS,0600U,Nfct ds wnd infctj 65orgs&30,,,16.64,19.27,8
HCPCS,0601T,ABLTJ IRE 1+TUMORS OPEN,,,8930.36,26873.26,21
HCPCS,0601T,Abltj ire 1+tumors open,,,2029.97,2350.49,8
HCPCS,0601T,IRE ABLATION 1+TUMORS PR ORGN W/FLUOR & US GDN OPN,13390.0,8703.5,1.1,30022.29,86
HCPCS,0601U,Nfct ds pji alys 11 bmrks ia,,,83.94,97.2,8
HCPCS,0602T,TRANSDERMAL GFR MEASUREMENTS,,,452.99,2739849.3,3
HCPCS,0602T,Transdermal gfr measurements,,,18.15,21.01,8
HCPCS,0602U,Endocrin dm ins gen mthyltn,,,83.94,97.2,8
HCPCS,0603T,TRANSDERMAL GFR MONITORING,,,1143.09,2739849.3,3
HCPCS,0603T,Transdermal gfr monitoring,,,18.15,21.01,8
HCPCS,0603U,Rx asy prsmv 77rx/metablt ur,,,30.12,34.88,8
HCPCS,0604T,REM OCT RTA DEV SETUP&EDUCAJ,,,114.68,601.13,4
HCPCS,0604T,Rem oct rta dev setup&educaj,,,47.73,55.26,8
HCPCS,0604U,All&immunology crae 4bk pep,,,18.15,21.01,8
HCPCS,0605T,REM OCT RTA TECHL SPRT MIN 8,,,32.72,188.08,4
HCPCS,0605T,Rem oct rta techl sprt min 8,,,47.73,55.26,8
HCPCS,0605U,All&immunology hat tpsab1,,,83.94,97.2,8
HCPCS,0606T,REM OCT RTA PHYS/QHP EA 30D,,,65.16,2739849.3,3
HCPCS,0606T,Rem oct rta phys/qhp ea 30d,,,405.62,469.67,8
HCPCS,0606U,Hem red cll memb do rbc oge,,,8.48,9.82,8
HCPCS,0607T,REM MNTR PULM FLU MNTR SETUP,,,2739849.3,2739849.3,1
HCPCS,0607T,Rem mntr pulm flu mntr setup,,,86.64,100.32,8
HCPCS,0607U,Reprdtve med ema rtpcr 31bct,,,83.94,97.2,8
HCPCS,0608T,REM MNTR PULM FLU MNTR ALYS,,,2739849.3,2739849.3,1
HCPCS,0608T,Rem mntr pulm flu mntr alys,,,86.64,100.32,8
HCPCS,0608U,Reprdtve med ema rtpcr 10bct,,,83.94,97.2,8
HCPCS,0609T,MRS DISC PAIN ACQUISJ DATA,,,212.58,1165.03,23
HCPCS,0609T,Mrs disc pain acquisj data,,,255.48,295.82,8
HCPCS,0609U,Onc prostate ia tot&free psa,,,18.15,21.01,8
HCPCS,0610T,Mrs disc pain transmis data,,,86.64,100.32,8
HCPCS,0610U,Nfct ds antmcr sc phenotypic,,,16.64,19.27,8
HCPCS,0611T,MRS DISC PAIN ALG ALYS DATA,,,212.58,1165.03,23
HCPCS,0611T,Mrs disc pain alg alys data,,,86.64,100.32,8
HCPCS,0611U,Onc lvr alys >1000 mr cfdna,,,83.94,97.2,8
HCPCS,0612T,MRS DISCOGENIC PAIN I&R,,,63.59,2739849.3,3
HCPCS,0612T,Mrs discogenic pain i&r,,,405.62,469.67,8
HCPCS,0612U,Onc lvr alys >1000 mr cfdna,,,83.94,97.2,8
HCPCS,0613T,PERQ TCAT IMPLTJ INTRATRL SEPTAL SHUNT DEVICE,12890.0,8378.5,1.1,3060831.65,86
HCPCS,0613T,PERQ TCAT INTRATRL SEPTL SHT,,,2739849.3,2739849.3,1
HCPCS,0613T,Perq tcat intratrl septl sht,,,14291.15,16547.65,8
HCPCS,0613U,Onc uc dna mthyltn&mut 6bmrk,,,83.94,97.2,8
HCPCS,0614T,RMVL&RPLCMT SS IMPL DFB PG,,,20449.5,61536.7,21
HCPCS,0614T,Rmvl&rplcmt ss impl dfb pg,,,21832.77,25280.05,8
HCPCS,0614U,Iem pmd alys 4 nzm cplx page,,,20.86,24.16,8
HCPCS,0615T,AUTO ALYS BINOCULAR EYE MVMT,,,110.82,333.49,21
HCPCS,0615T,Auto alys binocular eye mvmt,,,48.64,56.32,8
HCPCS,0615U,Bbrgdrferi ld antb detcj 26,,,23.08,26.72,8
HCPCS,0616T,INSERTION OF IRIS PROSTHESIS,,,15051.58,45293.27,2
HCPCS,0616T,Insertion of iris prosthesis,,,381.15,441.33,8
HCPCS,0616U,Neurol dementia alys >30000,,,83.94,97.2,8
HCPCS,0617T,INSJ IRIS PROSTH W/RMVL&INSJ,,,15051.58,45293.27,2
HCPCS,0617T,Insj iris prosth w/rmvl&insj,,,2420.84,2803.08,8
HCPCS,0617U,Cv ascvd dna alys >20000,,,83.94,97.2,8
HCPCS,0618T,INSJ IRIS PROSTH SEC IO LENS,,,15051.58,45293.27,2
HCPCS,0618T,Insj iris prosth sec io lens,,,2420.84,2803.08,8
HCPCS,0618U,Psyc bd dna mthyl alys>10000,,,83.94,97.2,8
HCPCS,0619T,CYSTO W/PRST8 COMMISSUROTOMY,,,7992.18,9509.0,9
HCPCS,0619T,Cysto w/prst8 commissurotomy,,,3284.72,3803.36,8
HCPCS,0619U,Pulm copd dna alys >18000,,,83.94,97.2,8
HCPCS,0620T,ENDOVASCULAR VENOUS ARTERIALIZATION TIBL/PRNL VN,20241.0,13156.650000000001,1.1,84180.56,256
HCPCS,0620U,Onc hcc dna mthyln alys>5000,,,83.94,97.2,8
HCPCS,0621T,TRABECULOSTOMY AB INTERNO BY LASER,3772.0,2451.8,1.1,11858.31,86
HCPCS,0621T,TRABECULOSTOMY INTERNO LASER,,,3729.35,10614.49,20
HCPCS,0621T,Trabeculostomy interno laser,,,381.15,441.33,8
HCPCS,0621U,Nfct ds lb dna alys>10000,,,83.94,97.2,8
HCPCS,0622T,TRABECULOSTOMY AB INTERNO LASER W/OPH ENDOSCOPE,3772.0,2451.8,1.1,3060831.65,86
HCPCS,0622T,TRABECULOSTOMY INT LSR W/SCP,,,2739849.3,2739849.3,1
HCPCS,0622T,Trabeculostomy int lsr w/scp,,,381.15,441.33,8
HCPCS,0622U,Psyc mdd dna alys >20000,,,83.94,97.2,8
HCPCS,0623T,AUTO QUANTIFICATION C PLAQUE,,,2739849.3,2739849.3,1
HCPCS,0623T,Auto quantification c plaque,,,71.45,82.73,8
HCPCS,0623U,Ai ms dna mthyl alys >5000,,,83.94,97.2,8
HCPCS,0624T,Auto quan c plaq data prep,,,86.82,100.53,8
HCPCS,0624U,Hep nash dna mthyl alys 5000,,,83.94,97.2,8
HCPCS,0625T,AUTO QUAN C PLAQ CPTR ALYS,,,865.47,2604.37,9
HCPCS,0625T,Auto quan c plaq cptr alys,,,86.82,100.53,8
HCPCS,0625U,Endocrinol op dna alys>5000,,,83.94,97.2,8
HCPCS,0626T,AUTO QUAN C PLAQ I&R,,,2739849.3,2739849.3,1
HCPCS,0626T,Auto quan c plaq i&r,,,86.82,100.53,8
HCPCS,0626U,Neurol pd dna alys >20000,,,83.94,97.2,8
HCPCS,0627T,PERQ NJX ALGC CELL &/PRDCT UNI/BI FLUOR LMBR 1ST,5626.5,3657.225,1.1,38384.94,256
HCPCS,0627U,Psyc scz dna alys >15000,,,83.94,97.2,8
HCPCS,0628T,PERQ NJX ALGC CELL &/PRDCT UNI/BI FLUOR LMBR EA,1078.0,700.7,1.1,4628.0,152
HCPCS,0628U,Nfro kdn ds genetic cond 449,,,83.94,97.2,8
HCPCS,0629T,PERQ NJX ALGC CELL&/PRDCT UNI/BI CT LMBR 1ST,3050.5,1982.8249999999998,1.1,38384.94,171
HCPCS,0629U,Nfct ds tb dna aly 1trgt pcr,,,83.94,97.2,8
HCPCS,0630T,PERQ NJX ALGC CELL&/PRDCT UNI/BI CT LMBR EA,1078.0,700.7,1.1,4628.0,152
HCPCS,0630U,Onc brst mrna gen prflg 80,,,83.94,97.2,8
HCPCS,0631T,TC VIS LIT HYPERSPECTRAL IMG,,,22.7,77.73,9
HCPCS,0631T,Tc vis lit hyperspectral img,,,86.82,100.53,8
HCPCS,0632T,PERQ TCAT US ABLTJ NRV P-ART,,,15212.67,45778.03,21
HCPCS,0632T,Perq tcat us abltj nrv p-art,,,5870.61,6797.55,8
HCPCS,0633T,CT BREAST W/3D UNI C-,,,95.38,551.66,23
HCPCS,0633T,Ct breast w/3d uni c-,,,183.67,212.67,8
HCPCS,0634T,CT BREAST W/3D UNI C+,,,159.4,903.92,23
HCPCS,0634T,Ct breast w/3d uni c+,,,183.67,212.67,8
HCPCS,0635T,CT BREAST W/3D UNI C-/C+,,,159.4,903.92,23
HCPCS,0635T,Ct breast w/3d uni c-/c+,,,183.67,212.67,8
HCPCS,0636T,CT BREAST W/3D BI C-,,,212.58,1165.03,23
HCPCS,0636T,Ct breast w/3d bi c-,,,393.75,455.92,8
HCPCS,0637T,CT BREAST W/3D BI C+,,,330.06,1863.61,23
HCPCS,0637T,Ct breast w/3d bi c+,,,393.75,455.92,8
HCPCS,0638T,CT BREAST W/3D BI C-/C+,,,330.06,1863.61,23
HCPCS,0638T,Ct breast w/3d bi c-/c+,,,393.75,455.92,8
HCPCS,0639T,WRLS SKN SNR ANISOTROPY MEAS,,,189.2,2739849.3,3
HCPCS,0639T,Wrls skn snr anisotropy meas,,,86.64,100.32,8
HCPCS,0640T,NCNTC IFR SPCTRSC O/T PAD 1,,,34.79,104.7,21
HCPCS,0640T,Ncntc ifr spctrsc o/t pad 1,,,86.82,100.53,8
HCPCS,0641T,Ncntc nr ifr spctrsc wnd img,,,86.82,100.53,8
HCPCS,0642T,Ncntc nr ifr spctrsc wnd i&r,,,405.62,469.67,8
HCPCS,0643T,TRANSCATHETER L VENTR RESTORATION DEVICE IMPLTJ,16497.0,10723.05,1.1,3060831.65,146
HCPCS,0644T,TCAT RMVL/DEBULK ICAR MASS SUCTION DEVICE PERQ,13582.0,8828.3,1.1,22806.0,170
HCPCS,0645T,TCAT IMPLANTATION CORONARY SINUS REDUCTION DEV,26267.5,17073.875,1.1,51140.13,170
HCPCS,0646T,"TRANSCATHETER TRICUSPID VALVE REPAIR,PERCUTANEOUS APPROACH; INIT",17007.0,11054.55,3707.53,17007.0,132
HCPCS,0646T,TTVI/RPLCMT PROSTC VLV PERQ W/R HRT CATH&ANGRPH,16980.0,11037.0,1.1,3060831.65,74
HCPCS,0647T,INSJ GTUBE PERQ MAG GASTRPXY,,,1650.8,1996.98,20
HCPCS,0647T,Insj gtube perq mag gastrpxy,,,299.41,346.69,8
HCPCS,0648T,QUAN MR TIS WO MRI 1ORGN,,,517.79,2604.37,23
HCPCS,0648T,Quan mr tis wo mri 1orgn,,,255.48,295.82,8
HCPCS,0649T,QUAN MR ALYS TISS COMPOSITION W/MRI,2053.5,1334.775,1.1,3802.0,171
HCPCS,0650T,PRGRMG DEV EVAL SCRMS REMOTE,,,32.72,98.45,21
HCPCS,0650T,Prgrmg dev eval scrms remote,,,22.84,26.44,8
HCPCS,0651T,MAG CTRLD CAPSULE ENDOSCOPY,,,786.42,2366.51,21
HCPCS,0651T,Mag ctrld capsule endoscopy,,,299.41,346.69,8
HCPCS,0652T,EGD FLEXIBLE TRANSNASAL DX W/COLLJ SPEC BR/WA,1037.0,674.05,1.1,5549.59,74
HCPCS,0652T,EGD FLX TRANSNASAL DX BR/WA,,,1650.8,1996.98,20
HCPCS,0652T,Egd flx transnasal dx br/wa,,,780.28,903.49,8
HCPCS,0653T,EGD FLEXIBLE TRANSNASAL W/BIOPSY SINGLE/MULTIPLE,1013.0,658.45,1.1,5549.59,74
HCPCS,0653T,EGD FLX TRANSNASAL BX 1/MLT,,,1650.8,1996.98,20
HCPCS,0653T,Egd flx transnasal bx 1/mlt,,,780.28,903.49,8
HCPCS,0654T,EGD FLEXIBLE TRANSNASAL W/INSJ INTRAL TUBE/CATH,8136.5,5288.725,1.1,15218.0,159
HCPCS,0655T,TRANSPERINEAL FOCAL LASER ABLATION OF MALIGNANT PROSTATE TISSUE,20334.0,13217.1,0.01,20334.0,85
HCPCS,0655T,TRANSPERINEAL FOCAL LASER ABLTJ MAL PRST8 TISS,5661.0,3679.65,1.1,10168.64,86
HCPCS,0656T,ANT LMBR VRT BDY TETH <7 SEG,,,11237.56,18247.18,13
HCPCS,0656T,ANT LUMBAR/TLMBR VRT BODY TETHRG <7VRT SEG,6834.0,4442.1,1.1,12553.16,86
HCPCS,0656T,Ant lmbr vrt bdy teth <7 seg,,,14056.95,16276.47,8
HCPCS,0657T,ANT LMBR VRT BDY TETH 8+ SEG,,,16588.34,2739849.3,13
HCPCS,0657T,Ant lmbr vrt bdy teth 8+ seg,,,14056.95,16276.47,8
HCPCS,0658T,ELEC IMPD SPECTRSC 1+SKN LES,,,53.07,281.79,23
HCPCS,0658T,Elec impd spectrsc 1+skn les,,,9.22,10.68,8
HCPCS,0659T,TCAT INTRA-C NFS SUPERSAT O2 W/PERQ C REVSC AMI,12042.5,7827.625,1.1,3060831.65,152
HCPCS,0660T,IMPLT ANT SGM IO NBIO RX SYS,,,3527.34,4301.59,20
HCPCS,0660T,IMPLTJ ANT SGM IO NBIODEGRADABLE RX ELUTING SYS,3353.0,2179.45,1.1,3060831.65,86
HCPCS,0660T,Implt ant sgm io nbio rx sys,,,198.21,229.5,8
HCPCS,0661T,RMVL&RIMPLTJ ANT SGM IMPLT,,,3527.34,4301.59,20
HCPCS,0661T,Rmvl&rimpltj ant sgm implt,,,198.21,229.5,8
HCPCS,0662T,SCALP COOL 1ST MEAS&CALBRJ,,,1138.63,3426.37,9
HCPCS,0662T,Scalp cool 1st meas&calbrj,,,9.22,10.68,8
HCPCS,0663T,Scalp cool plmt mntr rmvl,,,9.22,10.68,8
HCPCS,0664T,DON HYSTERECTOMY OPEN CDVR,,,2739849.3,2739849.3,1
HCPCS,0664T,Don hysterectomy open cdvr,,,1229.51,1423.64,8
HCPCS,0665T,DON HYSTERECTOMY OPEN LIV,,,2739849.3,2739849.3,1
HCPCS,0665T,Don hysterectomy open liv,,,3181.01,3683.27,8
HCPCS,0666T,DON HYSTERECTOMY LAPS LIV,,,2739849.3,2739849.3,1
HCPCS,0666T,Don hysterectomy laps liv,,,3181.01,3683.27,8
HCPCS,0667T,DON HYSTERECTOMY RCP UTER,,,2739849.3,2739849.3,1
HCPCS,0667T,Don hysterectomy rcp uter,,,1229.51,1423.64,8
HCPCS,0668T,BKBENCH PREP DON UTER ALGRFT,,,2739849.3,2739849.3,1
HCPCS,0668T,Bkbench prep don uter algrft,,,1229.51,1423.64,8
HCPCS,0669T,BKBENCH RCNSTJ DON UTER VEN,,,2739849.3,2739849.3,1
HCPCS,0669T,Bkbench rcnstj don uter ven,,,1229.51,1423.64,8
HCPCS,0670T,BKBENCH RCNSTJ DON UTER ARTL,,,2739849.3,2739849.3,1
HCPCS,0670T,Bkbench rcnstj don uter artl,,,1229.51,1423.64,8
HCPCS,0671T,INSJ ANT SGM AQ DRG DEV 1+,,,4534.31,5537.8,20
HCPCS,0671T,INSJ ANT SGM DRG DEV TRAB MW W/O RES&CTRC RMVL1+,6351.0,4128.15,1.1,15243.78,86
HCPCS,0671T,Insj ant sgm aq drg dev 1+,,,381.15,441.33,8
HCPCS,0672T,NDOVAG CRYG RF REMDL TISS,,,2739849.3,2739849.3,1
HCPCS,0672T,Ndovag cryg rf remdl tiss,,,49.68,57.52,8
HCPCS,0673T,ABLATION B9 THYROID NODULE PERQ LASER W/IMG GDN,1537.0,999.05,1.1,9739.23,86
HCPCS,0673T,ABLTJ B9 THYR NDUL PERQ LASR,,,1406.56,4232.62,21
HCPCS,0673T,Abltj b9 thyr ndul perq lasr,,,939.63,1087.99,8
HCPCS,0674T,LAPS INSJ NW/RPCMT PRM ISDSS,,,28250.24,2739849.3,20
HCPCS,0675T,LAPS INSJ NW/RPCMT ISDSS 1LD,,,10541.85,2739849.3,20
HCPCS,0675T,Laps insj nw/rpcmt isdss 1ld,,,2167.75,2510.02,8
HCPCS,0676T,LAPS INSJ NW/RPCMT ISDSS EA,,,2739849.3,2739849.3,1
HCPCS,0676T,Laps insj nw/rpcmt isdss ea,,,2167.75,2510.02,8
HCPCS,0677T,LAPS REPOS LEAD ISDSS 1ST LD,,,9651.62,2739849.3,20
HCPCS,0677T,Laps repos lead isdss 1st ld,,,2167.75,2510.02,8
HCPCS,0678T,LAPS REPOS LEAD ISDSS EA ADD,,,2739849.3,2739849.3,1
HCPCS,0678T,Laps repos lead isdss ea add,,,2167.75,2510.02,8
HCPCS,0679T,LAPS RMVL LEAD ISDSS,,,9651.62,2739849.3,20
HCPCS,0679T,Laps rmvl lead isdss,,,2167.75,2510.02,8
HCPCS,0680T,INSJ/RPLCMT PG ONLY ISDSS,,,18354.0,2739849.3,20
HCPCS,0681T,RLCJ PULSE GEN ONLY ISDSS,,,3188.1,2739849.3,20
HCPCS,0681T,Rlcj pulse gen only isdss,,,2167.75,2510.02,8
HCPCS,0682T,REMOVAL PULSE GEN ONLY ISDSS,,,3188.1,2739849.3,20
HCPCS,0682T,Removal pulse gen only isdss,,,2167.75,2510.02,8
HCPCS,0683T,PRGRMG DEV EVAL ISDSS IP,,,34.57,2739849.3,20
HCPCS,0683T,PROGRAMMING DEVICE EVALUATION IN PERSON ISDSS,291.0,189.15,1.1,3060831.65,80
HCPCS,0683T,Prgrmg dev eval isdss ip,,,22.84,26.44,8
HCPCS,0684T,PERI-PX DEV EVAL ISDSS IP,,,2739849.3,2739849.3,1
HCPCS,0684T,PERIPROCEDURAL DEVICE EVALUATION IN PERSON ISDSS,53.0,34.45,1.1,3060831.65,80
HCPCS,0684T,Peri-px dev eval isdss ip,,,22.84,26.44,8
HCPCS,0685T,INTERROG DEV EVAL ISDSS IP,,,34.57,2739849.3,20
HCPCS,0685T,INTERROGATION DEVICE EVALUATION IN PERSON ISDSS,126.0,81.9,1.1,3060831.65,80
HCPCS,0685T,Interrog dev eval isdss ip,,,22.84,26.44,8
HCPCS,0686T,HISTOTRIPSY MAL HEPATOCELLULAR TISS W/IMG GDN,41089.0,26707.850000000002,0.01,70002.0,171
HCPCS,0687T,TX AMBLYOPIA DEV SETUP 1ST,,,2739849.3,2739849.3,1
HCPCS,0687T,Tx amblyopia dev setup 1st,,,48.64,56.32,8
HCPCS,0688T,TX AMBLYOPIA ASSMT W/REPORT,,,2739849.3,2739849.3,1
HCPCS,0689T,QUAN US TIS CHARAC W/O DX US,,,78.83,418.21,23
HCPCS,0689T,Quan us tis charac w/o dx us,,,97.71,113.14,8
HCPCS,0690T,QUANTITATIVE US TISS CHARAC I&R W/DX US SM ANAT,81.0,52.650000000000006,1.1,348.91,152
HCPCS,0691T,AUTO ALYS XST CT STD VRT FX,,,19.06,2739849.3,3
HCPCS,0692T,THERAPEUTIC ULTRAFILTRATION,,,376.61,1641.25,21
HCPCS,0692T,Therapeutic ultrafiltration,,,277.57,321.4,8
HCPCS,0693T,COMPRE FUL BDY 3D MTN ALYS,,,319.14,1774.42,23
HCPCS,0693T,Compre ful bdy 3d mtn alys,,,391.75,453.61,8
HCPCS,0694T,3d vol img&rcnstj brst/ax,,,86.82,100.53,8
HCPCS,0695T,BDY SURF ACTIVATION MAPG PM/CVDFB LEADS TM IMPLT,82.0,53.3,1.1,661.95,86
HCPCS,0695T,Bdy srf mpg pm/cvdfb tm impl,,,23.5,27.21,8
HCPCS,0696T,BDY SURF ACTIVATION MAPG PM/CVDFB LEADS TM F/UP,82.0,53.3,1.1,661.95,86
HCPCS,0696T,BDY SURF MAPG PM/CVDFB F/UP,,,32.72,98.45,21
HCPCS,0696T,Bdy surf mapg pm/cvdfb f/up,,,23.5,27.21,8
HCPCS,0697T,QUAN MR TIS WO MRI MLT ORGN,,,528.75,2604.37,23
HCPCS,0697T,Quan mr tis wo mri mlt orgn,,,255.48,295.82,8
HCPCS,0698T,QUAN MR TISS W/MRI MLT ORGN,,,865.47,2604.37,21
HCPCS,0698T,Quan mr tiss w/mri mlt orgn,,,255.48,295.82,8
HCPCS,0699T,NJX PST CHMBR EYE MEDICATION,,,2021.72,6083.76,21
HCPCS,0699T,Njx pst chmbr eye medication,,,402.04,465.52,8
HCPCS,0700T,MOLEC FLUOR IMG SUS NEV 1ST,,,80.06,2739849.3,3
HCPCS,0700T,Molec fluor img sus nev 1st,,,9.22,10.68,8
HCPCS,0701T,MOLEC FLUOR IMG SUS NEV EA,,,23.65,2739849.3,3
HCPCS,0701T,Molec fluor img sus nev ea,,,9.22,10.68,8
HCPCS,0704T,REM TX AMBLYOPIA SETUP&EDU,,,2739849.3,2739849.3,1
HCPCS,0704T,Rem tx amblyopia setup&edu,,,48.64,56.32,8
HCPCS,0705T,REM TX AMBLYOPIA TECH SPRT,,,2739849.3,2739849.3,1
HCPCS,0706T,REM TX AMBLYOPIA I&R PHY/QHP,,,2739849.3,2739849.3,1
HCPCS,0707T,NJX BONE SUB MATRL INTO SUBCHONDRAL BONE DEFECT,6972.0,4531.8,1.1,12978.0,170
HCPCS,0708T,ID CA IMMNTX PREP & 1ST NJX,,,2739849.3,2739849.3,1
HCPCS,0708T,Id ca immntx prep & 1st njx,,,277.57,321.4,8
HCPCS,0709T,ID CA IMMNTX EACH ADDL NJX,,,2739849.3,2739849.3,1
HCPCS,0709T,Id ca immntx each addl njx,,,277.57,321.4,8
HCPCS,0710T,N-INVAS ARTL PLAQ ALYS,,,2739849.3,2739849.3,1
HCPCS,0710T,N-INVAS ARTL PLAQ ALYS DATA PRP QUAN REVIEW I&R,1016.0,660.4,1.1,3060831.65,80
HCPCS,0710T,N-invas artl plaq alys,,,71.45,82.73,8
HCPCS,0711T,N-nvs artl plaq alys dat prp,,,86.82,100.53,8
HCPCS,0712T,N-NVS ARTL PLAQ ALYS QUAN,,,78.83,237.23,21
HCPCS,0712T,N-nvs artl plaq alys quan,,,71.45,82.73,8
HCPCS,0713T,N-INVAS ARTL PLAQ ALYS DATA REVIEW I&R,1016.0,660.4,1.1,3060831.65,80
HCPCS,0713T,N-NVS ARTL PLAQ ALYS RVW I&R,,,2739849.3,2739849.3,1
HCPCS,0713T,N-nvs artl plaq alys rvw i&r,,,86.82,100.53,8
HCPCS,0714T,TRANSPERINEAL LASER ABLATION OF BENIGN PROSTATIC HYPERPLASIA INC,12364.5,8036.925,0.01,20334.0,171
HCPCS,0715T,Perq trluml coronry lithotrp,,,5870.61,6797.55,8
HCPCS,0716T,CAR ACOUS WAVFRM REC CAD RSK,,,53.07,159.69,21
HCPCS,0716T,Car acous wavfrm rec cad rsk,,,23.5,27.21,8
HCPCS,0717T,ADRC THER PRTL RC TEAR,,,3112.46,9366.03,21
HCPCS,0717T,Adrc ther prtl rc tear,,,251.58,291.3,8
HCPCS,0718T,ADRC THER PRTL RC TEAR NJX,,,3112.46,9366.03,21
HCPCS,0718T,Adrc ther prtl rc tear njx,,,174.77,202.37,8
HCPCS,0719T,PST VRT JT RPLCMT LMBR 1 SGM,,,2739849.3,2739849.3,1
HCPCS,0719T,Pst vrt jt rplcmt lmbr 1 sgm,,,3812.17,4414.09,8
HCPCS,0720T,PRQ ELC NRV STIM CN WO IMPLT,,,907.06,2729.53,9
HCPCS,0720T,Prq elc nrv stim cn wo implt,,,391.75,453.61,8
HCPCS,0721T,QUAN CT TISS CHARAC W/O CT,,,592.31,3293.17,23
HCPCS,0721T,Quan ct tiss charac w/o ct,,,183.67,212.67,8
HCPCS,0722T,QUAN CT TISS CHARAC W/CT,1476.5,959.725,1.1,2602.0,165
HCPCS,0723T,QMRCP W/O DX MRI SM ANAT SES,,,865.47,4811.92,23
HCPCS,0723T,Qmrcp w/o dx mri sm anat ses,,,255.48,295.82,8
HCPCS,0724T,QMRCP W/DX MRI SAME ANATOMY,1937.0,1259.0500000000002,1.1,3802.0,165
HCPCS,0725T,VESTIBULAR DEV IMPLTJ UNI,,,2739849.3,2739849.3,1
HCPCS,0725T,Vestibular dev impltj uni,,,3396.31,3932.57,8
HCPCS,0726T,RMVL IMPLT VSTIBULAR DEV UNI,,,2739849.3,2739849.3,1
HCPCS,0726T,Rmvl implt vstibular dev uni,,,2710.76,3138.77,8
HCPCS,0727T,RMVL&RPLCMT IMPLT VSTBLR DEV,,,2739849.3,2739849.3,1
HCPCS,0727T,Rmvl&rplcmt implt vstblr dev,,,3396.31,3932.57,8
HCPCS,0728T,DX ALYS VSTBLR IMPLT UNI 1ST,,,2739849.3,2739849.3,1
HCPCS,0728T,Dx alys vstblr implt uni 1st,,,22.84,26.44,8
HCPCS,0729T,DX ALYS VSTBLR IMPLT UNI SBQ,,,2739849.3,2739849.3,1
HCPCS,0729T,Dx alys vstblr implt uni sbq,,,22.84,26.44,8
HCPCS,0730T,TRABECULOTOMY LSR W/OCT GDN,,,2739849.3,2739849.3,1
HCPCS,0730T,Trabeculotomy lsr w/oct gdn,,,2420.84,2803.08,8
HCPCS,0731T,AUGMNT AI-BASED FCL PHNT A/R,,,53.07,159.69,21
HCPCS,0731T,Augmnt ai-based fcl phnt a/r,,,86.82,100.53,8
HCPCS,0732T,IMMNTX ADMN ELECTROPORATN IM,,,2739849.3,2739849.3,1
HCPCS,0732T,Immntx admn electroporatn im,,,45.54,52.73,8
HCPCS,0733T,REM R-T MTN NREHAB THER SPLY,,,32.72,357.03,21
HCPCS,0734T,REM R-T MTN NREHAB TX MGMT,,,2739849.3,2739849.3,1
HCPCS,0734T,Rem r-t mtn nrehab tx mgmt,,,86.64,100.32,8
HCPCS,0735T,Prep tum cav iort prim crnot,,,2698.82,3124.95,8
HCPCS,0736T,COLONIC LAVAGE 35+L WATER,,,121.73,2739849.3,21
HCPCS,0736T,Colonic lavage 35+l water,,,33.56,38.86,8
HCPCS,0737T,XENOGRAFT IMPLTJ ARTCLR SURF,,,11928.06,2739849.3,20
HCPCS,0737T,Xenograft impltj artclr surf,,,1831.46,2120.64,8
HCPCS,0738T,TX PLN MAG FLD ABLTJ PRST8,,,2739849.3,2739849.3,1
HCPCS,0738T,Tx pln mag fld abltj prst8,,,105.71,122.4,8
HCPCS,0739T,ABLTJ MAL PRST8 MAG FLD NDCT,,,2739849.3,2739849.3,1
HCPCS,0739T,Abltj mal prst8 mag fld ndct,,,3284.72,3803.36,8
HCPCS,0740T,REM AUTON ALG INSULIN DOSE 1ST SETUP& PT EDUCAJ,297.0,193.05,1.1,297.0,86
HCPCS,0740T,REM AUTON ALG NSLN CAL SETUP,,,53.07,159.69,21
HCPCS,0740T,Rem auton alg nsln cal setup,,,39.1,45.28,8
HCPCS,0741T,REM AUTON ALG NSLN DATA COLL,,,32.72,98.45,21
HCPCS,0741T,REM AUTON ALG NSLN DOS CAL SW DATA COLL TRANSMIS,465.0,302.25,1.1,465.0,86
HCPCS,0742T,AQMBF SPECT W/EXERCISE/RX STRESS & REST,585.0,380.25,1.1,585.0,74
HCPCS,0742T,Aqmbf spect xers/strs & rest,,,888.71,1029.03,8
HCPCS,0743T,B1 STR & FX RSK VRT FX ASSMT,,,224.08,2739849.3,22
HCPCS,0743T,BONE STRENGTH & FRACTURE RSK CNCRNT VRT FX ASSMT,96.0,62.4,1.1,3060831.65,86
HCPCS,0744T,INSERTION BIOPROSTHETIC VALVE OPEN FEMORAL VEIN,7136.0,4638.4,1.1,16027.4,86
HCPCS,0744T,INSJ BIOPROSTC VLV FEM VN,,,4767.51,5790.88,20
HCPCS,0744T,Insj bioprostc vlv fem vn,,,2799.05,3241.01,8
HCPCS,0745T,CAR FCL ABLTJ RADJ ARRHYT N-INVAS LOCLZJ & MAPG,33720.0,21918.0,1.1,3065831.37,153
HCPCS,0746T,CAR FCL ABLTJ RADJ ARRHYT CONV LOCLZJ & MAPG,33720.0,21918.0,1.1,3065831.37,153
HCPCS,0747T,CAR FCL ABLTJ RADJ ARRHYT DLVR RADJ THER,33720.0,21918.0,1.1,3065831.37,153
HCPCS,0748T,NJX STEM CLL PRDCT PERIANAL PERIFISTULAR SFT TIS,997.0,648.05,1.1,3060831.65,86
HCPCS,0748T,NJX STM CL PRDCT ANL SFT TIS,,,2739849.3,2739849.3,1
HCPCS,0748T,Njx stm cl prdct anl sft tis,,,1087.45,1259.15,8
HCPCS,0749T,B1 STR&FX RSK ASSMT DXR-BMD,,,2739849.3,2739849.3,1
HCPCS,0750T,B1 STR&FX RSK ASMT DXRBMD1VW,,,2739849.3,2739849.3,1
HCPCS,0751T,Dgtz gls mcrscp sld level ii,,,37.39,43.3,8
HCPCS,0752T,Dgtz gls mcrscp sld lvl iii,,,37.39,43.3,8
HCPCS,0753T,Dgtz gls mcrscp sld level iv,,,37.39,43.3,8
HCPCS,0754T,Dgtz gls mcrscp sld level v,,,68.5,79.31,8
HCPCS,0755T,Dgtz gls mcrscp sld level vi,,,68.5,79.31,8
HCPCS,0756T,Dgtz gls mcrscp sld spc grpi,,,37.39,43.3,8
HCPCS,0757T,Dgtz gls mcrscp sl spc grpii,,,37.39,43.3,8
HCPCS,0758T,Dgtz gls mcrscp sl spc hchem,,,68.5,79.31,8
HCPCS,0759T,Dgtz gls mcrscp sl sp grpiii,,,68.5,79.31,8
HCPCS,0760T,Dgtz gls mcrscp sl imm 1st,,,68.5,79.31,8
HCPCS,0761T,Dgtz gls mcrscp sl imm ea 1,,,68.5,79.31,8
HCPCS,0762T,Dgtz gls mcrscp sl imm ea m,,,68.5,79.31,8
HCPCS,0763T,Dgtz gls mcrscp mphmtrc alys,,,68.5,79.31,8
HCPCS,0764T,ASSTV ALG ECG RSK-BASED ASSMT RELATED CNCRT ECG,407.0,264.54999999999995,1.1,3060831.65,170
HCPCS,0765T,ASSTV ALG ECG RSK-BASED ASSMT RELATED PREV ECG,407.0,264.54999999999995,1.1,3060831.65,170
HCPCS,0766T,TC MAG STIMJ FCSD LW FRQ EMGNT PLS PN 1ST NERVE,308.0,200.2,1.1,741.48,80
HCPCS,0766T,TC MAG STIMJ PN 1ST NERVE,,,135.52,407.79,21
HCPCS,0766T,Tc mag stimj pn 1st nerve,,,391.75,453.61,8
HCPCS,0767T,TC MAG STIMJ FCSD LW FRQ EMGNT PLS PN EA ADD NRV,308.0,200.2,1.1,741.48,80
HCPCS,0767T,Tc mag stimj pn ea addl nrv,,,391.75,453.61,8
HCPCS,0768T,Tc mag stimj pn sbsq tx 1nrv,,,391.75,453.61,8
HCPCS,0769T,Tc mag stimj pn sbsq tx ea,,,391.75,453.61,8
HCPCS,0770T,VR TECHNOLOGY ASSIST THERAPY,,,2739849.3,2739849.3,1
HCPCS,0770T,Vr technology assist therapy,,,63.76,73.83,8
HCPCS,0771T,VR PX DISSOC SVC SM PHY 1ST,,,2739849.3,2739849.3,1
HCPCS,0771T,Vr px dissoc svc sm phy 1st,,,405.62,469.67,8
HCPCS,0772T,VR PX DISSOC SVC SM PHY EA,,,2739849.3,2739849.3,1
HCPCS,0772T,Vr px dissoc svc sm phy ea,,,405.62,469.67,8
HCPCS,0773T,VR PX DISSOC SVC OTH PHY 1ST,,,2739849.3,2739849.3,1
HCPCS,0773T,Vr px dissoc svc oth phy 1st,,,405.62,469.67,8
HCPCS,0774T,VR PX DISSOC SVC OTH PHY EA,,,2739849.3,2739849.3,1
HCPCS,0774T,Vr px dissoc svc oth phy ea,,,405.62,469.67,8
HCPCS,0775T,Arthrd si jt prq iartic impl,,,14056.95,16276.47,8
HCPCS,0776T,THER INDCTJ NTRABRN HYPTHRM,,,2739849.3,2739849.3,1
HCPCS,0776T,THERAPEUTIC INDUCTION OF INTRA-BRAIN HYPOTHERMIA,1906.0,1238.9,1.1,3060831.65,80
HCPCS,0776T,Ther indctj ntrabrn hypthrm,,,405.62,469.67,8
HCPCS,0777T,R-T PRESSURE SENSING EPIDURAL GUIDANCE SYSTEM,993.0,645.45,1.1,993.0,86
HCPCS,0777T,R-t prs sensing edrl gdn sys,,,565.54,654.83,8
HCPCS,0778T,SMMG CNCRNT APPL IMU SNR,,,121.73,736.25,23
HCPCS,0778T,SMMG CNCRNT APPL IMU SNR MEAS ROM POST GAIT MUSC,174.0,113.1,1.1,456.09,80
HCPCS,0778T,Smmg cncrnt appl imu snr,,,33.56,38.86,8
HCPCS,0779T,GI MYOELECTRICAL ACTIVITY STUDY STMCH-COLON I&R,69.0,44.85,1.1,1564.17,86
HCPCS,0779T,GI MYOELECTRICAL ACTV STUDY,,,353.04,1399.26,21
HCPCS,0779T,Gi myoelectrical actv study,,,391.75,453.61,8
HCPCS,0780T,INSTLJ FECAL MICROBIOTA SSP RCT NMA LWR GI TRC,559.5,363.67499999999995,1.1,4628.0,170
HCPCS,0781T,BRNCHSC RF DSTRJ PULM NRV BI MAINSTEM BRONCHI,1177.0,765.05,1.1,3060831.65,80
HCPCS,0781T,Brnchsc rf dstrj pulm nrv bi,,,1114.26,1290.2,8
HCPCS,0782T,BRNCHSC RF DSTRJ PULM NRV UNI MAINSTEM BRONCHUS,1177.0,765.05,1.1,3060831.65,80
HCPCS,0782T,Brnchsc rf dstrj plm nrv uni,,,1114.26,1290.2,8
HCPCS,0783T,TC AURICULAR NSTIMJ SETUP CALIBRATION &PT EDUCAJ,174.0,113.1,1.1,741.48,86
HCPCS,0783T,TC AURICULR NEUROSTIMULATION,,,121.73,407.79,21
HCPCS,0783T,Tc auriculr neurostimulation,,,86.64,100.32,8
HCPCS,0784T,INSJ/RPLCMT PERQ ELTRD RA SPI W/INTEGRATED NSTIM,26713.5,17363.775,1.1,49881.0,162
HCPCS,0785T,REVJ/RMVL NSTIM ELTRD RA SPI W/INTEGRATED NSTIM,8165.0,5307.25,1.1,13756.0,170
HCPCS,0786T,INSJ/RPLCMT PERQ ELTRD RA SAC W/INTEGRATED NSTIM,27306.5,17749.225000000002,1.1,51916.0,155
HCPCS,0787T,REVJ/RMVL NSTIM ELTRD RA SAC W/INTEGRATED NSTIM,7401.5,4810.974999999999,1.1,13756.0,170
HCPCS,0788T,ELEC ALYS SMPL PRGRMG IINS SP/SAC NRV 1-3 PARAM,377.5,245.375,1.1,388.0,170
HCPCS,0789T,ELEC ALYS CPLX PRGRMG IINS SP/SAC NRV 4+PARAM,382.0,248.3,1.1,397.0,170
HCPCS,0790T,REVJ RPLCMT/RMVL VRT TETHRG,,,16588.34,2739849.3,13
HCPCS,0790T,Revj rplcmt/rmvl vrt tethrg,,,14056.95,16276.47,8
HCPCS,0791T,MOTR COG VR GAIT TRAIN EA 15,,,2739849.3,2739849.3,1
HCPCS,0791T,Motr cog vr gait train ea 15,,,31.09,36.0,8
HCPCS,0792T,APPL SLVR DIAMN FLUORIDE 38%,,,2739849.3,2739849.3,1
HCPCS,0792T,Appl slvr diamn fluoride 38%,,,1011.53,1171.25,8
HCPCS,0793T,PRQ TCAT THRM ABLT NRV P-ART,,,15212.67,45778.03,21
HCPCS,0793T,Prq tcat thrm ablt nrv p-art,,,5870.61,6797.55,8
HCPCS,0794T,PT SPEC ALG RX-ONC TX OPTION,,,53.07,159.69,21
HCPCS,0794T,Pt spec alg rx-onc tx option,,,83.94,97.2,8
HCPCS,0795T,TRANSCATHETER INSERTION OF A PERMANENT DUAL CHAMBER LEADLESS PAC,16420.0,10673.0,1.1,56827.47,159
HCPCS,0796T,TRANSCATHETER INSERTION OF A PERMANENT DUAL CHAMBER LEADLESS PAC,14802.5,9621.625,1.1,56827.47,159
HCPCS,0797T,TRANSCATHETER INSERTION OF A PERMANENT DUAL CHAMBER LEADLESS PAC,13304.5,8647.925,1.1,56827.47,159
HCPCS,0798T,TRANSCATHETER REMOVAL OF PERMANENT DUAL CHAMBER LEADLESS PACEMAK,7923.5,5150.275,1.1,12590.0,159
HCPCS,0799T,TRANSCATHETER REMOVAL OF PERMANENT DUAL CHAMBER LEADLESS PACEMAK,8707.5,5659.875,1.1,12590.0,159
HCPCS,0800T,TRANSCATHETER REMOVAL OF PERMANENT DUAL CHAMBER LEADLESS PACEMAK,8707.5,5659.875,1.1,12590.0,159
HCPCS,0801T,TRANSCATHETER REMOVAL AND REPLACEMENT OF PERMANENT DUAL CHAMBER,16420.0,10673.0,1.1,56827.47,159
HCPCS,0802T,TRANSCATHETER REMOVAL AND REPLACEMENT OF PERMANENT DUAL CHAMBER,13304.5,8647.925,1.1,56827.47,159
HCPCS,0803T,TRANSCATHETER REMOVAL AND REPLACEMENT OF PERMANENT DUAL CHAMBER,13304.5,8647.925,1.1,56827.47,159
HCPCS,0804T,PROGRAMMING DEVICE EVALUATION (IN PERSON) WITH REVIEW AND REPORT,197.5,128.375,1.1,268.52,233
HCPCS,0805T,TCAT SUPR&IVC PROSTC VLV IMPLTJ PERQ FEM VN APPR,15750.0,10237.5,1.1,3060831.65,140
HCPCS,0806T,TCAT S&IVC PRSTC VL IMPL OPN,,,2739849.3,2739849.3,1
HCPCS,0806T,TCAT SUPR&IVC PROSTC VLV IMPLTJ OPEN FEM VN APPR,2070.0,1345.5,1.1,3060831.65,74
HCPCS,0806T,Tcat s&ivc prstc vl impl opn,,,14291.15,16547.65,8
HCPCS,0807T,PULM TISS VNTJ ALYS PREV CT,,,204.28,819.42,23
HCPCS,0807T,Pulm tiss vntj alys prev ct,,,183.67,212.67,8
HCPCS,0808T,PULM TISS VNTJ ALYS W/CT,,,204.28,1417.82,23
HCPCS,0808T,Pulm tiss vntj alys w/ct,,,183.67,212.67,8
HCPCS,0809T,Arthrd si jt prq tfx&implt,,,11196.34,12964.18,8
HCPCS,0810T,SUBRTA NJX RX AGT W/VTRC,,,3870.25,11646.37,21
HCPCS,0810T,Subrta njx rx agt w/vtrc,,,2885.13,3340.68,8
HCPCS,0811T,REM MULTI DAY CPLX UROFLOWMETRY SETUP&PT EDUCAJ,299.5,194.675,1.1,515.0,170
HCPCS,0812T,REM MULTI DAY CPLX UROFLOWMETRY DEV SPLY W/REPRT,355.0,230.75,1.1,626.0,164
HCPCS,0813T,EGD VOL ADJMT BARIATRIC BALO,,,786.42,2366.51,21
HCPCS,0813T,Egd vol adjmt bariatric balo,,,299.41,346.69,8
HCPCS,0814T,PRQ NJX BIOD OSTEO MATRL FEM,,,2739849.3,2739849.3,1
HCPCS,0814T,Prq njx biod osteo matrl fem,,,3067.73,3552.11,8
HCPCS,0815T,US REMS B1 DNS HIPS PLVS/SPI,,,2739849.3,2739849.3,1
HCPCS,0816T,OPEN INSJ/RPLCMT INTEGRATED NSTIMJ SYS PTN SUBQ,2856.0,1856.4,1.1,63800.42,86
HCPCS,0816T,OPN INSJ/RPLCMT INS PTN SUBQ,,,18354.0,57109.38,21
HCPCS,0816T,Opn insj/rplcmt ins ptn subq,,,19174.95,22202.58,8
HCPCS,0817T,OPEN INSERTION OR REPLACEMENT OF INTEGRATED NEUROSTIMULATION SYS,15277.0,9930.05,0.01,36683.4,85
HCPCS,0817T,OPEN INSJ/RPLCMT INTEGRATED NSTIMJ SYS PTN SUBF,2192.0,1424.8,1.1,63800.42,82
HCPCS,0818T,REVJ/RMVL INS PTN SUBQ,,,2951.88,8882.81,21
HCPCS,0818T,REVJ/RMVL INTEGRATED NSTIMJ SYS PTN SUBCUTANEOUS,2529.0,1643.85,1.1,9923.76,86
HCPCS,0818T,Revj/rmvl ins ptn subq,,,2167.75,2510.02,8
HCPCS,0819T,REVJ/RMVL INS PTN SUBF,,,2951.88,8882.81,21
HCPCS,0819T,REVJ/RMVL INTEGRATED NSTIMJ SYS PTN SUBFASCIAL,2529.0,1643.85,1.1,9923.76,80
HCPCS,0819T,Revj/rmvl ins ptn subf,,,2167.75,2510.02,8
HCPCS,0820T,CONT IP MNTR&IVNTJ PSYCHEDELIC MED THERAPY 1ST,1038.5,675.025,1.1,3060831.65,152
HCPCS,0821T,CONT IP MNTR&IVNTJ PSYCHEDELIC MED THERAPY 2ND,1038.5,675.025,1.1,1722.0,152
HCPCS,0822T,CONT IP MNTR&IVNTJ PSYCHEDELIC MED THERAPY STAFF,1038.5,675.025,1.1,1722.0,152
HCPCS,0823T,TCAT INSJ PERM 1CHMBR LDLS PACEMAKER R ATRIAL,13304.5,8647.925,1.1,56827.47,159
HCPCS,0824T,TCAT RMVL PERM 1CHMBR LDLS PACEMAKER R ATRIAL,7073.5,4597.775,1.1,12590.0,159
HCPCS,0825T,TCAT RMVL&RPLCMT PERM 1CHMBR LDLS PM R ATRIAL,12672.5,8237.125,1.1,56827.47,159
HCPCS,0826T,PRGRMG DEV EVAL LDLS PM SINGLE CAR CHAMBER IP,323.0,209.95,1.1,472.0,307
HCPCS,0827T,DGTZ GLS MCRSCP CYTP SMEARS,,,3.77,3.77,2
HCPCS,0827T,Dgtz gls mcrscp cytp smears,,,45.47,52.65,8
HCPCS,0828T,DGTZ GLS MCRSCP CYTP SMPL FL,,,3.77,3.77,2
HCPCS,0828T,Dgtz gls mcrscp cytp smpl fl,,,45.47,52.65,8
HCPCS,0829T,DGTZ GLS MCRSCP CYTP CONCTRJ,,,3.77,3.77,2
HCPCS,0829T,Dgtz gls mcrscp cytp conctrj,,,45.47,52.65,8
HCPCS,0830T,DGTZ GLS MCRSCP CYTP SLCTV,,,3.77,3.77,2
HCPCS,0830T,Dgtz gls mcrscp cytp slctv,,,45.47,52.65,8
HCPCS,0831T,DGTZ GLS MCRSCP CYTP C/V,,,3.77,3.77,2
HCPCS,0831T,Dgtz gls mcrscp cytp c/v,,,15.29,17.7,8
HCPCS,0832T,DGTZ GLS MCRSCP CYTP OTH SCR,,,3.77,3.77,2
HCPCS,0832T,Dgtz gls mcrscp cytp oth scr,,,45.47,52.65,8
HCPCS,0833T,DGTZ GLS MCRSCP CYTP OTH PRP,,,3.77,3.77,2
HCPCS,0833T,Dgtz gls mcrscp cytp oth prp,,,45.47,52.65,8
HCPCS,0834T,DGTZ GLS MCRSCP CYTP OTH XTN,,,3.77,3.77,2
HCPCS,0834T,Dgtz gls mcrscp cytp oth xtn,,,45.47,52.65,8
HCPCS,0835T,DGTZ GLS MCRSCP FNA 1ST EA,,,3.77,3.77,2
HCPCS,0835T,Dgtz gls mcrscp fna 1st ea,,,60.74,70.33,8
HCPCS,0836T,DGTZ GLS MCRSCP FNA EA ADDL,,,3.77,3.77,2
HCPCS,0836T,Dgtz gls mcrscp fna ea addl,,,60.74,70.33,8
HCPCS,0837T,DGTZ GLS MCRSCP FNA I&R,,,3.77,3.77,2
HCPCS,0837T,Dgtz gls mcrscp fna i&r,,,45.47,52.65,8
HCPCS,0838T,DGTZ GLS MCRSCP CSLT SLD ELS,,,3.77,3.77,2
HCPCS,0838T,Dgtz gls mcrscp cslt sld els,,,34.71,40.19,8
HCPCS,0839T,DGTZ GLS MCRSCP CSLT MAT PRP,,,3.77,3.77,2
HCPCS,0839T,Dgtz gls mcrscp cslt mat prp,,,34.71,40.19,8
HCPCS,0840T,DGTZ GLS MCRSCP CSLT COMPRE,,,3.77,3.77,2
HCPCS,0840T,Dgtz gls mcrscp cslt compre,,,34.71,40.19,8
HCPCS,0841T,DGTZ GLS MCRSCP PTH CSLT 1ST,,,3.77,3.77,2
HCPCS,0841T,Dgtz gls mcrscp pth cslt 1st,,,34.71,40.19,8
HCPCS,0842T,DGTZ GLS MCRSCP PTH CSLT EA,,,3.77,3.77,2
HCPCS,0842T,Dgtz gls mcrscp pth cslt ea,,,34.71,40.19,8
HCPCS,0843T,DGTZ GLS MCRSCP CSLT CYT 1ST,,,3.77,3.77,2
HCPCS,0843T,Dgtz gls mcrscp cslt cyt 1st,,,34.71,40.19,8
HCPCS,0844T,DGTZ GLS MCRSCP CSLT CYT EA,,,3.77,3.77,2
HCPCS,0844T,Dgtz gls mcrscp cslt cyt ea,,,34.71,40.19,8
HCPCS,0845T,DGTZ GLS MCRSCP IMFLUOR 1ST,,,3.77,3.77,2
HCPCS,0845T,Dgtz gls mcrscp imfluor 1st,,,37.39,43.3,8
HCPCS,0846T,DGTZ GLS MCRSCP IMFLUOR EA,,,3.77,3.77,2
HCPCS,0846T,Dgtz gls mcrscp imfluor ea,,,37.39,43.3,8
HCPCS,0847T,DGTZ GLS MCRSCP XM ARCH TISS,,,3.77,3.77,2
HCPCS,0847T,Dgtz gls mcrscp xm arch tiss,,,45.47,52.65,8
HCPCS,0848T,DGTZ GLS MCRSCP ISH 1ST,,,3.77,3.77,2
HCPCS,0848T,Dgtz gls mcrscp ish 1st,,,68.5,79.31,8
HCPCS,0849T,DGTZ GLS MCRSCP ISH EA ADL 1,,,3.77,3.77,2
HCPCS,0849T,Dgtz gls mcrscp ish ea adl 1,,,37.39,43.3,8
HCPCS,0850T,DGTZ GLS MCRSCP ISH EA MULT,,,3.77,3.77,2
HCPCS,0850T,Dgtz gls mcrscp ish ea mult,,,68.5,79.31,8
HCPCS,0851T,DGTZ GLS MCRSCP MPHMTRC 1ST,,,3.77,3.77,2
HCPCS,0851T,Dgtz gls mcrscp mphmtrc 1st,,,68.5,79.31,8
HCPCS,0852T,DGTZ GLS MCRSCP MPHMTRC EA 1,,,3.77,3.77,2
HCPCS,0852T,Dgtz gls mcrscp mphmtrc ea 1,,,37.39,43.3,8
HCPCS,0853T,DGTZ GLS MCRSCP MPHMTRC EA M,,,3.77,3.77,2
HCPCS,0853T,Dgtz gls mcrscp mphmtrc ea m,,,68.5,79.31,8
HCPCS,0854T,DGTZ GLS MCRSCP BLD SMR PRPH,,,3.77,3.77,2
HCPCS,0854T,Dgtz gls mcrscp bld smr prph,,,8.48,9.82,8
HCPCS,0855T,DGTZ GLS MCRSCP B1 MAROW SMR,,,3.77,3.77,2
HCPCS,0855T,Dgtz gls mcrscp b1 marow smr,,,173.12,200.45,8
HCPCS,0856T,DGTZ GLS MCRSCP ELECTRON MIC,,,3.77,3.77,2
HCPCS,0856T,Dgtz gls mcrscp electron mic,,,68.5,79.31,8
HCPCS,0857T,OPTO-ACOUSTIC IMG BREAST UNI AUGMNT ALYS&REPRT,425.0,276.25,1.1,787.0,310
HCPCS,0858T,EXT TRNSCRANL MAG STIMJ MEAS,,,2739849.3,2739849.3,1
HCPCS,0858T,Ext trnscranl mag stimj meas,,,538.64,623.69,8
HCPCS,0859T,Ncntc ifr spctrsc o/t pad ea,,,86.82,100.53,8
HCPCS,0860T,NCNTC IFR SPCTRSC SCR PAD,,,2739849.3,2739849.3,1
HCPCS,0860T,Ncntc ifr spctrsc scr pad,,,86.82,100.53,8
HCPCS,0861T,RMVL PG WCS LV BOTH COMPNT,,,3373.78,10252.04,21
HCPCS,0861T,Rmvl pg wcs lv both compnt,,,3007.01,3481.8,8
HCPCS,0862T,RLCJ PG WCS LV BATTERY ONLY,,,1582.09,4760.83,21
HCPCS,0862T,Rlcj pg wcs lv battery only,,,806.19,933.48,8
HCPCS,0863T,RLCJ PG WCS LV TRNSMTR ONLY,,,1582.09,4760.83,21
HCPCS,0863T,Rlcj pg wcs lv trnsmtr only,,,806.19,933.48,8
HCPCS,0864T,LOW INTENSITY ESWT CORPUS CAVERNOSUM LOW ENERGY,973.0,632.45,49.68,3443.0,84
HCPCS,0865T,QUAN MRI ALYS BRN W/O DX MRI,,,212.58,1181.95,23
HCPCS,0865T,Quan mri alys brn w/o dx mri,,,255.48,295.82,8
HCPCS,0866T,QUAN MRI ALYS BRAIN WITH DIAGNOSTIC MRI,967.0,628.55,1.1,1237.0,262
HCPCS,0866T,QUANTITATIVE MRI ANALYSIS OF THE BRAIN,967.0,628.55,212.58,967.0,84
HCPCS,0867T,TRANSPERINEAL LASER ABLATION OF BENIGN PROSTATE HYPERPLASIA INCL,12529.5,8144.175,0.01,20334.0,169
HCPCS,0868T,HI-RES GASTRIC EP MAPPING,,,353.04,531.24,19
HCPCS,0868T,Hi-res gastric ep mapping,,,299.41,346.69,8
HCPCS,0869T,NJX B1 SUB MTRL HW FIXJ AUG,,,3007.88,3405.12,19
HCPCS,0869T,Njx b1 sub mtrl hw fixj aug,,,174.77,202.37,8
HCPCS,0870T,IMP SUBQ PRTL ASCTS PMP SYS,,,32411.16,35652.28,12
HCPCS,0870T,Imp subq prtl ascts pmp sys,,,3471.98,4020.19,8
HCPCS,0871T,RPLCMT SUBQ PRTL ASCITES PMP,,,25466.01,28012.61,12
HCPCS,0871T,Rplcmt subq prtl ascites pmp,,,2029.97,2350.49,8
HCPCS,0872T,RPLCMT NDWLLG BLDR&PRTL CATH,,,3387.33,3726.07,12
HCPCS,0872T,Rplcmt ndwllg bldr&prtl cath,,,2029.97,2350.49,8
HCPCS,0873T,REVJ SUBQ PRTL ASCT PMP SYS,,,3387.33,3726.07,12
HCPCS,0873T,Revj subq prtl asct pmp sys,,,2029.97,2350.49,8
HCPCS,0874T,RMVL PERTL ASCITES PMP SYS,,,3387.33,3726.07,12
HCPCS,0874T,Rmvl pertl ascites pmp sys,,,2029.97,2350.49,8
HCPCS,0875T,PRGRM SUBQ PRTL ASCT PMP SYS,,,35.31,38.84,12
HCPCS,0875T,Prgrm subq prtl asct pmp sys,,,22.84,26.44,8
HCPCS,0876T,Duplex scan hemo fstl lmtd,,,97.71,113.14,8
HCPCS,0877T,AUGMNT ALYS CH CT ILD W/O CT,,,602.38,662.61,19
HCPCS,0877T,Augmnt alys ch ct ild w/o ct,,,183.67,212.67,8
HCPCS,0878T,AUGMNT ALYS CH CT ILD W/CT,,,602.38,662.61,19
HCPCS,0878T,Augmnt alys ch ct ild w/ct,,,183.67,212.67,8
HCPCS,0879T,Augmnt alys ch ct ild prep,,,86.82,100.53,8
HCPCS,0880T,Augmnt alys ch ct ild i&r,,,86.82,100.53,8
HCPCS,0881T,CRYOTHERAPY ORAL CAVITY,,,369.93,464.9,19
HCPCS,0881T,Cryotherapy oral cavity,,,405.62,469.67,8
HCPCS,0882T,Intraop ther estim pn ue 1st,,,1090.19,1262.33,8
HCPCS,0883T,Intraop ther estim pn ue ea,,,1090.19,1262.33,8
HCPCS,0884T,ESPHGSC FLX 1ST TNDSC DILAT,,,5518.49,6317.89,19
HCPCS,0884T,Esphgsc flx 1st tndsc dilat,,,1500.64,1737.58,8
HCPCS,0885T,COLSC FLX 1ST TNDSC DILAT,,,5518.49,6317.89,19
HCPCS,0886T,SGMDSC FLX 1ST TNDSC DILAT,,,5518.49,6317.89,19
HCPCS,0887T,End-tidal ctrl inhaled anes,,,200.6,232.28,8
HCPCS,0888T,HISTOTRIPSY MAL RENAL TISSUE,,,16205.81,88596.29,21
HCPCS,0888T,Histotripsy mal renal tissue,,,5673.89,6569.77,8
HCPCS,0889T,PRSNLZ TRGT DVL ARHFCMRIGTBS,,,880.18,968.2,19
HCPCS,0889T,Prsnlz trgt dvl arhfcmrigtbs,,,538.64,623.69,8
HCPCS,0890T,ARHFCMRIGTBS 1ST TX DAY,,,3473.04,3820.34,19
HCPCS,0890T,Arhfcmrigtbs 1st tx day,,,538.64,623.69,8
HCPCS,0891T,ARHFCMRIGTBS SBSQ TX DAY,,,3473.04,3820.34,19
HCPCS,0891T,Arhfcmrigtbs sbsq tx day,,,538.64,623.69,8
HCPCS,0892T,ARHFCMRIGTBS SBSQ PER TX DAY,,,3473.04,3820.34,19
HCPCS,0892T,Arhfcmrigtbs sbsq per tx day,,,538.64,623.69,8
HCPCS,0893T,N-INVAS ASSMT BLD OXYGNATION,,,55.07,138.46,19
HCPCS,0893T,N-invas assmt bld oxygnation,,,33.56,38.86,8
HCPCS,0894T,CANNULJ LVR ALGRFT PREPJ CONNJ NRMTHRMC PRFU DEV,6094.0,3961.1,1.1,6094.0,86
HCPCS,0894T,Cannulation liver allograft,,,1229.51,1423.64,8
HCPCS,0895T,CONNJ LVR ALGRFT NRMTHRMC PRFUJ DEV 1ST 4 HOURS,3924.0,2550.6,1.1,3924.0,74
HCPCS,0895T,Connj lvr algrft prfu dev 1,,,1229.51,1423.64,8
HCPCS,0896T,CONNJ LVR ALGRFT NRMTHRMC PRFUJ DEV EA ADDL HOUR,1666.0,1082.9,1.1,1666.0,74
HCPCS,0896T,Connj lvr algrft prfu dev ea,,,1229.51,1423.64,8
HCPCS,0897T,N-INVAS AUGMNT ARRHYT ALYS,,,812.43,1018.61,19
HCPCS,0897T,N-invas augmnt arrhyt alys,,,405.62,469.67,8
HCPCS,0898T,N-INVAS PRST8 CANCER EST MAP,,,812.43,1018.61,19
HCPCS,0898T,N-invas prst8 cancer est map,,,86.82,100.53,8
HCPCS,0899T,N-invas deter aqmbf aug cmr,,,255.48,295.82,8
HCPCS,0900T,N-invas est aqmbf asstv cmr,,,255.48,295.82,8
HCPCS,0901T,Plmt bone marrow smplg port,,,112.68,130.47,8
HCPCS,0902T,QTC NTRVL AUGMNT ALG ALY ECG,,,119.5,138.46,19
HCPCS,0902T,Qtc ntrvl augmnt alg aly ecg,,,23.5,27.21,8
HCPCS,0903T,Ecg alg 12 lead reduced i&r,,,23.5,27.21,8
HCPCS,0904T,ECG ALG 12 LD RDCD TRCG ONLY,,,55.07,61.39,19
HCPCS,0904T,Ecg alg 12 ld rdcd trcg only,,,23.5,27.21,8
HCPCS,0905T,Ecg alg 12 ld rdcd i&r only,,,23.5,27.21,8
HCPCS,0906T,COMS THER 1ST APPL<=50 SQ CM,,,184.2,208.8,19
HCPCS,0906T,Coms ther 1st appl<=50 sq cm,,,186.25,215.66,8
HCPCS,0907T,Coms ther ea addl<=50 sq cm,,,186.25,215.66,8
HCPCS,0908T,OPEN IMPLTJ INT NEUROSTIMULATION SYS VAGUS NERVE,4180.0,2717.0,1.1,4180.0,80
HCPCS,0908T,OPN IMP INT NSTM SYS VGS NRV,,,29193.76,32113.14,12
HCPCS,0909T,REPLACEMENT INT NEUROSTIMULATION SYS VAGUS NERVE,5108.0,3320.2,1.1,5108.0,80
HCPCS,0909T,RPLCMT INT NSTIM SYS VGS NRV,,,29193.76,32113.14,12
HCPCS,0910T,REMOVAL INT NEUROSTIMULATION SYS VAGUS NERVE,4226.0,2746.9,1.1,4226.0,80
HCPCS,0910T,RMVL INT NSTIM SYS VAGUS NRV,,,3307.59,3638.34,12
HCPCS,0910T,Rmvl int nstim sys vagus nrv,,,2167.75,2510.02,8
HCPCS,0911T,ELEC ALY NSTM SYS VGS NRV WO,,,55.81,61.39,12
HCPCS,0911T,ELEC ALYS INT NSTIMJ SYS VAGUS NRV W/O PRGRMG,163.0,105.95,1.1,163.0,80
HCPCS,0911T,Elec aly nstm sys vgs nrv wo,,,92.64,107.27,8
HCPCS,0912T,ELEC ALYS INT NSTIMJ SYS VAGUS NRV W/SMPL PRGRMG,330.5,214.825,1.1,363.0,156
HCPCS,0913T,PERQ TCAT THER RX DLVR NTRAC RX BALO 1 MAJ C ART,2708.0,1760.2,1.1,2708.0,82
HCPCS,0913T,PERQ TCAT THER RX DLVR NTRAC RX BALO 1 MAJ C ART PERQ TCAT THER,22806.0,14823.9,5285.54,22806.0,83
HCPCS,0914T,PERQ TCAT THER RX DLVR NTRAC RX BALO SEPARATE,7617.0,4951.05,1.1,12526.0,146
HCPCS,0915T,INSJ PERM CCM-D SYS PG&DUAL TRANSVNS ELTRDS/LDS,5227.0,3397.55,1.1,5227.0,80
HCPCS,0915T,INSJ PERM CCM-D SYS PG&ELTRD,,,29696.29,32665.91,19
HCPCS,0915T,Insj perm ccm-d sys pg&eltrd,,,21832.77,25280.05,8
HCPCS,0916T,INSERTION PERM CCM-D SYSTEM PULSE GENERATOR ONLY,2334.0,1517.1,1.1,2334.0,80
HCPCS,0916T,INSJ PERM CCM-D SYS PG ONLY,,,20808.52,23148.55,19
HCPCS,0916T,Insj perm ccm-d sys pg only,,,21832.77,25280.05,8
HCPCS,0917T,INSJ PERM CCM-D SYS 1 LEAD,,,7672.16,8612.07,19
HCPCS,0917T,INSJ PERM CCM-D SYS 1 TRANSVNS LEAD ONLY,2460.0,1599.0,1.1,2460.0,80
HCPCS,0917T,Insj perm ccm-d sys 1 lead,,,806.19,933.48,8
HCPCS,0918T,INSJ PERM CCM-D SYS DUAL LD,,,7672.16,8612.07,19
HCPCS,0918T,INSJ PERM CCM-D SYS DUAL TRANSVNS LEADS ONLY,2460.0,1599.0,1.1,2460.0,80
HCPCS,0918T,Insj perm ccm-d sys dual ld,,,806.19,933.48,8
HCPCS,0919T,REMOVAL PERM CCM-D SYSTEM PULSE GENERATOR ONLY,1436.0,933.4,1.1,1436.0,80
HCPCS,0919T,RMVL PERM CCM-D SYS PG ONLY,,,3373.78,3889.0,19
HCPCS,0919T,Rmvl perm ccm-d sys pg only,,,3007.01,3481.8,8
HCPCS,0920T,RMVL PERM CCM-D SYS 1 PAC LD,,,3373.78,3889.0,19
HCPCS,0920T,RMVL PERM CCM-D SYS 1 TRANSVNS PACING LEAD ONLY,3675.0,2388.75,1.1,3675.0,80
HCPCS,0920T,Rmvl perm ccm-d sys 1 pac ld,,,806.19,933.48,8
HCPCS,0921T,RMVL PERM CCM-D SYS 1 DFB LD,,,3373.78,3889.0,19
HCPCS,0921T,RMVL PERM CCM-D SYS 1 TRANSVNS DFB LEAD ONLY,3675.0,2388.75,1.1,3675.0,80
HCPCS,0921T,Rmvl perm ccm-d sys 1 dfb ld,,,806.19,933.48,8
HCPCS,0922T,RMVL PERM CCM-D SYS DUAL LD,,,3373.78,3889.0,19
HCPCS,0922T,RMVL PERM CCM-D SYS DUAL TRANSVNS LEADS ONLY,3675.0,2388.75,1.1,4461.08,80
HCPCS,0922T,Rmvl perm ccm-d sys dual ld,,,806.19,933.48,8
HCPCS,0923T,RMVL&RPLCMT PERM CCM-D PG,,,20808.52,23148.55,19
HCPCS,0923T,RMVL&RPLCMT PERMANENT CCM-D PULSE GENERATOR ONLY,2330.0,1514.5,1.1,2330.0,80
HCPCS,0923T,Rmvl&rplcmt perm ccm-d pg,,,21832.77,25280.05,8
HCPCS,0924T,REPOSITIONING PREV IMPL CCM-D TRANSVNS ELTRD/LD,2071.0,1346.15,1.1,2071.0,80
HCPCS,0924T,RPOS PRV CCM-D TRNSVNS ELTRD,,,573.15,652.82,19
HCPCS,0924T,Rpos prv ccm-d trnsvns eltrd,,,806.19,933.48,8
HCPCS,0925T,RELOCATION SKIN POCKET IMPLANTED CCM-D PG,2926.0,1901.9,1.1,2926.0,80
HCPCS,0925T,RLCJ SKIN POCKET CCM-D PG,,,1695.77,2147.22,19
HCPCS,0925T,Rlcj skin pocket ccm-d pg,,,806.19,933.48,8
HCPCS,0926T,PRGRMG DEV EVAL CCM-D IP,,,34.57,38.84,19
HCPCS,0926T,PROGRAMMING DEVICE EVAL IMPL CCM-D SYS IN PERSON,872.0,566.8,1.1,872.0,80
HCPCS,0926T,Prgrmg dev eval ccm-d ip,,,22.84,26.44,8
HCPCS,0927T,INTERROG DEV EVAL CCM-D IP,,,34.57,38.84,19
HCPCS,0927T,INTERROG DEV EVAL IMPL CCM-D SYSTEM IN PERSON,390.0,253.5,1.1,511.0,240
HCPCS,0927T,Interrog dev eval ccm-d ip,,,22.84,26.44,8
HCPCS,0928T,REMOTE INTERROG DEV EVAL CCM-D SYS <90D PHYS/QHP,279.0,181.35,1.1,279.0,80
HCPCS,0928T,Rem interrog dev ccm-d phys,,,22.84,26.44,8
HCPCS,0929T,REM INTERROG DEV CCM-D TECH,,,34.57,38.84,19
HCPCS,0929T,Rem interrog dev ccm-d tech,,,22.84,26.44,8
HCPCS,0930T,ELECTROPHYSIOLOGIC EVAL CCM-D LEADS AT 1ST IMPL,5227.0,3397.55,1.1,9161.0,216
HCPCS,0930T,EPHYS EVAL CCM-D LD 1ST IMPL,,,1125.42,1267.07,19
HCPCS,0930T,Ephys eval ccm-d ld 1st impl,,,1560.06,1806.39,8
HCPCS,0931T,ELECTROPHYSIOLOGIC EVAL CCM-D LEADS SEPARATE,5227.0,3397.55,1.1,9161.0,216
HCPCS,0931T,EPHYS EVAL CCM-D LD SEPARATE,,,1125.42,1267.07,19
HCPCS,0931T,Ephys eval ccm-d ld separate,,,1560.06,1806.39,8
HCPCS,0932T,N-INVS DET HRT FAIL AUG ECHO,,,278.03,319.63,19
HCPCS,0932T,N-invs det hrt fail aug echo,,,92.64,107.27,8
HCPCS,0933T,TCAT IMPL WRLS L ATR PRS SNR,,,2981.74,3373.83,19
HCPCS,0933T,TCAT IMPLT WRLS L ATR PRS SNR L-T L ATR PRS MNTR,2786.0,1810.9,1.1,2786.0,80
HCPCS,0933T,Tcat impl wrls l atr prs snr,,,1947.82,2255.37,8
HCPCS,0934T,REMOTE MNTR WIRELESS L ATRIAL PRESSURE SNR<30 D,325.0,211.25,1.1,325.0,80
HCPCS,0935T,CYSTO W/RNL PEL SYMPATHETIC DNRVTJ RF ABLTJ BI,3715.0,2414.75,1.1,3715.0,80
HCPCS,0935T,Cysto w/rnl pel symp dnrvtj,,,1004.31,1162.89,8
HCPCS,0936T,PHOTOBIOMODULATION THERAPY RETINA SINGLE SESSION,38.0,24.7,0.01,1858.16,148
HCPCS,0937T,XTRNL ECG REC>15D<30D REC SCAN ALYS RVW&INTERPJ,256.0,166.4,1.1,857.19,80
HCPCS,0937T,Xtrnl ecg rec>15d<30d,,,86.64,100.32,8
HCPCS,0938T,Xtrnl ecg rec>15d<30d rec,,,86.64,100.32,8
HCPCS,0939T,Xtrnl ecg rec>15d<30d scan,,,86.64,100.32,8
HCPCS,0940T,Xtrnl ecg rec>15d<30d r&i,,,86.64,100.32,8
HCPCS,0941T,CYSTO FLX INSJ&XPNSJ PROSTATIC URTL SCAFFOLD,762.0,495.3,1.1,762.0,80
HCPCS,0941T,Cysto flx ins&xpns urtl scaf,,,1127.93,1306.02,8
HCPCS,0942T,CYSTO FLX RMVL&RPLCMT PROSTATIC URTL SCAFFOLD,1306.0,848.9,1.1,3359.91,80
HCPCS,0942T,Cysto flx rmv&rplc urtl scaf,,,1127.93,1306.02,8
HCPCS,0943T,CYSTO FLX REMOVAL PROSTATIC URETHRAL SCAFFOLD,1306.0,848.9,1.1,2392.5,80
HCPCS,0943T,Cysto flx rmvl urtl scaffold,,,1127.93,1306.02,8
HCPCS,0944T,3D CNTR SIMULA TRGT LVR LES,,,224.08,1223.71,21
HCPCS,0944T,3D CONTOUR SIMULAJ TRGT LVR LES&MRGN MICRWV ABLT,93.0,60.45,1.1,801.19,80
HCPCS,0944T,3d cntr simula trgt lvr les,,,86.82,100.53,8
HCPCS,0945T,Intraop assmt abnl tum tiss,,,86.82,100.53,8
HCPCS,0946T,ORTHO IMPL MVMT ALYS PAIR CT,,,98.58,538.36,21
HCPCS,0946T,Ortho impl mvmt alys pair ct,,,183.67,212.67,8
HCPCS,0947T,MRGFUS STRTCTC BLD-BRN BARR DISRPJ MBUBB RSN8TR,7488.0,4867.2,1.1,7488.0,68
HCPCS,0948T,Rem interrog dev ccm phys,,,22.84,26.44,8
HCPCS,0949T,REM INTERROG DEV CCM TECH,,,35.31,38.84,12
HCPCS,0949T,Rem interrog dev ccm tech,,,22.84,26.44,8
HCPCS,0950T,ABLTJ B9 PRST8 TISSUE HIFU,,,8956.0,9851.6,12
HCPCS,0950T,Abltj b9 prst8 tissue hifu,,,3284.72,3803.36,8
HCPCS,0950T,PR ABLTJ B9 PRST8 TISSUE TRANSRECTAL HIFU W/US GDN,7092.0,4609.8,1.1,7092.0,80
HCPCS,0951T,Tot impl amei 1st plmt,,,9782.47,11327.07,8
HCPCS,0952T,Tot impl amei rev/rplc mstdc,,,9782.47,11327.07,8
HCPCS,0953T,Tot impl amei rev/rplc w/o,,,2710.76,3138.77,8
HCPCS,0954T,Tot impl amei rplc snd proc,,,1558.4,1804.46,8
HCPCS,0955T,Tot impl amei removal,,,1558.4,1804.46,8
HCPCS,0956T,PRT CRN CH CR&TUN ELT S-SCLP,,,25670.88,28237.96,12
HCPCS,0956T,Prt crn ch cr&tun elt s-sclp,,,19174.95,22202.58,8
HCPCS,0957T,REV S-SCLP ELTR RA RCVR&TLMT,,,1521.28,1673.41,12
HCPCS,0957T,Rev s-sclp eltr ra rcvr&tlmt,,,2167.75,2510.02,8
HCPCS,0958T,RMV S-SCLP ELTR RA RCVR&TLMT,,,3095.56,3405.12,12
HCPCS,0958T,Rmv s-sclp eltr ra rcvr&tlmt,,,2167.75,2510.02,8
HCPCS,0959T,RMV/RPLC MAGNET COIL ASSEM,,,1562.54,1718.79,12
HCPCS,0959T,Rmv/rplc magnet coil assem,,,2167.75,2510.02,8
HCPCS,0960T,RPL S-SCLP ELTR RA RCVR&TLMT,,,25670.88,28237.96,12
HCPCS,0960T,Rpl s-sclp eltr ra rcvr&tlmt,,,19174.95,22202.58,8
HCPCS,0961T,Shortwave ifr radiation img,,,68.5,79.31,8
HCPCS,0962T,ASSTV ALG ALYS ACOUS&ECG REC,,,125.87,138.46,12
HCPCS,0962T,Asstv alg alys acous&ecg rec,,,86.64,100.32,8
HCPCS,0963T,ANOSC SBMCSL NJX BULKING AGT,,,1132.12,1245.33,12
HCPCS,0964T,I&CUST PREP JAW XPNSJ 1ARCH,,,3136.68,3450.35,12
HCPCS,0964T,I&cust prep jaw xpnsj 1arch,,,1358.5,1573.0,8
HCPCS,0965T,I&CST PRP JW XPN DL ARCH NON,,,3136.68,3450.35,12
HCPCS,0965T,I&cst prp jw xpn dl arch non,,,1358.5,1573.0,8
HCPCS,0966T,I&CST PRP JW XPN DL ARCH FXD,,,3136.68,3450.35,12
HCPCS,0966T,I&cst prp jw xpn dl arch fxd,,,1358.5,1573.0,8
HCPCS,0967T,TRANAL INS TMP CLRC ANST DEV,,,1132.12,1245.33,12
HCPCS,0967T,Tranal ins tmp clrc anst dev,,,3466.13,4013.42,8
HCPCS,0968T,Insj/rplcmt epcrnl nstim sys,,,19174.95,22202.58,8
HCPCS,0969T,Removal epicranial nstim sys,,,2167.75,2510.02,8
HCPCS,0970T,ABLT B9 BRST TUM PERQ LSR EA,,,3704.3,4074.73,12
HCPCS,0970T,Ablt b9 brst tum perq lsr ea,,,1031.8,1194.71,8
HCPCS,0971T,ABLT MAL BRST TUM PQ LSR UNI,,,3704.3,4074.73,12
HCPCS,0971T,Ablt mal brst tum pq lsr uni,,,1031.8,1194.71,8
HCPCS,0972T,Asstv alg clsfctn burn hlg,,,86.82,100.53,8
HCPCS,0973T,SLCTV NZMTC DBRDMT T/A/L 1ST,,,384.59,423.05,12
HCPCS,0973T,Slctv nzmtc dbrdmt t/a/l 1st,,,559.63,647.99,8
HCPCS,0974T,Slctv nzmtc dbrdmt t/a/l ea,,,239.13,276.89,8
HCPCS,0975T,SLCTV NZMTC DBRDMT S/N/HF 1,,,384.59,423.05,12
HCPCS,0975T,Slctv nzmtc dbrdmt s/n/hf 1,,,559.63,647.99,8
HCPCS,0976T,Slctv nzmtc dbrdmt s/n/hf ea,,,239.13,276.89,8
HCPCS,0977T,UPR GI BLD DETCJ SNR CAPSULE,,,858.08,943.89,12
HCPCS,0977T,Upr gi bld detcj snr capsule,,,299.41,346.69,8
HCPCS,0978T,Submucosal cryolysis therapy,,,405.62,469.67,8
HCPCS,0979T,Sbmcsl crylys ther sft palt,,,405.62,469.67,8
HCPCS,0980T,Sbmcsl crylys ther tng&tnsl,,,405.62,469.67,8
HCPCS,0981T,TCAT IMPL WRLS IVC SNR,,,17343.14,19077.46,12
HCPCS,0981T,Tcat impl wrls ivc snr,,,6303.75,7299.08,8
HCPCS,0982T,REM MNTR IMPL IVC SNR SET-UP,,,125.96,138.55,12
HCPCS,0982T,Rem mntr impl ivc snr set-up,,,86.64,100.32,8
HCPCS,0983T,REM MNTR IMPL IVC SNR PHYS,,,35.31,38.84,12
HCPCS,0984T,Iv img xtrc cere vsl oct 1st,,,673.41,779.74,8
HCPCS,0985T,Iv img xtrc cere vsl oct ea,,,673.41,779.74,8
HCPCS,0986T,Iv img icr cere vsl oct 1st,,,673.41,779.74,8
HCPCS,0987T,Iv img icr cere vsl oct ea,,,673.41,779.74,8
HCPCS,0988T,OPEN INSJ/RPLCMT INT NSTIMJ SYS PTN SUBQ&SUBF,2192.0,1424.8,1.1,2192.0,68
HCPCS,0988T,Opn ins/rplc ins ptn sbq&sbf,,,19174.95,22202.58,8
HCPCS,0989T,REVJ/RMVL INS PTN SUBQ&SUBF,,,3307.59,3638.34,12
HCPCS,0989T,REVJ/RMVL INTEGRATED NSTIMJ SYS PTN SUBQ&SUBF,2529.0,1643.85,1.1,2529.0,68
HCPCS,0989T,Revj/rmvl ins ptn subq&subf,,,2167.75,2510.02,8
HCPCS,0990T,TRANSCRV INSTLJ BIOD HYDROGEL MATRL INTRAUTERINE,609.0,395.85,0.01,3443.0,134
HCPCS,0991T,CYSTO LO-NRG LITHOTRP&ACOUS ACTUATED MICROSPHERE,3200.0,2080.0,1.1,3200.0,68
HCPCS,0991T,CYSTO LO-NRG LITHTRP&MCRSPHR,,,8956.0,9851.6,12
HCPCS,0991T,Cysto lo-nrg lithtrp&mcrsphr,,,2117.28,2451.59,8
HCPCS,0992T,N-INVAS ASSMT CAR RSK W/O CT,,,225.74,248.31,12
HCPCS,0992T,N-invas assmt car rsk w/o ct,,,183.67,212.67,8
HCPCS,0993T,N-INVAS ASSMT CAR RSK AUGMNT SW ALYS FAT W/CT,975.0,633.75,1.1,1291.0,280
HCPCS,0994T,Evasc dlvr a-wal stbl rx prq,,,10445.39,12094.67,8
HCPCS,0995T,Evasc dlvr a-wal stbl rx opn,,,2623.14,3037.32,8
HCPCS,0996T,INS&SCLR FIX CAPS BAG PROSTH,,,2183.38,2401.72,12
HCPCS,0996T,Ins&sclr fix caps bag prosth,,,1320.08,1528.52,8
HCPCS,0997T,PRECUNEUS MAGNETIC STIMULATION TREATMENT PLNG,759.0,493.35,1.1,934.0,134
HCPCS,0998T,PRECUNEUS MAGNETIC STIMULATION TREATMENT DLVR,759.0,493.35,1.1,934.0,134
HCPCS,0999T,Autol musc cell therapy hrvg,,,1580.94,1830.57,8
HCPCS,10000,INC/DRNG CYST 1 LESION,557.0,362.05,1.1,557.0,68
HCPCS,10004,FINE NEEDLE ASPIRATION BX W/O IMG GDN EA ADDL,668.5,434.525,0.01,4628.0,286
HCPCS,10005,FINE NEEDLE ASPIRATION BX W/US GDN 1ST LESION,1939.5,1260.6750000000002,0.01,4628.0,496
HCPCS,10006,FINE NEEDLE ASPIRATION BX W/US GDN EA ADDL,691.0,449.15,0.01,4628.0,424
HCPCS,10007,FINE NEEDLE ASPIRATION BX W/FLUOR GDN 1ST LESION,3237.0,2104.05,0.01,4628.0,261
HCPCS,10007,FINE NEEDLE ASPIRATION BX W/FLUORO GDN 1ST LESION,724.0,470.6,1.1,2050.87,148
HCPCS,10008,FINE NEEDLE ASPIRATION BX W/FLUOR GDN EA ADDL,598.5,389.025,0.01,4628.0,355
HCPCS,10009,FINE NEEDLE ASPIRATION BX W/CT GDN 1ST LESION,2070.5,1345.825,0.01,4628.0,496
HCPCS,1000F,TOBACCO USE ASSESSED,,,0.03,0.03,1
HCPCS,1000F,Tobacco use assessed,,,10.69,12.38,8
HCPCS,1000T,Autol musc cell therapy admn,,,1066.44,1234.83,8
HCPCS,10010,FINE NEEDLE ASPIRATION BX W/CT GDN EA ADDL,1065.5,692.575,0.01,4628.0,355
HCPCS,10011,FINE NEEDLE ASPIRATION BX W/MR GDN 1ST LESION,2221.5,1443.9750000000001,0.01,4628.0,345
HCPCS,10012,FINE NEEDLE ASPIRATION BX W/MR GDN EA ADDL,1030.5,669.825,0.01,4628.0,291
HCPCS,1001T,Autol musc cell therapy njx,,,1087.45,1259.15,8
HCPCS,10021,FINE NEEDLE ASPIRATION BX W/O IMG GDN 1ST LESION,1145.5,744.575,0.01,12500.0,407
HCPCS,1002F,ASSESS ANGINAL SYMPTOM/LEVEL,,,0.03,0.03,1
HCPCS,1002F,Assess anginal symptom/level,,,10.69,12.38,8
HCPCS,1002T,AIR DISPLACMNT PLETHYSMOGRAP,,,27.36,30.1,12
HCPCS,1002T,Air displacmnt plethysmograp,,,86.64,100.32,8
HCPCS,10030,IMAGE-GUIDED CATHETER FLUID COLLECTION DRAINAGE,1605.5,1043.575,0.01,12500.0,322
HCPCS,10035,PERQ SFT TISS LOC DEVICE PLMT 1ST LES W/GDNCE,1448.0,941.2,0.01,4628.0,407
HCPCS,10036,PERQ SFT TISS LOC DEVICE PLMT ADD LES W/GDNCE,478.5,311.025,0.01,4628.0,284
HCPCS,1003F,LEVEL OF ACTIVITY ASSESS,,,0.03,0.03,1
HCPCS,1003F,Level of activity assess,,,10.69,12.38,8
HCPCS,1003T,ARTHRP 1ST CRP/MTCRPL PROSTC,,,12146.38,13361.02,12
HCPCS,1003T,Arthrp 1st crp/mtcrpl prostc,,,2382.18,2758.32,8
HCPCS,10040,ACNE SURGERY,498.0,323.7,0.01,12500.0,235
HCPCS,10040,MILIA EXTRACTION 1-5,250.0,162.5,1.1,584.65,148
HCPCS,10040,MILIA EXTRACTION EACH ADDTL 10,100.0,65.0,1.1,584.65,148
HCPCS,1004F,CLIN SYMP VOL OVRLD ASSESS,,,72.45,72.45,1
HCPCS,1004F,Clin symp vol ovrld assess,,,10.69,12.38,8
HCPCS,1004T,ELEC ALYS IMPL S-SCLP CONT BI EEG SYS W/O PRGRMG,544.0,353.6,92.64,544.0,76
HCPCS,1005F,ASTHMA SYMPTOMS EVALUATE,,,0.03,0.03,1
HCPCS,1005F,Asthma symptoms evaluate,,,10.69,12.38,8
HCPCS,1005T,ELEC ALYS IMPL S-SCLP CONT BI EEG SYS PRGRMG 1ST,389.0,252.85,89.94,389.0,76
HCPCS,10060,INCISION & DRAINAGE ABSCESS SIMPLE/SINGLE,566.5,368.225,0.01,12500.0,407
HCPCS,10061,INCISION & DRAINAGE ABSCESS COMPLICATED/MULTIPLE,1138.5,740.0250000000001,0.01,4392.0,409
HCPCS,1006F,OSTEOARTHRITIS ASSESS,,,0.03,0.03,1
HCPCS,1006F,Osteoarthritis assess,,,10.69,12.38,8
HCPCS,1006T,Elec alys s-scl eeg prgrm ea,,,92.64,107.27,8
HCPCS,1007F,ANTI-INFLM/ANLGSC OTC ASSESS,,,0.03,0.03,1
HCPCS,1007F,Anti-inflm/anlgsc otc assess,,,10.69,12.38,8
HCPCS,1007T,Eeg impl s-sclp eeg w/o vid,,,210.99,244.3,8
HCPCS,10080,INCISION & DRAINAGE PILONIDAL CYST SIMPLE,1324.0,860.6,0.01,12500.0,321
HCPCS,10081,INCISION & DRAINAGE PILONIDAL CYST COMPLICATED,1605.5,1043.575,0.01,12500.0,322
HCPCS,1008F,GI/RENAL RISK ASSESS,,,2739849.3,2739849.3,1
HCPCS,1008F,Gi/renal risk assess,,,10.69,12.38,8
HCPCS,1008T,REM MNTR S-SCLP IMPL CONT BI EEG SYS FITG SET-UP,544.0,353.6,86.64,544.0,76
HCPCS,1010F,SEVERITY ANGINA BY ACTVTY,,,2739849.3,2739849.3,1
HCPCS,1010F,Severity angina by actvty,,,10.69,12.38,8
HCPCS,1010T,CPTR OPH ALYS MONOC EYE MVMT,,,125.87,138.46,12
HCPCS,1010T,Cptr oph alys monoc eye mvmt,,,47.73,55.26,8
HCPCS,1011F,ANGINA PRESENT,,,2739849.3,2739849.3,1
HCPCS,1011F,Angina present,,,10.69,12.38,8
HCPCS,1011T,Pbm therapy of oral cavity,,,107.64,124.64,8
HCPCS,10120,INCISION & REMOVAL FOREIGN BODY SUBQ TISS SIMPLE,868.0,564.2,0.01,12500.0,407
HCPCS,10121,INCISION & REMOVAL FOREIGN BODY SUBQ TISS COMPL,3033.5,1971.775,0.01,5265.0,322
HCPCS,1012F,ANGINA ABSENT,,,2739849.3,2739849.3,1
HCPCS,1012F,Angina absent,,,10.69,12.38,8
HCPCS,1012T,MTRZ AB NTRNO TRPH SCL/TR MW,,,3910.54,4301.59,12
HCPCS,1012T,Mtrz ab ntrno trph scl/tr mw,,,2420.84,2803.08,8
HCPCS,1013T,LAP SRG IMP/RPL ESO NEA&PG/R,,,18354.0,20189.4,12
HCPCS,1013T,Lap srg imp/rpl eso nea&pg/r,,,19174.95,22202.58,8
HCPCS,10140,I&D HEMATOMA SEROMA/FLUID COLLECTION,2778.0,1805.7,0.01,12500.0,409
HCPCS,1014T,LAP RV/RMV ESO SPH NSTM ELTR,,,10541.85,11596.03,12
HCPCS,1014T,Lap rv/rmv eso sph nstm eltr,,,2167.75,2510.02,8
HCPCS,1015F,COPD SYMPTOMS ASSESS,,,2739849.3,2739849.3,1
HCPCS,1015F,Copd symptoms assess,,,10.69,12.38,8
HCPCS,1015T,REV/RMV LW ESOPH SPHNC NPG/R,,,3307.59,3638.34,12
HCPCS,1015T,Rev/rmv lw esoph sphnc npg/r,,,2167.75,2510.02,8
HCPCS,10160,PUNCTURE ASPIRATION ABSCESS HEMATOMA BULLA/CYST,849.5,552.175,0.01,12500.0,407
HCPCS,1016T,Elec alys npgs esoph intraop,,,92.64,107.27,8
HCPCS,1017T,ELEC ALY NPGS ESOPH SBSQ W/O,,,55.81,61.39,12
HCPCS,1017T,Elec aly npgs esoph sbsq w/o,,,22.84,26.44,8
HCPCS,10180,INCISION & DRAINAGE COMPLEX PO WOUND INFECTION,4753.0,3089.45,0.01,8586.0,322
HCPCS,1018F,ASSESS DYSPNEA NOT PRESENT,,,2739849.3,2739849.3,1
HCPCS,1018F,Assess dyspnea not present,,,10.69,12.38,8
HCPCS,1018T,ELEC ALYS NPGS ESOPH SBSQ W/,,,35.31,38.84,12
HCPCS,1018T,Elec alys npgs esoph sbsq w/,,,22.84,26.44,8
HCPCS,1019F,ASSESS DYSPNEA PRESENT,,,2739849.3,2739849.3,1
HCPCS,1019F,Assess dyspnea present,,,10.69,12.38,8
HCPCS,1019T,LYMPHOVENOUS BYPASS PER XTR,,,6282.11,6910.32,12
HCPCS,1019T,Lymphovenous bypass per xtr,,,2262.59,2619.84,8
HCPCS,1020T,RAMAN SPECTROSCOPY 1+SKN LES,,,55.81,305.12,13
HCPCS,1020T,Raman spectroscopy 1+skn les,,,9.22,10.68,8
HCPCS,1021T,ACTIVE THRC IRRIGATION SPX,,,593.48,652.82,12
HCPCS,1021T,Active thrc irrigation spx,,,760.55,880.64,8
HCPCS,1022F,PNEUMO IMM STATUS ASSESS,,,0.03,0.03,1
HCPCS,1022F,Pneumo imm status assess,,,10.69,12.38,8
HCPCS,1022T,Prq tis dsplmt ntra-abdl/pel,,,673.41,779.74,8
HCPCS,1023T,Prq tis dsplmt intrathoracic,,,673.41,779.74,8
HCPCS,1024T,Perq tiss dsplmt soft tissue,,,673.41,779.74,8
HCPCS,1025T,ALT ELEC FLD DOS&DLV SIM MDL,,,127.16,139.88,12
HCPCS,1025T,Alt elec fld dos&dlv sim mdl,,,105.71,122.4,8
HCPCS,1026F,CO-MORBID CONDITION ASSESS,,,2739849.3,2739849.3,1
HCPCS,1026F,Co-morbid condition assess,,,10.69,12.38,8
HCPCS,1030F,INFLUENZA IMM STATUS ASSESS,,,0.03,0.03,1
HCPCS,1030F,Influenza imm status assess,,,10.69,12.38,8
HCPCS,1031F,SMOKING & 2ND HAND ASSESSED,,,0.03,0.03,1
HCPCS,1031F,Smoking & 2nd hand assessed,,,10.69,12.38,8
HCPCS,1032F,SMOKER/EXPOSED 2ND HND SMOKE,,,68.5,68.5,1
HCPCS,1032F,Smoker/exposed 2nd hnd smoke,,,10.69,12.38,8
HCPCS,1033F,TOBACCO NONSMOKER NOR 2NDHND,,,0.03,0.03,1
HCPCS,1033F,Tobacco nonsmoker nor 2ndhnd,,,10.69,12.38,8
HCPCS,1034F,CURRENT TOBACCO SMOKER,,,0.03,0.03,1
HCPCS,1034F,Current tobacco smoker,,,10.69,12.38,8
HCPCS,1035F,SMOKELESS TOBACCO USER,,,0.03,0.03,1
HCPCS,1035F,Smokeless tobacco user,,,10.69,12.38,8
HCPCS,1036F,TOBACCO NON-USER,,,0.03,0.03,1
HCPCS,1036F,Tobacco non-user,,,10.69,12.38,8
HCPCS,1038F,PERSISTENT ASTHMA,,,0.03,0.03,1
HCPCS,1038F,Persistent asthma,,,10.69,12.38,8
HCPCS,1039F,INTERMITTENT ASTHMA,,,2739849.3,2739849.3,1
HCPCS,1039F,Intermittent asthma,,,10.69,12.38,8
HCPCS,1040F,DSM-5 INFO MDD DOCD,,,102.75,102.75,1
HCPCS,1040F,Dsm-5 info mdd docd,,,10.69,12.38,8
HCPCS,1050F,HISTORY OF MOLE CHANGES,,,2739849.3,2739849.3,1
HCPCS,1050F,History of mole changes,,,10.69,12.38,8
HCPCS,1052F,TYPE LOCATION ACTIVITYASSESS,,,2739849.3,2739849.3,1
HCPCS,1052F,Type location activityassess,,,10.69,12.38,8
HCPCS,1055F,VISUAL FUNCT STATUS ASSESS,,,2739849.3,2739849.3,1
HCPCS,1055F,Visual funct status assess,,,10.69,12.38,8
HCPCS,1060F,DOC PERM/CONT/PAROX ATR FIB,,,2739849.3,2739849.3,1
HCPCS,1060F,Doc perm/cont/parox atr fib,,,10.69,12.38,8
HCPCS,1061F,DOC LACK PERM&CONT&PAROX FIB,,,2739849.3,2739849.3,1
HCPCS,1061F,Doc lack perm&cont&parox fib,,,10.69,12.38,8
HCPCS,1065F,ISCHM STROKE SYMP LT3 HRSB/4,,,2739849.3,2739849.3,1
HCPCS,1065F,Ischm stroke symp lt3 hrsb/4,,,10.69,12.38,8
HCPCS,1066F,ISCHM STROKE SX ONSET>=3HR,,,2739849.3,2739849.3,1
HCPCS,1066F,Ischm stroke sx onset>=3hr,,,10.69,12.38,8
HCPCS,1070F,ALARM SYMP ASSESSED-ABSENT,,,2739849.3,2739849.3,1
HCPCS,1070F,Alarm symp assessed-absent,,,10.69,12.38,8
HCPCS,1071F,ALARM SYMP ASSESSED-1+ PRSNT,,,2739849.3,2739849.3,1
HCPCS,1071F,Alarm symp assessed-1+ prsnt,,,10.69,12.38,8
HCPCS,1090F,PRES/ABSN URINE INCON ASSESS,,,0.03,0.03,1
HCPCS,1090F,Pres/absn urine incon assess,,,10.69,12.38,8
HCPCS,1091F,URINE INCON CHARACTERIZED,,,0.03,0.03,1
HCPCS,1091F,Urine incon characterized,,,10.69,12.38,8
HCPCS,11000,DBRDMT EXTENSV ECZEMA/INFECT SKN UP 10% BDY SURF,1038.0,674.7,0.01,12500.0,235
HCPCS,11001,DBRDMT EXTNSVE ECZEMA/INFECT SKN EA 10% BDY SURF,209.5,136.175,0.01,3443.0,216
HCPCS,11004,DBRDMT SKN SUBQ T/M/F NECRO INFCTJ GENT&PR,2729.0,1773.85,0.01,4320.0,213
HCPCS,11005,DBRDMT SKIN ABDOMINAL WALL,,,2026.94,2026.94,1
HCPCS,11005,DBRDMT SKN SUBQ T/M/F NECRO INFCTJ ABDL WALL,5696.0,3702.4,1.1,5696.0,144
HCPCS,11005,Dbrdmt skin abdominal wall,,,559.63,647.99,8
HCPCS,11006,DBRDMT SKIN XTRNL GENT PER,,,1832.27,1832.27,1
HCPCS,11006,DBRDMT SKN SUBQ T/M/F NECRO INFCTJ GENT/ABDL,5240.0,3406.0,1.1,5240.0,144
HCPCS,11006,Dbrdmt skin xtrnl gent per,,,559.63,647.99,8
HCPCS,11008,REMOVAL PROSTHETIC MATRL ABDL WALL FOR INFECTION,2000.0,1300.0,1.1,2000.0,144
HCPCS,11008,RMV PRSTC MTRL/MESH ABD WALL,,,713.8,713.8,1
HCPCS,11008,Rmv prstc mtrl/mesh abd wall,,,559.63,647.99,8
HCPCS,1100F,PTFALLS ASSESS-DOCD GE2>/YR,,,0.03,0.03,1
HCPCS,1100F,Ptfalls assess-docd ge2>/yr,,,10.69,12.38,8
HCPCS,11010,DBRDMT W/RMVL FM FX&/DISLC SKIN&SUBQ TISSUS,1977.5,1285.375,1.1,5265.0,235
HCPCS,11011,DBRDMT W/RMVL FM FX&/DISLC SKN SUBQ T/M/F MUSC,2174.0,1413.1,1.1,2174.0,148
HCPCS,11011,DEBRIDE SKIN MUSC AT FX SITE,,,610.39,736.94,20
HCPCS,11011,Debride skin musc at fx site,,,239.13,276.89,8
HCPCS,11012,DBRDMT FX&/DISLC SUBQ T/M/F BONE,5804.5,3772.9249999999997,1.1,8586.0,235
HCPCS,1101F,PT FALLS ASSESS-DOCD LE1/YR,,,0.03,0.03,1
HCPCS,1101F,Pt falls assess-docd le1/yr,,,10.69,12.38,8
HCPCS,11042,DEBRIDEMENT SUBCUTANEOUS TISSUE 20 SQ CM/<,821.5,533.975,0.01,5265.0,409
HCPCS,11043,DEBRIDEMENT MUSCLE & FASCIA 20 SQ CM/<,1512.0,982.8000000000001,0.01,5265.0,322
HCPCS,11044,DEBRIDEMENT BONE MUSCLE &/FASCIA 20 SQ CM/<,3332.5,2166.125,0.01,5265.0,322
HCPCS,11045,DBRDMT SUBCUTANEOUS TISSUE EA ADDL 20 SQ CM,964.5,626.925,0.01,5265.0,355
HCPCS,11046,DEBRIDEMENT MUSCLE &/FASCIA EA ADDL 20 SQ CM,1432.0,930.8,0.01,5265.0,286
HCPCS,11047,DEBRIDEMENT BONE EA ADDL 20 SQ CM/<,720.0,468.0,1.1,720.0,148
HCPCS,11047,Dbrdmt bone each addl,,,559.63,647.99,8
HCPCS,11055,PARING/CUTTING BENIGN HYPERKERATOTIC LESION 1,375.0,243.75,0.01,12500.0,321
HCPCS,11056,PARING/CUTTING BENIGN HYPERKERATOTIC LESION 2-4,408.0,265.2,0.01,12500.0,235
HCPCS,11057,PARING/CUTTING BENIGN HYPERKERATOTIC LESION >4,441.0,286.65,0.01,12500.0,235
HCPCS,11102,TANGENTIAL BIOPSY SKIN SINGLE LESION,443.0,287.95,0.01,12500.0,322
HCPCS,11103,TANGENTIAL BIOPSY SKIN EA SEP/ADDITIONAL LESION,163.0,105.94999999999999,0.01,4628.0,286
HCPCS,11104,PUNCH BIOPSY SKIN SINGLE LESION,782.0,508.3,0.01,12500.0,583
HCPCS,11105,PUNCH BIOPSY SKIN EA SEP/ADDITIONAL LESION,191.0,124.14999999999999,0.01,4628.0,355
HCPCS,11106,INCISIONAL BIOPSY SKIN SINGLE LESION,1836.0,1193.4,0.01,4628.0,261
HCPCS,11106,INCISIONAL BIOSPY SKIN SINGLE LESION,404.0,262.6,1.1,1830.48,148
HCPCS,11107,INCISIONAL BIOPSY SKIN EA SEP/ADDITIONAL LESION,249.5,162.175,0.01,4628.0,286
HCPCS,1110F,PT LFT INPT FAC W/IN 60 DAYS,,,2739849.3,2739849.3,1
HCPCS,1110F,Pt lft inpt fac w/in 60 days,,,10.69,12.38,8
HCPCS,1111F,DSCHRG MED/CURRENT MED MERGE,,,0.03,0.03,1
HCPCS,1111F,Dschrg med/current med merge,,,10.69,12.38,8
HCPCS,1116F,AURIC/PERI PAIN ASSESSED,,,2739849.3,2739849.3,1
HCPCS,1116F,Auric/peri pain assessed,,,10.69,12.38,8
HCPCS,1118F,GERD SYMPS ASSESSED 12 MONTH,,,2739849.3,2739849.3,1
HCPCS,1118F,Gerd symps assessed 12 month,,,10.69,12.38,8
HCPCS,1119F,INIT EVAL FOR CONDITION,,,2739849.3,2739849.3,1
HCPCS,1119F,Init eval for condition,,,10.69,12.38,8
HCPCS,11200,REMOVAL SKN TAGS MLT FIBRQ TAGS ANY AREA UPW/15,478.5,311.025,0.01,12500.0,407
HCPCS,11200,SKIN TAG REMOVAL 1 - 15,250.0,162.5,1.1,584.65,148
HCPCS,11201,REMOVAL SK TGS MLT FIBRQ TAGS ANY AREA EA 10,233.0,151.45,0.01,338.0,216
HCPCS,11201,SKIN TAG REMOVAL EA ADDL 10,100.0,65.0,1.1,100.0,148
HCPCS,1121F,SUBS EVAL FOR CONDITION,,,2739849.3,2739849.3,1
HCPCS,1121F,Subs eval for condition,,,10.69,12.38,8
HCPCS,1123F,ACP DISCUSS/DSCN MKR DOCD,,,0.03,0.03,1
HCPCS,1123F,Acp discuss/dscn mkr docd,,,10.69,12.38,8
HCPCS,1124F,ACP DISCUSS-NO DSCNMKR DOCD,,,0.03,0.03,1
HCPCS,1124F,Acp discuss-no dscnmkr docd,,,10.69,12.38,8
HCPCS,1125F,AMNT PAIN NOTED PAIN PRSNT,,,0.03,0.03,1
HCPCS,1125F,Amnt pain noted pain prsnt,,,10.69,12.38,8
HCPCS,1126F,AMNT PAIN NOTED NONE PRSNT,,,0.03,0.03,1
HCPCS,1126F,Amnt pain noted none prsnt,,,10.69,12.38,8
HCPCS,1127F,NEW EPISODE FOR CONDITION,,,2739849.3,2739849.3,1
HCPCS,1127F,New episode for condition,,,10.69,12.38,8
HCPCS,1128F,SUBS EPISODE FOR CONDITION,,,2739849.3,2739849.3,1
HCPCS,1128F,Subs episode for condition,,,10.69,12.38,8
HCPCS,11300,SHAVING SKIN LESION 1 TRUNK/ARM/LEG DIAM 0.5CM/<,731.5,475.475,0.01,12500.0,235
HCPCS,11301,SHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM 0.6-1.0 CM,496.0,322.4,0.01,12500.0,235
HCPCS,11302,SHVG SKN LESION 1 TRUNK/ARM/LEG DIAM 1.1-2.0 CM,529.0,343.85,0.01,12500.0,235
HCPCS,11303,SHVG SKIN LESION 1 TRUNK/ARM/LEG DIAM >2.0 CM,874.5,568.425,0.01,12500.0,235
HCPCS,11305,SHAVING SKIN LESION 1 S/N/H/F/G DIAM 0.5 CM/<,474.0,308.1,0.01,12500.0,321
HCPCS,11306,SHAVING SKIN LESION 1 S/N/H/F/G DIAM 0.6-1.0 CM,509.0,330.85,0.01,12500.0,235
HCPCS,11307,SHAVING SKIN LESION 1 S/N/H/F/G DIAM 1.1-2.0 CM,562.0,365.29999999999995,0.01,12500.0,321
HCPCS,11308,SHAVING SKIN LESION 1 S/N/H/F/G DIAM >2.0 CM,920.5,598.325,0.01,12500.0,235
HCPCS,1130F,BK PAIN & FXN ASSESSED,,,2739849.3,2739849.3,1
HCPCS,1130F,Bk pain & fxn assessed,,,10.69,12.38,8
HCPCS,11310,SHAVING SKIN LESION 1 F/E/E/N/L/M DIAM 0.5 CM/<,474.0,308.1,0.01,12500.0,235
HCPCS,11311,SHVG SKIN LESION 1 F/E/E/N/L/M DIAM 0.6-1.0 CM,540.0,351.0,0.01,12500.0,235
HCPCS,11312,SHVG SKIN LESION 1 F/E/E/N/L/M DIAM 1.1-2.0 CM,885.5,575.575,0.01,12500.0,235
HCPCS,11313,SHAVING SKIN LESION 1 F/E/E/N/L/M DIAM >2.0 CM,969.0,629.85,0.01,12500.0,235
HCPCS,1134F,EPSD BK PAIN FOR 6 WKS/<,,,2739849.3,2739849.3,1
HCPCS,1134F,Epsd bk pain for 6 wks/<,,,10.69,12.38,8
HCPCS,1135F,EPSD BK PAIN FOR >6 WKS,,,2739849.3,2739849.3,1
HCPCS,1135F,Epsd bk pain for >6 wks,,,10.69,12.38,8
HCPCS,1136F,EPSD BK PAIN FOR 12 WKS/<,,,2739849.3,2739849.3,1
HCPCS,1136F,Epsd bk pain for 12 wks/<,,,10.69,12.38,8
HCPCS,1137F,EPSD BK PAIN FOR >12 WKS,,,2739849.3,2739849.3,1
HCPCS,1137F,Epsd bk pain for >12 wks,,,10.69,12.38,8
HCPCS,11400,EXC B9 LESION MRGN XCP SK TG T/A/L 0.5 CM/<,2111.0,1372.15,0.01,3443.0,173
HCPCS,11400,"REM LESION TRUNK, ARM, LEG <0.5CM",115.0,74.75,1.1,2050.87,148
HCPCS,11400,"REM LESION TRUNK,ARM, LEG <0.5 CM",360.0,234.0,1.1,2050.87,148
HCPCS,11401,EXC B9 LESION MRGN XCP SK TG T/A/L 0.6-1.0 CM,1199.0,779.35,0.01,3443.0,173
HCPCS,11401,"REM LESION TRUNK, ARM, LEG 0.6-1.0CM",130.0,84.5,1.1,1163.18,148
HCPCS,11401,"REM LESION TRUNK,ARM,LEG 0.6 -1.0CM",563.0,365.95,1.1,1163.18,148
HCPCS,11402,EXC B9 LESION MRGN XCP SK TG T/A/L 1.1-2.0 CM,2111.0,1372.15,0.01,4628.0,261
HCPCS,11402,"REM LESIO TRUNK, ARM, LEG 1.1-2.0CM",145.0,94.25,1.1,2050.87,148
HCPCS,11402,"REM LESIO TRUNK,ARM,LEG 1.1 -2.0CM",638.0,414.7,1.1,2050.87,148
HCPCS,11403,EXC B9 LESION MRGN XCP SK TG T/A/L 2.1-3.0 CM,2111.0,1372.15,0.01,4628.0,174
HCPCS,11403,"REM LESIO TRUNK, ARM, LEG 2.1-3.0CM",180.0,117.0,1.1,2050.87,148
HCPCS,11403,"REM LESIO TRUNK,ARM,LEG 2.1-3.0CM",810.0,526.5,1.1,2050.87,148
HCPCS,11404,EXC B9 LESION MRGN XCP SK TG T/A/L 3.1-4.0 CM,4861.0,3159.65,0.01,4861.0,87
HCPCS,11404,"REM LESIO TRUNK, ARM, LEG 3.0-4.0CM",205.0,133.25,1.1,4729.25,148
HCPCS,11404,"REM LESIO TRUNK,ARM,LEG 3.0-4.0CM",928.0,603.2,1.1,4729.25,148
HCPCS,11406,EXC B9 LESION MRGN XCP SK TG T/A/L >4.0 CM,4861.0,3159.65,0.01,5265.0,87
HCPCS,11406,"REM LESION TRUNK, ARM, LEG >4.0CM",340.0,221.0,1.1,4729.25,148
HCPCS,11406,"REM LESION TRUNK,ARM,LEG > 4.0CM",1549.0,1006.85,1.1,4729.25,148
HCPCS,11420,EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 0.5 CM/<,4861.0,3159.65,0.01,4861.0,259
HCPCS,11420,"REM LESION NEC, HAND, SCAL <0.5CM",115.0,74.75,1.1,4729.25,148
HCPCS,11420,"REM LESION NEC,HAND,SCAL<0.5CM",453.0,294.45,1.1,4729.25,148
HCPCS,11421,EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 0.6-1.0CM,2111.0,1372.15,0.01,4628.0,174
HCPCS,11421,"REM LESION NEC, HND, SCAL 0.6-1.0CM",150.0,97.5,1.1,2050.87,148
HCPCS,11421,"REM LESION NEC,HND,SCAL 0.6-1.0CM",647.0,420.55,1.1,2050.87,148
HCPCS,11422,EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 1.1-2.0CM,4861.0,3159.65,0.01,4861.0,174
HCPCS,11422,"REM LESION NEC, HND, SCAL, FEET, GENITALIA 1.1-2.0CM",175.0,113.75,1.1,4729.25,148
HCPCS,11422,"REM LESION NEC,HND,SCAL,FEET,GENITALIA 1.1-2.0CM",739.0,480.35,1.1,4729.25,148
HCPCS,11423,EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 2.1-3.0CM,4861.0,3159.65,0.01,4861.0,87
HCPCS,11423,"REM LESION NEC, HND, SCAL 2.1-3.0CM",230.0,149.5,1.1,4729.25,148
HCPCS,11423,"REM LESION NEC,HND,SCAL 2.1-3.0CM",906.0,588.9,1.1,4729.25,148
HCPCS,11424,EXC B9 LESION MRGN XCP SK TG S/N/H/F/G 3.1-4.0CM,4861.0,3159.65,0.01,6112.0,174
HCPCS,11424,"REM LESION NEC, HND, SCAL 3.1-4.0CM",240.0,156.0,1.1,4729.25,148
HCPCS,11424,"REM LESION NEC,HND,SCAL 3.1-4.0CM",1091.0,709.15,1.1,4729.25,148
HCPCS,11426,EXC B9 LESION MRGN XCP SK TG S/N/H/F/G > 4.0CM,8586.0,5580.9,0.01,8586.0,87
HCPCS,11426,"REM LESION NECK, HAND, SCAL >4.0CM",400.0,260.0,1.1,8286.13,148
HCPCS,11426,"REM LESION NECK,HAND,SCAL >4.0CM",1800.0,1170.0,1.1,8286.13,148
HCPCS,11440,EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M 0.5CM/<,2111.0,1372.15,0.01,4337.0,173
HCPCS,11440,"REM LESION FACE, EAR, EYEL <5MM",115.0,74.75,1.1,2050.87,148
HCPCS,11440,"REM LESION FACE,EAR,EYEL <5MM",462.0,300.3,1.1,2050.87,148
HCPCS,11441,EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 0.6-1.0CM,2111.0,1372.15,0.01,4392.0,87
HCPCS,11441,"REM LESION FACE, EAR, EYE 0.6-1CM",155.0,100.75,1.1,2050.87,148
HCPCS,11441,"REM LESION FACE,EAR,EYE 0.6-1CM",673.0,437.45,1.1,2050.87,148
HCPCS,11442,EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 1.1-2.0CM,2111.0,1372.15,0.01,4392.0,174
HCPCS,11442,"REM LESION FACE, EAR, EYE 1.1-2CM",175.0,113.75,1.1,2050.87,148
HCPCS,11442,"REM LESION FACE,EAR,EYE 1.1-2 CM",779.0,506.35,1.1,2050.87,148
HCPCS,11443,EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 2.1-3.0CM,4861.0,3159.65,0.01,4861.0,87
HCPCS,11443,"REM LESION FACE, EAR, EYE 2.1-3CM",230.0,149.5,1.1,4729.25,148
HCPCS,11443,"REM LESION FACE,EAR,EYE 2.1-3 CM",1030.0,669.5,1.1,4729.25,148
HCPCS,11444,EXC B9 LES MRGN XCP SK TG F/E/E/N/L/M 3.1-4.0CM,4861.0,3159.65,0.01,4861.0,87
HCPCS,11444,"REM LESION FACE, EAR, EYE 3.1-4CM",305.0,198.25,1.1,4729.25,148
HCPCS,11444,"REM LESION FACE,EAR,EYE 3.1-4 CM",1404.0,912.6,1.1,4729.25,148
HCPCS,11446,EXC B9 LESION MRGN XCP SK TG F/E/E/N/L/M > 4.0CM,8586.0,5580.9,0.01,8586.0,87
HCPCS,11446,"REM LESION FACE, EAR, EYE >4CM",460.0,299.0,1.1,8286.13,148
HCPCS,11446,"REM LESION FACE,EAR,EYE >4CM",2112.0,1372.8,1.1,8286.13,148
HCPCS,11450,EXCISION HIDRADENITIS AXILLARY SMPL/INTRM RPR,4937.0,3209.0499999999997,0.01,8586.0,235
HCPCS,11451,EXC SKN HDRDNT AX COMPLEX,,,2465.15,3022.89,20
HCPCS,11451,EXCISION HIDRADENITIS AXILLARY COMPLEX REPAIR,1772.0,1151.8,1.1,8286.13,148
HCPCS,11451,Exc skn hdrdnt ax complex,,,1713.83,1984.43,8
HCPCS,11462,EXCISION HIDRADENITIS INGUINAL SMPL/INTRM RPR,4893.0,3180.45,0.01,8586.0,235
HCPCS,11463,EXC SKN HDRDNT ING COMPLEX,,,2465.15,3022.89,20
HCPCS,11463,EXCISION HIDRADENITIS INGUINAL COMPLEX REPAIR,1772.0,1151.8,1.1,8286.13,148
HCPCS,11463,Exc skn hdrdnt ing complex,,,1713.83,1984.43,8
HCPCS,11470,EXCISION H/P/P/U SIMPLE/INTERMEDIATE REPAIR,5041.0,3276.6499999999996,0.01,8586.0,235
HCPCS,11471,EXC SKN H/P/P/U COMPLEX,,,2465.15,3022.89,20
HCPCS,11471,EXCISION H/P/P/U COMPLEX REPAIR,1956.0,1271.4,1.1,8286.13,148
HCPCS,11471,Exc skn h/p/p/u complex,,,1713.83,1984.43,8
HCPCS,1150F,DOC PT RSK DEATH W/IN 1YR,,,2739849.3,2739849.3,1
HCPCS,1150F,Doc pt rsk death w/in 1yr,,,10.69,12.38,8
HCPCS,1151F,DOC NO PT RSK DEATH W/IN 1YR,,,2739849.3,2739849.3,1
HCPCS,1151F,Doc no pt rsk death w/in 1yr,,,10.69,12.38,8
HCPCS,1152F,DOC ADVNCD DIS COMFORT 1ST,,,2739849.3,2739849.3,1
HCPCS,1152F,Doc advncd dis comfort 1st,,,10.69,12.38,8
HCPCS,1153F,DOC ADVNCD DIS CMFRT NOT 1ST,,,2739849.3,2739849.3,1
HCPCS,1153F,Doc advncd dis cmfrt not 1st,,,10.69,12.38,8
HCPCS,1157F,ADVNC CARE PLAN IN RCRD,,,0.03,0.03,1
HCPCS,1157F,Advnc care plan in rcrd,,,10.69,12.38,8
HCPCS,1158F,ADVNC CARE PLAN TLK DOCD,,,0.03,0.03,1
HCPCS,1158F,Advnc care plan tlk docd,,,10.69,12.38,8
HCPCS,1159F,MED LIST DOCD IN RCRD,,,0.03,0.03,1
HCPCS,1159F,Med list docd in rcrd,,,10.69,12.38,8
HCPCS,11600,EXCISION MAL LESION TRUNK/ARM/LEG 0.5 CM/<,2111.0,1372.15,0.01,3443.0,87
HCPCS,11600,MAL REM LESION 0.5 CM OR LESS,717.0,466.05,1.1,2050.87,148
HCPCS,11601,EXCISION MAL LESION TRUNK/ARM/LEG 0.6-1.0 CM,2111.0,1372.15,0.01,3443.0,87
HCPCS,11601,"MAL LESION TRUNK,ARM,LEG 0.6-1.0CM",911.0,592.15,1.1,2050.87,148
HCPCS,11602,EXCISION MAL LESION TRUNK/ARM/LEG 1.1-2.0 CM,1199.0,779.35,0.01,4392.0,87
HCPCS,11602,"MAL LESION TRUNK,ARM,LEG 1.1-2.0 CM",999.0,649.35,1.1,1163.18,148
HCPCS,11603,EXCISION MAL LESION TRUNK/ARM/LEG 2.1-3.0 CM,2111.0,1372.15,0.01,4392.0,87
HCPCS,11603,"MAL LESION TRUNK,ARM,LEG 2.1-3.0 CM",1241.0,806.65,1.1,2050.87,148
HCPCS,11604,EXCISION MAL LESION TRUNK/ARM/LEG 3.1-4.0 CM,2111.0,1372.15,0.01,5265.0,87
HCPCS,11604,"MAL LESION TRUNK,ARM,LEG 3.1-4.0 CM",1395.0,906.75,1.1,2050.87,148
HCPCS,11606,EXCISION MALIGNANT LESION TRUNK/ARM/LEG > 4.0 CM,3535.0,2297.75,0.01,5265.0,235
HCPCS,1160F,RVW MEDS BY RX/DR IN RCRD,,,0.03,0.03,1
HCPCS,1160F,Rvw meds by rx/dr in rcrd,,,10.69,12.38,8
HCPCS,11620,EXCISION MALIGNANT LESION S/N/H/F/G 0.5 CM/<,4861.0,3159.65,0.01,4861.0,87
HCPCS,11620,"MAL LESION TRUNK,ARM,LEG<0.5CM",656.0,426.4,1.1,4729.25,148
HCPCS,11621,EXCISION MALIGNANT LESION S/N/H/F/G 0.6-1.0 CM,2111.0,1372.15,0.01,3443.0,87
HCPCS,11621,"MAL LESION NECK,HAND,SCAL 0.6-1CM",832.0,540.8,1.1,2050.87,148
HCPCS,11622,EXCISION MALIGNANT LESION S/N/H/F/G 1.1-2.0 CM,2111.0,1372.15,0.01,4392.0,87
HCPCS,11622,"MAL LESION NECK,HAND,SCAL 1.1-2CM",964.0,626.6,1.1,2050.87,148
HCPCS,11623,EXCISION MALIGNANT LESION S/N/H/F/G 2.1-3.0 CM,4861.0,3159.65,0.01,12500.0,87
HCPCS,11623,"MAL LESION NECK,HAND,SCAL 2.1-3CM",1244.0,808.6,1.1,4729.25,148
HCPCS,11624,EXCISION MALIGNANT LESION S/N/H/F/G 3.1-4.0 CM,4861.0,3159.65,0.01,5265.0,87
HCPCS,11624,"MAL LESION NECK,HAND,SCAL 3.1-4CM",1448.0,941.2,1.1,4729.25,148
HCPCS,11626,EXC SKIN MALIG >4CM REMAINDR BODY,1844.0,1198.6,1.1,8286.13,148
HCPCS,11626,EXCISION MALIGNANT LESION S/N/H/F/G >4.0 CM,8586.0,5580.9,0.01,8586.0,87
HCPCS,11640,EXCISION MALIGNANT LESION F/E/E/N/L 0.5 CM/<,2111.0,1372.15,0.01,4337.0,87
HCPCS,11640,"MAL LESION FACE,EAR,EYEL <5MM",668.0,434.2,1.1,2050.87,148
HCPCS,11641,EXCISION MALIGNANT LESION F/E/E/N/L 0.6-1.0 CM,2111.0,1372.15,0.01,4337.0,87
HCPCS,11641,"MAL LESION FACE,EAR,EYEL 0.6-1CM",868.0,564.2,1.1,2050.87,148
HCPCS,11642,EXCISION MALIGNANT LESION F/E/E/N/L 1.1-2.0 CM,2111.0,1372.15,0.01,4392.0,87
HCPCS,11642,"MAL LESION FACE,EAR,EYEL 1.1-2CM",1048.0,681.2,1.1,2050.87,148
HCPCS,11643,EXCISION MALIGNANT LESION F/E/E/N/L 2.1-3.0 CM,4861.0,3159.65,0.01,4861.0,87
HCPCS,11643,"MAL LESION FACE,EAR,EYEL 2.1-3CM",1368.0,889.2,1.1,4729.25,148
HCPCS,11644,EXCISION MALIGNANT LESION F/E/E/N/L 3.1-4.0 CM,4861.0,3159.65,0.01,5265.0,87
HCPCS,11644,"MAL LESION FACE,EAR,EYEL 3.1-4CM",1736.0,1128.4,1.1,4729.25,148
HCPCS,11646,EXCISION MALIGNANT LESION F/E/E/N/L >4.0 CM,8586.0,5580.9,0.01,8586.0,87
HCPCS,11646,"MAL LESION FACE,EAR,EYEL >4.0CM",2504.0,1627.6,1.1,8286.13,148
HCPCS,1170F,FXNL STATUS ASSESSED,,,0.03,0.03,1
HCPCS,1170F,Fxnl status assessed,,,10.69,12.38,8
HCPCS,11719,TRIMMING NONDYSTROPHIC NAILS ANY NUMBER,126.5,82.225,0.01,12500.0,309
HCPCS,11720,DEBRIDEMENT NAIL ANY METHOD 1-5,178.0,115.7,0.01,12500.0,173
HCPCS,11720,"DEBRIDEMENT OF NAIL(S), 1-5",141.0,91.65,1.1,177.54,148
HCPCS,11721,DEBRIDEMENT NAIL ANY METHOD 6/>,178.0,115.7,0.01,12500.0,87
HCPCS,11721,"DEBRIDEMENT OF NAILS, 6 OR MORE",238.0,154.7,1.1,238.0,148
HCPCS,11730,AVULSION NAIL PLATE PARTIAL/COMPLETE SIMPLE 1,529.0,343.85,0.01,12500.0,321
HCPCS,11732,AVULSION NAIL PLATE PARTIAL/COMP SIMPLE EA ADDL,344.0,223.6,0.01,3443.0,284
HCPCS,11740,EVAC. SUBUNGUAL HEMATOMA,148.0,96.2,1.1,373.44,148
HCPCS,11740,EVACUATION SUBUNGUAL HEMATOMA,387.0,251.55,0.01,12500.0,173
HCPCS,11750,EXCISION NAIL MATRIX PERMANENT REMOVAL,947.0,615.55,0.01,3443.0,321
HCPCS,11755,BIOPSY NAIL UNIT SEPARATE PROCEDURE,1305.5,848.575,0.01,3443.0,235
HCPCS,1175F,FUNCTION STAT ASSESSED RVWD,,,2739849.3,2739849.3,1
HCPCS,1175F,Function stat assessed rvwd,,,10.69,12.38,8
HCPCS,11760,REPAIR NAIL BED,1836.0,1193.4,0.01,12500.0,173
HCPCS,11760,"REPAIR OF NAIL BED, SIMPLE",652.0,423.8,1.1,1830.48,148
HCPCS,11762,RECONSTRUC OF NAIL BED W GRAFT,1176.0,764.4,1.1,5320.02,148
HCPCS,11762,RECONSTRUCTION OF NAIL BED,,,1582.09,4760.83,21
HCPCS,11762,Reconstruction of nail bed,,,1060.53,1227.99,8
HCPCS,11765,WEDGE EXCISION SKIN NAIL FOLD,843.5,548.275,0.01,12500.0,321
HCPCS,11770,EXCISION PILONIDAL CYST/SINUS SIMPLE,4878.0,3170.7,0.01,8586.0,409
HCPCS,11771,EXC PILONIDAL CYST XTNSV,,,2465.15,7813.0,24
HCPCS,11771,EXCISION PILONIDAL CYST/SINUS EXTENSIVE,2680.0,1742.0,1.1,8286.13,148
HCPCS,11771,Exc pilonidal cyst xtnsv,,,1713.83,1984.43,8
HCPCS,11772,EXC PILONIDAL CYST COMP,,,2465.15,7813.0,23
HCPCS,11772,EXCISION PILONIDAL CYST/SINUS COMPLICATED,3234.0,2102.1,1.1,8286.13,148
HCPCS,11772,Exc pilonidal cyst comp,,,1713.83,1984.43,8
HCPCS,1180F,THROMBOEMB RISK ASSESSED,,,2739849.3,2739849.3,1
HCPCS,1180F,Thromboemb risk assessed,,,10.69,12.38,8
HCPCS,1181F,NEUROPSYCHIA SYMPTS ASSESSED,,,2739849.3,2739849.3,1
HCPCS,1181F,Neuropsychia sympts assessed,,,10.69,12.38,8
HCPCS,1182F,NEUROPSYCHI SYMPT 1+PRESENT,,,2739849.3,2739849.3,1
HCPCS,1182F,Neuropsychi sympt 1+present,,,10.69,12.38,8
HCPCS,1183F,NEUROPSYCHIATRIC SYMP ABSENT,,,2739849.3,2739849.3,1
HCPCS,1183F,Neuropsychiatric symp absent,,,10.69,12.38,8
HCPCS,11900,INJECTION INTRALESIONAL UP TO & INCLUD 7 LESIONS,412.5,268.125,0.01,12500.0,321
HCPCS,11901,INJECTION INTRALESIONAL >7 LESIONS,474.0,308.1,0.01,12500.0,235
HCPCS,11920,TATTOOING INCL MICROPIGMENTATION 6.0 CM/<,1240.0,806.0,0.01,12500.0,235
HCPCS,11921,TATTOOING INCL MICROPIGMENTATION 6.1-20.0 CM,1304.0,847.6,0.01,12500.0,235
HCPCS,11922,TATTOOING INCL MICROPIGMENTATION EA 20.0 CM,240.5,156.325,0.01,3443.0,216
HCPCS,11950,SUBCUTANEOUS INJECTION FILLING MATERIAL 1 CC/<,466.0,302.9,0.01,12500.0,233
HCPCS,11951,RENUVA 1.5 CC,817.0,531.05,1.1,1830.48,146
HCPCS,11951,RENUVA 3.0 CC,1619.0,1052.35,1.1,1830.48,146
HCPCS,11951,RENUVA 5.0 CC,2752.0,1788.8,1.1,2752.0,146
HCPCS,11951,SUBCUTANEOUS INJECTION FILLING MATRL 1.1-5.0 CC,1156.0,751.4000000000001,0.01,12500.0,233
HCPCS,11952,SUBCUTANEOUS INJECTION FILLING MATRL 5.1-10.0CC,1256.0,816.4000000000001,0.01,12500.0,233
HCPCS,11954,SUBCUTANEOUS INJECTION FILLING MATRL >10.0 CC,1288.0,837.2,0.01,12500.0,320
HCPCS,11960,INSERT TISSUE EXPANDER(S),,,3112.46,3687.9,20
HCPCS,11960,INSERTION TISSUE EXPANDER INCL SBSQ XPNSJ,4596.0,2987.4,1.1,10462.5,144
HCPCS,11960,Insert tissue expander(s),,,1713.83,1984.43,8
HCPCS,11970,REPLACEMENT TISSUE EXPANDER W/PERMANENT IMPLANT,3296.0,2142.4,1.1,20863.78,144
HCPCS,11970,RPLCMT TISS XPNDR PERM IMPLT,,,6206.54,11170.0,23
HCPCS,11970,Rplcmt tiss xpndr perm implt,,,3079.1,3565.28,8
HCPCS,11971,REMOVAL TISSUE EXPANDER W/O INSERTION IMPLANT,2808.0,1825.2,1.1,8286.13,144
HCPCS,11971,RMVL TIS XPNDR WO INSJ IMPLT,,,2351.0,7624.0,22
HCPCS,11971,Rmvl tis xpndr wo insj implt,,,1031.8,1194.71,8
HCPCS,11976,REMOVAL IMPLANTABLE CONTRACEPTIVE CAPSULES,1411.5,917.475,0.01,3443.0,235
HCPCS,11980,SUBCUTANEOUS HORMONE PELLET IMPLANT,440.0,286.0,1.1,1163.18,146
HCPCS,11980,SUBCUTANEOUS HORMONE PELLET IMPLANTATION,1197.0,778.05,0.01,12500.0,87
HCPCS,11981,INSERT DRUG IMPLANT DEVICE,444.5,288.925,1.1,502.0,296
HCPCS,11981,INSERTION DRUG DELIVERY IMPLANT,387.0,251.55,0.01,12500.0,87
HCPCS,11982,REMOVAL NON-BIODEGRADABLE DRUG DELIVERY IMPLANT,893.5,580.775,0.01,12500.0,321
HCPCS,11983,RMVL W/RINSJ NON-BIODEGRADABLE DRUG DLVR IMPLT,1018.5,662.025,0.01,12500.0,235
HCPCS,12001,"SIMP REPAIR SCALP,NECK,TRK <2.5CM",370.0,240.5,1.1,584.65,148
HCPCS,12001,SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.5CM/<,596.0,387.4,0.01,12500.0,173
HCPCS,12002,"SIMP REPAIR SCALP,NECK,TRK 2.6-7.5CM",502.0,326.3,1.1,584.65,148
HCPCS,12002,SMPL REPAIR SCALP/NECK/AX/GENIT/TRUNK 2.6-7.5CM,596.0,387.4,0.01,12500.0,173
HCPCS,12004,"SIMP REPAIR SCALP,NECK,TRK 7.6-12.5CM",634.0,412.1,1.1,634.0,148
HCPCS,12004,SIMPLE RPR SCALP/NECK/AX/GENIT/TRUNK 7.6-12.5CM,596.0,387.4,0.01,12500.0,174
HCPCS,12005,"SIMP REPAIR SCALP,NECK,TRK 12.6-20CM",867.0,563.55,1.1,1163.18,148
HCPCS,12005,SMPL RPR SCALP/NECK/AX/GENIT/TRUNK 12.6-20.0CM,1199.0,779.35,0.01,5265.0,174
HCPCS,12006,REPR SUPERF WND BODY 20.1-30,1052.0,683.8,1.1,1163.18,148
HCPCS,12006,SMPL RPR SCALP/NECK/AX/GENIT/TRUNK 20.1-30.0CM,1199.0,779.35,0.01,5265.0,261
HCPCS,12007,REPR SUPERF WND BODY >30CM,1276.0,829.4,1.1,1276.0,148
HCPCS,12007,SIMPLE REPAIR SCALP/NECK/AX/GENIT/TRUNK >30.0CM,596.0,387.4,165.69,5265.0,87
HCPCS,1200F,SEIZURE TYPE& FREQU DOCD,,,2739849.3,2739849.3,1
HCPCS,1200F,Seizure type& frequ docd,,,10.69,12.38,8
HCPCS,12011,"SIMP REPAIR FACE,EAR,EYE <2.5CM",471.0,306.15,1.1,584.65,148
HCPCS,12011,SIMPLE REPAIR F/E/E/N/L/M 2.5CM/<,596.0,387.4,0.01,12500.0,173
HCPCS,12013,"SIMP REPAIR FACE,EAR,EYE 2.6-5CM",537.0,349.05,1.1,584.65,148
HCPCS,12013,SIMPLE REPAIR F/E/E/N/L/M 2.6CM-5.0 CM,596.0,387.4,0.01,12500.0,173
HCPCS,12014,"SIMP REPAIR FACE,EAR,EYE 5.1-7.5CM",691.0,449.15,1.1,691.0,148
HCPCS,12014,SIMPLE REPAIR F/E/E/N/L/M 5.1CM-7.5 CM,596.0,387.4,0.01,12500.0,174
HCPCS,12015,"SIMP REPAIR FAC,EAR,EYE 7.6-12.5 CM",596.0,387.4,0.01,12500.0,87
HCPCS,12015,"SIMP REPAIR FAC,EAR,EYE 7.6-12.5CM",871.0,566.15,1.1,871.0,148
HCPCS,12015,SIMPLE REPAIR F/E/E/N/L/M 7.6CM-12.5 CM,596.0,387.4,116.53,4392.0,87
HCPCS,12016,"SIMP REPAIR FAC,EAR,EYE 12.6-20CM",1189.0,772.85,0.01,5265.0,235
HCPCS,12016,SIMPLE REPAIR F/E/E/N/L/M 12.6CM-20.0 CM,1199.0,779.35,157.64,5265.0,87
HCPCS,12017,SIMPLE REPAIR F/E/E/N/L/M 20.1CM-30.0 CM,1199.0,779.35,0.01,5265.0,174
HCPCS,12017,SREP F/E/N/L/MM 20.1-30.0CM,1399.0,909.35,1.1,1399.0,144
HCPCS,12018,SIMPLE REPAIR F/E/E/N/L/M >30.0 CM,596.0,387.4,165.69,5265.0,87
HCPCS,12020,TX SUPERFICIAL WOUND DEHISCENCE SIMPLE CLOSURE,1505.5,978.575,0.01,4392.0,320
HCPCS,12021,TX SUPERFICIAL WOUND DEHISCENCE W/PACKING,1015.5,660.075,0.01,4392.0,320
HCPCS,12031,"INT REPAIR SCALP,AXL,TRUNK <2.5CM",880.0,572.0,1.1,1163.18,148
HCPCS,12031,REPAIR INTERMEDIATE S/A/T/E 2.5 CM/<,1199.0,779.35,0.01,12500.0,173
HCPCS,12032,"INT REPAIR SCALP,AXL,TRUNK 2.6-7.5CM",1109.0,720.85,1.1,1163.18,148
HCPCS,12032,REPAIR INTERMEDIATE S/A/T/E 2.6-7.5 CM,1199.0,779.35,0.01,12500.0,174
HCPCS,12034,"INT REPAIR SCALP,AXL,TRUNK 7.6-12.5CM",1307.0,849.55,1.1,1307.0,148
HCPCS,12034,REPAIR INTERMEDIATE S/A/T/E 7.6-12.5 CM,1199.0,779.35,0.01,5265.0,174
HCPCS,12035,"INT REPAIR SCALP,AXL,TRUNK 12.6-20CM",1540.0,1001.0,1.1,1540.0,148
HCPCS,12035,REPAIR INTERMEDIATE S/A/T/E 12.6-20.0CM,1199.0,779.35,0.01,5265.0,174
HCPCS,12036,"LAYR CLOS WND TRUNK,ARM,LEG 20.1-30",1861.0,1209.65,1.1,1861.0,148
HCPCS,12036,REPAIR INTERMEDIATE S/A/T/E 20.1-30.0 CM,1836.0,1193.4,0.01,5265.0,174
HCPCS,12037,"LAYR CLOS WND TRUNK,ARM,LEG >30CM",2200.0,1430.0,1.1,5320.02,148
HCPCS,12037,REPAIR INTERMEDIATE S/A/T/E >30.0 CM,5488.0,3567.2,0.01,5488.0,174
HCPCS,12041,INT REPAIR NECK/HANDS/FEET/XTRNL GENT <2.5CM,924.0,600.6,1.1,1163.18,148
HCPCS,12041,REPAIR INTERMEDIATE N/H/F/XTRNL GENT 2.5CM/<,1199.0,779.35,0.01,12500.0,173
HCPCS,12042,"INT REPAIR NECK,HANDS,FEET, GENIT, 2.6-7.5 CM",1228.0,798.2,1.1,1228.0,148
HCPCS,12042,REPAIR INTERMEDIATE N/H/F/XTRNL GENT 2.6-7.5 CM,1199.0,779.35,0.01,12500.0,174
HCPCS,12044,"INT REPAIR SCALP,NEC,TRK 7.6-12.5CM",1404.0,912.6,1.1,1830.48,148
HCPCS,12044,REPAIR INTERMEDIATE N/H/F/XTRNL GENT 7.6-12.5CM,1836.0,1193.4,0.01,5265.0,174
HCPCS,12045,"INT REPAIR SCALP,NEC,TRK 12.6-20CM",1650.0,1072.5,1.1,1830.48,148
HCPCS,12045,REPAIR INTERMEDIATE N/H/F/XTRNL GENT 12.6-20 CM,1836.0,1193.4,0.01,5265.0,174
HCPCS,12046,LAYR CLOS WND REST BODY 20.1-30,1892.0,1229.8,1.1,1892.0,148
HCPCS,12046,RPR INTERMEDIATE N/H/F/XTRNL GENT 20.1-30.0 CM,1836.0,1193.4,239.13,5265.0,87
HCPCS,12047,LAYR CLOS WND REST BODY >30CM,2178.0,1415.7,1.1,5320.02,148
HCPCS,12047,REPAIR INTERMEDIATE N/H/F/XTRNL GENT >30.0 CM,5488.0,3567.2,239.13,5488.0,87
HCPCS,12051,"INT REPAIR FACE,EAR,EYE <2.5CM",1025.0,666.25,1.1,1163.18,148
HCPCS,12051,LAYER CLOSURE OF EAR LOBES,415.0,269.75,1.1,1163.18,148
HCPCS,12051,REPAIR INTERMEDIATE F/E/E/N/L&/MUC 2.5 CM/<,1199.0,779.35,0.01,12500.0,173
HCPCS,12052,"INT REPAIR FACE,EAR,EYE 2.6-5CM",1263.0,820.95,1.1,1263.0,148
HCPCS,12052,REPAIR INTERMEDIATE F/E/E/N/L&/MUC 2.6-5.0 CM,1199.0,779.35,0.01,12500.0,261
HCPCS,12053,"INT REPAIR FACE,EAR,EYE 5.1-7.5CM",1395.0,906.75,1.1,1395.0,148
HCPCS,12053,REPAIR INTERMEDIATE F/E/E/N/L&/MUC 5.1-7.5 CM,1199.0,779.35,0.01,12500.0,174
HCPCS,12054,"INT REPAIR FAC,EAR,EYE 7.6-12.5CM",1540.0,1001.0,1.1,1540.0,148
HCPCS,12054,REPAIR INTERMEDIATE F/E/E/N/L&/MUC 7.6-12.5 CM,1199.0,779.35,0.01,5265.0,174
HCPCS,12055,"INT REPAIR FAC,EAR,EYE 12.6-20CM",1980.0,1287.0,1.1,1980.0,148
HCPCS,12055,REPAIR INTERMEDIATE F/E/E/N/L&/MUC 12.6-20.0CM,1199.0,779.35,0.01,5265.0,174
HCPCS,12056,REPAIR INTERMEDIATE F/E/E/N/L&/MUC 20.1-30.0CM,1199.0,779.35,239.13,5265.0,87
HCPCS,12057,"LAYR CLOS WND FACE,FACIAL >30CM",2640.0,1716.0,1.1,2640.0,148
HCPCS,12057,REPAIR INTERMEDIATE F/E/E/N/L&/MUC >30.0 CM,1199.0,779.35,239.13,5265.0,87
HCPCS,1205F,EPI ETIOL SYND RVWD AND DOCD,,,2739849.3,2739849.3,1
HCPCS,1205F,Epi etiol synd rvwd and docd,,,10.69,12.38,8
HCPCS,1220F,PT SCREENED FOR DEPRESSION,,,0.03,0.03,1
HCPCS,1220F,Pt screened for depression,,,10.69,12.38,8
HCPCS,13100,REPAIR COMPLEX TRUNK 1.1-2.5 CM,1836.0,1193.4,0.01,5265.0,174
HCPCS,13100,REPR CMPL WND TRUNK 1.1-2.5CM,1200.0,780.0,1.1,1830.48,148
HCPCS,13101,REPAIR COMPLEX TRUNK 2.6-7.5 CM,1836.0,1193.4,0.01,7813.0,174
HCPCS,13101,REPR CMPL WND TRUNK 2.6-7.5CM,1400.0,910.0,1.1,1830.48,148
HCPCS,13102,REPAIR COMPLEX TRUNK EACH ADDITIONAL 5 CM/<,405.0,263.25,0.01,4392.0,286
HCPCS,13120,REPAIR COMPLEX SCALP/ARM/LEG 1.1-2.5 CM,1836.0,1193.4,0.01,5265.0,174
HCPCS,13120,"REPR CMPL WND SCALP,EXTR 1.1-2.5",1292.0,839.8,1.1,1830.48,148
HCPCS,13121,REPAIR COMPLEX SCALP/ARM/LEG 2.6-7.5 CM,1836.0,1193.4,0.01,7813.0,174
HCPCS,13121,"REPR CMPL WND SCALP,EXTR 2.6-7.5",1600.0,1040.0,1.1,1830.48,148
HCPCS,13122,REPAIR COMPLEX SCALP/ARM/LEG EA ADDL 5 CM/<,651.0,423.15,0.01,4392.0,286
HCPCS,13131,REPAIR COMPLEX F/C/C/M/N/AX/G/H/F 1.1-2.5 CM,1199.0,779.35,0.01,5265.0,174
HCPCS,13131,"REPR CMPL WND HEAD,FAC,HAND 1.1-2.5",1492.0,969.8,1.1,1492.0,148
HCPCS,13132,REPAIR COMPLEX F/C/C/M/N/AX/G/H/F 2.6-7.5 CM,1836.0,1193.4,0.01,7813.0,174
HCPCS,13132,"REPR CMPL WND HEAD,FAC,HAND 2.6-7.5",2103.0,1366.95,1.1,2103.0,148
HCPCS,13133,REPAIR COMPLEX F/C/C/M/N/AX/G/H/F EA ADDL 5 CM/<,1061.5,689.975,0.01,4392.0,286
HCPCS,13151,REPAIR COMPLEX EYELID/NOSE/EAR/LIP 1.1-2.5 CM,1836.0,1193.4,0.01,7813.0,174
HCPCS,13151,"REPR CMPL WND LID,NOS,EAR 1.1-2.5",1736.0,1128.4,1.1,1830.48,148
HCPCS,13152,REPAIR COMPLEX EYELID/NOSE/EAR/LIP 2.6-7.5 CM,1836.0,1193.4,0.01,7813.0,174
HCPCS,13152,"REPR CMPL WND LID,NOS,EAR 2.5-7.5",2136.0,1388.4,1.1,2136.0,148
HCPCS,13153,REPAIR COMPLX EYELID/NOSE/EAR/LIP EA ADDL 5 CM/<,777.5,505.375,0.01,7813.0,286
HCPCS,13160,SECONDARY CLOSURE SURG WOUND/DEHSN EXTSV/COMPLIC,5152.0,3348.8,0.01,5488.0,231
HCPCS,14000,ADJACENT TISSUE TRANSFER/REARGMT TRUNK 10 SQCM/<,5488.0,3567.2,0.01,5488.0,87
HCPCS,14000,TISSUE REARRAN TRUNK DEF <10SCM,2548.0,1656.2,1.1,5320.02,148
HCPCS,14001,ADJNT TIS TRANSFR/REARRANGE TRUNK 10.1-30.0 SQCM,5488.0,3567.2,0.01,7813.0,87
HCPCS,14001,TISSUE REARRAN TRUNK  10.1-30SCM,3512.0,2282.8,1.1,5320.02,148
HCPCS,1400F,PRKNS DIAG RVIEWED,,,2739849.3,2739849.3,1
HCPCS,1400F,Prkns diag rviewed,,,10.69,12.38,8
HCPCS,14020,ADJT TIS TRNSFR/REARGMT SCALP/ARM/LEG 10 SQ CM/<,5488.0,3567.2,0.01,7813.0,87
HCPCS,14020,"TISSUE REARRA SCALP,EXTRE LT 10SCM",2888.0,1877.2,1.1,5320.02,148
HCPCS,14021,"ADJ TISS XFER SCALP,EXTREM 10.1-30",3888.0,2527.2,1.1,5320.02,148
HCPCS,14021,ADJT/REARRGMT SCALP/ARM/LEG 10.1-30.0 SQ CM,5488.0,3567.2,0.01,7813.0,87
HCPCS,14040,ADJT TIS TRNS/REARGMT F/C/C/M/N/A/G/H/F 10SQCM/<,5488.0,3567.2,0.01,5488.0,87
HCPCS,14040,"TISSUE REARR MOUTH,FORE  <10SCM",3440.0,2236.0,1.1,5320.02,148
HCPCS,14041,ADJT/REARGMT F/C/C/M/N/AX/G/H/F 10.1-30.0 SQ CM,5488.0,3567.2,0.01,7813.0,87
HCPCS,14041,"TISSUE REARR MOUTH,FORE 10.1-30SCM",4332.0,2815.8,1.1,5320.02,148
HCPCS,14060,ADJT TIS TRNSFR/REARRGMT E/N/E/L DFCT 10 SQ CM/<,5488.0,3567.2,0.01,7813.0,87
HCPCS,14060,"TISSUE REARR LIP,EAR,EYE GT 10 SCM",4061.0,2639.65,1.1,5320.02,148
HCPCS,14061,ADJT TIS REARGMT EYE/NOSE/EAR/LIP 10.1-30.0 SQCM,5488.0,3567.2,0.01,7813.0,87
HCPCS,14061,"TISSUE REARR LIP,EAR,EYE 10.1-30SCM",5051.0,3283.15,1.1,5320.02,148
HCPCS,14301,ADJNT TIS TRNSFR/REARGMT ANY AREA 30.1-60 SQ CM,10983.0,7138.95,0.01,10983.0,87
HCPCS,14301,ATT/R ANY AREA DEFECT 30.1-60SQCM,5060.0,3289.0,1.1,10462.5,148
HCPCS,14302,ADJT TIS TRNSFR/REARGMT DEFEC EA ADDL 30 SQCM,3521.0,2288.65,0.01,10789.0,69
HCPCS,14302,ATT/R ANY AREA DEFECT EA ADDL 30SQCM OR PART,1641.0,1066.65,1.1,1641.0,144
HCPCS,14350,FILLETED FINGER/TOE FLAP,,,1582.09,2147.22,20
HCPCS,14350,FILLETED FINGER/TOE FLAP W/PREPJ RECIPIENT SITE,4420.0,2873.0,1.1,5320.02,144
HCPCS,14350,Filleted finger/toe flap,,,1469.08,1701.04,8
HCPCS,1450F,SYMPTOMS IMPROVED/CONSIST,,,2739849.3,2739849.3,1
HCPCS,1450F,Symptoms improved/consist,,,10.69,12.38,8
HCPCS,1451F,SYMPT SHOW CLIN IMPORT DROP,,,2739849.3,2739849.3,1
HCPCS,1451F,Sympt show clin import drop,,,10.69,12.38,8
HCPCS,1460F,QUAL CARD DIAG PRIOR 12 MONS,,,2739849.3,2739849.3,1
HCPCS,1460F,Qual card diag prior 12 mons,,,10.69,12.38,8
HCPCS,1461F,NO QUAL CARD DIAG PRIOR12MON,,,2739849.3,2739849.3,1
HCPCS,1461F,No qual card diag prior12mon,,,10.69,12.38,8
HCPCS,1490F,DEM SEVERITY CLASSIFIED MILD,,,2739849.3,2739849.3,1
HCPCS,1490F,Dem severity classified mild,,,10.69,12.38,8
HCPCS,1491F,DEM SEVERITY CLASSIFIED MOD,,,2739849.3,2739849.3,1
HCPCS,1491F,Dem severity classified mod,,,10.69,12.38,8
HCPCS,1493F,DEM SEVERITY CLASS SEVERE,,,2739849.3,2739849.3,1
HCPCS,1493F,Dem severity class severe,,,10.69,12.38,8
HCPCS,1494F,COGNIT ASSESSED AND REVIEWED,,,0.03,0.03,1
HCPCS,1494F,Cognit assessed and reviewed,,,10.69,12.38,8
HCPCS,15002,PREP SITE TRUNK/ARM/LEG 1ST 100 SQ CM/1PCT,3547.0,2305.55,0.01,5488.0,235
HCPCS,15003,PREP SITE TRUNK/ARM/LEG ADDL 100 SQ CM/1PCT,320.0,208.0,1.1,320.0,148
HCPCS,15003,Wound prep addl 100 cm,,,239.13,276.89,8
HCPCS,15004,PREP SITE F/S/N/H/F/G/M/D GT 1ST 100 SQ CM/1PCT,1834.0,1192.1,0.01,5265.0,235
HCPCS,15005,PREP SITE F/S/N/H/F/G/M/D GT ADDL 100 SQ CM/1PCT,640.0,416.0,1.1,640.0,148
HCPCS,15005,Wnd prep f/n/hf/g addl cm,,,239.13,276.89,8
HCPCS,1500F,SYMPTOM&SIGN SYMM POLYNEURO,,,2739849.3,2739849.3,1
HCPCS,1500F,Symptom&sign symm polyneuro,,,10.69,12.38,8
HCPCS,15011,HRV SKIN FOR SKIN CELL SSP AGRFT 1ST 25 SQ CM/<,929.0,603.85,1.1,929.0,84
HCPCS,15011,HRV SKN CLL SSP AGRFT 1ST 25,,,1695.77,2147.22,19
HCPCS,15011,Hrv skn cll ssp agrft 1st 25,,,1469.08,1701.04,8
HCPCS,15012,HRV SKIN FOR SKIN CELL SSP AGRFT EA ADDL 25 SQCM,929.0,603.85,1.1,929.0,84
HCPCS,15012,Hrv skn cll ssp agrft ea add,,,1469.08,1701.04,8
HCPCS,15013,PREPARATION SKIN CELL SSP AGRFT 1ST 25 SQ CM/<,1696.0,1102.4,1.1,1696.0,84
HCPCS,15013,PREPJ SKN CLL SSP AGRFT 1ST,,,5794.46,7385.52,19
HCPCS,15013,Prepj skn cll ssp agrft 1st,,,186.25,215.66,8
HCPCS,15014,PREPARATION SKIN CELL SSP AGRFT EA ADDL 25 SQ CM,1696.0,1102.4,1.1,1696.0,84
HCPCS,15014,Prepj skn cll ssp agrft ea,,,186.25,215.66,8
HCPCS,15015,APP SKN CL SSP AGRFT T/A/L 1,,,1695.77,2147.22,19
HCPCS,15015,APPL SKIN CELL SSP AGRFT T/A/L 1ST 480 SQ CM/<,697.0,453.05,1.1,1991.3,84
HCPCS,15015,App skn cl ssp agrft t/a/l 1,,,1469.08,1701.04,8
HCPCS,15016,APPL SKIN CELL SSP AGRFT T/A/L EA ADDL 480 SQ CM,697.0,453.05,1.1,697.0,84
HCPCS,15016,App skn cl ssp agrf t/a/l ea,,,1469.08,1701.04,8
HCPCS,15017,APP SKN CLL SSP F/N/G/HF 1ST,,,1695.77,2147.22,19
HCPCS,15017,APPL SKN CLL SSP AGRFT F/S/N/H/F/G/M/DGT 1ST 480,850.0,552.5,1.1,2294.28,84
HCPCS,15017,App skn cll ssp f/n/g/hf 1st,,,1469.08,1701.04,8
HCPCS,15018,APPL SKN CLL SSP AGRFT F/S/N/H/F/G/M/DGT EA ADDL,850.0,552.5,1.1,850.0,84
HCPCS,15018,App skn cll ssp f/n/g/hf ea,,,1469.08,1701.04,8
HCPCS,1501F,NOT INITIAL EVAL FOR COND,,,2739849.3,2739849.3,1
HCPCS,1501F,Not initial eval for cond,,,10.69,12.38,8
HCPCS,1502F,PT QUERIED PAIN FXN W/ INSTR,,,0.03,0.03,1
HCPCS,1502F,Pt queried pain fxn w/ instr,,,10.69,12.38,8
HCPCS,1503F,PT QUERIED SYMP RESP INSUFF,,,2739849.3,2739849.3,1
HCPCS,1503F,Pt queried symp resp insuff,,,10.69,12.38,8
HCPCS,15040,HARVEST CULTURED SKIN GRAFT,,,1582.09,2147.22,20
HCPCS,15040,HARVEST SKIN TISSUE CLTR SKIN AGRFT 100 CM/<,800.0,520.0,1.1,5320.02,146
HCPCS,15040,Harvest cultured skin graft,,,1469.08,1701.04,8
HCPCS,1504F,PT HAS RESP INSUFFICIENCY,,,2739849.3,2739849.3,1
HCPCS,1504F,Pt has resp insufficiency,,,10.69,12.38,8
HCPCS,15050,PINCH GRAFT 1/MLT SM ULCER TIP/OTH AREA 2CM,2228.0,1448.2,1.1,2228.0,148
HCPCS,15050,PINCH GRAFT UP TO 2 CM DIAM,,,544.87,769.14,20
HCPCS,15050,Pinch graft up to 2 cm diam,,,389.36,450.84,8
HCPCS,1505F,PT HAS NO RESP INSUFFICIENCY,,,2739849.3,2739849.3,1
HCPCS,1505F,Pt has no resp insufficiency,,,10.69,12.38,8
HCPCS,15100,SPLIT AGRFT T/A/L 1ST 100 CM/&/1% BDY INFT/CHLD,4724.0,3070.6,0.01,5488.0,235
HCPCS,15101,SPLIT AGRFT T/A/L EA 100 CM/EA 1% BDY INFT/CHLD,688.0,447.2,1.1,688.0,148
HCPCS,15101,Splt agrft t/a/l ea addl 100,,,1469.08,1701.04,8
HCPCS,15110,EPIDRM AGRFT T/A/L 1ST 100 CM/&/1% BDY INFT/CHLD,5157.5,3352.375,0.01,5488.0,235
HCPCS,15111,EPIDRM AGRFT T/A/L EA 100 CM/EA 1% BDY INFT/CHLD,740.0,481.0,1.1,740.0,148
HCPCS,15111,Epidrm agrft t/a/l ea addl,,,1469.08,1701.04,8
HCPCS,15115,EPDRM AGRFT F/S/N/H/F/G/M 1,,,1582.09,2147.22,20
HCPCS,15115,EPI AUTOGRFT FACE/NCK/HND/FT/GEN <100SQCM,4963.0,3225.95,1.1,5320.02,148
HCPCS,15115,Epdrm agrft f/s/n/h/f/g/m 1,,,1469.08,1701.04,8
HCPCS,15116,EPIDRM A-GRFT F/N/HF/G ADDL 100 SQ CM/1% BA,1000.0,650.0,1.1,1000.0,148
HCPCS,15116,Epdrm agrft f/s/n/h/f/g/m ea,,,1469.08,1701.04,8
HCPCS,15120,SPLIT AGRFT F/S/N/H/F/G/M/D GT 1ST 100 CM/</1 %,7521.5,4888.975,0.01,10983.0,235
HCPCS,15121,SPLIT AGRFT F/S/N/H/F/G/M/D GT EA 100 CM/EA 1 %,800.0,520.0,1.1,800.0,148
HCPCS,15121,Splt agrft f/s/n/h/f/g/m ea,,,1469.08,1701.04,8
HCPCS,15130,"DERM AUTOGRFT, TRNK/ARM/LEG <100SQCM",3012.0,1957.8,1.1,5320.02,148
HCPCS,15130,DRM AGRFT T/A/L 1ST 100 SQCM,,,1582.09,2147.22,20
HCPCS,15130,Drm agrft t/a/l 1st 100 sqcm,,,1469.08,1701.04,8
HCPCS,15131,"DERM AUTOGRFT TRNK/ARM/LEG, EA 100SQCM",600.0,390.0,1.1,600.0,148
HCPCS,15131,Drm agrft t/a/l ea addl,,,1469.08,1701.04,8
HCPCS,15135,DERM AUTOGRAFT FACE/NCK/HND/FT/GEN <100SQCM,4412.0,2867.8,1.1,10462.5,148
HCPCS,15135,DRM AGRFT F/S/N/H/F/G/M 1ST,,,3112.46,3687.9,20
HCPCS,15135,Drm agrft f/s/n/h/f/g/m 1st,,,1469.08,1701.04,8
HCPCS,15136,"DERM AUTOGRAFT FACE/NCK/HND/FT/GEN, EA 100SQCM",600.0,390.0,1.1,600.0,148
HCPCS,15136,Drm agrft f/s/n/h/f/g/m ea,,,1469.08,1701.04,8
HCPCS,15150,CLTR SKIN AUTOGRAFT T/A/L 1ST 25 CM/<,3756.0,2441.4,1.1,5320.02,148
HCPCS,15150,TIS CLTR SKN AGRFT T/A/L 1ST,,,1582.09,2147.22,20
HCPCS,15150,Tis cltr skn agrft t/a/l 1st,,,1469.08,1701.04,8
HCPCS,15151,CLTR SKIN AGRFT T/A/L ADDL 1 CM-75 CM,800.0,520.0,1.1,800.0,148
HCPCS,15151,Tis cltr skn agrft t/a/l add,,,1469.08,1701.04,8
HCPCS,15152,CLTR SKIN AGRFT T/A/L EA 100 CM/EA 1%BODY AREA,1000.0,650.0,1.1,1000.0,148
HCPCS,15152,Tis cltr skn agrft t/a/l ea,,,1469.08,1701.04,8
HCPCS,15155,CLTR SKIN AGRFT F/S/N/H/F/G/M/D GT 1ST 25CM/<,4056.0,2636.4,1.1,10462.5,148
HCPCS,15155,TIS CLTR AGRFT F/S/N/H/F/G 1,,,3112.46,3687.9,20
HCPCS,15155,Tis cltr agrft f/s/n/h/f/g 1,,,1469.08,1701.04,8
HCPCS,15156,CLTR SKIN AGRFT F/S/N/H/F/G/M/D GT ADDL 1-75CM,1100.0,715.0,1.1,1100.0,148
HCPCS,15156,Tis clt agrft f/s/n/h/f/g ad,,,1469.08,1701.04,8
HCPCS,15157,CLTR SKIN AGRFT F/S/N/H/F/G/M/D GT EA 100 EA,1200.0,780.0,1.1,1200.0,148
HCPCS,15157,Tis clt agrft f/s/n/h/f/g ea,,,1469.08,1701.04,8
HCPCS,15200,FTH/GFT FREE W/DIRECT CLOSURE TRUNK 20 CM/<,5488.0,3567.2,0.01,7813.0,87
HCPCS,15200,FULL GRAFT PROC TRUNK <20 SQCM,3660.0,2379.0,1.1,5320.02,148
HCPCS,15201,FULL GRAFT PROC TRUNK ADD 20 SQCM,581.0,377.65,1.1,581.0,148
HCPCS,15201,Fth/gft fr trnk each addl,,,1469.08,1701.04,8
HCPCS,15220,FTH/GFT FREE W/DIRECT CLOSURE S/A/L 20 CM/<,5488.0,3567.2,0.01,5488.0,87
HCPCS,15220,"FULL THICKNESS GRAFT SCALP, ARMS LEGS 20 SQ CM OR LESS",3236.0,2103.4,1.1,5320.02,148
HCPCS,15221,FTH/GFT FR W/DIR CLSR S/A/L EA ADDL 20 CM/<,5488.0,3567.2,0.01,5488.0,69
HCPCS,15221,"FULL GRAFT PROC SCALP,ARM ADD 20SQCM",476.0,309.4,1.1,476.0,148
HCPCS,15240,FTH/GFT FR W/DIR CLSR F/C/C/M/N/AX/G/H/F 20 CM/<,5488.0,3567.2,0.01,7813.0,87
HCPCS,15240,SKIN GRAFT HAND <20 SQ CM,4164.0,2706.6,1.1,5320.02,148
HCPCS,15241,FTH/GT FR W/DIR CLSR F/C/C/M/N/AX/G/H/F EA20CM/<,5488.0,3567.2,0.01,7813.0,69
HCPCS,15241,SKIN GRAFT HAND ADD'L 20 SCM,818.0,531.7,1.1,818.0,148
HCPCS,15260,FTH/GFT FREE W/DIRECT CLOSURE N/E/E/L 20 SQ CM/<,5488.0,3567.2,0.01,5488.0,87
HCPCS,15260,SKIN GRAFT NOSE <20 SQ CM,4656.0,3026.4,1.1,5320.02,148
HCPCS,15261,FTH/GFT FREE W/DIR CLSR N/E/E/L EA 20 SQ CM/<,5488.0,3567.2,0.01,5488.0,69
HCPCS,15261,SKIN GRAFT NOSE ADD'L 20SCM,892.0,579.8,1.1,892.0,148
HCPCS,15271,APP SKN SUB GRFT T/A/L AREA/100SQ CM /<1ST 25,5488.0,3567.2,0.01,5488.0,87
HCPCS,15271,APP SKN SUB GRFT T/A/L AREA/<100SCM /<1ST 25 SCM,660.0,429.0,1.1,5320.02,148
HCPCS,15272,APP SKN SUB GRFT T/A/L AREA/100SQ CM EA ADL 25SC,5488.0,3567.2,0.01,5488.0,69
HCPCS,15272,APP SKN SUB GRFT T/A/L AREA/<100SCM EA ADL 25SCM,145.0,94.25,1.1,145.0,148
HCPCS,15273,APP SKN SUB GRFT T/A/L AREA/>100SCM 1ST 100SCM,1400.0,910.0,1.1,10462.5,148
HCPCS,15273,APP SKN SUBGRFT T/A/L AREA/100SQ CM 1ST 100SQ CM,10983.0,7138.95,0.01,10983.0,87
HCPCS,15274,APP SKN SUB GRFT T/A/L AREA/>100SCM ADL 100SCM,320.0,208.0,1.1,320.0,148
HCPCS,15274,APP SKN SUB GRFT T/A/L AREA>/=100SCM ADL 100SQCM,10983.0,7138.95,0.01,10983.0,69
HCPCS,15275,SUB GRFT F/S/N/H/F/G/M/D /<100SCM /<1ST 25 SCM,732.0,475.8,1.1,5320.02,148
HCPCS,15275,SUB GRFT F/S/N/H/F/G/M/D <100SQ CM 1ST 25 SQ CM,5488.0,3567.2,0.01,5488.0,87
HCPCS,15276,SUB GRFT F/S/N/H/F/G/M/D /<100SCM EA ADL 25SCM,200.0,130.0,1.1,200.0,148
HCPCS,15276,SUB GRFT F/S/N/H/F/G/M/D<100SQ CM EA ADDL25SQ CM,5488.0,3567.2,0.01,5488.0,69
HCPCS,15277,SUB GRFT F/S/N/H/F/G/M/D />100SCM 1ST 100SCM,1600.0,1040.0,1.1,5320.02,148
HCPCS,15277,SUB GRFT F/S/N/H/F/G/M/D >/= 100SCM 1ST 100SQ CM,5488.0,3567.2,0.01,5488.0,87
HCPCS,15278,SUB GRFT F/S/N/H/F/G/M/D />100SCM ADL 100SCM,400.0,260.0,1.1,400.0,148
HCPCS,15278,SUB GRFT F/S/N/H/F/G/M/D >/= 100SCM ADL 100SQ CM,5488.0,3567.2,0.01,5488.0,69
HCPCS,15570,FRMJ DIRECT/TUBED PEDICLE W/WO TRANSFER TRUNK,4084.0,2654.6,1.1,5320.02,148
HCPCS,15570,SKIN PEDICLE FLAP TRUNK,,,1582.09,2147.22,20
HCPCS,15570,Skin pedicle flap trunk,,,1469.08,1701.04,8
HCPCS,15572,FRMJ DIRECT/TUBE PEDICLE W/WO TR SCALP ARMS/LEGS,4048.0,2631.2,1.1,10462.5,148
HCPCS,15572,SKIN PEDICLE FLAP ARMS/LEGS,,,3112.46,3687.9,20
HCPCS,15572,Skin pedicle flap arms/legs,,,1469.08,1701.04,8
HCPCS,15574,FRMJ DIR/TUBE PEDCL W/WOTR FH/CH/CH/M/N/AX/G/H/F,4884.0,3174.6,0.01,7813.0,235
HCPCS,15576,FRMJ DIRECT/TUBED PEDICLE W/WOTR E/N/E/L/NTRORAL,4618.0,3001.7,0.01,7813.0,235
HCPCS,15600,DELAY FLAP TRUNK,,,3112.46,3687.9,20
HCPCS,15600,DELAY/SECTN FLAP TRUNK,804.0,522.6,1.1,10462.5,148
HCPCS,15600,Delay flap trunk,,,1469.08,1701.04,8
HCPCS,15610,DELAY FLAP ARMS/LEGS,,,1582.09,2147.22,20
HCPCS,15610,"DELAY/SECTN FLAP SCALP,ARM,LEG",1008.0,655.2,1.1,5320.02,148
HCPCS,15610,Delay flap arms/legs,,,1469.08,1701.04,8
HCPCS,15620,DELAY FLAP/SECTIONING FLAP F/C/C/N/AX/G/H/F,5488.0,3567.2,0.01,10789.0,87
HCPCS,15620,"DELAY/SECTN FLAP FACE,GENIT,HAND,FT",1500.0,975.0,1.1,5320.02,148
HCPCS,15630,DELAY FLAP/SCTJ FLAP EYELIDS NOSE EARS/LIPS,5488.0,3567.2,0.01,7813.0,87
HCPCS,15630,"DELAY/SECTN FLAP LID,NOS,EAR,LIP",1632.0,1060.8,1.1,5320.02,148
HCPCS,15650,TRANSFER SKIN PEDICLE FLAP,1908.0,1240.2,1.1,5320.02,168
HCPCS,15650,Transfer skin pedicle flap,,,1469.08,1701.04,8
HCPCS,15730,MIDFACE FLAP W/PRESERVATION OF VASCULAR PEDICLES,8191.5,5324.475,0.01,10983.0,235
HCPCS,15731,FOREHEAD FLAP W/PRESERVATION VASCULAR PEDICLE,10983.0,7138.95,0.01,10983.0,87
HCPCS,15731,FOREHEAD FLAP W/VASC PEDICLE,5752.0,3738.8,1.1,10462.5,148
HCPCS,15733,MUSC MYOQ/FSCQ FLAP HEAD&NECK W/NAMED VASC PEDCL,6272.0,4076.8,1.1,10462.5,144
HCPCS,15733,MUSC MYOQ/FSCQ FLP H&N PEDCL,,,3112.46,7813.0,22
HCPCS,15733,Musc myoq/fscq flp h&n pedcl,,,1469.08,1701.04,8
HCPCS,15734,MUSC MYOCUTANEOUS/FASCIOCUTANEOUS FLAP TRUNK,9200.0,5980.0,1.1,10462.5,144
HCPCS,15734,MUSCLE-SKIN GRAFT TRUNK,,,3112.46,3687.9,20
HCPCS,15734,Muscle-skin graft trunk,,,1469.08,1701.04,8
HCPCS,15736,MUSC MYOCUTANEOUS/FASCIOCUTANEOUS FLAP UXTR,6816.0,4430.4,1.1,6816.0,144
HCPCS,15736,MUSCLE-SKIN GRAFT ARM,,,1582.09,2147.22,20
HCPCS,15736,Muscle-skin graft arm,,,1469.08,1701.04,8
HCPCS,15738,MUSC MYOCUTANEOUS/FASCIOCUTANEOUS FLAP LXTR,8378.0,5445.7,1.1,10462.5,144
HCPCS,15738,MUSCLE-SKIN GRAFT LEG,,,3112.46,3687.9,20
HCPCS,15738,Muscle-skin graft leg,,,1469.08,1701.04,8
HCPCS,15740,FLAP ISLAND PEDICLE ANATOMIC NAMED AXIAL ARTERY,5104.0,3317.6,0.01,5488.0,235
HCPCS,15750,NEUROVASCULAR PEDICLE FLAP,,,3112.46,3687.9,20
HCPCS,15750,NEUROVASCULAR PEDICLE GRAFT,5184.0,3369.6,1.1,10462.5,144
HCPCS,15750,Neurovascular pedicle flap,,,1469.08,1701.04,8
HCPCS,15756,FREE MUSC FLAP W MICROVASC ANAST,14776.0,9604.4,1.1,14776.0,144
HCPCS,15756,FREE MYO/SKIN FLAP MICROVASC,,,5937.63,5937.63,1
HCPCS,15756,Free myo/skin flap microvasc,,,1469.08,1701.04,8
HCPCS,15757,FREE SKIN FLAP MICROVASC,,,5900.12,5900.12,1
HCPCS,15757,FREE SKIN FLAP W MICROVASC ANAST,16346.0,10624.9,1.1,16346.0,144
HCPCS,15757,Free skin flap microvasc,,,1469.08,1701.04,8
HCPCS,15758,FREE FASCIAL FLAP MICROVASC,,,5874.48,5874.48,1
HCPCS,15758,FREE FASCIAL FLAP W/MICROVASCULAR ANASTOMOSIS,14760.0,9594.0,1.1,14760.0,144
HCPCS,15758,Free fascial flap microvasc,,,1469.08,1701.04,8
HCPCS,15760,GRAFT COMPOSITE W/PRIMARY CLOSURE DONOR AREA,4716.0,3065.3999999999996,0.01,5488.0,235
HCPCS,15769,FAT INJECTIONS FOR BUTTOCK AUGMENT (BBL) - MODERATE,1500.0,975.0,1.1,10462.5,144
HCPCS,15769,GRAFTING OF AUTOLOGOUS SOFT TISS BY DIRECT EXC,2672.0,1736.8,1.1,10462.5,144
HCPCS,15769,GRFG AUTOL SOFT TISS DIR EXC,,,3112.46,10789.0,23
HCPCS,15769,Grfg autol soft tiss dir exc,,,1469.08,1701.04,8
HCPCS,15770,DERMA-FAT-FASCIA GRAFT,,,3112.46,3687.9,20
HCPCS,15770,Derma-fat-fascia graft,,,1469.08,1701.04,8
HCPCS,15770,"GRAFT,DERMA-FAT-FASCIA",3942.0,2562.3,1.1,10462.5,144
HCPCS,15771,FAT INJECTIONS TO BREAST FOR CONTOUR - COMPLEX,3600.0,2340.0,1.1,10462.5,146
HCPCS,15771,FAT INJECTIONS TO BREAST FOR CONTOUR - MODERATE,3000.0,1950.0,1.1,10462.5,146
HCPCS,15771,FAT INJECTIONS TO BREAST FOR CONTOUR - SIMPLE,2400.0,1560.0,1.1,10462.5,146
HCPCS,15771,FAT TRANSFER FOR BREAST AUGMENT  50 CC OR LEES- SIMPLE,4500.0,2925.0,1.1,10462.5,146
HCPCS,15771,FAT TRANSFER FOR BREAST AUGMENT 50 CC OR LESS - MODERATE,4900.0,3185.0,1.1,10462.5,146
HCPCS,15771,FAT TRNASFER FOR BREAST AUGMENT 50 CC OR LESS - COMPLEX,5200.0,3380.0,1.1,10462.5,146
HCPCS,15771,GRAFTING OF AUTOLOGOUS FAT BY LIPO 50 CC OR LESS,2961.0,1924.65,1.1,10462.5,146
HCPCS,15771,GRFG AUTOL FAT LIPO 50 CC/<,,,3112.46,10789.0,24
HCPCS,15771,Grfg autol fat lipo 50 cc/<,,,1469.08,1701.04,8
HCPCS,15772,GRAFTING OF AUTOLOGOUS FAT BY LIPO EA ADDL 50 CC,1100.0,715.0,1.1,1100.0,146
HCPCS,15772,GRFG AUTOL FAT LIPO EA ADDL,,,4132.0,4132.0,1
HCPCS,15772,Grfg autol fat lipo ea addl,,,1469.08,1701.04,8
HCPCS,15773,FAT INJECTION FACE/NECK INC REVOLVE - MODERATE,990.0,643.5,1.1,5320.02,146
HCPCS,15773,GRAFTING OF AUTOLOGOUS FAT BY LIPO 25 CC OR LESS,2732.0,1775.8,1.1,5320.02,146
HCPCS,15773,GRFG AUTOL FAT LIPO 25 CC/<,,,1582.09,10364.0,21
HCPCS,15773,Grfg autol fat lipo 25 cc/<,,,1469.08,1701.04,8
HCPCS,15774,GRAFTING OF AUTOLOGOUS FAT BY LIPO EA ADDL 25 CC,964.0,626.6,1.1,964.0,146
HCPCS,15774,Gfrg autol fat lipo ea addl,,,1469.08,1701.04,8
HCPCS,15775,HAIR TRNSPL 1-15 PUNCH GRFTS,,,345.93,423.05,20
HCPCS,15775,HAIR XPLANT PUNCH GRFT 1-15,1580.0,1027.0,1.1,1580.0,134
HCPCS,15775,Hair trnspl 1-15 punch grfts,,,389.36,450.84,8
HCPCS,15776,HAIR TRANSPLANT - COMPLEX,7200.0,4680.0,1.1,7200.0,134
HCPCS,15776,HAIR TRANSPLANT - MODERATE,6500.0,4225.0,1.1,6500.0,134
HCPCS,15776,HAIR TRANSPLANT - SIMPLE,5200.0,3380.0,1.1,5200.0,134
HCPCS,15776,HAIR TRNSPL >15 PUNCH GRAFTS,,,345.93,423.05,20
HCPCS,15776,HAIR XPLANT PUNCH GRFT >15,2212.0,1437.8,1.1,2212.0,134
HCPCS,15776,Hair trnspl >15 punch grafts,,,389.36,450.84,8
HCPCS,15777,ACELLULAR DERM MATRIX IMPLT,,,4132.0,4132.0,1
HCPCS,15777,ALLODERM MESH PER BREAST,300.0,195.0,1.1,730.01,144
HCPCS,15777,Acellular derm matrix implt,,,1469.08,1701.04,8
HCPCS,15777,IMPLNT BIO IMPLNT FOR SOFT TISSUE REINFORCEMENT,1460.0,949.0,1.1,1460.0,144
HCPCS,15778,IMPL ABSRB MESH/PRSTH DLYD CLSR DFCT INFCTJ/TRMA,2820.0,1833.0,1.1,2820.0,144
HCPCS,15778,IMPL ABSRB MSH/PRSTH DLY CLS,,,1013.14,1013.14,1
HCPCS,15778,Impl absrb msh/prsth dly cls,,,1469.08,1701.04,8
HCPCS,15780,DERMABRAS RX SKIN TOTAL FACE,3492.0,2269.8,1.1,8286.13,134
HCPCS,15780,DERMABRASION TOTAL FACE,8586.0,5580.9,0.01,12615.0,173
HCPCS,15780,MICRODERMABRASION-FACE,125.0,81.25,1.1,8286.13,134
HCPCS,15781,DERMABRAS RX SKIN SGMENT FACE,2008.0,1305.2,1.1,2050.87,136
HCPCS,15781,DERMABRASION SEGMENTAL FACE,2111.0,1372.15,0.01,2351.0,87
HCPCS,15781,LASER RESURFACING/PARTIAL FACE,650.0,422.5,1.1,2050.87,136
HCPCS,15782,DERMABRASION REGIONAL OTHER THAN FACE,8586.0,5580.9,0.01,8586.0,87
HCPCS,15782,LASER RESURFACING/OTHER THAN FACE,600.0,390.0,1.1,8286.13,134
HCPCS,15783,DERMABRASION SUPERFICIAL ANY SITE,1199.0,779.35,0.01,2351.0,87
HCPCS,15783,LASER RESURFACING/SUPERFICIAL,500.0,325.0,1.1,1489.46,134
HCPCS,15783,MICRODERMABRASION,300.0,195.0,1.1,1489.46,134
HCPCS,15783,TATTOO REMOVAL,300.0,195.0,1.1,1489.46,134
HCPCS,15786,ABRAS SINGLE LESION,832.0,540.8,1.1,832.0,146
HCPCS,15786,ABRASION 1 LESION,596.0,387.4,0.01,12500.0,87
HCPCS,15786,"SCAR REVISION, ABRASIVE TECHNIQUE, SINGLE",225.0,146.25,1.1,762.11,146
HCPCS,15787,ABRASION EACH ADDITIONAL 4 LESIONS OR LESS,32.0,20.8,0.01,195.44,68
HCPCS,15787,"SCAR REVISION, ABRASION EA ADDL 4 LESIONS OR LESS",150.0,97.5,1.1,150.0,146
HCPCS,15788,ADD ON PEEL,50.0,32.5,1.1,1275.31,134
HCPCS,15788,"CHEM PEEL, FACE, EPIDERM",836.0,543.4,1.1,1275.31,134
HCPCS,15788,CHEMICAL PEEL FACIAL EPIDERMAL,1199.0,779.35,0.01,12500.0,87
HCPCS,15788,DIAMOND GLOW,175.0,113.75,1.1,1275.31,134
HCPCS,15788,ENERPEEL EYE & LIP PEEL,100.0,65.0,1.1,1275.31,134
HCPCS,15788,ENERPEEL NECK & CHEST,100.0,65.0,1.1,1275.31,134
HCPCS,15788,GLYCOLIC TRADITIONAL,100.0,65.0,1.1,1275.31,134
HCPCS,15788,HYDRA FACIAL BOOSTER (ADD ON TREATMENT),35.0,22.75,1.1,1275.31,134
HCPCS,15788,HYDRAFACIAL,175.0,113.75,1.1,1275.31,134
HCPCS,15788,MANDELIC,100.0,65.0,1.1,1275.31,134
HCPCS,15788,REJUVENIZE PEEL,185.0,120.25,1.1,1275.31,134
HCPCS,15788,SALICYLIC CLASSIC,125.0,81.25,1.1,1275.31,134
HCPCS,15788,SIGNATURE FACIAL,100.0,65.0,1.1,1275.31,134
HCPCS,15788,TEEN ACNE PEEL,60.0,39.0,1.1,1275.31,134
HCPCS,15788,THE ILLUMINIZE PEEL,115.0,74.75,1.1,1275.31,134
HCPCS,15788,THE PERFECT PEEL,250.0,162.5,1.1,1275.31,134
HCPCS,15788,VITALIZE PEEL,165.0,107.25,1.1,1275.31,134
HCPCS,15789,"CHEM PEEL, FACE, DERMAL",1964.0,1276.6,1.1,1964.0,134
HCPCS,15789,CHEMICAL PEEL FACIAL DERMAL,,,544.87,1639.62,21
HCPCS,15789,"CHEMICAL PEEL, FACIAL: DERMAL EA. AREA",250.0,162.5,1.1,1830.48,134
HCPCS,15789,"CHEMICAL PEEL, FACIAL: DERMAL, FULL FACE",700.0,455.0,1.1,1830.48,134
HCPCS,15789,Chemical peel facial dermal,,,168.79,195.44,8
HCPCS,15789,"PHENOL CHEMICAL PEEL, EACH ADDL AREA",1900.0,1235.0,1.1,1900.0,134
HCPCS,15789,"PHENOL CHEMICAL PEEL, FULL FACE",3600.0,2340.0,1.1,3600.0,134
HCPCS,15792,BACK TREATMENT/FULL,150.0,97.5,1.1,1830.48,134
HCPCS,15792,BACK TREATMENT/HALF,85.0,55.25,1.1,1830.48,134
HCPCS,15792,"CHEM PEEL, NONFACIAL EPIDERM",744.0,483.6,1.1,1830.48,134
HCPCS,15792,CHEMICAL PEEL NONFACIAL EPIDERMAL,1836.0,1193.4,0.01,12500.0,87
HCPCS,15792,"CHEMICAL PEEL, TCA-NON-FACIAL",250.0,162.5,1.1,1830.48,134
HCPCS,15792,ENERPEEL HANDS,60.0,39.0,1.1,1830.48,134
HCPCS,15793,"CHEM PEEL, NONFACIAL DERMAL",1391.5,904.4749999999999,0.01,12500.0,221
HCPCS,15793,"NON FACIAL, DERMAL (TCA)",250.0,162.5,1.1,1561.51,134
HCPCS,15819,CERVICOPLASTY   (REMOVAL EXCESS NECK SKIN),3000.0,1950.0,1.1,5320.02,76
HCPCS,15819,CERVICOPLASTY - COMPLEX,2850.0,1852.5,1.1,5320.02,76
HCPCS,15819,CERVICOPLASTY - MODERATE,2350.0,1527.5,1.1,5320.02,76
HCPCS,15819,CERVICOPLASTY - SIMPLE,1855.0,1205.75,1.1,5320.02,76
HCPCS,15819,PLASTIC SURGERY NECK,,,1582.09,4760.83,2
HCPCS,15819,Plastic surgery neck,,,1713.83,1984.43,8
HCPCS,15820,BLEPHAROPLASTY LOWER - COMPLEX,3250.0,2112.5,1.1,5320.02,136
HCPCS,15820,BLEPHAROPLASTY LOWER - MODERATE,2750.0,1787.5,1.1,5320.02,136
HCPCS,15820,BLEPHAROPLASTY LOWER - SIMPLE,1750.0,1137.5,1.1,5320.02,136
HCPCS,15820,BLEPHAROPLASTY LOWER EYELID,5488.0,3567.2,0.01,7813.0,87
HCPCS,15820,BLEPHAROPLASTY LOWER LID,2759.0,1793.35,1.1,5320.02,136
HCPCS,15821,BLEPHAROPLASTY LOWER EYELID HERNIATED FAT PAD,3010.0,1956.5,1.1,5320.02,134
HCPCS,15821,BLEPHAROPLASTY LOWER PLUS CHEECK - COMPLEX,4000.0,2600.0,1.1,5320.02,134
HCPCS,15821,BLEPHAROPLASTY LOWER PLUS CHEECK - MODERATE,3000.0,1950.0,1.1,5320.02,134
HCPCS,15821,BLEPHAROPLASTY LOWER PLUS CHEECK - SIMPLE,2000.0,1300.0,1.1,5320.02,134
HCPCS,15821,BLEPHAROPLASTY LOWER W/ FAT - COMPLEX,2275.0,1478.75,1.1,5320.02,134
HCPCS,15821,BLEPHAROPLASTY LOWER W/ FAT - MODERATE,2050.0,1332.5,1.1,5320.02,134
HCPCS,15821,BLEPHAROPLASTY LOWER W/ FAT - SIMPLE,1825.0,1186.25,1.1,5320.02,134
HCPCS,15821,BLEPHARP LWR EYELID FAT PAD,,,1582.09,2147.22,20
HCPCS,15821,Blepharp lwr eyelid fat pad,,,1713.83,1984.43,8
HCPCS,15822,BLEPHAROPLASTY UPPER - COMPLEX,2750.0,1787.5,1.1,5320.02,136
HCPCS,15822,BLEPHAROPLASTY UPPER - MODERATE,1750.0,1137.5,1.1,5320.02,136
HCPCS,15822,BLEPHAROPLASTY UPPER - SIMPLE,1250.0,812.5,1.1,5320.02,136
HCPCS,15822,BLEPHAROPLASTY UPPER EYELID,3760.5,2444.325,0.01,7813.0,223
HCPCS,15823,BLEPHAROPLASTY UPPER EYELID W/EXCESSIVE SKIN,4242.0,2757.3,0.01,13821.0,235
HCPCS,15824,FOREHEAD/BROW LIFT - COMPLEX,7000.0,4550.0,1.1,7000.0,88
HCPCS,15824,FOREHEAD/BROW LIFT - MODERATE,4700.0,3055.0,1.1,5320.02,88
HCPCS,15824,FOREHEAD/BROW LIFT - SIMPLE,2400.0,1560.0,1.1,5320.02,88
HCPCS,15824,RHYTIDECTOMY FOREHEAD,4486.0,2915.9,1.1,5320.02,108
HCPCS,15824,Rhytidectomy forehead,,,1713.83,1984.43,8
HCPCS,15825,NECKLIFT - COMPLEX,10000.0,6500.0,1.1,10462.5,88
HCPCS,15825,NECKLIFT - MODERATE,7800.0,5070.0,1.1,10462.5,88
HCPCS,15825,NECKLIFT - SIMPLE,5800.0,3770.0,1.1,10462.5,88
HCPCS,15825,PLATSYMAPLASTY - COMPLEX,3850.0,2502.5,1.1,10462.5,88
HCPCS,15825,PLATSYMAPLASTY - MODERATE,3544.0,2303.6,1.1,10462.5,88
HCPCS,15825,PLATSYMAPLASTY - SIMPLE,3240.0,2106.0,1.1,10462.5,88
HCPCS,15825,RHYTDCT NCK PLTYSML TGHTG,,,3112.46,3687.9,20
HCPCS,15825,RHYTIDECTOMY NECK W/PLATYSMAL TIGHTENING,5845.0,3799.25,1.1,10462.5,88
HCPCS,15825,Rhytdct nck pltysml tghtg,,,1713.83,1984.43,8
HCPCS,15826,BROWLIFT - COMPLEX,3500.0,2275.0,1.1,10462.5,88
HCPCS,15826,BROWLIFT - MODERATE,1450.0,942.5,1.1,10462.5,88
HCPCS,15826,BROWLIFT - SIMPLE,1200.0,780.0,1.1,10462.5,88
HCPCS,15826,RHYTIDECTOMY GLABELLAR FROWN LINES,6105.0,3968.25,1.1,10462.5,88
HCPCS,15826,RHYTIDECTOMY GLBLR FRN LINES,,,3112.46,3687.9,20
HCPCS,15826,Rhytidectomy glblr frn lines,,,1713.83,1984.43,8
HCPCS,15828,FACELIFT - COMPLEX,14500.0,9425.0,1.1,14500.0,88
HCPCS,15828,FACELIFT - MODERATE,10500.0,6825.0,1.1,10500.0,88
HCPCS,15828,FACELIFT - SIMPLE,7200.0,4680.0,1.1,10462.5,88
HCPCS,15828,RHYTIDECTOMY CHEEK CHIN & NECK,8610.0,5596.5,1.1,10462.5,88
HCPCS,15828,RHYTIDECTOMY CHEEK CHN & NCK,,,3112.46,7778.0,21
HCPCS,15828,Rhytidectomy cheek chn & nck,,,1713.83,1984.43,8
HCPCS,15829,RHYTIDECTOMY SMAS FLAP,9126.0,5931.9,1.1,10462.5,108
HCPCS,15829,Rhytidectomy smas flap,,,1713.83,1984.43,8
HCPCS,15829,SMAS FLAP/SHORTSCAR/MINILIFT - COMPLEX,8910.0,5791.5,1.1,10462.5,88
HCPCS,15829,SMAS FLAP/SHORTSCAR/MINILIFT - MODERATE,5950.0,3867.5,1.1,10462.5,88
HCPCS,15829,SMAS FLAP/SHORTSCAR/MINILIFT - SIMPLE,3450.0,2242.5,1.1,10462.5,88
HCPCS,15830,ABDOMINIOPLASTY (CIRCUM) - MODERATE,7450.0,4842.5,1.1,19017.99,144
HCPCS,15830,ABDOMINIOPLASTY FULL - MODERATE,5720.0,3718.0,1.1,19017.99,144
HCPCS,15830,ABDOMINIOPLASTY MINI - MODERATE,4120.0,2678.0,1.1,19017.99,144
HCPCS,15830,ABDOMINIOPLASTY T - MODERATE,6950.0,4517.5,1.1,19017.99,144
HCPCS,15830,ABDOMINOPLASTY (CIRCUM) - COMPLEX,8025.0,5216.25,1.1,19017.99,144
HCPCS,15830,ABDOMINOPLASTY (CIRCUM) - SIMPLE,7150.0,4647.5,1.1,19017.99,144
HCPCS,15830,ABDOMINOPLASTY FULL - COMPLEX,6100.0,3965.0,1.1,19017.99,144
HCPCS,15830,ABDOMINOPLASTY FULL - SIMPLE,4120.0,2678.0,1.1,19017.99,144
HCPCS,15830,ABDOMINOPLASTY MINI - COMPLEX,4400.0,2860.0,1.1,19017.99,144
HCPCS,15830,ABDOMINOPLASTY MINI - SIMPLE,3810.0,2476.5,1.1,19017.99,144
HCPCS,15830,ABDOMINOPLASTY T - COMPLEX,7100.0,4615.0,1.1,19017.99,144
HCPCS,15830,ABDOMINOPLASTY T - SIMPLE,6400.0,4160.0,1.1,19017.99,144
HCPCS,15830,EXC EXCESSIVE SKIN ABDOMEN,,,5597.0,13132.0,24
HCPCS,15830,EXCISION SKIN ABD INFRAUMBILICAL PANNICULECTOMY,6844.0,4448.6,1.1,19017.99,144
HCPCS,15830,Exc excessive skin abdomen,,,1713.83,1984.43,8
HCPCS,15830,PANNICULECTOMY ABDMN/INFRAUMBILICAL - COMPLEX,4690.0,3048.5,1.1,19017.99,144
HCPCS,15830,PANNICULECTOMY ABDMN/INFRAUMBILICAL - MODERATE,4195.0,2726.75,1.1,19017.99,144
HCPCS,15830,PANNICULECTOMY ABDMN/INFRAUMBILICAL - SIMPLE,3695.0,2401.75,1.1,19017.99,144
HCPCS,15832,EXC EXCESSIVE SKIN THIGH,,,2465.15,3022.89,20
HCPCS,15832,EXCISION EXCESSIVE SKIN & SUBQ TISSUE THIGH,5654.0,3675.1,1.1,8286.13,132
HCPCS,15832,Exc excessive skin thigh,,,1713.83,1984.43,8
HCPCS,15832,THIGH LIFT - COMPLEX,6500.0,4225.0,1.1,8286.13,132
HCPCS,15832,THIGH LIFT - MODERATE,6100.0,3965.0,1.1,8286.13,132
HCPCS,15832,THIGH LIFT - SIMPLE,5805.0,3773.25,1.1,8286.13,132
HCPCS,15833,EXC EXCESSIVE SKIN LEG,,,2465.15,6238.0,21
HCPCS,15833,EXCISION EXCESSIVE SKIN & SUBQ TISSUE LEG,5236.0,3403.4,1.1,8286.13,132
HCPCS,15833,Exc excessive skin leg,,,1713.83,1984.43,8
HCPCS,15834,EXC EXCESSIVE SKIN HIP,,,2465.15,3022.89,20
HCPCS,15834,EXCISE EXCESS SKIN HIP - COMPLEX,4400.0,2860.0,1.1,8286.13,132
HCPCS,15834,EXCISE EXCESS SKIN HIP - MODERATE,4200.0,2730.0,1.1,8286.13,132
HCPCS,15834,EXCISE EXCESS SKIN HIP - SIMPLE,4013.0,2608.45,1.1,8286.13,132
HCPCS,15834,EXCISION EXCESSIVE SKIN & SUBQ TISSUE HIP,4868.0,3164.2,1.1,8286.13,132
HCPCS,15834,Exc excessive skin hip,,,1713.83,1984.43,8
HCPCS,15835,EXC EXCESSIVE SKIN BUTTOCK,,,2465.15,3022.89,20
HCPCS,15835,"EXCISE EXCESS SKIN, BUTTOCK - COMPLEX",4600.0,2990.0,1.1,8286.13,132
HCPCS,15835,"EXCISE EXCESS SKIN, BUTTOCK - MODERATE",4400.0,2860.0,1.1,8286.13,132
HCPCS,15835,"EXCISE EXCESS SKIN, BUTTOCK - SIMPLE",4287.0,2786.55,1.1,8286.13,132
HCPCS,15835,EXCISION EXCESSIVE SKIN & SUBQ TISSUE BUTTOCK,5196.0,3377.4,1.1,8286.13,132
HCPCS,15835,Exc excessive skin buttock,,,1713.83,1984.43,8
HCPCS,15836,ARMLIFT - COMPLEX,5150.0,3347.5,1.1,8286.13,132
HCPCS,15836,ARMLIFT - MODERATE,4572.0,2971.8,1.1,8286.13,132
HCPCS,15836,ARMLIFT - SIMPLE,4250.0,2762.5,1.1,8286.13,132
HCPCS,15836,EXC EXCESSIVE SKIN ARM,,,2465.15,7624.0,21
HCPCS,15836,EXCISION EXCESSIVE SKIN & SUBQ TISSUE ARM,4668.0,3034.2,1.1,8286.13,132
HCPCS,15836,Exc excessive skin arm,,,1713.83,1984.43,8
HCPCS,15837,EXC EXCESSIVE SKIN &SUBQ TISSUE FOREARM/HAND,3820.0,2483.0,1.1,8286.13,136
HCPCS,15837,EXC EXCSV SKIN FOREARM/HAND,,,2465.15,7418.14,21
HCPCS,15837,Exc excsv skin forearm/hand,,,1713.83,1984.43,8
HCPCS,15838,EXC EXCSV SKIN & SUBQ TISSUE SUBMENTAL FAT PAD,3300.0,2145.0,1.1,8286.13,132
HCPCS,15838,EXC EXCSV SUBMENTAL FAT PAD,,,2465.15,7418.14,21
HCPCS,15838,EXCISION EXCESSIVE SKIN SUBMENTAL FAT PAD - COMPLEX,3400.0,2210.0,1.1,8286.13,132
HCPCS,15838,EXCISION EXCESSIVE SKIN SUBMENTAL FAT PAD - MODERATE,3100.0,2015.0,1.1,8286.13,132
HCPCS,15838,EXCISION EXCESSIVE SKIN SUBMENTAL FAT PAD - SIMPLE,2271.0,1476.15,1.1,8286.13,132
HCPCS,15838,Exc excsv submental fat pad,,,1713.83,1984.43,8
HCPCS,15839,CORRUGATOR EXCISION - COMPLEX,2600.0,1690.0,1.1,8286.13,148
HCPCS,15839,CORRUGATOR EXCISION - MODERATE,2400.0,1560.0,1.1,8286.13,148
HCPCS,15839,CORRUGATOR EXCISION - SIMPLE,2200.0,1430.0,1.1,8286.13,148
HCPCS,15839,EXC EXCESSIVE SKN OTHER AREA,,,2465.15,7624.0,21
HCPCS,15839,EXCISION EXCESSIVE SKIN & SUBQ TISSUE OTHER AREA,4200.0,2730.0,1.1,8286.13,148
HCPCS,15839,Exc excessive skn other area,,,1713.83,1984.43,8
HCPCS,15840,"GRAFT FACE N PALSY,FREE FASCIA",5996.0,3897.4,1.1,10462.5,144
HCPCS,15840,NERVE PALSY FASCIAL GRAFT,,,3112.46,3687.9,20
HCPCS,15840,Nerve palsy fascial graft,,,1469.08,1701.04,8
HCPCS,15841,"GRAFT FACE N PALSY,FREE MUSCLE",10396.0,6757.4,1.1,10462.5,144
HCPCS,15841,NERVE PALSY MUSCLE GRAFT,,,3112.46,3687.9,20
HCPCS,15841,Nerve palsy muscle graft,,,1469.08,1701.04,8
HCPCS,15842,GRF FACIAL NRV PALYSS FR MUSCLE FLAP MICROSURG,16404.0,10662.6,1.1,16404.0,144
HCPCS,15842,NERVE PALSY MICROSURG GRAFT,,,1582.09,2147.22,20
HCPCS,15842,Nerve palsy microsurg graft,,,1469.08,1701.04,8
HCPCS,15845,GRF FACIAL NERVE PARALYSIS REGIONAL MUSCLE TR,5728.0,3723.2,1.1,10462.5,144
HCPCS,15845,SKIN AND MUSCLE REPAIR FACE,,,3112.46,3687.9,20
HCPCS,15845,Skin and muscle repair face,,,1469.08,1701.04,8
HCPCS,15847,ABDOMINOPLASTY ADD-ON  (INCL FLEUR DE LIS),1000.0,650.0,1.1,2068.22,106
HCPCS,15847,"EXCISE EXCESS SKIN TISSUE,ABDOMEN, ADD-ON",5828.0,3788.2,1.1,5828.0,106
HCPCS,15847,Exc skin abd add-on,,,1713.83,1984.43,8
HCPCS,15850,Remove sutures same surgeon,,,1060.53,1227.99,8
HCPCS,15851,REMOVAL SUTR/STAPLE REQ ANES,,,1582.09,5457.0,21
HCPCS,15851,REMOVAL SUTURES/STAPLES REQUIRING ANESTHESIA,440.0,286.0,1.1,5320.02,148
HCPCS,15851,Removal sutr/staple req anes,,,1060.53,1227.99,8
HCPCS,15852,DRESSING CHANGE NOT FOR BURN,,,544.87,1639.62,21
HCPCS,15852,DRESSING CHANGE UNDER ANESTHESIA,344.0,223.6,1.1,1830.48,144
HCPCS,15852,Dressing change not for burn,,,186.25,215.66,8
HCPCS,15853,REMOVAL SUTURES OR STAPLES NOT REQUIRING ANESTHESIA,364.0,236.6,1.1,364.0,144
HCPCS,15853,REMOVAL SUTURES/STAPLES NOT REQUIRING ANESTHESIA,751.0,488.15,0.01,3443.0,68
HCPCS,15854,REMOVAL SUTURES&STAPLES NOT REQUIRING ANESTHESIA,1355.0,880.75,0.01,3443.0,68
HCPCS,15860,IV NJX TST VASC FLO FLAP/GRF,,,345.67,1040.19,21
HCPCS,15860,Iv njx tst vasc flo flap/grf,,,81.99,94.94,8
HCPCS,15860,TEST FOR BLOOD FLOW IN GRAFT,780.0,507.0,1.1,1163.18,144
HCPCS,15865,REMOVAL SUTURES & STAPLES NOT REQUIRING ANESTHESIA,337.0,219.05,1.1,337.0,70
HCPCS,15876,SUBMENTAL LIPOSUCTION,1710.0,1111.5,1.1,10462.5,96
HCPCS,15876,"SUCT ASSIS LIPECTOMY,HEAD/NECK",2456.0,1596.4,1.1,10462.5,96
HCPCS,15876,SUCTION LIPECTOMY HEAD&NECK,,,3112.46,3687.9,20
HCPCS,15876,Suction lipectomy head&neck,,,1713.83,1984.43,8
HCPCS,15877,LIPOSUCTION 360 TRUNK - COMLEX,4400.0,2860.0,1.1,10462.5,94
HCPCS,15877,LIPOSUCTION 360 TRUNK - MODERATE,4150.0,2697.5,1.1,10462.5,94
HCPCS,15877,LIPOSUCTION 360 TRUNK - SIMPLE,3742.0,2432.3,1.1,10462.5,94
HCPCS,15877,LIPOSUCTION ABD - MODERATE,3150.0,2047.5,1.1,10462.5,94
HCPCS,15877,LIPOSUCTION ABD - SIMPLE,2850.0,1852.5,1.1,10462.5,94
HCPCS,15877,"LIPOSUCTION, HIPS",3615.0,2349.75,1.1,10462.5,94
HCPCS,15877,"LIPOSUCTION, STOMACH",3615.0,2349.75,1.1,10462.5,94
HCPCS,15877,LIPSUCTION ABD - COMPLEX,3450.0,2242.5,1.1,10462.5,94
HCPCS,15877,"SUCT ASSIS LIPECTOMY,TRUNK",4640.0,3016.0,1.1,10462.5,94
HCPCS,15877,SUCTION ASSISTED LIPECTOMY; TRUNK,3615.0,2349.75,1.1,10462.5,94
HCPCS,15877,SUCTION LIPECTOMY TRUNK,,,3112.46,3687.9,20
HCPCS,15877,Suction lipectomy trunk,,,1713.83,1984.43,8
HCPCS,15878,LIPOSUCT ARM BILAT LYMPH/LIPEDEMA,15000.0,9750.0,1.1,15000.0,94
HCPCS,15878,LIPOSUCT UPPER EXTREMITY  LYMPH/LIPEDEMA,8500.0,5525.0,1.1,8500.0,94
HCPCS,15878,LIPOSUCTION UPPER EXTREM - COMPLEX,4000.0,2600.0,1.1,5320.02,94
HCPCS,15878,LIPOSUCTION UPPER EXTREM - MODERATE,3825.0,2486.25,1.1,5320.02,94
HCPCS,15878,LIPOSUCTION UPPER EXTREM - SIMPLE,3615.0,2349.75,1.1,5320.02,94
HCPCS,15878,"SUCT ASSIS LIPECTOMY,UP EXTREM",4777.0,3105.05,1.1,5320.02,94
HCPCS,15878,SUCTION LIPECTOMY UPR EXTREM,,,1582.09,17833.0,21
HCPCS,15878,Suction lipectomy upr extrem,,,1713.83,1984.43,8
HCPCS,15879,LIPOSUCT LEG BILAT LYMPH/LIPEDEMA,20000.0,13000.0,1.1,20000.0,94
HCPCS,15879,LIPOSUCT LOWER EXTREMITY LYMPH/LIPEDEMA,11500.0,7475.0,1.1,11500.0,94
HCPCS,15879,"LIPOSUCTION, LATERAL THIGHS - COMPLEX",3400.0,2210.0,1.1,10462.5,94
HCPCS,15879,"LIPOSUCTION, LATERAL THIGHS/HIPS - MODERATE",3100.0,2015.0,1.1,10462.5,94
HCPCS,15879,"LIPOSUCTION, LATERAL THIGHS/HIPS- SIMPLE",2800.0,1820.0,1.1,10462.5,94
HCPCS,15879,"LIPOSUCTION, THIGHS",3727.0,2422.55,1.1,10462.5,94
HCPCS,15879,"SUCT ASSIS LIPECTOMY,LOW EXTREM",4640.0,3016.0,1.1,10462.5,94
HCPCS,15879,SUCTION ASSISTED LIPECTOMY LOWER EXTREMITY,10983.0,7138.95,0.01,17833.0,85
HCPCS,15920,EXC COCCYGEAL PR ULC W/COCCYGECTOMY W/PRIM SUTR,3316.0,2155.4,1.1,8286.13,144
HCPCS,15920,EXC COCCYGL PR ULC PRIM SUTR,,,2465.15,3022.89,20
HCPCS,15920,Exc coccygl pr ulc prim sutr,,,559.63,647.99,8
HCPCS,15922,EXC COCCYGEAL PR ULC W/COCCYGECTOMY W/FLAP CLSR,4152.0,2698.8,1.1,10462.5,144
HCPCS,15922,EXC COCCYGL PR ULC FLAP CLSR,,,3112.46,3687.9,20
HCPCS,15922,Exc coccygl pr ulc flap clsr,,,559.63,647.99,8
HCPCS,15931,EXC SACRAL PR ULC PRIM SUTR,,,2465.15,3022.89,20
HCPCS,15931,EXCISION SACRAL PRESSURE ULCER W/PRIMARY SUTURE,4028.0,2618.2,1.1,8286.13,144
HCPCS,15931,Exc sacral pr ulc prim sutr,,,559.63,647.99,8
HCPCS,15933,EXC SAC PR ULC PRIM STR OSTC,,,2465.15,3022.89,20
HCPCS,15933,EXC SACRAL PRESSURE ULC W/PRIM SUTR W/OSTECTOMY,4708.0,3060.2,1.1,8286.13,144
HCPCS,15933,Exc sac pr ulc prim str ostc,,,559.63,647.99,8
HCPCS,15934,EXC SACRAL PR ULC SKN FLAP,,,3112.46,3687.9,20
HCPCS,15934,EXCISION SACRAL PRESSURE ULCER W/SKIN FLAP CLSR,5472.0,3556.8,1.1,10462.5,144
HCPCS,15934,Exc sacral pr ulc skn flap,,,559.63,647.99,8
HCPCS,15935,EXC SAC PR ULC SKN FLP OSTC,,,3112.46,3687.9,20
HCPCS,15935,EXC SACRAL PR ULCER W/SKN FLAP CLSR W/OSTECTOMY,6312.0,4102.8,1.1,10462.5,144
HCPCS,15935,Exc sac pr ulc skn flp ostc,,,559.63,647.99,8
HCPCS,15936,EXC SAC PR ULC PREP MUS FLAP,,,1582.09,2147.22,20
HCPCS,15936,EXC SAC PR ULC PREPJ MUSC/MYOQ FLAP/SKN GRF CLSR,5264.0,3421.6,1.1,5320.02,144
HCPCS,15936,Exc sac pr ulc prep mus flap,,,559.63,647.99,8
HCPCS,15937,EXC SAC PR ULC PREP MUS OSTC,,,1582.09,2147.22,20
HCPCS,15937,EXC SAC PR ULC PREPJ MUSC/MYOQ FLAP/SKN GRF OSTC,6056.0,3936.4,1.1,6056.0,144
HCPCS,15937,Exc sac pr ulc prep mus ostc,,,559.63,647.99,8
HCPCS,15940,EXC ISCHIAL PR ULC PRIM SUTR,,,2465.15,3022.89,20
HCPCS,15940,EXC ISCHIAL PRESSURE ULCER W/PRIMARY SUTURE,4080.0,2652.0,1.1,8286.13,144
HCPCS,15940,Exc ischial pr ulc prim sutr,,,559.63,647.99,8
HCPCS,15941,EXC ISCH PR ULC PRM SUT OSTC,,,2465.15,3022.89,20
HCPCS,15941,EXC ISCHIAL PR ULC W/PRIM SUTR W/OSTC ISCHIECT,4964.0,3226.6,1.1,8286.13,144
HCPCS,15941,Exc isch pr ulc prm sut ostc,,,559.63,647.99,8
HCPCS,15944,EXC ISCH PR ULC SKN FLP CLSR,,,3112.46,3687.9,20
HCPCS,15944,EXC ISCHIAL PRESSURE ULCER W/SKIN FLAP CLOSURE,4976.0,3234.4,1.1,10462.5,144
HCPCS,15944,Exc isch pr ulc skn flp clsr,,,559.63,647.99,8
HCPCS,15945,EXC ISCH PR ULC SKN FLP OSTC,,,1582.09,2147.22,20
HCPCS,15945,EXC ISCHIAL PR ULC W/SKN FLAP CLSR W/OSTECTOMY,5500.0,3575.0,1.1,5500.0,144
HCPCS,15945,Exc isch pr ulc skn flp ostc,,,559.63,647.99,8
HCPCS,15946,EXC ISCH PR ULC PREP MUS FLP,,,1582.09,2147.22,20
HCPCS,15946,EXC ISCHIAL PR ULCER W/OSTC MUSC/MYOQ FLAP/SKIN,9648.0,6271.2,1.1,9648.0,144
HCPCS,15946,Exc isch pr ulc prep mus flp,,,559.63,647.99,8
HCPCS,15950,EXC TRCHNTR PR ULC PRIM SUTR,,,1406.56,1718.79,20
HCPCS,15950,EXC TROCHANTERIC PRESSURE ULCER W/PRIMARY SUTR,3212.0,2087.8,1.1,4729.25,144
HCPCS,15950,Exc trchntr pr ulc prim sutr,,,559.63,647.99,8
HCPCS,15951,EXC TRCHNTR PR ULC OSTC,,,2465.15,3022.89,20
HCPCS,15951,EXC TRCHNTRIC PR ULCER W/PRIM SUTR W/OSTECTOMY,4632.0,3010.8,1.1,8286.13,144
HCPCS,15951,Exc trchntr pr ulc ostc,,,559.63,647.99,8
HCPCS,15952,EXC TRCHNTR PR ULC FLP CLSR,,,1582.09,2147.22,20
HCPCS,15952,EXC TROCHANTERIC PR ULCER W/SKIN FLAP CLOSURE,4924.0,3200.6,1.1,5320.02,144
HCPCS,15952,Exc trchntr pr ulc flp clsr,,,559.63,647.99,8
HCPCS,15953,EXC TRCHNTR PR ULC FLP OSTC,,,3112.46,3687.9,20
HCPCS,15953,EXC TRCHNTRIC PR ULC W/SKN FLAP CLSR W/OSTECTOMY,5428.0,3528.2,1.1,10462.5,144
HCPCS,15953,Exc trchntr pr ulc flp ostc,,,559.63,647.99,8
HCPCS,15956,EXC TRCHNTR PR ULC PREP FLAP,,,1582.09,2147.22,20
HCPCS,15956,EXC TROCHANTERIC PR ULCER MUSC/MYOQ FLAP/SKIN,6716.0,4365.4,1.1,6716.0,144
HCPCS,15956,Exc trchntr pr ulc prep flap,,,559.63,647.99,8
HCPCS,15958,EXC TRCHNTR PR ULC PREP OSTC,,,3112.46,3687.9,20
HCPCS,15958,EXC TRCHNTRIC PR ULC MUSC/MYOQ FLAP/SKIN W/OSTC,6700.0,4355.0,1.1,10462.5,144
HCPCS,15958,Exc trchntr pr ulc prep ostc,,,559.63,647.99,8
HCPCS,15999,UNLISTED PX EXC PRESSURE ULC,,,610.39,1836.79,21
HCPCS,15999,Unlisted px exc pressure ulc,,,186.25,215.66,8
HCPCS,16000,INITIAL TX 1ST DEGREE BURN LOCAL TX,596.0,387.4,0.01,12500.0,173
HCPCS,16000,"INITIAL TX, FIRST DEGREE BURN, LOCAL TREATMENT",356.0,231.4,1.1,584.65,146
HCPCS,16020,DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ SMALL,454.0,295.1,0.01,3443.0,321
HCPCS,16025,DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ MEDIUM,646.0,419.9,0.01,5265.0,322
HCPCS,16030,DRS&/DBRDMT PRTL-THKNS BURNS 1ST/SBSQ LARGE,1015.5,660.075,1.1,5265.0,235
HCPCS,16035,ESCHAROTOMY 1ST INCISION,,,345.93,1040.98,21
HCPCS,16035,ESCHAROTOMY; INIT INC,1496.0,972.4,1.1,1496.0,144
HCPCS,16035,Escharotomy 1st incision,,,239.13,276.89,8
HCPCS,16036,ESCHAROTOMY EA ADDL INCISION,,,215.83,215.83,1
HCPCS,16036,Escharotomy ea addl incision,,,239.13,276.89,8
HCPCS,17000,DESTRUCTION PREMALIGNANT LESION 1ST,596.0,387.4,0.01,12500.0,173
HCPCS,17000,"DESTRUCTION, 1ST LESION",268.0,174.2,1.1,584.65,148
HCPCS,17003,"DESTRUC BENIGN/PREMAL,2-14 LESIONS",18.0,11.7,1.1,21.76,148
HCPCS,17003,DESTRUCTION PREMALIGNANT LESION 2-14 EA,334.0,217.1,0.01,3443.0,68
HCPCS,17004,"DESTRUC BENIGN/PREMAL,>15 LESIONS",603.0,391.95,1.1,1163.18,148
HCPCS,17004,DESTRUCTION PREMALIGNANT LESION 15/>,1199.0,779.35,0.01,3443.0,87
HCPCS,17106,DESTRUCTION CUTANEOUS VASC PROLIFERATIVE <10CM,1411.5,917.4749999999999,0.01,3443.0,235
HCPCS,17106,LASER CVP LESIONS,300.0,195.0,1.1,1163.18,148
HCPCS,17107,"DESTR,CUTAN VASC LESION 10-50SCM",2108.0,1370.2,1.1,2108.0,148
HCPCS,17107,DSTRJ CUTANEOUS VASCULAR LESIONS 10.0-50.0 SQ CM,1836.0,1193.4,0.01,3443.0,87
HCPCS,17107,"LASER, DSTRJ CUTANEOUS VASCULAR LESIONS 10.0-50.0 SQ CM",650.0,422.5,1.1,1830.48,148
HCPCS,17108,DESTRUC CUT/VASC >50 SQ CM,3296.0,2142.4,1.1,5320.02,148
HCPCS,17108,DSTRJ CUTANEOUS VASCULAR LESIONS >50.0 SQ CM,5488.0,3567.2,0.01,5488.0,87
HCPCS,17108,"LASER, DSTRJ CUTANEOUS VASCULAR LESIONS >50.0 SQ CM",1100.0,715.0,1.1,5320.02,148
HCPCS,17110,DESTRUCTION BENIGN LESIONS UP TO 14,452.0,293.79999999999995,0.01,12500.0,321
HCPCS,17110,KERATOSES DESTRUCTION UP TO 14,200.0,130.0,1.1,584.65,148
HCPCS,17111,"DESTRUC FLAT WARTS, 15 OR MORE",427.0,277.55,1.1,584.65,148
HCPCS,17111,DESTRUCTION BENIGN LESIONS 15/>,596.0,387.4,0.01,12500.0,87
HCPCS,17111,KERATOSES DESTRUCTION 15 OR MORE,250.0,162.5,1.1,584.65,148
HCPCS,17250,CHEM CAUTER GRANULAR TISSUE,220.0,143.0,1.1,584.65,148
HCPCS,17250,CHEMICAL CAUTERIZATION OF GRANULATION TISSUE,596.0,387.4,0.01,12500.0,259
HCPCS,17260,"DESTR MALIG TRUNK,EXTREM <0.5 CM",422.0,274.3,1.1,584.65,148
HCPCS,17260,DESTRUCTION MALIGNANT LESION T/A/L 0.5 CM/<,596.0,387.4,0.01,12500.0,87
HCPCS,17261,"DESTR MALIG TRUNK,EXTREM 0.6-1 CM",537.0,349.05,1.1,584.65,148
HCPCS,17261,DESTRUCTION MAL LESION TRUNK/ARM/LEG 0.6-1.0 CM,596.0,387.4,0.01,12500.0,87
HCPCS,17262,"DESTR MALIG TRUNK,EXTREM 1.1-2 CM",717.0,466.05,1.1,717.0,148
HCPCS,17262,DESTRUCTION MAL LESION TRUNK/ARM/LEG 1.1-2.0CM,596.0,387.4,0.01,12500.0,87
HCPCS,17263,"DESTR MALIG TRUNK,EXTREM 2.1-3 CM",810.0,526.5,1.1,810.0,148
HCPCS,17263,DESTRUCTION MAL LESION TRUNK/ARM/LEG 2.1-3.0CM,596.0,387.4,0.01,12500.0,87
HCPCS,17264,"DESTR MALIG TRUNK,EXTREM 3.1-4 CM",876.0,569.4,1.1,1163.18,148
HCPCS,17264,DESTRUCTION MAL LESION TRUNK/ARM/LEG 3.1-4.0CM,1199.0,779.35,0.01,12500.0,87
HCPCS,17266,"DESTR MALIG TRUNK,EXTREM >4.0 CM",1052.0,683.8,1.1,1163.18,148
HCPCS,17266,DESTRUCTION MAL LESION TRUNK/ARM/LEG > 4.0 CM,1199.0,779.35,0.01,4337.0,87
HCPCS,17270,"DESTR MALIG SCAL,NCK,HAND <0.5 CM",548.0,356.2,1.1,584.65,148
HCPCS,17270,DESTRUCTION MALIGNANT LESION S/N/H/F/G 0.5 CM/>,596.0,387.4,0.01,12500.0,87
HCPCS,17271,"DESTR MALIG SCAL,NCK,HAND 0.6-1 CM",616.0,400.4,1.1,616.0,148
HCPCS,17271,DESTRUCTION MALIGNANT LESION S/N/H/F/G 0.6-1.0CM,596.0,387.4,0.01,12500.0,87
HCPCS,17272,"DESTR MALIG SCAL,NCK,HAND 1.1-2 CM",728.0,473.2,1.1,728.0,148
HCPCS,17272,DESTRUCTION MALIGNANT LESION S/N/H/F/G 1.1-2.0CM,596.0,387.4,0.01,12500.0,87
HCPCS,17273,"DESTR MALIG SCAL,NCK,HAND 2.1-3 CM",840.0,546.0,1.1,1163.18,148
HCPCS,17273,DESTRUCTION MALIGNANT LESION S/N/H/F/G 2.1-3.0CM,1199.0,779.35,0.01,12500.0,87
HCPCS,17274,"DESTR MALIG SCAL,NCK,HAND 3.1-4 CM",1056.0,686.4,1.1,1163.18,148
HCPCS,17274,DESTRUCTION MALIGNANT LESION S/N/H/F/G 3.1-4.0CM,1199.0,779.35,0.01,3443.0,87
HCPCS,17276,"DESTR MALIG SCAL,NCK,HAND >4 CM",1300.0,845.0,1.1,1300.0,148
HCPCS,17276,DSTRJ MAL LESION S/N/H/F/G LESION DIAM > 4.0 CM,1199.0,779.35,0.01,4337.0,87
HCPCS,17280,DESTRUCTION MALIGNANT LESION F/E/E/N/L/M 0.5CM/<,542.0,352.29999999999995,0.01,12500.0,235
HCPCS,17281,"DESTR MALIG FACE,NOSE,LIP 0.6-1 CM",708.0,460.2,1.1,1163.18,148
HCPCS,17281,DESTRUCTION MAL LESION F/E/E/N/L/M 0.6-1.0CM,596.0,387.4,0.01,12500.0,87
HCPCS,17282,"DESTR MALIG FACE,NOSE,LIP 1.1-2 CM",836.0,543.4,1.1,1163.18,148
HCPCS,17282,DESTRUCTION MAL LESION F/E/E/N/L/M 1.1-2.0CM,596.0,387.4,0.01,12500.0,87
HCPCS,17283,"DESTR MALIG FACE,NOSE,LIP 2.1-3 CM",1076.0,699.4,1.1,1163.18,148
HCPCS,17283,DESTRUCTION MAL LESION F/E/E/N/L/M 2.1-3.0CM,1199.0,779.35,0.01,12500.0,87
HCPCS,17284,"DESTR MALIG FACE,NOSE,LIP 3.1-4 CM",1280.0,832.0,1.1,1830.48,148
HCPCS,17284,DESTRUCTION MAL LESION F/E/E/N/L/M 3.1-4.0CM,1836.0,1193.4,0.01,3443.0,87
HCPCS,17286,"DESTR MALIG FACE,NOSE,LIP >4CM",1792.0,1164.8,1.1,1830.48,148
HCPCS,17286,DESTRUCTION MAL LESION F/E/E/N/L/M >4.0 CM,1836.0,1193.4,0.01,12500.0,87
HCPCS,17311,MOHS MICROGRAPHIC H/N/H/F/G 1ST STAGE 5 BLOCKS,2158.0,1402.7,0.01,4337.0,235
HCPCS,17312,MOHS MICROGRAPHIC H/N/H/F/G EACH ADDL STAGE,1051.0,683.15,0.01,3443.0,216
HCPCS,17313,MOHS TRUNK/ARM/LEG 1ST STAGE 5 BLOCKS,2030.0,1319.5,0.01,4337.0,235
HCPCS,17314,MOHS TRUNK/ARM/LEG EA STAGE AFTER 1ST STAGE,1064.0,691.6,0.01,3443.0,216
HCPCS,17315,MOHS TRUNK/ARM/LEG EA ADDL BLOCK ANY STAGE,537.5,349.375,0.01,3443.0,216
HCPCS,17340,CRYOTHERAPY CO2 SLUSH LIQUID N2 ACNE,308.0,200.2,1.1,308.0,148
HCPCS,17340,CRYOTHERAPY FOR ACNE,,,53.07,159.69,21
HCPCS,17340,Cryotherapy for acne,,,168.79,195.44,8
HCPCS,17360,CHEMICAL EXFOLIATION ACNE,584.0,379.6,1.1,584.65,167
HCPCS,17360,Chemical exfoliation acne,,,168.79,195.44,8
HCPCS,17380,ELECTROLYSIS EPILATION EA 30,,,544.87,1639.62,21
HCPCS,17380,ELECTROLYSIS EPILATION EACH 30 MINUTES,111.0,72.15,1.1,1830.48,88
HCPCS,17380,Electrolysis epilation ea 30,,,168.79,195.44,8
HCPCS,17999,ABDOMINOPLASY W/ FLEUR-DE-LIS W/O PANNICULECTOMY(COMP CODE 15830,7992.0,5194.8,0.01,7992.0,84
HCPCS,17999,ADD ON DERMABLADING,25.0,16.25,0.01,584.65,84
HCPCS,17999,CERVICOPLASTY (REMOVAL EXCESS NECK SKIN),990.0,643.5,0.01,990.0,84
HCPCS,17999,CONTACT RADIOFREQUENCY (COMP CODE 15781),400.0,260.0,0.01,584.65,84
HCPCS,17999,COOLSCULPTING CYCLES 1 (COMP 15877),750.0,487.5,0.01,750.0,84
HCPCS,17999,COOLSCULPTING CYCLES 10 (COMP 15877),5000.0,3250.0,0.01,5000.0,84
HCPCS,17999,COOLSCULPTING CYCLES 11 (COMP 15877),5500.0,3575.0,0.01,5500.0,84
HCPCS,17999,COOLSCULPTING CYCLES 12 (COMP 15877),6000.0,3900.0,0.01,6000.0,84
HCPCS,17999,COOLSCULPTING CYCLES 13 (COMP 15877),6500.0,4225.0,0.01,6500.0,84
HCPCS,17999,COOLSCULPTING CYCLES 14 (COMP 15877),7000.0,4550.0,0.01,7000.0,84
HCPCS,17999,COOLSCULPTING CYCLES 15 (COMP 15877),7500.0,4875.0,0.01,7500.0,84
HCPCS,17999,COOLSCULPTING CYCLES 2 (COMP 15877),1500.0,975.0,0.01,1500.0,84
HCPCS,17999,COOLSCULPTING CYCLES 3 (COMP 15877),2250.0,1462.5,0.01,2250.0,84
HCPCS,17999,COOLSCULPTING CYCLES 4 (COMP 15877),3000.0,1950.0,0.01,3000.0,84
HCPCS,17999,COOLSCULPTING CYCLES 5 (COMP 15877),3200.0,2080.0,0.01,3200.0,84
HCPCS,17999,COOLSCULPTING CYCLES 6 (COMP 15877),3800.0,2470.0,0.01,3800.0,84
HCPCS,17999,COOLSCULPTING CYCLES 7 (COMP 15877),4200.0,2730.0,0.01,4200.0,84
HCPCS,17999,COOLSCULPTING CYCLES 8 (COMP 15877),4500.0,2925.0,0.01,4500.0,84
HCPCS,17999,COOLSCULPTING CYCLES 9 (COMP 15877),4800.0,3120.0,0.01,4800.0,84
HCPCS,17999,COOLSCULPTING CYCLES ADV + 1 (COMP 15877),1500.0,975.0,0.01,1500.0,84
HCPCS,17999,COOLSCULPTING CYCLES ADV + 2 (COMP 15877),2700.0,1755.0,0.01,2700.0,84
HCPCS,17999,COOLSCULPTING CYCLES ADV + 3 (COMP 15877),3800.0,2470.0,0.01,3800.0,84
HCPCS,17999,COOLSCULPTING CYCLES ADV + 4 (COMP 15877),4500.0,2925.0,0.01,4500.0,84
HCPCS,17999,COOLSCULPTING CYCLES ADV + 5 (COMP 15877),5000.0,3250.0,0.01,5000.0,84
HCPCS,17999,COOLSCULPTING CYCLES ADV + 6 (COMP 15877),6000.0,3900.0,0.01,6000.0,84
HCPCS,17999,COOLSCULPTING CYCLES ADV + 7 (COMP 15877),7000.0,4550.0,0.01,7000.0,84
HCPCS,17999,CRYOABLATION ABDOMINAL WALL MASS (COMP CODE 20983),15823.5,10285.275,0.01,29447.0,168
HCPCS,17999,CRYOABLATION OF SUBCUTANEOOUS MASS (COMP CODE 20983),17806.5,11574.225,0.01,32861.0,168
HCPCS,17999,CUSTOMIZED MASK,15.0,9.75,0.01,584.65,84
HCPCS,17999,DERM TECH (COMP CODE 11102),315.5,205.075,0.01,3443.0,169
HCPCS,17999,DERMABLADING,60.0,39.0,0.01,584.65,84
HCPCS,17999,ELECTROHYDROLIC SHOCKWAVE ENERGY LEVEL 1 SMALL (COMP CODE 15781),800.0,520.0,0.01,800.0,84
HCPCS,17999,ELECTROHYDROLIC SHOCKWAVE ENERGY LEVEL 2 MEDIUM (COMP CODE 15781,1600.0,1040.0,0.01,1600.0,84
HCPCS,17999,ELECTROHYDROLIC SHOCKWAVE ENERGY LEVEL 3 LARGE (COMP CODE 15780),2200.0,1430.0,0.01,2200.0,84
HCPCS,17999,EXTRACTIONS,75.0,48.75,0.01,584.65,84
HCPCS,17999,"FACIAL RESURFACING, LASER (COMP CODE 17108)",3202.0,2081.3,0.01,3443.0,169
HCPCS,17999,FAT PAD BIOPSY (COMP CODE 20200),4018.5,2612.025,0.01,7453.0,168
HCPCS,17999,IMPLANTATION OF BIO IMPLANT FOR SOFT TISSUE REINF; OTHER AREAS (,1205.0,783.25,0.01,1205.0,84
HCPCS,17999,INRA THECAL PUMP SUBCUTANEOUS POCKET (COMP CODE 63688),2118.0,1376.7,0.01,2118.0,84
HCPCS,17999,INTRA THECAL PUMP SUBCUTANEOUS (COMP 63688),25.0,16.25,0.01,3443.0,85
HCPCS,17999,LASER FRACT ABLAT SINGLE-USE LARGE (COMP CODE 15780),5000.0,3250.0,0.01,5000.0,84
HCPCS,17999,LASER FRACT ABLAT SINGLE-USE MEDIUM (COMP CODE 15780),3000.0,1950.0,0.01,3000.0,84
HCPCS,17999,LASER FRACT ABLAT SINGLE-USE SMALL (COMP CODE 15781),1500.0,975.0,0.01,1500.0,84
HCPCS,17999,LASER FRACT ABLATIVE FULL FACE SUPERFICIAL /PARTIAL AGGRESSIVE (,900.0,585.0,0.01,900.0,84
HCPCS,17999,LASER FRACT ABLATIVE LARGE  (COMP CODE 15780),3500.0,2275.0,0.01,3500.0,84
HCPCS,17999,LASER FRACT ABLATIVE LIGHT MODE PARTIAL (COMP CODE 15781),400.0,260.0,0.01,584.65,84
HCPCS,17999,LASER FRACT ABLATIVE MEDIUM (COMP CODE 15780),2000.0,1300.0,0.01,2000.0,84
HCPCS,17999,LASER FRACT ABLATIVE SMALL (COMP CODIE 15781),900.0,585.0,0.01,900.0,84
HCPCS,17999,LASER FRACT NON-ABLAT SINGLE-USE LARGE (COMP CODE 15780),1100.0,715.0,0.01,1100.0,84
HCPCS,17999,LASER FRACT NON-ABLAT SINGLE-USE MEDIUM (COMP CODE 15780),800.0,520.0,0.01,800.0,84
HCPCS,17999,LASER FRACT NON-ABLAT SINGLE-USE SMALL (COMP CODE 15781),500.0,325.0,0.01,584.65,84
HCPCS,17999,LASER FRACT NON-ABLATIVE FULL FACE & NECK (COMP 15780),1000.0,650.0,0.01,1000.0,84
HCPCS,17999,LASER FRACT NON-ABLATIVE FULL FACE (COMP 15780),800.0,520.0,0.01,800.0,84
HCPCS,17999,LASER FRACT NON-ABLATIVE SPOT/PARTIAL FACE (COMP 15781),300.0,195.0,0.01,584.65,84
HCPCS,17999,LASER HAIR REMOVAL (COMP 17110),336.0,218.39999999999998,0.01,3443.0,169
HCPCS,17999,LASER HAIR REMOVAL - COMPLEX,750.0,487.5,0.01,750.0,84
HCPCS,17999,LASER HAIR REMOVAL - SIMPLE,275.0,178.75,0.01,584.65,84
HCPCS,17999,"LASER HAIR REMOVAL, MODERATE",500.0,325.0,0.01,584.65,84
HCPCS,17999,"LASER HAIR REMOVAL, XLARGE AREA",700.0,455.0,0.01,700.0,84
HCPCS,17999,LASER PROCEDURE,25.0,16.25,0.01,3443.0,85
HCPCS,17999,LASER VASC & PIGM LESIONS FACE & NECK/LARGE (COMP 15781),800.0,520.0,0.01,800.0,84
HCPCS,17999,LASER VASC & PIGM LESIONS FULL FACE/MEDIUM (COMP 15780),600.0,390.0,0.01,600.0,84
HCPCS,17999,LASER VASC & PIGM LESIONS SMALL (COMP CODE 15781),400.0,260.0,0.01,584.65,84
HCPCS,17999,MICRO-CORING SMALL (COMP CODE 15781),2000.0,1300.0,0.01,2000.0,84
HCPCS,17999,"MICRO-CORING, LARGE - LOWER FACE + NECK (COMP 15780)",4000.0,2600.0,0.01,4000.0,84
HCPCS,17999,"MICRO-CORING, MEDIUM (COMP CODE 15781)",3500.0,2275.0,0.01,3500.0,84
HCPCS,17999,"MICROFOCUSED ULTRASOUND, FULL FACE & SUBMENTUM (COMP CODE 15780)",3500.0,2275.0,0.01,3500.0,84
HCPCS,17999,"MICROFOCUSED ULTRASOUND, LOWER FACE & SUBMENTUM (COMP CODE 15781",2500.0,1625.0,0.01,2500.0,84
HCPCS,17999,"MICROFOCUSED ULTRASOUND, UPPER FACE (COMP CODE 15781)",1500.0,975.0,0.01,1500.0,84
HCPCS,17999,"MICROFOCUSED ULTRASOUND,NECK (COMP CODE 15782)",1800.0,1170.0,0.01,1800.0,84
HCPCS,17999,MICRONEEDLE -SCAR (COMP 15793),300.0,195.0,0.01,584.65,84
HCPCS,17999,MICRONEEDLE-REJUV (COMP 15793),450.0,292.5,0.01,584.65,84
HCPCS,17999,MICRONEEDLEN-ACNE (COMP 15793),600.0,390.0,0.01,600.0,84
HCPCS,17999,MICRONEEDLING LARGE (COMP CODE 15780),800.0,520.0,0.01,800.0,84
HCPCS,17999,MICRONEEDLING MEDIUM  (COMP CODE 15780),500.0,325.0,0.01,584.65,84
HCPCS,17999,MICRONEEDLING SCAR (COMP CODE15783),1358.5,883.0250000000001,0.01,3443.0,169
HCPCS,17999,MICRONEEDLING SMALL (COMP CODE 15781),250.0,162.5,0.01,584.65,84
HCPCS,17999,"NON INVASIVE RADIOFREQUENCY, LARGE (COMP CODE 15780)",2800.0,1820.0,0.01,2800.0,84
HCPCS,17999,"NON INVASIVE RADIOFREQUENCY, MEDIUM (COMP CODE 15781)",2500.0,1625.0,0.01,2500.0,84
HCPCS,17999,"NON INVASIVE RADIOFREQUENCY, SMALL (COMP CODE 15781)",1100.0,715.0,0.01,1100.0,84
HCPCS,17999,ONE SYRINGE OF DEFYNE,700.0,455.0,0.01,700.0,84
HCPCS,17999,ONE SYRINGE OF REFYNE,700.0,455.0,0.01,700.0,84
HCPCS,17999,PRP & MICRONEEDLING LARGE (COMP CODE 15780 + 0232T),1300.0,845.0,0.01,1300.0,84
HCPCS,17999,PRP & MICRONEEDLING MEDIUM (COMP CODE 15780 + 0232T),1100.0,715.0,0.01,1100.0,84
HCPCS,17999,PRP & MICRONEEDLING SMALL (COMP CODE 15781 + 0232T),600.0,390.0,0.01,600.0,84
HCPCS,17999,RADIOFREQUENCY ABLATION SUBCUTANEOUS MASS  (COMP CODE 20982),30997.5,20148.375,0.01,59187.0,168
HCPCS,17999,"RADIOFREQUENCY MICRONEEDLING, LARGE (COMP CODE 15780)",1200.0,780.0,0.01,1200.0,84
HCPCS,17999,"RADIOFREQUENCY MICRONEEDLING, MEDIUM (COMP CODE 15781)",900.0,585.0,0.01,900.0,84
HCPCS,17999,"RADIOFREQUENCY MICRONEEDLING, SMALL (COMP CODE 15781)",800.0,520.0,0.01,800.0,84
HCPCS,17999,"RADIOFREQUENCY MICRONEEDLING, XLARGE (COMP CODE 15781)",1600.0,1040.0,0.01,1600.0,84
HCPCS,17999,RESIDENT CLINIC FILLER,200.0,130.0,0.01,584.65,84
HCPCS,17999,STERNOHYOID/OMOHYOID ROTNAL MSCLE FLAP RPR ESOPHAGL INJRY (COMP,9200.0,5980.0,0.01,9200.0,84
HCPCS,17999,SUBDERMAL RADIOFREQUENCY ABDOMEN (5X8 AREA) OR UPPER BACK (COMP,1875.0,1218.75,0.01,1875.0,84
HCPCS,17999,"SUBDERMAL RADIOFREQUENCY, KNEES, BOTH (COMP 15780)",1250.0,812.5,0.01,1250.0,84
HCPCS,17999,"SUBDERMAL RADIOFREQUENCY, LOWER FACE & NECK SCULPTING (COMP 1578",4375.0,2843.75,0.01,4375.0,84
HCPCS,17999,"SUBDERMAL RADIOFREQUENCY, POSTERIOR ARMS, BOTH (COMP 15782)",3125.0,2031.25,0.01,3125.0,84
HCPCS,17999,"TATTOO REMOVAL, LASER (COMP 17110)",336.0,218.39999999999998,0.01,3443.0,169
HCPCS,17999,UMBILICOPLASTY (COMPARABLE CODE 49591),2533.0,1646.45,0.01,2533.0,84
HCPCS,17999,"UNLIST PROC, SKIN, MUCOUS MEMBRANE & SUBCUT TISSUE COMP TO 15777",1205.0,783.25,0.01,1205.0,84
HCPCS,17999,UNLISTED PROC SKIN MM & SQ TISS,25.0,16.25,6.95,3443.0,84
HCPCS,17999,VANQUISH,500.0,325.0,0.01,584.65,84
HCPCS,17999,VOLLURE,700.0,455.0,0.01,700.0,84
HCPCS,17999,WOUND ELECTROCAUTERIZATION/CONTROL OF BLEEDING (COMP 20103),1923.0,1249.95,0.01,1923.0,84
HCPCS,17999,WOUND EXPLORATION,881.0,572.65,0.01,881.0,84
HCPCS,19000,PUNCTURE ASPIRATION CYST BREAST,1223.5,795.2750000000001,0.01,4628.0,407
HCPCS,19001,PUNCTURE ASPIRATION BREAST EACH ADDITIONAL CYST,212.5,138.125,0.01,4628.0,284
HCPCS,19020,MASTOTOMY W/EXPLORATION/DRAINAGE ABSCESS DEEP,3196.5,2077.725,0.01,5265.0,322
HCPCS,19030,INJECTION MAMMARY DUCTOGRAM/GALACTOGRAM,549.0,356.85,0.01,4628.0,284
HCPCS,19081,BX BREAST W/DEVICE 1ST LESION STEREOTACTIC GUID,6314.0,4104.1,1.1,11180.0,235
HCPCS,19081,MAM STEREO BREAST BX FIRST LES,11180.0,7267.0,0.01,11180.0,87
HCPCS,19082,BX BREAST W/DEVICE ADDL LESION STEREOTACT GUID,1638.0,1064.7,1.1,5265.0,217
HCPCS,19083,BX BREAST W/DEVICE 1ST LESION ULTRASOUND GUID,6272.0,4076.8,0.01,11180.0,321
HCPCS,19084,BX BREAST W/DEVICE ADDL LESION ULTRASOUND GUID,1655.5,1076.075,0.01,5265.0,286
HCPCS,19085,BX BREAST W/DEVICE 1ST LESION MAGNETIC RES GUID,6391.0,4154.15,1.1,11180.0,235
HCPCS,19086,BX BREAST W/DEVICE ADDL LESION MAGNET RES GUID,1652.0,1073.8,1.1,5265.0,217
HCPCS,19100,BX BREAST NEEDLE CORE W/O IMAGING GUIDANCE SPX,2684.5,1744.925,0.01,4861.0,235
HCPCS,19101,BIOPSY BREAST OPEN INCISIONAL,6390.0,4153.5,0.01,11488.0,235
HCPCS,19105,ABLTJ CRYOSURGICAL W/US GID EA FIBROADENOMA,1476.0,959.4,1.1,11117.55,146
HCPCS,19105,CRYOSURG ABLATE FA EACH,,,3306.89,9951.1,21
HCPCS,19105,Cryosurg ablate fa each,,,1031.8,1194.71,8
HCPCS,19110,NIPPLE EXPLORATION,1776.0,1154.4,1.1,11117.55,169
HCPCS,19110,Nipple exploration,,,1031.8,1194.71,8
HCPCS,19112,EXCISE BREAST DUCT FISTULA,,,3306.89,4074.73,20
HCPCS,19112,EXCISION LACTIFEROUS DUCT FISTULA,1524.0,990.6,1.1,11117.55,148
HCPCS,19112,Excise breast duct fistula,,,1031.8,1194.71,8
HCPCS,19120,EXC CYST/ABERRANT BREAST TISSUE OPEN 1/> LESION,6928.0,4503.2,0.01,11488.0,322
HCPCS,19125,EXC BREAST LES PREOP PLMT RAD MARKER OPEN 1 LES,2944.0,1913.6,1.1,11117.55,148
HCPCS,19125,EXCISION BREAST LESION,,,3306.89,7813.0,24
HCPCS,19125,Excision breast lesion,,,1031.8,1194.71,8
HCPCS,19126,EXC BRST LES PREOP PLMT RAD MARKER OPN EA ADDL,1172.0,761.8,1.1,1172.0,144
HCPCS,19126,Excision addl breast lesion,,,1031.8,1194.71,8
HCPCS,19281,PERQ DEVICE PLACEMENT BREAST LOC 1ST LES W/GDNCE,2830.5,1839.825,0.01,6112.0,322
HCPCS,19282,PERQ DEVICE PLACEMT BREAST LOC EA LESION W/GDNCE,2650.5,1722.825,0.01,4861.0,286
HCPCS,19283,PERQ BREAST LOC DEVICE PLACEMT 1ST STRTCTC GDNCE,1495.5,972.075,0.01,4628.0,322
HCPCS,19284,PERQ BREAST LOC DEVICE PLACEMT EA LESION STRTCTC,1275.5,829.075,0.01,4628.0,286
HCPCS,19285,PERQ BREAST LOC DEVICE PLACEMT 1ST LESIO US IMAG,1429.5,929.1750000000001,0.01,4628.0,322
HCPCS,19286,PERQ BREAST LOC DEVICE PLACEMT EACH LES US IMAGE,1242.5,807.625,0.01,4628.0,286
HCPCS,19287,PERQ BREAST LOC DEVICE PLACEMT 1ST LESIO MR GUID,1565.5,1017.575,1.1,7431.0,235
HCPCS,19288,PERQ BREAST LOC DEVICE PLACEMT ADD LESIO MR GUID,1311.5,852.475,1.1,4628.0,217
HCPCS,19294,PREP TUMOR CAVITY IORT W/PARTIAL MASTECTOMY,1200.0,780.0,1.1,1200.0,144
HCPCS,19294,Prepj tum cav iort prtl mast,,,4882.9,5653.88,8
HCPCS,19296,PLACE PO BREAST CATH FOR RAD,,,7732.66,9580.56,20
HCPCS,19296,PLMT EXPANDABLE CATH BRST FOLLOWING PRTL MAST,1452.0,943.8,1.1,27493.9,148
HCPCS,19296,Place po breast cath for rad,,,3079.1,3565.28,8
HCPCS,19297,PLMT EXPANDABLE CATH BRST CONCURRENT PRTL MAST,688.0,447.2,1.1,688.0,144
HCPCS,19297,Place breast cath for rad,,,4882.9,5653.88,8
HCPCS,19298,PLACE BREAST RAD TUBE/CATHS,,,5657.4,14341.63,20
HCPCS,19298,PLMT RADTHX BRACHYTX BRST FOLLOWING PRTL MAST,2300.0,1495.0,1.1,19017.99,148
HCPCS,19298,Place breast rad tube/caths,,,3079.1,3565.28,8
HCPCS,19300,GYNECOMASTIA - COMPLEX,1750.0,1137.5,1.1,11117.55,148
HCPCS,19300,GYNECOMASTIA - MODERATE,1525.0,991.25,1.1,11117.55,148
HCPCS,19300,GYNECOMASTIA - SIMPLE,1316.0,855.4,1.1,11117.55,148
HCPCS,19300,MASTECTOMY FOR GYNECOMASTIA,2124.0,1380.6,1.1,11117.55,169
HCPCS,19300,Mastectomy for gynecomastia,,,1031.8,1194.71,8
HCPCS,19301,"MASTECTOMY, PARTIAL",4052.0,2633.8,1.1,11117.55,144
HCPCS,19301,PARTIAL MASTECTOMY,,,3306.89,7813.0,24
HCPCS,19301,Partial mastectomy,,,3079.1,3565.28,8
HCPCS,19302,"MASTECTOMY,PARTIAL,  WITH AXILLARY LYMPHADENECTOMY",5596.0,3637.4,1.1,19017.99,144
HCPCS,19302,P-MASTECTOMY W/LN REMOVAL,,,5657.4,6910.32,20
HCPCS,19302,P-mastectomy w/ln removal,,,3079.1,3565.28,8
HCPCS,19303,MAST SIMPLE COMPLETE,,,5657.4,13132.0,24
HCPCS,19303,"MASTECTOMY, SIMPLE, COMPLETE",6000.0,3900.0,1.1,19017.99,144
HCPCS,19303,Mast simple complete,,,3079.1,3565.28,8
HCPCS,19305,MAST RAD W/PECTORAL MUSCLES AXILLARY LYMPH NODES,6984.0,4539.6,1.1,6984.0,144
HCPCS,19305,MAST RADICAL,,,3018.03,3018.03,1
HCPCS,19305,Mast radical,,,4882.9,5653.88,8
HCPCS,19306,MAST RAD URBAN TYPE,,,3203.58,3203.58,1
HCPCS,19306,MAST RAD W/PECTORAL MUSC AX INT MAM LYMPH NODES,7252.0,4713.8,1.1,7252.0,144
HCPCS,19306,Mast rad urban type,,,4882.9,5653.88,8
HCPCS,19307,MAST MOD RAD,,,5657.4,17024.28,21
HCPCS,19307,MAST MODF RAD W/AX LYMPH NOD W/WO PECT/ALIS MIN,7196.0,4677.4,1.1,19017.99,144
HCPCS,19307,Mast mod rad,,,4882.9,5653.88,8
HCPCS,19316,MASTOPEXY,4880.0,3172.0,1.1,19017.99,167
HCPCS,19316,MASTOPEXY - COMPLEX,1700.0,1105.0,1.1,19017.99,144
HCPCS,19316,MASTOPEXY - MODERATE,1575.0,1023.75,1.1,19017.99,144
HCPCS,19316,MASTOPEXY - SIMPLE,1476.0,959.4,1.1,19017.99,144
HCPCS,19316,Mastopexy,,,3079.1,3565.28,8
HCPCS,19318,BREAST REDUCTION,,,5657.4,13132.0,25
HCPCS,19318,BREAST REDUCTION FEMALE - MODERATE,1820.0,1183.0,1.1,19017.99,144
HCPCS,19318,Breast reduction,,,4882.9,5653.88,8
HCPCS,19318,REDUCTION OF LARGE BREAST,7053.0,4584.45,1.1,19017.99,144
HCPCS,19324,Enlarge breast,,,1031.8,1194.71,8
HCPCS,19325,BREAST AUG (GEL) - MODERATE,2500.0,1625.0,1.1,27493.9,144
HCPCS,19325,BREAST AUG (SALINE) - COMPLEX,2250.0,1462.5,1.1,27493.9,144
HCPCS,19325,BREAST AUG (SALINE) - MODERATE,2075.0,1348.75,1.1,27493.9,144
HCPCS,19325,BREAST AUG (SALINE) - SIMPLE,1885.0,1225.25,1.1,27493.9,144
HCPCS,19325,BREAST AUG (SILICONE) - COMPLEX,2550.0,1657.5,1.1,27493.9,144
HCPCS,19325,BREAST AUG (SILICONE) - MODERATE,2355.0,1530.75,1.1,27493.9,144
HCPCS,19325,BREAST AUG (SILICONE) - SIMPLE,2155.0,1400.75,1.1,27493.9,144
HCPCS,19325,BREAST AUG (SILICONE) W/ MEDICAL PRO,3768.0,2449.2,1.1,27493.9,144
HCPCS,19325,BREAST AUGMENTATION W/IMPLT,,,4616.0,33436.0,23
HCPCS,19325,BREAST AUGMENTATION WITH IMPLANT,3573.0,2322.45,1.1,27493.9,144
HCPCS,19325,Breast augmentation w/implt,,,3079.1,3565.28,8
HCPCS,19328,BREAST IMPLANT REMOVAL - COMPLEX,2900.0,1885.0,1.1,11117.55,144
HCPCS,19328,BREAST IMPLANT REMOVAL - MODERATE,2500.0,1625.0,1.1,11117.55,144
HCPCS,19328,BREAST IMPLANT REMOVAL - SIMPLE,2100.0,1365.0,1.1,11117.55,144
HCPCS,19328,REMOVAL OF BREAST IMPLANT,7232.0,4700.8,0.01,11488.0,231
HCPCS,19330,RMVL RUPTURED BREAST IMPLANT,,,3306.89,7778.0,23
HCPCS,19330,RMVL RUPTURED BREAST IMPLANT W/IMPLANT CONTENTS,3600.0,2340.0,1.1,11117.55,144
HCPCS,19330,Rmvl ruptured breast implant,,,3079.1,3565.28,8
HCPCS,19340,INSERTION BREAST IMPLANT SAME DAY OF MASTECTOMY,4192.0,2724.8,1.1,19017.99,144
HCPCS,19340,INSJ BREAST IMPLT SM D MAST,,,3528.0,8505.92,22
HCPCS,19340,Insj breast implt sm d mast,,,3079.1,3565.28,8
HCPCS,19342,INSJ/RPLCMT BREAST IMPLANT SEP DAY MASTECTOMY,4611.0,2997.15,1.1,27493.9,144
HCPCS,19342,INSJ/RPLCMT BRST IMPLT SEP D,,,4616.0,9580.56,24
HCPCS,19342,Insj/rplcmt brst implt sep d,,,3079.1,3565.28,8
HCPCS,19350,NIPPLE/AREOLA RECONSTRUCTION,4008.0,2605.2,1.1,11117.55,170
HCPCS,19350,Nipple/areola reconstruction,,,3079.1,3565.28,8
HCPCS,19355,CORRECT INVERTED NIPPLE(S),3408.0,2215.2,1.1,11117.55,146
HCPCS,19355,CORRECTION INVERTED NIPPLES,11488.0,7467.2,0.01,11488.0,87
HCPCS,19355,INVERTED NIPPPLE CORRECTION,1600.0,1040.0,1.1,11117.55,146
HCPCS,19357,BREAST RECONSTRUC W TISS EXPANDR,6530.0,4244.5,1.1,51394.19,144
HCPCS,19357,TISS XPNDR PLMT BRST RCNSTJ,,,4616.0,17419.28,24
HCPCS,19357,Tiss xpndr plmt brst rcnstj,,,4882.9,5653.88,8
HCPCS,19361,BREAST RECONSTRUC W LAT DORSI FLAP,9344.0,6073.6,1.1,9344.0,144
HCPCS,19361,Brst rcnstj latsms drsi flap,,,4882.9,5653.88,8
HCPCS,19364,BREAST RECONSTRUC W FREE FLAP,18735.0,12177.75,1.1,18735.0,144
HCPCS,19364,Brst rcnstj free flap,,,4882.9,5653.88,8
HCPCS,19366,Breast reconstruction,,,4882.9,5653.88,8
HCPCS,19367,BREAST RECONSTRUCTION SINGLE PEDICLED TRAM FLAP,10720.0,6968.0,1.1,10720.0,144
HCPCS,19367,Brst rcnstj 1 pdcl tram flap,,,4882.9,5653.88,8
HCPCS,19368,BREAST RECONSTRUCTION 1PEDICLED TRAM FLAP ANAST,13560.0,8814.0,1.1,13560.0,144
HCPCS,19368,Brst rcnstj 1pdcl tram anast,,,4882.9,5653.88,8
HCPCS,19369,BREAST RECONSTRUCTION BIPEDICLED TRAM FLAP,12524.0,8140.6,1.1,12524.0,144
HCPCS,19369,Brst rcnstj 2 pdcl tram flap,,,4882.9,5653.88,8
HCPCS,19370,REVISION PERI-IMPLANT CAPSULE BREAST,4035.0,2622.75,1.1,11117.55,144
HCPCS,19370,REVJ PERI-IMPLT CAPSULE BRST,,,3306.89,10789.0,23
HCPCS,19370,Revj peri-implt capsule brst,,,3079.1,3565.28,8
HCPCS,19371,PERI-IMPLANT CAPSULECTOMY BREAST COMPLETE,4391.0,2854.15,1.1,11117.55,144
HCPCS,19371,PERI-IMPLT CAPSLC BRST COMPL,,,3306.89,7948.0,22
HCPCS,19371,Peri-implt capslc brst compl,,,3079.1,3565.28,8
HCPCS,19380,REVISE BREAST RECONSTRUCTION,4915.0,3194.75,1.1,19017.99,144
HCPCS,19380,REVJ RECONSTRUCTED BREAST,,,5657.4,13821.0,24
HCPCS,19380,Revj reconstructed breast,,,3079.1,3565.28,8
HCPCS,19396,DESIGN CUSTOM BREAST IMPLANT,,,3306.89,9951.1,21
HCPCS,19396,Design custom breast implant,,,1031.8,1194.71,8
HCPCS,19499,ENDOSCOPIC MASTECTOMY (COMP CODE 19303),6000.0,3900.0,0.01,11117.55,84
HCPCS,19499,PROC BREAST UNLISTD,3400.0,2210.0,945.2,6987.0,84
HCPCS,19499,REMOVAL BREAST BALLOON CATH,130.0,84.5,0.01,6391.95,85
HCPCS,19499,TAKEDOWN OF TRAM FLAP,5231.0,3400.15,0.01,11117.55,84
HCPCS,2000F,BLOOD PRESSURE MEASURE,,,0.03,0.03,1
HCPCS,2000F,Blood pressure measure,,,10.69,12.38,8
HCPCS,2001F,WEIGHT RECORD,,,0.03,0.03,1
HCPCS,2001F,Weight record,,,10.69,12.38,8
HCPCS,2002F,CLIN SIGN VOL OVRLD ASSESS,,,0.03,0.03,1
HCPCS,2002F,Clin sign vol ovrld assess,,,10.69,12.38,8
HCPCS,2004F,INITIAL EXAM INVOLVED JOINTS,,,0.03,0.03,1
HCPCS,2004F,Initial exam involved joints,,,10.69,12.38,8
HCPCS,20100,EXPL PENTRG WOUND NECK,,,472.1,1436.39,21
HCPCS,20100,EXPLORATION PENETRATING WOUND SPX NECK,4152.0,2698.8,1.1,4152.0,144
HCPCS,20100,Expl pentrg wound neck,,,559.63,647.99,8
HCPCS,20101,EXPLORATION PENETRATING WOUND SPX CHEST,4853.0,3154.4500000000003,1.1,8414.0,234
HCPCS,20102,EXPL PENETRATING WOUND SPX ABDOMEN/FLANK/BACK,1592.0,1034.8,1.1,5320.02,148
HCPCS,20102,EXPL PENTRG WND ABD/FLNK/BK,,,1582.09,4760.83,22
HCPCS,20102,Expl pentrg wnd abd/flnk/bk,,,559.63,647.99,8
HCPCS,20103,EXPLORATION PENETRATING WOUND SPX EXTREMITY,4794.5,3116.425,1.1,7453.0,234
HCPCS,2010F,VITAL SIGNS RECORDED,,,0.03,0.03,1
HCPCS,2010F,Vital signs recorded,,,10.69,12.38,8
HCPCS,2014F,MENTAL STATUS ASSESS,,,0.03,0.03,1
HCPCS,2014F,Mental status assess,,,10.69,12.38,8
HCPCS,20150,EXCISION EPIPHYSEAL BAR,,,2808.13,8450.24,21
HCPCS,20150,EXCISION OF EPIPHYSEAL BAR,5900.0,3835.0,1.1,9440.12,144
HCPCS,20150,Excision epiphyseal bar,,,1351.24,1564.6,8
HCPCS,2015F,ASTHMA IMPAIRMENT ASSESSED,,,2739849.3,2739849.3,1
HCPCS,2015F,Asthma impairment assessed,,,10.69,12.38,8
HCPCS,2016F,ASTHMA RISK ASSESSED,,,2739849.3,2739849.3,1
HCPCS,2016F,Asthma risk assessed,,,10.69,12.38,8
HCPCS,2018F,HYDRATION STATUS ASSESS,,,2739849.3,2739849.3,1
HCPCS,2018F,Hydration status assess,,,10.69,12.38,8
HCPCS,2019F,DILATED MACUL EXAM DONE,,,0.03,0.03,1
HCPCS,2019F,Dilated macul exam done,,,10.69,12.38,8
HCPCS,20200,BIOPSY MUSCLE SUPERFICIAL,584.0,379.6,1.1,4729.25,148
HCPCS,20200,MUSCLE BIOPSY SUPERFICIAL,,,1406.56,1718.79,20
HCPCS,20200,Muscle biopsy superficial,,,1351.24,1564.6,8
HCPCS,20205,BIOPSY MUSCLE DEEP,13165.0,8557.25,0.01,13165.0,87
HCPCS,20205,DEEP MUSCLE BIOPSY,940.0,611.0,1.1,8286.13,148
HCPCS,20206,BIOPSY MUSCLE PERCUTANEOUS NEEDLE,3924.5,2550.9249999999997,0.01,7453.0,409
HCPCS,2020F,DILATED FUNDUS EVAL DONE,,,2739849.3,2739849.3,1
HCPCS,2020F,Dilated fundus eval done,,,10.69,12.38,8
HCPCS,2021F,DILAT MACULAR EXAM DONE,,,0.03,0.03,1
HCPCS,2021F,Dilat macular exam done,,,10.69,12.38,8
HCPCS,20220,BIOPSY BONE TROCAR/NEEDLE SUPERFICIAL,7453.0,4844.45,0.01,7453.0,174
HCPCS,20220,"BONE BIOPSY,TROCAR/NEEDLE SUPERF",660.0,429.0,1.1,4729.25,148
HCPCS,20225,BIOPSY BONE TROCAR/NEEDLE DEEP,7453.0,4844.45,0.01,7453.0,174
HCPCS,20225,"BONE BIOPSY,TROCAR/NEEDLE DEEP",980.0,637.0,1.1,4729.25,148
HCPCS,2022F,DILAT RTA XM EVC RTNOPTHY,,,0.03,0.03,1
HCPCS,2022F,Dilat rta xm evc rtnopthy,,,10.69,12.38,8
HCPCS,2023F,DILAT RTA XM W/O RTNOPTHY,,,0.03,0.03,1
HCPCS,2023F,Dilat rta xm w/o rtnopthy,,,10.69,12.38,8
HCPCS,20240,BIOPSY BONE OPEN SUPERFICIAL,7156.5,4651.725,0.01,13165.0,231
HCPCS,20245,BIOPSY BONE OPEN DEEP,7902.5,5136.625,0.01,13165.0,231
HCPCS,2024F,7 FLD RTA PHOTO EVC RTNOPTHY,,,0.03,0.03,1
HCPCS,2024F,7 fld rta photo evc rtnopthy,,,10.69,12.38,8
HCPCS,20250,BIOPSY VERTEBRAL BODY OPEN THORACIC,2076.0,1349.4,1.1,9440.12,144
HCPCS,20250,BIOPSY VRT BDY OPEN THORACIC,,,2808.13,3405.12,20
HCPCS,20250,Biopsy vrt bdy open thoracic,,,3812.17,4414.09,8
HCPCS,20251,BIOPSY VERTEBRAL BODY OPEN LUMBAR/CERVICAL,2288.0,1487.2,1.1,20863.78,144
HCPCS,20251,BIOPSY VRT BDY OPEN LMBR/CRV,,,6206.54,7551.43,20
HCPCS,20251,Biopsy vrt bdy open lmbr/crv,,,3812.17,4414.09,8
HCPCS,2025F,7 FLD RTA PHOTO W/O RTNOPTHY,,,2739849.3,2739849.3,1
HCPCS,2025F,7 fld rta photo w/o rtnopthy,,,10.69,12.38,8
HCPCS,2026F,EYE IMG VALID EVC RTNOPTHY,,,0.03,0.03,1
HCPCS,2026F,Eye img valid evc rtnopthy,,,10.69,12.38,8
HCPCS,2027F,OPTIC NERVE HEAD EVAL DONE,,,0.03,0.03,1
HCPCS,2027F,Optic nerve head eval done,,,10.69,12.38,8
HCPCS,2028F,FOOT EXAM PERFORMED,,,0.03,0.03,1
HCPCS,2028F,Foot exam performed,,,10.69,12.38,8
HCPCS,2029F,COMPLETE PHYS SKIN EXAM DONE,,,214.54,214.54,1
HCPCS,2029F,Complete phys skin exam done,,,10.69,12.38,8
HCPCS,2030F,H2O STAT DOCD NORMAL,,,2739849.3,2739849.3,1
HCPCS,2030F,H2o stat docd normal,,,10.69,12.38,8
HCPCS,2031F,H2O STAT DOCD DEHYDRATED,,,2739849.3,2739849.3,1
HCPCS,2031F,H2o stat docd dehydrated,,,10.69,12.38,8
HCPCS,2033F,EYE IMG VALID W/O RTNOPTHY,,,2739849.3,2739849.3,1
HCPCS,2033F,Eye img valid w/o rtnopthy,,,10.69,12.38,8
HCPCS,2035F,TYMP MEMB MOTION EXAMD,,,2739849.3,2739849.3,1
HCPCS,2035F,Tymp memb motion examd,,,10.69,12.38,8
HCPCS,2040F,BK PN XM ON INIT VISIT DATE,,,2739849.3,2739849.3,1
HCPCS,2040F,Bk pn xm on init visit date,,,10.69,12.38,8
HCPCS,2044F,DOC MNTL TST B/4 BK TRXMNT,,,2739849.3,2739849.3,1
HCPCS,2044F,Doc mntl tst b/4 bk trxmnt,,,10.69,12.38,8
HCPCS,20500,INJECTION SINUS TRACT THERAPEUTIC SEPARATE PROC,3663.0,2380.9500000000003,1.1,12500.0,234
HCPCS,20501,INJECTION SINUS TRACT DIAGNOSTIC,691.0,449.15000000000003,0.01,4628.0,352
HCPCS,2050F,WOUND CHAR SIZE ETC DOCD,,,2739849.3,2739849.3,1
HCPCS,2050F,Wound char size etc docd,,,10.69,12.38,8
HCPCS,20520,REMOVAL FOREIGN BODY MUSCLE/TENDON SHEATH SIMPLE,4106.5,2669.225,0.01,7453.0,322
HCPCS,20525,RMVL FOREIGN BODY MUSCLE/TENDON SHEATH DEEP/COMP,7290.5,4738.825,0.01,13165.0,235
HCPCS,20526,INJECTION THERAPEUTIC CARPAL TUNNEL,886.0,575.9000000000001,0.01,4628.0,321
HCPCS,20527,INJECTION ENZYME PALMAR FASCIAL CORD,879.0,571.35,0.01,12500.0,235
HCPCS,20550,INJECTION 1 TENDON SHEATH/LIGAMENT APONEUROSIS,844.0,548.6,0.01,4628.0,407
HCPCS,20551,INJECTION SINGLE TENDON ORIGIN/INSERTION,844.0,548.6,0.01,4628.0,407
HCPCS,20552,INJECTION SINGLE/MLT TRIGGER POINT 1/2 MUSCLES,1358.0,882.7,0.01,4628.0,259
HCPCS,20552,TRIGGER POINT INJECTION MULTI 1-2 MUSCLE GR,290.0,188.5,1.1,863.2,148
HCPCS,20553,INJECTION SINGLE/MLT TRIGGER POINT 3/> MUSCLES,1358.0,882.7,0.01,4628.0,259
HCPCS,20553,TRIGGER POINT INJECTION MULTI 3+ MUSCLE GRP,330.0,214.5,1.1,863.2,148
HCPCS,20555,PLACE NDL MUSC/TIS FOR RT,,,2808.13,3405.12,20
HCPCS,20555,Place ndl musc/tis for rt,,,1351.24,1564.6,8
HCPCS,20560,NEEDLE INSERTION W/O INJECTION 1 OR 2 MUSCLES,127.0,82.55000000000001,0.01,12500.0,493
HCPCS,20561,NEEDLE INSERTION W/O INJECTION 3 OR MORE MUSCLES,162.0,105.30000000000001,0.01,12500.0,666
HCPCS,20600,ARTHROCENTESIS ASPIR&/INJ SMALL JT/BURSA W/O US,824.0,535.6,0.01,4628.0,407
HCPCS,20604,ARTHROCNT ASPIR&/INJ SMALL JT/BURSAW/US REC RPRT,875.0,568.75,0.01,12500.0,409
HCPCS,20605,ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/O US,828.5,538.525,0.01,4628.0,407
HCPCS,20606,ARTHROCENTESIS ASPIR&/INJ INTERM JT/BURS W/US,1813.0,1178.45,0.01,12500.0,496
HCPCS,2060F,PT INTRVWD ON/BEFORE DX MDD,,,2739849.3,2739849.3,1
HCPCS,2060F,Pt intrvwd on/before dx mdd,,,10.69,12.38,8
HCPCS,20610,ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/O US,853.0,554.45,0.01,4628.0,494
HCPCS,20611,ARTHROCENTESIS ASPIR&/INJ MAJOR JT/BURSA W/US,921.0,598.6500000000001,0.01,12500.0,409
HCPCS,20612,ASPIRATION&/INJECTION GANGLION CYST ANY LOCATJ,833.0,541.45,0.01,4628.0,407
HCPCS,20615,ASPIRATION & INJECTION TREATMENT BONE CYST,2084.5,1354.9250000000002,0.01,12500.0,321
HCPCS,20650,INSERTION WIRE/PIN W/APPL SKELETAL TRACTION SPX,7918.5,5147.025,1.1,14925.0,235
HCPCS,20660,APPL CRANIAL TONG/STRTCTC FRAME W/REMOVAL SPX,7362.0,4785.3,280.86,7362.0,86
HCPCS,20661,APPLICATION HALO CRANIAL,,,1375.01,1673.41,13
HCPCS,20661,APPLICATION HALO CRANIAL INCLUDING REMOVAL,2104.0,1367.6,1.1,2104.0,144
HCPCS,20661,Application halo cranial,,,1652.13,1912.99,8
HCPCS,20662,APPLICATION HALO PELVIC,,,1394.34,4195.84,21
HCPCS,20662,Application halo pelvic,,,1652.13,1912.99,8
HCPCS,20663,APPLICATION HALO FEMORAL,,,2808.13,8450.24,21
HCPCS,20663,Application halo femoral,,,1652.13,1912.99,8
HCPCS,20664,APPL HALO 6/> PINS THIN SKULL OSTEOLOGY,4024.0,2615.6,1.1,4024.0,144
HCPCS,20664,APPL HALO CRANIAL 6+PINS,,,1521.28,2351.71,13
HCPCS,20664,Appl halo cranial 6+pins,,,1652.13,1912.99,8
HCPCS,20665,REMOVAL TONG/HALO APPLIED BY ANOTHER INDIVIDUAL,544.0,353.6,1.1,1163.18,148
HCPCS,20665,RMVL TONGS/HALO ANTHR INDIV,,,345.67,1040.19,21
HCPCS,20665,Rmvl tongs/halo anthr indiv,,,251.58,291.3,8
HCPCS,20670,REMOVAL IMPLANT SUPERFICIAL SEPARATE PROCEDURE,4120.5,2678.325,0.01,7453.0,322
HCPCS,20680,REMOVAL DEEP IMPLANT,2622.0,1704.3,1.1,8286.13,148
HCPCS,20680,REMOVAL IMPLANT DEEP,13165.0,8557.25,0.01,13165.0,87
HCPCS,20690,APPL UNIPLN UNI EXT FIXJ SYS,,,6206.54,7551.43,20
HCPCS,20690,APPLICATION UNIPLANE EXTERNAL FIXATION SYSTEM,3512.0,2282.8,1.1,20863.78,144
HCPCS,20690,Appl unipln uni ext fixj sys,,,1652.13,1912.99,8
HCPCS,20692,APPL MLTPLN UNI EXT FIXJ SYS,,,11418.01,13361.02,20
HCPCS,20692,APPLICATION MULTIPLANE EXTERNAL FIXATION SYSTEM,6508.0,4230.2,1.1,38384.94,144
HCPCS,20692,Appl mltpln uni ext fixj sys,,,1652.13,1912.99,8
HCPCS,20693,ADJMT/REVJ EXT FIXJ SYS ANES,,,6206.54,7551.43,20
HCPCS,20693,ADJUSTMENT/REVJ XTRNL FIXATION SYSTEM REQ ANES,2424.0,1575.6,1.1,20863.78,144
HCPCS,20693,Adjmt/revj ext fixj sys anes,,,1652.13,1912.99,8
HCPCS,20694,REMOVAL EXTERNAL FIXATION SYSTEM UNDER ANES,1712.0,1112.8,1.1,4686.39,148
HCPCS,20694,RMVL EXT FIXJ SYS UNDER ANES,,,1394.34,1673.41,20
HCPCS,20694,Rmvl ext fixj sys under anes,,,1652.13,1912.99,8
HCPCS,20696,APP MLTPLN UNI XTRNL FIX 1ST,,,16167.8,48652.21,21
HCPCS,20696,App mltpln uni xtrnl fix 1st,,,1652.13,1912.99,8
HCPCS,20696,XTRNL FIXJ W/STEREOTACTIC ADJUSTMENT 1ST & SUBQ,7024.0,4565.6,1.1,54351.12,142
HCPCS,20697,XTRNL FIXJ W/STRTCTC ADJUSTMENT EXCHANGE STRUT,7915.0,5144.75,0.01,11545.0,231
HCPCS,20700,MANUAL PREP AND INSERTION DEEP DRUG DELIVERY DEV,429.5,279.175,0.01,4628.0,280
HCPCS,20701,REMOVAL DEEP DRUG DELIVERY DEVICE,564.5,366.925,0.01,4628.0,280
HCPCS,20702,MANUAL PREP&AMP;INSJ INTRAMEDULLARY DRUG DLVR DEVICE,1000.0,650.0,1.1,1000.0,144
HCPCS,20702,MANUAL PREP&INSJ INTRAMEDULLARY DRUG DLVR DEVICE,259.0,168.35,0.01,4628.0,136
HCPCS,20703,REMOVAL INTRAMEDULLARY DRUG DELIVERY DEVICE,676.0,439.4,0.01,4628.0,280
HCPCS,20704,MANUAL PREP&AMP;INSJ I-ARTIC DRUG DELIVERY DEVICE,1040.0,676.0,1.1,1040.0,144
HCPCS,20704,MANUAL PREP&INSJ I-ARTIC DRUG DELIVERY DEVICE,259.0,168.35,0.01,4628.0,136
HCPCS,20705,REMOVAL INTRA-ARTICULAR DRUG DELIVERY DEVICE,746.0,484.9,0.01,4628.0,280
HCPCS,20802,REPLANTATION ARM COMPLETE,,,7155.4,18247.18,13
HCPCS,20802,Replantation arm complete,,,6600.42,7642.59,8
HCPCS,20805,REPLANT FOREARM COMPLETE,,,8502.27,18247.18,13
HCPCS,20805,Replant forearm complete,,,4162.67,4819.94,8
HCPCS,20808,REPLANTATION HAND COMPLETE,,,10262.15,18247.18,13
HCPCS,20808,Replantation hand complete,,,1912.9,2214.94,8
HCPCS,20816,REPLANTATION DIGIT COMPLETE,,,1521.28,5357.39,13
HCPCS,20816,Replantation digit complete,,,1912.9,2214.94,8
HCPCS,20822,REPLANTATION DIGIT COMPLETE,,,1394.34,4195.84,21
HCPCS,20822,Replantation digit complete,,,1912.9,2214.94,8
HCPCS,20824,REPLANTATION THUMB COMPLETE,,,1521.28,5367.19,13
HCPCS,20824,Replantation thumb complete,,,1912.9,2214.94,8
HCPCS,20827,REPLANTATION THUMB COMPLETE,,,1521.28,4748.37,13
HCPCS,20827,Replantation thumb complete,,,1912.9,2214.94,8
HCPCS,20838,REPLANTATION FOOT COMPLETE,,,7257.74,18247.18,13
HCPCS,20838,Replantation foot complete,,,4090.38,4736.23,8
HCPCS,20900,BONE GRAFT ANY DONOR AREA MINOR/SMALL,1200.0,780.0,1.1,20863.78,148
HCPCS,20900,REMOVAL OF BONE FOR GRAFT,,,6206.54,7813.0,21
HCPCS,20900,Removal of bone for graft,,,1469.08,1701.04,8
HCPCS,20902,BONE GRAFT ANY DONOR AREA MAJOR/LARGE,1832.0,1190.8,1.1,20863.78,144
HCPCS,20902,REMOVAL OF BONE FOR GRAFT,,,6206.54,7551.43,20
HCPCS,20902,Removal of bone for graft,,,1469.08,1701.04,8
HCPCS,20910,CARTILAGE GRAFT COSTOCHONDRAL,2212.0,1437.8,1.1,2212.0,144
HCPCS,20910,REMOVE CARTILAGE FOR GRAFT,,,544.87,769.14,20
HCPCS,20910,Remove cartilage for graft,,,1469.08,1701.04,8
HCPCS,20912,CARTILAGE GRAFT NASAL SEPTUM,2616.0,1700.4,1.1,10462.5,144
HCPCS,20912,REMOVE CARTILAGE FOR GRAFT,,,3112.46,7813.0,22
HCPCS,20912,Remove cartilage for graft,,,1469.08,1701.04,8
HCPCS,20920,FASCIA LATA GRAFT BY STRIPPER,2204.0,1432.6,1.1,5320.02,144
HCPCS,20920,REMOVAL OF FASCIA FOR GRAFT,,,1582.09,2147.22,20
HCPCS,20920,Removal of fascia for graft,,,1469.08,1701.04,8
HCPCS,20922,FASCIA LATA GRAFT INCISION & AREA EXPOSURE,2772.0,1801.8,1.1,5320.02,148
HCPCS,20922,REMOVAL OF FASCIA FOR GRAFT,,,1582.09,2147.22,20
HCPCS,20922,Removal of fascia for graft,,,1469.08,1701.04,8
HCPCS,20924,REMOVAL OF TENDON FOR GRAFT,,,6206.54,7551.43,20
HCPCS,20924,Removal of tendon for graft,,,1469.08,1701.04,8
HCPCS,20924,TENDON GRAFT FROM A DISTANCE,2672.0,1736.8,1.1,20863.78,144
HCPCS,20930,ALLOGRAFT FOR SPINE SURGERY ONLY MORSELIZED,767.0,498.55,1.1,767.0,88
HCPCS,20930,Sp bone algrft morsel add-on,,,9326.79,10799.44,8
HCPCS,20931,ALLOGRAFT FOR SPINE SURGERY ONLY STRUCTURAL,724.0,470.6,1.1,724.0,144
HCPCS,20931,SP BONE ALGRFT STRUCT ADD-ON,,,4132.0,4132.0,1
HCPCS,20931,Sp bone algrft struct add-on,,,9326.79,10799.44,8
HCPCS,20932,OSTEOARTIUCLAR ALLOGRAFT W/ARTICULAR SURF & BONE,5204.0,3382.6,1.1,5204.0,144
HCPCS,20932,Osteoart algrft w/surf & b1,,,1469.08,1701.04,8
HCPCS,20933,HEMICORTICAL INTERCALARY ALLOGRAFT PARTIAL,4776.0,3104.4,1.1,4776.0,144
HCPCS,20933,Hemicrt intrclry algrft prtl,,,1469.08,1701.04,8
HCPCS,20934,INTERCALARY ALLOGRAFT COMPLETE,5200.0,3380.0,1.1,5200.0,144
HCPCS,20934,Intercalary algrft compl,,,1469.08,1701.04,8
HCPCS,20936,AUTOGRAFT SPINE SURGERY LOCAL FROM SAME INCISION,1089.0,707.85,1.1,1089.0,88
HCPCS,20936,Sp bone agrft local add-on,,,9326.79,10799.44,8
HCPCS,20937,AUTOGRAFT SPINE SURGERY MORSELIZED SEP INCISION,1116.0,725.4,1.1,1116.0,144
HCPCS,20937,Sp bone agrft morsel add-on,,,9326.79,10799.44,8
HCPCS,20938,AUTOGRAFT SPINE SURGERY BICORT/TRICORT SEP INC,1208.0,785.2,1.1,1208.0,144
HCPCS,20938,Sp bone agrft struct add-on,,,9326.79,10799.44,8
HCPCS,20939,BONE MARROW ASPIR BONE GRFG,383.0,248.95,1.1,383.0,144
HCPCS,20939,BONE MARROW ASPIRATION BONE GRFG SPI SURG ONLY,652.0,423.8,1.1,10799.44,213
HCPCS,20950,MNTR INTERSTITIAL FLUID PRESSURE CMPRT SYNDROME,1870.5,1215.825,0.01,3443.0,321
HCPCS,20955,BONE GRAFT MICROVASCULAR ANASTOMOSIS FIBULA,17714.0,11514.1,1.1,17714.0,144
HCPCS,20955,FIBULA BONE GRAFT MICROVASC,,,6864.94,7551.43,12
HCPCS,20955,Fibula bone graft microvasc,,,5335.2,6177.6,8
HCPCS,20956,ILIAC BONE GRAFT MICROVASC,,,6864.94,7551.43,13
HCPCS,20956,Iliac bone graft microvasc,,,3067.73,3552.11,8
HCPCS,20957,MT BONE GRAFT MICROVASC,,,6864.94,7551.43,12
HCPCS,20957,Mt bone graft microvasc,,,4090.38,4736.23,8
HCPCS,20962,BONE GRF W/MVASC ANAST OTH/THN ILIAC CREST/METAR,15684.0,10194.6,1.1,15684.0,144
HCPCS,20962,OTHER BONE GRAFT MICROVASC,,,6864.94,7551.43,13
HCPCS,20962,Other bone graft microvasc,,,5335.2,6177.6,8
HCPCS,20969,BONE/SKIN GRAFT MICROVASC,,,6864.94,7551.43,13
HCPCS,20969,Bone/skin graft microvasc,,,5335.2,6177.6,8
HCPCS,20969,FREE OSTQ FLAP W/MVASC ANAST METAR/GREAT TOE,18172.0,11811.8,1.1,18172.0,144
HCPCS,20970,BONE/SKIN GRAFT ILIAC CREST,,,6864.94,7551.43,13
HCPCS,20970,Bone/skin graft iliac crest,,,3067.73,3552.11,8
HCPCS,20970,FREE OSTQ FLAP W/MVASC ANASTOMOSIS ILIAC CREST,17832.0,11590.8,1.1,17832.0,144
HCPCS,20972,BONE/SKIN GRAFT METATARSAL,,,6206.54,18676.74,21
HCPCS,20972,Bone/skin graft metatarsal,,,4090.38,4736.23,8
HCPCS,20973,BONE/SKIN GRAFT GREAT TOE,,,6206.54,18676.74,21
HCPCS,20973,Bone/skin graft great toe,,,4090.38,4736.23,8
HCPCS,20974,ELECTRICAL STIMULATION BONE HEALING NONINVASIVE,248.0,161.2,1.1,281.34,148
HCPCS,20974,ESTIM AID BONE HEALG N-INVAS,,,61.5,132.56,28
HCPCS,20974,Estim aid bone healg n-invas,,,251.58,291.3,8
HCPCS,20975,ELECTRICAL STIMULATION BONE HEALING INVASIVE,1040.0,676.0,1.1,1040.0,144
HCPCS,20975,Estim aid bone healg invasiv,,,1351.24,1564.6,8
HCPCS,20979,LOW INTENSITY US STIMJ BONE HEALING NONINVASIVE,248.0,161.2,1.1,248.0,146
HCPCS,20979,LW NTSTY US STIMJ BONE HEALG,,,22.7,77.73,21
HCPCS,20979,Lw ntsty us stimj bone healg,,,251.58,291.3,8
HCPCS,20982,ABLATION BONE TUMOR RF PERQ W/IMG GDN WHEN DONE,30997.5,20148.375,0.01,59187.0,321
HCPCS,20983,ABLATJ BONE TUMOR CRYO PERQ W/IMG GDN WHEN PRFMD,17806.5,11574.225,0.01,32861.0,321
HCPCS,20985,CPTR-ASST SURGICAL NAVIGATION IMAGE-LESS,1000.0,650.0,1.1,1000.0,144
HCPCS,20985,Cptr-asst dir ms px,,,86.82,100.53,8
HCPCS,20999,ABD EXP & REAPPROXIMATION OF EXTERNAL OBLIQUE APONEUROSIS,6028.0,3918.2,0.01,6028.0,84
HCPCS,20999,ABDOMINAL INSERTION MESH,2457.0,1597.05,0.01,2457.0,84
HCPCS,20999,BONE MARROW ASPIRATION AND INJECTION,1112.0,722.8,0.01,1112.0,84
HCPCS,20999,CARTILAGE FROM EAR TO EYELID,2439.0,1585.35,0.01,2439.0,84
HCPCS,20999,"CORE NEEDLE BIOPSY, FACE (COMP CODE 20206)",3515.5,2285.0750000000003,0.01,6674.0,169
HCPCS,20999,CRYOABLATION OF SOFT TISSUE  MASS (COMP CODE 20983),17806.5,11574.225,0.01,32861.0,168
HCPCS,20999,DRY NEEDLE TRIGGER POINT INJECTION,343.0,222.95,95.35,4628.0,84
HCPCS,20999,EAR CARTILAGE GRAFT,2439.0,1585.35,0.01,2439.0,84
HCPCS,20999,EXPLANTATION OF OSTEOCUTANEOUS FREE FLAP/ HEAD AND NECK (COMP 35,4321.0,2808.65,0.01,4321.0,84
HCPCS,20999,"EXTRACORPOREAL SHOCK WAVE, LOW INTENSITY",150.0,97.5,0.01,3443.0,169
HCPCS,20999,FLOGRAFT CLINICAL (1.0 ML) (750K CELLS),2700.0,1755.0,0.01,2700.0,84
HCPCS,20999,FLOGRAFT CLINICAL WITH PRP,3200.0,2080.0,0.01,3200.0,84
HCPCS,20999,FLOGRAFT NEOGENISIS (1.0 ML) (1.2 M CELLS),3200.0,2080.0,0.01,3200.0,84
HCPCS,20999,FLOGRAFT SURGICAL (1.0 ML) (2 M CELLS),3500.0,2275.0,0.01,3500.0,84
HCPCS,20999,FLOGRAFT SURGICAL WITH PRP,4200.0,2730.0,0.01,4200.0,84
HCPCS,20999,INJECTION MUSCULOSKELETAL SYSTEM,343.0,222.95,95.35,4628.0,84
HCPCS,20999,LAP COMPONENT SEPARATION,2353.0,1529.45,0.01,2353.0,84
HCPCS,20999,LIPOGEMS ? AUTOLOGOUS ADIPOSE TISSUE HARVESTING/INJECTION,3500.0,2275.0,0.01,3500.0,84
HCPCS,20999,"MARROW ASPIRATION, PROXIMAL TIBIA (COMP CODE 38222)",619.0,402.35,0.01,688.73,84
HCPCS,20999,PROC MUSSKL SYS UNLISTD,2543.0,1652.95,0.01,4628.0,169
HCPCS,20999,RADIOFREQUENCY ABLATION SOFT TISSUE MASS (COMP CODE 20982),30997.5,20148.375,0.01,59187.0,168
HCPCS,20999,REVISION OF MESH,2457.0,1597.05,0.01,2457.0,84
HCPCS,20999,RFA MSK TUMOR (COMP CODE 20982),30997.5,20148.375,0.01,59187.0,168
HCPCS,20999,SHOCK WAVE THERAPY,180.0,117.0,0.01,688.73,84
HCPCS,20999,SKYE DX100 PLACENTAL TISSUE MATRIX (1.0 CC),1800.0,1170.0,0.01,1800.0,84
HCPCS,20999,SKYE DX100 PLACENTAL TISSUE MATRIX (1.0 CC) WITH PRP,2500.0,1625.0,0.01,2500.0,84
HCPCS,20999,SKYE PX50 PLACENTAL TISSUE MATRIX (.5 CC),1000.0,650.0,0.01,1000.0,84
HCPCS,20999,SKYE PX50 PLACENTAL TISSUE MATRIX (.5CC) WITH PRP,1700.0,1105.0,0.01,1700.0,84
HCPCS,20999,SKYE PX50 PLACENTAL TISSUE MATRIX (1.0 CC),1500.0,975.0,0.01,1500.0,84
HCPCS,20999,SKYE PX50 PLACENTAL TISSUE MATRIX (1.0CC) WITH PRP,2200.0,1430.0,0.01,2200.0,84
HCPCS,20999,UNLISTED PROCEDURE MUSCSKELETAL SYSTEM GENERAL,358.0,232.7,0.01,688.73,84
HCPCS,21010,ARTHROTOMY TEMPOROMANDIBULAR JOINT,4416.0,2870.4,1.1,9391.15,144
HCPCS,21010,INCISION OF JAW JOINT,,,2793.19,3450.35,20
HCPCS,21010,Incision of jaw joint,,,2059.35,2384.51,8
HCPCS,21011,EXCISION TUMOR SOFT TISS FACE/SCALP SUBQ < 2CM,1196.0,777.4,1.1,4729.25,148
HCPCS,21011,EXCISION TUMOR SOFT TISS FACE/SCALP SUBQ <2CM,7453.0,4844.45,0.01,12500.0,87
HCPCS,21012,EXCISION TUMOR SOFT TISS FACE/SCALP SUBQ 2 CM/>,7453.0,4844.45,0.01,7453.0,87
HCPCS,21012,EXCISION TUMOR SOFT TISS FACE/SCALP SUBQ 2+CM,1780.0,1157.0,1.1,4729.25,144
HCPCS,21013,EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL < 2CM,2168.0,1409.2,1.1,4729.25,148
HCPCS,21013,EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL <2CM,7453.0,4844.45,0.01,7453.0,87
HCPCS,21014,EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL 2 CM/>,13165.0,8557.25,0.01,13165.0,87
HCPCS,21014,EXC TUMOR SOFT TISS FACE&SCALP SUBFASCIAL 2+CM,2852.0,1853.8,1.1,8286.13,144
HCPCS,21015,RAD RESECTION TUMOR SOFT TISS FACE/SCALP < 2CM,3956.0,2571.4,1.1,8286.13,144
HCPCS,21015,RESECT FACE/SCALP TUM < 2 CM,,,2465.15,3022.89,20
HCPCS,21015,Resect face/scalp tum < 2 cm,,,1351.24,1564.6,8
HCPCS,21016,RAD RESECTION TUMOR SOFT TISS FACE/SCALP 2+CM,6104.0,3967.6,1.1,8286.13,144
HCPCS,21016,RESECT FACE/SCALP TUM 2 CM/>,,,2465.15,3022.89,20
HCPCS,21016,Resect face/scalp tum 2 cm/>,,,1351.24,1564.6,8
HCPCS,21025,EXCISION BONE MANDIBLE,15612.0,10147.8,0.01,27212.0,235
HCPCS,21026,EXCISION OF FACIAL BONE(S),2280.0,1482.0,1.1,17080.38,168
HCPCS,21026,Excision of facial bone(s),,,2059.35,2384.51,8
HCPCS,21029,CONTOUR OF FACE BONE LESION,,,2793.19,3450.35,20
HCPCS,21029,Contour of face bone lesion,,,2059.35,2384.51,8
HCPCS,21029,REMOVAL CONTOURING BENIGN TUMOR FACIAL BONE,3356.0,2181.4,1.1,9391.15,148
HCPCS,21030,EXC BENIGN TUMOR/CYST MAXL/ZYGOMA ENCL & CURTG,14588.0,9482.199999999999,0.01,27212.0,235
HCPCS,21031,EXCISION TORUS MANDIBULARIS,8119.0,5277.35,0.01,14918.0,235
HCPCS,21032,EXCISION MAXILLARY TORUS PALATINUS,1336.0,868.4,1.1,9391.15,148
HCPCS,21032,REMOVE EXOSTOSIS MAXILLA,,,2793.19,4315.0,21
HCPCS,21032,Remove exostosis maxilla,,,2059.35,2384.51,8
HCPCS,21034,EXCISE MAX/ZYGOMA MAL TUMOR,,,5080.55,6160.68,20
HCPCS,21034,EXCISION MALIGNANT TUMOR MAXILLA/ZYGOMA,7647.0,4970.55,1.1,17080.38,148
HCPCS,21034,Excise max/zygoma mal tumor,,,4527.92,5242.85,8
HCPCS,21040,EXCISION BENIGN TUMOR/CYST MANDIBLE ENCL & CURT,8441.0,5486.650000000001,0.01,14918.0,235
HCPCS,21044,EXCISION MALIGNANT TUMOR MANDIBLE,5120.0,3328.0,1.1,17080.38,144
HCPCS,21044,REMOVAL OF JAW BONE LESION,,,5080.55,6160.68,20
HCPCS,21044,Removal of jaw bone lesion,,,4527.92,5242.85,8
HCPCS,21045,EXCISION MALIGNANT TUMOR MANDIBLE RADICAL,7348.0,4776.2,1.1,7348.0,144
HCPCS,21045,EXTENSIVE JAW SURGERY,,,3117.9,6160.68,13
HCPCS,21045,Extensive jaw surgery,,,4527.92,5242.85,8
HCPCS,21046,EXC BENIGN TUMOR/CYST MNDBL INTRA-ORAL OSTEOT,5684.0,3694.6,1.1,17080.38,144
HCPCS,21046,REMOVE MANDIBLE CYST COMPLEX,,,5080.55,6160.68,20
HCPCS,21046,Remove mandible cyst complex,,,4527.92,5242.85,8
HCPCS,21047,EXC B9 TUM/CST MNDBL XTR-ORAL OSTEOT&PRTL MNDB,8028.0,5218.2,1.1,17080.38,144
HCPCS,21047,EXCISE LWR JAW CYST W/REPAIR,,,5080.55,6160.68,20
HCPCS,21047,Excise lwr jaw cyst w/repair,,,4527.92,5242.85,8
HCPCS,21048,EXC BENIGN TUMOR/CYST MAXL INTRA-ORAL OSTEOT,5884.0,3824.6,1.1,17080.38,144
HCPCS,21048,REMOVE MAXILLA CYST COMPLEX,,,5080.55,6160.68,20
HCPCS,21048,Remove maxilla cyst complex,,,4527.92,5242.85,8
HCPCS,21049,EXC B9 TUM/CST MAXL XTR-ORAL OSTEOT&PRTL MAXLC,7728.0,5023.2,1.1,17080.38,144
HCPCS,21049,EXCIS UPPR JAW CYST W/REPAIR,,,5080.55,6160.68,20
HCPCS,21049,Excis uppr jaw cyst w/repair,,,4527.92,5242.85,8
HCPCS,21050,CONDYLECTOMY TEMPOROMANDIBULAR JOINT SPX,4704.0,3057.6,1.1,17080.38,144
HCPCS,21050,REMOVAL OF JAW JOINT,,,5080.55,6160.68,20
HCPCS,21050,Removal of jaw joint,,,4527.92,5242.85,8
HCPCS,21060,MENISCECTOMY PRTL/COMPL TEMPOROMANDIBULAR JT SPX,4428.0,2878.2,1.1,17080.38,144
HCPCS,21060,REMOVE JAW JOINT CARTILAGE,,,5080.55,6160.68,20
HCPCS,21060,Remove jaw joint cartilage,,,4527.92,5242.85,8
HCPCS,21070,CORONOIDECTOMY SEPARATE PROCEDURE,3448.0,2241.2,1.1,17080.38,144
HCPCS,21070,REMOVE CORONOID PROCESS,,,5080.55,6160.68,20
HCPCS,21070,Remove coronoid process,,,4527.92,5242.85,8
HCPCS,21073,MANIPULATION TMJ THERAPEUTIC REQUIRE ANESTHESIA,1380.0,897.0,1.1,4447.63,146
HCPCS,21073,MNPJ OF TMJ W/ANESTH,,,1323.06,3981.36,21
HCPCS,21073,Mnpj of tmj w/anesth,,,824.67,954.88,8
HCPCS,21076,IMPRESSION&PREPARATION SURG OBTURATOR PROSTHES,6087.0,3956.55,0.01,6814.0,235
HCPCS,21077,IMPRESSION & PREPARATION ORBITAL PROSTHESIS,20346.0,13224.9,0.01,27212.0,235
HCPCS,21079,IMPRESSION & PREPARATION INTERIM OBTURATOR PROST,11921.0,7748.650000000001,0.01,14918.0,235
HCPCS,21080,IMPRESSION & PREPJ DEFINITIVE OBTURATOR PROSTHES,12471.0,8106.150000000001,0.01,14918.0,235
HCPCS,21081,IMPRESSION & PREPJ MANDIBULAR RESECTION PROSTHES,18176.0,11814.4,0.01,27212.0,235
HCPCS,21082,IMPRESSION & PREPJ PALATAL AUGMENTATION PROSTHES,11627.0,7557.55,0.01,14918.0,235
HCPCS,21083,IMPRESSION & PREPARATION PALATAL LIFT PROSTHESIS,11313.0,7353.450000000001,0.01,14918.0,235
HCPCS,21084,IMPRESSION & PREPARATION SPEECH AID PROSTHESIS,11955.0,7770.75,0.01,14918.0,235
HCPCS,21085,IMPRESSION & PREPARATION ORAL SURGICAL SPLINT,2332.0,1515.8000000000002,0.01,3596.0,235
HCPCS,21086,IMPRESSION & PREPARATION AURICULAR PROSTHESIS,12435.0,8082.75,0.01,14918.0,235
HCPCS,21087,IMPRESSION & PREPARATION NASAL PROSTHESIS,18582.0,12078.3,0.01,27212.0,235
HCPCS,21088,IMPRES&PREP FACIAL PROSTH,,,2793.19,8405.28,21
HCPCS,21088,IMPRESSION & PREPARATION FACIAL PROSTHESIS,7736.0,5028.4,1.1,9976.48,88
HCPCS,21088,Impres&prep facial prosth,,,1358.5,1573.0,8
HCPCS,21089,NASAL STRETCH STENT,269.0,174.85,0.01,1573.0,85
HCPCS,21089,UNLISTED MAXILLOFACIAL PROSTHETIC PROCEDURE,1144.0,743.6,0.01,1144.0,84
HCPCS,21100,APPL HALO APPLIANCE MAXILLOFACIAL FIXATION SPX,1892.0,1229.8,1.1,17080.38,148
HCPCS,21100,MAXILLOFACIAL FIXATION,,,5080.55,6160.68,20
HCPCS,21100,Maxillofacial fixation,,,1652.13,1912.99,8
HCPCS,21110,APPL INTERDENTAL FIXATION DEVICE NON-FX/DISLC,4605.0,2993.25,1.1,6814.0,235
HCPCS,21116,INJECTION TEMPOROMANDIBULAR JOINT ARTHROGRAPHY,324.0,210.6,1.1,724.34,148
HCPCS,21116,Injection jaw joint x-ray,,,81.99,94.94,8
HCPCS,21120,CHIN IMPLANT - COMPLEX,3300.0,2145.0,1.1,17080.38,146
HCPCS,21120,CHIN IMPLANT - MODERATE,3100.0,2015.0,1.1,17080.38,146
HCPCS,21120,CHIN IMPLANT - SIMPLE,2700.0,1755.0,1.1,17080.38,146
HCPCS,21120,GENIOPLASTY AUGMENTATION,2040.0,1326.0,1.1,17080.38,166
HCPCS,21120,Genioplasty augmentation,,,4527.92,5242.85,8
HCPCS,21121,GENIOP SLDG OSTEOT 1,,,2793.19,3450.35,20
HCPCS,21121,GENIOPLASTY SLIDING OSTEOTOMY SINGLE PIECE,3436.0,2233.4,1.1,9391.15,148
HCPCS,21121,Geniop sldg osteot 1,,,2059.35,2384.51,8
HCPCS,21122,GENIOP SLDG OSTEOT 2/>,,,5080.55,6160.68,20
HCPCS,21122,GENIOPLASTY - COMPLEX,4250.0,2762.5,1.1,17080.38,142
HCPCS,21122,GENIOPLASTY - MODERATE,4000.0,2600.0,1.1,17080.38,142
HCPCS,21122,GENIOPLASTY - SIMPLE,3870.0,2515.5,1.1,17080.38,142
HCPCS,21122,GENIOPLASTY 2/> SLIDING OSTEOTOMIES,3484.0,2264.6,1.1,17080.38,142
HCPCS,21122,Geniop sldg osteot 2/>,,,4527.92,5242.85,8
HCPCS,21123,GENIOP SLDG AUGMENTATION,,,2793.19,3450.35,20
HCPCS,21123,GENIOP SLIDING AGMNTJ W/INTERPOSAL BONE GRAFTS,4536.0,2948.4,1.1,9391.15,142
HCPCS,21123,Geniop sldg augmentation,,,2059.35,2384.51,8
HCPCS,21125,AGMNTJ MNDBLR BODY/ANGLE PROSTHETIC MATERIAL,4320.0,2808.0,1.1,17080.38,148
HCPCS,21125,AUGMENTATION MNDBLR PROSTC,,,5080.55,6160.68,20
HCPCS,21125,Augmentation mndblr prostc,,,4527.92,5242.85,8
HCPCS,21127,AGMNTJ MNDBLR BDY/ANGL W/GRF ONLAY/INTERPOSAL,4976.0,3234.4,1.1,17080.38,148
HCPCS,21127,AUGMENTATION MNDBLR B1 GRF,,,5080.55,6160.68,20
HCPCS,21127,Augmentation mndblr b1 grf,,,4527.92,5242.85,8
HCPCS,21137,RDCTJ FOREHEAD CNTRG ONLY,,,2793.19,3450.35,20
HCPCS,21137,REDUCTION FOREHEAD; CONTOURING ONLY,4096.0,2662.4,1.1,9391.15,144
HCPCS,21137,Rdctj forehead cntrg only,,,4527.92,5242.85,8
HCPCS,21138,RDCTJ FHD CNTRG & PROSTHETIC MATRL/BONE GRAFT,5148.0,3346.2,1.1,17080.38,144
HCPCS,21138,RDCTJ FOREHEAD CNTRG&PROSTC,,,5080.55,6160.68,20
HCPCS,21138,Rdctj forehead cntrg&prostc,,,4527.92,5242.85,8
HCPCS,21139,RDCTJ FHD CNTRG & SETBACK ANT FRONTAL SINUS WALL,6008.0,3905.2,1.1,17080.38,144
HCPCS,21139,RDCTJ FOREHEAD CNTRG&SETBACK,,,5080.55,6160.68,20
HCPCS,21139,Rdctj forehead cntrg&setback,,,4527.92,5242.85,8
HCPCS,21141,RCNSTJ MIDFACE LEFORT I 1PC,,,5080.55,8702.0,21
HCPCS,21141,"RECONST FACE,LEFORT I,1 PIECE",7828.0,5088.2,1.1,17080.38,144
HCPCS,21141,Rcnstj midface lefort i 1pc,,,4527.92,5242.85,8
HCPCS,21142,RCNSTJ MIDFACE LEFORT I 2PCS,,,5080.55,6160.68,20
HCPCS,21142,"RECONST FACE,LEFORT I,2 PIECES",8112.0,5272.8,1.1,17080.38,144
HCPCS,21142,Rcnstj midface lefort i 2pcs,,,4527.92,5242.85,8
HCPCS,21143,RCNSTJ MDFACE LEFORT I 3/>PC,,,5080.55,6160.68,20
HCPCS,21143,"RECONST FACE,LEFORT I,3+ PIECES",8420.0,5473.0,1.1,17080.38,144
HCPCS,21143,Rcnstj mdface lefort i 3/>pc,,,4527.92,5242.85,8
HCPCS,21145,RCNSTJ MDFC LEFORT I 1 W/GRF,,,5600.62,6160.68,12
HCPCS,21145,"RECONST FACE,LEFORT I,1 PIECE+GRFT",9576.0,6224.4,1.1,9576.0,144
HCPCS,21145,Rcnstj mdfc lefort i 1 w/grf,,,4527.92,5242.85,8
HCPCS,21146,RCNSTJ MDFC LEFORT I 2 W/GRF,,,5600.62,6160.68,12
HCPCS,21146,"RECONST FACE,LEFORT I,2 PIECES+GRFT",9948.0,6466.2,1.1,9948.0,144
HCPCS,21146,Rcnstj mdfc lefort i 2 w/grf,,,4527.92,5242.85,8
HCPCS,21147,RCNSTJ MDFC LEFORT I 3/>GRF,,,5600.62,6160.68,12
HCPCS,21147,"RECONST FACE,LEFORT I,3+PIECES+GRFT",10588.0,6882.2,1.1,10588.0,144
HCPCS,21147,Rcnstj mdfc lefort i 3/>grf,,,4527.92,5242.85,8
HCPCS,21150,RCNSTJ MDFC LEFRTII ANT NTRU,,,5080.55,6160.68,20
HCPCS,21150,RCNSTJ MIDFACE LEFORT II ANTERIOR INTRUSION,10384.0,6749.6,1.1,17080.38,144
HCPCS,21150,Rcnstj mdfc lefrtii ant ntru,,,4527.92,5242.85,8
HCPCS,21151,RCNSTJ MDFC LEFRTII W/B1 GRF,,,5600.62,6160.68,12
HCPCS,21151,RCNSTJ MIDFACE LEFORT II W/BONE GRAFTS,11608.0,7545.2,1.1,11608.0,144
HCPCS,21151,Rcnstj mdfc lefrtii w/b1 grf,,,4527.92,5242.85,8
HCPCS,21154,RCNSTJ MDFC LEFORT III W/O I,,,5600.62,6160.68,12
HCPCS,21154,RCNSTJ MIDFACE LEFORT III W/O LEFORT I,12516.0,8135.4,1.1,12516.0,144
HCPCS,21154,Rcnstj mdfc lefort iii w/o i,,,4527.92,5242.85,8
HCPCS,21155,RCNSTJ MDFC LEFORT III W/I,,,5600.62,6160.68,12
HCPCS,21155,"RECONST FACE,LEFORT III+LEFORT I",14088.0,9157.2,1.1,14088.0,144
HCPCS,21155,Rcnstj mdfc lefort iii w/i,,,4527.92,5242.85,8
HCPCS,21159,RCNST MDFC LFRTIII ADVM WO I,,,5600.62,6160.68,12
HCPCS,21159,RCNSTJ MIDFACE LEFORT III W/FHD W/O LEFORT I,17256.0,11216.4,1.1,17256.0,144
HCPCS,21159,Rcnst mdfc lfrtiii advm wo i,,,4527.92,5242.85,8
HCPCS,21160,RCNST MDFC LFRTIII ADVM W/I,,,5600.62,6160.68,12
HCPCS,21160,RCNSTJ MIDFACE LEFORT III W/FHD W/LEFORT I,18876.0,12269.4,1.1,18876.0,144
HCPCS,21160,Rcnst mdfc lfrtiii advm w/i,,,4527.92,5242.85,8
HCPCS,21172,RCNST SUPR-LAT ORB RM&LW FHD,,,5080.55,6160.68,20
HCPCS,21172,RCNSTJ SUPERIOR-LATERAL ORBITAL RIM & LOWER FHD,11280.0,7332.0,1.1,17080.38,144
HCPCS,21172,Rcnst supr-lat orb rm&lw fhd,,,4527.92,5242.85,8
HCPCS,21175,RCNST BFRNT SP ORB RM&LW FHD,,,5080.55,6160.68,20
HCPCS,21175,RCNSTJ BIFRONTAL SUPERIOR-LAT ORB RIMS & LWR FHD,13424.0,8725.6,1.1,17080.38,144
HCPCS,21175,Rcnst bfrnt sp orb rm&lw fhd,,,4527.92,5242.85,8
HCPCS,21179,RCNSTJ FOREHEAD &/ SUPRAORB RIMS W/ALGRF/PROSTC,9060.0,5889.0,1.1,9060.0,144
HCPCS,21179,RCNSTJ FOREHEAD WITH GRAFTS,,,5600.62,6160.68,12
HCPCS,21179,Rcnstj forehead with grafts,,,4527.92,5242.85,8
HCPCS,21180,RCNSTJ FOREHEAD &/ SUPRAORBITAL RIMS W/AUTOGRAFT,10232.0,6650.8,1.1,10232.0,144
HCPCS,21180,RCNSTJ FOREHEAD W/AUTOGRAFT,,,5600.62,6160.68,12
HCPCS,21180,Rcnstj forehead w/autograft,,,4527.92,5242.85,8
HCPCS,21181,RCNST CNTRG B9 TUM CRNL XTRC,,,5080.55,6160.68,20
HCPCS,21181,RCNSTJ CONTOURING BENIGN TUMOR CRNL BONES XTRC,4112.0,2672.8,1.1,17080.38,144
HCPCS,21181,Rcnst cntrg b9 tum crnl xtrc,,,2059.35,2384.51,8
HCPCS,21182,RCNSTJ ORBIT/FHD/NASETHMD EXCBONE TUM GRF<40SQCM,13032.0,8470.8,1.1,13032.0,144
HCPCS,21182,RECONSTRUCT CRANIAL BONE,,,5490.93,6160.68,13
HCPCS,21182,Reconstruct cranial bone,,,4527.92,5242.85,8
HCPCS,21183,RCNSTJ ORBIT/FHD/NASETHMD EXC BONE GRF>40 <80,14280.0,9282.0,1.1,14280.0,144
HCPCS,21183,RECONSTRUCT CRANIAL BONE,,,5600.62,6160.68,12
HCPCS,21183,Reconstruct cranial bone,,,4527.92,5242.85,8
HCPCS,21184,RCNSTJ ORBIT/FHD/NASETHMD EXC BONE TUM GRF>80SQ,15448.0,10041.2,1.1,15448.0,144
HCPCS,21184,RECONSTRUCT CRANIAL BONE,,,5600.62,6160.68,12
HCPCS,21184,Reconstruct cranial bone,,,4527.92,5242.85,8
HCPCS,21188,RCNSTJ MDFC OTH/THN LEFORT OSTEOT & BONE GRAFTS,9260.0,6019.0,1.1,9260.0,144
HCPCS,21188,RECONSTRUCTION OF MIDFACE,,,5600.62,6160.68,12
HCPCS,21188,Reconstruction of midface,,,2059.35,2384.51,8
HCPCS,21193,RCNSTJ MNDBLR RAMI HRZNTL/VER/C/L OSTEOT W/O GRF,7560.0,4914.0,1.1,17080.38,144
HCPCS,21193,RECONST LWR JAW W/O GRAFT,,,5080.55,6160.68,20
HCPCS,21193,Reconst lwr jaw w/o graft,,,2059.35,2384.51,8
HCPCS,21194,RCNSTJ MNDBLR RAMI HRZNTL/VER/C/L OSTEOT W/GRAFT,8728.0,5673.2,1.1,17080.38,144
HCPCS,21194,RECONST LWR JAW W/GRAFT,,,5080.55,6160.68,20
HCPCS,21194,Reconst lwr jaw w/graft,,,4527.92,5242.85,8
HCPCS,21195,RCNSTJ MNDBLR RAMI&/BODY SGTL SPLT W/O INT RGD,7664.0,4981.6,1.1,17080.38,144
HCPCS,21195,RECONST LWR JAW W/O FIXATION,,,5080.55,6160.68,20
HCPCS,21195,Reconst lwr jaw w/o fixation,,,4527.92,5242.85,8
HCPCS,21196,RCNSTJ MNDBLR RAMI&/BDY SGTL SPLT W/INT RGD FI,8332.0,5415.8,1.1,17080.38,144
HCPCS,21196,RECONST LWR JAW W/FIXATION,,,5080.55,6160.68,20
HCPCS,21196,Reconst lwr jaw w/fixation,,,4527.92,5242.85,8
HCPCS,21198,OSTEOTOMY MANDIBLE SEGMENTAL,6284.0,4084.6,1.1,17080.38,144
HCPCS,21198,RECONSTR LWR JAW SEGMENT,,,5080.55,6160.68,20
HCPCS,21198,Reconstr lwr jaw segment,,,4527.92,5242.85,8
HCPCS,21199,OSTEOTOMY MANDIBLE SGMTL W/GENIOGLOSSUS ADVMNT,6692.0,4349.8,1.1,17080.38,144
HCPCS,21199,RECONSTR LWR JAW W/ADVANCE,,,5080.55,6160.68,20
HCPCS,21199,Reconstr lwr jaw w/advance,,,2059.35,2384.51,8
HCPCS,21206,OSTEOTOMY MAXILLA SEGMENTAL,6236.0,4053.4,1.1,17080.38,144
HCPCS,21206,RECONSTRUCT UPPER JAW BONE,,,5080.55,6160.68,20
HCPCS,21206,Reconstruct upper jaw bone,,,4527.92,5242.85,8
HCPCS,2120683,NM PET CARDIAC PERF STRESS RB82,495.0,321.75,1.1,495.0,70
HCPCS,21208,AUGMENTATION OF FACIAL BONES,,,5080.55,6160.68,20
HCPCS,21208,Augmentation of facial bones,,,4527.92,5242.85,8
HCPCS,21208,OSTEOPLASTY FACIAL BONES AUGMENTATION,4568.0,2969.2,1.1,17080.38,148
HCPCS,21209,OSTEOPLASTY FACIAL BONES REDUCTION,3128.0,2033.2,1.1,17080.38,146
HCPCS,21209,REDUCTION OF FACIAL BONES,,,5080.55,6160.68,20
HCPCS,21209,Reduction of facial bones,,,4527.92,5242.85,8
HCPCS,21210,CHEECK IMPLANT W BONE GRAFT,2000.0,1300.0,1.1,17080.38,148
HCPCS,21210,GRAFT BONE NASAL/MAXILLARY/MALAR AREAS,16178.0,10515.699999999999,0.01,27212.0,235
HCPCS,21215,GRAFT BONE MANDIBLE,16052.0,10433.8,0.01,27212.0,235
HCPCS,21230,GRAFT RIB CRTLG AUTOGENOUS FACE/CHIN/NOSE/EAR,4468.0,2904.2,1.1,17080.38,144
HCPCS,21230,RHINOPLASTY (RIB) - COMPLEX,7950.0,5167.5,1.1,17080.38,144
HCPCS,21230,RHINOPLASTY (RIB) - MODERATE,6490.0,4218.5,1.1,17080.38,144
HCPCS,21230,RHINOPLASTY (RIB) - SIMPLE,5050.0,3282.5,1.1,17080.38,144
HCPCS,21230,RIB CARTILAGE GRAFT,,,5080.55,8702.0,21
HCPCS,21230,Rib cartilage graft,,,4527.92,5242.85,8
HCPCS,21235,GRAFT EAR CRTLG AUTOGENOUS NOSE/EAR,15106.0,9818.9,0.01,27212.0,235
HCPCS,21240,ARTHRP TEMPOROMANDIBULAR JOINT W/WO AUTOGRAFT,6428.0,4178.2,1.1,17080.38,144
HCPCS,21240,RECONSTRUCTION OF JAW JOINT,,,5080.55,6160.68,20
HCPCS,21240,Reconstruction of jaw joint,,,4527.92,5242.85,8
HCPCS,21242,ARTHROPLASTY TEMPOROMANDIBULAR JT W/ALLOGRAFT,5836.0,3793.4,1.1,17080.38,144
HCPCS,21242,RECONSTRUCTION OF JAW JOINT,,,5080.55,6160.68,20
HCPCS,21242,Reconstruction of jaw joint,,,4527.92,5242.85,8
HCPCS,21243,ARTHRP TMPRMAND JOINT W/PROSTHETIC REPLACEMENT,9812.0,6377.8,1.1,54351.12,144
HCPCS,21243,RECONSTRUCTION OF JAW JOINT,,,16167.8,28237.96,20
HCPCS,21243,Reconstruction of jaw joint,,,7882.2,9126.76,8
HCPCS,21244,RCNSTJ MNDBL XTRORAL W/TRANSOSTEAL BONE PLATE,5448.0,3541.2,1.1,17080.38,144
HCPCS,21244,RECONSTRUCTION OF LOWER JAW,,,5080.55,6160.68,20
HCPCS,21244,Reconstruction of lower jaw,,,4527.92,5242.85,8
HCPCS,21245,RCNSTJ MNDBL/MAXL SUBPRIOSTEAL IMPLANT PARTIAL,5248.0,3411.2,1.1,17080.38,148
HCPCS,21245,RECONSTRUCTION OF JAW,,,5080.55,6160.68,20
HCPCS,21245,Reconstruction of jaw,,,4527.92,5242.85,8
HCPCS,21246,RCNSTJ MNDBL/MAXL SUBPRIOSTEAL IMPLANT COMPLETE,5168.0,3359.2,1.1,17080.38,144
HCPCS,21246,RECONSTRUCTION OF JAW,,,5080.55,6160.68,20
HCPCS,21246,Reconstruction of jaw,,,4527.92,5242.85,8
HCPCS,21247,RCNSTJ MNDBLR CONDYLE W/BONE CARTLG AUTOGRAFTS,9748.0,6336.2,1.1,9748.0,144
HCPCS,21247,RECONSTRUCT LOWER JAW BONE,,,5600.62,6160.68,12
HCPCS,21247,Reconstruct lower jaw bone,,,4527.92,5242.85,8
HCPCS,21248,RCNSTJ MANDIBLE/MAXL ENDOSTEAL IMPLANT PARTIAL,16154.0,10500.1,0.01,27212.0,235
HCPCS,21249,RCNSTJ MANDIBLE/MAXL ENDOSTEAL IMPLANT COMPLETE,17360.0,11284.0,0.01,27212.0,235
HCPCS,21255,RCNSTJ ZYGMTC ARCH/GLENOID FOSSA W/BONE CARTLG,7384.0,4799.6,1.1,17080.38,144
HCPCS,21255,RECONSTRUCT LOWER JAW BONE,,,5080.55,6160.68,20
HCPCS,21255,Reconstruct lower jaw bone,,,4527.92,5242.85,8
HCPCS,21256,RECONSTRUCTION OF ORBIT,,,5080.55,6160.68,20
HCPCS,21256,RECONSTRUCTION ORBIT W/OSTEOTOMIES & BONE GRAFTS,7770.0,5050.5,1.1,17080.38,144
HCPCS,21256,Reconstruction of orbit,,,4527.92,5242.85,8
HCPCS,21260,REVISE EYE SOCKETS,,,5080.55,6160.68,20
HCPCS,21260,Revise eye sockets,,,4527.92,5242.85,8
HCPCS,21261,PERIORBITAL OSTEOTOMIES W/BONE GRAFTS ICRA & XTR,13628.0,8858.2,1.1,17080.38,144
HCPCS,21261,REVISE EYE SOCKETS,,,5080.55,6160.68,20
HCPCS,21261,Revise eye sockets,,,4527.92,5242.85,8
HCPCS,21263,REVISE EYE SOCKETS,,,5080.55,6160.68,20
HCPCS,21263,Revise eye sockets,,,4527.92,5242.85,8
HCPCS,21267,ORBITAL REPOSITIONING W/BONE GRAFTS EXTRACRANIAL,8276.0,5379.4,1.1,17080.38,144
HCPCS,21267,REVISE EYE SOCKETS,,,5080.55,6160.68,20
HCPCS,21267,Revise eye sockets,,,2059.35,2384.51,8
HCPCS,21268,ORBITAL REPOSITIONING W/BONE GRAFTS ICRA & XTRC,10828.0,7038.2,1.1,10828.0,144
HCPCS,21268,REVISE EYE SOCKETS,,,5186.38,6160.68,13
HCPCS,21268,Revise eye sockets,,,4527.92,5242.85,8
HCPCS,21270,AUGMENTATION CHEEK BONE,,,5080.55,6160.68,20
HCPCS,21270,Augmentation cheek bone,,,4527.92,5242.85,8
HCPCS,21270,CHEECK IMPLANT W/O BONE GRAFT,2000.0,1300.0,1.1,17080.38,148
HCPCS,21270,MALAR AUGMENTATION PROSTHETIC MATERIAL,4252.0,2763.8,1.1,17080.38,148
HCPCS,21275,REVISION ORBITOFACIAL BONES,,,5080.55,6160.68,20
HCPCS,21275,Revision orbitofacial bones,,,2059.35,2384.51,8
HCPCS,21275,SECONDARY REVISION ORBITOCRANIOFACIAL RCNSTJ,4704.0,3057.6,1.1,17080.38,144
HCPCS,21280,MEDIAL CANTHOPEXY,,,2793.19,3450.35,20
HCPCS,21280,MEDIAL CANTHOPEXY SEPARATE PROCEDURE,2852.0,1853.8,1.1,9391.15,142
HCPCS,21280,Medial canthopexy,,,2122.76,2457.93,8
HCPCS,21282,CANTHOPEXY,1538.0,999.7,1.1,9391.15,142
HCPCS,21282,CANTHOPEXY ;LATERAL,1708.0,1110.2,1.1,9391.15,142
HCPCS,21282,LATERAL CANTHOPEXY,,,2793.19,3450.35,20
HCPCS,21282,Lateral canthopexy,,,2122.76,2457.93,8
HCPCS,21295,REDUCTION MASSETER MUSCLE & BONE EXTRAORAL,760.0,494.0,1.1,4447.63,144
HCPCS,21295,REVISION OF JAW MUSCLE/BONE,,,1323.06,1614.71,20
HCPCS,21295,Revision of jaw muscle/bone,,,2059.35,2384.51,8
HCPCS,21296,REDUCTION MASSETER MUSCLE & BONE INTRAORAL,1912.0,1242.8,1.1,9391.15,144
HCPCS,21296,REVISION OF JAW MUSCLE/BONE,,,2793.19,3450.35,20
HCPCS,21296,Revision of jaw muscle/bone,,,2059.35,2384.51,8
HCPCS,21299,COMPLEX SCULPTING & CARVING OF CADAVERIC RIB EAR CARTILAGE FRAME,4022.0,2614.3,0.01,4022.0,84
HCPCS,21299,DAO TRANSORAL MYECTOMY (COMP CODE 21013),2304.0,1497.6,0.01,2304.0,84
HCPCS,21299,"PERSONALIZED, AUTOLOGOUS BONE GRAFT FOR MANDIBULAR RECONSTRUCTIO",7201.0,4680.65,0.01,7201.0,84
HCPCS,21299,REMOVAL BY CONTOURING OF BENIGN TUMOR FACIAL BONE (COMP CODE 210,3566.0,2317.9,0.01,3566.0,84
HCPCS,21299,"TRANS-OSTEAL PLATING FOR MANDIBLE RECONSTRUCTION, INTRAORAL, WIT",4904.0,3187.6,0.01,4904.0,84
HCPCS,21299,TRANSCER EXCIS STYLOID PROCESS LIGAMENT (COMP 61605),8438.0,5484.7,0.01,8438.0,84
HCPCS,21299,UNLISTED CRANFCL&MAXLFCL PX,,,211.91,637.68,21
HCPCS,21299,UNLISTED CRANIOFACIAL & MAXILLOFACIAL PROCEDURE,2727.0,1772.55,0.01,2727.0,84
HCPCS,21299,Unlisted cranfcl&maxlfcl px,,,2059.35,2384.51,8
HCPCS,21310,Closed tx nose fx w/o manj,,,295.11,341.7,8
HCPCS,21315,CLOSED TX NASAL BONE FX W/MNPJ W/O STABILIZATION,3618.0,2351.7000000000003,0.01,6814.0,322
HCPCS,21320,CLOSED TX NASAL BONE FX W/MNPJ W/STABILIZATION,7809.0,5075.85,0.01,14918.0,235
HCPCS,21325,OPEN TREATMENT NASAL FRACTURE UNCOMPLICATED,1672.0,1086.8,1.1,9391.15,144
HCPCS,21325,OPEN TX NOSE FX UNCOMPLICATD,,,2793.19,3450.35,20
HCPCS,21325,Open tx nose fx uncomplicatd,,,2059.35,2384.51,8
HCPCS,21330,OPEN TX NASAL FX COMP W/INT&/XTRNL SKELETAL FI,2316.0,1505.4,1.1,17080.38,144
HCPCS,21330,OPEN TX NOSE FX W/SKELE FIXJ,,,5080.55,6160.68,20
HCPCS,21330,Open tx nose fx w/skele fixj,,,2059.35,2384.51,8
HCPCS,21335,OPEN TX NASAL FX W/CONCOMITANT OPTX FXD SEPTUM,3608.0,2345.2,1.1,9391.15,144
HCPCS,21335,OPEN TX NOSE & SEPTAL FX,,,2793.19,3450.35,20
HCPCS,21335,Open tx nose & septal fx,,,2059.35,2384.51,8
HCPCS,21336,OPEN TX NASAL SEPTAL FRACTURE W/WO STABILIZATION,2708.0,1760.2,1.1,9440.12,144
HCPCS,21336,OPEN TX SEPTAL FX W/WO STABJ,,,2808.13,3405.12,20
HCPCS,21336,Open tx septal fx w/wo stabj,,,3603.21,4172.14,8
HCPCS,21337,CLOSED TX NASAL SEPTAL FRACT W/WO STABILIZATION,8137.0,5289.05,0.01,14918.0,320
HCPCS,21338,OPEN NASOETHMOID FX W/O FIXJ,,,5080.55,6160.68,20
HCPCS,21338,OPEN TX NASOETHMOID FX W/O EXTERNAL FIXATION,2748.0,1786.2,1.1,17080.38,144
HCPCS,21338,Open nasoethmoid fx w/o fixj,,,4527.92,5242.85,8
HCPCS,21339,OPEN NASOETHMOID FX W/ FIXJ,,,5080.55,6160.68,20
HCPCS,21339,OPEN TX NASOETHMOID FX W/EXTERNAL FIXATION,3400.0,2210.0,1.1,17080.38,144
HCPCS,21339,Open nasoethmoid fx w/ fixj,,,4527.92,5242.85,8
HCPCS,21340,PERCUTANEOUS TX NASOETHMOID COMPLEX FRACTURE,4596.0,2987.4,1.1,9391.15,144
HCPCS,21340,PERQ TX NASOETHMOID FX,,,2793.19,3450.35,20
HCPCS,21340,Perq tx nasoethmoid fx,,,2059.35,2384.51,8
HCPCS,21343,OPEN TX DEPRESSED FRONTAL SINUS FRACTURE,5728.0,3723.2,1.1,5728.0,144
HCPCS,21343,OPEN TX DPRSD FRONT SINUS FX,,,5600.62,6160.68,12
HCPCS,21343,Open tx dprsd front sinus fx,,,2059.35,2384.51,8
HCPCS,21344,OPEN TX COMPL FRONT SINUS FX,,,5600.62,6160.68,12
HCPCS,21344,OPEN TX COMPLICATED FRONTAL SINUS FRACTURE,8628.0,5608.2,1.1,8628.0,144
HCPCS,21344,Open tx compl front sinus fx,,,4527.92,5242.85,8
HCPCS,21345,CLOSED TX NOSE/JAW FX,,,1323.06,1614.71,20
HCPCS,21345,Closed tx nose/jaw fx,,,295.11,341.7,8
HCPCS,21346,OPN TX NASOMAX FX W/FIXJ,,,5080.55,15288.41,21
HCPCS,21346,OPTX NASOMAX CPLX FX LEFT II TYPE W/WIRG & FXJ,4580.0,2977.0,1.1,17080.38,144
HCPCS,21346,Opn tx nasomax fx w/fixj,,,4527.92,5242.85,8
HCPCS,21347,OPN TX NASOMAX FX MULTPLE,,,5080.55,15288.41,21
HCPCS,21347,OPTX NASOMAX CPLX FX LEFT II TYPE REQ MLT OPN,5412.0,3517.8,1.1,17080.38,144
HCPCS,21347,Opn tx nasomax fx multple,,,4527.92,5242.85,8
HCPCS,21348,OPN TX NASOMAX FX W/GRAFT,,,2860.23,6160.68,13
HCPCS,21348,Opn tx nasomax fx w/graft,,,4527.92,5242.85,8
HCPCS,21355,PERCUTANEOUS TX MALAR AREA FRACTURE,1780.0,1157.0,1.1,9391.15,148
HCPCS,21355,PERQ TX MALAR FRACTURE,,,2793.19,3450.35,20
HCPCS,21355,Perq tx malar fracture,,,2059.35,2384.51,8
HCPCS,21356,OPEN TX DEPRESSED ZYGOMATIC ARCH FRACTURE,1932.0,1255.8,1.1,17080.38,148
HCPCS,21356,OPN TX DPRSD ZYGOMATIC ARCH,,,5080.55,6160.68,20
HCPCS,21356,Opn tx dprsd zygomatic arch,,,2059.35,2384.51,8
HCPCS,21360,OPEN TX DEPRESSED MALAR FRACTURE,2876.0,1869.4,1.1,17080.38,144
HCPCS,21360,OPN TX DPRSD MALAR FRACTURE,,,5080.55,6160.68,20
HCPCS,21360,Opn tx dprsd malar fracture,,,2059.35,2384.51,8
HCPCS,21365,OPEN TX COMP FX MALAR W/INTERNAL FX&MULT SURG,6708.0,4360.2,1.1,17080.38,144
HCPCS,21365,OPN TX COMPLX MALAR FX,,,5080.55,13821.0,21
HCPCS,21365,Opn tx complx malar fx,,,4527.92,5242.85,8
HCPCS,21366,OPEN TX COMP FRACTURE MALAR AREA W/BONE GRAFT,7440.0,4836.0,1.1,17080.38,144
HCPCS,21366,OPN TX COMPLX MALAR W/GRFT,,,5080.55,6160.68,20
HCPCS,21366,Opn tx complx malar w/grft,,,4527.92,5242.85,8
HCPCS,21385,OPEN TX ORBITAL FLOOR BLOWOUT FX TRANSANTRAL,3828.0,2488.2,1.1,17080.38,144
HCPCS,21385,OPN TX ORBIT FX TRANSANTRAL,,,5080.55,6160.68,20
HCPCS,21385,Opn tx orbit fx transantral,,,4527.92,5242.85,8
HCPCS,21386,OPEN TX ORBITAL FLOOR BLOWOUT FX PERIORBITAL,3828.0,2488.2,1.1,17080.38,144
HCPCS,21386,OPN TX ORBIT FX PERIORBITAL,,,5080.55,6160.68,20
HCPCS,21386,Opn tx orbit fx periorbital,,,4527.92,5242.85,8
HCPCS,21387,OPEN TX ORBITAL FLOOR BLOWOUT FX COMBINED APPR,4044.0,2628.6,1.1,17080.38,144
HCPCS,21387,OPN TX ORBIT FX COMBINED,,,5080.55,6160.68,20
HCPCS,21387,Opn tx orbit fx combined,,,4527.92,5242.85,8
HCPCS,21390,OPN TX ORBIT PERIORBTL IMPLT,,,5080.55,9509.0,21
HCPCS,21390,OPTX ORB FLOOR BLWT FX PRI/BITAL APPR W/ALLPLSTC,4492.0,2919.8,1.1,17080.38,144
HCPCS,21390,Opn tx orbit periorbtl implt,,,4527.92,5242.85,8
HCPCS,21395,OPN TX ORBIT PERIORBT W/GRFT,,,5080.55,6160.68,20
HCPCS,21395,OPTX ORB FLOOR BLWT FX PRI/BITAL APPR W/BONE GRF,5880.0,3822.0,1.1,17080.38,144
HCPCS,21395,Opn tx orbit periorbt w/grft,,,4527.92,5242.85,8
HCPCS,21400,CLSD TX FX ORBIT EXCEPT BLOWOUT W/O MANIPULATION,1471.5,956.475,1.1,5265.0,233
HCPCS,21401,CLOSED TX ORBIT W/MANIPULJ,,,1323.06,1614.71,20
HCPCS,21401,Closed tx orbit w/manipulj,,,295.11,341.7,8
HCPCS,21406,OPEN TX FX ORBIT EXCEPT BLOWOUT W/O IMPLANT,2968.0,1929.2,1.1,17080.38,144
HCPCS,21406,OPN TX ORBIT FX W/O IMPLANT,,,5080.55,6160.68,20
HCPCS,21406,Opn tx orbit fx w/o implant,,,4527.92,5242.85,8
HCPCS,21407,OPEN TX FX ORBIT EXCEPT BLOWOUT W/IMPLANT,3608.0,2345.2,1.1,17080.38,144
HCPCS,21407,OPN TX ORBIT FX W/IMPLANT,,,5080.55,6160.68,20
HCPCS,21407,Opn tx orbit fx w/implant,,,2059.35,2384.51,8
HCPCS,21408,OPEN TX FX ORBIT EXCEPT BLOWOUT W/BONE GRAFT,5112.0,3322.8,1.1,17080.38,144
HCPCS,21408,OPN TX ORBIT FX W/BONE GRFT,,,5080.55,6160.68,20
HCPCS,21408,Opn tx orbit fx w/bone grft,,,2059.35,2384.51,8
HCPCS,21421,CLOSED TX PALATAL/MAXILLARY FX W/FIXATION/SPLINT,8663.0,5630.950000000001,1.1,14918.0,235
HCPCS,21422,OPEN TREATMENT PALATAL/MAXILLARY FRACTURE,3492.0,2269.8,1.1,17080.38,144
HCPCS,21422,OPTX PALATAL/MAX FRACTURE,,,5080.55,6160.68,20
HCPCS,21422,Optx palatal/max fracture,,,4527.92,5242.85,8
HCPCS,21423,OPEN TX PALATAL/MAXILLARY FX COMP MULTIPLE APPR,4340.0,2821.0,1.1,4340.0,144
HCPCS,21423,OPTX PALATAL/MAX FX COMP,,,5600.62,6160.68,12
HCPCS,21423,Optx palatal/max fx comp,,,4527.92,5242.85,8
HCPCS,21431,CLTX CRANIOFACIAL SEPARATION,,,5600.62,6160.68,12
HCPCS,21431,Cltx craniofacial separation,,,4527.92,5242.85,8
HCPCS,21432,OPEN TX CRANIOFACIAL SEP W/WIRING&/INT FIXJ,3528.0,2293.2,1.1,3528.0,144
HCPCS,21432,OPTX CRANFCL SEP W/WIRING,,,5600.62,6160.68,12
HCPCS,21432,Optx cranfcl sep w/wiring,,,4527.92,5242.85,8
HCPCS,21433,OPEN TX CRANIOFACIAL SEP COMPLICATED MLT APPR,10516.0,6835.4,1.1,10516.0,144
HCPCS,21433,OPTX CRANFCL SEP COMP MLT,,,5600.62,6160.68,12
HCPCS,21433,Optx cranfcl sep comp mlt,,,4527.92,5242.85,8
HCPCS,21435,OPEN TX CRANIOFACIAL SEP COMP W/INT&/XTRNL FIX,8104.0,5267.6,1.1,8104.0,144
HCPCS,21435,OPTX CRNFC SEP COMP INT&/XTR,,,5600.62,6160.68,12
HCPCS,21435,Optx crnfc sep comp int&/xtr,,,4527.92,5242.85,8
HCPCS,21436,OPTX CRNFCL SEP COMP MLT INT,,,5600.62,6160.68,12
HCPCS,21436,Optx crnfcl sep comp mlt int,,,4527.92,5242.85,8
HCPCS,21440,CLTX MANDIBULAR/MAXILLARY ALVEOLAR RIDGE FX SPX,8147.0,5295.55,1.1,14918.0,234
HCPCS,21445,OPTX MANDIBULAR/MAXILLARY ALVEOLAR RIDGE FX SPX,2504.0,1627.6,1.1,17080.38,148
HCPCS,21445,OPTX MNDBLR/MAX ALV RIDGE FX,,,5080.55,6160.68,20
HCPCS,21445,Optx mndblr/max alv ridge fx,,,4527.92,5242.85,8
HCPCS,21450,CLOSED TX MANDIBULAR FRACTURE W/O MANIPULATION,1484.0,964.6,1.1,1995.71,146
HCPCS,21450,CLOSED TX OF MANDIBULAR FRACTURE W/O MANIPULATION,2343.0,1522.95,295.11,7813.0,87
HCPCS,21451,CLOSED TX MANDIBULAR FRACTURE W/MANIPULATION,2260.0,1469.0,1.1,4447.63,148
HCPCS,21451,CLTX MNDBLR FX W/MNPJ,,,1323.06,1614.71,20
HCPCS,21451,Cltx mndblr fx w/mnpj,,,295.11,341.7,8
HCPCS,21452,PERQ TX MNDBLR FX XTRNL FIXJ,,,5080.55,6160.68,20
HCPCS,21452,Perq tx mndblr fx xtrnl fixj,,,4527.92,5242.85,8
HCPCS,21453,CLOSED TX MANDIBULAR FX W/INTERDENTAL FIXATION,14934.0,9707.1,0.01,27212.0,235
HCPCS,21454,OPEN TX MANDIBULAR FX W/EXTERNAL FIXATION,2944.0,1913.6,1.1,17080.38,144
HCPCS,21454,OPTX MNDBLR FX XTRNL FIXJ,,,5080.55,6160.68,20
HCPCS,21454,Optx mndblr fx xtrnl fixj,,,4527.92,5242.85,8
HCPCS,21461,OPEN TX MANDIBULAR FX W/O INTERDENTAL FIXATION,3724.0,2420.6,1.1,17080.38,148
HCPCS,21461,OPTX MNDBLR FX WO NTRDNTL,,,5080.55,9509.0,21
HCPCS,21461,Optx mndblr fx wo ntrdntl,,,4527.92,5242.85,8
HCPCS,21462,OPEN TX MANDIBULAR FX W/INTERDENTAL FIXATION,4404.0,2862.6,1.1,17080.38,148
HCPCS,21462,OPTX MNDBLR FX W/NTRDNTL,,,5080.55,9509.0,21
HCPCS,21462,Optx mndblr fx w/ntrdntl,,,4527.92,5242.85,8
HCPCS,21465,OPEN TREATMENT MANDIBULAR CONDYLAR FRACTURE,5248.0,3411.2,1.1,17080.38,144
HCPCS,21465,OPTX MNDBLR CNDYLR FX,,,5080.55,6160.68,20
HCPCS,21465,Optx mndblr cndylr fx,,,4527.92,5242.85,8
HCPCS,21470,OPTX COMP MANDIBULAR FX MLT APPR W/INT FIXATION,7016.0,4560.4,1.1,17080.38,144
HCPCS,21470,OPTX COMPLICATED MNDBLR FX,,,5080.55,6160.68,20
HCPCS,21470,Optx complicated mndblr fx,,,4527.92,5242.85,8
HCPCS,21480,CLOSED TX TEMPOROMANDIBULAR DISLOCATION 1ST/SBSQ,685.5,445.57500000000005,0.01,4392.0,322
HCPCS,21485,CLOSED TX TEMPOROMANDIBULAR DISLC COMP 1ST/SBSQ,1908.0,1240.2,1.1,4447.63,148
HCPCS,21485,CLTX TMPRMAND DISLC COMP,,,1323.06,1614.71,20
HCPCS,21485,Cltx tmprmand dislc comp,,,824.67,954.88,8
HCPCS,21490,OPEN TREATMENT TEMPOROMANDIBULAR DISLOCATION,5180.0,3367.0,1.1,9391.15,144
HCPCS,21490,OPTX TMPRMAND DISLOCATION,,,2793.19,3450.35,20
HCPCS,21490,Optx tmprmand dislocation,,,2059.35,2384.51,8
HCPCS,21497,INTERDENTAL WIRING OTHER THAN FRACTURE,4335.0,2817.75,1.1,6814.0,235
HCPCS,21499,OCCLUSAL ORTHOTIC DVC,302.0,196.3,0.01,2384.51,85
HCPCS,21499,RESECTION OF HYOID BONE (COMP 60280),1626.0,1056.9,0.01,1626.0,84
HCPCS,21501,I&D DEEP ABSC/HMTMA SOFT TISSUE NECK/THORAX,1592.0,1034.8,1.1,8286.13,148
HCPCS,21501,I&D DP ABSC/HMTMA SFT TS NCK,,,2465.15,3022.89,20
HCPCS,21501,I&d dp absc/hmtma sft ts nck,,,1722.25,1994.18,8
HCPCS,21502,I&D DP ABS/HMTM NCK RIB OSTC,,,2808.13,3405.12,20
HCPCS,21502,I&D DP ABSC/HMTMA SOFT TISS NCK/THORAX PRTL RI,3020.0,1963.0,1.1,9440.12,144
HCPCS,21502,I&d dp abs/hmtm nck rib ostc,,,1722.25,1994.18,8
HCPCS,21510,INC DEEP OPNG B1 CRTX THORAX,,,3095.56,3405.12,12
HCPCS,21510,INCISION DEEP OPENING BONE CORTEX THORAX,2480.0,1612.0,1.1,2480.0,144
HCPCS,21510,Inc deep opng b1 crtx thorax,,,1722.25,1994.18,8
HCPCS,21550,BIOPSY SOFT TISSUE NECK/CHEST,844.0,548.6,1.1,4729.25,148
HCPCS,21550,BIOPSY SOFT TISSUE NECK/THORAX,7453.0,4844.45,0.01,7453.0,174
HCPCS,21552,EXC TUMOR SOFT TIS NECK/ANT THORAX SUBQ 3 CM/>,13165.0,8557.25,0.01,13165.0,87
HCPCS,21552,EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBQ 3+CM,2596.0,1687.4,1.1,8286.13,144
HCPCS,21554,EXC NECK TUM DEEP 5 CM/>,,,2465.15,10364.0,22
HCPCS,21554,EXC TUMOR SOFT TISSUE NECK/THORAX SUBFASC 5+CM,4452.0,2893.8,1.1,8286.13,144
HCPCS,21554,Exc neck tum deep 5 cm/>,,,1722.25,1994.18,8
HCPCS,21555,EXC TUMOR SOFT TISSUE NECK/ANT THORAX SUBQ <3CM,4518.5,2937.0249999999996,0.01,7453.0,235
HCPCS,21556,EXC TUMOR SOFT TISS NECK/THORAX SUBFASCIAL <5CM,8114.5,5274.425,0.01,13165.0,231
HCPCS,21557,RAD RESECT TUMOR SOFT TISS NECK/ANT THORAX <5CM,5900.0,3835.0,1.1,8286.13,144
HCPCS,21557,RESECT NECK THORAX TUMOR<5CM,,,2465.15,3022.89,20
HCPCS,21557,Resect neck thorax tumor<5cm,,,1722.25,1994.18,8
HCPCS,21558,RAD RESECT TUMOR SOFT TISS NECK/ANT THORAX 5+CM,8632.0,5610.8,1.1,8632.0,144
HCPCS,21558,RESECT NECK TUMOR 5 CM/>,,,2465.15,3022.89,20
HCPCS,21558,Resect neck tumor 5 cm/>,,,3174.61,3675.86,8
HCPCS,21600,EXCISION RIB PARTIAL,2904.0,1887.6,1.1,20863.78,144
HCPCS,21600,PARTIAL REMOVAL OF RIB,,,6206.54,7551.43,20
HCPCS,21600,Partial removal of rib,,,1722.25,1994.18,8
HCPCS,21601,EXC CHEST WALL TUMOR W/RIBS,,,2465.15,3022.89,20
HCPCS,21601,EXCISION CHEST WALL TUMOR INCLUDING RIBS,7112.0,4622.8,1.1,8286.13,144
HCPCS,21601,Exc chest wall tumor w/ribs,,,1722.25,1994.18,8
HCPCS,21602,EXC CH WAL TUM W/O LYMPHADEC,,,3986.97,7551.43,13
HCPCS,21602,EXCISION CH WAL TUM W/RIB W/O MEDSTNL LYMPHADEC,8876.0,5769.4,1.1,8876.0,144
HCPCS,21602,Exc ch wal tum w/o lymphadec,,,3174.61,3675.86,8
HCPCS,21603,EXC CH WAL TUM W/LYMPHADEC,,,4380.19,7551.43,13
HCPCS,21603,EXCISION CH WAL TUM W/RIB W/MEDSTNL LYMPHADEC,10068.0,6544.2,1.1,10068.0,144
HCPCS,21603,Exc ch wal tum w/lymphadec,,,3174.61,3675.86,8
HCPCS,21610,COSTOTRANSVERSECTOMY,,,2808.13,3405.12,20
HCPCS,21610,COSTOTRANSVERSECTOMY SEPARATE PROCEDURE,6364.0,4136.6,1.1,9440.12,144
HCPCS,21610,Costotransversectomy,,,3812.17,4414.09,8
HCPCS,21615,EXCISION 1ST &/CERVICAL RIB,4180.0,2717.0,1.1,7624.0,157
HCPCS,21615,Excision 1st &/cervical rib,,,3174.61,3675.86,8
HCPCS,21616,EXC 1ST&/CRV RIB W/SYMPTH,,,6864.94,7551.43,12
HCPCS,21616,EXCISION 1ST &/CERVICAL RIB W/SYMPATHECTOMY,5076.0,3299.4,1.1,5076.0,144
HCPCS,21616,Exc 1st&/crv rib w/sympth,,,3174.61,3675.86,8
HCPCS,21620,OSTECTOMY STERNUM PARTIAL,2912.0,1892.8,1.1,3405.12,156
HCPCS,21620,Ostectomy sternum partial,,,1722.25,1994.18,8
HCPCS,21627,STERNAL DEBRIDEMENT,2920.0,1898.0,1.1,3405.12,156
HCPCS,21627,Sternal debridement,,,1722.25,1994.18,8
HCPCS,21630,RADICAL RESECTION STERNUM,,,6864.94,7551.43,12
HCPCS,21630,RADICAL RESECTN STERNUM,7672.0,4986.8,1.1,7672.0,144
HCPCS,21630,Radical resection sternum,,,3174.61,3675.86,8
HCPCS,21632,Extensive sternum surgery,,,3174.61,3675.86,8
HCPCS,21685,HYOID MYOTOMY & SUSPENSION,,,5080.55,6160.68,20
HCPCS,21685,HYOID MYOTOMY AND SUSPENSION,6104.0,3967.6,1.1,17080.38,144
HCPCS,21685,Hyoid myotomy & suspension,,,4527.92,5242.85,8
HCPCS,21700,DIVISION SCALENUS ANTICUS W/O RESCJ CERVICAL RIB,2524.0,1640.6,1.1,20863.78,144
HCPCS,21700,REVISION OF NECK MUSCLE,,,6206.54,7551.43,20
HCPCS,21700,Revision of neck muscle,,,3812.17,4414.09,8
HCPCS,21705,DIVISION SCALENUS ANTICUS RESECTION CERVICAL RIB,3968.0,2579.2,1.1,3968.0,144
HCPCS,21705,REVISION OF NECK MUSCLE/RIB,,,6864.94,7551.43,12
HCPCS,21705,Revision of neck muscle/rib,,,3812.17,4414.09,8
HCPCS,21720,DIVISION STERNOCLEIDOMASTOID OPEN W/O CAST,2320.0,1508.0,1.1,9440.12,144
HCPCS,21720,REVISION OF NECK MUSCLE,,,2808.13,3405.12,20
HCPCS,21720,Revision of neck muscle,,,1722.25,1994.18,8
HCPCS,21725,REVISION OF NECK MUSCLE,,,610.39,736.94,20
HCPCS,21725,Revision of neck muscle,,,3812.17,4414.09,8
HCPCS,21740,RECONSTRUCTION OF STERNUM,,,2688.05,7551.43,13
HCPCS,21740,REPAIR PECTUS EXCAVATUM/CARINATUM OPEN,7028.0,4568.2,1.1,7028.0,144
HCPCS,21740,Reconstruction of sternum,,,3174.61,3675.86,8
HCPCS,21742,REPAIR PECTUS EXCAVATM/CARINATM MINLY W/O THRSC,9670.0,6285.5,1.1,9670.0,106
HCPCS,21742,REPAIR STERN/NUSS W/O SCOPE,,,2808.13,8450.24,21
HCPCS,21742,Repair stern/nuss w/o scope,,,1722.25,1994.18,8
HCPCS,21743,REPAIR PECTUS EXCAVATM/CARINATM MINLY W/THRSC,10772.0,7001.8,1.1,10772.0,106
HCPCS,21743,REPAIR STERNUM/NUSS W/SCOPE,,,2808.13,8450.24,21
HCPCS,21743,Repair sternum/nuss w/scope,,,1722.25,1994.18,8
HCPCS,21750,CLOSE MEDIAN STERNOTOMY SEP W/WO DEBRIDEMENT SPX,4560.0,2964.0,1.1,4560.0,144
HCPCS,21750,REPAIR OF STERNUM SEPARATION,,,1770.92,7551.43,13
HCPCS,21750,Repair of sternum separation,,,3174.61,3675.86,8
HCPCS,21811,OPEN TX RIB FX W/FIXJ THORACOSCOPIC VIS 1-3 RIBS,4316.0,2805.4,1.1,20863.78,144
HCPCS,21811,OPTX OF RIB FX W/FIXJ SCOPE,,,6206.54,18676.74,21
HCPCS,21811,Optx of rib fx w/fixj scope,,,3603.21,4172.14,8
HCPCS,21812,OPEN TX RIB FX W/FIXJ THORACOSCOPIC VIS 4-6 RIBS,5200.0,3380.0,1.1,20863.78,144
HCPCS,21812,TREATMENT OF RIB FRACTURE,,,6206.54,18676.74,21
HCPCS,21812,Treatment of rib fracture,,,3603.21,4172.14,8
HCPCS,21813,OPEN TX RIB FX W/FIXJ THORACOSCOPIC VIS 7+ RIBS,7044.0,4578.6,1.1,7044.0,144
HCPCS,21813,TREATMENT OF RIB FRACTURE,,,1394.34,4195.84,21
HCPCS,21813,Treatment of rib fracture,,,3603.21,4172.14,8
HCPCS,21820,CLOSED TREATMENT STERNUM FRACTURE,1103.0,716.95,193.39,4392.0,87
HCPCS,21825,OPEN TX STERNUM FRACTURE W/WO SKELETAL FIXATION,3104.0,2017.6,1.1,3104.0,144
HCPCS,21825,TREAT STERNUM FRACTURE,,,1445.21,7551.43,13
HCPCS,21825,Treat sternum fracture,,,3603.21,4172.14,8
HCPCS,21899,DEBRIDE NECROTIZING TISS INFECT; NECK,3564.0,2316.6,0.01,3564.0,84
HCPCS,21899,EXPLORE FOR POST-OP WOUND DEHISCENCE/NECK,1313.0,853.45,0.01,1313.0,84
HCPCS,21899,INTRALESIONAL STEROID INJ,822.5,534.625,0.01,12615.0,168
HCPCS,21899,PECTORALIS MINOR TENDON RELEASE (COMP CODE 23405),2818.0,1831.7,0.01,2818.0,84
HCPCS,21899,PLATYSMAL MYOTOMY FOR SYNKINESIS/TIGHTNESS FOR FACIAL NERVE SPAS,2105.0,1368.25,0.01,2105.0,84
HCPCS,21899,STERNAL NONUNION TAKEDOWN (COMP CODE 27470),6171.0,4011.15,0.01,6171.0,84
HCPCS,21920,BIOPSY SOFT TISSUE BACK/FLANK SUPERFICIAL,4148.5,2696.525,0.01,7453.0,235
HCPCS,21925,BIOPSY SOFT TISSUE BACK/FLANK DEEP,1852.0,1203.8,1.1,4729.25,148
HCPCS,21925,BIOPSY SOFT TISSUE OF BACK,,,1406.56,1718.79,20
HCPCS,21925,Biopsy soft tissue of back,,,1351.24,1564.6,8
HCPCS,21930,EXCISION TUMOR SOFT TISSUE BACK/FLANK SUBQ <3CM,4714.5,3064.425,0.01,7453.0,235
HCPCS,21931,EXCISION TUMOR SOFT TIS BACK/FLANK SUBQ 3 CM/>,7453.0,4844.45,0.01,10364.0,174
HCPCS,21931,EXCISION TUMOR SOFT TISSUE BACK/FLANK SUBQ 3+CM,2752.0,1788.8,1.1,4729.25,144
HCPCS,21932,EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL <5CM,8546.5,5555.225,0.01,13165.0,231
HCPCS,21933,EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL 5 CM/>,13165.0,8557.25,0.01,13165.0,87
HCPCS,21933,EXC TUMOR SOFT TISS BACK/FLANK SUBFASCIAL 5+CM,4452.0,2893.8,1.1,8286.13,144
HCPCS,21935,RAD RESECTION TUMOR SOFT TISSUE BACK/FLANK <5CM,6288.0,4087.2,1.1,8286.13,144
HCPCS,21935,RESECT BACK TUM < 5 CM,,,2465.15,3022.89,20
HCPCS,21935,Resect back tum < 5 cm,,,1351.24,1564.6,8
HCPCS,21936,RAD RESECTION TUMOR SOFT TISSUE BACK/FLANK 5+CM,9020.0,5863.0,1.1,9020.0,144
HCPCS,21936,RESECT BACK TUM 5 CM/>,,,2465.15,3022.89,20
HCPCS,21936,Resect back tum 5 cm/>,,,1351.24,1564.6,8
HCPCS,22010,I&D DEEP ABSCESS PST SPINE CRV THRC/CERVICOTHR,5100.0,3315.0,1.1,5100.0,144
HCPCS,22010,I&D P-SPINE C/T/CERV-THOR,,,2560.61,7551.43,13
HCPCS,22010,I&d p-spine c/t/cerv-thor,,,9326.79,10799.44,8
HCPCS,22015,I&D ABSCESS P-SPINE L/S/LS,,,2496.52,7551.43,13
HCPCS,22015,I&D DEEP ABSCESS PST SPINE LUMBAR SAC/LUMBOSAC,5056.0,3286.4,1.1,5056.0,144
HCPCS,22015,I&d abscess p-spine l/s/ls,,,9326.79,10799.44,8
HCPCS,22100,PRTL EXC PST VRT INTRNSC B1Y LES 1 VRT SGM CRV,4400.0,2860.0,1.1,20863.78,144
HCPCS,22100,REMOVE PART OF NECK VERTEBRA,,,6206.54,7551.43,20
HCPCS,22100,Remove part of neck vertebra,,,3812.17,4414.09,8
HCPCS,22101,PRTL EXC PST VRT INTRNSC B1Y LES 1 VRT SGM THRC,4432.0,2880.8,1.1,20863.78,144
HCPCS,22101,REMOVE PART THORAX VERTEBRA,,,6206.54,7551.43,20
HCPCS,22101,Remove part thorax vertebra,,,3812.17,4414.09,8
HCPCS,22102,PRTL EXC PST VRT INTRNSC B1Y LES 1 VRT SGM LMBR,4432.0,2880.8,1.1,20863.78,144
HCPCS,22102,REMOVE PART LUMBAR VERTEBRA,,,6206.54,11170.0,21
HCPCS,22102,Remove part lumbar vertebra,,,3812.17,4414.09,8
HCPCS,22103,PRTL EXC PST VRT INTRNSC B1Y LES 1 VRT SGM EA,936.0,608.4,1.1,936.0,144
HCPCS,22103,Remove extra spine segment,,,3812.17,4414.09,8
HCPCS,22110,PRTL EXC VRT BDY B1Y LES W/O SPI CORD 1 SGM CRV,5600.0,3640.0,1.1,5600.0,144
HCPCS,22110,REMOVE PART OF NECK VERTEBRA,,,2799.7,7551.43,13
HCPCS,22110,Remove part of neck vertebra,,,9326.79,10799.44,8
HCPCS,22112,PRTL EXC VRT BDY B1Y LES W/O SPI CORD 1 SGM THRC,5628.0,3658.2,1.1,5628.0,144
HCPCS,22112,REMOVE PART THORAX VERTEBRA,,,3021.54,7551.43,13
HCPCS,22112,Remove part thorax vertebra,,,9326.79,10799.44,8
HCPCS,22114,PRTL EXC VRT BDY B1Y LES W/O SPI CORD 1 SGM LMBR,5628.0,3658.2,1.1,5628.0,144
HCPCS,22114,REMOVE PART LUMBAR VERTEBRA,,,3021.54,7551.43,13
HCPCS,22114,Remove part lumbar vertebra,,,9326.79,10799.44,8
HCPCS,22116,PRTL EXC VRT BDY B1Y LES W/O SPI CORD 1 SGM EA,928.0,603.2,1.1,928.0,144
HCPCS,22116,REMOVE EXTRA SPINE SEGMENT,,,370.83,370.83,1
HCPCS,22116,Remove extra spine segment,,,9326.79,10799.44,8
HCPCS,22206,INCIS SPINE 3 COLUMN THORAC,,,6479.39,7551.43,13
HCPCS,22206,Incis spine 3 column thorac,,,3812.17,4414.09,8
HCPCS,22206,OSTEOTOMY SPINE POSTERIOR 3 COLUMN THORACIC,14872.0,9666.8,1.1,14872.0,144
HCPCS,22207,INCIS SPINE 3 COLUMN LUMBAR,,,6334.06,7551.43,13
HCPCS,22207,Incis spine 3 column lumbar,,,3812.17,4414.09,8
HCPCS,22207,OSTEOTOMY SPINE POSTERIOR 3 COLUMN LUMBAR,14672.0,9536.8,1.1,14672.0,144
HCPCS,22208,INCIS SPINE 3 COLUMN ADL SEG,,,1553.14,1553.14,1
HCPCS,22208,Incis spine 3 column adl seg,,,3812.17,4414.09,8
HCPCS,22208,OSTEOTOMY SPINE POSTERIOR 3 COLUMN EA ADDL SGM,3864.0,2511.6,1.1,3864.0,144
HCPCS,22210,INCIS 1 VERTEBRAL SEG CERV,,,4724.09,7551.43,13
HCPCS,22210,Incis 1 vertebral seg cerv,,,3812.17,4414.09,8
HCPCS,22210,OSTEOTOMY SPINE PST/PSTLAT APPR 1 VRT SGM CRV,10152.0,6598.8,1.1,10152.0,144
HCPCS,22212,INCIS 1 VERTEBRAL SEG THORAC,,,3987.88,7551.43,13
HCPCS,22212,Incis 1 vertebral seg thorac,,,3812.17,4414.09,8
HCPCS,22212,OSTEOTOMY SPINE PST/PSTLAT APPR 1 VRT SGM THRC,8396.0,5457.4,1.1,8396.0,144
HCPCS,22214,INCIS 1 VERTEBRAL SEG LUMBAR,,,3989.49,7551.43,13
HCPCS,22214,Incis 1 vertebral seg lumbar,,,3812.17,4414.09,8
HCPCS,22214,OSTEOTOMY SPINE PST/PSTLAT APPR 1 VRT SGM LMBR,8408.0,5465.2,1.1,8408.0,144
HCPCS,22216,INCIS ADDL SPINE SEGMENT,,,950.97,950.97,1
HCPCS,22216,Incis addl spine segment,,,9326.79,10799.44,8
HCPCS,22216,OSTEOT SPI PST/PSTLAT APPR 1 VRT SGM EA VRT SGM,2653.0,1724.45,1.1,2653.0,144
HCPCS,22220,OSTEOT DSC ANT 1 VRT SGM CRV,,,4267.74,7551.43,13
HCPCS,22220,OSTEOTOMY SPINE W/DSC ANT APPR 1 VRT SGM CRV,9176.0,5964.4,1.1,9176.0,144
HCPCS,22220,Osteot dsc ant 1 vrt sgm crv,,,3812.17,4414.09,8
HCPCS,22222,OSTEOT DSC ANT 1VRT SGM THRC,,,4687.07,7551.43,13
HCPCS,22222,OSTEOTOMY SPINE W/DSC ANT APPR 1 VRT SGM THRC,9236.0,6003.4,1.1,9236.0,144
HCPCS,22222,Osteot dsc ant 1vrt sgm thrc,,,3812.17,4414.09,8
HCPCS,22224,OSTEOT DSC ANT 1VRT SGM LMBR,,,4155.95,7551.43,13
HCPCS,22224,OSTEOTOMY SPINE W/DSC ANT APPR 1 VRT SGM LUMBAR,9236.0,6003.4,1.1,9236.0,144
HCPCS,22224,Osteot dsc ant 1vrt sgm lmbr,,,3812.17,4414.09,8
HCPCS,22226,OSTEOT DSC ANT 1VRT SGM EA,,,940.97,940.97,1
HCPCS,22226,OSTEOTOMY SPINE W/DSC ANT APPR 1 VRT SGM EA ADDL,2412.0,1567.8,1.1,2412.0,144
HCPCS,22226,Osteot dsc ant 1vrt sgm ea,,,3812.17,4414.09,8
HCPCS,22310,CLTX VRT BDY FX W/O MANJ REQ&W/CSTING/BRACING,1241.5,806.975,0.01,4392.0,322
HCPCS,22315,CLOSED TX VERT FX W/MANJ,,,2808.13,3405.12,20
HCPCS,22315,CLTX VRT FX&/DISLC CSTING/BRACING MANJ/TRCJ,4044.0,2628.6,1.1,9440.12,148
HCPCS,22315,Closed tx vert fx w/manj,,,295.11,341.7,8
HCPCS,22318,OPTX&/RDCTJ ODNTD FX&/DISLC ANT FIXJ W/O GRAFT,9088.0,5907.2,1.1,9088.0,144
HCPCS,22318,TREAT ODONTOID FX W/O GRAFT,,,4402.06,13361.02,13
HCPCS,22318,Treat odontoid fx w/o graft,,,9326.79,10799.44,8
HCPCS,22319,TREAT ODONTOID FX W/GRAFT,,,4886.9,13361.02,13
HCPCS,22319,Treat odontoid fx w/graft,,,9326.79,10799.44,8
HCPCS,22325,OPTX&/RDCTJ VRT FX&/DISLC PST 1 VRT SGM LM,7948.0,5166.2,1.1,7948.0,144
HCPCS,22325,TREAT SPINE FRACTURE,,,3907.16,13361.02,13
HCPCS,22325,Treat spine fracture,,,9326.79,10799.44,8
HCPCS,22326,OPTX&/RDCTJ VRT FX&/DISLC PST 1 VRT SGM CR,8336.0,5418.4,1.1,8336.0,144
HCPCS,22326,TREAT NECK SPINE FRACTURE,,,4007.11,13361.02,13
HCPCS,22326,Treat neck spine fracture,,,9326.79,10799.44,8
HCPCS,22327,OPTX&/RDCTJ VRT FX&/DISLC PST 1 VRT SGM TH,8308.0,5400.2,1.1,8308.0,144
HCPCS,22327,TREAT THORAX SPINE FRACTURE,,,4073.97,13361.02,13
HCPCS,22327,Treat thorax spine fracture,,,9326.79,10799.44,8
HCPCS,22328,OPTX&/RDCTJ VRT FX&/DISLC PST 1 VRT SGM EA,1840.0,1196.0,1.1,1840.0,144
HCPCS,22328,TREAT EACH ADD SPINE FX,,,742.02,742.02,1
HCPCS,22328,Treat each add spine fx,,,9326.79,10799.44,8
HCPCS,22505,MANIPULATION OF SPINE,,,1394.34,1673.41,20
HCPCS,22505,MANIPULATION SPINE W ANESTHESIA,748.0,486.2,1.1,4686.39,144
HCPCS,22505,Manipulation of spine,,,824.67,954.88,8
HCPCS,22510,PERQ VERTEBROPLASTY UNI/BI INJX CERVICOTHORACIC,9042.5,5877.625,1.1,33436.0,322
HCPCS,22511,PERQ VERTEBROPLASTY UNI/BI INJECTION LUMBOSACRAL,8928.5,5803.525,1.1,33436.0,235
HCPCS,22512,VERTEBROPLASTY EACH ADDL CERVICOTHOR/LUMBOSACRAL,3050.5,1982.825,1.1,33436.0,217
HCPCS,22513,PERQ VERT AGMNTJ CAVITY CRTJ UNI/BI CANNULATION,3460.0,2249.0,0.01,33436.0,470
HCPCS,22514,PERQ VERT AGMNTJ CAVITY CRTJ UNI/BI CANNULJ LMBR,18028.5,11718.525000000001,0.01,33436.0,322
HCPCS,22515,PERQ VERT AGMNTJ CAVITY CRTJ UNI/BI CANNULJ EACH,6348.5,4126.525,0.01,33436.0,286
HCPCS,22526,"PERC INTRADISC ELECTRO ANNULOPLASTY, SINGLE LEVEL",2340.0,1521.0,1.1,6640.41,114
HCPCS,22526,PERQ INTRDSCL ELECTROTHRM ANNULOPLASTY 1 LEVEL,5573.0,3622.45,1214.91,10364.0,66
HCPCS,22527,PERQ INTRDSCL ELECTROTHRM ANNULOPLASTY ADDL LVL,2174.5,1413.425,1.1,10364.0,180
HCPCS,22532,ARTHRD LAT XTRCVTRY TQ THRC,,,4741.08,13361.02,13
HCPCS,22532,ARTHRODESIS LATERAL EXTRACAVITARY THORACIC,10396.0,6757.4,1.1,10396.0,144
HCPCS,22532,Arthrd lat xtrcvtry tq thrc,,,14056.95,16276.47,8
HCPCS,22533,ARTHRD LAT XTRCVTRY TQ LMBR,,,4369.7,18247.18,13
HCPCS,22533,ARTHRODESIS LATERAL EXTRACAVITARY LUMBAR,9916.0,6445.4,1.1,9916.0,144
HCPCS,22533,Arthrd lat xtrcvtry tq lmbr,,,14056.95,16276.47,8
HCPCS,22534,ARTHRD LAT XTRCVTRY TQ EA AD,,,947.82,947.82,1
HCPCS,22534,ARTHRODESIS LAT EXTRACAVITARY EA ADDL THRC/LMBR,2396.0,1557.4,1.1,2396.0,144
HCPCS,22534,Arthrd lat xtrcvtry tq ea ad,,,14056.95,16276.47,8
HCPCS,22548,ARTHRD ANT TORAL/XORAL C1-C2,,,5237.87,13361.02,13
HCPCS,22548,ARTHRD ANT TRANSORL/XTRORAL C1-C2 W/WO EXC ODNTD,10824.0,7035.6,1.1,10824.0,144
HCPCS,22548,Arthrd ant toral/xoral c1-c2,,,14056.95,16276.47,8
HCPCS,22551,ARTHRD ANT INTERBODY DECOMPRESS CERVICAL BELW C2,11000.0,7150.0,1.1,38384.94,144
HCPCS,22551,ARTHRD ANT NTRBDY CERVICAL,,,4616.0,34359.11,23
HCPCS,22551,Arthrd ant ntrbdy cervical,,,9326.79,10799.44,8
HCPCS,22552,ARTHRD ANT INTERDY CERVCL BELW C2 EA ADDL NTRSPC,2600.0,1690.0,1.1,2600.0,144
HCPCS,22552,Arthrd ant ntrbd cervical ea,,,9326.79,10799.44,8
HCPCS,22554,ARTHRD ANT INTERBODY MIN DSC CRV BELOW C2,7784.0,5059.6,1.1,38384.94,144
HCPCS,22554,ARTHRD ANT NTRBD MIN DSC CRV,,,11418.01,34359.11,21
HCPCS,22554,Arthrd ant ntrbd min dsc crv,,,9326.79,10799.44,8
HCPCS,22556,ARTHRD ANT INTERBODY MIN DSC THORACIC,9880.0,6422.0,1.1,9880.0,144
HCPCS,22556,ARTHRD ANT NTRBD MIN DSC THC,,,4455.46,18247.18,13
HCPCS,22556,Arthrd ant ntrbd min dsc thc,,,14056.95,16276.47,8
HCPCS,22558,ARTHRD ANT INTERBODY MIN DSC LUMBAR,10353.0,6729.45,1.1,10353.0,144
HCPCS,22558,ARTHRD ANT NTRBD MIN DSC LUM,,,4023.11,28237.96,13
HCPCS,22558,Arthrd ant ntrbd min dsc lum,,,9326.79,10799.44,8
HCPCS,22585,ARTHRD ANT NTRBD MIN DSC EA ADDL INTERSPACE,2429.0,1578.85,1.1,2429.0,144
HCPCS,22585,Arthrd ant ntrbd min dsc ea,,,9326.79,10799.44,8
HCPCS,22586,ARTHRD PRE-SAC NTRBDY L5-S1,,,5418.71,18247.18,13
HCPCS,22586,ARTHRODESIS PRESACRAL INTRBDY W/INSTRUMENT L5/S1,11248.0,7311.2,1.1,11248.0,144
HCPCS,22586,Arthrd pre-sac ntrbdy l5-s1,,,9326.79,10799.44,8
HCPCS,22590,ARTHRD PST TQ CRANIOCERVICAL,,,4221.24,13361.02,13
HCPCS,22590,ARTHRODESIS POSTERIOR CRANIOCERVICAL,8704.0,5657.6,1.1,8704.0,144
HCPCS,22590,Arthrd pst tq craniocervical,,,14056.95,16276.47,8
HCPCS,22595,ARTHRD PST TQ ATLAS-AXIS,,,4033.28,13361.02,13
HCPCS,22595,ARTHRODESIS POSTERIOR ATLAS-AXIS C1-C2,8256.0,5366.4,1.1,8256.0,144
HCPCS,22595,Arthrd pst tq atlas-axis,,,14056.95,16276.47,8
HCPCS,22600,ARTHRD PST TQ 1NTRSPC CRV,,,3450.78,18247.18,13
HCPCS,22600,ARTHRD PST/PSTLAT TQ 1NTRSPC CRV BELW C2 SEGMENT,6960.0,4524.0,1.1,6960.0,144
HCPCS,22600,Arthrd pst tq 1ntrspc crv,,,9326.79,10799.44,8
HCPCS,22610,ARTHRD PST TQ 1NTRSPC THRC,,,3388.67,18247.18,13
HCPCS,22610,ARTHRODESIS POSTERIOR/PSTLAT TQ 1NTRSPC THORACIC,7603.0,4941.95,1.1,7603.0,144
HCPCS,22610,Arthrd pst tq 1ntrspc thrc,,,14056.95,16276.47,8
HCPCS,22612,ARTHRD PST TQ 1NTRSPC LUMBAR,,,4616.0,48652.21,22
HCPCS,22612,ARTHRODESIS POSTERIOR/PSTLAT TQ 1NTRSPC LUMBAR,10353.0,6729.45,1.1,54351.12,144
HCPCS,22612,Arthrd pst tq 1ntrspc lumbar,,,9326.79,10799.44,8
HCPCS,22614,ARTHRODESIS PST/PSTLAT TQ 1NTRSPC EA ADDL NTRSPC,2829.0,1838.85,1.1,2829.0,144
HCPCS,22614,Arthrd pst tq 1ntrspc ea add,,,9326.79,10799.44,8
HCPCS,22630,ARTHRD PST TQ 1NTRSPC LUM,,,16167.8,28237.96,21
HCPCS,22630,ARTHRODESIS POSTERIOR INTERBODY 1 NTRSPC LUMBAR,9720.0,6318.0,1.1,54351.12,144
HCPCS,22630,Arthrd pst tq 1ntrspc lum,,,9326.79,10799.44,8
HCPCS,22632,ARTHRODESIS POSTERIOR INTERBODY 1 NTRSPC EA ADDL,2297.0,1493.05,1.1,2297.0,144
HCPCS,22632,Arthrd pst tq 1ntrspc lm ea,,,9326.79,10799.44,8
HCPCS,22633,ARTHRD CMBN 1NTRSPC LUMBAR,,,16167.8,48652.21,21
HCPCS,22633,ARTHRODESIS COMBINED TQ 1NTRSPC LUMBAR,11792.0,7664.8,1.1,54351.12,144
HCPCS,22633,Arthrd cmbn 1ntrspc lumbar,,,14056.95,16276.47,8
HCPCS,22634,ARTHRODESIS CMBN TQ 1NTRSPC EACH ADDITIONAL,3502.0,2276.3,1.1,3502.0,144
HCPCS,22634,Arthrd cmbn 1ntrspc ea addl,,,9326.79,10799.44,8
HCPCS,22800,ARTHRD PST DFRM<6 VRT SGM,,,3600.47,18247.18,13
HCPCS,22800,ARTHRODESIS POSTERIOR SPINAL DFRM <6 VRT SGM,8580.0,5577.0,1.1,8580.0,144
HCPCS,22800,Arthrd pst dfrm<6 vrt sgm,,,14056.95,16276.47,8
HCPCS,22802,ARTHRD PST DFRM 7-12 VRT SGM,,,5580.89,18247.18,13
HCPCS,22802,ARTHRODESIS POSTERIOR SPINAL DFRM 7-12 VRT SGM,14128.0,9183.2,1.1,14128.0,144
HCPCS,22802,Arthrd pst dfrm 7-12 vrt sgm,,,14056.95,16276.47,8
HCPCS,22804,ARTHRD PST DFRM 13+ VRT SGM,,,6406.07,18247.18,13
HCPCS,22804,ARTHRODESIS POSTERIOR SPINAL DFRM 13+ VRT SGM,16500.0,10725.0,1.1,16500.0,144
HCPCS,22804,Arthrd pst dfrm 13+ vrt sgm,,,14056.95,16276.47,8
HCPCS,22808,ARTHRD ANT DFRM 2-3 VRT SGM,,,4829.88,18247.18,13
HCPCS,22808,ARTHRODESIS ANTERIOR SPINAL DFRM 2-3 VRT SGM,11004.0,7152.6,1.1,11004.0,144
HCPCS,22808,Arthrd ant dfrm 2-3 vrt sgm,,,14056.95,16276.47,8
HCPCS,22810,ARTHRD ANT DFRM 4-7 VRT SGM,,,5245.62,18247.18,13
HCPCS,22810,ARTHRODESIS ANTERIOR SPINAL DFRM 4-7 VRT SGM,12600.0,8190.0,1.1,12600.0,144
HCPCS,22810,Arthrd ant dfrm 4-7 vrt sgm,,,14056.95,16276.47,8
HCPCS,22812,ARTHRD ANT DFRM 8+ VRT SGM,,,5746.25,18247.18,13
HCPCS,22812,ARTHRODESIS ANTERIOR SPINAL DFRM 8+ VRT SGM,13700.0,8905.0,1.1,13700.0,144
HCPCS,22812,Arthrd ant dfrm 8+ vrt sgm,,,14056.95,16276.47,8
HCPCS,22818,KYPHECTOMY 1-2 SEGMENTS,,,5616.34,18247.18,13
HCPCS,22818,"KYPHECTOMY, 1-2 SEGMENTS",13732.0,8925.8,1.1,13732.0,144
HCPCS,22818,Kyphectomy 1-2 segments,,,14056.95,16276.47,8
HCPCS,22819,KYPHECTOMY 3 OR MORE,,,6463.3,18247.18,13
HCPCS,22819,"KYPHECTOMY, 3 & MORE SEGMENT",15752.0,10238.8,1.1,15752.0,144
HCPCS,22819,Kyphectomy 3 or more,,,14056.95,16276.47,8
HCPCS,22830,EXPLORATION OF SPINAL FUSION,4937.0,3209.05,1.1,7551.43,157
HCPCS,22830,Exploration of spinal fusion,,,3812.17,4414.09,8
HCPCS,22836,ANT THORACIC VRT BODY TETHERING <7 VRT SEGMENTS,14080.0,9152.0,1.1,14080.0,142
HCPCS,22836,ANT THRC VRT BODY TETHRG <7,,,4489.41,18247.18,13
HCPCS,22836,Ant thrc vrt body tethrg <7,,,14056.95,16276.47,8
HCPCS,22837,ANT THORACIC VRT BODY TETHERING 8+ VRT SEGMENTS,15620.0,10153.0,1.1,15620.0,142
HCPCS,22837,ANT THRC VRT BODY TETHRG 8+,,,4947.02,18247.18,13
HCPCS,22837,Ant thrc vrt body tethrg 8+,,,14056.95,16276.47,8
HCPCS,22838,REV RPLC/RMV THRC VRT TETHRG,,,5012.97,18247.18,13
HCPCS,22838,REVJ RPLCMT/RMVL THORACIC VRT BODY TETHERING,15840.0,10296.0,1.1,15840.0,142
HCPCS,22838,Rev rplc/rmv thrc vrt tethrg,,,14056.95,16276.47,8
HCPCS,22840,Insert spine fixation device,,,14056.95,16276.47,8
HCPCS,22840,POSTERIOR NON-SEGMENTAL INSTRUMENTATION,5509.0,3580.85,1.1,5509.0,144
HCPCS,22841,INSERT SPINE FIXATION DEVICE,,,1096.0,1096.0,1
HCPCS,22841,INTERNAL SPINAL FIXATION WIRING SPINOUS PROCESS,2427.0,1577.55,1.1,2427.0,88
HCPCS,22841,Insert spine fixation device,,,9326.79,10799.44,8
HCPCS,22842,Insert spine fixation device,,,9326.79,10799.44,8
HCPCS,22842,POSTERIOR SEGMENTAL INSTRUMENTATION 3-6 VRT SEG,5526.0,3591.9,1.1,5526.0,144
HCPCS,22843,INSERT SPINE FIXATION DEVICE,,,2151.26,2151.26,1
HCPCS,22843,Insert spine fixation device,,,9326.79,10799.44,8
HCPCS,22843,POSTERIOR SEGMENTAL INSTRUMENTATION 7-12 VRT SEG,5914.0,3844.1,1.1,5914.0,144
HCPCS,22844,INSERT SPINE FIXATION DEVICE,,,2581.35,2581.35,1
HCPCS,22844,Insert spine fixation device,,,9326.79,10799.44,8
HCPCS,22844,POSTERIOR SEGMENTAL INSTRUMENTATION 13/> VRT SE,7225.0,4696.25,1.1,7225.0,144
HCPCS,22845,ANTERIOR INSTRUMENTATION 2-3 VERTEBRAL SEGMENTS,5254.0,3415.1,1.1,5254.0,144
HCPCS,22845,INSERT SPINE FIXATION DEVICE,,,9457.0,9457.0,1
HCPCS,22845,Insert spine fixation device,,,9326.79,10799.44,8
HCPCS,22846,ANTERIOR INSTRUMENTATION 4-7 VERTEBRAL SEGMENTS,5456.0,3546.4,1.1,5456.0,144
HCPCS,22846,INSERT SPINE FIXATION DEVICE,,,1991.57,1991.57,1
HCPCS,22846,Insert spine fixation device,,,14056.95,16276.47,8
HCPCS,22847,ANTERIOR INSTRUMENTATION 8/> VERTEBRAL SEGMENTS,6063.0,3940.95,1.1,6063.0,144
HCPCS,22847,INSERT SPINE FIXATION DEVICE,,,2080.56,2080.56,1
HCPCS,22847,Insert spine fixation device,,,14056.95,16276.47,8
HCPCS,22848,INSERT PELV FIXATION DEVICE,,,944.7,944.7,1
HCPCS,22848,Insert pelv fixation device,,,3812.17,4414.09,8
HCPCS,22848,PELVIC FIXATION OTHER THAN SACRUM,2636.0,1713.4,1.1,2636.0,144
HCPCS,22849,REINSERT SPINAL FIXATION,,,3447.28,13361.02,13
HCPCS,22849,REINSERTION SPINAL FIXATION DEVICE,8435.0,5482.75,1.1,8435.0,144
HCPCS,22849,Reinsert spinal fixation,,,9326.79,10799.44,8
HCPCS,22850,REMOVAL POSTERIOR NONSEGMENTAL INSTRUMENTATION,3928.0,2553.2,1.1,3928.0,144
HCPCS,22850,REMOVE SPINE FIXATION DEVICE,,,1940.14,7551.43,13
HCPCS,22850,Remove spine fixation device,,,3812.17,4414.09,8
HCPCS,22852,REMOVAL POSTERIOR SEGMENTAL INSTRUMENTATION,3748.0,2436.2,1.1,3748.0,144
HCPCS,22852,REMOVE SPINE FIXATION DEVICE,,,6864.94,7551.43,12
HCPCS,22852,Remove spine fixation device,,,3812.17,4414.09,8
HCPCS,22853,INSJ BIOMCHN DEV INTERVERTEBRAL DSC SPC W/ARTHRD,1870.0,1215.5,1.1,1870.0,144
HCPCS,22853,INSJ BIOMECHANICAL DEVICE,,,4132.0,7813.0,2
HCPCS,22853,Insj biomechanical device,,,9326.79,10799.44,8
HCPCS,22854,INSJ BIOMCHN DEV VRT CORPECTOMY DEFECT W/ARTHRD,2420.0,1573.0,1.1,2420.0,144
HCPCS,22854,Insj biomechanical device,,,14056.95,16276.47,8
HCPCS,22855,REMOVAL ANTERIOR INSTRMJ,,,2928.84,7551.43,13
HCPCS,22855,REMOVAL ANTERIOR INSTRUMENTATION,6978.0,4535.7,1.1,6978.0,144
HCPCS,22855,Removal anterior instrmj,,,3812.17,4414.09,8
HCPCS,22856,TOT DISC ARTHRP 1NTRSPC CRV,,,16167.8,48652.21,21
HCPCS,22856,TOTAL DISC ARTHRP ANT DSC 1 INTERSPACE CERVICAL,10582.0,6878.3,1.1,54351.12,144
HCPCS,22856,Tot disc arthrp 1ntrspc crv,,,14056.95,16276.47,8
HCPCS,22857,TOT DISC ARTHRP 1NTRSPC LMBR,,,4562.54,18247.18,13
HCPCS,22857,TOT DISC ARTHRP ANT DSC SINGLE INTERSPACE LUMBAR,10852.0,7053.8,1.1,10852.0,144
HCPCS,22857,Tot disc arthrp 1ntrspc lmbr,,,9326.79,10799.44,8
HCPCS,22858,TOT DISC ARTHRP ANT APPR DISC 2ND LEVEL CERVICAL,3360.0,2184.0,1.1,3360.0,144
HCPCS,22858,Tot disc arthrp 2nd lvl crv,,,14056.95,16276.47,8
HCPCS,22859,INSJ BIOMCHN DEV NTRVRT DISC SPACE W/O ARTHRD,2420.0,1573.0,1.1,2420.0,144
HCPCS,22859,Insj biomechanical device,,,9326.79,10799.44,8
HCPCS,22860,TOT DISC ARTHRP 2NTRSPC LMBR,,,900.47,900.47,1
HCPCS,22860,TOTAL DISC ARTHRP ANT SECOND INTERSPACE LUMBAR,2752.0,1788.8,1.1,2752.0,132
HCPCS,22860,Tot disc arthrp 2ntrspc lmbr,,,9326.79,10799.44,8
HCPCS,22861,REV RPLCM ARTHRP 1NTRSPC CRV,,,6179.96,18247.18,13
HCPCS,22861,REVJ RPLCMT DISC ARTHROPLASTY ANT 1 NTRSPC CRV,13344.0,8673.6,1.1,13344.0,142
HCPCS,22861,Rev rplcm arthrp 1ntrspc crv,,,9326.79,10799.44,8
HCPCS,22862,REV RPLCM RTHRP 1NTRSPC LMBR,,,6174.95,18247.18,13
HCPCS,22862,REVJ RPLCMT DISC ARTHROPLASTY ANT 1 NTRSPC LMBR,13052.0,8483.8,1.1,13052.0,130
HCPCS,22862,Rev rplcm rthrp 1ntrspc lmbr,,,9326.79,10799.44,8
HCPCS,22864,RMVL DISC ARTHROPLASTY ANT 1 INTERSPACE CERVICAL,11760.0,7644.0,1.1,11760.0,142
HCPCS,22864,RMVL TOT ARTHRP 1NTRSPC CRV,,,5516.47,7551.43,13
HCPCS,22864,Rmvl tot arthrp 1ntrspc crv,,,9326.79,10799.44,8
HCPCS,22865,RMVL DISC ARTHROPLASTY ANT 1 INTERSPACE LUMBAR,12700.0,8255.0,1.1,12700.0,130
HCPCS,22865,RMVL TOT ARTHRP 1NTRSPC LMBR,,,6025.62,7551.43,13
HCPCS,22865,Rmvl tot arthrp 1ntrspc lmbr,,,9326.79,10799.44,8
HCPCS,22867,INSJ STABLJ DEV W/DCMPRN,,,16167.8,18412.18,20
HCPCS,22867,INSJ STABLJ DEV W/DCMPRN LUMBAR SINGLE LEVEL,6000.0,3900.0,1.1,54351.12,142
HCPCS,22867,Insj stablj dev w/dcmprn,,,14056.95,16276.47,8
HCPCS,22868,INSJ STABLJ DEV W/DCMPRN LUMBAR SECOND LEVEL,1600.0,1040.0,1.1,1600.0,142
HCPCS,22868,Insj stablj dev w/dcmprn,,,14056.95,16276.47,8
HCPCS,22869,INSJ STABLJ DEV W/O DCMPRN,,,11418.01,13361.02,20
HCPCS,22869,INSJ STABLJ DEV W/O DCMPRN LUMBAR SINGLE LEVEL,2812.0,1827.8,1.1,38384.94,142
HCPCS,22869,Insj stablj dev w/o dcmprn,,,9326.79,10799.44,8
HCPCS,22870,INSJ STABLJ DEV W/O DCMPRN LUMBAR SECOND LEVEL,936.0,608.4,1.1,936.0,142
HCPCS,22870,Insj stablj dev w/o dcmprn,,,9326.79,10799.44,8
HCPCS,22899,IMAGE GUIDED VERTEBRAL BODY FIDUCIAL MARKER PLCMNT (COMP CODE 22,8084.5,5254.925,0.01,13324.0,168
HCPCS,22899,INTRAOSSEOUS DES LUMB/SACRUM,2719.0,1767.35,0.01,2719.0,84
HCPCS,22899,INTRAOSSEOUS DESTRUCT ADDL,1320.0,858.0,0.01,1320.0,84
HCPCS,22899,UNLISTED PROCEDURE SPINE,2412.0,1567.8,204.59,4628.0,84
HCPCS,22899,UNLISTED SPINE SURGERY OR PROCEDURE,661.0,429.65,0.01,889.37,84
HCPCS,22900,EXC ABDL TUM DEEP < 5 CM,,,2465.15,3022.89,20
HCPCS,22900,EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL <5CM,3328.0,2163.2,1.1,8286.13,144
HCPCS,22900,Exc abdl tum deep < 5 cm,,,1351.24,1564.6,8
HCPCS,22901,EXC TUMOR SOFT TISSUE ABDL WALL SUBFASCIAL 5+CM,8604.5,5592.925,0.01,13165.0,231
HCPCS,22902,EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ <3CM,4610.5,2996.825,0.01,11545.0,322
HCPCS,22903,EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ 3 CM/>,13165.0,8557.25,0.01,13165.0,174
HCPCS,22903,EXC TUMOR SOFT TISSUE ABDOMINAL WALL SUBQ 3+CM,2556.0,1661.4,1.1,8286.13,144
HCPCS,22904,RAD RESECTION TUMOR SOFT TISSUE ABDL WALL <5CM,6676.0,4339.4,1.1,8286.13,144
HCPCS,22904,RADICAL RESECT ABD TUMOR<5CM,,,2465.15,3022.89,20
HCPCS,22904,Radical resect abd tumor<5cm,,,1351.24,1564.6,8
HCPCS,22905,RAD RESECT ABD TUMOR 5 CM/>,,,2465.15,3022.89,20
HCPCS,22905,RAD RESECTION TUMOR SOFT TISSUE ABDL WALL 5+CM,8632.0,5610.8,1.1,8632.0,144
HCPCS,22905,Rad resect abd tumor 5 cm/>,,,1351.24,1564.6,8
HCPCS,22999,ABDOMINAL FAT PAD BIOPSY,2008.0,1305.2,0.01,3443.0,85
HCPCS,22999,ABDOMINAL WALL / MUSCLE REPAIR,3934.0,2557.1,0.01,3934.0,84
HCPCS,22999,EXPLORATORY OF ABDOMEN (COMP CODE 20102),1592.0,1034.8,0.01,1592.0,84
HCPCS,22999,I&D ABDOMINAL WALL HEMATOMA (COMP CODE 26990),3379.0,2196.35,0.01,3379.0,84
HCPCS,22999,INCISIONAL BIOPSY OF ABDOM WALL MASS (COMP 21920),696.0,452.4,0.01,696.0,84
HCPCS,22999,OPEN REPAIR SPORTS HERNIA (COMP 49505),2627.0,1707.55,0.01,2627.0,84
HCPCS,22999,REMOVAL OF MESH ABD WALL (COMP 20680),2457.0,1597.05,0.01,2457.0,84
HCPCS,23000,REMOVAL SUBDELTOID CALCAREOUS DEPOSITS OPEN,1792.0,1164.8,1.1,8286.13,148
HCPCS,23000,RMVL SBDLTD CLCREOUS DEP OPN,,,2465.15,3022.89,20
HCPCS,23000,Rmvl sbdltd clcreous dep opn,,,1351.24,1564.6,8
HCPCS,23020,CAPSULAR CONTRACTURE RELEASE,3744.0,2433.6,1.1,9440.12,164
HCPCS,23020,Capsular contracture release,,,3275.28,3792.43,8
HCPCS,23030,I&D SHOULDER DEEP ABSC/HMTMA,,,2465.15,3022.89,20
HCPCS,23030,I&D SHOULDER DEEP ABSCESS/HEMATOMA,1388.0,902.2,1.1,8286.13,148
HCPCS,23030,I&d shoulder deep absc/hmtma,,,1351.24,1564.6,8
HCPCS,23031,I&D SHOULDER INFECTED BURSA,1116.0,725.4,1.1,8286.13,168
HCPCS,23031,I&d shoulder infected bursa,,,1351.24,1564.6,8
HCPCS,23035,INCISION BONE CORTEX SHO,,,1394.34,1673.41,20
HCPCS,23035,INCISION BONE CORTEX SHOULDER AREA,3664.0,2381.6,1.1,4686.39,144
HCPCS,23035,Incision bone cortex sho,,,3275.28,3792.43,8
HCPCS,23040,ARTHROTOMY GLENOHUMERAL JT EXPL/DRG/RMVL FB,4290.0,2788.5,1.1,9440.12,144
HCPCS,23040,ARTHRT GH JT EXPL/DRG/RMV FB,,,2808.13,3405.12,20
HCPCS,23040,Arthrt gh jt expl/drg/rmv fb,,,3275.28,3792.43,8
HCPCS,23044,ARTHRT AC SC JT EXP/RMVL FB,,,2808.13,3405.12,20
HCPCS,23044,ARTHRT ACROMCLAV STRNCLAV JT EXPL/DRG/RMVL FB,3036.0,1973.4,1.1,9440.12,144
HCPCS,23044,Arthrt ac sc jt exp/rmvl fb,,,3275.28,3792.43,8
HCPCS,23065,BIOPSY SOFT TISSUE SHOULDER SUPERFICIAL,4186.5,2721.225,0.01,7453.0,235
HCPCS,23066,BIOPSY SOFT TISSUE SHOULDER DEEP,7442.5,4837.625,0.01,13165.0,235
HCPCS,23071,EXCISION TUMOR SOFT TISSUE SHOULDER SUBQ 3 CM/>,7453.0,4844.45,0.01,10364.0,87
HCPCS,23071,EXCISION TUMOR SOFT TISSUE SHOULDER SUBQ 3+CM,2364.0,1536.6,1.1,4729.25,144
HCPCS,23073,EXC TUMOR SOFT TISSUE SHOULDER SUBFASCIAL 5 CM/>,13165.0,8557.25,0.01,13165.0,87
HCPCS,23073,EXC TUMOR SOFT TISSUE SHOULDER SUBFASCIAL 5+CM,4052.0,2633.8,1.1,8286.13,144
HCPCS,23075,EXCISION TUMOR SOFT TISSUE SHOULDER SUBQ <3CM,4568.5,2969.5249999999996,0.01,7453.0,235
HCPCS,23076,EXC TUMOR SOFT TISS SHOULDER SUBFASC <5CM,8064.5,5241.925,0.01,13165.0,231
HCPCS,23077,RAD RESCJ TUM SHOULDER<5 CM,,,2465.15,3022.89,20
HCPCS,23077,RAD RESECTION TUMOR SOFT TISSUE SHOULDER <5CM,7064.0,4591.6,1.1,8286.13,144
HCPCS,23077,Rad rescj tum shoulder<5 cm,,,3275.28,3792.43,8
HCPCS,23078,RAD RESCJ TUM SHOULDER 5CM/>,,,2465.15,3022.89,20
HCPCS,23078,RAD RESECTION TUMOR SOFT TISSUE SHOULDER 5+CM,9020.0,5863.0,1.1,9020.0,144
HCPCS,23078,Rad rescj tum shoulder 5cm/>,,,3275.28,3792.43,8
HCPCS,23100,ARTHROTOMY GLENHUMRL JT W/BX,,,2808.13,3405.12,20
HCPCS,23100,ARTHROTOMY GLENOHUMERAL JOINT W/BIOPSY,2480.0,1612.0,1.1,9440.12,144
HCPCS,23100,Arthrotomy glenhumrl jt w/bx,,,3275.28,3792.43,8
HCPCS,23101,ARTHRT ACRMCLV/STRNCLAV JT,,,2808.13,3405.12,20
HCPCS,23101,ARTHRT ACROMCLAV/STRNCLAV JT W/BX&/EXC CRTLG,2288.0,1487.2,1.1,9440.12,144
HCPCS,23101,Arthrt acrmclv/strnclav jt,,,3275.28,3792.43,8
HCPCS,23105,ARTHROTOMY GLENOHUMERAL JT,,,6206.54,7551.43,20
HCPCS,23105,ARTHRT GLENOHUMRL JT W/SYNOVECTOMY W/WO BIOPSY,3392.0,2204.8,1.1,20863.78,144
HCPCS,23105,Arthrotomy glenohumeral jt,,,3275.28,3792.43,8
HCPCS,23106,ARTHROTOMY STRNCLAV JOINT,,,2808.13,3405.12,20
HCPCS,23106,ARTHRT GLENOHUMRL JT STRNCLAV JT W/SYNVCT W/WOBX,2452.0,1593.8,1.1,9440.12,144
HCPCS,23106,Arthrotomy strnclav joint,,,3275.28,3792.43,8
HCPCS,23107,ARTHRT GLENHUMRL JT W/EXPL,,,6206.54,7551.43,20
HCPCS,23107,ARTHRT GLENOHMRL JT W/JT EXPL W/WO RMVL LOOSE/FB,3548.0,2306.2,1.1,20863.78,144
HCPCS,23107,Arthrt glenhumrl jt w/expl,,,3275.28,3792.43,8
HCPCS,23120,CLAVICULECTOMY PARTIAL,3252.0,2113.8,1.1,9440.12,165
HCPCS,23120,Claviculectomy partial,,,3275.28,3792.43,8
HCPCS,23125,CLAVICULECTOMY TOTAL,4242.0,2757.3,1.1,9440.12,164
HCPCS,23125,Claviculectomy total,,,3275.28,3792.43,8
HCPCS,23130,ACROMP/ACROMIONECTOMY PRTL,,,2808.13,3405.12,20
HCPCS,23130,Acromp/acromionectomy prtl,,,3275.28,3792.43,8
HCPCS,23130,PARTIAL REPAIR OR REMOVAL OF SHOULDER BONE,3419.0,2222.35,1.1,9440.12,144
HCPCS,23140,EXC/CURTG BONE CYST/BENIGN TUMOR CLAV/SCAPULA,2848.0,1851.2,1.1,9440.12,144
HCPCS,23140,REMOVAL OF BONE LESION,,,2808.13,3405.12,20
HCPCS,23140,Removal of bone lesion,,,3275.28,3792.43,8
HCPCS,23145,REMOVAL OF BONE LESION,,,2808.13,3405.12,20
HCPCS,23145,Removal of bone lesion,,,3275.28,3792.43,8
HCPCS,23146,EXC/CURTG BONE CST/B9 TUM CLAV/SCAPULA W/ALGRFT,3232.0,2100.8,1.1,20863.78,144
HCPCS,23146,REMOVAL OF BONE LESION,,,6206.54,7551.43,20
HCPCS,23146,Removal of bone lesion,,,3275.28,3792.43,8
HCPCS,23150,EXC/CURTG BONE CYST/BENIGN TUMOR PROX HUMERUS,3564.0,2316.6,1.1,9440.12,144
HCPCS,23150,REMOVAL OF HUMERUS LESION,,,2808.13,7778.0,22
HCPCS,23150,Removal of humerus lesion,,,3275.28,3792.43,8
HCPCS,23155,EXC/CURTG BONE CYST/BENIGN TUM PROX HUM W/AGRFT,4344.0,2823.6,1.1,20863.78,144
HCPCS,23155,REMOVAL OF HUMERUS LESION,,,6206.54,7551.43,20
HCPCS,23155,Removal of humerus lesion,,,3275.28,3792.43,8
HCPCS,23156,EXC/CURTG BONE CYST/BENIGN TUM PROX HUM W/ALGRFT,3644.0,2368.6,1.1,20863.78,144
HCPCS,23156,REMOVAL OF HUMERUS LESION,,,6206.54,7778.0,21
HCPCS,23156,Removal of humerus lesion,,,3275.28,3792.43,8
HCPCS,23170,SEQUESTRECTOMY CLAVICLE,,,2808.13,3405.12,20
HCPCS,23170,"SEQUESTRECTOMY, CLAVICLE",2884.0,1874.6,1.1,9440.12,144
HCPCS,23170,Sequestrectomy clavicle,,,3275.28,3792.43,8
HCPCS,23172,SEQUESTRECTOMY SCAPULA,,,2808.13,3405.12,20
HCPCS,23172,Sequestrectomy scapula,,,3275.28,3792.43,8
HCPCS,23174,"SEQUESTRECTOMY,HUMER HEAD-SURG NECK",4020.0,2613.0,1.1,20863.78,144
HCPCS,23174,SQSTRCTMY HUMRL HEAD SRG NCK,,,6206.54,7551.43,20
HCPCS,23174,Sqstrctmy humrl head srg nck,,,3275.28,3792.43,8
HCPCS,23180,PARTIAL EXCISION BONE CLAVICLE,3596.0,2337.4,1.1,20863.78,144
HCPCS,23180,PRTL EXCISION BONE CLAVICLE,,,6206.54,7551.43,20
HCPCS,23180,Prtl excision bone clavicle,,,3275.28,3792.43,8
HCPCS,23182,PARTIAL EXCISION BONE SCAPULA,3444.0,2238.6,1.1,20863.78,144
HCPCS,23182,PRTL EXCISION BONE SCAPULA,,,6206.54,7551.43,20
HCPCS,23182,Prtl excision bone scapula,,,3275.28,3792.43,8
HCPCS,23184,PARTIAL EXCISION BONE PROXIMAL HUMERUS,3960.0,2574.0,1.1,20863.78,144
HCPCS,23184,PRTL EXCISION BONE PROX HUM,,,6206.54,7551.43,20
HCPCS,23184,Prtl excision bone prox hum,,,3275.28,3792.43,8
HCPCS,23190,OSTECTOMY SCAPULA PARTIAL,2988.0,1942.2,1.1,9440.12,164
HCPCS,23190,Ostectomy scapula partial,,,3275.28,3792.43,8
HCPCS,23195,RESECTION HUMERAL HEAD,4144.0,2693.6,1.1,20863.78,164
HCPCS,23195,Resection humeral head,,,3275.28,3792.43,8
HCPCS,23200,RAD RESECT CLAVICLE FOR TUMOR,9084.0,5904.6,1.1,9084.0,144
HCPCS,23200,RADICAL RESCJ TUMOR CLAVICLE,,,6864.94,7551.43,12
HCPCS,23200,Radical rescj tumor clavicle,,,3275.28,3792.43,8
HCPCS,23210,RAD RESECT SCAPULA FOR TUMOR,10884.0,7074.6,1.1,10884.0,144
HCPCS,23210,RADICAL RESCJ TUMOR SCAPULA,,,6864.94,7551.43,12
HCPCS,23210,Radical rescj tumor scapula,,,3275.28,3792.43,8
HCPCS,23220,RADICAL RESCJ TUMOR PROX HUM,,,6864.94,7551.43,12
HCPCS,23220,RADICAL RESECTION BONE TUMOR PROXIMAL HUMERUS,12084.0,7854.6,1.1,12084.0,144
HCPCS,23220,Radical rescj tumor prox hum,,,3275.28,3792.43,8
HCPCS,23330,REMOVAL FOREIGN BODY SHOULDER SUBCUTANEOUS,4106.5,2669.225,1.1,7453.0,235
HCPCS,23333,REMOVAL SHOULDER FOREIGN BODY DEEP SUBFASCIAL/IM,2400.0,1560.0,1.1,8286.13,144
HCPCS,23333,REMOVE SHOULDER FB DEEP,,,2465.15,3022.89,20
HCPCS,23333,Remove shoulder fb deep,,,1351.24,1564.6,8
HCPCS,23334,PROSTHESIS REMOVAL HUMERAL/GLENOID COMPONENT,6200.0,4030.0,1.1,8286.13,144
HCPCS,23334,SHOULDER PROSTHESIS REMOVAL,,,2465.15,7551.43,20
HCPCS,23334,Shoulder prosthesis removal,,,3275.28,3792.43,8
HCPCS,23335,PROSTHESIS REMOVAL HUMERAL AND GLENOID COMPONENT,7600.0,4940.0,1.1,7600.0,144
HCPCS,23335,SHOULDER PROSTHESIS REMOVAL,,,3312.66,7551.43,13
HCPCS,23335,Shoulder prosthesis removal,,,3275.28,3792.43,8
HCPCS,23350,INJECTION SHOULDER ARTHROGRAPHY/ CT/MRI ARTHG,580.5,377.325,0.01,4628.0,284
HCPCS,23395,MUSCLE TRANSFER SHOULDER/ARM,,,6206.54,7551.43,20
HCPCS,23395,MUSCLE TRANSFER SHOULDER/UPPER ARM SINGLE,7416.0,4820.4,1.1,20863.78,144
HCPCS,23395,Muscle transfer shoulder/arm,,,3275.28,3792.43,8
HCPCS,23397,MUSCLE TRANSFER SHOULDER/UPPER ARM MULTIPLE,6704.0,4357.6,1.1,20863.78,144
HCPCS,23397,MUSCLE TRANSFERS,,,6206.54,7551.43,20
HCPCS,23397,Muscle transfers,,,3275.28,3792.43,8
HCPCS,23400,FIXATION OF SHOULDER BLADE,,,6206.54,7551.43,20
HCPCS,23400,Fixation of shoulder blade,,,3275.28,3792.43,8
HCPCS,23400,SCAPULOPEXY,5548.0,3606.2,1.1,20863.78,144
HCPCS,23405,TENOTOMY SHOULDER AREA 1 TENDON,18138.5,11790.025000000001,0.01,32861.0,231
HCPCS,23406,TENOTOMY SHOULDER MULTIPLE THRU SAME INCISION,18632.5,12111.125,0.01,32861.0,231
HCPCS,23410,OPEN REPAIR OF ROTATOR CUFF ACUTE,4556.0,2961.4,1.1,20863.78,144
HCPCS,23410,REPAIR ROTATOR CUFF ACUTE,,,6206.54,13821.0,23
HCPCS,23410,Repair rotator cuff acute,,,3275.28,3792.43,8
HCPCS,23412,OPEN REPAIR OF ROTATOR CUFF CHRONIC,4772.0,3101.8,1.1,20863.78,144
HCPCS,23412,REPAIR ROTATOR CUFF CHRONIC,,,6206.54,7551.43,20
HCPCS,23412,Repair rotator cuff chronic,,,3275.28,3792.43,8
HCPCS,23415,CORACOACROMIAL LIGAMENT RELEAS W/WOACROMIOPLASTY,3692.0,2399.8,1.1,20863.78,144
HCPCS,23415,RELEASE OF SHOULDER LIGAMENT,,,6206.54,7551.43,20
HCPCS,23415,Release of shoulder ligament,,,3275.28,3792.43,8
HCPCS,23420,RECONSTRUCTION ROTATOR CUFF AVULSION CHRONIC,5416.0,3520.4,1.1,20863.78,144
HCPCS,23420,REPAIR OF SHOULDER,,,6206.54,7551.43,20
HCPCS,23420,Repair of shoulder,,,3275.28,3792.43,8
HCPCS,23430,REPAIR BICEPS TENDON,,,6206.54,11170.0,23
HCPCS,23430,Repair biceps tendon,,,3275.28,3792.43,8
HCPCS,23430,TENODESIS LONG TENDON BICEPS,4068.0,2644.2,1.1,20863.78,144
HCPCS,23440,REMOVE/TRANSPLANT TENDON,,,6206.54,7551.43,20
HCPCS,23440,RESECTION/TRANSPLANTATION LONG TENDON BICEPS,4256.0,2766.4,1.1,20863.78,144
HCPCS,23440,Remove/transplant tendon,,,3275.28,3792.43,8
HCPCS,23450,CAPSULORRHAPHY ANTERIOR PUTTI-PLATT/MAGNUSON,5480.0,3562.0,1.1,20863.78,144
HCPCS,23450,REPAIR SHOULDER CAPSULE,,,6206.54,7551.43,20
HCPCS,23450,Repair shoulder capsule,,,3275.28,3792.43,8
HCPCS,23455,CAPSULORRHAPHY ANTERIOR W/LABRAL REPAIR,5868.0,3814.2,1.1,20863.78,144
HCPCS,23455,REPAIR SHOULDER CAPSULE,,,6206.54,7551.43,20
HCPCS,23455,Repair shoulder capsule,,,3275.28,3792.43,8
HCPCS,23460,CAPSULORRHAPHY ANTERIOR WITH BONE BLOCK,6961.0,4524.65,1.1,20863.78,144
HCPCS,23460,REPAIR SHOULDER CAPSULE,,,6206.54,11170.0,21
HCPCS,23460,Repair shoulder capsule,,,3275.28,3792.43,8
HCPCS,23462,CAPSULORRHAPHY ANTERIOR W/CORACOID PROCESS TR,6288.0,4087.2,1.1,20863.78,144
HCPCS,23462,REPAIR SHOULDER CAPSULE,,,6206.54,7551.43,20
HCPCS,23462,Repair shoulder capsule,,,3275.28,3792.43,8
HCPCS,23465,CAPSULORRHAPHY GLENOHUMERAL JT PST W/WO BONE BLK,6520.0,4238.0,1.1,20863.78,144
HCPCS,23465,REPAIR SHOULDER CAPSULE,,,6206.54,7551.43,20
HCPCS,23465,Repair shoulder capsule,,,3275.28,3792.43,8
HCPCS,23466,CAPSULORRHAPHY GLENOHUMRL JT MULTI-DIRIONAL INS,6952.0,4518.8,1.1,20863.78,144
HCPCS,23466,REPAIR SHOULDER CAPSULE,,,6206.54,7551.43,20
HCPCS,23466,Repair shoulder capsule,,,3275.28,3792.43,8
HCPCS,23470,ARTHROPLASTY GLENOHUMRL JT HEMIARTHROPLASTY,7156.0,4651.4,1.1,38384.94,144
HCPCS,23470,RECONSTRUCT SHOULDER JOINT,,,11418.01,13361.02,21
HCPCS,23470,Reconstruct shoulder joint,,,7882.2,9126.76,8
HCPCS,23472,ARTHROPLASTY GLENOHUMERAL JOINT TOTAL SHOULDER,9737.0,6329.05,1.1,54351.12,144
HCPCS,23472,RECONSTRUCT SHOULDER JOINT,,,11170.0,33436.0,23
HCPCS,23472,Reconstruct shoulder joint,,,7882.2,9126.76,8
HCPCS,23473,REVIS RECONST SHOULDER JOINT,,,11418.01,13361.02,20
HCPCS,23473,REVIS SHOULDER ARTHRPLSTY HUMERAL/GLENOID COMPNT,10000.0,6500.0,1.1,38384.94,144
HCPCS,23473,Revis reconst shoulder joint,,,7882.2,9126.76,8
HCPCS,23474,REVIS RECONST SHOULDER JOINT,,,12146.38,13361.02,12
HCPCS,23474,REVIS SHOULDER ARTHRPLSTY HUMERAL&GLENOID COMPNT,10884.0,7074.6,1.1,10884.0,144
HCPCS,23474,Revis reconst shoulder joint,,,7882.2,9126.76,8
HCPCS,23480,OSTEOTOMY CLAVICLE W/WO INTERNAL FIXATION,4616.0,3000.4,1.1,20863.78,144
HCPCS,23480,REVISION OF COLLAR BONE,,,6206.54,7551.43,20
HCPCS,23480,Revision of collar bone,,,3275.28,3792.43,8
HCPCS,23485,OSTEOTOMY CLAV W/WO INT FIXJ W/BONE GRF NON/MAL,5564.0,3616.6,1.1,38384.94,144
HCPCS,23485,REVISION OF COLLAR BONE,,,11418.01,13361.02,20
HCPCS,23485,Revision of collar bone,,,6600.42,7642.59,8
HCPCS,23490,PROPH TX W/WO METHYLMETHACRYLATE CLAVICLE,4864.0,3161.6,1.1,20863.78,144
HCPCS,23490,REINFORCE CLAVICLE,,,6206.54,7551.43,20
HCPCS,23490,Reinforce clavicle,,,3275.28,3792.43,8
HCPCS,23491,PROPH TX W/WO METHYLMETHACRYLATE PROX HUMERUS,5816.0,3780.4,1.1,38384.94,144
HCPCS,23491,REINFORCE SHOULDER BONES,,,11418.01,13361.02,20
HCPCS,23491,Reinforce shoulder bones,,,3275.28,3792.43,8
HCPCS,23500,CLSD TX CLAVICULAR FRACTURE W/O MANIPULATION,1037.5,674.375,0.01,4392.0,322
HCPCS,23505,CLSD TX CLAVICULAR FRACTURE W/MANIPULATION,4447.0,2890.55,1.1,7362.0,235
HCPCS,23515,OPEN TX CLAVICULAR FRACTURE INTERNAL FIXATION,3876.0,2519.4,1.1,20863.78,144
HCPCS,23515,OPTX CLAVICULAR FX W/INT FIX,,,6206.54,11170.0,22
HCPCS,23515,Optx clavicular fx w/int fix,,,3603.21,4172.14,8
HCPCS,23520,CLSD TX STERNOCLAVICULAR DISLC W/O MANIPULATION,4139.0,2690.35,1.1,7362.0,233
HCPCS,23525,CLOSED TX STERNOCLAVICULAR DISLC W/MANIPULATION,1516.0,985.4,1.1,1516.0,148
HCPCS,23525,CLTX STRNCLAV DISLC W/MNPJ,,,204.59,256.7,20
HCPCS,23525,Cltx strnclav dislc w/mnpj,,,295.11,341.7,8
HCPCS,23530,OPEN TX STERNOCLAVICULAR DISLC ACUTE/CHRONIC,2992.0,1944.8,1.1,20863.78,144
HCPCS,23530,OPTX STRNCLAV DISLC AQT/CHRN,,,6206.54,7551.43,20
HCPCS,23530,Optx strnclav dislc aqt/chrn,,,3603.21,4172.14,8
HCPCS,23532,OPTX STRCLV DSLC AQ/CHRN GRF,,,6206.54,7551.43,20
HCPCS,23532,OPTX STRNCLAV DISLC ACUTE/CHRONIC W/FASCIAL GRF,3280.0,2132.0,1.1,20863.78,144
HCPCS,23532,Optx strclv dslc aq/chrn grf,,,3603.21,4172.14,8
HCPCS,23540,CLSD TX ACROMIOCLAVICULAR DISLC W/O MANIPULATION,1023.5,665.2750000000001,0.01,4392.0,320
HCPCS,23545,CLSD TX ACROMIOCLAVICULAR DISLC W/MANIPULATION,1237.5,804.375,1.1,4392.0,235
HCPCS,23550,OPEN TX ACROMIOCLAVICULAR DISLC ACUTE/CHRONIC,3036.0,1973.4,1.1,20863.78,144
HCPCS,23550,OPTX ACROMCLV DISLC AQT/CHRN,,,6206.54,7551.43,20
HCPCS,23550,Optx acromclv dislc aqt/chrn,,,3603.21,4172.14,8
HCPCS,23552,OPTX ACRCLV DSLC AQ/CHRN GRF,,,6206.54,7551.43,20
HCPCS,23552,OPTX ACROMCLAV DISLC ACUTE/CHRONIC W/FASCIAL GRF,3528.0,2293.2,1.1,20863.78,144
HCPCS,23552,Optx acrclv dslc aq/chrn grf,,,3603.21,4172.14,8
HCPCS,23570,CLOSED TX SCAPULAR FRACTURE W/O MANIPULATION,1023.5,665.2750000000001,0.01,4392.0,322
HCPCS,23575,CLTX SCAPULAR FX W/MANJ W/WO SKELETAL TRACTION,4527.0,2942.55,1.1,7362.0,235
HCPCS,23585,OPEN TX SCAPULAR FX W/INTERNAL FIXATION IF PFRMD,5692.0,3699.8,1.1,20863.78,144
HCPCS,23585,OPTX SCAPULAR FX W/INT FIXJ,,,6206.54,7551.43,20
HCPCS,23585,Optx scapular fx w/int fixj,,,3603.21,4172.14,8
HCPCS,23600,CLTX PROXIMAL HUMERAL FRACTURE W/O MANIPULATION,1151.5,748.475,0.01,3443.0,321
HCPCS,23605,CLTX PROX HUMRL FX W/MANJ W/WO SKELETAL TRACJ,4693.0,3050.45,1.1,7362.0,235
HCPCS,23615,OPEN TREATMENT PROXIMAL HUMERAL FRACTURE,4920.0,3198.0,1.1,38384.94,144
HCPCS,23615,OPTX PROX HUMRL FX W/INT FIX,,,9457.0,13361.02,22
HCPCS,23615,Optx prox humrl fx w/int fix,,,3603.21,4172.14,8
HCPCS,23616,OPEN PROX HUMERAL FRACTURE PROSTHETIC RPLCMT,7348.0,4776.2,1.1,54351.12,144
HCPCS,23616,OPTX PRX HMRL FX FIX RPR RPL,,,16167.8,18412.18,20
HCPCS,23616,Optx prx hmrl fx fix rpr rpl,,,3603.21,4172.14,8
HCPCS,23620,CLTX GREATER HUMERAL TUBEROSITY FX W/O MANJ,1061.5,689.975,0.01,3443.0,321
HCPCS,23625,CLTX GRTER HUMERAL TUBEROSITY FX W/MANIPULATION,4501.0,2925.65,1.1,7362.0,235
HCPCS,23630,OPEN TREATMENT GRTER HUMERAL TUBEROSITY FRACTURE,4228.0,2748.2,1.1,20863.78,144
HCPCS,23630,OPTX GR HMRL TBRS FX INT FIX,,,6206.54,7551.43,20
HCPCS,23630,Optx gr hmrl tbrs fx int fix,,,3603.21,4172.14,8
HCPCS,23650,CLSD TX SHOULDER DISLC W/MANIPULATION W/O ANES,1328.0,863.2,0.01,4392.0,322
HCPCS,23655,CLSD TX SHOULDER DISLC W/MANIPULATION REQ ANES,4728.0,3073.2,1.1,7362.0,405
HCPCS,23660,OPEN RX ACUTE SHLDR DISLOC,3064.0,1991.6,1.1,20863.78,144
HCPCS,23660,OPTX ACUTE SHOULDER DISLC,,,6206.54,7551.43,20
HCPCS,23660,Optx acute shoulder dislc,,,3603.21,4172.14,8
HCPCS,23665,CLTX SHOULDER DISLC W/FX HUMERAL TUBRST W/MANJ,4613.0,2998.45,0.01,7362.0,322
HCPCS,23670,OPEN TX SHOULDER DISLC W/HUMERAL TUBEROSITY FX,4912.0,3192.8,1.1,20863.78,144
HCPCS,23670,OPTX SHO DISLC FX,,,6206.54,7551.43,20
HCPCS,23670,Optx sho dislc fx,,,3603.21,4172.14,8
HCPCS,23675,CLTX SHO DISLC NECK FX MNPJ,,,1394.34,1673.41,20
HCPCS,23675,CLTX SHOULDER DISLC W/SURG/ANTMCL NECK FX W/MANJ,2508.0,1630.2,1.1,4686.39,148
HCPCS,23675,Cltx sho dislc neck fx mnpj,,,295.11,341.7,8
HCPCS,23680,OPEN TX SHOULDER DISLOCATION W/NECK FRACTURE,5260.0,3419.0,1.1,38384.94,144
HCPCS,23680,OPTX SHO DISLC NECK FX FIXJ,,,11418.01,13361.02,20
HCPCS,23680,Optx sho dislc neck fx fixj,,,3603.21,4172.14,8
HCPCS,23700,MANJ W/ANES SHOULDER JOINT W/FIXATION APPARATUS,1028.0,668.2,1.1,4686.39,144
HCPCS,23700,MNPJ ANES SHO JT FIXJ APRATS,,,1394.34,1673.41,20
HCPCS,23700,Mnpj anes sho jt fixj aprats,,,824.67,954.88,8
HCPCS,23800,ARTHRODESIS GLENOHUMERAL JOINT,5892.0,3829.8,1.1,20863.78,144
HCPCS,23800,ARTHRODESIS GLENOHUMERAL JT,,,6206.54,7551.43,20
HCPCS,23800,Arthrodesis glenohumeral jt,,,3275.28,3792.43,8
HCPCS,23802,ARTHRD GLENOHUMERAL JT W/GRF,,,11418.01,13361.02,20
HCPCS,23802,ARTHRODESIS GLENOHUMERAL JT W/AUTOGENOUS GRAFT,7368.0,4789.2,1.1,38384.94,144
HCPCS,23802,Arthrd glenohumeral jt w/grf,,,6600.42,7642.59,8
HCPCS,23900,INTERTHORACOSCAPULAR AMPUTATION,8288.0,5387.2,1.1,8288.0,144
HCPCS,23900,INTERTHORACOSCPLR AMPUTATION,,,3619.79,13361.02,13
HCPCS,23900,Interthoracoscplr amputation,,,6600.42,7642.59,8
HCPCS,23920,DISARTICULATION SHOULDER,6492.0,4219.8,1.1,13361.02,157
HCPCS,23920,Disarticulation shoulder,,,6600.42,7642.59,8
HCPCS,23921,DISARTICULATION SHO SEC CLSR,,,1582.09,2147.22,20
HCPCS,23921,Disarticulation sho sec clsr,,,1351.24,1564.6,8
HCPCS,23929,DELTOID REPAIR,3038.0,1974.7,0.01,3038.0,84
HCPCS,23929,INSERT CEMENT SPACER SHOULDER,4198.0,2728.7,0.01,4198.0,84
HCPCS,23929,PERCUTANEOUS PINNING OF HUMERUS,2135.0,1387.75,0.01,2135.0,84
HCPCS,23929,REMOVE CEMENT SPACER,603.0,391.95,0.01,688.73,84
HCPCS,23929,REPAIR PECTORALIS MAJOR MUSCLE (COMP 29828),2354.0,1530.1,0.01,2354.0,84
HCPCS,23929,SCAPULOTHORACIC FUSION (COMP 23802),6079.0,3951.35,0.01,6079.0,84
HCPCS,23929,SHOULDER AUGMENTATION W/CEMENT (COMP CODE 22513),18160.5,11804.325,0.01,32861.0,168
HCPCS,23929,SHOULDER SURG PROC UNLISTED (COMP CODE 20982),10131.0,6585.15,204.59,10131.0,84
HCPCS,23930,I&D UPPER ARM/ELBOW DEEP ABSCESS/HEMATOMA,1196.0,777.4,1.1,8286.13,148
HCPCS,23930,I&D UPR A/E DP ABSC/HMTMA,,,2465.15,3022.89,20
HCPCS,23930,I&d upr a/e dp absc/hmtma,,,1351.24,1564.6,8
HCPCS,23931,INCISION&DRAINAGE UPPER ARM/ELBOW BURSA,4094.5,2661.4249999999997,0.01,7453.0,322
HCPCS,23935,INC DEEP W/OPENING BONE CORTEX HUMERUS/ELBOW,2552.0,1658.8,1.1,9440.12,144
HCPCS,23935,INC DP OPN B1 CRTX HUM/ELBW,,,2808.13,3405.12,20
HCPCS,23935,Inc dp opn b1 crtx hum/elbw,,,4162.67,4819.94,8
HCPCS,24000,ARTHRT ELBOW W/EXPLORATION DRAINAGE/REMOVAL FB,2432.0,1580.8,1.1,9440.12,144
HCPCS,24000,ARTHRT ELBW EXPL DRG/RMVL FB,,,2808.13,3405.12,20
HCPCS,24000,Arthrt elbw expl drg/rmvl fb,,,1235.91,1431.06,8
HCPCS,24006,ARTHRT ELBOW CAPSULAR EXCISION CAPSULAR RLS SPX,4286.0,2785.9,1.1,9440.12,144
HCPCS,24006,ARTHRT ELBW CAPSL EXC RLS,,,2808.13,7778.0,21
HCPCS,24006,Arthrt elbw capsl exc rls,,,1235.91,1431.06,8
HCPCS,24065,"BX ARM/ELBOW SOFT TISSUE,SUPERFICIAL",4152.5,2699.125,0.01,7453.0,235
HCPCS,24066,BIOPSY SOFT TISSUE UPPER ARM/ELBOW AREA DEEP,13165.0,8557.25,0.01,13165.0,87
HCPCS,24066,"BX ARM/ELBOW SOFT TISSUE,DEEP",2140.0,1391.0,1.1,8286.13,148
HCPCS,24071,EXC TUMOR SOFT TISSUE UPPER ARM/ELBOW SUBQ 3+CM,2280.0,1482.0,1.1,8286.13,144
HCPCS,24071,EXC TUMOR SOFT TISSUE UPPER ARM/ELBOW SUBQ 3CM/>,13165.0,8557.25,0.01,13165.0,87
HCPCS,24073,EX ARM/ELBOW TUM DEEP 5 CM/>,,,2465.15,7624.0,22
HCPCS,24073,EXC TUMOR SOFT TISS UPPER ARM/ELBW SUBFASC 5+CM,4052.0,2633.8,1.1,8286.13,144
HCPCS,24073,Ex arm/elbow tum deep 5 cm/>,,,1235.91,1431.06,8
HCPCS,24075,EXC TUMOR SOFT TISS UPPER ARM/ELBOW SUBQ <3CM,4659.5,3028.675,0.01,7453.0,235
HCPCS,24076,EX ARM/ELBOW TUM DEEP < 5 CM,,,2465.15,5457.0,22
HCPCS,24076,EXC TUMOR SOFT TISS UPR ARM/ELBOW SUBFASC <5CM,3260.0,2119.0,1.1,8286.13,144
HCPCS,24076,Ex arm/elbow tum deep < 5 cm,,,1351.24,1564.6,8
HCPCS,24077,RAD RESCJ TUM TISS A/E <5CM,,,2465.15,7813.0,21
HCPCS,24077,RAD RESECT TUMOR SOFT TISS UPPER ARM/ELBOW <5CM,6288.0,4087.2,1.1,8286.13,144
HCPCS,24077,Rad rescj tum tiss a/e <5cm,,,3275.28,3792.43,8
HCPCS,24079,RAD RESCJ TUM TISS A/E 5 CM+,,,2465.15,3022.89,20
HCPCS,24079,RAD RESECT TUMOR SOFT TISS UPPER ARM/ELBOW 5+CM,8244.0,5358.6,1.1,8286.13,144
HCPCS,24079,Rad rescj tum tiss a/e 5 cm+,,,3275.28,3792.43,8
HCPCS,24100,ARTHRT ELBW SYNOVIAL BX ONLY,,,2808.13,3405.12,20
HCPCS,24100,Arthrt elbw synovial bx only,,,1235.91,1431.06,8
HCPCS,24101,ARTHRT ELBOW W/JNT EXPL W/WOBX W/WORMVL LOOSE/FB,2520.0,1638.0,1.1,9440.12,144
HCPCS,24101,ARTHRT ELBW JT EXPL BX RMVL,,,2808.13,3405.12,20
HCPCS,24101,Arthrt elbw jt expl bx rmvl,,,1235.91,1431.06,8
HCPCS,24102,ARTHROTOMY ELBOW W/SYNOVECTOMY,3304.0,2147.6,1.1,9440.12,144
HCPCS,24102,ARTHRT ELBOW W/SYNOVECTOMY,,,2808.13,3405.12,20
HCPCS,24102,Arthrt elbow w/synovectomy,,,1235.91,1431.06,8
HCPCS,24105,EXCISION OLECRANON BURSA,1512.0,982.8,1.1,9440.12,165
HCPCS,24105,Excision olecranon bursa,,,1235.91,1431.06,8
HCPCS,24110,EXC/CURTG B1 CST/B9 TUM HUM,,,2808.13,3405.12,20
HCPCS,24110,EXCISION/CURTG BONE CYST/BENIGN TUMOR HUMERUS,3032.0,1970.8,1.1,9440.12,144
HCPCS,24110,Exc/curtg b1 cst/b9 tum hum,,,3275.28,3792.43,8
HCPCS,24115,EXC/CRTG B1 CST/TUM HUM AGRF,,,6206.54,7551.43,20
HCPCS,24115,EXC/CURTG BONE CYST/BENIGN TUMOR HUMERUS W/AGRFT,4048.0,2631.2,1.1,20863.78,144
HCPCS,24115,Exc/crtg b1 cst/tum hum agrf,,,3275.28,3792.43,8
HCPCS,24116,EXC/CRTG B1 CST/TUM HUM ALGR,,,6206.54,7778.0,21
HCPCS,24116,EXC/CURTG BONE CYST/BENIGN TUM HUMERUS W/ALGRFT,4892.0,3179.8,1.1,20863.78,144
HCPCS,24116,Exc/crtg b1 cst/tum hum algr,,,3275.28,3792.43,8
HCPCS,24120,EXC/CRTG B1 CST/B9 TUM RDS,,,2808.13,7813.0,21
HCPCS,24120,EXC/CURTG BONE CYST/BENIGN TUMOR H/N RDS/OLECRN,2728.0,1773.2,1.1,9440.12,144
HCPCS,24120,Exc/crtg b1 cst/b9 tum rds,,,1235.91,1431.06,8
HCPCS,24125,EXC/CRTG B1 CST/TUM RDS AGRF,,,2808.13,3405.12,20
HCPCS,24125,Exc/crtg b1 cst/tum rds agrf,,,1235.91,1431.06,8
HCPCS,24126,EXC/CRTG B1 CST/TUM RDS ALGR,,,6206.54,7551.43,20
HCPCS,24126,EXC/CURTG BONE CST/B9 TUM H/N RDS/OLECRN W/ALGRT,3448.0,2241.2,1.1,20863.78,144
HCPCS,24126,Exc/crtg b1 cst/tum rds algr,,,4162.67,4819.94,8
HCPCS,24130,EXCISION RADIAL HEAD,2568.0,1669.2,1.1,9440.12,164
HCPCS,24130,Excision radial head,,,4162.67,4819.94,8
HCPCS,24134,SEQUESTRECTOMY SHFT/DSTL HUM,,,6206.54,7551.43,20
HCPCS,24134,"SEQUESTRECTOMY,MID/DIST HUMERUS",4088.0,2657.2,1.1,20863.78,144
HCPCS,24134,Sequestrectomy shft/dstl hum,,,3275.28,3792.43,8
HCPCS,24136,SEQUESTRECTOMY RADIAL H/N,,,2808.13,3405.12,20
HCPCS,24136,Sequestrectomy radial h/n,,,1235.91,1431.06,8
HCPCS,24138,SEQUESTRECTOMY OLECRN PROCES,,,6206.54,7551.43,20
HCPCS,24138,Sequestrectomy olecrn proces,,,4162.67,4819.94,8
HCPCS,24140,PARTIAL EXC BONE HUMERUS,,,2808.13,3405.12,20
HCPCS,24140,PARTIAL REMOVAL HUMERUS,3820.0,2483.0,1.1,9440.12,144
HCPCS,24140,Partial exc bone humerus,,,3275.28,3792.43,8
HCPCS,24145,PARTIAL REMOVAL RADIAL HEAD/NECK,3124.0,2030.6,1.1,20863.78,144
HCPCS,24145,PRTL EXC BONE RADIAL H/N,,,6206.54,7551.43,20
HCPCS,24145,Prtl exc bone radial h/n,,,4162.67,4819.94,8
HCPCS,24147,PARTIAL REMOVAL OLECRANNON PROCESS,3136.0,2038.4,1.1,9440.12,144
HCPCS,24147,PRTL EXC BONE OLECRN PROCESS,,,2808.13,3405.12,20
HCPCS,24147,Prtl exc bone olecrn process,,,1235.91,1431.06,8
HCPCS,24149,RAD RESCJ CAPSL TISS&HTRTPC BONE ELBW CONTRCT,7137.0,4639.05,1.1,20863.78,144
HCPCS,24149,RADICAL RESECTION OF ELBOW,,,6206.54,7551.43,20
HCPCS,24149,Radical resection of elbow,,,4162.67,4819.94,8
HCPCS,24150,RAD RESCJ TUM DSTL/SHFT HUM,,,6206.54,18676.74,21
HCPCS,24150,RADICAL RESECTION TUMOR SHAFT/DISTAL HUMERUS,9384.0,6099.6,1.1,20863.78,144
HCPCS,24150,Rad rescj tum dstl/shft hum,,,3275.28,3792.43,8
HCPCS,24152,RAD RESECTION TUM RADIAL H/N,,,6206.54,18676.74,21
HCPCS,24152,RADICAL RESEC RADIAL HEAD/NECK,6597.0,4288.05,1.1,20863.78,144
HCPCS,24152,RADICAL RESECTION TUMOR RADIAL HEAD/NECK,7996.0,5197.4,1.1,20863.78,144
HCPCS,24152,Rad resection tum radial h/n,,,4162.67,4819.94,8
HCPCS,24155,RESECTION ELBOW JOINT ARTHRECTOMY,4836.0,3143.4,1.1,9440.12,144
HCPCS,24155,RESECTION OF ELBOW JOINT,,,2808.13,3405.12,20
HCPCS,24155,Resection of elbow joint,,,1235.91,1431.06,8
HCPCS,24160,PROSTHESIS REMOVAL HUMERAL AND ULNAR COMPONENTS,7452.0,4843.8,1.1,9440.12,144
HCPCS,24160,RMVL PROSTHHUMRL&ULNAR CMPNT,,,2808.13,3405.12,20
HCPCS,24160,Rmvl prosthhumrl&ulnar cmpnt,,,1235.91,1431.06,8
HCPCS,24164,PROSTHESIS REMOVAL RADIAL HEAD,4000.0,2600.0,1.1,9440.12,144
HCPCS,24164,REMOVAL PROSTH RADIAL HEAD,,,2808.13,3405.12,20
HCPCS,24164,Removal prosth radial head,,,1235.91,1431.06,8
HCPCS,24200,RMVL FOREIGN BODY UPPER ARM/ELBOW SUBCUTANEOUS,4088.5,2657.525,1.1,12615.0,320
HCPCS,24201,REMOVAL FOREIGN BODY UPPER ARM/ELBOW DEEP,7522.5,4889.625,1.1,13165.0,235
HCPCS,24220,INJECTION ELBOW ARTHROGRAPHY,442.0,287.3,0.01,4628.0,136
HCPCS,24220,INJECTION FOR ELBOW ARTHROGRAM,524.0,340.6,1.1,648.54,148
HCPCS,24300,MANIPULATION ELBOW W/ANESTH,1616.0,1050.4,1.1,4686.39,144
HCPCS,24300,MNPJ ELBOW UNDER ANES,,,1394.34,4195.84,21
HCPCS,24300,Mnpj elbow under anes,,,824.67,954.88,8
HCPCS,24301,MUSC/TDN TRANSFER UPR A/E 1,,,6206.54,7551.43,20
HCPCS,24301,MUSCLE/TENDON TRANSFER UPPER ARM/ELBOW SINGLE,4152.0,2698.8,1.1,20863.78,144
HCPCS,24301,Musc/tdn transfer upr a/e 1,,,4162.67,4819.94,8
HCPCS,24305,"ARM/ELBOW TENDON LENGTHEN,SINGLE,EA",3048.0,1981.2,1.1,9440.12,144
HCPCS,24305,TENDON LNGTH UPR A/E EA TDN,,,2808.13,3405.12,20
HCPCS,24305,Tendon lngth upr a/e ea tdn,,,1235.91,1431.06,8
HCPCS,24310,"TENOTOMY,ELBOW-SHLDR,SINGL,EACH",2448.0,1591.2,1.1,9440.12,144
HCPCS,24310,TNOT OPN ELBW TO SHO EA TDN,,,2808.13,3405.12,20
HCPCS,24310,Tnot opn elbw to sho ea tdn,,,3275.28,3792.43,8
HCPCS,24320,TENOPLASTY ELBOW TO SHO 1,,,6206.54,7551.43,20
HCPCS,24320,"TENOPLASTY,ELB-SHLDR,MUSC XFER,SINGL",4344.0,2823.6,1.1,20863.78,144
HCPCS,24320,Tenoplasty elbow to sho 1,,,3275.28,3792.43,8
HCPCS,24330,FLEXOR-PLASTY ELBOW,,,6206.54,7551.43,20
HCPCS,24330,Flexor-plasty elbow,,,4162.67,4819.94,8
HCPCS,24331,FLEXOR-PLASTY ELBW W/ADVMNT,,,6206.54,7551.43,20
HCPCS,24331,Flexor-plasty elbw w/advmnt,,,1235.91,1431.06,8
HCPCS,24332,TENOLYSIS TRICEPS,,,2808.13,8450.24,21
HCPCS,24332,"TENOLYSIS, TRICEPS",3164.0,2056.6,1.1,9440.12,144
HCPCS,24332,Tenolysis triceps,,,3275.28,3792.43,8
HCPCS,24340,TENODESIS BICEPS TDN AT ELBW,,,6206.54,8702.0,22
HCPCS,24340,TENODESIS BICEPS TENDON ELBOW SEPARATE PROCEDURE,3232.0,2100.8,1.1,20863.78,144
HCPCS,24340,Tenodesis biceps tdn at elbw,,,3275.28,3792.43,8
HCPCS,24341,REPAIR TENDON/MUSCLE UPPER ARM/ELBOW EA,3796.0,2467.4,1.1,20863.78,144
HCPCS,24341,RPR TDN/MUSC UPR A/E EACH,,,6206.54,11170.0,21
HCPCS,24341,Rpr tdn/musc upr a/e each,,,3275.28,3792.43,8
HCPCS,24342,REPAIR OF RUPTURED TENDON,,,5597.0,11170.0,22
HCPCS,24342,RINSJ RPTD BICEPS/TRICEPS TDN DSTL W/WO TDN GRF,4344.0,2823.6,1.1,20863.78,144
HCPCS,24342,Repair of ruptured tendon,,,3275.28,3792.43,8
HCPCS,24343,REPAIR LATERAL COLLATERAL LIGAMENT ELBOW,3664.0,2381.6,1.1,9440.12,144
HCPCS,24343,REPR ELBOW LAT LIGMNT W/TISS,,,2808.13,3405.12,20
HCPCS,24343,Repr elbow lat ligmnt w/tiss,,,1235.91,1431.06,8
HCPCS,24344,RCNSTJ LAT COLTRL LIGM ELBOW W/TENDON GRAFT,6084.0,3954.6,1.1,20863.78,144
HCPCS,24344,RECONSTRUCT ELBOW LAT LIGMNT,,,6206.54,7551.43,20
HCPCS,24344,Reconstruct elbow lat ligmnt,,,4162.67,4819.94,8
HCPCS,24345,REPAIR MEDIAL COLLATERAL LIGAMENT ELBOW,3664.0,2381.6,1.1,20863.78,144
HCPCS,24345,REPR ELBW MED LIGMNT W/TISSU,,,6206.54,7551.43,20
HCPCS,24345,Repr elbw med ligmnt w/tissu,,,4162.67,4819.94,8
HCPCS,24346,RCNSTJ MEDIAL COLTRL LIGM ELBW W/TDN GRF,6084.0,3954.6,1.1,38384.94,144
HCPCS,24346,RECONSTRUCT ELBOW MED LIGMNT,,,11418.01,13361.02,20
HCPCS,24346,Reconstruct elbow med ligmnt,,,4162.67,4819.94,8
HCPCS,24357,TENOTOMY ELBOW LATERAL/MEDIAL PERCUTANEOUS,8550.5,5557.825,0.01,14925.0,318
HCPCS,24358,REPAIR ELBOW W/DEB OPEN,,,2808.13,3405.12,20
HCPCS,24358,Repair elbow w/deb open,,,1235.91,1431.06,8
HCPCS,24358,TNOT ELBOW LATERAL/MEDIAL DEBRIDE OPEN,2664.0,1731.6,1.1,9440.12,144
HCPCS,24359,REPAIR ELBOW DEB/ATTCH OPEN,,,2808.13,3405.12,20
HCPCS,24359,Repair elbow deb/attch open,,,1235.91,1431.06,8
HCPCS,24359,TNOT ELBOW LATERAL/MEDIAL DEBRIDE OPEN TDN RPR,3592.0,2334.8,1.1,9440.12,144
HCPCS,24360,"ARTHROPLASTY,ELBOW,W MEMBRANE",5575.0,3623.75,1.1,20863.78,144
HCPCS,24360,RECONSTRUCT ELBOW JOINT,,,6206.54,13821.0,21
HCPCS,24360,Reconstruct elbow joint,,,2382.18,2758.32,8
HCPCS,24361,ARTHROPLASTY ELBOW W/DISTAL HUMRL PROSTC RPLCMT,6340.0,4121.0,1.1,54351.12,144
HCPCS,24361,RECONSTRUCT ELBOW JOINT,,,16167.8,18412.18,20
HCPCS,24361,Reconstruct elbow joint,,,7882.2,9126.76,8
HCPCS,24362,ARTHRP ELBOW W/IMPLT&FSCA LATA LIGAMENT RCNSTJ,6128.0,3983.2,1.1,38384.94,144
HCPCS,24362,RECONSTRUCT ELBOW JOINT,,,11418.01,13361.02,20
HCPCS,24362,Reconstruct elbow joint,,,7882.2,9126.76,8
HCPCS,24363,ARTHRP ELBOW W/DISTAL HUM&PROX UR PROSTC RPLCM,8800.0,5720.0,1.1,54351.12,144
HCPCS,24363,REPLACE ELBOW JOINT,,,16167.8,18412.18,20
HCPCS,24363,Replace elbow joint,,,7882.2,9126.76,8
HCPCS,24365,ARTHROPLASTY RADIAL HEAD,3448.0,2241.2,1.1,38384.94,144
HCPCS,24365,RECONSTRUCT HEAD OF RADIUS,,,11418.01,13361.02,20
HCPCS,24365,Reconstruct head of radius,,,7882.2,9126.76,8
HCPCS,24366,ARTHROPLASTY RADIAL HEAD W/IMPLANT,3744.0,2433.6,1.1,38384.94,144
HCPCS,24366,RECONSTRUCT HEAD OF RADIUS,,,11418.01,13361.02,20
HCPCS,24366,Reconstruct head of radius,,,7882.2,9126.76,8
HCPCS,24370,REVIS ELBOW ARTHRPLSTY HUMERAL/ULNA COMPNT,9420.0,6123.0,1.1,38384.94,144
HCPCS,24370,REVISE RECONST ELBOW JOINT,,,11418.01,13361.02,20
HCPCS,24370,Revise reconst elbow joint,,,7882.2,9126.76,8
HCPCS,24371,REVIS ELBOW ARTHRPLSTY HUMERAL&ULNA COMPNT,11000.0,7150.0,1.1,54351.12,144
HCPCS,24371,REVISE RECONST ELBOW JOINT,,,16167.8,18412.18,20
HCPCS,24371,Revise reconst elbow joint,,,7882.2,9126.76,8
HCPCS,24400,OSTEOT HUMERUS W/WO INT FIXJ,,,6206.54,7551.43,20
HCPCS,24400,OSTEOTOMY HUMERUS W/WO INTERNAL FIXATION,4985.0,3240.25,1.1,20863.78,144
HCPCS,24400,Osteot humerus w/wo int fixj,,,3275.28,3792.43,8
HCPCS,24410,MLT OSTEOT RLGNM IMED RD HUM,,,11418.01,13361.02,20
HCPCS,24410,MLT OSTEOT W/RELIGNMT IMED ROD HUMERAL SHAFT,6044.0,3928.6,1.1,38384.94,144
HCPCS,24410,Mlt osteot rlgnm imed rd hum,,,3275.28,3792.43,8
HCPCS,24420,OSTEOPLASTY HUMERUS,5492.0,3569.8,1.1,20863.78,164
HCPCS,24420,Osteoplasty humerus,,,3275.28,3792.43,8
HCPCS,24430,REPAIR NON/MALUNION HUMERUS W/O GRAFT,6100.0,3965.0,1.1,38384.94,144
HCPCS,24430,RPR NON/MAL HUMERUS WO GRAFT,,,11418.01,13361.02,20
HCPCS,24430,Rpr non/mal humerus wo graft,,,6600.42,7642.59,8
HCPCS,24435,REPAIR NON/MALUNION HUMERUS W/ILIAC/OTH AGRFT,5996.0,3897.4,1.1,38384.94,144
HCPCS,24435,RPR NON/MAL HUM WITH AGRFT,,,11418.01,13361.02,20
HCPCS,24435,Rpr non/mal hum with agrft,,,6600.42,7642.59,8
HCPCS,24470,HEMIEPIPHYSEAL ARREST,,,2808.13,3405.12,20
HCPCS,24470,Hemiepiphyseal arrest,,,1235.91,1431.06,8
HCPCS,24495,DECOMPRESSION FASCT F/ARM W/BRACH ART EXPL,3364.0,2186.6,1.1,20863.78,144
HCPCS,24495,DECOMPRESSION FASCT FOREARM,,,6206.54,7551.43,20
HCPCS,24495,Decompression fasct forearm,,,4162.67,4819.94,8
HCPCS,24498,PROPH TX W/WO METHYLMETHACRYLATE HUMERAL SHAFT,4912.0,3192.8,1.1,38384.94,144
HCPCS,24498,PROPH TX W/WO MTHYLMTHCRYLT,,,5597.0,13361.02,21
HCPCS,24498,Proph tx w/wo mthylmthcrylt,,,3275.28,3792.43,8
HCPCS,24500,CLSD TX HUMERAL SHAFT FRACTURE W/O MANIPULATION,1301.5,845.975,0.01,4392.0,322
HCPCS,24505,CLTX HUMERAL SHFT FX W/MANJ W/WO SKELETAL TRACJ,4759.0,3093.3500000000004,0.01,7362.0,322
HCPCS,24515,OPTX HUMERAL SHFT FX W/PLATE/SCREWS W/WOCERCLAGE,4848.0,3151.2,1.1,38384.94,144
HCPCS,24515,OPTX HUMRL SHFT FX PLATE/SCR,,,9457.0,13361.02,21
HCPCS,24515,Optx humrl shft fx plate/scr,,,3603.21,4172.14,8
HCPCS,24516,TX HUMRAL SHAFT FX W/INSJ IMED IMPLT W/W CERCLGE,4876.0,3169.4,1.1,38384.94,144
HCPCS,24516,TX HUMRL SHAFT FX IMED IMPLT,,,11418.01,13361.02,20
HCPCS,24516,Tx humrl shaft fx imed implt,,,3603.21,4172.14,8
HCPCS,24530,CLTX SPRCNDYLR/TRANSCNDYLR HUMERAL FX W/WO MANJ,1289.5,838.175,0.01,4392.0,322
HCPCS,24535,CLTX SPRCNDYLR/TRANSCNDYLR HUMERAL FX W/MANJ,5103.0,3316.95,0.01,7362.0,322
HCPCS,24538,PRQ SKEL FIX SPRCNDLR HUM FX,,,3528.0,11170.0,24
HCPCS,24538,PRQ SKEL FIXJ SPRCNDYLR/TRANSCNDYLR HUMERAL FX,4299.0,2794.35,1.1,20863.78,144
HCPCS,24538,Prq skel fix sprcndlr hum fx,,,3603.21,4172.14,8
HCPCS,24545,OPEN TX HUMERAL SUPRACONDYLAR FRACTURE W/O XTN,5260.0,3419.0,1.1,38384.94,144
HCPCS,24545,OPTX HUM FX WO NTRCNDYLR XTN,,,9457.0,13361.02,21
HCPCS,24545,Optx hum fx wo ntrcndylr xtn,,,3603.21,4172.14,8
HCPCS,24546,OPEN TX HUMERAL SUPRACONDYLAR FRACTURE W/XTN,5964.0,3876.6,1.1,38384.94,144
HCPCS,24546,OPTX HUM FX W/NTRCNDYLR XTN,,,11418.01,13821.0,21
HCPCS,24546,Optx hum fx w/ntrcndylr xtn,,,3603.21,4172.14,8
HCPCS,24560,CLTX HUMERAL EPICONDYLAR FX MEDIAL/LAT W/O MANJ,1147.5,745.875,0.01,4392.0,409
HCPCS,24565,CLTX HUMERAL EPICONDYLAR FX MEDIAL/LAT W/MANJ,4837.0,3144.05,1.1,7362.0,235
HCPCS,24566,PRQ SKEL FIX EPCNDYLR HUM FX,,,1394.34,1673.41,20
HCPCS,24566,PRQ SKEL FIXJ HUMRL EPCNDYLR FX MEDIAL/LAT MANJ,3624.0,2355.6,1.1,4686.39,144
HCPCS,24566,Prq skel fix epcndylr hum fx,,,3603.21,4172.14,8
HCPCS,24575,OPEN TX HUMERAL EPICONDYLAR FRACTURE,3884.0,2524.6,1.1,38384.94,144
HCPCS,24575,OPTX HUMERAL EPCNDYLR FX,,,4616.0,13361.02,21
HCPCS,24575,Optx humeral epcndylr fx,,,3603.21,4172.14,8
HCPCS,24576,CLTX HUMERAL CONDYLAR FX MEDIAL/LAT W/O MANJ,1224.5,795.925,0.01,4392.0,322
HCPCS,24577,CLTX HUMERAL CONDYLAR FX MEDIAL/LATERAL W/MANJ,5003.0,3251.95,1.1,7362.0,235
HCPCS,24579,OPEN TREATMENT HUMERAL CONDYLAR FRACTURE,4576.0,2974.4,1.1,38384.94,144
HCPCS,24579,OPTX HUMRL CNDYLR FRACTURE,,,5597.0,13361.02,22
HCPCS,24579,Optx humrl cndylr fracture,,,3603.21,4172.14,8
HCPCS,24582,PRQ SKEL FIX HUMRL CNDYLR FX,,,6206.54,7624.0,21
HCPCS,24582,PRQ SKEL FIXJ HUMRL CNDYLR FX MEDIAL/LAT W/MANJ,4056.0,2636.4,1.1,20863.78,144
HCPCS,24582,Prq skel fix humrl cndylr fx,,,3603.21,4172.14,8
HCPCS,24586,OPTX PARTCLR FX&/DISLC ELBOW,,,4616.0,13361.02,21
HCPCS,24586,OPTX PERIARTICULAR FRACTURE &/DISLOCATION ELBO,6312.0,4102.8,1.1,38384.94,144
HCPCS,24586,Optx partclr fx&/dislc elbow,,,3603.21,4172.14,8
HCPCS,24587,OPTX PARTCLR FX&/DSLC ELBW W,,,11418.01,13361.02,20
HCPCS,24587,OPTX PRIARTICULAR FX&/DISLC ELBW W/IMPLT ARTHR,6316.0,4105.4,1.1,38384.94,144
HCPCS,24587,Optx partclr fx&/dslc elbw w,,,3603.21,4172.14,8
HCPCS,24600,TREATMENT CLOSED ELBOW DISLOCATION W/O ANES,1425.5,926.575,0.01,4392.0,322
HCPCS,24605,TREATMENT CLOSED ELBOW DISLOCATION REQ ANES,4809.0,3125.8500000000004,1.1,7362.0,231
HCPCS,24615,OPEN TX ACUTE/CHRONIC ELBOW DISLOCATION,3932.0,2555.8,1.1,20863.78,144
HCPCS,24615,OPTX AQT/CHRNC ELBOW DISLC,,,6206.54,7551.43,20
HCPCS,24615,Optx aqt/chrnc elbow dislc,,,3603.21,4172.14,8
HCPCS,24620,CLOSED TX MONTEGGIA FX DISLOCATION ELBOW W/MANJ,5125.0,3331.25,0.01,7362.0,318
HCPCS,24635,OPEN TX MONTEGGIA FRACTURE DISLOCATION ELBOW,3520.0,2288.0,1.1,20863.78,144
HCPCS,24635,OPTX MONTEGGIA FX DISLC ELBW,,,6206.54,7551.43,20
HCPCS,24635,Optx monteggia fx dislc elbw,,,3603.21,4172.14,8
HCPCS,24640,CLTX RDL HEAD SUBLXTJ CHLD NURSEMAID ELBW W/MANJ,826.5,537.225,0.01,2453.0,321
HCPCS,24650,CLOSED TX RADIAL HEAD/NECK FX W/O MANIPULATION,1059.5,688.675,0.01,12500.0,407
HCPCS,24655,CLOSED TX RADIAL HEAD/NECK FX W/MANIPULATION,4697.5,3053.375,0.01,7362.0,322
HCPCS,24665,OPEN TX RADIAL HEAD/NECK FRACTURE,3344.0,2173.6,1.1,20863.78,144
HCPCS,24665,OPTX RADIAL HEAD/NECK FX,,,6206.54,11170.0,21
HCPCS,24665,Optx radial head/neck fx,,,3603.21,4172.14,8
HCPCS,24666,OPEN TX RADIAL HEAD/NECK FRACTURE PROSTHETIC,3944.0,2563.6,1.1,38384.94,144
HCPCS,24666,OPTX RADIAL HEAD/NCK FX RPLC,,,9457.0,13361.02,21
HCPCS,24666,Optx radial head/nck fx rplc,,,3603.21,4172.14,8
HCPCS,24670,CLOSED TX ULNAR FRACTURE PROXIMAL END W/O MANJ,1089.5,708.175,0.01,4392.0,322
HCPCS,24675,CLOSED TX ULNAR FRACTURE PROXIMAL END W/MANJ,4663.0,3030.95,1.1,7362.0,235
HCPCS,24685,OPEN TREATMENT ULNAR FRACTURE PROXIMAL END,3348.0,2176.2,1.1,20863.78,144
HCPCS,24685,OPTX ULNAR FX PROX END W/FIX,,,6206.54,11170.0,21
HCPCS,24685,Optx ulnar fx prox end w/fix,,,3603.21,4172.14,8
HCPCS,24800,ARTHRODESIS ELBW JOINT LOCAL,,,6206.54,7551.43,20
HCPCS,24800,Arthrodesis elbw joint local,,,4162.67,4819.94,8
HCPCS,24802,ARTHRD ELBOW JT AUTOG GRAFT,,,11418.01,13361.02,20
HCPCS,24802,ARTHRODESIS ELBOW JOINT W/AUTOGENOUS GRAFT,5728.0,3723.2,1.1,38384.94,144
HCPCS,24802,Arthrd elbow jt autog graft,,,4162.67,4819.94,8
HCPCS,24900,AMPUTATION OF UPPER ARM,,,1941.29,13361.02,13
HCPCS,24900,"AMPUTATN ARM,THRU HUMERUS,PRIM CLOS",4072.0,2646.8,1.1,4072.0,144
HCPCS,24900,Amputation of upper arm,,,6600.42,7642.59,8
HCPCS,24920,AMPUTATE ARM-HUMER; OP CIRCULAR,4052.0,2633.8,1.1,4052.0,144
HCPCS,24920,AMPUTATION OF UPPER ARM,,,1925.62,13361.02,13
HCPCS,24920,Amputation of upper arm,,,6600.42,7642.59,8
HCPCS,24925,AMPUTATION FOLLOW-UP SURGERY,,,2808.13,3405.12,20
HCPCS,24925,"AMPUTATN ARM,THRU HUMER,SECOND CL",2920.0,1898.0,1.1,9440.12,144
HCPCS,24925,Amputation follow-up surgery,,,3275.28,3792.43,8
HCPCS,24930,AMPUTATE ARM-HUMERUS RE-AMPUT,4332.0,2815.8,1.1,4332.0,144
HCPCS,24930,AMPUTATION FOLLOW-UP SURGERY,,,2030.83,7551.43,13
HCPCS,24930,Amputation follow-up surgery,,,6600.42,7642.59,8
HCPCS,24931,AMPUTATE UPPER ARM & IMPLANT,,,2439.26,13361.02,13
HCPCS,24931,Amputate upper arm & implant,,,6600.42,7642.59,8
HCPCS,24935,REVISION OF AMPUTATION,,,6206.54,18676.74,21
HCPCS,24935,Revision of amputation,,,3275.28,3792.43,8
HCPCS,24935,"STUMP ELONGATN,UPPER EXTREM",6580.0,4277.0,1.1,20863.78,144
HCPCS,24940,REVISION OF UPPER ARM,,,934.34,13361.02,13
HCPCS,24940,Revision of upper arm,,,3275.28,3792.43,8
HCPCS,24999,ARTHROTOMY W/RMVL EXCHNG ELBOW SPACER,7772.0,5051.8,0.01,7772.0,84
HCPCS,24999,INSERT PROSTHETIC ANTIBIOTIC SPACER,7474.0,4858.1,0.01,7474.0,84
HCPCS,24999,ORIF OF OCD ELBOW WITH ALLOGRAFT?(COMP 27415),6600.0,4290.0,0.01,6600.0,84
HCPCS,24999,ORIF OF OCD ELBOW WITH AUTOGRAFT (COMP 27416),4673.0,3037.45,0.01,4673.0,84
HCPCS,24999,ORIF OF OCD ELBOW WITH DRILLING (COMP 29887),4520.0,2938.0,0.01,4520.0,84
HCPCS,24999,UNLISTED PX HUMERUS/ELBOW,,,204.59,615.65,21
HCPCS,24999,UPPER ARM COMPARTMENT DECOMPRESSON FASCIOTOMY/RELEASE WITH COMP,3561.0,2314.65,0.01,3561.0,84
HCPCS,24999,Unlisted px humerus/elbow,,,295.11,341.7,8
HCPCS,25000,INCISION EXTENSOR TENDON SHEATH WRIST,4391.0,2854.15,0.01,7813.0,231
HCPCS,25001,INCISE FLEXOR CARPI RADIALIS,,,2808.13,3405.12,20
HCPCS,25001,INCISE FLX TENDN SHEATH WRST,1516.0,985.4,1.1,9440.12,144
HCPCS,25001,Incise flexor carpi radialis,,,1168.27,1352.74,8
HCPCS,25020,DCMPRN FASCT F/ARM&WRST FLXR/XTNSR W/O DBRDMT,2424.0,1575.6,1.1,4686.39,144
HCPCS,25020,DECOMPRESS FOREARM 1 SPACE,,,1394.34,1673.41,20
HCPCS,25020,Decompress forearm 1 space,,,1235.91,1431.06,8
HCPCS,25023,DCMPRN FASCT F/ARM&/WRST FLXR/XTNSR W/DBRDMT,5532.0,3595.8,1.1,9440.12,144
HCPCS,25023,DECOMPRESS FOREARM 1 SPACE,,,2808.13,3405.12,20
HCPCS,25023,Decompress forearm 1 space,,,1235.91,1431.06,8
HCPCS,25024,DCMPRN FASCT F/ARM&/WRST FLXR&XTNSR W/O DB,4316.0,2805.4,1.1,9440.12,144
HCPCS,25024,DECOMPRESS FOREARM 2 SPACES,,,2808.13,3405.12,20
HCPCS,25024,Decompress forearm 2 spaces,,,1235.91,1431.06,8
HCPCS,25025,DCMPRN FASCT F/ARM&/WRST FLXR&XTNSR DBRDMT,7176.0,4664.4,1.1,7176.0,144
HCPCS,25025,DECOMPRESS FOREARM 2 SPACES,,,1394.34,1673.41,20
HCPCS,25025,Decompress forearm 2 spaces,,,1235.91,1431.06,8
HCPCS,25028,I&D F/ARM&/WRST DP ABSC/HMTM,,,2808.13,3405.12,20
HCPCS,25028,I&D FOREARM&/WRIST DEEP ABSCESS/HEMATOMA,2156.0,1401.4,1.1,9440.12,144
HCPCS,25028,I&d f/arm&/wrst dp absc/hmtm,,,1235.91,1431.06,8
HCPCS,25031,I&D FOREARM&/WRIST BURSA,,,1394.34,1673.41,20
HCPCS,25031,I&d forearm&/wrist bursa,,,1235.91,1431.06,8
HCPCS,25031,INCISION & DRAINAGE FOREARM&/WRIST BURSA,1704.0,1107.6,1.1,4686.39,144
HCPCS,25035,INC DP BONE CRTX F/ARM&/WRST,,,6206.54,7551.43,20
HCPCS,25035,INCISION DEEP BONE CORTEX FOREARM&/WRIST,3060.0,1989.0,1.1,20863.78,144
HCPCS,25035,Inc dp bone crtx f/arm&/wrst,,,4162.67,4819.94,8
HCPCS,25040,ARTHRT RDCRPL/MIDCARPL JT,,,2808.13,3405.12,20
HCPCS,25040,ARTHRT RDCRPL/MIDCARPL JT W/EXPL DRG/RMVL FB,3000.0,1950.0,1.1,9440.12,144
HCPCS,25040,Arthrt rdcrpl/midcarpl jt,,,1235.91,1431.06,8
HCPCS,25065,BIOPSY SOFT TISSUE FOREARM&/WRIST SUPERFICIAL,4134.5,2687.4249999999997,0.01,7453.0,235
HCPCS,25066,BIOPSY FOREARM SOFT TISSUES,,,2465.15,3022.89,20
HCPCS,25066,BIOPSY SOFT TISSUE FOREARM&/WRIST DEEP,1708.0,1110.2,1.1,8286.13,144
HCPCS,25066,Biopsy forearm soft tissues,,,1235.91,1431.06,8
HCPCS,25071,EXC TUMOR SOFT TISS FOREARM AND/WRIST SUBQ 3+CM,2364.0,1536.6,1.1,4729.25,144
HCPCS,25071,EXC TUMOR SOFT TISS FOREARM AND/WRIST SUBQ 3CM/>,7453.0,4844.45,0.01,10364.0,87
HCPCS,25073,EXC TUMOR SFT TISS FOREARM&//WRIST SUBFASC 3+CM,8008.5,5205.525,0.01,13165.0,231
HCPCS,25075,EXC TUMOR SOFT TISSUE FOREARM &/WRIST SUBQ <3CM,4518.5,2937.0249999999996,0.01,7453.0,235
HCPCS,25076,EXC FOREARM TUM DEEP < 3 CM,,,1406.56,1718.79,20
HCPCS,25076,EXC TUMOR SOFT TISS FOREARM&/WRIST SUBFASC <3CM,2696.0,1752.4,1.1,4729.25,144
HCPCS,25076,Exc forearm tum deep < 3 cm,,,1235.91,1431.06,8
HCPCS,25077,RAD RESECT TUMOR SOFT TISS FOREARM&/WRIST <3 CM,5172.0,3361.8,1.1,8286.13,144
HCPCS,25077,RESECT FOREARM/WRIST TUM<3CM,,,2465.15,3022.89,20
HCPCS,25077,Resect forearm/wrist tum<3cm,,,4162.67,4819.94,8
HCPCS,25078,RAD RESCJ TUM SOFT TISSUE FOREARM&/WRIST 3+CM,7076.0,4599.4,1.1,8286.13,144
HCPCS,25078,RESECT FORARM/WRIST TUM 3CM>,,,2465.15,3022.89,20
HCPCS,25078,Resect forarm/wrist tum 3cm>,,,4162.67,4819.94,8
HCPCS,25085,CAPSULOTOMY WRIST,2256.0,1466.4,1.1,9440.12,144
HCPCS,25085,INCISION OF WRIST CAPSULE,,,2808.13,3405.12,20
HCPCS,25085,Incision of wrist capsule,,,1235.91,1431.06,8
HCPCS,25100,ARTHROTOMY WRIST JOINT WITH BIOPSY,1608.0,1045.2,1.1,9440.12,144
HCPCS,25100,BIOPSY OF WRIST JOINT,,,2808.13,5265.0,21
HCPCS,25100,Biopsy of wrist joint,,,1235.91,1431.06,8
HCPCS,25101,ARTHRT WRST W/JT EXPL W/WO BX W/WO RMVL LOOSE/FB,1932.0,1255.8,1.1,9440.12,144
HCPCS,25101,EXPLORE/TREAT WRIST JOINT,,,2808.13,7624.0,21
HCPCS,25101,Explore/treat wrist joint,,,1235.91,1431.06,8
HCPCS,25105,ARTHROTOMY WRIST JOINT WITH SYNOVECTOMY,2408.0,1565.2,1.1,9440.12,144
HCPCS,25105,REMOVE WRIST JOINT LINING,,,2808.13,3405.12,20
HCPCS,25105,Remove wrist joint lining,,,1235.91,1431.06,8
HCPCS,25107,ARTHROTOMY DSTL RADIOULNAR JOINT RPR CARTILAGE,3080.0,2002.0,1.1,9440.12,144
HCPCS,25107,REMOVE WRIST JOINT CARTILAGE,,,2808.13,7778.0,21
HCPCS,25107,Remove wrist joint cartilage,,,1235.91,1431.06,8
HCPCS,25109,EXC TENDON FOREARM&/WRIST FLEXOR/EXTENSOR EA,2776.0,1804.4,1.1,9440.12,144
HCPCS,25109,EXCISE TENDON FOREARM/WRIST,,,2808.13,8450.24,21
HCPCS,25109,Excise tendon forearm/wrist,,,1235.91,1431.06,8
HCPCS,25110,"EXCIS TENDON SHEATH LESN,WRIST/FORE",1616.0,1050.4,1.1,4686.39,144
HCPCS,25110,REMOVE WRIST TENDON LESION,,,1394.34,1673.41,20
HCPCS,25110,Remove wrist tendon lesion,,,1235.91,1431.06,8
HCPCS,25111,EXCISION GANGLION WRIST DORSAL/VOLAR PRIMARY,4387.0,2851.55,0.01,7813.0,231
HCPCS,25112,EXCISION GANGLION WRIST DORSAL/VOLAR RECURRENT,1868.0,1214.2,1.1,4686.39,144
HCPCS,25112,REREMOVE WRIST TENDON LESION,,,1394.34,10789.0,22
HCPCS,25112,Reremove wrist tendon lesion,,,1168.27,1352.74,8
HCPCS,25115,RAD EXC BURSA SYNVA WRST/F/ARM TDN SHTHS FLXRS,4036.0,2623.4,1.1,4686.39,144
HCPCS,25115,REMOVE WRIST/FOREARM LESION,,,1394.34,1673.41,20
HCPCS,25115,Remove wrist/forearm lesion,,,1235.91,1431.06,8
HCPCS,25116,RAD EXC BURSA SYNVA WRST/F/ARM TDN SHTHS XTNSRS,3024.0,1965.6,1.1,9440.12,144
HCPCS,25116,REMOVE WRIST/FOREARM LESION,,,2808.13,7624.0,21
HCPCS,25116,Remove wrist/forearm lesion,,,1235.91,1431.06,8
HCPCS,25118,EXCISE WRIST TENDON SHEATH,,,1394.34,1673.41,20
HCPCS,25118,Excise wrist tendon sheath,,,1235.91,1431.06,8
HCPCS,25118,SYNOVECTOMY EXTENSOR TENDON SHTH WRIST 1 CMPRT,1804.0,1172.6,1.1,4686.39,144
HCPCS,25119,PARTIAL REMOVAL OF ULNA,,,2808.13,3405.12,20
HCPCS,25119,Partial removal of ulna,,,1235.91,1431.06,8
HCPCS,25119,SYNVCT XTNSR TDN SHTH WRST 1 RESCJ DSTL ULNA,2484.0,1614.6,1.1,9440.12,144
HCPCS,25120,EXCISION/CURETTAGE CYST/TUMOR RADIUS/ULNA,2508.0,1630.2,1.1,9440.12,144
HCPCS,25120,REMOVAL OF FOREARM LESION,,,2808.13,3405.12,20
HCPCS,25120,Removal of forearm lesion,,,1235.91,1431.06,8
HCPCS,25125,EXC/CURTG CYST/TUMOR RADIUS/ULNA W/AUTOGRAFT,3068.0,1994.2,1.1,4686.39,144
HCPCS,25125,REMOVE/GRAFT FOREARM LESION,,,1394.34,1673.41,20
HCPCS,25125,Remove/graft forearm lesion,,,1235.91,1431.06,8
HCPCS,25126,EXC/CURTG CYST/TUMOR RADIUS/ULNA W/ALLOGRAFT,3096.0,2012.4,1.1,9440.12,144
HCPCS,25126,REMOVE/GRAFT FOREARM LESION,,,2808.13,3405.12,20
HCPCS,25126,Remove/graft forearm lesion,,,1235.91,1431.06,8
HCPCS,25130,EXCISION/CURETTAGE CYST/TUMOR CARPAL BONES,2172.0,1411.8,1.1,9440.12,144
HCPCS,25130,REMOVAL OF WRIST LESION,,,2808.13,7624.0,21
HCPCS,25130,Removal of wrist lesion,,,1235.91,1431.06,8
HCPCS,25135,EXC/CURTG CYST/TUMOR CARPAL BONES W/AUTOGRAFT,2832.0,1840.8,1.1,20863.78,144
HCPCS,25135,REMOVE & GRAFT WRIST LESION,,,6206.54,7551.43,20
HCPCS,25135,Remove & graft wrist lesion,,,1235.91,1431.06,8
HCPCS,25136,EXC/CURTG CYST/TUMOR CARPAL BONES W/ALLOGRAFT,2456.0,1596.4,1.1,20863.78,144
HCPCS,25136,REMOVE & GRAFT WRIST LESION,,,6206.54,7551.43,20
HCPCS,25136,Remove & graft wrist lesion,,,1912.9,2214.94,8
HCPCS,25145,REMOVE FOREARM BONE LESION,,,2808.13,3405.12,20
HCPCS,25145,Remove forearm bone lesion,,,4162.67,4819.94,8
HCPCS,25145,"SEQUESTRECTOMY,FOREARM/WRIST",2616.0,1700.4,1.1,9440.12,144
HCPCS,25150,"PART REMOVAL BONE,ULNA",2952.0,1918.8,1.1,9440.12,144
HCPCS,25150,PARTIAL REMOVAL OF ULNA,,,2808.13,3405.12,20
HCPCS,25150,Partial removal of ulna,,,1235.91,1431.06,8
HCPCS,25151,"PART REMOVAL BONE,RADIUS",3072.0,1996.8,1.1,9440.12,144
HCPCS,25151,PARTIAL REMOVAL OF RADIUS,,,2808.13,3405.12,20
HCPCS,25151,Partial removal of radius,,,1235.91,1431.06,8
HCPCS,25170,RADICAL RESECTION TUMOR RADIUS OR ULNA,8884.0,5774.6,1.1,20863.78,144
HCPCS,25170,RESECT RADIUS/ULNAR TUMOR,,,6206.54,18676.74,21
HCPCS,25170,Resect radius/ulnar tumor,,,4162.67,4819.94,8
HCPCS,25210,CARPECTOMY 1 BONE,2448.0,1591.2,1.1,9440.12,144
HCPCS,25210,REMOVAL OF WRIST BONE,,,2808.13,7624.0,21
HCPCS,25210,Removal of wrist bone,,,1168.27,1352.74,8
HCPCS,25215,CARPECTOMY ALL BONES PROXIMAL ROW,3256.0,2116.4,1.1,9440.12,144
HCPCS,25215,REMOVAL OF WRIST BONES,,,2808.13,7778.0,21
HCPCS,25215,Removal of wrist bones,,,1912.9,2214.94,8
HCPCS,25230,PARTIAL REMOVAL OF RADIUS,,,2808.13,3405.12,20
HCPCS,25230,Partial removal of radius,,,1235.91,1431.06,8
HCPCS,25230,RADICAL STYLOIDECTOMY SEPARATE PROCEDURE,2148.0,1396.2,1.1,9440.12,144
HCPCS,25240,"EXCIS DISTAL ULNA,PART/COMPLETE",2124.0,1380.6,1.1,9440.12,144
HCPCS,25240,PARTIAL REMOVAL OF ULNA,,,2808.13,10789.0,21
HCPCS,25240,Partial removal of ulna,,,1235.91,1431.06,8
HCPCS,25246,INJECTION FOR WRIST ARTHROGRAM,580.0,377.0,1.1,668.65,148
HCPCS,25246,INJECTION WRIST ARTHROGRAPHY,637.0,414.05,0.01,4628.0,136
HCPCS,25248,EXPL W/REMOVAL DEEP FOREIGN BODY FOREARM/WRIST,4743.0,3082.95,0.01,7362.0,318
HCPCS,25250,REMOVAL OF WRIST PROSTHESIS,,,1394.34,1673.41,20
HCPCS,25250,REMOVAL WRIST PROSTHESIS SEPARATE PROCEDURE,2708.0,1760.2,1.1,4686.39,144
HCPCS,25250,Removal of wrist prosthesis,,,1235.91,1431.06,8
HCPCS,25251,REMOVAL OF WRIST PROSTHESIS,,,2808.13,3405.12,20
HCPCS,25251,REMOVAL WRIST PROSTH COMPLICATED W/TOTAL WRIST,3928.0,2553.2,1.1,9440.12,144
HCPCS,25251,Removal of wrist prosthesis,,,1235.91,1431.06,8
HCPCS,25259,MANIPULATE WRIST W/ANESTHES,1616.0,1050.4,1.1,4686.39,163
HCPCS,25259,Manipulate wrist w/anesthes,,,824.67,954.88,8
HCPCS,25260,RPR TDN/MUSC FLXR F/ARM&/WRST PRIM 1 EA TDN/MU,9070.5,5895.825,1.1,14925.0,231
HCPCS,25263,REPAIR FOREARM TENDON/MUSCLE,,,6206.54,7551.43,20
HCPCS,25263,RPR TDN/MUSC FLXR F/ARM&/WRIST SEC 1 EA TDN/MUS,3216.0,2090.4,1.1,20863.78,144
HCPCS,25263,Repair forearm tendon/muscle,,,1235.91,1431.06,8
HCPCS,25265,REPAIR FOREARM TENDON/MUSCLE,,,2808.13,3405.12,20
HCPCS,25265,RPR TDN/MUSC FLXR F/ARM&/WRISTSEC FR GRF EA,4040.0,2626.0,1.1,9440.12,144
HCPCS,25265,Repair forearm tendon/muscle,,,1235.91,1431.06,8
HCPCS,25270,REPAIR FOREARM TENDON/MUSCLE,,,2808.13,3405.12,20
HCPCS,25270,RPR TDN/MUSC XTNSR F/ARM&/WRIST PRIM 1 EA TDN,2468.0,1604.2,1.1,9440.12,144
HCPCS,25270,Repair forearm tendon/muscle,,,1235.91,1431.06,8
HCPCS,25272,REPAIR FOREARM TENDON/MUSCLE,,,2808.13,3405.12,20
HCPCS,25272,RPR TDN/MUSC XTNSR F/ARM&/WRIST SEC 1 EA TDN/MU,2884.0,1874.6,1.1,9440.12,144
HCPCS,25272,Repair forearm tendon/muscle,,,1235.91,1431.06,8
HCPCS,25274,REPAIR FOREARM TENDON/MUSCLE,,,2808.13,3405.12,20
HCPCS,25274,RPR TDN/MUSC XTNSR F/ARM&/WRST SEC FR GRF EA TDN,3576.0,2324.4,1.1,9440.12,144
HCPCS,25274,Repair forearm tendon/muscle,,,1235.91,1431.06,8
HCPCS,25275,REPAIR FOREARM TENDON SHEATH,,,2808.13,3405.12,20
HCPCS,25275,RPR TENDON SHEATH EXTENSOR F/ARM&/WRIST W/GRAFT,3584.0,2329.6,1.1,9440.12,144
HCPCS,25275,Repair forearm tendon sheath,,,1235.91,1431.06,8
HCPCS,25280,LNGTH/SHRT FLXR/XTNSR TDN F/ARM&/WRIST 1 EA TDN,2956.0,1921.4,1.1,9440.12,144
HCPCS,25280,REVISE WRIST/FOREARM TENDON,,,2808.13,3405.12,20
HCPCS,25280,Revise wrist/forearm tendon,,,1235.91,1431.06,8
HCPCS,25290,INCISE WRIST/FOREARM TENDON,,,2808.13,3405.12,20
HCPCS,25290,Incise wrist/forearm tendon,,,1235.91,1431.06,8
HCPCS,25290,TNOT FLXR/XTNSR TENDON FOREARM&/WRIST 1 EA,2172.0,1411.8,1.1,9440.12,144
HCPCS,25295,RELEASE WRIST/FOREARM TENDON,,,2808.13,3405.12,20
HCPCS,25295,Release wrist/forearm tendon,,,1235.91,1431.06,8
HCPCS,25295,TNOLS FLXR/XTNSR TENDON FOREARM&/WRIST 1 EA,2688.0,1747.2,1.1,9440.12,144
HCPCS,25300,FUSION OF TENDONS AT WRIST,,,2808.13,3405.12,20
HCPCS,25300,Fusion of tendons at wrist,,,4162.67,4819.94,8
HCPCS,25300,TENODESIS WRIST FLEXORS FINGERS,3608.0,2345.2,1.1,9440.12,144
HCPCS,25301,FUSION OF TENDONS AT WRIST,,,2808.13,3405.12,20
HCPCS,25301,Fusion of tendons at wrist,,,1235.91,1431.06,8
HCPCS,25301,TENODESIS WRIST EXTENSORS FINGERS,3436.0,2233.4,1.1,9440.12,144
HCPCS,25310,TDN TRNSPLJ/TR FLXR/XTNSR F/ARM&/WRST 1 EA TDN,3960.0,2574.0,1.1,9440.12,144
HCPCS,25310,TRANSPLANT FOREARM TENDON,,,2808.13,3405.12,20
HCPCS,25310,Transplant forearm tendon,,,1235.91,1431.06,8
HCPCS,25312,TDN TRNSPLJ/TR FLXR/XTNSR F/ARM&/WRST 1/TDN GR,4321.0,2808.65,1.1,9440.12,144
HCPCS,25312,TRANSPLANT FOREARM TENDON,,,2808.13,3405.12,20
HCPCS,25312,Transplant forearm tendon,,,1235.91,1431.06,8
HCPCS,25315,FLEXOR ORIGIN SLIDE FOREARM &/WRIST,4272.0,2776.8,1.1,20863.78,144
HCPCS,25315,REVISE PALSY HAND TENDON(S),,,6206.54,7551.43,20
HCPCS,25315,Revise palsy hand tendon(s),,,1912.9,2214.94,8
HCPCS,25316,REVISE PALSY HAND TENDON(S),,,6206.54,7551.43,20
HCPCS,25316,Revise palsy hand tendon(s),,,1912.9,2214.94,8
HCPCS,25320,CAPSL-RHPHY/RCNSTJ WRST OPN CARPL INS,5100.0,3315.0,1.1,20863.78,144
HCPCS,25320,REPAIR/REVISE WRIST JOINT,,,6206.54,7551.43,20
HCPCS,25320,Repair/revise wrist joint,,,4162.67,4819.94,8
HCPCS,25332,ARTHRP WRST W/WO INTERPOS W/WO XTRNL/INT FIXJ,4696.0,3052.4,1.1,9440.12,144
HCPCS,25332,REVISE WRIST JOINT,,,2808.13,3405.12,20
HCPCS,25332,Revise wrist joint,,,2382.18,2758.32,8
HCPCS,25335,CENTRALIZATION WRIST ON ULNA,,,2808.13,3405.12,20
HCPCS,25335,CENTRALIZATION WRST ULNA,5356.0,3481.4,1.1,9440.12,144
HCPCS,25335,Centralization wrist on ulna,,,1235.91,1431.06,8
HCPCS,25337,RCNSTJ STABLJ DSTL U/DSTL JT 2 SOFT TISS STABLJ,4692.0,3049.8,1.1,20863.78,144
HCPCS,25337,RECONSTRUCT ULNA/RADIOULNAR,,,6206.54,7551.43,20
HCPCS,25337,Reconstruct ulna/radioulnar,,,4162.67,4819.94,8
HCPCS,25350,"OSTEOTOMY RADIUS,DISTAL THIRD",3636.0,2363.4,1.1,20863.78,144
HCPCS,25350,REVISION OF RADIUS,,,6206.54,7551.43,20
HCPCS,25350,Revision of radius,,,4162.67,4819.94,8
HCPCS,25355,"OSTEOTOMY RADIUS,PROX/MID THIRD",4212.0,2737.8,1.1,9440.12,144
HCPCS,25355,REVISION OF RADIUS,,,2808.13,3405.12,20
HCPCS,25355,Revision of radius,,,1235.91,1431.06,8
HCPCS,25360,OSTEOTOMY ULNA,3496.0,2272.4,1.1,20863.78,144
HCPCS,25360,REVISION OF ULNA,,,6206.54,7551.43,20
HCPCS,25360,Revision of ulna,,,4162.67,4819.94,8
HCPCS,25365,OSTEOTOMY RADIUS/ULNA,5164.0,3356.6,1.1,38384.94,144
HCPCS,25365,REVISE RADIUS & ULNA,,,11418.01,13361.02,20
HCPCS,25365,Revise radius & ulna,,,4162.67,4819.94,8
HCPCS,25370,MLT OSTEOTOMIES W/RELIGNMT IMED ROD RADIUS/ULNA,5640.0,3666.0,1.1,9440.12,144
HCPCS,25370,REVISE RADIUS OR ULNA,,,2808.13,3405.12,20
HCPCS,25370,Revise radius or ulna,,,1235.91,1431.06,8
HCPCS,25375,MLT OSTEOTOMIES W/RELIGNMT IMED ROD RADIUS&ULNA,5420.0,3523.0,1.1,9440.12,144
HCPCS,25375,REVISE RADIUS & ULNA,,,2808.13,3405.12,20
HCPCS,25375,Revise radius & ulna,,,1235.91,1431.06,8
HCPCS,25390,OSTEOPLASTY RADIUS/ULNA SHORTENING,4280.0,2782.0,1.1,20863.78,144
HCPCS,25390,SHORTEN RADIUS OR ULNA,,,6206.54,7551.43,20
HCPCS,25390,Shorten radius or ulna,,,4162.67,4819.94,8
HCPCS,25391,LENGTHEN RADIUS OR ULNA,,,11418.01,13361.02,20
HCPCS,25391,Lengthen radius or ulna,,,4162.67,4819.94,8
HCPCS,25391,OSTEOPLASTY RADIUS/ULNA LENGTHENING W/AUTOGRAFT,5712.0,3712.8,1.1,38384.94,144
HCPCS,25392,OSTEOPLASTY RADIUS & ULNA SHORTENING,5832.0,3790.8,1.1,20863.78,144
HCPCS,25392,SHORTEN RADIUS & ULNA,,,6206.54,7551.43,20
HCPCS,25392,Shorten radius & ulna,,,4162.67,4819.94,8
HCPCS,25393,LENGTHEN RADIUS & ULNA,,,6206.54,7551.43,20
HCPCS,25393,Lengthen radius & ulna,,,4162.67,4819.94,8
HCPCS,25393,OSTEOPLASTY RADIUS&ULNA LENGTHENING W/AUTOGRAF,6624.0,4305.6,1.1,20863.78,144
HCPCS,25394,"OSTEOPLSTY CARPAL, SHORTNING",4340.0,2821.0,1.1,9440.12,144
HCPCS,25394,REPAIR CARPAL BONE SHORTEN,,,2808.13,3405.12,20
HCPCS,25394,Repair carpal bone shorten,,,1912.9,2214.94,8
HCPCS,25400,REPAIR RADIUS OR ULNA,,,6206.54,7551.43,20
HCPCS,25400,RPR NONUNION/MALUNION RADIUS/ULNA W/O AUTOGRAFT,4512.0,2932.8,1.1,20863.78,144
HCPCS,25400,Repair radius or ulna,,,4162.67,4819.94,8
HCPCS,25405,REPAIR/GRAFT RADIUS OR ULNA,,,6206.54,7551.43,20
HCPCS,25405,RPR NONUNION/MALUNION RADIUS/ULNA W/AUTOGRAFT,6004.0,3902.6,1.1,20863.78,144
HCPCS,25405,Repair/graft radius or ulna,,,4162.67,4819.94,8
HCPCS,25415,REPAIR RADIUS & ULNA,,,6206.54,7551.43,20
HCPCS,25415,RPR NONUNION/MALUNION RADIUS&ULNA W/O AUTOGRAF,5520.0,3588.0,1.1,20863.78,144
HCPCS,25415,Repair radius & ulna,,,4162.67,4819.94,8
HCPCS,25420,REPAIR/GRAFT RADIUS & ULNA,,,6206.54,7551.43,20
HCPCS,25420,RPR NONUNION/MALUNION RADIUS&ULNA W/AUTOGRAFT,6816.0,4430.4,1.1,20863.78,144
HCPCS,25420,Repair/graft radius & ulna,,,4162.67,4819.94,8
HCPCS,25425,FIX DEFECT RAD OR ULNA W AUTOGRFT,5488.0,3567.2,1.1,20863.78,144
HCPCS,25425,REPAIR/GRAFT RADIUS OR ULNA,,,6206.54,7551.43,20
HCPCS,25425,Repair/graft radius or ulna,,,4162.67,4819.94,8
HCPCS,25426,REPAIR/GRAFT RADIUS & ULNA,,,2808.13,3405.12,20
HCPCS,25426,Repair/graft radius & ulna,,,4162.67,4819.94,8
HCPCS,25430,VASC GRAFT INTO CARPAL BONE,,,2808.13,8450.24,21
HCPCS,25430,VASC PEDICL INTO CARPAL BONE,3884.0,2524.6,1.1,9440.12,144
HCPCS,25430,Vasc graft into carpal bone,,,1912.9,2214.94,8
HCPCS,25431,REP NONUNION CARPAL BONE EA,4356.0,2831.4,1.1,20863.78,144
HCPCS,25431,REPAIR NONUNION CARPAL BONE,,,6206.54,18676.74,21
HCPCS,25431,Repair nonunion carpal bone,,,3603.21,4172.14,8
HCPCS,25440,REPAIR NONU SCPHD CARPL B1,,,6206.54,7551.43,20
HCPCS,25440,RPR NONUNION SCAPHOID CARPAL BNE W/WO RDL STYLEC,4272.0,2776.8,1.1,20863.78,144
HCPCS,25440,Repair nonu scphd carpl b1,,,4162.67,4819.94,8
HCPCS,25441,ARTHROPLASTY W/PROSTHETIC RPLCMT DISTAL RADIUS,5316.0,3455.4,1.1,38384.94,144
HCPCS,25441,ARTHRP W/PROSTC DSTL RDS,,,11418.01,13361.02,20
HCPCS,25441,Arthrp w/prostc dstl rds,,,7882.2,9126.76,8
HCPCS,25442,ARTHROPLASTY W/PROSTHETIC RPLCMT DISTAL ULNA,4448.0,2891.2,1.1,54351.12,144
HCPCS,25442,ARTHRP W/PROSTC DSTL ULNA,,,16167.8,18412.18,20
HCPCS,25442,Arthrp w/prostc dstl ulna,,,7882.2,9126.76,8
HCPCS,25443,ARTHROPLASTY W/PROSTHETIC RPLCMT SCAPHOID CARPAL,4264.0,2771.6,1.1,20863.78,144
HCPCS,25443,ARTHRP PROSTC DSTL SCPH CRPL,,,6206.54,7551.43,20
HCPCS,25443,Arthrp prostc dstl scph crpl,,,2382.18,2758.32,8
HCPCS,25444,ARTHROPLASTY W/PROSTHETIC REPLACEMENT LUNATE,4568.0,2969.2,1.1,38384.94,144
HCPCS,25444,ARTHRP W/PROSTC LUNATE,,,11418.01,13361.02,20
HCPCS,25444,Arthrp w/prostc lunate,,,7882.2,9126.76,8
HCPCS,25445,ARTHROPLASTY W/PROSTHETIC REPLACEMENT TRAPEZIUM,3952.0,2568.8,1.1,20863.78,144
HCPCS,25445,ARTHRP W/PROSTC TRAPEZIUM,,,6206.54,7551.43,20
HCPCS,25445,Arthrp w/prostc trapezium,,,2382.18,2758.32,8
HCPCS,25446,ARTHRP W/PROSTC DST RDS&CRPS,,,16167.8,18412.18,20
HCPCS,25446,ARTHRP W/PROSTC RPLCMT DSTL RDS&PRTL/CARPUS,6920.0,4498.0,1.1,54351.12,144
HCPCS,25446,Arthrp w/prostc dst rds&crps,,,7882.2,9126.76,8
HCPCS,25447,ARTHRP INTERCARPAL/CARP/MTCRPL JT INTERPOSITION,4200.0,2730.0,1.1,9440.12,144
HCPCS,25447,ARTHRP NTRCRP/CRP/MTCR NTRPS,,,2808.13,13821.0,23
HCPCS,25447,Arthrp ntrcrp/crp/mtcr ntrps,,,2382.18,2758.32,8
HCPCS,25448,ARTHRP INTERCARPAL/CARP/MTCRPL JT SUSPENSION,5214.0,3389.1,1.1,5214.0,142
HCPCS,25448,ARTHRP NTRCRPL/CRP/MTCRP SSP,,,3007.88,10364.0,21
HCPCS,25448,Arthrp ntrcrpl/crp/mtcrp ssp,,,2382.18,2758.32,8
HCPCS,25449,REVJ ARTHRP W/REMOVAL IMPLANT WRIST JOINT,5976.0,3884.4,1.1,20863.78,144
HCPCS,25449,REVJ ARTHRP WRIST JOINT,,,6206.54,7551.43,20
HCPCS,25449,Revj arthrp wrist joint,,,2382.18,2758.32,8
HCPCS,25450,EPIPHYSL ARRST DSTL RDS/ULNA,,,2808.13,3405.12,20
HCPCS,25450,EPIPHYSL ARRST EPIPHYSIOD/STAPLING DSTL RDS/U,3224.0,2095.6,1.1,9440.12,144
HCPCS,25450,Epiphysl arrst dstl rds/ulna,,,1235.91,1431.06,8
HCPCS,25455,EPIPHYSL ARRST DSTL RDS&ULNA,,,2808.13,3405.12,20
HCPCS,25455,EPIPHYSL ARRST EPIPHYSIOD/STAPLING DSTL RDS&ULNA,3884.0,2524.6,1.1,9440.12,144
HCPCS,25455,Epiphysl arrst dstl rds&ulna,,,1235.91,1431.06,8
HCPCS,25490,PROPH TX N/P/PLTWR W/WO METHYLACRYLATE RADIUS,3892.0,2529.8,1.1,20863.78,144
HCPCS,25490,PROPHYLACTIC TX RADIUS,,,6206.54,7551.43,20
HCPCS,25490,Prophylactic tx radius,,,4162.67,4819.94,8
HCPCS,25491,PROPH TX N/P/PLTWR W/WO METHYLMETHACRYLATE ULNA,4060.0,2639.0,1.1,38384.94,144
HCPCS,25491,PROPHYLACTIC TX ULNA,,,11418.01,13361.02,20
HCPCS,25491,Prophylactic tx ulna,,,4162.67,4819.94,8
HCPCS,25492,PROPH TX N/P/PLTWR W/WO METHYLMECRYLATE RAD&UL,5064.0,3291.6,1.1,9440.12,144
HCPCS,25492,PROPHYLACTIC TX RADIUS&ULNA,,,2808.13,3405.12,20
HCPCS,25492,Prophylactic tx radius&ulna,,,1235.91,1431.06,8
HCPCS,25500,CLOSED TX RADIAL SHAFT FRACTURE W/O MANIPULATION,1071.5,696.475,0.01,12500.0,321
HCPCS,25505,CLOSED TX RADIAL SHAFT FRACTURE W/MANIPULATION,4771.0,3101.15,0.01,7362.0,322
HCPCS,25515,OPEN TREATMENT RADIAL SHAFT FRACTURE,3520.0,2288.0,1.1,20863.78,144
HCPCS,25515,OPTX RADIAL SHAFT FRACTURE,,,6206.54,11170.0,21
HCPCS,25515,Optx radial shaft fracture,,,3603.21,4172.14,8
HCPCS,25520,CLTX RDL SHFT FX&CLTX DISLC DSTL RAD/ULN JT,4981.0,3237.65,1.1,7362.0,235
HCPCS,25525,OPEN RDL SHAFT FX CLOSED RAD/ULN JT DISLOCATE,4220.0,2743.0,1.1,20863.78,144
HCPCS,25525,OPTX RDL SHFT FX&CLTX RAD/UL,,,6206.54,7551.43,20
HCPCS,25525,Optx rdl shft fx&cltx rad/ul,,,3603.21,4172.14,8
HCPCS,25526,OPEN RDL SHAFT FX OPEN RAD/ULN JT DISLOCATE,5260.0,3419.0,1.1,20863.78,144
HCPCS,25526,OPTX RDL SHFT FX&DSTL RAD/UL,,,6206.54,7551.43,20
HCPCS,25526,Optx rdl shft fx&dstl rad/ul,,,3603.21,4172.14,8
HCPCS,25530,CLOSED TX ULNAR SHAFT FRACTURE W/O MANIPULATION,999.5,649.675,0.01,12500.0,321
HCPCS,25535,CLOSED TX ULNAR SHAFT FRACTURE W/MANIPULATION,1623.5,1055.275,0.01,4392.0,322
HCPCS,25545,OPEN TREATMENT OF ULNAR SHAFT FRACTURE,3176.0,2064.4,1.1,20863.78,144
HCPCS,25545,OPTX ULNAR SHFT FX INT FIXJ,,,6206.54,7551.43,20
HCPCS,25545,Optx ulnar shft fx int fixj,,,3603.21,4172.14,8
HCPCS,25560,CLOSED TX RADIAL&ULNAR SHAFT FRACTURES W/O MAN,1069.5,695.175,0.01,12500.0,321
HCPCS,25565,CLOSED TX RADIAL&ULNAR SHAFT FRACTURES W/MANJ,4851.0,3153.15,0.01,7362.0,409
HCPCS,25574,OPEN TX RADIAL&ULNAR SHAFT FX W/FIXJ RADIUS/ULNA,3520.0,2288.0,1.1,20863.78,144
HCPCS,25574,OPTX RDL&ULN SHFT FX RDS/ULN,,,6206.54,7551.43,20
HCPCS,25574,Optx rdl&uln shft fx rds/uln,,,3603.21,4172.14,8
HCPCS,25575,OPEN TX RADIAL&ULNAR SHAFT FX W/FIXJ RADIUS&ULNA,4916.0,3195.4,1.1,20863.78,144
HCPCS,25575,OPTX RDL&ULN SHFT FX RDS&ULN,,,5597.0,11170.0,23
HCPCS,25575,Optx rdl&uln shft fx rds&uln,,,3603.21,4172.14,8
HCPCS,25600,CLTX DSTL RADIAL FX/EPIPHYSL SEP W/O MANJ,1107.5,719.875,0.01,12500.0,321
HCPCS,25605,CLTX DSTL RDL FX/EPIPHYSL SEP W/MANJ WHEN PERF,4931.0,3205.15,0.01,7813.0,322
HCPCS,25606,PERQ SKEL FIXJ DISTAL RADIAL FX/EPIPHYSL SEP,3324.0,2160.6,1.1,9440.12,144
HCPCS,25606,PERQ SKEL FIXJ DSTL RDL FX,,,2808.13,7813.0,22
HCPCS,25606,Perq skel fixj dstl rdl fx,,,3603.21,4172.14,8
HCPCS,25607,"OPEN RX DISTAL RADIUS FX, EXTRA-ARTICULAR",4206.0,2733.9,1.1,20863.78,144
HCPCS,25607,OPTX DST RD XARTC FX/EPI SEP,,,6206.54,13821.0,24
HCPCS,25607,Optx dst rd xartc fx/epi sep,,,3603.21,4172.14,8
HCPCS,25608,"OPEN RX DISTAL RADIUS FX, INTRA-ARTICULAR, 2 FRAG",4871.0,3166.15,1.1,20863.78,144
HCPCS,25608,OPTX DST RD XART FX/EPI SEP2,,,6206.54,11170.0,21
HCPCS,25608,Optx dst rd xart fx/epi sep2,,,3603.21,4172.14,8
HCPCS,25609,"OPEN RX DISTAL RADIUS FX, INTRA-ARTICULAR, 3+ FRAG",6327.0,4112.55,1.1,20863.78,144
HCPCS,25609,OPTX DST RD XART FX/EP SEP3+,,,6206.54,13821.0,23
HCPCS,25609,Optx dst rd xart fx/ep sep3+,,,3603.21,4172.14,8
HCPCS,25622,CLOSED TX CARPAL SCAPHOID FRACTURE W/O MANJ,1109.5,721.175,0.01,12500.0,321
HCPCS,25624,CLOSED TX CARPAL SCAPHOID FRACTURE W/MANJ,4635.0,3012.75,1.1,7362.0,322
HCPCS,25628,OPEN TX CARPAL SCAPHOID NAVICULAR FRACTURE,3868.0,2514.2,1.1,20863.78,144
HCPCS,25628,OPTX CARPL SCPHD FX INT FIXJ,,,5597.0,11170.0,24
HCPCS,25628,Optx carpl scphd fx int fixj,,,3603.21,4172.14,8
HCPCS,25630,CLTX CARPAL BONE FX W/O MANJ EACH BONE,1218.0,791.7,0.01,12500.0,407
HCPCS,25635,CLTX CARPAL BONE FX W/MANJ EACH BONE,4695.0,3051.75,1.1,7362.0,235
HCPCS,25645,OPEN TX CARPAL BONE FRACTURE OTH/THN SCAPHOID EA,2968.0,1929.2,1.1,9440.12,144
HCPCS,25645,OPTX CRPL FX OTH/THN SCPH EA,,,2808.13,3405.12,20
HCPCS,25645,Optx crpl fx oth/thn scph ea,,,3603.21,4172.14,8
HCPCS,25650,CLOSED TREATMENT ULNAR STYLOID FRACTURE,1197.5,778.375,0.01,12500.0,407
HCPCS,25651,PERQ SKEL FIX ULNAR STYLD FX,,,2808.13,8450.24,22
HCPCS,25651,PRQ SKELETAL FIXATION ULNAR STYLOID FRACTURE,2328.0,1513.2,1.1,9440.12,144
HCPCS,25651,Perq skel fix ulnar styld fx,,,3603.21,4172.14,8
HCPCS,25652,OPEN TREATMENT ULNAR STYLOID FRACTURE,3224.0,2095.6,1.1,20863.78,144
HCPCS,25652,OPTX ULNAR STYLOID FRACTURE,,,6206.54,7551.43,20
HCPCS,25652,Optx ulnar styloid fracture,,,3603.21,4172.14,8
HCPCS,25660,CLTX RDCRPL/INTERCARPL DISLC 1/> BONES W/MANJ,1547.5,1005.875,1.1,4392.0,231
HCPCS,25670,OPEN TX RADIOCARPAL/INTERCARPAL DISLC 1/> BONES,3236.0,2103.4,1.1,20863.78,144
HCPCS,25670,OPTX RDCRPL/NTRCRPL DISLC 1+,,,6206.54,7813.0,21
HCPCS,25670,Optx rdcrpl/ntrcrpl dislc 1+,,,3603.21,4172.14,8
HCPCS,25671,PERQ SKEL FIX RAD/ULN DISLC,,,2808.13,3405.12,20
HCPCS,25671,PRQ SKELETAL FIXJ DISTAL RADIOULNAR DISLOCATION,2584.0,1679.6,1.1,9440.12,144
HCPCS,25671,Perq skel fix rad/uln dislc,,,3603.21,4172.14,8
HCPCS,25675,CLOSED TX DISTAL RADIOULNAR DISLOCATION W/MANJ,1529.5,994.1750000000001,1.1,4392.0,235
HCPCS,25676,OPEN TX DISTAL RADIOULNAR DISLC ACUTE/CHRONIC,3316.0,2155.4,1.1,20863.78,144
HCPCS,25676,OPTX RAD/ULN DISLC AQT/CHRNC,,,6206.54,7551.43,20
HCPCS,25676,Optx rad/uln dislc aqt/chrnc,,,3603.21,4172.14,8
HCPCS,25680,CLTX TRANS-SCAPHOPRILUNAR TYP FX DISLC W/MANJ,2492.0,1619.8,1.1,2492.0,144
HCPCS,25680,CLTX TRNS-SCPHPRLNR FX MNPJ,,,204.59,256.7,20
HCPCS,25680,Cltx trns-scphprlnr fx mnpj,,,295.11,341.7,8
HCPCS,25685,OPEN TX TRANS-SCAPHOPERILUNAR FRACTURE DISLC,4036.0,2623.4,1.1,20863.78,144
HCPCS,25685,OPTX TRNS-SCPHPRLNR FX DISLC,,,6206.54,7551.43,20
HCPCS,25685,Optx trns-scphprlnr fx dislc,,,3603.21,4172.14,8
HCPCS,25690,CLOSED TX LUNATE DISLOCATION W/MANIPULATION,4825.0,3136.25,1.1,7362.0,231
HCPCS,25695,OPEN TREATMENT LUNATE DISLOCATION,3404.0,2212.6,1.1,20863.78,144
HCPCS,25695,OPTX LUNATE DISLOCATION,,,6206.54,7551.43,20
HCPCS,25695,Optx lunate dislocation,,,3603.21,4172.14,8
HCPCS,25800,ARTHRD WRIST COMPLETE WO GRF,,,6206.54,7551.43,20
HCPCS,25800,ARTHRODESIS WRIST COMPLETE W/O BONE GRAFT,4431.0,2880.15,1.1,20863.78,144
HCPCS,25800,Arthrd wrist complete wo grf,,,4162.67,4819.94,8
HCPCS,25805,ARTHRD WRIST W/SLIDING GRAFT,,,6206.54,7551.43,20
HCPCS,25805,ARTHRODESIS WRIST W/SLIDING GRAFT,4692.0,3049.8,1.1,20863.78,144
HCPCS,25805,Arthrd wrist w/sliding graft,,,4162.67,4819.94,8
HCPCS,25810,ARTHRD WRST ILIAC/OTH AGRFT,,,11418.01,13361.02,20
HCPCS,25810,ARTHRODESIS WRIST W/ILIAC/OTHER AUTOGRAFT,4780.0,3107.0,1.1,38384.94,144
HCPCS,25810,Arthrd wrst iliac/oth agrft,,,4162.67,4819.94,8
HCPCS,25820,ARTHRD WRIST LMTD W/O B1 GRF,,,6206.54,11170.0,22
HCPCS,25820,ARTHRODESIS WRIST LIMITED W/O BONE GRAFT,3056.0,1986.4,1.1,20863.78,144
HCPCS,25820,Arthrd wrist lmtd w/o b1 grf,,,1912.9,2214.94,8
HCPCS,25825,ARTHRD WRIST WITH AUTOGRAFT,,,6206.54,7551.43,20
HCPCS,25825,ARTHRODESIS WRIST LIMITED W/AUTOGRAFT,3876.0,2519.4,1.1,20863.78,144
HCPCS,25825,Arthrd wrist with autograft,,,1912.9,2214.94,8
HCPCS,25830,ARTHRD DST RAD/UL JT SGM RSC,,,6206.54,7551.43,20
HCPCS,25830,ARTHRD DSTL RAD/ULN JT SGMTL RSCJ ULNA W/WO BONE,4352.0,2828.8,1.1,20863.78,144
HCPCS,25830,Arthrd dst rad/ul jt sgm rsc,,,4162.67,4819.94,8
HCPCS,25900,AMPUTATION FOREARM THROUGH RADIUS & ULNA,3844.0,2498.6,1.1,3844.0,144
HCPCS,25900,AMPUTATION OF FOREARM,,,1881.78,7551.43,13
HCPCS,25900,Amputation of forearm,,,4162.67,4819.94,8
HCPCS,25905,AMP FOREARM THRU RADIUS & ULNA OPEN CIRCULAR,3836.0,2493.4,1.1,3836.0,144
HCPCS,25905,AMPUTATION OF FOREARM,,,1845.83,7551.43,13
HCPCS,25905,Amputation of forearm,,,6600.42,7642.59,8
HCPCS,25907,AMPUTATION FOLLOW-UP SURGERY,,,2808.13,3405.12,20
HCPCS,25907,Amputation follow-up surgery,,,1235.91,1431.06,8
HCPCS,25909,AMP FOREARM THRU RADIUS&ULNA RE-AMPUTATION,3724.0,2420.6,1.1,20863.78,144
HCPCS,25909,AMPUTATION FOLLOW-UP SURGERY,,,6206.54,18676.74,21
HCPCS,25909,Amputation follow-up surgery,,,4162.67,4819.94,8
HCPCS,25915,AMPUTATION OF FOREARM,,,3055.65,7551.43,13
HCPCS,25915,Amputation of forearm,,,6600.42,7642.59,8
HCPCS,25920,AMPUTATE HAND AT WRIST,,,1907.67,3405.12,13
HCPCS,25920,Amputate hand at wrist,,,4162.67,4819.94,8
HCPCS,25920,DISARTICULATION THROUGH WRIST,3612.0,2347.8,1.1,3612.0,144
HCPCS,25922,AMPUTATE HAND AT WRIST,,,1394.34,1673.41,20
HCPCS,25922,Amputate hand at wrist,,,1235.91,1431.06,8
HCPCS,25924,AMPUTATION FOLLOW-UP SURGERY,,,1863.8,3405.12,13
HCPCS,25924,Amputation follow-up surgery,,,4162.67,4819.94,8
HCPCS,25927,AMPUTATION OF HAND,,,2232.85,3405.12,13
HCPCS,25927,AMPUTATION TRANSMETACARPAL,3636.0,2363.4,1.1,3636.0,144
HCPCS,25927,Amputation of hand,,,1912.9,2214.94,8
HCPCS,25929,AMPUTATION FOLLOW-UP SURGERY,,,1582.09,2147.22,20
HCPCS,25929,Amputation follow-up surgery,,,1168.27,1352.74,8
HCPCS,25929,TRANSMETACARPAL AMPUTATION SEC CLOSURE/SCAR REVJ,3128.0,2033.2,1.1,5320.02,144
HCPCS,25931,AMPUTATION FOLLOW-UP SURGERY,,,2808.13,8450.24,21
HCPCS,25931,Amputation follow-up surgery,,,1235.91,1431.06,8
HCPCS,25931,RE-AMPUTATION TRANSMETACARPAL,3216.0,2090.4,1.1,9440.12,144
HCPCS,25999,DECOMPRESSION OF THE DISTAL RADIUS (COMP CODE 25035),3060.0,1989.0,0.01,3060.0,84
HCPCS,25999,RESURFACING OF THE CAPITATE (COMP CODE 25444),4911.0,3192.15,0.01,4911.0,84
HCPCS,25999,UNLISTED PROCEDURE FOREARM OR WRIST,400.0,260.0,111.2,3443.0,84
HCPCS,26010,DRAIN FINGER ABSCESS SIMPLE,700.0,455.0,1.1,1164.4,148
HCPCS,26010,DRAINAGE FINGER ABSCESS SIMPLE,914.0,594.1,0.01,12500.0,173
HCPCS,26011,DRAIN FINGER ABSCESS COMPL,986.0,640.9,1.1,4729.25,148
HCPCS,26011,DRAINAGE FINGER ABSCESS COMPLICATED,7453.0,4844.45,0.01,7453.0,174
HCPCS,26020,DRAIN HAND TENDON SHEATH,2736.0,1778.4,1.1,9440.12,144
HCPCS,26020,DRAINAGE TENDON SHEATH DIGIT&/PALM EACH,14925.0,9701.25,0.01,14925.0,174
HCPCS,26025,DRAINAGE OF PALM BURSA,,,2808.13,3405.12,20
HCPCS,26025,"DRAINAGE PALM BURSA,SINGLE",2032.0,1320.8,1.1,9440.12,144
HCPCS,26025,Drainage of palm bursa,,,1168.27,1352.74,8
HCPCS,26030,DRAINAGE OF PALM BURSAS,,,2808.13,3405.12,20
HCPCS,26030,"DRAINAGE PALM BURSA,MULTIP/COMPLX",2500.0,1625.0,1.1,9440.12,144
HCPCS,26030,Drainage of palm bursas,,,1168.27,1352.74,8
HCPCS,26034,INCIS DEEP FINGR/HAND BONE LESN,2652.0,1723.8,1.1,4686.39,144
HCPCS,26034,TREAT HAND BONE LESION,,,1394.34,1673.41,20
HCPCS,26034,Treat hand bone lesion,,,1168.27,1352.74,8
HCPCS,26035,DECOMPRESS FINGERS/HAND,,,2808.13,3405.12,20
HCPCS,26035,"DECOMPRESS FINGERS/HAND,INJECT INJ",4548.0,2956.2,1.1,9440.12,144
HCPCS,26035,Decompress fingers/hand,,,1912.9,2214.94,8
HCPCS,26037,DECOMPRESS FASCIOTOMY FINGR/HAND,3028.0,1968.2,1.1,9440.12,144
HCPCS,26037,DECOMPRESS FINGERS/HAND,,,2808.13,3405.12,20
HCPCS,26037,Decompress fingers/hand,,,1912.9,2214.94,8
HCPCS,26040,FASCIOTOMY PALMAR PERCUTANEOUS,4373.0,2842.4500000000003,0.01,10789.0,231
HCPCS,26045,FASCIOTOMY PALMAR OPEN PARTIAL,2292.0,1489.8,1.1,9440.12,144
HCPCS,26045,RELEASE PALM CONTRACTURE,,,2808.13,3405.12,20
HCPCS,26045,Release palm contracture,,,1168.27,1352.74,8
HCPCS,26055,INCISE FINGER TENDON SHEATH,1368.0,889.2,1.1,4686.39,148
HCPCS,26055,TENDON SHEATH INCISION,7362.0,4785.3,0.01,7362.0,87
HCPCS,26060,TENOTOMY PERCUTANEOUS SINGLE EACH DIGIT,4263.0,2770.9500000000003,1.1,7362.0,231
HCPCS,26070,ARTHRT EXPL DRG/RMVL LOOSE/FB CARP/MTCRPL JT,1524.0,990.6,1.1,4686.39,144
HCPCS,26070,EXPLORE/TREAT HAND JOINT,,,1394.34,1673.41,20
HCPCS,26070,Explore/treat hand joint,,,1168.27,1352.74,8
HCPCS,26075,ARTHRT EXPL DRG/RMVL LOOSE/FB MTCARPHLNGL JT EA,1564.0,1016.6,1.1,9440.12,144
HCPCS,26075,EXPLORE/TREAT FINGER JOINT,,,2808.13,3405.12,20
HCPCS,26075,Explore/treat finger joint,,,1168.27,1352.74,8
HCPCS,26080,ARTHRT EXPL DRG/RMVL LOOSE/FB IPHAL JT EA,4575.0,2973.75,1.1,10789.0,231
HCPCS,26100,ARTHROTOMY BIOPSY CARP/MTCRPL JOINT EACH,1516.0,985.4,1.1,9440.12,144
HCPCS,26100,BIOPSY HAND JOINT LINING,,,2808.13,3405.12,20
HCPCS,26100,Biopsy hand joint lining,,,1168.27,1352.74,8
HCPCS,26105,ARTHROTOMY BIOPSY MTCARPHLNGL JOINT EACH,1532.0,995.8,1.1,9440.12,144
HCPCS,26105,BIOPSY FINGER JOINT LINING,,,2808.13,3405.12,20
HCPCS,26105,Biopsy finger joint lining,,,1168.27,1352.74,8
HCPCS,26110,ARTHROTOMY BIOPSY INTERPHALANGEAL JOINT EACH,1460.0,949.0,1.1,4686.39,144
HCPCS,26110,BIOPSY FINGER JOINT LINING,,,1394.34,1673.41,20
HCPCS,26110,Biopsy finger joint lining,,,1168.27,1352.74,8
HCPCS,26111,EX TUM/VASC MALF SFT TISS HAND/FNGR SUBQ 1.5+CM,2168.0,1409.2,1.1,4729.25,144
HCPCS,26111,EX TUM/VASC MALF SFT TISS HAND/FNGR SUBQ 1.5CM/>,7453.0,4844.45,0.01,10364.0,87
HCPCS,26113,EX TUM/VASC MAL SFT TIS HAND/FNGR SUBFSC 1.5+CM,2852.0,1853.8,1.1,4729.25,144
HCPCS,26113,EXCISION SOFT TISSUE TUMOR SUBFASCIAL ON FINGER = / > 1.5CM (261,7453.0,4844.45,0.01,10364.0,87
HCPCS,26115,EXC TUM/VASC MAL SFT TISS HAND/FNGR SUBQ <1.5CM,4518.5,2937.0249999999996,0.01,7453.0,235
HCPCS,26116,EXC TUM/VAS MAL SFT TIS HAND/FNGR SUBFASC<1.5CM,5074.5,3298.425,0.01,7453.0,231
HCPCS,26117,RAD RESECT HAND TUMOR < 3 CM,,,2465.15,3022.89,20
HCPCS,26117,RAD RESECT TUMOR SOFT TISSUE HAND/FINGER <3CM,4052.0,2633.8,1.1,8286.13,144
HCPCS,26117,Rad resect hand tumor < 3 cm,,,1912.9,2214.94,8
HCPCS,26118,RAD RESCJ TUM SOFT TISSUE HAND/FINGER 3 CM/>,5924.0,3850.6,1.1,8286.13,144
HCPCS,26118,RAD RESECT HAND TUMOR 3 CM/>,,,2465.15,3022.89,20
HCPCS,26118,Rad resect hand tumor 3 cm/>,,,1912.9,2214.94,8
HCPCS,26121,FASCT PALM W/WO Z-PLASTY TISSUE REARGMT/SKN GRFT,3092.0,2009.8,1.1,9440.12,144
HCPCS,26121,RELEASE PALM CONTRACTURE,,,2808.13,7624.0,21
HCPCS,26121,Release palm contracture,,,1912.9,2214.94,8
HCPCS,26123,FASCT PRTL PALMAR 1 DGT PROX IPHAL JT W/WO RPR,9638.5,6265.025,0.01,14925.0,231
HCPCS,26125,FASCT PRTL PALMR ADDL DGT PROX IPHAL JT W/WO RPR,1840.0,1196.0,1.1,1840.0,144
HCPCS,26125,Release palm contracture,,,1912.9,2214.94,8
HCPCS,26130,REMOVE WRIST JOINT LINING,,,2808.13,3405.12,20
HCPCS,26130,Remove wrist joint lining,,,1168.27,1352.74,8
HCPCS,26130,SYNOVECTOMY CARPOMETACARPAL JOINT,2236.0,1453.4,1.1,9440.12,144
HCPCS,26135,REVISE FINGER JOINT EACH,,,2808.13,3405.12,20
HCPCS,26135,Revise finger joint each,,,1912.9,2214.94,8
HCPCS,26135,SYNVCT MTCARPHLNGL JT W/INTRNSC RLS&XTNSR HOOD,2852.0,1853.8,1.1,9440.12,144
HCPCS,26140,REVISE FINGER JOINT EACH,,,1394.34,1673.41,20
HCPCS,26140,Revise finger joint each,,,1168.27,1352.74,8
HCPCS,26140,SYNVCT PROX IPHAL JT W/XTNSR RCNSTJ EA IPHAL JT,2536.0,1648.4,1.1,4686.39,144
HCPCS,26145,SYNVCT TDN SHTH RAD FLXR TDN PALM&/FNGR EA TDN,2596.0,1687.4,1.1,4686.39,144
HCPCS,26145,TENDON EXCISION PALM/FINGER,,,1394.34,1673.41,20
HCPCS,26145,Tendon excision palm/finger,,,1912.9,2214.94,8
HCPCS,26160,EXC LESION TDN SHTH/JT CAPSL HAND/FNGR,4466.5,2903.225,0.01,7813.0,235
HCPCS,26170,EXCISION TENDON PALM FLEXOR/EXTENSOR SINGLE EACH,4663.0,3030.95,0.01,7813.0,231
HCPCS,26180,EXCISION TENDON FINGER FLEXOR/EXTENSOR EACH,2140.0,1391.0,1.1,4686.39,144
HCPCS,26180,REMOVAL OF FINGER TENDON,,,1394.34,1673.41,20
HCPCS,26180,Removal of finger tendon,,,1168.27,1352.74,8
HCPCS,26185,REMOVE FINGER BONE,,,1394.34,1673.41,20
HCPCS,26185,Remove finger bone,,,1168.27,1352.74,8
HCPCS,26185,"SESAMOIDECTOMY, THUMB/FINGER",2608.0,1695.2,1.1,4686.39,144
HCPCS,26200,EXCISION/CURETTAGE CYST/TUMOR METACARPAL,2260.0,1469.0,1.1,4686.39,144
HCPCS,26200,REMOVE HAND BONE LESION,,,1394.34,4315.0,21
HCPCS,26200,Remove hand bone lesion,,,1168.27,1352.74,8
HCPCS,26205,EXC/CURETTAGE CYST/TUMOR METACARPAL W/AUTOGRAFT,3172.0,2061.8,1.1,20863.78,144
HCPCS,26205,REMOVE/GRAFT BONE LESION,,,6206.54,7551.43,20
HCPCS,26205,Remove/graft bone lesion,,,1912.9,2214.94,8
HCPCS,26210,EXCISION/CURETTAGE CYST/TUMOR PHALANX FINGER,2128.0,1383.2,1.1,4686.39,144
HCPCS,26210,REMOVAL OF FINGER LESION,,,1394.34,5457.0,22
HCPCS,26210,Removal of finger lesion,,,1168.27,1352.74,8
HCPCS,26215,EXC/CURETTAGE CYST/TUMOR PHALANX FINGER W/AGRAFT,2908.0,1890.2,1.1,9440.12,144
HCPCS,26215,REMOVE/GRAFT FINGER LESION,,,2808.13,3405.12,20
HCPCS,26215,Remove/graft finger lesion,,,1912.9,2214.94,8
HCPCS,26230,"PART REMV BONE,METACARPAL",2588.0,1682.2,1.1,9440.12,144
HCPCS,26230,PARTIAL REMOVAL OF HAND BONE,,,2808.13,11545.0,21
HCPCS,26230,Partial removal of hand bone,,,1912.9,2214.94,8
HCPCS,26235,"PART REMV BONE,PROX/MID PHALANX",2532.0,1645.8,1.1,4686.39,144
HCPCS,26235,PARTIAL REMOVAL FINGER BONE,,,1394.34,1673.41,20
HCPCS,26235,Partial removal finger bone,,,1912.9,2214.94,8
HCPCS,26236,"PART REMV BONE,DISTAL PHALANX",2184.0,1419.6,1.1,4686.39,144
HCPCS,26236,PARTIAL EXCISION DISTAL PHALANX FINGER,7362.0,4785.3,0.01,7813.0,87
HCPCS,26250,EXTENSIVE HAND SURGERY,,,2808.13,3405.12,20
HCPCS,26250,Extensive hand surgery,,,1168.27,1352.74,8
HCPCS,26250,RADICAL RESECTION TUMOR METACARPAL,6084.0,3954.6,1.1,9440.12,144
HCPCS,26260,RAD RESECTION TUMOR PROX/MIDDLE PHALANX FINGER,4464.0,2901.6,1.1,9440.12,144
HCPCS,26260,RESECT PROX FINGER TUMOR,,,2808.13,3405.12,20
HCPCS,26260,Resect prox finger tumor,,,1912.9,2214.94,8
HCPCS,26262,RADICAL RESECTION TUMOR DISTAL PHALANX FINGER,3316.0,2155.4,1.1,4686.39,144
HCPCS,26262,RESECT DISTAL FINGER TUMOR,,,1394.34,1673.41,20
HCPCS,26262,Resect distal finger tumor,,,1168.27,1352.74,8
HCPCS,26320,REMOVAL OF IMPLANT FROM HAND/FINGR,4546.5,2955.225,0.01,7453.0,231
HCPCS,26340,MANIPULATE FINGER W/ANESTH,,,1394.34,1673.41,20
HCPCS,26340,MANIPULATION FINGER JOINT UNDER ANES EACH JOINT,1120.0,728.0,1.1,4686.39,142
HCPCS,26340,Manipulate finger w/anesth,,,824.67,954.88,8
HCPCS,26341,MANIPLATN PALAR FASCIAL CRD POST INJ SINGLE CORD,733.5,476.77500000000003,0.01,3443.0,235
HCPCS,26350,RPR/ADVMNT FLXR TDN N/Z/2 W/O FR GRAFT EA TENDON,8704.5,5657.925,1.1,14925.0,231
HCPCS,26352,REPAIR/GRAFT HAND TENDON,,,6206.54,7551.43,20
HCPCS,26352,RPR/ADVMNT FLXR TDN N/Z/2 W/FR GRAFT EA TENDON,3148.0,2046.2,1.1,20863.78,144
HCPCS,26352,Repair/graft hand tendon,,,1912.9,2214.94,8
HCPCS,26356,REPAIR FINGER/HAND TENDON,,,2808.13,10789.0,23
HCPCS,26356,RPR/ADVMNT FLXR TDN ZONE 2 W/O FR GRFT EA TENDON,3824.0,2485.6,1.1,9440.12,144
HCPCS,26356,Repair finger/hand tendon,,,1912.9,2214.94,8
HCPCS,26357,REPAIR FINGER/HAND TENDON,,,2808.13,3405.12,20
HCPCS,26357,RPR/ADVMNT FLXR TDN ZONE 2 W/O FR GRFT EA TENDON,4400.0,2860.0,1.1,9440.12,144
HCPCS,26357,Repair finger/hand tendon,,,1912.9,2214.94,8
HCPCS,26358,REPAIR/GRAFT HAND TENDON,,,6206.54,7551.43,20
HCPCS,26358,RPR/ADVMNT FLXR TDN ZONE 2 W/FR GRAFT EA TENDON,5040.0,3276.0,1.1,20863.78,144
HCPCS,26358,Repair/graft hand tendon,,,1912.9,2214.94,8
HCPCS,26370,REPAIR FINGER/HAND TENDON,,,2808.13,7624.0,21
HCPCS,26370,RPR/ADVMNT TDN W/NTC SUPFCIS TDN PRIM EA TDN,2912.0,1892.8,1.1,9440.12,144
HCPCS,26370,Repair finger/hand tendon,,,1912.9,2214.94,8
HCPCS,26372,REPAIR/GRAFT HAND TENDON,,,6206.54,7551.43,20
HCPCS,26372,RPR/ADVMNT TDN W/NTC SUPFCIS TDN W/FREE GRAFT EA,3604.0,2342.6,1.1,20863.78,144
HCPCS,26372,Repair/graft hand tendon,,,1912.9,2214.94,8
HCPCS,26373,REPAIR FINGER/HAND TENDON,,,2808.13,3405.12,20
HCPCS,26373,RPR/ADVMNT TDN W/NTC SUPFCIS TDN W/O FREE GRF EA,3364.0,2186.6,1.1,9440.12,144
HCPCS,26373,Repair finger/hand tendon,,,1912.9,2214.94,8
HCPCS,26390,EXC FLXR TDN W/IMPLTJ SYNTH ROD DLYD TDN GRF H/F,3772.0,2451.8,1.1,20863.78,144
HCPCS,26390,REVISE HAND/FINGER TENDON,,,6206.54,7551.43,20
HCPCS,26390,Revise hand/finger tendon,,,1912.9,2214.94,8
HCPCS,26392,REPAIR/GRAFT HAND TENDON,,,6206.54,7551.43,20
HCPCS,26392,RMVL SYNTH ROD & INSJ FLXR TDN GRF H/F EA ROD,4200.0,2730.0,1.1,20863.78,144
HCPCS,26392,Repair/graft hand tendon,,,1912.9,2214.94,8
HCPCS,26410,REPAIR EXTENSOR TENDON HAND W/O GRAFT EACH,4635.0,3012.75,0.01,7813.0,318
HCPCS,26412,REPAIR EXTENSOR TENDON HAND W/GRAFT EACH,2592.0,1684.8,1.1,9440.12,144
HCPCS,26412,REPAIR/GRAFT HAND TENDON,,,2808.13,3405.12,20
HCPCS,26412,Repair/graft hand tendon,,,1912.9,2214.94,8
HCPCS,26415,EXC XTNSR TDN W/IMPLTJ SYNTH ROD DLYD GRF H/F EA,3404.0,2212.6,1.1,9440.12,144
HCPCS,26415,EXCISION HAND/FINGER TENDON,,,2808.13,3405.12,20
HCPCS,26415,Excision hand/finger tendon,,,1912.9,2214.94,8
HCPCS,26416,GRAFT HAND OR FINGER TENDON,,,2808.13,3405.12,20
HCPCS,26416,Graft hand or finger tendon,,,1912.9,2214.94,8
HCPCS,26416,RMVL SYNTH ROD & INSJ XTNSR TDN GRF H/F EA ROD,3824.0,2485.6,1.1,9440.12,144
HCPCS,26418,REPAIR EXTENSOR TENDON FINGER W/O GRAFT EACH,4575.0,2973.75,1.1,10789.0,231
HCPCS,26420,REPAIR EXTENSOR TENDON FINGER W/GRAFT EACH,2776.0,1804.4,1.1,9440.12,144
HCPCS,26420,REPAIR/GRAFT FINGER TENDON,,,2808.13,3405.12,20
HCPCS,26420,Repair/graft finger tendon,,,1912.9,2214.94,8
HCPCS,26426,REPAIR FINGER/HAND TENDON,,,2808.13,3405.12,20
HCPCS,26426,RPR XTNSR TDN CNTRL SLIP TISS W/LAT BAND EA FNGR,2528.0,1643.2,1.1,9440.12,144
HCPCS,26426,Repair finger/hand tendon,,,1912.9,2214.94,8
HCPCS,26428,REPAIR/GRAFT FINGER TENDON,,,2808.13,3405.12,20
HCPCS,26428,RPR XTNSR TDN CNTRL SLIP SEC W/FR GRFT EA FINGER,2960.0,1924.0,1.1,9440.12,144
HCPCS,26428,Repair/graft finger tendon,,,1912.9,2214.94,8
HCPCS,26432,CLTX DSTL XTNSR TDN INSJ W/WO PERCUTAN PINNING,4513.0,2933.45,0.01,7813.0,231
HCPCS,26433,REPAIR EXTENSOR TENDON DISTAL INSERTION W/O GRF,1880.0,1222.0,1.1,9440.12,144
HCPCS,26433,REPAIR FINGER TENDON,,,2808.13,3405.12,20
HCPCS,26433,Repair finger tendon,,,1168.27,1352.74,8
HCPCS,26434,REPAIR EXTENSOR TENDON DISTAL INSERTION W/GRAFT,2504.0,1627.6,1.1,9440.12,144
HCPCS,26434,REPAIR/GRAFT FINGER TENDON,,,2808.13,3405.12,20
HCPCS,26434,Repair/graft finger tendon,,,1912.9,2214.94,8
HCPCS,26437,REALIGNMENT EXTENSOR TENDON HAND EACH TENDON,2396.0,1557.4,1.1,9440.12,144
HCPCS,26437,REALIGNMENT OF TENDONS,,,2808.13,3405.12,20
HCPCS,26437,Realignment of tendons,,,1168.27,1352.74,8
HCPCS,26440,RELEASE PALM/FINGER TENDON,,,1394.34,4315.0,21
HCPCS,26440,Release palm/finger tendon,,,1168.27,1352.74,8
HCPCS,26440,TENOLYSIS FLEXOR TENDON PALM/FINGER EACH TENDON,2064.0,1341.6,1.1,4686.39,144
HCPCS,26442,RELEASE PALM & FINGER TENDON,,,2808.13,3405.12,20
HCPCS,26442,Release palm & finger tendon,,,1912.9,2214.94,8
HCPCS,26442,TENOLYSIS FLEXOR TENDON PALM&FINGER EACH TENDO,4290.0,2788.5,1.1,9440.12,144
HCPCS,26445,RELEASE HAND/FINGER TENDON,,,2808.13,3405.12,20
HCPCS,26445,Release hand/finger tendon,,,1168.27,1352.74,8
HCPCS,26445,TENOLYSIS EXTENSOR TENDON HAND/FINGER EACH,1780.0,1157.0,1.1,9440.12,144
HCPCS,26449,RELEASE FOREARM/HAND TENDON,,,2808.13,3405.12,20
HCPCS,26449,Release forearm/hand tendon,,,1168.27,1352.74,8
HCPCS,26449,TENOLYSIS CPLX XTNSR TENDON FINGER W/FOREARM EA,3436.0,2233.4,1.1,9440.12,144
HCPCS,26450,INCISION OF PALM TENDON,,,2808.13,3405.12,20
HCPCS,26450,Incision of palm tendon,,,1168.27,1352.74,8
HCPCS,26450,"TENOTOMY PALM FLEX,SINGLE,OPEN,EACH",1516.0,985.4,1.1,9440.12,144
HCPCS,26455,INCISION OF FINGER TENDON,,,1394.34,1673.41,20
HCPCS,26455,Incision of finger tendon,,,1168.27,1352.74,8
HCPCS,26455,"TENOTOMY FINGR FLEX,SINGLE,OPEN,EACH",1504.0,977.6,1.1,4686.39,144
HCPCS,26460,INCISE HAND/FINGER TENDON,,,1394.34,1673.41,20
HCPCS,26460,Incise hand/finger tendon,,,1168.27,1352.74,8
HCPCS,26460,"TENOTOMY HAND EXTEN,SINGLE,OPEN,EACH",1432.0,930.8,1.1,4686.39,144
HCPCS,26471,FUSION OF FINGER TENDONS,,,2808.13,3405.12,20
HCPCS,26471,Fusion of finger tendons,,,1168.27,1352.74,8
HCPCS,26471,TENODESIS PROXIMAL INTERPHALANGEAL JOINT EACH,2360.0,1534.0,1.1,9440.12,144
HCPCS,26474,FUSION OF FINGER TENDONS,,,1394.34,1673.41,20
HCPCS,26474,Fusion of finger tendons,,,1168.27,1352.74,8
HCPCS,26474,TENODESIS DISTAL JOINT EACH,2196.0,1427.4,1.1,4686.39,144
HCPCS,26476,TENDON LENGTHENING,,,2808.13,3405.12,20
HCPCS,26476,"TENDON LENGTHENING,EXTEN,HAND/FINGR",2140.0,1391.0,1.1,9440.12,144
HCPCS,26476,Tendon lengthening,,,1168.27,1352.74,8
HCPCS,26477,TENDON SHORTENING,,,2808.13,3405.12,20
HCPCS,26477,"TENDON SHORTENING,EXTEN,HAND/FINGR",2128.0,1383.2,1.1,9440.12,144
HCPCS,26477,Tendon shortening,,,1168.27,1352.74,8
HCPCS,26478,LENGTHENING OF HAND TENDON,,,2808.13,3405.12,20
HCPCS,26478,Lengthening of hand tendon,,,1168.27,1352.74,8
HCPCS,26478,"TENDON LENGTHENING,FLEX,HAND/FINGR",2388.0,1552.2,1.1,9440.12,144
HCPCS,26479,SHORTENING OF HAND TENDON,,,2808.13,3405.12,20
HCPCS,26479,Shortening of hand tendon,,,1168.27,1352.74,8
HCPCS,26479,"TENDON SHORTENING,FLEX,HAND/FINGR",2364.0,1536.6,1.1,9440.12,144
HCPCS,26480,TR/TRNSPL TDN CARP/MTCRPL HAND W/O FR GRF EA TDN,3600.0,2340.0,1.1,9440.12,144
HCPCS,26480,TRANSPLANT HAND TENDON,,,2808.13,7624.0,21
HCPCS,26480,Transplant hand tendon,,,1912.9,2214.94,8
HCPCS,26483,TENDON TRANSFER TRANSPLANT CARP/MTCRPL GRAFT,3392.0,2204.8,1.1,9440.12,144
HCPCS,26483,TRANSPLANT/GRAFT HAND TENDON,,,2808.13,3405.12,20
HCPCS,26483,Transplant/graft hand tendon,,,1912.9,2214.94,8
HCPCS,26485,TRANSFER/TRANSPLANT TENDON PALMAR W/O GRAFT EACH,3156.0,2051.4,1.1,9440.12,144
HCPCS,26485,TRANSPLANT PALM TENDON,,,2808.13,3405.12,20
HCPCS,26485,Transplant palm tendon,,,1912.9,2214.94,8
HCPCS,26489,TRANSFER/TRANSPLANT TENDON PALMAR W/GRAFT EACH,3944.0,2563.6,1.1,9440.12,144
HCPCS,26489,TRANSPLANT/GRAFT PALM TENDON,,,2808.13,3405.12,20
HCPCS,26489,Transplant/graft palm tendon,,,1912.9,2214.94,8
HCPCS,26490,OPPONENSPLASTY SUPFCIS TDN TR TYP EA TDN,3440.0,2236.0,1.1,9440.12,144
HCPCS,26490,REVISE THUMB TENDON,,,2808.13,3405.12,20
HCPCS,26490,Revise thumb tendon,,,1912.9,2214.94,8
HCPCS,26492,OPPONENSPLASTY TDN TR W/GRF EA TDN,3936.0,2558.4,1.1,9440.12,144
HCPCS,26492,TENDON TRANSFER WITH GRAFT,,,2808.13,3405.12,20
HCPCS,26492,Tendon transfer with graft,,,1912.9,2214.94,8
HCPCS,26494,HAND TENDON/MUSCLE TRANSFER,,,2808.13,3405.12,20
HCPCS,26494,Hand tendon/muscle transfer,,,1912.9,2214.94,8
HCPCS,26494,OPPONENSPLASTY HYPOTHENAR MUSC TR,3464.0,2251.6,1.1,9440.12,144
HCPCS,26496,OPPONENSPLASTY OTHER METHODS,3912.0,2542.8,1.1,9440.12,144
HCPCS,26496,REVISE THUMB TENDON,,,2808.13,3405.12,20
HCPCS,26496,Revise thumb tendon,,,1912.9,2214.94,8
HCPCS,26497,FINGER TENDON TRANSFER,,,2808.13,3405.12,20
HCPCS,26497,Finger tendon transfer,,,1912.9,2214.94,8
HCPCS,26497,TR TDN RESTORE INTRNSC FUNCJ RING&SM FNGR,3904.0,2537.6,1.1,9440.12,144
HCPCS,26498,FINGER TENDON TRANSFER,,,2808.13,3405.12,20
HCPCS,26498,Finger tendon transfer,,,1912.9,2214.94,8
HCPCS,26498,TR TDN RESTORE INTRNSC FUNCJ ALL 4 FNGRS,5684.0,3694.6,1.1,9440.12,144
HCPCS,26499,CORRECTION CLAW FINGER OTHER,,,2808.13,3405.12,20
HCPCS,26499,CORRECTION CLAW FINGER OTHER METHODS,3668.0,2384.2,1.1,9440.12,144
HCPCS,26499,Correction claw finger other,,,1912.9,2214.94,8
HCPCS,26500,HAND TENDON RECONSTRUCTION,,,6206.54,7551.43,20
HCPCS,26500,Hand tendon reconstruction,,,1912.9,2214.94,8
HCPCS,26500,RCNSTJ TENDON PULLEY EACH W/LOCAL TISSUES SPX,2452.0,1593.8,1.1,20863.78,144
HCPCS,26502,HAND TENDON RECONSTRUCTION,,,2808.13,3405.12,20
HCPCS,26502,Hand tendon reconstruction,,,1912.9,2214.94,8
HCPCS,26502,RCNSTJ TDN PULLEY EA TDN W/TDN/FSCAL GRF SPX,2924.0,1900.6,1.1,9440.12,144
HCPCS,26508,RELEASE THENAR MUSCLE,2472.0,1606.8,1.1,9440.12,144
HCPCS,26508,RELEASE THUMB CONTRACTURE,,,2808.13,3405.12,20
HCPCS,26508,Release thumb contracture,,,1168.27,1352.74,8
HCPCS,26510,CROSS INTRINSIC TRANSFER EACH TENDON,2240.0,1456.0,1.1,9440.12,144
HCPCS,26510,THUMB TENDON TRANSFER,,,2808.13,3405.12,20
HCPCS,26510,Thumb tendon transfer,,,1912.9,2214.94,8
HCPCS,26516,CAPSULODESIS MTCARPHLNGL JOINT SINGLE DIGIT,2928.0,1903.2,1.1,9440.12,144
HCPCS,26516,FUSION OF KNUCKLE JOINT,,,2808.13,3405.12,20
HCPCS,26516,Fusion of knuckle joint,,,1168.27,1352.74,8
HCPCS,26517,CAPSULODESIS MTCARPHLNGL JOINT 2 DIGITS,3632.0,2360.8,1.1,9440.12,144
HCPCS,26517,FUSION OF KNUCKLE JOINTS,,,2808.13,3405.12,20
HCPCS,26517,Fusion of knuckle joints,,,1168.27,1352.74,8
HCPCS,26518,CAPSULODESIS MTCARPHLNGL JOINT 3/4 DIGITS,3708.0,2410.2,1.1,20863.78,144
HCPCS,26518,FUSION OF KNUCKLE JOINTS,,,6206.54,7551.43,20
HCPCS,26518,Fusion of knuckle joints,,,1912.9,2214.94,8
HCPCS,26520,CAPSULECTOMY/CAPSULOTOMY MTCARPHLNGL JOINT EACH,2188.0,1422.2,1.1,9440.12,144
HCPCS,26520,RELEASE KNUCKLE CONTRACTURE,,,2808.13,3405.12,20
HCPCS,26520,Release knuckle contracture,,,1168.27,1352.74,8
HCPCS,26525,CAPSULECTOMY/CAPSULOTOMY IPHAL JOINT EACH,2200.0,1430.0,1.1,4686.39,144
HCPCS,26525,RELEASE FINGER CONTRACTURE,,,1394.34,4315.0,21
HCPCS,26525,Release finger contracture,,,1168.27,1352.74,8
HCPCS,26530,ARTHROPLASTY METACARPOPHALANGEAL JOINT EACH,2752.0,1788.8,1.1,20863.78,144
HCPCS,26530,REVISE KNUCKLE JOINT,,,6206.54,7551.43,20
HCPCS,26530,Revise knuckle joint,,,2382.18,2758.32,8
HCPCS,26531,ARTHRP MTCARPHLNGL JT W/PROSTC IMPLT EA JT,3252.0,2113.8,1.1,20863.78,144
HCPCS,26531,REVISE KNUCKLE WITH IMPLANT,,,6206.54,7551.43,20
HCPCS,26531,Revise knuckle with implant,,,2382.18,2758.32,8
HCPCS,26535,ARTHROPLASTY INTERPHALANGEAL JOINT EACH,8544.5,5553.925,1.1,14925.0,231
HCPCS,26536,ARTHROPLASTY INTERPHALANGEAL JT W/PROSTHETIC EA,2624.0,1705.6,1.1,20863.78,144
HCPCS,26536,REVISE/IMPLANT FINGER JOINT,,,6206.54,7551.43,20
HCPCS,26536,Revise/implant finger joint,,,2382.18,2758.32,8
HCPCS,26540,REPAIR HAND JOINT,,,2808.13,10789.0,21
HCPCS,26540,RPR COLTRL LIGM MTCARPHLNGL/IPHAL JT,2640.0,1716.0,1.1,9440.12,144
HCPCS,26540,Repair hand joint,,,1168.27,1352.74,8
HCPCS,26541,RCNSTJ COLTRL LIGM MTCARPHLNGL 1 W/TDN/FSCAL GRF,3524.0,2290.6,1.1,9440.12,144
HCPCS,26541,REPAIR HAND JOINT WITH GRAFT,,,2808.13,3405.12,20
HCPCS,26541,Repair hand joint with graft,,,1912.9,2214.94,8
HCPCS,26542,RCNSTJ COLTRL LIGM MTCARPHLNGL 1 W/LOCAL TISS,2780.0,1807.0,1.1,9440.12,144
HCPCS,26542,REPAIR HAND JOINT WITH GRAFT,,,2808.13,3405.12,20
HCPCS,26542,Repair hand joint with graft,,,1912.9,2214.94,8
HCPCS,26545,RCNSTJ COLTRL LIGM IPHAL JT 1 W/GRF EA JT,2844.0,1848.6,1.1,9440.12,144
HCPCS,26545,RECONSTRUCT FINGER JOINT,,,2808.13,3405.12,20
HCPCS,26545,Reconstruct finger joint,,,1912.9,2214.94,8
HCPCS,26546,REPAIR NONUNION HAND,,,6206.54,7551.43,20
HCPCS,26546,RPR NON-UNION MTCRPL/PHALANX,4332.0,2815.8,1.1,20863.78,144
HCPCS,26546,Repair nonunion hand,,,1912.9,2214.94,8
HCPCS,26548,RECONSTRUCT FINGER JOINT,,,2808.13,7624.0,21
HCPCS,26548,RPR & RCNSTJ FINGER VOLAR PLATE INTERPHALANGEAL,3288.0,2137.2,1.1,9440.12,144
HCPCS,26548,Reconstruct finger joint,,,1912.9,2214.94,8
HCPCS,26550,POLLICIZATION DIGIT,,,2808.13,3405.12,20
HCPCS,26550,POLLICIZATION OF DIGIT,8672.0,5636.8,1.1,9440.12,144
HCPCS,26550,Pollicization digit,,,1912.9,2214.94,8
HCPCS,26551,GREAT TOE-HAND TRANSFER,,,6864.94,7551.43,12
HCPCS,26551,Great toe-hand transfer,,,4090.38,4736.23,8
HCPCS,26551,TR TOE-TO-HAND W/MVASC ANAST GRT TOE WRP/ARND,19392.0,12604.8,1.1,19392.0,144
HCPCS,26553,SINGLE TRANSFER TOE-HAND,,,6864.94,7551.43,12
HCPCS,26553,Single transfer toe-hand,,,4090.38,4736.23,8
HCPCS,26553,TR TOE-TO-HAND W/MVASC ANAST OTH/THN GRT TOE 1,19268.0,12524.2,1.1,19268.0,144
HCPCS,26554,DOUBLE TRANSFER TOE-HAND,,,6864.94,7551.43,12
HCPCS,26554,Double transfer toe-hand,,,4090.38,4736.23,8
HCPCS,26554,TR TOE-TO-HAND W/MVASC ANAST OTH/THN GRT TOE 2,22804.0,14822.6,1.1,22804.0,144
HCPCS,26555,POSITIONAL CHANGE OF FINGER,,,6206.54,7551.43,20
HCPCS,26555,Positional change of finger,,,1912.9,2214.94,8
HCPCS,26555,TR FNGR AXH POS W/O MVASC ANAST,6832.0,4440.8,1.1,20863.78,144
HCPCS,26556,TOE JOINT TRANSFER,,,6864.94,7551.43,12
HCPCS,26556,TRANSFER FREE TOE JOINT W/MVASC ANASTOMOSIS,19900.0,12935.0,1.1,19900.0,144
HCPCS,26556,Toe joint transfer,,,4090.38,4736.23,8
HCPCS,26560,REPAIR SYNDACTYLY EACH SPACE W/SKIN FLAPS,4785.0,3110.25,0.01,7362.0,231
HCPCS,26561,REPAIR OF WEB FINGER,,,2808.13,7624.0,21
HCPCS,26561,REPAIR SYNDACTYLY EACH SPACE W/SKIN FLAPS&GRAFT,4440.0,2886.0,1.1,9440.12,144
HCPCS,26561,Repair of web finger,,,1912.9,2214.94,8
HCPCS,26562,REPAIR OF WEB FINGER,,,2808.13,3405.12,20
HCPCS,26562,REPAIR SYNDACTYLY EACH SPACE COMPLEX,6672.0,4336.8,1.1,9440.12,144
HCPCS,26562,Repair of web finger,,,1912.9,2214.94,8
HCPCS,26565,CORRECT METACARPAL FLAW,,,2808.13,3405.12,20
HCPCS,26565,Correct metacarpal flaw,,,1912.9,2214.94,8
HCPCS,26565,OSTEOTOMY METACARPAL EACH,2764.0,1796.6,1.1,9440.12,144
HCPCS,26567,CORRECT FINGER DEFORMITY,,,2808.13,7624.0,21
HCPCS,26567,Correct finger deformity,,,1912.9,2214.94,8
HCPCS,26567,OSTEOTOMY PHALANX FINGER EACH,2796.0,1817.4,1.1,9440.12,144
HCPCS,26568,LENGTHEN METACARPAL/FINGER,,,6206.54,7551.43,20
HCPCS,26568,Lengthen metacarpal/finger,,,1912.9,2214.94,8
HCPCS,26568,OSTEOPLASTY LENGTHENING METACARPAL/PHALANX,3708.0,2410.2,1.1,20863.78,144
HCPCS,26580,REPAIR CLEFT HAND,7900.0,5135.0,1.1,9440.12,164
HCPCS,26580,Repair cleft hand,,,1912.9,2214.94,8
HCPCS,26587,POLYDACTYL DIIGIT SOFT TISS W/ BONE,15377.0,9995.05,0.01,15377.0,87
HCPCS,26587,RCNSTJ POLYDACTYLOUS DIGIT SOFT TISSUE & BONE,5800.0,3770.0,1.1,9440.12,144
HCPCS,26590,REPAIR FINGER DEFORMITY,,,1394.34,1673.41,20
HCPCS,26590,REPAIR MACRODACTYLIA EACH DIGIT,7468.0,4854.2,1.1,7468.0,144
HCPCS,26590,Repair finger deformity,,,1912.9,2214.94,8
HCPCS,26591,REPAIR INTRINSIC MUSCLES HAND EACH MUSCLE,1487.0,966.55,1.1,9440.12,144
HCPCS,26591,REPAIR MUSCLES OF HAND,,,2808.13,3405.12,20
HCPCS,26591,Repair muscles of hand,,,1912.9,2214.94,8
HCPCS,26593,RELEASE INTRINSIC MUSCLES HAND EACH MUSCLE,2200.0,1430.0,1.1,9440.12,144
HCPCS,26593,RELEASE MUSCLES OF HAND,,,2808.13,3405.12,20
HCPCS,26593,Release muscles of hand,,,1168.27,1352.74,8
HCPCS,26596,EXC CONSTRICTING RING FNGR W/MLT Z-PLASTIES,3656.0,2376.4,1.1,9440.12,144
HCPCS,26596,EXCISION CONSTRICTING TISSUE,,,2808.13,3405.12,20
HCPCS,26596,Excision constricting tissue,,,1912.9,2214.94,8
HCPCS,26600,CLTX METACARPAL FX W/O MANIPULATION EACH BONE,1123.5,730.2750000000001,0.01,12500.0,321
HCPCS,26605,CLTX METACARPAL FX W/MANIPULATION EACH BONE,1218.0,791.7,0.01,5265.0,409
HCPCS,26607,CLTX METACARPAL FX W/MANJ W/XTRNL FIXJ EA BONE,2192.0,1424.8,1.1,9440.12,144
HCPCS,26607,TREAT METACARPAL FRACTURE,,,2808.13,3405.12,20
HCPCS,26607,Treat metacarpal fracture,,,295.11,341.7,8
HCPCS,26608,PRQ SKELETAL FIXJ METACARPAL FX EACH BONE,2220.0,1443.0,1.1,9440.12,144
HCPCS,26608,TREAT METACARPAL FRACTURE,,,2808.13,10789.0,23
HCPCS,26608,Treat metacarpal fracture,,,3603.21,4172.14,8
HCPCS,26615,OPEN TX METACARPAL FRACTURE SINGLE EA BONE,2828.0,1838.2,1.1,9440.12,144
HCPCS,26615,TREAT METACARPAL FRACTURE,,,2808.13,10789.0,22
HCPCS,26615,Treat metacarpal fracture,,,3603.21,4172.14,8
HCPCS,26641,CLTX CARPO/METACARPAL DISLOCATION THUMB W/MANJ,1377.5,895.375,1.1,4392.0,235
HCPCS,26645,CLTX CARPO/METACARPAL FX DISLC THUMB W/MANJ,4597.0,2988.05,1.1,7362.0,322
HCPCS,26650,PRQ SKELETAL FIX CARPO/METACARPAL FX DISLC THUMB,2140.0,1391.0,1.1,9440.12,144
HCPCS,26650,TREAT THUMB FRACTURE,,,2808.13,3405.12,20
HCPCS,26650,Treat thumb fracture,,,3603.21,4172.14,8
HCPCS,26665,OPEN TX CARPOMETACARPAL FRACTURE DISLOCATE THUMB,3176.0,2064.4,1.1,9440.12,144
HCPCS,26665,TREAT THUMB FRACTURE,,,2808.13,3405.12,20
HCPCS,26665,Treat thumb fracture,,,3603.21,4172.14,8
HCPCS,26670,CLTX CARPO/METACARPL DISLC THMB MANJ EA W/O ANES,1317.5,856.375,1.1,4392.0,235
HCPCS,26675,CLTX CARPO/MTCRPL DISLC THUMB MANJ EA JT W/ANES,1932.0,1255.8,1.1,4686.39,148
HCPCS,26675,TREAT HAND DISLOCATION,,,1394.34,1673.41,20
HCPCS,26675,Treat hand dislocation,,,824.67,954.88,8
HCPCS,26676,PIN HAND DISLOCATION,,,2808.13,7624.0,21
HCPCS,26676,PRQ SKEL FIXJ CARPO/MTCRPL DISLC THMB MANJ EA JT,2296.0,1492.4,1.1,9440.12,144
HCPCS,26676,Pin hand dislocation,,,3603.21,4172.14,8
HCPCS,26685,OPEN TX CARPOMETACARPAL DISLOCATE NOT THUMB,2828.0,1838.2,1.1,9440.12,144
HCPCS,26685,TREAT HAND DISLOCATION,,,2808.13,3405.12,20
HCPCS,26685,Treat hand dislocation,,,3603.21,4172.14,8
HCPCS,26686,OPTX CARP/MTCRPL DISLC THMB CPLX MLT/DLYD RDCTJ,3268.0,2124.2,1.1,9440.12,144
HCPCS,26686,TREAT HAND DISLOCATION,,,2808.13,3405.12,20
HCPCS,26686,Treat hand dislocation,,,3603.21,4172.14,8
HCPCS,26700,CLTX METACARPOPHALANGEAL DISLC W/MANJ W/O ANES,1317.5,856.375,0.01,12500.0,322
HCPCS,26705,CLTX METACARPOPHALANGEAL DISLC W/MANJ W/ANES,4557.0,2962.05,0.01,7362.0,235
HCPCS,26706,PIN KNUCKLE DISLOCATION,,,2808.13,3405.12,20
HCPCS,26706,PRQ SKEL FIXJ METACARPOPHALANGEAL DISLC W/MANJ,2124.0,1380.6,1.1,9440.12,144
HCPCS,26706,Pin knuckle dislocation,,,3603.21,4172.14,8
HCPCS,26715,OPEN TREATMENT METACARPOPHALANGEAL DISLOCATION,2812.0,1827.8,1.1,9440.12,144
HCPCS,26715,TREAT KNUCKLE DISLOCATION,,,2808.13,3405.12,20
HCPCS,26715,Treat knuckle dislocation,,,3603.21,4172.14,8
HCPCS,26720,CLTX PHLNGL FX PROX/MIDDLE PX/F/T W/O MANJ EA,938.5,610.0250000000001,0.01,12500.0,322
HCPCS,26725,CLTX PHLNGL FX PROX/MIDDLE PX/F/T W/MANJ EA,1317.0,856.05,0.01,12500.0,322
HCPCS,26727,PRQ SKEL FIXJ PHLNGL SHFT FX PROX/MIDDLE PX/F/T,2168.0,1409.2,1.1,9440.12,144
HCPCS,26727,TREAT FINGER FRACTURE EACH,,,2808.13,25635.0,23
HCPCS,26727,Treat finger fracture each,,,3603.21,4172.14,8
HCPCS,26735,OPEN TX PHALANGEAL SHAFT FRACTURE PROX/MIDDLE EA,2968.0,1929.2,1.1,9440.12,144
HCPCS,26735,TREAT FINGER FRACTURE EACH,,,2808.13,10789.0,24
HCPCS,26735,Treat finger fracture each,,,3603.21,4172.14,8
HCPCS,26740,CLTX ARTCLR FX INVG MTCRPHLNGL/IPHAL JT W/O MANJ,965.5,627.575,0.01,12500.0,322
HCPCS,26742,CLTX ARTCLR FX INVG MTCARPHLNGL/IPHAL JT W/MANJ,4479.0,2911.3500000000004,0.01,7362.0,322
HCPCS,26746,OPEN TX ARTICULAR FRACTURE MCP/IP JOINT EA,9422.5,6124.625,1.1,14925.0,231
HCPCS,26750,CLTX DSTL PHLNGL FX FNGR/THMB W/O MANJ EA,911.5,592.475,0.01,12500.0,322
HCPCS,26755,CLTX DSTL PHLNGL FX FNGR/THMB W/MANJ EA,1197.5,778.375,0.01,12500.0,322
HCPCS,26756,PIN FINGER FRACTURE EACH,,,2808.13,3405.12,20
HCPCS,26756,PRQ SKEL FIXJ DSTL PHLNGL FX FNGR/THMB EA,1832.0,1190.8,1.1,9440.12,144
HCPCS,26756,Pin finger fracture each,,,3603.21,4172.14,8
HCPCS,26765,OPEN TX DISTAL PHALANGEAL FRACTURE EACH,8634.5,5612.425,1.1,14925.0,231
HCPCS,26770,CLTX IPHAL JT DISLC W/MANJ W/O ANES,1181.5,767.975,0.01,12500.0,322
HCPCS,26775,CLTX IPHAL JT DISLC W/MANJ REQ ANES,1391.0,904.15,1.1,5265.0,235
HCPCS,26776,PIN FINGER DISLOCATION,,,2808.13,3405.12,20
HCPCS,26776,PRQ SKEL FIXJ IPHAL JT DISLC W/MANJ,1996.0,1297.4,1.1,9440.12,144
HCPCS,26776,Pin finger dislocation,,,3603.21,4172.14,8
HCPCS,26785,OPEN TX INTERPHALANGEAL JOINT DISLOCATION,8782.5,5708.625,1.1,14925.0,231
HCPCS,26820,THUMB FUSION WITH GRAFT,,,6206.54,7551.43,20
HCPCS,26820,Thumb fusion with graft,,,1912.9,2214.94,8
HCPCS,26841,ARTHRD CARPO/METACARPAL JT THUMB W/WO INT FIXJ,2940.0,1911.0,1.1,20863.78,144
HCPCS,26841,FUSION OF THUMB,,,6206.54,7551.43,20
HCPCS,26841,Fusion of thumb,,,1912.9,2214.94,8
HCPCS,26842,ARTHRD CRP/MTACRPL JT THMB W/WO INT FIXJ W/AGRFT,3396.0,2207.4,1.1,20863.78,144
HCPCS,26842,THUMB FUSION WITH GRAFT,,,6206.54,7551.43,20
HCPCS,26842,Thumb fusion with graft,,,1912.9,2214.94,8
HCPCS,26843,ARTHRD CARP/MTCRPL JT DGT OTHER THAN THUMB EACH,3112.0,2022.8,1.1,20863.78,144
HCPCS,26843,FUSION OF HAND JOINT,,,6206.54,7551.43,20
HCPCS,26843,Fusion of hand joint,,,1168.27,1352.74,8
HCPCS,26844,ARTHRD CARP/MTCRPL JT DGT OTH/THN THMB W/AGRFT,3592.0,2334.8,1.1,20863.78,144
HCPCS,26844,FUSION/GRAFT OF HAND JOINT,,,6206.54,7551.43,20
HCPCS,26844,Fusion/graft of hand joint,,,1912.9,2214.94,8
HCPCS,26850,ARTHRODESIS METACARPOPHALANGEAL JT W/WO INT FIXJ,2856.0,1856.4,1.1,20863.78,144
HCPCS,26850,FUSION OF KNUCKLE,,,6206.54,7551.43,20
HCPCS,26850,Fusion of knuckle,,,1912.9,2214.94,8
HCPCS,26852,ARTHRODESIS MTCRPL JT W/WO INT FIXJ W/AUTOGRAFT,3484.0,2264.6,1.1,20863.78,144
HCPCS,26852,FUSION OF KNUCKLE WITH GRAFT,,,6206.54,7551.43,20
HCPCS,26852,Fusion of knuckle with graft,,,1912.9,2214.94,8
HCPCS,26860,ARTHRODESIS INTERPHALANGEAL JT W/WO INT FIXJ,1952.0,1268.8,1.1,9440.12,144
HCPCS,26860,FUSION OF FINGER JOINT,,,2808.13,7624.0,21
HCPCS,26860,Fusion of finger joint,,,1168.27,1352.74,8
HCPCS,26861,ARTHRODESIS IPHAL JT W/WO INT FIXJ EA IPHAL JT,696.0,452.4,1.1,696.0,144
HCPCS,26861,Fusion of finger jnt add-on,,,1168.27,1352.74,8
HCPCS,26862,ARTHRODESIS IPHAL JT W/WO INT FIXJ W/AUTOGRAFT,3024.0,1965.6,1.1,9440.12,144
HCPCS,26862,FUSION/GRAFT OF FINGER JOINT,,,2808.13,3405.12,20
HCPCS,26862,Fusion/graft of finger joint,,,1168.27,1352.74,8
HCPCS,26863,ARTHRODESIS IPHAL JT W/WO INT FIXJ W/AGRFT EA JT,1556.0,1011.4,1.1,1556.0,144
HCPCS,26863,Fuse/graft added joint,,,1168.27,1352.74,8
HCPCS,26910,AMP MTCRPL W/FINGER/THUMB W/WO INTEROSS TRANSFER,3116.0,2025.4,1.1,9440.12,144
HCPCS,26910,AMPUTATE METACARPAL BONE,,,2808.13,3405.12,20
HCPCS,26910,Amputate metacarpal bone,,,1912.9,2214.94,8
HCPCS,26951,AMP F/TH 1/2 JT/PHALANX W/NEURECT W/DIR CLSR,8670.5,5635.825,0.01,14925.0,405
HCPCS,26952,AMP F/TH 1/2 JT/PHALANX W/NEURECT LOCAL FLAP,8758.5,5693.025,1.1,14925.0,231
HCPCS,26989,CLOSED TX OF SESAMOID BONE FRAC IN THE FINGER OR HAND,265.0,172.25,0.01,3443.0,85
HCPCS,26989,CLOSED TX OF SESAMOID BONE FRAC IN THE FINGER OR HAND (COMP26600,867.0,563.55,0.01,867.0,84
HCPCS,26989,UNLISTED PROCEDURE HANDS OR FINGERS,400.0,260.0,111.2,3443.0,84
HCPCS,26989,UNLISTED RADICAL TENOSYNOVECTOMY ECD TENDON (COMP CODE 26145),2758.25,1792.86,0.01,2758.25,84
HCPCS,26990,DRAINAGE OF PELVIS LESION,,,2808.13,3405.12,20
HCPCS,26990,Drainage of pelvis lesion,,,3067.73,3552.11,8
HCPCS,26990,I&D PELVIS/HIP JT AREA DEEP ABSCESS/HEMATOMA,3180.0,2067.0,1.1,9440.12,144
HCPCS,26991,DRAINAGE OF PELVIS BURSA,,,1394.34,1673.41,20
HCPCS,26991,Drainage of pelvis bursa,,,1351.24,1564.6,8
HCPCS,26991,I&D PELVIS/HIP JOINT AREA INFECTED BURSA,2824.0,1835.6,1.1,4686.39,148
HCPCS,26992,DRAINAGE OF BONE LESION,,,3095.56,3405.12,12
HCPCS,26992,Drainage of bone lesion,,,3067.73,3552.11,8
HCPCS,26992,INCISION BONE CORTEX PELVIS&/HIP JOINT,5392.0,3504.8,1.1,5392.0,144
HCPCS,27000,TENOTOMY ADDUCTOR HIP PERCUTANEOUS SPX,4829.0,3138.8500000000004,0.01,7362.0,231
HCPCS,27001,TENOTOMY ADDUCTOR HIP OPEN,2856.0,1856.4,1.1,9440.12,165
HCPCS,27001,Tenotomy adductor hip open,,,3067.73,3552.11,8
HCPCS,27003,TNOT ADDUCTR SUBQ OPN NEURCT,,,6206.54,7551.43,20
HCPCS,27003,TX ADDUXOR SUBQ OPN W/OBTURATOR NEURECTOMY,3124.0,2030.6,1.1,20863.78,144
HCPCS,27003,Tnot adductr subq opn neurct,,,3067.73,3552.11,8
HCPCS,27005,TENOTOMY HIP FLEXOR OPEN,,,3095.56,3405.12,12
HCPCS,27005,TENOTOMY HIP FLEXOR OPEN SEPARATE PROCEDURE,4028.0,2618.2,1.1,4028.0,144
HCPCS,27005,Tenotomy hip flexor open,,,3067.73,3552.11,8
HCPCS,27006,TENOTOMY ABDUCTOR&/XTNSR HIP,,,2808.13,3405.12,20
HCPCS,27006,TENOTOMY ABDUCTORS&/EXTENSOR HIP OPEN SPX,4044.0,2628.6,1.1,9440.12,144
HCPCS,27006,Tenotomy abductor&/xtnsr hip,,,3067.73,3552.11,8
HCPCS,27025,FASCIOTOMY HIP/THIGH ANY TYP,,,3095.56,3405.12,12
HCPCS,27025,FASCIOTOMY HIP/THIGH ANY TYPE,5156.0,3351.4,1.1,5156.0,144
HCPCS,27025,Fasciotomy hip/thigh any typ,,,3067.73,3552.11,8
HCPCS,27027,DCMPRN FASCT PEL COMPARTMENT,,,6206.54,7551.43,20
HCPCS,27027,DECOMPRESSION FASCIOTOMY PELVIC COMPARTMENT UNI,5216.0,3390.4,1.1,20863.78,144
HCPCS,27027,Dcmprn fasct pel compartment,,,3067.73,3552.11,8
HCPCS,27030,ARTHROTOMY HIP W/DRAINAGE,5460.0,3549.0,1.1,7551.43,156
HCPCS,27030,Arthrotomy hip w/drainage,,,3067.73,3552.11,8
HCPCS,27033,ARTHROTOMY HIP EXPLORATION/REMOVAL FOREIGN BODY,5644.0,3668.6,1.1,20863.78,144
HCPCS,27033,ARTHRT HIP EXPL/RMV LOOSE/FB,,,6206.54,7551.43,20
HCPCS,27033,Arthrt hip expl/rmv loose/fb,,,3067.73,3552.11,8
HCPCS,27035,DENERVATION OF HIP JOINT,,,2808.13,3405.12,20
HCPCS,27035,Denervation of hip joint,,,3067.73,3552.11,8
HCPCS,27036,CAPSLCTOMY/CAPSUL HIP W/RLS HIP FLXR MUSC,5752.0,3738.8,1.1,5752.0,144
HCPCS,27036,CAPSULECTOMY/CAPSULOTOMY HIP,,,6864.94,7551.43,12
HCPCS,27036,Capsulectomy/capsulotomy hip,,,3067.73,3552.11,8
HCPCS,27040,BIOPSY SOFT TISSUE PELVIS&HIP AREA SUPERFICIAL,4310.5,2801.825,0.01,7453.0,235
HCPCS,27041,BIOPSY SOFT TISSUE PELVIS&HIP DEEP/SUBFSCAL/IM,5762.5,3745.625,0.01,7453.0,231
HCPCS,27043,EXCISION TUMOR SOFT TISSUE PELVIS&HIP SUBQ 3+CM,2752.0,1788.8,1.1,8286.13,144
HCPCS,27043,EXCISION TUMOR SOFT TISSUE PELVIS&HIP SUBQ 3CM/>,13165.0,8557.25,552.59,13165.0,87
HCPCS,27045,EXC HIP/PELV TUM DEEP 5 CM/>,,,2465.15,7813.0,21
HCPCS,27045,EXC TUMOR SOFT TISSUE PELVIS & HIP SUBFASC 5+CM,4452.0,2893.8,1.1,8286.13,144
HCPCS,27045,Exc hip/pelv tum deep 5 cm/>,,,1351.24,1564.6,8
HCPCS,27047,EXC TUMOR SOFT TISSUE PELVIS & HIP SUBQ <3CM,7669.5,4985.175,0.01,13165.0,235
HCPCS,27048,EXC HIP/PELV TUM DEEP < 5 CM,,,2465.15,3022.89,20
HCPCS,27048,EXC TUMOR SOFT TISSUE PELVIS & HIP SUBFASC <5CM,3540.0,2301.0,1.1,8286.13,144
HCPCS,27048,Exc hip/pelv tum deep < 5 cm,,,1351.24,1564.6,8
HCPCS,27049,RAD RESECT TUMOR SOFT TISSUE PELVIS & HIP <5 CM,8620.0,5603.0,1.1,8620.0,144
HCPCS,27049,RESECT HIP/PELV TUM < 5 CM,,,2465.15,3022.89,20
HCPCS,27049,Resect hip/pelv tum < 5 cm,,,3067.73,3552.11,8
HCPCS,27050,ARTHROTOMY W/BIOPSY SACROILIAC JOINT,1896.0,1232.4,1.1,4686.39,144
HCPCS,27050,BIOPSY OF SACROILIAC JOINT,,,1394.34,1673.41,20
HCPCS,27050,Biopsy of sacroiliac joint,,,3067.73,3552.11,8
HCPCS,27052,ARTHROTOMY W/BIOPSY HIP JOINT,2968.0,1929.2,1.1,4686.39,144
HCPCS,27052,BIOPSY OF HIP JOINT,,,1394.34,1673.41,20
HCPCS,27052,Biopsy of hip joint,,,3067.73,3552.11,8
HCPCS,27054,ARTHROTOMY W/SYNOVECTOMY HIP JOINT,3684.0,2394.6,1.1,3684.0,144
HCPCS,27054,REMOVAL OF HIP JOINT LINING,,,3095.56,3405.12,12
HCPCS,27054,Removal of hip joint lining,,,3067.73,3552.11,8
HCPCS,27057,BUTTOCK FASCIOTOMY W/DBRDMT,,,1394.34,1673.41,20
HCPCS,27057,Buttock fasciotomy w/dbrdmt,,,3067.73,3552.11,8
HCPCS,27057,DCMPRN FASCIOTOMY PELVIC CMPRT DBRDMT MUSCLE UNI,5964.0,3876.6,1.1,5964.0,144
HCPCS,27059,RAD RESECTION TUMOR SOFT TISS PELVIS&HIP 5+CM,11740.0,7631.0,1.1,11740.0,144
HCPCS,27059,RESECT HIP/PELV TUM 5 CM/>,,,2465.15,6238.0,21
HCPCS,27059,Resect hip/pelv tum 5 cm/>,,,3067.73,3552.11,8
HCPCS,27060,EXCISION ISCHIAL BURSA,2348.0,1526.2,1.1,20863.78,144
HCPCS,27060,REMOVAL OF ISCHIAL BURSA,,,6206.54,7551.43,20
HCPCS,27060,Removal of ischial bursa,,,3067.73,3552.11,8
HCPCS,27062,EXCISION TROCHANTERIC BURSA/CALCIFICATION,8612.5,5598.125,0.01,14925.0,231
HCPCS,27065,EXCISION BONE CYST/BNIGN TUMOR SUPERFICIAL,2620.0,1703.0,1.1,20863.78,144
HCPCS,27065,REMOVE HIP BONE LES SUPER,,,6206.54,7551.43,20
HCPCS,27065,Remove hip bone les super,,,3067.73,3552.11,8
HCPCS,27066,EXCISION BONE CYST/BENIGN TUMOR DEEP,4480.0,2912.0,1.1,9440.12,144
HCPCS,27066,REMOVE HIP BONE LES DEEP,,,2808.13,13821.0,21
HCPCS,27066,Remove hip bone les deep,,,3067.73,3552.11,8
HCPCS,27067,EXC B1 CST/B9 TUM W/AGRFT REQ SEP INC,5888.0,3827.2,1.1,20863.78,144
HCPCS,27067,REMOVE/GRAFT HIP BONE LESION,,,6206.54,7551.43,20
HCPCS,27067,Remove/graft hip bone lesion,,,3067.73,3552.11,8
HCPCS,27070,PART REMOVE HIP BONE SUPER,,,3095.56,3405.12,12
HCPCS,27070,PARTIAL EXCISION SUPERFICIAL PELVIS,4624.0,3005.6,1.1,4624.0,144
HCPCS,27070,Part remove hip bone super,,,3067.73,3552.11,8
HCPCS,27071,PART REMOVAL HIP BONE DEEP,,,3095.56,3405.12,12
HCPCS,27071,PARTIAL EXCISION DEEP PELVIS,5452.0,3543.8,1.1,5452.0,144
HCPCS,27071,Part removal hip bone deep,,,3067.73,3552.11,8
HCPCS,27075,RAD RESCT TUMOR WING OF ILIUM 1 PUBIC/ISCHIAL,13084.0,8504.6,1.1,13084.0,144
HCPCS,27075,RESECT HIP TUMOR,,,6864.94,7551.43,12
HCPCS,27075,Resect hip tumor,,,3067.73,3552.11,8
HCPCS,27076,RAD RESCT TUMOR ILIUM ACETABULUM BOTH PUBIC,16084.0,10454.6,1.1,16084.0,144
HCPCS,27076,RESECT HIP TUM INCL ACETABUL,,,6864.94,7551.43,12
HCPCS,27076,Resect hip tum incl acetabul,,,3067.73,3552.11,8
HCPCS,27077,RADICAL RESCTION TUMOR INNOMINATE BONE TOTAL,18084.0,11754.6,1.1,18084.0,144
HCPCS,27077,RESECT HIP TUM W/INNOM BONE,,,6864.94,7551.43,12
HCPCS,27077,Resect hip tum w/innom bone,,,11196.34,12964.18,8
HCPCS,27078,RAD RESCT TUMOR ISCHIAL TUBEROSITY&GRT TRCHNTR,12884.0,8374.6,1.1,12884.0,144
HCPCS,27078,RSECT HIP TUM INCL FEMUR,,,6864.94,7551.43,12
HCPCS,27078,Rsect hip tum incl femur,,,3067.73,3552.11,8
HCPCS,27080,COCCYGECTOMY PRIMARY,2756.0,1791.4,1.1,9440.12,144
HCPCS,27080,REMOVAL OF TAIL BONE,,,2808.13,3405.12,20
HCPCS,27080,Removal of tail bone,,,3067.73,3552.11,8
HCPCS,27086,RMVL FOREIGN BODY PELVIS/HIP SUBCUTANEOUS TISS,6966.5,4528.225,1.1,13165.0,235
HCPCS,27087,REMOVAL FOREIGN BODY PELVIS/HIP DEEP,9228.5,5998.525,1.1,14925.0,231
HCPCS,27090,REMOVAL OF HIP PROSTHESIS,4676.0,3039.4,1.1,7551.43,157
HCPCS,27090,Removal of hip prosthesis,,,3067.73,3552.11,8
HCPCS,27091,REMOVAL OF HIP PROSTHESIS,,,4159.43,13361.02,13
HCPCS,27091,RMVL HIP PROSTH COMP W/TOT HIP PROSTH MMA,9740.0,6331.0,1.1,9740.0,144
HCPCS,27091,Removal of hip prosthesis,,,3067.73,3552.11,8
HCPCS,27093,INJECTION HIP ARTHROGRAPHY W/O ANESTHESIA,624.0,405.6,0.01,4628.0,284
HCPCS,27095,INJECTION HIP ARTHROGRAPHY W/ANESTHESIA,736.5,478.725,1.1,4628.0,216
HCPCS,27096,INJECT SI JOINT ARTHRGRPHY&/ANES/STEROID W/IMA,1289.5,838.175,0.01,12500.0,286
HCPCS,27097,RELEASE/RECESSION HAMSTRING PROXIMAL,3708.0,2410.2,1.1,9440.12,144
HCPCS,27097,REVISION OF HIP TENDON,,,2808.13,3405.12,20
HCPCS,27097,Revision of hip tendon,,,3067.73,3552.11,8
HCPCS,27098,ADDUCTOR TRANSFER TO ISCHIUM,4101.0,2665.65,1.1,9440.12,144
HCPCS,27098,TRANSFER TENDON TO PELVIS,,,2808.13,3405.12,20
HCPCS,27098,Transfer tendon to pelvis,,,3067.73,3552.11,8
HCPCS,27100,TR XTRNL OBLQ MUSC TRCHNTR W/FSCAL/TDN XTN GRF,4540.0,2951.0,1.1,20863.78,144
HCPCS,27100,TRANSFER OF ABDOMINAL MUSCLE,,,6206.54,7551.43,20
HCPCS,27100,Transfer of abdominal muscle,,,3067.73,3552.11,8
HCPCS,27105,TRANSFER OF SPINAL MUSCLE,,,2808.13,3405.12,20
HCPCS,27105,Transfer of spinal muscle,,,3067.73,3552.11,8
HCPCS,27110,TRANSFER OF ILIOPSOAS MUSCLE,,,6206.54,7551.43,20
HCPCS,27110,Transfer of iliopsoas muscle,,,3067.73,3552.11,8
HCPCS,27111,TRANSFER OF ILIOPSOAS MUSCLE,,,2808.13,3405.12,20
HCPCS,27111,Transfer of iliopsoas muscle,,,3067.73,3552.11,8
HCPCS,27120,ACETABULOPLASTY,7700.0,5005.0,1.1,7700.0,144
HCPCS,27120,RECONSTRUCTION OF HIP SOCKET,,,3395.41,13361.02,13
HCPCS,27120,Reconstruction of hip socket,,,3067.73,3552.11,8
HCPCS,27122,ACETABULOPLASTY RESECTION FEMORAL HEAD,6436.0,4183.4,1.1,6436.0,144
HCPCS,27122,RECONSTRUCTION OF HIP SOCKET,,,2887.38,7551.43,13
HCPCS,27122,Reconstruction of hip socket,,,3067.73,3552.11,8
HCPCS,27125,HEMIARTHROPLASTY HIP PARTIAL,6656.0,4326.4,1.1,6656.0,144
HCPCS,27125,PARTIAL HIP REPLACEMENT,,,2959.78,13361.02,13
HCPCS,27125,Partial hip replacement,,,2382.18,2758.32,8
HCPCS,27130,ARTHRP ACETBLR/PROX FEM PROSTC AGRFT/ALGRFT,8624.0,5605.6,1.1,38384.94,144
HCPCS,27130,TOTAL HIP ARTHROPLASTY,,,11170.0,34359.11,23
HCPCS,27130,Total hip arthroplasty,,,7882.2,9126.76,8
HCPCS,27132,CONV PREV HIP TOT HIP ARTHRP W/WO AGRFT/ALGRFT,11304.0,7347.6,1.1,11304.0,144
HCPCS,27132,TOTAL HIP ARTHROPLASTY,,,4362.71,13361.02,14
HCPCS,27132,Total hip arthroplasty,,,7882.2,9126.76,8
HCPCS,27134,REVISE HIP JOINT REPLACEMENT,,,4972.2,13361.02,13
HCPCS,27134,REVJ TOT HIP ARTHRP BTH W/WO AGRFT/ALGRFT,13323.0,8659.95,1.1,13323.0,144
HCPCS,27134,Revise hip joint replacement,,,7882.2,9126.76,8
HCPCS,27137,REVISE HIP JOINT REPLACEMENT,,,3827.86,13361.02,13
HCPCS,27137,REVJ TOT HIP ARTHRP ACTBLR W/WO AGRFT/ALGRFT,9988.0,6492.2,1.1,9988.0,144
HCPCS,27137,Revise hip joint replacement,,,7882.2,9126.76,8
HCPCS,27138,REVISE HIP JOINT REPLACEMENT,,,3976.15,13361.02,13
HCPCS,27138,REVJ TOT HIP ARTHRP FEM ONLY W/WO ALGRFT,10428.0,6778.2,1.1,10428.0,144
HCPCS,27138,Revise hip joint replacement,,,7882.2,9126.76,8
HCPCS,27140,OSTEOTOMY&TRANSFER GREATER TROCHANTER SPX,5112.0,3322.8,1.1,5112.0,144
HCPCS,27140,TRANSPLANT FEMUR RIDGE,,,2350.84,7551.43,13
HCPCS,27140,Transplant femur ridge,,,3067.73,3552.11,8
HCPCS,27146,INCISION OF HIP BONE,,,3344.61,7551.43,13
HCPCS,27146,Incision of hip bone,,,3067.73,3552.11,8
HCPCS,27146,OSTEOTOMY ILIAC ACETABULAR/INNOMINATE BONE,7568.0,4919.2,1.1,7568.0,144
HCPCS,27147,OSTEOTOMY ILIAC ACETABULAR/INNOMINATE HIP RDCTJ,8828.0,5738.2,1.1,8828.0,144
HCPCS,27147,REVISION OF HIP BONE,,,3822.44,7551.43,13
HCPCS,27147,Revision of hip bone,,,3067.73,3552.11,8
HCPCS,27151,INCISION OF HIP BONES,,,4130.19,7551.43,13
HCPCS,27151,Incision of hip bones,,,3067.73,3552.11,8
HCPCS,27151,OSTEOTOMY ILIAC ACETABULAR/INNOMINATE FEM OSTEOT,9648.0,6271.2,1.1,9648.0,144
HCPCS,27156,OSTEOT ILIAC ACTBLR/INNOMINATE BONE OSTEOT RDCTJ,10492.0,6819.8,1.1,10492.0,144
HCPCS,27156,REVISION OF HIP BONES,,,4450.28,7551.43,13
HCPCS,27156,Revision of hip bones,,,3067.73,3552.11,8
HCPCS,27158,OSTEOTOMY PELVIS BILAT,9258.0,6017.7,1.1,9258.0,144
HCPCS,27158,REVISION OF PELVIS,,,3656.5,7551.43,13
HCPCS,27158,Revision of pelvis,,,3067.73,3552.11,8
HCPCS,27161,INCISION OF NECK OF FEMUR,,,3191.17,7551.43,13
HCPCS,27161,Incision of neck of femur,,,3067.73,3552.11,8
HCPCS,27161,OSTEOTOMY FEMORAL NECK SEPARATE PROCEDURE,7156.0,4651.4,1.1,7156.0,144
HCPCS,27165,INCISION/FIXATION OF FEMUR,,,3584.47,7551.43,13
HCPCS,27165,Incision/fixation of femur,,,3067.73,3552.11,8
HCPCS,27165,OSTEOT INTERTRCHNTRIC/SUBTRCHNTRIC W/INT/XTRNL,8116.0,5275.4,1.1,8116.0,144
HCPCS,27170,B1 GRF FEM H/N INTERTRCHNTRIC/SUBTRCHNTRIC AREA,7044.0,4578.6,1.1,7044.0,144
HCPCS,27170,REPAIR/GRAFT FEMUR HEAD/NECK,,,3060.17,7551.43,13
HCPCS,27170,Repair/graft femur head/neck,,,3067.73,3552.11,8
HCPCS,27175,TREAT SLIPPED EPIPHYSIS,,,1751.13,3405.12,13
HCPCS,27175,Treat slipped epiphysis,,,3603.21,4172.14,8
HCPCS,27176,TREAT SLIPPED EPIPHYSIS,,,2416.05,3405.12,13
HCPCS,27176,TX SLP FEM EPIPHYSIS SINGLE/MULTIPL PINNING SITU,5168.0,3359.2,1.1,5168.0,144
HCPCS,27176,Treat slipped epiphysis,,,3067.73,3552.11,8
HCPCS,27177,OPTX SLP FEM EPIPHYSIS SINGLE/MULT PIN/BONE GRFT,6436.0,4183.4,1.1,6436.0,144
HCPCS,27177,TREAT SLIPPED EPIPHYSIS,,,2920.18,3405.12,13
HCPCS,27177,Treat slipped epiphysis,,,3067.73,3552.11,8
HCPCS,27178,OPTX SLP FEM EPIPHYSIS CLSD MANJ SINGL/MLTPL PIN,5168.0,3359.2,1.1,5168.0,144
HCPCS,27178,TREAT SLIPPED EPIPHYSIS,,,2416.05,3405.12,13
HCPCS,27178,Treat slipped epiphysis,,,3603.21,4172.14,8
HCPCS,27179,OPTX SLP FEM EPIPHYSIS OSTPL FEM NCK HEYMAN PX,5588.0,3632.2,1.1,20863.78,144
HCPCS,27179,REVISE HEAD/NECK OF FEMUR,,,6206.54,18676.74,21
HCPCS,27179,Revise head/neck of femur,,,3067.73,3552.11,8
HCPCS,27181,OPTX SLP FEM EPIPHYSIS OSTEOT&INT FIXJ,6472.0,4206.8,1.1,6472.0,144
HCPCS,27181,TREAT SLIPPED EPIPHYSIS,,,2932.57,7551.43,13
HCPCS,27181,Treat slipped epiphysis,,,3603.21,4172.14,8
HCPCS,27185,EPIPHYSL ARRST EPIPHYSIOD/STAPLING TRCHNTR FEMUR,3916.0,2545.4,1.1,3916.0,144
HCPCS,27185,REVISION OF FEMUR EPIPHYSIS,,,1887.81,3405.12,13
HCPCS,27185,Revision of femur epiphysis,,,3067.73,3552.11,8
HCPCS,27187,PROPH TX N/P/PLTWR W/WO MMA FEM NCK & PROX FEMUR,5692.0,3699.8,1.1,5692.0,144
HCPCS,27187,REINFORCE HIP BONES,,,2608.01,7551.43,13
HCPCS,27187,Reinforce hip bones,,,3067.73,3552.11,8
HCPCS,27197,CLSD TX PELVIC RING FX W/O MANIPULATION,888.0,577.2,0.01,4392.0,318
HCPCS,27198,CLSD TX PELVIC RING FX,,,204.59,256.7,20
HCPCS,27198,CLSD TX PELVIC RING FX W/MANIPULATION W/ANES,2090.0,1358.5,1.1,2090.0,144
HCPCS,27198,Clsd tx pelvic ring fx,,,295.11,341.7,8
HCPCS,27200,CLOSED TREATMENT COCCYGEAL FRACTURE,935.5,608.075,0.01,12500.0,320
HCPCS,27202,OPEN TREATMENT COCCYGEAL FRACTURE,3216.0,2090.4,1.1,9440.12,144
HCPCS,27202,TREAT TAIL BONE FRACTURE,,,2808.13,3405.12,20
HCPCS,27202,Treat tail bone fracture,,,3603.21,4172.14,8
HCPCS,27212910,W NDLE ECHOTIP DISPOSABLE CHIBA,318.0,206.7,1.1,318.0,70
HCPCS,27215,OPTX ILIAC TUBRST AVLS/WING FX FIXJ IF PRFRMD,4180.0,2717.0,1.1,4180.0,112
HCPCS,27215,Treat pelvic fracture(s),,,3603.21,4172.14,8
HCPCS,27216,PERQ SKELETAL FIXATION PST PELVIC BONE FX&/DIS,6292.0,4089.8,1.1,6292.0,112
HCPCS,27216,Treat pelvic ring fracture,,,3603.21,4172.14,8
HCPCS,27217,OPTX ANT PELVIC BONE FX&/DISLC INT FIXJ IF PFR,6446.0,4189.9,1.1,6446.0,112
HCPCS,27217,Treat pelvic ring fracture,,,3603.21,4172.14,8
HCPCS,27218,OPTX POST PEL BONE FX&/DISLC INT FIXJ IF PFRMD,8372.0,5441.8,1.1,8372.0,112
HCPCS,27218,Treat pelvic ring fracture,,,3603.21,4172.14,8
HCPCS,27220,CLTX ACETABULUM HIP/SOCKT FX W/O MANJ,1761.5,1144.975,0.01,12500.0,322
HCPCS,27222,CLTX ACETABULM HIP/SOCKT FX MANJ W/WO SKEL TRACJ,3087.5,2006.875,1.1,5644.0,222
HCPCS,27226,OPTX PST/ANT ACTBLR WALL FX W/INT FIXJ,6228.0,4048.2,1.1,6228.0,144
HCPCS,27226,TREAT HIP WALL FRACTURE,,,6864.94,7551.43,12
HCPCS,27226,Treat hip wall fracture,,,3603.21,4172.14,8
HCPCS,27227,OPTX ACTBLR FX INVG ANT/PST 1 COLUMN/FX W/INT,10164.0,6606.6,1.1,10164.0,144
HCPCS,27227,TREAT HIP FRACTURE(S),,,6864.94,7551.43,12
HCPCS,27227,Treat hip fracture(s),,,3603.21,4172.14,8
HCPCS,27228,OPTX ACTBLR FX INVG ANT&POST 2 COLUMNS FX W/INT,11732.0,7625.8,1.1,11732.0,144
HCPCS,27228,TREAT HIP FRACTURE(S),,,6864.94,7551.43,12
HCPCS,27228,Treat hip fracture(s),,,3603.21,4172.14,8
HCPCS,27230,CLTX FEM FX PROX END NCK W/O MANJ,1713.5,1113.775,0.01,4392.0,322
HCPCS,27232,CLTX FEM FX PROX END NCK W/MANJ W/WO SKEL TRACJ,4780.5,3107.325,1.1,5265.0,223
HCPCS,27235,PRQ SKEL FIXJ FEMORAL FX PROX END NECK,5200.0,3380.0,1.1,20863.78,144
HCPCS,27235,TREAT THIGH FRACTURE,,,6206.54,7551.43,20
HCPCS,27235,Treat thigh fracture,,,3603.21,4172.14,8
HCPCS,27236,OPTX FEM FX PROX END NCK INT FIXJ/PROSTC RPLCMT,7044.0,4578.6,1.1,7044.0,144
HCPCS,27236,TREAT THIGH FRACTURE,,,6864.94,7551.43,12
HCPCS,27236,Treat thigh fracture,,,3603.21,4172.14,8
HCPCS,27238,CLTX INTER/PERI/SUBTROCHANTERIC FEM FX W/O MANJ,4831.0,3140.15,0.01,7362.0,318
HCPCS,27240,CLTX INTR/PERI/SBTRCHNTC FEMORAL FX W/MANJ,3672.0,2386.8,1.1,5524.0,223
HCPCS,27244,TREAT THIGH FRACTURE,,,3210.05,7551.43,13
HCPCS,27244,TX INTER/PR/SUBTRCHNTRIC FEMORAL FX SCREW IMPLT,7272.0,4726.8,1.1,7272.0,144
HCPCS,27244,Treat thigh fracture,,,3067.73,3552.11,8
HCPCS,27245,TREAT THIGH FRACTURE,,,3205.75,7551.43,13
HCPCS,27245,TX INTER/PR/SUBTRCHNTRIC FEM FX IMED IMPLTSCREW,7272.0,4726.8,1.1,7272.0,144
HCPCS,27245,Treat thigh fracture,,,3067.73,3552.11,8
HCPCS,27246,CLTX GREATER TROCHANTERIC FX W/O MANJ,1517.5,986.375,0.01,4392.0,322
HCPCS,27248,OPEN TREATMENT GREATER TROCHANTERIC FRACTURE,4312.0,2802.8,1.1,4312.0,144
HCPCS,27248,TREAT THIGH FRACTURE,,,1952.55,7551.43,13
HCPCS,27248,Treat thigh fracture,,,3603.21,4172.14,8
HCPCS,27250,CLTX HIP DISLOCATION TRAUMATIC W/O ANESTHESIA,1392.0,904.8000000000001,1.1,4392.0,231
HCPCS,27252,CLTX HIP DISLOCATION TRAUMATIC REQ ANESTHESIA,6107.5,3969.875,1.1,7362.0,231
HCPCS,27253,OPTX HIP DISLOCATION TRAUMATIC W/O INTERNAL FIXJ,5432.0,3530.8,1.1,5432.0,144
HCPCS,27253,TREAT HIP DISLOCATION,,,2460.22,3405.12,13
HCPCS,27253,Treat hip dislocation,,,3603.21,4172.14,8
HCPCS,27254,OPTX HIP DISLC TRAUMTC W/ACTBLR WALL&FEM HEAD,7576.0,4924.4,1.1,7576.0,144
HCPCS,27254,TREAT HIP DISLOCATION,,,3325.26,7551.43,13
HCPCS,27254,Treat hip dislocation,,,3067.73,3552.11,8
HCPCS,27256,TX SPONTAN HIP DISLC ABDCT SPLNT/TRCJ W/O ANES,1407.5,914.875,0.01,12500.0,322
HCPCS,27257,TX SPON HIP DISLC ABDCT SPLNT/TRCJ W/MANJ ANES,4757.0,3092.05,1.1,7813.0,231
HCPCS,27258,OPTX SPON HIP DISLC RPLCMT FEM HEAD ACTBLM,6472.0,4206.8,1.1,6472.0,144
HCPCS,27258,TREAT HIP DISLOCATION,,,2909.69,3405.12,13
HCPCS,27258,Treat hip dislocation,,,3067.73,3552.11,8
HCPCS,27259,OPTX SPON HIP DISLC RPLCMT FEM HEAD ACTBLM SHRT,9304.0,6047.6,1.1,9304.0,144
HCPCS,27259,TREAT HIP DISLOCATION,,,3095.56,4031.44,13
HCPCS,27259,Treat hip dislocation,,,3067.73,3552.11,8
HCPCS,27265,CLTX POST HIP ARTHRP DISLC W/O ANES,1599.5,1039.6750000000002,1.1,4392.0,316
HCPCS,27266,CLTX POST HIP ARTHRP DISLC REQ ANES,6616.0,4300.4,1.1,7362.0,492
HCPCS,27267,CLOSED TX FEMORAL FRACTURE PROX HEAD W/O MANJ,8562.5,5565.625,1.1,14925.0,231
HCPCS,27268,CLOSED TX FEMORAL FRACTURE PROX HEAD W/MANJ,2848.0,1851.2,1.1,2848.0,144
HCPCS,27268,CLTX THIGH FX W/MNPJ,,,1521.28,1673.41,12
HCPCS,27268,Cltx thigh fx w/mnpj,,,295.11,341.7,8
HCPCS,27269,OPEN TX FEMORAL FRACTURE PROXIMAL END HEAD,7556.0,4911.4,1.1,7556.0,144
HCPCS,27269,OPTX THIGH FX,,,6864.94,7551.43,12
HCPCS,27269,Optx thigh fx,,,3603.21,4172.14,8
HCPCS,27275,MANIPULATION HIP JOINT W ANESTHESIA,928.0,603.2,1.1,4686.39,144
HCPCS,27275,MANIPULATION OF HIP JOINT,,,1394.34,1673.41,20
HCPCS,27275,Manipulation of hip joint,,,824.67,954.88,8
HCPCS,27278,ARTHRD SI JT PLMT IARTIC DEV,,,16167.8,48652.21,21
HCPCS,27278,ARTHRD SI JT PRQ W/PLMT IARTIC IMPLT WO TFXJ DEV,3458.0,2247.7,1.1,54351.12,146
HCPCS,27278,Arthrd si jt plmt iartic dev,,,14056.95,16276.47,8
HCPCS,27279,ARTHRD SI JT PLMT TARTCLR DV,,,16167.8,48652.21,21
HCPCS,27279,ARTHRODESIS SI JOINT PERCUTANEOUS/MIN INVASIVE,4852.0,3153.8,1.1,54351.12,144
HCPCS,27279,Arthrd si jt plmt tartclr dv,,,11196.34,12964.18,8
HCPCS,27280,ARTHR SI JT OPN B1GRF INSTRM,,,3587.7,18247.18,13
HCPCS,27280,ARTHRODESIS SI JT OPN W/OBTAINING B1 GRF INSTRMJ,8000.0,5200.0,1.1,8000.0,144
HCPCS,27280,Arthr si jt opn b1grf instrm,,,11196.34,12964.18,8
HCPCS,27282,ARTHRODESIS SYMPHYSIS PUBIS,,,2253.76,3405.12,13
HCPCS,27282,ARTHRODESIS SYMPHYSIS PUBIS W/OBTAINING GRAFT,4740.0,3081.0,1.1,4740.0,144
HCPCS,27282,Arthrodesis symphysis pubis,,,11196.34,12964.18,8
HCPCS,27284,ARTHRODESIS HIP JOINT,,,4189.13,13361.02,13
HCPCS,27284,Arthrodesis hip joint,,,11196.34,12964.18,8
HCPCS,27286,ARTHRD HIP JT SBTRCHC OSTEOT,,,4289.85,13361.02,13
HCPCS,27286,Arthrd hip jt sbtrchc osteot,,,11196.34,12964.18,8
HCPCS,27290,AMPUTATION OF LEG AT HIP,,,4241.79,18247.18,13
HCPCS,27290,Amputation of leg at hip,,,11196.34,12964.18,8
HCPCS,27290,INTERPELVIABDOMINAL AMPUTATION,9820.0,6383.0,1.1,9820.0,144
HCPCS,27295,AMPUTATION OF LEG AT HIP,,,3303.07,18247.18,13
HCPCS,27295,Amputation of leg at hip,,,11196.34,12964.18,8
HCPCS,27295,DISARTICULATION OF HIP,7864.0,5111.6,1.1,7864.0,144
HCPCS,27299,ABDUCTOR ANCHOR RECONSTRUCTION (COMP CODE 27100),4880.0,3172.0,0.01,4880.0,84
HCPCS,27299,ARTHOTOMY REMOVAL/EXCHANGE HIP SPACER,8036.0,5223.4,0.01,8036.0,84
HCPCS,27299,CEMENTOPLASTY-HIP,5072.0,3296.8,204.59,5072.0,84
HCPCS,27299,CORE DECOMPRESSION-HIP,1961.0,1274.65,0.01,1961.0,84
HCPCS,27299,CT GUIDED ACETABULOPLASTY (COMP CODE 22511),7981.5,5187.975,0.01,13324.0,168
HCPCS,27299,FASCIAL TRANSFER TO REPAIR OF THE ABDUCTOR TENDON,3746.0,2434.9,0.01,3746.0,84
HCPCS,27299,GLUTEUS MEDIUS/MINIMUS REPAIR (COMP CODE 27385),2458.0,1597.7,0.01,2458.0,84
HCPCS,27299,OPEN HIP LABRAL REPAIR (COMP 27120),6353.0,4129.45,0.01,6353.0,84
HCPCS,27299,OPEN PX TO RPR ABDUCTOR MUSCULATURE TO TUMOR PROSTHESIS (COMP CO,4101.0,2665.65,0.01,4101.0,84
HCPCS,27299,OPEN TROCH FLIP OSTEOTOMY,4217.0,2741.05,0.01,4217.0,84
HCPCS,27299,PELVIS/HIP JOINT SURGERY UNLISTED,2751.0,1788.15,0.01,2751.0,84
HCPCS,27299,POSTERIOR CAPSULAR RECONSTRUCTION (COMP CODE 27100),4540.0,2951.0,0.01,4540.0,84
HCPCS,27299,PROPHYLACTIC FIXATION PELVIS/ACETABULUM (27227),9148.0,5946.2,0.01,9148.0,84
HCPCS,27299,SUTURE OF ABDUCTOR TENDON (COMP CODE 27385),3085.0,2005.25,0.01,3085.0,84
HCPCS,27299,"UNLIST PROC, PELVIS OR HIP JOINT COMPARED TO 27000",3519.5,2287.675,0.01,6125.0,169
HCPCS,27299,"UNLISTED PROC, PELVIS OR HIP JOINT COMPARED TO 27000",914.0,594.1,0.01,914.0,84
HCPCS,27299,UNLISTED PROC; OPEN TREATMENT TOTAL HIP REPLACEMENT DISLOCATION,2501.0,1625.65,0.01,2501.0,84
HCPCS,27301,I&D DEEP ABSC BURSA/HEMATOMA THIGH/KNEE REGION,7938.5,5160.025,0.01,13165.0,235
HCPCS,27303,DRAINAGE OF BONE LESION,,,3095.56,3405.12,12
HCPCS,27303,Drainage of bone lesion,,,2483.09,2875.16,8
HCPCS,27303,INC DEEP W/OPNG BONE CORTEX FEMUR/KNEE,3452.0,2243.8,1.1,3452.0,144
HCPCS,27305,"FASCIOTOMY,ILIOTIBIAL,OPEN",2472.0,1606.8,1.1,9440.12,144
HCPCS,27305,INCISE THIGH TENDON & FASCIA,,,2808.13,3405.12,20
HCPCS,27305,Incise thigh tendon & fascia,,,3067.73,3552.11,8
HCPCS,27306,TENOTOMY PRQ ADDUCTOR/HAMSTRING 1 TENDON SPX,8410.5,5466.825,0.01,14925.0,231
HCPCS,27307,TENOTOMY PRQ ADDUCTOR/HAMSTRING MULTIPLE TENDON,8674.5,5638.425,0.01,14925.0,231
HCPCS,27310,ARTHRT KNE W/EXPL DRG/RMVL FB,4000.0,2600.0,1.1,9440.12,144
HCPCS,27310,EXPLORATION OF KNEE JOINT,,,2808.13,3405.12,20
HCPCS,27310,Exploration of knee joint,,,2483.09,2875.16,8
HCPCS,27323,BIOPSY SOFT TISSUE THIGH/KNEE AREA SUPERFICIAL,4192.5,2725.125,0.01,7453.0,322
HCPCS,27324,BIOPSY SOFT TISSUE THIGH/KNEE AREA DEEP,7590.5,4933.825,0.01,13165.0,231
HCPCS,27325,NEURECTOMY HAMSTRING,,,1675.06,2032.17,20
HCPCS,27325,"NEURECTOMY, HAMSTRING MUSCLE",2880.0,1872.0,1.1,5632.24,144
HCPCS,27325,Neurectomy hamstring,,,3067.73,3552.11,8
HCPCS,27326,NEURECTOMY POPLITEAL,,,1675.06,2032.17,20
HCPCS,27326,"NEURECTOMY, POPLITEAL (GASTROCNEMIUS)",2588.0,1682.2,1.1,5632.24,144
HCPCS,27326,Neurectomy popliteal,,,2483.09,2875.16,8
HCPCS,27327,EXCISION TUMOR SOFT TISSUE THIGH/KNEE SUBQ <3CM,4518.5,2937.0249999999996,0.01,7453.0,235
HCPCS,27328,EXC THIGH/KNEE TUM DEEP <5CM,,,2465.15,3022.89,20
HCPCS,27328,EXC TUMOR SOFT TISSUE THIGH/KNEE SUBFASC <5CM,3540.0,2301.0,1.1,8286.13,144
HCPCS,27328,Exc thigh/knee tum deep <5cm,,,1351.24,1564.6,8
HCPCS,27329,RAD RESECT TUMOR SOFT TISSUE THIGH/KNEE <5CM,6288.0,4087.2,1.1,8286.13,144
HCPCS,27329,RESECT THIGH/KNEE TUM < 5 CM,,,2465.15,3022.89,20
HCPCS,27329,Resect thigh/knee tum < 5 cm,,,2483.09,2875.16,8
HCPCS,27330,ARTHROTOMY KNEE W/SYNOVIAL BIOPSY ONLY,2044.0,1328.6,1.1,9440.12,144
HCPCS,27330,BIOPSY KNEE JOINT LINING,,,2808.13,3405.12,20
HCPCS,27330,Biopsy knee joint lining,,,2483.09,2875.16,8
HCPCS,27331,ARTHRT KNE W/JT EXPL BX/RMVL LOOSE/FB,2408.0,1565.2,1.1,9440.12,144
HCPCS,27331,EXPLORE/TREAT KNEE JOINT,,,2808.13,3405.12,20
HCPCS,27331,Explore/treat knee joint,,,2483.09,2875.16,8
HCPCS,27332,ARTHRT W/EXC SEMILUNAR CRTLG KNEE MEDIAL/LAT,3384.0,2199.6,1.1,9440.12,144
HCPCS,27332,REMOVAL OF KNEE CARTILAGE,,,2808.13,3405.12,20
HCPCS,27332,Removal of knee cartilage,,,2483.09,2875.16,8
HCPCS,27333,ARTHRT W/EXC SEMILUNAR CRTLG KNEE MEDIAL&LAT,3020.0,1963.0,1.1,9440.12,144
HCPCS,27333,REMOVAL OF KNEE CARTILAGE,,,2808.13,3405.12,20
HCPCS,27333,Removal of knee cartilage,,,2483.09,2875.16,8
HCPCS,27334,ARTHROTOMY W/SYNOVECTOMY KNEE ANTERIOR/POSTERIOR,3676.0,2389.4,1.1,9440.12,144
HCPCS,27334,REMOVE KNEE JOINT LINING,,,2808.13,3405.12,20
HCPCS,27334,Remove knee joint lining,,,2483.09,2875.16,8
HCPCS,27335,ARTHRT W/SYNVCT KNE ANT&POST W/POP AREA,4220.0,2743.0,1.1,20863.78,144
HCPCS,27335,REMOVE KNEE JOINT LINING,,,6206.54,7551.43,20
HCPCS,27335,Remove knee joint lining,,,5335.2,6177.6,8
HCPCS,27337,EXCISON TUMOR SOFT TISSUE THIGH/KNEE SUBQ 3 CM/>,13165.0,8557.25,0.01,13165.0,87
HCPCS,27337,EXCISON TUMOR SOFT TISSUE THIGH/KNEE SUBQ 3+CM,2364.0,1536.6,1.1,8286.13,144
HCPCS,27339,EXC THIGH/KNEE TUM DEP 5CM/>,,,2465.15,7813.0,22
HCPCS,27339,EXC TUMOR SOFT TISSUE THIGH/KNEE SUBFASC 5+CM,4452.0,2893.8,1.1,8286.13,144
HCPCS,27339,Exc thigh/knee tum dep 5cm/>,,,1351.24,1564.6,8
HCPCS,27340,EXCISION PREPATELLAR BURSA,1728.0,1123.2,1.1,9440.12,144
HCPCS,27340,REMOVAL OF KNEECAP BURSA,,,2808.13,3405.12,20
HCPCS,27340,Removal of kneecap bursa,,,2483.09,2875.16,8
HCPCS,27345,EXCISION SYNOVIAL CYST POPLITEAL SPACE,2436.0,1583.4,1.1,9440.12,144
HCPCS,27345,REMOVAL OF KNEE CYST,,,2808.13,3405.12,20
HCPCS,27345,Removal of knee cyst,,,2483.09,2875.16,8
HCPCS,27347,EXCISION LESION MENISCUS/CAPSULE KNEE,2692.0,1749.8,1.1,9440.12,144
HCPCS,27347,REMOVE KNEE CYST,,,2808.13,3405.12,20
HCPCS,27347,Remove knee cyst,,,2483.09,2875.16,8
HCPCS,27350,PATELLECTOMY/HEMIPATELLECTOMY,3464.0,2251.6,1.1,20863.78,144
HCPCS,27350,REMOVAL OF KNEECAP,,,6206.54,7551.43,20
HCPCS,27350,Removal of kneecap,,,2483.09,2875.16,8
HCPCS,27355,EXCISION/CURETTAGE CYST/TUMOR FEMUR,3200.0,2080.0,1.1,9440.12,144
HCPCS,27355,REMOVE FEMUR LESION,,,2808.13,7813.0,22
HCPCS,27355,Remove femur lesion,,,3067.73,3552.11,8
HCPCS,27356,EXCISION/CURETTAGE CYST/TUMOR FEMUR W/ALLOGRAFT,4036.0,2623.4,1.1,38384.94,144
HCPCS,27356,REMOVE FEMUR LESION/GRAFT,,,11418.01,13361.02,20
HCPCS,27356,Remove femur lesion/graft,,,3067.73,3552.11,8
HCPCS,27357,EXCISION/CURETTAGE CYST/TUMOR FEMUR W/AUTOGRAFT,4464.0,2901.6,1.1,20863.78,144
HCPCS,27357,REMOVE FEMUR LESION/GRAFT,,,6206.54,7551.43,20
HCPCS,27357,Remove femur lesion/graft,,,3067.73,3552.11,8
HCPCS,27358,EXCISION/CURETTAGE CYST/TUMOR FEMUR INT FIXATION,1892.0,1229.8,1.1,1892.0,144
HCPCS,27358,Remove femur lesion/fixation,,,3067.73,3552.11,8
HCPCS,27360,PARTIAL REMOVAL LEG BONE(S),,,2808.13,3405.12,20
HCPCS,27360,PRTL EXC BONE FEMUR PROX TIBIA&/FIBULA,4584.0,2979.6,1.1,9440.12,144
HCPCS,27360,Partial removal leg bone(s),,,2483.09,2875.16,8
HCPCS,27364,RAD RESECTION TUMOR SOFT TISSUE THIGH/KNEE 5+CM,9796.0,6367.4,1.1,9796.0,144
HCPCS,27364,RESECT THIGH/KNEE TUM 5 CM/>,,,2465.15,3022.89,20
HCPCS,27364,Resect thigh/knee tum 5 cm/>,,,2483.09,2875.16,8
HCPCS,27365,"RAD RESEC TUMOR,FEMUR OR KNEE",12884.0,8374.6,1.1,12884.0,144
HCPCS,27365,RESECT FEMUR/KNEE TUMOR,,,3095.56,5357.08,13
HCPCS,27365,Resect femur/knee tumor,,,3067.73,3552.11,8
HCPCS,27369,NJX PX CNTRST KNE ARTHG CNTRST ENHNCD CT/MRI KNE,782.0,508.3,0.01,4628.0,204
HCPCS,27369,NJX PX CNTRST KNE ARTHG CONTRST ENHNCD CT/MRI KNE,308.0,200.2,1.1,624.58,148
HCPCS,27372,REMOVAL FOREIGN BODY DEEP THIGH/KNEE,13165.0,8557.25,475.77,25635.0,87
HCPCS,27372,"REMV FOREIGN BODY,KNEE/THIGH,DEEP",2084.0,1354.6,1.1,8286.13,148
HCPCS,27380,REPAIR OF KNEECAP TENDON,,,6206.54,7551.43,20
HCPCS,27380,Repair of kneecap tendon,,,2483.09,2875.16,8
HCPCS,27380,SUTURE INFRAPATELLAR TENDON PRIMARY,2980.0,1937.0,1.1,20863.78,144
HCPCS,27381,REPAIR/GRAFT KNEECAP TENDON,,,6206.54,7551.43,20
HCPCS,27381,Repair/graft kneecap tendon,,,5335.2,6177.6,8
HCPCS,27381,SUTR INFRAPATELLAR TDN 2 RCNSTJ W/FSCAL/TDN GRF,4304.0,2797.6,1.1,20863.78,144
HCPCS,27385,REPAIR OF THIGH MUSCLE,,,6206.54,7551.43,20
HCPCS,27385,Repair of thigh muscle,,,3067.73,3552.11,8
HCPCS,27385,SUTURE QUADRICEPS/HAMSTRING RUPTURE PRIMARY,3049.0,1981.85,1.1,20863.78,144
HCPCS,27386,REPAIR/GRAFT OF THIGH MUSCLE,,,6206.54,7551.43,20
HCPCS,27386,Repair/graft of thigh muscle,,,3067.73,3552.11,8
HCPCS,27386,SUTR QUADRICEPS/HAMSTRING MUSC RPT RCNSTJ,4452.0,2893.8,1.1,20863.78,144
HCPCS,27390,INCISION OF THIGH TENDON,,,2808.13,3405.12,20
HCPCS,27390,Incision of thigh tendon,,,3067.73,3552.11,8
HCPCS,27390,TENOTOMY OPEN HAMSTRING KNEE HIP SINGLE TENDON,2212.0,1437.8,1.1,9440.12,144
HCPCS,27391,INCISION OF THIGH TENDONS,,,2808.13,3405.12,20
HCPCS,27391,Incision of thigh tendons,,,3067.73,3552.11,8
HCPCS,27391,TENOTOMY OPN HAMSTRING KNEE HIP MULTIPLE 1 LEG,2996.0,1947.4,1.1,9440.12,144
HCPCS,27392,INCISION OF THIGH TENDONS,,,2808.13,3405.12,20
HCPCS,27392,Incision of thigh tendons,,,3067.73,3552.11,8
HCPCS,27392,TENOTOMY OPEN HAMSTRING KNEE HIP MULTIPLE BI,3852.0,2503.8,1.1,9440.12,144
HCPCS,27393,"LENGTHEN HAMSTR TENDON,SINGLE",2900.0,1885.0,1.1,20863.78,144
HCPCS,27393,LENGTHENING OF THIGH TENDON,,,6206.54,7551.43,20
HCPCS,27393,Lengthening of thigh tendon,,,3067.73,3552.11,8
HCPCS,27394,"LENGTHEN HAMSTR TENDON,MULTI,ONE LEG",3868.0,2514.2,1.1,20863.78,144
HCPCS,27394,LENGTHENING OF THIGH TENDONS,,,6206.54,7551.43,20
HCPCS,27394,Lengthening of thigh tendons,,,3067.73,3552.11,8
HCPCS,27395,"LENGTHEN HAMSTR TENDON,MULTI,2 LEGS",5386.0,3500.9,1.1,9440.12,144
HCPCS,27395,LENGTHENING OF THIGH TENDONS,,,2808.13,3405.12,20
HCPCS,27395,Lengthening of thigh tendons,,,3067.73,3552.11,8
HCPCS,27396,TRANSPLANT OF THIGH TENDON,,,6206.54,7551.43,20
HCPCS,27396,TRANSPLANT/TRANSFER THIGH XTNSR TO FLXR 1 TENDON,3260.0,2119.0,1.1,20863.78,144
HCPCS,27396,Transplant of thigh tendon,,,3067.73,3552.11,8
HCPCS,27397,TRANSPLANT/TRANSFER THIGH XTNSR TO FLXR MULT TDN,5064.0,3291.6,1.1,20863.78,144
HCPCS,27397,TRANSPLANTS OF THIGH TENDONS,,,6206.54,7551.43,20
HCPCS,27397,Transplants of thigh tendons,,,3067.73,3552.11,8
HCPCS,27400,REVISE THIGH MUSCLES/TENDONS,,,6206.54,7551.43,20
HCPCS,27400,Revise thigh muscles/tendons,,,3067.73,3552.11,8
HCPCS,27400,TRANSFER TENDON/MUSCLE HAMSTRINGS FEMUR,3732.0,2425.8,1.1,20863.78,144
HCPCS,27403,ARTHROTOMY W/MENISCUS REPAIR KNEE,3448.0,2241.2,1.1,20863.78,144
HCPCS,27403,REPAIR OF KNEE CARTILAGE,,,6206.54,7551.43,20
HCPCS,27403,Repair of knee cartilage,,,2483.09,2875.16,8
HCPCS,27405,REPAIR OF KNEE LIGAMENT,,,6206.54,7551.43,20
HCPCS,27405,RPR PRIMARY TORN LIGM&/CAPSULE KNEE COLLATERAL,3632.0,2360.8,1.1,20863.78,144
HCPCS,27405,Repair of knee ligament,,,5335.2,6177.6,8
HCPCS,27407,REPAIR OF KNEE LIGAMENT,,,6206.54,7551.43,20
HCPCS,27407,REPAIR PRIMARY TORN LIGM&/CAPSULE KNEE CRUCIAT,4340.0,2821.0,1.1,20863.78,144
HCPCS,27407,Repair of knee ligament,,,5335.2,6177.6,8
HCPCS,27409,REPAIR OF KNEE LIGAMENTS,,,6206.54,7551.43,20
HCPCS,27409,RPR 1 TORN LIGM&/CAPSL KNE COLTRL&CRUCIATE,5484.0,3564.6,1.1,20863.78,144
HCPCS,27409,Repair of knee ligaments,,,5335.2,6177.6,8
HCPCS,27412,AUTOCHONDROCYTE IMPLANT KNEE,,,6206.54,7551.43,20
HCPCS,27412,AUTOLOGOUS CHONDROCYTE IMPLANTATION KNEE,9896.0,6432.4,1.1,20863.78,144
HCPCS,27412,Autochondrocyte implant knee,,,4348.01,5034.54,8
HCPCS,27415,OSTEOCHONDRAL KNEE ALLOGRAFT,8000.0,5200.0,1.1,38384.94,164
HCPCS,27415,Osteochondral knee allograft,,,4348.01,5034.54,8
HCPCS,27416,OSTEOCHONDRAL AUTOGRAFT KNEE OPEN MOSAICPLASTY,5664.0,3681.6,1.1,20863.78,142
HCPCS,27416,OSTEOCHONDRAL KNEE AUTOGRAFT,,,6206.54,8702.0,21
HCPCS,27416,Osteochondral knee autograft,,,5335.2,6177.6,8
HCPCS,27418,ANTERIOR TIBIAL TUBERCLEPLASTY,4640.0,3016.0,1.1,20863.78,144
HCPCS,27418,REPAIR DEGENERATED KNEECAP,,,6206.54,7551.43,20
HCPCS,27418,Repair degenerated kneecap,,,5335.2,6177.6,8
HCPCS,27420,RCNSTJ DISLOCATING PATELLA,4104.0,2667.6,1.1,20863.78,144
HCPCS,27420,REVISION OF UNSTABLE KNEECAP,,,6206.54,7551.43,20
HCPCS,27420,Revision of unstable kneecap,,,5335.2,6177.6,8
HCPCS,27422,RCNSTJ DISLC PATELLA W/XTNSR RELIGNMT&/MUSC RL,4084.0,2654.6,1.1,20863.78,144
HCPCS,27422,REVISION OF UNSTABLE KNEECAP,,,6206.54,7551.43,20
HCPCS,27422,Revision of unstable kneecap,,,5335.2,6177.6,8
HCPCS,27424,RCNSTJ DISLC PATELLA W/PATELLECTOMY,4096.0,2662.4,1.1,20863.78,144
HCPCS,27424,REVISION/REMOVAL OF KNEECAP,,,6206.54,7551.43,20
HCPCS,27424,Revision/removal of kneecap,,,5335.2,6177.6,8
HCPCS,27425,LAT RETINACULAR RELEASE OPEN,,,2808.13,3405.12,20
HCPCS,27425,LATERAL RETINACULAR RELEASE OPEN,2156.0,1401.4,1.1,9440.12,144
HCPCS,27425,Lat retinacular release open,,,2483.09,2875.16,8
HCPCS,27427,LIGAMENTOUS RECONSTRUCTION KNEE EXTRA-ARTICULAR,3916.0,2545.4,1.1,20863.78,144
HCPCS,27427,RECONSTRUCTION KNEE,,,6206.54,11170.0,23
HCPCS,27427,Reconstruction knee,,,5335.2,6177.6,8
HCPCS,27428,LIGAMENTOUS RECONSTRUCTION KNEE INTRA-ARTICULAR,6232.0,4050.8,1.1,38384.94,144
HCPCS,27428,RECONSTRUCTION KNEE,,,11418.01,13361.02,20
HCPCS,27428,Reconstruction knee,,,5335.2,6177.6,8
HCPCS,27429,LIGMOUS RCNSTJ AGMNTJ KNE INTRA-ARTICULAR XTR,7016.0,4560.4,1.1,38384.94,144
HCPCS,27429,RECONSTRUCTION KNEE,,,11418.01,13361.02,20
HCPCS,27429,Reconstruction knee,,,5335.2,6177.6,8
HCPCS,27430,QUADRICEPSPLASTY,4064.0,2641.6,1.1,20863.78,144
HCPCS,27430,REVISION OF THIGH MUSCLES,,,6206.54,8702.0,21
HCPCS,27430,Revision of thigh muscles,,,3067.73,3552.11,8
HCPCS,27435,CAPSULOTOMY POSTERIOR CAPSULAR RELEASE KNEE,4352.0,2828.8,1.1,9440.12,144
HCPCS,27435,INCISION OF KNEE JOINT,,,2808.13,3405.12,20
HCPCS,27435,Incision of knee joint,,,2483.09,2875.16,8
HCPCS,27437,ARTHROPLASTY PATELLA W/O PROSTHESIS,3572.0,2321.8,1.1,20863.78,144
HCPCS,27437,REVISE KNEECAP,,,6206.54,7551.43,20
HCPCS,27437,Revise kneecap,,,2382.18,2758.32,8
HCPCS,27438,ARTHROPLASTY PATELLA W/PROSTHESIS,4756.0,3091.4,1.1,38384.94,144
HCPCS,27438,REVISE KNEECAP WITH IMPLANT,,,11418.01,13821.0,21
HCPCS,27438,Revise kneecap with implant,,,7882.2,9126.76,8
HCPCS,27440,REVISION OF KNEE JOINT,,,11418.01,34359.11,21
HCPCS,27440,Revision of knee joint,,,7882.2,9126.76,8
HCPCS,27441,ARTHRP KNEE TIBIAL PLATEAU DBRDMT&PRTL SYNVCT,4616.0,3000.4,1.1,38384.94,144
HCPCS,27441,REVISION OF KNEE JOINT,,,11418.01,13361.02,20
HCPCS,27441,Revision of knee joint,,,7882.2,9126.76,8
HCPCS,27442,ARTHROPLASTY FEM CONDYLES/TIBIAL PLATEAU KNEE,4948.0,3216.2,1.1,38384.94,144
HCPCS,27442,REVISION OF KNEE JOINT,,,11418.01,13361.02,20
HCPCS,27442,Revision of knee joint,,,7882.2,9126.76,8
HCPCS,27443,REVISION OF KNEE JOINT,,,11418.01,13361.02,20
HCPCS,27443,Revision of knee joint,,,7882.2,9126.76,8
HCPCS,27445,REVISION OF KNEE JOINT,,,3279.75,3279.75,1
HCPCS,27445,Revision of knee joint,,,7882.2,9126.76,8
HCPCS,27446,ARTHRP KNEE CONDYLE&PLATEAU MEDIAL/LAT CMPRT,6852.0,4453.8,1.1,38384.94,144
HCPCS,27446,REVISION OF KNEE JOINT,,,4616.0,13361.02,21
HCPCS,27446,Revision of knee joint,,,7882.2,9126.76,8
HCPCS,27447,ARTHRP KNE CONDYLE&PLATU MEDIAL&LAT COMPARTMENTS,7840.0,5096.0,1.1,38384.94,144
HCPCS,27447,TOTAL KNEE ARTHROPLASTY,,,4616.0,34359.11,23
HCPCS,27447,Total knee arthroplasty,,,7882.2,9126.76,8
HCPCS,27448,INCISION OF THIGH,,,2171.94,7551.43,13
HCPCS,27448,Incision of thigh,,,3067.73,3552.11,8
HCPCS,27448,OSTEOTOMY FEMUR SHAFT/SUPRACONDYLAR W/O FIXATION,4640.0,3016.0,1.1,4640.0,144
HCPCS,27450,INCISION OF THIGH,,,2642.21,7551.43,13
HCPCS,27450,Incision of thigh,,,3067.73,3552.11,8
HCPCS,27450,OSTEOTOMY FEMUR SHAFT/SUPRACONDYLAR W/FIXATION,5844.0,3798.6,1.1,5844.0,144
HCPCS,27454,OSTEOT MLT W/RELIGNMT IMED ROD FEM SHFT,7668.0,4984.2,1.1,7668.0,144
HCPCS,27454,REALIGNMENT OF THIGH BONE,,,3383.24,7551.43,13
HCPCS,27454,Realignment of thigh bone,,,3067.73,3552.11,8
HCPCS,27455,OSTEOT PROX TIBIA FIB EXC/OSTEOT BEFORE EPIPHYSL,5344.0,3473.6,1.1,5344.0,144
HCPCS,27455,REALIGNMENT OF KNEE,,,2513.62,7551.43,13
HCPCS,27455,Realignment of knee,,,5335.2,6177.6,8
HCPCS,27457,OSTEOT PROX TIBIA FIB EXC/OSTEOT AFTER EPIPHYSL,5612.0,3647.8,1.1,5612.0,144
HCPCS,27457,REALIGNMENT OF KNEE,,,2474.22,7551.43,13
HCPCS,27457,Realignment of knee,,,5335.2,6177.6,8
HCPCS,27458,OSTEOT FEMUR IMED LNGTH DEV,,,6864.94,7551.43,12
HCPCS,27458,OSTEOT FEMUR UNI INSJ XTRNL CTRLD IMED LNGTH DEV,11726.0,7621.9,1.1,11726.0,106
HCPCS,27458,Osteot femur imed lngth dev,,,3067.73,3552.11,8
HCPCS,27465,OSTEOPLASTY FEMUR SHORTENING EXCLUDING 64876,7440.0,4836.0,1.1,7440.0,144
HCPCS,27465,SHORTENING OF THIGH BONE,,,3262.93,7551.43,13
HCPCS,27465,Shortening of thigh bone,,,3067.73,3552.11,8
HCPCS,27466,LENGTHENING OF THIGH BONE,,,3099.87,7551.43,13
HCPCS,27466,Lengthening of thigh bone,,,3067.73,3552.11,8
HCPCS,27466,OSTEOPLASTY FEMUR LENGTHENING,6912.0,4492.8,1.1,6912.0,144
HCPCS,27468,SHORTEN/LENGTHEN THIGHS,,,3504.98,3504.98,1
HCPCS,27468,Shorten/lengthen thighs,,,3067.73,3552.11,8
HCPCS,27470,REPAIR OF THIGH,,,3090.14,7551.43,13
HCPCS,27470,RPR NON/MAL FEMUR DSTL H/N W/O GRF,6856.0,4456.4,1.1,6856.0,144
HCPCS,27470,Repair of thigh,,,3067.73,3552.11,8
HCPCS,27472,REPAIR/GRAFT OF THIGH,,,3308.14,7551.43,13
HCPCS,27472,RPR NON/MAL FEMUR DSTL H/N W/ILIAC/AUTOG BONE,8237.0,5354.05,1.1,8237.0,144
HCPCS,27472,Repair/graft of thigh,,,3067.73,3552.11,8
HCPCS,27475,ARREST EPIPHYSEAL DISTAL FEMUR,18216.5,11840.725,1.1,32861.0,230
HCPCS,27477,ARREST EPIPHYSEAL TIBIA & FIBULA PROXIMAL,4056.0,2636.4,1.1,20863.78,144
HCPCS,27477,SURGERY TO STOP LEG GROWTH,,,6206.54,18676.74,21
HCPCS,27477,Surgery to stop leg growth,,,2483.09,2875.16,8
HCPCS,27479,ARRST EPIPHYSL CMBN DSTL FEMUR PROX TIBFIB,5264.0,3421.6,1.1,20863.78,144
HCPCS,27479,SURGERY TO STOP LEG GROWTH,,,6206.54,18676.74,22
HCPCS,27479,Surgery to stop leg growth,,,5335.2,6177.6,8
HCPCS,27485,ARRST HEMIEPIPHYSL DSTL FEMUR/PROX TIBIA/FIBULA,3652.0,2373.8,1.1,20863.78,144
HCPCS,27485,SURGERY TO STOP LEG GROWTH,,,6206.54,18676.74,22
HCPCS,27485,Surgery to stop leg growth,,,2483.09,2875.16,8
HCPCS,27486,REVISE/REPLACE KNEE JOINT,,,3668.48,13361.02,14
HCPCS,27486,REVJ TOTAL KNEE ARTHRP W/WO ALGRFT 1 COMPONENT,8448.0,5491.2,1.1,8448.0,144
HCPCS,27486,Revise/replace knee joint,,,7882.2,9126.76,8
HCPCS,27487,REVISE/REPLACE KNEE JOINT,,,4577.58,18247.18,13
HCPCS,27487,REVJ TOT KNEE ARTHRP FEM&ENTIRE TIBIAL COMPONE,10844.0,7048.6,1.1,10844.0,144
HCPCS,27487,Revise/replace knee joint,,,7882.2,9126.76,8
HCPCS,27488,REMOVAL OF KNEE PROSTHESIS,,,3139.63,13361.02,13
HCPCS,27488,RMVL PROSTH TOT KNEE PROSTH MMA W/WO INSJ SPACER,7040.0,4576.0,1.1,7040.0,144
HCPCS,27488,Removal of knee prosthesis,,,5335.2,6177.6,8
HCPCS,27495,PROPH TX N/P/PLTWR W/WO METHYLMETHACRYLATE FEMUR,6616.0,4300.4,1.1,6616.0,144
HCPCS,27495,REINFORCE THIGH,,,2956.43,7551.43,13
HCPCS,27495,Reinforce thigh,,,3067.73,3552.11,8
HCPCS,27496,DECOMPRESSION FASCIOTOMY THIGH&/KNEE 1 COMPONENT,2712.0,1762.8,1.1,9440.12,144
HCPCS,27496,DECOMPRESSION OF THIGH/KNEE,,,2808.13,3405.12,20
HCPCS,27496,Decompression of thigh/knee,,,3067.73,3552.11,8
HCPCS,27497,DCMPRN FASCT THIGH&/KNEE DBRDMT MUSCLE&/NERVE,3116.0,2025.4,1.1,9440.12,144
HCPCS,27497,DECOMPRESSION OF THIGH/KNEE,,,2808.13,3405.12,20
HCPCS,27497,Decompression of thigh/knee,,,2483.09,2875.16,8
HCPCS,27498,DCMPRN FASCIOTOMY THIGH&/KNEE MLT COMPARTMENTS,3464.0,2251.6,1.1,4686.39,144
HCPCS,27498,DECOMPRESSION OF THIGH/KNEE,,,1394.34,1673.41,20
HCPCS,27498,Decompression of thigh/knee,,,2483.09,2875.16,8
HCPCS,27499,DCMPRN FASCT THIGH&/KNEE MLT DBRDMT NV MUSC&NRVE,3772.0,2451.8,1.1,20863.78,144
HCPCS,27499,DECOMPRESSION OF THIGH/KNEE,,,6206.54,7551.43,20
HCPCS,27499,Decompression of thigh/knee,,,2483.09,2875.16,8
HCPCS,27500,CLOSED TX FEMORAL SHAFT FX W/O MANIPULATION,1811.5,1177.475,0.01,4392.0,322
HCPCS,27501,CLTX SPRCNDYLR/TRNSCNDYLR FEM FX W/O MANJ,1841.5,1196.975,0.01,5265.0,322
HCPCS,27502,CLTX FEM SHFT FX W/MANJ W/WO SKIN/SKELETAL TRACJ,5953.0,3869.45,1.1,7362.0,231
HCPCS,27503,CLTX SPRCNDYLR/TRNSCNDYLR FEM FX W/MANJ,5935.0,3857.75,0.01,7813.0,318
HCPCS,27506,OPTX FEM SHFT FX W/INSJ IMED IMPLT W/WO SCREW,7860.0,5109.0,1.1,7860.0,144
HCPCS,27506,TREATMENT OF THIGH FRACTURE,,,3498.05,7551.43,13
HCPCS,27506,Treatment of thigh fracture,,,3067.73,3552.11,8
HCPCS,27507,OPTX FEM SHFT FX W/PLATE/SCREWS W/WO CERCLAGE,5792.0,3764.8,1.1,5792.0,144
HCPCS,27507,TREATMENT OF THIGH FRACTURE,,,2531.27,7551.43,13
HCPCS,27507,Treatment of thigh fracture,,,3603.21,4172.14,8
HCPCS,27508,CLTX FEM FX DSTL END MEDIAL/LAT CONDYLE W/O MANJ,1791.5,1164.475,0.01,4392.0,322
HCPCS,27509,PRQ SKELETAL FIXJ FEMORAL FX DISTAL END,3256.0,2116.4,1.1,20863.78,144
HCPCS,27509,TREATMENT OF THIGH FRACTURE,,,6206.54,7551.43,20
HCPCS,27509,Treatment of thigh fracture,,,3603.21,4172.14,8
HCPCS,27510,CLTX FEM FX DSTL END MEDIAL/LAT CONDYLE W/MANJ,5641.0,3666.65,1.1,7362.0,231
HCPCS,27511,OPEN TX FEMORAL SUPRACONDYLAR FRACTURE W/O XTN,6648.0,4321.2,1.1,6648.0,144
HCPCS,27511,TREATMENT OF THIGH FRACTURE,,,2605.79,13361.02,13
HCPCS,27511,Treatment of thigh fracture,,,3603.21,4172.14,8
HCPCS,27513,OPEN TX FEMORAL SUPRACONDYLAR FRACTURE W/XTN,8470.0,5505.5,1.1,8470.0,144
HCPCS,27513,TREATMENT OF THIGH FRACTURE,,,3228.35,13361.02,13
HCPCS,27513,Treatment of thigh fracture,,,3603.21,4172.14,8
HCPCS,27514,OPEN TX FEMORAL FRACTURE DISTAL MED/LAT CONDYLE,5840.0,3796.0,1.1,5840.0,144
HCPCS,27514,TREATMENT OF THIGH FRACTURE,,,12146.38,13361.02,12
HCPCS,27514,Treatment of thigh fracture,,,3603.21,4172.14,8
HCPCS,27516,CLTX DISTAL FEMORAL EPIPHYSL SEPARATION W/O MANJ,2236.0,1453.4,1.1,2236.0,148
HCPCS,27516,TREAT THIGH FX GROWTH PLATE,,,204.59,256.7,20
HCPCS,27516,Treat thigh fx growth plate,,,295.11,341.7,8
HCPCS,27517,TREAT THIGH FX GROWTH PLATE,,,1394.34,1673.41,20
HCPCS,27517,Treat thigh fx growth plate,,,295.11,341.7,8
HCPCS,27519,OPEN TX DISTAL FEMORAL EPIPHYSEAL SEPARATION,5300.0,3445.0,1.1,5300.0,144
HCPCS,27519,TREAT THIGH FX GROWTH PLATE,,,6864.94,7551.43,12
HCPCS,27519,Treat thigh fx growth plate,,,3067.73,3552.11,8
HCPCS,27520,CLOSED TX PATELLAR FRACTURE W/O MANIPULATION,1159.5,753.675,0.01,4392.0,322
HCPCS,27524,OPTX PATLLR FX W/INT FIXJ/PATLLC&SOFT TISS RPR,4148.0,2696.2,1.1,20863.78,144
HCPCS,27524,TREAT KNEECAP FRACTURE,,,5597.0,11170.0,22
HCPCS,27524,Treat kneecap fracture,,,3603.21,4172.14,8
HCPCS,27530,CLTX TIBIAL FX PROXIMAL W/O MANIPULATION,1134.5,737.425,0.01,4392.0,409
HCPCS,27532,CLTX TIBIAL FX PROXIMAL W/WO MANJ W/SKEL TRACJ,9123.5,5930.275,0.01,14925.0,322
HCPCS,27535,OPEN TX TIBIAL FRACTURE PROXIMAL UNICONDYLAR,5364.0,3486.6,1.1,5364.0,144
HCPCS,27535,TREAT KNEE FRACTURE,,,6864.94,7551.43,12
HCPCS,27535,Treat knee fracture,,,3603.21,4172.14,8
HCPCS,27536,OPTX TIBIAL FX PROX BICONDYLAR W/WO INT FIXJ,6956.0,4521.4,1.1,6956.0,144
HCPCS,27536,TREAT KNEE FRACTURE,,,6864.94,7551.43,12
HCPCS,27536,Treat knee fracture,,,3603.21,4172.14,8
HCPCS,27538,CLTX INTERCONDYLAR SPI&/TUBRST FX KNE W/WO MAN,1569.5,1020.1750000000001,0.01,4392.0,322
HCPCS,27540,OPEN TX INTERCONDYLAR SPINE/TUBRST FRACTURE KNEE,4520.0,2938.0,1.1,4520.0,144
HCPCS,27540,TREAT KNEE FRACTURE,,,6864.94,7551.43,12
HCPCS,27540,Treat knee fracture,,,3603.21,4172.14,8
HCPCS,27550,CLOSED TX KNEE DISLOCATION W/O ANESTHESIA,1747.5,1135.875,1.1,4392.0,235
HCPCS,27552,CLOSED TX KNEE DISLOCATION W/ANESTHESIA,3272.0,2126.8,1.1,4686.39,144
HCPCS,27552,TREAT KNEE DISLOCATION,,,1394.34,1673.41,20
HCPCS,27552,Treat knee dislocation,,,824.67,954.88,8
HCPCS,27556,TREAT KNEE DISLOCATION,,,6864.94,7551.43,12
HCPCS,27556,Treat knee dislocation,,,5335.2,6177.6,8
HCPCS,27557,TREAT KNEE DISLOCATION,,,6864.94,7551.43,12
HCPCS,27557,Treat knee dislocation,,,5335.2,6177.6,8
HCPCS,27558,OPEN TX KNEE DISLOCATION W/REPAIR/RECONSTRUCTION,8092.0,5259.8,1.1,8092.0,144
HCPCS,27558,TREAT KNEE DISLOCATION,,,6864.94,7551.43,12
HCPCS,27558,Treat knee dislocation,,,5335.2,6177.6,8
HCPCS,27560,CLOSED TX PATELLAR DISLOCATION W/O ANESTHESIA,1349.5,877.1750000000001,0.01,4392.0,322
HCPCS,27562,CLOSED TX PATELLAR DISLOCATION W/ANESTHESIA,1747.5,1135.875,1.1,4392.0,231
HCPCS,27566,OPTX PATELLAR DISLC W/WO PRTL/TOT PATELLECTOMY,5084.0,3304.6,1.1,20863.78,144
HCPCS,27566,TREAT KNEECAP DISLOCATION,,,6206.54,7551.43,20
HCPCS,27566,Treat kneecap dislocation,,,3603.21,4172.14,8
HCPCS,27570,FIXATION OF KNEE JOINT,,,1394.34,2351.0,21
HCPCS,27570,Fixation of knee joint,,,824.67,954.88,8
HCPCS,27570,MANIPULATION KNEE JOINT UNDER GENERAL ANESTHESIA,716.0,465.4,1.1,4686.39,144
HCPCS,27580,ARTHRODESIS KNEE ANY TECHNIQUE,8440.0,5486.0,1.1,8440.0,144
HCPCS,27580,FUSION OF KNEE,,,12146.38,13361.02,12
HCPCS,27580,Fusion of knee,,,5335.2,6177.6,8
HCPCS,27590,AMPUTATE LEG AT THIGH,,,3095.56,3405.12,12
HCPCS,27590,AMPUTATION THIGH THROUGH FEMUR ANY LEVEL,5927.0,3852.55,1.1,5927.0,144
HCPCS,27590,Amputate leg at thigh,,,3067.73,3552.11,8
HCPCS,27591,AMPUTATE LEG AT THIGH,,,3095.56,3405.12,12
HCPCS,27591,Amputate leg at thigh,,,3067.73,3552.11,8
HCPCS,27592,AMPUTATE LEG AT THIGH,,,3095.56,3405.12,12
HCPCS,27592,AMPUTATION THIGH THRU FEMUR OPEN CIRCULAR,4392.0,2854.8,1.1,4392.0,144
HCPCS,27592,Amputate leg at thigh,,,3067.73,3552.11,8
HCPCS,27594,AMP THIGH THRU FEMUR SEC CLOSURE/SCAR REVISION,2916.0,1895.4,1.1,9440.12,144
HCPCS,27594,AMPUTATION FOLLOW-UP SURGERY,,,2808.13,3405.12,20
HCPCS,27594,Amputation follow-up surgery,,,3067.73,3552.11,8
HCPCS,27596,AMPUTATION FOLLOW-UP SURGERY,,,3095.56,3405.12,12
HCPCS,27596,AMPUTATION THIGH THROUGH FEMUR RE-AMPUTATION,4516.0,2935.4,1.1,4516.0,144
HCPCS,27596,Amputation follow-up surgery,,,3067.73,3552.11,8
HCPCS,27598,AMPUTATE LOWER LEG AT KNEE,,,3095.56,3405.12,12
HCPCS,27598,Amputate lower leg at knee,,,5335.2,6177.6,8
HCPCS,27598,DISARTICULATION KNEE,4488.0,2917.2,1.1,4488.0,144
HCPCS,27599,"ALLOGRAFT STRUT, FEMUR (COMP CODE 27472)",8050.0,5232.5,0.01,8050.0,84
HCPCS,27599,ANCHORING FOR FLANK HERNIA REPAIR (COMP 27087),2914.0,1894.1,0.01,2914.0,84
HCPCS,27599,ANTIBIOTIC ROD FEMUR,6484.0,4214.6,0.01,6484.0,84
HCPCS,27599,"ARTHROPLASTY FEMORAL/FEMUR/PATELLA, KNEE (COMP CODE 27446)",7365.0,4787.25,0.01,7365.0,84
HCPCS,27599,EXCISION HETEROTROPHIC OSSIFICATION KNEE,3782.0,2458.3,0.01,3782.0,84
HCPCS,27599,FEMORAL BONE RECONSTRUCTION W/BONE GRAFT,11126.0,7231.9,0.01,11126.0,84
HCPCS,27599,FEMUR/KNEE SURG UNLISTED(COMP CODE 20982),10131.0,6585.15,204.59,10131.0,84
HCPCS,27599,INSERT FEMUR SPACER,481.0,312.65,0.01,688.73,84
HCPCS,27599,KNEE SPACER EXCHANGE,1927.0,1252.55,0.01,1927.0,84
HCPCS,27599,LENGTHEN/SHORTEN TENDON FEMUR/KNEE,2208.0,1435.2,0.01,2208.0,84
HCPCS,27599,MANIPULATION KNEE JOINT NOT UNDER GENERAL ANESTHESIA (COMP CODE,769.0,499.85,0.01,769.0,84
HCPCS,27599,OPEN FIXATION OF OCD,5717.0,3716.05,0.01,5717.0,84
HCPCS,27599,OPEN REPAIR OF MEDIAL RETINACULUM (COMP CODE 27424),4096.0,2662.4,0.01,4096.0,84
HCPCS,27599,"ORIF OF OCD, KNEE (COMP 20924)",2204.0,1432.6,0.01,2204.0,84
HCPCS,27599,ORIF OF THE OCD LESION FEMORAL CONDYLE,4818.0,3131.7,0.01,4818.0,84
HCPCS,27599,PATELLA TENDON IMBRICATN,3386.0,2200.9,0.01,3386.0,84
HCPCS,27599,PERCUTANEOUS HAMSTRING LENGTHENING (COMP 27393),2175.0,1413.75,0.01,2175.0,84
HCPCS,27599,PERCUTANEOUS ULTRASOUND GUIDED TENOTOMY OF LEFT KNEE (COMP TO 24,1795.0,1166.75,0.01,1795.0,84
HCPCS,27599,"POLYETHYLENE EXCHANGE- KNEE, ONE COMP",7322.0,4759.3,0.01,7322.0,84
HCPCS,27599,REMOVAL PATELLAR SPUR W/QUAD REPAIR,2767.0,1798.55,0.01,2767.0,84
HCPCS,27599,REPAIR MEDIAL RETINACULUM,1779.0,1156.35,0.01,1779.0,84
HCPCS,27599,STAGE 1 OSSEOINTEGRATION (COMP CODE 27495),7112.0,4622.8,0.01,7112.0,84
HCPCS,27599,"UNLISTED PROCEDURE, FEMUR OR KNEE COMPARED TO CPT 27365",8356.0,5431.4,0.01,8356.0,84
HCPCS,27599,"UNLSD PROC,FEMUR/KNEE EXP",3211.0,2087.15,0.01,3211.0,84
HCPCS,27600,DCMPRN FASCT LEG ANT&/LAT COMPARTMENTS ONLY,14925.0,9701.25,0.01,14925.0,87
HCPCS,27600,DECOMPRESS ANT/LAT LEG CMPART,2412.0,1567.8,1.1,9440.12,144
HCPCS,27601,DECOMPRESS POST LEG COMPARTMT,2420.0,1573.0,1.1,9440.12,144
HCPCS,27601,DECOMPRESSION OF LOWER LEG,,,2808.13,3405.12,20
HCPCS,27601,Decompression of lower leg,,,2483.09,2875.16,8
HCPCS,27602,DECOMPRESS ANT/LAT+POST LEG CMPART,3128.0,2033.2,1.1,9440.12,144
HCPCS,27602,DECOMPRESSION OF LOWER LEG,,,2808.13,3405.12,20
HCPCS,27602,Decompression of lower leg,,,2483.09,2875.16,8
HCPCS,27603,DRAIN LOWER LEG LESION,,,2465.15,3022.89,20
HCPCS,27603,Drain lower leg lesion,,,1351.24,1564.6,8
HCPCS,27603,INCISION & DRAINAGE LEG/ANKLE ABSCESS/HEMATOMA,2092.0,1359.8,1.1,8286.13,148
HCPCS,27604,DRAIN LOWER LEG BURSA,,,2808.13,3405.12,20
HCPCS,27604,Drain lower leg bursa,,,2483.09,2875.16,8
HCPCS,27604,INCISION & DRAINAGE LEG/ANKLE INFECTED BURSA,1836.0,1193.4,1.1,9440.12,148
HCPCS,27605,TENOTOMY PRQ ACHILLES TENDON SPX LOCAL ANES,4265.0,2772.25,0.01,7362.0,235
HCPCS,27606,INCISION OF ACHILLES TENDON,,,2351.0,4392.0,22
HCPCS,27606,Incision of achilles tendon,,,2483.09,2875.16,8
HCPCS,27606,TENOTOMY PRQ ACHILLES TENDON SPX GENERAL ANES,1672.0,1086.8,1.1,9440.12,144
HCPCS,27607,INCISION LEG/ANKLE,3448.0,2241.2,1.1,9440.12,144
HCPCS,27607,TREAT LOWER LEG BONE LESION,,,2808.13,3405.12,20
HCPCS,27607,Treat lower leg bone lesion,,,2483.09,2875.16,8
HCPCS,27610,ARTHROTOMY ANKLE W/EXPL DRAINAGE/REMOVAL FB,3652.0,2373.8,1.1,9440.12,144
HCPCS,27610,EXPLORE/TREAT ANKLE JOINT,,,2808.13,3405.12,20
HCPCS,27610,Explore/treat ankle joint,,,2483.09,2875.16,8
HCPCS,27612,ARTHRT PST CAPSUL RLS ANKLE W/WO ACHLL TDN LNGTH,3260.0,2119.0,1.1,9440.12,144
HCPCS,27612,EXPLORATION OF ANKLE JOINT,,,2808.13,7813.0,22
HCPCS,27612,Exploration of ankle joint,,,2483.09,2875.16,8
HCPCS,27613,BIOPSY SOFT TISSUE LEG/ANKLE AREA SUPERFICIAL,4170.5,2710.825,0.01,7453.0,235
HCPCS,27614,BIOPSY SOFT TISSUE LEG/ANKLE AREA DEEP,7742.5,5032.625,0.01,13165.0,235
HCPCS,27615,RAD RESECTION TUMOR SOFT TISSUE LEG/ANKLE <5CM,6288.0,4087.2,1.1,8286.13,144
HCPCS,27615,RESECT LEG/ANKLE TUM < 5 CM,,,2465.15,3022.89,20
HCPCS,27615,Resect leg/ankle tum < 5 cm,,,1351.24,1564.6,8
HCPCS,27616,RAD RESCJ TUM SOFT TISSUE LEG/ANKLE 5+CM,7852.0,5103.8,1.1,8286.13,144
HCPCS,27616,RESECT LEG/ANKLE TUM 5 CM/>,,,2465.15,3022.89,20
HCPCS,27616,Resect leg/ankle tum 5 cm/>,,,1351.24,1564.6,8
HCPCS,27618,EXC TUMOR SOFT TISSUE LEG/ANKLE SUBQ <3CM,4518.5,2937.0249999999996,0.01,7453.0,235
HCPCS,27619,EXC TUMOR SOFT TISSUE LEG/ANKLE SUBFASCIAL <5CM,7964.5,5176.925,0.01,13165.0,231
HCPCS,27620,ARTHRT ANKLE W/EXPL W/WO BX W/WO RMVL LOOSE/FB,2460.0,1599.0,1.1,9440.12,144
HCPCS,27620,EXPLORE/TREAT ANKLE JOINT,,,2808.13,3405.12,20
HCPCS,27620,Explore/treat ankle joint,,,2483.09,2875.16,8
HCPCS,27625,ARTHROTOMY W/SYNOVECTOMY ANKLE,3396.0,2207.4,1.1,9440.12,144
HCPCS,27625,REMOVE ANKLE JOINT LINING,,,2808.13,3405.12,20
HCPCS,27625,Remove ankle joint lining,,,2483.09,2875.16,8
HCPCS,27626,ARTHROTOMY W/SYNOVECTOMY ANKLE TENOSYNOVECTOMY,3640.0,2366.0,1.1,9440.12,144
HCPCS,27626,REMOVE ANKLE JOINT LINING,,,2808.13,7778.0,21
HCPCS,27626,Remove ankle joint lining,,,2483.09,2875.16,8
HCPCS,27630,EXCISION LESION TENDON SHEATH/CAPSULE LEG&/ANK,1976.0,1284.4,1.1,9440.12,148
HCPCS,27630,REMOVAL OF TENDON LESION,,,2808.13,7624.0,21
HCPCS,27630,Removal of tendon lesion,,,2483.09,2875.16,8
HCPCS,27632,EXCISION TUMOR SOFT TISSUE LEG/ANKLE SUBQ 3 CM/>,13165.0,8557.25,0.01,13165.0,87
HCPCS,27632,EXCISION TUMOR SOFT TISSUE LEG/ANKLE SUBQ 3+CM,2364.0,1536.6,1.1,8286.13,144
HCPCS,27634,EXC LEG/ANKLE TUM DEP 5 CM/>,,,2465.15,3022.89,20
HCPCS,27634,EXC TUMOR SOFT TISSUE LEG/ANKLE SUBFASC 5+CM,4052.0,2633.8,1.1,8286.13,144
HCPCS,27634,Exc leg/ankle tum dep 5 cm/>,,,2483.09,2875.16,8
HCPCS,27635,EXCISION/CURETTAGE BONE CYST/TUMOR TIBIA/FIBULA,3212.0,2087.8,1.1,9440.12,144
HCPCS,27635,REMOVE LOWER LEG BONE LESION,,,2808.13,7778.0,23
HCPCS,27635,Remove lower leg bone lesion,,,2483.09,2875.16,8
HCPCS,27637,EXC/CURETTAGE CYST/TUMOR TIBIA/FIBULA W/AGRAFT,4124.0,2680.6,1.1,20863.78,144
HCPCS,27637,REMOVE/GRAFT LEG BONE LESION,,,6206.54,7551.43,20
HCPCS,27637,Remove/graft leg bone lesion,,,5335.2,6177.6,8
HCPCS,27638,EXC/CURETTAGE CYST/TUMOR TIBIA/FIBULA W/ALGRAFT,4396.0,2857.4,1.1,20863.78,144
HCPCS,27638,REMOVE/GRAFT LEG BONE LESION,,,6206.54,7551.43,20
HCPCS,27638,Remove/graft leg bone lesion,,,5335.2,6177.6,8
HCPCS,27640,PARTIAL EXCISION BONE TIBIA,4896.0,3182.4,1.1,9440.12,144
HCPCS,27640,PARTIAL REMOVAL OF TIBIA,,,2808.13,3405.12,20
HCPCS,27640,Partial removal of tibia,,,5335.2,6177.6,8
HCPCS,27641,PARTIAL EXCISION BONE FIBULA,3936.0,2558.4,1.1,9440.12,144
HCPCS,27641,PARTIAL REMOVAL OF FIBULA,,,2808.13,3405.12,20
HCPCS,27641,Partial removal of fibula,,,2483.09,2875.16,8
HCPCS,27645,"RAD RESEC TUMOR,TIBIA",10884.0,7074.6,1.1,10884.0,144
HCPCS,27645,RESECT TIBIA TUMOR,,,3095.56,3405.12,12
HCPCS,27645,Resect tibia tumor,,,5335.2,6177.6,8
HCPCS,27646,"RAD RESEC TUMOR,FIBULA",9284.0,6034.6,1.1,9284.0,144
HCPCS,27646,RESECT FIBULA TUMOR,,,3095.56,3405.12,12
HCPCS,27646,Resect fibula tumor,,,5335.2,6177.6,8
HCPCS,27647,RADICAL RESECTION OF TUMOR TALUS OR CALCANEUS,8104.0,5267.6,1.1,9440.12,144
HCPCS,27647,RESECT TALUS/CALCANEUS TUM,,,2808.13,3405.12,20
HCPCS,27647,Resect talus/calcaneus tum,,,5335.2,6177.6,8
HCPCS,27648,INJECTION ANKLE ARTHROGRAPHY,517.5,336.375,1.1,4628.0,216
HCPCS,27650,REPAIR ACHILLES TENDON,,,6206.54,7813.0,22
HCPCS,27650,REPAIR PRIMARY OPEN/PRQ RUPTURED ACHILLES TENDON,3684.0,2394.6,1.1,20863.78,144
HCPCS,27650,Repair achilles tendon,,,2483.09,2875.16,8
HCPCS,27652,REPAIR/GRAFT ACHILLES TENDON,,,6206.54,7551.43,20
HCPCS,27652,RPR PRIMARY OPEN/PRQ RUPTURED ACHILLES W/GRAFT,4312.0,2802.8,1.1,20863.78,144
HCPCS,27652,Repair/graft achilles tendon,,,5335.2,6177.6,8
HCPCS,27654,REPAIR OF ACHILLES TENDON,,,6206.54,11170.0,23
HCPCS,27654,REPAIR SECONDARY ACHILLES TENDON W/WO GRAFT,4212.0,2737.8,1.1,20863.78,144
HCPCS,27654,Repair of achilles tendon,,,5335.2,6177.6,8
HCPCS,27656,REPAIR FASCIAL DEFECT LEG,1884.0,1224.6,1.1,9440.12,148
HCPCS,27656,REPAIR LEG FASCIA DEFECT,,,2808.13,3405.12,20
HCPCS,27656,Repair leg fascia defect,,,3067.73,3552.11,8
HCPCS,27658,REPAIR FLEXOR TENDON LEG PRIMARY W/O GRAFT EACH,2048.0,1331.2,1.1,9440.12,144
HCPCS,27658,REPAIR OF LEG TENDON EACH,,,2808.13,7624.0,21
HCPCS,27658,Repair of leg tendon each,,,2483.09,2875.16,8
HCPCS,27659,REPAIR OF LEG TENDON EACH,,,6206.54,7551.43,20
HCPCS,27659,RPR FLEXOR TENDON LEG SECONDARY W/O GRAFT EACH,2840.0,1846.0,1.1,20863.78,144
HCPCS,27659,Repair of leg tendon each,,,5335.2,6177.6,8
HCPCS,27664,REPAIR OF LEG TENDON EACH,,,6206.54,7551.43,20
HCPCS,27664,RPR EXTENSOR TENDON LEG PRIMARY W/O GRAFT EACH,1892.0,1229.8,1.1,20863.78,144
HCPCS,27664,Repair of leg tendon each,,,2483.09,2875.16,8
HCPCS,27665,REPAIR OF LEG TENDON EACH,,,6206.54,7551.43,20
HCPCS,27665,RPR EXTENSOR TENDON LEG SECONDRY W/WO GRAFT EACH,2228.0,1448.2,1.1,20863.78,144
HCPCS,27665,Repair of leg tendon each,,,5335.2,6177.6,8
HCPCS,27675,REPAIR LOWER LEG TENDONS,,,2808.13,7624.0,21
HCPCS,27675,RPR DISLOC PERONEAL TENDON W/O FIBULAR OSTEOTOMY,2940.0,1911.0,1.1,9440.12,144
HCPCS,27675,Repair lower leg tendons,,,2483.09,2875.16,8
HCPCS,27676,REPAIR DISLOCATING PERONEAL TENDON W/FIB OSTEOT,3492.0,2269.8,1.1,20863.78,144
HCPCS,27676,REPAIR LOWER LEG TENDONS,,,6206.54,7551.43,20
HCPCS,27676,Repair lower leg tendons,,,5335.2,6177.6,8
HCPCS,27680,RELEASE OF LOWER LEG TENDON,,,2808.13,3405.12,20
HCPCS,27680,Release of lower leg tendon,,,2483.09,2875.16,8
HCPCS,27680,TENOLYSIS FLXR/XTNSR TENDON LEG&/ANKLE 1 EACH,2352.0,1528.8,1.1,9440.12,144
HCPCS,27681,RELEASE OF LOWER LEG TENDONS,,,2808.13,3405.12,20
HCPCS,27681,Release of lower leg tendons,,,2483.09,2875.16,8
HCPCS,27681,TNOLS FLXR/XTNSR TDN LEG&/ANKLE MLT TDN,2820.0,1833.0,1.1,9440.12,144
HCPCS,27685,"LENGTH/SHORT LEG/ANKL TENDON,SINGLE",2676.0,1739.4,1.1,9440.12,148
HCPCS,27685,REVISION OF LOWER LEG TENDON,,,2808.13,7813.0,23
HCPCS,27685,Revision of lower leg tendon,,,2483.09,2875.16,8
HCPCS,27686,"LENGTH/SHORT LEG/ANKL TENDON,MULTI",3100.0,2015.0,1.1,9440.12,144
HCPCS,27686,REVISE LOWER LEG TENDONS,,,2808.13,3405.12,20
HCPCS,27686,Revise lower leg tendons,,,2483.09,2875.16,8
HCPCS,27687,GASTROCNEMIUS RECESSION,2564.0,1666.6,1.1,9440.12,144
HCPCS,27687,REVISION OF CALF TENDON,,,2808.13,7813.0,22
HCPCS,27687,Revision of calf tendon,,,2483.09,2875.16,8
HCPCS,27690,REVISE LOWER LEG TENDON,,,6206.54,11170.0,23
HCPCS,27690,Revise lower leg tendon,,,5335.2,6177.6,8
HCPCS,27690,TR/TRNSPL 1 TDN W/MUSC REDIRION/REROUTING SUPFC,3668.0,2384.2,1.1,20863.78,144
HCPCS,27691,REVISE LOWER LEG TENDON,,,6206.54,11170.0,23
HCPCS,27691,Revise lower leg tendon,,,5335.2,6177.6,8
HCPCS,27691,TR/TRNSPL 1 TDN W/MUSC REDIRION/REROUTING DP,4196.0,2727.4,1.1,20863.78,144
HCPCS,27692,Revise additional leg tendon,,,5335.2,6177.6,8
HCPCS,27692,TR/TRNSPL 1 TDN W/MUSC REDIRION/REROUTING EA TDN,748.0,486.2,1.1,748.0,144
HCPCS,27695,REPAIR OF ANKLE LIGAMENT,,,5265.0,11170.0,22
HCPCS,27695,RPR PRIMARY DISRUPTED LIGAMENT ANKLE COLLATERAL,2680.0,1742.0,1.1,20863.78,144
HCPCS,27695,Repair of ankle ligament,,,5335.2,6177.6,8
HCPCS,27696,REPAIR OF ANKLE LIGAMENTS,,,6206.54,7778.0,21
HCPCS,27696,RPR PRIM DISRUPTED LIGM ANKLE BTH COLTRL LIGMS,3432.0,2230.8,1.1,20863.78,144
HCPCS,27696,Repair of ankle ligaments,,,5335.2,6177.6,8
HCPCS,27698,REPAIR OF ANKLE LIGAMENT,,,3528.0,11170.0,23
HCPCS,27698,REPAIR SECONDARY DISRUPTED LIGAMENT ANKLE COLTRL,3844.0,2498.6,1.1,20863.78,144
HCPCS,27698,Repair of ankle ligament,,,5335.2,6177.6,8
HCPCS,27700,ARTHROPLASTY ANKLE JOINT,3864.0,2511.6,1.1,20863.78,144
HCPCS,27700,REVISION OF ANKLE JOINT,,,6206.54,7551.43,20
HCPCS,27700,Revision of ankle joint,,,2382.18,2758.32,8
HCPCS,27702,ARTHROPLASTY ANKLE W/IMPLANT,5768.0,3749.2,1.1,54351.12,144
HCPCS,27702,RECONSTRUCT ANKLE JOINT,,,16167.8,28237.96,20
HCPCS,27702,Reconstruct ankle joint,,,7882.2,9126.76,8
HCPCS,27703,ARTHROPLASTY ANKLE REVISION TOTAL ANKLE,6776.0,4404.4,1.1,6776.0,144
HCPCS,27703,RECONSTRUCTION ANKLE JOINT,,,16588.34,18247.18,12
HCPCS,27703,Reconstruction ankle joint,,,7882.2,9126.76,8
HCPCS,27704,REMOVAL OF ANKLE IMPLANT,3124.0,2030.6,1.1,9440.12,164
HCPCS,27704,Removal of ankle implant,,,2483.09,2875.16,8
HCPCS,27705,OSTEOTOMY TIBIA,4344.0,2823.6,1.1,20863.78,164
HCPCS,27705,Osteotomy tibia,,,5335.2,6177.6,8
HCPCS,27707,OSTEOTOMY FIBULA,1912.0,1242.8,1.1,9440.12,164
HCPCS,27707,Osteotomy fibula,,,5335.2,6177.6,8
HCPCS,27709,OSTEOTOMY TIBIA & FIBULA,6992.0,4544.8,1.1,38384.94,164
HCPCS,27709,Osteotomy tibia & fibula,,,5335.2,6177.6,8
HCPCS,27712,OSTEOT MLT RELIGNMT IMED ROD,,,12146.38,13361.02,12
HCPCS,27712,OSTEOT MLT W/RELIGNMT IMED ROD,6348.0,4126.2,1.1,6348.0,144
HCPCS,27712,Osteot mlt relignmt imed rod,,,5335.2,6177.6,8
HCPCS,27713,OSTEOT TIBIA IMED LNGTH DEV,,,6864.94,7551.43,12
HCPCS,27713,OSTEOT TIBIA UNI INSJ XTRNL CTRLD IMED LNGTH DEV,12320.0,8008.0,1.1,12320.0,106
HCPCS,27713,Osteot tibia imed lngth dev,,,5335.2,6177.6,8
HCPCS,27715,OSTEOPLASTY TIBIA & FIBULA LENGTHENING/SHORTENIN,6200.0,4030.0,1.1,6200.0,144
HCPCS,27715,OSTPL TIBFIB LNGTH/SHRT,,,12146.38,13361.02,12
HCPCS,27715,Ostpl tibfib lngth/shrt,,,5335.2,6177.6,8
HCPCS,27720,REPAIR NONUNION/MALUNION TIBIA W/O GRAFT,4944.0,3213.6,1.1,20863.78,144
HCPCS,27720,REPAIR OF TIBIA,,,6206.54,7551.43,20
HCPCS,27720,Repair of tibia,,,3603.21,4172.14,8
HCPCS,27722,REPAIR/GRAFT OF TIBIA,,,6206.54,7551.43,20
HCPCS,27722,Repair/graft of tibia,,,3603.21,4172.14,8
HCPCS,27724,REPAIR/GRAFT OF TIBIA,,,6864.94,7551.43,12
HCPCS,27724,RPR NON/MAL TIBIA W/ILIAC/OTH AGRFT,7724.0,5020.6,1.1,7724.0,144
HCPCS,27724,Repair/graft of tibia,,,3603.21,4172.14,8
HCPCS,27725,REPAIR OF LOWER LEG,,,6864.94,7551.43,12
HCPCS,27725,RPR NON/MAL TIBIA SYNOSTOSIS W/FIBULA ANY METH,6964.0,4526.6,1.1,6964.0,144
HCPCS,27725,Repair of lower leg,,,5335.2,6177.6,8
HCPCS,27726,REPAIR FIBULA NONUNION,,,6206.54,7551.43,20
HCPCS,27726,REPAIR FIBULA NONUNION/MALUNION W/INT FIXATION,5736.0,3728.4,1.1,20863.78,144
HCPCS,27726,Repair fibula nonunion,,,3603.21,4172.14,8
HCPCS,27727,REPAIR CONGEN PSEUDOARTHROSIS TIBIA,5936.0,3858.4,1.1,5936.0,144
HCPCS,27727,REPAIR OF LOWER LEG,,,3095.56,3405.12,12
HCPCS,27727,Repair of lower leg,,,5335.2,6177.6,8
HCPCS,27730,ARREST EPIPHYSEAL OPEN DISTAL TIBIA,3080.0,2002.0,1.1,9440.12,144
HCPCS,27730,REPAIR OF TIBIA EPIPHYSIS,,,2808.13,3405.12,20
HCPCS,27730,Repair of tibia epiphysis,,,2483.09,2875.16,8
HCPCS,27732,ARREST EPIPHYSEAL OPEN DISTAL FIBULA,2184.0,1419.6,1.1,9440.12,144
HCPCS,27732,REPAIR OF FIBULA EPIPHYSIS,,,2808.13,3405.12,20
HCPCS,27732,Repair of fibula epiphysis,,,2483.09,2875.16,8
HCPCS,27734,ARREST EPIPHYSEAL OPEN DISTAL TIBIA&FIBULA,3532.0,2295.8,1.1,9440.12,144
HCPCS,27734,REPAIR LOWER LEG EPIPHYSES,,,2808.13,3405.12,20
HCPCS,27734,Repair lower leg epiphyses,,,2483.09,2875.16,8
HCPCS,27740,ARREST EPIPHYSEAL ANY METHOD TIBIA & FIBULA,3844.0,2498.6,1.1,9440.12,144
HCPCS,27740,REPAIR OF LEG EPIPHYSES,,,2808.13,3405.12,20
HCPCS,27740,Repair of leg epiphyses,,,2483.09,2875.16,8
HCPCS,27742,ARRST EPIPHYSL ANY METH TIBFIB&DSTL FEMUR,4252.0,2763.8,1.1,9440.12,144
HCPCS,27742,REPAIR OF LEG EPIPHYSES,,,2808.13,8702.0,22
HCPCS,27742,Repair of leg epiphyses,,,2483.09,2875.16,8
HCPCS,27745,PROPH TX N/P/PLTWR W/WO METHYLMETHACRYLATE TIBIA,4196.0,2727.4,1.1,20863.78,144
HCPCS,27745,REINFORCE TIBIA,,,6206.54,7551.43,20
HCPCS,27745,Reinforce tibia,,,5335.2,6177.6,8
HCPCS,27750,CLTX TIBIAL SHAFT FX W/O MANIPULATION,1225.5,796.575,0.01,4392.0,409
HCPCS,27752,CLTX TIBIAL SHAFT FX W/MANJ W/WO SKEL TRACJ,4935.0,3207.75,0.01,7362.0,322
HCPCS,27756,PRQ SKELETAL FIXATION TIBIAL SHAFT FRACTURE,2980.0,1937.0,1.1,20863.78,144
HCPCS,27756,TREATMENT OF TIBIA FRACTURE,,,6206.54,7551.43,20
HCPCS,27756,Treatment of tibia fracture,,,3603.21,4172.14,8
HCPCS,27758,OPTX TIBIAL SHFT FX W/PLATE/SCREWS W/WO CERCLAGE,5016.0,3260.4,1.1,38384.94,144
HCPCS,27758,TREATMENT OF TIBIA FRACTURE,,,11418.01,13361.02,20
HCPCS,27758,Treatment of tibia fracture,,,3603.21,4172.14,8
HCPCS,27759,TREATMENT OF TIBIA FRACTURE,,,11418.01,13361.02,20
HCPCS,27759,TX TIBL SHFT FX IMED IMPLT W/WO SCREWS&/CERCLA,5780.0,3757.0,1.1,38384.94,144
HCPCS,27759,Treatment of tibia fracture,,,3603.21,4172.14,8
HCPCS,27760,CLTX MEDIAL MALLEOLUS FX W/O MANIPULATION,1193.5,775.7750000000001,0.01,4392.0,409
HCPCS,27762,CLTX MEDIAL MALLS FX W/MANJ W/WO SKN/SKEL TRACJ,4775.0,3103.75,0.01,7362.0,322
HCPCS,27766,OPEN TREATMENT MEDIAL MALLEOLUS FRACTURE,3156.0,2051.4,1.1,20863.78,144
HCPCS,27766,OPTX MEDIAL ANKLE FX,,,5597.0,11170.0,22
HCPCS,27766,Optx medial ankle fx,,,3603.21,4172.14,8
HCPCS,27767,CLOSED TREATMENT PST MALLEOLUS FRACTURE W/O MANJ,1079.5,701.675,0.01,4392.0,322
HCPCS,27768,CLOSED TREATMENT PST MALLEOLUS FRACTURE W/MANJ,4709.0,3060.8500000000004,0.01,7362.0,318
HCPCS,27769,OPEN TREATMENT POSTERIOR MALLEOLUS FRACTURE,4056.0,2636.4,1.1,20863.78,144
HCPCS,27769,OPTX POST ANKLE FX,,,6206.54,7551.43,20
HCPCS,27769,Optx post ankle fx,,,3603.21,4172.14,8
HCPCS,27780,CLTX PROX FIBULA/SHFT FX W/O MANJ,1117.5,726.375,0.01,4392.0,409
HCPCS,27781,CLTX PROX FIBULA/SHFT FX W/MANJ,4599.0,2989.3500000000004,1.1,7362.0,235
HCPCS,27784,OPEN TREATMENT PROXIMAL FIBULA/SHAFT FRACTURE,3868.0,2514.2,1.1,20863.78,144
HCPCS,27784,TREATMENT OF FIBULA FRACTURE,,,6206.54,9457.0,21
HCPCS,27784,Treatment of fibula fracture,,,3603.21,4172.14,8
HCPCS,27786,CLTX DSTL FIBULAR FX LAT MALLS W/O MANJ,1155.5,751.075,0.01,4392.0,409
HCPCS,27788,CLTX DSTL FIBULAR FX LAT MALLS W/MANJ,1479.5,961.6750000000001,0.01,4392.0,322
HCPCS,27792,OPEN TX DISTAL FIBULAR FRACTURE LAT MALLEOLUS,3500.0,2275.0,1.1,20863.78,144
HCPCS,27792,TREATMENT OF ANKLE FRACTURE,,,5597.0,11170.0,24
HCPCS,27792,Treatment of ankle fracture,,,3603.21,4172.14,8
HCPCS,27808,CLOSED TX BIMALLEOLAR ANKLE FRACTURE W/O MANJ,1157.5,752.375,0.01,4392.0,409
HCPCS,27810,CLOSED TX BIMALLEOLAR ANKLE FRACTURE W/MANJ,4745.0,3084.25,0.01,7362.0,322
HCPCS,27814,OPEN TREATMENT BIMALLEOLAR ANKLE FRACTURE,4248.0,2761.2,1.1,20863.78,144
HCPCS,27814,TREATMENT OF ANKLE FRACTURE,,,6206.54,11170.0,21
HCPCS,27814,Treatment of ankle fracture,,,3603.21,4172.14,8
HCPCS,27816,CLTX TRIMALLEOLAR ANKLE FX W/O MANIPULATION,1227.0,797.55,0.01,4392.0,322
HCPCS,27818,CLTX TRIMALLEOLAR ANKLE FX W/MANIPULATION,4933.0,3206.45,0.01,7362.0,409
HCPCS,27822,OPEN TX TRIMALLEOLAR ANKLE FX W/O FIXJ PST LIP,4484.0,2914.6,1.1,20863.78,144
HCPCS,27822,TREATMENT OF ANKLE FRACTURE,,,6206.54,7813.0,21
HCPCS,27822,Treatment of ankle fracture,,,3603.21,4172.14,8
HCPCS,27823,OPEN TX TRIMALLEOLAR ANKLE FX W/FIXJ PST LIP,5264.0,3421.6,1.1,20863.78,144
HCPCS,27823,TREATMENT OF ANKLE FRACTURE,,,6206.54,7551.43,20
HCPCS,27823,Treatment of ankle fracture,,,3603.21,4172.14,8
HCPCS,27824,CLTX FX W8 BRG ARTCLR PRTN DSTL TIBIA W/O MANJ,1213.5,788.7750000000001,0.01,4392.0,409
HCPCS,27825,CLTX FX W8 BRG ARTCLR PRTN DSTL TIB W/SKEL TRACJ,5019.0,3262.3500000000004,1.1,7362.0,235
HCPCS,27826,OPEN TREATMENT FRACTURE DISTAL TIBIA FIBULA,4440.0,2886.0,1.1,20863.78,144
HCPCS,27826,TREAT LOWER LEG FRACTURE,,,6206.54,7551.43,20
HCPCS,27826,Treat lower leg fracture,,,3603.21,4172.14,8
HCPCS,27827,OPEN TREATMENT FRACTURE DISTAL TIBIA ONLY,5916.0,3845.4,1.1,38384.94,144
HCPCS,27827,TREAT LOWER LEG FRACTURE,,,11418.01,13361.02,20
HCPCS,27827,Treat lower leg fracture,,,3603.21,4172.14,8
HCPCS,27828,OPEN TREATMENT FRACTURE DISTAL TIBIA & FIBULA,7372.0,4791.8,1.1,38384.94,144
HCPCS,27828,TREAT LOWER LEG FRACTURE,,,11418.01,13361.02,20
HCPCS,27828,Treat lower leg fracture,,,3603.21,4172.14,8
HCPCS,27829,OPEN TX DISTAL TIBIOFIBULAR JOINT DISRUPTION,3520.0,2288.0,1.1,20863.78,144
HCPCS,27829,TREAT LOWER LEG JOINT,,,5265.0,7551.43,21
HCPCS,27829,Treat lower leg joint,,,3603.21,4172.14,8
HCPCS,27830,CLTX PROX TIBFIB JT DISLC W/O ANES,1343.5,873.275,1.1,4392.0,235
HCPCS,27831,TREAT LOWER LEG DISLOCATION,,,2808.13,3405.12,20
HCPCS,27831,Treat lower leg dislocation,,,295.11,341.7,8
HCPCS,27832,OPEN TX PROX TIBFIB JOINT DISLOCATE EXC PROX FIB,4475.0,2908.75,1.1,20863.78,144
HCPCS,27832,TREAT LOWER LEG DISLOCATION,,,6206.54,7551.43,20
HCPCS,27832,Treat lower leg dislocation,,,3603.21,4172.14,8
HCPCS,27840,CLOSED TX ANKLE DISLOCATION W/O ANESTHESIA,1505.5,978.575,0.01,4392.0,318
HCPCS,27842,CLTX ANKLE DISLC REQ ANES W/WO PRQ SKEL FIXJ,2584.0,1679.6,1.1,4686.39,144
HCPCS,27842,TREAT ANKLE DISLOCATION,,,1394.34,1673.41,20
HCPCS,27842,Treat ankle dislocation,,,824.67,954.88,8
HCPCS,27846,OPTX ANKLE DISLOCATION W/O REPAIR/INTERNAL FIXJ,4112.0,2672.8,1.1,20863.78,144
HCPCS,27846,TREAT ANKLE DISLOCATION,,,6206.54,7551.43,20
HCPCS,27846,Treat ankle dislocation,,,3603.21,4172.14,8
HCPCS,27848,OPTX ANKLE DISLOCATION W/REPAIR/INT/XTRNL FIXJ,4672.0,3036.8,1.1,20863.78,144
HCPCS,27848,TREAT ANKLE DISLOCATION,,,6206.54,7551.43,20
HCPCS,27848,Treat ankle dislocation,,,3603.21,4172.14,8
HCPCS,27860,FIXATION OF ANKLE JOINT,,,2808.13,3405.12,20
HCPCS,27860,Fixation of ankle joint,,,824.67,954.88,8
HCPCS,27860,MANIPULATION ANKLE UNDER GENERAL ANESTHESIA,956.0,621.4,1.1,9440.12,144
HCPCS,27870,ARTHRODESIS ANKLE OPEN,6164.0,4006.6,1.1,38384.94,144
HCPCS,27870,FUSION OF ANKLE JOINT OPEN,,,11418.01,13361.02,20
HCPCS,27870,Fusion of ankle joint open,,,5335.2,6177.6,8
HCPCS,27871,ARTHRODESIS TIBIOFIBULAR JOINT PROXIMAL/DISTAL,3816.0,2480.4,1.1,38384.94,144
HCPCS,27871,FUSION OF TIBIOFIBULAR JOINT,,,11418.01,13361.02,20
HCPCS,27871,Fusion of tibiofibular joint,,,5335.2,6177.6,8
HCPCS,27880,AMPUTATION LOW LEG THRU TIB/FIB,6148.0,3996.2,1.1,6148.0,144
HCPCS,27880,AMPUTATION OF LOWER LEG,,,2356.54,7551.43,13
HCPCS,27880,Amputation of lower leg,,,5335.2,6177.6,8
HCPCS,27881,AMP LEG THRU TIBFIB W/IMMT FITG TQ W/1ST CST,5388.0,3502.2,1.1,5388.0,144
HCPCS,27881,AMPUTATION OF LOWER LEG,,,2202.11,3405.12,13
HCPCS,27881,Amputation of lower leg,,,5335.2,6177.6,8
HCPCS,27882,AMPUTATION LEG THRU TIBIA&FIBULA OPEN CIRCULAR,3916.0,2545.4,1.1,3916.0,144
HCPCS,27882,AMPUTATION OF LOWER LEG,,,1549.99,3405.12,13
HCPCS,27882,Amputation of lower leg,,,5335.2,6177.6,8
HCPCS,27884,AMP LEG THRU TIBIA&FIBULA SEC CLOSURE/SCAR REV,3504.0,2277.6,1.1,9440.12,144
HCPCS,27884,AMPUTATION FOLLOW-UP SURGERY,,,2808.13,3405.12,20
HCPCS,27884,Amputation follow-up surgery,,,2483.09,2875.16,8
HCPCS,27886,AMP LEG THRU TIBIA&FIBULA RE-AMPUTATION,4008.0,2605.2,1.1,4008.0,144
HCPCS,27886,AMPUTATION FOLLOW-UP SURGERY,,,1696.88,3405.12,13
HCPCS,27886,Amputation follow-up surgery,,,2483.09,2875.16,8
HCPCS,27888,AMP ANKLE-MALLI TIBFIB W/PLSTC CLSR&RESCJ NRV,4148.0,2696.2,1.1,4148.0,144
HCPCS,27888,AMPUTATION OF FOOT AT ANKLE,,,1510.34,3405.12,13
HCPCS,27888,Amputation of foot at ankle,,,5335.2,6177.6,8
HCPCS,27889,ANKLE DISARTICULATION,4344.0,2823.6,1.1,20863.78,164
HCPCS,27889,Ankle disarticulation,,,5335.2,6177.6,8
HCPCS,27892,DCMPRN FASCT LEG ANT&/LAT W/DBRDMT MUSC&/NERVE,3176.0,2064.4,1.1,9440.12,144
HCPCS,27892,DECOMPRESSION OF LEG,,,2808.13,3405.12,20
HCPCS,27892,Decompression of leg,,,3067.73,3552.11,8
HCPCS,27893,DCMPRN FASCT LEG PST W/DBRDMT MUSC&/NRV,3160.0,2054.0,1.1,20863.78,144
HCPCS,27893,DECOMPRESSION OF LEG,,,6206.54,7551.43,20
HCPCS,27893,Decompression of leg,,,3067.73,3552.11,8
HCPCS,27894,DCMPRN FASCT LEG ANT&/LAT&PST W/DBRDMT MUS,5068.0,3294.2,1.1,9440.12,144
HCPCS,27894,DECOMPRESSION OF LEG,,,2808.13,3405.12,20
HCPCS,27894,Decompression of leg,,,3067.73,3552.11,8
HCPCS,27899,ASPIRATION OF INTRAMUSCULAR HEMATOMA (COMP CODE 10160),636.0,413.4,0.01,3443.0,169
HCPCS,27899,"EXCISION OF ACCESSORY SOLEUS MUSCLE, LEG OR ANKLE AREA (COMP COD",2972.0,1931.8,0.01,2972.0,84
HCPCS,27899,HYDRODISSECTION LEG (COMP CODE 20552),750.5,487.825,0.01,3443.0,169
HCPCS,27899,OPEN MICRO FRACTURE ANKLE,4787.0,3111.55,0.01,4787.0,84
HCPCS,27899,REPAIR/SUTURE MUSCLE LOWER LEG (COMP CODE 27658),1844.0,1198.6,0.01,1844.0,84
HCPCS,27899,TENODESIS; HAMSTRING TENDON TO TIBIA,2666.0,1732.9,0.01,2666.0,84
HCPCS,27899,UNLISTED PROCEDURE LEG OR ANKLE,400.0,260.0,111.2,3443.0,84
HCPCS,28001,DRAINAGE OF BURSA OF FOOT,,,1406.56,1718.79,20
HCPCS,28001,Drainage of bursa of foot,,,1754.89,2031.98,8
HCPCS,28001,INCIS/DRAINAGE BURSA OF FOOT,800.0,520.0,1.1,4729.25,148
HCPCS,28002,I&D BELOW FASCIA FOOT 1 BURSAL SPACE,1116.0,725.4,1.1,4686.39,148
HCPCS,28002,TREATMENT OF FOOT INFECTION,,,1394.34,1673.41,20
HCPCS,28002,Treatment of foot infection,,,1754.89,2031.98,8
HCPCS,28003,I&D BELOW FASCIA FOOT MULTIPLE AREAS,2112.0,1372.8,1.1,9440.12,148
HCPCS,28003,TREATMENT OF FOOT INFECTION,,,2808.13,3405.12,20
HCPCS,28003,Treatment of foot infection,,,1351.24,1564.6,8
HCPCS,28005,INCISION BONE CORTEX FOOT,3776.0,2454.4,1.1,9440.12,144
HCPCS,28005,TREAT FOOT BONE LESION,,,2808.13,3405.12,20
HCPCS,28005,Treat foot bone lesion,,,4090.38,4736.23,8
HCPCS,28008,FASCIOTOMY FOOT&/TOE,8380.5,5447.325,0.01,14925.0,235
HCPCS,28010,TENOTOMY PERCUTANEOUS TOE SINGLE TENDON,4275.0,2778.75,0.01,7362.0,235
HCPCS,28011,TENOTOMY PERCUTANEOUS TOE MULTIPLE TENDON,4537.0,2949.05,0.01,7813.0,235
HCPCS,28020,ARTHRT W/EXPL DRG/RMVL LOOSE/FB NTRTRSL/TARS JT,2060.0,1339.0,1.1,9440.12,148
HCPCS,28020,EXPLORATION OF FOOT JOINT,,,2808.13,3405.12,20
HCPCS,28020,Exploration of foot joint,,,1754.89,2031.98,8
HCPCS,28022,ARTHRT W/EXPL DRG/RMVL LOOSE/FB MTTARPHLNGL JT,1924.0,1250.6,1.1,9440.12,148
HCPCS,28022,EXPLORATION OF FOOT JOINT,,,2808.13,3405.12,20
HCPCS,28022,Exploration of foot joint,,,1754.89,2031.98,8
HCPCS,28024,ARTHRT W/EXPL DRG/RMVL LOOSE/FB IPHAL JT,1808.0,1175.2,1.1,4686.39,148
HCPCS,28024,EXPLORATION OF TOE JOINT,,,1394.34,1673.41,20
HCPCS,28024,Exploration of toe joint,,,1754.89,2031.98,8
HCPCS,28035,DECOMPRESSION OF TIBIA NERVE,,,1675.06,4315.0,21
HCPCS,28035,Decompression of tibia nerve,,,2483.09,2875.16,8
HCPCS,28035,RELEASE TARSAL TUNNEL,2092.0,1359.8,1.1,5632.24,148
HCPCS,28039,EXC FOOT/TOE TUM SC 1.5 CM/>,,,2465.15,7624.0,22
HCPCS,28039,EXCISION TUMOR SOFT TISSUE FOOT/TOE SUBQ 1.5+CM,2168.0,1409.2,1.1,8286.13,148
HCPCS,28039,Exc foot/toe tum sc 1.5 cm/>,,,1754.89,2031.98,8
HCPCS,28041,EXC FOOT/TOE TUM DEP 1.5CM/>,,,2465.15,3022.89,20
HCPCS,28041,EXC TUMOR SOFT TISSUE FOOT/TOE SUBFASC 1.5+CM,2852.0,1853.8,1.1,8286.13,144
HCPCS,28041,Exc foot/toe tum dep 1.5cm/>,,,1754.89,2031.98,8
HCPCS,28043,EXCISION TUMOR SOFT TISSUE FOOT/TOE SUBQ <1.5CM,4518.5,2937.0249999999996,0.01,7453.0,235
HCPCS,28045,EXC FOOT/TOE TUM DEEP <1.5CM,,,2465.15,7813.0,21
HCPCS,28045,EXC TUMOR SOFT TISSUE FOOT/TOE SUBFASC <1.5CM,2180.0,1417.0,1.1,8286.13,148
HCPCS,28045,Exc foot/toe tum deep <1.5cm,,,1754.89,2031.98,8
HCPCS,28046,RAD RESECTION TUMOR SOFT TISSUE FOOT/TOE <3CM,4952.0,3218.8,1.1,8286.13,144
HCPCS,28046,RESECT FOOT/TOE TUMOR < 3 CM,,,2465.15,3022.89,20
HCPCS,28046,Resect foot/toe tumor < 3 cm,,,4090.38,4736.23,8
HCPCS,28047,RAD RESECTION TUMOR SOFT TISSUE FOOT/TOE 3+CM,6980.0,4537.0,1.1,8286.13,144
HCPCS,28047,RESECT FOOT/TOE TUMOR 3 CM/>,,,2465.15,3022.89,20
HCPCS,28047,Resect foot/toe tumor 3 cm/>,,,4090.38,4736.23,8
HCPCS,28050,ARTHRT W/BX INTERTARSAL/TARSOMETATARSAL JOINT,1756.0,1141.4,1.1,9440.12,148
HCPCS,28050,BIOPSY OF FOOT JOINT LINING,,,2808.13,3405.12,20
HCPCS,28050,Biopsy of foot joint lining,,,1754.89,2031.98,8
HCPCS,28052,ARTHRTOMY W/BX METATARSOPHALANGEAL JOINT,1624.0,1055.6,1.1,9440.12,148
HCPCS,28052,BIOPSY OF FOOT JOINT LINING,,,2808.13,3405.12,20
HCPCS,28052,Biopsy of foot joint lining,,,1754.89,2031.98,8
HCPCS,28054,ARTHRTOMY W/BX INTERPHALANGEAL JOINT,1428.0,928.2,1.1,9440.12,148
HCPCS,28054,BIOPSY OF TOE JOINT LINING,,,2808.13,3405.12,20
HCPCS,28054,Biopsy of toe joint lining,,,1754.89,2031.98,8
HCPCS,28055,NEURECTOMY FOOT,,,1675.06,2032.17,20
HCPCS,28055,"NEURECTOMY, INTRINSIC MUSCULATURE FOOT",2516.0,1635.4,1.1,5632.24,144
HCPCS,28055,Neurectomy foot,,,4090.38,4736.23,8
HCPCS,28060,FASCIECTOMY PLANTAR FASCIA PARTIAL,14925.0,9701.25,432.13,14925.0,87
HCPCS,28060,FASCIECTOMY PLANTAR FASCIA PARTIAL SPX,8542.5,5552.625,0.01,14925.0,235
HCPCS,28062,FASCIECTOMY PLANTAR FASCIA RADICAL SPX,2676.0,1739.4,1.1,9440.12,148
HCPCS,28062,REMOVAL OF FOOT FASCIA,,,2808.13,3405.12,20
HCPCS,28062,Removal of foot fascia,,,1754.89,2031.98,8
HCPCS,28070,REMOVAL OF FOOT JOINT LINING,,,6206.54,7551.43,20
HCPCS,28070,Removal of foot joint lining,,,1754.89,2031.98,8
HCPCS,28070,SYNVCT INTERTARSAL/TARSOMETATARSAL JT EA SPX,2096.0,1362.4,1.1,20863.78,148
HCPCS,28072,REMOVAL OF FOOT JOINT LINING,,,2808.13,3405.12,20
HCPCS,28072,Removal of foot joint lining,,,1754.89,2031.98,8
HCPCS,28072,SYNOVECTOMY METATARSOPHALANGEAL JOINT EACH,1888.0,1227.2,1.1,9440.12,148
HCPCS,28080,EXCISION INTERDIGITAL MORTON NEUROMA SINGLE EACH,1944.0,1263.6,1.1,4686.39,148
HCPCS,28080,REMOVAL OF FOOT LESION,,,1394.34,7813.0,21
HCPCS,28080,Removal of foot lesion,,,1754.89,2031.98,8
HCPCS,28086,EXCISE FOOT TENDON SHEATH,,,2808.13,3405.12,20
HCPCS,28086,Excise foot tendon sheath,,,1754.89,2031.98,8
HCPCS,28086,"SYNOVECTOMY FLEX TENDN SHEATH,FOOT",1968.0,1279.2,1.1,9440.12,148
HCPCS,28088,EXCISE FOOT TENDON SHEATH,,,2808.13,3405.12,20
HCPCS,28088,Excise foot tendon sheath,,,1754.89,2031.98,8
HCPCS,28088,"SYNOVECTOMY EXTEN TENDN SHEATH,FOOT",1592.0,1034.8,1.1,9440.12,148
HCPCS,28090,EXC LESION TENDON SHEATH/CAPSULE W/SYNVCT FOOT,1820.0,1183.0,1.1,4686.39,148
HCPCS,28090,REMOVAL OF FOOT LESION,,,1394.34,4315.0,21
HCPCS,28090,Removal of foot lesion,,,1754.89,2031.98,8
HCPCS,28092,EXC LESION TENDON SHEATH/CAPSULE W/SYNVCT TOE EA,4437.0,2884.05,0.01,7813.0,235
HCPCS,28100,EXCISION/CURETTAGE CYST/TUMOR TALUS/CALCANEUS,2332.0,1515.8,1.1,9440.12,148
HCPCS,28100,REMOVAL OF ANKLE/HEEL LESION,,,2808.13,3405.12,20
HCPCS,28100,Removal of ankle/heel lesion,,,4090.38,4736.23,8
HCPCS,28102,EXC/CURTG CST/B9 TUM TALUS/CLCNS W/ILIAC/AGRFT,3168.0,2059.2,1.1,20863.78,144
HCPCS,28102,REMOVE/GRAFT FOOT LESION,,,6206.54,7551.43,20
HCPCS,28102,Remove/graft foot lesion,,,4090.38,4736.23,8
HCPCS,28103,EXC/CURETTAGE CYST/TUMOR TALUS/CALCANEUS ALGRFT,2668.0,1734.2,1.1,20863.78,144
HCPCS,28103,REMOVE/GRAFT FOOT LESION,,,6206.54,7551.43,20
HCPCS,28103,Remove/graft foot lesion,,,4090.38,4736.23,8
HCPCS,28104,EXC/CURTG BONE CYST/B9 TUMORTARSAL/METATARSAL,2104.0,1367.6,1.1,9440.12,148
HCPCS,28104,REMOVAL OF FOOT LESION,,,2808.13,3405.12,20
HCPCS,28104,Removal of foot lesion,,,1754.89,2031.98,8
HCPCS,28106,EXC/CURTG CST/B9 TUM TARSAL/METAR W/ILIAC/AGRFT,2940.0,1911.0,1.1,20863.78,144
HCPCS,28106,REMOVE/GRAFT FOOT LESION,,,6206.54,7551.43,20
HCPCS,28106,Remove/graft foot lesion,,,4090.38,4736.23,8
HCPCS,28107,EXC/CURTG CST/B9 TUM TARSAL/METAR W/ALGRFT,2292.0,1489.8,1.1,20863.78,148
HCPCS,28107,REMOVE/GRAFT FOOT LESION,,,6206.54,7551.43,20
HCPCS,28107,Remove/graft foot lesion,,,4090.38,4736.23,8
HCPCS,28108,EXC/CURTG CST/B9 TUM PHALANGES FOOT,1720.0,1118.0,1.1,4686.39,148
HCPCS,28108,REMOVAL OF TOE LESIONS,,,1394.34,5265.0,22
HCPCS,28108,Removal of toe lesions,,,1754.89,2031.98,8
HCPCS,28110,OSTECTOMY PRTL 5TH METAR HEAD SPX,1688.0,1097.2,1.1,9440.12,148
HCPCS,28110,PART REMOVAL OF METATARSAL,,,2808.13,7813.0,22
HCPCS,28110,Part removal of metatarsal,,,4090.38,4736.23,8
HCPCS,28111,OSTECTOMY COMPLETE 1ST METATARSAL HEAD,2060.0,1339.0,1.1,9440.12,148
HCPCS,28111,PART REMOVAL OF METATARSAL,,,2808.13,3405.12,20
HCPCS,28111,Part removal of metatarsal,,,1754.89,2031.98,8
HCPCS,28112,OSTECTOMY COMPLETE OTHER METATARSAL HEAD 2/3/4,1852.0,1203.8,1.1,9440.12,148
HCPCS,28112,PART REMOVAL OF METATARSAL,,,2808.13,3405.12,20
HCPCS,28112,Part removal of metatarsal,,,1754.89,2031.98,8
HCPCS,28113,OSTECTOMY COMPLETE 5TH METATARSAL HEAD,2444.0,1588.6,1.1,9440.12,148
HCPCS,28113,PART REMOVAL OF METATARSAL,,,2808.13,6238.0,21
HCPCS,28113,Part removal of metatarsal,,,1754.89,2031.98,8
HCPCS,28114,OSTC COMPL ALL METAR HEADS W/PRTL PROX PHALANGC,4800.0,3120.0,1.1,9440.12,148
HCPCS,28114,REMOVAL OF METATARSAL HEADS,,,2808.13,3405.12,20
HCPCS,28114,Removal of metatarsal heads,,,4090.38,4736.23,8
HCPCS,28116,OSTECTOMY TARSAL COALITION,3656.0,2376.4,1.1,9440.12,148
HCPCS,28116,REVISION OF FOOT,,,2808.13,7813.0,21
HCPCS,28116,Revision of foot,,,1754.89,2031.98,8
HCPCS,28118,OSTECTOMY CALCANEUS,2452.0,1593.8,1.1,9440.12,148
HCPCS,28118,REMOVAL OF HEEL BONE,,,2808.13,10789.0,22
HCPCS,28118,Removal of heel bone,,,1754.89,2031.98,8
HCPCS,28119,OSTECTOMY CALCANEUS SPUR W/WO PLNTAR FASCIAL RLS,2224.0,1445.6,1.1,9440.12,148
HCPCS,28119,REMOVAL OF HEEL SPUR,,,2808.13,7624.0,21
HCPCS,28119,Removal of heel spur,,,1754.89,2031.98,8
HCPCS,28120,PART REMOVAL OF ANKLE/HEEL,,,2808.13,25635.0,23
HCPCS,28120,PARTIAL EXCISION BONE TALUS/CALCANEUS,2924.0,1900.6,1.1,9440.12,148
HCPCS,28120,Part removal of ankle/heel,,,1754.89,2031.98,8
HCPCS,28122,PARTIAL REMOVAL OF FOOT BONE,,,2808.13,7813.0,23
HCPCS,28122,PRTL EXC B1 TARSAL/METAR B1 XCP TALUS/CALCANEUS,2704.0,1757.6,1.1,9440.12,148
HCPCS,28122,Partial removal of foot bone,,,4090.38,4736.23,8
HCPCS,28124,PARTIAL REMOVAL OF TOE,,,2808.13,5597.0,21
HCPCS,28124,PARTICAL EXCISION BONE PHALANX TOE,2000.0,1300.0,1.1,9440.12,148
HCPCS,28124,Partial removal of toe,,,1754.89,2031.98,8
HCPCS,28126,PARTIAL REMOVAL OF TOE,,,2808.13,7624.0,21
HCPCS,28126,Partial removal of toe,,,1754.89,2031.98,8
HCPCS,28126,RESECTION PARTIAL/COMPLETE PHALANGEAL BASE EACH,1456.0,946.4,1.1,9440.12,148
HCPCS,28130,REMOVAL OF ANKLE BONE,,,6206.54,7551.43,20
HCPCS,28130,Removal of ankle bone,,,4090.38,4736.23,8
HCPCS,28130,TALECTOMY ASTRAGALECTOMY,3800.0,2470.0,1.1,20863.78,144
HCPCS,28140,METATARSECTOMY,2856.0,1856.4,1.1,9440.12,148
HCPCS,28140,REMOVAL OF METATARSAL,,,2808.13,3405.12,20
HCPCS,28140,Removal of metatarsal,,,1754.89,2031.98,8
HCPCS,28150,PHALANGECTOMY TOE EACH TOE,1692.0,1099.8,1.1,9440.12,148
HCPCS,28150,REMOVAL OF TOE,,,2808.13,3405.12,20
HCPCS,28150,Removal of toe,,,1754.89,2031.98,8
HCPCS,28153,PARTIAL REMOVAL OF TOE,,,2808.13,3405.12,20
HCPCS,28153,Partial removal of toe,,,1754.89,2031.98,8
HCPCS,28153,RESECTION CONDYLE DISTAL END PHALANX EACH TOE,1520.0,988.0,1.1,9440.12,148
HCPCS,28160,HEMIPHALANGECTOMY/INTERPHALANGEAL JOINT EXC TOE,1552.0,1008.8,1.1,9440.12,148
HCPCS,28160,PARTIAL REMOVAL OF TOE,,,2808.13,3405.12,20
HCPCS,28160,Partial removal of toe,,,1754.89,2031.98,8
HCPCS,28171,RESECT TARSAL TUMOR,,,2808.13,3405.12,20
HCPCS,28171,Resect tarsal tumor,,,4090.38,4736.23,8
HCPCS,28173,RADICAL RESECTION TUMOR METATARSAL,5664.0,3681.6,1.1,9440.12,144
HCPCS,28173,RESECT METATARSAL TUMOR,,,2808.13,3405.12,20
HCPCS,28173,Resect metatarsal tumor,,,4090.38,4736.23,8
HCPCS,28175,RADICAL RESECTION TUMOR PHALANX OR TOE,3316.0,2155.4,1.1,4686.39,144
HCPCS,28175,RESECT PHALANX OF TOE TUMOR,,,1394.34,1673.41,20
HCPCS,28175,Resect phalanx of toe tumor,,,1754.89,2031.98,8
HCPCS,28190,REMOVAL FOREIGN BODY FOOT SUBCUTANEOUS,3237.0,2104.05,0.01,4392.0,174
HCPCS,28190,"REMV FOOT FOREIGN BODY,SUBCUTANEOUS",884.0,574.6,1.1,2050.87,148
HCPCS,28192,REMOVAL FOREIGN BODY FOOT DEEP,7453.0,4844.45,0.01,7453.0,174
HCPCS,28192,"REMV FOOT FOREIGN BODY,DEEP",1912.0,1242.8,1.1,4729.25,148
HCPCS,28193,REMOVAL FOREIGN BODY FOOT COMPLICATED,7453.0,4844.45,437.63,10789.0,87
HCPCS,28193,"REMV FOOT FOREIGN BODY,COMPLEX",2360.0,1534.0,1.1,4729.25,148
HCPCS,28200,REPAIR OF FOOT TENDON,,,2808.13,7624.0,23
HCPCS,28200,RPR TDN FLXR FOOT 1/2 W/O FREE GRAFG EACH TENDON,1896.0,1232.4,1.1,9440.12,148
HCPCS,28200,Repair of foot tendon,,,1754.89,2031.98,8
HCPCS,28202,REPAIR/GRAFT OF FOOT TENDON,,,6206.54,7551.43,20
HCPCS,28202,RPR TENDON FLXR FOOT SEC W/FREE GRAFT EA TENDON,2828.0,1838.2,1.1,20863.78,148
HCPCS,28202,Repair/graft of foot tendon,,,4090.38,4736.23,8
HCPCS,28208,REPAIR OF FOOT TENDON,,,2808.13,3405.12,20
HCPCS,28208,REPAIR TENDON EXTENSOR FOOT 1/2 EACH TENDON,1804.0,1172.6,1.1,9440.12,148
HCPCS,28208,Repair of foot tendon,,,1754.89,2031.98,8
HCPCS,28210,REPAIR/GRAFT OF FOOT TENDON,,,6206.54,7551.43,20
HCPCS,28210,RPR TENDON XTNSR FOOT SEC W/FREE GRAFT EA TENDON,2608.0,1695.2,1.1,20863.78,148
HCPCS,28210,Repair/graft of foot tendon,,,4090.38,4736.23,8
HCPCS,28220,RELEASE OF FOOT TENDON,,,1394.34,1673.41,20
HCPCS,28220,Release of foot tendon,,,1754.89,2031.98,8
HCPCS,28220,TENOLYSIS FLEXOR FOOT SINGLE TENDON,1868.0,1214.2,1.1,4686.39,148
HCPCS,28222,RELEASE OF FOOT TENDONS,,,2808.13,3405.12,20
HCPCS,28222,Release of foot tendons,,,1754.89,2031.98,8
HCPCS,28222,TENOLYSIS FLEXOR FOOT MULTIPLE TENDONS,2304.0,1497.6,1.1,9440.12,148
HCPCS,28225,RELEASE OF FOOT TENDON,,,2808.13,3405.12,20
HCPCS,28225,Release of foot tendon,,,1754.89,2031.98,8
HCPCS,28225,TENOLYSIS EXTENSOR FOOT SINGLE TENDON,1512.0,982.8,1.1,9440.12,148
HCPCS,28226,RELEASE OF FOOT TENDONS,,,2808.13,3405.12,20
HCPCS,28226,Release of foot tendons,,,1754.89,2031.98,8
HCPCS,28226,TENOLYSIS EXTENSOR FOOT MULTIPLE TENDON,1868.0,1214.2,1.1,9440.12,148
HCPCS,28230,TX OPN TENDON FLEXOR FOOT SINGLE/MULT TENDON SPX,4553.0,2959.45,0.01,7362.0,235
HCPCS,28232,TX OPEN TENDON FLEXOR TOE 1 TENDON SPX,4383.0,2848.9500000000003,0.01,7362.0,235
HCPCS,28234,TENOTOMY OPEN EXTENSOR FOOT/TOE EACH TENDON,4389.0,2852.85,0.01,7362.0,235
HCPCS,28238,RCNSTJ PST TIBL TDN W/EXC ACCESSORY TARSL NAVCLR,3184.0,2069.6,1.1,20863.78,148
HCPCS,28238,REVISION OF FOOT TENDON,,,5597.0,7813.0,22
HCPCS,28238,Revision of foot tendon,,,4090.38,4736.23,8
HCPCS,28240,RELEASE OF BIG TOE,,,2808.13,3405.12,20
HCPCS,28240,Release of big toe,,,1754.89,2031.98,8
HCPCS,28240,TENOTOMY LENGTHENING/RLS ABDUCTOR HALLUCIS MUSC,1792.0,1164.8,1.1,9440.12,148
HCPCS,28250,DIVISN PLANTAR FASCIA/MUSCLE,2424.0,1575.6,1.1,9440.12,148
HCPCS,28250,REVISION OF FOOT FASCIA,,,2808.13,3405.12,20
HCPCS,28250,Revision of foot fascia,,,1754.89,2031.98,8
HCPCS,28260,"CAPSULOTOMY MIDFOOT JT,MED RELEASE",3276.0,2129.4,1.1,9440.12,148
HCPCS,28260,RELEASE OF MIDFOOT JOINT,,,2808.13,3405.12,20
HCPCS,28260,Release of midfoot joint,,,4090.38,4736.23,8
HCPCS,28261,"CAPSULOTOMY MIDFOOT,TENDN LENGTH",5244.0,3408.6,1.1,5244.0,148
HCPCS,28261,REVISION OF FOOT TENDON,,,1394.34,1673.41,20
HCPCS,28261,Revision of foot tendon,,,4090.38,4736.23,8
HCPCS,28262,CAPSUL MIDFOOT W/PST TALOTIBL CAPSUL&TDN LNGTH,7572.0,4921.8,1.1,20863.78,148
HCPCS,28262,REVISION OF FOOT AND ANKLE,,,6206.54,7551.43,20
HCPCS,28262,Revision of foot and ankle,,,4090.38,4736.23,8
HCPCS,28264,CAPSULOTOMY MIDTARSAL,4260.0,2769.0,1.1,4686.39,148
HCPCS,28264,RELEASE OF MIDFOOT JOINT,,,1394.34,1673.41,20
HCPCS,28264,Release of midfoot joint,,,4090.38,4736.23,8
HCPCS,28270,CAPSUL MTTARPHLNGL JT W/WO TENORRHAPHY EA JT SPX,1972.0,1281.8,1.1,9440.12,148
HCPCS,28270,RELEASE OF FOOT CONTRACTURE,,,2808.13,7813.0,23
HCPCS,28270,Release of foot contracture,,,1754.89,2031.98,8
HCPCS,28272,CAPSULOTOMY IPHAL JOINT EACH JOINT SPX,1568.0,1019.2,1.1,4686.39,148
HCPCS,28272,RELEASE OF TOE JOINT EACH,,,1394.34,6238.0,22
HCPCS,28272,Release of toe joint each,,,1754.89,2031.98,8
HCPCS,28280,FUSION OF TOES,,,2808.13,3405.12,20
HCPCS,28280,Fusion of toes,,,1754.89,2031.98,8
HCPCS,28280,SYNDACTYLIZATION TOES,2132.0,1385.8,1.1,9440.12,148
HCPCS,28285,CORRECTION HAMMERTOE,8699.0,5654.35,0.01,14925.0,235
HCPCS,28286,CORRECTION COCK-UP 5TH TOE W/PLASTIC CLOSURE,1880.0,1222.0,1.1,9440.12,148
HCPCS,28286,REPAIR OF HAMMERTOE,,,2808.13,3405.12,20
HCPCS,28286,Repair of hammertoe,,,1754.89,2031.98,8
HCPCS,28288,OSTC PRTL EXOSTC/CONDYLC METAR HEAD,2408.0,1565.2,1.1,9440.12,148
HCPCS,28288,PARTIAL REMOVAL OF FOOT BONE,,,2808.13,7624.0,21
HCPCS,28288,Partial removal of foot bone,,,1754.89,2031.98,8
HCPCS,28289,CORRJ HALUX RIGDUS W/O IMPLT,,,2808.13,7624.0,22
HCPCS,28289,Corrj halux rigdus w/o implt,,,4090.38,4736.23,8
HCPCS,28289,HALLUX RIGIDUS W/CHEILECTOMY 1ST MP JT W/O IMPLT,2760.0,1794.0,1.1,9440.12,148
HCPCS,28291,CORRJ HALUX RIGDUS W/IMPLT,,,6206.54,7551.43,20
HCPCS,28291,Corrj halux rigdus w/implt,,,4090.38,4736.23,8
HCPCS,28291,HALLUX RIGIDUS W/CHEILECTOMY 1ST MP JT W/IMPLT,3524.0,2290.6,1.1,20863.78,148
HCPCS,28292,COR HLX VLGS RSC PRX PHLX BS,,,2808.13,5265.0,21
HCPCS,28292,CORRJ HLX VLGS BNCTY SESMDC RESCJ PROX PHLX BASE,2976.0,1934.4,1.1,9440.12,148
HCPCS,28292,Cor hlx vlgs rsc prx phlx bs,,,4090.38,4736.23,8
HCPCS,28295,COR HLX VLGS PRX MTAR OSTEOT,,,2808.13,3405.12,20
HCPCS,28295,CORRJ HLX VLGS BNCTY SESMDC PROX METAR OSTEOT,3428.0,2228.2,1.1,9440.12,148
HCPCS,28295,Cor hlx vlgs prx mtar osteot,,,4090.38,4736.23,8
HCPCS,28296,COR HLX VLGS DSTL MTAR OSTEO,,,2808.13,7813.0,22
HCPCS,28296,CORRJ HLX VLGS BNCTY SESMDC DSTL METAR OSTEOT,3300.0,2145.0,1.1,9440.12,148
HCPCS,28296,Cor hlx vlgs dstl mtar osteo,,,4090.38,4736.23,8
HCPCS,28297,COR HLX VLGS JT ARTHRD,,,5597.0,13361.02,24
HCPCS,28297,CORRJ HLX VLGS BNCTY SESMDC JOINT ARTHRODESIS,3716.0,2415.4,1.1,20863.78,148
HCPCS,28297,Cor hlx vlgs jt arthrd,,,4090.38,4736.23,8
HCPCS,28298,COR HLX VLGS PRX PHLX OSTEOT,,,6206.54,7551.43,20
HCPCS,28298,CORRJ HLX VLGS BNCTY SESMDC PROX PHLX OSTEOT,3100.0,2015.0,1.1,20863.78,148
HCPCS,28298,Cor hlx vlgs prx phlx osteot,,,4090.38,4736.23,8
HCPCS,28299,COR HLX VLGS DOUBLE OSTEOT,,,6206.54,7551.43,20
HCPCS,28299,CORRJ HLX VLGS BNCTY SESMDC W/DOUBLE OSTEOTOMY,3716.0,2415.4,1.1,20863.78,148
HCPCS,28299,Cor hlx vlgs double osteot,,,4090.38,4736.23,8
HCPCS,28300,INCISION OF HEEL BONE,,,3528.0,7551.43,21
HCPCS,28300,Incision of heel bone,,,4090.38,4736.23,8
HCPCS,28300,OSTEOTOMY CALCANEUS W/WO INTERNAL FIXATION,3892.0,2529.8,1.1,20863.78,144
HCPCS,28302,INCISION OF ANKLE BONE,,,6206.54,7551.43,20
HCPCS,28302,Incision of ankle bone,,,4090.38,4736.23,8
HCPCS,28302,OSTEOTOMY TALUS,3896.0,2532.4,1.1,20863.78,144
HCPCS,28304,INCISION OF MIDFOOT BONES,,,6206.54,7551.43,20
HCPCS,28304,Incision of midfoot bones,,,4090.38,4736.23,8
HCPCS,28304,OSTEOTOMY TARSAL BONES OTH/THN CALCANEUS/TALUS,4140.0,2691.0,1.1,20863.78,148
HCPCS,28305,INCISE/GRAFT MIDFOOT BONES,,,6206.54,7551.43,20
HCPCS,28305,Incise/graft midfoot bones,,,4090.38,4736.23,8
HCPCS,28305,OSTEOT TARSAL OTH/THN CALCANEUS/TALUS W/AGRFT,4308.0,2800.2,1.1,20863.78,144
HCPCS,28306,INCISION OF METATARSAL,,,6206.54,10789.0,21
HCPCS,28306,Incision of metatarsal,,,1754.89,2031.98,8
HCPCS,28306,OSTEOT W/WO LNGTH SHRT/CORRJ 1ST METAR,2400.0,1560.0,1.1,20863.78,148
HCPCS,28307,INCISION OF METATARSAL,,,6206.54,7551.43,20
HCPCS,28307,Incision of metatarsal,,,4090.38,4736.23,8
HCPCS,28307,OSTEOT W/WO LNGTH SHRT/CORRJ METAR XCP 1ST TOE,2600.0,1690.0,1.1,20863.78,148
HCPCS,28308,INCISION OF METATARSAL,,,2808.13,7624.0,23
HCPCS,28308,Incision of metatarsal,,,1754.89,2031.98,8
HCPCS,28308,OSTEOT W/WO LNGTH SHRT/CORRJ METAR XCP 1ST EA,2192.0,1424.8,1.1,9440.12,148
HCPCS,28309,INCISION OF METATARSALS,,,6206.54,7551.43,20
HCPCS,28309,Incision of metatarsals,,,4090.38,4736.23,8
HCPCS,28309,OSTEOT W/WO LNGTH SHRT/ANGULAR CORRJ METAR MLT,5664.0,3681.6,1.1,20863.78,144
HCPCS,28310,OSTEOT SHRT CORRJ PROX PHALANX 1ST TOE,2228.0,1448.2,1.1,20863.78,148
HCPCS,28310,REVISION OF BIG TOE,,,6206.54,7551.43,20
HCPCS,28310,Revision of big toe,,,1754.89,2031.98,8
HCPCS,28312,OSTEOT SHRT CORRJ OTH PHALANGES ANY TOE,1876.0,1219.4,1.1,9440.12,148
HCPCS,28312,REVISION OF TOE,,,2808.13,3405.12,20
HCPCS,28312,Revision of toe,,,1754.89,2031.98,8
HCPCS,28313,RCNSTJ ANGULAR DFRM TOE SOFT TISS PX ONLY,2266.0,1472.9,1.1,9440.12,148
HCPCS,28313,REPAIR DEFORMITY OF TOE,,,2808.13,3405.12,20
HCPCS,28313,Repair deformity of toe,,,1754.89,2031.98,8
HCPCS,28315,REMOVAL OF SESAMOID BONE,,,2808.13,3405.12,20
HCPCS,28315,Removal of sesamoid bone,,,1754.89,2031.98,8
HCPCS,28315,SESAMOIDECTOMY FIRST TOE SPX,2000.0,1300.0,1.1,9440.12,148
HCPCS,28320,REPAIR NONUNION/MALUNION TARSAL BONES,3748.0,2436.2,1.1,38384.94,144
HCPCS,28320,REPAIR OF FOOT BONES,,,11418.01,13361.02,20
HCPCS,28320,Repair of foot bones,,,4090.38,4736.23,8
HCPCS,28322,REPAIR OF METATARSALS,,,6206.54,7551.43,20
HCPCS,28322,RPR NON/MALUNION METARSAL W/WO BONE GRAFT,3412.0,2217.8,1.1,20863.78,148
HCPCS,28322,Repair of metatarsals,,,4090.38,4736.23,8
HCPCS,28340,RCNSTJ TOE MACRODACTYLY SOFT TISSUE RESECTION,2860.0,1859.0,1.1,9440.12,148
HCPCS,28340,RESECT ENLARGED TOE TISSUE,,,2808.13,3405.12,20
HCPCS,28340,Resect enlarged toe tissue,,,1754.89,2031.98,8
HCPCS,28341,RCNSTJ TOE MACRODACTYLY REQUIRING BONE RESECTION,3488.0,2267.2,1.1,9440.12,148
HCPCS,28341,RESECT ENLARGED TOE,,,2808.13,3405.12,20
HCPCS,28341,Resect enlarged toe,,,4090.38,4736.23,8
HCPCS,28344,RECONSTRUCTION TOE POLYDACTYLY,1936.0,1258.4,1.1,9440.12,148
HCPCS,28344,REPAIR EXTRA TOE(S),,,2808.13,3405.12,20
HCPCS,28344,Repair extra toe(s),,,1754.89,2031.98,8
HCPCS,28345,RCNSTJ TOE SYNDACTYLY W/WO SKIN GRAFT EACH WEB,2436.0,1583.4,1.1,4686.39,148
HCPCS,28345,REPAIR WEBBED TOE(S),,,1394.34,1673.41,20
HCPCS,28345,Repair webbed toe(s),,,1754.89,2031.98,8
HCPCS,28360,RECONSTRUCT CLEFT FOOT,5968.0,3879.2,1.1,20863.78,165
HCPCS,28360,Reconstruct cleft foot,,,4090.38,4736.23,8
HCPCS,28400,CLOSED TX CALCANEAL FRACTURE W/O MANIPULATION,1013.5,658.7750000000001,0.01,4392.0,409
HCPCS,28405,CLOSED TX CALCANEAL FRACTURE W/MANIPULATION,1499.5,974.6750000000001,1.1,5265.0,235
HCPCS,28406,PRQ SKEL FIX CLCNL FX W/MNPJ,,,6206.54,7551.43,20
HCPCS,28406,PRQ SKELETAL FIXJ CALCANEAL FRACTURE W/MANJ,2624.0,1705.6,1.1,20863.78,144
HCPCS,28406,Prq skel fix clcnl fx w/mnpj,,,3603.21,4172.14,8
HCPCS,28415,OPEN TREATMENT CALCANEAL FRACTURE,6476.0,4209.4,1.1,20863.78,144
HCPCS,28415,OPTX CALCANEAL FRACTURE,,,6206.54,7551.43,20
HCPCS,28415,Optx calcaneal fracture,,,3603.21,4172.14,8
HCPCS,28420,OPEN TREATMENT CALCANEAL FRACTURE W BONE GRAFT,7008.0,4555.2,1.1,38384.94,144
HCPCS,28420,OPTX CALCANEAL FX W/BONE GRF,,,11418.01,13361.02,20
HCPCS,28420,Optx calcaneal fx w/bone grf,,,3603.21,4172.14,8
HCPCS,28430,CLOSED TX TALUS FRACTURE W/O MANIPULATION,995.5,647.075,0.01,12500.0,409
HCPCS,28435,CLOSED TX TALUS FRACTURE W/MANIPULATION,4389.0,2852.85,1.1,7362.0,235
HCPCS,28436,PRQ SKEL FIX TALUS FX W/MNPJ,,,6206.54,7551.43,20
HCPCS,28436,PRQ SKELETAL FIXATION TALUS FRACTURE W/MANJ,1960.0,1274.0,1.1,20863.78,144
HCPCS,28436,Prq skel fix talus fx w/mnpj,,,3603.21,4172.14,8
HCPCS,28445,OPEN TREATMENT TALUS FRACTURE,6304.0,4097.6,1.1,20863.78,144
HCPCS,28445,OPTX TALUS FRACTURE,,,6206.54,7551.43,20
HCPCS,28445,Optx talus fracture,,,3603.21,4172.14,8
HCPCS,28446,OPEN OSTEOCHONDRAL AUTOGRAFT TALUS,7084.0,4604.6,1.1,20863.78,142
HCPCS,28446,OPN OSTEOCHONDRL AGRFT TALUS,,,6206.54,7551.43,20
HCPCS,28446,Opn osteochondrl agrft talus,,,4090.38,4736.23,8
HCPCS,28450,TX TARSAL BONE FX XCP TALUS&CALCN W/O MANJ,998.0,648.7,0.01,12500.0,409
HCPCS,28455,TX TARSAL BONE FX XCP TALUS&CALCN W/MANJ,4394.0,2856.1,1.1,7362.0,322
HCPCS,28456,PRQ SKEL FIX TARSL FX W/MNPJ,,,6206.54,7551.43,20
HCPCS,28456,PRQ SKEL FIXJ TARSL FX XCP TALUS&CALCNS W/MANJ,1144.0,743.6,1.1,20863.78,144
HCPCS,28456,Prq skel fix tarsl fx w/mnpj,,,3603.21,4172.14,8
HCPCS,28465,OPEN TX TARSAL FRACTURE XCP TALUS & CALCANEUS EA,3520.0,2288.0,1.1,20863.78,144
HCPCS,28465,OPTX TARSAL BONE FX EACH,,,6206.54,11170.0,21
HCPCS,28465,Optx tarsal bone fx each,,,3603.21,4172.14,8
HCPCS,28470,CLOSED TX METATARSAL FRACTURE W/O MANIPULATION,998.0,648.7,0.01,12500.0,322
HCPCS,28475,CLTX METAR FX W/MANJ,1153.5,749.7750000000001,0.01,12500.0,322
HCPCS,28476,PRQ SKEL FIX METAR FX W/MNPJ,,,2808.13,3405.12,20
HCPCS,28476,PRQ SKEL FIXJ METAR FX W/MANJ,1440.0,936.0,1.1,9440.12,144
HCPCS,28476,Prq skel fix metar fx w/mnpj,,,3603.21,4172.14,8
HCPCS,28485,OPEN TREATMENT METATARSAL FRACTURE EACH,2976.0,1934.4,1.1,20863.78,144
HCPCS,28485,OPTX METATARSAL FX EACH,,,6206.54,11170.0,24
HCPCS,28485,Optx metatarsal fx each,,,3603.21,4172.14,8
HCPCS,28490,CLTX FX GRT TOE PHLX/PHLG W/O MANJ,785.5,510.57500000000005,0.01,12500.0,322
HCPCS,28495,CLTX FX GRT TOE PHLX/PHLG W/MANJ,887.5,576.875,0.01,12500.0,322
HCPCS,28496,PRQ SKEL FIXJ FX GRT TOE PHLX/PHLG W/MANJ,992.0,644.8,1.1,9440.12,148
HCPCS,28496,TREAT BIG TOE FRACTURE,,,2808.13,3405.12,20
HCPCS,28496,Treat big toe fracture,,,3603.21,4172.14,8
HCPCS,28505,OPEN TX FRACTURE GREAT TOE/PHALANX/PHALANGES,2976.0,1934.4,1.1,9440.12,148
HCPCS,28505,TREAT BIG TOE FRACTURE,,,2808.13,6238.0,21
HCPCS,28505,Treat big toe fracture,,,3603.21,4172.14,8
HCPCS,28510,CLTX FX PHLX/PHLG OTH/THN GRT TOE W/O MANJ,785.5,510.57500000000005,0.01,12500.0,322
HCPCS,28515,CLTX FX PHLX/PHLG OTH/THN GRT TOE W/MANJ,863.5,561.2750000000001,0.01,12500.0,409
HCPCS,28525,OPEN TX FRACTURE PHALANX/PHALANGES NOT GREAT TOE,2248.0,1461.2,1.1,9440.12,148
HCPCS,28525,TREAT TOE FRACTURE,,,2808.13,3405.12,20
HCPCS,28525,Treat toe fracture,,,3603.21,4172.14,8
HCPCS,28530,CLOSED TREATMENT SESAMOID FRACTURE,773.5,502.77500000000003,0.01,12500.0,322
HCPCS,28531,OPEN TX SESAMOID FRACTURE W/WO INTERNAL FIXATION,1028.0,668.2,1.1,20863.78,148
HCPCS,28531,TREAT SESAMOID BONE FRACTURE,,,6206.54,7551.43,20
HCPCS,28531,Treat sesamoid bone fracture,,,3603.21,4172.14,8
HCPCS,28540,CLTX TARSAL DISLC OTH/THN TALOTARSAL W/O ANES,989.5,643.175,1.1,4392.0,235
HCPCS,28545,CLTX TARSAL DISLC OTH/THN TALOTARSAL W/ANES,1040.0,676.0,1.1,9440.12,148
HCPCS,28545,TREAT FOOT DISLOCATION,,,2808.13,3405.12,20
HCPCS,28545,Treat foot dislocation,,,824.67,954.88,8
HCPCS,28546,PRQ SKEL FIXJ TARSL DISLC XCP TALOTARSAL W/MANJ,1360.0,884.0,1.1,4686.39,148
HCPCS,28546,TREAT FOOT DISLOCATION,,,1394.34,1673.41,20
HCPCS,28546,Treat foot dislocation,,,3603.21,4172.14,8
HCPCS,28555,OPEN TREATMENT TARSAL BONE DISLOCATION,3860.0,2509.0,1.1,20863.78,148
HCPCS,28555,REPAIR FOOT DISLOCATION,,,6206.54,7551.43,20
HCPCS,28555,Repair foot dislocation,,,3603.21,4172.14,8
HCPCS,28570,CLOSED TX TALOTARSAL JOINT DISLC W/O ANES,903.5,587.2750000000001,1.1,4392.0,235
HCPCS,28575,CLOSED TX TALOTARSAL JOINT DISLOCATION W/ANES,8160.5,5304.325,1.1,14925.0,235
HCPCS,28576,PRQ SKEL FIXJ TALOTARSAL JT DISLC W/MANJ,1840.0,1196.0,1.1,20863.78,144
HCPCS,28576,TREAT FOOT DISLOCATION,,,6206.54,7551.43,20
HCPCS,28576,Treat foot dislocation,,,3603.21,4172.14,8
HCPCS,28585,OPEN TREATMENT TALOTARSAL JOINT DISLOCATION,4452.0,2893.8,1.1,20863.78,148
HCPCS,28585,REPAIR FOOT DISLOCATION,,,6206.54,7551.43,20
HCPCS,28585,Repair foot dislocation,,,3603.21,4172.14,8
HCPCS,28600,CLOSED TX TARSOMETATARSAL DISLOCATION W/O ANES,955.5,621.075,0.01,12500.0,322
HCPCS,28605,CLOSED TX TARSOMETATARSAL DISLOCATION W/ANES,1156.0,751.4,1.1,1187.06,148
HCPCS,28605,TREAT FOOT DISLOCATION,,,204.59,256.7,20
HCPCS,28605,Treat foot dislocation,,,824.67,954.88,8
HCPCS,28606,PRQ SKEL FIXJ TARS JT DISLC W/MANJ,2036.0,1323.4,1.1,9440.12,144
HCPCS,28606,TREAT FOOT DISLOCATION,,,2808.13,3405.12,20
HCPCS,28606,Treat foot dislocation,,,3603.21,4172.14,8
HCPCS,28615,OPEN TREATMENT TARSOMETATARSAL JOINT DISLOCATION,4280.0,2782.0,1.1,20863.78,144
HCPCS,28615,REPAIR FOOT DISLOCATION,,,6206.54,7551.43,20
HCPCS,28615,Repair foot dislocation,,,3603.21,4172.14,8
HCPCS,28630,CLTX METATARSOPHLNGL JT DISLC W/O ANES,901.5,585.975,0.01,12500.0,320
HCPCS,28635,CLTX METATARSOPHLNGL JT DISLC REQ ANES,784.0,509.6,1.1,4686.39,148
HCPCS,28635,TREAT TOE DISLOCATION,,,1394.34,1673.41,20
HCPCS,28635,Treat toe dislocation,,,824.67,954.88,8
HCPCS,28636,PRQ SKEL FIXJ METATARSOPHLNGL JT DISLC W/MANJ,1108.0,720.2,1.1,9440.12,148
HCPCS,28636,TREAT TOE DISLOCATION,,,2808.13,3405.12,20
HCPCS,28636,Treat toe dislocation,,,3603.21,4172.14,8
HCPCS,28645,OPEN TX METATARSOPHALANGEAL JOINT DISLOCATION,2976.0,1934.4,1.1,9440.12,148
HCPCS,28645,REPAIR TOE DISLOCATION,,,2808.13,3405.12,20
HCPCS,28645,Repair toe dislocation,,,3603.21,4172.14,8
HCPCS,28660,CLTX INTERPHALANGEAL JOINT DISLOCATION W/O ANES,807.5,524.875,0.01,12500.0,320
HCPCS,28665,CLTX INTERPHALANGEAL JOINT DISLOCATION REQ ANES,1005.0,653.25,0.01,4392.0,322
HCPCS,28666,PRQ SKEL FIXJ INTERPHALANGEAL JOINT DISLC W/MANJ,1064.0,691.6,1.1,9440.12,144
HCPCS,28666,TREAT TOE DISLOCATION,,,2808.13,3405.12,20
HCPCS,28666,Treat toe dislocation,,,3603.21,4172.14,8
HCPCS,28675,OPEN TREATMENT INTERPHALANGEAL JOINT DISLOCATION,2248.0,1461.2,1.1,9440.12,148
HCPCS,28675,REPAIR OF TOE DISLOCATION,,,2808.13,3405.12,20
HCPCS,28675,Repair of toe dislocation,,,3603.21,4172.14,8
HCPCS,28705,ARTHRODESIS PANTALAR,8132.0,5285.8,1.1,54351.12,164
HCPCS,28705,Arthrodesis pantalar,,,4090.38,4736.23,8
HCPCS,28715,ARTHRODESIS TRIPLE,5368.0,3489.2,1.1,38384.94,165
HCPCS,28715,Arthrodesis triple,,,4090.38,4736.23,8
HCPCS,28725,ARTHRODESIS SUBTALAR,4488.0,2917.2,1.1,38384.94,165
HCPCS,28725,Arthrodesis subtalar,,,4090.38,4736.23,8
HCPCS,28730,ARTHRD MIDTARSL/TARSOMETATARSAL MULT/TRANSVRS,4280.0,2782.0,1.1,38384.94,144
HCPCS,28730,FUSION OF FOOT BONES,,,11418.01,13361.02,20
HCPCS,28730,Fusion of foot bones,,,4090.38,4736.23,8
HCPCS,28735,ARTHRD MIDTARSL/TARS MLT/TRANSVRS W/OSTEOT,4892.0,3179.8,1.1,38384.94,144
HCPCS,28735,FUSION OF FOOT BONES,,,11418.01,13361.02,20
HCPCS,28735,Fusion of foot bones,,,4090.38,4736.23,8
HCPCS,28737,ARTHRD W/TDN LNGTH&ADVMNT TARSL NVCLR-CUNEIFOR,4412.0,2867.8,1.1,38384.94,144
HCPCS,28737,REVISION OF FOOT BONES,,,11418.01,13361.02,20
HCPCS,28737,Revision of foot bones,,,4090.38,4736.23,8
HCPCS,28740,ARTHRODESIS MIDTARSOMETATARSAL SINGLE JOINT,3716.0,2415.4,1.1,20863.78,148
HCPCS,28740,FUSION OF FOOT BONES,,,6206.54,7551.43,20
HCPCS,28740,Fusion of foot bones,,,4090.38,4736.23,8
HCPCS,28750,ARTHRODESIS GREAT TOE METATARSOPHALANGEAL JOINT,3428.0,2228.2,1.1,20863.78,148
HCPCS,28750,FUSION OF BIG TOE JOINT,,,6206.54,11170.0,23
HCPCS,28750,Fusion of big toe joint,,,4090.38,4736.23,8
HCPCS,28755,ARTHRODESIS GREAT TOE INTERPHALANGEAL JOINT,1952.0,1268.8,1.1,20863.78,148
HCPCS,28755,FUSION OF BIG TOE JOINT,,,6206.54,11170.0,21
HCPCS,28755,Fusion of big toe joint,,,1754.89,2031.98,8
HCPCS,28760,ARTHRD W/XTNSR HALLUCIS LONGUS TR 1ST METAR NCK,3656.0,2376.4,1.1,20863.78,148
HCPCS,28760,FUSION OF BIG TOE JOINT,,,6206.54,7551.43,20
HCPCS,28760,Fusion of big toe joint,,,4090.38,4736.23,8
HCPCS,28800,"AMPUTATION FOOT,MIDTARSAL-CHOPART",3516.0,2285.4,1.1,3516.0,144
HCPCS,28800,AMPUTATION OF MIDFOOT,,,3095.56,3405.12,12
HCPCS,28800,Amputation of midfoot,,,4090.38,4736.23,8
HCPCS,28805,"AMPUTATION FOOT,TRANSMETATARSAL",5084.0,3304.6,1.1,9440.12,144
HCPCS,28805,AMPUTATION THRU METATARSAL,,,2808.13,3405.12,20
HCPCS,28805,Amputation thru metatarsal,,,4090.38,4736.23,8
HCPCS,28810,"AMPUTATION METATARSAL+TOE,SINGLE",2656.0,1726.4,1.1,9440.12,144
HCPCS,28810,AMPUTATION TOE & METATARSAL,,,2808.13,5265.0,21
HCPCS,28810,Amputation toe & metatarsal,,,4090.38,4736.23,8
HCPCS,28820,AMPUTATION OF TOE,,,2808.13,6238.0,22
HCPCS,28820,AMPUTATION TOE METATARSOPHALANGEAL JOINT,1544.0,1003.6,1.1,9440.12,148
HCPCS,28820,Amputation of toe,,,1754.89,2031.98,8
HCPCS,28825,AMPUTATION TOE INTERPHALANGEAL JOINT,8166.5,5308.225,0.01,14833.0,235
HCPCS,28890,ESWT HI NRG PHYS/QHP W/US GDN INVG PLNTAR FASCIA,1380.0,897.0,1.1,4686.39,148
HCPCS,28890,HI ENRGY ESWT PLANTAR FASCIA,,,1394.34,4195.84,21
HCPCS,28890,Hi enrgy eswt plantar fascia,,,1754.89,2031.98,8
HCPCS,28899,ARTHRODESIS INTERPHALANGEAL JOINT LESSER TOE (COMP CODE 28285),2414.0,1569.1,0.01,2414.0,84
HCPCS,28899,"ARTHROPLASTY, INTERPOSITION, INTERTARSAL OR TAROMETATARSAL JOINT",3676.0,2389.4,0.01,3676.0,84
HCPCS,28899,BIOPSY SOFT TISSUE FOOT (COMP 27613),733.0,476.45,0.01,733.0,84
HCPCS,28899,COMPLETE REMOVAL OF TARSAL BONE (COMP CODE 28130),4085.0,2655.25,0.01,4085.0,84
HCPCS,28899,"CORE NEEDLE BIOPSY, FOOT",1236.0,803.4,0.01,3443.0,85
HCPCS,28899,"CORE NEEDLE BIOPSY, FOOT (COMP 10021)",327.0,212.55,0.01,688.73,84
HCPCS,28899,FOOT/TOES SURGERY PROC UNLISTED,1870.0,1215.5,0.01,1870.0,84
HCPCS,28899,INTERPOSITION ARTHROPLASTY; FOOT (COMP 28750),2828.0,1838.2,0.01,2828.0,84
HCPCS,28899,PERINEURAL TARSAL TUNNEL INJECTION (COMP CODE 64450),2554.0,1660.1,0.01,4778.0,168
HCPCS,28899,REPAIR LIGAMENT FOOT (COMP CODE 27695),2413.0,1568.45,0.01,2413.0,84
HCPCS,28899,SUBTALAR JOINT?ARTHROEREISIS (COMP CODE 28725),4040.0,2626.0,0.01,4040.0,84
HCPCS,28899,TALUS DECOMPRESSION W/DRILLING (COMP CODE 28005),4059.0,2638.35,0.01,4059.0,84
HCPCS,28899,TARSAL TUNNEL INJECTION,337.5,219.375,0.01,3443.0,169
HCPCS,28899,UNLISTED PLANTAR PLATE REPAIR 2ND METATARSOPHALANGEAL JOINT OF L,1700.0,1105.0,0.01,1700.0,84
HCPCS,28899,"UNLISTED PROCEDURE, FOOT OR TOES  (COMPARISON CODE 27415)",733.0,476.45,0.01,733.0,84
HCPCS,29000,APPL HALO TYPE BODY CAST,,,232.99,701.11,21
HCPCS,29000,APPLICATION HALO TYPE BODY CAST,900.0,585.0,1.1,1212.57,148
HCPCS,29000,Appl halo type body cast,,,105.3,121.92,8
HCPCS,29010,APPLICATION RISSER JACKET LOCALIZER BODY ONLY,1023.0,664.95,1.1,2453.0,234
HCPCS,29015,APPL RISSR JACKET BDY W/HEAD,,,232.99,701.11,21
HCPCS,29015,Appl rissr jacket bdy w/head,,,105.3,121.92,8
HCPCS,29035,APPL BODY CAST SHO TO HIPS,,,232.99,701.11,21
HCPCS,29035,Appl body cast sho to hips,,,105.3,121.92,8
HCPCS,29040,APPL BDY CST SHO TO HIP HEAD,,,232.99,701.11,21
HCPCS,29040,Appl bdy cst sho to hip head,,,105.3,121.92,8
HCPCS,29044,APPL BDY CST SHO TO HIP 1THI,,,136.7,411.36,21
HCPCS,29044,Appl bdy cst sho to hip 1thi,,,105.3,121.92,8
HCPCS,29046,APPL BDY CST SHO TO HIP B TH,,,232.99,701.11,21
HCPCS,29046,"APPLY BODY CAST,SHLDR-HIP+2 THIGHS",964.0,626.6,1.1,1076.27,148
HCPCS,29046,Appl bdy cst sho to hip b th,,,105.3,121.92,8
HCPCS,29049,APPL CAST FIGURE-OF-EIGHT,,,232.99,701.11,21
HCPCS,29049,Appl cast figure-of-eight,,,105.3,121.92,8
HCPCS,29055,APPLICATION CAST SHOULDER SPICA,1222.0,794.3,105.3,2453.0,86
HCPCS,29055,"APPLY SHOULDER CAST,SPICA",712.0,462.8,1.1,783.62,148
HCPCS,29058,APPL CAST PLASTER VELPEAU,,,232.99,701.11,21
HCPCS,29058,Appl cast plaster velpeau,,,105.3,121.92,8
HCPCS,29065,APPLICATION CAST SHOULDER HAND LONG ARM,785.0,510.25,0.01,12500.0,493
HCPCS,29075,APPLICATION CAST ELBOW FINGER SHORT ARM,765.0,497.25,0.01,12500.0,493
HCPCS,29085,APPLICATION CAST HAND & LOWER FOREARM GAUNTLET,537.0,349.04999999999995,0.01,12500.0,407
HCPCS,29086,APPLICATION CAST FINGER,,,136.7,411.36,21
HCPCS,29086,APPLICATION FINGER CAST,248.0,161.2,1.1,459.15,146
HCPCS,29086,Application cast finger,,,105.3,121.92,8
HCPCS,29105,APPLICATION LONG ARM SPLINT SHOULDER HAND,523.0,339.95,0.01,12500.0,493
HCPCS,29125,APPLICATION SHORT ARM SPLINT FOREARM-HAND STATIC,406.5,264.225,0.01,12500.0,665
HCPCS,29126,APPLICATION SHORT ARM SPLINT DYNAMIC,593.0,385.45,56.42,2453.0,86
HCPCS,29126,"APPLY FOREARM SPLINT,DYNAMIC",299.0,194.35,1.1,373.44,148
HCPCS,29130,APPLICATION FINGER SPLINT STATIC,406.5,264.225,0.01,12500.0,665
HCPCS,29131,APPLICATION FINGER SPLINT DYNAMIC,273.0,177.45,0.01,12500.0,259
HCPCS,29131,"APPLY FINGER SPLINT,DYNAMIC",242.0,157.3,1.1,242.0,148
HCPCS,29200,STRAPPING THORAX,726.0,471.9,21.71,2453.0,86
HCPCS,29240,STRAPPING SHOULDER,382.5,248.625,0.01,12500.0,493
HCPCS,29260,STRAPPING ELBOW OR WRIST,172.0,111.8,1.1,177.54,148
HCPCS,29260,STRAPPING ELBOW/WRIST,273.0,177.45,0.01,12500.0,173
HCPCS,29280,STRAPPING HAND OR FINGER,172.0,111.8,1.1,177.54,146
HCPCS,29280,STRAPPING HAND/FINGER,273.0,177.45,0.01,12500.0,173
HCPCS,29305,APPL HIP SPICA CAST 1 LEG,,,232.99,701.11,21
HCPCS,29305,APPLICATION HIP SPICA CAST 1 LEG,812.0,527.8,1.1,847.3,148
HCPCS,29305,Appl hip spica cast 1 leg,,,105.3,121.92,8
HCPCS,29325,APPL HIP SPICA CAST ONE&ONE-HALF SPICA/BOTH LEGS,928.0,603.2,1.1,935.63,148
HCPCS,29325,APPL HIP SPICA CAST1&1/2,,,232.99,701.11,21
HCPCS,29325,Appl hip spica cast1&1/2,,,105.3,121.92,8
HCPCS,29345,APPLICATION LONG LEG CAST THIGH-TOE,891.0,579.15,0.01,12500.0,321
HCPCS,29355,APPLICATION LONG LEG CAST WALKER/AMBULATORY TYPE,917.0,596.05,0.01,12500.0,235
HCPCS,29358,APPLICATION LONG LEG CAST BRACE,897.0,583.05,1.1,2453.0,234
HCPCS,29365,APPLICATION CYLINDER CAST THIGH ANKLE,847.0,550.55,1.1,2453.0,320
HCPCS,29405,APPLICATION SHORT LEG CAST BELOW KNEE-TOE,771.0,501.15,0.01,12500.0,407
HCPCS,29425,APPLICATION SHORT LEG CAST WALKING/AMBULATORY,771.0,501.15,0.01,12500.0,321
HCPCS,29435,APPLICATION PATELLAR TENDON BEARING CAST,847.0,550.55,1.1,2453.0,320
HCPCS,29440,ADDING WALKER TO PREV CAST,,,136.7,411.36,21
HCPCS,29440,Adding walker to prev cast,,,105.3,121.92,8
HCPCS,29445,APPLICATION RIGID TOTAL CONTACT LEG CAST,967.0,628.55,0.01,12500.0,321
HCPCS,29450,APPL CLUBFOOT CAST MOLDING/MANJ LONG/SHORT LEG,820.5,533.325,0.01,12500.0,235
HCPCS,29505,APPLICATION LONG LEG SPLINT THIGH ANKLE/TOES,515.0,334.75,0.01,12500.0,665
HCPCS,29515,APPLICATION SHORT LEG SPLINT CALF FOOT,523.5,340.275,0.01,12500.0,579
HCPCS,29520,STRAPPING OF HIP,,,110.82,333.49,21
HCPCS,29520,Strapping of hip,,,56.47,65.38,8
HCPCS,29530,STRAPPING KNEE,382.5,248.625,0.01,12500.0,321
HCPCS,29540,STRAPPING ANKLE &/FOOT,449.0,291.84999999999997,0.01,12500.0,407
HCPCS,29550,STRAPPING OF TOES,110.0,71.5,1.1,177.54,148
HCPCS,29550,STRAPPING TOES,273.0,177.45,0.01,12500.0,173
HCPCS,29580,STRAP UNNA BOOT GP,726.0,471.9,31.54,2453.0,86
HCPCS,29580,STRAPPING UNNA BOOT,484.0,314.6,0.01,12500.0,321
HCPCS,29581,APPL MLTLAYR COMPRES LEG BELOW KNEE W/ANKLE FOOT,495.0,321.75,0.01,12500.0,235
HCPCS,29581,WRAP MULT LAYER VENOUS COMP,726.0,471.9,32.95,2453.0,86
HCPCS,29584,APPL MLTLAYR COMPRES SYS UPARM LWARM HAND&FING,726.0,471.9,0.01,12500.0,87
HCPCS,29584,APPL MLTLAYR COMPRES SYS UPARM LWARM HAND&FINGER,140.0,91.0,1.1,459.15,148
HCPCS,29700,REMOVAL/BIVALVING GAUNTLET BOOT/BODY CAST,725.0,471.25,1.1,2453.0,318
HCPCS,29705,REMOVAL/BIVALVING FULL ARM/FULL LEG CAST,763.0,495.95,1.1,2453.0,318
HCPCS,29710,RMVL/BIVALV SHO/HIP SPICA MINERVA/RISSER JACKET,536.0,348.4,1.1,783.62,146
HCPCS,29710,RMVL/BIVLV SHO/HIP SPICA,,,232.99,701.11,21
HCPCS,29710,Rmvl/bivlv sho/hip spica,,,105.3,121.92,8
HCPCS,29720,REPAIR SPICA BODY CST/JACKET,,,136.7,411.36,21
HCPCS,29720,Repair spica body cst/jacket,,,105.3,121.92,8
HCPCS,29730,WINDOWING CAST,726.0,471.9,49.81,2453.0,86
HCPCS,29740,WEDGING CAST EXCEPT CLUBFOOT CASTS,835.0,542.75,1.1,2453.0,232
HCPCS,29750,WEDGING OF CLUBFOOT CAST,,,232.99,701.11,21
HCPCS,29750,Wedging of clubfoot cast,,,105.3,121.92,8
HCPCS,29799,UNLISTED PROCEDURE CASTING OR STRAPPING,270.0,175.5,56.47,270.0,84
HCPCS,29799,UNLISTED PROCEDURE CASTING/STRAPPING,229.0,148.85,0.01,459.15,84
HCPCS,29800,ARTHRS TEMPOROMANDIBULR JT DX W/WO SYNVAL BX SPX,2736.0,1778.4,1.1,9440.12,144
HCPCS,29800,JAW ARTHROSCOPY/SURGERY,,,2808.13,3405.12,20
HCPCS,29800,Jaw arthroscopy/surgery,,,1831.46,2120.64,8
HCPCS,29804,ARTHROSCOPY TEMPOROMANDIBULAR JOINT SURGICAL,3548.0,2306.2,1.1,9440.12,144
HCPCS,29804,JAW ARTHROSCOPY/SURGERY,,,2808.13,3405.12,20
HCPCS,29804,Jaw arthroscopy/surgery,,,1831.46,2120.64,8
HCPCS,29805,DIAGNOSTIC ARTHROSCOPY SHOULDER +- SYNOVIAL BX,2412.0,1567.8,1.1,9440.12,144
HCPCS,29805,SHO ARTHRS DX +- SYNOVIAL BX,,,2808.13,3405.12,20
HCPCS,29805,Sho arthrs dx +- synovial bx,,,1831.46,2120.64,8
HCPCS,29806,SHO ARTHRS SRG CAPSULORRAPHY,,,6206.54,11170.0,23
HCPCS,29806,SURGICAL ARTHROSCOPY SHOULDER CAPSULORRHAPHY,6056.0,3936.4,1.1,20863.78,144
HCPCS,29806,Sho arthrs srg capsulorraphy,,,4348.01,5034.54,8
HCPCS,29807,SHO ARTHRS SRG RPR SLAP LES,,,6206.54,11170.0,21
HCPCS,29807,SURGICAL ARTHROSCOPY SHOULDER REPAIR SLAP LESION,5868.0,3814.2,1.1,20863.78,144
HCPCS,29807,Sho arthrs srg rpr slap les,,,4348.01,5034.54,8
HCPCS,29819,SHO ARTHRS SRG RMVL LOOSE/FB,,,2808.13,7813.0,21
HCPCS,29819,SURGICAL ARTHROSCOPY SHOULDER REMOVAL LOOSE/FB,3116.0,2025.4,1.1,9440.12,144
HCPCS,29819,Sho arthrs srg rmvl loose/fb,,,1831.46,2120.64,8
HCPCS,29820,SHO ARTHRS SRG PRTL SYNVCT,,,6206.54,7551.43,20
HCPCS,29820,SURGICAL ARTHROSCOPY SHOULDER PRTL SYNOVECTOMY,2884.0,1874.6,1.1,20863.78,144
HCPCS,29820,Sho arthrs srg prtl synvct,,,1831.46,2120.64,8
HCPCS,29821,SHO ARTHRS SRG COMPL SYNVCT,,,2808.13,3405.12,20
HCPCS,29821,SURGICAL ARTHROSCOPY SHOULDER COMPL SYNOVECTOMY,3156.0,2051.4,1.1,9440.12,144
HCPCS,29821,Sho arthrs srg compl synvct,,,4348.01,5034.54,8
HCPCS,29822,SHO ARTHRS SRG LMTD DBRDMT,,,2808.13,7778.0,22
HCPCS,29822,SURGICAL ARTHROSCOPY SHOULDER LMTD DBRDMT 1/2,3093.0,2010.45,1.1,9440.12,144
HCPCS,29822,Sho arthrs srg lmtd dbrdmt,,,1831.46,2120.64,8
HCPCS,29823,SHO ARTHRS SRG XTNSV DBRDMT,,,2808.13,9457.0,23
HCPCS,29823,SURGICAL ARTHROSCOPY SHOULDER XTNSV DBRDMT 3+,3511.0,2282.15,1.1,9440.12,144
HCPCS,29823,Sho arthrs srg xtnsv dbrdmt,,,1831.46,2120.64,8
HCPCS,29824,SHO ARTHRS SRG DSTL CLAVICLC,,,2808.13,9457.0,21
HCPCS,29824,SURGICAL ARTHROSCOPY SHOULDER DSTL CLAVICULC,3592.0,2334.8,1.1,9440.12,144
HCPCS,29824,Sho arthrs srg dstl claviclc,,,1831.46,2120.64,8
HCPCS,29825,SHO ARTHRS SRG LSS&RESCJ ADS,,,2808.13,3405.12,20
HCPCS,29825,SURGICAL ARTHROSCOPY SHOULDER W/LSS&RESCJ ADS,3116.0,2025.4,1.1,9440.12,144
HCPCS,29825,Sho arthrs srg lss&rescj ads,,,1831.46,2120.64,8
HCPCS,29826,SHO ARTHRS SRG DECOMPRESSION,,,4132.0,7813.0,3
HCPCS,29826,SURGICAL ARTHROSCOPY SHO W/CORACOACRM LIGM RLS,1320.0,858.0,1.1,1320.0,144
HCPCS,29826,Sho arthrs srg decompression,,,1831.46,2120.64,8
HCPCS,29827,SHO ARTHRS SRG RT8TR CUF RPR,,,6206.54,13821.0,24
HCPCS,29827,SURGICAL ARTHROSCOPY SHOULDER W/ROTATOR CUFF RPR,6236.0,4053.4,1.1,20863.78,144
HCPCS,29827,Sho arthrs srg rt8tr cuf rpr,,,4348.01,5034.54,8
HCPCS,29828,SHO ARTHRS SRG BICP TENODSIS,,,6206.54,10364.0,22
HCPCS,29828,SURGICAL ARTHROSCOPY SHOULDER BICEPS TENODESIS,5790.0,3763.5,1.1,20863.78,144
HCPCS,29828,Sho arthrs srg bicp tenodsis,,,4348.01,5034.54,8
HCPCS,29830,ARTHROSCOPY ELBOW DIAG W/WO SYNOVIAL BIOPSY SPX,2352.0,1528.8,1.1,9440.12,144
HCPCS,29830,ELBOW ARTHROSCOPY,,,2808.13,3405.12,20
HCPCS,29830,Elbow arthroscopy,,,1831.46,2120.64,8
HCPCS,29834,ARTHROSCOPY ELBOW SURGICAL W/REMOVAL LOOSE/FB,2568.0,1669.2,1.1,9440.12,144
HCPCS,29834,ELBOW ARTHROSCOPY/SURGERY,,,2808.13,7624.0,21
HCPCS,29834,Elbow arthroscopy/surgery,,,1831.46,2120.64,8
HCPCS,29835,ARTHROSCOPY ELBOW SURGICAL SYNOVECTOMY PARTIAL,2648.0,1721.2,1.1,9440.12,144
HCPCS,29835,ELBOW ARTHROSCOPY/SURGERY,,,2808.13,3405.12,20
HCPCS,29835,Elbow arthroscopy/surgery,,,1831.46,2120.64,8
HCPCS,29836,ARTHROSCOPY ELBOW SURGICAL SYNOVECTOMY COMPLETE,3088.0,2007.2,1.1,20863.78,144
HCPCS,29836,ELBOW ARTHROSCOPY/SURGERY,,,6206.54,7551.43,20
HCPCS,29836,Elbow arthroscopy/surgery,,,4348.01,5034.54,8
HCPCS,29837,ARTHROSCOPY ELBOW SURGICAL DEBRIDEMENT LIMITED,2804.0,1822.6,1.1,9440.12,144
HCPCS,29837,ELBOW ARTHROSCOPY/SURGERY,,,2808.13,3405.12,20
HCPCS,29837,Elbow arthroscopy/surgery,,,1831.46,2120.64,8
HCPCS,29838,ARTHROSCOPY ELBOW SURGICAL DEBRIDEMENT EXTENSIVE,3152.0,2048.8,1.1,9440.12,144
HCPCS,29838,ELBOW ARTHROSCOPY/SURGERY,,,2808.13,3405.12,20
HCPCS,29838,Elbow arthroscopy/surgery,,,1831.46,2120.64,8
HCPCS,29840,ARTHROSCOPY WRIST DIAG W/WO SYNOVIAL BIOPSY SPX,2272.0,1476.8,1.1,9440.12,144
HCPCS,29840,WRIST ARTHROSCOPY,,,2808.13,3405.12,20
HCPCS,29840,Wrist arthroscopy,,,1831.46,2120.64,8
HCPCS,29843,ARTHROSCOPY WRIST INFECTION LAVAGE&DRAINAGE,2460.0,1599.0,1.1,9440.12,144
HCPCS,29843,WRIST ARTHROSCOPY/SURGERY,,,2808.13,3405.12,20
HCPCS,29843,Wrist arthroscopy/surgery,,,1831.46,2120.64,8
HCPCS,29844,ARTHROSCOPY WRIST SURGICAL SYNOVECTOMY PARTIAL,2604.0,1692.6,1.1,9440.12,144
HCPCS,29844,WRIST ARTHROSCOPY/SURGERY,,,2808.13,3405.12,20
HCPCS,29844,Wrist arthroscopy/surgery,,,1831.46,2120.64,8
HCPCS,29845,ARTHROSCOPY WRIST SURGICAL SYNOVECTOMY COMPLETE,3076.0,1999.4,1.1,9440.12,144
HCPCS,29845,WRIST ARTHROSCOPY/SURGERY,,,2808.13,7624.0,21
HCPCS,29845,Wrist arthroscopy/surgery,,,1831.46,2120.64,8
HCPCS,29846,ARTHRS WRST EXC&/RPR TRIANG FIBROCART&/JOINT,2756.0,1791.4,1.1,9440.12,144
HCPCS,29846,WRIST ARTHROSCOPY/SURGERY,,,2808.13,7813.0,22
HCPCS,29846,Wrist arthroscopy/surgery,,,1831.46,2120.64,8
HCPCS,29847,ARTHROSCOPY WRIST SURG INT FIXJ FX/INSTABILITY,2888.0,1877.2,1.1,20863.78,144
HCPCS,29847,WRIST ARTHROSCOPY/SURGERY,,,6206.54,7551.43,20
HCPCS,29847,Wrist arthroscopy/surgery,,,4348.01,5034.54,8
HCPCS,29848,NDSC WRST SURG W/RLS TRANSVRS CARPL LIGM,2556.0,1661.4,1.1,4686.39,144
HCPCS,29848,WRIST ENDOSCOPY/SURGERY,,,1394.34,33436.0,24
HCPCS,29848,Wrist endoscopy/surgery,,,1831.46,2120.64,8
HCPCS,29850,ARTHROSCOPY AID TX SPINE&/FX KNEE W/O FIXJ,3308.0,2150.2,1.1,4686.39,144
HCPCS,29850,KNEE ARTHROSCOPY/SURGERY,,,1394.34,1673.41,20
HCPCS,29850,Knee arthroscopy/surgery,,,1831.46,2120.64,8
HCPCS,29851,ARTHROSCOPY AID TX SPINE&/FX KNEE W/FIXJ,5304.0,3447.6,1.1,5304.0,144
HCPCS,29851,KNEE ARTHROSCOPY/SURGERY,,,1394.34,1673.41,20
HCPCS,29851,Knee arthroscopy/surgery,,,1831.46,2120.64,8
HCPCS,29855,ARTHRS AID TIBIAL FRACTURE PROXIMAL UNICONDYLAR,4304.0,2797.6,1.1,20863.78,144
HCPCS,29855,TIBIAL ARTHROSCOPY/SURGERY,,,6206.54,7551.43,20
HCPCS,29855,Tibial arthroscopy/surgery,,,4348.01,5034.54,8
HCPCS,29856,ARTHRS AID TIBIAL FX PROX UNICONDYLAR BICONDYLAR,5712.0,3712.8,1.1,38384.94,144
HCPCS,29856,TIBIAL ARTHROSCOPY/SURGERY,,,11418.01,13361.02,20
HCPCS,29856,Tibial arthroscopy/surgery,,,4348.01,5034.54,8
HCPCS,29860,ARTHROSCOPY HIP DIAGNOSTIC W/WO SYNOVIAL BYP SPX,3600.0,2340.0,1.1,20863.78,144
HCPCS,29860,HIP ARTHROSCOPY DX,,,6206.54,7551.43,20
HCPCS,29860,Hip arthroscopy dx,,,4348.01,5034.54,8
HCPCS,29861,ARTHROSCOPY HIP SURGICAL W/REMOVAL LOOSE/FB,4040.0,2626.0,1.1,20863.78,144
HCPCS,29861,HIP ARTHRO W/FB REMOVAL,,,6206.54,7551.43,20
HCPCS,29861,Hip arthro w/fb removal,,,1831.46,2120.64,8
HCPCS,29862,ARTHRS HIP DEBRIDEMENT/SHAVING ARTICULAR CRTLG,4468.0,2904.2,1.1,20863.78,144
HCPCS,29862,HIP ARTHR0 W/DEBRIDEMENT,,,6206.54,7551.43,20
HCPCS,29862,Hip arthr0 w/debridement,,,4348.01,5034.54,8
HCPCS,29863,ARTHROSCOPY HIP SURGICAL W/SYNOVECTOMY,4915.0,3194.75,1.1,9440.12,144
HCPCS,29863,HIP ARTHR0 W/SYNOVECTOMY,,,2808.13,3405.12,20
HCPCS,29863,Hip arthr0 w/synovectomy,,,1831.46,2120.64,8
HCPCS,29866,ARTHROSCOPY KNEE OSTEOCHONDRAL AGRFT MOSAICPLAST,5868.0,3814.2,1.1,20863.78,144
HCPCS,29866,AUTGRFT IMPLNT KNEE W/SCOPE,,,6206.54,7551.43,20
HCPCS,29866,Autgrft implnt knee w/scope,,,4348.01,5034.54,8
HCPCS,29867,ALLGRFT IMPLNT KNEE W/SCOPE,,,11418.01,13361.02,20
HCPCS,29867,ARTHROSCOPY KNEE OSTEOCHONDRAL ALLOGRAFT,7356.0,4781.4,1.1,38384.94,144
HCPCS,29867,Allgrft implnt knee w/scope,,,4348.01,5034.54,8
HCPCS,29868,ARTHROSCOPY KNEE MENISCAL TRNSPLJ MED/LAT,10040.0,6526.0,1.1,20863.78,144
HCPCS,29868,MENISCAL TRNSPL KNEE W/SCPE,,,6206.54,7551.43,20
HCPCS,29868,Meniscal trnspl knee w/scpe,,,4348.01,5034.54,8
HCPCS,29870,ARTHROSCOPY KNEE DIAGNOSTIC W/WO SYNOVIAL BX SPX,8604.5,5592.925,0.01,14925.0,302
HCPCS,29870,DX KNEE ARTHROSCOPY MI EYE,2284.0,1484.6,1.1,2284.0,70
HCPCS,29871,ARTHROSCOPY KNEE INFECTION LAVAGE & DRAINAGE,2944.0,1913.6,1.1,9440.12,144
HCPCS,29871,ARTHRS KNEE SURG FOR INFCTJ,,,2808.13,3405.12,20
HCPCS,29871,Arthrs knee surg for infctj,,,1831.46,2120.64,8
HCPCS,29873,ARTHRS KNEE SURG W/LAT RLS,,,2808.13,3405.12,20
HCPCS,29873,ARTHRS KNEE W LAT RELEASE,2746.0,1784.9,1.1,9440.12,144
HCPCS,29873,Arthrs knee surg w/lat rls,,,1831.46,2120.64,8
HCPCS,29874,ARTHROSCOPY KNEE REMOVAL LOOSE/FOREIGN BODY,3164.0,2056.6,1.1,9440.12,144
HCPCS,29874,ARTHRS KNEE SURG RMV LOOS/FB,,,2808.13,7813.0,22
HCPCS,29874,Arthrs knee surg rmv loos/fb,,,1831.46,2120.64,8
HCPCS,29875,ARTHROSCOPY KNEE SYNOVECTOMY LIMITED SPX,2838.0,1844.7,1.1,9440.12,144
HCPCS,29875,ARTHRS KNEE SURG SYNVCT LMTD,,,2808.13,3405.12,20
HCPCS,29875,Arthrs knee surg synvct lmtd,,,1831.46,2120.64,8
HCPCS,29876,ARTHROSCOPY KNEE SYNOVECTOMY 2/>COMPARTMENTS,3548.0,2306.2,1.1,9440.12,144
HCPCS,29876,ARTHRS KNEE SURG SYNVCT MAJ,,,2808.13,7624.0,21
HCPCS,29876,Arthrs knee surg synvct maj,,,1831.46,2120.64,8
HCPCS,29877,ARTHRS KNEE DEBRIDEMENT/SHAVING ARTCLR CRTLG,3652.0,2373.8,1.1,9440.12,144
HCPCS,29877,ARTHRS KNEE SURG DBRDMT/SHVG,,,2808.13,10789.0,22
HCPCS,29877,Arthrs knee surg dbrdmt/shvg,,,1831.46,2120.64,8
HCPCS,29879,ARTHRS KNE SRG ABRASJ ARTHRP,,,2808.13,7813.0,22
HCPCS,29879,ARTHRS KNEE ABRASION ARTHRP/MLT DRLG/MICROFX,3596.0,2337.4,1.1,9440.12,144
HCPCS,29879,Arthrs kne srg abrasj arthrp,,,1831.46,2120.64,8
HCPCS,29880,ARTHRS KNE SRG MNISECTMY M&L,,,2808.13,10789.0,22
HCPCS,29880,ARTHRS KNEE W/MENISCECTOMY MED&LAT W/SHAVING,3252.0,2113.8,1.1,9440.12,144
HCPCS,29880,Arthrs kne srg mnisectmy m&l,,,1831.46,2120.64,8
HCPCS,29881,ARTHRS KNE SRG MNISECTMY M/L,,,2808.13,10789.0,24
HCPCS,29881,ARTHRS KNE SURG W/MENISCECTOMY MED/LAT W/SHVG,3093.0,2010.45,1.1,9440.12,144
HCPCS,29881,Arthrs kne srg mnisectmy m/l,,,1831.46,2120.64,8
HCPCS,29882,ARTHROSCOPY KNEE W/MENISCUS RPR MEDIAL/LATERAL,4224.0,2745.6,1.1,9440.12,144
HCPCS,29882,ARTHRS KNE SRG MNISC RPR M/L,,,2808.13,7813.0,24
HCPCS,29882,Arthrs kne srg mnisc rpr m/l,,,1831.46,2120.64,8
HCPCS,29883,ARTHROSCOPY KNEE W/MENISCUS RPR MEDIAL&LATERAL,4708.0,3060.2,1.1,9440.12,144
HCPCS,29883,ARTHRS KNE SRG MNISC RPR M&L,,,2808.13,3405.12,20
HCPCS,29883,Arthrs kne srg mnisc rpr m&l,,,1831.46,2120.64,8
HCPCS,29884,ARTHROSCOPY KNEE W/LYSIS ADHESIONS W/WO MANJ SPX,3312.0,2152.8,1.1,9440.12,144
HCPCS,29884,ARTHRS KNEE SURG LYSIS ADS,,,2808.13,3405.12,20
HCPCS,29884,Arthrs knee surg lysis ads,,,1831.46,2120.64,8
HCPCS,29885,ARTHRS KNE SRG DRLG OST DISS,,,6206.54,7551.43,20
HCPCS,29885,ARTHRS KNEE DRILL OSTEOCHONDRITIS DISSECANS GRFG,4084.0,2654.6,1.1,20863.78,144
HCPCS,29885,Arthrs kne srg drlg ost diss,,,4348.01,5034.54,8
HCPCS,29886,ARTHRS KNEE DRILLING OSTEOCHOND DISSECANS LESION,3736.0,2428.4,1.1,9440.12,144
HCPCS,29886,ARTHRS KNEE SURG DRLG OD LES,,,2808.13,7624.0,21
HCPCS,29886,Arthrs knee surg drlg od les,,,1831.46,2120.64,8
HCPCS,29887,ARTHRS KNEE DRLG OSTEOCHOND DISSECANS INT FIXJ,4064.0,2641.6,1.1,20863.78,144
HCPCS,29887,ARTHRS KNEE SRG DRLG OD FIXJ,,,6206.54,7813.0,21
HCPCS,29887,Arthrs knee srg drlg od fixj,,,4348.01,5034.54,8
HCPCS,29888,ARTHRS AID ACL RPR/AGMNTJ,,,5597.0,11170.0,24
HCPCS,29888,ARTHRS AIDED ANT CRUCIATE LIGM RPR/AGMNTJ/RCNSTJ,6292.0,4089.8,1.1,20863.78,144
HCPCS,29888,Arthrs aid acl rpr/agmntj,,,4348.01,5034.54,8
HCPCS,29889,ARTHRS AID PCL RPR/AGMNTJ,,,11418.01,13361.02,20
HCPCS,29889,ARTHRS AIDED PST CRUCIATE LIGM RPR/AGMNTJ/RCNSTJ,6964.0,4526.6,1.1,38384.94,144
HCPCS,29889,Arthrs aid pcl rpr/agmntj,,,4348.01,5034.54,8
HCPCS,29891,ARTHR ANK OSTCHN DF TAL&/TIB,,,2808.13,9457.0,21
HCPCS,29891,ARTHRS ANKLE EXC OSTCHNDRL DFCT W/DRLG DFCT,3868.0,2514.2,1.1,9440.12,144
HCPCS,29891,Arthr ank ostchn df tal&/tib,,,1831.46,2120.64,8
HCPCS,29892,ARTHRS AID RPR LES/TALAR DOME FX/TIBL PLAFOND FX,4108.0,2670.2,1.1,20863.78,144
HCPCS,29892,ARTHRS AID RPR OD LES/TIB FX,,,6206.54,7551.43,20
HCPCS,29892,Arthrs aid rpr od les/tib fx,,,4348.01,5034.54,8
HCPCS,29893,ENDOSCOPIC PLANTAR FASCIOTOMY,2528.0,1643.2,1.1,9440.12,148
HCPCS,29893,ENDOSCOPIC PLANTR FASCIOTOMY,,,2808.13,3405.12,20
HCPCS,29893,Endoscopic plantr fasciotomy,,,1754.89,2031.98,8
HCPCS,29894,ANKLE ARTHROSCOPY/SURGERY,,,2808.13,3405.12,20
HCPCS,29894,ARTHROSCOPY ANKLE W/REMOVAL LOOSE/FOREIGN BODY,2940.0,1911.0,1.1,9440.12,144
HCPCS,29894,Ankle arthroscopy/surgery,,,1831.46,2120.64,8
HCPCS,29895,ANKLE ARTHROSCOPY/SURGERY,,,2808.13,7624.0,21
HCPCS,29895,ARTHROSCOPY ANKLE SURGICAL SYNOVECTOMY PARTIAL,2852.0,1853.8,1.1,9440.12,144
HCPCS,29895,Ankle arthroscopy/surgery,,,1831.46,2120.64,8
HCPCS,29897,ANKLE ARTHROSCOPY/SURGERY,,,2808.13,7624.0,21
HCPCS,29897,ARTHROSCOPY ANKLE SURGICAL DEBRIDEMENT LIMITED,2928.0,1903.2,1.1,9440.12,144
HCPCS,29897,Ankle arthroscopy/surgery,,,1831.46,2120.64,8
HCPCS,29898,ANKLE ARTHROSCOPY/SURGERY,,,2808.13,7778.0,22
HCPCS,29898,ARTHROSCOPY ANKLE SURGICAL DEBRIDEMENT EXTENSIVE,3736.0,2428.4,1.1,9440.12,144
HCPCS,29898,Ankle arthroscopy/surgery,,,1831.46,2120.64,8
HCPCS,29899,ANKLE ARTHROSCOPY/SURGERY,,,6206.54,7551.43,20
HCPCS,29899,ARTHRS ANKLE W ARTHRODESIS,6164.0,4006.6,1.1,20863.78,144
HCPCS,29899,Ankle arthroscopy/surgery,,,4348.01,5034.54,8
HCPCS,29900,MCP JOINT ARTHROSCOPY DX,,,2808.13,3405.12,20
HCPCS,29900,Mcp joint arthroscopy dx,,,1831.46,2120.64,8
HCPCS,29901,MCP JOINT ARTHROSCOPY SURG,,,2808.13,3405.12,20
HCPCS,29901,Mcp joint arthroscopy surg,,,1831.46,2120.64,8
HCPCS,29902,MCP JOINT ARTHROSCOPY SURG,,,1394.34,1673.41,20
HCPCS,29902,Mcp joint arthroscopy surg,,,1831.46,2120.64,8
HCPCS,29904,SUBTALAR ARTHRO W/FB RMVL,,,2808.13,3405.12,20
HCPCS,29904,Subtalar arthro w/fb rmvl,,,1831.46,2120.64,8
HCPCS,29905,ARTHROSCOPY SUBTALAR JOINT WITH SYNOVECTOMY,3672.0,2386.8,1.1,20863.78,144
HCPCS,29905,SUBTALAR ARTHRO W/EXC,,,6206.54,7551.43,20
HCPCS,29905,Subtalar arthro w/exc,,,1831.46,2120.64,8
HCPCS,29906,ARTHROSCOPY SUBTALAR JOINT WITH DEBRIDEMENT,3860.0,2509.0,1.1,9440.12,144
HCPCS,29906,SUBTALAR ARTHRO W/DEB,,,2808.13,3405.12,20
HCPCS,29906,Subtalar arthro w/deb,,,1831.46,2120.64,8
HCPCS,29907,ARTHROSCOPY SUBTALAR JOINT SUBTALAR ARTHRODESIS,4872.0,3166.8,1.1,38384.94,144
HCPCS,29907,SUBTALAR ARTHRO W/FUSION,,,11418.01,13361.02,20
HCPCS,29907,Subtalar arthro w/fusion,,,4348.01,5034.54,8
HCPCS,29914,ARTHROSCOPY HIP W/FEMOROPLASTY,6455.0,4195.75,1.1,20863.78,144
HCPCS,29914,HIP ARTHRO W/FEMOROPLASTY,,,6206.54,7551.43,20
HCPCS,29914,Hip arthro w/femoroplasty,,,4348.01,5034.54,8
HCPCS,29915,ARTHROSCOPY HIP W/ACETABULOPLASTY,6000.0,3900.0,1.1,20863.78,144
HCPCS,29915,HIP ARTHRO ACETABULOPLASTY,,,6206.54,7551.43,20
HCPCS,29915,Hip arthro acetabuloplasty,,,4348.01,5034.54,8
HCPCS,29916,ARTHROSCOPY HIP W/LABRAL REPAIR,6000.0,3900.0,1.1,20863.78,144
HCPCS,29916,HIP ARTHRO W/LABRAL REPAIR,,,6206.54,7551.43,20
HCPCS,29916,Hip arthro w/labral repair,,,4348.01,5034.54,8
HCPCS,29999,ARTHR EXC CYCLOP KNEE,4000.0,2600.0,0.01,4000.0,84
HCPCS,29999,ARTHRO REMOVAL CALC DEPOS,5591.0,3634.15,0.01,5591.0,84
HCPCS,29999,ARTHROSCOPIC AC JOINT RECONSTRUCTION (COMP CODE 23462),6288.0,4087.2,0.01,6288.0,84
HCPCS,29999,ARTHROSCOPIC BONE EXCISION WITH GRAFTING (COMP CODE 27360),4584.0,2979.6,0.01,4584.0,84
HCPCS,29999,ARTHROSCOPIC CORACOPLASTY SHOULDER (COMP CODE 23182),3444.0,2238.6,0.01,3444.0,84
HCPCS,29999,ARTHROSCOPIC DENERVATION,927.0,602.55,0.01,927.0,84
HCPCS,29999,ARTHROSCOPIC EXCISION OF MENISCAL CYST OF THE KNEE (COMP CODE 29,2838.0,1844.7,0.01,2838.0,84
HCPCS,29999,ARTHROSCOPIC GLUTEUS MEDIUS REPAIR,2600.0,1690.0,0.01,2600.0,84
HCPCS,29999,ARTHROSCOPIC ILIOPSOAS RELEASE (COMP 27036),4745.0,3084.25,0.01,4745.0,84
HCPCS,29999,ARTHROSCOPIC MCL RECONSTRUCTION,4821.0,3133.65,0.01,4821.0,84
HCPCS,29999,ARTHROSCOPIC REMOVAL GLENOID COMPONENT,2816.0,1830.4,0.01,2816.0,84
HCPCS,29999,ARTHROSCOPIC REMOVAL OF IMPLANT (COMP CODE 20680),2622.0,1704.3,0.01,2622.0,84
HCPCS,29999,ARTHROSCOPIC REMPLISSAGE REPAIR (COMP CODE 29827),5613.0,3648.45,0.01,5613.0,84
HCPCS,29999,ARTHROSCOPIC REPAIR GREATER TUBEROSITY FRACTURE (COMP TO 29827),5145.0,3344.25,0.01,5145.0,84
HCPCS,29999,ARTHROSCOPIC SUPERIOR CAPSULAR RECONSTRUCTION (COMP 29827),5145.0,3344.25,0.01,5145.0,84
HCPCS,29999,ARTHROSCOPIC TENOTOMY (COMP CODE 23405),3416.0,2220.4,0.01,3416.0,84
HCPCS,29999,ARTHROSCOPIC TROCHANTERIC BURSECTOMY,1898.0,1233.7,0.01,1898.0,84
HCPCS,29999,ARTHROSCOPIC TROCHANTERIC BURSECTOMY (COMP CODE 27062),1898.0,1233.7,0.01,1898.0,84
HCPCS,29999,ARTHROSCOPICALLY AIDED CARPAL DECOMPRESSION/BONE DRILLING (COMP,3060.0,1989.0,0.01,3060.0,84
HCPCS,29999,ARTHROSCOPY KNEE MEDIAL RELEASE,3132.0,2035.8,0.01,3132.0,84
HCPCS,29999,ARTHROSCOPY KNEE SUBCHONDROPLAST,4193.0,2725.45,0.01,4193.0,84
HCPCS,29999,ARTHROSCOPY SHOULDER - BALLOON SPACER IMPLANTATION (COMP CODE 29,3432.0,2230.8,0.01,3432.0,84
HCPCS,29999,ARTHROSCOPY;PARTIAL REMVAL SCAPULA,1711.0,1112.15,0.01,1711.0,84
HCPCS,29999,ARTHROSCOPY;RELEASE BICEPS TENDONS,2256.0,1466.4,0.01,2256.0,84
HCPCS,29999,DEBRIDE LIGAMENTUM TERES; SCOPE,1940.0,1261.0,0.01,1940.0,84
HCPCS,29999,ENDOSCOPIC ILIOPSOAS TENDON RELEASE (COMP CODE 29862),4468.0,2904.2,0.01,4468.0,84
HCPCS,29999,EXCISE GANGLION KNEE; SCOPE,2221.0,1443.65,0.01,2221.0,84
HCPCS,29999,GLENOID FX ; INTERNAL FIXATION SCOPE,4696.0,3052.4,0.01,4696.0,84
HCPCS,29999,ILIOPSOAS TENDON RELEASE; SCOPE (COMP 27306),2356.0,1531.4,0.01,2356.0,84
HCPCS,29999,"KNEE DEBRIDEMENT TENDON/MUSCLE, SCOPE",4151.0,2698.15,0.01,4151.0,84
HCPCS,29999,SCOPE HETEROTOPIC OSSIFI EXCISION,4089.0,2657.85,0.01,4089.0,84
HCPCS,29999,TENOTOMY OF HIP FLEXORS (COMP CODE 27005),4330.0,2814.5,0.01,4330.0,84
HCPCS,29999,"UNLISTED PROC, ARTHROSCOPIC ULNAR WAFER PROC (REMOVING APPROX 2M",1752.0,1138.8,0.01,1752.0,84
HCPCS,29999,UNLISTED PX ARTHROSCOPY,,,204.59,615.65,21
HCPCS,29999,Unlisted px arthroscopy,,,1831.46,2120.64,8
HCPCS,30000,DRAINAGE ABSCESS/HEMATOMA NASAL INT APPROACH,830.0,539.5,0.01,12500.0,322
HCPCS,30020,"DRAIN ABSCESS/HEMATOMA,NASAL SEPTUM",592.0,384.8,1.1,1603.96,148
HCPCS,30020,DRAINAGE ABSCESS/HEMATOMA NASAL SEPTUM,2343.0,1522.95,0.01,12500.0,174
HCPCS,3006F,CXR DOC REV,,,1.23,1.23,1
HCPCS,3006F,Cxr doc rev,,,10.69,12.38,8
HCPCS,3008F,BODY MASS INDEX DOCD,,,0.03,0.03,1
HCPCS,3008F,Body mass index docd,,,10.69,12.38,8
HCPCS,30100,BIOPSY INTRANASAL,6814.0,4429.1,0.01,6814.0,87
HCPCS,30100,"BIOPSY,INTRANASAL",376.0,244.4,1.1,4447.63,148
HCPCS,30110,EXCISION NASAL POLYP SIMPLE,6814.0,4429.1,0.01,6814.0,87
HCPCS,30110,"EXCISION NOSE POLYP(S),SIMPLE",672.0,436.8,1.1,4447.63,148
HCPCS,30115,"EXCISION NOSE POLYP(S),EXTENSIVE",1776.0,1154.4,1.1,9391.15,144
HCPCS,30115,REMOVAL OF NOSE POLYP(S),,,2793.19,3450.35,20
HCPCS,30115,Removal of nose polyp(s),,,939.63,1087.99,8
HCPCS,30117,"EXCIS INTRANASAL LESN,INTERN APPRCH",1564.0,1016.6,1.1,9391.15,148
HCPCS,30117,EXCISION/DESTRUCTION INTRANASAL LESION INT APPR,14918.0,9696.7,0.01,14918.0,87
HCPCS,30118,"EXCIS INTRANASAL LESN,EXT APPRCH",3100.0,2015.0,1.1,9391.15,144
HCPCS,30118,REMOVAL OF INTRANASAL LESION,,,2793.19,3450.35,20
HCPCS,30118,Removal of intranasal lesion,,,1558.4,1804.46,8
HCPCS,3011F,LIPID PANEL DOC REV,,,0.03,0.03,1
HCPCS,3011F,Lipid panel doc rev,,,10.69,12.38,8
HCPCS,30120,EXCISION/SURGICAL PLANING SKIN NOSE RHINOPHYMA,8537.0,5549.05,0.01,14918.0,235
HCPCS,30124,EXCISION DERMOID CYST NOSE SIMPLE SUBCUTANEOUS,1280.0,832.0,1.1,4447.63,144
HCPCS,30124,REMOVAL OF NOSE LESION,,,1323.06,1614.71,20
HCPCS,30124,Removal of nose lesion,,,939.63,1087.99,8
HCPCS,30125,EXC DERMOID CYST NOSE COMPLEX UNDER BONE/CRTLG,2920.0,1898.0,1.1,17080.38,144
HCPCS,30125,REMOVAL OF NOSE LESION,,,5080.55,6160.68,20
HCPCS,30125,Removal of nose lesion,,,939.63,1087.99,8
HCPCS,30130,EXCISE INFERIOR TURBINATE,,,2793.19,7813.0,22
HCPCS,30130,EXCISION INFERIOR TURBINATE PARTIAL/COMPLETE,1527.0,992.55,1.1,9391.15,144
HCPCS,30130,Excise inferior turbinate,,,2059.35,2384.51,8
HCPCS,30140,RESECT INFERIOR TURBINATE,,,2793.19,6238.0,25
HCPCS,30140,Resect inferior turbinate,,,2059.35,2384.51,8
HCPCS,30140,SUBMUCOUS RESCJ INFERIOR TURBINATE PRTL/COMPL,1320.0,858.0,1.1,9391.15,148
HCPCS,3014F,SCREEN MAMMO DOC REV,,,0.03,0.03,1
HCPCS,3014F,Screen mammo doc rev,,,10.69,12.38,8
HCPCS,30150,RHINECTOMY PARTIAL,3820.0,2483.0,1.1,17080.38,164
HCPCS,30150,Rhinectomy partial,,,4527.92,5242.85,8
HCPCS,3015F,CERV CANCER SCREEN DOCD,,,0.03,0.03,1
HCPCS,3015F,Cerv cancer screen docd,,,10.69,12.38,8
HCPCS,30160,RHINECTOMY TOTAL,3996.0,2597.4,1.1,17080.38,164
HCPCS,30160,Rhinectomy total,,,4527.92,5242.85,8
HCPCS,3016F,PT SCRND UNHLTHY OH USE,,,0.03,0.03,1
HCPCS,3016F,Pt scrnd unhlthy oh use,,,10.69,12.38,8
HCPCS,3017F,COLORECTAL CA SCREEN DOC REV,,,0.03,0.03,1
HCPCS,3017F,Colorectal ca screen doc rev,,,10.69,12.38,8
HCPCS,3018F,PRE-PRXD RSK ET AL DOCD,,,2739849.3,2739849.3,1
HCPCS,3018F,Pre-prxd rsk et al docd,,,10.69,12.38,8
HCPCS,3019F,LVEF ASSESS PLANPOST DSCHRGE,,,2739849.3,2739849.3,1
HCPCS,3019F,Lvef assess planpost dschrge,,,10.69,12.38,8
HCPCS,30200,INJECTION TURBINATE THERAPEUTIC,1327.5,862.875,0.01,2351.0,235
HCPCS,3020F,LVF ASSESS,,,2739849.3,2739849.3,1
HCPCS,3020F,Lvf assess,,,10.69,12.38,8
HCPCS,30210,NASAL SINUS THERAPY,,,1323.06,3981.36,21
HCPCS,30210,Nasal sinus therapy,,,107.64,124.64,8
HCPCS,3021F,LVEF MOD/SEVER DEPRS SYST,,,0.03,0.03,1
HCPCS,3021F,Lvef mod/sever deprs syst,,,10.69,12.38,8
HCPCS,30220,INSERTION NASAL SEPTAL PROSTHESIS BUTTON,3725.0,2421.25,0.01,7813.0,235
HCPCS,3022F,LVEF >=40% SYSTOLIC,,,2739849.3,2739849.3,1
HCPCS,3022F,Lvef >=40% systolic,,,10.69,12.38,8
HCPCS,3023F,SPIROM DOC REV,,,0.03,0.03,1
HCPCS,3023F,Spirom doc rev,,,10.69,12.38,8
HCPCS,3025F,SPIROM FEV/FVC <70% W/COPD,,,0.03,0.03,1
HCPCS,3025F,Spirom fev/fvc <70% w/copd,,,10.69,12.38,8
HCPCS,3027F,SPIROM FEV/FVC>=70%/W/OCOPD,,,0.03,0.03,1
HCPCS,3027F,Spirom fev/fvc>=70%/w/ocopd,,,10.69,12.38,8
HCPCS,3028F,O2 SATURATION DOC REV,,,0.03,0.03,1
HCPCS,3028F,O2 saturation doc rev,,,10.69,12.38,8
HCPCS,30300,REMOVAL FOREIGN BODY INTRANASAL OFFICE PROCEDURE,536.5,348.725,0.01,12500.0,321
HCPCS,30310,REMOVAL FOREIGN BODY INTRANASAL GENERAL ANES,7861.0,5109.650000000001,1.1,14918.0,231
HCPCS,30320,REMOVE NASAL FOREIGN BODY,,,1323.06,1614.71,20
HCPCS,30320,Remove nasal foreign body,,,939.63,1087.99,8
HCPCS,3035F,O2 SATURATION<=88%/PAO<=55,,,12.33,12.33,1
HCPCS,3035F,O2 saturation<=88%/pao<=55,,,10.69,12.38,8
HCPCS,3037F,O2 SATURATION >88%/PAO>55 HG,,,2739849.3,2739849.3,1
HCPCS,3037F,O2 saturation >88%/pao>55 hg,,,10.69,12.38,8
HCPCS,3038F,PULM FX W/IN 12 MON B/4 SURG,,,2739849.3,2739849.3,1
HCPCS,3038F,Pulm fx w/in 12 mon b/4 surg,,,10.69,12.38,8
HCPCS,30400,RECONSTRUCTION OF NOSE,,,5080.55,10789.0,21
HCPCS,30400,RHINOPLASTY (TIP) - COMPLEX,6200.0,4030.0,1.1,17080.38,142
HCPCS,30400,RHINOPLASTY (TIP) - MODERATE,5650.0,3672.5,1.1,17080.38,142
HCPCS,30400,RHINOPLASTY (TIP) - SIMPLE,5170.0,3360.5,1.1,17080.38,142
HCPCS,30400,RHINOPLASTY REVISION - HNI ONLY,1061.0,689.65,1.1,17080.38,142
HCPCS,30400,RHINP PRIM LAT&ALAR CRTLGS&/ELVTN NASAL TI,4778.0,3105.7,1.1,17080.38,142
HCPCS,30400,Reconstruction of nose,,,2059.35,2384.51,8
HCPCS,3040F,FEV <40% PREDICTED VALUE,,,2739849.3,2739849.3,1
HCPCS,3040F,Fev <40% predicted value,,,10.69,12.38,8
HCPCS,30410,RECONSTRUCTION OF NOSE,,,5080.55,6160.68,20
HCPCS,30410,RHINOPLASTY (FULL) - COMPLEX,10000.0,6500.0,1.1,17080.38,142
HCPCS,30410,RHINOPLASTY (FULL) - MODERATE,8150.0,5297.5,1.1,17080.38,142
HCPCS,30410,RHINOPLASTY (FULL) - SIMPLE,6340.0,4121.0,1.1,17080.38,142
HCPCS,30410,RHINP PRIM COMPLETE XTRNL PARTS,5600.0,3640.0,1.1,17080.38,142
HCPCS,30410,Reconstruction of nose,,,4527.92,5242.85,8
HCPCS,30420,RECONSTRUCTION OF NOSE,,,5080.55,13821.0,23
HCPCS,30420,RHINOPLASTY PRIMARY W/MAJOR SEPTAL REPAIR,6760.0,4394.0,1.1,17080.38,144
HCPCS,30420,Reconstruction of nose,,,4527.92,5242.85,8
HCPCS,3042F,FEV >=40% PREDICTED VALUE,,,2739849.3,2739849.3,1
HCPCS,3042F,Fev >=40% predicted value,,,10.69,12.38,8
HCPCS,30430,REVISION OF NOSE,,,5080.55,6160.68,20
HCPCS,30430,RHINOPLASTY REVISION MINOR - COMPLEX,4500.0,2925.0,1.1,17080.38,142
HCPCS,30430,RHINOPLASTY REVISION MINOR - MODERATE,3000.0,1950.0,1.1,17080.38,142
HCPCS,30430,RHINOPLASTY REVISION MINOR - SIMPLE,1500.0,975.0,1.1,17080.38,142
HCPCS,30430,RHINOPLASTY SECONDARY MINOR REVISION,3296.0,2142.4,1.1,17080.38,142
HCPCS,30430,Revision of nose,,,1558.4,1804.46,8
HCPCS,30435,REVISION OF NOSE,,,5080.55,6160.68,20
HCPCS,30435,RHINOPLASTY REVISION INTERMEDIATE - COMPLEX,7500.0,4875.0,1.1,17080.38,142
HCPCS,30435,RHINOPLASTY REVISION INTERMEDIATE - MODERATE,5500.0,3575.0,1.1,17080.38,142
HCPCS,30435,RHINOPLASTY REVISION INTERMEDIATE - SIMPLE,3500.0,2275.0,1.1,17080.38,142
HCPCS,30435,RHINOPLASTY SECONDARY INTERMEDIATE REVISION,5601.0,3640.65,1.1,17080.38,142
HCPCS,30435,Revision of nose,,,4527.92,5242.85,8
HCPCS,3044F,HG A1C LEVEL LT 7.0%,,,0.03,0.03,1
HCPCS,3044F,Hg a1c level lt 7.0%,,,10.69,12.38,8
HCPCS,30450,REVISION OF NOSE,,,5080.55,8702.0,21
HCPCS,30450,RHINOPLASTY REVISION MAJOR - COMPLEX,15500.0,10075.0,1.1,17080.38,142
HCPCS,30450,RHINOPLASTY REVISION MAJOR - MODERATE,9500.0,6175.0,1.1,17080.38,142
HCPCS,30450,RHINOPLASTY REVISION MAJOR - SIMPLE,7260.0,4719.0,1.1,17080.38,142
HCPCS,30450,RHINOPLASTY SECONDARY MAJOR REVISION,7864.0,5111.6,1.1,17080.38,142
HCPCS,30450,Revision of nose,,,4527.92,5242.85,8
HCPCS,30460,REVISION OF NOSE,,,5080.55,6160.68,20
HCPCS,30460,RHINP DFRM W/COLUM LNGTH TIP ONLY,4128.0,2683.2,1.1,17080.38,144
HCPCS,30460,Revision of nose,,,4527.92,5242.85,8
HCPCS,30462,REVISION OF NOSE,,,5080.55,9509.0,21
HCPCS,30462,RHINP DFRM COLUM LNGTH TIP SEPTUM OSTEOT,8112.0,5272.8,1.1,17080.38,144
HCPCS,30462,Revision of nose,,,4527.92,5242.85,8
HCPCS,30465,NASAL VESTIBUL STENOS REPAIR,4944.0,3213.6,1.1,17080.38,144
HCPCS,30465,REPAIR NASAL STENOSIS,,,5080.55,33436.0,24
HCPCS,30465,Repair nasal stenosis,,,1558.4,1804.46,8
HCPCS,30468,RPR NSL VLV COLLAPSE SUBQ/SBMCSL LAT WALL IMPLT,14166.0,9207.9,1.1,27212.0,322
HCPCS,30469,RPR NSL VLV COLLAPSE LW NRG SUBQ/SBMCSL RMDLG,14094.0,9161.1,0.01,27212.0,235
HCPCS,3046F,HEMOGLOBIN A1C LEVEL >9.0%,,,0.03,0.03,1
HCPCS,3046F,Hemoglobin a1c level >9.0%,,,10.69,12.38,8
HCPCS,3048F,LDL-C <100 MG/DL,,,0.03,0.03,1
HCPCS,3048F,Ldl-c <100 mg/dl,,,10.69,12.38,8
HCPCS,3049F,LDL-C 100-129 MG/DL,,,0.03,0.03,1
HCPCS,3049F,Ldl-c 100-129 mg/dl,,,10.69,12.38,8
HCPCS,3050F,LDL-C >= 130 MG/DL,,,0.03,0.03,1
HCPCS,3050F,Ldl-c >= 130 mg/dl,,,10.69,12.38,8
HCPCS,3051F,HG A1C>EQUAL 7.0%<8.0%,,,0.03,0.03,1
HCPCS,3051F,Hg a1c>equal 7.0%<8.0%,,,10.69,12.38,8
HCPCS,30520,SEPTOPLASTY/SUBMUCOUS RESECJ W/WO CARTILAGE GRF,8861.0,5759.650000000001,0.01,14918.0,231
HCPCS,3052F,HG A1C>EQUAL 8.0%<EQUAL 9.0%,,,0.03,0.03,1
HCPCS,3052F,Hg a1c>equal 8.0%<equal 9.0%,,,10.69,12.38,8
HCPCS,30540,"REPAIR CHOANAL ATRESIA,INTRANASAL",3485.0,2265.25,1.1,17080.38,144
HCPCS,30540,RPR CHOANAL ATRESIA NTRANASL,,,5080.55,6160.68,20
HCPCS,30540,Rpr choanal atresia ntranasl,,,2710.76,3138.77,8
HCPCS,30545,"REPAIR CHOANAL ATRESIA,TRANSPALATIN",5113.0,3323.45,1.1,17080.38,144
HCPCS,30545,RPR CHOANAL ATRESIA TRSNPLTN,,,5080.55,6160.68,20
HCPCS,30545,Rpr choanal atresia trsnpltn,,,3314.27,3837.57,8
HCPCS,3055F,LVEF LESS THAN/EQUAL TO 35%,,,2739849.3,2739849.3,1
HCPCS,3055F,Lvef less than/equal to 35%,,,10.69,12.38,8
HCPCS,30560,LYSIS INTRANASAL SYNECHIA,1433.5,931.7750000000001,0.01,5265.0,235
HCPCS,3056F,LVEF GREATER THAN 35%,,,2739849.3,2739849.3,1
HCPCS,3056F,Lvef greater than 35%,,,10.69,12.38,8
HCPCS,30580,REPAIR FISTULA OROMAXILLARY,14982.0,9738.3,0.01,27212.0,235
HCPCS,30600,REPAIR FISTULA ORONASAL,2464.0,1601.6,1.1,17080.38,148
HCPCS,30600,REPAIR MOUTH/NOSE FISTULA,,,5080.55,6160.68,20
HCPCS,30600,Repair mouth/nose fistula,,,2710.76,3138.77,8
HCPCS,3060F,POS MICROALBUMINURIA REV,,,0.03,0.03,1
HCPCS,3060F,Pos microalbuminuria rev,,,10.69,12.38,8
HCPCS,3061F,NEG MICROALBUMINURIA REV,,,0.03,0.03,1
HCPCS,3061F,Neg microalbuminuria rev,,,10.69,12.38,8
HCPCS,30620,INTRANASAL RECONSTRUCTION,,,5080.55,6160.68,20
HCPCS,30620,Intranasal reconstruction,,,2710.76,3138.77,8
HCPCS,30620,SEPTAL/OTHER INTRANASAL DERMATOPLASTY,2464.0,1601.6,1.1,17080.38,144
HCPCS,3062F,POS MACROALBUMINURIA REV,,,0.03,0.03,1
HCPCS,3062F,Pos macroalbuminuria rev,,,10.69,12.38,8
HCPCS,30630,REPAIR NASAL SEPTAL PERFORATIONS,2916.0,1895.4,1.1,9391.15,144
HCPCS,30630,REPAIR NASAL SEPTUM DEFECT,,,2793.19,25635.0,22
HCPCS,30630,Repair nasal septum defect,,,2710.76,3138.77,8
HCPCS,3066F,NEPHROPATHY DOC TX,,,2739849.3,2739849.3,1
HCPCS,3066F,Nephropathy doc tx,,,10.69,12.38,8
HCPCS,3072F,LOW RISK FOR RETINOPATHY,,,0.03,0.03,1
HCPCS,3072F,Low risk for retinopathy,,,10.69,12.38,8
HCPCS,3073F,PRE-SURG EYE MEASURES DOCD,,,24.66,24.66,1
HCPCS,3073F,Pre-surg eye measures docd,,,10.69,12.38,8
HCPCS,3074F,SYST BP LT 130 MM HG,,,0.03,0.03,1
HCPCS,3074F,Syst bp lt 130 mm hg,,,10.69,12.38,8
HCPCS,3075F,SYST BP GE 130 - 139MM HG,,,0.03,0.03,1
HCPCS,3075F,Syst bp ge 130 - 139mm hg,,,10.69,12.38,8
HCPCS,3077F,SYST BP >= 140 MM HG,,,0.03,0.03,1
HCPCS,3077F,Syst bp >= 140 mm hg,,,10.69,12.38,8
HCPCS,3078F,DIAST BP <80 MM HG,,,0.03,0.03,1
HCPCS,3078F,Diast bp <80 mm hg,,,10.69,12.38,8
HCPCS,3079F,DIAST BP 80-89 MM HG,,,0.03,0.03,1
HCPCS,3079F,Diast bp 80-89 mm hg,,,10.69,12.38,8
HCPCS,30801,ABLTJ SOFT TIS INFERIOR TURBINATES UNI/BI SUPFC,3635.0,2362.75,0.01,6814.0,235
HCPCS,30802,ABLTJ SOF TISS INF TURBS UNI/BI SUPFC INTRAMURAL,3823.0,2484.9500000000003,0.01,6814.0,235
HCPCS,3080F,DIAST BP >= 90 MM HG,,,0.03,0.03,1
HCPCS,3080F,Diast bp >= 90 mm hg,,,10.69,12.38,8
HCPCS,3082F,KT/V <1.2,,,2739849.3,2739849.3,1
HCPCS,3082F,Kt/v <1.2,,,10.69,12.38,8
HCPCS,3083F,KT/V =/> 1.2 & <1.7,,,2739849.3,2739849.3,1
HCPCS,3083F,Kt/v =/> 1.2 & <1.7,,,10.69,12.38,8
HCPCS,3084F,KT/V >= 1.7,,,2739849.3,2739849.3,1
HCPCS,3084F,Kt/v >= 1.7,,,10.69,12.38,8
HCPCS,3085F,SUICIDE RISK ASSESSED,,,0.03,0.03,1
HCPCS,3085F,Suicide risk assessed,,,10.69,12.38,8
HCPCS,3088F,MDD MILD,,,1.23,1.23,1
HCPCS,3088F,Mdd mild,,,10.69,12.38,8
HCPCS,3089F,MDD MODERATE,,,2739849.3,2739849.3,1
HCPCS,3089F,Mdd moderate,,,10.69,12.38,8
HCPCS,30901,CONTROL NASAL HEMORRHAGE ANTERIOR SIMPLE,516.5,335.725,0.01,12500.0,321
HCPCS,30903,CONTROL NASAL HEMORRHAGE ANTERIOR COMPLEX,635.5,413.075,0.01,4392.0,322
HCPCS,30905,CTRL NSL HEMRRG PST NASAL PACKS&/CAUTERY 1ST,730.0,474.5,0.01,4392.0,322
HCPCS,30906,CTRL NSL HEMRRG PST NASAL PACKS&/CAUTERY SUBSQ,1073.0,697.45,1.1,4392.0,235
HCPCS,3090F,MDD SEVERE W/O PSYCH,,,2739849.3,2739849.3,1
HCPCS,3090F,Mdd severe w/o psych,,,10.69,12.38,8
HCPCS,30915,LIGATION ARTERIES ETHMOIDAL,2976.0,1934.4,1.1,9296.26,144
HCPCS,30915,LIGATION NASAL SINUS ARTERY,,,2765.32,3285.94,20
HCPCS,30915,Ligation nasal sinus artery,,,1244.56,1441.07,8
HCPCS,3091F,MDD SEVERE W/PSYCH,,,2739849.3,2739849.3,1
HCPCS,3091F,Mdd severe w/psych,,,10.69,12.38,8
HCPCS,30920,LIGATION ARTERIES INT MAXILLARY TRANSANTRAL,4902.0,3186.3,1.1,9296.26,144
HCPCS,30920,LIGATION UPPER JAW ARTERY,,,2765.32,3285.94,20
HCPCS,30920,Ligation upper jaw artery,,,1244.56,1441.07,8
HCPCS,3092F,MDD IN REMISSION,,,2739849.3,2739849.3,1
HCPCS,3092F,Mdd in remission,,,10.69,12.38,8
HCPCS,30930,FRACTURE NASAL INFERIOR TURBINATE THERAPEUTIC,7721.0,5018.650000000001,0.01,14918.0,231
HCPCS,3093F,DOC NEW DIAG 1ST/ADDL MDD,,,2739849.3,2739849.3,1
HCPCS,3093F,Doc new diag 1st/addl mdd,,,10.69,12.38,8
HCPCS,3095F,CENTRAL DEXA RESULTS DOCD,,,0.03,0.03,1
HCPCS,3095F,Central dexa results docd,,,10.69,12.38,8
HCPCS,3096F,CENTRAL DEXA ORDERED,,,2739849.3,2739849.3,1
HCPCS,3096F,Central dexa ordered,,,10.69,12.38,8
HCPCS,30999,BIL REPR NASAL VESTIB STEN W/POLY IMPLNT; LATERA (COMP 31295),1336.0,868.4,0.01,1336.0,84
HCPCS,30999,CRYOABLATION OF NASAL NERVE,1076.0,699.4,0.01,1076.0,84
HCPCS,30999,CRYOTHERPAY FOR RHINORRHEA,2372.0,1541.8,0.01,3443.0,85
HCPCS,30999,ENDOSCOPIC REMOVAL OF NASAL FOREIGN BODY?(COMP CODE 31238),1165.0,757.25,0.01,1165.0,84
HCPCS,30999,ENDOSCOPIC RESECTION OF NASAL LESION (COMP 30117),1076.0,699.4,0.01,1076.0,84
HCPCS,30999,EXCISION MIDDLE TURBINATE,1145.0,744.25,0.01,1145.0,84
HCPCS,30999,EXCISION OF MIDDLE TURBINATE (COMP 30130),1145.0,744.25,0.01,1145.0,84
HCPCS,30999,NASAL SURGERY PROCEDURE,1194.0,776.1,0.01,1194.0,84
HCPCS,30999,SEPTAL REPOSITIONING,926.0,601.9,0.01,3443.0,85
HCPCS,30999,UNLISTED PROC; CRYOABLATION THPY INTRANASAL NERVE(S) MULTIPLE (C,1076.0,699.4,0.01,1076.0,84
HCPCS,30999,UNLISTED PROC; NASAL SURG PROC (COMP TO 30465),4079.0,2651.35,0.01,4079.0,84
HCPCS,30999,UNLISTED PROCEDURE NOSE,926.0,601.9,211.91,3443.0,84
HCPCS,31000,LAVAGE CANNULATION MAXILLARY SINUS,774.0,503.1,0.01,12500.0,235
HCPCS,31002,IRRIGATION SPHENOID SINUS,,,1323.06,1614.71,20
HCPCS,31002,Irrigation sphenoid sinus,,,107.64,124.64,8
HCPCS,3100F,IMAGE TEST REF CAROT DIAM,,,0.03,0.03,1
HCPCS,3100F,Image test ref carot diam,,,10.69,12.38,8
HCPCS,31020,EXPLORATION MAXILLARY SINUS,,,2793.19,3450.35,20
HCPCS,31020,Exploration maxillary sinus,,,939.63,1087.99,8
HCPCS,31020,SINUSOTOMY MAXILLARY ANTROTOMY INTRANASAL,1228.0,798.2,1.1,9391.15,148
HCPCS,31030,EXPLORATION MAXILLARY SINUS,,,5080.55,6160.68,20
HCPCS,31030,Exploration maxillary sinus,,,2710.76,3138.77,8
HCPCS,31030,SINUSOTOMY MAXILLARY RAD W/O RMVL ANTROCH POLYPS,2404.0,1562.6,1.1,17080.38,148
HCPCS,31032,EXPLORE SINUS REMOVE POLYPS,,,5080.55,6160.68,20
HCPCS,31032,Explore sinus remove polyps,,,2710.76,3138.77,8
HCPCS,31032,SINUSOT MAX ANTRT RAD W/RMVL ANTROCH POLYPS,2676.0,1739.4,1.1,17080.38,144
HCPCS,31040,EXPLORATION BEHIND UPPER JAW,,,5080.55,6160.68,20
HCPCS,31040,Exploration behind upper jaw,,,4527.92,5242.85,8
HCPCS,31040,PTERYGOMAXILLARY FOSSA SURGERY ANY APPROACH,4299.0,2794.35,1.1,17080.38,144
HCPCS,31050,EXPLORATION SPHENOID SINUS,,,5080.55,6160.68,20
HCPCS,31050,Exploration sphenoid sinus,,,2710.76,3138.77,8
HCPCS,31050,SINUSOTOMY SPHENOID W/WO BIOPSY,2148.0,1396.2,1.1,17080.38,144
HCPCS,31051,SINUSOT SPHENOID W/MUCOSAL STRIPPING/RMVL POLYP,2900.0,1885.0,1.1,17080.38,144
HCPCS,31051,SPHENOID SINUS SURGERY,,,5080.55,6160.68,20
HCPCS,31051,Sphenoid sinus surgery,,,2710.76,3138.77,8
HCPCS,31070,EXPLORATION OF FRONTAL SINUS,,,5080.55,6160.68,20
HCPCS,31070,Exploration of frontal sinus,,,2710.76,3138.77,8
HCPCS,31070,SINUSOTOMY FRONTAL EXTERNAL SIMPLE,1760.0,1144.0,1.1,17080.38,142
HCPCS,31075,EXPLORATION OF FRONTAL SINUS,,,5080.55,6160.68,20
HCPCS,31075,Exploration of frontal sinus,,,2710.76,3138.77,8
HCPCS,31075,SINUSOTOMY FRONTAL TRANSORBITAL UNILATERAL,3804.0,2472.6,1.1,17080.38,144
HCPCS,31080,REMOVAL OF FRONTAL SINUS,,,5080.55,6160.68,20
HCPCS,31080,Removal of frontal sinus,,,3396.31,3932.57,8
HCPCS,31080,SINUSOTOMY FRNT OBLITERATIVE W/O FLAP BROW INC,5096.0,3312.4,1.1,17080.38,144
HCPCS,31081,REMOVAL OF FRONTAL SINUS,,,5080.55,6160.68,20
HCPCS,31081,Removal of frontal sinus,,,4527.92,5242.85,8
HCPCS,31081,SINUSOT FRNT OBLIT W/O OSTPL FLAP CORONAL INC,5676.0,3689.4,1.1,17080.38,144
HCPCS,31084,REMOVAL OF FRONTAL SINUS,,,5080.55,6160.68,20
HCPCS,31084,Removal of frontal sinus,,,2710.76,3138.77,8
HCPCS,31085,REMOVAL OF FRONTAL SINUS,,,5080.55,6160.68,20
HCPCS,31085,Removal of frontal sinus,,,3396.31,3932.57,8
HCPCS,31085,SINUSOT FRNT OBLIT W/OSTPL FLAP CORONAL INC,6256.0,4066.4,1.1,17080.38,144
HCPCS,31086,REMOVAL OF FRONTAL SINUS,,,5080.55,6160.68,20
HCPCS,31086,Removal of frontal sinus,,,3396.31,3932.57,8
HCPCS,31086,SINUSOT FRNT NONOBLIT W/OSTPL FLAP BROW INC,5744.0,3733.6,1.1,17080.38,144
HCPCS,31087,REMOVAL OF FRONTAL SINUS,,,5080.55,6160.68,20
HCPCS,31087,Removal of frontal sinus,,,2710.76,3138.77,8
HCPCS,31087,SINUSOT FRNT NONOBLIT W/OSTPL FLAP CORONAL INC,5828.0,3788.2,1.1,17080.38,144
HCPCS,31090,EXPLORATION OF SINUSES,,,5080.55,6160.68,20
HCPCS,31090,Exploration of sinuses,,,2710.76,3138.77,8
HCPCS,31090,SINUSOT UNI 3/> PARANSL SINUSES,4915.0,3194.75,1.1,17080.38,144
HCPCS,3110F,PRES/ABSN HMRHG/LESION DOCD,,,2739849.3,2739849.3,1
HCPCS,3110F,Pres/absn hmrhg/lesion docd,,,10.69,12.38,8
HCPCS,3111F,CT/MRI BRAIN DONE W/IN 24HRS,,,2739849.3,2739849.3,1
HCPCS,3111F,Ct/mri brain done w/in 24hrs,,,10.69,12.38,8
HCPCS,3112F,CT/MRI BRAIN DONE 24 HRS,,,2739849.3,2739849.3,1
HCPCS,3112F,Ct/mri brain done 24 hrs,,,10.69,12.38,8
HCPCS,3115F,QUANT RESULTS ACTIVITY &SYMP,,,2739849.3,2739849.3,1
HCPCS,3115F,Quant results activity &symp,,,10.69,12.38,8
HCPCS,3117F,HF ASSESSMENT TOOL COMPLETED,,,2739849.3,2739849.3,1
HCPCS,3117F,Hf assessment tool completed,,,10.69,12.38,8
HCPCS,3118F,NY HEART ASSOC CLASS DOCD,,,2739849.3,2739849.3,1
HCPCS,3118F,Ny heart assoc class docd,,,10.69,12.38,8
HCPCS,3119F,NO EVAL ACTIVITY CLIN SYMP,,,2739849.3,2739849.3,1
HCPCS,3119F,No eval activity clin symp,,,10.69,12.38,8
HCPCS,31200,ETHMOIDECTOMY INTRANASAL ANTERIOR,2056.0,1336.4,1.1,17080.38,144
HCPCS,31200,REMOVAL OF ETHMOID SINUS,,,5080.55,6160.68,20
HCPCS,31200,Removal of ethmoid sinus,,,2710.76,3138.77,8
HCPCS,31201,ETHMOIDECTOMY INTRANASAL TOTAL,3440.0,2236.0,1.1,4447.63,144
HCPCS,31201,REMOVAL OF ETHMOID SINUS,,,1323.06,1614.71,20
HCPCS,31201,Removal of ethmoid sinus,,,1558.4,1804.46,8
HCPCS,31205,ETHMOIDECTOMY EXTRANASAL TOTAL,4232.0,2750.8,1.1,9391.15,144
HCPCS,31205,REMOVAL OF ETHMOID SINUS,,,2793.19,3450.35,20
HCPCS,31205,Removal of ethmoid sinus,,,1558.4,1804.46,8
HCPCS,3120F,12-LEAD ECG PERFORMED,,,0.03,0.03,1
HCPCS,3120F,12-lead ecg performed,,,10.69,12.38,8
HCPCS,31225,MAXILLECTOMY W/O ORBITAL EXENTERATION,10680.0,6942.0,1.1,10680.0,144
HCPCS,31225,REMOVAL OF UPPER JAW,,,4675.04,4675.04,1
HCPCS,31225,Removal of upper jaw,,,4527.92,5242.85,8
HCPCS,31230,MAXILLECTOMY W/ORBITAL EXENTERATION,12328.0,8013.2,1.1,12328.0,144
HCPCS,31230,REMOVAL OF UPPER JAW,,,5225.45,5225.45,1
HCPCS,31230,Removal of upper jaw,,,4527.92,5242.85,8
HCPCS,31231,"NASAL ENDOS,DIAG,UNI/ BILATERAL",484.0,314.6,1.1,623.0,148
HCPCS,31231,NASAL ENDOSCOPY DIAGNOSTIC UNI/BI SPX,893.0,580.45,0.01,12500.0,174
HCPCS,31233,"NASAL/SINUS ENDOS,DIAG W/ MAX SI",872.0,566.8,1.1,1190.73,148
HCPCS,31233,NASAL/SINUS ENDOSCOPY DX MAXILLARY SINUSOSCOPY,1786.0,1160.9,0.01,5265.0,87
HCPCS,31235,NASAL/SINUS ENDOSCOPY DX SPHENOID SINUSOSCOPY,7933.0,5156.45,0.01,7933.0,87
HCPCS,31237,NASAL/SINUS NDSC SURG W/BX POLYPECT/DBRDMT SPX,4538.5,2950.025,0.01,7933.0,322
HCPCS,31238,NASAL/SINUS NDSC SURG W/CONTROL NASAL HEMRRG,4569.5,2970.1749999999997,0.01,7933.0,322
HCPCS,31239,NASAL/SINUS NDSC SURG W/DACRYOCSTORHINOSTOMY,3978.0,2585.7,1.1,10921.65,144
HCPCS,31239,NSL/SINUS ENDOSCOPY SURG DCR,,,3248.85,10789.0,22
HCPCS,31239,Nsl/sinus endoscopy surg dcr,,,1416.09,1639.68,8
HCPCS,31240,NASAL/SINUS NDSC SURG W/CONCHA BULLOSA RESECTION,1148.0,746.2,1.1,4949.64,144
HCPCS,31240,NSL/SNS NDSC CNCH BULL RESCJ,,,1472.47,6238.0,23
HCPCS,31240,Nsl/sns ndsc cnch bull rescj,,,266.89,309.03,8
HCPCS,31241,NASAL/SINUS NDSC W/LIG SPHENOPALATINE ARTERY,3520.0,2288.0,1.1,4949.64,144
HCPCS,31241,NSL/SNS NDSC LIG SPHNPTN ART,,,1472.47,1852.31,20
HCPCS,31241,Nsl/sns ndsc lig sphnptn art,,,1416.09,1639.68,8
HCPCS,31242,NASAL/SINUS NDSC DSTRJ RF ABLATION PST NSL NRV,14200.0,9230.0,0.01,27212.0,233
HCPCS,31243,NASAL/SINUS NDSC DSTRJ CRYOABLATION PST NSL NRV,1188.0,772.2,1.1,17080.38,146
HCPCS,31243,NSL/SINUS NDSC CRYOABLTJ PNN,,,5080.55,15288.41,22
HCPCS,31243,Nsl/sinus ndsc cryoabltj pnn,,,2710.76,3138.77,8
HCPCS,31253,NASAL/SINUS NDSC TOT W/FRNT SINS EXPL TISS RMVL,3960.0,2574.0,1.1,19960.78,144
HCPCS,31253,NSL/SINS NDSC TOTAL,,,5937.8,13821.0,24
HCPCS,31253,Nsl/sins ndsc total,,,3396.31,3932.57,8
HCPCS,31254,NASAL/SINUS NDSC W/PARTIAL ETHMOIDECTOMY,16861.0,10959.65,0.01,31843.0,235
HCPCS,31255,NASAL/SINUS NDSC W/TOTAL ETHOIDECTOMY,2530.0,1644.5,1.1,19960.78,144
HCPCS,31255,NSL/SINS NDSC W/TOT ETHMDCT,,,5937.8,13821.0,23
HCPCS,31255,Nsl/sins ndsc w/tot ethmdct,,,3396.31,3932.57,8
HCPCS,31256,NASAL/SINUS ENDOSCOPY W/MAXILLARY ANTROSTOMY,9164.0,5956.6,0.01,16960.0,231
HCPCS,31257,NASAL/SINUS NDSC TOTAL WITH SPHENOIDOTOMY,3520.0,2288.0,1.1,19960.78,144
HCPCS,31257,NSL/SINS NDSC TOT W/SPHENDT,,,5937.8,13821.0,24
HCPCS,31257,Nsl/sins ndsc tot w/sphendt,,,3396.31,3932.57,8
HCPCS,31259,NASAL/SINUS NDSC TOT W/SPHENDT W/SPHEN TISS RMVL,3731.0,2425.15,1.1,19960.78,144
HCPCS,31259,NSL/SINS NDSC SPHN TISS RMVL,,,5937.8,13821.0,24
HCPCS,31259,Nsl/sins ndsc sphn tiss rmvl,,,3396.31,3932.57,8
HCPCS,31267,NSL/SINUS NDSC MAX ANTROST W/RMVL TISS MAX SINUS,16951.0,11018.15,0.01,31843.0,231
HCPCS,3126F,ESOPH BX RPRT W/DYSPL INFO,,,0.03,0.03,1
HCPCS,3126F,Esoph bx rprt w/dyspl info,,,10.69,12.38,8
HCPCS,31276,NASAL/SINUS NDSC W/RMVL TISS FROM FRONTAL SINUS,2970.0,1930.5,1.1,19960.78,144
HCPCS,31276,NSL/SINS NDSC FRNT TISS RMVL,,,5597.0,13132.0,24
HCPCS,31276,Nsl/sins ndsc frnt tiss rmvl,,,266.89,309.03,8
HCPCS,31287,NASAL/SINUS ENDOSCOPY SURG,,,5937.8,7813.0,21
HCPCS,31287,NASAL/SINUS ENDOSCOPY W/SPHENOIDOTOMY,1540.0,1001.0,1.1,19960.78,144
HCPCS,31287,Nasal/sinus endoscopy surg,,,266.89,309.03,8
HCPCS,31288,NASAL/SINUS ENDOSCOPY SURG,,,5937.8,7778.0,21
HCPCS,31288,NSL/SINUS NDSC SPHENDT RMVL TISS SPHENOID SINUS,1640.0,1066.0,1.1,19960.78,144
HCPCS,31288,Nasal/sinus endoscopy surg,,,266.89,309.03,8
HCPCS,31290,NASAL/SINUS ENDOSCOPY SURG,,,2978.38,2978.38,1
HCPCS,31290,NASAL/SINUS NDSC RPR CEREBRSP FLUID LEAK ETHMOID,7444.0,4838.6,1.1,7444.0,144
HCPCS,31290,Nasal/sinus endoscopy surg,,,1416.09,1639.68,8
HCPCS,31291,NASAL/SINUS ENDOSCOPY SURG,,,3198.35,3198.35,1
HCPCS,31291,NASAL/SINUS NDSC RPR CEREBSP FLUID LEAK SPHENOID,7824.0,5085.6,1.1,7824.0,144
HCPCS,31291,Nasal/sinus endoscopy surg,,,1416.09,1639.68,8
HCPCS,31292,NASAL/SINUS NDSC SURG MEDIAL/INF ORB WALL DCMPRN,6996.0,4547.4,1.1,19960.78,144
HCPCS,31292,NSL/SINS NDSC MED/INF DCMPRN,,,5937.8,17868.06,21
HCPCS,31292,Nsl/sins ndsc med/inf dcmprn,,,1416.09,1639.68,8
HCPCS,31293,NASAL/SINUS NDSC SURG MEDIAL&INF ORB WALL DCMPRN,6988.0,4542.2,1.1,19960.78,144
HCPCS,31293,NSL/SINS NDSC MED&INF DCMPRN,,,5937.8,17868.06,21
HCPCS,31293,Nsl/sins ndsc med&inf dcmprn,,,1416.09,1639.68,8
HCPCS,31294,NASAL/SINUS NDSC SURG W/OPTIC NERVE DCMPRN,8124.0,5280.6,1.1,19960.78,144
HCPCS,31294,NSL/SINS NDSC SURG ON DCMPRN,,,5937.8,17868.06,21
HCPCS,31294,Nsl/sins ndsc surg on dcmprn,,,1416.09,1639.68,8
HCPCS,31295,NASAL/SINUS NDSC SURG W/DILATION MAXILLARY SINUS,31843.0,20697.95,0.01,31843.0,87
HCPCS,31295,NSL/SINUS NDSC SURG W/DILAT MAXILLARY SINUS,1080.0,702.0,1.1,19960.78,146
HCPCS,31296,NASAL/SINUS NDSC SURG W/DILATION FRONTAL SINUS,31843.0,20697.95,0.01,31843.0,87
HCPCS,31296,NSL/SINUS NDSC SURG W/DILAT FRONTAL SINUS,1364.0,886.6,1.1,19960.78,146
HCPCS,31297,NASAL/SINUS NDSC SURG W/DILATION SPHENOID SINUS,31843.0,20697.95,0.01,31843.0,87
HCPCS,31297,NSL/SINUS NDSC SURG W/DILAT SPHENOID SINUS,976.0,634.4,1.1,19960.78,146
HCPCS,31298,NASAL/SINUS NDSC SURG W/DILATION FRNT&SPHN SINUS,16821.5,10933.975,0.01,31843.0,233
HCPCS,31299,ENDO BILATERAL MOD LOTHROP,8290.0,5388.5,0.01,8290.0,84
HCPCS,31299,INSERT PROPEL SINUS STENT,95.0,61.75,0.01,1087.99,85
HCPCS,31299,MAXILLECTOMY; WITHOUT ORBITAL EXENTERATION (COMP 31225),9613.0,6248.45,0.01,9613.0,84
HCPCS,31299,"NASAL ENDOSCOPY, FOREIGN BODY REMOVAL (COMP 31237)",1032.0,670.8,0.01,1119.0,169
HCPCS,31299,TREATMENT OF NASOPHARYNGEAL STENOSIS W/ENDOSCOPIC ASSIST (COMP 3,1003.0,651.95,0.01,1003.0,84
HCPCS,31300,LARYNGOTOMY W/RMVL TUMOR/LARYNGOCELE CORDECTOMY,6364.0,4136.6,1.1,9391.15,144
HCPCS,31300,REMOVAL OF LARYNX LESION,,,2793.19,3450.35,20
HCPCS,31300,Removal of larynx lesion,,,1558.4,1804.46,8
HCPCS,3130F,UPPER GI ENDOSCOPY PERFORMED,,,2739849.3,2739849.3,1
HCPCS,3130F,Upper gi endoscopy performed,,,10.69,12.38,8
HCPCS,3132F,DOC REF UPPER GI ENDOSCOPY,,,2739849.3,2739849.3,1
HCPCS,3132F,Doc ref upper gi endoscopy,,,10.69,12.38,8
HCPCS,31360,LARYNGECTOMY TOTAL W/O RADICAL NECK DISSECTION,11964.0,7776.6,1.1,11964.0,144
HCPCS,31360,REMOVAL OF LARYNX,,,5327.05,5327.05,1
HCPCS,31360,Removal of larynx,,,3396.31,3932.57,8
HCPCS,31365,LARYNGECTOMY TOTAL W/RADICAL NECK DISSECTION,15524.0,10090.6,1.1,15524.0,144
HCPCS,31365,REMOVAL OF LARYNX,,,6583.86,6583.86,1
HCPCS,31365,Removal of larynx,,,3396.31,3932.57,8
HCPCS,31367,LARYNGECTOMY STOT SUPRAGLOTTIC W/O RAD NECK DSJ,12228.0,7948.2,1.1,12228.0,144
HCPCS,31367,PARTIAL REMOVAL OF LARYNX,,,5619.41,5619.41,1
HCPCS,31367,Partial removal of larynx,,,3396.31,3932.57,8
HCPCS,31368,LARYNGECTOMY STOT SUPRAGLOTTIC W/RAD NCK DSJ,13676.0,8889.4,1.1,13676.0,144
HCPCS,31368,PARTIAL REMOVAL OF LARYNX,,,6214.81,6214.81,1
HCPCS,31368,Partial removal of larynx,,,3396.31,3932.57,8
HCPCS,31370,PARTIAL LARYNGECTOMY HEMILARYGECTOMY HORIZONTAL,11028.0,7168.2,1.1,11028.0,144
HCPCS,31370,PARTIAL REMOVAL OF LARYNX,,,5263.81,5263.81,1
HCPCS,31370,Partial removal of larynx,,,3396.31,3932.57,8
HCPCS,31375,PARTIAL LARYNGECTOMY HEMILARYNG LATEROVERTICAL,10428.0,6778.2,1.1,10428.0,144
HCPCS,31375,PARTIAL REMOVAL OF LARYNX,,,5003.43,5003.43,1
HCPCS,31375,Partial removal of larynx,,,3396.31,3932.57,8
HCPCS,31380,PARTIAL LARYNGECTOMY HEMILARYNG ANTEROVERTICAL,10228.0,6648.2,1.1,10228.0,144
HCPCS,31380,PARTIAL REMOVAL OF LARYNX,,,4933.26,4933.26,1
HCPCS,31380,Partial removal of larynx,,,3396.31,3932.57,8
HCPCS,31382,PARTIAL LARYNG HEMILARYNG ANTERO-LATERO-VERTICAL,11428.0,7428.2,1.1,11428.0,144
HCPCS,31382,PARTIAL REMOVAL OF LARYNX,,,5405.86,5405.86,1
HCPCS,31382,Partial removal of larynx,,,3396.31,3932.57,8
HCPCS,31390,PHARYNGOLARYNGECTOMY W/RAD NECK DSJ W/O RCNSTJ,17004.0,11052.6,1.1,17004.0,144
HCPCS,31390,REMOVAL OF LARYNX & PHARYNX,,,7259.08,7259.08,1
HCPCS,31390,Removal of larynx & pharynx,,,3396.31,3932.57,8
HCPCS,31395,PHARYNGOLARYNGECTOMY W/RAD NECK DSJ W/RCNSTJ,17520.0,11388.0,1.1,17520.0,144
HCPCS,31395,RECONSTRUCT LARYNX & PHARYNX,,,7607.39,7607.39,1
HCPCS,31395,Reconstruct larynx & pharynx,,,3396.31,3932.57,8
HCPCS,31400,ARYTENOIDECTOMY/ARYTENOIDOPEXY XTRNL APPROACH,4640.0,3016.0,1.1,17080.38,144
HCPCS,31400,REVISION OF LARYNX,,,5080.55,6160.68,20
HCPCS,31400,Revision of larynx,,,3396.31,3932.57,8
HCPCS,3140F,UPPER GI ENDO SHOWS BARRTTS,,,2739849.3,2739849.3,1
HCPCS,3140F,Upper gi endo shows barrtts,,,10.69,12.38,8
HCPCS,3141F,UPPER GI ENDO NOT BARRTTS,,,2739849.3,2739849.3,1
HCPCS,3141F,Upper gi endo not barrtts,,,10.69,12.38,8
HCPCS,31420,EPIGLOTTIDECTOMY,4572.0,2971.8,1.1,17080.38,164
HCPCS,31420,Epiglottidectomy,,,3396.31,3932.57,8
HCPCS,3142F,BARIUM SWALLOW TEST ORDERED,,,2739849.3,2739849.3,1
HCPCS,3142F,Barium swallow test ordered,,,10.69,12.38,8
HCPCS,31500,INTUBATION ENDOTRACHEAL EMERGENCY PROCEDURE,1134.0,737.1,0.01,4628.0,575
HCPCS,31502,TRACHEOTOMY TUBE CHANGE PRIOR TO FISTULA TRACT,664.0,431.6,0.01,3443.0,317
HCPCS,31505,LARYNGOSCOPY INDIRECT DIAGNOSTIC SPX,893.0,580.45,0.01,12500.0,173
HCPCS,31505,"LARYNGOSCOPY,INDIRECT,DIAGNOSTIC",244.0,158.6,1.1,578.53,148
HCPCS,3150F,FORCEPS ESOPH BIOPSY DONE,,,2739849.3,2739849.3,1
HCPCS,3150F,Forceps esoph biopsy done,,,10.69,12.38,8
HCPCS,31510,LARYNGOSCOPY WITH BIOPSY,,,3248.85,3880.03,20
HCPCS,31510,"LARYNGOSCOPY,INDIRECT WITH BIOPSY",768.0,499.2,1.1,10921.65,148
HCPCS,31510,Laryngoscopy with biopsy,,,1416.09,1639.68,8
HCPCS,31511,LARYNGOSCOPY INDIRECT W/REMOVAL FOREIGN BODY,893.0,580.45,107.64,5265.0,87
HCPCS,31511,"LARYNGOSCOPY,INDIRECT+REMV FOR.BODY",864.0,561.6,1.1,864.0,148
HCPCS,31512,REMOVAL OF LARYNX LESION,,,3248.85,3880.03,20
HCPCS,31512,Removal of larynx lesion,,,1416.09,1639.68,8
HCPCS,31513,INJECTION INTO VOCAL CORD,,,354.25,407.03,20
HCPCS,31513,Injection into vocal cord,,,266.89,309.03,8
HCPCS,31515,LARYNGOSCOPY W/WO TRACHEOSCOPY ASPIRATION,1253.0,814.45,1.1,4392.0,235
HCPCS,31520,DX LARYNGOSCOPY NEWBORN,,,354.25,1066.0,21
HCPCS,31520,Dx laryngoscopy newborn,,,266.89,309.03,8
HCPCS,31520,LARYNGOSCOPY W/WO TRACHEOSCOPY DX NEWBORN,1024.0,665.6,1.1,1190.73,144
HCPCS,31525,LARYNGOSCOPY W/WO TRACHEOSCOPY DX EXCEPT NEWBORN,4492.5,2920.125,0.01,7933.0,322
HCPCS,31526,LARYNGOSCOPY W/WO TRACHEOSCOPY W/MICRO/TELESCOPE,4480.5,2912.325,1.1,7933.0,231
HCPCS,31527,LARYNGOSCOPY FOR TREATMENT,,,3248.85,3880.03,20
HCPCS,31527,Laryngoscopy for treatment,,,1416.09,1639.68,8
HCPCS,31528,LARYNGOSCOPY W/WO TRACHEOSCOPY W/DILATION IN,8954.0,5820.1,0.01,16960.0,231
HCPCS,31529,LARYNGOSCOPY W/WO TRACHEOSCOPY DILATION SUBSQ,9016.0,5860.4,0.01,16960.0,231
HCPCS,31530,LARYNGOSCOPY W/FOREIGN BODY REMOVAL,4642.5,3017.625,1.1,7933.0,231
HCPCS,31531,LARYNGOSCOPY FOREIGN BODY RMVL MICRO/TELESCOPE,1432.0,930.8,1.1,10921.65,144
HCPCS,31531,LARYNGOSCOPY W/FB & OP SCOPE,,,3248.85,3880.03,20
HCPCS,31531,Laryngoscopy w/fb & op scope,,,1416.09,1639.68,8
HCPCS,31535,LARYNGOSCOPY DIRECT OPERATIVE W/BIOPSY,1264.0,821.6,1.1,10921.65,144
HCPCS,31535,LARYNGOSCOPY W/BIOPSY,,,3248.85,7624.0,23
HCPCS,31535,Laryngoscopy w/biopsy,,,1416.09,1639.68,8
HCPCS,31536,LARYNGOSCOPY W/BIOPSY MICROSCOPE/TELESCOPE,9190.0,5973.5,0.01,16960.0,231
HCPCS,31540,LARYNGOSCOPY EXC TUM&/STRIPPING CORDS/EPIGLOTT,9304.0,6047.6,0.01,16960.0,318
HCPCS,31541,LARGSC EXC TUM&/STRPG CORDS/EPIGL MCRSCP/TLSCP,9384.0,6099.6,0.01,16960.0,318
HCPCS,31545,LARGSC MICRO/TELESCOPE RMVL LES VOCAL CORD FLAP,2772.0,1801.8,1.1,10921.65,144
HCPCS,31545,"LARYNGOSCOPY, DIRECT, OPERATIVE, W/OPERATING MICROSCOPE OR TELES",16960.0,11024.0,0.01,16960.0,87
HCPCS,31546,REMOVE VC LESION SCOPE/GRAFT,,,5937.8,7344.59,20
HCPCS,31546,Remove vc lesion scope/graft,,,1416.09,1639.68,8
HCPCS,31551,LARYNGOPLASTY LARYNGEAL STEN,,,5080.55,6160.68,20
HCPCS,31551,LARYNGOPLASTY LARYNGEAL STEN W/O STENT < 12 YRS,8600.0,5590.0,1.1,17080.38,144
HCPCS,31551,Laryngoplasty laryngeal sten,,,3396.31,3932.57,8
HCPCS,31552,LARYNGOPLASTY LARYNGEAL STEN,,,5080.55,6160.68,20
HCPCS,31552,LARYNGOPLASTY LARYNGEAL STEN W/O STENT 12 YRS >,8200.0,5330.0,1.1,17080.38,144
HCPCS,31552,Laryngoplasty laryngeal sten,,,2710.76,3138.77,8
HCPCS,31553,LARYNGOPLASTY LARYNGEAL STEN,,,5080.55,6160.68,20
HCPCS,31553,LARYNGOPLASTY LARYNGEAL STEN W/STENT < 12 YRS,8800.0,5720.0,1.1,17080.38,144
HCPCS,31553,Laryngoplasty laryngeal sten,,,3396.31,3932.57,8
HCPCS,31554,LARYNGOPLASTY LARYNGEAL STEN,,,5080.55,6160.68,20
HCPCS,31554,LARYNGOPLASTY LARYNGEAL STEN W/STENT 12 YRS >,8800.0,5720.0,1.1,17080.38,144
HCPCS,31554,Laryngoplasty laryngeal sten,,,2710.76,3138.77,8
HCPCS,3155F,CYTOGEN TEST MARROW B/4 TX,,,2739849.3,2739849.3,1
HCPCS,3155F,Cytogen test marrow b/4 tx,,,10.69,12.38,8
HCPCS,31560,LARYNGOSCOP W/ARYTENOIDECTOM,,,5937.8,7344.59,20
HCPCS,31560,LARYNGOSCOPY DIRECT OPERATIVE W/ARYTENOIDECTOMY,2398.0,1558.7,1.1,19960.78,144
HCPCS,31560,Laryngoscop w/arytenoidectom,,,1416.09,1639.68,8
HCPCS,31561,LARGSC ARYTENOIDECTOMY MICROSCOPE/TELESCOPE,17119.5,11127.675000000001,0.01,31843.0,231
HCPCS,31570,LARYNGOSCOPE INJECTION VOCAL CORD THERAPEUTIC,9252.0,6013.8,0.01,16960.0,235
HCPCS,31571,LARGSC W/NJX VOCAL CORD THER W/MICRO/TELESCOPE,9332.0,6065.8,0.01,16960.0,231
HCPCS,31572,LARYNGOSCOPY FLEXIBLE ABLATJ DESTJ LESION(S) UNI,9142.0,5942.3,0.01,16960.0,322
HCPCS,31573,LARYNGOSCOPY FLEXIBLE THERAPEUTIC INJECTION UNI,4452.5,2894.125,0.01,11545.0,235
HCPCS,31574,LARYNGOSCOPY FLEXIBLE W/INJECTION AGMNTJ UNI,4452.5,2894.125,0.01,11545.0,235
HCPCS,31575,LARYNGOSCOPY FLEXIBLE DIAGNOSTIC,653.5,424.77500000000003,0.01,12500.0,321
HCPCS,31576,LARYNGOSCOPY FLEXIBLE W/BIOPSY(IES),4344.5,2823.9249999999997,0.01,7933.0,322
HCPCS,31577,LARYNGOSCOPY FLX RMVL FOREIGN BODY(S),1786.0,1160.9,151.89,5265.0,87
HCPCS,31578,LARGSC W/REMOVAL LESION,,,3248.85,3880.03,20
HCPCS,31578,LARYNGOSCOPY FLEXIBLE RMVL LESION(S) NON-LASER,972.0,631.8,1.1,10921.65,148
HCPCS,31578,Largsc w/removal lesion,,,1416.09,1639.68,8
HCPCS,31579,LARYNGOSCOPY FLX/RGD TELESCOPIC W/STROBOSCOPY,1306.5,849.225,0.01,4392.0,496
HCPCS,31580,LARYNGOPLASTY LARYN WEB W/KEEL STENT INSERTION,5840.0,3796.0,1.1,17080.38,144
HCPCS,31580,LARYNGOPLASTY LARYNGEAL WEB,,,5080.55,6160.68,20
HCPCS,31580,Laryngoplasty laryngeal web,,,2710.76,3138.77,8
HCPCS,31584,LARYNGOPLASTY FX RDCTJ FIXJ,,,5080.55,6160.68,20
HCPCS,31584,LARYNGOPLASTY W/OPEN REDUCTION FRACTURE W/TRACHS,7032.0,4570.8,1.1,17080.38,144
HCPCS,31584,Laryngoplasty fx rdctj fixj,,,2710.76,3138.77,8
HCPCS,31587,LARYNGOPLASTY CRICOID SPLIT,,,5080.55,15288.41,21
HCPCS,31587,LARYNGOPLASTY CRICOID SPLIT W/O GRAFT PLACEMENT,6108.0,3970.2,1.1,17080.38,144
HCPCS,31587,Laryngoplasty cricoid split,,,3396.31,3932.57,8
HCPCS,31590,LARYNGEAL REINNERVATION NEUROMUSCULAR PEDICLE,3140.0,2041.0,1.1,17080.38,144
HCPCS,31590,REINNERVATE LARYNX,,,5080.55,6160.68,20
HCPCS,31590,Reinnervate larynx,,,3396.31,3932.57,8
HCPCS,31591,LARYNGOPLASTY MEDIALIZATION,,,5080.55,10789.0,23
HCPCS,31591,LARYNGOPLASTY MEDIALIZATION UNLIATERAL,5424.0,3525.6,1.1,17080.38,144
HCPCS,31591,Laryngoplasty medialization,,,2710.76,3138.77,8
HCPCS,31592,CRICOTRACHEAL RESECTION,10000.0,6500.0,1.1,17080.38,164
HCPCS,31592,Cricotracheal resection,,,3174.61,3675.86,8
HCPCS,31599,CHONDROLARYNGOPLASTY (TRACHEAL SHAVE/REDUCTION) (COMP 31591),3491.0,2269.15,0.01,3491.0,84
HCPCS,31599,DIRECT LARYNGOSCOPY WITH LYSIS LARYNGEAL STENOSIS (COMP 31541),1492.0,969.8,0.01,1580.23,84
HCPCS,31599,DL W LYSIS OF DENSE INTERARYTENOID SCAR (COMP 31561),2079.0,1351.35,0.01,2079.0,84
HCPCS,31599,DL W/ LYSIS OF LARYNGEAL STENOSIS (COMP 31541),1491.0,969.15,0.01,1580.23,84
HCPCS,31599,DL WITH LASER RESURFACING OF SUBGLOTTIC SKIN GRAFT (COMP 31536),1172.0,761.8,0.01,1580.23,84
HCPCS,31599,ENDOSCOPIC LARYNGOPLASTY W/ INDWELLING KEEL OR STENT (COMP 31580,4689.0,3047.85,0.01,4689.0,84
HCPCS,31599,ESOPHAGOSCOPY WITH ESOPHAGEAL STENT (COMP CODE 43212),1445.0,939.25,0.01,1580.23,84
HCPCS,31599,FLEXIBLE LARYNGOSCOPY W/ APPLICATION OF MITOMYCIN C PROCEDURE,828.0,538.2,0.01,1580.23,84
HCPCS,31599,FLEXIBLE LARYNGOSCOPY WITH APPLICATION OF MITOMYCIN C TECH,2538.0,1649.7,0.01,3443.0,85
HCPCS,31599,LARYNGOPHARYNGECTMY W LEVEL 6 NODE DISS,14760.0,9594.0,0.01,14760.0,84
HCPCS,31599,LARYNGOSCOP LSR SUPRALOTTIC LARYNGECTOM (COMP 31367),7727.0,5022.55,0.01,7727.0,84
HCPCS,31599,"LARYNGOSCOPY DIRECT, DIAGNOSTIC, FETUS (COMP 31520)",845.0,549.25,0.01,1580.23,84
HCPCS,31599,LASER LARYNGOSCOPIC CORDECTOMY,4336.0,2818.4,0.01,4336.0,84
HCPCS,31599,LASER VOCAL CORD POLYP,4472.0,2906.8,0.01,4472.0,85
HCPCS,31599,MICR DL W/PRT EXC SUPRAGLOTTIC LARYNX (COMP 31300),3772.0,2451.8,0.01,3772.0,84
HCPCS,31599,MICRODRCT LARYN W VOCAL CORDOTOMY (COMP CODE 31541),1836.0,1193.4,0.01,1836.0,84
HCPCS,31599,NECK EXPLR W RMVL LARYNX IMPLANT (COMP 35800),2597.0,1688.05,0.01,2597.0,84
HCPCS,31599,UNLISTED ENDOSCOPIC LARYNGOPLASTY WITH PLACEMENT OF POSTERIOR CR,7741.0,5031.65,0.01,7741.0,84
HCPCS,31599,UNLISTED PROCEDURE LARYNX,1641.0,1066.65,0.01,1641.0,84
HCPCS,31600,TRACHEOSTOMY PLANNED SEPARATE PROCEDURE,14918.0,9696.7,0.01,14918.0,79
HCPCS,31600,"TRACHEOSTOMY, PLANNED",2446.0,1589.9,1.1,9391.15,144
HCPCS,31601,PLANNED TRACHEOSTOMY<2 YRS,,,5080.55,15288.41,21
HCPCS,31601,"TRACHEOSTOMY, <2 Y/O",3200.0,2080.0,1.1,17080.38,144
HCPCS,31603,TRACHEOSTOMY EMERGENCY PROCEDURE TRANSTRACHEAL,4607.0,2994.55,0.01,6814.0,302
HCPCS,31605,TRACHEOSTOMY EMERGENCY CRICOTHYROID MEMBRANE,1824.0,1185.6,0.01,3443.0,301
HCPCS,3160F,DOC FE+ STORES B/4 EPO THX,,,2739849.3,2739849.3,1
HCPCS,3160F,Doc fe+ stores b/4 epo thx,,,10.69,12.38,8
HCPCS,31610,TRACHEOSTOMY FENEST SKIN FLP,,,5080.55,6160.68,20
HCPCS,31610,TRACHEOSTOMY FENESTRATION W/SKIN FLAPS,4800.0,3120.0,1.1,17080.38,144
HCPCS,31611,CONSTJ TRACHEOESOPHGL FSTL&INSJ SP PROSTH,8659.0,5628.35,0.01,14918.0,223
HCPCS,31612,PERQ TRCHL PNXR TTRACH ASPIR,,,2793.19,3450.35,20
HCPCS,31612,Perq trchl pnxr ttrach aspir,,,760.55,880.64,8
HCPCS,31613,TRACHEOSTOMA REVJ SMPL W/O FLAP ROTATION,8401.0,5460.650000000001,1.1,14918.0,223
HCPCS,31614,TRACHEOSTOMA REVJ COMPLEX,,,5080.55,6160.68,20
HCPCS,31614,TRACHEOSTOMA REVJ CPLX W/FLAP ROTATION,3452.0,2243.8,1.1,17080.38,144
HCPCS,31615,TRACHEOBRNCHSC THRU EST TRACHS INC,1576.5,1024.725,0.01,4392.0,322
HCPCS,31622,BRNCHSC INCL FLUOR GDNCE DX W/CELL WASHG SPX,4523.0,2939.95,0.01,7933.0,392
HCPCS,31623,BRNCHSC BRUSHING/PROTECTED BRUSHINGS,4545.0,2954.25,0.01,7933.0,235
HCPCS,31624,BRNCHSC W/BRNCL ALVEOLAR LAVAGE,4545.0,2954.25,0.01,7933.0,409
HCPCS,31625,BRONCHOSCOPY BRONCHIAL/ENDOBRNCL BX 1+ SITES,4650.5,3022.825,0.01,7933.0,322
HCPCS,31626,BRONCHOSCOPY W/PLMT FIDUCIAL MARKERS SINGLE/MULT,16703.5,10857.275,0.01,31843.0,322
HCPCS,31627,BRNCHSC W/CPTR-ASST IMAGE-GUIDED NAVIGATION,800.0,520.0,1.1,3502.07,148
HCPCS,31627,BRONCHOSCOPY W/CPTR-ASST IMAGE-GUIDED NAVIGATION,1624.0,1055.6,0.01,3443.0,68
HCPCS,31628,BRONCHOSCOPY W/TRANSBRONCHIAL LUNG BX 1 LOBE,9261.0,6019.65,0.01,16960.0,322
HCPCS,31629,BRONCHOSCOPY NEEDLE BX TRACHEA MAIN STEM&/BRON,9305.0,6048.25,0.01,16960.0,235
HCPCS,31630,BRNCHSC W/TRACHEAL/BRONCHIAL DILAT/CLSD RDCTJ FX,9242.0,6007.3,0.01,16960.0,231
HCPCS,31631,BRONCHOSCOPY W/PLACEMENT TRACHEAL STENT,16793.5,10915.775,0.01,31843.0,231
HCPCS,31632,BRONCHOSCOPY W/TRANSBRONCHIAL LUNG BX EACH LOBE,798.0,518.7,0.01,4337.0,216
HCPCS,31633,BRONCHOSCOPY W/TRANSBRONCL NDL ASPIR BX EA LOBE,971.0,631.15,0.01,4337.0,216
HCPCS,31634,BRONCHOSCOPY BALLOON OCCLUSION,16671.5,10836.475,0.01,31843.0,320
HCPCS,31635,BRONCHOSCOPY W/REMOVAL FOREIGN BODY,4719.0,3067.35,0.01,7933.0,235
HCPCS,31636,BRNCHSC W/PLACEMENT BRNCL STENT 1ST BRONCHUS,16781.5,10907.975,0.01,31843.0,231
HCPCS,31637,BRONCHOSCOPY EACH MAJOR BRONCHUS STENTED,1473.0,957.4499999999999,0.01,4392.0,213
HCPCS,31638,BRNCHSC REVJ TRACHEAL/BRNCL STENT INS PREV SESS,16897.5,10983.375,0.01,31843.0,231
HCPCS,31640,BRONCHOSCOPY W/EXCISION TUMOR,9466.0,6152.9,0.01,16960.0,231
HCPCS,31641,BRNCHSC W/DSTRJ TUM RELIEF STENOSIS OTH/THN EXC,9484.0,6164.6,0.01,16960.0,231
HCPCS,31643,BRNCHSC W/PLMT CATH INTRCV RADIOELMNT APPL,4664.5,3031.9249999999997,0.01,7933.0,231
HCPCS,31645,BRONCHOSCOPY W/THER ASPIR TRACHBRNCL TREE 1ST,4600.0,2990.0,0.01,7933.0,235
HCPCS,31646,BRONCHOSCOPY W/THER ASPIR TRACHBRNCL TREE SBSQ,1504.5,977.9250000000001,0.01,4392.0,231
HCPCS,31647,BRNCHSC OCCLUSION&INSERT BRONCH VALVE INIT LOBE,16751.5,10888.475,0.01,31843.0,229
HCPCS,31648,BRNCHSC REMOVAL BRONCHIAL VALVE INITIAL,9270.0,6025.5,0.01,16960.0,229
HCPCS,31649,BRNCHSC REMOVAL BRONCHIAL VALVE EA ADDL,4254.5,2765.4249999999997,0.01,7933.0,229
HCPCS,31651,BRNCHSC OCCLUSION&INSERT BRONCH VALVE ADDL LOBE,1959.0,1273.3500000000001,0.01,11545.0,211
HCPCS,31652,BRNCHSC EBUS GUIDED SAMPL 1/2 NODE STATION/STRUX,9461.0,6149.65,0.01,16960.0,409
HCPCS,31653,BRNCHSC EBUS GUIDED SAMPL 3/> NODE STATION/STRUX,9571.0,6221.15,0.01,16960.0,409
HCPCS,31654,BRNSCHSC TNDSC EBUS DX/TX INTERVENTION PERPH LES,1168.5,759.525,0.01,4628.0,286
HCPCS,31660,BRONCHOSCOPIC THERMOPLASTY ONE LOBE,16721.5,10868.975,0.01,31843.0,229
HCPCS,31661,BRONCHOSCOPIC THERMOPLASTY 2/> LOBES,16771.5,10901.475,0.01,31843.0,229
HCPCS,3170F,BASELIN FLO CYTOMETRY B/4 TX,,,2739849.3,2739849.3,1
HCPCS,3170F,Baselin flo cytometry b/4 tx,,,10.69,12.38,8
HCPCS,31717,BRONCHIAL BRUSH BIOPSY,,,354.25,407.03,20
HCPCS,31717,Bronchial brush biopsy,,,2619.86,3033.53,8
HCPCS,31720,CATHETER ASPIRATION NASOTRACHEAL SPX,936.0,608.4,0.01,4392.0,261
HCPCS,31720,"CATHETER ASPIRATN,NASOTRACH",424.0,275.6,1.1,621.38,144
HCPCS,31725,CLEARANCE OF AIRWAYS,,,204.82,204.82,1
HCPCS,31725,Clearance of airways,,,266.89,309.03,8
HCPCS,31730,TTRACH INTRO NDL WIRE DIL/STENT/TUBE O2 THER,4536.5,2948.725,0.01,7933.0,227
HCPCS,31750,TRACHEOPLASTY CERVICAL,6772.0,4401.8,1.1,17080.38,164
HCPCS,31755,TRACHPLSTY TRCHPHRYNGL FSTLJ,,,5080.55,6160.68,20
HCPCS,31760,TRACHEOPLASTY INTRATHORACIC,9392.0,6104.8,1.1,9392.0,145
HCPCS,31760,Tracheoplasty intrathoracic,,,3174.61,3675.86,8
HCPCS,31766,CARINAL RECONSTRUCTION,12668.0,8234.2,1.1,12668.0,145
HCPCS,31766,Carinal reconstruction,,,3174.61,3675.86,8
HCPCS,31770,BRONCHOPLASTY GRAFT REPAIR,9416.0,6120.4,1.1,9416.0,144
HCPCS,31770,REPAIR/GRAFT OF BRONCHUS,,,3458.81,3458.81,1
HCPCS,31770,Repair/graft of bronchus,,,3174.61,3675.86,8
HCPCS,31775,BRONCHOPLASTY EXCISION STENOSIS & ANASTOMOSIS,9836.0,6393.4,1.1,9836.0,144
HCPCS,31775,RECONSTRUCT BRONCHUS,,,3642.61,3642.61,1
HCPCS,31775,Reconstruct bronchus,,,3174.61,3675.86,8
HCPCS,31780,EXCISION TRACHEAL STENOSIS&ANASTOMOSIS CERVICA,7936.0,5158.4,1.1,7936.0,144
HCPCS,31780,RECONSTRUCT WINDPIPE,,,3130.75,3130.75,1
HCPCS,31781,EXC TRACHEAL STENOSIS&ANAST CERVICOTHORACIC,9940.0,6461.0,1.1,9940.0,144
HCPCS,31781,RECONSTRUCT WINDPIPE,,,3759.14,3759.14,1
HCPCS,31781,Reconstruct windpipe,,,3174.61,3675.86,8
HCPCS,31785,EXCISION TRACHEAL TUMOR/CARCINOMA CERVICAL,7340.0,4771.0,1.1,17080.38,144
HCPCS,31785,REMOVE WINDPIPE LESION,,,5080.55,15288.41,21
HCPCS,31786,EXCISION TRACHEAL TUMOR/CARCINOMA THORACIC,10168.0,6609.2,1.1,10168.0,144
HCPCS,31786,REMOVE WINDPIPE LESION,,,3754.4,3754.4,1
HCPCS,31786,Remove windpipe lesion,,,3174.61,3675.86,8
HCPCS,31800,REPAIR OF WINDPIPE INJURY,,,1818.68,1818.68,1
HCPCS,31800,SUTURE TRACHEAL WOUND/INJURY CERVICAL,3272.0,2126.8,1.1,3272.0,144
HCPCS,31805,REPAIR OF WINDPIPE INJURY,,,2133.72,2133.72,1
HCPCS,31805,Repair of windpipe injury,,,1722.25,1994.18,8
HCPCS,31805,SUTURE TRACHEAL WOUND/INJURY INTRATHORACIC,5368.0,3489.2,1.1,5368.0,144
HCPCS,31820,SURG CLSR TRACHEOSTOMY/FISTULA W/O PLASTIC RPR,8387.0,5451.55,0.01,14918.0,227
HCPCS,31825,SURG CLSR TRACHEOSTOMY/FISTULA W/PLASTIC RPR,8873.0,5767.450000000001,0.01,14918.0,227
HCPCS,31830,REVISE TRACHEOSTOMY SCAR,1848.0,1201.2,1.1,9391.15,148
HCPCS,31830,REVISION TRACHEOSTOMY SCAR,14918.0,9696.7,0.01,14918.0,79
HCPCS,31899,BRONCHOSCOPY RIGID OR FLEXIBLE W/INJECTION OF CONTRAST MATERIAL,3141.0,2041.65,0.01,3443.0,85
HCPCS,31899,CONTROL HEMORRHAGE FROM TRACHEOSTOMA (COMP 31613),1165.0,757.25,0.01,1165.0,84
HCPCS,31899,DL W/LYSIS OF TRACHEAL STENOSIS (COMP 31541),1628.0,1058.2,0.01,1628.0,84
HCPCS,31899,PLC OF ENDOBRONCHIAL BLOCKER,969.0,629.85,171.85,4628.0,84
HCPCS,31899,"UNLIST PROC, TRACHEA, BRONCHI COMPARED TO 31613",2002.0,1301.3,0.01,2002.0,84
HCPCS,31899,UNLISTED PROC; TRACHEOSTOMY TUBE EXCHANGE FOLLOWING ESTABLISHED,215.0,139.75,0.01,578.53,84
HCPCS,31899,UNLISTED PROCEDURE TRACHEA BRONCHI,292.0,189.8,81.18,3443.0,84
HCPCS,3200F,BARIUM SWALLOW TEST NOT REQ,,,2739849.3,2739849.3,1
HCPCS,3200F,Barium swallow test not req,,,10.69,12.38,8
HCPCS,32035,THORACOSTOMY W/RIB RESECTION,,,1912.19,1912.19,1
HCPCS,32035,"THORACOSTOMY,RIB RESECT,EMPYEMA",4516.0,2935.4,1.1,4516.0,144
HCPCS,32035,Thoracostomy w/rib resection,,,3174.61,3675.86,8
HCPCS,32036,THORACOSTOMY W/FLAP DRAINAGE,,,2060.37,2060.37,1
HCPCS,32036,"THORACOSTOMY,OPEN DRAIN/EMPYEMA",4920.0,3198.0,1.1,4920.0,144
HCPCS,32036,Thoracostomy w/flap drainage,,,3174.61,3675.86,8
HCPCS,32096,OPEN WEDGE/BX LUNG INFILTR,,,2084.98,2084.98,1
HCPCS,32096,Open wedge/bx lung infiltr,,,1722.25,1994.18,8
HCPCS,32096,THORACTOMY W/DX BX LUNG INFILTRATE UNILATERAL,5500.0,3575.0,1.1,5500.0,144
HCPCS,32097,OPEN WEDGE/BX LUNG NODULE,,,2088.24,2088.24,1
HCPCS,32097,Open wedge/bx lung nodule,,,3174.61,3675.86,8
HCPCS,32097,THORACTOMY W/DX BX LUNG NODULE/MASS UNILATERAL,5500.0,3575.0,1.1,5500.0,144
HCPCS,32098,OPEN BIOPSY OF LUNG PLEURA,,,1973.49,1973.49,1
HCPCS,32098,Open biopsy of lung pleura,,,3174.61,3675.86,8
HCPCS,32098,THORACOTOMY W/BIOPSY OF PLEURA,5164.0,3356.6,1.1,5164.0,144
HCPCS,32100,THORACOTOMY WITH EXPLORATION,4005.0,2603.25,1.1,13132.0,212
HCPCS,3210F,GRP A STREP TEST PERFORMED,,,0.03,0.03,1
HCPCS,3210F,Grp a strep test performed,,,10.69,12.38,8
HCPCS,32110,THORCOM CTRL TRAUMTC HEMRRG&/RPR LNG TEAR,10310.0,6701.5,1.1,13132.0,212
HCPCS,32120,RE-EXPLORATION OF CHEST,,,2273.3,2273.3,1
HCPCS,32120,Re-exploration of chest,,,3174.61,3675.86,8
HCPCS,32120,"THORACOTOMY,POSTOP COMPLICATNS",5756.0,3741.4,1.1,5756.0,144
HCPCS,32124,EXPLORE CHEST FREE ADHESIONS,,,2401.8,2401.8,1
HCPCS,32124,Explore chest free adhesions,,,1722.25,1994.18,8
HCPCS,32124,THORACOTOMY OPN INTRAPLEURAL PNEUMONOLYSIS,6180.0,4017.0,1.1,6180.0,144
HCPCS,32140,REMOVAL OF LUNG LESION(S),,,2581.82,2581.82,1
HCPCS,32140,Removal of lung lesion(s),,,1722.25,1994.18,8
HCPCS,32140,"THORACOTOMY,CYST REMOVAL",6664.0,4331.6,1.1,6664.0,144
HCPCS,32141,REMOVE/TREAT LUNG LESIONS,,,3960.01,3960.01,1
HCPCS,32141,Remove/treat lung lesions,,,3174.61,3675.86,8
HCPCS,32141,THORACOTOMY W/RESECTION BULLAE,10872.0,7066.8,1.1,10872.0,144
HCPCS,32150,REMOVAL OF LUNG LESION(S),,,2648.76,2648.76,1
HCPCS,32150,Removal of lung lesion(s),,,3174.61,3675.86,8
HCPCS,32150,THORCOM W/RMVL INTRAPLEURAL FB/FIBRIN DEP,6728.0,4373.2,1.1,6728.0,144
HCPCS,32151,REMOVE LUNG FOREIGN BODY,,,2619.96,2619.96,1
HCPCS,32151,Remove lung foreign body,,,1722.25,1994.18,8
HCPCS,32151,THORCOM W/RMVL IPUL FB,6776.0,4404.4,1.1,6776.0,144
HCPCS,3215F,PT IMMUNITY TO HEP A DOCD,,,2739849.3,2739849.3,1
HCPCS,3215F,Pt immunity to hep a docd,,,10.69,12.38,8
HCPCS,32160,THORACOTOMY W/CARDIAC MASSAGE,5570.5,3620.825,1.1,13132.0,212
HCPCS,3216F,PT IMMUNITY TO HEP B DOCD,,,2739849.3,2739849.3,1
HCPCS,3216F,Pt immunity to hep b docd,,,10.69,12.38,8
HCPCS,3218F,RNA TSTNG HEP C DOCD DONE,,,2739849.3,2739849.3,1
HCPCS,3218F,Rna tstng hep c docd done,,,10.69,12.38,8
HCPCS,32200,DRAIN OPEN LUNG LESION,,,2969.48,2969.48,1
HCPCS,32200,Drain open lung lesion,,,3174.61,3675.86,8
HCPCS,32200,PNEUMONOSTOMY W/OPEN DRAINAGE ABSCESS/CYST,7472.0,4856.8,1.1,7472.0,144
HCPCS,3220F,HEP C QUANT RNA TSTNG DOCD,,,2739849.3,2739849.3,1
HCPCS,3220F,Hep c quant rna tstng docd,,,10.69,12.38,8
HCPCS,32215,PLEURAL SCARIFICATION REPEAT PNEUMOTHORAX,5220.0,3393.0,1.1,5220.0,144
HCPCS,32215,TREAT CHEST LINING,,,2092.07,2092.07,1
HCPCS,32215,Treat chest lining,,,1722.25,1994.18,8
HCPCS,32220,DECORTICATION PULMONARY TOTAL SEPARATE PROCEDURE,10660.0,6929.0,1.1,10660.0,144
HCPCS,32220,RELEASE OF LUNG,,,4159.57,4159.57,1
HCPCS,32220,Release of lung,,,3174.61,3675.86,8
HCPCS,32225,DECORTICATION PULMONARY PARTIAL SEPARATE PROC,6700.0,4355.0,1.1,6700.0,144
HCPCS,32225,PARTIAL RELEASE OF LUNG,,,2590.75,2590.75,1
HCPCS,32225,Partial release of lung,,,1722.25,1994.18,8
HCPCS,3230F,NOTE HRING TST W/IN 6 MON,,,2739849.3,2739849.3,1
HCPCS,3230F,Note hring tst w/in 6 mon,,,10.69,12.38,8
HCPCS,32310,PLEURECTOMY PARIETAL SEPARATE PROCEDURE,6112.0,3972.8,1.1,6112.0,144
HCPCS,32310,REMOVAL OF CHEST LINING,,,2393.8,2393.8,1
HCPCS,32310,Removal of chest lining,,,1722.25,1994.18,8
HCPCS,32320,DECORTICATION & PARIETAL PLEURECTOMY,10900.0,7085.0,1.1,10900.0,144
HCPCS,32320,FREE/REMOVE CHEST LINING,,,4177.21,4177.21,1
HCPCS,32320,Free/remove chest lining,,,3174.61,3675.86,8
HCPCS,32400,BIOPSY PLEURA PERCUTANEOUS NEEDLE,4078.5,2651.025,0.01,7453.0,322
HCPCS,32405,Percut bx lung/mediastinum,,,760.55,880.64,8
HCPCS,32408,CORE NEEDLE BX LUNG/MEDIASTINUM PERQ W/IMG,4426.0,2876.9,0.01,11545.0,322
HCPCS,32440,REMOVAL OF LUNG PNEUMONECTOMY,10912.0,7092.8,1.1,10912.0,144
HCPCS,32440,REMOVE LUNG PNEUMONECTOMY,,,4083.64,4083.64,1
HCPCS,32440,Remove lung pneumonectomy,,,3174.61,3675.86,8
HCPCS,32442,REMOVAL LUNG PNEUMONECTOMY RESXN SGMNT TRACHEA,22588.0,14682.2,1.1,22588.0,144
HCPCS,32442,SLEEVE PNEUMONECTOMY,,,7946.22,7946.22,1
HCPCS,32442,Sleeve pneumonectomy,,,3174.61,3675.86,8
HCPCS,32445,REMOVAL LUNG PNEUMONECTOMY EXTRAPLEURAL,25536.0,16598.4,1.1,25536.0,144
HCPCS,32445,REMOVAL OF LUNG EXTRAPLEURAL,,,9184.81,9184.81,1
HCPCS,32445,Removal of lung extrapleural,,,3174.61,3675.86,8
HCPCS,32480,PARTIAL REMOVAL OF LUNG,,,3849.86,3849.86,1
HCPCS,32480,Partial removal of lung,,,3174.61,3675.86,8
HCPCS,32480,RMVL LUNG OTHER THAN PNEUMONECTOMY 1 LOBE LOBECT,10328.0,6713.2,1.1,10328.0,144
HCPCS,32482,BILOBECTOMY,,,4113.4,4113.4,1
HCPCS,32482,Bilobectomy,,,3174.61,3675.86,8
HCPCS,32482,RMVL LUNG OTHER THAN PNEUMONECT 2 LOBES BILOBEC,10976.0,7134.4,1.1,10976.0,144
HCPCS,32484,RMVL LUNG OTHER THAN PNEUMONECT 1 SEGMENTECTOMY,10152.0,6598.8,1.1,10152.0,144
HCPCS,32484,SEGMENTECTOMY,,,3730.92,3730.92,1
HCPCS,32484,Segmentectomy,,,3174.61,3675.86,8
HCPCS,32486,RMVL LUNG XCP TOT PNEUMONECTOMY SLEEVE LOBECTOMY,17152.0,11148.8,1.1,17152.0,144
HCPCS,32486,SLEEVE LOBECTOMY,,,6093.6,6093.6,1
HCPCS,32486,Sleeve lobectomy,,,3174.61,3675.86,8
HCPCS,32488,COMPLETION PNEUMONECTOMY,,,6223.75,6223.75,1
HCPCS,32488,Completion pneumonectomy,,,3174.61,3675.86,8
HCPCS,32488,RMVL LUNG OTHER/THAN PNUMEC COMPLETION PNUMEC,17196.0,11177.4,1.1,17196.0,144
HCPCS,32491,LUNG VOLUME REDUCTION,,,3835.78,3835.78,1
HCPCS,32491,Lung volume reduction,,,3174.61,3675.86,8
HCPCS,32491,RMVL LUNG OTH/THN PNUMEC RESXN-PLCTJ EMPHY LUNG,10096.0,6562.4,1.1,10096.0,130
HCPCS,32501,REPAIR BRONCHUS ADD-ON,,,633.76,633.76,1
HCPCS,32501,RESCJ&BRONCHOPLASTY PFRMD TM LOBEC/SGMECTOMY,1872.0,1216.8,1.1,1872.0,144
HCPCS,32501,Repair bronchus add-on,,,3174.61,3675.86,8
HCPCS,32503,RESCJ APICAL LUNG TUMOR W/O CHEST WALL RCNSTJ,12696.0,8252.4,1.1,12696.0,144
HCPCS,32503,RESECT APICAL LUNG TUMOR,,,4671.18,4671.18,1
HCPCS,32503,Resect apical lung tumor,,,3174.61,3675.86,8
HCPCS,32504,RESCJ APICAL LUNG TUMOR W/CHEST WALL RCNSTJ,14616.0,9500.4,1.1,14616.0,144
HCPCS,32504,RESECT APICAL LUNG TUM/CHEST,,,5323.6,5323.6,1
HCPCS,32504,Resect apical lung tum/chest,,,3174.61,3675.86,8
HCPCS,32505,THORACOTOMY W/THERAPEUTIC WEDGE RESEXN INITIAL,6300.0,4095.0,1.1,6300.0,144
HCPCS,32505,WEDGE RESECT OF LUNG INITIAL,,,2424.35,2424.35,1
HCPCS,32505,Wedge resect of lung initial,,,3174.61,3675.86,8
HCPCS,32506,THORACOTOMY W/THERAP WEDGE RESEXN ADDL IPSILATRL,1200.0,780.0,1.1,1200.0,144
HCPCS,32506,WEDGE RESECT OF LUNG ADD-ON,,,406.29,406.29,1
HCPCS,32506,Wedge resect of lung add-on,,,3174.61,3675.86,8
HCPCS,32507,THORACOTOMY W/DX WEDGE RESEXN &ANTOM LUNG RESEXN,1200.0,780.0,1.1,1200.0,144
HCPCS,32507,WEDGE RESECT OF LUNG DIAG,,,405.47,405.47,1
HCPCS,32507,Wedge resect of lung diag,,,3174.61,3675.86,8
HCPCS,3250F,NONPRIM LOC ANAT BX SITE TUM,,,2739849.3,2739849.3,1
HCPCS,3250F,Nonprim loc anat bx site tum,,,10.69,12.38,8
HCPCS,32540,EXTRAPLEURAL ENUCLEATION EMPYEMA EMPYEMECTOMY,12140.0,7891.0,1.1,12140.0,144
HCPCS,32540,REMOVAL OF LUNG LESION,,,4499.63,4499.63,1
HCPCS,32540,Removal of lung lesion,,,3174.61,3675.86,8
HCPCS,32550,INSERTION INDWELLING TUNNELED PLEURAL CATHETER,8901.0,5785.650000000001,0.01,16234.0,409
HCPCS,32551,TUBE THORACOSTOMY INCLUDES WATER SEAL,4181.0,2717.6499999999996,0.01,7146.0,492
HCPCS,32552,RMVL NDWELLG TUN PLEURAL CATH W/CUFF,1012.0,657.8,1.1,1833.54,148
HCPCS,32552,RMVL NDWELLG TUNNELED PLEURAL CATHETER W/CUFF,2844.0,1848.6,0.01,12500.0,348
HCPCS,32553,PLMT NTRSTL DEV RADJ THX GID PRQ INTRATHRC 1/MLT,3928.0,2553.2,1.1,8326.0,234
HCPCS,32554,THORACENTESIS NEEDLE/CATH PLEURA W/O IMAGING,1822.5,1184.625,0.01,4628.0,409
HCPCS,32555,THORACENTESIS NEEDLE/CATH PLEURA W/IMAGING,1921.5,1248.975,0.01,4628.0,496
HCPCS,32556,PERQ DRAINAGE PLEURA INSERT CATH W/O IMAGING,4913.0,3193.45,0.01,8726.0,409
HCPCS,32557,PERQ DRAINAGE PLEURA INSERT CATH W/IMAGING,4259.5,2768.6749999999997,0.01,7146.0,322
HCPCS,32560,INSTLJ VIA CHEST TUBE/CATH AGENT FOR PLEURODESIS,1730.0,1124.5,1.1,5265.0,235
HCPCS,32561,INSTLJ VIA CH TUBE/CATH AGENT FBRNLYSIS 1ST DAY,1700.0,1105.0,0.01,5265.0,235
HCPCS,32562,INSTLJ CH TUBE/CATH AGENT FBRNLYSIS SBSQ DAY,1670.0,1085.5,0.01,5265.0,235
HCPCS,32601,THORACOSCOPY DIAGNOSTIC,,,5005.78,11441.0,21
HCPCS,32601,THORSC DX LUNGS/PERICAR/MED/PLEURAL SPACE W/O BX,2200.0,1430.0,1.1,16829.38,144
HCPCS,32601,Thoracoscopy diagnostic,,,3174.61,3675.86,8
HCPCS,32604,THORACOSCOPY DX PERICARDIAL SAC W/BIOPSY SPX,3508.0,2280.2,1.1,30022.29,144
HCPCS,32604,THORACOSCOPY WBX SAC,,,8930.36,26873.26,21
HCPCS,32604,Thoracoscopy wbx sac,,,1722.25,1994.18,8
HCPCS,32606,THORACOSCOPY DX MEDIASTINAL SPACE W/BIOPSY SPX,3356.0,2181.4,1.1,16829.38,144
HCPCS,32606,THORACOSCOPY W/BX MED SPACE,,,5005.78,15063.4,21
HCPCS,32606,Thoracoscopy w/bx med space,,,3174.61,3675.86,8
HCPCS,32607,THORACOSCOPY W/BX INFILTRATE,,,8930.36,11062.31,20
HCPCS,32607,THORACOSCOPY W/DX BX OF LUNG INFILTRATE UNILATRL,2200.0,1430.0,1.1,30022.29,144
HCPCS,32607,Thoracoscopy w/bx infiltrate,,,3174.61,3675.86,8
HCPCS,32608,THORACOSCOPY W/BX NODULE,,,7813.0,11441.0,22
HCPCS,32608,THORACOSCOPY W/DX BX OF LUNG NODULES UNILATRL,2736.0,1778.4,1.1,30022.29,144
HCPCS,32608,Thoracoscopy w/bx nodule,,,3174.61,3675.86,8
HCPCS,32609,THORACOSCOPY WITH BIOPSIES OF PLEURA,26838.0,17444.7,0.01,26838.0,87
HCPCS,32609,THORACOSCOPY WITH BIOPSYIES OF PLEURA,1832.0,1190.8,1.1,16829.38,144
HCPCS,3260F,PT CAT/PN CAT/HIST GRD DOCD,,,83.82,83.82,1
HCPCS,3260F,Pt cat/pn cat/hist grd docd,,,10.69,12.38,8
HCPCS,32650,THORACOSCOPY SURG W PLEURODESIS,4332.0,2815.8,1.1,4332.0,144
HCPCS,32650,THORACOSCOPY W/PLEURODESIS,,,1740.42,1740.42,1
HCPCS,32650,Thoracoscopy w/pleurodesis,,,3174.61,3675.86,8
HCPCS,32651,THORACOSCOPY REMOVE CORTEX,,,2850.61,2850.61,1
HCPCS,32651,THORACOSCOPY SURG PART PULM DECORT,7512.0,4882.8,1.1,7512.0,144
HCPCS,32651,Thoracoscopy remove cortex,,,3174.61,3675.86,8
HCPCS,32652,THORACOSCOPY REM TOTL CORTEX,,,4326.35,4326.35,1
HCPCS,32652,THRSC TOT PULM DCRTCTJ INTRAPLEURAL PNEUMONOLSS,11652.0,7573.8,1.1,11652.0,144
HCPCS,32652,Thoracoscopy rem totl cortex,,,3174.61,3675.86,8
HCPCS,32653,THORACOSCOPY REMOV FB/FIBRIN,,,2753.04,2753.04,1
HCPCS,32653,THORACOSCOPY RMVL INTRAPLEURAL FB/FIBRIN DEPOSIT,7268.0,4724.2,1.1,7268.0,144
HCPCS,32653,Thoracoscopy remov fb/fibrin,,,1722.25,1994.18,8
HCPCS,32654,THORACOSCOPY CONTRL BLEEDING,,,3077.13,3077.13,1
HCPCS,32654,THORACOSCOPY CONTROL TRAUMATIC HEMORRHAGE,8208.0,5335.2,1.1,8208.0,144
HCPCS,32654,Thoracoscopy contrl bleeding,,,3174.61,3675.86,8
HCPCS,32655,THORACOSCOPY RESECT BULLAE,,,2491.15,2491.15,1
HCPCS,32655,THORACOSCOPY W/RESECTION BULLAE W/WO PLEURAL PX,6468.0,4204.2,1.1,6468.0,144
HCPCS,32655,Thoracoscopy resect bullae,,,3174.61,3675.86,8
HCPCS,32656,THORACOSCOPY SURG PART PLEURECTOMY,5304.0,3447.6,1.1,5304.0,144
HCPCS,32656,THORACOSCOPY W/PLEURECTOMY,,,2091.41,2091.41,1
HCPCS,32656,Thoracoscopy w/pleurectomy,,,1722.25,1994.18,8
HCPCS,32658,THORACOSCOPY W/RMVL CLOT/FB FROM PERICARDIAL SAC,4684.0,3044.6,1.1,4684.0,144
HCPCS,32658,THORACOSCOPY W/SAC FB REMOVE,,,1861.88,1861.88,1
HCPCS,32658,Thoracoscopy w/sac fb remove,,,3174.61,3675.86,8
HCPCS,32659,THORACOSCOPY W/SAC DRAINAGE,,,1912.16,1912.16,1
HCPCS,32659,THRSC CRTJ PRCRD WINDOW/PRTL RESCJ PRCRD SAC,4776.0,3104.4,1.1,4776.0,144
HCPCS,32659,Thoracoscopy w/sac drainage,,,3174.61,3675.86,8
HCPCS,3265F,RNA TSTNG HEPC VIR ORD/DOCD,,,2739849.3,2739849.3,1
HCPCS,3265F,Rna tstng hepc vir ord/docd,,,10.69,12.38,8
HCPCS,32661,THORACOSCOPY W/EXC PERICARDIAL CYST TUMOR/MASS,5332.0,3465.8,1.1,5332.0,144
HCPCS,32661,THORACOSCOPY W/PERICARD EXC,,,2081.3,2081.3,1
HCPCS,32661,Thoracoscopy w/pericard exc,,,3174.61,3675.86,8
HCPCS,32662,THORACOSCOPY W/EXC MEDIASTINAL CYST TUMOR/MASS,5996.0,3897.4,1.1,5996.0,144
HCPCS,32662,THORACOSCOPY W/MEDIAST EXC,,,2328.48,2328.48,1
HCPCS,32662,Thoracoscopy w/mediast exc,,,3174.61,3675.86,8
HCPCS,32663,THORACOSCOPY W/LOBECTOMY,,,3637.76,3637.76,1
HCPCS,32663,THORACOSCOPY W/LOBECTOMY SINGLE LOBE,9856.0,6406.4,1.1,9856.0,144
HCPCS,32663,Thoracoscopy w/lobectomy,,,3174.61,3675.86,8
HCPCS,32664,THORACOSCOPY W/THORACIC SYMPATHECTOMY,6283.0,4083.95,1.1,6283.0,144
HCPCS,32664,Thoracoscopy w/ th nrv exc,,,3174.61,3675.86,8
HCPCS,32665,THORACOSCOP W/ESOPH MUSC EXC,,,3205.17,3205.17,1
HCPCS,32665,THORACOSCOPY W/ESOPHAGOMYOTOMY HELLER TYPE,8612.0,5597.8,1.1,8612.0,144
HCPCS,32665,Thoracoscop w/esoph musc exc,,,3174.61,3675.86,8
HCPCS,32666,THORACOSCOPY W/THERA WEDGE RESEXN INITIAL UNILAT,5800.0,3770.0,1.1,5800.0,144
HCPCS,32666,THORACOSCOPY W/WEDGE RESECT,,,2265.13,2265.13,1
HCPCS,32666,Thoracoscopy w/wedge resect,,,3174.61,3675.86,8
HCPCS,32667,THORACOSCOPY W/THERA WEDGE RESEXN ADDL IPSILATRL,1200.0,780.0,1.1,1200.0,144
HCPCS,32667,THORACOSCOPY W/W RESECT ADDL,,,407.22,407.22,1
HCPCS,32667,Thoracoscopy w/w resect addl,,,3174.61,3675.86,8
HCPCS,32668,THORACOSCOPY W/DX WEDGE RESEXN ANATO LUNG RESEXN,1200.0,780.0,1.1,1200.0,144
HCPCS,32668,THORACOSCOPY W/W RESECT DIAG,,,407.22,407.22,1
HCPCS,32668,Thoracoscopy w/w resect diag,,,3174.61,3675.86,8
HCPCS,32669,THORACOSCOPY REMOVE SEGMENT,,,3492.02,3492.02,1
HCPCS,32669,THORACOSCOPY W/SEGMENTECTOMY,9412.0,6117.8,1.1,9412.0,144
HCPCS,32669,Thoracoscopy remove segment,,,3174.61,3675.86,8
HCPCS,3266F,HEPC GN TSTNG DOCD B/4TXMNT,,,2739849.3,2739849.3,1
HCPCS,3266F,Hepc gn tstng docd b/4txmnt,,,10.69,12.38,8
HCPCS,32670,THORACOSCOPY BILOBECTOMY,,,4162.14,4162.14,1
HCPCS,32670,THORACOSCOPY W/BILOBECTOMY,11408.0,7415.2,1.1,11408.0,144
HCPCS,32670,Thoracoscopy bilobectomy,,,3174.61,3675.86,8
HCPCS,32671,THORACOSCOPY PNEUMONECTOMY,,,4611.86,4611.86,1
HCPCS,32671,THORACOSCOPY W/PNEUMONECTOMY,12768.0,8299.2,1.1,12768.0,144
HCPCS,32671,Thoracoscopy pneumonectomy,,,3174.61,3675.86,8
HCPCS,32672,THORACOSCOPY FOR LVRS,,,3950.07,3950.07,1
HCPCS,32672,THORACOSCOPY W/RESEXN-PLICAJ EMPHYSEMA LUNG UNIL,10800.0,7020.0,1.1,10800.0,144
HCPCS,32672,Thoracoscopy for lvrs,,,3174.61,3675.86,8
HCPCS,32673,THORACOSCOPY RESEXN THYMUS UNI/BILATERAL,8452.0,5493.8,1.1,8452.0,144
HCPCS,32673,THORACOSCOPY W/THYMUS RESECT,,,3163.06,3163.06,1
HCPCS,32673,Thoracoscopy w/thymus resect,,,3174.61,3675.86,8
HCPCS,32674,THORACOSCOPY LYMPH NODE EXC,,,559.92,559.92,1
HCPCS,32674,THORCOSCPY W/MEDIASTINL &REGIONL LYMPHADENECTOMY,1648.0,1071.2,1.1,1648.0,144
HCPCS,32674,Thoracoscopy lymph node exc,,,673.41,779.74,8
HCPCS,3267F,PATH RPRT W/ PT PN CAT ET AL,,,0.03,0.03,1
HCPCS,3267F,Path rprt w/ pt pn cat et al,,,10.69,12.38,8
HCPCS,3268F,PSA/T/GLSC DOCD B/4 TXMNT,,,2739849.3,2739849.3,1
HCPCS,3268F,Psa/t/glsc docd b/4 txmnt,,,10.69,12.38,8
HCPCS,3269F,BONE SCN B/4 TXMNT/AFTR DX,,,2739849.3,2739849.3,1
HCPCS,3269F,Bone scn b/4 txmnt/aftr dx,,,10.69,12.38,8
HCPCS,32701,THORAX STEREOTACTIC RADIATION TARGET W/TX COURSE,1672.0,1086.8,1.1,1672.0,142
HCPCS,32701,Thorax stereo rad targetw/tx,,,405.62,469.67,8
HCPCS,3270F,NO BONE SCN B/4 TXMNT/AFTRDX,,,0.03,0.03,1
HCPCS,3270F,No bone scn b/4 txmnt/aftrdx,,,10.69,12.38,8
HCPCS,3271F,LOW RISK PROSTATE CANCER,,,0.03,0.03,1
HCPCS,3271F,Low risk prostate cancer,,,10.69,12.38,8
HCPCS,3272F,MED RISK PROSTATE CANCER,,,2739849.3,2739849.3,1
HCPCS,3272F,Med risk prostate cancer,,,10.69,12.38,8
HCPCS,3273F,HIGH RISK PROSTATE CANCER,,,2739849.3,2739849.3,1
HCPCS,3273F,High risk prostate cancer,,,10.69,12.38,8
HCPCS,3274F,PROST CNCR RSK NOT LW/MD/HGH,,,2739849.3,2739849.3,1
HCPCS,3274F,Prost cncr rsk not lw/md/hgh,,,10.69,12.38,8
HCPCS,3278F,SERUM LVLS CA/IPTH/LPD ORD,,,2739849.3,2739849.3,1
HCPCS,3278F,Serum lvls ca/ipth/lpd ord,,,10.69,12.38,8
HCPCS,3279F,HGB LVL >= 13 G/DL,,,2739849.3,2739849.3,1
HCPCS,3279F,Hgb lvl >= 13 g/dl,,,10.69,12.38,8
HCPCS,32800,REPAIR LUNG HERNIA,,,2454.03,2454.03,1
HCPCS,32800,REPAIR LUNG HERNIA THROUGH CHEST WALL,6284.0,4084.6,1.1,6284.0,144
HCPCS,32800,Repair lung hernia,,,3174.61,3675.86,8
HCPCS,3280F,HGB LVL 11-12.9 G/DL,,,2739849.3,2739849.3,1
HCPCS,3280F,Hgb lvl 11-12.9 g/dl,,,10.69,12.38,8
HCPCS,32810,CLOSE CHEST AFTER DRAINAGE,,,2350.34,2350.34,1
HCPCS,32810,CLSR CH WALL FLWG OPN FLAP DRG EMPYEMA,5980.0,3887.0,1.1,5980.0,144
HCPCS,32810,Close chest after drainage,,,3174.61,3675.86,8
HCPCS,32815,CLOSE BRONCHIAL FISTULA,,,7287.61,7287.61,1
HCPCS,32815,Close bronchial fistula,,,3174.61,3675.86,8
HCPCS,32815,OPEN CLOSURE MAJOR BRONCHIAL FISTULA,20012.0,13007.8,1.1,20012.0,144
HCPCS,3281F,HGB LVL <11 G/DL,,,2739849.3,2739849.3,1
HCPCS,3281F,Hgb lvl <11 g/dl,,,10.69,12.38,8
HCPCS,32820,MAJOR RECONSTRUCTION CHEST WALL POSTTRAUMATIC,9004.0,5852.6,1.1,9004.0,144
HCPCS,32820,RECONSTRUCT INJURED CHEST,,,3470.73,3470.73,1
HCPCS,32820,Reconstruct injured chest,,,3174.61,3675.86,8
HCPCS,3284F,IOP RED >=15% PRE-NTRV LVL,,,0.03,0.03,1
HCPCS,3284F,Iop red >=15% pre-ntrv lvl,,,10.69,12.38,8
HCPCS,32850,DONOR PNEUMONECTOMY,,,2342.7,2342.7,1
HCPCS,32850,Donor pneumonectomy,,,3135.87,3631.01,8
HCPCS,32851,LUNG TRANSPLANT 1 W/O CARDIOPULMONARY BYPASS,23856.0,15506.4,1.1,23856.0,144
HCPCS,32851,LUNG TRANSPLANT SINGLE,,,8515.65,8515.65,1
HCPCS,32851,Lung transplant single,,,1229.51,1423.64,8
HCPCS,32852,LUNG TRANSPLANT 1 W/CARDIOPULMONARY BYPASS,26200.0,17030.0,1.1,26200.0,144
HCPCS,32852,LUNG TRANSPLANT WITH BYPASS,,,9167.36,9167.36,1
HCPCS,32852,Lung transplant with bypass,,,3135.87,3631.01,8
HCPCS,32853,LUNG TRANSPLANT 2 W/O CARDIOPULMONARY BYPASS,33792.0,21964.8,1.1,33792.0,144
HCPCS,32853,LUNG TRANSPLANT DOUBLE,,,11907.79,11907.79,1
HCPCS,32853,Lung transplant double,,,1229.51,1423.64,8
HCPCS,32854,LUNG TRANSPLANT 2 W/CARDIOPULMONARY BYPASS,36000.0,23400.0,1.1,36000.0,144
HCPCS,32854,LUNG TRANSPLANT WITH BYPASS,,,12611.37,12611.37,1
HCPCS,32854,Lung transplant with bypass,,,3135.87,3631.01,8
HCPCS,32855,BKBENCH PREPJ CADAVER DONOR LUNG ALLOGRAFT UNI,6133.0,3986.45,1.1,6133.0,104
HCPCS,32855,PREPARE DONOR LUNG SINGLE,,,583.92,583.92,1
HCPCS,32855,Prepare donor lung single,,,1229.51,1423.64,8
HCPCS,32856,BKBENCH PREPJ CADAVER DONOR LUNG ALLOGRAFT BI,9101.0,5915.65,1.1,9101.0,104
HCPCS,32856,PREPARE DONOR LUNG DOUBLE,,,875.84,875.84,1
HCPCS,32856,Prepare donor lung double,,,1229.51,1423.64,8
HCPCS,3285F,IOP DOWN <15% OF PRE-SVC LVL,,,0.03,0.03,1
HCPCS,3285F,Iop down <15% of pre-svc lvl,,,10.69,12.38,8
HCPCS,3288F,FALL RISK ASSESSMENT DOCD,,,0.03,0.03,1
HCPCS,3288F,Fall risk assessment docd,,,10.69,12.38,8
HCPCS,32900,REMOVAL OF RIB(S),,,3546.85,3546.85,1
HCPCS,32900,RESECTION RIBS EXTRAPLEURAL ALL STAGES,9524.0,6190.6,1.1,9524.0,144
HCPCS,32900,Removal of rib(s),,,3174.61,3675.86,8
HCPCS,32905,REVISE & REPAIR CHEST WALL,,,3475.77,3475.77,1
HCPCS,32905,Revise & repair chest wall,,,3174.61,3675.86,8
HCPCS,32905,THORACOPLASTY SCHEDE TYPE/EXTRAPLEURAL,9316.0,6055.4,1.1,9316.0,144
HCPCS,32906,REVISE & REPAIR CHEST WALL,,,4289.8,4289.8,1
HCPCS,32906,Revise & repair chest wall,,,3174.61,3675.86,8
HCPCS,32906,THORACOP SCHEDE TYP/XTRPLEURAL CLSR BRNCPLR FSTL,11720.0,7618.0,1.1,11720.0,144
HCPCS,3290F,PT=D(RH)- AND UNSENSITIZED,,,2739849.3,2739849.3,1
HCPCS,3290F,Pt=d(rh)- and unsensitized,,,10.69,12.38,8
HCPCS,3291F,PT=D(RH)+ OR SENSITIZED,,,2739849.3,2739849.3,1
HCPCS,3291F,Pt=d(rh)+ or sensitized,,,10.69,12.38,8
HCPCS,3292F,HIV TSTNG ASKED/DOCD/REVWD,,,2739849.3,2739849.3,1
HCPCS,3292F,Hiv tstng asked/docd/revwd,,,10.69,12.38,8
HCPCS,3293F,ABO RH BLOOD TYPING DOCD,,,2739849.3,2739849.3,1
HCPCS,3293F,Abo rh blood typing docd,,,10.69,12.38,8
HCPCS,32940,PNEUMONOLYSIS XTRPRIOSTEAL W/FILLING/PACKING PX,8536.0,5548.4,1.1,8536.0,144
HCPCS,32940,REVISION OF LUNG,,,3211.28,3211.28,1
HCPCS,32940,Revision of lung,,,3174.61,3675.86,8
HCPCS,3294F,GRP B STREP SCREENING DOCD,,,2739849.3,2739849.3,1
HCPCS,3294F,Grp b strep screening docd,,,10.69,12.38,8
HCPCS,32960,THERAPEUTIC PNEUMOTHORAX,,,545.0,1640.03,21
HCPCS,32960,Therapeutic pneumothorax,,,760.55,880.64,8
HCPCS,32994,ABLATION THER 1+ PULM TUMORS PERQ CRYOABLATION,15153.5,9849.775,0.01,30022.29,322
HCPCS,32997,TOTAL LUNG LAVAGE,,,872.14,872.14,1
HCPCS,32997,TOTAL LUNG LAVAGE (UNILATERAL),2924.0,1900.6,1.1,2924.0,144
HCPCS,32997,Total lung lavage,,,2619.86,3033.53,8
HCPCS,32998,ABLATION THER 1+ PULM TUMORS PERQ RADIOFREQUENCY,15225.0,9896.25,0.01,26838.0,321
HCPCS,32999,CHEST TUBE EXCHANGE,802.0,521.3,0.01,1833.54,84
HCPCS,32999,CT LUNG LOCALIZATION,1845.0,1199.25,0.01,1845.0,85
HCPCS,32999,IMAGE GUIDED CHEST TUBE EXCHANGE REPOSITION (COMP CODE 49423),4230.5,2749.825,0.01,12615.0,168
HCPCS,32999,IMAGE GUIDED LUNG LOCALIZATION (COMP CODE 32553),3928.0,2553.2,0.01,12615.0,168
HCPCS,32999,LUNG CRYOABLATION,2363.0,1535.95,0.01,2363.0,84
HCPCS,32999,REVISE/DEBRIDE CLAGETT WINDOW NO CLOSURE,1532.0,995.8,0.01,1833.54,84
HCPCS,32999,THORACOTOMY FOR DELIVERY OF AN ENDOVASCULAR PROSTHESIS,5157.0,3352.05,0.01,5157.0,84
HCPCS,32999,UNLISTED PROC LUNG/PLEURA,1845.0,1199.25,512.91,12615.0,84
HCPCS,32999,UNLISTED PROCEDURE LUNGS & PLEURA,1165.0,757.25,0.01,1833.54,84
HCPCS,3300F,AJCC STAGE DOCD B/4 THXPY,,,0.03,0.03,1
HCPCS,3300F,Ajcc stage docd b/4 thxpy,,,10.69,12.38,8
HCPCS,33016,PERICARDIOCENTESIS W/IMG GUIDANCE WHEN PERFORMED,5346.0,3474.9,0.01,11545.0,753
HCPCS,33017,PERQ PRCRD DRG 6YR+ W/O CONGENITAL CAR ANOMALY,3723.0,2419.95,0.01,12615.0,485
HCPCS,33018,PERQ PRCRD DRG 0-5YR/ANY AGE W/CGEN CAR ANOMALY,3737.0,2429.05,0.01,12615.0,486
HCPCS,33019,PERQ PERICARDIAL DRG W/INSJ NDWELLG CATH W/CT,3601.0,2340.65,1.1,12615.0,348
HCPCS,3301F,CANCER STAGE DOCD METAST,,,2739849.3,2739849.3,1
HCPCS,3301F,Cancer stage docd metast,,,10.69,12.38,8
HCPCS,33020,PERICARDIOTOMY REMOVAL CLOT/FOREIGN BODY PRIMARY,5970.0,3880.5,1.1,13132.0,212
HCPCS,33025,CRTJ PERICARDIAL WINDOW/PRTL RESECJ W/DRG/BX,7354.0,4780.1,1.1,13132.0,280
HCPCS,33030,PARTIAL REMOVAL OF HEART SAC,,,5198.25,5198.25,1
HCPCS,33030,PRICARDIECTOMY STOT/COMPL W/O CARDPULM BYPASS,14400.0,9360.0,1.1,14400.0,144
HCPCS,33030,Partial removal of heart sac,,,3045.04,3525.83,8
HCPCS,33031,PARTIAL REMOVAL OF HEART SAC,,,6424.34,6424.34,1
HCPCS,33031,PRICARDIECTOMY STOT/COMPL W/CARDPULM BYPASS,18000.0,11700.0,1.1,18000.0,144
HCPCS,33031,Partial removal of heart sac,,,3045.04,3525.83,8
HCPCS,33050,RESECT HEART SAC LESION,,,2622.76,2622.76,1
HCPCS,33050,RESECTION PERICARDIAL CYST/TUMOR,6788.0,4412.2,1.1,6788.0,144
HCPCS,33050,Resect heart sac lesion,,,3045.04,3525.83,8
HCPCS,33120,EXC ICAR TUM RESC W/CARD BYP,,,5431.31,5431.31,1
HCPCS,33120,EXC INTRACARDIAC TUMOR RESCJ CARDIOPULMONARY BYP,15380.0,9997.0,1.1,15380.0,144
HCPCS,33120,Exc icar tum resc w/card byp,,,3045.04,3525.83,8
HCPCS,33130,RESCJ EXTERNAL CARDIAC TUMOR,,,3538.27,3538.27,1
HCPCS,33130,RESECTION EXTERNAL CARDIAC TUMOR,9668.0,6284.2,1.1,9668.0,144
HCPCS,33130,Rescj external cardiac tumor,,,3045.04,3525.83,8
HCPCS,33140,HEART REVASCULARIZE (TMR),,,4028.43,4028.43,1
HCPCS,33140,Heart revascularize (tmr),,,3045.04,3525.83,8
HCPCS,33140,TRANSMYOCARDIAL LASER REVASCULAR THORACOTOMY SPX,11336.0,7368.4,1.1,11336.0,144
HCPCS,33141,HEART TMR W/OTHER PROCEDURE,,,342.55,342.55,1
HCPCS,33141,Heart tmr w/other procedure,,,673.41,779.74,8
HCPCS,33141,TRANSMYOCRD LASER REVSC PFRMD TM OTH OPN CAR PX,1016.0,660.4,1.1,1016.0,144
HCPCS,3315F,ER+ OR PR+ BREAST CANCER,,,0.03,0.03,1
HCPCS,3315F,Er+ or pr+ breast cancer,,,10.69,12.38,8
HCPCS,3316F,ER- OR PR- BREAST CANCER,,,2739849.3,2739849.3,1
HCPCS,3316F,Er- or pr- breast cancer,,,10.69,12.38,8
HCPCS,3317F,PATH RPT MALIG CANCER DOCD,,,2739849.3,2739849.3,1
HCPCS,3317F,Path rpt malig cancer docd,,,10.69,12.38,8
HCPCS,3318F,PATH RPT MALIG CANCER DOCD,,,2739849.3,2739849.3,1
HCPCS,3318F,Path rpt malig cancer docd,,,10.69,12.38,8
HCPCS,3319F,X-RAY/CT/ULTRSND ET AL ORD,,,2739849.3,2739849.3,1
HCPCS,3319F,X-ray/ct/ultrsnd et al ord,,,10.69,12.38,8
HCPCS,33202,INSERT EPICARD ELTRD OPEN,,,2004.45,2004.45,1
HCPCS,33202,"INSERT EPICARDIAL ELECTRODE, OPEN",5808.0,3775.2,1.1,5808.0,144
HCPCS,33202,Insert epicard eltrd open,,,3045.04,3525.83,8
HCPCS,33203,INSERT EPICARD ELTRD ENDO,5588.0,3632.2,1.1,5588.0,145
HCPCS,33203,Insert epicard eltrd endo,,,6303.75,7299.08,8
HCPCS,33206,INS NEW/RPLCMT PRM PACEMAKR W/TRANS ELTRD ATRIAL,15017.5,9761.375,1.1,31142.61,316
HCPCS,33207,INS NEW/RPLC PRM PACEMAKER W/TRANSV ELTRD VENTR,15439.5,10035.675,1.1,31142.61,316
HCPCS,33208,INS NEW/RPLCMT PRM PM W/TRANSV ELTRD ATRIAL&VENT,14527.5,9442.875,1.1,31142.61,316
HCPCS,3320F,NO XRAY/CT/ ET AL ORDD,,,2739849.3,2739849.3,1
HCPCS,3320F,No xray/ct/ et al ordd,,,10.69,12.38,8
HCPCS,33210,INSJ/RPLCMT TEMP TRANSVNS 1CHMBR ELTRD/PM CATH,24464.5,15901.925,0.01,47587.0,489
HCPCS,33211,INSJ/RPLCMT TEMP TRANSVNS 2CHMBR PACG ELTRDS SPX,24421.5,15873.975,0.01,47587.0,231
HCPCS,33212,INS PM PLS GEN W/EXIST SINGLE LEAD,12370.5,8040.825,1.1,24778.8,231
HCPCS,33213,INS PACEMAKER PULSE GEN ONLY W/EXIST DUAL LEADS,14132.0,9185.8,1.1,31142.61,231
HCPCS,33214,UPG PACEMAKER SYS CONVERT 1CHMBR SYS 2CHMBR SYS,14410.5,9366.825,1.1,31142.61,230
HCPCS,33215,RPSG PREV IMPLTED PM/DFB R ATR/R VENTR ELECTRODE,10033.0,6521.450000000001,1.1,18098.0,316
HCPCS,33216,INSJ 1 TRANSVNS ELTRD PERM PACEMAKER/IMPLTBL DFB,16482.5,10713.625,1.1,30717.0,316
HCPCS,33217,INSJ 2 TRANSVNS ELTRD PERM PACEMAKER/IMPLTBL DFB,14513.5,9433.775000000001,1.1,26791.0,230
HCPCS,33218,RPR 1 TRANSVNS ELTRD PRM PM/PACING IMPLNTBL DFB,11627.0,7557.55,1.1,20926.0,230
HCPCS,3321F,AJCC CNCR 0/IA MELAN DOCD,,,2739849.3,2739849.3,1
HCPCS,3321F,Ajcc cncr 0/ia melan docd,,,10.69,12.38,8
HCPCS,33220,RPR 2 TRANSVNS ELECTRODES PRM PM/IMPLANTABLE DFB,11643.0,7567.95,1.1,20926.0,230
HCPCS,33221,INS PACEMAKER PULSE GEN ONLY W/EXIST MULT LEADS,23628.5,15358.525,1.1,56827.47,230
HCPCS,33222,RELOCATION OF SKIN POCKET FOR PACEMAKER,6229.0,4048.85,1.1,10518.0,231
HCPCS,33223,RELOCATE SKIN POCKET IMPLANTABLE DEFIBRILLATOR,6519.0,4237.35,1.1,10518.0,231
HCPCS,33224,INSJ ELTRD CAR VEN SYS ATTCH PREV PM/DFB PLS GEN,16563.0,10765.95,1.1,31142.61,316
HCPCS,33225,INSJ ELTRD CAR VEN SYS TM INSJ DFB/PM PLS GEN,9973.0,6482.450000000001,1.1,16614.0,280
HCPCS,33226,RPSG PREV IMPLTED CAR VEN SYS L VENTR ELTRD,10785.0,7010.25,1.1,18098.0,230
HCPCS,33227,REMVL PERM PM PLSE GEN W/REPL PLSE GEN SNGL LEAD,11797.5,7668.375,1.1,24778.8,316
HCPCS,33228,REMVL PERM PM PLS GEN W/REPL PLSE GEN 2 LEAD SYS,14472.0,9406.800000000001,1.1,31142.61,316
HCPCS,33229,REMVL PERM PM PLS GEN W/REPL PLSE GEN MULT LEAD,22640.0,14716.0,1.1,56827.47,316
HCPCS,3322F,MELANOMAAJCC STAGE 0 OR IA,,,2739849.3,2739849.3,1
HCPCS,3322F,Melanomaajcc stage 0 or ia,,,10.69,12.38,8
HCPCS,33230,INS PACNG CVDFB PLS GEN ONLY W/EXIST DUAL LEADS,2428.0,1578.2,1.1,68747.0,144
HCPCS,33230,INSJ IMPLNTBL DEFIB PULSE GEN W/EXIST DUAL LEADS,42695.0,27751.75,416.46,42695.0,86
HCPCS,33231,INS PACNG CVDFB PLS GEN ONLY W/EXIST MULTI LEADS,2536.0,1648.4,1.1,95950.11,144
HCPCS,33231,INSJ IMPLNTBL DEFIB PULSE GEN W/EXIST MULTILEADS,65538.0,42599.7,443.03,65538.0,86
HCPCS,33233,REMOVAL PERMANENT PACEMAKER PULSE GENERATOR ONLY,24421.5,15873.975,1.1,47587.0,318
HCPCS,33234,RMVL TRANSVNS PM ELTRD 1 LEAD SYS ATR/VENTR,11995.0,7796.75,1.1,20926.0,318
HCPCS,33235,RMVL TRANSVNS PM ELTRD DUAL LEAD SYS,12443.0,8087.95,1.1,20926.0,316
HCPCS,33236,REMOVE ELECTRODE/THORACOTOMY,,,2029.85,2029.85,1
HCPCS,33236,RMVL PRM EPICAR PM&ELTRDS THORCOM 1 LEAD SYS,5092.0,3309.8,1.1,5092.0,144
HCPCS,33236,Remove electrode/thoracotomy,,,3045.04,3525.83,8
HCPCS,33237,REMOVE ELECTRODE/THORACOTOMY,,,2179.89,2179.89,1
HCPCS,33237,RMVL PRM EPICAR PM&ELTRDS THORCOM DUAL LEAD SY,5536.0,3598.4,1.1,5536.0,144
HCPCS,33237,Remove electrode/thoracotomy,,,3045.04,3525.83,8
HCPCS,33238,REMOVE ELECTRODE/THORACOTOMY,,,2464.11,2464.11,1
HCPCS,33238,RMVL PRM TRANSVENOUS ELECTRODE THORACOTOMY,6160.0,4004.0,1.1,6160.0,144
HCPCS,33238,Remove electrode/thoracotomy,,,3045.04,3525.83,8
HCPCS,3323F,CLIN NODE STGNG DOCDB/4 SURG,,,2739849.3,2739849.3,1
HCPCS,3323F,Clin node stgng docdb/4 surg,,,10.69,12.38,8
HCPCS,33240,INSJ IMPLNTBL DEFIB PULSE GEN W/1 EXISTING LD,26160.0,17004.0,1.1,68747.0,230
HCPCS,33241,REMOVAL IMPLANTABLE DEFIB PULSE GENERATOR ONLY,11071.0,7196.15,1.1,20926.0,316
HCPCS,33243,REMOVE ELTRD/THORACOTOMY,,,3572.77,3572.77,1
HCPCS,33243,RMVL 1/DUAL CHAMBER DEFIB ELECTRODE BY THORACOM,9428.0,6128.2,1.1,9428.0,144
HCPCS,33243,Remove eltrd/thoracotomy,,,3045.04,3525.83,8
HCPCS,33244,RMVL1/DUAL CHMBR IMPLTBL DFB ELTRD TRANSVNS XTRJ,13211.0,8587.15,1.1,20926.0,316
HCPCS,33249,INSJ/RPLCMT PERM DFB W/TRNSVNS LDS 1/DUAL CHMBR,31304.5,20347.925,1.1,95950.11,316
HCPCS,3324F,MRI CT SCAN ORD RVWD RQSTD,,,2739849.3,2739849.3,1
HCPCS,3324F,Mri ct scan ord rvwd rqstd,,,10.69,12.38,8
HCPCS,33250,ABLATE HEART DYSRHYTHM FOCUS,,,3769.06,3769.06,1
HCPCS,33250,ABLATION ARRHYTHMOGENIC FOCI/PATHWAY W/O BYPASS,10360.0,6734.0,1.1,10360.0,144
HCPCS,33250,Ablate heart dysrhythm focus,,,3045.04,3525.83,8
HCPCS,33251,ABLATE HEART DYSRHYTHM FOCUS,,,4238.26,4238.26,1
HCPCS,33251,ABLATION ARRHYTHMOGENIC FOCI/PATHWAY W/BYPASS,11568.0,7519.2,1.1,11568.0,144
HCPCS,33251,Ablate heart dysrhythm focus,,,3045.04,3525.83,8
HCPCS,33254,ABLATE ATRIA LMTD,,,3538.46,3538.46,1
HCPCS,33254,ABLATION & RECONSTRUCTION ATRIA LIMITED,9484.0,6164.6,1.1,9484.0,144
HCPCS,33254,Ablate atria lmtd,,,3045.04,3525.83,8
HCPCS,33255,ABLATE ATRIA W/O BYPASS EXT,,,4206.5,4206.5,1
HCPCS,33255,ABLATION & RCNSTJ ATRIA EXTNSV W/O BYPASS,11616.0,7550.4,1.1,11616.0,144
HCPCS,33255,Ablate atria w/o bypass ext,,,3045.04,3525.83,8
HCPCS,33256,ABLATE ATRIA W/BYPASS EXTEN,,,4985.81,4985.81,1
HCPCS,33256,ABLATION & RCNSTJ ATRIA EXTNSV W/BYPASS,13960.0,9074.0,1.1,13960.0,144
HCPCS,33256,Ablate atria w/bypass exten,,,3045.04,3525.83,8
HCPCS,33257,ABLATE ATRIA LMTD ADD-ON,,,1511.99,1511.99,1
HCPCS,33257,ATRIA ABLATE & RCNSTJ W/OTHER PROCEDURE LIMITE,3852.0,2503.8,1.1,3852.0,144
HCPCS,33257,Ablate atria lmtd add-on,,,673.41,779.74,8
HCPCS,33258,ABLATE ATRIA X10SV ADD-ON,,,1681.68,1681.68,1
HCPCS,33258,ATRIA ABLTJ & RCNSTJ W/OTHER PX EXTENSIV W/O BYP,4400.0,2860.0,1.1,4400.0,144
HCPCS,33258,Ablate atria x10sv add-on,,,673.41,779.74,8
HCPCS,33259,ABLATE ATRIA W/BYPASS ADD-ON,,,2197.95,2197.95,1
HCPCS,33259,ATRIA ABLTJ & RCNSTJ W/OTHER PX EXTEN W/BYPASS,5656.0,3676.4,1.1,5656.0,144
HCPCS,33259,Ablate atria w/bypass add-on,,,673.41,779.74,8
HCPCS,3325F,PREOP ASSES 4 CATARACT SURG,,,2739849.3,2739849.3,1
HCPCS,3325F,Preop asses 4 cataract surg,,,10.69,12.38,8
HCPCS,33261,ABLATE HEART DYSRHYTHM FOCUS,,,4169.24,4169.24,1
HCPCS,33261,Ablate heart dysrhythm focus,,,3045.04,3525.83,8
HCPCS,33261,OPRATIVE ABLTJ VENTR ARRHYTHMOGENIC FOC W/BYPASS,11568.0,7519.2,1.1,11568.0,144
HCPCS,33262,REM PAC CVDFB PLSE GEN &REPL PLSE GEN SNGL LEAD,2324.0,1510.6,1.1,68747.0,144
HCPCS,33262,RMVL IMPLTBL DFB PLSE GEN W/REPL PLSE GEN 1 LEAD,42062.0,27340.3,410.14,42062.0,172
HCPCS,33263,REM PAC CVDFB PLSE GEN &REPL PLSE GEN DUAL LEAD,2432.0,1580.8,1.1,68747.0,144
HCPCS,33263,RMVL IMPLTBL DFB PLSE GEN W/RPLCMT PLSE GEN 2 LD,40488.0,26317.2,426.74,40488.0,172
HCPCS,33264,REM PAC CVDFB PLS GEN &REPL PLSE GEN MULTI LEAD,2540.0,1651.0,1.1,95950.11,144
HCPCS,33264,RMVL IMPLTBL DFB PLS GEN W/RPLCMT PLS GEN MLT LD,52725.0,34271.25,443.36,52725.0,172
HCPCS,33265,ABLATE ATRIA LMTD ENDO,,,3535.78,3535.78,1
HCPCS,33265,Ablate atria lmtd endo,,,3045.04,3525.83,8
HCPCS,33265,NDSC ABLATION & RCNSTJ ATRIA LIMITED W/O BYPAS,9484.0,6164.6,1.1,9484.0,144
HCPCS,33266,ABLATE ATRIA X10SV ENDO,,,4780.94,4780.94,1
HCPCS,33266,Ablate atria x10sv endo,,,3045.04,3525.83,8
HCPCS,33266,NDSC ABLATION & RCNSTJ ATRIA EXTEN W/O BYPASS,13216.0,8590.4,1.1,13216.0,144
HCPCS,33267,EXCL LAA OPEN ANY METHOD,,,2712.85,2712.85,1
HCPCS,33267,EXCLUSION LEFT ATRIAL APPENDAGE OPEN ANY METHOD,7400.0,4810.0,1.1,7400.0,144
HCPCS,33267,Excl laa open any method,,,3045.04,3525.83,8
HCPCS,33268,EXCL LAA OPN OTH PX ANY METH,,,336.2,336.2,1
HCPCS,33268,EXCLUSION LAA OPEN TM STRNT/THRCM ANY METHOD,1000.0,650.0,1.1,1000.0,144
HCPCS,33268,Excl laa opn oth px any meth,,,3045.04,3525.83,8
HCPCS,33269,EXCL LAA THRSCP ANY METHOD,,,2154.52,2154.52,1
HCPCS,33269,EXCLUSION L ATR APPENDAGE THORACOSCOPIC ANY METH,5724.0,3720.6,1.1,5724.0,144
HCPCS,33269,Excl laa thrscp any method,,,14291.15,16547.65,8
HCPCS,33270,INS/RPLCMNT PERM SUBQ IMPLTBL DFB W/SUBQ ELTRD,28116.0,18275.399999999998,1.1,95950.11,316
HCPCS,33271,INSJ OF SUBQ IMPLANTABLE DEFIBRILLATOR ELECTRODE,11360.0,7384.0,1.1,24778.8,230
HCPCS,33272,RMVL OF SUBQ IMPLANTABLE DEFIBRILLATOR ELECTRODE,11655.5,7576.075,1.1,20926.0,317
HCPCS,33273,REPOS PREVIOUSLY IMPLANTED SUBQ IMPLANTABLE DFB,11763.0,7645.95,1.1,20926.0,230
HCPCS,33274,TCAT INSJ/RPL PERM LEADLESS PACEMAKER RV W/IMG,20720.0,13468.0,1.1,56827.47,403
HCPCS,33275,TCAT REMOVAL PERM LEADLESS PM RIGHT VENTR W/IMG,10767.0,6998.55,1.1,18098.0,403
HCPCS,33276,INSJ PHRNC NRV STIM SYS,,,40974.76,123301.37,21
HCPCS,33276,Insj phrnc nrv stim sys,,,19174.95,22202.58,8
HCPCS,33277,Insj phrnc nrv stim transvns,,,2167.75,2510.02,8
HCPCS,33278,RMVL PHRNC NRV STIM SYS,,,2951.88,8882.81,21
HCPCS,33278,Rmvl phrnc nrv stim sys,,,2167.75,2510.02,8
HCPCS,33279,RMVL PHRNC NRV STIM TRANSVNS,,,2951.88,8882.81,21
HCPCS,33279,Rmvl phrnc nrv stim transvns,,,2167.75,2510.02,8
HCPCS,33280,RMVL PHRNC NRV STIM PG ONLY,,,2951.88,8882.81,21
HCPCS,33280,Rmvl phrnc nrv stim pg only,,,2167.75,2510.02,8
HCPCS,33281,REPOSG PHRNC NRV STIM TRNSVN,,,2951.88,8882.81,21
HCPCS,33281,Reposg phrnc nrv stim trnsvn,,,2167.75,2510.02,8
HCPCS,33285,INSERTION SUBQ CARDIAC RHYTHM MONITOR W/PRGRMG,7622.0,4954.3,1.1,24778.8,493
HCPCS,33286,REMOVAL SUBCUTANEOUS CARDIAC RHYTHM MONITOR,2323.0,1509.95,1.1,4628.0,493
HCPCS,33287,RMV&RPLCMT PHRNC NRV STIM PG,,,26939.5,81066.43,21
HCPCS,33287,Rmv&rplcmt phrnc nrv stim pg,,,19174.95,22202.58,8
HCPCS,33288,RMV&RPLCMT PHRNC NRV STIM LD,,,10541.85,35562.32,21
HCPCS,33289,TCAT IMPL WRLS P-ART PRS SNR L-T HEMODYN MNTR,20513.0,13333.45,1.1,84765.21,229
HCPCS,3328F,PRFRMNC DOCD 2 WKS B/4 SURG,,,2739849.3,2739849.3,1
HCPCS,3328F,Prfrmnc docd 2 wks b/4 surg,,,10.69,12.38,8
HCPCS,33300,REPAIR CARDIAC WOUND W/O BYPASS,18341.5,11921.975,1.1,18695.0,212
HCPCS,33305,REPAIR CARDIAC WOUND W/CARDIOPULMONARY BYPASS,30772.0,20001.8,1.1,30772.0,144
HCPCS,33305,REPAIR OF HEART WOUND,,,10640.13,10640.13,1
HCPCS,33305,Repair of heart wound,,,3045.04,3525.83,8
HCPCS,3330F,IMAGING STUDY ORDERED (BKP),,,2739849.3,2739849.3,1
HCPCS,3330F,Imaging study ordered (bkp),,,10.69,12.38,8
HCPCS,33310,CARDIOT EXPL W/RMVL FB ATR/VENTR THRMB W/O BYP,8136.0,5288.4,1.1,8136.0,144
HCPCS,33310,EXPLORATORY HEART SURGERY,,,3026.93,3026.93,1
HCPCS,33310,Exploratory heart surgery,,,3045.04,3525.83,8
HCPCS,33315,CARDIOT EXPL RMVL FB ATR/VENTR THRMB CARD BYP,14000.0,9100.0,1.1,14000.0,144
HCPCS,33315,EXPLORATORY HEART SURGERY,,,4981.32,4981.32,1
HCPCS,33315,Exploratory heart surgery,,,3045.04,3525.83,8
HCPCS,3331F,BK IMAGING TST NOT ORDERED,,,2739849.3,2739849.3,1
HCPCS,3331F,Bk imaging tst not ordered,,,10.69,12.38,8
HCPCS,33320,REPAIR MAJOR BLOOD VESSEL(S),,,2783.32,2783.32,1
HCPCS,33320,Repair major blood vessel(s),,,2623.14,3037.32,8
HCPCS,33320,SUTR RPR AORTA/GRT VSL W/O SHUNT/CARD BYP,7416.0,4820.4,1.1,7416.0,144
HCPCS,33321,REPAIR MAJOR VESSEL,,,3075.32,3075.32,1
HCPCS,33321,Repair major vessel,,,2623.14,3037.32,8
HCPCS,33321,SUTR RPR AORTA/GREAT VESSEL W/SHUNT BYPASS,8324.0,5410.6,1.1,8324.0,144
HCPCS,33322,REPAIR MAJOR BLOOD VESSEL(S),,,3632.8,3632.8,1
HCPCS,33322,Repair major blood vessel(s),,,2623.14,3037.32,8
HCPCS,33322,SUTURE REPAIR AORTA/GREAT VESSEL W/BYPASS,9768.0,6349.2,1.1,9768.0,144
HCPCS,33330,INSERT MAJOR VESSEL GRAFT,,,3687.36,3687.36,1
HCPCS,33330,INSJ GRAFT AORTA/GREAT VESSEL W/O SHUNT/BYPASS,10116.0,6575.4,1.1,10116.0,144
HCPCS,33330,Insert major vessel graft,,,2623.14,3037.32,8
HCPCS,33335,INSERT MAJOR VESSEL GRAFT,,,4833.17,4833.17,1
HCPCS,33335,INSJ GRAFT AORTA/GREAT VESSEL W/BYPASS,13564.0,8816.6,1.1,13564.0,144
HCPCS,33335,Insert major vessel graft,,,2623.14,3037.32,8
HCPCS,33340,PERQ CLSR TCAT L ATR APNDGE W/ENDOCARDIAL IMPLNT,9610.0,6246.5,1.1,16547.65,210
HCPCS,33361,REPLACE AORTIC VALVE PERQ FEMORAL ARTRY APPROACH,12502.0,8126.299999999999,1.1,16547.65,280
HCPCS,33362,REPLACE AORTIC VALVE OPENFEMORAL ARTERY APPROACH,9816.0,6380.4,1.1,9816.0,144
HCPCS,33362,TAVR OPEN FEMORAL APPROACH,28437.0,18484.05,1500.23,28437.0,68
HCPCS,33363,REPLACE AORTIC VALVE OPEN,,,3543.2,3543.2,1
HCPCS,33363,REPLACE AORTIC VALVE OPEN AXILLRY ARTRY APPROACH,10188.0,6622.2,1.1,10188.0,144
HCPCS,33363,Replace aortic valve open,,,14291.15,16547.65,8
HCPCS,33364,REPLACE AORTIC VALVE OPEN,,,3532.71,3532.71,1
HCPCS,33364,REPLACE AORTIC VALVE OPEN ILIAC ARTERY APPROACH,10388.0,6752.2,1.1,10388.0,144
HCPCS,33364,Replace aortic valve open,,,14291.15,16547.65,8
HCPCS,33365,REPLACE AORTIC VALVE OPEN TRANSAORTIC APPROACH,10636.0,6913.4,1.1,10636.0,144
HCPCS,33365,TAVR TRANSAORTIC APPROACH,40822.0,26534.3,1626.0,40822.0,68
HCPCS,33366,TRANSCATHETER TRANSAPICAL REPLACEMT AORTIC VALVE,21350.5,13877.825,1.1,29787.0,212
HCPCS,33367,REPLACE AORTIC VALVE W/BYP,,,1578.9,1578.9,1
HCPCS,33367,REPLACE AORTIC VALVE W/BYP PRQ ART/VENOUS APPRCH,4752.0,3088.8,1.1,4752.0,144
HCPCS,33367,Replace aortic valve w/byp,,,14291.15,16547.65,8
HCPCS,33368,REPLACE AORTIC VALVE W/BYP,,,1913.53,1913.53,1
HCPCS,33368,REPLACE AORTIC VALVE W/BYP OPEN ART/VENOUS APRCH,5756.0,3741.4,1.1,5756.0,144
HCPCS,33368,Replace aortic valve w/byp,,,14291.15,16547.65,8
HCPCS,33369,REPLACE AORTA VALVE W/BYP CNTRL ART/VENOUS APRCH,7600.0,4940.0,1.1,7600.0,144
HCPCS,33369,REPLACE AORTIC VALVE W/BYP,,,2525.92,2525.92,1
HCPCS,33369,Replace aortic valve w/byp,,,14291.15,16547.65,8
HCPCS,33370,TRANSCATHETER PLACEMENT&SBSQ REMOVAL CEPD PERQ,2067.0,1343.55,1.1,16547.65,280
HCPCS,33390,VALVULOPLASTY AORTIC VALVE,,,4986.01,4986.01,1
HCPCS,33390,VALVULOPLASTY AORTIC VALVE OPEN CARD BYP SIMPLE,14000.0,9100.0,1.1,14000.0,144
HCPCS,33390,Valvuloplasty aortic valve,,,3045.04,3525.83,8
HCPCS,33391,(2017) VALVULOPLASTY AORTIC VALVE OPEN CARD BYP COMPLEX,16600.0,10790.0,1.1,16600.0,144
HCPCS,33391,VALVULOPLASTY AORTIC VALVE,,,5910.37,5910.37,1
HCPCS,33391,Valvuloplasty aortic valve,,,3045.04,3525.83,8
HCPCS,33404,CONSTRUCTION APICAL-AORTIC CONDUIT,12548.0,8156.2,1.1,12548.0,144
HCPCS,33404,PREPARE HEART-AORTA CONDUIT,,,4525.47,4525.47,1
HCPCS,33404,Prepare heart-aorta conduit,,,3045.04,3525.83,8
HCPCS,33405,REPLACEMENT AORTIC VALVE OPN,,,5895.08,5895.08,1
HCPCS,33405,RPLCMT PROST AORTIC VALVE OPEN XCP HOMOGRF/STENT,18181.0,11817.65,1.1,18181.0,144
HCPCS,33405,Replacement aortic valve opn,,,3045.04,3525.83,8
HCPCS,33406,REPLACEMENT AORTIC VALVE OPN,,,7495.35,7495.35,1
HCPCS,33406,RPLCMT AORTIC VALVE OPN ALLOGRAFT VALVE FREEHAND,21072.0,13696.8,1.1,21072.0,144
HCPCS,33406,Replacement aortic valve opn,,,3045.04,3525.83,8
HCPCS,3340F,MAMMO ASSESS INC XRAY DOCD,,,0.03,0.03,1
HCPCS,3340F,Mammo assess inc xray docd,,,10.69,12.38,8
HCPCS,33410,REPLACEMENT AORTIC VALVE OPN,,,6597.4,6597.4,1
HCPCS,33410,RPLCMT AORTIC VALVE OPN W/STENTLESS TISSUE VALVE,20420.0,13273.0,1.1,20420.0,144
HCPCS,33410,Replacement aortic valve opn,,,3045.04,3525.83,8
HCPCS,33411,REPLACEMENT OF AORTIC VALVE,,,8700.6,8700.6,1
HCPCS,33411,RPLCMT AORTIC VALVE ANNULUS ENLGMENT NONC SINUS,24828.0,16138.2,1.1,24828.0,144
HCPCS,33411,Replacement of aortic valve,,,3045.04,3525.83,8
HCPCS,33412,REPLACEMENT AORTIC VALVE KONNO PROCEDURE,23600.0,15340.0,1.1,23600.0,144
HCPCS,33412,REPLACEMENT OF AORTIC VALVE,,,8135.39,8135.39,1
HCPCS,33412,Replacement of aortic valve,,,3045.04,3525.83,8
HCPCS,33413,REPLACEMENT AORTIC&PULMON VALVES ROSS PROCEDUR,23948.0,15566.2,1.1,23948.0,144
HCPCS,33413,REPLACEMENT OF AORTIC VALVE,,,8332.61,8332.61,1
HCPCS,33413,Replacement of aortic valve,,,3045.04,3525.83,8
HCPCS,33414,REPAIR OF AORTIC VALVE,,,5587.6,5587.6,1
HCPCS,33414,RPR VENTR O/F TRC OBSTRCJ PATCH ENLGMENT O/F TRC,15748.0,10236.2,1.1,15748.0,144
HCPCS,33414,Repair of aortic valve,,,3045.04,3525.83,8
HCPCS,33415,RESECTION/INCISION SUBVALVULAR TISSUE,14908.0,9690.2,1.1,14908.0,144
HCPCS,33415,REVISION SUBVALVULAR TISSUE,,,5267.24,5267.24,1
HCPCS,33415,Revision subvalvular tissue,,,3045.04,3525.83,8
HCPCS,33416,REVISE VENTRICLE MUSCLE,,,5254.96,5254.96,1
HCPCS,33416,Revise ventricle muscle,,,3045.04,3525.83,8
HCPCS,33416,VENTRICULOMYOTOMY-MYECTOMY,14624.0,9505.6,1.1,14624.0,144
HCPCS,33417,AORTOPLASTY SUPRAVALVULAR STENOSIS,11732.0,7625.8,1.1,11732.0,144
HCPCS,33417,REPAIR OF AORTIC VALVE,,,4345.72,4345.72,1
HCPCS,33417,Repair of aortic valve,,,3045.04,3525.83,8
HCPCS,33418,TCAT MITRAL VALVE REPAIR INITIAL PROSTHESIS,15598.5,10139.025,1.1,17007.0,210
HCPCS,33419,TCAT MITRAL VALVE REPAIR ADDL PROSTHESIS,5681.5,3692.9750000000004,1.1,16547.65,210
HCPCS,3341F,MAMMO ASSESS NEGATIVE DOCD,,,0.03,0.03,1
HCPCS,3341F,Mammo assess negative docd,,,10.69,12.38,8
HCPCS,33420,REVISION OF MITRAL VALVE,,,3755.72,3755.72,1
HCPCS,33420,Revision of mitral valve,,,3045.04,3525.83,8
HCPCS,33422,REVISION OF MITRAL VALVE,,,4305.2,4305.2,1
HCPCS,33422,Revision of mitral valve,,,3045.04,3525.83,8
HCPCS,33422,VALVOTOMY MITRAL VALVE OPEN HEART W/BYPASS,11892.0,7729.8,1.1,11892.0,144
HCPCS,33425,REPAIR OF MITRAL VALVE,,,7087.7,7087.7,1
HCPCS,33425,Repair of mitral valve,,,3045.04,3525.83,8
HCPCS,33425,VALVULOPLASTY MITRAL VALVE W/CARDIAC BYPASS,19984.0,12989.6,1.1,19984.0,144
HCPCS,33426,REPAIR OF MITRAL VALVE,,,6187.47,6187.47,1
HCPCS,33426,Repair of mitral valve,,,3045.04,3525.83,8
HCPCS,33426,VLVP MITRAL VALVE W/CARD BYP W/PROSTC RING,17312.0,11252.8,1.1,17312.0,144
HCPCS,33427,REPAIR OF MITRAL VALVE,,,6329.54,6329.54,1
HCPCS,33427,Repair of mitral valve,,,3045.04,3525.83,8
HCPCS,33427,VLVP MITRAL VALVE W/BYPASS RAD RCNSTJ W/WO RING,17932.0,11655.8,1.1,17932.0,144
HCPCS,3342F,MAMMO ASSESS BENGN DOCD,,,0.03,0.03,1
HCPCS,3342F,Mammo assess bengn docd,,,10.69,12.38,8
HCPCS,33430,REPLACEMENT MITRAL VALVE W/CARDIOPULMONARY BYP,20372.0,13241.8,1.1,20372.0,144
HCPCS,33430,REPLACEMENT OF MITRAL VALVE,,,7272.65,7272.65,1
HCPCS,33430,Replacement of mitral valve,,,3045.04,3525.83,8
HCPCS,3343F,MAMMO PROBABLY BENGN DOCD,,,0.03,0.03,1
HCPCS,3343F,Mammo probably bengn docd,,,10.69,12.38,8
HCPCS,33440,RPLCMT A-VALVE TLCJ AUTOL PV,,,8798.33,8798.33,1
HCPCS,33440,RPLCMT AORTIC VALVE BY TLCJ AUTOL PULM VALVE,25600.0,16640.0,1.1,25600.0,144
HCPCS,33440,Rplcmt a-valve tlcj autol pv,,,3045.04,3525.83,8
HCPCS,3344F,MAMMO ASSESS SUSP DOCD,,,2739849.3,2739849.3,1
HCPCS,3344F,Mammo assess susp docd,,,10.69,12.38,8
HCPCS,3345F,MAMMO ASSESS HGHLYMALIG DOC,,,2739849.3,2739849.3,1
HCPCS,3345F,Mammo assess hghlymalig doc,,,10.69,12.38,8
HCPCS,33460,REVISION OF TRICUSPID VALVE,,,6205.72,6205.72,1
HCPCS,33460,Revision of tricuspid valve,,,3045.04,3525.83,8
HCPCS,33460,VALVECTOMY TRICUSPID VALVE W/CARDIOPULMONARY BYP,17880.0,11622.0,1.1,17880.0,144
HCPCS,33463,VALVULOPLAS TRICUS NO RING INSERT,22832.0,14840.8,1.1,22832.0,144
HCPCS,33463,VALVULOPLASTY TRICUSPID,,,7979.48,7979.48,1
HCPCS,33463,Valvuloplasty tricuspid,,,3045.04,3525.83,8
HCPCS,33464,VALVULOPLAS TRICUS W RING INSERT,17848.0,11601.2,1.1,17848.0,144
HCPCS,33464,VALVULOPLASTY TRICUSPID,,,6324.96,6324.96,1
HCPCS,33464,Valvuloplasty tricuspid,,,3045.04,3525.83,8
HCPCS,33465,REPLACE TRICUSPID VALVE,,,7148.69,7148.69,1
HCPCS,33465,REPLACEMENT TRICUSPID VALVE W/CARD BYPASS,20288.0,13187.2,1.1,20288.0,144
HCPCS,33465,Replace tricuspid valve,,,3045.04,3525.83,8
HCPCS,33468,REVISION OF TRICUSPID VALVE,,,6373.43,6373.43,1
HCPCS,33468,Revision of tricuspid valve,,,3045.04,3525.83,8
HCPCS,33468,TRICUSPID VALVE RPSG&PLCTJ EBSTEIN ANOMALY,18052.0,11733.8,1.1,18052.0,144
HCPCS,33470,Revision of pulmonary valve,,,3045.04,3525.83,8
HCPCS,33471,VLVT PV CLSD HRT VIA P-ART,,,3451.11,3451.11,1
HCPCS,33471,Vlvt pv clsd hrt via p-art,,,3045.04,3525.83,8
HCPCS,33474,REVISION OF PULMONARY VALVE,,,5670.4,5670.4,1
HCPCS,33474,Revision of pulmonary valve,,,3045.04,3525.83,8
HCPCS,33474,VALVOTOMY PULMONARY VALVE OPEN HEART W/BYPASS,15760.0,10244.0,1.1,15760.0,144
HCPCS,33475,REPLACEMENT PULMONARY VALVE,,,6021.45,6021.45,1
HCPCS,33475,"REPLACEMENT, PULMONARY VALVE",16960.0,11024.0,1.1,16960.0,144
HCPCS,33475,Replacement pulmonary valve,,,3045.04,3525.83,8
HCPCS,33476,R VENTRIC RESCJ INFUND STEN W/WO COMMISSUROTOMY,10628.0,6908.2,1.1,10628.0,144
HCPCS,33476,REVISION OF HEART CHAMBER,,,3969.47,3969.47,1
HCPCS,33476,Revision of heart chamber,,,3045.04,3525.83,8
HCPCS,33477,TCAT PULMONARY VALVE IMPLANTATION PRQ APPROACH,14107.5,9169.875,1.1,18215.0,280
HCPCS,33478,OUTFLOW TRACT AGMNTJ W/WO COMMISSUR/INFUND RESCJ,11016.0,7160.4,1.1,11016.0,144
HCPCS,33478,REVISION OF HEART CHAMBER,,,4098.96,4098.96,1
HCPCS,33478,Revision of heart chamber,,,3045.04,3525.83,8
HCPCS,33496,REPAIR PROSTH VALVE CLOT,,,4308.05,4308.05,1
HCPCS,33496,RPR NON-STRUCT PROSTC VALVE DYSFUNCTION W/BYPASS,11936.0,7758.4,1.1,11936.0,144
HCPCS,33496,Repair prosth valve clot,,,3045.04,3525.83,8
HCPCS,33500,REPAIR HEART VESSEL FISTULA,,,4039.8,4039.8,1
HCPCS,33500,RPR CORONARY AV/ARTERIOCAR CHMBR FSTL W/BYPASS,11176.0,7264.4,1.1,11176.0,144
HCPCS,33500,Repair heart vessel fistula,,,3045.04,3525.83,8
HCPCS,33501,REPAIR HEART VESSEL FISTULA,,,2889.19,2889.19,1
HCPCS,33501,RPR CORONARY AV/ARTERIOCAR CHMBR FSTL W/O BYPASS,7804.0,5072.6,1.1,7804.0,144
HCPCS,33501,Repair heart vessel fistula,,,3045.04,3525.83,8
HCPCS,33502,CORONARY ARTERY CORRECTION,,,3331.29,3331.29,1
HCPCS,33502,Coronary artery correction,,,4802.69,5561.01,8
HCPCS,33502,RPR ANOM CORONARY ART PULM ART ORIGIN LIGATION,8740.0,5681.0,1.1,8740.0,144
HCPCS,33503,CORONARY ARTERY GRAFT,,,3460.92,3460.92,1
HCPCS,33503,Coronary artery graft,,,4802.69,5561.01,8
HCPCS,33503,RPR ANOM CORONARY ARTERY PULM ART ORIGIN GRAFT,9004.0,5852.6,1.1,9004.0,144
HCPCS,33504,CORONARY ARTERY GRAFT,,,3821.04,3821.04,1
HCPCS,33504,Coronary artery graft,,,4802.69,5561.01,8
HCPCS,33504,RPR ANOM CORONARY ART PULM ART ORIGIN GRF W/BYP,10184.0,6619.6,1.1,10184.0,144
HCPCS,33505,REPAIR ARTERY W/TUNNEL,,,5356.56,5356.56,1
HCPCS,33505,RPR ANOM CORON ART W/CONSTJ INTRAPULM ART TUNNEL,15360.0,9984.0,1.1,15360.0,144
HCPCS,33505,Repair artery w/tunnel,,,4802.69,5561.01,8
HCPCS,33506,REPAIR ARTERY TRANSLOCATION,,,5337.55,5337.55,1
HCPCS,33506,RPR ANOM CORONARY ART FROM PULM ART TO AORTA,15140.0,9841.0,1.1,15140.0,144
HCPCS,33506,Repair artery translocation,,,4802.69,5561.01,8
HCPCS,33507,REPAIR ART INTRAMURAL,,,4476.31,4476.31,1
HCPCS,33507,RPR ANOM AORTIC ORIGIN CORONARY ART UNROOF/TLCJ,12560.0,8164.0,1.1,12560.0,144
HCPCS,33507,Repair art intramural,,,4802.69,5561.01,8
HCPCS,33508,Endoscopic vein harvest,,,4802.69,5561.01,8
HCPCS,33508,NDSC SURG W/VIDEO-ASSISTED HARVEST VEIN CABG,124.0,80.6,1.1,124.0,144
HCPCS,33509,ENDOSCOPIC HARVEST UXTR ARTERY 1 SEGMENT CAB PX,1336.0,868.4,1.1,1336.0,144
HCPCS,33509,NDSC HRV UXTR ART 1 SGM CAB,,,448.07,448.07,1
HCPCS,33509,Ndsc hrv uxtr art 1 sgm cab,,,4802.69,5561.01,8
HCPCS,3350F,MAMMO BX PROVEN MALIG DOCD,,,2739849.3,2739849.3,1
HCPCS,3350F,Mammo bx proven malig docd,,,10.69,12.38,8
HCPCS,33510,CABG VEIN SINGLE,,,5019.63,5019.63,1
HCPCS,33510,CORONARY ARTERY BYPASS 1 CORONARY VENOUS GRAFT,13992.0,9094.8,1.1,13992.0,144
HCPCS,33510,Cabg vein single,,,4802.69,5561.01,8
HCPCS,33511,CABG VEIN TWO,,,5512.72,5512.72,1
HCPCS,33511,CORONARY ARTERY BYPASS 2 CORONARY VENOUS GRAFTS,15380.0,9997.0,1.1,15380.0,144
HCPCS,33511,Cabg vein two,,,4802.69,5561.01,8
HCPCS,33512,CABG VEIN THREE,,,6282.27,6282.27,1
HCPCS,33512,CORONARY ARTERY BYPASS 3 CORONARY VENOUS GRAFTS,17592.0,11434.8,1.1,17592.0,144
HCPCS,33512,Cabg vein three,,,4802.69,5561.01,8
HCPCS,33513,CABG VEIN FOUR,,,6419.14,6419.14,1
HCPCS,33513,CORONARY ARTERY BYPASS 4 CORONARY VENOUS GRAFTS,18148.0,11796.2,1.1,18148.0,144
HCPCS,33513,Cabg vein four,,,4802.69,5561.01,8
HCPCS,33514,CABG VEIN FIVE,,,6748.81,6748.81,1
HCPCS,33514,CORONARY ARTERY BYPASS 5 CORONARY VENOUS GRAFTS,19232.0,12500.8,1.1,19232.0,144
HCPCS,33514,Cabg vein five,,,4802.69,5561.01,8
HCPCS,33516,CABG VEIN SIX OR MORE,,,6984.73,6984.73,1
HCPCS,33516,CORONARY ARTERY BYPASS 6/+ CORONARY VENOUS GRAFT,19904.0,12937.6,1.1,19904.0,144
HCPCS,33516,Cabg vein six or more,,,4802.69,5561.01,8
HCPCS,33517,CABG ARTERY-VEIN SINGLE,,,486.24,486.24,1
HCPCS,33517,CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 1 VEIN,1588.0,1032.2,1.1,1588.0,144
HCPCS,33517,Cabg artery-vein single,,,4802.69,5561.01,8
HCPCS,33518,CABG ARTERY-VEIN TWO,,,1064.82,1064.82,1
HCPCS,33518,CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 2 VEIN,3489.0,2267.85,1.1,3489.0,144
HCPCS,33518,Cabg artery-vein two,,,4802.69,5561.01,8
HCPCS,33519,CABG ARTERY-VEIN THREE,,,1409.18,1409.18,1
HCPCS,33519,CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 3 VEIN,4616.0,3000.4,1.1,4616.0,144
HCPCS,33519,Cabg artery-vein three,,,4802.69,5561.01,8
HCPCS,3351F,NEG SCRN DEP SYMP BY DEPTOOL,,,0.03,0.03,1
HCPCS,3351F,Neg scrn dep symp by deptool,,,10.69,12.38,8
HCPCS,33521,CABG ARTERY-VEIN FOUR,,,1688.77,1688.77,1
HCPCS,33521,CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 4 VEIN,5540.0,3601.0,1.1,5540.0,144
HCPCS,33521,Cabg artery-vein four,,,4802.69,5561.01,8
HCPCS,33522,CABG ARTERY-VEIN FIVE,,,1898.3,1898.3,1
HCPCS,33522,CORONARY ARTERY BYP W/VEIN & ARTERY GRAFT 5 VEIN,6222.0,4044.3,1.1,6222.0,144
HCPCS,33522,Cabg artery-vein five,,,4802.69,5561.01,8
HCPCS,33523,CABG ART-VEIN SIX OR MORE,,,2136.35,2136.35,1
HCPCS,33523,CORONARY ARTERY BYP W/VEIN &ARTERY GRAFT 6 VEIN,7075.0,4598.75,1.1,7075.0,144
HCPCS,33523,Cabg art-vein six or more,,,4802.69,5561.01,8
HCPCS,3352F,NO SIG DEP SYMP BY DEP TOOL,,,2739849.3,2739849.3,1
HCPCS,3352F,No sig dep symp by dep tool,,,10.69,12.38,8
HCPCS,33530,CORONARY ARTERY BYPASS/REOP,,,1359.42,1359.42,1
HCPCS,33530,Coronary artery bypass/reop,,,4802.69,5561.01,8
HCPCS,33530,ROPRTJ CAB/VALVE PX > 1 MO AFTER ORIGINAL OPERJ,4052.0,2633.8,1.1,4052.0,144
HCPCS,33533,CABG ARTERIAL SINGLE,,,4860.9,4860.9,1
HCPCS,33533,CABG W/ARTERIAL GRAFT SINGLE ARTERIAL GRAFT,14850.0,9652.5,1.1,14850.0,144
HCPCS,33533,Cabg arterial single,,,4802.69,5561.01,8
HCPCS,33534,CABG ARTERIAL TWO,,,5710.57,5710.57,1
HCPCS,33534,"CABG, ARTERIAL, TWO",17547.0,11405.55,1.1,17547.0,144
HCPCS,33534,Cabg arterial two,,,4802.69,5561.01,8
HCPCS,33535,CABG ARTERIAL THREE,,,6348.03,6348.03,1
HCPCS,33535,"CABG, ARTERIAL, THREE",19690.0,12798.5,1.1,19690.0,144
HCPCS,33535,Cabg arterial three,,,4802.69,5561.01,8
HCPCS,33536,CABG ARTERIAL FOUR OR MORE,,,6841.97,6841.97,1
HCPCS,33536,"CABG, ARTERIAL, FOUR+",21309.0,13850.85,1.1,21309.0,144
HCPCS,33536,Cabg arterial four or more,,,4802.69,5561.01,8
HCPCS,3353F,MILD-MOD DEP SYMP BY DEPTOOL,,,0.03,0.03,1
HCPCS,3353F,Mild-mod dep symp by deptool,,,10.69,12.38,8
HCPCS,33542,MYOCARD RESECTN,19284.0,12534.6,1.1,19284.0,144
HCPCS,33542,REMOVAL OF HEART LESION,,,6808.41,6808.41,1
HCPCS,33542,Removal of heart lesion,,,3045.04,3525.83,8
HCPCS,33545,REPAIR OF HEART DAMAGE,,,7930.25,7930.25,1
HCPCS,33545,RPR POSTINFRCJ VENTRICULAR SEPTAL DEFECT,22824.0,14835.6,1.1,22824.0,144
HCPCS,33545,Repair of heart damage,,,3045.04,3525.83,8
HCPCS,33548,RESTORE/REMODEL VENTRICLE,,,7628.24,7628.24,1
HCPCS,33548,Restore/remodel ventricle,,,3045.04,3525.83,8
HCPCS,33548,SURG VENTRICULAR RSTRJ PX W/PROSTC PATCH PFRMD,21656.0,14076.4,1.1,21656.0,144
HCPCS,3354F,CLIN SIG DEP SYM BY DEP TOOL,,,2739849.3,2739849.3,1
HCPCS,3354F,Clin sig dep sym by dep tool,,,10.69,12.38,8
HCPCS,33572,CORONARY ENDARTERCOMY OPEN ANY METHOD,1776.0,1154.4,1.1,1776.0,144
HCPCS,33572,OPEN CORONARY ENDARTERECTOMY,,,598.99,598.99,1
HCPCS,33572,Open coronary endarterectomy,,,4802.69,5561.01,8
HCPCS,33600,CLOSURE ATRIOVENTRICULAR VALVE SUTURE/PATCH,12124.0,7880.6,1.1,12124.0,144
HCPCS,33600,CLOSURE OF VALVE,,,4477.95,4477.95,1
HCPCS,33600,Closure of valve,,,3045.04,3525.83,8
HCPCS,33602,CLOSURE OF VALVE,,,4346.63,4346.63,1
HCPCS,33602,Closure of valve,,,3045.04,3525.83,8
HCPCS,33606,ANAST PULMONARY ART AORTA DAMUS-KAYE-STANSEL PX,12612.0,8197.8,1.1,12612.0,144
HCPCS,33606,ANASTOMOSIS/ARTERY-AORTA,,,4629.72,4629.72,1
HCPCS,33606,Anastomosis/artery-aorta,,,3045.04,3525.83,8
HCPCS,33608,REPAIR ANOMALY W/CONDUIT,,,4688.25,4688.25,1
HCPCS,33608,RPR CAR ANOMAL XCP PULM ATRESIA VENTR SEPTL DFCT,14027.0,9117.55,1.1,14027.0,144
HCPCS,33608,Repair anomaly w/conduit,,,3045.04,3525.83,8
HCPCS,33610,REPAIR BY ENLARGEMENT,,,4623.45,4623.45,1
HCPCS,33610,RPR CAR ANOMAL SURG ENLGMENT VENTR SEPTL DFCT,12560.0,8164.0,1.1,12560.0,144
HCPCS,33610,Repair by enlargement,,,3045.04,3525.83,8
HCPCS,33611,REPAIR DOUBLE VENTRICLE,,,5071.88,5071.88,1
HCPCS,33611,RPR 2 OUTLET R VNTRC W/INTRAVENTR TUNNEL RPR,14228.0,9248.2,1.1,14228.0,144
HCPCS,33611,Repair double ventricle,,,3045.04,3525.83,8
HCPCS,33612,REPAIR DOUBLE VENTRICLE,,,5208.58,5208.58,1
HCPCS,33612,RPR 2 OUTLET R VNTRC RPR R VENTR O/F TRC OBSTRCJ,14628.0,9508.2,1.1,14628.0,144
HCPCS,33612,Repair double ventricle,,,3045.04,3525.83,8
HCPCS,33615,REPAIR MODIFIED FONTAN,,,5198.74,5198.74,1
HCPCS,33615,RPR CAR ANOMAL CLSR SEPTL DFCT SMPL FONTAN PX,14356.0,9331.4,1.1,14356.0,144
HCPCS,33615,Repair modified fontan,,,3045.04,3525.83,8
HCPCS,33617,REPAIR SINGLE VENTRICLE,,,5631.91,5631.91,1
HCPCS,33617,RPR COMPLEX CARDIAC ANOMALY MODIFIED FONTAN PX,17200.0,11180.0,1.1,17200.0,144
HCPCS,33617,Repair single ventricle,,,3045.04,3525.83,8
HCPCS,33619,REPAIR SINGLE VENTRICLE,,,7143.67,7143.67,1
HCPCS,33619,RPR 1 VNTRC W/O/F OBSTRCJ&AORTIC ARCH HYPOPLAS,19504.0,12677.6,1.1,19504.0,144
HCPCS,33619,Repair single ventricle,,,3045.04,3525.83,8
HCPCS,33620,APPLICATION RIGHT & LEFT PULMONARY ARTERY BANDS,13200.0,8580.0,1.1,13200.0,144
HCPCS,33620,APPLY R&L PULM ART BANDS,,,4288.24,4288.24,1
HCPCS,33620,Apply r&l pulm art bands,,,3045.04,3525.83,8
HCPCS,33621,TRANSTHOR CATH FOR STENT,,,2418.93,2418.93,1
HCPCS,33621,TRANSTHORACIC CATHETER INSERTION FOR STENT PLMT,6472.0,4206.8,1.1,6472.0,144
HCPCS,33621,Transthor cath for stent,,,3045.04,3525.83,8
HCPCS,33622,RECONSTRUCTION COMPLEX CARDIAC ANOMALY,25600.0,16640.0,1.1,25600.0,144
HCPCS,33622,REDO COMPL CARDIAC ANOMALY,,,8915.17,8915.17,1
HCPCS,33622,Redo compl cardiac anomaly,,,3045.04,3525.83,8
HCPCS,33641,REPAIR HEART SEPTUM DEFECT,,,4264.18,4264.18,1
HCPCS,33641,REPR ASD W BYPASS,11832.0,7690.8,1.1,11832.0,144
HCPCS,33641,Repair heart septum defect,,,3045.04,3525.83,8
HCPCS,33645,DIR/PTCH CLS SINUS VENOSUS W/WO ANOM PUL VEN DRG,12520.0,8138.0,1.1,12520.0,144
HCPCS,33645,REVISION OF HEART VEINS,,,4503.08,4503.08,1
HCPCS,33645,Revision of heart veins,,,3045.04,3525.83,8
HCPCS,33647,REPAIR HEART SEPTUM DEFECTS,,,4723.95,4723.95,1
HCPCS,33647,RPR ATRIAL & VENTRIC SEPTAL DFCT DIR/PATCH CLS,14520.0,9438.0,1.1,14520.0,144
HCPCS,33647,Repair heart septum defects,,,3045.04,3525.83,8
HCPCS,33660,REPAIR OF HEART DEFECTS,,,4566.79,4566.79,1
HCPCS,33660,RPR INCPLT/PRTL AV CANAL W/WO AV VALVE RPR,14005.0,9103.25,1.1,14005.0,144
HCPCS,33660,Repair of heart defects,,,3045.04,3525.83,8
HCPCS,33665,REPAIR OF HEART DEFECTS,,,4975.18,4975.18,1
HCPCS,33665,RPR INTRM/TRANSJ AV CANAL W/WO AV VALVE RPR,13940.0,9061.0,1.1,13940.0,144
HCPCS,33665,Repair of heart defects,,,3045.04,3525.83,8
HCPCS,33670,REPAIR OF HEART CHAMBERS,,,5125.91,5125.91,1
HCPCS,33670,RPR COMPL AV CANAL W/WO PROSTC VALVE,16117.0,10476.05,1.1,16117.0,144
HCPCS,33670,Repair of heart chambers,,,3045.04,3525.83,8
HCPCS,33675,CLOSE MULT VSD,,,5125.06,5125.06,1
HCPCS,33675,CLOSURE MULTIPLE VENTRICULAR SEPTAL DEFECTS,14380.0,9347.0,1.1,14380.0,144
HCPCS,33675,Close mult vsd,,,3045.04,3525.83,8
HCPCS,33676,CLOSE MULT VSD W/RESECTION,,,5261.76,5261.76,1
HCPCS,33676,"CLOSE MULTIPLE VSD, WITH RESECTION",14780.0,9607.0,1.1,14780.0,144
HCPCS,33676,Close mult vsd w/resection,,,3045.04,3525.83,8
HCPCS,33677,CL MULT VSD W/REM PUL BAND,,,5464.14,5464.14,1
HCPCS,33677,"CLOSE MULTIPLE VSD, REMOVE PA BAND",15380.0,9997.0,1.1,15380.0,144
HCPCS,33677,Cl mult vsd w/rem pul band,,,3045.04,3525.83,8
HCPCS,33681,CLOSURE 1 VSD W/WO PATCH,,,4800.21,4800.21,1
HCPCS,33681,CLSR 1 VENTRICULAR SEPTAL DEFECT W/WO PATCH,14230.0,9249.5,1.1,14230.0,144
HCPCS,33681,Closure 1 vsd w/wo patch,,,3045.04,3525.83,8
HCPCS,33684,CLSR 1 VSD W/WO PATCH W/VLVT,,,4909.45,4909.45,1
HCPCS,33684,CLSR V-SEPTL DFCT W/PULM VLVT/INFUND RESCJ,13748.0,8936.2,1.1,13748.0,144
HCPCS,33684,Clsr 1 vsd w/wo patch w/vlvt,,,3045.04,3525.83,8
HCPCS,33688,CLSR 1VSD W/WO PTCH RMVL BND,,,4893.97,4893.97,1
HCPCS,33688,CLSR V-SEPTAL DFCT W/RMVL P-ART BAND W/WO GUSSET,13900.0,9035.0,1.1,13900.0,144
HCPCS,33688,Clsr 1vsd w/wo ptch rmvl bnd,,,3045.04,3525.83,8
HCPCS,33690,BANDING PULM ARTERY,8144.0,5293.6,1.1,8144.0,144
HCPCS,33690,BANDING PULMONARY ARTERY,,,3132.26,3132.26,1
HCPCS,33690,Banding pulmonary artery,,,3045.04,3525.83,8
HCPCS,33692,COMP RPR TOF WO PULM ATRESIA,,,5083.06,5083.06,1
HCPCS,33692,COMPL RPR TETRALOGY FALLOT W/O PULM ATRESIA,14460.0,9399.0,1.1,14460.0,144
HCPCS,33692,Comp rpr tof wo pulm atresia,,,3045.04,3525.83,8
HCPCS,33694,CMP RPR TOF WO PLM ATRS PTCH,,,5071.88,5071.88,1
HCPCS,33694,COMPL RPR T-FALLOT W/O PULM ATRESIA TANULR PATCH,14228.0,9248.2,1.1,14228.0,144
HCPCS,33694,Cmp rpr tof wo plm atrs ptch,,,3045.04,3525.83,8
HCPCS,33697,COMPL RPR T-FALLOT W/PULM ATRESIA,15028.0,9768.2,1.1,15028.0,144
HCPCS,33697,COMPL RPR TOF W/PULM ATRESIA,,,5343.55,5343.55,1
HCPCS,33697,Compl rpr tof w/pulm atresia,,,3045.04,3525.83,8
HCPCS,33702,REPAIR OF HEART DEFECTS,,,4028.87,4028.87,1
HCPCS,33702,RPR SINUS VALSALVA FISTULA,10896.0,7082.4,1.1,10896.0,144
HCPCS,33702,Repair of heart defects,,,3045.04,3525.83,8
HCPCS,3370F,AJCC BRST CNCR STAGE 0 DOCD,,,2739849.3,2739849.3,1
HCPCS,3370F,Ajcc brst cncr stage 0 docd,,,10.69,12.38,8
HCPCS,33710,REPAIR OF HEART DEFECTS,,,5331.93,5331.93,1
HCPCS,33710,RPR SINUS VALSALVA FISTULA W/RPR V-SEPTAL DEFECT,15000.0,9750.0,1.1,15000.0,144
HCPCS,33710,Repair of heart defects,,,3045.04,3525.83,8
HCPCS,33720,REPAIR OF HEART DEFECT,,,4031.5,4031.5,1
HCPCS,33720,RPR SINUS VALSALVA ANEURYSM,10904.0,7087.6,1.1,10904.0,144
HCPCS,33720,Repair of heart defect,,,3045.04,3525.83,8
HCPCS,33722,Repair of heart defect,,,3045.04,3525.83,8
HCPCS,33724,REPAIR ISOLATED PARTIAL PULM VENOUS RETURN,11052.0,7183.8,1.1,11052.0,144
HCPCS,33724,REPAIR VENOUS ANOMALY,,,3998.54,3998.54,1
HCPCS,33724,Repair venous anomaly,,,3045.04,3525.83,8
HCPCS,33726,REPAIR PUL VENOUS STENOSIS,,,5283.05,5283.05,1
HCPCS,33726,REPAIR PULMONARY VENOUS STENOSIS,14848.0,9651.2,1.1,14848.0,144
HCPCS,33726,Repair pul venous stenosis,,,3045.04,3525.83,8
HCPCS,3372F,AJCC BRST CNCR STAGE 1 DOCD,,,2739849.3,2739849.3,1
HCPCS,3372F,Ajcc brst cncr stage 1 docd,,,10.69,12.38,8
HCPCS,33730,COMPLETE RPR ANOMALOUS PULMONARY VENOUS RETURN,14456.0,9396.4,1.1,14456.0,144
HCPCS,33730,REPAIR HEART-VEIN DEFECT(S),,,5221.12,5221.12,1
HCPCS,33730,Repair heart-vein defect(s),,,3045.04,3525.83,8
HCPCS,33732,REPAIR HEART-VEIN DEFECT,,,4295.09,4295.09,1
HCPCS,33732,RPR COR TRIATM/SUPVALVR RING RESCJ L ATRIAL MEMB,11584.0,7529.6,1.1,11584.0,144
HCPCS,33732,Repair heart-vein defect,,,3045.04,3525.83,8
HCPCS,33735,ATRIAL SEPTECTOMY/SEPTOSTOMY CLOSED HEART,8880.0,5772.0,1.1,8880.0,144
HCPCS,33735,REVISION OF HEART CHAMBER,,,3380.86,3380.86,1
HCPCS,33735,Revision of heart chamber,,,3045.04,3525.83,8
HCPCS,33736,ATR SEPTEC/SEPTOSTOMY OPEN W BYPASS,9728.0,6323.2,1.1,9728.0,144
HCPCS,33736,REVISION OF HEART CHAMBER,,,3667.46,3667.46,1
HCPCS,33736,Revision of heart chamber,,,3045.04,3525.83,8
HCPCS,33737,REVISION OF HEART CHAMBER,,,3384.48,3384.48,1
HCPCS,33737,Revision of heart chamber,,,3045.04,3525.83,8
HCPCS,33741,TAS CONGENITAL CARDIAC ANOMALIES ANY METHOD,5617.5,3651.375,1.1,16547.65,212
HCPCS,33745,TIS CRTJ ST CONGENITAL CARDIAC ANOMAL 1ST SHUNT,6559.5,4263.675,1.1,16547.65,280
HCPCS,33746,TIS CRTJ ST CONGENITAL CARDIAC ANOMAL EA ADDL,3315.0,2154.75,1.1,16547.65,212
HCPCS,3374F,AJCC BRST CNCR STAGE 1 DOCD,,,0.03,0.03,1
HCPCS,3374F,Ajcc brst cncr stage 1 docd,,,10.69,12.38,8
HCPCS,33750,SHUNT SUBCLAVIAN PULMONARY ARTERY,8888.0,5777.2,1.1,8888.0,144
HCPCS,33750,SHUNT SUBCLAVIAN TO PULM ART,,,3286.19,3286.19,1
HCPCS,33750,Shunt subclavian to pulm art,,,2623.14,3037.32,8
HCPCS,33755,SHUNT AS-AORT TO PULM ART,,,3435.0,3435.0,1
HCPCS,33755,SHUNT ASCENDING AORTA PULMONARY ARTERY,9040.0,5876.0,1.1,9040.0,144
HCPCS,33755,Shunt as-aort to pulm art,,,2623.14,3037.32,8
HCPCS,33762,SHUNT DESC AORTA TO PULM ART,,,3338.55,3338.55,1
HCPCS,33762,Shunt desc aorta to pulm art,,,2623.14,3037.32,8
HCPCS,33764,SHUNT CENTRAL W/PROSTC GRAFT,,,3435.0,3435.0,1
HCPCS,33764,SHUNT CENTRAL W/PROSTHETIC GRAFT,9040.0,5876.0,1.1,9040.0,144
HCPCS,33764,Shunt central w/prostc graft,,,2623.14,3037.32,8
HCPCS,33766,SHUNT SUPERIOR VENA CAVA PULMONARY ART 1 LUNG,9428.0,6128.2,1.1,9428.0,144
HCPCS,33766,SHUNT SUPR V/C P-ART 1 LUNG,,,3468.16,3468.16,1
HCPCS,33766,Shunt supr v/c p-art 1 lung,,,2623.14,3037.32,8
HCPCS,33767,SHUNT SUPERIOR VENA CAVA PULM ARTERY BOTH LUNGS,10120.0,6578.0,1.1,10120.0,144
HCPCS,33767,SHUNT SUPR V/C P-ART BTH LNG,,,3702.45,3702.45,1
HCPCS,33767,Shunt supr v/c p-art bth lng,,,2623.14,3037.32,8
HCPCS,33768,ANAST CAVOPULM SEC SUP V/C,,,1081.07,1081.07,1
HCPCS,33768,ANASTOMOSIS CAVOPULMARY 2ND SUPRIOR VENA CAVA,3200.0,2080.0,1.1,3200.0,144
HCPCS,33768,Anast cavopulm sec sup v/c,,,3045.04,3525.83,8
HCPCS,3376F,AJCC BRSTCNCR STAGE 2 DOCD,,,0.03,0.03,1
HCPCS,3376F,Ajcc brstcncr stage 2 docd,,,10.69,12.38,8
HCPCS,33770,RPR TGA W/O SURG ENLGMNT VSD,,,5500.85,5500.85,1
HCPCS,33770,RPR TRPOS GREAT VSLS W/O ENLGMNT V-SEPTL DFCT,15628.0,10158.2,1.1,15628.0,144
HCPCS,33770,Rpr tga w/o surg enlgmnt vsd,,,3045.04,3525.83,8
HCPCS,33771,RPR TGA W/SURG ENLGMNT VSD,,,5658.4,5658.4,1
HCPCS,33771,RPR TRPOS GREAT VSLS W/ENLGMNT V-SEPTL DFCT,16252.0,10563.8,1.1,16252.0,144
HCPCS,33771,Rpr tga w/surg enlgmnt vsd,,,3045.04,3525.83,8
HCPCS,33774,RPR TGA ATRIAL BAFFLE PX,,,4687.43,4687.43,1
HCPCS,33774,RPR TRPOS GREAT VSLS ATRIAL BAFFLE PX W/BYPASS,12692.0,8249.8,1.1,12692.0,144
HCPCS,33774,Rpr tga atrial baffle px,,,3045.04,3525.83,8
HCPCS,33775,RPR TGA ATR BFL RMVL PLM BND,,,4825.83,4825.83,1
HCPCS,33775,RPR TRPOS GREAT VSLS ATR BAFFLE W/RMVL PULM BAND,13196.0,8577.4,1.1,13196.0,144
HCPCS,33775,Rpr tga atr bfl rmvl plm bnd,,,3045.04,3525.83,8
HCPCS,33776,RPR TGA ATR BFL CLSR VSD,,,5104.84,5104.84,1
HCPCS,33776,RPR TRPOS GRT VSL ATR BAFFLE W/CLSR V-SEPTL DFCT,13900.0,9035.0,1.1,13900.0,144
HCPCS,33776,Rpr tga atr bfl clsr vsd,,,3045.04,3525.83,8
HCPCS,33777,RPR TGA BFL RPR SBPULM OBSTR,,,4921.2,4921.2,1
HCPCS,33777,RPR TRPOS GRT VSL ATR BAFFLE W/BYP SBPULM OBSTRC,13668.0,8884.2,1.1,13668.0,144
HCPCS,33777,Rpr tga bfl rpr sbpulm obstr,,,3045.04,3525.83,8
HCPCS,33778,RPR TGA AORTIC PULM ART RCNS,,,6116.78,6116.78,1
HCPCS,33778,RPR TRPOS GRT VESSEL AORTIC PULMONARY ART RCNSTJ,17100.0,11115.0,1.1,17100.0,144
HCPCS,33778,Rpr tga aortic pulm art rcns,,,2623.14,3037.32,8
HCPCS,33779,RPR TGA RCNSTJ RMVL PLM BND,,,6039.84,6039.84,1
HCPCS,33779,RPR TGV AORTIC PULM ART RCNSTJ W/RMVL PULM BAND,17292.0,11239.8,1.1,17292.0,144
HCPCS,33779,Rpr tga rcnstj rmvl plm bnd,,,2623.14,3037.32,8
HCPCS,33780,RPR TGA RCNSTJ CLSR VSD,,,6154.01,6154.01,1
HCPCS,33780,RPR TGV AORTIC P-ART RCNSTJ W/CLSR V-SEPTL DFCT,17560.0,11414.0,1.1,17560.0,144
HCPCS,33780,Rpr tga rcnstj clsr vsd,,,2623.14,3037.32,8
HCPCS,33781,RPR TGA RCNSTJ RPR SBPL OBST,,,6006.16,6006.16,1
HCPCS,33781,RPR TGV AORTIC P-ART RCNSTJ RPR SBPULMC OBSTRCJ,16852.0,10953.8,1.1,16852.0,144
HCPCS,33781,Rpr tga rcnstj rpr sbpl obst,,,2623.14,3037.32,8
HCPCS,33782,A-ROOT TLCJ VSD PULM STNS RPR W/O C OST RIMPLTJ,24032.0,15620.8,1.1,24032.0,144
HCPCS,33782,NIKAIDOH PROC,,,8383.33,8383.33,1
HCPCS,33782,Nikaidoh proc,,,3045.04,3525.83,8
HCPCS,33783,A-ROOT TLCJ VSD PULM STNS RPR W/ RIMPLTJ C OSTIA,28635.0,18612.75,1.1,28635.0,144
HCPCS,33783,NIKAIDOH PROC W/OSTIA IMPLT,,,9061.59,9061.59,1
HCPCS,33783,Nikaidoh proc w/ostia implt,,,3045.04,3525.83,8
HCPCS,33786,REPAIR ARTERIAL TRUNK,,,5920.87,5920.87,1
HCPCS,33786,REPAIR TRUNCUS ARTERIOSUS,16748.0,10886.2,1.1,16748.0,144
HCPCS,33786,Repair arterial trunk,,,3045.04,3525.83,8
HCPCS,33788,REIMPLANTATION ANOMALOUS PULMONARY ARTERY,10968.0,7129.2,1.1,10968.0,144
HCPCS,33788,REVISION OF PULMONARY ARTERY,,,3989.06,3989.06,1
HCPCS,33788,Revision of pulmonary artery,,,3045.04,3525.83,8
HCPCS,3378F,AJCC BRSTCNCR STAGE 3 DOCD,,,2739849.3,2739849.3,1
HCPCS,3378F,Ajcc brstcncr stage 3 docd,,,10.69,12.38,8
HCPCS,33800,AORTIC SUSPENSION,,,2568.09,2568.09,1
HCPCS,33800,AORTIC SUSPENSN FOR TRACH DECOMPRE,6912.0,4492.8,1.1,6912.0,144
HCPCS,33800,Aortic suspension,,,2623.14,3037.32,8
HCPCS,33802,DIVISION ABERRANT VESSEL,,,2831.49,2831.49,1
HCPCS,33802,DIVISION ABERRANT VESSEL VASCULAR RING,7348.0,4776.2,1.1,7348.0,144
HCPCS,33802,Division aberrant vessel,,,2623.14,3037.32,8
HCPCS,33803,DIV ABERRANT VSL W/REANAST,,,2996.79,2996.79,1
HCPCS,33803,DIVISION ABERRANT VESSEL W/REANASTOMOSIS,8124.0,5280.6,1.1,8124.0,144
HCPCS,33803,Div aberrant vsl w/reanast,,,2623.14,3037.32,8
HCPCS,3380F,AJCC BRSTCNCR STAGE 4 DOCD,,,2739849.3,2739849.3,1
HCPCS,3380F,Ajcc brstcncr stage 4 docd,,,10.69,12.38,8
HCPCS,33813,REPAIR SEPTAL DEFECT,,,3233.61,3233.61,1
HCPCS,33813,Repair septal defect,,,2623.14,3037.32,8
HCPCS,33814,OBLTRJ A-PULM SEP DEF W/BYP,,,3971.93,3971.93,1
HCPCS,33814,OBLTRJ AORTOPULMONARY SEPTAL DFCT W/CARD BYPASS,10628.0,6908.2,1.1,10628.0,144
HCPCS,33814,Obltrj a-pulm sep def w/byp,,,2623.14,3037.32,8
HCPCS,33820,REPAIR PATENT DUCTUS ARTERIOSUS LIGATION,6676.0,4339.4,1.1,6676.0,144
HCPCS,33820,REPAIR PDA BY LIGATION,,,2520.85,2520.85,1
HCPCS,33820,Repair pda by ligation,,,2623.14,3037.32,8
HCPCS,33822,REPAIR PDA DIV<18 YEARS,,,2658.43,2658.43,1
HCPCS,33822,RPR PATENT DUXUS ARTERIOSUS DIV UNDER 18 YR,7084.0,4604.6,1.1,7084.0,144
HCPCS,33822,Repair pda div<18 years,,,2623.14,3037.32,8
HCPCS,33824,REPAIR PDA DIV 18 YRS&OLDER,,,3079.29,3079.29,1
HCPCS,33824,Repair pda div 18 yrs&older,,,2623.14,3037.32,8
HCPCS,3382F,AJCC CLN CNCR STAGE 0 DOCD,,,2739849.3,2739849.3,1
HCPCS,3382F,Ajcc cln cncr stage 0 docd,,,10.69,12.38,8
HCPCS,33840,EXC COA W/DIRECT ANASTOMOSIS,,,3230.08,3230.08,1
HCPCS,33840,EXC COARCJ AORTA W/WO PDA W/DIRECT ANASTOMOSIS,8536.0,5548.4,1.1,8536.0,144
HCPCS,33840,Exc coa w/direct anastomosis,,,2623.14,3037.32,8
HCPCS,33845,EXCISION COA W/GRAFT,,,3479.39,3479.39,1
HCPCS,33845,EXCISION COARCTATION AORTA W/WO PDA W/GRAFT,9172.0,5961.8,1.1,9172.0,144
HCPCS,33845,Excision coa w/graft,,,2623.14,3037.32,8
HCPCS,3384F,AJCC CLN CNCR STAGE 1 DOCD,,,2739849.3,2739849.3,1
HCPCS,3384F,Ajcc cln cncr stage 1 docd,,,10.69,12.38,8
HCPCS,33851,EXC COA RPR L SUBCL ART/PRST,,,3317.95,3317.95,1
HCPCS,33851,EXC COARCJ AORTA W/L SUBCLAV ART/PROSTC GUSSET,8792.0,5714.8,1.1,8792.0,144
HCPCS,33851,Exc coa rpr l subcl art/prst,,,2623.14,3037.32,8
HCPCS,33852,RPR HYPOPL A-ARCH WO BYP,,,3647.27,3647.27,1
HCPCS,33852,RPR HYPOPLSTC A-ARCH W/AGRFT/PROSTC W/O BYPASS,9764.0,6346.6,1.1,9764.0,144
HCPCS,33852,Rpr hypopl a-arch wo byp,,,2623.14,3037.32,8
HCPCS,33853,RPR HYPOPL A-ARCH W/BYP,,,4774.31,4774.31,1
HCPCS,33853,RPR HYPOPLSTC A-ARCH W/AGRFT/PROSTC W/BYPASS,13004.0,8452.6,1.1,13004.0,144
HCPCS,33853,Rpr hypopl a-arch w/byp,,,2623.14,3037.32,8
HCPCS,33858,AS-AORT GRF W/CARD BYP F/AORTIC DISSECTION,20933.0,13606.45,1.1,25360.0,212
HCPCS,33859,AS-AORT GRF F/DS OTH/THN DSJ,,,6321.76,6321.76,1
HCPCS,33859,AS-AORT GRF W/CARD BYP F/AORTIC DS OTH/THN DSJ,18052.0,11733.8,1.1,18052.0,144
HCPCS,33859,As-aort grf f/ds oth/thn dsj,,,2623.14,3037.32,8
HCPCS,33863,AS-AORT GRF W/CARD BYP & AORTIC ROOT RPLCMT,23516.0,15285.4,1.1,23516.0,144
HCPCS,33863,ASCENDING AORTIC GRAFT,,,8157.69,8157.69,1
HCPCS,33863,Ascending aortic graft,,,2623.14,3037.32,8
HCPCS,33864,ASCENDING AORTA GRF VALVE SPARE ROOT REMODEL,24032.0,15620.8,1.1,24032.0,144
HCPCS,33864,ASCENDING AORTIC GRAFT,,,8332.67,8332.67,1
HCPCS,33864,Ascending aortic graft,,,2623.14,3037.32,8
HCPCS,33866,AORTIC HEMIARCH GRAFT W/ISOL & CTRL ARCH VESSELS,7810.0,5076.5,1.1,7810.0,144
HCPCS,33866,Aortic hemiarch graft,,,2623.14,3037.32,8
HCPCS,3386F,AJCC CLN CNCR STAGE 2 DOCD,,,0.03,0.03,1
HCPCS,3386F,Ajcc cln cncr stage 2 docd,,,10.69,12.38,8
HCPCS,33871,TRANSVRS A-ARCH GRF HYPTHRM,,,8445.23,8445.23,1
HCPCS,33871,TRANSVRS A-ARCH GRF W/CARD BYP PRFD HYPOTHERMIA,24352.0,15828.8,1.1,24352.0,144
HCPCS,33871,Transvrs a-arch grf hypthrm,,,2623.14,3037.32,8
HCPCS,33875,DESCENDING THORACIC AORTA GRAFT W/WO BYPASS,20288.0,13187.2,1.1,20288.0,144
HCPCS,33875,THORACIC AORTIC GRAFT,,,7121.95,7121.95,1
HCPCS,33875,Thoracic aortic graft,,,2623.14,3037.32,8
HCPCS,33877,RPR THORACOABDOMINAL AORTIC ANEURYS W/WO BYPASS,27612.0,17947.8,1.1,27612.0,144
HCPCS,33877,THORACOABDOMINAL GRAFT,,,9368.77,9368.77,1
HCPCS,33877,Thoracoabdominal graft,,,2623.14,3037.32,8
HCPCS,33880,EVASC RPR DTA COVERAGE ART ORIGIN 1ST ENDOPROSTH,13211.5,8587.474999999999,1.1,13832.0,212
HCPCS,33881,EVASC RPR DTA EXP COVERAGE W/O ART ORIGIN,11832.0,7690.8,1.1,11832.0,144
HCPCS,33881,EVASC RPR TA NDGFT XCOV LSA,,,3983.49,3983.49,1
HCPCS,33881,Evasc rpr ta ndgft xcov lsa,,,10445.39,12094.67,8
HCPCS,33882,EVASC RPR TA DPLMNT BRNCHD NDGFT MULTIPIECE SYS,15400.0,10010.0,1.1,15400.0,106
HCPCS,33882,Evasc rpr ta dplmt mltpc sys,,,10445.39,12094.67,8
HCPCS,33883,DELAYED PLMT PROX XTN PROSTH,,,2886.59,2886.59,1
HCPCS,33883,Delayed plmt prox xtn prosth,,,10445.39,12094.67,8
HCPCS,33883,PLMT PROX XTN PROSTH EVASC RPR DTA 1ST XTN,8436.0,5483.4,1.1,8436.0,144
HCPCS,33884,ENDOVASC PROSTH TAA ADD-ON,,,1029.39,1029.39,1
HCPCS,33884,Endovasc prosth taa add-on,,,10445.39,12094.67,8
HCPCS,33886,DELAYED PLMT DSTL XTN PROSTH,,,2491.67,2491.67,1
HCPCS,33886,Delayed plmt dstl xtn prosth,,,10445.39,12094.67,8
HCPCS,33886,PLMT DSTL XTN PROSTH DLYD AFTER EVASC RPR DTA,7236.0,4703.4,1.1,7236.0,144
HCPCS,33889,ARTERY TRANSPOSE/ENDOVAS TAA,,,2068.02,2068.02,1
HCPCS,33889,Artery transpose/endovas taa,,,2623.14,3037.32,8
HCPCS,3388F,AJCC CLN CNCR STAGE 3 DOCD,,,2739849.3,2739849.3,1
HCPCS,3388F,Ajcc cln cncr stage 3 docd,,,10.69,12.38,8
HCPCS,33891,CAR-CAR BP GRFT/ENDOVAS TAA,,,2509.18,2509.18,1
HCPCS,33891,Car-car bp grft/endovas taa,,,3890.39,4504.67,8
HCPCS,33894,EVASC ST RPR COARCJ THRC/AA ACRS MAJ SIDE BRNCH,6579.0,4276.35,1.1,12094.67,212
HCPCS,33895,EVASC ST RPR COARCJ THRC/AA XCRSG MAJ SIDE BRNCH,14588.5,9482.525,1.1,22779.0,212
HCPCS,33897,PERQ TRANSLUMINAL ANGIOPLASTY NATIVE/RECR COA,5526.0,3591.8999999999996,1.1,8711.0,212
HCPCS,33900,PERQ P-ART REVSC ST 1ST NML NATIVE CONNJ UNI,34810.0,22626.5,0.01,65208.0,403
HCPCS,33901,PERQ P-ART REVSC ST 1ST NML NATIVE CONNJ BI,35504.0,23077.6,0.01,65208.0,403
HCPCS,33902,PERQ P-ART REVSC ST 1ST ABNOR CONNJ UNILATERAL,54425.5,35376.575,0.01,103251.0,403
HCPCS,33903,PERQ P-ART REVSC ST 1ST ABNORMAL CONNJ BILATERAL,35904.0,23337.6,0.01,65208.0,403
HCPCS,33904,PERQ P-ART REVSC ST EA ADDL VSL/SEP LES NM/ABNL,2212.0,1437.8,1.1,2212.0,144
HCPCS,33904,Perq p-art revsc each addl,,,5870.61,6797.55,8
HCPCS,3390F,AJCC CLN CNCR STAGE 4 DOCD,,,2739849.3,2739849.3,1
HCPCS,3390F,Ajcc cln cncr stage 4 docd,,,10.69,12.38,8
HCPCS,33910,PULMONARY ARTERY EMBOLECTOMY W/CARD BYPASS,19284.0,12534.6,1.1,19284.0,144
HCPCS,33910,REMOVE LUNG ARTERY EMBOLI,,,6762.43,6762.43,1
HCPCS,33910,Remove lung artery emboli,,,2623.14,3037.32,8
HCPCS,33915,PULMONARY ARTERY EMBOLECTOMY W/O CARD BYPASS,9980.0,6487.0,1.1,9980.0,144
HCPCS,33915,REMOVE LUNG ARTERY EMBOLI,,,3559.42,3559.42,1
HCPCS,33915,Remove lung artery emboli,,,2623.14,3037.32,8
HCPCS,33916,PULMONARY ENDARTERCOMY W/WO EMBOLECTOMY W/BYPASS,31200.0,20280.0,1.1,31200.0,144
HCPCS,33916,SURGERY OF GREAT VESSEL,,,10807.79,10807.79,1
HCPCS,33916,Surgery of great vessel,,,2623.14,3037.32,8
HCPCS,33917,REPAIR PULMONARY ARTERY,,,3799.72,3799.72,1
HCPCS,33917,RPR PULMONARY ART STENOSIS RCNSTJ W/PATCH/GRAFT,10120.0,6578.0,1.1,10120.0,144
HCPCS,33917,Repair pulmonary artery,,,2623.14,3037.32,8
HCPCS,33920,REPAIR PULMONARY ATRESIA,,,4707.24,4707.24,1
HCPCS,33920,RPR PULMONARY ATRESIA W/CONSTJ/RPLCMT CONDUIT,13096.0,8512.4,1.1,13096.0,144
HCPCS,33920,Repair pulmonary atresia,,,3045.04,3525.83,8
HCPCS,33922,TRANSECT PULMONARY ARTERY,,,3622.42,3622.42,1
HCPCS,33922,TRANSECTION PULMONARY ARTERY W/CARD BYPASS,9688.0,6297.2,1.1,9688.0,144
HCPCS,33922,Transect pulmonary artery,,,2623.14,3037.32,8
HCPCS,33924,LIG&TKDN SYSIC-TO-PULM ART SHUNT W/CGEN HEART,2196.0,1427.4,1.1,2196.0,144
HCPCS,33924,REMOVE PULMONARY SHUNT,,,740.27,740.27,1
HCPCS,33924,Remove pulmonary shunt,,,3045.04,3525.83,8
HCPCS,33925,RPR P-ART ARBORIZJ ANOMAL UNIFCLIZJ W/O BYPASS,12520.0,8138.0,1.1,12520.0,144
HCPCS,33925,RPR PUL ART UNIFOCAL W/O CPB,,,4463.05,4463.05,1
HCPCS,33925,Rpr pul art unifocal w/o cpb,,,2623.14,3037.32,8
HCPCS,33926,REPR PUL ART UNIFOCAL W/CPB,,,6280.16,6280.16,1
HCPCS,33926,RPR P-ART ARBORIZJ ANOMAL UNIFCLIZJ W/BYPASS,17892.0,11629.8,1.1,17892.0,144
HCPCS,33926,Repr pul art unifocal w/cpb,,,2623.14,3037.32,8
HCPCS,33927,IMPLTJ TOT RPLCMT HRT SYS,,,6621.51,6621.51,1
HCPCS,33927,IMPLTJ TOTAL RPLCMT HEART SYS W/RCP CARDIECTOMY,19600.0,12740.0,1.1,19600.0,142
HCPCS,33927,Impltj tot rplcmt hrt sys,,,3045.04,3525.83,8
HCPCS,33928,REMOVAL & RPLCMT TOTAL RPLCMT HEART SYS,20031.0,13020.15,1.1,3060831.65,88
HCPCS,33928,RMVL & RPLCMT TOT HRT SYS,,,2739849.3,2739849.3,1
HCPCS,33928,Rmvl & rplcmt tot hrt sys,,,3045.04,3525.83,8
HCPCS,33929,REMOVAL TOTAL RPLCMT HEART SYS FOR HEART TRNSPL,27438.0,17834.7,1.1,3060831.65,88
HCPCS,33929,RMVL RPLCMT HRT SYS F/TRNSPL,,,2739849.3,2739849.3,1
HCPCS,33929,Rmvl rplcmt hrt sys f/trnspl,,,3045.04,3525.83,8
HCPCS,33930,REMOVAL OF DONOR HEART/LUNG,,,7809.0,7809.0,1
HCPCS,33930,Removal of donor heart/lung,,,1229.51,1423.64,8
HCPCS,33933,BKBENCH PREPJ CADAVER DONOR HEART/LUNG ALLOGRAFT,7415.0,4819.75,1.1,7415.0,104
HCPCS,33933,PREPARE DONOR HEART/LUNG,,,583.92,583.92,1
HCPCS,33933,Prepare donor heart/lung,,,1229.51,1423.64,8
HCPCS,33935,HEART-LUNG TRNSPL W/RECIPIENT CARDIECTOMY-PNUMEC,36712.0,23862.8,1.1,36712.0,144
HCPCS,33935,TRANSPLANTATION HEART/LUNG,,,12742.42,12742.42,1
HCPCS,33935,Transplantation heart/lung,,,1229.51,1423.64,8
HCPCS,33940,DONOR CARDIECTOMY,9815.0,6379.75,1.1,9815.0,82
HCPCS,33940,REMOVAL OF DONOR HEART,,,6507.5,6507.5,1
HCPCS,33940,Removal of donor heart,,,1229.51,1423.64,8
HCPCS,33944,BKBENCH PREPJ CADAVER DONOR HEART ALLOGRAFT,6741.0,4381.65,1.1,6741.0,104
HCPCS,33944,PREPARE DONOR HEART,,,583.92,583.92,1
HCPCS,33944,Prepare donor heart,,,1229.51,1423.64,8
HCPCS,33945,HEART TRANSPLANT W/WO REC CARDIECTOMY,35800.0,23270.0,1.1,35800.0,144
HCPCS,33945,TRANSPLANTATION OF HEART,,,12616.11,12616.11,1
HCPCS,33945,Transplantation of heart,,,1229.51,1423.64,8
HCPCS,33946,ECMO/ECLS INITIATION VENO-VENOUS,2567.5,1668.875,0.01,12615.0,281
HCPCS,33947,ECMO/ECLS INITIATION VENO-ARTERIAL,2837.0,1844.05,0.01,12615.0,281
HCPCS,33948,ECMO/ECLS DAILY MANAGEMENT EACH DAY VENO-VENOUS,2024.0,1315.6,0.01,12615.0,281
HCPCS,33949,ECMO/ECLS DAILY MANAGEMENT EA DAY VENO-ARTERIAL,1876.5,1219.725,0.01,12615.0,281
HCPCS,3394F,QUANT HER2 IHC EVAL BRST CX,,,0.03,0.03,1
HCPCS,3394F,Quant her2 ihc eval brst cx,,,10.69,12.38,8
HCPCS,33951,ECMO/ECLS INSJ OF PRPH CANNULA BIRTH-5 YRS PERQ,3260.0,2119.0,1.1,3260.0,144
HCPCS,33951,ECMO/ECLS INSJ PRPH CANNULA,,,1091.7,1091.7,1
HCPCS,33951,Ecmo/ecls insj prph cannula,,,1729.29,2002.34,8
HCPCS,33952,ECMO/ECLS INSJ OF PRPH CANNULA 6 YRS&OLDER PERQ,2966.5,1928.225,1.1,12615.0,212
HCPCS,33953,ECMO/ECLS INSJ OF PRPH CANNULA BIRTH-5 YRS OPEN,3644.0,2368.6,1.1,3644.0,144
HCPCS,33953,ECMO/ECLS INSJ PRPH CANNULA,,,1219.57,1219.57,1
HCPCS,33953,Ecmo/ecls insj prph cannula,,,1729.29,2002.34,8
HCPCS,33954,ECMO/ECLS INSJ OF PRPH CANNULA 6 YRS&OLDER OPEN,3644.0,2368.6,1.1,3644.0,144
HCPCS,33954,ECMO/ECLS INSJ PRPH CANNULA,,,1234.23,1234.23,1
HCPCS,33954,Ecmo/ecls insj prph cannula,,,1729.29,2002.34,8
HCPCS,33955,ECMO/ECLS INSJ CTR CANNULA,,,2136.41,2136.41,1
HCPCS,33955,ECMO/ECLS INSJ OF CENTRAL CANNULA BIRTH-5 YRS,6400.0,4160.0,1.1,6400.0,144
HCPCS,33955,Ecmo/ecls insj ctr cannula,,,1729.29,2002.34,8
HCPCS,33956,ECMO/ECLS INSJ CTR CANNULA,,,2169.34,2169.34,1
HCPCS,33956,ECMO/ECLS INSJ OF CENTRAL CANNULA 6 YRS & OLDER,6400.0,4160.0,1.1,6400.0,144
HCPCS,33956,Ecmo/ecls insj ctr cannula,,,1729.29,2002.34,8
HCPCS,33957,ECMO/ECLS REPOS PERIPH CANNULA PERQ BIRTH-5 YRS,1404.0,912.6,1.1,1404.0,144
HCPCS,33957,ECMO/ECLS REPOS PERPH CNULA,,,474.87,474.87,1
HCPCS,33957,Ecmo/ecls repos perph cnula,,,1729.29,2002.34,8
HCPCS,33958,ECMO/ECLS REPOS PERPH CANNULA PRQ 6 YRS & OLDER,1404.0,912.6,1.1,1404.0,144
HCPCS,33958,ECMO/ECLS REPOS PERPH CNULA,,,474.87,474.87,1
HCPCS,33958,Ecmo/ecls repos perph cnula,,,1729.29,2002.34,8
HCPCS,33959,ECMO/ECLS REPOS PERPH CANNULA OPEN BIRTH-5 YRS,1788.0,1162.2,1.1,1788.0,144
HCPCS,33959,ECMO/ECLS REPOS PERPH CNULA,,,605.43,605.43,1
HCPCS,33959,Ecmo/ecls repos perph cnula,,,1729.29,2002.34,8
HCPCS,3395F,QUANT NONHER2 IHC BRST CX,,,0.03,0.03,1
HCPCS,3395F,Quant nonher2 ihc brst cx,,,10.69,12.38,8
HCPCS,33962,ECMO/ECLS REPOS PERPH CANNULA OPEN 6 YRS & OLDER,1788.0,1162.2,1.1,1788.0,144
HCPCS,33962,ECMO/ECLS REPOS PERPH CNULA,,,605.43,605.43,1
HCPCS,33962,Ecmo/ecls repos perph cnula,,,1729.29,2002.34,8
HCPCS,33963,ECMO/ECLS REPOS CENTRAL PERPH CANNULA BIRTH-5YRS,3600.0,2340.0,1.1,3600.0,144
HCPCS,33963,ECMO/ECLS REPOS PERPH CNULA,,,1205.41,1205.41,1
HCPCS,33963,Ecmo/ecls repos perph cnula,,,1729.29,2002.34,8
HCPCS,33964,ECMO/ECLS ECLS REPOS CENTRAL CNULA 6YRS & OLDER,3800.0,2470.0,1.1,3800.0,144
HCPCS,33964,ECMO/ECLS REPOS PERPH CNULA,,,1272.81,1272.81,1
HCPCS,33964,Ecmo/ecls repos perph cnula,,,1729.29,2002.34,8
HCPCS,33965,ECMO/ECLS RMVL OF PERPH CANNULA PERQ BIRTH-5 YRS,1404.0,912.6,1.1,1404.0,144
HCPCS,33965,ECMO/ECLS RMVL PERPH CANNULA,,,474.87,474.87,1
HCPCS,33965,Ecmo/ecls rmvl perph cannula,,,1729.29,2002.34,8
HCPCS,33966,ECMO/ECLS RMVL OF PRPH CANNULA PRQ 6 YRS & OLDER,1800.0,1170.0,1.1,1800.0,144
HCPCS,33966,ECMO/ECLS RMVL PRPH CANNULA,,,614.55,614.55,1
HCPCS,33966,Ecmo/ecls rmvl prph cannula,,,1729.29,2002.34,8
HCPCS,33967,INSERTION INTRA-AORTIC BALLOON ASSIST DEV PERQ,2537.0,1649.0500000000002,0.01,12615.0,349
HCPCS,33968,REMOVAL INTRA-AORTIC BALLOON ASSIST DEVICE PRQ,821.5,533.975,1.1,12235.0,280
HCPCS,33969,ECMO/ECLS RMVL OF PERPH CANNULA OPEN BIRTH-5 YRS,2088.0,1357.2,1.1,2088.0,144
HCPCS,33969,ECMO/ECLS RMVL PERPH CANNULA,,,703.08,703.08,1
HCPCS,33969,Ecmo/ecls rmvl perph cannula,,,1729.29,2002.34,8
HCPCS,33970,AORTIC CIRCULATION ASSIST,,,914.06,914.06,1
HCPCS,33970,Aortic circulation assist,,,2623.14,3037.32,8
HCPCS,33970,INSJ INTRA-AORT BALO ASSIST DEV VIA FEM ART OPEN,2696.0,1752.4,1.1,2696.0,144
HCPCS,33971,AORTIC CIRCULATION ASSIST,,,1837.8,1837.8,1
HCPCS,33971,Aortic circulation assist,,,2623.14,3037.32,8
HCPCS,33971,RMVL I-AORT BALO ASST DEV W/RPR FEM ART W/WO GRF,4796.0,3117.4,1.1,4796.0,144
HCPCS,33973,INSERT BALLOON DEVICE,,,1294.87,1294.87,1
HCPCS,33973,INSJ I-AORT BALO ASSIST DEV VIA ASCENDING AORTA,3900.0,2535.0,1.1,3900.0,144
HCPCS,33973,Insert balloon device,,,2623.14,3037.32,8
HCPCS,33974,REMOVE INTRA-AORTIC BALLOON,,,2308.53,2308.53,1
HCPCS,33974,RMVL ASCENDING-AORTA BALO DEV W/RPR ASCEND-AORTA,6012.0,3907.8,1.1,6012.0,144
HCPCS,33974,Remove intra-aortic balloon,,,2623.14,3037.32,8
HCPCS,33975,IMPLANT VENTRICULAR DEVICE,,,3384.5,3384.5,1
HCPCS,33975,INSJ VENTRIC ASSIST DEV XTRCORP SINGLE VENTRICLE,10000.0,6500.0,1.1,10000.0,144
HCPCS,33975,Implant ventricular device,,,68198.62,78966.82,8
HCPCS,33976,IMPLANT VENTRICULAR DEVICE,,,4088.96,4088.96,1
HCPCS,33976,INSJ VENTRIC ASSIST DEV XTRCORP BIVENTRICULAR,12300.0,7995.0,1.1,12300.0,144
HCPCS,33976,Implant ventricular device,,,68198.62,78966.82,8
HCPCS,33977,REMOVAL VENTR ASSIST DEVICE XTRCORP 1 VENTRICLE,8344.0,5423.6,1.1,8344.0,144
HCPCS,33977,REMOVE VENTRICULAR DEVICE,,,2910.67,2910.67,1
HCPCS,33977,Remove ventricular device,,,3007.01,3481.8,8
HCPCS,33978,REMOVAL VENTR ASSIST DEVICE XTRCORP BIVENTR,10000.0,6500.0,1.1,10000.0,144
HCPCS,33978,REMOVE VENTRICULAR DEVICE,,,3434.07,3434.07,1
HCPCS,33978,Remove ventricular device,,,3007.01,3481.8,8
HCPCS,33979,INSERT INTRACORPOREAL DEVICE,,,5045.35,5045.35,1
HCPCS,33979,INSJ VENTR ASSIST DEV IMPLTABLE ICORP 1 VNTRC,15000.0,9750.0,1.1,15000.0,144
HCPCS,33979,Insert intracorporeal device,,,68198.62,78966.82,8
HCPCS,33980,REMOVE INTRACORPOREAL DEVICE,,,4625.72,4625.72,1
HCPCS,33980,RMVL VENTR ASSIST DEV IMPLTABLE ICORP 1 VNTRC,13400.0,8710.0,1.1,13400.0,142
HCPCS,33980,Remove intracorporeal device,,,3007.01,3481.8,8
HCPCS,33981,REPLACE VAD PUMP EXT,,,2140.79,2140.79,1
HCPCS,33981,REPLACE XTRA CORP VAD BIVENTRICLE PUMP,6444.0,4188.6,1.1,6444.0,144
HCPCS,33981,Replace vad pump ext,,,68198.62,78966.82,8
HCPCS,33982,PLCMT VAD PMP IMPLTBL ICORP 1 VENTR W/O BYPASS,15144.0,9843.6,1.1,15144.0,144
HCPCS,33982,REPLACE VAD INTRA W/O BP,,,5034.26,5034.26,1
HCPCS,33982,Replace vad intra w/o bp,,,68198.62,78966.82,8
HCPCS,33983,REPLACE VAD INTRA W/BP,,,5924.48,5924.48,1
HCPCS,33983,RPLCMT VAD PMP IMPLTBL ICORP 1 VNTR W/BYPASS,17816.0,11580.4,1.1,17816.0,144
HCPCS,33983,Replace vad intra w/bp,,,68198.62,78966.82,8
HCPCS,33984,ECMO/ECLS RMVL PRPH CANNULA,,,736.32,736.32,1
HCPCS,33984,ECMO/ECLS RMVL PRPH CANNULA OPEN 6 YRS & OLDER,2184.0,1419.6,1.1,2184.0,144
HCPCS,33984,Ecmo/ecls rmvl prph cannula,,,1729.29,2002.34,8
HCPCS,33985,ECMO/ECLS REMOVAL OF CENTRAL CANNULA BIRTH-5 YRS,3956.0,2571.4,1.1,3956.0,144
HCPCS,33985,ECMO/ECLS RMVL CTR CANNULA,,,1323.39,1323.39,1
HCPCS,33985,Ecmo/ecls rmvl ctr cannula,,,1729.29,2002.34,8
HCPCS,33986,ECMO/ECLS RMVL CTR CANNULA,,,1358.27,1358.27,1
HCPCS,33986,ECMO/ECLS RMVL OF CENTRAL CANNULA 6 YRS & OLDER,4000.0,2600.0,1.1,4000.0,144
HCPCS,33986,Ecmo/ecls rmvl ctr cannula,,,1729.29,2002.34,8
HCPCS,33987,ARTERY EXPOS/GRAFT ARTERY,,,537.86,537.86,1
HCPCS,33987,ARTERY EXPOS/GRAFT ARTERY PERFUSION ECMO/ECLS,1616.0,1050.4,1.1,1616.0,144
HCPCS,33987,Artery expos/graft artery,,,1729.29,2002.34,8
HCPCS,33988,INSERT LEFT HEART VENT BY THORACIC INC ECMO/ECLS,6000.0,3900.0,1.1,6000.0,144
HCPCS,33988,INSERTION OF LEFT HEART VENT,,,2003.32,2003.32,1
HCPCS,33988,Insertion of left heart vent,,,1729.29,2002.34,8
HCPCS,33989,REMOVAL OF LEFT HEART VENT,,,1272.81,1272.81,1
HCPCS,33989,RMVL LEFT HEART VENT BY THORACIC INCIS ECMO/ECLS,3800.0,2470.0,1.1,3800.0,144
HCPCS,33989,Removal of left heart vent,,,1729.29,2002.34,8
HCPCS,33990,INSJ PERQ VAD W/IMAGING ARTERY ACCESS ONLY,2970.0,1930.5,1.1,2970.0,144
HCPCS,33990,INSJ PERQ VAD W/RS&I L HRT ARTERIAL ACCESS ONLY,7901.0,5135.65,402.65,78966.82,68
HCPCS,33991,INSJ PERQ VAD L HRT ARTL&VEN,,,1175.08,1175.08,1
HCPCS,33991,INSJ PERQ VAD TRNSPTAL W/IMAGE ART&VENOUS ACCESS,3890.0,2528.5,1.1,3890.0,144
HCPCS,33991,Insj perq vad l hrt artl&ven,,,68198.62,78966.82,8
HCPCS,33992,REMOVAL PERQ LEFT HRT VAD ARTL/ARTL&VEN SEP INSJ,2938.0,1909.7,1.1,12615.0,212
HCPCS,33993,REPOSITIONING PERQ R/L VAD W/IMG GDN SEP INSJ,2064.0,1341.6,1.1,12615.0,212
HCPCS,33995,INSJ PERQ VAD W/RS&I R HEART VENOUS ACCESS ONLY,5182.0,3368.3,1.1,78966.82,212
HCPCS,33997,REMOVAL PERQ R HEART VAD VENOUS CANNULA SEP INSJ,1200.0,780.0,1.1,1200.0,144
HCPCS,33997,RMVL PERQ RIGHT HEART VAD,,,417.41,417.41,1
HCPCS,33997,Rmvl perq right heart vad,,,3007.01,3481.8,8
HCPCS,33999,ANGIOPLASTY LEFT CAROTID,4836.0,3143.4,0.01,4836.0,84
HCPCS,33999,AORTOPLASTY,21113.0,13723.45,0.01,21113.0,84
HCPCS,33999,ATRIAL APPENDAGE LIGATION,8322.0,5409.3,0.01,8322.0,84
HCPCS,33999,ATRIAL VENTRICULAR BYPASS (COMP CODE 33404),12974.0,8433.1,0.01,12974.0,84
HCPCS,33999,AXILLARY EXPOSURE FOR INSERTION OF VAD,1762.0,1145.3,0.01,1833.54,84
HCPCS,33999,CARDIAC SURGERY PROCEDURE THROMBECTOMY,6564.0,4266.6,545.0,12615.0,84
HCPCS,33999,ENDOVASCULAR REPAIR OF TRANSVERSE THORACIC AORTA (COMP CODE 3388,11411.0,7417.15,0.01,11411.0,84
HCPCS,33999,EXPLANT CPNS SYSTEM,5530.0,3594.5,545.0,5530.0,84
HCPCS,33999,EXPLANT CPNS SYSTEM (COMP TO 33289),2161.0,1404.65,0.01,2161.0,84
HCPCS,33999,IMPLANT CPNS SYSTEM,7373.0,4792.45,545.0,7373.0,84
HCPCS,33999,IMPLANT CPNS SYSTEM (COMP TO 33289),2161.0,1404.65,0.01,2161.0,84
HCPCS,33999,IMPLANT TOTAL HEART SYSTE,16645.0,10819.25,0.01,16645.0,84
HCPCS,33999,INSERT HIS ELECTRODE,2070.0,1345.5,545.0,12615.0,168
HCPCS,33999,LOOP REVISION,3924.0,2550.6,545.0,12615.0,84
HCPCS,33999,"OPEN ANTEGRADE DEPLOYMENT OF ENDOGRAFT, DESCENDING THORACIC AORT",16738.0,10879.7,0.01,16738.0,84
HCPCS,33999,OPEN AXILLARY INTRA AORTIC BALLON PUMP PLACEMENT,2224.0,1445.6,0.01,2224.0,84
HCPCS,33999,PERQ TCAT NO-IMPLANT IAS SHUNT CREATION (COMP TO 33741),5129.5,3334.175,0.01,5218.0,168
HCPCS,33999,REMOVAL INTRACARDIAC CATH,2464.0,1601.6,0.01,2464.0,84
HCPCS,33999,REPAIR ASCENDING AORTA INTRAMURAL HEMATOMA WITH PATCH GRAFT,19912.0,12942.8,0.01,19912.0,84
HCPCS,33999,REPLACE TRICUSPID VALVE PERQ,10751.0,6988.15,0.01,12960.0,168
HCPCS,33999,SUBCLAVIAN TRANS-CAROTID TAVR,17587.0,11431.55,545.0,17587.0,84
HCPCS,33999,TCAT IMPLANT OF IVC MONITORING DEVICE (COMP TO 33289),33676.0,21889.4,545.0,33676.0,84
HCPCS,33999,TCAT INSJ/RPL PERM LEADLESS PACEMAKER RA W/IMG (COMP TO 33274),37901.0,24635.65,545.0,37901.0,85
HCPCS,33999,THROMBECTOMY OF IVC/HEART CHAMBERS BY USE OF ANGIOVAC. (COMP COD,4558.0,2962.7,0.01,4558.0,84
HCPCS,33999,TRCATH RPLC MITRAL VALVE,12565.0,8167.25,0.01,12565.0,84
HCPCS,33999,TTVR/ TRANSVENOUS,8054.0,5235.1,0.01,8054.0,84
HCPCS,33999,UNLISTED CARDIAC SURG PROCEDURE,3722.0,2419.3,0.01,3722.0,84
HCPCS,33999,VATS LIGATION OF PDA (COMP CODE 33820),5508.0,3580.2,0.01,5508.0,84
HCPCS,34001,EMBLC/THRMBC CATH CRTD SUBCLA/INNOMINATE ART,7152.0,4648.8,1.1,7152.0,144
HCPCS,34001,REMOVAL OF ARTERY CLOT,,,2384.29,2384.29,1
HCPCS,34001,Removal of artery clot,,,1098.89,1272.4,8
HCPCS,34051,EMBLC/THRMBC INNOMINATE SUBCLAVIAN ARTERY,6796.0,4417.4,1.1,6796.0,144
HCPCS,34051,REMOVAL OF ARTERY CLOT,,,2573.38,2573.38,1
HCPCS,34051,Removal of artery clot,,,10445.39,12094.67,8
HCPCS,34101,EMBLC/THRMBC AX BRACH INNOMINATE SUBCLA ART,17727.0,11522.55,1.1,31082.0,230
HCPCS,34111,EMBLC/THRMBC W/WO CATH RADIAL/ULNAR ART ARM INC,4372.0,2841.8,1.1,16027.4,144
HCPCS,34111,REMOVAL OF ARM ARTERY CLOT,,,4767.51,14346.42,21
HCPCS,34111,Removal of arm artery clot,,,2799.05,3241.01,8
HCPCS,34151,EMBLC/THRMBC RNL CELIAC MESENTRY AORTO-ILIAC ART,10608.0,6895.2,1.1,10608.0,144
HCPCS,34151,REMOVAL OF ARTERY CLOT,,,3615.65,3615.65,1
HCPCS,34151,Removal of artery clot,,,2623.14,3037.32,8
HCPCS,34201,EMBLC/THRMBC FEMORAL POPLITEAL AORTO-ILIAC ART,7792.0,5064.8,1.1,16027.4,144
HCPCS,34201,"EMBO/THROM FEM/POP, AORTAILIAC ART",31082.0,20203.3,1180.3,31082.0,86
HCPCS,34203,EMBLC/THRMBC POPLITEAL-TIBIO-PRONEAL ART LEG INC,7144.0,4643.6,1.1,16027.4,144
HCPCS,34203,EMBO/THROM POP/TIBIO/PERONEAL ART,31082.0,20203.3,1095.2,31082.0,86
HCPCS,34401,REMOVAL OF VEIN CLOT,,,3875.59,3875.59,1
HCPCS,34401,Removal of vein clot,,,2623.14,3037.32,8
HCPCS,34401,THRMBC DIR/W/CATH VENA CAVA ILIAC VEIN ABDL INC,10608.0,6895.2,1.1,10608.0,144
HCPCS,34421,REMOVAL OF VEIN CLOT,,,2765.32,8321.41,21
HCPCS,34421,Removal of vein clot,,,2799.05,3241.01,8
HCPCS,34421,THRMBC DIR/W/CATH V/C ILIAC FEMPOP VEIN LEG INC,5348.0,3476.2,1.1,9296.26,144
HCPCS,34451,REMOVAL OF VEIN CLOT,,,3744.92,3744.92,1
HCPCS,34451,Removal of vein clot,,,2623.14,3037.32,8
HCPCS,34451,THRMBC DIR/W/CATH V/C ILIAC FEMPOP VEIN ABDL&LEG,11408.0,7415.2,1.1,11408.0,144
HCPCS,34471,REMOVAL OF VEIN CLOT,,,545.0,1640.03,21
HCPCS,34471,Removal of vein clot,,,2799.05,3241.01,8
HCPCS,34471,THRMBC DIR/W/CATH SUBCLAVIAN VEIN NECK INC,8444.0,5488.6,1.1,8444.0,144
HCPCS,34490,REMOVAL OF VEIN CLOT,,,2765.32,8321.41,21
HCPCS,34490,Removal of vein clot,,,2799.05,3241.01,8
HCPCS,34490,THRMBC DIR/W/CATH AXILL&SUBCLAVIAN VEIN ARM IN,4364.0,2836.6,1.1,9296.26,144
HCPCS,34501,REPAIR VALVE FEMORAL VEIN,,,4767.51,14346.42,21
HCPCS,34501,Repair valve femoral vein,,,2799.05,3241.01,8
HCPCS,34502,RECONSTRUCT VENA CAVA,,,4020.84,4020.84,1
HCPCS,34502,RECONSTRUCTION VENA CAVA ANY METHOD,11228.0,7298.2,1.1,11228.0,144
HCPCS,34502,Reconstruct vena cava,,,2623.14,3037.32,8
HCPCS,3450F,DYSPNEA SCRND NO-MILD DYSP,,,2739849.3,2739849.3,1
HCPCS,3450F,Dyspnea scrnd no-mild dysp,,,10.69,12.38,8
HCPCS,34510,TRANSPOSITION OF VEIN VALVE,,,4767.51,14346.42,21
HCPCS,34510,Transposition of vein valve,,,2799.05,3241.01,8
HCPCS,34510,VENOUS VALVE TRANSPOSITION ANY VEIN DONOR,7964.0,5176.6,1.1,16027.4,144
HCPCS,3451F,DYSPNEA SCRND MOD-HIGH DYSP,,,2739849.3,2739849.3,1
HCPCS,3451F,Dyspnea scrnd mod-high dysp,,,10.69,12.38,8
HCPCS,34520,CROSS-OVER VEIN GRAFT,,,4767.51,14346.42,21
HCPCS,34520,CROSS-OVER VEIN GRAFT VENOUS SYSTEM,7672.0,4986.8,1.1,16027.4,144
HCPCS,34520,Cross-over vein graft,,,2799.05,3241.01,8
HCPCS,3452F,DYSPNEA NOT SCREENED,,,2739849.3,2739849.3,1
HCPCS,3452F,Dyspnea not screened,,,10.69,12.38,8
HCPCS,34530,LEG VEIN FUSION,,,2765.32,8321.41,21
HCPCS,34530,Leg vein fusion,,,2799.05,3241.01,8
HCPCS,34530,SAPHENOPOPLITEAL VEIN ANASTOMOSIS,7172.0,4661.8,1.1,9296.26,144
HCPCS,3455F,TB SCR PFRMD&INTERPD 6 MO,,,2739849.3,2739849.3,1
HCPCS,3455F,Tb scr pfrmd&interpd 6 mo,,,10.69,12.38,8
HCPCS,34701,EVASC RPR DPLMNT AORTO-AORTIC NDGFT,19628.5,12758.525000000001,1.1,29773.0,213
HCPCS,34702,EVASC RPR DPLMNT AORTO-AORTIC NDGFT RPT,10439.0,6785.35,1.1,19185.0,213
HCPCS,34703,EVASC RPR DPLMNT AORTO-UN-ILIAC NDGFT,13222.5,8594.625,1.1,19185.0,213
HCPCS,34704,EVASC RPR DPLMNT AORTO-UN-ILIAC NDGFT RPT,16918.5,10997.025,1.1,19185.0,213
HCPCS,34705,EVASC RPR DPLMNT AORTO-BI-ILIAC NDGFT,21142.0,13742.3,1.1,30452.0,213
HCPCS,34706,EVASC RPR DPLMNT AORTO-BI-ILIAC NDGFT RPT,16918.5,10997.025,1.1,19185.0,213
HCPCS,34707,EVASC RPR DPLMNT ILIO-ILIAC NDGFT,12374.5,8043.424999999999,1.1,17833.0,282
HCPCS,34708,EVASC RPR DPLMNT ILIO-ILIAC NDGFT RPT,15218.5,9892.025,1.1,17833.0,213
HCPCS,34709,PLACEMENT XTN PROSTH FOR ENDOVASCULAR RPR,6431.0,4180.15,1.1,12094.67,213
HCPCS,3470F,RA DISEASE ACTIVITY LOW,,,2739849.3,2739849.3,1
HCPCS,3470F,Ra disease activity low,,,10.69,12.38,8
HCPCS,34710,DLYD PLACEMENT XTN PROSTH FOR EVASC RPR 1ST VSL,8131.0,5285.15,1.1,12094.67,213
HCPCS,34711,DLYD PLACEMENT XTN PROSTH FOR EVASC RPR EA ADDL,6331.0,4115.15,1.1,12094.67,213
HCPCS,34712,TRANSCATHETER DLVR ENHNCD FIXATION DEVICES RS&I,7531.0,4895.15,1.1,12094.67,213
HCPCS,34713,PERQ ACCESS & CLOSURE FEM ART FOR DELIVERY NDGFT,5320.0,3458.0,1.1,12094.67,212
HCPCS,34714,OPN FEM ART EXPOS W/CNDT CRTJ DLVR EVASC PROSTH,10380.0,6747.0,1.1,18660.0,212
HCPCS,34715,OPN AX/SUBCLA ART EXPOS DLVR EVASC PROSTH UNI,2400.0,1560.0,1.1,2400.0,144
HCPCS,34715,Opn ax/subcla art expos,,,2799.05,3241.01,8
HCPCS,34716,OPN AXILLARY/SUBCLAVIAN ART EXPOS W/CNDT CRTJ,2876.0,1869.4,1.1,2876.0,144
HCPCS,34716,Opn ax/subcla art expos cndt,,,673.41,779.74,8
HCPCS,34717,EVASC RPR ILIAC ART TM OF A-ILIAC ART NDGFT UNI,19292.5,12540.125,1.1,34625.0,212
HCPCS,34718,EVASC RPR ILIAC ART N/A A-ILIAC ART NDGFT UNI,21031.0,13670.15,1.1,31502.0,212
HCPCS,3471F,RA DISEASE ACTIVITY MOD,,,2739849.3,2739849.3,1
HCPCS,3471F,Ra disease activity mod,,,10.69,12.38,8
HCPCS,3472F,RA DISEASE ACTIVITY HIGH,,,2739849.3,2739849.3,1
HCPCS,3472F,Ra disease activity high,,,10.69,12.38,8
HCPCS,3475F,DISEASE PROGN RA POOR DOCD,,,2739849.3,2739849.3,1
HCPCS,3475F,Disease progn ra poor docd,,,10.69,12.38,8
HCPCS,3476F,DISEASE PROGN RA GOOD DOCD,,,2739849.3,2739849.3,1
HCPCS,3476F,Disease progn ra good docd,,,10.69,12.38,8
HCPCS,34808,EVASC PLACEMENT ILIAC ARTERY OCCLUSION DEVICE,14195.5,9227.075,1.1,26743.0,212
HCPCS,34812,OPN FEM ART EXPOS DLVR EVASC PROSTH UNI,10156.0,6601.4,1.1,18660.0,212
HCPCS,34813,FEMORAL ENDOVAS GRAFT ADD-ON,,,611.16,611.16,1
HCPCS,34813,Femoral endovas graft add-on,,,10445.39,12094.67,8
HCPCS,34813,PLMT FEM-FEM PROSTC GRF EVASC AORTIC ARYSM RPR,1916.0,1245.4,1.1,1916.0,144
HCPCS,34820,OPN ILIAC ART EXPOS,,,877.46,877.46,1
HCPCS,34820,OPN ILIAC ART EXPOS PROSTH/ILIAC OCCLS EVASC UNI,2800.0,1820.0,1.1,2800.0,144
HCPCS,34820,Opn iliac art expos,,,10445.39,12094.67,8
HCPCS,34830,OPEN AORTIC TUBE PROSTH REPR,,,4595.01,4595.01,1
HCPCS,34830,OPN RPR ARYSM RPR ARTL TRAUMA TUBE PROSTH,14092.0,9159.8,1.1,14092.0,144
HCPCS,34830,Open aortic tube prosth repr,,,2623.14,3037.32,8
HCPCS,34831,OPEN AORTOILIAC PROSTH REPR,,,5019.3,5019.3,1
HCPCS,34831,OPN RPR ARYSM RPR ARTL TRMA AORTOBIILIAC PROSTH,15192.0,9874.8,1.1,15192.0,144
HCPCS,34831,Open aortoiliac prosth repr,,,2623.14,3037.32,8
HCPCS,34832,OPEN AORTOFEMOR PROSTH REPR,,,4940.82,4940.82,1
HCPCS,34832,OPN RPR ARYSM RPR ARTL TRMA AORTO-BIFEM PROSTH,15192.0,9874.8,1.1,15192.0,144
HCPCS,34832,Open aortofemor prosth repr,,,2623.14,3037.32,8
HCPCS,34833,OPN ILAC ART EXPOS CNDT CRTJ,,,1024.05,1024.05,1
HCPCS,34833,OPN ILIAC ART EXPOS CRTJ PROSTH EST CARD BYP,3264.0,2121.6,1.1,3264.0,144
HCPCS,34833,Opn ilac art expos cndt crtj,,,673.41,779.74,8
HCPCS,34834,"OPN BRACH ART EXPOS PROS, UNLAT",19786.0,12860.9,150.47,19786.0,68
HCPCS,34834,OPN BRACHIAL ARTERY EXPOS DLVR EVASC PROSTH UNI,1166.0,757.9,1.1,1166.0,144
HCPCS,34839,PLNNING PT SPEC FENEST GRAFT,,,2739849.3,2739849.3,1
HCPCS,34839,PLNNING PT SPEC FENEST VISCERAL AORTIC GRAFT,3486.0,2265.9,1.1,3060831.65,88
HCPCS,34839,Plnning pt spec fenest graft,,,405.62,469.67,8
HCPCS,34841,ENDOVASC VISC AORTA 1 GRAFT,,,3449.03,3449.03,1
HCPCS,34841,ENDOVASC VISCER AORTA REPAIR FENEST 1 ENDOGRAFT,12429.0,8078.85,1.1,12429.0,104
HCPCS,34841,Endovasc visc aorta 1 graft,,,10445.39,12094.67,8
HCPCS,34842,ENDOVASC VISC AORTA 2 GRAFT,,,4173.65,4173.65,1
HCPCS,34842,ENDOVASC VISCER AORTA REPAIR FENEST 2 ENDOGRAFT,16135.0,10487.75,1.1,16135.0,104
HCPCS,34842,Endovasc visc aorta 2 graft,,,10445.39,12094.67,8
HCPCS,34843,ENDOVASC VISC AORTA 3 GRAFT,,,4083.37,4083.37,1
HCPCS,34843,ENDOVASC VISCER AORTA REPAIR FENEST 3 ENDOGRAFT,21031.0,13670.15,1.1,21031.0,104
HCPCS,34843,Endovasc visc aorta 3 graft,,,10445.39,12094.67,8
HCPCS,34844,ENDOVASC VISC AORTA 4 GRAFT,,,4219.38,4219.38,1
HCPCS,34844,ENDOVASC VISCER AORTA REPR FENEST 4+ ENDOGRAFT,23546.0,15304.9,1.1,23546.0,104
HCPCS,34844,Endovasc visc aorta 4 graft,,,10445.39,12094.67,8
HCPCS,34845,VISC & INFRAREN ABD 1 PROSTH,31502.0,20476.3,6867.44,31502.0,66
HCPCS,34845,VISCER AND INFRARENAL ABDOM AORTA 1 PROSTHESIS,5546.0,3604.9,1.1,5937.11,104
HCPCS,34846,VISC & INFRAREN ABD 2 PROSTH,34625.0,22506.25,7548.25,34625.0,66
HCPCS,34846,VISCER AND INFRARENAL ABDOM AORTA 2 PROSTHESIS,8117.0,5276.05,1.1,8157.79,104
HCPCS,34847,VISC & INFRAREN ABD 3 PROSTH,37750.0,24537.5,7778.0,37750.0,66
HCPCS,34847,VISCER AND INFRARENAL ABDOM AORTA 3 PROSTHESIS,9324.0,6060.6,1.1,10378.47,104
HCPCS,34848,VISC & INFRAREN ABD 4+ PROSTH,16400.0,10660.0,3575.2,16400.0,66
HCPCS,34848,VISCER AND INFRARENAL ABDOM AORTA 4+ PROSTHESIS,11885.0,7725.25,1.1,12599.15,92
HCPCS,3490F,HISTORY AIDS-DEFINING COND,,,2739849.3,2739849.3,1
HCPCS,3490F,History aids-defining cond,,,10.69,12.38,8
HCPCS,3491F,HIV UNSURE BABY OF HIV+MOMS,,,2739849.3,2739849.3,1
HCPCS,3491F,Hiv unsure baby of hiv+moms,,,10.69,12.38,8
HCPCS,3492F,HISTORY CD4+ CELL COUNT <350,,,2739849.3,2739849.3,1
HCPCS,3492F,History cd4+ cell count <350,,,10.69,12.38,8
HCPCS,3493F,NO HIST CD4+ CELL COUNT <350,,,2739849.3,2739849.3,1
HCPCS,3493F,No hist cd4+ cell count <350,,,10.69,12.38,8
HCPCS,3494F,CD4+CELL COUNT <200CELLS/MM3,,,2739849.3,2739849.3,1
HCPCS,3494F,Cd4+cell count <200cells/mm3,,,10.69,12.38,8
HCPCS,3495F,CD4+CELL CNT 200-499 CELLS,,,2739849.3,2739849.3,1
HCPCS,3495F,Cd4+cell cnt 200-499 cells,,,10.69,12.38,8
HCPCS,3496F,CD4+ CELL COUNT >= 500 CELLS,,,2739849.3,2739849.3,1
HCPCS,3496F,Cd4+ cell count >= 500 cells,,,10.69,12.38,8
HCPCS,3497F,CD4+ CELL PERCENTAGE <15%,,,2739849.3,2739849.3,1
HCPCS,3497F,Cd4+ cell percentage <15%,,,10.69,12.38,8
HCPCS,3498F,CD4+ CELL >=15% (HIV),,,2739849.3,2739849.3,1
HCPCS,3498F,Cd4+ cell >=15% (hiv),,,10.69,12.38,8
HCPCS,35001,DIR RPR ANEURYSM CAROTID-SUBCLAVIAN ARTERY,8324.0,5410.6,1.1,8324.0,144
HCPCS,35001,REPAIR DEFECT OF ARTERY,,,2915.03,2915.03,1
HCPCS,35001,Repair defect of artery,,,1098.89,1272.4,8
HCPCS,35002,DIR RPR RUPTD ANEURYSM CAROTID-SUBCLAVIAN ARTERY,8892.0,5779.8,1.1,8892.0,144
HCPCS,35002,REPAIR ARTERY RUPTURE NECK,,,2967.26,2967.26,1
HCPCS,35002,Repair artery rupture neck,,,1098.89,1272.4,8
HCPCS,35005,DIR RPR ANEURYSM VERTEBRAL ARTERY,7716.0,5015.4,1.1,7716.0,144
HCPCS,35005,REPAIR DEFECT OF ARTERY,,,2596.37,2596.37,1
HCPCS,35005,Repair defect of artery,,,1098.89,1272.4,8
HCPCS,3500F,CD4+CELL CNT/% DOCD AS DONE,,,2739849.3,2739849.3,1
HCPCS,3500F,Cd4+cell cnt/% docd as done,,,10.69,12.38,8
HCPCS,35011,DIR RPR ANEURYSM AXIL-BRACHIAL ARM INCISION,7432.0,4830.8,1.1,16027.4,144
HCPCS,35011,REPAIR DEFECT OF ARTERY,,,4767.51,14346.42,21
HCPCS,35011,Repair defect of artery,,,2799.05,3241.01,8
HCPCS,35013,DIR RPR RUPTD ANEURYSM AXIL-BRACHIAL ARM INCIS,9292.0,6039.8,1.1,9292.0,144
HCPCS,35013,REPAIR ARTERY RUPTURE ARM,,,3293.78,3293.78,1
HCPCS,35013,Repair artery rupture arm,,,2799.05,3241.01,8
HCPCS,35021,DIR RPR ANEURYSM INNOMINATE/SUBCLAVIAN ARTERY,8868.0,5764.2,1.1,8868.0,144
HCPCS,35021,REPAIR DEFECT OF ARTERY,,,3262.24,3262.24,1
HCPCS,35021,Repair defect of artery,,,2623.14,3037.32,8
HCPCS,35022,DIR RPR RUPTD ANEURYSM INNOMINATE/SUBCLAVIAN,10280.0,6682.0,1.1,10280.0,144
HCPCS,35022,REPAIR ARTERY RUPTURE CHEST,,,3733.52,3733.52,1
HCPCS,35022,Repair artery rupture chest,,,2623.14,3037.32,8
HCPCS,3502F,HIV RNA VRL LD <LMTS QUANTIF,,,2739849.3,2739849.3,1
HCPCS,3502F,Hiv rna vrl ld <lmts quantif,,,10.69,12.38,8
HCPCS,3503F,HIV RNA VRL LDNOT<LMTS QUNTF,,,2739849.3,2739849.3,1
HCPCS,3503F,Hiv rna vrl ldnot<lmts quntf,,,10.69,12.38,8
HCPCS,35045,DIR RPR RUPTD ANEURYSM RADIAL/ULNAR ARTERY,7204.0,4682.6,1.1,16027.4,144
HCPCS,35045,REPAIR DEFECT OF ARM ARTERY,,,4767.51,14346.42,21
HCPCS,35045,Repair defect of arm artery,,,2799.05,3241.01,8
HCPCS,35081,DIR RPR ANEURYSM ABDOMINAL AORTA,13412.0,8717.8,1.1,13412.0,144
HCPCS,35081,REPAIR DEFECT OF ARTERY,,,4500.4,4500.4,1
HCPCS,35081,Repair defect of artery,,,2623.14,3037.32,8
HCPCS,35082,DIR RPR RUPTD ANEURYSM ABDOMINAL AORTA,16836.0,10943.4,1.1,16836.0,144
HCPCS,35082,REPAIR ARTERY RUPTURE AORTA,,,5620.04,5620.04,1
HCPCS,35082,Repair artery rupture aorta,,,2623.14,3037.32,8
HCPCS,35091,DIR RPR ANEURYSM ABDOM AORTA W/VISCERAL VESSELS,14140.0,9191.0,1.1,14140.0,144
HCPCS,35091,REPAIR DEFECT OF ARTERY,,,4631.7,4631.7,1
HCPCS,35091,Repair defect of artery,,,2623.14,3037.32,8
HCPCS,35092,DIR RPR RUPTD ANEURSM ABDOM AORTA W/VISCERA VSLS,20388.0,13252.2,1.1,20388.0,144
HCPCS,35092,REPAIR ARTERY RUPTURE AORTA,,,6751.85,6751.85,1
HCPCS,35092,Repair artery rupture aorta,,,2623.14,3037.32,8
HCPCS,35102,DIR RPR ANEURYSM ABDOM AORTA W/ILIAC VESSELS,14612.0,9497.8,1.1,14612.0,144
HCPCS,35102,REPAIR DEFECT OF ARTERY,,,4893.8,4893.8,1
HCPCS,35102,Repair defect of artery,,,2623.14,3037.32,8
HCPCS,35103,DIR RPR RUPTD ANEURYSM ABDOM AORTA W/ILIAC VSLS,17448.0,11341.2,1.1,17448.0,144
HCPCS,35103,REPAIR ARTERY RUPTURE AORTA,,,5768.08,5768.08,1
HCPCS,35103,Repair artery rupture aorta,,,2623.14,3037.32,8
HCPCS,3510F,DOC TB SCRNG-RSLTS INTERPD,,,2739849.3,2739849.3,1
HCPCS,3510F,Doc tb scrng-rslts interpd,,,10.69,12.38,8
HCPCS,35111,DIR RPR ANEURYSM SPLENIC ARTERY,10512.0,6832.8,1.1,10512.0,144
HCPCS,35111,REPAIR DEFECT OF ARTERY,,,3464.26,3464.26,1
HCPCS,35111,Repair defect of artery,,,2623.14,3037.32,8
HCPCS,35112,DIR RPR RUPTD ANEURYSM SPLENIC ARTERY,13028.0,8468.2,1.1,13028.0,144
HCPCS,35112,REPAIR ARTERY RUPTURE SPLEEN,,,4259.82,4259.82,1
HCPCS,35112,Repair artery rupture spleen,,,2623.14,3037.32,8
HCPCS,3511F,CHLMYD/GONRH TSTS DOCD DONE,,,0.03,0.03,1
HCPCS,3511F,Chlmyd/gonrh tsts docd done,,,10.69,12.38,8
HCPCS,35121,DIR RPR ANEURYSM HEPATIC/CELIAC/RENAL/MESENTERIC,12608.0,8195.2,1.1,12608.0,144
HCPCS,35121,REPAIR DEFECT OF ARTERY,,,4120.28,4120.28,1
HCPCS,35121,Repair defect of artery,,,2623.14,3037.32,8
HCPCS,35122,DIR RPR RUPTD ANEURSM HEPATIC/CELIAC/RENAL/MESEN,15156.0,9851.4,1.1,15156.0,144
HCPCS,35122,REPAIR ARTERY RUPTURE BELLY,,,4930.08,4930.08,1
HCPCS,35122,Repair artery rupture belly,,,2623.14,3037.32,8
HCPCS,3512F,SYPH SCRNG DOCD AS DONE,,,2739849.3,2739849.3,1
HCPCS,3512F,Syph scrng docd as done,,,10.69,12.38,8
HCPCS,35131,DIR RPR ANEURYSM & GRAFT ILIAC ARTERY,10560.0,6864.0,1.1,10560.0,144
HCPCS,35131,REPAIR DEFECT OF ARTERY,,,3591.21,3591.21,1
HCPCS,35131,Repair defect of artery,,,2623.14,3037.32,8
HCPCS,35132,DIR RPR RUPTD ANEURYSM & GRAFT ILIAC ARTERY,13028.0,8468.2,1.1,13028.0,144
HCPCS,35132,REPAIR ARTERY RUPTURE GROIN,,,4259.82,4259.82,1
HCPCS,35132,Repair artery rupture groin,,,2623.14,3037.32,8
HCPCS,3513F,HEP B SCRNG DOCD AS DONE,,,2739849.3,2739849.3,1
HCPCS,3513F,Hep b scrng docd as done,,,10.69,12.38,8
HCPCS,35141,DIR RPR ANEURYSM & GRAFT COMMON FEMORAL ARTERY,8364.0,5436.6,1.1,8364.0,144
HCPCS,35141,REPAIR DEFECT OF ARTERY,,,2839.27,2839.27,1
HCPCS,35141,Repair defect of artery,,,2799.05,3241.01,8
HCPCS,35142,DIR RPR RUPTD ANEURYSM & GRF COMMON FEMORAL ART,10064.0,6541.6,1.1,10064.0,144
HCPCS,35142,REPAIR ARTERY RUPTURE THIGH,,,3428.45,3428.45,1
HCPCS,35142,Repair artery rupture thigh,,,2799.05,3241.01,8
HCPCS,3514F,HEP C SCRNG DOCD AS DONE,,,2739849.3,2739849.3,1
HCPCS,3514F,Hep c scrng docd as done,,,10.69,12.38,8
HCPCS,35151,DIR RPR ANEURYSM & GRAFT POPLITEAL ARTERY,9488.0,6167.2,1.1,9488.0,144
HCPCS,35151,REPAIR DEFECT OF ARTERY,,,3227.69,3227.69,1
HCPCS,35151,Repair defect of artery,,,2799.05,3241.01,8
HCPCS,35152,DIR RPR RUPTD ANEURYSM & GRF POPLITEAL ARTERY,11064.0,7191.6,1.1,11064.0,144
HCPCS,35152,REPAIR RUPTD POPLITEAL ART,,,3642.25,3642.25,1
HCPCS,35152,Repair ruptd popliteal art,,,2799.05,3241.01,8
HCPCS,3515F,PT HAS DOCD IMMUN TO HEP C,,,2739849.3,2739849.3,1
HCPCS,3515F,Pt has docd immun to hep c,,,10.69,12.38,8
HCPCS,3517F,HBV ASSESS&RESULTS INTRP 1YR,,,2739849.3,2739849.3,1
HCPCS,3517F,Hbv assess&results intrp 1yr,,,10.69,12.38,8
HCPCS,35180,REPAIR CONGENITAL AV FISTULA HEAD & NECK,6040.0,3926.0,1.1,6040.0,144
HCPCS,35180,RPR CGEN AV FISTULA HEAD&NCK,,,1389.42,4181.05,21
HCPCS,35180,Rpr cgen av fistula head&nck,,,1244.56,1441.07,8
HCPCS,35182,RPR CGEN AV FISTULA THRX&ABD,,,4663.56,4663.56,1
HCPCS,35182,RPR CONGENITAL AV FISTULA THORAX & ABDOMEN,12684.0,8244.6,1.1,12684.0,144
HCPCS,35182,Rpr cgen av fistula thrx&abd,,,2623.14,3037.32,8
HCPCS,35184,RPR CGEN AV FISTULA XTR,,,2765.32,8321.41,21
HCPCS,35184,RPR CONGENITAL AV FISTULA EXTREMITIES,7528.0,4893.2,1.1,9296.26,144
HCPCS,35184,Rpr cgen av fistula xtr,,,1244.56,1441.07,8
HCPCS,35188,RPR ACQ AV FISTULA HEAD&NECK,,,4767.51,5790.88,20
HCPCS,35188,RPR/TRAUMATIC AV FISTULA HEAD & NECK,7200.0,4680.0,1.1,16027.4,144
HCPCS,35188,Rpr acq av fistula head&neck,,,1244.56,1441.07,8
HCPCS,35189,RPR ACQ AV FISTULA THRX&ABD,,,3936.37,3936.37,1
HCPCS,35189,RPR/TRAUMATIC AV FISTULA THORAX & ABDOMEN,11992.0,7794.8,1.1,11992.0,144
HCPCS,35189,Rpr acq av fistula thrx&abd,,,2623.14,3037.32,8
HCPCS,35190,REPAIR ACQ AV FISTULA XTR,,,4767.51,5790.88,20
HCPCS,35190,RPR/TRAUMATIC AV FISTULA EXTREMITIES,5368.0,3489.2,1.1,16027.4,144
HCPCS,35190,Repair acq av fistula xtr,,,1244.56,1441.07,8
HCPCS,35201,REPAIR BLOOD VESSEL DIR NECK,,,4767.51,14346.42,21
HCPCS,35201,REPAIR BLOOD VESSEL DIRECT NECK,6772.0,4401.8,1.1,16027.4,144
HCPCS,35201,Repair blood vessel dir neck,,,1244.56,1441.07,8
HCPCS,35206,REPAIR BLOOD VESSEL DIRECT UPPER EXTREMITY,11817.0,7681.05,1.1,18098.0,230
HCPCS,35206,REPAIR BLOOD VESSEL UPPER EXT,18098.0,11763.7,913.47,18098.0,86
HCPCS,35207,REPAIR BLOOD VESSEL DIRECT HAND FINGER,11237.0,7304.05,1.1,18098.0,231
HCPCS,3520F,CDIFFICILE TESTING PERFORMED,,,2739849.3,2739849.3,1
HCPCS,3520F,Cdifficile testing performed,,,10.69,12.38,8
HCPCS,35211,RPR BLOOD VESSEL DIRECT INTRATHORACIC W/BYPASS,9832.0,6390.8,1.1,9832.0,144
HCPCS,35211,RPR BLVSL DIR NTRATHRC W/BYP,,,3619.51,3619.51,1
HCPCS,35211,Rpr blvsl dir ntrathrc w/byp,,,2623.14,3037.32,8
HCPCS,35216,RPR BLOOD VESSEL DIRECT INTRATHORACIC W/O BYPASS,14644.0,9518.6,1.1,14644.0,144
HCPCS,35216,RPR BLVSL DIR NTRTHRC WO BYP,,,5466.79,5466.79,1
HCPCS,35216,Rpr blvsl dir ntrthrc wo byp,,,2623.14,3037.32,8
HCPCS,35221,RPR BLD VSL DIR INTRA-ABDL,,,3840.16,3840.16,1
HCPCS,35221,RPR BLOOD VESSEL DIRECT INTRA-ABDOMINAL,10648.0,6921.2,1.1,10648.0,144
HCPCS,35221,Rpr bld vsl dir intra-abdl,,,2623.14,3037.32,8
HCPCS,35226,RPR BLOOD VESSEL DIRECT LOWER EXTREMITY,5083.0,3303.95,0.01,7966.0,403
HCPCS,35231,REPAIR BLOOD VESSEL W/VEIN GRAFT NECK,8464.0,5501.6,1.1,9296.26,144
HCPCS,35231,REPAIR BLVSL VN GRF NECK,,,2765.32,8321.41,21
HCPCS,35231,Repair blvsl vn grf neck,,,1244.56,1441.07,8
HCPCS,35236,REPAIR BLOOD VESSEL W/VEIN GRAFT UPPER EXTREMITY,7208.0,4685.2,1.1,16027.4,144
HCPCS,35236,REPAIR BLVSL VN GRF UXTR,,,4767.51,14346.42,21
HCPCS,35236,Repair blvsl vn grf uxtr,,,1244.56,1441.07,8
HCPCS,35241,RPR BLOOD VESSEL VEIN GRAFT INTRATHORACIC W/BYP,10232.0,6650.8,1.1,10232.0,144
HCPCS,35241,RPR BLVSL VN GRF NTRTHRC W/B,,,3717.52,3717.52,1
HCPCS,35241,Rpr blvsl vn grf ntrthrc w/b,,,2623.14,3037.32,8
HCPCS,35246,RPR BLOOD VESSEL VEIN GRF INTRATHORACIC W/O BYP,11292.0,7339.8,1.1,11292.0,144
HCPCS,35246,RPR BLVSL VN GRF NTRTHRC W/O,,,4046.05,4046.05,1
HCPCS,35246,Rpr blvsl vn grf ntrthrc w/o,,,2623.14,3037.32,8
HCPCS,35251,REPAIR BLOOD VESSEL VEIN GRAFT INTRA-ABDOMINAL,12764.0,8296.6,1.1,12764.0,144
HCPCS,35251,RPR BLVSL VN GRF INTRA-ABDL,,,4529.6,4529.6,1
HCPCS,35251,Rpr blvsl vn grf intra-abdl,,,2623.14,3037.32,8
HCPCS,35256,REPAIR BLOOD VESSEL VEIN GRAFT LOWER EXTREMITY,7624.0,4955.6,1.1,16027.4,144
HCPCS,35256,REPAIR BLVSL VN GRF LXTR,,,4767.51,14346.42,21
HCPCS,35256,Repair blvsl vn grf lxtr,,,2799.05,3241.01,8
HCPCS,35261,REPAIR BLOOD VESSEL W/GRAFT OTHER/THAN VEIN NECK,7584.0,4929.6,1.1,9296.26,144
HCPCS,35261,RPR BLVSL GRF OTH/THN VN NCK,,,2765.32,8321.41,21
HCPCS,35261,Rpr blvsl grf oth/thn vn nck,,,2799.05,3241.01,8
HCPCS,35266,RPR BLOOD VSL GRF OTH/THN VEIN UPPER EXTREMITY,6332.0,4115.8,1.1,16027.4,144
HCPCS,35266,RPR BLVSL GRF OTH/TH VN UXTR,,,4767.51,14346.42,21
HCPCS,35266,Rpr blvsl grf oth/th vn uxtr,,,1244.56,1441.07,8
HCPCS,35271,RPR BLOOD VSL GRF OTH/THN VEIN INTRATHRC W/BYP,9832.0,6390.8,1.1,9832.0,144
HCPCS,35271,RPR BLVS GR OT/TH VN NTRTH W,,,3600.88,3600.88,1
HCPCS,35271,Rpr blvs gr ot/th vn ntrth w,,,2623.14,3037.32,8
HCPCS,35276,RPR BLOOD VSL GRF OTH/THN VEIN INTRATHRC W/O BYP,10332.0,6715.8,1.1,10332.0,144
HCPCS,35276,RPR BLVS GR OT/T VN NTRTH WO,,,3775.75,3775.75,1
HCPCS,35276,Rpr blvs gr ot/t vn ntrth wo,,,2623.14,3037.32,8
HCPCS,35281,RPR BLVSL GR OT/TH VN NTR-AB,,,4213.93,4213.93,1
HCPCS,35281,RPR BLVSL W/GRFT OTHER/THAN VEIN INTRA-ABDOMINAL,12024.0,7815.6,1.1,12024.0,144
HCPCS,35281,Rpr blvsl gr ot/th vn ntr-ab,,,2623.14,3037.32,8
HCPCS,35286,RPR BLVSL GRF OTH/TH VN LXTR,,,4767.51,14346.42,21
HCPCS,35286,RPR BLVSL W/GRF OTHER/THAN VEIN LOWER EXTREMITY,6876.0,4469.4,1.1,16027.4,144
HCPCS,35286,Rpr blvsl grf oth/th vn lxtr,,,3890.39,4504.67,8
HCPCS,35301,RECHANNELING OF ARTERY,,,2932.92,2932.92,1
HCPCS,35301,Rechanneling of artery,,,1098.89,1272.4,8
HCPCS,35301,TEAEC W/PATCH GRF CAROTID VERTB SUBCLAV NECK INC,8464.0,5501.6,1.1,8464.0,144
HCPCS,35302,TEAEC W/GRAFT SUPERFICIAL FEMORAL ARTERY,17365.5,11287.575,1.1,26191.0,212
HCPCS,35303,RECHANNELING OF ARTERY,,,3185.2,3185.2,1
HCPCS,35303,Rechanneling of artery,,,2799.05,3241.01,8
HCPCS,35303,TEAEC W/GRAFT POPLITEAL ARTERY,9440.0,6136.0,1.1,9440.0,144
HCPCS,35304,RECHANNELING OF ARTERY,,,3316.3,3316.3,1
HCPCS,35304,Rechanneling of artery,,,2799.05,3241.01,8
HCPCS,35304,TEAEC W/GRAFT TIBIOPERONEAL TRUNK ARTERY,9840.0,6396.0,1.1,9840.0,144
HCPCS,35305,RECHANNELING OF ARTERY,,,3189.52,3189.52,1
HCPCS,35305,Rechanneling of artery,,,2799.05,3241.01,8
HCPCS,35305,TEAEC W/GRAFT TIBIAL/PERONEAL ART 1ST VESSEL,9440.0,6136.0,1.1,9440.0,144
HCPCS,35306,RECHANNELING OF ARTERY,,,1159.02,1159.02,1
HCPCS,35306,Rechanneling of artery,,,2799.05,3241.01,8
HCPCS,35306,TEAEC W/GRAFT EA ADDL TIBIAL/PERONEAL ART,3700.0,2405.0,1.1,3700.0,144
HCPCS,35311,RECHANNELING OF ARTERY,,,4023.01,4023.01,1
HCPCS,35311,Rechanneling of artery,,,2623.14,3037.32,8
HCPCS,35311,TEAEC W/WO PATCH GRF SUBCLAV INNOM THORACIC INC,11440.0,7436.0,1.1,11440.0,144
HCPCS,35321,RECHANNELING OF ARTERY,,,4767.51,14346.42,21
HCPCS,35321,Rechanneling of artery,,,2799.05,3241.01,8
HCPCS,35321,TEAEC W/WO PATCH GRF AXILLARY-BRACHIAL,6636.0,4313.4,1.1,16027.4,144
HCPCS,35331,RECHANNELING OF ARTERY,,,3778.84,3778.84,1
HCPCS,35331,Rechanneling of artery,,,2623.14,3037.32,8
HCPCS,35331,TEAEC W/WO PATCH GRAFT ABDOMINAL AORTA,11088.0,7207.2,1.1,11088.0,144
HCPCS,35341,RECHANNELING OF ARTERY,,,3601.18,3601.18,1
HCPCS,35341,Rechanneling of artery,,,2623.14,3037.32,8
HCPCS,35341,TEAEC W/WO PATCH GRAFT MESENTERIC CELIAC/RENAL,10484.0,6814.6,1.1,10484.0,144
HCPCS,35351,RECHANNELING OF ARTERY,,,3339.98,3339.98,1
HCPCS,35351,Rechanneling of artery,,,2623.14,3037.32,8
HCPCS,35351,TEAEC W/WO PATCH GRAFT ILIAC,9844.0,6398.6,1.1,9844.0,144
HCPCS,35355,TEAEC W/WO PATCH GRAFT ILIOFEMORAL,7301.0,4745.65,1.1,12615.0,212
HCPCS,35361,RECHANNELING OF ARTERY,,,3969.44,3969.44,1
HCPCS,35361,Rechanneling of artery,,,2623.14,3037.32,8
HCPCS,35361,TEAEC W/WO PATCH GRAFT COMBINED AORTOILIAC,12096.0,7862.4,1.1,12096.0,144
HCPCS,35363,RECHANNELING OF ARTERY,,,4232.18,4232.18,1
HCPCS,35363,Rechanneling of artery,,,2623.14,3037.32,8
HCPCS,35363,TEAEC W/WO PATCH GRAFT COMBINED AORTOILIOFEMORAL,12940.0,8411.0,1.1,12940.0,144
HCPCS,35371,RECHANNELING OF ARTERY,,,2114.73,2114.73,1
HCPCS,35371,Rechanneling of artery,,,2799.05,3241.01,8
HCPCS,35371,TEAEC W/WO PATCH GRAFT COMMON FEMORAL,6124.0,3980.6,1.1,6124.0,144
HCPCS,35372,TEAEC W/WO PATCH GRAFT DEEP PROFUNDA FEMORAL,17626.5,11457.225,1.1,27821.0,222
HCPCS,35390,REOPERATION CAROTID ADD-ON,,,412.45,412.45,1
HCPCS,35390,ROPRTJ CRTD TEAEC > 1 MO AFTER ORIGINAL OPRATIO,1276.0,829.4,1.1,1276.0,144
HCPCS,35390,Reoperation carotid add-on,,,1098.89,1272.4,8
HCPCS,35400,ANGIOSCOPY,,,384.34,384.34,1
HCPCS,35400,ANGIOSCOPY NON-CORONARY VESSEL/GRAFTS THER IVNTJ,1200.0,780.0,1.1,1200.0,144
HCPCS,35400,Angioscopy,,,112.68,130.47,8
HCPCS,35500,HARVEST UXTR VEIN 1 SGM LOWER EXTREMITY/CABG PX,2576.0,1674.4,1.1,2576.0,144
HCPCS,35500,Harvest vein for bypass,,,3890.39,4504.67,8
HCPCS,35501,ART BYP GRFT IPSILAT CAROTID,,,3803.42,3803.42,1
HCPCS,35501,Art byp grft ipsilat carotid,,,1098.89,1272.4,8
HCPCS,35501,BYPASS W/VEIN COMMON-IPSILATERAL CAROTID,11636.0,7563.4,1.1,11636.0,144
HCPCS,35506,ART BYP GRFT SUBCLAV-CAROTID,,,3319.89,3319.89,1
HCPCS,35506,Art byp grft subclav-carotid,,,1098.89,1272.4,8
HCPCS,35506,BYPASS W/VEIN CAROTID-SUBCLV/SUBCLAVIAN CAROTID,10132.0,6585.8,1.1,10132.0,144
HCPCS,35508,ART BYP GRFT CAROTID-VERTBRL,,,3463.03,3463.03,1
HCPCS,35508,Art byp grft carotid-vertbrl,,,1098.89,1272.4,8
HCPCS,35508,BYPASS W/VEIN CAROTID-VERTEBRAL,10436.0,6783.4,1.1,10436.0,144
HCPCS,35509,ART BYP GRFT CONTRAL CAROTID,,,3677.13,3677.13,1
HCPCS,35509,Art byp grft contral carotid,,,1098.89,1272.4,8
HCPCS,35509,BYPASS W/VEIN CAROTID-CONTRALATERAL CAROTID,11236.0,7303.4,1.1,11236.0,144
HCPCS,3550F,LOW RSK THROMBOEMBOLISM,,,2739849.3,2739849.3,1
HCPCS,3550F,Low rsk thromboembolism,,,10.69,12.38,8
HCPCS,35510,ART BYP GRFT CAROTID-BRCHIAL,,,3205.36,3205.36,1
HCPCS,35510,Art byp grft carotid-brchial,,,1098.89,1272.4,8
HCPCS,35510,BYPASS W/VEIN CAROTID-BRACHIAL,9756.0,6341.4,1.1,9756.0,144
HCPCS,35511,ART BYP GRFT SUBCLAV-SUBCLAV,,,2920.32,2920.32,1
HCPCS,35511,Art byp grft subclav-subclav,,,2623.14,3037.32,8
HCPCS,35512,ART BYP GRFT SUBCLAV-BRCHIAL,,,3142.83,3142.83,1
HCPCS,35512,Art byp grft subclav-brchial,,,3890.39,4504.67,8
HCPCS,35515,ART BYP GRFT SUBCLAV-VERTBRL,,,3463.03,3463.03,1
HCPCS,35515,Art byp grft subclav-vertbrl,,,2623.14,3037.32,8
HCPCS,35516,ART BYP GRFT SUBCLAV-AXILARY,,,3180.51,3180.51,1
HCPCS,35516,Art byp grft subclav-axilary,,,3890.39,4504.67,8
HCPCS,35516,BYPASS W/VEIN SUBCLAVIAN-AXILLARY,9684.0,6294.6,1.1,9684.0,144
HCPCS,35518,ART BYP GRFT AXILLARY-AXILRY,,,2976.6,2976.6,1
HCPCS,35518,Art byp grft axillary-axilry,,,3890.39,4504.67,8
HCPCS,3551F,INTRMED RSK THROMBOEMBOLISM,,,2739849.3,2739849.3,1
HCPCS,3551F,Intrmed rsk thromboembolism,,,10.69,12.38,8
HCPCS,35521,ART BYP GRFT AXILL-FEMORAL,,,3200.9,3200.9,1
HCPCS,35521,Art byp grft axill-femoral,,,2623.14,3037.32,8
HCPCS,35522,ART BYP GRFT AXILL-BRACHIAL,,,3048.11,3048.11,1
HCPCS,35522,Art byp grft axill-brachial,,,3890.39,4504.67,8
HCPCS,35522,BYPASS W/VEIN AXILLARY-BRACHIAL,9260.0,6019.0,1.1,9260.0,144
HCPCS,35523,ART BYP GRFT BRCHL-ULNR-RDL,,,3204.98,3204.98,1
HCPCS,35523,Art byp grft brchl-ulnr-rdl,,,3890.39,4504.67,8
HCPCS,35523,BYPASS W/VEIN BRACHIAL-ULNAR/-RADIAL,9652.0,6273.8,1.1,9652.0,144
HCPCS,35525,ART BYP GRFT BRACHIAL-BRCHL,,,2943.91,2943.91,1
HCPCS,35525,Art byp grft brachial-brchl,,,3890.39,4504.67,8
HCPCS,35525,BYPASS W/VEIN BRACHIAL-BRACHIAL,8676.0,5639.4,1.1,8676.0,144
HCPCS,35526,ART BYP GRFT AOR/CAROT/INNOM,,,4477.49,4477.49,1
HCPCS,35526,Art byp grft aor/carot/innom,,,2623.14,3037.32,8
HCPCS,35526,BYPASS W/VEIN AORTOSUBCLAV/CAROTID/INNOMINATE,12620.0,8203.0,1.1,12620.0,144
HCPCS,3552F,HGH RISK FOR THROMBOEMBOLISM,,,2739849.3,2739849.3,1
HCPCS,3552F,Hgh risk for thromboembolism,,,10.69,12.38,8
HCPCS,35531,ART BYP GRFT AORCEL/AORMESEN,,,5083.8,5083.8,1
HCPCS,35531,Art byp grft aorcel/aormesen,,,2623.14,3037.32,8
HCPCS,35531,BYPASS W/VEIN AORTOCELIAC/AORTOMESENTERIC,15644.0,10168.6,1.1,15644.0,144
HCPCS,35533,ART BYP GRFT AXILL/FEM/FEM,,,3929.24,3929.24,1
HCPCS,35533,Art byp grft axill/fem/fem,,,2799.05,3241.01,8
HCPCS,35533,BYPASS W/VEIN AXILLARY-FEMORAL-FEMORAL,11968.0,7779.2,1.1,11968.0,144
HCPCS,35535,ART BYP GRFT HEPATORENAL,,,4961.26,4961.26,1
HCPCS,35535,Art byp grft hepatorenal,,,2623.14,3037.32,8
HCPCS,35535,BYPASS W/VEIN HEPATORENAL,15252.0,9913.8,1.1,15252.0,144
HCPCS,35536,ART BYP GRFT SPLENORENAL,,,4404.55,4404.55,1
HCPCS,35536,Art byp grft splenorenal,,,2623.14,3037.32,8
HCPCS,35536,BYPASS W/VEIN SPLENORENAL,13492.0,8769.8,1.1,13492.0,144
HCPCS,35537,ART BYP GRFT AORTOILIAC,,,5434.79,5434.79,1
HCPCS,35537,Art byp grft aortoiliac,,,2623.14,3037.32,8
HCPCS,35537,"VEIN BYPASS GRAFT,AORTOILIOFEMORAL",16752.0,10888.8,1.1,16752.0,144
HCPCS,35538,ART BYP GRFT AORTOBI-ILIAC,,,6087.18,6087.18,1
HCPCS,35538,Art byp grft aortobi-iliac,,,2623.14,3037.32,8
HCPCS,35538,"VEIN BYPASS GRAFT,AORTOBI-ILIAC",18812.0,12227.8,1.1,18812.0,144
HCPCS,35539,ART BYP GRFT AORTOFEMORAL,,,5713.53,5713.53,1
HCPCS,35539,Art byp grft aortofemoral,,,2623.14,3037.32,8
HCPCS,35539,"VEIN BYPASS GRAFT,AORTOFEMORAL",17644.0,11468.6,1.1,17644.0,144
HCPCS,35540,ART BYP GRFT AORTBIFEMORAL,,,6367.73,6367.73,1
HCPCS,35540,Art byp grft aortbifemoral,,,2623.14,3037.32,8
HCPCS,35540,"VEIN BYPASS GRAFT,AORTOBIFEMORAL",19732.0,12825.8,1.1,19732.0,144
HCPCS,35556,ART BYP GRFT FEM-POPLITEAL,,,3617.65,3617.65,1
HCPCS,35556,Art byp grft fem-popliteal,,,3890.39,4504.67,8
HCPCS,35556,BYPASS W/VEIN FEMORAL-POPLITEAL,10700.0,6955.0,1.1,10700.0,144
HCPCS,35558,ART BYP GRFT FEM-FEMORAL,,,3214.35,3214.35,1
HCPCS,35558,Art byp grft fem-femoral,,,3890.39,4504.67,8
HCPCS,35558,BYPASS W/VEIN FEMORAL-FEMORAL,9252.0,6013.8,1.1,9252.0,144
HCPCS,3555F,PT INR MEASUREMENT PERFORMED,,,2739849.3,2739849.3,1
HCPCS,3555F,Pt inr measurement performed,,,10.69,12.38,8
HCPCS,35560,ART BYP GRFT AORTORENAL,,,4443.9,4443.9,1
HCPCS,35560,Art byp grft aortorenal,,,2623.14,3037.32,8
HCPCS,35560,BYPASS W/VEIN AORTORENAL,13612.0,8847.8,1.1,13612.0,144
HCPCS,35563,ART BYP GRFT ILIOILIAC,,,3451.11,3451.11,1
HCPCS,35563,Art byp grft ilioiliac,,,2623.14,3037.32,8
HCPCS,35563,BYPASS W/VEIN ILIOILIAC,10448.0,6791.2,1.1,10448.0,144
HCPCS,35565,ART BYP GRFT ILIOFEMORAL,,,3408.64,3408.64,1
HCPCS,35565,Art byp grft iliofemoral,,,2623.14,3037.32,8
HCPCS,35565,BYPASS W/VEIN ILIOFEMORAL,10052.0,6533.8,1.1,10052.0,144
HCPCS,35566,ART BYP FEM-ANT-POST TIB/PRL,,,4318.6,4318.6,1
HCPCS,35566,Art byp fem-ant-post tib/prl,,,3890.39,4504.67,8
HCPCS,35566,BYP FEM-ANT TIBL PST TIBL PRONEAL ART/OTH DSTL,12940.0,8411.0,1.1,12940.0,144
HCPCS,35570,ART BYP TIBIAL-TIB/PERONEAL,,,3841.73,3841.73,1
HCPCS,35570,Art byp tibial-tib/peroneal,,,3890.39,4504.67,8
HCPCS,35570,BYP TIBL-TIBL/PRONEAL-TIBL/TIBL/PRONEAL TRK-TIBL,11660.0,7579.0,1.1,11660.0,144
HCPCS,35571,ART BYP POP-TIBL-PRL-OTHER,,,3438.73,3438.73,1
HCPCS,35571,Art byp pop-tibl-prl-other,,,3890.39,4504.67,8
HCPCS,35571,BYP W/VEIN POP-TIBL-PRONEAL ART/OTH DSTL VSL,11229.0,7298.85,1.1,11229.0,144
HCPCS,35572,HARVEST FEMPOP VEIN 1 SGM VASC RCNSTJ PX,2724.0,1770.6,1.1,2724.0,144
HCPCS,35572,Harvest femoropopliteal vein,,,3890.39,4504.67,8
HCPCS,35583,IN-SITU VEIN BYPASS FEMORAL-POPLITEAL,11100.0,7215.0,1.1,11100.0,144
HCPCS,35583,VEIN BYP GRFT FEM-POPLITEAL,,,3744.76,3744.76,1
HCPCS,35583,Vein byp grft fem-popliteal,,,3890.39,4504.67,8
HCPCS,35585,IN-SITU FEM-ANT TIBL PST TIBL/PRONEAL ART,12940.0,8411.0,1.1,12940.0,144
HCPCS,35585,VEIN BYP FEM-TIBIAL PERONEAL,,,4338.43,4338.43,1
HCPCS,35585,Vein byp fem-tibial peroneal,,,3890.39,4504.67,8
HCPCS,35587,IN-SITU VEIN BYP POP-TIBL PRONEAL,10484.0,6814.6,1.1,10484.0,144
HCPCS,35587,VEIN BYP POP-TIBL PERONEAL,,,3472.48,3472.48,1
HCPCS,35587,Vein byp pop-tibl peroneal,,,3890.39,4504.67,8
HCPCS,35600,OPEN HARVEST UPPER EXTREMITY ART 1 SEGMENT CAB,1580.0,1027.0,1.1,1580.0,144
HCPCS,35600,OPEN HRV UXTR ART 1 SGM CAB,,,482.71,482.71,1
HCPCS,35600,Open hrv uxtr art 1 sgm cab,,,4802.69,5561.01,8
HCPCS,35601,BPG COM CRTD-IPSI INT CRTD,,,3641.3,3641.3,1
HCPCS,35601,BYP OTH/THN VEIN COMMON-IPSILATERAL CAROTID,10836.0,7043.4,1.1,10836.0,144
HCPCS,35601,Bpg com crtd-ipsi int crtd,,,1098.89,1272.4,8
HCPCS,35602,BPG OTH/THN VEIN CAROTID-CONTRALATERAL CAROTID,10353.0,6729.45,1.1,10353.0,106
HCPCS,35602,Bpg crtd-clat crtd,,,1098.89,1272.4,8
HCPCS,35606,ART BYPASS CAROTID-SUBCLAVIAN,28437.0,18484.05,1098.89,28437.0,68
HCPCS,35606,BYP OTH/THN VEIN CAROTID-SUBCLAVIAN,8984.0,5839.6,1.1,8984.0,144
HCPCS,35612,BYP OTH/THN VEIN SUBCLAVIAN-SUBCLAVIAN,6429.0,4178.85,1.1,12615.0,212
HCPCS,35616,BPG SUBCLAVIAN-AXILLARY,,,2872.04,2872.04,1
HCPCS,35616,BYP OTH/THN VEIN SUBCLAVIAN-AXILLARY,8728.0,5673.2,1.1,8728.0,144
HCPCS,35616,Bpg subclavian-axillary,,,3890.39,4504.67,8
HCPCS,35621,BPG AXILLARY-FEMORAL,,,2848.5,2848.5,1
HCPCS,35621,BYP OTH/THN VEIN AXILLARY-FEMORAL,8412.0,5467.8,1.1,8412.0,144
HCPCS,35621,Bpg axillary-femoral,,,3890.39,4504.67,8
HCPCS,35623,BPG AXILLARY-POP/-TIBIAL,,,3425.16,3425.16,1
HCPCS,35623,BYP OTH/THN VEIN AXILLARY-POPLITEAL/-TIBIAL,10368.0,6739.2,1.1,10368.0,144
HCPCS,35623,Bpg axillary-pop/-tibial,,,3890.39,4504.67,8
HCPCS,35626,BPG AOR-SUBCLA/INNOM/CAROTID,,,4113.37,4113.37,1
HCPCS,35626,BYPASS NOT VEIN AORTOSUBCLA/CAROTID/INNOMINATE,11656.0,7576.4,1.1,11656.0,144
HCPCS,35626,Bpg aor-subcla/innom/carotid,,,2623.14,3037.32,8
HCPCS,35631,BPG AOR-CELIAC-MSN-RENAL,,,4816.51,4816.51,1
HCPCS,35631,BYP OTH/THN VEIN AORTOCELIAC AORTOMSN AORTORNL,14412.0,9367.8,1.1,14412.0,144
HCPCS,35631,Bpg aor-celiac-msn-renal,,,2623.14,3037.32,8
HCPCS,35632,BPG ILIO-CELIAC,,,4709.21,4709.21,1
HCPCS,35632,BYPASS GRAFT W/OTHER THAN VEIN ILIO-CELIAC,14452.0,9393.8,1.1,14452.0,144
HCPCS,35632,Bpg ilio-celiac,,,2623.14,3037.32,8
HCPCS,35633,BPG ILIO-MESENTERIC,,,5159.58,5159.58,1
HCPCS,35633,BYPASS GRAFT W/OTHER THAN VEIN ILIO-MESENTERIC,15644.0,10168.6,1.1,15644.0,144
HCPCS,35633,Bpg ilio-mesenteric,,,2623.14,3037.32,8
HCPCS,35634,BPG ILIORENAL,,,4608.27,4608.27,1
HCPCS,35634,BYPASS GRAFT W/OTHER THAN VEIN ILIORENAL,14132.0,9185.8,1.1,14132.0,144
HCPCS,35634,Bpg iliorenal,,,2623.14,3037.32,8
HCPCS,35636,BPG SPLENORENAL,,,4157.1,4157.1,1
HCPCS,35636,BYP OTH/THN VEIN SPLENORENAL,12700.0,8255.0,1.1,12700.0,144
HCPCS,35636,Bpg splenorenal,,,2623.14,3037.32,8
HCPCS,35637,BPG AORTOILIAC,,,4322.19,4322.19,1
HCPCS,35637,"BYPASS GRAFT OTHR,AORTOILIAC",13220.0,8593.0,1.1,13220.0,144
HCPCS,35637,Bpg aortoiliac,,,2623.14,3037.32,8
HCPCS,35638,BPG AORTOBI-ILIAC,,,4507.49,4507.49,1
HCPCS,35638,"BYPASS GRAFT OTHR,AORTOBI-ILIAC",13440.0,8736.0,1.1,13440.0,144
HCPCS,35638,Bpg aortobi-iliac,,,2623.14,3037.32,8
HCPCS,35642,BYP OTH/THN VEIN CAROTID-VERTEBRAL,12041.0,7826.65,1.1,16506.0,212
HCPCS,35645,BPG SUBCLAVIAN-VERTEBRAL,,,2469.51,2469.51,1
HCPCS,35645,BYP OTH/THN VEIN SUBCLAVIAN-VERTEBRAL,7372.0,4791.8,1.1,7372.0,144
HCPCS,35645,Bpg subclavian-vertebral,,,2623.14,3037.32,8
HCPCS,35646,BPG AORTOBIFEMORAL,,,4429.68,4429.68,1
HCPCS,35646,BYP OTH/THN VEIN AORTOBIFEMORAL,13192.0,8574.8,1.1,13192.0,144
HCPCS,35646,Bpg aortobifemoral,,,2623.14,3037.32,8
HCPCS,35647,BPG AORTOFEMORAL,,,4026.57,4026.57,1
HCPCS,35647,BYP OTH/THN VEIN AORTOFEMORAL,11892.0,7729.8,1.1,11892.0,144
HCPCS,35647,Bpg aortofemoral,,,3890.39,4504.67,8
HCPCS,35650,BPG AXILLARY-AXILLARY,,,2662.92,2662.92,1
HCPCS,35650,BYP OTH/THN VEIN AXILLARY-AXILLARY,8064.0,5241.6,1.1,8064.0,144
HCPCS,35650,Bpg axillary-axillary,,,3890.39,4504.67,8
HCPCS,35654,BPG AXILLARY-FEMORAL-FEMORAL,,,3543.23,3543.23,1
HCPCS,35654,BYP OTH/THN VEIN AXILLARY-FEMORAL-FEMORAL,10512.0,6832.8,1.1,10512.0,144
HCPCS,35654,Bpg axillary-femoral-femoral,,,2623.14,3037.32,8
HCPCS,35656,BPG FEMORAL-POPLITEAL,,,2785.51,2785.51,1
HCPCS,35656,BYP OTH/THN VEIN FEMORAL-POPLITEAL,8188.0,5322.2,1.1,8188.0,144
HCPCS,35656,Bpg femoral-popliteal,,,3890.39,4504.67,8
HCPCS,35661,ART BYP FEMORAL-FEMORAL,21164.0,13756.6,1247.91,21164.0,68
HCPCS,35661,BYP OTH/THN VEIN FEMORAL-FEMORAL,8140.0,5291.0,1.1,8140.0,144
HCPCS,35663,BPG ILIOILIAC,,,3176.78,3176.78,1
HCPCS,35663,BYP OTH/THN VEIN ILIOILIAC,9572.0,6221.8,1.1,9572.0,144
HCPCS,35663,Bpg ilioiliac,,,2623.14,3037.32,8
HCPCS,35665,BPG ILIOFEMORAL,,,3048.47,3048.47,1
HCPCS,35665,BYP OTH/THN VEIN ILIOFEMORAL,8940.0,5811.0,1.1,8940.0,144
HCPCS,35665,Bpg iliofemoral,,,3890.39,4504.67,8
HCPCS,35666,BPG FEM-ANT TIB PST TIB/PRNL,,,3335.48,3335.48,1
HCPCS,35666,BYP OTH/THN VEIN FEM-ANT TIBL PST TIBL/PRONEAL,9464.0,6151.6,1.1,9464.0,144
HCPCS,35666,Bpg fem-ant tib pst tib/prnl,,,3890.39,4504.67,8
HCPCS,35671,BPG POP-TIBL/-PRNL ARTERY,,,2935.8,2935.8,1
HCPCS,35671,BYP OTH/THN VEIN POPLITEAL-TIBIAL/-PERONEAL ART,8308.0,5400.2,1.1,8308.0,144
HCPCS,35671,Bpg pop-tibl/-prnl artery,,,3890.39,4504.67,8
HCPCS,35681,BYPASS COMPOSITE GRAFT PROSTHETIC & VEIN,640.0,416.0,1.1,640.0,144
HCPCS,35681,COMPOSITE BYP GRFT PROS&VEIN,,,207.58,207.58,1
HCPCS,35681,Composite byp grft pros&vein,,,3890.39,4504.67,8
HCPCS,35682,BYP AUTOG COMPOSIT 2 SEG VEINS FROM 2 LOCATIONS,2876.0,1869.4,1.1,2876.0,144
HCPCS,35682,COMPOSITE BYP GRFT 2 VEINS,,,917.93,917.93,1
HCPCS,35682,Composite byp grft 2 veins,,,3890.39,4504.67,8
HCPCS,35683,BYP AUTOG COMPOSIT 3/> SEG FROM 2/> LOCATION,3396.0,2207.4,1.1,3396.0,144
HCPCS,35683,COMPOSITE BYP GRFT 3/> SEGMT,,,1065.15,1065.15,1
HCPCS,35683,Composite byp grft 3/> segmt,,,3890.39,4504.67,8
HCPCS,35685,Bypass graft patency/patch,,,3890.39,4504.67,8
HCPCS,35685,PLMT VEIN PATCH/CUFF DSTL ANAST BYP CONDUIT,1616.0,1050.4,1.1,1616.0,144
HCPCS,35686,Bypass graft/av fist patency,,,3890.39,4504.67,8
HCPCS,35686,CRTJ DSTL ARVEN FSTL LXTR BYP SURG NON-HEMO,1336.0,868.4,1.1,1336.0,144
HCPCS,35691,ART TRNSPOSJ VERTBRL CAROTID,,,2465.97,2465.97,1
HCPCS,35691,Art trnsposj vertbrl carotid,,,1098.89,1272.4,8
HCPCS,35691,TRPOS&/RIMPLTJ VERTEBRAL CAROTID ART,7364.0,4786.6,1.1,7364.0,144
HCPCS,35693,ART TRNSPOSJ SUBCLAVIAN,,,2180.68,2180.68,1
HCPCS,35693,Art trnsposj subclavian,,,2623.14,3037.32,8
HCPCS,35693,TRPOS&/RIMPLTJ VERTEBRAL SUBCLAVIAN ART,6292.0,4089.8,1.1,6292.0,144
HCPCS,35694,ART TRNSPOSJ SUBCLAV CAROTID,,,2575.85,2575.85,1
HCPCS,35694,Art trnsposj subclav carotid,,,1098.89,1272.4,8
HCPCS,35694,TRPOS&/RIMPLTJ SUBCLAVIAN CAROTID ART,7712.0,5012.8,1.1,7712.0,144
HCPCS,35695,ART TRNSPOSJ CAROTID SUBCLAV,,,2673.25,2673.25,1
HCPCS,35695,Art trnsposj carotid subclav,,,1098.89,1272.4,8
HCPCS,35695,TRPOS&/RIMPLTJ CAROTID SUBCLAVIAN ART,8024.0,5215.6,1.1,8024.0,144
HCPCS,35697,REIMPLANT ARTERY EACH,,,381.05,381.05,1
HCPCS,35697,RIMPLTJ VISC ART INFRARNL AORTIC PROSTH EA ART,1200.0,780.0,1.1,1200.0,144
HCPCS,35697,Reimplant artery each,,,2799.05,3241.01,8
HCPCS,35700,REOPERATION BYPASS GRAFT,,,394.18,394.18,1
HCPCS,35700,ROPRTJ > 1 MO AFTER ORIGINAL OPRATION,1232.0,800.8,1.1,1232.0,144
HCPCS,35700,Reoperation bypass graft,,,2799.05,3241.01,8
HCPCS,35701,EXPL N/FLWD SURG NECK ART,,,1137.37,1137.37,1
HCPCS,35701,EXPLORATION N/FLWD SURG NECK ARTERY,3300.0,2145.0,1.1,3300.0,144
HCPCS,35701,Expl n/flwd surg neck art,,,1098.89,1272.4,8
HCPCS,35702,EXPL N/FLWD SURG UXTR ART,,,1064.11,1064.11,1
HCPCS,35702,EXPLORATION N/FLWD SURG UPPER EXTREMITY ARTERY,2848.0,1851.2,1.1,2848.0,144
HCPCS,35702,Expl n/flwd surg uxtr art,,,2799.05,3241.01,8
HCPCS,35703,EXPL N/FLWD SURG LXTR ART,,,1079.92,1079.92,1
HCPCS,35703,EXPLORATION N/FLWD SURG LOWER EXTREMITY ARTERY,3000.0,1950.0,1.1,3000.0,144
HCPCS,35703,Expl n/flwd surg lxtr art,,,2799.05,3241.01,8
HCPCS,3570F,RPRT BONE SCINT XREF W XRAY,,,0.03,0.03,1
HCPCS,3570F,Rprt bone scint xref w xray,,,10.69,12.38,8
HCPCS,3572F,PT CONSID POSS RISK FX,,,2739849.3,2739849.3,1
HCPCS,3572F,Pt consid poss risk fx,,,10.69,12.38,8
HCPCS,3573F,PT NOT CONSID POSS RISK FX,,,2739849.3,2739849.3,1
HCPCS,3573F,Pt not consid poss risk fx,,,10.69,12.38,8
HCPCS,35800,EXPL PO HEMRRG THROMBOSIS/INFCTJ NCK,4800.0,3120.0,1.1,4800.0,144
HCPCS,35800,EXPLORE NECK VESSELS,,,1908.14,5790.88,13
HCPCS,35800,Explore neck vessels,,,2799.05,3241.01,8
HCPCS,35820,EXPL PO HEMRRG THROMBOSIS/INFCTJ CH,14756.0,9591.4,1.1,14756.0,144
HCPCS,35820,EXPLORE CHEST VESSELS,,,5230.47,5230.47,1
HCPCS,35820,Explore chest vessels,,,2799.05,3241.01,8
HCPCS,35840,EXPL PO HEMRRG THROMBOSIS/INFCTJ ABD,8300.0,5395.0,1.1,8300.0,144
HCPCS,35840,EXPLORE ABDOMINAL VESSELS,,,3179.63,3179.63,1
HCPCS,35840,Explore abdominal vessels,,,10445.39,12094.67,8
HCPCS,35860,EXPL PO HEMRRG THROMBOSIS/INFCTJ XTR,6100.0,3965.0,1.1,9296.26,144
HCPCS,35860,EXPLORE LIMB VESSELS,,,2765.32,8321.41,21
HCPCS,35860,Explore limb vessels,,,2799.05,3241.01,8
HCPCS,35870,REPAIR VESSEL GRAFT DEFECT,,,3252.24,3252.24,1
HCPCS,35870,RPR GRF-ENTERIC FSTL,9800.0,6370.0,1.1,9800.0,144
HCPCS,35870,Repair vessel graft defect,,,2623.14,3037.32,8
HCPCS,35875,REMOVAL OF CLOT IN GRAFT,,,4767.51,5790.88,20
HCPCS,35875,Removal of clot in graft,,,2799.05,3241.01,8
HCPCS,35875,THRMBC ARTL/VEN GRF OTH/THN HEMO GRF/FSTL,4288.0,2787.2,1.1,16027.4,144
HCPCS,35876,REMOVAL OF CLOT IN GRAFT,,,4767.51,5790.88,20
HCPCS,35876,Removal of clot in graft,,,2799.05,3241.01,8
HCPCS,35876,THRMBC ARTL/VEN GRF XCP HEMO GRF/FSTL W/REVJ GRF,7128.0,4633.2,1.1,16027.4,144
HCPCS,35879,REVISE GRAFT W/VEIN,,,4767.51,14346.42,21
HCPCS,35879,REVJ LXTR ARTL BYP OPN VEIN PATCH ANGIOP,6964.0,4526.6,1.1,16027.4,144
HCPCS,35879,Revise graft w/vein,,,3890.39,4504.67,8
HCPCS,35881,REVISE GRAFT W/VEIN,,,4767.51,14346.42,21
HCPCS,35881,REVJ LXTR ARTL BYP OPN W/SGMTL VEIN INTERPOS,7740.0,5031.0,1.1,16027.4,144
HCPCS,35881,Revise graft w/vein,,,3890.39,4504.67,8
HCPCS,35883,REVJ FEM ANAST BPG GRN OPN W/NONAUTOG PATCH GRF,9260.0,6019.0,1.1,16027.4,144
HCPCS,35883,REVJ FEM ANAST NONAUTOG GRF,,,4767.51,14346.42,21
HCPCS,35883,Revj fem anast nonautog grf,,,3890.39,4504.67,8
HCPCS,35884,"REVISE FEMORAL GRAFT, AUTOGENOUS GRAFT",9860.0,6409.0,1.1,16027.4,144
HCPCS,35884,REVJ FEM ANAST AUTOG VN GRF,,,4767.51,14346.42,21
HCPCS,35884,Revj fem anast autog vn grf,,,3890.39,4504.67,8
HCPCS,35901,EXCISION GRAFT NECK,,,1239.69,1239.69,1
HCPCS,35901,"EXCISION, INFEC GRAFT, NECK",3352.0,2178.8,1.1,3352.0,144
HCPCS,35901,Excision graft neck,,,2799.05,3241.01,8
HCPCS,35903,EXCISION INFECTED GRAFT EXTREMITY,18098.0,11763.7,646.01,18098.0,86
HCPCS,35903,"EXCISION, INFEC GRAFT, EXTREMITY",3812.0,2477.8,1.1,9296.26,144
HCPCS,35905,EXCISION GRAFT THORAX,,,4379.56,4379.56,1
HCPCS,35905,"EXCISION, INFEC GRAFT, THORAX",13408.0,8715.2,1.1,13408.0,144
HCPCS,35905,Excision graft thorax,,,2623.14,3037.32,8
HCPCS,35907,EXCISION GRAFT ABDOMEN,,,4966.58,4966.58,1
HCPCS,35907,"EXCISION, INFEC GRAFT, ABDOMEN",14908.0,9690.2,1.1,14908.0,144
HCPCS,35907,Excision graft abdomen,,,2623.14,3037.32,8
HCPCS,36000,INTRODUCTION NEEDLE/INTRACATHETER VEIN,159.0,103.35,0.01,4628.0,380
HCPCS,36002,INJECTION PX PRQ TX EXTREMITY PSEUDOANEURYSM,2169.5,1410.175,0.01,4628.0,493
HCPCS,36005,NJX PX XTR VNGRPH W/INTRO NDL/INTRACATH,1312.0,852.8000000000001,0.01,4628.0,352
HCPCS,36010,INTRO CATHETER SUPERIOR/INFERIOR VENA CAVA,3041.0,1976.65,0.01,4628.0,204
HCPCS,36010,INTRO. OF CATH SUP/INF VENA CAVA,872.0,566.8,1.1,1768.67,148
HCPCS,36011,SLCTV CATH PLMT VEN SYS 1ST ORDER BRANCH,2428.5,1578.525,0.01,4628.0,352
HCPCS,36012,SLCTV CATH PLMT VEN SYS 2ND ORDER/> SLCTV BRANC,2654.0,1725.1,0.01,4628.0,284
HCPCS,36013,INTRO CATHETER RIGHT HEART/MAIN PULMONARY ARTERY,1975.0,1283.75,1.1,4628.0,284
HCPCS,36014,SLCTV CATHETER PLMT LEFT/RIGHT PULMONARY ARTERY,2052.0,1333.8,0.01,4628.0,352
HCPCS,36015,SLCTV CATH PLMT SEGMENTAL/SUBSEGMENTAL PULM ART,2314.5,1504.425,0.01,4628.0,284
HCPCS,36100,Establish access to artery,,,357.7,414.18,8
HCPCS,36100,INTRO NEEDLE/INTRACATH CAROTID/VERTEBRAL ARTERY,1208.0,785.2,1.1,1850.45,148
HCPCS,36140,INTRO OF NEEDLE OR INTRACATHETER UPR/LXTR ARTERY,2180.5,1417.325,1.1,4628.0,216
HCPCS,36160,Establish access to aorta,,,357.7,414.18,8
HCPCS,36160,INTRO NEEDLE/INTRACATH AORTIC TRANSLUMBAR,1008.0,655.2,1.1,1838.92,148
HCPCS,36200,INTRODUCTION CATHETER AORTA,2091.5,1359.475,1.1,4628.0,284
HCPCS,36215,SLCTV CATHJ EA 1ST ORD THRC/BRCH/CPHLC BRNCH,4670.0,3035.5,0.01,7505.0,352
HCPCS,36216,SLCTV CATHJ 1ST 2ND ORD THRC/BRCH/CPHLC BRNCH,4873.0,3167.45,0.01,7638.0,284
HCPCS,36217,SLCTV CATHJ 3RD+ ORD SLCTV THRC/BRCH/CPHLC BRNCH,5320.5,3458.325,0.01,8125.0,352
HCPCS,36218,SLCTV CATHJ EA 2ND+ ORD THRC/BRCH/CPHLC BRNCH,697.0,453.05,0.01,4628.0,284
HCPCS,36221,NONSLCTV CATH THOR AORTA ANGIO INTR/XTRCRANL ART,9833.0,6391.450000000001,1.1,18098.0,320
HCPCS,36222,SLCTV CATH CAROTID/INNOM ART ANGIO XTRCRANL ART,10210.5,6636.825000000001,1.1,18098.0,406
HCPCS,36223,SLCTV CATH CAROTID/INNOM ART ANGIO INTRCRANL ART,16806.5,10924.225,1.1,31083.0,320
HCPCS,36224,SLCTV CATH INTRNL CAROTID ART ANGIO INTRCRNL ART,16916.5,10995.725,1.1,31083.0,234
HCPCS,36225,SLCTV CATH SUBCLAVIAN ART ANGIO VERTEBRAL ARTERY,10314.0,6704.1,0.01,18098.0,407
HCPCS,36226,SLCTV CATH VERTEBRAL ART ANGIO VERTEBRAL ARTERY,16916.5,10995.725,1.1,31083.0,234
HCPCS,36227,SLCTV CATH XTRNL CAROTID ANGIO XTRNL CAROTD CIRC,3693.0,2400.45,1.1,6466.0,216
HCPCS,36228,SLCTV CATH INTRCRNL BRNCH ANGIO INTRL CAROT/VERT,3773.0,2452.45,1.1,5846.0,216
HCPCS,36245,SLCTV CATHJ EA 1ST ORD ABDL PEL/LXTR ART BRNCH,3716.0,2415.4,0.01,4628.0,352
HCPCS,36246,SLCTV CATHJ 2ND ORDER ABDL PEL/LXTR ART BRNCH,3266.5,2123.225,0.01,4628.0,352
HCPCS,36247,SLCTV CATHJ 3RD+ ORD SLCTV ABDL PEL/LXTR BRNCH,4063.5,2641.275,0.01,5469.0,284
HCPCS,36248,SLCTV CATHJ EA 2ND+ ORD ABDL PEL/LXTR ART BRNCH,626.0,406.90000000000003,0.01,4628.0,284
HCPCS,36251,SLCTV CATH 1STORD W/WO ART PUNCT/FLUORO/S&I UN,18098.0,11763.7,294.94,18098.0,172
HCPCS,36251,SLCTV CATH 1STORD W/WO ART PUNCT/FLUORO/S&I UNI,2244.0,1458.6,1.1,9296.26,148
HCPCS,36252,SLCTV CATH 1STORD W/WO ART PUNCT/FLUOR/S&I BIL,18098.0,11763.7,399.8,18098.0,172
HCPCS,36252,SLCTV CATH 1STORD W/WO ART PUNCT/FLUOR/S&I BILAT,2966.0,1927.9,1.1,9296.26,148
HCPCS,36253,SUPSLCTV CATH 2ND+ORD RENAL&ACCESSORY ARTERY/S&I,31083.0,20203.95,413.11,31083.0,86
HCPCS,36253,SUPSLCTV CATH 2ND+ORD RENL&ACCES ARTERY/S&I UNI,3212.0,2087.8,1.1,16027.4,148
HCPCS,36254,SUPSLCTV CATH 2ND+ORD RENAL&ACCESSORY ARTERY/S&I,18098.0,11763.7,468.13,18098.0,86
HCPCS,36254,SUPSLCTV CATH 2ND+ORD RENL&ACCES ARTER/S&I BILAT,3160.0,2054.0,1.1,9296.26,148
HCPCS,36260,INSERTION OF INFUSION PUMP,,,4767.51,5790.88,20
HCPCS,36260,INSJ IMPLANTABLE INTRA-ARTERIAL INFUSION PUM,3964.0,2576.6,1.1,16027.4,144
HCPCS,36260,Insertion of infusion pump,,,6303.75,7299.08,8
HCPCS,36261,REVIS IMPLANT INTRA-ART INFUS PUMP,2252.0,1463.8,1.1,11454.26,144
HCPCS,36261,REVISION OF INFUSION PUMP,,,3373.78,3889.0,20
HCPCS,36261,Revision of infusion pump,,,806.19,933.48,8
HCPCS,36262,REMOV IMPLANT INTRA-ART INFUS PUMP,1644.0,1068.6,1.1,11454.26,144
HCPCS,36262,REMOVAL OF INFUSION PUMP,,,3373.78,3889.0,20
HCPCS,36262,Removal of infusion pump,,,806.19,933.48,8
HCPCS,36299,DIRECT PUNCTURE JUGULAR VEIN (COMP CODE 36005),1226.0,796.9000000000001,0.01,12615.0,150
HCPCS,36299,INJECTION FOR EGD W/ ECHO TIP (COMP CODE 36481),2232.0,1450.8,0.01,2232.0,84
HCPCS,36299,INJECTION HEPATIC ARTERY INFUSION PUMP (COMP CODE 36598),753.5,489.775,0.01,12615.0,150
HCPCS,36299,"UNLISTED PROCEDURE, VASCULAR INJECTION",500.0,325.0,109.0,12615.0,66
HCPCS,36299,VESSEL INJECTION PROCEDURE UNLISTED,345.0,224.25,0.01,345.0,84
HCPCS,36400,"VENIPUNC <3 Y/O,FEM,JUG,SAG SINUS",152.0,98.8,1.1,152.0,146
HCPCS,36400,VNPNXR <3 YEARS PHY/QHP SKILL FEMRAL/JUGLAR VEIN,158.0,102.7,0.01,158.0,136
HCPCS,36405,"VENIPUNC <3 Y/O, SCALP",124.0,80.6,1.1,124.0,146
HCPCS,36405,VNPNXR <3 YEARS PHYS/QHP SKILL SCALP VEIN,129.0,83.85,0.01,129.0,136
HCPCS,36406,"VENIPUNC <3 Y/O, OTHER",72.0,46.8,1.1,72.0,146
HCPCS,36406,VNPNXR <3 YEARS PHYS/QHP SKILL OTHER VEIN,129.0,83.85,0.01,129.0,136
HCPCS,36410,"VENIPUNC NEED PHYS SKILL,DX OR RX",79.0,51.35,1.1,79.0,146
HCPCS,36410,VNPNXR 3 YEARS/> PHYS/QHP SKILL,150.5,97.825,0.01,222.0,350
HCPCS,36415,COLLECTION VENOUS BLOOD VENIPUNCTURE,51.5,33.475,1.1,63.0,175
HCPCS,36415,ROUTINE VENIPUNCTURE,63.0,40.95,2.64,63.0,83
HCPCS,36415,VENIPUNCTURE,51.5,33.475,1.1,63.0,175
HCPCS,36416,COLL CAP BLOOD SPECIMEN,48.0,31.2,2.64,48.0,66
HCPCS,36416,COLLECTION CAPILLARY BLOOD,31.0,20.15,1.1,31.0,100
HCPCS,36416,COLLECTION CAPILLARY BLOOD SPECIMEN,48.0,31.2,2.64,48.0,66
HCPCS,36420,VENIPUNCTURE CUTDOWN UNDER AGE 1 YR,741.0,481.65,35.72,3443.0,86
HCPCS,36420,VENOUS CUTDOWN <1 Y/O,404.0,262.6,1.1,404.0,144
HCPCS,36425,VENIPUNCTURE CUTDOWN AGE 1 YR/>,2294.0,1491.1,35.72,3443.0,86
HCPCS,36425,VENOUS CUTDOWN >1 Y/O,304.0,197.6,1.1,1163.18,144
HCPCS,36430,TRANSFUSION BLOOD OR BLOOD COMPONENT - PACU,2514.0,1634.1,58.82,4392.0,87
HCPCS,36430,TRANSFUSION BLOOD OR BLOOD COMPONENTS,2514.0,1634.1,58.82,4392.0,87
HCPCS,36430,TRANSFUSION BLOOD/BLOOD COMPONENTS,1785.5,1160.5749999999998,1.1,4392.0,231
HCPCS,36430,TXFUS BLOOD/BLOOD COMPONENT,2514.0,1634.1,58.82,4392.0,87
HCPCS,36440,BLD PUSH TFUJ 2 YR/<,,,376.61,1133.29,21
HCPCS,36440,Bld push tfuj 2 yr/<,,,453.96,525.64,8
HCPCS,36450,BLD EXCHANGE TRUJ NEWBORN,,,376.61,1133.29,21
HCPCS,36450,Bld exchange truj newborn,,,453.96,525.64,8
HCPCS,36450,"EXCHANGE TRANSFUSION, NEWBORN",1400.0,910.0,1.1,1400.0,144
HCPCS,36455,EXCHNG TRANSFUSION BLOOD OTHER/THAN NEW BORN,1743.0,1132.9499999999998,1.1,3443.0,230
HCPCS,36456,PRTL EXCHANGE TRANSFUSE NB,,,376.61,459.12,20
HCPCS,36456,Prtl exchange transfuse nb,,,453.96,525.64,8
HCPCS,36460,INTRAUTERINE TRANSFUSION FTL,,,376.61,1133.29,21
HCPCS,36460,Intrauterine transfusion ftl,,,453.96,525.64,8
HCPCS,36460,TRANSFUSION INTRAUTERINE FETAL,2632.0,1710.8,1.1,2632.0,144
HCPCS,36465,NJX NONCMPND SCLEROSANT SINGLE INCMPTNT VEIN,5729.0,3723.85,0.01,10518.0,235
HCPCS,36466,NJX NONCMPND SCLEROSANT MULTIPLE INCMPTNT VEINS,5859.0,3808.35,0.01,10518.0,235
HCPCS,36468,INJECTION(S) SPIDER VEINS,110.0,71.5,1.1,1163.18,84
HCPCS,36468,INJECTION(S); SPIDER VEIN,100.0,65.0,1.1,1163.18,84
HCPCS,36468,INJECTIONS SCLEROSANT FOR SPIDER VEINS LIM/TRNK,1277.0,830.05,0.01,12500.0,253
HCPCS,36468,SCLEROTHERAPY/SPIDER VEINS-SINGLE OR MULTIPLE INJECTIONS,350.0,227.5,1.1,1163.18,84
HCPCS,36468,SPIDER VEINS EXTENSIVE-COSMETIC ONLY,500.0,325.0,1.1,1163.18,84
HCPCS,36468,SPIDER VEINS-LOW-COSMETIC,200.0,130.0,1.1,1163.18,84
HCPCS,36468,SPIDER VEINS-MODERATE-COSMETIC ONLY,300.0,195.0,1.1,1163.18,84
HCPCS,36468,US GUIDANCE AND SCLEROTHERAPY,500.0,325.0,1.1,1163.18,84
HCPCS,36470,"INJ SCLEROSING SOLUTION, SINGLE VEIN",2297.0,1493.05,43.96,12500.0,86
HCPCS,36470,INJECTION SCLEROSANT SINGLE INCMPTNT VEIN,1298.5,844.025,0.01,12500.0,235
HCPCS,36470,INJECTION THERAPY OF VEIN,114.0,74.1,1.1,1163.18,148
HCPCS,36470,"SCLEROTHERAPY/VARICOSE VEINS, SINGLE VEIN",225.0,146.25,1.1,1163.18,148
HCPCS,36471,INJECTION SCLEROSANT MULTIPLE INCMPTNT VEINS,1478.5,961.025,0.01,12500.0,235
HCPCS,36471,INJECTION THERAPY OF VEINS,114.0,74.1,1.1,1163.18,148
HCPCS,36471,"SCHLEROTHERAPY/VARICOSE VEINS, MULTIPLE VEINS",500.0,325.0,1.1,1163.18,148
HCPCS,36473,ENDOVEN ABLTJ INCMPTNT VEIN MCHNCHEM 1ST VEIN,9749.0,6336.85,0.01,18098.0,233
HCPCS,36474,ENDOVEN ABLTJ INCMPTNT VEIN MCHNCHEM SBSQ VEINS,2989.5,1943.175,0.01,5279.0,215
HCPCS,36475,ENDOVEN ABLTJ INCMPTNT VEIN XTR RF 1ST VEIN,10109.0,6570.85,1.1,33436.0,235
HCPCS,36476,Endovenous rf vein add-on,,,2140.36,2478.31,8
HCPCS,36478,ENDOVEN ABLTJ INCMPTNT VEIN XTR LASER 1ST VEIN,10215.0,6639.75,0.01,33436.0,322
HCPCS,36478,ENDOVENOUS LASER 1ST VEIN,650.0,422.5,1.1,9296.26,148
HCPCS,36479,ENDOVEN ABLTJ INCMPTNT VEIN XTR LASER 2ND+ VEINS,3358.0,2182.7,0.01,33436.0,217
HCPCS,36479,ENDOVENOUS LASER VEIN ADDON,321.0,208.65,1.1,1021.65,148
HCPCS,36481,PRQ PORTAL VEIN CATHETERIZATION ANY METHOD,2029.5,1319.175,0.01,5834.94,284
HCPCS,36482,ENDOVEN ABLTI THER CHEM ADHESIVE 1ST VEIN,16241.5,10556.975,1.1,31083.0,320
HCPCS,36483,ENDOVEN ABLTI THER CHEM ADHESIVE SBSQ VEIN,2170.0,1410.5,1.1,5265.0,284
HCPCS,36500,VEN CATHJ SLCTV ORGAN BLD SAMPLING,1532.0,995.8,0.01,4628.0,280
HCPCS,3650F,EEG ORDERED RVWD REQSTD,,,2739849.3,2739849.3,1
HCPCS,3650F,Eeg ordered rvwd reqstd,,,10.69,12.38,8
HCPCS,36510,CATHJ UMBILICAL VEIN DX/THER NB,282.5,183.625,0.01,12615.0,284
HCPCS,36511,THERAPEUTIC APHERESIS WHITE BLOOD CELLS,9426.0,6126.9,123.21,9426.0,172
HCPCS,36511,THR APHERESIS WHITE BLD CELL,880.0,572.0,1.1,4475.18,144
HCPCS,36512,THERAPEUTIC APHERESIS RED BLOOD CELLS,9426.0,6126.9,117.69,9426.0,86
HCPCS,36512,THR APHERESIS RED BLOOD CELL,880.0,572.0,1.1,4475.18,144
HCPCS,36513,THERAPEU APHERESIS PLATELETS,880.0,572.0,1.1,1267.25,144
HCPCS,36513,THERAPEUTIC APHERESIS PLATELETS,2514.0,1634.1,119.5,4337.0,86
HCPCS,36514,THERAPEUTIC APHERESIS PLASMA,796.0,517.4,1.1,4475.18,148
HCPCS,36514,THERAPEUTIC APHERESIS PLASMA PHERESIS,9426.0,6126.9,0.01,9426.0,173
HCPCS,36516,THER APHERESIS W/EXTRACORPOREAL IMMUNOADSORPTION,13813.0,8978.45,1.1,26940.0,234
HCPCS,36522,PHOTOPHERESIS EXTRACORPOREAL,13855.0,9005.75,1.1,26940.0,234
HCPCS,36555,INSJ NON-TUNNELED CENTRAL VENOUS CATH AGE < 5 Y,9473.5,6157.775000000001,0.01,18098.0,409
HCPCS,36556,INSJ NON-TUNNELED CENTRAL VENOUS CATH AGE 5 YR/>,9434.0,6132.1,0.01,18098.0,496
HCPCS,36557,INSERT TUNNELED CVC W/O SUBQ PORT/PMP AGE <5 YR,16617.5,10801.375,0.01,31083.0,322
HCPCS,36558,INSJ TUNNELED CVC W/O SUBQ PORT/PMP AGE 5 YR/>,10059.0,6538.35,0.01,18098.0,583
HCPCS,36560,INSJ TUNNELED CTR VAD W/SUBQ PORT UNDER 5 YR,2658.0,1727.7,0.01,9296.26,235
HCPCS,36561,INSJ TUNNELED CTR VAD W/SUBQ PORT AGE 5 YR/>,10323.0,6709.950000000001,0.01,18098.0,322
HCPCS,36563,INSERT TUNNELED CV CATH,,,4767.51,5790.88,20
HCPCS,36563,INSJ TUNNELED CTR VAD W/SUBQ PUMP,2636.0,1713.4,1.1,16027.4,148
HCPCS,36563,Insert tunneled cv cath,,,1624.42,1880.91,8
HCPCS,36565,"CV CATH INSERT,TUNNELED W/PUMP",1931.0,1255.15,1.1,9296.26,148
HCPCS,36565,INSJ TUN VAD REQ 2 CATH 2 SITS W/O SUBQ PORT/PMP,10323.0,6709.950000000001,0.01,18098.0,322
HCPCS,36566,INSJ TUN VAD REQ 2 CATH 2 SITS W/SUBQ PORT,16925.5,11001.575,0.01,31083.0,235
HCPCS,36568,INSERTION PICC W/O IMG GDN < 5 YR,4930.0,3204.5,0.01,8932.0,405
HCPCS,36569,INSERTION PICC W/O IMG GDN 5 YR/>,4884.0,3174.6,0.01,8932.0,492
HCPCS,36570,INSJ PRPH CTR VAD W/SUBQ PORT UNDER 5 YR,10173.0,6612.450000000001,0.01,18098.0,235
HCPCS,36571,INSJ PRPH CTR VAD W/SUBQ PORT AGE 5 YR/>,10169.0,6609.85,0.01,18098.0,322
HCPCS,36572,INSERTION PICC W/RS&I < 5 YR,2211.0,1437.15,0.01,5597.0,409
HCPCS,36572,INSERTION PICC W/RS&I < 5YR,801.0,520.65,1.1,1833.54,148
HCPCS,36573,"INSERTION PICC LINE, AGE 5 AND OLDER",892.0,579.8,1.1,4671.09,148
HCPCS,36573,INSERTION PICC W/RS&I 5 YR >,748.0,486.2,1.1,4671.09,148
HCPCS,36573,INSERTION PICC W/RS&I 5 YR/>,8932.0,5805.8,0.01,8932.0,348
HCPCS,36575,RPR TUN/NON-TUN CTR VAD CATH W/O SUBQ PORT/PMP,1911.5,1242.475,0.01,5265.0,409
HCPCS,36576,RPR CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ SIT,5064.0,3291.6,1.1,8932.0,322
HCPCS,36578,RPLCMT CATH CTR VAD SUBQ PORT/PMP,9707.0,6309.55,1.1,18098.0,322
HCPCS,36580,REPL NON-TUN CVC SAME ACCESS,432.0,280.8,1.1,4671.09,148
HCPCS,36580,RPLCMT COMPL NON-TUN CVC W/O SUBQ PORT/PMP,4754.0,3090.1,0.01,8932.0,496
HCPCS,36581,RPLCMT COMPL TUN CVC W/O SUBQ PORT/PMP,9695.0,6301.75,0.01,18098.0,496
HCPCS,36582,RPLCMT COMPL TUN CTR VAD W/SUBQ PORT,10047.0,6530.55,0.01,18098.0,322
HCPCS,36583,REPLACE TUNNELED CV CATH,,,4767.51,5790.88,20
HCPCS,36583,Replace tunneled cv cath,,,1624.42,1880.91,8
HCPCS,36584,COMPLETE REPLACEMENT PICC RS&I,4706.0,3058.9,0.01,8932.0,496
HCPCS,36584,REPLACE PICC SAME ACCESS VL,8932.0,5805.8,68.84,8932.0,87
HCPCS,36585,RPLCMT COMPL PRPH CTR VAD W/SUBQ PORT,9967.0,6478.55,1.1,18098.0,235
HCPCS,36589,RMVL TUN CVC W/O SUBQ PORT/PMP,2279.0,1481.35,0.01,4628.0,496
HCPCS,36590,RMVL TUN CTR VAD W/SUBQ PORT/PMP CTR/PRPH INSJ,5148.0,3346.2000000000003,0.01,8932.0,409
HCPCS,36591,BLOOD DRAW VENOUS ACCESS DEV,741.0,481.65,35.72,741.0,86
HCPCS,36591,COLLECT BLOOD FROM IMPLANT VENOUS ACCESS DEVICE,388.5,252.52499999999998,0.01,12500.0,574
HCPCS,36592,COLL BLOOD OFF PICC VENOUS,741.0,481.65,35.72,741.0,86
HCPCS,36592,COLLECT BLOOD FROM CATHETER VENOUS NOS,400.0,260.0,0.01,12500.0,401
HCPCS,36593,DECLOT BY THROMBOLYTIC AGENT IMPLANT DEVICE/CATH,1209.5,786.175,0.01,12500.0,492
HCPCS,36595,MCHNL RMVL PRICATH OBSTR CV DEV VIA VEN ACCESS,9767.0,6348.55,1.1,18098.0,235
HCPCS,36596,MCHNL RMVL INTRAL OBSTR CV DEV THRU DEV LUMEN,4616.0,3000.4,0.01,8932.0,322
HCPCS,36597,RPSG PREVIOUSLY PLACED CVC UNDER FLUOR GDNCE,4708.0,3060.2000000000003,0.01,8932.0,409
HCPCS,36598,CNTRST NJX RAD EVAL CTR VAD FLUOR IMG&REPRT,753.5,489.775,0.01,4628.0,321
HCPCS,36599,DUMMY PROC NAME,1898.0,1233.7,1.1,1898.0,70
HCPCS,36600,ARTERIAL PUNCTURE WITHDRAWAL BLOOD DX,434.5,282.425,0.01,12500.0,407
HCPCS,36620,ARTL CATHJ/CANNULJ MNTR/TRANSFUSION SPX PRQ,964.5,626.925,0.01,4628.0,416
HCPCS,36625,ARTL CATHJ/CANNULJ MNTR/TRANSFUSION SPX CUTDOWN,1166.5,758.225,0.01,1489.0,212
HCPCS,36640,ARTL CATHJ PROLNG NFS THER CHEMOTX CUTDOWN,18098.0,11763.7,0.01,18098.0,87
HCPCS,36660,CATHETERIZATION UMBILICAL NEWBORN ART DX/THERAPY,406.0,263.9,0.01,560.0,213
HCPCS,36680,PLACEMENT NEEDLE INTRAOSSEOUS INFUSION,2294.0,1491.1,0.01,12500.0,173
HCPCS,36680,PLACEMENT OF NEEDLE FOR INTRAOSSEOUS INFUSION,528.0,343.2,1.1,1163.18,144
HCPCS,36800,INSJ CANNULA HEMO OTH PURPOSE SPX VEIN VEIN,16076.0,10449.4,0.01,31083.0,231
HCPCS,36810,INSERTION OF CANNULA,,,2765.32,3285.94,20
HCPCS,36810,INSJ CANNULA HEMO OTH PURPOSE SPX ARVEN XTRNL,1584.0,1029.6,1.1,9296.26,144
HCPCS,36810,Insertion of cannula,,,1624.42,1880.91,8
HCPCS,36815,INSERTION OF CANNULA,,,4767.51,5790.88,20
HCPCS,36815,INSJ CANNULA HEMO OTH SPX ARVEN XTRNL REVJ/CLSR,1048.0,681.2,1.1,16027.4,144
HCPCS,36815,Insertion of cannula,,,1624.42,1880.91,8
HCPCS,36818,ARVEN ANAST OPN UPR ARM CEPHALIC VEIN TRPOS,4956.0,3221.4,1.1,16027.4,144
HCPCS,36818,AV FUSE UPPR ARM CEPHALIC,,,4767.51,5790.88,20
HCPCS,36818,Av fuse uppr arm cephalic,,,3153.41,3651.32,8
HCPCS,36819,ARTVEN ANAST OPN UPR ARM BASLILIC VEN TRANS,31083.0,20203.95,838.29,31083.0,87
HCPCS,36819,ARVEN ANAST OPN UPR ARM BASILIC VEIN TRPOS,5316.0,3455.4,1.1,16027.4,144
HCPCS,36820,ARVEN ANAST OPN F/ARM VEIN TRPOS,5228.0,3398.2,1.1,16027.4,144
HCPCS,36820,AV FUSION/FOREARM VEIN,,,4767.51,5790.88,20
HCPCS,36820,Av fusion/forearm vein,,,3153.41,3651.32,8
HCPCS,36821,ARTERIOVENOUS ANASTOMOSIS OPEN DIRECT,4760.0,3094.0,1.1,9296.26,144
HCPCS,36821,AV FUSION DIRECT ANY SITE,,,2765.32,7813.0,21
HCPCS,36821,Av fusion direct any site,,,3153.41,3651.32,8
HCPCS,36823,INSERTION OF CANNULA(S),,,3687.77,3687.77,1
HCPCS,36823,INSJ CNULA ISLTD XC-CIRCJ REG CHEMOTX XTR RMVL,9192.0,5974.8,1.1,9192.0,142
HCPCS,36823,Insertion of cannula(s),,,2799.05,3241.01,8
HCPCS,36825,ARTERY-VEIN AUTOGRAFT,,,4767.51,5790.88,20
HCPCS,36825,Artery-vein autograft,,,3153.41,3651.32,8
HCPCS,36825,CRTJ ARVEN FSTL XCP DIR ARVEN ANAST AUTOG GRF,5668.0,3684.2,1.1,16027.4,144
HCPCS,36830,ARTERY-VEIN NONAUTOGRAFT,,,4767.51,5790.88,20
HCPCS,36830,Artery-vein nonautograft,,,3153.41,3651.32,8
HCPCS,36830,CRTJ ARVEN FSTL XCP DIR ARVEN ANAST NONAUTOG GRF,4812.0,3127.8,1.1,16027.4,144
HCPCS,36831,OPEN THROMBECT AV FISTULA,,,4767.51,5790.88,20
HCPCS,36831,Open thrombect av fistula,,,3153.41,3651.32,8
HCPCS,36831,THRMBC OPN ARVEN FSTL W/O REVJ DIAL GRF,4400.0,2860.0,1.1,16027.4,144
HCPCS,36832,REVJ OPN ARVEN FSTL W/O THRMBC DIAL GRF,18241.5,11856.975,1.1,31083.0,231
HCPCS,36833,REVJ OPN ARVEN FSTL W/THRMBC DIAL GRF,18441.5,11986.975,1.1,31083.0,231
HCPCS,36835,INSERTION THOMAS SHUNT,,,2765.32,3285.94,20
HCPCS,36835,Insertion thomas shunt,,,3153.41,3651.32,8
HCPCS,36836,PERQ AV FISTULA CREATION UXTR SINGLE ACCESS,53065.5,34492.575,1.1,103251.0,318
HCPCS,36837,PERQ AV FISTULA CREATION UXTR SEP ACCESS SITES,53485.5,34765.575,1.1,103251.0,318
HCPCS,36838,DIST REVAS LIGATION HEMO,,,4767.51,5790.88,20
HCPCS,36838,DSTL REVSC&INTERVAL LIG UXTR HEMO ACCESS,8676.0,5639.4,1.1,16027.4,144
HCPCS,36838,Dist revas ligation hemo,,,3153.41,3651.32,8
HCPCS,36860,XTRNL CANNULA DECLTNG SPX W/O BALO CATH,8932.0,5805.8,124.89,8932.0,87
HCPCS,36861,XTRNL CANNULA DECLTNG SPX W/BALO CATH,16045.5,10429.575,1.1,31083.0,231
HCPCS,36901,INTRO CATH DIALYSIS CIRCUIT DX ANGRPH FLUOR S&I,5138.0,3339.7000000000003,1.1,12500.0,322
HCPCS,36902,INTRO CATH DIALYSIS CIRCUIT W/TRLUML BALO ANGIOP,17358.0,11282.699999999999,0.01,32784.0,409
HCPCS,36903,INTRO CATH DIALYSIS CIRCUIT W/TCAT PLMT IV STENT,17397.5,11308.375,1.1,32239.0,322
HCPCS,36904,PERQ THRMBC/NFS DIALYSIS CIRCUIT IMG DX ANGRPH,17892.0,11629.8,1.1,32784.0,322
HCPCS,36905,PERQ THRMBC/NFS DIAL CIRCUIT TRLUML BALO ANGIOP,34404.0,22362.6,1.1,65208.0,322
HCPCS,36906,PERQ THRMBC/NFS DIAL CIRCUIT TCAT PLMT IV STENT,28676.5,18639.725,1.1,53185.0,322
HCPCS,36907,(2017) TRLUML BALO ANGIOP CTR DIALYSIS SEG W/IMG S&I,1200.0,780.0,1.1,1985.46,148
HCPCS,36907,TRLUML BALO ANGIOP CTR DIALYSIS SEG W/IMG S&I,16227.0,10547.55,170.73,16227.0,138
HCPCS,36908,STENT PLMT CENTRAL DIAYLSIS SEG PFRMD DIAL CIR,13053.0,8484.45,1.1,24406.0,286
HCPCS,36909,DIALYIS CIRCUIT VASC EMBOLI OCCLS EVASC IMG S&I,12209.0,7935.85,1.1,22770.0,286
HCPCS,3700F,PSYCH DISORDERS ASSESSED,,,2739849.3,2739849.3,1
HCPCS,3700F,Psych disorders assessed,,,10.69,12.38,8
HCPCS,37140,REVISION OF CIRCULATION,,,6096.64,6096.64,1
HCPCS,37140,Revision of circulation,,,2623.14,3037.32,8
HCPCS,37140,VENOUS ANASTOMOSIS OPEN PORTOCAVAL,16000.0,10400.0,1.1,16000.0,144
HCPCS,37145,REVISION OF CIRCULATION,,,5656.4,5656.4,1
HCPCS,37145,Revision of circulation,,,2799.05,3241.01,8
HCPCS,37145,VENOUS ANASTOMOSIS OPEN RENOPORTAL,14800.0,9620.0,1.1,14800.0,144
HCPCS,37160,REVISION OF CIRCULATION,,,5809.35,5809.35,1
HCPCS,37160,Revision of circulation,,,2623.14,3037.32,8
HCPCS,37160,VENOUS ANASTOMOSIS OPEN CAVAL-MESENTERIC,15200.0,9880.0,1.1,15200.0,144
HCPCS,37180,REVISION OF CIRCULATION,,,5583.96,5583.96,1
HCPCS,37180,Revision of circulation,,,2623.14,3037.32,8
HCPCS,37180,VENOUS ANASTOMOSIS OPEN SPLENORENAL PROXIMAL,14600.0,9490.0,1.1,14600.0,144
HCPCS,37181,SPLICE SPLEEN/KIDNEY VEINS,,,6096.64,6096.64,1
HCPCS,37181,Splice spleen/kidney veins,,,2623.14,3037.32,8
HCPCS,37181,VENOUS ANASTOMOSIS OPEN SPLENORENAL DISTAL,16000.0,10400.0,1.1,16000.0,144
HCPCS,37182,INSJ TRANSVNS INTRAHEPATC PORTOSYSIC SHUNT,11959.5,7773.674999999999,1.1,19077.46,222
HCPCS,37183,REVJ TRANSVNS INTRAHEPATIC PORTOSYSTEMIC SHUNT,11742.0,7632.3,0.01,20388.0,321
HCPCS,37184,PRIM PRQ TRLUML MCHNL THRMBC N-COR N-ICRA 1ST,27064.0,17591.6,0.01,51140.13,321
HCPCS,37185,PRIM PRQ TRLUML MCHNL THRMBC N-COR N-ICRA SBSQ,3491.0,2269.15,0.01,5539.0,284
HCPCS,37186,SEC PRQ TRLUML THRMBC N-CORONARY N-INTRACRANIAL,4598.0,2988.7,1.1,9767.57,216
HCPCS,37187,PRQ TRANSLUMINAL MECHANICAL THROMBECTOMY VEIN,16598.5,10789.025,0.01,32085.4,321
HCPCS,37188,PRQ TRLUML MCHNL THRMBC VEIN REPEAT TX,10250.0,6662.5,0.01,18098.0,321
HCPCS,37191,INS INTRVAS VC FILTR W/WO VAS ACS VSL SELXN RS&I,10170.5,6610.825,0.01,18379.0,321
HCPCS,37192,REPSNG INTRVAS VC FILTR W/WO ACS VSL SELXN RS&I,10469.0,6804.85,1.1,18098.0,234
HCPCS,37193,RTRVL INTRVAS VC FILTR W/WO ACS VSL SELXN RS&I,10469.0,6804.85,0.01,18098.0,321
HCPCS,37195,THROMBOLYSIS CEREBRAL IV INFUSION,1991.0,1294.15,1.1,2453.0,190
HCPCS,37197,PRQ TRANSCATHETER RTRVL INTRVAS FB WITH IMAGING,10378.0,6745.700000000001,1.1,18098.0,320
HCPCS,37200,TRANSCATHETER BIOPSY,31083.0,20203.95,0.01,31083.0,173
HCPCS,37200,TRANSVASCULAR BIOPSY,1820.0,1183.0,1.1,16027.4,144
HCPCS,3720F,COGNIT IMPAIRMENT ASSESSED,,,2739849.3,2739849.3,1
HCPCS,3720F,Cognit impairment assessed,,,10.69,12.38,8
HCPCS,37211,THROMBOLYSIS ARTERIAL INFUSION ICRA RS&I INIT TX,31083.0,20203.95,0.01,31083.0,173
HCPCS,37211,THROMBOLYSIS ARTERIAL INFUSION W/IMAGING INIT TX,3100.0,2015.0,1.1,16027.4,144
HCPCS,37212,THROMBOLYSIS VENOUS INFUSION W/IMAGING INIT TX,10411.0,6767.150000000001,1.1,18098.0,402
HCPCS,37213,THROMBOLYSIS ART/VENOUS INFSN W/IMAGE SUBSQ TX,9999.0,6499.35,0.01,18098.0,403
HCPCS,37214,CESSATION THROMBOLYTIC THER W/CATHETER REMOVAL,18098.0,11763.7,0.01,18098.0,259
HCPCS,37214,CESSATION THROMBOLYTIC THRPY W/CATHETER REMOVAL,1096.0,712.4,1.1,9296.26,144
HCPCS,37215,TCAT IV STENT CRV CRTD ART EMBOLIC PROTECJ,14639.0,9515.35,1.1,21468.0,212
HCPCS,37216,TCAT IV STENT CRV CRTD ART W/O EMBOLIC PROTECJ,13436.0,8733.4,0.01,19680.0,233
HCPCS,37217,STENT PLACEMT RETRO CAROTID,,,2798.42,2798.42,1
HCPCS,37217,Stent placemt retro carotid,,,7691.42,8905.85,8
HCPCS,37217,TCATH STENT PLACEMT RETROGRAD CAROTID/INNOMINATE,8152.0,5298.8,1.1,8152.0,144
HCPCS,37218,TCATH STENT PLACEMT ANTEGRADE CAROTID/INNOMINATE,10843.5,7048.275,1.1,15787.0,212
HCPCS,37220,ILIAC REVASC,,,4958.66,14921.6,9
HCPCS,37220,Iliac revasc,,,4672.17,5409.88,8
HCPCS,37221,ILIAC REVASC W/STENT,,,9544.11,28720.16,9
HCPCS,37221,Iliac revasc w/stent,,,8435.63,9767.57,8
HCPCS,37222,Iliac revasc add-on,,,8435.63,9767.57,8
HCPCS,37223,Iliac revasc w/stent add-on,,,8435.63,9767.57,8
HCPCS,37224,FEM/POPL REVAS W/TLA,,,4958.66,14921.6,10
HCPCS,37224,Fem/popl revas w/tla,,,4672.17,5409.88,8
HCPCS,37225,FEM/POPL REVAS W/ATHER,,,15212.67,45778.03,9
HCPCS,37225,Fem/popl revas w/ather,,,8435.63,9767.57,8
HCPCS,37226,FEM/POPL REVASC W/STENT,,,9544.11,28720.16,9
HCPCS,37226,Fem/popl revasc w/stent,,,8435.63,9767.57,8
HCPCS,37227,FEM/POPL REVASC STNT & ATHER,,,15212.67,45778.03,9
HCPCS,37227,Fem/popl revasc stnt & ather,,,8435.63,9767.57,8
HCPCS,37228,TIB/PER REVASC W/TLA,,,9544.11,28720.16,9
HCPCS,37228,Tib/per revasc w/tla,,,4672.17,5409.88,8
HCPCS,37229,TIB/PER REVASC W/ATHER,,,11553.0,45778.03,10
HCPCS,37229,Tib/per revasc w/ather,,,8435.63,9767.57,8
HCPCS,37230,TIB/PER REVASC W/STENT,,,15212.67,45778.03,9
HCPCS,37230,Tib/per revasc w/stent,,,8435.63,9767.57,8
HCPCS,37231,REVSC OPN/PRQ TIB/PERO W/STNT/ATHR/ANGIOP SM VSL,45849.0,29801.85,915.17,45849.0,75
HCPCS,37232,Tib/per revasc add-on,,,8435.63,9767.57,8
HCPCS,37233,Tibper revasc w/ather add-on,,,8435.63,9767.57,8
HCPCS,37234,Revsc opn/prq tib/pero stent,,,8435.63,9767.57,8
HCPCS,37235,Tib/per revasc stnt & ather,,,8435.63,9767.57,8
HCPCS,37236,OPEN/PERQ PLACEMENT INTRAVASCULAR STENT INITIAL,21782.0,14158.3,1.1,40064.0,406
HCPCS,37237,OPEN/PERQ PLACE STENT EA ADD,14042.0,9127.3,242.9,14042.0,68
HCPCS,37237,OPEN/PERQ PLACEMENT INTRAVASCULAR STENT EA ADDL,7871.0,5116.15,1.1,14042.0,216
HCPCS,37238,OPEN/PERQ PLACEMENT INTRAVASCULAR STENT SAME 1ST,19796.0,12867.4,1.1,36934.0,320
HCPCS,37239,OPEN/PERQ PLACEMENT INTRAVASC STENT SAME EA ADDL,7569.5,4920.174999999999,1.1,13832.0,284
HCPCS,37241,VASCULAR EMBOLIZATION OR OCCLUSION VENOUS RS&I,34529.0,22443.85,1.1,65208.0,320
HCPCS,37242,VASCULAR EMBOLIZATION OR OCCLUSION ARTERIAL RS&I,31489.5,20468.175000000003,1.1,58667.0,320
HCPCS,37243,VASCULAR EMBOLIZE/OCCLUDE ORGAN TUMOR INFARCT,35187.0,22871.55,1.1,65208.0,234
HCPCS,37244,VASCULAR EMBOLIZATION OR OCCLUSION HEMORRHAGE,25838.0,16794.7,1.1,45626.0,234
HCPCS,37246,TRLML BALO ANGIOP OPEN/PERQ IMG S&I 1ST ART,17932.0,11655.8,1.1,32784.0,409
HCPCS,37247,TRLML BALO ANGIOP OPEN/PERQ IMG S&I EA ADDL ART,4373.0,2842.45,1.1,10789.0,217
HCPCS,37248,TRLML BALO ANGIOP OPEN/PERQ W/IMG S&I 1ST VEIN,17712.0,11512.8,1.1,32784.0,322
HCPCS,37249,TRLML BALO ANGIOP OPEN/PERQ W/IMG S&I ADDL VEIN,3355.5,2181.075,1.1,10789.0,286
HCPCS,37252,INTRAVASCULAR US NONCORONARY RS&I INTIAL VESSEL,3814.5,2479.425,1.1,6837.0,284
HCPCS,37253,INTRAVASCULAR US NONCORONARY RS&I ADDL VESSEL,2652.5,1724.125,1.1,4671.0,284
HCPCS,37254,REVSC EVASC IVT ANGIOP UNI SF LES 1ST VSL,18323.5,11910.275,1.1,33435.0,183
HCPCS,37255,REVSC EVASC IVT ANGIOP UNI SF LES EA ADDL VSL,17377.5,11295.375,1.1,33435.0,173
HCPCS,37256,REVSC EVASC IVT ANGIOP UNI CPLX LES 1ST VSL,19082.5,12403.625,1.1,33435.0,183
HCPCS,37257,REVSC EVASC IVT ANGIOP UNI CPLX LES EA ADDL VSL,17573.5,11422.775,1.1,33435.0,173
HCPCS,37258,REVSC EVASC IVT ST PLMT UNI SF LES 1ST VSL,35833.5,23291.775,1.1,67817.0,183
HCPCS,37259,REVSC EVASC IVT ST PLMT UNI SF LES EA ADDL VSL,34788.5,22612.525,1.1,67817.0,173
HCPCS,3725F,SCREEN DEPRESSION PERFORMED,,,0.03,0.03,1
HCPCS,3725F,Screen depression performed,,,10.69,12.38,8
HCPCS,37260,REVSC EVASC IVT ST PLMT UNI CPLX LES 1ST VSL,36700.5,23855.325,1.1,67817.0,183
HCPCS,37261,REVSC EVASC IVT ST PLMT UNI CPLX LES EA ADDL VSL,34843.5,22648.275,1.1,67817.0,173
HCPCS,37262,INTRAVASCULAR LITHOTRIPSY IVT WITHIN SAME ARTERY,3191.0,2074.15,1.1,8704.67,173
HCPCS,37263,REVSC EVASC FPVT ANGIOP UNI SF LES 1ST VSL,18422.5,11974.625,1.1,33435.0,183
HCPCS,37264,REVSC EVASC FPVT ANGIOP UNI SF LES EA ADDL VSL,17377.5,11295.375,1.1,33435.0,173
HCPCS,37265,REVSC EVASC FPVT ANGIOP UNI CPLX LES 1ST VSL,19027.5,12367.875,1.1,33435.0,183
HCPCS,37266,REVSC EVASC FPVT ANGIOP UNI CPLX LES EA ADDL VSL,17597.5,11438.375,1.1,33435.0,173
HCPCS,37267,REVSC EVASC FPVT ST PLMT UNI SF LES 1ST VSL,35833.5,23291.775,1.1,67817.0,183
HCPCS,37268,REVSC EVASC FPVT ST PLMT UNI SF LES EA ADDL VSL,34729.0,22573.850000000002,1.1,67817.0,173
HCPCS,37269,REVSC EVASC FPVT ST PLMT UNI CPLX LES 1ST VSL,37153.5,24149.775,1.1,67817.0,183
HCPCS,37270,REVSC EVASC FPVT ST PLMT UNI CPLX LES EA ADD VSL,35008.5,22755.525,1.1,67817.0,173
HCPCS,37271,REVSC EVASC FPVT ATHRC UNI SF LES 1ST VSL,55825.0,36286.25,1.1,107690.0,183
HCPCS,37272,REVSC EVASC FPVT ATHRC UNI SF LES EA ADDL VSL,54725.0,35571.25,1.1,107690.0,173
HCPCS,37273,REVSC EVASC FPVT ATHRC UNI CPLX LES 1ST VSL,56623.5,36805.275,1.1,107690.0,183
HCPCS,37274,REVSC EVASC FPVT ATHRC UNI CPLX LES EA ADDL VSL,55055.0,35785.75,1.1,107690.0,173
HCPCS,37275,REVSC EVASC FPVT ST ATHRC UNI SF LES 1ST VSL,56265.0,36572.25,1.1,107690.0,183
HCPCS,37276,REVSC EVASC FPVT ST ATHRC UNI SF LES EA ADDL VSL,54780.0,35607.0,1.1,107690.0,173
HCPCS,37277,REVSC EVASC FPVT ST ATHRC UNI CPLX LES 1ST VSL,57145.0,37144.25,1.1,107690.0,183
HCPCS,37278,REVSC EVSC FPVT ST ATHRC UNI CPLX LES EA ADD VSL,55165.0,35857.25,1.1,107690.0,173
HCPCS,37279,INTRAVASCULAR LITHOTRIPSY FPVT W/IN SAME ARTERY,1760.0,1144.0,1.1,11836.32,106
HCPCS,37279,Iv lithotrp fpvt w/in sm art,,,2523.55,2922.01,8
HCPCS,37280,REVSC EVASC TPVT ANGIOP UNI SF LES 1ST VSL,36064.5,23441.925000000003,1.1,67817.0,183
HCPCS,37281,REVSC EVASC TPVT ANGIOP UNI SF LES EA ADDL VSL,34568.5,22469.525,1.1,67817.0,173
HCPCS,37282,REVSC EVASC TPVT ANGIOP UNI CPLX LES 1ST VSL,36616.5,23800.725000000002,1.1,67817.0,183
HCPCS,37283,REVSC EVASC TPVT ANGIOP UNI CPLX LES EA ADDL VSL,34845.5,22649.575,1.1,67817.0,173
HCPCS,37284,REVSC EVASC TPVT ST PLMT UNI SF LES 1ST VSL,56045.0,36429.25,1.1,107690.0,183
HCPCS,37285,REVSC EVASC TPVT ST PLMT UNI SF LES EA ADDL VSL,54580.0,35477.0,1.1,107690.0,173
HCPCS,37286,REVSC EVASC TPVT ST PLMT UNI CPLX LES 1ST VSL,56806.0,36923.9,1.1,107690.0,183
HCPCS,37287,REVSC EVASC TPVT ST PLMT UNI CPLX LES EA ADD VSL,54945.0,35714.25,1.1,107690.0,173
HCPCS,37288,REVSC EVASC TPVT ATHRC UNI SF LES 1ST VSL,56815.0,36929.75,1.1,107690.0,183
HCPCS,37289,REVSC EVASC TPVT ATHRC UNI SF LES EA ADDL VSL,54890.0,35678.5,1.1,107690.0,173
HCPCS,37290,REVSC EVASC TPVT ATHRC UNI CPLX LES 1ST VSL,57585.0,37430.25,1.1,107690.0,183
HCPCS,37291,REVSC EVASC TPVT ATHRC UNI CPLX LES EA ADDL VSL,55275.0,35928.75,1.1,107690.0,173
HCPCS,37292,REVSC EVASC TPVT ST ATHRC UNI SF LES 1ST VSL,57145.0,37144.25,1.1,107690.0,183
HCPCS,37293,REVSC EVASC TPVT ST ATHRC UNI SF LES EA ADDL VSL,55275.0,35928.75,1.1,107690.0,173
HCPCS,37294,REVSC EVASC TPVT ST ATHRC UNI CPLX LES 1ST VSL,57805.0,37573.25,1.1,107690.0,183
HCPCS,37295,REVSC EVSC TPVT ST ATHRC UNI CPLX LES EA ADD VSL,55640.0,36166.0,1.1,107690.0,173
HCPCS,37296,REVSC EVASC IMVT ANGIOP UNI SF LES 1ST VSL,36328.5,23613.525,1.1,67817.0,183
HCPCS,37297,REVSC EVASC IMVT ANGIOP UNI SF LES EA ADDL VSL,34788.5,22612.525,1.1,67817.0,173
HCPCS,37298,REVSC EVASC IMVT ANGIOP UNI CPLX LES 1ST VSL,36922.5,23999.625,1.1,67817.0,183
HCPCS,37299,REVSC EVASC IMVT ANGIOP UNI CPLX LES EA ADDL VSL,35008.5,22755.525,1.1,67817.0,173
HCPCS,37500,ENDOSCOPY LIGATE PERF VEINS,,,4767.51,5412.2,8
HCPCS,37500,Endoscopy ligate perf veins,,,2799.05,3241.01,8
HCPCS,37501,UNLISTED VASC ENDOSCOPY PX,,,545.0,1640.03,21
HCPCS,37501,UNLISTED VASCULAR ENDOSCOPY PROCEDURE,109.0,70.85,0.01,1833.54,96
HCPCS,37501,Unlisted vasc endoscopy px,,,673.41,779.74,8
HCPCS,3750F,PTNOTRCVNGSTEROID>=10MG/DAY,,,2739849.3,2739849.3,1
HCPCS,3750F,Ptnotrcvngsteroid>=10mg/day,,,10.69,12.38,8
HCPCS,3751F,ELECTRODIAG POLYNEURO 6 MN,,,2739849.3,2739849.3,1
HCPCS,3751F,Electrodiag polyneuro 6 mn,,,10.69,12.38,8
HCPCS,3752F,NO ELECTRODIAG POLYNEURO 6MN,,,2739849.3,2739849.3,1
HCPCS,3752F,No electrodiag polyneuro 6mn,,,10.69,12.38,8
HCPCS,3753F,PT HAS SYMP&SIGNS NEUROPATHY,,,2739849.3,2739849.3,1
HCPCS,3753F,Pt has symp&signs neuropathy,,,10.69,12.38,8
HCPCS,3754F,SCREENING TESTS DM DONE,,,2739849.3,2739849.3,1
HCPCS,3754F,Screening tests dm done,,,10.69,12.38,8
HCPCS,3755F,COG&BEHAV IMPRMNT SCRNG DONE,,,2739849.3,2739849.3,1
HCPCS,3755F,Cog&behav imprmnt scrng done,,,10.69,12.38,8
HCPCS,37565,LIGATION INT JUGULAR VEIN,,,2765.32,8321.41,21
HCPCS,37565,LIGATION INTERNAL JUGULAR VEIN,4820.0,3133.0,1.1,9296.26,144
HCPCS,37565,Ligation int jugular vein,,,1244.56,1441.07,8
HCPCS,3756F,PT W/PSEUDOBULB AFFECT/ALS,,,2739849.3,2739849.3,1
HCPCS,3756F,Pt w/pseudobulb affect/als,,,10.69,12.38,8
HCPCS,3757F,PT W/O PSEUDOBULBAFFECT/ALS,,,2739849.3,2739849.3,1
HCPCS,3757F,Pt w/o pseudobulbaffect/als,,,10.69,12.38,8
HCPCS,3758F,PT REF PULM FX TEST/PEAKFLOW,,,2739849.3,2739849.3,1
HCPCS,3758F,Pt ref pulm fx test/peakflow,,,10.69,12.38,8
HCPCS,3759F,PT SCRN DYSPHAG/WT LOSS/NUTR,,,2739849.3,2739849.3,1
HCPCS,3759F,Pt scrn dysphag/wt loss/nutr,,,10.69,12.38,8
HCPCS,37600,LIGATION EXTERNAL CAROTID ARTERY,4968.0,3229.2,1.1,9296.26,144
HCPCS,37600,LIGATION XTRNL CAROTID ART,,,2765.32,8321.41,21
HCPCS,37600,Ligation xtrnl carotid art,,,1098.89,1272.4,8
HCPCS,37605,LIGATION INT/COM CAROTID ART,,,2765.32,8321.41,21
HCPCS,37605,LIGATION INTERNAL/COMMON CAROTID ARTERY,5712.0,3712.8,1.1,9296.26,144
HCPCS,37605,Ligation int/com carotid art,,,1098.89,1272.4,8
HCPCS,37606,LIG INT/COM CAROTID ART OCCL,,,2765.32,8321.41,21
HCPCS,37606,Lig int/com carotid art occl,,,1098.89,1272.4,8
HCPCS,37607,LIG/BANDING ANGIOACCESS ARTERIOVENOUS FISTULA,10299.0,6694.35,0.01,18098.0,318
HCPCS,37609,LIGATION/BIOPSY TEMPORAL ARTERY,5268.0,3424.2,0.01,9316.0,409
HCPCS,3760F,PT W/DYSPHAG/WT LOSS/NUTR,,,2739849.3,2739849.3,1
HCPCS,3760F,Pt w/dysphag/wt loss/nutr,,,10.69,12.38,8
HCPCS,37615,LIGATION MAJOR ARTERY NECK,3120.0,2028.0,1.1,9296.26,165
HCPCS,37615,Ligation major artery neck,,,1244.56,1441.07,8
HCPCS,37616,LIGATION MAJOR ARTERY CHEST,7588.0,4932.2,1.1,7588.0,145
HCPCS,37616,Ligation major artery chest,,,2623.14,3037.32,8
HCPCS,37617,LIGATION MAJOR ARTERY ABD,,,3462.81,5790.88,13
HCPCS,37617,LIGATION MAJOR ARTERY ABDOMEN,9516.0,6185.4,1.1,9516.0,144
HCPCS,37617,Ligation major artery abd,,,2623.14,3037.32,8
HCPCS,37618,LIGATION MAJOR ARTERY EXTREMITY,2412.0,1567.8,1.1,2412.0,144
HCPCS,37618,LIGATION MAJOR ARTERY XTR,,,1022.65,1022.65,1
HCPCS,37618,Ligation major artery xtr,,,1244.56,1441.07,8
HCPCS,37619,LIGATION OF INF VENA CAVA,,,4767.51,14346.42,21
HCPCS,37619,LIGATION OF INFERIOR VENA CAVA,12000.0,7800.0,1.1,16027.4,144
HCPCS,37619,Ligation of inf vena cava,,,2799.05,3241.01,8
HCPCS,3761F,PT W/O DYSPHAG/WT LOSS/NUTR,,,2739849.3,2739849.3,1
HCPCS,3761F,Pt w/o dysphag/wt loss/nutr,,,10.69,12.38,8
HCPCS,3762F,PATIENT IS DYSARTHRIC,,,2739849.3,2739849.3,1
HCPCS,3762F,Patient is dysarthric,,,10.69,12.38,8
HCPCS,3763F,PATIENT IS NOT DYSARTHRIC,,,2739849.3,2739849.3,1
HCPCS,3763F,Patient is not dysarthric,,,10.69,12.38,8
HCPCS,37650,LIGATION OF FEMORAL VEIN,3396.0,2207.4,1.1,9296.26,164
HCPCS,37650,Ligation of femoral vein,,,1244.56,1441.07,8
HCPCS,37660,LIGATION COMMON ILIAC VEIN,,,3454.4,3454.4,1
HCPCS,37660,LIGATION OF COMMON ILIAC VEIN,8912.0,5792.8,1.1,8912.0,144
HCPCS,37660,Ligation common iliac vein,,,2623.14,3037.32,8
HCPCS,37700,LIG&DIV LONG SAPH VEIN SAPHFEM JUNCT/INTERRUPJ,1528.0,993.2,1.1,9296.26,144
HCPCS,37700,LIGATION&DIV LONG SAPH VEIN,,,2765.32,3285.94,20
HCPCS,37700,Ligation&div long saph vein,,,2140.36,2478.31,8
HCPCS,37700,REVISE LEG VEIN,485.0,315.25,1.1,9296.26,144
HCPCS,37718,LIGJ DIVJ & STRIPPING SHORT SAPHENOUS VEIN,10475.0,6808.75,0.01,18098.0,231
HCPCS,37722,LIGJ DIVJ&STRIP LONG SAPH SAPHFEM JUNCT KNE/BELW,10844.0,7048.6,0.01,18098.0,231
HCPCS,37735,LIG&DIV&COMPL STRPG SAPH VN,,,2765.32,3285.94,20
HCPCS,37735,LIGJ & DIVJ RADICAL STRIP LONG/SHORT SAPHENOUS,4360.0,2834.0,1.1,9296.26,144
HCPCS,37735,Lig&div&compl strpg saph vn,,,2140.36,2478.31,8
HCPCS,3775F,ADENOMA DETECTED SCREENING,,,2739849.3,2739849.3,1
HCPCS,3775F,Adenoma detected screening,,,10.69,12.38,8
HCPCS,37760,LIG PRFRATR VEIN SUBFSCAL RAD INCL SKN GRF 1 LEG,4312.0,2802.8,1.1,9296.26,144
HCPCS,37760,LIG PRFRATR VN RADICAL 1 LEG,,,2765.32,3285.94,20
HCPCS,37760,Lig prfratr vn radical 1 leg,,,2140.36,2478.31,8
HCPCS,37761,LIG PRFRATR VEIN SUBFSCAL OPEN INCL US GID 1 LEG,3652.0,2373.8,1.1,9296.26,144
HCPCS,37761,LIGATE LEG VEINS OPEN,1100.0,715.0,1.1,9296.26,164
HCPCS,37761,Ligate leg veins open,,,2140.36,2478.31,8
HCPCS,37765,PHLEB VEINS - EXTREM - TO 20,2112.0,1372.8,1.1,9296.26,148
HCPCS,37765,STAB PHLEBT VARICOSE VEINS 1 XTR 10-20 STAB INCS,10105.0,6568.25,0.01,18098.0,235
HCPCS,37766,PHLEB VEINS - EXTREM 20+,2640.0,1716.0,1.1,9296.26,148
HCPCS,37766,STAB PHLEBT VARICOSE VEINS 1 XTR > 20 INCS,10369.0,6739.85,0.01,18098.0,235
HCPCS,3776F,ADENOMA NOT DETECT SCREENING,,,2739849.3,2739849.3,1
HCPCS,3776F,Adenoma not detect screening,,,10.69,12.38,8
HCPCS,37780,LIGJ & DIV SHORT SAPH VEIN SAPHENOPOP JUNCT SPX,1572.0,1021.8,1.1,9296.26,144
HCPCS,37780,REVISION OF LEG VEIN,,,2765.32,3285.94,20
HCPCS,37780,Revision of leg vein,,,2140.36,2478.31,8
HCPCS,37785,LIGJ DIVJ &/EXCJ VARICOSE VEIN CLUSTER 1 LEG,9913.5,6443.775000000001,0.01,18098.0,235
HCPCS,37788,REVASCULARIZATION PENIS,,,3282.3,3282.3,1
HCPCS,37788,Revascularization penis,,,2812.29,3256.34,8
HCPCS,37790,PENILE VENOUS OCCLUSION,,,3024.43,3668.39,20
HCPCS,37790,Penile venous occlusion,,,1192.85,1381.19,8
HCPCS,37799,AORTIC ARTERIAL JUMP GRAFT (COMP CODE 47147),2521.0,1638.65,0.01,2521.0,84
HCPCS,37799,BILAT MIDDLE MENINGEAL ARTERY LIDOCAINE INFUSION (COMP CODE 6165,5400.5,3510.325,0.01,6801.0,169
HCPCS,37799,"BYPASS GRAFT, WITH OTHER THAN VEIN; AXILLARY-BRACHIAL (COMP TO 3",9954.0,6470.1,0.01,9954.0,84
HCPCS,37799,"BYPASS GRAFT, WITH OTHER THAN VEIN; CAROTID-AXILLARY (COMP CODE",7412.0,4817.8,0.01,7412.0,84
HCPCS,37799,CAROTID TO CAROTID TRANSPOSITION (COMP CODE 35695),6620.0,4303.0,0.01,6620.0,84
HCPCS,37799,"CATH. OF UMBILICAL VEIN FOR DIAGNOSIS OR THERAPY, FETUS (COMP 36",461.0,299.65,0.01,2283.59,84
HCPCS,37799,"CREATION OF AVF, PERCUTANEOUS USING MAGNETIC-GUIDED ARTERIAL AND",2288.0,1487.2,0.01,2288.0,84
HCPCS,37799,CREATION OF MESORENAL SHUNT (SUP MESENTERIC VEIN TO RENAL VEIN),14401.0,9360.65,0.01,14401.0,84
HCPCS,37799,CRYOABLATION AVM (COMP CODE 20983),17806.5,11574.225,0.01,32861.0,169
HCPCS,37799,DISRUPTION-FIBRIN SHEATH W/BALLOON,3448.0,2241.2,545.0,4628.0,85
HCPCS,37799,ENDOVASC REPR ASCENDING THORACIC AORTA,21965.0,14277.25,0.01,21965.0,84
HCPCS,37799,"ENDOVASCULAR ATHERECTOMY/ANGIOPLASTY, OPEN/PERQ, ILIAC VEIN (COM",45849.0,29801.85,545.0,45849.0,85
HCPCS,37799,EXCISION /LIGATION ABDOMINAL VEINS (COMP CODE 35221),11314.0,7354.1,0.01,11314.0,84
HCPCS,37799,EXCISION OF GRAFT (COMP 35907),13418.0,8721.7,0.01,13418.0,84
HCPCS,37799,EXCISION OF INTERNAL JUGULAR VEIN TUMOR THROMBUS (COMP CODE 3447,7600.0,4940.0,0.01,7600.0,84
HCPCS,37799,EXCISION OF VEIN (COMP CODE 35206),3121.0,2028.65,0.01,3121.0,84
HCPCS,37799,"EXPLORATION OF VEIN, NOT FOLLOWED BY SURGICAL REPAIR (COMP CODE",2848.0,1851.2,0.01,2848.0,84
HCPCS,37799,EXTERNAL CAROTID ART ONLY UNI,4133.0,2686.45,545.0,4628.0,85
HCPCS,37799,EXTRACORPOREAL CARBO DIOXIDE REMOVAL (COMP 33958),1274.0,828.1,0.01,2283.59,84
HCPCS,37799,FENESTRATED ENDOGRAFT MAIN BODY 1 EXT,12158.0,7902.7,0.01,12158.0,84
HCPCS,37799,FENESTRATED MN BODY 4 EXT,18412.0,11967.8,0.01,18412.0,84
HCPCS,37799,FIBRIN SHEATH DISRUPTION W/BALLOON (COMP CODE 36595),9767.0,6348.55,0.01,18098.0,169
HCPCS,37799,INSERTION OF ENDOVASCULAR IVC FLOW REGULATOR DEVICE (COMP CODE 3,28274.0,18378.1,545.0,28274.0,85
HCPCS,37799,"LIGATION, AV FISTULA",1052.0,683.8,0.01,2283.59,84
HCPCS,37799,PERCUTANEOUS HEPATIC PERFUSION DELIVERY OF INTRA-ARTERIAL HIGH D,964.5,626.925,0.01,4628.0,169
HCPCS,37799,PORTAL/HEPATIC VEIN THROMBECTOMY (COMP CODE 34401),4339.0,2820.35,0.01,4339.0,84
HCPCS,37799,RELEASE MEDIAN LIGAMENT,4937.0,3209.05,0.01,4937.0,84
HCPCS,37799,REPAIR AORTOENTERIC FISTULA (COMP 35189),14676.0,9539.4,0.01,14676.0,84
HCPCS,37799,RESECTION VENOUS ANEURYSM,4531.0,2945.15,0.01,4531.0,84
HCPCS,37799,SELECTIVE EXTERNAL CAROTID ANGIOGRAPHY (COMP CODE 36227),3693.0,2400.45,0.01,6466.0,169
HCPCS,37799,"SPLENECTOMY,GASTROESOPHAGEAL DEVASCULARIZ",9883.0,6423.95,0.01,9883.0,84
HCPCS,37799,STAB INCISION UNDER 10 (COMP CODE 37765),2289.0,1487.85,0.01,2289.0,84
HCPCS,37799,STAB PHLEB VARICOSE LESS THAN 10,2289.0,1487.85,0.01,2289.0,84
HCPCS,37799,SUPERCHARGE COLONIC CONDUIT W/MVA (COMP 15757),6130.0,3984.5,0.01,6130.0,84
HCPCS,37799,THROMBECTOMY HEPATIC ARTERY ANASTOMOSIS,9244.0,6008.6,0.01,9244.0,84
HCPCS,37799,TRANSCATH RENAL DENERVATN,761.0,494.65,0.01,2283.59,84
HCPCS,37799,UNLISTED PROCEDURE VASCULAR SURGERY,823.0,534.95,0.01,2283.59,168
HCPCS,37799,UNLISTED VASC PROCEDURE,15286.0,9935.9,0.01,21965.0,254
HCPCS,37799,VASCULAR SURGERY PROCEDURE,110.0,71.5,0.01,2283.59,84
HCPCS,37799,VENA CAVA RESECTION WITH RECONSTRUCTION (COMP 34502),11116.0,7225.4,0.01,11116.0,84
HCPCS,37799,VENOUS SINUS TEST BALLOON OCCLUSION (COMP CODE 61623),26498.0,17223.7,0.01,49016.0,169
HCPCS,38100,REMOVAL OF SPLEEN TOTAL,,,3023.29,3023.29,1
HCPCS,38100,Removal of spleen total,,,2029.97,2350.49,8
HCPCS,38100,SPLENECTOMY TOTAL SEPARATE PROCEDURE,7820.0,5083.0,1.1,7820.0,144
HCPCS,38101,REMOVAL OF SPLEEN PARTIAL,,,3062.85,3062.85,1
HCPCS,38101,Removal of spleen partial,,,2029.97,2350.49,8
HCPCS,38101,SPLENECTOMY PARTIAL SEPARATE PROCEDURE,7820.0,5083.0,1.1,7820.0,144
HCPCS,38102,REMOVAL OF SPLEEN TOTAL,,,687.11,687.11,1
HCPCS,38102,Removal of spleen total,,,2029.97,2350.49,8
HCPCS,38102,SPLENC TOT EN BLOC EXTNSV DS CONJUNCT W/OTH PX,1916.0,1245.4,1.1,1916.0,144
HCPCS,38115,REPAIR OF RUPTURED SPLEEN,,,3398.75,3398.75,1
HCPCS,38115,RPR RPTD SPLEEN SPLENORRHAPHY W/WO PRTL SPLENECT,8752.0,5688.8,1.1,8752.0,144
HCPCS,38115,Repair of ruptured spleen,,,2029.97,2350.49,8
HCPCS,38120,LAPAROSCOPY SPLENECTOMY,,,8930.36,26873.26,21
HCPCS,38120,"LAPAROSCOPY, SURGICAL, SPLENECTOMY",6828.0,4438.2,1.1,30022.29,144
HCPCS,38120,Laparoscopy splenectomy,,,2029.97,2350.49,8
HCPCS,38129,"UNLIST LAP PROC, SPLEEN COMPARED TO 47300",6585.0,4280.25,0.01,16829.38,84
HCPCS,38129,"UNLISTED LAPAROSCOPY PROCEDURE, SPL",3856.0,2506.4,0.01,16829.38,84
HCPCS,38129,UNLISTED LAPS PX SPLEEN,,,5005.78,15063.4,21
HCPCS,38129,Unlisted laps px spleen,,,2029.97,2350.49,8
HCPCS,38200,INJECTION PROCEDURE SPLENOPORTOGRAPY,2243.0,1457.95,1.1,4628.0,212
HCPCS,38204,ACTIVATE DONOR SEARCH,2941.0,1911.65,405.62,2941.0,132
HCPCS,38205,BLD-DRV HEMATOP PROGEN CELL HRVG TRNSPLJ ALGNC,660.0,429.0,1.1,660.0,142
HCPCS,38205,HARV STEM CELL ALLOGENIC,5800.0,3770.0,93.12,9509.0,68
HCPCS,38206,BLD-DRV HEMATOP PROGEN CELL HRVG TRNSPLJ AUTOL,3608.5,2345.525,0.01,6557.0,231
HCPCS,38207,CRYOPRSRV/STRGE HEMATOPOIE CELL,1749.0,1136.85,376.61,2453.0,84
HCPCS,38207,TRNSPL PREPJ HEMATOP PROGEN CELLS CRYOPRSRV STOR,356.0,231.4,1.1,1267.25,98
HCPCS,38208,HEMATOPOIETIC THAW,1749.0,1136.85,376.61,2453.0,84
HCPCS,38209,TRNSP PREP HMATOP PROG THAW PREV HRV WSH PER DNR,96.0,62.4,1.1,1267.25,98
HCPCS,38209,WASHING HEMATOPOIETIC CELLS,1749.0,1136.85,376.61,2453.0,84
HCPCS,38210,T-CELL DEPLETION OF HARVEST CD34+,1749.0,1136.85,376.61,2453.0,84
HCPCS,38210,TRNSPL PREPJ HEMATOP PROGEN DEPLJ IN HRV T-CELL,628.0,408.2,1.1,1267.25,98
HCPCS,38211,TUMOR CELL DEPLETE OF HARVST,,,376.61,1133.29,21
HCPCS,38211,Tumor cell deplete of harvst,,,1580.94,1830.57,8
HCPCS,38212,TRNSPL PREPJ HEMATOP PROGEN RED BLD CELL RMVL,1062.5,690.625,0.01,2351.0,183
HCPCS,38213,PLATELET DEPLETE OF HARVEST,,,376.61,1133.29,21
HCPCS,38213,Platelet deplete of harvest,,,1580.94,1830.57,8
HCPCS,38214,TRNSPL PREPJ HEMATOP PROGEN PLSM VOL DEPLJ,1036.5,673.7249999999999,0.01,2351.0,183
HCPCS,38215,ALLO HPC(M) RBC COMP,1749.0,1136.85,376.61,2453.0,84
HCPCS,38215,TRNSPL PREPJ HEMATOP PROGEN CONCENTRATION PLSM,376.0,244.4,1.1,1267.25,98
HCPCS,38220,DIAGNOSTIC BONE MARROW ASPIRATIONS,3480.5,2262.325,0.01,6481.0,409
HCPCS,38221,DIAGNOSTIC BONE MARROW BIOPSIES,3496.5,2272.725,0.01,6481.0,409
HCPCS,38222,DIAGNOSTIC BONE MARROW BIOPSIES & ASPIRATIONS,6041.0,3926.65,0.01,11448.0,322
HCPCS,38225,CAR-T THERAPY HRVG BLD DRV T LMPHCYT PR DAY,1076.0,699.4,149.22,2453.0,66
HCPCS,38225,CAR-T THERAPY HRVG BLD-DRV T LYMPHCYT PR DAY,854.0,555.1,1.1,854.0,106
HCPCS,38226,CAR-T THERAPY PREPJ BLD-DRV T LYMPHCYT F/TRNS,348.0,226.2,1.1,2453.0,172
HCPCS,38227,CAR-T THERAPY RECEIPT & PREPJ CAR-T CELLS F/ADMN,352.0,228.8,1.1,4330.51,172
HCPCS,38228,CAR-T THERAPY AUTOL CAR-T CELL ADMINISTRATION,1320.0,858.0,1.1,1449.2,144
HCPCS,38228,CAR-T THERAPY AUTOLOGOUS CELL ADMINISTRATION,1327.0,862.55,149.22,2453.0,84
HCPCS,38230,BONE MARROW HARV TRANSPLANT,41529.5,26994.175,222.51,43127.0,172
HCPCS,38230,BONE MARROW HARVEST TRANSPLANTATION ALLOGENEIC,1400.0,910.0,1.1,4475.18,142
HCPCS,38232,BONE MARROW HARVEST TRANSPLANTATION AUTOLOGOUS,10070.5,6545.825,1.1,18741.0,230
HCPCS,38240,TRANSPLT ALLO HCT/DONOR,131220.0,85293.0,267.23,131220.0,86
HCPCS,38240,TRNSPLJ ALLOGENEIC HEMATOPOIETIC CELLS PER DONOR,66490.0,43218.5,1.1,159374.03,230
HCPCS,38241,TRNSPLJ AUTOLOGOUS HEMATOPOIETIC CELLS PER DONOR,3938.5,2560.025,1.1,10651.0,316
HCPCS,38242,ALLOGENEIC LYMPHOCYTE INFUSIONS,3742.5,2432.625,1.1,6557.0,230
HCPCS,38243,TRANSPLJ HEMATOPOIETIC BOOST CD34+,6557.0,4262.05,135.96,6557.0,87
HCPCS,38243,TRNSPLJ HEMATOPOIETIC CELL BOOST,852.0,553.8,1.1,4475.18,142
HCPCS,38300,DRAINAGE LYMPH NODE LESION,,,2465.15,3022.89,20
HCPCS,38300,DRG LYMPH NODE ABSC/LYMPHADENITIS SMPL,944.0,613.6,1.1,8286.13,148
HCPCS,38300,Drainage lymph node lesion,,,2262.59,2619.84,8
HCPCS,38305,DRAINAGE LYMPH NODE LESION,,,2465.15,3022.89,20
HCPCS,38305,DRG LYMPH NODE ABSC/LYMPHADENITIS EXTNSV,2672.0,1736.8,1.1,8286.13,144
HCPCS,38305,Drainage lymph node lesion,,,2262.59,2619.84,8
HCPCS,38308,INCISION OF LYMPH CHANNELS,,,3306.89,7624.0,21
HCPCS,38308,Incision of lymph channels,,,2262.59,2619.84,8
HCPCS,38308,LYMPHANGIOTOMY/OTH OPRATIONS LYMPHATIC CHANNELS,2724.0,1770.6,1.1,11117.55,144
HCPCS,38380,SUTR&/LIG THORACIC DUCT CERVICAL APPROACH,3384.0,2199.6,1.1,3384.0,144
HCPCS,38380,THORACIC DUCT PROCEDURE,,,1509.79,1509.79,1
HCPCS,38380,Thoracic duct procedure,,,2262.59,2619.84,8
HCPCS,38381,SUTR&/LIG THORACIC DUCT THORACIC APPROACH,5352.0,3478.8,1.1,5352.0,144
HCPCS,38381,THORACIC DUCT PROCEDURE,,,2102.73,2102.73,1
HCPCS,38381,Thoracic duct procedure,,,3174.61,3675.86,8
HCPCS,38382,SUTR&/LIG THORACIC DUCT ABDOMINAL APPROACH,4260.0,2769.0,1.1,4260.0,144
HCPCS,38382,THORACIC DUCT PROCEDURE,,,1784.48,1784.48,1
HCPCS,38382,Thoracic duct procedure,,,2029.97,2350.49,8
HCPCS,38500,BX/EXC LYMPH NODE OPEN SUPERFICIAL,8416.5,5470.724999999999,0.01,15317.0,235
HCPCS,38505,BX/EXC LYMPH NODE NEEDLE SUPERFICIAL,3558.5,2313.0249999999996,0.01,6481.0,409
HCPCS,38510,BX/EXC LYMPH NODE OPEN DEEP CERVICAL NODE,9006.5,5854.224999999999,0.01,15317.0,235
HCPCS,38520,BIOPSY/REMOVAL LYMPH NODES,,,3306.89,4074.73,20
HCPCS,38520,BX/EXC LYMPH NODE OPN DP CRV NODE W/EXC FAT PAD,2812.0,1827.8,1.1,11117.55,144
HCPCS,38520,Biopsy/removal lymph nodes,,,2262.59,2619.84,8
HCPCS,38525,BIOPSY/REMOVAL LYMPH NODES,,,3306.89,7624.0,24
HCPCS,38525,BX/EXC LYMPH NODE OPEN DEEP AXILLARY NODE,2572.0,1671.8,1.1,11117.55,144
HCPCS,38525,Biopsy/removal lymph nodes,,,2262.59,2619.84,8
HCPCS,38530,BIOPSY/REMOVAL LYMPH NODES,,,3306.89,4074.73,20
HCPCS,38530,BX/EXC LYMPH NODE OPEN INT MAMMARY NODE,3336.0,2168.4,1.1,11117.55,144
HCPCS,38530,Biopsy/removal lymph nodes,,,2262.59,2619.84,8
HCPCS,38531,OPEN BIOPSY/EXCISION INGUINOFEMORAL NODES,2696.0,1752.4,1.1,11117.55,144
HCPCS,38531,OPEN BX/EXC INGUINOFEM NODES,,,3306.89,7778.0,22
HCPCS,38531,Open bx/exc inguinofem nodes,,,2262.59,2619.84,8
HCPCS,38542,DISSECTION DEEP JUGULAR NODE,3180.0,2067.0,1.1,16829.38,144
HCPCS,38542,EXPLORE DEEP NODE(S) NECK,,,5005.78,6291.49,20
HCPCS,38542,Explore deep node(s) neck,,,2262.59,2619.84,8
HCPCS,38550,EXC CSTIC HYGROMA AX/CRV W/O DP NEUROVASC DSJ,2844.0,1848.6,1.1,11117.55,144
HCPCS,38550,REMOVAL NECK/ARMPIT LESION,,,3306.89,4074.73,20
HCPCS,38550,Removal neck/armpit lesion,,,2262.59,2619.84,8
HCPCS,38555,EXC CSTIC HYGROMA AX/CRV W/DP NEUROVASC DSJ,6236.0,4053.4,1.1,19017.99,144
HCPCS,38555,REMOVAL NECK/ARMPIT LESION,,,5657.4,6910.32,20
HCPCS,38555,Removal neck/armpit lesion,,,2262.59,2619.84,8
HCPCS,38562,LMTD LMPHADEC STAGING SPX PEL&PARA-AORTIC,4424.0,2875.6,1.1,4424.0,144
HCPCS,38562,REMOVAL PELVIC LYMPH NODES,,,1849.28,8505.92,13
HCPCS,38562,Removal pelvic lymph nodes,,,2029.97,2350.49,8
HCPCS,38564,LMTD LMPHADEC STAGING SPX RPR AORTIC&/SPLENIC,4552.0,2958.8,1.1,4552.0,144
HCPCS,38564,REMOVAL ABDOMEN LYMPH NODES,,,1839.12,1839.12,1
HCPCS,38564,Removal abdomen lymph nodes,,,2029.97,2350.49,8
HCPCS,38570,LAPAROSCOPY LYMPH NODE BIOP,,,5005.78,33436.0,24
HCPCS,38570,LAPS SURG RETROPERITONEAL LYMPH NODE BX 1/MLT,3736.0,2428.4,1.1,16829.38,144
HCPCS,38570,Laparoscopy lymph node biop,,,2029.97,2350.49,8
HCPCS,38571,LAPAROSCOPY LYMPHADENECTOMY,,,4616.0,33436.0,24
HCPCS,38571,LAPS SURG BILATERAL TOTAL PELVIC LMPHADECTOMY,5280.0,3432.0,1.1,30022.29,144
HCPCS,38571,Laparoscopy lymphadenectomy,,,2029.97,2350.49,8
HCPCS,38572,LAPAROSCOPY LYMPHADENECTOMY,,,8930.36,11062.31,20
HCPCS,38572,LAPS BI TOT PEL LMPHADEC & PRI-AORTIC LYMPH BX 1,6240.0,4056.0,1.1,30022.29,144
HCPCS,38572,Laparoscopy lymphadenectomy,,,2029.97,2350.49,8
HCPCS,38573,LAPS PELVIC LYMPHADEC,,,8930.36,11062.31,20
HCPCS,38573,LAPS W/BI TOT PEL LMPHADEC & OMNTC LYMPH BX,8000.0,5200.0,1.1,30022.29,144
HCPCS,38573,Laps pelvic lymphadec,,,2029.97,2350.49,8
HCPCS,38589,LAP ROBOTIC RETROPERITONEAL LYMPHADENECTOMY COMP 38780,7016.0,4560.4,0.01,16829.38,84
HCPCS,38589,LAPAROSCOPIC LYMPHANDECTOMY,1360.0,884.0,0.01,16829.38,84
HCPCS,38589,"UNLIST LAP PROC, LYMPHATIC SYSTEM COMPARED TO 38747",1610.0,1046.5,0.01,16829.38,84
HCPCS,38589,"UNLISTED LAPAROSCOPY PROCEDURE, LYMPHATIC SYSTEM (COMPARISON COD",1753.5,1139.775,0.01,16829.38,168
HCPCS,38589,UNLISTED LAPS PX LYMPHTC SYS,,,5005.78,6291.49,20
HCPCS,38589,UNLISTED PROC; LAP INGUINAL LYMPH NODE DISSECTION (COMPARED TO 3,4495.0,2921.75,0.01,16829.38,84
HCPCS,38589,Unlisted laps px lymphtc sys,,,2029.97,2350.49,8
HCPCS,38700,REMOVAL OF LYMPH NODES NECK,,,5657.4,17024.28,23
HCPCS,38700,Removal of lymph nodes neck,,,2262.59,2619.84,8
HCPCS,38700,SUPRAHYOID LYMPHADENECTOMY,5124.0,3330.6,1.1,19017.99,144
HCPCS,38720,CERVICAL LYMPHADENECTOMY,8780.0,5707.0,1.1,19017.99,144
HCPCS,38720,REMOVAL OF LYMPH NODES NECK,,,4616.0,17024.28,22
HCPCS,38720,Removal of lymph nodes neck,,,2262.59,2619.84,8
HCPCS,38724,CERVICAL LYMPHADEC MODIFIED RADICAL NECK DSJ,9580.0,6227.0,1.1,9580.0,144
HCPCS,38724,REMOVAL OF LYMPH NODES NECK,,,3795.67,3795.67,1
HCPCS,38724,Removal of lymph nodes neck,,,2262.59,2619.84,8
HCPCS,38740,AXILLARY LYMPHADENECTOMY SUPERFICIAL,4280.0,2782.0,1.1,16829.38,144
HCPCS,38740,REMOVE ARMPIT LYMPH NODES,,,5005.78,6291.49,20
HCPCS,38740,Remove armpit lymph nodes,,,1713.83,1984.43,8
HCPCS,38745,AXILLARY LYMPHADENECTOMY COMPLETE,5548.0,3606.2,1.1,16829.38,144
HCPCS,38745,REMOVE ARMPIT LYMPH NODES,,,5005.78,11441.0,21
HCPCS,38745,Remove armpit lymph nodes,,,1713.83,1984.43,8
HCPCS,38746,REMOVE THORACIC LYMPH NODES,,,558.06,558.06,1
HCPCS,38746,Remove thoracic lymph nodes,,,673.41,779.74,8
HCPCS,38746,THORCOM THRC W/MEDSTNL & REGIONAL LMPHADEC,1648.0,1071.2,1.1,1648.0,144
HCPCS,38747,ABDL LMPHADEC REG CELIAC GSTR PORTAL PRIPNCRTC,1952.0,1268.8,1.1,1952.0,144
HCPCS,38747,REMOVE ABDOMINAL LYMPH NODES,,,699.33,699.33,1
HCPCS,38747,Remove abdominal lymph nodes,,,2029.97,2350.49,8
HCPCS,38760,INGUINOFEM LMPHADEC SUPFC W/CLOQUETS NODE SPX,5448.0,3541.2,1.1,19017.99,144
HCPCS,38760,REMOVE GROIN LYMPH NODES,,,5657.4,6910.32,20
HCPCS,38760,Remove groin lymph nodes,,,2262.59,2619.84,8
HCPCS,38765,INGUINOFEM LMPHADEC SUPFC W/PEL LMPHADEC,8764.0,5696.6,1.1,8764.0,144
HCPCS,38765,REMOVE GROIN LYMPH NODES,,,3433.36,3433.36,1
HCPCS,38765,Remove groin lymph nodes,,,2262.59,2619.84,8
HCPCS,38770,PEL LMPHADEC W/XTRNL ILIAC HYPOGSTR&OBTURATOR,5624.0,3655.6,1.1,5624.0,144
HCPCS,38770,REMOVE PELVIS LYMPH NODES,,,2111.91,2111.91,1
HCPCS,38770,Remove pelvis lymph nodes,,,2029.97,2350.49,8
HCPCS,38780,REMOVE ABDOMEN LYMPH NODES,,,2756.93,2756.93,1
HCPCS,38780,RPR TABDL LMPHADEC EXTNSV W/PEL AORTIC&RNL,7080.0,4602.0,1.1,7080.0,144
HCPCS,38780,Remove abdomen lymph nodes,,,2029.97,2350.49,8
HCPCS,38790,INJECTION PROCEDURE LYMPHANGIOGRAPHY,2162.5,1405.625,0.01,4628.0,280
HCPCS,38792,INJ RADIOACTIVE TRACER FOR ID OF SENTINEL NODE,933.5,606.775,0.01,3443.0,321
HCPCS,38794,CANNULATION THORACIC DUCT,4497.5,2923.375,1.1,12615.0,212
HCPCS,38900,INTRAOP SENTINEL LYMPH NODE ID W/DYE INJECTION,1000.0,650.0,1.1,1000.0,144
HCPCS,38900,IO MAP OF SENT LYMPH NODE,,,4132.0,4132.0,1
HCPCS,38900,Io map of sent lymph node,,,81.99,94.94,8
HCPCS,38999,ALLOGENEIC ADMINISTRATION NKX 101 (COMP 0537T),1522.0,989.3,0.01,1522.0,84
HCPCS,38999,ALLOGENEIC INFUSION ALLO 715 (COMP 0540T),4333.0,2816.45,0.01,4333.0,84
HCPCS,38999,ALLOGENEIC INFUSION PBSC 1490 (COMP 0540T),4333.0,2816.45,0.01,4333.0,84
HCPCS,38999,EXCISION PENILE LYMPHEDEMA,12429.0,8078.85,0.01,12429.0,84
HCPCS,38999,ICG LYMPHOGRAPHY,1815.5,1180.075,0.01,3443.0,169
HCPCS,38999,"IMMEDIATE LVA (COMP 35206, 38308, 69990)",4774.0,3103.1,0.01,4774.0,84
HCPCS,38999,LNVA - MICROSURGERY,14750.0,9587.5,0.01,14750.0,84
HCPCS,38999,"LVA/LVB MICROSURGERY - PREVENTATIVE (COMP 35206, 38308, 69990)",4000.0,2600.0,0.01,4000.0,84
HCPCS,38999,"LVA/LVB MICROSURGERY - THERAPEUTIC (COMP 35206, 38308, 69990)",20000.0,13000.0,0.01,20000.0,84
HCPCS,38999,RESEARCH CAR T ALLOGENEIC COLLECTION (COMP 0537T),1281.0,832.65,0.01,1281.0,84
HCPCS,38999,RESEARCH IMMUNE EFFECTOR CELL (IEC) INFUSION (COMP 96413),650.0,422.5,0.01,1267.25,84
HCPCS,38999,RESEARCH IMMUNE EFFECTOR CELL COLLECTION FOR AUTO AND ALLO (COMP,1281.0,832.65,0.01,1281.0,84
HCPCS,38999,"THERAPEUTIC LVA (COMP 35206, 38308, 69990)",7956.0,5171.4,0.01,7956.0,84
HCPCS,38999,UNLISTED MAGTRACE INJECTION ADMINISTRATION (COMP CODE 38900),1063.0,690.95,0.01,1267.25,84
HCPCS,38999,UNLISTED PROCEDURE HEMIC/LYMPH,1423.0,924.95,376.61,4628.0,84
HCPCS,38999,"UNLISTED PROCEDURE, HEMIC OR LYMPHATIC SYSTEM (COMPARISON CODE 3",410.0,266.5,0.01,1267.25,84
HCPCS,39000,EXPLORATION OF CHEST,,,1317.34,1317.34,1
HCPCS,39000,Exploration of chest,,,1722.25,1994.18,8
HCPCS,39000,MEDIAST W/EXPL DRG RMVL FB/BX CRV APPR,3028.0,1968.2,1.1,3028.0,144
HCPCS,39010,EXPLORATION OF CHEST,,,2058.43,2058.43,1
HCPCS,39010,Exploration of chest,,,3174.61,3675.86,8
HCPCS,39010,MEDIAST W/EXPL DRG RMVL FB/BX TTHRC APPR,5276.0,3429.4,1.1,5276.0,144
HCPCS,39200,RESECT MEDIASTINAL CYST,,,2269.95,2269.95,1
HCPCS,39200,RESECTION OF MEDIASTINAL CYST,6036.0,3923.4,1.1,6036.0,144
HCPCS,39200,Resect mediastinal cyst,,,3174.61,3675.86,8
HCPCS,39220,RESECT MEDIASTINAL TUMOR,,,2960.3,2960.3,1
HCPCS,39220,RESECTION MEDIASTINAL TUMOR,7820.0,5083.0,1.1,7820.0,144
HCPCS,39220,Resect mediastinal tumor,,,3174.61,3675.86,8
HCPCS,39401,MEDIASTINOSCOPY INCLUDES MEDIASTINAL MASS BIOPSY,2176.0,1414.4,1.1,16829.38,144
HCPCS,39401,MEDIASTINOSCPY W/MEDSTNL BX,,,5005.78,6291.49,20
HCPCS,39401,Mediastinoscpy w/medstnl bx,,,1722.25,1994.18,8
HCPCS,39402,MEDIASTINOSCOPY WITH LYMPH NODE BIOPSY/IES,2900.0,1885.0,1.1,16829.38,144
HCPCS,39402,MEDIASTINOSCPY W/LMPH NOD BX,,,5005.78,6291.49,21
HCPCS,39402,Mediastinoscpy w/lmph nod bx,,,1722.25,1994.18,8
HCPCS,39499,UNLISTED PX MEDIASTINUM,,,2739999.97,2739999.97,1
HCPCS,39499,Unlisted px mediastinum,,,760.55,880.64,8
HCPCS,39501,REPAIR DIAPHRAGM LACERATION,,,2236.61,2236.61,1
HCPCS,39501,REPAIR LACERATION DIAPHRAGM ANY APPROACH,5592.0,3634.8,1.1,5592.0,144
HCPCS,39501,Repair diaphragm laceration,,,5578.94,6459.83,8
HCPCS,39503,REPAIR OF DIAPHRAGM HERNIA,,,15141.16,15141.16,1
HCPCS,39503,RPR NEONATAL DIPHRG HERNIA W/WO CHEST TUBE INSJ,43564.0,28316.6,1.1,43564.0,144
HCPCS,39503,Repair of diaphragm hernia,,,5578.94,6459.83,8
HCPCS,39540,REPAIR OF DIAPHRAGM HERNIA,,,2276.2,2276.2,1
HCPCS,39540,RPR DIPHRG HRNA OTH/THN NEONATAL TRAUMTC AQT,5828.0,3788.2,1.1,5828.0,144
HCPCS,39540,Repair of diaphragm hernia,,,5578.94,6459.83,8
HCPCS,39541,REPAIR OF DIAPHRAGM HERNIA,,,2446.87,2446.87,1
HCPCS,39541,RPR DIPHRG HRNA OTH/THN NEONATAL TRAUMTC CHRNC,6300.0,4095.0,1.1,6300.0,144
HCPCS,39541,Repair of diaphragm hernia,,,5578.94,6459.83,8
HCPCS,39545,IMBRICATION DIAPHRAGM EVENTRATION,5868.0,3814.2,1.1,5868.0,144
HCPCS,39545,REVISION OF DIAPHRAGM,,,2336.4,2336.4,1
HCPCS,39545,Revision of diaphragm,,,5578.94,6459.83,8
HCPCS,39560,RESCJ DIAPHRAGM W/SIMPLE REPAIR,5224.0,3395.6,1.1,5224.0,144
HCPCS,39560,RESECT DIAPHRAGM SIMPLE,,,2101.85,2101.85,1
HCPCS,39560,Resect diaphragm simple,,,5578.94,6459.83,8
HCPCS,39561,RESCJ DIAPHRAGM W/COMPLEX REPAIR,7996.0,5197.4,1.1,7996.0,144
HCPCS,39561,RESECT DIAPHRAGM COMPLEX,,,3280.52,3280.52,1
HCPCS,39561,Resect diaphragm complex,,,5578.94,6459.83,8
HCPCS,39599,LAP OR ROBOTIC REPAIR OF DIAPHRAGMATIC HERNIA; CHRONIC (COMP COD,5671.0,3686.15,0.01,3061000.0,84
HCPCS,39599,"UNLISTED PROC, LAPAROSCOPIC REPAIR OF DIAPHRAGMATIC HERNIA (NON-",4808.0,3125.2,0.01,3061000.0,84
HCPCS,39599,UNLISTED PROC; LAP DIAPHRAGM RESECTION (COMP TO 39560),5224.0,3395.6,0.01,3061000.0,84
HCPCS,39599,UNLISTED PX DIAPHRAGM,,,2739999.97,2739999.97,1
HCPCS,39599,UNLISTED THORACOSCOPIC REPAIR CONGENITAL DIAPHRAGMATIC HERNIA-NE,43564.0,28316.6,0.01,3061000.0,84
HCPCS,39599,Unlisted px diaphragm,,,5578.94,6459.83,8
HCPCS,39599,VATS PLICATION OF DIAPHRAGM (COMP CODE 39545),4841.0,3146.65,0.01,3061000.0,84
HCPCS,4000F,TOBACCO USE TXMNT COUNSELING,,,0.03,0.03,1
HCPCS,4000F,Tobacco use txmnt counseling,,,10.69,12.38,8
HCPCS,4001F,TOBACCO USE TXMNT PHARMACOL,,,0.03,0.03,1
HCPCS,4001F,Tobacco use txmnt pharmacol,,,10.69,12.38,8
HCPCS,4003F,PT ED WRITE/ORAL PTS W/ HF,,,2739849.3,2739849.3,1
HCPCS,4003F,Pt ed write/oral pts w/ hf,,,10.69,12.38,8
HCPCS,4004F,PT TOBACCO SCREEN RCVD TLK,,,0.03,0.03,1
HCPCS,4004F,Pt tobacco screen rcvd tlk,,,10.69,12.38,8
HCPCS,4005F,PHARM THX FOR OP RXD,,,0.03,0.03,1
HCPCS,4005F,Pharm thx for op rxd,,,10.69,12.38,8
HCPCS,4008F,BETA-BLOCKER THERAPY RXD/TKN,,,0.03,0.03,1
HCPCS,4008F,Beta-blocker therapy rxd/tkn,,,10.69,12.38,8
HCPCS,4010F,ACE/ARB THERAPY RXD/TAKEN,,,0.03,0.03,1
HCPCS,4010F,Ace/arb therapy rxd/taken,,,10.69,12.38,8
HCPCS,4011F,ORAL ANTIPLATELET THERAPY RX,,,0.03,0.03,1
HCPCS,4011F,Oral antiplatelet therapy rx,,,10.69,12.38,8
HCPCS,4012F,WARFARIN THERAPY RX,,,2739849.3,2739849.3,1
HCPCS,4012F,Warfarin therapy rx,,,10.69,12.38,8
HCPCS,4013F,STATIN THERAPY/CURRENTLY TKN,,,0.03,0.03,1
HCPCS,4013F,Statin therapy/currently tkn,,,10.69,12.38,8
HCPCS,4014F,WRITTEN DISCHARGE INSTR PRVD,,,2739849.3,2739849.3,1
HCPCS,4014F,Written discharge instr prvd,,,10.69,12.38,8
HCPCS,4015F,PERSIST ASTHMA MEDICINE CTRL,,,0.03,0.03,1
HCPCS,4015F,Persist asthma medicine ctrl,,,10.69,12.38,8
HCPCS,4016F,ANTI-INFLM/ANLGSC AGENT RX,,,2739849.3,2739849.3,1
HCPCS,4016F,Anti-inflm/anlgsc agent rx,,,10.69,12.38,8
HCPCS,4017F,GI PROPHYLAXIS FOR NSAID RX,,,2739849.3,2739849.3,1
HCPCS,4017F,Gi prophylaxis for nsaid rx,,,10.69,12.38,8
HCPCS,4018F,THERAPY EXERCISE JOINT RX,,,2739849.3,2739849.3,1
HCPCS,4018F,Therapy exercise joint rx,,,10.69,12.38,8
HCPCS,4019F,DOC RECPT COUNSL VIT D/CALC+,,,2739849.3,2739849.3,1
HCPCS,4019F,Doc recpt counsl vit d/calc+,,,10.69,12.38,8
HCPCS,4025F,INHALED BRONCHODILATOR RX,,,0.03,0.03,1
HCPCS,4025F,Inhaled bronchodilator rx,,,10.69,12.38,8
HCPCS,4030F,OXYGEN THERAPY RX,,,2739849.3,2739849.3,1
HCPCS,4030F,Oxygen therapy rx,,,10.69,12.38,8
HCPCS,4033F,PULMONARY REHAB REC,,,2739849.3,2739849.3,1
HCPCS,4033F,Pulmonary rehab rec,,,10.69,12.38,8
HCPCS,4035F,INFLUENZA IMM REC,,,2739849.3,2739849.3,1
HCPCS,4035F,Influenza imm rec,,,10.69,12.38,8
HCPCS,4037F,INFLUENZA IMM ORDER/ADMIN,,,0.03,0.03,1
HCPCS,4037F,Influenza imm order/admin,,,10.69,12.38,8
HCPCS,4040F,PNEUMOC VAC/ADMIN/RCVD,,,0.03,0.03,1
HCPCS,4040F,Pneumoc vac/admin/rcvd,,,10.69,12.38,8
HCPCS,4041F,DOC ORDER CEFAZOLIN/CEFUROX,,,1.23,1.23,1
HCPCS,4041F,Doc order cefazolin/cefurox,,,10.69,12.38,8
HCPCS,4042F,DOC ANTIBIO NOT GIVEN,,,2739849.3,2739849.3,1
HCPCS,4042F,Doc antibio not given,,,10.69,12.38,8
HCPCS,4043F,DOC ORDER GIVEN STOP ANTIBIO,,,2739849.3,2739849.3,1
HCPCS,4043F,Doc order given stop antibio,,,10.69,12.38,8
HCPCS,4044F,DOC ORDER GIVEN VTE PROPHYLX,,,0.03,0.03,1
HCPCS,4044F,Doc order given vte prophylx,,,10.69,12.38,8
HCPCS,4045F,EMPIRIC ANTIBIOTIC RX,,,2739849.3,2739849.3,1
HCPCS,4045F,Empiric antibiotic rx,,,10.69,12.38,8
HCPCS,4046F,DOC ANTIBIO GIVEN B/4 SURG,,,0.03,0.03,1
HCPCS,4046F,Doc antibio given b/4 surg,,,10.69,12.38,8
HCPCS,4047F,DOC ANTIBIO GIVEN B/4 SURG,,,0.03,0.03,1
HCPCS,4047F,Doc antibio given b/4 surg,,,10.69,12.38,8
HCPCS,4048F,DOC ANTIBIO GIVEN B/4 SURG,,,0.03,0.03,1
HCPCS,4048F,Doc antibio given b/4 surg,,,10.69,12.38,8
HCPCS,40490,BIOPSY OF LIP,778.0,505.70000000000005,0.01,12500.0,235
HCPCS,4049F,DOC ORDER GIVEN STOP ANTIBIO,,,0.03,0.03,1
HCPCS,4049F,Doc order given stop antibio,,,10.69,12.38,8
HCPCS,40500,VERMILIONECTOMY LIP SHV W/MUCOSAL ADVMNT,8353.0,5429.450000000001,0.01,14918.0,235
HCPCS,4050F,Ht care plan doc,,,10.69,12.38,8
HCPCS,40510,EXC LIP TRANSVRS WEDGE EXC W/PRIM CLSR,8423.0,5474.950000000001,0.01,14918.0,235
HCPCS,4051F,REFERRED FOR AN AV FISTULA,,,2739849.3,2739849.3,1
HCPCS,4051F,Referred for an av fistula,,,10.69,12.38,8
HCPCS,40520,EXC LIP V-EXC W/PRIM DIR LINR CLSR,1916.0,1245.4,1.1,9391.15,148
HCPCS,40520,PARTIAL EXCISION OF LIP,,,2793.19,3450.35,20
HCPCS,40520,Partial excision of lip,,,939.63,1087.99,8
HCPCS,40525,EXC LIP FULL THKNS RCNSTJ W/LOCAL FLAP,3088.0,2007.2,1.1,9391.15,144
HCPCS,40525,RECONSTRUCT LIP WITH FLAP,,,2793.19,3450.35,20
HCPCS,40525,Reconstruct lip with flap,,,1558.4,1804.46,8
HCPCS,40527,EXC LIP FULL THKNS RCNSTJ W/CROSS LIP FLAP,3728.0,2423.2,1.1,17080.38,144
HCPCS,40527,RECONSTRUCT LIP WITH FLAP,,,5080.55,6160.68,20
HCPCS,40527,Reconstruct lip with flap,,,2710.76,3138.77,8
HCPCS,4052F,HEMODIALYSIS VIA AV FISTULA,,,2739849.3,2739849.3,1
HCPCS,4052F,Hemodialysis via av fistula,,,10.69,12.38,8
HCPCS,40530,RESCJ LIP > ONE-FOURTH W/O RCNSTJ,8567.0,5568.55,0.01,14918.0,235
HCPCS,4053F,HEMODIALYSIS VIA AV GRAFT,,,2739849.3,2739849.3,1
HCPCS,4053F,Hemodialysis via av graft,,,10.69,12.38,8
HCPCS,4054F,HEMODIALYSIS VIA CATHETER,,,2739849.3,2739849.3,1
HCPCS,4054F,Hemodialysis via catheter,,,10.69,12.38,8
HCPCS,4055F,PT RCVNG PERITON DIALYSIS,,,2739849.3,2739849.3,1
HCPCS,4055F,Pt rcvng periton dialysis,,,10.69,12.38,8
HCPCS,4056F,APPROP ORAL REHYD RECOMMD,,,2739849.3,2739849.3,1
HCPCS,4056F,Approp oral rehyd recommd,,,10.69,12.38,8
HCPCS,4058F,PED GASTRO ED GIVEN CAREGVR,,,2739849.3,2739849.3,1
HCPCS,4058F,Ped gastro ed given caregvr,,,10.69,12.38,8
HCPCS,4060F,PSYCH SVCS PROVIDED,,,2739849.3,2739849.3,1
HCPCS,4060F,Psych svcs provided,,,10.69,12.38,8
HCPCS,4062F,PT REFERRAL PSYCH DOCD,,,2739849.3,2739849.3,1
HCPCS,4062F,Pt referral psych docd,,,10.69,12.38,8
HCPCS,4063F,ANTIDEPRES RXTHXPY NOT RXD,,,2739849.3,2739849.3,1
HCPCS,4063F,Antidepres rxthxpy not rxd,,,10.69,12.38,8
HCPCS,4064F,ANTIDEPRESSANT RX,,,2739849.3,2739849.3,1
HCPCS,4064F,Antidepressant rx,,,10.69,12.38,8
HCPCS,40650,RPR LIP FULL THICKNESS VERMILION ONLY,1927.5,1252.875,1.1,7813.0,235
HCPCS,40652,RPR LIP FULL THICKNESS HALF/< VERTICAL HEIGHT,2057.5,1337.375,1.1,7813.0,322
HCPCS,40654,RPR LIP FULL THKNS >ONE-HALF VERT HEIGHT/COMPLE,4503.0,2926.9500000000003,0.01,7813.0,322
HCPCS,4065F,ANTIPSYCHOTIC RX,,,2739849.3,2739849.3,1
HCPCS,4065F,Antipsychotic rx,,,10.69,12.38,8
HCPCS,4066F,ECT PROVIDED,,,2739849.3,2739849.3,1
HCPCS,4066F,Ect provided,,,10.69,12.38,8
HCPCS,4067F,PT REFERRAL FOR ECT DOCD,,,2739849.3,2739849.3,1
HCPCS,4067F,Pt referral for ect docd,,,10.69,12.38,8
HCPCS,4069F,VTE PROPHYLAXIS RCVD,,,2739849.3,2739849.3,1
HCPCS,4069F,Vte prophylaxis rcvd,,,10.69,12.38,8
HCPCS,40700,PLSTC RPR CL LIP/NSL DFRM PRIM PRTL/COMPL UNI,5668.0,3684.2,1.1,17080.38,144
HCPCS,40700,REPAIR CLEFT LIP/NASAL,,,5080.55,9509.0,21
HCPCS,40700,Repair cleft lip/nasal,,,3314.27,3837.57,8
HCPCS,40701,PLSTC RPR CL LIP/NSL DFRM PRIM BI 1 STG PX,6892.0,4479.8,1.1,17080.38,144
HCPCS,40701,REPAIR CLEFT LIP/NASAL,,,5080.55,6160.68,20
HCPCS,40701,Repair cleft lip/nasal,,,3314.27,3837.57,8
HCPCS,40702,PLSTC RPR CL LIP/NSL DFRM PRIM BI 1 2 STGS,5708.0,3710.2,1.1,17080.38,144
HCPCS,40702,REPAIR CLEFT LIP/NASAL,,,5080.55,6160.68,20
HCPCS,40702,Repair cleft lip/nasal,,,3314.27,3837.57,8
HCPCS,4070F,DVT PROPHYLX RECVD DAY 2,,,0.03,0.03,1
HCPCS,4070F,Dvt prophylx recvd day 2,,,10.69,12.38,8
HCPCS,40720,PLSTC RPR CL LIP/NSL DFRM SEC RECRTJ DFCT & RECL,6477.0,4210.05,1.1,9391.15,144
HCPCS,40720,REPAIR CLEFT LIP/NASAL,,,2793.19,3450.35,20
HCPCS,40720,Repair cleft lip/nasal,,,3314.27,3837.57,8
HCPCS,4073F,ORAL ANTIPLAT THX RX DISCHRG,,,2739849.3,2739849.3,1
HCPCS,4073F,Oral antiplat thx rx dischrg,,,10.69,12.38,8
HCPCS,4075F,ANTICOAG THX RX AT DISCHRG,,,2739849.3,2739849.3,1
HCPCS,4075F,Anticoag thx rx at dischrg,,,10.69,12.38,8
HCPCS,40761,PLSTC RPR CL LIP/NSL DFRM W/CROSS LIP PEDCL FLAP,6336.0,4118.4,1.1,17080.38,144
HCPCS,40761,REPAIR CLEFT LIP/NASAL,,,5080.55,6160.68,20
HCPCS,40761,Repair cleft lip/nasal,,,3314.27,3837.57,8
HCPCS,4077F,DOC T-PA ADMIN CONSIDERED,,,2739849.3,2739849.3,1
HCPCS,4077F,Doc t-pa admin considered,,,10.69,12.38,8
HCPCS,40799,FOREIGN BODY REMOVAL (TOOTH) AND I&D (COMP CODE 10061),746.0,484.9,0.01,1087.99,85
HCPCS,40799,LIP LIFT UPPER (COMP 11444 + 13132),2525.0,1641.25,0.01,2525.0,84
HCPCS,40799,"UNLISTED PROCEDURE, LIPS",382.0,248.3,106.2,1087.99,84
HCPCS,4079F,DOC REHAB SVCS CONSIDERED,,,2739849.3,2739849.3,1
HCPCS,4079F,Doc rehab svcs considered,,,10.69,12.38,8
HCPCS,40800,DRG ABSC CST HMTMA VESTIBULE MOUTH SMPL,1864.5,1211.9250000000002,0.01,12500.0,322
HCPCS,40801,DRG ABSC CST HMTMA VESTIBULE MOUTH COMP,1697.5,1103.375,1.1,5265.0,235
HCPCS,40804,RMVL EMBEDDED FB VESTIBULE MOUTH SMPL,2416.5,1570.725,0.01,12500.0,322
HCPCS,40805,RMVL EMBEDDED FB VESTIBULE MOUTH COMP,1729.5,1124.175,1.1,5265.0,235
HCPCS,40806,INCISION LABIAL FRENUM FRENOTOMY,1233.5,801.775,0.01,12500.0,233
HCPCS,40808,BIOPSY VESTIBULE MOUTH,2343.0,1522.95,0.01,12500.0,87
HCPCS,40808,"BIOPSY, MOUTH, VESTIBULE",420.0,273.0,1.1,1603.96,148
HCPCS,40810,EXC LES MUCOSA & SBMCSL VESTIBULE MOUTH W/O RPR,7731.0,5025.150000000001,0.01,14918.0,235
HCPCS,40812,EXC LESION MUCOSA & SBMCSL VESTIBULE SMPL RPR,3881.0,2522.65,0.01,6814.0,235
HCPCS,40814,EXC LESION MUCOSA & SBMCSL VESTIBULE CPLX RPR,8163.0,5305.950000000001,0.01,14918.0,235
HCPCS,40816,EXC LESION MUCOSA&SBMCSL VESTIBULE CPLX EXC MUSC,1508.0,980.2,1.1,9391.15,148
HCPCS,40816,EXCISION OF MOUTH LESION,,,2793.19,3450.35,20
HCPCS,40816,Excision of mouth lesion,,,1358.5,1573.0,8
HCPCS,40818,EXC MUCOSA VESTIBULE MOUTH AS DON GRF,1132.0,735.8,1.1,1603.96,148
HCPCS,40818,EXCISE ORAL MUCOSA FOR GRAFT,,,472.1,4392.0,23
HCPCS,40818,Excise oral mucosa for graft,,,1358.5,1573.0,8
HCPCS,40819,EXC FRENUM LABIAL/BUCCAL,3909.0,2540.8500000000004,0.01,6814.0,235
HCPCS,40820,DSTRJ LES/SCAR VESTIBULE MOUTH PHYSICAL METHS,7727.0,5022.55,0.01,14918.0,235
HCPCS,40830,CLOSURE LACERATION VESTIBULE MOUTH 2.5 CM/<,898.0,583.7,1.1,2453.0,234
HCPCS,40831,CLOSURE LACERATION VESTIBULE MOUTH > 2.5 CM/CPL,1685.5,1095.575,1.1,4392.0,235
HCPCS,40840,VESTIBULOPLASTY ANTERIOR,15436.0,10033.4,0.01,27212.0,235
HCPCS,40842,RECONSTRUCTION OF MOUTH,,,5080.55,6160.68,20
HCPCS,40842,Reconstruction of mouth,,,1358.5,1573.0,8
HCPCS,40842,VESTIBULOPLASTY POSTERIOR UNILATERAL,3660.0,2379.0,1.1,17080.38,148
HCPCS,40843,RECONSTRUCTION OF MOUTH,,,5080.55,6160.68,20
HCPCS,40843,Reconstruction of mouth,,,1358.5,1573.0,8
HCPCS,40843,VESTIBULOPLASTY POSTERIOR BILATERAL,5116.0,3325.4,1.1,17080.38,148
HCPCS,40844,RECONSTRUCTION OF MOUTH,,,5080.55,6160.68,20
HCPCS,40844,Reconstruction of mouth,,,1358.5,1573.0,8
HCPCS,40844,VESTIBULOPLASTY ENTIRE ARCH,6720.0,4368.0,1.1,17080.38,148
HCPCS,40845,RECONSTRUCTION OF MOUTH,,,5080.55,13821.0,22
HCPCS,40845,Reconstruction of mouth,,,1358.5,1573.0,8
HCPCS,40845,VESTIBULOPLASTY CPLX W/RIDGE XTN MUSC RPSG,7744.0,5033.6,1.1,17080.38,148
HCPCS,4084F,ASPIRIN RECVD W/IN 24 HRS,,,0.03,0.03,1
HCPCS,4084F,Aspirin recvd w/in 24 hrs,,,10.69,12.38,8
HCPCS,4086F,ASPIRIN/CLOPIDOGREL RXD,,,0.03,0.03,1
HCPCS,4086F,Aspirin/clopidogrel rxd,,,10.69,12.38,8
HCPCS,40899,LYSIS OF SCAR RMT FOR CORRECTION OF TRISMUS (COMP 40814),1162.0,755.3,0.01,1162.0,84
HCPCS,40899,TRANSORAL MYECTOMY OF DEPRESSOR ANGULI ORIS MUSCLE (COMP CODE 21,2168.0,1409.2,0.01,2168.0,84
HCPCS,40899,UNLISTED PX VESTIBULE MOUTH,,,211.91,637.68,21
HCPCS,40899,Unlisted px vestibule mouth,,,1358.5,1573.0,8
HCPCS,4090F,PT RCVNG EPO THXPY,,,2739849.3,2739849.3,1
HCPCS,4090F,Pt rcvng epo thxpy,,,10.69,12.38,8
HCPCS,4095F,PT NOT RCVNG EPO THXPY,,,2739849.3,2739849.3,1
HCPCS,4095F,Pt not rcvng epo thxpy,,,10.69,12.38,8
HCPCS,41000,INTRAORAL I&D TONGUE/FLOOR LINGUAL,1441.5,936.975,0.01,3443.0,321
HCPCS,41005,INTRAORAL I&D TONGUE/FLOOR SUBLNGL SUPFC,796.0,517.4000000000001,1.1,4392.0,235
HCPCS,41006,DRAINAGE OF MOUTH LESION,,,1323.06,1614.71,20
HCPCS,41006,Drainage of mouth lesion,,,939.63,1087.99,8
HCPCS,41006,INTRAORAL I&D TONGUE/FLOOR SUBLNGL DP SPRMLHYD,1336.0,868.4,1.1,4447.63,148
HCPCS,41007,INTRAORAL I&D TONGUE/FLOOR SUBMENTAL SPACE,4047.0,2630.55,1.1,6814.0,235
HCPCS,41008,INTRAORAL I&D TONGUE/FLOOR SUBMNDBLR SPACE,8151.0,5298.150000000001,0.01,14918.0,322
HCPCS,41009,INTRAORAL I&D TONGUE/FLOOR MASTICATOR SPACE,1987.5,1291.875,1.1,4392.0,235
HCPCS,4100F,BIPHOS THXPY VEIN ORD/RECVD,,,2739849.3,2739849.3,1
HCPCS,4100F,Biphos thxpy vein ord/recvd,,,10.69,12.38,8
HCPCS,41010,INCISION LINGUAL FRENUM FRENOTOMY,3629.0,2358.8500000000004,0.01,6814.0,235
HCPCS,41015,DRAINAGE OF MOUTH LESION,,,472.1,561.27,20
HCPCS,41015,Drainage of mouth lesion,,,1358.5,1573.0,8
HCPCS,41015,XTRORAL I&D ABSC CST/HMTMA FLOOR MOUTH SUBLNGL,1632.0,1060.8,1.1,1632.0,148
HCPCS,41016,XTRORAL I&D ABSC CST/HMTMA FLOOR MOUTH SUBMENT,14444.0,9388.6,0.01,27212.0,322
HCPCS,41017,XTRORAL I&D ABSC CST/HMTMA FLOOR MOUTH SUBMNDB,8297.0,5393.05,1.1,14918.0,235
HCPCS,41018,DRAINAGE OF MOUTH LESION,,,1323.06,1614.71,20
HCPCS,41018,Drainage of mouth lesion,,,1358.5,1573.0,8
HCPCS,41018,XTRORAL I&D FLOOR MASTICATOR SPACE,2088.0,1357.2,1.1,4447.63,148
HCPCS,41019,PLACE NEEDLES H&N FOR RT,,,5080.55,6160.68,20
HCPCS,41019,Place needles h&n for rt,,,3396.31,3932.57,8
HCPCS,41100,BIOPSY TONGUE ANTERIOR 2/3,568.0,369.2,1.1,1603.96,148
HCPCS,41100,BIOPSY TONGUE ANTERIOR TWO-THIRDS,2343.0,1522.95,0.01,4392.0,87
HCPCS,41105,BIOPSY TONGUE POSTERIOR ONE-THIRD,14918.0,9696.7,0.01,14918.0,87
HCPCS,41105,"BIOPSY TONGUE,POSTER 1/3",588.0,382.2,1.1,9391.15,148
HCPCS,41108,BIOPSY FLOOR MOUTH,7453.0,4844.45,0.01,7453.0,87
HCPCS,41108,"BIOPSY, MOUTH, FLOOR",484.0,314.6,1.1,4729.25,148
HCPCS,4110F,INT MAM ART USED FOR CABG,,,2739849.3,2739849.3,1
HCPCS,4110F,Int mam art used for cabg,,,10.69,12.38,8
HCPCS,41110,EXCISION LESION TONGUE W/O CLOSURE,7771.0,5051.150000000001,0.01,14918.0,235
HCPCS,41112,EXC LESION TONGUE W/CLSR ANTERIOR TWO-THIRDS,8025.0,5216.25,0.01,14918.0,235
HCPCS,41113,EXC LESION TONGUE W/CLSR POSTERIOR ONE-THIRD,8117.0,5276.05,0.01,14918.0,235
HCPCS,41114,EXC LESION TONGUE W/CLSR W/LOCAL TONGUE FLAP,3528.0,2293.2,1.1,9391.15,144
HCPCS,41114,EXCISION OF TONGUE LESION,,,2793.19,3450.35,20
HCPCS,41114,Excision of tongue lesion,,,1558.4,1804.46,8
HCPCS,41115,EXCISION LINGUAL FRENUM FRENECTOMY,6814.0,4429.1,0.01,6814.0,87
HCPCS,41115,EXCISION OF LINGUAL FRENUM (FRENECTOMY),716.0,465.4,1.1,4447.63,148
HCPCS,41116,EXCISION LESION FLOOR MOUTH,7963.0,5175.950000000001,0.01,14918.0,235
HCPCS,41120,GLOSSECTOMY <ONE-HALF TONGUE,4902.0,3186.3,1.1,17080.38,144
HCPCS,41120,PARTIAL REMOVAL OF TONGUE,,,5080.55,9509.0,21
HCPCS,41120,Partial removal of tongue,,,2710.76,3138.77,8
HCPCS,41130,GLOSSECTOMY HEMIGLOSSECTOMY,6296.0,4092.4,1.1,6296.0,144
HCPCS,41130,Partial removal of tongue,,,2710.76,3138.77,8
HCPCS,41135,GLOSSECTOMY PRTL W/UNI RADICAL NECK DSJ,12056.0,7836.4,1.1,12056.0,144
HCPCS,41135,TONGUE AND NECK SURGERY,,,5570.8,5570.8,1
HCPCS,41135,Tongue and neck surgery,,,3396.31,3932.57,8
HCPCS,41140,GLSSC COMPL/TOT W/WOTRACHS W/O RAD NECK DSJ,11660.0,7579.0,1.1,11660.0,144
HCPCS,41140,REMOVAL OF TONGUE,,,5598.53,5598.53,1
HCPCS,41140,Removal of tongue,,,3396.31,3932.57,8
HCPCS,41145,GLSSC COMPL/TOT W/WO TRACHS W/UNI RAD NECK DSJ,15172.0,9861.8,1.1,15172.0,144
HCPCS,41145,TONGUE REMOVAL NECK SURGERY,,,7060.82,7060.82,1
HCPCS,41145,Tongue removal neck surgery,,,3396.31,3932.57,8
HCPCS,41150,GLSSC COMPOSIT W/RESCJ FLOOR & MANDIBULAR RESCJ,11944.0,7763.6,1.1,11944.0,144
HCPCS,41150,TONGUE MOUTH JAW SURGERY,,,5646.02,5646.02,1
HCPCS,41150,Tongue mouth jaw surgery,,,3396.31,3932.57,8
HCPCS,41153,GLSSC COMPOSIT RESCJ FLOOR SUPRAHYOID NCK DSJ,13436.0,8733.4,1.1,13436.0,144
HCPCS,41153,TONGUE MOUTH NECK SURGERY,,,6152.48,6152.48,1
HCPCS,41153,Tongue mouth neck surgery,,,3396.31,3932.57,8
HCPCS,41155,GLSSC COMPOSIT RESCJ FLR MNDBLR RESCJ & RAD NECK,17720.0,11518.0,1.1,17720.0,144
HCPCS,41155,TONGUE JAW & NECK SURGERY,,,7688.19,7688.19,1
HCPCS,41155,Tongue jaw & neck surgery,,,3396.31,3932.57,8
HCPCS,4115F,BETA BLCKR ADMIN W/IN 24 HRS,,,2739849.3,2739849.3,1
HCPCS,4115F,Beta blckr admin w/in 24 hrs,,,10.69,12.38,8
HCPCS,4120F,ANTIBIOT RXD/GIVEN,,,0.03,0.03,1
HCPCS,4120F,Antibiot rxd/given,,,10.69,12.38,8
HCPCS,4124F,ANTIBIOT NOT RXD/GIVEN,,,0.03,0.03,1
HCPCS,4124F,Antibiot not rxd/given,,,10.69,12.38,8
HCPCS,41250,"REPAIR TONGUE LACER,<2.5CM",784.0,509.6,1.1,1163.18,148
HCPCS,41250,RPR LAC 2.5 CM/< MOUTH&/ANT TWO-THIRDS TONG,1836.0,1193.4,107.64,5265.0,87
HCPCS,41251,"REPAIR TONGUE LACER,POST 1/3",928.0,603.2,1.1,1052.35,148
HCPCS,41251,RPR LAC 2.5 CM/< PST ONE-THIRD TONGUE,1068.0,694.2,107.64,5265.0,87
HCPCS,41252,"REPAIR TONGUE LACER,2.6CM+/COMPLX",1208.0,785.2,1.1,1208.0,148
HCPCS,41252,RPR LAC TONGUE FLOOR MOUTH > 2.6 CM/CPLX,1068.0,694.2,0.01,5265.0,174
HCPCS,4130F,TOPICAL PREP RX AOE,,,2739849.3,2739849.3,1
HCPCS,4130F,Topical prep rx aoe,,,10.69,12.38,8
HCPCS,4131F,SYST ANTIMICROBIAL THX RX,,,2739849.3,2739849.3,1
HCPCS,4131F,Syst antimicrobial thx rx,,,10.69,12.38,8
HCPCS,4132F,NO SYST ANTIMICROBIAL THX RX,,,0.03,0.03,1
HCPCS,4132F,No syst antimicrobial thx rx,,,10.69,12.38,8
HCPCS,4133F,ANTIHIST/DECONG RX/RECOM,,,2739849.3,2739849.3,1
HCPCS,4133F,Antihist/decong rx/recom,,,10.69,12.38,8
HCPCS,4134F,NO ANTIHIST/DECONG RX/RECOM,,,2739849.3,2739849.3,1
HCPCS,4134F,No antihist/decong rx/recom,,,10.69,12.38,8
HCPCS,4135F,SYSTEMIC CORTICOSTEROIDS RX,,,2739849.3,2739849.3,1
HCPCS,4135F,Systemic corticosteroids rx,,,10.69,12.38,8
HCPCS,4136F,SYST CORTICOSTEROIDS NOT RX,,,2739849.3,2739849.3,1
HCPCS,4136F,Syst corticosteroids not rx,,,10.69,12.38,8
HCPCS,4140F,INHALED CORTICOSTEROIDS RXD,,,0.03,0.03,1
HCPCS,4140F,Inhaled corticosteroids rxd,,,10.69,12.38,8
HCPCS,4142F,CORTICOSTER SPARNG THRPY RXD,,,2739849.3,2739849.3,1
HCPCS,4142F,Corticoster sparng thrpy rxd,,,10.69,12.38,8
HCPCS,4144F,ALT LONG-TERM CNTRL MED RXD,,,2739849.3,2739849.3,1
HCPCS,4144F,Alt long-term cntrl med rxd,,,10.69,12.38,8
HCPCS,4145F,2+ ANTI-HYPRTNSV AGENTS TKN,,,0.03,0.03,1
HCPCS,4145F,2+ anti-hyprtnsv agents tkn,,,10.69,12.38,8
HCPCS,4148F,HEP A VAC INJXN ADMIN/RECVD,,,2739849.3,2739849.3,1
HCPCS,4148F,Hep a vac injxn admin/recvd,,,10.69,12.38,8
HCPCS,4149F,HEP B VAC INJXN ADMIN/RECVD,,,2739849.3,2739849.3,1
HCPCS,4149F,Hep b vac injxn admin/recvd,,,10.69,12.38,8
HCPCS,4150F,PT RECVNG ANTIVIR TXMNT HEPC,,,2739849.3,2739849.3,1
HCPCS,4150F,Pt recvng antivir txmnt hepc,,,10.69,12.38,8
HCPCS,41510,TONGUE TO LIP SURGERY,,,2793.19,3450.35,20
HCPCS,41510,Tongue to lip surgery,,,939.63,1087.99,8
HCPCS,41512,TONGUE SUSPENSION,,,5080.55,6160.68,20
HCPCS,41512,Tongue suspension,,,3396.31,3932.57,8
HCPCS,4151F,PT NOT RECVNG ANTIV HEP C,,,2739849.3,2739849.3,1
HCPCS,4151F,Pt not recvng antiv hep c,,,10.69,12.38,8
HCPCS,41520,FRENOPLASTY SURG REVJ FRENUM EG W/Z-PLASTY,1132.0,735.8,1.1,9391.15,148
HCPCS,41520,RECONSTRUCTION TONGUE FOLD,,,2793.19,3450.35,20
HCPCS,41520,Reconstruction tongue fold,,,2710.76,3138.77,8
HCPCS,41530,SUBMUCOSAL ABLTJ TONGUE RF 1/> SITES PR SESSION,1400.0,910.0,1.1,9391.15,146
HCPCS,41530,TONGUE BASE VOL REDUCTION,,,2793.19,8405.28,21
HCPCS,41530,Tongue base vol reduction,,,1558.4,1804.46,8
HCPCS,4153F,COMBO PEGINTF/RIB RX,,,2739849.3,2739849.3,1
HCPCS,4153F,Combo pegintf/rib rx,,,10.69,12.38,8
HCPCS,4155F,HEP A VAC SERIES PREV RECVD,,,2739849.3,2739849.3,1
HCPCS,4155F,Hep a vac series prev recvd,,,10.69,12.38,8
HCPCS,4157F,HEP B VAC SERIES PREV RECVD,,,124.01,124.01,1
HCPCS,4157F,Hep b vac series prev recvd,,,10.69,12.38,8
HCPCS,4158F,PT EDU RE ALCOH DRNKNG DONE,,,0.03,0.03,1
HCPCS,4158F,Pt edu re alcoh drnkng done,,,10.69,12.38,8
HCPCS,41599,LASER DESTRUCTION/TONGUE LESION (COMP 41110),515.0,334.75,0.01,713.21,84
HCPCS,41599,TONGUE ADVANCEMENT (COMP 15733),5645.0,3669.25,0.01,5645.0,84
HCPCS,41599,UNLISTED PX TONGUE FLR MOUTH,,,211.91,637.68,21
HCPCS,41599,Unlisted px tongue flr mouth,,,939.63,1087.99,8
HCPCS,4159F,CONTRCP TALK B/4 ANTIV TXMNT,,,2739849.3,2739849.3,1
HCPCS,4159F,Contrcp talk b/4 antiv txmnt,,,10.69,12.38,8
HCPCS,4163F,PT COUNS 4 TXMNT OPT PROST,,,2739849.3,2739849.3,1
HCPCS,4163F,Pt couns 4 txmnt opt prost,,,10.69,12.38,8
HCPCS,4164F,ADJV HRMNL THXPY RXD,,,2739849.3,2739849.3,1
HCPCS,4164F,Adjv hrmnl thxpy rxd,,,10.69,12.38,8
HCPCS,4165F,3D-CRT/IMRT RECEIVED,,,2739849.3,2739849.3,1
HCPCS,4165F,3d-crt/imrt received,,,10.69,12.38,8
HCPCS,4167F,HD BED TILTED 1ST DAY VENT,,,2739849.3,2739849.3,1
HCPCS,4167F,Hd bed tilted 1st day vent,,,10.69,12.38,8
HCPCS,4168F,PT CARE ICU&VENT W/IN 24HRS,,,2739849.3,2739849.3,1
HCPCS,4168F,Pt care icu&vent w/in 24hrs,,,10.69,12.38,8
HCPCS,4169F,NO PT CARE ICU/VENT IN 24HRS,,,2739849.3,2739849.3,1
HCPCS,4169F,No pt care icu/vent in 24hrs,,,10.69,12.38,8
HCPCS,4171F,PT RCVNG ESA THXPY,,,2739849.3,2739849.3,1
HCPCS,4171F,Pt rcvng esa thxpy,,,10.69,12.38,8
HCPCS,4172F,PT NOT RCVNG ESA THXPY,,,2739849.3,2739849.3,1
HCPCS,4172F,Pt not rcvng esa thxpy,,,10.69,12.38,8
HCPCS,4174F,COUNS POTENT GLAUC IMPCT,,,2739849.3,2739849.3,1
HCPCS,4174F,Couns potent glauc impct,,,10.69,12.38,8
HCPCS,4175F,VIS 20/40/> W/IN 90 DAYS,,,2739849.3,2739849.3,1
HCPCS,4175F,Vis 20/40/> w/in 90 days,,,10.69,12.38,8
HCPCS,4176F,TALK RE UV LIGHT PT/CRGVR,,,2739849.3,2739849.3,1
HCPCS,4176F,Talk re uv light pt/crgvr,,,10.69,12.38,8
HCPCS,4177F,TALK PT/CRGVR RE AREDS PREV,,,0.03,0.03,1
HCPCS,4177F,Talk pt/crgvr re areds prev,,,10.69,12.38,8
HCPCS,4178F,ANTID GLBLN RCVD W/IN 26WKS,,,2739849.3,2739849.3,1
HCPCS,4178F,Antid glbln rcvd w/in 26wks,,,10.69,12.38,8
HCPCS,4179F,TAMOXIFEN/AI PRESCRIBED,,,0.03,0.03,1
HCPCS,4179F,Tamoxifen/ai prescribed,,,10.69,12.38,8
HCPCS,41800,DRG ABSC CST HMTMA FROM DENTOALVEOLAR STRUXS,550.5,357.825,0.01,4392.0,409
HCPCS,41805,RMVL EMBEDDED FB FROM DENTALVLR STRUXS SOFT TISS,3675.0,2388.75,0.01,6814.0,235
HCPCS,41806,REMOVAL FOREIGN BODY JAWBONE,,,1323.06,3981.36,21
HCPCS,41806,RMVL EMBEDDED FB FROM DENTOALVEOLAR STRUXS BONE,1116.0,725.4,1.1,4447.63,148
HCPCS,41806,Removal foreign body jawbone,,,1358.5,1573.0,8
HCPCS,4180F,ADJV THXPYRXD/RCVD COLON CA,,,2739849.3,2739849.3,1
HCPCS,4180F,Adjv thxpyrxd/rcvd colon ca,,,10.69,12.38,8
HCPCS,4181F,CONFORMAL RADN THXPY RCVD,,,2739849.3,2739849.3,1
HCPCS,4181F,Conformal radn thxpy rcvd,,,10.69,12.38,8
HCPCS,41820,EXCISION GUM EACH QUADRANT,,,2793.19,8405.28,21
HCPCS,41820,Excision gum each quadrant,,,1358.5,1573.0,8
HCPCS,41820,GINGIVECTOMY EXC GINGIVA EACH QUADRANT,1372.0,891.8,1.1,9391.15,90
HCPCS,41821,EXCISION OF GUM FLAP,,,1323.06,3981.36,21
HCPCS,41821,Excision of gum flap,,,57.69,66.8,8
HCPCS,41821,OPRCULECTOMY EXC PRICORONAL TISSUE,282.0,183.3,1.1,4447.63,90
HCPCS,41822,EXC FIBROUS TUBEROSITIES DENTOALVEOLAR STRUXS,964.0,626.6,1.1,4447.63,148
HCPCS,41822,EXCISION OF GUM LESION,,,1323.06,3981.36,21
HCPCS,41822,Excision of gum lesion,,,1358.5,1573.0,8
HCPCS,41823,EXC OSS TUBEROSITIES DENTOALVEOLAR STRUXS,14360.0,9334.0,0.01,27212.0,235
HCPCS,41825,EXC LESION/TUMOR DENTOALVEOLAR STRUX W/O RPR,564.0,366.6,1.1,9391.15,148
HCPCS,41825,EXCISION OF GUM LESION,,,2793.19,8405.28,22
HCPCS,41825,Excision of gum lesion,,,1358.5,1573.0,8
HCPCS,41826,EXC LESION/TUMOR DENTOALVEOLAR STRUX W/SMPL RPR,7989.0,5192.85,0.01,14918.0,235
HCPCS,41827,EXC LESION/TUMOR DENTALVEOLAR STRUX W/CMPLX RPR,1685.0,1095.25,1.1,17080.38,148
HCPCS,41827,EXCISION OF GUM LESION,,,5080.55,6160.68,20
HCPCS,41827,Excision of gum lesion,,,1358.5,1573.0,8
HCPCS,41828,EXC HYPRPLSTC ALVEOLAR MUCOSA EA QUADRANT SPEC,4035.0,2622.75,0.01,6814.0,223
HCPCS,4182F,NO CONFORMAL RADN THXPY,,,2739849.3,2739849.3,1
HCPCS,4182F,No conformal radn thxpy,,,10.69,12.38,8
HCPCS,41830,ALVEOLECTOMY W/CURTG OSTEITIS/SEQUESTRECTOMY,8149.0,5296.85,0.01,14918.0,223
HCPCS,41850,DESTRUCTION LESION DENTOALVEOLAR STRUCTURES,3719.5,2417.675,0.01,6814.0,175
HCPCS,4185F,CONTINUOUS PPI OR H2RA RCVD,,,2739849.3,2739849.3,1
HCPCS,4185F,Continuous ppi or h2ra rcvd,,,10.69,12.38,8
HCPCS,4186F,NO CONT PPI OR H2RA RCVD,,,246.6,246.6,1
HCPCS,4186F,No cont ppi or h2ra rcvd,,,10.69,12.38,8
HCPCS,41870,PERIODONTAL MUCOSAL GRAFTING,4188.5,2722.525,0.01,6814.0,173
HCPCS,41872,GINGIVOPLASTY EACH QUADRANT,,,2793.19,8405.28,21
HCPCS,41872,GINGIVOPLASTY EACH QUADRANT SPECIFY,1204.0,782.6,1.1,9391.15,136
HCPCS,41872,Gingivoplasty each quadrant,,,1358.5,1573.0,8
HCPCS,41874,ALVEOLOPLASTY EACH QUADRANT SPECIFY,8161.0,5304.650000000001,0.01,14918.0,223
HCPCS,4187F,ANTI RHEUM DRUGTHXPYRXD/GVN,,,0.03,0.03,1
HCPCS,4187F,Anti rheum drugthxpyrxd/gvn,,,10.69,12.38,8
HCPCS,4188F,APPROP ACE/ARB TSTNG DONE,,,0.03,0.03,1
HCPCS,4188F,Approp ace/arb tstng done,,,10.69,12.38,8
HCPCS,41899,COMPLICATED FULL BONY EXTRACTION (COMP D7241),750.0,487.5,0.01,750.0,84
HCPCS,41899,"EXTRACT IMPACTED TOOTH, SURGICAL; SIMPLE REMOVAL (COMP D7140)",200.0,130.0,0.01,713.21,84
HCPCS,41899,"EXTRACT IMPACTED TOOTH, SURGICAL; SOFT TISSUE ONLY (COMP D7220)",300.0,195.0,0.01,713.21,84
HCPCS,41899,"EXTRACT IMPACTED TOOTH, SURGICAL; W/BONY EXTRACTION (COMP D7240)",500.0,325.0,0.01,713.21,84
HCPCS,41899,FULL BONY IMPACTION EXTRACTION (COMP D7240),600.0,390.0,0.01,713.21,84
HCPCS,41899,PARTIAL BONY IMPACTION EXTRACTION (COMP D7230),550.0,357.5,0.01,713.21,84
HCPCS,41899,REMOVAL RESIDUAL ROOT,302.0,196.3,0.01,13821.0,170
HCPCS,41899,REMOVE RESIDUAL ROOT (COMP D7250),400.0,260.0,0.01,713.21,84
HCPCS,41899,SCLEROTHERAPY TO THE ORAL CAVITY (COMP CODE 36470),300.0,195.0,0.01,713.21,84
HCPCS,41899,SIMPLE EXTRACTION ERUPTED TOOTH (COMP D7140),300.0,195.0,0.01,713.21,84
HCPCS,41899,SOFT TISSUE IMPACTION EXTRACTION (COMP D7220),500.0,325.0,0.01,713.21,84
HCPCS,41899,SURGICAL EXTRACTION ERUPTED TOOTH (COMP D7210),400.0,260.0,0.01,713.21,84
HCPCS,4189F,APPROP DIGOXIN TSTNG DONE,,,2739849.3,2739849.3,1
HCPCS,4189F,Approp digoxin tstng done,,,10.69,12.38,8
HCPCS,4190F,APPROP DIURETIC TSTNG DONE,,,2739849.3,2739849.3,1
HCPCS,4190F,Approp diuretic tstng done,,,10.69,12.38,8
HCPCS,4191F,APPROP ANTICONVULS TSTNG,,,2739849.3,2739849.3,1
HCPCS,4191F,Approp anticonvuls tstng,,,10.69,12.38,8
HCPCS,4192F,PT NOT RCVNG GLUCOCO THXPY,,,2739849.3,2739849.3,1
HCPCS,4192F,Pt not rcvng glucoco thxpy,,,10.69,12.38,8
HCPCS,4193F,PT RCV <10MG DAILY PREDNISO,,,2739849.3,2739849.3,1
HCPCS,4193F,Pt rcv <10mg daily predniso,,,10.69,12.38,8
HCPCS,4194F,PT RCV >=10MG DAILY PREDNISO,,,2739849.3,2739849.3,1
HCPCS,4194F,Pt rcv >=10mg daily predniso,,,10.69,12.38,8
HCPCS,4195F,PT RCVNG ANTI-RHEUM THXPY RA,,,2739849.3,2739849.3,1
HCPCS,4195F,Pt rcvng anti-rheum thxpy ra,,,10.69,12.38,8
HCPCS,4196F,PTNOT RCVNG ANTI-RHM THXPYRA,,,0.03,0.03,1
HCPCS,4196F,Ptnot rcvng anti-rhm thxpyra,,,10.69,12.38,8
HCPCS,42000,DRAINAGE ABSCESS PALATE UVULA,1068.0,694.2,0.01,5265.0,174
HCPCS,42000,DRAINAGE ABSCESS PALATE/UVULA,512.0,332.8,1.1,713.21,148
HCPCS,4200F,EXTERNAL BEAM TO PROST ONLY,,,2739849.3,2739849.3,1
HCPCS,4200F,External beam to prost only,,,10.69,12.38,8
HCPCS,4201F,EXTRNL BEAM OTHER THAN PROST,,,2739849.3,2739849.3,1
HCPCS,4201F,Extrnl beam other than prost,,,10.69,12.38,8
HCPCS,42100,BIOPSY PALATE UVULA,3706.0,2408.9,0.01,6814.0,235
HCPCS,42104,EXC LESION PALATE UVULA W/O CLOSURE,7797.0,5068.05,0.01,14918.0,235
HCPCS,42106,EXC LESION PALATE UVULA W/SMPL PRIM CLOSURE,7889.0,5127.85,0.01,14918.0,235
HCPCS,42107,EXC LESION PALATE UVULA W/LOCAL FLAP CLOSURE,1824.0,1185.6,1.1,17080.38,148
HCPCS,42107,EXCISION LESION MOUTH ROOF,,,5080.55,6160.68,20
HCPCS,42107,Excision lesion mouth roof,,,1558.4,1804.46,8
HCPCS,4210F,ACE/ARB THXPY FOR MOS/>,,,2739849.3,2739849.3,1
HCPCS,4210F,Ace/arb thxpy for mos/>,,,10.69,12.38,8
HCPCS,42120,REMOVE PALATE/LESION,,,5080.55,10789.0,21
HCPCS,42120,RESCJ PALATE/EXTENSIVE RESCJ LESION,4744.0,3083.6,1.1,17080.38,144
HCPCS,42120,Remove palate/lesion,,,1358.5,1573.0,8
HCPCS,42140,UVULECTOMY EXCISION UVULA,7799.0,5069.35,0.01,14918.0,235
HCPCS,42145,PALATOPHAYNGOPLASTY,3912.0,2542.8,1.1,17080.38,144
HCPCS,42145,REPAIR PALATE PHARYNX/UVULA,,,5080.55,9509.0,21
HCPCS,42145,Repair palate pharynx/uvula,,,3314.27,3837.57,8
HCPCS,42160,DSTRJ LESION PALATE/UVULA THERMAL CRYO/CHEM,7829.0,5088.85,0.01,14918.0,235
HCPCS,42180,REPAIR LACERATION PALATE </2 CM,2343.0,1522.95,209.64,4392.0,87
HCPCS,42180,REPAIR PALATE LACER <2CM,1020.0,663.0,1.1,1603.96,148
HCPCS,42182,REPAIR LACERATION PALATE >2 CM/COMPLEX,27212.0,17687.8,288.11,27212.0,87
HCPCS,42182,REPAIR PALATE LACER 2+CM OR COMPLX,1548.0,1006.2,1.1,17080.38,148
HCPCS,42200,PALATOP CL PALATE SOFT&/HARD PALATE ONLY,5012.0,3257.8,1.1,17080.38,144
HCPCS,42200,RECONSTRUCT CLEFT PALATE,,,5080.55,6160.68,20
HCPCS,42200,Reconstruct cleft palate,,,3314.27,3837.57,8
HCPCS,42205,PALATOPLASTY W/CLSR ALVEOLAR RIDGE SOFT TISSUE,5464.0,3551.6,1.1,9391.15,144
HCPCS,42205,RECONSTRUCT CLEFT PALATE,,,2793.19,3450.35,20
HCPCS,42205,Reconstruct cleft palate,,,3314.27,3837.57,8
HCPCS,4220F,DIGOXIN THXPY FOR 6 MOS/>,,,2739849.3,2739849.3,1
HCPCS,4220F,Digoxin thxpy for 6 mos/>,,,10.69,12.38,8
HCPCS,42210,PALATOP CLSR ALVEOLAR RIDGE GRF ALVEOLAR RIDGE,6012.0,3907.8,1.1,17080.38,144
HCPCS,42210,RECONSTRUCT CLEFT PALATE,,,5080.55,13821.0,21
HCPCS,42210,Reconstruct cleft palate,,,3314.27,3837.57,8
HCPCS,42215,PALATOPLASTY CLEFT PALATE MAJOR REVJ,3596.0,2337.4,1.1,17080.38,144
HCPCS,42215,RECONSTRUCT CLEFT PALATE,,,5080.55,6160.68,20
HCPCS,42215,Reconstruct cleft palate,,,3314.27,3837.57,8
HCPCS,4221F,DIURETIC THXPY FOR 6 MOS/>,,,0.03,0.03,1
HCPCS,4221F,Diuretic thxpy for 6 mos/>,,,10.69,12.38,8
HCPCS,42220,PALATOPLASTY CLEFT PALATE SEC LNGTH PX,2864.0,1861.6,1.1,17080.38,144
HCPCS,42220,RECONSTRUCT CLEFT PALATE,,,5080.55,6160.68,20
HCPCS,42220,Reconstruct cleft palate,,,3314.27,3837.57,8
HCPCS,42225,PALATOP CL PALATE ATTACHMENT PHARYNGEAL FLAP,3908.0,2540.2,1.1,17080.38,144
HCPCS,42225,RECONSTRUCT CLEFT PALATE,,,5080.55,6160.68,20
HCPCS,42225,Reconstruct cleft palate,,,3314.27,3837.57,8
HCPCS,42226,LENGTHENING OF PALATE,,,5080.55,6160.68,20
HCPCS,42226,LENGTHENING PALATE+PHARY FLAP,4140.0,2691.0,1.1,17080.38,144
HCPCS,42226,Lengthening of palate,,,3314.27,3837.57,8
HCPCS,42227,LENGTHENING OF PALATE,,,5080.55,6160.68,20
HCPCS,42227,LENGTHENING PALATE+ISLAND FLAP,3960.0,2574.0,1.1,17080.38,144
HCPCS,42227,Lengthening of palate,,,3314.27,3837.57,8
HCPCS,42235,REPAIR ANTER PALATE W VOMER FLAP,3204.0,2082.6,1.1,17080.38,144
HCPCS,42235,REPAIR PALATE,,,5080.55,6160.68,20
HCPCS,42235,Repair palate,,,3314.27,3837.57,8
HCPCS,42260,REPAIR NASOLABIAL FISTULA,4088.0,2657.2,1.1,17080.38,148
HCPCS,42260,REPAIR NOSE TO LIP FISTULA,,,5080.55,6160.68,20
HCPCS,42260,Repair nose to lip fistula,,,2710.76,3138.77,8
HCPCS,42280,PREPARATION PALATE MOLD,,,472.1,1436.39,21
HCPCS,42280,Preparation palate mold,,,1358.5,1573.0,8
HCPCS,42281,INSERTION PALATE PROSTHESIS,,,5080.55,15288.41,21
HCPCS,42281,INSJ PIN-RETAINED PALATAL PROSTHESIS,792.0,514.8,1.1,17080.38,148
HCPCS,42281,Insertion palate prosthesis,,,1358.5,1573.0,8
HCPCS,42299,PALATAL RECONSTRUCTION NOT FOR CLEFT PALATE (COMP 42200),4135.0,2687.75,0.01,4135.0,84
HCPCS,42299,SOMNOPLASTY -REPEAT TREATMENT,350.0,227.5,0.01,713.21,84
HCPCS,42299,"SOMNOPLASTY, PALATE, INIT TX",248.0,161.2,0.01,1573.0,85
HCPCS,42299,SOMNOPLASTY-REPEAT TREATMENT,162.0,105.3,0.01,1573.0,85
HCPCS,42299,UNLISTED PROCEDURE PALATE UVULA,248.0,161.2,68.94,1573.0,84
HCPCS,42300,"DRAIN ABSCESS PAROTID,SIMPLE",792.0,514.8,1.1,4447.63,148
HCPCS,42300,DRAINAGE OF SALIVARY GLAND,,,1323.06,1614.71,20
HCPCS,42300,Drainage of salivary gland,,,1358.5,1573.0,8
HCPCS,42305,"DRAIN ABSCESS PAROTID,COMPLIC",2524.0,1640.6,1.1,9391.15,144
HCPCS,42305,DRAINAGE OF SALIVARY GLAND,,,2793.19,4315.0,21
HCPCS,42305,Drainage of salivary gland,,,1558.4,1804.46,8
HCPCS,4230F,ANTICONV THXPY FOR 6 MOS/>,,,2739849.3,2739849.3,1
HCPCS,4230F,Anticonv thxpy for 6 mos/>,,,10.69,12.38,8
HCPCS,42310,"DRAIN ABSC-SUBMAX,SUBLING-INTRAORAL",644.0,418.6,1.1,1603.96,148
HCPCS,42310,DRAINAGE OF SALIVARY GLAND,,,472.1,561.27,20
HCPCS,42310,Drainage of salivary gland,,,1358.5,1573.0,8
HCPCS,42320,DRAIN ABSC-SUBMAX-EXTERNAL,960.0,624.0,1.1,1603.96,148
HCPCS,42320,DRAINAGE OF SALIVARY GLAND,,,472.1,561.27,20
HCPCS,42320,Drainage of salivary gland,,,1358.5,1573.0,8
HCPCS,42330,SIALOT SUBMNDBLR SUBLNGL/PRTD UNCOMP INTRAORAL,7911.0,5142.150000000001,0.01,14918.0,235
HCPCS,42335,SIALOLITHOTOMY SUBMNDBLR SUBMAX COMP INTRAORAL,8141.0,5291.650000000001,0.01,14918.0,235
HCPCS,42340,REMOVAL OF SALIVARY STONE,,,2793.19,3450.35,20
HCPCS,42340,Removal of salivary stone,,,1358.5,1573.0,8
HCPCS,42340,SIALOLITHOTOMY PRTD XTRORAL/COMP INTRAORAL,1888.0,1227.2,1.1,9391.15,148
HCPCS,42400,BIOPSY SALIVARY GLAND NEEDLE,3237.0,2104.05,0.01,4628.0,259
HCPCS,42400,"BIOPSY SALIVARY GLAND,NEEDLE",343.0,222.95,1.1,2050.87,148
HCPCS,42405,BIOPSY SALIVARY GLAND INCISIONAL,4075.0,2648.75,0.01,6814.0,235
HCPCS,42408,EXC SUBLINGUAL SALIVARY CYST RANULA,1864.0,1211.6,1.1,9391.15,148
HCPCS,42408,EXCISION OF SALIVARY CYST,,,2793.19,3450.35,20
HCPCS,42408,Excision of salivary cyst,,,1358.5,1573.0,8
HCPCS,42409,DRAINAGE OF SALIVARY CYST,,,2793.19,3450.35,20
HCPCS,42409,Drainage of salivary cyst,,,1358.5,1573.0,8
HCPCS,42409,MARSUPIALIZATION SUBLNGL SALIVARY CST RANULA,1164.0,756.6,1.1,9391.15,148
HCPCS,4240F,INSTR XRCZ BACK PAIN 12 WKS,,,2739849.3,2739849.3,1
HCPCS,4240F,Instr xrcz back pain 12 wks,,,10.69,12.38,8
HCPCS,42410,EXC PRTD TUM/PRTD GLND LAT LOBE W/O NRV DSJ,3828.0,2488.2,1.1,17080.38,144
HCPCS,42410,EXCISE PAROTID GLAND/LESION,,,5080.55,6160.68,20
HCPCS,42410,Excise parotid gland/lesion,,,2710.76,3138.77,8
HCPCS,42415,EXC PRTD TUM/PRTD GLND LAT DSJ&PRSRV FACIAL NR,6864.0,4461.6,1.1,17080.38,144
HCPCS,42415,EXCISE PAROTID GLAND/LESION,,,5080.55,25635.0,24
HCPCS,42415,Excise parotid gland/lesion,,,3396.31,3932.57,8
HCPCS,42420,EXC PRTD TUM/PRTD GLND TOT DSJ&PRSRV FACIAL NR,7812.0,5077.8,1.1,17080.38,144
HCPCS,42420,EXCISE PAROTID GLAND/LESION,,,5080.55,6160.68,20
HCPCS,42420,Excise parotid gland/lesion,,,3396.31,3932.57,8
HCPCS,42425,EXCISE PAROTID GLAND/LESION,,,5080.55,6160.68,20
HCPCS,42425,EXCISION PAROTID TUMOR/GLAND TOTAL EN BLOC RMVL,5368.0,3489.2,1.1,17080.38,144
HCPCS,42425,Excise parotid gland/lesion,,,3396.31,3932.57,8
HCPCS,42426,EXC PRTD TUM/PRTD GLND TOT W/UNI RAD NCK DSJ,9064.0,5891.6,1.1,9064.0,144
HCPCS,42426,EXCISE PAROTID GLAND/LESION,,,3532.33,3532.33,1
HCPCS,42426,Excise parotid gland/lesion,,,3396.31,3932.57,8
HCPCS,4242F,SPRVSD XRCZ BACK PN >12 WKS,,,2739849.3,2739849.3,1
HCPCS,4242F,Sprvsd xrcz back pn >12 wks,,,10.69,12.38,8
HCPCS,42440,EXCISE SUBMAXILLARY GLAND,,,5080.55,9509.0,23
HCPCS,42440,EXCISION SUBMANDIBULAR SUBMAXILLARY GLAND,2702.0,1756.3,1.1,17080.38,144
HCPCS,42440,Excise submaxillary gland,,,2710.76,3138.77,8
HCPCS,42450,EXCISE SUBLINGUAL GLAND,,,5080.55,9509.0,22
HCPCS,42450,EXCISION SUBLINGUAL GLAND,1896.0,1232.4,1.1,17080.38,148
HCPCS,42450,Excise sublingual gland,,,2710.76,3138.77,8
HCPCS,4245F,PT INSTR NRML ACTIVITIES,,,2739849.3,2739849.3,1
HCPCS,4245F,Pt instr nrml activities,,,10.69,12.38,8
HCPCS,4248F,PT INSTR NO BD REST 4 DAYS/>,,,2739849.3,2739849.3,1
HCPCS,4248F,Pt instr no bd rest 4 days/>,,,10.69,12.38,8
HCPCS,42500,PLSTC RPR SALIVARY DUX SIALODOCHOPLASTY PRIM,14490.0,9418.5,0.01,27212.0,235
HCPCS,42505,PLSTC RPR SALIVARY DUX SIALODOCHOPLASTY SEC/COMP,2528.0,1643.2,1.1,17080.38,148
HCPCS,42505,REPAIR SALIVARY DUCT,,,5080.55,9509.0,21
HCPCS,42505,Repair salivary duct,,,1358.5,1573.0,8
HCPCS,42507,PAROTID DUCT DIVERSION,,,5080.55,6160.68,20
HCPCS,42507,PAROTID DUCT DIVERSION BILATERAL WILKE PX,2500.0,1625.0,1.1,17080.38,144
HCPCS,42507,Parotid duct diversion,,,2710.76,3138.77,8
HCPCS,42509,PAROTID DUCT DIVERSION,,,5080.55,6160.68,20
HCPCS,42509,Parotid duct diversion,,,3396.31,3932.57,8
HCPCS,4250F,WRMNG 4 SURG NORMOTHERMIA,,,0.03,0.03,1
HCPCS,4250F,Wrmng 4 surg normothermia,,,10.69,12.38,8
HCPCS,42510,PAROTID DUCT DIVERSION,,,2793.19,3450.35,20
HCPCS,42510,PAROTID DUCT DVRJ BILATERAL WITH LIG BOTH DUCTS,3340.0,2171.0,1.1,9391.15,144
HCPCS,42510,Parotid duct diversion,,,2710.76,3138.77,8
HCPCS,42550,INJECTION PROCEDURE SIALOGRAPHY,500.0,325.0,1.1,515.65,148
HCPCS,42550,Injection for salivary x-ray,,,81.99,94.94,8
HCPCS,4255F,ANESTH 60 MIN/> AS DOCD,,,0.03,0.03,1
HCPCS,4255F,Anesth 60 min/> as docd,,,10.69,12.38,8
HCPCS,4256F,ANESTHE <60 MIN AS DOCD,,,0.03,0.03,1
HCPCS,4256F,Anesthe <60 min as docd,,,10.69,12.38,8
HCPCS,42600,CLOSURE OF SALIVARY FISTULA,1976.0,1284.4,1.1,9391.15,168
HCPCS,42600,Closure of salivary fistula,,,2710.76,3138.77,8
HCPCS,4260F,WOUND SRFC CULTURETECH USED,,,2739849.3,2739849.3,1
HCPCS,4260F,Wound srfc culturetech used,,,10.69,12.38,8
HCPCS,4261F,TECH OTHER THAN SURFC CULTR,,,2739849.3,2739849.3,1
HCPCS,4261F,Tech other than surfc cultr,,,10.69,12.38,8
HCPCS,42650,DILATION OF SALIVARY DUCT,308.0,200.2,1.1,4447.63,148
HCPCS,42650,DILATION SALIVARY DUCT,6814.0,4429.1,0.01,6814.0,87
HCPCS,4265F,WET-DRY DRESSINGS RX RECMD,,,24.66,24.66,1
HCPCS,4265F,Wet-dry dressings rx recmd,,,10.69,12.38,8
HCPCS,42660,DILAT&CATHJ SALIVARY DUCT W/WO INJECTION,452.0,293.8,1.1,1603.96,148
HCPCS,42660,DILATION OF SALIVARY DUCT,,,472.1,1436.39,21
HCPCS,42660,Dilation of salivary duct,,,1358.5,1573.0,8
HCPCS,42665,LIGATION OF SALIVARY DUCT,,,2793.19,3450.35,20
HCPCS,42665,LIGATION SALIVARY DUCT INTRAORAL,1052.0,683.8,1.1,9391.15,148
HCPCS,42665,Ligation of salivary duct,,,1358.5,1573.0,8
HCPCS,4266F,NO WET-DRY DRSSINGS RX RECMD,,,2739849.3,2739849.3,1
HCPCS,4266F,No wet-dry drssings rx recmd,,,10.69,12.38,8
HCPCS,4267F,COMPRSSION THXPY PRESCRIBED,,,0.14,0.14,1
HCPCS,4267F,Comprssion thxpy prescribed,,,10.69,12.38,8
HCPCS,4268F,PT ED RE COMP THXPY RCVD,,,2739849.3,2739849.3,1
HCPCS,4268F,Pt ed re comp thxpy rcvd,,,10.69,12.38,8
HCPCS,42699,IMPLNT ALLODERM/PAROTIDCTMY WOUND BED,1204.0,782.6,0.01,1204.0,84
HCPCS,42699,SIALOENDOSCOPY W HYDRO/MECHANICAL DILATION (COMP 31254),1485.0,965.25,0.01,1485.0,84
HCPCS,42699,SIALOENDOSCOPY W SALIVARY DUCT STONE EXTRACTION (COMP 31255),2473.0,1607.45,0.01,2473.0,84
HCPCS,42699,UNLISTED PX SALIVRY GLND/DUX,,,211.91,4132.0,22
HCPCS,42699,Unlisted px salivry glnd/dux,,,1358.5,1573.0,8
HCPCS,4269F,APPROPOS MTHD OFFLOADING RXD,,,2739849.3,2739849.3,1
HCPCS,4269F,Appropos mthd offloading rxd,,,10.69,12.38,8
HCPCS,42700,"I & D ABSCESS, PERITONSILLAR",668.0,434.2,1.1,713.21,148
HCPCS,42700,I&D ABSCESS PERITONSILLAR,1068.0,694.2,0.01,4392.0,174
HCPCS,4270F,PT RCVNG ANTI R-VIRAL THXPY,,,2739849.3,2739849.3,1
HCPCS,4270F,Pt rcvng anti r-viral thxpy,,,10.69,12.38,8
HCPCS,4271F,PT RCVNG ANTI R-VIRAL THXPY,,,2739849.3,2739849.3,1
HCPCS,4271F,Pt rcvng anti r-viral thxpy,,,10.69,12.38,8
HCPCS,42720,I&D ABSC PHRNGL NTRAORL APPR,,,2793.19,3450.35,20
HCPCS,42720,I&D ABSC RTRPHRNGL/PARAPHARYNGEAL INTRAORAL,2524.0,1640.6,1.1,9391.15,148
HCPCS,42720,I&d absc phrngl ntraorl appr,,,939.63,1087.99,8
HCPCS,42725,I&D ABSC PHRNGL XTRNL APPR,,,5080.55,6160.68,20
HCPCS,42725,I&D ABSC RTRPHRNGL/PARAPHARYNGEAL XTRNL APPR,4964.0,3226.6,1.1,17080.38,144
HCPCS,42725,I&d absc phrngl xtrnl appr,,,939.63,1087.99,8
HCPCS,4274F,FLU IMMUNO ADMIND RCVD,,,0.03,0.03,1
HCPCS,4274F,Flu immuno admind rcvd,,,10.69,12.38,8
HCPCS,4276F,POTENT ANTIVIR THXPY RXD,,,2739849.3,2739849.3,1
HCPCS,4276F,Potent antivir thxpy rxd,,,10.69,12.38,8
HCPCS,4279F,PCP PROPHYLAXIS RXD,,,2739849.3,2739849.3,1
HCPCS,4279F,Pcp prophylaxis rxd,,,10.69,12.38,8
HCPCS,42800,BIOPSY OROPHARYNX,3695.0,2401.75,0.01,6814.0,322
HCPCS,42804,BIOPSY NASOPHARYNX VISIBLE LESION SIMPLE,14918.0,9696.7,0.01,14918.0,87
HCPCS,42804,"BIOPSY NASOPHARYNX,SIMPLE",516.0,335.4,1.1,9391.15,148
HCPCS,42806,BIOPSY OF UPPER NOSE/THROAT,,,2793.19,3450.35,20
HCPCS,42806,BX NASOPHARYNX SURVEY UNKNOWN PRIMARY LESION,652.0,423.8,1.1,9391.15,148
HCPCS,42806,Biopsy of upper nose/throat,,,939.63,1087.99,8
HCPCS,42808,EXCISION/DESTRUCTION LESION PHARYNX ANY METHOD,7929.0,5153.85,0.01,14918.0,235
HCPCS,42809,REMOVAL FOREIGN BODY PHARYNX,1836.0,1193.4,0.01,3443.0,173
HCPCS,42809,REMOVE PHARYNX FOREIGN BODY,744.0,483.6,1.1,1163.18,148
HCPCS,4280F,PCP PROPHYLAX RXD 3MON LOW %,,,2739849.3,2739849.3,1
HCPCS,4280F,Pcp prophylax rxd 3mon low %,,,10.69,12.38,8
HCPCS,42810,EXC BRANCHIAL CLEFT CYST CONFINED SKN&SUBQ TIS,1352.0,878.8,1.1,9391.15,148
HCPCS,42810,EXCISION OF NECK CYST,,,2793.19,7813.0,22
HCPCS,42810,Excision of neck cyst,,,939.63,1087.99,8
HCPCS,42815,EXC BRANCHIAL CLEFT CYST BELOW SUBQ TISS&/PHRYNX,2924.0,1900.6,1.1,17080.38,144
HCPCS,42815,EXCISION OF NECK CYST,,,5080.55,6160.68,20
HCPCS,42815,Excision of neck cyst,,,2710.76,3138.77,8
HCPCS,42820,REMOVE TONSILS AND ADENOIDS,,,5080.55,9509.0,24
HCPCS,42820,Remove tonsils and adenoids,,,1434.54,1661.04,8
HCPCS,42820,TONSILLECTOMY & ADENOIDECTOMY <AGE 12,1688.0,1097.2,1.1,17080.38,144
HCPCS,42821,REMOVE TONSILS AND ADENOIDS,,,2793.19,13821.0,25
HCPCS,42821,Remove tonsils and adenoids,,,1434.54,1661.04,8
HCPCS,42821,TONSILLECTOMY & ADENOIDECTOMY AGE 12/>,1744.0,1133.6,1.1,9391.15,144
HCPCS,42825,REMOVAL OF TONSILS,,,5080.55,10789.0,24
HCPCS,42825,Removal of tonsils,,,1434.54,1661.04,8
HCPCS,42825,TONSILLECTOMY PRIMARY/SECONDARY <AGE 12,1404.0,912.6,1.1,17080.38,144
HCPCS,42826,REMOVAL OF TONSILS,,,2793.19,10789.0,24
HCPCS,42826,Removal of tonsils,,,1434.54,1661.04,8
HCPCS,42826,TONSILLECTOMY PRIMARY/SECONDARY AGE 12/>,1380.0,897.0,1.1,9391.15,144
HCPCS,42830,ADENOIDECTOMY PRIMARY <AGE 12,1060.0,689.0,1.1,9391.15,144
HCPCS,42830,REMOVAL OF ADENOIDS,,,2793.19,10789.0,26
HCPCS,42830,Removal of adenoids,,,1434.54,1661.04,8
HCPCS,42831,ADENOIDECTOMY PRIMARY AGE 12/>,1124.0,730.6,1.1,9391.15,144
HCPCS,42831,REMOVAL OF ADENOIDS,,,2793.19,10789.0,24
HCPCS,42831,Removal of adenoids,,,1434.54,1661.04,8
HCPCS,42835,ADENOIDECTOMY SECONDARY<AGE 12,952.0,618.8,1.1,9391.15,144
HCPCS,42835,REMOVAL OF ADENOIDS,,,2793.19,10789.0,22
HCPCS,42835,Removal of adenoids,,,1434.54,1661.04,8
HCPCS,42836,ADENOIDECTOMY SECONDARY AGE 12/>,1304.0,847.6,1.1,9391.15,144
HCPCS,42836,REMOVAL OF ADENOIDS,,,2793.19,3450.35,20
HCPCS,42836,Removal of adenoids,,,1434.54,1661.04,8
HCPCS,42842,EXTENSIVE SURGERY OF THROAT,,,5080.55,15288.41,21
HCPCS,42842,Extensive surgery of throat,,,1434.54,1661.04,8
HCPCS,42842,RADICAL RESECTION TONSIL W/O CLOSURE,4892.0,3179.8,1.1,17080.38,144
HCPCS,42844,EXTENSIVE SURGERY OF THROAT,,,5080.55,15288.41,21
HCPCS,42844,Extensive surgery of throat,,,1434.54,1661.04,8
HCPCS,42844,RADICAL RESCJ TONSIL CLOSURE W/LOCAL FLAP,7112.0,4622.8,1.1,17080.38,144
HCPCS,42845,EXTENSIVE SURGERY OF THROAT,,,5692.32,5692.32,1
HCPCS,42845,Extensive surgery of throat,,,1434.54,1661.04,8
HCPCS,42845,RADICAL RESCJ TONSIL CLOSURE W/OTHER FLAP,13024.0,8465.6,1.1,13024.0,144
HCPCS,42860,EXCISION OF TONSIL TAGS,920.0,598.0,1.1,9391.15,164
HCPCS,42860,Excision of tonsil tags,,,1434.54,1661.04,8
HCPCS,42870,EXC/DSTRJ LINGUAL TONSIL ANY METHOD SPX,2208.0,1435.2,1.1,17080.38,144
HCPCS,42870,EXCISION OF LINGUAL TONSIL,,,5080.55,6160.68,20
HCPCS,42870,Excision of lingual tonsil,,,1434.54,1661.04,8
HCPCS,42890,LIMITED PHARYNGECTOMY,7652.0,4973.8,1.1,17080.38,164
HCPCS,42890,Limited pharyngectomy,,,2710.76,3138.77,8
HCPCS,42892,RESCJ LAT PHRNGL WALL/PYRIFORM SINUS DIR CLSR,10412.0,6767.8,1.1,17080.38,144
HCPCS,42892,REVISION OF PHARYNGEAL WALLS,,,5080.55,6160.68,20
HCPCS,42892,Revision of pharyngeal walls,,,2710.76,3138.77,8
HCPCS,42894,RESCJ PHRNGL WALL CLSR W/FLP OR FLP W/MVASC ANAS,13568.0,8819.2,1.1,13568.0,144
HCPCS,42894,REVISION OF PHARYNGEAL WALLS,,,6101.19,6101.19,1
HCPCS,42894,Revision of pharyngeal walls,,,3396.31,3932.57,8
HCPCS,42900,REPAIR THROAT WOUND,,,1323.06,1614.71,20
HCPCS,42900,Repair throat wound,,,939.63,1087.99,8
HCPCS,42900,SUTURE PHARYNX WOUND/INJURY,2116.0,1375.4,1.1,4447.63,144
HCPCS,4290F,PT SCRNED FOR INJ DRUG USE,,,2739849.3,2739849.3,1
HCPCS,4290F,Pt scrned for inj drug use,,,10.69,12.38,8
HCPCS,4293F,PT SCRND HGH-RISK SEX BEHAV,,,2739849.3,2739849.3,1
HCPCS,4293F,Pt scrnd hgh-risk sex behav,,,10.69,12.38,8
HCPCS,42950,PHARYNGOPLASTY PLSTC/RCNSTV OPRATION PHARYNX,15260.0,9919.0,0.01,27212.0,231
HCPCS,42953,PHARYNGOESOPHAGEAL REPAIR,3780.0,2457.0,1.1,3780.0,144
HCPCS,42953,REPAIR THROAT ESOPHAGUS,,,2438.74,2438.74,1
HCPCS,42953,Repair throat esophagus,,,939.63,1087.99,8
HCPCS,42955,PHARYNGOSTOMY FSTLJ PHARYNX XTRNL FEEDING,3204.0,2082.6,1.1,4447.63,144
HCPCS,42955,SURGICAL OPENING OF THROAT,,,1323.06,1614.71,20
HCPCS,42955,Surgical opening of throat,,,939.63,1087.99,8
HCPCS,42960,CONTROL OROPHARYNGEAL HEMORRHAGE SIMPLE,1647.5,1070.875,0.01,4392.0,318
HCPCS,42961,CTRL OROPHARYNGEAL HEMORRHAGE COMP REQ HOSPITJ,2308.0,1500.2,1.1,2308.0,144
HCPCS,42961,Control throat bleeding,,,939.63,1087.99,8
HCPCS,42962,CTRL OROPHARYNGEAL HEMORRHAGE W/SEC SURG IVNTJ,9087.0,5906.55,0.01,14918.0,231
HCPCS,42970,CTRL NASOPHARYNGEAL HEMRRG SMPL W/PST NSL PACKS,1698.0,1103.7,1.1,3443.0,230
HCPCS,42971,Control nose/throat bleeding,,,1558.4,1804.46,8
HCPCS,42972,CONTROL NOSE/THROAT BLEEDING,,,2793.19,3450.35,20
HCPCS,42972,CTRL NASOPHARYNGEAL HEMORRHAGE W/SEC SURG IVNTJ,3036.0,1973.4,1.1,9391.15,144
HCPCS,42972,Control nose/throat bleeding,,,939.63,1087.99,8
HCPCS,42975,DISE DYN EVAL SLEEP DISORDERED BREATHING FLX DX,4314.0,2804.1,1.1,12500.0,316
HCPCS,42999,ALLODERM RECONSTRUCT PHARYNX,1205.0,783.25,0.01,1205.0,84
HCPCS,42999,DL W/LYSIS OF PHARYNG/HYPOPHARYNG STENOSIS (COMP 42950),2978.0,1935.7,0.01,2978.0,84
HCPCS,42999,ENDO CAUTERY OF PIRIFOM SINUS TRACT,776.0,504.4,0.01,776.0,84
HCPCS,42999,EXCISION OF TONSIL LESION (COMP 42808),776.0,504.4,0.01,776.0,84
HCPCS,42999,INJECTION OF FILLER INTO PHARYNGEAL WALL (COMP CODE 31574),1912.5,1243.125,0.01,3443.0,169
HCPCS,42999,NASOPHARYNGOSOCOPY W/BX NASOPHARYNX (COMP CODE 31237),1030.0,669.5,0.01,1030.0,84
HCPCS,42999,NASPHARSCOPY INJ PHARYNX,3434.0,2232.1,0.01,3443.0,169
HCPCS,4300F,PT RCVNG WARF THXPY,,,2739849.3,2739849.3,1
HCPCS,4300F,Pt rcvng warf thxpy,,,10.69,12.38,8
HCPCS,4301F,PT NOT RCVNG WARF THXPY,,,2739849.3,2739849.3,1
HCPCS,4301F,Pt not rcvng warf thxpy,,,10.69,12.38,8
HCPCS,43020,INCISION OF ESOPHAGUS,,,1323.06,3981.36,21
HCPCS,43020,Incision of esophagus,,,939.63,1087.99,8
HCPCS,43030,CRICOPHARYNGEAL MYOTOMY,,,5080.55,6160.68,20
HCPCS,43030,CRICOPHAYNGEAL MYOTOMY,3196.0,2077.4,1.1,17080.38,144
HCPCS,43030,Cricopharyngeal myotomy,,,2710.76,3138.77,8
HCPCS,43045,ESOPHAGOTOMY THORACIC APPR W/RMVL FB,8752.0,5688.8,1.1,8752.0,144
HCPCS,43045,ESOPHAGOTOMY THRC RMVL FB,,,3405.22,3405.22,1
HCPCS,43045,Esophagotomy thrc rmvl fb,,,3174.61,3675.86,8
HCPCS,4305F,PT ED RE FT CARE INSPCT RCVD,,,2739849.3,2739849.3,1
HCPCS,4305F,Pt ed re ft care inspct rcvd,,,10.69,12.38,8
HCPCS,4306F,PT TLK PSYCH & RX OPD ADDIC,,,2739849.3,2739849.3,1
HCPCS,4306F,Pt tlk psych & rx opd addic,,,10.69,12.38,8
HCPCS,43100,EXC LESION ESOPHOGUS W/PRIM RPR CERVICAL APPR,3864.0,2511.6,1.1,3864.0,144
HCPCS,43100,EXCISION OF ESOPHAGUS LESION,,,1666.06,1666.06,1
HCPCS,43100,Excision of esophagus lesion,,,3009.46,3484.64,8
HCPCS,43101,EXC LESION ESOPHAGUS W/PRIM RPR THRC/ABDL APPR,6828.0,4438.2,1.1,6828.0,144
HCPCS,43101,EXCISION OF ESOPHAGUS LESION,,,2627.77,2627.77,1
HCPCS,43101,Excision of esophagus lesion,,,3009.46,3484.64,8
HCPCS,43107,REMOVAL OF ESOPHAGUS,,,7763.0,7763.0,1
HCPCS,43107,Removal of esophagus,,,3156.08,3654.41,8
HCPCS,43107,TOT ESOPHAGECTOMY W/O THORCOM W/WO PYLOROPLASTY,20820.0,13533.0,1.1,20820.0,144
HCPCS,43108,REMOVAL OF ESOPHAGUS,,,11572.83,11572.83,1
HCPCS,43108,Removal of esophagus,,,3156.08,3654.41,8
HCPCS,43108,TOT ESOPHG W/O THORCOM COLON NTRPSTJ/INT RCNSTJ,33148.0,21546.2,1.1,33148.0,144
HCPCS,43112,ESPHG TOT W/THRCM,,,9008.87,9008.87,1
HCPCS,43112,Esphg tot w/thrcm,,,3156.08,3654.41,8
HCPCS,43112,TOTAL ESOPHAGECTOMY W/THORCOM W/WO PYLORPLASTY,24800.0,16120.0,1.1,24800.0,144
HCPCS,43113,REMOVAL OF ESOPHAGUS,,,11314.69,11314.69,1
HCPCS,43113,Removal of esophagus,,,3156.08,3654.41,8
HCPCS,43113,TOT ESOPHG W/THORCOM W/COLON NTRPSTJ/INT RCNSTJ,32024.0,20815.6,1.1,32024.0,144
HCPCS,43116,PARTIAL REMOVAL OF ESOPHAGUS,,,12939.7,12939.7,1
HCPCS,43116,PRTL ESOPHAGECTOMY CERVICAL W/FREE INTSTINAL GRF,37196.0,24177.4,1.1,37196.0,144
HCPCS,43116,Partial removal of esophagus,,,3156.08,3654.41,8
HCPCS,43117,PARTIAL REMOVAL OF ESOPHAGUS,,,8488.33,8488.33,1
HCPCS,43117,PRTL ESOPHECT DSTL W/WO PROX GASTRECT/PYLORPLSTY,23000.0,14950.0,1.1,23000.0,144
HCPCS,43117,Partial removal of esophagus,,,3156.08,3654.41,8
HCPCS,43118,PARTIAL REMOVAL OF ESOPHAGUS,,,9439.93,9439.93,1
HCPCS,43118,PRTL ESOPH DSTL W/WO PROX GASTRC W/COLON NTRPSTJ,26828.0,17438.2,1.1,26828.0,144
HCPCS,43118,Partial removal of esophagus,,,3156.08,3654.41,8
HCPCS,43121,PARTIAL REMOVAL OF ESOPHAGUS,,,7447.65,7447.65,1
HCPCS,43121,PRTL ESOPHAGEC W/WO PROX GASTREC/PYLOROPLASTY,20572.0,13371.8,1.1,20572.0,144
HCPCS,43121,Partial removal of esophagus,,,3156.08,3654.41,8
HCPCS,43122,PARTIAL REMOVAL OF ESOPHAGUS,,,6719.03,6719.03,1
HCPCS,43122,PRTL ESOPHG THORACOABD W/WO PROXGASTREC/PYLOROPL,17672.0,11486.8,1.1,17672.0,144
HCPCS,43122,Partial removal of esophagus,,,3156.08,3654.41,8
HCPCS,43123,PARTIAL REMOVAL OF ESOPHAGUS,,,11727.53,11727.53,1
HCPCS,43123,PRTL ESPHG THORACOABDL/ABDL APPR NTRPSTJ/RCNSTJ,33248.0,21611.2,1.1,33248.0,144
HCPCS,43123,Partial removal of esophagus,,,3156.08,3654.41,8
HCPCS,43124,REMOVAL OF ESOPHAGUS,,,9916.77,9916.77,1
HCPCS,43124,Removal of esophagus,,,3156.08,3654.41,8
HCPCS,43124,TOT/PRTL ESPHG W/O RCNSTJ W/CRV ESOPHAGOSTOMY,27636.0,17963.4,1.1,27636.0,144
HCPCS,43130,DIVERTICULECTOMY HYPOPHARYNX/ESOPH CRV APPR,5513.0,3583.45,1.1,17080.38,144
HCPCS,43130,REMOVAL OF ESOPHAGUS POUCH,,,5080.55,15288.41,21
HCPCS,43130,Removal of esophagus pouch,,,3156.08,3654.41,8
HCPCS,43135,DIVERTICULECTOMY HYPOPHARYNX/ESOPH THRC APPR,10468.0,6804.2,1.1,10468.0,144
HCPCS,43135,REMOVAL OF ESOPHAGUS POUCH,,,3835.23,3835.23,1
HCPCS,43135,Removal of esophagus pouch,,,3156.08,3654.41,8
HCPCS,43180,ESOPHAGOSCP RIG TRANSORAL HYPOPHARYNX CRV ESOPH,15412.0,10017.8,1.1,27212.0,231
HCPCS,43191,ESOPHAGOSCOPY RIGID TRANSORAL DIAGNOSTIC BRUSH,4861.0,3159.6499999999996,1.1,8726.0,231
HCPCS,43192,ESOPHAGOSCOPY RIGID TRANSORAL INJ SUBMUCOSAL,1116.0,725.4,1.1,5549.59,144
HCPCS,43192,ESOPHAGOSCP RIG TRNSO INJECT,,,1650.8,5457.0,21
HCPCS,43192,Esophagoscp rig trnso inject,,,1500.64,1737.58,8
HCPCS,43193,ESOPHAGOSCOPY RIGID TRANSORAL WITH BIOPSY,1116.0,725.4,1.1,5549.59,144
HCPCS,43193,ESOPHAGOSCP RIG TRNSO BIOPSY,,,1650.8,1996.98,20
HCPCS,43193,Esophagoscp rig trnso biopsy,,,1500.64,1737.58,8
HCPCS,43194,ESOPHAGOSCOPY RIG TRANSORAL REMOVAL FOREIGN BODY,1404.0,912.6,1.1,5549.59,144
HCPCS,43194,ESOPHAGOSCP RIG TRNSO REM FB,,,1650.8,1996.98,20
HCPCS,43194,Esophagoscp rig trnso rem fb,,,1500.64,1737.58,8
HCPCS,43195,ESOPHAGOSCOPY RIGID TRANSORAL BALLOON DILATION,1228.0,798.2,1.1,11169.59,144
HCPCS,43195,"ESOPHAGOSCOPY, RIGID, TRANSORAL; WITH BALLOON DILATION (LESS THA",17501.0,11375.65,0.01,17501.0,87
HCPCS,43196,ESOPHAGOSCOPY RIG TRANSORAL GUIDE WIRE DILATION,5025.0,3266.25,1.1,8726.0,231
HCPCS,43197,ESOPHAGOSCOPY FLEXIBLE TRANSNASAL DIAGNOSTIC,2460.5,1599.3249999999998,1.1,6112.0,235
HCPCS,43198,ESOPHAGOSCOPY FLEXIBLE TRANSNASAL WITH BIOPSY,2520.5,1638.3249999999998,0.01,5597.0,235
HCPCS,43200,ESOPHAGOSCOPY FLEXIBLE TRANSORAL DIAGNOSTIC,2469.0,1604.85,0.01,6112.0,322
HCPCS,43201,ESOPHAGOSCOPY FLEXIBLE TRANSORAL W SUBMUCOUS INJ,4707.0,3059.5499999999997,1.1,8726.0,235
HCPCS,43202,ESOPHAGOSCOPY FLEXIBLE TRANSORAL WITH BIOPSY,4707.0,3059.5499999999997,0.01,8726.0,322
HCPCS,43204,ESOPH SCOPE W/SCLEROSIS INJ,,,1650.8,1996.98,20
HCPCS,43204,ESOPHAGOSCOPY FLEX TRANSORAL INJECTION VARICES,932.0,605.8,1.1,5549.59,144
HCPCS,43204,Esoph scope w/sclerosis inj,,,780.28,903.49,8
HCPCS,43205,ESPHGOSCOPY FLEX W/BAND LIGATION ESOPHGL VARICES,4851.0,3153.1499999999996,1.1,8726.0,231
HCPCS,43206,ESOPH OPTICAL ENDOMICROSCOPY,,,1650.8,1996.98,20
HCPCS,43206,ESOPHAGOSCOPY TRANSORAL W/OPTICAL ENDOMICROSCOPY,916.0,595.4,1.1,5549.59,146
HCPCS,43206,Esoph optical endomicroscopy,,,1500.64,1737.58,8
HCPCS,4320F,PT TALK PSYCHSOC&RX OH DPND,,,2739849.3,2739849.3,1
HCPCS,4320F,Pt talk psychsoc&rx oh dpnd,,,10.69,12.38,8
HCPCS,43210,EGD PARTIAL/COMPL ESOPHAGOGASTRIC FUNDOPLASTY,25496.0,16572.4,1.1,47892.0,230
HCPCS,43211,ESOPHAGOSCOP MUCOSAL RESECT,,,1650.8,1996.98,20
HCPCS,43211,ESOPHAGOSCOPY FLEXIBLE TRANSORAL MUCOSAL RESEXN,1680.0,1092.0,1.1,5549.59,144
HCPCS,43211,Esophagoscop mucosal resect,,,780.28,903.49,8
HCPCS,43212,ESOPHAGOSCOPY TRANSORAL STENT PLACEMENT,14371.5,9341.475,1.1,27383.0,231
HCPCS,43213,ESOPHAGOSCOPY RETROGRADE DILATE BALLOON/OTHER,5289.0,3437.85,1.1,8726.0,235
HCPCS,43214,ESOPHAGOSC DILATE BALLOON 30,,,1650.8,1996.98,20
HCPCS,43214,ESOPHAGOSCOPY DILATE ESOPHAGUS BALLOON 30 MM,1360.0,884.0,1.1,5549.59,144
HCPCS,43214,Esophagosc dilate balloon 30,,,1500.64,1737.58,8
HCPCS,43215,ESOPHAGOSCOPY FLEXIBLE REMOVAL FOREIGN BODY,4851.0,3153.1499999999996,1.1,8726.0,235
HCPCS,43216,ESOPHAGOSCOPY LESION REMOVAL,,,1650.8,1996.98,20
HCPCS,43216,ESPHAGOSCOPY FLEX LESION REMOVAL HOT BX FORCEPS,920.0,598.0,1.1,5549.59,148
HCPCS,43216,Esophagoscopy lesion removal,,,780.28,903.49,8
HCPCS,43217,ESOPHAGOSCOPY FLEXIB LESION REMOVAL TUMOR SNARE,1120.0,728.0,1.1,5549.59,148
HCPCS,43217,ESOPHAGOSCOPY SNARE LES REMV,,,1650.8,1996.98,20
HCPCS,43217,Esophagoscopy snare les remv,,,780.28,903.49,8
HCPCS,43220,ESOPHAGOSCOPY FLEX BALLOON DILAT <30 MM DIAM,4763.0,3095.95,1.1,8726.0,235
HCPCS,43226,ESOPHAGOSCOPY FLEXIBLE GUIDE WIRE DILATION,4811.0,3127.1499999999996,1.1,8726.0,235
HCPCS,43227,ESOPHAGOSCOPY FLEXIBLE W/BLEEDING CONTROL,4941.0,3211.6499999999996,1.1,8726.0,235
HCPCS,43229,ESOPHAGOSCOPY FLEX TRANSORAL LESION ABLATION,1396.0,907.4,1.1,11169.59,148
HCPCS,43229,ESOPHAGOSCOPY LESION ABLATE,,,3322.52,4012.33,20
HCPCS,43229,Esophagoscopy lesion ablate,,,1500.64,1737.58,8
HCPCS,4322F,CRGVR PROV W/ ED ADDL RSRCS,,,2739849.3,2739849.3,1
HCPCS,4322F,Crgvr prov w/ ed addl rsrcs,,,10.69,12.38,8
HCPCS,43231,ESOPHAGOSCOPY FLEXIBLE TRANSORAL ULTRASOUND EXAM,4923.0,3199.95,1.1,8726.0,231
HCPCS,43232,ESOPHAGOSCOPY INTRA/TRANSMURAL NEEDLE ASPIRAT/BX,5081.0,3302.6499999999996,0.01,8726.0,318
HCPCS,43233,EGD ESOPHAGUS BALLOON DILATION 30 MM OR LARGER,5177.0,3365.0499999999997,1.1,8726.0,318
HCPCS,43235,ESOPHAGOGASTRODUODENOSCOPY TRANSORAL DIAGNOSTIC,2574.5,1673.425,0.01,6112.0,496
HCPCS,43236,ESOPHAGOGASTRODUODENOSCOPY SUBMUCOSAL INJECTION,2682.5,1743.625,1.1,6112.0,235
HCPCS,43237,ESOPHAGOGASTRODUODENOSCOPY US SCOPE W/ADJ STRXRS,5126.5,3332.225,1.1,8726.0,231
HCPCS,43238,EGD INTRMURAL US NEEDLE ASPIRATE/BIOPSY ESOPHAGS,5278.0,3430.7,1.1,8726.0,231
HCPCS,43239,EGD TRANSORAL BIOPSY SINGLE/MULTIPLE,2682.5,1743.625,0.01,6112.0,409
HCPCS,43240,EGD TRANSORAL TRANSMURAL DRAINAGE PSEUDOCYST,15264.5,9921.925000000001,1.1,27383.0,231
HCPCS,43241,EGD INTRALUMINAL TUBE/CATHETER INSERTION,4911.0,3192.1499999999996,1.1,8726.0,318
HCPCS,43242,EGD INTRMURAL NEEDLE ASPIR/BIOP ALTERED ANATOMY,5403.5,3512.2749999999996,1.1,8726.0,231
HCPCS,43243,EGD INJECTION SCLEROSIS ESOPHGL/GASTRIC VARICES,5302.5,3446.625,1.1,8726.0,318
HCPCS,43244,EGD BAND LIGATION ESOPHGEAL/GASTRIC VARICES,5331.0,3465.1499999999996,1.1,8726.0,231
HCPCS,43245,EGD DILATION GASTRIC/DUODENAL STRICTURE,5040.5,3276.325,1.1,8726.0,235
HCPCS,43246,EGD PERCUTANEOUS PLACEMENT GASTROSTOMY TUBE,5146.0,3344.8999999999996,0.01,8726.0,405
HCPCS,43247,EGD FLEXIBLE FOREIGN BODY REMOVAL,2840.5,1846.3249999999998,0.01,6112.0,409
HCPCS,43248,EGD INSERT GUIDE WIRE DILATOR PASSAGE ESOPHAGUS,2796.5,1817.725,1.1,6112.0,235
HCPCS,43249,EGD BALLOON DILATION ESOPHAGUS <30 MM DIAM,4950.5,3217.825,1.1,8726.0,235
HCPCS,4324F,PT QUERIED PRKNS COMPLIC,,,2739849.3,2739849.3,1
HCPCS,4324F,Pt queried prkns complic,,,10.69,12.38,8
HCPCS,43250,EGD FLEX REMOVAL LESION(S) BY HOT BIOPSY FORCEPS,5016.5,3260.725,1.1,8726.0,322
HCPCS,43251,EGD REMOVAL TUMOR POLYP/OTHER LESION SNARE TECH,5126.5,3332.225,1.1,8726.0,322
HCPCS,43252,EGD FLEX TRANSORAL W/OPTICAL ENDOMICROSCOPY,1302.0,846.3,1.1,5549.59,146
HCPCS,43252,EGD OPTICAL ENDOMICROSCOPY,,,1650.8,1996.98,20
HCPCS,43252,Egd optical endomicroscopy,,,3155.47,3653.71,8
HCPCS,43253,EGD US GUIDED TRANSMURAL INJXN/FIDUCIAL MARKER,5403.5,3512.2749999999996,1.1,8726.0,318
HCPCS,43254,EGD TRANSORAL ENDOSCOPIC MUCOSAL RESECTION,5434.5,3532.4249999999997,1.1,8726.0,231
HCPCS,43255,EGD TRANSORAL CONTROL BLEEDING ANY METHOD,8726.0,5671.9,232.25,8726.0,174
HCPCS,43255,"EGD WITH CONTROL OF BLEED,",1566.0,1017.9,1.1,5549.59,148
HCPCS,43257,EGD DELIVER THERMAL ENERGY SPHNCTR/CARDIA GERD,9580.5,6227.325,1.1,17501.0,231
HCPCS,43259,EDG US EXAM SURGICAL ALTER STOM DUODENUM/JEJUNUM,5171.0,3361.1499999999996,1.1,8726.0,231
HCPCS,4325F,MED TXMNT OPTIONS RVWD W/PT,,,2739849.3,2739849.3,1
HCPCS,4325F,Med txmnt options rvwd w/pt,,,10.69,12.38,8
HCPCS,43260,ERCP DX COLLECTION SPECIMEN BRUSHING/WASHING,9920.5,6448.325,1.1,17501.0,223
HCPCS,43261,ERCP W/BIOPSY SINGLE/MULTIPLE,9980.5,6487.325,1.1,17501.0,223
HCPCS,43262,ERCP W/SPHINCTEROTOMY/PAPILLOTOMY,10050.5,6532.825,1.1,17501.0,223
HCPCS,43263,ERCP W/PRESSURE MEASUREMENT SPHINCTER OF ODDI,5663.0,3680.95,1.1,8726.0,223
HCPCS,43264,ERCP REMOVE CALCULI/DEBRIS BILIARY/PANCREAS DUCT,10209.0,6635.849999999999,1.1,17501.0,223
HCPCS,43265,ERCP DESTRUCTION/LITHOTRIPSY CALCULI ANY METHOD,15436.0,10033.4,1.1,27383.0,231
HCPCS,43266,EGD ENDOSCOPIC STENT PLACEMENT W/WIRE& DILATION,14475.5,9409.075,1.1,27383.0,231
HCPCS,4326F,PT ASKED RE SYMP AUTO DYSFXN,,,2739849.3,2739849.3,1
HCPCS,4326F,Pt asked re symp auto dysfxn,,,10.69,12.38,8
HCPCS,43270,EGD ABLATE TUMOR POLYP/LESION W/DILATION& WIRE,5165.0,3357.25,1.1,8726.0,235
HCPCS,43273,ENDOSCOPIC PAPILLA CANNULATION BILE/PANCREATIC,2866.5,1863.2250000000001,1.1,10364.0,213
HCPCS,43274,ERCP STENT PLACEMENT BILIARY/PANCREATIC DUCT,15557.0,10112.050000000001,1.1,27383.0,231
HCPCS,43275,ERCP REMOVE FOREIGN BODY/STENT BILIARY/PANC DUCT,5872.0,3816.7999999999997,1.1,10364.0,223
HCPCS,43276,ERCP BILIARY/PANC DUCT STENT EXCHANGE W/DIL&WIRE,15636.5,10163.725,1.1,27383.0,231
HCPCS,43277,ERCP BALLOON DILATE BILIARY/PANC DUCT/AMPULLA EA,10130.5,6584.825,1.1,17501.0,231
HCPCS,43278,ERCP TUMOR/POLYP/LESION ABLATION W/DILATION&WIRE,10334.5,6717.424999999999,1.1,17501.0,231
HCPCS,43279,LAP MYOTOMY HELLER,,,3373.73,4616.0,2
HCPCS,43279,LAPS ESOPHAGOMYOTOMY W/FUNDOPLASTY IF PERFORMED,8840.0,5746.0,1.1,8840.0,144
HCPCS,43279,Lap myotomy heller,,,4773.02,5526.65,8
HCPCS,43280,LAPAROSCOPY FUNDOPLASTY,,,8930.36,11062.31,21
HCPCS,43280,LAPS SURG ESOPG/GSTR FUNDOPLASTY,7240.0,4706.0,1.1,30022.29,144
HCPCS,43280,Laparoscopy fundoplasty,,,4773.02,5526.65,8
HCPCS,43281,LAP PARAESOPHAG HERN REPAIR,,,8930.36,26873.26,21
HCPCS,43281,LAPS RPR PARAESPHGL HRNA INCL FUNDPLSTY W/O MESH,10640.0,6916.0,1.1,30022.29,144
HCPCS,43281,Lap paraesophag hern repair,,,5578.94,6459.83,8
HCPCS,43282,LAP PARAESOPH HER RPR W/MESH,,,8930.36,26873.26,21
HCPCS,43282,LAPS RPR PARAESPHGL HRNA INCL FUNDPLSTY W/MESH,12040.0,7826.0,1.1,30022.29,144
HCPCS,43282,Lap paraesoph her rpr w/mesh,,,5578.94,6459.83,8
HCPCS,43283,LAPS ESOPHAGEAL LENGTHENING ADDL,1298.0,843.7,1.1,1298.0,144
HCPCS,43283,Lap esoph lengthening,,,5578.94,6459.83,8
HCPCS,43284,LAPS ESOPHGL SPHNCTR AGMNTJ,,,8930.36,11062.31,20
HCPCS,43284,LAPS ESOPHGL SPHNCTR AGMNTJ PLMT DEV CRRPL,4052.0,2633.8,1.1,30022.29,142
HCPCS,43284,Laps esophgl sphnctr agmntj,,,4773.02,5526.65,8
HCPCS,43285,REMOVAL ESOPHAGEAL SPHINCTER AGMNTJ DEVICE,4188.0,2722.2,1.1,16829.38,142
HCPCS,43285,RMVL ESOPHGL SPHNCTR DEV,,,5005.78,6291.49,20
HCPCS,43285,Rmvl esophgl sphnctr dev,,,4773.02,5526.65,8
HCPCS,43286,ESOPHAGECTOMY TOTAL NEAR TOTAL W/LAPS MOBLJ,22000.0,14300.0,1.1,22000.0,144
HCPCS,43286,Esphg tot w/laps moblj,,,3156.08,3654.41,8
HCPCS,43287,ESOPHAGECTOMY DISTAL 2/3 W/LAPAROSCOPIC MOBLJ,25200.0,16380.0,1.1,25200.0,144
HCPCS,43287,Esphg dstl 2/3 w/laps moblj,,,3156.08,3654.41,8
HCPCS,43288,ESOPHAGECTOMY TOTAL NEAR TOTAL W/THRSC MOBLJ,26568.0,17269.2,1.1,26568.0,144
HCPCS,43288,Esphg thrsc moblj,,,3156.08,3654.41,8
HCPCS,43289,UNLISTED LAP ESOPHAGOPLASTY FOR CONGENITAL DEFECT (COMP CODE 433,22708.0,14760.2,0.01,22708.0,84
HCPCS,43289,"UNLISTED LAP RESECTION, ESOPHAGEAL DUPLICATION CYST (COMP CODE 4",7340.0,4771.0,0.01,16829.38,84
HCPCS,43289,UNLISTED LAPAROSCOPIC PROCEDURE ESOPHAGUS,9667.0,6283.55,0.01,16829.38,84
HCPCS,43289,UNLISTED LAPS PX ESOPH,,,5005.78,15063.4,21
HCPCS,43289,Unlisted laps px esoph,,,3009.46,3484.64,8
HCPCS,4328F,PT ASKED RE SLEEP DISTURB,,,2739849.3,2739849.3,1
HCPCS,4328F,Pt asked re sleep disturb,,,10.69,12.38,8
HCPCS,43290,EGD FLX TRNSORL DPLMNT BALO,,,1650.8,1996.98,20
HCPCS,43290,EGD FLX TRNSORL W/DPLMNT NTRGSTR BARIATRIC BALO,1244.0,808.6,1.1,8898.47,146
HCPCS,43290,Egd flx trnsorl dplmnt balo,,,780.28,903.49,8
HCPCS,43291,EGD FLX TRNSORL RMVL BALO,,,786.42,943.89,20
HCPCS,43291,EGD FLX TRNSORL W/RMVL NTRGSTR BARIATRIC BALO,1120.0,728.0,1.1,2644.7,146
HCPCS,43291,Egd flx trnsorl rmvl balo,,,780.28,903.49,8
HCPCS,43300,ESPHGP CRV APPR W/O RPR TRACHEOESOPHGL FSTL,3732.0,2425.8,1.1,3732.0,144
HCPCS,43300,REPAIR OF ESOPHAGUS,,,1638.25,1638.25,1
HCPCS,43300,Repair of esophagus,,,3009.46,3484.64,8
HCPCS,43305,ESPHGP CRV APPR W/RPR TRACHEOESOPHGL FSTL,7240.0,4706.0,1.1,7240.0,144
HCPCS,43305,REPAIR ESOPHAGUS AND FISTULA,,,2865.74,2865.74,1
HCPCS,43305,Repair esophagus and fistula,,,3156.08,3654.41,8
HCPCS,4330F,CNSLNG EPI SPEC SFTY ISSUES,,,2739849.3,2739849.3,1
HCPCS,4330F,Cnslng epi spec sfty issues,,,10.69,12.38,8
HCPCS,43310,ESPHGP THRC APPR W/O RPR TRACHEOESOPHGL FSTL,10504.0,6827.6,1.1,10504.0,144
HCPCS,43310,REPAIR OF ESOPHAGUS,,,3868.03,3868.03,1
HCPCS,43310,Repair of esophagus,,,4773.02,5526.65,8
HCPCS,43312,ESPHGP THRC APPR W/RPR TRACHEOESOPHGL FSTL,11700.0,7605.0,1.1,11700.0,144
HCPCS,43312,REPAIR ESOPHAGUS AND FISTULA,,,4142.99,4142.99,1
HCPCS,43312,Repair esophagus and fistula,,,4773.02,5526.65,8
HCPCS,43313,ESOPHAGOPLASTY CONGENITAL,,,7628.13,7628.13,1
HCPCS,43313,ESPHGP CGEN DFCT THRC APPR W/O RPR FSTL,19380.0,12597.0,1.1,19380.0,144
HCPCS,43313,Esophagoplasty congenital,,,4773.02,5526.65,8
HCPCS,43314,ESPHGP CGEN DFCT THRC APPR W/RPR FSTL,21372.0,13891.8,1.1,21372.0,144
HCPCS,43314,TRACHEO-ESOPHAGOPLASTY CONG,,,8177.91,8177.91,1
HCPCS,43314,Tracheo-esophagoplasty cong,,,4773.02,5526.65,8
HCPCS,43320,EGST W/WO VAGOTOMY&PYLOROPLASTY TABDL/TTHRC AP,9324.0,6060.6,1.1,9324.0,144
HCPCS,43320,FUSE ESOPHAGUS & STOMACH,,,3679.03,3679.03,1
HCPCS,43320,Fuse esophagus & stomach,,,3156.08,3654.41,8
HCPCS,43325,ESOPG/GSTR FUNDOPLASTY W/FUNDIC PATCH,9040.0,5876.0,1.1,9040.0,144
HCPCS,43325,Revise esophagus & stomach,,,4773.02,5526.65,8
HCPCS,43327,ESOPG/GSTR FUNDOPLASTY W/LAPT,5340.0,3471.0,1.1,5340.0,144
HCPCS,43327,Esoph fundoplasty lap,,,4773.02,5526.65,8
HCPCS,43328,ESOPG/GSTR FUNDOPLASTY W/THORCOM,7964.0,5176.6,1.1,7964.0,144
HCPCS,43328,ESOPH FUNDOPLASTY THOR,,,2928.76,2928.76,1
HCPCS,43328,Esoph fundoplasty thor,,,4773.02,5526.65,8
HCPCS,43330,ESOPHAGOMYOTOMY ABDOMINAL,,,3518.05,3518.05,1
HCPCS,43330,ESOPHAGOMYOTOMY HELLER TYPE ABDOMINAL APPROACH,8876.0,5769.4,1.1,8876.0,144
HCPCS,43330,Esophagomyotomy abdominal,,,4773.02,5526.65,8
HCPCS,43331,ESOPHAGOMYOTOMY HELLER TYPE THORACIC APPROACH,9224.0,5995.6,1.1,9224.0,144
HCPCS,43331,ESOPHAGOMYOTOMY THORACIC,,,3496.98,3496.98,1
HCPCS,43331,Esophagomyotomy thoracic,,,4773.02,5526.65,8
HCPCS,43332,RPR PARAESOPH HIATAL HERNIA W/LAPT W/O MESH,7848.0,5101.2,1.1,7848.0,144
HCPCS,43332,TRANSAB ESOPH HIAT HERN RPR,,,3019.07,3019.07,1
HCPCS,43332,Transab esoph hiat hern rpr,,,5578.94,6459.83,8
HCPCS,43333,LAPT RPR PARAESOPH HIATAL HERNIA W/ MESH,8584.0,5579.6,1.1,8584.0,144
HCPCS,43333,TRANSAB ESOPH HIAT HERN RPR,,,3307.1,3307.1,1
HCPCS,43333,Transab esoph hiat hern rpr,,,5578.94,6459.83,8
HCPCS,43334,RPR PARAESOPH HIATAL HERNIA W/THORCOM W/O MESH,8848.0,5751.2,1.1,8848.0,144
HCPCS,43334,TRANSTHOR DIAPHRAG HERN RPR,,,3236.9,3236.9,1
HCPCS,43334,Transthor diaphrag hern rpr,,,5578.94,6459.83,8
HCPCS,43335,RPR PARAESOPH HIATAL HERNIA W/THORCOM W/MESH,9588.0,6232.2,1.1,9588.0,144
HCPCS,43335,TRANSTHOR DIAPHRAG HERN RPR,,,3480.02,3480.02,1
HCPCS,43335,Transthor diaphrag hern rpr,,,5578.94,6459.83,8
HCPCS,43336,RPR PARAESOPH HIATAL HERNIA THORCOABDOM W/O MESH,10324.0,6710.6,1.1,10324.0,144
HCPCS,43336,THORABD DIAPHR HERN REPAIR,,,3777.31,3777.31,1
HCPCS,43336,Thorabd diaphr hern repair,,,5578.94,6459.83,8
HCPCS,43337,RPR PARAESOPH HIATAL HERNIA THORCOABDOM W/MESH,11060.0,7189.0,1.1,11060.0,144
HCPCS,43337,THORABD DIAPHR HERN REPAIR,,,4024.95,4024.95,1
HCPCS,43337,Thorabd diaphr hern repair,,,5578.94,6459.83,8
HCPCS,43338,ESOPH LENGTHENING,,,298.19,298.19,1
HCPCS,43338,ESOPHAGUS LENGTHENING,884.0,574.6,1.1,884.0,144
HCPCS,43338,Esoph lengthening,,,4773.02,5526.65,8
HCPCS,43340,ESOPHAGOJEJUNOSTOMY W/O TOT GSTRCT ABDL APPR,9196.0,5977.4,1.1,9196.0,144
HCPCS,43340,FUSE ESOPHAGUS & INTESTINE,,,3633.9,3633.9,1
HCPCS,43340,Fuse esophagus & intestine,,,3009.46,3484.64,8
HCPCS,43341,ESOPHAGOJEJUNOSTOMY W/O TOT GSTRCT THRC APPR,9692.0,6299.8,1.1,9692.0,144
HCPCS,43341,FUSE ESOPHAGUS & INTESTINE,,,3657.65,3657.65,1
HCPCS,43341,Fuse esophagus & intestine,,,3009.46,3484.64,8
HCPCS,43351,ESOPHAGOSTOMY FSTLJ ESOPH XTRNL THRC APPR,8820.0,5733.0,1.1,8820.0,144
HCPCS,43351,SURGICAL OPENING ESOPHAGUS,,,3445.41,3445.41,1
HCPCS,43351,Surgical opening esophagus,,,3009.46,3484.64,8
HCPCS,43352,ESOPHAGOSTOMY FSTLJ ESOPH XTRNL CRV APPR,7124.0,4630.6,1.1,7124.0,144
HCPCS,43352,SURGICAL OPENING ESOPHAGUS,,,2787.79,2787.79,1
HCPCS,43352,Surgical opening esophagus,,,3156.08,3654.41,8
HCPCS,43360,GASTROINTESTINAL REPAIR,,,5870.23,5870.23,1
HCPCS,43360,GI RCNSTJ PREV ESPHG/EXCLUSION W/STOMACH,16044.0,10428.6,1.1,16044.0,144
HCPCS,43360,Gastrointestinal repair,,,3156.08,3654.41,8
HCPCS,43361,GASTROINTESTINAL REPAIR,,,7093.83,7093.83,1
HCPCS,43361,GI RCNSTJ PREV ESPHG/EXCLUSION W/COLON SM INT,18272.0,11876.8,1.1,18272.0,144
HCPCS,43361,Gastrointestinal repair,,,3156.08,3654.41,8
HCPCS,43400,LIGATE ESOPHAGUS VEINS,,,4008.65,4008.65,1
HCPCS,43400,LIGATION DIRECT ESOPHAGEAL VARICES,10240.0,6656.0,1.1,10240.0,144
HCPCS,43400,Ligate esophagus veins,,,3156.08,3654.41,8
HCPCS,43405,LIG/STAPLING G-ESOP JUNCT PRE-ESOPHGL PRF8J,9892.0,6429.8,1.1,9892.0,144
HCPCS,43405,LIGATE/STAPLE ESOPHAGUS,,,3806.82,3806.82,1
HCPCS,43405,Ligate/staple esophagus,,,3009.46,3484.64,8
HCPCS,4340F,CNSLNG CHLDBRNG WOMEN EPI,,,2739849.3,2739849.3,1
HCPCS,4340F,Cnslng chldbrng women epi,,,10.69,12.38,8
HCPCS,43410,REPAIR ESOPHAGUS WOUND,,,2703.2,2703.2,1
HCPCS,43410,Repair esophagus wound,,,3156.08,3654.41,8
HCPCS,43410,SUTR ESOPHGL WND/INJ CRV APPR,6564.0,4266.6,1.1,6564.0,144
HCPCS,43415,REPAIR ESOPHAGUS WOUND,,,6735.47,6735.47,1
HCPCS,43415,Repair esophagus wound,,,3156.08,3654.41,8
HCPCS,43415,SUTR ESOPHGL WND/INJ TTHRC/TABDL APPR,17952.0,11668.8,1.1,17952.0,144
HCPCS,43420,CLSR ESOPHAGOSTOMY/FSTL CRV APPR,6712.0,4362.8,1.1,9391.15,144
HCPCS,43420,REPAIR ESOPHAGUS OPENING,,,2793.19,8405.28,21
HCPCS,43420,Repair esophagus opening,,,3156.08,3654.41,8
HCPCS,43425,CLSR ESOPHAGOSTOMY/FSTL TTHRC/TABDL APPR,10016.0,6510.4,1.1,10016.0,144
HCPCS,43425,REPAIR ESOPHAGUS OPENING,,,3764.98,3764.98,1
HCPCS,43425,Repair esophagus opening,,,3009.46,3484.64,8
HCPCS,43450,DILATION ESOPH UNGUIDED SOUND/BOUGIE 1/MULT PASS,2438.0,1584.6999999999998,1.1,6112.0,235
HCPCS,43453,DILATE ESOPHAGUS,,,1650.8,4392.0,22
HCPCS,43453,DILATION ESOPHAGUS GUIDE WIRE,564.0,366.6,1.1,5549.59,148
HCPCS,43453,Dilate esophagus,,,299.41,346.69,8
HCPCS,43460,ESOPG/GSTR TAMPONADE W/BALO SENGSTAKEN TYPE,1516.0,985.4,1.1,1516.0,142
HCPCS,43460,PRESSURE TREATMENT ESOPHAGUS,,,546.74,546.74,1
HCPCS,43460,Pressure treatment esophagus,,,3009.46,3484.64,8
HCPCS,43496,FREE JEJUNUM FLAP MICROVASC,,,6424.56,6424.56,1
HCPCS,43496,"FREE JEJUNUM XFER,MICROVASC ANAST",5238.0,3404.7,1.1,7178.05,104
HCPCS,43496,Free jejunum flap microvasc,,,3009.46,3484.64,8
HCPCS,43497,TRANSORAL LOWER ESOPHAGEAL MYOTOMY,5316.0,3455.4,1.1,16621.23,142
HCPCS,43497,TRANSORL LWR ESOPHGL MYOTOMY,,,4944.41,6317.89,20
HCPCS,43497,Transorl lwr esophgl myotomy,,,3009.46,3484.64,8
HCPCS,43499,EGD REPAIR ESOPHAGEAL PERFORATION W/HEMOCLIPS (COMP 43235),2237.0,1454.0500000000002,0.01,6112.0,168
HCPCS,43499,ENDOSCOPIC CRICOPHARYNGEAL MYOTOMY,2637.0,1714.05,0.01,2644.7,84
HCPCS,43499,ENDOSCOPIC SUBMUCOSAL DISSECTION OF  ESOPHAGUS - (COMP CODE 4304,9299.0,6044.35,0.01,9299.0,84
HCPCS,43499,"ENDOVAC, ESOPH; EGD (COMP 43235, 97605)",990.0,643.5,0.01,2644.7,84
HCPCS,43499,"ENDOVAC, ESOPH; ENTEROSCOPY (COMP 44360, 97605)",1134.0,737.1,0.01,2644.7,84
HCPCS,43499,"ENDOVAC, ESOPH; ENTEROSCOPY W/ILEUM (COMP 44376, 97605)",2092.0,1359.8,0.01,2644.7,84
HCPCS,43499,ESD ESOPHAGUS,6970.0,4530.5,0.01,8640.0,168
HCPCS,43499,ESD ESOPHAGUS (COMP 43211),5300.0,3445.0,0.01,5300.0,84
HCPCS,43499,PERORAL ENDOSCOPIC MYOTOMY,9116.0,5925.4,0.01,9116.0,84
HCPCS,43499,THORACOSCOPY W/ LIGATION OF TRACHEOESOPH FISTULA & REP OF ESOPHA,19235.0,12502.75,0.01,19235.0,84
HCPCS,43499,UNLISTED MIN INVASIVE FOKER - ANASTOMOSIS (COMP CODE 43313),20591.0,13384.15,0.01,20591.0,84
HCPCS,43499,UNLISTED MIN INVASIVE FOKER - STRETCHING (COMP CODE 43425),10642.0,6917.3,0.01,10642.0,84
HCPCS,43499,UNLISTED PROC; ORAL ENDOSCOPIC MYOTOMY (COMP TO 43279),7957.0,5172.05,0.01,7957.0,84
HCPCS,43499,ZENKERS DIVERTICULOPEXY,4135.0,2687.75,0.01,4135.0,84
HCPCS,43500,GASTROTOMY W/EXPLORATION/FOREIGN BODY REMOVAL,5116.0,3325.4,1.1,5116.0,144
HCPCS,43500,SURGICAL OPENING OF STOMACH,,,2072.51,2072.51,1
HCPCS,43500,Surgical opening of stomach,,,3009.46,3484.64,8
HCPCS,43501,GASTROTOMY W/SUTURE REPAIR BLEEDING ULCER,9040.0,5876.0,1.1,9040.0,144
HCPCS,43501,SURGICAL REPAIR OF STOMACH,,,3559.4,3559.4,1
HCPCS,43501,Surgical repair of stomach,,,3156.08,3654.41,8
HCPCS,43502,SURGICAL REPAIR OF STOMACH,,,4018.57,4018.57,1
HCPCS,43502,Surgical repair of stomach,,,3156.08,3654.41,8
HCPCS,4350F,CNSLNG PROVIDED SYMP MNGMNT,,,246.6,246.6,1
HCPCS,4350F,Cnslng provided symp mngmnt,,,10.69,12.38,8
HCPCS,43510,SURGICAL OPENING OF STOMACH,,,786.42,2366.51,21
HCPCS,43510,Surgical opening of stomach,,,3156.08,3654.41,8
HCPCS,43520,INCISION OF PYLORIC MUSCLE,,,1818.78,1818.78,1
HCPCS,43520,Incision of pyloric muscle,,,3009.46,3484.64,8
HCPCS,43520,PYLOROMYOTOMY CUTTING PYLORIC MUSC,4516.0,2935.4,1.1,4516.0,144
HCPCS,43605,BIOPSY OF STOMACH,,,2200.91,2200.91,1
HCPCS,43605,"BIOPSY OF STOMACH,BY LAPAROTOMY",5488.0,3567.2,1.1,5488.0,144
HCPCS,43605,Biopsy of stomach,,,3009.46,3484.64,8
HCPCS,43610,EXC LOCAL ULCER/BENIGN TUMOR STOMACH,6536.0,4248.4,1.1,6536.0,144
HCPCS,43610,EXCISION OF STOMACH LESION,,,2574.09,2574.09,1
HCPCS,43610,Excision of stomach lesion,,,3009.46,3484.64,8
HCPCS,43611,EXC LOCAL MALIGNANT TUMOR STOMACH,8152.0,5298.8,1.1,8152.0,144
HCPCS,43611,EXCISION OF STOMACH LESION,,,3233.06,3233.06,1
HCPCS,43611,Excision of stomach lesion,,,3156.08,3654.41,8
HCPCS,43620,GSTRCT TOT W/ESOPHAGOENTEROSTOMY,13616.0,8850.4,1.1,13616.0,144
HCPCS,43620,REMOVAL OF STOMACH,,,5217.21,5217.21,1
HCPCS,43620,Removal of stomach,,,3156.08,3654.41,8
HCPCS,43621,GSTRCT TOT W/ROUX-EN-Y RCNSTJ,15812.0,10277.8,1.1,15812.0,144
HCPCS,43621,REMOVAL OF STOMACH,,,5980.52,5980.52,1
HCPCS,43621,Removal of stomach,,,3156.08,3654.41,8
HCPCS,43622,GSTRCT TOT W/FRMJ INTSTINAL POUCH ANY TYPE,16012.0,10407.8,1.1,16012.0,144
HCPCS,43622,REMOVAL OF STOMACH,,,6079.02,6079.02,1
HCPCS,43622,Removal of stomach,,,3156.08,3654.41,8
HCPCS,43631,GSTRCT PRTL DSTL W/GASTRODUODENOSTOMY,9804.0,6372.6,1.1,9804.0,144
HCPCS,43631,REMOVAL OF STOMACH PARTIAL,,,3815.23,3815.23,1
HCPCS,43631,Removal of stomach partial,,,3156.08,3654.41,8
HCPCS,43632,GSTRCT PRTL DSTL W/GASTROJEJUNOSTOMY,14056.0,9136.4,1.1,14056.0,144
HCPCS,43632,REMOVAL OF STOMACH PARTIAL,,,5354.86,5354.86,1
HCPCS,43632,Removal of stomach partial,,,3156.08,3654.41,8
HCPCS,43633,GSTRCT PRTL DSTL W/ROUX-EN-Y RCNSTJ,13256.0,8616.4,1.1,13256.0,144
HCPCS,43633,REMOVAL OF STOMACH PARTIAL,,,5065.11,5065.11,1
HCPCS,43633,Removal of stomach partial,,,3156.08,3654.41,8
HCPCS,43634,GSTRCT PRTL DSTL W/FRMJ INTSTINAL POUCH,14656.0,9526.4,1.1,14656.0,144
HCPCS,43634,REMOVAL OF STOMACH PARTIAL,,,5591.96,5591.96,1
HCPCS,43634,Removal of stomach partial,,,3156.08,3654.41,8
HCPCS,43635,REMOVAL OF STOMACH PARTIAL,,,295.13,295.13,1
HCPCS,43635,Removal of stomach partial,,,3156.08,3654.41,8
HCPCS,43635,VAGOTOMY PFRMD W/PRTL DSTL GSTRCT,824.0,535.6,1.1,824.0,144
HCPCS,43640,VAGOTOMY & PYLORUS REPAIR,,,3138.26,3138.26,1
HCPCS,43640,VGTMY W/PYLORPLSTY W/WO GASTROST TRUNCAL/SLCTV,7824.0,5085.6,1.1,7824.0,144
HCPCS,43640,Vagotomy & pylorus repair,,,3009.46,3484.64,8
HCPCS,43641,VAGOTOMY & PYLORUS REPAIR,,,3174.43,3174.43,1
HCPCS,43641,Vagotomy & pylorus repair,,,3009.46,3484.64,8
HCPCS,43644,LAP GASTRIC BYPASS/ROUX-EN-Y,,,4574.92,11441.0,2
HCPCS,43644,LAPS GSTR RSTCV PX W/BYP ROUX-EN-Y LIMB <150 CM,12936.0,8408.4,1.1,12936.0,144
HCPCS,43644,Lap gastric bypass/roux-en-y,,,4773.02,5526.65,8
HCPCS,43645,LAP GASTR BYPASS INCL SMLL I,,,4861.72,4861.72,1
HCPCS,43645,LAPS GSTR RSTCV PX W/BYP&SM INT RCNSTJ,12612.0,8197.8,1.1,12612.0,144
HCPCS,43645,Lap gastr bypass incl smll i,,,4773.02,5526.65,8
HCPCS,43647,LAP IMPL ELECTRODE ANTRUM,,,10541.85,35562.32,21
HCPCS,43647,LAP IMPLANT/ REPLACE GASTRIC NEUROSTIM ANTRUM,1499.0,974.35,1.1,39728.72,106
HCPCS,43647,Lap impl electrode antrum,,,2029.97,2350.49,8
HCPCS,43648,LAP REVISE/REMOVE GASTRIC NEUROSTIM ANTRUM,1543.0,1002.95,1.1,30022.29,104
HCPCS,43648,LAP REVISE/REMV ELTRD ANTRUM,,,8930.36,26873.26,21
HCPCS,43648,Lap revise/remv eltrd antrum,,,2029.97,2350.49,8
HCPCS,43651,LAPAROSCOPY VAGUS NERVE,,,5005.78,15063.4,21
HCPCS,43651,LAPS SURG TRNSXJ VAGUS NRV TRUNCAL,4052.0,2633.8,1.1,16829.38,144
HCPCS,43651,Laparoscopy vagus nerve,,,2029.97,2350.49,8
HCPCS,43652,LAPAROSCOPY VAGUS NERVE,,,5005.78,15063.4,21
HCPCS,43652,LAPS SURG TRNSXJ VAGUS NRV SLCTV/HILY SLCTV,4852.0,3153.8,1.1,16829.38,144
HCPCS,43652,Laparoscopy vagus nerve,,,2029.97,2350.49,8
HCPCS,43653,LAPAROSCOPY GASTROSTOMY,,,5005.78,33436.0,23
HCPCS,43653,LAPS SURG GASTROSTOMY W/O CONSTJ GSTR TUBE SPX,3392.0,2204.8,1.1,16829.38,144
HCPCS,43653,Laparoscopy gastrostomy,,,3156.08,3654.41,8
HCPCS,43659,ESO/GASTRECTOMY W RY ESO/JEJUNOSTOMY,14637.0,9514.05,0.01,16829.38,84
HCPCS,43659,LAP DUODENAL SWITCH PROCEDURE (COMP 43845),10659.0,6928.35,0.01,16829.38,84
HCPCS,43659,LAP EXC. OF GASTRIC TUMOR (COMP 43610),5113.0,3323.45,0.01,16829.38,84
HCPCS,43659,LAP GASTRECT W/ROUX-EN-Y,9340.0,6071.0,0.01,16829.38,84
HCPCS,43659,LAP GASTRIC RESTRICTION,8373.0,5442.45,0.01,16829.38,84
HCPCS,43659,LAP GASTROTOMY (COMP 43500),4221.0,2743.65,0.01,16829.38,84
HCPCS,43659,LAP PARTIAL GASTRECTOMY (COMP CODE 43611),5069.0,3294.85,0.01,16829.38,84
HCPCS,43659,LAP PARTIAL GASTRECTOMY W RNY RECONSTRUC (COMP 43633),10936.0,7108.4,0.01,16829.38,84
HCPCS,43659,LAP REPAIR GASTRIC FISTULA (COMP 43880),9000.0,5850.0,0.01,16829.38,84
HCPCS,43659,LAP REVISION GASTROJEJUNOSTOMY (COMP 43860),6423.0,4174.95,0.01,16829.38,84
HCPCS,43659,LAP TOTAL GASTRECTOMY W/RESECTION OF THE GASTROJEJUNOSTOMY (COMP,13616.0,8850.4,0.01,16829.38,84
HCPCS,43659,"LAP, GASTROJEJUNOSTOMY (COMP 43820)",6115.0,3974.75,0.01,16829.38,84
HCPCS,43659,LAP. OVERSEW GASTR ULCER,5247.0,3410.55,0.01,16829.38,84
HCPCS,43659,LAPAROSCOPIC EXCISION MALIGNANT TUMOR OF STOMACH (COMP 43611),7398.0,4808.7,0.01,16829.38,84
HCPCS,43659,LAPAROSCOPIC EXCISION ULCER OR BENIGN TUMOR STOMACH (COMP CODE 4,7026.0,4566.9,0.01,16829.38,84
HCPCS,43659,"LAPAROSCOPIC GASTROJEJUNOSTOMY, WITHOUT VAGOTOMY (COMP 43820)",7435.0,4832.75,0.01,16829.38,84
HCPCS,43659,LAPAROSCOPIC GASTROPEXY (COMP CODE 43338),950.0,617.5,0.01,16829.38,84
HCPCS,43659,LAPAROSCOPIC GASTROPEXY WITH LAP RPR PARAESOPH HIATAL HERNIA W/,3747.0,2435.55,0.01,16829.38,84
HCPCS,43659,LAPAROSCOPIC PARTIAL GASTRECTOMY FOR EXCISION OF GASTROCUTANEOUS,8713.0,5663.45,0.01,16829.38,84
HCPCS,43659,LAPAROSCOPIC PYLOROMYOTOMY (COMP 43800),3728.0,2423.2,0.01,16829.38,84
HCPCS,43659,LAPAROSCOPIC PYLOROMYOTOMY (COMP CODE 43520),4854.0,3155.1,0.01,16829.38,84
HCPCS,43659,LAPAROSCOPIC PYLOROPLASTY,4484.0,2914.6,0.01,16829.38,84
HCPCS,43659,LAPAROSCOPIC REVISION GASTROJEJUNAL ANASTOMOSIS W/EXCISION GASTR,9204.0,5982.6,0.01,16829.38,84
HCPCS,43659,LAPAROSCOPIC TOTAL GASTRECTOMY W/ROUX-EN Y ANASTOMOSIS (COMPARIS,13045.0,8479.25,0.01,16829.38,84
HCPCS,43659,"UNLIST LAP PROC, STOMACH COMPARED TO 43633",12030.0,7819.5,0.01,16829.38,84
HCPCS,43659,"UNLIST LAP PROC, STOMACH COMPARED TO 43820",7435.0,4832.75,0.01,16829.38,84
HCPCS,43659,UNLISTED LAPAROSCOPIC PROCEDURE STOMACH,12030.0,7819.5,0.01,16829.38,84
HCPCS,43659,UNLISTED LAPAROSCOPIC PROCEDURE STOMACH (COMP CODE 43843),9120.0,5928.0,0.01,16829.38,84
HCPCS,43659,UNLISTED LAPAROSCOPIC PYLOROPLASTY (COMPARED TO 43800),5092.0,3309.8,0.01,16829.38,84
HCPCS,43659,"UNLISTED LAPAROSCOPY PROCEDURE, STOMACH (COMPARISON CODE 43631)",4260.0,2769.0,0.01,16829.38,84
HCPCS,43659,"UNLISTED LAPAROSCOPY PROCEDURE, STOMACH (COMPARISON CODE 43840)",7534.0,4897.1,0.01,16829.38,84
HCPCS,43659,"UNLISTED LAPAROSCOPY PROCEDURE, STOMACH (COMPARISON CODE 44680)",6520.0,4238.0,0.01,16829.38,84
HCPCS,43659,UNLISTED LAPAROSCOPY STOMACH,3879.0,2521.35,0.01,16829.38,84
HCPCS,43659,UNLISTED LAPS PX STOMACH,,,5005.78,11441.0,21
HCPCS,43659,"UNLISTED PROC, LAP DISTAL GASTRECTOMY W/GASTROJEJUNOSTOMY (COMP",12756.0,8291.4,0.01,16829.38,84
HCPCS,43659,UNLISTED PROC; LAPARSCOPIC REVISION ROUX-EN-Y GASTRIC BYPASS GAS,10808.0,7025.2,0.01,16829.38,84
HCPCS,43659,Unlisted laps px stomach,,,3009.46,3484.64,8
HCPCS,43752,NASO/ORO-GASTRIC TUBE PLMT REQ PHYS&FLUOR GDNCE,1096.0,712.4000000000001,0.01,12500.0,477
HCPCS,43753,GASTRIC INTUBATJ & ASPIRAJ W/PHYS SKILL/LAVAGE,1432.0,930.8,26.72,3443.0,86
HCPCS,43753,GASTRIC TUBE PLMT W/ASPIR & LAVAGE,180.0,117.0,1.1,915.24,144
HCPCS,43754,DX GASTR INTUB W/ASP SPEC,,,204.28,819.42,21
HCPCS,43754,Dx gastr intub w/asp spec,,,33.56,38.86,8
HCPCS,43754,GASTRIC TUBE DX PLMT W/ASPIR 1 SPECIMEN,180.0,117.0,1.1,915.24,148
HCPCS,43755,DX GASTR INTUB W/ASP SPECS,,,121.73,407.79,21
HCPCS,43755,Dx gastr intub w/asp specs,,,299.41,346.69,8
HCPCS,43755,GASTRIC TUBE DX PLMT W/ASPIR MULT SPECIMENS,376.0,244.4,1.1,680.24,148
HCPCS,43756,DX DUOD INTUB W/ASP SPEC,,,786.42,2366.51,21
HCPCS,43756,Dx duod intub w/asp spec,,,299.41,346.69,8
HCPCS,43757,DUODENAL INTUBAT W/IMAG GUIDED MULTIPLE SPECIMEN,4313.0,2803.45,90.17,6112.0,86
HCPCS,43757,DUODENAL TUBE DX PLMT W/IMG GID MULT SPECIMEN,504.0,327.6,1.1,2644.7,148
HCPCS,43761,REPOS NASO/ORO GASTRIC FEEDING TUBE THRU DUO,1001.5,650.975,1.1,4628.0,235
HCPCS,43762,PERQ REPLACEMENT GTUBE NOT REQ REVJ GSTRST TRC,724.5,470.925,0.01,4628.0,409
HCPCS,43763,PERQ REPLACEMENT GTUBE REQ REVJ GSTRST TRC,841.5,546.975,1.1,4628.0,322
HCPCS,43770,LAP PLACE GASTR ADJ DEVICE,,,8930.36,26873.26,21
HCPCS,43770,LAPS GASTRIC RESTRICTIVE PROCEDURE PLACE DEVICE,7200.0,4680.0,1.1,30022.29,144
HCPCS,43770,Lap place gastr adj device,,,4773.02,5526.65,8
HCPCS,43771,LAP REVISE GASTR ADJ DEVICE,,,3364.8,3364.8,1
HCPCS,43771,LAPS GASTRIC RESTRICTIVE PX REVISION DEVICE,8316.0,5405.4,1.1,8316.0,144
HCPCS,43771,Lap revise gastr adj device,,,4773.02,5526.65,8
HCPCS,43772,LAP RMVL GASTR ADJ DEVICE,,,3322.52,9998.15,21
HCPCS,43772,LAPS GASTRIC RESTRICTIVE PX REMOVE DEVICE,6280.0,4082.0,1.1,11169.59,144
HCPCS,43772,Lap rmvl gastr adj device,,,4773.02,5526.65,8
HCPCS,43773,LAP REPLACE GASTR ADJ DEVICE,,,5005.78,15063.4,21
HCPCS,43773,LAPS GASTRIC RESTRICTIVE PX REMOVE&RPLCMT DEVICE,8316.0,5405.4,1.1,16829.38,144
HCPCS,43773,Lap replace gastr adj device,,,4773.02,5526.65,8
HCPCS,43774,LAP RMVL GASTR ADJ ALL PARTS,,,3322.52,9998.15,21
HCPCS,43774,LAPS GASTRIC RESTRICTIVE PX REMOVE DEVICE & PORT,6304.0,4097.6,1.1,11169.59,144
HCPCS,43774,Lap rmvl gastr adj all parts,,,4773.02,5526.65,8
HCPCS,43775,LAP SLEEVE GASTRECTOMY,,,2919.33,11441.0,2
HCPCS,43775,LAPS GSTRC RSTRICTIV PX LONGITUDINAL GASTRECTOMY,8967.0,5828.55,1.1,8967.0,144
HCPCS,43775,Lap sleeve gastrectomy,,,3009.46,3484.64,8
HCPCS,43800,PYLOROPLASTY,6172.0,4011.8,1.1,6172.0,145
HCPCS,43800,Pyloroplasty,,,3009.46,3484.64,8
HCPCS,43810,GASTRODUODENOSTOMY,6752.0,4388.8,1.1,6752.0,145
HCPCS,43810,Gastroduodenostomy,,,3009.46,3484.64,8
HCPCS,43820,GASTROJEJUNOSTOMY W/O VAGOTOMY,9012.0,5857.8,1.1,9012.0,144
HCPCS,43820,GASTROJEJUNOSTOMY WO VAGOTMY,,,3541.5,3541.5,1
HCPCS,43820,Gastrojejunostomy wo vagotmy,,,3156.08,3654.41,8
HCPCS,43825,GASTROJEJUNOSTOMY W/VAGOTOMY,,,3454.67,3454.67,1
HCPCS,43825,GASTROJEJUNOSTOMY+VAGOTOMY,8704.0,5657.6,1.1,8704.0,144
HCPCS,43825,Gastrojejunostomy w/vagotomy,,,3009.46,3484.64,8
HCPCS,43830,GASTROSTOMY OPN W/O CONSTJ GSTR TUBE SPX,4340.0,2821.0,1.1,5549.59,144
HCPCS,43830,GSTRST OPEN WO CONSTJ TUBE,,,1650.8,4967.59,21
HCPCS,43830,Gstrst open wo constj tube,,,3009.46,3484.64,8
HCPCS,43831,GASTROSTOMY OPEN NEONATAL,,,786.42,2366.51,21
HCPCS,43831,GASTROSTOMY OPN NEONATAL FEEDING,3396.0,2207.4,1.1,3396.0,144
HCPCS,43831,Gastrostomy open neonatal,,,3009.46,3484.64,8
HCPCS,43832,GASTROSTOMY OPN W/CONSTJ GSTR TUBE,6936.0,4508.4,1.1,6936.0,144
HCPCS,43832,GSTRST OPEN W/CONSTJ TUBE,,,2757.54,2757.54,1
HCPCS,43832,Gstrst open w/constj tube,,,3156.08,3654.41,8
HCPCS,43840,GASTRORRHAPHY SUTR PRF8 DUOL/GSTR ULCER WND/INJ,9132.0,5935.8,1.1,9132.0,144
HCPCS,43840,GSTRRPHY SUTR DUOL/GSTR ULCR,,,3579.13,4012.33,13
HCPCS,43840,Gstrrphy sutr duol/gstr ulcr,,,3156.08,3654.41,8
HCPCS,43842,GASTRIC RSTCV W/O BYP VERTICAL-BANDED GASTROPLY,8412.0,5467.8,1.1,8412.0,112
HCPCS,43842,GSTR RSTCV PX V-BANDED GSTP,,,3011.4,3011.4,1
HCPCS,43842,Gstr rstcv px v-banded gstp,,,4773.02,5526.65,8
HCPCS,43843,GSTR RSTCV OTH/THN V-BAND,,,3383.24,3383.24,1
HCPCS,43843,GSTR RSTCV W/O BYP OTH/THN VER-BANDED GSTP,8484.0,5514.6,1.1,8484.0,144
HCPCS,43843,Gstr rstcv oth/thn v-band,,,4773.02,5526.65,8
HCPCS,43845,GASTRIC RSTCV W/PRTL GASTRECTOMY 50-100 CM,13320.0,8658.0,1.1,13320.0,142
HCPCS,43845,GASTROPLASTY DUODENAL SWITCH,,,5159.67,5159.67,1
HCPCS,43845,Gastroplasty duodenal switch,,,4773.02,5526.65,8
HCPCS,43846,GASTRIC RSTCV W/BYP W/SHORT LIMB 150 CM/<,10964.0,7126.6,1.1,10964.0,144
HCPCS,43846,GSTR RSTCV PX SHRT ROUX-EN-Y,,,4349.45,4349.45,1
HCPCS,43846,Gstr rstcv px shrt roux-en-y,,,4773.02,5526.65,8
HCPCS,43847,GASTRIC RSTCV W/BYP W/SM INT RCNSTJ LIMIT ABSRPJ,12112.0,7872.8,1.1,12112.0,144
HCPCS,43847,GSTR RSTCV PX SM INT RCNSTJ,,,4760.42,4760.42,1
HCPCS,43847,Gstr rstcv px sm int rcnstj,,,4773.02,5526.65,8
HCPCS,43848,REVISION OPEN GASTRIC RESTRICTIVE PX NOT DEVICE,13100.0,8515.0,1.1,13100.0,144
HCPCS,43848,REVJ OPEN GSTR RSTCV PX,,,5099.19,5099.19,1
HCPCS,43848,Revj open gstr rstcv px,,,4773.02,5526.65,8
HCPCS,43850,Revise stomach-bowel fusion,,,3009.46,3484.64,8
HCPCS,43855,Revise stomach-bowel fusion,,,3009.46,3484.64,8
HCPCS,43860,REVJ GSTR/JJ ANAST W/O VGTMY,,,4303.58,4303.58,1
HCPCS,43860,REVJ GSTR/JJ ANAST W/RCNSTJ W/O VGTMY,11156.0,7251.4,1.1,11156.0,144
HCPCS,43860,Revj gstr/jj anast w/o vgtmy,,,3156.08,3654.41,8
HCPCS,43865,REVJ GSTR/JJ ANAST W/RCNSTJ W/VGTMY,11620.0,7553.0,1.1,11620.0,144
HCPCS,43865,REVJ GSTR/JJ ANAST W/VGTMY,,,4502.12,4502.12,1
HCPCS,43865,Revj gstr/jj anast w/vgtmy,,,3156.08,3654.41,8
HCPCS,43870,CLOSURE GASTROSTOMY SURGICAL,,,3322.52,7624.0,21
HCPCS,43870,"CLOSURE OF GASTROSTOMY,SURGICAL",4576.0,2974.4,1.1,11169.59,144
HCPCS,43870,Closure gastrostomy surgical,,,3009.46,3484.64,8
HCPCS,43880,CLOSURE GASTROCOLIC FISTULA,10872.0,7066.8,1.1,10872.0,145
HCPCS,43880,Closure gastrocolic fistula,,,3156.08,3654.41,8
HCPCS,43881,IMPL/RPLCMT GSTR NSTIM ELTRD,,,1710.42,1710.42,1
HCPCS,43881,Impl/rplcmt gstr nstim eltrd,,,3156.08,3654.41,8
HCPCS,43881,OPEN IMPLANT/ REPLACE GASTRIC NEUROSTIM ANTRUM,5340.0,3471.0,1.1,5340.0,104
HCPCS,43882,REV/RMVL GSTR NSTIM ELTRD,,,1710.42,1710.42,1
HCPCS,43882,REVISION/RMVL GASTRIC NSTIM ELTRDE ANTRUM OPEN,1772.0,1151.8,1.1,1910.06,104
HCPCS,43882,Rev/rmvl gstr nstim eltrd,,,3009.46,3484.64,8
HCPCS,43886,GSTR RSTCV PX OPN REVJ PORT,,,3112.46,9366.03,21
HCPCS,43886,GSTR RSTCV PX OPN REVJ SUBQ PORT COMPONENT ONLY,1856.0,1206.4,1.1,10462.5,144
HCPCS,43886,Gstr rstcv px opn revj port,,,3009.46,3484.64,8
HCPCS,43887,GSTR RSTCV PX OPN RMVL PORT,,,1582.09,4760.83,21
HCPCS,43887,GSTR RSTCV PX OPN RMVL SUBQ PORT COMPONENT ONLY,1728.0,1123.2,1.1,5320.02,144
HCPCS,43887,Gstr rstcv px opn rmvl port,,,3009.46,3484.64,8
HCPCS,43888,GSTR RSTCV OPN RMVL & RPLCMT SUBQ PORT,2576.0,1674.4,1.1,10462.5,144
HCPCS,43888,GSTR RSTCV PX OPN RMVL&RPLC,,,3112.46,9366.03,21
HCPCS,43888,Gstr rstcv px opn rmvl&rplc,,,4773.02,5526.65,8
HCPCS,43889,GSTR RSTCV PX TRNSORL ESG,,,10056.64,11062.31,12
HCPCS,43889,GSTR RSTCV PX TRNSORL ESG W/ARGON PLASMA COAGJ,5526.0,3591.9,1.1,5526.0,106
HCPCS,43889,Gstr rstcv px trnsorl esg,,,4773.02,5526.65,8
HCPCS,43999,ADJUSTMENT OF GASTRIC BAND,67.0,43.55,0.01,2644.7,84
HCPCS,43999,CENTRAL GASTRECTOMY WITH GASTROGASTROSTOMY (COMP 43631),8824.0,5735.6,0.01,8824.0,84
HCPCS,43999,EGD W SUTURE OF GASTROCUTANEOUS FISTULA (COMP 43255),4598.5,2989.025,0.01,7833.0,168
HCPCS,43999,EGD W/ APSPIRATION THERAPY (COMP CODE 43753),149.0,96.85,0.01,2644.7,84
HCPCS,43999,EGD W/ GASTRO/GASTRIC FISTULA REPAIR (COMP CODE 44650),8290.0,5388.5,0.01,8290.0,84
HCPCS,43999,EGD W/ INTRAGASTRIC BALLOON PLACEMENT (COMP 43843),6999.0,4549.35,0.01,6999.0,84
HCPCS,43999,EGD W/ SUTURE REPAIR OF LG INTESTINE  (COMP CODE 44604),5993.0,3895.45,0.01,5993.0,84
HCPCS,43999,EGD W/ SUTURE REPAIR OF STOMACH (COMP CODE 43840),7534.0,4897.1,0.01,7534.0,84
HCPCS,43999,EGD/EUS GASTROJAJUNOSTOMY LAMS (COMP 43266 AND 43237),5000.0,3250.0,0.01,5000.0,84
HCPCS,43999,EGD/EUS GASTROJAJUNOSTOMY LAMS HB,7560.0,4914.0,786.42,7560.0,84
HCPCS,43999,ENDO GASTRIC BYPASS REVISON (COMP 43860),12052.0,7833.8,0.01,14904.0,168
HCPCS,43999,ENDOSCOPIC PYLOROMYOTOMY,4700.0,3055.0,0.01,4700.0,84
HCPCS,43999,ENDOSCOPIC PYLOROMYOTOMY (COMP 43520),4700.0,3055.0,0.01,4700.0,84
HCPCS,43999,ENDOSCOPIC PYLOROMYOTOMY HB,7560.0,4914.0,786.42,7560.0,84
HCPCS,43999,ENDOSCOPIC SLEEVE GASTROPLASTY (COMP 43775),14472.0,9406.8,786.42,14472.0,84
HCPCS,43999,ENDOSCOPIC SLEEVE GASTROPLASTY (COMP 43843),8900.0,5785.0,0.01,8900.0,84
HCPCS,43999,ENDOSCOPIC SUBMUCOSAL DISSECTION OF STOMACH - (COMP CODE 43611),8662.0,5630.3,0.01,8662.0,84
HCPCS,43999,ENDOSCOPIC WOUND VAC PLACEMENT (COMP CODE 43235 & 97605),1122.0,729.3,0.01,2644.7,84
HCPCS,43999,"ENDOVAC, STOMACH; ENTEROSCOPY (COMP 44360, 97605)",1134.0,737.1,0.01,2644.7,84
HCPCS,43999,"ENDOVAC, STOMACH; ENTEROSCOPY W/ILEUM (COMP 44376, 97605)",2092.0,1359.8,0.01,2644.7,84
HCPCS,43999,ESD STOMACH,6970.0,4530.5,0.01,8640.0,168
HCPCS,43999,ESD STOMACH (COMP 43254),5300.0,3445.0,0.01,5300.0,84
HCPCS,43999,EXC GASTROCUTANEOUS FISTULA (COMP 44640),4221.0,2743.65,0.01,4221.0,84
HCPCS,43999,GASTRIC BAND ADJ,224.0,145.6,0.01,3484.64,85
HCPCS,43999,GASTRIC LAP BAND ADJUSTMENT (COMP CODE 36598),56.0,36.4,0.01,2644.7,84
HCPCS,43999,IMAGE GUIDED REPOSITION G-TUBE (COMP CODE 43761),1001.5,650.975,0.01,6112.0,168
HCPCS,43999,INTRAGASTRIC BALLOON INS/REMV,6480.0,4212.0,786.42,6480.0,84
HCPCS,43999,"LAP, REVISION NISSEN FUNDOPLASTY (COMP 43280)",7240.0,4706.0,0.01,7240.0,84
HCPCS,43999,LAPAROSCOPIC PYLOROPLASTY,6333.0,4116.45,0.01,6333.0,84
HCPCS,43999,"LIGATION OF GASTRIC VARIED, OPEN (COMP CODE 43244)",1893.0,1230.45,0.01,2644.7,84
HCPCS,43999,OPEN GASTRIC BAND REMOVAL (COMP CODE 43774),6776.0,4404.4,0.01,6776.0,84
HCPCS,43999,OPEN GASTROPEXY (COMP TO 44680),5927.0,3852.55,0.01,5927.0,84
HCPCS,43999,PARTIAL GASTRECTOMY (COMP CODE 43610),2880.0,1872.0,0.01,2880.0,84
HCPCS,43999,"PARTIAL GATRECTOMY, PROXIMAL (COMP 43610)",8533.0,5546.45,0.01,8533.0,84
HCPCS,43999,REMOVAL OF GASTROSTOMY TUBE,315.0,204.75,0.01,2644.7,84
HCPCS,43999,REPAIR FIST W/PLUG,10711.0,6962.15,786.42,10711.0,84
HCPCS,43999,SLEEVE GASTRECTOMY TO SINGLE ANASTOMOSIS DUODENAL SWITCH (SADIS),13320.0,8658.0,0.01,13320.0,84
HCPCS,43999,TRANS ORAL GASTRIC OUTLET REDUCTION TORE (COMP CODE 43771),7485.0,4865.25,0.01,7485.0,84
HCPCS,43999,TRANSNASAL EGD W/REMOVAL OF FOREIGN BODY (COMP 43247),1368.0,889.2,0.01,2644.7,84
HCPCS,43999,"UNLISTED PROCEDURE, STOMACH (COMPARISON CODE 43880)",9866.0,6412.9,0.01,9866.0,84
HCPCS,43999,"UNLISTED PROCEDURE, STOMACH COMPARED TO CPT 43520",3726.0,2421.9,0.01,3726.0,84
HCPCS,44005,ENTEROLSS FRING INTSTINAL ADHESION SPX,7384.0,4799.6,1.1,7384.0,144
HCPCS,44005,FREEING OF BOWEL ADHESION,,,2869.96,2869.96,1
HCPCS,44005,Freeing of bowel adhesion,,,3466.13,4013.42,8
HCPCS,4400F,REHAB THXPY OPTIONS W/PT,,,2739849.3,2739849.3,1
HCPCS,4400F,Rehab thxpy options w/pt,,,10.69,12.38,8
HCPCS,44010,"DUODENOTOMY FOR EXPLOR,BX,FB REMOV",5704.0,3707.6,1.1,5704.0,144
HCPCS,44010,INCISION OF SMALL BOWEL,,,2222.83,2222.83,1
HCPCS,44010,Incision of small bowel,,,1591.31,1842.57,8
HCPCS,44015,INSERT NEEDLE CATH BOWEL,,,370.39,370.39,1
HCPCS,44015,Insert needle cath bowel,,,3466.13,4013.42,8
HCPCS,44015,TUBE/NEEDLE CATH JEJUNOSTOMY ANY METHOD,1048.0,681.2,1.1,1048.0,144
HCPCS,44020,ENTEROTOMY SM INT OTH/THN DUO EXPL BX/FB RMVL,6488.0,4217.2,1.1,6488.0,144
HCPCS,44020,EXPLORE SMALL INTESTINE,,,2559.6,2559.6,1
HCPCS,44020,Explore small intestine,,,3466.13,4013.42,8
HCPCS,44021,DECOMPRESS SMALL BOWEL,,,2553.68,2553.68,1
HCPCS,44021,Decompress small bowel,,,1591.31,1842.57,8
HCPCS,44021,ENTEROTOMY SM INT OTH/THN DUO DCMPRN,6524.0,4240.6,1.1,6524.0,144
HCPCS,44025,COLOTOMY EXPLORATION/BIOPSY/FOREIGN BODY REMOVAL,6604.0,4292.6,1.1,6604.0,144
HCPCS,44025,INCISION OF LARGE BOWEL,,,2581.11,2581.11,1
HCPCS,44025,Incision of large bowel,,,1591.31,1842.57,8
HCPCS,44050,RDCTJ VOLVULUS INTUSSUSCEPTION INT HRNA LAPT,6208.0,4035.2,1.1,6208.0,144
HCPCS,44050,REDUCE BOWEL OBSTRUCTION,,,2464.11,2464.11,1
HCPCS,44050,Reduce bowel obstruction,,,3466.13,4013.42,8
HCPCS,44055,CORRECT MALROTATION OF BOWEL,,,3917.76,3917.76,1
HCPCS,44055,CORRJ MALROTATION BANDS&/RDCTJ VOLVULUS,10252.0,6663.8,1.1,10252.0,144
HCPCS,44055,Correct malrotation of bowel,,,3466.13,4013.42,8
HCPCS,44100,BIOPSY OF BOWEL,,,786.42,943.89,20
HCPCS,44100,Biopsy of bowel,,,890.23,1030.79,8
HCPCS,44110,EXC 1/> SMALL/LARGE LESIONS INTESTINE ENTEROTOM,5616.0,3650.4,1.1,5616.0,144
HCPCS,44110,EXCISE INTESTINE LESION(S),,,2232.17,2232.17,1
HCPCS,44110,Excise intestine lesion(s),,,1591.31,1842.57,8
HCPCS,44111,EXC 1/> SM/LG LESIONS INTESTNE MULT ENTEROTOMIE,6608.0,4295.2,1.1,6608.0,144
HCPCS,44111,EXCISION OF BOWEL LESION(S),,,2566.94,2566.94,1
HCPCS,44111,Excision of bowel lesion(s),,,1591.31,1842.57,8
HCPCS,44120,ENTRC RESCJ SMALL INTESTINE 1 RESCJ & ANAST,8328.0,5413.2,1.1,8328.0,144
HCPCS,44120,REMOVAL OF SMALL INTESTINE,,,3212.29,3212.29,1
HCPCS,44120,Removal of small intestine,,,3466.13,4013.42,8
HCPCS,44121,ENTERECTOMY RESCJ SMALL INTESTINE EA RESCJ & ANA,1776.0,1154.4,1.1,1776.0,144
HCPCS,44121,REMOVAL OF SMALL INTESTINE,,,631.57,631.57,1
HCPCS,44121,Removal of small intestine,,,3466.13,4013.42,8
HCPCS,44125,ENTERECTOMY RESCJ SMALL INTESTINE W/ENTEROSTOMY,8813.0,5728.45,1.1,8813.0,144
HCPCS,44125,REMOVAL OF SMALL INTESTINE,,,3087.21,3087.21,1
HCPCS,44125,Removal of small intestine,,,3466.13,4013.42,8
HCPCS,44126,ENTERECTOMY W/O TAPER CONG,,,6493.28,6493.28,1
HCPCS,44126,ENTRC RESCJ ATRESIA RESCJ & ANAST W/O TAPRING,16892.0,10979.8,1.1,16892.0,144
HCPCS,44126,Enterectomy w/o taper cong,,,3466.13,4013.42,8
HCPCS,44127,ENTERECTOMY W/TAPER CONG,,,7500.83,7500.83,1
HCPCS,44127,ENTRC RESCJ ATRESIA RESCJ & ANAST SGM W/TAPRING,19720.0,12818.0,1.1,19720.0,144
HCPCS,44127,Enterectomy w/taper cong,,,3466.13,4013.42,8
HCPCS,44128,ENTERECTOMY CONG ADD-ON,,,638.28,638.28,1
HCPCS,44128,ENTRC RESCJ ATRESIA EA RESCJ & ANASTOMOSIS,1776.0,1154.4,1.1,1776.0,144
HCPCS,44128,Enterectomy cong add-on,,,3466.13,4013.42,8
HCPCS,44130,BOWEL TO BOWEL FUSION,,,3456.18,3456.18,1
HCPCS,44130,Bowel to bowel fusion,,,1591.31,1842.57,8
HCPCS,44130,ENTEROENTEROST ANAST INT W/WO CUTAN NTRSTM SPX,8844.0,5748.6,1.1,8844.0,144
HCPCS,44132,DONOR ENTERECTOMY OPEN CADAVER DONOR,15830.0,10289.5,1.1,3060831.65,82
HCPCS,44132,ENTERECTOMY CADAVER DONOR,,,2739849.3,2739849.3,1
HCPCS,44132,Enterectomy cadaver donor,,,1229.51,1423.64,8
HCPCS,44133,ENTERECTOMY LIVE DONOR,,,2739849.3,2739849.3,1
HCPCS,44133,Enterectomy live donor,,,1229.51,1423.64,8
HCPCS,44135,INTESTINAL ALLOTRANSPLANTATION CADAVER DONOR,35266.0,22922.9,1.1,58893.64,84
HCPCS,44135,INTESTINE TRANSPLNT CADAVER,,,52718.15,52718.15,1
HCPCS,44135,Intestine transplnt cadaver,,,1229.51,1423.64,8
HCPCS,44136,INTESTINAL ALLOTRANSPLANTATION LIVING DONOR,35821.0,23283.65,1.1,3060831.65,82
HCPCS,44136,INTESTINE TRANSPLANT LIVE,,,2739849.3,2739849.3,1
HCPCS,44136,Intestine transplant live,,,1229.51,1423.64,8
HCPCS,44137,REMOVE INTESTINAL ALLOGRAFT,,,2739849.3,2739849.3,1
HCPCS,44137,RMVL TRNSPLED INTESTINAL ALLOGRAFT COMPL,14032.0,9120.8,1.1,3060831.65,88
HCPCS,44137,Remove intestinal allograft,,,1229.51,1423.64,8
HCPCS,44139,MOBILIZATION OF COLON,,,314.25,314.25,1
HCPCS,44139,MOBLJ SPLENIC FLXR PFRMD CONJUNCT W/PRTL COLCT,892.0,579.8,1.1,892.0,144
HCPCS,44139,Mobilization of colon,,,3466.13,4013.42,8
HCPCS,44140,COLECTOMY PARTIAL W/ANASTOMOSIS,9036.0,5873.4,1.1,9036.0,144
HCPCS,44140,PARTIAL REMOVAL OF COLON,,,3523.01,3523.01,1
HCPCS,44140,Partial removal of colon,,,1591.31,1842.57,8
HCPCS,44141,COLECTOMY PRTL W/SKIN LEVEL CECOST/COLOSTOMY,11964.0,7776.6,1.1,11964.0,144
HCPCS,44141,PARTIAL REMOVAL OF COLON,,,4743.98,4743.98,1
HCPCS,44141,Partial removal of colon,,,3466.13,4013.42,8
HCPCS,44143,COLECTOMY PRTL W/END COLOSTOMY & CLSR DSTL SGMT,11116.0,7225.4,1.1,11116.0,144
HCPCS,44143,PARTIAL REMOVAL OF COLON,,,4326.35,4326.35,1
HCPCS,44143,Partial removal of colon,,,3466.13,4013.42,8
HCPCS,44144,COLECTOMY PRTL W/COLOST/ILEOST & MUCOFISTULA,11964.0,7776.6,1.1,11964.0,144
HCPCS,44144,PARTIAL REMOVAL OF COLON,,,4618.9,4618.9,1
HCPCS,44144,Partial removal of colon,,,1591.31,1842.57,8
HCPCS,44145,COLECTOMY PRTL W/COLOPROCTOSTOMY,11432.0,7430.8,1.1,11432.0,144
HCPCS,44145,PARTIAL REMOVAL OF COLON,,,4318.27,4318.27,1
HCPCS,44145,Partial removal of colon,,,3466.13,4013.42,8
HCPCS,44146,COLECTOMY PRTL W/COLOPROCTOSTOMY & COLOSTOMY,14120.0,9178.0,1.1,14120.0,144
HCPCS,44146,PARTIAL REMOVAL OF COLON,,,5480.79,5480.79,1
HCPCS,44146,Partial removal of colon,,,3466.13,4013.42,8
HCPCS,44147,COLECTOMY PRTL ABDOMINAL & TRANSANAL APPROACH,13476.0,8759.4,1.1,13476.0,144
HCPCS,44147,PARTIAL REMOVAL OF COLON,,,5065.22,5065.22,1
HCPCS,44147,Partial removal of colon,,,1591.31,1842.57,8
HCPCS,44150,COLCT TOT ABDL W/O PRCTECT W/ILEOST/ILEOPXTS,12072.0,7846.8,1.1,12072.0,144
HCPCS,44150,REMOVAL OF COLON,,,4832.92,4832.92,1
HCPCS,44150,Removal of colon,,,3466.13,4013.42,8
HCPCS,44151,COLCT TOT ABDL W/O PRCTECT W/CONTINENT ILEOST,13968.0,9079.2,1.1,13968.0,144
HCPCS,44151,REMOVAL OF COLON/ILEOSTOMY,,,5632.15,5632.15,1
HCPCS,44151,Removal of colon/ileostomy,,,3466.13,4013.42,8
HCPCS,44155,COLECTOMY TOT ABDL W/PROCTECTOMY W/ILEOSTOMY,13768.0,8949.2,1.1,13768.0,144
HCPCS,44155,REMOVAL OF COLON/ILEOSTOMY,,,5389.06,5389.06,1
HCPCS,44155,Removal of colon/ileostomy,,,3466.13,4013.42,8
HCPCS,44156,COLECTOMY TOT ABDL W/PROCTECTOMY W/CONTNT ILEOST,14968.0,9729.2,1.1,14968.0,144
HCPCS,44156,REMOVAL OF COLON/ILEOSTOMY,,,6021.2,6021.2,1
HCPCS,44156,Removal of colon/ileostomy,,,3466.13,4013.42,8
HCPCS,44157,COLECTOMY TOT ABD W/PROCTECTOMY ILEOANAL ANAST,14280.0,9282.0,1.1,14280.0,144
HCPCS,44157,COLECTOMY W/ILEOANAL ANAST,,,5727.2,5727.2,1
HCPCS,44157,Colectomy w/ileoanal anast,,,3466.13,4013.42,8
HCPCS,44158,COLCT TTL ABD W/PRCTECT ILEOANAL ANAST & RSVR,14680.0,9542.0,1.1,14680.0,144
HCPCS,44158,COLECTOMY W/NEO-RECTUM POUCH,,,5871.35,5871.35,1
HCPCS,44158,Colectomy w/neo-rectum pouch,,,3466.13,4013.42,8
HCPCS,44160,COLECTOMY PRTL W/RMVL TERMINAL ILEUM & ILEOCOLOS,8356.0,5431.4,1.1,8356.0,144
HCPCS,44160,REMOVAL OF COLON,,,3257.94,3257.94,1
HCPCS,44160,Removal of colon,,,1591.31,1842.57,8
HCPCS,44180,LAP ENTEROLYSIS,,,5005.78,15063.4,22
HCPCS,44180,LAPAROSCOPY ENTEROLYSIS SEPARATE PROCEDURE,6108.0,3970.2,1.1,16829.38,144
HCPCS,44180,Lap enterolysis,,,3466.13,4013.42,8
HCPCS,44186,LAP JEJUNOSTOMY,,,5005.78,15063.4,22
HCPCS,44186,LAPAROSCOPY SURGICAL JEJUNOSTOMY,4152.0,2698.8,1.1,16829.38,144
HCPCS,44186,Lap jejunostomy,,,3466.13,4013.42,8
HCPCS,44187,LAP ILEO/JEJUNO-STOMY,,,2838.72,2838.72,1
HCPCS,44187,LAPAROSCOPY SURG ILEOSTOMY/JEJUNOSTOMY NON-TUBE,6960.0,4524.0,1.1,6960.0,144
HCPCS,44187,Lap ileo/jejuno-stomy,,,1591.31,1842.57,8
HCPCS,44188,LAP COLOSTOMY,,,3165.69,3165.69,1
HCPCS,44188,LAPAROSCOPY SURG COLOSTOMY/SKN LVL CECOSTOMY,7740.0,5031.0,1.1,7740.0,144
HCPCS,44188,Lap colostomy,,,3466.13,4013.42,8
HCPCS,44202,LAP ENTERECTOMY,,,3639.38,3639.38,1
HCPCS,44202,LAPS ENTERECT RESCJ 1 SMALL INTEST RESCJ & ANA,9356.0,6081.4,1.1,9356.0,144
HCPCS,44202,Lap enterectomy,,,3466.13,4013.42,8
HCPCS,44203,LAP RESECT S/INTESTINE ADDL,,,628.88,628.88,1
HCPCS,44203,LAPAROSCOPY SMALL INTESTINE RESCJ & ANASTOMOSIS,1776.0,1154.4,1.1,1776.0,144
HCPCS,44203,Lap resect s/intestine addl,,,3466.13,4013.42,8
HCPCS,44204,LAPARO PARTIAL COLECTOMY,,,4017.11,4017.11,1
HCPCS,44204,LAPAROSCOPY COLECTOMY PARTIAL W/ANASTOMOSIS,10568.0,6869.2,1.1,10568.0,144
HCPCS,44204,Laparo partial colectomy,,,3466.13,4013.42,8
HCPCS,44205,LAP COLECTOMY PART W/ILEUM,,,3485.44,3485.44,1
HCPCS,44205,LAPS COLECTOMY PRTL W/RMVL TERMINAL ILEUM,10098.0,6563.7,1.1,10098.0,144
HCPCS,44205,Lap colectomy part w/ileum,,,1591.31,1842.57,8
HCPCS,44206,LAP PART COLECTOMY W/STOMA,,,4549.93,4549.93,1
HCPCS,44206,LAPS COLECTOMY PRTL W/END CLST & CLSR DSTL SGM,11916.0,7745.4,1.1,11916.0,144
HCPCS,44206,Lap part colectomy w/stoma,,,3466.13,4013.42,8
HCPCS,44207,L COLECTOMY/COLOPROCTOSTOMY,,,4725.16,4725.16,1
HCPCS,44207,L colectomy/coloproctostomy,,,3466.13,4013.42,8
HCPCS,44207,LAPS COLECTOMY PRTL W/COLOPXTSTMY LW ANAST,14045.0,9129.25,1.1,14045.0,144
HCPCS,44208,L COLECTOMY/COLOPROCTOSTOMY,,,5136.98,5136.98,1
HCPCS,44208,L colectomy/coloproctostomy,,,3466.13,4013.42,8
HCPCS,44208,LAPS COLECTMY PRTL W/COLOPXTSTMY LW ANAST W/CLST,14956.0,9721.4,1.1,14956.0,144
HCPCS,44210,LAPARO TOTAL PROCTOCOLECTOMY,,,4604.71,4604.71,1
HCPCS,44210,LAPS COLECTOMY TOT W/O PRCTECT W/ILEOST/ILEOPXTS,12036.0,7823.4,1.1,12036.0,144
HCPCS,44210,Laparo total proctocolectomy,,,3466.13,4013.42,8
HCPCS,44211,LAP COLECTOMY W/PROCTECTOMY,,,5475.97,5475.97,1
HCPCS,44211,LAPS COLCT TTL ABD W/PRCTECT ILEOANAL ANASTOMSIS,14832.0,9640.8,1.1,14832.0,144
HCPCS,44211,Lap colectomy w/proctectomy,,,3466.13,4013.42,8
HCPCS,44212,LAPARO TOTAL PROCTOCOLECTOMY,,,5254.83,5254.83,1
HCPCS,44212,LAPS COLECTOMY ABDL W/PROCTECTOMY W/ILEOSTOMY,13832.0,8990.8,1.1,13832.0,144
HCPCS,44212,Laparo total proctocolectomy,,,3466.13,4013.42,8
HCPCS,44213,LAP MOBIL SPLENIC FL ADD-ON,,,486.08,486.08,1
HCPCS,44213,LAPS MOBLJ SPLENIC FLXR PFRMD W/PRTL COLECTOMY,1400.0,910.0,1.1,1400.0,144
HCPCS,44213,Lap mobil splenic fl add-on,,,3466.13,4013.42,8
HCPCS,44227,LAP CLOSE ENTEROSTOMY,,,4332.16,4332.16,1
HCPCS,44227,LAPS CLSR NTRSTM LG/SM INT W/RESCJ & ANASTOMOSIS,11448.0,7441.2,1.1,11448.0,144
HCPCS,44227,Lap close enterostomy,,,3466.13,4013.42,8
HCPCS,44238,INTESTINE SURG PROCEDURE UNLISTED,5300.0,3445.0,0.01,16829.38,96
HCPCS,44238,LAP CLOSURE OF ILEOSIGMOID FISTULA (COMP 44650),5656.0,3676.4,0.01,16829.38,96
HCPCS,44238,LAP COLECTOMY W/REMOVAL OF TI; NO ANASTOMOSIS W/ STOMA (COMP 442,10725.0,6971.25,0.01,16829.38,96
HCPCS,44238,LAP DUODENODUODENOSTOMY,11274.0,7328.1,0.01,16829.38,96
HCPCS,44238,LAP EXCISION OF CECUM W/O ANASTOMOSIS (COMP 44110),6037.0,3924.05,0.01,16829.38,96
HCPCS,44238,LAP EXCISION OF LARGE BOWEL LESION(S) (COMP 44110),3791.0,2464.15,0.01,16829.38,96
HCPCS,44238,LAP EXCISION OF SMALL BOWEL LESION(S),3791.0,2464.15,0.01,16829.38,96
HCPCS,44238,LAP EXCISION SM BOWEL LESION,3861.0,2509.65,0.01,16829.38,96
HCPCS,44238,LAP GRAHAM PATCH INTESTINE (COMP 43840),8219.0,5342.35,0.01,16829.38,96
HCPCS,44238,"LAP REDUCE VOLVULUS,INTUSS,INTERNAL HERNIA (COMP 44050)",5122.0,3329.3,0.01,16829.38,96
HCPCS,44238,LAP REPAIR ENTEROCUTANEOUS FISTULA (COMP 44640),9684.0,6294.6,0.01,16829.38,96
HCPCS,44238,LAP REVISION COLOSTOMY W/RPR PARACOLOSTOMY HERNIA (COMP 44346),5035.0,3272.75,0.01,16829.38,96
HCPCS,44238,LAP REVISION OF ILEAL POUCH W/ RESECTION (COMP 46712),13123.0,8529.95,0.01,16829.38,96
HCPCS,44238,"LAP SUTURE OF LG INTESTINE, SINGLE/MULT (COMP 44604)",5857.0,3807.05,0.01,16829.38,96
HCPCS,44238,"LAP SUTURE OF SM INTESTINE, SINGLE (COMP 44602)",4495.0,2921.75,0.01,16829.38,96
HCPCS,44238,LAP/MALROTATION OF BOWEL,8044.0,5228.6,0.01,16829.38,96
HCPCS,44238,LAPAROSCOPIC APPENDICOSTOMY,2779.0,1806.35,0.01,16829.38,96
HCPCS,44238,LAPAROSCOPIC BRAUN ENTEROENTEROSTOMY (COMP 44130),9507.0,6179.55,0.01,16829.38,96
HCPCS,44238,LAPAROSCOPIC CECOPEXY (COMP CODE 44680),6466.0,4202.9,0.01,16829.38,96
HCPCS,44238,LAPAROSCOPIC ENTEROENTEROSTOMY,5243.0,3407.95,0.01,16829.38,96
HCPCS,44238,LAPAROSCOPIC EXCISION SMALL BOWEL LESION/S (COMP 44110),6037.0,3924.05,0.01,16829.38,96
HCPCS,44238,LAPAROSCOPIC ILEOCOLOSTOMY PEXY (COMP 44312),3395.0,2206.75,0.01,16829.38,96
HCPCS,44238,LAPAROSCOPIC PARTIAL COLECTOMY WITHOUT ANASTOMOSIS (COMP CODE 44,11360.0,7384.0,0.01,16829.38,96
HCPCS,44238,LAPAROSCOPIC REMOVAL OF FOREIGN BODY; SMALL INTESTINE (COMP 4402,5840.0,3796.0,0.01,16829.38,96
HCPCS,44238,LAPAROSCOPIC STRICTUROPLASTY (COMP 44615),6538.0,4249.7,0.01,16829.38,96
HCPCS,44238,LAPAROSCOPIC; MECKELS DIVERTICULECTOMY,4226.0,2746.9,0.01,16829.38,96
HCPCS,44238,LAPARSCOPIC CLOSURE ENTEROCOLIC FISTULA (COMP 44650),10096.0,6562.4,0.01,16829.38,96
HCPCS,44238,LX CLOSE ENTEROENTERIC FI,7718.0,5016.7,0.01,16829.38,96
HCPCS,44238,LX EXCISION OF MECKEL'S DIVERTICULUM (COMP CODE 44800),4226.0,2746.9,0.01,16829.38,96
HCPCS,44238,"LX PROCTOSIGMOID, CAA, ILEOSTOMY",10949.0,7116.85,0.01,16829.38,96
HCPCS,44238,LX REDUCT BOWEL OBSTRUCT,4524.0,2940.6,0.01,16829.38,96
HCPCS,44238,LX TAKEDOWN OF COLOVESICLE FIST W/RESECT (COMP CODE 44661),10664.0,6931.6,0.01,16829.38,96
HCPCS,44238,STRONG PROCEDURE FOR TX OF SMA SYNDROME (COMP 44180),14118.5,9177.03,0.01,16829.38,96
HCPCS,44238,SUTURE OF MESENTERY (SEPARATE PROCEDURE) (COMP CODE 44850),5147.0,3345.55,0.01,16829.38,96
HCPCS,44238,"UNLIST LAP PROC, INTEST (EXC RECTUM) COMPARED TO 44050",5378.0,3495.7,0.01,16829.38,192
HCPCS,44238,"UNLIST LAP PROC, INTESTINE (EXCEPT RECTUM) (COMP CODE 44144)",9721.0,6318.65,0.01,16829.38,96
HCPCS,44238,UNLISTED LAP LADDS PROCEDURE (COMP CODE 44055),9227.0,5997.55,0.01,16829.38,96
HCPCS,44238,UNLISTED LAPAROSCOPIC COMPLETION PROCTECTOMY WITH ILEOANAL POUCH,14118.5,9177.03,0.01,16829.38,96
HCPCS,44238,UNLISTED LAPAROSCOPIC DUODENODUODENOSTOMY (COMP CODE 44126),17948.0,11666.2,0.01,17948.0,96
HCPCS,44238,"UNLISTED LAPAROSCOPIC PROCEDURE, INTESTINE (EXCEPT RECTUM)  (COM",2120.0,1378.0,0.01,16829.38,96
HCPCS,44238,UNLISTED LAPAROSCOPY PX INTESTINE XCP RECTUM,8026.0,5216.9,0.01,16829.38,96
HCPCS,44238,UNLISTED LAPS PX INTESTINE,,,5005.78,15063.4,21
HCPCS,44238,"UNLISTED PROC, LAP REPAIR OF DUODENAL PERFORATION (COMP TO 44602",10506.0,6828.9,0.01,16829.38,96
HCPCS,44238,UNLISTED PROC; LAP REVISION OF ILEOSTOMY; COMPLICATED (COMP TO 4,17632.0,11460.8,0.01,17632.0,96
HCPCS,44238,Unlisted laps px intestine,,,1591.31,1842.57,8
HCPCS,44300,OPEN BOWEL TO SKIN,,,1815.43,2214.88,13
HCPCS,44300,Open bowel to skin,,,1591.31,1842.57,8
HCPCS,44300,PLACEMENT ENTEROSTOMY/CECOSTOMY TUBE OPEN,5500.0,3575.0,1.1,5500.0,144
HCPCS,44310,ILEOSTOMY/JEJUNOSTOMY,,,2724.08,2724.08,1
HCPCS,44310,"ILEOSTOMY/JEJUNOSTOMY,NONTUBE",7740.0,5031.0,1.1,7740.0,144
HCPCS,44310,Ileostomy/jejunostomy,,,1591.31,1842.57,8
HCPCS,44312,REVJ ILEOSTOMY SIMPLE RLS SUPERFICIAL SCAR SPX,10306.0,6698.9,1.1,16840.0,318
HCPCS,44314,REVISION OF ILEOSTOMY,,,2628.35,3687.9,13
HCPCS,44314,REVJ ILEOSTOMY COMPLIC RCNSTJ IN-DEPTH SPX,6696.0,4352.4,1.1,6696.0,144
HCPCS,44314,Revision of ileostomy,,,1591.31,1842.57,8
HCPCS,44316,CONTINENT ILEOSTOMY KOCK PROCEDURE SPX,9436.0,6133.4,1.1,9436.0,144
HCPCS,44316,DEVISE BOWEL POUCH,,,3725.36,3725.36,1
HCPCS,44316,Devise bowel pouch,,,1591.31,1842.57,8
HCPCS,44320,COLOSTOMY,,,3146.37,3146.37,1
HCPCS,44320,COLOSTOMY/SKIN LEVEL CECOSTOMY,7964.0,5176.6,1.1,7964.0,144
HCPCS,44320,Colostomy,,,3466.13,4013.42,8
HCPCS,44322,COLOSTOMY WITH BIOPSIES,,,2613.91,2613.91,1
HCPCS,44322,COLOSTOMY/SKN LVL CECOSTOMY W/MULT BXS SPX,5328.0,3463.2,1.1,5328.0,144
HCPCS,44322,Colostomy with biopsies,,,1591.31,1842.57,8
HCPCS,44340,REVJ COLOSTOMY SMPL RLS SUPFC SCAR SPX,10276.0,6679.4,1.1,16840.0,231
HCPCS,44345,REVISION OF COLOSTOMY,,,2750.99,3687.9,13
HCPCS,44345,REVJ COLOSTOMY COMP RCNSTJ IN-DEPTH SPX,6888.0,4477.2,1.1,6888.0,144
HCPCS,44345,Revision of colostomy,,,1591.31,1842.57,8
HCPCS,44346,REVISION OF COLOSTOMY,,,3097.08,3687.9,13
HCPCS,44346,REVJ COLOSTOMY W/RPR PARACLST HERNIA SPX,7852.0,5103.8,1.1,7852.0,144
HCPCS,44346,Revision of colostomy,,,3466.13,4013.42,8
HCPCS,44360,ENDOSCOPY UPPER SMALL INTESTINE,4861.0,3159.6499999999996,1.1,8726.0,231
HCPCS,44361,ENDOSCOPY UPPER SMALL INTESTINE W/BIOPSY,4917.0,3196.0499999999997,1.1,8726.0,231
HCPCS,44363,ENTEROSCOPY > 2ND PRTN W/RMVL FOREIGN BODY,5041.0,3276.6499999999996,1.1,8726.0,231
HCPCS,44364,ENTEROSCOPY > 2ND PRTN W/RMVL LESION SNARE,5089.0,3307.85,1.1,8726.0,231
HCPCS,44365,ENTEROSCOPY > 2ND PRTN W/RMVL LESION CAUTERY,5005.0,3253.25,1.1,8726.0,231
HCPCS,44366,ENTEROSCOPY > 2ND PRTN W/CONTROL BLEEDING,5223.0,3394.95,1.1,8726.0,231
HCPCS,44369,ENTEROSCOPY > 2ND PRTN ABLTJ LESION,5245.0,3409.25,1.1,8726.0,231
HCPCS,44370,ENTEROSCOPY > 2ND PRTN TNDSC STENT PLMT,14629.5,9509.175000000001,1.1,33436.0,231
HCPCS,44372,ENTEROSCOPY > 2ND PRTN W/PLMT PRQ TUBE,5223.0,3394.95,0.01,8726.0,492
HCPCS,44373,ENTEROSCOPY > 2ND PRTN CONV GSTRST TUBE,5041.0,3276.6499999999996,0.01,8726.0,318
HCPCS,44376,ENTEROSC >2ND PRTN W/ILEUM W/WO COLLJ SPEC SPX,5393.0,3505.45,1.1,8726.0,231
HCPCS,44377,ENTEROSC >2ND PRTN W/ILEUM W/BX SINGLE/MULTIPLE,5447.0,3540.5499999999997,1.1,8726.0,231
HCPCS,44378,ENTEROSCOPY > 2ND PRTN ILEUM CONTROL BLEEDING,5767.0,3748.5499999999997,1.1,8726.0,231
HCPCS,44379,ENTEROSCOPY > 2ND PRTN W/ILEUM W/STENT PLMT,2944.0,1913.6,1.1,16621.23,144
HCPCS,44379,S BOWEL ENDOSCOPE W/STENT,,,4944.41,6317.89,20
HCPCS,44379,S bowel endoscope w/stent,,,1500.64,1737.58,8
HCPCS,44380,ILEOSCOPY THRU STOMA DX W/COLLJ SPEC WHEN PRFMD,2330.5,1514.8249999999998,1.1,6112.0,322
HCPCS,44381,ILEOSCOPY STOMA W/BALLOON DILATION,4639.0,3015.35,0.01,8726.0,310
HCPCS,44382,ILEOSCOPY STOMA W/BX SINGLE/MULTIPLE,2390.5,1553.8249999999998,0.01,6112.0,409
HCPCS,44384,ILEOSCOPY STOMA W/PLMT OF ENDOSCOPIC STENT,4933.0,3206.45,1.1,33436.0,211
HCPCS,44385,NDSC EVAL INTSTINAL POUCH DX W/COLLJ SPEC SPX,2361.0,1534.6499999999999,1.1,6112.0,235
HCPCS,44386,NDSC EVAL INTSTINAL POUCH W/BX SINGLE/MULTIPLE,2427.0,1577.55,1.1,6112.0,235
HCPCS,44388,COLONOSCOPY STOMA DX INCLUDING COLLJ SPEC SPX,2641.0,1716.65,1.1,6112.0,235
HCPCS,44389,COLONOSCOPY STOMA W/BIOPSY SINGLE/MULTIPLE,3376.5,2194.725,1.1,6112.0,235
HCPCS,44390,COLONOSCOPY FOR FOREIGN BODY,,,792.91,967.79,20
HCPCS,44390,COLONOSCOPY STOMA W/RMVL FOREIGN BODY,1496.0,972.4,1.1,2666.13,148
HCPCS,44390,Colonoscopy for foreign body,,,890.23,1030.79,8
HCPCS,44391,COLONOSCOPY FOR BLEEDING,,,1023.77,1245.33,20
HCPCS,44391,COLONOSCOPY STOMA CONTROL BLEEDING,1648.0,1071.2,1.1,3440.56,148
HCPCS,44391,Colonoscopy for bleeding,,,890.23,1030.79,8
HCPCS,44392,COLONOSCOPY STOMA RMVL LES BY HOT BIOPSY FORCEPS,3418.0,2221.7,0.01,6112.0,322
HCPCS,44394,COLONOSCOPY STOMA W/RMVL TUM POLYP/OTH LES SNARE,3518.0,2286.7,1.1,6112.0,235
HCPCS,44401,COLONOSCOPY STOMA ABLATION LESION,3580.0,2327.0,1.1,7948.0,235
HCPCS,44402,COLONOSCOPY STOMA W/ENDOSCOPIC STENT PLCMT,14631.5,9510.475,1.1,27383.0,223
HCPCS,44403,COLONOSCOPY STOMA W/ENDOSCOPIC MUCOSAL RESCJ,3812.0,2477.8,1.1,7948.0,219
HCPCS,44404,COLONOSCOPY STOMA W/SUBMUCOSAL INJECTION,3316.0,2155.4,1.1,7948.0,223
HCPCS,44405,COLONOSCOPY STOMA W/BALLOON DILATION,3358.0,2182.7,1.1,7948.0,223
HCPCS,44406,COLONOSCOPY STOMA W/ENDOSCOPIC ULTRASOUND EXAM,3532.0,2295.8,1.1,7948.0,219
HCPCS,44407,COLONOSCOPY STOMA W/US GID NDL ASPIR/BX,3704.0,2407.6,1.1,7948.0,219
HCPCS,44408,COLONOSCOPY THROUGH STOMA WITH DECOMPRESSION,2925.0,1901.25,1.1,7948.0,231
HCPCS,44500,INTRO LONG GI TUBE,4313.0,2803.45,22.26,6112.0,86
HCPCS,44500,INTRODUCTION LONG GI TUBE SEPARATE PROCEDURE,2242.5,1457.625,0.01,12615.0,317
HCPCS,4450F,SELF-CARE ED PROVIDED TO PT,,,2739849.3,2739849.3,1
HCPCS,4450F,Self-care ed provided to pt,,,10.69,12.38,8
HCPCS,44602,ENTERORRHAPHY SINGLE PERFORATION,9888.0,6427.2,1.1,9888.0,144
HCPCS,44602,SUTURE SMALL INTESTINE,,,3647.57,4012.33,13
HCPCS,44602,Suture small intestine,,,3466.13,4013.42,8
HCPCS,44603,ENTERORRHAPHY MULTIPLE PERFORATIONS,11264.0,7321.6,1.1,11264.0,144
HCPCS,44603,SUTURE SMALL INTESTINE,,,4241.3,4241.3,1
HCPCS,44603,Suture small intestine,,,1591.31,1842.57,8
HCPCS,44604,SUTR LG INTESTINE 1/MULT PERFORAT W/O COLOSTOMY,7264.0,4721.6,1.1,7264.0,144
HCPCS,44604,SUTURE LARGE INTESTINE,,,2768.06,2768.06,1
HCPCS,44604,Suture large intestine,,,3466.13,4013.42,8
HCPCS,44605,REPAIR OF BOWEL LESION,,,3375.68,3375.68,1
HCPCS,44605,Repair of bowel lesion,,,1591.31,1842.57,8
HCPCS,44605,SUTR LG INTESTINE 1/MULT PERFORAT W/COLOSTOMY,8832.0,5740.8,1.1,8832.0,144
HCPCS,44615,INTESTINAL STRICTUROPLASTY,,,2799.6,2799.6,1
HCPCS,44615,INTSTINAL STRICTUROPLASTY W/WO DILAT OBSTRCJ,7264.0,4721.6,1.1,7264.0,144
HCPCS,44615,Intestinal stricturoplasty,,,3466.13,4013.42,8
HCPCS,44620,CLOSURE ENTEROSTOMY LG/SMALL INTESTINE,6349.0,4126.85,1.1,6349.0,144
HCPCS,44620,LAPAROSCOPIC OVERSEW OF SMALL BOWEL ANASTOMOSIS (COMP 44620),6204.0,4032.6,1.1,6204.0,144
HCPCS,44620,REPAIR BOWEL OPENING,,,2262.47,2262.47,1
HCPCS,44620,Repair bowel opening,,,1591.31,1842.57,8
HCPCS,44625,CLSR NTRSTM LG/SM RESCJ & ANAST OTH/THN CLRCT,6912.0,4492.8,1.1,6912.0,144
HCPCS,44625,REPAIR BOWEL OPENING,,,2642.81,2642.81,1
HCPCS,44625,Repair bowel opening,,,1591.31,1842.57,8
HCPCS,44626,CLSR NTRSTM LG/SM RESCJ & COLORECTAL ANASTOMOSIS,11160.0,7254.0,1.1,11160.0,144
HCPCS,44626,REPAIR BOWEL OPENING,,,4164.96,4164.96,1
HCPCS,44626,Repair bowel opening,,,3466.13,4013.42,8
HCPCS,44640,CLOSURE INTESTINAL CUTANEOUS FISTULA,9680.0,6292.0,1.1,9680.0,144
HCPCS,44640,REPAIR BOWEL-SKIN FISTULA,,,3656.78,3656.78,1
HCPCS,44640,Repair bowel-skin fistula,,,3466.13,4013.42,8
HCPCS,44650,CLSR ENTEROENTERIC/ENTEROCOLIC FSTL,10048.0,6531.2,1.1,10048.0,144
HCPCS,44650,REPAIR BOWEL FISTULA,,,3769.8,3769.8,1
HCPCS,44650,Repair bowel fistula,,,1591.31,1842.57,8
HCPCS,44660,CLSR ENTEROVES FSTL W/O INTSTINAL/BLADDER RESCJ,9564.0,6216.6,1.1,9564.0,144
HCPCS,44660,LAP CLOSURE OF ENTEROVESICAL FISTULA W/O RESECTION (COMP 44660),10281.0,6682.65,1.1,10281.0,144
HCPCS,44660,REPAIR BOWEL-BLADDER FISTULA,,,3512.93,3512.93,1
HCPCS,44660,Repair bowel-bladder fistula,,,1591.31,1842.57,8
HCPCS,44661,CLSR ENTEROVES FSTL W/INTESTINE&/BLADDER RESCJ,10940.0,7111.0,1.1,10940.0,144
HCPCS,44661,REPAIR BOWEL-BLADDER FISTULA,,,4033.8,4033.8,1
HCPCS,44661,Repair bowel-bladder fistula,,,1591.31,1842.57,8
HCPCS,44680,INTESTINAL PLICATION SEPARATE PROCEDURE,7184.0,4669.6,1.1,7184.0,144
HCPCS,44680,SURGICAL REVISION INTESTINE,,,2834.69,2834.69,1
HCPCS,44680,Surgical revision intestine,,,1591.31,1842.57,8
HCPCS,44700,EXCLUSION SM INT FROM PELVIS MESH/PROSTH/TISS,6992.0,4544.8,1.1,6992.0,144
HCPCS,44700,SUSPEND BOWEL W/PROSTHESIS,,,2619.11,2619.11,1
HCPCS,44700,Suspend bowel w/prosthesis,,,1591.31,1842.57,8
HCPCS,44701,INTRAOPERATIVE COLONIC LAVAGE,1240.0,806.0,1.1,1240.0,144
HCPCS,44701,Intraop colon lavage add-on,,,3466.13,4013.42,8
HCPCS,44705,PREPARE FECAL MICROBIOTA FOR INSTILLATION,568.0,369.2,1.1,568.0,114
HCPCS,44705,Prepare fecal microbiota,,,299.41,346.69,8
HCPCS,4470F,ICD COUNSELING PROVIDED,,,2739849.3,2739849.3,1
HCPCS,4470F,Icd counseling provided,,,10.69,12.38,8
HCPCS,44715,BKBENCH PREP CADAVER/LIVING DONOR INTESTINE,2673.0,1737.45,1.1,4462.94,88
HCPCS,44715,PREPARE DONOR INTESTINE,,,3995.19,3995.19,1
HCPCS,44715,Prepare donor intestine,,,1229.51,1423.64,8
HCPCS,44720,BKBENCH RCNSTJ INT ALGRFT VEN ANAST EA,2000.0,1300.0,1.1,2000.0,142
HCPCS,44720,PREP DONOR INTESTINE/VENOUS,,,716.81,716.81,1
HCPCS,44720,Prep donor intestine/venous,,,1229.51,1423.64,8
HCPCS,44721,BKBENCH RCNSTJ INT ALGRFT ARTL ANAST EA,2800.0,1820.0,1.1,2800.0,142
HCPCS,44721,PREP DONOR INTESTINE/ARTERY,,,1003.17,1003.17,1
HCPCS,44721,Prep donor intestine/artery,,,1229.51,1423.64,8
HCPCS,44799,BAE W/ENDOSCOPIC MUCOSAL RESECTION (COMP CODE 43254),2077.5,1350.375,0.01,6112.0,168
HCPCS,44799,CORRECTION OF GUT MALROTATION (EG. KAREEM'S PROCEDURE) - (COMP C,11020.0,7163.0,0.01,11020.0,84
HCPCS,44799,EGD THROUGH ARTIFICIAL STOMA (COMP 44369),1588.0,1032.2,0.01,2644.7,84
HCPCS,44799,EGD W/ CLIPPING OF INTESTINAL FISTULA (COMP 43255),1566.0,1017.9,0.01,2644.7,84
HCPCS,44799,ENDOSCOPIC SUBMUCOSAL DISSECTION OF SMALL INSTESTINE - (COMP COD,9941.0,6461.65,0.01,9941.0,84
HCPCS,44799,"ENDOVAC, SMALL INT; EGD (COMP 43235, 97605)",990.0,643.5,0.01,2644.7,84
HCPCS,44799,"ENDOVAC, SMALL INT; ENTEROSCOPY (COMP 44360, 97605)",1134.0,737.1,0.01,2644.7,84
HCPCS,44799,"ENDOVAC, SMALL INT; ENTEROSCOPY W/ILEUM (COMP 44376, 97605)",2092.0,1359.8,0.01,2644.7,84
HCPCS,44799,"ENDOVAC, SMALL INT; POUCHOSCOPY (COMP 44385, 97605)",2203.0,1431.95,0.01,2644.7,84
HCPCS,44799,ENTEROSCOPY W/DILATION (COMP CODE 43249),4353.5,2829.775,0.01,7833.0,168
HCPCS,44799,ENTEROSCOPY W/SUBMUCOSAL INJECTION (COMP CODE 43236),2306.5,1499.2250000000001,0.01,6112.0,168
HCPCS,44799,ESD SMALL INTESTINE,6970.0,4530.5,0.01,8640.0,168
HCPCS,44799,ESD SMALL INTESTINE (COMP 44364),6566.5,4268.225,0.01,7833.0,169
HCPCS,44799,ILEOSCOPY W/ CONTROL OF BLEEDING THROUGH THE STOMA (COMP 44378),3018.0,1961.7,0.01,3018.0,84
HCPCS,44799,ILEOSCOPY WITH ABLATION VIA STOMA,2946.0,1914.9,0.01,3443.0,85
HCPCS,44799,ILEOSCOPY WITH ABLATION VIA STOMA (COMP CODE 44401),1833.0,1191.45,0.01,2644.7,84
HCPCS,44799,J- TUBE REPLACEMENT W/O IMAGING,1699.0,1104.35,0.01,3443.0,85
HCPCS,44799,"LOWER BAE, RETROGRADE, W/O FLUORO (COMP 45378)",2420.5,1573.325,0.01,6112.0,168
HCPCS,44799,NON-CONG SM BOWEL TAPERING PROC,6610.0,4296.5,0.01,6610.0,84
HCPCS,44799,PANCREAS PRESERVING DUODENECTOMY (COMP 48153),16193.0,10525.45,0.01,16193.0,84
HCPCS,44799,POUCHOSCOPY W/ DILATION (COMP 44386),3762.0,2445.3,786.42,6112.0,84
HCPCS,44799,POUCHOSCOPY W/ HOT BIOPSY & DILATION (COMP 44386),2363.5,1536.275,0.01,6112.0,168
HCPCS,44799,POUCHOSCOPY W/ HOT BIOPSY & INJECTION (COMP 44386),3762.0,2445.3,786.42,6112.0,84
HCPCS,44799,POUCHOSCOPY W/ HOT BIOPSY (COMP 44386),3762.0,2445.3,786.42,6112.0,84
HCPCS,44799,POUCHOSCOPY W/ INJECTION (COMP 44386),3762.0,2445.3,786.42,6112.0,84
HCPCS,44799,POUCHOSCOPY W/ NEEDLEKNIFE,8208.0,5335.2,786.42,8208.0,84
HCPCS,44799,POUCHOSCOPY W/ SNARE & DILATION (COMP 44386),3762.0,2445.3,786.42,6112.0,84
HCPCS,44799,POUCHOSCOPY W/ SNARE & INJECTION (COMP 44386),3762.0,2445.3,786.42,6112.0,84
HCPCS,44799,POUCHOSCOPY W/ SNARE (COMP 44386),3762.0,2445.3,786.42,6112.0,84
HCPCS,44799,POUCHOSCOPY W/ STENT PLACEMENT (COMP 44402),1693.0,1100.45,0.01,2644.7,84
HCPCS,44799,POUCHOSCOPY W/ STRICTUROTOMY & INJECTION (COMP 44386),3762.0,2445.3,786.42,6112.0,84
HCPCS,44799,POUCHOSCOPY W/ STRICTUROTOMY/FISTULOTOMY (COMP 44386),3762.0,2445.3,786.42,6112.0,84
HCPCS,44799,POUCHOSCOPY W/DECOMPRESSION (COMP 45393),2059.0,1338.35,0.01,2644.7,84
HCPCS,44799,POUCHOSCOPY W/HOT BIOPSY & INJECTION (COMP 44386),965.0,627.25,0.01,2644.7,84
HCPCS,44799,POUCHOSCOPY W/HOT BIOPSY (COMP 44386),772.0,501.8,0.01,2644.7,84
HCPCS,44799,POUCHOSCOPY W/INJECTION (COMP 44386),482.0,313.3,0.01,2644.7,84
HCPCS,44799,POUCHOSCOPY W/SNARE & DILATION (COMP 44386),965.0,627.25,0.01,2644.7,84
HCPCS,44799,POUCHOSCOPY W/SNARE & INJECTION (COMP 44386),965.0,627.25,0.01,2644.7,84
HCPCS,44799,POUCHOSCOPY W/SNARE (COMP 44386),772.0,501.8,0.01,2644.7,84
HCPCS,44799,POUCHOSCOPY W/STRICTUROTOMY & INJECTION (COMP 44386),705.0,458.25,0.01,2644.7,84
HCPCS,44799,POUCHOSCOPY W/STRICTUROTOMY/FISTULOTOMY (COMP 44386),705.0,458.25,0.01,2644.7,84
HCPCS,44799,POUCHOSCOPY WITH DILATION (COMP 44386),624.0,405.6,0.01,2644.7,84
HCPCS,44799,POUCHOSCOPY WITH FOREIGN BODY REMOVAL (COMP 45332),2724.0,1770.6,0.01,6112.0,168
HCPCS,44799,REPAIR DUODENAL FISTULA (COMP 44650),4409.0,2865.85,0.01,4409.0,84
HCPCS,44799,RETROGRADE ENTEROSCOPY SUBMUCOSAL INJECTION (COMP 45381),3023.5,1965.2749999999999,0.01,6112.0,168
HCPCS,44799,RETROGRADE ENTEROSCOPY W/CONTROL OF BLEEDING (COMP 44378),5089.5,3308.175,0.01,7833.0,168
HCPCS,44799,RETROGRADE ENTEROSCOPY W/DILATION (COMP 45386),1659.0,1078.35,0.01,2644.7,84
HCPCS,44799,RETROGRADE SMALL INTESTINE ENTEROSCOPY W/BIOPSY (COMP 44377),4825.5,3136.575,0.01,7833.0,168
HCPCS,44799,REVISION JEJUNOJEJUNOSTOMY,5769.0,3749.85,0.01,5769.0,84
HCPCS,44799,REVISION OF ANASTOMOSIS (COMP 44125),8624.0,5605.6,0.01,8624.0,84
HCPCS,44799,REVISION OF JEJUNOSTOMY (COMP 44314),6696.0,4352.4,0.01,6696.0,84
HCPCS,44799,SERIAL TRANSVERSE ENTEROPLASTY (COMP 44603),11986.0,7790.9,0.01,11986.0,84
HCPCS,44799,SMALL BAE WITH DILATION,1069.0,694.85,0.01,2644.7,84
HCPCS,44799,SMALL BOWEL BAE W/ SUBMUCO INJECTION,2079.0,1351.35,0.01,3443.0,169
HCPCS,44799,SMALL INTESTINE MYRIAD COLLAGEN MATRIX IMPLANT (COMP 15777),1315.0,854.75,0.01,2644.7,84
HCPCS,44799,"UNLIST PROC, SMALL INTESTINE COMPARED TO 44110",4633.0,3011.45,0.01,4633.0,84
HCPCS,44799,"UNLISTED PROCEDURE, SMALL INTESTINE (COMP 43236)",2858.0,1857.7,786.42,6112.0,84
HCPCS,44799,"UNLISTED PROCEDURE, SMALL INTESTINE COMPARED TO 43236",881.0,572.65,0.01,2644.7,84
HCPCS,44799,"UNLISTED PROCEDURE, SMALL INTESTINE COMPARED TO 44394",1373.0,892.45,0.01,2644.7,84
HCPCS,44800,EXC MECKEL'S DIVERTICULUM/OMPHALOMESENTERIC DUCT,4820.0,3133.0,1.1,4820.0,144
HCPCS,44800,EXCISION OF BOWEL POUCH,,,2042.18,2042.18,1
HCPCS,44800,Excision of bowel pouch,,,1591.31,1842.57,8
HCPCS,4480F,PT RCVNG ACE/ARB B-BLOCKERTX,,,2739849.3,2739849.3,1
HCPCS,4480F,Pt rcvng ace/arb b-blockertx,,,10.69,12.38,8
HCPCS,4481F,PT RCVNG ACE/ARB BLKER <3MOS,,,2739849.3,2739849.3,1
HCPCS,4481F,Pt rcvng ace/arb blker <3mos,,,10.69,12.38,8
HCPCS,44820,EXCISION LESION MESENTERY SEPARATE PROCEDURE,5492.0,3569.8,1.1,5492.0,144
HCPCS,44820,EXCISION OF MESENTERY LESION,,,2244.03,2244.03,1
HCPCS,44820,Excision of mesentery lesion,,,1591.31,1842.57,8
HCPCS,44850,REPAIR OF MESENTERY,,,1967.84,1967.84,1
HCPCS,44850,Repair of mesentery,,,1591.31,1842.57,8
HCPCS,44850,SUTURE MESENTERY SEPARATE PROCEDURE,4844.0,3148.6,1.1,4844.0,144
HCPCS,44899,"UNLISTED PROCEDURE, MECKEL'S DIVERTICULUM AND THE MESENTERY (COM",4943.0,3212.95,0.01,3061000.0,84
HCPCS,44899,UNLISTED PX MECKEL'S DVRTCLM,,,2739999.97,2739999.97,1
HCPCS,44899,Unlisted px meckel's dvrtclm,,,1591.31,1842.57,8
HCPCS,44900,I&D APPENDIX ABSCESS OPEN,,,2065.47,2065.47,1
HCPCS,44900,I&d appendix abscess open,,,1591.31,1842.57,8
HCPCS,44900,INCISION AND DRAINAGE APPENDICEAL ABSCESS OPEN,5028.0,3268.2,1.1,5028.0,144
HCPCS,44950,APPENDECTOMY,4240.0,2756.0,1.1,22063.69,165
HCPCS,44950,Appendectomy,,,3466.13,4013.42,8
HCPCS,44955,APPENDEC INDICATED PURPOSE OTH MAJOR PX NOT SPX,612.0,397.8,1.1,612.0,144
HCPCS,44955,Appendectomy add-on,,,2029.97,2350.49,8
HCPCS,44960,APPENDEC RPTD APPENDIX ABSC/PRITONITIS,5800.0,3770.0,1.1,5800.0,144
HCPCS,44960,APPENDECTOMY,,,2309.22,2309.22,1
HCPCS,44960,Appendectomy,,,3466.13,4013.42,8
HCPCS,44970,LAPAROSCOPIC APPENDECTOMY,3780.0,2457.0,1.1,16829.38,144
HCPCS,44970,LAPAROSCOPY APPENDECTOMY,,,5005.78,25635.0,25
HCPCS,44970,Laparoscopy appendectomy,,,3466.13,4013.42,8
HCPCS,44979,LAP APPENDECTOMY AT TIME OTHER SURGERY (COMP CODE 44955),519.0,337.35,0.01,16829.38,84
HCPCS,44979,LAPAROSCOPIC APPENDICOLOSTOMY (COMP 44188),6386.0,4150.9,0.01,16829.38,84
HCPCS,44979,OPEN APPENDICOSTOMY (COMP 44188),6386.0,4150.9,0.01,16829.38,84
HCPCS,44979,UNLISTED LAPAROSCOPY PROCEDURE APPENDIX,571.0,371.15,0.01,16829.38,84
HCPCS,44979,"UNLISTED LAPAROSCOPY PROCEDURE, APP",519.0,337.35,0.01,16829.38,84
HCPCS,44979,"UNLISTED LAPAROSCOPY PROCEDURE, APPENDIX",519.0,337.35,0.01,16829.38,84
HCPCS,44979,UNLISTED LAPS PX APPENDIX,,,5005.78,15063.4,21
HCPCS,44979,UNLISTED PROC; LAP DRAINAGE OF APPENDICEAL ABSCESS W/DEBRIDEMENT,4526.0,2941.9,0.01,16829.38,84
HCPCS,44979,Unlisted laps px appendix,,,1591.31,1842.57,8
HCPCS,44999,DUMMY PROC NAME,1280.0,832.0,1.1,1280.0,70
HCPCS,45000,DRAINAGE OF PELVIC ABSCESS,,,1023.77,1245.33,20
HCPCS,45000,Drainage of pelvic abscess,,,1836.64,2126.64,8
HCPCS,45000,TRANSRECTAL DRAINAGE OF PELVIC ABSCESS,2520.0,1638.0,1.1,3440.56,144
HCPCS,45005,I&D SUBMUCOSAL ABSCESS RECTUM,3116.0,2025.4,1.1,5424.0,235
HCPCS,4500F,REF TO OUTPT CARD REHAB PROG,,,2739849.3,2739849.3,1
HCPCS,4500F,Ref to outpt card rehab prog,,,10.69,12.38,8
HCPCS,45020,DRAINAGE OF RECTAL ABSCESS,,,2435.91,2888.59,20
HCPCS,45020,Drainage of rectal abscess,,,1836.64,2126.64,8
HCPCS,45020,I&D DP SUPRALEVATOR PELVIRCT/RETRORCT ABSC,3424.0,2225.6,1.1,8188.18,144
HCPCS,45100,BX ANORECTAL WALL ANAL APPROACH,7115.5,4625.075,1.1,12615.0,318
HCPCS,45108,ANORECTAL MYOMECTOMY,2048.0,1331.2,1.1,8188.18,164
HCPCS,45108,Anorectal myomectomy,,,1836.64,2126.64,8
HCPCS,4510F,PREV CARDREHAB QUALCARDEVENT,,,2739849.3,2739849.3,1
HCPCS,4510F,Prev cardrehab qualcardevent,,,10.69,12.38,8
HCPCS,45110,PRCTECT COMPL CMBN ABDOMINOPRNL W/CLST,12304.0,7997.6,1.1,12304.0,144
HCPCS,45110,REMOVAL OF RECTUM,,,4726.94,4726.94,1
HCPCS,45110,Removal of rectum,,,1836.64,2126.64,8
HCPCS,45111,PARTIAL REMOVAL OF RECTUM,,,2843.98,2843.98,1
HCPCS,45111,PRCTECT PRTL RESCJ RECTUM TABDL APPR,7204.0,4682.6,1.1,7204.0,144
HCPCS,45111,Partial removal of rectum,,,1836.64,2126.64,8
HCPCS,45112,PRCTECT CMBN ABDOMINOPRNL PULL-THRU PX,13272.0,8626.8,1.1,13272.0,144
HCPCS,45112,REMOVAL OF RECTUM,,,4713.95,4713.95,1
HCPCS,45112,Removal of rectum,,,1836.64,2126.64,8
HCPCS,45113,PARTIAL PROCTECTOMY,,,4837.69,4837.69,1
HCPCS,45113,PRCTECT PRTL W/MUCOSEC ILEOANAL ANAST RSVR,13288.0,8637.2,1.1,13288.0,144
HCPCS,45113,Partial proctectomy,,,1836.64,2126.64,8
HCPCS,45114,PARTIAL REMOVAL OF RECTUM,,,4779.0,4779.0,1
HCPCS,45114,PRCTECT PRTL W/ANAST ABDL & TRANSSAC APPROACH,12316.0,8005.4,1.1,12316.0,144
HCPCS,45114,Partial removal of rectum,,,1836.64,2126.64,8
HCPCS,45116,PARTIAL REMOVAL OF RECTUM,,,4014.92,4014.92,1
HCPCS,45116,PRCTECT PRTL W/ANAST TRANSSAC APPR ONLY,11088.0,7207.2,1.1,11088.0,144
HCPCS,45116,Partial removal of rectum,,,1836.64,2126.64,8
HCPCS,45119,PRCTECT CMBN PULL-THRU W/RSVR W/NTRSTM,13392.0,8704.8,1.1,13392.0,144
HCPCS,45119,REMOVE RECTUM W/RESERVOIR,,,4873.83,4873.83,1
HCPCS,45119,Remove rectum w/reservoir,,,1836.64,2126.64,8
HCPCS,45120,PRCTECT COMPL W/PULL-THRU PX & ANASTOMOSIS,10560.0,6864.0,1.1,10560.0,144
HCPCS,45120,REMOVAL OF RECTUM,,,4209.19,4209.19,1
HCPCS,45120,Removal of rectum,,,1836.64,2126.64,8
HCPCS,45121,PRCTECT COMPL W/STOT/TOT COLCT W/MLT BXS,11632.0,7560.8,1.1,11632.0,144
HCPCS,45121,REMOVAL OF RECTUM AND COLON,,,4596.46,4596.46,1
HCPCS,45121,Removal of rectum and colon,,,1836.64,2126.64,8
HCPCS,45123,PARTIAL PROCTECTOMY,,,2900.84,2900.84,1
HCPCS,45123,PRCTECT PRTL W/O ANAST PRNL APPR,7544.0,4903.6,1.1,7544.0,144
HCPCS,45123,Partial proctectomy,,,1836.64,2126.64,8
HCPCS,45126,PELVIC EXENTERATION,,,7149.29,7149.29,1
HCPCS,45126,PELVIC EXENTERATION COLORECTAL MALIGNANCY,19640.0,12766.0,1.1,19640.0,144
HCPCS,45126,Pelvic exenteration,,,2029.97,2350.49,8
HCPCS,45130,EXC RCT PROCIDENTIA W/ANAST PERINEAL APPROACH,7400.0,4810.0,1.1,7400.0,144
HCPCS,45130,EXCISION OF RECTAL PROLAPSE,,,2827.32,2827.32,1
HCPCS,45130,Excision of rectal prolapse,,,1836.64,2126.64,8
HCPCS,45135,EXCISION OF RECTAL PROLAPSE,,,3370.72,3370.72,1
HCPCS,45135,Excision of rectal prolapse,,,1836.64,2126.64,8
HCPCS,45136,EXC ILEOANAL RESVR W/ILEOSTMY,12328.0,8013.2,1.1,12328.0,144
HCPCS,45136,EXCISE ILEOANAL RESERVIOR,,,4625.5,4625.5,1
HCPCS,45136,Excise ileoanal reservior,,,1836.64,2126.64,8
HCPCS,45150,DIVISION STRICTURE RECTUM,2340.0,1521.0,1.1,3440.56,144
HCPCS,45150,EXCISION OF RECTAL STRICTURE,,,1023.77,1245.33,20
HCPCS,45150,Excision of rectal stricture,,,1836.64,2126.64,8
HCPCS,45160,EXC RCT TUM PROCTOTOMY TRANSSAC/TRANSCOCCYGEAL,6532.0,4245.8,1.1,8188.18,144
HCPCS,45160,EXCISION OF RECTAL LESION,,,2435.91,2888.59,20
HCPCS,45160,Excision of rectal lesion,,,1836.64,2126.64,8
HCPCS,45171,EXC RCT TUM NOT INCL MUSCULARIS PROPRIA,3252.0,2113.8,1.1,8188.18,144
HCPCS,45171,EXC RECT TUM TRANSANAL PART,,,2435.91,8326.0,24
HCPCS,45171,Exc rect tum transanal part,,,1836.64,2126.64,8
HCPCS,45172,EXC RCT TUM INCL MUSCULARIS PROPRIA,4852.0,3153.8,1.1,8188.18,144
HCPCS,45172,EXC RECT TUM TRANSANAL FULL,,,2435.91,2888.59,20
HCPCS,45172,Exc rect tum transanal full,,,1836.64,2126.64,8
HCPCS,45190,DESTRUCTION RECTAL TUMOR,,,2435.91,2888.59,20
HCPCS,45190,DESTRUCTION RECTAL TUMOR TRANSANAL APPROACH,4168.0,2709.2,1.1,8188.18,144
HCPCS,45190,Destruction rectal tumor,,,1836.64,2126.64,8
HCPCS,4525F,NEUROPSYCHIA INTERVEN ORDER,,,2739849.3,2739849.3,1
HCPCS,4525F,Neuropsychia interven order,,,10.69,12.38,8
HCPCS,4526F,NEUROPSYCHIA INTERVEN RCVD,,,2739849.3,2739849.3,1
HCPCS,4526F,Neuropsychia interven rcvd,,,10.69,12.38,8
HCPCS,45300,PROCTOSGMDSC RGD DX W/WO COLLJ SPEC BR/WA SPX,2257.0,1467.05,1.1,4628.0,320
HCPCS,45303,PROCTOSGMDSC RIGID W/DILATION,2992.0,1944.8,1.1,6112.0,226
HCPCS,45305,PROCTOSGMDSC RIGID W/BX SINGLE/MULTIPLE,2942.0,1912.3,1.1,6112.0,235
HCPCS,45307,PROCTOSGMDSC RIGID W/RMVL FOREIGN BODY,640.0,416.0,1.1,8188.18,148
HCPCS,45307,PROCTOSIGMOIDOSCOPY FB,,,2435.91,2888.59,20
HCPCS,45307,Proctosigmoidoscopy fb,,,890.23,1030.79,8
HCPCS,45308,PROCTOSGMDSC RIGID RMVL 1 LESION CAUTERY,6567.5,4268.875,1.1,12615.0,227
HCPCS,45309,PROCTOSGMDSC RIGID RMVL 1 LESION SNARE TQ,2992.0,1944.8,1.1,6112.0,235
HCPCS,45315,PROCTOSGMDSC RIGID RMVL MULT TUMOR CAUTERY/SNARE,3052.0,1983.8,1.1,6112.0,235
HCPCS,45317,PROCTOSGMDSC RIGID CONTROL BLEEDING,3092.0,2009.8,1.1,6112.0,227
HCPCS,45320,PROCTOSGMDSC RIGID ABLATION LESION,672.0,436.8,1.1,8188.18,148
HCPCS,45320,PROCTOSIGMOIDOSCOPY ABLATE,,,2435.91,2888.59,20
HCPCS,45321,PROCTOSGMDSC RIGID DCMPRN VOLVULUS,660.0,429.0,1.1,8188.18,144
HCPCS,45321,PROCTOSIGMOIDOSCOPY VOLVUL,,,2435.91,2888.59,20
HCPCS,45327,PROCTOSIGMOIDOSCOPY W/STENT,,,4944.41,6317.89,20
HCPCS,45330,SIGMOIDOSCOPY FLX DX W/COLLJ SPEC BR/WA IF PFRMD,2282.0,1483.3,0.01,4628.0,321
HCPCS,45331,SIGMOIDOSCOPY FLX W/BIOPSY SINGLE/MULTIPLE,2348.0,1526.2,1.1,4628.0,235
HCPCS,45332,SIGMOIDOSCOPY FLX W/RMVL FOREIGN BODY,3099.0,2014.35,1.1,6112.0,235
HCPCS,45333,SIGMOIDOSCOPY FLX W/RMVL TUMOR BY HOT BX FORCEPS,2438.0,1584.7,1.1,4628.0,235
HCPCS,45334,SIGMOIDOSCOPY FLX CONTROL BLEEDING,3152.0,2048.8,1.1,6112.0,235
HCPCS,45335,SGMDSC FLX DIRED SBMCSL NJX ANY SBST,2326.0,1511.8999999999999,1.1,4628.0,235
HCPCS,45337,SGMDSC FLX W/DCMPRN W/PLMT DCMPRN TUBE,2559.0,1663.35,1.1,6112.0,231
HCPCS,45338,SGMDSC FLX RMVL TUM POLYP/OTH LES SNARE TQ,3163.0,2055.95,1.1,6112.0,235
HCPCS,45340,SIGMOIDOSCOPY FLX TNDSC BALO DILAT,2987.0,1941.55,1.1,6112.0,235
HCPCS,45341,SIGMOIDOSCOPY FLX NDSC US XM,2563.5,1666.275,1.1,6112.0,231
HCPCS,45342,SIGMOIDOSCOPY FLX TNDSC US GID NDL ASPIR/BX,3367.5,2188.875,0.01,5424.0,231
HCPCS,45346,SIGMOIDOSCOPY FLX ABLATION TUMOR POLYP/OTH LES,3330.0,2164.5,1.1,7948.0,235
HCPCS,45347,SIGMOIDOSCOPY FLX PLACEMENT OF ENDOSCOPIC STENT,27383.0,17798.95,178.84,27383.0,79
HCPCS,45347,SIGMOIDOSCOPY W/PLACEMENT OF STENT,1197.0,778.05,1.1,16621.23,144
HCPCS,45349,SGMDSC FLX WITH ENDOSCOPIC MUCOSAL RESECTION,7082.0,4603.3,1.1,12615.0,211
HCPCS,45350,SIGMOIDOSCOPY FLX WITH WITH BAND LIGATION(S),3081.5,2002.975,0.01,7948.0,397
HCPCS,45378,COLONOSCOPY FLX DX W/COLLJ SPEC WHEN PFRMD,2814.0,1829.1,1.1,6112.0,409
HCPCS,45379,COLONOSCOPY FLX W/REMOVAL OF FOREIGN BODY(S),3653.5,2374.775,1.1,6112.0,235
HCPCS,45380,COLONOSCOPY W/BIOPSY SINGLE/MULTIPLE,3495.0,2271.75,1.1,6112.0,235
HCPCS,45381,COLSC FLX WITH DIRECTED SUBMUCOSAL NJX ANY SBST,3495.0,2271.75,1.1,6112.0,235
HCPCS,45382,COLSC FLEXIBLE W/CONTROL BLEEDING ANY METHOD,3644.0,2368.6,1.1,6112.0,235
HCPCS,45384,COLSC FLX W/REMOVAL LESION BY HOT BX FORCEPS,3526.0,2291.9,1.1,6112.0,235
HCPCS,45385,COLSC FLX W/RMVL OF TUMOR POLYP LESION SNARE TQ,3717.5,2416.375,1.1,6112.0,235
HCPCS,45386,COLSC FLEXIBLE W/TRANSENDOSCOPIC BALLOON DILAT,3541.5,2301.975,1.1,6112.0,235
HCPCS,45388,COLONOSCOPY FLX ABLATION TUMOR POLYP/OTHER LES,3785.5,2460.575,1.1,8196.83,235
HCPCS,45389,COLONOSCOPY FLX WITH ENDOSCOPIC STENT PLACEMENT,14739.5,9580.675000000001,0.01,27383.0,302
HCPCS,45390,COLONOSCOPY FLX W/ENDOSCOPIC MUCOSAL RESECTION,7515.5,4885.075,1.1,12615.0,223
HCPCS,45391,COLSC FLX W/NDSC US XM RCTM ET AL LMTD&ADJ STRUX,3640.0,2366.0,1.1,6112.0,231
HCPCS,45392,COLSC FLX W/US GUID NDL ASPIR/BX W/US RCTM ET AL,3812.0,2477.8,1.1,6112.0,223
HCPCS,45393,COLONOSCOPY FLEXIBLE WITH DECOMPRESSION,3741.5,2431.975,1.1,7948.0,231
HCPCS,45395,LAP REMOVAL OF RECTUM,,,5085.66,5085.66,1
HCPCS,45395,LAPS PROCTECTOMY ABDOMINOPERINEAL W/COLOSTOMY,13200.0,8580.0,1.1,13200.0,144
HCPCS,45395,Lap removal of rectum,,,1836.64,2126.64,8
HCPCS,45397,LAP REMOVE RECTUM W/POUCH,,,5504.25,5504.25,1
HCPCS,45397,LAPS PROCTECTOMY COMBINED PULL-THRU W/RESERVOIR,14600.0,9490.0,1.1,14600.0,144
HCPCS,45397,Lap remove rectum w/pouch,,,1836.64,2126.64,8
HCPCS,45398,COLONOSCOPY FLEXIBLE WITH BAND LIGATION(S),3552.0,2308.8,0.01,7948.0,322
HCPCS,45399,DILATION OF COLOSTOMY (COMP 57800),1537.0,999.05,0.01,8326.0,169
HCPCS,45399,EDOSCOPIC STRICTUROTOMY (COMP 46700),4218.0,2741.7,0.01,4218.0,84
HCPCS,45399,ENDOSCOPIC DEFECT CLOSURE (COMP CODE 44604),7808.0,5075.2,0.01,7808.0,84
HCPCS,45399,ENDOSCOPIC SUBMUCOSAL DISSECTION OF COLON - (COMP CODE 44204),11229.0,7298.85,0.01,11229.0,84
HCPCS,45399,"ENDOVAC, COLON; COLONOSCOPY (COMP 45378, 97605)",1639.0,1065.35,0.01,2666.13,84
HCPCS,45399,"ENDOVAC, COLON; COLONOSCOPY VIA STOMA (COMP 45388, 97605)",2336.0,1518.4,0.01,2666.13,84
HCPCS,45399,"ENDOVAC, COLON; FLEX-SIG (COMP 45330, 97605)",599.0,389.35,0.01,2666.13,84
HCPCS,45399,ESD COLON,6970.0,4530.5,0.01,8640.0,169
HCPCS,45399,ESD COLON (COMP 45390),5300.0,3445.0,0.01,5300.0,84
HCPCS,45399,EXCISION OF LESION. STOMA WITHOUT SCOPE (COMP 44382),2176.0,1414.4,0.01,8326.0,169
HCPCS,45399,OPEN RESECTION OF CECUM W/O ANASTOMOSIS (COMP 44110),5055.0,3285.75,0.01,5055.0,84
HCPCS,45399,SERIAL TRANVERSE COLOPLASTY (COMP 44604),6538.0,4249.7,0.01,6538.0,84
HCPCS,45399,UNL BIOPSY OF STOMA,2101.0,1365.65,0.01,8326.0,85
HCPCS,45399,UNLISTED PROCEDURE COLON,13185.0,8570.25,0.01,13185.0,84
HCPCS,45400,LAPAROSCOPIC PROC,,,2951.28,7624.0,2
HCPCS,45400,LAPAROSCOPY PROCTOPEXY PROLAPSE,7776.0,5054.4,1.1,7776.0,144
HCPCS,45400,Laparoscopic proc,,,1836.64,2126.64,8
HCPCS,45402,LAP PROCTOPEXY W/SIG RESECT,,,3955.82,3955.82,1
HCPCS,45402,LAPAROSCOPY PROCTOPEXY PROLAPSE SIGMOID RESCJ,10604.0,6892.6,1.1,10604.0,144
HCPCS,45402,Lap proctopexy w/sig resect,,,1836.64,2126.64,8
HCPCS,4540F,DISEASE MODIF PHARMACOTHXPY,,,2739849.3,2739849.3,1
HCPCS,4540F,Disease modif pharmacothxpy,,,10.69,12.38,8
HCPCS,4541F,PT OFFERED TX FOR PSEUDOBULB,,,2739849.3,2739849.3,1
HCPCS,4541F,Pt offered tx for pseudobulb,,,10.69,12.38,8
HCPCS,45499,LAP COMPLETE PROCTECTOMY W/WO COLOANAL ANASTOMOSIS (COMP 45112),14267.0,9273.55,0.01,16829.38,84
HCPCS,45499,LAP EXCISION  RETRORECTAL MASS/TUMOR (COMP 45172),6239.0,4055.35,0.01,16829.38,84
HCPCS,45499,LAP PARTIAL PROCTECTOMY (COMP 45111),7744.0,5033.6,0.01,16829.38,84
HCPCS,45499,LAPAROSCOPE PROC RECTUM,,,5005.78,15063.4,21
HCPCS,45499,LAPAROSCOPIC ABDOMINAL PERINEAL EXCISION OF ILEAL J POUCH (COMP,13099.0,8514.35,0.01,16829.38,84
HCPCS,45499,LX COMP. PROC. IPAA +-ILEOSTOMY (COMP CODE 44211),9768.0,6349.2,0.01,16829.38,84
HCPCS,45499,Laparoscope proc rectum,,,1087.45,1259.15,8
HCPCS,45499,UNLISTED LAP SWENSON PROCEDURE (COMP CODE 45120),11220.0,7293.0,0.01,16829.38,84
HCPCS,45500,PROCTOPLASTY STENOSIS,3092.0,2009.8,1.1,8188.18,144
HCPCS,45500,REPAIR OF RECTUM,,,2435.91,2888.59,20
HCPCS,45500,Repair of rectum,,,1836.64,2126.64,8
HCPCS,45505,PROCTOPLASTY PROLAPSE MUCOUS MEMBRANE,3344.0,2173.6,1.1,8188.18,144
HCPCS,45505,REPAIR OF RECTUM,,,2435.91,2888.59,20
HCPCS,45505,Repair of rectum,,,1836.64,2126.64,8
HCPCS,4550F,NONINVAS RESP SUPPORT TALK,,,2739849.3,2739849.3,1
HCPCS,4550F,Noninvas resp support talk,,,10.69,12.38,8
HCPCS,4551F,NUTRITIONAL SUPPORT OFFERED,,,2739849.3,2739849.3,1
HCPCS,4551F,Nutritional support offered,,,10.69,12.38,8
HCPCS,45520,PERIRECTAL INJ SCLEROSING SOLUTION PROLAPSE,220.0,143.0,1.1,2666.13,148
HCPCS,45520,TREATMENT OF RECTAL PROLAPSE,,,792.91,2386.02,21
HCPCS,45520,Treatment of rectal prolapse,,,1087.45,1259.15,8
HCPCS,4552F,PT REF FOR SPEECH LANG PATH,,,2739849.3,2739849.3,1
HCPCS,4552F,Pt ref for speech lang path,,,10.69,12.38,8
HCPCS,4553F,PT ASST RE END LIFE ISSUES,,,2739849.3,2739849.3,1
HCPCS,4553F,Pt asst re end life issues,,,10.69,12.38,8
HCPCS,45540,CORRECT RECTAL PROLAPSE,,,2738.25,2738.25,1
HCPCS,45540,Correct rectal prolapse,,,1836.64,2126.64,8
HCPCS,45540,PROCTOPEXY ABDOMINAL APPROACH,7248.0,4711.2,1.1,7248.0,144
HCPCS,45541,CORRECT RECTAL PROLAPSE,,,2435.91,7330.16,21
HCPCS,45541,Correct rectal prolapse,,,1836.64,2126.64,8
HCPCS,45541,PROCTOPEXY PERINEAL APPROACH,5940.0,3861.0,1.1,8188.18,144
HCPCS,4554F,PT RECVD INHAL ANESTHETIC,,,0.03,0.03,1
HCPCS,4554F,Pt recvd inhal anesthetic,,,10.69,12.38,8
HCPCS,45550,PROCTOPEXY W/SIGMOID RESCJ ABDL APPR,9920.0,6448.0,1.1,9920.0,144
HCPCS,45550,REPAIR RECTUM/REMOVE SIGMOID,,,3782.98,3782.98,1
HCPCS,45550,Repair rectum/remove sigmoid,,,1836.64,2126.64,8
HCPCS,4555F,PT RECVD NO INHAL ANESTHIC,,,2739849.3,2739849.3,1
HCPCS,4555F,Pt recvd no inhal anesthic,,,10.69,12.38,8
HCPCS,45560,REPAIR OF RECTOCELE,,,2435.91,2888.59,20
HCPCS,45560,REPAIR RECTOCELE SEPARATE PROCEDURE,4600.0,2990.0,1.1,8188.18,144
HCPCS,45560,Repair of rectocele,,,1836.64,2126.64,8
HCPCS,45562,EXPL RPR & PRESACRAL DRG RECTAL INJURY,7192.0,4674.8,1.1,7192.0,144
HCPCS,45562,EXPLORATION/REPAIR OF RECTUM,,,3064.64,3064.64,1
HCPCS,45562,Exploration/repair of rectum,,,1836.64,2126.64,8
HCPCS,45563,EXPL RPR & PRESACRAL DRG RECTAL INJ W/COLOSTOMY,10552.0,6858.8,1.1,10552.0,144
HCPCS,45563,EXPLORATION/REPAIR OF RECTUM,,,4345.5,4345.5,1
HCPCS,45563,Exploration/repair of rectum,,,1836.64,2126.64,8
HCPCS,4556F,PT W/3+ POST-OP NAUSEA&VOM,,,0.03,0.03,1
HCPCS,4556F,Pt w/3+ post-op nausea&vom,,,10.69,12.38,8
HCPCS,4557F,PT W/O 3+ POST-OPNAUSEA&VOM,,,61.65,61.65,1
HCPCS,4557F,Pt w/o 3+ post-opnausea&vom,,,10.69,12.38,8
HCPCS,4558F,PT RECVD 2 RX ANTI-EMET AGT,,,2739849.3,2739849.3,1
HCPCS,4558F,Pt recvd 2 rx anti-emet agt,,,10.69,12.38,8
HCPCS,4559F,1 BODYTEMP >=35.5CW/IN 30MIN,,,2739849.3,2739849.3,1
HCPCS,4559F,1 bodytemp >=35.5cw/in 30min,,,10.69,12.38,8
HCPCS,4560F,ANESTH W/O GEN/NEURAX ANESTH,,,2739849.3,2739849.3,1
HCPCS,4560F,Anesth w/o gen/neurax anesth,,,10.69,12.38,8
HCPCS,4561F,PT W/ CORONARY ARTERY STENT,,,2739849.3,2739849.3,1
HCPCS,4561F,Pt w/ coronary artery stent,,,10.69,12.38,8
HCPCS,4562F,PT W/O CORONARY ARTERY STENT,,,2739849.3,2739849.3,1
HCPCS,4562F,Pt w/o coronary artery stent,,,10.69,12.38,8
HCPCS,4563F,PT RECVD ASPIRIN W/IN 24 HRS,,,2739849.3,2739849.3,1
HCPCS,4563F,Pt recvd aspirin w/in 24 hrs,,,10.69,12.38,8
HCPCS,45800,CLOSURE RECTOVESICAL FISTULA,8124.0,5280.6,1.1,8124.0,144
HCPCS,45800,REPAIR RECT/BLADDER FISTULA,,,3337.46,3337.46,1
HCPCS,45800,Repair rect/bladder fistula,,,1836.64,2126.64,8
HCPCS,45805,CLSR RECTOVESICAL FISTULA W/COLOSTOMY,9328.0,6063.2,1.1,9328.0,144
HCPCS,45805,REPAIR FISTULA W/COLOSTOMY,,,3849.12,3849.12,1
HCPCS,45805,Repair fistula w/colostomy,,,1836.64,2126.64,8
HCPCS,45820,CLOSURE RECTOURETHRAL FISTULA,8148.0,5296.2,1.1,8148.0,144
HCPCS,45820,REPAIR RECTOURETHRAL FISTULA,,,3346.33,3346.33,1
HCPCS,45820,Repair rectourethral fistula,,,1836.64,2126.64,8
HCPCS,45825,CLOSURE RECTOURETHRAL FISTULA W/COLOSTOMY,9668.0,6284.2,1.1,9668.0,144
HCPCS,45825,REPAIR FISTULA W/COLOSTOMY,,,4028.21,4028.21,1
HCPCS,45825,Repair fistula w/colostomy,,,1836.64,2126.64,8
HCPCS,45900,RDCTJ PROCIDENTIA UNDER ANES SEPARATE PROCEDURE,1196.0,777.4,1.1,2666.13,144
HCPCS,45900,REDUCTION OF RECTAL PROLAPSE,,,792.91,967.79,20
HCPCS,45900,Reduction of rectal prolapse,,,1087.45,1259.15,8
HCPCS,45905,DILAT ANAL SPHNCTR SPX UNDER ANES OTH/THN LOCAL,3182.0,2068.3,1.1,6112.0,231
HCPCS,45910,DILAT RCT STRIX SPX UNDER ANES OTH/THN LOCAL,1140.0,741.0,1.1,3440.56,144
HCPCS,45910,DILATION OF RECTAL NARROWING,,,1023.77,5457.0,21
HCPCS,45910,Dilation of rectal narrowing,,,1087.45,1259.15,8
HCPCS,45915,RMVL FECAL IMPACTION/FB SPX UNDER ANES,3350.0,2177.5,0.01,6112.0,322
HCPCS,45990,ANRCT XM SURG REQ ANES GENERAL SPI/EDRL DX,720.0,468.0,1.1,8188.18,144
HCPCS,45990,SURG DX EXAM ANORECTAL,,,2435.91,5457.0,24
HCPCS,45990,Surg dx exam anorectal,,,1087.45,1259.15,8
HCPCS,45999,"ENDOVAC, RECTUM; COLONOSCOPY (COMP 45378, 97605)",1639.0,1065.35,0.01,2666.13,84
HCPCS,45999,"ENDOVAC, RECTUM; COLONOSCOPY VIA STOMA (COMP 44388, 97605)",1217.0,791.05,0.01,2666.13,84
HCPCS,45999,"ENDOVAC, RECTUM; FLEX-SIG (COMP 45330, 97605)",599.0,389.35,0.01,2666.13,84
HCPCS,45999,ESD RECTUM,6970.0,4530.5,0.01,8640.0,168
HCPCS,45999,ESD RECTUM (COMP 45390),5300.0,3445.0,0.01,5300.0,84
HCPCS,45999,IMPLANT OF SPACEOAR,4599.0,2989.35,0.01,4599.0,85
HCPCS,45999,"OPEN REPAIR OF RECTAL FISTULA WO ANASTOMOSIS, TRANS-PERINEAL APP",6484.0,4214.6,0.01,6484.0,84
HCPCS,45999,RECTUM SURGERY PROCEDURE UNLISTED,5300.0,3445.0,0.01,5300.0,84
HCPCS,45999,REV ILEOANAL RES W/W/O ST (COMP 45113),14000.0,9100.0,0.01,14000.0,84
HCPCS,45999,REVISION/REDO POUCH AP APPROACH W/W/O STOMA (COMP 46712),13123.0,8529.95,0.01,13123.0,84
HCPCS,45999,SECOND STAGE PULL-THROUGH(TURNBULL)PROCEDURE (COMP 45505),911.0,592.15,0.01,2666.13,84
HCPCS,45999,TRANSANAL RPR COLOANAL ANASTOMOSIS (COMP 45505),2397.0,1558.05,0.01,2666.13,84
HCPCS,45999,UNLISTED PROCEDURE RECTUM,4599.0,2989.35,792.91,4599.0,84
HCPCS,46020,PLACEMENT OF SETON,818.0,531.7,1.1,8188.18,144
HCPCS,46020,PLACEMENT SETON,12615.0,8199.75,138.22,12615.0,87
HCPCS,46030,REMOVAL ANAL SETON OTHER MARKER,3008.0,1955.2,1.1,6112.0,235
HCPCS,46040,I&D ISCHIORECTAL&/PERIRECTAL ABSCESS SPX,3786.0,2460.9,0.01,7813.0,496
HCPCS,46045,I&D ABSC TRANAL UNDER ANES,,,2435.91,6238.0,22
HCPCS,46045,I&D INTRAMURAL IM/ABSC TRANSANAL ANES,2348.0,1526.2,1.1,8188.18,144
HCPCS,46045,I&d absc tranal under anes,,,1836.64,2126.64,8
HCPCS,46050,I&D PERIANAL ABSCESS SUPERFICIAL,4194.0,2726.1,0.01,4628.0,261
HCPCS,46050,"I/D PERIANAL ABSCESS, SUPERFICIAL",546.0,354.9,1.1,2666.13,148
HCPCS,46060,I&D ISCHIORCT/INTRAMURAL ABSC W/WO SETON,7581.5,4927.975,1.1,12615.0,318
HCPCS,46070,INCISION ANAL SEPTUM INFANT,,,2435.91,2888.59,20
HCPCS,46070,Incision anal septum infant,,,1087.45,1259.15,8
HCPCS,46080,SPHINCTEROTOMY ANAL DIVISION SPHINCTER SPX,1008.0,655.2,1.1,8188.18,148
HCPCS,46080,SPHNCTROTMY ANAL DIV SPHNCTR,,,2435.91,7813.0,23
HCPCS,46080,Sphnctrotmy anal div sphnctr,,,1087.45,1259.15,8
HCPCS,46083,INCISION THROMBOSED HEMORRHOID EXTERNAL,849.5,552.175,0.01,3443.0,321
HCPCS,46200,FISSURECTOMY INCL SPHINCTEROTOMY WHEN PERFORMED,1436.0,933.4,1.1,8188.18,148
HCPCS,46200,REMOVAL OF ANAL FISSURE,,,2435.91,6238.0,24
HCPCS,46200,Removal of anal fissure,,,1087.45,1259.15,8
HCPCS,46220,EXCISION SINGLE EXTERNAL PAPILLA OR TAG ANUS,3034.0,1972.1,0.01,6112.0,322
HCPCS,46221,HEMORRHOIDECTOMY INTERNAL RUBBER BAND LIGATIONS,2569.0,1669.85,1.1,4628.0,322
HCPCS,46230,EXCISION MULTIPLE EXTERNAL PAPILLAE/TAGS ANUS,6831.5,4440.475,1.1,12615.0,235
HCPCS,46250,HEMORRHOIDECTOMY XTRNL 2/> COLUMN/GROUP,7157.5,4652.375,0.01,12615.0,322
HCPCS,46255,HEMORRHOIDECTOMY (COMP CODE 46255),627.0,407.55,1.1,8188.18,148
HCPCS,46255,HEMORRHOIDECTOMY NTRNL & XTRNL 1 COLUMN/GROUP,7299.5,4744.675,1.1,12615.0,235
HCPCS,46257,HEMORRHOID NTRNL & XTRNL 1 COLUMN W/FISSURECTO,2304.0,1497.6,1.1,8188.18,144
HCPCS,46257,REMOVE IN/EX HEM GRP & FISS,,,2435.91,2888.59,20
HCPCS,46257,Remove in/ex hem grp & fiss,,,1836.64,2126.64,8
HCPCS,46258,HRHC 1 COL/GRP W/FSTULECTMY INCL FSSRECTOMY,2564.0,1666.6,1.1,8188.18,144
HCPCS,46258,REMOVE IN/EX HEM GRP W/FISTU,,,2435.91,2888.59,20
HCPCS,46258,Remove in/ex hem grp w/fistu,,,1836.64,2126.64,8
HCPCS,46260,HEMORRHOIDECTOMY INT & XTRNL 2/> COLUMN/GRO,2692.0,1749.8,1.1,8188.18,144
HCPCS,46260,REMOVE IN/EX HEM GROUPS 2+,,,2435.91,7813.0,24
HCPCS,46260,Remove in/ex hem groups 2+,,,1836.64,2126.64,8
HCPCS,46261,HRHC NTRNL & XTRNL 2/> COLUMN/GROUP W/FISSU,3104.0,2017.6,1.1,8188.18,144
HCPCS,46261,REMOVE IN/EX HEM GRPS & FISS,,,2435.91,2888.59,20
HCPCS,46261,Remove in/ex hem grps & fiss,,,1836.64,2126.64,8
HCPCS,46262,HRHC 2/> COL/GRP W/FSTULECTMY INCL FSSRECTMY,3164.0,2056.6,1.1,8188.18,144
HCPCS,46262,REMOVE IN/EX HEM GRPS W/FIST,,,2435.91,2888.59,20
HCPCS,46262,Remove in/ex hem grps w/fist,,,1836.64,2126.64,8
HCPCS,46270,SURG TX ANAL FISTULA SUBQ,7291.5,4739.475,0.01,12615.0,235
HCPCS,46275,SURG TX ANAL FISTULA INTERSPHINCTERIC,7391.5,4804.475,1.1,12615.0,235
HCPCS,46280,REMOVE ANAL FIST COMPLEX,,,2435.91,10789.0,23
HCPCS,46280,Remove anal fist complex,,,1836.64,2126.64,8
HCPCS,46280,TX ANAL FSTL TRANS/SUPRA/XTRASPHNCTRC INCL SETON,2556.0,1661.4,1.1,8188.18,144
HCPCS,46285,REMOVE ANAL FIST 2 STAGE,,,2435.91,6238.0,23
HCPCS,46285,Remove anal fist 2 stage,,,1087.45,1259.15,8
HCPCS,46285,SURG TX ANAL FISTULA 2ND STAGE,2168.0,1409.2,1.1,8188.18,148
HCPCS,46288,CLSR ANAL FSTL W/RCT ADVMNT FLAP,3124.0,2030.6,1.1,8188.18,144
HCPCS,46288,REPAIR ANAL FISTULA,,,2435.91,7948.0,23
HCPCS,46288,Repair anal fistula,,,1836.64,2126.64,8
HCPCS,46320,EXC THROMBOSED HEMORRHOID XTRNL,3040.0,1976.0,0.01,6112.0,409
HCPCS,46500,INJECTION SCLEROSING SOLUTION HEMORRHOIDS,2445.0,1589.25,0.01,4194.0,235
HCPCS,46505,CHEMODENERVATION INTERNAL ANAL SPHINCTER,3348.0,2176.2,1.1,6112.0,234
HCPCS,46600,ANOSCOPY DX W/COLLJ SPEC BR/WA SPX WHEN PRFRMD,417.5,271.375,0.01,12500.0,407
HCPCS,46601,ANOSCOPY DX W/HRA &CHEM AGNTS ENHANCEMENT,1238.0,804.7,1.1,4628.0,222
HCPCS,46604,ANOSCOPY W/DILATION,2918.0,1896.7,1.1,6112.0,234
HCPCS,46606,ANOSCOPY W/BX SINGLE/MULTIPLE,2976.0,1934.3999999999999,1.1,6112.0,234
HCPCS,46607,ANOSCOPY DX W/HRA &CHEM AGNTS ENHANCEMENT W/BX,3196.0,2077.4,1.1,7948.0,308
HCPCS,46608,ANOSCOPY W/RMVL FOREIGN BODY,4194.0,2726.1,100.5,4392.0,87
HCPCS,46608,"ANOSCOPY,REMOVE FOREIGN BODY",520.0,338.0,1.1,2666.13,148
HCPCS,46610,ANOSCOPY W/RMVL LESION CAUTERY,6563.5,4266.275,1.1,12615.0,306
HCPCS,46611,ANOSC RMVL 1 TUM POLYP/OTH LES SNARE TQ,2357.0,1532.05,1.1,6112.0,322
HCPCS,46612,ANOSC RMVL MULT TUMORS CAUTERY/SNARE,600.0,390.0,1.1,8188.18,148
HCPCS,46612,ANOSCOPY REMOVE LESIONS,,,2435.91,2888.59,20
HCPCS,46614,ANOSCOPY CONTROL BLEEDING,5424.0,3525.6,76.94,7813.0,87
HCPCS,46614,"ANOSCOPY,CONTROL BLEEDING",400.0,260.0,1.1,3440.56,148
HCPCS,46615,ANOSCOPY ABLATION LESION,12615.0,8199.75,106.89,12615.0,79
HCPCS,46615,"ANOSCOPY,ABLATE LESION",600.0,390.0,1.1,8188.18,148
HCPCS,46700,ANOPLASTY PLASTIC OPERATION STRICTURE ADULT,3924.0,2550.6,1.1,8188.18,144
HCPCS,46700,REPAIR OF ANAL STRICTURE,,,2435.91,2888.59,20
HCPCS,46700,Repair of anal stricture,,,1836.64,2126.64,8
HCPCS,46705,ANOPLASTY PLASTIC OPERATION STRICTURE INFANT,2972.0,1931.8,1.1,2972.0,144
HCPCS,46705,Repair of anal stricture,,,1836.64,2126.64,8
HCPCS,46706,REPAIR ANAL FISTULA W/FIBRIN GLUE,976.0,634.4,1.1,8188.18,144
HCPCS,46706,REPR OF ANAL FISTULA W/GLUE,,,2435.91,2888.59,20
HCPCS,46706,Repr of anal fistula w/glue,,,1087.45,1259.15,8
HCPCS,46707,REPAIR ANORECTAL FIST W/PLUG,,,2435.91,7330.16,21
HCPCS,46707,RPR ANORECTAL FISTULA W/ PLUG,2556.0,1661.4,1.1,8188.18,144
HCPCS,46707,Repair anorectal fist w/plug,,,1087.45,1259.15,8
HCPCS,46710,REPR PER/VAG POUCH SNGL PROC,,,2913.31,2913.31,1
HCPCS,46710,RPR ILEOANAL POUCH FSTL/POUCH ADVMNT TPRNL APPR,6856.0,4456.4,1.1,6856.0,144
HCPCS,46710,Repr per/vag pouch sngl proc,,,1836.64,2126.64,8
HCPCS,46712,REPR PER/VAG POUCH DBL PROC,,,5814.66,5814.66,1
HCPCS,46712,RPR ILEOANAL POUCH FSTL/POUCH ADVMNT CMBN APPR,14580.0,9477.0,1.1,14580.0,144
HCPCS,46712,Repr per/vag pouch dbl proc,,,1836.64,2126.64,8
HCPCS,46715,REP PERF ANOPER FISTU,,,1453.79,1453.79,1
HCPCS,46715,RPR LW IMPERFORATE ANUS W/ANOPRNL FSTL CUT-BK,3048.0,1981.2,1.1,3048.0,144
HCPCS,46715,Rep perf anoper fistu,,,1836.64,2126.64,8
HCPCS,46716,REP PERF ANOPER/VESTIB FISTU,,,3234.73,3234.73,1
HCPCS,46716,RPR LW IMPERFORATE ANUS W/TRPOS FISTULA,7016.0,4560.4,1.1,7016.0,144
HCPCS,46716,Rep perf anoper/vestib fistu,,,1836.64,2126.64,8
HCPCS,46730,CONSTRUCTION OF ABSENT ANUS,,,5217.18,5217.18,1
HCPCS,46730,Construction of absent anus,,,1836.64,2126.64,8
HCPCS,46730,RPR HI IMPRF ANUS W/O FSTL PRNL/SACROPRNL APPR,12260.0,7969.0,1.1,12260.0,144
HCPCS,46735,CONSTRUCTION OF ABSENT ANUS,,,6007.48,6007.48,1
HCPCS,46735,Construction of absent anus,,,1836.64,2126.64,8
HCPCS,46735,RPR HI IMPRF ANUS W/O FISTULA CMBN APPR,14456.0,9396.4,1.1,14456.0,144
HCPCS,46740,CONSTRUCTION OF ABSENT ANUS,,,5694.6,5694.6,1
HCPCS,46740,Construction of absent anus,,,1836.64,2126.64,8
HCPCS,46740,RPR HI IMPRF ANUS W/FSTL PRNL/SACROPRNL APPR,13560.0,8814.0,1.1,13560.0,144
HCPCS,46742,REPAIR OF IMPERFORATED ANUS,,,6582.88,6582.88,1
HCPCS,46742,RPR HI IMPRF ANUS W/FSTL TABDL & SACROPRNL,16056.0,10436.4,1.1,16056.0,144
HCPCS,46742,Repair of imperforated anus,,,1836.64,2126.64,8
HCPCS,46744,REPAIR OF CLOACAL ANOMALY,,,9289.5,9289.5,1
HCPCS,46744,RPR CLOACAL ANOMALY SACROPERINEAL,23576.0,15324.4,1.1,23576.0,144
HCPCS,46744,Repair of cloacal anomaly,,,1836.64,2126.64,8
HCPCS,46746,REPAIR OF CLOACAL ANOMALY,,,10234.23,10234.23,1
HCPCS,46746,RPR CLOACAL ANOMALY CMBN ABDL&SACROPRNL,26176.0,17014.4,1.1,26176.0,144
HCPCS,46746,Repair of cloacal anomaly,,,1836.64,2126.64,8
HCPCS,46748,REPAIR OF CLOACAL ANOMALY,,,11092.48,11092.48,1
HCPCS,46748,Repair of cloacal anomaly,,,1836.64,2126.64,8
HCPCS,46750,REPAIR OF ANAL SPHINCTER,,,2435.91,2888.59,20
HCPCS,46750,Repair of anal sphincter,,,1836.64,2126.64,8
HCPCS,46750,SPHNCTROP ANAL INCONTINENCE/PROLAPSE ADULT,4860.0,3159.0,1.1,8188.18,144
HCPCS,46751,Repair of anal sphincter,,,1836.64,2126.64,8
HCPCS,46751,SPHNCTROP ANAL INCONTINENCE/PROLAPSE CHLD,3720.0,2418.0,1.1,3720.0,144
HCPCS,46753,GRAFT THIERSCH RCT INCONTINENCE &/PROLAPSE,3556.0,2311.4,1.1,8188.18,144
HCPCS,46753,RECONSTRUCTION OF ANUS,,,2435.91,2888.59,20
HCPCS,46753,Reconstruction of anus,,,1836.64,2126.64,8
HCPCS,46754,REMOVAL OF SUTURE FROM ANUS,,,2435.91,2888.59,20
HCPCS,46754,RMVL THIERSCH WIRE/SUTURE ANAL CANAL,1204.0,782.6,1.1,8188.18,148
HCPCS,46754,Removal of suture from anus,,,1087.45,1259.15,8
HCPCS,46760,REPAIR OF ANAL SPHINCTER,,,2435.91,2888.59,20
HCPCS,46760,Repair of anal sphincter,,,1836.64,2126.64,8
HCPCS,46760,SPHINCTEROPLASTY ANAL MUSCLE TRANSPLANT,6980.0,4537.0,1.1,8188.18,144
HCPCS,46761,REPAIR OF ANAL SPHINCTER,,,2435.91,2888.59,20
HCPCS,46761,Repair of anal sphincter,,,1836.64,2126.64,8
HCPCS,46761,SPHNCTROP ANAL LEVATOR MUSC IMBRCJ,6116.0,3975.4,1.1,8188.18,144
HCPCS,46900,DSTRJ LESION ANUS SIMPLE CHEMICAL,1301.0,845.6500000000001,0.01,3443.0,235
HCPCS,46910,DSTRJ LESION ANUS SMPL ELTRDSICCATION,4589.0,2982.8500000000004,1.1,8414.0,234
HCPCS,46916,DSTRJ LESION ANUS SIMPLE CRYOSURGERY,839.0,545.35,0.01,12500.0,235
HCPCS,46917,DSTRJ LESION ANUS SIMPLE LASER SURG,6689.5,4348.175,1.1,12615.0,235
HCPCS,46922,DSTRJ LESION ANUS SIMPLE SURG EXCISION,6689.5,4348.175,0.01,12615.0,322
HCPCS,46924,DSTRJ LESION ANUS EXTENSIVE,6869.5,4465.175,0.01,12615.0,235
HCPCS,46930,DESTRUCTION INTERNAL HEMORRHOID THERMAL ENERGY,3034.0,1972.1,1.1,8326.0,235
HCPCS,46940,CURTG/CAUT ANAL FISSURE W/DILAT SPHNCTR SPX 1ST,940.0,611.0,1.1,8188.18,148
HCPCS,46940,TREATMENT OF ANAL FISSURE,,,2435.91,7330.16,21
HCPCS,46940,Treatment of anal fissure,,,1087.45,1259.15,8
HCPCS,46942,CURTG/CAUT ANAL FISSURE W/DILAT SPHNCTR SPX SBSQ,828.0,538.2,1.1,2666.13,148
HCPCS,46942,TREATMENT OF ANAL FISSURE,,,792.91,2386.02,21
HCPCS,46942,Treatment of anal fissure,,,1087.45,1259.15,8
HCPCS,46945,INT HRHC BY LIGATION SINGLE HROID W/O IMG GDN,7045.5,4579.575,1.1,12615.0,230
HCPCS,46946,INT HRHC BY LIGATION 2+ HROID W/O IMG GDN,7207.5,4684.875,1.1,12615.0,231
HCPCS,46947,HEMORRHOIDOPEXY BY STAPLING,2228.0,1448.2,1.1,8188.18,164
HCPCS,46947,Hemorrhoidopexy by stapling,,,1836.64,2126.64,8
HCPCS,46948,INT HRHC TRANAL DARTLZJ 2+,,,2435.91,11545.0,24
HCPCS,46948,INT HRHC TRANSANAL HROID DARTLZJ 2+ W/US GDN,2228.0,1448.2,1.1,8188.18,144
HCPCS,46948,Int hrhc tranal dartlzj 2+,,,1836.64,2126.64,8
HCPCS,46999,ANAL BIOPSY,2370.0,1540.5,0.01,3443.0,85
HCPCS,46999,ANAL BIOPSY (COMP 45100),363.0,235.95,0.01,2666.13,84
HCPCS,46999,"ANOSCOPY W/SUBMUCOSAL INJECTION, ANY SUBSTANCE (COMP 45381)",1566.0,1017.9,0.01,2666.13,84
HCPCS,46999,ANUSECTOMY,2599.0,1689.35,0.01,2666.13,84
HCPCS,46999,EXPLANATION OF ARTIFICIAL BOWEL SPHINCTER (COMP 53446),3968.0,2579.2,0.01,3968.0,84
HCPCS,46999,"HEMMORRHOIDECTOMY, EXTERNAL SINGLE (COMP 46320)",4858.0,3157.7,0.01,4858.0,85
HCPCS,46999,"HEMORRHOIDECTOMY, EXTERNAL, SINGLE COLUMN (COMP 46255)",1786.0,1160.9,0.01,2666.13,84
HCPCS,46999,"HEMORROIDECTOMY, EXTERNAL, SINGLE (COMP CODE 46220)",1402.0,911.3,0.01,2666.13,84
HCPCS,46999,"INJECTION ANAL MUCOSA, SOLESTA",1049.0,681.85,0.01,2666.13,84
HCPCS,46999,LAP ASSISTED CLOACA REPAIR (COMP 46748),27852.0,18103.8,0.01,27852.0,84
HCPCS,46999,MUCOSCETOMY,2683.0,1743.95,0.01,2683.0,84
HCPCS,46999,POST OP CONTROL OF BLEEDING,781.0,507.65,0.01,2666.13,84
HCPCS,46999,POST OP CONTROL OF BLEEDING ANUS (COMP 46945),746.0,484.9,0.01,2666.13,84
HCPCS,46999,POST OP CONTROL OF BLEEDING-ANUS (COMP CODE 46614),361.0,234.65,0.01,2666.13,84
HCPCS,46999,PROC RM - INJ ANAL SOLESTA,1023.0,664.95,284.39,4628.0,84
HCPCS,46999,REPAIR OF ENTEROANAL FIST,5634.0,3662.1,0.01,5634.0,84
HCPCS,46999,"REPAIR, CLOSURE OF ANAL FISTULA-OTHER THAN GLUE (COMP 46706)",1049.0,681.85,0.01,2666.13,84
HCPCS,46999,SUBMUCOSAL ANAL INJECTION FOR INFLAMMATION/PAIN (COMP CODE 46505,1367.0,888.55,0.01,2666.13,84
HCPCS,46999,"UNLIST PROC, ANUS COMPARED TO 45100",1333.0,866.45,0.01,2666.13,84
HCPCS,46999,"UNLIST PROC, ANUS COMPARED TO 46947",1838.0,1194.7,0.01,2666.13,84
HCPCS,46999,"UNLISTED PROC; TRANSANAL HEMORRHOIDAL DEARTERIALIZATION, SINGLE",1838.0,1194.7,0.01,2666.13,84
HCPCS,47000,BIOPSY LIVER NEEDLE PERCUTANEOUS,4056.5,2636.725,0.01,7453.0,322
HCPCS,47001,BX LVR NDL DONE PURPOSE TM OTH MAJOR PX,836.0,543.4,1.1,836.0,144
HCPCS,47001,NDL BIOPSY LVR TM OTH MAJ PX,,,4132.0,4132.0,1
HCPCS,47001,Ndl biopsy lvr tm oth maj px,,,461.87,534.8,8
HCPCS,47010,HEPATOT OPN DRG ABSC/CST 1/2,,,3184.76,3184.76,1
HCPCS,47010,HEPATOTOMY OPEN DRAINAGE ABSCESS/CYST 1/2 STAGES,7760.0,5044.0,1.1,7760.0,144
HCPCS,47010,Hepatot opn drg absc/cst 1/2,,,3471.98,4020.19,8
HCPCS,47015,LAPT ASPIR&/NJX HEP PRST CST,,,3059.48,3059.48,1
HCPCS,47015,LAPT W/ASPIR &/NJX HEPATC PARASITIC CYST/ABSCESS,7400.0,4810.0,1.1,7400.0,144
HCPCS,47015,Lapt aspir&/njx hep prst cst,,,3471.98,4020.19,8
HCPCS,47100,WEDGE BIOPSY OF LIVER,5164.0,3356.6,1.1,5164.0,144
HCPCS,47100,Wedge biopsy of liver,,,3471.98,4020.19,8
HCPCS,47120,HEPATECTOMY RESCJ PARTIAL LOBECTOMY,15604.0,10142.6,1.1,15604.0,144
HCPCS,47120,PARTIAL REMOVAL OF LIVER,,,6131.38,6131.38,1
HCPCS,47120,Partial removal of liver,,,3471.98,4020.19,8
HCPCS,47122,EXTENSIVE REMOVAL OF LIVER,,,8973.34,8973.34,1
HCPCS,47122,Extensive removal of liver,,,3471.98,4020.19,8
HCPCS,47122,HEPATECTOMY RESCJ TRISEGMENTECTOMY,23792.0,15464.8,1.1,23792.0,144
HCPCS,47125,HEPATECTOMY RESCJ TOTAL LEFT LOBECTOMY,21216.0,13790.4,1.1,21216.0,144
HCPCS,47125,PARTIAL REMOVAL OF LIVER,,,8081.14,8081.14,1
HCPCS,47125,Partial removal of liver,,,3471.98,4020.19,8
HCPCS,47130,HEPATECTOMY RESCJ TOTAL RIGHT LOBECTOMY,22876.0,14869.4,1.1,22876.0,144
HCPCS,47130,PARTIAL REMOVAL OF LIVER,,,8673.69,8673.69,1
HCPCS,47130,Partial removal of liver,,,3471.98,4020.19,8
HCPCS,47133,DONOR HEPATECTOMY CADAVER DONOR,15830.0,10289.5,1.1,15830.0,82
HCPCS,47133,REMOVAL OF DONOR LIVER,,,5310.12,5310.12,1
HCPCS,47133,Removal of donor liver,,,1229.51,1423.64,8
HCPCS,47135,LVR ALTRNSPLJ ORTHOTOPIC PRTL/WHL DON ANY AGE,39600.0,25740.0,1.1,39600.0,144
HCPCS,47135,TRANSPLANTATION OF LIVER,,,14170.9,14170.9,1
HCPCS,47135,Transplantation of liver,,,1229.51,1423.64,8
HCPCS,47140,DONOR HEPATECTOMY LIVING DONOR SEG II & III,23760.0,15444.0,1.1,23760.0,142
HCPCS,47140,PARTIAL REMOVAL DONOR LIVER,,,9390.12,9390.12,1
HCPCS,47140,Partial removal donor liver,,,1229.51,1423.64,8
HCPCS,47141,DONOR HEPATECTOMY LIVING DONOR SEG II III & IV,28600.0,18590.0,1.1,28600.0,142
HCPCS,47141,PARTIAL REMOVAL DONOR LIVER,,,11221.64,11221.64,1
HCPCS,47141,Partial removal donor liver,,,1229.51,1423.64,8
HCPCS,47142,DONOR HEPATECTOMY LIVING DONOR SEG V VI VII &VI,31776.0,20654.4,1.1,31776.0,142
HCPCS,47142,PARTIAL REMOVAL DONOR LIVER,,,12359.07,12359.07,1
HCPCS,47142,Partial removal donor liver,,,1229.51,1423.64,8
HCPCS,47143,BKBENCH PREP CADAVER DONOR,2673.0,1737.45,1.1,2673.0,104
HCPCS,47143,PREP DONOR LIVER WHOLE,,,957.38,957.38,1
HCPCS,47143,Prep donor liver whole,,,1229.51,1423.64,8
HCPCS,47144,BKBENCH PREPJ CADAVER WHOLE LIVER GRF I&IV VII,2875.0,1868.75,1.1,2875.0,104
HCPCS,47144,PREP DONOR LIVER 3-SEGMENT,,,957.38,957.38,1
HCPCS,47144,Prep donor liver 3-segment,,,1229.51,1423.64,8
HCPCS,47145,BKBENCH PREPJ CADAVER DONOR WHL LVR GRF I&V VI,3046.0,1979.9,1.1,3046.0,104
HCPCS,47145,PREP DONOR LIVER LOBE SPLIT,,,957.38,957.38,1
HCPCS,47145,Prep donor liver lobe split,,,1229.51,1423.64,8
HCPCS,47146,BKBENCH RCNSTJ LVR GRF VENOUS ANAST EA,2400.0,1560.0,1.1,2400.0,142
HCPCS,47146,PREP DONOR LIVER/VENOUS,,,858.2,858.2,1
HCPCS,47146,Prep donor liver/venous,,,1229.51,1423.64,8
HCPCS,47147,BKBENCH RCNSTJ LVR GRF ARTL ANAST EA,2800.0,1820.0,1.1,2800.0,142
HCPCS,47147,PREP DONOR LIVER/ARTERIAL,,,1002.02,1002.02,1
HCPCS,47147,Prep donor liver/arterial,,,1229.51,1423.64,8
HCPCS,47300,MARSUPIALIZE LIVER CYST/ABSCESS,7256.0,4716.4,1.1,7256.0,144
HCPCS,47300,SURGERY FOR LIVER LESION,,,2985.86,2985.86,1
HCPCS,47300,Surgery for liver lesion,,,3471.98,4020.19,8
HCPCS,47350,MGMT LVR HEMRRG SMPL SUTR LVR WND/INJ,8996.0,5847.4,1.1,8996.0,144
HCPCS,47350,REPAIR LIVER WOUND,,,3577.7,3577.7,1
HCPCS,47350,Repair liver wound,,,1363.63,1578.94,8
HCPCS,47360,MGMT LVR HEMRRG CPLX SUTR WND/INJ,12524.0,8140.6,1.1,12524.0,144
HCPCS,47360,REPAIR LIVER WOUND,,,4923.51,4923.51,1
HCPCS,47360,Repair liver wound,,,1363.63,1578.94,8
HCPCS,47361,MGMT LVR HEMRRG EXPL WND DBRDMT COAGJ/SUTR,21040.0,13676.0,1.1,21040.0,144
HCPCS,47361,REPAIR LIVER WOUND,,,7891.17,7891.17,1
HCPCS,47361,Repair liver wound,,,3471.98,4020.19,8
HCPCS,47362,MGMT LVR HEMRRG RE-EXPL WND RMVL PACKING,9416.0,6120.4,1.1,9416.0,144
HCPCS,47362,REPAIR LIVER WOUND,,,3809.01,3809.01,1
HCPCS,47362,Repair liver wound,,,1363.63,1578.94,8
HCPCS,47370,LAPARO ABLATE LIVER TUMOR RF,,,8930.36,26873.26,21
HCPCS,47370,LAPS SURG ABLTJ 1/> LVR TUM RF,8320.0,5408.0,1.1,30022.29,144
HCPCS,47370,Laparo ablate liver tumor rf,,,3471.98,4020.19,8
HCPCS,47371,LAPARO ABLATE LIVER CRYOSURG,,,8930.36,26873.26,21
HCPCS,47371,LAPS SURG ABLTJ 1 > LVR TUM CRYOSURG,8320.0,5408.0,1.1,30022.29,144
HCPCS,47371,Laparo ablate liver cryosurg,,,3471.98,4020.19,8
HCPCS,47379,"LAP DONOR HEPATECTOMY - RIGHT LIVING DONOR SEG V, VI, VII & VIII",52502.0,34126.3,0.01,52502.0,84
HCPCS,47379,LAP EXCISION LIVER CYST (COMP 47010),6057.0,3937.05,0.01,16829.38,84
HCPCS,47379,LAP LT LOBECTOMY LIVER (COMP 47125),22197.0,14428.05,0.01,22197.0,84
HCPCS,47379,LAP MARSUPIALIZATION HEPATIC CYST (COMP CODE 47300),5333.0,3466.45,0.01,16829.38,84
HCPCS,47379,LAP RT LOBECTOMY LIVER,22197.0,14428.05,0.01,22197.0,84
HCPCS,47379,LAP UNROOFING OF LIVER CYST(S),1159.0,753.35,0.01,16829.38,84
HCPCS,47379,LAP. DONOR HEPATECTOMY -LEFT LIVING DONOR SEG II III & IV (COMP,47190.0,30673.5,0.01,47190.0,84
HCPCS,47379,"LAPAROSCOPE PROCEDURE, LI",9979.0,6486.35,0.01,16829.38,84
HCPCS,47379,LAPAROSCOPIC EXC. OF CYSTIC LIVER LESION,6244.0,4058.6,0.01,16829.38,84
HCPCS,47379,LAPAROSCOPIC LIVER BIOPSY (COMP 47001),2765.0,1797.25,0.01,16829.38,84
HCPCS,47379,LAPAROSCOPIC PARTIAL HEPATIC LOBECTOMY W/ PARTIAL HEPATIC LOBECT,12873.0,8367.45,0.01,16829.38,84
HCPCS,47379,LAPAROSCOPIC POSTOPERATIVE LIVER HEMORRHAGE(COMP CODE 47361),22618.0,14701.7,0.01,22618.0,84
HCPCS,47379,LAPRO DONOR HEPATECTOMY LIVING DONOR LT SEG II & III (47140),25542.0,16602.3,0.01,25542.0,84
HCPCS,47379,SURGERY PERFORMED LAPAROSCOPY TOTAL RIGHT HEPATIC LOBECTOMY (COM,20760.0,13494.0,0.01,20760.0,84
HCPCS,47379,"UNLISTED LAPAROSCOPIC PROCEDURE, LIVER (COMPARISON CODE 47000)",310.0,201.5,0.01,16829.38,84
HCPCS,47379,"UNLISTED LAPAROSCOPIC PROCEDURE, LIVER (COMPARISON CODE 47001)",312.0,202.8,0.01,16829.38,84
HCPCS,47379,"UNLISTED LAPAROSCOPIC PROCEDURE, LIVER (COMPARISON CODE 47010)",6402.0,4161.3,0.01,16829.38,84
HCPCS,47379,"UNLISTED LAPAROSCOPIC PROCEDURE, LIVER (COMPARISON CODE 47100)",4260.0,2769.0,0.01,16829.38,84
HCPCS,47379,"UNLISTED LAPAROSCOPIC PROCEDURE, LIVER (COMPARISON CODE 47120)",5610.0,3646.5,0.01,16829.38,84
HCPCS,47379,UNLISTED LAPS PX LIVER,,,5005.78,6291.49,21
HCPCS,47379,Unlisted laps px liver,,,1363.63,1578.94,8
HCPCS,47380,ABLTJ OPN 1/> LVR TUM RF,9824.0,6385.6,1.1,9824.0,144
HCPCS,47380,OPEN ABLATE LIVER TUMOR RF,,,3806.76,3806.76,1
HCPCS,47380,Open ablate liver tumor rf,,,3471.98,4020.19,8
HCPCS,47381,OPEN ABLATE LIVER TUMOR CRYO,,,3900.17,3900.17,1
HCPCS,47381,Open ablate liver tumor cryo,,,1363.63,1578.94,8
HCPCS,47382,ABLTJ 1/> LVR TUM PRQ RF,16413.0,10668.45,1.1,26838.0,234
HCPCS,47383,ABLATION 1/> LIVER TUMOR PERQ CRYOABLATION,25722.0,16719.3,1.1,47892.0,234
HCPCS,47384,ABLATION IRE LIVER 1+ TUMORS W/IMG GDN PERQ,26500.5,17225.325,1.1,49956.0,183
HCPCS,47399,DESTRUCTION/FULGURATION LIVER LESION(S) (COMP 44005),6718.0,4366.7,0.01,6718.0,84
HCPCS,47399,EXC HEPATIC LESION,4260.0,2769.0,0.01,4260.0,84
HCPCS,47399,EXC OF HEPATIC HEMANGIOMA,9705.0,6308.25,0.01,9705.0,84
HCPCS,47399,FLUSHING OF LIVER IN SITU (COMP 47146),2400.0,1560.0,0.01,2400.0,84
HCPCS,47399,MARS THERAPY (COMP 90945),906.0,588.9,0.01,12615.0,168
HCPCS,47400,HEPATCOTOMY/HEPATCOSTOMY W/EXPL DRG/RMVL ST1,14544.0,9453.6,1.1,14544.0,144
HCPCS,47400,INCISION OF LIVER DUCT,,,5650.26,5650.26,1
HCPCS,47400,Incision of liver duct,,,1363.63,1578.94,8
HCPCS,47420,CHOLEDOCHOT/OST W/O SPHNCTROTOMY/SPHNCTROP,9693.0,6300.45,1.1,9693.0,144
HCPCS,47420,INCISION OF BILE DUCT,,,3518.93,3518.93,1
HCPCS,47420,Incision of bile duct,,,3471.98,4020.19,8
HCPCS,47425,CHOLEDOCHOT/OST W/SPHNCTROTOMY/SPHNCTROP,8924.0,5800.6,1.1,8924.0,144
HCPCS,47425,INCISION OF BILE DUCT,,,3593.7,3593.7,1
HCPCS,47425,Incision of bile duct,,,3023.0,3500.32,8
HCPCS,47460,INCISE BILE DUCT SPHINCTER,,,3336.53,3336.53,1
HCPCS,47460,Incise bile duct sphincter,,,1363.63,1578.94,8
HCPCS,47460,TRANSDUOL SPHINCTEROT/PLASTY W/WO RMVL CALCULUS,8208.0,5335.2,1.1,8208.0,144
HCPCS,47480,CHOLECSTOT/CHOLECSTOST W/EXPL DRG/RMVL ST1 SPX,5300.0,3445.0,1.1,5300.0,144
HCPCS,47480,INCISION OF GALLBLADDER,,,2295.0,2295.0,1
HCPCS,47480,Incision of gallbladder,,,3471.98,4020.19,8
HCPCS,47490,CHOLECYSTOSTOMY PRQ W/IMAGING & CATHETER PLMT,9164.0,5956.6,0.01,16234.0,317
HCPCS,47531,NJX CHOLANGIO PRQ W/IMG GID RS&I EXISTING ACCESS,8403.0,5461.95,0.01,16234.0,407
HCPCS,47532,NJX CHOLANGIO PRQ W/IMG GID RS&I NEW ACCESS,9052.0,5883.8,1.1,16234.0,320
HCPCS,47533,PRQ PLMT BILIARY DRG CATH W/IMG GID RS&I EXTERNL,9300.5,6045.325,1.1,16234.0,235
HCPCS,47534,PRQ PLMT BILIARY DRG CATH W/IMG GID RS&I INT-EXT,9789.0,6362.85,1.1,16234.0,235
HCPCS,47535,CONV EXT BIL DRG CATH TO INT-EXT BIL DRG CATH,8986.0,5840.900000000001,1.1,16234.0,322
HCPCS,47536,EXCHANGE BILIARY DRG CATHETER PRQ W/IMG GID RS&I,8691.0,5649.150000000001,1.1,16234.0,320
HCPCS,47537,REMOVAL BILIARY DRG CATHETER REQ FLUOR GID RS&I,2561.5,1664.975,1.1,6112.0,320
HCPCS,47538,PLMT BILE DUCT STENT PRQ EXISTING ACCESS,14464.0,9401.6,1.1,26838.0,320
HCPCS,47539,PLMT BILE DUCT STENT PRQ NEW ACCESS W/O SEP CATH,15169.0,9859.85,1.1,26838.0,320
HCPCS,47540,PLMT BILE DUCT STENT PRQ NEW ACCESS W/SEP CATH,15225.0,9896.25,1.1,26838.0,320
HCPCS,47541,PLMT ACCESS THRU BILIARY TREE INTO SMALL BWL NEW,15701.5,10205.975,1.1,28703.0,322
HCPCS,47542,BALLOON DILAT BILIARY DUCT/AMPULLA PRQ EACH DUCT,2634.5,1712.425,1.1,4628.0,284
HCPCS,47543,ENDOLUMINAL BX BILIARY TREE PRQ ANY METH 1/MLT,3810.0,2476.5,167.81,4628.0,136
HCPCS,47543,ENDOLUMINAL BX BILIARY TREE PRQ ANY METH SNG/MLT,1200.0,780.0,1.1,1332.14,148
HCPCS,47544,REMOVAL BILIARY DUCT &/GLBLDR CALCULI PERQ RS&I,3052.0,1983.8000000000002,1.1,4661.0,284
HCPCS,47550,BILIARY NDSC INTRAOPERATIVE,1208.0,785.2,1.1,1208.0,144
HCPCS,47550,Bile duct endoscopy add-on,,,2863.07,3315.14,8
HCPCS,47552,BILIARY ENDO PRQ T-TUBE DX W/COLLECT SPEC BRUSH,15557.5,10112.375,0.01,28703.0,318
HCPCS,47553,BILIARY NDSC PRQ T-TUBE W/BX SINGLE/MULTIPLE,15619.5,10152.675000000001,0.01,28703.0,318
HCPCS,47554,BILIARY ENDOSCOPY PRQ VIA T-TUBE W/RMVL CALCULUS,9927.0,6452.55,1.1,30022.29,231
HCPCS,47555,BILIARY NDSC PRQ T-TUBE W/DIL DUCT W/O STENT,9627.0,6257.55,0.01,16234.0,318
HCPCS,47556,BILIARY NDSC PRQ T-TUBE DILAT STRIX W/STENT,25656.0,16676.4,0.01,47892.0,318
HCPCS,47562,LAPAROSCOPIC CHOLECYSTECTOMY,,,5005.78,25635.0,24
HCPCS,47562,LAPAROSCOPY SURG CHOLECYSTECTOMY,4188.0,2722.2,1.1,16829.38,144
HCPCS,47562,Laparoscopic cholecystectomy,,,3023.0,3500.32,8
HCPCS,47563,LAPARO CHOLECYSTECTOMY/GRAPH,,,5005.78,25635.0,24
HCPCS,47563,LAPS SURG CHOLECYSTECTOMY W/CHOLANGIOGRAPHY,4588.0,2982.2,1.1,16829.38,144
HCPCS,47563,Laparo cholecystectomy/graph,,,3023.0,3500.32,8
HCPCS,47564,LAPARO CHOLECYSTECTOMY/EXPLR,,,8930.36,11062.31,20
HCPCS,47564,LAPS SURG CHOLECSTC W/EXPL COMMON DUCT,7200.0,4680.0,1.1,30022.29,144
HCPCS,47564,Laparo cholecystectomy/explr,,,3023.0,3500.32,8
HCPCS,47570,LAPARO CHOLECYSTOENTEROSTOMY,,,2045.77,2045.77,1
HCPCS,47570,LAPAROSCOPY SURG CHOLECYSTOENETEROSTOMY,5024.0,3265.6,1.1,5024.0,144
HCPCS,47570,Laparo cholecystoenterostomy,,,3023.0,3500.32,8
HCPCS,47579,LAP PORTOENTEROSTOMY (COMP CODE 47701),11492.0,7469.8,0.01,16829.38,84
HCPCS,47579,LAP RESECTION EXTRA BILE DUCT,6070.0,3945.5,0.01,16829.38,84
HCPCS,47579,LAPAROSCOPIC CHOLEYSTOSTOMY TUBE PLACEMENT,4373.0,2842.45,0.01,16829.38,84
HCPCS,47579,UNLISTED LAPS PX BILIARY TRC,,,5005.78,15063.4,21
HCPCS,47579,"UNLISTED PROC, LAP COMMON BILE DUCT EXPLORATION (COMP CODE 47420",7270.0,4725.5,0.01,16829.38,84
HCPCS,47579,UNLISTED PROC; LAP REPAIR OF COMMON BILE DUCT INJURY. (COMP TO 4,8146.0,5294.9,0.01,16829.38,84
HCPCS,47579,Unlisted laps px biliary trc,,,1363.63,1578.94,8
HCPCS,47600,CHOLECYSTECTOMY,6992.0,4544.8,1.1,6992.0,145
HCPCS,47600,Cholecystectomy,,,3471.98,4020.19,8
HCPCS,47605,CHOLECYSTECTOMY W/CHOLANG,,,2966.68,2966.68,1
HCPCS,47605,CHOLECYSTECTOMY W/CHOLANGIOGRAPHY,7392.0,4804.8,1.1,7392.0,144
HCPCS,47605,Cholecystectomy w/cholang,,,3471.98,4020.19,8
HCPCS,47610,CHOLECYSTECTOMY W/EXPLORATION COMMON DUCT,8368.0,5439.2,1.1,8368.0,144
HCPCS,47610,REMOVAL OF GALLBLADDER,,,3287.21,3287.21,1
HCPCS,47610,Removal of gallbladder,,,3471.98,4020.19,8
HCPCS,47612,CHOLECYSTECTOMY EXPL DUCT CHOLEDOCHOENTEROSTOMY,8484.0,5514.6,1.1,8484.0,144
HCPCS,47612,REMOVAL OF GALLBLADDER,,,3351.38,3351.38,1
HCPCS,47612,Removal of gallbladder,,,3023.0,3500.32,8
HCPCS,47620,CHOLECSTC EXPL DUX SPHNCTROTOMY/SPHNCTROP,9228.0,5998.2,1.1,9228.0,144
HCPCS,47620,REMOVAL OF GALLBLADDER,,,3619.24,3619.24,1
HCPCS,47620,Removal of gallbladder,,,3023.0,3500.32,8
HCPCS,47700,EXPLOR CONG ATRESIA BILE DUCTS,6600.0,4290.0,1.1,6600.0,144
HCPCS,47700,EXPLORATION OF BILE DUCTS,,,2783.95,2783.95,1
HCPCS,47700,Exploration of bile ducts,,,1363.63,1578.94,8
HCPCS,47701,BILE DUCT REVISION,,,4564.07,4564.07,1
HCPCS,47701,Bile duct revision,,,1363.63,1578.94,8
HCPCS,47701,PORTOENETEROSTOMY,11492.0,7469.8,1.1,11492.0,144
HCPCS,47711,EXC BILE DUX TUM W/WO PRIM RPR XTRHEPATC,10360.0,6734.0,1.1,10360.0,144
HCPCS,47711,EXCISION OF BILE DUCT TUMOR,,,4096.74,4096.74,1
HCPCS,47711,Excision of bile duct tumor,,,1363.63,1578.94,8
HCPCS,47712,EXC BILE DUX TUM W/WO PRIM RPR INTRAHEPATC,13488.0,8767.2,1.1,13488.0,144
HCPCS,47712,EXCISION OF BILE DUCT TUMOR,,,5246.36,5246.36,1
HCPCS,47712,Excision of bile duct tumor,,,1363.63,1578.94,8
HCPCS,47715,EXCISION OF BILE DUCT CYST,,,3498.93,3498.93,1
HCPCS,47715,EXCISION OF CHOLEDOCHAL CYST,8620.0,5603.0,1.1,8620.0,144
HCPCS,47715,Excision of bile duct cyst,,,1363.63,1578.94,8
HCPCS,47715,LAP RESECTION OF CHOLEDOCHAL CYST (COMP CODE 47715),9159.0,5953.35,1.1,9159.0,144
HCPCS,47720,CHOLECYSTOENTEROSTOMY; DIRECT,7336.0,4768.4,1.1,7336.0,144
HCPCS,47720,FUSE GALLBLADDER & BOWEL,,,3036.52,3036.52,1
HCPCS,47720,Fuse gallbladder & bowel,,,3023.0,3500.32,8
HCPCS,47721,FUSE UPPER GI STRUCTURES,,,3562.6,3562.6,1
HCPCS,47721,Fuse upper gi structures,,,3023.0,3500.32,8
HCPCS,47740,CHOLECYSTOENTEROSTOMY+ROUX-EN-Y,8492.0,5519.8,1.1,8492.0,144
HCPCS,47740,FUSE GALLBLADDER & BOWEL,,,3452.98,3452.98,1
HCPCS,47740,Fuse gallbladder & bowel,,,3023.0,3500.32,8
HCPCS,47741,CHOLECYSTOENTER+ROUX-EN-Y+GASTROENT,9684.0,6294.6,1.1,9684.0,144
HCPCS,47741,FUSE GALLBLADDER & BOWEL,,,3880.69,3880.69,1
HCPCS,47741,Fuse gallbladder & bowel,,,3023.0,3500.32,8
HCPCS,47760,ANAST EXTRAHEP DUCT TO GI TRACT,15328.0,9963.2,1.1,15328.0,144
HCPCS,47760,FUSE BILE DUCTS AND BOWEL,,,5919.44,5919.44,1
HCPCS,47760,Fuse bile ducts and bowel,,,3471.98,4020.19,8
HCPCS,47765,ANAST INTRAHEP DUCT TO GI TRACT,20876.0,13569.4,1.1,20876.0,144
HCPCS,47765,FUSE LIVER DUCTS & BOWEL,,,7964.39,7964.39,1
HCPCS,47765,Fuse liver ducts & bowel,,,3471.98,4020.19,8
HCPCS,47780,"ANAST,ROUX-EN-Y,EXTRAHEP TO GI TRCT",16928.0,11003.2,1.1,16928.0,144
HCPCS,47780,FUSE BILE DUCTS AND BOWEL,,,6509.64,6509.64,1
HCPCS,47780,Fuse bile ducts and bowel,,,3471.98,4020.19,8
HCPCS,47785,"ANAST,ROUX-EN-Y,INTRAHEP TO GI TRCT",22476.0,14609.4,1.1,22476.0,144
HCPCS,47785,FUSE BILE DUCTS AND BOWEL,,,8507.12,8507.12,1
HCPCS,47785,Fuse bile ducts and bowel,,,3471.98,4020.19,8
HCPCS,47800,RCNSTJ PLSTC BILIARY DUCTS W/END-TO-END ANAST,10468.0,6804.2,1.1,10468.0,144
HCPCS,47800,RECONSTRUCTION OF BILE DUCTS,,,4082.96,4082.96,1
HCPCS,47800,Reconstruction of bile ducts,,,1363.63,1578.94,8
HCPCS,47801,PLACEMENT BILE DUCT SUPPORT,,,2931.36,2931.36,1
HCPCS,47801,PLACEMENT CHOLEDOCHAL STENT,7040.0,4576.0,1.1,7040.0,144
HCPCS,47801,Placement bile duct support,,,3471.98,4020.19,8
HCPCS,47802,FUSE LIVER DUCT & INTESTINE,,,4007.85,4007.85,1
HCPCS,47802,Fuse liver duct & intestine,,,1363.63,1578.94,8
HCPCS,47900,SUTURE BILE DUCT INJURY,,,3626.14,3626.14,1
HCPCS,47900,SUTURE EXTRAHEPATIC BILE DUCT PRE-EXIST INJURY,8976.0,5834.4,1.1,8976.0,144
HCPCS,47900,Suture bile duct injury,,,1363.63,1578.94,8
HCPCS,47999,BILE DUCT RECONSTRUCTION (COMP CODE 47760),16477.0,10710.05,0.01,16477.0,84
HCPCS,47999,BILIARY FISTULA TRACT CLOSURE,2492.0,1619.8,0.01,2644.7,84
HCPCS,47999,ERCP W SPHINCTEROTOMY/REMOVAL OF CALCULI VIA GASTROSTOMY,2982.0,1938.3,786.42,6112.0,84
HCPCS,47999,ERCP W/ SUBMUCOSAL INJECTION (TATTOOING) (COMP 43236),1028.0,668.2,0.01,2644.7,84
HCPCS,47999,ERCP W/CONTROL OF BLEED,3038.0,1974.7,0.01,3038.0,85
HCPCS,47999,ERCP W/CONTROL OF BLEED (COMP CODE 44378),2278.0,1480.7,0.01,2644.7,84
HCPCS,47999,PROC BILIARY TRACT UNLISTD,1860.0,1209.0,517.08,12615.0,84
HCPCS,47999,REVISION BILIARY ANAST,12646.0,8219.9,0.01,12646.0,84
HCPCS,47999,RF ABLATION BILIARY TRACT (COMP CODE 47556),22724.5,14770.925,0.01,42370.0,168
HCPCS,47999,T TUBE PLACEMENT OPEN (COMP 47900),5521.0,3588.65,0.01,5521.0,84
HCPCS,47999,"UNLISTED PROCEDURE, BILIARY TRACT (COMPARISON CODE 47900)",9537.0,6199.05,0.01,9537.0,84
HCPCS,48000,DRAINAGE OF ABDOMEN,,,4950.93,4950.93,1
HCPCS,48000,Drainage of abdomen,,,3471.98,4020.19,8
HCPCS,48000,PLACE DRAIN PERIPANCREATIC ACUTE PANCREATITIS,12780.0,8307.0,1.1,12780.0,144
HCPCS,48001,PLACEMENT OF DRAIN PANCREAS,,,6063.87,6063.87,1
HCPCS,48001,Placement of drain pancreas,,,3471.98,4020.19,8
HCPCS,48020,REMOVAL OF PANCREATIC STONE,7636.0,4963.4,1.1,7636.0,145
HCPCS,48020,Removal of pancreatic stone,,,1363.63,1578.94,8
HCPCS,48100,BIOPSY OF PANCREAS OPEN,,,2347.58,2347.58,1
HCPCS,48100,Biopsy of pancreas open,,,3471.98,4020.19,8
HCPCS,48100,OPEN BIOPSY OF PANCREAS,5784.0,3759.6,1.1,5784.0,144
HCPCS,48102,BIOPSY PANCREA PERCUTANEOUS NEEDLE,4666.5,3033.225,1.1,7453.0,235
HCPCS,48105,RESECJ/DBRDMT PANCREAS NECROTIZING PANCREATITIS,19704.0,12807.6,1.1,19704.0,144
HCPCS,48105,RESECT/DEBRIDE PANCREAS,,,7386.6,7386.6,1
HCPCS,48105,Resect/debride pancreas,,,3471.98,4020.19,8
HCPCS,48120,EXCISION OF PANCREAS LESION,7364.0,4786.6,1.1,7364.0,144
HCPCS,48120,REMOVAL OF PANCREAS LESION,,,2932.68,2932.68,1
HCPCS,48120,Removal of pancreas lesion,,,3471.98,4020.19,8
HCPCS,48140,PARTIAL REMOVAL OF PANCREAS,,,4121.62,4121.62,1
HCPCS,48140,PNCRTECT DSTL STOT W/O PNCRTCOJEJUNOSTOMY,10528.0,6843.2,1.1,10528.0,144
HCPCS,48140,Partial removal of pancreas,,,3471.98,4020.19,8
HCPCS,48145,PARTIAL REMOVAL OF PANCREAS,,,4296.87,4296.87,1
HCPCS,48145,PNCRTECT DSTL STOT W/PNCRTCOJEJUNOSTOMY,10956.0,7121.4,1.1,10956.0,144
HCPCS,48145,Partial removal of pancreas,,,3471.98,4020.19,8
HCPCS,48146,PANCREATECTOMY,,,4946.11,4946.11,1
HCPCS,48146,PNCRTECT DSTL NR-TOT W/PRSRV DUO CHLD-TYP PX,12240.0,7956.0,1.1,12240.0,144
HCPCS,48146,Pancreatectomy,,,3471.98,4020.19,8
HCPCS,48148,EXCISION AMPULLA VATER,8156.0,5301.4,1.1,8156.0,144
HCPCS,48148,REMOVAL OF PANCREATIC DUCT,,,3290.93,3290.93,1
HCPCS,48148,Removal of pancreatic duct,,,1363.63,1578.94,8
HCPCS,48150,PARTIAL REMOVAL OF PANCREAS,,,8184.46,8184.46,1
HCPCS,48150,PNCRTECT PROX STOT W/PANCREATOJEJUNOSTOMY,21136.0,13738.4,1.1,21136.0,144
HCPCS,48150,Partial removal of pancreas,,,3471.98,4020.19,8
HCPCS,48152,PANCREATECTOMY,,,7577.14,7577.14,1
HCPCS,48152,PNCRTECT WHIPPLE W/O PANCREATOJEJUNOSTOMY,19460.0,12649.0,1.1,19460.0,144
HCPCS,48152,Pancreatectomy,,,3471.98,4020.19,8
HCPCS,48153,PANCREATECTOMY,,,8154.16,8154.16,1
HCPCS,48153,PNCRTECT W/PANCREATOJEJUNOSTOMY,21116.0,13725.4,1.1,21116.0,144
HCPCS,48153,Pancreatectomy,,,3471.98,4020.19,8
HCPCS,48154,PANCREATECTOMY,,,7610.71,7610.71,1
HCPCS,48154,PNCRTECT PROX STOT W/O PANCREATOJEJUNOSTOMY,19552.0,12708.8,1.1,19552.0,144
HCPCS,48154,Pancreatectomy,,,3471.98,4020.19,8
HCPCS,48155,PANCREATECTOMY TOTAL,11780.0,7657.0,1.1,11780.0,144
HCPCS,48155,REMOVAL OF PANCREAS,,,4772.34,4772.34,1
HCPCS,48155,Removal of pancreas,,,3471.98,4020.19,8
HCPCS,48160,PANCREAS REMOVAL/TRANSPLANT,,,6850.0,6850.0,1
HCPCS,48160,PANCREATECTOMY W/TRNSPLJ PANCREAS/ISLET CELLS,13636.0,8863.4,1.1,13636.0,88
HCPCS,48160,Pancreas removal/transplant,,,3471.98,4020.19,8
HCPCS,48400,INJECTION INTRAOP ADD-ON,,,279.21,279.21,1
HCPCS,48400,Injection intraop add-on,,,81.99,94.94,8
HCPCS,48500,SURGERY OF PANCREATIC CYST,,,3020.74,3020.74,1
HCPCS,48500,Surgery of pancreatic cyst,,,1363.63,1578.94,8
HCPCS,48510,DRAIN PANCREATIC PSEUDOCYST,,,2881.11,2881.11,1
HCPCS,48510,Drain pancreatic pseudocyst,,,3471.98,4020.19,8
HCPCS,48510,EXTERNAL DRAINAGE PSEUDOCYST OF PANCREAS OPEN,6876.0,4469.4,1.1,6876.0,144
HCPCS,48520,FUSE PANCREAS CYST AND BOWEL,,,2895.6,2895.6,1
HCPCS,48520,Fuse pancreas cyst and bowel,,,1363.63,1578.94,8
HCPCS,48520,INT ANAST PANCREATIC CYST GI TRACT DIRECT,7260.0,4719.0,1.1,7260.0,144
HCPCS,48540,FUSE PANCREAS CYST AND BOWEL,,,3441.0,3441.0,1
HCPCS,48540,Fuse pancreas cyst and bowel,,,1363.63,1578.94,8
HCPCS,48540,INT ANAST PANCREATIC CYST GI TRACT ROUX-EN-Y,8776.0,5704.4,1.1,8776.0,144
HCPCS,48545,PANCREATORRHAPHY,,,3544.63,3544.63,1
HCPCS,48545,PANCREATORRHAPHY INJURY,8892.0,5779.8,1.1,8892.0,144
HCPCS,48545,Pancreatorrhaphy,,,1363.63,1578.94,8
HCPCS,48547,DUODENAL EXCLUSION,,,4714.03,4714.03,1
HCPCS,48547,DUOL EXCLUSION W/GASTROJEJUNOSTOMY PNCRTC INJ,12152.0,7898.8,1.1,12152.0,144
HCPCS,48547,Duodenal exclusion,,,1363.63,1578.94,8
HCPCS,48548,FUSE PANCREAS AND BOWEL,,,4398.52,4398.52,1
HCPCS,48548,Fuse pancreas and bowel,,,1363.63,1578.94,8
HCPCS,48548,PANCREATICOJEJUNOSTOMY SIDE-TO-SIDE ANAST,11236.0,7303.4,1.1,11236.0,144
HCPCS,48550,DONOR PANCREATECTOMY,,,1301.5,1301.5,1
HCPCS,48550,Donor pancreatectomy,,,1229.51,1423.64,8
HCPCS,48551,BKBENCH PREPJ CADAVER DONOR PANCREAS ALLOGRAFT,4958.0,3222.7,1.1,4958.0,104
HCPCS,48551,PREP DONOR PANCREAS,,,595.43,595.43,1
HCPCS,48551,Prep donor pancreas,,,1229.51,1423.64,8
HCPCS,48552,BKBENCH RCNSTJ CDVR PNCRS ALGRFT VEN ANAST EA,1720.0,1118.0,1.1,1720.0,142
HCPCS,48552,PREP DONOR PANCREAS/VENOUS,,,617.92,617.92,1
HCPCS,48552,Prep donor pancreas/venous,,,1229.51,1423.64,8
HCPCS,48554,TRANSPL ALLOGRAFT PANCREAS,,,6873.02,6873.02,1
HCPCS,48554,TRANSPLANT ALLOGRAFT PANCREAS,15120.0,9828.0,1.1,15120.0,144
HCPCS,48554,Transpl allograft pancreas,,,1229.51,1423.64,8
HCPCS,48556,REMOVAL ALLOGRAFT PANCREAS,7788.0,5062.2,1.1,7788.0,145
HCPCS,48556,Removal allograft pancreas,,,1363.63,1578.94,8
HCPCS,48999,ABLATION PANCREATIC TUMOR (COMP 47380),6626.0,4306.9,0.01,6626.0,84
HCPCS,48999,EGD-PANCREATIC NECROSECTOMY,4900.0,3185.0,0.01,4900.0,84
HCPCS,48999,EGD-PANCREATIC NECROSECTOMY HB,7992.0,5194.8,610.39,7992.0,84
HCPCS,48999,EGD-PSEUDOCYST NECROSECTOMY (COMP 48105),21189.0,13772.85,0.01,21189.0,84
HCPCS,48999,ISLET AUTOLOGOUS CELL TRANSPLANT (COMP 36260),4510.0,2931.5,0.01,4510.0,84
HCPCS,48999,ISLET CELL TXPLNT FR PANCREAS,60000.0,39000.0,610.39,60000.0,84
HCPCS,48999,LAP ENUCLEATION PANCREAS LESION (COMP 48120),6075.0,3948.75,0.01,6075.0,84
HCPCS,48999,LAP PANCREAS DEBRIDEMENT (COMP 48105),16256.0,10566.4,0.01,16256.0,84
HCPCS,48999,LAP REMOVAL PANCREAS W/OR W/O SPLENECTOM,10857.0,7057.05,0.01,10857.0,84
HCPCS,48999,LAP REMOVAL PANCREAS W/OR W/O SPLENECTOM (COMP CODE 48140),10857.0,7057.05,0.01,10857.0,84
HCPCS,48999,LAPAROSCOPIC PYLORUS PRESERVING PANCREATICODUODENECTOMY (COMP CO,22699.0,14754.35,0.01,22699.0,84
HCPCS,48999,LAPAROSCOPIC WHIPPLE,21776.0,14154.4,0.01,21776.0,84
HCPCS,48999,PANCREAS RESECTION FREY PROCEDURE (COMP 48145),9064.0,5891.6,0.01,9064.0,84
HCPCS,48999,PANCREAS STONE SHOCK WAVE LITHOTRIPSY (COMP 50590),3224.0,2095.6,0.01,3224.0,84
HCPCS,48999,PANCREATECTOMY CENTRAL,6719.0,4367.35,0.01,6719.0,84
HCPCS,48999,PROC RM-EGD PSEUDOCYST NEC,4860.0,3159.0,610.39,4860.0,84
HCPCS,48999,UNLISTED LAP DEBRIDEMENT OF PANCREATIC CYST (COMP CODE 48105),16010.0,10406.5,0.01,16010.0,84
HCPCS,48999,"UNLISTED PROC, LAP PANCREATICODUODENECTOMY W/DISTAL GASTRECTOMY",19181.0,12467.65,0.01,19181.0,84
HCPCS,48999,UNLISTED PROC; ENDOSCOPIC DEBRIDEMENT OF PANCREATIC PSEUDOCYST (,2327.0,1512.55,0.01,2327.0,84
HCPCS,49000,EXPLORATORY LAPAROTOMY CELIOTOMY W/WO BIOPSY SPX,5016.0,3260.4,1.1,5016.0,144
HCPCS,49000,Exploration of abdomen,,,2029.97,2350.49,8
HCPCS,49002,REOPENING OF ABDOMEN,,,2740.55,2740.55,1
HCPCS,49002,REOPENING RECENT LAPAROTOMY,7052.0,4583.8,1.1,7052.0,144
HCPCS,49002,Reopening of abdomen,,,2029.97,2350.49,8
HCPCS,49010,EXPL RETROPERITONEUM W/WO BX SPX,6424.0,4175.6,1.1,6424.0,144
HCPCS,49010,EXPLORATION BEHIND ABDOMEN,,,2425.97,6737.21,13
HCPCS,49010,Exploration behind abdomen,,,2029.97,2350.49,8
HCPCS,49013,PREPERITONEAL PEL PACK F/HEMRRG ASSOC PEL TRMA,3340.0,2171.0,1.1,3340.0,144
HCPCS,49013,PRPERTL PEL PACK HEMRRG TRMA,,,1198.53,1198.53,1
HCPCS,49013,Prpertl pel pack hemrrg trma,,,2029.97,2350.49,8
HCPCS,49014,REEXPL PEL WND W/RMVL PREPERITONEAL PEL PACKING,2692.0,1749.8,1.1,2692.0,144
HCPCS,49014,REEXPLORATION PELVIC WOUND,,,995.33,995.33,1
HCPCS,49014,Reexploration pelvic wound,,,2029.97,2350.49,8
HCPCS,49020,DRAINAGE PERITON ABSCESS/LOCAL PERITONITIS OPEN,1274.0,828.1,0.01,7813.0,69
HCPCS,49020,DRG PERITONEAL ABSCESS/LOCAL PERITONITIS OPEN,10668.0,6934.2,1.1,10668.0,144
HCPCS,49040,DRAIN OPEN ABDOM ABSCESS,,,2636.26,2636.26,1
HCPCS,49040,DRAINAGE SUBDIAPHRAGMATIC/SUBPHREN ABSCESS OPEN,6608.0,4295.2,1.1,6608.0,144
HCPCS,49040,Drain open abdom abscess,,,5578.94,6459.83,8
HCPCS,49060,DRAIN OPEN RETROPERI ABSCESS,,,2875.52,2875.52,1
HCPCS,49060,DRAINAGE OF RETROPERITONEAL ABSCESS OPEN,7412.0,4817.8,1.1,7412.0,144
HCPCS,49060,Drain open retroperi abscess,,,2029.97,2350.49,8
HCPCS,49062,DRAIN TO PERITONEAL CAVITY,,,2026.64,2026.64,1
HCPCS,49062,DRG XTRAPERITONEAL LYMPHOCELE PERITON CAVITY OPN,4888.0,3177.2,1.1,4888.0,144
HCPCS,49062,Drain to peritoneal cavity,,,2029.97,2350.49,8
HCPCS,49082,ABDOM PARACENTESIS DX/THER W/O IMAGING GUIDANCE,2429.5,1579.175,0.01,5265.0,322
HCPCS,49082,BAND FLUID REMOVAL (COMP CODE 49082),149.0,96.85,1.1,2644.7,148
HCPCS,49083,ABDOM PARACENTESIS DX/THER W IMAGING GUIDANCE,880.0,572.0,1.1,2644.7,148
HCPCS,49083,ABDOM PARACENTESIS DX/THER W/IMAGING GUIDANCE,4313.0,2803.45,0.01,6112.0,261
HCPCS,49084,PERITONEAL LAVAGE W/WO IMAGING GUIDANCE,2596.5,1687.725,1.1,5265.0,231
HCPCS,49180,BX ABDL/RETROPERITONEAL MASS PRQ NEEDLE,7453.0,4844.45,0.01,7453.0,174
HCPCS,49180,BX ABDL/RPR MASS PRQ NDL,761.0,494.65,1.1,4729.25,148
HCPCS,49185,SCLEROTHERAPY FLUID COLLECTION PRQ W/IMG GID,4196.5,2727.725,0.01,11545.0,322
HCPCS,49186,OPEN EXC/DSTRJ INTRA-ABDL TUMOR/CST 5 CM OR LESS,9680.0,6292.0,1.1,9680.0,142
HCPCS,49186,Opn exc/dstr ntra-abd 5 cm/<,,,2029.97,2350.49,8
HCPCS,49187,OPEN EXC/DSTRJ INTRA-ABDL TUMOR/CST 5.1-10 CM,12606.0,8193.9,1.1,12606.0,142
HCPCS,49187,Opn exc/dstr ntra-abd 5.1-10,,,2029.97,2350.49,8
HCPCS,49188,OPEN EXC/DSTRJ INTRA-ABDL TUMOR/CST 10.1-20 CM,14960.0,9724.0,1.1,14960.0,142
HCPCS,49188,Opn exc/dst ntra-abd 10.1-20,,,2029.97,2350.49,8
HCPCS,49189,OPEN EXC/DSTRJ INTRA-ABDL TUMOR/CST 20.1-30 CM,17600.0,11440.0,1.1,17600.0,142
HCPCS,49189,Opn exc/dst ntra-abd 20.1-30,,,2029.97,2350.49,8
HCPCS,49190,OPEN EXC/DSTRJ INTRA-ABDL TUMOR/CYST >30 CM,22000.0,14300.0,1.1,22000.0,142
HCPCS,49190,Opn exc/dstr ntra-abd >30 cm,,,2029.97,2350.49,8
HCPCS,49203,Exc abd tum 5 cm or less,,,2029.97,2350.49,8
HCPCS,49204,Exc abd tum over 5 cm,,,2029.97,2350.49,8
HCPCS,49205,Exc abd tum over 10 cm,,,2029.97,2350.49,8
HCPCS,49215,EXCISE PRESACRAL/SACRAL TUMOR,15124.0,9830.6,1.1,15124.0,144
HCPCS,49215,EXCISE SACRAL SPINE TUMOR,,,5822.25,5822.25,1
HCPCS,49215,Excise sacral spine tumor,,,1836.64,2126.64,8
HCPCS,49220,Multiple surgery abdomen,,,2029.97,2350.49,8
HCPCS,49250,EXCISION OF UMBILICUS,,,3001.45,3726.07,20
HCPCS,49250,Excision of umbilicus,,,2436.53,2821.25,8
HCPCS,49250,UMBILECTOMY OMPHALECTOMY EXC UMBILICUS SPX,3604.0,2342.6,1.1,10089.06,144
HCPCS,49255,OMNTC EPIPLOECTOMY RESCJ OMENTUM SPX,5024.0,3265.6,1.1,5024.0,144
HCPCS,49255,REMOVAL OF OMENTUM,,,2081.99,6737.21,13
HCPCS,49255,Removal of omentum,,,2029.97,2350.49,8
HCPCS,49320,DIAG LAPARO SEPARATE PROC,,,5005.78,11441.0,24
HCPCS,49320,Diag laparo separate proc,,,2029.97,2350.49,8
HCPCS,49320,LAPS ABD PRTM&OMENTUM DX W/WO SPEC BR/WA SPX,2262.0,1470.3,1.1,16829.38,144
HCPCS,49321,L'SCOPE W/BIOPSY SINGLE/MULTIPLE,2176.0,1414.4,1.1,16829.38,144
HCPCS,49321,LAPAROSCOPY BIOPSY,,,5005.78,11441.0,24
HCPCS,49321,Laparoscopy biopsy,,,2029.97,2350.49,8
HCPCS,49322,L'SCOPE CAVITY/CYST SINGLE/MULTIPLE,2404.0,1562.6,1.1,16829.38,144
HCPCS,49322,LAPAROSCOPY ASPIRATION,,,5005.78,6291.49,20
HCPCS,49322,Laparoscopy aspiration,,,2029.97,2350.49,8
HCPCS,49323,L'SCOPE W/DRNG  LYMPHOCELE TO PERIT,4092.0,2659.8,1.1,16829.38,144
HCPCS,49323,LAPARO DRAIN LYMPHOCELE,,,5005.78,11441.0,21
HCPCS,49323,Laparo drain lymphocele,,,2029.97,2350.49,8
HCPCS,49324,LAP INSERT TUNNEL IP CATH,,,5005.78,13821.0,22
HCPCS,49324,LAPS INSERTION TUNNELED INTRAPERITONEAL CATHETER,2528.0,1643.2,1.1,16829.38,144
HCPCS,49324,Lap insert tunnel ip cath,,,2029.97,2350.49,8
HCPCS,49325,LAP REVISION PERM IP CATH,,,5005.78,15063.4,22
HCPCS,49325,LAPS W/REVISION INTRAPERITONEAL CATHETER,2728.0,1773.2,1.1,16829.38,144
HCPCS,49325,Lap revision perm ip cath,,,2029.97,2350.49,8
HCPCS,49326,LAPAROSCOPY W/OMENTOPEXY,1400.0,910.0,1.1,1400.0,144
HCPCS,49326,Lap w/omentopexy add-on,,,2029.97,2350.49,8
HCPCS,49327,LAPS W/INSERTION NTRSTL DEV W/IMG GID 1+,952.0,618.8,1.1,952.0,144
HCPCS,49327,Lap ins device for rt,,,200.93,232.66,8
HCPCS,49329,LAP DRAINAGE OF ABD ABSCESS (COMP 49020),3987.0,2591.55,0.01,16829.38,84
HCPCS,49329,"LAP EXCISION ABD, PERITONEUM, OMENTUM 10.1-20CM (COMP 49188)",14620.0,9503.0,0.01,16829.38,84
HCPCS,49329,"LAP EXCISION ABD, PERITONEUM, OMENTUM 20.1-30CM (COMP 49189)",17200.0,11180.0,0.01,17200.0,84
HCPCS,49329,"LAP EXCISION ABD, PERITONEUM, OMENTUM 5CM OR LESS (COMP 49186)",9460.0,6149.0,0.01,16829.38,84
HCPCS,49329,"LAP EXCISION ABD, PERITONEUM, OMENTUM GREATER THAN 30CM (COMP 49",21500.0,13975.0,0.01,21500.0,84
HCPCS,49329,LAP EXCISION ABDOMINAL WALL TUMOR,4932.0,3205.8,0.01,16829.38,84
HCPCS,49329,LAP EXCISION OF A PRESACRAL SINUS(FISTULA) TRACT/ABSCESS (COMP 4,15124.0,9830.6,0.01,16829.38,84
HCPCS,49329,LAP EXPLORATION FOR POST OP HEMORRHAGE,3190.0,2073.5,0.01,16829.38,84
HCPCS,49329,"LAP LYSIS ADHESIONS,PERITONEAL (COMP CODE 44180)",5013.0,3258.45,0.01,16829.38,84
HCPCS,49329,LAP RELEASE MEDIAN ARCUATE LIGAMENT (COMP 49320),2185.0,1420.25,0.01,16829.38,84
HCPCS,49329,LAP RMV/REVSION VETRICULOPERITONEL SHUNT,4574.0,2973.1,0.01,16829.38,84
HCPCS,49329,LAP RMVL FOREIGN IN OMENTUM/ABDOMEN,1779.0,1156.35,0.01,16829.38,84
HCPCS,49329,"LAP,EXCISION ABD, PERITONEUM, OMENTUM 5.1-10CM (COMP 49187)",12320.0,8008.0,0.01,16829.38,84
HCPCS,49329,LAP. REM. PANCREAS W/WO SPLEEN,3341.0,2171.65,0.01,16829.38,84
HCPCS,49329,LAPAR,2640.0,1716.0,0.01,16829.38,84
HCPCS,49329,LAPAROPSCOPIC URACHAL CYST EXCISION (COMP CODE 39545),6235.0,4052.75,0.01,16829.38,84
HCPCS,49329,LAPAROSCOPIC ABDOMINAL MESH REMOVAL (COMP TO 20680),1967.0,1278.55,0.01,16829.38,84
HCPCS,49329,LAPAROSCOPIC CREATION OF MYOFASCIAL CUTANEOUS MUSCLE FLAPS (COMP,7163.0,4655.95,0.01,16829.38,84
HCPCS,49329,LAPAROSCOPIC EVACUATION HEMATOMA (COMP 49002),1967.0,1278.55,0.01,16829.38,84
HCPCS,49329,LAPAROSCOPIC EXCISION OMENTUM (49255),3501.0,2275.65,0.01,16829.38,84
HCPCS,49329,LAPAROSCOPIC PERITONEAL DIALYSIS CATH REMOVAL (COMP TO 49422),2152.0,1398.8,0.01,16829.38,84
HCPCS,49329,LAPAROSCOPIC RELEASE OF MEDIAN ARCUATE LIGAMENT (MALS PROC) (COM,5883.0,3823.95,0.01,16829.38,84
HCPCS,49329,LAPROSCOPIC OMENTAL FLAP INTRA-ABDOMINAL (COMP CODE 49905),3294.0,2141.1,0.01,16829.38,84
HCPCS,49329,LX EXCISION OF RETROPERITONEAL TUMOR,5541.0,3601.65,0.01,16829.38,84
HCPCS,49329,LX EXCISION OF RETROPERITONEAL TUMOR (COMP 49203),5541.0,3601.65,0.01,16829.38,84
HCPCS,49329,POST OP LAP EXPLOR & CONTROL HEMORRHAGE ABD (COMP TO 35840),4557.0,2962.05,0.01,16829.38,84
HCPCS,49329,"UNLISTED LAP REMOVAL FOREIGN BODY , ABD (COMP CODE 49402)",3018.0,1961.7,0.01,16829.38,84
HCPCS,49329,"UNLISTED LAPAROSCOPY PROCEDURE, ABDOMEN, PERITONEUM AND OMENTUM",6165.5,4007.575,0.01,16829.38,336
HCPCS,49329,"UNLISTED LAPAROSCOPY, ABDOMEN, PERITONEUM AND OMENTUM (COMP CODE",2374.0,1543.1,0.01,16829.38,84
HCPCS,49329,UNLSTD LAPS PX ABD PERTM&OMN,,,5005.78,15063.4,22
HCPCS,49329,Unlstd laps px abd pertm&omn,,,2029.97,2350.49,8
HCPCS,49400,INJECTION AIR/CONTRAST PERITONEAL CAVITY SPX,538.5,350.025,1.1,4628.0,216
HCPCS,49402,REMOVAL PERITONEAL FOREIGN BODY FROM CAVITY,5636.0,3663.4,1.1,10089.06,144
HCPCS,49402,REMOVE FOREIGN BODY ADBOMEN,,,3001.45,3726.07,20
HCPCS,49402,Remove foreign body adbomen,,,2029.97,2350.49,8
HCPCS,49405,IMAGE-GUIDE FLUID COLLXN DRAINAGE CATH VISC PERQ,4526.5,2942.225,0.01,10364.0,321
HCPCS,49406,CT GD DRAIN PERI/RETROPERI PER,7453.0,4844.45,0.01,10364.0,87
HCPCS,49406,IMG-GUIDE FLUID COLLXN DRAINAG CATH PERITON PERQ,4606.5,2994.225,1.1,10364.0,234
HCPCS,49407,IMAGE FLUID COLLXN DRAINAG CATH TRANSREC/VAGINAL,4576.5,2974.725,1.1,7453.0,234
HCPCS,49411,INTERSTITIAL DEV PLMT RADIATION THERAPY 1/MLT,3861.0,2509.65,1.1,6294.0,234
HCPCS,49412,Ins device for rt guide open,,,200.93,232.66,8
HCPCS,49412,PLMT INTRSTL DEV OPN W/IMG GID 1+,600.0,390.0,1.1,600.0,144
HCPCS,49418,INSJ INTRAPERITONEAL CATHETER W/IMG GID,1584.0,1029.6,1.1,10089.06,148
HCPCS,49418,INSJ INTRAPERITONEAL CATHETER W/IMG GUID,16234.0,10552.1,0.01,16234.0,174
HCPCS,49419,INSERT TUN IP CATH W/PORT,,,4767.51,5790.88,20
HCPCS,49419,INSERTION TUNNEL INTRAPERITONEAL CATH SUBQ PORT,2832.0,1840.8,1.1,16027.4,144
HCPCS,49419,Insert tun ip cath w/port,,,2029.97,2350.49,8
HCPCS,49421,INSERTION TUNNEL INTRAPERITONEAL CATH DIAL OPEN,8959.0,5823.35,1.1,16234.0,231
HCPCS,49422,REMOVAL TUNNELED INTRAPERITONEAL CATHETER,8119.0,5277.35,0.01,14478.0,318
HCPCS,49423,EXCHNG ABSC/CST DRG CATH RAD GID SPX,4684.0,3044.6,0.01,8726.0,322
HCPCS,49424,CNTRST NJX ASSMT ABSC/CST VIA DRG CATH/TUBE SPX,482.5,313.625,0.01,4628.0,284
HCPCS,49425,INSERTION PERITONEAL-VENOUS SHUNT,11705.0,7608.25,918.85,11705.0,69
HCPCS,49426,REVIS PERITONEAL-VENOUS SHUNT,4164.0,2706.6,1.1,10089.06,144
HCPCS,49426,REVISE ABDOMEN-VENOUS SHUNT,,,3001.45,3726.07,20
HCPCS,49426,Revise abdomen-venous shunt,,,2029.97,2350.49,8
HCPCS,49427,INJECT EVALUATE PREVIOUS PERITONEAL-VENOUS SHUNT,579.0,376.35,1.1,4628.0,212
HCPCS,49428,LIGATION OF ABD-VENOUS SHUNT,2748.0,1786.2,1.1,2748.0,144
HCPCS,49428,Ligation of shunt,,,2029.97,2350.49,8
HCPCS,49429,RMVL PERITONEAL-VENOUS SHUNT,8727.0,5672.55,1.1,14478.0,231
HCPCS,49435,INSERT SUBQ EXTENSION INTRAPERITONEAL CATH,900.0,585.0,1.1,900.0,144
HCPCS,49435,Insert subq exten to ip cath,,,461.87,534.8,8
HCPCS,49436,DELAYED CREATION EXIT SITE EMBEDDED CATHETER,1088.0,707.2,1.1,5549.59,148
HCPCS,49436,EMBEDDED IP CATH EXIT-SITE,,,1650.8,4967.59,21
HCPCS,49436,Embedded ip cath exit-site,,,461.87,534.8,8
HCPCS,49440,INSERT GASTROSTOMY TUBE PERCUTANEOUS,5227.5,3397.875,1.1,8726.0,322
HCPCS,49441,INSERT DUODENOSTOMY/JEJUNOSTOMY TUBE PERQ,5267.0,3423.5499999999997,1.1,8726.0,235
HCPCS,49442,INSERT CECOSTOMY/OTHER COLONIC TUBE PERCUTANEOUS,3462.0,2250.3,1.1,8326.0,235
HCPCS,49446,CONVERT GASTROSTOMY-GASTRO-JEJUNOSTOMY TUBE PERQ,4975.0,3233.75,1.1,8726.0,322
HCPCS,49450,REPLACE GASTROSTOMY/CECOSTOMY TUBE PERCUTANEOUS,2428.5,1578.5249999999999,0.01,6112.0,407
HCPCS,49451,REPLACE DUODENOSTOMY/JEJUNOSTOMY TUBE PERQ,2524.5,1640.925,0.01,6112.0,496
HCPCS,49452,REPLACEMENT GASTRO-JEJUNOSTOMY TUBE PERCUTANEOUS,2728.5,1773.5249999999999,1.1,6112.0,320
HCPCS,49460,OBSTRUCTIVE MATERIAL REMOVAL FROM GI TUBE,2348.5,1526.5249999999999,1.1,6112.0,235
HCPCS,49465,CONTRAST INJECTION PERQ RADIOLOGIC EVAL GI TUBE,680.0,442.0,0.01,12500.0,321
HCPCS,49491,RPR 1ST INGUN HRNA PRETERM INFT RDC,5012.0,3257.8,1.1,16829.38,144
HCPCS,49491,RPR HERN PREEMIE REDUC,,,5005.78,15063.4,21
HCPCS,49491,Rpr hern preemie reduc,,,2436.53,2821.25,8
HCPCS,49492,RPR 1ST INGUN HRNA PRETERM INFT INCARCERATED,6172.0,4011.8,1.1,10089.06,144
HCPCS,49492,RPR ING HERN PREMIE BLOCKED,,,3001.45,9031.97,21
HCPCS,49492,Rpr ing hern premie blocked,,,2436.53,2821.25,8
HCPCS,49495,RPR 1ST INGUN HRNA FULL TERM INFT <6 MO RDC,2480.0,1612.0,1.1,10089.06,144
HCPCS,49495,RPR ING HERNIA BABY REDUC,,,3001.45,10789.0,22
HCPCS,49495,Rpr ing hernia baby reduc,,,2436.53,2821.25,8
HCPCS,49496,RPR 1ST INGUN HRNA FULL TERM INFT <6 MO INCARCER,3768.0,2449.2,1.1,10089.06,144
HCPCS,49496,RPR ING HERNIA BABY BLOCKED,,,3001.45,3726.07,20
HCPCS,49496,Rpr ing hernia baby blocked,,,2436.53,2821.25,8
HCPCS,49500,RPR 1ST INGUN HRNA AGE 6 MO-5 YRS REDUCIBLE,2336.0,1518.4,1.1,22063.69,144
HCPCS,49500,RPR ING HERNIA INIT REDUCE,,,5784.5,10789.0,24
HCPCS,49500,Rpr ing hernia init reduce,,,2436.53,2821.25,8
HCPCS,49501,RPR 1ST INGUN HRNA AGE 6 MO-5 YRS INCARCERATED,3744.0,2433.6,1.1,10089.06,144
HCPCS,49501,RPR ING HERNIA INIT BLOCKED,,,3001.45,3726.07,20
HCPCS,49501,Rpr ing hernia init blocked,,,2436.53,2821.25,8
HCPCS,49505,PRP I/HERN INIT REDUC >5 YR,,,3001.45,10789.0,26
HCPCS,49505,Prp i/hern init reduc >5 yr,,,2436.53,2821.25,8
HCPCS,49505,RPR 1ST INGUN HRNA AGE 5 YRS/> REDUCIBLE,3184.0,2069.6,1.1,10089.06,144
HCPCS,49507,PRP I/HERN INIT BLOCK >5 YR,,,3001.45,33436.0,23
HCPCS,49507,Prp i/hern init block >5 yr,,,2436.53,2821.25,8
HCPCS,49507,RPR 1ST INGUN HRNA AGE 5 YRS/> INCARCERATED,3636.0,2363.4,1.1,10089.06,144
HCPCS,49520,REREPAIR ING HERNIA REDUCE,,,3001.45,11545.0,23
HCPCS,49520,RPR RECRT INGUINAL HERNIA ANY AGE REDUCIBLE,3996.0,2597.4,1.1,10089.06,144
HCPCS,49520,Rerepair ing hernia reduce,,,2436.53,2821.25,8
HCPCS,49521,REREPAIR ING HERNIA BLOCKED,,,5784.5,6737.21,20
HCPCS,49521,RPR RECRT INGUN HERNIA ANY AGE INCARCERATED,4592.0,2984.8,1.1,22063.69,144
HCPCS,49521,Rerepair ing hernia blocked,,,2436.53,2821.25,8
HCPCS,49525,REPAIR ING HERNIA SLIDING,,,3001.45,10789.0,23
HCPCS,49525,RPR INGUN HERNIA SLIDING ANY AGE,3572.0,2321.8,1.1,10089.06,144
HCPCS,49525,Repair ing hernia sliding,,,2436.53,2821.25,8
HCPCS,49540,REPAIR LUMBAR HERNIA,4296.0,2792.4,1.1,16829.38,164
HCPCS,49540,Repair lumbar hernia,,,3392.26,3927.88,8
HCPCS,49550,RPR 1ST FEM HRNA ANY AGE REDUCIBLE,3596.0,2337.4,1.1,10089.06,144
HCPCS,49550,RPR REM HERNIA INIT REDUCE,,,3001.45,3726.07,20
HCPCS,49550,Rpr rem hernia init reduce,,,2436.53,2821.25,8
HCPCS,49553,RPR 1ST FEM HERNIA ANY AGE INCARCERATED,3968.0,2579.2,1.1,10089.06,144
HCPCS,49553,RPR FEM HERNIA INIT BLOCKED,,,3001.45,3726.07,20
HCPCS,49553,Rpr fem hernia init blocked,,,2436.53,2821.25,8
HCPCS,49555,REREPAIR FEM HERNIA REDUCE,,,3001.45,3726.07,20
HCPCS,49555,RPR RECRT FEM HERNIA REDUCIBLE,3756.0,2441.4,1.1,10089.06,144
HCPCS,49555,Rerepair fem hernia reduce,,,2436.53,2821.25,8
HCPCS,49557,REREPAIR FEM HERNIA BLOCKED,,,3001.45,3726.07,20
HCPCS,49557,RPR RECRT FEM HRNA INCARCERATED,4648.0,3021.2,1.1,10089.06,144
HCPCS,49557,Rerepair fem hernia blocked,,,2436.53,2821.25,8
HCPCS,49560,Rpr ventral hern init reduc,,,3392.26,3927.88,8
HCPCS,49561,Rpr ventral hern init block,,,3392.26,3927.88,8
HCPCS,49565,Rerepair ventrl hern reduce,,,3392.26,3927.88,8
HCPCS,49566,Rerepair ventrl hern block,,,3392.26,3927.88,8
HCPCS,49568,Hernia repair w/mesh,,,3392.26,3927.88,8
HCPCS,49570,Rpr epigastric hern reduce,,,3392.26,3927.88,8
HCPCS,49572,Rpr epigastric hern blocked,,,3392.26,3927.88,8
HCPCS,49580,Rpr umbil hern reduc < 5 yr,,,2436.53,2821.25,8
HCPCS,49582,Rpr umbil hern block < 5 yr,,,2436.53,2821.25,8
HCPCS,49585,Rpr umbil hern reduc > 5 yr,,,2436.53,2821.25,8
HCPCS,49587,Rpr umbil hern block > 5 yr,,,2436.53,2821.25,8
HCPCS,49590,Repair spigelian hernia,,,3392.26,3927.88,8
HCPCS,49591,RPR AA HERNIA 1ST < 3 CM REDUCIBLE,2622.0,1704.3,1.1,10089.06,144
HCPCS,49591,RPR AA HRN 1ST < 3 CM RDC,,,3001.45,10789.0,25
HCPCS,49591,Rpr aa hrn 1st < 3 cm rdc,,,3392.26,3927.88,8
HCPCS,49592,RPR AA HERNIA 1ST < 3 CM NCRC8/STRANGULATED,3722.0,2419.3,1.1,16829.38,144
HCPCS,49592,RPR AA HRN 1ST < 3 NCR/STRN,,,5005.78,33436.0,24
HCPCS,49592,Rpr aa hrn 1st < 3 ncr/strn,,,3392.26,3927.88,8
HCPCS,49593,RPR AA HERNIA 1ST 3-10 CM REDUCIBLE,4514.0,2934.1,1.1,10089.06,144
HCPCS,49593,RPR AA HRN 1ST 3-10 RDC,,,3001.45,10789.0,24
HCPCS,49593,Rpr aa hrn 1st 3-10 rdc,,,3392.26,3927.88,8
HCPCS,49594,RPR AA HERNIA 1ST 3-10 CM NCRC8/STRANGULATED,5922.0,3849.3,1.1,16829.38,144
HCPCS,49594,RPR AA HRN 1ST 3-10 NCR/STRN,,,5005.78,33436.0,24
HCPCS,49594,Rpr aa hrn 1st 3-10 ncr/strn,,,3392.26,3927.88,8
HCPCS,49595,RPR AA HERNIA 1ST > 10 CM REDUCIBLE,6134.0,3987.1,1.1,10089.06,144
HCPCS,49595,RPR AA HRN 1ST > 10 RDC,,,3001.45,6737.21,20
HCPCS,49595,Rpr aa hrn 1st > 10 rdc,,,3392.26,3927.88,8
HCPCS,49596,RPR AA HERNIA 1ST > 10 CM NCRC8/STRANGULATED,8215.0,5339.75,1.1,8215.0,144
HCPCS,49596,RPR AA HRN 1ST > 10 NCR/STRN,,,2699.94,2699.94,1
HCPCS,49596,Rpr aa hrn 1st > 10 ncr/strn,,,3392.26,3927.88,8
HCPCS,49600,REPAIR UMBILICAL LESION,,,3001.45,3726.07,20
HCPCS,49600,RPR SMALL OMPHALOCELE W/PRIMARY CLOSURE,4620.0,3003.0,1.1,10089.06,144
HCPCS,49600,Repair umbilical lesion,,,3392.26,3927.88,8
HCPCS,49605,REPAIR UMBILICAL LESION,,,12928.5,12928.5,1
HCPCS,49605,RPR LG OMPHALOCELE/GASTROSCHISIS W/WO PROSTH,34836.0,22643.4,1.1,34836.0,144
HCPCS,49605,Repair umbilical lesion,,,3392.26,3927.88,8
HCPCS,49606,REPAIR UMBILICAL LESION,,,2992.27,2992.27,1
HCPCS,49606,RPR LG OMPHALOCELE/GASTROSCHISIS RMVL PROSTH,7600.0,4940.0,1.1,7600.0,144
HCPCS,49606,Repair umbilical lesion,,,3392.26,3927.88,8
HCPCS,49610,REPAIR UMBILICAL LESION,,,1830.81,1830.81,1
HCPCS,49610,Repair umbilical lesion,,,3392.26,3927.88,8
HCPCS,49611,REPAIR UMBILICAL LESION,,,1612.0,1612.0,1
HCPCS,49611,RPR OMPHALOCELE GROSS TYP OPRATION 2ND STG,3736.0,2428.4,1.1,3736.0,144
HCPCS,49611,Repair umbilical lesion,,,3392.26,3927.88,8
HCPCS,49613,RPR AA HERNIA RECR < 3 CM REDUCIBLE,2968.0,1929.2,1.1,10089.06,144
HCPCS,49613,RPR AA HRN RCR < 3 RDC,,,3001.45,7624.0,21
HCPCS,49613,Rpr aa hrn rcr < 3 rdc,,,3392.26,3927.88,8
HCPCS,49614,RPR AA HERNIA RECR < 3 CM NCRC8/STRANGULATED,4100.0,2665.0,1.1,16829.38,144
HCPCS,49614,RPR AA HRN RCR < 3 NCR/STRN,,,5005.78,6291.49,20
HCPCS,49614,Rpr aa hrn rcr < 3 ncr/strn,,,3392.26,3927.88,8
HCPCS,49615,RPR AA HERNIA RECR 3-10 CM REDUCIBLE,4584.0,2979.6,1.1,10089.06,144
HCPCS,49615,RPR AA HRN RCR 3-10 RDC,,,3001.45,7624.0,21
HCPCS,49615,Rpr aa hrn rcr 3-10 rdc,,,3392.26,3927.88,8
HCPCS,49616,RPR AA HERNIA RECR 3-10 CM NCRC8/STRANGULATED,6842.0,4447.3,1.1,6842.0,144
HCPCS,49616,RPR AA HRN RCR 3-10 NCR/STRN,,,2266.39,9457.0,2
HCPCS,49616,Rpr aa hrn rcr 3-10 ncr/strn,,,3392.26,3927.88,8
HCPCS,49617,RPR AA HERNIA RECR > 10 CM REDUCIBLE,6412.0,4167.8,1.1,6412.0,144
HCPCS,49617,RPR AA HRN RCR > 10 RDC,,,2334.07,2334.07,1
HCPCS,49617,Rpr aa hrn rcr > 10 rdc,,,3392.26,3927.88,8
HCPCS,49618,RPR AA HERNIA RECR > 10 CM NCRC8/STRANGULATED,9068.0,5894.2,1.1,9068.0,144
HCPCS,49618,RPR AA HRN RCR > 10 NCR/STRN,,,3272.35,3272.35,1
HCPCS,49618,Rpr aa hrn rcr > 10 ncr/strn,,,3392.26,3927.88,8
HCPCS,49621,RPR PARASTOMAL HERNIA 1ST/RECR REDUCIBLE,5480.0,3562.0,1.1,5480.0,144
HCPCS,49621,RPR PARASTOMAL HERNIA RDC,,,1956.36,1956.36,1
HCPCS,49621,Rpr parastomal hernia rdc,,,3392.26,3927.88,8
HCPCS,49622,RPR PARASTOMAL HRNA 1ST/RECR NCRC8/STRANGULATED,6824.0,4435.6,1.1,6824.0,144
HCPCS,49622,RPR PARASTOMAL HRNA NCR/STRN,,,2413.2,2413.2,1
HCPCS,49622,Rpr parastomal hrna ncr/strn,,,3392.26,3927.88,8
HCPCS,49623,RMVL NINFCT MESH HERNIA RPR,,,4132.0,4132.0,1
HCPCS,49623,RMVL NONINFCT MESH/PROSTH AA/PARASTOMAL HRNA RPR,1500.0,975.0,1.1,1500.0,144
HCPCS,49623,Rmvl ninfct mesh hernia rpr,,,3392.26,3927.88,8
HCPCS,49650,LAP ING HERNIA REPAIR INIT,,,5005.78,11441.0,24
HCPCS,49650,LAPAROSCOPY SURG RPR INITIAL INGUINAL HERNIA,2544.0,1653.6,1.1,16829.38,144
HCPCS,49650,Lap ing hernia repair init,,,2436.53,2821.25,8
HCPCS,49651,LAP ING HERNIA REPAIR RECUR,,,5005.78,25635.0,22
HCPCS,49651,LAPS SURG RPR RECURRENT INGUINAL HERNIA,3352.0,2178.8,1.1,16829.38,144
HCPCS,49651,Lap ing hernia repair recur,,,2436.53,2821.25,8
HCPCS,49652,Lap vent/abd hernia repair,,,3392.26,3927.88,8
HCPCS,49653,Lap vent/abd hern proc comp,,,3392.26,3927.88,8
HCPCS,49654,Lap inc hernia repair,,,3392.26,3927.88,8
HCPCS,49655,Lap inc hern repair comp,,,3392.26,3927.88,8
HCPCS,49656,Lap inc hernia repair recur,,,3392.26,3927.88,8
HCPCS,49657,Lap inc hern recur comp,,,3392.26,3927.88,8
HCPCS,49659,LAP INCAR INGUINAL HERNIA REPAIR,3413.0,2218.45,0.01,16829.38,84
HCPCS,49659,LAP REPAIR INITIAL FEMORAL HERNIA; INCAR OR STRANG (COMP CODE 49,3572.0,2321.8,0.01,16829.38,84
HCPCS,49659,LAP REPAIR OF ACUTE TRAUMATIC DIAPHRAGMATIC HERNIA (COMP 39540),6265.0,4072.25,0.01,16829.38,84
HCPCS,49659,LAP REPAIR OF FEMORAL HERNIA (COMP 49550),3827.0,2487.55,0.01,16829.38,84
HCPCS,49659,LAP. PERISTOMAL HERNIA REPAIR,5160.0,3354.0,0.01,16829.38,84
HCPCS,49659,LAP. REPAIR PARAESOPHAGEAL HERNIA,3696.0,2402.4,0.01,16829.38,84
HCPCS,49659,LAPAROSCOPIC CONGENITAL HERNIA REPAIR W/ MESH (COMP 43282),10837.0,7044.05,0.01,16829.38,84
HCPCS,49659,LAPAROSCOPIC REPAIR RECURRENT FEMORAL HERNIA (COMP CODE 49555),3381.0,2197.65,0.01,16829.38,84
HCPCS,49659,REPAIR INTERNAL HERNIA,6583.0,4278.95,0.01,16829.38,84
HCPCS,49659,"UNLISTED LAPAROSCOPY PROCEDURE, HERNIOPLASTY, HERNIORRHAPHY, HER",1680.0,1092.0,0.01,16829.38,84
HCPCS,49659,UNLISTED LAPS PX HRNAP HERNIORRHAPHY HERNIOTOMY,3264.0,2121.6,0.01,16829.38,84
HCPCS,49659,UNLSTD LAPS PX HRNAP HRNRPHY,,,5005.78,11441.0,21
HCPCS,49659,Unlstd laps px hrnap hrnrphy,,,3392.26,3927.88,8
HCPCS,49900,REPAIR OF ABDOMINAL WALL,,,2162.46,2162.46,1
HCPCS,49900,Repair of abdominal wall,,,2029.97,2350.49,8
HCPCS,49900,SEC ABDOMINAL WALL SUTURE EVISCERATION/DEHSN,4964.0,3226.6,1.1,4964.0,144
HCPCS,49904,OMENTAL FLAP EXTRA-ABDOM,,,3641.19,3641.19,1
HCPCS,49904,OMENTAL FLAP EXTRA-ABDOMINAL,8940.0,5811.0,1.1,8940.0,144
HCPCS,49904,Omental flap extra-abdom,,,2029.97,2350.49,8
HCPCS,49905,OMENTAL FLAP INTRA-ABDOM,,,924.5,924.5,1
HCPCS,49905,OMENTAL FLAP INTRA-ABDOMINAL,2616.0,1700.4,1.1,2616.0,144
HCPCS,49905,Omental flap intra-abdom,,,2029.97,2350.49,8
HCPCS,49906,FREE OMENTAL FLAP MICROVASC,,,813.48,813.48,1
HCPCS,49906,"FREE OMENTAL FLAP,MICROVASC ANAST",3043.0,1977.95,1.1,5241.27,88
HCPCS,49906,Free omental flap microvasc,,,2029.97,2350.49,8
HCPCS,49999,ABDOMEN SURGERY PROCEDURE,570.0,370.5,0.01,2644.7,84
HCPCS,49999,"ALLODER,PERMACOL, SURGISIS MESH",2556.0,1661.4,0.01,2644.7,84
HCPCS,49999,CORE NEEDLE BIOPSY ABDOMEN/PERITONEUM/OMENTUM AT TIME OF OTHER P,818.0,531.7,0.01,2644.7,84
HCPCS,49999,CRYOABLATION OF INTRA ABDOMINAL MASS (COMP CODE 50593),14601.5,9490.975,0.01,25651.0,168
HCPCS,49999,DRAINAGE SUBHEPATIC ABSCESS,8801.0,5720.65,0.01,8801.0,84
HCPCS,49999,EXPL OF GROIN WOUND W/ RELEASE OF SCAR FORMATION (COMP CODE 3584,7471.0,4856.15,0.01,7471.0,84
HCPCS,49999,INCISION FOR EXPLORATION ABDOMEN WOUND,813.0,528.45,0.01,2644.7,84
HCPCS,49999,LAP OMENTAL FLAP INTRA-ABDOMN,4005.0,2603.25,0.01,4005.0,84
HCPCS,49999,LYMPHO SCLEROSIS VIA CATH,1199.0,779.35,0.01,2644.7,84
HCPCS,49999,LYPHOCELE SCLEROSIS VIA CATH,606.0,393.9,0.01,3443.0,85
HCPCS,49999,MANUAL REDUCTION OF INGUINAL HERNIA (COMP CODE 49505),2866.0,1862.9,0.01,3443.0,85
HCPCS,49999,MESENTERIC OR OMENTUM BIOPSY (COMP 49000),3111.0,2022.15,0.01,3111.0,84
HCPCS,49999,OBTRUATOR HERNIA (COMP 49550),2967.0,1928.55,0.01,2967.0,84
HCPCS,49999,"OMENTAL FLAP, LAPARCOCOPIC (COMP CODE 49905)",2812.0,1827.8,0.01,2812.0,84
HCPCS,49999,PERCUTANEOUS CRYOABLATION ABDOMEN,8123.0,5279.95,461.87,8123.0,84
HCPCS,49999,PERCUTANEOUS CRYOABLATION ABDOMEN (COMP CODE 32994),3251.0,2113.15,0.01,3251.0,84
HCPCS,49999,PERITONEAL DIALYSIS CATHETER REVISION,7269.0,4724.85,461.87,7269.0,84
HCPCS,49999,PLCMT CLIP/WIRE SURG LOC ABD,4669.0,3034.85,461.87,6112.0,84
HCPCS,49999,PREOP WIRE LOCALIZATION INTRAPERITONEAL (COMP CODE 49411),3861.0,2509.65,0.01,6294.0,168
HCPCS,49999,RADIOFREQUENCY ABLATION INTRA ABDOMINAL MASS (COMP CODE 50592),14729.0,9573.85,0.01,26838.0,168
HCPCS,49999,"REMOVAL FOREIGN BODY, ABD WALL (COMP CODE 11008)",3152.0,2048.8,0.01,3152.0,84
HCPCS,49999,REPAIR HERNIA PERINEAL (COMP 44050),3934.0,2557.1,0.01,3934.0,84
HCPCS,49999,REPOSITION PERITONEAL DIALYSIS CATH (COMP CODE 36597),4708.0,3060.2000000000003,0.01,8932.0,168
HCPCS,49999,RMVL F.B. ABDOMEN DEEP,3152.0,2048.8,0.01,3152.0,84
HCPCS,49999,UNLISTED PROC OPEN DRAINAGE OF INTRA ABD FLUID (COMP CODE 49062),4888.0,3177.2,0.01,4888.0,84
HCPCS,49999,UNLISTED PROCEDURE ABD PERITONEUM,4669.0,3034.85,461.87,4669.0,84
HCPCS,49999,"UNLISTED PROCEDURE, ABDOMEN, PERITONEUM & OMENTUM COMPARED TO 44",5588.0,3632.2,0.01,5588.0,84
HCPCS,50010,RENAL EXPLORATION,,,1839.99,1839.99,1
HCPCS,50010,RNL EXPL X NECESSITATING OTH SPEC PX,4912.0,3192.8,1.1,4912.0,144
HCPCS,50010,Renal exploration,,,5673.89,6569.77,8
HCPCS,50020,"ABCESS DRAINAGE,RENAL/PERIRENA",7232.0,4700.8,1.1,7232.0,144
HCPCS,50020,DRG PERIRNL/RENAL ABSC OPEN,,,1767.05,5317.41,21
HCPCS,50020,Drg perirnl/renal absc open,,,5673.89,6569.77,8
HCPCS,50040,NEPHROSTOMY/NEPHROTOMY W/DRAINAGE,6672.0,4336.8,1.1,6672.0,144
HCPCS,50040,NFROS NFROT W/DRG,,,2410.46,2410.46,1
HCPCS,50040,Nfros nfrot w/drg,,,5673.89,6569.77,8
HCPCS,50045,NEPHROTOMY W/EXPLORATION,,,2428.13,2428.13,1
HCPCS,50045,Nephrotomy w/exploration,,,5673.89,6569.77,8
HCPCS,5005F,PT COUNSLD ON EXAM FOR MOLES,,,2739849.3,2739849.3,1
HCPCS,5005F,Pt counsld on exam for moles,,,10.69,12.38,8
HCPCS,50060,NEPHROLITHOTOMY REMOVAL STAGE 1,8380.0,5447.0,1.1,8380.0,144
HCPCS,50060,NL REMOVAL CALCULUS,,,2964.46,2964.46,1
HCPCS,50060,Nl removal calculus,,,5673.89,6569.77,8
HCPCS,50065,NEPHROLITHOTOMY SECONDARY FOR CALCULUS,8928.0,5803.2,1.1,8928.0,144
HCPCS,50065,NL SEC SURG OPERJ CALCULUS,,,3141.44,3141.44,1
HCPCS,50065,Nl sec surg operj calculus,,,5673.89,6569.77,8
HCPCS,50070,NL COMP CGEN KDN ABNORMALITY,,,3081.57,3081.57,1
HCPCS,50070,Nl comp cgen kdn abnormality,,,5673.89,6569.77,8
HCPCS,50075,NEPHROLITHOTOMY RMVL LG STAGHORN STAGE 1,10836.0,7043.4,1.1,10836.0,144
HCPCS,50075,NL RMVL LG STAGHORN CALCULUS,,,3787.56,3787.56,1
HCPCS,50075,Nl rmvl lg staghorn calculus,,,5673.89,6569.77,8
HCPCS,50080,PERQ NL/PL LITHOTRP SIMPLE UP TO 2 CM 1 LOCATION,5460.0,3549.0,1.1,26866.4,144
HCPCS,50080,PERQ NL/PL LITHOTRP SMPL<2CM,,,4616.0,24050.1,23
HCPCS,50080,Perq nl/pl lithotrp smpl<2cm,,,5673.89,6569.77,8
HCPCS,50081,PERQ NL/PL LITHOTRP COMPLEX >2 CM MLT LOCATIONS,9200.0,5980.0,1.1,26866.4,144
HCPCS,50081,PERQ NL/PL LITHOTRP CPLX>2CM,,,4616.0,24050.1,23
HCPCS,50081,Perq nl/pl lithotrp cplx>2cm,,,5673.89,6569.77,8
HCPCS,50100,TRNSXJ/REPOS ABRRNT RNL VSLS,,,2848.01,2848.01,1
HCPCS,50100,Trnsxj/repos abrrnt rnl vsls,,,5673.89,6569.77,8
HCPCS,5010F,MACUL RESULT PHY/QHP MNG DM,,,0.03,0.03,1
HCPCS,5010F,Macul result phy/qhp mng dm,,,10.69,12.38,8
HCPCS,50120,EXPLOR RENAL PELVIS,6884.0,4474.6,1.1,6884.0,144
HCPCS,50120,PYELOTOMY W/EXPLORATION,,,2472.66,2472.66,1
HCPCS,50120,Pyelotomy w/exploration,,,5673.89,6569.77,8
HCPCS,50125,PYELOTOMY W/DRAINAGE PYELOSTOMY,7128.0,4633.2,1.1,7128.0,144
HCPCS,50125,PYELOTOMY W/DRG PYELOSTOMY,,,2558.39,2558.39,1
HCPCS,50125,Pyelotomy w/drg pyelostomy,,,5673.89,6569.77,8
HCPCS,50130,PYELOTOMY W/REMOVAL CALCULUS,7528.0,4893.2,1.1,7528.0,145
HCPCS,50130,Pyelotomy w/removal calculus,,,2117.28,2451.59,8
HCPCS,50135,PYELOTOMY COMPLICATED,,,2915.96,2915.96,1
HCPCS,50135,Pyelotomy complicated,,,5673.89,6569.77,8
HCPCS,5015F,DOC FX & TEST/TXMNT FOR OP,,,2739849.3,2739849.3,1
HCPCS,5015F,Doc fx & test/txmnt for op,,,10.69,12.38,8
HCPCS,50200,RENAL BIOPSY PRQ TROCAR/NEEDLE,4250.0,2762.5,0.01,7453.0,322
HCPCS,50205,RENAL BIOPSY SURG EXPOSURE KIDNEY,4916.0,3195.4,1.1,4916.0,144
HCPCS,50205,RENAL BX SURG EXPOSURE KDN,,,1986.39,1986.39,1
HCPCS,50205,Renal bx surg exposure kdn,,,5673.89,6569.77,8
HCPCS,5020F,TXMNTS 2 PHYS/QHP BY 1 MON,,,2739849.3,2739849.3,1
HCPCS,5020F,Txmnts 2 phys/qhp by 1 mon,,,10.69,12.38,8
HCPCS,50220,NEPHRECTOMY W/PRTL URETERECTOMY W/OPEN RIB RESCJ,7472.0,4856.8,1.1,7472.0,144
HCPCS,50220,REMOVE KIDNEY OPEN,,,2748.17,2748.17,1
HCPCS,50220,Remove kidney open,,,5673.89,6569.77,8
HCPCS,50225,NEPHRECTOMY W/PRTL URETERECT OPN RIB RESCJ COMPL,8752.0,5688.8,1.1,8752.0,144
HCPCS,50225,REMOVAL KIDNEY OPEN COMPLEX,,,3159.25,3159.25,1
HCPCS,50225,Removal kidney open complex,,,5673.89,6569.77,8
HCPCS,50230,NEPHRECTOMY W/PRTL URETERECT OPEN RIB RESCJ RAD,9524.0,6190.6,1.1,9524.0,144
HCPCS,50230,REMOVAL KIDNEY OPEN RADICAL,,,3332.69,3332.69,1
HCPCS,50230,Removal kidney open radical,,,5673.89,6569.77,8
HCPCS,50234,NEPHRECTOMY W/TOT URETERECT&BLDR CUFF SAME INC,10582.0,6878.3,1.1,10582.0,144
HCPCS,50234,REMOVAL OF KIDNEY & URETER,,,3384.67,3384.67,1
HCPCS,50234,Removal of kidney & ureter,,,5673.89,6569.77,8
HCPCS,50236,NEPHRECTOMY TOT URETEREC&BLDR CUFF SEPAR INCISN,10776.0,7004.4,1.1,10776.0,144
HCPCS,50236,REMOVAL OF KIDNEY & URETER,,,3804.11,3804.11,1
HCPCS,50236,Removal of kidney & ureter,,,5673.89,6569.77,8
HCPCS,50240,NEPHRECTOMY PARTIAL,9684.0,6294.6,1.1,9684.0,145
HCPCS,50240,Nephrectomy partial,,,5673.89,6569.77,8
HCPCS,50250,OPEN ABLATION RENAL MASS CRYOSURG ULTRASOUND,8888.0,5777.2,1.1,8888.0,144
HCPCS,50250,OPN ABLTJ 1/> RNL MAS CRYSRG,,,3164.23,3164.23,1
HCPCS,50250,Opn abltj 1/> rnl mas crysrg,,,5673.89,6569.77,8
HCPCS,50280,EXC/UNROOFING CYST KIDNEY,,,2463.31,2463.31,1
HCPCS,50280,EXCIS/UNROOF RENAL CYST,6836.0,4443.4,1.1,6836.0,144
HCPCS,50280,Exc/unroofing cyst kidney,,,5673.89,6569.77,8
HCPCS,50290,EXCISION PERINEPHRIC CYST,6460.0,4199.0,1.1,6460.0,145
HCPCS,50290,Excision perinephric cyst,,,5673.89,6569.77,8
HCPCS,50300,REMOVE CADAVER DONOR KIDNEY,,,2013.9,2013.9,1
HCPCS,50300,Remove cadaver donor kidney,,,1791.93,2074.86,8
HCPCS,50320,"LIVING DONOR NEPHRECTOMY, OPEN",8972.0,5831.8,1.1,8972.0,142
HCPCS,50320,REMOVE KIDNEY LIVING DONOR,,,3997.93,3997.93,1
HCPCS,50320,Remove kidney living donor,,,1791.93,2074.86,8
HCPCS,50323,BKBENCH PREPJ CADAVER DONOR RENAL ALLOGRAFT,1136.0,738.4,1.1,1136.0,104
HCPCS,50323,PREP CADAVER RENAL ALLOGRAFT,,,554.69,554.69,1
HCPCS,50323,Prep cadaver renal allograft,,,1229.51,1423.64,8
HCPCS,50325,BKBENCH PREPJ LIVING RENAL DONOR ALLOGRAFT,1136.0,738.4,1.1,1136.0,104
HCPCS,50325,PREP DONOR RENAL GRAFT,,,554.69,554.69,1
HCPCS,50325,Prep donor renal graft,,,1229.51,1423.64,8
HCPCS,50327,BKBENCH RCNSTJ RENAL ALGRFT VENOUS ANAST EA,1760.0,1144.0,1.1,1760.0,142
HCPCS,50327,PREP RENAL GRAFT/VENOUS,,,567.29,567.29,1
HCPCS,50327,Prep renal graft/venous,,,1229.51,1423.64,8
HCPCS,50328,BKBENCH RCNSTJ RENAL ALLOGRAFT ARTERIAL ANAST EA,1400.0,910.0,1.1,1400.0,142
HCPCS,50328,PREP RENAL GRAFT/ARTERIAL,,,497.42,497.42,1
HCPCS,50328,Prep renal graft/arterial,,,1229.51,1423.64,8
HCPCS,50329,BKBENCH RCNSTJ ALGRFT URETERAL ANAST EA,1336.0,868.4,1.1,1336.0,142
HCPCS,50329,PREP RENAL GRAFT/URETERAL,,,470.95,470.95,1
HCPCS,50329,Prep renal graft/ureteral,,,1229.51,1423.64,8
HCPCS,50340,RECIPIENT NEPHRECTOMY,,,2522.72,2522.72,1
HCPCS,50340,RECIPIENT NEPHRECTOMY SEPARATE PROCEDURE,6178.0,4015.7,1.1,6178.0,144
HCPCS,50340,Recipient nephrectomy,,,5673.89,6569.77,8
HCPCS,50360,RENAL ALLOTRANSPLANTATION W/ GRAFT W/O RECIPIENT NEPHRECTOMY,17547.0,11405.55,1.1,17547.0,144
HCPCS,50360,RNL ALTRNSPLJ W/O RCP NFRCT,,,6402.06,6402.06,1
HCPCS,50360,Rnl altrnsplj w/o rcp nfrct,,,1791.93,2074.86,8
HCPCS,50365,"RENAL ALLOTRANSPLANTATION, IMPLANTATION OF GRAFT; WITH RECIPIENT",18452.0,11993.8,1.1,18452.0,144
HCPCS,50365,RNL ALTRNSPLJ W/RCP NFRCT,,,7626.49,7626.49,1
HCPCS,50365,Rnl altrnsplj w/rcp nfrct,,,1791.93,2074.86,8
HCPCS,50370,RMVL TRANSPLANTED RNL ALGRFT,,,3196.92,3196.92,1
HCPCS,50370,RMVL TRNSPLED RENAL ALLOGRAFT,7552.0,4908.8,1.1,7552.0,144
HCPCS,50370,Rmvl transplanted rnl algrft,,,5673.89,6569.77,8
HCPCS,50380,RENAL AUTOTRNSPLJ REIMPLANTATION KIDNEY,12044.0,7828.6,1.1,12044.0,144
HCPCS,50380,RNL AUTOTRNSPLJ RIMPLTJ KDN,,,5354.37,5354.37,1
HCPCS,50380,Rnl autotrnsplj rimpltj kdn,,,1791.93,2074.86,8
HCPCS,50382,RMV/RPLC INDW URET BI-S,9423.0,6124.95,0.01,9423.0,87
HCPCS,50382,RMVL & RPLCMT INTLY DWELLING URETERAL STENT PRQ,5761.5,3744.975,1.1,9423.0,234
HCPCS,50384,REMOVAL INDWELLING URETERAL STENT PRQ,5661.5,3679.975,1.1,9423.0,234
HCPCS,50384,RMV ONLY INDW URET BI-S,9423.0,6124.95,0.01,9423.0,87
HCPCS,50385,CHANGE STENT VIA TRANSURETH,,,1767.05,2175.43,20
HCPCS,50385,Change stent via transureth,,,1004.31,1162.89,8
HCPCS,50385,REMOVE & REPLACE INDWELL URETERAL STENT TRURTHRL,1676.0,1089.4,1.1,5941.4,148
HCPCS,50386,REMOVE INT DWELL URETERAL STENT TRANSURETHRAL,5321.5,3458.975,1.1,9423.0,235
HCPCS,50387,RMVL & RPLCMT XTRNL ACCESSIBLE NEPHROURTRL CATH,5061.5,3289.975,0.01,9423.0,321
HCPCS,50389,RMVL NFROS TUBE REQ FLUORO GUIDANCE,1777.0,1155.05,0.01,4628.0,321
HCPCS,50390,ASPIR &/NJX RENAL CYST/PELVIS NEEDLE PRQ,2010.5,1306.825,0.01,4628.0,318
HCPCS,50391,INSTLJ THER AGENT RENAL PELVIS&/URETER VIA TUB,951.5,618.475,0.01,3443.0,235
HCPCS,50391,JELMYTO INSTILLATION W/O NEPHROSTOGRAM/URETEROGRAM,784.0,509.6,1.1,784.0,148
HCPCS,50396,MANOMETRIC STDS THRU TUBE/NDWELLG URTRL CATH,836.0,543.4,1.1,1992.71,144
HCPCS,50396,MEASURE KIDNEY PRESSURE,,,592.63,725.67,20
HCPCS,50396,Measure kidney pressure,,,284.76,329.73,8
HCPCS,50400,PYELOPLASTY SIMPLE,9359.0,6083.35,1.1,9359.0,144
HCPCS,50400,REVISION OF KIDNEY/URETER,,,3005.86,3005.86,1
HCPCS,50400,Revision of kidney/ureter,,,5673.89,6569.77,8
HCPCS,50405,PYELOPLASTY COMPLICATED,11378.0,7395.7,1.1,11378.0,144
HCPCS,50405,REVISION OF KIDNEY/URETER,,,3627.32,3627.32,1
HCPCS,50405,Revision of kidney/ureter,,,5673.89,6569.77,8
HCPCS,50430,JELMYTO INSTILLATION VIA NEPHROSTOGRAM/URETEROGRAM,1160.0,754.0,1.1,2124.29,148
HCPCS,50430,NJX PX ANTEGRDE NFROSGRM &/URTRGRM NEW ACCESS,2115.0,1374.75,0.01,5597.0,407
HCPCS,50431,"JELMYTO INSTILLATION , ANTEGRADE VIA EXISTING ACCESS",440.0,286.0,1.1,1992.71,148
HCPCS,50431,NJX PX ANTEGRDE NFROSGRM &/URTRGRM EXSTNG ACESS,1755.0,1140.75,0.01,5597.0,407
HCPCS,50432,PLMT NEPHROSTOMY CATH PRQ NEW ACCESS RS&I,5511.5,3582.475,0.01,11545.0,322
HCPCS,50433,PLMT NEPHROURETERAL CATH PRQ NEW ACCESS RS&I,8942.5,5812.625,1.1,15865.0,235
HCPCS,50434,CONVERT NEPHROSTOMY CATH TO NEPHROURTRL CATH PRQ,5461.5,3549.975,1.1,9423.0,235
HCPCS,50435,EXCHANGE NEPHROSTOMY CATHETER PRQ W/IMG GID RS&I,5112.0,3322.7999999999997,0.01,9423.0,496
HCPCS,50436,PERQ DILATION XST TRC ENDOUROLOGIC PX W/IMG,8488.5,5517.525,1.1,15865.0,318
HCPCS,50437,PERQ DILATION XST TRC NEW ACCESS RENAL COLTJ SYS,8902.5,5786.625,1.1,15865.0,318
HCPCS,50500,NEPHRORRHAPHY SUTURE KIDNEY WOUND/INJURY,8488.0,5517.2,1.1,8488.0,144
HCPCS,50500,REPAIR OF KIDNEY WOUND,,,3391.6,3391.6,1
HCPCS,50500,Repair of kidney wound,,,5673.89,6569.77,8
HCPCS,5050F,PLAN 2 MAIN DR BY 1 MONTH,,,0.03,0.03,1
HCPCS,5050F,Plan 2 main dr by 1 month,,,10.69,12.38,8
HCPCS,50520,CLOSE KIDNEY-SKIN FISTULA,,,3053.92,3053.92,1
HCPCS,50520,CLOSURE NEPHROCUTANEOUS/PYELOCUTANEOUS FISTULA,7552.0,4908.8,1.1,7552.0,144
HCPCS,50520,Close kidney-skin fistula,,,2117.28,2451.59,8
HCPCS,50525,CLOSE NEPHROVISCERAL FISTULA,,,3872.88,3872.88,1
HCPCS,50525,CLSR NEPHROVISCERAL FISTULA W/VISC RPR ABDL APPR,9756.0,6341.4,1.1,9756.0,144
HCPCS,50525,Close nephrovisceral fistula,,,5673.89,6569.77,8
HCPCS,50526,CLOSE NEPHROVISCERAL FISTULA,,,4147.76,4147.76,1
HCPCS,50526,Close nephrovisceral fistula,,,5673.89,6569.77,8
HCPCS,50540,REVISION OF HORSESHOE KIDNEY,,,2983.86,2983.86,1
HCPCS,50540,Revision of horseshoe kidney,,,5673.89,6569.77,8
HCPCS,50540,SYMPHYSIOTOMY HORSESHOE KDN W/WO PLOP UNI/BI,8440.0,5486.0,1.1,8440.0,144
HCPCS,50541,LAPARO ABLATE RENAL CYST,,,8930.36,26873.26,21
HCPCS,50541,LAPAROSCOPY SURG ABLATION RENAL CYSTS,6744.0,4383.6,1.1,30022.29,144
HCPCS,50541,Laparo ablate renal cyst,,,2117.28,2451.59,8
HCPCS,50542,LAPARO ABLATE RENAL MASS,,,8930.36,26873.26,21
HCPCS,50542,LAPS ABLTJ RENAL MASS LESION W/INTRAOP US,8544.0,5553.6,1.1,30022.29,144
HCPCS,50542,Laparo ablate renal mass,,,5673.89,6569.77,8
HCPCS,50543,LAPARO PARTIAL NEPHRECTOMY,,,4616.0,26873.26,22
HCPCS,50543,LAPAROSC PARTIAL NEPHRECTOMY,10964.0,7126.6,1.1,30022.29,144
HCPCS,50543,Laparo partial nephrectomy,,,5673.89,6569.77,8
HCPCS,50544,LAPAROSCOPY PYELOPLASTY,,,4616.0,26873.26,23
HCPCS,50544,"LAPAROSCOPY, SURGICAL; PYELOPLASTY",9348.0,6076.2,1.1,30022.29,144
HCPCS,50544,Laparoscopy pyeloplasty,,,5673.89,6569.77,8
HCPCS,50545,LAPARO RADICAL NEPHRECTOMY,,,3471.63,11441.0,2
HCPCS,50545,LAPAROSCOPY RADICAL NEPHRECTOMY,10024.0,6515.6,1.1,10024.0,144
HCPCS,50545,Laparo radical nephrectomy,,,5673.89,6569.77,8
HCPCS,50546,LAPAROSCOPIC NEPHRECTOMY,,,3133.38,3133.38,1
HCPCS,50546,LAPAROSCOPY NEPHRECTOMY W/PARTIAL URETERECT,8748.0,5686.2,1.1,8748.0,144
HCPCS,50546,Laparoscopic nephrectomy,,,5673.89,6569.77,8
HCPCS,50547,LAPARO REMOVAL DONOR KIDNEY,,,4257.44,4257.44,1
HCPCS,50547,LAPAROSCOPY DONOR NEPHRECTOMY LIVING DONOR,10536.0,6848.4,1.1,10536.0,142
HCPCS,50547,Laparo removal donor kidney,,,5673.89,6569.77,8
HCPCS,50548,LAPARO REMOVE W/URETER,,,3491.64,3491.64,1
HCPCS,50548,LAPAROSCOPY NEPHRECTOMY W/TOTAL URETERECTOMY,10144.0,6593.6,1.1,10144.0,144
HCPCS,50548,Laparo remove w/ureter,,,5673.89,6569.77,8
HCPCS,50549,LAP RENAL AUTOTXP REIMPL,12047.0,7830.55,0.01,16829.38,84
HCPCS,50549,"LAPAROSCOPE PROC, RENAL (COMP CODE 50365)",18452.0,11993.8,0.01,18452.0,84
HCPCS,50549,"LAPAROSCOPE PROC, URETER",7553.0,4909.45,0.01,16829.38,84
HCPCS,50549,LAPAROSCOPIC CALICEAL DIVERTICULECTOMY,7520.0,4888.0,0.01,16829.38,84
HCPCS,50549,LAPAROSCOPIC PYELOLITHOTOMY (COMP 50130),7689.0,4997.85,0.01,16829.38,84
HCPCS,50549,LAPAROSCOPIC RENAL AUTOTRANSPLANTATION (COMP CODE 50380),10840.0,7046.0,0.01,16829.38,84
HCPCS,50549,LAPAROSCOPIC RENAL CYST EXCISION (COMP CODE 50280),6836.0,4443.4,0.01,16829.38,84
HCPCS,50549,LAPAROSCOPIC URETEROLYSIS,7553.0,4909.45,0.01,16829.38,84
HCPCS,50549,LAPAROSCOPIC URETEROPLASTY (COMP CODE 50700),6009.0,3905.85,0.01,16829.38,84
HCPCS,50549,LX ILEAL CONDUIT,7553.0,4909.45,0.01,16829.38,84
HCPCS,50549,LX REMOVAL URETER W/ PART BLADDER CUFF,7553.0,4909.45,0.01,16829.38,84
HCPCS,50549,LX URETEROURETEROSTOMY,7553.0,4909.45,0.01,16829.38,84
HCPCS,50549,"UNLISTED LAPAROSCOPY PROCEDURE, RENAL (COMP CODE 50234)",10341.0,6721.65,0.01,16829.38,84
HCPCS,50549,UNLISTED LAPS PX RENAL,,,5005.78,15063.4,22
HCPCS,50549,Unlisted laps px renal,,,1004.31,1162.89,8
HCPCS,50551,KIDNEY ENDOSCOPY,,,4489.04,5579.94,20
HCPCS,50551,Kidney endoscopy,,,2117.28,2451.59,8
HCPCS,50551,RENAL ENDOSCOPY NEPHROSTOMY W/WO IRRIGATION,2236.0,1453.4,1.1,15090.73,148
HCPCS,50553,KIDNEY ENDOSCOPY,,,4489.04,5579.94,20
HCPCS,50553,Kidney endoscopy,,,2117.28,2451.59,8
HCPCS,50553,RENAL NDSC NEPHROST W/URETERAL CATH W/WO DILA,2392.0,1554.8,1.1,15090.73,148
HCPCS,50555,KIDNEY ENDOSCOPY & BIOPSY,,,7992.18,9851.6,20
HCPCS,50555,Kidney endoscopy & biopsy,,,2117.28,2451.59,8
HCPCS,50555,RENAL NDSC NEPHROS/PYELOSTOMY BIOPSY,2608.0,1695.2,1.1,26866.4,148
HCPCS,50557,KIDNEY ENDOSCOPY & TREATMENT,,,7992.18,9851.6,20
HCPCS,50557,Kidney endoscopy & treatment,,,2117.28,2451.59,8
HCPCS,50557,RENAL NDSC NEPHROS/PYELOSTOMY FULG&/INC W/WO BI,2644.0,1718.6,1.1,26866.4,148
HCPCS,50561,KIDNEY ENDOSCOPY & TREATMENT,,,4489.04,5579.94,20
HCPCS,50561,Kidney endoscopy & treatment,,,2117.28,2451.59,8
HCPCS,50561,RENAL NDSC NEPHROS/PYELOSTOMY RMVL FB/CALCULUS,3032.0,1970.8,1.1,15090.73,148
HCPCS,50562,RENAL NDSC NEPHROS/PYELOSTOMY RESCJ TUMOR,4360.0,2834.0,1.1,26866.4,144
HCPCS,50562,RENAL SCOPE W/TUMOR RESECT,,,7992.18,24050.1,21
HCPCS,50562,Renal scope w/tumor resect,,,2117.28,2451.59,8
HCPCS,50570,KIDNEY ENDOSCOPY,,,3024.43,9101.13,21
HCPCS,50570,Kidney endoscopy,,,2117.28,2451.59,8
HCPCS,50570,RENAL NDSC NEPHROTOMY W/WO IRRIGATION,3812.0,2477.8,1.1,10168.64,144
HCPCS,50572,KIDNEY ENDOSCOPY,,,592.63,1783.36,21
HCPCS,50572,Kidney endoscopy,,,1004.31,1162.89,8
HCPCS,50572,RNL NDSC NFROT W/URTRL CATHJ W/WO DILAT URETER,4132.0,2685.8,1.1,4132.0,144
HCPCS,50574,KIDNEY ENDOSCOPY & BIOPSY,,,3024.43,9101.13,21
HCPCS,50574,Kidney endoscopy & biopsy,,,2117.28,2451.59,8
HCPCS,50574,RENAL NDSC NEPHROTOMY W/BIOPSY,4400.0,2860.0,1.1,10168.64,144
HCPCS,50575,KIDNEY ENDOSCOPY,,,4489.04,13508.42,21
HCPCS,50575,Kidney endoscopy,,,2117.28,2451.59,8
HCPCS,50575,RNL NDSC NFROT/PLOT W/ENDOPYELOTOMY,5584.0,3629.6,1.1,15090.73,144
HCPCS,50576,KIDNEY ENDOSCOPY & TREATMENT,,,7992.18,24050.1,21
HCPCS,50576,Kidney endoscopy & treatment,,,2117.28,2451.59,8
HCPCS,50576,RNL NDSC NFROT FULGURATION &/INCISION W/WO BX,4388.0,2852.2,1.1,26866.4,144
HCPCS,50580,KIDNEY ENDOSCOPY & TREATMENT,,,4489.04,13508.42,21
HCPCS,50580,Kidney endoscopy & treatment,,,2117.28,2451.59,8
HCPCS,50580,RNL NDSC NFROT/PLOT W/RMVL FB/CALCULUS,4736.0,3078.4,1.1,15090.73,144
HCPCS,50590,LITHOTRIPSY,17957.0,11672.05,1.1,17957.0,148
HCPCS,50590,LITHOTRIPSY XTRCORP SHOCK WAVE,9886.5,6426.225,0.01,25635.0,322
HCPCS,50592,ABLTJ 1/> RENAL TUMOR PRQ UNI RADIOFREQUENCY,14729.0,9573.85,0.01,26838.0,321
HCPCS,50593,ABLATION RENAL TUMOR UNILATERAL PERQ CRYOTHERAPY,14601.5,9490.975,0.01,30022.29,409
HCPCS,50600,EXPLORATION OF URETER,,,2441.18,10423.75,8
HCPCS,50600,Exploration of ureter,,,2117.28,2451.59,8
HCPCS,50600,URTROTOMY W/EXPL/DRG SEPARATE PROCEDURE,6868.0,4464.2,1.1,6868.0,144
HCPCS,50605,Insert ureteral support,,,2117.28,2451.59,8
HCPCS,50605,URETEROTOMY INSERTION INDWELLING STENT ALL TYPES,6716.0,4365.4,1.1,6716.0,144
HCPCS,50606,ENDOLUMINAL BX URTR &/RNL PELVIS NONENDOSCOPIC,934.0,607.1,1.1,6569.77,216
HCPCS,5060F,FNDNGS MAMMO 2PT W/IN 3 DAYS,,,2739849.3,2739849.3,1
HCPCS,5060F,Fndngs mammo 2pt w/in 3 days,,,10.69,12.38,8
HCPCS,50610,REMOVAL OF URETER STONE,,,2458.27,2458.27,1
HCPCS,50610,Removal of ureter stone,,,2117.28,2451.59,8
HCPCS,50610,URTROLITHOTOMY UPPER ONE-THIRD URETER,6900.0,4485.0,1.1,6900.0,144
HCPCS,50620,REMOVAL OF URETER STONE,,,2351.74,2351.74,1
HCPCS,50620,Removal of ureter stone,,,2117.28,2451.59,8
HCPCS,50620,URTROLITHOTOMY MIDDLE ONE-THIRD URETER,6572.0,4271.8,1.1,6572.0,144
HCPCS,5062F,MAMMO RESULT COM TO PT 5 DAY,,,2739849.3,2739849.3,1
HCPCS,5062F,Mammo result com to pt 5 day,,,10.69,12.38,8
HCPCS,50630,REMOVAL OF URETER STONE,,,2324.53,2324.53,1
HCPCS,50630,Removal of ureter stone,,,2117.28,2451.59,8
HCPCS,50630,URTROLITHOTOMY LOWER ONE-THIRD URETER,6484.0,4214.6,1.1,6484.0,144
HCPCS,50650,REMOVAL OF URETER,,,2706.65,2706.65,1
HCPCS,50650,Removal of ureter,,,2832.26,3279.46,8
HCPCS,50650,URETRECECTOMY W/BLADDER CUFF SEPARATE PROCEDURE,8281.0,5382.65,1.1,8281.0,144
HCPCS,50660,REMOVAL OF URETER,,,2974.11,2974.11,1
HCPCS,50660,Removal of ureter,,,5673.89,6569.77,8
HCPCS,50660,URETERECTOMY TOT ECTOPIC URETER CMBN APPR,8408.0,5465.2,1.1,8408.0,144
HCPCS,50684,INJ PX URETEROGRAPHY/URETEROPYLOGRAPHY CATH,415.0,269.75,1.1,4628.0,216
HCPCS,50686,MEASURE URETER PRESSURE,,,121.73,407.79,21
HCPCS,50686,Measure ureter pressure,,,49.68,57.52,8
HCPCS,50688,CHNG URTROST TUBE/XTRNLLY ACCESSIBLE STENT ILEAL,4951.5,3218.475,0.01,9423.0,318
HCPCS,50690,NJX VISUALIZATION ILEAL CONDUIT&/URETEROPYELOG,731.5,475.475,0.01,4628.0,284
HCPCS,50693,PLMT URTRL STENT PRQ PRE-EXISTING NFROS TRACT,8724.5,5670.925,0.01,15865.0,322
HCPCS,50694,PLMT URTRL STNT PRQ NEW ACESS W/O SEP NFROS CATH,8982.5,5838.625,0.01,15865.0,322
HCPCS,50695,PLMT URTRL STENT PRQ NEW ACCESS W/SEP NFROS CATH,9292.5,6040.125,0.01,15865.0,322
HCPCS,50700,REVISION OF URETER,,,2412.27,2412.27,1
HCPCS,50700,Revision of ureter,,,5673.89,6569.77,8
HCPCS,50700,URETEROPLASTY PLASTIC OPERATION URETER,6676.0,4339.4,1.1,6676.0,144
HCPCS,50705,URETERAL EMBOLIZATION/OCCLUSION W/IMG GID RS&I,1108.0,720.2,1.1,6569.77,216
HCPCS,50706,BALLOON DILAT URETERAL STRICTURE W/IMG GID RS&I,1413.0,918.45,1.1,6569.77,216
HCPCS,50715,RELEASE OF URETER,,,3161.03,3161.03,1
HCPCS,50715,Release of ureter,,,2117.28,2451.59,8
HCPCS,50715,URETEROLYSIS W/WORPSG URETER RETROPERIT FIBROSIS,8256.0,5366.4,1.1,8256.0,144
HCPCS,50722,RELEASE OF URETER,,,2680.02,2680.02,1
HCPCS,50722,Release of ureter,,,2117.28,2451.59,8
HCPCS,50725,RELEASE/REVISE URETER,,,2866.64,2866.64,1
HCPCS,50725,Release/revise ureter,,,5673.89,6569.77,8
HCPCS,50725,URTROLSS RETROCAVAL URTR W/REANAST,8080.0,5252.0,1.1,8080.0,144
HCPCS,50727,REVISE URETER,,,3024.43,9101.13,21
HCPCS,50727,REVJ URINARY-CUTANEOUS ANASTAMOSIS,3312.0,2152.8,1.1,10168.64,144
HCPCS,50727,Revise ureter,,,1066.44,1234.83,8
HCPCS,50728,REVISE URETER,,,1826.7,1826.7,1
HCPCS,50728,REVJ UR-CUTAN ANAST RPR FSCAL DFCT & HERNIA,4872.0,3166.8,1.1,4872.0,144
HCPCS,50728,Revise ureter,,,2832.26,3279.46,8
HCPCS,50740,FUSION OF URETER & KIDNEY,,,3227.23,3227.23,1
HCPCS,50740,Fusion of ureter & kidney,,,5673.89,6569.77,8
HCPCS,50740,URETEROPYELOSTOMY ANAST URETER RENAL PELVIS,8028.0,5218.2,1.1,8028.0,144
HCPCS,50750,FUSION OF URETER & KIDNEY,,,2999.64,2999.64,1
HCPCS,50750,Fusion of ureter & kidney,,,5673.89,6569.77,8
HCPCS,50750,URETEROCALYCOSTOMY ANAST URETER RENAL CALYX,8488.0,5517.2,1.1,8488.0,144
HCPCS,50760,URETEROURETEROSTOMY,8028.0,5218.2,1.1,8028.0,145
HCPCS,50760,Ureteroureterostomy,,,5673.89,6569.77,8
HCPCS,50770,SPLICING OF URETERS,,,2999.64,2999.64,1
HCPCS,50770,Splicing of ureters,,,5673.89,6569.77,8
HCPCS,50770,TRANSURETEROURETEROSTOMY ANAST URETER CLAT URTR,8488.0,5517.2,1.1,8488.0,144
HCPCS,50780,URETERONEOCYSTOSTOMY ANAST 1 URETER BLADDER,7817.5,5081.375,1.1,12615.0,212
HCPCS,50782,REIMPLANT URETER IN BLADDER,,,2796.2,2796.2,1
HCPCS,50782,Reimplant ureter in bladder,,,5673.89,6569.77,8
HCPCS,50782,URETERONEOCYSTOSTOMY ANAST DUPLICATE URETER BLDR,7864.0,5111.6,1.1,7864.0,144
HCPCS,50783,REIMPLANT URETER IN BLADDER,,,2931.88,2931.88,1
HCPCS,50783,Reimplant ureter in bladder,,,5673.89,6569.77,8
HCPCS,50783,URETERONEOCYSTOSTOMY W/URETERAL TAILORING,8280.0,5382.0,1.1,8280.0,144
HCPCS,50785,REIMPLANT URETER IN BLADDER,,,3156.37,3156.37,1
HCPCS,50785,Reimplant ureter in bladder,,,2832.26,3279.46,8
HCPCS,50785,URTRONEOCSTOST W/VESICO-PSOAS HITCH/BLDR FLAP,8892.0,5779.8,1.1,8892.0,144
HCPCS,50800,IMPLANT URETER IN BOWEL,,,2401.42,2401.42,1
HCPCS,50800,Implant ureter in bowel,,,5673.89,6569.77,8
HCPCS,50800,URETEROENTEROSTOMY ANAST URETER INTESTINE,7220.0,4693.0,1.1,7220.0,144
HCPCS,50810,FUSION OF URETER & BOWEL,,,3699.96,3699.96,1
HCPCS,50810,Fusion of ureter & bowel,,,5673.89,6569.77,8
HCPCS,50810,URETEROSIGMOIDOSTOMY W/SIGMOID BLADDER & COLOSTO,9044.0,5878.6,1.1,9044.0,144
HCPCS,50815,URETEROCOLON CONDUIT INTESTINE ANASTOMOSIS,8904.0,5787.6,1.1,8904.0,144
HCPCS,50815,URINE SHUNT TO INTESTINE,,,3185.8,3185.8,1
HCPCS,50815,Urine shunt to intestine,,,5673.89,6569.77,8
HCPCS,50820,CONSTRUCT BOWEL BLADDER,,,3416.1,3416.1,1
HCPCS,50820,Construct bowel bladder,,,2832.26,3279.46,8
HCPCS,50820,URETEROILEAL CONDUIT W/INTESTINE ANASTOMOSIS,9628.0,6258.2,1.1,9628.0,144
HCPCS,50825,CONSTRUCT BOWEL BLADDER,,,4278.62,4278.62,1
HCPCS,50825,CONTINENT DVRJ W/INT ANAST ANY SGM SM&/LG INTSTN,12272.0,7976.8,1.1,12272.0,144
HCPCS,50825,Construct bowel bladder,,,2832.26,3279.46,8
HCPCS,50830,REVISE URINE FLOW,,,4679.34,4679.34,1
HCPCS,50830,Revise urine flow,,,5673.89,6569.77,8
HCPCS,50830,URINARY UN-DIVERSION,13508.0,8780.2,1.1,13508.0,144
HCPCS,50840,REPLACE URETER BY BOWEL,,,3202.48,3202.48,1
HCPCS,50840,RPLCMT ALL/PART URETER INTESTINE SGM W/ANAST,8956.0,5821.4,1.1,8956.0,144
HCPCS,50840,Replace ureter by bowel,,,5673.89,6569.77,8
HCPCS,50845,APPENDICO-VESICOSTOMY,,,3263.64,3263.64,1
HCPCS,50845,Appendico-vesicostomy,,,2832.26,3279.46,8
HCPCS,50845,CUTANANEOUS APPENDICO-VESICOSTOMY,8984.0,5839.6,1.1,8984.0,144
HCPCS,50860,TRANSPLANT URETER TO SKIN,,,2462.41,2462.41,1
HCPCS,50860,Transplant ureter to skin,,,5673.89,6569.77,8
HCPCS,50860,URETEROSTOMY TRANSPLANTATION URETER SKIN,6832.0,4440.8,1.1,6832.0,144
HCPCS,50900,REPAIR OF URETER,,,2196.44,2196.44,1
HCPCS,50900,Repair of ureter,,,2117.28,2451.59,8
HCPCS,50900,URETERORRHAPHY SUTURE URETER SEPARATE PROCEDURE,6016.0,3910.4,1.1,6016.0,144
HCPCS,50920,CLOSURE URETER/SKIN FISTULA,,,2296.86,2296.86,1
HCPCS,50920,CLOSURE URETEROCUTANEOUS FISTULA,6324.0,4110.6,1.1,6324.0,144
HCPCS,50920,Closure ureter/skin fistula,,,2117.28,2451.59,8
HCPCS,50930,CLOSURE URETER/BOWEL FISTULA,,,2864.01,2864.01,1
HCPCS,50930,CLOSURE URETEROCUTANEOUS FISTULA W/VISC RPR,8076.0,5249.4,1.1,8076.0,144
HCPCS,50930,Closure ureter/bowel fistula,,,2832.26,3279.46,8
HCPCS,50940,DELIGATION OF URETER,6372.0,4141.8,1.1,6372.0,144
HCPCS,50940,RELEASE OF URETER,,,2311.82,2311.82,1
HCPCS,50940,Release of ureter,,,2117.28,2451.59,8
HCPCS,50945,LAPAROSCOPY URETEROLITHOTOMY,,,5005.78,15063.4,21
HCPCS,50945,"LAPAROSCOPY, SURGICAL, URETEROLITHO",7188.0,4672.2,1.1,16829.38,144
HCPCS,50945,Laparoscopy ureterolithotomy,,,2117.28,2451.59,8
HCPCS,50947,LAPARO NEW URETER/BLADDER,,,8930.36,11062.31,20
HCPCS,50947,LAPS URTRONEOCSTOST W/CSTSC&URTRL STENT PLMT,11343.0,7372.95,1.1,30022.29,144
HCPCS,50947,Laparo new ureter/bladder,,,5673.89,6569.77,8
HCPCS,50948,LAPARO NEW URETER/BLADDER,,,8930.36,11062.31,20
HCPCS,50948,LAPS URTRONEOCSTOST W/O CSTSC&URTRL STENT PLMT,10481.0,6812.65,1.1,30022.29,144
HCPCS,50948,Laparo new ureter/bladder,,,2117.28,2451.59,8
HCPCS,50949,LAP ILEAL CONDUIT (COMP 50820),7553.0,4909.45,0.01,16829.38,84
HCPCS,50949,LAP URETEROURETEROSTOMY (COMP 50760),7553.0,4909.45,0.01,16829.38,84
HCPCS,50949,LAPAROSCOPIC DISSECTION'S OF THE URETER AND REIMPLANTATION INTO,9558.0,6212.7,0.01,16829.38,84
HCPCS,50949,LAPAROSCOPIC URETERECTOMY WITH BLADDER CUFF (COMP CODE 50650),8093.0,5260.45,0.01,16829.38,84
HCPCS,50949,LAPAROSCOPIC URETEROCALICOSTOMY (COMP CODE 50750),8488.0,5517.2,0.01,16829.38,84
HCPCS,50949,LAPAROSCOPIC URETEROLYSIS (COMP 50715),7431.0,4830.15,0.01,16829.38,84
HCPCS,50949,LAPAROSCOPIC URINARY UNDIVERSION (COMP 50830),13848.0,9001.2,0.01,16829.38,84
HCPCS,50949,UNLISTED LAPAROSCOPY PROCEDURE URETER,8308.0,5400.2,0.01,16829.38,84
HCPCS,50949,UNLISTED LAPS PX URETER,,,5005.78,15063.4,21
HCPCS,50949,Unlisted laps px ureter,,,1004.31,1162.89,8
HCPCS,50951,ENDOSCOPY OF URETER,,,3024.43,3668.39,20
HCPCS,50951,Endoscopy of ureter,,,1004.31,1162.89,8
HCPCS,50951,URETERAL ENDOSCOPY VIA URETEROSTOMY,2332.0,1515.8,1.1,10168.64,148
HCPCS,50953,ENDOSCOPY OF URETER,,,3024.43,3668.39,20
HCPCS,50953,Endoscopy of ureter,,,1004.31,1162.89,8
HCPCS,50953,URETERAL ENDOSCOPY VIA URETEROST W/WO DIL URETER,2492.0,1619.8,1.1,10168.64,148
HCPCS,50955,URETER ENDOSCOPY & BIOPSY,,,4489.04,5579.94,20
HCPCS,50955,URETERAL ENDOSCOPY VIA URETEROSTOMY W/BIOPSY,2696.0,1752.4,1.1,15090.73,148
HCPCS,50955,Ureter endoscopy & biopsy,,,2117.28,2451.59,8
HCPCS,50957,URETER ENDOSCOPY & TREATMENT,,,4489.04,5579.94,20
HCPCS,50957,URETERAL ENDOSCOPY W/DEST&/INC W/WO BIOPSY,2712.0,1762.8,1.1,15090.73,148
HCPCS,50957,Ureter endoscopy & treatment,,,2117.28,2451.59,8
HCPCS,50961,URETERAL ENDOSCOPY VIA URETEROST W/RMVL FB/STONE,12900.5,8385.325,0.01,23385.0,235
HCPCS,50970,URETER ENDOSCOPY,,,3024.43,3668.39,20
HCPCS,50970,URETERAL ENDOSCOPY VIA URETEROTOMY W/O IMAGING,2852.0,1853.8,1.1,10168.64,144
HCPCS,50970,Ureter endoscopy,,,1004.31,1162.89,8
HCPCS,50972,NDSC URETEROTOMY URTRL CATHJ W/WO DILAT URETER,2752.0,1788.8,1.1,10168.64,144
HCPCS,50972,URETER ENDOSCOPY & CATHETER,,,3024.43,3668.39,20
HCPCS,50972,Ureter endoscopy & catheter,,,1004.31,1162.89,8
HCPCS,50974,URETER ENDO&BX/URETEROTOMY,3664.0,2381.6,1.1,15090.73,144
HCPCS,50974,URETER ENDOSCOPY & BIOPSY,,,4489.04,5579.94,20
HCPCS,50974,Ureter endoscopy & biopsy,,,2117.28,2451.59,8
HCPCS,50976,URETER ENDOSCOPY & TREATMENT,,,4489.04,5579.94,20
HCPCS,50976,URETERAL ENDOSC VIA URETEROT W/DEST&/INC W/WO BX,3612.0,2347.8,1.1,15090.73,144
HCPCS,50976,Ureter endoscopy & treatment,,,2117.28,2451.59,8
HCPCS,50980,NDSC URETEROTOMY RMVL FB/CALCULUS,2736.0,1778.4,1.1,15090.73,144
HCPCS,50980,URETER ENDOSCOPY & TREATMENT,,,4489.04,5579.94,20
HCPCS,50980,Ureter endoscopy & treatment,,,2117.28,2451.59,8
HCPCS,5100F,RSK FX REF W/N 24 HRS XRAY,,,2739849.3,2739849.3,1
HCPCS,5100F,Rsk fx ref w/n 24 hrs xray,,,10.69,12.38,8
HCPCS,51020,CYSTOTOMY/CYSTOSTOMY FULG&/INSJ RADACT MATRL,3076.0,1999.4,1.1,10168.64,144
HCPCS,51020,CYSTOTOMY/CYSTOSTOMY W/FULG,,,3024.43,3668.39,20
HCPCS,51020,Cystotomy/cystostomy w/fulg,,,1066.44,1234.83,8
HCPCS,51030,INCISE & TREAT BLADDER,,,3024.43,3024.43,1
HCPCS,51030,Incise & treat bladder,,,1066.44,1234.83,8
HCPCS,51040,CYSTOSTOMY CYSTOTOMY W/DRAINAGE,5609.5,3646.175,1.1,10789.0,318
HCPCS,51045,CYSTOTOMY W/INSJ URETERAL CATH/STENT SPX,3124.0,2030.6,1.1,5941.4,144
HCPCS,51045,INCISE BLADDER/DRAIN URETER,,,1767.05,2175.43,20
HCPCS,51045,Incise bladder/drain ureter,,,1066.44,1234.83,8
HCPCS,51050,CYSTOLITHOTOMY CYSTOTOMY W/RMVL CALCULUS,3188.0,2072.2,1.1,15090.73,144
HCPCS,51050,REMOVAL OF BLADDER STONE,,,4489.04,9509.0,21
HCPCS,51050,Removal of bladder stone,,,2832.26,3279.46,8
HCPCS,51060,REMOVAL OF URETER STONE,,,1767.05,5317.41,21
HCPCS,51060,Removal of ureter stone,,,1004.31,1162.89,8
HCPCS,51060,TRANSVESICAL URETEROLITHOTOMY,3980.0,2587.0,1.1,5941.4,144
HCPCS,51065,CYSTOTOMY W/CALCULUS BASKET XTRJ&/FRAGMENTATIO,3980.0,2587.0,1.1,10168.64,144
HCPCS,51065,REMOVE URETER CALCULUS,,,3024.43,3668.39,20
HCPCS,51065,Remove ureter calculus,,,1066.44,1234.83,8
HCPCS,51080,DRAINAGE OF BLADDER ABSCESS,,,2465.15,3022.89,20
HCPCS,51080,DRG PRIVESICAL/PREVESICAL SPACE ABSC,2684.0,1744.6,1.1,8286.13,144
HCPCS,51080,Drainage of bladder abscess,,,1066.44,1234.83,8
HCPCS,51100,ASPIRATION BLADDER NEEDLE,715.5,465.07500000000005,1.1,3443.0,234
HCPCS,51101,ASPIRATION BLADDER TROCAR/INTRACATHETER,408.0,265.2,1.1,3048.76,148
HCPCS,51101,DRAIN BLADDER BY TROCAR/CATH,,,812.43,1018.61,20
HCPCS,51101,Drain bladder by trocar/cath,,,284.76,329.73,8
HCPCS,51102,ASPIRATION BLADDER INSERT SUPRAPUBIC CATHETER,5251.5,3413.475,0.01,9423.0,496
HCPCS,51500,EXC URACHAL CYST/SINUS W/WO UMBILICAL HERNIA RPR,4420.0,2873.0,1.1,16829.38,144
HCPCS,51500,REMOVAL OF BLADDER CYST,,,5005.78,6291.49,20
HCPCS,51500,Removal of bladder cyst,,,2436.53,2821.25,8
HCPCS,51520,CYSTOTOMY SIMPLE EXCISION VESICAL NECK,4084.0,2654.6,1.1,10168.64,144
HCPCS,51520,REMOVAL OF BLADDER LESION,,,3024.43,3668.39,20
HCPCS,51520,Removal of bladder lesion,,,1066.44,1234.83,8
HCPCS,51525,CYSTOTOMY EXCISE BLADDER DIVERTICULUM 1/MULTIPLE,6168.0,4009.2,1.1,6168.0,144
HCPCS,51525,REMOVAL OF BLADDER LESION,,,2234.8,2234.8,1
HCPCS,51525,Removal of bladder lesion,,,2832.26,3279.46,8
HCPCS,51530,"CYSTOTOMY,EXCIS BLADDER TUMOR",5484.0,3564.6,1.1,5484.0,144
HCPCS,51530,REMOVAL OF BLADDER LESION,,,2007.63,2007.63,1
HCPCS,51530,Removal of bladder lesion,,,2832.26,3279.46,8
HCPCS,51535,CYSTOTOMY EXCISE/INCISE/REPAIR URETEROCELE,5560.0,3614.0,1.1,10168.64,144
HCPCS,51535,REPAIR OF URETER LESION,,,3024.43,9101.13,21
HCPCS,51535,Repair of ureter lesion,,,1066.44,1234.83,8
HCPCS,51550,CYSTECTOMY PARTIAL SIMPLE,6892.0,4479.8,1.1,6892.0,144
HCPCS,51550,PARTIAL REMOVAL OF BLADDER,,,2513.7,2513.7,1
HCPCS,51550,Partial removal of bladder,,,2832.26,3279.46,8
HCPCS,51555,CYSTECTOMY PARTIAL COMPLICATED,9272.0,6026.8,1.1,9272.0,144
HCPCS,51555,PARTIAL REMOVAL OF BLADDER,,,3284.11,3284.11,1
HCPCS,51555,Partial removal of bladder,,,2832.26,3279.46,8
HCPCS,51565,CSTC PRTL W/RIMPLTJ URTR IN BLDR URTRONEOCSTOST,9472.0,6156.8,1.1,9472.0,144
HCPCS,51565,REVISE BLADDER & URETER(S),,,3350.09,3350.09,1
HCPCS,51565,Revise bladder & ureter(s),,,2832.26,3279.46,8
HCPCS,51570,CYSTECTOMY COMPLETE SEPARATE PROCEDURE,10984.0,7139.6,1.1,10984.0,144
HCPCS,51570,REMOVAL OF BLADDER,,,3830.77,3830.77,1
HCPCS,51570,Removal of bladder,,,2832.26,3279.46,8
HCPCS,51575,CYSTECTOMY W/BI PELVIC LYMPHADENECTOMY,13672.0,8886.8,1.1,13672.0,144
HCPCS,51575,REMOVAL OF BLADDER & NODES,,,4717.51,4717.51,1
HCPCS,51575,Removal of bladder & nodes,,,2832.26,3279.46,8
HCPCS,51580,CYSTECTOMY W/URETEROSIGMOIDOSTOMY W/NODES,15563.0,10115.95,1.1,15563.0,144
HCPCS,51580,REMOVE BLADDER/REVISE TRACT,,,4924.79,4924.79,1
HCPCS,51585,CYSTECTOMY W/URETEROSIGMOID BI PELV LYMPH NODES,17442.0,11337.3,1.1,17442.0,144
HCPCS,51585,REMOVAL OF BLADDER & NODES,,,5476.96,5476.96,1
HCPCS,51590,CSTC COMPL W/URTROILEAL CONDUIT/BLDR W/INT ANAST,14532.0,9445.8,1.1,14532.0,144
HCPCS,51590,REMOVE BLADDER/REVISE TRACT,,,5013.68,5013.68,1
HCPCS,51590,Remove bladder/revise tract,,,2832.26,3279.46,8
HCPCS,51595,CSTC COMPL W/CONDUIT/SIGMOID BLDR PEL LMPHADEC,16528.0,10743.2,1.1,16528.0,144
HCPCS,51595,REMOVE BLADDER/REVISE TRACT,,,5676.95,5676.95,1
HCPCS,51595,Remove bladder/revise tract,,,2832.26,3279.46,8
HCPCS,51596,CSTC COMPL W/CONTINENT DVRJ OPN NEOBLDR,17704.0,11507.6,1.1,17704.0,144
HCPCS,51596,REMOVE BLADDER/CREATE POUCH,,,6115.93,6115.93,1
HCPCS,51597,PELVIC EXENTERATION COMPLETE MALIGNANCY,17144.0,11143.6,1.1,17144.0,144
HCPCS,51597,REMOVAL OF PELVIC STRUCTURES,,,5973.61,5973.61,1
HCPCS,51600,NJX CSTOGRAPY/VOIDING URETHROCSTOGRAPY,700.0,455.0,0.01,12615.0,284
HCPCS,51605,Preparation for bladder xray,,,81.99,94.94,8
HCPCS,51610,NJX RETROGRADE URETHROCSTOGRAPY,877.5,570.375,0.01,12615.0,284
HCPCS,51700,"BLADDER IRRIGATION,SIMPLE,LAVAGE",843.0,547.95,1.1,843.0,148
HCPCS,51700,BLDR IRRIGATION SMPL LAVAGE &/INSTLJ,691.5,449.475,0.01,12500.0,321
HCPCS,51701,INSJ NON-NDWELLG BLADDER CATHETER,414.0,269.1,0.01,12500.0,642
HCPCS,51702,INSERTION OF TEMP INDWELLING BLADDER CAT,521.0,338.65,1.1,521.0,148
HCPCS,51702,INSJ TEMP NDWELLG BLADDER CATHETER SIMPLE,406.5,264.225,0.01,12500.0,580
HCPCS,51703,"INSERTION OF INDWELLING CATH, COMPLEX",896.0,582.4,1.1,896.0,148
HCPCS,51703,INSJ TEMP NDWELLG BLADDER CATHETER COMPLICATED,654.0,425.1,0.01,4628.0,494
HCPCS,51705,CHANGE CYSTOSTOMY TUBE SIMPLE,1119.0,727.35,0.01,4628.0,555
HCPCS,51710,CHANGE CYSTOSTOMY TUBE COMPLICATED,1805.0,1173.25,0.01,4628.0,496
HCPCS,51715,NDSC NJX IMPLT MATRL URT&/BLDR NCK,8678.5,5641.025,0.01,15865.0,235
HCPCS,51720,BLADDER INSTILLATION,1362.0,885.3,1.1,1992.71,148
HCPCS,51720,BLADDER INSTILLATION ANTICARCINOGENIC AGENT,1726.5,1122.225,0.01,4628.0,321
HCPCS,51721,INSJ TRURL ABLTJ TRNSDCR DLVR THRM US PRST8 TISS,1782.0,1158.3,1.1,1832.21,144
HCPCS,51721,TULSA DEVICE MANAGEMENT (DONE BY TWO PHYS) INSERT OF TRANSURETHR,2128.0,1383.2,0.01,4337.0,67
HCPCS,51725,"CYSTOMETROGRAM, SIMPLE",1223.5,795.2750000000001,1.1,1783.0,270
HCPCS,51725,SIMPLE CYSTOMETROGRAM,1119.0,727.35,0.01,3443.0,87
HCPCS,51726,BLADDER PRESSURE MEASUREMENT DURING FILLING,1119.0,727.35,0.01,4392.0,357
HCPCS,51726,CYSTOMETROGRAM (CMG),1456.0,946.4,1.1,1456.0,144
HCPCS,51727,CMG W URETHRAL PRESSURE PROFILE,1384.0,899.6,1.1,1992.71,144
HCPCS,51727,COMPLEX CYSTOMETROGRAM URETHRAL PRESS PROFILE,3070.0,1995.5,1.1,4392.0,357
HCPCS,51728,CMG W VPP,1448.0,941.2,1.1,1992.71,144
HCPCS,51728,COMPLEX CYSTOMETROGRAM VOIDING PRESSURE STUDIES,3070.0,1995.5,0.01,12500.0,357
HCPCS,51729,CMG W VPS AND UPP,1305.0,848.25,1.1,1992.71,144
HCPCS,51729,COMPLX CYSTOMETRO W/VOID PRESS & URETHRAL PROFIL,3070.0,1995.5,0.01,12500.0,87
HCPCS,51729,COMPLX CYSTOMETRO W/VOID PRESS&URETHRAL PROFILE,2639.0,1715.35,1.1,4174.0,270
HCPCS,51736,SIMPLE UROFLOMETRY,364.5,236.92499999999998,1.1,661.0,270
HCPCS,51736,URINE FLOW MEASUREMENT,,,110.82,333.49,21
HCPCS,51736,Urine flow measurement,,,49.68,57.52,8
HCPCS,51741,COMPLEX UROFLOMETRY,1432.0,930.8,1.1,1500.0,442
HCPCS,51741,UROFLOWMETRY COMPLEX,619.0,402.35,1.1,915.24,144
HCPCS,51772,URETHRAL PRESSURE PROFILE,530.0,344.5,1.1,530.0,70
HCPCS,51784,EMG STDS ANAL/URTL SPHNCTR OTH/THN NDL,720.0,468.0,1.1,12500.0,568
HCPCS,51785,NDL EMG STDS EMG ANAL/URTL SPHNCTR ANY TQ,1119.0,727.35,0.01,4392.0,357
HCPCS,51792,STIMULUS EVOKED RESPONSE,440.0,286.0,1.1,884.07,356
HCPCS,51797,VOID PRESSURE STUDIES INTRAABDOMINAL,1135.0,737.75,0.01,3443.0,338
HCPCS,51798,MEAS POST-VOIDING RESIDUAL URINE&/BLADDER CAP,157.5,102.375,0.01,12500.0,576
HCPCS,51798,MEASURE OF P/V RESIDUAL,279.0,181.35,1.1,279.0,144
HCPCS,51800,CSTOPLASTY/CSTOURTP PLSTC ANY,7556.0,4911.4,1.1,7556.0,144
HCPCS,51800,REVISION OF BLADDER/URETHRA,,,2701.59,2701.59,1
HCPCS,51800,Revision of bladder/urethra,,,2832.26,3279.46,8
HCPCS,51820,CSTOURTP W/UNI/BI URTRONEOCSTOST,7836.0,5093.4,1.1,7836.0,144
HCPCS,51820,REVISION OF URINARY TRACT,,,2823.3,2823.3,1
HCPCS,51820,Revision of urinary tract,,,2832.26,3279.46,8
HCPCS,51840,ANT VESICOURETHROPEXY/URETHROPEXY SMPL,4544.0,2953.6,1.1,4544.0,144
HCPCS,51840,ATTACH BLADDER/URETHRA,,,4732.7,5205.97,12
HCPCS,51840,Attach bladder/urethra,,,2832.26,3279.46,8
HCPCS,51841,ANT VESICOURETHROPEXY/URETHROPEXY COMP,5472.0,3556.8,1.1,5472.0,144
HCPCS,51841,Attach bladder/urethra,,,2832.26,3279.46,8
HCPCS,51845,ABDOMINO-VAG VESICAL NCK SSP W/WO NDSC CTRL,4060.0,2639.0,1.1,14506.08,144
HCPCS,51845,REPAIR BLADDER NECK,,,4315.14,5205.97,20
HCPCS,51845,Repair bladder neck,,,2832.26,3279.46,8
HCPCS,51860,CYSTORRHAPHY SUTR BLDR WND INJ/RPT SIMPLE,5040.0,3276.0,1.1,26866.4,144
HCPCS,51860,REPAIR OF BLADDER WOUND,,,7992.18,24050.1,21
HCPCS,51860,Repair of bladder wound,,,2832.26,3279.46,8
HCPCS,51865,CYSTORRHAPHY SUTR BLDR WND INJ/RPT COMPLICATED,6320.0,4108.0,1.1,6320.0,144
HCPCS,51865,REPAIR OF BLADDER WOUND,,,2336.32,2336.32,1
HCPCS,51865,Repair of bladder wound,,,2832.26,3279.46,8
HCPCS,51880,CLOSE CYSTOSTOMY,3148.0,2046.2,1.1,10168.64,144
HCPCS,51880,REPAIR OF BLADDER OPENING,,,3024.43,3668.39,20
HCPCS,51880,Repair of bladder opening,,,1066.44,1234.83,8
HCPCS,51900,CLSR VESICOVAGINAL FISTUL AABDL APPROACH,5852.0,3803.8,1.1,5852.0,144
HCPCS,51900,REPAIR BLADDER/VAGINA LESION,,,2147.67,2147.67,1
HCPCS,51900,Repair bladder/vagina lesion,,,4028.01,4664.01,8
HCPCS,51920,CLOSE BLADDER-UTERUS FISTULA,,,1990.09,1990.09,1
HCPCS,51920,CLOSURE VESICOUTERINE FISTULA,5364.0,3486.6,1.1,5364.0,144
HCPCS,51920,Close bladder-uterus fistula,,,1703.89,1972.93,8
HCPCS,51925,HYSTERECTOMY/BLADDER REPAIR,,,2822.09,2822.09,1
HCPCS,51925,Hysterectomy/bladder repair,,,3181.01,3683.27,8
HCPCS,51940,CLOSURE EXSTROPHY BLADDER,12264.0,7971.6,1.1,12264.0,144
HCPCS,51940,CORRECTION OF BLADDER DEFECT,,,4262.95,4262.95,1
HCPCS,51960,ENTEROCYSTOPLASTY W/INTESTINAL ANASTOMOSIS,11176.0,7264.4,1.1,11176.0,144
HCPCS,51960,REVISION OF BLADDER & BOWEL,,,3600.11,3600.11,1
HCPCS,51960,Revision of bladder & bowel,,,2832.26,3279.46,8
HCPCS,51980,CUTANEOUS VESICOSTOMY,5028.0,3268.2,1.1,5028.0,144
HCPCS,51980,Construct bladder opening,,,2832.26,3279.46,8
HCPCS,51990,LAPARO URETHRAL SUSPENSION,,,5005.78,6291.49,20
HCPCS,51990,LAPAROSCOPY URETHRAL SUSPENSION STRESS INCONT,5344.0,3473.6,1.1,16829.38,144
HCPCS,51990,Laparo urethral suspension,,,2111.89,2445.34,8
HCPCS,51992,LAPARO SLING OPERATION,,,5005.78,6291.49,20
HCPCS,51992,"LAPAROSCOPY, SURGICAL; SLING OPERAT",5948.0,3866.2,1.1,16829.38,144
HCPCS,51992,Laparo sling operation,,,2111.89,2445.34,8
HCPCS,51999,"EXCISION OF URACHAL CYST OR SINUS, W/WO UMBILICAL HERNIA REPAIR",4420.0,2873.0,0.01,16829.38,84
HCPCS,51999,LAP CYSTECTOMY W/ PELVIC LYMPHADENECTOMY (COMP 51575),18052.0,11733.8,0.01,18052.0,84
HCPCS,51999,LAP CYSTOPLASTY OR CYSTOURETHROPLASTY (COMP 51800),6568.0,4269.2,0.01,16829.38,84
HCPCS,51999,LAP REPAIR BLADDER REPAIR (COMP 51860),5198.0,3378.7,0.01,16829.38,84
HCPCS,51999,LAPAROSCOPIC ANTERIOR VAGINECTOMY (COMP CODE 57106),3225.0,2096.25,0.01,16829.38,84
HCPCS,51999,LAPAROSCOPIC BLADDER REPAIR,4641.0,3016.65,0.01,16829.38,84
HCPCS,51999,"LAPAROSCOPIC CLOSURE OF VESICOVAGINAL FISTULA, ABDOMINAL APPROAC",6290.0,4088.5,0.01,16829.38,84
HCPCS,51999,LAPAROSCOPIC CYSTECTOMY (COMP 51570),15839.0,10295.35,0.01,16829.38,84
HCPCS,51999,LAPAROSCOPIC DIVERTICULECTOMY (COMP 51525),4306.0,2798.9,0.01,16829.38,84
HCPCS,51999,LAPAROSCOPY PARTIAL CYSTECTOMY (COMP 51555),14126.0,9181.9,0.01,16829.38,84
HCPCS,51999,LAPARSCOP URETERCTOMY,7764.0,5046.6,0.01,16829.38,84
HCPCS,51999,ROBOTIC (LAP) CYSTECTOMY W/ NEOBLADDER URINARY DIVERSION (COMP 5,41039.0,26675.35,0.01,41039.0,84
HCPCS,51999,ROBOTIC (LAP) PELVIC EXENTERATION (COMP 51597),37500.0,24375.0,0.01,37500.0,84
HCPCS,51999,ROBOTIC (LAP) PELVIC EXENTERATION W/ NEOBLADDER (COMP 51597),42500.0,27625.0,0.01,42500.0,84
HCPCS,51999,ROBOTIC CYSTECTOMY W/ CONDUIT & PELVIC LYMPHADENECTOMY (COMP 515,37762.0,24545.3,0.01,37762.0,84
HCPCS,51999,"STONE REMOVAL FROM BLADDER, LAPAROSCOPIC APPROACH WITH ROBOTIC A",3427.0,2227.55,0.01,16829.38,84
HCPCS,51999,UNLISTED LAPAROSCOPIC PROCEDURE BLADDER (COMP CODE 51590),15621.0,10153.65,0.01,16829.38,84
HCPCS,51999,"UNLISTED LAPAROSCOPY PROCEDURE, BLADDER",9249.5,6012.175,0.01,16829.38,168
HCPCS,51999,UNLISTED LAPS PX BLADDER,,,5005.78,15063.4,22
HCPCS,51999,UNLISTED PROC; LAPAROSCOPIC PARTICAL CYSTECTOMY (COMP TO 51550),6255.0,4065.75,0.01,16829.38,84
HCPCS,51999,Unlisted laps px bladder,,,1066.44,1234.83,8
HCPCS,52000,CYSTOSCOPY,3020.0,1963.0,1.1,3020.0,148
HCPCS,52000,CYSTOURETHROSCOPY,1871.5,1216.475,0.01,4392.0,409
HCPCS,52001,CYSTO W/IRRIG & EVAC MULTPLE OBSTRUCTING CLOTS,9020.5,5863.325,0.01,15865.0,322
HCPCS,52005,CYSTO BLADDER W/URETERAL CATHETERIZATION,5233.0,3401.45,0.01,9423.0,322
HCPCS,52005,CYSTO RETROGRADE PYELOGRAM,6616.0,4300.4,1.1,6616.0,148
HCPCS,52005,"JELMYTO INSTILLATION, RETROGRADE VIA CYSTOURETHROSCOPY",1043.0,677.95,1.1,5941.4,148
HCPCS,52007,CYSTO URTRL CATHJ BRUSH BX,,,3024.43,3668.39,20
HCPCS,52007,CYSTO W/URTRL CATHJ BRUSH BX URTR&/RENAL PELVIS,1208.0,785.2,1.1,10168.64,148
HCPCS,52007,Cysto urtrl cathj brush bx,,,1004.31,1162.89,8
HCPCS,5200F,EVAL APPROS SURG THXPY EPI,,,2739849.3,2739849.3,1
HCPCS,5200F,Eval appros surg thxpy epi,,,10.69,12.38,8
HCPCS,52010,CYSTO W/EJACULATORY DUCT CATHETERIZATION,1208.0,785.2,1.1,1992.71,148
HCPCS,52010,CYSTOSCOPY & DUCT CATHETER,,,592.63,725.67,20
HCPCS,52010,Cystoscopy & duct catheter,,,2111.89,2445.34,8
HCPCS,52204,CYSTOURETHROSCOPY WITH BIOPSY,9423.0,6124.95,0.01,9423.0,87
HCPCS,52204,"CYSTOURETHROSCOPY,BIOPSY",1036.0,673.4,1.1,5941.4,148
HCPCS,52214,CYSTO W/DESTRUCTION OF LESIONS,8632.5,5611.125,0.01,15865.0,235
HCPCS,52224,CYSTO FULG MINOR TUMOR,4409.0,2865.85,1.1,10168.64,148
HCPCS,52224,CYSTO W/REMOVAL OF LESIONS MINOR <0.5CM,8742.5,5682.625,0.01,15865.0,235
HCPCS,52234,CYSTO W/REMOVAL OF TUMORS SMALL,8856.5,5756.725,0.01,15865.0,231
HCPCS,52235,CYSTOURETHROSCOPY W/DEST &/RMVL MED BLADDER TUM,9020.5,5863.325,0.01,15865.0,231
HCPCS,52235,MEDIUM BLADDER TUMORS,6517.0,4236.05,1.1,10168.64,144
HCPCS,52240,CYSTOURETHROSCOPY W/DEST &/RMVL TUMOR LARGE,13342.5,8672.625,0.01,23385.0,231
HCPCS,52240,LARGE BLADDER TUMORS,9124.0,5930.6,1.1,15090.73,144
HCPCS,52250,CYSTOSCOPY AND RADIOTRACER,,,3024.43,3668.39,20
HCPCS,52250,CYSTOURETHROSCOPY INSJ RADIOACT SBST W/WOBX/FULG,1796.0,1167.4,1.1,10168.64,144
HCPCS,52250,Cystoscopy and radiotracer,,,1066.44,1234.83,8
HCPCS,52260,CYSTOURETHROSCOPY W/DIL BLADDER GENERAL ANESTH,5493.5,3570.775,0.01,9423.0,231
HCPCS,52265,CYSTOSCOPY AND TREATMENT,,,1767.05,2175.43,20
HCPCS,52265,"CYSTOSCOPY,DIL BLADDER,LOCAL ANESTH",1176.0,764.4,1.1,5941.4,148
HCPCS,52265,Cystoscopy and treatment,,,1066.44,1234.83,8
HCPCS,52270,CYSTOSCOPY & REVISE URETHRA,,,1767.05,2175.43,20
HCPCS,52270,"CYSTOSCOPY,INTERN URETHROTOMY,FEMALE",1344.0,873.6,1.1,5941.4,148
HCPCS,52270,Cystoscopy & revise urethra,,,2111.89,2445.34,8
HCPCS,52275,CYSTOSCOPY & REVISE URETHRA,,,1767.05,2175.43,20
HCPCS,52275,"CYSTOSCOPY,INTERN URETHROTOMY,MALE",1876.0,1219.4,1.1,5941.4,148
HCPCS,52275,Cystoscopy & revise urethra,,,2111.89,2445.34,8
HCPCS,52276,CYSTOSCOPY AND TREATMENT,,,1767.05,2175.43,20
HCPCS,52276,CYSTOURETHROSCOPY W/INTERNAL URETHROTOMY MALE,1996.0,1297.4,1.1,5941.4,144
HCPCS,52276,Cystoscopy and treatment,,,2111.89,2445.34,8
HCPCS,52277,CYSTOSCOPY AND TREATMENT,,,3024.43,3668.39,20
HCPCS,52277,"CYSTOSCOPY,RESEC EXTERN SPHINCTER",2464.0,1601.6,1.1,10168.64,144
HCPCS,52277,Cystoscopy and treatment,,,2111.89,2445.34,8
HCPCS,52281,CYSTO CALIBRATION DILAT URTL STRIX/STENOSIS,5316.5,3455.725,0.01,9423.0,322
HCPCS,52282,CYSTOURETHROSCOPY INSERTION PERM URETHRAL STENT,9210.5,5986.825,0.01,33436.0,231
HCPCS,52283,CYSTOSCOPY AND TREATMENT,,,1767.05,2175.43,20
HCPCS,52283,"CYSTOSCOPY,STEROID INJ,STRICTURE",1492.0,969.8,1.1,5941.4,148
HCPCS,52283,Cystoscopy and treatment,,,2111.89,2445.34,8
HCPCS,52284,CYSTO RX BALO CATH URTL STRX,,,4489.04,13508.42,23
HCPCS,52284,CYSTO W/DILAT RX BALO CATH URTL STRIX/STEN MALE,1364.0,886.6,1.1,15090.73,146
HCPCS,52284,Cysto rx balo cath urtl strx,,,2111.89,2445.34,8
HCPCS,52285,CYSTOSCOPY AND TREATMENT,,,592.63,725.67,20
HCPCS,52285,"CYSTOSCOPY,RX FEMALE URETHRAL SYND",1440.0,936.0,1.1,1992.71,148
HCPCS,52285,Cystoscopy and treatment,,,2111.89,2445.34,8
HCPCS,52287,CYSTOURETHROSCOPY INJ CHEMODENERVATION BLADDER,5351.5,3478.475,0.01,17833.0,322
HCPCS,52287,CYSTOURETHROSCOPY W INJ FOR BLADDER,3143.0,2042.95,1.1,5941.4,148
HCPCS,52290,CYSTOSCOPY AND TREATMENT,,,1767.05,2175.43,20
HCPCS,52290,CYSTOURETHROSCOPY W/URETERAL MEATOTOMY UNI/BI,1832.0,1190.8,1.1,5941.4,144
HCPCS,52290,Cystoscopy and treatment,,,1066.44,1234.83,8
HCPCS,52300,CYSTO W/RESCJ/FULG ORTHOPIC URETEROCELE UNI/BI,2120.0,1378.0,1.1,10168.64,144
HCPCS,52300,CYSTOSCOPY AND TREATMENT,,,3024.43,3668.39,20
HCPCS,52300,Cystoscopy and treatment,,,2832.26,3279.46,8
HCPCS,52301,CYSTO W/RESECJ ECTOPIC URETEROCELE UNI/BI,2200.0,1430.0,1.1,10168.64,144
HCPCS,52301,CYSTOSCOPY AND TREATMENT,,,3024.43,3668.39,20
HCPCS,52301,Cystoscopy and treatment,,,1066.44,1234.83,8
HCPCS,52305,CYSTO INC/RESCJ ORIFICE BLDR DIVERTICULUM 1/MLT,2120.0,1378.0,1.1,15090.73,144
HCPCS,52305,CYSTOSCOPY AND TREATMENT,,,4489.04,5579.94,20
HCPCS,52305,Cystoscopy and treatment,,,2832.26,3279.46,8
HCPCS,52310,CYSTO W/SIMPLE REMOVAL STONE & STENT,5273.5,3427.775,0.01,9423.0,322
HCPCS,52310,CYSTO W/STENT REMOVAL,4036.0,2623.4,1.1,5941.4,148
HCPCS,52315,CYSTO W/COMPLEX REMOVAL STONE & STENT,5751.5,3738.475,0.01,9423.0,235
HCPCS,52315,CYSTOURETHROSCOPY,5417.0,3521.05,1.1,5941.4,148
HCPCS,52317,LITHOLAPAXY SMPL/SM <2.5 CM,9274.5,6028.425,0.01,15865.0,235
HCPCS,52317,LITHOLAPAXY:CRUSHING & FRAG,9088.0,5907.2,1.1,10168.64,148
HCPCS,52318,LITHOLAPAXY COMP/LG > 2.5 CM,9768.5,6349.525,0.01,15865.0,231
HCPCS,52320,CYSTOSCOPY AND TREATMENT,,,3024.43,3668.39,20
HCPCS,52320,CYSTOURETHROSCOPY W/RMVL URETERAL CALCULUS,1876.0,1219.4,1.1,10168.64,144
HCPCS,52320,Cystoscopy and treatment,,,1066.44,1234.83,8
HCPCS,52325,CYSTO FRAGMENTATION URETERAL STONE,2460.0,1599.0,1.1,15090.73,144
HCPCS,52325,CYSTOSCOPY STONE REMOVAL,,,4489.04,5579.94,20
HCPCS,52325,Cystoscopy stone removal,,,2832.26,3279.46,8
HCPCS,52327,CYSTO W/SUBURTRIC NJX IMPLT MATRL,2072.0,1346.8,1.1,15090.73,144
HCPCS,52327,CYSTOSCOPY INJECT MATERIAL,,,4489.04,8702.0,21
HCPCS,52327,Cystoscopy inject material,,,2832.26,3279.46,8
HCPCS,52330,CYSTO MANJ W/O RMVL URETERAL STONE,2012.0,1307.8,1.1,10168.64,148
HCPCS,52330,CYSTOSCOPY AND TREATMENT,,,3024.43,3668.39,20
HCPCS,52330,Cystoscopy and treatment,,,1066.44,1234.83,8
HCPCS,52332,CYSTO W/INSERT URETERAL STENT,8496.5,5522.725,0.01,15865.0,409
HCPCS,52332,CYSTO W/PLACE DBL J STENT,5653.0,3674.45,1.1,10168.64,148
HCPCS,52334,CREATE PASSAGE TO KIDNEY,,,3024.43,3668.39,20
HCPCS,52334,CYSTO INSJ URTRL GD WIRE PRQ NFROS RTRGR,1483.0,963.95,1.1,10168.64,144
HCPCS,52334,Create passage to kidney,,,1004.31,1162.89,8
HCPCS,52341,CYSTO W/TX URETERAL STRICTURE,15865.0,10312.25,0.01,15865.0,87
HCPCS,52341,CYSTO W/URETER STRICTURE TX,2140.0,1391.0,1.1,10168.64,144
HCPCS,52342,CYSTO W/TX URETEROPELVIC JUNCTION STRICTURE,2340.0,1521.0,1.1,10168.64,144
HCPCS,52342,CYSTO W/UP STRICTURE TX,,,3024.43,3668.39,20
HCPCS,52342,Cysto w/up stricture tx,,,1004.31,1162.89,8
HCPCS,52343,CYSTO W/RENAL STRICTURE TX,,,3024.43,3668.39,20
HCPCS,52343,CYSTO W/TX INTRA-RENAL STRICTURE,2620.0,1703.0,1.1,10168.64,144
HCPCS,52343,Cysto w/renal stricture tx,,,1004.31,1162.89,8
HCPCS,52344,CYSTO W/URTROSCOPY W/TX URETERAL STRICTURE,2820.0,1833.0,1.1,10168.64,144
HCPCS,52344,CYSTO/URETERO STRICTURE TX,,,3024.43,7624.0,22
HCPCS,52344,Cysto/uretero stricture tx,,,1066.44,1234.83,8
HCPCS,52345,CYSTO W/URTROSCOPY W/TX URTROPEL JUNCT STRIX,3020.0,1963.0,1.1,10168.64,144
HCPCS,52345,CYSTO/URETERO W/UP STRICTURE,,,3024.43,3668.39,20
HCPCS,52345,Cysto/uretero w/up stricture,,,2832.26,3279.46,8
HCPCS,52346,CYSTO W/URTROSCOPY W/TX INTRA-RENAL STRICTURE,3432.0,2230.8,1.1,15090.73,144
HCPCS,52346,CYSTOURETERO W/RENAL STRICT,,,4489.04,5579.94,20
HCPCS,52346,Cystouretero w/renal strict,,,2117.28,2451.59,8
HCPCS,52351,CYSTO W/URTROSCOPY&/PYELOSCOPY DX,9197.5,5978.375,0.01,15865.0,231
HCPCS,52352,CYSTO W/URETEROSCOPY W/RMVL/MANJ STONES,9282.5,6033.625,0.01,15865.0,231
HCPCS,52352,CYSTOURETHROSCOPY,7948.0,5166.2,1.1,10168.64,144
HCPCS,52353,CYSTO W/URETEROSCOPY W/LITHOTRIPSY,3000.0,1950.0,1.1,15090.73,144
HCPCS,52353,CYSTOURETERO W/LITHOTRIPSY,,,4489.04,9509.0,21
HCPCS,52353,Cystouretero w/lithotripsy,,,2117.28,2451.59,8
HCPCS,52354,CYSTO/PYELOSCOPY BX&/FULGURATION PELIVC LESION,13292.5,8640.125,1.1,23385.0,231
HCPCS,52355,CYSTO/PYELOSCOPY RESCJ PELVIC TUMOR,3600.0,2340.0,1.1,15090.73,144
HCPCS,52355,CYSTOURETERO W/EXCISE TUMOR,,,4489.04,5579.94,20
HCPCS,52355,Cystouretero w/excise tumor,,,2117.28,2451.59,8
HCPCS,52356,CYSTO/URETERO W/LITHOTRIPSY &INDWELL STENT INSRT,13292.5,8640.125,0.01,23385.0,318
HCPCS,52400,CYSTO CGEN POST URTL VALVES,,,3024.43,3668.39,20
HCPCS,52400,CYSTO INC FULG/RESCJ URTL VALVES/FOLDS,3476.0,2259.4,1.1,10168.64,144
HCPCS,52400,Cysto cgen post urtl valves,,,2111.89,2445.34,8
HCPCS,52402,CSTO W/TRURL RESCJ/INC EJACULATORY DUXS,2108.0,1370.2,1.1,10168.64,144
HCPCS,52402,CYSTO TRURL RESCJ EJACUL DUX,,,3024.43,3668.39,20
HCPCS,52402,Cysto trurl rescj ejacul dux,,,2111.89,2445.34,8
HCPCS,52441,CYSTO INSERTION TRANSPROSTATIC IMPLANT SINGLE,3072.5,1997.125,0.01,7431.0,217
HCPCS,52442,CYSTO INSERTION TRANSPROSTATIC IMPLANT EA ADDL,4716.5,3065.7250000000004,0.01,8989.0,217
HCPCS,52443,CYSTO 1ST TRURL ANT PRST8 COMIS NONRX BALO CATH,1593.0,1035.45,1.1,15055.51,106
HCPCS,52443,CYSTO 1ST TRURL PRST8 COMIS,,,8956.0,9851.6,12
HCPCS,52443,Cysto 1st trurl prst8 comis,,,3284.72,3803.36,8
HCPCS,52450,TRANSURETHRAL INC PROSTATE,,,3024.43,3668.39,20
HCPCS,52450,TRANSURETHRAL INCISION OF PROSTATE,3112.0,2022.8,1.1,10168.64,144
HCPCS,52450,TRANSURETHRAL INSCISION,2567.0,1668.55,1.1,10168.64,144
HCPCS,52450,Transurethral inc prostate,,,1127.93,1306.02,8
HCPCS,52500,TRANSURETHRAL RESEC BLADDER NECK,3256.0,2116.4,1.1,10168.64,144
HCPCS,52500,TRURL RESECTION BLADDER NECK,,,3024.43,7624.0,21
HCPCS,52500,TURBN,2751.0,1788.15,1.1,10168.64,144
HCPCS,52500,Trurl resection bladder neck,,,1066.44,1234.83,8
HCPCS,5250F,ASTHMA DISCHARGE PLAN PRESNT,,,2739849.3,2739849.3,1
HCPCS,5250F,Asthma discharge plan presnt,,,10.69,12.38,8
HCPCS,52597,TRURL RBTC WTRJT RESCJ PRST8,,,8956.0,9851.6,12
HCPCS,52597,TRURL ROBOTIC-ASSISTED WATERJET RESECTION PRST8,4510.0,2931.5,1.1,4510.0,106
HCPCS,52597,Trurl rbtc wtrjt rescj prst8,,,3284.72,3803.36,8
HCPCS,52601,PROSTATECTOMY (TURP),,,4489.04,10789.0,23
HCPCS,52601,Prostatectomy (turp),,,3284.72,3803.36,8
HCPCS,52601,TRANSURETH ELECTRO RESECT,4600.0,2990.0,1.1,15090.73,144
HCPCS,52601,TRURL ELECTROSURG RESCJ PROSTATE BLEED COMPLETE,5790.0,3763.5,1.1,15090.73,144
HCPCS,52630,REMOVE PROSTATE REGROWTH,,,4489.04,5579.94,20
HCPCS,52630,Remove prostate regrowth,,,3284.72,3803.36,8
HCPCS,52630,TRURL RESCJ RESIDUAL/REGROWTH OBSTR PRSTATE TISS,2620.0,1703.0,1.1,15090.73,144
HCPCS,52640,RELIEVE BLADDER CONTRACTURE,,,3024.43,3668.39,20
HCPCS,52640,Relieve bladder contracture,,,1066.44,1234.83,8
HCPCS,52640,TRURL RESCJ POSTOP BLADDER NECK CONTRACTURE,1916.0,1245.4,1.1,10168.64,144
HCPCS,52647,LASER SURGERY OF PROSTATE,,,4489.04,5089.74,8
HCPCS,52647,Laser surgery of prostate,,,3284.72,3803.36,8
HCPCS,52648,CONTACT LASER VAPORIZATION,4010.0,2606.5,1.1,15090.73,148
HCPCS,52648,LASER SURGERY OF PROSTATE,,,4489.04,9509.0,22
HCPCS,52648,LASER VAPORIZATION OF PROSTATE FOR URINE FLOW,4860.0,3159.0,1.1,15090.73,148
HCPCS,52648,Laser surgery of prostate,,,3284.72,3803.36,8
HCPCS,52649,LASER ENUCLEATION PROSTATE W/MORCELLATION,5824.0,3785.6,1.1,15090.73,144
HCPCS,52649,PROSTATE LASER ENUCLEATION,,,4489.04,13508.42,23
HCPCS,52649,Prostate laser enucleation,,,3284.72,3803.36,8
HCPCS,52700,DRAINAGE OF PROSTATE ABSCESS,,,3024.43,6238.0,21
HCPCS,52700,Drainage of prostate abscess,,,1127.93,1306.02,8
HCPCS,52700,TRURL DRAINAGE PROSTATIC ABSCESS,2996.0,1947.4,1.1,10168.64,144
HCPCS,53000,INCISION OF URETHRA,,,1767.05,2175.43,20
HCPCS,53000,Incision of urethra,,,2111.89,2445.34,8
HCPCS,53000,URTT/URTS XTRNL SPX PENDULOUS URETHRA,932.0,605.8,1.1,5941.4,144
HCPCS,53010,INCISION OF URETHRA,,,4392.0,5579.94,21
HCPCS,53010,Incision of urethra,,,3635.15,4209.12,8
HCPCS,53010,URETHROTOMY/URETHROSTOMY XT SPX PERINEAL URETHRA,1780.0,1157.0,1.1,15090.73,144
HCPCS,53020,MEATOTOMY CUTTING MEATUS SPX EXCEPT INFANT,5065.5,3292.575,0.01,9423.0,231
HCPCS,53025,MEATOTOMY CUTTING MEATUS SPX INFANT,4937.5,3209.375,0.01,9423.0,231
HCPCS,53040,DRAINAGE DEEP PERIURETHRAL ABSCESS,2620.0,1703.0,1.1,10168.64,144
HCPCS,53040,DRAINAGE OF URETHRA ABSCESS,,,3024.43,3668.39,20
HCPCS,53040,Drainage of urethra abscess,,,2111.89,2445.34,8
HCPCS,53060,DRG OF SKENE'S GLAND ABSCESS OR CYST,1072.0,696.8,0.01,9423.0,321
HCPCS,53080,DRAINAGE OF URINARY LEAKAGE,,,592.63,725.67,20
HCPCS,53080,Drainage of urinary leakage,,,284.76,329.73,8
HCPCS,53085,DRAINAGE OF URINARY LEAKAGE,,,1767.05,5317.41,21
HCPCS,53085,DRG PERINEAL URINARY XTRVASATION COMPLIC,4472.0,2906.8,1.1,5941.4,144
HCPCS,53085,Drainage of urinary leakage,,,2111.89,2445.34,8
HCPCS,53200,BIOPSY OF URETHRA,1036.0,673.4,1.1,5941.4,148
HCPCS,53200,BIOPSY URETHRA,9423.0,6124.95,0.01,9423.0,87
HCPCS,53210,REMOVAL OF URETHRA,,,3024.43,3668.39,20
HCPCS,53210,Removal of urethra,,,2111.89,2445.34,8
HCPCS,53210,URETHRECTOMY TOT W/CYSTOST FEMALE,5488.0,3567.2,1.1,10168.64,144
HCPCS,53215,REMOVAL OF URETHRA,,,4489.04,5579.94,20
HCPCS,53215,Removal of urethra,,,3635.15,4209.12,8
HCPCS,53215,URETHRECTOMY TOT W/CYSTOST MALE,6740.0,4381.0,1.1,15090.73,144
HCPCS,53220,EXC/FULGURATION CARCINOMA URETHRA,3052.0,1983.8,1.1,10168.64,144
HCPCS,53220,TREATMENT OF URETHRA LESION,,,3024.43,3668.39,20
HCPCS,53220,Treatment of urethra lesion,,,2111.89,2445.34,8
HCPCS,53230,EXC URETHRAL DIVERTICULUM SPX FEMALE,4176.0,2714.4,1.1,15090.73,144
HCPCS,53230,REMOVAL OF URETHRA LESION,,,4489.04,9509.0,21
HCPCS,53230,Removal of urethra lesion,,,3635.15,4209.12,8
HCPCS,53235,EXC URETHRAL DIVERTICULUM SPX MALE,4396.0,2857.4,1.1,15090.73,144
HCPCS,53235,REMOVAL OF URETHRA LESION,,,4489.04,5579.94,20
HCPCS,53235,Removal of urethra lesion,,,3635.15,4209.12,8
HCPCS,53240,MARSUPIALIZATION URTL DIVERTICULUM MALE/FEMALE,2832.0,1840.8,1.1,10168.64,144
HCPCS,53240,SURGERY FOR URETHRA POUCH,,,3024.43,3668.39,20
HCPCS,53240,Surgery for urethra pouch,,,2111.89,2445.34,8
HCPCS,53250,EXCISION OF BULBOURETHRAL GLAND,2608.0,1695.2,1.1,10168.64,144
HCPCS,53250,REMOVAL OF URETHRA GLAND,,,3024.43,3668.39,20
HCPCS,53250,Removal of urethra gland,,,2111.89,2445.34,8
HCPCS,53260,EXC/FULGURATION URETHRAL POLYP DSTL URETHRA,1212.0,787.8,1.1,10168.64,148
HCPCS,53260,TREATMENT OF URETHRA LESION,,,3024.43,4315.0,22
HCPCS,53260,Treatment of urethra lesion,,,2111.89,2445.34,8
HCPCS,53265,EXC/FULGURATION URETHRAL CARUNCLE,5345.5,3474.575,0.01,9423.0,235
HCPCS,53270,EXCISION OR FULGURATION SKENES GLANDS,1256.0,816.4,1.1,10168.64,148
HCPCS,53270,REMOVAL OF URETHRA GLAND,,,3024.43,3668.39,20
HCPCS,53270,Removal of urethra gland,,,2111.89,2445.34,8
HCPCS,53275,EXCISION/FULGURATION URETHRAL PROLAPSE,1828.0,1188.2,1.1,10168.64,144
HCPCS,53275,REPAIR OF URETHRA DEFECT,,,3024.43,3668.39,20
HCPCS,53275,Repair of urethra defect,,,2111.89,2445.34,8
HCPCS,53400,REVISE URETHRA STAGE 1,,,4489.04,7813.0,21
HCPCS,53400,Revise urethra stage 1,,,3635.15,4209.12,8
HCPCS,53400,URETHROPLASTY 1ST STG FISTULA/DIVERTICULUM/STRIX,5652.0,3673.8,1.1,15090.73,144
HCPCS,53405,REVISE URETHRA STAGE 2,,,4489.04,7778.0,21
HCPCS,53405,Revise urethra stage 2,,,3635.15,4209.12,8
HCPCS,53405,URETHROPLASTY 2ND STAGE W/URINARY DIVERSION,6264.0,4071.6,1.1,15090.73,144
HCPCS,53410,RECONSTRUCTION OF URETHRA,,,3528.0,7778.0,23
HCPCS,53410,Reconstruction of urethra,,,3635.15,4209.12,8
HCPCS,53410,URETHROPLASTY 1 STG RECNST MALE ANTERIOR URETHRA,7072.0,4596.8,1.1,15090.73,144
HCPCS,53415,Reconstruction of urethra,,,3635.15,4209.12,8
HCPCS,53415,URTP TRANSPUBIC/PRNL 1 STG RCNSTJ/RPR URT,8280.0,5382.0,1.1,8280.0,144
HCPCS,53420,RECONSTRUCT URETHRA STAGE 1,,,4489.04,5579.94,20
HCPCS,53420,Reconstruct urethra stage 1,,,3635.15,4209.12,8
HCPCS,53420,URTP 2-STG RCNSTJ/RPR PROSTAT/URETHRA 1ST STAGE,6068.0,3944.2,1.1,15090.73,144
HCPCS,53425,RECONSTRUCT URETHRA STAGE 2,,,4489.04,5579.94,20
HCPCS,53425,Reconstruct urethra stage 2,,,3635.15,4209.12,8
HCPCS,53425,URTP 2-STG RCNSTJ/RPR PROSTAT/URETHRA 2ND STAGE,6828.0,4438.2,1.1,15090.73,144
HCPCS,53430,RECONSTRUCTION OF URETHRA,,,4489.04,7778.0,21
HCPCS,53430,Reconstruction of urethra,,,3635.15,4209.12,8
HCPCS,53430,URETHROPLASTY RCNSTJ FEMALE URETHRA,6972.0,4531.8,1.1,15090.73,144
HCPCS,53431,RECONSTRUCT URETHRA/BLADDER,,,4489.04,5579.94,20
HCPCS,53431,Reconstruct urethra/bladder,,,3635.15,4209.12,8
HCPCS,53431,URTP W/TUBULARIZATION POST URT&/LWR BLDR,8472.0,5506.8,1.1,15090.73,144
HCPCS,53440,MALE SLING PROCEDURE,,,3528.0,13730.23,23
HCPCS,53440,Male sling procedure,,,3635.15,4209.12,8
HCPCS,53440,SLING OPRATION CORRJ MALE URINARY INCONTINENCE,5344.0,3473.6,1.1,37439.09,144
HCPCS,53442,REMOVE/REVISE MALE SLING,,,4489.04,5579.94,20
HCPCS,53442,RMVL/REVJ SLING MALE URINARY INCONTINENCE,5396.0,3507.4,1.1,15090.73,144
HCPCS,53442,Remove/revise male sling,,,3635.15,4209.12,8
HCPCS,53444,INSERT TANDEM CUFF,,,17500.12,21569.36,20
HCPCS,53444,INSERTION TANDEM CUFF,5676.0,3689.4,1.1,58832.42,144
HCPCS,53444,Insert tandem cuff,,,3635.15,4209.12,8
HCPCS,53445,INSERT URO/VES NCK SPHINCTER,,,4392.0,21569.36,22
HCPCS,53445,INSJ INFLATABLE URETHRAL/BLADDER NECK SPHINCTER,5200.0,3380.0,1.1,58832.42,144
HCPCS,53445,Insert uro/ves nck sphincter,,,2832.26,3279.46,8
HCPCS,53446,REMOVE URO SPHINCTER,,,4489.04,5579.94,20
HCPCS,53446,REMVL INFLATABLE URETHRAL/BLADDER NECK SPHINCTER,4408.0,2865.2,1.1,15090.73,144
HCPCS,53446,Remove uro sphincter,,,3635.15,4209.12,8
HCPCS,53447,REMOVE/REPLACE UR SPHINCTER,,,17500.12,21569.36,20
HCPCS,53447,RMVL & RPLCMT NFLTL URETHRAL/BLADDER NECK SPHINC,5712.0,3712.8,1.1,58832.42,144
HCPCS,53447,Remove/replace ur sphincter,,,2832.26,3279.46,8
HCPCS,53448,REMOV/REPLC UR SPHINCTR COMP,,,3318.44,3318.44,1
HCPCS,53448,RMVL & RPLCMT NFLTBL NCK SPHNCTR THRU INFCT FLD,9376.0,6094.4,1.1,9376.0,144
HCPCS,53448,Remov/replc ur sphinctr comp,,,3635.15,4209.12,8
HCPCS,53449,REPAIR URO SPHINCTER,,,7992.18,9851.6,20
HCPCS,53449,RPR NFLTBL URETHRAL/BLADDER NECK SPHINCTER,4224.0,2745.6,1.1,26866.4,142
HCPCS,53449,Repair uro sphincter,,,3635.15,4209.12,8
HCPCS,53450,REVISION OF URETHRA,,,3024.43,4315.0,21
HCPCS,53450,Revision of urethra,,,2111.89,2445.34,8
HCPCS,53450,URETHROMEATOPLASTY W/MUCOSAL ADVANCEMENT,2708.0,1760.2,1.1,10168.64,144
HCPCS,53451,TPRNL BALO CNTNC DEV BI,,,11136.66,13730.23,20
HCPCS,53451,Tprnl balo cntnc dev bi,,,3635.15,4209.12,8
HCPCS,53452,TPRNL BALO CNTNC DEV UNI,,,7992.18,9851.6,20
HCPCS,53452,Tprnl balo cntnc dev uni,,,2111.89,2445.34,8
HCPCS,53453,PERIURETHRAL TPRNL ADJTBL BALO CNTNC DEV RMVL EA,5414.0,3519.1,0.01,10168.64,88
HCPCS,53453,TPRNL BALO CNTNC DEV RMVL EA,,,3024.43,9101.13,21
HCPCS,53453,Tprnl balo cntnc dev rmvl ea,,,2111.89,2445.34,8
HCPCS,53454,TPRNL BALO CNTNC DEV ADJMT,,,214.41,645.22,21
HCPCS,53454,Tprnl balo cntnc dev adjmt,,,284.76,329.73,8
HCPCS,53460,REVISION OF URETHRA,,,3024.43,3668.39,20
HCPCS,53460,Revision of urethra,,,2111.89,2445.34,8
HCPCS,53460,URETHROMEATOPLASTY W/PRTL EXC DSTL URTL SGM,3100.0,2015.0,1.1,10168.64,144
HCPCS,53500,URETHRLYS TRANSVAG W/ SCOPE,,,3024.43,3668.39,20
HCPCS,53500,URETHROLSS TRVG SEC OPN W/CSTO,5200.0,3380.0,1.1,10168.64,144
HCPCS,53500,Urethrlys transvag w/ scope,,,2111.89,2445.34,8
HCPCS,53502,REPAIR OF URETHRA INJURY,,,3024.43,3668.39,20
HCPCS,53502,Repair of urethra injury,,,2111.89,2445.34,8
HCPCS,53502,URETHRORRHAPHY SUTR URETHRAL WOUND/INJ FEMALE,3304.0,2147.6,1.1,10168.64,144
HCPCS,53505,REPAIR OF URETHRA INJURY,,,4489.04,5579.94,20
HCPCS,53505,Repair of urethra injury,,,2111.89,2445.34,8
HCPCS,53505,URETHRORRHAPHY SUTR URETHRAL WOUND/INJ PENILE,3304.0,2147.6,1.1,15090.73,144
HCPCS,53510,REPAIR OF URETHRA INJURY,,,4489.04,5579.94,20
HCPCS,53510,Repair of urethra injury,,,3635.15,4209.12,8
HCPCS,53510,URETHRORRHAPHY SUTR URETHRAL WOUND/INJ PERINEAL,4384.0,2849.6,1.1,15090.73,144
HCPCS,53515,REPAIR OF URETHRA INJURY,,,4489.04,5579.94,20
HCPCS,53515,Repair of urethra injury,,,3635.15,4209.12,8
HCPCS,53515,URTORR SUTR URETHRAL WND/INJ PROSTATOMEMBRANOUS,5688.0,3697.2,1.1,15090.73,144
HCPCS,53520,CLSR URETHROSTOMY/URETHROQ FSTL MALE SPX,3792.0,2464.8,1.1,15090.73,144
HCPCS,53520,REPAIR OF URETHRA DEFECT,,,4489.04,9509.0,21
HCPCS,53520,Repair of urethra defect,,,3635.15,4209.12,8
HCPCS,53600,DILAT URETHRAL STRIX DILATOR MALE 1ST,801.5,520.975,0.01,3443.0,321
HCPCS,53600,DILATION OF URETHRAL STRICTURE,2030.0,1319.5,1.1,2030.0,148
HCPCS,53601,DILAT URETHRAL STRIX DILATOR MALE SBSQ,492.5,320.125,0.01,3443.0,235
HCPCS,53605,DILAT URETHRAL STRIX/VESICAL NCK DILAT MALE ANES,512.0,332.8,1.1,10168.64,144
HCPCS,53605,DILATE URETHRA STRICTURE,,,3024.43,3668.39,20
HCPCS,53605,Dilate urethra stricture,,,284.76,329.73,8
HCPCS,53620,DILAT URETHRAL STRIX FILIFORM & FOLLWR MALE 1ST,1859.0,1208.35,0.01,3443.0,235
HCPCS,53621,DILAT URETHRAL STRIX FILIFORM & FOLLWR MALE SBSQ,829.5,539.175,0.01,3443.0,235
HCPCS,53660,DILAT FEMALE URETHRA W/SUPPOSITORY&/INSTLJ INI,502.0,326.3,0.01,12500.0,235
HCPCS,53661,DILAT FEMALE URT W/SUPPOSITORY&/INSTLJ SBSQ,440.5,286.325,0.01,12500.0,235
HCPCS,53665,DILAT FEMALE URETHRA GENERAL/CNDJ SPINAL ANES,304.0,197.6,1.1,5941.4,144
HCPCS,53665,DILATION OF URETHRA,,,1767.05,2175.43,20
HCPCS,53665,Dilation of urethra,,,284.76,329.73,8
HCPCS,53850,PROSTATIC MICROWAVE THERMOTX,,,3024.43,9101.13,21
HCPCS,53850,Prostatic microwave thermotx,,,1127.93,1306.02,8
HCPCS,53850,TRURL DSTRJ PRSTATE TISS MICROWAVE THERMOTH,2168.0,1409.2,1.1,10168.64,148
HCPCS,53852,TRURL DSTRJ PRSTATE TISS RF THERMOTH,9118.5,5927.025,0.01,15865.0,235
HCPCS,53854,TRURL DSTRJ PRST8 TISS RF WV THERMOTHERAPY,9237.0,6004.05,0.01,15865.0,491
HCPCS,53855,INSERT TEMP PROSTATIC URETH STENT W/MEASUREMENT,5039.5,3275.6749999999997,0.01,12500.0,235
HCPCS,53860,TRANSURETHRAL RF TREATMENT,,,1767.05,5317.41,21
HCPCS,53860,Transurethral rf treatment,,,2111.89,2445.34,8
HCPCS,53865,CYSTO INSJ TEMP DEV ISCHMC RMDLG BLDR NECK&PRST8,17442.5,11337.625,0.01,33521.0,228
HCPCS,53866,CATHJ RMVL TEMP DEV ISCHMC RMDLG BLDR NECK&PRST8,885.0,575.25,0.01,12500.0,228
HCPCS,53899,BLADDER NECK CLOSURE,6429.0,4178.85,0.01,6429.0,84
HCPCS,53899,"CALCULUS REMOVAL, URETHRA, VIA INCISION COMP 52315",4739.5,3080.675,0.01,7763.0,169
HCPCS,53899,CYSTO W/URETEROSCOPY W/LITHOTRIPSY (COMP CODE 52353),3225.0,2096.25,0.01,3225.0,84
HCPCS,53899,CYSTO/URETERO W/LITHOTRIPSY &INDWELL STENT INSRT (COMP CODE 5235,3440.0,2236.0,0.01,3440.0,84
HCPCS,53899,DILATATION OF STOMA,1129.0,733.8499999999999,0.01,3443.0,169
HCPCS,53899,EXCISE PERINEPHRIC TUMOR,6633.0,4311.45,0.01,6633.0,84
HCPCS,53899,EXCISION OF URETHRAL FISTULA (COMP CODE 46710),6730.0,4374.5,0.01,6730.0,84
HCPCS,53899,INJECTION INTO BLADDER LESIONS (NON CHEMODENERVATION) (COMP CODE,5351.5,3478.475,0.01,9423.0,169
HCPCS,53899,ITIND DEVICE INSERTION (COMP CODE 52441),1539.0,1000.35,0.01,1539.0,84
HCPCS,53899,ITIND DEVICE REMOVAL COMPLICATED (COMP CODE 52315 COMPLICATED),4825.5,3136.575,0.01,7763.0,169
HCPCS,53899,ITIND DEVICE REMOVAL SIMPLE (COMP CODE 52310 SIMPLE),4391.5,2854.475,0.01,7763.0,169
HCPCS,53899,LAP URINARY UNDIVERSION,13848.0,9001.2,0.01,13848.0,84
HCPCS,53899,LAPAROSCOPIC DIVERTICULECTOMY,4306.0,2798.9,0.01,4306.0,84
HCPCS,53899,LX CYSTOPLASTY OR CYSTOURETHROPLASTY,6568.0,4269.2,0.01,6568.0,84
HCPCS,53899,LYSIS OF BLADDER,2092.0,1359.8,0.01,2092.0,84
HCPCS,53899,OPEN NEOBLADDER/UR DIV LAP URETHRA,18258.0,11867.7,0.01,18258.0,84
HCPCS,53899,PLCMNT RETRO NEPHROURETERAL CATHETER (COMP CODE 50688),4951.5,3218.475,0.01,9423.0,168
HCPCS,53899,POUCHOSCOPY STONE REMOVAL,2630.0,1709.5,0.01,2630.0,84
HCPCS,53899,PROC URINARY UNLISTD,1511.0,982.15,0.01,4628.0,169
HCPCS,53899,REVISION OF ILEAL CONDUIT,7822.0,5084.3,0.01,7822.0,84
HCPCS,53899,SUPRA PUBIC CATHETER REPOSITION (COMP CODE 36597),4708.0,3060.2000000000003,0.01,8932.0,168
HCPCS,53899,UNLISTED EXCISION OF PERUIRETHRAL CYST,1610.0,1046.5,0.01,1610.0,84
HCPCS,53899,URETERAL DILATION,1999.0,1299.35,0.01,1999.0,84
HCPCS,54000,SLITTING OF PREPUCE,,,3024.43,3668.39,20
HCPCS,54000,SLITTING PREPUCE DORSAL/LATERAL SPX NEWBORN,636.0,413.4,1.1,10168.64,148
HCPCS,54000,Slitting of prepuce,,,284.76,329.73,8
HCPCS,54001,SLITTING PREPUCE DORSAL/LAT SPX XCP NEWBORN,5159.5,3353.6749999999997,0.01,9423.0,235
HCPCS,54015,I&D PENIS DEEP,,,1406.56,1718.79,20
HCPCS,54015,I&d penis deep,,,1192.85,1381.19,8
HCPCS,54015,"INCIS/DRAIN PENIS,DEEP",2144.0,1393.6,1.1,4729.25,144
HCPCS,54050,DSTRJ LESION PENIS SIMPLE CHEMICAL,1203.0,781.95,0.01,12500.0,235
HCPCS,54055,DSTRJ LESION PENIS SIMPLE ELECTRODESICCATION,4457.0,2897.05,0.01,8414.0,235
HCPCS,54056,DSTRJ LESION PENIS SIMPLE CRYOSURGERY,741.0,481.65,0.01,12500.0,235
HCPCS,54057,DSTRJ LESION PENIS SIMPLE LASER,4465.0,2902.25,0.01,8414.0,235
HCPCS,54060,DSTRJ LESION PENIS SIMPLE SURG EXCISION,4603.0,2991.9500000000003,0.01,8414.0,235
HCPCS,54065,DSTRJ LESION PENIS EXTENSIVE,4701.0,3055.65,0.01,8414.0,235
HCPCS,54100,BIOPSY PENIS SEPARATE PROCEDURE,4106.5,2669.225,0.01,7453.0,235
HCPCS,54105,BIOPSY OF PENIS,,,2465.15,3022.89,20
HCPCS,54105,"BIOPSY OF PENIS,DEEP STRUCT",1416.0,920.4,1.1,8286.13,148
HCPCS,54105,Biopsy of penis,,,1192.85,1381.19,8
HCPCS,54110,EXCIS PENILE PLAQUE,4368.0,2839.2,1.1,10168.64,144
HCPCS,54110,TREATMENT OF PENIS LESION,,,3024.43,7624.0,21
HCPCS,54110,Treatment of penis lesion,,,1192.85,1381.19,8
HCPCS,54111,"EXCIS PENILE PLAQUE,GRAFT <5CM",5768.0,3749.2,1.1,15090.73,144
HCPCS,54111,TREAT PENIS LESION GRAFT,,,4489.04,5579.94,20
HCPCS,54111,Treat penis lesion graft,,,2812.29,3256.34,8
HCPCS,54112,"EXCIS PENILE PLAQUE,GRAFT >5CM",6792.0,4414.8,1.1,26866.4,144
HCPCS,54112,TREAT PENIS LESION GRAFT,,,3528.0,9851.6,24
HCPCS,54112,Treat penis lesion graft,,,2812.29,3256.34,8
HCPCS,54115,REMV FOR.BODY DEEP PENILE TISS,2780.0,1807.0,1.1,8286.13,148
HCPCS,54115,TREATMENT OF PENIS LESION,,,2465.15,3022.89,20
HCPCS,54115,Treatment of penis lesion,,,1192.85,1381.19,8
HCPCS,54120,PARTIAL REMOVAL OF PENIS,,,3024.43,3668.39,20
HCPCS,54120,Partial removal of penis,,,2812.29,3256.34,8
HCPCS,54120,"REMOVAL PENIS,PARTIAL",4404.0,2862.6,1.1,10168.64,144
HCPCS,54125,REMOVAL OF PENIS,,,2145.75,2145.75,1
HCPCS,54125,"REMOVAL PENIS,TOTAL",5824.0,3785.6,1.1,5824.0,144
HCPCS,54125,Removal of penis,,,2812.29,3256.34,8
HCPCS,54130,AMPUTATION PENIS RADW/BI INGUINOFEMORAL LMPHADE,8736.0,5678.4,1.1,8736.0,144
HCPCS,54130,REMOVE PENIS & NODES,,,3106.8,3106.8,1
HCPCS,54130,Remove penis & nodes,,,2812.29,3256.34,8
HCPCS,54135,AMPUTATION PENIS RADICAL W/LYMPH NODES,11268.0,7324.2,1.1,11268.0,144
HCPCS,54135,REMOVE PENIS & NODES,,,3927.54,3927.54,1
HCPCS,54135,Remove penis & nodes,,,2812.29,3256.34,8
HCPCS,54150,CIRCUMCISION W/CLAMP/OTH DEV W/BLOCK,5091.5,3309.475,0.01,9423.0,235
HCPCS,54160,CIRCUMCISION NEONATE,2041.0,1326.65,0.01,5265.0,235
HCPCS,54161,CIRCUMCISION,3927.0,2552.55,1.1,5941.4,144
HCPCS,54161,CIRCUMCISION AGE >28 DAYS,5375.5,3494.075,0.01,9423.0,231
HCPCS,54162,LYSIS/EXCISION PENILE POSTCIRCUMCISION ADHESIONS,5375.5,3494.075,0.01,9423.0,235
HCPCS,54163,REP INCOMPLETE CIRCUMCISION,5375.5,3494.075,0.01,9423.0,231
HCPCS,54164,FRENULOTOMY OF PENIS,5275.5,3429.075,0.01,9423.0,231
HCPCS,54200,INJECTION PEYRONIE DISEASE,827.0,537.55,0.01,2351.0,383
HCPCS,54205,NJX PX PEYRONIE DS EXPS PLAQ,,,4489.04,5579.94,20
HCPCS,54205,Njx px peyronie ds exps plaq,,,2812.29,3256.34,8
HCPCS,54220,IRRIGATION CORPORA CAVERNOSA PRIAPISM,1043.5,678.2750000000001,0.01,4392.0,322
HCPCS,54230,INJECTION CORPORA CAVERNOSOGRAPY,536.0,348.4,1.1,536.0,148
HCPCS,54230,Njx corpora cavernosograpy,,,1192.85,1381.19,8
HCPCS,54231,DYNAMIC CAVERNOSOMETRY,,,214.41,645.22,21
HCPCS,54231,DYNAMIC CAVERNOSOMETRY NJX VASOACTIVE DRUGS,898.0,583.7,1.1,898.0,148
HCPCS,54231,Dynamic cavernosometry,,,1192.85,1381.19,8
HCPCS,54235,NJX C/P/A CAVERNOSA W/PHARMACOLOGIC AGT,797.5,518.375,0.01,12500.0,407
HCPCS,54240,PENILE PLETHYSMOGRAPHY,,,204.28,819.42,21
HCPCS,54240,Penile plethysmography,,,49.68,57.52,8
HCPCS,54250,NOCTURNAL PENILE TUMESCENCE &/RIGIDITY TEST,1119.0,727.35,1.1,3443.0,354
HCPCS,54300,PENIS STRAIGHTENING CHORDEE,4480.0,2912.0,1.1,10168.64,144
HCPCS,54300,REVISION OF PENIS,,,3024.43,8702.0,24
HCPCS,54300,Revision of penis,,,1192.85,1381.19,8
HCPCS,54304,PENIS CORRJ CHORDEE/1ST STAGE HYPOSPADIAS RPR,5312.0,3452.8,1.1,10168.64,144
HCPCS,54304,REVISION OF PENIS,,,3024.43,8702.0,21
HCPCS,54304,Revision of penis,,,1192.85,1381.19,8
HCPCS,54308,RECONSTRUCTION OF URETHRA,,,4489.04,5579.94,20
HCPCS,54308,Reconstruction of urethra,,,2812.29,3256.34,8
HCPCS,54308,URETHROPLASTY 2ND STAGE HYPOSPADIAS RPR <3 CM,5048.0,3281.2,1.1,15090.73,144
HCPCS,54312,RECONSTRUCTION OF URETHRA,,,3024.43,7778.0,22
HCPCS,54312,Reconstruction of urethra,,,2812.29,3256.34,8
HCPCS,54312,URETHROPLASTY 2ND STAGE HYPOSPADIAS RPR > 3 CM,5804.0,3772.6,1.1,10168.64,144
HCPCS,54316,RECONSTRUCTION OF URETHRA,,,7992.18,9851.6,20
HCPCS,54316,Reconstruction of urethra,,,2812.29,3256.34,8
HCPCS,54316,URETHROPLASTY 2ND STAGE HYPOSPADIAS RPR SKIN GRF,7220.0,4693.0,1.1,26866.4,144
HCPCS,54318,RECONSTRUCTION OF URETHRA,,,3024.43,3668.39,20
HCPCS,54318,Reconstruction of urethra,,,2812.29,3256.34,8
HCPCS,54318,URETHROPLASTY 3RD STG HYPOSPADIAS RPR RLS PENIS,4972.0,3231.8,1.1,10168.64,144
HCPCS,54322,1 STG DSTL HYPOSPADIAS RPR W/SMPL MEATAL ADVMNT,5592.0,3634.8,1.1,10168.64,144
HCPCS,54322,RECONSTRUCTION OF URETHRA,,,3024.43,7624.0,21
HCPCS,54322,Reconstruction of urethra,,,2812.29,3256.34,8
HCPCS,54324,1 STG DSTL HYPOSPADIAS RPR W/URTP SKIN FLAPS,7020.0,4563.0,1.1,10168.64,144
HCPCS,54324,RECONSTRUCTION OF URETHRA,,,3024.43,7813.0,22
HCPCS,54324,Reconstruction of urethra,,,2812.29,3256.34,8
HCPCS,54326,1 STG DSTL HYPOSPADIAS RPR URTP SKN FLAPS,7489.0,4867.85,1.1,10168.64,144
HCPCS,54326,RECONSTRUCTION OF URETHRA,,,3024.43,3668.39,20
HCPCS,54326,Reconstruction of urethra,,,2812.29,3256.34,8
HCPCS,54328,1 STAGE DSTL HYPOSPADIAS RPR W/EXTENSIVE DSJ,6756.0,4391.4,1.1,10168.64,144
HCPCS,54328,REVISE PENIS/URETHRA,,,3024.43,8702.0,21
HCPCS,54328,Revise penis/urethra,,,2812.29,3256.34,8
HCPCS,54332,1 STAGE PROX PENILE/PENOSCROTAL HYPOSPADIAS RPR,7348.0,4776.2,1.1,10168.64,144
HCPCS,54332,REVISE PENIS/URETHRA,,,3024.43,9101.13,22
HCPCS,54332,Revise penis/urethra,,,2812.29,3256.34,8
HCPCS,54336,1 STG PERINEAL HYPOSPADIAS RPR W/GRF&/FLAP,9513.0,6183.45,1.1,10168.64,144
HCPCS,54336,REVISE PENIS/URETHRA,,,3024.43,9101.13,21
HCPCS,54336,Revise penis/urethra,,,2812.29,3256.34,8
HCPCS,54340,RPR HYPOSPADIAS COMPLCTJS CLSR INC/EXC SIMPLE,3884.0,2524.6,1.1,10168.64,144
HCPCS,54340,RPR HYPSPAD COMP SIMPLE,,,3024.43,3668.39,20
HCPCS,54340,Rpr hypspad comp simple,,,1192.85,1381.19,8
HCPCS,54344,RPR HYPOSPADIAS COMPLCTJS MOBLJ FLAPS & URTP,6824.0,4435.6,1.1,26866.4,144
HCPCS,54344,RRP HYPSPAD COMP MOBLJ&URTP,,,7992.18,9851.6,21
HCPCS,54344,Rrp hypspad comp moblj&urtp,,,2812.29,3256.34,8
HCPCS,54348,RPR HYPOSPADIAS COMPLCTJS DSJ & URTP FLAP/GRF,15356.5,9981.725,1.1,23385.0,231
HCPCS,54352,REVISION PRIOR HYPOSPADIAS REPAIR DSJ&EXC RCNSTJ,10452.0,6793.8,1.1,15090.73,144
HCPCS,54352,REVJ PRIOR HYPSPAD REPAIR,,,4489.04,5579.94,20
HCPCS,54352,Revj prior hypspad repair,,,2812.29,3256.34,8
HCPCS,54360,PENIS PLASTIC SURGERY,,,3024.43,8702.0,24
HCPCS,54360,PLASTIC RPR PENIS CORRECT ANGULATION,5112.0,3322.8,1.1,10168.64,144
HCPCS,54360,Penis plastic surgery,,,1192.85,1381.19,8
HCPCS,54380,PLASTIC RPR PENIS EPISPADIAS DSTL SPHNCTR,5672.0,3686.8,1.1,5941.4,144
HCPCS,54380,REPAIR PENIS,,,1767.05,2175.43,20
HCPCS,54380,Repair penis,,,1192.85,1381.19,8
HCPCS,54385,REPAIR PENIS,,,1767.05,2175.43,20
HCPCS,54385,Repair penis,,,1192.85,1381.19,8
HCPCS,54390,PLASTIC RPR PENIS EPISPADIAS W/EXSTROPHY BLADDER,9108.0,5920.2,1.1,9108.0,144
HCPCS,54390,REPAIR PENIS AND BLADDER,,,3230.57,3230.57,1
HCPCS,54390,Repair penis and bladder,,,2812.29,3256.34,8
HCPCS,54400,INSERT SEMI-RIGID PROSTHESIS,,,7813.0,13730.23,21
HCPCS,54400,INSJ PENILE PROSTHESIS NON-INFLATABLE SEMI-RIGID,3668.0,2384.2,1.1,37439.09,142
HCPCS,54400,Insert semi-rigid prosthesis,,,12555.75,14538.24,8
HCPCS,54401,INSERT SELF-CONTD PROSTHESIS,,,17500.12,21569.36,20
HCPCS,54401,INSJ PENILE PROSTHESOS INFLATABLE SELF-CONTAINED,4176.0,2714.4,1.1,58832.42,142
HCPCS,54401,Insert self-contd prosthesis,,,12555.75,14538.24,8
HCPCS,54405,INSERT MULTI-COMP PENIS PROS,,,7813.0,21569.36,22
HCPCS,54405,INSJ MULTI-COMPONENT INFLATABLE PENILE PROSTH,5808.0,3775.2,1.1,58832.42,142
HCPCS,54405,Insert multi-comp penis pros,,,12555.75,14538.24,8
HCPCS,54405,PENILE IMPLANT,42000.0,27300.0,1.1,58832.42,142
HCPCS,54406,REMOVE MUTI-COMP PENIS PROS,,,3024.43,3668.39,20
HCPCS,54406,RMVL INFLATABLE PENILE PROSTH W/O RPLCMT PROSTH,5156.0,3351.4,1.1,10168.64,144
HCPCS,54406,Remove muti-comp penis pros,,,1192.85,1381.19,8
HCPCS,54408,REPAIR MULTI-COMP PENIS PROS,,,4489.04,5579.94,20
HCPCS,54408,RPR COMPONENT INFLATABLE PENILE PROSTHESIS,5564.0,3616.6,1.1,15090.73,142
HCPCS,54408,Repair multi-comp penis pros,,,1192.85,1381.19,8
HCPCS,54410,REMOVE/REPLACE PENIS PROSTH,,,7813.0,21569.36,21
HCPCS,54410,RMVL & RPLCMT INFLATABLE PENILE PROSTH SAME SESS,6072.0,3946.8,1.1,58832.42,142
HCPCS,54410,Remove/replace penis prosth,,,12555.75,14538.24,8
HCPCS,54411,REMOV/REPLC PENIS PROS COMP,,,17500.12,52661.43,21
HCPCS,54411,RMVL & RPLCMT NFLTBL PENILE PROSTH INFECTED FIEL,7340.0,4771.0,1.1,58832.42,142
HCPCS,54411,Remov/replc penis pros comp,,,12555.75,14538.24,8
HCPCS,54415,REMOVE SELF-CONTD PENIS PROS,,,3024.43,3668.39,20
HCPCS,54415,RMVL NON-NFLTBL/NFLTBL PENILE PROSTH W/O RPLCMT,3552.0,2308.8,1.1,10168.64,144
HCPCS,54415,Remove self-contd penis pros,,,1192.85,1381.19,8
HCPCS,54416,REMV/REPL PENIS CONTAIN PROS,,,17500.12,21569.36,20
HCPCS,54416,RMVL & RPLCMT NON-NFLTBL/NFLTBL PENILE PROSTHESI,4832.0,3140.8,1.1,58832.42,142
HCPCS,54416,Remv/repl penis contain pros,,,12555.75,14538.24,8
HCPCS,54417,REMV/REPLC PENIS PROS COMPL,,,11136.66,33512.47,21
HCPCS,54417,RMVL & RPLCMT PENILE PROSTHESIS INFECTED FIELD,6440.0,4186.0,1.1,37439.09,142
HCPCS,54417,Remv/replc penis pros compl,,,12555.75,14538.24,8
HCPCS,54420,CORPORA CAVERNOSA-SAPHENOUS VEIN SHUNT UNI/BI,4956.0,3221.4,1.1,10168.64,144
HCPCS,54420,REVISION OF PENIS,,,3024.43,3668.39,20
HCPCS,54420,Revision of penis,,,1192.85,1381.19,8
HCPCS,54430,CORPORA CAVERNOSA-CORPUS SPONGIOSUM SHUNT UNI/BI,4424.0,2875.6,1.1,4424.0,144
HCPCS,54430,REVISION OF PENIS,,,1667.48,1667.48,1
HCPCS,54430,Revision of penis,,,1192.85,1381.19,8
HCPCS,54435,CORPORA CAVERNOSA-GLANS PENIS FSTLJ PRIAPISM,2724.0,1770.6,1.1,10168.64,144
HCPCS,54435,REVISION OF PENIS,,,3024.43,3668.39,20
HCPCS,54435,Revision of penis,,,1192.85,1381.19,8
HCPCS,54437,REPAIR CORPOREAL TEAR,,,3024.43,9101.13,21
HCPCS,54437,REPAIR OF TRAUMATIC CORPOREAL TEAR(S),4600.0,2990.0,1.1,10168.64,144
HCPCS,54437,Repair corporeal tear,,,2812.29,3256.34,8
HCPCS,54438,REPLANTATION OF PENIS,,,3477.06,3477.06,1
HCPCS,54438,Replantation of penis,,,3635.15,4209.12,8
HCPCS,54440,PLASTIC OPERATION PENIS INJURY,5550.0,3607.5,1.1,10168.64,90
HCPCS,54440,REPAIR OF PENIS,,,3024.43,3668.39,20
HCPCS,54440,Repair of penis,,,1192.85,1381.19,8
HCPCS,54450,FORESKN MANJ W/LSS PREPUTIAL ADS&STRETCHING,783.5,509.275,0.01,4392.0,322
HCPCS,54500,BIOPSY OF TESTIS,,,2465.15,3022.89,20
HCPCS,54500,BIOPSY TESTIS NEEDLE SEPARATE PROCEDURE,524.0,340.6,1.1,8286.13,144
HCPCS,54500,Biopsy of testis,,,284.76,329.73,8
HCPCS,54505,BIOPSY TESTIS INCISIONAL SEPARATE PROCEDURE,8632.5,5611.125,0.01,15865.0,231
HCPCS,54512,EXC XTRPARENCHYMAL LESION TESTIS,3732.0,2425.8,1.1,10168.64,144
HCPCS,54512,EXCISE LESION TESTIS,,,3024.43,6238.0,21
HCPCS,54512,Excise lesion testis,,,1494.77,1730.78,8
HCPCS,54520,ORCHIECTOMY SIMPLE SCROTAL/INGUINAL APPROACH,2332.0,1515.8,1.1,10168.64,144
HCPCS,54520,REMOVAL OF TESTIS,,,3024.43,7813.0,24
HCPCS,54520,Removal of testis,,,1494.77,1730.78,8
HCPCS,54522,ORCHIECTOMY PARTIAL,,,3024.43,3668.39,20
HCPCS,54522,Orchiectomy partial,,,1192.85,1381.19,8
HCPCS,54522,PARTIAL ORCHIECTOMY,4100.0,2665.0,1.1,10168.64,144
HCPCS,54530,ORCHIECTOMY RADICAL TUMOR INGUINAL APPROACH,3384.0,2199.6,1.1,10089.06,144
HCPCS,54530,"ORCHIECTOMY, RADICAL, INGUINAL APPROACH",7680.0,4992.0,1.1,10089.06,144
HCPCS,54530,REMOVAL OF TESTIS,,,3001.45,10789.0,23
HCPCS,54530,Removal of testis,,,1192.85,1381.19,8
HCPCS,54535,EXTENSIVE TESTIS SURGERY,,,3024.43,9101.13,21
HCPCS,54535,Extensive testis surgery,,,1192.85,1381.19,8
HCPCS,54535,ORCHIECTOMY RADICAL TUMOR W/ABDOMINAL EXPL,5276.0,3429.4,1.1,10168.64,144
HCPCS,54550,EXPL UNDESCENDED TSTIS INGUN/SCROTAL AREA,3364.0,2186.6,1.1,10089.06,144
HCPCS,54550,EXPLORATION FOR TESTIS,,,3001.45,3726.07,20
HCPCS,54550,Exploration for testis,,,1494.77,1730.78,8
HCPCS,54560,EXPL UNDESCENDED TESTIS W/ABDOMINAL EXPL,4840.0,3146.0,1.1,5941.4,144
HCPCS,54560,EXPLORATION FOR TESTIS,,,1767.05,5317.41,21
HCPCS,54560,Exploration for testis,,,1192.85,1381.19,8
HCPCS,54600,RDCTJ TORSION TSTIS W/WO FIXJ CLAT TESTIS,3056.0,1986.4,1.1,10168.64,144
HCPCS,54600,REDUCE TESTIS TORSION,,,3024.43,4315.0,21
HCPCS,54600,Reduce testis torsion,,,1494.77,1730.78,8
HCPCS,54620,FIXATION CONTRALATERAL TESTIS SEPARATE PROCEDURE,2084.0,1354.6,1.1,10168.64,144
HCPCS,54620,SUSPENSION OF TESTIS,,,3024.43,3668.39,20
HCPCS,54620,Suspension of testis,,,1494.77,1730.78,8
HCPCS,54640,ORCHIOPEXY INGUINAL OR SCROTAL APPROACH,3401.0,2210.65,1.1,10089.06,144
HCPCS,54640,ORCHIOPEXY INGUN/SCROT APPR,,,3001.45,10789.0,24
HCPCS,54640,Orchiopexy ingun/scrot appr,,,1494.77,1730.78,8
HCPCS,54650,ORCHIOPEXY (FOWLER-STEPHENS),,,3001.45,9031.97,21
HCPCS,54650,ORCHIOPEXY ABDL APPROACH INTRA-ABDOMINAL TESTIS,5452.0,3543.8,1.1,10089.06,144
HCPCS,54650,Orchiopexy (fowler-stephens),,,1192.85,1381.19,8
HCPCS,54660,INSJ TESTICULAR PROSTH SEPARATE PROCEDURE,2296.0,1492.4,1.1,15090.73,142
HCPCS,54660,REVISION OF TESTIS,,,4489.04,9509.0,21
HCPCS,54660,Revision of testis,,,1192.85,1381.19,8
HCPCS,54670,REPAIR TESTIS INJURY,,,3024.43,3668.39,20
HCPCS,54670,Repair testis injury,,,1494.77,1730.78,8
HCPCS,54670,SUTURE/REPAIR TESTICULAR INJURY,2660.0,1729.0,1.1,10168.64,144
HCPCS,54680,RELOCATION OF TESTIS(ES),,,3024.43,3668.39,20
HCPCS,54680,Relocation of testis(es),,,1192.85,1381.19,8
HCPCS,54680,TRANSPLANTATION TESTIS TO THIGH,5616.0,3650.4,1.1,10168.64,144
HCPCS,54690,LAPAROSCOPY ORCHIECTOMY,,,5005.78,6291.49,20
HCPCS,54690,"LAPAROSCOPY, SURGICAL; ORCHIECTOMY",4680.0,3042.0,1.1,16829.38,144
HCPCS,54690,Laparoscopy orchiectomy,,,1192.85,1381.19,8
HCPCS,54692,LAPAROSCOPY ORCHIOPEXY,,,5005.78,15063.4,23
HCPCS,54692,LAPAROSCOPY ORCHIOPEXY INTRA-ABDOMINAL TESTIS,5496.0,3572.4,1.1,16829.38,144
HCPCS,54692,Laparoscopy orchiopexy,,,1192.85,1381.19,8
HCPCS,54699,UNLISTED LAPS PX TESTIS,,,5005.78,15063.4,21
HCPCS,54699,Unlisted laps px testis,,,1494.77,1730.78,8
HCPCS,54700,I&D EPIDIDYMIS TSTIS&/SCROTAL SPACE,5405.5,3513.575,0.01,9423.0,318
HCPCS,54800,BIOPSY OF EPIDIDYMIS,,,1406.56,1718.79,20
HCPCS,54800,"BIOPSY OF EPIDIDYMIS,NEEDLE",932.0,605.8,1.1,4729.25,144
HCPCS,54800,Biopsy of epididymis,,,1494.77,1730.78,8
HCPCS,54830,EXCISION LOCAL LESION EPIDIDYMIS,2404.0,1562.6,1.1,10168.64,144
HCPCS,54830,REMOVE EPIDIDYMIS LESION,,,3024.43,4315.0,21
HCPCS,54830,Remove epididymis lesion,,,1494.77,1730.78,8
HCPCS,54840,EXCISION SPERMATOCELE W/WO EPIDIDYMECTOMY,5765.5,3747.575,0.01,10789.0,231
HCPCS,54860,EPIDIDYMECTOMY UNILATERAL,2780.0,1807.0,1.1,10168.64,144
HCPCS,54860,REMOVAL OF EPIDIDYMIS,,,3024.43,6238.0,21
HCPCS,54860,Removal of epididymis,,,1494.77,1730.78,8
HCPCS,54861,EPIDIDYMECTOMY BILATERAL,3880.0,2522.0,1.1,10168.64,144
HCPCS,54861,REMOVAL OF EPIDIDYMIS,,,3024.43,3668.39,20
HCPCS,54861,Removal of epididymis,,,1192.85,1381.19,8
HCPCS,54865,EXPLORATION OF EPIDIDYMIS W/WO BIOPSY,2539.0,1650.35,1.1,10168.64,144
HCPCS,54865,EXPLORE EPIDIDYMIS,,,3024.43,3668.39,20
HCPCS,54865,Explore epididymis,,,1494.77,1730.78,8
HCPCS,54900,EPIDIDYMOVASOSTOMY ANAST EPIDIDYMIS UNI,5680.0,3692.0,1.1,5941.4,142
HCPCS,54900,FUSION OF SPERMATIC DUCTS,,,1767.05,2175.43,20
HCPCS,54900,Fusion of spermatic ducts,,,1494.77,1730.78,8
HCPCS,54901,EPIDIDYMOVASOSTOMY ANAST EPIDIDYMIS BI,7640.0,4966.0,1.1,10168.64,142
HCPCS,54901,FUSION OF SPERMATIC DUCTS,,,3024.43,3668.39,20
HCPCS,54901,Fusion of spermatic ducts,,,1192.85,1381.19,8
HCPCS,55000,PNXR ASPIR HYDROCELE TUNICA VAGIS W/WO NJX MED,1904.5,1237.9250000000002,0.01,12500.0,235
HCPCS,55040,EXCISION HYDROCELE UNILATERAL,9207.0,5984.55,0.01,16234.0,231
HCPCS,55041,EXCISION HYDROCELE BILATERAL,3758.0,2442.7,1.1,10089.06,144
HCPCS,55041,REMOVAL OF HYDROCELES,,,3001.45,8326.0,22
HCPCS,55041,Removal of hydroceles,,,1192.85,1381.19,8
HCPCS,55060,REPAIR OF HYDROCELE,,,3024.43,4315.0,21
HCPCS,55060,RPR TUNICA VAGINALIS HYDROCELE BOTTLE TYPE,2460.0,1599.0,1.1,10168.64,144
HCPCS,55060,Repair of hydrocele,,,1494.77,1730.78,8
HCPCS,55100,DRAINAGE SCROTAL WALL ABSCESS,4216.5,2740.725,0.01,7453.0,322
HCPCS,55110,EXPLORE SCROTUM,2532.0,1645.8,1.1,10168.64,164
HCPCS,55110,Explore scrotum,,,1192.85,1381.19,8
HCPCS,55120,REMOVAL FOREIGN BODY SCROTUM,2288.0,1487.2,1.1,5941.4,144
HCPCS,55120,REMOVAL OF SCROTUM LESION,,,1767.05,5265.0,21
HCPCS,55120,Removal of scrotum lesion,,,1494.77,1730.78,8
HCPCS,55150,REMOVAL OF SCROTUM,,,2351.0,3668.39,21
HCPCS,55150,RESECTION SCROTUM,3256.0,2116.4,1.1,10168.64,144
HCPCS,55150,Removal of scrotum,,,1494.77,1730.78,8
HCPCS,55175,REVISION OF SCROTUM,,,2351.0,7624.0,23
HCPCS,55175,Revision of scrotum,,,1494.77,1730.78,8
HCPCS,55175,SCROTOPLASTY SIMPLE,2348.0,1526.2,1.1,10168.64,144
HCPCS,55180,REVISION OF SCROTUM,,,3528.0,5579.94,21
HCPCS,55180,Revision of scrotum,,,1192.85,1381.19,8
HCPCS,55180,SCROTOPLASTY COMPLICATED,4712.0,3062.8,1.1,15090.73,144
HCPCS,55200,INCISION OF SPERM DUCT,,,3024.43,3668.39,20
HCPCS,55200,Incision of sperm duct,,,1494.77,1730.78,8
HCPCS,55200,VASOTOMY CANNULIZATION W/WO VAS INC UNI/BI SPX,1820.0,1183.0,1.1,10168.64,148
HCPCS,55250,VASECTOMY SURGERY,2736.0,1778.4,1.1,5941.4,148
HCPCS,55250,VASECTOMY UNI/BI SPX W/POSTOP SEMEN EXAMS,5385.5,3500.575,0.01,9423.0,235
HCPCS,55300,Prepare sperm duct x-ray,,,49.68,57.52,8
HCPCS,55300,VASOTOMY VASOGRAMS UNI/BI,1400.0,910.0,1.1,1400.0,144
HCPCS,55400,REPAIR OF SPERM DUCT,,,3024.43,3668.39,20
HCPCS,55400,Repair of sperm duct,,,1192.85,1381.19,8
HCPCS,55400,VASOVASOSTOMY VASOVASORRHAPHY,3788.0,2462.2,1.1,10168.64,142
HCPCS,55500,EXC HYDROCELE SPRMATIC CORD UNI SPX,2488.0,1617.2,1.1,10168.64,144
HCPCS,55500,REMOVAL OF HYDROCELE,,,3024.43,3668.39,20
HCPCS,55500,Removal of hydrocele,,,1494.77,1730.78,8
HCPCS,55520,EXC LESION SPERMATIC CORD SEPARATE PROCEDURE,2664.0,1731.6,1.1,10168.64,144
HCPCS,55520,REMOVAL OF SPERM CORD LESION,,,3024.43,6238.0,21
HCPCS,55520,Removal of sperm cord lesion,,,1494.77,1730.78,8
HCPCS,55530,EXC VARICOCELE/LIGATION SPERMATIC VEINS SPX,2300.0,1495.0,1.1,10168.64,144
HCPCS,55530,REVISE SPERMATIC CORD VEINS,,,3024.43,10789.0,24
HCPCS,55530,Revise spermatic cord veins,,,1192.85,1381.19,8
HCPCS,55535,EXC VARICOCELE/LIGATION SPERMATIC VEINS ABDL,2876.0,1869.4,1.1,22063.69,144
HCPCS,55535,REVISE SPERMATIC CORD VEINS,,,5784.5,6737.21,20
HCPCS,55535,Revise spermatic cord veins,,,1494.77,1730.78,8
HCPCS,55540,EXC VARICOCELE/LIGATION VEINS W/HERNIA RPR,3320.0,2158.0,1.1,10089.06,144
HCPCS,55540,REVISE HERNIA & SPERM VEINS,,,3001.45,3726.07,20
HCPCS,55540,Revise hernia & sperm veins,,,1192.85,1381.19,8
HCPCS,55550,LAPARO LIGATE SPERMATIC VEIN,,,5005.78,33436.0,22
HCPCS,55550,LAPS LIGATION SPERMATIC VEINS VARICOCELE,2880.0,1872.0,1.1,16829.38,144
HCPCS,55550,Laparo ligate spermatic vein,,,1192.85,1381.19,8
HCPCS,55559,LAPAROSCOPIC EXCISION OF SPERMATIC CORD LESION (COMP 55520),2664.0,1731.6,0.01,16829.38,84
HCPCS,55559,"UNLISTED LAPAROSCOY PROCEDURE, SPERMATIC CORD (COMPARISON CODE 5",2664.0,1731.6,0.01,16829.38,84
HCPCS,55559,UNLISTED LAPROSCOPY PROCEDURE SPERMATIC CORD,6868.0,4464.2,0.01,16829.38,84
HCPCS,55559,UNLSTD LAPS PX SPRMATIC CORD,,,5005.78,6291.49,20
HCPCS,55559,Unlstd laps px sprmatic cord,,,1494.77,1730.78,8
HCPCS,55600,VESICULOTOMY,3084.0,2004.6,1.1,5941.4,164
HCPCS,55600,Vesiculotomy,,,1494.77,1730.78,8
HCPCS,55605,Vesiculotomy complicated,,,1192.85,1381.19,8
HCPCS,55650,Remove sperm duct pouch,,,1192.85,1381.19,8
HCPCS,55650,VESICULECTOMY ANY APPROACH,5060.0,3289.0,1.1,5060.0,144
HCPCS,55680,EXCISION MULLERIAN DUCT CYST,2268.0,1474.2,1.1,10168.64,144
HCPCS,55680,REMOVE SPERM POUCH LESION,,,3024.43,3668.39,20
HCPCS,55680,Remove sperm pouch lesion,,,1192.85,1381.19,8
HCPCS,55700,BIOPSY OF PROSTATE,,,1767.05,5457.0,12
HCPCS,55700,Biopsy of prostate,,,1127.93,1306.02,8
HCPCS,55705,BIOPSY PROSTATE INCISIONAL ANY APPROACH,8854.5,5755.425,0.01,15865.0,231
HCPCS,55706,BX PROSTATE STRTCTC SATURATION SAMPLING IMG GID,9188.5,5972.525,0.01,15865.0,231
HCPCS,55707,BIOPSY PROSTATE TRANSRECTAL ULTRASOUND-GUIDED,8861.5,5759.974999999999,0.01,16566.0,260
HCPCS,55708,BX PROSTATE TRANSRECTAL US GID W/MRI FUS GDN 1ST,9029.0,5868.849999999999,0.01,16566.0,260
HCPCS,55709,BX PROSTATE TRANSPERINEAL ULTRASOUND-GUIDED,8993.5,5845.775,0.01,16566.0,260
HCPCS,55710,BX PROSTATE TRANSPERINEAL US GID W/MRI FUS GDN 1,9121.0,5928.65,0.01,16566.0,260
HCPCS,55711,BX PROSTATE TRANSRECTAL MRI-US GID TRGT LES 1ST,8857.0,5757.05,0.01,16566.0,260
HCPCS,55712,BX PROSTATE TPRNL MRI-US GID TRGT LES 1ST,8965.0,5827.25,0.01,16566.0,260
HCPCS,55713,BX PROSTATE IN-BORE CT/MRI BX ADDL TRGT LES 1ST,13479.0,8761.35,0.01,25198.0,260
HCPCS,55714,BX PROSTATE IN-BORE CT/MRI TRGT LES ONLY 1ST,13395.5,8707.075,0.01,25198.0,260
HCPCS,55715,BX PROSTATE EA ADDL MRI-US FUSION/IN-BORE CT/MRI,12830.0,8339.5,0.01,25198.0,240
HCPCS,55720,PROSTATOTOMY EXTERNAL DRG ABSCESS SIMPLE,9478.5,6161.025,0.01,15865.0,231
HCPCS,55725,DRAINAGE OF PROSTATE ABSCESS,,,3024.43,3668.39,20
HCPCS,55725,Drainage of prostate abscess,,,1127.93,1306.02,8
HCPCS,55725,PROSTATOTOMY EXTERNAL DRG ABSCESS COMPLICATED,4422.0,2874.3,1.1,10168.64,144
HCPCS,55801,PROSTATECTOMY PERINEAL SUBTOTAL,7920.0,5148.0,1.1,7920.0,144
HCPCS,55801,REMOVAL OF PROSTATE,,,2850.64,2850.64,1
HCPCS,55801,Removal of prostate,,,3284.72,3803.36,8
HCPCS,55810,EXTENSIVE PROSTATE SURGERY,,,3399.16,3399.16,1
HCPCS,55810,Extensive prostate surgery,,,3284.72,3803.36,8
HCPCS,55810,PROSTATECTOMY PERINEAL RADICAL,9716.0,6315.4,1.1,9716.0,144
HCPCS,55812,EXTENSIVE PROSTATE SURGERY,,,4178.86,4178.86,1
HCPCS,55812,Extensive prostate surgery,,,3284.72,3803.36,8
HCPCS,55815,EXTENSIVE PROSTATE SURGERY,,,4575.25,4575.25,1
HCPCS,55815,Extensive prostate surgery,,,3284.72,3803.36,8
HCPCS,55821,PROSTATECTOMY SUPRAPUBIC SUBTOTAL 1/2 STAGES,6072.0,3946.8,1.1,6072.0,144
HCPCS,55821,REMOVAL OF PROSTATE,,,2186.44,2186.44,1
HCPCS,55821,Removal of prostate,,,3284.72,3803.36,8
HCPCS,55831,PROSTATECTOMY RETROPUBIC SUBTOTAL,6240.0,4056.0,1.1,6240.0,144
HCPCS,55831,REMOVAL OF PROSTATE,,,2242.06,2242.06,1
HCPCS,55831,Removal of prostate,,,3284.72,3803.36,8
HCPCS,55840,EXTENSIVE PROSTATE SURGERY,,,3046.36,3046.36,1
HCPCS,55840,Extensive prostate surgery,,,3284.72,3803.36,8
HCPCS,55840,PROSTATECTOMY RETROPUBIC W/WO NERVE SPARING,8544.0,5553.6,1.1,8544.0,144
HCPCS,55842,EXTENSIVE PROSTATE SURGERY,,,3044.63,3044.63,1
HCPCS,55842,Extensive prostate surgery,,,3284.72,3803.36,8
HCPCS,55842,PROSTECT RETROPUBIC RAD W/WO NRV SPAR W/LYMPH BX,8544.0,5553.6,1.1,8544.0,144
HCPCS,55845,EXTENSIVE PROSTATE SURGERY,,,3542.98,3542.98,1
HCPCS,55845,Extensive prostate surgery,,,3284.72,3803.36,8
HCPCS,55845,PROSTECT RETROPUB RAD W/WO NRV SPAR & BI PLV LYM,11079.0,7201.35,1.1,11079.0,144
HCPCS,55860,SURGICAL EXPOSURE PROSTATE,,,4489.04,13508.42,21
HCPCS,55860,Surgical exposure prostate,,,3284.72,3803.36,8
HCPCS,55862,EXTENSIVE PROSTATE SURGERY,,,2850.45,2850.45,1
HCPCS,55862,Extensive prostate surgery,,,3284.72,3803.36,8
HCPCS,55865,EXTENSIVE PROSTATE SURGERY,,,3470.37,3470.37,1
HCPCS,55865,Extensive prostate surgery,,,3284.72,3803.36,8
HCPCS,55866,LAPS PROSTECT RETROPUBIC RAD W/NRV SPARING ROBOT,9882.0,6423.3,1.1,30022.29,144
HCPCS,55866,LAPS SURG PRST8ECT RPBIC RAD,,,4616.0,26873.26,23
HCPCS,55866,Laps surg prst8ect rpbic rad,,,3284.72,3803.36,8
HCPCS,55867,LAPS SURG PRST8ECT SMPL STOT,,,4616.0,26873.26,23
HCPCS,55867,LAPS SURG PRST8ECT SMPL STOT ROBOTIC ASSISTANCE,7812.0,5077.8,1.1,30022.29,144
HCPCS,55867,Laps surg prst8ect smpl stot,,,3284.72,3803.36,8
HCPCS,55868,LAP SRG PRST8CT LYMPH NOD BX,,,10056.64,11062.31,12
HCPCS,55868,LAPS SURG PRST8ECT RPBIC RADICAL W/LYMPH NODE BX,9882.0,6423.3,1.1,9882.0,106
HCPCS,55868,Lap srg prst8ct lymph nod bx,,,3284.72,3803.36,8
HCPCS,55869,LAP SRG PRST8CT BI PL LMPHAD,,,10056.64,11062.31,12
HCPCS,55869,LAPS SURG PRST8ECT RPBIC RAD W/BI PEL LYMPHADEC,12060.0,7839.0,1.1,12060.0,106
HCPCS,55869,Lap srg prst8ct bi pl lmphad,,,3284.72,3803.36,8
HCPCS,55870,ELECTROEJACULATION,1032.0,670.8,1.1,2344.73,155
HCPCS,55870,Electroejaculation,,,284.76,329.73,8
HCPCS,55873,CRYOABLATE PROSTATE,,,7992.18,9851.6,20
HCPCS,55873,CRYOSURGICAL ABLATION PROSTATE W/US & MONITORI,5440.0,3536.0,1.1,26866.4,148
HCPCS,55873,Cryoablate prostate,,,3284.72,3803.36,8
HCPCS,55874,TRANSPERINEAL PLMT BIODEGRADABLE MATRL 1/MLT NJX,12298.5,7994.025,0.01,23385.0,233
HCPCS,55875,TRANSPERINEAL PLMT NDL/CATHS PROSTATE RADJ INSJ,14384.5,9349.925,1.1,33436.0,231
HCPCS,55876,PLACE RT DEVICE/MARKER PROS,571.0,371.15,1.1,4040.52,148
HCPCS,55876,PLMT INTERSTITIAL DEV RADIAT TX PROSTATE 1/MULT,3493.0,2270.45,0.01,6294.0,235
HCPCS,55877,ABLATION IRE PRST8 1 OR MORE TUMORS PERCUTANEOUS,5940.0,3861.0,1.1,5940.0,106
HCPCS,55877,ABLTJ IRE PRST8 1+ TUM PERQ,,,10056.64,11062.31,12
HCPCS,55877,Abltj ire prst8 1+ tum perq,,,3284.72,3803.36,8
HCPCS,55880,TRANSRECTAL ABLTJ MAL PRST8 TISSUE HIFU W/US,24814.5,16129.425,1.1,42537.0,318
HCPCS,55881,ABLATION TRANSURETHRAL PRST8 TISSUE W/THERMAL US,4312.0,2802.8,1.1,28944.23,144
HCPCS,55881,"TULSA TREATMENT (DONE BY TWO PHYSICIANS) ABLATION PROSTATE TISS,",33629.0,21858.85,0.01,33629.0,67
HCPCS,55882,ABLT TRURL PRST8 TIS THRM US INS TRURL US TRNSDC,5060.0,3289.0,1.1,29972.29,144
HCPCS,55882,"TULSA COMP PROC (DONE BY SING PHYS)ABL PROSTATE TISS, TRANSURETH",19510.0,12681.5,0.01,19510.0,84
HCPCS,55899,ASPIRATION OF SPERMATOCELE (COMP CODE 55000),1645.0,1069.25,0.01,4337.0,169
HCPCS,55899,BURIED PENIS REPAIR,3696.0,2402.4,0.01,3696.0,84
HCPCS,55899,"DEGLOVING;PLASTIC RPR PENIS,SCRTL SKIN",7676.0,4989.4,0.01,7676.0,84
HCPCS,55899,DENERVATION MICROSURGICAL SPERM CORD (COMP 55530 & 55520),1849.0,1201.85,0.01,1849.0,84
HCPCS,55899,EXAM MALE GENITALIA UNDER ANESTHESIA,578.0,375.7,0.01,719.34,84
HCPCS,55899,"EXAM UNDER ANESTHESIA, MALE",520.0,338.0,0.01,719.34,84
HCPCS,55899,EXC FB SCROTAL/GENITALIA,2360.0,1534.0,0.01,2360.0,84
HCPCS,55899,FIRST STAGE SCROTAL TUNNELING,5128.0,3333.2,0.01,5128.0,84
HCPCS,55899,FREE FLAP PHALLOPLASTY (COMP CODE 15757),15975.0,10383.75,0.01,15975.0,84
HCPCS,55899,"GENITAL SURG PROC,MALE UNLISTED",608.0,395.2,0.01,719.34,84
HCPCS,55899,HIFU PROCEDURE - HIGH INTENSITY FOCUSED ULTRASOUND (COMP 55873),3326.0,2161.9,0.01,3326.0,84
HCPCS,55899,IMPL TESTIES IN HEMISCROT (COMP CODE 54680),4590.0,2983.5,0.01,4590.0,84
HCPCS,55899,LAPAROSCOPIC VASECTOMY,2740.0,1781.0,0.01,2740.0,84
HCPCS,55899,LAPAROSCOPIC VESICULECTOMY (COMP CODE 55650),5060.0,3289.0,0.01,5060.0,84
HCPCS,55899,LIBERATION OF BURIED PENIS,2247.0,1460.55,0.01,2247.0,84
HCPCS,55899,MICRODISSECTION TESTICULAR SPERM EXTRACTION (54522),8489.0,5517.849999999999,0.01,13287.0,168
HCPCS,55899,MICROSCOPIC CREMASTERIC LYSIS (COMP CODE 64722),3434.0,2232.1,0.01,3434.0,84
HCPCS,55899,PERC EPIDIDYMAL SPERM ASPIRATION UNI/BILAT(PESA) (COMP 54505),2300.0,1495.0,0.01,2300.0,84
HCPCS,55899,PESA,1736.0,1128.4,0.01,4337.0,85
HCPCS,55899,ROBOTIC URETEROCALYCOSTOMY,7005.0,4553.25,0.01,7005.0,84
HCPCS,55899,SECOND STAGE SCROTAL RELEASE,4102.0,2666.3,0.01,4102.0,84
HCPCS,55899,"SEED IMPLANT ""GOLD"" PROSTATE MARKER",851.0,553.15,0.01,851.0,84
HCPCS,55899,SEMINAL VESICLE BX SINGLE OR MULTI,3789.0,2462.85,0.01,4337.0,85
HCPCS,55899,SEMINAL VESICLE BX SINGLE OR MULTI (COMP 55700),1064.0,691.6,0.01,1064.0,84
HCPCS,55899,TESTIC. PROSTH. REMOVAL,3934.0,2557.1,0.01,3934.0,84
HCPCS,55899,"TESTICULAR SPERM EXTRACTION, UNI/BILAT (MICRO TESE)(COMP 54550)",4734.0,3077.1,0.01,4734.0,84
HCPCS,55899,UNLISTED PROCEDURE MALE GENITAL SYSTEM,1736.0,1128.4,214.41,4337.0,84
HCPCS,55920,PLACE NEEDLES PELVIC FOR RT,,,4315.14,5205.97,20
HCPCS,55920,PLACEMENT NEEDLE PELVIC ORGAN RADIOELEMENT APPL,3324.0,2160.6,1.1,14506.08,144
HCPCS,55920,Place needles pelvic for rt,,,2832.26,3279.46,8
HCPCS,55970,SEX TRANSFORMATION M TO F,,,4315.14,12985.13,21
HCPCS,55970,Sex transformation m to f,,,2812.29,3256.34,8
HCPCS,55980,SEX TRANSFORMATION F TO M,,,3024.43,9101.13,21
HCPCS,55980,Sex transformation f to m,,,4028.01,4664.01,8
HCPCS,56405,I&D VULVA/PERINEAL ABSCESS,997.5,648.375,0.01,4392.0,322
HCPCS,56420,I&D OF BARTHOLINS GLAND ABSCESS,750.5,487.825,0.01,4392.0,322
HCPCS,56440,MARSUP BARTHOLIN GLAND CYST,1156.0,751.4,1.1,9118.72,144
HCPCS,56440,MARSUPIALIZATION BARTHOLINS GLAND CYST,14626.0,9506.9,0.01,14626.0,87
HCPCS,56441,LYSIS LABIAL ADHESIONS,7717.0,5016.05,0.01,14626.0,235
HCPCS,56442,HYMENOTOMY SIMPLE INCISION,14626.0,9506.9,0.01,14626.0,174
HCPCS,56442,"HYMENOTOMY, SIMPLE INCISION",272.0,176.8,1.1,9118.72,144
HCPCS,56501,DESTRUCTION LESIONS VULVA SIMPLE,4523.0,2939.9500000000003,0.01,8414.0,235
HCPCS,56515,DESTRUCTION LESIONS VULVA EXTENSIVE,4884.5,3174.925,0.01,8414.0,235
HCPCS,56605,BIOPSY VULVA/PERINEUM 1 LESION SPX,2222.5,1444.625,0.01,4392.0,235
HCPCS,56606,BIOPSY VULVA/PERINEUM EACH ADDL LESION,502.0,326.3,0.01,3443.0,216
HCPCS,56620,PART SIMPLE REMV VULVA - COMPLEX,2400.0,1560.0,1.1,9118.72,144
HCPCS,56620,PART SIMPLE REMV VULVA - MODERATE,2100.0,1365.0,1.1,9118.72,144
HCPCS,56620,PART SIMPLE REMV VULVA - SIMPLE,1750.0,1137.5,1.1,9118.72,144
HCPCS,56620,VULVECTOMY SIMPLE PARTIAL,3313.0,2153.45,1.1,13821.0,167
HCPCS,56620,Vulvectomy simple partial,,,1469.37,1701.37,8
HCPCS,56625,VULVECTOMY SIMPLE COMPLETE,4259.0,2768.35,1.1,9118.72,165
HCPCS,56625,Vulvectomy simple complete,,,4028.01,4664.01,8
HCPCS,56630,VULVECTOMY RADICAL PARTIAL,6512.0,4232.8,1.1,6512.0,157
HCPCS,56630,Vulvectomy radical partial,,,4028.01,4664.01,8
HCPCS,56631,VLVCTMY RAD PRTL UNI LYMPHAD,,,3119.27,3119.27,1
HCPCS,56631,VULVECTOMY RAD PRTL UNI INGUINOFEM LMPHADECTOMY,7596.0,4937.4,1.1,7596.0,144
HCPCS,56631,Vlvctmy rad prtl uni lymphad,,,4028.01,4664.01,8
HCPCS,56632,VLVCTMY RAD PRTL BI LYMPHAD,,,3761.61,3761.61,1
HCPCS,56632,VULVECTOMY RAD PRTL BI INGUINOFEM LMPHADECTOMY,8744.0,5683.6,1.1,8744.0,144
HCPCS,56632,Vlvctmy rad prtl bi lymphad,,,4028.01,4664.01,8
HCPCS,56633,VULVECTOMY RADICAL COMPLETE,7848.0,5101.2,1.1,7848.0,145
HCPCS,56633,Vulvectomy radical complete,,,4028.01,4664.01,8
HCPCS,56634,VLVCTMY RAD COMP UNI LYMPHAD,,,3405.63,3405.63,1
HCPCS,56634,VULVECTOMY RAD COMPL UNI INGUINOFEM LMPHADECTOMY,8264.0,5371.6,1.1,8264.0,144
HCPCS,56634,Vlvctmy rad comp uni lymphad,,,4028.01,4664.01,8
HCPCS,56637,VLVCTMY RAD COMP BI LYMPHAD,,,3992.65,3992.65,1
HCPCS,56637,VULVECTOMY RAD COMPL BI INGUINOFEM LMPHADECTOMY,9900.0,6435.0,1.1,9900.0,144
HCPCS,56637,Vlvctmy rad comp bi lymphad,,,4028.01,4664.01,8
HCPCS,56640,VLVCTMY RAD COMP W/LYMPHADEC,,,4012.48,4012.48,1
HCPCS,56640,VULVECTOMY RAD COMPL ILIAC & PELVIC LMPHADECTOMY,9912.0,6442.8,1.1,9912.0,144
HCPCS,56640,Vlvctmy rad comp w/lymphadec,,,4028.01,4664.01,8
HCPCS,56700,PRTL HYMENECTOMY/REVJ HYMENAL RING,7881.0,5122.65,0.01,14626.0,231
HCPCS,56740,EXC BARTHOLINS GLAND/CYST,1952.0,1268.8,1.1,9118.72,164
HCPCS,56740,Exc bartholins gland/cyst,,,1469.37,1701.37,8
HCPCS,56800,PLASTIC REPAIR INTROITUS,8099.0,5264.349999999999,0.01,14626.0,231
HCPCS,56805,CLITOROPLASTY INTERSEX STATE,8747.0,5685.55,1.1,9118.72,167
HCPCS,56805,Clitoroplasty intersex state,,,1469.37,1701.37,8
HCPCS,56810,PERINEOPLASTY RPR PER NONOB,,,2712.29,13821.0,21
HCPCS,56810,PERINEOPLASTY RPR PERINEUM NONOBSTETRICAL SPX,1716.0,1115.4,1.1,9118.72,144
HCPCS,56810,Perineoplasty rpr per nonob,,,1469.37,1701.37,8
HCPCS,56820,COLPOSCOPY VULVA,925.0,601.25,0.01,12500.0,87
HCPCS,56820,"COLPOSCOPY, VULVA",600.0,390.0,1.1,600.0,148
HCPCS,56821,COLPOSCOPY VULVA W/BIOPSY,1109.5,721.175,0.01,4392.0,235
HCPCS,57000,COLPOTOMY W/EXPLORATION,7917.0,5146.05,0.01,14626.0,231
HCPCS,57010,COLPOTOMY DRG PEL ABSCESS,,,2712.29,3368.83,20
HCPCS,57010,COLPOTOMY W/DRAINAGE PELVIC ABSCESS,2736.0,1778.4,1.1,9118.72,144
HCPCS,57010,Colpotomy drg pel abscess,,,1469.37,1701.37,8
HCPCS,57020,COLPOCENTESIS SEPARATE PROCEDURE,11654.0,7575.1,0.01,22708.0,235
HCPCS,57022,I&D VAGINAL HEMATOMA OBSTETRICAL/POSTPARTUM,1092.0,709.8,1.1,8286.13,144
HCPCS,57022,"INCISION AND DRAINAGE HEMATOMA, VAGINAL OB/POSTPARTUM",3866.0,2512.9,200.78,6112.0,87
HCPCS,57023,I&D VAGINAL HEMATOMA NON-OB,,,2465.15,3022.89,20
HCPCS,57023,I&D VAGINAL HEMATOMA NON-OBSTETRICAL,2072.0,1346.8,1.1,8286.13,144
HCPCS,57023,I&d vaginal hematoma non-ob,,,1469.37,1701.37,8
HCPCS,57061,DESTRUCTION VAGINAL LESIONS SIMPLE,7599.0,4939.349999999999,0.01,14626.0,235
HCPCS,57065,DESTRUCTION VAGINAL LESIONS EXTENSIVE,7898.0,5133.7,0.01,14626.0,235
HCPCS,57100,BIOPSY VAGINAL MUCOSA SIMPLE,2242.5,1457.625,0.01,4392.0,235
HCPCS,57105,BIOPSY VAGINAL MUCOSA EXTENSIVE,7661.0,4979.65,0.01,14626.0,235
HCPCS,57106,VAGINECTOMY PARTIAL REMOVAL VAGINAL WALL,3000.0,1950.0,1.1,9118.72,144
HCPCS,57106,VAGNC PRTL RMVL VAG WALL,,,2712.29,8161.83,21
HCPCS,57106,Vagnc prtl rmvl vag wall,,,1469.37,1701.37,8
HCPCS,57107,VAGINECTOMY PRTL RMVL VAG WALL & PARAVAGINAL T,9824.0,6385.6,1.1,9824.0,144
HCPCS,57107,VAGNC COMPL RMVL PARAVAG TIS,,,2712.29,8161.83,21
HCPCS,57107,Vagnc compl rmvl paravag tis,,,4028.01,4664.01,8
HCPCS,57109,VAGNC BI TOTAL PEL LYMPHADEC,,,2712.29,8161.83,21
HCPCS,57109,VAGNC PRTL RMVL VAG WALL W/BI TOT PEL LMPHADEC,11360.0,7384.0,1.1,11360.0,144
HCPCS,57109,Vagnc bi total pel lymphadec,,,4028.01,4664.01,8
HCPCS,57110,VAGINECTOMY COMPLETE REMOVAL VAGINAL WALL,6192.0,4024.8,1.1,6192.0,144
HCPCS,57110,VAGNC COMPL RMVL VAG WALL,,,2376.1,2376.1,1
HCPCS,57110,Vagnc compl rmvl vag wall,,,4028.01,4664.01,8
HCPCS,57111,VAGINECTOMY COMPL RMVL VAG WALL & PARAVAG TISS,11360.0,7384.0,1.1,11360.0,144
HCPCS,57111,VAGNC COMPL RMVL PARAVAG TIS,,,4549.91,4549.91,1
HCPCS,57111,Vagnc compl rmvl paravag tis,,,4028.01,4664.01,8
HCPCS,57112,Vaginectomy w/nodes compl,,,4028.01,4664.01,8
HCPCS,57120,COLPOCLEISIS LE FORT TYPE,3312.0,2152.8,1.1,14506.08,165
HCPCS,57120,Colpocleisis le fort type,,,4028.01,4664.01,8
HCPCS,57130,EXCIS VAGINAL SEPTUM,984.0,639.6,1.1,9118.72,148
HCPCS,57130,EXCISION VAGINAL SEPTUM,,,2712.29,3368.83,20
HCPCS,57130,Excision vaginal septum,,,1469.37,1701.37,8
HCPCS,57135,EXCIS VAGINAL CYST/TUMOR,1080.0,702.0,1.1,9118.72,148
HCPCS,57135,EXCISION VAGINAL CYST/TUMOR,14626.0,9506.9,0.01,14626.0,87
HCPCS,57150,IRRIGATION VAGINA&/APPL MEDICAMENT TX DISEASE,200.0,130.0,1.1,200.0,148
HCPCS,57150,TREAT VAGINA INFECTION,,,53.07,159.69,21
HCPCS,57150,Treat vagina infection,,,68.6,79.43,8
HCPCS,57155,INSERTION UTERINE TANDEM&/VAGINAL OVOIDS,12487.0,8116.55,1.1,22708.0,235
HCPCS,57156,INSERTION VAGINAL RADIATION DEVICE,1237.5,804.375,0.01,4337.0,235
HCPCS,57160,FIT&INSJ PESSARY/OTH INTRAVAGINAL SUPPORT DEVI,640.5,416.325,0.01,12500.0,321
HCPCS,57170,DIAPHRAGM/CERVICAL CAP FITTING W/INSTRUCTIONS,644.5,418.925,0.01,12500.0,235
HCPCS,57180,INTRO ANY HEMOSTATIC AGENT/PACK VAG HEMRRG SPX,788.5,512.525,0.01,4392.0,322
HCPCS,57200,COLPORRHAPHY SUTURE INJURY VAGINA,8197.0,5328.05,0.01,14626.0,318
HCPCS,57210,COLPOPERINEORRHAPHY SUTURE INJ VAGINA&/PERINEU,2284.0,1484.6,1.1,9118.72,144
HCPCS,57210,REPAIR VAGINA/PERINEUM,,,2712.29,3368.83,20
HCPCS,57210,Repair vagina/perineum,,,1469.37,1701.37,8
HCPCS,57220,PLASTIC URETHRAL SPHINCTER VAGINAL APPROACH,1940.0,1261.0,1.1,14506.08,144
HCPCS,57220,REVISION OF URETHRA,,,4315.14,5205.97,20
HCPCS,57220,Revision of urethra,,,2111.89,2445.34,8
HCPCS,57230,PLASTIC REPAIR URETHROCELE,2520.0,1638.0,1.1,9118.72,144
HCPCS,57230,REPAIR OF URETHRAL LESION,,,2712.29,3368.83,20
HCPCS,57230,Repair of urethral lesion,,,2111.89,2445.34,8
HCPCS,57240,ANTERIOR COLPORRAPHY RPR CYSTOCELE W/CYSTO,4032.0,2620.8,1.1,14506.08,144
HCPCS,57240,ANTERIOR COLPORRHAPHY,,,4315.14,9509.0,21
HCPCS,57240,Anterior colporrhaphy,,,2111.89,2445.34,8
HCPCS,57250,POST COLPORRHAPHY RECTOCELE W/WO PERINEORRHAPHY,4435.0,2882.75,1.1,14506.08,144
HCPCS,57250,REPAIR RECTUM & VAGINA,,,4315.14,13821.0,23
HCPCS,57250,Repair rectum & vagina,,,1087.45,1259.15,8
HCPCS,57260,CMBN ANT PST COLPRHY,,,4315.14,13821.0,23
HCPCS,57260,CMBND ANTERPOST COLPORRAPHY W/CYSTO,5830.0,3789.5,1.1,14506.08,144
HCPCS,57260,Cmbn ant pst colprhy,,,2111.89,2445.34,8
HCPCS,57265,CMBN AP COLPRHY W/NTRCL RPR,,,4315.14,11545.0,22
HCPCS,57265,CMBND ANTERPOST COLPORRAPHY W/CYSTO W/NTRCL RPR,6000.0,3900.0,1.1,14506.08,144
HCPCS,57265,Cmbn ap colprhy w/ntrcl rpr,,,1087.45,1259.15,8
HCPCS,57267,INSJ MESH/PROSTH PELVIC FLOOR DEFECT EACH SITE,1952.0,1268.8,1.1,1952.0,144
HCPCS,57267,Insert mesh/pelvic flr addon,,,3635.15,4209.12,8
HCPCS,57268,REPAIR ENTEROCELE VAGINAL APPROACH SPX,3028.0,1968.2,1.1,14506.08,144
HCPCS,57268,REPAIR OF BOWEL BULGE,,,4315.14,5205.97,20
HCPCS,57268,Repair of bowel bulge,,,1087.45,1259.15,8
HCPCS,57270,REPAIR ENTEROCELE ABDOMINAL APPROACH SPX,5468.0,3554.2,1.1,5468.0,144
HCPCS,57270,REPAIR OF BOWEL POUCH,,,2137.58,2137.58,1
HCPCS,57270,Repair of bowel pouch,,,1087.45,1259.15,8
HCPCS,57280,COLPOPEXY ABDOMINAL APPROACH,6688.0,4347.2,1.1,6688.0,144
HCPCS,57280,SUSPENSION OF VAGINA,,,2535.84,2535.84,1
HCPCS,57280,Suspension of vagina,,,4028.01,4664.01,8
HCPCS,57282,COLPOPEXY EXTRAPERITONEAL,,,4616.0,19727.45,22
HCPCS,57282,COLPOPEXY VAGINAL EXTRAPERITONEAL APPROACH,4652.0,3023.8,1.1,22039.2,144
HCPCS,57282,Colpopexy extraperitoneal,,,1469.37,1701.37,8
HCPCS,57283,COLPOPEXY INTRAPERITONEAL,,,4616.0,19727.45,22
HCPCS,57283,COLPOPEXY VAGINAL INTRAPERITONEAL APPROACH,4664.0,3031.6,1.1,22039.2,144
HCPCS,57283,Colpopexy intraperitoneal,,,1469.37,1701.37,8
HCPCS,57284,PARAVAGINAL DEFECT REPAIR OPEN ABDOMINAL APPR,5732.0,3725.8,1.1,14506.08,144
HCPCS,57284,REPAIR PARAVAG DEFECT OPEN,,,4315.14,5205.97,20
HCPCS,57284,Repair paravag defect open,,,4028.01,4664.01,8
HCPCS,57285,PARAVAGINAL DEFECT REPAIR VAGINAL APPROACH,4640.0,3016.0,1.1,22039.2,144
HCPCS,57285,REPAIR PARAVAG DEFECT VAG,,,6555.71,7717.13,20
HCPCS,57285,Repair paravag defect vag,,,1469.37,1701.37,8
HCPCS,57287,RMVL/REVJ SLING STRESS INCONTINENCE,9543.0,6202.95,0.01,14626.0,231
HCPCS,57288,REPAIR BLADDER DEFECT,,,4315.14,13821.0,24
HCPCS,57288,Repair bladder defect,,,2111.89,2445.34,8
HCPCS,57288,SLING OPER STRES INCONTINENCE,5337.0,3469.05,1.1,14506.08,144
HCPCS,57288,SLING OPERATION FOR SUI,4101.0,2665.65,1.1,14506.08,144
HCPCS,57289,PEREYA PROC+ANTER COLPORRHAPHY,5120.0,3328.0,1.1,22039.2,144
HCPCS,57289,REPAIR BLADDER & VAGINA,,,6555.71,7717.13,20
HCPCS,57289,Repair bladder & vagina,,,2111.89,2445.34,8
HCPCS,57291,CONSTRUCTION ARTIFICIAL VAGINA W/O GRAFT,3456.0,2246.4,1.1,14506.08,144
HCPCS,57291,CONSTRUCTION OF VAGINA,,,4315.14,5205.97,20
HCPCS,57291,Construction of vagina,,,4028.01,4664.01,8
HCPCS,57292,CONSTRUCT VAGINA WITH GRAFT,,,4315.14,12985.13,21
HCPCS,57292,CONSTRUCTION ARTIFICIAL VAGINA W/GRAFT,5604.0,3642.6,1.1,14506.08,144
HCPCS,57292,Construct vagina with graft,,,4028.01,4664.01,8
HCPCS,57295,REVJ/RMVL PROSTHETIC VAGINAL GRAFT VAGINAL APP,8877.0,5770.05,1.1,33436.0,231
HCPCS,57296,REVISE VAG GRAFT OPEN ABD,,,2521.62,2521.62,1
HCPCS,57296,REVJ W/RMVL PROSTHETIC VAGINAL GRAFT ABDML APPR,6624.0,4305.6,1.1,6624.0,144
HCPCS,57296,Revise vag graft open abd,,,4028.01,4664.01,8
HCPCS,57300,CLSR RECTOVAGINAL FISTULA VAGINAL/TRANSANAL APPR,3484.0,2264.6,1.1,9118.72,144
HCPCS,57300,REPAIR RECTUM-VAGINA FISTULA,,,2712.29,3368.83,20
HCPCS,57300,Repair rectum-vagina fistula,,,4028.01,4664.01,8
HCPCS,57305,CLSR RECTOVAGINAL FISTULA ABDOMINAL APPROACH,6140.0,3991.0,1.1,6140.0,144
HCPCS,57305,REPAIR RECTUM-VAGINA FISTULA,,,2562.2,2562.2,1
HCPCS,57305,Repair rectum-vagina fistula,,,1836.64,2126.64,8
HCPCS,57307,CLSR RECTOVAG FSTL ABDL APPR W/CONCOMITANT CLST,6868.0,4464.2,1.1,6868.0,144
HCPCS,57307,FISTULA REPAIR & COLOSTOMY,,,2814.77,2814.77,1
HCPCS,57307,Fistula repair & colostomy,,,4028.01,4664.01,8
HCPCS,57308,CLSR RECTOVAG FSTL TPRNL PRNL BDY RCNSTJ,4236.0,2753.4,1.1,4236.0,144
HCPCS,57308,FISTULA REPAIR TRANSPERINE,,,1735.93,6238.0,2
HCPCS,57308,Fistula repair transperine,,,1469.37,1701.37,8
HCPCS,57310,CLOSE URETHROVAGINAL FISTULA,3060.0,1989.0,1.1,22039.2,144
HCPCS,57310,REPAIR URETHROVAGINAL LESION,,,6555.71,19727.45,21
HCPCS,57310,Repair urethrovaginal lesion,,,4028.01,4664.01,8
HCPCS,57311,CLSR URETHROVAG FSTL W/BULBOCAVERNOSUS TRNSPL,3564.0,2316.6,1.1,3564.0,144
HCPCS,57311,REPAIR URETHROVAGINAL LESION,,,1452.23,1452.23,1
HCPCS,57311,Repair urethrovaginal lesion,,,4028.01,4664.01,8
HCPCS,57320,CLOSURE VESICOVAGINAL FISTULA VAGINAL APPROACH,3552.0,2308.8,1.1,14506.08,144
HCPCS,57320,REPAIR BLADDER-VAGINA LESION,,,4315.14,5205.97,20
HCPCS,57320,Repair bladder-vagina lesion,,,4028.01,4664.01,8
HCPCS,57330,CLSR VESICOVAG FSTL TRANSVESICAL&VAG APPR,5284.0,3434.6,1.1,22039.2,144
HCPCS,57330,REPAIR BLADDER-VAGINA LESION,,,6555.71,19727.45,21
HCPCS,57330,Repair bladder-vagina lesion,,,4028.01,4664.01,8
HCPCS,57335,REPAIR VAGINA,,,4315.14,12985.13,21
HCPCS,57335,Repair vagina,,,4028.01,4664.01,8
HCPCS,57335,VAGINOPLASTY INTERSEX STATE,8008.0,5205.2,1.1,14506.08,144
HCPCS,57400,DILATION OF VAGINA,,,2712.29,3368.83,20
HCPCS,57400,DILATION VAGINA W/ANESTHESIA OTHER THAN LOCAL,908.0,590.2,1.1,9118.72,144
HCPCS,57400,Dilation of vagina,,,1469.37,1701.37,8
HCPCS,57410,PELVIC EXAMINATION W/ANESTHESIA OTHER THAN LOCAL,7663.0,4980.95,1.1,14626.0,231
HCPCS,57415,REMOVAL IMPACTED VAG FB SPX W/ANES OTH/THN LOCAL,996.0,647.4,1.1,9118.72,144
HCPCS,57415,REMOVE VAGINAL FOREIGN BODY,,,2712.29,5265.0,21
HCPCS,57415,Remove vaginal foreign body,,,1469.37,1701.37,8
HCPCS,57420,COLPOSCOPY ENTIRE VAGINA W/CERVIX IF PRESENT,1019.5,662.675,0.01,4392.0,235
HCPCS,57421,COLPOSCOPY ENTIRE VAGINA W/VAGINA/CERVIX BX,2442.5,1587.625,0.01,4392.0,235
HCPCS,57423,PARAVAGINAL DEFECT REPAIR LAPAROSCOPIC APPROACH,6432.0,4180.8,1.1,30022.29,144
HCPCS,57423,REPAIR PARAVAG DEFECT LAP,,,8930.36,11062.31,20
HCPCS,57423,Repair paravag defect lap,,,4028.01,4664.01,8
HCPCS,57425,LAPAROSCOPY COLPOPEXY SUSPENSION VAGINAL APEX,6812.0,4427.8,1.1,30022.29,144
HCPCS,57425,LAPAROSCOPY SURG COLPOPEXY,,,4616.0,25635.0,23
HCPCS,57425,Laparoscopy surg colpopexy,,,4028.01,4664.01,8
HCPCS,57426,REVISE PROSTH VAG GRAFT LAP,,,6555.71,19727.45,21
HCPCS,57426,REVISION PROSTHETIC VAGINAL GRAFT LAPAROSCOPIC,5720.0,3718.0,1.1,22039.2,144
HCPCS,57426,Revise prosth vag graft lap,,,4028.01,4664.01,8
HCPCS,57452,COLPOSCOPY CERVIX UPPER/ADJACENT VAGINA,762.5,495.625,0.01,4392.0,235
HCPCS,57454,COLPOSCOPY CERVIX BX CERVIX & ENDOCRV CURRETAGE,1165.5,757.575,0.01,4392.0,235
HCPCS,57455,COLPOSCOPY CERVIX UPPR/ADJCNT VAGINA W/CERVIX BX,1097.5,713.375,0.01,4392.0,235
HCPCS,57456,COLPOSCOPY CERVIX ENDOCERVICAL CURETTAGE,1069.5,695.175,0.01,4392.0,235
HCPCS,57460,COLPOSCOPY CERVIX VAG LOOP ELTRD BX CERVIX,7879.0,5121.349999999999,0.01,14626.0,235
HCPCS,57461,COLPOSCOPY CERVIX VAG ELTRD CONIZATION CERVIX,7999.0,5199.349999999999,0.01,14626.0,235
HCPCS,57465,COMPUTER-AIDED MAPG CERVIX UTERI DRG COLPOSCOPY,324.0,210.6,1.1,324.0,148
HCPCS,57465,Cam cervix uteri drg colp,,,204.9,237.25,8
HCPCS,57500,BIOPSY CERVIX SINGLE/MULT/EXCISION OF LESION SPX,2266.5,1473.225,0.01,4392.0,322
HCPCS,57505,ENDOCERVICAL CURETTAGE NOT DONE AS PART OF D&C,2240.5,1456.325,0.01,4392.0,235
HCPCS,57510,CAUTERY CERVIX ELECTRO/THERMAL,7693.0,5000.45,0.01,14626.0,235
HCPCS,57511,CAUTERY CERVIX CRYOCAUTERY INITIAL/REPEAT,1089.5,708.175,0.01,4392.0,235
HCPCS,57513,CAUTERY CERVIX LASER ABLATION,780.0,507.0,1.1,9118.72,148
HCPCS,57513,LASER SURGERY OF CERVIX,,,2712.29,3368.83,20
HCPCS,57513,Laser surgery of cervix,,,1703.89,1972.93,8
HCPCS,57520,CONIZATION CERVIX W/WO D&C RPR KNIFE/LASER,1644.0,1068.6,1.1,9118.72,148
HCPCS,57520,CONIZATION OF CERVIX,,,2712.29,6238.0,22
HCPCS,57520,Conization of cervix,,,1703.89,1972.93,8
HCPCS,57522,CONIZATION CERVIX W/WO D&C RPR ELTRD EXC,8047.0,5230.55,0.01,14626.0,235
HCPCS,57530,REMOVAL OF CERVIX,,,4315.14,5205.97,20
HCPCS,57530,Removal of cervix,,,1703.89,1972.93,8
HCPCS,57530,TRACHELECTOMY CERVICECTOMY AMP CERVIX SPX,2108.0,1370.2,1.1,14506.08,144
HCPCS,57531,RAD TRACHELECTOMY W/BI PEL LMPHADEC,11980.0,7787.0,1.1,11980.0,144
HCPCS,57531,REMOVAL OF CERVIX RADICAL,,,4854.02,4854.02,1
HCPCS,57531,Removal of cervix radical,,,2785.66,3225.5,8
HCPCS,57540,REMOVAL OF RESIDUAL CERVIX,,,2081.63,2081.63,1
HCPCS,57540,Removal of residual cervix,,,2785.66,3225.5,8
HCPCS,57545,REMOVE CERVIX/REPAIR PELVIS,,,2193.42,2193.42,1
HCPCS,57545,Remove cervix/repair pelvis,,,2785.66,3225.5,8
HCPCS,57550,EXCISION CERVICAL STUMP VAGINAL APPROACH,2536.0,1648.4,1.1,14506.08,144
HCPCS,57550,REMOVAL OF RESIDUAL CERVIX,,,4315.14,5205.97,20
HCPCS,57550,Removal of residual cervix,,,1703.89,1972.93,8
HCPCS,57555,EXC CRV STUMP VAG APPR W/ANT &/POST REPAIR,3976.0,2584.4,1.1,14506.08,144
HCPCS,57555,REMOVE CERVIX/REPAIR VAGINA,,,4315.14,5205.97,20
HCPCS,57555,Remove cervix/repair vagina,,,1703.89,1972.93,8
HCPCS,57556,REMOVE CERVIX REPAIR BOWEL,,,4315.14,5205.97,20
HCPCS,57556,Remove cervix repair bowel,,,2785.66,3225.5,8
HCPCS,57558,D&C OF CERVICAL STUMP,,,2712.29,3368.83,20
HCPCS,57558,D&c of cervical stump,,,1703.89,1972.93,8
HCPCS,57558,DILATION & CURETTAGE CERVICAL STUMP,688.0,447.2,1.1,9118.72,148
HCPCS,57700,CERCLAGE UTERINE CERVIX NONOBSTETRICAL,1740.0,1131.0,1.1,9118.72,144
HCPCS,57700,REVISION OF CERVIX,,,2712.29,3368.83,20
HCPCS,57700,Revision of cervix,,,1703.89,1972.93,8
HCPCS,57720,REVISION OF CERVIX,,,2712.29,3368.83,20
HCPCS,57720,Revision of cervix,,,1703.89,1972.93,8
HCPCS,57720,TRACHELORRHAPHY PLSTC RPR UTERINE CERVIX VAG,1844.0,1198.6,1.1,9118.72,144
HCPCS,57800,DILATION CERVICAL CANAL INSTRUMENTAL SPX,7467.0,4853.55,0.01,14626.0,235
HCPCS,58100,ENDOMETRIAL BX W/WO ENDOCERVIX BX W/O DILAT SPX,728.5,473.525,0.01,12500.0,321
HCPCS,58110,ENDOMETRIAL BX CONJUNCT W/COLPOSCOPY,377.5,245.375,0.01,3443.0,216
HCPCS,58120,DILATION & CURETTAGE DX&/THER NONOBSTETRIC,8031.0,5220.15,0.01,14626.0,235
HCPCS,58140,MYOMECTOMY 1-4 MYOMAS W/250 GM/< ABDOMINAL APPR,6316.0,4105.4,1.1,6316.0,144
HCPCS,58140,MYOMECTOMY ABDOM METHOD,,,9509.0,9509.0,1
HCPCS,58140,Myomectomy abdom method,,,5500.26,6368.73,8
HCPCS,58145,MYOMECTOMY 1-4 MYOMAS 250 GM/< VAGINAL APPR,9095.0,5911.75,0.01,14626.0,318
HCPCS,58146,MYOMECTOMY 5/> MYOMAS &/>250 GM ABDOMINA,8136.0,5288.4,1.1,8136.0,144
HCPCS,58146,MYOMECTOMY ABDOM COMPLEX,,,7778.0,7778.0,1
HCPCS,58146,Myomectomy abdom complex,,,5500.26,6368.73,8
HCPCS,58150,TOTAL ABDOMINAL HYSTERECT W/WO RMVL TUBE OVARY,5771.0,3751.15,1.1,10201.0,212
HCPCS,58152,TOT ABD HYST W/WO RMVL TUBE OVARY W/COLPURETHRXY,8744.0,5683.6,1.1,8744.0,144
HCPCS,58152,TOTAL HYSTERECTOMY,,,3258.82,3258.82,1
HCPCS,58152,Total hysterectomy,,,5500.26,6368.73,8
HCPCS,58180,PARTIAL HYSTERECTOMY,,,2530.44,2530.44,1
HCPCS,58180,Partial hysterectomy,,,3181.01,3683.27,8
HCPCS,58180,SUPRACERVICAL ABDL HYSTER W/WO RMVL TUBE OVARY,6640.0,4316.0,1.1,6640.0,144
HCPCS,58200,EXTENSIVE HYSTERECTOMY,,,3545.45,3545.45,1
HCPCS,58200,Extensive hysterectomy,,,5500.26,6368.73,8
HCPCS,58200,TOT ABD HYST W/PARAORTIC & PELVIC LYMPH NODE SAM,9240.0,6006.0,1.1,9240.0,144
HCPCS,58210,EXTENSIVE HYSTERECTOMY,,,4785.77,4785.77,1
HCPCS,58210,Extensive hysterectomy,,,5500.26,6368.73,8
HCPCS,58210,RAD ABDL HYSTERECTOMY W/BI PELVIC LMPHADENECTOMY,12364.0,8036.6,1.1,12364.0,144
HCPCS,58240,PEL EXNTJ GYNECOLOGIC MAL,19732.0,12825.8,1.1,19732.0,144
HCPCS,58240,REMOVAL OF PELVIS CONTENTS,,,7666.3,7666.3,1
HCPCS,58240,Removal of pelvis contents,,,5500.26,6368.73,8
HCPCS,58260,VAGINAL HYSTERECTOMY,,,4315.14,12985.13,22
HCPCS,58260,VAGINAL HYSTERECTOMY UTERUS 250 GM/<,5660.0,3679.0,1.1,14506.08,144
HCPCS,58260,Vaginal hysterectomy,,,3181.01,3683.27,8
HCPCS,58262,VAG HYST 250 GM/< W/RMVL TUBE&/OVARY,6376.0,4144.4,1.1,14506.08,144
HCPCS,58262,VAG HYST INCLUDING T/O,,,4315.14,12985.13,22
HCPCS,58262,Vag hyst including t/o,,,3181.01,3683.27,8
HCPCS,58263,VAG HYST 250 GM/< W/RMVL TUBE OVARY W/RPR NTRCL,6892.0,4479.8,1.1,14506.08,144
HCPCS,58263,VAG HYST W/T/O & VAG REPAIR,,,4315.14,12985.13,21
HCPCS,58263,Vag hyst w/t/o & vag repair,,,3181.01,3683.27,8
HCPCS,58267,VAG HYST 250 GM/< W/COLPO-URTCSTOPEXY,7344.0,4773.6,1.1,7344.0,144
HCPCS,58267,VAG HYST W/URINARY REPAIR,,,2814.94,2814.94,1
HCPCS,58267,Vag hyst w/urinary repair,,,3181.01,3683.27,8
HCPCS,58270,VAG HYST W/ENTEROCELE REPAIR,,,4315.14,12985.13,21
HCPCS,58270,VAGINAL HYSTERECTOMY 250 GM/< W/RPR ENTEROCELE,6120.0,3978.0,1.1,14506.08,144
HCPCS,58270,Vag hyst w/enterocele repair,,,3181.01,3683.27,8
HCPCS,58275,HYSTERECTOMY/REVISE VAGINA,,,2607.11,2607.11,1
HCPCS,58275,Hysterectomy/revise vagina,,,3181.01,3683.27,8
HCPCS,58275,VAGINAL HYSTERECTOMY W/TOT/PRTL VAGINECTOMY,6812.0,4427.8,1.1,6812.0,144
HCPCS,58280,HYSTERECTOMY/REVISE VAGINA,,,2790.99,2790.99,1
HCPCS,58280,Hysterectomy/revise vagina,,,3181.01,3683.27,8
HCPCS,58280,VAG HYSTER W/TOT/PRTL VAGINECT W/RPR ENTEROCELE,7332.0,4765.8,1.1,7332.0,144
HCPCS,58285,EXTENSIVE HYSTERECTOMY,,,3737.14,3737.14,1
HCPCS,58285,Extensive hysterectomy,,,3181.01,3683.27,8
HCPCS,58285,VAGINAL HYSTERECTOMY RADICAL SCHAUTA OPERATION,9352.0,6078.8,1.1,9352.0,144
HCPCS,58290,VAG HYST COMPLEX,,,6555.71,19727.45,21
HCPCS,58290,VAGINAL HYSTERECTOMY UTERUS > 250 GM,8108.0,5270.2,1.1,22039.2,144
HCPCS,58290,Vag hyst complex,,,5500.26,6368.73,8
HCPCS,58291,VAG HYST > 250 GM RMVL TUBE&/OVARY,8824.0,5735.6,1.1,14506.08,144
HCPCS,58291,VAG HYST INCL T/O COMPLEX,,,4315.14,12985.13,21
HCPCS,58291,Vag hyst incl t/o complex,,,5500.26,6368.73,8
HCPCS,58292,VAG HYST > 250 GM RMVL TUBE&/OVARY W/RPR ENTRCLE,9340.0,6071.0,1.1,22039.2,144
HCPCS,58292,VAG HYST T/O & REPAIR COMPL,,,6555.71,19727.45,21
HCPCS,58292,Vag hyst t/o & repair compl,,,5500.26,6368.73,8
HCPCS,58293,Vag hyst w/uro repair compl,,,3181.01,3683.27,8
HCPCS,58294,VAG HYST W/ENTEROCELE COMPL,,,4315.14,12985.13,21
HCPCS,58294,VAGINAL HYSTERECTOMY >250 GM RPR ENTEROCELE,8620.0,5603.0,1.1,14506.08,144
HCPCS,58294,Vag hyst w/enterocele compl,,,5500.26,6368.73,8
HCPCS,58300,INSERT INTRAUTERINE DEVICE,444.0,288.6,1.1,444.0,116
HCPCS,58300,INSERTION INTRAUTERINE DEVICE IUD,502.0,326.3,0.01,12500.0,133
HCPCS,58301,REMOVAL INTRAUTERINE DEVICE IUD,1399.0,909.35,0.01,4628.0,259
HCPCS,58301,REMOVE INTRAUTERINE DEVICE,559.0,363.35,1.1,936.67,148
HCPCS,58321,"ARTIF INSEMINATION,INTRA-CERVICAL",368.0,239.2,1.1,936.67,134
HCPCS,58321,ARTIFICIAL INSEMINATION,,,278.32,837.51,21
HCPCS,58321,Artificial insemination,,,151.26,175.14,8
HCPCS,58322,ARTIFIC INSEMINATION INTRAUTERIN,440.0,286.0,1.1,581.59,134
HCPCS,58322,ARTIFICIAL INSEMINATION INTRA-UTERINE,925.0,601.25,0.01,2351.0,87
HCPCS,58323,SPERM WASHING,,,172.88,520.22,21
HCPCS,58323,SPERM WASHING FOR ARTIF INSEM,92.0,59.8,1.1,581.59,134
HCPCS,58323,Sperm washing,,,151.26,175.14,8
HCPCS,58340,CATH & SALINE/CONTRAST SONOHYSTER/HYSTEROSALPI,609.0,395.85,0.01,4628.0,284
HCPCS,58345,TRANSCERV FALLOPIAN TUBE CATH W/WO HYSTOSALPING,8253.0,5364.45,1.1,14626.0,216
HCPCS,58346,INSERT HEYMAN UTERI CAPSULE,,,4315.14,5205.97,20
HCPCS,58346,Insert heyman uteri capsule,,,1703.89,1972.93,8
HCPCS,58350,CHROMOTUBATION OVIDUCT W/MATERIALS,424.0,275.6,1.1,14506.08,134
HCPCS,58350,REOPEN FALLOPIAN TUBE,,,4315.14,9509.0,22
HCPCS,58350,Reopen fallopian tube,,,1703.89,1972.93,8
HCPCS,58353,ENDOMETR ABLATE THERMAL,,,4315.14,5205.97,20
HCPCS,58353,ENDOMETRIAL ABLTJ THERMAL W/O HYSTEROSCOPIC GUID,1440.0,936.0,1.1,14506.08,148
HCPCS,58353,Endometr ablate thermal,,,1703.89,1972.93,8
HCPCS,58356,ENDOMETRIAL CRYOABLATION W/US & ENDOMETRIAL CR,12636.0,8213.4,0.01,22708.0,235
HCPCS,58400,SUSPENSION OF UTERUS,,,1216.01,1216.01,1
HCPCS,58400,Suspension of uterus,,,1703.89,1972.93,8
HCPCS,58400,UTERINE SUSPENSION W/WO SHORTENING LIGAMENTS SPX,2856.0,1856.4,1.1,2856.0,142
HCPCS,58410,SUSPENSION OF UTERUS,,,2146.35,2146.35,1
HCPCS,58410,Suspension of uterus,,,2785.66,3225.5,8
HCPCS,58410,UTERINE SUSP W/WO SHORT LIGAMNTS W/SYMPATHECTOMY,5520.0,3588.0,1.1,5520.0,142
HCPCS,58520,HYSTERORRHAPHY REPAIR RUPT UTERUS NONOBSTETRICAL,5392.0,3504.8,1.1,5392.0,144
HCPCS,58520,REPAIR OF RUPTURED UTERUS,,,2101.47,2101.47,1
HCPCS,58520,Repair of ruptured uterus,,,2785.66,3225.5,8
HCPCS,58540,REVISION OF UTERINE ANOMALY,6284.0,4084.6,1.1,6284.0,144
HCPCS,58540,REVISION OF UTERUS,,,2414.52,2414.52,1
HCPCS,58540,Revision of uterus,,,2785.66,3225.5,8
HCPCS,58541,LAPAROSCOPY SUPRACERVICAL HYSTERECTOMY 250 GM/<,4916.0,3195.4,1.1,30022.29,144
HCPCS,58541,LSH UTERUS 250 G OR LESS,,,8930.36,11062.31,20
HCPCS,58541,Lsh uterus 250 g or less,,,5500.26,6368.73,8
HCPCS,58542,LAPS SUPRACRV HYSTERECT 250 GM/< RMVL TUBE/OVAR,6230.0,4049.5,1.1,30022.29,144
HCPCS,58542,LSH W/T/O UT 250 G OR LESS,,,8930.36,11062.31,21
HCPCS,58542,Lsh w/t/o ut 250 g or less,,,5500.26,6368.73,8
HCPCS,58543,"LAP, SUPRACERVIAL HYSTERECTOMY, >250G",6332.0,4115.8,1.1,30022.29,144
HCPCS,58543,LSH UTERUS ABOVE 250 G,,,8930.36,11062.31,20
HCPCS,58543,Lsh uterus above 250 g,,,5500.26,6368.73,8
HCPCS,58544,LAPS SUPRACRV HYSTEREC >250 G RMVL TUBE/OVARY,6240.0,4056.0,1.1,30022.29,144
HCPCS,58544,LSH W/T/O UTERUS ABOVE 250 G,,,8930.36,11062.31,20
HCPCS,58544,Lsh w/t/o uterus above 250 g,,,5500.26,6368.73,8
HCPCS,58545,LAPAROSCOPIC MYOMECTOMY,,,5005.78,33436.0,23
HCPCS,58545,LAPS MYOMECTOMY EXC 1-4 MYOMAS 250 GM/<,6220.0,4043.0,1.1,16829.38,144
HCPCS,58545,Laparoscopic myomectomy,,,5500.26,6368.73,8
HCPCS,58546,LAPARO-MYOMECTOMY COMPLEX,,,8930.36,11062.31,21
HCPCS,58546,LAPS MYOMECTOMY EXC 5/> MYOMAS >250 GRAMS,7976.0,5184.4,1.1,30022.29,144
HCPCS,58546,Laparo-myomectomy complex,,,5500.26,6368.73,8
HCPCS,58548,LAP RADICAL HYST,,,4947.18,4947.18,1
HCPCS,58548,LAPS W/RAD HYST W/BILAT LMPHADEC RMVL TUBE/OVARY,12652.0,8223.8,1.1,12652.0,144
HCPCS,58548,Lap radical hyst,,,5500.26,6368.73,8
HCPCS,58550,LAPARO-ASST VAG HYSTERECTOMY,,,5005.78,6291.49,20
HCPCS,58550,LAPS VAGINAL HYSTERECTOMY UTERUS 250 GM/<,6040.0,3926.0,1.1,16829.38,144
HCPCS,58550,Laparo-asst vag hysterectomy,,,5500.26,6368.73,8
HCPCS,58552,LAPARO-VAG HYST INCL T/O,,,8930.36,11062.31,20
HCPCS,58552,LAPS W/VAG HYSTERECT 250 GM/&RMVL TUBE&/OVARIES,6764.0,4396.6,1.1,30022.29,144
HCPCS,58552,Laparo-vag hyst incl t/o,,,5500.26,6368.73,8
HCPCS,58553,LAPARO-VAG HYST COMPLEX,,,8930.36,26873.26,21
HCPCS,58553,LAPS W/VAGINAL HYSTERECTOMY > 250 GRAMS,8024.0,5215.6,1.1,30022.29,144
HCPCS,58553,Laparo-vag hyst complex,,,5500.26,6368.73,8
HCPCS,58554,LAPARO-VAG HYST W/T/O COMPL,,,8930.36,26873.26,21
HCPCS,58554,LAPS VAGINAL HYSTERECT > 250 GM RMVL TUBE&/OVAR,9244.0,6008.6,1.1,30022.29,144
HCPCS,58554,Laparo-vag hyst w/t/o compl,,,5500.26,6368.73,8
HCPCS,58555,HYSTEROSCOPY DIAGNOSTIC SEPARATE PROCEDURE,14626.0,9506.9,0.01,14626.0,87
HCPCS,58555,"HYSTEROSCOPY, DIAGNOSTIC (SEPARATE",1166.0,757.9,1.1,9118.72,148
HCPCS,58558,HYSTEROSCOPY BX ENDOMETRIUM&/POLYPC W/WO D&C,8230.5,5349.825,0.01,14626.0,235
HCPCS,58559,HYSTEROSCOPY LYSIS INTRAUTERINE ADHESIONS,12394.0,8056.1,0.01,22708.0,231
HCPCS,58560,HYSTEROSCOPY DIV/RESCJ INTRAUTERINE SEPTUM,12504.0,8127.6,0.01,22708.0,231
HCPCS,58561,HYSTEROSCOPY REMOVAL LEIOMYOMATA,12806.0,8323.9,0.01,22708.0,231
HCPCS,58562,HYSTEROSCOPY REMOVAL IMPACTED FOREIGN BODY,8113.0,5273.45,0.01,14626.0,235
HCPCS,58563,HYSTEROSCOPY ENDOMETRIAL ABLATION,12337.5,8019.375,0.01,33436.0,235
HCPCS,58565,HYSTEROSCOPY BI TUBE OCCLUSION W/PERM IMPLNTS,12778.0,8305.7,0.01,33436.0,233
HCPCS,58570,LAPAROSCOPY W TOTAL HYSTERECTOMY UTERUS 250 GM/<,5344.0,3473.6,1.1,30022.29,144
HCPCS,58570,TLH UTERUS 250 G OR LESS,,,4616.0,11062.31,22
HCPCS,58570,Tlh uterus 250 g or less,,,5500.26,6368.73,8
HCPCS,58571,LAPS TOTAL HYSTERECT 250 GM/< W/RMVL TUBE/OVARY,6600.0,4290.0,1.1,30022.29,144
HCPCS,58571,TLH W/T/O 250 G OR LESS,,,4616.0,33436.0,24
HCPCS,58571,Tlh w/t/o 250 g or less,,,5500.26,6368.73,8
HCPCS,58572,LAPAROSCOPY TOTAL HYSTERECTOMY UTERUS >250 GM,7792.0,5064.8,1.1,30022.29,144
HCPCS,58572,TLH UTERUS OVER 250 G,,,8930.36,11062.31,21
HCPCS,58572,Tlh uterus over 250 g,,,5500.26,6368.73,8
HCPCS,58573,LAPAROSCOPY TOT HYSTERECTOMY >250 G W/TUBE/OVAR,8316.0,5405.4,1.1,30022.29,144
HCPCS,58573,TLH W/T/O UTERUS OVER 250 G,,,4616.0,33436.0,24
HCPCS,58573,Tlh w/t/o uterus over 250 g,,,5500.26,6368.73,8
HCPCS,58575,LAPS TOT HYSTERECTOMY RESJ MALIGNANCY W/OMNTC,13040.0,8476.0,1.1,13040.0,144
HCPCS,58575,Laps tot hyst resj mal,,,5500.26,6368.73,8
HCPCS,58578,LAP REPAIR PERFORATED UTERUS,4536.0,2948.4,0.01,16829.38,84
HCPCS,58578,LAPAROSCOPIC CERCLAGE,1741.0,1131.65,0.01,16829.38,84
HCPCS,58578,LAPAROSCOPIC CERVICAL STOMA CREATION (COMP CODE 44187),6960.0,4524.0,0.01,16829.38,84
HCPCS,58578,LAPAROSCOPIC ISTHMOCELE REPAIR (COMP CODE 58520),5392.0,3504.8,0.01,16829.38,84
HCPCS,58578,UNL PRESACRAL NEURECTOMY,3101.0,2015.65,0.01,16829.38,84
HCPCS,58578,UNLISTED LAP REMOVAL OF UTERINE HORN (COMP CODE 58540),5106.0,3318.9,0.01,16829.38,84
HCPCS,58578,UNLISTED LAPAROSCOPIC HYSTEROTOMY (COMP CODE 59100),5348.0,3476.2,0.01,16829.38,84
HCPCS,58578,"UNLISTED LAPAROSCOPY PROCEDURE, UTERUS (COMPARISON CODE 59325)",1474.0,958.1,0.01,16829.38,84
HCPCS,58578,UNLISTED LAPS PX UTERUS,,,5005.78,11441.0,21
HCPCS,58578,UNLISTED PROC; ROBOTIC LAPAROSCOPIC TRACHELECTOMY AMPUTATION OF,1739.0,1130.35,0.01,16829.38,84
HCPCS,58578,Unlisted laps px uterus,,,1703.89,1972.93,8
HCPCS,58579,HYSTEROSCOPIC INTRAUTERINE BOTOX INJECTIONS (COMP CODE 52287),1153.0,749.45,0.01,1153.0,84
HCPCS,58579,UNLISTED HYSTEROSCOPIC ABLATION OF ISTHMOCELE (COMP CODE 58563),1922.0,1249.3,0.01,1922.0,84
HCPCS,58579,"UNLISTED HYSTEROSCOPY PROCEDURE, UT",2776.0,1804.4,0.01,2776.0,84
HCPCS,58579,UNLISTED HYSTSC PX UTERUS,,,172.88,210.4,20
HCPCS,58579,Unlisted hystsc px uterus,,,204.9,237.25,8
HCPCS,58580,TRANSCERVICAL ABLATION UTERINE FIBROID RF,18594.0,12086.1,1.1,34016.0,234
HCPCS,58600,DIVISION OF FALLOPIAN TUBE,,,2712.29,3368.83,20
HCPCS,58600,Division of fallopian tube,,,1703.89,1972.93,8
HCPCS,58600,LIG/TRNSXJ FLP TUBE ABDL/VAG APPR UNI/BI,2364.0,1536.6,1.1,9118.72,144
HCPCS,58605,DIVISION OF FALLOPIAN TUBE,,,886.53,886.53,1
HCPCS,58605,Division of fallopian tube,,,1837.47,2127.6,8
HCPCS,58605,LIG/TRNSXJ FLP TUBE ABDL/VAG POSTPARTUM SPX,2112.0,1372.8,1.1,2112.0,144
HCPCS,58611,LIG/TRNSXJ FALOPIAN TUBE CESAREAN DEL/ABDML SURG,638.0,414.7,1.1,638.0,144
HCPCS,58611,LIGATE OVIDUCT(S) ADD-ON,,,198.1,198.1,1
HCPCS,58611,Ligate oviduct(s) add-on,,,1837.47,2127.6,8
HCPCS,58615,OCCLUDE FALLOPIAN TUBE(S),,,2712.29,3368.83,20
HCPCS,58615,OCCLUSION FLP TUBE DEV VAG/SUPRAPUBIC APPR,1576.0,1024.4,1.1,9118.72,144
HCPCS,58615,Occlude fallopian tube(s),,,1703.89,1972.93,8
HCPCS,58660,LAPAROSCOPY LYSIS,,,5005.78,6291.49,20
HCPCS,58660,LAPAROSCOPY W/LYSIS OF ADHESION,4636.0,3013.4,1.1,16829.38,144
HCPCS,58660,Laparoscopy lysis,,,2785.66,3225.5,8
HCPCS,58661,LAPAROSCOPY REMOVE ADNEXA,,,5005.78,13821.0,24
HCPCS,58661,LAPAROSCOPY W/RMVL ADNEXAL STRUCTURES,4994.0,3246.1,1.1,16829.38,144
HCPCS,58661,Laparoscopy remove adnexa,,,2785.66,3225.5,8
HCPCS,58661,UNLISTED VNOTES  BILATERAL SALPINGECTOMY (COMP CODE 58661),4121.0,2678.65,1.1,16829.38,144
HCPCS,58662,LAPAROSCOPY EXCISE LESIONS,,,5005.78,13821.0,24
HCPCS,58662,LAPS FULG/EXC OVARY VISCERA/PERITONEAL SURFACE,4860.0,3159.0,1.1,16829.38,144
HCPCS,58662,Laparoscopy excise lesions,,,2785.66,3225.5,8
HCPCS,58670,LAPAROSCOPY FULGURATION OVIDUCTS,2364.0,1536.6,1.1,16829.38,144
HCPCS,58670,LAPAROSCOPY TUBAL CAUTERY,,,5005.78,6291.49,20
HCPCS,58670,Laparoscopy tubal cautery,,,2785.66,3225.5,8
HCPCS,58671,LAPAROSCOPY TUBAL BLOCK,,,5005.78,6291.49,20
HCPCS,58671,LAPAROSCOPY W/PLMT OCCLUSION DEVICE OVIDUCTS,2364.0,1536.6,1.1,16829.38,144
HCPCS,58671,Laparoscopy tubal block,,,2785.66,3225.5,8
HCPCS,58672,LAPAROSCOPY FIMBRIOPLASTY,5164.0,3356.6,1.1,16829.38,164
HCPCS,58672,Laparoscopy fimbrioplasty,,,2785.66,3225.5,8
HCPCS,58673,LAPAROSCOPY SALPINGOSTOMY,5616.0,3650.4,1.1,30022.29,165
HCPCS,58673,Laparoscopy salpingostomy,,,2785.66,3225.5,8
HCPCS,58674,LAPS ABLTJ UTERINE FIBROIDS,,,8930.36,11062.31,20
HCPCS,58674,LAPS ABLTJ UTERINE FIBROIDS W/INTRAOP US GDN,5632.0,3660.8,1.1,30022.29,144
HCPCS,58674,Laps abltj uterine fibroids,,,5500.26,6368.73,8
HCPCS,58679,LAPAROSCOPIC TUBAL RE-ANASTOMOSIS (COMP CODE 58750),5631.0,3660.15,0.01,16829.38,84
HCPCS,58679,LAPAROSCOPIC UTERINE AND OVARIAN TRANSPOSITION (COMP CODE 58571),6600.0,4290.0,0.01,16829.38,84
HCPCS,58679,UNLISTED LAPAROSCOPIC DETORSION OF OVARY (COMP CODE 49322),2584.0,1679.6,0.01,16829.38,84
HCPCS,58679,"UNLISTED LAPAROSCOPY PROCEDURE, OVIDUCT OVARY (COMPARISON CODE 5",1360.0,884.0,0.01,16829.38,84
HCPCS,58679,UNLISTED LAPS PX OVIDCT OVRY,,,5005.78,6291.49,20
HCPCS,58679,"UNLISTED PROC, LAPAROSCOPIC BIL OVARIAN TRANSPOSITION (COMP CODE",3970.0,2580.5,0.01,16829.38,84
HCPCS,58679,Unlisted laps px ovidct ovry,,,1703.89,1972.93,8
HCPCS,58700,SALPINGECTOMY COMPLETE/PARTIAL UNI/BI SPX,4599.5,2989.675,1.1,10651.0,213
HCPCS,58720,Removal of ovary/tube(s),,,2785.66,3225.5,8
HCPCS,58720,SALPINGO-OOPHORECTOMY COMPL/PRTL UNI/BI SPX,4864.0,3161.6,1.1,4864.0,144
HCPCS,58740,Adhesiolysis tube ovary,,,2785.66,3225.5,8
HCPCS,58740,LYSIS OF ADHESIONS SALPINX/OVARY,5960.0,3874.0,1.1,5960.0,144
HCPCS,58750,REPAIR OVIDUCT,,,2395.03,2395.03,1
HCPCS,58750,Repair oviduct,,,2785.66,3225.5,8
HCPCS,58750,TUBOTUBAL ANASTOMOSIS,6256.0,4066.4,1.1,6256.0,130
HCPCS,58752,REVISE OVARIAN TUBE(S),,,2389.31,2389.31,1
HCPCS,58752,Revise ovarian tube(s),,,1703.89,1972.93,8
HCPCS,58752,TUBO-UTERINE IMPLANT,6256.0,4066.4,1.1,6256.0,130
HCPCS,58760,FIMBRIOPLASTY,5572.0,3621.8,1.1,5572.0,130
HCPCS,58760,Fimbrioplasty,,,1703.89,1972.93,8
HCPCS,58770,CREATE NEW TUBAL OPENING,,,2712.29,3368.83,20
HCPCS,58770,Create new tubal opening,,,1703.89,1972.93,8
HCPCS,58770,SALPINGOSTOMY,5908.0,3840.2,1.1,9118.72,132
HCPCS,58800,DRAINAGE OF OVARIAN CYST(S),,,2712.29,3368.83,20
HCPCS,58800,DRAINAGE OVARIAN CYST UNI/BI SPX VAGINAL APPR,1848.0,1201.2,1.1,9118.72,148
HCPCS,58800,Drainage of ovarian cyst(s),,,1703.89,1972.93,8
HCPCS,58805,DRAINAGE OF OVARIAN CYST(S),,,2712.29,3368.83,20
HCPCS,58805,DRAINAGE OVARIAN CYST UNI/BI SPX ABDOMINAL,2568.0,1669.2,1.1,9118.72,144
HCPCS,58805,Drainage of ovarian cyst(s),,,1703.89,1972.93,8
HCPCS,58820,DRAIN OVARY ABSCESS OPEN,,,2712.29,3368.83,20
HCPCS,58820,DRAINAGE OVARIAN ABSCESS VAGINAL APPR OPEN,1880.0,1222.0,1.1,9118.72,144
HCPCS,58820,Drain ovary abscess open,,,1703.89,1972.93,8
HCPCS,58822,DRAIN OVARY ABSCESS PERCUT,,,1880.02,1880.02,1
HCPCS,58822,DRAINAGE OVARIAN ABSCESS ABDOMINAL APPROACH,4724.0,3070.6,1.1,4724.0,144
HCPCS,58822,Drain ovary abscess percut,,,1703.89,1972.93,8
HCPCS,58825,TRANSPOSITION OVARY(S),,,1866.71,1866.71,1
HCPCS,58825,"TRANSPOSITION, OVARY(S)",4712.0,3062.8,1.1,4712.0,144
HCPCS,58825,Transposition ovary(s),,,2785.66,3225.5,8
HCPCS,58900,BIOPSY OVARY UNI/BI SEPARATE PROCEDURE,8631.0,5610.15,1.1,14626.0,231
HCPCS,58920,PARTIAL REMOVAL OF OVARY(S),,,6555.71,7717.13,20
HCPCS,58920,Partial removal of ovary(s),,,2785.66,3225.5,8
HCPCS,58920,WEDGE RESCJ/BISCTJ OVARY UNI/BI,4780.0,3107.0,1.1,22039.2,144
HCPCS,58925,OVARIAN CYSTECTOMY UNI/BI,13840.0,8996.0,1.1,22708.0,231
HCPCS,58940,OOPHORECTOMY PARTIAL/TOTAL UNI/BI,13162.5,8555.625,1.1,22708.0,213
HCPCS,58943,OOPHORECTOMY PRTL/TOT UNI/BI OVARIAN MALIGNANCY,7808.0,5075.2,1.1,7808.0,144
HCPCS,58943,REMOVAL OF OVARY(S),,,3153.33,3153.33,1
HCPCS,58943,Removal of ovary(s),,,2785.66,3225.5,8
HCPCS,58950,RESCJ OVARIAN/TUBAL/PERITONEAL MALIGNANCY W/BSO,7348.0,4776.2,1.1,7348.0,144
HCPCS,58950,RESECT OVARIAN MALIGNANCY,,,3019.78,3019.78,1
HCPCS,58950,Resect ovarian malignancy,,,2785.66,3225.5,8
HCPCS,58951,RESCJ PRIM PRTL MAL W/BSO & OMNTC TAH & LMPHAD,9704.0,6307.6,1.1,9704.0,144
HCPCS,58951,RESECT OVARIAN MALIGNANCY,,,3791.58,3791.58,1
HCPCS,58951,Resect ovarian malignancy,,,5500.26,6368.73,8
HCPCS,58952,RESCJ PRIM PRTL MAL W/BSO & OMNTC RAD DEBULKING,10916.0,7095.4,1.1,10916.0,144
HCPCS,58952,RESECT OVARIAN MALIGNANCY,,,4328.54,4328.54,1
HCPCS,58952,Resect ovarian malignancy,,,2785.66,3225.5,8
HCPCS,58953,BSO W/OMENTECTOMY TAH&RAD DEBULKING DISSECTION,13652.0,8873.8,1.1,13652.0,144
HCPCS,58953,TAH RAD DISSECT FOR DEBULK,,,5262.83,5262.83,1
HCPCS,58953,Tah rad dissect for debulk,,,5500.26,6368.73,8
HCPCS,58954,BSO W/OMENTECTOMY TAH DEBULKING W/LMPHADECTOMY,14852.0,9653.8,1.1,14852.0,144
HCPCS,58954,TAH RAD DEBULK/LYMPH REMOVE,,,5697.61,5697.61,1
HCPCS,58954,Tah rad debulk/lymph remove,,,5500.26,6368.73,8
HCPCS,58956,BSO OMENTECTOMY W/TAH,,,3577.97,3577.97,1
HCPCS,58956,BSO W/TOT OMENTECTOMY & HYSTERECTOMY MALIGNANC,9120.0,5928.0,1.1,9120.0,144
HCPCS,58956,Bso omentectomy w/tah,,,5500.26,6368.73,8
HCPCS,58957,RESECT RECURRENT GYN MAL,,,4178.42,4178.42,1
HCPCS,58957,Resect recurrent gyn mal,,,5500.26,6368.73,8
HCPCS,58958,RESC RECR OVR TBL PP UTR MAL,,,4358.57,4358.57,1
HCPCS,58958,RESCJ RECR OVR TBL PP UTR MAL OMNTC PEL LMPHADEC,11688.0,7597.2,1.1,11688.0,144
HCPCS,58958,Resc recr ovr tbl pp utr mal,,,5500.26,6368.73,8
HCPCS,58960,EXPLORATION OF ABDOMEN,,,2617.14,2617.14,1
HCPCS,58960,Exploration of abdomen,,,2785.66,3225.5,8
HCPCS,58960,LAPT STG/RESTG OVARIAN TUBAL/PRIM MAL 2ND LOOK,6316.0,4105.4,1.1,6316.0,144
HCPCS,58970,FOLLICLE PUNCTURE OOCYTE RETRIEVAL ANY METHOD,2777.0,1805.05,0.01,4392.0,221
HCPCS,58974,EMBRYO TRANSFER INTRAUTERINE,4005.0,2603.25,0.01,4392.0,85
HCPCS,58974,"TRANSFER OF EMBRYO,INTRAUTERINE",1163.0,755.95,1.1,2344.73,88
HCPCS,58976,TRANSFER OF EMBRYO,,,278.32,317.13,20
HCPCS,58976,Transfer of embryo,,,151.26,175.14,8
HCPCS,58999,CHEMODENERVATION VAGINAL MUSCLE,646.0,419.9,0.01,3443.0,85
HCPCS,58999,CHEMODENERVATION VAGINAL MUSCLE (COMP CODE 64646 CHEMODENERV TRU,594.0,386.1,0.01,594.0,84
HCPCS,58999,ECISION GRANNULATION TISSUE,962.0,625.3,0.01,3443.0,85
HCPCS,58999,EXP LAPAROTOMY REPAIR VAG CUFF,5500.0,3575.0,0.01,5500.0,84
HCPCS,58999,INJ/ASP ECTOPIC PREGNANCY,2158.0,1402.7,172.88,4628.0,84
HCPCS,58999,LAP PARTIAL VAGINECTOMY,3094.0,2011.1,0.01,3094.0,84
HCPCS,58999,LAPAROSCOPIC PARTIAL VAGINECTOMY (COMP CODE 57106),3094.0,2011.1,0.01,3094.0,84
HCPCS,58999,LAPAROSCOPIC REPAIR COLOVAGINAL FISTULA (COMP 57305),3655.0,2375.75,0.01,3655.0,84
HCPCS,58999,LAPAROSCOPIC RESECTION OF NEOVAGINA (COMP 57110),6656.0,4326.4,0.01,6656.0,84
HCPCS,58999,LAPAROSCOPIC UTEROSACRAL LIGAMENT SUSPENSION (COMP CODE 57283),4664.0,3031.6,0.01,4664.0,84
HCPCS,58999,LUNA,3558.0,2312.7,0.01,3558.0,84
HCPCS,58999,LYSIS OF ADHESIONS OF VAGINAL (COMP CODE 56441),398.0,258.7,0.01,581.59,84
HCPCS,58999,LYSIS VAGINAL ADHESIONS,14626.0,9506.9,0.01,14626.0,85
HCPCS,58999,NEEDLE CORE BX RECTOVAG,698.0,453.7,0.01,3443.0,85
HCPCS,58999,SUPPORT TRIAL,500.0,325.0,0.01,581.59,84
HCPCS,58999,UNL LAP RAD TRACHELECTOMY,12374.0,8043.1,0.01,12374.0,84
HCPCS,58999,UNL REVISION/REMOVE VAGINAL SCAR TISSUE,936.0,608.4,0.01,3443.0,85
HCPCS,58999,UNLISTED EXCISION GRANULATION TISSUE VAGINA (COMP CODE 57210),1856.0,1206.4,0.01,1856.0,84
HCPCS,58999,UNLISTED INSERTION FOLEY CATH INTO UTERUS (COMP CODE 51702),213.0,138.45,0.01,581.59,84
HCPCS,58999,UNLISTED LAPOROSCOPIC RADICAL PARTIAL VAGINECTOMY (COMP CODE 571,10566.0,6867.9,0.01,10566.0,84
HCPCS,58999,UNLISTED NEEDLE CORE BIOPSY RECTOVAGINAL (COMP CODE 57500),510.0,331.5,0.01,581.59,84
HCPCS,58999,"UNLISTED PROC, EXCISION OF VAGINAL CUFF LESION (COMP TO 57135)",891.0,579.15,0.01,891.0,84
HCPCS,58999,UNLISTED PROCEDURE FEMALE GENITAL SYS,2158.0,1402.7,172.88,3443.0,84
HCPCS,58999,UNLISTED TRANSVAGINAL REPAIR OF CESAREAN SCAR DEFECT (COMP CODE,3255.0,2115.75,0.01,3255.0,84
HCPCS,58999,UNLISTED VAGINAL CUFF REPAIR (COMP CODE 57200),1602.0,1041.3,0.01,1602.0,84
HCPCS,58999,UNLISTED VAGINOPLASTY FOR STRICTURE,1813.0,1178.45,0.01,1813.0,84
HCPCS,58999,UNLISTED VNOTES BILATERAL SALPINGECTOMY (COMP CODE 58661),4121.0,2678.65,0.01,4121.0,84
HCPCS,58999,UNLISTED VULVAR VESTIBULECTOMY,2389.0,1552.85,0.01,2389.0,84
HCPCS,58999,VAGINAL CUFF BIOPSY (COMP CODE 57100),2242.5,1457.625,0.01,4628.0,168
HCPCS,59000,AMNIOCENTESIS DIAGNOSIC,2001.5,1300.975,0.01,3483.0,235
HCPCS,59001,AMNIOCENTESIS THER AMNIOTIC FLUID RDCTJ US GUID,1208.5,785.525,0.01,3443.0,231
HCPCS,59012,CORDOCENTESIS INTRAUTERINE,1217.0,791.05,236.15,12615.0,86
HCPCS,59012,CORDOCENTESIS(INTRAUTERINE),1376.0,894.4,1.1,1376.0,144
HCPCS,59015,CHORIONIC VILLUS SAMPLING,2181.5,1417.975,0.01,12500.0,235
HCPCS,59020,FETAL CONTRACT STRESS TEST,,,172.88,520.22,21
HCPCS,59020,FETAL CONTRACTION STRESS TEST,264.0,171.6,1.1,264.0,126
HCPCS,59020,Fetal contract stress test,,,257.14,297.74,8
HCPCS,59025,FETAL NON-STRESS TEST,805.0,523.25,1.1,1038.0,396
HCPCS,59025,FETAL NONSTRESS TEST,805.0,523.25,59.72,4628.0,344
HCPCS,59025,FETAL NST TEST,805.0,523.25,59.72,805.0,172
HCPCS,59030,FETAL SCALP BLOOD SAMPLING,796.0,517.4,1.1,936.67,165
HCPCS,59030,Fetal scalp blood sampling,,,257.14,297.74,8
HCPCS,59050,FETAL MONITORING LABOR PHYS WRITTEN REPORT,380.0,247.0,58.47,380.0,68
HCPCS,59051,FETAL MONITOR/INTERPRET ONLY,,,111.41,111.41,1
HCPCS,59051,Fetal monitor/interpret only,,,405.62,469.67,8
HCPCS,59070,TRANSABDOMINAL AMNIOINFUSION W/ULTRSND GUIDANCE,1656.5,1076.725,1.1,3443.0,232
HCPCS,59072,FETAL UMBILICAL CORD OCCLUSION W/ULTRSND GUIDNCE,3596.0,2337.4,1.1,3596.0,142
HCPCS,59072,UMBILICAL CORD OCCLUD W/US,,,278.32,837.51,21
HCPCS,59072,Umbilical cord occlud w/us,,,2362.56,2735.59,8
HCPCS,59074,FETAL FLUID DRAINAGE W/ULTRASOUND GUIDANCE,1656.5,1076.725,0.01,3443.0,235
HCPCS,59076,FETAL SHUNT PLACEMENT W/ULTRASOUND GUIDANCE,3596.0,2337.4,1.1,3596.0,144
HCPCS,59076,FETAL SHUNT PLACEMENT W/US,,,278.32,837.51,21
HCPCS,59076,Fetal shunt placement w/us,,,2362.56,2735.59,8
HCPCS,59100,HYSTEROTOMY ABDOMINAL,5348.0,3476.2,1.1,14506.08,144
HCPCS,59100,REMOVE UTERUS LESION,,,4315.14,12985.13,21
HCPCS,59100,Remove uterus lesion,,,3783.28,4380.64,8
HCPCS,59120,TX ECTOPIC PREGNANCY ABDOMINAL/VAGINAL APPR,5068.0,3294.2,1.1,5068.0,144
HCPCS,59120,Treat ectopic pregnancy,,,3783.28,4380.64,8
HCPCS,59121,TX ECTOPIC PREGNANCY W/O SALPING&/OOPHORECTOMY,5096.0,3312.4,1.1,5096.0,144
HCPCS,59121,Treat ectopic pregnancy,,,3783.28,4380.64,8
HCPCS,59130,TX ECTOPIC PREGNANCY ABDL PREGNANCY,6032.0,3920.8,1.1,6032.0,144
HCPCS,59130,Treat ectopic pregnancy,,,3783.28,4380.64,8
HCPCS,59135,Treat ectopic pregnancy,,,3181.01,3683.27,8
HCPCS,59136,TX ECTOPIC PREGNANCY NTRSTL PRTL RESCJ UTER,5700.0,3705.0,1.1,5700.0,144
HCPCS,59136,Treat ectopic pregnancy,,,3783.28,4380.64,8
HCPCS,59140,TX ECTOPIC PREGNANCY CERVICAL W/EVACUATION,2376.0,1544.4,1.1,2376.0,144
HCPCS,59140,Treat ectopic pregnancy,,,3783.28,4380.64,8
HCPCS,59150,LAPS TX ECTOPIC PREG W/O SALPING&/OOPHORECTOMY,4916.0,3195.4,1.1,16829.38,144
HCPCS,59150,TREAT ECTOPIC PREGNANCY,,,5005.78,6291.49,20
HCPCS,59150,Treat ectopic pregnancy,,,3783.28,4380.64,8
HCPCS,59151,LAPS TX ECTOPIC PREG W/SALPING&/OOPHORECTOMY,4844.0,3148.6,1.1,16829.38,144
HCPCS,59151,TREAT ECTOPIC PREGNANCY,,,5005.78,13821.0,22
HCPCS,59151,Treat ectopic pregnancy,,,3783.28,4380.64,8
HCPCS,59160,CURETTAGE POSTPARTUM,6911.0,4492.150000000001,0.01,12718.0,322
HCPCS,59200,INSERTION CERVICAL DILATOR SEPARATE PROCEDURE,872.5,567.125,0.01,4628.0,407
HCPCS,59300,EPISIOTOMY/VAG RPR OTH/THN ATTENDING,6841.0,4446.650000000001,1.1,12718.0,234
HCPCS,59320,CERCLAGE CERVIX PREGNANCY VAGINAL,992.0,644.8,1.1,9118.72,144
HCPCS,59320,REVISION OF CERVIX,,,2712.29,3368.83,20
HCPCS,59320,Revision of cervix,,,1837.47,2127.6,8
HCPCS,59325,CERCLAGE CERVIX PREGNANCY ABDOMINAL,1624.0,1055.6,1.1,1624.0,144
HCPCS,59325,REVISION OF CERVIX,,,636.94,636.94,1
HCPCS,59325,Revision of cervix,,,1837.47,2127.6,8
HCPCS,59350,HYSTERORRHAPHY RUPTURED UTERUS,1976.0,1284.4,1.1,1976.0,144
HCPCS,59350,REPAIR OF UTERUS,,,739.39,739.39,1
HCPCS,59350,Repair of uterus,,,1837.47,2127.6,8
HCPCS,59400,OB CARE ANTEPARTUM VAG DLVR & POSTPARTUM,14800.0,9620.0,1.1,14800.0,142
HCPCS,59400,OBSTETRICAL CARE,,,6373.68,6373.68,1
HCPCS,59400,Obstetrical care,,,2299.38,2662.44,8
HCPCS,59409,VAGINAL DELIVERY ONLY,9520.5,6188.325000000001,1.1,12718.0,316
HCPCS,59410,OBSTETRICAL CARE,,,2863.35,2863.35,1
HCPCS,59410,Obstetrical care,,,2299.38,2662.44,8
HCPCS,59410,VAGINAL DELIVERY ONLY W/POSTPARTUM CARE,8254.0,5365.1,1.1,8254.0,144
HCPCS,59412,ANTEPARTUM MANIPULATION,,,2712.29,8161.83,21
HCPCS,59412,Antepartum manipulation,,,660.47,764.75,8
HCPCS,59412,EXTERNAL CEPHALIC VERSION W/WO TOCOLYSIS,684.0,444.6,1.1,9118.72,144
HCPCS,59414,DELIVER PLACENTA,644.0,418.6,1.1,9118.72,144
HCPCS,59414,DELIVERY OF PLACENTA,8937.0,5809.05,108.18,8937.0,86
HCPCS,59414,DELIVERY PLACENTA SEPARATE PROCEDURE,12718.0,8266.7,108.18,12718.0,86
HCPCS,59425,ANTEPARTUM CARE 4-6 VISIT MIDWIFE,3120.0,2028.0,1.1,3120.0,146
HCPCS,59425,ANTEPARTUM CARE ONLY,,,1150.01,1150.01,1
HCPCS,59425,Antepartum care only,,,128.04,148.26,8
HCPCS,59426,ANTEPARTUM CARE ONLY,,,2112.02,2112.02,1
HCPCS,59426,ANTEPARTUM CARE ONLY 7 OR > VISITS.,5720.0,3718.0,1.1,5720.0,146
HCPCS,59426,Antepartum care only,,,128.04,148.26,8
HCPCS,59430,POSTPARTUM CARE ONLY SEPARATE PROCEDURE,771.5,501.475,0.01,3443.0,217
HCPCS,59510,CESAREAN DELIVERY,,,7098.85,7098.85,1
HCPCS,59510,Cesarean delivery,,,1597.06,1849.23,8
HCPCS,59510,OB ANTEPARTUM CARE CESAREAN DLVR & POSTPARTUM,16420.0,10673.0,1.1,16420.0,130
HCPCS,59514,CESAREAN DELIVERY ONLY,7097.0,4613.05,1.1,7097.0,145
HCPCS,59514,Cesarean delivery only,,,1597.06,1849.23,8
HCPCS,59515,CESAREAN DELIVERY,,,3557.01,3557.01,1
HCPCS,59515,CESAREAN DELIVERY+POSTPARTUM CARE,10028.0,6518.2,1.1,10028.0,144
HCPCS,59515,Cesarean delivery,,,1597.06,1849.23,8
HCPCS,59525,STOT/TOT HYSTERECTOMY AFTER CESAREAN DELIVERY,3801.0,2470.65,0.01,12615.0,212
HCPCS,59610,ROUTINE OB CARE VAG DLVRY & POSTPARTUM CARE VB,15484.0,10064.6,1.1,15484.0,130
HCPCS,59610,VBAC DELIVERY,,,6694.48,6694.48,1
HCPCS,59610,Vbac delivery,,,2299.38,2662.44,8
HCPCS,59612,VAGINAL DELIVERY AFTER CESAREAN DELIVERY,6436.0,4183.4,1.1,9118.72,144
HCPCS,59612,VBAC DELIVERY ONLY,,,2712.29,8161.83,21
HCPCS,59612,Vbac delivery only,,,2299.38,2662.44,8
HCPCS,59614,VAGINAL DELIVERY & POSTPARTUM CARE VBAC,8192.0,5324.8,1.1,8192.0,144
HCPCS,59614,VBAC CARE AFTER DELIVERY,,,3105.11,3105.11,1
HCPCS,59614,Vbac care after delivery,,,2299.38,2662.44,8
HCPCS,59618,ATTEMPTED VBAC DELIVERY,,,7177.29,7177.29,1
HCPCS,59618,Attempted vbac delivery,,,1597.06,1849.23,8
HCPCS,59618,ROUTINE OBSTETRICAL CARE ATTEMPTED VBAC,16628.0,10808.2,1.1,16628.0,130
HCPCS,59620,ATTEMPTED VBAC DELIVERY ONLY,,,2493.04,2493.04,1
HCPCS,59620,Attempted vbac delivery only,,,1597.06,1849.23,8
HCPCS,59620,CESAREAN DELIVERY ATTEMPTED VBAC,6664.0,4331.6,1.1,6664.0,142
HCPCS,59622,ATTEMPTED VBAC AFTER CARE,,,3685.27,3685.27,1
HCPCS,59622,Attempted vbac after care,,,1597.06,1849.23,8
HCPCS,59622,CESAREAN DLVRY & POSTPARTUM CARE ATTEMPTED VBA,9328.0,6063.2,1.1,9328.0,144
HCPCS,59812,TX INCOMPLETE ABORTION ANY TRIMESTER SURGICAL,7247.0,4710.55,0.01,13821.0,322
HCPCS,59820,TX MISSED ABORTION FIRST TRIMESTER SURGICAL,7327.0,4762.55,0.01,13821.0,322
HCPCS,59821,TX MISSED ABORTION SECOND TRIMESTER SURGICAL,7377.0,4795.05,0.01,13821.0,322
HCPCS,59830,TX SEPTIC ABORTION SURGICAL,2636.0,1713.4,1.1,2636.0,144
HCPCS,59830,Treat uterus infection,,,2047.23,2370.48,8
HCPCS,59840,INDUCED ABORTION D&C,,,2712.29,13821.0,22
HCPCS,59840,INDUCED ABORTION DILATION AND CURETTAGE,1204.0,782.6,1.1,9118.72,148
HCPCS,59840,Induced abortion d&c,,,2047.23,2370.48,8
HCPCS,59841,INDUCED ABORTION DILAT&EVAC,,,2712.29,8326.0,21
HCPCS,59841,INDUCED ABORTION DILATION & EVACUATION,2260.0,1469.0,1.1,9118.72,148
HCPCS,59841,Induced abortion dilat&evac,,,2047.23,2370.48,8
HCPCS,59850,INDUCED ABORTION 1/> AMNIOTIC INJX W/D&C/EVACJ,2360.0,1534.0,1.1,2360.0,144
HCPCS,59850,Induced abortion 1+ njx,,,2047.23,2370.48,8
HCPCS,59851,INDUCE ABORT 1/> AMNIOT NJXS DLVR FETUS D&C,2368.0,1539.2,1.1,2368.0,144
HCPCS,59851,Induced abortion 1+njx d&c,,,2047.23,2370.48,8
HCPCS,59852,INDUCE ABORT 1/> AMNIOT NJXS DLVR FETUS HYSTOTM,3292.0,2139.8,1.1,3292.0,144
HCPCS,59852,Induced abortion 1+njx hyst,,,2047.23,2370.48,8
HCPCS,59855,INDUCED ABORT 1/> VAG SUPPOSITORIES DLVR FETUS,2572.0,1671.8,1.1,2572.0,144
HCPCS,59855,INDUCED ABORTION 1+VAG SUPP,,,1129.02,1129.02,1
HCPCS,59855,Induced abortion 1+vag supp,,,2047.23,2370.48,8
HCPCS,59856,INDUCED ABORT 1/> VAG SUPP DLVR FETUS D&C &/EVAC,3005.5,1953.575,1.1,6112.0,213
HCPCS,59857,INDUCED AB 1+VAG SUPP HYST,,,1541.66,1541.66,1
HCPCS,59857,INDUCED ABORT 1/> VAG SUPPOS DLVR FETUS HYSTOT,3732.0,2425.8,1.1,3732.0,144
HCPCS,59857,Induced ab 1+vag supp hyst,,,2047.23,2370.48,8
HCPCS,59866,MULTIFETAL PREGNANCY REDUCTION,1217.0,791.05,0.01,2370.48,87
HCPCS,59866,MULTIFETAL PREGNANCY REDUCTION(S),1596.0,1037.4,1.1,1596.0,132
HCPCS,59870,EVACUATE MOLE OF UTERUS,,,2712.29,3368.83,20
HCPCS,59870,Evacuate mole of uterus,,,3783.28,4380.64,8
HCPCS,59870,UTERINE EVACUATION & CURETTAGE HYDATIDIFORM MOLE,2628.0,1708.2,1.1,9118.72,144
HCPCS,59871,REMOVAL CERCLAGE SUTURE UNDER ANESTHESIA,852.0,553.8,1.1,9118.72,144
HCPCS,59871,REMOVE CERCLAGE SUTURE,,,2712.29,3368.83,20
HCPCS,59871,Remove cerclage suture,,,1837.47,2127.6,8
HCPCS,59897,ECTOPIC ASPIRA W/GUIDE,777.0,505.05,0.01,3443.0,85
HCPCS,59897,"OPEN FETAL SURGERY, INCL. HYSTEROTOMY, AMNIO INFUS. US & INTENS.",18150.0,11797.5,0.01,18150.0,82
HCPCS,59897,UNLISTED FETAL INVASIVE PX W/ULTRASOUND,1154.0,750.1,0.01,1154.0,82
HCPCS,59897,UNLISTED HYSTEROSCOPIC RESECTION OF CESAREAN ECTOPIC PREGNANCY (,2052.0,1333.8,0.01,2052.0,82
HCPCS,59897,UNLISTED U/S GUIDED FETAL INJECTION (COMP CODE 59850),2142.0,1392.3,0.01,2142.0,82
HCPCS,59898,UNLISTED LAPAROSCOPIC EXCISION OF CESAREAN SCAR DEFECT ECTOPIC P,6686.0,4345.9,0.01,16829.38,82
HCPCS,59898,UNLSTD LAPS PX MAT CARE&DLVR,,,5005.78,15063.4,21
HCPCS,59898,Unlstd laps px mat care&dlvr,,,1837.47,2127.6,8
HCPCS,59899,JADA PROCEDURE (COMP CODE43460),1629.0,1058.85,0.01,1629.0,84
HCPCS,59899,PROC MATERNITY CARE UNLISTD - IUPC,351.0,228.15,97.58,4628.0,84
HCPCS,59899,PROC MATERNITY CARE UNLISTED,379.0,246.35,0.01,4337.0,85
HCPCS,59899,UNLISTED INSERT BAKRI BALLOON POSTPARTUM,1160.0,754.0,0.01,1160.0,84
HCPCS,59899,UNLISTED MANUAL UTERINE INVERSION,1630.0,1059.5,0.01,1630.0,84
HCPCS,59899,"UNLISTED PROCEDURE, MATERNITY CARE AND DELIVERY (COMPARISON CODE",220.0,143.0,0.01,581.59,84
HCPCS,60000,I&D THYROGLOSSAL DUCT CYST,724.0,470.6,1.1,4447.63,148
HCPCS,60000,I&D THYROGLOSSAL DUCT CYST INFECTED,5925.0,3851.25,182.91,5925.0,87
HCPCS,6005F,CARE LEVEL RATIONALE DOC,,,2739849.3,2739849.3,1
HCPCS,6005F,Care level rationale doc,,,10.69,12.38,8
HCPCS,60100,BIOPSY THYROID PERCUTANEOUS CORE NEEDLE,1719.0,1117.35,0.01,4628.0,321
HCPCS,6010F,DYSPHAG TEST DONE B/4 EATING,,,2739849.3,2739849.3,1
HCPCS,6010F,Dysphag test done b/4 eating,,,10.69,12.38,8
HCPCS,6015F,DYSPHAG TEST DONE B/4 EATING,,,2739849.3,2739849.3,1
HCPCS,6015F,Dysphag test done b/4 eating,,,10.69,12.38,8
HCPCS,60200,EXC CYST/ADENOMA THYROID/TRANSECTION ISTHMUS,4008.0,2605.2,1.1,16829.38,144
HCPCS,60200,REMOVE THYROID LESION,,,5005.78,6291.49,20
HCPCS,60200,Remove thyroid lesion,,,4313.71,4994.83,8
HCPCS,6020F,NPO (NOTHING-MOUTH) ORDERED,,,2739849.3,2739849.3,1
HCPCS,6020F,Npo (nothing-mouth) ordered,,,10.69,12.38,8
HCPCS,60210,PARTIAL THYROID EXCISION,,,5005.78,6291.49,20
HCPCS,60210,PRTL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY,4492.0,2919.8,1.1,16829.38,144
HCPCS,60210,Partial thyroid excision,,,4313.71,4994.83,8
HCPCS,60212,PARTIAL THYROID EXCISION,,,5005.78,6291.49,20
HCPCS,60212,PRTL THYROID LOBEC UNI W/CONTRATLAT STOT LOBEC,6572.0,4271.8,1.1,16829.38,144
HCPCS,60212,Partial thyroid excision,,,4313.71,4994.83,8
HCPCS,60220,PARTIAL REMOVAL OF THYROID,,,3528.0,25635.0,24
HCPCS,60220,Partial removal of thyroid,,,4313.71,4994.83,8
HCPCS,60220,TOTAL THYROID LOBECTOMY UNI W/WO ISTHMUSECTOMY,4924.0,3200.6,1.1,16829.38,144
HCPCS,60225,PARTIAL REMOVAL OF THYROID,,,5005.78,6291.49,20
HCPCS,60225,Partial removal of thyroid,,,4313.71,4994.83,8
HCPCS,60225,TOTAL THYROID LOBEC UNI W/CONTRALAT STOT LOBEC,6508.0,4230.2,1.1,16829.38,144
HCPCS,60240,REMOVAL OF THYROID,,,5005.78,11441.0,23
HCPCS,60240,Removal of thyroid,,,4313.71,4994.83,8
HCPCS,60240,THYROIDECTOMY TOTAL/COMPLETE,6618.0,4301.7,1.1,16829.38,144
HCPCS,60252,REMOVAL OF THYROID,,,5080.55,9509.0,21
HCPCS,60252,Removal of thyroid,,,4313.71,4994.83,8
HCPCS,60252,THYROIDECTOMY TOTAL/SUBTOTAL LMTD NECK DISSECT,8804.0,5722.6,1.1,17080.38,144
HCPCS,60254,EXTENSIVE THYROID SURGERY,,,4374.33,4374.33,1
HCPCS,60254,Extensive thyroid surgery,,,4313.71,4994.83,8
HCPCS,60254,THYROIDECTOMY TOTAL/SUBTOTAL RAD NECK DISSECT,11368.0,7389.2,1.1,11368.0,144
HCPCS,60260,REPEAT THYROID SURGERY,,,5080.55,9509.0,21
HCPCS,60260,Repeat thyroid surgery,,,4313.71,4994.83,8
HCPCS,60260,THYROIDECTOMY RMVL REMAINING TISS FLWG PRTL RMVL,7304.0,4747.6,1.1,17080.38,144
HCPCS,60270,REMOVAL OF THYROID,,,3577.76,3577.76,1
HCPCS,60270,Removal of thyroid,,,4313.71,4994.83,8
HCPCS,60270,THYROIDECT W/SUBSTERNAL SPLIT/TRANSTHORACIC,9280.0,6032.0,1.1,9280.0,144
HCPCS,60271,REMOVAL OF THYROID,,,5080.55,8702.0,21
HCPCS,60271,Removal of thyroid,,,4313.71,4994.83,8
HCPCS,60271,THYROIDECTOMY SUBSTERNAL CERVICAL APPROACH,7048.0,4581.2,1.1,17080.38,144
HCPCS,60280,EXCISION THYROGLOSSAL DUCT CYST/SINUS,2464.0,1601.6,1.1,16829.38,144
HCPCS,60280,REMOVE THYROID DUCT LESION,,,5005.78,11441.0,23
HCPCS,60280,Remove thyroid duct lesion,,,4313.71,4994.83,8
HCPCS,60281,EXCISION THYROGLOSSAL DUCT CYST/SINUS RECURRENT,3528.0,2293.2,1.1,16829.38,144
HCPCS,60281,REMOVE THYROID DUCT LESION,,,5005.78,6291.49,20
HCPCS,60281,Remove thyroid duct lesion,,,4313.71,4994.83,8
HCPCS,60300,ASPIRATION AND/OR INJECTION THYROID CYST,1601.0,1040.6499999999999,0.01,12500.0,322
HCPCS,6030F,MAX STERILE BARRIERS FLWD,,,0.03,0.03,1
HCPCS,6030F,Max sterile barriers flwd,,,10.69,12.38,8
HCPCS,6040F,APPRO RAD DS DVCS TECHS DOCD,,,2739849.3,2739849.3,1
HCPCS,6040F,Appro rad ds dvcs techs docd,,,10.69,12.38,8
HCPCS,6045F,RADXPS IN END RPRT4FLURO PXD,,,0.03,0.03,1
HCPCS,6045F,Radxps in end rprt4fluro pxd,,,10.69,12.38,8
HCPCS,60500,PARATHYROIDECTOMY/EXPLORATION PARATHYROIDS,15263.5,9921.275000000001,1.1,23663.0,231
HCPCS,60502,PARATHYROIDECTOMY/EXPLOR PARATHYROIDS RE-EXPLOR,8460.0,5499.0,1.1,17080.38,144
HCPCS,60502,RE-EXPLORE PARATHYROIDS,,,5080.55,8702.0,21
HCPCS,60502,Re-explore parathyroids,,,4313.71,4994.83,8
HCPCS,60505,EXPLORE PARATHYROID GLANDS,,,3675.05,3675.05,1
HCPCS,60505,Explore parathyroid glands,,,4313.71,4994.83,8
HCPCS,60505,PARATHYRDEC/EXPL PARATHYR MEDSTNL STERNAL/TTHRC,9224.0,5995.6,1.1,9224.0,144
HCPCS,60512,Autotransplant parathyroid,,,4313.71,4994.83,8
HCPCS,60512,PARATHYROID AUTOTRANSPLANTATION ADD-ON,1776.0,1154.4,1.1,1776.0,144
HCPCS,60520,REMOVAL OF THYMUS GLAND,,,5080.55,6160.68,20
HCPCS,60520,Removal of thymus gland,,,3174.61,3675.86,8
HCPCS,60520,THYMECTOMY PRTL/TOT TRANSCERVICAL APPR SPX,6864.0,4461.6,1.1,17080.38,144
HCPCS,60521,REMOVAL OF THYMUS GLAND,,,2935.99,2935.99,1
HCPCS,60521,Removal of thymus gland,,,3174.61,3675.86,8
HCPCS,60521,THYMECTOMY PRTL/TOT W/O RAD MEDSTNL DSJ SPX,7672.0,4986.8,1.1,7672.0,144
HCPCS,60522,REMOVAL OF THYMUS GLAND,,,3557.29,3557.29,1
HCPCS,60522,Removal of thymus gland,,,3174.61,3675.86,8
HCPCS,60522,THYMECTOMY PRTL/TOT RAD MEDSTNL DSJ SPX,9392.0,6104.8,1.1,9392.0,144
HCPCS,60540,ADRENALECTOMY W/EXPL W/WO BX ABDL/LMBR/DRSAL SPX,7929.0,5153.85,1.1,7929.0,144
HCPCS,60540,EXPLORE ADRENAL GLAND,,,2831.76,2831.76,1
HCPCS,60540,Explore adrenal gland,,,2029.97,2350.49,8
HCPCS,60545,ADRENALECTOMY EXPL W/EXC RETROPERTINEAL TUMOR,8372.0,5441.8,1.1,8372.0,144
HCPCS,60545,EXPLORE ADRENAL GLAND,,,3284.74,3284.74,1
HCPCS,60545,Explore adrenal gland,,,2029.97,2350.49,8
HCPCS,60600,EXC CAROTID BODY TUMOR W/O EXC CAROTID ARTERY,10036.0,6523.4,1.1,10036.0,144
HCPCS,60600,REMOVE CAROTID BODY LESION,,,3586.77,3586.77,1
HCPCS,60600,Remove carotid body lesion,,,1098.89,1272.4,8
HCPCS,60605,EXC CAROTID BODY TUMOR W EXC CAROTID ARTERY,12784.0,8309.6,1.1,12784.0,144
HCPCS,60605,REMOVE CAROTID BODY LESION,,,4291.72,4291.72,1
HCPCS,60605,Remove carotid body lesion,,,1098.89,1272.4,8
HCPCS,60650,LAPAROSCOPY ADRENALECTOMY,,,3130.72,11441.0,3
HCPCS,60650,LAPAROSCOPY ADRENALECTOMY PARTIAL OR COM,8292.0,5389.8,1.1,8292.0,144
HCPCS,60650,Laparoscopy adrenalectomy,,,2029.97,2350.49,8
HCPCS,60659,"UNLISTED LAPAROSCOPY PROCEDURE, END",6915.0,4494.75,0.01,16829.38,84
HCPCS,60659,UNLISTED LAPS PX ENDOC SYS,,,5005.78,15063.4,21
HCPCS,60659,Unlisted laps px endoc sys,,,2029.97,2350.49,8
HCPCS,60660,ABLTJ 1/+THYROID NODULE 1 LOBE/ISTHMUS PERQ RF,4505.5,2928.575,1.1,10364.0,228
HCPCS,60661,ABLTJ 1/+THYR NDUL ADDL LOBE PERQ RADIOFREQUENCY,1870.0,1215.5,1.1,1870.0,144
HCPCS,60661,Abltj 1/+thyr ndul addl prq,,,4313.71,4994.83,8
HCPCS,60699,AUTOTRANS OF CRYO TISSUE (COMP CODE 60512),1599.0,1039.35,0.01,16829.38,84
HCPCS,60699,CRYOPRESERVATION OF PARATHYROID GLANDS (COMP 60200),3307.0,2149.55,0.01,16829.38,84
HCPCS,60699,CT BIOPSY ADRENAL,740.0,481.0,205.72,10592.0,84
HCPCS,60699,IMAGE GUIDED - CRYOABLATION OF ADRENAL GLAND (COMP CODE 50593),21214.5,13789.425,0.01,39232.0,168
HCPCS,60699,MICROWAVE ABLATION ADRENAL GLAND (COMP CODE 50592),14729.0,9573.85,0.01,26838.0,168
HCPCS,60699,OPEN INCISIONAL BX THYROID (COMP 60200),2174.0,1413.1,0.01,16829.38,84
HCPCS,60699,OPEN THYROID LOBE BIOPSIES,3479.0,2261.35,0.01,16829.38,84
HCPCS,60699,PROC ENDOCRINE UNLISTD,1423.0,924.95,395.59,10592.0,84
HCPCS,60699,RADIOFREQUENCY ABLATION PARATHYROID ADENOMA (COMP CODE 20982),30997.5,20148.375,0.01,59187.0,168
HCPCS,60699,THYR RF ABAL W/US (COMP 47382),14381.5,9347.975,0.01,23750.0,168
HCPCS,6070F,PT ASKED/CNSLD AED EFFECTS,,,2739849.3,2739849.3,1
HCPCS,6070F,Pt asked/cnsld aed effects,,,10.69,12.38,8
HCPCS,6080F,PT/CAREGIVER QUERIED FALLS,,,2739849.3,2739849.3,1
HCPCS,6080F,Pt/caregiver queried falls,,,10.69,12.38,8
HCPCS,6090F,PT/CAREGIVER COUNSEL SAFETY,,,2739849.3,2739849.3,1
HCPCS,6090F,Pt/caregiver counsel safety,,,10.69,12.38,8
HCPCS,61000,REMOVE CRANIAL CAVITY FLUID,,,599.95,1805.39,21
HCPCS,61000,Remove cranial cavity fluid,,,289.33,335.02,8
HCPCS,61000,SUBDURAL TAP FONTANELLE/SUTUR INFANT UNI/BI INIT,632.0,410.8,1.1,2017.2,144
HCPCS,61001,REMOVE CRANIAL CAVITY FLUID,,,599.95,1805.39,21
HCPCS,61001,Remove cranial cavity fluid,,,289.33,335.02,8
HCPCS,6100F,VERIFY PT SITE PXD DOCD,,,2739849.3,2739849.3,1
HCPCS,6100F,Verify pt site pxd docd,,,10.69,12.38,8
HCPCS,6101F,SAFETY COUNSELING DEMENTIA,,,2739849.3,2739849.3,1
HCPCS,6101F,Safety counseling dementia,,,10.69,12.38,8
HCPCS,61020,VENTRICULAR PUNCTURE PREVIOUS BURR HOLE W/O NJX,3373.5,2192.775,0.01,6143.0,318
HCPCS,61026,VENTRICULAR PUNCTURE PREVIOUS BURR HOLE W/INJ,2727.0,1772.55,0.01,4778.0,231
HCPCS,6102F,SAFETY COUNSELING DEM ORDER,,,2739849.3,2739849.3,1
HCPCS,6102F,Safety counseling dem order,,,10.69,12.38,8
HCPCS,61050,CISTERNAL/LATERAL C1-C2 PUNCTURE W/O INJ SPX,1320.5,858.325,1.1,4628.0,231
HCPCS,61055,CISTERNAL/LATERAL C1-C2 PUNCTURE W/INJECTION,1438.5,935.025,0.01,4628.0,318
HCPCS,61070,PUNCTURE SHUNT TUBE/RESERVOIR ASPIRATION/INJ PX,2585.0,1680.25,0.01,4778.0,405
HCPCS,61105,TDH SDRL/VENTR PNXR,,,1236.12,1236.12,1
HCPCS,61105,TWIST DRILL HOLE SUBDURAL/VENTRICULAR PUNCTURE,2180.0,1417.0,1.1,2180.0,144
HCPCS,61105,Tdh sdrl/ventr pnxr,,,5036.43,5831.66,8
HCPCS,61107,TWIST DRILL HOLE IMPLT VENTRICULAR CATH/DEVICE,5331.5,3465.4750000000004,0.01,8667.0,281
HCPCS,61108,TWIST DRILL HOLE EVAC&/DRG SUBDURAL HEMATOMA,8989.5,5843.175,1.1,13323.0,280
HCPCS,6110F,COUNSEL PROV DRIVING RISKS,,,2739849.3,2739849.3,1
HCPCS,6110F,Counsel prov driving risks,,,10.69,12.38,8
HCPCS,61120,BURR HOLE FOR VENTR PUNCTURE,,,2002.67,2002.67,1
HCPCS,61120,Burr hole for ventr puncture,,,5036.43,5831.66,8
HCPCS,61140,BURR HOLE/TREPH BX BRAIN/LES,,,3397.05,3397.05,1
HCPCS,61140,BURR HOLE/TREPHINE W/BX BRAIN/INTRACRNIAL LESION,6892.0,4479.8,1.1,6892.0,144
HCPCS,61140,Burr hole/treph bx brain/les,,,5036.43,5831.66,8
HCPCS,61150,BUR HOL/TRPH DRG BRN ABS/CST,,,3606.85,3606.85,1
HCPCS,61150,BURR HOLE/TREPHINE W/DRG BRAIN ABSCESS/CYST,7560.0,4914.0,1.1,7560.0,144
HCPCS,61150,Bur hol/trph drg brn abs/cst,,,5036.43,5831.66,8
HCPCS,61151,BURR HOLE/TREPH SBSQ TAPPING,,,2654.65,2654.65,1
HCPCS,61151,BURR HOLE/TREPHINE W/SBSQ TAPPING ICRA ABSC/CST,5396.0,3507.4,1.1,5396.0,144
HCPCS,61151,Burr hole/treph sbsq tapping,,,5036.43,5831.66,8
HCPCS,61154,BURR HOLE W/EVAC&/DRG HEMATOMA XDRL/SDRL,6828.0,4438.2,1.1,6828.0,144
HCPCS,61154,BURR HOLE W/EVAC&/DRG HMTMA,,,3410.31,3410.31,1
HCPCS,61154,Burr hole w/evac&/drg hmtma,,,5036.43,5831.66,8
HCPCS,61156,BURR HOL ASPIR HMTM/CST ICER,,,3312.11,3312.11,1
HCPCS,61156,BURR HOLE W/ASPIR HEMATOMA/CYST INTRACEREBRAL,6980.0,4537.0,1.1,6980.0,144
HCPCS,61156,Burr hol aspir hmtm/cst icer,,,5036.43,5831.66,8
HCPCS,61210,BURR HOLE IMPLANT VENTRICULAR CATH/OTHER DEVICE,3446.5,2240.225,1.1,5831.66,212
HCPCS,61215,INS SUBQ RSVR PMP/NFS SYS,,,5779.17,9132.89,20
HCPCS,61215,INSJ SUBQ RSVR PUMP/INFUSION SYSTEM VENTRIC CATH,2340.0,1521.0,1.1,19428.17,144
HCPCS,61215,Ins subq rsvr pmp/nfs sys,,,3812.17,4414.09,8
HCPCS,61250,BURR HOLE/TREPH STTL EXPL,,,2318.09,2318.09,1
HCPCS,61250,BURR HOLE/TREPHINE SUPRATENTORIAL W/O OTH SURG,4596.0,2987.4,1.1,4596.0,144
HCPCS,61250,Burr hole/treph sttl expl,,,5036.43,5831.66,8
HCPCS,61253,BURR HOLE TREPH ITTL UNI/BI,,,2654.65,2654.65,1
HCPCS,61253,BURR HOLE/TREPHINE INFRATENTORIAL UNI/BI,5396.0,3507.4,1.1,5396.0,144
HCPCS,61253,Burr hole treph ittl uni/bi,,,5036.43,5831.66,8
HCPCS,61304,CRANIECTOMY/CRANIOTOMY EXPL SUPRATENTORIAL,9364.0,6086.6,1.1,9364.0,144
HCPCS,61304,CRNEC/CRNOT EXPL SUPRATNTORL,,,4377.23,4377.23,1
HCPCS,61304,Crnec/crnot expl supratntorl,,,2698.82,3124.95,8
HCPCS,61305,CRANIECTOMY/CRANIOTOMY EXPL INFRATENTORIAL,12602.0,8191.3,1.1,12602.0,144
HCPCS,61305,CRNEC/CRNOT EXPL INFRATNTORL,,,5352.4,5352.4,1
HCPCS,61305,Crnec/crnot expl infratntorl,,,2698.82,3124.95,8
HCPCS,61312,CRANIECTOMY HMTMA SUPRATENTORIAL EXTRA/SUBDURAL,12068.0,7844.2,1.1,12068.0,144
HCPCS,61312,CRNEC/CRNOT STTL XDRL/SDRL,,,5526.06,5526.06,1
HCPCS,61312,Crnec/crnot sttl xdrl/sdrl,,,2698.82,3124.95,8
HCPCS,61313,CRANIECTOMY HMTMA SUPRATENTORIAL INTRACEREBRAL,11236.0,7303.4,1.1,11236.0,144
HCPCS,61313,CRNEC/CRNOT STTL ICERE,,,5298.37,5298.37,1
HCPCS,61313,Crnec/crnot sttl icere,,,2698.82,3124.95,8
HCPCS,61314,CRANIECTOMY HMTMA INFRATENTORIAL EXTRA/SUBDURAL,10360.0,6734.0,1.1,10360.0,144
HCPCS,61314,CRNEC/CRNOT ITTL XDRL/SDRL,,,4870.24,4870.24,1
HCPCS,61314,Crnec/crnot ittl xdrl/sdrl,,,2698.82,3124.95,8
HCPCS,61315,CRANIECTOMY HMTMA SUPRATENTORIAL INTRACEREBRAL,11860.0,7709.0,1.1,11860.0,144
HCPCS,61315,CRNEC/CRNOT ITTL NTRACEREBLR,,,5523.87,5523.87,1
HCPCS,61315,Crnec/crnot ittl ntracereblr,,,2698.82,3124.95,8
HCPCS,61316,INC&SUBQ PLMT CRNL BONE GRF,,,232.3,232.3,1
HCPCS,61316,INCISION & SUBCUTANEOUS PLMT CRANIAL BONE GRAF,556.0,361.4,1.1,556.0,144
HCPCS,61316,Inc&subq plmt crnl bone grf,,,2698.82,3124.95,8
HCPCS,61320,CRANIECTOMY/CRANIOTMY DRG ABSCESS SUPRATENTORIAL,10968.0,7129.2,1.1,10968.0,144
HCPCS,61320,CRNEC/CRNOT DRG ICR ABS STTL,,,5053.68,5053.68,1
HCPCS,61320,Crnec/crnot drg icr abs sttl,,,2698.82,3124.95,8
HCPCS,61321,CRANIECTOMY/CRANIOTMY DRG ABSCESS INFRATENTORIAL,12212.0,7937.8,1.1,12212.0,144
HCPCS,61321,CRNEC/CRNOT DRG ICR ABS ITTL,,,5669.58,5669.58,1
HCPCS,61321,Crnec/crnot drg icr abs ittl,,,2698.82,3124.95,8
HCPCS,61322,CRANIECT/CRANIOT W/WO DURAPLASTY W/O LOBECTOMY,13704.0,8907.6,1.1,13704.0,144
HCPCS,61322,CRNEC/CRNOT DCMPRV W/O LOBEC,,,6357.4,6357.4,1
HCPCS,61322,Crnec/crnot dcmprv w/o lobec,,,2698.82,3124.95,8
HCPCS,61323,CRANIECT/CRANIOT W/WO DURAPLASTY W/LOBECTOMY,14024.0,9115.6,1.1,14024.0,144
HCPCS,61323,CRNEC/CRNOT DCMPRV W/LOBEC,,,6381.3,6381.3,1
HCPCS,61323,Crnec/crnot dcmprv w/lobec,,,2698.82,3124.95,8
HCPCS,61330,DCMPRN ORBIT ONLY TRANSCRNL,,,2793.19,8405.28,21
HCPCS,61330,DECOMPRESSION ORBIT ONLY TRANSCRANIAL APPROACH,10120.0,6578.0,1.1,10120.0,144
HCPCS,61330,Dcmprn orbit only transcrnl,,,2698.82,3124.95,8
HCPCS,61333,EXPL ORBIT TRANSCRANIAL APPROACH W/RMVL LESION,11708.0,7610.2,1.1,11708.0,144
HCPCS,61333,EXPL ORBIT W/REMOVAL LESION,,,5383.28,5383.28,1
HCPCS,61333,Expl orbit w/removal lesion,,,2698.82,3124.95,8
HCPCS,61340,SUBTEMPORAL CRANIAL DCMPRN,,,3845.95,3845.95,1
HCPCS,61340,SUBTEMPORAL CRANIAL DECOMPRESSION,8044.0,5228.6,1.1,8044.0,144
HCPCS,61340,Subtemporal cranial dcmprn,,,2698.82,3124.95,8
HCPCS,61343,CRNEC SOPL CRV LAM DCMPRN,,,5846.89,5846.89,1
HCPCS,61343,CRNEC SUBOCCIPITAL CRV LAM DCMPRN MEDULLA & CORD,12744.0,8283.6,1.1,12744.0,144
HCPCS,61343,Crnec sopl crv lam dcmprn,,,2698.82,3124.95,8
HCPCS,61345,OTH CRANIAL DCMPRN PST FOSSA,,,5452.22,5452.22,1
HCPCS,61345,OTHER CRANIAL DECOMPRESSION POSTERIOR FOSSA,11692.0,7599.8,1.1,11692.0,144
HCPCS,61345,Oth cranial dcmprn pst fossa,,,2698.82,3124.95,8
HCPCS,61450,CRNEC STPL SCTJ CMPRN/DCMPRN,,,5126.62,5126.62,1
HCPCS,61450,CRNEC STPL SCTJ COMPRESSION/DCMPRN GANGLION,11076.0,7199.4,1.1,11076.0,144
HCPCS,61450,Crnec stpl sctj cmprn/dcmprn,,,2698.82,3124.95,8
HCPCS,61458,CRNEC SOPL EXPL/DCMPRN CRNL NRV,11536.0,7498.4,1.1,11536.0,144
HCPCS,61458,CRNEC SOPL XPL/DCMPR CRL NRV,,,5366.15,5366.15,1
HCPCS,61458,Crnec sopl xpl/dcmpr crl nrv,,,2698.82,3124.95,8
HCPCS,61460,CRANIECTOMY SUBOCCIPITAL SECTION 1/> CRANIAL NR,12096.0,7862.4,1.1,12096.0,144
HCPCS,61460,CRNEC SOPL SCTJ 1+CRNL NRV,,,5621.8,5621.8,1
HCPCS,61460,Crnec sopl sctj 1+crnl nrv,,,2698.82,3124.95,8
HCPCS,61500,CRANIECTOMY W/EXCISION TUMOR/LESION SKULL,6207.5,4034.875,0.01,7672.0,213
HCPCS,61501,CRANIECTOMY F/OSTEOMYELITIS,,,2987.34,2987.34,1
HCPCS,61501,CRANIECTOMY OSTEOMYELITIS,6540.0,4251.0,1.1,6540.0,144
HCPCS,61501,Craniectomy f/osteomyelitis,,,2698.82,3124.95,8
HCPCS,6150F,PT NOTRCVNG1ST ANTITNF TXMNT,,,2739849.3,2739849.3,1
HCPCS,6150F,Pt notrcvng1st antitnf txmnt,,,10.69,12.38,8
HCPCS,61510,CRANIEC TREPHINE BONE FLP BRAIN TUMOR SUPRTENTOR,13565.0,8817.25,1.1,13565.0,144
HCPCS,61510,CRNEC TREPH EXC BRN TUM STTL,,,5871.35,5871.35,1
HCPCS,61510,Crnec treph exc brn tum sttl,,,2698.82,3124.95,8
HCPCS,61512,CRNEC TREPH EXC MNGIOMA STTL,,,6807.26,6807.26,1
HCPCS,61512,CRNEC TREPHINE BONE FLAP MENINGIOMA SUPRATENTOR,14856.0,9656.4,1.1,14856.0,144
HCPCS,61512,Crnec treph exc mngioma sttl,,,2698.82,3124.95,8
HCPCS,61514,CRNEC TREPH EXC BRN ABS STTL,,,5107.2,5107.2,1
HCPCS,61514,CRNEC TREPHINE BONE FLAP BRAIN ABSC SUPRATENTOR,10892.0,7079.8,1.1,10892.0,144
HCPCS,61514,Crnec treph exc brn abs sttl,,,2698.82,3124.95,8
HCPCS,61516,CRNEC TREPH EXC CYST STTL,,,5003.38,5003.38,1
HCPCS,61516,CRNEC TREPHINE BONE FLAP FENEST CYST SUPRATENTOR,10632.0,6910.8,1.1,10632.0,144
HCPCS,61516,Crnec treph exc cyst sttl,,,2698.82,3124.95,8
HCPCS,61517,IMPLT BRN INTRCV CHEMOTX AGT,,,231.39,231.39,1
HCPCS,61517,IMPLTJ BRAIN INTRACAVITARY CHEMOTHERAPY AGENT,552.0,358.8,1.1,552.0,144
HCPCS,61517,Implt brn intrcv chemotx agt,,,5036.43,5831.66,8
HCPCS,61518,CRNEC EXC BRAIN TUMOR INFRATENTORIAL/POST FOSSA,15956.0,10371.4,1.1,15956.0,144
HCPCS,61518,REMOVAL OF BRAIN LESION,,,7387.18,7387.18,1
HCPCS,61518,Removal of brain lesion,,,2698.82,3124.95,8
HCPCS,61519,CRNEC EXC TUM INFRATENTOR/POST FOSSA MENINGIOMA,17372.0,11291.8,1.1,17372.0,144
HCPCS,61519,REMOVE BRAIN LINING LESION,,,7841.63,7841.63,1
HCPCS,61519,Remove brain lining lesion,,,2698.82,3124.95,8
HCPCS,61520,CRNEC TUM INFRATTL/POSTFOSSA CRBLOPNT ANGLE TUM,22836.0,14843.4,1.1,22836.0,144
HCPCS,61520,REMOVAL OF BRAIN LESION,,,9877.54,9877.54,1
HCPCS,61520,Removal of brain lesion,,,2698.82,3124.95,8
HCPCS,61521,CRNEC TUM INFRATTL/PFOSSA MIDLINE TUM BASE SKULL,18796.0,12217.4,1.1,18796.0,144
HCPCS,61521,REMOVAL OF BRAIN LESION,,,8474.3,8474.3,1
HCPCS,61521,Removal of brain lesion,,,2698.82,3124.95,8
HCPCS,61522,CRNEC INFRATNTORIAL/POST FOSSA EXC BRAIN ABSCESS,12616.0,8200.4,1.1,12616.0,144
HCPCS,61522,REMOVAL OF BRAIN ABSCESS,,,5839.16,5839.16,1
HCPCS,61522,Removal of brain abscess,,,2698.82,3124.95,8
HCPCS,61524,CRNEC INFRATNTOR/POSTFOSSA EXC/FENESTRATION CYST,13152.0,8548.8,1.1,13152.0,144
HCPCS,61524,REMOVAL OF BRAIN LESION,,,5563.54,5563.54,1
HCPCS,61524,Removal of brain lesion,,,2698.82,3124.95,8
HCPCS,61526,CRNEC TRANSTEMPOR EXC CEREBELLOPONTINE ANGLE TUM,23795.0,15466.75,1.1,23795.0,144
HCPCS,61526,REMOVAL OF BRAIN LESION,,,8826.55,8826.55,1
HCPCS,61526,Removal of brain lesion,,,2698.82,3124.95,8
HCPCS,61530,CRNEC EXC CEREBELLOPNTIN ANGLE TUM MID/POSTFOSSA,20046.0,13029.9,1.1,20046.0,144
HCPCS,61530,REMOVAL OF BRAIN LESION,,,8189.18,8189.18,1
HCPCS,61530,Removal of brain lesion,,,2698.82,3124.95,8
HCPCS,61531,IMPLANT BRAIN ELECTRODES,,,3274.68,3274.68,1
HCPCS,61531,Implant brain electrodes,,,5036.43,5831.66,8
HCPCS,61531,SUBDURAL IMPLTJ ELECTRODES SEIZURE MONITORING,6564.0,4266.6,1.1,6564.0,144
HCPCS,61533,CRANIOT SUBDURAL IMPLT ELCTRD SEIZURE MONITORING,8584.0,5579.6,1.1,8584.0,144
HCPCS,61533,IMPLANT BRAIN ELECTRODES,,,4079.67,4079.67,1
HCPCS,61533,Implant brain electrodes,,,2698.82,3124.95,8
HCPCS,61534,CRANIOT EPILEPTOGENIC FOC W/O ELECTRCORTICOGRPHY,9204.0,5982.6,1.1,9204.0,144
HCPCS,61534,REMOVAL OF BRAIN LESION,,,4409.73,4409.73,1
HCPCS,61534,Removal of brain lesion,,,2698.82,3124.95,8
HCPCS,61535,CRANIOT RMVL EPID/SUBDURL ELCTRD W/O EXC TIS SPX,5260.0,3419.0,1.1,5260.0,144
HCPCS,61535,REMOVE BRAIN ELECTRODES,,,2687.2,2687.2,1
HCPCS,61535,Remove brain electrodes,,,2698.82,3124.95,8
HCPCS,61536,CRANIOT EPILEPTOGENIC FOCUS W/ELECTROCORTCOGRPHY,15088.0,9807.2,1.1,15088.0,144
HCPCS,61536,REMOVAL OF BRAIN LESION,,,6874.58,6874.58,1
HCPCS,61536,Removal of brain lesion,,,2698.82,3124.95,8
HCPCS,61537,CRANIOT TEMPORAL LOBE W/O ELECTROCORTICOGRAPHY,16038.0,10424.7,1.1,16038.0,144
HCPCS,61537,REMOVAL OF BRAIN TISSUE,,,6554.57,6554.57,1
HCPCS,61537,Removal of brain tissue,,,2698.82,3124.95,8
HCPCS,61538,CRANIOT LOBEC TEMPORAL LOBE W/ELECTROCORTCOGRPHY,15780.0,10257.0,1.1,15780.0,144
HCPCS,61538,REMOVAL OF BRAIN TISSUE,,,7094.98,7094.98,1
HCPCS,61538,Removal of brain tissue,,,2698.82,3124.95,8
HCPCS,61539,CRANIOT LOBECTOMY OTH/THN TEMPORAL LOBE W/ECOG,13712.0,8912.8,1.1,13712.0,144
HCPCS,61539,REMOVAL OF BRAIN TISSUE,,,6296.79,6296.79,1
HCPCS,61539,Removal of brain tissue,,,2698.82,3124.95,8
HCPCS,61540,CRANIOT LOBECTOMY OTH/THN TEMPORAL LOBE W/O ECOG,13829.0,8988.85,1.1,13829.0,144
HCPCS,61540,REMOVAL OF BRAIN TISSUE,,,5809.35,5809.35,1
HCPCS,61540,Removal of brain tissue,,,2698.82,3124.95,8
HCPCS,61541,CRANIOTOMY TRANSECTION CORPUS CALLOSUM,13614.0,8849.1,1.1,13614.0,144
HCPCS,61541,INCISION OF BRAIN TISSUE,,,5738.46,5738.46,1
HCPCS,61541,Incision of brain tissue,,,2698.82,3124.95,8
HCPCS,61543,CRANIOTOMY PARTIAL/SUBTOTAL HEMISPHERECTOMY,13776.0,8954.4,1.1,13776.0,144
HCPCS,61543,REMOVAL OF BRAIN TISSUE,,,5801.21,5801.21,1
HCPCS,61543,Removal of brain tissue,,,2698.82,3124.95,8
HCPCS,61544,CRANIOTOMY EXCISION/COAGULATION CHOROID PLEXUS,10944.0,7113.6,1.1,10944.0,144
HCPCS,61544,REMOVE & TREAT BRAIN LESION,,,5070.04,5070.04,1
HCPCS,61544,Remove & treat brain lesion,,,2698.82,3124.95,8
HCPCS,61545,CRANIOTOMY EXCISION CRANIOPHARYNGIOMA,18572.0,12071.8,1.1,18572.0,144
HCPCS,61545,EXCISION OF BRAIN TUMOR,,,8495.12,8495.12,1
HCPCS,61545,Excision of brain tumor,,,2698.82,3124.95,8
HCPCS,61546,CRANIOT HYPOPHYSEC/EXC PITUITARY TUMOR ICRL APPR,13376.0,8694.4,1.1,13376.0,144
HCPCS,61546,REMOVAL OF PITUITARY GLAND,,,6158.97,6158.97,1
HCPCS,61546,Removal of pituitary gland,,,2698.82,3124.95,8
HCPCS,61548,HYPOPHYSEC/EXC PITUITARY TUM TRANSNASAL/SEPTAL,9348.0,6076.2,1.1,9348.0,144
HCPCS,61548,REMOVAL OF PITUITARY GLAND,,,4169.57,4169.57,1
HCPCS,61548,Removal of pituitary gland,,,4527.92,5242.85,8
HCPCS,61550,CRANIECTOMY CRANIOSYNOSTOSIS 1 CRANIAL SUTURE,6236.0,4053.4,1.1,6236.0,144
HCPCS,61550,RELEASE OF SKULL SEAMS,,,3196.81,7778.0,2
HCPCS,61550,Release of skull seams,,,2698.82,3124.95,8
HCPCS,61552,CRANIECT CRANIOSYNOSTOSIS MULT CRANIAL SUTURES,8160.0,5304.0,1.1,8160.0,144
HCPCS,61552,RELEASE OF SKULL SEAMS,,,3970.53,3970.53,1
HCPCS,61552,Release of skull seams,,,2698.82,3124.95,8
HCPCS,61556,CRANIEC CRANIOSYNOSTOSIS FRONT/PARIET BONE FLAP,9636.0,6263.4,1.1,9636.0,144
HCPCS,61556,INCISE SKULL/SUTURES,,,4563.06,4563.06,1
HCPCS,61556,Incise skull/sutures,,,2698.82,3124.95,8
HCPCS,61557,CRANIECTOMY CRANIOSYNOSTOSIS BIFRONTAL BONE FLAP,9324.0,6060.6,1.1,9324.0,144
HCPCS,61557,INCISE SKULL/SUTURES,,,4505.0,4505.0,1
HCPCS,61557,Incise skull/sutures,,,2698.82,3124.95,8
HCPCS,61558,EXCISION OF SKULL/SUTURES,,,5027.46,5027.46,1
HCPCS,61558,Excision of skull/sutures,,,2698.82,3124.95,8
HCPCS,61558,XTN CRANIECT MULTIPLE SUTURE CRANIOSYNOSTOSIS,10600.0,6890.0,1.1,10600.0,144
HCPCS,61559,EXCISION OF SKULL/SUTURES,,,6399.76,6399.76,1
HCPCS,61559,Excision of skull/sutures,,,2698.82,3124.95,8
HCPCS,61559,XTN CRNEC MLT SUTR CRANIOSYNOSTOSIS W/BONE GRAFT,13608.0,8845.2,1.1,13608.0,144
HCPCS,61563,EXC BENIGN TUM CRANIAL BONE W/O OPTIC NRV DCMPRN,11376.0,7394.4,1.1,11376.0,144
HCPCS,61563,EXCISION OF SKULL TUMOR,,,5292.72,5292.72,1
HCPCS,61563,Excision of skull tumor,,,2698.82,3124.95,8
HCPCS,61564,EXCISION OF SKULL TUMOR,,,6420.37,6420.37,1
HCPCS,61564,Excision of skull tumor,,,2698.82,3124.95,8
HCPCS,61566,CRANIOTOMY SELECTIVE AMYGDALOHIPPOCAMPECTOMY,14278.0,9280.7,1.1,14278.0,144
HCPCS,61566,REMOVAL OF BRAIN TISSUE,,,5978.93,5978.93,1
HCPCS,61566,Removal of brain tissue,,,2698.82,3124.95,8
HCPCS,61567,INCISION OF BRAIN TISSUE,,,6809.94,6809.94,1
HCPCS,61567,Incision of brain tissue,,,2698.82,3124.95,8
HCPCS,61570,CRANIECTOMY/CRANIOTOMY EXC FOREIGN BODY BRAIN,10604.0,6892.6,1.1,10604.0,144
HCPCS,61570,REMOVE FOREIGN BODY BRAIN,,,4998.12,4998.12,1
HCPCS,61570,Remove foreign body brain,,,2698.82,3124.95,8
HCPCS,61571,CRANIECTOMY/CRANIOTOMY TX PENETRATNG WOUND BRAIN,11368.0,7389.2,1.1,11368.0,144
HCPCS,61571,INCISE SKULL FOR BRAIN WOUND,,,5316.97,5316.97,1
HCPCS,61571,Incise skull for brain wound,,,2698.82,3124.95,8
HCPCS,61575,SKULL BASE/BRAINSTEM SURGERY,,,6680.23,6680.23,1
HCPCS,61575,Skull base/brainstem surgery,,,4527.92,5242.85,8
HCPCS,61575,TRNSRAL SKULL BSE/BR STEM/CORD BX/DCOMPR/EXC LES,14624.0,9505.6,1.1,14624.0,144
HCPCS,61576,SKULL BASE/BRAINSTEM SURGERY,,,11034.61,11034.61,1
HCPCS,61576,Skull base/brainstem surgery,,,4527.92,5242.85,8
HCPCS,61580,CRANIOFACIAL ANT CRANIAL FOSSA W/O ORBITAL EXNTJ,13804.0,8972.6,1.1,13804.0,144
HCPCS,61580,CRANIOFACIAL APPROACH SKULL,,,6472.4,6472.4,1
HCPCS,61580,Craniofacial approach skull,,,4527.92,5242.85,8
HCPCS,61581,CRANIOFACIAL ANT CRANIAL FOSSA W/ORBITAL EXNTJ,15652.0,10173.8,1.1,15652.0,144
HCPCS,61581,CRANIOFACIAL APPROACH SKULL,,,7033.83,7033.83,1
HCPCS,61581,Craniofacial approach skull,,,4527.92,5242.85,8
HCPCS,61582,CRANFCL ANT CRANIAL FOSSA UNI/BI CRANIOT/OSTEOT,14056.0,9136.4,1.1,14056.0,144
HCPCS,61582,CRANIOFACIAL APPROACH SKULL,,,7854.76,7854.76,1
HCPCS,61582,Craniofacial approach skull,,,4527.92,5242.85,8
HCPCS,61583,CRANFCL ANT CRANIAL FOSSA UNI/BIFRNTL ELEV LOBE,15400.0,10010.0,1.1,15400.0,144
HCPCS,61583,CRANIOFACIAL APPROACH SKULL,,,7702.09,7702.09,1
HCPCS,61583,Craniofacial approach skull,,,4527.92,5242.85,8
HCPCS,61584,ORBITOCRANIAL ANT CRANIAL FOSSA W/O ORBIT EXNTJ,16588.0,10782.2,1.1,16588.0,144
HCPCS,61584,ORBITOCRANIAL APPROACH/SKULL,,,7590.84,7590.84,1
HCPCS,61584,Orbitocranial approach/skull,,,4527.92,5242.85,8
HCPCS,61585,ORBITOCRANIAL ANT CRANIAL FOSSA W/ORBITAL EXNTJ,17028.0,11068.2,1.1,17028.0,144
HCPCS,61585,ORBITOCRANIAL APPROACH/SKULL,,,8659.28,8659.28,1
HCPCS,61585,Orbitocranial approach/skull,,,4527.92,5242.85,8
HCPCS,61586,BICORONAL TRANSZYGMTC&/LEFORT I W/O BONE GRFT,10992.0,7144.8,1.1,10992.0,144
HCPCS,61586,RESECT NASOPHARYNX SKULL,,,6621.24,6621.24,1
HCPCS,61586,Resect nasopharynx skull,,,4527.92,5242.85,8
HCPCS,61590,INFRATEMPORAL APPROACH/SKULL,,,7891.28,7891.28,1
HCPCS,61590,INFRATEMPORAL MID CRANIAL FOSSA W/WO DISARTICLTN,20698.0,13453.7,1.1,20698.0,144
HCPCS,61590,Infratemporal approach/skull,,,4527.92,5242.85,8
HCPCS,61591,INFRATEMPO MID CRANIAL FOSSA W/WO DCOMPR&/MOBI,20689.0,13447.85,1.1,20689.0,144
HCPCS,61591,INFRATEMPORAL APPROACH/SKULL,,,8039.85,8039.85,1
HCPCS,61591,Infratemporal approach/skull,,,4527.92,5242.85,8
HCPCS,61592,ORBITOCRANIAL APPROACH/SKULL,,,8379.19,8379.19,1
HCPCS,61592,ORBITOCRNL APPR MID CRANIAL FOSSA TEMPORAL LOBE,17232.0,11200.8,1.1,17232.0,144
HCPCS,61592,Orbitocranial approach/skull,,,4527.92,5242.85,8
HCPCS,61595,TRANSTEMP APPR POST CRAN FOSSA DCOMPR SINUS/NRV,13496.0,8772.4,1.1,13496.0,144
HCPCS,61595,TRANSTEMPORAL APPROACH/SKULL,,,6261.91,6261.91,1
HCPCS,61595,Transtemporal approach/skull,,,4527.92,5242.85,8
HCPCS,61596,TRANSCOCHLEAR APPROACH/SKULL,,,6352.55,6352.55,1
HCPCS,61596,TRANSCOCHLR POST CRNL FOSSA W/WO MOBIL NRV/ART,15772.0,10251.8,1.1,15772.0,144
HCPCS,61596,Transcochlear approach/skull,,,4527.92,5242.85,8
HCPCS,61597,TRANSCONDYLAR APPROACH/SKULL,,,7850.51,7850.51,1
HCPCS,61597,TRNSCONDLR POST CRNL FOSSA DCOMPR ART W/WO MOBIL,16328.0,10613.2,1.1,16328.0,144
HCPCS,61597,Transcondylar approach/skull,,,4527.92,5242.85,8
HCPCS,61598,TRANSPETROSAL APPROACH/SKULL,,,7534.01,7534.01,1
HCPCS,61598,TRANSPTRSAL POST CRNL FOSSA CLIVUS/FORAMN MAGNUM,14612.0,9497.8,1.1,14612.0,144
HCPCS,61598,Transpetrosal approach/skull,,,4527.92,5242.85,8
HCPCS,61600,RESCJ/EXC LES BASE ANT CRANIAL FOSSA EXTRADURAL,12004.0,7802.6,1.1,12004.0,144
HCPCS,61600,RESECT/EXCISE CRANIAL LESION,,,5534.64,5534.64,1
HCPCS,61600,Resect/excise cranial lesion,,,2698.82,3124.95,8
HCPCS,61601,RESCJ/EXC LES BASE ANT CRNL FOSSA INDRL W/WO GRF,13702.0,8906.3,1.1,13702.0,144
HCPCS,61601,RESECT/EXCISE CRANIAL LESION,,,6412.59,6412.59,1
HCPCS,61601,Resect/excise cranial lesion,,,2698.82,3124.95,8
HCPCS,61605,RESCJ/EXC LES INFRATEMPOR FOSSA SPACE APEX XDRL,14331.0,9315.15,1.1,14331.0,144
HCPCS,61605,RESECT/EXCISE CRANIAL LESION,,,5635.28,5635.28,1
HCPCS,61605,Resect/excise cranial lesion,,,2698.82,3124.95,8
HCPCS,61606,RESCJ/EXC LES ITPRL FOSSA SPACE APEX IDRL W/RPR,18502.0,12026.3,1.1,18502.0,144
HCPCS,61606,RESECT/EXCISE CRANIAL LESION,,,7669.37,7669.37,1
HCPCS,61606,Resect/excise cranial lesion,,,2698.82,3124.95,8
HCPCS,61607,RESCJ/EXC LES PARASELLAR SINUS CLIVUS/MSB XDRL,16372.0,10641.8,1.1,16372.0,144
HCPCS,61607,RESECT/EXCISE CRANIAL LESION,,,8043.52,8043.52,1
HCPCS,61607,Resect/excise cranial lesion,,,2698.82,3124.95,8
HCPCS,61608,RESCJ/EXC LES PARASELLAR SINUS CLIVUS/MSB IDRL,18216.0,11840.4,1.1,18216.0,144
HCPCS,61608,RESECT/EXCISE CRANIAL LESION,,,8690.68,8690.68,1
HCPCS,61608,Resect/excise cranial lesion,,,2698.82,3124.95,8
HCPCS,61611,TRANSECT ARTERY SINUS,,,1240.32,1240.32,1
HCPCS,61611,Transect artery sinus,,,1098.89,1272.4,8
HCPCS,61613,OBLTRJ CAROTID ARYSM ARTVEN CAROTID FISTULA DSJ,18012.0,11707.8,1.1,18012.0,144
HCPCS,61613,REMOVE ANEURYSM SINUS,,,8705.39,8705.39,1
HCPCS,61613,Remove aneurysm sinus,,,1098.89,1272.4,8
HCPCS,61615,RESCJ/EXC LES BASE POST CRNL FOSSA JUG FRMN XDRL,14308.0,9300.2,1.1,14308.0,144
HCPCS,61615,RESECT/EXCISE LESION SKULL,,,7429.4,7429.4,1
HCPCS,61615,Resect/excise lesion skull,,,2698.82,3124.95,8
HCPCS,61616,RESCJ/EXC LES BASE PCF FORAMEN VRT BODIES IDRL,20566.0,13367.9,1.1,20566.0,144
HCPCS,61616,RESECT/EXCISE LESION SKULL,,,8828.99,8828.99,1
HCPCS,61616,Resect/excise lesion skull,,,2698.82,3124.95,8
HCPCS,61618,REPAIR DURA,,,3410.34,3410.34,1
HCPCS,61618,Repair dura,,,2698.82,3124.95,8
HCPCS,61618,SECONDARY RPR DURA CSF LEAK FREE TISSUE GRAFT,7476.0,4859.4,1.1,7476.0,144
HCPCS,61619,REPAIR DURA,,,3786.57,3786.57,1
HCPCS,61619,Repair dura,,,2698.82,3124.95,8
HCPCS,61619,SEC RPR DURA CSF LEAK LOCAL/REGIONALIZED FLAP,8840.0,5746.0,1.1,8840.0,144
HCPCS,61623,EVASC TEMP BALLOON ARTL OCCLUSION HEAD/NECK,26498.0,17223.7,0.01,49016.0,317
HCPCS,61624,TCAT PERMANENT OCCLUSION/EMBOLIZATION PRQ CNS,11278.5,7331.025,1.1,19077.46,222
HCPCS,61626,TCAT PERMANT OCCLUSION/EMBOLIZATION PRQ NON-CNS,29440.0,19136.0,0.01,52240.0,317
HCPCS,61630,BALLON ANGIOPLASTY  INTRACRANIAL PERCUTANEOUS,8828.0,5738.2,1.1,8828.0,130
HCPCS,61630,BALLOON ANGIOPLASTY INTRACRANIAL PERCUTANEOUS,26324.0,17110.6,1615.46,26324.0,68
HCPCS,61635,TCAT PLMT IV STENT ICRA W/BALO ANGIOP IF PFRMD,23802.0,15471.3,1.1,37892.0,198
HCPCS,61640,BALLOON DILAT INTRACRANIAL VASOSPASM PRQ INITIAL,15626.0,10156.9,1.1,26324.0,164
HCPCS,61641,PERQ BALO DILA IC VSPSM EA VSL SM VASC TER,5042.0,3277.3,1.1,12615.0,164
HCPCS,61642,PERQ BALO DILA IC VSPSM EA VSL DIFF VASC TER,10269.5,6675.175,1.1,17075.0,164
HCPCS,61645,PERQ ART TRLUML M-THROMBEC &/NFS INTRACRANIAL,9297.0,6043.05,1.1,19185.0,212
HCPCS,61650,EVASC INTRACRANIAL PROLNG ADMN RX AGENT ART 1ST,5400.5,3510.325,1.1,12615.0,212
HCPCS,61651,EVASC INTRACRANIAL PROLNG ADMN RX AGENT ART ADDL,3970.5,2580.825,1.1,12615.0,212
HCPCS,61680,INTRACRANIAL ARVEN MALFRMJ SUPRATENTRL SMPL,13020.0,8463.0,1.1,13020.0,144
HCPCS,61680,INTRACRANIAL VESSEL SURGERY,,,6054.63,6054.63,1
HCPCS,61680,Intracranial vessel surgery,,,1098.89,1272.4,8
HCPCS,61682,INTRACRANIAL ARVEN MALFRMJ SUPRATENTRL CMPL,25364.0,16486.6,1.1,25364.0,144
HCPCS,61682,INTRACRANIAL VESSEL SURGERY,,,11109.44,11109.44,1
HCPCS,61682,Intracranial vessel surgery,,,1098.89,1272.4,8
HCPCS,61684,INTRACRANIAL ARVEN MALFRMJ INFRATENTRL SMPL,16656.0,10826.4,1.1,16656.0,144
HCPCS,61684,INTRACRANIAL VESSEL SURGERY,,,7576.76,7576.76,1
HCPCS,61684,Intracranial vessel surgery,,,1098.89,1272.4,8
HCPCS,61686,INTRACRANIAL ARVEN MALFRMJ INFRATENTRL CMPL,27000.0,17550.0,1.1,27000.0,144
HCPCS,61686,INTRACRANIAL VESSEL SURGERY,,,11952.81,11952.81,1
HCPCS,61686,Intracranial vessel surgery,,,1098.89,1272.4,8
HCPCS,61690,INTRACRANIAL ARVEN MALFRMJ DURAL SMPL,12536.0,8148.4,1.1,12536.0,144
HCPCS,61690,INTRACRANIAL VESSEL SURGERY,,,5822.91,5822.91,1
HCPCS,61690,Intracranial vessel surgery,,,1098.89,1272.4,8
HCPCS,61692,INTRACRANIAL ARVEN MALFRMJ DURAL CMPL,21836.0,14193.4,1.1,21836.0,144
HCPCS,61692,INTRACRANIAL VESSEL SURGERY,,,9716.31,9716.31,1
HCPCS,61692,Intracranial vessel surgery,,,1098.89,1272.4,8
HCPCS,61697,BRAIN ANEURYSM REPR COMPLX,,,11244.0,11244.0,1
HCPCS,61697,Brain aneurysm repr complx,,,1098.89,1272.4,8
HCPCS,61697,COMPLX INTRACRANIAL ARYSM CAROTID CIRCULATION,25360.0,16484.0,1.1,25360.0,144
HCPCS,61698,BRAIN ANEURYSM REPR COMPLX,,,12308.74,12308.74,1
HCPCS,61698,Brain aneurysm repr complx,,,1098.89,1272.4,8
HCPCS,61698,CPLX INTRACRANIAL ARYSM VERTEBROBASILAR CRCJ,27852.0,18103.8,1.1,27852.0,144
HCPCS,61700,BRAIN ANEURYSM REPR SIMPLE,,,9087.1,9087.1,1
HCPCS,61700,Brain aneurysm repr simple,,,1098.89,1272.4,8
HCPCS,61700,SIMPLE INTRACRANIAL ARYSM CAROTID CIRCULATION,20248.0,13161.2,1.1,20248.0,144
HCPCS,61702,INNER SKULL VESSEL SURGERY,,,10700.71,10700.71,1
HCPCS,61702,Inner skull vessel surgery,,,1098.89,1272.4,8
HCPCS,61702,SIMPLE INTRACRANIAL ARYSM VERTEBROBASILAR CRCJ,24016.0,15610.4,1.1,24016.0,144
HCPCS,61703,CLAMP NECK ARTERY,,,3633.4,3633.4,1
HCPCS,61703,Clamp neck artery,,,1098.89,1272.4,8
HCPCS,61703,ICRA CRV APPL OCCLUDING CLAMP CRV CRTD ART,7520.0,4888.0,1.1,7520.0,144
HCPCS,61705,ARYSM VASC MALFRMJ/CRTD-OCCLUSION CRTD ART,15240.0,9906.0,1.1,15240.0,144
HCPCS,61705,REVISE CIRCULATION TO HEAD,,,6938.2,6938.2,1
HCPCS,61705,Revise circulation to head,,,1098.89,1272.4,8
HCPCS,61708,REVISE CIRCULATION TO HEAD,,,6789.86,6789.86,1
HCPCS,61708,Revise circulation to head,,,1098.89,1272.4,8
HCPCS,61710,ARYSM VASC MALFRMJ IA EMBOLIZATION,12516.0,8135.4,1.1,12516.0,144
HCPCS,61710,REVISE CIRCULATION TO HEAD,,,5727.37,5727.37,1
HCPCS,61710,Revise circulation to head,,,1098.89,1272.4,8
HCPCS,61711,ANAST ARTL EXTRACRANIAL-INTRACRANIAL ARTERIES,15292.0,9939.8,1.1,15292.0,144
HCPCS,61711,FUSION OF SKULL ARTERIES,,,6952.2,6952.2,1
HCPCS,61711,Fusion of skull arteries,,,1098.89,1272.4,8
HCPCS,61715,MRGFUS STEREOTACTIC ABLATION TARGET INTRACRANIAL,47423.0,30824.95,1.1,86045.0,177
HCPCS,61720,INCISE SKULL/BRAIN SURGERY,,,5779.17,17390.7,21
HCPCS,61720,Incise skull/brain surgery,,,5036.43,5831.66,8
HCPCS,61735,CRTJ LES STRTCTC BURR SUBCORTICAL STRUX OTH/THN,9834.0,6392.1,1.1,9834.0,144
HCPCS,61735,INCISE SKULL/BRAIN SURGERY,,,4263.39,4263.39,1
HCPCS,61735,Incise skull/brain surgery,,,5036.43,5831.66,8
HCPCS,61736,LITT ICR 1 TRAJ 1 SMPL LES,,,3213.94,3213.94,1
HCPCS,61736,LITT LES ICR SINGLE TRAJECTORY 1 SIMPLE LESION,7624.0,4955.6,1.1,7624.0,142
HCPCS,61736,Litt icr 1 traj 1 smpl les,,,5036.43,5831.66,8
HCPCS,61737,LITT ICR MLT TRJ MLT/CPLX LS,,,3875.87,3875.87,1
HCPCS,61737,LITT LES ICR MLT TRAJECTORIES MLT/CPLX LESIONS,9068.0,5894.2,1.1,9068.0,142
HCPCS,61737,Litt icr mlt trj mlt/cplx ls,,,5036.43,5831.66,8
HCPCS,61750,INCISE SKULL/BRAIN BIOPSY,,,3759.28,3759.28,1
HCPCS,61750,Incise skull/brain biopsy,,,5036.43,5831.66,8
HCPCS,61750,STEREOTACTIC BX ASPIR/EXC BURR INTRACRANIAL LES,7932.0,5155.8,1.1,7932.0,144
HCPCS,61751,BRAIN BIOPSY W/CT/MR GUIDE,,,3704.1,3704.1,1
HCPCS,61751,Brain biopsy w/ct/mr guide,,,5036.43,5831.66,8
HCPCS,61751,STRTCTC BX ASPIR/EXC BURR ICRA LESION W/CT&I/MR,7516.0,4885.4,1.1,7516.0,144
HCPCS,61760,IMPLANT BRAIN ELECTRODES,,,4210.89,4210.89,1
HCPCS,61760,Implant brain electrodes,,,5036.43,5831.66,8
HCPCS,61760,STRTCTC IMPLTJ ELTRD CEREBRUM SEIZURE MONITORING,8956.0,5821.4,1.1,8956.0,144
HCPCS,61770,INCISE SKULL FOR TREATMENT,,,3231.94,17390.7,21
HCPCS,61770,Incise skull for treatment,,,5036.43,5831.66,8
HCPCS,61770,STRTCTC LOCLZJ INSJ CATH/PRB PLMT RADJ SRC,9276.0,6029.4,1.1,19428.17,144
HCPCS,61781,STRTCTC CPTR ASSTD PX CRANIAL INTRADURAL,1500.0,975.0,1.1,1500.0,144
HCPCS,61781,Scan proc cranial intra,,,1703.65,1972.65,8
HCPCS,61782,SCAN PROC CRANIAL EXTRA,,,4132.0,4392.0,2
HCPCS,61782,STRTCTC CPTR ASSTD PX EXTRADURAL CRANIAL,1399.0,909.35,1.1,1399.0,144
HCPCS,61782,Scan proc cranial extra,,,1703.65,1972.65,8
HCPCS,61783,STEREOTACTIC COMPUTER ASSISTED PX SPINAL,1500.0,975.0,1.1,1500.0,144
HCPCS,61783,Scan proc spinal,,,3812.17,4414.09,8
HCPCS,61790,CREATE LESION STRTCTC PRQ NEUROLYTIC GASSERIAN,4640.0,3016.0,1.1,5632.24,144
HCPCS,61790,TREAT TRIGEMINAL NERVE,,,1675.06,2032.17,20
HCPCS,61790,Treat trigeminal nerve,,,1703.65,1972.65,8
HCPCS,61791,TREAT TRIGEMINAL TRACT,,,1675.06,2032.17,20
HCPCS,61791,Treat trigeminal tract,,,1703.65,1972.65,8
HCPCS,61796,SRS CRANIAL LESION SIMPLE,,,2720.08,2720.08,1
HCPCS,61796,STEREOTACTIC RADIOSURGERY 1 SIMPLE CRANIAL LES,5572.0,3621.8,1.1,5572.0,144
HCPCS,61796,Srs cranial lesion simple,,,4012.14,4645.63,8
HCPCS,61797,SRS CRAN LES SIMPLE ADDL,,,583.1,583.1,1
HCPCS,61797,STRTCTC RADIOSURGERY EA ADDL CRANIAL LES SIMPLE,1392.0,904.8,1.1,1392.0,144
HCPCS,61797,Srs cran les simple addl,,,4012.14,4645.63,8
HCPCS,61798,SRS CRANIAL LESION COMPLEX,,,3687.74,3687.74,1
HCPCS,61798,STEREOTACTIC RADIOSURGERY 1 COMPLEX CRANIAL LES,7940.0,5161.0,1.1,7940.0,144
HCPCS,61798,Srs cranial lesion complex,,,4012.14,4645.63,8
HCPCS,61799,SRS CRAN LES COMPLEX ADDL,,,805.72,805.72,1
HCPCS,61799,STRTCTC RADIOSURGERY EA ADDL CRANIAL LES COMPLEX,1924.0,1250.6,1.1,1924.0,144
HCPCS,61799,Srs cran les complex addl,,,4012.14,4645.63,8
HCPCS,61800,APPL STRTCTC HEADFRAME STEREOTACTIC RADIOSURGERY,900.0,585.0,1.1,900.0,144
HCPCS,61800,APPLY SRS HEADFRAME ADD-ON,,,399.22,399.22,1
HCPCS,61800,Apply srs headframe add-on,,,4012.14,4645.63,8
HCPCS,61850,IMPLANT NEUROELECTRODES,,,2636.46,2636.46,1
HCPCS,61850,Implant neuroelectrodes,,,19174.95,22202.58,8
HCPCS,61860,CRNEC/CRX IMPLTJ NSTIM ELTRD CERE CORTICAL,8904.0,5787.6,1.1,8904.0,144
HCPCS,61860,IMPLANT NEUROELECTRODES,,,4176.2,4176.2,1
HCPCS,61860,Implant neuroelectrodes,,,19174.95,22202.58,8
HCPCS,61863,IMPLANT NEUROELECTRODE,,,4020.32,4020.32,1
HCPCS,61863,Implant neuroelectrode,,,19174.95,22202.58,8
HCPCS,61863,STRTCTC IMPLTJ NSTIM ELTRD W/O RECORD 1ST ARRAY,8284.0,5384.6,1.1,8284.0,144
HCPCS,61864,IMPLANT NEUROELECTRDE ADDL,,,750.02,750.02,1
HCPCS,61864,Implant neuroelectrde addl,,,19174.95,22202.58,8
HCPCS,61864,STRTCTC IMPLTJ NSTIM ELTRD W/O RECORD EA ARRAY,1796.0,1167.4,1.1,1796.0,144
HCPCS,61867,IMPLANT NEUROELECTRODE,,,6085.9,6085.9,1
HCPCS,61867,Implant neuroelectrode,,,19174.95,22202.58,8
HCPCS,61867,STRTCTC IMPLTJ NSTIM ELTRD W/RECORD 1ST ARRAY,14533.0,9446.45,1.1,14533.0,144
HCPCS,61868,IMPLANT NEUROELECTRDE ADDL,,,1325.17,1325.17,1
HCPCS,61868,Implant neuroelectrde addl,,,19174.95,22202.58,8
HCPCS,61868,STRTCTC IMPLTJ NSTIM ELTRD W/RECORD EA ARRAY,3480.0,2262.0,1.1,3480.0,144
HCPCS,61870,Implant neuroelectrodes,,,19174.95,22202.58,8
HCPCS,61880,REVISE/REMOVE NEUROELECTRODE,,,2951.88,8882.81,21
HCPCS,61880,REVJ/RMVL INTRACRANIAL NEUROSTIMULATOR ELTRDS,2780.0,1807.0,1.1,9923.76,144
HCPCS,61880,Revise/remove neuroelectrode,,,2167.75,2510.02,8
HCPCS,61885,INSJ/RPLCMT CRANIAL NEUROSTIM PULSE GENERATOR,2662.0,1730.3,1.1,63800.42,144
HCPCS,61885,INSRT/REDO NEUROSTIM 1 ARRAY,,,9016.0,32113.14,21
HCPCS,61885,Insrt/redo neurostim 1 array,,,19174.95,22202.58,8
HCPCS,61886,IMPLANT NEUROSTIM ARRAYS,,,7813.0,32113.14,22
HCPCS,61886,INSJ/RPLCMT CRANIAL NEUROSTIM GENER 2/> ELTRDS,4369.0,2839.85,1.1,90562.75,144
HCPCS,61886,Implant neurostim arrays,,,19174.95,22202.58,8
HCPCS,61888,REVISE/REMOVE NEURORECEIVER,,,4616.0,12485.31,21
HCPCS,61888,REVJ/RMVL NEUROSTIMULATOR PULSE GENERATOR,2092.0,1359.8,1.1,39728.72,144
HCPCS,61888,Revise/remove neuroreceiver,,,2167.75,2510.02,8
HCPCS,61889,INS SK-MNT CRNL NSTM PG/RCVR,,,3337.48,3337.48,1
HCPCS,61889,INSERTION SKULL-MNTD CRANIAL NSTIM PG/RECEIVER,11330.0,7364.5,1.1,11330.0,142
HCPCS,61889,Ins sk-mnt crnl nstm pg/rcvr,,,19174.95,22202.58,8
HCPCS,61891,REV/RPLCMT SK-MNT CRNL NSTM,,,18978.24,57109.38,21
HCPCS,61891,REVJ/RPLCMT SKULL-MNTD CRANIAL NSTIM PG/RECEIVER,4950.0,3217.5,1.1,63800.42,142
HCPCS,61892,REMOVAL SKULL-MNTD CRANIAL NSTIM PG/RCVR W/CRNOP,6600.0,4290.0,1.1,9440.12,142
HCPCS,61892,RMV SK-MNT CRNL NSTM PG/RCVR,,,2808.13,8450.24,21
HCPCS,61892,Rmv sk-mnt crnl nstm pg/rcvr,,,2167.75,2510.02,8
HCPCS,62000,ELEVATION DEPRESSED SKULL FX SIMPLE EXTRADURAL,5572.0,3621.8,1.1,9391.15,144
HCPCS,62000,TREAT SKULL FRACTURE,,,2793.19,8405.28,21
HCPCS,62000,Treat skull fracture,,,5036.43,5831.66,8
HCPCS,62005,ELVTN DEPRS SKL FX COMPOUND/COMMIND XDRL,7052.0,4583.8,1.1,7052.0,144
HCPCS,62005,TREAT SKULL FRACTURE,,,3402.31,3402.31,1
HCPCS,62005,Treat skull fracture,,,2698.82,3124.95,8
HCPCS,62010,ELVTN DEPRS SKL FX W/RPR DURA&/DBRDMT BRN,8572.0,5571.8,1.1,8572.0,144
HCPCS,62010,TREATMENT OF HEAD INJURY,,,4107.81,4107.81,1
HCPCS,62010,Treatment of head injury,,,2698.82,3124.95,8
HCPCS,62100,CRX RPR DURAL/CSF LEAK RHINORRHEA/OTORRHEA,10353.0,6729.45,1.1,10353.0,144
HCPCS,62100,REPAIR BRAIN FLUID LEAKAGE,,,4182.5,4182.5,1
HCPCS,62100,Repair brain fluid leakage,,,2698.82,3124.95,8
HCPCS,62115,REDUCTION OF SKULL DEFECT,,,4502.51,4502.51,1
HCPCS,62115,Reduction of skull defect,,,5036.43,5831.66,8
HCPCS,62117,REDUCTION OF SKULL DEFECT,,,5244.99,5244.99,1
HCPCS,62117,Reduction of skull defect,,,5036.43,5831.66,8
HCPCS,62120,REPAIR SKULL CAVITY LESION,,,5474.96,5474.96,1
HCPCS,62120,RPR ENCEPHALOCELE SKULL VAULT W/CRANIOPLASTY,9836.0,6393.4,1.1,9836.0,144
HCPCS,62120,Repair skull cavity lesion,,,5036.43,5831.66,8
HCPCS,62121,CRANIOTOMY FOR ENCEPHALOCELE REPAIR SKULL BASE,10133.0,6586.45,1.1,10133.0,144
HCPCS,62121,INCISE SKULL REPAIR,,,4097.72,4097.72,1
HCPCS,62121,Incise skull repair,,,5036.43,5831.66,8
HCPCS,62140,CRANIOPLASTY SKULL DEFECT </5 CM DIAMETER,5820.0,3783.0,1.1,5820.0,144
HCPCS,62140,CRNOP SKULL DEFECT<5 CM DIAM,,,2717.59,2717.59,1
HCPCS,62140,Crnop skull defect<5 cm diam,,,5036.43,5831.66,8
HCPCS,62141,CRANIOPLASTY SKULL DEFECT >5 CM DIAMETER,6428.0,4178.2,1.1,6428.0,144
HCPCS,62141,CRNOP SKULL DEFECT>5 CM DIAM,,,3045.54,3045.54,1
HCPCS,62141,Crnop skull defect>5 cm diam,,,5036.43,5831.66,8
HCPCS,62142,RMVL B1 FLP/PROSTC PLATE SKL,,,2378.13,2378.13,1
HCPCS,62142,RMVL BONE FLAP/PROSTHETIC PLATE SKULL,4732.0,3075.8,1.1,4732.0,144
HCPCS,62142,Rmvl b1 flp/prostc plate skl,,,5036.43,5831.66,8
HCPCS,62143,RPL B1 FLP/PROSTC PLATE SKL,,,2784.11,2784.11,1
HCPCS,62143,RPLCMT BONE FLAP/PROSTHETIC PLATE SKULL,5660.0,3679.0,1.1,5660.0,144
HCPCS,62143,Rpl b1 flp/prostc plate skl,,,5036.43,5831.66,8
HCPCS,62145,CRANIOPLASTY SKULL DEFECT REPARATIVE BRAIN SURG,8036.0,5223.4,1.1,8036.0,144
HCPCS,62145,REPAIR OF SKULL & BRAIN,,,3794.93,3794.93,1
HCPCS,62145,Repair of skull & brain,,,5036.43,5831.66,8
HCPCS,62146,CRANIOPLASTY W/AUTOGRAFT </ 5 CM DIAMETER,6912.0,4492.8,1.1,6912.0,144
HCPCS,62146,CRNOP W/AUTOGRAFT<5 CM DIAM,,,3342.2,3342.2,1
HCPCS,62146,Crnop w/autograft<5 cm diam,,,5036.43,5831.66,8
HCPCS,62147,CRANIOPLASTY W/AUTOGRAFT > 5 CM DIAMETER,8268.0,5374.2,1.1,8268.0,144
HCPCS,62147,CRNOP W/AUTOGRAFT>5 CM DIAM,,,3775.12,3775.12,1
HCPCS,62147,Crnop w/autograft>5 cm diam,,,5036.43,5831.66,8
HCPCS,62148,INCISE&RETRIEVAL SUBQ CRANIOPLASTY BONE GRAFT,800.0,520.0,1.1,800.0,144
HCPCS,62148,RETR BONE FLAP TO FIX SKULL,,,333.9,333.9,1
HCPCS,62148,Retr bone flap to fix skull,,,5036.43,5831.66,8
HCPCS,62160,NUNDSC ICRA PLMT/RPLCMT VENTR CATH SHUNT SYS,1200.0,780.0,1.1,1200.0,144
HCPCS,62160,Neuroendoscopy add-on,,,5036.43,5831.66,8
HCPCS,62161,DISSECT BRAIN W/SCOPE,,,4074.27,4074.27,1
HCPCS,62161,Dissect brain w/scope,,,5036.43,5831.66,8
HCPCS,62161,NUNDSC ICRA DSJ ADS FENESTRATION SEPTUM CSTS,8492.0,5519.8,1.1,8492.0,144
HCPCS,62162,NUNDSC ICRA FENESTEXC CYST W/VENTRIC CATH DRG,10720.0,6968.0,1.1,10720.0,144
HCPCS,62162,REMOVE COLLOID CYST W/SCOPE,,,5045.9,5045.9,1
HCPCS,62162,Remove colloid cyst w/scope,,,5036.43,5831.66,8
HCPCS,62163,Zneuroendoscopy w/fb removal,,,5036.43,5831.66,8
HCPCS,62164,NEUROENDOSCOPY ICRA W/RETRIEVAL FOREIGN BODY,11772.0,7651.8,1.1,11772.0,144
HCPCS,62164,REMOVE BRAIN TUMOR W/SCOPE,,,5590.37,5590.37,1
HCPCS,62164,Remove brain tumor w/scope,,,5036.43,5831.66,8
HCPCS,62165,NUNDSC ICRA EXC PITUITRY TUM TRNSNSL/SPHENOID,9292.0,6039.8,1.1,9292.0,144
HCPCS,62165,REMOVE PITUIT TUMOR W/SCOPE,,,4015.28,4015.28,1
HCPCS,62165,Remove pituit tumor w/scope,,,5036.43,5831.66,8
HCPCS,62180,ESTABLISH BRAIN CAVITY SHUNT,,,4274.37,4274.37,1
HCPCS,62180,Establish brain cavity shunt,,,5357.22,6203.1,8
HCPCS,62180,VENTRICULO-CISTERNOSTOMY,9032.0,5870.8,1.1,9032.0,144
HCPCS,62190,CRTJ SHUNT SARACH/SDRL-ATR-JUG-AUR,4868.0,3164.2,1.1,4868.0,144
HCPCS,62190,ESTABLISH BRAIN CAVITY SHUNT,,,2485.26,2485.26,1
HCPCS,62190,Establish brain cavity shunt,,,5357.22,6203.1,8
HCPCS,62192,CRTJ SHUNT SARACH/SDRL-PRTL-PLEURAL OTH,5340.0,3471.0,1.1,5340.0,144
HCPCS,62192,ESTABLISH BRAIN CAVITY SHUNT,,,2654.84,2654.84,1
HCPCS,62192,Establish brain cavity shunt,,,5357.22,6203.1,8
HCPCS,62194,REPLACE/IRRIGATE CATHETER,,,1675.06,2032.17,20
HCPCS,62194,RPLCMT/IRRG SUBARACHNOID/SUBDURAL CATHETER,2312.0,1502.8,1.1,5632.24,144
HCPCS,62194,Replace/irrigate catheter,,,565.54,654.83,8
HCPCS,62200,ESTABLISH BRAIN CAVITY SHUNT,,,3678.72,3678.72,1
HCPCS,62200,Establish brain cavity shunt,,,5357.22,6203.1,8
HCPCS,62200,"VENTRICULO-CISTERNOSTOMY,3RD VENT",7716.0,5015.4,1.1,7716.0,144
HCPCS,62201,BRAIN CAVITY SHUNT W/SCOPE,,,3241.15,3241.15,1
HCPCS,62201,Brain cavity shunt w/scope,,,5357.22,6203.1,8
HCPCS,62201,VENTRICULOCISTERNOSTOMY 3RD VNTRC NEURONDSC,6416.0,4170.4,1.1,6416.0,144
HCPCS,62220,CREATE SHUNT; VENTRIC-ATR JUGUL AURICL,5640.0,3666.0,1.1,5640.0,144
HCPCS,62220,ESTABLISH BRAIN CAVITY SHUNT,,,2601.27,2601.27,1
HCPCS,62220,Establish brain cavity shunt,,,5357.22,6203.1,8
HCPCS,62223,CRTJ SHUNT VENTRICULO-PERITNEAL-PLEURAL TERMINUS,6182.0,4018.3,1.1,6182.0,144
HCPCS,62223,ESTABLISH BRAIN CAVITY SHUNT,,,2748.85,7624.0,2
HCPCS,62223,Establish brain cavity shunt,,,5357.22,6203.1,8
HCPCS,62225,RPLCMT/IRRIGATION VENTRICULAR CATHETER,23456.0,15246.4,0.01,44188.0,231
HCPCS,62230,RPLCMT/REVJ CSF SHUNT VALVE/CATH SHUNT SYS,24380.0,15847.0,1.1,44188.0,231
HCPCS,62252,REPRGRMG PROGRAMMABLE CEREBROSPINAL SHUNT,2069.0,1344.85,0.01,5265.0,444
HCPCS,62256,REMOVE BRAIN CAVITY SHUNT,,,1630.33,1630.33,1
HCPCS,62256,RMVL COMPL CSF SHUNT SYSTEM W/O RPLCMT SHUNT,2952.0,1918.8,1.1,2952.0,144
HCPCS,62256,Remove brain cavity shunt,,,5357.22,6203.1,8
HCPCS,62258,REPLACE BRAIN CAVITY SHUNT,,,2973.17,2973.17,1
HCPCS,62258,RMVL COMPLETE CSF SHUNT SYSTEM W/RPLCMT SHUNT,6256.0,4066.4,1.1,6256.0,144
HCPCS,62258,Replace brain cavity shunt,,,5357.22,6203.1,8
HCPCS,62263,EPIDURAL LYSIS MULT SESSIONS,,,790.76,920.46,20
HCPCS,62263,Epidural lysis mult sessions,,,565.54,654.83,8
HCPCS,62263,PRQ LYSIS EPIDURAL ADHESIONS MULT SESS 2/> DAYS,2000.0,1300.0,1.1,2656.95,148
HCPCS,62264,EPIDURAL LYSIS ON SINGLE DAY,,,790.76,920.46,20
HCPCS,62264,Epidural lysis on single day,,,565.54,654.83,8
HCPCS,62264,PRQ LYSIS EPIDURAL ADHESIONS MULT SESSIONS 1 DAY,1768.0,1149.2,1.1,2656.95,148
HCPCS,62267,PRQ ASPIR PULPOSUS/INTERVERTEBRAL DISC/PVRT TISS,3027.5,1967.875,0.01,33436.0,322
HCPCS,62268,DRAIN SPINAL CORD CYST,,,790.76,920.46,20
HCPCS,62268,Drain spinal cord cyst,,,565.54,654.83,8
HCPCS,62268,PERCUTANEOUS ASPIRATION SPINAL CORD CYST/SYRINX,1892.0,1229.8,1.1,2656.95,144
HCPCS,62269,NEEDLE BIOPSY SPINAL CORD,,,1406.56,1718.79,20
HCPCS,62269,Needle biopsy spinal cord,,,565.54,654.83,8
HCPCS,62270,DIAGNOSTIC LUMBAR SPINAL PUNCTURE,2657.5,1727.375,0.01,4778.0,583
HCPCS,62272,THERAPEUTIC SPINAL PUNCTURE DRAINAGE CSF,2705.0,1758.25,0.01,4778.0,409
HCPCS,62273,INJECTION EPIDURAL BLOOD/CLOT PATCH,2862.0,1860.3,0.01,4778.0,583
HCPCS,62280,INJX/INFUSION NEUROLYTIC SUBSTANCE SUBARACHNOID,1052.0,683.8,1.1,2656.95,148
HCPCS,62280,TREAT SPINAL CORD LESION,,,790.76,920.46,20
HCPCS,62280,Treat spinal cord lesion,,,565.54,654.83,8
HCPCS,62281,INJX/INFUS NEUROLYT SUBST EPIDURAL CERV/THORACIC,3603.5,2342.275,0.01,6143.0,235
HCPCS,62282,INJX/INFUS NEUROLYT SBST EPIDURAL LUMBAR/SACRAL,3584.0,2329.6,1.1,6143.0,235
HCPCS,62284,INJECTION PROCEDURE MYELOGRAPHY/CT LUMBAR,1097.5,713.375,0.01,4628.0,284
HCPCS,62287,DCMPRN PQ NUC PUL 1/MLT LMBR,,,1675.06,2032.17,20
HCPCS,62287,DCMPRN PX PERQ NUCLEUS PULPOSUS 1/MLT LVL LUMBAR,3612.0,2347.8,1.1,5632.24,144
HCPCS,62287,Dcmprn pq nuc pul 1/mlt lmbr,,,3812.17,4414.09,8
HCPCS,62290,INJECTION PX DISCOGRAPHY EACH LEVEL LUMBAR,1651.5,1073.475,0.01,4628.0,284
HCPCS,62291,INJECTION PX DISCOGRPHY EA LVL CERVICAL/THORACIC,1346.0,874.9000000000001,1.1,4628.0,216
HCPCS,62292,INJECTION PX CHEMONUCLEOLYSIS 1/MLT LUMBAR,3696.0,2402.4,1.1,5632.24,144
HCPCS,62292,NJX CHEMONUCLEOLYSIS LMBR,,,1675.06,5040.59,21
HCPCS,62292,Njx chemonucleolysis lmbr,,,565.54,654.83,8
HCPCS,62294,INJECTION INTO SPINAL ARTERY,,,790.76,920.46,20
HCPCS,62294,Injection into spinal artery,,,565.54,654.83,8
HCPCS,62302,MYELOGRAPHY VIA LUMBAR INJECTION RS&I CERVICAL,3183.5,2069.275,0.01,7948.0,321
HCPCS,62303,MYELOGRAPHY VIA LUMBAR INJECTION RS&I THORACIC,3183.5,2069.275,0.01,7948.0,321
HCPCS,62304,MYELOGRAPHY VIA LUMBAR INJECT RS&I LUMBOSACRAL,3175.5,2064.075,0.01,7948.0,321
HCPCS,62305,MYELOGRAPHY VIA LUMBAR INJECTION RS&I 2+ REGIONS,3195.5,2077.075,0.01,7948.0,321
HCPCS,62320,NJX DX/THER SBST INTRLMNR CRV/THRC W/O IMG GDN,2785.0,1810.25,0.01,4778.0,322
HCPCS,62321,NJX DX/THER SBST INTRLMNR CRV/THRC W/IMG GDN,2818.0,1831.6999999999998,0.01,4778.0,322
HCPCS,62322,NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN,3412.5,2218.125,0.01,6143.0,322
HCPCS,62323,NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN,2785.0,1810.25,0.01,4778.0,409
HCPCS,62324,NJX DX/THER SBST INTRLMNR CRV/THRC W/O IMG GDN,3487.5,2266.875,0.01,6143.0,235
HCPCS,62325,NJX DX/THER SBST INTRLMNR CRV/THRC W/IMG GDN,3555.5,2311.075,0.01,6143.0,235
HCPCS,62326,NJX DX/THER SBST INTRLMNR LMBR/SAC W/O IMG GDN,3463.0,2250.95,0.01,6143.0,322
HCPCS,62327,NJX DX/THER SBST INTRLMNR LMBR/SAC W/IMG GDN,3489.5,2268.1749999999997,0.01,6143.0,235
HCPCS,62328,DIAGNOSTIC LUMBAR SPINAL PUNCTURE W/FLUOR OR CT,2735.0,1777.75,0.01,4778.0,566
HCPCS,62329,THERAPEUTIC SPINAL PNXR DRAINAGE CSF W/FLUOR/CT,2795.0,1816.75,0.01,4778.0,496
HCPCS,62330,DCMPRN PERQ PRTL RMVL LIGA FLAVM BI 1NTRSPC LMBR,3520.0,2288.0,1.1,3520.0,106
HCPCS,62330,DCMPRN PRQ RMV LIG FLV 1LMBR,,,6864.94,7551.43,12
HCPCS,62330,Dcmprn prq rmv lig flv 1lmbr,,,3812.17,4414.09,8
HCPCS,62331,DCMPRN PRQ PRT RMV LIGA FLAVM BI ADD NTRSPC LMBR,1870.0,1215.5,1.1,1870.0,106
HCPCS,62331,Dcmprn prq rmv lig flv addl,,,3812.17,4414.09,8
HCPCS,62350,IMPLTJ REVJ/RPSG ITHCL/EDRL CATH PMP W/O LAM,14406.5,9364.225,1.1,26151.0,231
HCPCS,62351,IMPLANT SPINAL CANAL CATH,,,6206.54,18676.74,21
HCPCS,62351,IMPLTJ REVJ/RPSG ITHCL/EDRL CATH W/LAM,4664.0,3031.6,1.1,20863.78,144
HCPCS,62351,Implant spinal canal cath,,,9326.79,10799.44,8
HCPCS,62355,RMVL PREVIOUSLY IMPLTED ITHCL/EDRL CATH,7447.0,4840.55,1.1,13474.0,231
HCPCS,62360,IMPLTJ/RPLCMT ITHCL/EDRL DRUG NFS SUBQ RSVR,18311.0,11902.15,1.1,52012.51,231
HCPCS,62361,IMPLTJ/RPLCMT FS NON-PRGRBL PUMP,18652.5,12124.125,1.1,52012.51,231
HCPCS,62362,IMPLTJ/RPLCMT ITHCL/EDRL DRUG NFS PRGRBL PUMP,18878.5,12271.025,1.1,52012.51,231
HCPCS,62365,RMVL SUBQ RSVR/PUMP INTRATHECAL/EPIDURAL INFUS,22880.0,14872.0,1.1,44188.0,231
HCPCS,62367,ELECT ANLYS IMPLT ITHCL/EDRL PMP W/O REPRG/REFIL,1140.0,741.0,0.01,4337.0,319
HCPCS,62368,ELECT ANALYS IMPLT ITHCL/EDRL PUMP W/REPRGRMG,1182.0,768.3,0.01,4337.0,321
HCPCS,62369,ANAL SP INF PMP W/REPRG&FILL,295.0,191.75,1.1,872.39,148
HCPCS,62369,ELECT ANLYS IMPLT ITHCL/EDRL PMP W/REPRG&REFIL,2069.0,1344.85,0.01,12500.0,87
HCPCS,62370,ELEC ANLYS IMPLT ITHCL/EDRL PMP W/REPR PHYS/QHP,2069.0,1344.85,0.01,12500.0,87
HCPCS,62370,ELEC ANLYS IMPLT ITHCL/EDRL PMP W/REPR&REF PHYS,396.0,257.4,1.1,872.39,148
HCPCS,62380,NDSC DCMPRN SPINAL CORD 1 W/LAMOT NTRSPC LUMBAR,27604.0,17942.6,1.1,49292.0,175
HCPCS,63001,LAM W/O FACETEC FORAMOT/DSC 1/2 VRT SGM CRV,7044.0,4578.6,1.1,20863.78,144
HCPCS,63001,REMOVE SPINE LAMINA 1/2 CRVL,,,6206.54,18676.74,21
HCPCS,63001,Remove spine lamina 1/2 crvl,,,3812.17,4414.09,8
HCPCS,63003,LAMINECTOMY W/O FFD 1/2 VERT SEG THORACIC,7096.0,4612.4,1.1,20863.78,144
HCPCS,63003,REMOVE SPINE LAMINA 1/2 THRC,,,6206.54,18676.74,21
HCPCS,63003,Remove spine lamina 1/2 thrc,,,3812.17,4414.09,8
HCPCS,63005,LAMINECTOMY W/O FFD 1/2 VERT SEG LUMBAR,6572.0,4271.8,1.1,20863.78,144
HCPCS,63005,REMOVE SPINE LAMINA 1/2 LMBR,,,6206.54,18676.74,21
HCPCS,63005,Remove spine lamina 1/2 lmbr,,,3812.17,4414.09,8
HCPCS,63011,LAMINECTOMY W/O FFD 1/2 VERT SEG SACRAL,6364.0,4136.6,1.1,20863.78,144
HCPCS,63011,REMOVE SPINE LAMINA 1/2 SCRL,,,6206.54,18676.74,21
HCPCS,63011,Remove spine lamina 1/2 scrl,,,3812.17,4414.09,8
HCPCS,63012,LAMINECTOMY W/RMVL ABNORMAL FACETS LUMBAR,6740.0,4381.0,1.1,20863.78,144
HCPCS,63012,REMOVE LAMINA/FACETS LUMBAR,,,6206.54,18676.74,21
HCPCS,63012,Remove lamina/facets lumbar,,,3812.17,4414.09,8
HCPCS,63015,LAMINECTOMY W/O FFD > 2 VERT SEG CERVICAL,8340.0,5421.0,1.1,20863.78,144
HCPCS,63015,REMOVE SPINE LAMINA >2 CRVCL,,,6206.54,18676.74,21
HCPCS,63015,Remove spine lamina >2 crvcl,,,3812.17,4414.09,8
HCPCS,63016,LAMINECTOMY W/O FFD > 2 VERT SEG THORACIC,8812.0,5727.8,1.1,20863.78,144
HCPCS,63016,REMOVE SPINE LAMINA >2 THRC,,,6206.54,18676.74,21
HCPCS,63016,Remove spine lamina >2 thrc,,,3812.17,4414.09,8
HCPCS,63017,LAMINECTOMY W/O FFD > 2 VERT SEG LUMBAR,6932.0,4505.8,1.1,20863.78,144
HCPCS,63017,REMOVE SPINE LAMINA >2 LMBR,,,6206.54,18676.74,21
HCPCS,63017,Remove spine lamina >2 lmbr,,,3812.17,4414.09,8
HCPCS,63020,LAMNOTMY INCL W/DCMPRSN NRV ROOT 1 INTRSPC CERVC,5964.0,3876.6,1.1,20863.78,144
HCPCS,63020,LAMOT DCMPRN NRV RT 1 CERV,,,6206.54,7551.43,20
HCPCS,63020,Lamot dcmprn nrv rt 1 cerv,,,3812.17,4414.09,8
HCPCS,63030,LAMNOTMY INCL W/DCMPRSN NRV ROOT 1 INTRSPC LUMBR,4800.0,3120.0,1.1,20863.78,144
HCPCS,63030,LAMOT DCMPRN NRV RT 1 LMBR,,,6206.54,33436.0,24
HCPCS,63030,Lamot dcmprn nrv rt 1 lmbr,,,3812.17,4414.09,8
HCPCS,63032,LAMOT DCMPRN NRV RT RPR ANULR DFCT 1NTRSPC LMBR,1100.0,715.0,1.1,1100.0,106
HCPCS,63032,Lamot rpr anulr dfct 1 lmbr,,,3812.17,4414.09,8
HCPCS,63035,LAMNOTMY W/DCMPRSN NRV EACH ADDL CRVCL/LMBR,1544.0,1003.6,1.1,1544.0,144
HCPCS,63035,LAMOT DCMPRN NRV RT EA ADDL,,,10364.0,10364.0,1
HCPCS,63035,Lamot dcmprn nrv rt ea addl,,,3812.17,4414.09,8
HCPCS,63040,LAMINOTOMY SINGLE CERVICAL,,,6206.54,18676.74,21
HCPCS,63040,LAMOT PRTL FFD EXC DISC REEXPL 1 NTRSPC CERVICAL,8124.0,5280.6,1.1,20863.78,144
HCPCS,63040,Laminotomy single cervical,,,3812.17,4414.09,8
HCPCS,63042,LAMINOTOMY SINGLE LUMBAR,,,6206.54,18676.74,22
HCPCS,63042,LAMOT PRTL FFD EXC DISC REEXPL 1 NTRSPC LUMBAR,7504.0,4877.6,1.1,20863.78,144
HCPCS,63042,Laminotomy single lumbar,,,3812.17,4414.09,8
HCPCS,63043,LAMOT PRTL FFD EXC DISC REEXPL 1 NTRSPC EA CRV,4346.0,2824.9,1.1,4346.0,106
HCPCS,63043,Laminotomy addl cervical,,,3812.17,4414.09,8
HCPCS,63044,LAMOT W/PRTL FFD HRNA8 REEXPL 1 NTRSPC EA LMBR,3744.0,2433.6,1.1,3744.0,106
HCPCS,63044,Laminotomy addl lumbar,,,9326.79,10799.44,8
HCPCS,63045,LAM FACETEC & FORAMOT CRV,,,6206.54,18676.74,21
HCPCS,63045,LAM FACETECTOMY & FORAMOTOMY 1 VRT SGM CERVICAL,7180.0,4667.0,1.1,20863.78,144
HCPCS,63045,Lam facetec & foramot crv,,,3812.17,4414.09,8
HCPCS,63046,LAM FACETEC & FORAMOT THRC,,,6206.54,18676.74,22
HCPCS,63046,LAM FACETECTOMY & FORAMOTOMY 1 VRT SGM THORACIC,7590.0,4933.5,1.1,20863.78,144
HCPCS,63046,Lam facetec & foramot thrc,,,3812.17,4414.09,8
HCPCS,63047,LAM FACETEC & FORAMOT LUMBAR,,,6206.54,18676.74,24
HCPCS,63047,LAM FACETECTOMY & FORAMOTOMY 1 VRT SGM LUMBAR,6763.0,4395.95,1.1,20863.78,144
HCPCS,63047,Lam facetec & foramot lumbar,,,3812.17,4414.09,8
HCPCS,63048,LAM FACETEC &FORAMOT EA ADDL,,,10364.0,10364.0,1
HCPCS,63048,LAM FACETECTOMY&FORAMOT 1 VRT SGM EA ADDL SGM,1527.0,992.55,1.1,1527.0,144
HCPCS,63048,Lam facetec &foramot ea addl,,,3812.17,4414.09,8
HCPCS,63050,CERVICAL LAMINOPLSTY 2/> SEG,,,3871.51,3871.51,1
HCPCS,63050,Cervical laminoplsty 2/> seg,,,9326.79,10799.44,8
HCPCS,63050,LAMOP CERVICAL W/DCMPRN SPI CORD 2/> VERT SEG,9684.0,6294.6,1.1,9684.0,144
HCPCS,63051,C-LAMINOPLASTY W/GRAFT/PLATE,,,4468.5,4468.5,1
HCPCS,63051,C-laminoplasty w/graft/plate,,,9326.79,10799.44,8
HCPCS,63051,LAMOPLASTY CERVICAL DCMPRN CORD 2/> SEG RCNSTJ,11224.0,7295.6,1.1,11224.0,144
HCPCS,63052,LAM FACETEC/FORAMOT DRG ARTHRD LUMBAR 1 VRT SGM,1700.0,1105.0,1.1,1700.0,142
HCPCS,63052,Lam facetc/frmt arthrd lum 1,,,9326.79,10799.44,8
HCPCS,63053,LAM FACETEC/FORAMOT DRG ARTHRD LMBR EA ADDL SGM,1512.0,982.8,1.1,1512.0,142
HCPCS,63053,Lam factc/frmt arthrd lum ea,,,9326.79,10799.44,8
HCPCS,63055,DECOMPRESS SPINAL CORD THRC,,,6206.54,18676.74,21
HCPCS,63055,Decompress spinal cord thrc,,,3812.17,4414.09,8
HCPCS,63055,TRANSPEDICULAR DCMPRN SPINAL CORD 1 SEG THORACIC,9420.0,6123.0,1.1,20863.78,144
HCPCS,63056,DECOMPRESS SPINAL CORD LMBR,,,6206.54,18676.74,21
HCPCS,63056,Decompress spinal cord lmbr,,,3812.17,4414.09,8
HCPCS,63056,TRANSPEDICULAR DCMPRN SPINAL CORD 1 SEG LUMBAR,8744.0,5683.6,1.1,20863.78,144
HCPCS,63057,Decompress spine cord add-on,,,3812.17,4414.09,8
HCPCS,63057,TRANSPEDICULAR DCMPRN 1 SEG EA THORACIC/LUMBAR,2100.0,1365.0,1.1,2100.0,144
HCPCS,63064,COSTOVERTEBRAL DCMPRN SPINAL CORD THORACIC 1 SEG,10488.0,6817.2,1.1,20863.78,144
HCPCS,63064,DECOMPRESS SPINAL CORD THRC,,,6206.54,18676.74,21
HCPCS,63064,Decompress spinal cord thrc,,,3812.17,4414.09,8
HCPCS,63066,COSTOVERTEBRAL DCMPRN SPINE CORD THORACIC EA SEG,1304.0,847.6,1.1,1304.0,144
HCPCS,63066,Decompress spine cord add-on,,,3812.17,4414.09,8
HCPCS,63075,DISCECTOMY ANT DCMPRN CORD CERVICAL 1 NTRSPC,7840.0,5096.0,1.1,20863.78,144
HCPCS,63075,NECK SPINE DISK SURGERY,,,6206.54,18676.74,21
HCPCS,63075,Neck spine disk surgery,,,9326.79,10799.44,8
HCPCS,63076,DISCECTOMY ANT DCMPRN CORD CERVICAL EA NTRSPC,1616.0,1050.4,1.1,1616.0,144
HCPCS,63076,Neck spine disk surgery,,,9326.79,10799.44,8
HCPCS,63077,DISCECTOMY ANT DCMPRN CORD THORACIC 1 NTRSPC,9152.0,5948.8,1.1,9152.0,144
HCPCS,63077,SPINE DISK SURGERY THORAX,,,3823.2,3823.2,1
HCPCS,63077,Spine disk surgery thorax,,,3812.17,4414.09,8
HCPCS,63078,DISCECTOMY ANT DCMPRN CORD THORACIC EA NTRSPC,1312.0,852.8,1.1,1312.0,144
HCPCS,63078,SPINE DISK SURGERY THORAX,,,548.66,548.66,1
HCPCS,63078,Spine disk surgery thorax,,,9326.79,10799.44,8
HCPCS,63081,REMOVE VERT BODY DCMPRN CRVL,,,4669.59,4669.59,1
HCPCS,63081,Remove vert body dcmprn crvl,,,9326.79,10799.44,8
HCPCS,63081,VERTEBRAL CORPECTOMY ANT DCMPRN CERVICAL 1 SEG,10440.0,6786.0,1.1,10440.0,144
HCPCS,63082,REMOVE VERTEBRAL BODY ADD-ON,,,701.19,701.19,1
HCPCS,63082,Remove vertebral body add-on,,,14056.95,16276.47,8
HCPCS,63082,VERTEBRAL CORPECTOMY DCMPRN CERVICAL EA SEG,1744.0,1133.6,1.1,1744.0,144
HCPCS,63085,REMOVE VERT BODY DCMPRN THRC,,,5149.64,5149.64,1
HCPCS,63085,Remove vert body dcmprn thrc,,,14056.95,16276.47,8
HCPCS,63085,VERTEBRAL CORPECTOMY DCMPRN CORD THORACIC 1 SEG,11788.0,7662.2,1.1,11788.0,144
HCPCS,63086,REMOVE VERTEBRAL BODY ADD-ON,,,505.31,505.31,1
HCPCS,63086,Remove vertebral body add-on,,,14056.95,16276.47,8
HCPCS,63086,VERTEBRAL CORPECTOMY DCMPRN CORD THORACIC EA SEG,1276.0,829.4,1.1,1276.0,144
HCPCS,63087,REMOV VERTBR DCMPRN THRCLMBR,,,6408.26,6408.26,1
HCPCS,63087,Remov vertbr dcmprn thrclmbr,,,14056.95,16276.47,8
HCPCS,63087,VCRPEC THORACOLMBR DCMPRN LWR THRC/LMBR 1 SEG,15012.0,9757.8,1.1,15012.0,144
HCPCS,63088,REMOVE VERTEBRAL BODY ADD-ON,,,683.68,683.68,1
HCPCS,63088,Remove vertebral body add-on,,,14056.95,16276.47,8
HCPCS,63088,VCRPEC THORACOLMBR DCMPRN LWR THRC/LMBR EA SEG,1728.0,1123.2,1.1,1728.0,144
HCPCS,63090,REMOVE VERT BODY DCMPRN LMBR,,,5133.88,5133.88,1
HCPCS,63090,Remove vert body dcmprn lmbr,,,14056.95,16276.47,8
HCPCS,63090,VCRPEC TRANSPRTL/RPR DCMPRN THRC LMBR/SAC 1 SEG,12372.0,8041.8,1.1,12372.0,144
HCPCS,63091,REMOVE VERTEBRAL BODY ADD-ON,,,460.43,460.43,1
HCPCS,63091,Remove vertebral body add-on,,,14056.95,16276.47,8
HCPCS,63091,VCRPEC TRANSPRTL/RPR DCMPRN THRC LMBR/SAC EA SEG,1212.0,787.8,1.1,1212.0,144
HCPCS,63101,REMOVE VERT BODY DCMPRN THRC,,,6168.89,6168.89,1
HCPCS,63101,Remove vert body dcmprn thrc,,,14056.95,16276.47,8
HCPCS,63101,VERTEB CORPECT LAT XTRCAVITARY DCMPRN THRC 1 SEG,13640.0,8866.0,1.1,13640.0,144
HCPCS,63102,REMOVE VERT BODY DCMPRN LMBR,,,6048.22,6048.22,1
HCPCS,63102,Remove vert body dcmprn lmbr,,,14056.95,16276.47,8
HCPCS,63102,VERTEB CORPECT LAT XTRCAVITARY DCMPRN LMBR 1 SEG,15004.0,9752.6,1.1,15004.0,144
HCPCS,63103,REMOVE VERTEBRAL BODY ADD-ON,,,773.31,773.31,1
HCPCS,63103,Remove vertebral body add-on,,,14056.95,16276.47,8
HCPCS,63103,VCRPEC LAT XTRCAVITARY DCMPRN THRC/LMBR EA SEG,2121.0,1378.65,1.1,2121.0,144
HCPCS,63170,INCISE SPINAL CORD TRACT(S),,,4258.95,4258.95,1
HCPCS,63170,Incise spinal cord tract(s),,,14056.95,16276.47,8
HCPCS,63170,LAM W/MYELOTOMY CERVICAL/THORACIC/THORACOLUMBAR,8884.0,5774.6,1.1,8884.0,144
HCPCS,63172,DRAINAGE OF SPINAL CYST,,,3777.04,3777.04,1
HCPCS,63172,Drainage of spinal cyst,,,3812.17,4414.09,8
HCPCS,63172,LAM W/DRG INTRMEDULLARY CYST/SYRINX SUBARACHNOID,7904.0,5137.6,1.1,7904.0,144
HCPCS,63173,DRAINAGE OF SPINAL CYST,,,4613.42,4613.42,1
HCPCS,63173,Drainage of spinal cyst,,,14056.95,16276.47,8
HCPCS,63173,LAM W/DRG INTRMEDULRY CYST/SYRINX PRTL/PLEURAL,9724.0,6320.6,1.1,9724.0,144
HCPCS,63180,Revise spinal cord ligaments,,,14056.95,16276.47,8
HCPCS,63182,Revise spinal cord ligaments,,,14056.95,16276.47,8
HCPCS,63185,INCISE SPINE NRV HALF SEGMNT,,,3283.84,3283.84,1
HCPCS,63185,Incise spine nrv half segmnt,,,3812.17,4414.09,8
HCPCS,63190,INCISE SPINE NRV >2 SEGMNTS,,,3247.12,3247.12,1
HCPCS,63190,Incise spine nrv >2 segmnts,,,3812.17,4414.09,8
HCPCS,63190,LAMINECTOMY W/RHIZOTOMY > 2 SEGMENTS,7556.0,4911.4,1.1,7556.0,144
HCPCS,63191,INCISE SPINE ACCESSORY NERVE,,,3692.12,3692.12,1
HCPCS,63191,Incise spine accessory nerve,,,3812.17,4414.09,8
HCPCS,63194,Incise spine & cord cervical,,,14056.95,16276.47,8
HCPCS,63195,Incise spine & cord thoracic,,,14056.95,16276.47,8
HCPCS,63196,Incise spine&cord 2 trx crvl,,,14056.95,16276.47,8
HCPCS,63197,LAM W/CORDOTOMY 1STG THRC,,,4573.61,4573.61,1
HCPCS,63197,LAM W/CORDOTOMY SCTJ SPINOTHALAMIC TRC 1STG THRC,9632.0,6260.8,1.1,9632.0,144
HCPCS,63197,Lam w/cordotomy 1stg thrc,,,14056.95,16276.47,8
HCPCS,63198,Incise spin&cord 2 stgs crvl,,,14056.95,16276.47,8
HCPCS,63199,Incise spin&cord 2 stgs thrc,,,14056.95,16276.47,8
HCPCS,63200,LAMINECTOMY RELEASE TETHERED SPINAL CORD LUMBAR,9434.0,6132.1,1.1,9434.0,144
HCPCS,63200,RELEASE SPINAL CORD LUMBAR,,,4087.92,4087.92,1
HCPCS,63200,Release spinal cord lumbar,,,9326.79,10799.44,8
HCPCS,63250,LAM EXC/OCCLUSION AVM SPINAL CORD CERVICAL,17544.0,11403.6,1.1,17544.0,144
HCPCS,63250,REVISE SPINAL CORD VSLS CRVL,,,7902.9,7902.9,1
HCPCS,63250,Revise spinal cord vsls crvl,,,14056.95,16276.47,8
HCPCS,63251,LAM EXC/OCCLUSION AVM SPINAL CORD THORACIC,17856.0,11606.4,1.1,17856.0,144
HCPCS,63251,REVISE SPINAL CORD VSLS THRC,,,8077.71,8077.71,1
HCPCS,63251,Revise spinal cord vsls thrc,,,14056.95,16276.47,8
HCPCS,63252,LAM EXC/OCCLUSION AVM SPI CORD THORACOLUMBAR,17852.0,11603.8,1.1,17852.0,144
HCPCS,63252,REVISE SPINE CORD VSL THRLMB,,,8076.84,8076.84,1
HCPCS,63252,Revise spine cord vsl thrlmb,,,14056.95,16276.47,8
HCPCS,63265,EXCISE INTRASPINL LESION CRV,,,6206.54,18676.74,21
HCPCS,63265,Excise intraspinl lesion crv,,,3812.17,4414.09,8
HCPCS,63265,LAM EXC/EVAC ISPI LES OTH/THN NEO XDRL CERVICAL,9528.0,6193.2,1.1,20863.78,144
HCPCS,63266,EXCISE INTRSPINL LESION THRC,,,6206.54,18676.74,21
HCPCS,63266,Excise intrspinl lesion thrc,,,3812.17,4414.09,8
HCPCS,63266,LAM EXC/EVAC ISPI LES OTH/THN NEO XDRL THORACIC,9872.0,6416.8,1.1,20863.78,144
HCPCS,63267,EXCISE INTRSPINL LESION LMBR,,,6206.54,11170.0,21
HCPCS,63267,Excise intrspinl lesion lmbr,,,3812.17,4414.09,8
HCPCS,63267,LAM EXC/EVAC ISPI LESION OTH/THN NEO XDRL LUMBAR,7780.0,5057.0,1.1,20863.78,144
HCPCS,63268,EXCISE INTRSPINL LESION SCRL,,,6206.54,18676.74,21
HCPCS,63268,Excise intrspinl lesion scrl,,,3812.17,4414.09,8
HCPCS,63268,LAM EXC/EVAC ISPI LES OTH/THN NEO XDRL SACRAL,8008.0,5205.2,1.1,20863.78,144
HCPCS,63270,EXCISE INTRSPINL LESION CRVL,,,5547.68,5547.68,1
HCPCS,63270,Excise intrspinl lesion crvl,,,9326.79,10799.44,8
HCPCS,63270,LAM EXC ISPI LES OTH/THN NEO IDRL CERVICAL,11920.0,7748.0,1.1,11920.0,144
HCPCS,63271,EXCISE INTRSPINL LESION THRC,,,5530.8,5530.8,1
HCPCS,63271,Excise intrspinl lesion thrc,,,14056.95,16276.47,8
HCPCS,63271,LAM EXC ISPI LES OTH/THN NEO IDRL THORACIC,11968.0,7779.2,1.1,11968.0,144
HCPCS,63272,EXCISE INTRSPINL LESION LMBR,,,4978.88,4978.88,1
HCPCS,63272,Excise intrspinl lesion lmbr,,,9326.79,10799.44,8
HCPCS,63272,LAM EXC ISPI LES OTH/THN NEO IDRL LUMBAR,11000.0,7150.0,1.1,11000.0,144
HCPCS,63273,EXCISE INTRSPINL LESION SCRL,,,4991.05,4991.05,1
HCPCS,63273,Excise intrspinl lesion scrl,,,9326.79,10799.44,8
HCPCS,63273,LAM EXC ISPI LES OTH/THN NEO IDRL SACRAL,10588.0,6882.2,1.1,10588.0,144
HCPCS,63275,BX/EXC XDRL SPINE LESN CRVL,,,4792.7,4792.7,1
HCPCS,63275,Bx/exc xdrl spine lesn crvl,,,14056.95,16276.47,8
HCPCS,63275,LAMINECTOMY BX/EXC ISPI NEO XDRL CERVICAL,10344.0,6723.6,1.1,10344.0,144
HCPCS,63276,BX/EXC XDRL SPINE LESN THRC,,,4763.22,4763.22,1
HCPCS,63276,Bx/exc xdrl spine lesn thrc,,,14056.95,16276.47,8
HCPCS,63276,LAMINECTOMY BX/EXC ISPI NEO XDRL THORACIC,10276.0,6679.4,1.1,10276.0,144
HCPCS,63277,BX/EXC XDRL SPINE LESN LMBR,,,4147.62,4147.62,1
HCPCS,63277,Bx/exc xdrl spine lesn lmbr,,,14056.95,16276.47,8
HCPCS,63277,LAMINECTOMY BX/EXC ISPI NEO XDRL LUMBAR,8956.0,5821.4,1.1,8956.0,144
HCPCS,63278,BX/EXC XDRL SPINE LESN SCRL,,,4260.34,4260.34,1
HCPCS,63278,Bx/exc xdrl spine lesn scrl,,,14056.95,16276.47,8
HCPCS,63278,LAMINECTOMY BX/EXC ISPI NEO XDRL SACRAL,8848.0,5751.2,1.1,8848.0,144
HCPCS,63280,BX/EXC IDRL SPINE LESN CRVL,,,5656.37,5656.37,1
HCPCS,63280,Bx/exc idrl spine lesn crvl,,,14056.95,16276.47,8
HCPCS,63280,LAM BX/EXC ISPI NEO IDRL XMED CERVICAL,12116.0,7875.4,1.1,12116.0,144
HCPCS,63281,BX/EXC IDRL SPINE LESN THRC,,,5609.0,5609.0,1
HCPCS,63281,Bx/exc idrl spine lesn thrc,,,14056.95,16276.47,8
HCPCS,63281,LAM BX/EXC ISPI NEO IDRL XMED THORACIC,11996.0,7797.4,1.1,11996.0,144
HCPCS,63282,BX/EXC IDRL SPINE LESN LMBR,,,5283.79,5283.79,1
HCPCS,63282,Bx/exc idrl spine lesn lmbr,,,9326.79,10799.44,8
HCPCS,63282,LAM BX/EXC ISPI NEO IDRL XMED LUMBAR,11260.0,7319.0,1.1,11260.0,144
HCPCS,63283,BX/EXC IDRL SPINE LESN SCRL,,,5084.59,5084.59,1
HCPCS,63283,Bx/exc idrl spine lesn scrl,,,14056.95,16276.47,8
HCPCS,63283,LAM BX/EXC ISPI NEO IDRL SACRAL,10704.0,6957.6,1.1,10704.0,144
HCPCS,63285,BX/EXC IDRL IMED LESN CERVL,,,6975.99,6975.99,1
HCPCS,63285,Bx/exc idrl imed lesn cervl,,,14056.95,16276.47,8
HCPCS,63285,LAM BX/EXC ISPI NEO IDRL IMED CERVICAL,15220.0,9893.0,1.1,15220.0,144
HCPCS,63286,BX/EXC IDRL IMED LESN THRC,,,6860.52,6860.52,1
HCPCS,63286,Bx/exc idrl imed lesn thrc,,,14056.95,16276.47,8
HCPCS,63286,LAM BX/EXC ISPI NEO IDRL IMED THORACIC,15048.0,9781.2,1.1,15048.0,144
HCPCS,63287,BX/EXC IDRL IMED LESN THRLMB,,,7315.36,7315.36,1
HCPCS,63287,Bx/exc idrl imed lesn thrlmb,,,14056.95,16276.47,8
HCPCS,63287,LAM BX/EXC ISPI NEO IDRL IMED THORACOLMBR,16032.0,10420.8,1.1,16032.0,144
HCPCS,63290,BX/EXC XDRL/IDRL LSN ANY LVL,,,7438.99,7438.99,1
HCPCS,63290,Bx/exc xdrl/idrl lsn any lvl,,,14056.95,16276.47,8
HCPCS,63290,LAM BX/EXC ISPI NEO XDRL-IDRL LES ANY LVL,16328.0,10613.2,1.1,16328.0,144
HCPCS,63295,OSTPL RCNSTJ DORSAL SPI ELMNTS FLWG ISPI PX,2100.0,1365.0,1.1,2100.0,144
HCPCS,63295,REPAIR LAMINECTOMY DEFECT,,,872.44,872.44,1
HCPCS,63295,Repair laminectomy defect,,,9326.79,10799.44,8
HCPCS,63300,REMOVE VERT XDRL BODY CRVCL,,,4805.22,4805.22,1
HCPCS,63300,Remove vert xdrl body crvcl,,,14056.95,16276.47,8
HCPCS,63300,VCRPEC LES 1 SGM XDRL CERVICAL,10720.0,6968.0,1.1,10720.0,144
HCPCS,63301,REMOVE VERT XDRL BODY THRC,,,5890.29,5890.29,1
HCPCS,63301,Remove vert xdrl body thrc,,,14056.95,16276.47,8
HCPCS,63301,VCRPEC LES 1 SGM XDRL THORACIC TTHRC,12628.0,8208.2,1.1,12628.0,144
HCPCS,63302,REMOVE VERT XDRL BODY THRLMB,,,5819.6,5819.6,1
HCPCS,63302,Remove vert xdrl body thrlmb,,,14056.95,16276.47,8
HCPCS,63303,REMOV VERT XDRL BDY LMBR/SAC,,,6176.65,6176.65,1
HCPCS,63303,Remov vert xdrl bdy lmbr/sac,,,14056.95,16276.47,8
HCPCS,63303,VCRPEC LES 1 SEG XDRL LMBR/SAC TRANSPRTL/RPR,13420.0,8723.0,1.1,13420.0,144
HCPCS,63304,REMOVE VERT IDRL BODY CRVCL,,,6270.13,6270.13,1
HCPCS,63304,Remove vert idrl body crvcl,,,14056.95,16276.47,8
HCPCS,63304,VERTEBRAL CORPECTOMY EXC LES 1 SEG IDRL CERVICAL,13540.0,8801.0,1.1,13540.0,144
HCPCS,63305,REMOVE VERT IDRL BODY THRC,,,6672.17,6672.17,1
HCPCS,63305,Remove vert idrl body thrc,,,14056.95,16276.47,8
HCPCS,63305,VERTEBRAL CORPECTOMY LES 1 SEG IDRL THRC TTHRC,14496.0,9422.4,1.1,14496.0,144
HCPCS,63306,REMOV VERT IDRL BDY THRCLMBR,,,6555.48,6555.48,1
HCPCS,63306,Remov vert idrl bdy thrclmbr,,,14056.95,16276.47,8
HCPCS,63307,REMOV VERT IDRL BDY LMBR/SAC,,,6419.82,6419.82,1
HCPCS,63307,Remov vert idrl bdy lmbr/sac,,,14056.95,16276.47,8
HCPCS,63307,VCRPEC LES 1 SEG IDRL LMBR/SAC TRANSPRTL/RPR,13984.0,9089.6,1.1,13984.0,144
HCPCS,63308,REMOVE VERTEBRAL BODY ADD-ON,,,847.56,847.56,1
HCPCS,63308,Remove vertebral body add-on,,,14056.95,16276.47,8
HCPCS,63308,VERTEBRAL CORPECTOMY EXC INDRL LES EACH SEG,2096.0,1362.4,1.1,2096.0,144
HCPCS,63600,REMOVE SPINAL CORD LESION,,,1675.06,2032.17,20
HCPCS,63600,Remove spinal cord lesion,,,3812.17,4414.09,8
HCPCS,63610,STIMULATION OF SPINAL CORD,,,1675.06,2032.17,20
HCPCS,63610,Stimulation of spinal cord,,,3812.17,4414.09,8
HCPCS,63620,SRS SPINAL LESION,,,3008.9,3008.9,1
HCPCS,63620,STEREOTACTIC RADIOSURGERY 1 SPINAL LESION,6864.0,4461.6,1.1,6864.0,144
HCPCS,63620,Srs spinal lesion,,,4012.14,4645.63,8
HCPCS,63621,SRS SPINAL LESION ADDL,,,669.66,669.66,1
HCPCS,63621,STEREOTACTIC RADIOSURGERY EA ADDL SPINAL LESION,1760.0,1144.0,1.1,1760.0,144
HCPCS,63621,Srs spinal lesion addl,,,4012.14,4645.63,8
HCPCS,63650,PRQ IMPLTJ NSTIM ELECTRODE ARRAY EPIDURAL,14277.5,9280.375,0.01,25409.0,306
HCPCS,63655,IMPLANT NEUROELECTRODES,,,18354.0,57109.38,21
HCPCS,63655,Implant neuroelectrodes,,,19174.95,22202.58,8
HCPCS,63655,LAM IMPLTJ NSTIM ELTRDS PLATE/PADDLE EDRL,4805.0,3123.25,1.1,63800.42,144
HCPCS,63661,RMVL SPINAL NSTIM ELTRD PRQ ARRAY INCL FLUOR,7854.5,5105.425,0.01,13474.0,322
HCPCS,63662,REMOVE SPINE ELTRD PLATE,,,2951.88,3638.34,20
HCPCS,63662,RMVL SPINAL NSTIM ELTRD PLATE/PADDLE INCL FLUOR,4840.0,3146.0,1.1,9923.76,144
HCPCS,63662,Remove spine eltrd plate,,,2167.75,2510.02,8
HCPCS,63663,REVJ INCL RPLCMT NSTIM ELTRD PRQ RA INCL FLUOR,13617.0,8851.05,1.1,23824.0,227
HCPCS,63664,REVISE SPINE ELTRD PLATE,,,10541.85,12485.31,20
HCPCS,63664,REVJ INCL RPLCMT NSTIM ELTRD PLT/PDLE INCL FLUOR,5069.0,3294.85,1.1,39728.72,144
HCPCS,63664,Revise spine eltrd plate,,,19174.95,22202.58,8
HCPCS,63685,INSJ/RPLCMT SPINAL NPG/RCVR POCKET CRTJ&CONNJ,21380.5,13897.324999999999,1.1,90562.75,318
HCPCS,63688,REVJ/RMVL IMPL SPI NPG/RCVR DTCH CONNJ ELTRD RA,12821.5,8333.975,1.1,23729.0,231
HCPCS,63700,REPAIR OF SPINAL HERNIATION,,,3505.72,3505.72,1
HCPCS,63700,"REPR MENINGOCELE,<5CM DIA",6988.0,4542.2,1.1,6988.0,144
HCPCS,63700,Repair of spinal herniation,,,3812.17,4414.09,8
HCPCS,63702,REPAIR OF SPINAL HERNIATION,,,3829.81,3829.81,1
HCPCS,63702,"REPR MENINGOCELE,5+CM DIA",7764.0,5046.6,1.1,7764.0,144
HCPCS,63702,Repair of spinal herniation,,,3812.17,4414.09,8
HCPCS,63704,REPAIR OF SPINAL HERNIATION,,,4453.16,4453.16,1
HCPCS,63704,"REPR MYELOMENIGOCELE,<5CM DIA",8972.0,5831.8,1.1,8972.0,144
HCPCS,63704,Repair of spinal herniation,,,3812.17,4414.09,8
HCPCS,63706,REPAIR OF SPINAL HERNIATION,,,4943.56,4943.56,1
HCPCS,63706,"REPR MYELOMENIGOCELE,5+CM DIA",10140.0,6591.0,1.1,10140.0,144
HCPCS,63706,Repair of spinal herniation,,,3812.17,4414.09,8
HCPCS,63707,REPAIR SPINAL FLUID LEAKAGE,,,2484.85,2484.85,1
HCPCS,63707,REPR DURAL/CSF LEAK,5060.0,3289.0,1.1,5060.0,144
HCPCS,63707,Repair spinal fluid leakage,,,3812.17,4414.09,8
HCPCS,63709,REPAIR SPINAL FLUID LEAKAGE,,,2951.69,2951.69,1
HCPCS,63709,REPR DURAL/CSF LEAK W LAMINECTOMY,6260.0,4069.0,1.1,6260.0,144
HCPCS,63709,Repair spinal fluid leakage,,,9326.79,10799.44,8
HCPCS,63710,"DURAL GRAFT REPAIR,SPINE DEFECT",6160.0,4004.0,1.1,6160.0,144
HCPCS,63710,GRAFT REPAIR OF SPINE DEFECT,,,2862.75,2862.75,1
HCPCS,63710,Graft repair of spine defect,,,9326.79,10799.44,8
HCPCS,63740,CRTJ SHUNT LMBR SARACH-PRTL-PLEURAL/OTH W/LAM,5052.0,3283.8,1.1,5052.0,144
HCPCS,63740,INSTALL SPINAL SHUNT,,,2631.47,2631.47,1
HCPCS,63740,Install spinal shunt,,,5357.22,6203.1,8
HCPCS,63741,CRTJ SHUNT LMBR SARACH-PRTL-PLEURAL PRQ X LAM,3648.0,2371.2,1.1,19428.17,144
HCPCS,63741,INSTALL SPINAL SHUNT,,,5779.17,17390.7,21
HCPCS,63741,Install spinal shunt,,,5357.22,6203.1,8
HCPCS,63744,REVISION OF SPINAL SHUNT,,,3231.94,6411.78,20
HCPCS,63744,RPLCMT IRRIGATION/REVJ LUMBOSARACH SHUNT,3576.0,2324.4,1.1,19428.17,144
HCPCS,63744,Revision of spinal shunt,,,5357.22,6203.1,8
HCPCS,63746,REMOVAL OF SPINAL SHUNT,,,1675.06,2032.17,20
HCPCS,63746,RMVL ENTIRE LUMBOSARACH SHUNT SYS W/O RPLCMT,2932.0,1905.8,1.1,5632.24,144
HCPCS,63746,Removal of spinal shunt,,,1090.19,1262.33,8
HCPCS,64400,INJECTION AA&/STRD TRIGEMINAL NERVE EACH BRANCH,1183.5,769.275,0.01,4628.0,409
HCPCS,64405,INJECTION AA&/STRD GREATER OCCIPITAL NERVE,1225.5,796.575,0.01,4628.0,583
HCPCS,64408,INJECTION AA&/STRD VAGUS NERVE,1183.5,769.275,0.01,4392.0,235
HCPCS,64415,INJECTION AA&/STRD BRACHIAL PLEXUS,6143.0,3992.95,89.94,6143.0,87
HCPCS,64415,INJECTION AA&/STRD BRACHIAL PLEXUS W/IMG GDN,3401.5,2210.975,0.01,6143.0,235
HCPCS,64416,INJECTION AA&/STRD BRACH PLEX CONT NFS CATH IMG,3467.5,2253.875,1.1,6143.0,231
HCPCS,64416,INJECTION AA&/STRD BRACHIAL PLEXUS CONT NFS CATH,6143.0,3992.95,0.01,6143.0,87
HCPCS,64417,INJECTION AA&/STRD AXILLARY NERVE W/IMG GDN,3359.5,2183.6749999999997,0.01,6143.0,322
HCPCS,64418,INJECTION AA&/STRD SUPRASCAPULAR NERVE,2631.0,1710.1499999999999,0.01,4778.0,409
HCPCS,64420,INJECTION AA&/STRD INTERCOSTAL NRV SINGLE LVL,2626.5,1707.225,0.01,4778.0,322
HCPCS,64421,INJECTION AA&/STRD INTERCOSTAL NRV EA ADDL LVL,3181.5,2067.975,0.01,6143.0,409
HCPCS,64425,INJECTION AA&/STRD ILIOINGUINAL IH NERVES,2609.0,1695.85,0.01,4778.0,322
HCPCS,64430,INJECTION AA&/STRD PUDENDAL NERVE,3291.5,2139.475,0.01,6143.0,409
HCPCS,64435,INJECTION AA&/STRD PARACERVICAL NERVE,2554.0,1660.1,0.01,4778.0,235
HCPCS,64445,INJECTION AA&/STRD SCIATIC NERVE,4778.0,3105.7,87.62,4778.0,87
HCPCS,64445,INJECTION AA&/STRD SCIATIC NERVE W/IMG GDN,2695.0,1751.75,0.01,4778.0,322
HCPCS,64446,INJECTION AA&/STRD SCIATIC NRV CONT NFS CATH IMG,3456.5,2246.725,0.01,6143.0,318
HCPCS,64447,INJECTION AA&/STRD FEMORAL NERVE,4778.0,3105.7,81.71,4778.0,86
HCPCS,64447,INJECTION AA&/STRD FEMORAL NERVE W/IMG GDN,2684.0,1744.6,0.01,12615.0,321
HCPCS,64448,INJECTION AA&/STRD FEM NRV CONT NFS CATH IMG GDN,3441.0,2236.65,1.1,6143.0,231
HCPCS,64448,INJECTION AA&/STRD FEMORAL NERVE CONT NFS CATH,6143.0,3992.95,0.01,6143.0,87
HCPCS,64449,INJECTION AA&/STRD LUMBAR PLEXUS CONT NFS CATH,3351.0,2178.15,0.01,6143.0,318
HCPCS,64450,INJECTION AA&/STRD OTHER PERIPHERAL NERVE/BRANCH,2554.0,1660.1,0.01,4778.0,409
HCPCS,64451,INJECTION AA&/STRD NERVES NRVTG SI JOINT W/IMG,2723.5,1770.2749999999999,0.01,4778.0,496
HCPCS,64454,INJECTION AA&/STRD GENICULAR NRV BRANCHES W/IMG,2723.5,1770.2749999999999,0.01,4778.0,409
HCPCS,64455,NJX AA&/STRD PLANTAR COMMON DIGITAL NERVES,1183.5,769.275,0.01,12500.0,235
HCPCS,64461,PVB THORACIC SINGLE INJECTION SITE W/IMG GID,2774.0,1803.1,0.01,12500.0,235
HCPCS,64462,PVB THORACIC SECOND & ADDL INJ SITE W/IMG GID,903.0,586.95,0.01,4392.0,217
HCPCS,64463,PVB THORACIC CONT CATHETER INFUSION W/IMG GID,2807.0,1824.55,0.01,12500.0,322
HCPCS,64466,THORACIC FASCIAL PLANE BLOCK UNI INJECTION,2498.0,1623.7,1.1,4336.0,211
HCPCS,64467,THORACIC FASCIAL PLANE BLOCK UNI CONT INFUSION,766.0,497.9,1.1,766.0,144
HCPCS,64467,Thrc fascial pln blk uni nfs,,,289.33,335.02,8
HCPCS,64468,THORACIC FASCIAL PLANE BLOCK BI INJECTION,735.0,477.75,1.1,735.0,144
HCPCS,64468,Thrc fascial pln blk bi njx,,,703.77,814.89,8
HCPCS,64469,THORACIC FASCIAL PLANE BLOCK BI CONT INFUSION,805.0,523.25,1.1,1091.15,144
HCPCS,64469,Thrc fascial pln blk bi nfs,,,703.77,814.89,8
HCPCS,64470,INJ FACET ANES/STER PARA VERT SINGL,672.0,436.8,1.1,672.0,70
HCPCS,64472,INJ FACET ANES/STER PARA VERT MULTI,469.0,304.85,1.1,469.0,70
HCPCS,64473,LOWER XTR FASCIAL PLANE BLOCK UNI INJECTION,671.5,436.475,0.01,3443.0,278
HCPCS,64474,LOWER XTR FASCIAL PLANE BLOCK UNI CONT INFUSION,735.0,477.75,1.1,735.0,144
HCPCS,64474,Lwr xtr fscl pln blk uni nfs,,,289.33,335.02,8
HCPCS,64476,INJ FACET ANES/STER LS  MULTI,355.0,230.75,1.1,355.0,70
HCPCS,64479,NJX AA&/STRD TFRML EPI CERVICAL/THORACIC 1 LEVEL,3575.5,2324.075,0.01,6143.0,322
HCPCS,64480,NJX AA&/STRD TFRML EPI CERVICAL/THORACIC EA ADDL,944.5,613.925,0.01,4628.0,286
HCPCS,64483,NJX AA&/STRD TFRML EPI LUMBAR/SACRAL 1 LEVEL,3489.5,2268.1749999999997,0.01,6143.0,409
HCPCS,64484,NJX AA&/STRD TFRML EPI LUMBAR/SACRAL EA ADDL,961.0,624.65,0.01,4628.0,286
HCPCS,64486,TAP BLOCK UNILATERAL BY INJECTION(S),967.5,628.875,0.01,4628.0,284
HCPCS,64487,TAP BLOCK UNILATERAL BY CONTINUOUS INFUSION(S),1009.5,656.175,0.01,4337.0,216
HCPCS,64488,TAP BLOCK BILATERAL BY INJECTION(S),1011.5,657.4749999999999,0.01,4628.0,284
HCPCS,64489,TAP BLOCK BILATERAL BY CONTINUOUS INFUSION(S),1088.5,707.525,0.01,4337.0,216
HCPCS,64490,NJX DX/THER AGT PVRT FACET JT CRV/THRC 1 LEVEL,3472.0,2256.7999999999997,0.01,6143.0,322
HCPCS,64491,NJX DX/THER AGT PVRT FACET JT CRV/THRC 2ND LEVEL,583.0,378.95,0.01,4628.0,355
HCPCS,64492,NJX DX/THER AGT PVRT FACET JT CRV/THRC 3+ LEVEL,583.0,378.95,0.01,4628.0,286
HCPCS,64493,NJX DX/THER AGT PVRT FACET JT LMBR/SAC 1 LEVEL,3406.0,2213.9,0.01,6143.0,409
HCPCS,64494,NJX DX/THER AGT PVRT FACET JT LMBR/SAC 2ND LEVEL,1088.5,707.525,0.01,4628.0,355
HCPCS,64495,NJX DX/THER AGT PVRT FACET JT LMBR/SAC 3+ LEVEL,850.0,552.5,0.01,4628.0,355
HCPCS,64505,INJ ANES SPHENOPALATINE GANGLION,2037.0,1324.05,118.89,3443.0,86
HCPCS,64505,INJECTION ANES AGENT SPHENOPALATINE GANGLION,1317.5,856.375,0.01,3443.0,235
HCPCS,64510,NJX ANES STELLATE GANGLION CRV SYMPATHETIC,3340.0,2171.0,0.01,6143.0,322
HCPCS,64517,INJECTION ANES SUPERIOR HYPOGASTRIC PLEXUS,3555.5,2311.075,0.01,6143.0,322
HCPCS,64520,INJECTION ANES LMBR/THRC PARAVERTBRL SYMPATHETIC,3368.5,2189.525,0.01,6143.0,322
HCPCS,64530,INJX ANES CELIAC PLEXUS W/WO RADIOLOGIC MONITRNG,3419.0,2222.35,0.01,6143.0,322
HCPCS,64553,IMPLANT NEUROELECTRODES,,,10541.85,12485.31,20
HCPCS,64553,Implant neuroelectrodes,,,19174.95,22202.58,8
HCPCS,64553,PRQ IMPLTJ NEUROSTIMULATOR ELTRD CRANIAL NERVE,2452.0,1593.8,1.1,39728.72,148
HCPCS,64555,PRQ IMPLTJ NEUROSTIMULATOR ELTRD PERIPHERAL NRV,14841.0,9646.650000000001,0.01,19945.48,306
HCPCS,64555,PRQ IMPLTJ NEUROSTIMULATOR ELTRD PERIPHERAL NRV (64555),2304.0,1497.6,1.1,19945.48,148
HCPCS,64561,PRQ IMPLTJ NEUROSTIM ELTRD SACRAL NRVE W/IMAGING,13410.0,8716.5,0.01,24426.0,306
HCPCS,64566,NEUROELTRD STIM POST TIBIAL,2037.0,1324.05,35.12,5265.0,87
HCPCS,64566,PERC TIB NEUROSTIMULATION PRQ NEEDLE ELECTRODE,264.0,171.6,1.1,863.2,146
HCPCS,64566,POST TIB NEUROSTIMULATION PRQ NEEDLE ELECTRODE,2037.0,1324.05,0.01,5265.0,174
HCPCS,64566,PTNS,914.0,594.1,1.1,914.0,146
HCPCS,64567,PERQ ELEC NRV FIELD STIMJ CN,,,858.08,943.89,12
HCPCS,64567,PERQ ELEC NRV FIELD STIMJ CRANIAL NRV W/O IMPLTJ,660.0,429.0,1.1,2941.43,106
HCPCS,64567,Perq elec nrv field stimj cn,,,538.64,623.69,8
HCPCS,64568,OPEN IMPLANTATION CRANIAL NERVE NEA & PULSE GEN,3600.0,2340.0,1.1,90562.75,144
HCPCS,64568,OPN IMPLTJ CRNL NRV NEA&PG,,,7663.0,45838.5,23
HCPCS,64568,Opn impltj crnl nrv nea&pg,,,19174.95,22202.58,8
HCPCS,64569,REVISE/REPL VAGUS N ELTRD,,,10541.85,12485.31,20
HCPCS,64569,REVISION/REPLMT NEUROSTIMLATOR ELTRD CRANIAL NRV,4400.0,2860.0,1.1,39728.72,144
HCPCS,64569,Revise/repl vagus n eltrd,,,19174.95,22202.58,8
HCPCS,64570,REMOVAL CRNL NRV NSTIM ELTRDS & PULSE GENERATOR,23914.0,15544.1,0.01,44188.0,231
HCPCS,64575,OPEN IMPLANTATION NEA PERIPHERAL NERVE,16454.0,10695.1,1.1,39728.72,231
HCPCS,64580,OPEN IMPLANTATION NEA NEUROMUSCULAR,1676.0,1089.4,1.1,63800.42,144
HCPCS,64580,OPN IMPLTJ NEA NEUROMUSCULAR,,,18354.0,21470.19,20
HCPCS,64580,Opn impltj nea neuromuscular,,,19174.95,22202.58,8
HCPCS,64581,OPEN IMPLANTATION NEA SACRAL NERVE,11808.5,7675.525,1.1,19945.48,223
HCPCS,64582,OPEN IMPLTJ HPGLSL NRV NSTIM RA PG&RESPIR SENSOR,5600.0,3640.0,1.1,90562.75,142
HCPCS,64582,OPN MPLTJ HPGLSL NSTM ARY PG,,,9016.0,81066.43,23
HCPCS,64582,Opn mpltj hpglsl nstm ary pg,,,19174.95,22202.58,8
HCPCS,64583,REV/RPLCT HPGLSL NSTM ARY PG,,,10541.85,12485.31,20
HCPCS,64583,REVJ/RPLCMT HPGLSL NERVE NSTIM RA PG&RESPIR SNR,5800.0,3770.0,1.1,39728.72,142
HCPCS,64584,REMOVAL HYPOGLOSSAL NERVE NSTIM RA PG&RESPIR SNR,4800.0,3120.0,1.1,19428.17,142
HCPCS,64584,RMVL HPGLSL NSTIM ARY PG,,,3231.94,6411.78,20
HCPCS,64584,Rmvl hpglsl nstim ary pg,,,2167.75,2510.02,8
HCPCS,64585,REVJ/RMVL PERIPHERAL NEUROSTIMULATOR ELECTRODE,12286.5,7986.225,0.01,23729.0,322
HCPCS,64590,INS/RPLC PERPH SAC/GSTRC NPG/RCVR PCKT CRTJ&CONN,15068.0,9794.199999999999,0.01,63800.42,235
HCPCS,64590,INSERTION/RPLCMT PERIPHERAL/GASTRIC NPGR,27892.0,18129.8,343.9,27892.0,87
HCPCS,64595,REV/RMV PRPH SAC/GSTRC NPG/RCV DTCH CONN ELTR RA,12622.5,8204.625,0.01,23729.0,322
HCPCS,64596,INS/RPLCMT PRQ ELTRD RA PN 1,,,10541.85,35562.32,21
HCPCS,64596,INSJ/RPLCMT PERQ ELTRD RA PN W/INT NSTIM 1ST RA,2856.0,1856.4,1.1,39728.72,88
HCPCS,64597,INSJ/RPLCMT PERQ ELTRD RA PN INT NSTIM EA ADD RA,2856.0,1856.4,1.1,2856.0,88
HCPCS,64598,REVISION/REMOVAL NSTIM ELTRD ARRAY PN INT NSTIM,1047.0,680.55,1.1,9923.76,88
HCPCS,64598,REVJ/RMVL NEA PN W/INT NSTIM,,,2951.88,8882.81,21
HCPCS,64598,Revj/rmvl nea pn w/int nstim,,,2167.75,2510.02,8
HCPCS,64600,DSTRJ TRIGEMINAL NRV SUPRAORB INFRAORB BRANCH,3769.5,2450.1749999999997,0.01,6143.0,235
HCPCS,64605,DSTR NEUROLYTIC TRIGEMINAL NRV 2/3 DIV BRANCH (64605),13474.0,8758.1,0.01,13474.0,87
HCPCS,64605,DSTRJ NEUROLYTIC TRIGEMINAL NRV 2/3 DIV BRANCH,2260.0,1469.0,1.1,5632.24,148
HCPCS,64610,DSTRJ NEURLYTIC TRIGEM NRV 2/3 DIV RADIO MONITOR,8177.0,5315.05,0.01,13474.0,235
HCPCS,64611,CHEMODENERV PAROTID&SUBMANDIBL SALIVARY GLNDS,2037.0,1324.05,0.01,12500.0,87
HCPCS,64611,CHEMODENERV PAROTID&SUBMANDIBL SALIVARY GLNDS BI,412.0,267.8,1.1,863.2,148
HCPCS,64612,CHEMODNRVTJ MUSC MUSC INNERVATED FACIAL NRV UNIL,1328.5,863.525,0.01,3443.0,235
HCPCS,64615,CHEMODERVATE FACIAL/TRIGEM/CERV MUSC MIGRAINE,1425.5,926.575,0.01,12500.0,322
HCPCS,64616,CHEMODENERVATION MUSCLE NECK UNILAT FOR DYSTONIA,1355.0,880.75,0.01,12500.0,322
HCPCS,64617,CHEMODENERVATION MUSCLE LARYNX UNILAT W/EMG,2807.0,1824.55,0.01,12500.0,235
HCPCS,64620,DSTRJ NEUROLYTIC AGENT INTERCOSTAL NERVE,3707.5,2409.875,0.01,6143.0,235
HCPCS,64624,DESTRUCTION NEUROLYTIC AGT GENICULAR NERVE W/IMG,7237.0,4704.05,0.01,13474.0,496
HCPCS,64625,RADIOFREQUENCY ABLTJ NRV NRVTG SI JT W/IMG GDN,7415.0,4819.75,0.01,13474.0,409
HCPCS,64628,THERMAL DSTRJ INTRAOSSEOUS BVN 1ST 2 LMBR/SAC,23829.5,15489.175,1.1,44799.0,229
HCPCS,64629,THERMAL DSTRJ INTRAOSSEOUS BVN EA ADDL LMBR/SAC,1508.0,980.2,1.1,1508.0,142
HCPCS,64629,Trml dstrj ios bvn ea addl,,,9326.79,10799.44,8
HCPCS,64630,DSTRJ NEUROLYTIC AGENT PUDENDAL NERVE,3742.5,2432.625,0.01,6143.0,322
HCPCS,64632,DEST BY NEUROLYTIC AGENT; PLANTAR COMM DIG NERVE,541.0,351.65,1.1,863.2,148
HCPCS,64632,DSTRJ NEUROLYTIC PLANTAR COMMON DIGITAL NERVE,2037.0,1324.05,0.01,12500.0,87
HCPCS,64633,DSTR NROLYTC AGNT PARVERTEB FCT SNGL CRVCL/THORA,7467.5,4853.875,0.01,13474.0,322
HCPCS,64634,DSTR NROLYTC AGNT PARVERTEB FCT ADDL CRVCL/THORA,747.5,485.875,0.01,4628.0,286
HCPCS,64635,DSTR NROLYTC AGNT PARVERTEB FCT SNGL LMBR/SACRAL,7467.5,4853.875,0.01,13474.0,322
HCPCS,64636,DSTR NROLYTC AGNT PARVERTEB FCT ADDL LMBR/SACRAL,1888.5,1227.525,0.01,4628.0,286
HCPCS,64640,DSTRJ NEUROLYTIC AGENT OTHER PERIPHERAL NERVE,3507.0,2279.5499999999997,0.01,6143.0,235
HCPCS,64642,CHEMODENERVATION ONE EXTREMITY 1-4 MUSCLE,2752.0,1788.8,0.01,12500.0,322
HCPCS,64643,CHEMODENERVATION 1 EXTREMITY EA ADDL 1-4 MUSCLE,1651.5,1073.4750000000001,0.01,4628.0,286
HCPCS,64644,CHEMODENERVATION 1 EXTREMITY 5 OR MORE MUSCLES,2789.5,1813.175,0.01,12500.0,322
HCPCS,64645,CHEMODENERVATION 1 EXTREMITY EA ADDL 5/> MUSCLES,1420.5,923.3249999999999,0.01,4628.0,286
HCPCS,64646,CHEMODENERVATION OF TRUNK MUSCLE 1-5 MUSCLES,2785.0,1810.25,0.01,12500.0,235
HCPCS,64647,CHEMODENERVATION OF TRUNK 6 OR MORE MUSCLES,2811.0,1827.1499999999999,0.01,12500.0,235
HCPCS,64650,CHEMODENERVATION ECCRINE GLANDS BOTH AXILLAE,1158.5,753.025,0.01,3443.0,235
HCPCS,64653,CHEMODENERVATION ECCRINE GLANDS OTH AREA PER DAY,1194.5,776.425,0.01,3443.0,235
HCPCS,64654,INITIAL OPEN IMPLANTATION BAT MODULATION SYSTEM,92421.0,60073.65,1.1,180002.0,183
HCPCS,64655,REVISION/RPLCMT BAT MODULATION SYSTEM LEAD ONLY,9629.5,6259.174999999999,1.1,14287.0,183
HCPCS,64656,REVISION/RPLCMT BAT MODULATION SYSTEM PG ONLY,17525.0,11391.25,1.1,32113.14,183
HCPCS,64657,REMOVAL BAT MODULATION SYSTEM TOTAL SYSTEM,5337.0,3469.05,1.1,5337.0,106
HCPCS,64657,RMVL BAT MODULJ SYS TOT SYS,,,3231.94,3555.13,12
HCPCS,64657,Rmvl bat modulj sys tot sys,,,2167.75,2510.02,8
HCPCS,64658,REMOVAL BAT MODULATION SYSTEM LEAD ONLY,3938.0,2559.7,1.1,3938.0,106
HCPCS,64658,RMVL BAT MODUL SYS LEAD ONLY,,,3307.59,3638.34,12
HCPCS,64658,Rmvl bat modul sys lead only,,,2167.75,2510.02,8
HCPCS,64659,REMOVAL BAT MODULATION SYSTEM PG ONLY,3621.0,2353.65,1.1,3621.0,106
HCPCS,64659,RMVL BAT MODULJ SYS PG ONLY,,,3307.59,3638.34,12
HCPCS,64659,Rmvl bat modulj sys pg only,,,2167.75,2510.02,8
HCPCS,64680,DSTRJ NEUROLYTIC W/WO RAD MONITOR CELIAC PLEXUS,3659.0,2378.35,0.01,6143.0,235
HCPCS,64681,DSTRJ NULYT W/WORAD MNTR SUPRIOR HYPOGSTR PLEXUS,3827.5,2487.875,0.01,6143.0,322
HCPCS,64702,NEUROPLASTY DIGITAL 1/BOTH SAME DIGIT,2504.0,1627.6,1.1,5632.24,144
HCPCS,64702,REVISE FINGER/TOE NERVE,,,1675.06,2032.17,20
HCPCS,64702,Revise finger/toe nerve,,,1090.19,1262.33,8
HCPCS,64704,NEUROPLASTY NERVE HAND/FOOT,1876.0,1219.4,1.1,5632.24,144
HCPCS,64704,REVISE HAND/FOOT NERVE,,,1675.06,2032.17,20
HCPCS,64704,Revise hand/foot nerve,,,1090.19,1262.33,8
HCPCS,64708,NEURP MAJOR PRPH NRV ARM/LEG OPN OTH/THN SPEC,2544.0,1653.6,1.1,5632.24,144
HCPCS,64708,REVISE ARM/LEG NERVE,,,1675.06,6238.0,23
HCPCS,64708,Revise arm/leg nerve,,,1090.19,1262.33,8
HCPCS,64712,NEURP MAJOR PRPH NRV OPN ARM/LEG SCIATIC NRV,3228.0,2098.2,1.1,5632.24,144
HCPCS,64712,REVISION OF SCIATIC NERVE,,,1675.06,6238.0,21
HCPCS,64712,Revision of sciatic nerve,,,3555.79,4117.23,8
HCPCS,64713,NEURP MAJOR PRPH NRV OPN ARM/LEG BRACH PLEXUS,4560.0,2964.0,1.1,5632.24,144
HCPCS,64713,REVISION OF ARM NERVE(S),,,1675.06,2032.17,20
HCPCS,64713,Revision of arm nerve(s),,,3555.79,4117.23,8
HCPCS,64714,NEURP MAJOR PRPH NRV OPN ARM/LEG LMBR PLEXUS,4220.0,2743.0,1.1,5632.24,144
HCPCS,64714,REVISE LOW BACK NERVE(S),,,1675.06,2032.17,20
HCPCS,64714,Revise low back nerve(s),,,3555.79,4117.23,8
HCPCS,64716,NEUROPLASTY &/TRANSPOSITION CRANIAL NERVE,3076.0,1999.4,1.1,5632.24,144
HCPCS,64716,REVISION OF CRANIAL NERVE,,,1675.06,7813.0,21
HCPCS,64716,Revision of cranial nerve,,,3555.79,4117.23,8
HCPCS,64718,NEUROPLASTY &/TRANSPOSITION ULNAR NERVE ELBOW,2904.0,1887.6,1.1,5632.24,144
HCPCS,64718,REVISE ULNAR NERVE AT ELBOW,,,1675.06,6238.0,23
HCPCS,64718,Revise ulnar nerve at elbow,,,1090.19,1262.33,8
HCPCS,64719,NEUROPLASTY &/TRANSPOSITION ULNAR NERVE WRIST,1988.0,1292.2,1.1,5632.24,144
HCPCS,64719,REVISE ULNAR NERVE AT WRIST,,,1675.06,2032.17,20
HCPCS,64719,Revise ulnar nerve at wrist,,,1090.19,1262.33,8
HCPCS,64721,NEUROPLASTY &/TRANSPOS MEDIAN NRV CARPAL TUNNE,7731.0,5025.150000000001,0.01,13474.0,235
HCPCS,64722,DECOMPRESSION UNSPEC NERVE,,,1675.06,4392.0,22
HCPCS,64722,DECOMPRESSION UNSPECIFIED NERVE,1928.0,1253.2,1.1,5632.24,144
HCPCS,64722,Decompression unspec nerve,,,1090.19,1262.33,8
HCPCS,64726,DCMPRN PLANTAR DIGITAL NERVE,,,1675.06,2032.17,20
HCPCS,64726,DECOMPRESSION PLANTAR DIGITAL NERVE,1708.0,1110.2,1.1,5632.24,144
HCPCS,64726,Dcmprn plantar digital nerve,,,1090.19,1262.33,8
HCPCS,64727,INTERNAL NEUROLYSIS REQ OPERATING MICROSCOPE,1240.0,806.0,1.1,1240.0,144
HCPCS,64727,Internal neurolysis,,,3555.79,4117.23,8
HCPCS,64728,DCMPRN MEDIAN NRV AT CARPL TUNL PERQ BALO DILAT,1188.0,772.2,1.1,3441.81,106
HCPCS,64728,DCMPRN MEDIAN NRV CARPL TUNL,,,1847.43,2032.17,12
HCPCS,64728,Dcmprn median nrv carpl tunl,,,1090.19,1262.33,8
HCPCS,64732,INCISION OF BROW NERVE,,,1675.06,2032.17,20
HCPCS,64732,Incision of brow nerve,,,1090.19,1262.33,8
HCPCS,64732,TRANSECTION/AVULSION SUPRAORBITAL NERVE,1956.0,1271.4,1.1,5632.24,144
HCPCS,64734,INCISION OF CHEEK NERVE,,,1675.06,2032.17,20
HCPCS,64734,Incision of cheek nerve,,,1090.19,1262.33,8
HCPCS,64734,TRANSECTION/AVULSION INFRAORBITAL NERVE,2220.0,1443.0,1.1,5632.24,144
HCPCS,64736,INCISION OF CHIN NERVE,,,1675.06,2032.17,20
HCPCS,64736,Incision of chin nerve,,,1090.19,1262.33,8
HCPCS,64736,TRANSECT OR AVULSE; MENTAL NERVE,2092.0,1359.8,1.1,5632.24,144
HCPCS,64738,INCISION OF JAW NERVE,,,1675.06,2032.17,20
HCPCS,64738,Incision of jaw nerve,,,1090.19,1262.33,8
HCPCS,64738,TRANSECTION/AVULSION INF ALVEOLAR NRV W/OSTEO,2544.0,1653.6,1.1,5632.24,144
HCPCS,64740,INCISION OF TONGUE NERVE,,,1675.06,2032.17,20
HCPCS,64740,Incision of tongue nerve,,,1090.19,1262.33,8
HCPCS,64740,TRANSECTION/AVULSION LINGUAL NERVE,2488.0,1617.2,1.1,5632.24,144
HCPCS,64742,INCISION OF FACIAL NERVE,,,1675.06,2032.17,20
HCPCS,64742,Incision of facial nerve,,,1090.19,1262.33,8
HCPCS,64742,TRANSECTION/AVULSION FACIAL NRV DIFFERENT/CMPL,2740.0,1781.0,1.1,5632.24,144
HCPCS,64744,INCISE NERVE BACK OF HEAD,,,1675.06,2032.17,20
HCPCS,64744,Incise nerve back of head,,,3555.79,4117.23,8
HCPCS,64744,TRANSECTION/AVULSION GREATER OCCIPITAL NERVE,2288.0,1487.2,1.1,5632.24,144
HCPCS,64746,INCISE DIAPHRAGM NERVE,,,1675.06,2032.17,20
HCPCS,64746,Incise diaphragm nerve,,,3555.79,4117.23,8
HCPCS,64746,TRANSECTION/AVULSION PHRENIC NERVE,2624.0,1705.6,1.1,5632.24,144
HCPCS,64755,INCISION OF STOMACH NERVES,,,2427.39,2427.39,1
HCPCS,64755,Incision of stomach nerves,,,2029.97,2350.49,8
HCPCS,64755,TRANSECTION/AVULSION VAGUS NERVES,6020.0,3913.0,1.1,6020.0,144
HCPCS,64760,INCISION OF VAGUS NERVE,,,1370.9,1370.9,1
HCPCS,64760,Incision of vagus nerve,,,2029.97,2350.49,8
HCPCS,64760,TRANSECTION/AVULSION VAGUS NERVE ABDOMINAL,3036.0,1973.4,1.1,3036.0,144
HCPCS,64763,INCISE HIP/THIGH NERVE,,,1675.06,5040.59,21
HCPCS,64763,Incise hip/thigh nerve,,,1090.19,1262.33,8
HCPCS,64766,INCISE HIP/THIGH NERVE,,,1675.06,5040.59,21
HCPCS,64766,Incise hip/thigh nerve,,,1090.19,1262.33,8
HCPCS,64771,SEVER CRANIAL NERVE,,,1675.06,2032.17,20
HCPCS,64771,Sever cranial nerve,,,3555.79,4117.23,8
HCPCS,64771,TRANSECTION/AVULSION OTH CRANIAL NRV XDRL,3260.0,2119.0,1.1,5632.24,144
HCPCS,64772,INCISION OF SPINAL NERVE,,,1675.06,6238.0,23
HCPCS,64772,Incision of spinal nerve,,,1090.19,1262.33,8
HCPCS,64772,LAPAROSCOPIC NEURECTOMY (COMP CODE 64772),3332.0,2165.8,1.1,5632.24,144
HCPCS,64772,TRANSECTION/AVULSION OTH SPINAL NRV XDRL,3136.0,2038.4,1.1,5632.24,144
HCPCS,64774,EXC NEUROMA CUTAN NRV SURGLY IDENTIFIABLE,7897.0,5133.05,1.1,13474.0,231
HCPCS,64776,EXC NEUROMA DIGITAL NERVE 1 OR BOTH SAME DIGIT,2240.0,1456.0,1.1,5632.24,144
HCPCS,64776,REMOVE DIGIT NERVE LESION,,,1675.06,2032.17,20
HCPCS,64776,Remove digit nerve lesion,,,1090.19,1262.33,8
HCPCS,64778,Digit nerve surgery add-on,,,1090.19,1262.33,8
HCPCS,64778,"EXCISE DIGITAL NEUROMA,ADDNL DIGIT",1244.0,808.6,1.1,1244.0,144
HCPCS,64782,EXC NEUROMA HAND/FOOT XCP DIGITAL NERVE,2744.0,1783.6,1.1,5632.24,144
HCPCS,64782,REMOVE LIMB NERVE LESION,,,1675.06,2032.17,20
HCPCS,64782,Remove limb nerve lesion,,,1090.19,1262.33,8
HCPCS,64783,EXC NEUROMA HAND/FOOT EA NRV XCP SM DGT,1484.0,964.6,1.1,1484.0,144
HCPCS,64783,Limb nerve surgery add-on,,,1090.19,1262.33,8
HCPCS,64784,EXC NEUROMA MAJOR PERIPHERAL NRV XCP SCIATIC,4248.0,2761.2,1.1,5632.24,144
HCPCS,64784,REMOVE NERVE LESION,,,1675.06,7813.0,21
HCPCS,64784,Remove nerve lesion,,,1090.19,1262.33,8
HCPCS,64786,EXCISE SCIATIC NERVE NEUROMA,6500.0,4225.0,1.1,19428.17,144
HCPCS,64786,REMOVE SCIATIC NERVE LESION,,,3231.94,6411.78,20
HCPCS,64786,Remove sciatic nerve lesion,,,3555.79,4117.23,8
HCPCS,64787,IMPLANT NERVE END TO BONE/MUSC,1716.0,1115.4,1.1,1716.0,144
HCPCS,64787,Implant nerve end,,,3555.79,4117.23,8
HCPCS,64788,EXC NEUROFIBROMA/NEUROLEMMOMA CUTAN NRV,2096.0,1362.4,1.1,5632.24,144
HCPCS,64788,REMOVE SKIN NERVE LESION,,,1675.06,7813.0,22
HCPCS,64788,Remove skin nerve lesion,,,1090.19,1262.33,8
HCPCS,64790,EXC NEUROFIBROMA/NEUROLEMMOMA MAJOR PRPH NRV,4840.0,3146.0,1.1,5632.24,144
HCPCS,64790,REMOVAL OF NERVE LESION,,,1675.06,5597.0,21
HCPCS,64790,Removal of nerve lesion,,,3555.79,4117.23,8
HCPCS,64792,EXC NEUROFIBROMA/NEUROLEMMOMA EXTNSV,6344.0,4123.6,1.1,19428.17,144
HCPCS,64792,REMOVAL OF NERVE LESION,,,3231.94,6411.78,20
HCPCS,64792,Removal of nerve lesion,,,3555.79,4117.23,8
HCPCS,64795,BIOPSY OF NERVE,1204.0,782.6,1.1,5632.24,165
HCPCS,64795,Biopsy of nerve,,,1090.19,1262.33,8
HCPCS,64802,SYMPATHECTOMY CERVICAL,,,1675.06,2032.17,20
HCPCS,64802,"SYMPATHECTOMY,CERVICAL",4148.0,2696.2,1.1,5632.24,144
HCPCS,64802,Sympathectomy cervical,,,1090.19,1262.33,8
HCPCS,64804,SYMPATHECTOMY CERVICOTHORAC,,,1675.06,5040.59,21
HCPCS,64804,"SYMPATHECTOMY,CERVICOTHORACIC",6364.0,4136.6,1.1,6364.0,144
HCPCS,64804,Sympathectomy cervicothorac,,,3555.79,4117.23,8
HCPCS,64809,SYMPATHECTOMY THORACOLUMBAR,,,2911.09,2911.09,1
HCPCS,64809,"SYMPATHECTOMY,THORACOLUMBAR",5884.0,3824.6,1.1,5884.0,144
HCPCS,64809,Sympathectomy thoracolumbar,,,3555.79,4117.23,8
HCPCS,64818,SYMPATHECTOMY LUMBAR,,,2038.45,2038.45,1
HCPCS,64818,"SYMPATHECTOMY,LUMBAR",4536.0,2948.4,1.1,4536.0,144
HCPCS,64818,Sympathectomy lumbar,,,3555.79,4117.23,8
HCPCS,64820,SYMPATHECTOMY DIGITAL ARTERY,,,1675.06,5040.59,21
HCPCS,64820,"SYMPATHECTOMY,DIGITAL ARTERIES",4296.0,2792.4,1.1,5632.24,144
HCPCS,64820,Sympathectomy digital artery,,,1090.19,1262.33,8
HCPCS,64821,SYMPATHECTOMY RADIAL ARTERY,3732.0,2425.8,1.1,9440.12,164
HCPCS,64821,Sympathectomy radial artery,,,1090.19,1262.33,8
HCPCS,64822,SYMPATHECTOMY ULNAR ARTERY,3732.0,2425.8,1.1,9440.12,165
HCPCS,64822,Sympathectomy ulnar artery,,,1090.19,1262.33,8
HCPCS,64823,SYMPATHECTOMY SUPERFICIAL PALMAR ARCH,4376.0,2844.4,1.1,9440.12,144
HCPCS,64823,SYMPATHECTOMY SUPFC PALMAR,,,2808.13,8450.24,21
HCPCS,64823,Sympathectomy supfc palmar,,,1090.19,1262.33,8
HCPCS,64831,REPAIR OF DIGIT NERVE,,,1675.06,10789.0,22
HCPCS,64831,Repair of digit nerve,,,1090.19,1262.33,8
HCPCS,64831,SUTURE DIGITAL NERVE HAND/FOOT 1 NERVE,3664.0,2381.6,1.1,5632.24,144
HCPCS,64832,Repair nerve add-on,,,3555.79,4117.23,8
HCPCS,64832,SUTR DIGITAL NRV HAND/FOOT EA DGTAL NRV,2260.0,1469.0,1.1,2260.0,144
HCPCS,64834,REPAIR OF HAND OR FOOT NERVE,,,3231.94,6411.78,20
HCPCS,64834,Repair of hand or foot nerve,,,3555.79,4117.23,8
HCPCS,64834,SUTURE 1 NERVE HAND/FOOT COMMON SENSORY NERVE,4324.0,2810.6,1.1,19428.17,144
HCPCS,64835,REPAIR OF HAND OR FOOT NERVE,,,3231.94,6411.78,20
HCPCS,64835,Repair of hand or foot nerve,,,3555.79,4117.23,8
HCPCS,64835,SUTURE 1 NERVE MEDIAN MOTOR THENAR,5161.0,3354.65,1.1,19428.17,144
HCPCS,64836,REPAIR OF HAND OR FOOT NERVE,,,3231.94,6411.78,20
HCPCS,64836,Repair of hand or foot nerve,,,3555.79,4117.23,8
HCPCS,64836,SUTURE 1 NERVE ULNAR MOTOR,4692.0,3049.8,1.1,19428.17,144
HCPCS,64837,Repair nerve add-on,,,3555.79,4117.23,8
HCPCS,64837,SUTURE EACH ADDITIONAL NERVE HAND/FOOT,2500.0,1625.0,1.1,2500.0,144
HCPCS,64840,REPAIR OF LEG NERVE,,,5779.17,9132.89,20
HCPCS,64840,Repair of leg nerve,,,3555.79,4117.23,8
HCPCS,64840,SUTURE POSTERIOR TIBIAL NERVE,5608.0,3645.2,1.1,19428.17,144
HCPCS,64856,REPAIR/TRANSPOSE NERVE,,,5779.17,9132.89,20
HCPCS,64856,Repair/transpose nerve,,,3555.79,4117.23,8
HCPCS,64856,SUTR PRPH NRV ARM/LEG XCP SCIATIC W/TRPOS,6028.0,3918.2,1.1,19428.17,144
HCPCS,64857,REPAIR ARM/LEG NERVE,,,3231.94,6411.78,20
HCPCS,64857,Repair arm/leg nerve,,,3555.79,4117.23,8
HCPCS,64857,SUTR PRPH NRV ARM/LEG XCP SCIATIC W/O TRPOS,6328.0,4113.2,1.1,19428.17,144
HCPCS,64858,REPAIR SCIATIC NERVE,,,1675.06,2032.17,20
HCPCS,64858,Repair sciatic nerve,,,3555.79,4117.23,8
HCPCS,64858,SUTURE SCIATIC NERVE,7128.0,4633.2,1.1,7128.0,144
HCPCS,64859,Nerve surgery,,,3555.79,4117.23,8
HCPCS,64859,SUTURE EACH ADDITIONAL PERIPHERAL NERVE,1700.0,1105.0,1.1,1700.0,144
HCPCS,64861,REPAIR OF ARM NERVES,,,1675.06,2032.17,20
HCPCS,64861,Repair of arm nerves,,,3555.79,4117.23,8
HCPCS,64861,SUTURE BRACHIAL PLEXUS,8356.0,5431.4,1.1,8356.0,144
HCPCS,64862,REPAIR OF LOW BACK NERVES,,,3231.94,6411.78,20
HCPCS,64862,Repair of low back nerves,,,3555.79,4117.23,8
HCPCS,64862,SUTURE LUMBAR PLEXUS,8436.0,5483.4,1.1,19428.17,144
HCPCS,64864,REPAIR OF FACIAL NERVE,,,5779.17,9132.89,20
HCPCS,64864,Repair of facial nerve,,,3555.79,4117.23,8
HCPCS,64864,SUTURE FACIAL NERVE EXTRACRANIAL,5900.0,3835.0,1.1,19428.17,144
HCPCS,64865,REPAIR OF FACIAL NERVE,,,3231.94,6411.78,20
HCPCS,64865,Repair of facial nerve,,,3555.79,4117.23,8
HCPCS,64865,SUTURE FACIAL NERVE INFRATEMPORAL W/WO GRAFT,6436.0,4183.4,1.1,19428.17,144
HCPCS,64866,ANAST FACIAL-SPINAL ACCESS,6732.0,4375.8,1.1,6732.0,144
HCPCS,64866,FUSION OF FACIAL/OTHER NERVE,,,3214.76,3214.76,1
HCPCS,64866,Fusion of facial/other nerve,,,3555.79,4117.23,8
HCPCS,64868,ANAST FACIAL-HYPOGLOSSAL NERVE,5960.0,3874.0,1.1,5960.0,144
HCPCS,64868,FUSION OF FACIAL/OTHER NERVE,,,2586.59,2586.59,1
HCPCS,64868,Fusion of facial/other nerve,,,3555.79,4117.23,8
HCPCS,64872,"REPR NERVE,SECONDARY/DELAY",796.0,517.4,1.1,796.0,144
HCPCS,64872,Subsequent repair of nerve,,,3555.79,4117.23,8
HCPCS,64874,"REPR/TRANSPOSE NERVE,SECONADARY",1192.0,774.8,1.1,1192.0,144
HCPCS,64874,Repair & revise nerve add-on,,,3555.79,4117.23,8
HCPCS,64876,Repair nerve/shorten bone,,,3555.79,4117.23,8
HCPCS,64885,NERVE GRAFT HEAD/NECK <4 CM,,,5779.17,9132.89,20
HCPCS,64885,"NERVE GRAFT,HEAD/NECK,ONE,=<4CM",7040.0,4576.0,1.1,19428.17,144
HCPCS,64885,Nerve graft head/neck <4 cm,,,3555.79,4117.23,8
HCPCS,64886,NERVE GRAFT HEAD/NECK >4 CM,,,3528.0,9132.89,23
HCPCS,64886,"NERVE GRAFT,HEAD/NECK,ONE,>4CM",8328.0,5413.2,1.1,19428.17,144
HCPCS,64886,Nerve graft head/neck >4 cm,,,3555.79,4117.23,8
HCPCS,64890,"NERVE GRAFT,HAND/FOOT,ONE,=<4CM",6496.0,4222.4,1.1,19428.17,144
HCPCS,64890,NRV GRF 1STRND HND/FOOT <4CM,,,5779.17,9132.89,20
HCPCS,64890,Nrv grf 1strnd hnd/foot <4cm,,,3555.79,4117.23,8
HCPCS,64891,NRV GRF 1STRND HND/FOOT >4CM,,,5779.17,9132.89,20
HCPCS,64891,Nrv grf 1strnd hnd/foot >4cm,,,3555.79,4117.23,8
HCPCS,64892,"NERVE GRAFT,ARM/LEG,ONE,UP TO 4CM",6296.0,4092.4,1.1,19428.17,144
HCPCS,64892,NRV GRF 1STRND ARM/LEG <4CM,,,5779.17,9132.89,20
HCPCS,64892,Nrv grf 1strnd arm/leg <4cm,,,3555.79,4117.23,8
HCPCS,64893,"NERVE GRAFT,ARM/LEG,ONE,>4CM",6748.0,4386.2,1.1,19428.17,144
HCPCS,64893,NRV GRF 1STRND ARM/LEG >4 CM,,,3231.94,6411.78,20
HCPCS,64893,Nrv grf 1strnd arm/leg >4 cm,,,3555.79,4117.23,8
HCPCS,64895,NRV GR MUL HND/FT TO 4 CM,8156.0,5301.4,1.1,19428.17,144
HCPCS,64895,NRV GRF MLTST HND/FOOT <4 CM,,,5779.17,9132.89,20
HCPCS,64895,Nrv grf mltst hnd/foot <4 cm,,,3555.79,4117.23,8
HCPCS,64896,NERVE GRAFT MULT STR HND/FT; > 4CM,8784.0,5709.6,1.1,19428.17,144
HCPCS,64896,NRV GRF MLTST HND/FOOT >4 CM,,,5779.17,9132.89,20
HCPCS,64896,Nrv grf mltst hnd/foot >4 cm,,,3555.79,4117.23,8
HCPCS,64897,"NERV GRFT,ARM/LEG,MULT,=<4CM",7752.0,5038.8,1.1,19428.17,144
HCPCS,64897,NRV GRF MLTST ARM/LEG <4 CM,,,5779.17,9132.89,20
HCPCS,64897,Nrv grf mltst arm/leg <4 cm,,,3555.79,4117.23,8
HCPCS,64898,NERVE GRAFT MULTI STR ARM/LEG; > 4 CM,8388.0,5452.2,1.1,19428.17,144
HCPCS,64898,NRV GRF MLTST ARM/LEG >4 CM,,,5779.17,9132.89,20
HCPCS,64898,Nrv grf mltst arm/leg >4 cm,,,3555.79,4117.23,8
HCPCS,64901,"ADDNL NERVE GRAFT,SINGLE STRAND",4080.0,2652.0,1.1,4080.0,144
HCPCS,64901,Nerve graft add-on,,,3555.79,4117.23,8
HCPCS,64902,"ADDNL NERVE GRAFT,MULTPL STRANDS",4724.0,3070.6,1.1,4724.0,144
HCPCS,64902,Nerve graft add-on,,,3555.79,4117.23,8
HCPCS,64905,NERVE PEDICLE TRANSFER,,,5779.17,9132.89,20
HCPCS,64905,"NERVE PEDICLE XFER,FIRST STAGE",6044.0,3928.6,1.1,19428.17,144
HCPCS,64905,Nerve pedicle transfer,,,3555.79,4117.23,8
HCPCS,64907,NERVE PEDICLE TRANSFER,,,5779.17,9132.89,20
HCPCS,64907,"NERVE PEDICLE XFER,SECOND STAGE",8012.0,5207.8,1.1,19428.17,144
HCPCS,64907,Nerve pedicle transfer,,,3555.79,4117.23,8
HCPCS,64910,NERVE REPAIR W/ALLOGRAFT,,,5779.17,17390.7,21
HCPCS,64910,NERVE REPAIR W/CONDUIT EACH NERVE,4629.0,3008.85,1.1,19428.17,144
HCPCS,64910,Nerve repair w/allograft,,,3555.79,4117.23,8
HCPCS,64911,NERVE REPAIR W/AUTOGENOUS VEIN GRAFT EA NERVE,5600.0,3640.0,1.1,19428.17,144
HCPCS,64911,NEURORRAPHY W/VEIN AUTOGRAFT,,,5779.17,17390.7,21
HCPCS,64911,Neurorraphy w/vein autograft,,,3555.79,4117.23,8
HCPCS,64912,NERVE REPAIR W/NERVE ALLOGRAFT FIRST STRAND,4800.0,3120.0,1.1,19428.17,144
HCPCS,64912,NRV RPR W/NRV ALGRFT 1ST,,,5779.17,9132.89,21
HCPCS,64912,Nrv rpr w/nrv algrft 1st,,,3555.79,4117.23,8
HCPCS,64913,NERVE REPAIR W/NERVE ALLOGRAFT EA ADDL STRAND,1200.0,780.0,1.1,1200.0,144
HCPCS,64913,Nrv rpr w/nrv algrft ea addl,,,3555.79,4117.23,8
HCPCS,64999,ANTER CRANFAC RESECT W ENDOS ASSIS (COMP 61601),21664.0,14081.6,0.01,21664.0,82
HCPCS,64999,ANTER CRANFAC RESECT W/ENDOS ASSIS (COMP CODE 61580),14951.0,9718.15,0.01,14951.0,82
HCPCS,64999,AUTOLITT PROCEDURE W/O BIOPSY,12718.0,8266.7,0.01,12718.0,82
HCPCS,64999,BILAT  PUDENDAL NRV PULSED RF ABLATION,860.0,559.0,239.08,4628.0,84
HCPCS,64999,BLOCK BIER EXTREMITY LOWER,518.0,336.7,0.01,3443.0,85
HCPCS,64999,BLOCK CERVICAL PLEXUS,659.0,428.35,183.2,4628.0,84
HCPCS,64999,BOTOX INJECTION INTO PERIVASCULAR TISSUE (CODE 64644),601.0,390.65,0.01,863.2,82
HCPCS,64999,BOTOX INJECTION INTO PERIVASCULAR TISSUE (COMP 64644),4270.0,2775.5,0.01,4270.0,85
HCPCS,64999,"CHEMODENERVATION ECCRINE GLANDS, PALM/FOOT (COMP 64650)",281.0,182.65,0.01,863.2,82
HCPCS,64999,CONTINUOUS CATHETER TAP BLOCK,597.0,388.05,0.01,863.2,82
HCPCS,64999,CORE NEEDLE BX INTRACRAN,515.0,334.75,0.01,863.2,82
HCPCS,64999,DESTR PULSED RAD FREQ ABLATION OF PUDENAL NERVE/BILAT,975.0,633.75,0.01,3443.0,85
HCPCS,64999,DESTR RFA/SACROILIAC JOINT/BILAT/COOL METHOD,975.0,633.75,0.01,3443.0,85
HCPCS,64999,"DSTR NRLYTC AGNT OTHER PERIPH NER/BRNCH, LOW THERM <80* (COMP CO",851.0,553.15,0.01,863.2,82
HCPCS,64999,"DSTR NRLYTC AGNT PARAVERT FCT EA ADDT CERV/THOR, LOW THERM <80*",436.0,283.4,0.01,863.2,82
HCPCS,64999,"DSTR NRLYTC AGNT PARAVERT FCT EA ADDT LUMB/SACRAL, LOW THERM <80",383.0,248.95,0.01,863.2,82
HCPCS,64999,"DSTR NRLYTC AGNT PARAVERT FCT SNG LUMB/SACRAL, LOW THERM <80* (C",1247.0,810.55,0.01,1247.0,82
HCPCS,64999,"DSTR NRLYTC AGNT PARAVERT FCT SNGL CERV/THOR, LOW THERM <80* (CO",1267.0,823.55,0.01,1267.0,82
HCPCS,64999,EDAM,9883.0,6423.95,0.01,9883.0,82
HCPCS,64999,EDAS (ENCEPHALO DURO ARTERIO SYNAGIOSIS),5030.0,3269.5,0.01,5030.0,82
HCPCS,64999,EMS ENCEPHALOMYOSYNANGIOSIS,4941.0,3211.65,0.01,4941.0,82
HCPCS,64999,"ENDO ENDONASAL, RESECTN ORB TUMOR; COMPLEX (COMP 61333-22)",12073.75,7847.94,0.01,12073.75,82
HCPCS,64999,"ENDOS RESCT SKULL BASE MALIG,PTERGOMAX",23930.0,15554.5,0.01,23930.0,82
HCPCS,64999,ENDOS RESCT TRANSNASAL SKULL BASE TMR,23930.0,15554.5,0.01,23930.0,82
HCPCS,64999,ENDOS TRANSNASAL INTRACRANIAL BIOPSY,8570.0,5570.5,0.01,8570.0,82
HCPCS,64999,ENDOS TRANSNASAL INTRACRANIAL BIOPSY (COMP CODE 61570),8570.0,5570.5,0.01,8570.0,82
HCPCS,64999,ENDOSCOPIC BURR HOLE/TREPHINE W DRAIN OF BRAIN ABSCESS OR CYST (,6204.0,4032.6,0.01,6204.0,82
HCPCS,64999,ENDOSCOPIC ENDONASAL APPROACH FOR RESECTION OF ORBITAL TUMOR (CO,9659.0,6278.35,0.01,9659.0,82
HCPCS,64999,"ERECTOR SPINAE BLOCKAGE, RIGHT T7 UNDER FLUOROSCOPIC GUIDANCE (C",753.0,489.45,0.01,863.2,82
HCPCS,64999,EXTERNAL VENTRICULAR CATH,1235.0,802.75,0.01,1235.0,82
HCPCS,64999,EXTERNAL VENTRICULAR CATH (COMP CODE 61107),1235.0,802.75,0.01,1235.0,82
HCPCS,64999,FIDUCIAL MARKER PLACEMENT,1798.0,1168.7,0.01,1798.0,82
HCPCS,64999,GANGLION IMPAR BLOCK INJ,419.0,272.35,0.01,863.2,82
HCPCS,64999,GANGLION OF IMPAR BLOCKADE UNDER FLUOROSCOPIC GUIDANCE (COMP COD,171.0,111.15,0.01,863.2,82
HCPCS,64999,IMPAR GANGLION COCCYGEAL NEUROLYSIS (COMP CODE 64680),3659.0,2378.35,0.01,6143.0,166
HCPCS,64999,INJ ANESTHETIC AGENT PHRENIC NERVE BIL,1194.0,776.1,256.95,4628.0,84
HCPCS,64999,INJ ANESTHETIC AGENT PHRENIC NERVE UNIL,597.0,388.05,165.97,4628.0,84
HCPCS,64999,"INJ, ANESTHETIC AGENT; CERVICAL PLEXUS (COMP 64425)",578.0,375.7,0.01,863.2,82
HCPCS,64999,LAP PLACEMENT OF VP SHUNT,3478.0,2260.7,0.01,3478.0,82
HCPCS,64999,LARYNGEAL REINNERVATION USING CERVICAL NERVE BRANCHES (COMP CODE,6059.0,3938.35,0.01,6059.0,82
HCPCS,64999,LASER INTERSTITIAL THERMAL THERAPY(LITT,13543.0,8802.95,0.01,13543.0,82
HCPCS,64999,MASSETER NRV TO FAC NRV ANASTOMOSIS (COMP 64865),4917.0,3196.05,0.01,4917.0,82
HCPCS,64999,MIDDLE CRANFAC RESECT W/ENDO ASSIST (COMP 61608),26416.0,17170.4,0.01,26416.0,82
HCPCS,64999,NERVE WRAPPING (COMP CODE 15271),646.0,419.9,0.01,863.2,82
HCPCS,64999,NEUROENDO REPAIR CSF LEAK,11909.0,7740.85,0.01,11909.0,82
HCPCS,64999,NEUROENDO REPAIR CSF LEAK (COMP CODE 31291),5518.0,3586.7,0.01,5518.0,82
HCPCS,64999,NEUROENDO REPAIR OF SKULL BASE ENCEPHALOCELE; UNILAT (COMP 62121,7600.0,4940.0,0.01,7600.0,82
HCPCS,64999,"NEUROENDO REPR, SKULL BASE ENCEPHALOCELE; BIL (COMP 62121-50)",15200.0,9880.0,0.01,15200.0,82
HCPCS,64999,NEUROENDOSCOPY INTRACRANIAL WITH SELLAR RECONSTRUCTION,9688.0,6297.2,0.01,9688.0,82
HCPCS,64999,"NEUROENDOSCOPY, EXPLORATORY/BIOPSY W/O EXCISION OF PITUITARY TUM",7119.0,4627.35,0.01,7119.0,82
HCPCS,64999,PARS BLOCK INJECTION,502.0,326.3,0.01,863.2,82
HCPCS,64999,PARS INTERARTICULARIS INJ,1022.0,664.3,256.95,4628.0,84
HCPCS,64999,PECS 1 & PECS 2 UNILAT CONTINUOUS INFUSION CATH (COMP CODE 64487,629.0,408.85,0.01,863.2,82
HCPCS,64999,PECTO-INTERCOSTAL NERVE BLOCK (COMP 64450),2418.0,1571.7,0.01,4628.0,166
HCPCS,64999,PERCUTANEOUS GASSERIAN BALLOON DECOMPRESSION (COMP 64605),1855.0,1205.75,0.01,1855.0,82
HCPCS,64999,POST-OPERATIVE INTERCOSTAL NERVE BLOCK (COMP 64809),4854.0,3155.1,0.01,4854.0,82
HCPCS,64999,"PULSED RF LUMB/SACR, 1ST LEVEL",1388.0,902.2,0.01,1388.0,82
HCPCS,64999,PULSED RF POPLITEAL NERVE,708.0,460.2,0.01,3443.0,85
HCPCS,64999,QUTENZA APPLICATION (COMP 64632),1117.5,726.375,0.01,3443.0,167
HCPCS,64999,REMOVAL OF OMMAYA RESERVOIR,1627.0,1057.55,0.01,1627.0,82
HCPCS,64999,REMOVAL OF SEEG ELECTRODES,4340.0,2821.0,0.01,4340.0,82
HCPCS,64999,"RFA OTHER (ROOT GANGLION, JOINT, ETC)",864.0,561.6,0.01,864.0,82
HCPCS,64999,SACRAL FUSE W/INSTR S1/S2,9280.0,6032.0,0.01,9280.0,82
HCPCS,64999,SPINAL ACCESSORY NERVE BLOCK (COMP CODE 64405),1225.5,796.575,0.01,4628.0,166
HCPCS,64999,SPINAL HARDWARE INJECTION (COMP CODE 64493),646.0,419.9,0.01,863.2,82
HCPCS,64999,SPINAL HARDWARE INJECTION 1 LEVEL,502.0,326.3,0.01,863.2,82
HCPCS,64999,SUBTEMP SKULLBASE MID & POST FOSSA TMR (61616),28895.0,18781.75,0.01,28895.0,82
HCPCS,64999,TRANSMASTOID RPR ENCEPH BY TISS GRFT,6131.0,3985.15,0.01,6131.0,82
HCPCS,64999,TRANSPALATAL APPROACH FOR REMOVAL OF FOREIGN BODY (61575),14624.0,9505.6,0.01,14624.0,82
HCPCS,64999,TRIGEMINAL BALLOON COMPRESSION,2565.5,1667.575,0.01,4628.0,166
HCPCS,64999,"UNLIST PROC, NERVOUS SYSTEM COMPARED TO 64640",1637.5,1064.375,0.01,3443.0,167
HCPCS,64999,UNLISTED LAP ILIOINGUINAL AND GENITOFEMORAL NEURECTOMY (COMP COD,3332.0,2165.8,0.01,3332.0,82
HCPCS,64999,UNLISTED LAPAROSCOPIC PUDENDAL NERVE DECOMPRESSION (COMP CODE 64,4220.0,2743.0,0.01,4220.0,82
HCPCS,64999,"UNLISTED PROC, INJECTION, ANESTHETIC AGENT, CERVICAL PLEXUS (COM",488.0,317.2,0.01,863.2,82
HCPCS,64999,UNLISTED PROCEDURE NERVOUS SYSTEM,12718.0,8266.7,0.01,12718.0,82
HCPCS,64999,"UNLISTED PROCEDURE, NERVOUS",268.0,174.2,0.01,3443.0,85
HCPCS,65091,EVISCERATION OCULAR CONTENTS W/O IMPLANT,2904.0,1887.6,1.1,11276.72,144
HCPCS,65091,REVISE EYE,,,3354.3,4091.35,20
HCPCS,65091,Revise eye,,,2122.76,2457.93,8
HCPCS,65093,EVISCERATION OCULAR CONTENTS W/IMPLANT,2816.0,1830.4,1.1,11276.72,144
HCPCS,65093,REVISE EYE WITH IMPLANT,,,3354.3,4091.35,20
HCPCS,65093,Revise eye with implant,,,2122.76,2457.93,8
HCPCS,65101,ENUCLEATION OF EYE W/O IMPLANT,3320.0,2158.0,1.1,11276.72,144
HCPCS,65101,REMOVAL OF EYE,,,3354.3,4091.35,20
HCPCS,65101,Removal of eye,,,2122.76,2457.93,8
HCPCS,65103,ENUCLEATION EYE IMPLT MUSC X ATTACHED IMPLT,3536.0,2298.4,1.1,11276.72,144
HCPCS,65103,REMOVE EYE/INSERT IMPLANT,,,3354.3,4091.35,20
HCPCS,65103,Remove eye/insert implant,,,2122.76,2457.93,8
HCPCS,65105,ENUCLEATION EYE IMPLT MUSC ATTACHED IMPLT,4369.0,2839.85,1.1,11276.72,144
HCPCS,65105,REMOVE EYE/ATTACH IMPLANT,,,3354.3,7778.0,22
HCPCS,65105,Remove eye/attach implant,,,2122.76,2457.93,8
HCPCS,65110,EXENTERATION ORBIT REMVL ORBITAL CONTENTS ONLY,6280.0,4082.0,1.1,11276.72,144
HCPCS,65110,REMOVAL OF EYE,,,3354.3,4091.35,20
HCPCS,65110,Removal of eye,,,2122.76,2457.93,8
HCPCS,65112,EXENTERATION ORBIT RMVL ORBIT CONTENTS & BONE,7404.0,4812.6,1.1,11276.72,144
HCPCS,65112,REMOVE EYE/REVISE SOCKET,,,3354.3,4091.35,20
HCPCS,65112,Remove eye/revise socket,,,2122.76,2457.93,8
HCPCS,65114,EXNTJ ORBIT RMVL ORB CNTS W/MUSC/MYOQ FLAP,7860.0,5109.0,1.1,11276.72,144
HCPCS,65114,REMOVE EYE/REVISE SOCKET,,,3354.3,4091.35,20
HCPCS,65114,Remove eye/revise socket,,,2122.76,2457.93,8
HCPCS,65125,MODIFICAJ OC IMPLT W/PLMT/RPLCMT PEGS SPX,1308.0,850.2,1.1,6813.79,148
HCPCS,65125,REVISE OCULAR IMPLANT,,,2027.3,2474.21,20
HCPCS,65125,Revise ocular implant,,,2122.76,2457.93,8
HCPCS,65130,INSERT OCULAR IMPLANT,,,3354.3,4091.35,20
HCPCS,65130,INSJ OC IMPLT SEC AFTER EVSC SCLL SHELL,3368.0,2189.2,1.1,11276.72,144
HCPCS,65130,Insert ocular implant,,,2122.76,2457.93,8
HCPCS,65135,INSERT OCULAR IMPLANT,,,3354.3,4091.35,20
HCPCS,65135,Insert ocular implant,,,2122.76,2457.93,8
HCPCS,65140,ATTACH OCULAR IMPLANT,,,3354.3,4091.35,20
HCPCS,65140,Attach ocular implant,,,2122.76,2457.93,8
HCPCS,65140,INSJ OC IMPLT AFTER ENCL MUSC ATTACHED,3784.0,2459.6,1.1,11276.72,144
HCPCS,65150,REINSERTION OCULAR IMPLT W/WO CONJUNCTIVAL GRAFT,2572.0,1671.8,1.1,11276.72,144
HCPCS,65150,REVISE OCULAR IMPLANT,,,3354.3,4091.35,20
HCPCS,65150,Revise ocular implant,,,2122.76,2457.93,8
HCPCS,65155,REINSERT OCULAR IMPLANT,,,3354.3,4091.35,20
HCPCS,65155,REINSERTION OCULAR IMPLT RNFCMT &/ ATTACH MUSCLE,4040.0,2626.0,1.1,11276.72,144
HCPCS,65155,Reinsert ocular implant,,,2122.76,2457.93,8
HCPCS,65175,REMOVAL OF OCULAR IMPLANT,2960.0,1924.0,1.1,11276.72,164
HCPCS,65175,Removal of ocular implant,,,2122.76,2457.93,8
HCPCS,65205,REMOVAL FB EYE CONJUNCTIVAL SUPERFICIAL,404.5,262.925,0.01,12500.0,403
HCPCS,65210,RMVL FB XTRNL EYE EMBED SCJNCL/SCLERAL NONPERFOR,1052.0,683.8000000000001,0.01,12500.0,321
HCPCS,65220,RMVL FB XTRNL EYE CORNEAL W/O SLIT LAMP,1074.0,698.1,0.01,12500.0,407
HCPCS,65222,RMVL FB XTRNL EYE CORNEAL W/SLIT LAMP,481.5,312.975,0.01,12500.0,321
HCPCS,65235,RMVL FB INTRAOCULAR ANT CHAMBER EYE/LENS,7047.5,4580.875,1.1,10491.0,231
HCPCS,65260,REMOVE FOREIGN BODY FROM EYE,,,2021.72,2401.72,20
HCPCS,65260,RMVL FB IO FROM POST SEG MAG XTRJ ANT/POST ROUTE,5016.0,3260.4,1.1,6795.42,144
HCPCS,65260,Remove foreign body from eye,,,402.04,465.52,8
HCPCS,65265,REMOVE FOREIGN BODY FROM EYE,,,2021.72,2401.72,20
HCPCS,65265,RMVL FB IO FROM POST SEG NONMAGNETIC XTRJ,5736.0,3728.4,1.1,6795.42,144
HCPCS,65265,Remove foreign body from eye,,,402.04,465.52,8
HCPCS,65270,RPR LAC CJNC W/WO NONPERFOR LAC SCLERA DIR CLSR,5756.0,3741.4,0.01,10732.0,235
HCPCS,65272,RPR LAC CJNC MOBLJ& REARGMT W/O HOSPITALIZATION,6290.0,4088.5,0.01,10732.0,235
HCPCS,65273,REPAIR OF EYE WOUND,,,966.73,966.73,1
HCPCS,65273,Repair of eye wound,,,1153.81,1335.99,8
HCPCS,65275,REPAIR OF EYE WOUND,,,3354.3,4091.35,20
HCPCS,65275,RPR LAC CORNEA NONPERFOR W/WO RMVL FOREIGN BODY,2516.0,1635.4,1.1,11276.72,148
HCPCS,65275,Repair of eye wound,,,2774.75,3212.87,8
HCPCS,65280,REPAIR OF EYE WOUND,,,4534.31,10789.0,21
HCPCS,65280,RPR LAC CORNEA&/SCLERA PERFOR X INVG UVEAL TIS,3640.0,2366.0,1.1,15243.78,144
HCPCS,65280,Repair of eye wound,,,2774.75,3212.87,8
HCPCS,65285,REPAIR OF EYE WOUND,,,4534.31,5537.8,20
HCPCS,65285,RPR LAC CORN&/SCLRA PERF W/REPOS/RESCJ UVEAL T,6144.0,3993.6,1.1,15243.78,144
HCPCS,65285,Repair of eye wound,,,2774.75,3212.87,8
HCPCS,65286,RPR LAC APPL TISSUE GLUE WOUND CORNEA&/SCLERA,6571.5,4271.474999999999,0.01,10491.0,235
HCPCS,65290,REPAIR OF EYE SOCKET WOUND,,,3354.3,4091.35,20
HCPCS,65290,RPR WND EXTRAOCULAR MUSCLE TENDON&/TENON CAPSU,2612.0,1697.8,1.1,11276.72,144
HCPCS,65290,Repair of eye socket wound,,,2122.76,2457.93,8
HCPCS,65400,EXCISION LESION CORNEA XCP PTERYGIUM,3727.5,2422.875,0.01,4455.0,235
HCPCS,65410,BIOPSY OF CORNEA,588.0,382.2,1.1,6813.79,168
HCPCS,65410,Biopsy of cornea,,,318.36,368.63,8
HCPCS,65420,EXCISION/TRANSPOSITION PTERYGIUM W/O GRAFT,1744.0,1133.6,1.1,6813.79,148
HCPCS,65420,REMOVAL OF EYE LESION,,,2027.3,4315.0,21
HCPCS,65420,Removal of eye lesion,,,318.36,368.63,8
HCPCS,65426,EXCISION/TRANSPOSITION PTERYGIUM W/GRAFG,2420.0,1573.0,1.1,6813.79,148
HCPCS,65426,REMOVAL OF EYE LESION,,,2027.3,13821.0,23
HCPCS,65426,Removal of eye lesion,,,2774.75,3212.87,8
HCPCS,65430,CORNEA SCRAPING DIAGNOSTIC SMEAR &/CULTURE,1212.0,787.8000000000001,0.01,12500.0,235
HCPCS,65435,RMVL CORNEAL EPITHELIUM W/WO CHEMOCAUTERIZATION,2411.5,1567.475,0.01,4455.0,321
HCPCS,65436,RMVL CORNEAL EPITHELIUM W/APPL CHELATING AGENT,6330.0,4114.5,0.01,12500.0,235
HCPCS,65450,DSTRJ LESION CRYOTHER PHOTO/THERMOCAUTZATION,1388.0,902.2,1.1,1388.0,148
HCPCS,65450,TREATMENT OF CORNEAL LESION,,,252.73,760.51,21
HCPCS,65450,Treatment of corneal lesion,,,318.36,368.63,8
HCPCS,65600,MULT PUNC ANTER CORNEA,1680.0,1092.0,1.1,6813.79,148
HCPCS,65600,MULTIPLE PUNCTURES ANTERIOR CORNEA,10732.0,6975.8,0.01,10732.0,87
HCPCS,65710,CORNEAL TRANSPLANT,,,4534.31,5537.8,20
HCPCS,65710,Corneal transplant,,,2774.75,3212.87,8
HCPCS,65710,KERATOPLASTY ANTERIOR LAMELLAR,5780.0,3757.0,1.1,15243.78,144
HCPCS,65730,CORNEAL TRANSPLANT,,,3527.34,11545.0,21
HCPCS,65730,Corneal transplant,,,2774.75,3212.87,8
HCPCS,65730,KERATOPLASTY PENTRG EXCEPT APHAKIA/PSEUDOPHAKIA,7194.0,4676.1,1.1,11858.31,144
HCPCS,65750,CORNEAL TRANSPLANT,,,4534.31,11545.0,22
HCPCS,65750,Corneal transplant,,,2774.75,3212.87,8
HCPCS,65750,KERATOPLASTY PENETRAING APHAKIA,6760.0,4394.0,1.1,15243.78,144
HCPCS,65755,CORNEAL TRANSPLANT,,,3527.34,8702.0,21
HCPCS,65755,Corneal transplant,,,2774.75,3212.87,8
HCPCS,65755,KERATOPLASTY PENETRATING PSEUDOPHAKIA,6716.0,4365.4,1.1,11858.31,144
HCPCS,65756,CORNEAL TRNSPL ENDOTHELIAL,,,3527.34,25635.0,23
HCPCS,65756,Corneal trnspl endothelial,,,2774.75,3212.87,8
HCPCS,65756,KERATOPLASTY ENDOTHELIAL,7410.0,4816.5,1.1,11858.31,144
HCPCS,65757,BACKBENCH PREPJ CORNEAL ENDOTHELIAL ALLOGRAFT,1284.0,834.6,1.1,1816.12,104
HCPCS,65757,Prep corneal endo allograft,,,2774.75,3212.87,8
HCPCS,65760,KERATOMILEUSIS,,,3253.75,3253.75,1
HCPCS,65760,Keratomileusis,,,318.36,368.63,8
HCPCS,65765,KERATOPHAKIA,,,3253.75,3253.75,1
HCPCS,65765,Keratophakia,,,318.36,368.63,8
HCPCS,65767,EPIKERATOPLASTY,,,3018.38,3018.38,1
HCPCS,65767,Epikeratoplasty,,,318.36,368.63,8
HCPCS,65770,KERATOPROSTHESIS,7896.0,5132.4,1.1,36156.53,164
HCPCS,65770,Keratoprosthesis,,,2774.75,3212.87,8
HCPCS,65771,RADIAL KERATOTOMY,,,3253.75,3253.75,1
HCPCS,65771,Radial keratotomy,,,318.36,368.63,8
HCPCS,65772,CRNL RELAXING INC CORRJ INDUCED ASTIGMATISM,3245.5,2109.575,0.01,10789.0,235
HCPCS,65775,CORRECTION OF ASTIGMATISM,,,2027.3,2474.21,20
HCPCS,65775,CRNL WEDGE RESCJ CORRJ INDUCED ASTIGMATISM,2764.0,1796.6,1.1,6813.79,144
HCPCS,65775,Correction of astigmatism,,,318.36,368.63,8
HCPCS,65778,PLACE AMNIOTIC MEMB OCULAR SURFACE SELF RETAIN,2904.0,1887.6,1.1,4797.44,148
HCPCS,65778,PLACE AMNIOTIC MEMBRA OCULAR SURFACE W/O SUTURES,2395.5,1557.075,0.01,13821.0,235
HCPCS,65779,PLACE AMNIOTIC MEMBRANE OCULAR SURFACE SUTURED,9023.5,5865.275,0.01,17347.0,235
HCPCS,65780,OCULAR RECONST TRANSPLANT,,,3354.3,4091.35,20
HCPCS,65780,OCULAR SURFACE RECONSTRUCTION AMNIOTIC MEMBRANE,2812.0,1827.8,1.1,11276.72,144
HCPCS,65780,Ocular reconst transplant,,,2774.75,3212.87,8
HCPCS,65781,OCULAR RECONST TRANSPLANT,,,4534.31,5537.8,20
HCPCS,65781,OCULAR SURFACE RECONSTRUCTION LIMBAL ALLOGRAFT,7256.0,4716.4,1.1,15243.78,144
HCPCS,65781,Ocular reconst transplant,,,2774.75,3212.87,8
HCPCS,65782,OCCULAR SURFACE RECONSTRUCTION LIMBAL AUTOGRAFT,6172.0,4011.8,1.1,11276.72,144
HCPCS,65782,OCULAR RECONST TRANSPLANT,,,3354.3,4091.35,20
HCPCS,65782,Ocular reconst transplant,,,2774.75,3212.87,8
HCPCS,65785,IMPLANTATION INTRASTROMAL CORNEAL RING SEGMENTS,10438.5,6785.025,0.01,18505.0,235
HCPCS,65800,PARACENTSIS ANT CHAMB EYE ASPIR AQUEOUS SPX,5582.0,3628.2999999999997,0.01,10491.0,322
HCPCS,65810,DRAINAGE OF EYE,,,2021.72,2401.72,20
HCPCS,65810,Drainage of eye,,,381.15,441.33,8
HCPCS,65810,PARACENTSIS ANT CHAM RMVL VITREOUS W/WO AIR INJX,2328.0,1513.2,1.1,6795.42,144
HCPCS,65815,PARACEN ANT CHAM RMVL BLOOD W/WO IRRIG&/AIR IN,6445.5,4189.575,0.01,10491.0,235
HCPCS,65820,GONIOTOMY,3920.0,2548.0,1.1,11858.31,168
HCPCS,65820,Goniotomy,,,381.15,441.33,8
HCPCS,65850,TRABECULOTOMY AB EXTERNO,4556.0,2961.4,1.1,6795.42,165
HCPCS,65850,Trabeculotomy ab externo,,,2420.84,2803.08,8
HCPCS,65855,TRABECULOPLASTY BY LASER SURGERY,1922.0,1249.3,0.01,4392.0,235
HCPCS,65860,SEVERING ADHESIONS ANTERIOR SEGMENT LASER SPX,1980.0,1287.0,0.01,7966.0,235
HCPCS,65865,INCISE INNER EYE ADHESIONS,,,2021.72,2401.72,20
HCPCS,65865,Incise inner eye adhesions,,,381.15,441.33,8
HCPCS,65865,SEVERING ADS ANT SEG INCAL TQ SPX GONIOSYNECHIAE,2308.0,1500.2,1.1,6795.42,144
HCPCS,65870,INCISE INNER EYE ADHESIONS,,,2021.72,10789.0,21
HCPCS,65870,Incise inner eye adhesions,,,381.15,441.33,8
HCPCS,65870,SEVERING ADS ANT SEG INCAL SPX ANT SYNECHIAE,2956.0,1921.4,1.1,6795.42,144
HCPCS,65875,INCISE INNER EYE ADHESIONS,,,2021.72,4315.0,21
HCPCS,65875,Incise inner eye adhesions,,,381.15,441.33,8
HCPCS,65875,SEVERING ADS ANT SEG INCAL SPX POST SYNECHIAE,3124.0,2030.6,1.1,6795.42,144
HCPCS,65880,INCISE INNER EYE ADHESIONS,,,3527.34,4301.59,20
HCPCS,65880,Incise inner eye adhesions,,,2420.84,2803.08,8
HCPCS,65900,RMVL EPITHELIAL DOWNGROWTH ANT CHAMBER EYE,7747.5,5035.875,0.01,13821.0,231
HCPCS,65920,RMVL IMPLANTED MATERIAL ANTERIO SEGMENT EYE,7243.5,4708.275,0.01,25635.0,231
HCPCS,65930,REMOVE BLOOD CLOT FROM EYE,,,2021.72,2401.72,20
HCPCS,65930,RMVL BLOOD CLOT ANTERIOR SEGMENT EYE,3356.0,2181.4,1.1,6795.42,144
HCPCS,65930,Remove blood clot from eye,,,381.15,441.33,8
HCPCS,66020,"INJECT ANTER CHMBR EYE,AIR/FLUID",656.0,426.4,1.1,6795.42,148
HCPCS,66020,INJX ANTERIOR CHAMBER EYE AIR/LIQUID SPX,10491.0,6819.15,0.01,10491.0,87
HCPCS,66030,"INJECT ANTER CHMBR EYE,MEDICATN",520.0,338.0,1.1,6795.42,148
HCPCS,66030,INJX ANTERIOR CHAMBER EYE MEDICATION SPX,10491.0,6819.15,0.01,10491.0,87
HCPCS,66130,REMOVE EYE LESION,,,2027.3,2474.21,20
HCPCS,66130,"REMOVE EYE LESION,SCLERA",3132.0,2035.8,1.1,6813.79,148
HCPCS,66130,Remove eye lesion,,,381.15,441.33,8
HCPCS,66150,GLAUCOMA SURGERY,,,3527.34,4301.59,20
HCPCS,66150,Glaucoma surgery,,,2420.84,2803.08,8
HCPCS,66155,GLAUCOMA SURGERY,,,3527.34,4301.59,20
HCPCS,66155,Glaucoma surgery,,,2420.84,2803.08,8
HCPCS,66160,FSTLJ SCLERA SCLERECTOMY PUNCH/SCISSORS IRIDECT,5452.0,3543.8,1.1,6795.42,144
HCPCS,66160,GLAUCOMA SURGERY,,,2021.72,2401.72,20
HCPCS,66160,Glaucoma surgery,,,2420.84,2803.08,8
HCPCS,66170,FSTLJ SCLERA GLAUCOMA TRABECULECT AB EXTERNO,5576.0,3624.4,1.1,6795.42,144
HCPCS,66170,GLAUCOMA SURGERY,,,2021.72,10789.0,22
HCPCS,66170,Glaucoma surgery,,,2420.84,2803.08,8
HCPCS,66172,FSTLJ SCLERA GLC TRBEC AB EXTERNO SCARRING,5936.0,3858.4,1.1,6795.42,144
HCPCS,66172,INCISION OF EYE,,,2021.72,2401.72,20
HCPCS,66172,Incision of eye,,,2420.84,2803.08,8
HCPCS,66174,TRLUML DIL AQ O/F CAN W/O ST,,,3527.34,33436.0,24
HCPCS,66174,TRLUML DILAT AQUEOUS O/F CAN WO RETENTION DEV/ST,3353.0,2179.45,1.1,11858.31,142
HCPCS,66174,Trluml dil aq o/f can w/o st,,,2420.84,2803.08,8
HCPCS,66175,TRLUML DIL AQ O/F CAN W/ST,,,4534.31,5537.8,20
HCPCS,66175,TRLUML DILAT AQUEOUS O/F CAN W/RETENTION DEV/ST,3736.0,2428.4,1.1,15243.78,142
HCPCS,66175,Trluml dil aq o/f can w/st,,,2420.84,2803.08,8
HCPCS,66179,AQUEOUS SHUNT EXTRAOCULAR RESERVOIR W/O GRAFT,5600.0,3640.0,1.1,15243.78,144
HCPCS,66179,AQUEOUS SHUNT EYE W/O GRAFT,,,4534.31,13644.65,21
HCPCS,66179,Aqueous shunt eye w/o graft,,,2420.84,2803.08,8
HCPCS,66180,AQUEOUS SHUNT EXTRAOC EQUAT PLATE RSVR W/GRAFT,6600.0,4290.0,1.1,11858.31,144
HCPCS,66180,AQUEOUS SHUNT EYE W/GRAFT,,,3527.34,13821.0,24
HCPCS,66180,Aqueous shunt eye w/graft,,,2420.84,2803.08,8
HCPCS,66183,INSERT ANT DRAINAGE DEVICE,,,3527.34,4301.59,20
HCPCS,66183,INSERT ANTER DRAINAGE DEV W/O EXTRAOC RESERVOIR,5808.0,3775.2,1.1,11858.31,142
HCPCS,66183,Insert ant drainage device,,,2420.84,2803.08,8
HCPCS,66184,REVISION OF AQUEOUS SHUNT,,,2021.72,6083.76,22
HCPCS,66184,REVJ SHUNT EXTRAOCULAR RESERVOIR W/O GRAFT,3832.0,2490.8,1.1,6795.42,144
HCPCS,66184,Revision of aqueous shunt,,,381.15,441.33,8
HCPCS,66185,REVISE AQUEOUS SHUNT EYE,,,2021.72,6238.0,21
HCPCS,66185,REVJ AQUEOUS SHUNT EXTRAOCULAR RESERVOIR W/GRAFT,4232.0,2750.8,1.1,6795.42,144
HCPCS,66185,Revise aqueous shunt eye,,,381.15,441.33,8
HCPCS,66225,REPAIR SCLERA STAPHYLOMA W GRAFT,5052.0,3283.8,1.1,15243.78,144
HCPCS,66225,REPAIR/GRAFT EYE LESION,,,4534.31,5537.8,20
HCPCS,66225,Repair/graft eye lesion,,,2420.84,2803.08,8
HCPCS,66250,REVJ/RPR OPRATIVE WOUND ANTERIOR SEGMENT,6786.0,4410.9,0.01,10732.0,235
HCPCS,66500,INCISION OF IRIS,,,2021.72,4315.0,21
HCPCS,66500,IRIDOTOMY STAB INC SPX XCP TRANSFIXION,1532.0,995.8,1.1,6795.42,144
HCPCS,66500,Incision of iris,,,381.15,441.33,8
HCPCS,66505,INCISION OF IRIS,,,2021.72,2401.72,20
HCPCS,66505,IRIDOTOMY STAB INC SPX TRANSFIXION,1688.0,1097.2,1.1,6795.42,144
HCPCS,66505,Incision of iris,,,381.15,441.33,8
HCPCS,66600,IRDEC CRNLSCLRL/CRNL SCTJ RMVL LES,4048.0,2631.2,1.1,11858.31,144
HCPCS,66600,REMOVE IRIS AND LESION,,,3527.34,4301.59,20
HCPCS,66600,Remove iris and lesion,,,2420.84,2803.08,8
HCPCS,66605,IRDEC CRNLSCLRL/CRNL SCTJ CYCLECTOMY,5688.0,3697.2,1.1,6795.42,144
HCPCS,66605,REMOVAL OF IRIS,,,2021.72,2401.72,20
HCPCS,66605,Removal of iris,,,2420.84,2803.08,8
HCPCS,66625,IRDEC CRNLSCLRL/CRNL SCTJ PRPH GLC SPX,2120.0,1378.0,1.1,6795.42,144
HCPCS,66625,REMOVAL OF IRIS,,,2021.72,2401.72,20
HCPCS,66625,Removal of iris,,,381.15,441.33,8
HCPCS,66630,IRDEC CRNLSCLRL/CRNL SCTJ SECTOR GLC SPX,2912.0,1892.8,1.1,6795.42,144
HCPCS,66630,REMOVAL OF IRIS,,,2021.72,2401.72,20
HCPCS,66630,Removal of iris,,,381.15,441.33,8
HCPCS,66635,IRDEC CRNLSCLRL/CRNL SCTJ OPTICAL SPX,2948.0,1916.2,1.1,6795.42,144
HCPCS,66635,REMOVAL OF IRIS,,,2021.72,2401.72,20
HCPCS,66635,Removal of iris,,,381.15,441.33,8
HCPCS,66680,REPAIR IRIS & CILIARY BODY,,,2021.72,2401.72,20
HCPCS,66680,REPAIR IRIS/CILIARY BODY,3188.0,2072.2,1.1,6795.42,144
HCPCS,66680,Repair iris & ciliary body,,,381.15,441.33,8
HCPCS,66682,REPAIR IRIS & CILIARY BODY,,,2021.72,2401.72,20
HCPCS,66682,Repair iris & ciliary body,,,381.15,441.33,8
HCPCS,66682,SUTURE IRIS CILIARY BODY SPX RETRIEVAL SUTURE,3496.0,2272.4,1.1,6795.42,144
HCPCS,66683,IMPLANTATION IRIS PROSTHESIS,,,15218.7,17130.53,19
HCPCS,66683,IMPLTJ IRIS PROSTHESIS W/SUTR FIXJ&RPR/RMVL IRIS,4695.0,3051.75,1.1,4695.0,140
HCPCS,66683,Implantation iris prosthesis,,,2420.84,2803.08,8
HCPCS,66700,CILIARY BODY DESTRUCTION DIATHERMY,2056.0,1336.4,1.1,6795.42,148
HCPCS,66700,DESTRUCTION CILIARY BODY,,,2021.72,2401.72,20
HCPCS,66700,Destruction ciliary body,,,381.15,441.33,8
HCPCS,66710,CILIARY BODY DSTRJ CYCLOPHOTOCOAG TRANSSCERAL,6394.0,4156.1,0.01,10732.0,235
HCPCS,66711,ECP CILIARY BODY DESTRUCTION,,,2021.72,2401.72,20
HCPCS,66711,ECP CILIARY BODY DSTRJ W/O RMVL CRYSTALLINE LENS,2248.0,1461.2,1.1,6795.42,144
HCPCS,66711,Ecp ciliary body destruction,,,381.15,441.33,8
HCPCS,66720,CILIARY BODY DESTRUCTION CRYOTHERAPY,1900.0,1235.0,1.1,6813.79,148
HCPCS,66720,DESTRUCTION CILIARY BODY,,,2027.3,2474.21,20
HCPCS,66720,Destruction ciliary body,,,381.15,441.33,8
HCPCS,66740,CILIARY BODY DESTRUCTION CYCLODIALYSIS,2056.0,1336.4,1.1,6813.79,148
HCPCS,66740,DESTRUCTION CILIARY BODY,,,2027.3,4315.0,21
HCPCS,66740,Destruction ciliary body,,,381.15,441.33,8
HCPCS,66761,IRIDOTOMY/IRIDECTOMY BY LASER,1320.0,858.0,1.1,1695.79,148
HCPCS,66761,IRIDOTOMY/IRRIDECTOMY LASER SURG PER SESSION,2524.0,1640.6,0.01,7813.0,87
HCPCS,66762,IRIDOPLASTY PHOTOCOAGULATION 1/> SESSIONS,2338.0,1519.6999999999998,0.01,3443.0,235
HCPCS,66770,DSTRJ CYST/LESION IRIS/CILIARY BODY,2452.0,1593.8,1.1,2452.0,148
HCPCS,66770,REMOVAL OF INNER EYE LESION,,,504.28,1517.49,21
HCPCS,66770,Removal of inner eye lesion,,,381.15,441.33,8
HCPCS,66820,"DISCISSION,2ND CATARACT,INCIS",1604.0,1042.6,1.1,6795.42,144
HCPCS,66820,INCISION SECONDARY CATARACT,,,2021.72,6083.76,21
HCPCS,66820,Incision secondary cataract,,,318.36,368.63,8
HCPCS,66821,POST-CATARACT LASER SURGERY,2014.5,1309.425,0.01,5265.0,235
HCPCS,66825,REPOSITION INTRAOCULAR LENS,,,2021.72,6238.0,21
HCPCS,66825,REPOSITIONING IO LENS PROSTHESIS REQ INC SPX,3604.0,2342.6,1.1,6795.42,144
HCPCS,66825,Reposition intraocular lens,,,1320.08,1528.52,8
HCPCS,66830,RMVL SEC MEMBRANOUS CTRC CORNEO-SCLL SCTJ,7139.5,4640.674999999999,0.01,10789.0,231
HCPCS,66840,REMOVAL OF LENS MATERIAL,,,2021.72,10789.0,22
HCPCS,66840,RMVL LENS MATERIAL ASPIR TQ 1/> STAGES,3672.0,2386.8,1.1,6795.42,144
HCPCS,66840,Removal of lens material,,,1320.08,1528.52,8
HCPCS,66850,REMOVAL OF LENS MATERIAL,,,2021.72,4315.0,21
HCPCS,66850,RMVL LENS MATERIAL PHACOFRAGMENTATION ASPIR,4220.0,2743.0,1.1,6795.42,144
HCPCS,66850,Removal of lens material,,,1320.08,1528.52,8
HCPCS,66852,REMOVAL OF LENS MATERIAL,,,3527.34,9509.0,21
HCPCS,66852,RMVL LENS MATERIAL PARS PLANA W/WO VITRECTOMY,4564.0,2966.6,1.1,11858.31,144
HCPCS,66852,Removal of lens material,,,1320.08,1528.52,8
HCPCS,66920,EXTRACTION OF LENS,,,2021.72,4315.0,21
HCPCS,66920,Extraction of lens,,,1320.08,1528.52,8
HCPCS,66920,RMVL LENS MATERIAL INTRACAPSULAR,4052.0,2633.8,1.1,6795.42,144
HCPCS,66930,EXTRACTION OF LENS,,,3527.34,8326.0,21
HCPCS,66930,Extraction of lens,,,1320.08,1528.52,8
HCPCS,66930,REMOVAL LENS MATRL INTRACAPSULAR DISLOCATED LENS,4644.0,3018.6,1.1,11858.31,144
HCPCS,66940,EXTRACTION OF LENS,,,2021.72,4315.0,21
HCPCS,66940,Extraction of lens,,,1320.08,1528.52,8
HCPCS,66940,REMOVAL LENS MATERIAL EXTRACAPSULAR,4148.0,2696.2,1.1,6795.42,144
HCPCS,66982,XCAPSL CTRC RMVL CPLX WO ECP,,,2021.72,26192.0,24
HCPCS,66982,XCAPSL CTRC RMVL INSJ IO LENS PROSTH CPLX WO ECP,4510.0,2931.5,1.1,6795.42,144
HCPCS,66982,Xcapsl ctrc rmvl cplx wo ecp,,,1320.08,1528.52,8
HCPCS,66983,CATARACT SURG W/IOL 1 STAGE,,,2021.72,2401.72,20
HCPCS,66983,Cataract surg w/iol 1 stage,,,1320.08,1528.52,8
HCPCS,66983,ICAPSULAR CATARACT XTRJ INSJ IO LENS PRSTH 1 STG,4416.0,2870.4,1.1,6795.42,106
HCPCS,66984,XCAPSL CTRC RMVL INSJ IO LENS PROSTH W/O ECP,3234.0,2102.1,1.1,6795.42,144
HCPCS,66984,XCAPSL CTRC RMVL W/O ECP,,,2021.72,26192.0,25
HCPCS,66984,Xcapsl ctrc rmvl w/o ecp,,,1320.08,1528.52,8
HCPCS,66985,INSERT LENS PROSTHESIS,,,2021.72,17833.0,22
HCPCS,66985,INSJ IO LENS PROSTHESIS NOT W/CONCURRENT RMVL,4391.0,2854.15,1.1,6795.42,144
HCPCS,66985,Insert lens prosthesis,,,1320.08,1528.52,8
HCPCS,66986,EXCHANGE INTRAOCULAR LENS,4904.0,3187.6,1.1,6795.42,144
HCPCS,66986,EXCHANGE LENS PROSTHESIS,,,2021.72,17833.0,22
HCPCS,66986,Exchange lens prosthesis,,,1320.08,1528.52,8
HCPCS,66987,XCAPSL CTRC RMVL CPLX W/ECP,,,3527.34,4301.59,20
HCPCS,66987,Xcapsl ctrc rmvl cplx w/ecp,,,1320.08,1528.52,8
HCPCS,66988,XCAPSL CTRC RMVL W/ECP,,,3527.34,4301.59,20
HCPCS,66988,Xcapsl ctrc rmvl w/ecp,,,1320.08,1528.52,8
HCPCS,66989,XCAPSL CTRC RMVL INSJ IO LENS PRSTH CPLX INSJ 1+,14293.5,9290.775,1.1,23735.0,228
HCPCS,66990,Ophthalmic endoscope add-on,,,405.62,469.67,8
HCPCS,66991,XCAPSL CTRC RMVL INSJ IO LENS PROSTH INSJ 1+,13898.0,9033.7,1.1,23735.0,228
HCPCS,66999,AMNIOTIC MEMBRANE W/GLUE,1295.0,841.75,0.01,6795.42,84
HCPCS,66999,ASA ENHANCEMENT 1-2 YEAR,250.0,162.5,0.01,6795.42,84
HCPCS,66999,ASA ENHANCEMENT 2-3 YEAR,1000.0,650.0,0.01,6795.42,84
HCPCS,66999,BIOPSY CILIARY BODY OR IRIS BIOPSY,485.0,315.25,0.01,6795.42,84
HCPCS,66999,"DESTRUCTION ANTERIOR SEGMENT LESION, RADIATION IMPLANT",6719.0,4367.35,0.01,6795.42,84
HCPCS,66999,"EYE SURGERY PROCEDURE, ANT SEGMENT",2928.0,1903.2,0.01,6795.42,84
HCPCS,66999,FEMTOSECOND LASER,1000.0,650.0,0.01,6795.42,84
HCPCS,66999,FEMTOSECOND LASER W/PRESBYOPIA TREATMENT,500.0,325.0,0.01,6795.42,84
HCPCS,66999,FLAP LIFT W/TISSEEL GLUE,1760.0,1144.0,0.01,6795.42,169
HCPCS,66999,FLAP LIFT W/WO SUTURE,1785.0,1160.25,0.01,6795.42,169
HCPCS,66999,IMPLANTATION CORNEAL RING SEGMENTS,5282.0,3433.3,0.01,6795.42,84
HCPCS,66999,INTACS/TERMED/ USE CPT 65875,5445.0,3539.25,0.01,6795.42,84
HCPCS,66999,INTRALASE LASER INCISION/PER EYE,200.0,130.0,0.01,6795.42,84
HCPCS,66999,INTRASTROMAL INJ OF MITOMYCIN-C (COMP CODE 66030),5072.5,3297.125,0.01,9592.0,169
HCPCS,66999,"LASER ASSISTED CORRECTION OF ASTIGMATISM, STANDARD LENS",1900.0,1235.0,0.01,6795.42,84
HCPCS,66999,"LASER ASSISTED CORRECTION OF ASTIGMATISM, TORIC LENS",500.0,325.0,0.01,6795.42,84
HCPCS,66999,LASER CORREC OF ASTIG,1200.0,780.0,0.01,6795.42,84
HCPCS,66999,LASIK,2260.5,1469.325,0.01,6795.42,169
HCPCS,66999,LASIK CUSTOM,2675.0,1738.75,0.01,6795.42,84
HCPCS,66999,LASIK ENHANCEMENT 1-2 YEARS,250.0,162.5,0.01,6795.42,84
HCPCS,66999,LASIK ENHANCEMENT 2-3 YEARS,1000.0,650.0,0.01,6795.42,84
HCPCS,66999,LASIK ENHANCEMENT 3-5 YEARS,1500.0,975.0,0.01,6795.42,84
HCPCS,66999,LASIK SMILE,2675.0,1738.75,0.01,6795.42,84
HCPCS,66999,LRI/NON-SURGICALLY INDUCED,450.0,292.5,0.01,6795.42,84
HCPCS,66999,PHAKIC ICL,4500.0,2925.0,0.01,6795.42,84
HCPCS,66999,PHOTOTHERAPEUTIC KERATECTOMY,1846.0,1199.9,0.01,3907.82,85
HCPCS,66999,PLACEMENT AMNIOTIC MEMBRANE USING GLUE,1295.0,841.75,0.01,6795.42,84
HCPCS,66999,PRK,2675.0,1738.75,0.01,6795.42,84
HCPCS,66999,REFRACTIVE LENS EXCHANGE,4000.0,2600.0,0.01,6795.42,84
HCPCS,66999,SCLERAL BIOPSY,485.0,315.25,0.01,6795.42,84
HCPCS,66999,UNLISTED PROCEDURE ANT SEG OF EYE,3941.0,2561.65,381.15,3941.0,84
HCPCS,67005,PARTIAL REMOVAL OF EYE FLUID,,,2021.72,7948.0,22
HCPCS,67005,Partial removal of eye fluid,,,402.04,465.52,8
HCPCS,67005,RMVL VITREOUS ANT APPR PARTIAL REMOVAL,2356.0,1531.4,1.1,6795.42,144
HCPCS,67010,PARTIAL REMOVAL OF EYE FLUID,,,2021.72,10789.0,22
HCPCS,67010,Partial removal of eye fluid,,,402.04,465.52,8
HCPCS,67010,RMVL VITREOUS ANT APPR SUBTOT RMVL MECH VITRECT,2824.0,1835.6,1.1,6795.42,144
HCPCS,67015,ASPIRATION/RELEASE VITREOUS SUBRETINAL/CHOROIDAL,6673.5,4337.775,0.01,10491.0,231
HCPCS,67025,INJ SUBSTITUTE PARS PLANA/LIMBL W/WO ASPIR SPX,6867.5,4463.875,0.01,10491.0,235
HCPCS,67027,IMPLTJ INTRAVITREAL DRUG DLVR SYS RMVL VTS,37663.0,24480.949999999997,0.01,70678.0,231
HCPCS,67028,INTRAVITREAL NJX PHARMACOLOGIC AGT SPX,1080.0,702.0,0.01,3443.0,235
HCPCS,67030,INCISE INNER EYE STRANDS,,,2021.72,2401.72,20
HCPCS,67030,Incise inner eye strands,,,402.04,465.52,8
HCPCS,67031,SEVERING VITREOUS STRANS LASER 1/> STAGES,2156.0,1401.4,0.01,5265.0,235
HCPCS,67036,REMOVAL OF INNER EYE FLUID,,,3527.34,10789.0,24
HCPCS,67036,Removal of inner eye fluid,,,2885.13,3340.68,8
HCPCS,67036,VITRECTOMY MECHANICAL PARS PLANA,5337.0,3469.05,1.1,11858.31,144
HCPCS,67039,LASER TREATMENT OF RETINA,,,3527.34,25635.0,22
HCPCS,67039,Laser treatment of retina,,,2885.13,3340.68,8
HCPCS,67039,VITRECTOMY MCHNL PARS PLNA FOCAL ENDOLASER PC,5280.0,3432.0,1.1,11858.31,144
HCPCS,67040,LASER TREATMENT OF RETINA,,,3527.34,25635.0,23
HCPCS,67040,Laser treatment of retina,,,2885.13,3340.68,8
HCPCS,67040,VTRECTOMY MCHNL PARS PLNA ENDOLASER PANRTA PC,5800.0,3770.0,1.1,11858.31,144
HCPCS,67041,VIT FOR MACULAR PUCKER,,,3527.34,4301.59,20
HCPCS,67041,VITRECTOMY PARS PLANA REMOVE PRERETINAL MEMBRANE,7185.0,4670.25,1.1,11858.31,144
HCPCS,67041,Vit for macular pucker,,,2885.13,3340.68,8
HCPCS,67042,VIT FOR MACULAR HOLE,,,3527.34,13821.0,24
HCPCS,67042,VITRECTOMY PARS PLANA REMOVE INT MEMB RETINA,6532.0,4245.8,1.1,11858.31,144
HCPCS,67042,Vit for macular hole,,,2885.13,3340.68,8
HCPCS,67043,VIT FOR MEMBRANE DISSECT,,,3527.34,4301.59,20
HCPCS,67043,VITRECTOMY PARS PLANA REMOVE SUBRETINAL MEMBRANE,6960.0,4524.0,1.1,11858.31,144
HCPCS,67043,Vit for membrane dissect,,,2885.13,3340.68,8
HCPCS,67101,REPAIR DETACHED RETINA CRTX,,,2021.72,6083.76,21
HCPCS,67101,RPR RETINAL DTCHMNT DRG SUBRETINAL FLUID CRTX,1400.0,910.0,1.1,6795.42,148
HCPCS,67101,Repair detached retina crtx,,,2885.13,3340.68,8
HCPCS,67105,REPAIR DETACHED RETINA PC,,,504.28,4132.0,22
HCPCS,67105,RPR RETINAL DTCHMNT DRG SUBRETINAL FLUID PC,1356.0,881.4,1.1,1695.79,148
HCPCS,67105,Repair detached retina pc,,,402.04,465.52,8
HCPCS,67107,REPAIR DETACHED RETINA,,,3527.34,13821.0,24
HCPCS,67107,REPAIR RETINAL DETACHMENT SCLERAL BUCKLING,6400.0,4160.0,1.1,11858.31,144
HCPCS,67107,Repair detached retina,,,2885.13,3340.68,8
HCPCS,67108,REPAIR DETACHED RETINA,,,3527.34,25635.0,24
HCPCS,67108,RPR RETINAL DTCHMNT W/VITRECTOMY ANY METH,7537.0,4899.05,1.1,11858.31,144
HCPCS,67108,Repair detached retina,,,2885.13,3340.68,8
HCPCS,67110,RPR RETINAL DTCHMNT INJECTION AIR/OTHER GAS,7295.5,4742.075,0.01,10491.0,235
HCPCS,67113,REPAIR RETINAL DETACH CPLX,,,4534.31,25635.0,24
HCPCS,67113,RPR COMPLEX RETINA DETACH VITRECT &MEMBRANE PEEL,8360.0,5434.0,1.1,15243.78,144
HCPCS,67113,Repair retinal detach cplx,,,2885.13,3340.68,8
HCPCS,67115,RELEASE ENCIRCLING MATERIAL,,,3527.34,4301.59,20
HCPCS,67115,Release encircling material,,,402.04,465.52,8
HCPCS,67120,REMOVE EYE IMPLANT MATERIAL,,,2021.72,5265.0,21
HCPCS,67120,RMVL IMPLNT MATL POSTERIOR SEGMENT EXTRAOCULAR,2840.0,1846.0,1.1,6795.42,148
HCPCS,67120,Remove eye implant material,,,402.04,465.52,8
HCPCS,67121,REMOVE EYE IMPLANT MATERIAL,,,2021.72,7778.0,23
HCPCS,67121,RMVL IMPLT MATRL POSTERIOR SEGMENT INTRAOCULAR,4900.0,3185.0,1.1,6795.42,144
HCPCS,67121,Remove eye implant material,,,402.04,465.52,8
HCPCS,67141,PROPH RETINAL DTCHMNT W/O DRG CRTX DIATHERMY,1193.5,775.775,0.01,5265.0,235
HCPCS,67145,PROPH RETINAL DTCHMNT W/O DRG PHOTOCOAGULATION,2524.0,1640.6,0.01,5265.0,87
HCPCS,67145,"PROPHYLAXIS RETINA DETACH,PHOTOCOAG",1113.0,723.45,1.1,1787.79,148
HCPCS,67208,DSTRJ LOCLZD LESION RETINA 1/> SESS CRTX DTHRM,3060.0,1989.0,1.1,3060.0,148
HCPCS,67208,TREATMENT OF RETINAL LESION,,,252.73,760.51,21
HCPCS,67208,Treatment of retinal lesion,,,198.21,229.5,8
HCPCS,67210,DSTRJ LOCLZD LESION RETINA 1/> SESS PC,2534.0,1647.1,0.01,10651.0,235
HCPCS,67218,DSTRJ LESION RETINA 1/> SESS RADJ IMPLTJ,8958.0,5822.7,1.1,11276.72,144
HCPCS,67218,TREATMENT OF RETINAL LESION,,,3354.3,13821.0,23
HCPCS,67218,Treatment of retinal lesion,,,2885.13,3340.68,8
HCPCS,67220,DSTRJ LESION CHOROID PC 1/> SESS,2534.0,1647.1,0.01,4392.0,235
HCPCS,67221,DSTRJ LESION CHOROID PHOTODYNAMIC THERAPY,1952.0,1268.8,0.01,3443.0,235
HCPCS,67225,DSTRJ LESION CHOROID PDT 2ND EYE 1 SESSION,188.0,122.2,1.1,188.0,148
HCPCS,67225,Eye photodynamic ther add-on,,,402.04,465.52,8
HCPCS,67227,DESTRUCTION RETINOPATHY CRYOTHERAPY DIATHERMY,1400.0,910.0,1.1,11276.72,148
HCPCS,67227,DSTRJ EXTENSIVE RETINOPATHY,,,3354.3,4091.35,20
HCPCS,67227,Dstrj extensive retinopathy,,,2885.13,3340.68,8
HCPCS,67228,TREATMENT EXTENSIVE RETINOPATHY PHOTOCOAGULATION,2228.0,1448.1999999999998,0.01,5265.0,235
HCPCS,67229,EXTENSIVE RETINOPATHY 1/> SESS PRETERM INFANT,7172.0,4661.8,1.1,7172.0,144
HCPCS,67229,TR RETINAL LES PRETERM INF,,,504.28,572.37,20
HCPCS,67229,Tr retinal les preterm inf,,,402.04,465.52,8
HCPCS,67250,REINFORCE EYE WALL,,,2027.3,2474.21,20
HCPCS,67250,Reinforce eye wall,,,402.04,465.52,8
HCPCS,67250,SCLERAL REINFORCEMENT SPX W/O GRAFT,3844.0,2498.6,1.1,6813.79,144
HCPCS,67255,REINFORCE/GRAFT EYE WALL,,,3527.34,4315.0,21
HCPCS,67255,Reinforce/graft eye wall,,,402.04,465.52,8
HCPCS,67255,SCLERAL REINFORCEMENT SPX W/GRAFT,3352.0,2178.8,1.1,11858.31,144
HCPCS,67299,AUTOLOGOUS RETINAL GRAFT (COMP 67042),6532.0,4245.8,0.01,6795.42,84
HCPCS,67299,CHORIODAL BIOPSY,1468.0,954.2,0.01,6795.42,84
HCPCS,67299,GLOBE EXPLORATION,340.0,221.0,0.01,6795.42,84
HCPCS,67299,UNLISTED PX POSTERIOR SEGMNT,,,2021.72,6083.76,21
HCPCS,67299,Unlisted px posterior segmnt,,,402.04,465.52,8
HCPCS,67311,REVISE EYE MUSCLE,,,2027.3,7813.0,24
HCPCS,67311,Revise eye muscle,,,1936.21,2241.93,8
HCPCS,67311,STRABISMUS RECESSION/RESCJ 1 HRZNTL MUSC,2609.0,1695.85,1.1,6813.79,144
HCPCS,67312,REVISE TWO EYE MUSCLES,,,3354.3,7948.0,23
HCPCS,67312,Revise two eye muscles,,,1936.21,2241.93,8
HCPCS,67312,STRABISMUS RECESSION/RESCJ 2 HRZNTL MUSC,3800.0,2470.0,1.1,11276.72,144
HCPCS,67314,REVISE EYE MUSCLE,,,2027.3,6238.0,22
HCPCS,67314,Revise eye muscle,,,1936.21,2241.93,8
HCPCS,67314,STRABISMUS RECESSION/RESCJ 1 VER MUSC,2609.0,1695.85,1.1,6813.79,144
HCPCS,67316,REVISE TWO EYE MUSCLES,,,2027.3,2474.21,20
HCPCS,67316,Revise two eye muscles,,,1936.21,2241.93,8
HCPCS,67316,STRABISMUS RECESSION/RESCJ 2/MORE VER MUSC,4124.0,2680.6,1.1,6813.79,144
HCPCS,67318,REVISE EYE MUSCLE(S),,,2027.3,2474.21,20
HCPCS,67318,Revise eye muscle(s),,,1936.21,2241.93,8
HCPCS,67318,STRABISMUS ANY SUPERIOR OBLIQUE MUSCLE,3920.0,2548.0,1.1,6813.79,144
HCPCS,67320,Revise eye muscle(s) add-on,,,1936.21,2241.93,8
HCPCS,67320,TRANSPOSITION PROCEDURE EXTRAOCULAR MUSC,1200.0,780.0,1.1,1200.0,144
HCPCS,67331,Eye surgery follow-up add-on,,,1936.21,2241.93,8
HCPCS,67331,"STRABISM SURG,PREV EYE SURG,NOT MUSC",800.0,520.0,1.1,1114.81,144
HCPCS,67332,REREVISE EYE MUSCLES ADD-ON,,,4132.0,10789.0,2
HCPCS,67332,Rerevise eye muscles add-on,,,1936.21,2241.93,8
HCPCS,67332,STRABISMUS SCARRING EO MUSC/RSTCV MYOPATHY,1400.0,910.0,1.1,1400.0,144
HCPCS,67334,Revise eye muscle w/suture,,,1936.21,2241.93,8
HCPCS,67334,STRABISMUS POST FIXJ SUTR TQ W/WO MUSC RECESSION,906.0,588.9,1.1,1100.47,144
HCPCS,67335,Eye suture during surgery,,,1936.21,2241.93,8
HCPCS,67335,PLACEMENT ADJUSTABLE SUTURE STRABISMUS,1292.0,839.8,1.1,1292.0,144
HCPCS,67340,Revise eye muscle add-on,,,1936.21,2241.93,8
HCPCS,67340,STRABISMUS EXPL&/RPR DETACHED EXTROCULAR MUSC,2000.0,1300.0,1.1,2000.0,144
HCPCS,67343,RELEASE EYE TISSUE,,,2027.3,2474.21,20
HCPCS,67343,RLS XTNSV SCAR TISS W/O DETACHING EO MUSC SPX,3388.0,2202.2,1.1,6813.79,144
HCPCS,67343,Release eye tissue,,,1936.21,2241.93,8
HCPCS,67345,CHEMODENERVATION EXTRAOCULAR MUSCLE,1324.0,860.6,1.1,1324.0,148
HCPCS,67345,CHEMODENERVATION EXTRAOCULAR MUSCLE (67345),1375.0,893.75,0.01,3443.0,87
HCPCS,67346,BIOPSY EYE MUSCLE,,,3354.3,4091.35,20
HCPCS,67346,BIOPSY OF EXTRAOCULAR MUSCLE,1148.0,746.2,1.1,11276.72,142
HCPCS,67346,Biopsy eye muscle,,,1936.21,2241.93,8
HCPCS,67399,UNLISTED PX EXTRAOCULAR MUSC,,,252.73,760.51,21
HCPCS,67399,Unlisted px extraocular musc,,,198.21,229.5,8
HCPCS,67400,EXPLORE/BIOPSY EYE SOCKET,,,3354.3,7624.0,21
HCPCS,67400,Explore/biopsy eye socket,,,2122.76,2457.93,8
HCPCS,67400,ORBITTMY W/O BN FLP EXP W W/O BX,4480.0,2912.0,1.1,11276.72,144
HCPCS,67405,EXPLORE/DRAIN EYE SOCKET,,,2027.3,2474.21,20
HCPCS,67405,Explore/drain eye socket,,,2122.76,2457.93,8
HCPCS,67405,ORBITTMY W/O BN FLP;W DRAINAGE,3680.0,2392.0,1.1,6813.79,144
HCPCS,67412,EXPLORE/TREAT EYE SOCKET,,,2027.3,13821.0,22
HCPCS,67412,Explore/treat eye socket,,,2122.76,2457.93,8
HCPCS,67412,ORBITTMY W/O BN FLP W REM LESION,4120.0,2678.0,1.1,6813.79,144
HCPCS,67413,EXPLORE/TREAT EYE SOCKET,,,2027.3,4315.0,21
HCPCS,67413,Explore/treat eye socket,,,2122.76,2457.93,8
HCPCS,67413,ORBITTMY W/O BN FLP W REM FB,4096.0,2662.4,1.1,6813.79,144
HCPCS,67414,EXPLR/DECOMPRESS EYE SOCKET,,,3354.3,4091.35,20
HCPCS,67414,Explr/decompress eye socket,,,2122.76,2457.93,8
HCPCS,67414,ORBITOTOMY W/O BONE FLAP W/RMVL BONE DCMPRN,7176.0,4664.4,1.1,11276.72,144
HCPCS,67415,ASPIRATION ORBITAL CONTENTS,,,2027.3,2474.21,20
HCPCS,67415,Aspiration orbital contents,,,402.04,465.52,8
HCPCS,67415,FINE NEEDLE ASPIRATION ORBITAL CONTENTS,704.0,457.6,1.1,6813.79,144
HCPCS,67420,EXPLORE/TREAT EYE SOCKET,,,3354.3,4091.35,20
HCPCS,67420,Explore/treat eye socket,,,4527.92,5242.85,8
HCPCS,67420,ORBITOTOMY BONE FLAP/WINDOW LAT RMVL LESION,8748.0,5686.2,1.1,11276.72,144
HCPCS,67430,EXPLORE/TREAT EYE SOCKET,,,3354.3,4091.35,20
HCPCS,67430,Explore/treat eye socket,,,2059.35,2384.51,8
HCPCS,67440,EXPLORE/DRAIN EYE SOCKET,,,3354.3,4091.35,20
HCPCS,67440,Explore/drain eye socket,,,4527.92,5242.85,8
HCPCS,67445,EXPLR/DECOMPRESS EYE SOCKET,,,3354.3,4091.35,20
HCPCS,67445,Explr/decompress eye socket,,,4527.92,5242.85,8
HCPCS,67445,ORBITOTOMY BONE FLAP/WINDOW LAT RMVL BONE DCMPRN,7648.0,4971.2,1.1,11276.72,144
HCPCS,67450,EXPLORE/BIOPSY EYE SOCKET,,,3354.3,4091.35,20
HCPCS,67450,Explore/biopsy eye socket,,,4527.92,5242.85,8
HCPCS,67450,ORBITOTOMY BONE FLAP/WINDOW LAT EXPL W/WO BX,6164.0,4006.6,1.1,11276.72,144
HCPCS,67500,"RETROBULBAR INJECT,MEDICATN",472.0,306.8,1.1,850.96,148
HCPCS,67500,RETROBULBAR INJECTION MEDICATION SPX,1375.0,893.75,0.01,12500.0,87
HCPCS,67505,"RETROBULBAR INJECT,ALCOHOL",472.0,306.8,1.1,850.96,148
HCPCS,67505,RETROBULBAR INJECTION ALCOHOL,1375.0,893.75,0.01,3443.0,87
HCPCS,67515,INJECTION MEDICATION/OTHER SUBST TENON CAPSULE,852.5,554.125,0.01,3443.0,235
HCPCS,67516,SUPRACHOROIDAL SPACE NJX PHARMACOLOGIC AGENT,1099.5,714.675,0.01,12500.0,235
HCPCS,67550,INSERT EYE SOCKET IMPLANT,,,3354.3,4091.35,20
HCPCS,67550,Insert eye socket implant,,,2122.76,2457.93,8
HCPCS,67550,ORBITAL IMPLANT INSERTION,4708.0,3060.2,1.1,11276.72,144
HCPCS,67560,ORBITAL IMPLANT REMOVAL/REVISION,4872.0,3166.8,1.1,11276.72,144
HCPCS,67560,REVISE EYE SOCKET IMPLANT,,,3354.3,7624.0,21
HCPCS,67560,Revise eye socket implant,,,2122.76,2457.93,8
HCPCS,67570,DECOMPRESS OPTIC NERVE,,,3354.3,4091.35,20
HCPCS,67570,Decompress optic nerve,,,2122.76,2457.93,8
HCPCS,67570,OPTIC NERVE DECOMPRESSION,5760.0,3744.0,1.1,11276.72,144
HCPCS,67599,UNLISTED PROCEDURE ORBIT,1200.0,780.0,198.21,1200.0,84
HCPCS,67700,BLEPHAROTOMY DRAINAGE ABSCESS EYELID,967.5,628.875,0.01,3443.0,407
HCPCS,67710,SEVERING TARSORRHAPHY,2441.5,1586.975,0.01,4455.0,235
HCPCS,67715,CANTHOTOMY SEPARATE PROCEDURE,5620.0,3653.0,1.1,10732.0,235
HCPCS,67800,"EXCIS CHALAZION,SINGLE",564.0,366.6,1.1,850.96,148
HCPCS,67800,EXCISION CHALAZION SINGLE,1375.0,893.75,0.01,3443.0,87
HCPCS,67801,"EXCIS CHALAZION,MULT,SAME LID",764.0,496.6,1.1,2953.87,148
HCPCS,67801,EXCISION CHALAZION MULTIPLE SAME LID,4455.0,2895.75,0.01,4455.0,87
HCPCS,67805,EXCISION CHALAZION MULTIPLE DIFFERENT LIDS,1141.5,741.975,0.01,3443.0,235
HCPCS,67808,EXC CHALAZION ANES REQ HOSPIZATION SINGLE/MULT,1840.0,1196.0,1.1,6813.79,144
HCPCS,67808,REMOVE EYELID LESION(S),,,2027.3,6238.0,22
HCPCS,67808,Remove eyelid lesion(s),,,1153.81,1335.99,8
HCPCS,67810,INCISIONAL BIOPSY EYELID SKIN & LID MARGIN,947.0,615.55,0.01,3443.0,235
HCPCS,67820,CORRECTION TRICHIASIS EPILATION FORCEPS ONLY,367.0,238.55,0.01,12500.0,235
HCPCS,67825,CORRECTION TRICHIASIS EPILATION OTH/THAN FORCEPS,1002.0,651.3,0.01,2351.0,235
HCPCS,67830,CORRECTION TRICHIASIS INCCISION LID MARGIN,2577.5,1675.375,0.01,5265.0,235
HCPCS,67835,CORRJ TRICHIASIS INC LID MRGN W/FR MUC MEMB GRF,2280.0,1482.0,1.1,6813.79,144
HCPCS,67835,REVISE EYELASHES,,,2027.3,2474.21,20
HCPCS,67835,Revise eyelashes,,,1530.64,1772.32,8
HCPCS,67840,EXC LESION EYELID W/O CLSR/W/SIMPLE DIR CLOSURE,2645.5,1719.575,0.01,4455.0,235
HCPCS,67850,DESTRUCTION LESION LID MARGIN </ 1 CM,696.0,452.4,1.1,2953.87,148
HCPCS,67850,DSTRJ LESION LID MARGIN <1CM,,,878.34,2643.11,21
HCPCS,67850,Dstrj lesion lid margin <1cm,,,198.21,229.5,8
HCPCS,67875,TEMP CLOSURE EYELID BY SUTURE,540.0,351.0,1.1,2953.87,148
HCPCS,67875,TEMPORARY CLOSURE EYELIDS SUTURE,4455.0,2895.75,0.01,4455.0,87
HCPCS,67880,CONSTJ INTERMARGIN ADHES/TARSORRH/CANTHORRHAPY,6378.0,4145.7,0.01,10732.0,235
HCPCS,67882,CONSTJ INTERMARGIN ADHES/TARSOR/CANTHOR W/TRPOS,6570.0,4270.5,0.01,10732.0,235
HCPCS,67900,REPAIR BROW PTOSIS,6866.5,4463.225,0.01,10789.0,233
HCPCS,67900,REPAIR BROW PTOSIS - COMPLEX,4500.0,2925.0,1.1,6813.79,146
HCPCS,67900,REPAIR BROW PTOSIS - MODERATE,3800.0,2470.0,1.1,6813.79,146
HCPCS,67900,REPAIR BROW PTOSIS - SIMPLE,3600.0,2340.0,1.1,6813.79,146
HCPCS,67901,REPAIR EYELID DEFECT,,,2027.3,2474.21,20
HCPCS,67901,RPR BLEPHAROPTOSIS FRONTALIS MUSC SUTR/OTH MATRL,3036.0,1973.4,1.1,6813.79,148
HCPCS,67901,Repair eyelid defect,,,1530.64,1772.32,8
HCPCS,67902,REPAIR EYELID DEFECT,,,3354.3,7778.0,21
HCPCS,67902,RPR BLEPHAROPT FRONTALIS MUSC AUTOL FASCAL SLING,3928.0,2553.2,1.1,11276.72,144
HCPCS,67902,Repair eyelid defect,,,1530.64,1772.32,8
HCPCS,67903,REPAIR EYELID DEFECT,,,2027.3,2474.21,20
HCPCS,67903,RPR BLEPHAROPTOSIS LEVATOR RESCJ/ADVMNT INTERNAL,2604.0,1692.6,1.1,6813.79,148
HCPCS,67903,Repair eyelid defect,,,1530.64,1772.32,8
HCPCS,67904,REPAIR EYELID DEFECT,,,2027.3,10789.0,22
HCPCS,67904,RPR BLEPHAROPTOSIS LEVATOR RESCJ/ADVMNT XTRNL,3507.0,2279.55,1.1,6813.79,148
HCPCS,67904,Repair eyelid defect,,,1530.64,1772.32,8
HCPCS,67906,REPAIR EYELID DEFECT,,,3354.3,4091.35,20
HCPCS,67906,RPR BLEPHAROPTOSIS SUPERIOR RECTUS FASCIAL SLING,2772.0,1801.8,1.1,11276.72,144
HCPCS,67906,Repair eyelid defect,,,1530.64,1772.32,8
HCPCS,67908,REPAIR EYELID DEFECT,,,2027.3,10789.0,24
HCPCS,67908,RPR BLPOS CONJUNCTIVO-TARSO-MUSC-LEVATOR RESCJ,2332.0,1515.8,1.1,6813.79,148
HCPCS,67908,Repair eyelid defect,,,1530.64,1772.32,8
HCPCS,67909,REDUCTION OVERCORRECTION PTOSIS,2228.0,1448.2,1.1,6813.79,148
HCPCS,67909,REVISE EYELID DEFECT,,,2027.3,2474.21,20
HCPCS,67909,Revise eyelid defect,,,1530.64,1772.32,8
HCPCS,67911,CORRECT LID RETRACTION,3000.0,1950.0,1.1,6813.79,144
HCPCS,67911,REVISE EYELID DEFECT,,,2027.3,2474.21,20
HCPCS,67911,Revise eyelid defect,,,1153.81,1335.99,8
HCPCS,67912,CORRJ LAGOPHTHALMOS IMPLTJ UPR EYELID LID LOAD,6638.0,4314.7,0.01,10732.0,235
HCPCS,67914,"FIX ECTROPION,SUTURE",1500.0,975.0,1.1,6813.79,148
HCPCS,67914,REPAIR ECTROPION SUTURE,10732.0,6975.8,0.01,10732.0,87
HCPCS,67915,REPAIR EYELID DEFECT,,,2027.3,2474.21,20
HCPCS,67915,Repair eyelid defect,,,1153.81,1335.99,8
HCPCS,67916,"FIX ECTROPION,EXCIS TARSAL WEDGE",2192.0,1424.8,1.1,6813.79,148
HCPCS,67916,REPAIR EYELID DEFECT,,,2027.3,2474.21,20
HCPCS,67916,Repair eyelid defect,,,1153.81,1335.99,8
HCPCS,67917,REPAIR ECTROPION EXTENSIVE,6552.0,4258.8,0.01,10789.0,235
HCPCS,67921,ENTROPION REPAIR/SUTURE,1388.0,902.2,1.1,6813.79,148
HCPCS,67921,REPAIR ENTROPION SUTURE,10732.0,6975.8,0.01,10732.0,87
HCPCS,67922,"FIX ENTROPION,THERMOCAUT",812.0,527.8,1.1,6813.79,148
HCPCS,67922,REPAIR EYELID DEFECT,,,2027.3,2474.21,20
HCPCS,67922,Repair eyelid defect,,,1153.81,1335.99,8
HCPCS,67923,"FIX ENTROPION,EXCIS TARSAL WEDGE",2411.0,1567.15,1.1,6813.79,148
HCPCS,67923,REPAIR EYELID DEFECT,,,2027.3,2474.21,20
HCPCS,67923,Repair eyelid defect,,,1530.64,1772.32,8
HCPCS,67924,REPAIR EYELID DEFECT,,,2027.3,2474.21,20
HCPCS,67924,REPAIR OF ENTROPION; EXTENSIVE?,2372.0,1541.8,1.1,6813.79,148
HCPCS,67924,Repair eyelid defect,,,1530.64,1772.32,8
HCPCS,67930,SUTR WND EYELID/MARGIN/TARSUS/CONJUNC PRTL THICK,6096.0,3962.4,1.1,10732.0,235
HCPCS,67935,SUTR WND EYELID/MARGIN/TARSUS/CONJUNC FULL THICK,6638.0,4314.7,0.01,10732.0,322
HCPCS,67938,REMOVAL EMBEDDED FOREIGN BODY EYELID,1375.0,893.75,0.01,12500.0,173
HCPCS,67938,"REMOVE EYELID FOREIGN BODY,EMBEDDED",552.0,358.8,1.1,1003.72,148
HCPCS,67950,CANTHOPLASTY LATERAL,2636.0,1713.4,1.1,6813.79,148
HCPCS,67950,CANTHOPLASTY LATERAL - COMPLEX,2100.0,1365.0,1.1,6813.79,148
HCPCS,67950,CANTHOPLASTY LATERAL - MODERATE,1850.0,1202.5,1.1,6813.79,148
HCPCS,67950,CANTHOPLASTY LATERAL - SIMPLE,1550.0,1007.5,1.1,6813.79,148
HCPCS,67950,REVISION OF EYELID,,,2027.3,2474.21,20
HCPCS,67950,Revision of eyelid,,,1153.81,1335.99,8
HCPCS,67961,EXCISION & REPAIR EYELID < ONE-FOURTH LID MARGIN,2344.0,1523.6,1.1,6813.79,148
HCPCS,67961,REVISION OF EYELID,,,2027.3,5597.0,21
HCPCS,67961,Revision of eyelid,,,1530.64,1772.32,8
HCPCS,67966,EXCISION & REPAIR EYELID ONE-FOURTH LID MARGIN,3588.0,2332.2,1.1,6813.79,148
HCPCS,67966,REVISION OF EYELID,,,2027.3,7813.0,24
HCPCS,67966,Revision of eyelid,,,1530.64,1772.32,8
HCPCS,67971,RCNSTJ EYELID FULL THICKNESS </TWO-THIRDS 1 STG,4004.0,2602.6,1.1,6813.79,144
HCPCS,67971,RECONSTRUCTION OF EYELID,,,2027.3,2474.21,20
HCPCS,67971,Reconstruction of eyelid,,,1530.64,1772.32,8
HCPCS,67973,"RECONSTRUC EYELID,TOT LOWER,1 STAGE",5252.0,3413.8,1.1,6813.79,144
HCPCS,67973,RECONSTRUCTION OF EYELID,,,2027.3,4315.0,21
HCPCS,67973,Reconstruction of eyelid,,,1530.64,1772.32,8
HCPCS,67974,"RECONSTRUC EYELID,TOT UPPER,1 STAGE",5240.0,3406.0,1.1,11276.72,144
HCPCS,67974,RECONSTRUCTION OF EYELID,,,3354.3,4091.35,20
HCPCS,67974,Reconstruction of eyelid,,,1530.64,1772.32,8
HCPCS,67975,RCNSTJ EYELID FULL THICKNESS SECOND STAGE,10732.0,6975.8,0.01,10732.0,87
HCPCS,67975,"RECONSTRUC EYELID,SECOND STAGE",3740.0,2431.0,1.1,6813.79,144
HCPCS,67999,ENDOSCOPIC BROW PTOSIS (COMP CODE 67900),4500.0,2925.0,0.01,4500.0,84
HCPCS,67999,FACELIFT - ENDOSCOPIC,2760.0,1794.0,0.01,2760.0,84
HCPCS,67999,FOREHEAD LIFT - ENDOSCOPIC,3346.0,2174.9,0.01,3346.0,84
HCPCS,67999,GOLD WEIGHT REMOVAL,265.0,172.25,0.01,488.51,85
HCPCS,67999,MYECTOMY _EYELID,455.0,295.75,0.01,850.96,84
HCPCS,67999,"ORBICULARIS OCULI LATERAL MYECTOMY, UNILATERAL (COMP CODE 15823)",2996.0,1947.4,0.01,2996.0,84
HCPCS,67999,REMOVAL OF IMPLANT EYELID (COMP CODE 67938),587.0,381.55,0.01,850.96,84
HCPCS,68020,INCISION CONJUNCTIVA DRAINAGE OF CYST,2511.5,1632.475,0.01,4455.0,235
HCPCS,68040,TREATMENT OF EYELID LESIONS,,,252.73,760.51,21
HCPCS,68040,Treatment of eyelid lesions,,,198.21,229.5,8
HCPCS,68100,BIOPSY CONJUNCTIVA,10732.0,6975.8,0.01,10732.0,87
HCPCS,68100,BIOPSY OF CONJUNCTIVA,540.0,351.0,1.1,6813.79,148
HCPCS,68110,EXCISION LESION CONJUNCTIVA </1 CM,5730.0,3724.5,0.01,10732.0,235
HCPCS,68115,EXCISION LESION CONJUNCTIVA > 1 CM,5848.0,3801.2000000000003,0.01,10732.0,235
HCPCS,68130,EXC LES CONJUNCTIVA ADJ SCL,,,2027.3,2474.21,20
HCPCS,68130,EXCISION LESION CONJUNCTIVA ADJACENT SCLERA,2040.0,1326.0,1.1,6813.79,148
HCPCS,68130,Exc les conjunctiva adj scl,,,1530.64,1772.32,8
HCPCS,68135,DESTRUCTION LESION CONJUNCTIVA,5744.0,3733.6,0.01,10732.0,235
HCPCS,68200,SUBCONJUNCTIVAL INJECTION,1836.0,1193.4,0.01,12500.0,87
HCPCS,68200,SUBCONJUNCTIVAL INJECTN,196.0,127.4,1.1,1163.18,148
HCPCS,68320,CONJUNCTIVOPLASTY W/GRF/XTNSV REARRANGEMENT,2922.0,1899.3,1.1,6813.79,148
HCPCS,68320,REVISE/GRAFT EYELID LINING,,,2027.3,10789.0,23
HCPCS,68320,Revise/graft eyelid lining,,,1153.81,1335.99,8
HCPCS,68325,CONJUNCTIVOPLASTY W/BUCCAL MUC MEMB GRAFT,3452.0,2243.8,1.1,11276.72,144
HCPCS,68325,REVISE/GRAFT EYELID LINING,,,3354.3,4091.35,20
HCPCS,68325,Revise/graft eyelid lining,,,1530.64,1772.32,8
HCPCS,68326,CJP RCNSTJ CUL-DE-SAC BUCCAL GRF/XTNSV REARRGMT,3368.0,2189.2,1.1,11276.72,144
HCPCS,68326,REVISE/GRAFT EYELID LINING,,,3354.3,7624.0,21
HCPCS,68326,Revise/graft eyelid lining,,,1530.64,1772.32,8
HCPCS,68328,CONJUNCTPL CUL-DE-SAC W/BUCCAL MUC MEMB GRAFT,3780.0,2457.0,1.1,6813.79,144
HCPCS,68328,REVISE/GRAFT EYELID LINING,,,2027.3,2474.21,20
HCPCS,68328,Revise/graft eyelid lining,,,1530.64,1772.32,8
HCPCS,68330,REVISE EYELID LINING,,,2021.72,2401.72,20
HCPCS,68330,RPR SYMBLEPHARON CONJUNCTIVOPLASTY W/O GRAFT,2312.0,1502.8,1.1,6795.42,148
HCPCS,68330,Revise eyelid lining,,,1153.81,1335.99,8
HCPCS,68335,REVISE/GRAFT EYELID LINING,,,3354.3,4091.35,20
HCPCS,68335,RPR SYMBLEPHARON FR GRF CJNC/BUCCAL MUC MEMB,3384.0,2199.6,1.1,11276.72,144
HCPCS,68335,Revise/graft eyelid lining,,,1530.64,1772.32,8
HCPCS,68340,RPR & DIV SYMBLEPHARON W/WO CONFORM/CONTACT LE,1988.0,1292.2,1.1,6813.79,148
HCPCS,68340,SEPARATE EYELID ADHESIONS,,,2027.3,2474.21,20
HCPCS,68340,Separate eyelid adhesions,,,1153.81,1335.99,8
HCPCS,68360,"CONJUNC FLAP,BRIDGE/PARTIAL",2068.0,1344.2,1.1,11276.72,148
HCPCS,68360,REVISE EYELID LINING,,,3354.3,4091.35,20
HCPCS,68360,Revise eyelid lining,,,1530.64,1772.32,8
HCPCS,68362,"CONJUNC FLAP,TOTAL",3444.0,2238.6,1.1,6813.79,144
HCPCS,68362,REVISE EYELID LINING,,,2027.3,2474.21,20
HCPCS,68362,Revise eyelid lining,,,1530.64,1772.32,8
HCPCS,68371,HARVEST EYE TISSUE ALOGRAFT,,,2027.3,2474.21,20
HCPCS,68371,Harvest eye tissue alograft,,,1153.81,1335.99,8
HCPCS,68399,UNLISTED PX CONJUNCTIVA,,,252.73,760.51,21
HCPCS,68399,Unlisted px conjunctiva,,,198.21,229.5,8
HCPCS,68400,I&D LACRIMAL GLAND,,,878.34,2643.11,21
HCPCS,68400,I&d lacrimal gland,,,1153.81,1335.99,8
HCPCS,68400,INCISION DRAINAGE LACRIMAL GLAND,696.0,452.4,1.1,2953.87,148
HCPCS,68420,INCISION DRAINAGE LACRIMAL SAC,5836.0,3793.4,0.01,10732.0,235
HCPCS,68440,SNIP INCISION LACRIMAL PUNCTUM,885.5,575.575,0.01,3443.0,235
HCPCS,68500,EXCISION LACRIMAL GLAND XCPT TUMOR TOTAL,5108.0,3320.2,1.1,11276.72,144
HCPCS,68500,REMOVAL OF TEAR GLAND,,,3354.3,4091.35,20
HCPCS,68500,Removal of tear gland,,,1530.64,1772.32,8
HCPCS,68505,EXCISION LACRIMAL GLAND XCPT TUMOR PRTL,5076.0,3299.4,1.1,11276.72,144
HCPCS,68505,PARTIAL REMOVAL TEAR GLAND,,,3354.3,7778.0,21
HCPCS,68505,Partial removal tear gland,,,1530.64,1772.32,8
HCPCS,68510,BIOPSY LACRIMAL GLAND,1840.0,1196.0,1.1,6813.79,148
HCPCS,68510,BIOPSY OF TEAR GLAND,,,2027.3,4315.0,21
HCPCS,68510,Biopsy of tear gland,,,1530.64,1772.32,8
HCPCS,68520,EXCISION LACRIMAL SAC,3512.0,2282.8,1.1,11276.72,144
HCPCS,68520,REMOVAL OF TEAR SAC,,,3354.3,4091.35,20
HCPCS,68520,Removal of tear sac,,,1530.64,1772.32,8
HCPCS,68525,BIOPSY LACRIMAL SAC,1768.0,1149.2,1.1,6813.79,144
HCPCS,68525,BIOPSY OF TEAR SAC,,,2027.3,2474.21,20
HCPCS,68525,Biopsy of tear sac,,,1153.81,1335.99,8
HCPCS,68530,RMVL FB/DACRYOLITH LACRIMAL PASSAGES,1427.5,927.875,0.01,12500.0,235
HCPCS,68540,EXC LACRIMAL GLAND TUMOR FRONTAL APPROACH,4872.0,3166.8,1.1,6813.79,144
HCPCS,68540,REMOVE TEAR GLAND LESION,,,2027.3,4315.0,21
HCPCS,68540,Remove tear gland lesion,,,1530.64,1772.32,8
HCPCS,68550,EXC LACRIMAL GLAND TUMOR W/OSTEOTOMY,6064.0,3941.6,1.1,11276.72,144
HCPCS,68550,REMOVE TEAR GLAND LESION,,,3354.3,4091.35,20
HCPCS,68550,Remove tear gland lesion,,,1530.64,1772.32,8
HCPCS,68700,PLASTIC REPAIR CANALICULI,3463.0,2250.95,1.1,6813.79,144
HCPCS,68700,REPAIR TEAR DUCTS,,,2027.3,4315.0,21
HCPCS,68700,Repair tear ducts,,,1153.81,1335.99,8
HCPCS,68705,CORRECTION EVERTED PUNCTUM CAUTERY,844.0,548.6,1.1,972.84,148
HCPCS,68705,REVISE TEAR DUCT OPENING,,,252.73,760.51,21
HCPCS,68705,Revise tear duct opening,,,198.21,229.5,8
HCPCS,68720,CREATE TEAR SAC DRAIN,,,3354.3,4091.35,20
HCPCS,68720,Create tear sac drain,,,1530.64,1772.32,8
HCPCS,68720,DACRYOCYSTORHINOSTOMY,4382.0,2848.3,1.1,11276.72,144
HCPCS,68745,CREATE TEAR DUCT DRAIN,,,3354.3,4091.35,20
HCPCS,68745,Create tear duct drain,,,1530.64,1772.32,8
HCPCS,68750,CONJUNCTIVORHINOSTOMY INSJ TUBE/STENT,4040.0,2626.0,1.1,11276.72,144
HCPCS,68750,CREATE TEAR DUCT DRAIN,,,3354.3,10789.0,21
HCPCS,68750,Create tear duct drain,,,1530.64,1772.32,8
HCPCS,68760,CLSR LACRIMAL PUNCTUM THERMOCAUT LIG/LASER,1043.5,678.275,0.01,12500.0,235
HCPCS,68761,CLSR LACRIMAL PUNCTUM PLUG EACH,997.5,648.375,0.01,12500.0,235
HCPCS,68770,CLOSE TEAR SYSTEM FISTULA,,,2027.3,2474.21,20
HCPCS,68770,CLOSURE LACRIMAL FISTULA SPX,3316.0,2155.4,1.1,6813.79,144
HCPCS,68770,Close tear system fistula,,,1530.64,1772.32,8
HCPCS,68801,DILATION LACRIMAL PUNCTUM W/WO IRRGATION,1082.0,703.3000000000001,0.01,12500.0,235
HCPCS,68810,PROBE NASOLACRIMAL DUCT W/WO IRRIGATION,1026.5,667.225,0.01,4392.0,235
HCPCS,68811,PROBE NASOLACRIMAL DUCT,,,2027.3,6238.0,23
HCPCS,68811,PROBE NASOLACRIMAL DUCT W/WO IRRIG REQ GEN ANES,766.0,497.9,1.1,6813.79,144
HCPCS,68811,Probe nasolacrimal duct,,,1153.81,1335.99,8
HCPCS,68815,PROBE NASOLACRIMAL DUCT W/WO IRRG INSJ TUBE/STNT,5960.0,3874.0,0.01,10732.0,235
HCPCS,68816,PROBE NASOLACRIMAL DUCT WITH CATHETER DILATION,924.0,600.6,1.1,6813.79,148
HCPCS,68816,PROBE NL DUCT W/BALLOON,,,2027.3,8326.0,24
HCPCS,68816,Probe nl duct w/balloon,,,1153.81,1335.99,8
HCPCS,68840,PROBE LACRIMAL CANALICULI W/WO IRRIGATION,973.5,632.775,0.01,12500.0,321
HCPCS,68841,INSJ RX ELUTING IMPLT PUNCTAL DILAT LAC CANAL EA,5474.0,3558.1,1.1,10732.0,233
HCPCS,68850,Injection for tear sac x-ray,,,81.99,94.94,8
HCPCS,68899,ENDOSCOPIC MARSUPIALIZATION BILAT. NASOLACRIMAL DUCT CYSTS(COMP,1890.0,1228.5,0.01,1890.0,84
HCPCS,68899,UNLISTED PX LACRIMAL SYSTEM,,,252.73,4132.0,22
HCPCS,68899,Unlisted px lacrimal system,,,198.21,229.5,8
HCPCS,69000,DRAINAGE EXTERNAL EAR ABSCESS/HEMATOMA SIMPLE,1737.0,1129.05,0.01,12500.0,407
HCPCS,69005,DRAINAGE EXTERNAL EAR ABSCESS/HEMATOMA CMPLX,3672.5,2387.125,0.01,6481.0,322
HCPCS,69020,DRAINAGE EXTERNAL AUDITORY CANAL ABSCESS,1713.0,1113.45,0.01,12500.0,321
HCPCS,69090,EAR PIERCING,53.0,34.45,0.01,176.73,310
HCPCS,69090,"EAR PIERCING, BOTH EARS W/EARRINGS",125.0,81.25,1.1,200.0,176
HCPCS,69100,BIOPSY EXTERNAL EAR,626.5,407.225,0.01,2351.0,235
HCPCS,69105,BIOPSY EXTERNAL AUDITORY CANAL,3149.5,2047.175,0.01,5925.0,235
HCPCS,69110,EXCISION EXTERNAL EAR PARTIAL SIMPLE REPAIR,6430.0,4179.5,0.01,11448.0,235
HCPCS,69120,EXCISION EXTERNAL EAR COMPLETE AMPUTATION,1656.0,1076.4,1.1,17080.38,144
HCPCS,69120,REMOVAL OF EXTERNAL EAR,,,5080.55,6160.68,20
HCPCS,69120,Removal of external ear,,,2710.76,3138.77,8
HCPCS,69140,EXCISION EXOSTOSIS EXTERNAL AUDITORY CANAL,3256.0,2116.4,1.1,17080.38,144
HCPCS,69140,REMOVE EAR CANAL LESION(S),,,5080.55,6160.68,20
HCPCS,69140,Remove ear canal lesion(s),,,2710.76,3138.77,8
HCPCS,69145,EXCISION SOFT TIS LESION EXTERNAL AUDITORY CANAL,1080.0,702.0,1.1,8286.13,148
HCPCS,69145,REMOVE EAR CANAL LESION(S),,,2465.15,7624.0,21
HCPCS,69145,Remove ear canal lesion(s),,,1558.4,1804.46,8
HCPCS,69150,EXTENSIVE EAR CANAL SURGERY,,,5080.55,6160.68,20
HCPCS,69150,Extensive ear canal surgery,,,2710.76,3138.77,8
HCPCS,69150,RAD EXC XTRNL AUDITORY CANAL LES W/O NCK DSJ,5988.0,3892.2,1.1,17080.38,144
HCPCS,69155,EXTENSIVE EAR/NECK SURGERY,,,4227.93,4227.93,1
HCPCS,69155,Extensive ear/neck surgery,,,3396.31,3932.57,8
HCPCS,69200,RMVL FB XTRNL AUDITORY CANAL W/O ANES,427.5,277.875,0.01,12500.0,321
HCPCS,69205,CLEAR OUTER EAR CANAL,,,1406.56,5457.0,24
HCPCS,69205,Clear outer ear canal,,,939.63,1087.99,8
HCPCS,69205,RMVL FB XTRNL AUDITORY CANAL ANES,532.0,345.8,1.1,4729.25,144
HCPCS,69209,REMOVAL IMPACTED CERUMEN IRRIGATION/LVG UNILAT,248.0,161.2,0.01,12500.0,317
HCPCS,69210,REMOVAL IMPACTED CERUMEN INSTRUMENTATION UNILAT,253.0,164.45,0.01,12500.0,321
HCPCS,69220,"DEBRID MASTOIDECTOM CAVITY,SIMP",332.0,215.8,1.1,584.65,148
HCPCS,69220,DEBRIDEMENT MASTOIDECTOMY CAVITY SIMPLE,795.0,516.75,0.01,12500.0,87
HCPCS,69222,"DEBRIDE MASTOID CAVITY,COMPLEX",580.0,377.0,1.1,1603.96,148
HCPCS,69222,DEBRIDEMENT MASTOIDECTOMY CAVITY CMPLX,2037.0,1324.05,0.01,4392.0,87
HCPCS,69300,OTOPLASTY - COMPLEX,1315.0,854.75,1.1,9391.15,148
HCPCS,69300,OTOPLASTY - MODERATE,1215.0,789.75,1.1,9391.15,148
HCPCS,69300,OTOPLASTY - SIMPLE,1115.5,725.08,1.1,9391.15,148
HCPCS,69300,OTOPLASTY PROTRUDING EAR W/WO SIZE RDCTJ,2576.0,1674.4,1.1,9391.15,148
HCPCS,69300,REVISE EXTERNAL EAR,,,2793.19,3450.35,20
HCPCS,69300,Revise external ear,,,2710.76,3138.77,8
HCPCS,69310,REBUILD OUTER EAR CANAL,,,5080.55,9509.0,23
HCPCS,69310,RECONSTRUCTION EXTERNAL AUDITORY CANAL SPX,4388.0,2852.2,1.1,17080.38,144
HCPCS,69310,Rebuild outer ear canal,,,3396.31,3932.57,8
HCPCS,69320,RCNSTJ XTRNL AUD CANAL CONGENITAL ATRESIA 1 STG,6872.0,4466.8,1.1,17080.38,144
HCPCS,69320,REBUILD OUTER EAR CANAL,,,5080.55,6160.68,20
HCPCS,69320,Rebuild outer ear canal,,,2710.76,3138.77,8
HCPCS,69399,EAR MOLDING INTL VISIT,100.0,65.0,0.01,12500.0,85
HCPCS,69399,ENDOSCOPIC EXTERNAL AUDITORY CANAL (COMP CODE 69200),339.0,220.35,0.01,713.21,84
HCPCS,69399,PEDIATRIC EAR MOLD FITTING,200.0,130.0,0.01,713.21,84
HCPCS,69399,REMOVE PACKING EAC W GEN ANESTHESIA,390.0,253.5,0.01,713.21,84
HCPCS,69399,REVISION OF OSSEOINTEGRATED BONE ANCHORED IMPANT ABUTMENT (COMP,3164.0,2056.6,0.01,3164.0,84
HCPCS,69420,MYRINGOTOMY ASPIR&/EUSTACHIAN TUBE NFLTJ,740.5,481.32500000000005,0.01,7431.0,235
HCPCS,69421,INCISION OF EARDRUM,,,2793.19,5597.0,23
HCPCS,69421,Incision of eardrum,,,939.63,1087.99,8
HCPCS,69421,MYRINGOTOMY ASPIR&/EUSTACHIAN TUBE NFLTJ ANES,783.0,508.95,1.1,9391.15,144
HCPCS,69424,REMOVE VENTILATING TUBE,,,2351.0,7778.0,24
HCPCS,69424,Remove ventilating tube,,,939.63,1087.99,8
HCPCS,69424,VENTILATING TUBE RMVL REQUIRING GENERAL ANES,340.0,221.0,1.1,9391.15,148
HCPCS,69433,TYMPANOSTOMY LOCAL/TOPICAL ANESTHESIA,1332.5,866.125,0.01,7431.0,321
HCPCS,69436,TYMPANOSTOMY GENERAL ANESTHESIA,3404.5,2212.925,0.01,7813.0,231
HCPCS,69440,EXPLORATION OF MIDDLE EAR,,,2793.19,3450.35,20
HCPCS,69440,Exploration of middle ear,,,1558.4,1804.46,8
HCPCS,69440,MIDDLE EAR EXPL THRU POSTAUR/EAR CANAL INC,3084.0,2004.6,1.1,9391.15,144
HCPCS,69450,EARDRUM REVISION,,,2793.19,3450.35,20
HCPCS,69450,Eardrum revision,,,1558.4,1804.46,8
HCPCS,69450,TYMPANOLYSIS TRANSCANAL,2276.0,1479.4,1.1,9391.15,144
HCPCS,69501,MASTOIDECTOMY,,,5080.55,25635.0,21
HCPCS,69501,Mastoidectomy,,,3396.31,3932.57,8
HCPCS,69501,TRANSMASTOID ANTROTOMY,3684.0,2394.6,1.1,17080.38,144
HCPCS,69502,MASTOIDECTOMY,,,5080.55,6160.68,20
HCPCS,69502,"MASTOIDECTOMY,COMPLETE",5024.0,3265.6,1.1,17080.38,144
HCPCS,69502,Mastoidectomy,,,3396.31,3932.57,8
HCPCS,69505,"MASTOIDECTOMY,MOD RADICAL",5268.0,3424.2,1.1,17080.38,144
HCPCS,69505,REMOVE MASTOID STRUCTURES,,,5080.55,6160.68,20
HCPCS,69505,Remove mastoid structures,,,2710.76,3138.77,8
HCPCS,69511,EXTENSIVE MASTOID SURGERY,,,5080.55,25635.0,21
HCPCS,69511,Extensive mastoid surgery,,,3396.31,3932.57,8
HCPCS,69511,"MASTOIDECTOMY,RADICAL",5480.0,3562.0,1.1,17080.38,144
HCPCS,69530,EXTENSIVE MASTOID SURGERY,,,5080.55,6160.68,20
HCPCS,69530,Extensive mastoid surgery,,,3396.31,3932.57,8
HCPCS,69530,PETROUS APICECTOMY RADICAL MASTOIDECTOMY,8152.0,5298.8,1.1,17080.38,144
HCPCS,69535,REMOVE PART OF TEMPORAL BONE,,,6891.84,6891.84,1
HCPCS,69535,"RESECT TEMPORAL BONE,EXTERN APPRCH",14968.0,9729.2,1.1,14968.0,144
HCPCS,69535,Remove part of temporal bone,,,4527.92,5242.85,8
HCPCS,69540,EXCISION AURAL POLYP,3212.5,2088.125,0.01,5925.0,235
HCPCS,69550,EXC AURL GLOMUS TUM TRNSCANL,,,5080.55,9509.0,21
HCPCS,69550,EXCISION AURAL GLOMUS TUMOR TRANSCANAL,4460.0,2899.0,1.1,17080.38,144
HCPCS,69550,Exc aurl glomus tum trnscanl,,,2710.76,3138.77,8
HCPCS,69552,EXC AURL GLOMUS TUM TRNSMSTD,,,5080.55,6160.68,20
HCPCS,69552,EXCISION AURAL GLOMUS TUMOR TRANSMASTOID,7924.0,5150.6,1.1,17080.38,144
HCPCS,69552,Exc aurl glomus tum trnsmstd,,,3396.31,3932.57,8
HCPCS,69554,EXC AURL GLOMUS TUM EXTENDED,,,6557.18,6557.18,1
HCPCS,69554,EXCISION AURAL GLOMUS TUMOR EXTENDED,14388.0,9352.2,1.1,14388.0,144
HCPCS,69554,Exc aurl glomus tum extended,,,1558.4,1804.46,8
HCPCS,69601,REVJ MASTOIDECTOMY RSLTG COMPL MASTOIDECTOMY,5380.0,3497.0,1.1,17080.38,144
HCPCS,69601,REVJ MSTDC RSLTG COMPL MSTDC,,,5080.55,6160.68,20
HCPCS,69601,Revj mstdc rsltg compl mstdc,,,3396.31,3932.57,8
HCPCS,69602,REV MSTDC RSLT MOD RAD MSTDC,,,5080.55,6160.68,20
HCPCS,69602,REVJ MASTOIDECTOMY RSLTG MODF RAD MSTDC,5504.0,3577.6,1.1,17080.38,144
HCPCS,69602,Rev mstdc rslt mod rad mstdc,,,3396.31,3932.57,8
HCPCS,69603,REVJ MASTOIDECTOMY RSLTG RAD MASTOIDECTOMY,5680.0,3692.0,1.1,17080.38,144
HCPCS,69603,REVJ MSTDC RSLTG RAD MSTDC,,,5080.55,6160.68,20
HCPCS,69603,Revj mstdc rsltg rad mstdc,,,3396.31,3932.57,8
HCPCS,69604,REVJ MASTOIDECTOMY RSLTG TYMPANOPLASTY,5680.0,3692.0,1.1,17080.38,144
HCPCS,69604,REVJ MSTDC RSLTG TYMPANPLSTY,,,5080.55,9509.0,21
HCPCS,69604,Revj mstdc rsltg tympanplsty,,,3396.31,3932.57,8
HCPCS,69605,Mastoid surgery revision,,,3396.31,3932.57,8
HCPCS,69610,TYMPANIC MEMB RPR W/WO PREPJ PERFOR PATCH,3946.0,2564.9,0.01,7431.0,235
HCPCS,69620,MYRINGOPLASTY,2653.0,1724.45,1.1,9391.15,172
HCPCS,69620,Myringoplasty,,,1558.4,1804.46,8
HCPCS,69631,REPAIR EARDRUM STRUCTURES,,,5080.55,13821.0,24
HCPCS,69631,Repair eardrum structures,,,2710.76,3138.77,8
HCPCS,69631,TYMPANOPLASTY W/O MASTOIDECT W/O OSSICLE RECNSTJ,4020.0,2613.0,1.1,17080.38,144
HCPCS,69632,REBUILD EARDRUM STRUCTURES,,,5080.55,13821.0,22
HCPCS,69632,Rebuild eardrum structures,,,3396.31,3932.57,8
HCPCS,69632,TYMPNOPLSTY W/O MSTDC 1ST/REVJ W/OSICLE RECNSTJ,5184.0,3369.6,1.1,17080.38,144
HCPCS,69633,REBUILD EARDRUM STRUCTURES,,,5080.55,13821.0,23
HCPCS,69633,Rebuild eardrum structures,,,3396.31,3932.57,8
HCPCS,69633,TYMPANOPLASTY W/O MASTOIDEC 1ST/REVJ PROSTH TORP,4924.0,3200.6,1.1,17080.38,144
HCPCS,69635,REPAIR EARDRUM STRUCTURES,,,5080.55,6160.68,20
HCPCS,69635,Repair eardrum structures,,,2710.76,3138.77,8
HCPCS,69635,TYMPP ANTRT/MASTOID W/O OSSICULAR CHAIN RECNSTJ,5404.0,3512.6,1.1,17080.38,144
HCPCS,69636,REBUILD EARDRUM STRUCTURES,,,5080.55,6160.68,20
HCPCS,69636,Rebuild eardrum structures,,,3396.31,3932.57,8
HCPCS,69636,TYMPP ANTRT/MASTOID W/OSSICULAR CHAIN RECNSTJ,6172.0,4011.8,1.1,17080.38,144
HCPCS,69637,REBUILD EARDRUM STRUCTURES,,,5080.55,6160.68,20
HCPCS,69637,Rebuild eardrum structures,,,3396.31,3932.57,8
HCPCS,69637,TMPP ANTRT/MASTOIDOTOMY PROSTHESIS TORP,6128.0,3983.2,1.1,17080.38,144
HCPCS,69641,REVISE MIDDLE EAR & MASTOID,,,5080.55,25635.0,23
HCPCS,69641,Revise middle ear & mastoid,,,3396.31,3932.57,8
HCPCS,69641,TMPP MASTOIDECTOMY W/O OSSICULAR CHAIN RECNSTJ,5156.0,3351.4,1.1,17080.38,144
HCPCS,69642,REVISE MIDDLE EAR & MASTOID,,,5080.55,6160.68,20
HCPCS,69642,Revise middle ear & mastoid,,,3396.31,3932.57,8
HCPCS,69642,TMPP MASTOIDECTOMY W/OSSICULAR CHAIN RECNSTJ,6824.0,4435.6,1.1,17080.38,144
HCPCS,69643,REVISE MIDDLE EAR & MASTOID,,,5080.55,25635.0,22
HCPCS,69643,Revise middle ear & mastoid,,,3396.31,3932.57,8
HCPCS,69643,TMPP MASTOIDECT NTC/RCNSTED WALL W/O OCR,6860.0,4459.0,1.1,17080.38,144
HCPCS,69644,REVISE MIDDLE EAR & MASTOID,,,5080.55,25635.0,22
HCPCS,69644,Revise middle ear & mastoid,,,3396.31,3932.57,8
HCPCS,69644,TMPP MASTOIDECT NTC/RCNSTED CANAL WALL OCR,6892.0,4479.8,1.1,17080.38,144
HCPCS,69645,REVISE MIDDLE EAR & MASTOID,,,5080.55,6160.68,20
HCPCS,69645,Revise middle ear & mastoid,,,3396.31,3932.57,8
HCPCS,69645,TYMPANOPLASTY MASTOIDECTOMY RAD/COMPL W/O OCR,6684.0,4344.6,1.1,17080.38,144
HCPCS,69646,REVISE MIDDLE EAR & MASTOID,,,5080.55,6160.68,20
HCPCS,69646,Revise middle ear & mastoid,,,3396.31,3932.57,8
HCPCS,69646,TYMPANOPLASTY MASTOIDECTOMY RAD/COMPL W/OCR,7348.0,4776.2,1.1,17080.38,144
HCPCS,69650,STAPES MOBILIZATION,,,2793.19,4315.0,21
HCPCS,69650,Stapes mobilization,,,2710.76,3138.77,8
HCPCS,69660,REVISE MIDDLE EAR BONE,,,5080.55,13821.0,24
HCPCS,69660,Revise middle ear bone,,,2710.76,3138.77,8
HCPCS,69660,STAPEDECTOMY/STAPEDOTOMY,4812.0,3127.8,1.1,17080.38,144
HCPCS,69661,REVISE MIDDLE EAR BONE,,,5080.55,6160.68,20
HCPCS,69661,Revise middle ear bone,,,2710.76,3138.77,8
HCPCS,69661,STAPEDECTOMY/STAPEDOTOMY W/FOOTPLATE DRILL OUT,6368.0,4139.2,1.1,17080.38,144
HCPCS,69662,REVISE MIDDLE EAR BONE,,,5080.55,6160.68,20
HCPCS,69662,REVISION STAPEDECTOMY/STAPEDOTOMY,6240.0,4056.0,1.1,17080.38,144
HCPCS,69662,Revise middle ear bone,,,2710.76,3138.77,8
HCPCS,69666,REPAIR MIDDLE EAR STRUCTURES,,,2793.19,3450.35,20
HCPCS,69666,REPAIR OVAL WINDOW FISTULA,3956.0,2571.4,1.1,9391.15,144
HCPCS,69666,Repair middle ear structures,,,1558.4,1804.46,8
HCPCS,69667,REPAIR MIDDLE EAR STRUCTURES,,,2793.19,3450.35,20
HCPCS,69667,Repair middle ear structures,,,1558.4,1804.46,8
HCPCS,69670,MASTOID OBLITERATION,4692.0,3049.8,1.1,17080.38,144
HCPCS,69670,REMOVE MASTOID AIR CELLS,,,5080.55,9509.0,22
HCPCS,69670,Remove mastoid air cells,,,3396.31,3932.57,8
HCPCS,69676,REMOVE MIDDLE EAR NERVE,,,2793.19,3450.35,20
HCPCS,69676,Remove middle ear nerve,,,2710.76,3138.77,8
HCPCS,69700,CLOSE MASTOID FISTULA,,,1323.06,4315.0,21
HCPCS,69700,Close mastoid fistula,,,1558.4,1804.46,8
HCPCS,69705,SURG NASOPHARYNGOSCOPY DILAT EUSTACHIAN TUBE UNI,12431.5,8080.475,0.01,23663.0,320
HCPCS,69706,SURG NASOPHARYNGOSCOPY DILAT EUSTACHIAN TUBE BI,12685.5,8245.575,0.01,23663.0,320
HCPCS,69710,IMPLANT/REPLACE HEARING AID,,,1561.8,1561.8,1
HCPCS,69710,Implant/replace hearing aid,,,4541.34,5258.4,8
HCPCS,69711,REMOVE/REPAIR HEARING AID,,,2793.19,3450.35,20
HCPCS,69711,RMVL/RPR EMGNT BONE CNDJ DEV TEMPORAL BONE,4248.0,2761.2,1.1,9391.15,144
HCPCS,69711,Remove/repair hearing aid,,,2710.76,3138.77,8
HCPCS,69714,IMPL OI IMPLT SKULL PERQ ESP,,,11418.01,33436.0,21
HCPCS,69714,IMPLTJ OI IMPLT SKULL PERQ ATTACHMENT ESP,2939.0,1910.35,1.1,38384.94,144
HCPCS,69714,Impl oi implt skull perq esp,,,4541.34,5258.4,8
HCPCS,69715,Temple bne implnt w/stimulat,,,4541.34,5258.4,8
HCPCS,69716,IMPL OI IMPLT SKULL MAG TC ATTACHMENT ESP<100,27539.5,17900.675000000003,1.1,51467.0,229
HCPCS,69717,RPLCMT OI IMPLT SKULL PERQ ATTACHMENT ESP,15869.5,10315.175,0.01,33436.0,231
HCPCS,69718,Revise temple bone implant,,,4541.34,5258.4,8
HCPCS,69719,RPLCMT OI IMPLT SKULL MAG TC ATTACHMENT ESP<100,27814.5,18079.425000000003,1.1,51467.0,229
HCPCS,69720,DCMPRN FACIAL NRV INTRATEMPORAL LAT GANGLION,5884.0,3824.6,1.1,17080.38,144
HCPCS,69720,RELEASE FACIAL NERVE,,,5080.55,6160.68,20
HCPCS,69720,Release facial nerve,,,1703.65,1972.65,8
HCPCS,69725,DCMPRN NRV INTRATEMPORAL MEDIAL GENICULATE,12162.0,7905.3,1.1,17080.38,144
HCPCS,69725,RELEASE FACIAL NERVE,,,5080.55,6160.68,20
HCPCS,69725,Release facial nerve,,,1703.65,1972.65,8
HCPCS,69726,REMOVAL OI IMPLT SKULL PERQ ATTACHMENT ESP,7761.0,5044.650000000001,1.1,12978.0,228
HCPCS,69727,REMOVAL ENTIRE OI IMPLT SKL MAG TC ATTCH ESP<100,7965.0,5177.25,1.1,12978.0,228
HCPCS,69728,RMV NTR OI IMP SK TC>=100,,,2808.13,8450.24,21
HCPCS,69728,RMVL ENTIRE OI IMPLT SKL MAG TC ATTCH ESP>=100,3400.0,2210.0,1.1,9440.12,144
HCPCS,69728,Rmv ntr oi imp sk tc>=100,,,1558.4,1804.46,8
HCPCS,69729,IMPL OI IMPLT SK TC ESP>=100,,,11418.01,13361.02,20
HCPCS,69729,IMPL OI IMPLT SKULL MAG TC ATTACHMENT ESP>=100,3988.0,2592.2,1.1,38384.94,144
HCPCS,69729,Impl oi implt sk tc esp>=100,,,4541.34,5258.4,8
HCPCS,69730,RPLC OI IMPLT SK TC ESP>=100,,,11418.01,13361.02,20
HCPCS,69730,RPLCMT OI IMPLT SKULL MAG TC ATTACHMENT ESP>=100,4100.0,2665.0,1.1,38384.94,144
HCPCS,69730,Rplc oi implt sk tc esp>=100,,,4541.34,5258.4,8
HCPCS,69740,REPAIR FACIAL NERVE,,,5080.55,6160.68,20
HCPCS,69740,Repair facial nerve,,,1703.65,1972.65,8
HCPCS,69745,REPAIR FACIAL NERVE,,,5080.55,6160.68,20
HCPCS,69745,Repair facial nerve,,,1703.65,1972.65,8
HCPCS,69799,BILTRL ET BALLOON DILATN (COMP 68816-50),1528.0,993.2,0.01,1528.0,84
HCPCS,69799,CATHETER OBLITERATION EUSTACHIAN TUBE,1878.0,1220.7,0.01,1878.0,84
HCPCS,69799,DEBRID PURULENT MID EAR,302.0,196.3,0.01,3443.0,85
HCPCS,69799,EUSTACHIAN TUBE INJECTION ENDOSCOPIC (COMP CODE 69705),8962.5,5825.625,0.01,16650.0,169
HCPCS,69799,NASAL ENDOSC W/DILATION OF EUSTACHIAN TUBE; UNILAT (COMP 68816),903.0,586.95,0.01,903.0,84
HCPCS,69799,REPLACE ABUTMENT FOR BAHA (COMP 20670),1045.5,679.575,0.01,3443.0,169
HCPCS,69799,RPF SSCDS/TRNSCNL W GRAFT,3267.0,2123.55,0.01,3267.0,84
HCPCS,69799,SIGMOID RESURFACING W/ SIMPLE MASOIDECTOMY (COMP CODE 69501 AND,2928.0,1903.2,0.01,2928.0,84
HCPCS,69801,LABYRINTHOTOMY TRANSCANAL,3415.5,2220.075,0.01,13821.0,235
HCPCS,69805,"ENDOLYMPH SAC OPERATN,NO SHUNT",5884.0,3824.6,1.1,17080.38,144
HCPCS,69805,EXPLORE INNER EAR,,,5080.55,6160.68,20
HCPCS,69805,Explore inner ear,,,3396.31,3932.57,8
HCPCS,69806,ENDOLYMPH SAC OP W SHUNT,5052.0,3283.8,1.1,17080.38,144
HCPCS,69806,EXPLORE INNER EAR,,,5080.55,6160.68,20
HCPCS,69806,Explore inner ear,,,2710.76,3138.77,8
HCPCS,69905,"EXCIS LABYRINTH,TRANSCANAL",4954.0,3220.1,1.1,17080.38,144
HCPCS,69905,REMOVE INNER EAR,,,5080.55,9509.0,21
HCPCS,69905,Remove inner ear,,,2710.76,3138.77,8
HCPCS,69910,EXCIS LABYRINTH W MASTOIDECTOMY,5564.0,3616.6,1.1,17080.38,144
HCPCS,69910,REMOVE INNER EAR & MASTOID,,,5080.55,9509.0,21
HCPCS,69910,Remove inner ear & mastoid,,,3396.31,3932.57,8
HCPCS,69915,INCISE INNER EAR NERVE,,,2793.19,3450.35,20
HCPCS,69915,Incise inner ear nerve,,,2710.76,3138.77,8
HCPCS,69915,VESTIBULAR NRV SECTION TRANSLABYRINTHINE APPR,9108.0,5920.2,1.1,9391.15,144
HCPCS,69930,COCHLEAR DEVICE IMPLANTATION W/WO MASTOIDECTOMY,7092.0,4609.8,1.1,97802.01,144
HCPCS,69930,IMPLANT COCHLEAR DEVICE,,,9016.0,34313.59,23
HCPCS,69930,Implant cochlear device,,,9782.47,11327.07,8
HCPCS,69949,REMOVAL OF COCHLEAR IMPLANT (COMP 69501),3039.0,1975.35,0.01,3039.0,82
HCPCS,69949,REVISE COCHLEAR IMPLANT (COMP 69930),6383.0,4148.95,0.01,6383.0,82
HCPCS,69949,SUPERIOR SEMICIRCULAR CANAL DEHISCENCE REPAIR (COMP 62100),7765.0,5047.25,0.01,7765.0,82
HCPCS,69949,UNLISTED PX INNER EAR,,,211.91,637.68,21
HCPCS,69949,Unlisted px inner ear,,,939.63,1087.99,8
HCPCS,69950,INCISE INNER EAR NERVE,,,4547.61,4547.61,1
HCPCS,69950,Incise inner ear nerve,,,5036.43,5831.66,8
HCPCS,69950,"VESTIBULAR NERV SECTN,TRANSCRANIAL",11052.0,7183.8,1.1,11052.0,132
HCPCS,69955,RELEASE FACIAL NERVE,,,5080.55,15288.41,21
HCPCS,69955,Release facial nerve,,,5036.43,5831.66,8
HCPCS,69955,TOTAL FACIAL NERVE DECOMPRESSION &/REPAIR,11768.0,7649.2,1.1,17080.38,144
HCPCS,69960,DECOMPRESS INTERN AUDITORY CANAL,12945.0,8414.25,1.1,17080.38,144
HCPCS,69960,RELEASE INNER EAR CANAL,,,5080.55,15288.41,21
HCPCS,69960,Release inner ear canal,,,5036.43,5831.66,8
HCPCS,69970,REMOVE INNER EAR LESION,,,5080.55,15288.41,21
HCPCS,69970,"REMOVE TUMOR,TEMPORAL BONE",12964.0,8426.6,1.1,17080.38,144
HCPCS,69970,Remove inner ear lesion,,,4527.92,5242.85,8
HCPCS,69979,UNLISTED PX TEMPORAL BONE,,,211.91,637.68,21
HCPCS,69979,Unlisted px temporal bone,,,2059.35,2384.51,8
HCPCS,69990,MICROSURG TQS REQ USE OPERATING MICROSCOPE,1384.0,899.6,1.1,1384.0,144
HCPCS,69990,Microsurgery add-on,,,405.62,469.67,8
HCPCS,70010,CONTRAST X-RAY OF BRAIN,,,330.06,81842.52,27
HCPCS,70010,Contrast x-ray of brain,,,380.6,440.69,8
HCPCS,70015,CISTERNOGRAPHY BRAIN(POS CONTRAST),5451.0,3543.15,1.1,5927.0,394
HCPCS,70015,CONTRAST X-RAY OF BRAIN,,,244.43,81848.36,29
HCPCS,70015,Contrast x-ray of brain,,,386.08,447.04,8
HCPCS,70030,RADIOLOGIC EXAMINATION EYE DETECT FOREIGN BODY,608.0,395.2,1.1,81865.9,481
HCPCS,70100,RADIOLOGIC EXAMINATION MANDIPLE PRTL <4 VIEWS,608.0,395.2,1.1,81947.72,481
HCPCS,7010F,PT INFO INTO RECALL SYSTEM,,,2739849.3,2739849.3,1
HCPCS,7010F,Pt info into recall system,,,10.69,12.38,8
HCPCS,70110,RADIOLOG EXAM MANDIBLE COMPL MINIMUM 4 VIEWS,734.0,477.1,1.1,81959.42,568
HCPCS,70120,RADIOLOGIC EXAM MASTOIDS < 3 VIEWS PER SIDE,734.0,477.1,1.1,81971.1,481
HCPCS,70130,RADEX MASTOIDS COMPL MINIMUM 3 VIEWS PR SIDE,734.0,477.1,1.1,81982.8,481
HCPCS,70134,X-RAY EXAM OF MIDDLE EAR,,,99.94,81987.48,29
HCPCS,70134,X-ray exam of middle ear,,,56.78,65.75,8
HCPCS,70140,RADEX FACIAL BONES < 3 VIEWS,608.0,395.2,1.1,81994.48,481
HCPCS,70150,RADEX FACIAL BONES COMPLETE MINIMUM 3 VIEWS,734.0,477.1,1.1,82006.18,481
HCPCS,70160,RADEX NASAL BONES COMPLETE MINIMUM 3 VIEWS,608.0,395.2,1.1,82017.86,481
HCPCS,70170,X-RAY EXAM OF TEAR DUCT,,,212.58,82029.56,29
HCPCS,70170,X-ray exam of tear duct,,,142.61,165.13,8
HCPCS,70190,RADEX OPTIC FORAMINA,608.0,395.2,1.1,692.0,394
HCPCS,70190,X-RAY EXAM OF EYE SOCKETS,,,68.24,82052.94,29
HCPCS,70190,X-ray exam of eye sockets,,,56.78,65.75,8
HCPCS,70200,RADEX ORBITS COMPLETE MINIMUM 4 VIEWS,734.0,477.1,1.1,82064.62,481
HCPCS,7020F,MAMMO ASSESS CAT IN DBASE,,,2739849.3,2739849.3,1
HCPCS,7020F,Mammo assess cat in dbase,,,10.69,12.38,8
HCPCS,70210,RADEX SINUSES PARANASAL <3 VIEWS,608.0,395.2,1.1,82076.32,481
HCPCS,70220,RADEX SINUSES PARANASAL COMPL MINIMUM 3 VIEWS,608.0,395.2,1.1,82088.01,481
HCPCS,70240,RADIOLOGIC EXAMINATION SELLA TURCICA,608.0,395.2,1.1,82111.39,481
HCPCS,70250,RADIOLOGIC EXAMINATION SKULL 4< VIEWS,734.0,477.1,1.1,82123.08,481
HCPCS,7025F,PT INFOSYS ALARM 4 NXT MAMMO,,,0.03,0.03,1
HCPCS,7025F,Pt infosys alarm 4 nxt mammo,,,10.69,12.38,8
HCPCS,70260,RADIOLOGIC EXAM SKULL COMPLETE MINIMUM 4 VIEWS,734.0,477.1,1.1,82134.77,481
HCPCS,70300,RADIOLOGIC EXAMINATION TEETH 1 VIEW,608.0,395.2,1.1,82181.53,481
HCPCS,70310,RADIOLOGIC EXAM TEETH PRTL EXAM < FULL MOUTH,1668.0,1084.2,1.1,82193.22,481
HCPCS,70320,RADIOLOGIC EXAM TEETH COMPLETE FULL MOUTH,1668.0,1084.2,1.1,82204.91,481
HCPCS,70328,RADEX TEMPOROMANDBLE JT OPN & CLSD MOUTH UNILAT,608.0,395.2,1.1,82214.26,481
HCPCS,70330,RADEX TEMPOROMANDBLE JT OPN & CLSD MOUTH BILAT,608.0,395.2,1.1,82216.6,481
HCPCS,70332,TEMPOROMANDBLE JT ARTHROGRAPHY RS&I,1668.0,1084.2,1.1,1884.0,394
HCPCS,70332,X-RAY EXAM OF JAW JOINT,,,139.08,82218.93,29
HCPCS,70332,X-ray exam of jaw joint,,,142.61,165.13,8
HCPCS,70336,MRI TEMPOROMANDIBULAR JOINT,1668.0,1084.2,1.1,2260.0,481
HCPCS,70350,CEPHALOGRAM ORTHODONTIC,608.0,395.2,1.1,82239.98,481
HCPCS,70355,ORTHOPANTOGRAM,608.0,395.2,1.1,82245.82,481
HCPCS,70360,RADIOLOGIC EXAMINATION NECK SOFT TISSUE,608.0,395.2,1.1,82251.67,481
HCPCS,70370,RADEX PHARYNX/LARX W/FLUOR&/MAGNIFICATION TQ,608.0,395.2,1.1,736.0,394
HCPCS,70370,THROAT X-RAY & FLUOROSCOPY,,,78.83,82263.36,29
HCPCS,70370,Throat x-ray & fluoroscopy,,,56.78,65.75,8
HCPCS,70371,CPLX DYNAMIC PHARYNGEAL&SP EVAL C/V REC,1668.0,1084.2,132.56,82264.53,87
HCPCS,70380,RADIOLOGIC EXAMINATION SALIVARY GLAND CALCULUS,608.0,395.2,1.1,82275.05,481
HCPCS,70390,SIALOGRAPHY RS&I,1668.0,1084.2,1.1,82286.74,481
HCPCS,70450,CT HEAD/BRAIN W/O CONTRAST MATERIAL,734.0,477.1,1.1,82356.88,481
HCPCS,70460,CT HEAD/BRAIN W/CONTRAST MATERIAL,1228.0,798.2,1.1,82368.57,481
HCPCS,70470,CT HEAD/BRAIN W/O & W/CONTRAST MATERIAL,1228.0,798.2,1.1,82380.26,481
HCPCS,70471,CTA HEAD&NECK C+ W/NONCONTRAST IMG&POST-PXESSING,2459.0,1598.35,1.1,3559.0,395
HCPCS,70472,CT CERE PRFUJ ALYS C+ W/CT/CTA SAME ANATOMY,1228.0,798.2,1.1,1567.0,385
HCPCS,70473,CT CERE PRFUJ ALYS C+ W/O CT/CTA SAME ANATOMY,1236.0,803.4,1.1,1676.0,395
HCPCS,70480,CT ORBIT SELLA/POST FOSSA/EAR W/O CONTRAST MATRL,734.0,477.1,1.1,82391.95,481
HCPCS,70481,CT ORBIT SELLA/POST FOSSA/EAR W/CONTRAST MATRL,1228.0,798.2,1.1,82393.11,481
HCPCS,70482,CT ORBIT SELLA/POST FOSSA/EAR W/O & W/CONTR MATR,1228.0,798.2,1.1,82394.29,481
HCPCS,70486,CT MAXILLOFACIAL W/O CONTRAST MATERIAL,734.0,477.1,1.1,82398.97,481
HCPCS,70487,CT MAXILLOFACIAL W/CONTRAST MATERIAL,1228.0,798.2,1.1,82400.13,481
HCPCS,70488,CT MAXILLOFACIAL W/O & W/CONTRAST MATERIAL,1228.0,798.2,1.1,82401.3,481
HCPCS,70490,CT SOFT TISSUE NECK W/O CONTRAST MATERIAL,734.0,477.1,1.1,82403.64,481
HCPCS,70491,CT SOFT TISSUE NECK W/CONTRAST MATERIAL,1228.0,798.2,1.1,82404.81,481
HCPCS,70492,CT SOFT TISSUE NECK W/O & W/CONTRAST MATERIAL,1228.0,798.2,1.1,82405.98,481
HCPCS,70496,CT ANGIOGRAPHY HEAD W/CONTRAST/NONCONTRAST,1228.0,798.2,1.1,82410.65,481
HCPCS,70498,CT ANGIOGRAPHY NECK W/CONTRAST/NONCONTRAST,1228.0,798.2,1.1,82413.0,481
HCPCS,70540,MRI ORBIT FACE &/NECK W/O CONTRAST,1668.0,1084.2,1.1,2262.0,481
HCPCS,70542,MRI ORBIT FACE & NECK W/CONTRAST MATERIAL,2464.0,1601.6,1.1,3112.0,481
HCPCS,70543,MRI ORBIT FACE & NECK W/O & W/CONTRAST MATRL,2464.0,1601.6,1.1,3324.0,481
HCPCS,70544,MRA HEAD W/O CONTRST MATERIAL,1668.0,1084.2,212.58,1668.0,87
HCPCS,70544,"MRA, HEAD W/O CONTRAST",1668.0,1084.2,1.1,2148.0,394
HCPCS,70545,MRA HEAD W/CONTRAST MATERIAL,2464.0,1601.6,310.55,2464.0,87
HCPCS,70545,"MRA, HEAD, WITH CONTRAST",2464.0,1601.6,1.1,2944.0,394
HCPCS,70546,MRA HEAD W/O & W/CONTRAST MATERIAL,2464.0,1601.6,310.77,2464.0,87
HCPCS,70546,MRA; HEAD W & WO CONTRAST,2464.0,1601.6,1.1,3115.0,394
HCPCS,70547,MRA NECK W/O CONTRST MATERIAL,1668.0,1084.2,212.58,1668.0,87
HCPCS,70547,"MRA, NECK; W/O CONTRAST",1668.0,1084.2,1.1,2196.0,394
HCPCS,70548,MRA NECK W/CONTRAST MATERIAL,2464.0,1601.6,310.77,2464.0,87
HCPCS,70548,"MRA, NECK; W/CONTRAST",2464.0,1601.6,1.1,3064.0,394
HCPCS,70549,MRA NECK W/O &W/CONTRAST MATERIAL,2464.0,1601.6,310.77,2464.0,87
HCPCS,70549,"MRA,NECK; W/WO CONTRAST",2464.0,1601.6,1.1,3184.0,394
HCPCS,70551,MRI BRAIN BRAIN STEM W/O CONTRAST MATERIAL,1668.0,1084.2,1.1,2319.0,481
HCPCS,70552,MRI BRAIN BRAIN STEM W/CONTRAST MATERIAL,2464.0,1601.6,1.1,3247.0,481
HCPCS,70553,MRI BRAIN BRAIN STEM W/O W/CONTRAST MATERIAL,2464.0,1601.6,1.1,3472.0,481
HCPCS,70554,MRI BRAIN FUNCTIONAL W/O PHYSICIAN ADMNISTRATION,1668.0,1084.2,1.1,2512.0,481
HCPCS,70555,MRI BRAIN FUNCTIONAL W/PHYSICIAN ADMNISTRATION,1668.0,1084.2,1.1,2684.0,409
HCPCS,70557,MRI BRAIN OPEN INTRACRANIAL PX W/O CONTRAST MATL,3783.0,2458.95,1.1,5059.0,409
HCPCS,70558,MRI BRAIN OPEN INTRACRANIAL PX W/CONTRAST MATL,1408.0,915.2,1.1,2636.0,409
HCPCS,70559,MRI BRAIN OPEN INTRACRANIAL PX W/O & W/CONTRAST,1280.0,832.0,1.1,2508.0,409
HCPCS,71045,RADIOLOGIC EXAM CHEST SINGLE VIEW,608.0,395.2,1.1,83052.44,568
HCPCS,71046,RADIOLOGIC EXAM CHEST 2 VIEWS,608.0,395.2,1.1,83053.61,655
HCPCS,71047,RADIOLOGIC EXAM CHEST 3 VIEWS,608.0,395.2,1.1,83054.78,568
HCPCS,71048,RADIOLOGIC EXAM CHEST 4+ VIEWS,734.0,477.1,1.1,83055.95,568
HCPCS,71090,X-RAY & PACEMAKER INSERTION,196.0,127.4,1.1,196.0,70
HCPCS,71100,RADEX RIBS UNILATERAL 2 VIEWS,608.0,395.2,1.1,83116.74,481
HCPCS,71101,RADEX RIBS UNI W/POSTEROANT CH MINIMUM 3 VIEWS,734.0,477.1,1.1,83117.9,481
HCPCS,71110,RADEX RIBS BILATERAL 3 VIEWS,734.0,477.1,1.1,83128.43,481
HCPCS,71111,RADEX RIBS BI W/POSTEROANT CH MINIMUM 4 VIEWS,734.0,477.1,1.1,83129.6,481
HCPCS,71120,RADEX STERNUM MINIMUM 2 VIEWS,608.0,395.2,1.1,83140.12,568
HCPCS,71130,RADEX STERNOCLAVICULAR JT/JTS MINIMUM 3 VIEWS,608.0,395.2,1.1,83151.81,481
HCPCS,71250,DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX W/O CNTRST,734.0,477.1,1.1,83292.09,481
HCPCS,71260,DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX W/CONTRAST,1228.0,798.2,1.1,1738.0,568
HCPCS,71270,DIAGNOSTIC COMPUTED TOMOGRAPHY THORAX C-/C+,1228.0,798.2,1.1,1778.0,481
HCPCS,71271,COMPUTED TOMOGRAPHY THORAX LW DOSE LNG CA SCR C-,734.0,477.1,1.1,83316.64,481
HCPCS,71275,CT ANGIOGRAPHY CHEST W/CONTRAST/NONCONTRAST,1228.0,798.2,1.1,2029.0,481
HCPCS,71550,MRI CHEST W/O CONTRAST MATERIAL,1668.0,1084.2,1.1,2252.0,481
HCPCS,71551,MRI CHEST W/CONTRAST MATERIAL,5451.0,3543.15,386.08,5451.0,87
HCPCS,71551,"MRI,CHEST; W/CONTRAST",5451.0,3543.15,1.1,6143.0,394
HCPCS,71552,MRI CHEST W/O & W/CONTRAST MATERIAL,2464.0,1601.6,1.1,3368.0,481
HCPCS,71555,MR ANGIO CHEST (MRA),6274.0,4078.1,1.1,7070.0,394
HCPCS,71555,MRA CHEST W CON,6274.0,4078.1,246.84,6274.0,69
HCPCS,71555,MRA CHEST W CONTRAST,6274.0,4078.1,1.1,7070.0,463
HCPCS,71555,MRA CHEST W/O & W/CONTRAST MATERIAL,6274.0,4078.1,1.1,7070.0,394
HCPCS,71555,MRA CHEST WITH OR W/O CONT,6274.0,4078.1,1.1,7070.0,394
HCPCS,71555,MRA CHEST WO,6274.0,4078.1,246.84,6274.0,69
HCPCS,71555,MRA CHEST WO CONTR,6274.0,4078.1,246.84,6274.0,69
HCPCS,71555,MRA CHEST WO/W,6274.0,4078.1,246.84,6274.0,69
HCPCS,71555,MRA CHEST WO/W CONTR,6274.0,4078.1,246.84,6274.0,69
HCPCS,72020,RADEX SPINE 1 VIEW SPECIFY LEVEL,608.0,395.2,1.1,84192.23,481
HCPCS,72040,RADEX SPINE CERVICAL 2 OR 3 VIEWS,608.0,395.2,1.1,84215.61,481
HCPCS,72050,RADEX SPINE CERVICAL 4 OR 5 VIEWS,734.0,477.1,1.1,84227.3,481
HCPCS,72052,RADEX SPINE CERVICAL 6 OR MORE VIEWS,734.0,477.1,1.1,84229.63,481
HCPCS,72070,RADEX SPINE THORACIC 2 VIEWS,734.0,477.1,1.1,84250.68,481
HCPCS,72072,RADEX SPINE THORACIC 3 VIEWS,734.0,477.1,1.1,84253.01,481
HCPCS,72074,RADEX SPINE THORACIC MINIMUM 4 VIEWS,734.0,477.1,1.1,84255.36,481
HCPCS,72080,RADEX SPINE THORACOLUMBAR JUNCTION MIN 2 VIEWS,608.0,395.2,1.1,84262.37,481
HCPCS,72081,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 1 VW,608.0,395.2,1.1,84263.53,568
HCPCS,72082,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 2/3 VW,734.0,477.1,1.1,84264.71,568
HCPCS,72083,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 4/5 VW,734.0,477.1,1.1,84265.88,481
HCPCS,72084,RADEX ENTIR THRC LMBR CRV SAC SPI W/SKULL 6/> VW,734.0,477.1,1.1,84267.04,481
HCPCS,72100,RADEX SPINE LUMBOSACRAL 2/3 VIEWS,734.0,477.1,1.1,84285.75,481
HCPCS,72110,RADEX SPINE LUMBOSACRAL MINIMUM 4 VIEWS,734.0,477.1,1.1,84297.44,481
HCPCS,72114,RADEX SPINE LUMBSCRL COMPL W/BENDING VIEWS MIN 6,734.0,477.1,1.1,84302.12,481
HCPCS,72120,RADEX SPINE LUMBOSACRAL ONLY BENDING 2/3 VIEWS,734.0,477.1,1.1,84309.13,481
HCPCS,72125,CT CERVICAL SPINE W/O CONTRAST MATERIAL,734.0,477.1,1.1,1174.0,568
HCPCS,72126,CT CERVICAL SPINE W/CONTRAST MATERIAL,2464.0,1601.6,1.1,2952.0,481
HCPCS,72127,CT CERVICAL SPINE W/O &W/CONTRAST MATERIAL,1228.0,798.2,1.1,1736.0,481
HCPCS,72128,CT THORACIC SPINE W/O CONTRAST MATERIAL,734.0,477.1,1.1,1134.0,481
HCPCS,72129,CT THORACIC SPINE W/CONTRAST MATERIAL,1228.0,798.2,1.1,1716.0,481
HCPCS,72130,CT THORACIC SPINE W/O & W/CONTRAST MATERIAL,1228.0,798.2,1.1,1736.0,481
HCPCS,72131,CT LUMBAR SPINE W/O CONTRAST MATERIAL,734.0,477.1,1.1,1174.0,481
HCPCS,72132,CT LUMBAR SPINE W/CONTRAST MATERIAL,2464.0,1601.6,1.1,3001.0,481
HCPCS,72133,CT LUMBAR SPINE W/O & W/CONTRAST MATERIAL,1228.0,798.2,1.1,1787.0,481
HCPCS,72141,MRI SPINAL CANAL CERVICAL W/O CONTRAST MATRL,1668.0,1084.2,1.1,2319.0,481
HCPCS,72142,MRI SPINAL CANAL CERVICAL W/CONTRAST MATRL,2464.0,1601.6,1.1,3247.0,481
HCPCS,72146,MRI SPINAL CANAL THORACIC W/O CONTRAST MATRL,1668.0,1084.2,1.1,2319.0,481
HCPCS,72147,MRI SPINAL CANAL THORACIC W/CONTRAST MATRL,2464.0,1601.6,1.1,3247.0,481
HCPCS,72148,MRI SPINAL CANAL LUMBAR W/O CONTRAST MATERIAL,1668.0,1084.2,1.1,2260.0,481
HCPCS,72149,MRI SPINAL CANAL LUMBAR W/CONTRAST MATERIAL,2464.0,1601.6,1.1,3176.0,481
HCPCS,72156,MRI SPINAL CANAL CERVICAL W/O & W/CONTR MATRL,2464.0,1601.6,1.1,3472.0,481
HCPCS,72157,MRI SPINAL CANAL THORACIC W/O & W/CONTR MATRL,2464.0,1601.6,1.1,3380.0,481
HCPCS,72158,MRI SPINAL CANAL LUMBAR W/O & W/CONTR MATRL,2464.0,1601.6,1.1,3380.0,481
HCPCS,72159,MR ANGIO SPINE (MRA),3068.0,1994.2,1.1,3788.0,394
HCPCS,72159,MRA SPINAL CANAL WO/W,3068.0,1994.2,248.56,3068.0,69
HCPCS,72159,"MRA SPINAL CANAL, CONTENTS W/WO CONTRAST MATERIAL",3068.0,1994.2,248.56,3068.0,69
HCPCS,72159,MRA SPINE WITH OR W/O CONT,3068.0,1994.2,1.1,3788.0,394
HCPCS,72159,MRA W/CONTRAST SPINAL CANAL,3068.0,1994.2,248.56,3068.0,69
HCPCS,72159,MRA W/O CONTRAST SPINAL CANAL,3068.0,1994.2,248.56,3068.0,69
HCPCS,72159,MRA WO/W CONTRAST SPINAL CANAL,3068.0,1994.2,1.1,3788.0,394
HCPCS,72170,RADIOLOGIC EXAMINATION PELVIS 1/2 VIEWS,734.0,477.1,1.1,84367.58,481
HCPCS,72190,RADIOLOGIC EXAM PELVIS COMPL MINIMUM 3 VIEWS,734.0,477.1,1.1,84390.96,481
HCPCS,72191,CT ANGIOGRAPHY PELVIS W/CONTRAST/NONCONTRAST,1228.0,798.2,1.1,1952.0,481
HCPCS,72192,CT PELVIS W/O CONTRAST MATERIAL,734.0,477.1,1.1,1170.0,481
HCPCS,72193,CT PELVIS W/CONTRAST MATERIAL,1228.0,798.2,1.1,1738.0,481
HCPCS,72194,CT PELVIS W/O & W/CONTRAST MATERIAL,1228.0,798.2,1.1,1765.0,481
HCPCS,72195,MRI PELVIS W/O CONTRAST MATERIAL,1668.0,1084.2,1.1,2310.0,568
HCPCS,72196,MRI PELVIS W/CONTRAST MATERIAL,2464.0,1601.6,1.1,3225.0,568
HCPCS,72197,MRI PELVIS W/O & W/CONTRAST MATERIAL,2464.0,1601.6,1.1,3432.0,481
HCPCS,72198,MRA PELV W CONTRL,6296.0,4092.4,1.1,7088.0,463
HCPCS,72198,MRA PELV WO CONTR,6296.0,4092.4,245.83,6296.0,69
HCPCS,72198,MRA PELV WO CONTRL,6296.0,4092.4,1.1,7088.0,463
HCPCS,72198,MRA PELV WO/W CONTR,6296.0,4092.4,245.83,6296.0,138
HCPCS,72198,MRA PELVIS W/WO CONTRAST MATERIAL,6296.0,4092.4,1.1,7088.0,394
HCPCS,72198,MRA PELVIS WITH OR W/O CONT,6296.0,4092.4,1.1,7088.0,394
HCPCS,72200,RADIOLOGIC EXAMINATION SACROILIAC JNTS <3 VIEWS,734.0,477.1,1.1,84402.65,481
HCPCS,72202,RADIOLOGIC EXAM SACROILIAC JOINTS 3/MORE VIEWS,734.0,477.1,1.1,84404.99,568
HCPCS,72220,RADEX SACRUM & COCCYX MINIMUM 2 VIEWS,608.0,395.2,1.1,84426.03,481
HCPCS,72240,MYELOGRAPHY CERVICAL RS&I,5451.0,3543.15,1.1,84449.41,481
HCPCS,72255,MYELOGRAPHY THORACIC RS&I,5451.0,3543.15,1.1,84466.95,481
HCPCS,72265,MYELOGRAPY LUMBOSACRAL RS&I,5451.0,3543.15,1.1,84478.63,481
HCPCS,72270,MYELOGRAPY 2/MORE REGIONS RS&I,5451.0,3543.15,1.1,84484.48,481
HCPCS,72275,EPIDUROGRAPHY,,,202.48,216.6,2
HCPCS,72275,Epidurography,,,112.68,130.47,8
HCPCS,72285,DISCOGRAPHY CERV/THOR SPINE,,,142.81,84502.01,29
HCPCS,72285,DISKOGRAPY CERVICAL/THORACIC RS&I,13474.0,8758.1,1.1,13938.0,394
HCPCS,72285,Discography cerv/thor spine,,,380.6,440.69,8
HCPCS,72295,DISKOGRAPY LUMBAR RS&I,13474.0,8758.1,1.1,84513.71,481
HCPCS,73000,RADEX CLAVICLE COMPLETE,608.0,395.2,1.1,85337.86,481
HCPCS,73010,RADEX SCAPULA COMPLETE,734.0,477.1,1.1,85349.55,481
HCPCS,73020,RADEX SHOULDER 1 VIEW,608.0,395.2,1.1,85361.24,481
HCPCS,73030,RADEX SHOULDER COMPLETE MINIMUM 2 VIEWS,608.0,395.2,1.1,85372.93,481
HCPCS,73040,RADEX SHOULDER ARTHROGRAPHY RS&I,2464.0,1601.6,1.1,85384.62,481
HCPCS,73050,RADEX A-C JOINTS BI W/WO WEIGHTED DISTRCJ,608.0,395.2,1.1,85396.31,481
HCPCS,73060,RADEX HUMERUS MINIMUM 2 VIEWS,608.0,395.2,1.1,85408.0,568
HCPCS,73070,RADEX ELBOW 2 VIEWS,608.0,395.2,1.1,85419.69,568
HCPCS,73080,RADEX ELBOW COMPLETE MINIMUM 3 VIEWS,608.0,395.2,1.1,85431.38,481
HCPCS,73085,RADEX ELBOW ARTHROGRAPHY RS&I,2464.0,1601.6,1.1,85437.22,481
HCPCS,73090,RADEX FOREARM 2 VIEWS,608.0,395.2,1.1,85443.07,481
HCPCS,73092,RADEX UPPER EXTREMITY INFANT MINIMUM 2 VIEWS,734.0,477.1,1.1,85445.41,481
HCPCS,73100,RADEX WRIST 2 VIEWS,608.0,395.2,1.1,85454.76,568
HCPCS,73110,RADEX WRIST COMPLETE MINIMUM 3 VIEWS,608.0,395.2,1.1,85466.45,568
HCPCS,73115,RADEX WRIST ARTHROGRAPHY RS&I,2464.0,1601.6,1.1,85472.3,481
HCPCS,73120,RADEX HAND 2 VIEWS,734.0,477.1,1.1,85478.14,481
HCPCS,73130,RADEX HAND MINIMUM 3 VIEWS,608.0,395.2,1.1,85489.83,481
HCPCS,73140,RADEX FINGR MINIMUM 2 VIEWS,608.0,395.2,1.1,85501.52,568
HCPCS,73200,CT UPPER EXTREMITY W/O CONTRAST MATERIAL,734.0,477.1,1.1,1174.0,481
HCPCS,73201,CT UPPER EXTREMITY W/CONTRAST MATERIAL,2464.0,1601.6,1.1,2974.0,481
HCPCS,73202,CT UPPER EXTREMITY W/O & W/CONTRAST MATERIAL,1228.0,798.2,1.1,1765.0,481
HCPCS,73206,CT ANGIOGRAPHY UPPER EXTREMITY,1228.0,798.2,1.1,1952.0,481
HCPCS,73218,MRI UPPER EXTREMITY OTH THAN JT W/O CONTR MATRL,1668.0,1084.2,1.1,2208.0,481
HCPCS,73219,MRI UPPER EXTREMITY OTH THAN JT W/CONTR MATRL,2464.0,1601.6,1.1,3112.0,481
HCPCS,73220,MRI UPPER EXTREM OTHER THAN JT W/O & W/CONTRAS,2464.0,1601.6,1.1,3324.0,481
HCPCS,73221,MRI ANY JT UPPER EXTREMITY W/O CONTRAST MATRL,1668.0,1084.2,1.1,2208.0,481
HCPCS,73222,MRI ANY JT UPPER EXTREMITY W/CONTRAST MATRL,5451.0,3543.15,1.1,6099.0,481
HCPCS,73223,MRI ANY JT UPPER EXTREMITY W/O & W/CONTR MATRL,2464.0,1601.6,1.1,3324.0,481
HCPCS,73225,MR ANGIO UPPER EXTREM,6296.0,4092.4,1.1,7088.0,394
HCPCS,73225,MRA UPPER EXT W CONT,6296.0,4092.4,238.81,6296.0,69
HCPCS,73225,MRA UPPER EXT WO CONT,4288.0,2787.2,1.1,49880.0,463
HCPCS,73225,MRA UPPER EXT WO/W CONT,4288.0,2787.2,238.81,4288.0,69
HCPCS,73225,MRA UPPER EXTREMITY W/WO CONTRAST MATERIAL,4288.0,2787.2,1.1,4980.0,394
HCPCS,73501,RADEX HIP UNILATERAL WITH PELVIS 1 VIEW,608.0,395.2,1.1,85923.53,568
HCPCS,73502,RADEX HIP UNILATERAL WITH PELVIS 2-3 VIEWS,608.0,395.2,1.1,85924.71,568
HCPCS,73503,RADEX HIP UNILATERAL WITH PELVIS MINIMUM 4 VIEWS,734.0,477.1,1.1,85925.87,481
HCPCS,73521,RADEX HIPS BILATERAL WITH PELVIS 2 VIEWS,734.0,477.1,1.1,85946.91,481
HCPCS,73522,RADEX HIPS BILATERAL WITH PELVIS 3-4 VIEWS,734.0,477.1,1.1,85948.09,481
HCPCS,73523,RADEX HIPS BILATERAL WITH PELVIS MINIMUM 5 VIEWS,734.0,477.1,1.1,85949.25,481
HCPCS,73525,RADEX HIP ARTHROGRAPHY RS&I,2464.0,1601.6,1.1,85951.59,481
HCPCS,73551,RADIOLOGIC EXAMINATION FEMUR 1 VIEW,608.0,395.2,1.1,85981.99,568
HCPCS,73552,RADIOLOGIC EXAMINATION FEMUR MINIMUM 2 VIEWS,608.0,395.2,1.1,85983.15,481
HCPCS,73560,RADIOLOGIC EXAMINATION KNEE 1/2 VIEWS,608.0,395.2,1.1,85992.5,568
HCPCS,73562,RADIOLOGIC EXAMINATION KNEE 3 VIEWS,608.0,395.2,1.1,85994.85,568
HCPCS,73564,RADIOLOGIC EXAM KNEE COMPLETE 4/MORE VIEWS,734.0,477.1,1.1,85997.18,655
HCPCS,73565,RADIOLOGIC EXAM BOTH KNEES STANDING ANTEROPOST,608.0,395.2,1.1,85998.35,481
HCPCS,73580,RADIOLOGIC EXAM KNEE ARTHROGRAPHY RS&I,2464.0,1601.6,1.1,86015.88,481
HCPCS,73590,RADIOLOGIC EXAMINATION TIBIA & FIBULA 2 VIEWS,608.0,395.2,1.1,86027.58,568
HCPCS,73592,RADEX LOWER EXTREMITY INFANT MINIMUM 2 VIEWS,608.0,395.2,1.1,86029.91,481
HCPCS,73600,RADIOLOGIC EXAMINATION ANKLE 2 VIEWS,608.0,395.2,1.1,86039.26,568
HCPCS,73610,RADEX ANKLE COMPLETE MINIMUM 3 VIEWS,608.0,395.2,1.1,86050.96,481
HCPCS,73615,RADEX ANKLE ARTHROGRAPHY RS&I,2464.0,1601.6,1.1,86056.8,481
HCPCS,73620,RADIOLOGIC EXAMINATION FOOT 2 VIEWS,608.0,395.2,1.1,86062.65,481
HCPCS,73630,RADEX FOOT COMPLETE MINIMUM 3 VIEWS,608.0,395.2,1.1,86074.34,481
HCPCS,73650,RADEX CALCANEUS MINIMUM 2 VIEWS,608.0,395.2,1.1,86097.72,481
HCPCS,73660,RADEX TOE MINIMUM 2 VIEWS,608.0,395.2,1.1,86109.41,481
HCPCS,73700,CT LOWER EXTREMITY W/O CONTRAST MATERIAL,734.0,477.1,1.1,1174.0,568
HCPCS,73701,CT LOWER EXTREMITY W/CONTRAST MATERIAL,1228.0,798.2,1.1,1738.0,481
HCPCS,73702,CT LOWER EXTREMITY W/O & W/CONTRAST MATRL,1228.0,798.2,1.1,1765.0,481
HCPCS,73706,CT ANGIOGRAPHY LOWER EXTREMITY,1228.0,798.2,1.1,1988.0,481
HCPCS,73718,MRI LOWER EXTREM OTH/THN JT W/O CONTR MATRL,1668.0,1084.2,1.1,2262.0,481
HCPCS,73719,MRI LOWER EXTREM OTH/THN JT W/CONTRAST MATRL,2464.0,1601.6,1.1,3177.0,481
HCPCS,73720,MRI LOWER EXTREM OTH/THN JT W/O & W/CONTR MATR,2464.0,1601.6,1.1,3410.0,481
HCPCS,73721,MRI ANY JT LOWER EXTREM W/O CONTRAST MATRL,1668.0,1084.2,1.1,2262.0,481
HCPCS,73722,MRI ANY JT LOWER EXTREM W/CONTRAST MATERIAL,5451.0,3543.15,1.1,6164.0,481
HCPCS,73723,MRI ANY JT LOWER EXTREM W/O & W/CONTRAST MATRL,2464.0,1601.6,1.1,3410.0,481
HCPCS,73725,MR ANGIO LOWER EXTREM (MRA),6006.0,3903.9,1.1,6734.0,394
HCPCS,73725,MRA LOWER EXTREMITY W/WO CONTRAST MATERIAL,6006.0,3903.9,1.1,6734.0,394
HCPCS,73725,MRA LWR EX WO/W,6006.0,3903.9,247.95,6006.0,69
HCPCS,73725,MRA LWR EXT W CONTR,6006.0,3903.9,247.95,6006.0,69
HCPCS,73725,MRA LWR EXT W CONTRL,6006.0,3903.9,1.1,6734.0,394
HCPCS,73725,MRA LWR EXT WITH OR W/O CONT,6006.0,3903.9,1.1,6734.0,394
HCPCS,73725,MRA LWR EXT WO CONTR,6006.0,3903.9,247.95,6006.0,69
HCPCS,73725,MRA LWR EXT WO/W CONTR,6006.0,3903.9,247.95,6006.0,69
HCPCS,74018,RADIOLOGIC EXAM ABDOMEN 1 VIEW,608.0,395.2,1.1,86527.92,568
HCPCS,74019,RADIOLOGIC EXAM ABDOMEN 2 VIEWS,734.0,477.1,1.1,86529.08,568
HCPCS,74021,RADIOLOGIC EXAM ABDOMEN 3+ VIEWS,734.0,477.1,1.1,86531.42,568
HCPCS,74022,RADIOLOGIC EXAM COMPLETE ACUTE ABDOMEN SERIES,734.0,477.1,1.1,86532.59,481
HCPCS,74150,CT ABDOMEN W/O CONTRAST,734.0,477.1,1.1,1258.0,394
HCPCS,74150,CT ABDOMEN W/O CONTRAST MATERIAL,734.0,477.1,95.38,734.0,87
HCPCS,74160,CT ABDOMEN W/CONTRAST,1228.0,798.2,1.1,1787.0,394
HCPCS,74160,CT ABDOMEN W/CONTRAST MATERIAL,1228.0,798.2,159.4,1228.0,87
HCPCS,74170,CT ABDOMEN W & W/O CONTRAST,1228.0,798.2,1.1,1844.0,394
HCPCS,74170,CT ABDOMEN W/O & W/CONTRAST MATERIAL,1228.0,798.2,159.4,1228.0,87
HCPCS,74174,CT ANGIO ABD&PLVIS CNTRST MTRL W/WO CNTRST IMG,2464.0,1601.6,330.06,2464.0,87
HCPCS,74174,CT ANGIO ABD&PLVIS CNTRST MTRL W/WO CNTRST IMGES,2464.0,1601.6,1.1,3432.0,394
HCPCS,74175,CT ANGIOGRAPHY ABDOMEN W/CONTRAST/NONCONTRAST,1228.0,798.2,1.1,1956.0,568
HCPCS,74176,CT ABD & PELVIS W/O CONTRAST,1668.0,1084.2,1.1,2434.0,394
HCPCS,74176,CT ABDOMEN & PELVIS W/O CONTRAST MATERIAL,1668.0,1084.2,212.58,1668.0,87
HCPCS,74177,CT ABD & PELVIS W/CONTRAST,2464.0,1601.6,1.1,3265.0,394
HCPCS,74177,CT ABDOMEN & PELVIS W/CONTRAST MATERIAL,2464.0,1601.6,330.06,2464.0,87
HCPCS,74178,CT ABD & PELVIS W/WO CONTRST 1+ BODY REGNS,2464.0,1601.6,1.1,3268.0,394
HCPCS,74178,CT ABDOMEN & PELVIS W/WO CONTRST 1/> BODY RE,2464.0,1601.6,330.06,2464.0,87
HCPCS,74181,MRI ABDOMEN W/O CONTRAST MATERIAL,1668.0,1084.2,212.58,1668.0,87
HCPCS,74181,"MRI, ABDOMEN (MRI)",1668.0,1084.2,1.1,2252.0,394
HCPCS,74182,MRI ABDOMEN W/CONTRAST MATERIAL,2464.0,1601.6,1.1,86719.64,481
HCPCS,74183,MRI ABDOMEN W/O & W/CONTRAST MATERIAL,2464.0,1601.6,1.1,86720.8,481
HCPCS,74185,MR ABDOMINAL AORTA ANGIOGRAM,2579.0,1676.35,1.1,3299.0,394
HCPCS,74185,MRA ABD W CONT,2579.0,1676.35,245.83,2579.0,69
HCPCS,74185,MRA ABD W CONTR,2579.0,1676.35,1.1,3299.0,463
HCPCS,74185,MRA ABD WITH OR W/O CONT,2579.0,1676.35,1.1,3299.0,394
HCPCS,74185,MRA ABD WO CONT,2579.0,1676.35,245.83,2579.0,69
HCPCS,74185,MRA ABD WO CONTR,2579.0,1676.35,245.83,2579.0,69
HCPCS,74185,MRA ABD WO/W CONTR,2579.0,1676.35,245.83,2579.0,69
HCPCS,74185,MRA ABDOMEN WO/W CONT,2579.0,1676.35,245.83,2579.0,69
HCPCS,74190,PERITONEOGRAM RS&I,3783.0,2458.95,142.61,86728.99,170
HCPCS,74190,X-RAY EXAM OF PERITONEUM,3783.0,2458.95,1.1,3975.0,324
HCPCS,74210,RADIOLOGIC EXAM PHRNX&/CRV ESOPH CONTRAST STUDY,1228.0,798.2,1.1,86752.37,481
HCPCS,74220,RADIOLOGIC EXAM ESOPHAGUS SINGLE CONTRAST STUDY,1228.0,798.2,1.1,86764.05,481
HCPCS,74221,RADIOLOGIC EXAM ESOPHAGUS DOUBLE CONTRAST STUDY,1228.0,798.2,1.1,86765.22,481
HCPCS,74230,RADIOLOGIC EXAM SWALLOW FUNCTION CONTRAST STUDY,1228.0,798.2,1.1,86775.75,481
HCPCS,74235,REMOVE ESOPHAGUS OBSTRUCTION,,,164.09,175.54,2
HCPCS,74235,Remove esophagus obstruction,,,112.68,130.47,8
HCPCS,74240,RADIOLOGIC EXAM UPR GI TRC SINGLE CONTRAST STUDY,1228.0,798.2,1.1,86787.43,481
HCPCS,74246,RADIOLOGIC EXAM UPR GI TRC DOUBLE CONTRAST STUDY,1228.0,798.2,1.1,86794.45,481
HCPCS,74248,RADIOLOGIC SMALL INTESTINE FOLLOW-THROUGH STUDY,795.0,516.75,1.1,86796.78,462
HCPCS,74250,RADIOLOGIC EXAM SMALL INT SINGLE CONTRAST STUDY,1228.0,798.2,1.1,86799.13,481
HCPCS,74251,RADIOLOGIC EXAM SMALL INT DOUBLE CONTRAST STUDY,1228.0,798.2,1.1,86800.29,481
HCPCS,74261,CT COLONOGRPHY DX IMAGE POSTPROCESS W/O CONTRAST,1056.0,686.4,1.1,1790.0,568
HCPCS,74262,CT COLONOGRPHY DX IMAGE POSTPROCESS W/CONTRAST,1228.0,798.2,1.1,2328.0,481
HCPCS,74263,CT COLONOGRAPHY SCREENING IMAGE POSTPROCESSING,1668.0,1084.2,1.1,3345.71,477
HCPCS,74270,RADIOLOGIC EXAM COLON SINGLE CONTRAST STUDY,1228.0,798.2,1.1,86822.51,481
HCPCS,74280,RADIOLOGIC EXAM COLON DOUBLE CONTRAST STUDY,1228.0,798.2,1.1,86834.19,481
HCPCS,74283,THERAPEUTIC ENEMA RDCTJ INTUSSUSCEPTION/OBSTRCJ,1228.0,798.2,1.1,86837.7,481
HCPCS,74290,CONTRAST X-RAY GALLBLADDER,,,144.68,86845.89,29
HCPCS,74290,Contrast x-ray gallbladder,,,142.61,165.13,8
HCPCS,74300,CHOLANGIOGRAPHY&/PANCREATOGRAPHY NTRAOP RS&I,1101.0,715.65,1.1,1227.0,390
HCPCS,74301,CHOLANGIO&/PANCREATOGRAPHY ADDL SET INTRAOP RS,214.0,139.1,1.1,342.38,390
HCPCS,74328,ENDOSCOPIC CATHJ BILIARY DUCTAL SYSTEM RS&I,436.0,283.4,1.1,620.0,390
HCPCS,74329,ENDOSCOPIC CATHJ PANCREATIC DUCTAL SYS RS&I,757.0,492.05,1.1,976.0,390
HCPCS,74330,CMBN NDSC CATHJ BILIARY&PNCRTC DUCTAL SYS RS&I,927.0,602.55,1.1,1187.0,390
HCPCS,74340,INTRO LONG GI TUBE W/FLUORO/FILMS,632.0,410.8,1.1,843.0,324
HCPCS,74340,INTRO LONG GI TUBE W/MULT FLUORO & IMAGES RS&I,632.0,410.8,77.68,632.0,66
HCPCS,74355,PERCUTANEOUS PLACEMENT ENTEROCLYSIS TUBE RS&I,427.0,277.55,1.1,780.0,390
HCPCS,74360,INTRALUMINAL DILATION STRICTURES&/OBSTRCJS RS&I,894.0,581.1,1.1,1105.0,390
HCPCS,74363,PRQ TRANSHEPATC DILAT BILIARY DUCT STRICTRE RS&I,1645.0,1069.25,1.1,2054.0,390
HCPCS,74400,UROGRAPHY IV W/WO KUB W/WO TOMOGRAPHY,1228.0,798.2,1.1,86974.47,481
HCPCS,74410,UROGRAPHY INFUSION DRIP &/BOLUS TECHNIQUE,1228.0,798.2,1.1,86986.17,481
HCPCS,74415,UROGRAPHY NFS DRIP &/BOLUS W/NEPHROTOMOGRAPHY,1228.0,798.2,1.1,1444.0,394
HCPCS,74415,UROGRAPHY NFS DRIP&/BLS W/NF,,,159.4,86992.01,29
HCPCS,74415,Urography nfs drip&/bls w/nf,,,142.61,165.13,8
HCPCS,74420,UROGRAPHY RETROGRADE WITH/WO KUB,2464.0,1601.6,1.1,86997.85,481
HCPCS,74425,ANTEGRADE UROGRAPHY RADIOLOGICAL SUPVJ & INTERPJ,2464.0,1601.6,1.1,87003.7,481
HCPCS,74430,CYSTOGRAPHY MINIMUM 3 VIEWS RS&I,2464.0,1601.6,1.1,87009.55,481
HCPCS,74440,VASOGRAPY VESICULOGRAPY/EPIDIDYMOGRAPY RS&I,1668.0,1084.2,132.46,87021.23,87
HCPCS,74440,XRAY EXAM MALE GENITAL TRACT,1668.0,1084.2,1.1,1835.0,394
HCPCS,74445,CORPORA CAVERNOSOGRAPY RS&I,734.0,477.1,1.1,87027.08,409
HCPCS,74450,URETHROCYSTOGRAPHY RETROGRADE RS&I,1668.0,1084.2,1.1,87032.93,409
HCPCS,74455,URETHROCYSTOGRAPHY VOIDING RS&I,1668.0,1084.2,1.1,87038.77,481
HCPCS,74470,RADEX RENAL CYST STUDY TRANSLUMBAR RS&I,3783.0,2458.95,1.1,87056.31,409
HCPCS,74485,DILATION URETERS/URETHRA RS&I,14135.0,9187.75,1.1,87073.84,481
HCPCS,74710,X-RAY MEASUREMENT OF PELVIS,,,54.27,87336.87,6
HCPCS,74710,X-ray measurement of pelvis,,,56.78,65.75,8
HCPCS,74712,FETAL MRI W/PLACNTL MATRNL PLVC IMG SING/1ST GES,1668.0,1084.2,1.1,2868.0,481
HCPCS,74713,FETAL MRI W/PLACNTL MATRNL PLVC IMG EA ADDL GES,1815.0,1179.75,1.1,87340.37,462
HCPCS,74740,HYSTEROSALPINGOGRAPHY RS&I,1668.0,1084.2,1.1,87371.94,481
HCPCS,74742,TRANSCERVICAL CATHJ FALLOPIAN TUBE RS&I,419.0,272.35,1.1,663.0,390
HCPCS,74775,PERINEOGRAM,1668.0,1084.2,142.61,87412.86,85
HCPCS,74775,X-RAY PERINEOGRAM,1668.0,1084.2,1.1,1941.0,324
HCPCS,75557,CARDIAC MRI MORPHOLOGY & FUNCTION W/O CONTRAST,1668.0,1084.2,1.1,2608.0,481
HCPCS,75559,CARDIAC MRI W/O CONTRAST W/STRESS IMAGING,3783.0,2458.95,1.1,5081.0,481
HCPCS,75561,CARDIAC MRI W/WO CONTRAST & FURTHER SEQ,2464.0,1601.6,1.1,3608.0,481
HCPCS,75563,CARD MRI W/W/O CON W/STRESS IMAGE,5451.0,3543.15,1.1,6651.0,394
HCPCS,75563,CARDIAC MRI W/W/O CONTRAST W/STRESS,5451.0,3543.15,386.08,5451.0,87
HCPCS,75565,CARDIAC MRI FOR VELOCITY FLOW MAPPING,566.0,367.9,1.1,88336.37,462
HCPCS,75571,CT CALCIUM SCORING - SELF PAY,608.0,395.2,1.1,840.0,481
HCPCS,75571,CT HEART NO CONTRAST QUANT EVAL CORONRY CALCIUM,608.0,395.2,1.1,840.0,481
HCPCS,75571,CT HRT W/O DYE W/CA TEST,608.0,395.2,53.08,608.0,87
HCPCS,75572,CT HEART CONTRAST EVAL CARDIAC STRUCTURE&MORPH,2464.0,1601.6,1.1,3164.0,481
HCPCS,75573,CT HEART C+ CARDIAC STRUX&MORPH CGEN HRT DS,2464.0,1601.6,1.1,3484.0,568
HCPCS,75574,CTA HRT CORNRY ART/BYPASS GRFTS CONTRST 3D POST,2464.0,1601.6,1.1,3424.0,481
HCPCS,75577,QUAN&CHARAC C ATHEROSCLEROTC PLAQ ASSES SEV C DS,6558.0,4262.7,1.1,6932.0,395
HCPCS,75580,N-INVAS EST C FFR AUGMNT SW ALYS CTA I&R PHY/QHP,7020.0,4563.0,1.1,7350.0,480
HCPCS,75600,AORTOGRAPHY THORACIC W/O SERIALOGRAPHY RS&I,21718.0,14116.7,1.1,21914.0,481
HCPCS,75605,AORTOGRAPHY THORACIC SERIALOGRAPHY RS&I,37299.0,24244.35,1.1,37801.0,568
HCPCS,75625,AORTOGRAPHY ABDOMINAL SERIALOGRAPHY RS&I,21718.0,14116.7,1.1,22294.0,481
HCPCS,75630,AORTOGRAPHY ABDL BI ILIOFEM LOW EXTREM CATH RS&I,21718.0,14116.7,1.1,22518.0,481
HCPCS,75635,CTA ABDL AORTA&BI ILIOFEM W/CONTRAST&POSTP,1228.0,798.2,1.1,2188.0,481
HCPCS,75705,ANGIOGRAPHY SPINAL SELECTIVE RS&I,37299.0,24244.35,1.1,38171.0,481
HCPCS,75710,ANGIOGRAPHY EXTREMITY UNILATERAL RS&I,21718.0,14116.7,1.1,22418.0,481
HCPCS,75716,ANGIOGRAPHY EXTREMITY BILATERAL RS&I,21718.0,14116.7,1.1,22506.0,481
HCPCS,75726,ANGIOGRAPHY VISCERAL SLCTV/SUPRASLCTV RS&I,37299.0,24244.35,1.1,38119.0,481
HCPCS,75731,ANGIO ADRENAL UNILAT SELECT,21718.0,14116.7,1.1,22220.0,394
HCPCS,75731,ANGIOGRAPHY ADRENAL UNILATERAL SLCTV RS&I,21718.0,14116.7,201.06,21718.0,87
HCPCS,75733,ANGIOGRAPHY ADRENAL BILATERAL SLCTV RS&I,21718.0,14116.7,226.27,21718.0,87
HCPCS,75736,ANGIOGRAPHY PELVIC SLCTV/SUPRASLCTV RS&I,37299.0,24244.35,1.1,37755.0,481
HCPCS,75741,ANGIOGRAPHY PULMONARY UNILATERAL SLCTV RS&I,21718.0,14116.7,1.1,22242.0,481
HCPCS,75743,ANGIOGRAPHY PULMONARY BILATERAL SLCTV RS&I,21718.0,14116.7,1.1,22382.0,481
HCPCS,75746,ANGRPH PULMONARY NONSLCTV CATH/VEN NJX RS&I,21718.0,14116.7,1.1,22220.0,481
HCPCS,75756,ANGIOGRAPHY INTERNAL MAMMARY RS&I,21718.0,14116.7,1.1,22174.0,481
HCPCS,75774,ANGRPH SLCTV EA VSL STUDIED AFTER BASIC XM RS&I,4182.0,2718.3,1.1,4586.0,462
HCPCS,75801,LYMPHANGIOGRAM EXTREM UNILATER,4266.0,2772.9,1.1,4590.0,324
HCPCS,75801,LYMPHANGIOGRAPHY EXTREMITY ONLY UNILAT RS&I,4266.0,2772.9,545.0,88612.26,85
HCPCS,75803,LYMPHANGIO EXTREM BILAT,10719.0,6967.35,1.1,11234.0,324
HCPCS,75803,LYMPHANGIOGRAPHY EXTREMITY ONLY BILATERAL RS&I,10719.0,6967.35,654.66,88614.6,85
HCPCS,75805,LYMPHANGIOGRAPHY PELVIC/ABDOMINAL UNILAT RS&I,21718.0,14116.7,1.1,88616.93,409
HCPCS,75807,LYMPHANGIOGRAPHY PELVIC/ABDOMINAL BILATERAL RS&I,21718.0,14116.7,1.1,88619.28,409
HCPCS,75809,SHUNTOGRAM INDWELLING NONVASCULAR SHUNT RS&I,734.0,477.1,1.1,88621.61,481
HCPCS,75810,SPLENOPORTOGRAM,21718.0,14116.7,1.1,22174.0,324
HCPCS,75810,SPLENOPORTOGRAPY RS&I,21718.0,14116.7,654.66,21718.0,85
HCPCS,75820,VENOGRAPHY EXTREMITY UNILATERAL RS&I,10719.0,6967.35,1.1,11139.0,481
HCPCS,75822,VENOGRAPHY EXTREMITY BILATERAL RS&I,10719.0,6967.35,1.1,11311.0,481
HCPCS,75825,VENOGRAPHY CAVAL INFERIOR SERIALOGRAPHY RS&I,21718.0,14116.7,1.1,22220.0,481
HCPCS,75827,VENOGRAPHY CAVAL SUPERIOR SERIALOGRAPHY RS&I,10719.0,6967.35,1.1,11175.0,481
HCPCS,75831,VENOGRAPHY RENAL UNILATERAL SELECTIVE RS&I,21718.0,14116.7,1.1,22174.0,481
HCPCS,75833,VENOGRAPHY RENAL BILATERAL SELECTIVE RS&I,21718.0,14116.7,1.1,22314.0,481
HCPCS,75840,VENOGRAPHY ADRENAL UNILATERAL SELECTIVE RS&I,21718.0,14116.7,1.1,22174.0,481
HCPCS,75842,VEIN X-RAY ADRENAL GLANDS,,,463.77,14346.42,12
HCPCS,75842,Vein x-ray adrenal glands,,,2860.76,3312.46,8
HCPCS,75860,VENOGRAM SINUS/JUGULAR,456.0,296.4,1.1,456.0,126
HCPCS,75860,VENOGRAPHY VENOUS SINUS/JUGULAR CATH RS&I,21718.0,14116.7,1.1,22174.0,481
HCPCS,75870,VENOGRAPHY SUPERIOR SAGITTAL SINUS RS&I,21718.0,14116.7,1.1,22220.0,481
HCPCS,75872,VEIN X-RAY SKULL EPIDURAL,,,381.73,2741.96,25
HCPCS,75872,VENOGRAM EPIDURAL,4266.0,2772.9,1.1,4768.0,394
HCPCS,75872,Vein x-ray skull epidural,,,654.66,758.03,8
HCPCS,75880,VEIN X-RAY EYE SOCKET,,,387.19,2741.96,25
HCPCS,75880,VENOGRAM ORBITAL,4266.0,2772.9,1.1,4574.0,394
HCPCS,75880,Vein x-ray eye socket,,,654.66,758.03,8
HCPCS,75885,PRQ TRANSHEPATC PORTOGRAPY HEMODYN EVAL RS&I,21718.0,14116.7,1.1,22294.0,481
HCPCS,75887,PRQ TRANSHEPATC PORTOGRAPY W/O HEMODYN EVL INTRP,21718.0,14116.7,1.1,22294.0,481
HCPCS,75889,HEPATC VNGRPH WDG/FR HEMODYN EVAL RS&I,21718.0,14116.7,1.1,22174.0,481
HCPCS,75889,HEPATC VNGRPH WDG/FR HEMODYN EVAL RS&I (75889A),456.0,296.4,1.1,9296.26,142
HCPCS,75891,HEPATC VNGRPH WDG/FR W/O HEMODYN EVAL RS&I,21718.0,14116.7,1.1,22174.0,481
HCPCS,75891,HEPATC VNGRPH WDG/FR W/O HEMODYN EVAL RS&I (75891A),456.0,296.4,1.1,9296.26,142
HCPCS,75893,VENOUS SAMPLING THRU CATH W/WO ANGIOGRAPHY RS&,37299.0,24244.35,1.1,37515.0,481
HCPCS,75894,TRANSCATHETER EMBOLIZATION ANY METH RS&I,3113.0,2023.45,1.1,3637.0,516
HCPCS,75898,ANGRPH CATH F-UP STD TCAT OTHER THAN THROMBYLSIS,21718.0,14116.7,1.1,22378.0,554
HCPCS,75901,MECHANICAL RMVL PERICATHETER OBSTR MATRL RS&I,720.0,468.0,1.1,916.0,462
HCPCS,75902,INTRALUMINAL CATH STRIPPING,156.0,101.4,1.1,156.0,126
HCPCS,75902,MECHANICAL RMVL INTRALUMINAL OBSTR MATRL RS&I,419.0,272.35,1.1,575.0,462
HCPCS,75956,XRAY ENDOVASC THOR AO REPR,,,870.25,870.25,1
HCPCS,75956,Xray endovasc thor ao repr,,,112.68,130.47,8
HCPCS,75957,XRAY ENDOVASC THOR AO REPR,,,747.39,747.39,1
HCPCS,75957,Xray endovasc thor ao repr,,,112.68,130.47,8
HCPCS,75958,XRAY PLACE PROX EXT THOR AO,,,490.51,490.51,1
HCPCS,75958,Xray place prox ext thor ao,,,112.68,130.47,8
HCPCS,75959,XRAY PLACE DIST EXT THOR AO,,,435.17,435.17,1
HCPCS,75959,Xray place dist ext thor ao,,,112.68,130.47,8
HCPCS,75968,REPAIR ARTERY BLOCKAGE EACH,,,270.99,289.89,2
HCPCS,75970,TRANSCATHETER BIOPSY RS&I,3670.0,2385.5,112.68,3670.0,66
HCPCS,75970,TRANSVASCULAR BIOPSY,3670.0,2385.5,1.1,4002.0,324
HCPCS,75984,CHANGE PRQ TUBE/DRAINAGE CATH W CONTRAST RS&I,1051.0,683.15,1.1,88826.19,462
HCPCS,75989,RADIOLOGICAL GUIDANCE PRQ DRG W/PLMT CATH RS&I,2127.0,1382.55,1.1,88832.03,598
HCPCS,76000,FLUOROSCOPY UP TO 1 HOUR PHYSICIAN/QHP TIME,1668.0,1084.2,1.1,88844.89,481
HCPCS,76003,NEEDLE LOCALIZATION BY X-RAY,157.0,102.05,1.1,157.0,70
HCPCS,76006,X-RAY STRESS VIEW,199.0,129.35,1.1,199.0,70
HCPCS,76010,RADEX FROM NOSE RECTUM FOREIGN BODY 1 VIEW CHLD,608.0,395.2,1.1,88856.59,481
HCPCS,76014,MR SAFETY IMPLANT&/FB ASSMT CLIN STAF 1ST 15 MIN,169.0,109.85,1.1,322.0,364
HCPCS,76015,MR SAFETY IMPLANT&/FB ASSMT CLIN STAFF EA ADD 30,716.0,465.4,1.1,1059.0,347
HCPCS,76016,MR SAFETY DETERMINATION PHYSICIAN/OTHER QHP,608.0,395.2,1.1,872.0,476
HCPCS,76017,MR SAFETY MED PHYSICS XM CUSTOMIZATION PLNG&MNTR,1668.0,1084.2,1.1,2002.0,476
HCPCS,76018,MR SAFETY IMPLT ELECTRONICS PREPJ SUPVJ PHYS/QHP,633.0,411.45,1.1,963.0,476
HCPCS,76019,MR SAFETY IMPLANT POS&/IMMOBLJ SUPVJ PHYS/QHP,410.0,266.5,1.1,674.0,476
HCPCS,76080,RADEX ABSCESS/FISTULA/SINUS TRACT RS&I,3783.0,2458.95,1.1,88938.41,481
HCPCS,76098,RADIOLOGICAL EXAMINATION SURGICAL SPECIMEN,3783.0,2458.95,1.1,88959.46,568
HCPCS,76100,RADEX 1 PLNE BODY SECTION OTH/THN W/UROGRAPY,734.0,477.1,1.1,88961.79,481
HCPCS,76101,COMPLEX BODY SECTION X-RAY,,,301.28,322.3,2
HCPCS,76101,Complex body section x-ray,,,56.78,65.75,8
HCPCS,76102,COMPLEX BODY SECTION X-RAYS,,,433.66,463.91,2
HCPCS,76102,Complex body section x-rays,,,56.78,65.75,8
HCPCS,76120,CINERADIOGRAPY/VIDRADIOGRAPY XCPT WHERE SPEC,734.0,477.1,1.1,88985.17,481
HCPCS,76125,CINE/VIDEO X-RAYS ADD-ON,,,40.91,43.77,2
HCPCS,76125,Cine/video x-rays add-on,,,56.78,65.75,8
HCPCS,76140,CONSLTJ X-RAY XM MADE ELSEWHERE WRTTN REPRT,1732.0,1125.8,1.1,1873.0,222
HCPCS,76140,X-RAY CONSULTATION,,,117.82,117.82,1
HCPCS,76140,X-ray consultation,,,86.82,100.53,8
HCPCS,76145,MEDICAL PHYSICS DOSE EVAL RADIATION EXPOS W/RPRT,3661.0,2379.65,105.71,3661.0,87
HCPCS,76376,3D RENDERING W/INTERP & POSTPROCESS SUPERVISION,566.0,367.9,1.1,654.0,734
HCPCS,76376,CT 3D WO POSTPROCESS,566.0,367.9,32.47,566.0,68
HCPCS,76377,3D RENDERING W/INTERP&POSTPROC DIFF WORK STATION,1436.0,933.4,1.1,1752.0,802
HCPCS,76380,CT LIMITED/LOCALIZED FOLLOW UP STUDY,608.0,395.2,1.1,1000.0,481
HCPCS,76390,MRI SPECTROSCOPY,608.0,395.2,1.1,1282.88,460
HCPCS,76391,MAGNETIC RESONANCE ELASTOGRAPHY,1668.0,1084.2,1.1,89301.98,568
HCPCS,76496,ANGIOGRAM ITA (INFERIOR THYROID ARTERY) (COMP CODE 75710),19530.0,12694.5,0.01,20311.0,321
HCPCS,76496,BRONCHOGRAPHY,249.0,161.85,56.78,409.57,85
HCPCS,76496,CONDYLAR EMISSRAY VENOGRAM (COMP CODE 75860),21718.0,14116.7,0.01,22174.0,321
HCPCS,76496,UNLISTED FLUOROSCOPIC PROCEDURE,308.0,200.2,56.78,409.57,85
HCPCS,76496,"UNLISTED FLUOROSCOPIC PROCEDURE (EG, DIAGNOSTIC, INTERVENTIONAL",249.0,161.85,0.01,406.0,236
HCPCS,76496,VENOGRAM AZYGOS VEIN (COMP CODE 75705),33929.0,22053.85,0.01,34714.0,236
HCPCS,76496,VENOGRAM AZYGOS VEIN (COMP COMP CODE 75705),33929.0,22053.85,56.78,33929.0,85
HCPCS,76496,VENOGRAM CARDINAL VARIX (COMP CODE 75891),21718.0,14116.7,0.01,22174.0,321
HCPCS,76496,VENOGRAM FACIAL VLM (VENOLYTIC MALFORMATION) (COMP CODE 75860),21718.0,14116.7,0.01,22174.0,321
HCPCS,76496,VENOGRAM GASTRIC VEIN (COMP CODE 75891),19680.0,12792.0,0.01,20091.0,321
HCPCS,76496,VENOGRAM GASTRODUODENAL SHUNT (COMP CODE 75891),21718.0,14116.7,0.01,22174.0,321
HCPCS,76496,VENOGRAM GONADAL VEIN (COMP CODE 75831),19680.0,12792.0,0.01,20091.0,321
HCPCS,76496,VENOGRAM ILIOLUMBAR VEIN (COMP CODE 75705),37264.0,24221.6,0.01,38171.0,321
HCPCS,76496,VENOGRAM IMV (INFERIOR MESENTERIC VEIN) (COMP CODE 75891),19680.0,12792.0,0.01,20091.0,321
HCPCS,76496,VENOGRAM PARASPINAL VEIN (COMP CODE 75705),33929.0,22053.85,0.01,34714.0,321
HCPCS,76496,VENOGRAM PARAVERTEBRAL VEIN (COMP CODE 75705),37299.0,24244.35,0.01,38171.0,321
HCPCS,76496,VENOGRAM PERIUTERINE VEIN (COMP CODE 75736),33929.0,22053.85,0.01,34340.0,321
HCPCS,76496,VENOGRAM SAPHENOUS VEIN (COMP CODE 75820),10719.0,6967.35,0.01,11139.0,321
HCPCS,76496,VENOGRAM SEGMENTAL VEIN (COMP CODE 75705),37299.0,24244.35,0.01,38171.0,321
HCPCS,76496,VENOGRAM SPLENIC VEIN (COMP CODE 75891),21718.0,14116.7,0.01,22174.0,321
HCPCS,76496,VENOGRAM SUPERIOR  MESENTERIC VEIN (COMP CODE 75891),21718.0,14116.7,0.01,22174.0,321
HCPCS,76496,VENOGRAM VENOLYMPHATIC MALFORMATION (COMP CODE 75774),4182.0,2718.3,0.01,4586.0,321
HCPCS,76496,VENOGRAM VENOUS MALFORMATION (COMP CODE 75774),3872.0,2516.8,0.01,4236.0,321
HCPCS,76496,VENOGRAM VERTEBRAL VEIN (COMP CODE 75705),37299.0,24244.35,0.01,38171.0,321
HCPCS,76496,"VENOGRAM, INFERIOR PETROSAL SINUS (COMP CODE 75870)",21718.0,14116.7,0.01,22220.0,321
HCPCS,76497,CALCIUM SCORE,740.0,481.0,0.01,740.0,94
HCPCS,76497,CT CALCIUM SCORING,65.0,42.25,18.07,409.57,85
HCPCS,76497,CT CHEST WO SCREENING,99.0,64.35,27.52,409.57,85
HCPCS,76497,LOW DOSE WHOLE BODY CT,10064.0,6541.6,78.83,10064.0,85
HCPCS,76497,LOW DOSE WHOLE BODY CT (COMP CODE 78813),10064.0,6541.6,0.01,10864.0,236
HCPCS,76497,UNLISTED COMPUTED TOMOGRAPHY PROCEDURE,65.0,42.25,0.01,266.31,236
HCPCS,76498,MMR BRAIN WITH PC,2464.0,1601.6,0.01,3051.0,321
HCPCS,76498,MRI 3D CAD,1231.0,800.15,78.83,1231.0,85
HCPCS,76498,MRI 3D CAD (COMP CODE 76377),1231.0,800.15,0.01,1488.0,236
HCPCS,76498,MRI BRAIN LOCALIZATION W IVCON,2651.0,1723.15,78.83,2651.0,85
HCPCS,76498,MRI BRAIN LOCALIZATION WO CONT,2319.0,1507.35,0.01,4018.0,321
HCPCS,76498,MRI BRAIN LOCALIZATION WWO CONT,1929.0,1253.85,0.01,2685.0,321
HCPCS,76498,MRI BRAIN W/WO CONTAST PC,2464.0,1601.6,78.83,2464.0,85
HCPCS,76498,MRI BRAIN W/WO CONTRAST PC,2464.0,1601.6,0.01,3243.0,236
HCPCS,76498,MRI BREAST LIMITED,225.0,146.25,0.01,409.57,321
HCPCS,76498,MRI CERVICAL LOCALIZATION W IVCON,2651.0,1723.15,0.01,3230.0,321
HCPCS,76498,MRI GAMMA KNIFE LOCAL W CONT,2455.0,1595.75,0.01,3042.0,321
HCPCS,76498,MRI LUMBAR LOCALIZATION W IVCON,1619.0,1052.3500000000001,0.01,3238.0,321
HCPCS,76498,MRI PRE- OP MAPPING W/WO CONTR,608.0,395.2,78.83,608.0,85
HCPCS,76498,MRI PRE-OP MAPPING W/CONTRAST,629.0,408.85,0.01,1237.0,321
HCPCS,76498,MRI PRE-OP MAPPING W/O CONTRAST,608.0,395.2,78.83,608.0,85
HCPCS,76498,MRI PRE-OP MAPPING W/O CONTRST,608.0,395.2,0.01,1131.0,236
HCPCS,76498,MRI PRE-OP MAPPING W/WO CNTRST,835.0,542.75,0.01,1443.0,236
HCPCS,76498,MRI PROSTATE LIMITED WO IVCON,280.0,182.0,0.01,409.57,321
HCPCS,76498,MRI THORACIC LOCALIZATION W IVCON,2651.0,1723.15,0.01,3230.0,321
HCPCS,76498,MRI-TRUS FUSION-GUIDED PROSTRATE BIOPSY,1289.0,837.8499999999999,0.01,1347.0,179
HCPCS,76498,UNLISTED MAGNETIC RESONANCE PROCED,1650.0,1072.5,0.01,1650.0,94
HCPCS,76498,WHOLE BODY MRI,10064.0,6541.6,78.83,10064.0,85
HCPCS,76498,WHOLE BODY MRI (COMP CODE 78816),10064.0,6541.6,0.01,10965.0,236
HCPCS,76499,3D RENDERING LIVER (DONOR) S&I,1436.0,933.4,0.01,2535.0,331
HCPCS,76499,BD WHOLE BODY COMPOSITION,734.0,477.1,0.01,819.0,246
HCPCS,76499,CT ABDOMEN W/O SCREENING,734.0,477.1,0.01,1258.0,331
HCPCS,76499,ENDOVASCULAR REPAIR OF ASCENDING AORTA; RS&I (COMP TO 75957),2146.5,1395.225,0.01,2161.0,167
HCPCS,76499,ENDOVASCULAR REPAIR OF TRANSVERSE AORTIC ARCH; INVOLVING COVERAG,2753.5,1789.775,0.01,3011.0,167
HCPCS,76499,G100247 DGTL BREAST TOMOSYNTH,269.0,174.85,56.78,269.0,88
HCPCS,76499,LYMPHANGIOGRAPHY OF FACE & NECK,10719.0,6967.35,56.78,10719.0,85
HCPCS,76499,LYMPHANGIOGRAPHY OF FACE & NECK (COMP CODE 75803),10719.0,6967.35,0.01,11223.0,246
HCPCS,76499,PROC XR UNLISTD,277.5,180.375,55.88,409.57,170
HCPCS,76499,UNLISTED DIAGNOSTIC RADIOGRAPHIC PROCEDURE,201.0,130.65,0.01,267.0,246
HCPCS,76499,UNLISTED DXA BODY COMPOSITION STUDY,734.0,477.1,56.78,734.0,85
HCPCS,76499,UNLISTED DXA BODY COMPOSITION STUDY (COMP CODE 77080),734.0,477.1,0.01,819.0,246
HCPCS,76499,UNLISTED PROC; SPY ELITE EVAL OF INTESTINE,2773.0,1802.45,56.78,2773.0,85
HCPCS,76499,UNLISTED PROC; SPY ELITE EVAL OF INTESTINE (COMP TO 78445),2773.0,1802.45,0.01,2935.0,246
HCPCS,76499,"VENOGRAPHY, PULM, SEL. RADIOLOGICAL SUPV & INTERP (COMP CODE 757",19680.0,12792.0,56.78,19680.0,85
HCPCS,76499,"VENOGRAPHY, PULM, SEL. RADIOLOGICAL SUPV.&INTERP",21718.0,14116.7,56.78,21718.0,85
HCPCS,76499,"VENOGRAPHY, PULM, SEL. RADIOLOGICAL SUPV.&INTERP (COMP CODE 7574",21718.0,14116.7,0.01,21750.0,246
HCPCS,76499,XR DEXA WHOLE BODY COMPOSITION,734.0,477.1,56.78,734.0,85
HCPCS,76506,ECHOENCEPHALOGRAPHY REAL TIME IMAGING,734.0,477.1,1.1,89436.42,481
HCPCS,76510,OPHTHALMIC US DX B-SCAN&QUAN A-SCAN SM PT ENCTR,889.0,577.85,1.1,89441.09,481
HCPCS,76511,OPHTHALMIC US DX QUANTITATIVE A-SCAN ONLY,734.0,477.1,1.1,89442.26,568
HCPCS,76512,OPHTHALMIC US DX B-SCAN W/WO NON-QUAN A-SCAN,734.0,477.1,1.1,89443.43,655
HCPCS,76513,DX OPHTHALMIC US ANT SEGMENT IMMERSION UNI/BI,734.0,477.1,1.1,89444.59,481
HCPCS,76514,OPHTHALMIC US DX CORNEAL PACHYMETRY UNI/BI,169.0,109.85,1.1,89445.77,481
HCPCS,76516,OPHTHALMIC BIOMETRY US ECHOGRAPY A-SCAN,734.0,477.1,1.1,89448.1,481
HCPCS,76519,OPH BMTRY US ECHOGRAPY A-SCAN IO LENS PWR CAL,734.0,477.1,1.1,89451.61,481
HCPCS,76529,ECHO EXAM OF EYE,,,78.83,89463.3,29
HCPCS,76529,Echo exam of eye,,,47.73,55.26,8
HCPCS,76529,OPHTHALMIC ULTRASONIC FOREIGN BODY LOCALIZATION,608.0,395.2,1.1,836.0,394
HCPCS,76536,US SOFT TISSUE HEAD & NECK REAL TIME IMGE DOCM,734.0,477.1,1.1,89471.48,481
HCPCS,76604,US CHEST REAL TIME W/IMAGE DOCUMENTATION,734.0,477.1,1.1,89550.98,481
HCPCS,76641,US BREAST UNI REAL TIME WITH IMAGE COMPLETE,734.0,477.1,1.1,89594.23,568
HCPCS,76642,US BREAST UNI REAL TIME WITH IMAGE LIMITED,608.0,395.2,1.1,89595.4,568
HCPCS,76700,US ABDOMINAL REAL TIME W/IMAGE DOCUMENTATION,734.0,477.1,1.1,89663.2,481
HCPCS,76705,US ABDOMINAL REAL TIME W/IMAGE LIMITED,734.0,477.1,1.1,89669.04,568
HCPCS,76706,US ABDOMINAL AORTA REAL TIME SCREEN STUDY AAA,734.0,477.1,1.1,89670.22,457
HCPCS,76770,RENAL ECHOGRAPHY,1883.0,1223.95,1.1,1883.0,142
HCPCS,76770,US RETROPERITONEAL REAL TIME W/IMAGE COMPLETE,734.0,477.1,1.1,89745.04,481
HCPCS,76775,US RETROPERITONEAL REAL TIME W/IMAGE LIMITED,734.0,477.1,1.1,89750.88,481
HCPCS,76776,US TRNSPLNT KIDNEY REAL TIME W/IMAGE DOCMTN,734.0,477.1,1.1,89752.05,481
HCPCS,76800,ULTRASOUND SPINAL CANAL & CONTENTS,734.0,477.1,1.1,89780.1,481
HCPCS,76801,US PREGNANT UTERUS 14 WK TRANSABDL 1/1ST GESTAT,734.0,477.1,1.1,89781.27,481
HCPCS,76802,US PREG UTERUS 14 WK TRANSABDL EACH GESTATION,711.0,462.15,1.1,89782.45,462
HCPCS,76805,US PREG UTERUS AFTER 1ST TRIMEST 1/1ST GESTATION,734.0,477.1,1.1,89785.94,481
HCPCS,76810,US PREG UTERUS > 1ST TRIMESTER ABDL EA GESTATIO,711.0,462.15,1.1,89791.8,462
HCPCS,76811,US PREG UTERUS W/DETAIL FETAL ANAT 1ST GESTATION,1668.0,1084.2,1.1,89792.96,481
HCPCS,76812,US PREG UTERUS DETAIL FETAL ANAT EXAM EA GESTAT,712.0,462.8,1.1,89794.13,462
HCPCS,76813,US FETAL NUCHAL TRANSLUCENCY 1ST GESTATION,734.0,477.1,1.1,89795.3,481
HCPCS,76814,US FETAL NUCHAL TRANSLUCENCY EA ADDL GESTATION,426.0,276.9,1.1,89796.47,462
HCPCS,76815,US PREGNANT UTERUS LIMITED 1/> FETUSES,734.0,477.1,1.1,89797.64,481
HCPCS,76816,US PREG UTERUS REAL TIME F/U TRNSABDL PER FETUS,734.0,477.1,1.1,89798.81,481
HCPCS,76817,US PREG UTERUS REAL TIME W/IMAGE DCMTN TRANSVAG,734.0,477.1,1.1,89799.97,481
HCPCS,76818,FETAL BIOPHYSICAL PROFILE NON-STRESS TESTING,734.0,477.1,1.1,89801.15,481
HCPCS,76819,FETAL BIOPHYSICAL PROFILE W/O NON-STRESS TESTING,734.0,477.1,1.1,89802.32,481
HCPCS,76820,DOPPLER VELOCIMETRY FETAL UMBILICAL ARTERY,734.0,477.1,1.1,89803.48,481
HCPCS,76821,DOPPLER VELOCIMETRY FETAL MIDDLE CEREBRAL ART,734.0,477.1,1.1,89804.65,481
HCPCS,76825,ECHO FETAL CARDIOVASC W/WO M-MODE RECORDING,3783.0,2458.95,1.1,89809.32,568
HCPCS,76826,ECHO FETAL CARDIOVASC W/WO M-MODE REPEAT STD,1668.0,1084.2,1.1,89810.5,481
HCPCS,76827,DOPPLER ECHO FETAL SPECTRAL DISPLAY COMPLETE,734.0,477.1,1.1,966.0,481
HCPCS,76828,DOPPLER ECHO FETAL PULS SPECTRAL F/U/REPEAT,734.0,477.1,1.1,89812.83,481
HCPCS,76830,US TRANSVAGINAL,734.0,477.1,1.1,89815.18,481
HCPCS,76831,SALINE INFUS SONOHYSTEROGRAPHY W/COLOR DOPPLER,1668.0,1084.2,1.1,89816.34,481
HCPCS,76856,US PELVIC NONOBSTETRIC REAL-TIME IMAGE COMPLETE,734.0,477.1,1.1,89845.57,481
HCPCS,76857,FOLLICULAR US X 5,1325.0,861.25,1.1,1325.0,142
HCPCS,76857,US PELVIC NONOBSTETRIC IMAGE DCMTN LIMITED/F/U,734.0,477.1,1.1,89846.73,568
HCPCS,76870,US SCROTUM & CONTENTS,734.0,477.1,1.1,89861.94,481
HCPCS,76872,GENITALIA ECHOGRAPHY TRANS,1782.0,1158.3,1.1,1782.0,142
HCPCS,76872,US TRANSRECTAL,734.0,477.1,95.38,89864.27,87
HCPCS,76872,"US, TRANSRECTAL",734.0,477.1,1.1,1010.0,394
HCPCS,76873,US TRANSRCT PRSTATE VOL BRACHYTX PLNNING SPX,734.0,477.1,1.1,89865.44,481
HCPCS,76881,US COMPL JOINT R-T W/IMAGE DOCUMENTATION,734.0,477.1,1.1,89874.79,481
HCPCS,76882,US LMTD JOINT/OTH NONVASC XTR STRUX R-T W/IMG,734.0,477.1,1.1,89875.97,481
HCPCS,76883,US NRV&ACC STRUX 1 XTR COMPRE W/IMG PR EXTREMITY,734.0,477.1,1.1,1266.0,481
HCPCS,76885,US INFT HIPS R-T IMG DYNAMIC REQ PHYS/QHP MANJ,608.0,395.2,1.1,89879.47,481
HCPCS,76886,US INFT HIPS R-T IMG LMTD STATIC PHYS/QHP MANJ,608.0,395.2,1.1,89880.64,568
HCPCS,76932,ECHO GUIDE FOR HEART BIOPSY,,,93.62,100.15,2
HCPCS,76932,Echo guide for heart biopsy,,,93.21,107.93,8
HCPCS,76936,US CMPRN RPR ARTL PSEUDOARYSM/ARVEN FSTL,2149.0,1396.85,1.1,89939.09,481
HCPCS,76937,US GUIDE VASCULAR ACCESS,29.0,18.85,1.1,129.82,142
HCPCS,76937,US VASC ACCESS SITS VSL PATENCY NDL ENTRY,266.0,172.9,1.1,89940.25,530
HCPCS,76940,US &MNTR PARENCHYMAL TISSUE ABLATION,800.0,520.0,1.1,1498.0,390
HCPCS,76941,ECHO GUIDE FOR TRANSFUSION,,,197.14,210.9,2
HCPCS,76941,Echo guide for transfusion,,,93.21,107.93,8
HCPCS,76941,US INTRAUTERINE FTL TFUJ/CORDOCNTS IMG S&I,724.0,470.6,1.1,1260.0,324
HCPCS,76942,ECHO GUIDE FOR BIOPSY,66.0,42.9,1.1,193.59,142
HCPCS,76942,ULTRASONIC GUIDED NEEDLE BX,1425.0,926.25,1.1,1425.0,142
HCPCS,76942,US GUIDANCE NEEDLE PLACEMENT IMG S&I,863.0,560.95,0.01,89946.11,802
HCPCS,76945,US GUIDANCE CHORIONIC VILLUS SAMPLING IMG S&I,268.0,174.2,1.1,507.0,390
HCPCS,76946,US GUIDANCE AMNIOCENTESIS IMG S&I,366.0,237.9,1.1,89950.78,462
HCPCS,76948,US GUIDANCE ASPIRATION OVA IMG S&I,268.0,174.2,1.1,89953.12,450
HCPCS,76965,US GUIDANCE INTERSTITIAL RADIOELMENT APPLICATION,1192.0,774.8,1.1,89972.99,463
HCPCS,76970,ULTRASOUND EXAM FOLLOW-UP,,,195.02,208.62,2
HCPCS,76970,Ultrasound exam follow-up,,,97.71,113.14,8
HCPCS,76975,GI ENDOSCOPIC ULTRASOUND,,,212.58,1165.03,25
HCPCS,76975,GI ENDOSCOPIC US S&I,1668.0,1084.2,1.1,1992.0,324
HCPCS,76975,Gi endoscopic ultrasound,,,93.21,107.93,8
HCPCS,76977,US BONE DENSITY MEASURE,734.0,477.1,1.1,89987.01,423
HCPCS,76978,ULTRASOUND TRGT DYNAMIC MICROBUBBLE 1ST LESION,1228.0,798.2,1.1,89988.19,481
HCPCS,76979,ULTRASOUND TRGT DYNAMIC MICROBUBBLE EA ADDL LES,766.0,497.9,143.11,89989.36,136
HCPCS,76979,ULTRASOUND TRGT DYNAMIC MICROBUBBLE EA ADDLT LES,766.0,497.9,1.1,1106.0,394
HCPCS,76981,ULTRASOUND ELASTOGRAPHY PARENCHYMA,734.0,477.1,1.1,89991.69,568
HCPCS,76982,ULTRASOUND ELASTOGRAPHY FIRST TARGET LESION,734.0,477.1,1.1,89992.87,568
HCPCS,76983,ULTRASOUND ELASTOGRAPHY EA ADDL TAGET LESION,1030.0,669.5,80.3,89994.03,68
HCPCS,76983,ULTRASOUND ELASTOGRAPHY EA ADDL TARGET LESION,1030.0,669.5,1.1,1218.0,394
HCPCS,76983,USE EA ADDL TARGET LESION,1030.0,669.5,80.3,89994.03,68
HCPCS,76984,DX INTRAOP THORACIC AORTA US,,,81.19,81.19,1
HCPCS,76984,Dx intraop thoracic aorta us,,,673.41,779.74,8
HCPCS,76987,DX INTRAOP EPICAR CAR US CHD,,,247.7,247.7,1
HCPCS,76987,Dx intraop epicar car us chd,,,673.41,779.74,8
HCPCS,76988,DX NTROP EPCR US CHD IMG ACQ,,,157.85,157.85,1
HCPCS,76988,Dx ntrop epcr us chd img acq,,,673.41,779.74,8
HCPCS,76989,DX INTRAOP EPCAR US CHD I&R,,,92.61,92.61,1
HCPCS,76989,Dx intraop epcar us chd i&r,,,673.41,779.74,8
HCPCS,76998,INTRA OP ULTRASONIC GUIDANCE,843.0,547.95,1.1,1243.0,322
HCPCS,76998,ULTRASONIC GUIDANCE INTRAOPERATIVE,843.0,547.95,93.21,843.0,66
HCPCS,76999,US UNLISTED SOFT TISSUE,323.0,209.95,78.83,409.57,85
HCPCS,77001,FLUORO CENTRAL VENOUS ACCESS DEV PLACEMENT,823.0,534.95,1.1,990.0,462
HCPCS,77002,FLUOROSCOPIC GUIDANCE NEEDLE PLACEMENT ADD ON,838.0,544.7,1.1,1076.0,462
HCPCS,77003,FLUOR NEEDLE/CATH SPINE/PARASPINAL DX/THER ADDON,996.0,647.4,1.1,1260.0,462
HCPCS,77011,CT GUIDANCE STEREOTACTIC LOCALIZATION,1527.0,992.55,1.1,90026.77,462
HCPCS,77012,CT GUIDANCE NEEDLE PLACEMENT,2193.0,1425.45,1.1,90027.93,462
HCPCS,77013,CT GUIDANCE &MONITORING VISC TISS ABLATION,2593.0,1685.45,1.1,4189.0,390
HCPCS,77014,CT SCAN FOR THERAPY GUIDE,,,208.07,90030.28,6
HCPCS,77014,Ct scan for therapy guide,,,111.4,128.99,8
HCPCS,77021,MRI GUIDANCE NEEDLE PLACEMENT RS&I,2053.0,1334.45,1.1,90038.45,462
HCPCS,77022,MRI GDN PARNCHYMA TISS ABLTJ,,,604.91,647.12,2
HCPCS,77022,MRI GUIDANCE FOR PARENCHYMAL TISSUE ABLATION,1696.0,1102.4,1.1,3330.0,324
HCPCS,77022,Mri gdn parnchyma tiss abltj,,,52.12,60.35,8
HCPCS,77046,MRI BREAST WITHOUT CONTRAST MATERIAL UNILATERAL,1668.0,1084.2,1.1,90067.68,480
HCPCS,77047,MRI BREAST WITHOUT CONTRAST MATERIAL BILATERAL,1668.0,1084.2,1.1,90068.85,566
HCPCS,77048,MRI BREAST W/OUT&WITH CONTRAST W/CAD UNILATERAL,4970.0,3230.5,386.08,90070.02,136
HCPCS,77048,MRI BREAST WITHOUT&WITH CONTRAST W/CAD UNILATERAL,4970.0,3230.5,1.1,5810.0,394
HCPCS,77049,MRI BREAST BIL W/ CONTR,5984.0,3889.6,386.08,90071.18,68
HCPCS,77049,MRI BREAST BILAT W CONTR,5984.0,3889.6,1.1,6904.0,394
HCPCS,77049,MRI BREAST BILAT WO/W CONTR,5984.0,3889.6,1.1,90071.18,462
HCPCS,77049,MRI BREAST WITHOUT&WITH CONTRAST W/CAD BILATERAL,5984.0,3889.6,1.1,90071.18,462
HCPCS,77053,MAMMARY DUCTOGRAM OR GALACTOGRAM SINGLE,1668.0,1084.2,1.1,1812.0,481
HCPCS,77054,MAMMARY DUCTOGRAM OR GALACTOGRAM MULTIPLE,1668.0,1084.2,1.1,1848.0,481
HCPCS,77061,DIGITAL BREAST TOMOSYNTHESIS UNILATERAL,111.0,72.15,1.1,462.83,376
HCPCS,77062,DIGITAL BREAST TOMOSYNTHESIS BILATERAL,134.0,87.1,1.1,591.75,376
HCPCS,77063,SCREENING DIGITAL BREAST TOMOSYNTHESIS BI,240.0,156.0,1.1,90087.56,564
HCPCS,77065,DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ UNI,563.0,365.95,1.1,887.0,480
HCPCS,77066,DIAGNOSTIC MAMMOGRAPHY COMPUTER-AIDED DETCJ BI,706.0,458.9,1.1,1106.0,480
HCPCS,77067,SCREENING MAMMOGRAPHY BI 2-VIEW BREAST INC CAD,609.0,395.85,1.1,913.0,480
HCPCS,77071,MANUAL APPL STRESS PFRMD PHYS/QHP JOINT FILMS,394.0,256.1,1.1,90096.91,229
HCPCS,77072,BONE AGE STUDIES,734.0,477.1,1.1,90098.07,481
HCPCS,77073,BONE LENGTH STUDIES,734.0,477.1,1.1,90099.24,481
HCPCS,77074,RADIOLOGIC EXAMINATION OSSEOUS SURVEY LIMITED,734.0,477.1,1.1,90100.42,481
HCPCS,77075,RADIOLOGIC EXAMINATION OSSEOUS SURVEY COMPL,734.0,477.1,1.1,90101.58,481
HCPCS,77076,RADIOLOGIC EXAMINATION OSSEOUS SURVEY INFANT,734.0,477.1,1.1,90102.75,481
HCPCS,77077,JOINT SURVEY SINGLE VIEW 2 OR MORE JOINTS,734.0,477.1,1.1,90103.92,481
HCPCS,77078,CT BONE DENSITY AXIAL,,,78.83,90105.09,28
HCPCS,77078,CT BONE MINERL DENSITY STUDY 1/> SITS AXIAL SKE,608.0,395.2,1.1,708.0,394
HCPCS,77080,BONE DENSITY,822.0,534.3,1.1,822.0,142
HCPCS,77080,DXA BONE DENSITY STUDY 1/> SITES AXIAL SKEL,734.0,477.1,1.1,90107.43,473
HCPCS,77081,DXA BONE DENSITY STUDY 1/>SITES APPENDICLR SKEL,608.0,395.2,1.1,90108.59,473
HCPCS,77084,MRI BONE MARROW BLOOD SUPPLY,,,212.58,90112.1,28
HCPCS,77084,Mri bone marrow blood supply,,,255.48,295.82,8
HCPCS,77085,DXA BONE DENSITY STUDY AXIAL SKELETON,734.0,477.1,1.1,90113.27,552
HCPCS,77086,VERTEBRAL FRACTURE ASSESSMENT VIA DXA,608.0,395.2,1.1,90114.45,473
HCPCS,77089,TBS DXA/OTHER IMG CALCULATION W/I&R FX RISK,198.5,129.025,1.1,309.0,203
HCPCS,77090,TBS TECHL PREP&TRANSMIS DATA ALYS PFRMD ELSEWHR,541.0,351.65,1.1,608.0,221
HCPCS,77091,TBS TECHNICAL CALCULATION ONLY,383.0,248.95,1.1,608.0,221
HCPCS,77092,TBS INTERPRETATION & REPORT FX RISK BY OTHER QHP,95.0,61.75,1.1,469.67,211
HCPCS,77261,THER RADIOLOGY TX PLNG SMPL,,,183.72,183.72,1
HCPCS,77261,THERAPEUTIC RADIOLOGY TX PLANNING SIMPLE,572.0,371.8,1.1,572.0,142
HCPCS,77261,Ther radiology tx plng smpl,,,105.71,122.4,8
HCPCS,77262,THER RADIOLOGY TX PLNG INTRM,,,281.4,281.4,1
HCPCS,77262,THERAPEUTIC RADIOLOGY TX PLANNING INTERMEDIATE,880.0,572.0,1.1,880.0,142
HCPCS,77262,Ther radiology tx plng intrm,,,105.71,122.4,8
HCPCS,77263,THERAPEUTIC RADIOLOGY TX PLANNING COMPLEX,1258.5,818.025,1.1,1382.0,211
HCPCS,77280,THER RAD SIMULAJ-AIDED FIELD SETTING SIMPLE,916.0,595.4,1.1,1224.0,481
HCPCS,77285,THER RAD SIMULAJ-AIDED FIELD SETTING INTERMED,2526.0,1641.9,1.1,2988.0,481
HCPCS,77290,THER RAD SIMULAJ-AIDED FIELD SETTING COMPLEX,2526.0,1641.9,1.1,3212.0,481
HCPCS,77293,RESPIRATORY MOTION MANAGEMENT SIMULATION,2981.0,1937.65,1.1,3861.0,462
HCPCS,77295,3-D RADIOTHERAPY PLAN DOSE-VOLUME HISTOGRAMS,9441.0,6136.65,1.1,11329.0,481
HCPCS,77299,RESEARCH PLANNING,2160.0,1404.0,105.71,2160.0,85
HCPCS,77300,BASIC RAD DOSIMETRY CALCULATION,916.0,595.4,1.1,1189.0,394
HCPCS,77300,BASIC RADIATION DOSIMETRY CALCULATION,916.0,595.4,85.09,916.0,87
HCPCS,77301,NTSTY MODUL RADTHX PLN DOSE-VOL HISTOS,9441.0,6136.65,1.1,12957.0,481
HCPCS,77306,TELETHX ISODOSE PLN SMPL W/DOSIMETRY CALCULATION,2526.0,1641.9,1.1,3142.0,481
HCPCS,77307,TELETHX ISODOSE PLN CPLX W/BASIC DOSIMETRY,2526.0,1641.9,1.1,3802.0,481
HCPCS,77316,BRACHYTX ISODOSE PLN SMPL W/DOSIMETRY CAL,2526.0,1641.9,1.1,3086.0,481
HCPCS,77317,BRACHYTX ISODOSE PLN INTERMED W/DOSIMETRY CAL,2526.0,1641.9,1.1,3258.0,481
HCPCS,77318,BRACHYTX ISODOSE PLN CPLX W/DOSIMETRY CAL,2526.0,1641.9,1.1,3802.0,481
HCPCS,77321,SPEC TELETHX PORT PLN PARTS HEMIBDY TOT BDY,2526.0,1641.9,1.1,2944.0,481
HCPCS,77331,SPEC DOSIM ONLY PRESCRIBED TREATING PHYS,916.0,595.4,1.1,1299.0,481
HCPCS,77332,TX DEVICES DESIGN & CONSTRUCTION SIMPLE,916.0,595.4,49.65,916.0,87
HCPCS,77332,TX DEVICES DESIGN/CONSTR SIMPLE,916.0,595.4,1.1,1114.0,394
HCPCS,77333,TX DEVICES DESIGN & CONSTRUCTION INTERMEDIATE,916.0,595.4,105.71,916.0,87
HCPCS,77333,TX DEVICES DESIGN/CONSTR INTERMED,916.0,595.4,1.1,1246.0,394
HCPCS,77334,TX DEVICES DESIGN & CONSTRUCTION COMPLEX,2526.0,1641.9,162.81,2526.0,87
HCPCS,77334,TX DEVICES DESIGN/CONSTR COMPLEX,2526.0,1641.9,1.1,3032.0,394
HCPCS,77336,CONTINUING MEDICAL PHYSICS CONSLTJ PR WK,1003.5,652.275,1.1,1091.0,229
HCPCS,77338,MLC IMRT DESIGN & CONSTRUCTION PER IMRT PLAN,2526.0,1641.9,1.1,4414.0,481
HCPCS,77370,SPEC MEDICAL RADJ PHYSICS CONSLTJ,916.0,595.4,105.71,916.0,87
HCPCS,77370,SPECIAL RADIATION PHYSICS CONSULT,1131.0,735.15,1.1,1131.0,142
HCPCS,77371,RADIATION DELIVERY STEREOTACTIC CRANIAL COBALT,52747.0,34285.55,4012.14,116265.0,85
HCPCS,77372,RADIATION DELIVERY STEREOTACTIC CRANIAL LINEAR,52747.0,34285.55,1337.65,116265.0,87
HCPCS,77373,STEREOTACTIC BODY RADIATION DELIVERY,13083.0,8503.95,1.1,14050.0,316
HCPCS,77385,NTSTY MODUL RAD TX DLVR SMPL,,,510.69,1536.78,9
HCPCS,77385,Ntsty modul rad tx dlvr smpl,,,358.52,415.13,8
HCPCS,77386,NTSTY MODUL RAD TX DLVR CPLX,,,510.69,1536.78,9
HCPCS,77386,Ntsty modul rad tx dlvr cplx,,,358.52,415.13,8
HCPCS,77387,GUIDANCE FOR LOC OF TARGET VOL RADIAJ TX DLVR,299.0,194.35,1.1,336.36,250
HCPCS,77387,GUIDANCE FOR LOCLZJ TARGET VOL FOR RADJ TX DLVR,392.0,254.8,48.14,392.0,67
HCPCS,77399,EXTERNAL RADIATION DOSIMETRY,861.0,559.65,0.01,1277.0,246
HCPCS,77399,UNLISTED PX MED RADJ PHYSICS,,,117.71,354.23,21
HCPCS,77399,Unlisted px med radj physics,,,105.71,122.4,8
HCPCS,77401,RADIATION TX DELIVERY SUPFC,,,101.51,313.05,9
HCPCS,77401,Radiation tx delivery supfc,,,136.52,158.07,8
HCPCS,77402,RADIATION TREATMENT DELIVERY 1 MEV >= SIMPLE,897.0,583.05,1.1,897.0,306
HCPCS,77407,RADIATION TX DELIVERY 1 MEV >= INTERMEDIATE,3388.0,2202.2,1.1,3388.0,306
HCPCS,77412,RADIATION TREATMENT DELIVERY 1 MEV >= COMPLEX,4855.0,3155.75,1.1,4855.0,220
HCPCS,77417,THERAPEUTIC RADIOLOGY PORT IMAGES(S),534.5,347.42499999999995,1.1,586.0,181
HCPCS,77423,NEUTRON BEAM TX COMPLEX,,,510.69,1536.78,21
HCPCS,77423,Neutron beam tx complex,,,358.52,415.13,8
HCPCS,77424,INTRAOP RADIAJ TX DELIVER XRAY SINGLE TX SESSION,52747.0,34285.55,989.77,52747.0,85
HCPCS,77425,INTRAOP RADIAJ TX DELIVER ELECTRONS SNGL TX SESS,52747.0,34285.55,989.77,52747.0,85
HCPCS,77427,RADIATION TREATMENT MANAGEMENT 5 TREATMENTS,1483.0,963.95,1.1,1483.0,142
HCPCS,77427,RADIATION TX MANAGEMENT X5,,,495.64,495.64,1
HCPCS,77427,Radiation tx management x5,,,169.91,196.74,8
HCPCS,77431,RADIATION THERAPY MANAGEMENT,,,279.29,279.29,1
HCPCS,77431,RADIATION THERAPY MGMT 1/2 FRACTIONS ONLY,796.0,517.4,1.1,796.0,142
HCPCS,77431,Radiation therapy management,,,169.91,196.74,8
HCPCS,77432,STEREOTACTIC RADIATION TRMT,,,1105.7,1105.7,1
HCPCS,77432,STERETCTC RADIATION TX MANAGEMENT CRANIAL LESION,3485.0,2265.25,1.1,3485.0,142
HCPCS,77432,Stereotactic radiation trmt,,,169.91,196.74,8
HCPCS,77435,STEREOTACTIC BODY RADIATION MANAGEMENT,5223.0,3394.95,1.1,5223.0,142
HCPCS,77435,Sbrt management,,,169.91,196.74,8
HCPCS,77436,SURF RADJ THER TX PLANNING,,,35.34,38.87,12
HCPCS,77436,Surf radj ther tx planning,,,105.71,122.4,8
HCPCS,77437,SURF RADJ THER SUPFC<=150KV,,,96.53,106.18,12
HCPCS,77437,Surf radj ther supfc<=150kv,,,136.52,158.07,8
HCPCS,77438,SURF RAD THR ORTHVLT>150-500,,,96.53,106.18,12
HCPCS,77438,Surf rad thr orthvlt>150-500,,,136.52,158.07,8
HCPCS,77439,Surf rad thr img gdn us plmt,,,93.21,107.93,8
HCPCS,77469,INTRAOPERATIVE RADIATION TREATMENT MANAGEMENT,2300.0,1495.0,1.1,2300.0,142
HCPCS,77469,IO RADIATION TX MANAGEMENT,,,829.75,829.75,1
HCPCS,77469,Io radiation tx management,,,169.91,196.74,8
HCPCS,77470,SPECIAL TREATMENT PROCEDURE,3991.0,2594.15,1.1,4884.0,481
HCPCS,77499,RESEARCH LINAC 60 MINUTES,4320.0,2808.0,169.91,3065999.97,67
HCPCS,77520,PROTON TRMT SIMPLE W/O COMP,,,510.69,1536.78,21
HCPCS,77520,Proton trmt simple w/o comp,,,358.52,415.13,8
HCPCS,77522,PROTON TRMT SIMPLE W/COMP,,,1182.35,3703.44,21
HCPCS,77522,Proton trmt simple w/comp,,,989.77,1146.05,8
HCPCS,77523,PROTON TRMT INTERMEDIATE,,,1182.35,3703.44,21
HCPCS,77523,Proton trmt intermediate,,,989.77,1146.05,8
HCPCS,77525,PROTON TREATMENT COMPLEX,,,1182.35,3703.44,21
HCPCS,77525,Proton treatment complex,,,989.77,1146.05,8
HCPCS,77600,HYPERTHERMIA EXTERNAL GENERATED SUPERFICIAL,1815.0,1179.75,1.1,2391.0,481
HCPCS,77605,HYPERTHERMIA EXT GEN DEEP,,,622.02,1871.78,21
HCPCS,77605,HYPERTHERMIA EXTERNAL GENERATED DEEP,4787.0,3111.55,1.1,5523.0,394
HCPCS,77605,Hyperthermia ext gen deep,,,358.52,415.13,8
HCPCS,77610,HYPERTHERMIA INTERSTITIAL PROBE 1-5,3991.0,2594.15,1.1,4515.0,394
HCPCS,77610,HYPERTHERMIA NTRSTL PRB 5/<,,,510.69,1536.78,21
HCPCS,77610,Hyperthermia ntrstl prb 5/<,,,358.52,415.13,8
HCPCS,77615,HYPERTHERMIA INTERSTITIAL PROBE 6+,3991.0,2594.15,1.1,4727.0,394
HCPCS,77615,HYPERTHERMIA NTRSTL PRB>5,,,510.69,1536.78,21
HCPCS,77615,Hyperthermia ntrstl prb>5,,,358.52,415.13,8
HCPCS,77620,HYPERTHERMIA GEN INTRCV PRB,,,510.69,1536.78,21
HCPCS,77620,HYPERTHERMIA INTRACAVITARY PROBES,3991.0,2594.15,1.1,4615.0,394
HCPCS,77620,Hyperthermia gen intrcv prb,,,358.52,415.13,8
HCPCS,77750,INFUSE RADIOACTIVE MATERIALS,2000.0,1300.0,1.1,3815.0,415
HCPCS,77750,Infuse radioactive materials,,,136.52,158.07,8
HCPCS,77761,APPLY INTRCAV RADIAT SIMPLE,,,510.69,1536.78,21
HCPCS,77761,Apply intrcav radiat simple,,,358.52,415.13,8
HCPCS,77761,INTRACAVITARY RADIATION SOURCE APPLIC SIMPLE,3991.0,2594.15,1.1,5531.0,394
HCPCS,77762,APPLY INTRCAV RADIAT INTERM,,,510.69,1536.78,21
HCPCS,77762,Apply intrcav radiat interm,,,989.77,1146.05,8
HCPCS,77763,APPLY INTRCAV RADIAT COMPL,,,622.02,1871.78,21
HCPCS,77763,Apply intrcav radiat compl,,,989.77,1146.05,8
HCPCS,77763,INTRACAVITARY RADIATION SOURCE APPLIC COMPLEX,4787.0,3111.55,1.1,8251.0,394
HCPCS,77767,HDR RDNCL SKN SURF BRACHYTX LES </2CM/1 CHAN,1815.0,1179.75,1.1,2235.0,481
HCPCS,77768,HDR RDNCL SK SRF BRCHYTX LES >2CM&2CHAN/MLT LES,1815.0,1179.75,1.1,2375.0,481
HCPCS,77770,HDR RDNCL NTRSTL/INTRCAV BRACHYTX 1 CHANNEL,4787.0,3111.55,1.1,5567.0,481
HCPCS,77771,HDR RDNCL NTRSTL/INTRCAV BRACHYTX 2-12 CHANNEL,4787.0,3111.55,1.1,6307.0,481
HCPCS,77772,HDR RDNCL NTRSTL/INTRCAV BRACHYTX >12 CHANNELS,4787.0,3111.55,1.1,6947.0,481
HCPCS,77778,INTERSTITIAL RADIATION SOURCE APPLIC COMPLEX,4787.0,3111.55,1.1,8650.0,568
HCPCS,77789,APPLY SURF LDR RADIONUCLIDE,,,96.53,313.05,21
HCPCS,77789,Apply surf ldr radionuclide,,,136.52,158.07,8
HCPCS,77790,SUPERVISION HANDLING LOADING RADIATION SOURCE,961.0,624.65,1.1,1407.0,292
HCPCS,77799,INTERSTITIAL RADIATION LDR,741.0,481.65,96.53,741.0,85
HCPCS,77799,UNLISTED PROCEDURE CLINICAL BRACHYTHERAPY,2937.0,1909.05,0.01,3678.0,246
HCPCS,78012,THYROID UPTAKE SINGLE/MULTIPLE QUANT MEASUREMENT,2773.0,1802.45,1.1,91196.94,481
HCPCS,78013,THYROID IMAGING WITH VASCULAR FLOW,2773.0,1802.45,1.1,91198.11,481
HCPCS,78014,THYROID UPTAKE W/BLOOD FLOW SNGLE/MULT QUAN MEAS,2773.0,1802.45,1.1,91199.29,481
HCPCS,78015,THYROID CARCINOMA METASTASES IMG LMTD AREA,2773.0,1802.45,1.1,3041.0,394
HCPCS,78015,THYROID MET IMAGING,,,357.81,91200.45,29
HCPCS,78015,Thyroid met imaging,,,311.35,360.51,8
HCPCS,78016,THYROID MET IMAGING/STUDIES,,,357.81,91201.62,29
HCPCS,78016,Thyroid met imaging/studies,,,311.35,360.51,8
HCPCS,78018,THYROID CARCINOMA METASTASES IMG WHOLE BODY,3714.0,2414.1,1.1,91203.96,481
HCPCS,78020,THYROID CARCINOMA METASTASES UPTAKE,883.0,573.95,1.1,91206.3,462
HCPCS,78070,PARATHYROID PLANAR IMAGING,2773.0,1802.45,1.1,91264.75,481
HCPCS,78071,PARATHYROID PLANAR IMAGING W/WO SUBTRACTION,2773.0,1802.45,1.1,91265.92,481
HCPCS,78072,PARATHYROID IMAGING W/TOMOGRAPHIC SPECT & CT,3714.0,2414.1,1.1,91267.09,481
HCPCS,78075,ADRENAL CORTEX & MEDULLA IMG,,,1037.35,91270.6,29
HCPCS,78075,ADRENAL IMAGING CORTEX &/MEDULLA,9008.0,5855.2,1.1,9304.0,394
HCPCS,78075,Adrenal cortex & medulla img,,,888.71,1029.03,8
HCPCS,78099,UNLISTED ENDOCRINE PX DX NUC,,,357.81,1909.17,23
HCPCS,78099,Unlisted endocrine px dx nuc,,,311.35,360.51,8
HCPCS,78102,BONE MARROW IMAGING LIMITED AREA,2773.0,1802.45,218.26,91302.16,87
HCPCS,78102,"BONE MARROW IMAGING, LTD",2773.0,1802.45,1.1,2993.0,394
HCPCS,78103,BONE MARROW IMAGING MULTIPLE AREAS,2773.0,1802.45,231.39,91303.33,87
HCPCS,78103,"BONE MARROW IMAGING, MULT",2773.0,1802.45,1.1,3073.0,394
HCPCS,78104,BONE MARROW IMAGING WHOLE BODY,2773.0,1802.45,307.78,91304.49,87
HCPCS,78104,"BONE MARROW IMAGING, BODY",2773.0,1802.45,1.1,3093.0,394
HCPCS,78110,PLASMA VOLUME SINGLE,,,225.24,91311.51,29
HCPCS,78110,Plasma volume single,,,888.71,1029.03,8
HCPCS,78111,PLASMA VOLUME MULTIPLE,,,233.63,91312.68,29
HCPCS,78111,Plasma volume multiple,,,888.71,1029.03,8
HCPCS,78120,RED CELL MASS SINGLE,,,222.45,91323.2,29
HCPCS,78120,Red cell mass single,,,311.35,360.51,8
HCPCS,78121,RED CELL MASS MULTIPLE,,,225.24,91324.36,29
HCPCS,78121,Red cell mass multiple,,,311.35,360.51,8
HCPCS,78122,WHOLE BLOOD VOLUME DETERM PLASMA&RED CELL VOLU,3714.0,2414.1,1.1,91325.54,481
HCPCS,78130,RED CELL SURVIVAL STUDY,,,357.81,91334.89,29
HCPCS,78130,Red cell survival study,,,311.35,360.51,8
HCPCS,78135,RED CELL SURVIVAL KINETICS,,,845.13,904.1,2
HCPCS,78135,Red cell survival kinetics,,,311.35,360.51,8
HCPCS,78140,LABELED RBC SEQUESTRATION DIFFERNTL ORGAN/TISSUE,2773.0,1802.45,1.1,3017.0,394
HCPCS,78140,RED CELL SEQUESTRATION,,,279.31,91346.58,29
HCPCS,78140,Red cell sequestration,,,311.35,360.51,8
HCPCS,78185,SPLEEN IMAGING,,,357.81,91399.18,29
HCPCS,78185,Spleen imaging,,,311.35,360.51,8
HCPCS,78191,PLATELET SURVIVAL STUDY,,,357.81,91406.2,29
HCPCS,78191,Platelet survival study,,,311.35,360.51,8
HCPCS,78195,LYMPHATICS & LYMPH NODES IMAGING,3714.0,2414.1,1.1,91410.88,481
HCPCS,78199,UNLSTD HEMATOP RET/ENDO LYMP,,,357.81,1909.17,23
HCPCS,78199,Unlstd hematop ret/endo lymp,,,311.35,360.51,8
HCPCS,78201,LIVER IMAGING STATIC ONLY,3714.0,2414.1,1.1,91417.89,481
HCPCS,78202,LIVER IMAGING W/VASCULAR FLOW,3714.0,2414.1,1.1,91419.06,481
HCPCS,78215,LIVER & SPLEEN IMAGING STATIC ONLY,2773.0,1802.45,1.1,91434.26,481
HCPCS,78216,LIVER & SPLEEN IMAGING W/VASCULAR FLOW,2773.0,1802.45,1.1,3001.0,394
HCPCS,78216,LVR&SPLEEN IMG W/VASC FLOW,,,255.07,91435.42,29
HCPCS,78216,Lvr&spleen img w/vasc flow,,,888.71,1029.03,8
HCPCS,78226,HEPATOBILIARY SYST IMAGING INCLUDING GALLBLADDER,2773.0,1802.45,1.1,91447.12,481
HCPCS,78227,HEPATOBIL SYST IMAG INC GB W/PHARMA INTERVENJ,3714.0,2414.1,1.1,91448.28,481
HCPCS,78230,NM SALIVARY GLAND,180.0,117.0,1.1,180.0,126
HCPCS,78230,SALIVARY GLAND IMAGING,2773.0,1802.45,220.82,91451.79,87
HCPCS,78231,NM SALIVARY GLAND IMAGING,648.5,421.525,1.1,1202.97,212
HCPCS,78231,SALIVARY GLAND IMAGING SERIAL IMAGES,2773.0,1802.45,1.1,91452.96,481
HCPCS,78232,SALIVARY GLAND FUNCTION STUDY,2773.0,1802.45,1.1,91454.13,481
HCPCS,78258,ESOPHAGEAL MOTILITY,2773.0,1802.45,1.1,91484.53,481
HCPCS,78261,GASTRIC MUCOSA IMAGING,2773.0,1802.45,1.1,91488.03,423
HCPCS,78261,Gastric mucosa imaging,,,311.35,360.51,8
HCPCS,78262,GASTROESOPHAGEAL REFLUX STUDY,2773.0,1802.45,1.1,91489.2,481
HCPCS,78264,GASTRIC EMPTYING IMAGING STUDY,2773.0,1802.45,311.35,91491.54,87
HCPCS,78264,GASTRIC EMPTYING STUDY,2773.0,1802.45,1.1,3121.0,394
HCPCS,78265,GASTRIC EMPTYNG IMAG STD W/SM BWL TRANSIT,2773.0,1802.45,1.1,91492.7,481
HCPCS,78266,GSTRC EMPTNG IMAG STD W/SM BWL COL TRNST MLT DAY,3714.0,2414.1,1.1,91493.88,481
HCPCS,78267,UREA BREATH TST C-14 ACQUISJ,,,11.06,71.48,23
HCPCS,78267,Urea breath tst c-14 acquisj,,,18.15,21.01,8
HCPCS,78268,UREA BREATH TEST C-14 ALYS,,,94.41,477.95,23
HCPCS,78268,Urea breath test c-14 alys,,,36.89,42.71,8
HCPCS,78278,ACUTE GASTROINTESTINAL BLOOD LOSS IMAGING,2773.0,1802.45,357.81,91507.91,87
HCPCS,78278,ACUTE GI BLOOD LOSS IMAGING,2773.0,1802.45,1.1,3169.0,394
HCPCS,78282,GI PROTEIN LOSS,,,357.81,91512.58,29
HCPCS,78282,Gi protein loss,,,311.35,360.51,8
HCPCS,78290,INTESTINE IMAGING,2773.0,1802.45,1.1,91521.94,481
HCPCS,78291,PERITONEAL-VENOUS SHUNT PATENCY TEST,2773.0,1802.45,1.1,91523.1,481
HCPCS,78299,UNLISTED GI PX DX NUC MED,,,357.81,1909.17,23
HCPCS,78299,Unlisted gi px dx nuc med,,,311.35,360.51,8
HCPCS,78300,BONE &/JOINT IMAGING LIMITED AREA,2773.0,1802.45,1.1,91533.62,481
HCPCS,78305,BONE &/JOINT IMAGING MULTIPLE AREAS,2773.0,1802.45,1.1,3105.0,394
HCPCS,78305,BONE IMAGING MULTIPLE AREAS,,,357.81,91539.46,29
HCPCS,78305,Bone imaging multiple areas,,,311.35,360.51,8
HCPCS,78306,BONE &/JOINT IMAGING WHOLE BODY,2773.0,1802.45,1.1,91540.64,481
HCPCS,78315,BONE &/JOINT IMAGING 3 PHASE STUDY,2773.0,1802.45,1.1,91551.16,481
HCPCS,78350,BONE MINERAL SINGLE PHOTON,,,28.03,109.51,3
HCPCS,78350,"BONE MINERAL, SINGLE PHOTON",2751.0,1788.15,1.1,2839.0,306
HCPCS,78350,Bone mineral single photon,,,311.35,360.51,8
HCPCS,78351,BONE MINERAL DUAL PHOTON,,,34.54,77.72,3
HCPCS,78351,Bone mineral dual photon,,,311.35,360.51,8
HCPCS,78399,UNLISTED MUSCSKEL PX DX NUC,,,357.81,1909.17,23
HCPCS,78399,Unlisted muscskel px dx nuc,,,311.35,360.51,8
HCPCS,78414,NON-IMAGING HEART FUNCTION,,,63.75,91666.89,29
HCPCS,78414,Non-imaging heart function,,,311.35,360.51,8
HCPCS,78428,CARDIAC SHUNT DETECTION,2773.0,1802.45,1.1,91683.25,481
HCPCS,78429,MYOCRD IMG PET METAB EVAL SINGLE STUDY CNCRNT CT,10064.0,6541.6,0.01,91684.42,434
HCPCS,78430,MYOCRD IMG PET PRFUJ 1STD REST/STRESS CNCRNT CT,10064.0,6541.6,0.01,91685.6,434
HCPCS,78431,MYOCRD IMG PET PRFUJ MLT STD RST & STRS CNCRNT CT,15528.0,10093.2,1.1,16288.0,292
HCPCS,78431,MYOCRD IMG PET PRFUJ MLT STD RST&STRS CNCRNT CT,15528.0,10093.2,0.01,91686.76,154
HCPCS,78432,MYOCRD IMG PET PRFUJ W/METAB DUAL RADIOTRACER,12768.0,8299.2,0.01,91687.93,434
HCPCS,78433,MYOCRD IMG PET PRFUJ W/METAB 2RTRACER CNCRNT CT,13458.0,8747.7,0.01,91689.1,434
HCPCS,78434,AQMBF PET REST AND PHARMACOLOGIC STRESS,3209.0,2085.85,1.1,3461.0,338
HCPCS,78445,VASCULAR FLOW IMAGING,,,357.81,91703.12,29
HCPCS,78445,Vascular flow imaging,,,311.35,360.51,8
HCPCS,78451,MYOCARDIAL SPECT SINGLE STUDY AT REST OR STRESS,9008.0,5855.2,1.1,91710.14,481
HCPCS,78452,MYOCARDIAL SPECT MULTIPLE STUDIES,9008.0,5855.2,1.1,91711.31,481
HCPCS,78453,MYOCARDIAL PERFUSION PLANAR 1 STUDY REST/STRESS,9008.0,5855.2,1.1,91712.48,481
HCPCS,78454,MYOCARDIAL PERFUSION PLANAR MULTIPLE STUDIES,9008.0,5855.2,1.1,91713.65,481
HCPCS,78456,ACUTE VENOUS THROMBOSIS IMAGING PEPTIDE,9008.0,5855.2,1.1,9408.0,394
HCPCS,78456,ACUTE VENOUS THROMBUS IMAGE,,,723.01,91715.99,29
HCPCS,78456,Acute venous thrombus image,,,311.35,360.51,8
HCPCS,78457,VENOUS THROMBOSIS IMAGING,,,418.2,91717.15,29
HCPCS,78457,Venous thrombosis imaging,,,888.71,1029.03,8
HCPCS,78458,VEN THROMBOSIS IMAGES BILAT,,,330.57,91718.33,29
HCPCS,78458,Ven thrombosis images bilat,,,311.35,360.51,8
HCPCS,78459,MYOCRD IMG PET METAB EVAL SINGLE STUDY,9008.0,5855.2,1.1,91719.5,401
HCPCS,78466,HEART INFARCT IMAGE,,,357.81,91727.68,29
HCPCS,78466,Heart infarct image,,,311.35,360.51,8
HCPCS,78466,MYOCARDIAL IMAGING INFARCT AVID PLANAR QUAL/QUAN,2773.0,1802.45,1.1,3049.0,394
HCPCS,78468,HEART INFARCT IMAGE (EF),,,420.07,91730.01,29
HCPCS,78468,Heart infarct image (ef),,,311.35,360.51,8
HCPCS,78468,MYOCRD IMG INFARCT AVID PLNR EJEC FXJ 1ST PS TQ,3714.0,2414.1,1.1,4034.0,394
HCPCS,78469,MYOCRD INFARCT AVID PLNR TOMOG SPECT W/WO QUANTJ,3714.0,2414.1,1.1,91731.18,481
HCPCS,78472,CARD BLOOD POOL GATED PLANAR 1 STUDY REST/STRESS,2773.0,1802.45,1.1,91734.69,481
HCPCS,78473,CARD BL POOL GATED MLT STDY WAL MOTN EJECT FRACT,2773.0,1802.45,1.1,91735.86,481
HCPCS,78481,CARD BL POOL PLANAR 1 STDY WAL MOTN EJECT FRACT,3714.0,2414.1,1.1,91745.21,481
HCPCS,78483,CARD BL POOL PLNR MLT STDY WAL MOTN EJECT FRACT,3714.0,2414.1,1.1,91747.55,481
HCPCS,78491,MYOCRD IMG PET PRFUJ SINGLE STUDY REST/STRESS,10064.0,6541.6,1.1,91756.9,401
HCPCS,78492,MYOCRD IMG PET PRFUJ MULTIPLE STUDY REST&STRESS,10064.0,6541.6,1.1,91758.07,401
HCPCS,78494,HEART IMAGE SPECT,,,357.81,91760.41,29
HCPCS,78494,Heart image spect,,,311.35,360.51,8
HCPCS,78496,HEART FIRST PASS ADD-ON,664.0,431.6,1.1,91762.75,400
HCPCS,78496,Heart first pass add-on,,,311.35,360.51,8
HCPCS,78499,UNLISTED CV PX DX NUC MED,,,357.81,1909.17,23
HCPCS,78499,Unlisted cv px dx nuc med,,,311.35,360.51,8
HCPCS,78579,PULMONARY VENTILATION IMAGING,2773.0,1802.45,1.1,91859.78,481
HCPCS,78580,PULMONARY PERFUSION IMAGING PARTICULATE,2773.0,1802.45,1.1,91860.94,481
HCPCS,78582,PULMONARY VENTILATION & PERFUSION IMAGING,3714.0,2414.1,1.1,91863.29,481
HCPCS,78597,QUANT DIFFERENTIAL PULM PERFUSION W/WO IMAGING,2773.0,1802.45,1.1,91880.81,481
HCPCS,78598,QUANT DIFF PULM PRFUSION & VENTLAJ W/WO IMAGIN,3714.0,2414.1,1.1,91881.99,481
HCPCS,78599,UNLISTED RESP PX DX NUC MED,,,357.81,1909.17,23
HCPCS,78599,Unlisted resp px dx nuc med,,,311.35,360.51,8
HCPCS,78600,BRAIN IMAGE < 4 VIEWS,,,357.81,91884.32,29
HCPCS,78600,Brain image < 4 views,,,311.35,360.51,8
HCPCS,78601,BRAIN IMAGING <4 STATIC VIEWS W/VASCULAR FLOW,2773.0,1802.45,1.1,91885.49,481
HCPCS,78605,BRAIN IMAGING MINIMUM 4 STATIC VIEWS,3714.0,2414.1,250.76,91890.17,87
HCPCS,78605,"BRAIN IMAGING, COMPLETE",3714.0,2414.1,1.1,3926.0,394
HCPCS,78606,BRAIN IMAGING MIN 4 STATIC VIEWS W VASCULAR FLOW,3714.0,2414.1,1.1,91891.34,481
HCPCS,78608,BRAIN IMAGING PET METABOLIC EVALUATION,10064.0,6541.6,1.1,91893.68,401
HCPCS,78609,BRAIN IMAGING (PET),,,184.73,184.73,1
HCPCS,78610,BRAIN FLOW IMAGING ONLY,,,424.72,91896.02,29
HCPCS,78610,"BRAIN IMAGING, VASC FLOW ONLY",3714.0,2414.1,1.1,3834.0,394
HCPCS,78610,Brain flow imaging only,,,311.35,360.51,8
HCPCS,78630,CEREBROSPINAL FLUID FLOW W/O MATL CISTERNOGRAPHY,3714.0,2414.1,1.1,91919.4,481
HCPCS,78635,CSF VENTRICULOGRAPHY,,,468.92,91925.24,29
HCPCS,78635,Csf ventriculography,,,311.35,360.51,8
HCPCS,78645,CEREBROSPINAL FLUID FLOW W/O MATL SHUNT EVALTJ,3714.0,2414.1,1.1,91936.93,481
HCPCS,78650,CEREBROSPINAL FLUID LEAK DETECTION&LOCALIZATIO,9008.0,5855.2,1.1,91942.78,481
HCPCS,78660,NUCLEAR EXAM OF TEAR FLOW,,,357.81,91954.46,29
HCPCS,78660,Nuclear exam of tear flow,,,311.35,360.51,8
HCPCS,78699,PET BRAIN PLAQUE,2700.0,1755.0,311.35,2700.0,85
HCPCS,78700,KIDNEY IMAGING MORPHOL,,,357.81,92001.22,29
HCPCS,78700,KIDNEY IMAGING MORPHOLOGY,2773.0,1802.45,1.1,2953.0,394
HCPCS,78700,Kidney imaging morphol,,,311.35,360.51,8
HCPCS,78701,KIDNEY IMAGING MORPHOOGY W/VASCULAR FLOW,2773.0,1802.45,1.1,92002.39,481
HCPCS,78707,KIDNEY IMG MORPHOLOGY VASCULAR FLOW 1 W/O RX,3714.0,2414.1,1.1,92009.41,481
HCPCS,78708,KIDNEY IMG MORPHOLOGY VASCULAR FLOW 1 W/RX,3714.0,2414.1,1.1,92010.58,481
HCPCS,78709,KIDNEY IMG MORPHOLOGY VASCULAR FLOW MULTIPLE,3714.0,2414.1,1.1,92011.74,481
HCPCS,78725,KIDNEY FUNCJ STUDY NON-IMG RADIOISOTOPIC STUDY,2773.0,1802.45,1.1,2925.0,481
HCPCS,78730,URINARY BLADDER RETENTION,,,181.03,92036.3,6
HCPCS,78730,Urinary bladder retention,,,311.35,360.51,8
HCPCS,78740,URETERAL REFLUX STUDY RP VOIDING CYSTOGRAM,2773.0,1802.45,1.1,92047.99,481
HCPCS,78761,TESTICULAR IMAGING WITH VASCULAR FLOW,2773.0,1802.45,1.1,92072.53,481
HCPCS,78799,UNLISTED GU PX DX NUC MED,,,357.81,1909.17,23
HCPCS,78799,Unlisted gu px dx nuc med,,,311.35,360.51,8
HCPCS,78800,RP LOCLZJ TUM PLNR 1 AREA SINGLE DAY IMAGING,2773.0,1802.45,1.1,92118.13,481
HCPCS,78801,RP LOCLZJ TUM PLNR 2+AREA 1+D IMG/1 AREA IMG>2+D,2773.0,1802.45,1.1,92119.29,481
HCPCS,78802,RP LOCLZJ TUM PLNR WHOLE BODY SINGLE DAY IMAGING,9008.0,5855.2,1.1,92120.47,481
HCPCS,78803,RP LOCLZJ TUM SPECT 1 AREA SINGLE DAY IMAGING,9008.0,5855.2,1.1,92121.64,568
HCPCS,78804,RP LOCLZJ TUM PLNR WHOLE BODY 2+ DAYS IMAGING,9008.0,5855.2,1.1,92122.8,481
HCPCS,78808,NJX RP LOCLZJ NON-IMG PROBE STUDY INTRAVENOUS,1426.0,926.9,1.1,92127.48,229
HCPCS,78811,PET IMAGING LIMITED AREA CHEST HEAD/NECK,9008.0,5855.2,1.1,92130.99,478
HCPCS,78812,PET IMAGING SKULL BASE TO MID-THIGH,10064.0,6541.6,1.1,92132.15,401
HCPCS,78813,PET IMAGE FULL BODY,10064.0,6541.6,1.1,10864.0,324
HCPCS,78813,PET IMAGING WHOLE BODY,10064.0,6541.6,1352.17,92133.32,77
HCPCS,78814,PET IMAGING CT FOR ATTENUATION LIMITED AREA,10064.0,6541.6,1.1,92134.5,555
HCPCS,78815,PET IMAGING CT ATTENUATION SKULL BASE MID-THIGH,10064.0,6541.6,1.1,92135.66,555
HCPCS,78816,PET IMAGING FOR CT ATTENUATION WHOLE BODY,10064.0,6541.6,1.1,92136.83,555
HCPCS,78830,RP LOCLZJ TUM SPECT W/CT 1 AREA 1 DAY IMAGING,9008.0,5855.2,0.01,92153.2,568
HCPCS,78831,RP LOCLZJ TUM SPECT 2 AREA/SEP ACQUISJ IMG,9008.0,5855.2,0.01,92154.37,568
HCPCS,78832,RP LOCLZJ TUM SPECT CT 2AREA/SEP ACQUISJ IMG,10064.0,6541.6,0.01,92155.53,568
HCPCS,78835,RADIOPHARMACEUTICAL QUANTIFICATION MEAS 1 AREA,410.0,266.5,1.1,92159.04,462
HCPCS,78999,MRI FUSION TO PET (COMP CODE 76376),656.0,426.4,0.01,1909.17,331
HCPCS,78999,UNLISTED MISCELLANEOUS PX DX NUCLEAR MEDICINE,537.0,349.05,0.01,1202.97,164
HCPCS,79005,RP THERAPY ORAL ADMINISTRATION,1546.0,1004.9,1.1,92357.77,481
HCPCS,79101,RP THERAPY INTRAVENOUS ADMINISTRATION,1546.0,1004.9,1.1,92470.0,568
HCPCS,79200,INTRACAVITARY NUCLEAR TREATMNT,1546.0,1004.9,1.1,2342.0,394
HCPCS,79200,NUCLEAR RX INTRACAV ADMIN,,,145.62,92585.73,29
HCPCS,79200,Nuclear rx intracav admin,,,271.92,314.85,8
HCPCS,79300,NUCLR RX INTERSTIT COLLOID,,,207.78,92702.63,27
HCPCS,79300,Nuclr rx interstit colloid,,,271.92,314.85,8
HCPCS,79403,RP THER RADIOLBLD MONOCLONAL ANTIBODY IV INFUS,1546.0,1004.9,1.1,2446.0,568
HCPCS,79440,NUCLEAR RX INTRA-ARTICULAR,,,124.18,92866.29,29
HCPCS,79440,Nuclear rx intra-articular,,,271.92,314.85,8
HCPCS,79445,RP THERAPY INTRA-ARTERIAL PARTICULATE ADMN,1546.0,1004.9,1.1,92872.14,494
HCPCS,79999,RP THERAPY UNLISTED PX,,,207.78,1263.71,23
HCPCS,79999,Rp therapy unlisted px,,,271.92,314.85,8
HCPCS,80047,BASIC METABOLIC PANEL WITH CALCIUM IONIZED,95.0,61.75,1.1,95.0,88
HCPCS,80047,BMP I STAT ANALYZER,95.0,61.75,9.74,95.0,84
HCPCS,80047,BMP I STAT ANALYZER (POINT OF CARE LAB),95.0,61.75,9.74,95.0,84
HCPCS,80048,BASIC METABOLIC PANEL,58.0,37.7,7.91,58.0,84
HCPCS,80048,BASIC METABOLIC PANEL CALCIUM TOTAL,58.0,37.7,1.1,58.0,88
HCPCS,80050,GENERAL HEALTH PANEL,497.0,323.05,17.36,1666801.85,67
HCPCS,80051,ELECTROLYTE PANEL,48.0,31.2,1.1,48.0,172
HCPCS,80053,COMPRE META PANL,73.0,47.45,5.99,73.0,84
HCPCS,80053,COMPREHENSIVE METABOLIC PANEL,73.0,47.45,1.1,73.0,88
HCPCS,80055,OB PANEL,330.0,214.5,19.67,381.89,84
HCPCS,80061,%NMRLIP CHOLESTEROL,92.0,59.8,13.39,92.0,84
HCPCS,80061,LIPID PANEL,92.0,59.8,1.1,92.0,88
HCPCS,80061,LIPID-LIPO PANEL 1,92.0,59.8,13.39,92.0,84
HCPCS,80061,LIPID-LIPO PANEL 1 (POINT OF CARE LAB),92.0,59.8,13.39,92.0,84
HCPCS,80061,LIPOEL LIPID PANEL,92.0,59.8,13.39,92.0,84
HCPCS,80069,RENAL FUNC PANL,60.0,39.0,8.68,60.0,84
HCPCS,80069,RENAL FUNCT PNL,60.0,39.0,1.1,60.0,88
HCPCS,80074,ACUTE HEPATITIS PANEL,329.0,213.85,1.1,329.0,88
HCPCS,80074,HEPATITIS ACUTE PANEL,329.0,213.85,19.67,329.0,84
HCPCS,80076,HEP FUNC PANL,56.0,36.4,4.04,56.0,84
HCPCS,80076,HEPATIC FUNCTION PNL,56.0,36.4,1.1,56.0,88
HCPCS,80081,OBSTETRIC PANEL INC HIV TSTG,,,36.97,205.12,28
HCPCS,80081,Obstetric panel inc hiv tstg,,,19.67,22.77,8
HCPCS,80100,DRUG SCREEN QUALITATE/MULTI,,,276.01,276.01,1
HCPCS,80101,DRUG SCREEN SINGLE,,,160.67,160.67,1
HCPCS,80102,DRUG CONFIRMATION,,,63.89,63.89,1
HCPCS,80103,DRUG ANALYSIS TISSUE PREP,,,13.42,13.42,1
HCPCS,80143,ACETAMINOPHEN BL TEST,129.0,83.85,7.46,129.0,84
HCPCS,80145,ADALIMUMAB ACT NEUT AB,266.0,172.9,15.43,266.0,84
HCPCS,80145,ANSADA MEAS SER ADA,266.0,172.9,15.43,266.0,84
HCPCS,80150,AMIKACIN ASSAY,104.0,67.6,7.44,104.0,84
HCPCS,80151,AMIODARONE,129.0,83.85,7.46,129.0,84
HCPCS,80152,ASSAY OF AMITRIPTYLINE,,,137.86,137.86,1
HCPCS,80154,ASSAY OF BENZODIAZEPINES,,,31.34,31.34,1
HCPCS,80155,CAFFEINE,266.0,172.9,15.43,266.0,84
HCPCS,80155,DRUG SCREEN QUANT CAFFEINE,266.0,172.9,1.1,266.0,88
HCPCS,80156,CARBAZEPINE TEGRETOL,101.0,65.65,7.19,101.0,84
HCPCS,80156,DRUG ASSAY CARBAMAZEPINE TOTAL,101.0,65.65,1.1,101.0,88
HCPCS,80157,CARBAMAZEPINE FREE,91.0,59.15,6.54,91.0,84
HCPCS,80157,DRUG ASSAY CARBAMAZEPINE FREE,91.0,59.15,1.1,91.0,88
HCPCS,80158,CYCLOSPORINE ASSAY,125.0,81.25,8.91,125.0,84
HCPCS,80158,DRUG ASSAY CYCLOSPORINE,125.0,81.25,1.1,125.0,88
HCPCS,80158,NY CYCLOSPORINE A,125.0,81.25,8.91,125.0,84
HCPCS,80159,CLOZAPINE,139.0,90.35,9.13,139.0,84
HCPCS,80159,DRUG SCREEN QUANT CLOZAPINE,139.0,90.35,1.1,139.0,172
HCPCS,80160,ASSAY OF DESIPRAMINE,,,132.53,132.53,1
HCPCS,80161,CARBAMAZEPINE-10-11-EPOXI,129.0,83.85,7.46,129.0,84
HCPCS,80162,DIGOXIN ASSAY,92.0,59.8,6.56,92.0,84
HCPCS,80162,DRUG SCREEN QUANTITATIVE DIGOXIN TOTAL,92.0,59.8,1.1,92.0,88
HCPCS,80163,DIGOXIN FREE,92.0,59.8,6.56,92.0,84
HCPCS,80164,DRUG ASSAY VALPROIC DIPROPYLACETIC ACID TOTAL,93.0,60.45,1.1,93.0,88
HCPCS,80164,VALPROIC ACID-DEPAKENE,93.0,60.45,6.69,93.0,84
HCPCS,80165,DRUG SCREEN QUANT DIPROPYLACETIC ACID FREE,93.0,60.45,1.1,93.0,88
HCPCS,80165,VALPROIC ACID FREE,93.0,60.45,6.69,93.0,84
HCPCS,80166,ASSAY OF DOXEPIN,,,105.07,105.07,1
HCPCS,80167,FELBAMATE,129.0,83.85,7.46,129.0,84
HCPCS,80168,ETHOSUXIMID/ZARONTIN,113.0,73.45,1.1,113.0,88
HCPCS,80168,ETHOSUXIMIDE LEVEL,113.0,73.45,8.07,113.0,84
HCPCS,80168,ETHOSUXIMIDE ZARONTIN,113.0,73.45,8.07,113.0,84
HCPCS,80169,DRUG SCREEN QUANT EVEROLIMUS,95.0,61.75,1.1,95.0,88
HCPCS,80169,EVEROLIMUS,95.0,61.75,6.78,95.0,84
HCPCS,80169,NY EVEROLIMUS,95.0,61.75,6.78,95.0,84
HCPCS,80170,DRUG SCREEN QUANTITATIVE GENTAMICIN,113.0,73.45,1.1,113.0,88
HCPCS,80170,GENTAMICIN ASSAY,113.0,73.45,8.09,113.0,84
HCPCS,80171,DRUG SCREEN QUANT GABAPENTIN,150.0,97.5,1.1,150.0,88
HCPCS,80171,GABAPENTIN,150.0,97.5,8.67,150.0,84
HCPCS,80172,ASSAY OF GOLD,,,71.92,71.92,1
HCPCS,80173,DRUG SCREEN QUANTITATIVE HALOPRIDOL,247.0,160.55,1.1,247.0,88
HCPCS,80173,HALOPERIDOL,109.0,70.85,7.19,109.0,84
HCPCS,80174,ASSAY OF IMIPRAMINE,,,53.02,53.02,1
HCPCS,80175,DRUG SCREEN QUAN LAMOTRIGINE,91.0,59.15,1.1,91.0,116
HCPCS,80175,Drug screen quan lamotrigine,,,18.31,21.2,8
HCPCS,80176,LIDOCAINE BLD,101.0,65.65,1.1,101.0,88
HCPCS,80176,LIDOCAINE PLASMA,101.0,65.65,7.26,101.0,84
HCPCS,80177,DRUG SCRN QUAN LEVETIRACETAM,91.0,59.15,1.1,91.0,88
HCPCS,80177,LEVETIRACETAM/KEPPRA,91.0,59.15,6.54,91.0,84
HCPCS,80178,DRUG SCREEN QUANTITATIVE LITHIUM,46.0,29.9,1.1,46.0,88
HCPCS,80178,LITHIUM ASSAY,46.0,29.9,6.61,46.0,84
HCPCS,80179,SALICYLATE,129.0,83.85,7.46,129.0,84
HCPCS,80180,DRUG SCRN QUAN MYCOPHENOLATE,125.0,81.25,1.1,125.0,88
HCPCS,80180,MYCOPHENOLIC ACID,125.0,81.25,8.91,125.0,84
HCPCS,80181,FLECAINIDE,129.0,83.85,7.46,129.0,84
HCPCS,80182,ASSAY OF NORTRIPTYLINE,,,73.83,73.83,1
HCPCS,80183,DRUG SCRN QUANT OXCARBAZEPIN,91.0,59.15,1.1,91.0,88
HCPCS,80183,OXCARBAZEPINE,91.0,59.15,6.54,91.0,84
HCPCS,80184,DRUG SCREEN QUANTITATIVE PHENOBARBITAL,106.0,68.9,1.1,106.0,88
HCPCS,80184,PHENOBARBITAL ASSAY,106.0,68.9,6.12,106.0,84
HCPCS,80184,PHENOBARBITAL FREE (UNBOUND),106.0,68.9,6.12,106.0,84
HCPCS,80185,DRUG SCREEN QUANTITATIVE PHENYTOIN TOTAL,91.0,59.15,1.1,91.0,88
HCPCS,80185,PHENYTOIN-DILANTIN,91.0,59.15,6.54,91.0,84
HCPCS,80186,DRUG SCREEN QUANTITATIVE PHENYTOIN FREE,95.0,61.75,1.1,95.0,88
HCPCS,80186,PHENYTOIN FREE PLASMA,95.0,61.75,6.8,95.0,84
HCPCS,80187,POSACONAZOLE,187.0,121.55,10.84,187.0,84
HCPCS,80188,%FREE PRIMIDONE PLASMA,114.0,74.1,8.19,127.78,84
HCPCS,80189,ITRACONAZOLE,187.0,121.55,10.84,187.0,84
HCPCS,80190,ASSAY OF PROCAINAMIDE,,,24.0,221.33,28
HCPCS,80190,Assay of procainamide,,,18.31,21.2,8
HCPCS,80192,DRUG SCREEN QUANTITATIVE PROCAINAMIDE METABOLITE,116.0,75.4,1.1,116.0,88
HCPCS,80192,PROCAINAMIDE/NAPA,116.0,75.4,8.27,116.0,84
HCPCS,80193,LEFLUNOMIDE METABOLITE,266.0,172.9,15.43,266.0,84
HCPCS,80194,DRUG SCREEN QUANTITATIVE QUINIDINE,101.0,65.65,1.1,101.0,88
HCPCS,80194,QUINIDINE,101.0,65.65,7.21,101.0,84
HCPCS,80195,DRUG SCREEN QUANTITATIVE SIROLIMUS,95.0,61.75,1.1,95.0,88
HCPCS,80195,NY SIROLIMUS,95.0,61.75,6.78,95.0,84
HCPCS,80195,SIROLIMUS ASSAY,95.0,61.75,6.78,95.0,84
HCPCS,80196,ASSAY OF SALICYLATE,,,22.12,22.12,1
HCPCS,80197,DRUG SCREEN QUANTITATIVE TACROLIMUS,95.0,61.75,1.1,95.0,88
HCPCS,80197,NY TACROLIMUS,95.0,61.75,6.78,95.0,84
HCPCS,80197,TACROLIMUS ASSAY,95.0,61.75,6.78,95.0,84
HCPCS,80198,DRUG SCREEN QUANTITATIVE THEOPHYLLINE,98.0,63.7,1.1,98.0,88
HCPCS,80198,THEOPHYLLINE ASSAY,98.0,63.7,6.98,98.0,84
HCPCS,80199,DRUG SCREEN QUANT TIAGABINE,187.0,121.55,1.1,187.0,88
HCPCS,80199,GABITRIL SERUM,187.0,121.55,10.84,187.0,84
HCPCS,80200,TOBRAMYCIN ASSAY,111.0,72.15,7.96,111.0,84
HCPCS,80201,DRUG SCREEN QUANTITATIVE TOPIRAMATE,82.0,53.3,1.1,82.0,88
HCPCS,80201,TOPIRAMATE,82.0,53.3,5.89,82.0,84
HCPCS,80202,DRUG SCREEN QUANTITATIVE VANCOMYCIN,93.0,60.45,1.1,93.0,88
HCPCS,80202,VANCOMYCIN,93.0,60.45,6.69,93.0,84
HCPCS,80203,DRUG SCREEN QUANT ZONISAMIDE,91.0,59.15,1.1,91.0,88
HCPCS,80203,ZONISAMIDE,91.0,59.15,6.54,91.0,84
HCPCS,80204,METHOTREXATE,266.0,172.9,15.43,266.0,84
HCPCS,80210,RUFINAMIDE,187.0,121.55,10.84,187.0,168
HCPCS,80220,"HYDROXYCHLOROQUINE, BLOOD",129.0,83.85,7.46,129.0,84
HCPCS,80230,ANSIFX MEAS SER ADA,266.0,172.9,15.43,266.0,84
HCPCS,80230,"INFLIXIMAB, SERUM",266.0,172.9,15.43,266.0,84
HCPCS,80230,INFLIXIMAB/BIOSIMILAR ACT NEUT AB,266.0,172.9,15.43,266.0,84
HCPCS,80235,LACOSAMIDE,187.0,121.55,10.84,187.0,84
HCPCS,80280,ANSVDZ MEAS SER VDZ,266.0,172.9,15.43,266.0,84
HCPCS,80280,"VEDOLIZUMAB QN, S",266.0,172.9,15.43,266.0,84
HCPCS,80285,VORICONAZOLE,187.0,121.55,10.84,187.0,84
HCPCS,80299,%TADID QUANT X4,129.0,83.85,18.31,129.0,84
HCPCS,80299,"5-FLUCYTOSINE, S",129.0,83.85,18.31,129.0,84
HCPCS,80299,ACETAZOLAMIDE,129.0,83.85,18.31,129.0,84
HCPCS,80299,ADANEU THEARP DRG QNT,129.0,83.85,18.31,129.0,84
HCPCS,80299,ANSUST MEAS SER UST,129.0,83.85,18.31,129.0,84
HCPCS,80299,BRIVARACETAM - QUANTITATIVE ASSAY DRUG,129.0,83.85,18.31,129.0,84
HCPCS,80299,"BROMIDE, SER PL",129.0,83.85,18.31,129.0,84
HCPCS,80299,"CENOBAMATE (XCOPRI), PLASMA",129.0,83.85,18.31,129.0,84
HCPCS,80299,CIMETIDINE SERUM,129.0,83.85,18.31,129.0,84
HCPCS,80299,DEXAMETHASONE SERUM,129.0,83.85,18.31,129.0,84
HCPCS,80299,DIGITOXIN,129.0,83.85,18.31,129.0,84
HCPCS,80299,DILTIAZEM,129.0,83.85,18.31,129.0,84
HCPCS,80299,DISOPYRAMIDE NORPACE,129.0,83.85,18.31,129.0,84
HCPCS,80299,"ECULIZUMAB, SERUM",129.0,83.85,18.31,129.0,84
HCPCS,80299,ETHAMBUTOL,129.0,83.85,18.31,129.0,84
HCPCS,80299,FLECAINIDE BLOOD,129.0,83.85,18.31,129.0,84
HCPCS,80299,FLUCONAZOLE SERUM,129.0,83.85,18.31,129.0,84
HCPCS,80299,IBUPROFEN,129.0,83.85,18.31,129.0,84
HCPCS,80299,IFXNEU THEARP DRG QNT,129.0,83.85,18.31,129.0,84
HCPCS,80299,ITRACONAZOLE,129.0,83.85,18.31,129.0,84
HCPCS,80299,LEFLUNOMIDE METABOLITE,129.0,83.85,18.31,129.0,84
HCPCS,80299,MAPROTILINE HPLC-UV,129.0,83.85,18.31,129.0,84
HCPCS,80299,MEXILETINE PLASMA,129.0,83.85,18.31,129.0,84
HCPCS,80299,MITOTANE,129.0,83.85,18.31,129.0,84
HCPCS,80299,PAROXETINE SERUM,129.0,83.85,18.31,129.0,84
HCPCS,80299,PERAMPANEL - QUANTITATIVE ASSAY DRUG,129.0,83.85,18.31,129.0,84
HCPCS,80299,POSACONAZOLE,129.0,83.85,18.31,129.0,84
HCPCS,80299,PROPAFENONE,129.0,83.85,18.31,129.0,84
HCPCS,80299,PROPOXY CONF,129.0,83.85,18.31,129.0,84
HCPCS,80299,PROTRIPTYLINE,129.0,83.85,18.31,129.0,84
HCPCS,80299,QUETIAPINE,129.0,83.85,18.31,129.0,84
HCPCS,80299,SOTALOL,129.0,83.85,18.31,129.0,84
HCPCS,80299,SULFONAMIDES,129.0,83.85,18.31,129.0,84
HCPCS,80299,"SYNTHETIC GLUCOCORTICOID SCREEN, URINE",129.0,83.85,18.31,129.0,84
HCPCS,80299,THERAPEUTIC DRUG LEVEL,129.0,83.85,18.31,129.0,84
HCPCS,80299,THIOPURINE METAB LC-MS/MS,129.0,83.85,18.31,129.0,84
HCPCS,80299,"USTEKINUMAB QN, S",129.0,83.85,18.31,129.0,84
HCPCS,80299,VENLAFAXINE&METABOLITE,129.0,83.85,18.31,129.0,84
HCPCS,80299,VORICONAZOLE,129.0,83.85,18.31,129.0,84
HCPCS,80299,WARFARIN/COUMADIN CHRM,129.0,83.85,18.31,129.0,84
HCPCS,80305,DRUG TEST PRSMV DIR OPT OBS,,,12.6,34.52,27
HCPCS,80305,Drug test prsmv dir opt obs,,,30.12,34.88,8
HCPCS,80306,DRUG TEST PRSMV INSTRMNT (POINT OF CARE LAB),118.0,76.7,7.18,118.0,84
HCPCS,80307,%DRANCO PRESUMPTIVE DRGS,429.0,278.85,31.92,429.0,84
HCPCS,80307,DATE RAPE PANEL,429.0,278.85,31.92,429.0,84
HCPCS,80307,DRG SCRN 9 PANEL,429.0,278.85,31.92,429.0,84
HCPCS,80307,DRG SCRN 9 PANEL SER OR PL,429.0,278.85,31.92,429.0,84
HCPCS,80307,DRUG ABUSE SURVEY UR,429.0,278.85,31.92,429.0,84
HCPCS,80307,DRUG ANALYSIS UR,429.0,278.85,31.92,429.0,84
HCPCS,80307,DRUG DET PNL UMB CRD,429.0,278.85,31.92,429.0,84
HCPCS,80307,"DRUG DETECT PNL, UMB CORD",429.0,278.85,31.92,429.0,84
HCPCS,80307,"DRUG SCRN, BLD",429.0,278.85,31.92,429.0,84
HCPCS,80307,DRUG TEST PRSMV CHEM ANLYZR,429.0,278.85,31.92,429.0,84
HCPCS,80307,DRUG TESTS PRESUMPTIVE,429.0,278.85,31.92,429.0,84
HCPCS,80307,DRUGS OF ABUSE 9A SCRN UR,429.0,278.85,31.92,429.0,84
HCPCS,80307,DRUGS OF ABUSE ORAL FLUID,429.0,278.85,31.92,429.0,84
HCPCS,80307,ETHYL GLUC UR SCRN,429.0,278.85,31.92,429.0,84
HCPCS,80307,FLUNITRAZEPAM SCREEN UR,429.0,278.85,31.92,429.0,84
HCPCS,80307,G HYDROXYBUTYRIC,429.0,278.85,31.92,429.0,84
HCPCS,80307,"LSD, UR",429.0,278.85,31.92,429.0,84
HCPCS,80307,MATERNAL 8PC DRUG SCREEN,429.0,278.85,31.92,429.0,84
HCPCS,80307,MECONIUM DRG SCRN 5,429.0,278.85,31.92,429.0,84
HCPCS,80307,MECONIUM DRG SCRN 9,429.0,278.85,31.92,429.0,84
HCPCS,80307,MEPHEDRONE MDPV & METHYLONE,429.0,278.85,31.92,429.0,84
HCPCS,80307,MEPHEDRONE MDPV CONF UR,429.0,278.85,31.92,429.0,84
HCPCS,80307,"MITRAGYNINE (KRATOM), URINE",429.0,278.85,31.92,429.0,84
HCPCS,80307,"OXYCODONE SCRN, UR",429.0,278.85,31.92,429.0,84
HCPCS,80307,UR ALCOHOL CONF RFLX,429.0,278.85,31.92,429.0,84
HCPCS,80307,UR BARBITURATE CONF RFLX,429.0,278.85,31.92,429.0,84
HCPCS,80307,UR BENZODIAZ CONF RFLX,429.0,278.85,31.92,429.0,84
HCPCS,80307,UR FLUNITRAZ CONF RFLX,429.0,278.85,31.92,429.0,84
HCPCS,80307,UR KETAMINE CONF RFLX,429.0,278.85,31.92,429.0,84
HCPCS,80320,DRUG SCREEN QUANTALCOHOLS,,,4.46,2739849.3,3
HCPCS,80320,DRUG SCREEN QUANTITATIVE ALCOHOLS,158.0,102.7,1.1,3060831.65,88
HCPCS,80320,Drug screen quantalcohols,,,30.12,34.88,8
HCPCS,80321,ALCOHOLS BIOMARKERS 1OR 2,,,5.33,2739849.3,3
HCPCS,80321,Alcohols biomarkers 1or 2,,,30.12,34.88,8
HCPCS,80321,DRUG SCREEN QUANT ALCOHOLS BIOMARKERS 1 OR 2,252.0,163.8,1.1,3060831.65,82
HCPCS,80322,ALCOHOLS BIOMARKERS 3/MORE,,,4.61,2739849.3,3
HCPCS,80322,Alcohols biomarkers 3/more,,,30.12,34.88,8
HCPCS,80323,ALKALOIDS NOT OTHERWISE SPECIFIED,334.0,217.1,1.1,3060831.65,88
HCPCS,80323,KRATOM (MITRAGYNINE) CONFIRMATION,334.0,217.1,8.21,1851898.14,67
HCPCS,80324,DRUG SCREEN AMPHETAMINES 1/2,,,6.05,46.22,3
HCPCS,80324,DRUG SCREEN QUANT AMPHETAMINES 1 OR 2,64.0,41.6,1.1,64.0,88
HCPCS,80324,Drug screen amphetamines 1/2,,,30.12,34.88,8
HCPCS,80325,AMPHETAMINES 3OR 4,,,5.18,2739849.3,3
HCPCS,80325,Amphetamines 3or 4,,,30.12,34.88,8
HCPCS,80326,AMPHETAMINES 5 OR MORE,,,3.74,2739849.3,3
HCPCS,80326,Amphetamines 5 or more,,,30.12,34.88,8
HCPCS,80327,ANABOLIC STEROID 1 OR 2,,,8.93,2739849.3,3
HCPCS,80327,Anabolic steroid 1 or 2,,,30.12,34.88,8
HCPCS,80327,DRUG SCREEN QUANT ANABOLIC STEROID 1 OR 2,230.0,149.5,1.1,3060831.65,88
HCPCS,80328,ANABOLIC STEROID 3 OR MORE,,,9.94,2739849.3,3
HCPCS,80328,Anabolic steroid 3 or more,,,30.12,34.88,8
HCPCS,80329,ANALGESICS NON-OPIOID 1 OR 2,,,4.61,2739849.3,3
HCPCS,80329,Analgesics non-opioid 1 or 2,,,30.12,34.88,8
HCPCS,80329,DRUG SCREEN ANALGESICS NON-OPIOID 1 OR 2,232.0,150.8,1.1,3060831.65,88
HCPCS,80330,ANALGESICS NON-OPIOID 3-5,,,2.02,2739849.3,3
HCPCS,80330,Analgesics non-opioid 3-5,,,30.12,34.88,8
HCPCS,80331,ANALGESICS NON-OPIOID 6/MORE,,,3.31,2739849.3,3
HCPCS,80331,Analgesics non-opioid 6/more,,,30.12,34.88,8
HCPCS,80331,DRUG SCREEN ANALGESICS NON-OPIOID 6 OR MORE,32.0,20.8,1.1,3060831.65,82
HCPCS,80332,ANTIDEPRESSANTS CLASS 1 OR 2,,,7.92,2739849.3,3
HCPCS,80332,Antidepressants class 1 or 2,,,34.82,40.32,8
HCPCS,80333,ANTIDEPRESSANTS CLASS 3-5,,,5.9,2739849.3,3
HCPCS,80333,ANTIDEPRESSANTS SEROTONERGIC CLASS 3-5,252.0,163.8,1.1,3060831.65,82
HCPCS,80333,Antidepressants class 3-5,,,30.12,34.88,8
HCPCS,80334,ANTIDEPRESSANTS CLASS 6/MORE,,,3.89,2739849.3,3
HCPCS,80334,ANTIDEPRESSANTS SEROTONERGIC CLASS 6 OR MORE,36.0,23.4,1.1,3060831.65,82
HCPCS,80334,Antidepressants class 6/more,,,30.12,34.88,8
HCPCS,80335,ANTIDEPRESSANT TRICYCLIC 1/2,,,2.02,2739849.3,3
HCPCS,80335,Antidepressant tricyclic 1/2,,,30.12,34.88,8
HCPCS,80336,ANTIDEPRESSANT TRICYCLIC 3-5,,,8.06,2739849.3,3
HCPCS,80336,Antidepressant tricyclic 3-5,,,30.12,34.88,8
HCPCS,80337,TRICYCLIC & CYCLICALS 6/MORE,,,4.18,2739849.3,3
HCPCS,80337,Tricyclic & cyclicals 6/more,,,30.12,34.88,8
HCPCS,80338,VENLAFAXINE SERUM/PLASMA - ARUP,36.0,23.4,5.04,1851898.14,67
HCPCS,80339,ANTIEPILEPTICS NOS 1-3,,,2.02,2739849.3,3
HCPCS,80339,ANTIEPILEPTICS NOT OTHERWISE SPECIFIED 1-3,440.0,286.0,1.1,3060831.65,88
HCPCS,80339,Antiepileptics nos 1-3,,,34.82,40.32,8
HCPCS,80340,ANTIEPILEPTICS NOS 4-6,,,3.02,2739849.3,3
HCPCS,80340,Antiepileptics nos 4-6,,,30.12,34.88,8
HCPCS,80341,ANTIEPILEPTICS NOS 7/MORE,,,2.59,2739849.3,3
HCPCS,80341,ANTIEPILEPTICS NOT OTHERWISE SPECIFIED 7/MORE,32.0,20.8,1.1,3060831.65,82
HCPCS,80341,Antiepileptics nos 7/more,,,30.12,34.88,8
HCPCS,80342,ANTIPSYCHOTICS NOS 1-3,,,5.62,2739849.3,3
HCPCS,80342,Antipsychotics nos 1-3,,,30.12,34.88,8
HCPCS,80343,ANTIPSYCHOTICS NOS 4-6,,,12.96,2739849.3,3
HCPCS,80343,Antipsychotics nos 4-6,,,30.12,34.88,8
HCPCS,80344,ANTIPSYCHOTICS NOS 7/MORE,,,3.31,2739849.3,3
HCPCS,80344,ANTIPSYCHOTICS NOT OTHERWISE SPECIFIED 7/MORE,36.0,23.4,1.1,3060831.65,82
HCPCS,80344,Antipsychotics nos 7/more,,,30.12,34.88,8
HCPCS,80345,DRUG SCREENING BARBITURATES,,,4.32,46.22,3
HCPCS,80345,Drug screening barbiturates,,,30.12,34.88,8
HCPCS,80346,BENZODIAZEPINES1-12,,,6.48,61.65,3
HCPCS,80346,Benzodiazepines1-12,,,30.12,34.88,8
HCPCS,80347,BENZODIAZEPINES 13 OR MORE,,,9.22,2739849.3,3
HCPCS,80347,Benzodiazepines 13 or more,,,30.12,34.88,8
HCPCS,80347,DRUG SCREENING BENZODIAZEPINES 13 OR MORE,490.0,318.5,1.1,3060831.65,82
HCPCS,80348,DRUG SCREENING BUPRENORPHINE,28.0,18.2,1.1,3060831.65,85
HCPCS,80348,Drug screening buprenorphine,,,30.12,34.88,8
HCPCS,80349,CANNABINOIDS NATURAL,53.0,34.45,5.33,53.0,67
HCPCS,80349,DRUG SCREENING CANNABINOIDS NATURAL,53.0,34.45,1.1,53.0,88
HCPCS,80350,CANNABINOIDS SYNTHETIC 1-3,,,5.18,2739849.3,3
HCPCS,80350,Cannabinoids synthetic 1-3,,,30.12,34.88,8
HCPCS,80351,CANNABINOIDS SYNTHETIC 4-6,,,6.62,2739849.3,3
HCPCS,80351,Cannabinoids synthetic 4-6,,,30.12,34.88,8
HCPCS,80352,CANNABINOID SYNTHETIC 7/MORE,,,6.48,2739849.3,3
HCPCS,80352,Cannabinoid synthetic 7/more,,,30.12,34.88,8
HCPCS,80352,DRUG SCREENING CANNABINOIDS SYNTHETIC 7/MORE,732.0,475.8,1.1,3060831.65,82
HCPCS,80353,DRUG SCREENING COCAINE,27.0,17.55,1.1,3060831.65,91
HCPCS,80353,Drug screening cocaine,,,30.12,34.88,8
HCPCS,80354,DRUG SCREENING FENTANYL,28.0,18.2,1.1,36.94,91
HCPCS,80354,Drug screening fentanyl,,,30.12,34.88,8
HCPCS,80355,DRUG SCREENING GABAPENTIN NON-BLOOD,32.0,20.8,1.1,3060831.65,88
HCPCS,80355,GABAPENTIN NON-BLOOD,,,3.74,2739849.3,3
HCPCS,80355,Gabapentin non-blood,,,30.12,34.88,8
HCPCS,80356,DRUG SCREENING HEROIN METABOLITE,77.0,50.05,1.1,3060831.65,88
HCPCS,80356,HEROIN METABOLITE,,,6.34,2739849.3,3
HCPCS,80356,Heroin metabolite,,,30.12,34.88,8
HCPCS,80357,KETAMINE AND NORKETAMINE,,,4.9,2739849.3,3
HCPCS,80357,Ketamine and norketamine,,,30.12,34.88,8
HCPCS,80358,DRUG SCREENING METHADONE,12.0,7.8,1.1,33.67,91
HCPCS,80358,Drug screening methadone,,,30.12,34.88,8
HCPCS,80359,METHYLENEDIOXYAMPHETAMINES,,,4.03,2739849.3,3
HCPCS,80359,Methylenedioxyamphetamines,,,30.12,34.88,8
HCPCS,80360,DRUG SCREENING METHYLPHENIDATE,32.0,20.8,1.1,3060831.65,88
HCPCS,80360,METHYLPHENIDATE,,,4.32,2739849.3,3
HCPCS,80360,Methylphenidate,,,30.12,34.88,8
HCPCS,80361,DRUG SCREENING OPIATES 1 OR MORE,28.0,18.2,1.1,70.4,88
HCPCS,80361,OPIATES 1 OR MORE,,,6.77,61.65,3
HCPCS,80361,Opiates 1 or more,,,30.12,34.88,8
HCPCS,80362,DRUG SCREENING OPIOIDS AND OPIATE ANALOGS 1 OR 2,476.0,309.4,1.1,3060831.65,88
HCPCS,80362,OPIOIDS & OPIATE ANALOGS 1/2,,,5.47,2739849.3,3
HCPCS,80362,Opioids & opiate analogs 1/2,,,30.12,34.88,8
HCPCS,80363,DRUG SCREENING OPIOIDS AND OPIATE ANALOGS 3 OR 4,28.0,18.2,1.1,3060831.65,82
HCPCS,80363,OPIOIDS & OPIATE ANALOGS 3/4,,,8.5,2739849.3,3
HCPCS,80363,Opioids & opiate analogs 3/4,,,30.12,34.88,8
HCPCS,80364,OPIOID &OPIATE ANALOG 5/MORE,,,6.34,151.66,3
HCPCS,80364,Opioid &opiate analog 5/more,,,30.12,34.88,8
HCPCS,80365,DRUG SCREENING OXYCODONE,28.0,18.2,1.1,34.34,91
HCPCS,80365,Drug screening oxycodone,,,30.12,34.88,8
HCPCS,80366,DRUG SCREENING PREGABALIN,32.0,20.8,1.1,3060831.65,88
HCPCS,80366,"PREGABALIN, URINE",32.0,20.8,3.31,1851898.14,67
HCPCS,80367,DRUG SCREENING PROPOXYPHENE,,,5.04,2739849.3,3
HCPCS,80367,Drug screening propoxyphene,,,30.12,34.88,8
HCPCS,80368,DRUG SCREENING SEDATIVE HYPNOTICS,36.0,23.4,1.1,36.0,88
HCPCS,80368,SEDATIVE HYPNOTICS,,,4.18,30.83,3
HCPCS,80368,Sedative hypnotics,,,30.12,34.88,8
HCPCS,80369,DRUG SCREENING SKELETAL MUSCLE RELAXANTS 1 OR 2,276.0,179.4,1.1,3060831.65,88
HCPCS,80369,SKELETAL MUSCLE RELAXANT 1/2,,,5.33,2739849.3,3
HCPCS,80369,Skeletal muscle relaxant 1/2,,,30.12,34.88,8
HCPCS,80370,DRUG SCREENING SKEL MUSCLE RELAXANTS 3 OR MORE,76.0,49.4,1.1,3060831.65,82
HCPCS,80370,SKEL MUSC RELAXANT 3 OR MORE,,,4.75,2739849.3,3
HCPCS,80370,Skel musc relaxant 3 or more,,,30.12,34.88,8
HCPCS,80371,STIMULANTS SYNTHETIC,,,5.62,2739849.3,3
HCPCS,80371,Stimulants synthetic,,,30.12,34.88,8
HCPCS,80372,DRUG SCREENING TAPENTADOL,38.0,24.7,1.1,52.04,91
HCPCS,80372,Drug screening tapentadol,,,30.12,34.88,8
HCPCS,80373,DRUG SCREENING TRAMADOL,36.0,23.4,1.1,36.0,91
HCPCS,80373,Drug screening tramadol,,,30.12,34.88,8
HCPCS,80374,STEREOISOMER ANALYSIS,,,4.75,2739849.3,3
HCPCS,80374,Stereoisomer analysis,,,30.12,34.88,8
HCPCS,80375,DRUG/SUBSTANCE NOS 1-3,,,8.64,2739849.3,3
HCPCS,80375,Drug/substance nos 1-3,,,34.82,40.32,8
HCPCS,80376,DRUG/SUBSTANCE NOS 4-6,,,8.93,2739849.3,3
HCPCS,80376,Drug/substance nos 4-6,,,30.12,34.88,8
HCPCS,80377,DRUG/SUBSTANCE DEFINITIVE QUAL/QUANT NOS 7/MORE,32.0,20.8,1.1,3060831.65,88
HCPCS,80377,DRUG/SUBSTANCE NOS 7/MORE,,,3.17,2739849.3,3
HCPCS,80377,Drug/substance nos 7/more,,,30.12,34.88,8
HCPCS,80400,%ACTH STIMULATION PANEL,225.0,146.25,16.11,225.0,84
HCPCS,80400,ACTH STIM W/2 TIME PTS,225.0,146.25,16.11,225.0,84
HCPCS,80400,ACTH STIMULATION PANEL ADRENAL INSUFFICIENCY,225.0,146.25,1.1,225.0,88
HCPCS,80402,ACTH STIM PANEL/21OH ASE,600.0,390.0,27.68,600.0,84
HCPCS,80402,ACTH STIMULATION PANEL 21 HYDROXYLASE DEFICIENCY,600.0,390.0,1.1,600.0,88
HCPCS,80406,ACTH STIMULATION PANEL,,,38.65,345.62,28
HCPCS,80406,Acth stimulation panel,,,27.68,32.05,8
HCPCS,80408,ALDOSTERONE SUPPRESS,866.0,562.9,1.1,866.0,88
HCPCS,80408,ALDOSTERONE SUPPRESSION,866.0,562.9,27.68,866.0,84
HCPCS,80410,CALCITONIN STIMUL PANEL,,,13.23,354.83,28
HCPCS,80410,Calcitonin stimul panel,,,27.68,32.05,8
HCPCS,80412,CRH STIMULATION PANEL,,,320.65,2414.9,28
HCPCS,80412,Crh stimulation panel,,,173.12,200.45,8
HCPCS,80414,TESTOSTERONE RESPONSE PANEL,,,25.5,179.86,28
HCPCS,80414,Testosterone response panel,,,27.68,32.05,8
HCPCS,80415,TOT ESTRADIOL RESPONSE PANEL,,,27.6,246.83,28
HCPCS,80415,Tot estradiol response panel,,,27.68,32.05,8
HCPCS,80416,RENIN STIMULATION PANEL,,,83.73,630.58,28
HCPCS,80416,Renin stimulation panel,,,116.49,134.88,8
HCPCS,80417,RENIN STIMULATION PANEL,,,21.72,155.14,28
HCPCS,80417,Renin stimulation panel,,,27.68,32.05,8
HCPCS,80418,PITUITARY EVALUATION,3998.0,2598.7,1.1,3998.0,172
HCPCS,80420,DEXAMET SUPR48HUR+BL,1117.0,726.05,1.1,1117.0,88
HCPCS,80420,DEXAMETHAZONE SUP 48HR,1117.0,726.05,64.75,1117.0,84
HCPCS,80422,GLUCAGON TOLERANCE PANEL,318.0,206.7,1.1,318.0,88
HCPCS,80422,GLUCAGON/INSULIN TOLERANC,318.0,206.7,22.75,318.0,84
HCPCS,80424,GLUCAGON TOLERANCE PANEL,,,24.94,223.11,28
HCPCS,80424,Glucagon tolerance panel,,,27.68,32.05,8
HCPCS,80426,GNRH STIMULATION,1024.0,665.6,1.1,1024.0,172
HCPCS,80428,GH STIM PANEL,460.0,299.0,1.1,460.0,88
HCPCS,80428,GROWTH HORMONE STIM,460.0,299.0,27.68,460.0,84
HCPCS,80428,GROWTH HORMONE STIM PEDS,460.0,299.0,27.68,460.0,84
HCPCS,80430,GROWTH HORMONE SUPPRESS,892.0,579.8,27.68,892.0,84
HCPCS,80430,GROWTH HORMONE SUPRS,892.0,579.8,1.1,892.0,88
HCPCS,80432,CPEPSP INSULIN SUPPRESSION PANEL,1143.0,742.95,66.72,1143.0,84
HCPCS,80432,INSULIN SUPPRESSION PANEL,1143.0,742.95,1.1,1143.0,88
HCPCS,80434,INSULIN TOLERANCE PANEL,,,114.01,858.66,28
HCPCS,80434,Insulin tolerance panel,,,116.49,134.88,8
HCPCS,80435,INSULIN TOL/GROWTH HORMN,711.0,462.15,27.68,967.46,84
HCPCS,80435,INSULIN TOLERANCE,711.0,462.15,1.1,711.0,88
HCPCS,80436,METYRAPONE PANEL,,,45.02,402.64,28
HCPCS,80436,Metyrapone panel,,,27.68,32.05,8
HCPCS,80438,TRH STIMULATION BLD,348.0,226.2,1.1,348.0,88
HCPCS,80438,TRH STIMULATION PANEL,,,24.9,222.46,28
HCPCS,80438,Trh stimulation panel,,,27.68,32.05,8
HCPCS,80439,TRH STIMULATION PANEL,,,33.19,296.67,28
HCPCS,80439,Trh stimulation panel,,,27.68,32.05,8
HCPCS,80440,TRH STIMULATION PANEL,,,256.66,256.66,1
HCPCS,80500,LAB PATHOLOGY CONSULTATION,,,49.23,109.35,4
HCPCS,80500,Lab pathology consultation,,,34.71,40.19,8
HCPCS,80502,LAB PATHOLOGY CONSULTATION,,,95.06,380.11,4
HCPCS,80502,Lab pathology consultation,,,34.71,40.19,8
HCPCS,80503,PATH CLIN CONSLTJ SF 5-20,189.0,122.85,1.1,189.0,159
HCPCS,80503,Path clin consltj sf 5-20,,,34.71,40.19,8
HCPCS,80504,PATH CLIN CONSLTJ MOD 21-40,,,46.97,445.91,25
HCPCS,80504,Path clin consltj mod 21-40,,,34.71,40.19,8
HCPCS,80505,PATH CLIN CONSLTJ HIGH 41-60,,,88.55,445.91,25
HCPCS,80505,Path clin consltj high 41-60,,,34.71,40.19,8
HCPCS,80506,PATH CLIN CONSLTJ PROLNG SVC,,,42.15,97.34,4
HCPCS,80506,Path clin consltj prolng svc,,,34.71,40.19,8
HCPCS,81000,URINALYSIS NONAUTO W SCPE (POINT OF CARE LAB),28.0,18.2,4.02,28.0,84
HCPCS,81000,URINLS DIP STICK/TABLET REAGNT NON-AUTO MICRSCPY,44.5,28.924999999999997,1.1,61.0,176
HCPCS,81001,URINALYSIS AUTO W SCPE,22.0,14.3,3.17,22.0,84
HCPCS,81001,URINALYSIS WITH MICRO (POINT OF CARE LAB),22.0,14.3,3.17,22.0,84
HCPCS,81001,URNLS DIP STICK/TABLET REAGENT AUTO MICROSCOPY,55.0,35.75,1.1,88.0,176
HCPCS,81002,N-AUTOM URINALYS WO MICRO (POINT OF CARE LAB),24.0,15.6,3.48,24.0,84
HCPCS,81002,UA NON-AUTO W/O MICRO (POINT OF CARE LAB),24.0,15.6,3.48,24.0,84
HCPCS,81002,URNLS DIP STICK/TABLET RGNT NON-AUTO W/O MICRSCP,35.5,23.075,1.1,47.0,176
HCPCS,81003,URINALYSIS (POINT OF CARE LAB),16.0,10.4,2.25,17.31,84
HCPCS,81003,URINALYSIS AUTO WO SCPE,16.0,10.4,2.25,17.31,84
HCPCS,81003,URINALYSIS AUTO WO SCPE (POINT OF CARE LAB),16.0,10.4,2.25,17.31,168
HCPCS,81003,URINALYSIS ONLY,16.0,10.4,2.25,17.31,84
HCPCS,81003,URNLS DIP STICK/TABLET RGNT AUTO W/O MICROSCOPY,30.5,19.825,1.1,45.0,176
HCPCS,81005,"ADULTERANTS SURVEY, UR",15.0,9.75,1.07,15.0,84
HCPCS,81005,BILIRUBIN SCREEN URINE,15.0,9.75,1.07,15.0,84
HCPCS,81005,"URINANALYSIS, QUAL OR SEMI-QUANT",15.0,9.75,1.07,15.0,84
HCPCS,81007,URINE SCREEN FOR BACTERIA,,,11.24,90.32,28
HCPCS,81007,Urine screen for bacteria,,,6.37,7.38,8
HCPCS,81015,URINALYSIS MICROSCOP ONLY,21.0,13.65,3.05,21.0,84
HCPCS,81015,URINALYSIS MICROSCOP ONLY (POINT OF CARE LAB),21.0,13.65,3.05,21.0,84
HCPCS,81020,URINALYSIS GLASS TEST,,,1.88,16.11,28
HCPCS,81020,Urinalysis glass test,,,6.37,7.38,8
HCPCS,81025,HCG QUAL FLUID/URINE,59.0,38.35,6.37,59.0,84
HCPCS,81025,HCG URINE (POINT OF CARE LAB),59.0,38.35,6.37,59.0,84
HCPCS,81025,PREGNANCY TEST URINE (POINT OF CARE LAB),59.0,38.35,6.37,59.0,168
HCPCS,81025,URINE PREGNANCY TEST VISUAL COLOR CMPRSN METHS,59.0,38.35,1.1,59.0,88
HCPCS,81050,VOL MEASURE TIMED UR OUT,25.0,16.25,1.48,25.0,84
HCPCS,81050,VOLUME MEASUREMENT TIMED COLLECTION EACH,25.0,16.25,1.1,25.0,88
HCPCS,81099,UNLISTED URINALYSIS PX,,,2466002.74,2466002.74,1
HCPCS,81099,Unlisted urinalysis px,,,6.37,7.38,8
HCPCS,81105,HPA-1 GENOTYPING,843.0,547.95,83.94,843.0,168
HCPCS,81106,HPA-2 GENOTYPING,843.0,547.95,83.94,843.0,168
HCPCS,81107,HPA-3 GENOTYPING,843.0,547.95,83.94,843.0,168
HCPCS,81108,HPA-4 GENOTYPING,843.0,547.95,83.94,843.0,168
HCPCS,81109,HPA-5 GENOTYPING,843.0,547.95,83.94,843.0,168
HCPCS,81110,HPA-6 GENOTYPING,843.0,547.95,83.94,843.0,168
HCPCS,81111,HPA-9 GENOTYPING,843.0,547.95,83.94,843.0,168
HCPCS,81112,HPA-15 GENOTYPING,843.0,547.95,83.94,843.0,168
HCPCS,81120,%IDH12 IDH1,1333.0,866.45,116.49,1333.0,84
HCPCS,81120,%IDHI12 GENE ANALYSIS IDH1,1333.0,866.45,116.49,1333.0,84
HCPCS,81120,IDH1 COMMON VARIANTS,1333.0,866.45,116.49,1333.0,84
HCPCS,81120,IDH1 GENE ANALYSIS,1333.0,866.45,116.49,1333.0,84
HCPCS,81120,IDH1 HOTSPOT VARIANT BM,1333.0,866.45,116.49,1333.0,84
HCPCS,81120,IDH1 HOTSPOT VARIANT PB,1333.0,866.45,116.49,1333.0,84
HCPCS,81121,%IDH12 IDH2,2041.0,1326.65,116.49,2041.0,84
HCPCS,81121,%IDHI12 GENE ANALYSIS IDH2,2041.0,1326.65,116.49,2041.0,84
HCPCS,81121,IDH2 COMMON VARIANTS,2041.0,1326.65,116.49,2041.0,84
HCPCS,81121,IDH2 GENE ANALYISIS,2041.0,1326.65,116.49,2041.0,84
HCPCS,81121,IDH2 HOTSPOT VARIANT PB,2041.0,1326.65,116.49,2041.0,84
HCPCS,81121,IHD2 HOTSPOT VARIANT BM,2041.0,1326.65,116.49,2041.0,84
HCPCS,81161,DBMDXS TEST,1925.0,1251.25,111.6,1925.0,84
HCPCS,81161,DBMDYS TEST,1925.0,1251.25,111.6,1925.0,84
HCPCS,81162,BRCA1&2 GEN FULL SEQ DUP/DEL,,,901.17,5000.17,28
HCPCS,81162,Brca1&2 gen full seq dup/del,,,672.05,778.16,8
HCPCS,81163,BRCA1&2 GENE FULL SEQ ALYS,,,187.2,1282.32,28
HCPCS,81163,Brca1&2 gene full seq alys,,,109.69,127.01,8
HCPCS,81164,BRCA1&2 GEN FUL DUP/DEL ALYS,,,233.69,1600.79,28
HCPCS,81164,Brca1&2 gen ful dup/del alys,,,109.69,127.01,8
HCPCS,81165,BRCA1 GENE FULL SEQ ALYS,,,113.15,775.09,28
HCPCS,81165,Brca1 gene full seq alys,,,116.49,134.88,8
HCPCS,81166,BRCA1 GENE FULL DUP/DEL ALYS,,,120.54,825.7,28
HCPCS,81166,Brca1 gene full dup/del alys,,,116.49,134.88,8
HCPCS,81167,BRCA2 GENE FULL DUP/DEL ALYS,,,113.15,775.09,28
HCPCS,81167,Brca2 gene full dup/del alys,,,116.49,134.88,8
HCPCS,81168,CCND1/IGH TRANSLOCATION ALYS,,,82.92,568.03,28
HCPCS,81168,Ccnd1/igh translocation alys,,,116.49,134.88,8
HCPCS,81170,BCR-ABL1 KINASE MUT DET BY SANGER SEQ BM,2070.0,1345.5,116.49,2070.0,84
HCPCS,81170,BCR-ABL1 KINASE MUT DET SANGER BLD,2070.0,1345.5,116.49,2070.0,84
HCPCS,81170,KINASE TEST,2070.0,1345.5,116.49,2070.0,84
HCPCS,81171,AFF2 GEN ALY DETC ABNL ALLEL,,,54.8,375.38,28
HCPCS,81171,Aff2 gen aly detc abnl allel,,,116.49,134.88,8
HCPCS,81172,AFF2 GEN ALYS CHARAC ALLELES,,,109.93,753.03,28
HCPCS,81172,Aff2 gen alys charac alleles,,,116.49,134.88,8
HCPCS,81173,AR GENE FULL GENE SEQUENCE,,,120.54,825.7,28
HCPCS,81173,Ar gene full gene sequence,,,116.49,134.88,8
HCPCS,81174,AR GENE KNOWN FAMIL VARIANT,,,74.08,507.45,28
HCPCS,81174,Ar gene known famil variant,,,116.49,134.88,8
HCPCS,81175,ASXL1 FULL GENE SEQUENCE,,,188.14,1853.61,28
HCPCS,81175,Asxl1 full gene sequence,,,173.12,200.45,8
HCPCS,81176,ASXL1 GENE TARGET SEQ ALYS,,,110.13,662.81,28
HCPCS,81176,Asxl1 gene target seq alys,,,116.49,134.88,8
HCPCS,81177,DRPLA DNA TEST,945.0,614.25,54.8,945.0,84
HCPCS,81178,SCA1 DNA TEST,945.0,614.25,54.8,945.0,84
HCPCS,81179,SCA2 EXPANSION,945.0,614.25,54.8,945.0,84
HCPCS,81180,SCA3 DNA TEST,945.0,614.25,54.8,945.0,84
HCPCS,81181,SCA7 DNA TEST,945.0,614.25,54.8,945.0,84
HCPCS,81182,ATXN8OS GEN DETC ABNOR ALLEL,,,54.8,375.38,28
HCPCS,81182,Atxn8os gen detc abnor allel,,,116.49,134.88,8
HCPCS,81183,ATXN10 GENE DETC ABNOR ALLEL,,,54.8,375.38,28
HCPCS,81183,Atxn10 gene detc abnor allel,,,116.49,134.88,8
HCPCS,81184,SCA6 DNA TEST,945.0,614.25,54.8,945.0,84
HCPCS,81185,HEMMIG CACNA1A,5839.0,3795.35,173.12,5839.0,84
HCPCS,81186,CACNA1A GEN KNOWN FAMIL VRNT,,,74.08,507.45,28
HCPCS,81186,Cacna1a gen known famil vrnt,,,116.49,134.88,8
HCPCS,81187,DM2 DNA TEST,945.0,614.25,54.8,945.0,84
HCPCS,81188,CSTB GENE DETC ABNOR ALLELE,,,54.8,375.38,28
HCPCS,81188,Cstb gene detc abnor allele,,,116.49,134.88,8
HCPCS,81189,CSTB GENE FULL GENE SEQUENCE,,,109.93,753.03,28
HCPCS,81189,Cstb gene full gene sequence,,,116.49,134.88,8
HCPCS,81190,CSTB GENE KNOWN FAMIL VRNT,,,74.08,507.45,28
HCPCS,81190,Cstb gene known famil vrnt,,,116.49,134.88,8
HCPCS,81191,NTRK1 TRANSLOCATION ANALYSIS,,,82.92,568.03,28
HCPCS,81191,Ntrk1 translocation analysis,,,116.49,134.88,8
HCPCS,81192,NTRK2 TRANSLOCATION ANALYSIS,,,82.92,568.03,28
HCPCS,81192,Ntrk2 translocation analysis,,,116.49,134.88,8
HCPCS,81193,NTRK3 TRANSLOCATION ANALYSIS,,,82.92,568.03,28
HCPCS,81193,Ntrk3 translocation analysis,,,116.49,134.88,8
HCPCS,81194,NTRK NGS,3576.0,2324.4,109.69,3576.0,84
HCPCS,81195,CYTOG GENOM-WID ALYS HEM MAL,,,1263.53,2842.95,20
HCPCS,81195,Cytog genom-wid alys hem mal,,,672.05,778.16,8
HCPCS,81200,%AJPWO CANVAN,326.0,211.9,18.9,326.0,84
HCPCS,81200,AJPNL ASPA GENE,326.0,211.9,18.9,326.0,84
HCPCS,81200,ASPA GENE ANALYSIS COMMON VARIANTS,326.0,211.9,1.1,326.0,88
HCPCS,81200,CANVAN TEST,326.0,211.9,18.9,326.0,84
HCPCS,81200,CSPNL ASPA GENE,326.0,211.9,18.9,326.0,84
HCPCS,81201,APC GENE FULL SEQUENCE,,,312.0,2434.03,29
HCPCS,81201,Apc gene full sequence,,,173.12,200.45,8
HCPCS,81202,APC GENE ANALYSIS KNOWN FAMILIAL VARIANTS,1932.0,1255.8,1.1,1932.0,88
HCPCS,81202,APC GENE KNOWN FAM VARIANTS,,,112.0,767.2,28
HCPCS,81202,Apc gene known fam variants,,,116.49,134.88,8
HCPCS,81203,APC GENE DUP/DELET VARIANTS,,,80.0,738.78,29
HCPCS,81203,Apc gene dup/delet variants,,,116.49,134.88,8
HCPCS,81204,KENNEDY'S DIS DNA,945.0,614.25,54.8,945.0,84
HCPCS,81205,%AJPWO BCKDHB,655.0,425.75,38.0,655.0,84
HCPCS,81205,AJPNL BCKDHB GENE,655.0,425.75,38.0,655.0,84
HCPCS,81205,BCKDHB GENE ANALYSIS COMMON VARIANTS,655.0,425.75,1.1,655.0,88
HCPCS,81205,CSPNL BCKDHB GENE,655.0,425.75,38.0,655.0,84
HCPCS,81206,%ABLQUL BCR/ABL1 MAJ,1131.0,735.15,80.97,1262.54,84
HCPCS,81206,%BCRQL BCR/ABL1 MAJ BRKPT,1131.0,735.15,80.97,1262.54,168
HCPCS,81206,BCR/ABL QUANT BLOOD TEST,1131.0,735.15,80.97,1262.54,84
HCPCS,81206,BCR/ABL QUANT BONE MARROW,1131.0,735.15,80.97,1262.54,84
HCPCS,81206,BCRBM BCR/ABL1 GENE MAJOR BP,1131.0,735.15,80.97,1262.54,84
HCPCS,81206,BCRPB BCR/ABL1 GENE MAJOR BP,1131.0,735.15,80.97,1262.54,84
HCPCS,81206,BCRQLM BCR/ABL1 MAJ BRKPT,1131.0,735.15,80.97,1262.54,84
HCPCS,81207,%ABLQUL BCR/ABL1 MIN,999.0,649.35,71.52,1115.21,84
HCPCS,81207,%BCRQL BCR/ABL1 MIN BRKPT,999.0,649.35,71.52,1115.21,84
HCPCS,81207,190PCR BONE MARROW TEST,999.0,649.35,71.52,1115.21,84
HCPCS,81207,BCR/ABL1 MINOR BREAKPNT QUALITATIVE/QUANTITATIVE,999.0,649.35,1.1,999.0,88
HCPCS,81207,BCRBM BCR/ABL1 GENE MINOR BP,999.0,649.35,71.52,1115.21,84
HCPCS,81207,BCRPB BCR/ABL1 GENE MINOR BP,999.0,649.35,71.52,1115.21,84
HCPCS,81207,BCRQLM BCR/ABL1 MIN BRKPT,999.0,649.35,71.52,1115.21,84
HCPCS,81207,P190PCR BLOOD,999.0,649.35,71.52,1115.21,84
HCPCS,81208,%ABLQUL BCR/ABL1 OTH,1481.0,962.65,85.85,1481.0,84
HCPCS,81208,%BCRQL BCR/ABL1 OTH BRKPT,1481.0,962.65,85.85,1481.0,84
HCPCS,81208,BCRQLM BCR/ABL1 OTH BRKPT,1481.0,962.65,85.85,1481.0,84
HCPCS,81209,%AJPWO BLOOM,271.0,176.15,15.72,271.0,84
HCPCS,81209,AJPNL BLM GENE,271.0,176.15,15.72,271.0,84
HCPCS,81209,CSPNL BLM GENE,271.0,176.15,15.72,271.0,84
HCPCS,81210,%BRAFBM TEST,1210.0,786.5,70.16,1210.0,84
HCPCS,81210,%BRAFGN BRAF GENE AN,1210.0,786.5,70.16,1210.0,84
HCPCS,81210,%NGSCOL BRAF,1210.0,786.5,70.16,1210.0,84
HCPCS,81210,%NGSMEL BRAF,1210.0,786.5,70.16,1210.0,168
HCPCS,81210,%UVAHA HVA,1210.0,786.5,70.16,1210.0,84
HCPCS,81210,BRAF GENE ANALYSIS,1210.0,786.5,70.16,1210.0,84
HCPCS,81210,BRAF V600E MUT DETECT BLOOD,1210.0,786.5,70.16,1210.0,84
HCPCS,81210,BRAF V600E MUT DETECT BM,1210.0,786.5,70.16,1210.0,84
HCPCS,81210,BRAF V600E MUT DETECT OTHER,1210.0,786.5,70.16,1210.0,84
HCPCS,81210,BRAF V600E/D AND V600K/R MUTATION DETECTION CIRCULATING TUMOR DN,1335.0,867.75,70.16,1335.0,84
HCPCS,81210,GIST BRAF GENE,1210.0,786.5,70.16,1210.0,84
HCPCS,81210,GISTCY BRAF GENE,1210.0,786.5,70.16,1210.0,84
HCPCS,81210,NGSCCY BRAF,1210.0,786.5,70.16,1210.0,84
HCPCS,81210,NGSMCY BRAF,1210.0,786.5,70.16,1210.0,84
HCPCS,81212,BRCA1&2 185&5385&6174 VRNT,,,176.0,1205.6,28
HCPCS,81212,Brca1&2 185&5385&6174 vrnt,,,109.69,127.01,8
HCPCS,81215,BRCA1 GENE KNOWN FAMIL VRNT,,,150.1,1028.19,28
HCPCS,81215,Brca1 gene known famil vrnt,,,109.69,127.01,8
HCPCS,81216,BRCA2 GENE FULL SEQ ALYS,,,74.05,507.23,28
HCPCS,81216,Brca2 gene full seq alys,,,116.49,134.88,8
HCPCS,81217,BRCA2 GENE KNOWN FAMIL VRNT,,,150.1,1028.19,28
HCPCS,81217,Brca2 gene known famil vrnt,,,109.69,127.01,8
HCPCS,81218,CEBPA MUT ANALYSIS,1669.0,1084.85,116.49,1669.0,84
HCPCS,81218,CEBPA MUT ANYS MARROW,1669.0,1084.85,116.49,1669.0,84
HCPCS,81219,CALR EXON 9 MUTATION,839.0,545.35,60.06,839.0,84
HCPCS,81219,CALR GENE ANALYSIS,839.0,545.35,60.06,839.0,84
HCPCS,81220,*CYSTIC FIBROSIS CARRIER SCR,3841.0,2496.65,109.69,4289.05,84
HCPCS,81220,CF PATHOGENIC VARIANT,3841.0,2496.65,109.69,4289.05,84
HCPCS,81220,CFNGS 139 VAR,3841.0,2496.65,109.69,4289.05,84
HCPCS,81220,CFSCRN TEST,3841.0,2496.65,109.69,4289.05,84
HCPCS,81220,CFTR GENE ANALYSIS COMMON VARIANTS,3841.0,2496.65,1.1,3841.0,88
HCPCS,81220,CSPNL CFTR GENE COM VARS,3841.0,2496.65,109.69,4289.05,84
HCPCS,81221,CFTR GENE KNOWN FAM VARIANTS,,,38.89,266.38,28
HCPCS,81221,Cftr gene known fam variants,,,83.94,97.2,8
HCPCS,81222,CFTR GENE DUP/DELET VARIANTS,,,174.03,1192.09,28
HCPCS,81222,Cftr gene dup/delet variants,,,109.69,127.01,8
HCPCS,81223,*CFTR GENE FULL SEQUENCE,3443.0,2237.95,109.69,3443.0,84
HCPCS,81223,CF-CFTR-SEQ,3443.0,2237.95,109.69,3443.0,84
HCPCS,81223,CFTR GENE ANALYSIS FULL GENE SEQUENCE,3443.0,2237.95,1.1,3443.0,88
HCPCS,81224,*CFTR GENE INTRON POLY T,1164.0,756.6,67.5,1164.0,84
HCPCS,81224,CFTR GENE ANALYSIS INTRON 8 POLY-T ANALYSIS,1164.0,756.6,1.1,1164.0,88
HCPCS,81224,CFTR TEST,1164.0,756.6,67.5,1164.0,84
HCPCS,81225,2C19AO-CYP2C19 GTYP AN ON,2010.0,1306.5,116.49,2010.0,84
HCPCS,81225,2C19PL TEST,2010.0,1306.5,116.49,2010.0,84
HCPCS,81225,CP2C19-CYP2C19 GENOTYPING,2010.0,1306.5,116.49,2010.0,84
HCPCS,81225,CYP2C19 GENE ANALYSIS COMMON VARIANTS,2010.0,1306.5,1.1,2010.0,88
HCPCS,81225,CYTOCHROME P450 2C19,2010.0,1306.5,116.49,2010.0,84
HCPCS,81225,PGANTI CYP2C19 GENE COM VAR,2010.0,1306.5,116.49,2010.0,84
HCPCS,81225,PGANTS CYP2C19 GENE COM VAR,2010.0,1306.5,116.49,2010.0,84
HCPCS,81225,PGXAO CYP2C19 GENE COM VAR,2010.0,1306.5,116.49,2010.0,84
HCPCS,81226,2D6 TEST,3111.0,2022.15,109.69,3111.0,84
HCPCS,81226,2D6AO-CYP2D6 GTYP AN ON,3111.0,2022.15,109.69,3111.0,84
HCPCS,81226,CYP2D6 GENE ANALYSIS COMMON VARIANTS,3111.0,2022.15,1.1,3111.0,88
HCPCS,81226,CYTOCHROME P450 2D6,3111.0,2022.15,109.69,3111.0,84
HCPCS,81226,CYTOCHROME P450 2D6 GENO,3111.0,2022.15,109.69,3111.0,84
HCPCS,81226,PGANTI CYP2D6 GENE COM VAR,3111.0,2022.15,109.69,3111.0,84
HCPCS,81226,PGANTS CYP2D6 GENE COM VAR,3111.0,2022.15,109.69,3111.0,84
HCPCS,81226,PGPAIN CYP2D6 GENE COM VAR,3111.0,2022.15,109.69,3111.0,84
HCPCS,81227,PHARMACOGENOMICS CYP2C9,1206.0,783.9,69.92,1206.0,84
HCPCS,81227,WARSEN 2C9 TEST,1206.0,783.9,69.92,1206.0,84
HCPCS,81227,WRFSEN CYP2C9 GENE VAR,1206.0,783.9,69.92,1206.0,84
HCPCS,81228,%HYDROXYINDOLE ACET RANDM,6210.0,4036.5,173.12,6210.0,84
HCPCS,81228,COL3A1 DELETION/DUP ANLS,6210.0,4036.5,173.12,6210.0,84
HCPCS,81229,CRMSNP TEST,4500.0,2925.0,540.0,4500.0,168
HCPCS,81229,CYTOG ALYS CHRMOML ABNOR CPY NUMBER&SNP VRNT CGH,4182.0,2718.3,1.1,4182.0,88
HCPCS,81229,CYTOGEN SNP MICROARRAY,4500.0,2925.0,540.0,4500.0,84
HCPCS,81229,CYTOGENOMIC SNP MICROARRAY - FETAL,4500.0,2925.0,540.0,4500.0,84
HCPCS,81229,HDSNP TEST,4500.0,2925.0,540.0,4500.0,84
HCPCS,81229,"MICROARRAY ANALYSIS, POC FFPE",1335.0,867.75,377.54,4279.01,84
HCPCS,81229,"MICROARRAY ANALYSIS, SNP, FORMALIN FIXED PARAFFIN EMBEDDED TISSU",1335.0,867.75,377.54,4279.01,84
HCPCS,81229,POCHF PROD CONCEPT+SNP,4500.0,2925.0,540.0,4500.0,84
HCPCS,81229,"PRENATAL SNP MICROARRAY, AMNIOTIC FLUID, CVS",4500.0,2925.0,540.0,4500.0,84
HCPCS,81229,PROD OF CONCEPTION + SNP,4500.0,2925.0,540.0,4500.0,84
HCPCS,81230,CYP3A4 GENE COMMON VARIANTS,,,110.13,478.98,28
HCPCS,81230,Cyp3a4 gene common variants,,,116.49,134.88,8
HCPCS,81231,PHARMACOGENOMICS CYP3A5,1206.0,783.9,110.13,1206.0,84
HCPCS,81232,5-FLUOROURACIL TOX 5 MUT,1206.0,783.9,116.49,1206.0,84
HCPCS,81232,5FUDPD DPYD GENE COMMON VARS,1206.0,783.9,116.49,1206.0,84
HCPCS,81232,DPD 5FU GENOTYPR,1206.0,783.9,116.49,1206.0,84
HCPCS,81232,DPYDAO-DYPD GTYP AN ON,1206.0,783.9,116.49,1206.0,84
HCPCS,81232,DUPNL DPYD GENE COMMON VARIANTS,1206.0,783.9,116.49,1206.0,84
HCPCS,81232,DYPD GENOTYPING,1206.0,783.9,116.49,1206.0,84
HCPCS,81233,BTK GENE ANALYISIS,1210.0,786.5,70.16,1210.0,84
HCPCS,81234,DM1 DNA TEST,945.0,614.25,54.8,945.0,84
HCPCS,81235,%EGFRTI TEST,2240.0,1456.0,109.69,2240.0,84
HCPCS,81235,%NGSLUNG EGFR,2240.0,1456.0,109.69,2240.0,84
HCPCS,81235,EGFR GENE ANALYSIS,2240.0,1456.0,109.69,2240.0,84
HCPCS,81235,EGFR GENETIC ANALYSIS,2240.0,1456.0,109.69,2240.0,84
HCPCS,81235,EGFRCP TEST,2240.0,1456.0,109.69,2240.0,84
HCPCS,81236,EZH2 GENE FULL GENE SEQUENCE,,,113.15,775.09,28
HCPCS,81236,Ezh2 gene full gene sequence,,,116.49,134.88,8
HCPCS,81237,EZH2 GENE COMMON VARIANTS,,,70.16,480.6,28
HCPCS,81237,Ezh2 gene common variants,,,116.49,134.88,8
HCPCS,81238,F9 FULL GENE SEQUENCE,,,110.13,1644.0,28
HCPCS,81238,F9 full gene sequence,,,173.12,200.45,8
HCPCS,81239,DMPK GENE CHARAC ALLELES,,,109.93,753.03,28
HCPCS,81239,Dmpk gene charac alleles,,,116.49,134.88,8
HCPCS,81240,F2 GENE ANALYSIS 20210G >A VARIANT,453.0,294.45,1.1,453.0,88
HCPCS,81240,PTGENEO TEST,453.0,294.45,26.28,453.0,84
HCPCS,81241,F5 COAGULATION FACTOR V ANAL LEIDEN VARIANT,506.0,328.9,1.1,506.0,88
HCPCS,81241,FACT V LEIDEN TEST,506.0,328.9,30.18,506.0,84
HCPCS,81242,%AJPWO FANCONI,253.0,164.45,14.65,253.0,84
HCPCS,81242,AJPNL FANCC GENE,253.0,164.45,14.65,253.0,84
HCPCS,81242,CSPNL FANCC GENE,253.0,164.45,14.65,253.0,84
HCPCS,81243,%FRAX FMR 1 TEST,394.0,256.1,22.82,930.61,84
HCPCS,81243,CSPNL FMR1 GENE DETECTION,394.0,256.1,22.82,930.61,84
HCPCS,81243,FMR1 GENE ALYS EVAL TO DETECT ABNORMAL ALLELES,394.0,256.1,1.1,394.0,88
HCPCS,81243,FMR1 GENE DETECTION,394.0,256.1,22.82,930.61,84
HCPCS,81244,XPANSION INTERPRETER REFL,310.0,201.5,17.96,310.0,84
HCPCS,81245,%FLT3 ITD TEST,1142.0,742.3,66.2,1142.0,84
HCPCS,81245,%FLT3M ITD GENE,1142.0,742.3,66.2,1142.0,84
HCPCS,81245,%FLT3MD VARIANTS,1142.0,742.3,66.2,1142.0,84
HCPCS,81245,F3MRW MUT ANSYS BM,1142.0,742.3,66.2,1142.0,84
HCPCS,81245,FLT3 ITD MUT ANSYS BLD,1142.0,742.3,66.2,1142.0,84
HCPCS,81245,FLT3 ITD MUT ANSYS BM,1142.0,742.3,66.2,1142.0,84
HCPCS,81245,FLT3 TKDM VARIANTS BM,1142.0,742.3,66.2,1142.0,84
HCPCS,81245,FLT3PB MUT ANSYS BLD,1142.0,742.3,66.2,1142.0,84
HCPCS,81246,%FLT3 TKD TEST,573.0,372.45,33.2,573.0,84
HCPCS,81246,%FLT3M TKD GENE,573.0,372.45,33.2,573.0,84
HCPCS,81246,%FLT3MD TKD VARIANTS,573.0,372.45,33.2,573.0,84
HCPCS,81246,F3MRW GENE ANSYS BM,573.0,372.45,33.2,573.0,84
HCPCS,81246,FLT3 GENE ANLYS TYROSINE KINASE DOMAIN VARIANTS,573.0,372.45,1.1,573.0,88
HCPCS,81246,FLT3 TKD TEST,573.0,372.45,33.2,573.0,84
HCPCS,81246,FLT3 TKDM BONE MARROW,573.0,372.45,33.2,573.0,168
HCPCS,81246,FLT3PB GENE ANSYS BLD,573.0,372.45,33.2,573.0,84
HCPCS,81247,G6PD GENE ALYS CMN VARIANT,,,174.81,478.98,28
HCPCS,81247,G6pd gene alys cmn variant,,,116.49,134.88,8
HCPCS,81248,G6PD KNOWN FAMILIAL VARIANT,,,375.25,1028.19,28
HCPCS,81248,G6pd known familial variant,,,109.69,127.01,8
HCPCS,81249,G6PD FULL GENE SEQUENCE,,,236.41,1644.0,28
HCPCS,81249,G6pd full gene sequence,,,173.12,200.45,8
HCPCS,81250,%AJPWO G6PC,404.0,262.6,23.4,404.0,84
HCPCS,81250,AJPNL G6PC GENE,404.0,262.6,23.4,404.0,84
HCPCS,81250,CSPNL G6PC GENE,404.0,262.6,23.4,404.0,84
HCPCS,81250,G6PC GENE ANALYSIS COMMON VARIANTS,404.0,262.6,1.1,404.0,88
HCPCS,81251,%AJPWO GAUCHER,326.0,211.9,47.25,326.0,84
HCPCS,81251,AJPNL GBA GENE,326.0,211.9,47.25,326.0,84
HCPCS,81251,CSPNL GBA GENE,326.0,211.9,47.25,326.0,84
HCPCS,81251,GAUCHR TEST,326.0,211.9,47.25,326.0,84
HCPCS,81251,GBA GENE,326.0,211.9,47.25,326.0,84
HCPCS,81251,GBA GLUCOSIDASE/BETA/ACID ANAL COMM VARIANTS,326.0,211.9,1.1,326.0,88
HCPCS,81252,CON26 TEST,698.0,453.7,40.45,698.0,84
HCPCS,81253,GJB2 GENE KNOWN FAM VARIANTS,,,24.61,168.56,28
HCPCS,81253,Gjb2 gene known fam variants,,,83.94,97.2,8
HCPCS,81254,GJB6 GENE COM VARIANTS,,,14.0,95.9,28
HCPCS,81254,Gjb6 gene com variants,,,83.94,97.2,8
HCPCS,81255,%AJPWO TAY SACHS,355.0,230.75,51.45,355.0,84
HCPCS,81255,AJPNL HEXA GENE,355.0,230.75,51.45,355.0,84
HCPCS,81255,CSPNL HEXA GENE,355.0,230.75,51.45,355.0,84
HCPCS,81256,HEMDNA TEST,451.0,293.15,32.28,503.27,84
HCPCS,81256,HFE HEMOCHROMATOSIS GENE ANAL COMMON VARIANTS,451.0,293.15,1.1,451.0,88
HCPCS,81256,HFE TARGETED MUT BY SANGER SEQ,451.0,293.15,32.28,503.27,84
HCPCS,81257,ALPHA THALASSEMIA TEST,706.0,458.9,40.9,1397.77,84
HCPCS,81257,HBA1/HBA2 ANALYSIS FOR COMMON DELETIONS/VARIANT,706.0,458.9,1.1,706.0,88
HCPCS,81258,HBA1/HBA2 GENE FAM VRNT,,,375.25,1028.19,28
HCPCS,81258,Hba1/hba2 gene fam vrnt,,,109.69,127.01,8
HCPCS,81259,HBA1/HBA2 FULL GENE SEQUENCE,,,127.51,1644.0,28
HCPCS,81259,Hba1/hba2 full gene sequence,,,173.12,200.45,8
HCPCS,81260,%AJPWO FAMILIAL DYSAUTO,271.0,176.15,15.72,271.0,84
HCPCS,81260,AJPNL IKBKAP GENE,271.0,176.15,15.72,271.0,84
HCPCS,81260,CSPNL IKBKAP GENE,271.0,176.15,15.72,271.0,84
HCPCS,81261,%T2BPCR IGH GENE REARR,1366.0,887.9,97.77,1524.53,84
HCPCS,81261,BCBMD I TEST,1366.0,887.9,97.77,1524.53,84
HCPCS,81261,BCBMDM LGH REARR HCL,1366.0,887.9,97.77,1524.53,84
HCPCS,81261,BCBMDO LGH REARR HCL,1366.0,887.9,97.77,1524.53,84
HCPCS,81261,IGH@ REARRANGE ABNORMAL CLONAL POP AMPLIFIED,1366.0,887.9,1.1,1366.0,88
HCPCS,81261,IGHM LGH REARR HCL,1366.0,887.9,97.77,1524.53,84
HCPCS,81261,IGHO LGH REARR HCL,1366.0,887.9,97.77,1524.53,84
HCPCS,81261,IGHPCR TEST,1366.0,887.9,97.77,1524.53,84
HCPCS,81262,IGH@ REARRANGE ABNORMAL CLONAL POP DIRECT PROBE,473.0,307.45,1.1,473.0,88
HCPCS,81262,IGHSB TEST,473.0,307.45,27.42,473.0,84
HCPCS,81262,IMGENE IGH SB TEST,473.0,307.45,27.42,473.0,84
HCPCS,81263,IGH VARI REGIONAL MUTATION,2032.0,1320.8,116.49,2032.0,84
HCPCS,81263,IGH@ VARIABLE REGION SOMATIC MUTATION ANALYSIS,2032.0,1320.8,1.1,2032.0,88
HCPCS,81264,BCBMD II TEST,1192.0,774.8,73.74,1192.0,84
HCPCS,81264,BCBMDM LGK REARR KLCL,1192.0,774.8,73.74,1192.0,84
HCPCS,81264,BCBMDO LGK REARR KLCL,1192.0,774.8,73.74,1192.0,84
HCPCS,81264,IGKM LGK REARR KLCL,1192.0,774.8,73.74,1192.0,84
HCPCS,81264,IGKO LGK REARR KLCL,1192.0,774.8,73.74,1192.0,84
HCPCS,81264,IGKPCR TEST,1192.0,774.8,73.74,1192.0,84
HCPCS,81265,%NFIB1 COMP ANLYS STR,1608.0,1045.2,106.2,1608.0,84
HCPCS,81265,BMENGS SNP MARKERS SPECIMEN ANAL,1608.0,1045.2,106.2,1608.0,84
HCPCS,81265,COMPARATIVE ANAL STR MARKERS PATIENT&COMP SPEC,1608.0,1045.2,1.1,1608.0,88
HCPCS,81265,DNA FINGERPRNT TEST,1608.0,1045.2,106.2,1608.0,84
HCPCS,81265,FETAL CELL CONTAMINATION (FCC),1608.0,1045.2,106.2,1608.0,84
HCPCS,81265,MATERNAL CELL CONTAMINATION,1608.0,1045.2,106.2,1608.0,84
HCPCS,81265,MATRNL TEST,1608.0,1045.2,106.2,1608.0,84
HCPCS,81265,RECIPIENT TYPING FOR ENGRAFTMENT MONITORING,1608.0,1045.2,106.2,1608.0,84
HCPCS,81265,"SHORT TANDEM REPEAT ANALYSIS FOR SPECIMEN IDENTIFICATION, BLOOD",1608.0,1045.2,106.2,1608.0,84
HCPCS,81265,"SHORT TANDEM REPEAT ANALYSIS FOR SPECIMEN IDENTIFICATION, OTHER",1608.0,1045.2,106.2,1608.0,84
HCPCS,81265,"STR ANALYSIS FOR MOL PREG, BLD",1608.0,1045.2,106.2,1608.0,84
HCPCS,81265,"STR ANALYSIS FOR MOL PREG, OTHER",1608.0,1045.2,106.2,1608.0,84
HCPCS,81265,STR GENOTYPING,1608.0,1045.2,106.2,1608.0,84
HCPCS,81265,TISSUE DNA FP FOR MOLAR PREG - IHC SENDOUT,1608.0,1045.2,106.2,1608.0,84
HCPCS,81265,TZYGOS STR MKRS SPEC ANALYSIS,1608.0,1045.2,106.2,1608.0,84
HCPCS,81266,TZYGOS STR MKRS ADDTL,2103.0,1366.95,116.49,2103.0,84
HCPCS,81267,CHIMERISM W/COMP TO BASELINE W/O CELL SELECTION,1431.0,930.15,1.1,1431.0,88
HCPCS,81267,CHIMERISM/ENGRAFTMENT ANALY W/COMP TO BASLINE,1431.0,930.15,102.45,1431.0,84
HCPCS,81267,"DNA EXTRACT-RSSOP,SSP&SBT-VER",1431.0,930.15,102.45,1431.0,84
HCPCS,81267,POST-TX FOLLOW-UP ENGRAFTMENT MONITORING,1431.0,930.15,102.45,1431.0,84
HCPCS,81267,POST-TX NO-T-CELL FOLLOW-UP ENGRAFTMENT MONITORING,1431.0,930.15,102.45,1431.0,84
HCPCS,81268,%BMEMAL W CELL SELECT,1799.0,1169.35,116.49,1799.0,84
HCPCS,81268,BM ENGRAFT F/U TEST,1799.0,1169.35,116.49,1799.0,84
HCPCS,81268,BMFUNG CHIMERISM ANAL W/CELL SELECT,1799.0,1169.35,116.49,1799.0,84
HCPCS,81268,CHIMERISM TEST-STR-3 OR MORE,1799.0,1169.35,116.49,1799.0,84
HCPCS,81269,A THALASSEMIA GENE DEL,1397.0,908.05,47.53,1397.0,84
HCPCS,81269,HBA1 HBA2 DEL/DUP,1397.0,908.05,47.53,1397.0,84
HCPCS,81270,JAK2 GENE ANALYSIS P.VAL617PHE VARIANT,632.0,410.8,1.1,632.0,88
HCPCS,81270,"JAK2 GENE ANALYSIS, VAL617PHE VARIANT",632.0,410.8,45.27,632.0,84
HCPCS,81270,JAK2 TEST,632.0,410.8,45.27,632.0,168
HCPCS,81271,HUNTINGTON'S DISEASE,945.0,614.25,54.8,945.0,84
HCPCS,81272,%KITGN KIT TARGET SEQ,2274.0,1478.1,116.49,2274.0,84
HCPCS,81272,%NGSMEL KIT,2274.0,1478.1,116.49,2274.0,84
HCPCS,81272,GIST KIT GENE,2274.0,1478.1,116.49,2274.0,84
HCPCS,81272,GISTCY KIT GENE,2274.0,1478.1,116.49,2274.0,84
HCPCS,81272,KIT GENE ANALYSIS TARGETED SEQUENCE ANALYSIS,2274.0,1478.1,1.1,2274.0,88
HCPCS,81272,"KIT MUT EX 18-11, 17 SEQ",2274.0,1478.1,116.49,2274.0,84
HCPCS,81272,KITAML MUTATION ANALYS,2274.0,1478.1,116.49,2274.0,84
HCPCS,81272,KITBM KIT TARGET SEQ,2274.0,1478.1,116.49,2274.0,84
HCPCS,81272,KITPB KIT TARGET SEQ,2274.0,1478.1,116.49,2274.0,84
HCPCS,81272,NGSMCY KIT,2274.0,1478.1,116.49,2274.0,84
HCPCS,81273,KIT D816V MUT DETECT,862.0,560.3,49.95,862.0,84
HCPCS,81273,KIT D816V MUT DETECT BLD,862.0,560.3,49.95,862.0,84
HCPCS,81273,KIT D816V MUT DETECT BM,862.0,560.3,49.95,862.0,84
HCPCS,81273,KIT D816V MUT DETECT OTHER,862.0,560.3,49.95,862.0,84
HCPCS,81273,KIT D816V MUTATION PCR,862.0,560.3,49.95,862.0,84
HCPCS,81273,KITBM MUT ANLYS,862.0,560.3,49.95,862.0,84
HCPCS,81273,KITPB MUT ANLYS,862.0,560.3,49.95,862.0,84
HCPCS,81274,HTT GENE CHARAC ALLELES,,,109.93,753.03,28
HCPCS,81274,Htt gene charac alleles,,,116.49,134.88,8
HCPCS,81275,"%EXKRAS KRAS CODON 12,13",1333.0,866.45,77.3,1333.0,84
HCPCS,81275,%KRASGN KRAS EXON2,1333.0,866.45,77.3,1333.0,84
HCPCS,81275,"%NGSCOL KRAS 12,13",1333.0,866.45,77.3,1333.0,84
HCPCS,81275,%TYMUT KRAS MUTATION,1333.0,866.45,77.3,1333.0,84
HCPCS,81275,KRAS GENE,1333.0,866.45,77.3,1333.0,84
HCPCS,81275,KRAS GENETIC ANALYSIS,1333.0,866.45,77.3,1333.0,84
HCPCS,81275,"KRAS,CONDONS 12 &13, KRAS ADDVAR",1333.0,866.45,77.3,1333.0,84
HCPCS,81275,"NGSCCY KRAS 12,13",1333.0,866.45,77.3,1333.0,84
HCPCS,81276,%EXKRAS KRAS CODON 61,1333.0,866.45,77.3,1333.0,84
HCPCS,81276,%KRASGN KRAS ADD VAR,1333.0,866.45,77.3,1333.0,84
HCPCS,81276,%NGSCOL KRAS 61,1333.0,866.45,77.3,1333.0,84
HCPCS,81276,%NGSLUNG KRAS 61,1333.0,866.45,77.3,1333.0,84
HCPCS,81276,KRAS ADDITIONAL VARIANTS,1333.0,866.45,77.3,1333.0,84
HCPCS,81276,NGSCCY KRAS 61,1333.0,866.45,77.3,1333.0,84
HCPCS,81277,BLLSNP CYTO NEOPL MICROAR,8004.0,5202.6,464.0,8004.0,84
HCPCS,81277,BMCHF CYTO NEOPL MICROAR,8004.0,5202.6,464.0,8004.0,84
HCPCS,81277,BMHSNP CYTO NEOPL MICROAR,8004.0,5202.6,464.0,8004.0,84
HCPCS,81277,MICORARRAY SNP FFPET,8004.0,5202.6,464.0,8004.0,84
HCPCS,81278,IGH@/BCL2 TRANSLOCATION ALYS,,,82.92,568.03,28
HCPCS,81278,Igh@/bcl2 translocation alys,,,116.49,134.88,8
HCPCS,81279,JAK2 EX 12-16 MUT DET BLD,1278.0,830.7,74.08,1278.0,84
HCPCS,81279,"JAK2 GENE ANALYSIS, EXONS 12 AND 13",1278.0,830.7,74.08,1278.0,84
HCPCS,81279,JAKNON EX 12-16 SEQ BLD,1278.0,830.7,74.08,1278.0,84
HCPCS,81283,IL28B ASSOC VAR 2 SNP,506.0,328.9,73.37,506.0,84
HCPCS,81284,FRIEDREICH ATAX DNA,945.0,614.25,54.8,945.0,84
HCPCS,81285,FXN GENE CHARAC ALLELES,,,109.93,753.03,28
HCPCS,81285,Fxn gene charac alleles,,,116.49,134.88,8
HCPCS,81286,FXN GENE FULL GENE SEQUENCE,,,109.93,753.03,28
HCPCS,81286,Fxn gene full gene sequence,,,116.49,134.88,8
HCPCS,81287,MGMT GENE PROMOTER METHYLATION ANALYSIS,860.0,559.0,1.1,860.0,88
HCPCS,81287,MGMT TEST,860.0,559.0,49.86,860.0,84
HCPCS,81288,MLH1 PROMOTER HYPERMETH,1327.0,862.55,76.93,1327.0,84
HCPCS,81289,FXN GENE KNOWN FAMIL VARIANT,,,74.08,507.45,28
HCPCS,81289,Fxn gene known famil variant,,,116.49,134.88,8
HCPCS,81290,%AJPWO MUCOLIPIDOSIS IV,271.0,176.15,15.72,271.0,84
HCPCS,81290,AJPNL MCOLN1 GENE,271.0,176.15,15.72,271.0,84
HCPCS,81290,CSPNL MCOLN1 GENE,271.0,176.15,15.72,271.0,84
HCPCS,81291,MTHFR BY PCR TEST,451.0,293.15,26.14,451.0,84
HCPCS,81291,MTHFR GENE ANALYSIS COMMON VARIANTS,451.0,293.15,1.1,451.0,88
HCPCS,81291,MTHRF 2 VARIANTS,451.0,293.15,26.14,451.0,84
HCPCS,81292,MLH1 GENE FULL SEQ,,,270.16,1850.6,28
HCPCS,81292,Mlh1 gene full seq,,,173.12,200.45,8
HCPCS,81293,MLH1 GENE KNOWN VARIANTS,,,132.4,906.94,28
HCPCS,81293,Mlh1 gene known variants,,,116.49,134.88,8
HCPCS,81294,MLH1 GENE ANALYSIS DUPLICATION/DELETION VARIANTS,1397.0,908.05,1.1,1397.0,88
HCPCS,81294,MLH1 GENE DUP/DELETE VARIANT,,,80.96,554.58,28
HCPCS,81294,Mlh1 gene dup/delete variant,,,116.49,134.88,8
HCPCS,81295,MSH2 GENE FULL SEQ,,,152.68,1045.86,28
HCPCS,81295,Msh2 gene full seq,,,109.69,127.01,8
HCPCS,81296,MSH2 GENE KNOWN VARIANTS,,,135.09,925.38,28
HCPCS,81296,Msh2 gene known variants,,,116.49,134.88,8
HCPCS,81297,MSH2 GENE DUP/DELETE VARIANT,,,85.32,584.44,28
HCPCS,81297,Msh2 gene dup/delete variant,,,116.49,134.88,8
HCPCS,81298,MSH6 GENE FULL SEQ,,,256.74,1758.67,28
HCPCS,81298,Msh6 gene full seq,,,173.12,200.45,8
HCPCS,81299,MSH6 GENE KNOWN VARIANTS,,,123.2,843.92,28
HCPCS,81299,Msh6 gene known variants,,,116.49,134.88,8
HCPCS,81300,MSH6 GENE DUP/DELETE VARIANT,,,95.2,652.12,28
HCPCS,81300,Msh6 gene dup/delete variant,,,116.49,134.88,8
HCPCS,81301,MICROSATELLITE INSTABILITY DET (MSIID),2405.0,1563.25,116.49,2405.0,84
HCPCS,81301,MSI3 TEST,2405.0,1563.25,116.49,2405.0,84
HCPCS,81301,MSICCT TEST,2405.0,1563.25,116.49,2405.0,84
HCPCS,81302,RETT ANALYSIS TEST,3642.0,2367.3,109.69,3642.0,84
HCPCS,81302,RETTFG MECP2 GENE FULL SEQ,3642.0,2367.3,109.69,3642.0,84
HCPCS,81303,MECP2 GENE KNOWN VARIANT,,,48.0,328.8,28
HCPCS,81303,Mecp2 gene known variant,,,83.94,97.2,8
HCPCS,81304,RETT DUP/DEL TEST,1035.0,672.75,60.0,1035.0,84
HCPCS,81304,RETTFG MECP2 GENE DUP/DELET VARIANT,1035.0,672.75,60.0,1035.0,84
HCPCS,81305,MYD88 L265P MUT ANLS,1210.0,786.5,70.16,1210.0,84
HCPCS,81305,MYD88 L265P MUT ANLS BM,1210.0,786.5,70.16,1210.0,84
HCPCS,81305,MYD88 L265P MUT ANLS OTH,1210.0,786.5,70.16,1210.0,84
HCPCS,81306,NUDT15 GENE COMMON VARIANTS,,,116.54,798.33,28
HCPCS,81306,Nudt15 gene common variants,,,116.49,134.88,8
HCPCS,81307,PALB2 GENE FULL GENE SEQ,,,113.15,1853.61,28
HCPCS,81307,Palb2 gene full gene seq,,,173.12,200.45,8
HCPCS,81308,PALB2 GENE KNOWN FAMIL VRNT,,,120.54,825.7,28
HCPCS,81308,Palb2 gene known famil vrnt,,,116.49,134.88,8
HCPCS,81309,ADD ON PIK3CA NGS,1896.0,1232.4,109.93,1896.0,84
HCPCS,81309,PIK3CA GENE ANALYSIS NGS,1896.0,1232.4,109.93,1896.0,84
HCPCS,81310,NMP1 MUTATION DETECTION BY RT-PCR,1701.0,1105.65,98.61,1701.0,84
HCPCS,81310,NPM1 GENE ANALYSIS BM,1701.0,1105.65,98.61,1701.0,84
HCPCS,81310,NPM1 GENE ANALYSIS OTHER,1701.0,1105.65,98.61,1701.0,84
HCPCS,81310,NPM1 GENE ANALYSIS PB,1701.0,1105.65,98.61,1701.0,84
HCPCS,81310,NPM1 NUCLEOPHOSMIN GENE ANAL EXON 12 VARIANTS,1701.0,1105.65,1.1,1701.0,88
HCPCS,81310,NPM1 TEST,1701.0,1105.65,98.61,1701.0,84
HCPCS,81310,NPM1 TEST BONE MARROW,1701.0,1105.65,98.61,1701.0,84
HCPCS,81311,%NGSCOL NRAS,2041.0,1326.65,116.49,2041.0,84
HCPCS,81311,%NGSMEL NRAS,2041.0,1326.65,116.49,2041.0,84
HCPCS,81311,%NRASGN GENE ANALYSIS,2041.0,1326.65,116.49,2041.0,84
HCPCS,81311,%NRAST BY PYROSEQ,2041.0,1326.65,116.49,2041.0,84
HCPCS,81311,%TYMUT NRAS GENE ANLS,2041.0,1326.65,116.49,2041.0,84
HCPCS,81311,NGSCCY NRAS,2041.0,1326.65,116.49,2041.0,84
HCPCS,81311,NGSMCY NRAS,2041.0,1326.65,116.49,2041.0,84
HCPCS,81312,OPMD DNA TEST,945.0,614.25,54.8,945.0,84
HCPCS,81313,PCA3 TEST,1760.0,1144.0,102.02,1760.0,84
HCPCS,81313,PCA3/KLK3 PROSTATE SPECIFIC ANTIGEN RATIO,1760.0,1144.0,1.1,1760.0,88
HCPCS,81314,GIST PDGFRA GENE,2274.0,1478.1,116.49,2274.0,84
HCPCS,81314,GISTCY PDGFRA GENE,2274.0,1478.1,116.49,2274.0,84
HCPCS,81314,PDGFRA GENE ANALYSIS,2274.0,1478.1,116.49,2274.0,84
HCPCS,81315,APLPCR RTPCR TEST,1430.0,929.5,102.38,1596.35,84
HCPCS,81315,PML/RARALPHA COMMON BREAKPOINTS QUAL/QUANT,1430.0,929.5,1.1,1430.0,88
HCPCS,81316,PML/RARALPHA 1 BREAKPOINT,,,102.38,568.03,28
HCPCS,81316,Pml/raralpha 1 breakpoint,,,116.49,134.88,8
HCPCS,81317,PMS2 GENE FULL SEQ ANALYSIS,,,282.81,1853.61,28
HCPCS,81317,Pms2 gene full seq analysis,,,173.12,200.45,8
HCPCS,81318,PMS2 KNOWN FAMILIAL VARIANTS,,,132.4,906.94,28
HCPCS,81318,Pms2 known familial variants,,,116.49,134.88,8
HCPCS,81319,PMS2 GENE DUP/DELET VARIANTS,,,81.4,557.59,28
HCPCS,81319,Pms2 gene dup/delet variants,,,116.49,134.88,8
HCPCS,81320,PLCG2 GENE ANALYSIS,2010.0,1306.5,116.49,2010.0,84
HCPCS,81321,PTEN ANALYSIS TEST,4140.0,2691.0,173.12,4140.0,84
HCPCS,81321,PTEN GENE ANALYSIS FULL SEQUENCE ANALYSIS,4140.0,2691.0,1.1,4140.0,88
HCPCS,81322,PTEN GENE KNOWN FAM VARIANT,,,21.14,127.68,28
HCPCS,81322,Pten gene known fam variant,,,83.94,97.2,8
HCPCS,81323,PTEN DUP/DEL TEST,2070.0,1345.5,116.49,2070.0,84
HCPCS,81323,PTEN GENE ANALYSIS DUPLICATION/DELETION VARIANT,2070.0,1345.5,1.1,2070.0,88
HCPCS,81324,%MULNEU PMP22 GENE ANALYSIS,5233.0,3401.45,173.12,5233.0,84
HCPCS,81324,HNPP PMP22 ANALYSIS TEST,5233.0,3401.45,173.12,5233.0,84
HCPCS,81324,PMP22,5233.0,3401.45,173.12,5233.0,84
HCPCS,81324,PMP22 GENE ANAL DUPLICATION/DELETION ANALYSIS,5233.0,3401.45,1.1,5233.0,88
HCPCS,81325,HNPP PMP22 FSA TEST,5310.0,3451.5,173.12,5310.0,84
HCPCS,81325,PMP22 GENE ANALYSIS FULL SEQUENCE ANALYSIS,5310.0,3451.5,1.1,5310.0,88
HCPCS,81325,PMP22 TEST,5310.0,3451.5,173.12,5310.0,84
HCPCS,81326,PMP22 GENE KNOWN FAM VARIANT,,,21.14,127.68,28
HCPCS,81326,Pmp22 gene known fam variant,,,83.94,97.2,8
HCPCS,81327,EPI PROCOLON,1325.0,861.25,33.47,1325.0,84
HCPCS,81328,SLCO1B1 GENE COM VARIANTS,,,174.81,478.98,28
HCPCS,81328,Slco1b1 gene com variants,,,116.49,134.88,8
HCPCS,81329,CSPNL SMN1 GENE DOS/DEL,945.0,614.25,54.8,945.0,84
HCPCS,81329,SMA CARRIER SCRN DIAG,945.0,614.25,54.8,945.0,84
HCPCS,81330,%AJPWO NIEMANN PICK,324.0,210.6,18.8,324.0,84
HCPCS,81330,AJPNL SMPD1 GENE COMMON VARS,324.0,210.6,18.8,324.0,84
HCPCS,81330,CSPNL SMPD1 GENE COMMON VARS,324.0,210.6,18.8,324.0,84
HCPCS,81330,SMPD1 GENE ANALYSIS COMMON VARIANTS,324.0,210.6,1.1,324.0,88
HCPCS,81331,PRADER-WILLI METH,352.0,228.8,20.43,352.0,84
HCPCS,81332,%HA1AT SERPINA1 GENE ANLY,301.0,195.65,21.56,301.0,84
HCPCS,81332,%SERPINA1 GENE ANALYSIS,301.0,195.65,21.56,301.0,84
HCPCS,81332,SERPINA1 GENE ANALYSIS COMMON VARIANTS,301.0,195.65,1.1,301.0,88
HCPCS,81332,SERPINA1 TARG MUT BY SANGER SEQ,301.0,195.65,21.56,301.0,84
HCPCS,81333,TGFBI GENE COMMON VARIANTS,,,54.8,375.38,28
HCPCS,81333,Tgfbi gene common variants,,,116.49,134.88,8
HCPCS,81334,RUNX1 GENE TARGETED SEQ ALYS,,,110.13,902.86,28
HCPCS,81334,Runx1 gene targeted seq alys,,,116.49,134.88,8
HCPCS,81335,TPMT GENOTYPE ASSAY,1206.0,783.9,110.13,1206.0,84
HCPCS,81336,SMN1 GENE FULL GENE SEQUENCE,,,120.54,825.7,28
HCPCS,81336,Smn1 gene full gene sequence,,,116.49,134.88,8
HCPCS,81337,SMN1 GEN NOWN FAMIL SEQ VRNT,,,74.08,507.45,28
HCPCS,81337,Smn1 gen nown famil seq vrnt,,,116.49,134.88,8
HCPCS,81338,MPL MUTATION ANSYS BLD,1037.0,674.05,60.13,1037.0,84
HCPCS,81338,MPL MUTATION ANSYS BM,1037.0,674.05,60.13,1037.0,84
HCPCS,81339,MPL GENE ANALYSIS,1278.0,830.7,74.08,1278.0,84
HCPCS,81340,TCBMD II TEST,1442.0,937.3,103.17,1442.0,84
HCPCS,81340,TCBMDM GENE REARRANGE AMP,1442.0,937.3,103.17,1442.0,84
HCPCS,81340,TCBMDO GENE REARRANGE AMP,1442.0,937.3,103.17,1442.0,84
HCPCS,81340,TCRB TEST,1442.0,937.3,103.17,1442.0,84
HCPCS,81340,TCRBM GENE REARRANGE AMP,1442.0,937.3,103.17,1442.0,84
HCPCS,81340,TCRBO GENE REARRANGE AMP,1442.0,937.3,103.17,1442.0,84
HCPCS,81341,IMGENE TCRB SB TEST,342.0,222.3,24.49,342.0,84
HCPCS,81341,TCRBSB TEST,342.0,222.3,24.49,342.0,84
HCPCS,81341,TRB@ REARRANGEMENT ANAL DIRECT PROBE METHODOLOGY,342.0,222.3,1.1,342.0,88
HCPCS,81342,T GAMMA TEST,1390.0,903.5,99.5,1390.0,168
HCPCS,81342,TCBMDM GENE REARRANGE ANAL,1390.0,903.5,99.5,1390.0,84
HCPCS,81342,TCBMDO GENE REARRANGE ANAL,1390.0,903.5,99.5,1390.0,84
HCPCS,81342,TCRGM GENE REARRANGE ANAL,1390.0,903.5,99.5,1390.0,84
HCPCS,81342,TCRGO GENE REARRANGE ANAL,1390.0,903.5,99.5,1390.0,84
HCPCS,81343,PPP2R2B GEN DETC ABNOR ALLEL,,,54.8,375.38,28
HCPCS,81343,Ppp2r2b gen detc abnor allel,,,116.49,134.88,8
HCPCS,81344,SCA17 DNA TEST,945.0,614.25,54.8,945.0,84
HCPCS,81345,TERT GENE TARGETED SEQ ALYS,,,74.08,507.45,28
HCPCS,81345,Tert gene targeted seq alys,,,116.49,134.88,8
HCPCS,81346,5FLUO TYMS GENE ANLYS,1206.0,783.9,110.13,1206.0,168
HCPCS,81347,SF3B1 MUTATION ANALYS BLD,1333.0,866.45,77.3,1333.0,84
HCPCS,81347,SF3B1 MUTATION ANALYS BM,1333.0,866.45,77.3,1333.0,84
HCPCS,81348,SRSF2 GENE COMMON VARIANTS,,,70.16,480.6,28
HCPCS,81348,Srsf2 gene common variants,,,116.49,134.88,8
HCPCS,81349,CYTOG ALYS CHRML ABNR LW-PS,,,360.0,3178.4,24
HCPCS,81349,Cytog alys chrml abnr lw-ps,,,672.05,778.16,8
HCPCS,81350,DUPNL UGT1A1 GENE COMMON VARIANTS,1615.0,1049.75,93.6,1615.0,84
HCPCS,81350,UGT1A1 GENE ANALYSIS COMMON VARIANTS,1615.0,1049.75,1.1,1615.0,88
HCPCS,81350,UGT1A1 GENOTYPING,1615.0,1049.75,93.6,1615.0,84
HCPCS,81350,UGT1A1 GENOTYPING ANALYSIS ONLY,1615.0,1049.75,93.6,1615.0,84
HCPCS,81350,UGT1A1 TARG MUT DET BY SANGER,1615.0,1049.75,93.6,1615.0,84
HCPCS,81351,FULL GENE SEQUENCE ANALYSIS OF THE TP53 (TUMOR PROTEIN 53) GENE,4429.0,2878.85,173.12,4429.0,84
HCPCS,81351,TP53 SOMATIC MUT PROG,4429.0,2878.85,173.12,4429.0,84
HCPCS,81352,"TP53 SOMATIC MUT, PROGNOSTIC",2274.0,1478.1,116.49,2274.0,168
HCPCS,81353,TP53 GENE KNOWN FAMIL VRNT,,,123.2,843.92,28
HCPCS,81353,Tp53 gene known famil vrnt,,,116.49,134.88,8
HCPCS,81354,CYTOG ALYS CHRML ABNOR OGM,,,1263.53,2842.95,13
HCPCS,81354,Cytog alys chrml abnor ogm,,,83.94,97.2,8
HCPCS,81355,WARSEN VKORC1 TEST,609.0,395.85,35.28,609.0,84
HCPCS,81355,WRFSEN TPMT GENE VAR,609.0,395.85,35.28,609.0,84
HCPCS,81357,U2AF1 GENE COMMON VARIANTS,,,77.3,529.51,28
HCPCS,81357,U2af1 gene common variants,,,116.49,134.88,8
HCPCS,81360,ZRSR2 GENE COMMON VARIANTS,,,77.3,529.51,28
HCPCS,81360,Zrsr2 gene common variants,,,116.49,134.88,8
HCPCS,81361,HBB GENE COM VARIANTS,,,174.81,478.98,28
HCPCS,81361,Hbb gene com variants,,,116.49,134.88,8
HCPCS,81362,HBB GENE KNOWN FAM VARIANT,,,127.51,1028.19,28
HCPCS,81362,Hbb gene known fam variant,,,109.69,127.01,8
HCPCS,81363,HBB GENE DUP/DEL VARIANTS,,,202.4,554.58,28
HCPCS,81363,Hbb gene dup/del variants,,,116.49,134.88,8
HCPCS,81364,HBB GENE SEQUENCING,2240.0,1456.0,116.49,2240.0,84
HCPCS,81370,"HLA-A,B,C,DR,DQ,DRB345_RT-PCR",2775.0,1803.75,109.69,2775.0,84
HCPCS,81370,"HLA-A,B,CW,DR,DQ,DRB345-RSSOP",2775.0,1803.75,109.69,2775.0,84
HCPCS,81370,SOLID ORGAN NGS FEE,2775.0,1803.75,109.69,2775.0,84
HCPCS,81371,"HLA-A-B,CW,DR,DQ,DRB345-RSSOP-Q9 VERIF",2791.0,1814.15,109.69,2791.0,84
HCPCS,81372,HLA CLASS I TYPING LOW RESOLUTION COMPLETE,2785.0,1810.25,1.1,2785.0,88
HCPCS,81372,HLABC TEST,2785.0,1810.25,109.69,2785.0,84
HCPCS,81372,"PLATELET RECIP HLA A,B TYPING",2785.0,1810.25,109.69,2785.0,84
HCPCS,81373,HLA-B51,879.0,571.35,54.99,879.0,84
HCPCS,81374,%HLAA29 TEST,513.0,333.45,35.92,513.0,84
HCPCS,81374,B27PCR TEST,513.0,333.45,35.92,513.0,84
HCPCS,81374,HLA I LOW RESOLUTION ONE ANTIGEN EQUIVALENT EACH,513.0,333.45,1.1,513.0,88
HCPCS,81374,HLA-B58,513.0,333.45,35.92,513.0,84
HCPCS,81375,HLA II TYPING AG EQUIV LR,,,109.01,604.83,28
HCPCS,81375,Hla ii typing ag equiv lr,,,116.49,134.88,8
HCPCS,81376,HLA CLASS II TYPING LOW RESOLUTION ONE LOCUS EA,843.0,547.95,1.1,843.0,88
HCPCS,81376,HLADR TEST,843.0,547.95,60.36,843.0,84
HCPCS,81377,HLA II LOW RESOLUTION ONE ANTIGEN EQUIVALENT EA,654.0,425.1,1.1,654.0,88
HCPCS,81377,NARCO1 HLADRB1 TEST,654.0,425.1,45.34,654.0,84
HCPCS,81378,"HLA-A,B,CW,DR,DP-SBT",2384.0,1549.6,116.49,2384.0,84
HCPCS,81378,"HLA-A,B,CW,DR,DQ,DP-NGS-BMT",2384.0,1549.6,116.49,2384.0,84
HCPCS,81378,"NGS HLA-A,B,C,DR,DQ,DP,DRB345",2384.0,1549.6,116.49,2384.0,84
HCPCS,81379,HLA I TYPING COMPLETE HR,,,165.62,918.94,28
HCPCS,81379,Hla i typing complete hr,,,116.49,134.88,8
HCPCS,81380,HLA CLASS I TYPING HIGH RESOLUTION ONE LOCUS EA,1223.0,794.95,1.1,1223.0,88
HCPCS,81380,HLA I TYPING 1 LOCUS HR,1223.0,794.95,87.53,1223.0,84
HCPCS,81381,"HLA ALLELE, EA",1172.0,761.8,67.96,1172.0,84
HCPCS,81381,HLA B5701,1172.0,761.8,67.96,1172.0,84
HCPCS,81381,HLA I TYPING HIGH RESOLUTION 1 ALLELE/ALLELE GRP,1172.0,761.8,1.1,1172.0,88
HCPCS,81381,HLA-B*15:02,1172.0,761.8,67.96,1172.0,84
HCPCS,81382,%CELCMP HLADQ2 TEST,853.0,554.45,61.08,853.0,84
HCPCS,81382,%CELCMP HLADQ8 TEST,853.0,554.45,61.08,853.0,168
HCPCS,81382,CELIAC GLUTEN FREE PANEL X2,853.0,554.45,61.08,853.0,84
HCPCS,81382,CEPLUS TEST,853.0,554.45,61.08,853.0,84
HCPCS,81382,DPB1 LOCUS HI RES SBT,853.0,554.45,61.08,853.0,84
HCPCS,81382,DRB1 HIGH RESOLUTION,853.0,554.45,61.08,853.0,84
HCPCS,81382,HLA CLASS II TYPING HIGH RESOLUTION ONE LOCUS EA,853.0,554.45,1.1,853.0,88
HCPCS,81382,HLA II TYPING 1 LOC HR,853.0,554.45,61.08,853.0,84
HCPCS,81382,HLA-B345-SSP-Q9 OR MORE AMPL,853.0,554.45,61.08,853.0,84
HCPCS,81382,HLA-DP-SBT,853.0,554.45,61.08,853.0,84
HCPCS,81382,HLADQ2 TEST,853.0,554.45,61.08,853.0,84
HCPCS,81382,HLADQ8 TEST,853.0,554.45,61.08,853.0,84
HCPCS,81382,NARCOLEPSY GENOTYPING (HLADQB1* 06:02),853.0,554.45,61.08,853.0,84
HCPCS,81383,DRB345 INT RESOLUTION,753.0,489.45,53.89,753.0,84
HCPCS,81383,HLA II HIGH RESOLUTION 1 ALLELE/ALLELE GROUP,753.0,489.45,1.1,753.0,88
HCPCS,81383,NARCOLEPSY ASSOC AG,753.0,489.45,53.89,753.0,84
HCPCS,81383,PROSTATIC ACID PHOS,753.0,489.45,53.89,753.0,84
HCPCS,81400,%5FLUO DPYD MUTATIONS,441.0,286.65,25.58,1608.07,84
HCPCS,81400,%AJPWO MOL PATH LVL 1,441.0,286.65,25.58,1608.07,84
HCPCS,81400,%IL28B RS12979860 VAR,441.0,286.65,25.58,1608.07,84
HCPCS,81400,5FU TEST,441.0,286.65,25.58,1608.07,84
HCPCS,81400,AJPNL MOPATH PROC LVL 1,441.0,286.65,25.58,1608.07,84
HCPCS,81400,CSPNL MOPATH PROC LVL 1,441.0,286.65,25.58,1608.07,84
HCPCS,81400,DYSTONIA DNA TEST,441.0,286.65,25.58,1608.07,84
HCPCS,81400,MOLECULAR PATHOLOGY PROCEDURE LEVEL 1,441.0,286.65,1.1,441.0,88
HCPCS,81400,MOPATH PROCEDURE LEVEL 1,441.0,286.65,25.58,1608.07,84
HCPCS,81400,PAIGEN TEST,441.0,286.65,25.58,1608.07,84
HCPCS,81400,PLA 1/2 BY PCR TEST,441.0,286.65,25.58,1608.07,84
HCPCS,81400,XIIIVL TEST,441.0,286.65,25.58,1608.07,84
HCPCS,81401,%5FLUO TYMS MUTATIONS,945.0,614.25,54.8,2297.92,84
HCPCS,81401,%ADALZ MOL PATH LVL1,945.0,614.25,54.8,2297.92,84
HCPCS,81401,%AJPWO MOL PATH LVL 2,945.0,614.25,54.8,2297.92,84
HCPCS,81401,%TYMUT PAX8/PPAR,945.0,614.25,54.8,2297.92,84
HCPCS,81401,ACHONDROPLASIA FGFR3,945.0,614.25,54.8,2297.92,84
HCPCS,81401,AJPNL MOPATH PROC LVL 2,945.0,614.25,54.8,2297.92,84
HCPCS,81401,APOALZ TEST,945.0,614.25,54.8,2297.92,84
HCPCS,81401,APOE GENOTYPING ALZHEIMER,945.0,614.25,54.8,2297.92,84
HCPCS,81401,APOEG TEST,945.0,614.25,54.8,2297.92,84
HCPCS,81401,CBFB-MYH11 INV(16),945.0,614.25,54.8,2297.92,84
HCPCS,81401,CROHN TEST,945.0,614.25,54.8,2297.92,84
HCPCS,81401,CSPNL MOPATH PROC LVL 2,945.0,614.25,54.8,2297.92,84
HCPCS,81401,DM1DNA TEST,945.0,614.25,54.8,2297.92,84
HCPCS,81401,DM2DNA TEST,945.0,614.25,54.8,2297.92,84
HCPCS,81401,DRPLA TEST,945.0,614.25,54.8,2297.92,84
HCPCS,81401,FRIED TEST,945.0,614.25,54.8,2297.92,84
HCPCS,81401,HERPAN TEST,945.0,614.25,54.8,2297.92,84
HCPCS,81401,HUNTDI TEST,945.0,614.25,54.8,2297.92,84
HCPCS,81401,KENEDY TEST,945.0,614.25,54.8,2297.92,84
HCPCS,81401,LHON TEST,945.0,614.25,54.8,2297.92,84
HCPCS,81401,MELAS TEST,945.0,614.25,54.8,2297.92,84
HCPCS,81401,MERRF TEST,945.0,614.25,54.8,2297.92,84
HCPCS,81401,MOPATH PROCEDURE LEVEL 2,945.0,614.25,54.8,2297.92,84
HCPCS,81401,NOD2 GENOTYPING,945.0,614.25,54.8,2297.92,84
HCPCS,81401,OPMD TEST,945.0,614.25,54.8,2297.92,84
HCPCS,81401,PPTMPT TEST,945.0,614.25,54.8,2297.92,84
HCPCS,81401,RUNX1-RUNX1T1,945.0,614.25,54.8,2297.92,84
HCPCS,81401,SCA1 DNA TEST,945.0,614.25,54.8,2297.92,84
HCPCS,81401,SCA17 TEST,945.0,614.25,54.8,2297.92,84
HCPCS,81401,SCA2 DNA TEST,945.0,614.25,54.8,2297.92,84
HCPCS,81401,SCA3 DNA TEST,945.0,614.25,54.8,2297.92,84
HCPCS,81401,SCA7 DNA TEST,945.0,614.25,54.8,2297.92,84
HCPCS,81401,SMADNA TEST,945.0,614.25,54.8,2297.92,84
HCPCS,81401,SMN1 SMN2 SCRN DIAG,945.0,614.25,54.8,2297.92,84
HCPCS,81401,TPMT GENOTYPING ASSAY,945.0,614.25,54.8,2297.92,84
HCPCS,81402,%CYP21A2 COMMON VARI,1037.0,674.05,60.13,1728.34,84
HCPCS,81402,BCL2 BY PCR TEST,1037.0,674.05,60.13,1728.34,84
HCPCS,81402,KITMST TEST,1037.0,674.05,60.13,1728.34,84
HCPCS,81402,T-CELL RECEPTOR DELTA,1037.0,674.05,60.13,1728.34,84
HCPCS,81403,%IDH12F EXON 4 VAR X2,1278.0,830.7,74.08,1988.72,84
HCPCS,81403,%TYMUT HRAS MUTATION,1278.0,830.7,74.08,1988.72,84
HCPCS,81403,ALLOGEN MICA TYPING,1278.0,830.7,74.08,1988.72,84
HCPCS,81403,ARC ABO COM ALL DETERMIN,1278.0,830.7,74.08,1988.72,84
HCPCS,81403,ARC ABO VARIANTS,1278.0,830.7,74.08,1988.72,84
HCPCS,81403,CSF3R MUTATION ANLYS BLD,1278.0,830.7,74.08,1988.72,84
HCPCS,81403,CSF3R MUTATION ANLYS BM,1278.0,830.7,74.08,1988.72,84
HCPCS,81403,EXON28 TEST,1278.0,830.7,74.08,1988.72,84
HCPCS,81403,HUMAN ERYTHROCYTE AG,1278.0,830.7,74.08,1988.72,84
HCPCS,81403,IDH1 GENE ANALYSIS,1278.0,830.7,74.08,1988.72,84
HCPCS,81403,IDH2 GENE ANALYSIS,1278.0,830.7,74.08,1988.72,84
HCPCS,81403,JAKNON TEST,1278.0,830.7,74.08,1988.72,84
HCPCS,81403,KCNJ TEST,1278.0,830.7,74.08,1988.72,84
HCPCS,81403,MCADD TEST,1278.0,830.7,74.08,1988.72,84
HCPCS,81403,MICA GENOTYPING-RSSOP,1278.0,830.7,74.08,1988.72,84
HCPCS,81403,MOPATH PROCEDURE LEVEL 4,1278.0,830.7,74.08,1988.72,84
HCPCS,81403,MPL MUTATION ANLYS BLD,1278.0,830.7,74.08,1988.72,84
HCPCS,81403,MPL TEST,1278.0,830.7,74.08,1988.72,168
HCPCS,81403,MPLDNA TEST,1278.0,830.7,74.08,1988.72,84
HCPCS,81403,OBESTY TEST,1278.0,830.7,74.08,1988.72,84
HCPCS,81403,PARD UNLISTED MOL PATH,1278.0,830.7,74.08,1988.72,84
HCPCS,81403,RED CELL GENOTYPING,1278.0,830.7,74.08,1988.72,84
HCPCS,81403,RHCE VARIANT ANTIGEN,1278.0,830.7,74.08,1988.72,84
HCPCS,81403,RHD VARIANT ANTIGEN,1278.0,830.7,74.08,1988.72,84
HCPCS,81403,SANGER SEQ DNA BLD,1278.0,830.7,74.08,1988.72,84
HCPCS,81403,SANGER SEQ DNA OTHER,1278.0,830.7,74.08,1988.72,84
HCPCS,81403,SANGER SEQ RNA BLD,1278.0,830.7,74.08,1988.72,84
HCPCS,81403,SANGER SEQ RNA BONE MARROW,1278.0,830.7,74.08,1988.72,84
HCPCS,81403,SANGER SQ DNA BONE MARROW,1278.0,830.7,74.08,1988.72,84
HCPCS,81403,SF3B1 MUTATION ANLYS BLD,1278.0,830.7,74.08,1988.72,84
HCPCS,81403,SF3B1 MUTATION ANLYS BM,1278.0,830.7,74.08,1988.72,84
HCPCS,81403,UBA1 MUT DET BY DDPCR BLOOD,1278.0,830.7,74.08,1988.72,84
HCPCS,81403,UBA1 MUT DET BY DDPCR BONE MARROW,1278.0,830.7,74.08,1988.72,84
HCPCS,81403,UBA1 MUT DET BY DDPCR OTHER,1278.0,830.7,74.08,1988.72,84
HCPCS,81403,UBA1 MUTATION TESTING FOR VEXAS SYNDROME,1278.0,830.7,74.08,1988.72,84
HCPCS,81403,UBA1 TARG MUT DET BY SANGER BM,1278.0,830.7,74.08,1988.72,84
HCPCS,81403,UBA1 TARG MUT DET BY SANGER OTHER,1278.0,830.7,74.08,1988.72,84
HCPCS,81403,UGTA1 TARG MUT DET BY SANGER BLD,1278.0,830.7,74.08,1988.72,84
HCPCS,81403,VWF TSA EXON 28,1278.0,830.7,74.08,1988.72,84
HCPCS,81403,VWF TYPE 2A EX 28,1278.0,830.7,74.08,1988.72,84
HCPCS,81403,XCISE AMPD1 TEST,1278.0,830.7,74.08,1988.72,84
HCPCS,81403,XCISE CPT2 TEST,1278.0,830.7,74.08,1988.72,84
HCPCS,81403,XCISE PYGM TEST,1278.0,830.7,74.08,1988.72,84
HCPCS,81403,YCMICR TEST,1278.0,830.7,74.08,1988.72,84
HCPCS,81404,%MODY TCF1,1896.0,1232.4,109.93,1896.0,84
HCPCS,81404,%NFIB1 MOL PATH LVL 5,1896.0,1232.4,109.93,1896.0,84
HCPCS,81404,%NGSLUNG PIK3CA,1896.0,1232.4,109.93,1896.0,84
HCPCS,81404,%PANCPL PRSS1,1896.0,1232.4,109.93,1896.0,84
HCPCS,81404,%PANCPL SPINK1,1896.0,1232.4,109.93,1896.0,84
HCPCS,81404,%TYMUT NRAS MUTATION,1896.0,1232.4,109.93,1896.0,84
HCPCS,81404,*MOPATH PROCEDURE LEVEL 5,1896.0,1232.4,109.93,1896.0,84
HCPCS,81404,ADD ON PIK3CA NGS,1896.0,1232.4,109.93,1896.0,84
HCPCS,81404,ALPHA GLOBIN SEQUENCING,1896.0,1232.4,109.93,1896.0,84
HCPCS,81404,BETA GLOBIN SEQUENCING,1896.0,1232.4,109.93,1896.0,84
HCPCS,81404,CPT2 TEST,1896.0,1232.4,109.93,1896.0,84
HCPCS,81404,FAMILAL MEDITER FEVER SEQ,1896.0,1232.4,109.93,1896.0,84
HCPCS,81404,FAMILIAL MEDITERR FEVER,1896.0,1232.4,109.93,1896.0,84
HCPCS,81404,FSHDNA TEST,1896.0,1232.4,109.93,1896.0,84
HCPCS,81404,"HBA1_HBA2,DUP_DEL",1896.0,1232.4,109.93,1896.0,84
HCPCS,81404,HSD1B2 TEST,1896.0,1232.4,109.93,1896.0,84
HCPCS,81404,MODY3 (TCF2) PT2,1896.0,1232.4,109.93,1896.0,84
HCPCS,81404,MOPATH PROCEDURE LEVEL 5,1896.0,1232.4,109.93,1896.0,84
HCPCS,81404,PIK3CA GENE ANALYSIS NGS,1896.0,1232.4,109.93,1896.0,84
HCPCS,81404,TRANSTHYRETIN DNA SQ,1896.0,1232.4,109.93,1896.0,84
HCPCS,81404,TTR GENE FULL ANALYSIS,1896.0,1232.4,109.93,1896.0,84
HCPCS,81404,TTR GENOTYPING LV5,1896.0,1232.4,109.93,1896.0,84
HCPCS,81405,%CYP21A2 FULL GENE ANA,2079.0,1351.35,116.49,2079.0,84
HCPCS,81405,%MODY HNF1A,2079.0,1351.35,116.49,2079.0,84
HCPCS,81405,%MODY HNF1B,2079.0,1351.35,116.49,2079.0,84
HCPCS,81405,%NFIB1 MOPATH 6,2079.0,1351.35,116.49,2079.0,84
HCPCS,81405,%PANCPL MOPATH LVL 6,2079.0,1351.35,116.49,2079.0,84
HCPCS,81405,%PS1SY MOPATH LVL 6,2079.0,1351.35,116.49,2079.0,84
HCPCS,81405,ACTA2 TEST,2079.0,1351.35,116.49,2079.0,84
HCPCS,81405,FABRY TEST,2079.0,1351.35,116.49,2079.0,84
HCPCS,81405,FHHE TEST,2079.0,1351.35,116.49,2079.0,84
HCPCS,81405,GCH1 TEST,2079.0,1351.35,116.49,2079.0,84
HCPCS,81405,MPZERO TEST,2079.0,1351.35,116.49,2079.0,84
HCPCS,81405,P53MUT TEST,2079.0,1351.35,116.49,2079.0,84
HCPCS,81405,SHOX DNA DX,2079.0,1351.35,116.49,2079.0,84
HCPCS,81405,SLC2A1 TEST,2079.0,1351.35,116.49,2079.0,84
HCPCS,81405,TGFB TGFBR1 TEST,2079.0,1351.35,116.49,2079.0,84
HCPCS,81405,TGFB TGFBR2 TEST,2079.0,1351.35,116.49,2079.0,84
HCPCS,81405,TGFB2 GENOTYPING LV6,2079.0,1351.35,116.49,2079.0,84
HCPCS,81405,TP53MU MOPATH PROC LVL 6,2079.0,1351.35,116.49,2079.0,84
HCPCS,81405,VASDPL TGFBR1 TEST,2079.0,1351.35,116.49,2079.0,84
HCPCS,81405,VASDPL TGFBR2 TEST,2079.0,1351.35,116.49,2079.0,84
HCPCS,81405,VON WILLEBRAND TYPE2N,2079.0,1351.35,116.49,2079.0,84
HCPCS,81405,VWD EXON 9 REFLEX,2079.0,1351.35,116.49,2079.0,84
HCPCS,81405,VWF2A SEQ 9 EXON REFLEX,2079.0,1351.35,116.49,2079.0,84
HCPCS,81406,%BTKMUT MOL PATH LVL7,1952.0,1268.8,113.15,3582.53,84
HCPCS,81406,ACADM TEST,1952.0,1268.8,113.15,3582.53,84
HCPCS,81406,AIRE TEST,1952.0,1268.8,113.15,3582.53,84
HCPCS,81406,BMHSNP MOPATH LVL 7,1952.0,1268.8,113.15,3582.53,84
HCPCS,81406,CADASL TEST,1952.0,1268.8,113.15,3582.53,84
HCPCS,81406,CALP3 TEST,1952.0,1268.8,113.15,3582.53,84
HCPCS,81406,GALACTOSYLCERAMDE,1952.0,1268.8,113.15,3582.53,84
HCPCS,81406,HEMMIG ATP1A2,1952.0,1268.8,113.15,3582.53,84
HCPCS,81406,LDLR TEST,1952.0,1268.8,113.15,3582.53,84
HCPCS,81406,LEUK BLD CNCR CHROMOSOME + SNP,1952.0,1268.8,113.15,3582.53,84
HCPCS,81406,MEN2 TEST,1952.0,1268.8,113.15,3582.53,84
HCPCS,81406,MFN2 TEST,1952.0,1268.8,113.15,3582.53,84
HCPCS,81406,MODY1 (HNF4A),1952.0,1268.8,113.15,3582.53,84
HCPCS,81406,MODY2 (GCK),1952.0,1268.8,113.15,3582.53,84
HCPCS,81406,MOLECULAR PATHOLOGY PROCEDURE LEVEL 7,1952.0,1268.8,1.1,1952.0,88
HCPCS,81406,NEUFIB TEST,1952.0,1268.8,113.15,3582.53,84
HCPCS,81406,POLG1 TEST,1952.0,1268.8,113.15,3582.53,84
HCPCS,81406,SETX TEST,1952.0,1268.8,113.15,3582.53,84
HCPCS,81407,HEMMIG SCN1A TEST,5839.0,3795.35,173.12,5839.0,168
HCPCS,81408,COLA12 COL1A1 TEST,13800.0,8970.0,672.05,13800.0,84
HCPCS,81408,COLA12 COL1A2 TEST,13800.0,8970.0,672.05,13800.0,84
HCPCS,81408,DMD SEQ BILL REFLEX,13800.0,8970.0,672.05,13800.0,84
HCPCS,81408,DMD SEQUENCING BILL,13800.0,8970.0,672.05,13800.0,84
HCPCS,81408,FBN1 TEST,13800.0,8970.0,672.05,13800.0,84
HCPCS,81408,NFIB1 COLA11 COL1A2,13800.0,8970.0,672.05,13800.0,84
HCPCS,81408,VWFSEQ VON WILLEBRAND DISEASE SEQ,13800.0,8970.0,672.05,13800.0,84
HCPCS,81410,VASCULAR DISEASE PANEL,3478.0,2260.7,109.69,3478.0,84
HCPCS,81411,AORTIC DYSFUNCTION/DILATION,,,540.08,3699.52,28
HCPCS,81411,Aortic dysfunction/dilation,,,672.05,778.16,8
HCPCS,81412,ASHKENAZI JEWISH DISEASES,16895.0,10981.75,672.05,16895.0,84
HCPCS,81413,CAR ION CHNNLPATH INC 10 GNS,,,288.84,1602.63,28
HCPCS,81413,Car ion chnnlpath inc 10 gns,,,109.69,127.01,8
HCPCS,81414,CAR ION CHNNLPATH INC 2 GNS,,,288.84,1602.63,28
HCPCS,81414,Car ion chnnlpath inc 2 gns,,,109.69,127.01,8
HCPCS,81415,EXOME SEQUENCING AHUS1,11950.0,7767.5,672.05,11950.0,84
HCPCS,81416,EXOME SEQUENCE ANALYSIS,,,4800.0,32880.0,25
HCPCS,81416,Exome sequence analysis,,,672.05,778.16,8
HCPCS,81417,EXOME RE-EVALUATION,,,128.0,876.8,28
HCPCS,81417,Exome re-evaluation,,,116.49,134.88,8
HCPCS,81418,RX METAB GEN SEQ ALYS PNL 6,,,699.2,2512.8,24
HCPCS,81418,Rx metab gen seq alys pnl 6,,,173.12,200.45,8
HCPCS,81419,EPILEPSY GEN SEQ ALYS PANEL,,,979.42,6709.05,28
HCPCS,81419,Epilepsy gen seq alys panel,,,672.05,778.16,8
HCPCS,81420,FETAL CHROMOSOMAL ANEUPLOIDY GENOMIC SEQ ANALYS,5237.0,3404.05,1.1,5237.0,88
HCPCS,81420,MATERNIT21 PLUS,5237.0,3404.05,173.12,5237.0,84
HCPCS,81420,MATGEN FETAL CHRMOML ANEU,5237.0,3404.05,173.12,5237.0,84
HCPCS,81422,MATGEN FETAL CHRMOML MICR,5237.0,3404.05,173.12,5237.0,84
HCPCS,81425,GENOME SEQUENCE ANALYSIS,,,846.27,13785.49,28
HCPCS,81425,Genome sequence analysis,,,672.05,778.16,8
HCPCS,81426,GENOME SEQUENCE ANALYSIS,,,846.27,7425.26,28
HCPCS,81426,Genome sequence analysis,,,672.05,778.16,8
HCPCS,81427,GENOME RE-EVALUATION,,,423.14,6405.16,28
HCPCS,81427,Genome re-evaluation,,,672.05,778.16,8
HCPCS,81430,HEARING LOSS SEQUENCE ANALYS,,,650.0,4452.5,28
HCPCS,81430,Hearing loss sequence analys,,,672.05,778.16,8
HCPCS,81431,HEARING LOSS DUP/DEL ANALYS,,,271.83,1862.02,28
HCPCS,81431,Hearing loss dup/del analys,,,173.12,200.45,8
HCPCS,81432,HRDTRY BRST CA-RLATD DO 5+,,,335.33,1860.6,28
HCPCS,81432,Hrdtry brst ca-rlatd do 5+,,,173.12,200.45,8
HCPCS,81433,HRDTRY BRST CA-RLATD DSORDRS,,,216.76,1202.67,7
HCPCS,81433,Hrdtry brst ca-rlatd dsordrs,,,109.69,127.01,8
HCPCS,81434,HERED RTA DO GEN SEQ 15,,,239.16,1638.27,28
HCPCS,81434,Hered rta do gen seq 15,,,109.69,127.01,8
HCPCS,81435,HERED COLON CA-RLATD DO 5+,,,288.84,1602.63,28
HCPCS,81435,Hered colon ca-rlatd do 5+,,,109.69,127.01,8
HCPCS,81436,HEREDITARY COLON CA DSORDRS,,,288.84,1602.63,7
HCPCS,81436,Hereditary colon ca dsordrs,,,109.69,127.01,8
HCPCS,81437,HERED NEUROEND TUM-RLT DO 5+,,,216.76,1434.35,28
HCPCS,81437,Hered neuroend tum-rlt do 5+,,,109.69,127.01,8
HCPCS,81438,HEREDTRY NURONDCRN TUM DSRDR,,,216.76,1202.67,7
HCPCS,81438,Heredtry nurondcrn tum dsrdr,,,109.69,127.01,8
HCPCS,81439,HRDTRY CARDMYPY GENE PANEL,,,288.84,1602.63,28
HCPCS,81439,Hrdtry cardmypy gene panel,,,109.69,127.01,8
HCPCS,81440,MITOCHONDRIAL GENE,,,1329.6,12261.57,28
HCPCS,81440,Mitochondrial gene,,,672.05,778.16,8
HCPCS,81441,IBMFS SEQ ALYS PNL 30 GENES,,,979.42,6709.05,24
HCPCS,81441,Ibmfs seq alys pnl 30 genes,,,672.05,778.16,8
HCPCS,81442,NOONAN SPECTRUM DISORDERS,,,857.44,5873.46,28
HCPCS,81442,Noonan spectrum disorders,,,672.05,778.16,8
HCPCS,81443,GENOMIC SEQUENCING AHUS1,6121.0,3978.65,672.05,6121.0,84
HCPCS,81445,HEAD AND NECK NGS,1737.0,1129.05,109.69,2205.57,84
HCPCS,81445,HS50CB 50GN CELL BLK NGS,3126.0,2031.9,109.69,3126.0,84
HCPCS,81445,HS50CY CNCR 50GN CYTO NGS,3126.0,2031.9,109.69,3126.0,84
HCPCS,81445,HS50FT 50GN TISSUE NGS,3126.0,2031.9,109.69,3126.0,84
HCPCS,81445,LNG550 LUNG CANCER GENE PNL,2409.0,1565.85,109.69,2409.0,84
HCPCS,81445,LUNG CANCER HOTSPOT CYTO,1992.0,1294.8,109.69,2205.57,84
HCPCS,81445,NTRK GENE ANALYSIS,3438.0,2234.7,109.69,3438.0,84
HCPCS,81445,SARCOMA FUSION NGS PANEL,3438.0,2234.7,109.69,3438.0,84
HCPCS,81445,THYROID CANCER MUT PNL,3423.0,2224.95,109.69,3423.0,84
HCPCS,81448,HRDTRY PERPH NEURPHY PANEL,,,584.9,1952.38,28
HCPCS,81448,Hrdtry perph neurphy panel,,,109.69,127.01,8
HCPCS,81449,SO NEO GSAP 5-50 RNA ALYS,,,239.16,1638.27,24
HCPCS,81449,So neo gsap 5-50 rna alys,,,672.05,778.16,8
HCPCS,81450,ALLBM ALL PANEL NGS BM,5241.0,3406.65,173.12,5241.0,84
HCPCS,81450,ALLMRW TRGTD GENOMIC SEQ ANLYS,5241.0,3406.65,173.12,5241.0,84
HCPCS,81450,ALLPB ALL PANEL NGS BLD,5241.0,3406.65,173.12,5241.0,84
HCPCS,81450,ALLPBL TRGTD GENOMIC SEQ ANLYS,5241.0,3406.65,173.12,5241.0,84
HCPCS,81450,"B-CELL LYMPHOMA, NGS",5241.0,3406.65,173.12,5241.0,84
HCPCS,81450,GBL MYL NGS 5-50 GENE,5241.0,3406.65,173.12,5241.0,84
HCPCS,81450,"HISTIOCYTIC NEOPLASMS, NGS",5241.0,3406.65,173.12,5241.0,84
HCPCS,81450,LPMNGS TRGTD GENOMIC SEQ ANLYS,5241.0,3406.65,173.12,5241.0,84
HCPCS,81450,LPPNGS TRGTD GENOMIC SEQ ANLYS,5241.0,3406.65,173.12,5241.0,84
HCPCS,81450,MYELOID NGS 5-50 GENE,5241.0,3406.65,173.12,5241.0,84
HCPCS,81450,MYMNGS TRGTD GENOMIC SEQ ANLYS,5241.0,3406.65,173.12,5241.0,84
HCPCS,81450,MYPNGS TRGTD GENOMIC SEQ ANLYS,5241.0,3406.65,173.12,5241.0,84
HCPCS,81450,ONKOSIGHT ADVANCED CHRONIC LYMPHOID NGS PANEL,5241.0,3406.65,173.12,5241.0,84
HCPCS,81450,"T-CELL LYMPHOMA, NGS",5241.0,3406.65,173.12,5241.0,84
HCPCS,81450,TARGETED B-ALL FUS ANLYS,5241.0,3406.65,173.12,5241.0,84
HCPCS,81451,HL NEO GSAP 5-50 RNA ALYS,,,303.81,2081.11,24
HCPCS,81451,Hl neo gsap 5-50 rna alys,,,173.12,200.45,8
HCPCS,81455,"ACUTE LEUKEMIA RAPID NGS PANEL, BLOOD",3000.0,1950.0,672.05,6569.1,84
HCPCS,81455,"ACUTE LEUKEMIA RAPID NGS PANEL, BONE MARROW",3000.0,1950.0,672.05,6569.1,84
HCPCS,81455,HDMNGS ACUTE LEUK NGS PNL BM,3000.0,1950.0,672.05,6569.1,84
HCPCS,81455,HDONGS ACUTE LEUK NGS PNL OTHER,3000.0,1950.0,672.05,6569.1,84
HCPCS,81455,HDPNGS ACUTE LEUK NGS PNL BLD,3000.0,1950.0,672.05,6569.1,84
HCPCS,81455,HEMATOLOGIC CANCER FUSION,3802.0,2471.3,672.05,6569.1,84
HCPCS,81455,HFMNGS HN FUSION NGS PNL BLD,1616.0,1050.4,457.0,6569.1,84
HCPCS,81455,HFONGS HN FUSION NGS PNL OTHER,1616.0,1050.4,457.0,6569.1,84
HCPCS,81455,HFPNGS HN FUSION NGS PNL BLD,1616.0,1050.4,457.0,6569.1,84
HCPCS,81455,HNCPBM NGS,1616.0,1050.4,457.0,6569.1,84
HCPCS,81455,HNCPPB NGS,1616.0,1050.4,457.0,6569.1,84
HCPCS,81455,HNMNGS HN NGS SEQ PANEL BM,1616.0,1050.4,457.0,6569.1,84
HCPCS,81455,HNONGS HN NGS SEQ PANEL OTHER,1616.0,1050.4,457.0,6569.1,84
HCPCS,81455,HNPNGS HN NGS SEQ PANEL P BLD,1616.0,1050.4,457.0,6569.1,84
HCPCS,81455,LPMNGS CHRONIC LYMPHOPRO NGS BM,1616.0,1050.4,457.0,6569.1,84
HCPCS,81455,LPONGS CHRONIC LYMPHOPRO NGS OTHER,1616.0,1050.4,457.0,6569.1,84
HCPCS,81455,LPPNGS CHRONIC LYMPHOPRO NGS P BLD,1616.0,1050.4,457.0,6569.1,84
HCPCS,81455,MYENGS PANEL NGS,5217.0,3391.05,672.05,6569.1,84
HCPCS,81455,MYNGSM MYELOID PANEL NGS BM,1616.0,1050.4,457.0,6569.1,84
HCPCS,81455,MYNGSO MYELOID PANEL NGS OTHER,1616.0,1050.4,457.0,6569.1,84
HCPCS,81455,MYNGSP MYELOID PANEL NGS P BLD,1616.0,1050.4,457.0,6569.1,84
HCPCS,81455,PAN-SOLID TUMOR NGS,4574.0,2973.1,672.05,6569.1,84
HCPCS,81455,SARCOMA FUSION NGS,1737.0,1129.05,491.22,6569.1,84
HCPCS,81455,TARGETED ONCOLOGY PANEL - FINE NEEDLE ASPIRATE,4400.0,2860.0,672.05,6569.1,84
HCPCS,81455,TARGETED ONCOLOGY PANEL LOW PURITY,4400.0,2860.0,672.05,6569.1,84
HCPCS,81455,"TOPBM TGT ONC NGS, BM",4400.0,2860.0,672.05,6569.1,84
HCPCS,81455,"TOPCY TGT ONC NGS, CYTO",4400.0,2860.0,672.05,6569.1,84
HCPCS,81455,"TOPPB TGT ONC NGS, PER BLD",4400.0,2860.0,672.05,6569.1,84
HCPCS,81455,"TOPTO TGT ONC NGS, OTH",4400.0,2860.0,672.05,6569.1,84
HCPCS,81456,SO/HL 51/>GSAP RNA ALYS,,,1167.84,7999.7,24
HCPCS,81456,So/hl 51/>gsap rna alys,,,672.05,778.16,8
HCPCS,81457,SO NEO GSAP DNA MCRSTL INS,,,239.16,2739849.3,23
HCPCS,81457,So neo gsap dna mcrstl ins,,,109.69,127.01,8
HCPCS,81458,SO GSAP DNA CPY NMBR&MCRSTL,,,239.16,2739849.3,23
HCPCS,81458,So gsap dna cpy nmbr&mcrstl,,,109.69,127.01,8
HCPCS,81459,SO NEO GSAP DNA/DNA&RNA,,,239.16,2739849.3,23
HCPCS,81459,So neo gsap dna/dna&rna,,,109.69,127.01,8
HCPCS,81460,WHOLE MITOCHONDRIAL GENOME,,,514.8,3526.38,28
HCPCS,81460,Whole mitochondrial genome,,,672.05,778.16,8
HCPCS,81462,SO GSAP CLL FR DNA/DNA&RNA,,,239.16,2739849.3,23
HCPCS,81462,So gsap cll fr dna/dna&rna,,,109.69,127.01,8
HCPCS,81463,SO GSAP CL FR CPY NMBR&MCRST,,,239.16,2739849.3,23
HCPCS,81463,So gsap cl fr cpy nmbr&mcrst,,,109.69,127.01,8
HCPCS,81464,SO GSAP CLL FR MCRSTL INS,,,239.16,2739849.3,23
HCPCS,81464,So gsap cll fr mcrstl ins,,,109.69,127.01,8
HCPCS,81465,DNADEL MELAS TEST,6458.0,4197.7,173.12,6458.0,84
HCPCS,81470,X-LINKED INTELLECTUAL DBLT GENOMIC SEQ ANALYS,6307.0,4099.55,1.1,6307.0,88
HCPCS,81470,XLID TEST,6307.0,4099.55,173.12,6307.0,84
HCPCS,81471,X-LINKED INTELLECTUAL DBLT,,,846.27,2504.36,28
HCPCS,81471,X-linked intellectual dblt,,,173.12,200.45,8
HCPCS,81479,%5FLUO TEST,216.0,140.4,47.09,1666801.85,67
HCPCS,81479,%AJPWO UNLISTED MOL PATH,67.0,43.55,14.61,1666801.85,67
HCPCS,81479,%BTKNUT UNLIST MOL PATH,350.0,227.5,76.3,1666801.85,67
HCPCS,81479,%HA1AT UNLISTED MOPATH,297.0,193.05,64.75,1666801.85,67
HCPCS,81479,%IL28B RS8099917 VAR,65.0,42.25,14.17,1666801.85,67
HCPCS,81479,%MLH1 UNLISTED PROC,92.0,59.8,20.06,1666801.85,67
HCPCS,81479,%NFIB1 UNLISTED,378.0,245.7,82.4,1666801.85,67
HCPCS,81479,%NGSLUNG HER2,54.0,35.1,11.77,1666801.85,67
HCPCS,81479,%PANCPL UNLISTED MOPATH,268.0,174.2,58.42,1666801.85,67
HCPCS,81479,%PS1SY UNLISTED MOPATH,713.0,463.45,83.94,1666801.85,67
HCPCS,81479,*UNLISTED MOLECULAR PATHOLOGY,2808.0,1825.2,83.94,1666801.85,67
HCPCS,81479,3B1AO-HSD3B1 GTYP AN ON,324.0,210.6,70.63,1666801.85,67
HCPCS,81479,A1A SERPINA1 F & I,360.0,234.0,78.48,1666801.85,67
HCPCS,81479,AJPNL UNLISTED MOPATH,70.0,45.5,15.26,1666801.85,67
HCPCS,81479,APOL1 SEQUENCING,383.0,248.95,83.49,1666801.85,67
HCPCS,81479,BCR ABL QUAL MPLEX PCR,1170.0,760.5,83.94,1666801.85,67
HCPCS,81479,BCR/ABL KINASE DOMAIN RT-PCR,1062.0,690.3,83.94,1666801.85,67
HCPCS,81479,BLAU NOD2,2822.0,1834.3,83.94,1666801.85,67
HCPCS,81479,BLAU SYNDROME,1620.0,1053.0,83.94,1666801.85,67
HCPCS,81479,C9ORF72 EXPANSION ASSAY,329.0,213.85,71.72,1666801.85,67
HCPCS,81479,CALR EXON 9 MUTATION,940.0,611.0,83.94,1666801.85,67
HCPCS,81479,COL3 TEST,2808.0,1825.2,83.94,1666801.85,67
HCPCS,81479,CSF3RM MUTATION ANANLYSIS BM,1227.0,797.55,83.94,1666801.85,67
HCPCS,81479,CSF3RP MUTATION ANANLYSIS BLD,1227.0,797.55,83.94,1666801.85,67
HCPCS,81479,CSPNL UNLISTED MOPATH,70.0,45.5,15.26,1666801.85,67
HCPCS,81479,"CXCR4 MUTATION ANALYSIS, SOMATIC",891.0,579.15,83.94,1666801.85,67
HCPCS,81479,CYP2D6 REFLX ONLY UNLIST MOLEC PATH,550.0,357.5,83.94,1666801.85,67
HCPCS,81479,CYP2D6 UNLISTED MOLEC PATH,550.0,357.5,83.94,1666801.85,67
HCPCS,81479,DMD SEQUENCING,1863.0,1210.95,83.94,1666801.85,67
HCPCS,81479,DNA FINGERPRNT TEST-NGS-FOLLOW UP,4128.0,2683.2,83.94,1666801.85,67
HCPCS,81479,DNA FINGERPRNT TEST-NGS-GENOTYPING,4128.0,2683.2,83.94,1666801.85,67
HCPCS,81479,DNADEL MT DELETION TEST,427.0,277.55,83.94,1666801.85,67
HCPCS,81479,ERBB2 GENE ANALYSIS,54.0,35.1,11.77,1666801.85,67
HCPCS,81479,FBN1DD TEST,2570.0,1670.5,83.94,1666801.85,67
HCPCS,81479,GIST NGS GIST,189.0,122.85,41.2,1666801.85,67
HCPCS,81479,GISTCY NGS UNLIST MOLEC,189.0,122.85,41.2,1666801.85,67
HCPCS,81479,HEMMIG UNLISTED MOPATH,106.0,68.9,23.11,1666801.85,67
HCPCS,81479,HNPP UNLISTED MOPATH,106.0,68.9,23.11,1666801.85,67
HCPCS,81479,HOTSPOT DESMOID NGS,1879.0,1221.35,83.94,1666801.85,67
HCPCS,81479,HSD3B1 GENOTYPING,324.0,210.6,70.63,1666801.85,67
HCPCS,81479,IBDSGI ATG16L1 TEST,144.0,93.6,31.39,1666801.85,67
HCPCS,81479,IBDSGI NKX23 TEST,144.0,93.6,31.39,1666801.85,67
HCPCS,81479,IBDSGI STAT3 TEST,144.0,93.6,31.39,1666801.85,67
HCPCS,81479,IBDSGI UNLISTED MOL PATH,144.0,93.6,31.39,1666801.85,67
HCPCS,81479,IDH1&2-COMMON VARIANTS,1160.0,754.0,83.94,1666801.85,67
HCPCS,81479,JK VARIANT DETERMINATION,540.0,351.0,83.94,1666801.85,67
HCPCS,81479,MATGEN UNLISTED MOPATH,162.0,105.3,35.32,1666801.85,67
HCPCS,81479,MEN2 FMTC MUT TEST,505.0,328.25,83.94,1666801.85,67
HCPCS,81479,MET GENE ANALYSIS,556.0,361.4,83.94,1666801.85,67
HCPCS,81479,MFN2 UNLISTED MOPATH,106.0,68.9,23.11,1666801.85,67
HCPCS,81479,MNGS PATHOGEN DX,7250.0,4712.5,83.94,1666801.85,67
HCPCS,81479,MODY4 (IPF1),848.0,551.2,83.94,1666801.85,67
HCPCS,81479,MODY4 TEST,1980.0,1287.0,83.94,1666801.85,67
HCPCS,81479,MODY5 (UNLISTED),853.0,554.45,83.94,1666801.85,67
HCPCS,81479,MOLECULAR GENE ANALYSIS,292.0,189.8,63.66,1666801.85,67
HCPCS,81479,MPZERO UNLISTED MOPATH,106.0,68.9,23.11,1666801.85,67
HCPCS,81479,MTRAT TEST,1042.0,677.3,83.94,1666801.85,67
HCPCS,81479,MUCKLE TEST,2117.0,1376.05,83.94,1666801.85,67
HCPCS,81479,MVK TEST,1785.0,1160.25,83.94,1666801.85,67
HCPCS,81479,MYD88 L265P MUT ANLYS,599.0,389.35,83.94,1666801.85,67
HCPCS,81479,MYD88 L265P MUTATION,950.0,617.5,83.94,1666801.85,67
HCPCS,81479,MYELOPROLIF NEOPL PNL BLD,896.0,582.4,83.94,1666801.85,67
HCPCS,81479,MYELOPROLIF NEOPL PNL BM,896.0,582.4,83.94,1666801.85,67
HCPCS,81479,NEONATAL ALLOIMMUNE THROMBOCYTOPENIA (NAIT)-INITIAL TESTING MATE,2727.0,1772.55,83.94,1666801.85,201
HCPCS,81479,NTRK NGS,1879.0,1221.35,83.94,1666801.85,67
HCPCS,81479,PARD UNLISTED MOL PATH,437.0,284.05,83.94,1666801.85,67
HCPCS,81479,PAX6 TEST,216.0,140.4,47.09,1666801.85,67
HCPCS,81479,PMP22 UNLISTED MOPATH,106.0,68.9,23.11,1666801.85,67
HCPCS,81479,POLE DROPLET DIGITAL PCR,378.0,245.7,82.4,1666801.85,67
HCPCS,81479,POLE TARG MUT DET BY SANGER,378.0,245.7,82.4,1666801.85,67
HCPCS,81479,POLG2 TEST,1620.0,1053.0,83.94,1666801.85,67
HCPCS,81479,RCGP UNLISTED MOL PATH,41.0,26.65,8.94,1666801.85,67
HCPCS,81479,RETINAL DYSTROPHY NGS,2916.0,1895.4,83.94,1666801.85,67
HCPCS,81479,RHD VARIANT SENDOUT,567.0,368.55,83.94,1666801.85,67
HCPCS,81479,SCN6 DNA TEST,1254.0,815.1,83.94,1666801.85,67
HCPCS,81479,SERPINA1 GENOTYPING,756.0,491.4,83.94,1666801.85,67
HCPCS,81479,SHOX DNA DIAGNOSTIC,486.0,315.9,83.94,1666801.85,67
HCPCS,81479,SMAD3 TEST,1366.0,887.9,83.94,1666801.85,67
HCPCS,81479,TRAPS TEST,2001.0,1300.65,83.94,1666801.85,67
HCPCS,81479,TWINK C100RF2,2020.0,1313.0,83.94,1666801.85,67
HCPCS,81479,TYPE2N UNLISTED MOPATH,106.0,68.9,23.11,1666801.85,67
HCPCS,81479,VASDPL ACTA2 TEST,685.0,445.25,83.94,1666801.85,67
HCPCS,81479,VASDPL COL3A1 TEST,685.0,445.25,83.94,1666801.85,67
HCPCS,81479,VASDPL SMAD3 TEST,685.0,445.25,83.94,1666801.85,67
HCPCS,81479,VASDPL TGFB2 TEST,685.0,445.25,83.94,1666801.85,67
HCPCS,81479,WEAK RHD ANLYS UNLISTED,427.0,277.55,83.94,1666801.85,67
HCPCS,81479,WRFSEN UNLISTED MOPATH,59.0,38.35,12.86,1666801.85,67
HCPCS,81490,AUTOIMMUNE RA ALYS 12 BMRK,,,336.26,2303.38,28
HCPCS,81490,Autoimmune ra alys 12 bmrk,,,173.12,200.45,8
HCPCS,81493,COR ARTERY DISEASE MRNA,,,420.0,2877.0,28
HCPCS,81493,Cor artery disease mrna,,,672.05,778.16,8
HCPCS,81499,ALLOMAP HTX,2765.0,1797.25,602.77,2765.0,58
HCPCS,81500,ONCO (OVAR) TWO PROTEINS,,,104.2,713.77,28
HCPCS,81500,Onco (ovar) two proteins,,,116.49,134.88,8
HCPCS,81503,ONCO (OVARIAN) BIOCHEMICAL ASSAY FIVE PROTEINS,6189.0,4022.85,1.1,6189.0,88
HCPCS,81503,OVA1,6189.0,4022.85,173.12,6189.0,84
HCPCS,81504,ONCOLOGY TISSUE OF ORIGIN,,,208.0,1424.8,28
HCPCS,81504,Oncology tissue of origin,,,109.69,127.01,8
HCPCS,81506,ENDO ASSAY SEVEN ANAL,,,32.41,188.84,28
HCPCS,81506,Endo assay seven anal,,,83.94,97.2,8
HCPCS,81507,FETAL ANEUPLOIDY TRISOM RISK,,,645.0,2178.3,25
HCPCS,81507,Fetal aneuploidy trisom risk,,,173.12,200.45,8
HCPCS,81508,MATERNAL SCN 1ST TRI,375.0,243.75,21.72,375.0,84
HCPCS,81509,FTL CGEN ABNOR 3 PROTEINS,,,594.95,4075.39,28
HCPCS,81509,Ftl cgen abnor 3 proteins,,,672.05,778.16,8
HCPCS,81510,FTL CGEN ABNOR THREE ANAL,,,22.22,152.18,28
HCPCS,81510,Ftl cgen abnor three anal,,,83.94,97.2,8
HCPCS,81511,PRENATAL QUAD SCREEN,1059.0,688.35,61.4,1059.0,84
HCPCS,81512,FTL CGEN ABNOR FIVE ANAL,,,27.81,190.48,28
HCPCS,81512,Ftl cgen abnor five anal,,,83.94,97.2,8
HCPCS,81513,BACTERIAL VAGINOSIS AMPLIFICATION,984.0,639.6,57.05,984.0,84
HCPCS,81514,NFCT DS BV&VAGINITIS DNA ALG,,,105.2,792.27,28
HCPCS,81514,Nfct ds bv&vaginitis dna alg,,,116.49,134.88,8
HCPCS,81515,NFCT DS BV&VAGINITIS DNA ALG,,,262.99,591.74,20
HCPCS,81515,Nfct ds bv&vaginitis dna alg,,,116.49,134.88,8
HCPCS,81517,ENHANCED LIVER FIBROSIS (ELF) SCORE,1216.0,790.4,116.49,1216.0,83
HCPCS,81518,ONC BRST MRNA 11 GENES,,,1549.2,10612.02,28
HCPCS,81518,Onc brst mrna 11 genes,,,672.05,778.16,8
HCPCS,81519,ONCOLOGY BREAST MRNA,,,1549.2,10612.02,28
HCPCS,81519,Oncology breast mrna,,,672.05,778.16,8
HCPCS,81520,ONC BREAST MRNA 58 GENES,,,2439.99,6877.98,28
HCPCS,81520,Onc breast mrna 58 genes,,,672.05,778.16,8
HCPCS,81521,ONC BREAST MRNA 70 GENES,,,2439.99,10612.02,28
HCPCS,81521,Onc breast mrna 70 genes,,,672.05,778.16,8
HCPCS,81522,ONC BREAST MRNA 12 GENES,,,1549.2,10612.02,28
HCPCS,81522,Onc breast mrna 12 genes,,,672.05,778.16,8
HCPCS,81523,ONC BRST MRNA 70 CNT 31 GENE,,,1549.2,10612.02,25
HCPCS,81523,Onc brst mrna 70 cnt 31 gene,,,672.05,778.16,8
HCPCS,81524,"Onc cns tum dna mthyl 10,000",,,83.94,97.2,8
HCPCS,81525,ONCOLOGY COLON MRNA,,,1246.4,8537.84,28
HCPCS,81525,Oncology colon mrna,,,672.05,778.16,8
HCPCS,81528,ONCOLOGY COLORECTAL SCR,,,203.55,1394.3,28
HCPCS,81528,Oncology colorectal scr,,,109.69,127.01,8
HCPCS,81529,ONC CUTAN MLNMA MRNA 31 GENE,,,2877.2,19708.82,25
HCPCS,81529,Onc cutan mlnma mrna 31 gene,,,672.05,778.16,8
HCPCS,81535,ONCOLOGY GYNECOLOGIC,,,231.78,1587.72,28
HCPCS,81535,Oncology gynecologic,,,109.69,127.01,8
HCPCS,81536,ONCOLOGY GYNECOLOGIC,,,71.02,486.51,28
HCPCS,81536,Oncology gynecologic,,,116.49,134.88,8
HCPCS,81538,ONCOLOGY LUNG,,,1148.4,7866.54,28
HCPCS,81538,Oncology lung,,,672.05,778.16,8
HCPCS,81539,ONCOLOGY PROSTATE PROB SCORE,,,304.0,2082.4,28
HCPCS,81539,Oncology prostate prob score,,,173.12,200.45,8
HCPCS,81540,ONCOLOGY TUM UNKNOWN ORIGIN,,,1500.0,10275.0,28
HCPCS,81540,Oncology tum unknown origin,,,672.05,778.16,8
HCPCS,81541,ONC PROSTATE MRNA 46 GENES,,,126.0,10612.02,28
HCPCS,81541,Onc prostate mrna 46 genes,,,672.05,778.16,8
HCPCS,81542,ONC PROSTATE MRNA 22 CNT GEN,,,573.2,10612.02,28
HCPCS,81542,Onc prostate mrna 22 cnt gen,,,672.05,778.16,8
HCPCS,81545,Oncology thyroid,,,672.05,778.16,8
HCPCS,81546,"ONC THYR MRNA 10,196 GEN ALG",,,1440.0,9864.0,28
HCPCS,81546,"Onc thyr mrna 10,196 gen alg",,,672.05,778.16,8
HCPCS,81551,ONC PROSTATE 3 GENES,,,13.62,5562.2,28
HCPCS,81551,Onc prostate 3 genes,,,672.05,778.16,8
HCPCS,81552,ONC UVEAL MLNMA MRNA 15 GENE,,,309.84,21306.24,25
HCPCS,81552,Onc uveal mlnma mrna 15 gene,,,672.05,778.16,8
HCPCS,81554,PULM DS IPF MRNA 190 GEN ALG,,,2200.0,15070.0,28
HCPCS,81554,Pulm ds ipf mrna 190 gen alg,,,672.05,778.16,8
HCPCS,81558,TRNSPL REJ KDN MRNA QPCR 139,,,3240.0,7290.0,20
HCPCS,81558,Trnspl rej kdn mrna qpcr 139,,,672.05,778.16,8
HCPCS,81560,INTESTINAL TRANSPLANT REJECTION RISK EVALUATION (PLEXIMMUNE),4421.0,2873.65,67.56,4421.0,84
HCPCS,81595,CARDIOLOGY HRT TRNSPL MRNA,,,1296.0,8877.6,28
HCPCS,81595,Cardiology hrt trnspl mrna,,,672.05,778.16,8
HCPCS,81596,LIVER FIBRO AND ACTI,498.0,323.7,28.88,498.0,84
HCPCS,81599,%MYPRS MULT ANALYTE ALG,27.0,17.55,5.89,1851898.14,67
HCPCS,81599,DIF LG BCELL LYMPH SUBTYP,953.0,619.45,83.94,1851898.14,67
HCPCS,81599,"LIVER FIBROSIS, CHRONIC VIRAL HEPATITIS (ARUP)",106.0,68.9,23.11,1851898.14,67
HCPCS,81599,MYELOMA PROG RISK SIG,2484.0,1614.6,83.94,1851898.14,67
HCPCS,82000,ASSAY OF BLOOD ACETALDEHYDE,,,54.67,54.67,1
HCPCS,82003,ASSAY OF ACETAMINOPHEN,,,62.33,62.33,1
HCPCS,82009,KETONE BODYS QUAL,,,2.23,13.27,29
HCPCS,82009,Ketone bodys qual,,,11.75,13.61,8
HCPCS,82010,ACETOACETATE,56.0,36.4,8.17,56.0,84
HCPCS,82010,ACETONE,56.0,36.4,8.17,56.0,84
HCPCS,82010,KETONE BODIES SERUM QUANTITATIVE,56.0,36.4,1.1,56.0,88
HCPCS,82010,QUANT SERUM ACETONES/KETONES,56.0,36.4,8.17,56.0,84
HCPCS,82013,%ACHFHB ACETYLCHOL,85.0,55.25,5.52,85.0,84
HCPCS,82013,ACETYLCHOLINESTERASE,85.0,55.25,5.52,85.0,84
HCPCS,82016,%GMAPS ACYLCARNITINES QL,114.0,74.1,6.85,114.0,84
HCPCS,82017,%ACYLM QUANT,116.0,75.4,8.33,129.85,84
HCPCS,82017,ACYLCARN PRO1 QT PLASMA,116.0,75.4,8.33,129.85,84
HCPCS,82017,ACYLCARNITINES NEONATES,116.0,75.4,8.33,129.85,84
HCPCS,82017,ACYLCARNITINES QUANTIATIVE EACH SPECIMEN,116.0,75.4,1.1,116.0,88
HCPCS,82017,"ACYLCARNITINES, QUANTIT, P-MAYO",116.0,75.4,8.33,129.85,84
HCPCS,82017,PROTEIN ELECTRO.FLUID QT,116.0,75.4,8.33,129.85,84
HCPCS,82017,UC5DC ACYLCARNITINES QUANT,116.0,75.4,8.33,129.85,84
HCPCS,82017,X C4 ACYLCARNITINE U,116.0,75.4,8.33,129.85,84
HCPCS,82024,ACTH,266.0,172.9,19.07,266.0,84
HCPCS,82024,ADRENOCORTICOTROPIC HORMONE ACTH,266.0,172.9,1.1,266.0,88
HCPCS,82030,ADENOSINE 5-MONOPHOSPHATE CYCLIC,178.0,115.7,1.1,178.0,88
HCPCS,82030,ASSAY OF ADP & AMP,,,12.74,113.86,28
HCPCS,82030,Assay of adp & amp,,,22.0,25.48,8
HCPCS,82040,ALBUMIN SERUM ASSAY,34.0,22.1,4.95,34.0,84
HCPCS,82040,ALBUMIN SERUM PLASMA/WHOLE BLOOD,34.0,22.1,1.1,34.0,88
HCPCS,82040,LYMRFX SERUM ALBUMIN,34.0,22.1,4.95,34.0,84
HCPCS,82042,ALBUMIN URINE/OTHER QUANT,54.0,35.1,3.11,54.0,84
HCPCS,82042,LYMRFX CSF ALBUMIN,54.0,35.1,3.11,54.0,84
HCPCS,82042,OTHER SOURCE ALBUMIN QUANTITATIVE EACH SPECIMEN,54.0,35.1,1.1,54.0,88
HCPCS,82043,*MICROALBUMIN URINE QUANT,40.0,26.0,2.86,40.0,84
HCPCS,82043,URINE ALBUMIN QUANTITATIVE,40.0,26.0,1.1,40.0,88
HCPCS,82044,ALBUMIN URINE,43.0,27.95,6.23,43.0,84
HCPCS,82044,MICROALBUMIN UR SEMI QNT (POINT OF CARE LAB),43.0,27.95,6.23,43.0,84
HCPCS,82044,MICROALBUMIN; URINE SEMIQUAN,43.0,27.95,6.23,43.0,84
HCPCS,82044,URINE ALBUMIN SEMIQUANTITATIVE,43.0,27.95,1.1,43.0,88
HCPCS,82045,ALBUMIN ISCHEMIA MODIFIED,234.0,152.1,1.1,234.0,116
HCPCS,82045,Albumin ischemia modified,,,20.86,24.16,8
HCPCS,82055,ASSAY OF ETHANOL,,,33.27,33.27,1
HCPCS,82075,ASSAY OF BREATH ETHANOL,,,12.0,84.92,29
HCPCS,82075,Assay of breath ethanol,,,30.12,34.88,8
HCPCS,82077,ETHANOL PLASMA,119.0,77.35,6.91,119.0,84
HCPCS,82085,ALDOLASE,67.0,43.55,4.8,67.0,84
HCPCS,82088,ALDOSTERONE,281.0,182.65,20.12,281.0,84
HCPCS,82088,ASSAY OF ALDOSTERONE,281.0,182.65,1.1,281.0,88
HCPCS,82101,ASSAY OF URINE ALKALOIDS,,,35.65,35.65,1
HCPCS,82103,%A1APHE A1A TOTAL,93.0,60.45,6.64,93.0,84
HCPCS,82103,%PHA1A TOTAL,93.0,60.45,6.64,93.0,84
HCPCS,82103,%SERPINA1 A1A,93.0,60.45,6.64,93.0,84
HCPCS,82103,A1A CLEARANCE,93.0,60.45,6.64,93.0,84
HCPCS,82103,ALPHA 1 ANTRY STOOL,93.0,60.45,6.64,93.0,84
HCPCS,82103,ALPHA-1 ANTITRYPSIN TOTAL,93.0,60.45,6.64,93.0,84
HCPCS,82103,"ALPHA-1-ANTITRYPSIN,STOOL",93.0,60.45,6.64,93.0,84
HCPCS,82103,ALPHA-1-ANTITRYPSIN; TOTAL,93.0,60.45,1.1,93.0,88
HCPCS,82104,%A1APHE A1A PHENOTYPE,100.0,65.0,7.14,100.0,84
HCPCS,82104,%PHAIA PHENOTYPE,100.0,65.0,7.14,100.0,84
HCPCS,82104,ACETYLCHOL REC/BLOCK,100.0,65.0,7.14,100.0,84
HCPCS,82105,%2ND TRI AFP,116.0,75.4,8.28,116.0,84
HCPCS,82105,%SEQ2 ALPHA FETOPROTEIN,116.0,75.4,8.28,116.0,84
HCPCS,82105,ALPHA-FETOPROTEIN SERUM,116.0,75.4,1.1,116.0,172
HCPCS,82106,AFP AMNIOTIC FLUID,117.0,76.05,8.28,129.17,84
HCPCS,82106,ALPHA FETOPROT AFL,117.0,76.05,1.1,117.0,88
HCPCS,82107,AFP-L3 FRACTION ISOFORM & TOTAL AFP W/RATIO,444.0,288.6,1.1,444.0,88
HCPCS,82107,ALPHA-FETOPROTEIN L3,444.0,288.6,20.86,444.0,84
HCPCS,82108,ALUM ASSAY,176.0,114.4,12.58,176.0,84
HCPCS,82120,"AMINES, VAGINAL FLUID",41.0,26.65,5.99,41.0,84
HCPCS,82120,"AMINES, VAGINAL FLUID, QUAL",41.0,26.65,5.99,41.0,84
HCPCS,82127,"AMINO ACID, SINGLE QUAL",98.0,63.7,1.1,98.0,88
HCPCS,82127,ASSAY SERUM NA,98.0,63.7,6.85,98.0,84
HCPCS,82128,%GMAPS AA MULT QL,96.0,62.4,6.85,96.0,84
HCPCS,82128,%NEO AMINO ACIDS X3,96.0,62.4,6.85,96.0,84
HCPCS,82131,%ANEMIA  AMINO ACID SGL,159.0,103.35,9.19,159.0,84
HCPCS,82131,AMINO ACID SINGL QUANT,159.0,103.35,9.19,159.0,84
HCPCS,82131,AMINO ACIDS 1 QUANTITATIVE EACH SPECIMEN,159.0,103.35,1.1,159.0,88
HCPCS,82131,HOMOCYSTINE UR QNT,159.0,103.35,9.19,159.0,84
HCPCS,82131,USULFC AMINO AC SNGL QNT,159.0,103.35,9.19,159.0,84
HCPCS,82135,AMINOLEVULINIC ACID (ALA) URINE,114.0,74.1,8.12,114.0,84
HCPCS,82136,%ANEMIA AMINO ADID 2-5 QT,135.0,87.75,8.33,135.0,84
HCPCS,82136,"AMINO ACIDS, 2-5 QUANT",135.0,87.75,1.1,135.0,88
HCPCS,82136,UCYS24 AMINO ACIDS QUANT 2-5,135.0,87.75,8.33,135.0,84
HCPCS,82139,AMINO ACID>=6 QUANT EA,116.0,75.4,8.33,129.85,84
HCPCS,82139,AMINO ACIDS 6/> AMINO ACIDS QUANTITATIVE EA SPE,116.0,75.4,1.1,116.0,88
HCPCS,82140,%SSAT24 AMMONIUM,101.0,65.65,7.2,101.0,84
HCPCS,82140,AMMONIA,101.0,65.65,7.2,101.0,84
HCPCS,82140,"AMMONIUM, 24 HOUR, URINE",101.0,65.65,7.2,101.0,84
HCPCS,82140,"AMMONIUM, RANDOM, URINE",101.0,65.65,7.2,101.0,84
HCPCS,82140,ASSAY OF AMMONIA,101.0,65.65,1.1,101.0,88
HCPCS,82143,AMNIOTIC FLUID SCAN,,,3.74,30.22,28
HCPCS,82143,Amniotic fluid scan,,,11.75,13.61,8
HCPCS,82145,ASSAY OF AMPHETAMINES,,,47.86,47.86,1
HCPCS,82150,*AMYLASE ASSAY,45.0,29.25,6.48,45.0,84
HCPCS,82150,AMYLASE,45.0,29.25,6.48,45.0,168
HCPCS,82150,ASSAY OF AMYLASE,45.0,29.25,1.1,45.0,88
HCPCS,82154,ANDROSTANEDIOL GLUCURONIDE,,,14.24,127.31,28
HCPCS,82154,Androstanediol glucuronide,,,22.0,25.48,8
HCPCS,82157,%HIRSUT ANDROSTENEDIONE,202.0,131.3,14.46,202.0,84
HCPCS,82157,ANDROSTENEDIONE,202.0,131.3,14.46,202.0,84
HCPCS,82157,ANDROSTENEDIONE BLD,202.0,131.3,1.1,202.0,88
HCPCS,82157,CAHSP ASSAY OF ANDROSTENEDIONE,202.0,131.3,14.46,202.0,84
HCPCS,82160,%GMAPS ANDROSTERONE,176.0,114.4,12.35,176.0,84
HCPCS,82163,ANGIOTENSIN II,142.0,92.3,1.1,158.03,172
HCPCS,82164,ANGIOTENSIN CONV ENZYM,101.0,65.65,7.21,101.0,84
HCPCS,82166,ASSAY OF ANTI-MULLERIAN HORMONE,266.0,172.9,15.45,266.0,83
HCPCS,82166,HVIIVF ANTI MULLERIAN,266.0,172.9,15.45,266.0,83
HCPCS,82172,%LIVFIB APOLIPOPROTEIN,146.0,94.9,8.44,146.0,84
HCPCS,82172,%NASH APOLIPOPROTEIN,146.0,94.9,8.44,146.0,84
HCPCS,82172,APOLIPOPROTEIN A1+B X2,146.0,94.9,8.44,146.0,84
HCPCS,82172,APOLIPOPROTEIN EA ASSAY,146.0,94.9,8.44,146.0,84
HCPCS,82172,APOLIPOPROTEIN EACH,146.0,94.9,1.1,146.0,88
HCPCS,82175,%UTXM3 ARSENIC,131.0,85.15,9.37,131.0,84
HCPCS,82175,%UTXM4 ARSENIC,131.0,85.15,9.37,131.0,84
HCPCS,82175,ARSENIC,131.0,85.15,9.37,131.0,84
HCPCS,82175,ARSENIC HAIR OR NAILS,131.0,85.15,9.37,131.0,84
HCPCS,82175,ARSENIC URINE,131.0,85.15,9.37,131.0,84
HCPCS,82175,ASSAY OF ARSENIC,131.0,85.15,1.1,131.0,88
HCPCS,82180,%GMAPS ASCORBIC ACID,68.0,44.2,4.88,68.0,84
HCPCS,82180,ASSAY OF ASCORBIC ACID,68.0,44.2,4.88,68.0,84
HCPCS,82180,ASSAY OF ASCORBIC ACID BLOOD,68.0,44.2,1.1,68.0,88
HCPCS,82190,ATOMIC ABSORP SPECTROSCOPY EA,110.0,71.5,7.36,110.0,84
HCPCS,82205,ASSAY OF BARBITURATES,,,75.67,75.67,1
HCPCS,82232,%CADEXR B2-MICROGLOBULIN,112.0,72.8,7.99,112.0,84
HCPCS,82232,BETA 2 MICROGLOBULIN ASSAY,112.0,72.8,7.99,112.0,84
HCPCS,82232,BETA 2 MICROGLOBULIN BLD,112.0,72.8,7.99,112.0,84
HCPCS,82232,BETA-2 MICROGLOBULIN,112.0,72.8,1.1,112.0,88
HCPCS,82233,BETA-AMYLOID 1-40 (ABETA 40),,,128.92,290.07,13
HCPCS,82233,Beta-amyloid 1-40 (abeta 40),,,116.49,134.88,8
HCPCS,82234,BETA-AMYLOID; 1-42 (ABETA 42),121.0,78.65,33.64,141.81,76
HCPCS,82239,%GMAPS BILE ACIDS,118.0,76.7,8.46,118.0,84
HCPCS,82239,BILE ACIDS TOTAL,118.0,76.7,8.46,118.0,168
HCPCS,82240,BILE ACIDS CHOLYLGLYCINE,,,13.12,117.31,28
HCPCS,82240,BILE ACIDS FRACT BLD,183.0,118.95,1.1,183.0,88
HCPCS,82240,Bile acids cholylglycine,,,20.86,24.16,8
HCPCS,82247,%GMAPS BILIRUBIN TOTAL,35.0,22.75,4.36,35.0,84
HCPCS,82247,%LIVFIB BILIRUBIN,35.0,22.75,4.36,35.0,84
HCPCS,82247,%NASH BILIRUBIN TOTAL,35.0,22.75,4.36,35.0,84
HCPCS,82247,BILIRUBIN TOTAL,35.0,22.75,1.1,35.0,172
HCPCS,82247,BILIRUBIN TOTAL (BACK OFFICE),35.0,22.75,4.36,35.0,84
HCPCS,82247,TOTAL BILIRUBIN,35.0,22.75,4.36,35.0,84
HCPCS,82248,BILIRUBIN DIR,35.0,22.75,5.02,35.0,84
HCPCS,82248,BILIRUBIN DIRECT,35.0,22.75,1.1,35.0,88
HCPCS,82252,FECAL BILIRUBIN TEST,,,2.25,19.95,28
HCPCS,82252,Fecal bilirubin test,,,11.75,13.61,8
HCPCS,82261,ASSAY BIOTINIDASE,116.0,75.4,1.1,116.0,88
HCPCS,82261,BIOTINIDASE ASSAY EA,116.0,75.4,8.33,116.0,84
HCPCS,82270,BLOOD OCCULT PEROXIDASE ACTV QUAL FECES 1 DETER,30.0,19.5,1.1,30.0,88
HCPCS,82270,HEMOCULT FECES SCREEN (POINT OF CARE LAB),30.0,19.5,4.31,30.0,84
HCPCS,82270,OCCULT BLOOD FECES COLORECT,30.0,19.5,4.31,30.0,84
HCPCS,82270,OCCULT BLOOD SCREEN,30.0,19.5,4.31,30.0,84
HCPCS,82271,%FGSTRO GSTRC OCCULT BLD,37.0,24.05,5.32,37.0,84
HCPCS,82271,BLOOD OCCULT PEROXIDASE ACTV QUAL OTHER SOURCES,37.0,24.05,1.1,37.0,88
HCPCS,82272,BLOOD OCCULT PEROXIDASE ACTV QUAL FECES 1-3 SPEC,29.0,18.85,1.1,29.0,92
HCPCS,82272,OCCULT BLOOD FECES 1-3 TEST,29.0,18.85,4.23,29.0,168
HCPCS,82272,OCCULT BLOOD FECES 1-3 TEST (POINT OF CARE LAB),29.0,18.85,4.23,29.0,84
HCPCS,82274,BLOOD OCCULT FECAL HGB DETER IA QUAL FECES 1-3,110.0,71.5,1.1,110.0,88
HCPCS,82274,"IMMUNOASSAY, FECAL OCCULT BLOOD",110.0,71.5,7.86,110.0,84
HCPCS,82274,OCCULT BLD IA SCRN,110.0,71.5,7.86,110.0,84
HCPCS,82286,ASSAY OF BRADYKININ,,,2.55,30.29,28
HCPCS,82286,Assay of bradykinin,,,11.75,13.61,8
HCPCS,82300,%CADEXR CADMIUM X2,163.0,105.95,11.43,163.0,84
HCPCS,82300,%UTXM4 CADMIUM,163.0,105.95,11.43,163.0,84
HCPCS,82300,"CADMIUM, WHOLE BLOOD",163.0,105.95,11.43,163.0,84
HCPCS,82306,25 HYDROXY INCLUDES FRACTIONS IF PERFORMED,204.0,132.6,1.1,204.0,88
HCPCS,82306,D2D3 25-OH VITAMIN,204.0,132.6,16.78,204.0,84
HCPCS,82306,VITAMIN D 25 HYDROXY,204.0,132.6,16.78,204.0,84
HCPCS,82308,CALCITONIN BLOOD,185.0,120.25,1.1,185.0,88
HCPCS,82308,CALCITONIN FNA LYMPH ND,185.0,120.25,13.23,185.0,84
HCPCS,82308,UREA CLEARANCE 24 HR UR,185.0,120.25,13.23,185.0,84
HCPCS,82310,CALCIUM,36.0,23.4,2.55,36.0,84
HCPCS,82310,CALCIUM; TOTAL,36.0,23.4,1.1,36.0,88
HCPCS,82330,*CALCIUM IONIZED,94.0,61.1,6.75,94.0,84
HCPCS,82330,ASSAY IONIZED CA,94.0,61.1,6.75,94.0,84
HCPCS,82330,ASSAY IONIZED CA (POINT OF CARE LAB),94.0,61.1,6.75,94.0,84
HCPCS,82330,CALCIUM IONIZED BLD,94.0,61.1,1.1,94.0,88
HCPCS,82331,CALCIUM INFUSION TEST,,,5.34,36.55,28
HCPCS,82331,Calcium infusion test,,,18.15,21.01,8
HCPCS,82340,CA URINE QUANT TIMED,42.0,27.3,2.98,42.0,84
HCPCS,82340,CALCIUM URINE QUANTITATIVE TIMED SPECIMEN,42.0,27.3,1.1,42.0,88
HCPCS,82340,"SSAT24 CALCIUM, UR",42.0,27.3,2.98,42.0,84
HCPCS,82355,CALCULUS ANALYSIS QUAL,,,5.72,38.54,28
HCPCS,82355,Calculus analysis qual,,,18.15,21.01,8
HCPCS,82360,CALCULUS ASSAY QUANT,,,6.36,35.85,29
HCPCS,82360,Calculus assay quant,,,18.15,21.01,8
HCPCS,82365,CALCULI (STONE) ANALYSIS,89.0,57.85,6.37,89.0,84
HCPCS,82365,CALCULUS INFRARED SPECTROSCOPY,89.0,57.85,1.1,89.0,88
HCPCS,82370,X-RAY ASSAY CALCULUS,,,6.18,51.23,28
HCPCS,82370,X-ray assay calculus,,,18.15,21.01,8
HCPCS,82373,CARBOHYDR DEF TRANS PED,125.0,81.25,8.92,139.04,84
HCPCS,82373,CARBOHYDRATE DEF TRANSF,125.0,81.25,8.92,139.04,84
HCPCS,82373,CARBOHYDRATE DEF TRANSFER,125.0,81.25,8.92,139.04,84
HCPCS,82374,BICARONATE URINE,34.0,22.1,2.41,34.0,84
HCPCS,82374,CARBON DIOXIDE BICARBONATE,34.0,22.1,1.1,34.0,88
HCPCS,82374,CO2 BLOOD ASSAY,34.0,22.1,2.41,34.0,84
HCPCS,82375,CARBOXYHEMOGLOBIN,85.0,55.25,6.08,85.0,84
HCPCS,82375,CARBOXYHEMOGLOBIN (POINT OF CARE LAB),85.0,55.25,6.08,85.0,84
HCPCS,82375,CARBOXYHEMOGLOBIN QUANTITATIVE,85.0,55.25,1.1,85.0,88
HCPCS,82376,ASSAY CARBOXYHB QUAL,,,5.63,38.55,28
HCPCS,82376,Assay carboxyhb qual,,,18.15,21.01,8
HCPCS,82378,CARCINOEMBRYONIC ANTIGEN (CEA),131.0,85.15,1.1,131.0,88
HCPCS,82378,CEA AG,131.0,85.15,9.36,131.0,84
HCPCS,82379,%GMAPS CARNITINE,116.0,75.4,8.33,129.85,84
HCPCS,82379,CARNITINE FR & TOT PLASMA,116.0,75.4,8.33,129.85,84
HCPCS,82379,CARNITINE TOTAL & FREE QUANT,116.0,75.4,8.33,129.85,84
HCPCS,82379,"CARNITINE, P",116.0,75.4,8.33,129.85,84
HCPCS,82380,CAROTENE,64.0,41.6,4.56,64.0,84
HCPCS,82380,CAROTENE BLD,64.0,41.6,1.1,64.0,88
HCPCS,82382,ASSAY URINE CATECHOLAMINES,,,10.92,74.8,29
HCPCS,82382,Assay urine catecholamines,,,22.0,25.48,8
HCPCS,82383,%GMAPS CATECHOLAMINES,201.0,130.65,12.37,201.0,84
HCPCS,82384,*CATECHOLAMINE FRACT ASSAY,174.0,113.1,12.47,174.0,84
HCPCS,82384,CATECHOLAMINE FRAC UR,174.0,113.1,12.47,174.0,84
HCPCS,82384,CATECHOLAMINE FRACT PL,174.0,113.1,12.47,174.0,84
HCPCS,82384,CATECHOLAMINES FRACTIONATED,174.0,113.1,1.1,174.0,88
HCPCS,82387,ASSAY OF CATHEPSIN-D,,,8.92,91.8,28
HCPCS,82387,Assay of cathepsin-d,,,18.15,21.01,8
HCPCS,82390,CERULOPLASMIN BLD,74.0,48.1,1.1,74.0,88
HCPCS,82390,CERULOPLASMIN LEVEL,74.0,48.1,5.3,74.0,84
HCPCS,82397,%FSII CHEMILUMINESCENT,97.0,63.05,6.97,104.92,84
HCPCS,82397,ADANEU CHEMILUMINESCENT,97.0,63.05,6.97,104.92,84
HCPCS,82397,ALPHA SUBUNIT,97.0,63.05,6.97,104.92,84
HCPCS,82397,"ANTI-HMGCR ANTIBODY, IGG",97.0,63.05,6.97,104.92,168
HCPCS,82397,CHEMILUMINESCENT ASSAY,97.0,63.05,1.1,104.92,172
HCPCS,82397,IBDSGI CHEMILUM X4,97.0,63.05,6.97,104.92,84
HCPCS,82397,IFXNEU CHEMILUMINESCENT,97.0,63.05,6.97,104.92,84
HCPCS,82397,IGFBP-3 INSULIN,97.0,63.05,6.97,104.92,84
HCPCS,82397,MCROHN SAA CHEMILUM,97.0,63.05,6.97,104.92,84
HCPCS,82397,PTH RELATED PEPTIDE,97.0,63.05,6.97,104.92,84
HCPCS,82397,REACTIVE OXYGEN SPECIES,97.0,63.05,6.97,104.92,84
HCPCS,82397,TOTAL ANTIOXIDANT CAPACITY,97.0,63.05,6.97,104.92,84
HCPCS,82397,"VEDOLIZUMAB AB, S",97.0,63.05,6.97,104.92,84
HCPCS,82415,ASSAY OF CHLORAMPHENICOL,,,6.26,55.83,28
HCPCS,82415,Assay of chloramphenicol,,,18.31,21.2,8
HCPCS,82415,CHLORAMPHENICOL BLD,87.0,56.55,1.1,87.0,88
HCPCS,82435,*CHLORIDE,32.0,20.8,2.27,32.0,84
HCPCS,82435,ASSAY BLOOD CHLORIDE,32.0,20.8,2.27,32.0,84
HCPCS,82435,CHLORIDE (POINT OF CARE LAB),32.0,20.8,2.27,32.0,84
HCPCS,82435,CHLORIDE BLD,32.0,20.8,1.1,32.0,88
HCPCS,82436,CHLORIDE URINE,40.0,26.0,1.1,40.0,88
HCPCS,82436,CL URINE ASSAY,40.0,26.0,2.48,40.0,84
HCPCS,82436,"SSAT24 CHLORIDE, UR",40.0,26.0,2.48,40.0,84
HCPCS,82438,CHLORIDE OTHER SOURCE,35.0,22.75,1.1,35.0,88
HCPCS,82438,CL OTHER SOURCE ASSAY,35.0,22.75,2.41,37.65,84
HCPCS,82441,LINDANE BLOOD,41.0,26.65,2.97,41.0,84
HCPCS,82441,POLYCHLOR BIPHENYLS,41.0,26.65,2.97,41.0,84
HCPCS,82465,%GMAPS CHOLESTEROL TOTAL,30.0,19.5,4.35,30.0,84
HCPCS,82465,%NASH CHOLESTEROL TOTAL,30.0,19.5,4.35,30.0,84
HCPCS,82465,CHOLESTEROL BLOOD TOTAL,30.0,19.5,4.35,30.0,84
HCPCS,82465,CHOLESTEROL SERUM/WHOLE BLOOD TOTAL,30.0,19.5,1.1,30.0,88
HCPCS,82480,CHOLINESTERASE; SERUM,54.0,35.1,1.1,54.0,88
HCPCS,82480,PSEUDOCHOLINESTERASE TOTAL,54.0,35.1,3.89,54.0,84
HCPCS,82482,ASSAY HCG,68.0,44.2,3.92,68.0,84
HCPCS,82482,CHOLINESTERASE RBC,68.0,44.2,1.1,68.0,88
HCPCS,82485,%UMUCPO CHONDRO QUANT,142.0,92.3,10.2,159.03,84
HCPCS,82486,GAS/LIQUID CHROMATOGRAPHY,,,139.04,139.04,1
HCPCS,82487,PAPER CHROMATOGRAPHY,,,70.37,70.37,1
HCPCS,82488,PAPER CHROMATOGRAPHY,,,94.29,94.29,1
HCPCS,82489,THIN LAYER CHROMATOGRAPHY,,,122.08,122.08,1
HCPCS,82491,CHROMOTOGRAPHY QUANT SING,,,134.47,134.47,1
HCPCS,82492,CHROMOTOGRAPHY QUANT MULT,,,139.04,139.04,1
HCPCS,82495,CHROMIUM BLOOD,140.0,91.0,10.02,142.17,84
HCPCS,82495,CHROMIUM URINE,140.0,91.0,10.02,142.17,84
HCPCS,82495,CHSER,140.0,91.0,10.02,142.17,84
HCPCS,82507,%GMAPS CITRATE,192.0,124.8,13.73,192.0,84
HCPCS,82507,*CITRATE ASSAY,192.0,124.8,13.73,192.0,84
HCPCS,82507,ASSAY OF CITRATE,192.0,124.8,1.1,192.0,88
HCPCS,82507,CITRIC ACID URINE,192.0,124.8,13.73,192.0,84
HCPCS,82507,"SSAT24 CITRATE EXCR, UR",192.0,124.8,13.73,192.0,84
HCPCS,82520,ASSAY OF COCAINE,,,46.67,46.67,1
HCPCS,82523,COLLAGEN CROSS LINKS,129.0,83.85,9.23,129.0,84
HCPCS,82523,COLLAGEN CROSS LINKS ANY METHOD,129.0,83.85,1.1,129.0,88
HCPCS,82523,CROSS-LINK N-TELOPEPTIDES,129.0,83.85,9.23,129.0,84
HCPCS,82525,ASSAY OF COPPER,86.0,55.9,1.1,86.0,88
HCPCS,82525,COPPER BLOOD,86.0,55.9,6.13,95.56,84
HCPCS,82525,COPPER URINE,86.0,55.9,6.13,95.56,84
HCPCS,82525,"COPPER, FREE, SERUM OR PLASMA",86.0,55.9,6.13,95.56,84
HCPCS,82525,"COPPER, TISSUE",86.0,55.9,6.13,95.56,84
HCPCS,82528,CORTICOSTERONE,155.0,100.75,11.12,155.0,84
HCPCS,82530,CORTISOL FREE,115.0,74.75,1.1,115.0,172
HCPCS,82530,FREE CORTISOL UR LCM X3,115.0,74.75,8.25,115.0,84
HCPCS,82530,FREE CORTISOL URINE LCM,115.0,74.75,8.25,115.0,84
HCPCS,82533,%GMAPS CORTISOL TOTAL,112.0,72.8,8.05,112.0,84
HCPCS,82533,CAHSP TOTAL CORTISOL,112.0,72.8,8.05,112.0,84
HCPCS,82533,CORTISOL,112.0,72.8,8.05,112.0,84
HCPCS,82533,CORTISOL PLASMA,112.0,72.8,8.05,112.0,84
HCPCS,82533,CORTISOL SERUM RFLX,112.0,72.8,8.05,112.0,84
HCPCS,82533,CORTISOL TOTAL,112.0,72.8,8.05,112.0,168
HCPCS,82533,CORTISOL; TOTAL,112.0,72.8,1.1,112.0,88
HCPCS,82540,%GMAPS CREATINE,32.0,20.8,2.29,35.18,84
HCPCS,82540,%PCA3 INTERP REPORT PC,32.0,20.8,2.29,35.18,84
HCPCS,82540,ASSAY CREATINE,32.0,20.8,1.1,32.0,88
HCPCS,82540,"CREATINE, URINE",32.0,20.8,2.29,35.18,84
HCPCS,82540,GUANID CREATINE,32.0,20.8,2.29,35.18,84
HCPCS,82540,UGUANI CREATINE,32.0,20.8,2.29,35.18,84
HCPCS,82541,COLUMN CHROMOTOGRAPHY QUAL,,,79.59,79.59,1
HCPCS,82542,%ANEMIA GCMS ANALYTE QT,166.0,107.9,9.64,166.0,84
HCPCS,82542,%F2 MS/MS QUANTITATIVE,166.0,107.9,9.64,166.0,84
HCPCS,82542,%GMAPS COL CHROMOTOG,166.0,107.9,9.64,166.0,84
HCPCS,82542,%NEUR CHROMAT QN,166.0,107.9,9.64,166.0,84
HCPCS,82542,%UDRPAN CHROM QUANT,166.0,107.9,9.64,166.0,84
HCPCS,82542,%UMPSSC QUAL,166.0,107.9,9.64,166.0,84
HCPCS,82542,%UMUCPO CHROMAT QUANT,166.0,107.9,9.64,166.0,84
HCPCS,82542,*PRO-PREDICTR METAB,166.0,107.9,9.64,166.0,84
HCPCS,82542,18 HYDROXYCORTICOSTERONE,166.0,107.9,9.64,166.0,84
HCPCS,82542,5 METHYLTETRAHYDROFOLATE,166.0,107.9,9.64,166.0,84
HCPCS,82542,7ALPHAC4,166.0,107.9,9.64,166.0,84
HCPCS,82542,ACYLGLYCINES QNT UR,166.0,107.9,9.64,166.0,84
HCPCS,82542,AMIODARONE,166.0,107.9,9.64,166.0,84
HCPCS,82542,ANSADA MEAS AB ATI,166.0,107.9,9.64,166.0,84
HCPCS,82542,ANSIFX MEAS AB ATI,166.0,107.9,9.64,166.0,84
HCPCS,82542,ANSUST MEAS AB ATI,166.0,107.9,9.64,166.0,84
HCPCS,82542,ANSVDZ MEAS AB ATI,166.0,107.9,9.64,166.0,84
HCPCS,82542,"BROMIDE, BLOOD",166.0,107.9,9.64,166.0,84
HCPCS,82542,CHOLESTEROL BIO INTERMED,166.0,107.9,9.64,166.0,84
HCPCS,82542,COENZYME Q10,166.0,107.9,9.64,166.0,84
HCPCS,82542,COL-CHR/MS NONDRUG ANALYTE NES QUAL/QUAN EA SPEC,166.0,107.9,1.1,166.0,88
HCPCS,82542,COQ10 LEUKOCYTES,166.0,107.9,9.64,166.0,84
HCPCS,82542,DIHYDROTESTOSTERONE,166.0,107.9,9.64,166.0,84
HCPCS,82542,GUANID CHROMOTOGRAPHY,166.0,107.9,9.64,166.0,84
HCPCS,82542,HEX4 GLC4,166.0,107.9,9.64,166.0,84
HCPCS,82542,HYPEROXALURIA,166.0,107.9,9.64,166.0,84
HCPCS,82542,"IOHEXOL GLOMERULAR FILTRATION RATE (GFR), PLASMA",166.0,107.9,9.64,166.0,84
HCPCS,82542,"LEUKOTRIENE E4, UR",166.0,107.9,9.64,166.0,84
HCPCS,82542,METHYLPARATHIONE BLOOD,166.0,107.9,9.64,166.0,84
HCPCS,82542,N-METHYLHISTAMINE UR,166.0,107.9,9.64,166.0,84
HCPCS,82542,NEOPTERIN CSF,166.0,107.9,9.64,166.0,84
HCPCS,82542,OMEGACHECK,166.0,107.9,9.64,166.0,84
HCPCS,82542,OXYSTEROLS,166.0,107.9,9.64,166.0,84
HCPCS,82542,PIPECOLIC ACID SERUM,166.0,107.9,9.64,166.0,84
HCPCS,82542,"PIPECOLIC ACID, URINE",166.0,107.9,9.64,166.0,84
HCPCS,82542,PLASMA THYMIDINE DETERMINATION,166.0,107.9,9.64,166.0,84
HCPCS,82542,PRO-PREDICT R 6MP X2,166.0,107.9,9.64,166.0,84
HCPCS,82542,PTH RELATED PEPTIDE,166.0,107.9,9.64,166.0,84
HCPCS,82542,PURINE&PYRIMIDINE,166.0,107.9,9.64,166.0,84
HCPCS,82542,PYRIDOXAL 5 PHOSPHATE,166.0,107.9,9.64,166.0,84
HCPCS,82542,"SMITH - LEMLI-OPITZ SCREEN, PL",166.0,107.9,9.64,166.0,84
HCPCS,82542,"SUCCINYLADENOSINE, CSF",166.0,107.9,9.64,166.0,84
HCPCS,82542,"TOTAL LIPID FATTY ACID PROFILE, RBC",166.0,107.9,9.64,166.0,84
HCPCS,82542,TRIMETHYLAMINE N-OXIDE,166.0,107.9,9.64,166.0,84
HCPCS,82542,UGUANI CHROMOTOGRAPHY,166.0,107.9,9.64,166.0,84
HCPCS,82542,UMHISR COL CHROMOTOGRAPHY,166.0,107.9,9.64,166.0,84
HCPCS,82543,COLUMN CHROMOTOGRAPH/ISOTOPE,,,139.04,139.04,1
HCPCS,82544,COLUMN CHROMOTOGRAPH/ISOTOPE,,,139.04,139.04,1
HCPCS,82550,*CREATINE KINASE TOTAL ASSAY,45.0,29.25,6.51,45.0,168
HCPCS,82550,CREATINE KINASE TOTAL,45.0,29.25,1.1,45.0,88
HCPCS,82552,*CREATINE KINASE ISOENZYME,92.0,59.8,6.61,92.0,84
HCPCS,82552,CK ISOENZYMES,92.0,59.8,1.1,92.0,88
HCPCS,82553,*CREATINE KINASE MB FRACT,80.0,52.0,5.7,80.0,84
HCPCS,82553,CREATINE KINASE MB FRACTION ONLY,80.0,52.0,1.1,80.0,88
HCPCS,82554,CREATINE ISOFORMS,,,5.86,52.29,28
HCPCS,82554,Creatine isoforms,,,18.15,21.01,8
HCPCS,82565,%GMAPS CREATININE BLD,35.0,22.75,2.53,35.0,84
HCPCS,82565,*CREATININE BLOOD,35.0,22.75,2.53,35.0,84
HCPCS,82565,CREATININE BLOOD (POINT OF CARE LAB),35.0,22.75,2.53,35.0,84
HCPCS,82565,CREATININE BLOOD ASSAY,35.0,22.75,2.53,35.0,84
HCPCS,82565,CREATININE SERUM (TRPHOS),35.0,22.75,2.53,35.0,84
HCPCS,82565,CREATININE; BLOOD,35.0,22.75,1.1,35.0,88
HCPCS,82565,STRNGVIL ISTAT CREATININE,35.0,22.75,2.53,35.0,84
HCPCS,82570,%CADEXR CREATININE,36.0,23.4,5.18,36.0,84
HCPCS,82570,%F2 CREATININE,36.0,23.4,5.18,36.0,84
HCPCS,82570,%GMAPS CREATININE UR,36.0,23.4,5.18,36.0,84
HCPCS,82570,%OHCREATININE,36.0,23.4,5.18,36.0,84
HCPCS,82570,%U17K CREATININE,36.0,23.4,5.18,36.0,84
HCPCS,82570,%UCAT24 CREATININE,36.0,23.4,5.18,36.0,84
HCPCS,82570,%UFLUOR CREATININE,36.0,23.4,5.18,36.0,84
HCPCS,82570,%URCAT CREATININE UR,36.0,23.4,5.18,36.0,84
HCPCS,82570,*CREATININE OTHER SOURCE ASSAY,36.0,23.4,5.18,36.0,84
HCPCS,82570,CREATININE OTHER SOURCE,36.0,23.4,1.1,36.0,172
HCPCS,82570,CREATININE UR/FLUID,36.0,23.4,5.18,36.0,84
HCPCS,82570,CREATININE URINE (TRPHOS),36.0,23.4,5.18,36.0,84
HCPCS,82570,"CREATININE, UR (LABCORP PORPHOBILINOGEN, QN, RANDOM UR)",36.0,23.4,5.18,36.0,84
HCPCS,82570,HEX4 CREATININE,36.0,23.4,5.18,36.0,84
HCPCS,82570,PURINE PROFILE URINARYX2,36.0,23.4,5.18,36.0,84
HCPCS,82570,"SSAT24 CREATININE, UR",36.0,23.4,5.18,36.0,84
HCPCS,82570,UGUANI CREATINE,36.0,23.4,5.18,36.0,84
HCPCS,82570,UMHISR UR CREATININE,36.0,23.4,5.18,36.0,84
HCPCS,82575,CREATININE CLEARANCE TEST,65.0,42.25,4.67,65.0,84
HCPCS,82575,CREATININE; CLEARANCE,65.0,42.25,1.1,65.0,88
HCPCS,82585,CRYOFIBRINOGEN,98.0,63.7,5.66,98.0,84
HCPCS,82585,CRYOFIBRINOGEN BLOOD,98.0,63.7,1.1,98.0,88
HCPCS,82595,CRYOGLOBULIN QL,45.0,29.25,3.19,49.8,168
HCPCS,82595,CRYOGLOBULIN QUALITATIVE/SEMI-QUANTITATIVE,45.0,29.25,1.1,45.0,88
HCPCS,82595,CRYOGLOBULN QI W/REFLX T,45.0,29.25,3.19,49.8,84
HCPCS,82600,CYANIDE BLD,134.0,87.1,1.1,134.0,88
HCPCS,82600,CYANIDE BLOOD,134.0,87.1,9.58,134.0,84
HCPCS,82607,CYANOCOBALAMIN VITAMIN B-12,104.0,67.6,1.1,104.0,88
HCPCS,82607,VIT B-12,104.0,67.6,8.54,104.0,84
HCPCS,82607,VITAMIN B12 BLOOD,104.0,67.6,8.54,104.0,84
HCPCS,82608,CYANOCOBALAMIN VIT B-12 UNSAT BINDING CAPACITY,99.0,64.35,1.1,99.0,88
HCPCS,82608,HALOPERIDOL,99.0,64.35,7.07,99.0,84
HCPCS,82610,CYSTATIN C,128.0,83.2,1.1,128.0,172
HCPCS,82610,CYSTATIN C WITH GFR,128.0,83.2,7.41,128.0,84
HCPCS,82615,CYSTINE QUAL UR,66.0,42.9,1.1,66.0,88
HCPCS,82615,TEST FOR URINE CYSTINES,,,4.03,32.77,28
HCPCS,82615,Test for urine cystines,,,11.75,13.61,8
HCPCS,82626,CAHSP DEHYDROEPIANDROSTERONE,174.0,113.1,12.48,174.0,84
HCPCS,82626,DEHYDROEPIANDROSTERONE,174.0,113.1,12.48,174.0,84
HCPCS,82626,DHEA BLOOD,174.0,113.1,1.1,174.0,88
HCPCS,82627,DEHYDROEPIANDROSTERONE-SULFATE,153.0,99.45,1.1,153.0,88
HCPCS,82627,DHEA-S,153.0,99.45,10.98,153.0,84
HCPCS,82627,HIRSUT DHEA-SULFATE,153.0,99.45,10.98,153.0,84
HCPCS,82633,11 DEOXYCORTICOSTERONE,214.0,139.1,15.3,214.0,84
HCPCS,82633,CAHSP DESOXYCORTICOSTERONE,214.0,139.1,15.3,214.0,84
HCPCS,82634,11-DEOXYCORTISOL,202.0,131.3,14.46,202.0,84
HCPCS,82634,CAHSP DEOXYCORTISOL,202.0,131.3,14.46,202.0,84
HCPCS,82634,DEOXYCORTISOL-11,202.0,131.3,1.1,202.0,88
HCPCS,82638,%PSEUDOCHOL PHENOTYPE,85.0,55.25,6.05,85.0,84
HCPCS,82638,PSEUDOCHOLIN PHENOTY,85.0,55.25,1.1,85.0,88
HCPCS,82642,DIHYDROTESTOSTERONE,202.0,131.3,13.01,202.0,84
HCPCS,82646,ASSAY OF DIHYDROCODEINONE,,,63.61,63.61,1
HCPCS,82649,ASSAY OF DIHYDROMORPHINONE,,,113.42,113.42,1
HCPCS,82651,ASSAY OF DIHYDROTESTOSTERONE,,,79.51,79.51,1
HCPCS,82652,1 25 DIHYDROXY INCLUDES FRACTIONS IF PERFORMED,266.0,172.9,1.1,266.0,88
HCPCS,82652,VIT D 1 25 DIHYDROXY,266.0,172.9,19.01,266.0,84
HCPCS,82653,ELASTASE PANCREATIC FECAL,158.0,102.7,9.19,158.0,84
HCPCS,82654,ASSAY OF DIMETHADIONE,,,61.01,61.01,1
HCPCS,82656,EL-1 FECAL QUAL/SEMIQ,,,5.7,94.19,29
HCPCS,82656,El-1 fecal qual/semiq,,,18.15,21.01,8
HCPCS,82657,%ETCF FIBRO ENZ ACT X5,153.0,99.45,8.92,153.0,84
HCPCS,82657,%ETCMIT EMZ ACT X8,153.0,99.45,8.92,153.0,84
HCPCS,82657,%ETCMUS TIS ENZ ACT X8,153.0,99.45,8.92,153.0,84
HCPCS,82657,%MYOENZ ENZ ACT X9,153.0,99.45,8.92,153.0,84
HCPCS,82657,%OXPHO1 ENZYME ASSAY X17,153.0,99.45,8.92,153.0,84
HCPCS,82657,%OXPHOF ENZ ACT,153.0,99.45,8.92,153.0,84
HCPCS,82657,ALPHA GALACTOS SERUM,153.0,99.45,8.92,153.0,84
HCPCS,82657,"ALPHA GALACTOSIDASE, WBC",153.0,99.45,8.92,153.0,84
HCPCS,82657,ALPHA-GALACTOSIDASE,153.0,99.45,8.92,153.0,84
HCPCS,82657,AMINOLEV ACID DEHYD,153.0,99.45,8.92,153.0,84
HCPCS,82657,"ARYLSULFATASE A, WBC",153.0,99.45,8.92,153.0,84
HCPCS,82657,ASPARAGINASE ENZYME ACTIVITY,153.0,99.45,8.92,153.0,84
HCPCS,82657,"BETA GALACTOSIDASE, WBC",153.0,99.45,8.92,153.0,84
HCPCS,82657,CPALMF ENZYME CELL ACTIVITY,153.0,99.45,8.92,153.0,84
HCPCS,82657,CPALMT ENZYME CELL ACTIVITY,153.0,99.45,8.92,153.0,84
HCPCS,82657,DISACCHARIDASE IN TISSUE,153.0,99.45,8.92,153.0,84
HCPCS,82657,ENZYME ACTIVITY NRADIOAC NOS,153.0,99.45,8.92,153.0,84
HCPCS,82657,FAOACM ENZYME CELL ACTIVITY X8,153.0,99.45,8.92,153.0,84
HCPCS,82657,FAOSCM ENZYME CELL ACTIVITY X4,153.0,99.45,8.92,153.0,84
HCPCS,82657,GAUCHER GBA ACTIVITY LEUKOCYTES,153.0,99.45,8.92,153.0,84
HCPCS,82657,LYSO ACID LIPASE ACT,153.0,99.45,8.92,153.0,84
HCPCS,82657,NEURO CEROID LIPO CLN2,153.0,99.45,8.92,153.0,84
HCPCS,82657,NEURO CEROID LIPOFUCIN,153.0,99.45,8.92,153.0,84
HCPCS,82657,NEUT OXIDATIVE BURST,153.0,99.45,8.92,153.0,84
HCPCS,82657,NZYM ACTIV BLD CELLS/TISS NONRADACT SUBSTRATE EA,153.0,99.45,1.1,153.0,88
HCPCS,82657,PBGDEP ENZYME CELL ACT,153.0,99.45,8.92,153.0,84
HCPCS,82657,PORPHOBILINOGEN SERUM,153.0,99.45,8.92,153.0,84
HCPCS,82657,SIALIC ACID URINE,153.0,99.45,8.92,153.0,84
HCPCS,82657,THIOPURINE METHYLT TPMT,153.0,99.45,8.92,153.0,84
HCPCS,82658,%MYOENZ ENZ ACT RADIO,304.0,197.6,17.61,304.0,84
HCPCS,82658,*%BO OXI PHOS MUSC MITO X6,304.0,197.6,17.61,304.0,84
HCPCS,82658,CPALMF ENZYME CELL ACTIVITY RA X2,304.0,197.6,17.61,304.0,84
HCPCS,82658,CPALMT ENZYME CELL ACTIVITY RA X2,304.0,197.6,17.61,304.0,84
HCPCS,82658,GALACTOCEREBROSIDASE,304.0,197.6,17.61,304.0,84
HCPCS,82658,HPRT,304.0,197.6,17.61,304.0,84
HCPCS,82658,NZYM ACTV BLOOD CELLS/TISS RADACT SUBSTRATE EA,304.0,197.6,1.1,304.0,88
HCPCS,82664,%OXPH01 ELECTROPH TECH,424.0,275.6,20.86,424.0,84
HCPCS,82664,CHYLOMICRON SCREEN,424.0,275.6,20.86,424.0,84
HCPCS,82664,"CHYLOSCREEN, BF ELECTROPHORESIS, REFLEX",424.0,275.6,20.86,424.0,84
HCPCS,82664,ELCTROPHORETIC TECHNIQUE NOT ELSEWHERE SPECIFIED,424.0,275.6,1.1,424.0,88
HCPCS,82664,ELECTROPHORESIS NON-SPEC,424.0,275.6,20.86,424.0,84
HCPCS,82664,ISOELECTRIC FOCUSING HB,424.0,275.6,20.86,424.0,84
HCPCS,82664,MPS ELECTROPHORESIS,424.0,275.6,20.86,424.0,84
HCPCS,82666,ASSAY OF EPIANDROSTERONE,,,84.51,84.51,1
HCPCS,82668,ASSAY OF ERYTHROPOIETIN,130.0,84.5,1.1,130.0,88
HCPCS,82668,ERYTHROPOIETIN,130.0,84.5,9.28,130.0,84
HCPCS,82670,ASSAY OF TOTAL ESTRADIOL,193.0,125.45,1.1,193.0,88
HCPCS,82670,ESTRADIOL TANDEM MASS SP,193.0,125.45,13.8,193.0,84
HCPCS,82670,ESTRADIOL-17B,193.0,125.45,13.8,193.0,84
HCPCS,82671,ASSAY OF ESTROGENS FRACTIONATED,223.0,144.95,1.1,223.0,88
HCPCS,82671,ESTROGENS; FRACTIONATED,223.0,144.95,15.95,223.0,84
HCPCS,82672,ASSAY OF ESTROGEN,,,10.71,63.58,29
HCPCS,82672,Assay of estrogen,,,22.0,25.48,8
HCPCS,82672,ESTROGEN TOTAL,150.0,97.5,1.1,150.0,88
HCPCS,82677,%QUAD4 MARKERS  ESTRIOL,167.0,108.55,11.94,167.0,84
HCPCS,82677,%SEQ2 ESTRIOL,167.0,108.55,11.94,167.0,84
HCPCS,82677,ASSAY OF ESTRIOL,167.0,108.55,1.1,167.0,88
HCPCS,82677,ESTRIOL SERUM,167.0,108.55,11.94,167.0,84
HCPCS,82679,ASSAY OF ESTRONE,172.0,111.8,1.1,172.0,88
HCPCS,82679,ESTRONE SERUM,172.0,111.8,22.0,172.0,84
HCPCS,82681,ASSAY DIR MEAS FR ESTRADIOL,,,11.18,76.56,28
HCPCS,82681,Assay dir meas fr estradiol,,,22.0,25.48,8
HCPCS,82690,ASSAY OF ETHCHLORVYNOL,,,71.52,71.52,1
HCPCS,82693,ETHYLENE GLYCOL,103.0,66.95,1.1,103.0,172
HCPCS,82696,ASSAY OF ETIOCHOLANOLONE,,,11.65,104.11,28
HCPCS,82696,Assay of etiocholanolone,,,22.0,25.48,8
HCPCS,82705,"FAT, FECAL QUAL",35.0,22.75,2.52,35.0,84
HCPCS,82705,"FATS/LIPIDS, FECES, QUALITATIVE",35.0,22.75,1.1,35.0,88
HCPCS,82705,FECAL FAT QUALITATIVE,35.0,22.75,2.52,35.0,84
HCPCS,82710,FECAL FAT QUANT FECES,117.0,76.05,8.3,117.0,84
HCPCS,82715,ASSAY OF FECAL FAT,,,9.19,75.97,28
HCPCS,82715,Assay of fecal fat,,,18.15,21.01,8
HCPCS,82725,FATTY ACIDS FREE,130.0,84.5,7.51,130.0,84
HCPCS,82725,FATTY ACIDS NONESTERIFIED,130.0,84.5,1.1,130.0,172
HCPCS,82725,GMAPS FATTY ACIDS NONESTERIFIED,130.0,84.5,7.51,130.0,84
HCPCS,82726,%CFA VERY LONG CHAIN,136.0,88.4,8.92,139.04,84
HCPCS,82726,%GMAPS VLCHAIN FATTY ACID,136.0,88.4,8.92,139.04,84
HCPCS,82726,LONG CHAIN FAT ACIDS,136.0,88.4,1.1,136.0,88
HCPCS,82726,LONG CHAIN FATTY ACIDS,136.0,88.4,8.92,139.04,84
HCPCS,82726,PEROXISOMAL PANEL,136.0,88.4,8.92,139.04,84
HCPCS,82728,ASSAY FERRITIN,94.0,61.1,1.1,94.0,88
HCPCS,82728,FERRITIN ASSAY,94.0,61.1,6.73,94.0,84
HCPCS,82731,FETAL FIBRONECTIN,444.0,288.6,1.1,444.0,172
HCPCS,82735,%UFLUOR FLUORIDE UR,128.0,83.2,9.16,183.29,84
HCPCS,82735,FLUORIDE SERUM,128.0,83.2,9.16,183.29,84
HCPCS,82742,ASSAY OF FLURAZEPAM,,,87.32,87.32,1
HCPCS,82746,%GMAPS FOLIC ACID,101.0,65.65,7.26,101.0,84
HCPCS,82746,ASSAY OF FOLIC ACID SERUM,101.0,65.65,1.1,101.0,88
HCPCS,82746,FOLIC ACID SERUM ASSAY,101.0,65.65,7.26,101.0,84
HCPCS,82747,%RBCFLP RBC FOLATE,122.0,79.3,8.55,122.0,84
HCPCS,82747,ASSAY OF FOLIC ACID RBC,122.0,79.3,1.1,122.0,88
HCPCS,82747,FOLIC ACID RBC TEST,122.0,79.3,8.55,122.0,84
HCPCS,82747,"RBC FOLATE (REFLAB ONLY, REQUIRES HCT WITHIN 24 HRS)",122.0,79.3,8.55,122.0,84
HCPCS,82757,FRUCTOSE QUAL SEMEN,120.0,78.0,8.56,120.0,84
HCPCS,82757,SEMEN FRUCTOSE QUANT,120.0,78.0,1.1,120.0,88
HCPCS,82759,GALACTOKINASE ACTIVITY,148.0,96.2,10.61,202.1,84
HCPCS,82760,%GMAPS GALACTOSE,77.0,50.05,5.53,77.0,84
HCPCS,82760,GALACTOSE QUANT UR,77.0,50.05,5.53,77.0,84
HCPCS,82760,"GALACTOSE QUANT, PLASMA",77.0,50.05,5.53,77.0,84
HCPCS,82760,"GALACTOSE, QUANT, UR",77.0,50.05,5.53,77.0,84
HCPCS,82775,GALAC PHOS URIDYL TRANS,145.0,94.25,10.4,162.23,84
HCPCS,82776,%NEO GIPO4 URIDYL TRANS,81.0,52.65,4.7,81.0,84
HCPCS,82777,GALECTIN 3,305.0,198.25,1.1,305.0,88
HCPCS,82777,GALECTIN-3 SERUM,305.0,198.25,17.7,305.0,84
HCPCS,82784,%CELCMP GAMMALOBULIN,64.0,41.6,4.59,64.0,84
HCPCS,82784,%CEPLUS GAMMALOBULIN,64.0,41.6,4.59,64.0,84
HCPCS,82784,*CRYSTAL EXAM FLUID/TIS,64.0,41.6,4.59,64.0,84
HCPCS,82784,ASSAY OF GAMMAGLOBULIN IGA IGD IGG IGM EACH,64.0,41.6,1.1,64.0,88
HCPCS,82784,GAMMAGLOBULIN ASSAY,64.0,41.6,4.59,64.0,84
HCPCS,82784,HUMOR1 ASSAY GAMMAG X3,64.0,41.6,4.59,64.0,84
HCPCS,82784,"IMGLB IGG, A, M X3",64.0,41.6,4.59,64.0,84
HCPCS,82784,"IMMUNOGLOB D QT, SERUM",64.0,41.6,4.59,64.0,84
HCPCS,82784,LYMRFX IGG QUANT,64.0,41.6,4.59,64.0,84
HCPCS,82785,*GAMMAGLOBULIN ASSAY IGE,114.0,74.1,8.13,114.0,84
HCPCS,82785,"ASSAY, GAMMAGLOBULIN IGE",114.0,74.1,1.1,114.0,88
HCPCS,82785,ATLANTIC RESPIRATORY PANEL IGE TOTAL,114.0,74.1,8.13,114.0,84
HCPCS,82785,ATOPIC GAMMAGLOB IGE,114.0,74.1,8.13,114.0,84
HCPCS,82785,GAMMAGLOBULIN ASSAY IGE,114.0,74.1,8.13,114.0,84
HCPCS,82787,%IGA12 IGA SUBCLASS 1&2,55.0,35.75,3.96,55.0,84
HCPCS,82787,%IGG SUBCLASSES X4,55.0,35.75,3.96,55.0,84
HCPCS,82787,GAMMAGLOBULIN IMMUNOGLOBULIN SUBCLASSES,55.0,35.75,1.1,55.0,88
HCPCS,82787,HUMOR1 IGG SUBCLASSES X4,55.0,35.75,3.96,55.0,84
HCPCS,82800,LAB VENOUS-PH,76.0,49.4,4.4,89.32,84
HCPCS,82800,"PH, BLOOD (POINT OF CARE LAB)",76.0,49.4,4.4,89.32,84
HCPCS,82803,BLOOD GAS ARTERIAL (POINT OF CARE LAB),180.0,117.0,10.43,180.0,84
HCPCS,82803,BLOOD GAS MIXED WO O2 SAT,180.0,117.0,10.43,180.0,84
HCPCS,82803,BLOOD GAS VENOUS (POINT OF CARE LAB),180.0,117.0,10.43,180.0,84
HCPCS,82803,BLOOD GAS W CALC O2 SATUR (POINT OF CARE LAB),180.0,117.0,10.43,180.0,84
HCPCS,82803,BLOOD GASES ANY COMBINATION PH PCO2 PO2 CO2 HCO3,180.0,117.0,1.1,180.0,88
HCPCS,82805,BLD GAS PH/PO2/PCO2 W SAT (POINT OF CARE LAB),544.0,353.6,31.51,544.0,84
HCPCS,82805,BLOOD GAS,544.0,353.6,31.51,544.0,84
HCPCS,82805,BLOOD GAS (POINT OF CARE LAB),544.0,353.6,31.51,544.0,84
HCPCS,82805,BLOOD GAS PH/PO2/PCO2 W SATUR,544.0,353.6,31.51,544.0,84
HCPCS,82805,GASES BLOOD PH DIRECT MEAS XCPT PULSE OXIMITRY,544.0,353.6,1.1,544.0,88
HCPCS,82810,BLOOD GAS O2 SATUR ONLY,67.0,43.55,4.31,67.0,84
HCPCS,82810,BLOOD GAS O2 SATUR ONLY (POINT OF CARE LAB),67.0,43.55,4.31,67.0,168
HCPCS,82820,HEMOGLOBIN-OXYGEN AFFINITY,92.0,59.8,1.1,92.0,88
HCPCS,82820,OXY DISSOC P50 BY HEMOX,92.0,59.8,5.34,92.0,84
HCPCS,82926,ASSAY OF GASTRIC ACID,,,23.93,23.93,1
HCPCS,82928,ASSAY OF GASTRIC ACID,,,28.81,28.81,1
HCPCS,82928,GASTRIC RT ANALYSIS,58.0,37.7,1.1,58.0,70
HCPCS,82930,GASTRIC ACID ANALYIS W/PH EACH SPECIMEN,46.0,29.9,1.1,46.0,88
HCPCS,82930,GASTRIC ANALY W/PH EA SPEC,,,2.69,18.39,28
HCPCS,82930,Gastric analy w/ph ea spec,,,11.75,13.61,8
HCPCS,82938,%GASTST GASTRIN STIMX4,122.0,79.3,8.74,174.01,84
HCPCS,82941,%GASTST GASTRIN,122.0,79.3,8.71,122.0,84
HCPCS,82941,ASSAY OF GASTRIN,122.0,79.3,1.1,122.0,88
HCPCS,82941,GASTRIN,122.0,79.3,8.71,122.0,84
HCPCS,82943,GLUCAGON,99.0,64.35,7.06,110.02,168
HCPCS,82945,GLUC BODY FLUID NOT BLOOD,27.0,17.55,1.94,27.0,84
HCPCS,82945,GLUCOSE BF,27.0,17.55,1.94,27.0,84
HCPCS,82945,GLUCOSE BODY FLUID OTHER THAN BLOOD,27.0,17.55,1.1,27.0,88
HCPCS,82945,GLUCOSE RANDOM UR,27.0,17.55,1.94,27.0,84
HCPCS,82945,"GLUCOSE RANDOM, UR",27.0,17.55,1.94,27.0,84
HCPCS,82946,GLUCAGON TOLERANCE TEST,,,7.44,55.75,28
HCPCS,82946,Glucagon tolerance test,,,18.15,21.01,8
HCPCS,82947,%GMAPS GLUCOSE QT,27.0,17.55,1.94,27.0,84
HCPCS,82947,%NASH GLUC QUANT,27.0,17.55,1.94,27.0,84
HCPCS,82947,GLUC BLOOD QUANT ASSAY,27.0,17.55,1.94,27.0,84
HCPCS,82947,"GLUC, FASTING",27.0,17.55,1.94,27.0,84
HCPCS,82947,GLUCOSE QUANT,27.0,17.55,1.94,27.0,84
HCPCS,82947,GLUCOSE QUANT (POINT OF CARE LAB),27.0,17.55,1.94,27.0,84
HCPCS,82947,GLUCOSE QUANTITATIVE BLOOD XCPT REAGENT STRIP,27.0,17.55,1.1,27.0,88
HCPCS,82948,GLUCOSE BLOOD REAGENT STRIP,35.0,22.75,1.1,58.16,88
HCPCS,82948,GLUCOSE BLOOD REAGENT STRIP (POINT OF CARE LAB),35.0,22.75,5.04,35.0,84
HCPCS,82950,GLUC NON GEST TOLERANCE,33.0,21.45,4.75,33.0,84
HCPCS,82950,GLUCOSE POST GLUCOSE DOSE,33.0,21.45,1.1,33.0,88
HCPCS,82950,GLUCOSE SCRN POST DOSE,33.0,21.45,4.75,33.0,84
HCPCS,82951,GLUCOSE TOLERANCE TEST GTT 3 SPECIMENS,89.0,57.85,1.1,89.0,88
HCPCS,82951,GTT 3SPEC,89.0,57.85,12.87,89.0,84
HCPCS,82952,GLUCOSE TOLERANCE EA ADDL BEYOND 3 SPECIMENS,27.0,17.55,1.1,27.0,88
HCPCS,82952,GTT EA ADD SPEC BEYOND 3,27.0,17.55,3.92,27.0,84
HCPCS,82953,GLUCOSE-TOLBUTAMIDE TEST,,,66.79,66.79,1
HCPCS,82955,GLUC-6-PHOSPHATE DEHYDROGENASE QUANTITATIVE,67.0,43.55,1.1,67.0,88
HCPCS,82955,GLUCOSE 6 PHOS DEHYD QT,67.0,43.55,4.79,67.0,84
HCPCS,82960,G6PD SCREEN,42.0,27.3,2.99,42.0,84
HCPCS,82960,GLUC-6-PHOSPHATE DEHYDROGENASE SCREEN,42.0,27.3,1.1,42.0,88
HCPCS,82962,GLUC BLD GLUC MNTR DEV CLEARED FDA SPEC HOME USE,23.0,14.95,1.1,23.0,88
HCPCS,82962,GLUC BLOOD TEST BY DVC (POINT OF CARE LAB),23.0,14.95,3.28,23.0,84
HCPCS,82962,GLUCOSE BLD BY MONIT DEV (POINT OF CARE LAB),23.0,14.95,3.28,23.0,84
HCPCS,82963,BETA-GLUCOSIDASE LEUK,148.0,96.2,10.61,148.0,84
HCPCS,82965,ASSAY OF GDH ENZYME,,,5.26,36.03,28
HCPCS,82965,Assay of gdh enzyme,,,18.15,21.01,8
HCPCS,82975,ASSAY OF GLUTAMINE,,,69.8,69.8,1
HCPCS,82977,%HCVSUR GLUTTRANS GAMMA,50.0,32.5,7.2,50.0,84
HCPCS,82977,%LIVFIB GGT,50.0,32.5,7.2,50.0,84
HCPCS,82977,%NASH GGT,50.0,32.5,7.2,50.0,84
HCPCS,82977,ASSAY OF GLUTAMYLTRASE GAMMA,50.0,32.5,1.1,50.0,88
HCPCS,82977,"GAMMA GLUTAMYL TRANSFERASE, FIBROMETER",50.0,32.5,7.2,50.0,84
HCPCS,82977,GGT ASSAY,50.0,32.5,7.2,50.0,84
HCPCS,82978,%GMAPS GLUTATHIONE,107.0,69.55,7.04,107.0,84
HCPCS,82978,GLUTATHIONE ASSAY,107.0,69.55,1.1,107.0,88
HCPCS,82978,GLUTATHIONE TOTAL,107.0,69.55,7.04,107.0,84
HCPCS,82979,ASSAY RBC GLUTATHIONE,,,4.66,30.29,28
HCPCS,82979,Assay rbc glutathione,,,11.75,13.61,8
HCPCS,82980,ASSAY OF GLUTETHIMIDE,,,80.83,80.83,1
HCPCS,82985,ALBUMIN GLYCATED,116.0,75.4,16.76,116.0,84
HCPCS,82985,ASSAY OF GLYCATED PROTEIN,116.0,75.4,1.1,116.0,172
HCPCS,82985,GLYCATED PROTEIN,116.0,75.4,16.76,116.0,84
HCPCS,82985,GLYCOPROTEINS,116.0,75.4,16.76,116.0,84
HCPCS,83001,GONADOTROPIN FOLLICLE STIMULATING HORMONE,128.0,83.2,1.1,128.0,88
HCPCS,83001,GONADOTROPIN FSH,128.0,83.2,18.58,128.0,84
HCPCS,83002,GONADOTROPIN LH,128.0,83.2,18.52,128.0,84
HCPCS,83002,GONADOTROPIN LUTEINIZING HORMONE,128.0,83.2,1.1,128.0,88
HCPCS,83002,"LH, PEDIATRIC",128.0,83.2,18.52,128.0,84
HCPCS,83002,LUTEINING HORMONE,128.0,83.2,18.52,128.0,84
HCPCS,83003,ASSAY OF GROWTH HORMONE HUMAN,115.0,74.75,1.1,115.0,88
HCPCS,83003,GROWTH HORMONE HUMAN,115.0,74.75,8.23,115.0,84
HCPCS,83006,GVHPRE GROWTH STIMULATION GENE 2,522.0,339.3,27.68,522.0,84
HCPCS,83006,GVHPST GROWTH STIMULATION GENE 2,522.0,339.3,27.68,522.0,84
HCPCS,83006,GVHSYM GROWTH STIMULATION GENE 2,522.0,339.3,27.68,522.0,84
HCPCS,83008,ASSAY OF GUANOSINE,,,74.0,74.0,1
HCPCS,83009,H PYLORI (C-13) BLOOD,,,33.26,377.67,28
HCPCS,83009,H pylori (c-13) blood,,,36.89,42.71,8
HCPCS,83010,%LIVFIB HAPTOGLOBIN QNT,87.0,56.55,6.21,87.0,84
HCPCS,83010,%NASH HAPTOGLOBIN QNT,87.0,56.55,6.21,87.0,84
HCPCS,83010,ASSAY OF HAPTOGLOBIN QUANTITATIVE,87.0,56.55,1.1,87.0,88
HCPCS,83010,HAPTOGLOBIN QUANT,87.0,56.55,6.21,87.0,84
HCPCS,83010,HAPTOGLOBIN QUANT ASSAY,87.0,56.55,6.21,87.0,84
HCPCS,83012,ASSAY OF HAPTOGLOBINS,,,10.76,73.68,28
HCPCS,83012,Assay of haptoglobins,,,20.86,24.16,8
HCPCS,83013,H.PYLORI BREATH TEST,465.0,302.25,33.26,465.0,84
HCPCS,83013,HPYLORI BREATH ANAL UREASE ACT NON-RADACT ISTOPE,465.0,302.25,1.1,465.0,88
HCPCS,83014,ADMIN DRUG H PYLORI (POINT OF CARE LAB),54.0,35.1,7.86,60.56,84
HCPCS,83014,HELICOBACTER PYLORI ; DRUG ADMINISTRATION,54.0,35.1,1.1,54.0,88
HCPCS,83015,HEAVY METAL QUAL ANY NUMBER,,,9.3,57.38,28
HCPCS,83015,Heavy metal qual any number,,,16.21,18.77,8
HCPCS,83018,ANTIMONY BLOOD,152.0,98.8,10.85,152.0,84
HCPCS,83018,ANTIMONY URINE,152.0,98.8,10.85,152.0,84
HCPCS,83018,IODIDE SERUM,152.0,98.8,10.85,152.0,84
HCPCS,83018,IODINE TOTAL URINE,152.0,98.8,10.85,152.0,84
HCPCS,83018,"IODINE, RANDOM URINE",152.0,98.8,10.85,152.0,84
HCPCS,83018,TIN,152.0,98.8,10.85,152.0,84
HCPCS,83018,TITANIUM SER/PLAS,152.0,98.8,10.85,152.0,84
HCPCS,83018,"TOXIC METAL, QUANT EA",152.0,98.8,10.85,152.0,84
HCPCS,83020,CSPNL HGB ELECTROPHORESIS,89.0,57.85,6.36,89.0,84
HCPCS,83020,HBSCN1 REFLEX,89.0,57.85,6.36,89.0,84
HCPCS,83020,HEMOGLOBIN ELECTROPHORESIS,,,7.49,7.49,2
HCPCS,83020,HEMOGLOBIN FRACT AND QUANT,89.0,57.85,6.36,89.0,84
HCPCS,83020,HEMOGLOBIN FRACTJ/QUANTJ ELECTROPHORESIS,163.0,105.95,1.1,163.0,218
HCPCS,8302026,HEMOGLOBIN ELECTROPHORESIS,,,7.49,7.49,2
HCPCS,83021,HEMOGLOBIN A2 ASCAA,125.0,81.25,8.48,125.0,84
HCPCS,83021,HEMOGLOBIN FRACTJ/QUANTJ CHROMOTOGRAPHY,125.0,81.25,1.1,125.0,88
HCPCS,83026,HEMOGLOBIN COPPER SULFATE,,,4.01,10.99,26
HCPCS,83026,Hemoglobin copper sulfate,,,8.48,9.82,8
HCPCS,83030,NEWBORN SCREEN,74.0,48.1,4.3,81.02,84
HCPCS,83033,%ACHFHB FETAL HB,55.0,35.75,3.2,55.0,84
HCPCS,83033,F(FETAL) QUAL,55.0,35.75,3.2,55.0,84
HCPCS,83033,HEMOGLOBIN F FETAL QUALITATIVE,55.0,35.75,1.1,55.0,88
HCPCS,83033,STOOL APT TEST,55.0,35.75,3.2,55.0,84
HCPCS,83036,HEMOGLOBIN GLYCOSYLATED A1C,67.0,43.55,1.1,67.0,88
HCPCS,83036,HGB A1C GLYCOSYLATED,67.0,43.55,9.71,67.0,84
HCPCS,83036,HGB A1C GLYCOSYLATED (POINT OF CARE LAB),67.0,43.55,9.71,67.0,84
HCPCS,83037,HB GLYCOSYLATED A1C HOME DEV,,,9.71,26.61,26
HCPCS,83037,HGB GLYCOSYLATED DEVICE CLEARED FDA HOME USE,67.0,43.55,1.1,67.0,88
HCPCS,83037,Hb glycosylated a1c home dev,,,11.75,13.61,8
HCPCS,83045,HGB METHEMOGLOBIN QUAL,,,2.6,21.82,28
HCPCS,83045,Hgb methemoglobin qual,,,11.75,13.61,8
HCPCS,83050,HEMOGLOBIN METHEMOGLOBIN QUANTITATIVE,57.0,37.05,1.1,57.0,88
HCPCS,83050,METHEMOGLOBIN QUANT,57.0,37.05,3.62,57.0,84
HCPCS,83050,METHEMOGLOBIN QUANT (POINT OF CARE LAB),57.0,37.05,3.62,57.0,84
HCPCS,83051,ASSAY OF HEMOGLOBIN PLASMA,50.0,32.5,1.1,50.0,88
HCPCS,83051,HEMOGLOBIN PLASMA,50.0,32.5,3.61,51.56,168
HCPCS,83051,HEMOGLOBIN SERUM (POINT OF CARE LAB),50.0,32.5,3.61,51.56,84
HCPCS,83051,HGB; PLASMA,50.0,32.5,3.61,51.56,84
HCPCS,83055,BLOOD SULFHEMOGLOBIN TEST,,,21.62,21.62,1
HCPCS,83060,HGB SULFHEMOGLOBIN QUAN,,,4.08,36.39,28
HCPCS,83060,Hgb sulfhemoglobin quan,,,11.75,13.61,8
HCPCS,83065,HEMOGLOBIN THERMOLABILE,,,3.6,30.29,28
HCPCS,83065,Hemoglobin thermolabile,,,11.75,13.61,8
HCPCS,83068,HEMOGLOBIN UNSTABLE ASCAA,65.0,42.25,4.18,65.0,84
HCPCS,83069,ASSAY OF HEMOGLOBIN URINE,27.0,17.55,1.1,27.0,88
HCPCS,83069,HEMOGLOBIN QUAL URINE,27.0,17.55,1.95,27.0,84
HCPCS,83070,ASSAY OF HEMOSIDERIN QUAL,33.0,21.45,1.1,33.0,88
HCPCS,83070,HEMOSIDERIN URINE,33.0,21.45,2.34,33.0,84
HCPCS,83071,ASSAY OF HEMOSIDERIN QUANT,,,30.22,30.22,1
HCPCS,83080,HEXOSAMINIDASE A & TOTAL X2,116.0,75.4,8.33,129.85,84
HCPCS,83080,MISC SENDOUT CPT 83080,116.0,75.4,8.33,129.85,84
HCPCS,83080,PROC CHEM UNL,116.0,75.4,8.33,129.85,84
HCPCS,83088,ASSAY OF HISTAMINE,204.0,132.6,1.1,204.0,88
HCPCS,83088,HISTAMINE,204.0,132.6,14.58,204.0,84
HCPCS,83090,ASSAY OF HOMOCYSTEINE,124.0,80.6,1.1,124.0,88
HCPCS,83090,HOMOCYSTEINE ASSAY,124.0,80.6,8.33,124.0,84
HCPCS,83090,HOMOCYSTINE UR QNT,124.0,80.6,8.33,124.0,84
HCPCS,83150,%GMAPS HVA,155.0,100.75,9.56,155.0,84
HCPCS,83150,%NEUR HVA,155.0,100.75,9.56,155.0,84
HCPCS,83150,HOMOVANILLIC ACID (HVA),155.0,100.75,9.56,155.0,84
HCPCS,83150,HOMOVANILLIC ACID URINE,155.0,100.75,9.56,155.0,84
HCPCS,83150,MISC SENDOUT CPT 83150,155.0,100.75,9.56,155.0,84
HCPCS,83491,%17-OHCORTICOSTEROIDS,124.0,80.6,8.66,134.89,84
HCPCS,83497,%NEUR 5-HIAA,89.0,57.85,6.37,99.26,84
HCPCS,83497,5 HIAA URINE,89.0,57.85,6.37,99.26,84
HCPCS,83497,"5-HIAA, PLASMA - LABCORP",89.0,57.85,6.37,99.26,84
HCPCS,83497,ASSAY OF HYDROXYINDOLACETIC ACID 5-HIAA,89.0,57.85,1.1,89.0,88
HCPCS,83498,%NEO 17 OH PROGESTERONE,187.0,121.55,13.42,187.0,84
HCPCS,83498,17-HYDROXYPROG QNT TIMED X2,187.0,121.55,13.42,187.0,84
HCPCS,83498,17-HYDROXYPROGESTERONE UR,187.0,121.55,13.42,187.0,84
HCPCS,83498,17-OH PROGESTERONE,187.0,121.55,13.42,187.0,84
HCPCS,83498,ASSAY OF HYDROXYPROGESTERONE 17-D,187.0,121.55,1.1,187.0,88
HCPCS,83498,CAHSP ASY HYDROXYPROGESTERONE 17-D,187.0,121.55,13.42,187.0,84
HCPCS,83499,Assay of progesterone 20-,,,111.21,111.21,1
HCPCS,83500,ASSAY FREE HYDROXYPROLINE,,,11.18,62.6,28
HCPCS,83500,Assay free hydroxyproline,,,22.0,25.48,8
HCPCS,83500,HYDROXYPROLINE FR UR,156.0,101.4,1.1,156.0,88
HCPCS,83505,ASSAY TOTAL HYDROXYPROLINE,,,12.0,66.58,29
HCPCS,83505,Assay total hydroxyproline,,,22.0,25.48,8
HCPCS,83505,HYDROXYPROLINE 24H U,168.0,109.2,1.1,168.0,88
HCPCS,83516,%ANCA C+P EIA X2,80.0,52.0,11.53,80.0,84
HCPCS,83516,%CELCMP TRANSGLUT IGA,80.0,52.0,11.53,80.0,84
HCPCS,83516,%RHEUMA IMMUNO X2,80.0,52.0,11.53,80.0,84
HCPCS,83516,%SENMOT IMMUNOASSAY,80.0,52.0,11.53,80.0,84
HCPCS,83516,%SENNRO IMMUNOASSAY,80.0,52.0,11.53,80.0,84
HCPCS,83516,*IMMUNOASSAY NONINF QUAL/SEMI,80.0,52.0,11.53,80.0,84
HCPCS,83516,ACESTR IMMUNOASSAY NONANTIBODY X2,80.0,52.0,11.53,80.0,84
HCPCS,83516,ACETYLCHOL REC MOD,80.0,52.0,11.53,80.0,84
HCPCS,83516,ALLOGEN AUTOANTIBODY,80.0,52.0,11.53,80.0,84
HCPCS,83516,ANCA - MPO/PR-3 X2,80.0,52.0,11.53,80.0,84
HCPCS,83516,ANTI ALPHA FODRIN AB IGA,80.0,52.0,11.53,80.0,84
HCPCS,83516,ANTI ALPHA FODRIN AB IGG,80.0,52.0,11.53,80.0,84
HCPCS,83516,ANTI ALPHA FODRIN AB IGG IGA X2,80.0,52.0,11.53,80.0,84
HCPCS,83516,ANTI AT1R AB DETERMINATION,80.0,52.0,11.53,80.0,84
HCPCS,83516,ANTI IGE,80.0,52.0,11.53,80.0,84
HCPCS,83516,ANTI-C1Q AB IGG,80.0,52.0,11.53,80.0,84
HCPCS,83516,ANTI-CN-1A (NT5C1A) IBM,80.0,52.0,11.53,80.0,84
HCPCS,83516,ANTI-HMGCR AUTO AB,80.0,52.0,11.53,80.0,84
HCPCS,83516,"ANTI-SP100 AND ANTI-GP210 ANTIBODIES, IGG",80.0,52.0,11.53,80.0,84
HCPCS,83516,ANTIBODY IMMUNOASSAY (POLMYO),80.0,52.0,11.53,80.0,84
HCPCS,83516,AT1R-ANTIBODY-REFERENCE SAMPLE,80.0,52.0,11.53,80.0,84
HCPCS,83516,"BULLOUS PEMPHIGOID, BP180 AND BP230, IGG ANTIBODIES",80.0,52.0,11.53,80.0,84
HCPCS,83516,DERMATOMYOSITIS PANEL,80.0,52.0,11.53,80.0,84
HCPCS,83516,DERMATOMYOSITIS PANEL X6,80.0,52.0,11.53,80.0,84
HCPCS,83516,GANGLIOSIDE ABS X2,80.0,52.0,11.53,80.0,84
HCPCS,83516,GANGLIOSIDE ABS X6,80.0,52.0,11.53,80.0,84
HCPCS,83516,GBMGP IMMUNOASSAY NONANTIBODY,80.0,52.0,11.53,80.0,84
HCPCS,83516,GLOM BASE MEM AB IGG,80.0,52.0,11.53,80.0,84
HCPCS,83516,GM1 ANTIBODY PANEL X2,80.0,52.0,11.53,80.0,84
HCPCS,83516,HSP-70 AB,80.0,52.0,11.53,80.0,84
HCPCS,83516,HYDROXYLASE-21 AB,80.0,52.0,11.53,80.0,84
HCPCS,83516,IMMUNOASSAY (MYOSPL),80.0,52.0,11.53,80.0,84
HCPCS,83516,IMMUNOASSAY NONANTIBODY,80.0,52.0,11.53,80.0,84
HCPCS,83516,MAG ANTIBODY IGM,80.0,52.0,11.53,80.0,84
HCPCS,83516,NEURONAL ABS IGG,80.0,52.0,11.53,80.0,84
HCPCS,83516,NS6S ANTIBODY,80.0,52.0,11.53,80.0,84
HCPCS,83516,"PT AB, IGG",80.0,52.0,11.53,80.0,84
HCPCS,83516,RIBPRO IMMUNO NON AB,80.0,52.0,11.53,80.0,84
HCPCS,83516,RNA POLYMER III IGG,80.0,52.0,11.53,80.0,84
HCPCS,83516,SENMOT IMMUNOASSAY (ARUP),80.0,52.0,11.53,80.0,84
HCPCS,83516,SENNRO IMMUNOASSAY (ARUP),80.0,52.0,11.53,80.0,84
HCPCS,83516,SGPG ANTIBODY IGM,80.0,52.0,11.53,80.0,84
HCPCS,83516,TH/TO ANTIBODY,80.0,52.0,11.53,80.0,84
HCPCS,83516,TYSABRI ANTIBODIES,80.0,52.0,11.53,80.0,84
HCPCS,83518,IMMUNOASSAY DIPSTICK,,,4.19,37.3,28
HCPCS,83518,Immunoassay dipstick,,,11.75,13.61,8
HCPCS,83519,%CEPHAL IA/RIA,127.0,82.55,7.36,127.0,84
HCPCS,83519,%LAMBRT IA;QNT RIA X4 MOD,127.0,82.55,7.36,127.0,84
HCPCS,83519,%MYGRAV ACHR ABX2,127.0,82.55,7.36,127.0,84
HCPCS,83519,%PARNEO AB BIND X2 MOD,127.0,82.55,7.36,127.0,84
HCPCS,83519,*IMMUNOASSAY NONINF QUANT RIA,127.0,82.55,7.36,127.0,84
HCPCS,83519,21 HYDROXYLASE AB,127.0,82.55,7.36,127.0,84
HCPCS,83519,ACESTR RIA NONANTIBODY,127.0,82.55,7.36,127.0,84
HCPCS,83519,ACETYLCHOL REC MOD,127.0,82.55,7.36,127.0,84
HCPCS,83519,ACH RECEPT BIND AB RFLX,127.0,82.55,7.36,127.0,84
HCPCS,83519,ADIPONECTIN,127.0,82.55,7.36,127.0,84
HCPCS,83519,AIDYSA RIA NONAB,127.0,82.55,7.36,127.0,84
HCPCS,83519,ENCSER RIA NON AB X3,127.0,82.55,7.36,127.0,84
HCPCS,83519,GANGLIONIC ACHR AUTOAB,127.0,82.55,7.36,127.0,84
HCPCS,83519,GANGLIONIC NACHR ANTIBOD,127.0,82.55,7.36,127.0,84
HCPCS,83519,IGF BINDING PROTEIN 2,127.0,82.55,7.36,127.0,84
HCPCS,83519,IGF-II INSULIN LIKE GR,127.0,82.55,7.36,127.0,84
HCPCS,83519,IMMUNOASSAY,127.0,82.55,7.36,127.0,84
HCPCS,83519,INTERLEUKIN 4,127.0,82.55,7.36,127.0,84
HCPCS,83519,MELANOCYTE STIM HORMONE ALP,127.0,82.55,7.36,127.0,84
HCPCS,83519,"MG/LES EVAL, SER",127.0,82.55,7.36,127.0,84
HCPCS,83519,MUSCLE MODULATING AB,127.0,82.55,7.36,127.0,84
HCPCS,83519,MUSK ANTIBODY,127.0,82.55,7.36,127.0,84
HCPCS,83519,MYASTHENIA GRAVIS EVAL,127.0,82.55,7.36,127.0,84
HCPCS,83519,NEURO VG K CHAN ABS MOD,127.0,82.55,7.36,127.0,84
HCPCS,83519,"OREXIN A, SPINAL FLUID (ORXCSF)",127.0,82.55,7.36,127.0,84
HCPCS,83519,PANCREASTATIN,127.0,82.55,7.36,127.0,84
HCPCS,83519,PANCREATIC POLYPE,127.0,82.55,7.36,127.0,84
HCPCS,83519,PROCOL TYPEL N TARMINAL,127.0,82.55,7.36,127.0,84
HCPCS,83519,TRYPSINOGEN,127.0,82.55,7.36,127.0,84
HCPCS,83519,VOLTAGE-GATED CAL IGG AB,127.0,82.55,7.36,127.0,84
HCPCS,83519,VOLTAGE-GATED KCHANNEL AB,127.0,82.55,7.36,127.0,84
HCPCS,83520,%ADALZ IMMUNOASSAY QNT,119.0,77.35,6.91,119.0,84
HCPCS,83520,%CEPHAL IA QNTNOS NONABX4,119.0,77.35,6.91,119.0,84
HCPCS,83520,%CEPLUS IMMUNOASSAY X3,119.0,77.35,6.91,119.0,84
HCPCS,83520,%CROHN ELISA X5,119.0,77.35,6.91,119.0,84
HCPCS,83520,%FSII IMMUNO QUANT,119.0,77.35,6.91,119.0,84
HCPCS,83520,%INHAB IMMUNO QT,119.0,77.35,6.91,119.0,84
HCPCS,83520,%LAMBRT IMMUNASSY QNT;NOS,119.0,77.35,6.91,119.0,84
HCPCS,83520,%MULNEU IMMUN QNT NOS NONAB,119.0,77.35,6.91,119.0,84
HCPCS,83520,%MYGRAV STRIATIONAL AB,119.0,77.35,6.91,119.0,84
HCPCS,83520,%PARNEO STRIATIONAL AB,119.0,77.35,6.91,119.0,84
HCPCS,83520,%SENNRO SENSRY NEU IMMX6,119.0,77.35,6.91,119.0,84
HCPCS,83520,*IMMUNOASSAY QUANT NOS,119.0,77.35,6.91,119.0,84
HCPCS,83520,"14.3.3 ETA PROTEIN, SER",119.0,77.35,6.91,119.0,84
HCPCS,83520,ADAMTS13 ANTIBODY,119.0,77.35,6.91,119.0,84
HCPCS,83520,ADIPONECTIN,119.0,77.35,6.91,119.0,168
HCPCS,83520,ADMARK PHOS TAU CSF X3,119.0,77.35,6.91,119.0,84
HCPCS,83520,AIDYSA IMMUNO QNT NOS NONAB,119.0,77.35,6.91,119.0,84
HCPCS,83520,ANIT-ALPHA FODRIN AB X2,119.0,77.35,6.91,119.0,84
HCPCS,83520,ANTI IGE,119.0,77.35,6.91,119.0,84
HCPCS,83520,ANTI MULLERIAN HORMONE,119.0,77.35,6.91,119.0,84
HCPCS,83520,"ANTI-ALPHA FODRIN AB, IGA",119.0,77.35,6.91,119.0,84
HCPCS,83520,"ANTI-ALPHA FODRIN AB, IGG",119.0,77.35,6.91,119.0,84
HCPCS,83520,ANTI-IGA ANTIBODY,119.0,77.35,6.91,119.0,84
HCPCS,83520,ATOPIC IMMUNO QNT NONAB,119.0,77.35,6.91,119.0,84
HCPCS,83520,CAR AUTOANTIBODY,119.0,77.35,6.91,119.0,84
HCPCS,83520,COLLAGEN TYPE II AB,119.0,77.35,6.91,119.0,84
HCPCS,83520,"CV2 AB IGG CBA-IFA SCREEN, SERUM",119.0,77.35,6.91,119.0,84
HCPCS,83520,"CXCL9 QUANTITATION, SERUM",119.0,77.35,6.91,119.0,84
HCPCS,83520,CYTOKINE PANEL,119.0,77.35,6.91,119.0,84
HCPCS,83520,EOSINOPHIL CATIONIC PROT,119.0,77.35,6.91,119.0,84
HCPCS,83520,GALOP AUTOANTIBODY X2,119.0,77.35,6.91,119.0,84
HCPCS,83520,GANGLIOSIDE ABS MAYO X6,119.0,77.35,6.91,119.0,84
HCPCS,83520,GM1 TRIAD AUTO AB X4,119.0,77.35,6.91,119.0,84
HCPCS,83520,GQ1B AUTOANTIBODY,119.0,77.35,6.91,119.0,84
HCPCS,83520,GROWTH DIFF FACTOR 15,119.0,77.35,6.91,119.0,84
HCPCS,83520,GVHPRE IMMUNOASSAY QUANT NOS NONAB,119.0,77.35,6.91,119.0,84
HCPCS,83520,GVHPST IMMUNOASSAY QUANT NOS NONAB,119.0,77.35,6.91,119.0,84
HCPCS,83520,GVHSYM IMMUNOASSAY QUANT NOS NONAB,119.0,77.35,6.91,119.0,84
HCPCS,83520,HU AUTOANTIBODY,119.0,77.35,6.91,119.0,84
HCPCS,83520,HUMAN ANTI-MOUSE AB (HAMA),119.0,77.35,6.91,119.0,168
HCPCS,83520,HUMAN TGB-B1,119.0,77.35,6.91,119.0,84
HCPCS,83520,IBDSGI ELISA X6,119.0,77.35,6.91,119.0,84
HCPCS,83520,IMMUNOASSAY QUANT NOS NONAB,119.0,77.35,6.91,119.0,168
HCPCS,83520,INHIBIN B,119.0,77.35,6.91,119.0,168
HCPCS,83520,INTERLEUKIN 2,119.0,77.35,6.91,119.0,84
HCPCS,83520,INTERLEUKIN 2 RECEPTOR,119.0,77.35,6.91,119.0,84
HCPCS,83520,INTERLEUKIN 4,119.0,77.35,6.91,119.0,168
HCPCS,83520,INTERLEUKIN 5,119.0,77.35,6.91,119.0,84
HCPCS,83520,INTERLEUKIN 6,119.0,77.35,6.91,119.0,84
HCPCS,83520,LEPTIN,119.0,77.35,6.91,119.0,84
HCPCS,83520,MANNOSE BINDING PROTEIN,119.0,77.35,6.91,119.0,84
HCPCS,83520,MATRIX METALLOPRO-9 MMP-9,119.0,77.35,6.91,119.0,84
HCPCS,83520,MCROHN IMM QNT NOS NONAB,119.0,77.35,6.91,119.0,84
HCPCS,83520,MELATONIN,119.0,77.35,6.91,119.0,84
HCPCS,83520,NEOPTERIN BLD/CSF,119.0,77.35,6.91,119.0,84
HCPCS,83520,NEOSEN NEURO PARANEO X3,119.0,77.35,6.91,119.0,84
HCPCS,83520,"NERUON SPEC ENOLASE, SER",119.0,77.35,6.91,119.0,84
HCPCS,83520,NEUROFILAMENT LIGHT (NFL),119.0,77.35,6.91,119.0,84
HCPCS,83520,NEURON SPECIFIC ENO CSF,119.0,77.35,6.91,119.0,84
HCPCS,83520,"NITROGEN, URINE 24 HR",119.0,77.35,6.91,119.0,84
HCPCS,83520,OXIDIZED LDL,119.0,77.35,6.91,119.0,84
HCPCS,83520,"PAN.ELASTASE, FECAL",119.0,77.35,6.91,119.0,84
HCPCS,83520,"PHOSPHOLIPASE A2 RECEPTOR AB, ELISA, SERUM",119.0,77.35,6.91,119.0,84
HCPCS,83520,PHOSPHOLIPASE A2 RECEPTOR IGG ANTIBODY ELISA,119.0,77.35,6.91,119.0,84
HCPCS,83520,PLASMIN ACT INHIBITOR AG,119.0,77.35,6.91,119.0,84
HCPCS,83520,"PRIMARY MEMBRANOUS NEPHROPATHY DIAG CASCADE, SER",119.0,77.35,6.91,119.0,84
HCPCS,83520,RECOMBX MA TA AUTOAB,119.0,77.35,6.91,119.0,84
HCPCS,83520,RI AUTOANTIBODY,119.0,77.35,6.91,119.0,84
HCPCS,83520,RIBOSOMAL P PROTEIN IGG,119.0,77.35,6.91,119.0,84
HCPCS,83520,SENMOT IMMUNOASSAY X11,119.0,77.35,6.91,119.0,84
HCPCS,83520,SULFATIDE AUTOANTIBODYX2,119.0,77.35,6.91,119.0,84
HCPCS,83520,TRYPSINOGEN,119.0,77.35,6.91,119.0,84
HCPCS,83520,TUMOR NECROSIS SERUM,119.0,77.35,6.91,119.0,84
HCPCS,83520,UFLCKL IMMUNO QNT NOS NAB,119.0,77.35,6.91,119.0,84
HCPCS,83520,"USTEKINUMAB AB, S",119.0,77.35,6.91,119.0,84
HCPCS,83520,VASC ENDO GROWTH FACT,119.0,77.35,6.91,119.0,84
HCPCS,83520,YO AUTOANTIBODY,119.0,77.35,6.91,119.0,84
HCPCS,83521,IMMUNOGL LT CHNS FR EA,119.0,77.35,6.91,119.0,84
HCPCS,83525,ASSAY OF INSULIN TOTAL,79.0,51.35,1.1,79.0,88
HCPCS,83525,INSULIN ASSAY,79.0,51.35,5.64,79.0,84
HCPCS,83527,ASSAY OF INSULIN FREE,89.0,57.85,1.1,89.0,88
HCPCS,83527,INSULIN FREE,89.0,57.85,6.39,99.71,84
HCPCS,83528,ASSAY OF INTRINSIC FACTOR,,,7.93,61.84,29
HCPCS,83528,Assay of intrinsic factor,,,18.15,21.01,8
HCPCS,83529,"ADALIMUMAB, SERUM",119.0,77.35,6.91,119.0,84
HCPCS,83529,ASSAY OF INTERLEUKIN-6 (IL-6),119.0,77.35,6.91,119.0,84
HCPCS,83529,CYTOKP INTERLEUKIN-6,119.0,77.35,6.91,119.0,84
HCPCS,83540,*FE ASSAY,45.0,29.25,3.2,45.0,84
HCPCS,83540,ASSAY OF IRON,45.0,29.25,1.1,45.0,88
HCPCS,83540,FE ASSAY,45.0,29.25,3.2,45.0,84
HCPCS,83550,*FE BINDING CAPACITY,60.0,39.0,4.32,60.0,84
HCPCS,83550,IRON BINDING CAPACITY,60.0,39.0,1.1,60.0,88
HCPCS,83570,ASSAY OF IDH ENZYME,,,4.37,38.95,28
HCPCS,83570,Assay of idh enzyme,,,11.75,13.61,8
HCPCS,83582,ASSAY OF KETOGENIC STEROIDS,,,7.0,62.5,28
HCPCS,83582,Assay of ketogenic steroids,,,22.0,25.48,8
HCPCS,83586,%U17K 17KETOSTEROIDS 24UR,88.0,57.2,6.32,88.0,84
HCPCS,83586,KETOSTEROID TOT 24HU,88.0,57.2,1.1,88.0,88
HCPCS,83593,FRACTIONATION KETOSTEROIDS,,,12.99,109.25,29
HCPCS,83593,Fractionation ketosteroids,,,22.0,25.48,8
HCPCS,83593,KETOSTEROID FRACT UR,197.0,128.05,1.1,197.0,88
HCPCS,83605,%GMAPS LACTATE,80.0,52.0,11.57,80.0,84
HCPCS,83605,ASSAY LACTIC ACID,80.0,52.0,11.57,80.0,84
HCPCS,83605,ASSAY LACTIC ACID (POINT OF CARE LAB),80.0,52.0,11.57,80.0,84
HCPCS,83605,ASSAY OF LACTATE,80.0,52.0,1.1,80.0,88
HCPCS,83605,ASSAY OF LACTIC ACID,80.0,52.0,11.57,80.0,84
HCPCS,83605,LACTATE (LACTIC ACID),80.0,52.0,11.57,80.0,84
HCPCS,83605,LACTATE(LACTIC ACID),80.0,52.0,11.57,80.0,84
HCPCS,83615,LAC (LD)(LDH),42.0,27.3,2.98,42.0,168
HCPCS,83615,LACTATE DEHYDROGENASE LDH,42.0,27.3,1.1,42.0,88
HCPCS,83625,%LDISO LD ISOENZYMES,88.0,57.2,6.32,88.0,84
HCPCS,83625,LD ISOENZYMES,88.0,57.2,1.1,88.0,88
HCPCS,83630,"IMMUNOASSAY, LACTOFERRIN, FECAL, QUALITATIVE",136.0,88.4,9.7,136.0,84
HCPCS,83630,"LACTOFERRIN, FECAL",136.0,88.4,9.7,136.0,84
HCPCS,83631,LACTOFERRIN FECAL (QUANT),,,9.7,100.72,28
HCPCS,83631,Lactoferrin fecal (quant),,,18.15,21.01,8
HCPCS,83632,HUMAN PLACENTAL LACTOGEN,140.0,91.0,9.99,140.0,84
HCPCS,83632,PLACENTA LACTOGEN BL,140.0,91.0,1.1,140.0,88
HCPCS,83633,TEST URINE FOR LACTOSE,,,4.5,30.83,28
HCPCS,83633,Test urine for lactose,,,18.15,21.01,8
HCPCS,83634,ASSAY OF URINE FOR LACTOSE,,,32.77,32.77,1
HCPCS,83655,%OSHA LEAD,84.0,54.6,12.11,84.0,84
HCPCS,83655,%UTXM3 LEAD,84.0,54.6,12.11,84.0,84
HCPCS,83655,%UTXM4 LEAD,84.0,54.6,12.11,84.0,84
HCPCS,83655,ASSAY OF LEAD,84.0,54.6,1.1,84.0,88
HCPCS,83655,LEAD CONCENTRATION,84.0,54.6,12.11,84.0,84
HCPCS,83655,LEAD UR 24HR,84.0,54.6,12.11,84.0,84
HCPCS,83661,L/S RATIO,152.0,98.8,10.86,152.0,84
HCPCS,83661,L/S RATIO AMNIO FL,152.0,98.8,1.1,152.0,88
HCPCS,83662,FOAM STABILITY FETAL LUNG,,,9.34,66.85,28
HCPCS,83662,Foam stability fetal lung,,,18.15,21.01,8
HCPCS,83663,FLUORO POLARIZE FETAL LUNG,,,9.34,51.81,28
HCPCS,83663,Fluoro polarize fetal lung,,,18.15,21.01,8
HCPCS,83664,FETAL LUNG MATURITY LAMELLAR BODY DENSITY,133.0,86.45,1.1,133.0,88
HCPCS,83664,LAMELLAR BODY COUNT,133.0,86.45,9.34,133.0,84
HCPCS,83670,ASSAY LAP ENZYME,68.0,44.2,1.1,68.0,88
HCPCS,83670,LEUCINE AMINOPEP LAP SER,68.0,44.2,4.52,68.0,84
HCPCS,83690,ASSAY OF LIPASE,48.0,31.2,1.1,48.0,88
HCPCS,83690,LIPASE ASSAY,48.0,31.2,3.4,48.0,84
HCPCS,83695,ASSAY OF LIPOPROTEIN(A),99.0,64.35,1.1,99.0,88
HCPCS,83695,LP (A),99.0,64.35,6.39,99.0,84
HCPCS,83698,LIPOPROTEIN (LP-PLA2) ASSAY,320.0,208.0,18.52,320.0,84
HCPCS,83698,LIPOPROTEIN-ASSOCIATED PHOSPHOLIPASE A2,320.0,208.0,1.1,320.0,88
HCPCS,83698,LP-PLA2 ACTIVITY,320.0,208.0,18.52,320.0,84
HCPCS,83700,LIPOPROTEIN BLOOD ELECTROPHORECTIC SEP&QUAN,78.0,50.7,1.1,78.0,88
HCPCS,83700,LIPOPROTEIN ELECTROPHOR,78.0,50.7,5.56,78.0,84
HCPCS,83701,%VAP ULTRACENRIF LIPOPTN,234.0,152.1,13.54,234.0,84
HCPCS,83701,HDL CHOL SUBFRACTIONS,234.0,152.1,13.54,234.0,84
HCPCS,83704,*LIPOPROTEIN MR SPECTROSCOPY,236.0,153.4,15.58,236.0,84
HCPCS,83704,LIPOPROTEIN BLOOD QUAN NUMBERS & SUBCLASSES,236.0,153.4,1.1,236.0,88
HCPCS,83704,NMRLIPO PARTICLE QT,236.0,153.4,15.58,236.0,84
HCPCS,83718,HDL CHOLESTEROL DIR ASSAY,57.0,37.05,7.93,57.0,84
HCPCS,83718,LIPOPROTEIN DIR MEAS HIGH DENSITY CHOLESTEROL,57.0,37.05,1.1,57.0,88
HCPCS,83719,ASSAY OF BLOOD LIPOPROTEIN,,,5.74,51.23,28
HCPCS,83719,Assay of blood lipoprotein,,,18.15,21.01,8
HCPCS,83721,LDL CHOLESTE,72.0,46.8,10.5,72.0,84
HCPCS,83721,LIPOPROTEIN DIRECT MEASUREMENT LDL CHOLESTEROL,72.0,46.8,1.1,72.0,88
HCPCS,83721,OXIDIZED LOW-DENSITY LIPOPROTEIN (OXLDL),72.0,46.8,10.5,72.0,84
HCPCS,83722,LIPOPRTN DIR MEAS SD LDL CHL,,,14.02,93.68,28
HCPCS,83722,Lipoprtn dir meas sd ldl chl,,,20.86,24.16,8
HCPCS,83727,ASSAY OF LRH HORMONE,,,8.49,75.88,28
HCPCS,83727,Assay of lrh hormone,,,22.0,25.48,8
HCPCS,83735,%STCATH MAGNESIUM,46.0,29.9,3.31,46.0,84
HCPCS,83735,ASSAY OF MAGNESIUM,46.0,29.9,1.1,46.0,88
HCPCS,83735,MAG ASSAY,46.0,29.9,3.31,46.0,84
HCPCS,83735,MAGNESIUM RBC,46.0,29.9,3.31,46.0,84
HCPCS,83735,MAGNESIUM STOOL,46.0,29.9,3.31,46.0,84
HCPCS,83735,"SSAT24 MAGNESIUM, UR",46.0,29.9,3.31,46.0,84
HCPCS,83735,STCATH ASSAY OF MAGNESIUM,46.0,29.9,3.31,46.0,84
HCPCS,83775,ASSAY MALATE DEHYDROGENASE,,,3.64,32.44,28
HCPCS,83775,Assay malate dehydrogenase,,,11.75,13.61,8
HCPCS,83785,MANGANESE BLOOD,184.0,119.6,12.15,184.0,84
HCPCS,83785,MANGANESE SERUM,184.0,119.6,12.15,184.0,84
HCPCS,83785,MANGANESE URINE,184.0,119.6,12.15,184.0,84
HCPCS,83788,MASS SPECTROMETRY QUAL,,,139.04,139.04,1
HCPCS,83789,"%CDG MS, MS/MS",166.0,107.9,9.64,166.0,84
HCPCS,83789,%GMAPS MASS SPEC,166.0,107.9,9.64,166.0,84
HCPCS,83789,"%NCDG MS, MS/MS",166.0,107.9,9.64,166.0,84
HCPCS,83789,%UPURIN MS QUANT X3,166.0,107.9,9.64,166.0,84
HCPCS,83789,*MASS SPECTRMTRY QUANT EA,166.0,107.9,9.64,166.0,84
HCPCS,83789,ATMS MASS SPEC QUAL,166.0,107.9,9.64,166.0,84
HCPCS,83789,BILE ACIDS FRACTIONATED,166.0,107.9,9.64,166.0,84
HCPCS,83789,"GFR, RENAL FUNCTION",166.0,107.9,9.64,166.0,84
HCPCS,83789,MASS SPECT&TANDEM MASS SPECT NONDRG ANAL NES EA,166.0,107.9,1.1,166.0,88
HCPCS,83789,PLTHY MASS SPEC QUANT,166.0,107.9,9.64,166.0,84
HCPCS,83789,SILVER UR QUANT,166.0,107.9,9.64,166.0,84
HCPCS,83789,TETRAHYDROBIO NECPT CFS,166.0,107.9,9.64,166.0,84
HCPCS,83805,ASSAY OF MEPROBAMATE,,,77.72,77.72,1
HCPCS,83825,%UTXM3 MERCURY,112.0,72.8,8.03,112.0,84
HCPCS,83825,%UTXM4 MERCURY,112.0,72.8,8.03,112.0,84
HCPCS,83825,ASSAY OF MERCURY QUANTITATIVE,112.0,72.8,1.1,112.0,88
HCPCS,83825,MERCURY QUANT,112.0,72.8,8.03,112.0,84
HCPCS,83825,MERCURY URINE,112.0,72.8,8.03,112.0,84
HCPCS,83835,METANEPHRINES URINE,117.0,76.05,8.37,130.46,84
HCPCS,83840,ASSAY OF METHADONE,,,28.71,28.71,1
HCPCS,83857,ASSAY OF METHEMALBUMIN,,,5.3,179.72,28
HCPCS,83857,Assay of methemalbumin,,,11.75,13.61,8
HCPCS,83857,METHEMALBUMIN BLD,74.0,48.1,1.1,74.0,88
HCPCS,83858,ASSAY OF METHSUXIMIDE,,,65.27,65.27,1
HCPCS,83861,MICROFLUID ANALY TEARS,,,8.99,61.6,28
HCPCS,83861,MICROFLUID ANALYSIS TEAR OSMOLARITY,155.0,100.75,1.1,155.0,88
HCPCS,83861,Microfluid analy tears,,,18.15,21.01,8
HCPCS,83864,MUCOPOLYSACCHARIDES MG/MMOL CRT,197.0,128.05,11.4,197.0,84
HCPCS,83864,MUCOPOLYSACCHARIDES QT,197.0,128.05,11.4,197.0,84
HCPCS,83864,UMPSSC MUCOPOLYSACCHARIDE,197.0,128.05,11.4,197.0,84
HCPCS,83866,MUCOPOLYSACCHARIDES SCREEN,,,43.39,43.39,1
HCPCS,83872,MUCIN SYNOVIAL FLUID,40.0,26.0,2.9,40.0,84
HCPCS,83872,ROUTINE SYNOVIAL FL,40.0,26.0,1.1,40.0,88
HCPCS,83873,MYELIN BASIC PROTEIN,119.0,77.35,8.5,119.0,84
HCPCS,83873,MYELIN BASIC PROTEIN CEREBROSPINAL FLUID,119.0,77.35,1.1,119.0,88
HCPCS,83874,MYOGLOBIN,89.0,57.85,1.1,89.0,88
HCPCS,83874,MYOGLOBIN BLOOD,89.0,57.85,6.38,89.0,84
HCPCS,83874,MYOGLOBIN URINE,89.0,57.85,6.38,89.0,84
HCPCS,83876,MYELOPEROXIDASE (MPO),351.0,228.15,20.34,351.0,84
HCPCS,83876,MYELOPEROXIDASE MPO,351.0,228.15,1.1,351.0,88
HCPCS,83880,B-TUP NATRIURETC PEPTIDE (POINT OF CARE LAB),271.0,176.15,20.86,271.0,84
HCPCS,83880,NATRIURETIC PEPTIDE,271.0,176.15,1.1,271.0,88
HCPCS,83880,NATRIURETIC PEPTIDE ASSAY,271.0,176.15,20.86,271.0,84
HCPCS,83880,NT PRO BNP,271.0,176.15,20.86,271.0,84
HCPCS,83883,%FSII NEPHELOMETRY EA,94.0,61.1,6.72,94.0,84
HCPCS,83883,%LIVFIB NEPHELOMETRY,94.0,61.1,6.72,94.0,84
HCPCS,83883,%NASH NEPHELOMETRY,94.0,61.1,6.72,94.0,84
HCPCS,83883,*NEPHELOMETRY ASSAY EA NOS,94.0,61.1,6.72,94.0,84
HCPCS,83883,ASSAY OF NEPHELOMETRY EACH ANALYTE NES,94.0,61.1,1.1,94.0,88
HCPCS,83883,CHRONIC VIRAL HEPATITIS NEPHELOMETRY (ARUP),94.0,61.1,6.72,94.0,84
HCPCS,83883,"KAPLAM, FREE URX2",94.0,61.1,6.72,94.0,84
HCPCS,83883,KAPPA & LAMBDA SERUM X2,94.0,61.1,6.72,94.0,84
HCPCS,83883,"KAPPA FREE, URINE",94.0,61.1,6.72,94.0,84
HCPCS,83883,KAPPA/LAMDA FR LT CH UR,94.0,61.1,6.72,94.0,84
HCPCS,83883,"LAMBDA FREE, URINE",94.0,61.1,6.72,94.0,84
HCPCS,83883,RETINOL BINDING PROTEIN,94.0,61.1,6.72,94.0,84
HCPCS,83883,UBJP NON SPEC NEPHELOMETRY X2,94.0,61.1,6.72,94.0,84
HCPCS,83884,NEUROFILAMENT LIGHT (NFL),119.0,77.35,33.08,134.88,76
HCPCS,83885,NICKEL SERUM,169.0,109.85,12.1,169.0,84
HCPCS,83887,ASSAY OF NICOTINE,,,53.0,53.0,1
HCPCS,83890,MOLECULE ISOLATE,,,110.4,110.4,1
HCPCS,83891,MOLECULE ISOLATE NUCLEIC,,,125.96,125.96,1
HCPCS,83892,MOLECULAR DIAGNOSTICS,,,42.16,42.16,1
HCPCS,83893,MOLECULE DOT/SLOT/BLOT,,,89.14,89.14,1
HCPCS,83894,MOLECULE GEL ELECTROPHOR,,,77.32,77.32,1
HCPCS,83896,MOLECULAR DIAGNOSTICS,,,33.27,33.27,1
HCPCS,83897,MOLECULE NUCLEIC TRANSFER,,,128.08,128.08,1
HCPCS,83898,MOLECULE NUCLEIC AMPLI EACH,,,175.82,175.82,1
HCPCS,83900,MOLECULE NUCLEIC AMPLI 2 SEQ,,,216.58,216.58,1
HCPCS,83901,MOLECULE NUCLEIC AMPLI ADDON,,,58.33,58.33,1
HCPCS,83902,MOLECULAR DIAGNOSTICS,,,121.09,121.09,1
HCPCS,83903,MOLECULE MUTATION SCAN,,,178.99,178.99,1
HCPCS,83904,MOLECULE MUTATION IDENTIFY,,,73.29,73.29,1
HCPCS,83905,MOLECULE MUTATION IDENTIFY,,,14.77,14.77,1
HCPCS,83906,MOLECULE MUTATION IDENTIFY,,,188.8,188.8,1
HCPCS,83907,LYSE CELLS FOR NUCLEIC EXT,,,80.4,80.4,1
HCPCS,83908,NUCLEIC ACID SIGNAL AMPLI,,,85.99,85.99,1
HCPCS,83909,NUCLEIC ACID HIGH RESOLUTE,,,554.03,554.03,1
HCPCS,83912,GENETIC EXAMINATION,,,134.73,134.73,1
HCPCS,83913,MOLECULAR RNA STABILIZATION,,,77.2,77.2,1
HCPCS,83914,MUTATION IDENT OLA/SBCE/ASPE,,,41.01,41.01,1
HCPCS,83915,NUCLEOTIDASE-5,77.0,50.05,5.51,77.0,84
HCPCS,83916,OLIGOCLONAL BAND TEST,189.0,122.85,10.96,189.0,84
HCPCS,83916,OLIGOCLONAL IMMUNE,189.0,122.85,1.1,189.0,88
HCPCS,83918,%UORA ORG ACIDS UR QNT,163.0,105.95,9.44,163.0,84
HCPCS,83918,METABOLIC COMPLETE U,163.0,105.95,1.1,163.0,88
HCPCS,83918,ORGANIC ACIDS QUANT EA,163.0,105.95,9.44,163.0,84
HCPCS,83919,%GMAPS ORGANIC ACIDS QL,114.0,74.1,8.12,126.71,84
HCPCS,83919,"ORGANIC ACID, UR",114.0,74.1,8.12,126.71,84
HCPCS,83921,%ANEMIA ORG ACIDS X2,146.0,94.9,8.48,146.0,84
HCPCS,83921,%ANEMIA ORGANIC ADID QT,146.0,94.9,8.48,146.0,84
HCPCS,83921,3 METHYLGLUTACONIC ACID,146.0,94.9,8.48,146.0,84
HCPCS,83921,3-METHYLGLUTACONIC ACID,146.0,94.9,8.48,146.0,84
HCPCS,83921,METHYLMALONIC ACID BL,146.0,94.9,8.48,146.0,84
HCPCS,83921,METHYLMALONIC ACID URINE,146.0,94.9,8.48,146.0,84
HCPCS,83921,ORGANIC ACID SINGLE QUANT,146.0,94.9,1.1,146.0,88
HCPCS,83921,ORGANIC ACID SNGL QUANT,146.0,94.9,8.48,146.0,84
HCPCS,83921,ORGANIC ACID SNGL QUANT-LABCORP,146.0,94.9,8.48,146.0,84
HCPCS,83925,ASSAY OF OPIATES,,,48.79,48.79,1
HCPCS,83930,ASSAY OF OSMOLALITY BLOOD,46.0,29.9,1.1,46.0,88
HCPCS,83930,OSMOLALITY BLOOD ASSAY,46.0,29.9,3.26,46.0,84
HCPCS,83930,"OSMOLALITY, BODY FLUID",46.0,29.9,3.26,46.0,84
HCPCS,83935,ASSAY OF OSMOLALITY URINE,47.0,30.55,1.1,47.0,88
HCPCS,83935,OSMOLALITY URINE ASSAY,47.0,30.55,3.37,47.0,84
HCPCS,83935,"SSAT24 OSMOLALITY, UR",47.0,30.55,3.37,47.0,84
HCPCS,83937,ASSAY OF OSTEOCALCIN,206.0,133.9,1.1,206.0,88
HCPCS,83937,OSTEOCALCIN,206.0,133.9,14.74,206.0,84
HCPCS,83945,%GMAPS OXALATE,100.0,65.0,6.36,100.0,84
HCPCS,83945,*OXALATE ASSAY,100.0,65.0,6.36,100.0,84
HCPCS,83945,ASSAY OXALATE,100.0,65.0,1.1,100.0,88
HCPCS,83945,OXALATE URINE,100.0,65.0,6.36,100.0,84
HCPCS,83945,"SSAT24 OXOLATE, UR",100.0,65.0,6.36,100.0,84
HCPCS,83950,HER-2/NEU SERUM,444.0,288.6,20.86,444.0,84
HCPCS,83950,ONCOPROTEIN HER-2/NEU,444.0,288.6,1.1,444.0,88
HCPCS,83951,PIVKA II,444.0,288.6,20.86,444.0,84
HCPCS,83970,ASSAY OF PARATHORMONE,285.0,185.25,1.1,285.0,88
HCPCS,83970,PARATHYROID HORMONE ASSAY,285.0,185.25,20.38,285.0,168
HCPCS,83986,"%SSAT24 PH, UR",25.0,16.25,1.77,27.56,84
HCPCS,83986,PH BODY FLUID EXCEPT BLD (POINT OF CARE),25.0,16.25,1.77,27.56,84
HCPCS,83986,PH BODY FLUID NOT ELSEWHERE SPECIFIED,25.0,16.25,1.1,25.0,88
HCPCS,83986,"PH BODY FLUID, NES",25.0,16.25,1.77,27.56,84
HCPCS,83986,"PH BODY FLUID, NES (POINT OF CARE LAB)",25.0,16.25,1.77,27.56,84
HCPCS,83986,SSAT24 PH,25.0,16.25,1.77,27.56,84
HCPCS,83987,EXHALED BREATH CONDENSATE,,,1.77,71.37,28
HCPCS,83987,Exhaled breath condensate,,,11.75,13.61,8
HCPCS,83992,PHENCYCLIDINE CONFIRMATION,108.0,70.2,7.2,1666801.85,67
HCPCS,83993,ASSAY FOR CALPROTECTIN FECAL,135.0,87.75,1.1,151.13,172
HCPCS,84022,ASSAY OF PHENOTHIAZINE,,,68.69,68.69,1
HCPCS,84030,%NEO PHENYLALANINE,38.0,24.7,2.72,39.14,84
HCPCS,84030,PHENYLALANINE (PKU) EA,38.0,24.7,2.72,39.14,84
HCPCS,84035,%GMAPS PHENYLKETONES,27.0,17.55,1.81,27.0,84
HCPCS,84060,ACID PHOSPHATASE TOTL,53.0,34.45,3.65,53.0,84
HCPCS,84060,ASSAY ACID PHOSPHATASE,53.0,34.45,1.1,53.0,88
HCPCS,84061,Phosphatase forensic exam,,,34.8,34.8,1
HCPCS,84066,PROSTATIC ACID PHOS,67.0,43.55,4.77,67.0,84
HCPCS,84075,ALKA PHOSPHTA,36.0,23.4,5.18,36.0,84
HCPCS,84075,ASSAY OF PHOSPHATASE ALKALINE,36.0,23.4,1.1,36.0,88
HCPCS,84078,ASSAY ALKALINE PHOSPHATASE,,,3.6,67.19,28
HCPCS,84078,Assay alkaline phosphatase,,,11.75,13.61,8
HCPCS,84080,ALK-P BONE SPECIFIC,102.0,66.3,7.3,102.0,84
HCPCS,84080,ALKA PHOSPHTAS ISOENZYME,102.0,66.3,7.3,102.0,84
HCPCS,84080,ASSAY OF PHOSPHATASE ALKALINE ISOENZYMES,102.0,66.3,1.1,102.0,88
HCPCS,84081,ASSAY PHOSPHATIDYLGLYCEROL,,,8.16,77.56,29
HCPCS,84081,Assay phosphatidylglycerol,,,18.15,21.01,8
HCPCS,84085,ASSAY OF RBC PG6D ENZYME,,,4.66,26.98,28
HCPCS,84085,Assay of rbc pg6d enzyme,,,11.75,13.61,8
HCPCS,84087,ASSAY PHOSPHOHEXOSE ENZYMES,,,5.1,45.51,28
HCPCS,84087,Assay phosphohexose enzymes,,,11.75,13.61,8
HCPCS,84100,%STCATH PHOSPOROUS,33.0,21.45,2.34,33.0,84
HCPCS,84100,ASSAY OF PHOSPHORUS INORGANIC,33.0,21.45,1.1,33.0,88
HCPCS,84100,"INORGANIC PHOSPHATE, SERUM (TRPHOS)",33.0,21.45,2.34,33.0,84
HCPCS,84100,PHOSPHOROUS ASSAY,33.0,21.45,2.34,33.0,84
HCPCS,84105,"INORGANIC PHOSPHATE, URINE (TRPHOS)",40.0,26.0,2.56,40.0,84
HCPCS,84105,PHOSPHOROUS URINE ASSAY,40.0,26.0,2.56,40.0,84
HCPCS,84105,"SSAT24 PHOSPHORUS, UR",40.0,26.0,2.56,40.0,84
HCPCS,84106,*PORPHOBILINOGEN URINE QUANT,40.0,26.0,2.33,40.0,84
HCPCS,84106,PORPHOBILINOGEN UR SCN,40.0,26.0,2.33,40.0,84
HCPCS,84110,"PORPHOBILINOGEN, QN, RANDOM UR",58.0,37.7,4.17,58.09,84
HCPCS,84112,ACTIM*ACTIM PROM,677.0,440.05,36.89,677.0,84
HCPCS,84112,ROM RUPTURE OF FETAL MEMBRANES,677.0,440.05,36.89,677.0,84
HCPCS,84119,%PORPHYRIN SCREEN,92.0,59.8,5.34,92.0,84
HCPCS,84119,*PORPHYRINS URINE QUAL,92.0,59.8,5.34,92.0,84
HCPCS,84119,PORPHYRIN SCRN RAN U,92.0,59.8,1.1,92.0,88
HCPCS,84120,PORPHYRINS URINE,101.0,65.65,7.26,113.27,84
HCPCS,84120,PORPHYRINS URINE QUANTITATION & FRACTIONATION,101.0,65.65,1.1,101.0,88
HCPCS,84126,HEMOQUANT FECAL,270.0,175.5,15.64,270.0,84
HCPCS,84126,PORPHYRINS STOOL,270.0,175.5,15.64,270.0,84
HCPCS,84126,"PORPHYRINS, FECAL",270.0,175.5,15.64,270.0,84
HCPCS,84126,STFRTP ASSAY OF FECES PORPHYRINS,270.0,175.5,15.64,270.0,84
HCPCS,84127,ASSAY OF FECES PORPHYRINS,,,51.32,51.32,1
HCPCS,84132,*POTASSIUM SERUM,33.0,21.45,2.27,33.0,84
HCPCS,84132,ELECTROLYTE K BLOOD,33.0,21.45,2.27,33.0,84
HCPCS,84132,POTASSIUM,33.0,21.45,2.27,33.0,84
HCPCS,84132,POTASSIUM (POINT OF CARE LAB),33.0,21.45,2.27,33.0,84
HCPCS,84132,POTASSIUM BLOOD (POINT OF CARE LAB),33.0,21.45,2.27,33.0,84
HCPCS,84132,POTASSIUM SERUM PLASMA/WHOLE BLOOD,33.0,21.45,1.1,33.0,88
HCPCS,84133,K URINE ASSAY,33.0,21.45,2.13,33.0,84
HCPCS,84133,POTASSIUM URINE,33.0,21.45,1.1,33.0,88
HCPCS,84133,"SSAT24 POTASSIUM, UR",33.0,21.45,2.13,33.0,84
HCPCS,84134,PREALBUMIN ASSAY,101.0,65.65,7.2,101.0,84
HCPCS,84134,PREALBUMIN BLD,101.0,65.65,1.1,101.0,88
HCPCS,84135,ASSAY OF PREGNANEDIOL,,,9.45,67.3,28
HCPCS,84135,Assay of pregnanediol,,,22.0,25.48,8
HCPCS,84138,ASSAY OF PREGNANETRIOL,,,9.35,83.51,28
HCPCS,84138,Assay of pregnanetriol,,,22.0,25.48,8
HCPCS,84138,PREGNANETRIOL 24HR U,145.0,94.25,1.1,145.0,88
HCPCS,84140,PREGNENOLONE BLOOD,143.0,92.95,1.1,143.0,88
HCPCS,84140,PREGNENOLONE SERUM,143.0,92.95,10.21,143.0,84
HCPCS,84143,ASSAY/17-HYDROXYPREGNENOLONE,157.0,102.05,1.1,157.0,88
HCPCS,84143,CAHSP ASSAY OF 17-HYDROXYPREGNENO,157.0,102.05,11.26,157.0,84
HCPCS,84143,HYDROXYPREGNENELONE-17,157.0,102.05,11.26,157.0,84
HCPCS,84144,ASSAY OF PROGESTERONE,144.0,93.6,1.1,144.0,88
HCPCS,84144,CAHSP ASSAY OF PROGESTERONE,144.0,93.6,10.3,144.0,84
HCPCS,84144,PROGESTERONE,144.0,93.6,10.3,144.0,84
HCPCS,84145,PROCALCITONIN,188.0,122.2,13.23,188.0,84
HCPCS,84146,*PROLACTIN ASSAY,134.0,87.1,9.57,134.0,84
HCPCS,84146,ASSAY OF PROLACTIN,134.0,87.1,1.1,134.0,88
HCPCS,84146,PROLACTIN,134.0,87.1,9.57,134.0,84
HCPCS,84146,PROLACTIN MACROADENOMA,134.0,87.1,9.57,134.0,84
HCPCS,84150,ASSAY OF PROSTAGLANDIN,288.0,187.2,1.1,288.0,116
HCPCS,84150,Assay of prostaglandin,,,27.68,32.05,8
HCPCS,84152,ASSAY OF PSA COMPLEXED,,,9.08,81.13,28
HCPCS,84152,Assay of psa complexed,,,18.15,21.01,8
HCPCS,84153,%PHI PROST SPEC AG TOT,127.0,82.55,10.42,127.0,84
HCPCS,84153,ASSAY OF PROSTATE SPECIFIC ANTIGEN TOTAL,127.0,82.55,1.1,127.0,88
HCPCS,84153,BRWK PSA DIAGNOSTIC,127.0,82.55,10.42,127.0,84
HCPCS,84153,PHI PROST SPEC AG TOT,127.0,82.55,10.42,127.0,84
HCPCS,84153,PSA DIAGNOSTIC,127.0,82.55,10.42,127.0,84
HCPCS,84153,PSA SCREENING,127.0,82.55,10.42,127.0,84
HCPCS,84154,%PHI PROST SPEC AG FREE,127.0,82.55,9.08,127.0,84
HCPCS,84154,ASSAY OF PROSTATE SPECIFIC ANTIGEN FREE,127.0,82.55,1.1,127.0,88
HCPCS,84154,PSA FREE,127.0,82.55,9.08,127.0,168
HCPCS,84155,PROTEIN TOTAL SERUM ASSAY,25.0,16.25,3.67,25.0,84
HCPCS,84156,*PROTEIN TOTAL URINE ASSAY,25.0,16.25,1.81,25.0,84
HCPCS,84156,PROTEIN TOTAL XCPT REFRACTOMETRY URINE,25.0,16.25,1.1,25.0,88
HCPCS,84156,UBJP PROTEIN UR,25.0,16.25,1.81,25.0,84
HCPCS,84156,UFLCKL PROTEIN UR,25.0,16.25,1.81,25.0,84
HCPCS,84157,%CSFPE PROTEIN TOTAL CSF,28.0,18.2,1.81,28.0,84
HCPCS,84157,CPALMF ASSAY OF PROTEIN OTHER,28.0,18.2,1.81,28.0,84
HCPCS,84157,CPALMT ASSAY OF PROTEIN OTHER,28.0,18.2,1.81,28.0,84
HCPCS,84157,FAOACM ASSAY OF PROTEIN OTHER,28.0,18.2,1.81,28.0,84
HCPCS,84157,FAOSCM ASSAY OF PROTEIN OTHER,28.0,18.2,1.81,28.0,84
HCPCS,84157,PROTEIN TOTAL OTHER ASSAY,28.0,18.2,1.81,28.0,84
HCPCS,84157,PROTEIN TOTAL XCPT REFRACTOMETRY OTH SRC,28.0,18.2,1.1,28.0,88
HCPCS,84157,"PROTEIN TOTAL, OTHER SOURCE",28.0,18.2,1.81,28.0,84
HCPCS,84160,ASSAY OF PROTEIN ANY SOURCE,,,2.56,22.72,28
HCPCS,84160,Assay of protein any source,,,11.75,13.61,8
HCPCS,84163,%1ST TRI PAPP-A,104.0,67.6,7.44,115.95,84
HCPCS,84163,PAPP-A,104.0,67.6,7.44,115.95,84
HCPCS,84163,PREGNANCY-ASSOCIATED PLASMA PROTEIN-A,104.0,67.6,1.1,104.0,88
HCPCS,84165,PROTEIN E-PHORESIS SERUM,,,7.49,7.49,2
HCPCS,84165,PROTEIN ELECPHRSIS SERUM,74.0,48.1,5.3,74.0,84
HCPCS,84165,PROTEIN ELECT & QUANT,74.0,48.1,5.3,74.0,84
HCPCS,84165,PROTEIN ELECTROPHORETIC FRACTJ&QUANTJ SERUM,163.0,105.95,1.1,163.0,218
HCPCS,8416526,PROTEIN E-PHORESIS SERUM,,,7.49,7.49,2
HCPCS,84166,%CSFPE PROT ELEC SCF QT,123.0,79.95,13.62,123.0,84
HCPCS,84166,PROTEIN E-PHORESIS/URINE/CSF,,,16.75,16.75,2
HCPCS,84166,PROTEIN ELECTRO.FLUID QT,123.0,79.95,13.62,123.0,84
HCPCS,84166,PROTEIN ELECTROP FXJ&QUAN OTH FLUS CONCENTRATI,163.0,105.95,1.1,163.0,218
HCPCS,84166TC,PROTEIN E-PHORESIS/URINE/CSF,,,16.75,16.75,2
HCPCS,84181,%CEPHAL WESTERN BLOT,118.0,76.7,8.41,118.0,84
HCPCS,84181,GBM ANTIBODY,118.0,76.7,8.41,118.0,84
HCPCS,84181,HUWB WESTERN BLOT TEST,118.0,76.7,8.41,118.0,84
HCPCS,84181,INNER EAR 68KD ANTIBODY,118.0,76.7,8.41,118.0,84
HCPCS,84181,MAG AB IGM WB W/REFLEX,118.0,76.7,8.41,118.0,84
HCPCS,84181,PROTEIN WESTRN BLOT I&R BLOOD/OTHER FLUID,118.0,76.7,1.1,118.0,92
HCPCS,84181,WESTERN BLOT BLOOD OR BODY FL,118.0,76.7,8.41,118.0,84
HCPCS,84181,WESTERN BLOT TEST,,,7.49,7.49,2
HCPCS,8418126,WESTERN BLOT TEST,,,7.49,7.49,2
HCPCS,84182,%CJD WESTERN BLOT,202.0,131.3,11.68,202.0,84
HCPCS,84182,CRMP 5 IGG WEST BLOT CSF,202.0,131.3,11.68,202.0,84
HCPCS,84182,CRMP-5 WB BAND ID,202.0,131.3,11.68,202.0,84
HCPCS,84182,DERMYO PROT WB IMMUNO,202.0,131.3,11.68,202.0,84
HCPCS,84182,IMMUNOBLOT (POLMYO),202.0,131.3,11.68,202.0,84
HCPCS,84182,"MA2/TA ANTIBODY, IGG CSF",202.0,131.3,11.68,202.0,84
HCPCS,84182,"MA2/TA ANTIBODY, IGG SERUM",202.0,131.3,11.68,202.0,84
HCPCS,84182,MLPTHY CRMP-5 WB,202.0,131.3,11.68,202.0,84
HCPCS,84182,"NEURONAL AB (TR/DNER) IGG, CSF",202.0,131.3,11.68,202.0,84
HCPCS,84182,"NEURONAL AB (TR/DNER) IGG, SER",202.0,131.3,11.68,202.0,84
HCPCS,84182,NEURONAL NUC AB IGG X4,202.0,131.3,11.68,202.0,84
HCPCS,84182,"NEURONAL NUCLEAR AB (HU) IGG, IB, CSF",202.0,131.3,11.68,202.0,84
HCPCS,84182,"NEURONAL NUCLEAR AB (HU) IGG, IB, SERUM",202.0,131.3,11.68,202.0,84
HCPCS,84182,PARA AB WB BND ID,202.0,131.3,11.68,202.0,84
HCPCS,84182,PARA AB WB CSF,202.0,131.3,11.68,202.0,84
HCPCS,84182,PROT WB IMMUNO (MYOSPL),202.0,131.3,11.68,202.0,84
HCPCS,84182,PROTEIN WESTERN BLOT TEST,,,7.49,7.49,2
HCPCS,84182,PROTEIN WESTRN BLOT BLOOD/OTH FLU IMMUNOLOGICAL,202.0,131.3,1.1,202.0,92
HCPCS,84182,REFLEX IMMUNOBLOT SER FOR PARNEO,202.0,131.3,11.68,202.0,84
HCPCS,84182,RFLX IMBLOT PARNEO AIDYSA,202.0,131.3,11.68,202.0,84
HCPCS,84182,RFLX IMMUNBLOT PARCSF,202.0,131.3,11.68,202.0,84
HCPCS,8418226,PROTEIN WESTERN BLOT TEST,,,7.49,7.49,2
HCPCS,84202,%OSHA ZPP,99.0,64.35,7.08,110.47,84
HCPCS,84202,PROTOPORPHYRIN RBC QUANT,99.0,64.35,7.08,110.47,84
HCPCS,84202,PROTOPORPHYRIN RBC; QUAN,99.0,64.35,1.1,99.0,88
HCPCS,84202,ZINC PROTOPORPHYRINS,99.0,64.35,7.08,110.47,84
HCPCS,84203,TEST RBC PROTOPORPHYRIN,,,4.25,37.91,28
HCPCS,84203,Test rbc protoporphyrin,,,11.75,13.61,8
HCPCS,84206,ASSAY OF PROINSULIN,184.0,119.6,1.1,184.0,88
HCPCS,84206,PROINSULIN SERUM,184.0,119.6,10.68,184.0,84
HCPCS,84207,%GMAPS VIT B-6,194.0,126.1,13.88,194.0,84
HCPCS,84207,ASSAY OF PYRIDOXAL PHOSPHATE,194.0,126.1,1.1,194.0,88
HCPCS,84207,VITAMIN B6 PLASMA,194.0,126.1,13.88,194.0,84
HCPCS,84210,%GMAPS PYRUVATE,100.0,65.0,5.79,100.0,84
HCPCS,84210,PYRUVIC ACID CSF,100.0,65.0,5.79,100.0,84
HCPCS,84220,PYRUVATE KINASE,65.0,42.25,4.66,65.0,84
HCPCS,84220,PYRUVATE KINASE BLD,65.0,42.25,1.1,65.0,88
HCPCS,84228,ASSAY OF QUININE,,,5.74,31.87,28
HCPCS,84228,Assay of quinine,,,18.31,21.2,8
HCPCS,84233,ASSAY OF ESTROGEN,,,35.15,284.42,28
HCPCS,84233,Assay of estrogen,,,27.68,32.05,8
HCPCS,84234,ASSAY OF PROGESTERONE,,,32.04,286.43,28
HCPCS,84234,Assay of progesterone,,,27.68,32.05,8
HCPCS,84235,ASSAY OF ENDOCRINE HORMONE,,,28.49,231.03,28
HCPCS,84235,Assay of endocrine hormone,,,27.68,32.05,8
HCPCS,84238,ASSAY NONENDOCRINE RECEPTOR,252.0,163.8,18.06,252.0,84
HCPCS,84238,INTERLEUKIN 2 RECEPTOR,252.0,163.8,18.06,252.0,84
HCPCS,84238,RECEPTOR ASSAY NON-ENDOCRINE SPECIFY RECEPTOR,252.0,163.8,1.1,252.0,88
HCPCS,84238,SOLUBLE TRANSFERRINE RECEPTOR,252.0,163.8,18.06,252.0,84
HCPCS,84244,ASSAY OF RENIN,152.0,98.8,1.1,152.0,88
HCPCS,84244,RENIN PLASMA,152.0,98.8,10.86,152.0,84
HCPCS,84252,%GMAPS VITAMIN B-2,140.0,91.0,9.99,140.0,84
HCPCS,84252,ASSAY OF RIBOFLAVIN-VITAMIN B-2,140.0,91.0,1.1,140.0,88
HCPCS,84252,VIT B-2 ASSAY,140.0,91.0,9.99,140.0,84
HCPCS,84255,ASSAY OF SELENIUM,176.0,114.4,1.1,176.0,88
HCPCS,84255,SELENIUM BLOOD,176.0,114.4,12.61,176.0,84
HCPCS,84260,%GMAPS SEROTONIN,214.0,139.1,15.3,214.0,84
HCPCS,84260,ASSAY OF SEROTONIN,214.0,139.1,1.1,214.0,88
HCPCS,84260,SEROTONIN ASSAY,214.0,139.1,15.3,214.0,84
HCPCS,84260,SEROTONIN SERUM,214.0,139.1,15.3,214.0,84
HCPCS,84260,SEROTONIN WHOLE BLOOD,214.0,139.1,15.3,214.0,84
HCPCS,84270,*SEX HORMONE BINDING GLOBULIN,150.0,97.5,10.73,150.0,84
HCPCS,84270,ASSAY OF SEX HORMONE BINDING GLOBULIN,150.0,97.5,1.1,150.0,88
HCPCS,84270,BTSTFC ASSAY OF SEX HORMONE GLOBUL,150.0,97.5,10.73,150.0,84
HCPCS,84270,HIRSUT SHBG,150.0,97.5,10.73,150.0,84
HCPCS,84270,SEX-HORMONE BIND GLOBULIN,150.0,97.5,10.73,150.0,84
HCPCS,84275,LIPID ASSOC SIALIC ACID,93.0,60.45,6.64,103.46,84
HCPCS,84285,SILICON,174.0,113.1,1.1,174.0,88
HCPCS,84285,SILICON SERUM,174.0,113.1,11.62,174.0,84
HCPCS,84295,*SODIUM BLOOD,33.0,21.45,2.38,33.0,84
HCPCS,84295,SODIUM,33.0,21.45,2.38,33.0,84
HCPCS,84295,SODIUM BLOOD (POINT OF CARE LAB),33.0,21.45,2.38,33.0,84
HCPCS,84295,SODIUM SERUM PLASMA OR WHOLE BLOOD,33.0,21.45,1.1,33.0,88
HCPCS,84300,ASSAY OF URINE SODIUM,35.0,22.75,1.1,35.0,88
HCPCS,84300,NA URINE ASSAY,35.0,22.75,2.4,35.0,84
HCPCS,84300,"SSAT24 SODIUM, UR",35.0,22.75,2.4,35.0,84
HCPCS,84302,ASSAY OF SODIUM OTHER SOURCE,34.0,22.1,1.1,34.0,88
HCPCS,84302,SODIUM FLUID,34.0,22.1,2.4,34.0,84
HCPCS,84305,ASSAY OF SOMATOMEDIN,147.0,95.55,1.1,147.0,88
HCPCS,84305,INSULIN LIK GR FAC 1,147.0,95.55,10.5,147.0,84
HCPCS,84307,SOMATOSTATIN,126.0,81.9,9.02,140.77,84
HCPCS,84311,%ETCF SPECTROPHOTO X5,56.0,36.4,3.45,56.0,84
HCPCS,84311,%ETCMIT SPECTRO X8,56.0,36.4,3.45,56.0,84
HCPCS,84311,%ETCMUS SPECTROPHOTO X8,56.0,36.4,3.45,56.0,84
HCPCS,84311,%MRATIO SPECTROPHOTO,56.0,36.4,3.45,56.0,84
HCPCS,84311,%MYOENZ SPECTRO X9,56.0,36.4,3.45,56.0,84
HCPCS,84311,ADENOSINE DEAMINASE,56.0,36.4,3.45,56.0,84
HCPCS,84311,"ADENOSINE DEAMINASE, PF",56.0,36.4,3.45,56.0,84
HCPCS,84311,"ADENOSINE DEAMINASE, RBC",56.0,36.4,3.45,56.0,84
HCPCS,84311,"ADENOSINE DEAMINASE, SER",56.0,36.4,3.45,56.0,84
HCPCS,84311,"ARYLSULFATASE A, URINE",56.0,36.4,3.45,56.0,84
HCPCS,84311,"CHYMOTRYPSIN, STOOL",56.0,36.4,3.45,56.0,84
HCPCS,84311,FAOACM SPECTROPHOTOMETRY X8,56.0,36.4,3.45,56.0,84
HCPCS,84311,FAOSCM SPECTROPHOTOMETRY X4,56.0,36.4,3.45,56.0,84
HCPCS,84311,PBG DEAMINASE,56.0,36.4,3.45,56.0,84
HCPCS,84311,PHOSPHOLIPIDS,56.0,36.4,3.45,56.0,84
HCPCS,84311,PORPHYRINS PLASMA,56.0,36.4,3.45,56.0,84
HCPCS,84311,PORPHYRINS SERUM TOTAL,56.0,36.4,3.45,56.0,84
HCPCS,84311,SPECTROPHOTOMETRY ANALYT NOT ELSEWHERE SPECIFIED,56.0,36.4,1.1,56.0,88
HCPCS,84311,SPECTROPHOTOMETRY NOS,56.0,36.4,3.45,56.0,84
HCPCS,84311,UMUCPO SPECTROPHOTOMETRY,56.0,36.4,3.45,56.0,84
HCPCS,84315,ROUTINE SYNOVIAL FL,23.0,14.95,1.1,23.0,88
HCPCS,84315,SPECIFIC GRAVITY BDY FLD,23.0,14.95,1.31,23.0,84
HCPCS,84375,%CDG SUGAR CHROMATOGR,269.0,174.85,15.6,269.0,84
HCPCS,84375,%NCDG SUGAR CHROMATOGR,269.0,174.85,15.6,269.0,84
HCPCS,84376,SUGARS SINGLE QUAL,,,2.72,42.35,29
HCPCS,84376,Sugars single qual,,,11.75,13.61,8
HCPCS,84377,%GMAPS SUGARS QL,38.0,24.7,2.72,38.0,84
HCPCS,84377,"CARBOHYDRATE, UR",38.0,24.7,2.72,38.0,84
HCPCS,84377,SUGARS MONO DI&OLIGOS MLT QUALITATIVE EACH SPE,38.0,24.7,1.1,38.0,88
HCPCS,84377,SUGARS MULT QL EA,38.0,24.7,2.72,38.0,84
HCPCS,84378,"15AGTL - 1,5 ANHYDROGLUCITOL",80.0,52.0,5.69,80.0,84
HCPCS,84378,GALACTOSE-1-PHOSPHATE,80.0,52.0,5.69,80.0,84
HCPCS,84378,GLYCOMARK,80.0,52.0,5.69,80.0,84
HCPCS,84379,"CARBOHYDRATE, UR",80.0,52.0,5.69,80.0,84
HCPCS,84392,"SSAT24 SULFATE, UR",38.0,24.7,2.34,38.0,84
HCPCS,84392,USO4 ASSAY OF URINE SULFATE,38.0,24.7,2.34,38.0,84
HCPCS,84393,"TAU, PHOSPHORYLATED (EG, PTAU 181, PTAU 217), EACH",121.0,78.65,23.08,141.81,152
HCPCS,84394,"TAU, TOTAL (TTAU)",121.0,78.65,33.64,141.81,76
HCPCS,84402,BTSTFC TESTOSTERONE FR,176.0,114.4,12.58,176.0,84
HCPCS,84402,FTTESM TESTO FR AD MALE,176.0,114.4,12.58,176.0,84
HCPCS,84402,TESTOSTERONE FR AD MALE,176.0,114.4,12.58,176.0,84
HCPCS,84402,TESTOSTERONE FREE,176.0,114.4,1.1,176.0,172
HCPCS,84402,"TESTOSTERONE, FREE, SERUM",176.0,114.4,12.58,176.0,84
HCPCS,84403,*TESTOSTERONE TOTAL ASSAY,178.0,115.7,12.75,178.0,84
HCPCS,84403,ASSAY OF TESTOSTERONE TOTAL,178.0,115.7,1.1,178.0,88
HCPCS,84403,CAHSP ASSAY OF TOTAL TESTOSTERONE,178.0,115.7,12.75,178.0,84
HCPCS,84403,FTTESM TESTOSTERONE,178.0,115.7,12.75,178.0,84
HCPCS,84403,HIRSUT TESTOSTERONE TOTAL,178.0,115.7,12.75,178.0,84
HCPCS,84403,TESTOSTERONE TOTAL ASSAY,178.0,115.7,12.75,178.0,168
HCPCS,84403,"TESTOSTERONE, TOTAL, SERUM",178.0,115.7,12.75,178.0,84
HCPCS,84410,TESTOSTERONE BIOAVAILABLE,,,25.33,140.51,28
HCPCS,84410,Testosterone bioavailable,,,27.68,32.05,8
HCPCS,84425,%GMAPS VIT B-1,146.0,94.9,10.48,146.0,84
HCPCS,84425,ASSAY OF THIAMINE (VITAMIN B-1),146.0,94.9,1.1,146.0,88
HCPCS,84425,TRANSKETOLASE,146.0,94.9,10.48,146.0,84
HCPCS,84425,VIT B-1 ASSAY,146.0,94.9,10.48,146.0,84
HCPCS,84425,VITAMIN B WHOLE BLOOD,146.0,94.9,10.48,146.0,84
HCPCS,84425,VITAMIN B1 PLASMA,146.0,94.9,10.48,146.0,84
HCPCS,84430,THIOCYANATE,80.0,52.0,5.74,80.0,84
HCPCS,84430,THIOCYANATE UR RANDOM,80.0,52.0,5.74,80.0,84
HCPCS,84431,THROMBOXANE URINE,,,14.04,96.2,28
HCPCS,84431,Thromboxane urine,,,20.86,24.16,8
HCPCS,84432,ASSAY OF THYROGLOBULIN,111.0,72.15,1.1,111.0,88
HCPCS,84432,THYROGLOB AB INTERFERENCE,111.0,72.15,7.93,111.0,84
HCPCS,84432,THYROGLOBULIN,111.0,72.15,7.93,111.0,84
HCPCS,84432,THYROGLOBULIN FLUID,111.0,72.15,7.93,111.0,84
HCPCS,84433,TPMT ASY THIOPURIN S-MTHYLTRNSFRS,153.0,99.45,8.87,153.0,84
HCPCS,84436,*THYROXINE TOTAL ASSAY,47.0,30.55,3.39,47.0,84
HCPCS,84436,"ASSAY, TOTAL THYROXINE",47.0,30.55,1.1,47.0,88
HCPCS,84436,THYROXINE TOTAL ASSAY,47.0,30.55,3.39,47.0,84
HCPCS,84437,ASSAY OF NEONATAL THYROXINE,,,3.19,28.49,28
HCPCS,84437,Assay of neonatal thyroxine,,,22.0,25.48,8
HCPCS,84439,ASSAY OF FREE THYROXINE,62.0,40.3,1.1,62.0,88
HCPCS,84439,THYROXIN FREE,62.0,40.3,5.11,62.0,84
HCPCS,84439,THYROXINE FREE ASSAY,62.0,40.3,5.11,62.0,84
HCPCS,84442,ASSAY OF THYROXINE BINDING GLOBULIN,102.0,66.3,1.1,102.0,88
HCPCS,84442,THYROXINE BIND GLOBULIN,102.0,66.3,7.3,102.0,84
HCPCS,84443,%NEO TSH,116.0,75.4,16.8,116.0,84
HCPCS,84443,ASSAY OF THYROID STIMULATING HORMONE TSH,116.0,75.4,1.1,116.0,88
HCPCS,84443,THYROID STIMULATING HORMONE (TSH),116.0,75.4,16.8,116.0,84
HCPCS,84445,%TRAB THYROID STIM IMMUN,351.0,228.15,25.11,351.0,84
HCPCS,84445,THYROID STIMULATING IMMUNE GLOBULINS TSI,351.0,228.15,1.1,351.0,88
HCPCS,84446,%GMAPS VIT E,98.0,63.7,7.0,102.87,84
HCPCS,84446,ASSAY OF TOCOPHEROL ALPHA VITAMIN E,98.0,63.7,1.1,98.0,88
HCPCS,84446,VIT E ALPHA-TOCO TEST,98.0,63.7,7.0,102.87,84
HCPCS,84449,CORTICOSTEROID-BINDING GLOGULIN,124.0,80.6,8.89,124.0,84
HCPCS,84450,%NASH AST,36.0,23.4,5.18,36.0,84
HCPCS,84450,"ASPARTATE AMINOTRANSFERASE, FIBROMETER",36.0,23.4,5.18,36.0,84
HCPCS,84450,AST/SGOT,36.0,23.4,5.18,36.0,84
HCPCS,84450,TRANSFERASE ASPARTATE AMINO AST SGOT,36.0,23.4,1.1,36.0,88
HCPCS,84460,%HCVSUR ALT (SGPT),37.0,24.05,5.3,37.0,84
HCPCS,84460,%LIVFIB ALANINE AMINO,37.0,24.05,5.3,37.0,84
HCPCS,84460,%NASH AST,37.0,24.05,5.3,37.0,84
HCPCS,84460,"ALANINE AMINOTRANSFERASE, FIBROMETER",37.0,24.05,5.3,37.0,84
HCPCS,84460,ALT/SGPT,37.0,24.05,5.3,37.0,84
HCPCS,84460,TRANSFERASE ALANINE AMINO ALT SGPT,37.0,24.05,1.1,37.0,88
HCPCS,84466,ASSAY OF L7383TRANSFERRIN,88.0,57.2,1.1,88.0,88
HCPCS,84466,TRANSFERRIN,88.0,57.2,6.3,88.0,84
HCPCS,84478,%NASH TRIGLYCERIDES,40.0,26.0,5.74,40.0,84
HCPCS,84478,%VAP TRIGLYCERIDES,40.0,26.0,5.74,40.0,84
HCPCS,84478,ASSAY OF TRIGLYCERIDES,40.0,26.0,1.1,40.0,88
HCPCS,84478,TRIGLYCERIDES ASSAY,40.0,26.0,5.74,40.0,84
HCPCS,84478,TRIGLYCERIDES BF W REFLEX TO CHYLOMICRON ELECTROPH,40.0,26.0,5.74,40.0,84
HCPCS,84479,%T4TFI T4 UPTAKE,45.0,29.25,3.19,45.0,84
HCPCS,84479,T3 UPTAKE,45.0,29.25,3.19,45.0,84
HCPCS,84479,THYROID HORM UPTK/THYROID HORMONE BINDING RATIO,45.0,29.25,1.1,45.0,88
HCPCS,84480,ASSAY OF TRIIODOTHYRONINE T3 TOTAL TT3,98.0,63.7,1.1,98.0,88
HCPCS,84480,TRIIODOTHYRONINE TOTAL(TT-3),98.0,63.7,7.0,98.0,84
HCPCS,84481,ASSAY OF TRIIODOTHYRONINE T3 FREE,117.0,76.05,1.1,117.0,88
HCPCS,84481,T3 DIAL FREE,117.0,76.05,8.37,117.0,84
HCPCS,84481,TRIIODOTHYRONINE FREE(FT-3),117.0,76.05,8.37,117.0,84
HCPCS,84482,REVERSE T3,109.0,70.85,7.78,109.0,84
HCPCS,84482,TRIIODOTHYRONINE T3 REVERSE,109.0,70.85,1.1,109.0,88
HCPCS,84484,ASSAY OF TROPONIN QUANTITATIVE,86.0,55.9,1.1,86.0,88
HCPCS,84484,TROPONIN I,86.0,55.9,4.99,86.0,84
HCPCS,84484,TROPONIN T,86.0,55.9,4.99,86.0,84
HCPCS,84485,ASSAY DUODENAL FLUID TRYPSIN,,,3.56,33.1,28
HCPCS,84485,Assay duodenal fluid trypsin,,,11.75,13.61,8
HCPCS,84488,TEST FECES FOR TRYPSIN,50.0,32.5,1.1,50.0,117
HCPCS,84488,Test feces for trypsin,,,11.75,13.61,8
HCPCS,84490,ASSAY OF FECES FOR TRYPSIN,,,3.97,33.46,28
HCPCS,84490,Assay of feces for trypsin,,,11.75,13.61,8
HCPCS,84510,%GMAPS TYROSINE,73.0,47.45,5.14,73.0,84
HCPCS,84510,"TYROSINE, PLASMA, EA",73.0,47.45,5.14,73.0,84
HCPCS,84512,TROPONIN ASSAY QUAL (POINT OF CARE LAB),70.0,45.5,4.04,70.0,84
HCPCS,84520,ASSAY OF UREA NITROGEN QUANTITATIVE,27.0,17.55,1.1,27.0,88
HCPCS,84520,BUN,27.0,17.55,1.95,27.0,84
HCPCS,84520,I STAT BUN DETERMINATION (POINT OF CARE LAB),27.0,17.55,1.95,27.0,84
HCPCS,84520,"UREA NITROGEN, SERUM, FIBROMETER",27.0,17.55,1.95,27.0,84
HCPCS,84525,%GMAPS UREA NITROGEN,35.0,22.75,2.05,35.0,84
HCPCS,84540,SSAT24 UREA NITROGEN,38.0,24.7,2.34,38.0,84
HCPCS,84540,UREA NITROGEN URINE ASSAY,38.0,24.7,2.34,38.0,84
HCPCS,84545,UREA CLEARANCE 24 HR UR,50.0,32.5,3.26,50.0,84
HCPCS,84545,UREA-N CLEARANCE TEST,50.0,32.5,1.1,50.0,88
HCPCS,84550,%GMAPS URIC ACID BLD,31.0,20.15,4.52,31.0,84
HCPCS,84550,ASSAY OF BLOOD/URIC ACID,31.0,20.15,1.1,31.0,88
HCPCS,84550,URIC ACID BLOOD,31.0,20.15,4.52,31.0,84
HCPCS,84550,URIC ACID BLOOD ASSAY,31.0,20.15,4.52,31.0,84
HCPCS,84560,%GMAPS UR/URIC ACID,35.0,22.75,2.34,35.0,84
HCPCS,84560,ASSAY OF URIC ACID OTHER SOURCE,35.0,22.75,1.1,35.0,88
HCPCS,84560,"SSAT24 URIC ACID, UR",35.0,22.75,2.34,35.0,84
HCPCS,84560,URIC ACID BODY FLUID,35.0,22.75,2.34,35.0,84
HCPCS,84560,URIC ACID OTHER SOURCE ASSAY,35.0,22.75,2.34,35.0,84
HCPCS,84577,ASSAY OF FECES/UROBILINOGEN,,,7.59,46.03,28
HCPCS,84577,Assay of feces/urobilinogen,,,18.15,21.01,8
HCPCS,84578,TEST URINE UROBILINOGEN,,,1.79,52.94,28
HCPCS,84578,Test urine urobilinogen,,,11.75,13.61,8
HCPCS,84580,ASSAY OF URINE UROBILINOGEN,,,4.03,31.21,28
HCPCS,84580,Assay of urine urobilinogen,,,11.75,13.61,8
HCPCS,84583,UROBILINOGEN RND UR,42.0,27.3,1.1,42.0,88
HCPCS,84583,UROBILINOGEN SC URINE,42.0,27.3,2.48,42.0,84
HCPCS,84585,VMA (VANILLYLMANDELIC ACID),107.0,69.55,7.65,119.32,84
HCPCS,84585,VMA URINE,107.0,69.55,7.65,119.32,84
HCPCS,84586,ASSAY OF VASOACTIVE INTESTINAL PEPTIDE,244.0,158.6,1.1,244.0,88
HCPCS,84586,VIP,244.0,158.6,17.45,272.08,84
HCPCS,84588,ASSAY OF VASOPRESSIN ANTI-DIURETIC HORMONE,234.0,152.1,1.1,234.0,88
HCPCS,84588,"COPEPTIN PROAVP, PLASMA",234.0,152.1,16.76,234.0,84
HCPCS,84590,%GMAPS VIT A,80.0,52.0,5.73,89.35,84
HCPCS,84590,VIT A (RETINAL) TEST,80.0,52.0,5.73,89.35,84
HCPCS,84590,VITAMIN A/RETINOL,80.0,52.0,1.1,80.0,88
HCPCS,84591,ASSAY OF VITAMIN NOT OTHERWISE SPECIFIED,118.0,76.7,1.1,118.0,88
HCPCS,84591,VITAMIN B3 (NIACIN AND METABOLITES),118.0,76.7,6.82,118.0,84
HCPCS,84591,VITAMIN B5,118.0,76.7,6.82,118.0,84
HCPCS,84591,VITAMIN B7 (BIOTIN),118.0,76.7,6.82,118.0,84
HCPCS,84591,VITAMIN NOS,118.0,76.7,6.82,118.0,84
HCPCS,84597,VITAMIN K,95.0,61.75,6.78,104.38,84
HCPCS,84600,BENZENE QT WHOLE BLD,118.0,76.7,7.94,118.0,84
HCPCS,84600,METHYL ETHYL KETONE URIN,118.0,76.7,7.94,118.0,84
HCPCS,84600,PROPYLENE GLYCOL,118.0,76.7,7.94,118.0,84
HCPCS,84600,TOLUENE BLOOD,118.0,76.7,7.94,118.0,84
HCPCS,84600,VOLATILES ASSAY,118.0,76.7,7.94,118.0,84
HCPCS,84620,XYLOSE ABSORPTION BLOOD &/OR URINE,89.0,57.85,1.1,89.0,88
HCPCS,84620,XYLOSE TOLERANCE TEST,,,5.85,35.37,28
HCPCS,84620,Xylose tolerance test,,,18.15,21.01,8
HCPCS,84630,ZINC BLOOD,79.0,51.35,5.62,87.67,84
HCPCS,84630,ZINC WHOL BLOOD,79.0,51.35,5.62,87.67,84
HCPCS,84630,"ZINC, UR QNT",79.0,51.35,5.62,87.67,84
HCPCS,84630,"ZINC, URINE QUANTITATIVE",79.0,51.35,5.62,87.67,84
HCPCS,84681,ASSAY OF C-PEPTIDE,144.0,93.6,1.1,144.0,88
HCPCS,84681,C-PEPTIDE SERUM,144.0,93.6,10.28,144.0,84
HCPCS,84681,UCPEP C PEPTIDE URINE,144.0,93.6,10.28,144.0,84
HCPCS,84702,%1ST TRI HCG QUANT,104.0,67.6,7.44,104.0,84
HCPCS,84702,%FIRSCN HCG QUANT,104.0,67.6,7.44,104.0,84
HCPCS,84702,%SEQ1 HCG,104.0,67.6,7.44,104.0,84
HCPCS,84702,%SEQ2 HCG QUANT,104.0,67.6,7.44,104.0,84
HCPCS,84702,BETA HCG QUANT SERUM,104.0,67.6,7.44,104.0,84
HCPCS,84702,BETA HCG QUANT TUMOR MARKER,104.0,67.6,7.44,104.0,84
HCPCS,84702,BETA-HCG QNT TM CSF,104.0,67.6,7.44,104.0,84
HCPCS,84702,GONADOTROPIN CHORIONIC QUANTITATIVE,104.0,67.6,1.1,104.0,88
HCPCS,84702,HCG QUANT SERUM,104.0,67.6,7.44,104.0,84
HCPCS,84703,CHORIONIC GONADOTROPIN ASSAY,52.0,33.8,7.52,52.0,84
HCPCS,84703,GONADOTROPIN CHORIONIC QUALITATIVE,52.0,33.8,1.1,52.0,88
HCPCS,84703,HCG TEST QUAL,52.0,33.8,7.52,52.0,84
HCPCS,84703,HCG TEST QUAL (POINT OF CARE LAB),52.0,33.8,7.52,52.0,84
HCPCS,84703,UA DIP URINE HCG (POINT OF CARE LAB),52.0,33.8,7.52,52.0,84
HCPCS,84704,BETA HCG QNT TUMOR MKR,106.0,68.9,7.44,106.0,84
HCPCS,84830,OVULATION TESTS,,,12.7,44.21,26
HCPCS,84830,Ovulation tests,,,22.0,25.48,8
HCPCS,84999,CHITOTRIOSIDASE,288.0,187.2,18.15,1666801.85,67
HCPCS,84999,FECAL WT 24HR WET WEIGHT,89.0,57.85,4.36,1666801.85,134
HCPCS,84999,"NITROGEN, TOTAL, FECES",761.0,494.65,18.15,1666801.85,67
HCPCS,84999,"OSMOLALITY, STOOL",75.0,48.75,16.35,1666801.85,67
HCPCS,84999,"POTASSIUM, BODY FLUID",56.0,36.4,12.21,1666801.85,67
HCPCS,84999,"POTASSIUM, STOOL",62.0,40.3,13.52,1666801.85,67
HCPCS,84999,PROMETHEUS ANSER ADA,2129.0,1383.85,18.15,1666801.85,67
HCPCS,84999,PROMETHEUS ANSER IFX,2129.0,1383.85,18.15,1666801.85,67
HCPCS,84999,PROMETHEUS ANSER UST,2129.0,1383.85,18.15,1666801.85,67
HCPCS,84999,PROMETHEUS ANSER VDZ,2129.0,1383.85,18.15,1666801.85,67
HCPCS,84999,SP REQUEST SERVICE FEE,62.0,40.3,13.52,1666801.85,67
HCPCS,84999,TEG RESEARCH,29.0,18.85,6.32,1666801.85,67
HCPCS,85002,BLEEDING TIME RATNOFF,33.0,21.45,2.23,66.48,84
HCPCS,85002,BLEEDING TIME SIMPLATE,33.0,21.45,2.23,66.48,84
HCPCS,85004,AUTOMATED DIFF WBC COUNT,,,3.19,19.92,29
HCPCS,85004,Automated diff wbc count,,,8.48,9.82,8
HCPCS,85007,AVN MANUAL DIFF,26.0,16.9,1.7,26.0,84
HCPCS,85007,BLOOD COUNT SMEAR MCRSCP W/MNL DIFRNTL WBC COUNT,26.0,16.9,1.1,26.0,88
HCPCS,85007,WBC COUNT MANUAL DIFF,26.0,16.9,1.7,26.0,84
HCPCS,85008,BL SMEAR W/O DIFF WBC COUNT,,,1.52,10.34,29
HCPCS,85008,Bl smear w/o diff wbc count,,,8.48,9.82,8
HCPCS,85009,BLOOD COUNT MANUAL DIFRNTL WBC COUNT BUFFY COAT,35.0,22.75,1.1,35.0,88
HCPCS,85009,BUFFY COAT SEZARY CELL,35.0,22.75,2.03,35.0,84
HCPCS,85013,BLOOD COUNT SPUN MICRO HCT,48.0,31.2,7.0,48.0,84
HCPCS,85013,BLOOD COUNT SPUN MICROHEMATOCRIT,48.0,31.2,1.1,48.0,88
HCPCS,85014,*BLOOD COUNT HCT,16.0,10.4,2.31,16.0,84
HCPCS,85014,BLOOD COUNT HCT (POINT OF CARE LAB),16.0,10.4,2.31,16.0,84
HCPCS,85014,BLOOD COUNT HEMATOCRIT,16.0,10.4,1.1,16.0,88
HCPCS,85014,HEMATOCRIT,16.0,10.4,2.31,16.0,84
HCPCS,85014,HEMATOCRIT (POINT OF CARE LAB),16.0,10.4,2.31,16.0,84
HCPCS,85018,*BLOOD COUNT HGB,16.0,10.4,2.37,16.0,84
HCPCS,85018,BLOOD COUNT HEMOGLOBIN,16.0,10.4,1.1,16.0,88
HCPCS,85018,BLOOD COUNT HGB,16.0,10.4,2.37,16.0,84
HCPCS,85018,BLOOD COUNT HGB (POINT OF CARE LAB),16.0,10.4,2.37,16.0,84
HCPCS,85024,AUTOMATED HEMOGRAM,74.0,48.1,1.1,74.0,70
HCPCS,85025,BLOOD COUNT COMPLETE AUTO&AUTO DIFRNTL WBC,54.0,35.1,1.1,54.0,88
HCPCS,85025,CBC AUTO W AUTO DIFF,54.0,35.1,7.77,54.0,84
HCPCS,85027,BLOOD COUNT COMPLETE AUTOMATED,45.0,29.25,1.1,45.0,88
HCPCS,85027,CBC AUTO WO DIFF,45.0,29.25,6.47,45.0,84
HCPCS,85032,BLOOD COUNT MANUAL CELL COUNT EACH,30.0,19.5,1.1,30.0,88
HCPCS,85032,MANUAL CELL COUNT EA,30.0,19.5,2.13,30.0,84
HCPCS,85032,"SMEAR, PARASITEMIA CELL COUNT",30.0,19.5,2.13,30.0,84
HCPCS,85041,AUTOMATED RBC COUNT,21.0,13.65,1.49,21.0,84
HCPCS,85041,CSPNL AUTO RBC COUNT,21.0,13.65,1.49,21.0,84
HCPCS,85044,MANUAL RETICULOCYTE COUNT,,,2.13,32.59,28
HCPCS,85044,Manual reticulocyte count,,,8.48,9.82,8
HCPCS,85045,BLOOD COUNT RETICULOCYTE AUTOMATED,28.0,18.2,1.1,28.0,88
HCPCS,85045,RETICULOCYTE COUNT AUTO,28.0,18.2,1.97,28.0,84
HCPCS,85046,BLOOD COUNT RETICULOCYTES AUTO 1/> CELL MEAS,38.0,24.7,1.1,38.0,88
HCPCS,85046,RETICULOCYTE HEMOGLOBIN,38.0,24.7,2.75,38.0,84
HCPCS,85048,*LEUKO (WBC) COUNT AUTO,18.0,11.7,1.25,18.0,84
HCPCS,85048,BLOOD COUNT LEUKOCYTE WBC AUTOMATED,18.0,11.7,1.1,18.0,88
HCPCS,85048,LEUKO (WBC) COUNT AUTO,18.0,11.7,1.25,18.0,84
HCPCS,85049,BLOOD COUNT PLATELET AUTOMATED,31.0,20.15,1.1,31.0,88
HCPCS,85049,PLT COUNT AUTO,31.0,20.15,2.21,31.0,84
HCPCS,85055,IMMATURE PLATELET FRACT,247.0,160.55,14.3,247.0,84
HCPCS,85060,BLOOD SMEAR INTERPRETATION,,,17.36,74.75,7
HCPCS,85060,BLOOD SMEAR PERIPHERAL INTERP PHYS W/WRIT REPORT,198.0,128.7,1.1,198.0,130
HCPCS,85060,Blood smear interpretation,,,8.48,9.82,8
HCPCS,85097,BONE MARROW ROUTINE,5637.0,3664.05,11.81,5637.0,174
HCPCS,85097,BONE MARROW SMEAR INTERPRETATION,414.0,269.1,1.1,2506.96,134
HCPCS,85130,CHROMOGENIC SUBSTRATE ASSAY,,,5.87,52.42,28
HCPCS,85130,Chromogenic substrate assay,,,8.48,9.82,8
HCPCS,85170,BLOOD CLOT RETRACTION,,,6.52,49.1,28
HCPCS,85170,Blood clot retraction,,,9.71,11.24,8
HCPCS,85175,BLOOD CLOT LYSIS TIME,,,8.15,61.36,28
HCPCS,85175,Blood clot lysis time,,,47.02,54.44,8
HCPCS,85210,CLOTTING FACTOR II PROTHROMBIN SPECIFIC,90.0,58.5,1.1,90.0,88
HCPCS,85210,COAG FACT ASSAY 2,90.0,58.5,6.41,90.0,84
HCPCS,85220,CLOTTING FACTOR V ACG/PROACCELERIN LABILE FACTOR,122.0,79.3,1.1,122.0,88
HCPCS,85220,COAG FACT ASSAY 5,122.0,79.3,8.72,122.0,84
HCPCS,85230,COAG FACT ASSAY 7,124.0,80.6,8.84,124.0,84
HCPCS,85230,FACTOR VII:C ASSAY,124.0,80.6,1.1,124.0,88
HCPCS,85240,%VWD2N ONE STAGE,124.0,80.6,8.84,124.0,84
HCPCS,85240,CLOTTING FACTOR VIII AHG 1 STAGE,124.0,80.6,1.1,124.0,88
HCPCS,85240,COAG FACT ASSAY 8,124.0,80.6,8.84,124.0,84
HCPCS,85244,CLOT FACTOR VIII RELTD ANTGN,,,10.08,61.51,28
HCPCS,85244,Clot factor viii reltd antgn,,,47.02,54.44,8
HCPCS,85245,CLOT FACTOR VIII VW RISTOCTN,158.0,102.7,11.33,158.0,84
HCPCS,85245,CLOTTING FACTOR VIII VW FACTOR RISTOCETIN COFACT,158.0,102.7,1.1,158.0,88
HCPCS,85246,%VWD2N FACTOR ANTIGEN,158.0,102.7,11.33,158.0,84
HCPCS,85246,CLOTTING FACTOR VIII VW FACTOR ANTIGEN,158.0,102.7,1.1,158.0,88
HCPCS,85246,VON WILLEBRAND ANTIGEN,158.0,102.7,11.33,158.0,84
HCPCS,85247,VWF MULTIMER,158.0,102.7,11.33,176.68,84
HCPCS,85250,CLOTTING FACTOR IX PTC/CHRISTMAS,131.0,85.15,1.1,131.0,88
HCPCS,85250,COAG FACT ASSAY 9,131.0,85.15,9.4,131.0,84
HCPCS,85260,COAG FACT ASSAY 10,124.0,80.6,8.84,124.0,84
HCPCS,85260,FACTOR X:C ASSAY,124.0,80.6,1.1,124.0,88
HCPCS,85270,CLOTTING FACTOR XI PTA,124.0,80.6,1.1,124.0,88
HCPCS,85270,COAG FACT ASSAY 11,124.0,80.6,8.84,124.0,84
HCPCS,85280,CLOTTING FACTOR XII HAGEMAN,134.0,87.1,1.1,134.0,88
HCPCS,85280,COAG FACT ASSAY 12,134.0,87.1,9.56,134.0,84
HCPCS,85290,COAG FACTOR ASSAY 13,113.0,73.45,8.07,113.0,84
HCPCS,85290,FACTOR XIII ASSAY,113.0,73.45,1.1,113.0,88
HCPCS,85291,CLOT FACTOR XIII FIBRIN SCRN,,,4.39,39.12,28
HCPCS,85291,Clot factor xiii fibrin scrn,,,9.71,11.24,8
HCPCS,85292,PREKALLIKREIN FLETCHER,131.0,85.15,9.35,131.0,84
HCPCS,85293,CLOTTING; HMW KININOGEN ASSAY,131.0,85.15,9.35,145.81,84
HCPCS,85300,ANTITHROMBIN 3,82.0,53.3,5.85,82.0,84
HCPCS,85300,CLOTTING INHIBITORS ANTITHROMBIN III ACTIVITY,82.0,53.3,1.1,82.0,88
HCPCS,85301,ANTITHROMBIN III AG ASSAY,75.0,48.75,5.34,75.0,84
HCPCS,85302,CLOTTING INHIBITORS PROTEIN C ANTIGEN,83.0,53.95,1.1,83.0,88
HCPCS,85302,PROTEIN C IMMUNO,83.0,53.95,5.93,87.58,84
HCPCS,85303,CLOTTING INHIBITOR; PROTEIN C ACTIVITY,95.0,61.75,1.1,95.0,88
HCPCS,85303,PROTEIN C FUNCTIONAL,95.0,61.75,6.83,95.0,84
HCPCS,85305,CLOTTING INHIBITORS PROTEIN S TOTAL,80.0,52.0,1.1,80.0,88
HCPCS,85305,PROTEIN S TOTAL,80.0,52.0,5.73,89.35,84
HCPCS,85306,CLOTTING INHIBITORS PROTEIN S FREE,106.0,68.9,1.1,106.0,88
HCPCS,85306,PROTEIN S FREE,106.0,68.9,7.57,106.0,84
HCPCS,85307,ACTIVATED PROTEIN C APC RESISTANCE ASSAY,106.0,68.9,1.1,106.0,88
HCPCS,85307,APC RESISTANCE,106.0,68.9,7.57,106.0,84
HCPCS,85335,%AD13IN FACTR INHIB TEST,89.0,57.85,6.36,99.1,84
HCPCS,85337,THROMBOMODULIN,,,6.91,52.03,28
HCPCS,85337,Thrombomodulin,,,9.71,11.24,8
HCPCS,85345,COAGULATION TIME LEE & WHITE,,,2.13,18.87,28
HCPCS,85345,Coagulation time lee & white,,,9.71,11.24,8
HCPCS,85347,ACTIVATED COAGULATION,30.0,19.5,2.1,32.77,168
HCPCS,85347,COAG TIME ACTIVATED (POINT OF CARE LAB),30.0,19.5,2.1,32.77,84
HCPCS,85347,COAGULATION TIME,30.0,19.5,1.1,30.0,88
HCPCS,85348,COAGULATION TIME OTR METHOD,,,1.84,16.35,28
HCPCS,85348,Coagulation time otr method,,,9.71,11.24,8
HCPCS,85360,EUGLOBULIN LYSIS,58.0,37.7,1.1,58.0,88
HCPCS,85360,EUGLOBULIN LYSIS TIME,58.0,37.7,4.15,58.82,168
HCPCS,85362,DEGRADATION PRODUCTS,48.0,31.2,3.4,53.05,84
HCPCS,85362,FIBRIN DGRADJ SPLT PRODUXS AGGLUJ SLIDE SEMIQUAN,48.0,31.2,1.1,48.0,88
HCPCS,85366,FIBRINOGEN TEST,,,32.18,242.38,28
HCPCS,85366,Fibrinogen test,,,47.02,54.44,8
HCPCS,85370,FIBRINOGEN TEST,,,5.61,50.03,28
HCPCS,85370,Fibrinogen test,,,9.71,11.24,8
HCPCS,85378,FIBRIN DEGRADE SEMIQUANT,,,3.89,49.89,28
HCPCS,85378,Fibrin degrade semiquant,,,9.71,11.24,8
HCPCS,85379,D-DIMER (POINT OF CARE LAB),70.0,45.5,5.02,70.0,84
HCPCS,85379,D-DIMER QUANT,70.0,45.5,5.02,70.0,84
HCPCS,85379,FIBRIN DGRADJ PRODUCTS D-DIMER QUANTITATIVE,70.0,45.5,1.1,70.0,88
HCPCS,85380,FIBRIN DEGRADJ D-DIMER,,,5.02,42.41,28
HCPCS,85380,Fibrin degradj d-dimer,,,8.48,9.82,8
HCPCS,85384,FIBRINOGEN,67.0,43.55,4.2,67.0,168
HCPCS,85384,FIBRINOGEN ACTIVITY,67.0,43.55,1.1,67.0,88
HCPCS,85384,MANUAL HEME - FIBRINOGEN,67.0,43.55,4.2,67.0,84
HCPCS,85384,MANUAL HEME- FIBRINOGEN,67.0,43.55,4.2,67.0,84
HCPCS,85385,FIBRIN AG,100.0,65.0,5.78,100.0,84
HCPCS,85385,FIBRINOGEN ANTIGEN,100.0,65.0,1.1,100.0,88
HCPCS,85390,COAGULOPATHY INTERPRET,107.0,69.55,6.19,107.0,84
HCPCS,85390,FIBRINOLYSINS SCREEN I&R,107.0,69.55,6.19,107.0,86
HCPCS,85390,FIBRINOLYSINS/COAGULOPATHY SCREEN INTERP&REPOR,107.0,69.55,1.1,107.0,92
HCPCS,85390,PLTEMS FIBRINOLYSINS SCREEN I&R,107.0,69.55,6.19,107.0,84
HCPCS,8539026,FIBRINOLYSINS SCREEN I&R,,,7.49,7.49,2
HCPCS,85396,%THROMBOGRAPH,163.0,105.95,13.95,163.0,68
HCPCS,85396,COAGJ/FBRNLYS ASSAY WHOLE BLOOD ADDITIVE PER DAY,163.0,105.95,1.1,163.0,130
HCPCS,85396,COAGULATION/FIBRINOLYSIS,163.0,105.95,13.95,163.0,68
HCPCS,85397,%AD13AC COAG/FIBFUNC ACT,213.0,138.45,30.86,213.0,84
HCPCS,85397,VWF GPIBM ACTIVITY,213.0,138.45,30.86,213.0,84
HCPCS,85400,FIBRINOLYTIC PLASMIN,,,3.8,33.62,28
HCPCS,85400,Fibrinolytic plasmin,,,9.71,11.24,8
HCPCS,85410,ALPHA 2 ANTIPLASMIN,53.0,34.45,1.1,58.82,172
HCPCS,85415,FBRNLYC FACTORS&INHIBITORS PLSMNG ACTIVATOR,119.0,77.35,1.1,119.0,88
HCPCS,85415,FIBRIN PLASMINOGEN ACTIVATOR,119.0,77.35,8.49,119.0,84
HCPCS,85415,PLASMINOGEN ACTIV INHIB AG,119.0,77.35,8.49,119.0,84
HCPCS,85420,FIBRINOLYTIC PLASMINOGEN,45.0,29.25,1.1,45.0,88
HCPCS,85420,PLASMINOGEN FUNCTIONAL,45.0,29.25,3.22,46.35,84
HCPCS,85421,FIBRINOLYTIC PLASMINOGEN,,,5.03,33.62,28
HCPCS,85421,Fibrinolytic plasminogen,,,9.71,11.24,8
HCPCS,85441,HEINZ BODY STAIN,29.0,18.85,2.07,29.0,84
HCPCS,85441,HEINZ STAIN BLD,29.0,18.85,1.1,29.0,88
HCPCS,85441,HNZBSN HEINZ BOD DIRECT,29.0,18.85,2.07,29.0,84
HCPCS,85445,HNZBSN HEINZ BOD INDUCED,47.0,30.55,3.37,47.0,84
HCPCS,85460,HGB/RBCS FETAL FETOMATERNAL HEMRRG DIFRNTL LYSIS,53.0,34.45,1.1,53.0,88
HCPCS,85460,KLEIHAUER BETKE ST,53.0,34.45,3.82,59.61,84
HCPCS,85461,HGB FETAL ROS,65.0,42.25,3.74,90.26,84
HCPCS,85461,HGB/RBCS FETAL FETOMATERNAL HEMRRG ROSETTE,65.0,42.25,1.1,65.0,88
HCPCS,85475,HAM TEST BLD,61.0,39.65,1.1,61.0,88
HCPCS,85475,HEMOLYSIN ACID,,,4.38,39.71,28
HCPCS,85475,Hemolysin acid,,,9.71,11.24,8
HCPCS,85520,ANTIXA,90.0,58.5,6.46,90.0,84
HCPCS,85520,HEPARIN ASSAY,90.0,58.5,1.1,90.0,172
HCPCS,85525,HEPARIN NEUTRALIZATION,,,5.85,40.34,28
HCPCS,85525,Heparin neutralization,,,9.71,11.24,8
HCPCS,85530,HEPARIN-PROTAMINE TOLERANCE,,,6.46,62.52,28
HCPCS,85530,Heparin-protamine tolerance,,,9.71,11.24,8
HCPCS,85536,IRON STAIN MISC,47.0,30.55,3.19,115.77,84
HCPCS,85536,IRON STAIN PERIPHERAL BLOOD,47.0,30.55,1.1,47.0,88
HCPCS,85540,LAP STAIN-LEUK ALK PHOS,59.0,38.35,4.25,66.27,84
HCPCS,85540,LEUKOCYTE ALKALINE PHOSPHATASE,59.0,38.35,4.25,66.27,84
HCPCS,85540,WBC ALKALINE PHOSPHATASE COUNT,59.0,38.35,1.1,59.0,88
HCPCS,85547,RBC MECHANICAL FRAGILITY,,,4.25,37.88,28
HCPCS,85547,Rbc mechanical fragility,,,8.48,9.82,8
HCPCS,85549,MURAMIDASE,129.0,83.85,1.1,129.0,172
HCPCS,85555,OSMOTIC FRAG ERYTHRO,52.0,33.8,3.3,52.0,84
HCPCS,85555,RBC OSMOTIC FRAGILITY,52.0,33.8,1.1,52.0,88
HCPCS,85557,OSMOTIC FRAG INCUB,92.0,59.8,6.6,92.0,84
HCPCS,85576,*BLOOD PLT AGGREGATION EA,172.0,111.8,10.61,172.0,168
HCPCS,85576,BLOOD PLATELET AGGREGATION,,,7.49,7.49,2
HCPCS,85576,PLATELET AGGREGATION IN VITRO EACH AGENT,163.0,105.95,1.1,163.0,218
HCPCS,8557626,BLOOD PLATELET AGGREGATION,,,7.49,7.49,2
HCPCS,85597,PHOSPHOLIPID NEUTRALIZATION PLATELET,124.0,80.6,1.1,124.0,88
HCPCS,85597,PLATELET NEUTRALIZATION,124.0,80.6,8.88,124.0,84
HCPCS,85598,HEXAGOAL PHASE PHOSPHOLIPID NEUTRALIZATION,124.0,80.6,8.88,124.0,84
HCPCS,85598,LUPUS ANTICOAG INTERP PANEL,124.0,80.6,8.88,124.0,84
HCPCS,85610,*PRO TIME,30.0,19.5,4.29,30.0,168
HCPCS,85610,CLOTTING TEST,30.0,19.5,4.29,30.0,84
HCPCS,85610,CLOTTING TEST (POINT OF CARE LAB),30.0,19.5,4.29,30.0,84
HCPCS,85610,MANUAL HEME - PRO TIME,30.0,19.5,4.29,30.0,84
HCPCS,85610,PRO TIME (POINT OF CARE LAB),30.0,19.5,4.29,30.0,168
HCPCS,85610,PROTHROMBIN TIME,21.5,13.975,1.1,30.0,176
HCPCS,85610,PROTHROMBIN TIME AND INR (POINT OF CARE LAB),30.0,19.5,4.29,30.0,84
HCPCS,85611,*PRO TIME TEST PLASMA FRACT EA,27.0,17.55,1.95,30.36,84
HCPCS,85611,PROTHROMBIN TIME SUBSTITUTION PLASMA FRCTJ EACH,27.0,17.55,1.1,27.0,88
HCPCS,85612,VIPER VENOM PROTHROMBIN TIME,,,7.0,52.69,28
HCPCS,85612,Viper venom prothrombin time,,,9.71,11.24,8
HCPCS,85613,DILUTE RVVT X2,66.0,42.9,4.73,66.0,84
HCPCS,85613,RUSSELL VIPER VENOM TIME DILUTED,66.0,42.9,1.1,66.0,88
HCPCS,85635,REPTILASE R TIME,68.0,44.2,4.86,68.0,84
HCPCS,85635,REPTILASE TEST,68.0,44.2,1.1,68.0,88
HCPCS,85635,REPTILASE TIME 1:1 MIX BILL,68.0,44.2,4.86,68.0,84
HCPCS,85651,SED RATE WESTERGREN,29.0,18.85,4.27,29.0,84
HCPCS,85651,SEDIMENTATION RATE RBC NON-AUTOMATED,29.0,18.85,1.1,29.0,88
HCPCS,85652,SEDIMENTATION RATE AUTO,19.0,12.35,2.7,19.0,84
HCPCS,85652,SEDIMENTATION RATE RBC AUTOMATED,19.0,12.35,1.1,19.0,88
HCPCS,85660,RBC SICKLING REDUC,38.0,24.7,2.72,38.0,168
HCPCS,85660,SICKLING RBC REDUCTION,38.0,24.7,1.1,38.0,88
HCPCS,85670,THROMBIN TIME,40.0,26.0,1.1,40.0,172
HCPCS,85675,THROMBIN TIME TITER,,,3.38,30.14,28
HCPCS,85675,Thrombin time titer,,,9.71,11.24,8
HCPCS,85705,THROMBOPLASTIN INHIBITION,,,4.76,42.37,28
HCPCS,85705,Thromboplastin inhibition,,,9.71,11.24,8
HCPCS,85730,*PTT PLASMA/WHOLE BLOOD,41.0,26.65,2.97,41.0,84
HCPCS,85730,MANUAL HEME - PTT PLASMA/WHOLE BLOOD,41.0,26.65,2.97,41.0,84
HCPCS,85730,THROMBOPLASTIN TIME PARTIAL PLASMA/WHOLE BLOOD,41.0,26.65,1.1,41.0,88
HCPCS,85732,*PTT PLASMA FRACT EA,45.0,29.25,3.19,45.0,84
HCPCS,85732,THROMBOPLASTIN TIME PRTL SUBSTIT PLASMA FRCTJ EA,45.0,29.25,1.1,45.0,88
HCPCS,85810,VISCOSITY,81.0,52.65,1.1,81.0,88
HCPCS,85810,VISCOSITY BLOOD,81.0,52.65,5.76,81.0,84
HCPCS,85810,VISCOSITY SERUM,81.0,52.65,5.76,81.0,84
HCPCS,85999,UNLISTED HEMATOLOGY&COAGJ PX,,,2466002.74,2466002.74,1
HCPCS,85999,Unlisted hematology&coagj px,,,8.48,9.82,8
HCPCS,86000,TULRFX AB AGG RFLX,48.0,31.2,3.45,48.0,84
HCPCS,86001,%ABPA2 IGG TOTAL,54.0,35.1,3.13,54.0,84
HCPCS,86001,*ALLERGEN IGG QUANT/SEMI EA,54.0,35.1,3.13,54.0,84
HCPCS,86001,ALGN FOOD PANEL IGG X19,54.0,35.1,3.13,54.0,84
HCPCS,86001,ALLERGEN IGG EACH,54.0,35.1,3.13,54.0,84
HCPCS,86001,ALLERGEN SPECIFIC IGG QUAN/SEMIQUAN EA ALLERGEN,54.0,35.1,1.1,54.0,88
HCPCS,86001,HYPERSENSITIVITY PNEUMONITIS EVALUATION X8,54.0,35.1,3.13,54.0,84
HCPCS,86003,%PNUTCP ALLG SPEC IGE,36.0,23.4,2.96,36.0,84
HCPCS,86003,*ALLERG SP IGE;QT OR QUAL,36.0,23.4,2.96,36.0,84
HCPCS,86003,ALGN CHAETOMIUM GLOB IGE,36.0,23.4,2.96,36.0,84
HCPCS,86003,ALGN OCCUPATNL TOBACCO,36.0,23.4,2.96,36.0,84
HCPCS,86003,ALGN ORRIS ROOT IGE,36.0,23.4,2.96,36.0,84
HCPCS,86003,ALLERGEN IGE EACH,36.0,23.4,2.96,36.0,84
HCPCS,86003,ALLERGEN IGE QUANT/SEMI EA,36.0,23.4,2.96,36.0,84
HCPCS,86003,ALLERGEN SPEC IGE CRUDE ALLERGEN EXTRACT EACH,36.0,23.4,1.1,36.0,88
HCPCS,86003,"ALLERGEN, EGG IGE X2",36.0,23.4,2.96,36.0,84
HCPCS,86003,"ALLERGEN, FOOD, ANCHOVY IGE",36.0,23.4,2.96,36.0,84
HCPCS,86003,"ALLERGEN, FOOD, ANNATTO SEED IGE",36.0,23.4,2.96,36.0,84
HCPCS,86003,"ALLERGEN, FOOD, APRICOT",36.0,23.4,2.96,36.0,84
HCPCS,86003,"ALLERGEN, FOOD, ASPARAGUS IGE",36.0,23.4,2.96,36.0,84
HCPCS,86003,"ALLERGEN, FOOD, BLACK OLIVE IGE",36.0,23.4,2.96,36.0,84
HCPCS,86003,"ALLERGEN, FOOD, CAROB GUM IGE",36.0,23.4,2.96,36.0,84
HCPCS,86003,"ALLERGEN, FOOD, CAULIFLOWER IGE",36.0,23.4,2.96,36.0,84
HCPCS,86003,"ALLERGEN, FOOD, EGGPLANT",36.0,23.4,2.96,36.0,84
HCPCS,86003,"ALLERGEN, FOOD, GINGER IGE",36.0,23.4,2.96,36.0,84
HCPCS,86003,"ALLERGEN, FOOD, GOAT MILK IGE",36.0,23.4,2.96,36.0,84
HCPCS,86003,"ALLERGEN, FOOD, LAMB",36.0,23.4,2.96,36.0,84
HCPCS,86003,"ALLERGEN, FOOD, LIMA BEAN/WHITE BEAN",36.0,23.4,2.96,36.0,84
HCPCS,86003,"ALLERGEN, FOOD, NAVY BEAN IGE",36.0,23.4,2.96,36.0,84
HCPCS,86003,"ALLERGEN, FOOD, NUTMEG IGE",36.0,23.4,2.96,36.0,84
HCPCS,86003,"ALLERGEN, FOOD, SARDINE IGE",36.0,23.4,2.96,36.0,84
HCPCS,86003,"ALLERGEN, FOOD, SPINACH",36.0,23.4,2.96,36.0,84
HCPCS,86003,"ALLERGEN, FOOD, SUMMER SQUASH IGE",36.0,23.4,2.96,36.0,84
HCPCS,86003,"ALLERGEN, FOOD, TEA IGE",36.0,23.4,2.96,36.0,84
HCPCS,86003,"ALLERGEN, FOOD, TURMERIC IGE",36.0,23.4,2.96,36.0,84
HCPCS,86003,"ALLERGEN, FUNGI/MOLD, B. SPICIFERA IGE",36.0,23.4,2.96,36.0,84
HCPCS,86003,"ALLERGEN, FUNGI/MOLD, CURVULARIA LUNATA",36.0,23.4,2.96,36.0,84
HCPCS,86003,"ALLERGEN, HONEY BEE IGE WITH REFLEX TO COMPONENTS",36.0,23.4,2.96,36.0,84
HCPCS,86003,"ALLERGEN, INSECT, BUMBLE BEE VENOM IGE",36.0,23.4,2.96,36.0,84
HCPCS,86003,"ALLERGEN, INSECT, FIRE ANT, IMPORTED",36.0,23.4,2.96,36.0,84
HCPCS,86003,"ALLERGEN, INSECT, MOSQUITO, IGE",36.0,23.4,2.96,36.0,84
HCPCS,86003,"ALLERGEN, MILK IGE X4",36.0,23.4,2.96,36.0,84
HCPCS,86003,"ALLERGEN, PAPER WASP IGE WITH REFLEX TO COMPONENT",36.0,23.4,2.96,36.0,84
HCPCS,86003,"ALLERGEN, REGION 3 SOUTH ATLANTIC RESPIRATORY PANEL IGE",36.0,23.4,2.96,36.0,84
HCPCS,86003,"ALLERGEN, SESAME SEED WITH COMPONENT REFLEX",36.0,23.4,2.96,36.0,84
HCPCS,86003,"ALLERGEN, TOTAL VENOM PANEL IGE WITH REFLEX TO COMPONENTS",36.0,23.4,2.96,36.0,84
HCPCS,86003,"ALLERGEN, TREE, PALM/QUEEN TREE IGE",36.0,23.4,2.96,36.0,84
HCPCS,86003,"ALLERGEN, WEED, SAGEBRUSH/WORMWOOD IGE",36.0,23.4,2.96,36.0,84
HCPCS,86003,"ALLERGEN, WHEAT WITH COMPONENT REFLEX",36.0,23.4,2.96,36.0,84
HCPCS,86003,"ALLERGEN, YELLOW JACKET (COMMON WASP) IGE WITH REFLEX TO COMPONE",36.0,23.4,2.96,36.0,84
HCPCS,86003,ATOPIC ALGN IGE QNT X11,36.0,23.4,2.96,36.0,84
HCPCS,86003,CHEESE MOZZARELLA IGE,36.0,23.4,2.96,36.0,84
HCPCS,86003,CHEESE PARMESAN IGE,36.0,23.4,2.96,36.0,84
HCPCS,86003,CHEESE SWISS IGE,36.0,23.4,2.96,36.0,84
HCPCS,86003,F324-IGE HOP (FOOD),36.0,23.4,2.96,36.0,84
HCPCS,86003,"HOPS, IGE ALLERGEN",36.0,23.4,2.96,36.0,84
HCPCS,86003,HYPERSENSITIVITY PNEUMO IGE QUANT,36.0,23.4,2.96,36.0,84
HCPCS,86003,LUPINE SEED (LUPINUS ALBUS) IGE,36.0,23.4,2.96,36.0,84
HCPCS,86005,HYPERSENSITIVITY PNEUMO IGE QUAL,55.0,35.75,3.94,55.0,84
HCPCS,86008,%PNUTCP ALLG IGE RECOMBX5,124.0,80.6,17.93,124.0,84
HCPCS,86008,"ALGN FOOD, ALPHA-GAL IGE",124.0,80.6,17.93,124.0,84
HCPCS,86008,"ALLERGEN, BROMELAIN IGE",124.0,80.6,17.93,124.0,84
HCPCS,86008,"ALLERGEN, PAPER WASP COMPONENT IGE",124.0,80.6,17.93,124.0,84
HCPCS,86008,"ALLERGEN, SESAME SEED RSES I 1 COMPONENT",124.0,80.6,17.93,124.0,84
HCPCS,86008,"ALLERGEN, WHEAT, RTRI A OMEGA-5-GLIADIN COMPONENT",124.0,80.6,17.93,124.0,84
HCPCS,86008,"ALLERGEN, YELLOW JACKET (COMMON WASP) COMPONENTS IGE",124.0,80.6,17.93,124.0,84
HCPCS,86008,ALLG SPEC IGE IN HOUSE,124.0,80.6,17.93,124.0,84
HCPCS,86008,ALLG SPEC IGE RECOMB EA,124.0,80.6,17.93,124.0,168
HCPCS,86008,"GALAC-ALPHA 1,3-GALAC IGE",124.0,80.6,17.93,124.0,84
HCPCS,86015,ACTIN SMOOTH MUSCLE AB EA,83.0,53.95,4.61,83.0,84
HCPCS,86021,AB ID LEUKO AB,104.0,67.6,7.44,104.0,84
HCPCS,86021,ANTIBODY IDENTIFICATION LEUKOCYTE ANTIBODIES,104.0,67.6,1.1,104.0,88
HCPCS,86022,*AB ID PLT AB,127.0,82.55,9.07,127.0,84
HCPCS,86022,ANTI PLATELET FACT 4 X2,127.0,82.55,9.07,127.0,84
HCPCS,86022,ANTIBODY IDENTIFICATION PLATELET ANTIBODIES,127.0,82.55,1.1,127.0,88
HCPCS,86022,PLATELET AB DETECTION,127.0,82.55,9.07,127.0,84
HCPCS,86022,PLATELET ANTIBODIES,127.0,82.55,9.07,127.0,168
HCPCS,86022,PLATELET ANTIBODY SCRNX4,127.0,82.55,9.07,127.0,84
HCPCS,86022,PLATELET SURFACE GLYCOPROTEIN EXPRESSION,127.0,82.55,9.07,127.0,84
HCPCS,86022,SEROTONIN RELEASE LMWH,127.0,82.55,9.07,127.0,84
HCPCS,86023,*AB ID PLT IG ASSAY,86.0,55.9,6.15,95.9,84
HCPCS,86036,ANTINEUT CYT AB SCR EA,83.0,53.95,4.82,83.0,84
HCPCS,86036,ANTINEUTROPHIL CYTOPLASMIC ANTB SCREEN EA ANTB,83.0,53.95,1.1,83.0,88
HCPCS,86036,IBDSER ANTINEUT CYT AB SCR EA,83.0,53.95,4.82,83.0,84
HCPCS,86037,ANCA TITER EACH ANTIBODY,,,4.82,33.02,25
HCPCS,86037,Anca titer each antibody,,,23.08,26.72,8
HCPCS,86038,%FANA ANA AB,83.0,53.95,5.97,83.0,84
HCPCS,86038,ANTINUCLEAR,83.0,53.95,5.97,83.0,84
HCPCS,86038,ANTINUCLEAR AB (ANA);,83.0,53.95,1.1,83.0,88
HCPCS,86039,*%ANA,77.0,50.05,5.51,77.0,84
HCPCS,86039,ANA (POLMYO),77.0,50.05,5.51,77.0,84
HCPCS,86039,ANA BY IFA IGG REFLEX,77.0,50.05,5.51,77.0,84
HCPCS,86039,ANTINUCLEAR ANTIBODIES ANA TITER,77.0,50.05,1.1,77.0,88
HCPCS,86039,"NA BY IFA, IGG",77.0,50.05,5.51,77.0,84
HCPCS,86039,SEMIQUANTITATIVE ANA (DERMYO),77.0,50.05,5.51,77.0,84
HCPCS,86039,SEMIQUANTITATIVE ANA (MYOSPL),77.0,50.05,5.51,77.0,84
HCPCS,86041,ACETYLCHOLINE RECEPTOR (ACHR) BINDING ANTIBODY,127.0,82.55,7.36,127.0,83
HCPCS,86041,ACETYLCHOLINE RECEPTOR BINDING ANTIBODY,127.0,82.55,7.36,127.0,83
HCPCS,86042,ACETYLCHOLINE RECEPTOR (ACHR) BLOCKING ANTIBODY,127.0,82.55,7.36,127.0,83
HCPCS,86042,ACETYLCHOLINE RECEPTOR BLOCKING ANTIBODY,127.0,82.55,7.36,127.0,83
HCPCS,86043,ACETYLCHOLINE RECEPTOR MODULATING ANTIBODY,83.0,53.95,4.82,83.0,83
HCPCS,86051,AQUAPORIN-4 ANTB ELISA,,,4.61,31.59,25
HCPCS,86051,Aquaporin-4 antb elisa,,,23.08,26.72,8
HCPCS,86052,AQPCSF AQ-4 AB EA,83.0,53.95,4.82,83.0,84
HCPCS,86052,"NMO/AQP4 AB IGG CBA-IFA SCREEN, CSF",83.0,53.95,4.82,83.0,84
HCPCS,86052,"NMO/AQP4 AB IGG CBA-IFA SCREEN, SERUM",83.0,53.95,4.82,83.0,168
HCPCS,86052,NMOIFA AQ-4 AB EA,83.0,53.95,4.82,83.0,84
HCPCS,86053,CDS1SE AQ4 AB FL CYT EA,260.0,169.0,4.82,260.0,84
HCPCS,86053,MLPTHY NMO/AQP4 FACS,260.0,169.0,4.82,260.0,84
HCPCS,86053,NMO/AQP4 FACS SER RFLX,260.0,169.0,4.82,260.0,84
HCPCS,86053,NMOA4 FACS ASSAY SERUM,260.0,169.0,4.82,260.0,84
HCPCS,86060,*ANTISTREPTOLYSIN 0 TITER,50.0,32.5,3.6,50.0,84
HCPCS,86060,ANTI-STREPTOLYSIN O,50.0,32.5,3.6,50.0,84
HCPCS,86060,ANTISTREPTOLYSIN O TITER,50.0,32.5,1.1,50.0,88
HCPCS,86063,ANTISTREPTOLYSIN O SCREEN,,,2.85,19.32,29
HCPCS,86063,Antistreptolysin o screen,,,23.08,26.72,8
HCPCS,86077,BLD BANK PHYS SVCS DIFFC CROSS MATCH&/EVAL REP,414.0,269.1,1.1,414.0,134
HCPCS,86077,PHYS BLOOD BANK SERV XMATCH,,,22.7,116.2,27
HCPCS,86077,Phys blood bank serv xmatch,,,34.71,40.19,8
HCPCS,86078,BLD BANK PHYS SVCS INVSTGJ TFUJ RXN REPRT,414.0,269.1,1.1,498.94,134
HCPCS,86078,TRANS REACTION EVAL,1182.0,768.3,30.88,1182.0,87
HCPCS,86079,BLD BANK PHYS SVCS AUTHJ DEVIJ STANDARD REPRT,414.0,269.1,1.1,414.0,134
HCPCS,86079,PHYS BLOOD BANK SERV AUTHRJ,,,13.62,162.07,26
HCPCS,86079,Phys blood bank serv authrj,,,34.71,40.19,8
HCPCS,86140,%IBDSGI C REAC PROTEIN,36.0,23.4,5.18,36.0,84
HCPCS,86140,C-REACTIVE PROTEIN,36.0,23.4,1.1,36.0,172
HCPCS,86141,C-REACTIVE PROTEIN HIGH SENSE,89.0,57.85,6.39,89.0,84
HCPCS,86141,C-REACTIVE PROTEIN HIGH SENSITIVITY,89.0,57.85,1.1,89.0,88
HCPCS,86141,MCROHN C-REAC PROTEIN HS,89.0,57.85,6.39,89.0,84
HCPCS,86146,*BETA 2 GLYCOPROTEIN I AB EA,176.0,114.4,12.57,176.0,84
HCPCS,86146,BETA 2 GLYC IGG GM GA X3,176.0,114.4,12.57,176.0,84
HCPCS,86146,BETA 2 GLYCOPROTEIN I ANTIBODY EACH,176.0,114.4,1.1,176.0,88
HCPCS,86146,BETA2 GLYCOPROT IGG/MX2,176.0,114.4,12.57,176.0,84
HCPCS,86147,CARDIOLIPIN AB SCREEN,176.0,114.4,12.57,176.0,84
HCPCS,86147,CARDIOLIPIN ANTIBODY EACH IG CLASS,176.0,114.4,1.1,176.0,88
HCPCS,86148,*PHOSPHOLIPID AB,111.0,72.15,7.94,111.0,84
HCPCS,86148,PHOSPHOLIPID ANTIBODY,111.0,72.15,1.1,111.0,88
HCPCS,86152,CELL ENUMERATION & ID,1730.0,1124.5,116.49,1730.0,84
HCPCS,86153,CELL ENUMERATION PHYS INTERP,,,14.11,85.82,5
HCPCS,86153,Cell enumeration phys interp,,,28.66,33.19,8
HCPCS,8615326,CELL ENUMERATION PHYS INTERP,,,14.11,14.11,2
HCPCS,86155,%CHEMOTAXIS,110.0,71.5,7.9,123.08,84
HCPCS,86155,NEUTROPHIL ACTIVITY,110.0,71.5,1.1,110.0,88
HCPCS,86156,COLD AGGLUTININ SCREEN,,,3.31,29.02,28
HCPCS,86156,Cold agglutinin screen,,,23.08,26.72,8
HCPCS,86157,COLD AGGLUTININ TITER,56.0,36.4,1.1,56.0,88
HCPCS,86157,COLD AGGLUTININS,56.0,36.4,3.98,56.0,84
HCPCS,86160,C1 ESTERASE INHIBITOR,83.0,53.95,5.92,83.0,84
HCPCS,86160,C2 COMPLEMENT AG,83.0,53.95,5.92,83.0,84
HCPCS,86160,C3 COMPLEMENT B1C/B1A,83.0,53.95,5.92,83.0,84
HCPCS,86160,C3 NEPHRITIC FACTOR,83.0,53.95,5.92,83.0,84
HCPCS,86160,"COMPLEMENT AG, EA",83.0,53.95,5.92,83.0,84
HCPCS,86160,COMPLEMENT ANTIGEN EACH COMPONENT,83.0,53.95,1.1,83.0,88
HCPCS,86160,COMPLEMENT C2,83.0,53.95,5.92,83.0,84
HCPCS,86160,"COMPLEMENT C3, SER",83.0,53.95,5.92,83.0,84
HCPCS,86160,"COMPLEMENT C4, SER",83.0,53.95,5.92,83.0,84
HCPCS,86160,COMPLEMENT COMP3A,83.0,53.95,5.92,83.0,84
HCPCS,86160,COMPLEMENT COMP4A,83.0,53.95,5.92,83.0,84
HCPCS,86160,COMPLEMENT FACTOR B,83.0,53.95,5.92,83.0,84
HCPCS,86160,COMPLEMENT FACTOR H,83.0,53.95,5.92,83.0,84
HCPCS,86160,COMPLEMENT FACTOR I,83.0,53.95,5.92,83.0,84
HCPCS,86160,SC5B-9 LEVEL MAC COMPLEX,83.0,53.95,5.92,83.0,84
HCPCS,86161,C5COMF COMPLEMENT/FUNCTION ACTIVITY,83.0,53.95,5.92,83.0,84
HCPCS,86161,COMPLEMENT AH50 FUNC,83.0,53.95,5.92,83.0,84
HCPCS,86161,COMPLEMENT C1,83.0,53.95,5.92,83.0,84
HCPCS,86161,"COMPLEMENT C2, SER",83.0,53.95,5.92,83.0,84
HCPCS,86161,"COMPLEMENT C7, FUNC",83.0,53.95,5.92,83.0,84
HCPCS,86161,COMPLEMENT C9 FUNCTIONAL,83.0,53.95,5.92,83.0,84
HCPCS,86161,COMPLEMENT FUNCT ACT C8,83.0,53.95,5.92,83.0,84
HCPCS,86161,COMPLEMENT FUNCTIONAL ACTIVITY EACH COMPONENT,83.0,53.95,1.1,83.0,88
HCPCS,86161,COMPLEMENT/FUNC ACTIVITY EA,83.0,53.95,5.92,83.0,84
HCPCS,86162,COMP ALTERNATE PATHWAY,140.0,91.0,10.04,140.0,84
HCPCS,86162,COMPLEMENT DEFICIENCY,140.0,91.0,10.04,140.0,84
HCPCS,86162,COMPLEMENT; TOT HEMOLYTIC (CH50),140.0,91.0,1.1,140.0,88
HCPCS,86171,COMPLEMENT FIXATION EA AG,69.0,44.85,4.94,69.0,84
HCPCS,86171,"COMPLEMENT FIXATION, EACH",69.0,44.85,1.1,69.0,88
HCPCS,86185,Counterimmunoelectrophoresis,,,41.24,41.24,1
HCPCS,86200,CYCLIC CITRU PEPT ANTI IG,89.0,57.85,6.39,89.0,84
HCPCS,86200,CYCLIC CITRULLINATED PEPTIDE ANTIBODY,89.0,57.85,1.1,89.0,88
HCPCS,86215,*DEOXYRIBONUCLEASE AB,91.0,59.15,6.54,91.0,84
HCPCS,86215,DEOXYRIBONUCLEASE ANTIBODY,91.0,59.15,1.1,91.0,88
HCPCS,86225,DNA AB DOUBLE STRANDED,95.0,61.75,6.79,95.0,84
HCPCS,86225,DNA AB NATIVE/DOUBLE STRAND,95.0,61.75,6.79,95.0,84
HCPCS,86225,DNA ANTIBODY,95.0,61.75,6.79,95.0,84
HCPCS,86225,DNA ANTIBODY NATIVE/DOUBLE STRANDED,95.0,61.75,1.1,95.0,88
HCPCS,86226,DNA SINGLE STRAND AB,84.0,54.6,1.1,84.0,88
HCPCS,86226,SS DNA ANTIBODY IGG,84.0,54.6,5.98,84.0,84
HCPCS,86231,EMA EACH IG CLASS,,,4.84,33.13,25
HCPCS,86231,Ema each ig class,,,23.08,26.72,8
HCPCS,86235,*EXTRACT NUC AG EA AB,124.0,80.6,8.86,124.0,84
HCPCS,86235,ENA (MYOSPL),124.0,80.6,8.86,124.0,84
HCPCS,86235,ENA ANY METHOD,124.0,80.6,8.86,124.0,84
HCPCS,86235,EXTRACTABLE NUCLEAR ANTIGEN ANTIBODY ANY METHOD,124.0,80.6,1.1,124.0,88
HCPCS,86235,IMMUNOASSAY ENA (POLMYO),124.0,80.6,8.86,124.0,84
HCPCS,86235,PM - 1 ANTIBODY,124.0,80.6,8.86,124.0,84
HCPCS,86235,U3 RNP AB,124.0,80.6,8.86,124.0,84
HCPCS,86243,Fc receptor,,,77.51,77.51,1
HCPCS,86255,%CEPHAL FLOUR AB X3,83.0,53.95,5.95,83.0,84
HCPCS,86255,%IBDSER NEUTROPH SP ABS,83.0,53.95,5.95,83.0,84
HCPCS,86255,%PARNEO FLUORESCENT X9,83.0,53.95,5.95,83.0,84
HCPCS,86255,ACESTR FLUORESCENT ANTIBODY SCREEN,83.0,53.95,5.95,83.0,84
HCPCS,86255,ACHR MODULATING FL RFLX,83.0,53.95,5.95,83.0,84
HCPCS,86255,ADRENAL ANTIBODY,83.0,53.95,5.95,83.0,84
HCPCS,86255,AIDYSA FLUOR AB SCRN,83.0,53.95,5.95,83.0,84
HCPCS,86255,ALPHA INTERNEXIN CBA,83.0,53.95,5.95,83.0,84
HCPCS,86255,AMPA RECEPTOR AB CBA,83.0,53.95,5.95,83.0,84
HCPCS,86255,AMPA-R AB CBA CSF,83.0,53.95,5.95,83.0,84
HCPCS,86255,AMPHSX &2/3 FLUOR AB SCRN,83.0,53.95,5.95,83.0,84
HCPCS,86255,ANTI NEUT CY AB,83.0,53.95,5.95,83.0,84
HCPCS,86255,"APBCSR - AP3B2 AB, CB ASSAY, SER, REFLEX ONLY",83.0,53.95,5.95,83.0,84
HCPCS,86255,AQUAPORIN4 REC AB IGG CSF,83.0,53.95,5.95,83.0,84
HCPCS,86255,CASPR2 IGG REFLEX,83.0,53.95,5.95,83.0,84
HCPCS,86255,CNS DEMYELINATING DIS EVAL SER X2,83.0,53.95,5.95,83.0,84
HCPCS,86255,CRMPSX FLUOR AB SCRN,83.0,53.95,5.95,83.0,84
HCPCS,86255,DPCBAX FLUOR AB SCRN,83.0,53.95,5.95,83.0,84
HCPCS,86255,DPPX AB CBA CSF RFLX,83.0,53.95,5.95,83.0,84
HCPCS,86255,DPPX AB IFA CSF RFLX,83.0,53.95,5.95,83.0,84
HCPCS,86255,"DPPX AB IFA, SERUM",83.0,53.95,5.95,83.0,84
HCPCS,86255,ENCCSF FLUORESCENT AB X21,83.0,53.95,5.95,83.0,84
HCPCS,86255,ENCSER FLUORESCENT AB SCRN,83.0,53.95,5.95,83.0,84
HCPCS,86255,EPIDERMAL ABS & REFLEXX2,83.0,53.95,5.95,83.0,84
HCPCS,86255,FAB SCREEN E,83.0,53.95,5.95,83.0,84
HCPCS,86255,FAB SCREEN EA AB,83.0,53.95,5.95,83.0,84
HCPCS,86255,FLUORESCENT ANTIBODY SCREEN,,,7.49,7.49,2
HCPCS,86255,"FLUORESCENT IMMUNOASSAY SCREEN QUAL, CSF",83.0,53.95,5.95,83.0,84
HCPCS,86255,"FLUORESCENT IMMUNOASSAY SCREEN QUAL, SERUM",83.0,53.95,5.95,83.0,84
HCPCS,86255,FLUORESCENT NONNFCT AGT ANTB SCREEN EA ANTIBODY,163.0,105.95,1.1,163.0,218
HCPCS,86255,GABA-B RECEPTOR AB CBA,83.0,53.95,5.95,83.0,84
HCPCS,86255,"GABA-B-R AB CBA, CSF",83.0,53.95,5.95,83.0,84
HCPCS,86255,GBMGP FLUORESCENT ANTIBODY SCREEN,83.0,53.95,5.95,83.0,84
HCPCS,86255,GFAP CBA RFLX,83.0,53.95,5.95,83.0,84
HCPCS,86255,"GLOM BASE AB, IGG IFA",83.0,53.95,5.95,83.0,84
HCPCS,86255,HUANT FLUORESCENT ANTIBODY SCREEN,83.0,53.95,5.95,83.0,84
HCPCS,86255,IGLON5 CBA RFLX,83.0,53.95,5.95,83.0,84
HCPCS,86255,LGI1 IGG,83.0,53.95,5.95,83.0,84
HCPCS,86255,LRP4 AB TEST,83.0,53.95,5.95,83.0,84
HCPCS,86255,MGLUR1 AB CBA CSF RFLX,83.0,53.95,5.95,83.0,84
HCPCS,86255,"MGLUR1 AB CBA, SER",83.0,53.95,5.95,83.0,84
HCPCS,86255,MGLUR1 AB IFA CSF RFLX,83.0,53.95,5.95,83.0,84
HCPCS,86255,"MGLUR1 AB IFA, SER",83.0,53.95,5.95,83.0,84
HCPCS,86255,MLPTHY FLUORESCENT AB SCREEN,83.0,53.95,5.95,83.0,84
HCPCS,86255,MOG-IGG1 FACS,83.0,53.95,5.95,83.0,84
HCPCS,86255,MYELIN ANTIBODY IGG,83.0,53.95,5.95,83.0,84
HCPCS,86255,N-METHYL-D-ASP CSF,83.0,53.95,5.95,83.0,84
HCPCS,86255,"NCDCFX - NEUROCHONDRIN AB CB ASSAY, SF, REFLEX ONLY",83.0,53.95,5.95,83.0,84
HCPCS,86255,"NCDCSR - NEUROCHONDRIN AB CB ASSAY, SER, REFLEX ONLY",83.0,53.95,5.95,83.0,84
HCPCS,86255,NIF HEAVY CHAIN CBA RFLX,83.0,53.95,5.95,83.0,84
HCPCS,86255,NIF LIGHT CHAIN CBA RFLX,83.0,53.95,5.95,83.0,84
HCPCS,86255,NMDA IGG,83.0,53.95,5.95,83.0,84
HCPCS,86255,NMDA RECEPTOR AB CBA,83.0,53.95,5.95,83.0,84
HCPCS,86255,NMDA-R AB CBA CSF,83.0,53.95,5.95,83.0,84
HCPCS,86255,NMO AQUAPORIN 4-IGG FACS,83.0,53.95,5.95,83.0,84
HCPCS,86255,NMO AQUAPORIN4 IGG,83.0,53.95,5.95,83.0,84
HCPCS,86255,NMO AQUAPORIN4 IGG CSF,83.0,53.95,5.95,83.0,84
HCPCS,86255,NMOA4 AQUAPORIN4 IGG,83.0,53.95,5.95,83.0,84
HCPCS,86255,OVARAN AB SCRN W RFLX,83.0,53.95,5.95,83.0,84
HCPCS,86255,PARANEOPLAST ABS CSF X9,83.0,53.95,5.95,83.0,84
HCPCS,86255,PARANEOPLSTC AB PANEL X2,83.0,53.95,5.95,83.0,84
HCPCS,86255,"PCCA/ANNA BY IFA, SERUM",83.0,53.95,5.95,83.0,84
HCPCS,86255,PHOSPHOLIP A2-R AB IGG,83.0,53.95,5.95,83.0,84
HCPCS,86255,"PLA2R, IMMUNOFLUORESCENCE, S (REFLEX ONLY)",83.0,53.95,5.95,83.0,84
HCPCS,86255,PRKTRX & PURK1X/2X FLUOR AB SCRN,83.0,53.95,5.95,83.0,84
HCPCS,86255,RETICULIN IGA IGG ABS,83.0,53.95,5.95,83.0,84
HCPCS,86255,"SEND-OUT PHOSPHOLIPASE A2 RECEPTOR (PLA2R) ANTIBODY, IGG BY IMMU",83.0,53.95,5.95,83.0,84
HCPCS,86255,SENMOT FLUORESCENT ANTIBODY (ARUP),83.0,53.95,5.95,83.0,84
HCPCS,86255,SENNRO FLUORESCENT AB (ARUP),83.0,53.95,5.95,83.0,84
HCPCS,86255,SKELETAL MUSCLE AB SCREEN,83.0,53.95,5.95,83.0,84
HCPCS,86255,"SP7CFX - SEPTIN-7 AB CB ASSAY, SF, REFLEX ONLY",83.0,53.95,5.95,83.0,84
HCPCS,86255,"SP7CSR - SEPTIN-7 AB CB ASSAY, SER, REFLEX ONLY",83.0,53.95,5.95,83.0,84
HCPCS,86255,SPSDEV FLUORESCENT AB SCREEN,83.0,53.95,5.95,83.0,84
HCPCS,86255,"THSD7A AB, S",83.0,53.95,5.95,83.0,84
HCPCS,86255,"TRIM46 AB CBA, CSF",83.0,53.95,5.95,83.0,84
HCPCS,86255,"TRIM46 AB CBA, S",83.0,53.95,5.95,83.0,84
HCPCS,8625526,FLUORESCENT ANTIBODY SCREEN,,,7.49,7.49,2
HCPCS,86256,*FAB TITER EA AB,83.0,53.95,5.95,104.69,84
HCPCS,86256,ADRENAL AB TITER RFLX,83.0,53.95,5.95,104.69,84
HCPCS,86256,"AGNTFX - AGNA-1 TITER, SF, REFLEX ONLY",83.0,53.95,5.95,104.69,84
HCPCS,86256,"AGNTSR - AGNA-1 TITER, SER, REFLEX ONLY",83.0,53.95,5.95,104.69,84
HCPCS,86256,"AMPA RECEPTOR AB IGG TITER, CSF",83.0,53.95,5.95,104.69,84
HCPCS,86256,"AMPA RECEPTOR AB IGG TITER, SERUM - REFLEX",83.0,53.95,5.95,104.69,84
HCPCS,86256,AMPA-RECEP AB TITER,83.0,53.95,5.95,104.69,84
HCPCS,86256,AMPIFC FLUORESCENT ANTIBODY TITER,83.0,53.95,5.95,104.69,84
HCPCS,86256,"AN1TFX - ANNA-1 TITER, SF, REFLEX ONLY",83.0,53.95,5.95,104.69,84
HCPCS,86256,"AN1TSR - ANNA-1 TITER, SER, REFLEX ONLY",83.0,53.95,5.95,104.69,84
HCPCS,86256,"AN2TFX - ANNA-2 TITER, SF, REFLEX ONLY",83.0,53.95,5.95,104.69,84
HCPCS,86256,"AN2TSR- ANNA-2 TITER, SER, REFLEX ONLY",83.0,53.95,5.95,104.69,84
HCPCS,86256,"AN3TFX - ANNA-3 TITER, SF, REFLEX ONLY",83.0,53.95,5.95,104.69,84
HCPCS,86256,"AN3TSR - ANNA-3 TITER, SER, REFLEX ONLY",83.0,53.95,5.95,104.69,84
HCPCS,86256,ANCA TITER,83.0,53.95,5.95,104.69,84
HCPCS,86256,ANCA TITER BILL,83.0,53.95,5.95,104.69,84
HCPCS,86256,"APBTSR - AP3B2 AB, TISS IMMFL TITER, SER, REFLEX ONLY",83.0,53.95,5.95,104.69,84
HCPCS,86256,"APHCFX - AMPHIPHYSIN AB TITER, SF, REFLEX ONLY",83.0,53.95,5.95,104.69,84
HCPCS,86256,"APHTSR - AMPHIPHYSIN AB TITER, SER, REFLEX ONLY",83.0,53.95,5.95,104.69,84
HCPCS,86256,BM2 ABS TITER,83.0,53.95,5.95,104.69,84
HCPCS,86256,"CASPR2 AB IGG CBA-IFA TITER, CSF",83.0,53.95,5.95,104.69,84
HCPCS,86256,"CASPR2 AB IGG TITER BY CBA-IFA, SER",83.0,53.95,5.95,104.69,84
HCPCS,86256,"CRMCFX - CRMP-5 IGG TITER, SF, REFLEX ONLY",83.0,53.95,5.95,104.69,84
HCPCS,86256,"CRMTSR - CRMP-5 NEURONAL IGG TITER, SER, REFLEX ONLY",83.0,53.95,5.95,104.69,84
HCPCS,86256,"CV2 ANTIBODY TITER, IGG",83.0,53.95,5.95,104.69,84
HCPCS,86256,DPIFAX FLUOR AB TITER,83.0,53.95,5.95,104.69,84
HCPCS,86256,DPPX AB IFA TITER CSF RFLX,83.0,53.95,5.95,104.69,84
HCPCS,86256,"DPPX AB IGG CBA-IFA TITER, CSF",83.0,53.95,5.95,104.69,84
HCPCS,86256,"DPPX AB IGG TITER BY CBA-IFA, SER",83.0,53.95,5.95,104.69,84
HCPCS,86256,ENDOMYSTAL AB IGG,83.0,53.95,5.95,104.69,84
HCPCS,86256,FLUORESCENT ANTIBODY TITER,83.0,53.95,5.95,104.69,86
HCPCS,86256,FLUORESCENT NONNFCT AGT ANTB TITER EA ANTIBODY,83.0,53.95,1.1,83.0,92
HCPCS,86256,"GABA-A RECE$TOR IGG CBA-IFA TITER, SERUM",83.0,53.95,5.95,104.69,84
HCPCS,86256,"GABA-AR AB IGG CBA-IFA TITER, CSF",83.0,53.95,5.95,104.69,84
HCPCS,86256,"GABA-B-R AB CBA, CSF",83.0,53.95,5.95,104.69,84
HCPCS,86256,GABA-B-RECEP IFA TITER,83.0,53.95,5.95,104.69,84
HCPCS,86256,"GABA-BR AB IGG CBA-IFA TITER, CSF",83.0,53.95,5.95,104.69,84
HCPCS,86256,"GABA-BR AB IGG CBA-IFA TITER, SER",83.0,53.95,5.95,104.69,84
HCPCS,86256,GABTTR FLUORESCENT ANTIBODY TITER,83.0,53.95,5.95,104.69,84
HCPCS,86256,GFAP IFA TITER RFLX,83.0,53.95,5.95,104.69,84
HCPCS,86256,HUTIT FLUORESCENT ANTIBODY TITER,83.0,53.95,5.95,104.69,84
HCPCS,86256,IGLON5 IFA TITER RFLX,83.0,53.95,5.95,104.69,84
HCPCS,86256,INTERCELL SUB AB TITER,83.0,53.95,5.95,104.69,84
HCPCS,86256,"LGI1 AB IGG CBA-IFA TITER, CSF",83.0,53.95,5.95,104.69,84
HCPCS,86256,"LGI1 AB IGG TITER BY CBA-IFA, SER",83.0,53.95,5.95,104.69,84
HCPCS,86256,MGLUR1 AB IFA TITER CSF RFLX,83.0,53.95,5.95,104.69,84
HCPCS,86256,"MGLUR1 AB IFA TITER, SER",83.0,53.95,5.95,104.69,84
HCPCS,86256,"MGLUR1 AB IGG CBA-IFA TITER, CSF",83.0,53.95,5.95,104.69,84
HCPCS,86256,"MOG AB IGG TITER BY CBA-IFA, SER",83.0,53.95,5.95,104.69,84
HCPCS,86256,"MOG FACS TITER, S REF",83.0,53.95,5.95,104.69,84
HCPCS,86256,MPOA FLUOR AB TITER,83.0,53.95,5.95,104.69,84
HCPCS,86256,NANNTR FLUORESCENT ANTIBODY TITER,83.0,53.95,5.95,104.69,84
HCPCS,86256,"NCDTSR - NEUROCHONDRIN AB, TISS IMMFL TITER, REFLEX ONLY",83.0,53.95,5.95,104.69,84
HCPCS,86256,"NCTCFX - NEUROCHONDRIN AB TISS IMMFL TITER, SF, REFLEX ONLY",83.0,53.95,5.95,104.69,84
HCPCS,86256,NEURO OPTICA/AQP4 IGG REF,83.0,53.95,5.95,104.69,84
HCPCS,86256,NEUROMYELITIS OPT AQP4IGG,83.0,53.95,5.95,104.69,84
HCPCS,86256,"NEURONAL NUCLEAR AB (ANNA) IFA TITER, IGG",83.0,53.95,5.95,104.69,84
HCPCS,86256,"NEURONAL NUCLEAR ANTIBODY (ANNA) IFA TITER, IGG, CSF",83.0,53.95,5.95,104.69,84
HCPCS,86256,NIF IFA TITER RFLX,83.0,53.95,5.95,104.69,84
HCPCS,86256,NMDA R AB IFA TITER CSF,83.0,53.95,5.95,104.69,84
HCPCS,86256,NMDA-RECEP AB TITER,83.0,53.95,5.95,104.69,84
HCPCS,86256,NMDAG TITER,83.0,53.95,5.95,104.69,84
HCPCS,86256,NMO/AQP4 FACS TITER,83.0,53.95,5.95,104.69,84
HCPCS,86256,OVARIAN AB TITER REFLX,83.0,53.95,5.95,104.69,84
HCPCS,86256,"PC1TSR - PCA-1 TITER, SER, REFLEX ONLY",83.0,53.95,5.95,104.69,84
HCPCS,86256,"PC2TSR  - PCA-2 TITER, SER, REFLEX ONLY",83.0,53.95,5.95,104.69,84
HCPCS,86256,"PCA1FX - PCA-1 TITER, SF, REFLEX ONLY",83.0,53.95,5.95,104.69,84
HCPCS,86256,"PCA2FX - PCA-2 TITER, SF, REFLEX ONLY",83.0,53.95,5.95,104.69,84
HCPCS,86256,"PCCTFX - PCA-TR TITER SF, REFLEX ONLY",83.0,53.95,5.95,104.69,84
HCPCS,86256,"PCTTSR - PCATR TITER SER, REFLEX ONLY",83.0,53.95,5.95,104.69,84
HCPCS,86256,"PDE10A AB IFA TITER, CSF",83.0,53.95,5.95,104.69,84
HCPCS,86256,"PDE10A AB IFA TITER, S",83.0,53.95,5.95,104.69,84
HCPCS,86256,"PHOSPHOLIPASE RECEPTOR A2 ANTIBODY, IGG TITER",83.0,53.95,5.95,104.69,84
HCPCS,86256,PLA2R AB IGG TITER,83.0,53.95,5.95,104.69,84
HCPCS,86256,PURKINJE AB IGG TITER,83.0,53.95,5.95,104.69,84
HCPCS,86256,"PURKINJE CELL ANTIBODY, TITER",83.0,53.95,5.95,104.69,84
HCPCS,86256,"PURKINJE CELL ANTIBODY, TITER, CSF",83.0,53.95,5.95,104.69,84
HCPCS,86256,"REFLEX MGLUR1 AB IGG CBA-IFA TITER, SERUM",83.0,53.95,5.95,104.69,84
HCPCS,86256,RETICULIN AB IGA TITER,83.0,53.95,5.95,104.69,84
HCPCS,86256,"SP7TFX - SEPTIN-7 AB, TISS IMMFL TITER, SF, REFLEX ONLY",83.0,53.95,5.95,104.69,84
HCPCS,86256,"SP7TSR - SEPTIN-7 AB, TISS IMMFL TITER, SER, REFLEX ONLY",83.0,53.95,5.95,104.69,84
HCPCS,86256,STRIATED MUSCLE TITER,83.0,53.95,5.95,104.69,84
HCPCS,86256,"TRIM46 AB IFA TITER, CSF",83.0,53.95,5.95,104.69,84
HCPCS,86256,"TRIM46 AB IFA TITER, S",83.0,53.95,5.95,104.69,84
HCPCS,8625626,FLUORESCENT ANTIBODY TITER,,,7.49,7.49,2
HCPCS,86258,GLIADIN ANTIBODY EACH,83.0,53.95,4.61,83.0,84
HCPCS,86265,"FROZEN BLOOD, PREPARATION FOR FREEZING, EACH UNIT INCLUDING PROC",5.0,3.25,1.1,5.0,70
HCPCS,86277,GROWTH HORMONE ANTIBODY,,,7.77,69.43,28
HCPCS,86277,Growth hormone antibody,,,23.08,26.72,8
HCPCS,86280,HEMAGGLUTINATION INHIBITION,,,4.05,36.04,28
HCPCS,86280,Hemagglutination inhibition,,,23.08,26.72,8
HCPCS,86294,IMMUNOASSAY TUMOR QUAL,,,25.57,77.04,26
HCPCS,86294,Immunoassay tumor qual,,,23.08,26.72,8
HCPCS,86300,IMMUNOASSAY TUMOR ANTIGEN QUANTITATIVE CA 15-3,144.0,93.6,1.1,144.0,88
HCPCS,86300,IMMUNOASSY TUMOR CA 15-3,144.0,93.6,10.28,144.0,84
HCPCS,86301,IMMUNOASSAY TUMOR ANTIGEN QUANTITATIVE CA 19-9,144.0,93.6,1.1,144.0,88
HCPCS,86301,IMMUNOASSY TUMOR CA 19-9,144.0,93.6,10.28,144.0,84
HCPCS,86304,IMMUNOASSAY TUMOR ANTIGEN QUANTITATIVE CA 125,144.0,93.6,1.1,144.0,88
HCPCS,86304,IMMUNOASSY TUMOR CA 125,144.0,93.6,10.28,144.0,84
HCPCS,86305,HE4,144.0,93.6,10.28,144.0,84
HCPCS,86308,HETEROPHILE AB W RFLX,36.0,23.4,5.18,36.0,84
HCPCS,86308,HETEROPHILE ANTIBODIES SCREEN,36.0,23.4,1.1,36.0,88
HCPCS,86308,HETRPHL AB SCRN,36.0,23.4,5.18,36.0,84
HCPCS,86308,HTEROPHIL AB SCREEN,36.0,23.4,5.18,36.0,84
HCPCS,86308,HTEROPHIL AB SCREEN (POINT OF CARE LAB),36.0,23.4,5.18,36.0,84
HCPCS,86309,HETEROPHILE AB TITER,45.0,29.25,3.19,45.0,84
HCPCS,86309,HETEROPHILE ANTIBODIES,45.0,29.25,1.1,45.0,88
HCPCS,86310,HETEROPHILE ANTIBODY ABSRBJ,,,3.64,32.44,28
HCPCS,86310,Heterophile antibody absrbj,,,23.08,26.72,8
HCPCS,86316,%CJD IMMUNO QT,144.0,93.6,10.28,144.0,84
HCPCS,86316,%PHI IMMUNO TUMOR AG,144.0,93.6,10.28,144.0,84
HCPCS,86316,AFP CSF TUMOR MARKER,144.0,93.6,10.28,144.0,84
HCPCS,86316,CHROMOGRANIN A,144.0,93.6,10.28,144.0,168
HCPCS,86316,CNSE IMMUNOASSAY TUMOR OT,144.0,93.6,10.28,144.0,84
HCPCS,86316,IMMUNOASSAY TUMOR ANTIGEN QUANTITATIVE,144.0,93.6,1.1,144.0,88
HCPCS,86316,"NEURON SPECIFIC ENOLASE, SER",144.0,93.6,10.28,144.0,84
HCPCS,86316,PANCREASTATIN,144.0,93.6,10.28,144.0,84
HCPCS,86316,S-100B PROTEIN,144.0,93.6,10.28,144.0,84
HCPCS,86316,TUMOR OR OTHER AG QUANT,144.0,93.6,10.28,144.0,84
HCPCS,86317,%HUMOR DIPHTHERIA TOX AB,103.0,66.95,7.4,103.0,84
HCPCS,86317,%HUMOR PNEUMO IGG X14,103.0,66.95,7.4,103.0,84
HCPCS,86317,%HUMOR TETANUS TOX AB,103.0,66.95,7.4,103.0,84
HCPCS,86317,*HEP C AB,103.0,66.95,7.4,103.0,84
HCPCS,86317,ASPERGILLUS FUMIGATUS ANTIBODY IGG,103.0,66.95,7.4,103.0,84
HCPCS,86317,CJD IMASSAY IA AB QNT,103.0,66.95,7.4,103.0,84
HCPCS,86317,DIPHTHERIA TOXOID IGG,103.0,66.95,7.4,103.0,84
HCPCS,86317,DIPTHERIA TETANUS AB,103.0,66.95,7.4,103.0,168
HCPCS,86317,HAEMOPHILUS INFLU B IGG,103.0,66.95,7.4,103.0,84
HCPCS,86317,HEPATITIS B SUR AB QUANT,103.0,66.95,7.4,103.0,84
HCPCS,86317,HUMOR1 IMMUNASSY INF AG X4,103.0,66.95,7.4,103.0,84
HCPCS,86317,HUMOR1 IMMUNASSY INF AG1 X6,103.0,66.95,7.4,103.0,84
HCPCS,86317,HUMOR1 IMMUNASSY INF AG2 X6,103.0,66.95,7.4,103.0,84
HCPCS,86317,HUMORAL IMMUNITY PANELS 1/2,103.0,66.95,7.4,103.0,84
HCPCS,86317,IMMUNOASSAY INFECTIOUS AGENT ANTIBODY QUAN NOS,103.0,66.95,1.1,103.0,88
HCPCS,86317,N MENINGITIIDIS IGG X4,103.0,66.95,7.4,103.0,84
HCPCS,86317,STREP PNEUMO ABS X14,103.0,66.95,7.4,103.0,84
HCPCS,86317,TETANUS TOXOID IGG,103.0,66.95,7.4,103.0,84
HCPCS,86318,IA INFECTIOUS AGT ANTIBODY QUAL/SEMIQ 1STEP METH,125.0,81.25,1.1,125.0,88
HCPCS,86318,OXIDATIVE METABOLOISM,125.0,81.25,18.09,125.0,84
HCPCS,86320,SERUM IMMUNOELECTROPHORESIS,206.0,133.9,1.1,206.0,157
HCPCS,86320,Serum immunoelectrophoresis,,,28.66,33.19,8
HCPCS,8632026,SERUM IMMUNOELECTROPHORESIS,,,7.49,7.49,2
HCPCS,86325,OTHER IMMUNOELECTROPHORESIS,160.0,104.0,1.1,160.0,157
HCPCS,86325,Other immunoelectrophoresis,,,23.08,26.72,8
HCPCS,8632526,OTHER IMMUNOELECTROPHORESIS,,,7.49,7.49,2
HCPCS,86327,IMMUNOELECTROPHORESIS ASSAY,,,8.5,100.11,9
HCPCS,86327,Immunoelectrophoresis assay,,,28.66,33.19,8
HCPCS,8632726,IMMUNOELECTROPHORESIS ASSAY,,,8.5,8.5,2
HCPCS,86328,IA NFCT AB SARSCOV2 COVID19,,,18.11,136.4,29
HCPCS,86328,Ia nfct ab sarscov2 covid19,,,23.08,26.72,8
HCPCS,86329,TEICHOIC ACID ANTIBODIES,97.0,63.05,6.94,97.0,84
HCPCS,86331,%ABPA2 ASPERG QUAL OUCHT,83.0,53.95,5.92,83.0,84
HCPCS,86331,*IMMUNODIF QUAL EA AB/AG,83.0,53.95,5.92,83.0,84
HCPCS,86331,BIRD FANCIERS PRECIPITIN,83.0,53.95,5.92,83.0,84
HCPCS,86331,HYPERSENSITIVITY PNEUMO ID QUAL,83.0,53.95,5.92,83.0,84
HCPCS,86331,IMMUNODIFFUSION GEL DIFFUSION QUAL EA AG/ANTBDY,83.0,53.95,1.1,83.0,88
HCPCS,86332,C1Q BINDING ASSAY,168.0,109.2,12.04,168.0,84
HCPCS,86332,IMMUNE CMPLX ASSAY,168.0,109.2,12.04,168.0,84
HCPCS,86334,%IMMUNOFIXATION,154.0,100.1,11.04,154.0,84
HCPCS,86334,IMFIX ELECT IGD IGE,154.0,100.1,11.04,154.0,84
HCPCS,86334,IMMUNOFIX E-PHORESIS SERUM,163.0,105.95,1.1,163.0,220
HCPCS,86334,IMMUNOFIX ELEC GEL,154.0,100.1,11.04,154.0,84
HCPCS,8633426,IMMUNOFIX E-PHORESIS SERUM,,,7.49,7.49,2
HCPCS,86335,%UBJP B CELLS COUNT,203.0,131.95,13.62,203.0,84
HCPCS,86335,*IMMUNOFIX ELECPHRSIS OTHER,203.0,131.95,13.62,203.0,84
HCPCS,86335,IMMUNFIX E-PHORSIS/URINE/CSF,,,6.1,6.1,2
HCPCS,86335,IMMUNOFIXJ ELECTROPHORESIS OTHER FLUIDS,163.0,105.95,1.1,163.0,218
HCPCS,86335,"MONOCLONAL PROTEIN,FLUID",203.0,131.95,13.62,203.0,84
HCPCS,86335TC,IMMUNFIX E-PHORSIS/URINE/CSF,,,6.1,6.1,2
HCPCS,86336,%QUAD4 MARKERS INHIBIN,108.0,70.2,7.7,108.0,84
HCPCS,86336,INHIBIN A,108.0,70.2,1.1,108.0,256
HCPCS,86337,INSULIN ANTIBODIES,148.0,96.2,1.1,148.0,88
HCPCS,86337,INSULIN ANTIBODY,148.0,96.2,10.57,148.0,84
HCPCS,86340,INT FAC AB,104.0,67.6,7.44,104.0,84
HCPCS,86340,INTRINSIC FACTOR AB,104.0,67.6,1.1,104.0,88
HCPCS,86341,%CEPHAL ISLET CELL AB,163.0,105.95,9.77,163.0,84
HCPCS,86341,AIDYSA ISLET CELL AB,163.0,105.95,9.77,163.0,84
HCPCS,86341,ENCCSF ISLET CELL AB,163.0,105.95,9.77,163.0,84
HCPCS,86341,ENCSER ISLET CELL AB,163.0,105.95,9.77,163.0,84
HCPCS,86341,GAD65 ANTIBODY,163.0,105.95,9.77,163.0,168
HCPCS,86341,GLUTAMIC ACID DECARBOXYLASE ANTIBODY,163.0,105.95,9.77,163.0,84
HCPCS,86341,GLUTAMIC ACID DECARBOXYLASE ANTIBODY CSF,163.0,105.95,9.77,163.0,84
HCPCS,86341,ISLET CELL AB,163.0,105.95,1.1,163.0,172
HCPCS,86341,ISLET CELL ANTIBODY,163.0,105.95,9.77,163.0,84
HCPCS,86341,MLPTHY GAD65 AB,163.0,105.95,9.77,163.0,84
HCPCS,86341,SPSDEV GAD65 AB,163.0,105.95,9.77,163.0,84
HCPCS,86341,ZINC TRANSPORTER 8 ANTIBODY,163.0,105.95,9.77,163.0,84
HCPCS,86343,LEUKOCYTE HISTAMINE RELEASE,,,6.15,54.93,28
HCPCS,86343,Leukocyte histamine release,,,23.08,26.72,8
HCPCS,86344,LEUKOCYTE PHAGOCYTOSIS,,,4.16,35.27,28
HCPCS,86344,Leukocyte phagocytosis,,,23.08,26.72,8
HCPCS,86352,ADALIMUMAB ACT/NEUT AB,937.0,609.05,28.66,937.0,84
HCPCS,86352,ANTI-IGE RCPTR ANTIBODY,937.0,609.05,28.66,937.0,84
HCPCS,86352,CELLULAR FUNCTION ASSAY STIMUL&DETECT BIOMARKE,937.0,609.05,1.1,937.0,88
HCPCS,86352,FLOW CD107A CELL FUNCTION,937.0,609.05,28.66,937.0,84
HCPCS,86352,IMMUNE FUN ASSY ATP,937.0,609.05,28.66,937.0,84
HCPCS,86352,INFLIX ACT & NEUT AB X2,937.0,609.05,28.66,937.0,84
HCPCS,86352,NABFERON AB,937.0,609.05,28.66,937.0,84
HCPCS,86352,NABFERON AB TITER,937.0,609.05,28.66,937.0,84
HCPCS,86352,NEUTROPHIL OX BURST BLD,937.0,609.05,28.66,937.0,84
HCPCS,86352,PSTAT5 CELL FUNCTION,937.0,609.05,28.66,937.0,84
HCPCS,86352,URTICARIA-IND ACTIVITY,937.0,609.05,28.66,937.0,84
HCPCS,86353,%RETROVIR LYMPH TRANSF,338.0,219.7,24.21,358.7,84
HCPCS,86353,LPT TO BERYLLIUM,338.0,219.7,24.21,358.7,84
HCPCS,86353,LYMPH TRANS TEST,338.0,219.7,24.21,358.7,84
HCPCS,86353,LYMPHOCYTE ANTIGEN PROLIFERATION,338.0,219.7,24.21,358.7,84
HCPCS,86353,LYMPHOCYTE TR MITOGEN/AG INDUCED BLASTOGENESIS,338.0,219.7,1.1,338.0,88
HCPCS,86355,*B CELL TOTAL COUNT,260.0,169.0,18.63,260.0,84
HCPCS,86355,B CELL TOTAL-ARUP,260.0,169.0,18.63,260.0,84
HCPCS,86355,B CELLS TOTAL COUNT,260.0,169.0,1.1,260.0,172
HCPCS,86355,"B CELLS, TOTAL COUNT",260.0,169.0,18.63,260.0,84
HCPCS,86355,CD45RR B CELLS TOTAL COUNT,260.0,169.0,18.63,260.0,84
HCPCS,86356,%PNH CELL AG,185.0,120.25,13.22,185.0,84
HCPCS,86356,BAL FCM MARKERS,185.0,120.25,13.22,185.0,84
HCPCS,86356,BPHENO MONONUCLEAR AG,185.0,120.25,13.22,185.0,84
HCPCS,86356,BPHENO MONONUCLEAR AG - ARUP,185.0,120.25,13.22,185.0,84
HCPCS,86356,"CD20 MONONUCLEAR CELL ANTIGEN, QUANT",185.0,120.25,13.22,185.0,84
HCPCS,86356,CD45RR MONONUCLEAR CELL ANTIGEN X2,185.0,120.25,13.22,185.0,84
HCPCS,86356,MONONUCLEAR CELL ANTIGEN QUANTITATIVE NOS EA,185.0,120.25,1.1,185.0,88
HCPCS,86356,TCELL SUBSETS,185.0,120.25,13.22,185.0,84
HCPCS,86357,*NATURAL KILLER TOTAL COUNT,260.0,169.0,18.63,260.0,84
HCPCS,86357,CD45RR NK CELLS TOTAL COUNT,260.0,169.0,18.63,260.0,84
HCPCS,86357,NATURAL KILLER CELLS TOTAL COUNT,260.0,169.0,1.1,260.0,88
HCPCS,86357,NK CELLS TOTAL COUNT,260.0,169.0,18.63,260.0,84
HCPCS,86359,*T CELL TOTAL COUNT,260.0,169.0,18.63,260.0,84
HCPCS,86359,CD45RR T CELLS TOTAL COUNT,260.0,169.0,18.63,260.0,84
HCPCS,86359,T CELLS TOTAL COUNT,260.0,169.0,1.1,260.0,172
HCPCS,86359,TCLACV T CELLS TOTAL CNT,260.0,169.0,18.63,260.0,84
HCPCS,86360,*T CELL ABSOLUTE COUNT W RATIO,324.0,210.6,23.2,324.0,84
HCPCS,86360,CD45RR T CELL ABSOLUTE COUNT/RATIO,324.0,210.6,23.2,324.0,84
HCPCS,86360,T CELL ABSOLUTE COUNT/RATIO,324.0,210.6,23.2,324.0,84
HCPCS,86360,T CELLS ABSOLUTE CD4&CD8 COUNT RATIO,324.0,210.6,1.1,324.0,88
HCPCS,86361,%CD4ABS ABSOLUTE COUNT,185.0,120.25,13.22,185.0,84
HCPCS,86361,"LYMPHOCYTE SUBSET 2, CD4 PCT. AND ABSL",185.0,120.25,13.22,185.0,84
HCPCS,86361,T CELLS ABSOLUTE CD4 COUNT,185.0,120.25,1.1,185.0,88
HCPCS,86361,TCLACV T CELL ABSOLUTE CT,185.0,120.25,13.22,185.0,84
HCPCS,86362,"MOG AB IGG CBA-IFA SCREEN, SERUM",83.0,53.95,4.82,83.0,168
HCPCS,86363,CDS1SE MOG-IGG1 AB FL EA,260.0,169.0,4.82,260.0,84
HCPCS,86363,MLPTHY MOG FACS,260.0,169.0,4.82,260.0,84
HCPCS,86363,"MOG AB IGG CBA-IFA SCREEN, SERUM",260.0,169.0,4.82,260.0,84
HCPCS,86363,"MOG FACS TITNER, SERUM RFLX",260.0,169.0,4.82,260.0,84
HCPCS,86364,TISSUE TRANSGLUTAMINASE EA,80.0,52.0,4.61,80.0,84
HCPCS,86366,"MUSCLE-SPECIFIC KINASE (MUSK) AUTOANTIBODY, SERUM",127.0,82.55,7.36,127.0,83
HCPCS,86367,PB STEM CELL COUNT,537.0,349.05,28.66,537.0,84
HCPCS,86367,STEM CELLS TOTAL COUNT,537.0,349.05,1.1,537.0,88
HCPCS,86376,MICROSOMAL AB EACH,100.0,65.0,1.1,100.0,88
HCPCS,86376,MICROSOMAL ANTIBODIES EA,100.0,65.0,7.18,100.0,84
HCPCS,86376,THYROID PEROXIDASE AB,100.0,65.0,7.18,100.0,84
HCPCS,86378,Migration inhibitory factor,,,58.61,58.61,1
HCPCS,86381,MITOCHONDRIAL ANTIBODY EACH,176.0,114.4,10.18,176.0,84
HCPCS,86382,*VIRUS AB NOS,117.0,76.05,8.35,117.0,84
HCPCS,86384,NITROBLUE TETRAZOLIUM,94.0,61.1,5.62,94.0,84
HCPCS,86386,NUCLEAR MATRIX PROTEIN 22,,,8.71,65.61,28
HCPCS,86386,Nuclear matrix protein 22,,,23.08,26.72,8
HCPCS,86403,%CANDA PART AGG,80.0,52.0,5.03,80.0,84
HCPCS,86403,*PARTCL AGGLUT SCREEN EA,80.0,52.0,5.03,80.0,84
HCPCS,86403,CMV SCREENING EACH UNIT,80.0,52.0,5.03,80.0,84
HCPCS,86403,CRYPTOCOCCAL ANTIGEN,80.0,52.0,5.03,80.0,84
HCPCS,86403,PARTICLE AGGLUTINATION SCREEN EACH ANTIBODY,80.0,52.0,1.1,80.0,88
HCPCS,86403,STREPTOZYME SCREEN,80.0,52.0,5.03,80.0,84
HCPCS,86406,STREPTOZYME TITER,73.0,47.45,5.25,73.0,84
HCPCS,86408,NEUTRLZG ANTB SARSCOV2 SCR,,,16.85,115.44,26
HCPCS,86408,Neutrlzg antb sarscov2 scr,,,23.08,26.72,8
HCPCS,86409,NEUTRLZG ANTB SARSCOV2 TITER,,,6.0,237.11,26
HCPCS,86409,Neutrlzg antb sarscov2 titer,,,23.08,26.72,8
HCPCS,86413,SARS-COV-2 ANTB QUANTITATIVE,,,6.0,140.92,26
HCPCS,86413,Sars-cov-2 antb quantitative,,,28.66,33.19,8
HCPCS,86430,RHEUMATOID FACTOR TEST QUAL,,,2.8,18.5,29
HCPCS,86430,Rheumatoid factor test qual,,,23.08,26.72,8
HCPCS,86431,RHEUMATOID FACTOR QUANT,39.0,25.35,2.8,39.0,84
HCPCS,86431,RHEUMATOID FACTOR QUANTITATIVE,39.0,25.35,1.1,39.0,88
HCPCS,86431,RHEUMATOID FACTOR TEST QUANT,39.0,25.35,2.8,39.0,84
HCPCS,86480,"QUANTIFERON-TB GOLD PLUS, BLOOD",428.0,278.2,28.66,428.0,84
HCPCS,86480,TB CELL MEDIATED ANTIGN RESPNSE GAMMA INTERFERON,428.0,278.2,1.1,428.0,88
HCPCS,86480,TB GOLD PLUS,428.0,278.2,28.66,428.0,84
HCPCS,86481,TB AG RESPONSE T-CELL SUSP,,,40.0,301.25,28
HCPCS,86481,Tb ag response t-cell susp,,,28.66,33.19,8
HCPCS,86485,CANDIDA; SKIN TEST BO,52.0,33.8,1.1,85.71,88
HCPCS,86485,TEST SKIN CANDIDA,169.0,109.85,8.35,169.0,85
HCPCS,86486,"SKIN TEST, UNLISTED ANTIGEN EA",169.0,109.85,8.64,169.0,87
HCPCS,86490,COCCIDIOIDOMYCOSIS SKIN TEST,,,5.49,159.69,5
HCPCS,86490,Coccidioidomycosis skin test,,,28.66,33.19,8
HCPCS,86510,HISTOPLASMOSIS SKIN TEST,,,6.96,125.24,26
HCPCS,86510,Histoplasmosis skin test,,,28.66,33.19,8
HCPCS,86580,SKIN TEST TUBERCULOSIS INTRADERMAL,46.0,29.9,1.1,85.71,130
HCPCS,86580,TUBERCULOSIS INTRADERMAL (POINT OF CARE LAB),169.0,109.85,13.1,169.0,87
HCPCS,86581,PNEUMO ABS SEROTYPES X23,106.0,68.9,28.66,106.0,76
HCPCS,86581,STREP PNEUMO ABS X14,106.0,68.9,28.66,106.0,76
HCPCS,86590,STREPTOKINASE ANTIBODY,,,5.46,48.53,28
HCPCS,86590,Streptokinase antibody,,,23.08,26.72,8
HCPCS,86592,POMER4 RPR,29.0,18.85,2.11,29.0,84
HCPCS,86592,SYPHILIS TEST QUAL,29.0,18.85,2.11,29.0,252
HCPCS,86592,VDRL/RPR QUAL,29.0,18.85,2.11,29.0,84
HCPCS,86592,WHIIVF SYPHILIS TEST,29.0,18.85,2.11,29.0,84
HCPCS,86593,SYPHILIS TEST QUANT,30.0,19.5,2.18,31.66,84
HCPCS,86593,SYPHILIS TEST QUANTITATIVE,30.0,19.5,1.1,30.0,88
HCPCS,86596,%PARNEO VOLTAGE-GTD CA CHNL ANTB EA,83.0,53.95,7.36,83.0,84
HCPCS,86596,VOLTAGE-GATED NA CH AB EA,83.0,53.95,7.36,83.0,84
HCPCS,86602,ANTINOMYCES ANTIBODY,70.0,45.5,1.1,70.0,116
HCPCS,86602,Antinomyces antibody,,,23.08,26.72,8
HCPCS,86603,ADENOVIRUS AB,89.0,57.85,6.36,89.0,84
HCPCS,86603,"ADENOVIRUS ABS, IGG",89.0,57.85,6.36,89.0,84
HCPCS,86603,"ADENOVIRUS ABS, IGG/IGMX2",89.0,57.85,6.36,89.0,84
HCPCS,86603,"ADENOVIRUS ABS, IGM",89.0,57.85,6.36,89.0,84
HCPCS,86603,ADENOVIRUS ANTIBODY,89.0,57.85,6.36,89.0,84
HCPCS,86606,%ABPA IMMDIFF QUAL,104.0,67.6,7.44,105.93,84
HCPCS,86606,"A FUMIGATUS AB, IGG",104.0,67.6,7.44,105.93,84
HCPCS,86606,ANTIBODY ASPERGILLUS,104.0,67.6,1.1,104.0,88
HCPCS,86606,ASPERGILLUS AB IMDIFF,104.0,67.6,7.44,105.93,84
HCPCS,86606,ASPERGILLUS ID,104.0,67.6,7.44,105.93,168
HCPCS,86606,ASPERGILLUS QUAL OR SEMI-QUANT,104.0,67.6,7.44,105.93,84
HCPCS,86606,FUNCF ASPERGILLUS ID,104.0,67.6,7.44,105.93,84
HCPCS,86606,HYPERSENSITIVITY PNEUMO IA QUAL,104.0,67.6,7.44,105.93,84
HCPCS,86609,ANTIBODY BACTERIUM NOT ELSEWHERE SPECIFIED,89.0,57.85,1.1,89.0,88
HCPCS,86609,LISTERIA ANTIBODY,89.0,57.85,6.36,89.0,84
HCPCS,86609,NEISSERIA GONORRHOEA AB T,89.0,57.85,6.36,89.0,84
HCPCS,86609,STREPTO.PNEUM.X14,89.0,57.85,6.36,89.0,84
HCPCS,86609,TOXIC SHOCK SYNDROME X3,89.0,57.85,6.36,89.0,84
HCPCS,86611,AB; BARTONELLA,70.0,45.5,1.1,70.0,88
HCPCS,86611,BART QUINTANA ABS X2,70.0,45.5,5.02,78.37,84
HCPCS,86611,BARTONELLA,70.0,45.5,5.02,78.37,84
HCPCS,86612,%FABCSF BLASTOMYCES,89.0,57.85,6.37,99.37,84
HCPCS,86612,ANTIBODY BLASTOMYCES,89.0,57.85,1.1,89.0,88
HCPCS,86612,BLASOMYCES DERMATITIDIS AB,89.0,57.85,6.37,99.37,84
HCPCS,86612,BLASTOMYCES D AB RFLX,89.0,57.85,6.37,99.37,84
HCPCS,86612,BLASTOMYCES ID,89.0,57.85,6.37,99.37,84
HCPCS,86612,FUNCF BLASOMYCES DERMATITIDIS AB,89.0,57.85,6.37,99.37,84
HCPCS,86615,ANTIBODY BORDETELLA,91.0,59.15,1.1,91.0,88
HCPCS,86615,B PERTUSSIS AB IGA IB,91.0,59.15,6.51,91.0,84
HCPCS,86615,B PERTUSSIS AB IGG IB,91.0,59.15,6.51,91.0,84
HCPCS,86615,B PERTUSSIS AB IGM IB,91.0,59.15,6.51,91.0,84
HCPCS,86615,BORDETELLA QUAL OR SEMI-QUANT,91.0,59.15,6.51,91.0,84
HCPCS,86615,PERTUSSIS/PARAPERT GAM X3,91.0,59.15,6.51,91.0,84
HCPCS,86617,ANTIBODY BORRELIA BURGDORFERI CONFIRMATORY TST,107.0,69.55,1.1,107.0,88
HCPCS,86617,B BURGDO AB IGG IGM X2,107.0,69.55,7.65,107.0,84
HCPCS,86617,LYME DISEASE AB RFLX,107.0,69.55,7.65,107.0,84
HCPCS,86617,LYME IGG/IGM IB CSF X2,107.0,69.55,7.65,107.0,84
HCPCS,86617,LYME WESTERN BLOT,107.0,69.55,7.65,107.0,84
HCPCS,86618,ANTIBODY BORRELIA BURGDORFERI LYME DISEASE,118.0,76.7,1.1,118.0,88
HCPCS,86618,BORELIA BURGDORFERI LYME,118.0,76.7,8.41,118.0,84
HCPCS,86618,LYME IGG & IGM SERUM,118.0,76.7,8.41,118.0,84
HCPCS,86618,LYME IGG CSF,118.0,76.7,8.41,118.0,84
HCPCS,86618,"LYME REFLEX PNL, CSF",118.0,76.7,8.41,118.0,84
HCPCS,86618,LYMRFX BORRELIA ANTIBODY,118.0,76.7,8.41,118.0,84
HCPCS,86619,BORRELIA ANTIBODY,,,6.61,59.0,28
HCPCS,86619,Borrelia antibody,,,23.08,26.72,8
HCPCS,86622,%FEBAB BRUCCLLA,62.0,40.3,4.41,68.79,84
HCPCS,86622,*BRUCELLA AB,62.0,40.3,4.41,68.79,84
HCPCS,86622,BRUCELLA AB TOTAL,62.0,40.3,4.41,68.79,84
HCPCS,86622,BRUCELLA CONFIRM,62.0,40.3,4.41,68.79,84
HCPCS,86622,"BRUCELLA IGG/IGM CONF, REFLEX ONLY",62.0,40.3,4.41,68.79,84
HCPCS,86625,CAMPY JEJUNI AB IGG,91.0,59.15,6.48,91.0,84
HCPCS,86625,"CAMPYLOBACTER, ANTIBODY",91.0,59.15,1.1,91.0,88
HCPCS,86628,%CANDA ALBICAN AB X3,83.0,53.95,5.93,92.43,84
HCPCS,86628,ANTIBODY CANDIDA,83.0,53.95,1.1,83.0,88
HCPCS,86628,"CANDIDA ABS IGA,G,M X3",83.0,53.95,5.93,92.43,84
HCPCS,86628,CANDIDA IMMUNE COMPLEX,83.0,53.95,5.93,92.43,84
HCPCS,86631,%CIGIM ABS X3,82.0,53.3,5.84,82.0,84
HCPCS,86631,ANTIBODY CHLAMYDIA,82.0,53.3,1.1,82.0,88
HCPCS,86631,CHLAMYDIA,82.0,53.3,5.84,82.0,84
HCPCS,86631,CHLAMYDIA AB PANEL X3,82.0,53.3,5.84,82.0,84
HCPCS,86632,%CIGIM IGM ABS X3,87.0,56.55,6.26,87.0,84
HCPCS,86632,ANTIBODY CHLAMYDIA IGM,87.0,56.55,1.1,87.0,88
HCPCS,86632,CHLAMYDIA IGM,87.0,56.55,6.26,87.0,84
HCPCS,86632,CHLAMYDIA IGM PANEL X3,87.0,56.55,6.26,87.0,84
HCPCS,86635,%FABCSF COCCIDIODE IGG/M ABS,79.0,51.35,5.67,88.34,84
HCPCS,86635,ANTIBODY COCCIDIOIDES,79.0,51.35,1.1,79.0,88
HCPCS,86635,COCCIDIODES IGG/M ABS X2,79.0,51.35,5.67,88.34,84
HCPCS,86635,COCCIDIOIDES ID,79.0,51.35,5.67,88.34,84
HCPCS,86635,"COCCIDOIDES AB, CF",79.0,51.35,5.67,88.34,84
HCPCS,86635,FUNCF COCCIDOIDES AB,79.0,51.35,5.67,88.34,84
HCPCS,86638,*Q FEVER (COXIELLA) AB,84.0,54.6,5.99,84.0,84
HCPCS,86638,COXIELLA BURNETII IGG X2,84.0,54.6,5.99,84.0,84
HCPCS,86638,COXIELLA IGG IGM IGA X6,84.0,54.6,5.99,84.0,84
HCPCS,86638,QFEVER AB IGG IGM PH I&II,84.0,54.6,5.99,84.0,84
HCPCS,86641,CRYPTOCOCCUS ANTIBODY,,,7.12,60.64,28
HCPCS,86641,Cryptococcus antibody,,,23.08,26.72,8
HCPCS,86644,%IDM CMV,99.0,64.35,7.11,99.0,84
HCPCS,86644,%TORCH AB CMV IGG,99.0,64.35,7.11,99.0,84
HCPCS,86644,ANTIBODY; CYTOMEGALOVIRUS (CMV),99.0,64.35,1.1,99.0,88
HCPCS,86644,CMV AB,99.0,64.35,7.11,99.0,168
HCPCS,86644,CMV IGG ANTIBODY,99.0,64.35,7.11,99.0,84
HCPCS,86644,CMV IGG AVIDITY,99.0,64.35,7.11,99.0,84
HCPCS,86644,WHIIVF2 CMV IGG AB,99.0,64.35,7.11,99.0,84
HCPCS,86645,%TORCHM AB CMV IGM,116.0,75.4,8.32,116.0,84
HCPCS,86645,ANTIBODY CYTOMEGALOVIRUS CMV IGM,116.0,75.4,1.1,116.0,88
HCPCS,86645,CMV IGM EIA AB,116.0,75.4,8.32,116.0,84
HCPCS,86645,WHIIVF2 CMV IGM EIA AB,116.0,75.4,8.32,116.0,84
HCPCS,86648,%DIPHTHERIA,105.0,68.25,7.51,105.0,84
HCPCS,86648,DIPHTHERIA ANTIBODY,105.0,68.25,1.1,105.0,88
HCPCS,86651,%ARBOVIRUS ENCEPH CA-LA X,91.0,59.15,6.51,91.0,84
HCPCS,86651,CALIFORNIA ENCEPH X2,91.0,59.15,6.51,91.0,84
HCPCS,86651,ENCEPH CALIF LACROSSE,91.0,59.15,6.51,91.0,84
HCPCS,86652,E EQUINE ENCEPH X2,91.0,59.15,6.51,91.0,84
HCPCS,86652,ENCEPH EASTERN,91.0,59.15,6.51,91.0,84
HCPCS,86653,ARBOVIRUS ST LOUIS,91.0,59.15,6.51,91.0,84
HCPCS,86653,ST LOUS ENCEPH X2,91.0,59.15,6.51,91.0,84
HCPCS,86654,ENCEPH WESTERN,91.0,59.15,6.51,91.0,84
HCPCS,86654,W EQUINE ENCEPH X2,91.0,59.15,6.51,91.0,84
HCPCS,86658,*ENTEROVIRUS AB,90.0,58.5,6.43,100.33,84
HCPCS,86658,ANTIBODY ENTEROVIRUS,90.0,58.5,1.1,90.0,88
HCPCS,86658,COXSACKIE A ABS,90.0,58.5,6.43,100.33,84
HCPCS,86658,COXSACKIE A DIFF AB X6,90.0,58.5,6.43,100.33,84
HCPCS,86658,ECHOVIRUS ANTIBODIES X5,90.0,58.5,6.43,100.33,84
HCPCS,86658,POLIOVIRUS ABS NEUTRAL X2,90.0,58.5,6.43,100.33,84
HCPCS,86658,POLIOVIRUS ANTIBODIES X3,90.0,58.5,6.43,100.33,84
HCPCS,86663,ANTIBODY EPSTEIN-BARR EB VIRUS EARLY ANTIGEN EA,91.0,59.15,1.1,91.0,88
HCPCS,86663,EBV-EA IFA,91.0,59.15,6.48,91.0,84
HCPCS,86664,ANTIBODY EPSTEIN-BARR EB VIRUS NUCLEAR AG EBNA,106.0,68.9,1.1,106.0,88
HCPCS,86664,EBV-NA IFA,106.0,68.9,7.55,106.0,84
HCPCS,86665,ANTIBODY EPSTEIN-BARR EB VIRUS VIRAL CAPSID VCA,125.0,81.25,1.1,125.0,88
HCPCS,86665,EBV-VCA IFA IGG,125.0,81.25,8.96,125.0,84
HCPCS,86666,"A PHAGO AB, IGG/IGM X2",70.0,45.5,5.02,78.37,84
HCPCS,86666,AB; ERLICHIA,70.0,45.5,1.1,70.0,88
HCPCS,86666,EHRLICHIA,70.0,45.5,5.02,78.37,84
HCPCS,86666,EHRLICHIA CHAF IGG/IGMX2,70.0,45.5,5.02,78.37,84
HCPCS,86668,FRANCISELLA TULARENSIS AB,98.0,63.7,5.66,98.0,84
HCPCS,86668,TULAREMIA AB BLOOD,98.0,63.7,1.1,98.0,88
HCPCS,86671,%IBDSER SACCH CEREV X2,85.0,55.25,6.05,85.0,84
HCPCS,86671,*FUNGI AB NOS,85.0,55.25,6.05,85.0,84
HCPCS,86671,"FUNGUS, ANTIBODY",85.0,55.25,1.1,85.0,88
HCPCS,86674,GIARDIA LAMBLIA,102.0,66.3,1.1,102.0,88
HCPCS,86674,GIARDIA LAMBLIA IG/GAM X3,102.0,66.3,7.27,103.03,84
HCPCS,86677,*H PYLORI AB,116.0,75.4,7.16,116.0,84
HCPCS,86677,AB; HELICOBACTER PYLORI,116.0,75.4,1.1,116.0,88
HCPCS,86677,H PYLORI AB,116.0,75.4,7.16,116.0,84
HCPCS,86677,H PYLORI AB (BACK OFFICE),116.0,75.4,7.16,116.0,84
HCPCS,86682,ANTIBODY HELMINTH NOT ELSEWHERE SPECIFIED,90.0,58.5,1.1,90.0,88
HCPCS,86682,FILARIASIS ABS IGG4,90.0,58.5,6.42,90.0,84
HCPCS,86682,"HELMINTH, NES",90.0,58.5,6.42,90.0,84
HCPCS,86682,SCHISTOSOMA IGG AB,90.0,58.5,6.42,90.0,84
HCPCS,86682,STRONGYLOIDES IGG ABS,90.0,58.5,6.42,90.0,84
HCPCS,86682,TOXOCARA ANTIBODIES,90.0,58.5,6.42,90.0,84
HCPCS,86684,HEMOPHILUS INFLUENZA ANTIBDY,,,7.82,53.08,29
HCPCS,86684,Hemophilus influenza antibdy,,,23.08,26.72,8
HCPCS,86687,%IDM ANTI HTLV I,63.0,40.95,4.14,63.0,84
HCPCS,86687,ANTIBODY HTLV-I,63.0,40.95,1.1,63.0,88
HCPCS,86687,HTLV I AB,63.0,40.95,4.14,63.0,168
HCPCS,86688,HTLV-II,97.0,63.05,1.1,97.0,88
HCPCS,86688,HTLV-II ANTIBODY,,,6.92,61.78,28
HCPCS,86688,Htlv-ii antibody,,,23.08,26.72,8
HCPCS,86689,ANTIBODY HTLV/HIV ANTIBODY CONFIRMATORY TEST,134.0,87.1,1.1,134.0,88
HCPCS,86689,HIV  CONFIRMATION,134.0,87.1,9.56,134.0,84
HCPCS,86689,HIV AB CONFIRM/WESTERN BLOT,134.0,87.1,9.56,134.0,84
HCPCS,86689,HIV-2 IGG ABS CONFIRM,134.0,87.1,9.56,134.0,84
HCPCS,86689,HIV2 AB CONF SERUM,134.0,87.1,9.56,134.0,84
HCPCS,86692,HEP DELTA AB,118.0,76.7,1.1,118.0,88
HCPCS,86692,HEPATITIS DELTA AB,118.0,76.7,8.48,118.0,84
HCPCS,86694,%PREXP EXP HERPES BL X2,99.0,64.35,7.11,99.0,84
HCPCS,86694,%TORCHM HSV 1/2 IGM,99.0,64.35,7.11,99.0,84
HCPCS,86694,ANTIBODY HERPES SMPLX NON-SPECIFIC TYPE TEST,99.0,64.35,1.1,99.0,88
HCPCS,86694,HERPES SIMPLEX IGM ABS,99.0,64.35,7.11,99.0,84
HCPCS,86695,%HIVIFA HSV 1 IGM,91.0,59.15,6.51,91.0,84
HCPCS,86695,%HSVG12 IGG 1,91.0,59.15,6.51,91.0,84
HCPCS,86695,%HSVIFA HSV 2 IGM,91.0,59.15,6.51,91.0,84
HCPCS,86695,ANTIBODY HERPES SMPLX TYPE 1,91.0,59.15,1.1,91.0,88
HCPCS,86695,HERPES SIMPLEX TYPE I,91.0,59.15,6.51,91.0,84
HCPCS,86695,HSV 1 IGM TITER REFLEX,91.0,59.15,6.51,91.0,84
HCPCS,86696,%12IFA HERPES SIMP 2,134.0,87.1,9.56,134.0,84
HCPCS,86696,%HSVG12 IGG 2,134.0,87.1,9.56,134.0,84
HCPCS,86696,*AB; HSV II,134.0,87.1,9.56,134.0,84
HCPCS,86696,AB; HSV TYPE 2,134.0,87.1,1.1,134.0,88
HCPCS,86696,HSV 2 IGM TITER REFLEX,134.0,87.1,9.56,134.0,84
HCPCS,86698,ANTIBODY HISTOPLASMA,95.0,61.75,1.1,95.0,88
HCPCS,86698,FUNCF HISTOPLASMA AB X2,95.0,61.75,6.17,96.24,84
HCPCS,86698,HISTO ABS CF+ID CSF X3,95.0,61.75,6.17,96.24,84
HCPCS,86698,HISTO ID,95.0,61.75,6.17,96.24,84
HCPCS,86698,HISTOPLASMA,95.0,61.75,6.17,96.24,84
HCPCS,86698,"HISTOPLASMA AB, CF X2",95.0,61.75,6.17,96.24,84
HCPCS,86701,HIV ANTIBODY,61.0,39.65,8.89,61.0,84
HCPCS,86701,HIV-1 ANTIBODY EIA SCRN,61.0,39.65,8.89,61.0,84
HCPCS,86702,HIV-2 AB IGG EIA,93.0,60.45,1.1,93.0,88
HCPCS,86702,HIV-2 ANTIBODY,,,6.68,59.61,28
HCPCS,86702,Hiv-2 antibody,,,23.08,26.72,8
HCPCS,86703,ANTIBODY HIV-1&HIV-2 SINGLE RESULT,95.0,61.75,1.1,95.0,88
HCPCS,86703,HIV 1 HIV 2 SNGL ASSAY AB,95.0,61.75,6.77,95.0,252
HCPCS,86703,HIV 1&2 ANTIBODY SCREEN,95.0,61.75,6.77,95.0,84
HCPCS,86703,HIV-1/HIV2 SNG ASSY (POINT OF CARE LAB),95.0,61.75,6.77,95.0,84
HCPCS,86703,HIV1 HIV2 SNGL ASSAY AB,95.0,61.75,6.77,95.0,84
HCPCS,86704,*HEP B CORE AB TOTAL,83.0,53.95,5.95,83.0,84
HCPCS,86704,HEP B CORE AB TOTAL,83.0,53.95,5.95,83.0,168
HCPCS,86704,HEPATITIS B CORE ANTIBODY HBCAB TOTAL,83.0,53.95,1.1,83.0,88
HCPCS,86704,IDM HEP B CORE AB TOTAL,83.0,53.95,5.95,83.0,84
HCPCS,86704,WHIIVF HEP B CORE AB TOTA,83.0,53.95,5.95,83.0,84
HCPCS,86705,HEP B CORE IGM AB,81.0,52.65,5.82,81.0,84
HCPCS,86705,HEPATITIS B CORE ANTIBODY HBCAB IGM ANTIBODY,81.0,52.65,1.1,81.0,88
HCPCS,86706,*HEP B SURFACE AB,74.0,48.1,5.3,74.0,84
HCPCS,86706,HEPATITIS B SURF ANTIBODY HBSAB,74.0,48.1,1.1,74.0,88
HCPCS,86707,HEPATITIS BE ANTIBODY,80.0,52.0,5.71,80.0,84
HCPCS,86707,HEPATITIS BE ANTIBODY HBEAB,80.0,52.0,1.1,80.0,88
HCPCS,86708,HEP A AB TOTAL,85.0,55.25,6.12,85.0,84
HCPCS,86708,HEPATITIS A ANTIBODY HAAB,85.0,55.25,1.1,85.0,88
HCPCS,86709,"HEP A, HEP A AB IGM",78.0,50.7,5.56,78.0,84
HCPCS,86709,HEPATITIS ANTIBODY HAAB IGM ANTIBODY,78.0,50.7,1.1,78.0,88
HCPCS,86710,*INFLUENZA VIRUS AB,93.0,60.45,6.69,93.0,84
HCPCS,86710,INFLUENZA A+B CF X2,93.0,60.45,6.69,93.0,84
HCPCS,86711,JOHN CUNNINGHAM ANTIBODY,,,7.11,50.88,29
HCPCS,86711,John cunningham antibody,,,23.08,26.72,8
HCPCS,86713,LEGIONELLA ANTIBODY,106.0,68.9,7.56,106.0,84
HCPCS,86713,LEGIONELLA IGM ABS,106.0,68.9,7.56,106.0,84
HCPCS,86713,LEGIONELLA PNEUMOPHILA AB,106.0,68.9,7.56,106.0,84
HCPCS,86717,LEISHMANIA,85.0,55.25,1.1,85.0,88
HCPCS,86717,LEISHMANIASIS,85.0,55.25,6.05,85.0,84
HCPCS,86720,ANTIBODY LEPTOSPIRA,112.0,72.8,1.1,112.0,88
HCPCS,86720,LEPTOSPIRA ANTIBODY,112.0,72.8,6.51,112.0,84
HCPCS,86723,LISTERIA ANTIBODY,91.0,59.15,6.51,101.56,84
HCPCS,86727,*LYMPH CHORIOMENINGITIS AB,89.0,57.85,6.36,89.0,84
HCPCS,86727,MENINGITIS AB,89.0,57.85,1.1,89.0,88
HCPCS,86729,Lympho venereum antibody,,,52.64,52.64,1
HCPCS,86732,MUCORMYCOSIS ANTIBODY,,,6.51,58.17,28
HCPCS,86732,Mucormycosis antibody,,,23.08,26.72,8
HCPCS,86735,ANTIBODY MUMPS,90.0,58.5,1.1,90.0,88
HCPCS,86735,MUMPS IGG ANTIBODY,90.0,58.5,6.44,90.0,84
HCPCS,86735,MUMPS VIRUS AB IGM,90.0,58.5,6.44,90.0,84
HCPCS,86738,AB; MYCOPLASMA,91.0,59.15,1.1,91.0,88
HCPCS,86738,MYCOPLASMA AB,91.0,59.15,6.54,91.0,84
HCPCS,86738,MYCOPLASMA IGM AB,91.0,59.15,6.54,91.0,84
HCPCS,86741,MISC SENDOUT CPT 86741,91.0,59.15,6.51,91.0,84
HCPCS,86741,"N. MENINGITIDIS A, C, W-135 AND Y IGG",91.0,59.15,6.51,91.0,84
HCPCS,86741,NEISSERIA MENINGITIDIS,91.0,59.15,1.1,91.0,88
HCPCS,86744,NOCARDIA,110.0,71.5,1.1,110.0,88
HCPCS,86744,NOCARDIA ANTIBODY,,,6.51,58.17,28
HCPCS,86744,Nocardia antibody,,,23.08,26.72,8
HCPCS,86747,ANTIBODY PARVOVIRUS,104.0,67.6,1.1,104.0,88
HCPCS,86747,PARVO B19 AB IGG & IGMX2,104.0,67.6,7.42,104.0,84
HCPCS,86750,MALARIA ANTIBODY IGG,91.0,59.15,6.51,101.56,84
HCPCS,86753,%IDM CHAGAS,85.0,55.25,6.12,90.01,84
HCPCS,86753,ANTIBODY PROTOZOA NES,85.0,55.25,1.1,85.0,88
HCPCS,86753,BABESIA MICROTI G+M X2,85.0,55.25,6.12,90.01,84
HCPCS,86753,ENTAMOEBA HISTO IGG,85.0,55.25,6.12,90.01,84
HCPCS,86753,TRYPANOSOMA CRUZI AB IGG,85.0,55.25,6.12,90.01,84
HCPCS,86753,TRYPANOSOMA CRUZI AB IGM,85.0,55.25,6.12,90.01,84
HCPCS,86756,RESPIRATORY SYNCYTIAL AB,110.0,71.5,6.36,110.0,84
HCPCS,86757,%FEBAB RICKETTSIA X4,134.0,87.1,9.56,134.0,84
HCPCS,86757,*RICKETTSIA AB,134.0,87.1,9.56,134.0,84
HCPCS,86759,ROTAVIRUS ANTIBODY,,,7.29,58.17,28
HCPCS,86759,Rotavirus antibody,,,23.08,26.72,8
HCPCS,86762,%TORC AB RUBELLA IGM,99.0,64.35,7.11,99.0,84
HCPCS,86762,%TORCHM AB RUBELLA IGM,99.0,64.35,7.11,99.0,84
HCPCS,86762,ANTIBODY RUBELLA,99.0,64.35,1.1,99.0,88
HCPCS,86762,POMER4 RUBIGG,99.0,64.35,7.11,99.0,84
HCPCS,86762,RUBELLA IGG SEMI-QUANT,99.0,64.35,7.11,99.0,84
HCPCS,86762,RUBELLA IGM IFA,99.0,64.35,7.11,99.0,84
HCPCS,86762,WHIIVF2 RUBELLA IGG SEMI-QUANT,99.0,64.35,7.11,99.0,84
HCPCS,86762,WHIIVF2 RUBELLA IGM IFA,99.0,64.35,7.11,99.0,84
HCPCS,86765,ANTIBODY RUBEOLA,89.0,57.85,1.1,89.0,88
HCPCS,86765,MEASLES-RUBEOLA IGG AB,89.0,57.85,6.36,89.0,84
HCPCS,86765,MEASLES-RUBEOLA IGM AB,89.0,57.85,6.36,89.0,84
HCPCS,86768,%FEBAB SALMONELLA  X5,91.0,59.15,6.51,91.0,84
HCPCS,86768,*AB; SALMONELLA,91.0,59.15,6.51,91.0,84
HCPCS,86769,COVID19 IGG QUAL BY CIA,291.0,189.15,16.85,291.0,85
HCPCS,86771,SHIGELLA ANTIBODY,,,9.79,73.74,28
HCPCS,86771,Shigella antibody,,,23.08,26.72,8
HCPCS,86774,TETANUS,102.0,66.3,1.1,102.0,88
HCPCS,86774,TETANUS ANTIBODY,,,7.31,49.56,29
HCPCS,86774,Tetanus antibody,,,23.08,26.72,8
HCPCS,86777,%CSFTOX TOXOPLAS IGG,99.0,64.35,7.11,99.0,84
HCPCS,86777,%TORCH AB TOXOPLS IGG,99.0,64.35,7.11,99.0,84
HCPCS,86777,ANTIBODY TOXOPLASMA,99.0,64.35,1.1,99.0,88
HCPCS,86777,TOXOPLAS IGG,99.0,64.35,7.11,99.0,84
HCPCS,86778,%CSFTOX TOXOPLAS IGM,99.0,64.35,7.11,99.0,84
HCPCS,86778,%TORCHM AB TOXOPLS IGM,99.0,64.35,7.11,99.0,84
HCPCS,86778,ANTIBODY TOXOPLASMA IGM,99.0,64.35,1.1,99.0,88
HCPCS,86778,TOXOPLASMOSIS IGM AB,99.0,64.35,7.11,99.0,84
HCPCS,86780,SYPHILIS T PALLIDUM IGG,91.0,59.15,13.24,91.0,84
HCPCS,86780,TREPONEMA PALLIDUM,91.0,59.15,1.1,91.0,172
HCPCS,86780,WHIIVF SYPHILIS,91.0,59.15,13.24,91.0,84
HCPCS,86780,WHIIVF SYPHILIS T PALLIDUM REFLEX,91.0,59.15,13.24,91.0,84
HCPCS,86784,TRICHINELLA IGG AB,87.0,56.55,6.2,87.0,84
HCPCS,86787,ANTIBODY VARICELLA-ZOSTER,89.0,57.85,1.1,89.0,88
HCPCS,86787,VARICELLA ZOSTER IGG AB,89.0,57.85,6.36,89.0,84
HCPCS,86787,VARICELLA ZOSTER IGM,89.0,57.85,6.36,89.0,84
HCPCS,86787,"VZV IGG AB, CSF",89.0,57.85,6.36,89.0,84
HCPCS,86788,%CNILE WEST NILE VRS IGM,116.0,75.4,8.32,116.0,84
HCPCS,86788,ANTIBODY WEST NILE VIRUS IGM,116.0,75.4,1.1,116.0,88
HCPCS,86788,ARBOVIRUS W NILE,116.0,75.4,8.32,116.0,84
HCPCS,86788,WEST NILE VIRUS IGM,116.0,75.4,8.32,116.0,84
HCPCS,86789,%ARBOVIRUS W NILE AB IGG,99.0,64.35,7.11,110.69,84
HCPCS,86789,%CNILE WEST NILE VRS IGG,99.0,64.35,7.11,110.69,84
HCPCS,86789,WEST NILE VIRUS ANTIBODY,99.0,64.35,1.1,99.0,88
HCPCS,86789,WEST NILE VIRUS IGG,99.0,64.35,7.11,110.69,84
HCPCS,86790,ANTIBODY VIRUS NOT ELSEWHERE SPECIFIFED,89.0,57.85,1.1,89.0,88
HCPCS,86790,CHIKUNGUNYA AB IGG IGM X2,89.0,57.85,6.36,89.0,84
HCPCS,86790,CHIKUNGUNYA AB W/ REFLEX,89.0,57.85,6.36,89.0,84
HCPCS,86790,CHIKUNGUNYA IGG TITER,89.0,57.85,6.36,89.0,84
HCPCS,86790,CHIKUNGUNYA IGM TITER,89.0,57.85,6.36,89.0,84
HCPCS,86790,DENGUE FEVER ABS IGG/M X2,89.0,57.85,6.36,89.0,84
HCPCS,86790,DENGUE VIRUS IGG AB,89.0,57.85,6.36,89.0,84
HCPCS,86790,DENGUE VIRUS IGM AB,89.0,57.85,6.36,89.0,84
HCPCS,86790,HATAVIRUS IGG & IGM,89.0,57.85,6.36,89.0,84
HCPCS,86790,HEPATITIS E IGG,89.0,57.85,6.36,89.0,84
HCPCS,86790,HEPATITIS E IGG/IGM ABX2,89.0,57.85,6.36,89.0,84
HCPCS,86790,HEPATITIS E IGM,89.0,57.85,6.36,89.0,84
HCPCS,86790,HERPES VIRUS 6 IGG AB,89.0,57.85,6.36,89.0,84
HCPCS,86790,HERPESVIR 6 AB IGM TITER,89.0,57.85,6.36,89.0,84
HCPCS,86790,HERPESVIRUS 6 IGM AB,89.0,57.85,6.36,89.0,84
HCPCS,86790,HERPESVIRUS-7 IGG/M X2,89.0,57.85,6.36,89.0,84
HCPCS,86790,HTLV I/II ANTIBODY EIA,89.0,57.85,6.36,89.0,84
HCPCS,86790,HV6 HUMAN IGG/IGM ABSX2,89.0,57.85,6.36,89.0,84
HCPCS,86790,PARAINFLU 123ABS IGG/MX3,89.0,57.85,6.36,89.0,84
HCPCS,86790,ZIKA VIRUS IGG,89.0,57.85,6.36,89.0,84
HCPCS,86790,ZIKA VIRUS IGG IGM X2,89.0,57.85,6.36,89.0,84
HCPCS,86790,ZIKA VIRUS IGM,89.0,57.85,6.36,89.0,84
HCPCS,86793,YERSINIA ANTIBODY,,,6.51,58.17,28
HCPCS,86793,Yersinia antibody,,,23.08,26.72,8
HCPCS,86794,ZIKA VIRUS IGM,116.0,75.4,16.85,116.0,84
HCPCS,86800,%ENDOAB THYRGLOBU AB,110.0,71.5,7.86,110.0,84
HCPCS,86800,THYROGLOBULIN AB,110.0,71.5,1.1,110.0,172
HCPCS,86803,*HEP C AB,98.0,63.7,14.27,98.0,168
HCPCS,86803,HEP C AB,98.0,63.7,14.27,98.0,168
HCPCS,86803,HEPATITIS C AB TEST,98.0,63.7,1.1,98.0,88
HCPCS,86803,IDM HEP C AB,98.0,63.7,14.27,98.0,84
HCPCS,86803,WHIIVF HEP C AB,98.0,63.7,14.27,98.0,84
HCPCS,86804,HEP C AB TEST CONFIRM,,,7.65,270.35,28
HCPCS,86804,HEP C VIRUS BY RIBA,107.0,69.55,1.1,107.0,88
HCPCS,86804,Hep c ab test confirm,,,23.08,26.72,8
HCPCS,86805,XM AUTO UNFRACTIONATED/T CELLS,1308.0,850.2,52.25,1308.0,84
HCPCS,86805,XM B CYTOTOXIC ALLO,1308.0,850.2,52.25,1308.0,84
HCPCS,86805,XM B CYTOTOXIC AUTO,1308.0,850.2,52.25,1308.0,84
HCPCS,86805,XM B OR T CYTOTOXIC ALLO-DECEASED,1308.0,850.2,52.25,1308.0,84
HCPCS,86805,XM T CYTOTOXIC ALLO,1308.0,850.2,52.25,1308.0,84
HCPCS,86805,XM T CYTOTOXIC AUTO,1308.0,850.2,52.25,1308.0,84
HCPCS,86806,LYMPHOCYTOTOXICITY ASSAY,,,23.5,210.14,28
HCPCS,86806,Lymphocytotoxicity assay,,,67.56,78.23,8
HCPCS,86807,LYMPHOCYTOTOXIC B ABID,543.0,352.95,31.46,543.0,84
HCPCS,86808,AB POST TX DSA MONITORING,205.0,133.25,14.66,228.56,84
HCPCS,86812,HLA B27 FLOW,178.0,115.7,12.74,178.0,84
HCPCS,86812,HLA TYPING A/B/C SNGL AG,178.0,115.7,12.74,178.0,84
HCPCS,86813,HLA ABCDR TT UPDATE,400.0,260.0,28.64,400.0,84
HCPCS,86813,HLA TYPING A/B/C MULT AG,400.0,260.0,28.64,400.0,84
HCPCS,86813,"HLA-A,B TYPING",400.0,260.0,28.64,400.0,84
HCPCS,86813,"HLA-A,B TYPING VERIFICATION",400.0,260.0,28.64,400.0,84
HCPCS,86813,"HLA-A,B,CW - TYPING DECEASED DONOR",400.0,260.0,28.64,400.0,84
HCPCS,86813,HLA-CW TYPING,400.0,260.0,28.64,400.0,84
HCPCS,86816,HLA TYPING DR/DQ SNGL AG,208.0,135.2,13.76,208.0,84
HCPCS,86816,"HLA TYPING, DR/DQ,SINGLE ANTIGEN",208.0,135.2,1.1,208.0,88
HCPCS,86817,HLA TYPING DR/DQ MULT AG,732.0,475.8,42.46,732.0,168
HCPCS,86817,"HLA-DR,DQ,DR51,52,53 -TYPING DECEASED DONOR",732.0,475.8,42.46,732.0,84
HCPCS,86817,"HLA-DR,DQ,DRW TYPING",732.0,475.8,42.46,732.0,84
HCPCS,86821,LYMPHOCYTE CULTURE MIXED,,,18.06,142.53,28
HCPCS,86821,Lymphocyte culture mixed,,,67.56,78.23,8
HCPCS,86822,Lymphocyte culture primed,,,142.53,142.53,1
HCPCS,86825,*HLA X-MATCH NON-CYTOTOXIC,755.0,490.75,43.8,755.0,84
HCPCS,86825,XM T & B FLOW ALLO,755.0,490.75,43.8,755.0,84
HCPCS,86825,XM T & B FLOW AUTO,755.0,490.75,43.8,755.0,84
HCPCS,86825,XM T&B FLOW ALLO DECEASED DONOR,755.0,490.75,43.8,755.0,84
HCPCS,86826,HLA CROSSMATCH NONCYTOTOXIC ADDL SERUM/DILUTION,252.0,163.8,1.1,252.0,88
HCPCS,86826,XM T & B FLOW ALLO- ADD SERUM SAMPLE,252.0,163.8,14.61,252.0,84
HCPCS,86828,AB PRA FLOW,443.0,287.95,25.68,443.0,84
HCPCS,86828,AB PRA FLOW REPEAT,443.0,287.95,25.68,443.0,84
HCPCS,86828,HLA CLASS I&II ANTIBODY QUAL,443.0,287.95,25.68,443.0,84
HCPCS,86829,HLA CLASS I/II ANTIBODY QUAL,,,25.68,175.88,28
HCPCS,86829,Hla class i/ii antibody qual,,,67.56,78.23,8
HCPCS,86830,HLA CLASS I PHENOTYPE QUAL,,,39.87,261.72,28
HCPCS,86830,Hla class i phenotype qual,,,67.56,78.23,8
HCPCS,86831,HLA CLASS II PHENOTYPE QUAL,,,34.18,224.35,28
HCPCS,86831,Hla class ii phenotype qual,,,67.56,78.23,8
HCPCS,86832,AB ID & VPRA -CLASS I C1Q,2234.0,1452.1,52.25,2234.0,84
HCPCS,86832,AB ID & VPRA -CLASS I LUMINEX,2234.0,1452.1,52.25,2234.0,84
HCPCS,86832,AB ID & VPRA -CLASS I LUMINEX REPEAT,2234.0,1452.1,52.25,2234.0,84
HCPCS,86832,AB ID & VPRA-CLASS I C1Q REPEAT,2234.0,1452.1,52.25,2234.0,84
HCPCS,86832,AB ID CLASS I PHENO BEADS,2234.0,1452.1,52.25,2234.0,84
HCPCS,86832,AB ID CLASS I PHENO BEADS REPEAT,2234.0,1452.1,52.25,2234.0,84
HCPCS,86832,AB ID DILUTION - CLASS I LUMINEX,2234.0,1452.1,52.25,2234.0,84
HCPCS,86832,XM POST-TX DSA MONITORING  CLASS I,2234.0,1452.1,52.25,2234.0,84
HCPCS,86833,AB ID & VPRA -CLASS II LUMINEX,2248.0,1461.2,52.25,2248.0,84
HCPCS,86833,AB ID & VPRA -CLASS II LUMINEX REPEAT,2248.0,1461.2,52.25,2248.0,84
HCPCS,86833,AB ID & VPRA-CLAS II LUMINEX-C1Q,2248.0,1461.2,52.25,2248.0,84
HCPCS,86833,AB ID & VPRA-CLASS II C1Q REPEAT,2248.0,1461.2,52.25,2248.0,84
HCPCS,86833,AB ID CLASS II PHENO BEADS,2248.0,1461.2,52.25,2248.0,84
HCPCS,86833,AB ID CLASS II PHENO BEADS REPEAT,2248.0,1461.2,52.25,2248.0,84
HCPCS,86833,AB ID DILUTION - CLASS II LUMINEX,2248.0,1461.2,52.25,2248.0,84
HCPCS,86833,HLA CLASS II HIGH DEFIN Q,2248.0,1461.2,52.25,2248.0,84
HCPCS,86833,XM POST-TX DSA MONITORING  CLASS II,2248.0,1461.2,52.25,2248.0,84
HCPCS,86834,HLA CLASS I SEMIQUANT PANEL,,,176.57,979.71,28
HCPCS,86834,Hla class i semiquant panel,,,52.25,60.5,8
HCPCS,86835,HLA CLASS II SEMIQUANT PANEL,,,159.49,884.91,28
HCPCS,86835,Hla class ii semiquant panel,,,52.25,60.5,8
HCPCS,86849,%MYPRS UNLISTED IMMUNO,30.0,19.5,6.54,32.25,66
HCPCS,86849,"PT AB, IGG & IGM X2",326.0,211.9,23.08,326.0,66
HCPCS,86849,UNLISTED IMMUNOLOGY,317.0,206.05,0.01,317.0,82
HCPCS,86850,*RBC AB SCREEN EA SERUM,67.0,43.55,3.91,168.05,85
HCPCS,86850,ANTIBODY SCREEN RBC EACH SERUM TECHNIQUE,67.0,43.55,1.1,67.0,88
HCPCS,86850,PAT CROSSMATCH TYPE & SC,67.0,43.55,3.91,168.05,85
HCPCS,86850,SOLID PHASE AB SCRN,67.0,43.55,3.91,168.05,85
HCPCS,86850,WHIVF RBC AB ACRN,67.0,43.55,3.91,168.05,85
HCPCS,86860,RBC AB ELUTION EA ELUTION,1182.0,768.3,13.39,1182.0,85
HCPCS,86860,RBC ANTIB ELUTION,1182.0,768.3,13.39,1182.0,85
HCPCS,86870,CRC AB ID PANEL,2482.0,1613.3,18.29,2482.0,85
HCPCS,86870,RBC AB ID EA PANL,2482.0,1613.3,18.29,2482.0,170
HCPCS,86880,AGT DIR MONOSPECIF C3,37.0,24.05,2.66,61.39,85
HCPCS,86880,COOMBS TEST DIR EA ANTISERUM,37.0,24.05,2.66,61.39,85
HCPCS,86885,COOMBS TEST INDIRECT QUAL,39.0,25.35,2.83,177.3,85
HCPCS,86885,"CRC AB ID, EACH CELL",39.0,25.35,2.83,177.3,85
HCPCS,86886,ANTIBODY TITER,36.0,23.4,2.56,177.3,85
HCPCS,86886,COOMBS TEST INDIRECT TITER,36.0,23.4,2.56,177.3,85
HCPCS,86886,SENDOUT ANTIBODY TITER,36.0,23.4,2.56,177.3,85
HCPCS,86890,AUTOLOGOUS BLOOD PROCESS,1182.0,768.3,1.1,1182.0,114
HCPCS,86890,Autologous blood process,,,64.15,74.28,8
HCPCS,86891,CELL SALVAGE 1 UNIT,5637.0,3664.05,59.33,5637.0,85
HCPCS,86891,CELL SALVAGE SUPPLY,5637.0,3664.05,59.33,5637.0,85
HCPCS,86891,DISCARD CS COLLECT FEE,5637.0,3664.05,59.33,5637.0,85
HCPCS,86891,SALVAGED BL PROCESSING EA,5637.0,3664.05,59.33,5637.0,85
HCPCS,86900,ABO BLOOD TYPING,21.0,13.65,1.48,138.46,85
HCPCS,86900,ABO TYPRING (FULL),21.0,13.65,1.48,138.46,85
HCPCS,86900,BLOOD TYPING SEROLOGIC ABO,21.0,13.65,1.1,21.0,88
HCPCS,86900,PAT ABO BLOOD TYPING,21.0,13.65,1.48,138.46,85
HCPCS,86900,WHIVF BLD BYPE ABO,21.0,13.65,1.48,138.46,85
HCPCS,86901,*BLOOD TYPING RH(D),21.0,13.65,1.48,39.3,170
HCPCS,86901,BLOOD TYPING SEROLOGIC RH (D),21.0,13.65,1.1,21.0,88
HCPCS,86901,PAT BLOOD TYPING RH(D),21.0,13.65,1.48,39.3,85
HCPCS,86901,WHIVF BLD TYPE RHD,21.0,13.65,1.48,39.3,85
HCPCS,86901,WKD D AG TYPING,21.0,13.65,1.48,39.3,85
HCPCS,86902,BLOOD TYPE ANTIGEN DONOR REAGENT SERUM EA,44.0,28.6,1.1,44.0,88
HCPCS,86902,SPECIAL ANTIGEN SCREEN,44.0,28.6,2.54,373.03,85
HCPCS,86903,"BLOOD TYPING, ANTIGEN SCREEN",,,61.04,61.04,1
HCPCS,86904,AG SCREEN W P,113.0,73.45,6.54,113.0,85
HCPCS,86905,BLOOD TYPING RBC ANTIGENS OTH/THN ABO/RH D EACH,26.0,16.9,1.1,26.0,88
HCPCS,86905,RBC AG NOT AB,26.0,16.9,1.89,373.03,85
HCPCS,86905,RBC AG NOT ABO/RH(D) EA,26.0,16.9,1.89,373.03,85
HCPCS,86905,RBC ANTIGEN TYPING,26.0,16.9,1.89,373.03,85
HCPCS,86906,BLD TYPING SEROLOGIC RH PHNT,,,3.83,39.3,29
HCPCS,86906,Bld typing serologic rh phnt,,,27.84,32.24,8
HCPCS,86910,BLOOD TYPING PATERNITY TEST,,,10.8,2466002.74,6
HCPCS,86910,Blood typing paternity test,,,27.84,32.24,8
HCPCS,86911,BLOOD TYPING ANTIGEN SYSTEM,,,9.36,2466002.74,6
HCPCS,86911,Blood typing antigen system,,,27.84,32.24,8
HCPCS,86920,COMPATIBILITY EACH UNIT IMMEDIATE SPIN TECHNIQUE,1182.0,768.3,1.1,1182.0,88
HCPCS,86920,COMPATIBILITY TEST SPIN,1182.0,768.3,14.83,1182.0,85
HCPCS,86920,PLATELET CROSSMATCH,1182.0,768.3,14.83,1182.0,85
HCPCS,86921,COMPATIBILITY EACH UNIT INCUBATION,1182.0,768.3,1.1,1182.0,88
HCPCS,86921,INCUBATION CROSSMATCH,1182.0,768.3,13.39,1182.0,85
HCPCS,86922,COMPATIBILITY EACH UNIT ANTIGLOBULIN,1182.0,768.3,1.1,1182.0,88
HCPCS,86922,COMPATIBILITY TEST ANTIGLOB,1182.0,768.3,15.84,1182.0,85
HCPCS,86923,COMPATIBILITY TEST ELECTRIC,1182.0,768.3,1.1,1182.0,88
HCPCS,86923,ELECTRONIC CROSSMATCH,1182.0,768.3,11.81,1182.0,85
HCPCS,86927,FRESH FROZEN PLASMA THAWING EACH UNIT,1182.0,768.3,1.1,1182.0,88
HCPCS,86927,THAW FFP EA UNIT,1182.0,768.3,8.35,1182.0,85
HCPCS,86930,FROZEN BLOOD PREP,,,49.39,655.34,26
HCPCS,86930,Frozen blood prep,,,64.15,74.28,8
HCPCS,86931,FROZEN BLOOD THAW,1182.0,768.3,1.1,1182.0,114
HCPCS,86931,Frozen blood thaw,,,64.15,74.28,8
HCPCS,86932,FROZEN BLOOD FREEZE/THAW,,,34.79,152.2,26
HCPCS,86932,"FROZEN BLOOD, FREEZE/THAW",271.0,176.15,1.1,271.0,88
HCPCS,86932,Frozen blood freeze/thaw,,,64.15,74.28,8
HCPCS,86940,ARCDL HEMOLYSINS/AGG AU,61.0,39.65,4.05,61.0,84
HCPCS,86941,ARCDL HEMOLYSINS INCUB,84.0,54.6,5.98,84.0,84
HCPCS,86945,IRRADIATION BLOOD PRODUCT,271.0,176.15,12.38,271.0,85
HCPCS,86950,LEUKACYTE TRANSFUSION,,,32.11,445.91,26
HCPCS,86950,Leukacyte transfusion,,,64.15,74.28,8
HCPCS,86960,VOL REDUCTION OF BLOOD/PROD,,,13.82,445.91,25
HCPCS,86960,Vol reduction of blood/prod,,,64.15,74.28,8
HCPCS,86965,POOLING BLOOD PLT OR OTHER BLD PRD,1182.0,768.3,13.82,1182.0,85
HCPCS,86970,DTT TREATMENT,410.0,266.5,12.38,410.0,85
HCPCS,86970,PRETREAT RBC AB ID DRUG,410.0,266.5,12.38,410.0,85
HCPCS,86971,PRETREATMENT W/ENZYME,1182.0,768.3,9.94,1182.0,85
HCPCS,86972,PRETREAT RBC AB ID DENSITYSEP,1182.0,768.3,17.28,1182.0,85
HCPCS,86975,RBC SERUM PRETX INCUBJ DRUGS,,,13.39,1040.19,26
HCPCS,86975,Rbc serum pretx incubj drugs,,,64.15,74.28,8
HCPCS,86976,PREWARM MODIFICATION,169.0,109.85,14.83,169.0,85
HCPCS,86976,"RBC PRETREATMENT,SERUM DILUTN",169.0,109.85,1.1,169.0,88
HCPCS,86977,R E S ABSORP TEST,1182.0,768.3,14.83,1182.0,85
HCPCS,86978,PRETREAT SERUM AB ID ABSORP,410.0,266.5,14.83,410.0,85
HCPCS,86978,TRIPLE ABSORPTION X3,410.0,266.5,14.83,410.0,85
HCPCS,86985,SPLITTING BLOOD/BLOOD PRODUCTS EACH UNIT,1182.0,768.3,1.1,1182.0,173
HCPCS,86999,TRANSFUSION PLATLET RICH PLASMA INJ,485.0,315.25,0.01,485.0,82
HCPCS,86999,UNLISTED TRANSFUSION MED PX,,,22.7,77.73,23
HCPCS,86999,Unlisted transfusion med px,,,27.84,32.24,8
HCPCS,87001,SMALL ANIMAL INOCULATION,,,58.28,58.28,1
HCPCS,87003,SMALL ANIMAL INOCULATION,,,8.32,74.24,28
HCPCS,87003,Small animal inoculation,,,16.64,19.27,8
HCPCS,87015,CONCENTRATION INFECTIOUS AGENTS,46.0,29.9,1.1,46.0,88
HCPCS,87015,PROCESSING AFB REDIGESTION,46.0,29.9,3.3,46.0,84
HCPCS,87015,"PROCESSING, AFB CONCENTRATION",46.0,29.9,3.3,46.0,84
HCPCS,87015,"PROCESSING, CYTOSPIN",46.0,29.9,3.3,46.0,84
HCPCS,87015,"PROCESSING, FLUID CONCENTRATION",46.0,29.9,3.3,46.0,84
HCPCS,87015,"PROCESSING, THICK SMEAR PREPARATION",46.0,29.9,3.3,46.0,84
HCPCS,87040,CULTURE BACTERIAL BLOOD AEROBIC W/ID ISOLATES,71.0,46.15,1.1,71.0,88
HCPCS,87040,"CULTURE, BACTERIAL, BLOOD, AEROBIC AND ANAEROBIC",71.0,46.15,5.1,71.0,84
HCPCS,87045,CUL BACT STOOL AEROBIC ISOL SALMONELLA&SHIGELL,65.0,42.25,1.1,65.0,88
HCPCS,87045,"CULTURE, BACTERIAL, STOOL, SALMONELLA SHIGELLA",65.0,42.25,4.66,65.0,84
HCPCS,87046,CUL BACT STOOL AEROBIC ADDL PATHOGENS&ID EA,65.0,42.25,1.1,65.0,88
HCPCS,87046,"CULTURE, BACTERIAL, STOOL, EACH PLATE",65.0,42.25,4.66,65.0,84
HCPCS,87070,%IOHWC CULTURE,59.0,38.35,4.26,59.0,84
HCPCS,87070,CUL BACT XCPT URINE BLOOD/STOOL AEROBIC ISOL,59.0,38.35,1.1,59.0,88
HCPCS,87070,"CULTURE, BACTERIAL, AEROBIC",59.0,38.35,4.26,59.0,84
HCPCS,87070,TRFX MED FUNGAL SCRN,59.0,38.35,4.26,59.0,84
HCPCS,87070,TRFX MED MISC SCRN,59.0,38.35,4.26,59.0,84
HCPCS,87071,CUL BACT QUAN AEROBIC ISOL XCPT UR BLOOD/STOOL,68.0,44.2,1.1,68.0,88
HCPCS,87071,"CULTURE, BACTERIAL, AEROBIC, QUANTITATIVE",68.0,44.2,4.66,68.0,84
HCPCS,87073,CUL BACT QUAN ANAERC ISOL XCPT UR BLOOD/STOOL,67.0,43.55,1.1,67.0,88
HCPCS,87073,"CULTURE, BACTERIAL, ANAEROBIC, QUANTITATIVE",67.0,43.55,4.66,67.0,84
HCPCS,87075,CULTURE BACTERIAL ANY SOURCE ANAEROBIC ISO&ID,65.0,42.25,1.1,65.0,88
HCPCS,87075,"CULTURE, BACTERIAL, ANAEROBIC",65.0,42.25,4.68,65.0,84
HCPCS,87076,CUL BACT ANAEROBIC ADDL METHS DEFINITIVE EA ISOL,56.0,36.4,1.1,56.0,88
HCPCS,87076,"IDENTIFICATION, ANAEROBIC ISOLATE",56.0,36.4,3.99,62.24,84
HCPCS,87077,CUL BACT AEROBIC ADDL METHS DEFINITIVE EA ISOL,56.0,36.4,1.1,56.0,88
HCPCS,87077,CULT AEROBIC DEFIN ID EA ISOL,56.0,36.4,8.08,62.24,84
HCPCS,87077,"IDENTIFICATION, AEROBIC ISOLATE",56.0,36.4,8.08,62.24,84
HCPCS,87077,"IDENTIFICATION, AEROBIC ISOLATE (POINT OF CARE LAB)",56.0,36.4,8.08,62.24,84
HCPCS,87081,CUL PRSMPTV PTHGNC ORGANISM SCRN W/COLONY ESTIMJ,46.0,29.9,1.1,46.0,88
HCPCS,87081,CULT SCREEN ONLY,46.0,29.9,3.27,46.0,84
HCPCS,87081,"CULTURE, PRESUMPTIVE SCREENING",46.0,29.9,3.27,46.0,84
HCPCS,87084,CULTURE OF SPECIMEN BY KIT,,,10.83,81.55,28
HCPCS,87084,Culture of specimen by kit,,,16.64,19.27,8
HCPCS,87086,CULT/COLONY COUNT QUANT URINE,56.0,36.4,3.98,56.0,84
HCPCS,87086,CULTURE BACTERIAL QUANTTATIVE COLONY COUNT URINE,56.0,36.4,1.1,56.0,88
HCPCS,87086,"CULTURE,  BACTERIAL, URINE, QUANTITATIVE",56.0,36.4,3.98,56.0,84
HCPCS,87088,CULT AEROBIC UR QUANT,56.0,36.4,4.0,56.0,84
HCPCS,87088,CULTURE BCT ISOL&PRSMPTV ID ISOLATE EA URINE,56.0,36.4,1.1,56.0,88
HCPCS,87088,"IDENTIFICATION, URINE, PRESUMPTIVE",56.0,36.4,4.0,56.0,84
HCPCS,87101,CUL FNGI MOLD/YEAST PRSMPTV ID SKN HAIR/NAIL,53.0,34.45,1.1,53.0,88
HCPCS,87101,CULT FUNGI SKIN HAIR NAIL,53.0,34.45,3.8,59.38,84
HCPCS,87101,"CULTURE, FUNGAL ISOLATION, HAIR, SKIN, NAIL",53.0,34.45,3.8,59.38,84
HCPCS,87101,FUNGAL CULTURE SKIN,53.0,34.45,3.8,59.38,84
HCPCS,87102,*CULT FUNGI PRES ID OTHER,58.0,37.7,4.15,58.0,84
HCPCS,87102,CULTURE FNGI MOLD/YEAST PRSMPTV OTH XCPT BLOOD,58.0,37.7,1.1,58.0,88
HCPCS,87102,"CULTURE, FUNGAL ISOLATION",58.0,37.7,4.15,58.0,84
HCPCS,87103,CULTURE FNGI MOLD/YEAST ISOL PRSMPTV ISOL BLOOD,141.0,91.65,1.1,141.0,88
HCPCS,87103,"CULTURE, FUNGAL ISOLATION, BLOOD",141.0,91.65,8.18,141.0,84
HCPCS,87106,CULTURE FUNGI DEFINITIVE ID EACH ORGANISM YEAST,71.0,46.15,1.1,71.0,88
HCPCS,87106,"IDENTIFICATION, YEAST",71.0,46.15,5.1,71.0,84
HCPCS,87107,CULTURE FUNGI DEFINITIVE ID EACH ORGANISM MOLD,71.0,46.15,1.1,71.0,88
HCPCS,87107,"IDENTIFICATION, MOLD",71.0,46.15,5.1,71.0,84
HCPCS,87109,CULT MYCOPLASMA ANY SOURCE,106.0,68.9,7.6,106.0,84
HCPCS,87109,"CULTURE, MYCOPLASMA",106.0,68.9,7.6,106.0,84
HCPCS,87109,MYCOPLASMA CULT,106.0,68.9,1.1,106.0,88
HCPCS,87110,*CULT CHLAMYDIA ANY SOURCE,135.0,87.75,9.68,135.0,84
HCPCS,87116,"CULTURE, ACID FAST",75.0,48.75,5.34,75.0,84
HCPCS,87118,"IDENTIFICATION, MYCOBACTERIAL",101.0,65.65,5.84,101.0,84
HCPCS,87118,ORG ID AFB,101.0,65.65,1.1,101.0,88
HCPCS,87140,*CULT TYPE IF EA ANTISERUM,38.0,24.7,2.75,38.0,84
HCPCS,87140,HERPES TYPING,38.0,24.7,2.75,38.0,84
HCPCS,87143,CULTURE TYPING GLC/HPLC,,,6.18,55.19,28
HCPCS,87143,Culture typing glc/hplc,,,16.64,19.27,8
HCPCS,87147,CULTURE TYPE IMMUNOLOGIC,36.0,23.4,2.56,36.0,84
HCPCS,87147,E COLI AGGL,36.0,23.4,2.56,36.0,84
HCPCS,87147,HAEMOPHILUS AGGL,36.0,23.4,2.56,36.0,84
HCPCS,87147,SALMONELLA AGGL,36.0,23.4,2.56,36.0,84
HCPCS,87147,SHIGELLA AGGL,36.0,23.4,2.56,36.0,84
HCPCS,87147,TYPING BY IMMUNOLOGIC METHOD,36.0,23.4,2.56,36.0,84
HCPCS,87149,GNB BLD CULT ID VERIGENE,138.0,89.7,9.9,138.0,84
HCPCS,87149,GPC BLD CULT ID VERIGENE,138.0,89.7,9.9,138.0,84
HCPCS,87149,MICRO ID BY PNA FISH,138.0,89.7,9.9,138.0,84
HCPCS,87150,"AMPLIFICATION, STREPTOCOCCUS, GROUP B WITH LIM BROTH",242.0,157.3,17.33,242.0,84
HCPCS,87150,BCID DNA/RNA AMP PROBE,242.0,157.3,17.33,242.0,84
HCPCS,87150,CLARITHROMYCIN RESIST,242.0,157.3,17.33,242.0,84
HCPCS,87150,CULTYP NUC ACID AMP PRB CULT/ISOLATE EA ORGNISM,242.0,157.3,1.1,242.0,88
HCPCS,87152,CULTURE TYPE PULSE FIELD GEL,,,3.1,23.32,28
HCPCS,87152,Culture type pulse field gel,,,16.64,19.27,8
HCPCS,87153,"IDENTIFICATION, NUCLEIC ACID SEQUENCING",796.0,517.4,49.14,796.0,84
HCPCS,87154,"IDENTIFICATION, BLOOD PATHOGEN PANEL",1505.0,978.25,49.14,1505.0,84
HCPCS,87158,CULTURE TYPING OTHER METHODS,53.0,34.45,1.1,53.0,88
HCPCS,87158,ID BY PYROSEQUENCING,53.0,34.45,3.1,53.0,84
HCPCS,87158,"IDENTIFICATION, OTHER METHODS",53.0,34.45,3.1,53.0,84
HCPCS,87164,DARK FIELD EXAM SPEC COLLJ,,,5.3,48.83,30
HCPCS,87164,Dark field exam spec collj,,,16.64,19.27,8
HCPCS,8716426,DARK FIELD EXAM SPEC COLLJ,,,7.49,7.49,2
HCPCS,87166,DARK FIELD EXAM W/O COLLJ,,,5.58,49.81,28
HCPCS,87166,Dark field exam w/o collj,,,16.64,19.27,8
HCPCS,87168,MACROSCOPIC EXAM ARTHROPOD,29.0,18.85,1.1,29.0,88
HCPCS,87168,"MACROSCOPIC EXAM, ARTHROPOD",29.0,18.85,2.11,39.45,84
HCPCS,87169,MACROSCOPIC EXAM PARASITE,30.0,19.5,1.1,30.0,88
HCPCS,87169,"MACROSCOPIC EXAM, PARASITE",30.0,19.5,2.11,32.88,84
HCPCS,87172,PIN WORM PREP,29.0,18.85,1.1,29.0,88
HCPCS,87172,PINWORM PREP PERIANAL,29.0,18.85,2.11,29.0,84
HCPCS,87172,PINWORM PREP PERIANAL (POINT OF CARE LAB),29.0,18.85,2.11,29.0,84
HCPCS,87176,HOMOGENIZATION TISSUE CULTURE,41.0,26.65,1.1,41.0,88
HCPCS,87176,"PROCESSING, TISSUE HOMOGENIZATION",41.0,26.65,2.9,45.32,84
HCPCS,87177,"CONCENTRATION AND ID, OVA AND PARASITE",61.0,39.65,4.4,61.0,84
HCPCS,87177,OVA&PARASITES DIRECT SMEARS CONCENTRATION & ID,61.0,39.65,1.1,61.0,88
HCPCS,87181,"ANTIBIOTIC SENS,AGAR DIFFUSN,EA",33.0,21.45,1.1,33.0,88
HCPCS,87181,SUSCEPTIBILITY AGAR DIL,33.0,21.45,2.34,33.0,84
HCPCS,87181,"SUSCEPTIBILITY, AGAR DILUTION, PER AGENT",33.0,21.45,2.34,33.0,84
HCPCS,87182,"SUSCEPTIBILITY, CARBAPENAMASE ENZYME DETECTION, PER ISOLATE",260.0,169.0,1.9,260.0,66
HCPCS,87183,SC STD CARBAPENEM RESIST GEN,,,14.04,78.96,15
HCPCS,87183,Sc std carbapenem resist gen,,,33.62,38.93,8
HCPCS,87184,"ANTIBIOTIC SENS,DISK,EACH",52.0,33.8,1.1,52.0,88
HCPCS,87184,SENSITIVITY - DISK PER PLATE,52.0,33.8,3.4,53.16,84
HCPCS,87184,"SUSCEPTIBILITY, DISK METHOD, PER PLATE",52.0,33.8,3.4,53.16,84
HCPCS,87185,SUSCEPTIBILITY STUDY ANTIMICROBIAL ENZYME DETCJ,33.0,21.45,1.1,33.0,88
HCPCS,87185,"SUSCEPTIBILITY, ENZYME DETECTION, PER ENZYME",33.0,21.45,2.34,33.0,84
HCPCS,87186,"SUSCEPTIBILITY, MULTI-ANTIMICROBIAL",60.0,39.0,4.27,60.0,84
HCPCS,87186,"SUSCEPTIBILITY, MULTI-ANTIMICROBIAL AFB",60.0,39.0,4.27,60.0,84
HCPCS,87186,"SUSCEPTIBILITY, MULTI-ANTIMICROBIAL PHOENIX",60.0,39.0,4.27,60.0,84
HCPCS,87186,"SUSCEPTIBILITY, MULTI-ANTIMICROBIAL SENSITITRE",60.0,39.0,4.27,60.0,84
HCPCS,87186,"SUSCEPTIBILITY, MULTI-ANTIMICROBIAL VITEK",60.0,39.0,4.27,60.0,84
HCPCS,87186,SUSCEPTIBLTY STDY ANTIMICRBIAL MICRO/AGAR DILUTJ,60.0,39.0,1.1,60.0,88
HCPCS,87187,SC STD MICRODIL/AGAR MLC,,,16.07,121.01,29
HCPCS,87187,Sc std microdil/agar mlc,,,33.62,38.93,8
HCPCS,87188,AMBCAN AMPHOTERICIN B/CANDIN SUSCEPTIBILITY PANEL X4,46.0,29.9,3.28,51.09,84
HCPCS,87188,AZOLE PANEL X4,46.0,29.9,3.28,51.09,84
HCPCS,87188,MOLD SUSCEPT 2 DRUG X2,46.0,29.9,3.28,51.09,84
HCPCS,87188,MOLD SUSCEPT 3 DRUGS X3,46.0,29.9,3.28,51.09,84
HCPCS,87188,SUSCEPTIBILITY MACROBROTH,46.0,29.9,3.28,51.09,84
HCPCS,87190,SC STD MYOBACTERIA PROP METH,,,2.92,22.02,29
HCPCS,87190,Sc std myobacteria prop meth,,,16.64,19.27,8
HCPCS,87197,SERUM BACTERIA TITER,104.0,67.6,1.1,104.0,88
HCPCS,87197,SERUM BACTERICIDAL TITER,,,7.42,66.26,28
HCPCS,87197,Serum bactericidal titer,,,16.64,19.27,8
HCPCS,87205,%IOHWC GRAM STAIN,29.0,18.85,2.11,29.0,84
HCPCS,87205,KRUGER'S TEST,29.0,18.85,2.11,29.0,84
HCPCS,87205,"SMEAR, GRAM STAIN",29.0,18.85,2.11,29.0,84
HCPCS,87205,SMR PRIM SRC GRAM/GIEMSA STAIN BCT FUNGI/CELL,29.0,18.85,1.1,29.0,88
HCPCS,87206,*SMEAR FLUORESCENT/ACID STAIN,37.0,24.05,2.66,37.0,84
HCPCS,87206,"SMEAR, ACID FAST FLUORESCENT",37.0,24.05,2.66,37.0,84
HCPCS,87206,"SMEAR, FUNGAL FLUORESCENT",37.0,24.05,2.66,37.0,84
HCPCS,87206,SMR PRIM SRC FLUORESCENT&/AFS BCT FNGI PARASIT,37.0,24.05,1.1,37.0,88
HCPCS,87207,SMEAR SPECIAL STAIN,,,7.49,7.49,2
HCPCS,87207,"SMEAR, BLOOD PARASITE",41.0,26.65,2.96,58.34,84
HCPCS,87207,"SMEAR, PARASITE SPECIAL STAIN",102.0,66.3,1.1,163.0,302
HCPCS,8720726,SMEAR SPECIAL STAIN,,,7.49,7.49,2
HCPCS,87209,"SMEAR, TRICHROME STAIN",124.0,80.6,8.88,124.0,84
HCPCS,87209,SMR PRIM SRC CPLX SPEC STAIN OVA&PARASITS,124.0,80.6,1.1,124.0,88
HCPCS,87210,SMEAR WET MOUNT,40.0,26.0,5.68,40.0,168
HCPCS,87210,SMR PRIM SRC WET MOUNT NFCT AGT,40.0,26.0,1.1,40.0,88
HCPCS,87220,KOH EXAM,49.0,31.85,1.1,49.0,88
HCPCS,87220,KOH EXAM (POINT OF CARE LAB),29.0,18.85,4.27,29.0,84
HCPCS,87220,TISS KOH SLIDE SAMPS SKN/HR/NLS FNGI/ECTOPARASIT,29.0,18.85,1.1,29.0,88
HCPCS,87220,TISSUE EXAM KOH,29.0,18.85,4.27,29.0,84
HCPCS,87230,C DIFF CYTOTOX CELL ASY,136.0,88.4,9.75,136.0,84
HCPCS,87250,VIRUS INOCULATE EGGS/ANIMAL,,,9.66,86.24,28
HCPCS,87250,Virus inoculate eggs/animal,,,16.64,19.27,8
HCPCS,87252,%HSVCUL VIR INNOC TISSUE,180.0,117.0,12.87,180.0,84
HCPCS,87252,ENTEROVIRUS CULTURE,180.0,117.0,12.87,180.0,84
HCPCS,87252,TISSUE CULTURE,180.0,117.0,12.87,180.0,84
HCPCS,87253,%HSVCUL VIR INNOC TIS ADD,139.0,90.35,9.98,155.51,84
HCPCS,87253,VIRUS CULTURE W/STAIN,139.0,90.35,9.98,155.51,84
HCPCS,87253,VIRUS TISSUE CULTURE ADDL STDY/ID EACH ISOLATE,139.0,90.35,1.1,139.0,88
HCPCS,87254,CULTURE ANTIGEN DFA,135.0,87.75,9.66,135.0,84
HCPCS,87254,CYTOMEGALOVIRUS,135.0,87.75,9.66,135.0,84
HCPCS,87254,IN HOUSE CULT ANTIGEN DFA,135.0,87.75,9.66,135.0,84
HCPCS,87255,HERPES SIMPLEX CULTURE,234.0,152.1,16.72,234.0,84
HCPCS,87255,HSVCUL GENETIC VIRUS ISOLATION HSV,234.0,152.1,16.72,234.0,84
HCPCS,87255,VIRUS ID NON-IMMUNOLOGIC,234.0,152.1,16.72,234.0,84
HCPCS,87255,VIRUS ID NON-IMMUNOLOGIC OTH/THN CYTOPATHIC,234.0,152.1,1.1,234.0,88
HCPCS,87260,*%DFA ADENO,100.0,65.0,5.92,100.0,84
HCPCS,87265,B. PERTUSSIS DFA,83.0,53.95,1.1,83.0,88
HCPCS,87265,BORDETELLA PERTUSS DFA X2,83.0,53.95,5.92,83.0,84
HCPCS,87267,ENTEROVIRUS ANTIBODY DFA,,,5.92,50.03,28
HCPCS,87267,Enterovirus antibody dfa,,,16.64,19.27,8
HCPCS,87269,GIARDIA AG IF,,,5.92,46.29,28
HCPCS,87269,Giardia ag if,,,16.64,19.27,8
HCPCS,87270,C TRACHOMATIS DFA,83.0,53.95,5.92,83.0,84
HCPCS,87270,C. TRACHOMATIS DFA,83.0,53.95,1.1,83.0,88
HCPCS,87271,CYTOMEGALOVIRUS DFA,,,5.92,50.03,28
HCPCS,87271,Cytomegalovirus dfa,,,16.64,19.27,8
HCPCS,87272,CRYPTOSPORIDIUM AG IF,,,5.92,52.85,28
HCPCS,87272,Cryptosporidium ag if,,,16.64,19.27,8
HCPCS,87273,HERPES SIMPLEX 2 AG IF,,,5.92,52.85,28
HCPCS,87273,Herpes simplex 2 ag if,,,16.64,19.27,8
HCPCS,87274,HERPES SIMPLEX 1 AG IF,,,5.92,52.85,28
HCPCS,87274,Herpes simplex 1 ag if,,,16.64,19.27,8
HCPCS,87275,IAADI INFLUENZA B VIRUS,85.0,55.25,1.1,85.0,88
HCPCS,87275,INFLUENZA B AG IF,,,5.92,107.02,29
HCPCS,87275,Influenza b ag if,,,16.64,19.27,8
HCPCS,87276,INFLUENZA A AG IF,,,6.43,116.37,29
HCPCS,87276,"INFLUENZA AG, DFA",111.0,72.15,1.1,111.0,88
HCPCS,87276,Influenza a ag if,,,16.64,19.27,8
HCPCS,87277,Legionella micdadei ag if,,,52.85,52.85,1
HCPCS,87278,LEGION PNEUMOPHILIA AG IF,,,6.24,46.99,28
HCPCS,87278,LEGIONELLA CULT/DFA,108.0,70.2,1.1,108.0,88
HCPCS,87278,Legion pneumophilia ag if,,,16.64,19.27,8
HCPCS,87279,PARAINFLUENZA 123 DFA X3,113.0,73.45,6.57,113.0,84
HCPCS,87280,RESPIRATORY SYNCYTIAL AG IF,,,5.92,72.56,29
HCPCS,87280,Respiratory syncytial ag if,,,16.64,19.27,8
HCPCS,87281,PNEUMOCYSTIS CARINII AG IF,,,5.92,52.85,28
HCPCS,87281,Pneumocystis carinii ag if,,,16.64,19.27,8
HCPCS,87283,RUBEOLA AG IF,,,24.32,183.16,28
HCPCS,87283,Rubeola ag if,,,33.62,38.93,8
HCPCS,87285,TREPONEMA PALLIDUM AG IF,,,5.92,52.85,28
HCPCS,87285,Treponema pallidum ag if,,,16.64,19.27,8
HCPCS,87290,IAADI VARICELLA ZOSTER VIRUS,93.0,60.45,1.1,93.0,88
HCPCS,87290,VARICELLA ZOSTER DFA,93.0,60.45,5.92,93.0,84
HCPCS,87299,ANTIBODY DETECTION NOS IF,,,6.44,48.5,29
HCPCS,87299,Antibody detection nos if,,,16.64,19.27,8
HCPCS,87300,HERPES SIMPLEX DFA,83.0,53.95,5.92,83.0,84
HCPCS,87300,IAADI POLYV MLT ORGANISMS EA POLYV ANTISERUM,83.0,53.95,1.1,83.0,88
HCPCS,87301,%ROTAD ADENOV 40-41,83.0,53.95,5.92,83.0,84
HCPCS,87301,ROTAD ADENOV 40-41,83.0,53.95,5.92,83.0,84
HCPCS,87305,"ASPER GALACTOMAN, BAL",83.0,53.95,5.92,92.38,84
HCPCS,87305,ASPERGILLUS GALACT SERUM,83.0,53.95,5.92,92.38,84
HCPCS,87305,IAAD IA ASPERGILLUS,83.0,53.95,1.1,83.0,88
HCPCS,87320,CHLMYD TRACH AG IA,,,6.0,52.85,28
HCPCS,87320,Chlmyd trach ag ia,,,16.64,19.27,8
HCPCS,87324,IAAD IA CLOSTRIDIUM DIFFICILE TOXIN,83.0,53.95,1.1,83.0,88
HCPCS,87324,"IMMUNOASSAY, CLOSTRIDIUM DIFFICILE TOXIN",83.0,53.95,5.92,83.0,84
HCPCS,87327,CRYPTOCOCCUS NEOFORM AG IA,,,5.92,76.76,29
HCPCS,87327,Cryptococcus neoform ag ia,,,16.64,19.27,8
HCPCS,87328,IAAD IA CRYPTOSPORIDIUM,95.0,61.75,1.1,95.0,88
HCPCS,87328,"IMMUNOASSAY, CRYPTOSPORIDIUM",95.0,61.75,5.92,95.0,84
HCPCS,87329,"GIARDIA ANTIGEN, STOOL",83.0,53.95,5.92,83.0,84
HCPCS,87329,IAAD IA GIARDIA,83.0,53.95,1.1,83.0,88
HCPCS,87329,"IMMUNOASSAY, GIARDIA",83.0,53.95,5.92,83.0,84
HCPCS,87332,CYTOMEGALOVIRUS AG IA,,,5.92,52.85,28
HCPCS,87332,Cytomegalovirus ag ia,,,16.64,19.27,8
HCPCS,87335,E COLI 0157 AG IA,,,5.92,52.85,28
HCPCS,87335,E coli 0157 ag ia,,,16.64,19.27,8
HCPCS,87336,ENTAMOEB HIST DISPR AG IA,,,6.4,52.85,28
HCPCS,87336,Entamoeb hist dispr ag ia,,,16.64,19.27,8
HCPCS,87337,ENTAMOEBA HISTOLYT AG,83.0,53.95,5.92,83.0,84
HCPCS,87337,IAAD IA ENTAMOEBA HISTOLYTICA GRP,83.0,53.95,1.1,83.0,88
HCPCS,87338,IAAD IA HPYLORI STOOL,99.0,64.35,1.1,99.0,88
HCPCS,87338,"IMMUNOASSAY, H. PYLORI",99.0,64.35,7.1,99.0,84
HCPCS,87339,H PYLORI AG IA,,,6.4,52.85,28
HCPCS,87339,H pylori ag ia,,,16.64,19.27,8
HCPCS,87340,*%HEP HBSAG,71.0,46.15,5.1,71.0,84
HCPCS,87340,*HEP B SURFACE AG EIA,71.0,46.15,5.1,71.0,84
HCPCS,87340,HEP B SURF ANTIG W/REF,71.0,46.15,5.1,71.0,84
HCPCS,87340,HEP B SURFACE AG EIA,71.0,46.15,5.1,71.0,168
HCPCS,87340,IAAD IA HEPATITIS B SURFACE ANTIGEN,71.0,46.15,1.1,71.0,88
HCPCS,87340,POMER4 HBSAG,71.0,46.15,5.1,71.0,84
HCPCS,87340,WHIIVF *%HEP HBSAG,71.0,46.15,5.1,71.0,84
HCPCS,87341,HEPATITIS B SURFACE AG EIA NEUTRALIZATION,71.0,46.15,1.1,71.0,88
HCPCS,87341,HEPATITIS HBSAG CONF,71.0,46.15,5.1,71.0,84
HCPCS,87350,HEPATITIS BE ANTIGEN,80.0,52.0,5.69,80.0,84
HCPCS,87350,IAAD IA HEPATITIS BE ANTIGEN,80.0,52.0,1.1,80.0,88
HCPCS,87380,HEP DELTA VIRUS AG,127.0,82.55,1.1,127.0,88
HCPCS,87380,HEPATITIS DELTA AG,127.0,82.55,8.1,127.0,84
HCPCS,87385,HISTOPLASMA ANTIGEN SERUM,91.0,59.15,5.92,92.38,84
HCPCS,87385,HISTOPLASMA ANTIGEN UR,91.0,59.15,5.92,92.38,84
HCPCS,87385,HISTOPLASMA CAPSULA AG,91.0,59.15,5.92,92.38,84
HCPCS,87385,"HISTOPLASMA GALACTOMANNAN EIA, BAL",91.0,59.15,5.92,92.38,84
HCPCS,87385,"HISTOPLASMA GALACTOMANNAN EIA, CSF",91.0,59.15,5.92,92.38,84
HCPCS,87385,IAAD IA HISTOPLASM CAPSULATUM,91.0,59.15,1.1,91.0,88
HCPCS,87389,%HEXP HIV 1&2 AG/AB,166.0,107.9,11.89,166.0,84
HCPCS,87389,HIV 1&2 ANTIGEN/ANTIBODY,166.0,107.9,11.89,166.0,84
HCPCS,87389,IAAD EIA HIV-1 AG W/HIV-1&HIV-2 ANTBDY SINGLE,166.0,107.9,1.1,166.0,88
HCPCS,87389,POMER4 HIV12C,166.0,107.9,11.89,166.0,84
HCPCS,87389,WHIIVF HIV 1&2 AG/AB,166.0,107.9,11.89,166.0,84
HCPCS,87390,HIV-1 AG EIA,166.0,107.9,9.62,166.0,84
HCPCS,87391,HIV-2 AG IA,,,8.76,65.97,28
HCPCS,87391,Hiv-2 ag ia,,,16.64,19.27,8
HCPCS,87400,IAAD IA INFLUENZA A/B EACH,97.0,63.05,1.1,97.0,88
HCPCS,87400,INFLUENZA A/B EACH AG IA,,,5.92,69.21,29
HCPCS,87400,Influenza a/b each ag ia,,,16.64,19.27,8
HCPCS,87420,RSV EIA,96.0,62.4,5.92,96.0,84
HCPCS,87425,%ROTAD ROTAVIRUS,83.0,53.95,5.92,83.0,84
HCPCS,87425,"IMMUNOASSAY, ROTAVIRUS",83.0,53.95,5.92,83.0,84
HCPCS,87426,SARSCOV CORONAVIRUS AG IA,,,14.13,102.06,26
HCPCS,87426,Sarscov coronavirus ag ia,,,16.64,19.27,8
HCPCS,87427,%STOOL SHIGA LIKE TOX X2,83.0,53.95,5.92,83.0,84
HCPCS,87427,IAAD IA SHIGA-LIKE TOXIN,83.0,53.95,1.1,83.0,88
HCPCS,87428,SARSCOV & INF VIR A&B AG IA,,,19.78,192.59,29
HCPCS,87428,Sarscov & inf vir a&b ag ia,,,33.62,38.93,8
HCPCS,87430,IAAD IA STREPTOCOCCUS GROUP A,116.0,75.4,1.1,116.0,88
HCPCS,87430,STREP SCREEN,116.0,75.4,6.72,116.0,252
HCPCS,87449,*INFECT AGENT NOS EIA MULT,83.0,53.95,11.98,83.0,84
HCPCS,87449,AG DETECT NOS IA MULT,83.0,53.95,11.98,83.0,168
HCPCS,87449,BLASTOMYCES ANTIGEN,83.0,53.95,11.98,83.0,84
HCPCS,87449,CAMPYLOBACTER AG,83.0,53.95,11.98,83.0,84
HCPCS,87449,FUNGI ASSAY FOR B-D GLUC,83.0,53.95,11.98,83.0,84
HCPCS,87449,IAAD IA NOT OTHERWISE SPECIFIED EACH ORGANISM,83.0,53.95,1.1,83.0,88
HCPCS,87449,NORWALK-LIKE VIRUS AG,83.0,53.95,11.98,83.0,84
HCPCS,87450,Ag detect nos ia single,,,4.74,22.4,11
HCPCS,87451,POLYVALENT MULT ORG EA AG IA,,,4.74,42.19,28
HCPCS,87451,Polyvalent mult org ea ag ia,,,16.64,19.27,8
HCPCS,87467,HEPATITIS B SURFACE AG QUAN,,,6.02,2739849.3,23
HCPCS,87467,Hepatitis b surface ag quan,,,16.64,19.27,8
HCPCS,87468,EHRANA ANAPLSMA PHGCYTOPHLM AMP PRB,242.0,157.3,14.04,242.0,84
HCPCS,87469,BABESIA MICROTI AMP PRB,,,14.04,96.15,24
HCPCS,87469,Babesia microti amp prb,,,33.62,38.93,8
HCPCS,87470,Bartonella dna dir probe,,,88.47,88.47,1
HCPCS,87471,*BARTONELLA DNA AMPL PROBE,242.0,157.3,17.33,242.0,84
HCPCS,87471,*INFECT AGENT NOS AMPL PROBE,242.0,157.3,17.33,242.0,84
HCPCS,87471,"BARTONELLA, DNA, AMP PROBE",242.0,157.3,1.1,242.0,88
HCPCS,87472,BARTONELLA DNA QUANT,,,21.15,189.09,28
HCPCS,87472,Bartonella dna quant,,,33.62,38.93,8
HCPCS,87475,LYME DIS DNA DIR PROBE,,,9.9,88.47,28
HCPCS,87475,Lyme dis dna dir probe,,,16.64,19.27,8
HCPCS,87476,IADNA BORRELIA BURGDORFERI AMPLIFIED PROBE TQ,242.0,157.3,1.1,242.0,88
HCPCS,87476,LYME DISEASE DNA AMPL PROBE,242.0,157.3,17.33,247.11,84
HCPCS,87477,Lyme dis dna quant,,,189.09,189.09,1
HCPCS,87478,BORRELIA MIYAMOTOI AMP PRB,,,14.04,96.15,24
HCPCS,87478,Borrelia miyamotoi amp prb,,,33.62,38.93,8
HCPCS,87480,%VAGONA CANDIDA,138.0,89.7,9.9,138.0,84
HCPCS,87480,IADNA CANDIDA SPECIES DIRECT PROBE TQ,138.0,89.7,1.1,138.0,88
HCPCS,87481,CANDIDA DNA AMP PROBE,242.0,157.3,19.88,242.0,84
HCPCS,87482,CANDIDA DNA QUANT,,,22.3,184.33,28
HCPCS,87482,Candida dna quant,,,33.62,38.93,8
HCPCS,87483,CNS DNA AMP PROBE TYPE 12-25,2876.0,1869.4,49.14,2876.0,84
HCPCS,87483,"FILM ARRAY, MENINGITIS/ENCEPHALITIS",2876.0,1869.4,49.14,2876.0,84
HCPCS,87484,EHRANA EHRLICHA CHAFFEENSIS AMP PRB,242.0,157.3,14.04,242.0,84
HCPCS,87485,CHLMYD PNEUM DNA DIR PROBE,,,9.9,88.47,28
HCPCS,87485,Chlmyd pneum dna dir probe,,,16.64,19.27,8
HCPCS,87486,%E18RP CHLAMYDIA PNEU AMP,242.0,157.3,17.33,789.1,84
HCPCS,87486,CHLAMYDIA PNEUM DNA AMPL PROB,242.0,157.3,17.33,789.1,84
HCPCS,87486,IADNA CHLAMYDIA PNEUMONIAE AMPLIFIED PROBE TQ,242.0,157.3,1.1,242.0,88
HCPCS,87486,RPRAPD CHLAMYDIA PNEU AMP,242.0,157.3,17.33,789.1,84
HCPCS,87487,CHLMYD PNEUM DNA QUANT,,,21.15,189.09,28
HCPCS,87487,Chlmyd pneum dna quant,,,33.62,38.93,8
HCPCS,87490,CHLMYD TRACH DNA DIR PROBE,,,9.9,88.47,28
HCPCS,87490,"CHYLMD TRACH, DNA, DIR PROBE",157.0,102.05,1.1,157.0,88
HCPCS,87490,Chlmyd trach dna dir probe,,,16.64,19.27,8
HCPCS,87491,%CTNG CTRACH SUREPATH TMA,242.0,157.3,19.88,242.0,168
HCPCS,87491,%CTNGAO CHLAMYDIA OCULAR,242.0,157.3,19.88,242.0,84
HCPCS,87491,*CHLAMYDIA TRACH DNA AMPL PROB,242.0,157.3,19.88,242.0,84
HCPCS,87491,CHLAMYDIA DNA PROBE,242.0,157.3,19.88,242.0,84
HCPCS,87491,CHLAMYDIA TRACH AMPLIFY,242.0,157.3,19.88,242.0,84
HCPCS,87491,CHLAMYDIATRACH AMP OCULAR,242.0,157.3,19.88,242.0,84
HCPCS,87491,IADNA CHLAMYDIA TRACHOMATIS AMPLIFIED PROBE TQ,242.0,157.3,1.1,242.0,88
HCPCS,87491,LYMPHOGRANULOMA VENEREUM PCR,242.0,157.3,19.88,242.0,84
HCPCS,87491,UCTGC CHLAMYDIA TRACH AMP,242.0,157.3,19.88,242.0,84
HCPCS,87491,WHIIVF CHLAMYDIA TRACH AM,242.0,157.3,19.88,242.0,84
HCPCS,87492,CHLMYD TRACH DNA QUANT,,,21.39,161.08,28
HCPCS,87492,Chlmyd trach dna quant,,,33.62,38.93,8
HCPCS,87493,"AMPLIFICATION, CLOSTRIDIUM DIFFICILE",257.0,167.05,17.33,257.0,84
HCPCS,87493,INF AGENT DET NUCLEIC ACID CLOSTRIDIUM AMP PROBE,257.0,167.05,1.1,257.0,88
HCPCS,87494,"AMPLIFIED PROBE, GC/CT",484.0,314.6,16.64,484.0,76
HCPCS,87494,"SHORT TANDEM REPEAT ANALYSIS FOR SPECIMEN IDENTIFICATION, OTHER",484.0,314.6,16.64,484.0,76
HCPCS,87495,CYTOMEG DNA DIR PROBE,,,12.01,90.47,28
HCPCS,87495,Cytomeg dna dir probe,,,33.62,38.93,8
HCPCS,87496,CMV BONE MARROW,242.0,157.3,17.33,242.0,84
HCPCS,87496,CMV DNA AMPL PROB,242.0,157.3,17.33,242.0,84
HCPCS,87496,CMV PCR M4,242.0,157.3,17.33,242.0,168
HCPCS,87496,"CYTOMEGALOVIRUS (CMV) PCR, AMNIOTIC FLUID",242.0,157.3,17.33,242.0,84
HCPCS,87496,CYTOMEGALOVIRUS CMV,242.0,157.3,17.33,242.0,84
HCPCS,87496,IADNA CYTOMEGALOVIRUS AMPLIFIED PROBE TQ,242.0,157.3,1.1,242.0,88
HCPCS,87496,OCULAR CMV PCR,242.0,157.3,17.33,242.0,84
HCPCS,87497,IADNA CYTOMEGALOVIRUS QUANTIFICATION,296.0,192.4,1.1,296.0,88
HCPCS,87497,NY CYTOMEG QNT PCR,296.0,192.4,21.15,296.0,84
HCPCS,87497,"QUANTIFICATION, CYTOMEGALOVIRUS",296.0,192.4,21.15,296.0,84
HCPCS,87498,ENTEROVIRUS BY PCR,242.0,157.3,17.33,242.0,84
HCPCS,87498,ENTEROVIRUS PCR,242.0,157.3,17.33,242.0,84
HCPCS,87498,ENTEROVIRUS PCR PLASMA,242.0,157.3,17.33,242.0,84
HCPCS,87498,"ENTEROVIRUS, REAL-TIME PCR, AMNIOTIC FLUID",242.0,157.3,17.33,242.0,84
HCPCS,87500,VANOMYCIN DNA AMP PROBE,,,17.33,166.48,28
HCPCS,87500,Vanomycin dna amp probe,,,33.62,38.93,8
HCPCS,87501,INFLUENZA DNA AMP PROB 1+,,,25.34,154.57,28
HCPCS,87501,Influenza dna amp prob 1+,,,33.62,38.93,8
HCPCS,87502,FLU A H1N1 PCR,661.0,429.65,49.14,661.0,84
HCPCS,87502,FLUPCR RAPID PCR FLU,661.0,429.65,49.14,661.0,84
HCPCS,87502,FLUPCR RAPID PCR FLU (POINT OF CARE LAB),661.0,429.65,49.14,661.0,84
HCPCS,87502,INFECTIOUS AGENT DNA/RNA INFLUENZA 1ST 2 TYPES,661.0,429.65,1.1,661.0,88
HCPCS,87502,INFLUENZA A&B MOLECULAR (POINT OF CARE LAB),661.0,429.65,49.14,661.0,84
HCPCS,87502,INFLUENZA DETECTION,661.0,429.65,49.14,661.0,84
HCPCS,87502,"SEQUENCING, INFLUENZA",661.0,429.65,49.14,661.0,84
HCPCS,87503,"SEQUENCING, INFLUENZA PLUS",202.0,131.3,11.69,202.0,84
HCPCS,87505,"GASTROINTESTINAL PANEL, 5 VIRAL TARGETS",885.0,575.25,49.14,885.0,84
HCPCS,87505,NFCT AGENT DETECTION GI,885.0,575.25,49.14,885.0,84
HCPCS,87505,NFCT AGENT DNA/RNA GASTROINTESTINAL PATHOGEN,885.0,575.25,1.1,885.0,88
HCPCS,87506,IADNA-DNA/RNA PROBE TQ 6-11,,,105.4,792.27,28
HCPCS,87506,Iadna-dna/rna probe tq 6-11,,,49.14,56.9,8
HCPCS,87507,STOOL GASTROINT PNL PCR,2876.0,1869.4,49.14,2876.0,84
HCPCS,87510,%VAGDNA GARDNERELLA,138.0,89.7,9.9,138.0,84
HCPCS,87510,IADNA GARDNERELLA VAGINALIS DIRECT PROBE TQ,138.0,89.7,1.1,138.0,88
HCPCS,87511,GARDNER VAG DNA AMP PROBE,,,17.33,154.93,28
HCPCS,87511,Gardner vag dna amp probe,,,33.62,38.93,8
HCPCS,87512,GARDNER VAG DNA QUANT,,,20.62,184.33,28
HCPCS,87512,Gardner vag dna quant,,,33.62,38.93,8
HCPCS,87513,H PYLRI CLRTHMCN RST AMP PRB,,,35.09,78.96,20
HCPCS,87513,H pylri clrthmcn rst amp prb,,,33.62,38.93,8
HCPCS,87515,Hepatitis b dna dir probe,,,88.47,88.47,1
HCPCS,87516,%IDM HBVNAT,242.0,157.3,17.33,242.0,84
HCPCS,87516,IADNA HEPATITIS B VIRUS AMPLIFIED PROBE TQ,242.0,157.3,1.1,242.0,88
HCPCS,87517,IADNA HEPATITIS B VIRUS QUANTIFICATION,296.0,192.4,1.1,296.0,88
HCPCS,87517,"QUANTIFICATION, HEPATITIS B VIRUS",296.0,192.4,21.15,296.0,84
HCPCS,87520,HEPATITIS C RNA DIR PROBE,,,12.49,94.05,29
HCPCS,87520,Hepatitis c rna dir probe,,,33.62,38.93,8
HCPCS,87521,*HEP C AMP PROBE,242.0,157.3,17.33,270.23,84
HCPCS,87521,HEPATITIS C AMPLIFIED PROBE,242.0,157.3,17.33,270.23,84
HCPCS,87521,IADNA HEPATITIS C AMPLIFIED PROBE&REVRSE TRANSCR,242.0,157.3,1.1,242.0,88
HCPCS,87522,IADNA HEPATITIS C QUANT & REVERSE TRANSCRIPTION,296.0,192.4,1.1,296.0,88
HCPCS,87522,"QUANTIFICATION, HEPATITIS C VIRUS",296.0,192.4,21.15,296.0,84
HCPCS,87523,HEPATITIS DELTA VIRUS BY QUANTITATIVE PCR,296.0,192.4,17.14,296.0,83
HCPCS,87525,HEPATITIS G DNA DIR PROBE,,,11.92,89.77,28
HCPCS,87525,Hepatitis g dna dir probe,,,16.64,19.27,8
HCPCS,87526,HEPATITIS G DNA AMP PROBE,,,17.33,154.93,28
HCPCS,87526,Hepatitis g dna amp probe,,,33.62,38.93,8
HCPCS,87527,HEPATITIS G DNA QUANT,,,20.62,184.33,28
HCPCS,87527,Hepatitis g dna quant,,,33.62,38.93,8
HCPCS,87528,HSV DNA DIR PROBE,,,9.9,88.47,28
HCPCS,87528,Hsv dna dir probe,,,16.64,19.27,8
HCPCS,87529,*HERPES SIMPLEX DNA AMPL PROBE,242.0,157.3,17.33,270.23,84
HCPCS,87529,"AMPLIFIED PROBE, HERPES SIMPLEX VIRUS",296.0,192.4,17.33,296.0,84
HCPCS,87529,HSV 1&2 QT PCR BAL X2,242.0,157.3,17.33,270.23,84
HCPCS,87529,HSV DNA AMP PROBE X2,242.0,157.3,17.33,270.23,84
HCPCS,87529,HSV PCR MISC SPEC,242.0,157.3,17.33,270.23,84
HCPCS,87529,HSV PCR OCULAR FLD,242.0,157.3,17.33,270.23,168
HCPCS,87529,IADNA HERPES SOMPLX VIRUS AMPLIFIED PROBE TQ,242.0,157.3,1.1,242.0,88
HCPCS,87529,OCULAR HSV 1&2 PCR X2,242.0,157.3,17.33,270.23,84
HCPCS,87529,PCRHSV HSV DNA AMP PROBE X2,242.0,157.3,17.33,270.23,84
HCPCS,87530,HSV 1&2 QT PCR BAL X2,296.0,192.4,21.15,458.88,84
HCPCS,87531,HHV-6 DNA DIR PROBE,,,23.2,174.73,28
HCPCS,87531,Hhv-6 dna dir probe,,,33.62,38.93,8
HCPCS,87532,HHV-6 PCR,242.0,157.3,17.33,242.0,84
HCPCS,87533,"HHV-6, DNA, QUANT",288.0,187.2,1.1,288.0,88
HCPCS,87533,HHV-6A HHV-6B QT PCR,288.0,187.2,20.62,321.49,84
HCPCS,87534,HIV-1 DNA DIR PROBE,,,9.9,88.47,28
HCPCS,87534,Hiv-1 dna dir probe,,,16.64,19.27,8
HCPCS,87535,HIV-1 DNA BY PCR,242.0,157.3,17.33,242.0,84
HCPCS,87535,HIV-1 RNA,242.0,157.3,17.33,242.0,84
HCPCS,87535,"HIV-1 RNA QUAL, TMA",242.0,157.3,17.33,242.0,84
HCPCS,87535,IDM HIV-1 DNA BY PCR,242.0,157.3,17.33,242.0,84
HCPCS,87536,IADNA HIV-1 QUANT & REVERSE TRANSCRIPTION,587.0,381.55,1.1,587.0,88
HCPCS,87536,"QUANTIFICATION, HIV-1",587.0,381.55,33.62,587.0,84
HCPCS,87537,HIV-2 DNA DIR PROBE,,,9.9,88.47,28
HCPCS,87537,Hiv-2 dna dir probe,,,16.64,19.27,8
HCPCS,87538,HIV-2 DNA AMPL PROBE,242.0,157.3,17.33,270.23,84
HCPCS,87538,HIV-2 RNA,242.0,157.3,17.33,270.23,84
HCPCS,87538,IADNA HIV-2 AMPLIFIED PROBE & REVERSE TRANSCRIPJ,242.0,157.3,1.1,242.0,88
HCPCS,87539,HIV-2 QUANT&REVRSE TRNSCRIPJ,,,23.45,189.09,28
HCPCS,87539,Hiv-2 quant&revrse trnscripj,,,33.62,38.93,8
HCPCS,87540,LEGION PNEUMO DNA DIR PROB,,,9.9,88.47,28
HCPCS,87540,Legion pneumo dna dir prob,,,16.64,19.27,8
HCPCS,87541,"LEGION PNEUMO, DNA, AMP PROB",242.0,157.3,1.1,242.0,88
HCPCS,87541,LEGIONELLA PNEUM PCR,242.0,157.3,17.33,242.0,84
HCPCS,87542,LEGION PNEUMO DNA QUANT,,,20.62,184.33,28
HCPCS,87542,Legion pneumo dna quant,,,33.62,38.93,8
HCPCS,87550,IADNA MYCOBACTERIA SPECIES DIRECT PROBE TQ,138.0,89.7,1.1,138.0,88
HCPCS,87550,ID-PROBE M GORDONAE,138.0,89.7,9.9,138.0,84
HCPCS,87551,%AFBPCR MYCOBACT PROBE,333.0,216.45,19.3,333.0,84
HCPCS,87551,%TBPPCR MYCOBAC AMP PROB,333.0,216.45,19.3,333.0,84
HCPCS,87551,*MYCOBACTERIA AMPLIF NA PROBE,333.0,216.45,19.3,333.0,84
HCPCS,87551,IADNA MYCOBACTERIA SPECIES AMPLIFIED PROBE TQ,333.0,216.45,1.1,333.0,88
HCPCS,87551,ID MTB COMPLEX VS NTM,333.0,216.45,19.3,333.0,84
HCPCS,87552,MYCOBACTERIA DNA QUANT,,,21.15,189.09,28
HCPCS,87552,Mycobacteria dna quant,,,33.62,38.93,8
HCPCS,87555,M.TUBERCULO DNA DIR PROBE,,,10.75,80.98,28
HCPCS,87555,"M.TUBERCULO, DNA, DIR PROBE",185.0,120.25,1.1,185.0,88
HCPCS,87555,M.tuberculo dna dir probe,,,16.64,19.27,8
HCPCS,87556,"AMPLIFICATION, MYCOBACTERIA TUBERCULOSIS",288.0,187.2,17.33,288.0,84
HCPCS,87556,IADNA MYCOBACTERIA TUBERCULOSIS AMP PRB,288.0,187.2,1.1,288.0,88
HCPCS,87556,MYCOBACTERIA TB AMPLIFIED PROBE,288.0,187.2,17.33,288.0,84
HCPCS,87556,MYCOBACTERIA TB DNA AMPL PROB,288.0,187.2,17.33,288.0,84
HCPCS,87557,M.TUBERCULO DNA QUANT,,,21.15,189.09,28
HCPCS,87557,M.tuberculo dna quant,,,33.62,38.93,8
HCPCS,87560,M.AVIUM-INTRA DNA DIR PROB,,,10.92,82.21,28
HCPCS,87560,"M.AVIUM-INTRA, DNA, DIR PROB",188.0,122.2,1.1,188.0,88
HCPCS,87560,M.avium-intra dna dir prob,,,16.64,19.27,8
HCPCS,87561,M.AVIUM-INTRA DNA AMP PROB,,,17.33,131.03,29
HCPCS,87561,M.avium-intra dna amp prob,,,33.62,38.93,8
HCPCS,87562,M.AVIUM-INTRA DNA QUANT,,,21.15,189.09,28
HCPCS,87562,M.avium-intra dna quant,,,33.62,38.93,8
HCPCS,87563,MYCOPLASMA GENITALIUM PCR,242.0,157.3,14.04,242.0,84
HCPCS,87563,URMPCR MYCOPLAS GENITALIUM AMP,242.0,157.3,14.04,242.0,84
HCPCS,87564,"AMPLIFICATION, MYCOBACTERIUM TUBERCULOSIS",530.0,344.5,33.62,530.0,82
HCPCS,87564,MTB RIF RES,530.0,344.5,33.62,530.0,82
HCPCS,87580,M.PNEUMON DNA DIR PROBE,,,9.9,88.47,28
HCPCS,87580,M.pneumon dna dir probe,,,16.64,19.27,8
HCPCS,87581,%E18RP MYCOPLAS PNEU AMP,242.0,157.3,17.33,242.0,84
HCPCS,87581,IADNA MYCOPLSM PNEUMONIAE AMPLIFIED PROBE TQ,242.0,157.3,1.1,242.0,88
HCPCS,87581,MYCOPLASMA PNEUM DNA AMPL,242.0,157.3,17.33,242.0,84
HCPCS,87581,RPRAPD M.PNEUM AMP PRB,242.0,157.3,17.33,242.0,84
HCPCS,87582,M.PNEUMON DNA QUANT,,,121.05,911.64,28
HCPCS,87582,M.pneumon dna quant,,,49.14,56.9,8
HCPCS,87590,N.GONORRHOEAE DNA DIR PROB,,,10.75,88.47,28
HCPCS,87590,"N.GONORRHOEAE, DNA, DIR PROB",185.0,120.25,1.1,185.0,88
HCPCS,87590,N.gonorrhoeae dna dir prob,,,16.64,19.27,8
HCPCS,87591,%CTNG NGONORRHAE SUREPATH,242.0,157.3,19.88,242.0,84
HCPCS,87591,%CTNGAO NGONORRHOEAE OCUL,242.0,157.3,19.88,242.0,84
HCPCS,87591,*NEISSERIA GONORR DNA AMPL,242.0,157.3,19.88,242.0,84
HCPCS,87591,GC AMPLIFICATION,242.0,157.3,19.88,242.0,84
HCPCS,87591,GC DNA PROBE,242.0,157.3,19.88,242.0,84
HCPCS,87591,IADNA NEISSERIA GONORRHOEAE AMPLIFIED PROBE TQ,242.0,157.3,1.1,242.0,88
HCPCS,87591,NGONORRHOEAE AMP OCULAR,242.0,157.3,19.88,242.0,84
HCPCS,87591,UCTGC GC AMPLIFICATION,242.0,157.3,19.88,242.0,84
HCPCS,87591,WHIIVF GC AMP,242.0,157.3,19.88,242.0,84
HCPCS,87592,N.GONORRHOEAE DNA QUANT,,,21.15,129.06,28
HCPCS,87592,N.gonorrhoeae dna quant,,,33.62,38.93,8
HCPCS,87593,"AMPLIFICATION, ORTHOPOX VIRUS",354.0,230.1,17.33,1851898.14,83
HCPCS,87593,MONKEYPOX VIRUS QUAL PCR,354.0,230.1,17.33,1851898.14,83
HCPCS,87594,"AMPLIFIED PROBE, PNEUMOCYSTIS JIROVECII",242.0,157.3,33.62,242.0,82
HCPCS,87620,HPV DNA DIR PROBE,,,88.47,88.47,1
HCPCS,87621,HPV DNA AMP PROBE,,,108.09,108.09,1
HCPCS,87622,HPV DNA QUANT,,,184.33,184.33,1
HCPCS,87623,HPV LOW-RISK TYPES,,,17.33,105.71,28
HCPCS,87623,Hpv low-risk types,,,33.62,38.93,8
HCPCS,87624,HPV DNA 16 18 PCR,242.0,157.3,19.1,242.0,84
HCPCS,87624,HPV DNA ASSAY,242.0,157.3,19.1,242.0,84
HCPCS,87624,HPV DNA HI RISK ANL RECT,242.0,157.3,19.1,242.0,168
HCPCS,87624,HPV DNA PROBE REFLEX,242.0,157.3,19.1,242.0,84
HCPCS,87624,HPV DNA PROBE SUREPATH,242.0,157.3,19.1,242.0,84
HCPCS,87624,HPV SCREEN BY TMA (ARUP),242.0,157.3,19.1,242.0,84
HCPCS,87624,HPVSFX HPV HIGH-RISK TYPE,242.0,157.3,19.1,242.0,84
HCPCS,87624,IADNA HUMAN PAPILLOMAVIRUS HIGH-RISK TYPES,242.0,157.3,1.1,242.0,88
HCPCS,87625,HPV GENOTYPE BY TMA (ARUP REFLEX),280.0,182.0,17.33,280.0,84
HCPCS,87625,HPV TYPES 16 & 18 ONLY,280.0,182.0,17.33,280.0,84
HCPCS,87625,IADNA HUMAN PAPILLOMAVIRUS TYPES 16 & 18 ONLY,280.0,182.0,1.1,280.0,88
HCPCS,87626,IADNA HPV SEP RPRT HI-RSK TYP&HI-RSK POOLD RSLTS,484.0,314.6,33.62,484.0,82
HCPCS,87627,JT SPC PTHGN&RX RSIST GEN26+,,,271.91,1529.49,15
HCPCS,87627,Jt spc pthgn&rx rsist gen26+,,,83.94,97.2,8
HCPCS,87631,IADNA RESPIRATRY PROBE & REV TRNSCR 3-5 TARGETS,984.0,639.6,1.1,984.0,88
HCPCS,87631,INFLUENZA RAPID PCR,984.0,639.6,49.14,984.0,84
HCPCS,87631,INFLUENZA RSV DETECT,984.0,639.6,49.14,984.0,84
HCPCS,87631,RESP VIRUS 3-5 TARGETS,984.0,639.6,49.14,984.0,84
HCPCS,87631,RPRAPD INFLUENZA RAPID PCR,984.0,639.6,49.14,984.0,84
HCPCS,87632,RESP VIRUS 6-11 TARGETS,,,105.4,656.91,28
HCPCS,87632,Resp virus 6-11 targets,,,49.14,56.9,8
HCPCS,87633,IADNA RESPIRATRY PROBE & REV TRNSCR 12-25 TARGET,2876.0,1869.4,1.1,2876.0,88
HCPCS,87633,RVP BY PCR,2876.0,1869.4,49.14,2876.0,84
HCPCS,87634,IADNA DNA/RNA RSV AMPLIFIED PROBE TECHNIQUE,484.0,314.6,1.1,484.0,88
HCPCS,87634,RSV RAPID PCR,484.0,314.6,33.62,484.0,84
HCPCS,87634,RSV RAPID PCR (POINT OF CARE LAB),484.0,314.6,33.62,484.0,84
HCPCS,87635,COVID-19 MOLECULAR (POINT OF CARE LAB),354.0,230.1,20.52,354.0,85
HCPCS,87635,COVID19 INHOUSE,354.0,230.1,20.52,354.0,85
HCPCS,87635,COVID19 INHOUSE (POINT OF CARE LAB),354.0,230.1,20.52,354.0,85
HCPCS,87635,COVID19 SENDOUT,354.0,230.1,20.52,354.0,85
HCPCS,87635,IADNA SARS-COV-2 COVID-19 AMPLIFIED PROBE TQ,354.0,230.1,1.1,354.0,88
HCPCS,87636,COVID-19 MOLECULAR (POC) & INFLUENZA A&B MOLECULAR (POC),984.0,639.6,33.62,984.0,85
HCPCS,87636,SARSCOV2 & INF A&B AMP PRB,984.0,639.6,1.1,984.0,258
HCPCS,87637,"AMPLIFICATION, EXPEDITED, COVID, FLU A/B, RSV",925.0,601.25,33.62,925.0,85
HCPCS,87637,"COVID & INFLUENZA A/B & RSV NAAT, ROUTINE",984.0,639.6,33.62,984.0,85
HCPCS,87637,IADNA SARSCOV2 & INF A&B & RSV MULT AMP PROBE TQ,560.0,364.0,1.1,560.0,88
HCPCS,87640,"AMPLIFICATION, STAPHYLOCOCCUS AUREUS",242.0,157.3,17.33,242.0,84
HCPCS,87640,IADNA S AUREUS AMPLIFIED PROBE TQ,242.0,157.3,1.1,242.0,88
HCPCS,87641,"AMPLIFICATION, METHICILLIN RESISTANCE",242.0,157.3,17.33,242.0,84
HCPCS,87650,IADNA STREPTOCOCCUS GROUP A DIRECT PROBE TQ,138.0,89.7,1.1,138.0,88
HCPCS,87650,STREP GROUP A AMPLIFICTN,138.0,89.7,9.9,138.0,84
HCPCS,87651,"AMPLIFICATION, STREPTOCOCCUS, GROUP A",242.0,157.3,33.62,242.0,84
HCPCS,87651,GROUP A STREP PCR (POINT OF CARE LAB),242.0,157.3,33.62,242.0,84
HCPCS,87651,IADNA STREPTOCOCCUS GROUP A AMPLIFIED PROBE TQ,242.0,157.3,1.1,242.0,88
HCPCS,87651,STREP A (MOLECULAR),217.0,141.05,1.1,217.0,88
HCPCS,87652,STREP A DNA QUANT,,,20.62,184.33,28
HCPCS,87652,Strep a dna quant,,,33.62,38.93,8
HCPCS,87653,"AMPLIFICATION, STREPTOCOCCUS, GROUP B",242.0,157.3,17.33,242.0,84
HCPCS,87653,IADNA STREPTOCOCCUS GROUP B AMPLIFIED PROBE TQ,242.0,157.3,1.1,242.0,88
HCPCS,87660,%VAGDNA TRICHOMONAS,138.0,89.7,9.9,138.0,84
HCPCS,87660,IADNA TRICHOMONAS VAGINALIS DIRECT PROBE TQ,138.0,89.7,1.1,138.0,88
HCPCS,87661,IADNA TRICHOMONAS VAGINALIS AMPLIFIED PROBE TECH,242.0,157.3,1.1,242.0,88
HCPCS,87661,T VAGINALIS UR MALES,242.0,157.3,19.15,242.0,84
HCPCS,87661,TRICHOMONAS VAG AMP,242.0,157.3,19.15,242.0,84
HCPCS,87661,TRICHOMONAS VAGINALIS AMPLIF,242.0,157.3,19.15,242.0,84
HCPCS,87662,ZIKA VIRUS RT-PCR,354.0,230.1,17.63,354.0,84
HCPCS,87662,"ZIKA VIRUS RT-PCR, UR",354.0,230.1,17.63,354.0,84
HCPCS,87797,DETECT AGENT NOS DNA DIR,,,12.01,88.47,25
HCPCS,87797,"DETECT AGENT NOS, DNA, DIR",207.0,134.55,1.1,207.0,88
HCPCS,87797,Detect agent nos dna dir,,,33.62,38.93,8
HCPCS,87798,%E18GIP INFECT AGAMP X21,242.0,157.3,19.88,242.0,84
HCPCS,87798,%E18RP INFECT AGENT AMP,242.0,157.3,19.88,242.0,84
HCPCS,87798,%IDM W NILE RNA PCR,242.0,157.3,19.88,242.0,84
HCPCS,87798,%MTBAM1 PROBE PCR,242.0,157.3,19.88,242.0,168
HCPCS,87798,"ACANTHAMOEBA SPECIES DETECTION, PCR",242.0,157.3,19.88,242.0,84
HCPCS,87798,ADENOVIRUS PCR,242.0,157.3,19.88,242.0,84
HCPCS,87798,"AMPLIFICATION, RIFAMPIN RESISTANCE",242.0,157.3,19.88,242.0,168
HCPCS,87798,"AMPLIFIED PROBE, VARICELLA ZOSTER VIRUS",242.0,157.3,19.88,242.0,84
HCPCS,87798,ASPERGILLUS DNA QL PCR,242.0,157.3,19.88,242.0,84
HCPCS,87798,BK VIRUS PCR QUAL BLD,242.0,157.3,19.88,242.0,84
HCPCS,87798,BK VIRUS QUAL URINE,242.0,157.3,19.88,242.0,84
HCPCS,87798,BORDETELLA PCR X2,242.0,157.3,19.88,242.0,84
HCPCS,87798,BORDETELLA PERTUSSIS,242.0,157.3,19.88,242.0,84
HCPCS,87798,CARBAPENEM RESISTANCE GENE PCR,242.0,157.3,19.88,242.0,84
HCPCS,87798,CHIKUNGUNYA BY PCR,242.0,157.3,19.88,242.0,84
HCPCS,87798,DENGUE VIRUS PCR,242.0,157.3,19.88,242.0,84
HCPCS,87798,EHRLICHIA/ANAPLASMA PCR,242.0,157.3,19.88,242.0,84
HCPCS,87798,EPSTEIN BARR VIRUS PCR,242.0,157.3,19.88,242.0,84
HCPCS,87798,"EPSTEIN-BARR VIRUS BY QUALITATIVE PCR, CSF",242.0,157.3,19.88,242.0,84
HCPCS,87798,HEP D VIRUS PCR,242.0,157.3,19.88,242.0,84
HCPCS,87798,HTLV I/II DNA PCR X2,242.0,157.3,19.88,242.0,84
HCPCS,87798,HUMAN METAPNEUM RT-PCR,242.0,157.3,19.88,242.0,84
HCPCS,87798,JC VIRUS BY PCR,242.0,157.3,19.88,242.0,84
HCPCS,87798,JC VIRUS DNA PCR,242.0,157.3,19.88,242.0,84
HCPCS,87798,M HOMINTS PCR,242.0,157.3,19.88,242.0,84
HCPCS,87798,MEASLES VIRUS QUAL NAAT,242.0,157.3,19.88,242.0,84
HCPCS,87798,MONKEYPOX VIRUS QUAL PCR,242.0,157.3,19.88,242.0,84
HCPCS,87798,MTBAM1 AMPLIFICATION,242.0,157.3,19.88,242.0,84
HCPCS,87798,MTBCSF DET AG NOS DNA AMP,242.0,157.3,19.88,242.0,84
HCPCS,87798,MUCORALES BY PCR,242.0,157.3,19.88,242.0,84
HCPCS,87798,MUMPS VIRUS BY PCR,242.0,157.3,19.88,242.0,84
HCPCS,87798,MYPCRF DETECT AGENT NOS DNA AMP,242.0,157.3,19.88,242.0,84
HCPCS,87798,NOROVIR 1 & 2 DETECT X2,242.0,157.3,19.88,242.0,84
HCPCS,87798,OCULAR TOXOPL GONDII PCR,242.0,157.3,19.88,242.0,84
HCPCS,87798,OCULAR VZV PCR,242.0,157.3,19.88,242.0,84
HCPCS,87798,P JIROVECI PCR,242.0,157.3,19.88,242.0,84
HCPCS,87798,PARVO B19 PLASMA PCR,242.0,157.3,19.88,242.0,84
HCPCS,87798,"PARVOVIRUS B19 PCR, AMNIOTIC FLUID",242.0,157.3,19.88,242.0,84
HCPCS,87798,PLASMODIUM SP DIFF PCR X5,242.0,157.3,19.88,242.0,84
HCPCS,87798,RPRAPD INFECT AGENT NOS AMP,242.0,157.3,19.88,242.0,84
HCPCS,87798,RSV PCR,242.0,157.3,19.88,242.0,84
HCPCS,87798,RSV RAPID PCR,242.0,157.3,19.88,242.0,84
HCPCS,87798,RT-QULC ANALYSIS CSF,242.0,157.3,19.88,242.0,84
HCPCS,87798,STAPH AUREUS AMPLIFICATION,242.0,157.3,19.88,242.0,84
HCPCS,87798,"TOXOPLASMA GONDII, PCR, AMNIOTIC FLUID",242.0,157.3,19.88,242.0,84
HCPCS,87798,TOXOPLASMA PCR,242.0,157.3,19.88,242.0,84
HCPCS,87798,UREAPLASMA PCR X2,242.0,157.3,19.88,242.0,84
HCPCS,87798,UREAPLASMA SPECIES BY PCR,242.0,157.3,19.88,242.0,84
HCPCS,87798,UREAPLASMA SPECIES MOLEC DETEC PCR FLU TIS,242.0,157.3,19.88,242.0,84
HCPCS,87798,URMPCR DETECT AGENT NOS DNA AMP,242.0,157.3,19.88,242.0,84
HCPCS,87798,VARICELLA ZOSTER PCR,242.0,157.3,19.88,242.0,84
HCPCS,87798,WEST NILE VIRU RNA RT,242.0,157.3,19.88,242.0,84
HCPCS,87798,WEST NILE VIRUS PCR PLS,242.0,157.3,19.88,242.0,84
HCPCS,87798,WHIPPLE DNA WHOLE BLD,242.0,157.3,19.88,242.0,84
HCPCS,87798,ZIKA RT-PCR,242.0,157.3,19.88,242.0,84
HCPCS,87799,ADENOVIRUS PCR QUANT,296.0,192.4,21.15,309.32,84
HCPCS,87799,ADENOVIRUS QT RT-PCR,296.0,192.4,21.15,309.32,84
HCPCS,87799,BK VIRUS QUANT URINE,296.0,192.4,21.15,309.32,168
HCPCS,87799,EBV BY PCR QUANT CSF,296.0,192.4,21.15,309.32,84
HCPCS,87799,HEPATITIS D VIRUS QNT PCR,296.0,192.4,21.15,309.32,84
HCPCS,87799,HEPATITIS E QNT PCR,296.0,192.4,21.15,309.32,84
HCPCS,87799,HERPESVIRUS 7 PCR QUANT,296.0,192.4,21.15,309.32,84
HCPCS,87799,HHV8 BY QUANTITATIVE PCR,296.0,192.4,21.15,309.32,84
HCPCS,87799,JC VIRUS QUANT PCR,296.0,192.4,21.15,309.32,84
HCPCS,87799,JCV DNA QNT RT-PCR CSF,296.0,192.4,21.15,309.32,84
HCPCS,87799,NY BK VIRUS QNT PCR BLD,296.0,192.4,21.15,309.32,84
HCPCS,87799,NY EBV QNT PCR,296.0,192.4,21.15,309.32,84
HCPCS,87799,"QUANTIFICATION, BK VIRUS",296.0,192.4,21.15,309.32,84
HCPCS,87799,"QUANTIFICATION, EPSTEIN-BARR VIRUS",296.0,192.4,21.15,309.32,84
HCPCS,87800,DETECT AGNT MULT DNA DIREC,,,19.81,131.56,28
HCPCS,87800,Detect agnt mult dna direc,,,33.62,38.93,8
HCPCS,87801,%FABPCR INF AG AMP PRBX2,484.0,314.6,33.62,484.0,84
HCPCS,87801,*DNA/RNA;MULTI ORG-AMP PR,484.0,314.6,33.62,484.0,84
HCPCS,87801,"BACTERIAL PCR, DIRECT SPEC",484.0,314.6,33.62,484.0,84
HCPCS,87801,IADNA MULTIPLE ORGANISMS AMPLIFIED PROBE TQ,484.0,314.6,1.1,484.0,88
HCPCS,87801,UNIVERSAL FUNGAL PCR,484.0,314.6,33.62,484.0,84
HCPCS,87802,STREP B ASSAY W/OPTIC,,,5.92,44.77,29
HCPCS,87802,Strep b assay w/optic,,,16.64,19.27,8
HCPCS,87803,CLOSTRIDIUM TOXIN A W/OPTIC,,,6.4,50.03,28
HCPCS,87803,Clostridium toxin a w/optic,,,16.64,19.27,8
HCPCS,87804,*INFLUENZA A,114.0,74.1,15.92,114.0,84
HCPCS,87804,IAADIADOO INFLUENZA,114.0,74.1,1.1,114.0,88
HCPCS,87804,INFLUENZA OIA (POINT OF CARE LAB),114.0,74.1,15.92,114.0,84
HCPCS,87804,RAPID FLU X2,114.0,74.1,15.92,114.0,84
HCPCS,87806,HIV ANTIGEN W/HIV ANTIBODIES,90.0,58.5,13.11,98.72,84
HCPCS,87806,HIV ANTIGEN W/HIV ANTIBODIES (POINT OF CARE LAB),90.0,58.5,13.11,98.72,84
HCPCS,87807,IAADIADOO RESPIRATORY SYNCTIAL VIRUS,90.0,58.5,1.1,90.0,88
HCPCS,87807,RSV DIRECT OPTICAL,90.0,58.5,13.1,90.0,84
HCPCS,87807,RSV IA W DIR OBSERV,90.0,58.5,13.1,90.0,84
HCPCS,87807,RSV IA W DIR OBSERV (POINT OF CARE LAB),90.0,58.5,13.1,90.0,84
HCPCS,87808,IAADIADOO TRICHOMONAS VAGINALIS,106.0,68.9,1.1,106.0,88
HCPCS,87808,TRICHOMONAS ANTIGEN,106.0,68.9,15.29,106.0,84
HCPCS,87809,ADENOVIRUS ASSAY W/OPTIC,,,21.76,65.55,26
HCPCS,87809,Adenovirus assay w/optic,,,16.64,19.27,8
HCPCS,87810,CHLMYD TRACH ASSAY W/OPTIC,,,14.12,106.31,28
HCPCS,87810,Chlmyd trach assay w/optic,,,33.62,38.93,8
HCPCS,87811,SARS-COV-2 COVID19 W/OPTIC,,,16.55,113.38,26
HCPCS,87811,Sars-cov-2 covid19 w/optic,,,16.64,19.27,8
HCPCS,87812,SARSCOV2&INF TYP A&B W/OPTIC,,,29.79,167.58,15
HCPCS,87812,Sarscov2&inf typ a&b w/optic,,,16.64,19.27,8
HCPCS,87850,N. GONORRHOEAE ASSAY W/OPTIC,,,9.82,73.98,28
HCPCS,87850,N. gonorrhoeae assay w/optic,,,16.64,19.27,8
HCPCS,87880,IAADIADOO STREPTOCOCCUS GROUP A,114.0,74.1,1.1,114.0,88
HCPCS,87880,STREP A ASSAY W/OPTIC,114.0,74.1,16.53,114.0,168
HCPCS,87880,STREP ASSAY (POINT OF CARE LAB),114.0,74.1,16.53,114.0,84
HCPCS,87899,CRYPTOCOCCUS AG DETECTION,111.0,72.15,6.43,111.0,84
HCPCS,87899,HIV I/II POST EXP AG SRN,111.0,72.15,6.43,111.0,84
HCPCS,87899,HIV-1/2 AG/AB COMBO,111.0,72.15,6.43,111.0,84
HCPCS,87899,"IMMUNOASSAY, CAD",111.0,72.15,6.43,111.0,84
HCPCS,87899,"IMMUNOASSAY, CAD TITER",111.0,72.15,6.43,111.0,84
HCPCS,87899,"IMMUNOASSAY, MALARIA P. FALCIPARUM",111.0,72.15,6.43,111.0,84
HCPCS,87899,"IMMUNOASSAY, PAN-MALARIAL",111.0,72.15,6.43,111.0,84
HCPCS,87899,"IMMUNOASSAY, STREP PNEUMONIAE ANTIGEN",111.0,72.15,6.43,111.0,84
HCPCS,87899,LIMULUS AMEBOCYTE LT,111.0,72.15,6.43,111.0,84
HCPCS,87900,%HIVGEN PHENOTYPE,899.0,584.35,49.14,899.0,84
HCPCS,87900,%HIVPHS PHENOTYPE,899.0,584.35,49.14,899.0,84
HCPCS,87900,CYTSEQ PHENOTYPE INFECT AGENT DRUG,899.0,584.35,49.14,899.0,84
HCPCS,87900,HIVNGS PHENOTYPE INFECT AGENT DRUG,899.0,584.35,49.14,899.0,84
HCPCS,87900,NFCT AGT DRUG SUSCEPT PHENOTYPE PREDICTION,899.0,584.35,1.1,899.0,88
HCPCS,87901,%HIVGEN HIV GENOTYPING,1776.0,1154.4,116.49,1776.0,84
HCPCS,87901,%HIVPHS GENOTYPE,1776.0,1154.4,116.49,1776.0,84
HCPCS,87901,HIV 1 GENOTYPE RNA REVERSE,1776.0,1154.4,116.49,1776.0,84
HCPCS,87901,HIVNGS GENOTYPE DNA HIV REVERSE T,1776.0,1154.4,116.49,1776.0,84
HCPCS,87901,NFCT GEXYP NUCLEIC ACID HIV REV TRNSCR&PROTEAS,1776.0,1154.4,1.1,1776.0,88
HCPCS,87902,"GENOTYPE, HEPATITIS C VIRUS",1776.0,1154.4,116.49,1776.0,84
HCPCS,87902,HCV NS5A DRG RES SEQ,1776.0,1154.4,116.49,1776.0,84
HCPCS,87902,NFCT AGNT GENOTYP NUCLEIC ACID HEPATITIS C VIRUS,1776.0,1154.4,1.1,1776.0,88
HCPCS,87903,%HIVPHE ANALYSIS NUCLEIC ACID,3372.0,2191.8,109.69,3372.0,84
HCPCS,87903,%HIVPHS PHENO 1-10 DRUGS,3372.0,2191.8,109.69,3372.0,84
HCPCS,87904,%HIVPHS PHENO EA ADD X12,180.0,117.0,12.87,180.0,84
HCPCS,87904,*HIV PHENOTYPE DNA DRUG EA ADD,180.0,117.0,12.87,180.0,84
HCPCS,87905,INFECTIOUS AGENT ENZYMATIC ACTV OTH/THN VIRUS,84.0,54.6,1.1,84.0,88
HCPCS,87905,RAPID BACTERIAL VAGINOSIS,84.0,54.6,12.22,84.0,84
HCPCS,87906,GENOSURE INTEGRASE,888.0,577.2,49.14,888.0,84
HCPCS,87906,GENOTYPE DNA HIV OTHER REGION,888.0,577.2,49.14,888.0,84
HCPCS,87906,HIVNGS GENOTYPE DNA/RNA HIV,888.0,577.2,49.14,888.0,84
HCPCS,87906,NFCT GEXYP DNA/RNA HIV 1 OTHER REGION,888.0,577.2,1.1,888.0,88
HCPCS,87910,CYTSEQ NFCT AGT GNTYP ALYS CMV,1776.0,1154.4,49.14,1776.0,84
HCPCS,87910,NFCT AGT GENOTYPE NUCLEIC ACID CYTOMEGALOVIRUS,1776.0,1154.4,1.1,1776.0,88
HCPCS,87912,HBV DRUG RESISTANCE SEQ,1776.0,1154.4,49.14,1776.0,84
HCPCS,87912,HEPATITIS B GENOTYPING,1776.0,1154.4,49.14,1776.0,84
HCPCS,87913,NFCT AGT GNTYP ALYS SARSCOV2,,,0.01,705.41,24
HCPCS,87913,Nfct agt gntyp alys sarscov2,,,49.14,56.9,8
HCPCS,87999,TROFILE CO-RECEPTOR,3154.0,2050.1,16.64,3154.0,66
HCPCS,88000,AUTOPSY (NECROPSY) GROSS,,,315.62,2466002.74,4
HCPCS,88005,AUTOPSY (NECROPSY) GROSS,,,368.48,2466002.74,4
HCPCS,88007,AUTOPSY (NECROPSY) GROSS,,,385.74,2466002.74,4
HCPCS,88012,AUTOPSY (NECROPSY) GROSS,,,297.1,2466002.74,4
HCPCS,88014,AUTOPSY (NECROPSY) GROSS,,,289.44,2466002.74,4
HCPCS,88016,AUTOPSY (NECROPSY) GROSS,,,297.1,2466002.74,4
HCPCS,88020,AUTOPSY (NECROPSY) COMPLETE,,,53.79,2466002.74,4
HCPCS,88020,"AUTOPSY COMPL,W/O CNS",1325.0,861.25,1.1,2754903.06,88
HCPCS,88025,AUTOPSY (NECROPSY) COMPLETE,,,53.79,2466002.74,4
HCPCS,88027,AUTOPSY (NECROPSY) COMPLETE,,,561.08,2466002.74,4
HCPCS,88028,AUTOPSY (NECROPSY) COMPLETE,,,315.62,2466002.74,4
HCPCS,88029,AUTOPSY (NECROPSY) COMPLETE,,,315.62,2466002.74,4
HCPCS,88036,LIMITED AUTOPSY,,,158.07,2466002.74,4
HCPCS,88037,LIMITED AUTOPSY,,,140.27,2466002.74,4
HCPCS,88040,FORENSIC AUTOPSY (NECROPSY),,,608.16,2466002.74,4
HCPCS,88045,CORONERS AUTOPSY (NECROPSY),,,87.93,2466002.74,4
HCPCS,88099,UNLISTED NECROPSY (AUTOPSY),,,53.79,2739999.97,2
HCPCS,88104,CYTOLOGY BRUSHING MOD,271.0,176.15,34.79,271.0,86
HCPCS,88104,CYTP FLU WASHGS/BRUSHINGS XCPT C/V SMRS INTERPJ,246.0,159.9,1.1,246.0,256
HCPCS,88104,CYTPATH NONGYN SMEAR INTERP,271.0,176.15,34.79,271.0,86
HCPCS,88106,CYTOPATH FL NONGYN FILTER,,,22.7,77.73,24
HCPCS,88106,Cytopath fl nongyn filter,,,45.47,52.65,8
HCPCS,88107,CYTOPATH FL NONGYN SM/FLTR,,,102.1,102.1,1
HCPCS,88108,CYTOLOGY FLUID,271.0,176.15,34.79,271.0,86
HCPCS,88108,CYTP CONCENTRATION SMEARS & INTERPRETATION,329.5,214.175,1.1,465.0,256
HCPCS,88112,BILIARY TRACT MALIG,369.0,239.85,45.47,369.0,86
HCPCS,88112,CYTOLOGY FLUID TP,369.0,239.85,45.47,369.0,86
HCPCS,88112,CYTP SLCTV CELL ENHANCEMENT INTERPJ XCPT C/V,246.0,159.9,1.1,246.0,256
HCPCS,88112,MISC SENDOUT CPT 88112,369.0,239.85,45.47,369.0,86
HCPCS,88120,CYTP INSITU HYBRID URINE SPEC 3-5 PROBES EA MNL,528.0,343.2,1.1,1382.33,256
HCPCS,88120,FISH FOR BLADDER CANCER,1182.0,768.3,60.74,1182.0,86
HCPCS,88120,FISH FOR BLADDER CANCER W/URINARY CYTO,1182.0,768.3,60.74,1182.0,86
HCPCS,88121,CYTP URINE 3-5 PROBES CMPTR,,,148.18,655.34,23
HCPCS,88121,Cytp urine 3-5 probes cmptr,,,60.74,70.33,8
HCPCS,88125,FORENSIC CYTOPATHOLOGY,,,35.26,141.47,24
HCPCS,88125,Forensic cytopathology,,,45.47,52.65,8
HCPCS,88130,SEX CHROMATIN IDENTIFICATION,,,17.98,54.16,26
HCPCS,88130,Sex chromatin identification,,,8.96,10.37,8
HCPCS,88140,SEX CHROMATIN IDENTIFICATION,,,7.99,24.07,26
HCPCS,88140,Sex chromatin identification,,,8.96,10.37,8
HCPCS,88141,CYTOPATH C/V INTERPRET,,,32.97,74.78,4
HCPCS,88141,CYTP CERVICAL/VAGINAL REQ INTERP PHYSICIAN,114.0,74.1,1.1,114.0,130
HCPCS,88141,Cytopath c/v interpret,,,15.29,17.7,8
HCPCS,88142,CYTOLOGY GYN SC THIN PREP,140.0,91.0,15.29,140.0,83
HCPCS,88142,CYTOLOGY SUREPATH PAP,140.0,91.0,15.29,140.0,83
HCPCS,88142,CYTP CERV/VAG AUTO THIN LAYER PREP MNL SCREEN,140.0,91.0,1.1,140.0,88
HCPCS,88142,PAP AND REFLEX HPV SCREEN- ARUP,140.0,91.0,15.29,140.0,83
HCPCS,88142,PAP SMR THN PRP,140.0,91.0,15.29,140.0,83
HCPCS,88142,PAP WITH REFLEX HPV SCREEN-ARUP,140.0,91.0,15.29,140.0,83
HCPCS,88143,CYTOPATH C/V THIN LAYER REDO,,,23.04,69.4,26
HCPCS,88143,Cytopath c/v thin layer redo,,,15.29,17.7,8
HCPCS,88147,CYTOPATH C/V AUTOMATED,,,46.57,152.31,26
HCPCS,88147,Cytopath c/v automated,,,15.29,17.7,8
HCPCS,88148,CYTOPATH C/V AUTO RESCREEN,,,17.76,48.66,26
HCPCS,88148,Cytopath c/v auto rescreen,,,15.29,17.7,8
HCPCS,88150,CYTOPATH C/V MANUAL,,,12.81,48.66,26
HCPCS,88150,CYTP SLIDES C/V MNL SCR UNDER PHYS,126.0,81.9,1.1,126.0,88
HCPCS,88150,Cytopath c/v manual,,,15.29,17.7,8
HCPCS,88152,CYTOPATH C/V AUTO REDO,,,27.64,83.26,26
HCPCS,88152,Cytopath c/v auto redo,,,15.29,17.7,8
HCPCS,88153,CYTOPATH C/V REDO,,,24.03,72.4,26
HCPCS,88153,Cytopath c/v redo,,,15.29,17.7,8
HCPCS,88154,Cytopath c/v select,,,25.3,25.3,1
HCPCS,88155,CYTOPATH C/V INDEX ADD-ON,,,14.65,44.14,26
HCPCS,88155,Cytopath c/v index add-on,,,15.29,17.7,8
HCPCS,88160,CYTP SMRS ANY OTH SRC SCR&INTERPJ,220.0,143.0,1.1,220.0,256
HCPCS,88160,CYTPATH SMEAR OTHER,169.0,109.85,22.7,169.0,86
HCPCS,88161,CYTP SMRS ANY OTH SRC PREPJ SCR&INTERPJ,220.0,143.0,1.1,220.0,126
HCPCS,88161,CYTPATH SMEAR OTHER W PREP,169.0,109.85,22.7,169.0,86
HCPCS,88161,PATH TOUCH PREP INIT,169.0,109.85,22.7,169.0,86
HCPCS,88162,CYTOPATH SMEAR OTHER SOURCE,,,47.01,141.47,24
HCPCS,88162,CYTP SMRS ANY OTH SRC EXTND STD > 5 SLIDES,334.0,217.1,1.1,334.0,130
HCPCS,88162,Cytopath smear other source,,,45.47,52.65,8
HCPCS,88164,CYTPATH CERV/VAG SCREENING,126.0,81.9,14.03,126.0,83
HCPCS,88165,CYTOPATH TBS C/V REDO,,,25.3,127.19,26
HCPCS,88165,Cytopath tbs c/v redo,,,15.29,17.7,8
HCPCS,88166,CYTOPATH TBS C/V AUTO REDO,,,17.76,48.66,26
HCPCS,88166,Cytopath tbs c/v auto redo,,,15.29,17.7,8
HCPCS,88167,CYTOPATH TBS C/V SELECT,,,17.76,48.66,26
HCPCS,88167,Cytopath tbs c/v select,,,15.29,17.7,8
HCPCS,88172,CYTP FINE NDL ASPIRATE IMMT CYTOHIST STD DX 1ST,304.0,197.6,1.1,498.94,256
HCPCS,88172,CYTPATH FNA IMMEDIATE EVAL,259.0,168.35,51.11,335.61,86
HCPCS,88173,CYTP EVAL FINE NEEDLE ASPIRATE INTERP & REPORT,612.0,397.8,1.1,612.0,256
HCPCS,88173,CYTPATH FNA I&R,369.0,239.85,34.71,369.0,86
HCPCS,88174,CYTOPATH C/V AUTO IN FLUID,,,25.37,76.43,26
HCPCS,88174,Cytopath c/v auto in fluid,,,15.29,17.7,8
HCPCS,88175,CYTO IMAGER GYN TP DIAG,184.0,119.6,15.29,184.0,83
HCPCS,88175,CYTO IMAGER GYN TP SCREEN,184.0,119.6,15.29,184.0,83
HCPCS,88175,PAP WITH REFLEX HPV SCREEN-ARUP,184.0,119.6,15.29,184.0,83
HCPCS,88177,CYTO SECOND PASS ADEQ,147.0,95.55,11.0,147.0,68
HCPCS,88177,CYTP FINE NDL ASPIRATE IMMT CYTOHIST STD EA EVAL,185.0,120.25,1.1,185.0,256
HCPCS,88180,TRANSPLANT ACTIVATE,94.0,61.1,1.1,94.0,70
HCPCS,88182,DNA CONTENT/CELL CYC ANLS,369.0,239.85,45.47,369.0,172
HCPCS,88182,"FLOW CYTO, DNA",369.0,239.85,45.47,369.0,86
HCPCS,88182,TELOMERE LENGTH MEASUREMENT,369.0,239.85,45.47,369.0,86
HCPCS,88184,%ACLUK2 1ST MARK,2482.0,1613.3,60.74,2482.0,86
HCPCS,88184,%BAL FCM 1ST MARKER,2482.0,1613.3,60.74,2482.0,86
HCPCS,88184,%BLYMPHOMA 1ST MARKER,2482.0,1613.3,60.74,2482.0,86
HCPCS,88184,%CD2 CD3 MONITOR 1ST MARK,2482.0,1613.3,60.74,2482.0,86
HCPCS,88184,%CVID FLOW FIRST MARKER,2482.0,1613.3,60.74,2482.0,86
HCPCS,88184,%IMMUNE ACT 1ST MARKER,2482.0,1613.3,60.74,2482.0,86
HCPCS,88184,%LGLYM 1ST MRK,2482.0,1613.3,60.74,2482.0,86
HCPCS,88184,%MYCELL 1ST MRK BLOOD,2482.0,1613.3,60.74,2482.0,172
HCPCS,88184,%MYELOMA 1ST MARKER,2482.0,1613.3,60.74,2482.0,86
HCPCS,88184,%NKFUNC FIRST MARKER,2482.0,1613.3,60.74,2482.0,86
HCPCS,88184,%NUCLEAR TDT BY FCM 1ST MARKER,2482.0,1613.3,60.74,2482.0,86
HCPCS,88184,%PLAFLW FLOW 1ST MARKER,2482.0,1613.3,60.74,2482.0,86
HCPCS,88184,%PLTFLOW CYTO 1ST MARKER,2482.0,1613.3,60.74,2482.0,86
HCPCS,88184,%PNH BY FCM 1ST MARK X2,2482.0,1613.3,60.74,2482.0,86
HCPCS,88184,%PNH PANEL 1ST MARKER,2482.0,1613.3,60.74,2482.0,86
HCPCS,88184,%RLLLIP 1ST MARKER,2482.0,1613.3,60.74,2482.0,86
HCPCS,88184,%RLLYMP FC LYMP 1ST MRK,2482.0,1613.3,60.74,2482.0,86
HCPCS,88184,%SURFACE/CYTO IGM 1ST MARKER,2482.0,1613.3,60.74,2482.0,86
HCPCS,88184,%T CELL VBETA 1ST MARKER,2482.0,1613.3,60.74,2482.0,86
HCPCS,88184,%ZAP70 FIRST MARKER,2482.0,1613.3,60.74,2482.0,86
HCPCS,88184,ALPS FLOW CYTOMETRY,2482.0,1613.3,60.74,2482.0,86
HCPCS,88184,B CELL CD20 1ST MRK,2482.0,1613.3,60.74,2482.0,86
HCPCS,88184,CD52EX FIRST MARKER,2482.0,1613.3,60.74,2482.0,86
HCPCS,88184,FL CYT LAB1243 1ST MKR,2482.0,1613.3,60.74,2482.0,86
HCPCS,88184,FLOW CD107A,2482.0,1613.3,60.74,2482.0,86
HCPCS,88184,"FLOW CYTO, 1ST MARKER",2482.0,1613.3,60.74,2482.0,86
HCPCS,88184,FLOW CYTOMETRY CELL SURF MARKER TECHL ONLY 1ST,2482.0,1613.3,1.1,2482.0,130
HCPCS,88184,FLOW PERFORIN/GRANZYME B,2482.0,1613.3,60.74,2482.0,86
HCPCS,88184,FLOW PSTAT5,2482.0,1613.3,60.74,2482.0,86
HCPCS,88184,FLOW SAP (XLP1) AND XIAP (XLP2),2482.0,1613.3,60.74,2482.0,86
HCPCS,88184,FLOW SCRN TUBE 1ST MKR,2482.0,1613.3,60.74,2482.0,86
HCPCS,88184,FLOW TH17,2482.0,1613.3,60.74,2482.0,86
HCPCS,88184,FLW CYT LYMP WKUP LAB2500,2482.0,1613.3,60.74,2482.0,86
HCPCS,88184,INDIVIDUAL FCM MARKER X1,2482.0,1613.3,60.74,2482.0,86
HCPCS,88184,"KIRFLW FLOW CYTOMETRY; FIRST CELL SURFACE, CYTOPLASMIC OR NUCLEA",2482.0,1613.3,60.74,2482.0,86
HCPCS,88184,RBCB3 PROTEIN RED,2482.0,1613.3,60.74,2482.0,86
HCPCS,88184,TCLACV FLOWCYTO 1ST MKR,2482.0,1613.3,60.74,2482.0,86
HCPCS,88185,%ANTIE EA ADD MARKER X2,149.0,96.85,24.28,149.0,68
HCPCS,88185,%BPHENO FLW CYTO EAADDX7,149.0,96.85,24.28,149.0,68
HCPCS,88185,%CVID FLW EA ADD MARK X2,149.0,96.85,24.28,149.0,68
HCPCS,88185,%MYCELL EA ADD MRK BLDX5,149.0,96.85,24.28,149.0,136
HCPCS,88185,"%MYPRS FLOW CYTOM, ADDTL",149.0,96.85,24.28,149.0,68
HCPCS,88185,%NKFUNC ADDTL MARKERS X2,149.0,96.85,24.28,149.0,68
HCPCS,88185,%PLAFLW FLW ADD MARKER X5,149.0,96.85,24.28,149.0,68
HCPCS,88185,%PNH BY FCM ADD MARK X7,149.0,96.85,24.28,149.0,68
HCPCS,88185,%RLLYMP LYMPH MRK ADD X17,149.0,96.85,24.28,149.0,68
HCPCS,88185,%UTBAS FLW CYT ADD MKR X2,149.0,96.85,24.28,149.0,68
HCPCS,88185,%ZAP70 ADDTL MARKERS,149.0,96.85,24.28,149.0,68
HCPCS,88185,ADDITIONAL MARKERS,149.0,96.85,24.28,149.0,68
HCPCS,88185,ALPS FLOW MARKERS,149.0,96.85,24.28,149.0,68
HCPCS,88185,B CELL CD20 ADDTL MRK,149.0,96.85,24.28,149.0,68
HCPCS,88185,CD52EX ADDITIONAL MARKERS,149.0,96.85,24.28,149.0,68
HCPCS,88185,FLOW CD107A ADDITIONAL,149.0,96.85,24.28,149.0,68
HCPCS,88185,"FLOW CYTO, EA ADD MARKER",149.0,96.85,24.28,149.0,68
HCPCS,88185,FLOW CYTOMETRY CELL SURF MARKER TECHL ONLY EA,149.0,96.85,1.1,149.0,130
HCPCS,88185,FLOW PERFORIN/GRANZYME B ADDITIONAL,149.0,96.85,24.28,149.0,68
HCPCS,88185,FLOW PSTAT5 ADDITIONAL,149.0,96.85,24.28,149.0,68
HCPCS,88185,FLOW SAP (XLP1) AND XIAP (XLP2) ADDITIONAL,149.0,96.85,24.28,149.0,68
HCPCS,88185,FLOW TH17 ADDITIONAL,149.0,96.85,24.28,149.0,68
HCPCS,88185,"KIRFLW FLOW CYTOMETRY; ADDITIONAL CELL SURFACE, CYTOPLASMIC OR N",149.0,96.85,24.28,149.0,68
HCPCS,88187,FLOW CYTOMETRY INTERPRETATION 2-8 MARKE,326.0,211.9,1.1,326.0,130
HCPCS,88187,FLOWCYTOMETRY/READ 2-8,,,54.96,197.93,5
HCPCS,88187,Flowcytometry/read 2-8,,,45.47,52.65,8
HCPCS,88188,ALPS FLOW INTERP,1947.0,1265.55,45.47,1947.0,68
HCPCS,88188,FLOW CYTOMETRY INTERP 9-15 MARKERS,528.0,343.2,1.1,528.0,130
HCPCS,88189,FLOW CYTOMETRY INTERP 16 OR MORE MARKERS,748.0,486.2,1.1,748.0,130
HCPCS,88189,FLOWCYTOMETRY/READ 16 & >,,,127.71,257.14,5
HCPCS,88189,Flowcytometry/read 16 & >,,,45.47,52.65,8
HCPCS,88199,UNLISTED CYTOPATHOLOGY PX,,,45.96,141.47,24
HCPCS,88199,Unlisted cytopathology px,,,45.47,52.65,8
HCPCS,88230,%CHROMO BLD TISSUE CULT,804.0,522.6,60.74,804.0,83
HCPCS,88230,%NFIB1 TISSUE CULT,804.0,522.6,60.74,804.0,83
HCPCS,88230,*TIS CULT LYMPHOCYTE,804.0,522.6,60.74,804.0,83
HCPCS,88230,CHRCON BLD TISSUE CULT,804.0,522.6,60.74,804.0,83
HCPCS,88230,CHRMOS TIS CUL LYMPHOCYTE,804.0,522.6,60.74,804.0,83
HCPCS,88230,TISS CUL NON-NEO DISORDERS LYMPHOCYTE,804.0,522.6,1.1,804.0,88
HCPCS,88233,%ETCF FIBROBLASTS,971.0,631.15,60.74,1083.61,83
HCPCS,88233,%FCULT SKIN CULTURE,971.0,631.15,60.74,1083.61,83
HCPCS,88233,*TIS CULT SKIN/BX,971.0,631.15,60.74,1083.61,83
HCPCS,88233,CHROM TISSUE CULT PROCESS,971.0,631.15,60.74,1083.61,83
HCPCS,88233,CPALMF TISSUE CULTURE SKIN/BIOPSY,971.0,631.15,60.74,1083.61,83
HCPCS,88233,CVCULT TISSUE CULTURE,971.0,631.15,60.74,1083.61,83
HCPCS,88233,FIBROBLAST CULTURE MAYO,971.0,631.15,60.74,1083.61,83
HCPCS,88233,POCHF CHROM TIS CUL PROC,971.0,631.15,60.74,1083.61,83
HCPCS,88233,TIS CULT SKIN/BX,971.0,631.15,60.74,1083.61,83
HCPCS,88235,%CHROMO CULT AMNIOTIC,1037.0,674.05,60.74,1037.0,83
HCPCS,88235,%ISIGHT TIS CULT AM FLX2,1037.0,674.05,60.74,1037.0,83
HCPCS,88235,AMNIOTIC FLUID FETAL CELL CULTURE,1037.0,674.05,60.74,1037.0,83
HCPCS,88235,CHROM POC CULTURE PROCESS,1037.0,674.05,60.74,1037.0,83
HCPCS,88235,CHROMOSOME AMNIOTIC FLUID,1037.0,674.05,60.74,1037.0,83
HCPCS,88235,CVS FETAL CELL CULTURE,1037.0,674.05,60.74,1037.0,83
HCPCS,88235,"LABCORP CMBP CHROMOSOME ANALYSIS, CHORIONIC VILLUS",1037.0,674.05,60.74,1037.0,83
HCPCS,88235,REFLEX AMNIOTIC FLUID CULTURE,1037.0,674.05,60.74,1037.0,83
HCPCS,88235,REFLEX AMNIOTIC FLUID CULTURE PROCESSING FEE,1037.0,674.05,60.74,1037.0,83
HCPCS,88237,%CHHEMA TISSU CULT BN MAR,992.0,644.8,60.74,992.0,83
HCPCS,88237,%CHRMDS CULT PROC,992.0,644.8,60.74,992.0,83
HCPCS,88237,1221FH TISSUE CULT BLOOD,992.0,644.8,60.74,992.0,83
HCPCS,88237,1221FM TISSUE CULT BM,992.0,644.8,60.74,992.0,83
HCPCS,88237,20Q8 TISSUE CULT BLD,992.0,644.8,60.74,992.0,83
HCPCS,88237,20Q8 TISSUE CULT BM,992.0,644.8,60.74,992.0,83
HCPCS,88237,5Q TISSUE CULT BM,992.0,644.8,60.74,992.0,83
HCPCS,88237,5QFSH TISSUE CULT BLOOD,992.0,644.8,60.74,992.0,83
HCPCS,88237,7Q TISSUE CULT BM,992.0,644.8,60.74,992.0,83
HCPCS,88237,814FSH TISSUE CULT BLD,992.0,644.8,60.74,992.0,83
HCPCS,88237,AMLFBM TISSUE CULT BM,992.0,644.8,60.74,992.0,83
HCPCS,88237,AMLFSH TISSUE CULT BLOOD,992.0,644.8,60.74,992.0,83
HCPCS,88237,APLFBM TISSUE CULT BM,992.0,644.8,60.74,992.0,83
HCPCS,88237,APLFSH TISSUE CULT BLOOD,992.0,644.8,60.74,992.0,83
HCPCS,88237,BCL2 TISSUE CULT BLOOD,992.0,644.8,60.74,992.0,83
HCPCS,88237,BCL2 TISSUE CULT BM,992.0,644.8,60.74,992.0,83
HCPCS,88237,BCL6 TISSUE CULT BLOOD,992.0,644.8,60.74,992.0,83
HCPCS,88237,BCL6 TISSUE CULT BM,992.0,644.8,60.74,992.0,83
HCPCS,88237,BCRFSH TISSUE CULT BLOOD,992.0,644.8,60.74,992.0,83
HCPCS,88237,BCRFSM TISSUE CULT BM,992.0,644.8,60.74,992.0,83
HCPCS,88237,CCND1F TISSUE CULT BLOOD,992.0,644.8,60.74,992.0,83
HCPCS,88237,CCND1M TISSUE CULT BM,992.0,644.8,60.74,992.0,83
HCPCS,88237,CHRAML CULT PROC,992.0,644.8,60.74,992.0,83
HCPCS,88237,CHROM BM CULT PROC,992.0,644.8,60.74,992.0,83
HCPCS,88237,CHROM LEUK BLD CULT PROC,992.0,644.8,60.74,992.0,83
HCPCS,88237,CLLFSH TISSUE CULT BLD,992.0,644.8,60.74,992.0,83
HCPCS,88237,CLLFSM TISSUE CULT BLD,992.0,644.8,60.74,992.0,83
HCPCS,88237,CRIGBP TISSUE CULT BLOOD,992.0,644.8,60.74,992.0,83
HCPCS,88237,CRIGHB TISSUE CULT BLOOD,992.0,644.8,60.74,992.0,83
HCPCS,88237,CRIGHM TISSUE CULT BLOOD,992.0,644.8,60.74,992.0,83
HCPCS,88237,CRIGMP TISSUE CULT BLOOD,992.0,644.8,60.74,992.0,83
HCPCS,88237,CRL2FB TISSUE CULT BLOOD,992.0,644.8,60.74,992.0,83
HCPCS,88237,CRLF2M TISSUE CULT BLOOD,992.0,644.8,60.74,992.0,83
HCPCS,88237,FABCBM TISSUE CULT BM,992.0,644.8,60.74,992.0,83
HCPCS,88237,FABCFP TISSUE CULT BLOOD,992.0,644.8,60.74,992.0,83
HCPCS,88237,FAMLPM TISSUE CULT BM,992.0,644.8,60.74,992.0,83
HCPCS,88237,FAMLPN TISSUE CULT BLOOD,992.0,644.8,60.74,992.0,83
HCPCS,88237,FGFR1F TISSUE CULT BLOOD,992.0,644.8,60.74,992.0,83
HCPCS,88237,FGFR1M TISSUE CULT BM,992.0,644.8,60.74,992.0,83
HCPCS,88237,FHT410 TISSUE CULT BLOOD,992.0,644.8,60.74,992.0,83
HCPCS,88237,FISH 3Q26 TISSUE CULT BM,992.0,644.8,60.74,992.0,83
HCPCS,88237,FISH3Q36 TISSUE CULT BLOOD,992.0,644.8,60.74,992.0,83
HCPCS,88237,FISH7Q TISSUE CULT BLD,992.0,644.8,60.74,992.0,83
HCPCS,88237,FSBLLM TISSUE CULT BM,992.0,644.8,60.74,992.0,83
HCPCS,88237,FSHBLL TISSUE CULT BLOOD,992.0,644.8,60.74,992.0,83
HCPCS,88237,FSHMDS TISSUE CULT BLOOD,992.0,644.8,60.74,992.0,83
HCPCS,88237,FSMDSM TISSUE CULT BM,992.0,644.8,60.74,992.0,83
HCPCS,88237,FT410M TISSUE CULT BM,992.0,644.8,60.74,992.0,83
HCPCS,88237,IGH/BCL2 TISSUE CULT BLD,992.0,644.8,60.74,992.0,83
HCPCS,88237,IGH/BCL2 TISSUE CULT BM,992.0,644.8,60.74,992.0,83
HCPCS,88237,IGH/CCND1 TISSUE CULT BLD,992.0,644.8,60.74,992.0,83
HCPCS,88237,IGH/CCND1 TISSUE CULT BM,992.0,644.8,60.74,992.0,83
HCPCS,88237,IGH/MYC TISSUE CULT BM,992.0,644.8,60.74,992.0,83
HCPCS,88237,INV16F TISSUE CULT BLOOD,992.0,644.8,60.74,992.0,83
HCPCS,88237,INV16M TISSUE CULT BM,992.0,644.8,60.74,992.0,83
HCPCS,88237,MLLFBM TISSUE CULT BM,992.0,644.8,60.74,992.0,83
HCPCS,88237,MLLFSH TISSUE CULT BLOOD,992.0,644.8,60.74,992.0,83
HCPCS,88237,MPNFSH TISSUE CULT BM,992.0,644.8,60.74,992.0,83
HCPCS,88237,MPNFSM TISSUE CULT BM,992.0,644.8,60.74,992.0,83
HCPCS,88237,MYC TISSUE CULT BM,992.0,644.8,60.74,992.0,83
HCPCS,88237,MYCFSH TISSUE CULT BLOOD,992.0,644.8,60.74,992.0,83
HCPCS,88237,PDGFAM TISSUE CULT BM,992.0,644.8,60.74,992.0,83
HCPCS,88237,PDGFBM TISSUE CULT BM,992.0,644.8,60.74,992.0,83
HCPCS,88237,PDGFRA TISSUE CULT BLOOD,992.0,644.8,60.74,992.0,83
HCPCS,88237,PDGFRB TISSUE CULT BLOOD,992.0,644.8,60.74,992.0,83
HCPCS,88237,RARFSH TISSUE CULT BLOOD,992.0,644.8,60.74,992.0,83
HCPCS,88237,RARFSM TISSUE CULT BM,992.0,644.8,60.74,992.0,83
HCPCS,88237,TISS CUL NEO DISORDERS BONE MARROW BLOOD CELLS,992.0,644.8,1.1,992.0,88
HCPCS,88239,%CHROMO SOL TUMOR CULTURE,1018.0,661.7,60.74,1026.15,83
HCPCS,88239,CHROMO NEOPLS TIS CULTURE,1018.0,661.7,60.74,1026.15,83
HCPCS,88239,TISS CUL NEO DISORDERS SOLID TUMOR,1018.0,661.7,1.1,1018.0,88
HCPCS,88240,%ETCF CRYOPRESERVE,90.0,58.5,8.96,90.0,83
HCPCS,88240,%FCULT CRYOPRESER,90.0,58.5,8.96,90.0,166
HCPCS,88240,%IN VITRO CULT CRYO/STORE,90.0,58.5,8.96,90.0,83
HCPCS,88240,ALLO BM FRZ STORE,90.0,58.5,8.96,90.0,83
HCPCS,88240,AUTO BM FRZ STORE,90.0,58.5,8.96,90.0,83
HCPCS,88240,CELL CRYOPRESERVE/STORAGE,90.0,58.5,8.96,90.0,83
HCPCS,88240,CELL PROCESSING AND STORAGE,90.0,58.5,8.96,90.0,83
HCPCS,88240,CELLS PROCESSING AND STORAGE,90.0,58.5,8.96,90.0,83
HCPCS,88240,CPALMF CELL CRYOPRESERVE/STORAGE,90.0,58.5,8.96,90.0,83
HCPCS,88240,CRYOPRESERVATION OF OVARIAN TISSUE,90.0,58.5,8.96,90.0,83
HCPCS,88240,CVCULT CRYOPRESERVATN,90.0,58.5,8.96,90.0,83
HCPCS,88240,STEM CELL PROCESSING,90.0,58.5,8.96,90.0,83
HCPCS,88241,CORD BLOOD THAW,83.0,53.95,8.96,83.0,83
HCPCS,88245,CHROMOSOME ANALYSIS 20-25,,,173.17,638.79,26
HCPCS,88245,Chromosome analysis 20-25,,,116.49,134.88,8
HCPCS,88248,CHROMOSOME ANALYSIS 50-100,,,173.17,646.64,27
HCPCS,88248,Chromosome analysis 50-100,,,116.49,134.88,8
HCPCS,88249,MISC SENDOUT CPT 88249,1195.0,776.75,116.49,1195.0,83
HCPCS,88261,%CRMCON CHROMANALY SCELL,1824.0,1185.6,116.49,1824.0,83
HCPCS,88261,"REFLEX COUNT 5, 1 KARYOTYPE",1824.0,1185.6,116.49,1824.0,166
HCPCS,88262,%CHRMDS KARY 15-20,866.0,562.9,83.94,866.0,83
HCPCS,88262,%CHROMO HEM KAROTYPES,866.0,562.9,83.94,866.0,83
HCPCS,88262,%CHROMO POC KARY 15-20,866.0,562.9,83.94,866.0,83
HCPCS,88262,CHRMSM COUNT 15-20 CLL 2KARYOTYP BANDING,866.0,562.9,1.1,866.0,88
HCPCS,88262,CHROMOSOME ANLYS KARY 15-20,866.0,562.9,83.94,866.0,83
HCPCS,88262,POCHF CHR ANLS KARY 15-20,866.0,562.9,83.94,866.0,83
HCPCS,88263,CHRMOS CHROM ANLS 45,1037.0,674.05,116.49,1037.0,83
HCPCS,88264,%CHHEMA CHROM ANLY 20-25,998.0,648.7,116.49,998.0,83
HCPCS,88264,BMCHFX CHROM ANLY 20-25,998.0,648.7,116.49,998.0,83
HCPCS,88264,CHRAML CHROM ANLY 20-25,998.0,648.7,116.49,998.0,83
HCPCS,88264,CHRBLL CHROM ANLY 20-25,998.0,648.7,116.49,998.0,83
HCPCS,88264,CHRBMH CHROM ANLY 20-25,998.0,648.7,116.49,998.0,83
HCPCS,88264,CHRMDS CHROM ANLY 20-25,998.0,648.7,116.49,998.0,83
HCPCS,88264,CHRNPT CHROM ANLY 20-25,998.0,648.7,116.49,998.0,83
HCPCS,88264,CHRSOL CHROM ANLY 20-25,998.0,648.7,116.49,998.0,83
HCPCS,88267,%CHROMO AMNIOTIC FL,1301.0,845.65,116.49,1301.0,83
HCPCS,88267,%CVC CHROMOSOME ANALYSIS,1301.0,845.65,116.49,1301.0,83
HCPCS,88267,%ISIGHT CHROM AMNIO FLD,1301.0,845.65,116.49,1301.0,83
HCPCS,88267,CHROMOSOME ANALYSIS CVS,1301.0,845.65,116.49,1301.0,83
HCPCS,88269,"CHROMOSOME ANALYSIS 6-12 COLONIES, 1 KARYOTYPE",1198.0,778.7,116.49,1198.0,83
HCPCS,88269,CHROMOSOME ANALYSIS AMNIOTIC FLUID,1198.0,778.7,116.49,1198.0,83
HCPCS,88269,FAMCYT CHROMOSOME ANALYSIS AMNIOTIC,1198.0,778.7,116.49,1198.0,83
HCPCS,88271,%1221FH PROBE X2,148.0,96.2,21.42,164.91,83
HCPCS,88271,%20Q8FH PROBE X2,148.0,96.2,21.42,164.91,83
HCPCS,88271,%814FSH PROBE X2,148.0,96.2,21.42,164.91,83
HCPCS,88271,%BCL2FH PROBE X2,148.0,96.2,21.42,164.91,83
HCPCS,88271,%BCL6 BM PROBE X2,148.0,96.2,21.42,164.91,83
HCPCS,88271,%CHROMO CULT AMNIOTIC,148.0,96.2,21.42,164.91,249
HCPCS,88271,%CLLFSH PROBE X7,148.0,96.2,21.42,164.91,83
HCPCS,88271,%DGEORG DNA PROBEX2,148.0,96.2,21.42,164.91,166
HCPCS,88271,%FABCFP PROBE X8,148.0,96.2,21.42,164.91,83
HCPCS,88271,%FAMLPN PROBE,148.0,96.2,21.42,164.91,83
HCPCS,88271,%FISH7Q PROBE X2,148.0,96.2,21.42,164.91,83
HCPCS,88271,%FSHBLL PROBE X12,148.0,96.2,21.42,164.91,83
HCPCS,88271,%FSHMDS PROBE X6,148.0,96.2,21.42,164.91,83
HCPCS,88271,%FSHPCM DNA PROBE,148.0,96.2,21.42,164.91,166
HCPCS,88271,%IGH/BCL2 BM PROBE X2,148.0,96.2,21.42,164.91,83
HCPCS,88271,%IGH/CCND1 BM PROBE X2,148.0,96.2,21.42,164.91,83
HCPCS,88271,%INV16F PROBE X2,148.0,96.2,21.42,164.91,83
HCPCS,88271,%ISIGHT TIS CULT AM FLX2,148.0,96.2,21.42,164.91,166
HCPCS,88271,%MLLFSH PROBE X2,148.0,96.2,21.42,164.91,83
HCPCS,88271,%PAX6 PROBE X10,148.0,96.2,21.42,164.91,83
HCPCS,88271,%PMCEXT DNA PROBE X14,148.0,96.2,21.42,164.91,83
HCPCS,88271,%RARFSH PROBE X2,148.0,96.2,21.42,164.91,83
HCPCS,88271,%UROFISH MOLE GEN DNA X4,148.0,96.2,21.42,164.91,83
HCPCS,88271,1221FM BM PROBE X2,148.0,96.2,21.42,164.91,83
HCPCS,88271,"13, 21 AMNIO ANEUPLOID FISH",148.0,96.2,21.42,164.91,83
HCPCS,88271,"18, XY AMNIO ANEUPLOID FISH",148.0,96.2,21.42,164.91,83
HCPCS,88271,20Q8 BM PROBE X2,148.0,96.2,21.42,164.91,83
HCPCS,88271,5Q BM PROBE X2,148.0,96.2,21.42,164.91,83
HCPCS,88271,5QFSH PROBE BLD X2,148.0,96.2,21.42,164.91,83
HCPCS,88271,7Q BM PROBE X2,148.0,96.2,21.42,164.91,83
HCPCS,88271,ADDITIONAL DNA PROBE SET MAYO (IF APPROPRIATE),148.0,96.2,21.42,164.91,332
HCPCS,88271,"ADDITIONAL DNA PROBE SET MAYO (IF APPROPRIATE)-I(12P), GERM CELL",148.0,96.2,21.42,164.91,83
HCPCS,88271,"ADDITIONAL DNA PROBE SET MAYO (IF APPROPRIATE)-JAK2 (9P24.1), FI",148.0,96.2,21.42,164.91,83
HCPCS,88271,"ADDITIONAL DNA PROBE SET MAYO (IF APPROPRIATE)-NR4A3, REARRANGEM",148.0,96.2,21.42,164.91,83
HCPCS,88271,"ADDITIONAL DNA PROBE SET MAYO (IF APPROPRIATE)-PDGFB (22Q13), FI",148.0,96.2,21.42,164.91,83
HCPCS,88271,ADDITIONAL DNA PROBE SET MAYO (IF APPROPRIATE)-PLASMA CELL PROLI,148.0,96.2,21.42,164.91,83
HCPCS,88271,"ADDITIONAL DNA PROBE SET MAYO (IF APPROPRIATE)-PRKACA, REARRANGE",148.0,96.2,21.42,164.91,83
HCPCS,88271,"ALK, (2P23), IMT, FISH",148.0,96.2,21.42,164.91,83
HCPCS,88271,AMLFBM BM PROBE X2,148.0,96.2,21.42,164.91,83
HCPCS,88271,AMLFSH TIS CULT AM FLX2,148.0,96.2,21.42,164.91,83
HCPCS,88271,APLFBM BM PROBE X2,148.0,96.2,21.42,164.91,83
HCPCS,88271,APLFSH PROBE X2,148.0,96.2,21.42,164.91,83
HCPCS,88271,BCL2 BM PROBE X2,148.0,96.2,21.42,164.91,83
HCPCS,88271,BCL6 BLD PROBE X2,148.0,96.2,21.42,164.91,83
HCPCS,88271,BCRFSM BM PROBE X2,148.0,96.2,21.42,164.91,83
HCPCS,88271,CCND1F PROBE BLD X2,148.0,96.2,21.42,164.91,83
HCPCS,88271,CHROMOSOME FISH PRENATAL,148.0,96.2,21.42,164.91,83
HCPCS,88271,CLLFSM PROBE X7,148.0,96.2,21.42,164.91,83
HCPCS,88271,CRIGBP PROBE X4,148.0,96.2,21.42,164.91,83
HCPCS,88271,CRIGHB PROBE,148.0,96.2,21.42,164.91,83
HCPCS,88271,CRIGHM PROBE,148.0,96.2,21.42,164.91,83
HCPCS,88271,CRIGMP PROBE X4,148.0,96.2,21.42,164.91,83
HCPCS,88271,CRL2FB PROBE,148.0,96.2,21.42,164.91,83
HCPCS,88271,CRL2FB PROBE X2,148.0,96.2,21.42,164.91,83
HCPCS,88271,DDIT3 PROBE X2,148.0,96.2,21.42,164.91,83
HCPCS,88271,FABCBM BM PROBE X8,148.0,96.2,21.42,164.91,83
HCPCS,88271,FAMLPM BM PROBE,148.0,96.2,21.42,164.91,83
HCPCS,88271,FGFR1M BM PROBE X2,148.0,96.2,21.42,164.91,83
HCPCS,88271,FHT410 PROBE X2,148.0,96.2,21.42,164.91,83
HCPCS,88271,FISH 3Q26 BLD PROBE,148.0,96.2,21.42,164.91,83
HCPCS,88271,FISH 3Q36 BM PROBE,148.0,96.2,21.42,164.91,83
HCPCS,88271,FISH FOR BCR/ABL 1 PROBE X2,148.0,96.2,21.42,164.91,83
HCPCS,88271,FISH FOR FGFR1 PROBE X2,148.0,96.2,21.42,164.91,83
HCPCS,88271,FISH FOR PDGFRA PROBE X3,148.0,96.2,21.42,164.91,83
HCPCS,88271,FISH FOR PDGFRB PROBE X2,148.0,96.2,21.42,164.91,83
HCPCS,88271,FSBLLM BM PROBE X12,148.0,96.2,21.42,164.91,83
HCPCS,88271,FSMDSM BM PROBE X6,148.0,96.2,21.42,164.91,83
HCPCS,88271,FT410M BM PROBE X2,148.0,96.2,21.42,164.91,83
HCPCS,88271,"FUS (16P11.2), FISH",148.0,96.2,21.42,164.91,83
HCPCS,88271,HLA I TYPING COMPLETE HR,148.0,96.2,21.42,164.91,83
HCPCS,88271,"I(12P), GERM CELL TUMOR, FISH, TS",148.0,96.2,21.42,164.91,83
HCPCS,88271,IGH/BCL2 BLD PROBE X2,148.0,96.2,21.42,164.91,83
HCPCS,88271,IGH/CCND1 BLD PROBE X2,148.0,96.2,21.42,164.91,83
HCPCS,88271,IGH/MYC BM PROBE X2,148.0,96.2,21.42,164.91,83
HCPCS,88271,INV16M BM PROBE X2,148.0,96.2,21.42,164.91,83
HCPCS,88271,ISIGHT DNA PROBE,148.0,96.2,21.42,164.91,83
HCPCS,88271,"JAK2 (9P24.1), FISH",148.0,96.2,21.42,164.91,83
HCPCS,88271,MAML2 FISH DNA PROBES,148.0,96.2,21.42,164.91,83
HCPCS,88271,MLLFBM BM PROBE X2,148.0,96.2,21.42,164.91,83
HCPCS,88271,MOLECULAR CYTOGENETIC TEST,148.0,96.2,21.42,164.91,83
HCPCS,88271,MOLECULAR CYTOGENETICS DNA PROBE EACH,148.0,96.2,1.1,148.0,88
HCPCS,88271,MPNFSH BM PROBE X9,148.0,96.2,21.42,164.91,83
HCPCS,88271,MPNFSM BM PROBE X9,148.0,96.2,21.42,164.91,83
HCPCS,88271,MYC BM PROBE X2,148.0,96.2,21.42,164.91,83
HCPCS,88271,MYCFSH BLD PROBE X2,148.0,96.2,21.42,164.91,83
HCPCS,88271,MYCNFB DNA PROBE X2,148.0,96.2,21.42,164.91,83
HCPCS,88271,"NR4A3, REARRANGEMENT, FISH",148.0,96.2,21.42,164.91,83
HCPCS,88271,PDGFAM BM PROBE X2,148.0,96.2,21.42,164.91,83
HCPCS,88271,"PDGFB (22Q13), FISH, TS",148.0,96.2,21.42,164.91,83
HCPCS,88271,PDGFBM BM PROBE X2,148.0,96.2,21.42,164.91,83
HCPCS,88271,"PLASMA CELL PROLIFERATIVE DISORDER, FISH",148.0,96.2,21.42,164.91,83
HCPCS,88271,"PRKACA, REARRANGEMENT, FISH",148.0,96.2,21.42,164.91,83
HCPCS,88271,RARFSM BM PROBE X2,148.0,96.2,21.42,164.91,83
HCPCS,88271,SET 3 DNA PROBES MAYO (IF APPROPRIATE),148.0,96.2,21.42,164.91,332
HCPCS,88271,"SET 3 DNA PROBES MAYO (IF APPROPRIATE)-I(12P), GERM CELL TUMOR,",148.0,96.2,21.42,164.91,83
HCPCS,88271,"SET 3 DNA PROBES MAYO (IF APPROPRIATE)-JAK2 (9P24.1), FISH",148.0,96.2,21.42,164.91,83
HCPCS,88271,"SET 3 DNA PROBES MAYO (IF APPROPRIATE)-NR4A3, REARRANGEMENT, FIS",148.0,96.2,21.42,164.91,83
HCPCS,88271,"SET 3 DNA PROBES MAYO (IF APPROPRIATE)-PDGFB (22Q13), FISH, TS",148.0,96.2,21.42,164.91,83
HCPCS,88271,SET 3 DNA PROBES MAYO (IF APPROPRIATE)-PLASMA CELL PROLIFERATIVE,148.0,96.2,21.42,164.91,83
HCPCS,88271,"SET 3 DNA PROBES MAYO (IF APPROPRIATE)-PRKACA, REARRANGEMENT, FI",148.0,96.2,21.42,164.91,83
HCPCS,88271,SET 4 DNA PROBES MAYO (IF APPROPRIATE),148.0,96.2,21.42,164.91,332
HCPCS,88271,"SET 4 DNA PROBES MAYO (IF APPROPRIATE)-I(12P), GERM CELL TUMOR,",148.0,96.2,21.42,164.91,83
HCPCS,88271,"SET 4 DNA PROBES MAYO (IF APPROPRIATE)-JAK2 (9P24.1), FISH",148.0,96.2,21.42,164.91,83
HCPCS,88271,"SET 4 DNA PROBES MAYO (IF APPROPRIATE)-NR4A3, REARRANGEMENT, FIS",148.0,96.2,21.42,164.91,83
HCPCS,88271,"SET 4 DNA PROBES MAYO (IF APPROPRIATE)-PDGFB (22Q13), FISH, TS",148.0,96.2,21.42,164.91,83
HCPCS,88271,SET 4 DNA PROBES MAYO (IF APPROPRIATE)-PLASMA CELL PROLIFERATIVE,148.0,96.2,21.42,164.91,83
HCPCS,88271,"SET 4 DNA PROBES MAYO (IF APPROPRIATE)-PRKACA, REARRANGEMENT, FI",148.0,96.2,21.42,164.91,83
HCPCS,88271,SET 5 DNA PROBES MAYO (IF APPROPRIATE),148.0,96.2,21.42,164.91,332
HCPCS,88271,"SET 5 DNA PROBES MAYO (IF APPROPRIATE)-I(12P), GERM CELL TUMOR,",148.0,96.2,21.42,164.91,83
HCPCS,88271,"SET 5 DNA PROBES MAYO (IF APPROPRIATE)-JAK2 (9P24.1), FISH",148.0,96.2,21.42,164.91,83
HCPCS,88271,"SET 5 DNA PROBES MAYO (IF APPROPRIATE)-NR4A3, REARRANGEMENT, FIS",148.0,96.2,21.42,164.91,83
HCPCS,88271,"SET 5 DNA PROBES MAYO (IF APPROPRIATE)-PDGFB (22Q13), FISH, TS",148.0,96.2,21.42,164.91,83
HCPCS,88271,SET 5 DNA PROBES MAYO (IF APPROPRIATE)-PLASMA CELL PROLIFERATIVE,148.0,96.2,21.42,164.91,83
HCPCS,88271,"SET 5 DNA PROBES MAYO (IF APPROPRIATE)-PRKACA, REARRANGEMENT, FI",148.0,96.2,21.42,164.91,83
HCPCS,88271,T-CELL ALL FISH 10 PROBE SETS,148.0,96.2,21.42,164.91,83
HCPCS,88271,T-CELL ALL FISH ADDITIONAL PROBE SET,148.0,96.2,21.42,164.91,83
HCPCS,88271,"T-LYMPHOBLASTIC LEUKEMIA/LYMPHOMA, FISH",148.0,96.2,21.42,164.91,83
HCPCS,88271,YQHFSH DNA PROBE EA X2,148.0,96.2,21.42,164.91,83
HCPCS,88272,CYTOGENETICS 3-5,,,40.7,150.14,26
HCPCS,88272,"CYTOGENETICS, 3-5",281.0,182.65,1.1,281.0,88
HCPCS,88272,Cytogenetics 3-5,,,83.94,97.2,8
HCPCS,88273,%WMS CHROMO HYBRID,240.0,156.0,34.81,240.0,83
HCPCS,88273,MOLECULAR CYTOGENETICS CHRMOML ISH 10-30 CLL,240.0,156.0,1.1,240.0,88
HCPCS,88273,YQHFSH 10-30 CELLS,240.0,156.0,34.81,240.0,83
HCPCS,88274,%FSHPCM ANALY 25-99,292.0,189.8,42.38,292.0,83
HCPCS,88274,%PCMEXT ANALY 25-99,292.0,189.8,42.38,292.0,83
HCPCS,88274,FISH MAYO 25 TO 99 CELLS (IF APPROPRIATE),292.0,189.8,42.38,292.0,332
HCPCS,88274,"FISH MAYO 25 TO 99 CELLS (IF APPROPRIATE)-I(12P), GERM CELL TUMO",292.0,189.8,42.38,292.0,83
HCPCS,88274,"FISH MAYO 25 TO 99 CELLS (IF APPROPRIATE)-JAK2 (9P24.1), FISH",292.0,189.8,42.38,292.0,83
HCPCS,88274,"FISH MAYO 25 TO 99 CELLS (IF APPROPRIATE)-NR4A3, REARRANGEMENT,",292.0,189.8,42.38,292.0,83
HCPCS,88274,"FISH MAYO 25 TO 99 CELLS (IF APPROPRIATE)-PDGFB (22Q13), FISH, T",292.0,189.8,42.38,292.0,83
HCPCS,88274,FISH MAYO 25 TO 99 CELLS (IF APPROPRIATE)-PLASMA CELL PROLIFERAT,292.0,189.8,42.38,292.0,83
HCPCS,88274,"FISH MAYO 25 TO 99 CELLS (IF APPROPRIATE)-PRKACA, REARRANGEMENT,",292.0,189.8,42.38,292.0,83
HCPCS,88274,FISH MAYO LESS THAN 25 CELLS (IF APPROPRIATE),292.0,189.8,42.38,292.0,332
HCPCS,88274,"FISH MAYO LESS THAN 25 CELLS (IF APPROPRIATE)-I(12P), GERM CELL",292.0,189.8,42.38,292.0,83
HCPCS,88274,"FISH MAYO LESS THAN 25 CELLS (IF APPROPRIATE)-JAK2 (9P24.1), FIS",292.0,189.8,42.38,292.0,83
HCPCS,88274,"FISH MAYO LESS THAN 25 CELLS (IF APPROPRIATE)-NR4A3, REARRANGEME",292.0,189.8,42.38,292.0,83
HCPCS,88274,"FISH MAYO LESS THAN 25 CELLS (IF APPROPRIATE)-PDGFB (22Q13), FIS",292.0,189.8,42.38,292.0,83
HCPCS,88274,FISH MAYO LESS THAN 25 CELLS (IF APPROPRIATE)-PLASMA CELL PROLIF,292.0,189.8,42.38,292.0,83
HCPCS,88274,"FISH MAYO LESS THAN 25 CELLS (IF APPROPRIATE)-PRKACA, REARRANGEM",292.0,189.8,42.38,292.0,83
HCPCS,88274,INTER FISH ANALYSIS 25-99 CELLS,292.0,189.8,42.38,292.0,83
HCPCS,88274,ISIGHT CYTOGENETICS 25-99,292.0,189.8,42.38,292.0,166
HCPCS,88275,%1221FH HYBRIDIZAT,353.0,229.45,51.19,353.0,83
HCPCS,88275,%20Q8FH ANALY 100-300,353.0,229.45,51.19,353.0,83
HCPCS,88275,%5QFSH ANALY 100-300,353.0,229.45,51.19,353.0,83
HCPCS,88275,%814FSH ANALY 100-300,353.0,229.45,51.19,353.0,83
HCPCS,88275,%AMLFSH ANALY 100-300,353.0,229.45,51.19,353.0,83
HCPCS,88275,%APLFSH ANALY 100-300,353.0,229.45,51.19,353.0,83
HCPCS,88275,%BCL2FH ANALY 100-300,353.0,229.45,51.19,353.0,83
HCPCS,88275,%BCL6 BM 100-300,353.0,229.45,51.19,353.0,83
HCPCS,88275,%BCRFSH ANALY 100-300,353.0,229.45,51.19,353.0,83
HCPCS,88275,%BRAF MICRODISECT MAN,353.0,229.45,51.19,353.0,83
HCPCS,88275,%CCND1F ANALY 100-300,353.0,229.45,51.19,353.0,83
HCPCS,88275,%CLLFSH ANALY 100-300 X3,353.0,229.45,51.19,353.0,83
HCPCS,88275,%DGEORG IN SITU HYBRIDIZ,353.0,229.45,51.19,353.0,83
HCPCS,88275,%EGFRTI MICRODISECT,353.0,229.45,51.19,353.0,83
HCPCS,88275,%FABCFP ANALY 100-300 X4,353.0,229.45,51.19,353.0,83
HCPCS,88275,%FAMLPN ANALY 100-300,353.0,229.45,51.19,353.0,83
HCPCS,88275,%FGFR1F ANALY 100-300,353.0,229.45,51.19,353.0,83
HCPCS,88275,%FISH7Q ANALY 100-300,353.0,229.45,51.19,353.0,83
HCPCS,88275,%FSHBLL ANALY 100-300,353.0,229.45,51.19,353.0,83
HCPCS,88275,%FSHCON ANALY 100-300,353.0,229.45,51.19,353.0,83
HCPCS,88275,%FSHMDS ANALY 100-300 X3,353.0,229.45,51.19,353.0,83
HCPCS,88275,%FSHPCM ANALY 100-300,353.0,229.45,51.19,353.0,83
HCPCS,88275,%IGH/BCL2 BM 100-300,353.0,229.45,51.19,353.0,83
HCPCS,88275,%IGH/CCND1 BM 100-300,353.0,229.45,51.19,353.0,166
HCPCS,88275,%INV16F ANALY 100-300,353.0,229.45,51.19,353.0,83
HCPCS,88275,%ISIGHT MOL CY 100 - 300,353.0,229.45,51.19,353.0,83
HCPCS,88275,%MLLFSH ANALY 100-300,353.0,229.45,51.19,353.0,83
HCPCS,88275,%MYC(8Q24) BM 100-300,353.0,229.45,51.19,353.0,83
HCPCS,88275,%PCMEXT ANALY 100-300,353.0,229.45,51.19,353.0,83
HCPCS,88275,%PDGFRA ANALY 100-300,353.0,229.45,51.19,353.0,83
HCPCS,88275,%PDGFRB ANALY 100-300,353.0,229.45,51.19,353.0,83
HCPCS,88275,%RARFSH ANALY 100-300,353.0,229.45,51.19,353.0,83
HCPCS,88275,1221FM BM 100-300,353.0,229.45,51.19,353.0,83
HCPCS,88275,20Q8 BM 100-300,353.0,229.45,51.19,353.0,83
HCPCS,88275,5Q BM 100-300,353.0,229.45,51.19,353.0,83
HCPCS,88275,7Q BM 100-300,353.0,229.45,51.19,353.0,83
HCPCS,88275,AMLFBM BM 100-300,353.0,229.45,51.19,353.0,83
HCPCS,88275,APLFBM BM 100-300,353.0,229.45,51.19,353.0,83
HCPCS,88275,BCL2 BM 100-300,353.0,229.45,51.19,353.0,83
HCPCS,88275,BCL6 BLD 100-300,353.0,229.45,51.19,353.0,83
HCPCS,88275,BCRFSM BM 100-300,353.0,229.45,51.19,353.0,83
HCPCS,88275,CCND1F ANALY 100-300 BLD,353.0,229.45,51.19,353.0,83
HCPCS,88275,CHROMOSOME ANALYSIS AMNIOTIC FLUID,353.0,229.45,51.19,353.0,83
HCPCS,88275,CLLFSM ANALY 100-300 X3,353.0,229.45,51.19,353.0,83
HCPCS,88275,CRIGBP ANALY 100-300 X2,353.0,229.45,51.19,353.0,83
HCPCS,88275,CRIGHB ANALY 100-300,353.0,229.45,51.19,353.0,83
HCPCS,88275,CRIGHM ANALY 100-300,353.0,229.45,51.19,353.0,83
HCPCS,88275,CRIGMP ANALY 100-300 X2,353.0,229.45,51.19,353.0,83
HCPCS,88275,CRL2FB ANALY 100-300,353.0,229.45,51.19,353.0,83
HCPCS,88275,CRLF2M ANALY 100-300,353.0,229.45,51.19,353.0,83
HCPCS,88275,DDIT3 ANALY 100-300,353.0,229.45,51.19,353.0,83
HCPCS,88275,FABCBM BM 100-300 X4,353.0,229.45,51.19,353.0,83
HCPCS,88275,FAMLPM BM 100-300,353.0,229.45,51.19,353.0,83
HCPCS,88275,FGFR1M BM 100-300,353.0,229.45,51.19,353.0,83
HCPCS,88275,FHT410 100-300,353.0,229.45,51.19,353.0,83
HCPCS,88275,FISH 3Q26 BLD ANALYSIS,353.0,229.45,51.19,353.0,83
HCPCS,88275,FISH 3Q26 BM ANALYSIS,353.0,229.45,51.19,353.0,83
HCPCS,88275,FISH MAYO 100 OR MORE CELLS (IF APPROPRIATE),353.0,229.45,51.19,353.0,83
HCPCS,88275,"FISH MAYO 100 OR MORE CELLS (IF APPROPRIATE)-JAK2 (9P24.1), FISH",353.0,229.45,51.19,353.0,83
HCPCS,88275,"FISH MAYO 100 OR MORE CELLS (IF APPROPRIATE)-NR4A3, REARRANGEMEN",353.0,229.45,51.19,353.0,83
HCPCS,88275,FISH MAYO 100 OR MORE CELLS (IF APPROPRIATE)-PLASMA CELL PROLIFE,353.0,229.45,51.19,353.0,83
HCPCS,88275,"FISH MAYO 100 OR MORE CELLS (IF APPROPRIATE)-PRKACA, REARRANGEME",353.0,229.45,51.19,353.0,83
HCPCS,88275,FISH MAYO GREATER THAN 100 CELLS (IF APPROPRIATE),353.0,229.45,51.19,353.0,83
HCPCS,88275,FSBLLM BM 100-300,353.0,229.45,51.19,353.0,83
HCPCS,88275,FSMDSM BM 100-300 X3,353.0,229.45,51.19,353.0,83
HCPCS,88275,FT410M BM 100-300,353.0,229.45,51.19,353.0,83
HCPCS,88275,IGH/BCL2 BLD 100-300,353.0,229.45,51.19,353.0,83
HCPCS,88275,IGH/CCND1 BLD 100-300,353.0,229.45,51.19,353.0,83
HCPCS,88275,IGH/MYC BM 100-300,353.0,229.45,51.19,353.0,83
HCPCS,88275,INTERPHASE IN SITU HYBRIDIZATION,353.0,229.45,51.19,353.0,83
HCPCS,88275,INV16M BM 100-300,353.0,229.45,51.19,353.0,83
HCPCS,88275,MLLFBM BM 100-300,353.0,229.45,51.19,353.0,83
HCPCS,88275,MPNFSH BM 100-300 X4,353.0,229.45,51.19,353.0,83
HCPCS,88275,MPNFSM BM 100-300 X4,353.0,229.45,51.19,353.0,83
HCPCS,88275,MYCFSH BLD 100-300,353.0,229.45,51.19,353.0,83
HCPCS,88275,MYCNFB INSITU 100-300,353.0,229.45,51.19,353.0,83
HCPCS,88275,PDGFAM BM 100-300,353.0,229.45,51.19,353.0,83
HCPCS,88275,PDGFBM BM 100-300,353.0,229.45,51.19,353.0,83
HCPCS,88275,RARFSM BM 100-300,353.0,229.45,51.19,353.0,83
HCPCS,88275,T-CELL ALL FISH 100-300 CELLS ADDITIONAL PROBE SET,353.0,229.45,51.19,353.0,83
HCPCS,88275,TALLAF FISH 100-300 CELLS,353.0,229.45,51.19,353.0,83
HCPCS,88280,"CHROMOSOME ANAL, KAROTYPE EA",231.0,150.15,33.47,231.0,83
HCPCS,88280,CHROMOSOME ANALYSIS ADDITIONAL KARYOTYPE,231.0,150.15,33.47,231.0,83
HCPCS,88280,CVCYTO CHROMOSOME KARYOTYPE,231.0,150.15,33.47,231.0,83
HCPCS,88283,CHROMOSOME BANDING STUDY,,,68.6,253.05,26
HCPCS,88283,Chromosome banding study,,,83.94,97.2,8
HCPCS,88285,ADDITIONAL CELLS COUNTED,186.0,120.9,26.91,186.0,83
HCPCS,88285,CHROMO COUNT ADD,186.0,120.9,26.91,186.0,83
HCPCS,88285,CVCYTO CHROMOSOME COUNT ADDITIONAL,186.0,120.9,26.91,186.0,83
HCPCS,88285,FAMCYT CHROMOSOME COUNT ADDITIONAL,186.0,120.9,26.91,186.0,83
HCPCS,88289,CHRBLD CHROMO STDY ADD,238.0,154.7,34.43,238.0,83
HCPCS,88289,CHROMOSOME STUDY: ADDITIONAL,238.0,154.7,1.1,238.0,88
HCPCS,88289,CHROMS STUDY ADDTL,238.0,154.7,34.43,238.0,83
HCPCS,88291,CYTO/MOLECULAR REPORT,,,50.78,86.12,5
HCPCS,88291,CYTOGENETICS&MOLEC CYTOGENETICS INTERP&REP,229.0,148.85,1.1,229.0,130
HCPCS,88291,Cyto/molecular report,,,34.71,40.19,8
HCPCS,88299,UNLISTED CYTOGENETIC STUDY,,,47.01,141.47,23
HCPCS,88299,Unlisted cytogenetic study,,,83.94,97.2,8
HCPCS,88300,LEVEL I SURG PATHOLOGY GROSS EXAMINATION ONLY,35.0,22.75,1.1,85.71,256
HCPCS,88300,SURG PATH GROSS ONLY LVL I,169.0,109.85,21.57,169.0,86
HCPCS,88302,LEVEL II SURG PATHOLOGY GROSS&MICROSCOPIC EXAM,57.0,37.05,1.1,85.71,256
HCPCS,88302,SURG PATH GROSS MICRO LVL II,271.0,176.15,25.83,271.0,86
HCPCS,88304,LEVEL III SURG PATHOLOGY GROSS&MICROSCOPIC EXAM,97.0,63.05,1.1,159.17,256
HCPCS,88304,PATHOLOGY LEVEL 3 MOD,369.0,239.85,37.39,369.0,86
HCPCS,88304,SKIN MICRO LVL III,369.0,239.85,37.39,369.0,86
HCPCS,88304,SURG PATH GROSS MICRO LVL III,369.0,239.85,37.39,369.0,86
HCPCS,88305,EM THICK ONLY,369.0,239.85,37.39,369.0,86
HCPCS,88305,LEVEL IV SURG PATHOLOGY GROSS&MICROSCOPIC EXAM,330.0,214.5,1.1,330.0,256
HCPCS,88305,SKIN MICRO LEVEL 4,369.0,239.85,37.39,369.0,86
HCPCS,88305,SP BIOPSY PROSTATE,369.0,239.85,37.39,369.0,86
HCPCS,88305,SURGERY PATH GROSS MICRO LEVEL 4,369.0,239.85,37.39,369.0,86
HCPCS,88307,%AHTBX PATH LVL V,2482.0,1613.3,68.5,2482.0,86
HCPCS,88307,LEVEL V SURG PATHOLOGY GROSS&MICROSCOPIC EXAM,1531.5,995.475,1.1,2363.0,382
HCPCS,88307,TISSUE EXAM BY PATH LVL V,2482.0,1613.3,68.5,2482.0,86
HCPCS,88309,LEVEL VI SURG PATHOLOGY GROSS&MICROSCOPIC EXAM,1232.0,800.8,1.1,2506.96,256
HCPCS,88309,SURG PATH GROSS MICRO LVL VI MOD,5637.0,3664.05,68.5,5637.0,86
HCPCS,88309,TISSUE EXAM BY PATH LVL VI,5637.0,3664.05,68.5,5637.0,86
HCPCS,88311,DECALCIFICATION MOD,106.0,68.9,13.08,106.0,68
HCPCS,88311,DECALCIFICATION PROC,106.0,68.9,13.08,106.0,68
HCPCS,88311,DECALCIFICATION PROCEDURE,106.0,68.9,1.1,106.0,382
HCPCS,88312,E SPEC STAIN GP I TECH,207.0,134.55,37.39,207.0,86
HCPCS,88312,SPEC STN GRP I,207.0,134.55,37.39,207.0,86
HCPCS,88312,SPECIAL STAIN GROUP 1,207.0,134.55,37.39,207.0,86
HCPCS,88312,SPECIAL STAIN GROUP 1 MICROORGANISMS I&R,238.0,154.7,1.1,279.35,382
HCPCS,88312,"SPECIAL STAIN GRP I EA, SEMEN",207.0,134.55,37.39,207.0,86
HCPCS,88313,"*SPEC STN GRP II, REV TO 312",126.0,81.9,35.63,138.46,86
HCPCS,88313,E SPEC STAIN GRP II TECH,126.0,81.9,35.63,138.46,86
HCPCS,88313,O/S PATHOL/HYSTOL,126.0,81.9,35.63,138.46,86
HCPCS,88313,SPCL STN 2 I&R EXCPT MICROORG/ENZYME/IMCYT,116.0,75.4,1.1,206.12,382
HCPCS,88313,SPEC STN GRP II,126.0,81.9,35.63,138.46,344
HCPCS,88313,"SPECIAL STAIN GRP II EA, SEMEN",126.0,81.9,35.63,138.46,86
HCPCS,88314,SPECIAL STAIN I&R HISTOCHEMICAL W/FROZEN TISSU,198.0,128.7,1.1,208.67,256
HCPCS,88314,SPECIAL STAIN ON FS,184.0,119.6,37.39,184.0,68
HCPCS,88318,CHEMICAL HISTOCHEMISTRY,,,113.97,113.97,1
HCPCS,88319,HISTOCHEMISTRY FOR ENZYME,5637.0,3664.05,68.5,5637.0,86
HCPCS,88319,SPECIAL STAIN I&R GROUP III ENZYME CONSITUENTS,2935.0,1907.75,1.1,5637.0,382
HCPCS,88321,CONSLTJ&REPRT SLIDES PREPARED ELSEWHERE,717.0,466.05,1.1,717.0,204
HCPCS,88321,CONSULT SLIDE PREP ELSEWHERE,271.0,176.15,34.71,271.0,86
HCPCS,88321,EPATH CONSULT 1-7 SLIDES,271.0,176.15,34.71,271.0,86
HCPCS,88321,EPATH CONSULT 8+ SLIDES,271.0,176.15,34.71,271.0,86
HCPCS,88321,EPATH MICROSLIDE CONSULT 1-7,290.0,188.5,1.1,290.0,134
HCPCS,88321,EPATH MICROSLIDE CONSULT 8+,315.0,204.75,1.1,315.0,134
HCPCS,88321,OCPATH MICROSLIDE CONSULT,212.0,137.8,1.1,264.79,134
HCPCS,88321,PATHOUT MICROSLIDE CONSULT,212.0,137.8,1.1,264.79,134
HCPCS,88323,CONSLTJ&REPRT MATERIAL REQUIRING PREPJ SLIDES,805.0,523.25,1.1,805.0,256
HCPCS,88323,CONSULT SLIDE W PREP,369.0,239.85,34.71,369.0,86
HCPCS,88325,CONSLTJ COMPRE REVIEW REPRT REFERRED MATRL,1254.0,815.1,1.1,1254.0,134
HCPCS,88325,CONSULT COMPRE DATA REVIEW,1182.0,768.3,34.71,1182.0,86
HCPCS,88329,OR CONSULTATION,410.0,266.5,34.71,410.0,86
HCPCS,88329,PATHOLOGY CONSULTATION DURING SURGERY,295.0,191.75,1.1,295.0,134
HCPCS,88331,PATH CONSLTJ SURG 1ST BLK FROZEN SCTJ 1 SPEC,524.0,340.6,1.1,524.0,256
HCPCS,88331,PATH CONSULT OR 1ST BLOCK,1182.0,768.3,34.71,1182.0,86
HCPCS,88332,PATH CONSLTJ SURG EA ADDL BLK FROZEN SECTION,260.0,169.0,1.1,260.0,256
HCPCS,88332,PATH CONSULT OR ADD TIS BLOCK,183.0,118.95,34.71,183.0,68
HCPCS,88333,PATH CONSLTJ SURG CYTOLOGIC EXAM INITIAL SITE,528.0,343.2,1.1,2506.96,256
HCPCS,88333,PATH TOUCH PREP INIT,5637.0,3664.05,34.71,5637.0,86
HCPCS,88334,PATH CONSLTJ SURG CYTOLOGIC EXAM ADDL SITE,321.0,208.65,1.1,321.0,256
HCPCS,88334,PATH TOUCH PREP EA ADD,183.0,118.95,28.79,183.0,68
HCPCS,88341,EIHC EACH ADD AB/BLK,247.0,160.55,37.39,247.0,68
HCPCS,88341,IHC /SPC EA ADD AB STN,247.0,160.55,37.39,247.0,68
HCPCS,88341,IHC ADDTL AB PER SLIDE,247.0,160.55,37.39,247.0,68
HCPCS,88341,IHC EA ADDTL AB/BLOCK,247.0,160.55,37.39,247.0,68
HCPCS,88341,IMHISTOCHEM/CYTCHM EA ADDL ANTIBODY SLIDE,246.0,159.9,1.1,246.0,256
HCPCS,88341,IMMUNO H/C EA ADDTL AB STAIN,247.0,160.55,37.39,247.0,68
HCPCS,88342,%MLYFSH FISH IHC FOR IGH,1182.0,768.3,68.5,1182.0,86
HCPCS,88342,%REFMYL IHC REFLEX MY X2,1182.0,768.3,68.5,1182.0,172
HCPCS,88342,EIMMUNOCYTOCHEM TC,1182.0,768.3,68.5,1182.0,86
HCPCS,88342,IMHISTOCHEM/CYTCHM 1ST ANTIBODY STAIN PROCEDURE,745.0,484.25,1.1,1182.0,382
HCPCS,88342,IMMUNOHISTOCHEM EA AB,1182.0,768.3,68.5,1182.0,172
HCPCS,88344,IHC EA MULTIPLEX AB,2482.0,1613.3,68.5,2482.0,86
HCPCS,88344,IMHISTOCHEM/CYTCHM EA MULTIPLEX ANTIBODY SLIDE,339.0,220.35,1.1,1046.86,256
HCPCS,88346,%CROHN IFA FIRST,1182.0,768.3,68.5,1182.0,172
HCPCS,88346,%IBDSGI IFA FIRST,1182.0,768.3,68.5,1182.0,86
HCPCS,88346,%OVARAN AB FIRST,1182.0,768.3,68.5,1182.0,86
HCPCS,88346,%PEMGUS IFL FIRST,1182.0,768.3,68.5,1182.0,172
HCPCS,88346,*IMMUNOFLUOR ANTB 1ST STAIN,1182.0,768.3,68.5,1182.0,86
HCPCS,88346,CIFAB AB IGG FIRST,1182.0,768.3,68.5,1182.0,86
HCPCS,88346,DIRECT IMMUNOFLUOR-EACH,1182.0,768.3,68.5,1182.0,86
HCPCS,88346,IMMUNOFL INITIAL MOD PC,1182.0,768.3,68.5,1182.0,86
HCPCS,88346,IMMUNOFLUOR ANTB 1ST STAIN,1182.0,768.3,68.5,1182.0,86
HCPCS,88346,IMMUNOFLUORESCENCE PER SPEC 1ST SINGL ANTB STAIN,754.0,490.09999999999997,1.1,1182.0,382
HCPCS,88347,IMMUNOFLUORESCENT STUDY,,,198.6,198.6,1
HCPCS,88348,%AHTBX ELEC MICR,5637.0,3664.05,68.5,5637.0,86
HCPCS,88348,CILIARY MOTILITY - EM DIAG,5637.0,3664.05,68.5,5637.0,86
HCPCS,88348,ELECTRON MICRO DX,5637.0,3664.05,68.5,5637.0,86
HCPCS,88348,ELECTRON MICROSCOPY,664.0,431.6,1.1,2506.96,256
HCPCS,88348,ELECTRON MICROSCPY MOD,5637.0,3664.05,68.5,5637.0,86
HCPCS,88348,PLTEMS ELECTRON MICROSCOPY,5637.0,3664.05,68.5,5637.0,86
HCPCS,88349,SCANNING ELECTRON MICROSCOPY,,,446.27,446.27,1
HCPCS,88350,%CROHN IFA ADDTL,249.0,161.85,1.73,249.0,68
HCPCS,88350,%ENTERO AB ADDTL X2,249.0,161.85,1.73,249.0,68
HCPCS,88350,%IBDSGI IFA ADDTL,249.0,161.85,1.73,249.0,68
HCPCS,88350,%PEMGUS IFL ADDTL,249.0,161.85,1.73,249.0,136
HCPCS,88350,CIFAB AB IGG ADDTL,249.0,161.85,1.73,249.0,68
HCPCS,88350,IMFLUOR EA ADDL 1ANTB STN PX,,,2.45,16.06,4
HCPCS,88350,IMMUNOFLUOR ADDTL,249.0,161.85,1.73,249.0,68
HCPCS,88350,IMMUNOFLUOR MOD ADDTL,249.0,161.85,1.73,249.0,68
HCPCS,88350,IMMUNOFLUORESCENCE PER SPEC ADD SINGL ANTB STAIN,260.0,169.0,1.1,260.0,126
HCPCS,8835026,IMFLUOR EA ADDL 1ANTB STN PX,,,16.06,16.06,2
HCPCS,88350TC,IMFLUOR EA ADDL 1ANTB STN PX,,,2.45,2.45,2
HCPCS,88355,M/PHMTRC ALYS SKELETAL MUSC,,,148.18,445.91,24
HCPCS,88355,M/phmtrc alys skeletal musc,,,68.5,79.31,8
HCPCS,88356,ANALYSIS NERVE,,,47.01,462.03,24
HCPCS,88356,Analysis nerve,,,37.39,43.3,8
HCPCS,88358,ANALYSIS TUMOR,,,148.18,445.91,24
HCPCS,88358,Analysis tumor,,,68.5,79.31,8
HCPCS,88360,"E IHC QUANTITATIVE, TC",1182.0,768.3,68.5,1182.0,86
HCPCS,88360,IMMUNOHISTOCHEM QT,1182.0,768.3,68.5,1182.0,86
HCPCS,88360,M/PHMTRC ALYS TUMOR IMHCHEM EA ANTIBODY MANUAL,778.0,505.7,1.1,1182.0,382
HCPCS,88360,"PD-L1 (28-8), SEMIQUANT IHC, MANUAL",1182.0,768.3,68.5,1182.0,86
HCPCS,88360,"PD-L1 (SP142) SEMIQUANT IHC, MANUAL",1182.0,768.3,68.5,1182.0,86
HCPCS,88360,"PD-L1 (SP263) SEMIQUANT IHC, MANUAL",1182.0,768.3,68.5,1182.0,86
HCPCS,88360,PD-L1 22C3 IHC WITH TPS,1182.0,768.3,68.5,1182.0,86
HCPCS,88361,TUMOR IMMUNOHISTOCHEM/COMPUT,,,126.24,938.4,25
HCPCS,88361,Tumor immunohistochem/comput,,,68.5,79.31,8
HCPCS,88362,NERVE TEASING PREPARATIONS,955.0,620.75,1.1,2506.96,154
HCPCS,88362,Nerve teasing preparations,,,68.5,79.31,8
HCPCS,88363,EXAM & SELECT ARCHIVE TISSUE MOLECULAR ANALYSIS,163.0,105.95,1.1,163.0,134
HCPCS,88363,XM ARCHIVE TISSUE MOLEC ANAL,,,22.7,77.73,23
HCPCS,88363,Xm archive tissue molec anal,,,45.47,52.65,8
HCPCS,88364,CISH ADDTL,935.0,607.75,37.39,935.0,68
HCPCS,88364,CISH ADDTL PROBE MOD,935.0,607.75,37.39,935.0,68
HCPCS,88364,CISH HPV LOW RISK ADTL,935.0,607.75,37.39,935.0,68
HCPCS,88364,IN SITU HYBRIDIZATION EA ADDL PROBE STAIN,621.5,403.975,1.1,935.0,382
HCPCS,88365,CISH EA PROBE,673.0,437.45,68.5,673.0,86
HCPCS,88365,CISH EA PROBE MOD,673.0,437.45,68.5,673.0,86
HCPCS,88365,CISH EACH PROBE,673.0,437.45,68.5,673.0,172
HCPCS,88365,CISH FOR EPSTEIN BARR,673.0,437.45,68.5,673.0,86
HCPCS,88365,CISH HPV HR TC/CISH HPV HR + LR TC X2/CISH HPV LR TC/CISH EBER T,673.0,437.45,68.5,673.0,86
HCPCS,88365,CISH KAPPA,673.0,437.45,68.5,673.0,86
HCPCS,88365,CISH LAMDA,673.0,437.45,68.5,673.0,86
HCPCS,88365,EIHC ISH TECH ONLY,673.0,437.45,68.5,673.0,86
HCPCS,88365,FISH FOR C-MYC (8Q24),673.0,437.45,68.5,673.0,86
HCPCS,88365,IN SITU HYBRIDIZATION 1ST PROBE STAIN,530.0,344.5,1.1,673.0,382
HCPCS,88365,INSITU HYBRID EA PROBE,673.0,437.45,68.5,673.0,344
HCPCS,88365,INSITU HYBRIDIZATION (FISH),673.0,437.45,68.5,673.0,86
HCPCS,88366,FISH FOR BK VIRUS,1182.0,768.3,68.5,1182.0,86
HCPCS,88366,IN SITU HYBRIDIZATION EA MULTIPLEX PROBE STAIN,546.0,354.9,1.1,546.0,126
HCPCS,88366,INSITU HYBRIDIZATION DUAL,1182.0,768.3,68.5,1182.0,86
HCPCS,88366,"RET GENE REARRANGEMENTS, FISH",1182.0,768.3,68.5,1182.0,86
HCPCS,88366,"SEND OUT ALK GENE REARRANGEMENTS BY FISH, LUNG",1182.0,768.3,68.5,1182.0,86
HCPCS,88366,SEND OUT ROS1 BY FISH,1182.0,768.3,68.5,1182.0,86
HCPCS,88367,FISH FOR 5Q BIOVIEW X2,2482.0,1613.3,68.5,2482.0,86
HCPCS,88367,FISH PLASMA CELL PROBE,2482.0,1613.3,68.5,2482.0,86
HCPCS,88368,%MLYFSH FISH IGH BA X2,2482.0,1613.3,68.5,2482.0,86
HCPCS,88368,%REFMYL FISH REFLX,2482.0,1613.3,68.5,2482.0,86
HCPCS,88368,FGFR1 TISSUE X2,2482.0,1613.3,68.5,2482.0,86
HCPCS,88368,FISH ALK NSCLC X2,2482.0,1613.3,68.5,2482.0,86
HCPCS,88368,FISH FOR BIRC3/MALT1,2482.0,1613.3,68.5,2482.0,86
HCPCS,88368,FISH FOR CLL X5,2482.0,1613.3,68.5,2482.0,86
HCPCS,88368,FISH MORP EA PRBE MOD,2482.0,1613.3,68.5,2482.0,86
HCPCS,88368,FISH MYELODYSP MANUAL X6,2482.0,1613.3,68.5,2482.0,86
HCPCS,88368,FISH T(11;14)MCL X2,2482.0,1613.3,68.5,2482.0,86
HCPCS,88368,FISH T(14;18) FCL,2482.0,1613.3,68.5,2482.0,86
HCPCS,88368,INSITU HYBRID EA PROBE MAN,2482.0,1613.3,68.5,2482.0,86
HCPCS,88368,M/PHMTRC ALYS IN SITU HYBRIDIZATION EA PROBE MNL,1434.5,932.425,1.1,2482.0,382
HCPCS,88368,QFEVER ABS IGG PH1 RFLX,2482.0,1613.3,68.5,2482.0,86
HCPCS,88368,QFEVER ABS IGG PH2 RFLX,2482.0,1613.3,68.5,2482.0,86
HCPCS,88368,QFEVER ABS IGM PH1 RFLX,2482.0,1613.3,68.5,2482.0,86
HCPCS,88368,QFEVER ABS IGM PH2 RFLX,2482.0,1613.3,68.5,2482.0,86
HCPCS,88369,M/PHMTRC ALYSISHQUANT/SEMIQ,,,128.76,193.14,2
HCPCS,88369,M/phmtrc alysishquant/semiq,,,37.39,43.3,8
HCPCS,88371,DYSTROPHIN,153.0,99.45,33.35,170.55,66
HCPCS,88371,GBM AB/ANTI GBM,153.0,99.45,1.1,153.0,92
HCPCS,88372,PROTEIN ANALYSIS W/PROBE,,,39.33,59.0,6
HCPCS,88372,Protein analysis w/probe,,,45.47,52.65,8
HCPCS,88373,M/PHMTRC ALYS ISHQUANT/SEMIQ,,,70.67,106.01,2
HCPCS,88373,M/phmtrc alys ishquant/semiq,,,37.39,43.3,8
HCPCS,88374,M/PHMTRC ALYS ISHQUANT/SEMIQ,1182.0,768.3,68.5,1182.0,86
HCPCS,88375,OPTICAL ENDOMICROSCPY INTERP,,,73.8,122.23,3
HCPCS,88375,Optical endomicroscpy interp,,,34.71,40.19,8
HCPCS,88377,1P19Q FISH FOR 1P/19Q,1182.0,768.3,68.5,1182.0,86
HCPCS,88377,"2 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-B-CELL LYMPHOMA, F",1182.0,768.3,68.5,1182.0,86
HCPCS,88377,"2 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-SLL, FISH",1182.0,768.3,68.5,1182.0,86
HCPCS,88377,"2 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-T-CELL LYMPHOMA, F",1182.0,768.3,68.5,1182.0,86
HCPCS,88377,"3 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-B-CELL LYMPHOMA, F",1182.0,768.3,68.5,1182.0,86
HCPCS,88377,"3 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-SLL, FISH",1182.0,768.3,68.5,1182.0,86
HCPCS,88377,"3 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-T-CELL LYMPHOMA, F",1182.0,768.3,68.5,1182.0,86
HCPCS,88377,"4 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-B-CELL LYMPHOMA, F",1182.0,768.3,68.5,1182.0,86
HCPCS,88377,"4 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-SLL, FISH",1182.0,768.3,68.5,1182.0,86
HCPCS,88377,"4 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-T-CELL LYMPHOMA, F",1182.0,768.3,68.5,1182.0,86
HCPCS,88377,"5 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-B-CELL LYMPHOMA, F",1182.0,768.3,68.5,1182.0,86
HCPCS,88377,"5 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-SLL, FISH",1182.0,768.3,68.5,1182.0,86
HCPCS,88377,"5 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-T-CELL LYMPHOMA, F",1182.0,768.3,68.5,1182.0,86
HCPCS,88377,"6 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-B-CELL LYMPHOMA, F",1182.0,768.3,68.5,1182.0,86
HCPCS,88377,"6 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-SLL, FISH",1182.0,768.3,68.5,1182.0,86
HCPCS,88377,"6 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-T-CELL LYMPHOMA, F",1182.0,768.3,68.5,1182.0,86
HCPCS,88377,"7 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-SLL, FISH",1182.0,768.3,68.5,1182.0,86
HCPCS,88377,"7 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-T-CELL LYMPHOMA, F",1182.0,768.3,68.5,1182.0,86
HCPCS,88377,"8 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-SLL, FISH",1182.0,768.3,68.5,1182.0,86
HCPCS,88377,"8 ADDITIONAL PROBE SETS MAYO (IF APPROPRIATE)-T-CELL LYMPHOMA, F",1182.0,768.3,68.5,1182.0,86
HCPCS,88377,"ADDITIONAL PROBE SET MAYO (IF APPROPRIATE)-B-CELL LYMPHOMA, FISH",1182.0,768.3,68.5,1182.0,86
HCPCS,88377,"ADDITIONAL PROBE SET MAYO (IF APPROPRIATE)-SLL, FISH",1182.0,768.3,68.5,1182.0,86
HCPCS,88377,"ADDITIONAL PROBE SET MAYO (IF APPROPRIATE)-T-CELL LYMPHOMA, FISH",1182.0,768.3,68.5,1182.0,86
HCPCS,88377,ALK FISH LUNG NSCLC,1182.0,768.3,68.5,1182.0,86
HCPCS,88377,"B-CELL LYMPHOMA, FISH, TISSUE",1182.0,768.3,68.5,1182.0,86
HCPCS,88377,BILIARY TRACT FISH,1182.0,768.3,68.5,1182.0,86
HCPCS,88377,BTM FISH REFLEX 1,1182.0,768.3,68.5,1182.0,86
HCPCS,88377,BTM FISH REFLEX 2,1182.0,768.3,68.5,1182.0,86
HCPCS,88377,BTM FISH REFLEX 3,1182.0,768.3,68.5,1182.0,86
HCPCS,88377,BTM FISH REFLEX 4,1182.0,768.3,68.5,1182.0,86
HCPCS,88377,BTM FISH REFLEX 5,1182.0,768.3,68.5,1182.0,86
HCPCS,88377,BTM FISH REFLEX 6,1182.0,768.3,68.5,1182.0,86
HCPCS,88377,ERBB2 GENE AMP GASTRIC TIS,1182.0,768.3,68.5,1182.0,86
HCPCS,88377,FISH ALK NSCLC,1182.0,768.3,68.5,1182.0,86
HCPCS,88377,FISH C-MYC (8Q24) PRFN,1182.0,768.3,68.5,1182.0,86
HCPCS,88377,FISH CCND1F PARAFFIN,1182.0,768.3,68.5,1182.0,86
HCPCS,88377,FISH CUTANE MELANOMA,1182.0,768.3,68.5,1182.0,172
HCPCS,88377,FISH EA MULTIPLEX PROBE STAIN PROC,1182.0,768.3,68.5,1182.0,86
HCPCS,88377,FISH EWSR1 (22Q12),1182.0,768.3,68.5,1182.0,86
HCPCS,88377,FISH FOR 19Q,1182.0,768.3,68.5,1182.0,86
HCPCS,88377,FISH FOR 1P36,1182.0,768.3,68.5,1182.0,86
HCPCS,88377,FISH FOR AGG B CL LYM,1182.0,768.3,68.5,1182.0,86
HCPCS,88377,FISH FOR ALK CYTO BLOCK,1182.0,768.3,68.5,1182.0,86
HCPCS,88377,FISH FOR ALK TRANS,1182.0,768.3,68.5,1182.0,86
HCPCS,88377,FISH FOR ANGIO MYC AMP,1182.0,768.3,68.5,1182.0,86
HCPCS,88377,FISH FOR BCL2,1182.0,768.3,68.5,1182.0,86
HCPCS,88377,FISH FOR BIRC3/MALT1,1182.0,768.3,68.5,1182.0,86
HCPCS,88377,FISH FOR CHOP GENE,1182.0,768.3,68.5,1182.0,86
HCPCS,88377,FISH FOR DUSP22-IRF4 TISS,1182.0,768.3,68.5,1182.0,86
HCPCS,88377,FISH FOR EGFR,1182.0,768.3,68.5,1182.0,86
HCPCS,88377,FISH FOR FKHR GENE,1182.0,768.3,68.5,1182.0,86
HCPCS,88377,FISH FOR FUS GENE,1182.0,768.3,68.5,1182.0,86
HCPCS,88377,FISH FOR IGH/BCL2 TIS X2,1182.0,768.3,68.5,1182.0,86
HCPCS,88377,FISH FOR IGH/CCND1 TIS X2,1182.0,768.3,68.5,1182.0,86
HCPCS,88377,FISH FOR IGH/MYC/CEP8 TISSUE,1182.0,768.3,68.5,1182.0,86
HCPCS,88377,FISH FOR IGHFSH,1182.0,768.3,68.5,1182.0,86
HCPCS,88377,FISH FOR MALT 1 18Q21,1182.0,768.3,68.5,1182.0,86
HCPCS,88377,FISH FOR MDM2,1182.0,768.3,68.5,1182.0,86
HCPCS,88377,FISH FOR RET CYTO BLOCK,1182.0,768.3,68.5,1182.0,86
HCPCS,88377,FISH FOR RET PRFN,1182.0,768.3,68.5,1182.0,86
HCPCS,88377,FISH FOR ROS1 CYTO BLOCK,1182.0,768.3,68.5,1182.0,86
HCPCS,88377,FISH FOR ROS1 PRFN,1182.0,768.3,68.5,1182.0,86
HCPCS,88377,FISH FOR TP63 TISSUE,1182.0,768.3,68.5,1182.0,86
HCPCS,88377,FISH FOR WWTR1/CAMTA1,1182.0,768.3,68.5,1182.0,86
HCPCS,88377,FISH HER-2,1182.0,768.3,68.5,1182.0,86
HCPCS,88377,FISH MORPHOMETRIC ANALYSIS,1182.0,768.3,68.5,1182.0,86
HCPCS,88377,FISH RENAL CELL CARCINOMA PNL,1182.0,768.3,68.5,1182.0,86
HCPCS,88377,FISH RENAL CELL CARCINOMA TFE3,1182.0,768.3,68.5,1182.0,86
HCPCS,88377,FISH RENAL CELL CARCINOMA TFEB,1182.0,768.3,68.5,1182.0,86
HCPCS,88377,FISH SYT GENE(18Q11),1182.0,768.3,68.5,1182.0,86
HCPCS,88377,FISH T(8;14)(Q24;Q32),1182.0,768.3,68.5,1182.0,86
HCPCS,88377,FISH TP63 DUSP22 PANEL,1182.0,768.3,68.5,1182.0,86
HCPCS,88377,"HER2 AMPLIFICATION, MISCELLANEOUS TUMOR, FISH",1182.0,768.3,68.5,1182.0,86
HCPCS,88377,"ISH, QUANT/SEMI QUANT, MULTIPLEX PROBE STAIN",1182.0,768.3,68.5,1182.0,86
HCPCS,88377,M/PHMTRC ALYS ISH QUANT/SEMIQ MNL EACH MULTIPRB,899.0,584.3499999999999,1.1,1182.0,382
HCPCS,88377,"MDM2, FISH",1182.0,768.3,68.5,1182.0,86
HCPCS,88377,"MORPHOMETRIC ANALYSIS, IN SITU HYBRID (HER2FGAST)",1182.0,768.3,68.5,1182.0,86
HCPCS,88377,"MYCN (N-MYC), FISH",1182.0,768.3,68.5,1182.0,86
HCPCS,88377,REFLEX FISH HER2/D17,1182.0,768.3,68.5,1182.0,172
HCPCS,88377,"SLL, FISH",1182.0,768.3,68.5,1182.0,86
HCPCS,88377,"T-CELL LYMPHOMA, FISH",1182.0,768.3,68.5,1182.0,86
HCPCS,88380,ATMS MICRODISECTION,519.0,337.35,68.5,519.0,68
HCPCS,88381,%IDH12F MICRODISECT TECH,519.0,337.35,37.39,519.0,68
HCPCS,88381,%MSI3 MICRO DELETION X3,519.0,337.35,37.39,519.0,68
HCPCS,88381,%NRAST MICRODISSECT,519.0,337.35,37.39,519.0,68
HCPCS,88381,*MICRODISECTION MANUAL,519.0,337.35,37.39,519.0,68
HCPCS,88381,MICRODISSECTION PREP IDENTIFIED TARGET MANUAL,233.0,151.45,1.1,478.66,256
HCPCS,88384,EVAL MOLECULAR PROBES 11-50,,,141.45,141.45,1
HCPCS,88385,EVAL MOLECUL PROBES 51-250,,,623.85,623.85,1
HCPCS,88386,EVAL MOLECUL PROBES 251-500,,,854.51,854.51,1
HCPCS,88387,%TBPPCR MACROSE EXAM,49.0,31.85,10.68,65.09,68
HCPCS,88387,MACRO EXAM DISSECT&PREP TISS NONMICRO STD EA,273.0,177.45,1.1,273.0,126
HCPCS,88388,TISS EX MOLECUL STUDY ADD-ON,,,39.28,39.28,1
HCPCS,88388,Tiss ex molecul study add-on,,,34.71,40.19,8
HCPCS,88399,EM PROCESSING AND HOLD,335.0,217.75,45.47,335.0,84
HCPCS,88399,H&E UNSTAINED SLIDES,335.0,217.75,45.47,335.0,84
HCPCS,88399,PARATHYROID GLAND CRYOPRESERVA,335.0,217.75,45.47,335.0,84
HCPCS,88720,BILIRUBIN TOTAL TRANSCUT (POINT OF CARE LAB),35.0,22.75,2.84,35.0,83
HCPCS,88720,BILIRUBIN TOTAL TRANSCUTANEOUS,35.0,22.75,1.1,35.0,88
HCPCS,88738,HGB QUANT TRANSCUTANEOUS,35.0,22.75,1.1,35.0,116
HCPCS,88738,Hgb quant transcutaneous,,,8.48,9.82,8
HCPCS,88740,TRANSCUTANEOUS CARBOXYHB,,,3.75,34.57,28
HCPCS,88740,Transcutaneous carboxyhb,,,8.48,9.82,8
HCPCS,88741,TRANSCUTANEOUS METHB,,,3.75,34.57,28
HCPCS,88741,Transcutaneous methb,,,8.48,9.82,8
HCPCS,88749,UNLISTED IN VIVO LAB SERVICE,,,2466002.74,2466002.74,1
HCPCS,88749,Unlisted in vivo lab service,,,8.96,10.37,8
HCPCS,89049,CHCT FOR MAL HYPERTHERMIA,,,99.22,445.91,26
HCPCS,89049,Chct for mal hyperthermia,,,60.74,70.33,8
HCPCS,89050,BODY FLUID CELL COUNT,,,2.33,21.9,29
HCPCS,89050,Body fluid cell count,,,8.96,10.37,8
HCPCS,89051,CELL COUNT & DIFF,39.0,25.35,2.72,42.4,83
HCPCS,89051,CELL COUNT FLUID DIFF COUNT,39.0,25.35,2.72,42.4,83
HCPCS,89051,CELL COUNT MISC BODY FLUIDS W/DIFFERENTIAL COUNT,39.0,25.35,1.1,39.0,158
HCPCS,89055,FECAL LEUKOCYTES,29.0,18.85,2.11,32.88,83
HCPCS,89060,CRYSTAL ID LIGHT MICROSCOPY ALYS TISS/ANY FLUID,163.0,105.95,1.1,163.0,218
HCPCS,89060,EXAM SYNOVIAL FLUID CRYSTALS,51.0,33.15,3.53,51.0,168
HCPCS,8906026,EXAM SYNOVIAL FLUID CRYSTALS,,,7.49,7.49,2
HCPCS,89100,SAMPLE INTESTINAL CONTENTS,,,42.37,42.37,1
HCPCS,89105,SAMPLE INTESTINAL CONTENTS,,,36.58,36.58,1
HCPCS,89125,FAT STAIN FECES URINE/RESPIR SECRETIONS,41.0,26.65,1.1,41.0,88
HCPCS,89125,FATS URINE,41.0,26.65,2.35,41.0,83
HCPCS,89130,SAMPLE STOMACH CONTENTS,213.0,138.45,1.1,213.0,71
HCPCS,89132,SAMPLE STOMACH CONTENTS,,,14.61,14.61,1
HCPCS,89135,SAMPLE STOMACH CONTENTS,,,51.64,51.64,1
HCPCS,89136,SAMPLE STOMACH CONTENTS,,,13.43,13.43,1
HCPCS,89140,SAMPLE STOMACH CONTENTS,,,76.48,76.48,1
HCPCS,89141,SAMPLE STOMACH CONTENTS,,,75.38,75.38,1
HCPCS,89160,EXAM FECES FOR MEAT FIBERS,,,1.94,13.29,28
HCPCS,89160,Exam feces for meat fibers,,,8.96,10.37,8
HCPCS,89190,EOSINOPHIL SMEAR MISC,40.0,26.0,2.34,40.0,83
HCPCS,89190,NASAL SMEAR EOSINOPHILS,40.0,26.0,1.1,40.0,88
HCPCS,89220,COLL SPUTUM AEROSOL,1182.0,768.3,6.62,1182.0,86
HCPCS,89220,SPUTUM COLLECTION,1182.0,768.3,6.62,1182.0,86
HCPCS,89225,"STARCH GRANULES, FECES",,,6.0,6.0,1
HCPCS,89230,SWEAT COLLECTION IONTOPHO,369.0,239.85,1.44,369.0,86
HCPCS,89230,SWEAT COLLECTION IONTOPHORESIS,154.0,100.1,1.1,159.17,130
HCPCS,89235,WATER LOAD TEST,,,21.2,21.2,1
HCPCS,89240,CRYOPS WITHDRAW,369.0,239.85,45.47,369.0,84
HCPCS,89250,CULT OOCYTE/EMBRYO<4DAY,5150.0,3347.5,24.85,5150.0,84
HCPCS,89251,CULTR OOCYTE/EMBRYO <4 DAYS,,,148.18,9188.2,26
HCPCS,89251,Cultr oocyte/embryo <4 days,,,24.85,28.78,8
HCPCS,89253,ASSISTED EMBRYO HATCHING,1050.0,682.5,24.85,1050.0,84
HCPCS,89254,OOCYTE IDENTIFICATION FROM FOLLICULAR FLUID,500.0,325.0,24.85,1470.1,84
HCPCS,89255,PREP EMBRYO FOR TRNFER,700.0,455.0,24.85,700.0,84
HCPCS,89257,PERCUTANEOUS SPERM ASPIRATION,1010.0,656.5,24.85,1010.0,84
HCPCS,89258,CRYOPRESERVATION EMBRYO,2450.0,1592.5,22.63,2450.0,84
HCPCS,89259,CRYOPRESERVATION SPERM,540.0,351.0,24.85,540.0,84
HCPCS,89259,SEMEN CRYOPRESERVATION INITIAL-BW,540.0,351.0,24.85,540.0,84
HCPCS,89260,SPERM WASH FOR INSEMINATI,268.0,174.2,24.85,397.39,84
HCPCS,89261,SPERM WASH SECOND INSEM,500.0,325.0,24.85,500.0,84
HCPCS,89264,TESTICULAR BIOPSY PREP,1620.0,1053.0,24.85,1620.0,84
HCPCS,89268,INSEMINATION OOCYTES,650.0,422.5,24.85,650.0,84
HCPCS,89272,EXTN CULT OOCYTE/EMBRYO 4-7D,1400.0,910.0,24.85,1476.35,84
HCPCS,89280,OOCYTE FERTILIZATION<=10,2450.0,1592.5,24.85,2450.0,84
HCPCS,89281,OOCYTE FERTILIZATION>10,2700.0,1755.0,24.85,2700.0,84
HCPCS,89290,BX OOCYTE/EMBRYO<=5EMBRYO,3488.0,2267.2,24.85,3488.0,84
HCPCS,89291,BX OOCYTE/EMBRYO>5EMBRYO,3694.0,2401.1,24.85,3694.0,84
HCPCS,89300,SEMEN ALYS PRESENCE&/MOTILITY SPRM HUHNER,68.0,44.2,1.1,68.0,88
HCPCS,89300,SEMEN ANALYSIS W/HUHNER,,,4.41,68.68,29
HCPCS,89300,Semen analysis w/huhner,,,8.96,10.37,8
HCPCS,89310,AV BILL FREEZE CASA,59.0,38.35,4.25,60.05,83
HCPCS,89310,SPERM COUNT/MOTILITY SEMEN,59.0,38.35,4.25,60.05,83
HCPCS,89320,CASA,205.0,133.25,5.95,205.0,83
HCPCS,89320,SEMEN ANAL VOL/COUNT/MOT,314.0,204.1,1.1,314.0,88
HCPCS,89321,SEMEN ANAL POST VASEC,191.0,124.15,5.95,191.0,83
HCPCS,89321,SEMEN ANALYSIS SPERM PRESENCE&/MOTILITY SPRM,209.0,135.85,1.1,209.0,88
HCPCS,89322,SEMEN ANALYSIS STRICT MORPHOLOGIC CRITERIA,107.0,69.55,1.1,107.0,88
HCPCS,89322,SPERM DIFFERENTIAL,107.0,69.55,7.65,107.0,83
HCPCS,89325,ANTI SPERM AB TYPING,210.0,136.5,5.27,210.0,83
HCPCS,89325,SPERM ANTIBODIES,306.0,198.9,1.1,306.0,88
HCPCS,89325,TEST SPERM AB,210.0,136.5,5.27,210.0,166
HCPCS,89329,EVAL SPERM HAMSTER TEST,135.0,87.75,8.96,135.0,83
HCPCS,89329,HYPO-OSMOT SWELLING,135.0,87.75,1.1,135.0,88
HCPCS,89330,EVAL SPERM CERV MUCUS TEST,72.0,46.8,4.88,72.0,83
HCPCS,89331,RETRO AN SPERM COUNT,135.0,87.75,8.96,135.0,83
HCPCS,89331,SPERM EVALUATION RETROGRADE EJACULATION URINE,135.0,87.75,1.1,135.0,88
HCPCS,89335,CRYOPRESERVE TESTICULAR TISS,,,47.01,150.0,25
HCPCS,89335,Cryopreserve testicular tiss,,,24.85,28.78,8
HCPCS,89337,CRYOPRESERVATION OOCYTE(S),972.0,631.8,24.85,972.0,84
HCPCS,89342,STORAGE EMBRYO EA YR,700.0,455.0,24.85,700.0,84
HCPCS,89343,STORAGE SEMEN/SPERM PER YEAR,319.0,207.35,24.85,335.61,84
HCPCS,89343,STORAGE/YEAR; SPERM/SEMEN,207.0,134.55,1.1,498.94,82
HCPCS,89344,"STORAGE (PER YEAR); REPRODUCTIVE TISSUE, TESTICULAR/OVARIAN",489.0,317.85,24.85,489.0,84
HCPCS,89346,STORAGE/YEAR OOCYTE(S),500.0,325.0,24.85,655.34,84
HCPCS,89352,THAW CRYOPRESERVE EMBRYO,1450.0,942.5,24.85,1450.0,84
HCPCS,89353,THAW CRYOPRESERVE SPERM/SEMEN,250.0,162.5,24.85,250.0,84
HCPCS,89353,THAWING CRYOPRESERVED SPERM/SEMEN EACH ALIQUOT,126.0,81.9,1.1,1211.06,82
HCPCS,89354,THAW CRYOPRSVRD REPROD TISS,,,148.18,445.91,25
HCPCS,89354,Thaw cryoprsvrd reprod tiss,,,24.85,28.78,8
HCPCS,89356,THAW CRYOPR OOCYTES EA ALIQ,350.0,227.5,24.85,350.0,84
HCPCS,89398,PERCUTANEOUS SPERM ASPIRATION,378.0,245.7,45.47,378.0,84
HCPCS,89398,TESTICULAR BIOPSY PREP,378.0,245.7,45.47,378.0,84
HCPCS,89398,UNLISTED REPROD MED LAB PROC,595.0,386.75,0.01,595.0,80
HCPCS,9001F,AORTIC ANEURYSM<5CM DIAM CT,,,2739849.3,2739849.3,1
HCPCS,9001F,Aortic aneurysm<5cm diam ct,,,10.69,12.38,8
HCPCS,9002F,AORTIC ANEURYSM 5-5.4CM DIAM,,,2739849.3,2739849.3,1
HCPCS,9002F,Aortic aneurysm 5-5.4cm diam,,,10.69,12.38,8
HCPCS,9003F,AORTIC ANRYSM5.5-5.9CM DIAM,,,2739849.3,2739849.3,1
HCPCS,9003F,Aortic anrysm5.5-5.9cm diam,,,10.69,12.38,8
HCPCS,9004F,AORTIC ANRYSM 6/> CM DIAM,,,2739849.3,2739849.3,1
HCPCS,9004F,Aortic anrysm 6/> cm diam,,,10.69,12.38,8
HCPCS,9005F,ASYMPT CAROT/VRTBRBAS STEN,,,2739849.3,2739849.3,1
HCPCS,9005F,Asympt carot/vrtbrbas sten,,,10.69,12.38,8
HCPCS,9006F,SYMPT STEN-TIA/STRK<120DAYS,,,2739849.3,2739849.3,1
HCPCS,9006F,Sympt sten-tia/strk<120days,,,10.69,12.38,8
HCPCS,9007F,OTHER CAROT STEN 120 DAYS/>,,,2739849.3,2739849.3,1
HCPCS,9007F,Other carot sten 120 days/>,,,10.69,12.38,8
HCPCS,90281,HUMAN IG IM,,,128.44,308.17,8
HCPCS,90281,Human ig im,,,52.18,60.42,8
HCPCS,90281,IMMUNE GLOBULIN IG HUMAN IM USE,220.0,143.0,1.1,342.83,78
HCPCS,9028100,HUMAN IG IM,,,172.62,221.11,3
HCPCS,90283,HUMAN IG IV,,,135.01,304.3,8
HCPCS,90283,Human ig iv,,,52.18,60.42,8
HCPCS,9028300,HUMAN IG IV,,,135.01,172.94,3
HCPCS,90284,HUMAN IG SC,,,27.0,60.99,8
HCPCS,90284,Human ig sc,,,52.18,60.42,8
HCPCS,9028400,HUMAN IG SC,,,27.0,34.59,3
HCPCS,90287,BOTULINUM ANTITOXIN,,,38.2,38.2,1
HCPCS,90287,Botulinum antitoxin,,,141.84,164.23,8
HCPCS,90288,BOTULISM IG IV,,,43.73,134303.4,6
HCPCS,90288,Botulism ig iv,,,14262.54,16514.52,8
HCPCS,9028800,BOTULISM IG IV,,,104850.9,134303.4,3
HCPCS,90291,CMV IG IV,,,3189.74,5776.52,8
HCPCS,90291,Cmv ig iv,,,4882.66,5653.6,8
HCPCS,9029100,CMV IG IV,,,3189.74,4085.74,3
HCPCS,90296,DIPHTHERIA ANTITOXIN,,,196.6,196.6,1
HCPCS,90296,Diphtheria antitoxin,,,52.18,60.42,8
HCPCS,90371,HEP B IG IM,,,245.34,314.25,3
HCPCS,90371,HEP B IMMUNE GLOBULIN,988.0,642.2,137.82,1622.37,93
HCPCS,90371,HEPATITIS B IMMUNE GLOBULIN HBIG HUMAN IM,988.0,642.2,1.1,988.0,82
HCPCS,9037100,HEP B IG IM,,,245.34,314.25,3
HCPCS,90375,RABIES IG IM/SC,,,498.31,638.29,3
HCPCS,90375,RABIES IG INJECTION,2000.0,1300.0,279.94,3329.32,93
HCPCS,90375,RABIES IMMUNE GLOBULIN RIG HUMAN IM/SUBQ,2000.0,1300.0,1.1,2000.0,82
HCPCS,9037500,RABIES IG IM/SC,,,498.31,638.29,3
HCPCS,90376,RABIES IG 150U/ML IM 2ML,2397.0,1558.05,352.44,3329.32,93
HCPCS,90376,RABIES IG HEAT TREATED,,,821.68,1052.49,3
HCPCS,90376,RABIES IG HEAT-TREATED HUMAN IM/SUBQ,2397.0,1558.05,1.1,2397.0,82
HCPCS,9037600,RABIES IG HEAT TREATED,,,821.68,1052.49,3
HCPCS,90377,RABIES IG HT&SOL HUMAN IM/SC,,,30.02,858.62,33
HCPCS,90377,Rabies ig ht&sol human im/sc,,,2875.32,3329.32,8
HCPCS,9037700,RABIES IG HT&SOL HUMAN IM/SC,,,427.43,547.5,3
HCPCS,90378,RESPIRATORY SYNCYTIAL VIRUS IG IM 50 MG E,4967.0,3228.55,1.1,5459.79,78
HCPCS,90378,RSV MAB IM 50MG,,,3305.58,4234.12,3
HCPCS,90378,"RSV-IG, 50 MG-SYNAGIS",4967.0,3228.55,339.68,4967.0,93
HCPCS,9037800,RSV MAB IM 50MG,,,3305.58,4234.12,3
HCPCS,90380,RSV MONOC ANTB SEASN .5ML IM,,,1009.72,1293.35,3
HCPCS,90380,RSV MONOCLONAL ANTB SEASONAL DOSE 0.5ML IM USE,2080.0,1352.0,1.1,2681.91,153
HCPCS,9038000,RSV MONOC ANTB SEASN .5ML IM,,,1009.72,1293.35,3
HCPCS,90381,RSV MONOC ANTB SEASN 1 ML IM,,,1009.72,1293.35,3
HCPCS,90381,RSV MONOCLONAL ANTB SEASONAL DOSE 1 ML IM USE,2080.0,1352.0,1.1,2080.0,153
HCPCS,9038100,RSV MONOC ANTB SEASN 1 ML IM,,,1009.72,1293.35,3
HCPCS,90382,RSV MONOC ANTB SEASN .7ML IM,,,1187.62,1521.22,5
HCPCS,90382,Rsv monoc antb seasn .7ml im,,,1401.14,1622.37,8
HCPCS,9038200,RSV MONOC ANTB SEASN .7ML IM,,,1187.62,1521.22,3
HCPCS,90384,RH IG FULL-DOSE IM,,,150.39,192.64,3
HCPCS,90384,"RHO IG, HUMAN, FULL DOSE, IM",303.0,196.95,66.05,303.0,75
HCPCS,90384,RHO(D) IMMUNE GLOBULIN HUMAN FULL-DOSE IM,303.0,196.95,1.1,336.71,78
HCPCS,9038400,RH IG FULL-DOSE IM,,,150.39,192.64,3
HCPCS,90385,RH IG MINIDOSE IM,,,10.0,168.8,21
HCPCS,90385,Rh ig minidose im,,,52.18,60.42,8
HCPCS,9038500,RH IG MINIDOSE IM,,,54.18,69.4,3
HCPCS,90386,RH IG IV,,,18.71,1424.87,8
HCPCS,90386,Rh ig iv,,,3543.91,4103.47,8
HCPCS,9038600,RH IG IV,,,18.71,23.96,3
HCPCS,90389,TETANUS IG IM,,,1178.63,2072.29,8
HCPCS,90389,Tetanus ig im,,,141.84,164.23,8
HCPCS,9038900,TETANUS IG IM,,,1178.63,1509.7,3
HCPCS,90393,VACCINA IG IM,,,495.99,495.99,1
HCPCS,90393,Vaccina ig im,,,141.84,164.23,8
HCPCS,90396,VARICELLA-ZOSTER IG HUMAN IM,15554.0,10110.1,725.74,15554.0,93
HCPCS,90396,VARICELLA-ZOSTER IG IM,,,4140.94,5304.12,3
HCPCS,90396,VARICELLA-ZOSTER IMMUNE GLOBULIN HUMAN IM,935.0,607.75,1.1,6905.62,78
HCPCS,9039600,VARICELLA-ZOSTER IG IM,,,4140.94,5304.12,3
HCPCS,90399,UNLISTED IMMUNE GLOBULIN,,,919.96,2739999.97,3
HCPCS,90399,Unlisted immune globulin,,,52.18,60.42,8
HCPCS,90460,IM ADMIN 1ST/ONLY COMPONENT,70.0,45.5,15.26,70.0,68
HCPCS,90460,IMADM THROUGH 18YR ANY ROUTE 1ST VAC/TOXOID,96.0,62.4,1.1,96.0,142
HCPCS,90460,VFC IM ADMIN 1ST/ONLY THRU 18,21.25,13.81,4.63,30.56,68
HCPCS,90460,VFC IM ADMIN/ONLY THRU 18,21.25,13.81,1.1,74.35,142
HCPCS,90461,IM ADM THRU 18YR ANY RTE ADDL VAC/TOX COMPT,27.0,17.55,5.89,27.0,68
HCPCS,90461,IMADM THROUGH 18YR ANY ROUTE EA ADDL VAC/TOXOID,72.0,46.8,1.1,72.0,130
HCPCS,90470,H1N1 INFLUENZA VACC ADMIN W/COUNSELING,62.0,40.3,1.1,62.0,70
HCPCS,90471,ADMIN FLU VIRUS VACCINE,68.0,44.2,1.1,205.09,142
HCPCS,90471,ADMIN VACCINE FLU,214.0,139.1,17.08,214.0,86
HCPCS,90471,ADMIN VACCINE PNEUMONIA,214.0,139.1,17.08,214.0,86
HCPCS,90471,ADMIN VACCINE SNGL,214.0,139.1,17.08,214.0,86
HCPCS,90471,IM ADM PRQ ID SUBQ/IM NJXS 1 VACCINE,68.0,44.2,1.1,205.09,142
HCPCS,90471,IMMUNIZ INJ-HEP B VACC ONLY,214.0,139.1,17.08,214.0,86
HCPCS,90471,RSV VACCINE PREF SUBUNIT BIVALENT FOR IM USE,33.0,21.45,9.17,74.93,86
HCPCS,90472,ADMIN VAC EA ADD CHILD,64.0,41.6,13.95,64.0,68
HCPCS,90472,ADMIN VACCINE EA ADD,64.0,41.6,13.95,64.0,68
HCPCS,90472,IM ADM PRQ ID SUBQ/IM NJXS EA VACCINE,60.0,39.0,1.1,60.0,142
HCPCS,90473,IM ADM INTRANSL/ORAL 1 VACCINE,68.0,44.2,1.1,205.09,142
HCPCS,90473,IMMUNE ADMIN ORAL/NAS 1ST,214.0,139.1,17.08,214.0,86
HCPCS,90474,IM ADM INTRANSL/ORAL EA VACCINE,60.0,39.0,1.1,60.0,142
HCPCS,90474,IMM ADMIN ORAL/NASAL ADDL,190.0,123.5,14.98,190.0,68
HCPCS,90476,ADENOVIRUS VACCINE TYPE 4,,,46.0,126.04,2
HCPCS,90476,Adenovirus vaccine type 4,,,9.99,11.57,8
HCPCS,90477,ADENOVIRUS VACCINE TYPE 7,,,13.12,13.12,1
HCPCS,90477,Adenovirus vaccine type 7,,,9.99,11.57,8
HCPCS,90480,ADMINISTRATION COVID VACCINE,286.0,185.9,17.08,286.0,82
HCPCS,90480,ADMINISTRATION COVID VACCINE (2023-2024),293.0,190.45,1.1,293.0,88
HCPCS,90480,VFC ADMINISTRATION COVID VACCINE,21.25,13.81,1.1,138.2,170
HCPCS,90481,IMM ADMN SARSCOV2 VACCINE EACH ADDL COMPONENT,286.0,185.9,1.1,286.0,134
HCPCS,90482,IMM CNSL PHYS/QHP IMM NOT ADMN SAME DOS 3<10 MIN,88.0,57.2,1.1,106.0,138
HCPCS,90483,IMM CNSL PHYS/QHP IMM NOT ADMN SM DOS>10<20 MIN,145.0,94.25,1.1,220.0,138
HCPCS,90484,IMM CNSL PHYS/QHP IMM NOT ADMN SAME DOS>20 MIN,200.0,130.0,1.1,330.0,138
HCPCS,90581,ANTHRAX VACCINE SC OR IM,,,179.74,325.51,8
HCPCS,90581,Anthrax vaccine sc or im,,,16.84,19.5,8
HCPCS,9058100,ANTHRAX VACCINE SC OR IM,,,179.74,230.23,3
HCPCS,90584,DENGUE VACC QUAD 2 DOSE SUBQ,,,2739849.3,2739849.3,1
HCPCS,90584,Dengue vacc quad 2 dose subq,,,16.84,19.5,8
HCPCS,90585,BCG VACCINE PERCUT,,,147.34,516.44,9
HCPCS,90585,Bcg vaccine percut,,,9.99,11.57,8
HCPCS,9058500,BCG VACCINE PERCUT,,,330.39,423.19,3
HCPCS,90586,BCG VACCINE INTRAVESICAL,,,146.56,438.19,11
HCPCS,90586,Bcg vaccine intravesical,,,16.84,19.5,8
HCPCS,9058600,BCG VACCINE INTRAVESICAL,,,291.87,373.85,3
HCPCS,90587,DENGUE VACC QUAD 3 DOSE SUBQ,,,50.0,332.03,9
HCPCS,90587,Dengue vacc quad 3 dose subq,,,16.84,19.5,8
HCPCS,9058700,DENGUE VACC QUAD 3 DOSE SUBQ,,,119.83,153.49,3
HCPCS,90589,CHIKUNGUNYA VACCINE LIVE IM,,,587.4,752.4,3
HCPCS,90589,"CHIKUNGUNYA VACCINE, LIVE",990.0,643.5,16.84,990.0,75
HCPCS,90589,CHIKUNGUNYA VIRUS VACCINE LIVE FOR IM USE,990.0,643.5,1.1,3060831.65,78
HCPCS,9058900,CHIKUNGUNYA VACCINE LIVE IM,,,587.4,752.4,3
HCPCS,90593,CHIKUNGUNYA VACC RECOMB IM,,,587.4,752.4,3
HCPCS,90593,"CHIKUNGUNYA VACCINE, RECOMBINANT (VIMKUNYA)",991.0,644.15,1.1,991.0,149
HCPCS,9059300,CHIKUNGUNYA VACC RECOMB IM,,,587.4,752.4,3
HCPCS,90610,INITIAL CONSULTATION;EXTENSIVE,77.0,50.05,1.1,77.0,68
HCPCS,90611,JYNNEOS VACCINE (MPOX) 0.5 ML,785.7,510.71,0.01,809.68,171
HCPCS,90611,SMALLPOX&MONKEYPOX VAC 0.5ML,,,490.21,627.91,3
HCPCS,9061100,SMALLPOX&MONKEYPOX VAC 0.5ML,,,490.21,627.91,3
HCPCS,90612,Inf&sarscov2 vacc 31.7/.32im,,,9.99,11.57,8
HCPCS,90613,Inf&sarscov2 vacc 40/0.4 im,,,9.99,11.57,8
HCPCS,90619,MENACWY-TT VACCINE IM,,,321.33,411.59,3
HCPCS,90619,"MENINGOCOCCAL VACCINE, QUADRIVALENT (MENQUADFI)",617.0,401.05,1.1,617.0,149
HCPCS,9061900,MENACWY-TT VACCINE IM,,,321.33,411.59,3
HCPCS,90620,MENB RECOMBINANT PROT W/OUT MEMBR VESIC VACC IM,852.0,553.8,1.1,852.0,78
HCPCS,90620,MENB RP W/OMV VACCINE IM,852.0,553.8,16.84,852.0,75
HCPCS,90620,MENB-4C VACCINE IM,,,430.3,551.17,3
HCPCS,9062000,MENB-4C VACCINE IM,,,430.3,551.17,3
HCPCS,90621,MENB RLP VACCINE IM,604.0,392.6,16.84,604.0,75
HCPCS,90621,MENB-FHBP RECOMBNT LIPOPROTEIN VACC 2/3 DOSE IM,604.0,392.6,1.1,658.12,78
HCPCS,90621,MENB-FHBP VACC 2/3 DOSE IM,,,376.19,481.86,3
HCPCS,9062100,MENB-FHBP VACC 2/3 DOSE IM,,,376.19,481.86,3
HCPCS,90622,VACCINIA VRS VAC 0.3 ML PERQ,,,0.01,0.03,27
HCPCS,90622,Vaccinia vrs vac 0.3 ml perq,,,9.99,11.57,8
HCPCS,90623,MENACWY-TT MENB-FHBP VACC IM,,,430.12,2739849.3,8
HCPCS,90623,Menacwy-tt menb-fhbp vacc im,,,16.84,19.5,8
HCPCS,9062300,MENACWY-TT MENB-FHBP VACC IM,,,430.12,550.94,3
HCPCS,90624,MENB-4C&MENACWY VACC IM,,,455.04,603.81,5
HCPCS,90624,Menb-4c&menacwy vacc im,,,16.84,19.5,8
HCPCS,9062400,MENB-4C&MENACWY VACC IM,,,455.04,582.86,3
HCPCS,90625,CHOLERA VACCINE ADULT 1 DOSE LIVE FOR ORAL USE,734.0,477.1,1.1,1010.13,74
HCPCS,90625,CHOLERA VACCINE LIVE ORAL,734.0,477.1,9.99,734.0,78
HCPCS,9062500,CHOLERA VACCINE LIVE ORAL,,,529.25,677.91,3
HCPCS,90626,TIC-BRN ENCEPH VAC 0.25ML IM,,,551.76,706.75,3
HCPCS,90626,TICK-BORNE ENCEPH VACC INACTIVATED 0.25ML IM USE,304.0,197.6,1.1,3060831.65,153
HCPCS,9062600,TIC-BRN ENCEPH VAC 0.25ML IM,,,551.76,706.75,3
HCPCS,90627,TIC-BRN ENCEPH VAC 0.5ML IM,,,551.76,706.75,3
HCPCS,90627,TICK-BORNE ENCEPH VACC INACTIVATED 0.5ML IM USE,304.0,197.6,1.1,911.34,153
HCPCS,9062700,TIC-BRN ENCEPH VAC 0.5ML IM,,,551.76,706.75,3
HCPCS,90630,FLU VACC IIV4 NO PRESERV ID,,,21.11,739.8,5
HCPCS,90630,Flu vacc iiv4 no preserv id,,,9.99,11.57,8
HCPCS,9063000,FLU VACC IIV4 NO PRESERV ID,,,32.4,41.5,3
HCPCS,90631,H5 vaccine pandemic im use,,,9.99,11.57,8
HCPCS,90632,HEP A/ADULT,308.0,200.2,9.99,308.0,75
HCPCS,90632,HEPA VACCINE ADULT DOSE FOR INTRAMUSCULAR USE,308.0,200.2,1.1,308.0,82
HCPCS,90632,HEPA VACCINE ADULT IM,,,130.9,167.67,3
HCPCS,9063200,HEPA VACCINE ADULT IM,,,130.9,167.67,3
HCPCS,90633,HEP A/PEDIATRIC ADOLESEN,138.0,89.7,9.99,138.0,75
HCPCS,90633,HEPA VACC PED/ADOL 2 DOSE IM,,,72.48,92.84,3
HCPCS,90633,HEPA VACCINE 2 DOSE SCHEDULE PED/ADOLESC IM USE,138.0,89.7,1.1,138.0,78
HCPCS,9063300,HEPA VACC PED/ADOL 2 DOSE IM,,,72.48,92.84,3
HCPCS,90634,HEPA VACC PED/ADOL 3 DOSE,,,54.74,70.11,3
HCPCS,90634,HEPA VACCINE 3 DOSE SCHEDULE PED/ADOLESC IM USE,88.0,57.2,1.1,119.38,78
HCPCS,90634,PEDI IM 3 DOSE HEP-A VACCINE,88.0,57.2,9.99,88.0,74
HCPCS,9063400,HEPA VACC PED/ADOL 3 DOSE,,,54.74,70.11,3
HCPCS,90635,H5n1 vacc drv cll cul adj im,,,9.99,11.57,8
HCPCS,90636,HEP A/HEP B VACC ADULT IM,,,240.0,307.41,3
HCPCS,90636,HEPATITIS A & B VACCINE HEPA-HEPB ADULT IM,472.0,306.8,1.1,472.0,78
HCPCS,90636,IM ADULT HEPA-HEPB,472.0,306.8,16.84,472.0,75
HCPCS,9063600,HEP A/HEP B VACC ADULT IM,,,240.0,307.41,3
HCPCS,90637,Vacc qirv mrna 30mcg/.5ml im,,,9.99,11.57,8
HCPCS,90638,Vacc qirv mrna 60mcg/.5ml im,,,9.99,11.57,8
HCPCS,90644,HIB-MENCY VACC 6WK-18M0 IM,,,44.41,80.42,6
HCPCS,90644,Hib-mency vacc 6wk-18m0 im,,,16.84,19.5,8
HCPCS,9064400,HIB-MENCY VACC 6WK-18M0 IM,,,44.41,56.89,3
HCPCS,90647,HIB PRP-OMP VACC 3 DOSE IM,,,57.58,73.76,3
HCPCS,90647,HIB PRP-OMP VACCINE 3 DOSE SCHEDULE IM USE,108.0,70.2,1.1,108.0,78
HCPCS,90647,"IM 3 DOSE HIB, PRP-OMP",108.0,70.2,9.99,108.0,75
HCPCS,9064700,HIB PRP-OMP VACC 3 DOSE IM,,,57.58,73.76,3
HCPCS,90648,HIB PRP-T VACCINE 4 DOSE IM,,,25.01,32.03,3
HCPCS,90648,HIB PRP-T VACCINE 4 DOSE SCHEDULE IM USE,47.0,30.55,1.1,47.0,78
HCPCS,90648,"HIB, PRP-T",47.0,30.55,9.99,47.0,75
HCPCS,9064800,HIB PRP-T VACCINE 4 DOSE IM,,,25.01,32.03,3
HCPCS,90649,4VHPV VACCINE 3 DOSE IM,,,290.57,372.19,3
HCPCS,90649,4VHPV VACCINE 3 DOSE SCHEDULE FOR IM USE,442.0,287.3,1.1,593.83,78
HCPCS,90649,H PAPILLOMA VACC 3 DOSE IM,442.0,287.3,16.84,442.0,74
HCPCS,9064900,4VHPV VACCINE 3 DOSE IM,,,290.57,372.19,3
HCPCS,90650,2VHPV VACCINE 3 DOSE IM,,,251.43,429.22,6
HCPCS,90650,2vhpv vaccine 3 dose im,,,9.99,11.57,8
HCPCS,9065000,2VHPV VACCINE 3 DOSE IM,,,251.43,322.05,3
HCPCS,90651,9VHPV VACC 2/3 DOSE SCHED IM USE,1106.0,718.9,1.1,1106.0,78
HCPCS,90651,9VHPV VACCINE 2/3 DOSE IM,,,597.28,765.05,3
HCPCS,90651,HPV VIRUS VACCINE 9 VAL IM,1106.0,718.9,16.84,1106.0,150
HCPCS,9065100,9VHPV VACCINE 2/3 DOSE IM,,,597.28,765.05,3
HCPCS,90653,IIV ADJUVANT VACCINE IM,,,12.27,223.8,13
HCPCS,90653,Iiv adjuvant vaccine im,,,9.99,11.57,8
HCPCS,9065300,IIV ADJUVANT VACCINE IM,,,174.72,223.8,3
HCPCS,90654,FLU VACC IIV3 NO PRESERV ID,,,19.63,58.66,5
HCPCS,90654,Flu vacc iiv3 no preserv id,,,9.99,11.57,8
HCPCS,9065400,FLU VACC IIV3 NO PRESERV ID,,,30.12,38.58,3
HCPCS,90655,FLU VACCINE NO PRESERV 6-35M,22.0,14.3,4.8,27.69,74
HCPCS,90655,IIV3 VACC NO PRSV 0.25 ML IM,,,29.01,37.16,3
HCPCS,90655,IIV3 VACC PRESRV FREE 0.25 ML DOSAGE IM USE,22.0,14.3,1.1,122.44,78
HCPCS,9065500,IIV3 VACC NO PRSV 0.25 ML IM,,,29.01,37.16,3
HCPCS,90656,FLU VACCINE NO PRESERV 0.25 ML,74.7,48.56,9.99,74.7,75
HCPCS,90656,IIV3 VACC NO PRSV 0.5 ML IM,,,41.33,52.94,3
HCPCS,90656,IIV3 VACC PRESERVATIVE FREE 0.5 ML DOSAGE IM USE,74.7,48.56,1.1,74.7,82
HCPCS,90656,INFLUENZA VACCINE,74.7,48.56,9.99,74.7,75
HCPCS,9065600,IIV3 VACC NO PRSV 0.5 ML IM,,,41.33,52.94,3
HCPCS,90657,IIV3 VACCINE SPLIT VIRUS 0.25 ML DOSAGE IM USE,24.0,15.6,1.1,58.16,78
HCPCS,90657,IIV3 VACCINE SPLT 0.25 ML IM,,,1.38,51.02,13
HCPCS,90657,Iiv3 vaccine splt 0.25 ml im,,,9.99,11.57,8
HCPCS,9065700,IIV3 VACCINE SPLT 0.25 ML IM,,,19.63,25.15,3
HCPCS,90658,IIV3 VACCINE SPLIT VIRUS 0.5 ML DOSAGE IM USE,69.7,45.31,1.1,69.7,228
HCPCS,90658,IIV3 VACCINE SPLT 0.5 ML IM,,,39.28,50.32,3
HCPCS,9065800,IIV3 VACCINE SPLT 0.5 ML IM,,,39.28,50.32,3
HCPCS,90660,FLUMIST VACC NSPR 0.2ML,62.9,40.89,9.99,62.9,75
HCPCS,90660,LAIV3 VACCINE INTRANASAL,,,52.88,67.74,3
HCPCS,90660,LAIV3 VACCINE LIVE FOR INTRANASAL USE,62.9,40.89,1.1,87.35,78
HCPCS,9066000,LAIV3 VACCINE INTRANASAL,,,52.88,67.74,3
HCPCS,90661,CCIIV3 VAC ABX FR 0.5 ML IM,,,6.19,112.86,13
HCPCS,90661,Cciiv3 vac abx fr 0.5 ml im,,,9.99,11.57,8
HCPCS,9066100,CCIIV3 VAC ABX FR 0.5 ML IM,,,88.11,112.86,3
HCPCS,90662,FLU VACC PRSV FREE INC ANTIG,203.3,132.15,9.99,203.3,75
HCPCS,90662,IIV NO PRSV INCREASED AG IM,,,174.72,223.8,3
HCPCS,90662,IIV VACCINE PRESERV FREE INCREASED AG CONTENT IM,203.3,132.15,1.1,288.59,82
HCPCS,9066200,IIV NO PRSV INCREASED AG IM,,,174.72,223.8,3
HCPCS,90664,LAIV VACC PANDEMIC INTRANASL,,,75.46,75.46,1
HCPCS,90664,Laiv vacc pandemic intranasl,,,9.99,11.57,8
HCPCS,90666,FLU VAC PANDEM PRSRV FREE IM,,,143.85,143.85,1
HCPCS,90666,Flu vac pandem prsrv free im,,,9.99,11.57,8
HCPCS,90667,IIV VACC PANDEMIC ADJUVT IM,,,19.73,19.73,1
HCPCS,90667,Iiv vacc pandemic adjuvt im,,,9.99,11.57,8
HCPCS,90668,IIV VACCINE PANDEMIC IM,,,32.66,32.66,1
HCPCS,90668,Iiv vaccine pandemic im,,,9.99,11.57,8
HCPCS,90670,PCV13 VACCINE FOR INTRAMUSCULAR USE,814.0,529.1,1.1,814.0,82
HCPCS,90670,PCV13 VACCINE IM,,,410.88,526.29,3
HCPCS,90670,PREVNAR13 PNEUMOCOCCAL VACC IM,814.0,529.1,16.84,814.0,75
HCPCS,9067000,PCV13 VACCINE IM,,,410.88,526.29,3
HCPCS,90671,PCV15 VACCINE IM,,,33.66,694.75,13
HCPCS,90671,Pcv15 vaccine im,,,16.84,19.5,8
HCPCS,9067100,PCV15 VACCINE IM,,,479.37,614.03,3
HCPCS,90672,FLU VACCINE 4 VALENT NASAL,57.0,37.05,9.99,65.34,75
HCPCS,90672,LAIV4 VACCINE FOR INTRANASAL USE,57.0,37.05,1.1,85.71,82
HCPCS,90672,LAIV4 VACCINE INTRANASAL,,,44.25,56.68,3
HCPCS,9067200,LAIV4 VACCINE INTRANASAL,,,44.25,56.68,3
HCPCS,90673,FLUBLOK TRIVALENT,284.6,184.99,9.99,284.6,75
HCPCS,90673,RIV3 VACCINE NO PRESERV IM,,,174.72,223.8,3
HCPCS,90673,RIV3 VACCINE PRESERVATIVE FREE FOR IM USE,284.6,184.99,1.1,288.59,78
HCPCS,9067300,RIV3 VACCINE NO PRESERV IM,,,174.72,223.8,3
HCPCS,90674,CCIIV4 VAC NO PRSV 0.5 ML IM,,,54.41,69.7,3
HCPCS,90674,CCIIV4 VACCINE PRESERVATIVE FREE 0.5 ML IM USE,109.0,70.85,9.99,109.0,75
HCPCS,9067400,CCIIV4 VAC NO PRSV 0.5 ML IM,,,54.41,69.7,3
HCPCS,90675,RABIES VACCINE IM,,,569.16,729.03,3
HCPCS,90675,"RABIES VACCINE, IM",1491.0,969.15,1.1,1491.0,175
HCPCS,9067500,RABIES VACCINE IM,,,569.16,729.03,3
HCPCS,90676,RABIES VACCINE ID,,,29.61,764.87,28
HCPCS,90676,"RABIES VACCINE, ID",456.0,296.4,1.1,854.02,78
HCPCS,90676,Rabies vaccine id,,,16.84,19.5,8
HCPCS,9067600,RABIES VACCINE ID,,,140.62,180.12,3
HCPCS,90677,PCV20 VACCINE FOR INTRAMUSCULAR USE,1018.0,661.7,1.1,1018.0,78
HCPCS,90677,PCV20 VACCINE IM,,,556.96,713.41,3
HCPCS,90677,PNEUMOCOCCAL 20-VALENT CONJUGATE VACCINE CODE 90677,1018.0,661.7,16.84,1018.0,75
HCPCS,9067700,PCV20 VACCINE IM,,,556.96,713.41,3
HCPCS,90678,RSV VACC PREF BIVALENT IM,,,557.03,713.5,3
HCPCS,90678,RSV VACCINE PREF SUBUNIT BIVALENT FOR IM USE,1106.0,718.9,1.1,1106.0,78
HCPCS,90678,"RSV VACCINE, BIVALENT (ABRYSVO)",1106.0,718.9,1.1,1106.0,153
HCPCS,9067800,RSV VACC PREF BIVALENT IM,,,557.03,713.5,3
HCPCS,90679,RSV VACC PREF RECOMB ADJT IM,,,556.21,712.45,3
HCPCS,90679,"RSV VACCINE, ADJUVANTED (AREXVY)",363.0,235.95,1.1,1028.5,153
HCPCS,9067900,RSV VACC PREF RECOMB ADJT IM,,,556.21,712.45,3
HCPCS,90680,ROTOVIRUS VAC ORAL USE,309.0,200.85,16.84,309.0,75
HCPCS,90680,RV5 VACC 3 DOSE LIVE ORAL,,,186.31,238.65,3
HCPCS,90680,RV5 VACCINE 3 DOSE SCHEDULE LIVE FOR ORAL USE,309.0,200.85,1.1,352.02,78
HCPCS,9068000,RV5 VACC 3 DOSE LIVE ORAL,,,186.31,238.65,3
HCPCS,90681,ROTAVIRUS VAC 2 DOSE ORAL,402.0,261.3,9.99,402.0,75
HCPCS,90681,RV1 VACC 2 DOSE LIVE ORAL,,,266.7,341.61,3
HCPCS,90681,RV1 VACCINE 2 DOSE SCHEDULE LIVE FOR ORAL USE,402.0,261.3,1.1,495.88,78
HCPCS,9068100,RV1 VACC 2 DOSE LIVE ORAL,,,266.7,341.61,3
HCPCS,90682,FLUBLOK QUADRIVALENT PFS,233.0,151.45,9.99,233.0,75
HCPCS,90682,RIV4 VACC RECOMBINANT DNA IM,,,116.89,149.73,3
HCPCS,90682,RIV4 VACC RECOMBINANT DNA PRSRV ANTIBIO FREE IM,233.0,151.45,1.1,233.0,82
HCPCS,9068200,RIV4 VACC RECOMBINANT DNA IM,,,116.89,149.73,3
HCPCS,90683,RSV VACC MRNA LIPID NANO IM,,,526.52,2739849.3,8
HCPCS,90683,Rsv vacc mrna lipid nano im,,,9.99,11.57,8
HCPCS,9068300,RSV VACC MRNA LIPID NANO IM,,,526.52,674.42,3
HCPCS,90684,PCV21 VACCINE IM,,,43.03,798.66,12
HCPCS,90684,Pcv21 vaccine im,,,16.84,19.5,8
HCPCS,9068400,PCV21 VACCINE IM,,,612.77,784.89,3
HCPCS,90685,FLU VAC NO PRSV 4 VAL 6-35 M,36.0,23.4,7.85,36.0,75
HCPCS,90685,IIV4 VACC PRSRV FREE 0.25 ML DOS FOR IM USE,34.0,22.1,1.1,70.4,78
HCPCS,90686,FLU VAC NO PRSV 4 VAL,70.0,45.5,9.99,70.0,75
HCPCS,90686,IIV4 VACC NO PRSV 0.5 ML IM,,,35.6,45.6,3
HCPCS,90686,IIV4 VACC PRESRV FREE 0.5 ML DOS FOR IM USE,70.0,45.5,1.1,70.0,82
HCPCS,9068600,IIV4 VACC NO PRSV 0.5 ML IM,,,35.6,45.6,3
HCPCS,90687,IIV4 VACC SPLIT VIRUS 0.25 ML DOS FOR IM USE,33.0,21.45,1.1,33.0,82
HCPCS,90687,IIV4 VACCINE SPLT 0.25 ML IM,,,1.15,28.61,9
HCPCS,90687,Iiv4 vaccine splt 0.25 ml im,,,9.99,11.57,8
HCPCS,9068700,IIV4 VACCINE SPLT 0.25 ML IM,,,16.63,21.3,3
HCPCS,90688,FLUZONE QUADRIVALENT MDV,67.0,43.55,9.99,67.0,75
HCPCS,90688,IIV4 VACC SPLIT VIRUS 0.5 ML DOS FOR IM USE,67.0,43.55,1.1,67.0,82
HCPCS,90688,IIV4 VACCINE SPLT 0.5 ML IM,,,33.25,42.59,3
HCPCS,9068800,IIV4 VACCINE SPLT 0.5 ML IM,,,33.25,42.59,3
HCPCS,90689,IIV4 VACC INACTIVATED PRSRV FR 0.25ML DOS IM USE,44.0,28.6,1.1,52.04,68
HCPCS,90689,VACC IIV4 NO PRSRV 0.25ML IM,,,47.02,47.02,1
HCPCS,90689,Vacc iiv4 no prsrv 0.25ml im,,,9.99,11.57,8
HCPCS,90690,TYPHOID VACC CAP EC,115.0,74.75,9.99,194.04,75
HCPCS,90690,TYPHOID VACCINE ORAL,,,212.91,272.71,3
HCPCS,90690,"TYPHOID VACCINE, ORAL",115.0,74.75,1.1,351.65,78
HCPCS,9069000,TYPHOID VACCINE ORAL,,,212.91,272.71,3
HCPCS,90691,TYPHOID VACCINE IM,,,293.4,375.81,3
HCPCS,90691,TYPHOID VACCINE VI CAPSULAR POLYSACCHARIDE IM,441.0,286.65,1.1,484.6,82
HCPCS,90691,TYPHOID VI 25MCG/0.5ML SYG,441.0,286.65,9.99,441.0,75
HCPCS,9069100,TYPHOID VACCINE IM,,,293.4,375.81,3
HCPCS,90694,AIIV4 VACC INACTIVATED PRSRV FR 0.5ML DOS IM USE,243.0,157.95,9.99,243.0,75
HCPCS,90694,VACC AIIV4 NO PRSRV 0.5ML IM,,,123.21,157.82,3
HCPCS,9069400,VACC AIIV4 NO PRSRV 0.5ML IM,,,123.21,157.82,3
HCPCS,90695,H5n8 vacc drv cll cul adj im,,,9.99,11.57,8
HCPCS,90696,DTAP-IPV VACC 4-6 YR IM,210.0,136.5,9.99,328.03,75
HCPCS,90696,DTAP-IPV VACCINE 4-6 YRS IM,,,118.48,151.76,3
HCPCS,90696,DTAP-IPV VACCINE CHILD 4-6 YRS FOR IM USE,210.0,136.5,1.1,210.0,78
HCPCS,9069600,DTAP-IPV VACCINE 4-6 YRS IM,,,118.48,151.76,3
HCPCS,90697,DTAP-IPV-HIB-HEPB VACCINE IM,526.05,341.93,9.99,804.51,78
HCPCS,90697,DTAP-IPV-HIB-HEPB VACCINE INTRAMUSCULAR,526.05,341.93,1.1,535.68,78
HCPCS,9069700,DTAP-IPV-HIB-HEPB VACCINE IM,,,292.99,375.29,3
HCPCS,90698,"DTAP-HIB-IP VACCINE, IM",370.0,240.5,9.99,370.0,75
HCPCS,90698,DTAP-IPV/HIB VACCINE FOR INTRAMUSCULAR USE,370.0,240.5,1.1,375.0,78
HCPCS,90698,DTAP-IPV/HIB VACCINE IM,,,227.04,290.81,3
HCPCS,9069800,DTAP-IPV/HIB VACCINE IM,,,227.04,290.81,3
HCPCS,90700,DIPHTH TETANUS TOX ACELL PERTUSSIS VACC<7 YR IM,102.0,66.3,1.1,102.0,78
HCPCS,90700,DTAP 5 PERTUSSIS ANTIGENS VACC < 7 YR IM DAPTACEL LATEX FREE,102.0,66.3,1.1,102.0,153
HCPCS,90700,DTAP IMMUNIZATION,102.0,66.3,9.99,102.0,75
HCPCS,90700,DTAP VACCINE < 7 YRS IM,,,55.54,71.14,3
HCPCS,9070000,DTAP VACCINE < 7 YRS IM,,,55.54,71.14,3
HCPCS,90702,DT VACCINE UNDER 7 YRS IM,,,119.54,153.12,3
HCPCS,90702,DT VACCINE YOUNGER THAN 7 YRS FOR IM USE,222.0,144.3,1.1,222.0,74
HCPCS,90702,TETANUS-DIPHTHERIA TOXOID PED,222.0,144.3,9.99,222.0,75
HCPCS,9070200,DT VACCINE UNDER 7 YRS IM,,,119.54,153.12,3
HCPCS,90707,MEASLES MUMPS RUBELLA VIRUS VACCINE LIVE SUBQ,336.0,218.4,1.1,336.0,78
HCPCS,90707,MMR VACCINE SC,,,178.25,228.32,3
HCPCS,90707,MUMPS RUBELLA MEA,336.0,218.4,9.99,336.0,75
HCPCS,9070700,MMR VACCINE SC,,,178.25,228.32,3
HCPCS,90710,"MMR+VARICELLA,SQ-COMBINED VACCINE",992.0,644.8,1.1,992.0,78
HCPCS,90710,MMRV VACCINE,992.0,644.8,9.99,992.0,76
HCPCS,90710,MMRV VACCINE SC,,,524.1,671.32,3
HCPCS,9071000,MMRV VACCINE SC,,,524.1,671.32,3
HCPCS,90713,INACTIVE POLIO VACCINE,151.0,98.15,9.99,151.0,75
HCPCS,90713,POLIOVIRUS IPV SC/IM,,,90.66,116.12,3
HCPCS,90713,POLIOVIRUS VACCINE INACTIVATED SUBQ/IM,151.0,98.15,1.1,151.0,78
HCPCS,9071300,POLIOVIRUS IPV SC/IM,,,90.66,116.12,3
HCPCS,90714,TD VACC NO PRESV 7 YRS+ IM,,,69.37,88.85,3
HCPCS,90714,TD VACCINE NO PRSRV >= 7 IM,141.0,91.65,9.99,141.0,75
HCPCS,90714,TD VACCINE PRSRV FREE 7 YRS OR OLDER FOR IM USE,141.0,91.65,1.1,141.0,82
HCPCS,9071400,TD VACC NO PRESV 7 YRS+ IM,,,69.37,88.85,3
HCPCS,90715,TDAP VACCINE 7 YRS/> IM,170.0,110.5,1.1,170.0,85
HCPCS,90715,TDAP VACCINE >7 IM,170.0,110.5,9.99,170.0,75
HCPCS,9071500,TDAP VACCINE 7 YRS/> IM,,,70.65,90.49,3
HCPCS,90716,VAR VACCINE LIVE FOR SUBCUTANEOUS USE,657.0,427.05,1.1,657.0,78
HCPCS,90716,VAR VACCINE LIVE SUBQ,,,348.58,446.49,3
HCPCS,90716,VARICELLA VIRUS VACCINE LIVE,657.0,427.05,16.84,657.0,75
HCPCS,9071600,VAR VACCINE LIVE SUBQ,,,348.58,446.49,3
HCPCS,90717,YELLOW FEVER VACCINE LIVE SUBQ,648.0,421.2,1.1,768.66,78
HCPCS,90717,YELLOW FEVER VACCINE SUBQ,,,465.38,596.11,3
HCPCS,90717,"YELLOW FEVER VACCINE, SQ LIVE",648.0,421.2,16.84,648.0,75
HCPCS,9071700,YELLOW FEVER VACCINE SUBQ,,,465.38,596.11,3
HCPCS,90723,DTAP-HEP B-IPV VACCINE IM,,,195.8,250.8,3
HCPCS,90723,DTAP-HEPB-IPV VACCINE INTRAMUSCULAR,312.0,202.8,1.1,336.71,78
HCPCS,90723,PEDIARIX,312.0,202.8,9.99,312.0,75
HCPCS,9072300,DTAP-HEP B-IPV VACCINE IM,,,195.8,250.8,3
HCPCS,90732,PNEUMOCOCCAL VACCINE 23V,423.0,274.95,9.99,423.0,75
HCPCS,90732,PPSV23 VACC 2 YRS+ SUBQ/IM,,,237.58,304.31,3
HCPCS,90732,PPSV23 VACCINE 2 YRS OR OLDER FOR SUBQ/IM USE,423.0,274.95,1.1,423.0,82
HCPCS,9073200,PPSV23 VACC 2 YRS+ SUBQ/IM,,,237.58,304.31,3
HCPCS,90733,MENOMUNE VAC,344.0,223.6,16.84,344.0,74
HCPCS,90733,MPSV4 VACCINE GROUPS ACYW-135 SUBQ USE,344.0,223.6,1.1,422.42,78
HCPCS,90733,MPSV4 VACCINE SUBQ,,,223.39,286.14,3
HCPCS,9073300,MPSV4 VACCINE SUBQ,,,223.39,286.14,3
HCPCS,90734,MENACWYD/MENACWY-CRM CONJ VACC GRPS ACWY IM USE,565.0,367.25,1.1,565.0,78
HCPCS,90734,MENACWYD/MENACWYCRM VACC IM,,,302.53,387.51,3
HCPCS,90734,"MENINGOCOCCAL VACCINE, IM",565.0,367.25,16.84,565.0,75
HCPCS,9073400,MENACWYD/MENACWYCRM VACC IM,,,302.53,387.51,3
HCPCS,90736,HZV VACCINE LIVE SUBQ,,,386.12,494.58,3
HCPCS,90736,ZOSTAVAX VACC INJ,804.0,522.6,16.84,804.0,74
HCPCS,90736,ZOSTER VACCINE HZV LIVE FOR SUBCUTANEOUS USE,804.0,522.6,1.1,808.1,78
HCPCS,9073600,HZV VACCINE LIVE SUBQ,,,386.12,494.58,3
HCPCS,90738,INACTIVATED JE VACC IM,,,535.76,686.26,3
HCPCS,90738,JAPANESE ENCEPHALITIS VACC IM,1036.0,673.4,16.84,1036.0,75
HCPCS,9073800,INACTIVATED JE VACC IM,,,535.76,686.26,3
HCPCS,90739,HEPATITIS B / HEPLISAV-B,182.0,118.3,1.1,522.03,82
HCPCS,90739,HEPB VACC 2 DOSE ADULT IM,562.0,365.3,9.99,562.0,75
HCPCS,90739,HEPB VACC 2/4 DOSE ADULT IM,,,316.06,404.84,3
HCPCS,90739,HEPB VACCINE ADULT 2 DOSE SCHEDULE FOR IM USE,562.0,365.3,1.1,562.0,82
HCPCS,9073900,HEPB VACC 2/4 DOSE ADULT IM,,,316.06,404.84,3
HCPCS,90740,HEPB VACC 3 DOSE IMMUNSUP IM,,,292.67,374.88,3
HCPCS,90740,HEPB VACCINE DIALYSIS/IMMUNSUP PAT 3 DOSE IM,258.0,167.7,1.1,483.39,82
HCPCS,90740,IM DIALYSIS/IMC HEP-B 1ML,258.0,167.7,16.84,340.02,75
HCPCS,9074000,HEPB VACC 3 DOSE IMMUNSUP IM,,,292.67,374.88,3
HCPCS,90743,HEPB VACC 2 DOSE ADOLESC IM,,,133.77,171.34,3
HCPCS,90743,HEPB VACCINE ADOLESCENT 2 DOSE SCHEDULE IM,139.0,90.35,1.1,229.58,78
HCPCS,90743,IM ADOLES 2D HEP-B VACCINE,139.0,90.35,9.99,161.57,75
HCPCS,9074300,HEPB VACC 2 DOSE ADOLESC IM,,,133.77,171.34,3
HCPCS,90744,HEP B/PEDIATRIC/ADOLESCEN,104.0,67.6,9.99,104.0,75
HCPCS,90744,HEPB VACC 3 DOSE PED/ADOL IM,,,59.1,75.7,3
HCPCS,90744,HEPB VACCINE PED/ADOLESC 3 DOSE SCHEDULE IM,104.0,67.6,1.1,104.0,82
HCPCS,9074400,HEPB VACC 3 DOSE PED/ADOL IM,,,59.1,75.7,3
HCPCS,90746,HEPB VACCINE 3 DOSE ADULT IM,,,133.77,171.34,3
HCPCS,90746,HEPB VACCINE ADULT 3 DOSE SCHEDULE FOR IM USE,258.0,167.7,1.1,258.0,82
HCPCS,90746,IMMUNIZATION HEPATITIS,258.0,167.7,9.99,258.0,75
HCPCS,9074600,HEPB VACCINE 3 DOSE ADULT IM,,,133.77,171.34,3
HCPCS,90747,"HEPATITIS B VACCINE, IMMUNOSUP",230.0,149.5,16.84,302.61,75
HCPCS,90747,HEPB VACC 4 DOSE IMMUNSUP IM,,,292.67,374.88,3
HCPCS,90747,HEPB VACCINE DIALYSIS/IMMUNSUP PAT 4 DOSE IM,230.0,149.5,1.1,483.39,82
HCPCS,9074700,HEPB VACC 4 DOSE IMMUNSUP IM,,,292.67,374.88,3
HCPCS,90748,HIB-HEPB VACCINE FOR INTRAMUSCULAR USE,132.0,85.8,1.1,159.17,78
HCPCS,90748,HIB-HEPB VACCINE IM,,,76.36,97.81,3
HCPCS,90748,IM HEPB-HIB VACCINE,132.0,85.8,9.99,132.0,74
HCPCS,9074800,HIB-HEPB VACCINE IM,,,76.36,97.81,3
HCPCS,90749,MENINGOCOCCAL B-BEXSERO VAC,577.0,375.05,9.99,577.0,74
HCPCS,90749,UNLISTED VACCINE/TOXOID,635.0,412.75,0.01,635.0,80
HCPCS,90750,HZV VACC RECOMBINANT IM,,,391.28,501.19,3
HCPCS,90750,HZV VACC RECOMBINANT IM NJX,777.0,505.05,16.84,777.0,75
HCPCS,90750,HZV ZOSTER VACC RECOMBINANT ADJUVANTED IM NJX,777.0,505.05,1.1,777.0,78
HCPCS,9075000,HZV VACC RECOMBINANT IM,,,391.28,501.19,3
HCPCS,90756,CCIIV4 VACC ABX FREE IM,,,3.57,88.69,9
HCPCS,90756,Cciiv4 vacc abx free im,,,9.99,11.57,8
HCPCS,9075600,CCIIV4 VACC ABX FREE IM,,,51.57,66.05,3
HCPCS,90758,ZAIRE EBOLAVIRUS VAC LIVE IM,,,2739849.3,2739849.3,1
HCPCS,90758,Zaire ebolavirus vac live im,,,16.84,19.5,8
HCPCS,90759,HEP B VAC 3AG 10MCG 3 DOS IM,,,131.4,168.31,3
HCPCS,90759,HEP B VACC 3 AG 10 MCG 3 DOSE SCHED FOR IM USE,83.0,53.95,1.1,226.51,153
HCPCS,9075900,HEP B VAC 3AG 10MCG 3 DOS IM,,,131.4,168.31,3
HCPCS,90760,"IV INFUSION, HYDRATION, 1ST HOUR",444.0,288.6,1.1,444.0,68
HCPCS,90761,"IV INFUSION, HYDRATION, EA ADD HOUR",427.0,277.55,1.1,427.0,68
HCPCS,90765,"IV INFUSION, THER/PROPH/DIAG, 1ST HOUR",476.0,309.4,1.1,476.0,68
HCPCS,90766,"IV INFUSION, THER/PROPH/DIAG, EA ADD HOUR",410.0,266.5,1.1,410.0,68
HCPCS,90767,"IV INFUSE, THER/PROPH/DIAG, ADDL SEQ INF, 1ST HR",443.0,287.95,1.1,443.0,68
HCPCS,90768,"IV INFUSION,THER/PROPH/DIAG, CONCURRENT INF",427.0,277.55,1.1,427.0,68
HCPCS,90775,"THER/PROPH/DIAG INJECTION, IV PUSH, EA ADD",277.0,180.05,1.1,277.0,68
HCPCS,90779,UNLISTED THER/PROP/DIAG INJECTION/INFUSION PROC,361.0,234.65,1.1,361.0,68
HCPCS,90785,PSYCHOTHERAPY COMPLEX INTERACTIVE,149.0,96.85,1.1,153.0,360
HCPCS,90785,PSYCHOTHERAPY COMPLEX INTERACTIVE - VIRTUAL VISIT,145.0,94.25,1.1,145.0,156
HCPCS,90791,PSYCHIATRIC DIAGNOSTIC EVALUATION,1009.0,655.85,1.1,1536.0,240
HCPCS,90791,VIRTUAL VISIT DIAGNOSTIC EVAL (PSYCHOLOGISTS/THERAPISTS),1536.0,998.4,1.1,1536.0,154
HCPCS,90791,VIRTUAL VISIT PSYCH DIAGNOSTIC EVAL,1536.0,998.4,1.1,1536.0,154
HCPCS,90792,PSYCHIATRIC DIAGNOSTIC EVAL W/MEDICAL SERVICES,1073.0,697.4499999999999,1.1,1664.0,238
HCPCS,90792,VIRTUAL VISIT DIAGNOSTIC EVAL W/MEDICAL  (PSYCHIATRISTS/MID LEVE,1664.0,1081.6,1.1,1664.0,152
HCPCS,90832,PSYCHOTHERAPY 30 MINUTES PATIENT,744.0,483.6,1.1,744.0,156
HCPCS,90832,PSYCHOTHERAPY W/PATIENT 30 MINUTES,482.0,313.3,95.1,482.0,172
HCPCS,90832,VIRTUAL VISIT INDIVIDUAL PSYCHOTHERAPY 30 (16-37* MIN),744.0,483.6,1.1,744.0,156
HCPCS,90832,VIRTUAL VISIT PSYTX PT&/FAMILY 30 MINS,744.0,483.6,1.1,744.0,156
HCPCS,90833,PSYCHOTHERAPY PT&/FAMILY W/E&M SRVCS 30 MIN,656.0,426.4,1.1,656.0,152
HCPCS,90833,PSYCHOTHERAPY W/PATIENT W/E&M SRVCS 30 MIN,162.0,105.3,35.32,162.0,68
HCPCS,90833,VIRTUAL VISIT E/M + PSYCHOTHERAPY ADD-ON (30 MIN),656.0,426.4,1.1,656.0,152
HCPCS,90834,PSYCHOTHERAPY 45 MINUTES WITH PATIENT,980.0,637.0,1.1,980.0,156
HCPCS,90834,PSYCHOTHERAPY W/PATIENT 45 MINUTES,482.0,313.3,118.97,482.0,172
HCPCS,90834,VIRTUAL VISIT INDIVIDUAL PSYCHOTHERAPY  45 (38-52* MIN),980.0,637.0,1.1,980.0,156
HCPCS,90834,VIRTUAL VISIT PSYTX PT&/FAMILY 45 MINS,980.0,637.0,1.1,980.0,156
HCPCS,90836,PSYCHOTHERAPY PT&/FAMILY W/E&M SRVCS 45 MIN,832.0,540.8,1.1,832.0,152
HCPCS,90836,PSYCHOTHERAPY W/PATIENT W/E&M SRVCS 45 MIN,189.0,122.85,41.2,189.0,68
HCPCS,90836,VIRTUAL VISIT E/M + PSYCHOTHERAPY ADD-ON (45 MIN),832.0,540.8,1.1,832.0,152
HCPCS,90837,PSYCHOTHERAPY 60 MINUTES WITH PATIENT,1452.0,943.8,1.1,1452.0,156
HCPCS,90837,PSYCHOTHERAPY W/PATIENT 60 MINUTES,482.0,313.3,118.97,482.0,258
HCPCS,90837,VIRTUAL VISIT  INDIVIDUAL PSYCHOTHERAPY 60 (53+ *MIN),1452.0,943.8,1.1,1452.0,156
HCPCS,90837,VIRTUAL VISIT PSYTX PT&/FAMILY 60 MINS,1452.0,943.8,1.1,1452.0,156
HCPCS,90838,PSYCHOTHERAPY PT&/FAMILY W/E&M SRVCS 60 MIN,1096.0,712.4,1.1,1096.0,152
HCPCS,90838,PSYCHOTHERAPY W/PATIENT W/E&M SRVCS 60 MIN,197.0,128.05,42.95,197.0,68
HCPCS,90838,VIRTUAL VISIT E/M + PSYCHOTHERAPY ADD-ON (60 MIN),1096.0,712.4,1.1,1096.0,152
HCPCS,90839,PSYCHOTHERAPY FOR CRISIS INITIAL 60 MINS,1509.0,980.85,1.1,1509.0,154
HCPCS,90839,PSYCHOTHERAPY FOR CRISIS INITIAL 60 MINUTES,482.0,313.3,118.97,482.0,86
HCPCS,90839,VIRTUAL PSYCHOTHERAPY FOR CRISIS INITIAL 60 MINUTES,482.0,313.3,118.97,482.0,86
HCPCS,90839,VIRTUAL PSYTX CRISIS INITIAL 60 MIN,1509.0,980.85,1.1,1509.0,154
HCPCS,90840,PSYCHOTHERAPY FOR CRISIS EACH ADDL 30 MINUTES,659.5,428.675,1.1,722.0,222
HCPCS,90840,VIRTUAL PSYCHOTHERAPY FOR CRISIS EACH ADDL 30 MINUTES,597.0,388.05,88.93,597.0,68
HCPCS,90840,VIRTUAL PSYTX CRISIS EA ADDL 30 MIN,722.0,469.3,1.1,722.0,154
HCPCS,90845,MEDICAL PSYCHOANALYSIS,920.0,598.0,1.1,920.0,148
HCPCS,90845,PSYCHOANALYSIS,,,138.32,416.23,21
HCPCS,90845,Psychoanalysis,,,118.97,137.75,8
HCPCS,90846,FAMILY PSYCHOTHERAPY W/O PATIENT PRESENT 50 MINS,767.0,498.54999999999995,1.1,1052.0,240
HCPCS,90846,VIRTUAL VISIT FAMILY PSYCHOTHERAPY W/O PATIENT,1052.0,683.8,1.1,1052.0,154
HCPCS,90847,FAM THERAPY W PATIENT DTOX,482.0,313.3,136.31,482.0,88
HCPCS,90847,FAMILY PSYCHOTHERAPY W/PATIENT PRESENT 50 MINS,789.0,512.85,1.1,1096.0,242
HCPCS,90847,VIRTUAL VISIT FAMILY PSYCHOTHERAPY WITH PATIENT,1096.0,712.4,1.1,1096.0,156
HCPCS,90847,VIRTUAL VISIT FAMILY PSYTX W/PATIENT,1096.0,712.4,1.1,1096.0,156
HCPCS,90849,MULTIPLE FAMILY GROUP PSYCHOTHERAPY,371.0,241.15,1.1,482.0,328
HCPCS,90853,GROUP PSYCHOTHERAPY,260.0,169.0,1.1,260.19,156
HCPCS,90853,GROUP THERAPY,278.0,180.7,33.67,278.0,86
HCPCS,90853,VIRTUAL VISIT GROUP PSYCHOTHERAPY,260.0,169.0,1.1,260.19,156
HCPCS,90853,VIRTUAL VISIT GROUP THERAPY,278.0,180.7,33.67,278.0,86
HCPCS,90853,VIRTUAL VISIT MH IOP GROUP THERAPY,278.0,180.7,33.67,278.0,86
HCPCS,90863,PHARMACOLOGIC MANAGEMENT W/PSYCHOTHERAPY,192.0,124.8,1.1,192.0,114
HCPCS,90863,PHARMACOLOGIC MGMT W/PSYTX,158.0,102.7,10.58,158.0,66
HCPCS,90865,NARCOSYNTHESIS,,,138.32,416.23,21
HCPCS,90865,Narcosynthesis,,,197.35,228.51,8
HCPCS,90867,REPET TMS TX INITIAL W/MAP/MOTR THRESHLD/DEL&M,534.5,347.425,1.1,1239.34,212
HCPCS,90867,TCRANIAL MAGN STIM TX PLAN,934.0,607.1,204.28,934.0,84
HCPCS,90868,THERAP REPETITIVE TMS TX SUBSEQ DELIVERY & MNG,584.0,379.6,1.1,934.0,296
HCPCS,90869,REPET TMS TX SUBSEQ MOTR THRESHLD W/DELIV & MN,724.5,470.925,1.1,1517.59,190
HCPCS,90869,REPET TMS TX SUBSEQ MOTR THRESHLD W/DELIV & MNGT,584.0,379.6,1.1,1517.59,106
HCPCS,90870,ELECTROCONVULSIVE THERAPY,1296.0,842.4,1.1,1592.0,255
HCPCS,90875,INDIV PSYCHOPHYS BIOFEED TRAIN W/PSYTX 30 MIN,426.5,277.225,1.1,480.0,234
HCPCS,90876,INDIV PSYCHOPHYS BIOFEED TRAIN W/PSYTX 45 MIN,602.5,391.625,1.1,760.0,234
HCPCS,90880,HYPNOTHERAPY,,,77.33,232.71,22
HCPCS,90880,Hypnotherapy,,,95.1,110.12,8
HCPCS,90880,MEDICAL HYPNOTHERAPY,876.0,569.4,1.1,876.0,136
HCPCS,90882,ENVIRONMENTAL IVNTJ MGMT PURPOSES PSYC PT,281.0,182.65,1.1,281.0,88
HCPCS,90882,ENVRN IVNTJ MED MGMT PSYC PT,,,101.52,101.52,1
HCPCS,90882,Envrn ivntj med mgmt psyc pt,,,41.45,47.99,8
HCPCS,90885,PSYCHIATRIC EVAL HOSPITAL RECORDS DX PURPOSES,388.0,252.2,1.1,388.0,98
HCPCS,90885,Psy evaluation of records,,,41.45,47.99,8
HCPCS,90887,INTERPJ/EXPLNAJ RESULTS PSYCHIATRIC EXAM FAMILY,592.0,384.8,1.1,592.0,104
HCPCS,90887,Interpj/explnaj rslt psyc xm,,,158.8,183.88,8
HCPCS,90889,Preparation of report,,,41.45,47.99,8
HCPCS,90899,OTHER,230.0,149.5,0.01,230.0,90
HCPCS,90899,PROC PSYCH UNLISTD,57.0,37.05,15.85,110.12,84
HCPCS,90899,UNKEPT APPT,75.0,48.75,0.01,82.65,90
HCPCS,90901,BIOFDBK TRAIN ANY METHOD GO,319.0,207.35,23.22,319.0,85
HCPCS,90901,BIOFDBK TRAIN ANY METHOD GP,319.0,207.35,23.22,319.0,85
HCPCS,90901,BIOFEEDBACK TRAINING ANY MODALITY,319.0,207.35,23.22,319.0,85
HCPCS,90901,"BIOFEEDBACK TRAINING,ANY MODALITY",180.0,117.0,1.1,212.43,142
HCPCS,90912,BFB TRAING W/EMG &/MANOMETRY 1ST 15 MIN CNTCT,267.0,173.55,52.06,267.0,255
HCPCS,90912,BFB TRAING W/EMG &AMP;/MANOMETRY 1ST 15 MIN CNTCT,396.0,257.4,1.1,396.0,134
HCPCS,90913,BFB TRAING W/EMG&/MANOMETRY EA ADDL 15 MIN CNTCT,267.0,173.55,29.16,267.0,255
HCPCS,90913,BFB TRAING W/EMG&AMP;/MANOMETRY EA ADDL 15 MIN CNTCT,220.0,143.0,1.1,220.0,134
HCPCS,90935,HD SNGL EVAL ESRD (PER TX),4828.0,3138.2,85.0,4828.0,86
HCPCS,90935,HEMO 1 EVAL IP,4828.0,3138.2,85.0,4828.0,86
HCPCS,90935,HEMO 1 EVAL OP,4828.0,3138.2,85.0,4828.0,86
HCPCS,90935,HEMODIALYSIS,4828.0,3138.2,85.0,4828.0,86
HCPCS,90935,HEMODIALYSIS ONE EVALUATION,4828.0,3138.2,85.0,4828.0,86
HCPCS,90935,HEMODIALYSIS PROCEDURE W/ PHYS/QHP EVALUATION,651.0,423.15,1.1,2038.63,144
HCPCS,90935,INTENSIVE CARE IHD,4828.0,3138.2,85.0,4828.0,86
HCPCS,90937,HEMODIALYSIS PX REPEAT EVAL W/WO REVJ DIALYS RX,928.0,603.2,1.1,928.0,144
HCPCS,90937,HEMODIALYSIS REPEATED EVAL,,,265.1,265.1,1
HCPCS,90937,Hemodialysis repeated eval,,,373.09,432.0,8
HCPCS,90940,Hemodialysis access study,,,357.7,414.18,8
HCPCS,90945,CAVH DIALYSIS OP,2938.0,1909.7,102.71,2938.0,86
HCPCS,90945,CONTIN AV HEMOFILTRATION CAVH,2938.0,1909.7,102.71,2938.0,86
HCPCS,90945,CRRT - SINGLE EVALUATION,2938.0,1909.7,102.71,2938.0,86
HCPCS,90945,DIALYSIS OTHER/THAN HEMODIALYSIS 1 PHYS/QHP EVAL,686.0,445.9,1.1,1291.74,144
HCPCS,90945,PERITON DIALYS CAPD PEDS,2938.0,1909.7,102.71,2938.0,86
HCPCS,90945,PERITON DIALYS CCPD,2938.0,1909.7,102.71,2938.0,86
HCPCS,90945,PERITON DIALYS CCPD OP,2938.0,1909.7,102.71,2938.0,86
HCPCS,90945,PERITONEAL DIALYSIS CAPD,2938.0,1909.7,102.71,2938.0,86
HCPCS,90945,PERITONEAL DIALYSIS CCPD,2938.0,1909.7,102.71,2938.0,86
HCPCS,90945,PERITONEAL DIALYSIS NON-CAPD,2938.0,1909.7,102.71,2938.0,86
HCPCS,90945,ULTRAFILTRATION,2938.0,1909.7,102.71,2938.0,86
HCPCS,90947,DIALYSIS OTH/THN HEMODIALY REPEAT PHYS/QHP EVALS,3132.0,2035.8000000000002,0.01,5256.0,213
HCPCS,90951,ESRD RELATED SVC MONTHLY & <2 YR OLD 4/> VISITS,9568.0,6219.2,1.1,9568.0,144
HCPCS,90951,ESRD SERV 4 VISITS P MO <2YR,,,3048.39,3048.39,1
HCPCS,90951,Esrd serv 4 visits p mo <2yr,,,357.34,413.77,8
HCPCS,90952,ESRD RELATED SVC MONTHLY <2 YR OLD 2/3 VISITS,3790.0,2463.5,1.1,3790.0,106
HCPCS,90952,ESRD SERV 2-3 VSTS P MO <2YR,,,1317.53,1317.53,1
HCPCS,90952,Esrd serv 2-3 vsts p mo <2yr,,,357.34,413.77,8
HCPCS,90953,ESRD RELATED SVC MONTHLY <2 YR OLD 1 VISIT,2370.0,1540.5,1.1,2370.0,106
HCPCS,90953,ESRD SERV 1 VISIT P MO <2YRS,,,1133.7,1133.7,1
HCPCS,90953,Esrd serv 1 visit p mo <2yrs,,,357.34,413.77,8
HCPCS,90954,ESRD RELATED SVC MONTHLY 2-11 YR OLD 4/> VISITS,8344.0,5423.6,1.1,8344.0,144
HCPCS,90954,ESRD SERV 4 VSTS P MO 2-11,,,2615.38,2615.38,1
HCPCS,90954,Esrd serv 4 vsts p mo 2-11,,,357.34,413.77,8
HCPCS,90955,ESRD RELATED SVC MONTHLY 2-11 YR OLD 2/3 VISITS,4128.0,2683.2,1.1,4128.0,144
HCPCS,90955,ESRD SRV 2-3 VSTS P MO 2-11,,,1355.92,1355.92,1
HCPCS,90955,Esrd srv 2-3 vsts p mo 2-11,,,357.34,413.77,8
HCPCS,90956,ESRD RELATED SVC MONTHLY 2-11 YR OLD 1 VISIT,2656.0,1726.4,1.1,2656.0,144
HCPCS,90956,ESRD SRV 1 VISIT P MO 2-11,,,901.71,901.71,1
HCPCS,90956,Esrd srv 1 visit p mo 2-11,,,357.34,413.77,8
HCPCS,90957,ESRD RELATED SVC MONTHLY 12-19 YR OLD 4/> VISITS,6184.0,4019.6,1.1,6184.0,144
HCPCS,90957,ESRD SRV 4 VSTS P MO 12-19,,,1997.82,1997.82,1
HCPCS,90957,Esrd srv 4 vsts p mo 12-19,,,357.34,413.77,8
HCPCS,90958,ESRD RELATED SVC MONTHLY 12-19 YR OLD 2/3 VISITS,3948.0,2566.2,1.1,3948.0,144
HCPCS,90958,ESRD SRV 2-3 VSTS P MO 12-19,,,1298.54,1298.54,1
HCPCS,90958,Esrd srv 2-3 vsts p mo 12-19,,,357.34,413.77,8
HCPCS,90959,ESRD RELATED SVC MONTHLY 12-19 YR OLD 1 VISIT,2476.0,1609.4,1.1,2476.0,144
HCPCS,90959,ESRD SERV 1 VST P MO 12-19,,,844.99,844.99,1
HCPCS,90959,Esrd serv 1 vst p mo 12-19,,,357.34,413.77,8
HCPCS,90960,ESRD RELATED SVC MONTHLY 20&/> YR OLD 4/> VISITS,2708.0,1760.2,1.1,2708.0,144
HCPCS,90960,ESRD SRV 4 VISITS P MO 20+,,,916.75,916.75,1
HCPCS,90960,Esrd srv 4 visits p mo 20+,,,357.34,413.77,8
HCPCS,90961,ESRD RELATED SVC MONTHLY 20/>YR OLD 2/3 VISITS,2208.0,1435.2,1.1,2208.0,144
HCPCS,90961,ESRD SRV 2-3 VSTS P MO 20+,,,760.51,760.51,1
HCPCS,90961,Esrd srv 2-3 vsts p mo 20+,,,357.34,413.77,8
HCPCS,90962,ESRD RELATED SVC MONTHLY 20&/>YR OLD 1 VISIT,1428.0,928.2,1.1,1428.0,144
HCPCS,90962,ESRD SERV 1 VISIT P MO 20+,,,522.96,522.96,1
HCPCS,90962,Esrd serv 1 visit p mo 20+,,,357.34,413.77,8
HCPCS,90963,ESRD HOME PT SERV P MO <2YRS,,,1576.19,1576.19,1
HCPCS,90963,ESRD SVC HOME DIALYSIS FULL MONTH <2YR OLD,4836.0,3143.4,1.1,4836.0,144
HCPCS,90963,Esrd home pt serv p mo <2yrs,,,357.34,413.77,8
HCPCS,90964,ESRD HOME PT SERV P MO 2-11,,,1350.22,1350.22,1
HCPCS,90964,ESRD SVC HOME DIALYSIS FULL MONTH 2-11 YR OLD,4100.0,2665.0,1.1,4100.0,144
HCPCS,90964,Esrd home pt serv p mo 2-11,,,357.34,413.77,8
HCPCS,90965,ESRD HOME PT SERV P MO 12-19,,,1295.53,1295.53,1
HCPCS,90965,ESRD SVC HOME DIALYSIS FULL MONTH 12-19 YR OLD,3920.0,2548.0,1.1,3920.0,144
HCPCS,90965,Esrd home pt serv p mo 12-19,,,357.34,413.77,8
HCPCS,90966,ESRD HOME PT SERV P MO 20+,,,760.51,760.51,1
HCPCS,90966,ESRD SVC HOME DIALYSIS FULL MONTH 20 YR OLD,2208.0,1435.2,1.1,2208.0,144
HCPCS,90966,Esrd home pt serv p mo 20+,,,357.34,413.77,8
HCPCS,90967,ESRD RELATED SVC <FULL MONTH <2 YR OLD,140.0,91.0,1.1,140.0,144
HCPCS,90967,ESRD SVC PR DAY PT <2,,,45.51,45.51,1
HCPCS,90967,Esrd svc pr day pt <2,,,373.09,432.0,8
HCPCS,90968,ESRD RELATED SVC <FULL MONTH 2-11 YR OLD,136.0,88.4,1.1,136.0,144
HCPCS,90968,ESRD SVC PR DAY PT 2-11,,,44.61,44.61,1
HCPCS,90968,Esrd svc pr day pt 2-11,,,373.09,432.0,8
HCPCS,90969,ESRD RELATED SVC <FULL MONTH 12-19 YR OLD,132.0,85.8,1.1,132.0,144
HCPCS,90969,ESRD SVC PR DAY PT 12-19,,,43.73,43.73,1
HCPCS,90969,Esrd svc pr day pt 12-19,,,373.09,432.0,8
HCPCS,90970,ESRD RELATED SVC <FULL MONTH 20/>YR OLD,72.0,46.8,1.1,72.0,144
HCPCS,90970,ESRD SVC PR DAY PT 20+,,,24.44,24.44,1
HCPCS,90970,Esrd svc pr day pt 20+,,,373.09,432.0,8
HCPCS,90989,DIALYSIS TRAINING COMPLETE,,,1301.5,1301.5,1
HCPCS,90989,DIALYSIS TRAINING PATIENT COMPLETED COURSE,2512.0,1632.8,1.1,2512.0,88
HCPCS,90989,Dialysis training complete,,,39.1,45.28,8
HCPCS,90993,DIALYSIS TRAINING INCOMPL,,,52.06,52.06,1
HCPCS,90993,DIALYSIS TRAINING PATIENT PER TRAINING SESSION,534.0,347.1,1.1,534.0,88
HCPCS,90993,Dialysis training incompl,,,39.1,45.28,8
HCPCS,90997,HEMOPERFUSION,,,228.41,228.41,1
HCPCS,90997,Hemoperfusion,,,373.09,432.0,8
HCPCS,90999,ESRD CCPD OP,1301.0,845.65,283.62,1301.0,66
HCPCS,90999,ESRD HEMODIALYSIS OP,1544.0,1003.6,336.59,1544.0,66
HCPCS,91010,ESOPHAGEAL MOTILITY STUDY W/INTERP&RPT,2441.0,1586.65,1.1,4628.0,482
HCPCS,91013,ESOPHAGEAL MOTILITY STD W/I&R STIM/PERFUSION,1541.0,1001.65,33.45,4628.0,68
HCPCS,91020,GASTRIC MOTILITY MANOMETRIC STUDIES,2441.0,1586.65,1.1,3017.0,396
HCPCS,91020,GASTRIC MOTILITY STUDIES,,,353.04,1399.26,21
HCPCS,91020,Gastric motility studies,,,299.41,346.69,8
HCPCS,91022,DUODENAL MOTILITY MANOMETRIC STUDY,2441.0,1586.65,1.1,3017.0,396
HCPCS,91022,DUODENAL MOTILITY STUDY,,,353.04,1399.26,21
HCPCS,91022,Duodenal motility study,,,299.41,346.69,8
HCPCS,91030,ACID PERFUSION OF ESOPHAGUS,,,353.04,1399.26,21
HCPCS,91030,Acid perfusion of esophagus,,,299.41,346.69,8
HCPCS,91030,ESOPHAGUS ACID PERFUSION TEST ESOPHAGITIS,2441.0,1586.65,1.1,2805.0,396
HCPCS,91034,GASTROESOPHAG REFLX TEST W/CATH PH ELTRD PLCMT,2441.0,1586.65,1.1,4628.0,482
HCPCS,91035,GASTROESOPHAG REFLX TEST W/TELEMTRY PH ELTRD,2441.0,1586.65,1.1,5265.0,570
HCPCS,91037,GASTROESOPHAG REFLX TEST W/INTRLUML IMPED ELTRD,1432.0,930.8,1.1,4628.0,482
HCPCS,91038,ESOPHGL FUNCJ G-ESOP RFLX IMPD ELTRD PROLNG,2441.0,1586.65,1.1,4628.0,482
HCPCS,91040,ESOPH BALLOON DISTENSION TST,,,353.04,4132.0,22
HCPCS,91040,ESOPHGL BALO DISTENSION DX STD W/PROVOCATION,2441.0,1586.65,1.1,2829.0,396
HCPCS,91040,Esoph balloon distension tst,,,299.41,346.69,8
HCPCS,91065,BREATH HYDROGEN/METHANE TEST,720.0,468.0,1.1,4628.0,482
HCPCS,91110,GI TRC IMG INTRALUMINAL ESOPHAGUS-ILEUM W/I&R,4313.0,2803.45,1.1,6112.0,568
HCPCS,91111,GI TRACT IMAGING INTRALUMINAL ESOPHAGUS WI&R,4313.0,2803.45,1.1,6112.0,482
HCPCS,91112,GI TRANSIT & PRES MEAS WIRELESS CAPSULE W/INTERP,4313.0,2803.45,1.1,6112.0,482
HCPCS,91113,GI TRACT IMAGING INTRALUMINAL COLON I&R,4194.0,2726.1,1.1,5158.0,482
HCPCS,91117,COLON MOTILITY 6 HR STUDY,,,204.28,819.42,21
HCPCS,91117,COLON MOTILITY STDY MIN 6 HR CONT RECORD W/I&R,980.0,637.0,1.1,980.0,144
HCPCS,91117,Colon motility 6 hr study,,,299.41,346.69,8
HCPCS,91120,RECTAL SENSATION TEST,,,272.31,4132.0,10
HCPCS,91120,Rectal sensation test,,,391.75,453.61,8
HCPCS,91122,ANORECTAL MANOMETRY,,,272.31,4132.0,10
HCPCS,91122,Anorectal manometry,,,391.75,453.61,8
HCPCS,91124,RECTAL SENSATION TONE&COMPLIANCE STUDY,1522.0,989.3,1.1,3443.0,395
HCPCS,91125,ANRCT MANO RCT SENSATION&RCT BALO EXPULSION TEST,1754.0,1140.1,1.1,3443.0,395
HCPCS,91132,ELECTROGASTROGRAPHY DX TRANSCUTANEOUS,1432.0,930.8,1.1,4628.0,481
HCPCS,91133,ELECTROGASTROGRAPHY DX TRANSCUT W/PROVOCTVE TSTG,593.0,385.45,1.1,4628.0,481
HCPCS,91200,LIVER ELASTOGRAPHY W/O IMAG W/I&R,720.0,468.0,0.01,812.0,654
HCPCS,91299,PROC GASTROENTERO UNLISTED (COMP 91110),395.0,256.75,109.81,4628.0,84
HCPCS,91300,SARSCOV2 VAC 30MCG/0.3ML IM,,,0.01,0.01,1
HCPCS,91300,Sarscov2 vac 30mcg/0.3ml im,,,9.99,11.57,8
HCPCS,91301,SARSCOV2 VAC 100MCG/0.5ML IM,,,0.01,0.01,1
HCPCS,91301,Sarscov2 vac 100mcg/0.5ml im,,,9.99,11.57,8
HCPCS,91302,Sarscov2 vac 5x1010vp/.5mlim,,,9.99,11.57,8
HCPCS,91303,Sarscov2 vac ad26 .5ml im,,,9.99,11.57,8
HCPCS,91304,SARSCOV2 VAC 5MCG/0.5ML IM,,,23.99,437.58,12
HCPCS,91304,Sarscov2 vac 5mcg/0.5ml im,,,9.99,11.57,8
HCPCS,9130400,SARSCOV2 VAC 5MCG/0.5ML IM,,,341.62,437.58,3
HCPCS,91305,Sarscov2 vac 30 mcg trs-sucr,,,9.99,11.57,8
HCPCS,91306,Sarscov2 vac 50mcg/0.25ml im,,,9.99,11.57,8
HCPCS,91307,Sarscov2 vac 10 mcg trs-sucr,,,9.99,11.57,8
HCPCS,91308,Sarscov2 vac 3 mcg trs-sucr,,,9.99,11.57,8
HCPCS,91309,Sarscov2 vac 50mcg/0.5ml im,,,9.99,11.57,8
HCPCS,91310,Sarscov2 vac 5mcg/0.5ml as03,,,9.99,11.57,8
HCPCS,91311,Sarscov2 vac 25mcg/0.25ml im,,,9.99,11.57,8
HCPCS,91312,Sarscov2 vac bvl 30mcg/0.3ml,,,9.99,11.57,8
HCPCS,91313,Sarscov2 vac bvl 50mcg/0.5ml,,,9.99,11.57,8
HCPCS,91314,Sarscov2 vac bvl 25mcg/.25ml,,,9.99,11.57,8
HCPCS,91315,Sarscov2 vac bvl 10mcg/0.2ml,,,9.99,11.57,8
HCPCS,91316,Sarscov2 vac bvl 10mcg/0.2ml,,,9.99,11.57,8
HCPCS,91317,Sarscov2 vac bvl 3mcg/0.2ml,,,9.99,11.57,8
HCPCS,91318,PFIZER-BIONTECH COVID-19 VACCINE (2023-24 SEASON) AGE 6 MO - 4 Y,140.0,91.0,1.1,202.03,153
HCPCS,91318,SARSCOV2 VAC 3MCG TRS-SUC IM,,,104.4,133.72,3
HCPCS,9131800,SARSCOV2 VAC 3MCG TRS-SUC IM,,,104.4,133.72,3
HCPCS,91319,PFIZER-BIONTECH COVID-19 VACCINE (2023-24 SEASON)?AGE 5 YR - 11,278.0,180.7,1.1,278.71,153
HCPCS,91319,SARSCV2 VAC 10MCG TRS-SUC IM,,,168.74,216.14,3
HCPCS,9131900,SARSCV2 VAC 10MCG TRS-SUC IM,,,168.74,216.14,3
HCPCS,91320,SARSCOV2 VACC 30MCG/0.3ML TRIS-SUCROSE IM USE,512.85,333.355,1.1,532.7,153
HCPCS,91320,SARSCV2 VAC 30MCG TRS-SUC IM,,,299.7,383.88,3
HCPCS,9132000,SARSCV2 VAC 30MCG TRS-SUC IM,,,299.7,383.88,3
HCPCS,91321,SARSCOV2 VAC 25 MCG/.25ML IM,,,261.77,335.3,3
HCPCS,91321,SARSCOV2 VACCINE 25 MCG/0.25 ML FOR IM USE,465.4,302.51,1.1,465.4,153
HCPCS,9132100,SARSCOV2 VAC 25 MCG/.25ML IM,,,261.77,335.3,3
HCPCS,91322,SARSCOV2 VAC 50 MCG/0.5ML IM,,,20.21,399.82,12
HCPCS,91322,Sarscov2 vac 50 mcg/0.5ml im,,,9.99,11.57,8
HCPCS,9132200,SARSCOV2 VAC 50 MCG/0.5ML IM,,,287.74,368.56,3
HCPCS,91323,SARSCOV2 VAC 10 MCG/0.2ML IM,,,25.24,468.43,10
HCPCS,91323,Sarscov2 vac 10 mcg/0.2ml im,,,9.99,11.57,8
HCPCS,9132300,SARSCOV2 VAC 10 MCG/0.2ML IM,,,359.4,460.35,3
HCPCS,92002,OPHTH MEDICAL XM&EVAL INTERMEDIATE NEW PT,490.0,318.5,0.01,593.0,235
HCPCS,92004,OPHTH MEDICAL XM&EVAL COMPRE NEW PT 1/> VST,660.5,429.325,0.01,728.0,235
HCPCS,92012,OPHTH MEDICAL XM&EVAL INTERMEDIATE ESTAB PT,480.5,312.325,0.01,593.0,235
HCPCS,92014,OPHTH MEDICAL XM&EVAL COMPRHNSV ESTAB PT 1/>,580.5,377.325,0.01,593.0,235
HCPCS,92015,DETERMINATION REFRACTIVE STATE,40.0,26.0,1.1,73.83,182
HCPCS,92015,REFRACTION,35.0,22.75,1.1,65.13,116
HCPCS,92018,OPHTH XM&EVAL ANES W/WO MANJ GLOBE COMPL,5866.0,3812.9,0.01,10732.0,231
HCPCS,92019,LMTD OPH EXAM GENERAL ANES,,,2027.3,6100.56,21
HCPCS,92019,Lmtd oph exam general anes,,,198.21,229.5,8
HCPCS,92019,OPHTH XM&EVAL ANES W/WO MANJ GLOBE LMTD,524.0,340.6,1.1,6813.79,144
HCPCS,92020,GONIOSCOPY SEPARATE PROCEDURE,378.0,245.7,0.01,593.0,321
HCPCS,92025,COMPUTERIZED CORNEAL TOPOGRAPHY UNI/BI,273.0,177.45,1.1,427.0,482
HCPCS,92060,SENSORMOTOR XM W/MLT MEAS OCULAR DEVIJ W/I&R SPX,276.0,179.4,1.1,549.0,482
HCPCS,92065,ORTHOP TRAING PFRMD PHYS/QHP,,,86.69,86.69,1
HCPCS,92065,ORTHOPTIC TRAINING PERFORMED BY PHYS/OTHER QHP,284.0,184.6,1.1,284.0,228
HCPCS,92065,Orthop traing pfrmd phys/qhp,,,122.08,141.35,8
HCPCS,92066,ORTHOP TRAING SUPVJ PHYS/QHP,,,53.07,159.69,21
HCPCS,92066,Orthop traing supvj phys/qhp,,,122.08,141.35,8
HCPCS,92071,Contact lens fitting for tx,,,48.64,56.32,8
HCPCS,92071,FIT CONTACT LENS TX OCULAR SURFACE DISEASE,268.0,174.2,1.1,268.0,148
HCPCS,92072,Fitg c-lens keratoconus 1st,,,48.64,56.32,8
HCPCS,92072,KERATOCONUS FIT INITIAL BOTH EYES,788.0,512.2,1.1,788.0,146
HCPCS,92072,KERATOCONUS FIT INITIAL ONE EYE,788.0,512.2,1.1,788.0,146
HCPCS,92081,VISUAL FIELD XM UNI/BI W/INTERPRETJ LIMITED EXAM,273.0,177.45,1.1,405.0,482
HCPCS,92082,VISUAL FIELD XM UNI/BI W/INTERP INTERMED EXAM,273.0,177.45,1.1,449.0,482
HCPCS,92083,VISUAL FIELD XM UNI/BI W/INTERP EXTENDED EXAM,593.0,385.45,1.1,813.0,482
HCPCS,92100,SERIAL TONOMETRY SPX W/MLT MEAS INTRAOCULAR PRES,268.0,174.2,1.1,277.87,148
HCPCS,92100,Serial tonometry,,,48.64,56.32,8
HCPCS,92132,CPTRIZED OPH DX IMG ANTERIOR SEGMENT UNI/BI,273.0,177.45,1.1,401.0,482
HCPCS,92133,CPTRIZED OPH DX IMG PST SEGMENT UNI/BI OPTIC NRV,273.0,177.45,1.1,409.0,482
HCPCS,92134,CPTRIZED OPH DX IMG PST SEGMENT UNI/BI RETINA,273.0,177.45,1.1,414.0,482
HCPCS,92136,OPH BMTRY PRTL COHER INTRFRMTRY IO LENS PWR CAL,593.0,385.45,1.1,831.0,482
HCPCS,92137,CPTRIZD OPH DX IMG PST SGM UNI/BI RTA OCT ANGRPH,1432.0,930.8,1.1,1714.0,478
HCPCS,92145,CORNEA HYSTERESIS DETERMIN IMPULSE STIMJ UNI/BI,273.0,177.45,1.1,313.0,480
HCPCS,92201,OPSCPY EXTND RTA DRAW UNI/BI,,,53.07,159.69,21
HCPCS,92201,OPSCPY EXTND RTA DRAWING &AMP; SCL DEPRSN I&AMP;R UNI/BI,176.0,114.4,1.1,177.54,148
HCPCS,92201,Opscpy extnd rta draw uni/bi,,,47.73,55.26,8
HCPCS,92202,OPSCPY EXTND ON/MAC DRAW,,,53.07,159.69,21
HCPCS,92202,OPSCPY EXTND OPTIC NRV/MACULA DRAWING I&AMP;R UNI/BI,114.0,74.1,1.1,177.54,148
HCPCS,92202,Opscpy extnd on/mac draw,,,47.73,55.26,8
HCPCS,92227,IMG RTA DETCJ/MNTR DS STAFF,,,53.07,159.69,21
HCPCS,92227,Img rta detcj/mntr ds staff,,,47.73,55.26,8
HCPCS,92227,REMOTE DX RETINAL IMAGING,132.0,85.8,1.1,177.54,142
HCPCS,92227,REMOTE IMG DX RETINL DIS W/ALYS & REPORT UNI/BI,21.0,13.65,1.1,177.54,142
HCPCS,92228,IMG RTA DETC/MNTR DS PHY/QHP,,,34.79,104.7,21
HCPCS,92228,Img rta detc/mntr ds phy/qhp,,,47.73,55.26,8
HCPCS,92229,IMG RETINA DETCJ/MNTR DS POC AUTO A/R UNI/BI,272.5,177.125,1.1,273.0,230
HCPCS,92230,FLUORESCEIN ANGIOSCOPY I&R,,,353.04,1399.26,21
HCPCS,92230,FLUORESCEIN ANGIOSCOPY INTERPRETATION & REPORT,240.0,156.0,1.1,1564.17,148
HCPCS,92230,Fluorescein angioscopy i&r,,,198.21,229.5,8
HCPCS,92235,FLUORESCEIN ANGRPH W/MULTIFRAME I&R UNI/BI,1432.0,930.8,1.1,1762.0,482
HCPCS,92240,INDOCYANINE-GREEN ANGRPH W/MULTIFRAME I&R UNI/BI,1432.0,930.8,1.1,1784.0,482
HCPCS,92242,FLUORESCEIN ICG ANGRPH W/MULTIFRAME I&R UNI/BI,1432.0,930.8,1.1,1850.0,458
HCPCS,92250,FUNDUS PHOTOGRAPHY W/INTERPRETATION & REPORT,593.0,385.45,1.1,769.0,482
HCPCS,92260,OPHTHALMODYNAMOMETRY,,,34.79,104.7,21
HCPCS,92260,OPHTHALMOSCOPY/DYNAMOMETRY,80.0,52.0,1.1,116.32,148
HCPCS,92260,Ophthalmodynamometry,,,47.73,55.26,8
HCPCS,92265,NDL OCULOELECTROMYOGRAPHY 1+,,,53.07,159.69,21
HCPCS,92265,Ndl oculoelectromyography 1+,,,48.64,56.32,8
HCPCS,92270,ELECTRO-OCULOGRAPY W/INTERPRETATION & REPORT,593.0,385.45,1.1,917.0,482
HCPCS,92273,FULL FIELD ELECTRORETINOGRAPHY W/I&R,1432.0,930.8,1.1,1736.0,482
HCPCS,92274,MULTIFOCAL ELECTRORETINOGRAPHY W/I&R,720.0,468.0,1.1,988.0,482
HCPCS,92283,COLOR VISION XM EXTENDED ANOMALOSCOPE/EQUIV,273.0,177.45,1.1,341.0,482
HCPCS,92284,DARK ADAPTATION XM W/INTERPRETATION & REPORT,1836.0,1193.4,1.1,1938.0,346
HCPCS,92285,XTRNL OCULAR PHOTOG W/I&R DOCMT MEDICAL PROGRE,181.0,117.65,1.1,203.0,482
HCPCS,92286,ANT SGM IMAGING W/MICROSCOPY ENDOTHELIAL ANALY,593.0,385.45,1.1,769.0,482
HCPCS,92287,ANT SGM IMAGING W/FLUOROSCEIN ANGIO & I&R,593.0,385.45,1.1,753.0,482
HCPCS,92288,SCREENING DARK ADAPTATION MEASUREMENT W/I&R,955.5,621.075,0.01,1836.0,141
HCPCS,92310,COMPRE. C/L EXAM GAS PERMEABLE,75.0,48.75,1.1,331.49,114
HCPCS,92310,COMPREHENSIVE C/L EXAM DAILY WEAR,150.0,97.5,1.1,331.49,114
HCPCS,92310,CONTACT LENS EVALUATION,30.0,19.5,1.1,331.49,114
HCPCS,92310,"CONTACT LENS FIT,KERACONUS ONE EYE",379.0,246.35,1.1,379.0,114
HCPCS,92310,"CONTACT LENS FIT,KERACONUS OU",631.0,410.15,1.1,631.0,114
HCPCS,92310,CONTACT LENS FITTING,90.0,58.5,1.1,331.49,114
HCPCS,92310,CONTACT LENS FITTING OU,,,148.23,148.23,1
HCPCS,92310,CONTACT LENS FOLLOW-UP/CHECK-UP,35.0,22.75,1.1,331.49,114
HCPCS,92310,CONTACT LENS REFIT,50.0,32.5,1.1,331.49,114
HCPCS,92310,Contact lens fitting ou,,,48.64,56.32,8
HCPCS,92310,DIAGNOSTIC CONTACT LENS FITTING,55.0,35.75,1.1,331.49,114
HCPCS,92310,"KERATOCONUS FIT, ANNUAL EXAM NO CHANGE",55.0,35.75,1.1,331.49,114
HCPCS,92310,"KERATOCONUS, BASIC REFIT",100.0,65.0,1.1,331.49,114
HCPCS,92310,"KERATOCONUS,MODERATE REFIT>2 F/U VISIT",234.0,152.1,1.1,331.49,114
HCPCS,92310,MONOVISION/MULTIFOCAL REFIT,125.0,81.25,1.1,331.49,114
HCPCS,92310,MULTIFOCAL/SPECIALTY TORIC CONTACT LENS EXAM,205.0,133.25,1.1,331.49,114
HCPCS,92310,STANDARD CL EVAL,55.0,35.75,1.1,331.49,114
HCPCS,92311,"CONTACT LENS FIT APHAKIA, ONE EYE",394.0,256.1,1.1,1163.18,146
HCPCS,92311,CONTACT LENS FITG APHAKIA 1,,,345.67,1040.19,21
HCPCS,92311,Contact lens fitg aphakia 1,,,48.64,56.32,8
HCPCS,92311,RX&FITG CONTACT CORNEAL LENS APHAKIA 1 EYE,432.0,280.8,1.1,1163.18,146
HCPCS,92312,APHAKIA REFIT,135.0,87.75,1.1,400.76,146
HCPCS,92312,CONACT LENS FIT APHAKIA OU,636.0,413.4,1.1,636.0,146
HCPCS,92312,CONTACT LENS FITG APHAKIA OU,,,110.82,333.49,21
HCPCS,92312,Contact lens fitg aphakia ou,,,48.64,56.32,8
HCPCS,92313,C-LENS FITG CORNEOSCLRL LENS,,,110.82,333.49,21
HCPCS,92313,C-lens fitg corneosclrl lens,,,48.64,56.32,8
HCPCS,92313,"SCLERAL LENS FITTING, BOTH EYES",631.0,410.15,1.1,631.0,146
HCPCS,92313,"SCLERAL LENS FITTING, ONE EYE",379.0,246.35,1.1,379.0,146
HCPCS,92314,C-LENS FITG TECH OU,,,87.68,87.68,1
HCPCS,92314,C-lens fitg tech ou,,,48.64,56.32,8
HCPCS,92315,C-LENS FITG TECH APHAKIA 1,,,110.82,333.49,21
HCPCS,92315,C-lens fitg tech aphakia 1,,,48.64,56.32,8
HCPCS,92316,C-LENS FITG TECH APHAKIA OU,,,110.82,333.49,21
HCPCS,92316,C-lens fitg tech aphakia ou,,,48.64,56.32,8
HCPCS,92317,C-LENS FITG TECH CORNEOSCLRL,,,34.79,104.7,21
HCPCS,92317,C-lens fitg tech corneosclrl,,,48.64,56.32,8
HCPCS,92325,MODIFICATION OF CONTACT LENS,,,110.82,333.49,21
HCPCS,92325,Modification of contact lens,,,48.64,56.32,8
HCPCS,92326,REPLACEMENT OF CONTACT LENS,,,53.07,159.69,21
HCPCS,92326,Replacement of contact lens,,,48.64,56.32,8
HCPCS,92340,FIT SPECTACLES MONOFOCAL,,,46.5,46.5,1
HCPCS,92340,Fit spectacles monofocal,,,48.64,56.32,8
HCPCS,92341,FIT SPECTACLES BIFOCAL,,,59.65,59.65,1
HCPCS,92341,Fit spectacles bifocal,,,48.64,56.32,8
HCPCS,92342,FIT SPECTACLES MULTIFOCAL,,,67.49,67.49,1
HCPCS,92342,Fit spectacles multifocal,,,48.64,56.32,8
HCPCS,92352,FIT APHAKIA SPECTCL MONOFOCL,,,53.07,159.69,21
HCPCS,92352,Fit aphakia spectcl monofocl,,,48.64,56.32,8
HCPCS,92353,FIT APHAKIA SPECTCL MULTIFOC,,,53.07,159.69,21
HCPCS,92353,Fit aphakia spectcl multifoc,,,48.64,56.32,8
HCPCS,92354,FITG SPECT LOW VIS 1SYSTEM,,,34.79,104.7,21
HCPCS,92354,Fitg spect low vis 1system,,,48.64,56.32,8
HCPCS,92355,FITG SPECT LW VIS CMPND LENS,,,34.79,104.7,21
HCPCS,92355,Fitg spect lw vis cmpnd lens,,,48.64,56.32,8
HCPCS,92358,APHAKIA PROSTH SERVICE TEMP,,,53.07,159.69,21
HCPCS,92358,Aphakia prosth service temp,,,48.64,56.32,8
HCPCS,92370,RPR&REFITG SPECT XCP APHAKIA,,,40.36,40.36,1
HCPCS,92370,Rpr&refitg spect xcp aphakia,,,63.76,73.83,8
HCPCS,92371,RPR&REFIT SPCT PRSTH APHAKIA,,,53.07,159.69,21
HCPCS,92371,Rpr&refit spct prsth aphakia,,,48.64,56.32,8
HCPCS,92499,ANNUAL CONTACT LENS CHECK,55.0,35.75,0.01,85.71,84
HCPCS,92499,CONT. LENS POLISH/PAIR,17.5,11.38,0.01,85.71,168
HCPCS,92499,COSMETIC EDUCATIONAL VIRTUAL VISIT,200.0,130.0,0.01,200.0,84
HCPCS,92499,LASIK SCREENING - EHP,150.0,97.5,0.01,150.0,84
HCPCS,92499,ORA INTRAOPERATIVE WAVEFRONT ABERROMETRY,200.0,130.0,0.01,200.0,84
HCPCS,92499,POSTAGE & HANDLING/2ND DAY DEL.,20.0,13.0,0.01,85.71,168
HCPCS,92499,POSTAGE & HANDLING/OVERNIGHT,25.0,16.25,0.01,85.71,168
HCPCS,92499,POSTAGE AND HANDLING,14.0,9.1,0.01,85.71,168
HCPCS,92499,POSTAGE AND HANDLING E-DOCTOR,10.0,6.5,0.01,85.71,168
HCPCS,92502,EAR AND THROAT EXAMINATION,,,472.1,1436.39,21
HCPCS,92502,Ear and throat examination,,,107.64,124.64,8
HCPCS,92502,OTOLARYNGOLOGIC EXAM UNDER GENERAL ANESTHESIA,604.0,392.6,1.1,1603.96,144
HCPCS,92504,BINOCULAR MICROSCOPY SEPARATE DX PROCEDURE,86.0,55.900000000000006,1.1,97.4,216
HCPCS,92507,SPEECH/HEARING THERAPY INDIV,473.0,307.45,70.74,473.0,86
HCPCS,92507,TX SPEECH LANG VOICE COMMJ &/AUDITORY PROC IND,496.5,322.725,1.1,520.0,314
HCPCS,92507,VV SPEECH THERAPY (92507),496.5,322.725,1.1,520.0,228
HCPCS,92508,SLT-SPEECH/LANGUAG THERAPY GRP,283.0,183.95,30.03,283.0,86
HCPCS,92508,TX SPEECH LANGUAGE VOICE COMMJ AUDITRY 2/>INDIV,207.5,134.875,1.1,283.0,314
HCPCS,92511,NASOPHARYNGOSCOPY W/ENDOSCOPE SPX,522.5,339.625,0.01,3443.0,407
HCPCS,92512,NASAL FUNCTION STUDIES,220.0,143.0,1.1,915.24,169
HCPCS,92512,Nasal function studies,,,245.35,284.09,8
HCPCS,92516,FACIAL NERVE FUNCTION STUDIES,172.0,111.8,1.1,915.24,148
HCPCS,92516,FACIAL NERVE FUNCTION TEST,,,204.28,819.42,21
HCPCS,92516,Facial nerve function test,,,245.35,284.09,8
HCPCS,92517,CERVICAL VEMP TESTING W/I&R,473.0,307.45,1.1,626.0,234
HCPCS,92518,OCULAR VEMP TESTING W/I&R,473.0,307.45,1.1,626.0,234
HCPCS,92519,CERVICAL & OCULAR VEMP TESTING W/I&R,863.0,560.95,1.1,1246.0,234
HCPCS,92520,LARYNGEAL FUNCTION STUDIES,516.0,335.4,44.77,528.46,87
HCPCS,92520,LARYNGEAL FUNCTION STUDY,300.0,195.0,1.1,373.44,148
HCPCS,92521,EVAL OF SPEECH FLUENCY,593.0,385.45,70.74,593.0,85
HCPCS,92521,"EVALUATION OF SPEECH FLUENCY (EG, STUTTERING, CLUTTERING)",896.0,582.4,1.1,896.0,142
HCPCS,92521,EVALUATION OF SPEECH FLUENCY (STUTTER CLUTTER),549.0,356.85,70.74,549.0,85
HCPCS,92521,VV FLUENCY EVAL (92521),593.0,385.45,70.74,593.0,85
HCPCS,92521,VV FLUENCY EVALUATION (92521),896.0,582.4,1.1,896.0,142
HCPCS,92522,EVAL OF SPEECH PRODUCTION,573.0,372.45,70.74,573.0,85
HCPCS,92522,EVALUATION OF SPEECH SOUND PRODUCTION ARTICULATE,670.5,435.825,1.1,768.0,227
HCPCS,92522,VV SOUND PRODUCTION EVALUATION (92522),670.5,435.825,1.1,768.0,227
HCPCS,92523,EVAL SPEECH SOUND LANG COMPREH,1002.0,651.3,70.74,1002.0,85
HCPCS,92523,EVAL SPEECH SOUND PRODUCT LANGUAGE COMPREHENSION,1269.0,824.8499999999999,1.1,1536.0,227
HCPCS,92523,VV SPEECH SOUND LANGUAGE COMPREHENSIVE EVAL (92523),1002.0,651.3,70.74,1002.0,85
HCPCS,92523,VV SPEECH SOUND LANGUAGE COMPREHENSIVE EVALUATION (92523),1536.0,998.4,1.1,1536.0,142
HCPCS,92524,BEHAV QUAL ANLYS VOICE MO,544.0,353.6,70.74,544.0,85
HCPCS,92524,BEHAVIORAL & QUALIT ANALYSIS VOICE AND RESONANCE,544.0,353.6,70.74,544.0,170
HCPCS,92524,BEHAVIORAL AND QUALITATIVE ANALYSIS OF VOICE AND RESONANCE,768.0,499.2,1.1,768.0,142
HCPCS,92524,GA VOICE CARE EVAL,275.0,178.75,1.1,370.19,142
HCPCS,92524,VV VOICE EVAL (92524),544.0,353.6,70.74,544.0,85
HCPCS,92524,VV VOICE EVALUATION (92524),768.0,499.2,1.1,768.0,142
HCPCS,92526,TREAT SWALLOWING DYSFUNCTION,664.0,431.6,85.08,664.0,86
HCPCS,92526,TX SWALLOWING DYSFUNCTION&/ORAL FUNCJ FEEDING,600.0,390.0,1.1,664.0,230
HCPCS,92531,SPONTANEOUS NYSTAGMUS STUDY,599.0,389.35,1.1,1048.0,156
HCPCS,92532,POSITIONAL NYSTAGMUS STUDY,215.0,139.75,1.1,215.0,90
HCPCS,92532,Positional nystagmus test,,,40.0,46.32,8
HCPCS,92533,Caloric vestibular test,,,40.0,46.32,8
HCPCS,92534,Optokinetic nystagmus test,,,245.35,284.09,8
HCPCS,92537,CALORIC VEST TEST BITHERMAL,626.0,406.9,50.03,626.0,86
HCPCS,92537,CALORIC VESTIBULAR TEST W/REC BI BITHERMAL,626.0,406.9,1.1,890.0,396
HCPCS,92538,CALORIC VEST TEST MONOTHERMAL,626.0,406.9,27.49,626.0,86
HCPCS,92538,CALORIC VESTIBULAR TEST W/REC BI MONOTHERMAL,626.0,406.9,1.1,758.0,396
HCPCS,92540,BASIC VESTIBULAR EVAL,626.0,406.9,132.51,626.0,86
HCPCS,92540,VSTBLR FUNCJ NYSTAG FOVL&PERPH STIMJ OSCIL TRKG,660.0,429.0,1.1,1286.0,396
HCPCS,92541,READ SPONTANEOUS GAZE TEST,434.0,282.1,1.1,692.0,270
HCPCS,92541,SPONTANEOUS NYSTAGMUS TEST,516.0,335.4,1.1,692.0,482
HCPCS,92542,POSITIONAL NYSTAGMUS TEST,516.0,335.4,1.1,727.0,482
HCPCS,92542,READ POSITIONAL (STATIC-DYNAMIC),469.0,304.85,1.1,727.0,270
HCPCS,92544,OPTKINETIC NYSTAG BIDIR/FOVEAL/PERIPH STIM W/REC,720.0,468.0,1.1,839.0,396
HCPCS,92544,OPTOKINETIC NYSTAGMUS TEST,720.0,468.0,22.14,720.0,86
HCPCS,92545,OSCILLATING TRACKING TEST,1432.0,930.8,20.81,1432.0,86
HCPCS,92545,OSCILLATING TRACKING TEST W/RECORDING,1432.0,930.8,1.1,1542.0,396
HCPCS,92546,SINUSOIDAL VERTICAL AXIS ROTATIONAL TESTING,720.0,468.0,1.1,848.0,482
HCPCS,92547,Supplemental electrical test,,,245.35,284.09,8
HCPCS,92547,USE VERTICAL ELECTRODES,187.0,121.55,1.1,187.0,144
HCPCS,92548,CDP-SOT 6 CONDITIONS W/INTERPRETATION & REPORT,593.0,385.45,1.1,861.0,482
HCPCS,92549,CDP-SOT 6 CONDITIONS W/I&R W/MCT & ADT,593.0,385.45,80.04,593.0,86
HCPCS,92550,TYMP & REFLEX THRESH,626.0,406.9,27.65,626.0,86
HCPCS,92550,TYMPANOMETRY AND REFLEX THRESHOLD MEASUREMENTS,154.0,100.1,1.1,456.09,144
HCPCS,92551,SCREENING TEST PURE TONE AIR ONLY,63.0,40.95,1.1,64.0,176
HCPCS,92552,AUDIOMETRY THRESHOLD TEST,516.0,335.4,40.0,516.0,86
HCPCS,92552,PURE TONE AUDIOMETRY AIR ONLY,127.0,82.55,1.1,373.44,144
HCPCS,92553,AUDIOMETRY AIR AND BONE,626.0,406.9,64.56,626.0,86
HCPCS,92553,PURE TONE AUDIOMETRY AIR & BONE,166.0,107.9,1.1,456.09,144
HCPCS,92555,SPEECH AUDIOMETRY THRESHOLD,161.0,104.64999999999999,1.1,238.0,230
HCPCS,92556,SPEECH AUDIOMETRY THRESHOLD SPEECH RECOGNIJ,147.0,95.55,1.1,177.54,144
HCPCS,92556,SPEECH RECEPTION THRESHOLD,238.0,154.7,40.0,238.0,86
HCPCS,92557,AUDIOMETRY EVAL & SPEECH RECOG,626.0,406.9,35.94,626.0,86
HCPCS,92557,COMPRE AUDIOMETRY THRESHOLD EVAL SP RECOGNIJ,445.0,289.25,1.1,626.0,234
HCPCS,92558,EVOKED OTOACOUSTIC EMISSIONS SCREEN AUTO ANALYS,186.0,120.9,40.0,186.0,66
HCPCS,92559,Group audiometric testing,,,40.0,46.32,8
HCPCS,92560,Bekesy audiometry screen,,,40.0,46.32,8
HCPCS,92561,Bekesy audiometry diagnosis,,,40.0,46.32,8
HCPCS,92562,LOUDNESS BALANCE BINAURAL/MONAURAL,104.0,67.6,1.1,915.24,142
HCPCS,92562,LOUDNESS BALANCE TEST,,,204.28,819.42,21
HCPCS,92562,Loudness balance test,,,40.0,46.32,8
HCPCS,92563,TONE DECAY,98.0,63.7,1.1,116.32,142
HCPCS,92563,TONE DECAY TEST,157.0,102.05,34.79,157.0,86
HCPCS,92564,Sisi hearing test,,,40.0,46.32,8
HCPCS,92565,PURE TONE STENGER,100.0,65.0,1.1,177.54,142
HCPCS,92565,STENGER TEST PURE TONE,238.0,154.7,29.32,238.0,86
HCPCS,92567,TYMPANOMETRY,122.5,79.625,1.1,157.0,320
HCPCS,92568,ACOUSTIC REFLEX,116.0,75.4,1.1,116.32,148
HCPCS,92568,ACOUSTIC REFLEX THRESHOLD,157.0,102.05,17.56,157.0,86
HCPCS,92570,ACOUSTIC IMMIT TEST TYMPANOM/ACOUST REFLX/DECAY,434.0,282.1,1.1,626.0,234
HCPCS,92570,GA VOICE CARE AIT,275.0,178.75,1.1,456.09,148
HCPCS,92571,FILTERED SPEECH TEST,,,34.79,104.7,21
HCPCS,92571,Filtered speech test,,,40.0,46.32,8
HCPCS,92572,STAGGERED SPONDAIC WORD TEST,,,121.73,407.79,21
HCPCS,92572,Staggered spondaic word test,,,134.62,155.88,8
HCPCS,92575,SENSORINEURAL ACUITY LVL TST,,,34.79,104.7,21
HCPCS,92575,SENSORINEURAL ACUITY TEST,86.0,55.9,1.1,238.47,142
HCPCS,92575,Sensorineural acuity lvl tst,,,40.0,46.32,8
HCPCS,92576,SYNTHETIC SENTENCE ID TEST,,,34.79,104.7,21
HCPCS,92576,Synthetic sentence id test,,,40.0,46.32,8
HCPCS,92577,SPEECH STENGER,144.0,93.6,1.1,1564.17,142
HCPCS,92577,STENGER TEST SPEECH,2122.0,1379.3,30.73,2122.0,86
HCPCS,92579,VISUAL REINFORCEMENT AUDIOMETRY,467.0,303.54999999999995,1.1,626.0,234
HCPCS,92582,AUDIOMETRY CONDITION PLAY,626.0,406.9,121.73,626.0,86
HCPCS,92582,CONDITIONING PLAY AUDIOMETRY,168.0,109.2,1.1,456.09,144
HCPCS,92583,SELECT PICTURE AUDIOMETRY,209.5,136.175,1.1,238.0,228
HCPCS,92584,ELECTROCOCHLEOGRAPHY,533.0,346.45,1.1,626.0,228
HCPCS,92585,Auditor evoke potent compre,,,134.62,155.88,8
HCPCS,92586,Auditor evoke potent limit,,,134.62,155.88,8
HCPCS,92587,DISTORT PRODUCT EVOKED OTOACOUSTIC EMISNS LIMITD,1246.0,809.9,1.1,1400.0,396
HCPCS,92587,TEST EVOKED AUDITORY LTD,1246.0,809.9,27.14,1246.0,86
HCPCS,92588,DISTRT PROD EVOKD OTOACOUSTIC EMSNS COMP/DX EVAL,1246.0,809.9,1.1,1488.0,396
HCPCS,92588,TEST EVOKED AUDITORY COMPR,1246.0,809.9,42.27,1246.0,86
HCPCS,92590,HEARING AID XM&SLCTN MONAURL,,,128.78,128.78,1
HCPCS,92590,Hearing aid xm&slctn monaurl,,,40.0,46.32,8
HCPCS,92591,HEARING AID XM&SLCTN BINAURL,,,167.14,167.14,1
HCPCS,92591,Hearing aid xm&slctn binaurl,,,40.0,46.32,8
HCPCS,92592,HEARING AID CHECK MONAURAL,,,47.13,47.13,1
HCPCS,92592,Hearing aid check monaural,,,40.0,46.32,8
HCPCS,92593,HEARING AID CHECK BINAURAL,,,88.78,88.78,1
HCPCS,92593,Hearing aid check binaural,,,40.0,46.32,8
HCPCS,92594,ELECTRO HEARNG AID TEST ONE,,,47.13,47.13,1
HCPCS,92594,Electro hearng aid test one,,,40.0,46.32,8
HCPCS,92595,ELECTRO HEARNG AID TST BOTH,,,88.78,88.78,1
HCPCS,92595,Electro hearng aid tst both,,,40.0,46.32,8
HCPCS,92596,EAR PROTECTOR ATTEN MEASURES,121.0,78.65,1.1,234.03,130
HCPCS,92596,EAR PROTECTOR EVALUATION,,,34.79,104.7,21
HCPCS,92596,Ear protector evaluation,,,40.0,46.32,8
HCPCS,92597,EVAL&/FITG VOICE PROSTC DEV SUPLMNT ORAL SPEEC,504.0,327.6,1.1,504.0,142
HCPCS,92597,FIT PROSTHTIC VOICE DVC 440,636.0,413.4,70.74,636.0,85
HCPCS,92601,ANALYSIS COCHLEAR IMPLT PT <7 YR PRGRMG,626.0,406.9,22.84,626.0,86
HCPCS,92601,ANLYS COCHLR IMP < 7 YR W PROG,1012.0,657.8,1.1,1012.0,148
HCPCS,92602,ANALYSIS COCHLEAR IMPLT PT <7 YR SBSQ REPRGRMG,626.0,406.9,22.84,626.0,86
HCPCS,92602,ANLYS COCHLR IMP < 7 YR REPROG,572.0,371.8,1.1,572.0,148
HCPCS,92603,ANALYSIS COCHLEAR IMPLT 7 YR/> PRGRMG,626.0,406.9,22.84,626.0,86
HCPCS,92603,ANLYS COCHLR IMP 7+ YR W PROG,990.0,643.5,1.1,990.0,148
HCPCS,92604,ANALYSIS COCHLEAR IMPLT 7 YR/> SBSQ REPRGRMG,626.0,406.9,22.84,626.0,86
HCPCS,92604,ANLYS COCHLR IMP 7+ YR REPROG,550.0,357.5,1.1,550.0,148
HCPCS,92605,EVAL RX N-SP-GEN AUGMT ALT COMMUN DEV F2F 1ST HR,700.0,455.0,1.1,700.0,102
HCPCS,92605,EX FOR NONSPEECH DEVICE RX,,,222.79,222.79,1
HCPCS,92605,Ex for nonspeech device rx,,,70.74,81.91,8
HCPCS,92606,NON-SPEECH DEVICE SERVICE,,,177.17,177.17,1
HCPCS,92606,Non-speech device service,,,31.09,36.0,8
HCPCS,92607,EVAL SPCH - GEN DEV 1 HR,1420.0,923.0,70.74,1420.0,85
HCPCS,92607,RX SP-GENRATJ AUGMNT&COMUNICAJ DEV 1ST HR,1080.0,702.0,1.1,1420.0,227
HCPCS,92608,EVAL SPCH - GEN DEV 30 MN,172.0,111.8,47.82,172.0,85
HCPCS,92608,RX SP-GENRATJ AUGMNT&COMUNICAJ DEV EA 30 MIN,280.0,182.0,1.1,280.0,142
HCPCS,92609,SLT-THERA SVC COM DEV PRG MOD,629.0,408.85,85.08,629.0,85
HCPCS,92609,THER SP-GENRATJ DEV PRGRMG&MODIFICAJ,600.0,390.0,1.1,600.0,142
HCPCS,92610,EVAL ORAL&PHARYNGEAL SWLNG FUNCJ,545.0,354.25,1.1,570.0,403
HCPCS,92610,EVALUATE SWALLOWING FUNCTION,570.0,370.5,70.74,570.0,85
HCPCS,92611,MOTION FLUOR EVAL SWLNG FUNCJ C/V REC,682.5,443.625,1.1,829.0,229
HCPCS,92611,SWALLOW EVAL FUNC FLUORO GN,829.0,538.85,113.53,829.0,85
HCPCS,92612,FEES W CINE OR VIDEO,1084.0,704.6,74.78,1084.0,85
HCPCS,92612,FLEXIBLE ENDOSCOPIC EVAL SWALLOW C/V REC,508.0,330.2,1.1,658.72,148
HCPCS,92613,ENDOSCOPY SWALLOW (FEES) I&R,,,94.39,94.39,1
HCPCS,92613,Endoscopy swallow (fees) i&r,,,107.64,124.64,8
HCPCS,92613,FLEXIBLE ENDOSCOPIC EVAL SWALLOW C/V REC I&R,312.0,202.8,1.1,312.0,130
HCPCS,92614,LARYNGOSCOPIC SENSORY VID,,,74.61,169.47,25
HCPCS,92614,Laryngoscopic sensory vid,,,107.64,124.64,8
HCPCS,92615,LARYNGOSCOPIC SENSORY I&R,,,84.75,84.75,1
HCPCS,92615,Laryngoscopic sensory i&r,,,107.64,124.64,8
HCPCS,92616,FEES W/LARYNGEAL SENSE TEST,,,110.4,257.23,25
HCPCS,92616,FLEXIBLE NDSC EVAL SWLNG&LARYN SENS C/V REC,752.0,488.8,1.1,755.73,148
HCPCS,92616,Fees w/laryngeal sense test,,,107.64,124.64,8
HCPCS,92617,FEES W/LARYNGEAL SENSE I&R,,,105.76,105.76,1
HCPCS,92617,Fees w/laryngeal sense i&r,,,107.64,124.64,8
HCPCS,92618,EVAL RX N-SP-GEN AUGMT ALT COMMUN DEV ADD 30 MIN,264.0,171.6,1.1,268.0,168
HCPCS,92620,AUDITORY FUNCTION 60 MIN,,,121.73,407.79,21
HCPCS,92620,Auditory function 60 min,,,70.74,81.91,8
HCPCS,92620,EVAL CENTRAL AUDITORY FUNCJ W/REPRT 1ST 60 MIN,600.0,390.0,1.1,600.0,148
HCPCS,92621,Auditory function + 15 min,,,70.74,81.91,8
HCPCS,92621,EVAL CENTRAL AUDITORY FUNCJ W/REPRT EA 15 MIN,140.0,91.0,1.1,140.0,148
HCPCS,92622,"BAI / OSSEO HRG DEVICE ANALYSIS, PROGRAM & VERIFICATION, 1ST 6OM",626.0,406.9,22.84,626.0,86
HCPCS,92622,DX ALY PRGRMG&VERIF AUD OI SOUND PROCESSR 1ST 60,550.0,357.5,1.1,550.0,148
HCPCS,92623,"BAI / OSSEO HRG DEVICE ANALYSIS, PROGRAM & VERIFICATION, EACH AD",156.0,101.4,19.73,156.0,68
HCPCS,92623,DX ALY PRGRMG&VERIF AUD OI SOUND PROCESSR EA ADL,145.0,94.25,1.1,145.0,148
HCPCS,92625,TINNITUS ASSESSMENT,460.0,299.0,1.1,460.0,167
HCPCS,92625,Tinnitus assessment,,,134.62,155.88,8
HCPCS,92626,EVAL AUD FUNCJ CAND/PO SURG IMPLT DEV 1ST HR,560.0,364.0,1.1,560.0,148
HCPCS,92626,EVAL AUD REHAB STATUS,626.0,406.9,70.74,626.0,86
HCPCS,92627,EVAL AUD FUNCJ CAND/PO SURG IMPLT DEV EA ADDL 15,104.0,67.6,1.1,132.0,216
HCPCS,92628,EVALUATION HEARING AID CANDIDACY 1ST 30 MINUTES,206.5,134.225,1.1,313.0,136
HCPCS,92629,EVALUATION HEARING AID CANDIDACY EA ADDL 15 MIN,157.0,102.05,34.23,157.0,66
HCPCS,92630,AUDITORY REHABILITATION PRELINGUAL HEARING LOSS,290.5,188.825,1.1,425.86,162
HCPCS,92631,HEARING AID SELECTION SERVICES 1ST 30 MINUTES,206.5,134.225,1.1,313.0,136
HCPCS,92632,HEARING AID SELECTION SERVICES EA ADDL 15 MIN,157.0,102.05,34.23,157.0,66
HCPCS,92633,AUDITORY REHABILITATION POSTLINGUAL HEARING LOSS,321.0,208.64999999999998,1.1,440.78,150
HCPCS,92634,HEARING AID FITTING SERVICES 1ST 60 MINUTES,463.0,300.95,1.1,626.0,136
HCPCS,92635,HEARING AID FITTING SERVICES EA ADDL 15 MINUTES,157.0,102.05,34.23,157.0,66
HCPCS,92636,HEARING AID POST-FITTING F-UP SVC 1ST 30 MINUTES,181.5,117.975,1.1,313.0,136
HCPCS,92637,HEARING AID POST-FITTING F-UP SVC EA ADDL 15 MIN,91.0,59.15,1.1,157.0,136
HCPCS,92638,BEHAVIORAL VERIFICATION OF AMPLIFICATION,626.0,406.9,40.0,626.0,66
HCPCS,92639,HEARING AID MEAS VERIF W/PROBE MICROPHONE,626.0,406.9,40.0,626.0,66
HCPCS,92640,ANALYSIS W/PRGRMG AUD BRAINSTEM IMPLANT PR HR,704.0,457.6,1.1,704.0,148
HCPCS,92640,AUD BRAINSTEM IMPLT PROGRAMG,,,121.73,407.79,21
HCPCS,92640,Aud brainstem implt programg,,,85.08,98.52,8
HCPCS,92641,HEARING DEVICE VERIFICATION ELECTROACOUSTIC ALYS,626.0,406.9,40.0,626.0,66
HCPCS,92642,HEARING ASSISTIVE DEVICE SUPPL TECH FITTING SVC,363.0,235.95,1.1,626.0,136
HCPCS,92650,AEP SCR AUDITORY POTENTIAL W/STIMULI AUTO ALYS,370.5,240.825,1.1,631.0,174
HCPCS,92651,AEP HEARING STATUS DETER BROADBAND STIMULI I&R,823.0,534.95,1.1,1246.0,230
HCPCS,92652,AEP THRESHOLD ESTIMATION MLT FREQUENCIES I&R,923.0,599.95,1.1,1246.0,316
HCPCS,92653,AEP NEURODIAGNOSTIC INTERPRETATION AND REPORT,833.0,541.45,1.1,1246.0,316
HCPCS,92700,ASSR,283.0,183.95,0.01,283.0,84
HCPCS,92700,BAI CHECK,100.0,65.0,0.01,100.0,84
HCPCS,92700,BAI CONSULT,75.0,48.75,0.01,85.71,84
HCPCS,92700,BAI EVAL,100.0,65.0,0.01,100.0,84
HCPCS,92700,BAI FITTING,500.0,325.0,0.01,500.0,84
HCPCS,92700,BONE CONDUCTION CHECK,108.0,70.2,22.7,124.64,84
HCPCS,92700,BONE CONDUCTION DEVICE EVAL,108.0,70.2,22.7,124.64,84
HCPCS,92700,BONE CONDUCTION FITTING FEE,540.0,351.0,22.7,540.0,84
HCPCS,92700,BRIEF SPEECH SCREEN EVAL,319.0,207.35,22.7,319.0,84
HCPCS,92700,COCHLEAR IMPLANT REMOTE CHECK,75.0,48.75,0.01,85.71,84
HCPCS,92700,"DISPENSING FEE, BAHA",500.0,325.0,0.01,500.0,84
HCPCS,92700,DYNAMIC VISUAL ACUITY TEST,132.0,85.8,0.01,132.0,84
HCPCS,92700,DYNAMIC VISUAL ACUITY TESTING,319.0,207.35,22.7,319.0,84
HCPCS,92700,FISTULA,115.0,74.75,0.01,170.0,168
HCPCS,92700,"FITTING FEE, HAT",108.0,70.2,22.7,124.64,84
HCPCS,92700,MODF CLINICAL TEST SENS INTERACTION BALANCE,625.0,406.25,22.7,625.0,84
HCPCS,92700,MODF CLINICAL TEST SENS INTERACTION ON BALANCE,165.0,107.25,0.01,165.0,84
HCPCS,92700,NECK NYSTAGMUS,132.0,85.8,0.01,132.0,84
HCPCS,92700,NECK NYSTAGMUS TEST,170.0,110.5,22.7,170.0,84
HCPCS,92700,OSSEINTEGRATED HRG DEVICE EVAL,100.0,65.0,0.01,100.0,84
HCPCS,92700,PROC ENT UNLISTD 444,174.0,113.1,22.7,174.0,84
HCPCS,92700,PROC ENT UNLISTD 471,11.0,7.15,3.06,124.64,84
HCPCS,92700,READ VEMP,286.0,185.9,0.01,286.0,84
HCPCS,92700,READ VEMP & MCTSIB,451.0,293.15,0.01,451.0,84
HCPCS,92700,READ VEMP & VHIT,418.0,271.7,0.01,418.0,84
HCPCS,92700,"READ VEMP,VHIT,DVAT,MCTSIB",715.0,464.75,0.01,715.0,84
HCPCS,92700,"READ VEMP,VHIT,MCTSIB",583.0,378.95,0.01,583.0,84
HCPCS,92700,READ VHIT & DVAT,264.0,171.6,0.01,264.0,84
HCPCS,92700,READ VHIT & MCTSIB,297.0,193.05,0.01,297.0,84
HCPCS,92700,"READ VHIT,DVAT,MCTSIB",429.0,278.85,0.01,429.0,84
HCPCS,92700,SMELL TEST,63.0,40.95,17.51,124.64,84
HCPCS,92700,SPEECH IN NOISE TEST (COMP 92556),113.5,73.775,0.01,163.0,168
HCPCS,92700,TESTING VEMP & MCTSIB,893.0,580.45,22.7,893.0,84
HCPCS,92700,TESTING VEMP & VHIT,586.0,380.9,22.7,586.0,84
HCPCS,92700,"TESTING VEMP,VHIT,DVAT,MCTSIB",1530.0,994.5,22.7,1530.0,84
HCPCS,92700,"TESTING VEMP,VHIT,MCTSIB",1212.0,787.8,22.7,1212.0,84
HCPCS,92700,TESTING VHIT & DVAT,637.0,414.05,22.7,637.0,84
HCPCS,92700,TESTING VHIT & MCTSIB,944.0,613.6,22.7,944.0,84
HCPCS,92700,"TESTING VHIT,DVAT,MCTSIB",1263.0,820.95,22.7,1263.0,84
HCPCS,92700,TINNITUS MANAGEMENT CLINIC,300.0,195.0,0.01,300.0,84
HCPCS,92700,TMC GROUP VIRTUAL VISIT,200.0,130.0,0.01,200.0,84
HCPCS,92700,TMC INDIVIDUAL SCREENINGS,100.0,65.0,0.01,100.0,84
HCPCS,92700,UNLISTED ENT PROCED/SERVICE,174.0,113.1,22.7,174.0,84
HCPCS,92700,VEMP,277.0,180.05,0.01,286.0,168
HCPCS,92700,VIDEO HEAD IMPULSE TEST,319.0,207.35,22.7,319.0,84
HCPCS,92700,VIDEO HEAD IMPULSE TEST (COMP CODE 92541),172.0,111.8,0.01,172.0,84
HCPCS,92700,WIRELESS ACCESSORY SETUP,125.0,81.25,0.01,125.0,84
HCPCS,92920,PRQ CARDIAC ANGIOPLAST 1 ART,32784.0,21309.6,497.76,32784.0,86
HCPCS,92920,PRQ TRLUML CORONARY ANGIOPLASTY ONE ART/BRANCH,18559.0,12063.349999999999,1.1,32784.0,231
HCPCS,92920,PTCA + CORONARY LITHOTRIPSY,4334.0,2817.1,1.1,16670.21,144
HCPCS,92920,PTCA + IVUS/OCT,4334.0,2817.1,1.1,16670.21,144
HCPCS,92921,Prq cardiac angio addl art,,,5870.61,6797.55,8
HCPCS,92924,PRQ CARDIAC ANGIO/ARTHRECT 1 ART,30204.0,19632.6,603.68,30204.0,86
HCPCS,92924,PRQ TRLUML CORONARY ANGIO/ATHERECT ONE ART/BRNCH,17450.0,11342.5,1.1,32085.4,231
HCPCS,92925,Prq card angio/athrect addl,,,5870.61,6797.55,8
HCPCS,92928,PRQ CARDIAC STENT W/ANGIO 1 VSL,42281.0,27482.65,596.27,42281.0,86
HCPCS,92928,PRQ TRLUML CORONARY STENT W/ANGIO ONE ART/BRNCH,4822.0,3134.3,1.1,32085.4,144
HCPCS,92929,Prq card stent w/angio addl,,,5870.61,6797.55,8
HCPCS,92930,PERQ TCAT PLMT NTRAC ST 2+LES 2+ST 2+C SEGMENTS,67254.0,43715.1,1.1,129228.0,183
HCPCS,92933,PRQ TRLUML CORONRY STENT/ATH/ANGIO ONE ART/BRNCH,25311.0,16452.149999999998,1.1,51140.13,230
HCPCS,92934,Prq card stent/ath/angio,,,5870.61,6797.55,8
HCPCS,92937,PRQ BM REVASC CABG 1 VSL,44674.0,29038.1,673.42,44674.0,86
HCPCS,92937,PRQ TRLUML CORONARY BYP GRFT REVASC ONE VESSEL,4818.0,3131.7,1.1,32085.4,144
HCPCS,92938,Prq revasc byp graft addl,,,5870.61,6797.55,8
HCPCS,92941,PRQ CARD REVASC MI 1 VSL,33050.0,21482.5,758.22,33050.0,68
HCPCS,92941,PRQ TRLUML CORONRY TOT OCCLUS REVASC MI ONE VSL,4924.0,3200.6,1.1,4924.0,144
HCPCS,92943,PRQ DES REVASC CHRONIC 1VSL,38342.0,24922.3,799.28,38342.0,86
HCPCS,92943,PRQ TRLUML CORONRY CHRONIC OCCLUS REVASC ONE VSL,5416.0,3520.4,1.1,32085.4,144
HCPCS,92944,Prq card revasc chronic addl,,,5870.61,6797.55,8
HCPCS,92945,PERQ TRLUML REVSC CHRNC TOT OCCLS 1 ANTGRD&RTRGR,43990.0,28593.5,1.1,81380.0,183
HCPCS,92950,CARDIO-PULMONARY RESUSCITATION,1760.0,1144.0,1.1,1760.0,148
HCPCS,92950,CARDIOPULMONARY RESUSCITATION,1791.0,1164.15,0.01,1791.0,431
HCPCS,92953,TEMPORARY TRANSCUTANEOUS PACING,1884.0,1224.6,0.62,3763.0,230
HCPCS,92960,CARDIOVERSION ELECTIVE ARRHYTHMIA EXTERNAL,2321.5,1508.975,1.1,3763.0,408
HCPCS,92961,CARDIOVERSION ELECTIVE ARRHYTHMIA INTERNAL SPX,2749.5,1787.175,1.1,3763.0,230
HCPCS,92970,CARDIOASSIST INTERNAL,,,487.14,487.14,1
HCPCS,92970,CARDIOASSIST-METH CIRCULATORY ASSIST INTERNAL,1404.0,912.6,1.1,1404.0,144
HCPCS,92970,Cardioassist internal,,,2523.55,2922.01,8
HCPCS,92971,CARDIOASSIST EXTERNAL,,,258.0,258.0,1
HCPCS,92971,Cardioassist external,,,397.56,460.33,8
HCPCS,92972,PERCUTANEOUS TRANSLUMINAL CORONARY LITHOTRIPSY,3184.5,2069.925,1.1,6797.55,210
HCPCS,92973,PRQ TRANSLUMINAL CORONARY MECHANICL THROMBECTOMY,2566.5,1668.225,1.1,6797.55,212
HCPCS,92974,TCAT PLACEMENT RADJ DLVR DEV SBSQ C IV BRACHYTX,7038.5,4575.025,1.1,12877.0,212
HCPCS,92975,DISSOLVE CLOT HEART VESSEL,,,970.89,970.89,1
HCPCS,92975,Dissolve clot heart vessel,,,2860.76,3312.46,8
HCPCS,92977,DISSOLVE CLOT HEART VESSEL,,,293.81,884.14,9
HCPCS,92977,Dissolve clot heart vessel,,,391.01,452.75,8
HCPCS,92978,ENDOLUMINAL CORONARY IVUS OCT I&R INITIAL VESSEL,5062.0,3290.3,1.1,5854.0,388
HCPCS,92979,ENDOLUMINAL CORONARY IVUS OCT I&R ADDL VESSEL,3905.0,2538.25,1.1,4628.0,388
HCPCS,92986,PRQ BALLOON VALVULOPLASTY AORTIC VALVE,14999.5,9749.675,1.1,20959.0,230
HCPCS,92987,PRQ BALLOON VALVULOPLASTY MITRAL VALVE,22683.5,14744.275,1.1,36015.0,230
HCPCS,92990,PRQ BALLOON VALVULOPLASTY PULMONARY VALVE,36258.0,23567.699999999997,1.1,65208.0,230
HCPCS,92992,Revision of heart chamber,,,5870.61,6797.55,8
HCPCS,92993,Revision of heart chamber,,,5870.61,6797.55,8
HCPCS,92997,PRQ TRLUML PULMONARY ART BALLOON ANGIOP 1 VSL,35000.0,22750.0,1.1,65208.0,230
HCPCS,92998,PRQ TRLUML PULMONARY ART BALLOON ANGIOP EA VSL,4095.0,2661.75,1.1,37117.0,212
HCPCS,93000,ECG ROUTINE ECG W/LEAST 12 LDS W/I&R,245.0,159.25,1.1,415.0,213
HCPCS,93005,ECG ROUTINE ECG W/LEAST 12 LDS TRCG ONLY W/O I&R,318.5,207.025,1.1,342.0,318
HCPCS,93010,ECG ROUTINE ECG W/LEAST 12 LDS I&R ONLY,75.0,48.75,1.1,75.0,144
HCPCS,93010,EKG INTERPRETATION,56.0,36.4,1.1,56.0,144
HCPCS,93010,ELECTROCARDIOGRAM REPORT,,,21.07,21.07,1
HCPCS,93010,Electrocardiogram report,,,23.5,27.21,8
HCPCS,93015,CV STRESS TEST SUPVJ I&R,,,182.98,182.98,1
HCPCS,93015,CV STRS TST XERS&/OR RX CONT ECG W/SI&R,330.0,214.5,1.1,330.0,144
HCPCS,93015,Cv stress test supvj i&r,,,108.55,125.69,8
HCPCS,93016,CV STRESS TEST SUPVJ ONLY,,,54.39,54.39,1
HCPCS,93016,CV STRS TST XERS&/OR RX CONT ECG W/O I&R,198.0,128.7,1.1,198.0,144
HCPCS,93016,Cv stress test supvj only,,,108.55,125.69,8
HCPCS,93017,CV STRS TST XERS&/OR RX CONT ECG TRCG ONLY,1154.0,750.1,1.1,1791.0,228
HCPCS,93018,CONCENTRA PROGRAM STRESS TEST,200.0,130.0,1.1,200.0,144
HCPCS,93018,CV STRESS TEST I&R ONLY,,,36.0,36.0,1
HCPCS,93018,CV STRS TST XERS&/OR RX CONT ECG I&R ONLY,132.0,85.8,1.1,132.0,144
HCPCS,93018,Cv stress test i&r only,,,108.55,125.69,8
HCPCS,93024,ERGONOVINE PROVOCATION TST,2294.0,1491.1,1.1,2809.0,482
HCPCS,93025,MICROVOLT T-WAVE ASSESS VENTRICULAR ARRHYTHMIAS,900.0,585.0,1.1,1200.0,458
HCPCS,93040,RHYTHM ECG 1-3 LEADS W/INTERPRETATION & REPORT,60.0,39.0,1.1,60.0,142
HCPCS,93040,RHYTHM ECG WITH REPORT,,,33.29,33.29,1
HCPCS,93040,Rhythm ecg with report,,,23.5,27.21,8
HCPCS,93041,RHYTHM ECG 1-3 LEADS TRACING ONLY W/O I&R,207.0,134.55,1.1,342.0,316
HCPCS,93042,RHYTHM ECG 1-3 LEADS INTERPRETATION & REPRT ON,66.0,42.9,1.1,66.0,142
HCPCS,93042,RHYTHM ECG REPORT,,,17.65,17.65,1
HCPCS,93042,Rhythm ecg report,,,23.5,27.21,8
HCPCS,93042,TRANS-TELEPHONIC ARRHYTHMIA MONITORING,20.0,13.0,1.1,23.09,142
HCPCS,93050,ART PRESS WAVEFORM ANALYS CENTRAL ART PRESSURE,141.0,91.65,1.1,209.0,482
HCPCS,93145,INTERROG EVAL CRTD SINS BAT MODULJ SYS IP WO,596.5,387.72499999999997,1.1,907.0,183
HCPCS,93146,INTERROG EVAL CRTD SINS BAT MODULJ SYS IP W/,651.5,423.47499999999997,1.1,907.0,183
HCPCS,93150,THER ACTIVATION IMPL PHRENIC NRV STIMULATOR SYS,503.5,327.275,1.1,633.0,232
HCPCS,93151,INTERROG&PRGRMG IMPL PHRENIC NRV STIMULATOR SYS,492.5,320.125,1.1,633.0,232
HCPCS,93152,INTERROG&PRGRMG IPNSS DURING POLYSOMNOGRAPHY,1435.0,932.75,1.1,2069.0,232
HCPCS,93153,INTERROGATION WITHOUT PROGRAMMING IPNSS,411.0,267.15,1.1,633.0,232
HCPCS,93224,XTRNL ECG & 48 HR RECORD SCAN STOR W/R&I,172.0,111.8,1.1,244.68,144
HCPCS,93224,XTRNL ECG REC UP TO 48 HRS,,,179.99,179.99,1
HCPCS,93224,Xtrnl ecg rec up to 48 hrs,,,86.64,100.32,8
HCPCS,93225,XTRNL ECG & 48 HR RECORDING,549.0,356.85,1.1,741.0,230
HCPCS,93226,EXTERNAL ECG SCANNING ANALYSIS REPORT,546.0,354.9,1.1,750.0,230
HCPCS,93227,XTRNL ECG CONTINUOUS RHYTHM W/I&R UP TO 48 HRS,172.0,111.8,1.1,172.0,144
HCPCS,93227,XTRNL ECG REC<48 HR R&I,,,47.35,47.35,1
HCPCS,93227,Xtrnl ecg rec<48 hr r&i,,,86.64,100.32,8
HCPCS,93228,REMOTE 30 DAY ECG REV/REPORT,,,64.64,64.64,1
HCPCS,93228,XTRNL MOBILE CV TELEMETRY W/I&REPORT 30 DAYS,211.0,137.15,1.1,211.0,144
HCPCS,93229,REMOTE 30 DAY ECG TECH SUPP,,,272.31,819.42,21
HCPCS,93241,XTRNL ECG REC>48HR<7D,,,637.87,637.87,1
HCPCS,93241,Xtrnl ecg rec>48hr<7d,,,86.64,100.32,8
HCPCS,93242,EXTERNAL ECG REC>48HR<7D RECORDING,277.0,180.05,1.1,328.0,230
HCPCS,93243,EXTERNAL ECG REC>48HR<7D SCANNING ALYS W/REPORT,741.0,481.65,86.64,741.0,172
HCPCS,93244,EXT ECG>48HR<7D REV&INTERPJ,,,59.79,59.79,1
HCPCS,93244,EXTERNAL ECG REC>48HR<7D REVIEW & INTERPRETATION,200.0,130.0,1.1,200.0,144
HCPCS,93244,Ext ecg>48hr<7d rev&interpj,,,86.64,100.32,8
HCPCS,93245,EXT ECG>7D<15D REC SCAN A/R,,,670.97,670.97,1
HCPCS,93245,Ext ecg>7d<15d rec scan a/r,,,86.64,100.32,8
HCPCS,93246,EXTERNAL ECG REC>7D<15D RECORDING,277.0,180.05,1.1,328.0,230
HCPCS,93247,EXTERNAL ECG REC>7D<15D SCANNING ALYS W/REPORT,741.0,481.65,86.64,741.0,86
HCPCS,93248,EXT ECG>7D<15D REV&INTERPJ,,,65.92,65.92,1
HCPCS,93248,EXTERNAL ECG REC>7D<15D REVIEW & INTERPRETATION,242.0,157.3,1.1,242.0,144
HCPCS,93248,Ext ecg>7d<15d rev&interpj,,,86.64,100.32,8
HCPCS,93260,PRGRMG DEV EVAL IMPLANTABLE SUBQ LEAD DFB SYSTEM,374.0,243.1,1.1,588.0,481
HCPCS,93261,INTERROGATION EVAL F2F IMPLANT SUBQ LEAD DEFIB,326.0,211.9,1.1,540.0,481
HCPCS,93264,REMOTE MNTR WIRELESS P-ART PRS SNR UP TO 30 D,261.0,169.64999999999998,1.1,308.0,224
HCPCS,93268,ECG RECORD/REVIEW,,,433.69,433.69,1
HCPCS,93268,XTRNL PT ACTIV ECG TRANSMIS W/R&I </30 DAYS,208.0,135.2,1.1,575.22,144
HCPCS,93270,XTRNL PT ACTIVATED ECG RECORD MONITOR 30 DAYS,375.5,244.075,1.1,537.0,222
HCPCS,93271,XTRNL PT ACTIVATED ECG REC DWNLD 30 DAYS,397.5,258.375,1.1,528.0,222
HCPCS,93272,"ECG/REVIEW, INTERPRET ONLY",6.0,3.9,1.31,32.32,60
HCPCS,93272,XTRNL PT ACTIVTD ECG DWNLD W/R&I </30 DAYS,208.0,135.2,1.1,208.0,144
HCPCS,93278,SIGNAL AVERAGED ELECTROCARDIOGRAPHY W/WO ECG,342.0,222.3,1.1,442.0,481
HCPCS,93279,PACEMAKER PROGRAMMING SINGLE,260.0,169.0,1.1,260.0,144
HCPCS,93279,PRGRMG DEV EVAL 1 LEAD PM/LDLS PM 1 CAR CHMBR IP,260.0,169.0,1.1,474.0,483
HCPCS,93280,PACEMAKER PROGRAMMING DUAL,308.0,200.2,1.1,308.0,144
HCPCS,93280,PROGRAM EVAL IMPLANTABLE IN PERSN DUAL LD PACER,308.0,200.2,1.1,522.0,483
HCPCS,93281,PACEMAKER PROGRAMMING MULT,374.0,243.1,1.1,374.0,144
HCPCS,93281,PROGRAM EVAL IMPLANTABLE IN PRSN MULTI LD PACER,374.0,243.1,1.1,588.0,483
HCPCS,93282,DEFIBRILLATOR PROGRAMMING SINGLE,374.0,243.1,1.1,374.0,144
HCPCS,93282,PRGRMNG DEV EVAL IMPLANTABLE IN PERSN 1 LD DFB,374.0,243.1,1.1,588.0,483
HCPCS,93283,DEFIBRILLATOR PROGRAMMING DUAL,506.0,328.9,1.1,506.0,144
HCPCS,93283,PRGRMG EVAL IMPLANTABLE IN PRSN DUAL LEAD DFB,506.0,328.9,1.1,720.0,483
HCPCS,93284,DEFIBRILLATOR PROGRAMMING MULT,550.0,357.5,1.1,550.0,144
HCPCS,93284,PRGRMG EVAL IMPLANTABLE IN PERSON MULTI LEAD DFB,550.0,357.5,1.1,764.0,570
HCPCS,93285,PRGRMG DEV EVAL SCRMS PHYS/QHP IN PERSON,214.0,139.1,1.1,422.0,483
HCPCS,93286,PACEMAKER PERI PROCEDURAL,132.0,85.8,1.1,150.82,144
HCPCS,93286,PERI-PX DEV EVAL PM/LDLS PM PHYS/QHP IN PERSON,302.0,196.3,1.1,434.0,464
HCPCS,93287,DEFIBRILLATOR PERI PROCEDURAL,198.0,128.7,1.1,198.0,144
HCPCS,93287,PERI-PX DEV EVAL & PROG SING/DUAL/MULTI LEAD DFB,339.0,220.35,1.1,537.0,464
HCPCS,93288,INTERROG DEV EVAL PM/LDLS PM PHYS/QHP IN PERSON,214.0,139.1,1.1,386.0,569
HCPCS,93288,PACEMAKER INTERROGATION,172.0,111.8,1.1,185.24,144
HCPCS,93289,INTERROG EVAL F2F 1/DUAL/MLT LEADS IMPLTBL DFB,330.0,214.5,1.1,544.0,483
HCPCS,93290,INTERROG DEV EVAL ICPMS PHYS/QHP IN PERSON,214.0,139.1,1.1,403.0,483
HCPCS,93290,PHYSIOLOGICAL MONITOR INTERROGATION,189.0,122.85,1.1,189.0,144
HCPCS,93291,IMPLANTABLE LOOP RECORDER INTERROGATION,163.0,105.95,1.1,163.26,144
HCPCS,93291,INTERROG DEV EVAL SCRMS PHYS/QHP IN PERSON,163.0,105.95,1.1,304.0,483
HCPCS,93292,INTERROGATION EVAL IN PERSON WR DEFIBRILLATOR,214.0,139.1,1.1,386.0,483
HCPCS,93292,WEARABLE DEFIBRILLATOR INTERROGATION,172.0,111.8,1.1,172.0,144
HCPCS,93293,TELEPHONIC MONITORING,136.0,88.4,1.1,148.78,144
HCPCS,93293,TRANSTELEPHONIC RHYTHM STRIP PACEMAKER EVAL,214.0,139.1,1.1,350.0,483
HCPCS,93294,REM INTERROG EVL PM/LDLS PM,,,76.34,76.34,1
HCPCS,93294,REM INTERROG PM/LDLS PM <90 D PHYS/QHP,240.0,156.0,1.1,240.0,144
HCPCS,93294,Rem interrog evl pm/ldls pm,,,22.84,26.44,8
HCPCS,93295,DEV INTERROG REMOTE 1/2/MLT,,,94.72,94.72,1
HCPCS,93295,Dev interrog remote 1/2/mlt,,,22.84,26.44,8
HCPCS,93295,INTERROGATION EVAL REMOTE </90 D 1/2/MLT LD DFB,326.0,211.9,1.1,326.0,144
HCPCS,93296,DEFIBRILLATOR HEART RHYTHM DATA PRO CODE,89.0,57.85,1.1,110.2,144
HCPCS,93296,REM INTERROG PM/LDLS PM/IDS <90 D TECH REVIEW,214.0,139.1,22.84,214.0,87
HCPCS,93297,REM INTERROG ICPMS <30 D PHYS/QHP,214.0,139.1,1.1,422.0,451
HCPCS,93298,REM INTERROG SCRMS <30 D PHYS/QHP,214.0,139.1,1.1,422.0,451
HCPCS,93303,COMPLETE TTHRC ECHO CONGENITAL CARDIAC ANOMALY,3153.0,2049.45,1.1,3725.0,483
HCPCS,93304,F-UP/LIMITED TTHRC ECHO CONGENITAL CAR ANOMALY,3153.0,2049.45,1.1,3483.0,483
HCPCS,93306,ECHO TTHRC R-T 2D M-MODE COMPL SPEC&COLR D W/O CONTRAST,3153.0,2049.45,258.45,3153.0,87
HCPCS,93306,ECHO TTHRC R-T 2D W/WOM-MODE COMPL SPEC&COLR D,3153.0,2049.45,1.1,3795.0,483
HCPCS,93307,ECHO TRANSTHORAC R-T 2D W/WO M-MODE REC COMP,1390.0,903.5,1.1,1795.0,483
HCPCS,93308,ECHO TRANSTHORC R-T 2D W/WO M-MODE REC F-UP/LMTD,1390.0,903.5,1.1,1623.0,744
HCPCS,93312,ECHO TRANSESOPHAG R-T 2D W/PRB IMG ACQUISJ I&R,3153.0,2049.45,1.1,4165.0,570
HCPCS,93313,ECHO R-T 2D W/PROBE PLACEMENT ONLY,114.0,74.1,1.1,1610.09,144
HCPCS,93313,ECHO TRANSESOPHAGEAL,,,478.61,1440.23,21
HCPCS,93313,Echo transesophageal,,,353.35,409.15,8
HCPCS,93314,ECHO TRANSESOPHAG R-T 2D IMG ACQUISJ I&R ONLY,2237.0,1454.05,1.1,3051.0,464
HCPCS,93315,ECHO TRANSESOPHAG CONGEN PROBE PLCMT IMGNG I&R,3153.0,2049.45,1.1,4337.0,411
HCPCS,93316,ECHO TRANSESOPHAG CONGEN PROBE PLCMT ONLY,264.0,171.6,1.1,1610.09,144
HCPCS,93316,ECHO TRANSESOPHAGEAL,,,478.61,1440.23,21
HCPCS,93316,Echo transesophageal,,,353.35,409.15,8
HCPCS,93317,"ECHO TRANSESOPH,CONG ANOM,ACQ,INTERP",607.2,394.68,1.1,894.56,106
HCPCS,93317,ECHO TRANSESOPHAG IMAGE ACQUISJ INTERP&REPORT,810.0,526.5,1.1,894.56,232
HCPCS,93317,Echo transesophageal,,,353.35,409.15,8
HCPCS,93318,ECHO TRANSESOPHAG MONTR CARDIAC PUMP FUNCTJ,3153.0,2049.45,1.1,4099.0,411
HCPCS,93319,3D ECHO IMG&PST-PXESSING TEE/TTE CGEN CAR ANOMAL,518.0,336.7,28.49,518.0,68
HCPCS,93319,ECHO 3D IMG&PST-PXESSING TEE/TTE CGEN CAR ANOMAL,220.0,143.0,1.1,220.0,148
HCPCS,93320,DOPPLER ECHOCARD PULSE WAVE W/SPECTRAL DISPLAY,1333.0,866.45,1.1,1500.0,464
HCPCS,93321,DOP ECHOCARD PULSE WAVE W/SPECTRAL F-UP/LMTD STD,600.0,390.0,1.1,666.0,464
HCPCS,93325,DOP ECHOCARD COLOR FLOW VELOCITY MAPPING,1066.0,692.9,1.1,1097.0,464
HCPCS,93350,ECHO TTHRC R-T 2D W/WO M-MODE COMPLETE REST&ST,3153.0,2049.45,1.1,3795.0,483
HCPCS,93351,ECHO TTHRC R-T 2D W/WO M-MODE REST&STRS CONT ECG,3153.0,2049.45,1.1,3923.0,483
HCPCS,93352,ADMIN ECG CONTRAST AGENT,,,86.75,86.75,1
HCPCS,93352,Admin ecg contrast agent,,,353.35,409.15,8
HCPCS,93352,USE OF ECHO CONTRAST AGENT DURING STRESS ECHO,84.0,54.6,1.1,110.16,144
HCPCS,93355,ECHO TEE GUID TCAT ICAR/VESSEL STRUCTURAL INTVN,3049.0,1981.85,1.1,4048.0,280
HCPCS,93356,HOSPITAL MYOCRD STRAIN,69.0,44.85,13.67,409.15,68
HCPCS,93356,MYOCRD STRAIN IMG SPECKLE TRCK ASSMT MYOCRD MECH,87.5,56.875,1.1,409.15,216
HCPCS,93451,RIGHT HEART CATH O2 SATURATION & CARDIAC OUTPUT,18494.0,12021.1,1.1,19581.0,470
HCPCS,93452,L HRT CATH W/NJX L VENTRICULOGRAPHY IMG S&I,18494.0,12021.1,1.1,20474.0,470
HCPCS,93453,R & L HRT CATH W/NJX L VENTRICULOG IMG S&I,18494.0,12021.1,1.1,21130.0,470
HCPCS,93454,CATH PLACEMENT & NJX CORONARY ART ANGIO IMG S&I,18494.0,12021.1,1125.32,18494.0,86
HCPCS,93454,CATH PLMT & NJX CORONARY ART ANGIO IMG S&I,18494.0,12021.1,1.1,20492.0,384
HCPCS,93454,CORONARY ANGIOGRAPHY + FFR,1998.0,1298.7,1.1,9504.41,144
HCPCS,93454,CORONARY ANIO + FFR/3D MAPPING (CATHWORKS),1998.0,1298.7,1.1,9504.41,144
HCPCS,93455,CATH PLMT & NJX CORONARY ART/GRFT ANGIO IMG S&I,18494.0,12021.1,1.1,20822.0,470
HCPCS,93456,CATH PLMT R HRT & ARTS W/NJX & ANGIO IMG S&I,18494.0,12021.1,1.1,21090.0,470
HCPCS,93457,CATH PLMT R HRT/ARTS/GRFTS W/NJX& ANGIO IMG S&I,18494.0,12021.1,1520.96,18494.0,86
HCPCS,93457,CATH PLMT R HRT/ARTS/GRFTS W/NJX&ANGIO IMG S&I,18494.0,12021.1,1.1,21416.0,384
HCPCS,93458,CATH PLMT L HRT & ARTS W/NJX & ANGIO IMG S&I,18494.0,12021.1,1.1,20958.0,470
HCPCS,93459,CATH PLMT L HRT/ARTS/GRFTS WNJX & ANGIO IMG S&I,18494.0,12021.1,1.1,21288.0,470
HCPCS,93460,R & L HRT CATH WINJX HRT ART& L VENTR IMG,18494.0,12021.1,1.1,21618.0,470
HCPCS,93461,R& L HRT CATH W/INJEC HRT ART/GRFT& L VENT I,18494.0,12021.1,1.1,21948.0,470
HCPCS,93462,LEFT HEART CATH BY TRANSEPTAL PUNCTURE,5567.0,3618.55,1.1,10260.0,212
HCPCS,93463,MEDICATION ADMIN & HEMODYNAMIC MEASURMENT,2705.0,1758.25,1.1,4628.0,280
HCPCS,93464,PHYSIOLOGIC EXERCISE STUDY & HEMODYNAMIC MEASU,2831.0,1840.15,108.55,4628.0,68
HCPCS,93464,PHYSIOLOGIC EXERCISE STUDY & HEMODYNAMIC MEASURE,2831.0,1840.15,1.1,3551.0,396
HCPCS,93503,INSERTION FLOW DIRECTED CATHETER FOR MONITORING,4906.0,3188.9,0.01,10260.0,491
HCPCS,93505,ENDOMYOCARDIAL BIOPSY,18098.0,11763.7,1.1,19911.0,470
HCPCS,93530,Rt heart cath congenital,,,1947.82,2255.37,8
HCPCS,93531,R & l heart cath congenital,,,1947.82,2255.37,8
HCPCS,93532,R & l heart cath congenital,,,1947.82,2255.37,8
HCPCS,93533,R & l heart cath congenital,,,1947.82,2255.37,8
HCPCS,93561,Cardiac output measurement,,,81.99,94.94,8
HCPCS,93562,Card output measure subsq,,,81.99,94.94,8
HCPCS,93563,INJ CONGENITAL CARD CATH,5341.0,3471.65,58.8,11132.0,68
HCPCS,93563,NJX SEL HRT ART CONGENITAL HRT CATH W/S&I,400.0,260.0,1.1,400.0,142
HCPCS,93564,INJ HRT CONGNTL ART/GRFT,5592.0,3634.8,61.09,11132.0,68
HCPCS,93564,INJECTION PROCEDURE DURING CARDIAC CATHETERIZATION,5592.0,3634.8,61.09,11132.0,68
HCPCS,93564,NJX SEL HRT ART/GRFT CONGENITAL HRT CATH W/S&I,412.0,267.8,1.1,412.0,142
HCPCS,93565,NJX SEL L VENT/ATRIAL ANGIO HRT CATH W/S&I,2223.0,1444.95,1.1,11132.0,210
HCPCS,93566,NJX SEL R VENT/ATRIAL ANGIO HRT CATH W/S&I,2124.0,1380.6,1.1,11132.0,210
HCPCS,93567,NJX SUPRAVALV AORTOG HRT CATH W/S&I,2447.0,1590.55,1.1,11132.0,210
HCPCS,93568,NJX DRG C-CATHJ NSLCTV P-ART ANGIOGRAPHY,2463.0,1600.95,1.1,11132.0,210
HCPCS,93569,NJX DRG C-CATHJ SLCTV P-ART ANGIOGRAPHY UNI,6622.5,4304.625,1.1,12902.0,210
HCPCS,93571,IV DOP VEL&/OR PRESS C/FLO RSRV MEAS 1ST VSL,2620.5,1703.325,1.1,7735.57,560
HCPCS,93572,IV DOP VEL&/OR PRESS C/FLO RSRV MEAS ADDL VSL,2621.0,1703.65,1.1,7719.15,456
HCPCS,93573,NJX DRG C-CATHJ SLCTV P-ART ANGIOGRAPHY BI,8880.5,5772.325,1.1,17189.0,210
HCPCS,93574,NJX DRG C-CATHJ SLCTV PULM VEN ANGIOGRAPHY,1000.5,650.325,1.1,4628.0,210
HCPCS,93575,NJX DRG C-CATHJ SLCTV PULM ANGRPH MAPCA CHD EA,2734.0,1777.1,1.1,4628.0,210
HCPCS,93580,CLSR ASD TX CATH W IMP,33856.0,22006.4,1083.76,33856.0,86
HCPCS,93580,PRQ TCAT CLSR CGEN INTRATRL COMUNICAJ W/IMPLT,20881.5,13572.975,1.1,51140.13,228
HCPCS,93581,PRQ TCAT CLSR CGEN VENTR SEPTAL DFCT W/IMPLT,25998.0,16898.7,1.1,51140.13,228
HCPCS,93582,PERCUTAN TRANSCATH CLOSURE PAT DUCT ARTERIOSUS,28104.5,18267.925,1.1,51285.0,228
HCPCS,93583,PERCUTANEOUS TRANSCATHETER SEPTAL REDUCTION THER,5660.5,3679.325,1.1,16547.65,210
HCPCS,93584,VENOGRAPHY CHD ANOMALOUS/PERSISTENT SVC NT DRG,30034.5,19522.425,1.1,59541.0,210
HCPCS,93585,VENOGRAPHY CHD AZYGOS/HEMIAZYGOS VENOUS SYSTEM,30019.0,19512.350000000002,1.1,59541.0,210
HCPCS,93586,VENOGRAPHY CHD CORONARY SINUS,30085.0,19555.25,1.1,59541.0,210
HCPCS,93587,VENOGRAPHY CHD VENOVENOUS COLTRL AT/ABOVE HRT,30234.5,19652.425,1.1,59541.0,210
HCPCS,93588,VENOGRAPHY CHD VENOVENOUS COLLATERAL BELOW HEART,30239.0,19655.350000000002,1.1,59541.0,210
HCPCS,93590,PERQ TRANSCATH CLS PARAVALVR LEAK 1 MITRAL VALVE,35031.5,22770.475,1.1,61383.0,228
HCPCS,93591,PERQ TRANSCATH CLS PARAVALVR LEAK 1 AORTIC VALVE,36247.0,23560.55,1.1,65306.0,228
HCPCS,93592,PERQ TRANSCATH CLS PARAVALVR LEAK EACH OCCLS DEV,3287.0,2136.55,1.1,16547.65,210
HCPCS,93593,R HRT CATH CHD W/IMG CATH TRGT ZONE NML NT CONNJ,18494.0,12021.1,0.03,20090.0,358
HCPCS,93594,R HRT CATH CHD W/IMG CATH TRGT ZON ABNL NT CONNJ,18494.0,12021.1,0.03,20934.0,358
HCPCS,93595,L HRT CATH CHD IMG CATH TRGT ZON NML/ABNL NT CNJ,18494.0,12021.1,0.03,21035.0,358
HCPCS,93596,R&L HRT CATH CHD IMG CATH TRGT ZONE NML NT CONNJ,18494.0,12021.1,1.1,21230.0,362
HCPCS,93597,R&L HRT CATH CHD IMG CATH TRGT ZON ABNL NT CONNJ,18494.0,12021.1,1.1,22046.0,362
HCPCS,93598,CAR OUTP MEAS DRG CAR CATH EVAL CGEN HRT DEFECT,673.0,437.45,0.03,4628.0,340
HCPCS,93600,BUNDLE OF HIS RECORDING,20747.0,13485.55,1.1,21782.08,407
HCPCS,93602,INTRA-ATRIAL RECORDING,43632.0,28360.8,1.1,44565.0,406
HCPCS,93603,RIGHT VENTRICULAR RECORDING,6980.0,4537.0,1.1,7913.0,406
HCPCS,93609,INTRA-VENTRIC&/ATRIAL MAPG TACHYCARD W/CATH MA,5963.0,3875.95,1.1,14036.41,388
HCPCS,93610,INTRA-ATRIAL PACING,43632.0,28360.8,1.1,44961.0,406
HCPCS,93612,INTRAVENTRICULAR PACING,43632.0,28360.8,1.1,44961.0,406
HCPCS,93613,INTRACARDIAC ELECTROPHYSIOLOGIC 3D MAPPING,7717.0,5016.049999999999,1.1,13342.0,278
HCPCS,93615,ESOPHAGEAL RECORDING,,,1032.51,3107.02,21
HCPCS,93615,ESOPHGL REC ATRIAL W/WO VENTRICULAR ELECTROGRAMS,6980.0,4537.0,1.1,7306.0,322
HCPCS,93615,Esophageal recording,,,1560.06,1806.39,8
HCPCS,93616,ESOPHAGEAL RECORDING W/PACG,,,1032.51,3107.02,21
HCPCS,93616,ESOPHGL REC ATRIAL W/WO VENTR ELECTRGRAMS W/PACG,6980.0,4537.0,1.1,7526.0,322
HCPCS,93616,Esophageal recording w/pacg,,,1560.06,1806.39,8
HCPCS,93618,INDUCTION ARRHYTHMIA ELECTRICAL PACING,6980.0,4537.0,1.1,10201.0,406
HCPCS,93619,COMPRE ELECTROPHYSIOLOGIC W/O ARRHYT INDUCTION,43632.0,28360.8,1.1,46632.0,407
HCPCS,93620,COMPRE ELECTROPHYSIOLOGIC ARRHYTHMIA INDUCTION,43632.0,28360.8,1.1,48613.0,403
HCPCS,93621,COMPRE ELECTROPHYSIOL XM W/LEFT ATRIAL PACNG/REC,14588.0,9482.2,1.1,15248.0,388
HCPCS,93622,COMPRE ELECTROPHYSIOL XM W/LEFT VENTR PACNG/REC,10514.0,6834.1,1.1,11827.0,454
HCPCS,93623,PROGRAMMED STIMJ & PACG AFTER IV DRUG NFS,9664.0,6281.6,1.1,10095.0,388
HCPCS,93624,EP F-UP STUDY PACG&REC,,,6479.06,19496.8,21
HCPCS,93624,Ep f-up study pacg&rec,,,1560.06,1806.39,8
HCPCS,93631,INTRAOP EPICAR& ENDOCAR PACG& MAPG,24103.0,15666.95,1.1,27443.0,322
HCPCS,93631,Ntraop epicar&endcar pac&map,,,1560.06,1806.39,8
HCPCS,93640,EPHYS EVAL PACG CVDFB LDS INITIAL IMPLAN/REPLACE,3549.0,2306.85,1.1,4108.0,322
HCPCS,93640,Ep eval 1/2chmbr pacg cvdfb,,,1560.06,1806.39,8
HCPCS,93641,EPHYS EVAL PACG CVDFB LDS W/TSTG OF PULSE GEN,3938.0,2559.7,1.1,9402.0,454
HCPCS,93642,EPHYS EVAL PACG CVDFB PRGRMG/REPRGRMG PARAMETERS,6980.0,4537.0,1.1,9402.0,479
HCPCS,93644,EPHYS EVAL SUBQ IMPLANTABLE DEFIBRILLATOR,5773.0,3752.45,1.1,7111.0,458
HCPCS,93650,ICAR CATHETER ABLATION ATRIOVENTR NODE FUNCTION,13093.5,8510.775,1.1,22091.0,228
HCPCS,93653,COMPRE EP EVAL ABLTJ 3D MAPG TX SVT,42613.5,27698.775,1.1,78627.0,231
HCPCS,93654,COMPRE EP EVAL ABLTJ 3D MAPG TX VT,41384.5,26899.925,1.1,74805.0,231
HCPCS,93655,ICAR CATHETER ABLATION ARRHYTHMIA ADD ON,4648.5,3021.525,1.1,14036.41,212
HCPCS,93656,COMPRE EP EVAL ABLTJ ATR FIB PULM VEIN ISOLATION,38554.0,25060.1,1.1,69628.0,231
HCPCS,93657,ABLATE L/R ATRIAL FIBRIL W/ ISOLATED PULM VEIN,2420.0,1573.0,1.1,2420.0,144
HCPCS,93657,ABLATE L/R ATRIAL FIBRIL W/ISOLATED PULM VEIN,6667.0,4333.55,333.89,14036.41,68
HCPCS,93660,CARDIOVASCULAR FUNCTION EVAL W/TILT TABLE W/MNTR,3051.0,1983.15,1.1,3883.0,483
HCPCS,93662,INTRACARD ECHOCARD W/THER/DX IVNTJ INCL IMG S&I,6873.0,4467.45,1.1,7507.0,458
HCPCS,93668,PERIPHERAL ARTERIAL DISEASE REHAB PER SESSION,342.0,222.3,20.39,342.0,87
HCPCS,93701,BIOMPEDANCE-DERIVED PHYSIOLOGIC CV ANALYSIS,464.0,301.59999999999997,1.1,741.0,230
HCPCS,93702,BIS EXTRACELLULAR FLUID ALYS LYMPHEDEMA ASSMNT,897.5,583.375,0.01,900.0,315
HCPCS,93722,PLETHYSMOGRAPHY REPORT,62.0,40.3,1.1,62.0,70
HCPCS,93724,ELECTRONIC ANALYSIS ANTITACHY PACEMAKER SYSTEM,2147.0,1395.55,1.1,3871.0,483
HCPCS,93727,ELECTRONIC ANALYSIS OF IMPLANTABLE,283.0,183.95,1.1,283.0,70
HCPCS,93735,"ANALYZE PACER SYS,SINGL+REPROGR",377.0,245.05,1.1,377.0,70
HCPCS,93740,TEMPERATURE GRADIENT STUDIES,,,121.73,407.79,21
HCPCS,93740,Temperature gradient studies,,,86.82,100.53,8
HCPCS,93741,ELECTRONIC ANALYSIS OF PACING CARDI,372.0,241.8,1.1,372.0,70
HCPCS,93742,ELECTRONIC ANALYSIS OF PACING CARDI,411.0,267.15,1.1,411.0,70
HCPCS,93744,ELECTRONIC ANALYSIS OF PACING CARDI,677.0,440.05,1.1,677.0,70
HCPCS,93745,1ST SET-UP & PRGRMG PHYS/QHP OF WEARABLE CVDFB,1724.0,1120.6,1.1,2015.0,290
HCPCS,93745,SET-UP CARDIOVERT-DEFIBRILL,,,259.13,779.78,21
HCPCS,93745,Set-up cardiovert-defibrill,,,86.64,100.32,8
HCPCS,93750,INTERROGATION VAD IN PRSON W/PHYS/QHP ANALYSIS,528.0,343.2,0.01,528.0,174
HCPCS,93750,INTERROGATION VAD IN PRSON W/PHYSICIAN ANALYSIS,330.0,214.5,1.1,330.0,148
HCPCS,93770,Determination venous press,,,86.64,100.32,8
HCPCS,93784,AMBL BP MNTR W/SOFTWARE,,,116.15,116.15,1
HCPCS,93784,AMBULATORY BP MNTR W/SW 24 HR+ REC SCAN ALYS I&R,167.0,108.55,1.1,167.0,132
HCPCS,93784,Ambl bp mntr w/software,,,86.64,100.32,8
HCPCS,93786,AMBULATORY BP MNTR W/SW 24 HR+ RECORDING ONLY,508.5,330.525,1.1,741.0,216
HCPCS,93788,AMBULATORY BP MNTR W/SW 24 HR+ SCANNING A/R,741.0,481.65,7.7,741.0,86
HCPCS,93790,AMBL BP MNTR W/SW I&R,,,46.47,46.47,1
HCPCS,93790,AMBULATORY BP MNTR W/SW 24 HR+ REVIEW W/I&R,167.0,108.55,1.1,167.0,130
HCPCS,93790,Ambl bp mntr w/sw i&r,,,86.64,100.32,8
HCPCS,93792,PT/CAREGIVER TRAING HOME INR,,,172.78,172.78,1
HCPCS,93792,PT/CAREGIVER TRAINJ FOR INITIATION HOME INR MNTR,535.0,347.75,1.1,535.0,142
HCPCS,93792,Pt/caregiver traing home inr,,,39.1,45.28,8
HCPCS,93793,ANTICOAG MGMT PT WARFARIN,,,29.35,29.35,1
HCPCS,93793,ANTICOAGULANT MGMT FOR PT TAKING WARFARIN,79.0,51.35,1.1,79.0,142
HCPCS,93793,Anticoag mgmt pt warfarin,,,21.85,25.3,8
HCPCS,93797,CARD REHAB NUTRITION PHASE II,724.0,470.6,10.63,724.0,86
HCPCS,93797,REHAB CARD PHASE I,724.0,470.6,10.63,724.0,86
HCPCS,93797,REHAB CARD PHASE II,724.0,470.6,10.63,724.0,86
HCPCS,93798,OUTPATIENT CARDIAC REHAB W/CONT ECG MONITORING,112.0,72.8,1.1,385.69,148
HCPCS,93798,REHAB CARD OP DEPT W ECG,724.0,470.6,16.53,724.0,86
HCPCS,93799,AORTIC SCALLOP INTENTIONAL LACERATION (BASILICA) (COMP CODE 9298,7315.0,4754.75,0.01,7315.0,84
HCPCS,93799,ATRIAL BALLOON OSTOMY,182.0,118.3,23.5,321.47,85
HCPCS,93799,ATRIAL BALLOON OSTOMY (COMP CODE 33735 ATRIAL SEPTECTOMY OR SEPT,7326.0,4761.9,0.01,7326.0,84
HCPCS,93799,CARDIOMEMS IMPLANTSENSOR,2592.0,1684.8,23.5,2592.0,85
HCPCS,93799,CARDIOVASCULAR PROCEDURE,1145.0,744.25,23.5,4628.0,84
HCPCS,93799,CLSR PDA,8608.0,5595.2,23.5,8608.0,84
HCPCS,93799,FFR WITHOUT CORONARY CATHETERIZATION (COMP 93571),594.0,386.1,0.01,594.0,84
HCPCS,93799,FRACT FLOW RES-UNL-STANDALONE,4070.0,2645.5,23.5,4628.0,84
HCPCS,93799,IFR STANDALONE-ADD'L VESSEL,2848.0,1851.2,23.5,4628.0,84
HCPCS,93799,IMAGING OF CORONARY VESSEL OR GRAFT USING IVUS,594.0,386.1,0.01,594.0,84
HCPCS,93799,INSTANTANEOUS WAVE-FREE RATIO (IFR) 1 VESSEL (COMP CODE 93571),3964.0,2576.6,23.5,4628.0,84
HCPCS,93799,"INSTANTANEOUS WAVE-FREE RATIO (IFR) 2 VESSEL (COMP CODE 93571,93",7193.0,4675.45,23.5,7193.0,84
HCPCS,93799,"INSTANTANEOUS WAVE-FREE RATIO (IFR) 3 VESSEL (COMP CODE 93571, 9",10422.0,6774.3,23.5,10422.0,84
HCPCS,93799,INTRAVASC US-STANDALONE,3827.0,2487.55,23.5,4628.0,84
HCPCS,93799,ISOPROTERENOL CHALLENGE FOR PVC INDUCTION ONLY (COMP CODE 93623),9664.0,6281.6,23.5,9664.0,85
HCPCS,93799,LAA FILTER SYSTEM WATCHMAN,19625.0,12756.25,0.01,19625.0,84
HCPCS,93799,LAA LARIAT,10454.0,6795.1,23.5,10454.0,84
HCPCS,93799,MELODY TRANSCATH PULM VALVE REPLACEMENT,14905.0,9688.25,0.01,14905.0,84
HCPCS,93799,PDA BALLOON OCCLUSION,6186.0,4020.8999999999996,0.01,9088.0,168
HCPCS,93799,PERC PARAVALVULAR LEAK,5400.0,3510.0,23.5,5400.0,84
HCPCS,93799,PERCUTANEOUS ASPIRATION AND OCCLUSION OF ATRIAL HEMATOMA (COMP C,10045.0,6529.25,0.01,10045.0,84
HCPCS,93799,PERCUTANEOUS TRANSCATHETER CLOSURE OF AQUIRED ASD  (COMP CODE935,10045.0,6529.25,0.01,10045.0,84
HCPCS,93799,PROCAINAMIDE INFUSION CHALLENGE,3823.0,2484.95,23.5,3823.0,85
HCPCS,93799,PRQ COR ASPIR THROMBECT ONLY (COMP TO 92973),2310.0,1501.5,0.01,4628.0,168
HCPCS,93799,REHAB CARD PHASE III,6.0,3.9,1.67,156.65,84
HCPCS,93799,SMARTPHONE MONITORING 30 DAY,50.0,32.5,0.01,456.09,84
HCPCS,93799,SMARTPHONE MONITORING CHRONIC,20.0,13.0,0.01,456.09,84
HCPCS,93799,SPHYGMOCOR/UNLST CV,243.0,157.95,23.5,243.0,84
HCPCS,93799,STAND ALONE INTRACARDIAC ECHO,5892.0,3829.8,23.5,5892.0,84
HCPCS,93799,"STAND ALONE IVUS, ADD'L VESSEL (COMP TO 92979)",2276.5,1479.725,0.01,4628.0,168
HCPCS,93799,TELEMETRY,289.0,187.85,23.5,289.0,84
HCPCS,93799,TRICUSPID VALVULOPLASTY,8926.5,5802.225,0.01,11824.0,168
HCPCS,93799,UNLISTED TRICUSPID BALLOON VALVUPLASTY (COMP CODE 33958),1274.0,828.1,0.01,1274.0,84
HCPCS,93799,VASCULAR SCREENING,180.0,117.0,0.01,456.09,84
HCPCS,93799C,"INTRAVASC CORONARY SONO, 1ST VESSEL",594.0,386.1,1.1,594.0,70
HCPCS,93880,DUPLEX SCAN EXTRACRANIAL ART COMPL BI STUDY,1390.0,903.5,1.1,1742.0,483
HCPCS,93882,DUPLEX SCAN EXTRACRANIAL ART UNI/LMTD STUDY,611.0,397.15,1.1,811.0,569
HCPCS,93886,TRANSCRANIAL DOPPLER STDY INTRACRANIAL ART COMPL,1390.0,903.5,1.1,1750.0,483
HCPCS,93888,TRANSCRANIAL DOPPLER STDY INTRACRANIAL ART LMTD,611.0,397.15,1.1,932.0,483
HCPCS,93890,TCD VASOREACTIVITY STUDY,,,212.58,639.71,2
HCPCS,93890,Tcd vasoreactivity study,,,97.71,113.14,8
HCPCS,93892,TRANSCRANIAL DOPPLER INTRACRAN ART EMBOLI DETECT,611.0,397.15,1.1,1071.0,483
HCPCS,93893,TCD STD ICR ART VEN-ARTL SHNT DETCJ IV MBUBB NJX,611.0,397.15,1.1,1071.0,483
HCPCS,93895,CAROTID INTIMA MEDIA & CAROTID ATHEROMA EVAL BI,512.0,332.8,1.1,3060831.65,289
HCPCS,93896,VASOREACTIVITY STUDY W/TCD ICR ARTERIES COMPLETE,1634.0,1062.1,1.1,1990.0,461
HCPCS,93897,EMBOLI DETCJ W/O IV MBUBB NJX TCD ICR ART COMPL,745.0,484.25,1.1,1066.0,394
HCPCS,93897,Emboli detcj wo iv mbubb njx,,,150.27,174.0,8
HCPCS,93898,VEN-ARTL SHNT DETC IV MBUB NJX TCD ICR ART COMPL,745.0,484.25,1.1,1119.0,394
HCPCS,93898,Ven-artl shunt det mbubb njx,,,150.27,174.0,8
HCPCS,93922,NON-INVAS PHYSIOLOGIC STD EXTREMITY ART 2 LEVEL,741.0,481.65,1.1,851.0,655
HCPCS,93923,NON-INVASIVE PHYSIOLOGIC STUDY EXTREMITY 3 LEVLS,900.0,585.0,1.1,1098.0,483
HCPCS,93924,N-INVAS PHYSIOLOGIC STD LXTR ART COMPL BI,900.0,585.0,1.1,1100.0,483
HCPCS,93925,DUP-SCAN LXTR ART/ARTL BPGS COMPL BI STUDY,1390.0,903.5,1.1,1710.0,483
HCPCS,93926,DUP-SCAN LXTR ART/ARTL BPGS UNI/LMTD STUDY,611.0,397.15,1.1,811.0,569
HCPCS,93930,DUP-SCAN UXTR ART/ARTL BPGS COMPL BI STUDY,1390.0,903.5,1.1,1710.0,483
HCPCS,93931,DUP-SCAN UXTR ART/ARTL BPGS UNI/LMTD STUDY,611.0,397.15,1.1,811.0,483
HCPCS,93931,UPPER EXTREMITY STUDY,200.0,130.0,1.1,401.32,144
HCPCS,93970,DUP SCAN EXT VEIN BILAT,1390.0,903.5,150.27,1390.0,87
HCPCS,93970,DUP-SCAN XTR VEINS COMPLETE BILATERAL STUDY,1390.0,903.5,1.1,1670.0,396
HCPCS,93970,EXTREMITY STUDY,57.0,37.05,1.1,713.21,144
HCPCS,93970,TECH DUPLEX SCAN COMPL BILATERAL STUDY,1390.0,903.5,150.27,1390.0,87
HCPCS,93971,DUP-SCAN XTR VEINS UNILATERAL/LIMITED STUDY,611.0,397.15,1.1,809.0,483
HCPCS,93971,EXTREMITY STUDY,36.0,23.4,1.1,387.98,144
HCPCS,93975,DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN COM,1390.0,903.5,1.1,1900.0,570
HCPCS,93976,DUP-SCAN ARTL FLO ABDL/PEL/SCROT&/RPR ORGN LMT,611.0,397.15,1.1,963.0,570
HCPCS,93978,DUP-SCAN AORTA IVC ILIAC VASCL/BPGS COMPLETE,1390.0,903.5,1.1,1742.0,483
HCPCS,93979,DUP-SCAN AORTA IVC ILIAC VASCL/BPGS UNI/LMTD,611.0,397.15,1.1,831.0,483
HCPCS,93980,DUP-SCAN ARTL INFL&VEN O/F PEN VSL COMPL,611.0,397.15,1.1,1111.0,483
HCPCS,93981,DUP-SCAN ARTL INFL&VEN O/F PEN VSL F-UP/LMTD STD,611.0,397.15,1.1,787.0,483
HCPCS,93985,DUPLEX SCAN ARTL INFL&AMP;VEN O/F HEMO COMPL BI STD,1390.0,903.5,1.1,1710.0,396
HCPCS,93985,DUPLEX SCAN ARTL INFL&VEN O/F HEMO COMPL BI STD,1390.0,903.5,0.01,1390.0,260
HCPCS,93986,DUPLEX SCAN ARTL INFL&AMP;VEN O/F HEMO COMPL UNI STD,611.0,397.15,1.1,811.0,396
HCPCS,93986,DUPLEX SCAN ARTL INFL&VEN O/F HEMO COMPL UNI STD,611.0,397.15,0.01,611.0,260
HCPCS,93990,DOPPLER FLOW TESTING,228.0,148.2,1.1,418.04,144
HCPCS,93990,DUPLEX SCAN HEMODIALYSIS ACCESS,611.0,397.15,1.1,811.0,483
HCPCS,93998,PHLEBOTEST EXTREMITY STUDY,154.0,100.1,22.7,154.0,85
HCPCS,93998,UNLISTED NONINVASIVE VASCULAR DIAGNOSTIC STUDY,139.0,90.35,0.01,139.0,82
HCPCS,93998,US PSEUDOANEURYSM,154.0,100.1,22.7,154.0,85
HCPCS,93998,US TEMPORAL ARTERIES (COMP CODE 93880),803.0,521.95,0.01,1261.0,167
HCPCS,94002,VENTILATION ASSIST & MGMT INPATIENT 1ST DAY,1958.5,1273.025,1.1,3041.0,230
HCPCS,94003,VENTILATION ASSIST & MGMT INPATIENT EA SBSQ DA,1822.0,1184.3,1.1,3041.0,230
HCPCS,94004,VENT MGMT NF PER DAY,,,124.09,124.09,1
HCPCS,94004,VENTILATION ASSIST & MGMT NURSING FAC PR DAY,400.0,260.0,1.1,400.0,132
HCPCS,94004,Vent mgmt nf per day,,,680.77,788.26,8
HCPCS,94005,HOME VENT MGMT SUPERVISION,,,233.64,233.64,1
HCPCS,94010,SPMTRY W/VC EXPIRATORY FLO W/WO MXML VOL VNTJ,720.0,468.0,1.1,795.0,483
HCPCS,94011,MEAS SPIROMTRC FORCD EXPIRATORY FLO INFANT-2 YR,700.0,455.0,1.1,700.0,144
HCPCS,94011,SPIROMETRY UP TO 2 YRS OLD,,,121.73,407.79,21
HCPCS,94011,Spirometry up to 2 yrs old,,,64.98,75.24,8
HCPCS,94012,MEAS SPIRO FORCD EXP FLO PRE&POST BRONCH INF-2Y,1140.0,741.0,1.1,1140.0,144
HCPCS,94012,SPIRMTRY W/BRNCHDIL INF-2 YR,,,204.28,819.42,21
HCPCS,94012,Spirmtry w/brnchdil inf-2 yr,,,127.97,148.17,8
HCPCS,94013,MEAS LUNG VOL THRU 2 YRS,,,353.04,1399.26,21
HCPCS,94013,MEAS LUNG VOLUMES INFANT OR CHILD THRU 2 YRS,164.0,106.6,1.1,1564.17,144
HCPCS,94013,Meas lung vol thru 2 yrs,,,127.97,148.17,8
HCPCS,94014,PATIENT RECORDED SPIROMETRY,,,345.67,1040.19,21
HCPCS,94014,Patient recorded spirometry,,,127.97,148.17,8
HCPCS,94015,PATIENT-INITIATED SPIROMETRIC RECORDING,1432.0,930.8,44.82,1432.0,87
HCPCS,94016,PATIENT-INITIATED SPIROMETRIC PHYS/QHP R&I ONLY,208.0,135.2,1.1,208.0,144
HCPCS,94016,REVIEW PATIENT SPIROMETRY,,,31.91,63.21,28
HCPCS,94016,Review patient spirometry,,,64.98,75.24,8
HCPCS,94060,BRNCDILAT RSPSE SPMTRY PRE&POST-BRNCDILAT ADMN,1432.0,930.8,1.1,1529.0,483
HCPCS,94070,BRNCSPSM PROVOCATION EVAL MLT SPMTRY W/ADMN AGT,1432.0,930.8,1.1,1672.0,483
HCPCS,94150,VITAL CAPACITY TOTAL SEPARATE PROCEDURE,720.0,468.0,1.1,748.0,477
HCPCS,94200,MAX BREATHING CAPACITY MAXIMAL VOLUNTARY VENTJ,273.0,177.45,1.1,293.0,483
HCPCS,94240,"LUNG VOLUMES, HELIUM DILUTION",95.0,61.75,1.1,95.0,70
HCPCS,94250,Expired gas collection,,,64.98,75.24,8
HCPCS,94375,RESPIRATORY FLOW VOLUME LOOP,,,204.28,819.42,21
HCPCS,94375,Respiratory flow volume loop,,,127.97,148.17,8
HCPCS,94400,Co2 breathing response curve,,,64.98,75.24,8
HCPCS,94450,BREATHING RESPONSE TO HYPOXIA,720.0,468.0,1.1,844.0,483
HCPCS,94452,HIGH ALTITUDE SIMULATJ TEST W/PHYS INTERP&REPORT,593.0,385.45,1.1,729.0,481
HCPCS,94453,HIGH ALTITUDE SIMULATJ W/PHYS I&R W/O2 TITRATION,593.0,385.45,1.1,769.0,481
HCPCS,94610,INTRAPULM SURFACTANT ADMN,,,185.04,556.82,21
HCPCS,94610,Intrapulm surfactant admn,,,64.98,75.24,8
HCPCS,94617,XERS TST BRNCSPSM PRE&POST SPMTRY&PLS OX W/ECG,593.0,385.45,1.1,901.0,483
HCPCS,94618,ADULT - OXIMETRY WITH AMBULATION,392.5,255.125,1.1,593.0,270
HCPCS,94618,ADULT - SIX MINUTE WALK,593.0,385.45,1.1,593.0,144
HCPCS,94618,OXYGEN TITRATION-TRANSPLANT,392.5,255.125,1.1,593.0,270
HCPCS,94618,PULMONARY STRESS TEST (6-MINUTE WALK) INTERP ONLY,192.0,124.8,1.1,373.44,270
HCPCS,94618,PULMONARY STRESS TESTING,593.0,385.45,1.1,785.0,483
HCPCS,94619,XERS TST BRNCSPSM PRE&POST SPMTRY&PLS OX WO /ECG,273.0,177.45,1.1,469.0,483
HCPCS,94621,CARDIOPULMONARY EXERCISE TESTING,1432.0,930.8,1.1,2000.0,483
HCPCS,94625,PHYS/QHP SVCS OP PULM REHAB WO CONT OXIMTRY MNTR,273.0,177.45,21.8,273.0,86
HCPCS,94626,PHYS/QHP SVCS OP PULM REHAB W/CONT OXIMTRY MNTR,273.0,177.45,32.9,273.0,86
HCPCS,94640,DAILY PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT,2901.0,1885.65,10.99,2901.0,86
HCPCS,94640,PRESSURIZED/NONPRESSURIZED INHALATION TREATMENT,545.0,354.25,1.1,936.0,316
HCPCS,94642,PENTAMIDINE AERSL INHALATION PNEUMOCYSTIS/PROPH,647.5,420.875,1.1,936.0,176
HCPCS,94644,CONTINUOUS INHALATION TREATMENT 1ST HR,593.0,385.45,64.98,593.0,86
HCPCS,94644,"CONTINUOUS INHALATION TX, 1ST HR",121.0,78.65,1.1,373.44,144
HCPCS,94645,CONTINUOUS INHALATION TREATMENT EA ADDL HR,162.0,105.3,22.74,162.0,68
HCPCS,94645,"CONTINUOUS INHALATION TX, EACH ADD HR",35.0,22.75,1.1,60.47,144
HCPCS,94660,CPAP VENTILATION CPAP INITIATION&MGMT,620.0,403.0,1.1,936.0,234
HCPCS,94662,NEG PRESS VENTILATION CNP,,,543.67,1636.0,9
HCPCS,94662,Neg press ventilation cnp,,,680.77,788.26,8
HCPCS,94664,DEMO&/EVAL OF PT UTILIZ AERSL GEN/NEB/INHLR/IP,530.0,344.5,1.1,936.0,402
HCPCS,94667,MANJ CH WALL FACILITATE LNG FUNCJ 1 DEMO&/EVAL,395.0,256.75,1.1,593.0,230
HCPCS,94668,MANJ CHEST WALL FACILITATE LUNG FUNCTION SUBSQ,593.0,385.45,54.59,593.0,173
HCPCS,94669,MECHANICAL CHEST WALL OSCILLATION LUNG FUNCTION,936.0,608.4,28.56,936.0,86
HCPCS,94680,O2 UPTK EXP GAS ANALYSIS REST&XERS DIRECT SIMP,720.0,468.0,1.1,824.0,396
HCPCS,94680,O2 UPTK RST&XERS DIR SIMPLE,,,121.73,407.79,21
HCPCS,94680,O2 uptk rst&xers dir simple,,,64.98,75.24,8
HCPCS,94681,O2 UPTK EXP GAS ALYS W/CO2 OUTPUT % O2 XTRC,1432.0,930.8,1.1,1520.0,483
HCPCS,94681,"OXYGEN UPTAKE, EXPIRED GAS ANALYSIS; CO2 OUTPUT",1432.0,930.8,64.61,1432.0,87
HCPCS,94690,O2 UPTAKE EXP GAS ANALYSIS REST INDIRECT SPX,273.0,177.45,1.1,301.0,396
HCPCS,94690,O2 UPTK REST INDIRECT,,,53.07,159.69,21
HCPCS,94690,O2 uptk rest indirect,,,64.98,75.24,8
HCPCS,94720,CARBON MONOXIDE DIFFUSING CAPACITY,329.5,214.175,1.1,564.0,140
HCPCS,94726,PLETHYSMOGRAPHY LUNG VOLUMES W/WO AIRWAY RESIST,1432.0,930.8,1.1,1546.0,570
HCPCS,94727,GAS DILUT/WASHOUT LUNG VOL W/WO DISTRIB VENT&V,720.0,468.0,59.54,720.0,87
HCPCS,94727,GAS DILUT/WASHOUT LUNG VOL W/WO DISTRIB VENT&VOL,720.0,468.0,1.1,834.0,396
HCPCS,94728,AIRWAY RESISTANCE BY IMPULSE OSCILLOMETRY,720.0,468.0,1.1,824.0,396
HCPCS,94728,AIRWAY RESISTANCE BY OSCILLOMETRY,720.0,468.0,59.07,720.0,87
HCPCS,94729,CO DIFFUSING CAPACITY,605.0,393.25,64.98,605.0,68
HCPCS,94729,DIFFUSING CAPACITY,605.0,393.25,1.1,681.0,396
HCPCS,94750,Pulmonary compliance study,,,64.98,75.24,8
HCPCS,94760,NONINVASIVE EAR/PULSE OXIMETRY SINGLE DETER,234.0,152.1,1.1,348.0,402
HCPCS,94761,NONINVASIVE EAR/PULSE OXIMETRY MULTIPLE DETER,273.0,177.45,1.1,348.0,334
HCPCS,94762,NONINVASIVE EAR/PULSE OXIMETRY OVERNIGHT MONITOR,482.5,313.625,1.1,720.0,303
HCPCS,94770,Exhaled carbon dioxide test,,,64.98,75.24,8
HCPCS,94772,CIRCADIAN RESPIR PATTERN REC,,,353.04,1399.26,21
HCPCS,94772,CIRCADIAN RESPIRATRY PATTERN REC 12-24 HR INFANT,2441.0,1586.65,1.1,2837.0,280
HCPCS,94772,Circadian respir pattern rec,,,127.97,148.17,8
HCPCS,94774,PED HOME APNEA MNTR EVNT REC,,,2739849.3,2739849.3,1
HCPCS,94774,Ped home apnea mntr evnt rec,,,64.98,75.24,8
HCPCS,94775,PED HOME APNEA MNTR ATT ONLY,,,121.73,407.79,21
HCPCS,94775,Ped home apnea mntr att only,,,64.98,75.24,8
HCPCS,94776,PED HOME APNEA MNTR DL&ALYS,,,121.73,407.79,21
HCPCS,94776,Ped home apnea mntr dl&alys,,,64.98,75.24,8
HCPCS,94777,PED HOME APNEA MNTR RVW I&R,,,2739849.3,2739849.3,1
HCPCS,94777,PEDIATRIC APNEA MONITOR PHYS/QHP REVIEW,226.0,146.9,1.1,3060831.65,102
HCPCS,94777,Ped home apnea mntr rvw i&r,,,64.98,75.24,8
HCPCS,94780,CAR SEAT/BED TEST INFT THRU 12 MO 60 MIN,181.0,117.65,28.16,181.0,86
HCPCS,94780,CAR SEAT/BED TESTING W/INTERP & REPORT 60 MIN,192.0,124.8,1.1,203.57,146
HCPCS,94781,CAR SEAT/BED TESTNG W/INTERP & REPORT +30MIN,68.0,44.2,1.1,80.26,146
HCPCS,94781,Cars/bd tst inft-12mo +30min,,,64.98,75.24,8
HCPCS,94799,CAR SEAT CHALLENGE,110.0,71.5,30.58,321.47,85
HCPCS,94799,MINI-BAL RT,424.0,275.6,64.98,424.0,84
HCPCS,94799,RESPIRATORY THERAPY EVAL-HOSP,359.0,233.35,64.98,359.0,84
HCPCS,94799,RT DAILY ASSESSMENT,483.0,313.95,64.98,483.0,84
HCPCS,94799,RT MONITORING TRANSPORT,486.0,315.9,64.98,486.0,84
HCPCS,94799,TRACH ASPIRATION,424.0,275.6,64.98,424.0,84
HCPCS,94799,UNLISTED PULMONARY SERVICE (RESPIRATORY EVALUATION),332.0,215.8,64.98,332.0,84
HCPCS,94799,UNLSTD CAR SEAT STY,113.0,73.45,31.41,321.47,85
HCPCS,94799,UNLSTD PUL REHB PHASE 3,8.0,5.2,2.22,156.65,84
HCPCS,95004,PERCUTANEOUS TESTS W/ALLERGENIC EXTRACTS,169.0,109.85,1.1,3048.76,222
HCPCS,95012,NITRIC OXIDE EXPIRED GAS DETERMINATION,94.5,61.425,1.1,118.0,229
HCPCS,95017,ALLG TSTG PERQ & IC VENOMS IMMED REACT W/ I&R,28.0,18.2,1.1,85.71,148
HCPCS,95017,ALLG TSTG PERQ & IC VENOMS IMMED REACT W/I&R,73.0,47.45,4.05,178.84,86
HCPCS,95018,ALLG TEST PERQ & IC DRUG/BIOL IMMED REACT W/ I&R,165.0,107.25,1.1,165.0,148
HCPCS,95018,ALLG TEST PERQ & IC DRUG/BIOL IMMED REACT W/I&R,165.0,107.25,8.27,178.84,86
HCPCS,95024,INTRACUTANEOUS TESTS W/ALLERGENIC EXTRACTS,163.0,105.95,0.62,178.84,234
HCPCS,95027,INTRACUTANEOUS TESTS W/ALLERGENIC XTRCS AIRBORNE,5.0,3.25,1.1,85.71,144
HCPCS,95027,IQ TSTS SEQL&INCRL AIRBORNE,,,22.7,77.73,21
HCPCS,95027,Iq tsts seql&incrl airborne,,,154.45,178.84,8
HCPCS,95028,IC TSTS W/ALLGIC XTRCS DLYD TYP RXN W/READING,48.0,31.2,1.1,116.32,144
HCPCS,95028,IQ TSTS ALLERGY DELAYED RXN,,,34.79,104.7,21
HCPCS,95028,Iq tsts allergy delayed rxn,,,154.45,178.84,8
HCPCS,95044,PATCH TEST(S) SPECIFY NUMBER,408.0,265.2,1.1,3048.76,144
HCPCS,95044,PATCH/APPLICATION TEST SPECIFY NUMBER TESTS,408.0,265.2,6.76,1018.61,78
HCPCS,95052,PHOTO PATCH TEST SPECIFY NUMBER TSTS,178.0,115.7,8.37,178.84,86
HCPCS,95052,PHOTO PATCH TEST(S) SPECIFY NUM,52.0,33.8,1.1,177.54,144
HCPCS,95056,PHOTO TESTS,387.0,251.55,73.2,387.0,78
HCPCS,95056,PHOTOSENSITIVITY TESTS,53.0,34.45,1.1,373.44,144
HCPCS,95060,EYE ALLERGY TESTS,94.0,61.1,1.1,373.44,144
HCPCS,95060,OPH MUCOUS MEMBRANE TESTS,,,110.82,333.49,21
HCPCS,95065,DIR NSL MUCOUS MEMBRANE TEST,,,34.79,104.7,21
HCPCS,95065,DIRECT NASAL MUCOUS MEMBRANE TEST,126.0,81.9,1.1,126.0,144
HCPCS,95065,Dir nsl mucous membrane test,,,154.45,178.84,8
HCPCS,95070,INHLJ BRNCL CHALLENGE TSTG W/HISTAM/METHACHOL,1059.5,688.675,1.1,1592.0,301
HCPCS,95071,Bronchial allergy tests,,,154.45,178.84,8
HCPCS,95076,INGESTION CHALLENGE TEST INITIAL 120 MINUTES,1126.0,731.9,1.1,1592.0,234
HCPCS,95079,INGESTION CHALLENGE TEST EACH ADDL 60 MINUTES,441.5,286.975,1.1,607.0,216
HCPCS,95115,IMMUNOTHERAPY 1 INJ,138.0,89.7,14.28,138.0,86
HCPCS,95115,PROF SVCS ALLG IMMNTX X W/PRV ALLGIC XTRCS 1 NJX,60.0,39.0,1.1,137.75,144
HCPCS,95117,IMMUNOTHERAPY>=2 INJ,198.0,128.7,17.1,198.0,86
HCPCS,95117,PROF SVCS ALLG IMMNTX X W/PRV ALLGIC XTRCS NJXS,198.0,128.7,1.1,198.0,144
HCPCS,95120,IMMUNOTHERAPY ONE INJECTION,,,45.76,45.76,1
HCPCS,95120,Immunotherapy one injection,,,19.85,22.98,8
HCPCS,95125,IMMUNOTHERAPY 2/> INJECTIONS,,,49.59,49.59,1
HCPCS,95125,Immunotherapy 2/> injections,,,19.85,22.98,8
HCPCS,95130,IMMNTX 1 STING INSECT,,,34.25,34.25,1
HCPCS,95130,Immntx 1 sting insect,,,19.85,22.98,8
HCPCS,95131,IMMNTX 2 STING INSECTS,,,41.1,41.1,1
HCPCS,95131,Immntx 2 sting insects,,,19.85,22.98,8
HCPCS,95132,IMMNTX 3 STING INSECTS,,,97.0,97.0,1
HCPCS,95132,Immntx 3 sting insects,,,19.85,22.98,8
HCPCS,95133,IMMNTX 4 STING INSECTS,,,111.24,111.24,1
HCPCS,95133,Immntx 4 sting insects,,,19.85,22.98,8
HCPCS,95134,IMMNTX 5 STING INSECTS,,,75.35,75.35,1
HCPCS,95134,Immntx 5 sting insects,,,19.85,22.98,8
HCPCS,95144,ANTIGEN THERAPY SERVICES,138.0,89.7,3.55,138.0,86
HCPCS,95144,PREPJ& ANTIGEN PRV ALLERGEN IMMUNOTHERAPY 1 DO,24.0,15.6,1.1,137.75,148
HCPCS,95145,PREPJ& ANTIGEN ALLERGEN IMMUNOTHERAPY 1 INSECT,24.0,15.6,1.1,137.75,148
HCPCS,95145,VENOM INSECT 1 VIAL,138.0,89.7,3.55,138.0,86
HCPCS,95146,PREPJ& ANTIGEN ALLERGEN IMMUNOTHERAPY 2 INSECT,24.0,15.6,1.1,195.15,148
HCPCS,95146,VENOM MULTIDOSE 2 VIAL,138.0,89.7,3.55,138.0,86
HCPCS,95147,PREPJ& ANTIGEN ALLERGEN IMMUNOTHERAPY 3 INSECT,24.0,15.6,1.1,205.09,148
HCPCS,95147,VENOM MULTIDOSE 3 VIAL,214.0,139.1,3.55,214.0,86
HCPCS,95148,PREPJ& ANTIGEN ALLERGEN IMMUNOTHERAPY 4 INSECT,24.0,15.6,1.1,278.42,148
HCPCS,95148,VENOM MULTIDOSE 4 VIAL,214.0,139.1,3.55,214.0,86
HCPCS,95149,PREPJ& ANTIGEN ALLERGEN IMMUNOTHERAPY 5 INSECT,24.0,15.6,1.1,368.12,148
HCPCS,95149,VENOM MULTIDOSE 5 VIAL,214.0,139.1,3.55,214.0,86
HCPCS,95165,PREPJ& ALLERGEN IMMUNOTHERAPY 1/MLT ANTIGEN,124.0,80.6,1.1,137.75,234
HCPCS,95170,PREPJ& ANTIGEN ALLERGEN IMMUNOTHERAPY WHL INSE,81.0,52.65,1.1,138.0,234
HCPCS,95180,RAPID DESENSITIZATION PROCEDURE EACH HOUR,1000.5,650.325,1.1,1197.0,226
HCPCS,95199,UNLISTED ALL/IMMLG SVC/PX,,,22.7,77.73,21
HCPCS,95199,Unlisted all/immlg svc/px,,,154.45,178.84,8
HCPCS,95249,CONT GLUC MONITORING PATIENT PROVIDED EQUIPMENT,238.0,154.7,39.1,238.0,172
HCPCS,95249,CONT GLUC MONITORING PATIENT PROVIDED EQUIPTMENT,297.0,193.05,1.1,297.0,142
HCPCS,95250,CONT GLUC MNTR PHYSICIAN/QHP PROVIDED EQUIPMENT,454.0,295.1,1.1,515.0,228
HCPCS,95251,CONT GLUC MNTR ANALYSIS I&R,,,90.2,90.2,1
HCPCS,95251,CONTINUOUS GLUCOSE MONITORING ANALYSIS I&R,280.0,182.0,1.1,280.0,142
HCPCS,95251,Cont gluc mntr analysis i&r,,,86.64,100.32,8
HCPCS,95700,EEG CONT REC W/VIDEO BY TECH MIN 8 CHANNELS,869.5,565.175,0.01,1080.0,357
HCPCS,95705,EEG W/O VIDEO BY TECH 2-12 HR UNMONITORED,1772.5,1152.125,1.1,2149.0,187
HCPCS,95706,EEG W/O VIDEO BY TECH 2-12 HR INTERMITTENT MNTR,2149.0,1396.85,204.28,2149.0,85
HCPCS,95707,EEG W/O VIDEO BY TECH 2-12HR CONTINUOUS R-T MNTR,2149.0,1396.85,204.28,2149.0,85
HCPCS,95708,EEG W/O VID BY TECH EA INCR 12-26HR UNMONITORED,2528.5,1643.525,1.1,3661.0,187
HCPCS,95709,EEG W/O VID BY TECH EA INCR 12-26 HR INTMT MNTR,3661.0,2379.65,353.04,3661.0,85
HCPCS,95710,EEG W/O VID TECH EA INCR 12-26 HR CONT R-T MNTR,3661.0,2379.65,353.04,3661.0,85
HCPCS,95711,VEEG BY TECH 2-12 HOURS UNMONITORED,2381.5,1547.975,1.1,2614.0,187
HCPCS,95712,VEEG BY TECH 2-12 HR INTERMITTENT MONITORING,2381.5,1547.975,1.1,2614.0,187
HCPCS,95713,VEEG BY TECH 2-12 HR CONTINUOUS R-T MONITORING,3137.5,2039.375,1.1,3661.0,187
HCPCS,95714,VEEG BY TECH EA INCR 12-26 HR UNMONITORED,3137.5,2039.375,1.1,3661.0,187
HCPCS,95715,VEEG BY TECH EA INCR 12-26 HR INTERMITTENT MNTR,3137.5,2039.375,1.1,3661.0,187
HCPCS,95716,VEEG BY TECH EA INCR 12-26 HR CONT R-T MNTR,4817.0,3131.05,1.1,7020.0,187
HCPCS,95717,EEG PHYS/QHP 2-12 HR W/O VID,,,273.56,273.56,1
HCPCS,95717,EEG PHYS/QHP 2-12 HR WITHOUT VIDEO,880.0,572.0,1.1,880.0,148
HCPCS,95717,Eeg phys/qhp 2-12 hr w/o vid,,,210.99,244.3,8
HCPCS,95718,EEG PHYS/QHP 2-12 HR W/VEEG,,,346.75,346.75,1
HCPCS,95718,EEG PHYS/QHP 2-12 HR WITH VEEG,1100.0,715.0,1.1,1100.0,148
HCPCS,95718,Eeg phys/qhp 2-12 hr w/veeg,,,210.99,244.3,8
HCPCS,95719,EEG PHYS/QHP EA INCR W/O VID,,,414.01,414.01,1
HCPCS,95719,EEG PHYS/QHP EA INCR>12HR<26HR AFTER 24HR WO VID,1320.0,858.0,1.1,1320.0,148
HCPCS,95719,Eeg phys/qhp ea incr w/o vid,,,210.99,244.3,8
HCPCS,95720,EEG PHY/QHP EA INCR W/VEEG,,,533.72,533.72,1
HCPCS,95720,EEG PHYS/QHP EA INCR>12HR<26HR AFTER 24HR W/VEEG,1698.0,1103.7,1.1,1698.0,148
HCPCS,95720,Eeg phy/qhp ea incr w/veeg,,,210.99,244.3,8
HCPCS,95721,EEG COMPLETE STD PHYS/QHP>36 HR<60 HR W/O VIDEO,1698.0,1103.7,1.1,1698.0,148
HCPCS,95721,EEG PHY/QHP>36<60 HR W/O VID,,,532.79,532.79,1
HCPCS,95721,Eeg phy/qhp>36<60 hr w/o vid,,,210.99,244.3,8
HCPCS,95722,EEG COMPLETE STD PHYS/QHP>36 HR<60 HR W/VEEG,2068.0,1344.2,1.1,2068.0,148
HCPCS,95722,EEG PHY/QHP>36<60 HR W/VEEG,,,646.64,646.64,1
HCPCS,95722,Eeg phy/qhp>36<60 hr w/veeg,,,695.79,805.65,8
HCPCS,95723,EEG COMPLETE STD PHYS/QHP>60 HR<84 HR W/O VIDEO,2090.0,1358.5,1.1,2090.0,148
HCPCS,95723,EEG PHY/QHP>60<84 HR W/O VID,,,646.69,646.69,1
HCPCS,95723,Eeg phy/qhp>60<84 hr w/o vid,,,695.79,805.65,8
HCPCS,95724,EEG COMPLETE STD PHYS/QHP>60 HR<84 HR W/VEEG,2640.0,1716.0,1.1,2640.0,148
HCPCS,95724,EEG PHY/QHP>60<84 HR W/VEEG,,,813.78,813.78,1
HCPCS,95724,Eeg phy/qhp>60<84 hr w/veeg,,,695.79,805.65,8
HCPCS,95725,EEG COMPLETE STD PHYS/QHP&GT;84 HR W/O VID,2376.0,1544.4,1.1,2376.0,148
HCPCS,95725,EEG PHY/QHP>84 HR W/O VID,,,745.83,745.83,1
HCPCS,95725,Eeg phy/qhp>84 hr w/o vid,,,695.79,805.65,8
HCPCS,95726,EEG COMPLETE STD PHYS/QHP&GT;84 HR W/VEEG,3335.0,2167.75,1.1,3335.0,148
HCPCS,95726,EEG PHY/QHP>84 HR W/VEEG,,,1042.19,1042.19,1
HCPCS,95726,Eeg phy/qhp>84 hr w/veeg,,,695.79,805.65,8
HCPCS,95782,POLYSOM <6 YRS SLEEP STAGE 4/> ADDL PARAM ATTND,7020.0,4563.0,1.1,8164.0,475
HCPCS,95783,POLYSOM <6 YRS SLEEP W/CPAP/BILVL VENT 4/> PARAM,7020.0,4563.0,1.1,8265.0,475
HCPCS,95800,SLP STDY UNATTENDED,,,135.52,407.79,21
HCPCS,95800,Slp stdy unattended,,,86.32,99.95,8
HCPCS,95801,SLP STDY UNATND W/ANAL,,,53.07,159.69,21
HCPCS,95801,SLP STDY UNATND W/MIN HRT RATE/O2 SAT/RESP ANAL,410.0,266.5,1.1,750.0,394
HCPCS,95801,Slp stdy unatnd w/anal,,,86.32,99.95,8
HCPCS,95803,ACTIGRAPHY TESTING,,,53.07,159.69,21
HCPCS,95803,ACTIGRAPHY TESTING RECORDING ANALYSIS I&R,410.0,266.5,1.1,770.0,394
HCPCS,95803,Actigraphy testing,,,86.64,100.32,8
HCPCS,95805,MLT SLEEP LATENCY/MAINT OF WAKEFULNESS TSTG,3661.0,2379.65,1.1,4189.0,475
HCPCS,95806,SLEEP STD AIRFLOW HRT RATE&O2 SAT EFFORT UNATT,1080.0,702.0,1.1,1489.0,568
HCPCS,95807,SLEEP STD REC VNTJ RESPIR ECG/HRT RATE&O2 ATTN,3661.0,2379.65,1.1,4224.0,473
HCPCS,95808,POLYSOM ANY AGE 1-3> PARAM,,,812.43,2729.53,21
HCPCS,95808,POLYSOM ANY AGE SLEEP STAGE 1-3 ADDL PARAM ATTND,7020.0,4563.0,1.1,7786.0,396
HCPCS,95810,POLYSOM 6/>YRS SLEEP 4/> ADDL PARAM ATTND,7020.0,4563.0,1.1,8120.0,475
HCPCS,95811,POLYSOM 6/>YRS SLEEP W/CPAP 4/> ADDL PARAM ATTND,7020.0,4563.0,1.1,8164.0,475
HCPCS,95812,ELECTROENCEPHALOGRAM EXTEND MONITORING 41-60 MIN,2149.0,1396.85,1.1,2581.0,483
HCPCS,95813,EEG EXTENDED MONITORING 61-119 MINUTES,2149.0,1396.85,1.1,2801.0,483
HCPCS,95816,ELECTROENCEPHALOGRAM W/REC AWAKE&DROWSY,2149.0,1396.85,1.1,2624.0,483
HCPCS,95819,ELECTROENCEPHALOGRAM W/REC AWAKE&ASLEEP,2149.0,1396.85,1.1,2624.0,483
HCPCS,95822,ELECTROENCEPHALOGRAM REC COMA/SLEEP ONLY,2149.0,1396.85,1.1,2624.0,483
HCPCS,95824,ELECTROENCEPHALOGRAM CERE DEATH EVAL ONLY,3661.0,2379.65,1.1,3957.0,409
HCPCS,95829,ELECTROCORTICOGRAM SURGERY SPX,2711.0,1762.15,210.99,2765.74,68
HCPCS,95829,SURGERY ELECTROCORTICOGRAM,2728.0,1773.2,1.1,5724.75,396
HCPCS,95830,INSERTION SPHENOIDAL ELECTRODES EEG PHYS/QHP,774.0,503.1,0.01,2233.6,215
HCPCS,95836,ECOG IMPLANTED BRAIN NPGT W/REC I&R <30 DAYS,524.5,340.92499999999995,1.1,792.0,302
HCPCS,95851,RANGE OF MOTION MEASUREMENTS,,,9.27,20.19,28
HCPCS,95851,Range of motion measurements,,,33.56,38.86,8
HCPCS,95852,RANGE OF MOTION MEASUREMENTS,,,6.76,14.06,28
HCPCS,95852,Range of motion measurements,,,33.56,38.86,8
HCPCS,95857,CHOLINESTERASE CHALLENGE,,,204.28,819.42,21
HCPCS,95857,CHOLINESTERASE INHIBITOR CHALLENGE TEST,212.0,137.8,1.1,915.24,148
HCPCS,95857,Cholinesterase challenge,,,391.75,453.61,8
HCPCS,95860,NDL EMG 1 XTR W/WO RELATED PARASPINAL AREAS,889.0,577.85,1.1,1273.0,483
HCPCS,95861,NDL EMG 2 XTR W/WO RELATED PARASPINAL AREAS,889.0,577.85,1.1,1505.0,483
HCPCS,95863,NDL EMG 3 XTR W/WO RELATED PARASPINAL AREAS,1080.0,702.0,1.1,1828.0,396
HCPCS,95863,NEEDLE EMG 3 EXTREMITIES,,,121.73,407.79,21
HCPCS,95863,Needle emg 3 extremities,,,391.75,453.61,8
HCPCS,95864,NDL EMG 4 XTR W/WO RELATED PARASPINAL AREAS,1080.0,702.0,1.1,1876.0,483
HCPCS,95865,NEEDLE ELECTROMYOGRAPHY LARYNX,889.0,577.85,1.1,1517.0,483
HCPCS,95866,NEEDLE ELECTROMYOGRAPHY HEMIDIAPHRAGM,1080.0,702.0,1.1,1580.0,483
HCPCS,95867,NEEDLE ELECTROMYOGRAPHY CRANIAL NRV MUSCLE UNI,2149.0,1396.85,1.1,2465.0,483
HCPCS,95868,NEEDLE ELECTROMYOGRAPHY CRANIAL NRV MUSCLE BI,2149.0,1396.85,1.1,2621.0,483
HCPCS,95869,NEEDLE EMG THRC PARASPI MUSC EXCLUDING T1/T12,2149.0,1396.85,1.1,2297.0,483
HCPCS,95870,NEEDLE EMG LMTD STD MUSC 1 XTR/NON-LIMB UNI/BI,889.0,577.85,1.1,1037.0,483
HCPCS,95872,NEEDLE EMG W/1 FIBER ELECTRODE QUAN MEAS JITTER,1152.0,748.8,1.1,2232.0,483
HCPCS,95873,ELECTRICAL STIMULATION GUID W/CHEMODENERVATION,163.0,105.95,1.1,335.02,464
HCPCS,95874,NEEDLE EMG GUID W/CHEMODENERVATION,782.0,508.3,102.79,782.0,68
HCPCS,95874,NEEDLE EMG GUIDANCE FOR CHEMODENERVATION,782.0,508.3,1.1,945.0,396
HCPCS,95875,ISCHEMIC LIMB XERS TST SPEC ACQUISJ METAB,1080.0,702.0,1.1,1520.0,394
HCPCS,95875,LIMB EXERCISE TEST,,,121.73,407.79,21
HCPCS,95875,Limb exercise test,,,391.75,453.61,8
HCPCS,95885,NEEDLE EMG EA EXTREMITY W/PARASPINL AREA LIMITED,997.0,648.05,1.1,1137.0,464
HCPCS,95886,NEEDLE EMG EA EXTREMTY W/PARASPINL AREA COMPLETE,1466.0,952.9,1.1,1844.0,464
HCPCS,95887,NEEDLE EMG NONEXTREMTY MSCLES W/NERVE CONDUCTION,558.0,362.7,1.1,870.0,464
HCPCS,95905,MOTOR &/SENS NRV CNDJ  PRECONF ELTRD ARRAY LIMB,2753.0,1789.45,1.1,2773.0,372
HCPCS,95905,MOTOR &/SENS NRV CNDJ PRECONF ELTRD ARRAY LIMB,2753.0,1789.45,46.34,2753.0,87
HCPCS,95907,NERVE CONDUCTION STUDIES 1-2 STUDIES,1080.0,702.0,1.1,1520.0,483
HCPCS,95908,NERVE CONDUCTION STUDIES 3-4 STUDIES,2149.0,1396.85,1.1,2699.0,483
HCPCS,95909,NERVE CONDUCTION STUDIES 5-6 STUDIES,2149.0,1396.85,1.1,2809.0,483
HCPCS,95910,NERVE CONDUCTION STUDIES 7-8 STUDIES,2149.0,1396.85,1.1,3029.0,483
HCPCS,95911,NERVE CONDUCTION STUDIES 9-10 STUDIES,3661.0,2379.65,1.1,4761.0,483
HCPCS,95912,NERVE CONDUCTION STUDIES 11-12 STUDIES,3661.0,2379.65,1.1,4981.0,483
HCPCS,95913,NERVE CONDUCTION STUDIES 13/> STUDIES,3661.0,2379.65,1.1,5227.0,483
HCPCS,95919,QUAN PUPLMTRY PHY/QHP UNI/BI,,,110.82,333.49,21
HCPCS,95919,QUANTITATIVE PUPILLOMETRY PHYS/QHP I&R UNI/BI,889.0,577.85,1.1,961.0,396
HCPCS,95919,Quan puplmtry phy/qhp uni/bi,,,391.75,453.61,8
HCPCS,95921,TSTG ANS FUNCJ CARDIOVAGAL INNERVAJ PARASYMP,1080.0,702.0,1.1,1440.0,482
HCPCS,95922,TSTG ANS FUNCJ VASOMOTOR ADRENERGIC INNERVAJ,889.0,577.85,1.1,1273.0,569
HCPCS,95923,TESTING AUTONOMIC NERVOUS SYSTEM FUNCTION,889.0,577.85,1.1,1249.0,480
HCPCS,95924,TSTG ANS FUNCJ PARASYMP&SYMP W/5 MIN PASIVE TILT,2149.0,1396.85,1.1,2910.0,480
HCPCS,95925,SHORT-LATENCY SOMATOSENS EP STD UPR LIMBS,2149.0,1396.85,1.1,2365.0,482
HCPCS,95926,SHORT-LATENCY SOMATOSENS EP STD LWR LIMBS,2149.0,1396.85,1.1,2365.0,482
HCPCS,95927,SHORT-LATENCY SOMATOSENS EP STD TRNK/HEAD,2149.0,1396.85,1.1,2365.0,396
HCPCS,95927,SOMATOSENSORY TESTING,,,204.28,819.42,21
HCPCS,95927,Somatosensory testing,,,391.75,453.61,8
HCPCS,95928,CTR MOTOR EP STD TRANSCRNL MOTOR STIMJ UPR LIMBS,7020.0,4563.0,1.1,7620.0,482
HCPCS,95929,CTR MOTOR EP STD TRANSCRNL MOTOR STIMJ LWR LIMBS,3661.0,2379.65,1.1,4261.0,482
HCPCS,95930,VISUAL EP TESTING CNS EXCEPT GLAUCOMA W/I&R,2149.0,1396.85,1.1,2289.0,568
HCPCS,95933,ORBICULARIS OCULI REFLX ELECTRODIAGNOSTIC TEST,410.0,266.5,1.1,646.0,480
HCPCS,95937,NEUROMUSCULAR JUNCT TSTG EA NRV ANY 1 METH,1080.0,702.0,1.1,1340.0,483
HCPCS,95938,SHORT-LATENCY SOMATOSENS EP STD UPR & LOW LIMB,3661.0,2379.65,391.75,3661.0,86
HCPCS,95938,SHORT-LATENCY SOMATOSENS EP STD UPR & LOW LIMBS,3661.0,2379.65,1.1,4005.0,396
HCPCS,95939,CTR MOTR EP STD TRANSCRNL MOTR STIM UPR&LOW LI,7020.0,4563.0,391.75,7020.0,86
HCPCS,95939,CTR MOTR EP STD TRANSCRNL MOTR STIM UPR&LOW LIMB,7020.0,4563.0,1.1,7920.0,396
HCPCS,95940,IONM 1 ON 1 IN OR W/ATTENDANCE EACH 15 MINUTES,264.0,171.6,1.1,264.0,144
HCPCS,95940,Ionm in operatng room 15 min,,,405.62,469.67,8
HCPCS,95941,IONM REMOTE/NEARBY/>1 PATIENT IN OR PER HOUR,1767.0,1148.55,1.1,1767.0,94
HCPCS,95941,Ionm remote/>1 pt or per hr,,,405.62,469.67,8
HCPCS,95943,Parasymp&symp hrt rate test,,,391.75,453.61,8
HCPCS,95954,EEG MONITORING/GIVING DRUGS,,,353.04,1399.26,21
HCPCS,95954,Eeg monitoring/giving drugs,,,210.99,244.3,8
HCPCS,95955,EEG NONINTRACRANIAL SURGERY,1193.0,775.45,1.1,1597.0,462
HCPCS,95957,DIGITAL ANALYSIS ELECTROENCEPHALOGRAM,792.0,514.8,1.1,900.29,270
HCPCS,95957,Eeg digital analysis,,,22.84,26.44,8
HCPCS,95958,WADA ACTIVATION TEST HEMISPHERIC FUNCTION W/EEG,7020.0,4563.0,1.1,8716.0,483
HCPCS,95961,FUNCJAL CORT&SUBCORT MAPG PHYS/QHP ATTND INIT HR,7020.0,4563.0,1.1,8208.0,483
HCPCS,95962,FUNCJAL CORT&SUBCORT MAPG PHYS/QHP ATTND ADDL HR,1284.0,834.6,1.1,1884.0,464
HCPCS,95965,MAGNETOENCEPHALOGRAPHY SPON BRAIN ACTIVITY,7020.0,4563.0,1.1,10216.0,409
HCPCS,95966,MAGNETOENCEPHALOGRAPY EVOKED FIELDS 1 MODALITY,7020.0,4563.0,1.1,8616.0,409
HCPCS,95967,MAGNETOENCEPHALOGRAPY EVOKED FIELDS EACH ADDL,4281.0,2782.65,1.1,5677.0,390
HCPCS,95970,ELEC ALYS IMPLT NPGT PHYS/QHP W/O PROGRAMMING,521.5,338.975,1.1,889.0,234
HCPCS,95971,ELEC ALYS IMPLT NPGT SMPL SP/PN NPGT PRGRMG,488.0,317.2,1.1,4392.0,235
HCPCS,95972,ELEC ALYS IMPLT NPGT CPLX SP/PN PRGRMG,492.5,320.125,1.1,633.0,234
HCPCS,95976,ELEC ALYS IMPLT SMPL CN NPGT PRGRMG,289.0,187.85000000000002,1.1,321.0,320
HCPCS,95977,ELEC ALYS IMPLT CPLX CN NPGT PRGRMG,510.5,331.825,1.1,633.0,320
HCPCS,95980,ELEC ALYS NSTIM PLS GEN GASTRIC INTRAOP W/PRGRMG,390.0,253.5,1.1,460.0,210
HCPCS,95981,ELEC ALYS NSTIM GEN GASTRIC SBSQ W/O REPRGRMG,265.0,172.25,1.1,410.0,232
HCPCS,95982,ELEC ALYS NSTIM PLS GEN GASTRIC SBSQ W/REPRGRMG,258.5,168.025,1.1,260.0,232
HCPCS,95983,ELEC ALYS IMPLT BRN NPGT PRGRMG 1ST 15 MIN,516.5,335.725,1.1,633.0,234
HCPCS,95984,ELEC ALYS IMPLT BRN NPGT PRGRMG EA ADDL 15 MIN,355.5,231.075,1.1,359.0,216
HCPCS,95990,REFILL SPINE/BRAIN PUMP,2289.0,1487.85,45.54,2289.0,87
HCPCS,95990,REFILL&MAINTENANCE PUMP DRUG DLVR SPINAL/BRAIN,1253.0,814.4499999999999,0.01,2289.0,231
HCPCS,95991,REFILL SPINE/BRAIN PUMP PHYS,2037.0,1324.05,45.54,2037.0,87
HCPCS,95991,RFL&MAIN IMPLT PMP/RSVR DLVR SPI/BRN PHY/QHP,339.0,220.35,1.1,863.2,148
HCPCS,95992,CANALITH REPOSITIONING PROCEDURE,270.0,175.5,1.1,300.0,488
HCPCS,95999,NON-CLINICAL NEURO DIAG RSCH,230.0,149.5,63.94,453.61,85
HCPCS,95999,PUMP TITRATION,1155.0,750.75,0.01,1155.0,84
HCPCS,95999,RNS ECOG REVIEW,740.0,481.0,121.73,740.0,85
HCPCS,96000,COMPRE CPTR MTN ALYS VIDEO TAPING 3D KINEMATICS,2190.5,1423.825,1.1,3661.0,228
HCPCS,96001,MOTION TEST W/FT PRESS MEAS,,,812.43,2729.53,21
HCPCS,96001,Motion test w/ft press meas,,,391.75,453.61,8
HCPCS,96002,DYNAMIC SURFACE EMG,,,204.28,819.42,21
HCPCS,96002,Dynamic surface emg,,,391.75,453.61,8
HCPCS,96003,DYNAMIC FINE WIRE EMG,,,272.31,819.42,2
HCPCS,96003,Dynamic fine wire emg,,,391.75,453.61,8
HCPCS,96004,PHYS/QHP R&I CPTR MTN ALYS WALK/FUNCJL ACTV REPR,1499.5,974.675,1.1,2143.0,210
HCPCS,96020,TEST SELECT & ADMN FUNCTL BRAIN MAP PHYS/QHP,8496.0,5522.4,1.1,9868.0,376
HCPCS,96040,GENETIC COUNSELING 30 MIN,,,127.14,127.14,1
HCPCS,96040,Genetic counseling 30 min,,,68.73,79.59,8
HCPCS,96041,MED GENETICS&GENETIC COUNSELING SVCS EACH 30 MIN,465.0,302.25,0.01,650.0,161
HCPCS,96105,ASSESS APHASIA PER HR,480.0,312.0,124.17,480.0,85
HCPCS,96105,ASSESSMENT APHASIA W/INTERP & REPORT PER HOUR,700.0,455.0,1.1,700.0,144
HCPCS,96110,DEVELOPMENTAL SCREEN W/SCORING & DOC STD INSTRM,176.0,114.4,1.1,316.0,310
HCPCS,96110,DEVELOPMENTAL TEST LIMITED,316.0,205.4,68.89,316.0,66
HCPCS,96110,PT DEVELOPMENTAL TEST/LMTD,316.0,205.4,68.89,316.0,66
HCPCS,96110,"SLT-DEVELOPMENTAL TEST,LIM",316.0,205.4,68.89,316.0,66
HCPCS,96112,DEVEL TST PHYS/QHP 1ST HR,1080.0,702.0,121.73,1080.0,258
HCPCS,96112,DEVELOPMENTAL TST ADMIN PHYS/QHP 1ST HOUR,1052.0,683.8,1.1,1080.0,234
HCPCS,96113,DEVEL TST PHYS/QHP EA ADDL,302.0,196.3,64.36,302.0,204
HCPCS,96113,DEVELOPMENTAL TST ADMIN PHYS/QHP EA ADDL 30 MIN,383.0,248.95000000000002,1.1,464.0,216
HCPCS,96116,NEUROBEHAVIORAL STATUS XM PHYS/QHP 1ST HOUR,1446.5,940.2249999999999,1.1,2149.0,238
HCPCS,96121,NEUROBEHAVIORAL STATUS XM PHYS/QHP EA ADDL HOUR,571.0,371.15,1.1,752.0,218
HCPCS,96125,COGNITIVE TEST BY HC PRO,662.0,430.3,129.95,662.0,85
HCPCS,96125,COGNITIVE TEST BY HCPRO GN,662.0,430.3,129.95,662.0,85
HCPCS,96125,STANDARDIZED COGNITIVE PERFORMANCE TESTING,671.0,436.15,1.1,680.0,312
HCPCS,96127,BEHAV ASSMT W/SCORE & DOCD/STAND INSTRUMENT,66.0,42.9,1.1,116.32,228
HCPCS,96127,DEPRESSION SCREENING AUTO BILLING,66.0,42.9,1.1,116.32,142
HCPCS,96127,VIRTUAL BRIEF EMOTIONAL/BEHAV ASSMT,66.0,42.9,6.18,66.0,86
HCPCS,96130,PSYCHOLOGICAL TST EVAL SVC PHYS/QHP FIRST HOUR,1030.0,669.5,1.1,1126.0,238
HCPCS,96131,PSYCHOLOGICAL TST EVAL SVC PHYS/QHP EA ADDL HOUR,626.0,406.9,1.1,862.0,220
HCPCS,96132,NEUROPSYCHOLOGICAL TST EVAL PHYS/QHP 1ST HOUR,1359.0,883.3499999999999,1.1,1592.0,238
HCPCS,96133,NEUROPSYCHOLOGICAL TST EVAL PHYS/QHP EA ADDL HR,626.0,406.9,1.1,862.0,220
HCPCS,96136,PSYL/NRPSYCL TST PHYS/QHP 2+ TST 1ST 30 MIN,314.5,204.425,1.1,387.0,238
HCPCS,96137,PSYCL/NRPSYCL TST PHYS/QHP 2+ TST EA ADDL 30 MIN,296.0,192.4,1.1,390.0,220
HCPCS,96138,PSYCL/NRPSYCL TST TECH 2+ TST 1ST 30 MIN,992.5,645.125,1.1,1197.0,220
HCPCS,96139,PSYCL/NRPSYCL TST TECH 2+ TST EA ADDL 30 MIN,589.0,382.85,1.1,788.0,200
HCPCS,96146,PSYCL/NRPSYCL TST ELEC PLATFORM AUTO RESULT,138.0,89.69999999999999,1.03,238.95,230
HCPCS,96156,HEALTH BEHAVIOR ASSESSMENT/RE-ASSESSMENT,599.0,389.35,1.1,920.0,312
HCPCS,96156,VV HEALTH BEHAVIOR ASSESSMENT/RE-ASSESSMENT,920.0,598.0,1.1,920.0,140
HCPCS,96158,HEALTH BEHAVIOR IVNTJ INDIV F2F 1ST 30 MIN,559.0,363.35,1.1,636.0,312
HCPCS,96158,VV HEALTH BEHAVIOR IVNTJ INDIV F2F 1ST 30 MIN,636.0,413.4,1.1,636.0,140
HCPCS,96159,HEALTH BEHAVIOR IVNTJ INDIV F2F EA ADDL 15 MIN,206.0,133.9,1.1,220.0,276
HCPCS,96159,VV HEALTH BEHAVIOR IVNTJ INDIV F2F EA ADDL 15 MIN,220.0,143.0,1.1,220.0,140
HCPCS,96160,PT-FOCUSED HLTH RISK ASSMT SCORE DOC STND INSTRM,67.5,43.875,0.01,89.0,315
HCPCS,96160,VV PT-FOCUSED HLTH RISK ASSMT SCORE DOC STND INSTRM,46.0,29.9,1.1,55.06,142
HCPCS,96161,CAREGIVER HLTH RISK ASSMT SCORE DOC STND INSTRM,89.0,57.85,0.01,89.0,229
HCPCS,96161,VV CAREGIVER HLTH RISK ASSMT SCORE DOC STND INSTRM,89.0,57.85,1.1,89.0,142
HCPCS,96164,HEALTH BEHAVIOR IVNTJ GROUP F2F 1ST 30 MIN,90.5,58.825,1.1,152.57,312
HCPCS,96164,VV HEALTH BEHAVIOR IVNTJ GROUP F2F 1ST 30 MIN,92.0,59.8,1.1,92.0,140
HCPCS,96165,HEALTH BEHAVIOR IVNTJ GROUP F2F EA ADDL 15 MIN,66.5,43.225,1.1,309.0,276
HCPCS,96165,VV HEALTH BEHAVIOR IVNTJ GROUP F2F EA ADDL 15 MIN,44.0,28.6,1.1,309.0,140
HCPCS,96167,HEALTH BEHAVIOR IVNTJ FAM W/PT F2F 1ST 30 MIN,384.5,249.925,1.1,680.0,312
HCPCS,96167,VV HEALTH BEHAVIOR IVNTJ FAM W/PT F2F 1ST 30 MIN,680.0,442.0,1.1,680.0,140
HCPCS,96168,HEALTH BEHAVIOR IVNTJ FAM W/PT F2F EA ADD 15 MIN,164.5,106.925,1.1,240.0,276
HCPCS,96168,VV HEALTH BEHAVIOR IVNTJ FAM W/PT F2F EA ADD 15 MIN,240.0,156.0,1.1,240.0,140
HCPCS,96170,HEALTH BEHAVIOR IVNTJ FAM W/O PT F2F 1ST 30 MIN,370.5,240.825,1.1,600.0,236
HCPCS,96170,VV HEALTH BEHAVIOR IVNTJ FAM W/O PT F2F 1ST 30 MIN,600.0,390.0,1.1,600.0,104
HCPCS,96171,HEALTH BEHAVIOR IVNTJ FAM W/O PT F2F EA ADDL 15,143.0,92.95,1.1,216.0,236
HCPCS,96171,VV HEALTH BEHAVIOR IVNTJ FAM W/O PT F2F EA ADDL 15,216.0,140.4,1.1,216.0,104
HCPCS,96202,MLT FAM GROUP BHV MGMT/MODIFICAJ TRAING 1ST 60,208.5,135.525,0.01,245.0,307
HCPCS,96203,MLT FAM GROUP BHV MGMT/MODIFICAJ TRAING EA ADDL,53.5,34.775,0.01,152.57,303
HCPCS,96360,IV HYDRATE INIT 31-60MIN,1454.0,945.1,43.43,1454.0,87
HCPCS,96360,IV INFUSION HYDRATION INITIAL 31 MIN-1 HOUR,75.0,48.75,1.1,624.44,144
HCPCS,96361,IV HYDRATE EA ADD HR,318.0,206.7,16.11,452.75,87
HCPCS,96361,IV INFUSION HYDRATION EACH ADDITIONAL HOUR,40.0,26.0,1.1,137.75,144
HCPCS,96365,IV INF INIT UP TO 1 HR,1454.0,945.1,84.89,1454.0,87
HCPCS,96365,IV INFUSION THERAPY/PROPHYLAXIS /DX 1ST TO 1 HR,92.0,59.8,1.1,624.44,144
HCPCS,96365,THERAPEUTIC IV INFUSION 1ST HR,1454.0,945.1,84.89,1454.0,87
HCPCS,96366,IV INF SEQ EA ADD HR,318.0,206.7,26.4,452.75,87
HCPCS,96366,IV INFUSION THERAPY PROPHYLAXIS/DX EA HOUR,79.0,51.35,1.1,137.75,144
HCPCS,96366,THERAP IV INFUSION EA ADDL HR,318.0,206.7,26.4,452.75,87
HCPCS,96367,IV INF SEQ UP TO 1HR,491.0,319.15,37.57,491.0,87
HCPCS,96367,IV INFUSION THER PROPH ADDL SEQUENTIAL TO 1 HR,84.0,54.6,1.1,205.09,144
HCPCS,96368,IV INF CONCUR THERAPY,762.0,495.3,25.57,762.0,68
HCPCS,96368,IV NFS THERAPY PROPHYLAXIS/DX CONCURRENT NFS,75.0,48.75,1.1,75.0,144
HCPCS,96369,SC THER INFUSION UP TO 1 HR,1454.0,945.1,185.95,1454.0,87
HCPCS,96370,SC THER INFUSION ADDL HR,318.0,206.7,20.29,452.75,87
HCPCS,96371,SC THER INFUSION RESET PUMP,,,61.12,183.91,21
HCPCS,96371,Sc ther infusion reset pump,,,277.57,321.4,8
HCPCS,96372,IM/SC INJECTION (MONTHLY),491.0,319.15,17.51,491.0,87
HCPCS,96372,INJ SQ/IM,491.0,319.15,17.51,491.0,87
HCPCS,96372,THERAPEUTIC PROPHYLACTIC/DX INJECTION SUBQ/IM,491.0,319.15,1.1,491.0,235
HCPCS,96373,THER/PROPH/DIAG INJ IA,1454.0,945.1,24.16,1454.0,87
HCPCS,96374,INJ IVPUSH INIT DRUG,1454.0,945.1,45.54,1454.0,87
HCPCS,96374,INJECTION IV PUSH INIT,1454.0,945.1,45.54,1454.0,87
HCPCS,96374,THER PROPH/DX NJX IV PUSH SINGLE/1ST SBST/DRUG,79.0,51.35,1.1,624.44,144
HCPCS,96375,INJ IV PUSH SEQ NEW DRUG,318.0,206.7,20.23,318.0,87
HCPCS,96375,INJ IVPUSH SEQ NEW DRUG,318.0,206.7,20.23,318.0,87
HCPCS,96375,THERAPEUTIC INJECTION IV PUSH EACH NEW DRUG,44.0,28.6,1.1,137.75,144
HCPCS,96376,INJ IV PUSH SEQ SAME DRUG,488.0,317.2,45.54,488.0,66
HCPCS,96376,THER PROPH/DX NJX EA SEQL IV PUSH SBST/DRUG FAC,390.0,253.5,1.1,390.0,102
HCPCS,96377,APPL ON-BODY INJECTOR FOR TIMED SUBQ INJECTION,196.5,127.725,1.1,3174.0,231
HCPCS,96379,UNL THER/PROP/DIAG INJ/INF,,,41.21,124.01,21
HCPCS,96379,Unl ther/prop/diag inj/inf,,,45.54,52.73,8
HCPCS,96380,"ADMIN BEYFORTUS IM INJ, W/ COUNSELING",158.0,102.7,17.08,158.0,68
HCPCS,96380,"ADMIN BEYFORTUS IM INJ,W/ COUNSELING",158.0,102.7,1.1,158.0,130
HCPCS,96380,"VFC ADMIN BEYFORTUS IM INJ,W/ COUNSELING",21.25,13.81,1.1,76.65,130
HCPCS,96380,"VFC ADMIN BEYFORTUS, W/COUNSELING",21.25,13.81,4.63,39.64,68
HCPCS,96381,ADMIN BEYFORTUS IM INJ,158.0,102.7,1.1,158.0,198
HCPCS,96401,"CHEMOTHER,NON-HORMONE ANTI-NEOPL, SUB-Q/IM",92.0,59.8,1.1,234.61,144
HCPCS,96401,CHEMOTX ADMN SUBQ/IM NON-HORMONAL ANTI-NEO,491.0,319.15,45.54,491.0,258
HCPCS,96402,CHEMO ADMINISTRATION,1128.0,733.2,1.1,1128.0,144
HCPCS,96402,CHEMOTHER HORMON ANTINEOPL SUB-Q/IM,84.0,54.6,1.1,205.09,144
HCPCS,96402,CHEMOTX ADMN SUBQ/IM HORMONAL ANTI-NEO,491.0,319.15,45.54,491.0,172
HCPCS,96405,CHEMOTHERAPY ADMINISTRATION INTRALESIONAL </7,360.0,234.0,1.1,491.0,320
HCPCS,96406,CHEMOTHERAPY ADMINISTRATION INTRALESIONAL >7,903.0,586.95,1.1,1454.0,234
HCPCS,96409,"CHEMOTHER, IV PUSH, SNGL DRUG",106.0,68.9,1.1,988.7,144
HCPCS,96409,CHEMOTX ADMN IV PUSH TQ 1/1ST SBST/DRUG,2289.0,1487.85,45.54,2289.0,172
HCPCS,96411,"CHEMOTHER, IV PUSH,EA ADD DRUG",88.0,57.2,1.1,205.09,144
HCPCS,96411,CHEMOTX ADMN IV PUSH TQ EA SBST/DRUG,491.0,319.15,45.54,491.0,172
HCPCS,96413,"CHEMOTHER, IV INFUSION, 1 HR",123.0,79.95,1.1,988.7,144
HCPCS,96413,CHEMOTX ADMN IV NFS TQ UP 1 HR 1/1ST SBST/DRUG,2289.0,1487.85,177.24,2289.0,430
HCPCS,96415,"CHEMOTHER, IV INFUSION, EA ADD HR",84.0,54.6,1.1,205.09,144
HCPCS,96415,CHEMOTHERAPY ADMN IV INFUSION TQ EA HR,491.0,319.15,36.34,491.0,86
HCPCS,96416,CHEMOTHER PROLONG INFUSE W/PUMP,92.0,59.8,1.1,988.7,144
HCPCS,96416,CHEMOTX ADMN TQ INIT PROLNG CHEMOTX NFUS PMP,2289.0,1487.85,175.18,2289.0,172
HCPCS,96417,"CHEMOTHER, IV INFUSE, EACH SEQU INFUS",92.0,59.8,1.1,207.9,144
HCPCS,96417,CHEMOTX ADMN IV NFS TQ EA SEQL NFS TO 1 HR,491.0,319.15,61.12,491.0,86
HCPCS,96420,CHEMOTHERAPY ADMIN INTRA-ARTERIAL PUSH TQ,1182.0,768.3,1.1,2289.0,230
HCPCS,96422,CHEMOTHERAPY ADMIN INTRA-ARTERIAL INFUS </1 HR,1178.5,766.025,1.1,2289.0,230
HCPCS,96423,CHEMOTHERAPY ADMN INTRAARTERIAL INFUSION EA HR,318.0,206.7,41.21,452.75,86
HCPCS,96425,CHEMOTHERAPY ADMIN INTRA-ARTERIAL  INFUSION TECHNIQUE >8 HR PRTB,2289.0,1487.85,232.27,2289.0,86
HCPCS,96440,CHEMOTX ADMN PLEURAL CAVITY REQ&W/THORACNTS,1568.5,1019.525,0.01,2431.21,321
HCPCS,96446,CHEMOTX ADMN PERTL CAVITY IMPLANTED PORT/CATH,1226.0,796.9,1.1,2289.0,232
HCPCS,96450,CHEMOTX ADMN CNS REQ SPINAL PUNCTURE,1450.5,942.8249999999999,0.01,2289.0,321
HCPCS,96521,FILL PORTABLE PUMP,1454.0,945.1,45.54,1454.0,87
HCPCS,96521,"REFILL/MAINT, PORTABLE PUMP",92.0,59.8,1.1,624.44,144
HCPCS,96522,FILL IMP PUMP RESVOIR IV OR IA,1454.0,945.1,45.54,1454.0,87
HCPCS,96522,FILL IMP PUMP SYSTEMIC,1454.0,945.1,45.54,1454.0,87
HCPCS,96522,REFILL/MAINT SYSTEMIC PUMP/RESVR,92.0,59.8,1.1,624.44,144
HCPCS,96523,IRRIG DRUG DELIVERY DEVICE,410.0,266.5,34.52,410.0,174
HCPCS,96523,IRRIG IMP VAD,410.0,266.5,34.52,410.0,87
HCPCS,96523,IRRIGAJ IMPLNTD VENOUS ACCESS DRUG DELIVERY SYST,214.0,139.1,0.01,410.0,403
HCPCS,96542,CHEMOTX NJX SUBARACHND/INTRAVENTR RSVR 1/MULT,1294.5,841.425,1.1,2289.0,234
HCPCS,96547,INTRAOPERATIVE HIPEC PX FIRST 60 MINUTES,2612.0,1697.8,1.1,2612.0,130
HCPCS,96547,Intraop hipec px 1st 60 min,,,673.41,779.74,8
HCPCS,96548,INTRAOPERATIVE HIPEC PX EACH ADDL 30 MINUTES,1200.0,780.0,1.1,1649.73,130
HCPCS,96548,Ntraop hipec px ea add 30min,,,673.41,779.74,8
HCPCS,96549,CONCURRENT CHEMO INFUSION UNLISTED,761.0,494.65,41.21,761.0,84
HCPCS,96549,INTRA-OPERATIVE CHEMOTHERAPY INFUSION (HIPEC) (COMP 96446),611.0,397.15,0.01,611.0,82
HCPCS,96549,INTRA-OPRATIVE CHEMOTHERAPY INFUSION (COMP 96446),541.0,351.65,0.01,541.0,82
HCPCS,96549,UNLISTED HITEC - HYPERTHERMIC INTRATHORACIC CHEMOTHERAPY (COMP C,764.0,496.6,0.01,764.0,82
HCPCS,96567,PDT DSTR PRMLG LES SKN ILLUM/ACTIVJ PER DAY,518.5,337.025,1.1,596.0,228
HCPCS,96570,PDT NDSC ABL ABNOR TISS VIA ACTIVJ RX 30 MIN,440.0,286.0,1.1,440.0,142
HCPCS,96570,PHOTODYNAMIC THERAPY BY ENDOSCOPIC APPLICATION OF LIGHT,119.0,77.35,25.94,12615.0,68
HCPCS,96571,PDT NDSC ABL ABNOR TISS VIA ACTIVJ RX A 15 MIN,220.0,143.0,1.1,220.0,142
HCPCS,96571,Photodynamic tx addl 15 min,,,112.68,130.47,8
HCPCS,96573,PDT DSTR PRMLG LES SKN ILLUM/ACTIVJ BY PHYS/QHP,403.5,262.275,1.1,742.11,228
HCPCS,96574,DEBRIDEMENT PRMLG HYPERKERATOTIC LES W/PDT,520.0,338.0,0.01,3443.0,315
HCPCS,96900,ACTINOTHERAPY ULTRAVIOLET LIGHT,105.0,68.25,1.1,118.0,230
HCPCS,96902,MCRSCP XM HAIR PLUCK/CLIP FOR CNTS/STRUCT ABNORM,167.5,108.875,1.1,171.0,168
HCPCS,96904,WHOLE BODY INTEGUMENTARY PHOTOGRAPHY,176.0,114.4,38.37,469.67,68
HCPCS,96910,PHOTOCHEMOTX TAR&UVB/PETROLATUM/UVB,156.0,101.4,1.1,377.31,230
HCPCS,96912,PHOTOCHEMOTX PSORALENS&ULTRAVIOLET PUVA,172.5,112.125,1.1,321.61,230
HCPCS,96913,PHOTOCHEMOTX SEV DERMATOSES,,,345.93,1040.98,21
HCPCS,96913,Photochemotx sev dermatoses,,,168.79,195.44,8
HCPCS,96920,EXCIMER LASER TX PSORIASIS TOT AREA <250 SQ CM,464.0,301.6,1.1,3443.0,234
HCPCS,96921,EXCIMER LASER TX PSORIASIS 250-500 SQ CM,478.0,310.7,1.1,3443.0,234
HCPCS,96922,EXCIMER LASER TX PSORIASIS >500 SQ CM,829.5,539.175,1.1,3443.0,234
HCPCS,96931,RCM IMG ACQUISJ&I&R 1ST LES,,,422.86,422.86,1
HCPCS,96931,Rcm img acquisj&i&r 1st les,,,9.22,10.68,8
HCPCS,96932,Rcm img acquisj only 1st les,,,9.22,10.68,8
HCPCS,96933,RCM I&R ONLY 1ST LESION,,,111.33,111.33,1
HCPCS,96933,Rcm i&r only 1st lesion,,,9.22,10.68,8
HCPCS,96934,Rcm img acquisj&i&r ea addl,,,9.22,10.68,8
HCPCS,96935,Rcm img acquisj only ea addl,,,9.22,10.68,8
HCPCS,96936,Rcm i&r only ea addl lesion,,,9.22,10.68,8
HCPCS,96999,SKIN EVALUATION,35.0,22.75,0.01,584.65,84
HCPCS,96999,UNLISTED SPEC DERM SERVICE,270.0,175.5,75.06,270.0,84
HCPCS,96999,UNLISTED SPECIAL DERM SERVICE,27.0,17.55,0.01,335.72,85
HCPCS,96999,VAGINAL LASER THERAPY,260.0,169.0,0.01,584.65,169
HCPCS,96999,VITILIGO EXC LASER <250 SQ CM,621.0,403.65,168.79,621.0,84
HCPCS,97007,MCHNL SCLP COOL CAP SPLY HEAD MEAS FITG&EDUCAJ,10008.0,6505.2,0.01,10008.0,78
HCPCS,97008,MCHNL SCLP COOL HAIR PREPJ CAP PLMT THER&PRECOOL,12078.0,7850.7,0.01,12078.0,68
HCPCS,97009,MCHNL SCLP COOL AFTER CHEMO EACH 30 MINUTES,3020.0,1963.0,0.01,3020.0,68
HCPCS,97010,APPLICATION MODALITY 1/> AREAS HOT/COLD PACKS,24.0,15.6,1.1,24.0,98
HCPCS,97010,HOT OR COLD PACKS THERAPY,,,16.11,16.11,1
HCPCS,97010,Hot or cold packs therapy,,,31.09,36.0,8
HCPCS,97012,APPL MODALITY 1/> AREAS TRACTION MECHANICAL,100.0,65.0,1.1,100.0,142
HCPCS,97012,APPLY TRACTION MECH GP,194.0,126.1,18.14,194.0,86
HCPCS,97014,APPL MODALITY 1/> AREAS ELEC STIMJ UNATTENDED,124.5,80.925,0.01,177.0,232
HCPCS,97014,ELEC STIM - UNAT,177.0,115.05,31.09,177.0,67
HCPCS,97014,ELECTRICAL STIM. UNATTENDED,177.0,115.05,31.09,177.0,67
HCPCS,97016,APPL MODALITY 1/> AREAS VASOPNEUMATIC DEVICES,72.0,46.8,1.1,72.0,142
HCPCS,97016,JOBST COMPRESSION UT,203.0,131.95,14.7,203.0,86
HCPCS,97016,VASOPNEUMATIC DVC GP,203.0,131.95,14.7,203.0,86
HCPCS,97018,APPL MODALITY 1/> AREAS PARAFFIN BATH,24.0,15.6,1.1,24.0,144
HCPCS,97018,PARAFFIN,166.0,107.9,7.04,166.0,86
HCPCS,97018,PARAFFIN BATH GO,166.0,107.9,7.04,166.0,86
HCPCS,97022,APPLICATION MODALITY 1/> AREAS WHIRLPOOL,68.0,44.2,1.1,68.0,142
HCPCS,97022,WHIRLPOOL GO,179.0,116.35,20.16,179.0,86
HCPCS,97022,WHIRLPOOL GP,179.0,116.35,20.16,179.0,172
HCPCS,97024,DIATHERMY EG MICROWAVE,,,9.28,18.58,28
HCPCS,97024,Diathermy eg microwave,,,31.09,36.0,8
HCPCS,97026,APPLICATION MODALITY 1/> AREAS INFRARED,37.0,24.049999999999997,1.1,48.0,216
HCPCS,97028,ULTRAVIOLET THERAPY,,,10.45,21.18,28
HCPCS,97028,Ultraviolet therapy,,,31.09,36.0,8
HCPCS,97032,APPL MODALITY 1/> AREAS ELEC STIMJ EA 15 MIN,169.5,110.175,0.01,239.0,400
HCPCS,97032,ELECTR STIM 15MIN GP,239.0,155.35,18.49,239.0,86
HCPCS,97032,OT ELECTRICAL STIMULATION 15 M,239.0,155.35,18.49,239.0,86
HCPCS,97033,APPL MODALITY 1/> AREAS IONTOPHORESIS EA 15 MIN,104.0,67.6,1.1,104.0,130
HCPCS,97033,IONTOPHORESIS 15MIN GO,189.0,122.85,23.82,189.0,86
HCPCS,97033,PT IONTOPHORESIS 15MIN GP,189.0,122.85,23.82,189.0,86
HCPCS,97034,APPL MODALITY 1/> AREAS CONTRAST BATHS EA 15 MIN,105.0,68.25,1.1,126.0,228
HCPCS,97034,"CONTRAST BATH, EA 15 MIN",126.0,81.9,17.37,126.0,172
HCPCS,97035,APPL MODALITY 1/> AREAS ULTRASOUND EA 15 MIN,129.0,83.85,1.1,174.0,228
HCPCS,97035,US 15MIN GO,174.0,113.1,17.59,174.0,86
HCPCS,97035,US 15MIN GP,174.0,113.1,17.59,174.0,86
HCPCS,97036,HUBBARD 15MIN GP,232.0,150.8,45.89,232.0,86
HCPCS,97037,APPL MODALITY 1+LLLT PO PAIN,,,34.79,104.7,21
HCPCS,97037,Appl modality 1+lllt po pain,,,31.09,36.0,8
HCPCS,97039,"APPLICATION OF MODALITY UNSPECIFIED, CONSTANT ATTENDANCE",110.0,71.5,0.01,1759999.98,67
HCPCS,97039,UNLIST MODALITY SPEC TYPE&TIME CONSTANT ATTEND,179.0,116.35,1.1,3061000.0,82
HCPCS,97110,OT THERAPEUT PROC/EXER 15 MIN,258.0,167.7,37.06,258.0,86
HCPCS,97110,"PT THERAPEUT PROC/EXER, 15 MIN",258.0,167.7,37.06,258.0,86
HCPCS,97110,THERA EXER 1,258.0,167.7,37.06,258.0,86
HCPCS,97110,THERA EXER 15MIN,258.0,167.7,37.06,258.0,172
HCPCS,97110,THERA EXER 15MIN GO,258.0,167.7,37.06,258.0,86
HCPCS,97110,THERA EXER EA 15 MINS,258.0,167.7,37.06,258.0,86
HCPCS,97110,THERAPEUTIC EXERCISES EA 15MIN,258.0,167.7,37.06,258.0,86
HCPCS,97110,"THERAPEUTIC EXERCISES RE, EA 15 MIN.",198.0,128.7,1.1,198.0,142
HCPCS,97110,VV THERAPEUTIC EXERCISE  OT (97110),258.0,167.7,37.06,258.0,86
HCPCS,97110,VV THERAPEUTIC EXERCISE OT (97110),198.0,128.7,1.1,198.0,142
HCPCS,97110,VV THERAPEUTIC EXERCISE PT (97110),228.0,148.2,1.1,258.0,228
HCPCS,97112,NEURMSCL THERAPY 15MIN,261.0,169.65,41.24,261.0,172
HCPCS,97112,THER PX 1/> AREAS EACH 15 MIN NEUROMUSC REEDUCA,240.5,156.325,1.1,261.0,228
HCPCS,97112,VV NEUROMUSCULAR EDUCATION  OT (97112),261.0,169.65,41.24,261.0,86
HCPCS,97112,VV NEUROMUSCULAR EDUCATION OT (97112),220.0,143.0,1.1,220.0,142
HCPCS,97112,VV NEUROMUSCULAR EDUCATION PT (97112),240.5,156.325,1.1,261.0,228
HCPCS,97113,AQUATIC THERAPY 15MIN GP,326.0,211.9,46.13,326.0,86
HCPCS,97113,THER PX 1/> AREAS EACH 15 MIN AQUA THER W/XERSS,268.5,174.525,1.1,326.0,228
HCPCS,97116,GAIT TRAINING THERAPY 15M,228.0,148.2,31.09,228.0,86
HCPCS,97116,THER PX 1/> AREAS EA 15 MIN GAIT TRAING W/STAIR,213.0,138.45,1.1,228.0,228
HCPCS,97116,VV GAIT TRAINING THERAPY  (97116),228.0,148.2,31.09,228.0,86
HCPCS,97116,VV GAIT TRAINING THERAPY PT (97116),198.0,128.7,1.1,198.0,142
HCPCS,97124,THER PX 1/> AREAS EACH 15 MINUTES MASSAGE,171.0,111.15,1.1,202.0,228
HCPCS,97129,THER IVNTJ COG FUNCJ CNTCT 1ST 15 MINUTES,202.5,131.625,1.1,205.0,741
HCPCS,97130,THER IVNTJ COG FUNCJ CNTCT EA ADDL 15 MINUTES,198.5,129.025,1.1,205.0,737
HCPCS,97139,UNLISTED THERAPEUTIC PROCEDURE SPECIFY,130.0,84.5,1.1,3061000.0,82
HCPCS,97139,UNLISTED THERAPEUTIC PX,,,2739999.97,2739999.97,1
HCPCS,97139,Unlisted therapeutic px,,,31.09,36.0,8
HCPCS,97140,MANUAL THERAPY 15MIN,241.0,156.65,34.41,241.0,86
HCPCS,97140,MANUAL THERAPY 15MIN GP,241.0,156.65,34.41,241.0,86
HCPCS,97140,MANUAL THERAPY TQS 1/> REGIONS EACH 15 MINUTES,215.0,139.75,1.1,241.0,400
HCPCS,97150,GROUP THERAPY GO,234.0,152.1,22.65,234.0,86
HCPCS,97150,GROUP THERAPY GP,234.0,152.1,22.65,234.0,86
HCPCS,97150,THERAPEUTIC PROCEDURES GROUP 2/> INDIVIDUALS,116.0,75.4,1.1,116.0,142
HCPCS,97151,BEHAVIOR ID ASSESSMENT BY PHYS/QHP EA 15 MIN,272.0,176.8,1.1,425.0,178
HCPCS,97152,BEHAVIOR ID SUPPORT ASSMT BY 1 TECH EA 15 MIN,359.0,233.35,1.1,425.0,178
HCPCS,97153,ADAPTIVE BEHAVIOR TX BY PROTOCOL TECH EA 15 MIN,335.5,218.075,1.1,425.0,178
HCPCS,97154,GROUP ADAPTIVE BHV TX BY PROTOCOL TECH EA 15 MIN,159.0,103.35,1.1,210.73,178
HCPCS,97155,ADAPT BHV TX PRTCL MODIFICAJ PHYS/QHP EA 15 MIN,492.5,320.125,1.1,739.0,178
HCPCS,97156,FAMILY ADAPT BHV TX GDN PHYS/QHP EA 15 MIN,117.5,76.375,1.1,294.38,178
HCPCS,97157,MULTIPLE FAM GROUP BHV TX GDN PHYS/QHP EA 15 MIN,137.0,89.05,1.1,210.73,178
HCPCS,97158,GRP ADAPT BHV PRTCL MODIFCAJ PHYS/QHP EA 15 MIN,106.0,68.9,1.1,210.73,178
HCPCS,97161,PHYSICAL THERAPY EVALUATION LOW COMPLEX 20 MINS,610.5,396.825,1.1,616.0,227
HCPCS,97161,PT EVAL - LOW,605.0,393.25,93.19,605.0,85
HCPCS,97161,VV EVALUATION LOW COMPLEXITY  (97161),605.0,393.25,93.19,605.0,85
HCPCS,97161,VV EVALUATION LOW COMPLEXITY OT (97161),616.0,400.4,1.1,616.0,142
HCPCS,97161,VV EVALUATION LOW COMPLEXITY PT (97161),616.0,400.4,1.1,616.0,142
HCPCS,97162,PHYSICAL THERAPY EVALUATION MOD COMPLEX 30 MINS,616.0,400.4,1.1,616.0,142
HCPCS,97162,PT EVAL - MOD,605.0,393.25,93.19,605.0,85
HCPCS,97162,VV EVALUATION MODERATE COMPLEXITY  (97162),605.0,393.25,93.19,605.0,85
HCPCS,97162,VV EVALUATION MODERATE COMPLEXITY OT (97162),616.0,400.4,1.1,616.0,142
HCPCS,97162,VV EVALUATION MODERATE COMPLEXITY PT (97162),616.0,400.4,1.1,616.0,142
HCPCS,97163,PHYSICAL THERAPY EVALUATION HIGH COMPLEX 45 MINS,616.0,400.4,1.1,616.0,142
HCPCS,97163,PT EVAL - HIGH,605.0,393.25,93.19,605.0,85
HCPCS,97163,VV EVALUATION HIGH COMPLEXITY (97163),605.0,393.25,93.19,605.0,85
HCPCS,97163,VV EVALUATION HIGH COMPLEXITY OT (97163),616.0,400.4,1.1,616.0,142
HCPCS,97163,VV EVALUATION HIGH COMPLEXITY PT (97163),616.0,400.4,1.1,616.0,142
HCPCS,97164,PHYSICAL THERAPY RE-EVAL EST PLAN CARE 20 MINS,384.0,249.6,1.1,384.0,142
HCPCS,97164,PT RE-EVAL,383.0,248.95,86.04,383.0,85
HCPCS,97165,OCCUPATIONAL THERAPY EVAL LOW COMPLEX 30 MINS,616.0,400.4,1.1,616.0,142
HCPCS,97165,OT EVAL - LOW,674.0,438.1,128.09,674.0,85
HCPCS,97165,VV EVALUATION LOW COMPLEXITY (97165),674.0,438.1,128.09,674.0,85
HCPCS,97166,OCCUPATIONAL THERAPY EVAL MOD COMPLEX 45 MINS,616.0,400.4,1.1,616.0,142
HCPCS,97166,OT EVAL - MOD,674.0,438.1,128.09,674.0,85
HCPCS,97166,VV EVALUATION MODERATE COMPLEXITY (97166),674.0,438.1,128.09,674.0,85
HCPCS,97167,OCCUPATIONAL THERAPY EVAL HIGH COMPLEX 60 MINS,616.0,400.4,1.1,616.0,142
HCPCS,97167,OT EVAL - HIGH,674.0,438.1,128.09,674.0,85
HCPCS,97167,VV EVALUATION HIGH COMPLEXITY (97167),674.0,438.1,128.09,674.0,85
HCPCS,97168,OCCUPATIONAL THER RE-EVAL EST PLAN CARE 30 MINS,383.5,249.27499999999998,1.1,384.0,227
HCPCS,97169,ATHLETIC TRN EVAL LOW CMPLX,,,184.95,184.95,1
HCPCS,97169,Athletic trn eval low cmplx,,,68.73,79.59,8
HCPCS,97170,ATHLETIC TRN EVAL MOD CMPLX,,,215.78,215.78,1
HCPCS,97170,Athletic trn eval mod cmplx,,,68.73,79.59,8
HCPCS,97171,ATHLETIC TRN EVAL HIGH CMPLX,,,2739849.3,2739849.3,1
HCPCS,97171,Athletic trn eval high cmplx,,,68.73,79.59,8
HCPCS,97172,ATHLETIC TRN RE-EVAL PLAN CR,,,2739849.3,2739849.3,1
HCPCS,97172,Athletic trn re-eval plan cr,,,68.73,79.59,8
HCPCS,97530,THERA ACTIVITY DIR 15MIN,274.0,178.1,44.62,274.0,86
HCPCS,97530,THERA FUNC ACTIVITIES 15M,274.0,178.1,44.62,274.0,86
HCPCS,97530,THERAPEUT ACTVITY DIRECT PT CONTACT EACH 15 MIN,225.0,146.25,1.1,274.0,486
HCPCS,97530,VV THERAPEUTIC ACTIVITIES (97530),274.0,178.1,44.62,274.0,86
HCPCS,97530,VV THERAPEUTIC ACTIVITIES PT (97530),176.0,114.4,1.1,176.0,142
HCPCS,97530,VV THERAPEUTIC ACTIVITY OT (97530),225.0,146.25,1.1,274.0,228
HCPCS,97533,PT SENSORY INTEGRATIVE TCH/15M,188.0,122.2,52.26,188.0,85
HCPCS,97533,"SENSORY INTEGRATION, EA 1",188.0,122.2,52.26,188.0,85
HCPCS,97533,SENSORY INTEGRATIVE TECHNIQUES EACH 15 MINUTES,192.0,124.8,1.1,207.99,142
HCPCS,97533,SENSORY INTEGRATN EA 15M,188.0,122.2,52.26,188.0,85
HCPCS,97535,EDUC HOME MGMT EA 15MIN GO,274.0,178.1,31.09,274.0,86
HCPCS,97535,EDUC HOME MGMT EA 15MIN GP,274.0,178.1,31.09,274.0,86
HCPCS,97535,SELF-CARE/HOME MGMT TRAINING EACH 15 MINUTES,180.0,117.0,1.1,180.0,142
HCPCS,97535,VV SELF-CARE HOME MANAGEMENT  PT (97535),274.0,178.1,31.09,274.0,86
HCPCS,97535,VV SELF-CARE HOME MANAGEMENT OT (97535),227.0,147.55,1.1,274.0,228
HCPCS,97535,VV SELF-CARE HOME MANAGEMENT PT (97535),180.0,117.0,1.1,180.0,142
HCPCS,97537,COMMUNITY/WORK REINTEGRATION TRAING EA 15 MIN,192.0,124.8,1.1,192.0,142
HCPCS,97537,OT COMMUNITY REINTEGRATION/15M,176.0,114.4,40.05,176.0,86
HCPCS,97537,P.T. COMMUNITY REINTEG 15 MIN,176.0,114.4,40.05,176.0,86
HCPCS,97542,OT WHEELCHAIR MANAGEMENT 15 MI,254.0,165.1,39.57,254.0,86
HCPCS,97542,WHEELCHAIR MGMT EA 15 MIN,223.0,144.95,1.1,254.0,314
HCPCS,97545,PT/OT WORK CONDITION,1004.0,652.6,31.09,1004.0,67
HCPCS,97545,WORK HARDENING INIT 2HR GO,1004.0,652.6,31.09,1004.0,67
HCPCS,97545,WORK HARDENING/CONDITIONING 1ST 2 HR,661.5,429.975,1.1,1004.0,155
HCPCS,97546,WC/WH EA ADDTL HR,503.0,326.95,31.09,503.0,67
HCPCS,97546,WORK HARDENING (ADDL HR),503.0,326.95,31.09,503.0,67
HCPCS,97546,WORK HARDENING/CONDITIONING EACH HOUR,129.0,83.85,1.1,168.36,88
HCPCS,97550,CAREGIVER TRAINING STRATEGIES&TQ 1ST 30 MINUTES,663.5,431.275,0.01,887.0,232
HCPCS,97550,OT CAREGIVER TRAINING STRATEGIES&TQ 1ST 30 MINUTES,887.0,576.55,39.1,887.0,85
HCPCS,97550,PT CAREGIVER TRAINING STRATEGIES&TQ 1ST 30 MINUTES,887.0,576.55,39.1,887.0,85
HCPCS,97550,PT/OT CAREGIVER TRAINING STRATEGIES&TQ 1ST 30 MINUTES,887.0,576.55,0.01,887.0,86
HCPCS,97550,SLT CAREGIVER TRAINING STRATEGIES&TQ 1ST 30 MINUTES,887.0,576.55,39.1,887.0,85
HCPCS,97551,CAREGIVER TRAINING STRATEGIES&TQ EA ADDL 15 MIN,562.5,365.625,0.01,887.0,232
HCPCS,97551,OT CAREGIVER TRAINING STRATEGIES&TQ EA ADDL 15 MIN,887.0,576.55,30.26,887.0,85
HCPCS,97551,PT CAREGIVER TRAINING STRATEGIES&TQ EA ADDL 15 MIN,887.0,576.55,30.26,887.0,85
HCPCS,97551,PT/OT CAREGIVER TRAINING STRATEGIES&TQ EA ADDL 15 MIN,887.0,576.55,0.01,887.0,86
HCPCS,97551,SLT CAREGIVER TRAINING STRATEGIES&TQ EA ADDL 15 MIN,887.0,576.55,30.26,887.0,85
HCPCS,97552,GROUP CAREGIVER TRAINING STRATEGIES & TECHNIQUE,494.0,321.09999999999997,0.01,887.0,232
HCPCS,97552,SLT GROUP CAREGIVER TRAINING STRATEGIES & TECHNIQUE,887.0,576.55,13.13,887.0,85
HCPCS,97552,SLT GROUP CAREGIVER TRAINING STRATEGIES & TECHNIQUE?,887.0,576.55,0.01,887.0,86
HCPCS,97597,DEBRIDEMENT OPEN WOUND 20 SQ CM/<,611.0,397.15,0.01,4628.0,493
HCPCS,97597,TX WOUND<=20CM,914.0,594.1,43.12,3443.0,86
HCPCS,97598,DEBRIDEMENT OPEN WOUND EACH ADDITIONAL 20 SQ CM,483.0,313.95,0.01,3443.0,352
HCPCS,97598,TX WOUND>21CM,746.0,484.9,29.21,3443.0,68
HCPCS,97602,RMVL DEVITAL TISS N-SLCTV DBRDMT W/O ANES 1 SESS,529.0,343.85,0.01,914.0,260
HCPCS,97602,RMVL WOUND FB GP,914.0,594.1,173.69,2453.0,84
HCPCS,97605,"NEG PRESS WOUND TX, < 50 CM",914.0,594.1,30.08,914.0,86
HCPCS,97605,NEGATIVE PRESSURE WOUND THERAPY DME </= 50 SQ CM,578.0,375.70000000000005,0.01,914.0,405
HCPCS,97606,"NEG PRESS WOUND TX, > 50 CM",1838.0,1194.7,32.95,1838.0,86
HCPCS,97606,NEGATIVE PRESSURE WOUND THERAPY DME >50 SQ CM,1051.0,683.15,0.01,1838.0,406
HCPCS,97607,NEG PRESSURE WOUND THERAPY NON DME </= 50 SQ CM,1009.0,655.85,0.01,1838.0,493
HCPCS,97608,NEG PRESSURE WOUND THERAPY NON DME >50 SQ CM,1020.0,663.0,0.01,1838.0,406
HCPCS,97610,LOW FREQUENCY NON-THERMAL ULTRASOUND PER DAY,537.0,349.05,1.1,1426.64,220
HCPCS,97610,MIST WOUND ULTRASOUND,914.0,594.1,21.86,914.0,86
HCPCS,97750,PHYSICAL PERFORMANCE TEST/MEAS W/REPRT EA 15 MIN,226.0,146.9,1.1,272.0,228
HCPCS,97750,TEST PHYSCL PERF EA 15MIN GO,272.0,176.8,42.65,272.0,86
HCPCS,97750,TEST PHYSCL PERF EA 15MIN GP,272.0,176.8,42.65,272.0,86
HCPCS,97755,ASSTV TECHNOL ASSMT DIR CNTCT W/REPRT EA 15 MIN,296.0,192.4,48.65,296.0,85
HCPCS,97760,ORTHO MGMT EXT/TRUNK 15MN GO,295.0,191.75,60.21,295.0,85
HCPCS,97760,ORTHO MGMT EXT/TRUNK 15MN GP,295.0,191.75,60.21,295.0,85
HCPCS,97760,ORTHOTICS MGMT & TRAING INITIAL ENCTR EA 15 MINS,200.0,130.0,1.1,200.0,142
HCPCS,97761,PROSTHETICS TRAINING INITIAL ENCTR EA 15 MINS,200.0,130.0,1.1,200.0,142
HCPCS,97761,PROSTHTIC TRAINING EXT 15M GO,270.0,175.5,52.32,270.0,85
HCPCS,97761,PROSTHTIC TRAINING EXT 15M GP,270.0,175.5,52.32,270.0,85
HCPCS,97763,ORTH/PROS MGMT EA 15 MIN GO,320.0,208.0,66.46,320.0,85
HCPCS,97763,ORTH/PROS MGMT EA 15 MIN GP,320.0,208.0,66.46,320.0,85
HCPCS,97763,ORTHOTICS/PROSTH MGMT &/TRAINJ SBSQ ENCTR 15 MIN,192.0,124.8,1.1,192.0,142
HCPCS,97799,ALTER G 30 MIN,30.0,19.5,6.54,4341999.96,67
HCPCS,97799,ALTER G 45 MIN,45.0,29.25,9.81,4341999.96,67
HCPCS,97799,AQUATICS,11.0,7.15,2.4,4341999.96,67
HCPCS,97799,DANCE PERFORMANCE INITIAL,110.0,71.5,23.98,4341999.96,67
HCPCS,97799,DRIVER ON ROAD PER 60 MINS,100.0,65.0,21.8,4341999.96,67
HCPCS,97799,EMPLOYEE REIKI,60.0,39.0,0.01,3061000.0,84
HCPCS,97799,EXERCISE 30 MINS,30.0,19.5,6.54,4341999.96,67
HCPCS,97799,EXERCISE 45 MIN,45.0,29.25,9.81,4341999.96,67
HCPCS,97799,EXERCISE 60 MINS,60.0,39.0,13.08,4341999.96,67
HCPCS,97799,FOLLOW UP / GROUP CHARGE,25.0,16.25,5.45,4341999.96,67
HCPCS,97799,FUNCTIONAL EXERCISE GROUP,20.0,13.0,4.36,4341999.96,67
HCPCS,97799,GOLF EVAL W/VIDEO ANALYSIS (MASTERS PKG),323.0,209.95,0.01,3061000.0,84
HCPCS,97799,GOLF PERFORMANCE,110.0,71.5,23.98,4341999.96,67
HCPCS,97799,HERBAL THERAPY EST (COMP 9800340),75.0,48.75,16.35,4341999.96,67
HCPCS,97799,HERBAL THERAPY ESTABLISHED,75.0,48.75,0.01,3061000.0,84
HCPCS,97799,HERBAL THERAPY NEW,150.0,97.5,0.01,3061000.0,84
HCPCS,97799,HERBAL THERAPY NEW (COMP 9800341),150.0,97.5,31.09,4341999.96,67
HCPCS,97799,HYDROSTATIS WEIGH,59.0,38.35,12.86,4341999.96,67
HCPCS,97799,INITIAL ASSESSMENT,125.0,81.25,27.25,4341999.96,67
HCPCS,97799,JUMP RIGHT,110.0,71.5,23.98,4341999.96,67
HCPCS,97799,LACTATE TEST,216.0,140.4,31.09,4341999.96,67
HCPCS,97799,MANUAL LYMPH DRAINAGE (MLD,75.0,48.75,0.01,3061000.0,84
HCPCS,97799,MANUAL LYMPH DRAINAGE (MLD) (COMP 97799A),75.0,48.75,16.35,4341999.96,67
HCPCS,97799,MASSAGE THERAPY,90.0,58.5,0.01,3061000.0,84
HCPCS,97799,MASSAGE THERAPY (COMP 97799RVU),90.0,58.5,19.62,4341999.96,67
HCPCS,97799,MATCH FIT  SOCCER,110.0,71.5,23.98,4341999.96,67
HCPCS,97799,METABOLIC INITIAL ASSESSMENT,75.0,48.75,16.35,4341999.96,67
HCPCS,97799,METABOLIC INITIAL RMR,125.0,81.25,27.25,4341999.96,67
HCPCS,97799,METABOLIC RE-TEST,54.0,35.1,11.77,4341999.96,67
HCPCS,97799,PERFORMANCE EVAL,220.0,143.0,31.09,4341999.96,67
HCPCS,97799,PERFORMANCE EXERCISE 30 MIN,30.0,19.5,6.54,4341999.96,67
HCPCS,97799,PERFORMANCE EXERCISE 45 MINUTES,45.0,29.25,9.81,4341999.96,67
HCPCS,97799,PERFORMANCE EXERCISE 60 MIN,60.0,39.0,13.08,4341999.96,67
HCPCS,97799,PREP 30 MIN,60.0,39.0,13.08,4341999.96,67
HCPCS,97799,PREP 60 MIN,100.0,65.0,21.8,4341999.96,67
HCPCS,97799,PREP ASSESSMENT,119.0,77.35,25.94,4341999.96,67
HCPCS,97799,PREP EVALUATION,27.0,17.55,5.89,4341999.96,67
HCPCS,97799,PREP F/U 30 MIN (SELF PAY),60.0,39.0,0.01,3061000.0,84
HCPCS,97799,PREP F/U 35 MIN (SELF PAY),35.0,22.75,0.01,3061000.0,84
HCPCS,97799,PREP F/U 45 MIN (SELF PAY),80.0,52.0,0.01,3061000.0,84
HCPCS,97799,PREP F/U 60 MIN (SELF PAY),100.0,65.0,0.01,3061000.0,84
HCPCS,97799,REIKI THERAPY,60.0,39.0,0.01,3061000.0,84
HCPCS,97799,REIKI THERAPY (COMP 9800342),60.0,39.0,13.08,4341999.96,67
HCPCS,97799,RUN SMART,110.0,71.5,23.98,4341999.96,67
HCPCS,97799,SHARED ACUPUNCTURE MEDICAL APPT,50.0,32.5,0.01,3061000.0,84
HCPCS,97799,SKATING,110.0,71.5,23.98,4341999.96,67
HCPCS,97799,SKIN FOLD BODY,26.0,16.9,5.45,4341999.96,134
HCPCS,97799,STRENGTH TESTING EVAL,140.0,91.0,30.52,4341999.96,67
HCPCS,97799,TAI CHI,75.0,48.75,0.01,3061000.0,84
HCPCS,97799,THERAPEUTIC YOGA,75.0,48.75,0.01,3061000.0,84
HCPCS,97799,THERAPEUTIC YOGA (COMP 9800715),75.0,48.75,16.35,4341999.96,67
HCPCS,97799,THROW RIGHT FITNESS TRAINING,110.0,71.5,23.98,4341999.96,67
HCPCS,97799,THROW RIGHT INIT EVAL & VIDEO ANALYSIS,297.0,193.05,0.01,3061000.0,84
HCPCS,97799,TRAIN RIGHT,110.0,71.5,23.98,4341999.96,67
HCPCS,97799,UNLISTED PHYSICAL MED/REHAB SERV,280.0,182.0,31.09,4341999.96,67
HCPCS,97799,VIDEO ANALYSIS SPORTS HEALTH,80.0,52.0,17.44,4341999.96,67
HCPCS,97799,WELLNESS YOGA,60.0,39.0,0.01,3061000.0,84
HCPCS,97799,WELLNESS YOGA EHP,30.0,19.5,0.01,3061000.0,84
HCPCS,97802,MEDICAL NUTRITION ASSMT&IVNTJ INDIV EACH 15 MI,212.0,137.8,1.1,212.0,231
HCPCS,97802,"NUTRITION THERAPY, INITIAL 15 MIN",212.0,137.8,1.1,212.0,231
HCPCS,97802,"VIRTUAL INITIAL NUTRITION THERAPY, EA. 15M",212.0,137.8,35.63,212.0,85
HCPCS,97802,"VIRTUAL VISIT MNT, INITIAL, EA. 15 MIN INCREMENT 97802",212.0,137.8,1.1,212.0,146
HCPCS,97803,MEDICAL NUTRITION RE-ASSMT&IVNTJ INDIV EA 15 M,180.0,117.0,1.1,180.0,316
HCPCS,97803,"NUTRITION THERAPY, REASSES EA 15 MIN",180.0,117.0,1.1,180.0,316
HCPCS,97803,"VIRTUAL REASSESS NUTRITION THERAPY, EA 15 M",180.0,117.0,29.84,180.0,85
HCPCS,97803,"VIRTUAL VISIT MNT, RE ASSES, EA. 15 MIN INCREMENT 97803",180.0,117.0,1.1,180.0,146
HCPCS,97804,GRP NUTRITION THERAPY; EA 30M,100.0,65.0,16.62,100.0,85
HCPCS,97804,MEDICAL NUTRITION THERAPY GRP2/ INDIV EA 30 MI,100.0,65.0,1.1,100.0,316
HCPCS,97804,NON EHP EAT WELL GROUP,100.0,65.0,1.1,100.0,146
HCPCS,97804,NUTRITION GROUP THERAPY,100.0,65.0,1.1,100.0,231
HCPCS,97804,"VIRTUAL GROUP NUTRITION THERAPY, EA. 30 M",100.0,65.0,16.62,100.0,85
HCPCS,97804,"VV MNT GROUP, EA. 30 MIN",100.0,65.0,1.1,100.0,146
HCPCS,97810,ACUPUNCTURE 1/> NDLES W/O ELEC STIMJ INIT 15 MIN,54.5,35.425,1.1,128.63,232
HCPCS,97811,ACUPUNCTURE 1/> NDLS W/O ESTIM EACH ADDL 15 MIN,54.5,35.425,1.1,97.67,214
HCPCS,97813,ACUPUNCTURE 1/> NDLS W/ELEC STIMJ 1ST 15 MIN,54.5,35.425,1.1,151.55,318
HCPCS,97814,ACUPUNCTURE 1/> NDLS W/ESTIM EACH ADDL 15 MIN,54.5,35.425,1.1,123.83,282
HCPCS,98000,ONDEMAND SYNCHRONOUS?AUDIO-VIDEO?VISIT NEW?SF MDM 15 MIN,372.0,241.8,1.1,372.0,110
HCPCS,98000,SYNCHRONOUS AUDIO-VIDEO VISIT NEW SF MDM 15 MIN,372.0,241.8,1.1,372.0,110
HCPCS,98000,Synch audio-video new sf 15,,,68.73,79.59,8
HCPCS,98001,ONDEMAND SYNCHRONOUS?AUDIO-VIDEO?VISIT NEW?LOW MDM 30 MIN,640.0,416.0,1.1,640.0,110
HCPCS,98001,SYNCHRONOUS?AUDIO-VIDEO?VISIT NEW?LOW MDM 30 MIN,640.0,416.0,1.1,640.0,110
HCPCS,98001,Synch audio-video new low 30,,,68.73,79.59,8
HCPCS,98002,ONDEMAND SYNCHRONOUS?AUDIO-VIDEO?VISIT NEW?MOD MDM 45 MIN,1040.0,676.0,1.1,1040.0,110
HCPCS,98002,SYNCHRONOUS?AUDIO-VIDEO?VISIT NEW?MOD MDM 45 MIN,1040.0,676.0,1.1,1040.0,110
HCPCS,98002,Synch audio-video new mod 45,,,68.73,79.59,8
HCPCS,98003,ONDEMAND SYNCHRONOUS?AUDIO-VIDEO?VST NEW?HIGH MDM 60 MIN,1400.0,910.0,1.1,1400.0,98
HCPCS,98003,SYNCHRONOUS?AUDIO-VIDEO?VST NEW?HIGH MDM 60 MIN,1400.0,910.0,1.1,1400.0,98
HCPCS,98003,Synch audio-video new hi 60,,,68.73,79.59,8
HCPCS,98004,ONDEMAND SYNCHRONOUS?AUDIO-VIDEO?VISIT EST?SF MDM 10 MIN,280.0,182.0,1.1,280.0,110
HCPCS,98004,SYNCHRONOUS?AUDIO-VIDEO?VISIT EST?SF MDM 10 MIN,280.0,182.0,1.1,280.0,110
HCPCS,98004,Synch audio-video est sf 10,,,68.73,79.59,8
HCPCS,98005,ONDEMAND SYNCHRONOUS?AUDIO-VIDEO?VISIT EST?LOW MDM 20 MIN,520.0,338.0,1.1,520.0,110
HCPCS,98005,SYNCHRONOUS?AUDIO-VIDEO?VISIT EST?LOW MDM 20 MIN,520.0,338.0,1.1,520.0,110
HCPCS,98005,Synch audio-video est low 20,,,68.73,79.59,8
HCPCS,98006,ONDEMAND SYNCHRONOUS?AUDIO-VIDEO?VISIT EST?MOD MDM 30 MIN,768.0,499.2,1.1,768.0,110
HCPCS,98006,SYNCHRONOUS?AUDIO-VIDEO?VISIT EST?MOD MDM 30 MIN,768.0,499.2,1.1,768.0,110
HCPCS,98006,Synch audio-video est mod 30,,,68.73,79.59,8
HCPCS,98007,ONDEMAND SYNCHRONOUS?AUDIO-VIDEO?VISIT EST?HIGH MDM 40 MIN,1120.0,728.0,1.1,1120.0,98
HCPCS,98007,SYNCHRONOUS AUDIO-VIDEO VST EST HIGH MDM 40 MIN,1040.0,676.0,1.1,1040.0,98
HCPCS,98007,Synch audio-video est hi 40,,,68.73,79.59,8
HCPCS,98008,SYNCHRONOUS AUDIO-ONLY VISIT NEW SF MDM 15 MIN,360.0,234.0,1.1,360.0,110
HCPCS,98008,Synch audio-only new sf 15,,,68.73,79.59,8
HCPCS,98009,SYNCHRONOUS AUDIO-ONLY VISIT NEW LOW MDM 30 MIN,620.0,403.0,1.1,620.0,110
HCPCS,98009,Synch audio-only new low 30,,,68.73,79.59,8
HCPCS,98010,SYNCHRONOUS AUDIO-ONLY VISIT NEW MOD MDM 45 MIN,968.0,629.2,1.1,968.0,110
HCPCS,98010,Synch audio-only new mod 45,,,68.73,79.59,8
HCPCS,9801047,AUDIOGRAM,28.0,18.2,1.1,28.0,70
HCPCS,9801051,DOT PHYSICAL EXAM,110.0,71.5,1.1,110.0,70
HCPCS,9801052,EKG W/INTERPRETATION,70.0,45.5,1.1,70.0,70
HCPCS,9801057,LIFT TEST/PHYSICAL ABILITY,45.0,29.25,1.1,45.0,70
HCPCS,9801059,PRE-PLACEMENT EXAM,65.0,42.25,1.1,65.0,70
HCPCS,9801060,PHYSICAL EXAM,65.0,42.25,1.1,65.0,70
HCPCS,9801061,PULMONARY FUNCTION TEST,60.0,39.0,1.1,60.0,70
HCPCS,9801062,RESPIRATOR FIT TEST,35.0,22.75,1.1,35.0,70
HCPCS,9801063,OSHA RESPIRATOR QUESTIONNAIRE REVIEW,35.0,22.75,1.1,35.0,70
HCPCS,9801064,RESPIRATOR MEDICAL EVALUATION,35.0,22.75,1.1,35.0,70
HCPCS,9801065,RETURN TO WORK EXAM,65.0,42.25,1.1,65.0,70
HCPCS,9801068,TB SKIN TEST,30.0,19.5,1.1,30.0,70
HCPCS,9801069,TITMUS VISION,45.0,29.25,1.1,45.0,70
HCPCS,9801070,URINE COLLECTION ONLY,25.0,16.25,1.1,25.0,70
HCPCS,9801073,"X-RAY, CHEST, 2 VIEWS",105.0,68.25,1.1,105.0,70
HCPCS,9801074,RAPID URINE DRUG SCREEN 10-PANEL - MEDTOX,65.0,42.25,1.1,65.0,70
HCPCS,9801075,RAPID URINE DRUG SCREEN 5-PANEL - MEDTOX,65.0,42.25,1.1,65.0,70
HCPCS,9801077,URINE DRUG SCREEN 10-PANEL - MEDTOX,50.0,32.5,1.1,50.0,70
HCPCS,9801083,URINE DRUG SCREEN 12-PANEL - MEDTOX,95.0,61.75,1.1,95.0,70
HCPCS,9801084,URINE DRUG SCREEN 4-PANEL (NO THC) - MEDTOX,50.0,32.5,1.1,50.0,70
HCPCS,9801085,URINE DRUG SCREEN 5-PANEL - MEDTOX,50.0,32.5,1.1,50.0,70
HCPCS,9801087,URINE DRUG SCREEN 9-PANEL (NO THC) - MEDTOX,50.0,32.5,1.1,50.0,70
HCPCS,9801088,URINE DRUG SCREEN DOT - MEDTOX,50.0,32.5,1.1,50.0,70
HCPCS,9801090,URINE DRUG SCREEN CRL WS66 - CRL,95.0,61.75,1.1,95.0,70
HCPCS,9801092,HAIR DRUG SCREEN 5-PANEL - OMEGA,105.0,68.25,1.1,105.0,70
HCPCS,9801099,BREATH ALCOHOL TEST - CCAW / WW,30.0,19.5,1.1,30.0,70
HCPCS,98011,SYNCHRONOUS AUDIO-ONLY VISIT NEW HIGH MDM 60 MIN,1280.0,832.0,1.1,1280.0,98
HCPCS,98011,Synch audio-only new high 60,,,68.73,79.59,8
HCPCS,98012,SYNCHRONOUS AUDIO-ONLY VISIT EST SF MDM 10 MIN,260.0,169.0,1.1,260.0,110
HCPCS,98012,Synch audio-only est sf 10,,,68.73,79.59,8
HCPCS,9801201,TB SKIN TESTING (2-STEP) (RETURN TO CLINIC FOR READING WITHIN 48,60.0,39.0,1.1,60.0,70
HCPCS,98013,SYNCHRONOUS AUDIO-ONLY VISIT EST LOW MDM 20 MIN,480.0,312.0,1.1,480.0,110
HCPCS,98013,Synch audio-only est low 20,,,68.73,79.59,8
HCPCS,98014,SYNCHRONOUS AUDIO-ONLY VISIT EST MOD MDM 30 MIN,700.0,455.0,1.1,700.0,110
HCPCS,98014,Synch audio-only est mod 30,,,68.73,79.59,8
HCPCS,98015,SYNCHRONOUS AUDIO-ONLY VISIT EST HIGH MDM 40 MIN,1040.0,676.0,1.1,1040.0,98
HCPCS,98015,Synch audio-only est high 40,,,68.73,79.59,8
HCPCS,98016,BRIEF COMMUNICATION TECH-BSD SVC EST PT 5-10 MIN,132.0,85.8,1.1,132.0,144
HCPCS,98016,Brief comunicaj tech-bsd svc,,,10.74,12.43,8
HCPCS,98925,"OSTEOPATHIC MANIP,1-2 BODY REGN",139.0,90.35000000000001,0.01,202.0,235
HCPCS,98925,OSTEOPATHIC MANIPULATIVE TX 1-2 BODY REGIONS,76.0,49.4,20.43,76.0,258
HCPCS,98926,"OSTEOPATHIC MANIP,3-4 BODY REGN",312.0,202.8,1.1,312.0,148
HCPCS,98926,OSTEOPATHIC MANIPULATIVE TX 3-4 BODY REGIONS,76.0,49.4,20.43,107.33,174
HCPCS,98927,"OSTEOPATHIC MANIP,5-6 BODY REGN",422.0,274.3,1.1,422.0,148
HCPCS,98927,OSTEOPATHIC MANIPULATIVE TX 5-6 BODY REGIONS,76.0,49.4,20.43,107.33,87
HCPCS,98928,"OSTEOPATHIC MANIP,7-8 BODY REGN",532.0,345.8,1.1,532.0,148
HCPCS,98928,OSTEOPATHIC MANIPULATION (98928),76.0,49.4,0.01,76.72,87
HCPCS,98928,OSTEOPATHIC MANIPULATIVE TX 7-8 BODY REGIONS,76.0,49.4,20.43,107.33,87
HCPCS,98929,"OSTEOPATHIC MANIP,9-10 BODY REGN",642.0,417.3,1.1,642.0,148
HCPCS,98929,OSTEOPATHIC MANIPULATIVE TX 9-10 BODY REGIONS,76.0,49.4,20.43,107.33,87
HCPCS,98940,"CHIROPRAC MANIP,SPINAL,1-2 REGIONS",202.0,131.3,1.1,202.0,148
HCPCS,98940,CHIROPRACTIC MANIPULATIVE TX SPINAL 1-2 REGIONS,76.0,49.4,20.43,76.0,86
HCPCS,98941,"CHIROPRAC MANIP,SPINAL,3-4 REGIONS",312.0,202.8,1.1,312.0,148
HCPCS,98941,CHIROPRACTIC MANIPULATIVE TX SPINAL 3-4 REGIONS,76.0,49.4,20.43,76.0,86
HCPCS,98942,"CHIROPRAC MANIP,SPINAL,5 REGIONS",422.0,274.3,1.1,422.0,148
HCPCS,98942,CHIROPRACTIC MANIPULATIVE TX SPINAL 5 REGIONS,76.0,49.4,20.43,76.0,86
HCPCS,98943,"CHIROPRAC MANIP,EXTRASPINAL,1+ REGNS",184.0,119.6,1.1,184.0,102
HCPCS,98943,CHIROPRACTIC MANIPLTV TX EXTRASPINAL 1/> REGION,123.0,79.95,26.81,123.0,66
HCPCS,98960,EDUCATION&TRAINING PT SELF-MGMT NQHP INDIV PT,101.5,65.975,1.1,126.0,230
HCPCS,98960,VIRTUAL MGMT DIABETES SNGL 30 MIN,101.5,65.975,1.1,126.0,164
HCPCS,98960,VV EDUC SELF MGMT 30MIN INDV,126.0,81.9,27.47,126.0,66
HCPCS,98961,EDUCATION&TRAINING PT SELF-MGMT NQHP 2-4 PTS,86.0,55.9,1.1,95.0,164
HCPCS,98961,"MGMT DIABETES GROUP 30 MIN, 2-4 PT",95.0,61.75,20.71,95.0,66
HCPCS,98961,"VIRTUAL MGMT DIABETES GRP 30 MIN, 2-4 PT",77.0,50.05,1.1,77.0,98
HCPCS,98961,VIRTUAL MGMT DIABETES GRP 30 MIN; 2-4 PT,95.0,61.75,20.71,95.0,66
HCPCS,98961,"VV MGMT DIABETES GRP 30 MIN, 2-4 PT",95.0,61.75,20.71,95.0,66
HCPCS,98962,EDUCATION&TRAINING PT SELF-MGMT NQHP 5-8 PTS,33.0,21.45,1.1,33.28,98
HCPCS,98962,"MGMT DIABETES GRP 30MIN, 5- 8",84.0,54.6,18.31,84.0,66
HCPCS,98962,"VIRTUAL MGMT DIABETES GRP 30 MIN, 5-8 PT",33.0,21.45,1.1,33.28,98
HCPCS,98962,VIRTUAL MGMT DIABETES GRP 30 MIN; 5-8 PT,84.0,54.6,18.31,84.0,66
HCPCS,98962,"VV MGMT DIABETES GRP 30MIN, 5- 8",84.0,54.6,18.31,84.0,66
HCPCS,98966,TELEPHONE ASSMT&MGMT SVC NQHP EST PT 5-10 MIN,101.0,65.65,1.1,102.0,219
HCPCS,98967,TELEPHONE ASSMT&MGMT SVC NQHP EST PT 11-20 MIN,204.0,132.6,1.1,208.0,219
HCPCS,98968,TELEPHONE ASSMT&MGMT SVC NQHP EST PT 21-30 MIN,306.5,199.225,1.1,313.0,219
HCPCS,98970,MY CHART MEDICAL ADVICE MESSAGING: QNHP ONLINE DIGITAL E/M SVC E,65.0,42.25,1.1,65.0,130
HCPCS,98970,NQHP OL DIG ASSMT&MGMT 5-10,,,14.49,30.72,28
HCPCS,98970,NQHP OL DIGITAL ASSMT&MGMT EST PT <7 D 5-10 MIN,65.0,42.25,1.1,65.0,130
HCPCS,98970,Nqhp ol dig assmt&mgmt 5-10,,,68.73,79.59,8
HCPCS,98971,MY CHART MEDICAL ADVICE MESSAGING: QNHP ONLINE DIGITAL E/M SVC E,80.0,52.0,1.1,80.0,134
HCPCS,98971,NQHP OL DIG ASSMT&MGMT 11-20,,,26.33,54.42,28
HCPCS,98971,NQHP OL DIGITAL ASSMT&MGMT EST PT <7 D 11-20 MIN,80.0,52.0,1.1,80.0,134
HCPCS,98971,Nqhp ol dig assmt&mgmt 11-20,,,68.73,79.59,8
HCPCS,98972,MY CHART MEDICAL ADVICE MESSAGING: QNHP ONLINE DIGITAL E/M SVC E,120.0,78.0,1.1,120.0,134
HCPCS,98972,NQHP OL DIG ASSMT&MGMT 21+,,,40.46,80.12,28
HCPCS,98972,NQHP OL DIGITAL ASSMT&MGMT EST PT <7 D 21+ MIN,120.0,78.0,1.1,120.0,134
HCPCS,98972,Nqhp ol dig assmt&mgmt 21+,,,68.73,79.59,8
HCPCS,98975,REMOTE THERAPEUTIC MNTR 1ST SET-UP&PT EDUCAJ EQ,593.0,385.45,27.62,593.0,86
HCPCS,98975,REMOTE THERAPEUTIC MNTR 1ST SET-UP&PT EDUCAJ EQP,593.0,385.45,27.62,593.0,86
HCPCS,98976,RTM DEV SPLY RESP SYS 16-30D,,,32.72,98.45,21
HCPCS,98977,REM THER MNTR DEV SPLY DATA MUSCSKEL SYS EA 30 D,172.0,111.8,32.72,172.0,156
HCPCS,98978,REM THER MNTR DEV SPLY DATA COG BHV THER EA 30 D,185.0,120.25,1.1,258.0,172
HCPCS,98979,RTM TX MGMT 1 R-T IA COMUNICAJ CAL MO 1ST 10 MIN,263.0,170.95,1.1,593.0,244
HCPCS,98980,REMOTE THER MNTR TX MGMT PHYS/QHP 1ST 20 MIN,160.0,104.0,1.1,248.0,356
HCPCS,98981,REMOTE THER MNTR TX MGMT PHYS/QHP EA ADDL 20 MIN,158.0,102.69999999999999,1.1,244.0,356
HCPCS,98984,RTM DEV SPLY DATA RESPIR SYS 2-15 DAYS IN 30D PD,263.0,170.95,35.31,263.0,69
HCPCS,98985,RTM DEV SPLY DATA MUSCSKEL SYS 2-15 D IN 30D PD,161.0,104.64999999999999,1.1,263.0,175
HCPCS,98986,RTM DEV SPLY DATA CBT 2-15 DAYS IN 30 D PD,260.5,169.325,0.01,263.0,139
HCPCS,9899202C,COSMETIC CONSULTATION,100.0,65.0,1.1,100.0,70
HCPCS,99000,HANDLG&/OR CONVEY OF SPEC FOR TR OFFICE TO LAB,41.0,26.65,1.1,41.0,88
HCPCS,99000,SPECIMEN ACQUISITION KIT- DD WAIT LIST,49.0,31.85,2.64,49.0,66
HCPCS,99001,FLOW CYTOMETRY XM,59.0,38.35,2.64,59.0,66
HCPCS,99001,HANDLG&/OR CONVEY OF SPEC FOR TR FROM PT TO LAB,52.0,33.8,1.1,52.0,88
HCPCS,99001,SERUM PROCESSING AND STORAGE,59.0,38.35,2.64,59.0,66
HCPCS,99001,SPECIMEN ACQUISITION-KIT - DAILY TESTING,59.0,38.35,2.64,59.0,66
HCPCS,99001,SPECIMEN TRANSFER,59.0,38.35,2.64,59.0,132
HCPCS,99002,DEVICE HANDLING PHYS/QHP,,,26.58,26.58,1
HCPCS,99002,Device handling phys/qhp,,,405.62,469.67,8
HCPCS,99002,HANDLE/CONVEY/ANY OTH SVC DEVICE FIT PHYS/QHP,60.0,39.0,1.1,60.0,88
HCPCS,99024,POSTOP FOLLOW-UP VISIT,,,64.94,64.94,1
HCPCS,99024,Postop follow-up visit,,,63.76,73.83,8
HCPCS,99026,IN-HOSPITAL ON CALL SERVICE,,,2739849.3,2739849.3,1
HCPCS,99026,In-hospital on call service,,,405.62,469.67,8
HCPCS,99027,OUT-OF-HOSP ON CALL SERVICE,,,2739849.3,2739849.3,1
HCPCS,99027,Out-of-hosp on call service,,,405.62,469.67,8
HCPCS,99050,SERVICES PROVIDED OFFICE OTH/THN REG SCHED HOURS,143.0,92.95,1.1,143.0,102
HCPCS,99050,STAT/AFTER-HOURS REQUEST,144.0,93.6,10.74,144.0,66
HCPCS,99051,MED SERV EVE/WKEND/HOLIDAY,,,54.8,54.8,1
HCPCS,99051,Med serv eve/wkend/holiday,,,10.74,12.43,8
HCPCS,99053,MED SERV 10PM-8AM 24 HR FAC,,,54.8,54.8,1
HCPCS,99053,"MEDICAL SERVICES 10PM-8AM, 24 HR FAC",110.0,71.5,0.01,110.0,88
HCPCS,99053,Med serv 10pm-8am 24 hr fac,,,10.74,12.43,8
HCPCS,99056,MED SERVICE OUT OF OFFICE,,,33.7,33.7,1
HCPCS,99056,Med service out of office,,,405.62,469.67,8
HCPCS,99058,OFFICE EMERGENCY CARE,,,12.6,12.6,1
HCPCS,99058,Office emergency care,,,10.74,12.43,8
HCPCS,99058,SVC PRV EMER BASIS IN OFFICE DISRUPTING SVCS,211.0,137.15,0.01,211.0,88
HCPCS,99060,OUT OF OFFICE EMERG MED SERV,,,2739849.3,2739849.3,1
HCPCS,99060,OUT OF OFFICE EMERG MEDICAL SERVICES,116.0,75.4,0.01,3060831.65,88
HCPCS,99060,Out of office emerg med serv,,,10.74,12.43,8
HCPCS,99070,ADHESIVE - PROSTHETIC AIDE,17.0,11.05,0.01,73.46,82
HCPCS,99070,SPECIAL SUPPLIES PHYS/QHP,,,64.94,64.94,1
HCPCS,99070,Special supplies phys/qhp,,,16.97,19.65,8
HCPCS,99071,PATIENT EDUCATION MATERIALS,,,30.69,30.69,1
HCPCS,99071,Patient education materials,,,63.76,73.83,8
HCPCS,99072,ADDL SUPL MATRL&STAF TM PHE,,,27.4,27.4,1
HCPCS,99072,Addl supl matrl&staf tm phe,,,16.97,19.65,8
HCPCS,99075,MEDICAL TESTIMONY,,,122.75,122.75,1
HCPCS,99075,Medical testimony,,,405.62,469.67,8
HCPCS,99078,GROUP HEALTH EDUCATION,17.0,11.05,3.71,51.72,66
HCPCS,99078,PHYS/QHP EDUCATION SVCS RENDERED PTS GRP SETTING,79.0,51.35,1.1,79.0,94
HCPCS,99080,M3P FINAL REPORT,75.0,48.75,1.1,75.0,82
HCPCS,99080,SPEC REPORTS > USUAL MED COMUNICAJ/STAND RPRTG,119.0,77.35,1.1,119.0,82
HCPCS,99080,SPECIAL REPORTS OR FORMS,,,26.03,26.03,1
HCPCS,99080,Special reports or forms,,,405.62,469.67,8
HCPCS,99082,UNUSUAL PHYSICIAN TRAVEL,,,195.09,195.09,1
HCPCS,99082,Unusual physician travel,,,405.62,469.67,8
HCPCS,99091,COLLJ & INTERPJ PHYSIOL DATA MIN 30 MIN EA 30 D,484.0,314.6,1.1,484.0,132
HCPCS,99100,ANESTHESIA EXTREME AGE PATIENT UNDER 1 YR/<,136.0,88.4,1.1,138.2,84
HCPCS,99100,Anes pt exteme age<1 yr&>70,,,200.6,232.28,8
HCPCS,99116,ANES COMPLICJ UTILIZATION TOTAL BODY HYPOTHERMIA,133.0,86.45,0.01,133.0,84
HCPCS,99116,Anes comp tot bdy hypthrm,,,200.6,232.28,8
HCPCS,99135,ANES COMPLICJ UTILIZATION CONTROLLED HYPOTENSION,136.0,88.4,1.1,691.04,84
HCPCS,99135,Anes comp ctrld hypotension,,,200.6,232.28,8
HCPCS,99140,ANES COMPLICJ EMERGENCY CONDITIONS SPECIFY,137.0,89.05,1.1,276.42,84
HCPCS,99140,Anes comp emergency cond,,,200.6,232.28,8
HCPCS,99151,MOD SED SAME PHYS/QHP INITIAL 15 MINS <5 YRS,694.5,451.425,1.1,1169.0,216
HCPCS,99152,MOD SED SAME PHYS/QHP INITIAL 15 MINS 5/> YRS,405.5,263.575,0.01,701.0,352
HCPCS,99152,MODERATE SEDATION FOR ENDOSCOPY,405.5,263.575,1.1,701.0,216
HCPCS,99153,MOD SED SAME PHYS/QHP EACH ADDL 15 MINS,193.0,125.45,0.01,276.0,348
HCPCS,99155,MOD SED OTHER PHYS/QHP INITIAL 15 MINS <5 YRS,738.5,480.025,1.1,1040.28,212
HCPCS,99156,MOD SED OTHER PHYS/QHP INITIAL 15 MINS 5/> YRS,622.0,404.3,1.1,916.19,212
HCPCS,99157,MOD SED OTHER PHYS/QHP EACH ADDL 15 MINS,388.0,252.2,1.1,740.43,212
HCPCS,99170,ANOGENITAL XM MAGNIFY CHILD/SUSPECT TRAUMA W IMG,1157.0,752.05,68.73,1157.0,86
HCPCS,99172,OCULAR FUNCTION SCREEN,,,42.74,42.74,1
HCPCS,99172,Ocular function screen,,,63.76,73.83,8
HCPCS,99173,SCREENING TEST VISUAL ACUITY QUANTITATIVE BILAT,116.0,75.4,1.1,180.0,176
HCPCS,99174,OCULAR INSTRUMNT SCREEN BIL,,,15.65,15.65,1
HCPCS,99174,Ocular instrumnt screen bil,,,63.76,73.83,8
HCPCS,99175,IPECAC/SIMILAR ADMN EMESIS&OBS STOMACH EMPTIED,184.0,119.6,33.56,184.0,68
HCPCS,99177,INSTRUMENT BASED OCULAR SCR BI W/ONSITE ANALYSIS,155.0,100.75,1.1,156.0,176
HCPCS,99183,HYPERBARIC OXYGEN THERAPY,,,276.33,276.33,1
HCPCS,99183,Hyperbaric oxygen therapy,,,405.62,469.67,8
HCPCS,99183,PHYS/QHP ATTN&SUPVJ HYPRBARIC OXYGEN TX/SESSION,844.0,548.6,1.1,844.0,144
HCPCS,99184,HYPOTHERMIA ILL NEONATE,,,557.51,557.51,1
HCPCS,99184,Hypothermia ill neonate,,,405.62,469.67,8
HCPCS,99184,INITIAT SELECTIVE HEAD/BODY HYPOTHERMIA NEONATE,1800.0,1170.0,1.1,1800.0,142
HCPCS,99188,APP TOPICAL FLUORIDE VARNISH,,,25.4,25.4,1
HCPCS,99188,APPLICATION TOPICAL FLUORIDE VARNISH BY PHS/QHP,80.0,52.0,1.1,80.0,116
HCPCS,99188,App topical fluoride varnish,,,1011.53,1171.25,8
HCPCS,99190,SPECIAL PUMP SERVICES,,,41.1,41.1,1
HCPCS,99190,Special pump services,,,405.62,469.67,8
HCPCS,99191,SPECIAL PUMP SERVICES,,,21.92,21.92,1
HCPCS,99191,Special pump services,,,405.62,469.67,8
HCPCS,99192,SPECIAL PUMP SERVICES,,,27.4,27.4,1
HCPCS,99192,Special pump services,,,405.62,469.67,8
HCPCS,99195,PHLEBOTOMY,889.0,577.85,35.72,889.0,87
HCPCS,99195,PHLEBOTOMY THERAPEUTIC SEPARATE PROCEDURE,628.5,408.525,0.01,889.0,317
HCPCS,99195,THERAPEUTIC PHLEBOTOMY,889.0,577.85,35.72,889.0,86
HCPCS,99199,BP MONITOR (DEVICE NOT RETURNED),1404.0,912.6,306.07,1404.0,66
HCPCS,99199,EXEC HEALTH EXAM INS,939.0,610.35,0.01,3061000.0,80
HCPCS,99199,EXEC HEALTH EXAM PREMIER ESTABLISHED PT,1250.0,812.5,0.01,3061000.0,80
HCPCS,99199,EXERCISE CLASS,11.0,7.15,2.4,469.67,66
HCPCS,99199,FOLLOW UP EMPLOYEE FITNESS,11.0,7.15,2.4,469.67,66
HCPCS,99199,GENERAL EXERCISE EVAL,113.0,73.45,24.63,469.67,66
HCPCS,99199,HEALTH COACHING,22.0,14.3,4.8,469.67,66
HCPCS,99199,IMMIGRATION PHYSICAL,175.0,113.75,0.01,3061000.0,80
HCPCS,99199,INITIAL EVAL EMPLOYEE FITNESS,60.0,39.0,13.08,469.67,66
HCPCS,99199,NO SHOW SLEEP STUDY FEE,270.0,175.5,58.86,2159999.98,67
HCPCS,99199,PSYCHEDELIC DOSING SESSION PER HOUR (PI TIME),583.0,378.95,0.01,3061000.0,80
HCPCS,99199,SANE EVAL,700.0,455.0,152.6,700.0,66
HCPCS,99199,SELF PAY ROUTINE EYE EXAM,150.0,97.5,0.01,3061000.0,80
HCPCS,99199,SMOKING INTERMEDIATE COUNSEL 3-10 MIN,55.0,35.75,0.01,3061000.0,80
HCPCS,99199,SPECILAIZED POPULATION EVAL,86.0,55.9,18.75,469.67,66
HCPCS,99199,UNRETURNED ACTIGRAPHY DEVICE,500.0,325.0,0.01,3061000.0,80
HCPCS,99199,UNRETURNED HOLTER MONITOR,2032.8,1321.32,0.01,3061000.0,80
HCPCS,99199,UNRETURNED HOME SLEEP STUDY STARTER KIT (EQUIPMENT),4860.0,3159.0,405.62,2159999.98,67
HCPCS,99199,WTHH EXERCISE TRAINING,11.0,7.15,2.4,469.67,66
HCPCS,99201,Office/outpatient visit new,,,68.73,79.59,8
HCPCS,99202,NEW PATIENT VISIT LEVEL II,286.0,185.9,1.1,286.0,152
HCPCS,99202,OD NEW ONLINE E&M LEVEL 2,372.0,241.8,1.1,372.0,152
HCPCS,99202,OFFICE O/P NEW SF 15 MIN,,,94.76,123.55,2
HCPCS,99202,OFFICE/OUTPATIENT NEW SF MDM 15 MINUTES,372.0,241.8,1.1,372.0,152
HCPCS,99202,OFFICE/OUTPATIENT VISIT NEW,68.0,44.2,1.1,177.69,152
HCPCS,99202,Office o/p new sf 15 min,,,68.73,79.59,8
HCPCS,99203,NEW PATIENT VISIT LEVEL III,429.0,278.85,1.1,429.0,152
HCPCS,99203,OD NEW ONLINE E&M LEVEL 3,640.0,416.0,1.1,640.0,152
HCPCS,99203,OFFICE/OUTPATIENT NEW LOW MDM 30 MINUTES,640.0,416.0,1.1,640.0,152
HCPCS,99203,OFFICE/OUTPATIENT NEW LOW MDM 30-44 MINUTES,139.0,90.35,0.01,141.11,69
HCPCS,99203,OFFICE/OUTPATIENT VISIT NEW,103.0,66.95,1.1,277.03,152
HCPCS,99204,NEW PATIENT LEVEL COMPLETE,686.0,445.9,1.1,686.0,152
HCPCS,99204,OD NEW ONLINE E&M LEVEL 4,1040.0,676.0,1.1,1040.0,152
HCPCS,99204,OFFICE/OUTPATIENT NEW MODERATE MDM 45 MINUTES,1040.0,676.0,1.1,1040.0,152
HCPCS,99204,OFFICE/OUTPATIENT NEW MODERATE MDM 45-59 MINUTES,174.0,113.1,0.01,211.15,69
HCPCS,99204,OFFICE/OUTPATIENT VISIT NEW,175.0,113.75,1.1,412.41,152
HCPCS,99205,NEW PATIENT VISIT LEVEL V,716.0,465.4,1.1,716.0,152
HCPCS,99205,OD NEW ONLINE E&M LEVEL 5,1400.0,910.0,1.1,1400.0,152
HCPCS,99205,OFFICE O/P NEW HI 60 MIN,,,280.16,472.92,2
HCPCS,99205,OFFICE/OUTPATIENT NEW HIGH MDM 60 MINUTES,1400.0,910.0,1.1,1400.0,152
HCPCS,99205,Office o/p new hi 60 min,,,68.73,79.59,8
HCPCS,99211,ESTABLISHED PATIENT LEVEL I,177.0,115.05,1.1,177.0,152
HCPCS,99211,OD EST ONLINE E&M LEVEL 1,79.0,51.35,1.1,85.46,152
HCPCS,99211,OFFICE/OUTPATIENT EST PT MAY NOT REQ PHYS/QHP,114.5,74.425,0.01,150.0,701
HCPCS,99212,EST PATIENT VISIT LEVEL II,280.0,182.0,1.1,280.0,152
HCPCS,99212,OD EST ONLINE E&M LEVEL 2,280.0,182.0,1.1,280.0,152
HCPCS,99212,OFFICE/OUTPATIENT ESTABLISHED SF MDM 10 MIN,280.0,182.0,1.1,280.0,152
HCPCS,99212,OFFICE/OUTPATIENT ESTABLISHED SF MDM 10-19 MIN,150.0,97.5,0.01,150.0,137
HCPCS,99212,OFFICE/OUTPATIENT VISIT EST,35.0,22.75,1.1,138.61,152
HCPCS,99213,COSMETIC CLINIC,94.0,61.1,1.1,200.07,152
HCPCS,99213,COSMETIC PROCEDURE,218.0,141.7,1.1,218.0,152
HCPCS,99213,EST PATIENT VISIT LEVEL III,520.0,338.0,1.1,520.0,152
HCPCS,99213,OD EST ONLINE E&M LEVEL 3,520.0,338.0,1.1,520.0,152
HCPCS,99213,OFFICE/OUTPATIENT ESTABLISHED LOW MDM 20 MIN,520.0,338.0,1.1,520.0,152
HCPCS,99213,OFFICE/OUTPATIENT ESTABLISHED LOW MDM 20-29 MIN,150.0,97.5,0.01,150.0,69
HCPCS,99213,OFFICE/OUTPATIENT VISIT EST,68.0,44.2,1.1,200.07,152
HCPCS,99214,ESTABLISHED PATIENT LEVEL IV,515.0,334.75,1.1,515.0,152
HCPCS,99214,OD EST ONLINE E&M LEVEL 4,768.0,499.2,1.1,768.0,152
HCPCS,99214,OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30 MIN,768.0,499.2,1.1,768.0,152
HCPCS,99214,OFFICE/OUTPATIENT ESTABLISHED MOD MDM 30-39 MIN,187.0,121.55,0.01,187.0,69
HCPCS,99214,OFFICE/OUTPATIENT VISIT EST,106.0,68.9,1.1,283.48,152
HCPCS,99215,EST PATIENT VISIT LEVEL V,707.0,459.55,1.1,707.0,152
HCPCS,99215,OD EST ONLINE E&M LEVEL 5,1120.0,728.0,1.1,1120.0,152
HCPCS,99215,OFFICE/OUTPATIENT ESTABLISHED HIGH MDM 40 MIN,1120.0,728.0,1.1,1120.0,152
HCPCS,99215,OFFICE/OUTPATIENT ESTABLISHED HIGH MDM 40-54 MIN,240.0,156.0,0.01,240.0,69
HCPCS,99215,OFFICE/OUTPATIENT VISIT EST,150.0,97.5,1.1,442.72,152
HCPCS,99217,Observation care discharge,,,68.73,79.59,8
HCPCS,99218,Initial observation care,,,68.73,79.59,8
HCPCS,99219,Initial observation care,,,68.73,79.59,8
HCPCS,99220,Initial observation care,,,68.73,79.59,8
HCPCS,99221,1ST HOSP IP/OBS SF/LOW 40,,,216.05,216.05,1
HCPCS,99221,1ST HOSPITAL IP/OBS CARE SF/LOW MDM 40 MINUTES,652.0,423.8,1.1,652.0,146
HCPCS,99221,1st hosp ip/obs sf/low 40,,,68.73,79.59,8
HCPCS,99221,"INITIAL HOSPITAL CARE, LEVEL I",652.0,423.8,1.1,652.0,146
HCPCS,99221,"INITIAL HOSPITAL CARE,LEVL I",652.0,423.8,1.1,652.0,146
HCPCS,99221,"VIRTUAL INITIAL HOSPITAL CARE, E&M (30 MIN)",652.0,423.8,1.1,652.0,146
HCPCS,99222,1ST HOSP IP/OBS MODERATE 55,,,340.42,340.42,1
HCPCS,99222,1ST HOSPITAL IP/OBS CARE MODERATE MDM 55 MINUTES,1040.0,676.0,1.1,1040.0,146
HCPCS,99222,1st hosp ip/obs moderate 55,,,68.73,79.59,8
HCPCS,99222,VIRTUAL 1ST HOSPITAL IP/OBS CARE MODERATE MDM 55 MINUTES,1040.0,676.0,1.1,1040.0,146
HCPCS,99223,1ST HOSP IP/OBS HIGH 75,,,450.89,450.89,1
HCPCS,99223,1ST HOSPITAL IP/OBS CARE HIGH MDM 75 MINUTES,1400.0,910.0,1.1,1400.0,146
HCPCS,99223,1st hosp ip/obs high 75,,,68.73,79.59,8
HCPCS,99224,Subsequent observation care,,,68.73,79.59,8
HCPCS,99225,Subsequent observation care,,,68.73,79.59,8
HCPCS,99226,Subsequent observation care,,,68.73,79.59,8
HCPCS,99231,SBSQ HOSP IP/OBS SF/LOW 25,,,129.11,129.11,1
HCPCS,99231,SBSQ HOSPITAL IP/OBS CARE SF/LOW MDM 25 MINUTES,400.0,260.0,1.1,400.0,148
HCPCS,99231,Sbsq hosp ip/obs sf/low 25,,,68.73,79.59,8
HCPCS,99231,VIRTUAL  SBSQ HOSPITAL IP/OBS CARE SF/LOW MDM 25 MINUTES,400.0,260.0,1.1,400.0,148
HCPCS,99232,SBSQ HOSP IP/OBS MODERATE 35,,,205.28,205.28,1
HCPCS,99232,SBSQ HOSPITAL IP/OBS CARE MOD MDM 35 MINUTES,636.0,413.4,1.1,636.0,148
HCPCS,99232,Sbsq hosp ip/obs moderate 35,,,68.73,79.59,8
HCPCS,99232,VIRTUAL SBSQ HOSPITAL IP/OBS CARE MOD MDM 35 MINUTES,636.0,413.4,1.1,636.0,148
HCPCS,99233,SBSQ HOSP IP/OBS HIGH 50,,,308.83,308.83,1
HCPCS,99233,SBSQ HOSPITAL IP/OBS CARE HIGH MDM 50 MINUTES,960.0,624.0,1.1,960.0,148
HCPCS,99233,Sbsq hosp ip/obs high 50,,,68.73,79.59,8
HCPCS,99233,VIRTUAL SBSQ HOSPITAL IP/OBS CARE HIGH MDM 50 MINUTES,960.0,624.0,1.1,960.0,148
HCPCS,99234,HOSP IP/OBS SM DT SF/LOW 45,,,254.85,254.85,1
HCPCS,99234,HOSPITAL IP/OBS CARE SAME DATE SF/LOW MDM 45 MIN,800.0,520.0,1.1,800.0,148
HCPCS,99234,Hosp ip/obs sm dt sf/low 45,,,68.73,79.59,8
HCPCS,99234,VV HOSPITAL IP/OBS CARE SAME DATE SF/LOW MDM 45 MIN (99234),800.0,520.0,1.1,800.0,148
HCPCS,99235,HOSP IP/OBS SAME DATE MOD 70,,,415.11,415.11,1
HCPCS,99235,HOSPITAL IP/OBS CARE SAME DATE MOD MDM 70 MIN,1296.0,842.4,1.1,1296.0,148
HCPCS,99235,Hosp ip/obs same date mod 70,,,68.73,79.59,8
HCPCS,99235,VV HOSPITAL IP/OBS CARE SAME DATE MOD MDM 70 MIN (99235),1296.0,842.4,1.1,1296.0,148
HCPCS,99236,HOSP IP/OBS SAME DATE HI 85,,,542.96,542.96,1
HCPCS,99236,HOSPITAL IP/OBS CARE SAME DATE HIGH MDM 85 MIN,1720.0,1118.0,1.1,1720.0,148
HCPCS,99236,Hosp ip/obs same date hi 85,,,68.73,79.59,8
HCPCS,99236,VV HOSPITAL IP/OBS CARE SAME DATE HIGH MDM 85 MIN (99236),1720.0,1118.0,1.1,1720.0,148
HCPCS,99238,HOSP IP/OBS DSCHRG MGMT 30/<,,,210.16,210.16,1
HCPCS,99238,HOSPITAL IP/OBS DISCHARGE DAY MGMT 30 MIN/<,600.0,390.0,1.1,600.0,148
HCPCS,99238,Hosp ip/obs dschrg mgmt 30/<,,,21.85,25.3,8
HCPCS,99238,VIRTUAL IP/OBS DISCHARGE =/<30 MIN,600.0,390.0,1.1,600.0,148
HCPCS,99239,HOSP IP/OBS DSCHRG MGMT >30,,,296.71,296.71,1
HCPCS,99239,HOSPITAL IP/OBS DISCHARGE DAY MGMT > 30 MIN,860.0,559.0,1.1,860.0,148
HCPCS,99239,Hosp ip/obs dschrg mgmt >30,,,21.85,25.3,8
HCPCS,99239,VIRTUAL IP/OBS DISCHARGE DAY > 30 MIN,860.0,559.0,1.1,860.0,148
HCPCS,99241,Office consultation,,,68.73,79.59,8
HCPCS,99242,OFF/OP CONSLTJ NEW/EST SF 20,,,145.06,145.06,1
HCPCS,99242,OFFICE/OP CONSLTJ NEW/EST PT SF MDM 20 MINUTES,319.0,207.35,1.1,475.0,360
HCPCS,99242,Off/op consltj new/est sf 20,,,68.73,79.59,8
HCPCS,99242,VV OFFICE/OP CONSLTJ NEW/EST PT SF MDM 20 MINUTES,475.0,308.75,1.1,475.0,120
HCPCS,99243,OFF/OP CNSLTJ NEW/EST LOW 30,,,229.72,229.72,1
HCPCS,99243,OFFICE/OP CONSLTJ NEW/EST PT LOW MDM 30 MINUTES,449.0,291.85,1.1,720.0,360
HCPCS,99243,Off/op cnsltj new/est low 30,,,68.73,79.59,8
HCPCS,99243,VV OFFICE/OP CONSLTJ NEW/EST PT LOW MDM 30 MINUTES,720.0,468.0,1.1,720.0,120
HCPCS,99244,OFFICE/OP CONSLTJ NEW/EST PT MOD MDM 40 MINUTES,1076.0,699.4,0.01,5310.0,253
HCPCS,99244,VV OFFICE/OP CONSLTJ NEW/EST PT MOD MDM 40 MINUTES,1076.0,699.4,1.1,1076.0,120
HCPCS,99245,OFF/OP CONSLTJ NEW/EST HI 55,,,470.57,470.57,1
HCPCS,99245,OFFICE/OP CONSLTJ NEW/EST PT HIGH MDM 55 MINUTES,1200.0,780.0,1.1,1500.0,240
HCPCS,99245,Off/op consltj new/est hi 55,,,68.73,79.59,8
HCPCS,99245,VV OFFICE/OP CONSLTJ NEW/EST PT HIGH MDM 55 MINUTES,1500.0,975.0,1.1,1500.0,120
HCPCS,99251,Inpatient consultation,,,68.73,79.59,8
HCPCS,99252,IP/OBS CONSLTJ NEW/EST PT SF MDM 35 MINUTES,600.0,390.0,1.1,600.0,116
HCPCS,99252,IP/OBS CONSLTJ NEW/EST SF 35,,,185.42,185.42,1
HCPCS,99252,Ip/obs consltj new/est sf 35,,,68.73,79.59,8
HCPCS,99253,IP/OBS CNSLTJ NEW/EST LOW 45,,,259.2,259.2,1
HCPCS,99253,IP/OBS CONSLTJ NEW/EST PT LOW MDM 45 MINUTES,880.0,572.0,1.1,880.0,116
HCPCS,99253,Ip/obs cnsltj new/est low 45,,,68.73,79.59,8
HCPCS,99253,VIRTUAL INPATIENT CONSULTATION SERVICES (45 MIN),880.0,572.0,1.1,880.0,116
HCPCS,99254,IP/OBS CNSLTJ NEW/EST MOD 60,,,359.41,359.41,1
HCPCS,99254,IP/OBS CONSLTJ NEW/EST PT MOD MDM 60 MINUTES,1197.0,778.05,1.1,1197.0,116
HCPCS,99254,Ip/obs cnsltj new/est mod 60,,,68.73,79.59,8
HCPCS,99255,IP/OBS CONSLTJ NEW/EST HI 80,,,485.34,485.34,1
HCPCS,99255,IP/OBS CONSLTJ NEW/EST PT HIGH MDM 80 MINUTES,1698.0,1103.7,1.1,1698.0,116
HCPCS,99255,Ip/obs consltj new/est hi 80,,,68.73,79.59,8
HCPCS,99281,EMERGENCY DEPARTMENT VISIT MAY NOT REQ PHYS/QHP,359.0,233.35,1.1,1962.0,235
HCPCS,99282,EMERGENCY DEPARTMENT VISIT STRAIGHTFORWARD MDM,751.0,488.15000000000003,1.1,1962.0,235
HCPCS,99283,EMERGENCY DEPARTMENT VISIT LOW MDM,1307.5,849.875,1.1,3196.0,235
HCPCS,99284,EMERGENCY DEPARTMENT VISIT MODERATE MDM,2072.0,1346.8,1.1,3196.0,322
HCPCS,99285,EMERGENCY DEPARTMENT VISIT HIGH MDM,2995.0,1946.75,1.1,3807.0,235
HCPCS,99288,DIRECT ADVANCED LIFE SUPPORT,,,104.12,104.12,1
HCPCS,99288,Direct advanced life support,,,68.73,79.59,8
HCPCS,99288,PHYS/QHP DIRECTION EMERGENCY MEDICAL SYSTEMS,427.0,277.55,1.1,427.0,80
HCPCS,99291,CRITICAL CARE ILL/INJURED PATIENT INIT 30-74 MIN,3897.0,2533.05,1.1,5232.6,322
HCPCS,99292,CRITICAL CARE ILL/INJURED PATIENT ADDL 30 MIN,1738.5,1130.025,1.1,3005.0,217
HCPCS,99295,"NEONATAL CRITICAL CARE,INITIAL",3768.0,2449.2,1.1,3768.0,68
HCPCS,99304,1ST NF CARE SF/LOW MDM 25,,,208.51,208.51,1
HCPCS,99304,1st nf care sf/low mdm 25,,,68.73,79.59,8
HCPCS,99304,INITIAL NURSING FACILITY CARE SF/LOW MDM 25 MIN,600.0,390.0,1.1,600.0,152
HCPCS,99305,1ST NF CARE MODERATE MDM 35,,,346.31,346.31,1
HCPCS,99305,1st nf care moderate mdm 35,,,68.73,79.59,8
HCPCS,99305,INITIAL NURSING FACILITY CARE MOD MDM 35 MINUTES,1000.0,650.0,1.1,1000.0,152
HCPCS,99306,1ST NF CARE HIGH MDM 50,,,473.47,473.47,1
HCPCS,99306,1st nf care high mdm 50,,,68.73,79.59,8
HCPCS,99306,INITIAL NURSING FACILITY CARE HI MDM 50 MINUTES,1400.0,910.0,1.1,1400.0,152
HCPCS,99307,SBSQ NF CARE SF MDM 10,,,104.23,104.23,1
HCPCS,99307,SBSQ NURSING FACILITY CARE SF MDM 10 MINUTES,280.0,182.0,1.1,280.0,152
HCPCS,99307,Sbsq nf care sf mdm 10,,,68.73,79.59,8
HCPCS,99308,SBSQ NF CARE LOW MDM 20,,,192.81,192.81,1
HCPCS,99308,SBSQ NURSING FACILITY CARE LOW MDM 20 MINUTES,520.0,338.0,1.1,520.0,152
HCPCS,99308,Sbsq nf care low mdm 20,,,68.73,79.59,8
HCPCS,99309,SBSQ NF CARE MODERATE MDM 30,,,279.12,279.12,1
HCPCS,99309,SBSQ NURSING FACILITY CARE MOD MDM 30 MINUTES,768.0,499.2,1.1,768.0,152
HCPCS,99309,Sbsq nf care moderate mdm 30,,,68.73,79.59,8
HCPCS,99310,SBSQ NF CARE HIGH MDM 45,,,398.89,398.89,1
HCPCS,99310,SBSQ NURSING FACILITY CARE HIGH MDM 45 MINUTES,1120.0,728.0,1.1,1120.0,152
HCPCS,99310,Sbsq nf care high mdm 45,,,68.73,79.59,8
HCPCS,99315,NF DSCHRG MGMT 30 MIN/LESS,,,211.69,211.69,1
HCPCS,99315,NURSING FACILITY DSCHRG MGMT 30 MIN/< TOT TIME,600.0,390.0,1.1,600.0,144
HCPCS,99315,Nf dschrg mgmt 30 min/less,,,68.73,79.59,8
HCPCS,99316,NF DSCHRG MGMT 30 MIN+,,,340.58,340.58,1
HCPCS,99316,NURSING FACILITY DSCHRG MGMT 30 MIN+ TOT TIME,1000.0,650.0,1.1,1000.0,144
HCPCS,99316,Nf dschrg mgmt 30 min+,,,68.73,79.59,8
HCPCS,99318,Annual nursing fac assessmnt,,,68.73,79.59,8
HCPCS,99324,Domicil/r-home visit new pat,,,68.73,79.59,8
HCPCS,99325,Domicil/r-home visit new pat,,,68.73,79.59,8
HCPCS,99326,Domicil/r-home visit new pat,,,68.73,79.59,8
HCPCS,99327,Domicil/r-home visit new pat,,,68.73,79.59,8
HCPCS,99328,Domicil/r-home visit new pat,,,68.73,79.59,8
HCPCS,99334,Domicil/r-home visit est pat,,,68.73,79.59,8
HCPCS,99335,Domicil/r-home visit est pat,,,68.73,79.59,8
HCPCS,99336,Domicil/r-home visit est pat,,,68.73,79.59,8
HCPCS,99337,Domicil/r-home visit est pat,,,68.73,79.59,8
HCPCS,99339,Domicil/r-home care supervis,,,21.85,25.3,8
HCPCS,99340,Domicil/r-home care supervis,,,21.85,25.3,8
HCPCS,99341,HOME/RES VISIT NEW PATIENT SF MDM 15 MINUTES,440.0,286.0,1.1,440.0,148
HCPCS,99341,HOME/RES VST NEW SF MDM 15,,,70.04,128.67,2
HCPCS,99341,Home/res vst new sf mdm 15,,,68.73,79.59,8
HCPCS,99342,HOME/RES VISIT NEW PATIENT LOW MDM 30 MINUTES,579.0,376.35,1.1,726.0,366
HCPCS,99342,HOME/RES VST NEW LOW MDM 30,,,99.91,204.49,2
HCPCS,99342,Home/res vst new low mdm 30,,,68.73,79.59,8
HCPCS,99343,HOME VISIT NEW PATIENT,,,164.8,164.8,1
HCPCS,99343,"HOME VISIT,NEW PATIENT,LEVEL III",679.0,441.35,1.1,679.0,140
HCPCS,99343,Home visit new patient,,,68.73,79.59,8
HCPCS,99344,HOME/RES VISIT NEW PATIENT MOD MDM 60 MINUTES,1112.0,722.8,1.1,1263.0,358
HCPCS,99344,HOME/RES VST NEW MOD MDM 60,,,233.81,370.39,2
HCPCS,99344,Home/res vst new mod mdm 60,,,68.73,79.59,8
HCPCS,99345,HOME/RES VISIT NEW PATIENT HIGH MDM 75 MINUTES,1163.0,755.95,1.1,1707.0,358
HCPCS,99345,HOME/RES VST NEW HIGH MDM 75,,,284.28,524.93,2
HCPCS,99345,Home/res vst new high mdm 75,,,68.73,79.59,8
HCPCS,99347,HOME/RES VISIT EST PATIENT SF MDM 20 MINUTES,332.0,215.79999999999998,1.1,396.0,366
HCPCS,99347,HOME/RES VST EST SF MDM 20,,,70.04,118.07,2
HCPCS,99347,Home/res vst est sf mdm 20,,,68.73,79.59,8
HCPCS,99348,HOME/RES VISIT EST PATIENT LOW MDM 30 MINUTES,268.0,174.2,1.1,660.0,366
HCPCS,99348,HOME/RES VST EST LOW MDM 30,,,107.12,199.2,2
HCPCS,99348,Home/res vst est low mdm 30,,,68.73,79.59,8
HCPCS,99349,HOME/RES VISIT EST PATIENT MOD MDM 40 MINUTES,849.0,551.85,1.1,1074.0,366
HCPCS,99349,HOME/RES VST EST MOD MDM 40,,,163.77,331.02,2
HCPCS,99349,Home/res vst est mod mdm 40,,,68.73,79.59,8
HCPCS,99350,HOME/RES VISIT EST PATIENT HIGH MDM 60 MINUTES,1232.0,800.8,1.1,1584.0,358
HCPCS,99350,HOME/RES VST EST HIGH MDM 60,,,228.66,482.54,2
HCPCS,99350,Home/res vst est high mdm 60,,,68.73,79.59,8
HCPCS,99354,PROLNG SVC O/P 1ST HOUR,,,165.83,165.83,1
HCPCS,99354,Prolng svc o/p 1st hour,,,63.76,73.83,8
HCPCS,99355,PROLNG SVC O/P EA ADDL 30,,,125.66,125.66,1
HCPCS,99355,Prolng svc o/p ea addl 30,,,63.76,73.83,8
HCPCS,99356,PROLNG SVC I/P/OBS 1ST HOUR,,,118.45,118.45,1
HCPCS,99356,Prolng svc i/p/obs 1st hour,,,63.76,73.83,8
HCPCS,99357,PROLNG SVC I/P/OBS EA ADDL,,,119.48,119.48,1
HCPCS,99357,Prolng svc i/p/obs ea addl,,,63.76,73.83,8
HCPCS,99358,PROLONGED E&M SERVICE-1ST HOUR,792.0,514.8,1.1,792.0,102
HCPCS,99358,Prolong service w/o contact,,,63.76,73.83,8
HCPCS,99359,"PROLONGED SERV,NO CONTCT,EA ADD 1/2",330.0,214.5,1.1,330.0,98
HCPCS,99359,Prolong serv w/o contact add,,,63.76,73.83,8
HCPCS,99360,"PHYSICIAN STANDBY SERV,EA 30 MIN",480.0,312.0,1.1,480.0,100
HCPCS,99360,PHYSICIAN STANDBY SERVICES,,,152.56,152.56,1
HCPCS,99360,Physician standby services,,,405.62,469.67,8
HCPCS,99366,TEAM CONFERENCE FACE-TO-FACE NONPHYSICIAN,298.5,194.02499999999998,1.1,328.0,168
HCPCS,99367,TEAM CONFERENCE NON-FACE-TO-FACE PHYSICIAN,440.0,286.0,1.1,440.0,98
HCPCS,99367,Team conf w/o pat by phys,,,21.85,25.3,8
HCPCS,99368,TEAM CONFERENCE NON-FACE-TO-FACE NONPHYSICIAN,262.5,170.625,1.1,288.0,164
HCPCS,99374,"HOME HEALTH CARE SUPERV,15-29 MIN",440.0,286.0,1.1,440.0,102
HCPCS,99374,HOME HEALTH CARE SUPERVISION,,,140.32,140.32,1
HCPCS,99375,CARE PLAN OVERSIGHT/30-60,692.0,449.8,1.1,692.0,102
HCPCS,99375,HOME HEALTH CARE SUPERVISION,,,219.25,219.25,1
HCPCS,99377,HOSPICE CARE SUPERVISION,,,140.32,140.32,1
HCPCS,99377,"HOSPICE CARE SUPERVISION,15-29 MIN",440.0,286.0,1.1,440.0,102
HCPCS,99378,HOSPICE CARE SUPERVISION,,,219.25,219.25,1
HCPCS,99378,"HOSPICE CARE SUPERVISION,30+ MIN",692.0,449.8,1.1,692.0,102
HCPCS,99379,NURSING FAC CARE SUPERVISION,,,140.32,140.32,1
HCPCS,99380,NURSING FAC CARE SUPERVISION,,,219.25,219.25,1
HCPCS,99381,INITIAL PREVENTIVE MEDICINE NEW PATIENT <1YEAR,99.0,64.35,0.01,99.0,67
HCPCS,99381,"PREVENTIVE VISIT,NEW,INFANT",600.0,390.0,1.1,600.0,116
HCPCS,99382,INITIAL PREVENTIVE MEDICINE NEW PT AGE 1-4 YRS,108.0,70.2,0.01,108.0,67
HCPCS,99382,"PREVENTIVE VISIT,NEW,AGE 1-4",640.0,416.0,1.1,640.0,116
HCPCS,99383,INITIAL PREVENTIVE MEDICINE NEW PT AGE 5-11 YRS,154.0,100.1,0.01,154.0,67
HCPCS,99383,"PREVENTIVE VISIT,NEW,AGE5-11",680.0,442.0,1.1,680.0,118
HCPCS,99384,INITIAL PREVENTIVE MEDICINE NEW PT AGE 12-17 YR,186.0,120.9,0.01,186.0,67
HCPCS,99384,WELLNESS EXAMS NEW 12-17 YRS,800.0,520.0,1.1,800.0,118
HCPCS,99385,INITIAL PREVENTIVE MEDICINE NEW PT AGE 18-39YRS,184.0,119.6,0.01,184.0,67
HCPCS,99385,WELLNESS EXAM NEW 18-39 YRS,768.0,499.2,1.1,768.0,118
HCPCS,99386,INITIAL PREVENTIVE MEDICINE NEW PATIENT 40-64YRS,254.0,165.1,0.01,254.0,67
HCPCS,99386,WELLNESS EXAMS NEW 40-64 YRS,932.0,605.8,1.1,932.0,118
HCPCS,99387,INITIAL PREVENTIVE MEDICINE NEW PATIENT 65YRS&>,291.0,189.15,0.01,291.0,67
HCPCS,99387,WELLNESS EXAMS NEW 65+ YRS,1000.0,650.0,1.1,1000.0,116
HCPCS,99391,PERIODIC PREVENTIVE MED ESTABLISHED PATIENT <1Y,144.0,93.6,0.01,144.0,67
HCPCS,99391,"PREVENTIVE VISIT,EST,INFANT",548.0,356.2,1.1,548.0,116
HCPCS,99392,PERIODIC PREVENTIVE MED EST PATIENT 1-4YRS,153.0,99.45,0.01,153.0,67
HCPCS,99392,"PREVENTIVE VISIT,EST,AGE 1-4",600.0,390.0,1.1,600.0,116
HCPCS,99393,PERIODIC PREVENTIVE MED EST PATIENT 5-11YRS,185.0,120.25,0.01,185.0,67
HCPCS,99393,"PREVENTIVE VISIT,EST,AGE5-11",600.0,390.0,1.1,600.0,116
HCPCS,99394,PERIODIC PREVENTIVE MED EST PATIENT 12-17YRS,211.0,137.15,0.01,211.0,67
HCPCS,99394,"PREVENTIVE VISIT,EST,12-17",680.0,442.0,1.1,680.0,116
HCPCS,99395,PERIODIC PREVENTIVE MED EST PATIENT 18-39 YRS,313.0,203.45,0.01,313.0,67
HCPCS,99395,WELLNESS EXAMS EST 18-39 YRS,700.0,455.0,1.1,700.0,116
HCPCS,99396,PERIODIC PREVENTIVE MED EST PATIENT 40-64YRS,230.0,149.5,0.01,230.0,67
HCPCS,99396,WELLNESS EXAMS EST 40-64 YRS,760.0,494.0,1.1,760.0,116
HCPCS,99397,PERIODIC PREVENTIVE MED EST PATIENT 65YRS& OLDER,243.0,157.95,0.01,243.0,67
HCPCS,99397,WELLNESS EXAMS EST 65+ YRS,800.0,520.0,1.1,800.0,116
HCPCS,99401,PREVENT MED COUNSEL&/RISK FACTOR REDJ SPX 15 MIN,158.0,102.69999999999999,0.01,192.0,183
HCPCS,99402,PREVENT MED COUNSEL&/RISK FACTOR REDJ SPX 30 MIN,307.0,199.55,0.01,392.0,183
HCPCS,99403,PREVENT MED COUNSEL&/RISK FACTOR REDJ SPX 45 MIN,460.5,299.32500000000005,0.01,584.0,181
HCPCS,99404,PREVENT MED COUNSEL&/RISK FACTOR REDJ SPX 60 MIN,614.0,399.1,0.01,780.0,181
HCPCS,99406,TOBACCO USE CESSATION INTERMEDIATE 3-10 MINUTES,92.5,60.125,1.1,96.0,234
HCPCS,99407,TOBACCO USE CESSATION INTENSIVE >10 MINUTES,144.5,93.925,1.1,200.0,234
HCPCS,99408,ALCOHOL/SUBSTANCE SCREEN & INTERVEN 15-30 MIN,260.0,169.0,1.1,260.0,108
HCPCS,99408,AUDIT/DAST 15-30 MIN,,,82.45,82.45,1
HCPCS,99408,Audit/dast 15-30 min,,,47.12,54.56,8
HCPCS,99409,ALCOHOL/SUBSTANCE SCREEN & INTERVENTION >30 MIN,520.0,338.0,1.1,520.0,108
HCPCS,99409,AUDIT/DAST OVER 30 MIN,,,164.92,164.92,1
HCPCS,99409,Audit/dast over 30 min,,,47.12,54.56,8
HCPCS,99411,PREV MED COUNSEL & RISK FACTOR REDJ GRP SPX 30 M,60.0,39.0,1.1,60.0,100
HCPCS,99411,PREVENTIVE COUNSELING GROUP,,,19.29,19.29,1
HCPCS,99411,Preventive counseling group,,,86.57,100.24,8
HCPCS,99412,PREV MED COUNSEL & RISK FACTOR REDJ GRP SPX 60 M,125.5,81.575,0.01,151.0,167
HCPCS,99415,PROLNG CLINCL STAFF SVC DURING O/P E/M 1ST HR,273.0,177.45,1.1,273.0,142
HCPCS,99415,PROLONG CLINCL STAFF SVC,269.0,174.85,12.36,269.0,68
HCPCS,99416,PROLNG CLINCL STAFF SVC DURING O/P E/M EA 30 MIN,273.0,177.45,0.74,273.0,142
HCPCS,99416,PROLONG CLINCL STAFF SVC ADD,269.0,174.85,7.21,269.0,68
HCPCS,99417,PROLNG OP E/M EACH 15 MIN,,,64.89,78.06,2
HCPCS,99417,PROLONGED OUTPATIENT E/M SERVICE EACH 15 MINUTES,268.0,174.2,1.1,268.0,108
HCPCS,99417,Prolng op e/m each 15 min,,,63.76,73.83,8
HCPCS,99417,VIRTUAL PROLONGED OUTPATIENT E/M SERVICE EACH 15 MINUTES,268.0,174.2,1.1,268.0,108
HCPCS,99418,PROLNG IP/OBS E/M EA 15 MIN,,,102.64,102.64,1
HCPCS,99418,PROLONGED INPATIENT/OBSERVATION EM SVC EA 15 MIN,356.0,231.4,1.1,356.0,104
HCPCS,99418,Prolng ip/obs e/m ea 15 min,,,63.76,73.83,8
HCPCS,99418,VV?PROLONGED INPATIENT/OBSERVATION EM SVC EA 15 MIN,356.0,231.4,1.1,356.0,104
HCPCS,99421,E VISIT ONLINE DIGITAL E/M SVC EST PT <7 D 5-10 MINUTES,65.0,42.25,1.1,65.0,144
HCPCS,99421,MYCHART MEDICAL ADVICE MESSAGING: ONLINE DIGITAL E/M SVC EAT PT,65.0,42.25,1.1,65.0,144
HCPCS,99421,OL DIG E/M SVC 5-10 MIN,,,33.26,33.26,1
HCPCS,99421,ONLINE DIGITAL E/M SVC EST PT &LT;7 D 5-10 MINUTES,65.0,42.25,1.1,65.0,144
HCPCS,99421,Ol dig e/m svc 5-10 min,,,68.73,79.59,8
HCPCS,99422,E VISIT ONLINE DIGITAL E/M SVC EST PT <7 D 11-20 MINUTES,80.0,52.0,1.1,80.0,144
HCPCS,99422,MYCHART MEDICAL ADVICE MESSAGING: ONLINE DIGITAL E/M SVC EAT PT,80.0,52.0,1.1,80.0,144
HCPCS,99422,OL DIG E/M SVC 11-20 MIN,,,65.73,65.73,1
HCPCS,99422,ONLINE DIGITAL E/M SVC EST PT &LT;7 D 11-20 MINUTES,80.0,52.0,1.1,80.0,144
HCPCS,99422,Ol dig e/m svc 11-20 min,,,68.73,79.59,8
HCPCS,99423,E VISIT ONLINE DIGITAL E/M SVC EST PT <7 D 21+ MINUTES,120.0,78.0,1.1,120.0,144
HCPCS,99423,MYCHART MEDICAL ADVICE MESSAGING: ONLINE DIGITAL E/M SVC EAT PT,120.0,78.0,1.1,120.0,144
HCPCS,99423,OL DIG E/M SVC 21+ MIN,,,105.13,105.13,1
HCPCS,99423,ONLINE DIGITAL E/M SVC EST PT &LT;7 D 21+ MINUTES,120.0,78.0,1.1,120.0,144
HCPCS,99423,Ol dig e/m svc 21+ min,,,68.73,79.59,8
HCPCS,99424,PRIN CARE MGMT PHYS 1ST 30,,,193.42,193.42,1
HCPCS,99424,PRINCIPAL CARE MGMT SVC 1ST 30 PHYS/QHP CAL MO,580.0,377.0,1.1,580.0,132
HCPCS,99425,PRIN CARE MGMT PHYS EA ADDL,,,133.0,133.0,1
HCPCS,99425,PRINCIPAL CARE MGMT SVC EA ADL 30 PHY/QHP CAL MO,400.0,260.0,1.1,400.0,132
HCPCS,99426,PRIN CARE MGMT STAFF 1ST 30,,,77.33,232.71,21
HCPCS,99426,PRINCIPAL CARE MGMT SVC 1ST 30 STAFF CAL MO,400.0,260.0,1.1,400.0,132
HCPCS,99427,PRINCIPAL CARE MGMT SVC EA ADDL 30 STAFF CAL MO,284.0,184.6,1.1,284.0,132
HCPCS,99429,METABOLIC WEIGHT MANAGEMENT PROGRAM,150.0,97.5,0.01,2013999.98,80
HCPCS,99429,UNLISTED PREVENTIVE MEDICINE SERVICE,103.0,66.95,0.01,2013999.98,80
HCPCS,99429,UNLISTED PREVENTIVE SERVICE,,,2739999.97,2739999.97,1
HCPCS,99429,Unlisted preventive service,,,63.76,73.83,8
HCPCS,99431,"INITIAL CARE, NORMAL NEWBORN",408.0,265.2,1.1,408.0,68
HCPCS,99433,"F/U NEWBORN CARE,HOSP,PER DAY",216.0,140.4,1.1,216.0,68
HCPCS,99435,HOSPITAL NB DISCHARGE SAMEDAY,380.0,247.0,1.1,380.0,68
HCPCS,99436,"ATTENDANCE, BIRTH/INITIAL STABILIZE",596.0,387.4,1.1,596.0,68
HCPCS,99437,CHRONIC CARE MGMT SVC PHYS EA ADDL 30 MIN CAL MO,254.0,165.1,0.01,440.0,193
HCPCS,99439,CHRONIC CARE MANAGEMENT SERVICES EA ADDL 20 MIN,280.0,182.0,1.1,280.0,134
HCPCS,99439,CHRONIC CARE MGMT SVC STAF EA ADDL 20 MIN CAL MO,247.0,160.55,0.01,247.0,61
HCPCS,99441,PHONE E/M PHYS/QHP 5-10 MIN,,,70.04,91.13,2
HCPCS,99441,Phone e/m phys/qhp 5-10 min,,,68.73,79.59,8
HCPCS,99442,PHONE E/M PHYS/QHP 11-20 MIN,,,113.3,170.76,2
HCPCS,99442,Phone e/m phys/qhp 11-20 min,,,68.73,79.59,8
HCPCS,99443,PHONE E/M PHYS/QHP 21-30 MIN,,,160.68,253.07,2
HCPCS,99443,Phone e/m phys/qhp 21-30 min,,,68.73,79.59,8
HCPCS,99445,REM MNTR PHYSIOL PARAM DEV SPLY W/REC 2-15 DAYS,150.0,97.5,0.01,263.0,176
HCPCS,99446,NTRPROF PH1/NTRNET/EHR 5-10,,,27.81,46.44,2
HCPCS,99446,NTRPROF PHONE/NTRNET/EHR ASSMT&MGMT 5-10 MIN,154.0,100.1,1.1,154.0,142
HCPCS,99447,NTRPROF PH1/NTRNET/EHR 11-20,,,55.62,94.64,2
HCPCS,99447,NTRPROF PHONE/NTRNET/EHR ASSMT&MGMT 11-20 MIN,280.0,182.0,1.1,280.0,142
HCPCS,99448,NTRPROF PH1/NTRNET/EHR 21-30,,,83.43,140.15,2
HCPCS,99448,NTRPROF PHONE/NTRNET/EHR ASSMT&MGMT 21-30 MIN,420.0,273.0,1.1,420.0,142
HCPCS,99449,NTRPROF PH1/NTRNET/EHR 31/>,,,111.24,186.48,2
HCPCS,99449,NTRPROF PHONE/NTRNET/EHR ASSMT&MGMT 31/> MIN,560.0,364.0,1.1,560.0,142
HCPCS,99450,BASIC LIFE DISABILITY EXAM,,,41.73,41.73,1
HCPCS,99450,Basic life disability exam,,,68.73,79.59,8
HCPCS,99450,LIFE/DISABILITY EVALUATION,651.0,423.15,1.1,651.0,82
HCPCS,99451,NTRPROF PH1/NTRNET/EHR 5/>,,,56.65,91.13,2
HCPCS,99451,NTRPROF PHONE/NTRNET/EHR ASSMT&MGMT 5/> MIN,280.0,182.0,1.1,280.0,142
HCPCS,99452,NTRPROF PH1/NTRNET/EHR RFRL,,,56.65,88.58,2
HCPCS,99452,NTRPROF PHONE/NTRNET/EHR REFERRAL SVC 30 MIN,280.0,182.0,1.1,280.0,142
HCPCS,99453,REM MNTR PHYSIOL PARAM 1ST SET UP PT EDUCAJ EQP,37.0,24.05,1.1,253.66,144
HCPCS,99453,REMOTE MONITORING EDUCATION AND SET UP,889.0,577.85,27.62,889.0,86
HCPCS,99454,REM MNTR PHYSIOL PARAM 1ST DEV SUPPLY EA 30 D,118.0,76.7,1.1,132.86,144
HCPCS,99454,"REMOTE MONITORING, INITIAL SUPPLY",257.0,167.05,32.72,257.0,78
HCPCS,99455,WORK RELATED DISABILITY EXAM,,,117.82,117.82,1
HCPCS,99455,WORK RELATED/MED DBLT XM TREATING PHYS,193.0,125.45,1.1,193.0,82
HCPCS,99455,Work related disability exam,,,68.73,79.59,8
HCPCS,99456,WORK RELATED/MED DBLT XM OTH/THN TREATING PHYS,571.0,371.15000000000003,0.01,918.0,149
HCPCS,99457,REMOTE MONITORING 20 MIN,72.0,46.8,15.7,72.0,60
HCPCS,99457,REMOTE PHYSIOLOGIC MONITORING 20 MIN+ PER MONTH,244.0,158.6,1.1,244.0,148
HCPCS,99458,REMOTE PHYSIOLOGIC MONITORING EA ADDL 20 MIN MO,156.0,101.4,0.01,244.0,269
HCPCS,99459,PELVIC EXAMINATION,53.0,34.45,1.1,53.0,144
HCPCS,99459,Pelvic examination,,,68.73,79.59,8
HCPCS,99460,1ST HOSP/BIRTHING CENTER CARE PER DAY NML NB,768.0,499.2,1.1,768.0,144
HCPCS,99460,INIT NB EM PER DAY HOSP,,,114.68,345.1,21
HCPCS,99460,Init nb em per day hosp,,,68.73,79.59,8
HCPCS,99461,1ST CARE PR DAY NML NB XCPT HOSP/BIRTHING CENTER,504.0,327.6,1.1,504.0,148
HCPCS,99461,INIT NB EM PER DAY NON-FAC,,,158.97,158.97,1
HCPCS,99461,Init nb em per day non-fac,,,68.73,79.59,8
HCPCS,99462,SBSQ NB EM PER DAY HOSP,,,106.26,106.26,1
HCPCS,99462,SUBQ HOSPITAL CARE PER DAY E/M NORMAL NEWBORN,336.0,218.4,1.1,336.0,144
HCPCS,99462,Sbsq nb em per day hosp,,,68.73,79.59,8
HCPCS,99463,1ST HOSP/BIRTHING CENTER NB ADMIT & DSCHG SM DAT,852.0,553.8,1.1,852.0,144
HCPCS,99463,SAME DAY NB DISCHARGE,,,114.68,345.1,21
HCPCS,99463,Same day nb discharge,,,68.73,79.59,8
HCPCS,99464,ATTN AT DELIVERY 1ST STABILIZATION OF NEWBORN,600.0,390.0,1.1,600.0,144
HCPCS,99464,Attendance at delivery,,,405.62,469.67,8
HCPCS,99465,DELIVERY/BIRTHING ROOM RESUSCITATION,2843.5,1848.275,1.1,4515.0,403
HCPCS,99466,CRITICAL CARE INTERFACILITY TRANSPORT 30-74 MIN,1916.0,1245.4,1.1,1916.0,142
HCPCS,99466,Ped crit care transport,,,68.73,79.59,8
HCPCS,99467,CRITICAL CARE INTERFACILITY TRANSPORT EA 30 MIN,960.0,624.0,1.1,960.0,142
HCPCS,99467,Ped crit care transport addl,,,68.73,79.59,8
HCPCS,99468,1ST INPATIENT CRITICAL CARE PR DAY AGE 28 DAYS/<,8122.0,5279.3,1.1,8122.0,144
HCPCS,99468,NEONATE CRIT CARE INITIAL,,,2325.52,2325.52,1
HCPCS,99468,Neonate crit care initial,,,68.73,79.59,8
HCPCS,99469,NEONATE CRIT CARE SUBSQ,,,1005.58,1005.58,1
HCPCS,99469,Neonate crit care subsq,,,68.73,79.59,8
HCPCS,99469,SUBQ I/P CRITICAL CARE PR DAY AGE 28 DAYS/<,3516.0,2285.4,1.1,3516.0,144
HCPCS,99470,RPM TX MGMT 1 R-T IA COMUNICAJ CAL MO 1ST 10 MIN,190.0,123.5,0.01,244.0,166
HCPCS,99471,INITIAL PED CRITICAL CARE 29 DAYS THRU 24 MONTHS,7031.0,4570.15,1.1,7031.0,144
HCPCS,99471,PED CRITICAL CARE INITIAL,,,2014.72,2014.72,1
HCPCS,99471,Ped critical care initial,,,68.73,79.59,8
HCPCS,99472,PED CRITICAL CARE SUBSQ,,,1031.17,1031.17,1
HCPCS,99472,Ped critical care subsq,,,68.73,79.59,8
HCPCS,99472,SUBSQ PED CRITICAL CARE 29 DAYS THRU 24 MO,3516.0,2285.4,1.1,3516.0,144
HCPCS,99473,SELF-MEAS BP PT EDUCAJ/TRAING & DEV CALIBRATION,195.0,126.75,0.01,221.0,231
HCPCS,99473,SELF-MEAS BP PT EDUCAJ/TRAING &AMP; DEV CALIBRATION,169.0,109.85,19.92,169.0,86
HCPCS,99474,SELF-MEAS BP 2 READG 1 MIN APART BID 30 DAY PD,72.0,46.8,1.1,72.0,148
HCPCS,99474,SELF-MEAS BP 2 READG BID 30D,,,22.8,22.8,1
HCPCS,99475,INITIAL PED CRITICAL CARE 2 THRU 5 YEARS,4950.0,3217.5,1.1,4950.0,144
HCPCS,99475,PED CRIT CARE AGE 2-5 INIT,,,1451.19,1451.19,1
HCPCS,99475,Ped crit care age 2-5 init,,,68.73,79.59,8
HCPCS,99476,PED CRIT CARE AGE 2-5 SUBSQ,,,873.29,873.29,1
HCPCS,99476,Ped crit care age 2-5 subsq,,,68.73,79.59,8
HCPCS,99476,SUBSEQUENT PED CRITICAL CARE 2 THRU 5 YEARS,2970.0,1930.5,1.1,2970.0,144
HCPCS,99477,INIT DAY HOSP NEONATE CARE,,,880.83,880.83,1
HCPCS,99477,INITIAL HOSP NEONATE 28 D/< NOT CRITICALLY ILL,3080.0,2002.0,1.1,3080.0,144
HCPCS,99477,Init day hosp neonate care,,,68.73,79.59,8
HCPCS,99478,"SBSQ IC VLBW INF<1,500 GM",,,346.88,346.88,1
HCPCS,99478,SUBSEQUENT INTENSIVE CARE INFANT < 1500 GRAMS,1210.0,786.5,1.1,1210.0,144
HCPCS,99478,"Sbsq ic vlbw inf<1,500 gm",,,68.73,79.59,8
HCPCS,99479,"SBSQ IC LBW INF 1,500-2,500",,,315.24,315.24,1
HCPCS,99479,SUBSEQUENT INTENSIVE CARE INFANT 1500-2500 GRAMS,1100.0,715.0,1.1,1100.0,144
HCPCS,99479,"Sbsq ic lbw inf 1,500-2,500",,,68.73,79.59,8
HCPCS,99480,"SBSQ IC INF PBW 2,501-5,000",,,303.02,303.02,1
HCPCS,99480,SUBSEQUENT INTENSIVE CARE INFANT 2501-5000 GRAMS,1056.0,686.4,1.1,1056.0,144
HCPCS,99480,"Sbsq ic inf pbw 2,501-5,000",,,68.73,79.59,8
HCPCS,99483,ASSMT & CARE PLANNING PT W/COGNITIVE IMPAIRMENT,1164.0,756.6,1.1,1690.0,232
HCPCS,99484,CARE MGMT SERVICES BEHAVIORAL HLTH COND 20 MINS,289.0,187.85000000000002,1.1,372.0,214
HCPCS,99485,SUPERVISION INTERFACILITY TRANSPORT INIT 30 MIN,660.0,429.0,1.1,660.0,98
HCPCS,99485,SUPRV INTERFACILTY TRANSPORT,,,190.32,190.32,1
HCPCS,99485,Suprv interfacilty transport,,,68.73,79.59,8
HCPCS,99486,SUPERVISION INTERFACILITY TRANSPORT ADDL 30 MIN,572.0,371.8,1.1,572.0,98
HCPCS,99486,SUPRV INTERFAC TRNSPORT ADDL,,,164.92,164.92,1
HCPCS,99486,Suprv interfac trnsport addl,,,68.73,79.59,8
HCPCS,99487,COMPLX CHRON CARE COORD W/O PT VST 1ST HR PER MO,724.0,470.6,1.1,724.0,134
HCPCS,99487,CPLX CHRNC CARE 1ST 60 MIN,,,138.32,416.23,21
HCPCS,99490,CHRONIC CARE MGMT SVCS STAFF 1ST 20 MIN CAL MO,519.0,337.35,0.01,638.0,215
HCPCS,99491,CHRNC CARE MGMT PHYS 1ST 30,,,196.16,196.16,1
HCPCS,99491,CHRONIC CARE MGMT SVC AT LEAST 30 MIN PER MONTH,600.0,390.0,1.1,600.0,134
HCPCS,99492,1ST PSYCHIATRIC COLLAB CARE MGMT 1ST 70 MINS,732.5,476.125,1.1,827.0,214
HCPCS,99493,SBSQ PSYCHIATRIC COLLAB CARE MGMT 1ST 60 MINS,770.0,500.5,1.1,902.0,214
HCPCS,99494,1ST/SBSQ PSYCH COLLAB CARE MGMT EA ADDL 30 MINS,361.0,234.65,1.1,361.0,136
HCPCS,99495,TRANSJ CARE MGMT MOD MDM F2F 14 CAL D DISCHARGE,1000.5,650.325,0.01,1112.0,221
HCPCS,99496,TRANSJ CARE MGMT HIGH MDM F2F 7 CAL D DISCHARGE,1202.5,781.625,0.01,1516.0,221
HCPCS,99497,ADVANCE CARE PLANNING FIRST 30 MINS,619.0,402.35,0.01,638.0,233
HCPCS,99497,VIRTUAL ADVANCE CARE PLANNING FIRST 30 MIN,600.0,390.0,1.1,600.0,146
HCPCS,99498,ADVANCE CARE PLANNING EA ADDL 30 MINS,329.0,213.85,0.01,560.0,215
HCPCS,99498,VIRTUAL ADVANCE CARE PLANNING EA ADDL 30 MIN,385.0,250.25,1.1,385.0,146
HCPCS,99499,CHAIR MASSAGE (OH),25.0,16.25,5.45,79.59,66
HCPCS,99499,CHART PREP/NO CHARGE,11.0,7.15,2.4,79.59,66
HCPCS,99499,COSMETIC ASSESSMENT,99.0,64.35,0.01,2013999.98,80
HCPCS,99499,COSMETIC CONSULT,250.0,162.5,0.01,2013999.98,80
HCPCS,99499,COSMETIC ESTABLISHED,75.0,48.75,0.01,2013999.98,80
HCPCS,99499,DOT PHYSICAL,75.0,48.75,0.01,2013999.98,80
HCPCS,99499,ECC ADOPTION EVAL ADMIN,209.0,135.85,0.01,2013999.98,80
HCPCS,99499,ECC ADOPTION-GENERAL INFO,157.0,102.05,0.01,2013999.98,80
HCPCS,99499,ECC CHOLESTEROL/BP MG ADM,88.0,57.2,0.01,2013999.98,80
HCPCS,99499,ECC DIABETES/RELATED ADM,88.0,57.2,0.01,2013999.98,80
HCPCS,99499,ECC GASTRO DISORDER ADMIN,88.0,57.2,0.01,2013999.98,80
HCPCS,99499,ECC HEALTHY EATING ADMIN,88.0,57.2,0.01,2013999.98,80
HCPCS,99499,ECC HEALTHY LIFESTYLE ADM,43.0,27.95,0.01,2013999.98,80
HCPCS,99499,ECC NUTRIT SUPP/OTHER ADM,43.0,27.95,0.01,2013999.98,80
HCPCS,99499,ECC NUTRITION (CONSUMER) ADMIN,110.0,71.5,0.01,2013999.98,80
HCPCS,99499,ECC NUTRITION (CONSUMER) CLINICAL,135.0,87.75,0.01,2013999.98,80
HCPCS,99499,ECC NUTRITION (EXT CORP) ADMIN,101.0,65.65,0.01,2013999.98,80
HCPCS,99499,ECC NUTRITION (EXT CORP) CLINICAL,124.0,80.6,0.01,2013999.98,80
HCPCS,99499,ECC NUTRITION (INT CORP)  ADMIN,88.0,57.2,0.01,2013999.98,80
HCPCS,99499,ECC NUTRITION (INT CORP) CLINICAL,107.0,69.55,0.01,2013999.98,80
HCPCS,99499,ECC PLSTC SURG COSM CNSLT,75.0,48.75,0.01,2013999.98,80
HCPCS,99499,ECC SECONDARY PREVENT ADM,88.0,57.2,0.01,2013999.98,80
HCPCS,99499,ECC SPORT NUTRITION ADMIN,88.0,57.2,0.01,2013999.98,80
HCPCS,99499,ECC VEG DIETS ADMIN,88.0,57.2,0.01,2013999.98,80
HCPCS,99499,ECC WEIGHT MGMT ADMIN,88.0,57.2,0.01,2013999.98,80
HCPCS,99499,ECLEVELANDCLINIC SECOND OPINION LEV,311.0,202.15,0.01,2013999.98,80
HCPCS,99499,EMPLOYEE MASSAGE,75.0,48.75,0.01,2013999.98,80
HCPCS,99499,EMPLOYEE MASSAGE (COMP 99499RVU1),75.0,48.75,16.35,79.59,66
HCPCS,99499,EST VIRTUAL VISIT RESEARCH,83.28,54.13,0.01,2013999.98,80
HCPCS,99499,MIND BODY COACHING,50.0,32.5,0.01,2013999.98,80
HCPCS,99499,NEW PATIENT OFFICE VISIT SELF PAY,3000.0,1950.0,0.01,2013999.98,80
HCPCS,99499,REASSESMENT NUTRITION THERAPY 61-75 MIN,36.0,23.4,0.01,2013999.98,80
HCPCS,99499,RENEW GROUP COACHING - CHAGRIN FALLS,900.0,585.0,0.01,2013999.98,80
HCPCS,99499,RENEW GROUP COACHING - MAIN CAMPUS,1020.0,663.0,0.01,2013999.98,80
HCPCS,99499,RESEARCH CHART REVIEW 1,65.0,42.25,0.01,2013999.98,80
HCPCS,99499,SHARED ACUPUNT MED APPT (COMP 9800346),50.0,32.5,10.9,79.59,66
HCPCS,99499,SPORTS EXAM OR PHYSICAL,35.0,22.75,0.01,2013999.98,80
HCPCS,99499,TAI CHI (COMP 9800833),75.0,48.75,16.35,79.59,66
HCPCS,99499,WELLNESS YOGA - (GROUP) (COMP 9800929),10.0,6.5,2.18,79.59,66
HCPCS,99499,WELLNESS YOGA EHP (COMP 9800939),30.0,19.5,6.54,79.59,66
HCPCS,99500,HOME VISIT PRENATAL,,,156.18,156.18,1
HCPCS,99501,HOME VISIT POSTNATAL,,,2739849.3,2739849.3,1
HCPCS,99502,HOME VISIT NB CARE,,,2739849.3,2739849.3,1
HCPCS,99503,HOME VISIT RESP THERAPY,,,92.48,92.48,1
HCPCS,99504,HOME VISIT MECH VENTILATOR,,,2739849.3,2739849.3,1
HCPCS,99505,HOME VISIT STOMA CARE,,,2739849.3,2739849.3,1
HCPCS,99506,HOME VISIT IM INJECTION,,,307.43,307.43,1
HCPCS,99507,HOME VISIT CATH MAINTAIN,,,2739849.3,2739849.3,1
HCPCS,99509,HOME VISIT DAY LIFE ACTIVITY,,,2739849.3,2739849.3,1
HCPCS,99510,HOME VISIT SING/M/FAM COUNS,,,1380.08,1380.08,1
HCPCS,99511,HOME VISIT FECAL/ENEMA MGMT,,,2739849.3,2739849.3,1
HCPCS,99512,HOME VISIT FOR HEMODIALYSIS,,,2739849.3,2739849.3,1
HCPCS,99600,UNLISTED HOME VISIT SVC/PX,,,2739999.97,2739999.97,1
HCPCS,99601,HOME NFS VISIT <2 HRS,,,208.24,208.24,1
HCPCS,99602,HOME NFS VISIT EACH ADDL HR,,,104.12,104.12,1
HCPCS,99605,MTMS BY PHARM NP 15 MIN,,,231.45,231.45,1
HCPCS,99605,Mtms by pharm np 15 min,,,63.76,73.83,8
HCPCS,99606,MTMS BY PHARM EST 15 MIN,,,2739849.3,2739849.3,1
HCPCS,99606,Mtms by pharm est 15 min,,,63.76,73.83,8
HCPCS,99607,MTMS BY PHARM ADDL 15 MIN,,,231.45,231.45,1
HCPCS,99607,Mtms by pharm addl 15 min,,,63.76,73.83,8
HCPCS,99999,ACUPRESSURE - ESTABLISHED PATIENT,75.0,48.75,1.1,75.0,68
HCPCS,99999,ACUPRESSURE - NEW PATIENT,150.0,97.5,1.1,150.0,68
HCPCS,99999,ASYNCH EVISIT EXPRESS / ACUTE,20.0,13.0,1.1,20.0,68
HCPCS,99999,BARIATRIC SURGERY SELF-PAY PACKAGE,25000.0,16250.0,1.1,25000.0,68
HCPCS,99999,CULINARY CONSULT,200.0,130.0,43.6,200.0,59
HCPCS,99999,CULINARY CONSULT 60 MIN,200.0,130.0,1.1,200.0,68
HCPCS,99999,EVISIT,35.0,22.75,1.1,35.0,68
HCPCS,99999,FLUZONE HIGH DOSE,75.0,48.75,1.1,75.0,68
HCPCS,99999,GENETIC COUNSELING VIRTUAL VISIT (SELF PAY),159.0,103.35,34.66,159.0,58
HCPCS,99999,HEALTHCOACH EST OFFICE VISIT 30 MIN,30.0,19.5,1.1,30.0,68
HCPCS,99999,HEALTHCOACH EST PHONE / VIRTUAL VISIT 30 MIN,30.0,19.5,1.1,30.0,68
HCPCS,99999,NUTRIGENOMIX CONSULTS PHONE OR IN PERSON $200,200.0,130.0,1.1,200.0,68
HCPCS,99999,NUTRIGENOMIX VISIT,95.0,61.75,1.1,95.0,68
HCPCS,99999,NUTRITIONIST PHONE VISIT 30 MIN,100.0,65.0,1.1,100.0,68
HCPCS,99999,NUTRITIONIST VIRTUAL PHONE NEW ($240.00),240.0,156.0,1.1,240.0,68
HCPCS,99999,ONLINE BASIC REVIEW,20.0,13.0,1.1,20.0,68
HCPCS,99999,ONLINE BASIC TRTMNT PLAN,55.0,35.75,1.1,55.0,68
HCPCS,99999,ONLINE CMPLX TRTMNT PLAN,200.0,130.0,1.1,200.0,68
HCPCS,99999,ONLINE COMPLEX REVIEW,300.0,195.0,1.1,300.0,68
HCPCS,99999,ONLINE EXT TRTMNT PLAN,300.0,195.0,1.1,300.0,68
HCPCS,99999,ONLINE EXTENSIVE REVIEW,200.0,130.0,1.1,200.0,68
HCPCS,99999,ONLINE INTERMED TRTMNT PL,250.0,162.5,1.1,250.0,68
HCPCS,99999,ONLINE INTERMEDIATE RVW,150.0,97.5,1.1,150.0,68
HCPCS,99999,ONLINE MODERATE PLAN,100.0,65.0,1.1,100.0,68
HCPCS,99999,ONLINE MODERATE REVIEW,75.0,48.75,1.1,75.0,68
HCPCS,99999,ONLINE SAMSUNG URG CARE,59.0,38.35,1.1,59.0,68
HCPCS,99999,ONLINE SIMPLE REVIEW,55.0,35.75,1.1,55.0,68
HCPCS,99999,ONLINE SIMPLE TRTMNT PLAN,150.0,97.5,1.1,150.0,68
HCPCS,99999,PHONE CONSULTS $200,200.0,130.0,1.1,200.0,68
HCPCS,99999,SELF-PAY  INJECTION,33.0,21.45,1.1,33.0,68
HCPCS,99999,SELF-PAY ADDITIONAL INJECTION,16.0,10.4,1.1,16.0,68
HCPCS,99999,SHARED NUTRITION NUTRIGENOMICS APPT,50.0,32.5,1.1,50.0,68
HCPCS,99999,SHRINGRIX,505.0,328.25,1.1,505.0,68
HCPCS,99999,TETANUS,62.0,40.3,1.1,62.0,68
HCPCS,99999,VIP NUTRITION VISIT,200.0,130.0,1.1,200.0,68
HCPCS,99999,VIRTUAL VISIT 25 MINS,200.0,130.0,1.1,200.0,68
HCPCS,99999,VIRTUAL VISIT 45 MINS,400.0,260.0,1.1,400.0,68
HCPCS,99999,VIRTUAL VISIT 60 MINS,550.0,357.5,1.1,550.0,68
HCPCS,99999,VIRTUAL VISIT SAMSUNG,59.0,38.35,1.1,59.0,68
HCPCS,99999,WELLNESS SELF PAY VISIT,1500.0,975.0,1.1,1500.0,68
HCPCS,99999IVI,IMAGING VIDEO INTERPRETATION,40.0,26.0,1.1,40.0,68
HCPCS,99999IVR,IMAGING VIDEO REPORT LEVEL 1,20.0,13.0,1.1,20.0,68
HCPCS,99999IVR,IMAGING VIDEO REPORT LEVEL 2,40.0,26.0,1.1,40.0,68
HCPCS,99999IVR,IMAGING VIDEO REPORT LEVEL 3,90.0,58.5,1.1,90.0,68
HCPCS,A0021,Outside state ambulance serv,,,178.1,178.1,1
HCPCS,A0080,Noninterest escort in non er,,,10.96,10.96,1
HCPCS,A0090,Interest escort in non er,,,10.96,10.96,1
HCPCS,A0100,Nonemergency transport taxi,,,54.8,54.8,1
HCPCS,A0110,Nonemergency transport bus,,,13.7,13.7,1
HCPCS,A0120,Noner transport mini-bus,,,123.3,123.3,1
HCPCS,A0130,Noner transport wheelch van,,,104.12,104.12,1
HCPCS,A0140,Nonemergency transport air,,,3288.0,3288.0,1
HCPCS,A0160,Noner transport case worker,,,13.7,13.7,1
HCPCS,A0170,Transport parking fees/tolls,,,13.7,13.7,1
HCPCS,A0180,Noner transport lodgng recip,,,13.7,13.7,1
HCPCS,A0190,Noner transport meals recip,,,27.4,27.4,1
HCPCS,A0200,Noner transport lodgng escrt,,,274.0,274.0,1
HCPCS,A0210,Noner transport meals escort,,,27.4,27.4,1
HCPCS,A0225,Neonatal emergency transport,,,3633.24,3633.24,1
HCPCS,A0380,Basic life support mileage,,,27.7,27.7,1
HCPCS,A0382,Basic support routine suppls,,,41.1,41.1,1
HCPCS,A0384,Bls defibrillation supplies,,,60.28,60.28,1
HCPCS,A0390,Advanced life support mileag,,,27.7,27.7,1
HCPCS,A0392,Als defibrillation supplies,,,41.1,41.1,1
HCPCS,A0394,Als iv drug therapy supplies,,,109.6,109.6,1
HCPCS,A0396,Als esophageal intub suppls,,,137.0,137.0,1
HCPCS,A0398,Als routine disposble suppls,,,41.1,41.1,1
HCPCS,A0420,Ambulance waiting 1/2 hr,,,68.5,68.5,1
HCPCS,A0422,Ambulance 02 life sustaining,,,137.0,137.0,1
HCPCS,A0424,Extra ambulance attendant,,,109.6,109.6,1
HCPCS,A0425,Ground mileage,,,37.07,37.07,1
HCPCS,A0426,Als 1,,,856.77,856.77,1
HCPCS,A0427,Als1-emergency,,,1356.57,1356.57,1
HCPCS,A0428,Bls,,,713.99,713.99,1
HCPCS,A0429,Bls-emergency,,,1142.36,1142.36,1
HCPCS,A0430,Fixed wing air transport,,,9679.46,9679.46,1
HCPCS,A0431,Rotary wing air transport,,,11253.84,11253.84,1
HCPCS,A0432,Pi volunteer ambulance co,,,1249.47,1249.47,1
HCPCS,A0433,Als 2,,,1963.43,1963.43,1
HCPCS,A0434,Specialty care transport,,,2320.42,2320.42,1
HCPCS,A0435,Fixed wing air mileage,,,28.77,28.77,1
HCPCS,A0436,Rotary wing air mileage,,,76.69,76.69,1
HCPCS,A0888,Noncovered ambulance mileage,,,27.7,27.7,1
HCPCS,A0998,Ambulance response/treatment,,,438.4,438.4,1
HCPCS,A0999,Unlisted ambulance service,,,2739999.97,2739999.97,1
HCPCS,A2001,"Innovamatrix ac, per sq cm",,,117.73,3420.0,19
HCPCS,A200100,"Innovamatrix ac, per sq cm",,,2670.0,3420.0,3
HCPCS,A2002,Mirragen adv wnd mat per sq,,,117.73,650.31,16
HCPCS,A2004,"Xcellistem, 1 mg",,,11.14,35.57,15
HCPCS,A200400,"Xcellistem, 1 mg",,,27.77,35.57,3
HCPCS,A2005,"Microlyte matrix, per sq cm",,,117.73,547.33,16
HCPCS,A2006,Novosorb synpath per sq cm,,,117.73,129.51,12
HCPCS,A2007,"Restrata, per sq cm",,,117.73,551.76,19
HCPCS,A200700,"Restrata, per sq cm",,,430.76,551.76,3
HCPCS,A2008,"Theragenesis, per sq cm",,,117.73,405.77,19
HCPCS,A200800,"Theragenesis, per sq cm",,,316.79,405.77,3
HCPCS,A2009,"Symphony, per sq cm",,,117.73,269.12,16
HCPCS,A2010,"Apis, per square centimeter",,,117.73,5482.5,14
HCPCS,A2011,"Supra sdrm, per sq cm",,,117.73,1275.41,20
HCPCS,A2012,"Suprathel, per sq cm",,,117.73,1275.41,20
HCPCS,A2013,"Innovamatrix fs, per sq cm",,,117.73,3693.6,27
HCPCS,A201300,"Innovamatrix fs, per sq cm",,,2883.6,3693.6,3
HCPCS,A2014,Omeza collag compl 100 mg,,,153.19,350.55,7
HCPCS,A2014,Omeza collag per 100 mg,,,1101.49,1275.41,8
HCPCS,A201400,Omeza collag compl 100 mg,,,273.68,350.55,3
HCPCS,A2015,"Phoenix wnd mtrx, per sq cm",,,117.73,3093.12,24
HCPCS,A2016,"Permeaderm b, per sq cm",,,117.73,1275.41,20
HCPCS,A2017,"Permeaderm glove, each",,,1101.49,1275.41,8
HCPCS,A2018,"Permeaderm c, per sq cm",,,117.73,1275.41,20
HCPCS,A2019,Kerecis marigen shld sq cm,,,117.73,1629.01,19
HCPCS,A201900,Kerecis marigen shld sq cm,,,1271.77,1629.01,3
HCPCS,A2021,Neomatrix per sq cm,,,117.73,4717.48,19
HCPCS,A202100,Neomatrix per sq cm,,,3682.94,4717.48,3
HCPCS,A2022,Innovabrn/innovamatx xl sqcm,,,117.73,3898.8,19
HCPCS,A202200,Innovabrn/innovamatx xl sqcm,,,3043.8,3898.8,3
HCPCS,A2023,"Innovamatrix pd, 1 mg",,,31.99,44.46,7
HCPCS,A202300,"Innovamatrix pd, 1 mg",,,34.71,44.46,3
HCPCS,A2024,Resolve or xenopatch sq cm,,,117.73,4172.7,16
HCPCS,A2025,Miro3d per cubic cm,,,117.73,570.0,19
HCPCS,A202500,Miro3d per cubic cm,,,445.0,570.0,3
HCPCS,A2027,Matriderm per sq cm,,,117.73,129.51,12
HCPCS,A2028,Micromatrix flex per mg,,,1671.21,2140.65,5
HCPCS,A202800,Micromatrix flex per mg,,,1671.21,2140.65,3
HCPCS,A2029,Mirotract matrix sheet,,,117.73,1140.0,17
HCPCS,A202900,Mirotract matrix sheet,,,890.0,1140.0,3
HCPCS,A2030,"Miro3d fibers, per mg",,,9.79,12.54,5
HCPCS,A203000,"Miro3d fibers, per mg",,,9.79,12.54,3
HCPCS,A2031,"Mirodry, per sq cm",,,117.73,1368.0,17
HCPCS,A203100,"Mirodry, per sq cm",,,1068.0,1368.0,3
HCPCS,A2032,"Myriad matrix, per sq cm",,,36.85,47.2,5
HCPCS,A203200,"Myriad matrix, per sq cm",,,36.85,47.2,3
HCPCS,A2033,"Myriad morcells, 4 mg",,,23.5,30.1,5
HCPCS,A203300,"Myriad morcells, 4 mg",,,23.5,30.1,3
HCPCS,A2036,Cohealyx col dml mx pr sq cm,,,117.73,129.51,12
HCPCS,A2038,"Marigen pacto, per sq cm",,,117.73,129.51,12
HCPCS,A2039,"Innovamatrix fd, per sq cm",,,117.73,129.51,12
HCPCS,A4100,Nosht skin sub fda clrd nos,,,1101.49,1275.41,8
HCPCS,A4206,1 cc sterile syringe&needle,,,16.97,19.65,8
HCPCS,A4207,2 cc sterile syringe&needle,,,16.97,19.65,8
HCPCS,A4208,3 cc sterile syringe&needle,,,16.97,19.65,8
HCPCS,A4209,5+ cc sterile syringe&needle,,,16.97,19.65,8
HCPCS,A4210,Nonneedle injection device,,,0.9,19.65,9
HCPCS,A4211,Supp for self-adm injections,,,16.97,19.65,8
HCPCS,A4212,Non coring needle or stylet,,,16.97,19.65,8
HCPCS,A4213,20+ cc syringe only,,,16.97,19.65,8
HCPCS,A4215,BIOPINCE FULL CORE BIOPSY INST 18GA 10CM BX/5,292.5,190.13,16.97,292.5,67
HCPCS,A4215,BIOPINCE FULL CORE BIOPSY INSTR 18GA 15CM BX/5,292.5,190.13,16.97,292.5,67
HCPCS,A4215,FULL CORE BIOPSY INSTRUMENT CA/5,292.5,190.13,16.97,292.5,67
HCPCS,A4215,STERILE NEEDLE,9.0,5.85,0.24,9.0,80
HCPCS,A4216,"Sterile water/saline, 10 ml",,,16.97,19.65,8
HCPCS,A4217,"Sterile water/saline, 500 ml",,,16.97,19.65,8
HCPCS,A4218,Sterile saline or water,,,16.97,19.65,8
HCPCS,A4220,Infusion pump refill kit,,,11.14,12.9,8
HCPCS,A4221,Supp non-insulin inf cath/wk,,,11.14,12.9,8
HCPCS,A4222,SUPPLIES DRUG INFSN PUMP/CASS,69.75,45.34,15.21,69.75,66
HCPCS,A4223,Infusion supplies w/o pump,,,16.97,19.65,8
HCPCS,A4224,Supply insulin inf cath/wk,,,16.97,19.65,8
HCPCS,A4225,Sup/ext insulin inf pump syr,,,16.97,19.65,8
HCPCS,A4226,Weekly supply maint cgs pump,,,16.97,2739849.3,9
HCPCS,A4230,Infus insulin pump non needl,,,846.64,980.32,8
HCPCS,A4231,Infusion insulin pump needle,,,50.71,385.65,11
HCPCS,A423100,Infusion insulin pump needle,,,50.71,64.96,3
HCPCS,A4232,Syringe w/needle insulin 3cc,,,5.89,19.65,9
HCPCS,A4233,Alkalin batt for glucose mon,,,1.4,19.65,9
HCPCS,A4234,J-cell batt for glucose mon,,,6.47,19.65,9
HCPCS,A4235,Lithium batt for glucose mon,,,2.74,19.65,9
HCPCS,A4236,Silvr oxide batt glucose mon,,,3.18,19.65,9
HCPCS,A4238,Adju cgm supply allowance,,,58.52,736.4,9
HCPCS,A4239,Non-adju cgm supply allow,,,58.52,716.89,9
HCPCS,A4244,Alcohol or peroxide per pint,,,16.97,19.65,8
HCPCS,A4245,Alcohol wipes per box,,,16.97,19.65,8
HCPCS,A4246,Betadine/phisohex solution,,,16.97,19.65,8
HCPCS,A4247,Betadine/iodine swabs/wipes,,,11.14,12.9,8
HCPCS,A4248,Chlorhexidine antisept,,,0.05,19.65,13
HCPCS,A424800,Chlorhexidine antisept,,,0.05,0.07,3
HCPCS,A4250,URINE REAGENT STRIPS/TABLETS,35.0,22.75,1.1,69.1,86
HCPCS,A4250,Urine reagent strips/tablets,,,16.97,49.65,9
HCPCS,A4252,Blood ketone test or strip,,,16.97,83.32,9
HCPCS,A4253,Blood glucose/reagent strips,,,16.97,19.65,8
HCPCS,A4255,Glucose monitor platforms,,,16.97,19.65,8
HCPCS,A4256,Calibrator solution/chips,,,11.14,12.9,8
HCPCS,A4257,Replace lensshield cartridge,,,11.14,47.7,9
HCPCS,A4258,Lancet device each,,,11.14,12.9,8
HCPCS,A4259,Lancets per box,,,16.97,19.65,8
HCPCS,A4261,Cervical cap contraceptive,,,11.14,78.97,9
HCPCS,A4262,Temporary tear duct plug,,,16.97,19.65,8
HCPCS,A4263,PERMANENT TEAR DUCT PLUG,14.0,9.1,1.1,78.43,86
HCPCS,A4263,Permanent tear duct plug,,,11.14,12.9,8
HCPCS,A4264,PR INTRATUBAL OCCLUSION DEVICE,3000.0,1950.0,1.1,6709.71,80
HCPCS,A4264,"PROSTH IMPL, NOS",3000.0,1950.0,200.93,3000.0,76
HCPCS,A4265,Paraffin,,,16.97,19.65,8
HCPCS,A4266,DIAPHRAGM,78.27,50.88,1.1,97.95,80
HCPCS,A4266,DIAPHRAGM MILEX,68.5,44.53,14.93,68.5,67
HCPCS,A4267,Male condom,,,16.97,41.07,9
HCPCS,A4268,FEMALE CONDOM,69.0,44.85,1.1,69.0,80
HCPCS,A4268,Female condom,,,0.63,19.65,9
HCPCS,A4269,Spermicide,,,16.97,2739849.3,9
HCPCS,A4270,Disposable endoscope sheath,,,36.52,42.28,8
HCPCS,A4271,Home lancing/test cartridges,,,16.97,19.65,8
HCPCS,A4280,Brst prsths adhsv attchmnt,,,16.97,19.65,8
HCPCS,A4281,Replacement breastpump tube,,,21.56,42.28,9
HCPCS,A4282,Replacement breastpump adpt,,,30.14,42.28,9
HCPCS,A4283,Replacement breastpump cap,,,10.63,42.28,9
HCPCS,A4284,Replcmnt breast pump shield,,,18.55,42.28,9
HCPCS,A4285,Replcmnt breast pump bottle,,,21.84,36.7,9
HCPCS,A4286,Replcmnt breastpump lok ring,,,14.39,42.28,9
HCPCS,A4287,Disp col sto bag breast milk,,,11.14,2739849.3,9
HCPCS,A4288,Replacement breastpump valve,,,16.97,19.65,8
HCPCS,A4290,Sacral nerve stim test lead,,,16.97,19.65,8
HCPCS,A4295,Straigh tip hydrophilic cath,,,16.97,19.65,8
HCPCS,A4296,Coude tip hydrophilic cath,,,16.97,19.65,8
HCPCS,A4297,Hydrophilic coat insert sup,,,16.97,19.65,8
HCPCS,A4300,Cath impl vasc access portal,,,11.14,12.9,8
HCPCS,A4301,Implantable access syst perc,,,11.14,12.9,8
HCPCS,A4305,Drug delivery system >=50 ml,,,11.14,12.9,8
HCPCS,A4306,Drug delivery system <=50 ml,,,11.14,12.9,8
HCPCS,A4310,Insert tray w/o bag/cath,,,16.97,19.65,8
HCPCS,A4311,Catheter w/o bag 2-way latex,,,11.14,12.9,8
HCPCS,A4312,Cath w/o bag 2-way silicone,,,11.14,12.9,8
HCPCS,A4313,Catheter w/bag 3-way,,,11.14,12.9,8
HCPCS,A4314,Cath w/drainage 2-way latex,,,36.52,42.28,8
HCPCS,A4315,Cath w/drainage 2-way silcne,,,36.52,42.28,8
HCPCS,A4316,Cath w/drainage 3-way,,,36.52,42.28,8
HCPCS,A4318,Fem urinary cup w/wo attch,,,16.97,19.65,8
HCPCS,A4320,Irrigation tray,,,16.97,19.65,8
HCPCS,A4321,Cath therapeutic irrig agent,,,16.97,19.65,8
HCPCS,A4322,Irrigation syringe,,,16.97,19.65,8
HCPCS,A4326,Male external catheter,,,11.14,12.9,8
HCPCS,A4327,Fem urinary collect dev cup,,,36.52,42.28,8
HCPCS,A4328,Fem urinary collect pouch,,,16.97,19.65,8
HCPCS,A4330,Stool collection pouch,,,16.97,19.65,8
HCPCS,A4331,Extension drainage tubing,,,16.97,19.65,8
HCPCS,A4332,Lube sterile packet,,,16.97,19.65,8
HCPCS,A4333,Urinary cath anchor device,,,16.97,19.65,8
HCPCS,A4334,Urinary cath leg strap,,,16.97,19.65,8
HCPCS,A4335,Incontinence supply,,,16.97,19.65,8
HCPCS,A4336,Urethral insert,,,16.97,19.65,8
HCPCS,A4337,Incontinent rectal insert,,,16.97,19.65,8
HCPCS,A4338,INDWELLING CATHETER LATEX,17.0,11.05,1.1,56.38,90
HCPCS,A4338,Indwelling catheter latex,,,11.14,12.9,8
HCPCS,A4340,INDWELLING CATHETER SPECIAL,45.0,29.25,1.1,124.0,90
HCPCS,A4340,Indwelling catheter special,,,36.52,42.28,8
HCPCS,A4341,Iduc valve pat inst repl,,,36.52,912.26,9
HCPCS,A4342,Iduc valve sply repl,,,11.14,12.9,8
HCPCS,A4344,CATH INDW FOLEY 2 WAY SILICN,23.0,14.95,1.1,73.56,90
HCPCS,A4344,Cath indw foley 2 way silicn,,,11.14,12.9,8
HCPCS,A4346,Cath indw foley 3 way,,,16.97,19.65,8
HCPCS,A4349,Disposable male external cat,,,16.97,19.65,8
HCPCS,A4351,STRAIGHT TIP URINE CATHETER,2.0,1.3,0.51,7.81,90
HCPCS,A4351,Straight tip urine catheter,,,16.97,19.65,8
HCPCS,A4352,COUDE TIP URINARY CATHETER,10.0,6.5,1.1,25.09,90
HCPCS,A4352,Coude tip urinary catheter,,,16.97,19.65,8
HCPCS,A4353,Intermittent urinary cath,,,16.97,19.65,8
HCPCS,A4354,Cath insertion tray w/bag,,,11.14,12.9,8
HCPCS,A4355,Bladder irrigation tubing,,,16.97,19.65,8
HCPCS,A4356,EXT URETH CLMP OR COMPR DVC,10.0,6.5,1.1,209.67,90
HCPCS,A4356,Ext ureth clmp or compr dvc,,,36.52,42.28,8
HCPCS,A4357,BEDSIDE DRAINAGE BAG,14.0,9.1,1.1,44.6,90
HCPCS,A4357,Bedside drainage bag,,,16.97,19.65,8
HCPCS,A4358,URINARY LEG BAG,9.0,5.85,1.1,30.48,90
HCPCS,A4358,Urinary leg or abdomen bag,,,16.97,19.65,8
HCPCS,A4360,Disposable ext urethral dev,,,16.97,19.65,8
HCPCS,A4361,Ostomy face plate,,,11.14,12.9,8
HCPCS,A4362,Solid skin barrier,,,16.97,19.65,8
HCPCS,A4363,"Ostomy clamp, replacement",,,8.85,19.65,9
HCPCS,A4364,OSTOMY/CATH ADHESIVE,10.5,6.83,2.29,19.65,66
HCPCS,A4366,Ostomy vent,,,16.97,19.65,8
HCPCS,A4367,Ostomy belt,,,16.97,19.65,8
HCPCS,A4368,Ostomy filter,,,16.97,19.65,8
HCPCS,A4369,Skin barrier liquid per oz,,,16.97,19.65,8
HCPCS,A4371,Skin barrier powder per oz,,,16.97,19.65,8
HCPCS,A4372,Skin barrier solid 4x4 equiv,,,16.97,19.65,8
HCPCS,A4373,Skin barrier with flange,,,16.97,19.65,8
HCPCS,A4375,Drainable plastic pch w fcpl,,,11.14,12.9,8
HCPCS,A4376,Drainable rubber pch w fcplt,,,36.52,42.28,8
HCPCS,A4377,Drainable plstic pch w/o fp,,,16.97,19.65,8
HCPCS,A4378,Drainable rubber pch w/o fp,,,36.52,42.28,8
HCPCS,A4379,Urinary plastic pouch w fcpl,,,11.14,12.9,8
HCPCS,A4380,Urinary rubber pouch w fcplt,,,36.52,42.28,8
HCPCS,A4381,Urinary plastic pouch w/o fp,,,16.97,19.65,8
HCPCS,A4382,Urinary hvy plstc pch w/o fp,,,11.14,12.9,8
HCPCS,A4383,Urinary rubber pouch w/o fp,,,36.52,42.28,8
HCPCS,A4384,Ostomy faceplt/silicone ring,,,16.97,19.65,8
HCPCS,A4385,Ost skn barrier sld ext wear,,,16.97,19.65,8
HCPCS,A4387,Ost clsd pouch w att st barr,,,16.97,19.65,8
HCPCS,A4388,Drainable pch w ex wear barr,,,16.97,19.65,8
HCPCS,A4389,Drainable pch w st wear barr,,,16.97,19.65,8
HCPCS,A4390,Drainable pch ex wear convex,,,16.97,19.65,8
HCPCS,A4391,Urinary pouch w ex wear barr,,,16.97,19.65,8
HCPCS,A4392,Urinary pouch w st wear barr,,,16.97,19.65,8
HCPCS,A4393,Urine pch w ex wear bar conv,,,16.97,19.65,8
HCPCS,A4394,Ostomy pouch liq deodorant,,,16.97,19.65,8
HCPCS,A4395,Ostomy pouch solid deodorant,,,16.97,19.65,8
HCPCS,A4396,Peristomal hernia supprt blt,,,36.52,42.28,8
HCPCS,A4397,Irrigation supply sleeve,,,16.97,19.65,8
HCPCS,A4398,Ostomy irrigation bag,,,11.14,12.9,8
HCPCS,A4399,Ostomy irrig cone/cath w brs,,,11.14,12.9,8
HCPCS,A4400,Ostomy irrigation set,,,31.69,36.7,8
HCPCS,A4402,Lubricant per ounce,,,16.97,19.65,8
HCPCS,A4404,Ostomy ring each,,,16.97,19.65,8
HCPCS,A4405,Nonpectin based ostomy paste,,,16.97,19.65,8
HCPCS,A4406,STOMAHESIVE PAST-CONVATEC,6.7,4.36,1.46,19.65,74
HCPCS,A4407,"Ext wear ost skn barr <=4sq""",,,16.97,19.65,8
HCPCS,A4408,"Ext wear ost skn barr >4sq""",,,16.97,19.65,8
HCPCS,A4409,Ost skn barr convex <=4 sq i,,,16.97,19.65,8
HCPCS,A4410,Ost skn barr extnd >4 sq,,,16.97,19.65,8
HCPCS,A4411,Ost skn barr extnd =4sq,,,16.97,19.65,8
HCPCS,A4412,Ost pouch drain high output,,,16.97,19.65,8
HCPCS,A4413,2 pc drainable ost pouch,,,16.97,19.65,8
HCPCS,A4414,Ost sknbar w/o conv<=4 sq in,,,16.97,19.65,8
HCPCS,A4415,Ost skn barr w/o conv >4 sqi,,,16.97,19.65,8
HCPCS,A4416,Ost pch clsd w barrier/filtr,,,16.97,19.65,8
HCPCS,A4417,Ost pch w bar/bltinconv/fltr,,,16.97,19.65,8
HCPCS,A4418,Ost pch clsd w/o bar w filtr,,,16.97,19.65,8
HCPCS,A4419,Ost pch for bar w flange/flt,,,16.97,19.65,8
HCPCS,A4420,Ost pch clsd for bar w lk fl,,,16.97,19.65,8
HCPCS,A4421,BAG HANGER,1.04,0.68,0.23,19.65,67
HCPCS,A4421,OSTOMY SUPPLY MISC,23.0,14.95,0.01,23.0,80
HCPCS,A4422,Ost pouch absorbent material,,,16.97,19.65,8
HCPCS,A4423,Ost pch for bar w lk fl/fltr,,,16.97,19.65,8
HCPCS,A4424,Ost pch drain w bar & filter,,,16.97,19.65,8
HCPCS,A4425,Ost pch drain for barrier fl,,,16.97,19.65,8
HCPCS,A4426,Ost pch drain 2 piece system,,,16.97,19.65,8
HCPCS,A4427,Ost pch drain/barr lk flng/f,,,16.97,19.65,8
HCPCS,A4428,Urine ost pouch w faucet/tap,,,16.97,19.65,8
HCPCS,A4429,Urine ost pouch w bltinconv,,,16.97,19.65,8
HCPCS,A4430,Ost urine pch w b/bltin conv,,,16.97,19.65,8
HCPCS,A4431,Ost pch urine w barrier/tapv,,,16.97,19.65,8
HCPCS,A4432,Os pch urine w bar/fange/tap,,,16.97,19.65,8
HCPCS,A4433,Urine ost pch bar w lock fln,,,16.97,19.65,8
HCPCS,A4434,Ost pch urine w lock flng/ft,,,16.97,19.65,8
HCPCS,A4435,1pc ost pch drain hgh output,,,16.97,19.65,8
HCPCS,A4436,Irr supply sleev reus per mo,,,9.17,19.65,11
HCPCS,A443600,Irr supply sleev reus per mo,,,9.17,11.74,3
HCPCS,A4437,Irr supply sleev disp per mo,,,7.4,19.65,11
HCPCS,A443700,Irr supply sleev disp per mo,,,7.4,9.48,3
HCPCS,A4438,Adhesive clip ext ens contr,,,16.97,19.65,8
HCPCS,A4450,MEFIX TAPE-MOLNYCKE,8.91,5.79,1.94,19.65,66
HCPCS,A4452,PINK TAPE-PERMATYPE,3.24,2.11,0.71,19.65,66
HCPCS,A4452,WATERPROOF TAPE,84.04,54.63,0.34,84.04,90
HCPCS,A4453,"Rec cath any transanal, each",,,11.14,12.9,8
HCPCS,A4455,Adhesive remover per ounce,,,16.97,19.65,8
HCPCS,A4456,"Adhesive remover, wipes",,,16.97,19.65,8
HCPCS,A4457,Enema tube any type repl,,,16.97,2739849.3,9
HCPCS,A4458,Reusable enema bag,,,16.97,19.65,8
HCPCS,A4459,"Transanal irrigation, any",,,16.97,19.65,8
HCPCS,A4461,Surgicl dress hold non-reuse,,,16.97,19.65,8
HCPCS,A4463,Surgical dress holder reuse,,,11.14,12.9,8
HCPCS,A4465,Non-elastic extremity binder,,,16.97,19.65,8
HCPCS,A4467,KNEE / DELUX,33.58,21.83,7.32,33.58,74
HCPCS,A4467,KNEE/ DELUXE,33.58,21.83,7.32,33.58,67
HCPCS,A4467,NEOPRENE ELBOW SUPPORT,22.0,14.3,4.8,22.0,67
HCPCS,A4467,WRIST SPLINT THUMB SPICA,172.0,111.8,16.97,172.0,74
HCPCS,A4468,Exsuff belt incl all sup acc,,,1288.13,2739849.3,9
HCPCS,A4470,Gravlee jet washer,,,16.97,19.65,8
HCPCS,A4479,"Electro pump enema, reusable",,,1288.13,1491.52,8
HCPCS,A4480,Vabra aspirator,,,16.97,19.65,8
HCPCS,A4481,Tracheostoma filter,,,16.97,19.65,8
HCPCS,A4483,Moisture exchanger,,,16.97,19.65,8
HCPCS,A4490,Above knee surgical stocking,,,11.14,43.84,9
HCPCS,A4495,Thigh length surg stocking,,,16.97,49.32,9
HCPCS,A4500,Below knee surgical stocking,,,16.97,24.66,9
HCPCS,A4510,Full length surg stocking,,,36.52,54.8,9
HCPCS,A4520,Incontinence garment anytype,,,0.82,19.65,9
HCPCS,A4540,Trans elec nerv periph nerv,,,91.28,2739849.3,9
HCPCS,A4541,Monthly supp use with e0733,,,36.52,107.74,9
HCPCS,A4542,Supp ext up limb tremor stim,,,36.52,1382.08,9
HCPCS,A4543,Supply trans elec nerve stim,,,31.69,36.7,8
HCPCS,A4544,Electro nerve stimulator rls,,,11.14,12.9,8
HCPCS,A4545,Suppl accessor tibial stim,,,36.52,42.28,8
HCPCS,A4550,SURGICAL TRAY,668.0,434.2,1.1,668.0,86
HCPCS,A4550,SURGICAL TRAYS,53.0,34.45,1.1,78.43,86
HCPCS,A4550,TRAY BIOPSY PROCEDURE CA/20,457.8,297.57,16.97,457.8,67
HCPCS,A4550,TRAY PROCEDURE PARACENTESIS BX/5,615.0,399.75,16.97,615.0,67
HCPCS,A4550,TRAY THORCNTS 16CM 6FR SFCNTS CA/10,851.4,553.41,16.97,851.4,67
HCPCS,A4553,"Nondisp underpads, all sizes",,,16.97,24.22,9
HCPCS,A4554,Disposable underpads,,,0.9,19.65,9
HCPCS,A4555,Ca tx e-stim electr/transduc,,,36.52,2739849.3,9
HCPCS,A4556,"Electrodes, pair",,,11.14,12.9,8
HCPCS,A4557,"Lead wires, pair",,,11.14,12.9,8
HCPCS,A4558,Conductive gel or paste,,,16.97,19.65,8
HCPCS,A4559,Coupling gel or paste,,,16.97,19.65,8
HCPCS,A4560,Nmes disposable,,,36.52,42.28,8
HCPCS,A4561,"PESSARY RUBBER, ANY TYPE",115.0,74.75,1.1,115.0,90
HCPCS,A4561,RUBBER PESSARY ANY TYPE,58.0,37.7,11.14,58.0,74
HCPCS,A4561,"RUBBER PESSARY, ANY TYPE",109.0,70.85,11.14,109.0,74
HCPCS,A4562,"PESSARY, NON RUBBER",115.0,74.75,25.07,115.0,75
HCPCS,A4562,"PESSARY, NON RUBBER,ANY TYPE",67.0,43.55,1.1,233.98,90
HCPCS,A4563,VAG INSER RECTAL CONTROL SYS,2400.0,1560.0,36.52,2400.0,75
HCPCS,A4564,"Pessary, disposable any type",,,16.97,19.65,8
HCPCS,A4565,SLING PEDIATRIC MEDIUM,6.9,4.49,1.5,19.65,67
HCPCS,A4565,SLINGS,19.0,12.35,1.1,35.38,90
HCPCS,A4566,Should sling/vest/abrestrain,,,16.97,137.0,9
HCPCS,A4570,SPLINT,32.0,20.8,1.1,52.04,219
HCPCS,A4570,SPLINT THUMB SPICA,142.5,92.63,16.97,142.5,67
HCPCS,A4575,Hyperbaric o2 chamber disps,,,16.97,3971.38,9
HCPCS,A4580,CAST SUPPLIES (PLASTER),9.0,5.85,1.1,70.4,80
HCPCS,A4580,Cast supplies (plaster),,,16.97,63.02,9
HCPCS,A4590,"SHORT LEG SPLINT, FIBERGLASS",73.0,47.45,15.91,73.0,67
HCPCS,A4590,SPECIAL CASTING MATERIAL,36.0,23.4,1.1,110.2,153
HCPCS,A4593,Neuromod sti sys adj rehab,,,16923.09,19595.16,8
HCPCS,A4594,Neuromod adj rehab mouthpie,,,846.64,980.32,8
HCPCS,A4595,Tens suppl 2 lead per month,,,36.52,42.28,8
HCPCS,A4596,Ces system monthly supp,,,58.52,103.8,10
HCPCS,A4600,"Sleeve, inter limb comp dev",,,11.14,203.72,9
HCPCS,A4601,Lith ion non prosth recharge,,,16.97,205.5,9
HCPCS,A4602,Replace lithium battery 1.5v,,,16.97,19.65,8
HCPCS,A4604,Tubing with heating element,,,31.69,36.7,8
HCPCS,A4605,Trach suction cath close sys,,,11.14,12.9,8
HCPCS,A4606,Oxygen probe used w oximeter,,,16.97,19.65,8
HCPCS,A4608,TRANSTRACHEAL O2 CATHETER EACH,207.54,134.9,31.69,207.54,66
HCPCS,A4611,Heavy duty battery,,,351.41,406.89,9
HCPCS,A4612,Battery cables,,,31.69,131.03,9
HCPCS,A4613,Battery charger,,,58.52,278.08,9
HCPCS,A4614,"PEAK EXPIR FLOW METER,HAND HELD",34.0,22.1,1.1,109.29,90
HCPCS,A4614,"PEAK EXPIRE FLOW MTR,HAND HELD",38.0,24.7,8.28,38.0,66
HCPCS,A4615,Cannula nasal,,,16.97,19.65,8
HCPCS,A4616,SCOOP CATHETER 02 HOSE,6.0,3.9,0.05,6.0,90
HCPCS,A4616,SCOOP CATHETER O2 PER FOOT,38.24,24.86,8.34,38.24,66
HCPCS,A4617,Mouth piece,,,16.97,19.65,8
HCPCS,A4618,Breathing circuits,,,16.97,19.65,8
HCPCS,A4619,Face tent,,,16.97,19.65,8
HCPCS,A4620,Variable concentration mask,,,16.97,19.65,8
HCPCS,A4623,Tracheostomy inner cannula,,,16.97,19.65,8
HCPCS,A4624,Tracheal suction tube,,,16.97,19.65,8
HCPCS,A4625,SCOOP CATHETER CLEANING KIT,38.0,24.7,1.1,38.0,90
HCPCS,A4625,TRACHEOSTOMY CARE KIT,43.7,28.41,9.53,43.7,74
HCPCS,A4626,Tracheostomy cleaning brush,,,16.97,19.65,8
HCPCS,A4627,AEROCHAMBER SPACER WITH MASK,9.0,5.85,1.1,79.12,86
HCPCS,A4627,SPACER BAG/RESERVOIR,48.0,31.2,10.46,48.0,66
HCPCS,A4628,Oropharyngeal suction cath,,,16.97,19.65,8
HCPCS,A4629,Tracheostomy care kit,,,16.97,19.65,8
HCPCS,A4630,Repl bat t.e.n.s. own by pt,,,16.97,19.81,9
HCPCS,A4633,Uvl replacement bulb,,,36.52,153.44,9
HCPCS,A4634,Replacement bulb th lightbox,,,16.97,19.65,8
HCPCS,A4635,CRUTCHES ARM GRIP/PAD EACH,52.27,33.98,11.39,52.27,66
HCPCS,A4635,UNDERARM CRUTCH PAD,2.0,1.3,0.51,18.37,90
HCPCS,A4636,HANDGRIP FOR CANE ETC,2.0,1.3,0.51,13.79,90
HCPCS,A4636,Handgrip for cane etc,,,10.28,19.65,9
HCPCS,A4637,REPL TIP CANE/CRUTCH/WALKER,3.0,1.95,0.76,8.15,90
HCPCS,A4637,Repl tip cane/crutch/walker,,,5.7,19.65,9
HCPCS,A4638,Repl batt pulse gen sys,,,16.97,2739849.3,9
HCPCS,A4639,Infrared ht sys replcmnt pad,,,91.28,1127.78,9
HCPCS,A4640,Alternating pressure pad,,,31.69,181.61,9
HCPCS,A4641,Radiopharm dx agent noc,,,129.5,149.95,8
HCPCS,A4642,In111 satumomab,,,10.69,3819.0,15
HCPCS,A464200,In111 satumomab,,,2981.5,3819.0,3
HCPCS,A4648,BARD US BIOPSY CLIP,151.25,98.31,32.89,232.66,75
HCPCS,A4648,CLIP/TISSUE MARKER,110.0,71.5,23.98,232.66,67
HCPCS,A4648,FIDUCIAL MARKER DOUBLE STRANDED,395.0,256.75,86.11,395.0,74
HCPCS,A4648,FIDUCIAL MARKER SINGLE STRANDED,206.0,133.9,44.91,232.66,74
HCPCS,A4648,GEL MARKER,825.0,536.25,179.85,825.0,74
HCPCS,A4648,HOLOGIC STEREO BIOPSY CLIP,123.75,80.44,26.91,232.66,75
HCPCS,A4648,HYDROMARK US BIOPSY CLIP,187.0,121.55,40.66,232.66,75
HCPCS,A4648,IMPLANTABLE TISSUE MARKER,73.0,47.45,1.1,691.04,80
HCPCS,A4648,NEEDLE LOC WIRE,45.38,29.5,9.87,232.66,75
HCPCS,A4648,SAVI SCOUT REFLECTOT,600.0,390.0,130.8,600.0,75
HCPCS,A4648,TISSUE MARKER,820.0,533.0,178.76,820.0,75
HCPCS,A4648,US BRST CLIP,218.0,141.7,47.52,232.66,67
HCPCS,A4648,US ULTRA CLIP RIBN/WING SHAPE,131.25,85.31,28.61,232.66,67
HCPCS,A4648,W IMP TISSUE MARKER BREAST,442.0,287.3,96.36,442.0,75
HCPCS,A4649,ANGIASSIST GAS MANAGEMENT AND DELIVERY SYSTEM,166.0,107.9,16.97,166.0,67
HCPCS,A4649,BARD MARQUEE US BIOPSY DEVICE,187.5,121.88,16.97,187.5,67
HCPCS,A4649,BARD MARQUEE US BIOPSY DEVICE W/GUIDE,91.0,59.15,16.97,91.0,67
HCPCS,A4649,CENTURION VASECTOMY SET,108.0,70.2,16.97,108.0,67
HCPCS,A4649,EVIVA STEREO DEVICE,450.0,292.5,16.97,450.0,67
HCPCS,A4649,"G000201/S25,STYLE 410 BREAST",1325.0,861.25,16.97,1325.0,69
HCPCS,A4649,G030240/S001 ACTIVA DBS LEAD,2004.6,1302.99,16.97,2004.6,69
HCPCS,A4649,G030240/S001 ACTIVA EXTENSION,595.0,386.75,16.97,595.0,69
HCPCS,A4649,G030240/S001 ACTIVA NEUROSTIM,17095.0,11111.75,16.97,17095.0,69
HCPCS,A4649,G030240/S001 ACTIVA PT PROGMER,660.0,429.0,16.97,660.0,69
HCPCS,A4649,G130138 A LEADLESS PACEMAKER,9500.0,6175.0,16.97,9500.0,69
HCPCS,A4649,G130245 MICRA PACEMAKER SYS,9600.0,6240.0,16.97,9600.0,69
HCPCS,A4649,HEMOSTATIS CLIP,108.0,70.2,16.97,108.0,67
HCPCS,A4649,MEDIHONEY  PER OZ.,22.94,14.91,5.0,22.94,67
HCPCS,A4649,STEREO BIOPSY TRAY,22.0,14.3,4.8,22.0,67
HCPCS,A4649,SURGICAL SUPPLIES,38.0,24.7,0.01,38.0,80
HCPCS,A4649,US BIOPSY TRAY,76.35,49.63,16.64,76.35,67
HCPCS,A4650,Implant radiation dosimeter,,,200.93,232.66,8
HCPCS,A4651,Calibrated microcap tube,,,16.97,19.65,8
HCPCS,A4652,Microcapillary tube sealant,,,16.97,19.65,8
HCPCS,A4653,Pd catheter anchor belt,,,16.97,19.65,8
HCPCS,A4657,SUPPLIES-SYRINGE TO ADMIN DRUG,9.36,6.08,2.04,19.65,67
HCPCS,A4660,SPHYG/BP APP W CUFF AND STET,22.05,14.33,1.1,105.86,86
HCPCS,A4660,Sphyg/bp app w cuff and stet,,,36.52,42.28,8
HCPCS,A4663,DIALYSIS BLOOD PRESSURE CUFF,15.5,10.08,1.1,114.02,86
HCPCS,A4663,Dialysis blood pressure cuff,,,16.97,19.65,8
HCPCS,A4670,"AUTOMATIC BP MONITOR, DIAL",70.5,45.83,1.1,380.07,86
HCPCS,A4670,"Automatic bp monitor, dial",,,31.69,112.81,9
HCPCS,A4671,Disposable cycler set,,,16.97,2739849.3,9
HCPCS,A4672,"Drainage ext line, dialysis",,,16.97,2739849.3,9
HCPCS,A4673,Ext line w easy lock connect,,,16.97,2739849.3,9
HCPCS,A4674,"Chem/antisept solution, 8oz",,,16.97,2739849.3,9
HCPCS,A4680,"Activated carbon filter, ea",,,16.97,19.65,8
HCPCS,A4690,"Dialyzer, each",,,11.14,12.9,8
HCPCS,A4706,Bicarbonate conc sol per gal,,,16.97,19.65,8
HCPCS,A4707,Bicarbonate conc pow per pac,,,16.97,19.65,8
HCPCS,A4708,Acetate conc sol per gallon,,,16.97,19.65,8
HCPCS,A4709,Acid conc sol per gallon,,,16.97,19.65,8
HCPCS,A4714,Treated water per gallon,,,16.97,19.65,8
HCPCS,A4719,"""y set"" tubing",,,11.14,12.9,8
HCPCS,A4720,Dialysat sol fld vol > 249cc,,,16.97,19.65,8
HCPCS,A4721,Dialysat sol fld vol > 999cc,,,16.97,19.65,8
HCPCS,A4722,Dialys sol fld vol > 1999cc,,,16.97,19.65,8
HCPCS,A4723,Dialys sol fld vol > 2999cc,,,16.97,19.65,8
HCPCS,A4724,Dialys sol fld vol > 3999cc,,,16.97,19.65,8
HCPCS,A4725,Dialys sol fld vol > 4999cc,,,16.97,19.65,8
HCPCS,A4726,Dialys sol fld vol > 5999cc,,,16.97,19.65,8
HCPCS,A4728,"Dialysate solution, non-dex",,,16.97,2739849.3,9
HCPCS,A4730,"Fistula cannulation set, ea",,,11.14,12.9,8
HCPCS,A4736,"Topical anesthetic, per gram",,,16.97,19.65,8
HCPCS,A4737,Inj anesthetic per 10 ml,,,16.97,19.65,8
HCPCS,A4740,Shunt accessory,,,16.97,19.65,8
HCPCS,A4750,Art or venous blood tubing,,,11.14,12.9,8
HCPCS,A4755,Comb art/venous blood tubing,,,16.97,19.65,8
HCPCS,A4760,"Dialysate sol test kit, each",,,16.97,19.65,8
HCPCS,A4765,Dialysate conc pow per pack,,,16.97,19.65,8
HCPCS,A4766,Dialysate conc sol add 10 ml,,,11.14,12.9,8
HCPCS,A4770,Blood collection tube/vacuum,,,16.97,19.65,8
HCPCS,A4771,Serum clotting time tube,,,16.97,19.65,8
HCPCS,A4772,Blood glucose test strips,,,16.97,19.65,8
HCPCS,A4773,Occult blood test strips,,,16.97,19.65,8
HCPCS,A4774,Ammonia test strips,,,16.97,19.65,8
HCPCS,A4802,Protamine sulfate per 50 mg,,,16.97,36.43,13
HCPCS,A480200,Protamine sulfate per 50 mg,,,28.44,36.43,3
HCPCS,A4860,Disposable catheter tips,,,16.97,19.65,8
HCPCS,A4870,Plumb/elec wk hm hemo equip,,,16.97,19.65,8
HCPCS,A4890,Repair/maint cont hemo equip,,,16.97,19.65,8
HCPCS,A4911,Drain bag/bottle,,,16.97,19.65,8
HCPCS,A4913,Misc dialysis supplies noc,,,16.97,19.65,8
HCPCS,A4918,Venous pressure clamp,,,16.97,19.65,8
HCPCS,A4927,Non-sterile gloves,,,16.97,19.65,8
HCPCS,A4928,Surgical mask,,,16.97,19.65,8
HCPCS,A4929,"Tourniquet for dialysis, ea",,,16.97,19.65,8
HCPCS,A4930,"Sterile, gloves per pair",,,16.97,19.65,8
HCPCS,A4931,Reusable oral thermometer,,,16.97,19.65,8
HCPCS,A4932,Reusable rectal thermometer,,,16.97,19.65,8
HCPCS,A5051,Pouch clsd w barr attached,,,16.97,19.65,8
HCPCS,A5052,Clsd ostomy pouch w/o barr,,,16.97,19.65,8
HCPCS,A5053,Clsd ostomy pouch faceplate,,,16.97,19.65,8
HCPCS,A5054,Clsd ostomy pouch w/flange,,,16.97,19.65,8
HCPCS,A5055,Stoma cap,,,16.97,19.65,8
HCPCS,A5056,1 pc ost pouch w filter,,,16.97,19.65,8
HCPCS,A5057,1 pc ost pou w built-in conv,,,16.97,19.65,8
HCPCS,A5061,Pouch drainable w barrier at,,,16.97,19.65,8
HCPCS,A5062,Drnble ostomy pouch w/o barr,,,16.97,19.65,8
HCPCS,A5063,Drain ostomy pouch w/flange,,,16.97,19.65,8
HCPCS,A5071,Urinary pouch w/barrier,,,16.97,19.65,8
HCPCS,A5072,Urinary pouch w/o barrier,,,16.97,19.65,8
HCPCS,A5073,Urinary pouch on barr w/flng,,,16.97,19.65,8
HCPCS,A5081,"Stoma plug or seal, any type",,,16.97,19.65,8
HCPCS,A5082,Continent stoma catheter,,,11.14,12.9,8
HCPCS,A5083,Stoma absorptive cover,,,16.97,19.65,8
HCPCS,A5093,Ostomy accessory convex inse,,,16.97,19.65,8
HCPCS,A5102,Bedside drain btl w/wo tube,,,11.14,12.9,8
HCPCS,A5105,Urinary suspensory,,,36.52,42.28,8
HCPCS,A5112,Urinary leg bag,,,36.52,42.28,8
HCPCS,A5113,Latex leg strap,,,14.99,19.65,9
HCPCS,A5114,Foam/fabric leg strap,,,16.97,28.44,9
HCPCS,A5120,"Skin barrier, wipe or swab",,,16.97,19.65,8
HCPCS,A5121,Solid skin barrier 6x6,,,16.97,19.65,8
HCPCS,A5122,Solid skin barrier 8x8,,,11.14,12.9,8
HCPCS,A5126,Disk/foam pad +or- adhesive,,,16.97,19.65,8
HCPCS,A5131,Appliance cleaner,,,11.14,12.9,8
HCPCS,A5200,NU-HOPE CATHETER HOLDER,14.0,9.1,3.05,14.0,67
HCPCS,A5500,Diab shoe for density insert,,,31.69,237.75,9
HCPCS,A5501,DIABETES CUSTOM MOLDED SHOE,296.0,192.4,64.53,406.89,66
HCPCS,A5503,Diabetic shoe w/roller/rockr,,,36.52,121.25,9
HCPCS,A5504,Diabetic shoe with wedge,,,36.52,121.25,9
HCPCS,A5505,Diab shoe w/metatarsal bar,,,36.52,121.25,9
HCPCS,A5506,Diabetic shoe w/off set heel,,,36.52,121.25,9
HCPCS,A5507,MODIFICATION DIABETIC SHOE,63.47,41.26,1.1,148.78,90
HCPCS,A5507,Modification diabetic shoe,,,36.52,121.25,9
HCPCS,A5508,Diabetic deluxe shoe,,,16.97,68.36,9
HCPCS,A5510,Compression form shoe insert,,,16.97,19.65,8
HCPCS,A5512,MULTI DEN INSERT DIRECT FORM,48.0,31.2,1.1,119.17,156
HCPCS,A5513,Multi den insert custom mold,,,36.52,144.7,9
HCPCS,A5514,Mult den insert dir carv/cam,,,36.52,144.7,9
HCPCS,A6000,Wound warming wound cover,,,16.97,2739849.3,9
HCPCS,A6010,Collagen based wound filler,,,36.52,42.28,8
HCPCS,A6011,Collagen gel/paste wound fil,,,16.97,19.65,8
HCPCS,A6021,COLLAGEN DRESSING <=16 SQ IN,37.0,24.05,1.1,96.61,156
HCPCS,A6021,PRISMA 16 SQ IN OR LESS,15.92,10.35,3.47,15.92,67
HCPCS,A6021,PROGRAN 16 SQ IN OR LESS,15.92,10.35,3.47,15.92,67
HCPCS,A6021,"PURACOL PLUS 2""X2.25""",25.0,16.25,5.45,25.0,66
HCPCS,A6021,"PURACOL PLUS AG 2""X2""",20.8,13.52,4.53,20.8,66
HCPCS,A6022,COLLAGEN DRSG>6<=48 SQ IN,92.96,60.425,1.1,170.0,156
HCPCS,A6022,ENDOFORM DRESSING,70.24,45.66,11.14,70.24,67
HCPCS,A6022,"FIBRACOL 4""X4.375""",35.0,22.75,7.63,35.0,66
HCPCS,A6022,PRISMA >16 SQ IN >48 SQ IN,15.92,10.35,3.47,15.92,67
HCPCS,A6022,PROGRAN >16 SQ IN >48 SQ IN,15.92,10.35,3.47,15.92,67
HCPCS,A6022,"PURACOL PLUS 4 1/4 "" X 4 1/2 """,31.0,20.15,6.76,31.0,66
HCPCS,A6023,Collagen dressing >48 sq in,,,58.52,67.76,8
HCPCS,A6024,Collagen dsg wound filler,,,16.97,19.65,8
HCPCS,A6025,"SILICONE GEL SHEET, EACH",15.0,9.75,1.1,41.46,86
HCPCS,A6025,"Silicone gel sheet, each",,,16.97,19.65,8
HCPCS,A6154,HOLLISTER DRAIN COLL #9773(SM),17.43,11.33,3.8,17.43,66
HCPCS,A6154,WOUND MANAGER (LG),37.17,24.16,8.1,37.17,66
HCPCS,A6154,WOUND MANAGER (MED),43.79,28.46,9.55,43.79,66
HCPCS,A6196,"ALGINATE DRESS,<16 SQ IN, EACH",11.0,7.15,1.1,33.84,90
HCPCS,A6196,ALGINATE DRSG 2X2,11.0,7.15,2.4,19.65,66
HCPCS,A6196,ALGINATE DRSG 3X3,20.14,13.09,4.39,20.14,66
HCPCS,A6196,ALGINATE DRSG 4X4,15.0,9.75,3.27,19.65,66
HCPCS,A6196,CALCIUM ALGINATE ROPE,11.0,7.15,2.4,19.65,66
HCPCS,A6196,DRAWTEX 3X3,20.14,13.09,4.39,20.14,67
HCPCS,A6197,"ALGINATE DRESS,16-48 SQ IN,EACH",83.0,53.95,1.1,83.0,90
HCPCS,A6197,ALGINATE DRSG >16 <=48 SQ IN,32.0,20.8,6.98,32.0,66
HCPCS,A6198,Alginate dressing > 48 sq in,,,11.14,12.9,8
HCPCS,A6199,DRAWTEX 4X39 ROLLS,9.32,6.06,2.03,19.65,67
HCPCS,A6199,GRAFT MATRISTEM PORCINE UR BLDDR 10X7CM,29.29,19.04,6.39,29.29,75
HCPCS,A6203,COVADERM PLUS 4X4,1.2,0.78,0.26,19.65,66
HCPCS,A6204,Composite drsg >16<=48 sq in,,,16.97,19.65,8
HCPCS,A6205,Composite drsg > 48 sq in,,,16.97,19.65,8
HCPCS,A6206,CONTACT LAYER <= 16 SQ IN,7.0,4.55,1.53,19.65,66
HCPCS,A6207,CONTACT LAYER >16<= 48 SQ IN,18.0,11.7,3.92,19.65,66
HCPCS,A6207,"CONTACT LAYER,16-48 SQ IN, EACH",18.0,11.7,1.1,33.75,90
HCPCS,A6207,RESTORE 4X5,9.38,6.1,2.04,19.65,66
HCPCS,A6207,RESTORE AG 4X5,16.88,10.97,3.68,19.65,132
HCPCS,A6208,Contact layer > 48 sq in,,,16.97,19.65,8
HCPCS,A6209,Foam drsg <=16 sq in w/o bdr,,,16.97,19.65,8
HCPCS,A6210,FOAM DRG >16<=48 SQ IN W/O B,35.0,22.75,7.63,35.0,66
HCPCS,A6211,Foam drg > 48 sq in w/o brdr,,,36.52,42.28,8
HCPCS,A6212,ALLEVYN FOAM 5X5,36.56,23.76,7.97,36.56,67
HCPCS,A6212,DIALYSIS DRESSING CHANGE-INPT.,12.0,7.8,2.62,19.65,66
HCPCS,A6213,Foam drg >16<=48 sq in w/bdr,,,16.97,19.65,8
HCPCS,A6214,Foam drg > 48 sq in w/border,,,16.97,19.65,8
HCPCS,A6215,POLYMEM WIC SILVER ROPE WOUND FILLER,25.0,16.25,5.45,25.0,67
HCPCS,A6216,DUODERM 4X4,6.0,3.9,1.31,19.65,67
HCPCS,A6216,"GAUZE,NONIMPREG,<16 SQ IN,NO ADHESIV",6.0,3.9,0.03,6.0,90
HCPCS,A6217,Non-sterile gauze>16<=48 sq,,,16.97,19.65,8
HCPCS,A6218,"GAUZE,NONIMPREG,>48 SQ IN,NO ADHESVE",22.0,14.3,0.2,22.0,86
HCPCS,A6218,Non-sterile gauze > 48 sq in,,,16.97,19.65,8
HCPCS,A6219,GAUZE PADS,3.0,1.95,0.65,19.65,66
HCPCS,A6220,Gauze >16 <=48 sq in w/bordr,,,16.97,19.65,8
HCPCS,A6221,Gauze > 48 sq in w/border,,,16.97,19.65,8
HCPCS,A6222,Gauze <=16 in no w/sal w/o b,,,16.97,19.65,8
HCPCS,A6223,MESALT 6X6 DRESSING,1.63,1.06,0.36,19.65,67
HCPCS,A6224,Gauze > 48 in no w/sal w/o b,,,16.97,19.65,8
HCPCS,A6228,MESALT DRESSING (1),2.5,1.63,0.55,19.65,66
HCPCS,A6229,Gauze >16<=48 sq in watr/sal,,,16.97,19.65,8
HCPCS,A6230,Gauze > 48 sq in water/salne,,,16.97,19.65,8
HCPCS,A6231,TEGADERM FOAM 3 1/2 X 3 1/2,4.5,2.93,0.98,19.65,66
HCPCS,A6232,Hydrogel dsg>16<=48 sq in,,,16.97,19.65,8
HCPCS,A6233,Hydrogel dressing >48 sq in,,,11.14,12.9,8
HCPCS,A6234,DUODERM 4X4 EXTRA THIN,11.0,7.15,2.4,19.65,66
HCPCS,A6234,"HYDROCOLLOID,<16 SQ IN,NO ADHES,EA",8.0,5.2,1.1,30.09,90
HCPCS,A6235,Hydrocolld drg >16<=48 w/o b,,,11.14,12.9,8
HCPCS,A6236,Hydrocolld drg > 48 in w/o b,,,36.52,42.28,8
HCPCS,A6237,"HYDROCOLLOID,<16 SQ IN,ADHESIVE,EA",9.0,5.85,1.1,36.35,90
HCPCS,A6237,Hydrocolld drg <=16 in w/bdr,,,16.97,19.65,8
HCPCS,A6238,Hydrocolld drg >16<=48 w/bdr,,,11.14,12.9,8
HCPCS,A6239,Hydrocolld drg > 48 in w/bdr,,,11.14,12.9,8
HCPCS,A6240,Hydrocolld drg filler paste,,,11.14,12.9,8
HCPCS,A6241,Hydrocolloid drg filler dry,,,16.97,19.65,8
HCPCS,A6242,"HYDROGEL,<16 SQ IN,NO ADHESIVE,EA",9.0,5.85,1.1,27.81,90
HCPCS,A6242,Hydrogel drg <=16 in w/o bdr,,,16.97,19.65,8
HCPCS,A6243,ELTA SILVER GEL PER OZ,15.16,9.85,3.3,15.16,67
HCPCS,A6243,"HYDROGEL,16-48 SQ IN,NO ADHESIVE,EA",15.0,9.75,1.1,56.64,90
HCPCS,A6244,Hydrogel drg >48 in w/o bdr,,,36.52,42.28,8
HCPCS,A6245,Hydrogel drg <= 16 in w/bdr,,,16.97,19.65,8
HCPCS,A6246,Hydrogel drg >16<=48 in w/b,,,16.97,19.65,8
HCPCS,A6247,Hydrogel drg > 48 sq in w/b,,,11.14,12.9,8
HCPCS,A6248,Hydrogel drsg gel filler,,,11.14,12.9,8
HCPCS,A6250,INTERDRY AG SHEET,65.4,42.51,0.07,65.4,67
HCPCS,A6250,Skin seal protect moisturizr,,,0.07,0.09,3
HCPCS,A625000,Skin seal protect moisturizr,,,0.07,0.09,3
HCPCS,A6251,ABSORPT DRG <=16 SQ IN W/O B,5.0,3.25,1.09,19.65,66
HCPCS,A6252,Absorpt drg >16 <=48 w/o bdr,,,16.97,19.65,8
HCPCS,A6253,Absorpt drg > 48 sq in w/o b,,,16.97,19.65,8
HCPCS,A6254,Absorpt drg <=16 sq in w/bdr,,,16.97,19.65,8
HCPCS,A6255,Absorpt drg >16<=48 in w/bdr,,,16.97,19.65,8
HCPCS,A6256,Absorpt drg > 48 sq in w/bdr,,,16.97,19.65,8
HCPCS,A6257,Transparent film <= 16 sq in,,,16.97,19.65,8
HCPCS,A6258,Transparent film >16<=48 in,,,16.97,19.65,8
HCPCS,A6259,Transparent film > 48 sq in,,,11.14,12.9,8
HCPCS,A6260,Wound cleanser any type/size,,,16.97,19.65,8
HCPCS,A6261,Wound filler gel/paste /oz,,,16.97,19.65,8
HCPCS,A6262,Wound filler dry form / gram,,,16.97,19.65,8
HCPCS,A6266,Impreg gauze no h20/sal/yard,,,16.97,19.65,8
HCPCS,A6402,Sterile gauze <= 16 sq in,,,16.97,19.65,8
HCPCS,A6403,Sterile gauze>16 <= 48 sq in,,,16.97,19.65,8
HCPCS,A6404,"GAUZE,NONIMPREG,STER,>48 SQ IN,EA",6.0,3.9,0.2,8.95,86
HCPCS,A6404,Sterile gauze > 48 sq in,,,16.97,19.65,8
HCPCS,A6407,"Packing strips, non-impreg",,,16.97,19.65,8
HCPCS,A6410,Sterile eye pad,,,16.97,19.65,8
HCPCS,A6411,Non-sterile eye pad,,,16.97,19.65,8
HCPCS,A6412,Occlusive eye patch,,,16.97,19.65,8
HCPCS,A6413,"Adhesive bandage, first-aid",,,0.69,19.65,9
HCPCS,A6441,"Pad band w>=3"" <5""/yd",,,16.97,19.65,8
HCPCS,A6442,"Conform band n/s w<3""/yd",,,16.97,19.65,8
HCPCS,A6443,CONFORM BAND N/S W>=3?<5?/YD,8.0,5.2,0.25,8.0,90
HCPCS,A6443,"Conform band n/s w>=3""<5""/yd",,,16.97,19.65,8
HCPCS,A6444,"Conform band n/s w>=5""/yd",,,16.97,19.65,8
HCPCS,A6445,"Conform band s w <3""/yd",,,16.97,19.65,8
HCPCS,A6446,CONFORM BAND S W>=3? <5?/YD,1.5,0.98,0.34,1.79,90
HCPCS,A6446,"Conform band s w>=3"" <5""/yd",,,16.97,19.65,8
HCPCS,A6447,"Conform band s w >=5""/yd",,,16.97,19.65,8
HCPCS,A6448,"LT COMPRES BAND <3""/YD",6.25,4.06,1.36,19.65,66
HCPCS,A6449,10CM X 5 YD SHORT BANDAGE,10.0,6.5,2.18,19.65,66
HCPCS,A6449,8CM X 5 YD SHORT BANDAGE,10.0,6.5,2.18,19.65,66
HCPCS,A6449,ACE BANDAGE,8.0,5.2,1.74,19.65,67
HCPCS,A6449,"LT COMPRES BAND >=3"" <5""/YD",10.0,6.5,2.18,19.65,66
HCPCS,A6449,LT COMPRES BAND >=3? <5?/YD,8.0,5.2,1.1,8.06,90
HCPCS,A6450,"Lt compres band >=5""/yd",,,16.97,19.65,8
HCPCS,A6451,"Mod compres band w>=3""<5""/yd",,,16.97,19.65,8
HCPCS,A6452,"HIGH COMPRES BAND W>=3""<5""YD",29.0,18.85,6.32,29.0,66
HCPCS,A6452,HIGH COMPRES BAND W>=3?<5?YD,29.0,18.85,1.1,29.0,90
HCPCS,A6453,"Self-adher band w <3""/yd",,,16.97,19.65,8
HCPCS,A6454,"SELF-ADHER BAND W>=3"" <5""/YD",25.0,16.25,5.45,25.0,133
HCPCS,A6454,SELF-ADHER BAND W>=3? <5?/YD,5.0,3.25,0.7,5.0,90
HCPCS,A6455,"Self-adher band >=5""/yd",,,16.97,19.65,8
HCPCS,A6456,UNNA BOOT,46.0,29.9,10.03,46.0,66
HCPCS,A6456,ZINC PASTE BAND W >=3?<5?/YD,46.0,29.9,1.1,46.0,90
HCPCS,A6457,TUBIGRIP,52.0,33.8,11.34,52.0,66
HCPCS,A6460,Synthetic drsg <= 16 sq in,,,16.97,19.65,8
HCPCS,A6461,Synthetic drsg >16<=48 sq in,,,16.97,19.65,8
HCPCS,A6501,Compres burngarment bodysuit,,,36.52,42.28,8
HCPCS,A6502,Compres burngarment chinstrp,,,36.52,42.28,8
HCPCS,A6503,Compres burngarment facehood,,,36.52,42.28,8
HCPCS,A6504,Cmprsburngarment glove-wrist,,,36.52,42.28,8
HCPCS,A6505,Cmprsburngarment glove-elbow,,,36.52,42.28,8
HCPCS,A6506,Cmprsburngrmnt glove-axilla,,,36.52,42.28,8
HCPCS,A6507,Cmprs burngarment foot-knee,,,36.52,42.28,8
HCPCS,A6508,Cmprs burngarment foot-thigh,,,36.52,42.28,8
HCPCS,A6509,Compres burn garment jacket,,,36.52,42.28,8
HCPCS,A6510,Compres burn garment leotard,,,36.52,42.28,8
HCPCS,A6511,Compres burn garment panty,,,36.52,42.28,8
HCPCS,A6512,"Compres burn garment, noc",,,36.52,42.28,8
HCPCS,A6513,Compress burn mask face/neck,,,16.97,184.95,9
HCPCS,A6515,Grad com wrap w str fu le cu,,,58.52,67.76,8
HCPCS,A6516,Grad com wrap w strap foo cu,,,58.52,67.76,8
HCPCS,A6517,Grad com wrap w strap bn cus,,,31.69,36.7,8
HCPCS,A6518,Grad com wrap w strap arm cu,,,11.14,12.9,8
HCPCS,A6519,Grad com garm noc night use,,,11.14,12.9,8
HCPCS,A6520,G com garmnt glove nghttime,,,11.14,327.54,9
HCPCS,A6521,G com garmnt glove nght cust,,,11.14,1299.66,9
HCPCS,A6522,G com garment arm nighttime,,,11.14,795.89,9
HCPCS,A6523,G com garment arm nght custm,,,11.14,1888.33,9
HCPCS,A6524,G com garmnt lwr leg/ft nght,,,11.14,992.95,9
HCPCS,A6525,G com garm lwrleg/ft ngt cus,,,11.14,2004.58,9
HCPCS,A6526,G com garmt full leg/ft nght,,,11.14,1795.19,9
HCPCS,A6527,G garmt full leg/ft nght cus,,,11.14,3301.15,9
HCPCS,A6528,G com garment bra nighttime,,,36.52,1726.2,9
HCPCS,A6529,G com garmt bra night custm,,,36.52,2727.67,9
HCPCS,A6530,15-20MMHG KNEE HIGHS,37.92,24.65,8.27,37.92,66
HCPCS,A6530,20-30MMHG KNEE HIGHS,64.1,41.67,11.14,64.1,66
HCPCS,A6530,8-15MMHG KNEE HIGHS/ULCER CARE LINERS,23.38,15.2,5.1,23.38,66
HCPCS,A6530,COMPRESSION STOCKING 18-30 MM,64.1,41.67,11.14,64.1,67
HCPCS,A6530,COMPRESSION STOCKING BK18-30,30.0,19.5,1.1,115.13,86
HCPCS,A6530,COMPRESSION STOCKING BK20-30,64.1,41.67,11.14,64.1,66
HCPCS,A6530,RELIEF KNEE HIGHS 20-30 MMHG,33.1,21.52,7.22,33.1,66
HCPCS,A6531,30-40MMHG KNEE HIGHS,64.1,41.67,13.97,64.1,66
HCPCS,A6531,30-40MMHG KNEE HIGHS/VAIROX/500 SERIES,84.0,54.6,18.31,84.0,66
HCPCS,A6531,30-40MMHG RELIEF KNEE HIGHS,33.1,21.52,7.22,42.28,66
HCPCS,A6531,COMPRESSION STOCKING BK30-40,64.1,41.67,13.97,64.1,66
HCPCS,A6531,KNEE HIGH COMPRESS GARMENT 30-,85.0,55.25,18.53,85.0,67
HCPCS,A6532,Compress stking bk40-50 surg,,,31.69,227.91,9
HCPCS,A6533,GC STOCKING THIGHLNGTH 15-20,50.1,32.57,10.92,50.1,132
HCPCS,A6533,GC STOCKING THIGHLNGTH 18-30,50.0,32.5,1.1,159.17,86
HCPCS,A6533,GC STOCKING THIGHLNGTH 20-30,79.06,51.39,11.14,79.06,66
HCPCS,A6533,THIGH HI COMPRESSION GARMENT 2,122.7,79.76,11.14,122.7,67
HCPCS,A6534,GC STOCKING THIGHLNGTH 30-40,79.06,51.39,17.24,79.06,66
HCPCS,A6534,THIGH HI COMPRESSION GARMENT30,122.7,79.76,26.75,122.7,67
HCPCS,A6535,Gc stocking thighlngth 40+,,,58.52,186.81,9
HCPCS,A6536,GC STOCKING FULL LNGTH 18-30,35.0,22.75,1.09,214.27,153
HCPCS,A6537,Gc stocking full lngth 30-40,,,58.52,227.09,9
HCPCS,A6538,Gc stocking full lngth 40+,,,58.52,265.89,9
HCPCS,A6539,GC STOCKING WAISTLNGTH,63.18,41.07,13.77,67.76,67
HCPCS,A6539,GC STOCKING WAISTLNGTH 20-30,99.7,64.81,21.73,99.7,66
HCPCS,A6540,Gc stocking waistlngth 30-40,,,58.52,302.22,9
HCPCS,A6541,Gc stocking waistlngth 40+,,,58.52,358.01,9
HCPCS,A6544,Gc stocking garter belt,,,36.52,2739849.3,9
HCPCS,A6545,GRAD COM NON-ELASTIC BK SURG,22.6,14.69,1.1,355.08,90
HCPCS,A6545,JUZO VELCRO WRAP CALF,77.0,50.05,16.79,77.0,67
HCPCS,A6545,JUZO VELCRO WRAP FOOT,40.0,26.0,8.72,40.0,67
HCPCS,A6548,Acces cust grad silic band,,,11.14,12.9,8
HCPCS,A6549,G COMPRESSION STOCKING,18.0,11.7,0.01,468.33,80
HCPCS,A6549,GC STOCKING CSTM W/ THUMB STUB,80.2,52.13,11.14,80.2,67
HCPCS,A6550,Neg pres wound ther drsg set,,,11.14,12.9,8
HCPCS,A6552,Grad com stocking bk 30-40,,,11.14,150.18,9
HCPCS,A6553,G com stcking bk 30-40 custm,,,36.52,586.39,9
HCPCS,A6554,Grad com stocking bk 40+,,,31.69,206.49,9
HCPCS,A6555,G com stcking bk 40+ custm,,,31.69,586.39,9
HCPCS,A6556,G com stcking thgh18-30 cust,,,11.14,803.61,9
HCPCS,A6557,G com stcking thgh30-40 cust,,,58.52,803.61,9
HCPCS,A6558,G com stcking thgh 40+ cust,,,58.52,829.32,9
HCPCS,A6559,G stckng full/chap18-30 cust,,,58.52,2739849.3,9
HCPCS,A6560,G stckng full/chap30-40 cust,,,58.52,2739849.3,9
HCPCS,A6561,G stockng full/chap 40+ cust,,,58.52,2739849.3,9
HCPCS,A6562,G com stckng waist18-30 cust,,,58.52,2630.07,9
HCPCS,A6563,G com stckng waist30-40 cust,,,58.52,2630.07,9
HCPCS,A6564,G com stckng waist 40+ cust,,,58.52,2833.16,9
HCPCS,A6565,Grad comp gauntlet custom,,,11.14,454.46,9
HCPCS,A6566,Grad com garment neck/head,,,36.52,659.87,9
HCPCS,A6567,G com garment neck/head cust,,,36.52,2073.3,9
HCPCS,A6568,G com garment torso/shldr,,,36.52,430.65,9
HCPCS,A6569,G com garmnt torso/shdr cust,,,36.52,2452.3,9
HCPCS,A6570,Grad com garment genital,,,36.52,293.43,9
HCPCS,A6571,G com garment genital custm,,,36.52,1763.55,9
HCPCS,A6572,Grad com garment toe caps,,,36.52,272.27,9
HCPCS,A6573,Grad com garmnt toe cap cust,,,36.52,646.09,9
HCPCS,A6574,Custom gradient sleev/glov,,,36.52,823.67,9
HCPCS,A6575,Gradient comp sleev/glov,,,36.52,266.93,9
HCPCS,A6576,Custom grad com sleeve med,,,36.52,505.53,9
HCPCS,A6577,Custom grad cm sleeve heavy,,,36.52,418.4,9
HCPCS,A6578,Gradient comp sleeve,,,36.52,206.05,9
HCPCS,A6579,Custom grad com glove med,,,36.52,811.42,9
HCPCS,A6580,Custom grad com glove heavy,,,36.52,805.45,9
HCPCS,A6581,Gradient comp glove,,,36.52,189.06,9
HCPCS,A6582,Gradient comp gauntlet,,,36.52,126.09,9
HCPCS,A6583,Grad com wrap w straps bk,,,31.69,414.78,9
HCPCS,A6584,Grad com wrap w straps,,,11.14,2739849.3,9
HCPCS,A6585,Grad com wrap w straps ak,,,11.14,491.12,9
HCPCS,A6586,Grad com wrap w strap fu leg,,,58.52,1446.88,9
HCPCS,A6587,Grad com wrap w straps foot,,,31.69,189.53,9
HCPCS,A6588,Grad com wrap w strap arm,,,11.14,631.68,9
HCPCS,A6589,Grad com wrap w straps bra,,,11.14,249.37,9
HCPCS,A6590,Urinary cath disp suc pump,,,16.97,19.65,8
HCPCS,A6591,Urinary cath suc pump,,,16.97,19.65,8
HCPCS,A6593,Grad com accessory gmt_wrap,,,16.97,2739849.3,9
HCPCS,A6594,G comp bandge liner lwr extr,,,16.97,90.8,9
HCPCS,A6595,G comp bandge liner upr extr,,,16.97,89.3,9
HCPCS,A6596,G comp bandge conform gauze,,,0.47,19.65,9
HCPCS,A6597,G comp bandage long stretch,,,4.03,19.65,9
HCPCS,A6598,G comp bandage med stretch,,,1.95,19.65,9
HCPCS,A6599,G comp bandage short stretch,,,4.41,19.65,9
HCPCS,A6600,G com bandge hgh dn foam sht,,,7.95,19.65,9
HCPCS,A6601,G com bandge hgh dn foam pad,,,8.93,19.65,9
HCPCS,A6602,G com bandge hgh dn foamroll,,,13.04,19.65,9
HCPCS,A6603,G com bandge low dn foamchnl,,,6.11,19.65,9
HCPCS,A6604,G com bandge low dn foam flt,,,3.56,19.65,9
HCPCS,A6605,G com bandage padded foam,,,4.08,19.65,9
HCPCS,A6606,G com bandage padded textile,,,12.11,19.65,9
HCPCS,A6607,G com bandage tub protct lyr,,,3.23,19.65,9
HCPCS,A6608,G com bandage tub protct pad,,,13.48,19.65,9
HCPCS,A6609,G compression bandaging,,,16.97,2739849.3,9
HCPCS,A6610,G com stcking bk 18-30 custm,,,11.14,586.39,9
HCPCS,A6611,Grad com wrap w strap ak cus,,,11.14,12.9,8
HCPCS,A7000,Disposable canister for pump,,,16.97,27.37,9
HCPCS,A7001,Nondisposable pump canister,,,36.52,123.66,9
HCPCS,A7002,Tubing used w suction pump,,,14.33,19.65,9
HCPCS,A7003,NEBULIZER ADMINISTRATION SET,12.0,7.8,1.1,12.0,90
HCPCS,A7003,Nebulizer administration set,,,4.88,19.65,9
HCPCS,A7004,Disposable nebulizer sml vol,,,4.08,19.65,9
HCPCS,A7005,Nondisposable nebulizer set,,,36.52,42.28,9
HCPCS,A7006,Filtered nebulizer admin set,,,16.97,25.67,9
HCPCS,A7007,Lg vol nebulizer disposable,,,11.34,19.65,9
HCPCS,A7008,Disposable nebulizer prefill,,,11.14,41.1,9
HCPCS,A7009,Nebulizer reservoir bottle,,,36.52,157.22,9
HCPCS,A7010,Disposable corrugated tubing,,,11.14,52.01,9
HCPCS,A7012,Nebulizer water collec devic,,,9.04,19.65,9
HCPCS,A7013,Disposable compressor filter,,,1.89,19.65,9
HCPCS,A7014,Compressor nondispos filter,,,10.96,19.65,9
HCPCS,A7015,Aerosol mask used w nebulize,,,4.16,19.65,9
HCPCS,A7016,NEBULIZER DOME & MOUTHPIECE,6.0,3.9,1.1,30.61,90
HCPCS,A7016,Nebulizer dome & mouthpiece,,,16.97,27.13,9
HCPCS,A7017,Nebulizer not used w oxygen,,,58.52,400.94,9
HCPCS,A7018,Water distilled w/nebulizer,,,1.12,19.65,9
HCPCS,A7020,"Interface, cough stim device",,,11.14,54.12,9
HCPCS,A7021,Suppl and access lung expan,,,16.97,19.65,8
HCPCS,A7023,Mech allergen parti barrier,,,351.41,2739849.3,9
HCPCS,A7025,Replace chest compress vest,,,846.64,980.32,8
HCPCS,A7026,Replace chst cmprss sys hose,,,36.52,107.46,9
HCPCS,A7027,Combination oral/nasal mask,,,58.52,396.78,9
HCPCS,A7028,Repl oral cushion combo mask,,,31.69,112.09,9
HCPCS,A7029,Repl nasal pillow comb mask,,,11.14,50.03,9
HCPCS,A7030,Cpap full face mask,,,58.52,287.02,9
HCPCS,A7031,Replacement facemask interfa,,,31.69,108.56,9
HCPCS,A7032,Replacement nasal cushion,,,36.52,59.81,9
HCPCS,A7033,Replacement nasal pillows,,,11.14,50.31,9
HCPCS,A7034,Nasal application device,,,58.52,181.74,9
HCPCS,A7035,Pos airway press headgear,,,36.52,59.62,9
HCPCS,A7036,Pos airway press chinstrap,,,11.14,35.18,9
HCPCS,A7037,Pos airway pressure tubing,,,36.52,42.28,9
HCPCS,A7038,Pos airway pressure filter,,,6.74,19.65,9
HCPCS,A7039,"Filter, non disposable w pap",,,11.14,20.39,9
HCPCS,A7040,One way chest drain valve,,,31.69,36.7,8
HCPCS,A7041,Water seal drain container,,,31.69,36.7,8
HCPCS,A7044,Pap oral interface,,,58.52,282.69,9
HCPCS,A7045,Repl exhalation port for pap,,,11.14,41.62,9
HCPCS,A7046,"Repl water chamber, pap dev",,,11.14,44.55,9
HCPCS,A7047,Resp suction oral interface,,,16.97,19.65,8
HCPCS,A7048,PLEURIX DRAINAGE SYSTEM,92.75,60.29,20.22,92.75,67
HCPCS,A7049,Epap nasal valve,,,58.52,2739849.3,9
HCPCS,A7501,"TRACHEOSTOMA VALVE, INCLUDING DIAPHRAM, EA",44.0,28.6,9.59,67.76,67
HCPCS,A7502,Replacement diaphragm/fplate,,,31.69,36.7,8
HCPCS,A7503,Hmes filter holder or cap,,,11.14,12.9,8
HCPCS,A7504,Tracheostoma hmes filter,,,16.97,19.65,8
HCPCS,A7505,Hmes or trach valve housing,,,16.97,19.65,8
HCPCS,A7506,Hmes/trachvalve adhesivedisk,,,16.97,19.65,8
HCPCS,A7507,HME CASSETTES,166.25,108.06,16.97,166.25,67
HCPCS,A7507,PROVOX TUBE HOLDERS,42.0,27.3,9.16,42.0,67
HCPCS,A7508,Housing & integrated adhesiv,,,16.97,19.65,8
HCPCS,A7509,Heat & moisture exchange sys,,,16.97,19.65,8
HCPCS,A7520,9/55 LARY TUBES,215.25,139.91,36.52,215.25,67
HCPCS,A7520,SAFE-T-TUBE MONTGOMERY,215.0,139.75,36.52,215.0,74
HCPCS,A7520,SHILEY UN-CUFFED TRACH TUBE,98.0,63.7,21.36,98.0,74
HCPCS,A7520,SHILEY UNCUFFED,111.21,72.29,24.24,111.21,67
HCPCS,A7520,SHILEY XLT UNCUFFED,110.01,71.51,23.98,110.01,67
HCPCS,A7520,"STANDARD, LARYTUBE 9/36",252.0,163.8,36.52,252.0,67
HCPCS,A7520,TRACH TUBE NEONATE 3.0MM,90.0,58.5,19.62,90.0,66
HCPCS,A7520,TRACH/LARYN TUBE NON-CUFFED,86.0,55.9,1.1,218.16,90
HCPCS,A7520,TRACOE  303 UNCUFFED,73.41,47.72,16.0,73.41,67
HCPCS,A7520,TRACOE 304 UNCUFFED,77.82,50.58,16.96,77.82,67
HCPCS,A7520,TRACOE 313 UNCUFFED,106.94,69.51,23.31,106.94,67
HCPCS,A7520,TRACOE 314 UNCUFFED,106.09,68.96,23.13,106.09,67
HCPCS,A7520,TRACOE COMFORT UNCUFFED,247.5,160.88,36.52,247.5,67
HCPCS,A7520,W TUBE TRACH UNCUF W/DIC,77.0,50.05,16.79,77.0,74
HCPCS,A7521,PEDS TRACH TUBE,218.0,141.7,36.52,218.0,74
HCPCS,A7521,PROVOX LARYBUTTON 12/8,264.0,171.6,36.52,264.0,67
HCPCS,A7521,SHILEY CUFFED,123.59,80.33,26.94,123.59,67
HCPCS,A7521,SHILEY TRACH TUBE,143.5,93.28,31.28,143.5,74
HCPCS,A7521,SHILEY XLT CUFFED,110.01,71.51,23.98,110.01,67
HCPCS,A7521,SHILEY-FENE TRACHTUBE-M51,97.0,63.05,21.15,97.0,74
HCPCS,A7521,TRACH/LARYN TUBE CUFFED,85.0,55.25,1.1,216.16,90
HCPCS,A7521,TRACOE 301 CUFFED,79.45,51.64,17.32,79.45,67
HCPCS,A7522,Trach/laryn tube stainless,,,36.52,42.28,8
HCPCS,A7523,Tracheostomy shower protect,,,16.97,19.65,8
HCPCS,A7524,BIVONA STOMA STENT,94.5,61.43,20.6,94.5,66
HCPCS,A7524,HOOD SPECIAL CURVED STOMA STENT,512.76,333.29,31.69,512.76,67
HCPCS,A7524,HOOD SPECIAL STRAIGHT STOMA STENT,438.17,284.81,31.69,438.17,67
HCPCS,A7524,HOOD STOMA STENT CURVED,250.27,162.68,31.69,250.27,67
HCPCS,A7524,HOOD STOMA STENT STRAIGHT,239.42,155.62,31.69,239.42,67
HCPCS,A7524,HOOD TRACHEAL T TUBE STOMA STENT,295.86,192.31,31.69,295.86,67
HCPCS,A7524,PROVOX LARY BUTTON 12/8,264.0,171.6,31.69,264.0,67
HCPCS,A7524,TRACHEOSTOMA STENT/STUD/BTTN,231.0,150.15,1.1,355.71,90
HCPCS,A7525,Tracheostomy mask,,,16.97,19.65,8
HCPCS,A7526,TRACH HOLDER,43.0,27.95,9.37,43.0,74
HCPCS,A7527,Trach/laryn tube plug/stop,,,16.97,19.65,8
HCPCS,A8000,SOFT PROTECT HELMET PREFAB,385.0,250.25,58.52,385.0,66
HCPCS,A8001,Hard protect helmet prefab,,,58.52,573.37,9
HCPCS,A8002,Soft protect helmet custom,,,16.97,1153.54,9
HCPCS,A8003,HARD PROTECT HELMET CUSTOM,1376.0,894.4,16.97,1376.0,66
HCPCS,A8004,"Repl soft interface, helmet",,,16.97,685.0,9
HCPCS,A8006,Grip glove replacement only,,,351.41,406.89,8
HCPCS,A9150,MISC/EXPER NON-PRESCRIPT DRU,2.0,1.3,0.01,2.0,80
HCPCS,A9150,Misc/exper non-prescript dru,,,0.74,19.65,9
HCPCS,A9152,Single vitamin nos,,,16.97,2739849.3,9
HCPCS,A9153,Multi-vitamin nos,,,16.97,2739849.3,9
HCPCS,A9154,"Artificial saliva, 1 ml",,,0.46,19.65,13
HCPCS,A915400,"Artificial saliva, 1 ml",,,0.46,0.59,3
HCPCS,A9155,Artificial saliva,,,16.8,2739849.3,12
HCPCS,A915500,Artificial saliva,,,16.8,21.52,3
HCPCS,A9156,Oral mucoadhesive per 1 ml,,,5.18,19.65,13
HCPCS,A915600,Oral mucoadhesive per 1 ml,,,5.18,6.63,3
HCPCS,A9180,"Lice treatment, topical",,,1.9,2739849.3,14
HCPCS,A918000,"Lice treatment, topical",,,1.9,2.44,3
HCPCS,A9268,Programmer orally ingest cap,,,16.97,2739849.3,9
HCPCS,A9269,Programable ingest capsule,,,16.97,2739849.3,9
HCPCS,A9270,ACCOMMODATING LENS WORK UP/NON-COVERED,2182.0,1418.3,0.01,2182.0,80
HCPCS,A9270,ACTICOAT 7 6X6 SHEET,51.24,33.31,11.17,51.24,67
HCPCS,A9270,EMST150 EXPIRATORY MUSCLE STRENGTH TRAINER,88.0,57.2,16.97,88.0,67
HCPCS,A9270,FOREARM STRAP NON-CUSTOM,34.0,22.1,7.41,34.0,67
HCPCS,A9270,MULTIFOCAL SPHERICAL LENS WORK UP/NON COVERED,2237.0,1454.05,0.01,2237.0,80
HCPCS,A9270,MULTIFOCAL TORIC LENS WORKUP/ NON COVERED,2237.0,1454.05,0.01,2237.0,80
HCPCS,A9270,PADS MET U HAPAD,9.0,5.85,1.96,19.65,67
HCPCS,A9270,SYMFONY IOL WORK UP NON-COVERED,2387.0,1551.55,0.01,2387.0,80
HCPCS,A9270,SYMFONY TORIC IOL WORK UP/NONCOVERED,2237.0,1454.05,0.01,2237.0,80
HCPCS,A9270,TORIC IOL WORKUP,1127.0,732.55,0.01,1127.0,80
HCPCS,A9270,TRIFOCAL IOL WORKUP,2137.0,1389.05,0.01,2137.0,80
HCPCS,A9272,"Disp wound suct, drsg/access",,,11.14,536.36,9
HCPCS,A9273,Hot/cold botle/cap/col/wrap,,,16.97,87.68,9
HCPCS,A9274,Ext amb insulin delivery sys,,,96.56,775.49,9
HCPCS,A9275,Disp home glucose monitor,,,16.97,2739849.3,9
HCPCS,A9276,"Disposable sensor, cgm sys",,,16.97,27.4,9
HCPCS,A9277,"External transmitter, cgm",,,16.97,1493.74,9
HCPCS,A9278,"External receiver, cgm sys",,,16.97,1265.88,9
HCPCS,A9279,Monitoring feature/devicenoc,,,16.97,2739999.97,9
HCPCS,A9280,"Alert device, noc",,,16.97,2739849.3,9
HCPCS,A9281,Reaching/grabbing device,,,16.97,54.8,9
HCPCS,A9282,Wig any type,,,16.97,822.0,9
HCPCS,A9283,TRUVUE HEEL PROTECTOR,164.0,106.6,16.97,164.0,66
HCPCS,A9284,NON-ELECTRONIC SPIROMETER,4.36,2.83,1.1,69.1,80
HCPCS,A9284,Non-electronic spirometer,,,16.97,19.65,8
HCPCS,A9285,Inversion eversion cor devic,,,91.28,274.0,9
HCPCS,A9286,"Any hygienic item, device",,,16.97,2739849.3,9
HCPCS,A9291,Pres dig cog behav thera fda,,,2739849.3,2739849.3,1
HCPCS,A9292,Pres dig visual therapy fda,,,86.82,2739849.3,9
HCPCS,A9293,Fertility cycl tracking soft,,,33.56,38.86,8
HCPCS,A9300,ROPE & PULLEY SET,15.5,10.08,3.38,19.65,66
HCPCS,A9500,"SUPPLY TECHNICIUM SESTAMIBI,PER DOSE",66.0,42.9,1.1,639.82,74
HCPCS,A9500,TC99M SESTAMIBI PER DOSE,66.0,42.9,14.39,968.75,63
HCPCS,A9500,Tc99m sestamibi,,,228.02,292.07,3
HCPCS,A950000,Tc99m sestamibi,,,228.02,292.07,3
HCPCS,A9501,Technetium tc-99m teboroxime,,,129.5,149.95,8
HCPCS,A9502,SUPPLY TECHNICIUM TETROFOSMIN / DOSE,65.0,42.25,1.1,121.08,74
HCPCS,A9502,TC99M TETROFOSMIN/PER DOSE,62.0,40.3,13.52,339.38,63
HCPCS,A9502,Tc99m tetrofosmin,,,182.15,233.31,3
HCPCS,A950200,Tc99m tetrofosmin,,,182.15,233.31,3
HCPCS,A9503,"SUPPLY TECHNETIUM MEDRONATE,TO 30 MC",62.0,40.3,1.1,62.0,74
HCPCS,A9503,TC99M MEDRONATE<30MCI,56.0,36.4,12.21,149.95,63
HCPCS,A9503,Tc99m medronate,,,27.77,35.57,3
HCPCS,A950300,Tc99m medronate,,,27.77,35.57,3
HCPCS,A9504,Tc99m apcitide,,,129.5,1140.0,15
HCPCS,A950400,Tc99m apcitide,,,890.0,1140.0,3
HCPCS,A9505,Tl201 thallium,,,69.76,149.95,15
HCPCS,A950500,Tl201 thallium,,,69.76,89.35,3
HCPCS,A9506,Tc-99m graphite crucible,,,41.08,848.16,34
HCPCS,A950600,Tc-99m graphite crucible,,,662.16,848.16,3
HCPCS,A9507,IN111 CAPROMAB<10MCI,4038.0,2624.7,129.5,4038.0,73
HCPCS,A9507,In111 capromab,,,9389.87,12027.48,3
HCPCS,A950700,In111 capromab,,,9389.87,12027.48,3
HCPCS,A9508,"I131 IODOBENGUATE, DX",9896.0,6432.4,1.1,9896.0,74
HCPCS,A9508,"I131 iodobenguate, dx",,,119.13,2215.7,29
HCPCS,A950800,"I131 iodobenguate, dx",,,1578.79,2022.27,3
HCPCS,A9509,I-123 CAP PER 1 MCI,210.0,136.5,45.78,331.04,63
HCPCS,A9509,IODINE I-123 SOD IODIDE MIL,210.0,136.5,1.1,3081.68,74
HCPCS,A9509,Iodine i-123 sod iodide mil,,,3862.96,4948.06,3
HCPCS,A950900,Iodine i-123 sod iodide mil,,,3862.96,4948.06,3
HCPCS,A9510,Tc99m disofenin,,,128.66,191.52,15
HCPCS,A951000,Tc99m disofenin,,,149.52,191.52,3
HCPCS,A9512,TC99 PERTECHNET,34.0,22.1,3.76,149.95,63
HCPCS,A9512,TECHNETIUMTC99MPERTECHNETATE,34.0,22.1,1.1,34.0,74
HCPCS,A9512,Tc99m pertechnetate,,,3.61,4.63,3
HCPCS,A951200,Tc99m pertechnetate,,,3.61,4.63,3
HCPCS,A9513,"LUTETIUM LU 177 DOTATATE, TX",671.0,436.15,186.54,21625.09,85
HCPCS,A9513,"LUTETIUM LU 177, DOTATATE, THERAPEUTIC, 1 MILLICURIE",106520.0,69238.0,1.1,106520.0,78
HCPCS,A9513,Lutetium lu 177 dotatat ther,,,651.53,834.55,3
HCPCS,A951300,Lutetium lu 177 dotatat ther,,,651.53,834.55,3
HCPCS,A9515,Choline c-11,,,129.5,13680.0,36
HCPCS,A951500,Choline c-11,,,10680.0,13680.0,3
HCPCS,A9516,I-123 SODIUM CAP 100 UCI,210.0,136.5,45.78,239.94,63
HCPCS,A9516,I-123 SODIUM CAP 200 UCI,210.0,136.5,45.78,239.94,63
HCPCS,A9516,I-123 SODIUM IODIDE CAPSULE,210.0,136.5,1.1,210.0,74
HCPCS,A9516,Iodine i-123 sod iodide mic,,,226.91,290.65,3
HCPCS,A951600,Iodine i-123 sod iodide mic,,,226.91,290.65,3
HCPCS,A9517,I131 THERA CAPSL /MCI,180.0,117.0,21.34,391.19,85
HCPCS,A9517,"I131 iodide cap, rx",,,76.26,97.68,3
HCPCS,A9517,TH I131 SO IODIDE CAP MILLIC,180.0,117.0,1.1,180.0,74
HCPCS,A951700,"I131 iodide cap, rx",,,76.26,97.68,3
HCPCS,A9520,TC99 TILMANOCEPT DIAG 0.5MCI,1190.0,773.5,129.5,1190.0,63
HCPCS,A9520,Tc99 tilmanocept diag 0.5mci,,,1413.12,1810.07,3
HCPCS,A952000,Tc99 tilmanocept diag 0.5mci,,,1413.12,1810.07,3
HCPCS,A9521,TC99M EXAMETAZIME<25MCI,3128.0,2033.2,129.5,3128.0,80
HCPCS,A9521,TECHNETIUMTC-99M EXAMETAZINE,3128.0,2033.2,1.1,3128.0,74
HCPCS,A9521,Tc99m exametazime,,,3661.03,4689.41,3
HCPCS,A952100,Tc99m exametazime,,,3661.03,4689.41,3
HCPCS,A9524,"I131 serum albumin, dx",,,798.33,1022.58,3
HCPCS,A9524,RADPHARM DX I131 SERUM ALBUMIN,180.0,117.0,39.24,774.73,63
HCPCS,A952400,"I131 serum albumin, dx",,,798.33,1022.58,3
HCPCS,A9526,"AMMONIA N-13, PER DOSE",250.0,162.5,1.1,510.99,74
HCPCS,A9526,NITROGEN N-13 AMMONIA,250.0,162.5,54.5,1581.45,63
HCPCS,A9526,Nitrogen n-13 ammonia,,,1548.39,1983.33,3
HCPCS,A952600,Nitrogen n-13 ammonia,,,1548.39,1983.33,3
HCPCS,A9527,Iodine i-125 sodium iodide,,,54.77,448.45,25
HCPCS,A9528,DX I131 SO IODIDE CAP MILLIC,180.0,117.0,1.1,180.0,74
HCPCS,A9528,I131 DX CAPSL /MCI,180.0,117.0,39.24,203.07,63
HCPCS,A9529,DX I131 SO IODIDE SOL MILLIC,180.0,117.0,1.1,180.0,74
HCPCS,A9529,"IODINE I-131 SODIUM IODID SOLUTION, DIAG, PER MCI",180.0,117.0,39.24,180.0,63
HCPCS,A9530,I131 THERA SOL THERA /MCI,180.0,117.0,20.4,391.19,85
HCPCS,A9530,TH I131 SO IODIDE SOL MILLIC,180.0,117.0,1.1,180.0,74
HCPCS,A9531,I131 max 100uci,,,7.98,149.95,12
HCPCS,A9532,"I125 serum albumin, dx",,,46.73,989.72,29
HCPCS,A953200,"I125 serum albumin, dx",,,46.73,59.85,3
HCPCS,A9536,Tc99m depreotide,,,129.5,3192.0,15
HCPCS,A953600,Tc99m depreotide,,,2492.0,3192.0,3
HCPCS,A9537,TC99M MEBROFENIN,62.0,40.3,1.1,80.23,74
HCPCS,A9537,TC99M MEBROFENIN<15MCI,62.0,40.3,13.52,243.94,63
HCPCS,A9537,Tc99m mebrofenin,,,118.16,151.35,3
HCPCS,A953700,Tc99m mebrofenin,,,118.16,151.35,3
HCPCS,A9538,TC99M PYROPHOSPHATE<25MCI,118.0,76.7,25.72,149.95,63
HCPCS,A9538,"TECHNETIUM TC-99M PYROPHOSPHATE, DIAGNOSTIC",118.0,76.7,1.1,118.0,74
HCPCS,A9538,Tc99m pyrophosphate,,,136.81,175.24,3
HCPCS,A953800,Tc99m pyrophosphate,,,136.81,175.24,3
HCPCS,A9539,TC99M PENTETATE,240.0,156.0,1.1,240.0,74
HCPCS,A9539,TC99M PENTETATE<25MCI,240.0,156.0,52.32,240.0,63
HCPCS,A9539,Tc99m pentetate,,,66.93,85.73,3
HCPCS,A953900,Tc99m pentetate,,,66.93,85.73,3
HCPCS,A9540,TC99M MAA,1092.0,709.8,1.1,1092.0,74
HCPCS,A9540,TC99M MAA<10MCI,1092.0,709.8,63.3,1092.0,63
HCPCS,A9540,Tc99m maa,,,64.08,82.08,3
HCPCS,A954000,Tc99m maa,,,64.08,82.08,3
HCPCS,A9541,TC99M FILTERED SULFUR COLLOID,200.0,130.0,43.6,1615.51,63
HCPCS,A9541,TC99M SULFUR COLLOID,200.0,130.0,1.1,379.67,74
HCPCS,A9541,TC99M SULFUR COLLOID =< 20MCI,200.0,130.0,43.6,1615.51,63
HCPCS,A9541,Tc99m sulfur colloid,,,571.1,731.52,3
HCPCS,A954100,Tc99m sulfur colloid,,,571.1,731.52,3
HCPCS,A9542,"In111 ibritumomab, dx",,,129.5,9576.0,22
HCPCS,A954200,"In111 ibritumomab, dx",,,7476.0,9576.0,3
HCPCS,A9543,"Y90 ibritumomab, rx",,,7103.07,185519.15,38
HCPCS,A954300,"Y90 ibritumomab, rx",,,144835.13,185519.15,3
HCPCS,A9546,Co57/58,,,2.45,149.95,12
HCPCS,A9547,IN111 OXYQUINOLINE,5030.0,3269.5,1.1,5030.0,74
HCPCS,A9547,"INDIUM IN-111 OXYQUINOLINE, DIAG, PER 0.5 MCI",5030.0,3269.5,129.5,5030.0,80
HCPCS,A9547,In111 oxyquinoline,,,4496.24,5759.23,3
HCPCS,A954700,In111 oxyquinoline,,,4496.24,5759.23,3
HCPCS,A9548,"IN-111 PENTETATE, PER 0.5 MCI",4518.0,2936.7,129.5,4518.0,80
HCPCS,A9548,IN111 DTPA.5MCI,4518.0,2936.7,129.5,4518.0,80
HCPCS,A9548,IN111 PENTETATE,4518.0,2936.7,1.1,4518.0,74
HCPCS,A9548,In111 pentetate,,,1891.43,2422.73,3
HCPCS,A954800,In111 pentetate,,,1891.43,2422.73,3
HCPCS,A9550,Tc99m gluceptate,,,129.5,149.95,8
HCPCS,A9551,TC99M SUCCIMER,288.0,187.2,1.1,970.34,74
HCPCS,A9551,TC99M SUCCIMER<10MCI,288.0,187.2,80.06,1392.45,73
HCPCS,A9551,Tc99m succimer,,,1280.35,1640.0,3
HCPCS,A955100,Tc99m succimer,,,1280.35,1640.0,3
HCPCS,A9552,F18 FDG,250.0,162.5,1.1,509.85,74
HCPCS,A9552,F18 FDG DOSE,250.0,162.5,54.5,897.82,63
HCPCS,A9552,F18 fdg,,,672.75,861.73,3
HCPCS,A9552,PET SCAN ISOTP UP TO 45MCI,250.0,162.5,54.5,897.82,63
HCPCS,A955200,F18 fdg,,,672.75,861.73,3
HCPCS,A9553,Cr51 chromate,,,129.5,4046.9,29
HCPCS,A955300,Cr51 chromate,,,1204.7,1543.1,3
HCPCS,A9554,"I125 iothalamate, dx",,,80.1,1370.74,29
HCPCS,A955400,"I125 iothalamate, dx",,,80.1,102.6,3
HCPCS,A9555,RB82 RUBIDIUM,800.0,520.0,1.1,800.0,74
HCPCS,A9555,RB82<60MCI,800.0,520.0,129.5,972.23,63
HCPCS,A9556,GA67 CITRTE1MCI,2626.0,1706.9,47.3,2626.0,63
HCPCS,A9556,GA67 GALLIUM,2626.0,1706.9,1.1,2626.0,74
HCPCS,A9556,Ga67 gallium,,,288.4,369.41,3
HCPCS,A955600,Ga67 gallium,,,288.4,369.41,3
HCPCS,A9557,TC99M BICISATE,3766.0,2447.9,1.1,5206.19,74
HCPCS,A9557,TC99M BICISATE<25MCI,3766.0,2447.9,129.5,3766.0,80
HCPCS,A9557,Tc99m bicisate,,,7831.27,10031.07,3
HCPCS,A955700,Tc99m bicisate,,,7831.27,10031.07,3
HCPCS,A9558,Xe133 xenon 10mci,,,129.5,697.95,15
HCPCS,A955800,Xe133 xenon 10mci,,,544.89,697.95,3
HCPCS,A9559,Co57 cyano,,,129.5,541.76,15
HCPCS,A955900,Co57 cyano,,,156.48,200.43,3
HCPCS,A9560,TC99 RBC DOSE,350.0,227.5,76.3,350.0,63
HCPCS,A9560,TC99M LABELED RBC,350.0,227.5,1.1,350.0,74
HCPCS,A9560,Tc99m labeled rbc,,,199.5,255.54,3
HCPCS,A956000,Tc99m labeled rbc,,,199.5,255.54,3
HCPCS,A9561,TC99M OXIDRONATE<30MCI,82.0,53.3,17.88,149.95,63
HCPCS,A9561,Tc99m oxidronate,,,93.98,120.38,3
HCPCS,A956100,Tc99m oxidronate,,,93.98,120.38,3
HCPCS,A9562,TC99M MERTIATIDE,568.0,369.2,1.1,1254.2,74
HCPCS,A9562,TC99M MERTIATIDE<15MCI,568.0,369.2,123.82,1651.69,63
HCPCS,A9562,Tc99m mertiatide,,,1654.92,2119.78,3
HCPCS,A956200,Tc99m mertiatide,,,1654.92,2119.78,3
HCPCS,A9563,P32 na phosphate,,,34.78,834.14,36
HCPCS,A956300,P32 na phosphate,,,651.21,834.14,3
HCPCS,A9564,P32 chromic phosphate,,,287.11,2739849.3,16
HCPCS,A956400,P32 chromic phosphate,,,620.44,794.72,3
HCPCS,A9566,Tc99m fanolesomab,,,129.5,149.95,8
HCPCS,A9567,TC99M AERO<75MCI,240.0,156.0,38.66,240.0,63
HCPCS,A9567,TECHNETIUM TC-99M AEROSOL,240.0,156.0,1.1,240.0,74
HCPCS,A9568,Technetium tc99m arcitumomab,,,129.5,2964.0,22
HCPCS,A956800,Technetium tc99m arcitumomab,,,2314.0,2964.0,3
HCPCS,A9569,TC99M CERETEC WBC,2568.0,1669.2,129.5,2568.0,80
HCPCS,A9569,"TECHNETIUM TC-99M EXAMETAZIME LBLD AUTO WHT BLD CELLS,DIAG,PER S",2568.0,1669.2,129.5,2568.0,80
HCPCS,A9569,Technetium tc-99m auto wbc,,,3661.03,4689.41,3
HCPCS,A956900,Technetium tc-99m auto wbc,,,3661.03,4689.41,3
HCPCS,A9570,IN111 AUTO WBC DIAG/PER DOSE,4928.0,3203.2,129.5,4928.0,80
HCPCS,A9570,INDIUM IN-111 AUTO WBC,4928.0,3203.2,1.1,5978.14,74
HCPCS,A9570,Indium in-111 auto wbc,,,8992.47,11518.45,3
HCPCS,A957000,Indium in-111 auto wbc,,,8992.47,11518.45,3
HCPCS,A9571,INDIUM IN-111 AUTO PLATELET,4928.0,3203.2,1.1,5978.14,74
HCPCS,A9571,Indium in-111 auto platelet,,,129.5,11518.45,15
HCPCS,A957100,Indium in-111 auto platelet,,,8992.47,11518.45,3
HCPCS,A9572,IND111 PENTETREOTIDE DOSE,10558.0,6862.7,129.5,10558.0,80
HCPCS,A9572,INDIUM IN-111 PENTETREOTIDE,10558.0,6862.7,1.1,10558.0,74
HCPCS,A9572,Indium in-111 pentetreotide,,,8266.32,10588.32,3
HCPCS,A957200,Indium in-111 pentetreotide,,,8266.32,10588.32,3
HCPCS,A9573,"INJ, GADOPICLENOL, 1 ML",4.0,2.6,0.87,28.93,146
HCPCS,A9573,"Inj, gadopiclenol, 1 ml",,,5.87,7.52,3
HCPCS,A957300,"Inj, gadopiclenol, 1 ml",,,5.87,7.52,3
HCPCS,A9575,20 ML DOTAREM INJ 0.1 ML,1.83,1.19,0.12,1.83,78
HCPCS,A9575,DOTAREM 10 MMOL SYRINGE 20ML,2.27,1.48,0.18,28.93,72
HCPCS,A9575,DOTAREM 7.5 MMOL SYRING 15ML,2.27,1.48,0.18,28.93,72
HCPCS,A9575,"DOTAREM INJ 0.1 ML, 10 ML",2.27,1.48,0.18,28.93,72
HCPCS,A9575,"DOTAREM INJ 0.1 ML, 15 ML",2.27,1.48,0.18,28.93,72
HCPCS,A9575,"DOTAREM INJ 0.1ML, 20 ML",2.27,1.48,0.18,28.93,72
HCPCS,A9575,Inj gadoterate meglumi 0.1ml,,,0.18,0.23,3
HCPCS,A957500,Inj gadoterate meglumi 0.1ml,,,0.18,0.23,3
HCPCS,A9576,"GAD-BASE MR CONTRAST NOS,1ML",33.0,21.45,2.48,33.0,72
HCPCS,A9576,Inj prohance multipack,,,2.53,3.24,3
HCPCS,A957600,Inj prohance multipack,,,2.53,3.24,3
HCPCS,A9577,"INJ MULTIHANCE 20 ML, PER 1ML",22.0,14.3,3.15,28.93,72
HCPCS,A9577,Inj multihance,,,3.2,4.1,3
HCPCS,A957700,Inj multihance,,,3.2,4.1,3
HCPCS,A9578,Inj multihance multipack,,,1.82,28.93,19
HCPCS,A957800,Inj multihance multipack,,,3.13,4.01,3
HCPCS,A9579,"GAD-BASE MR CONTRAST NOS,1ML",32.0,20.8,2.56,32.0,72
HCPCS,A9579,GADOLINIUM (287) PER ML,4.8,3.12,1.05,28.93,66
HCPCS,A9579,"Gad-base mr contrast nos,1ml",,,2.6,3.33,3
HCPCS,A9579,INJ OPTIMARK 20ML,15.0,9.75,1.1,15.0,78
HCPCS,A957900,"Gad-base mr contrast nos,1ml",,,2.6,3.33,3
HCPCS,A9580,SODIUM FLUORIDE F-18,217.0,141.05,1.1,400.5,74
HCPCS,A9580,SODIUM FLUORIDE F-18 < 30 MCI,217.0,141.05,47.31,563.32,63
HCPCS,A9580,Sodium fluoride f-18,,,640.8,820.8,3
HCPCS,A958000,Sodium fluoride f-18,,,640.8,820.8,3
HCPCS,A9581,Gadoxetate disodium inj,,,26.26,33.63,3
HCPCS,A9581,INJ EOVIST GADOXETATE DISODIUM PER ML,46.0,29.9,1.1,65.65,78
HCPCS,A9581,"INJ EOVIST GADOXETATE DISODIUM, PER 1ML",147.0,95.55,24.99,147.0,72
HCPCS,A958100,Gadoxetate disodium inj,,,26.26,33.63,3
HCPCS,A9582,I-123 MIBG DOSE UP TO 15MCI,8816.0,5730.4,129.5,8816.0,83
HCPCS,A9582,Iodine i-123 iobenguane,,,10911.56,13976.61,3
HCPCS,A9582,PR IODINE I-123 IOBENGUANE,8816.0,5730.4,1.1,8816.0,74
HCPCS,A958200,Iodine i-123 iobenguane,,,10911.56,13976.61,3
HCPCS,A9583,Gadofosveset trisodium inj,,,37.4,47.9,3
HCPCS,A9583,INJ GADOFOSVESET TRISODIUM ML,118.0,76.7,24.99,118.0,71
HCPCS,A958300,Gadofosveset trisodium inj,,,37.4,47.9,3
HCPCS,A9584,GENERIC IOFLUPANE1-123 UP TO 5 MCI,3843.5,2498.275,1.1,4537.0,154
HCPCS,A9584,IODINE I-123 IOFLUPANE,5331.0,3465.15,1.1,5331.0,74
HCPCS,A9584,IOFLUPANE I-123 UP TO 5 MCI,4537.0,2949.05,129.5,4537.0,80
HCPCS,A9584,Iodine i-123 ioflupane,,,5536.51,7091.71,3
HCPCS,A958400,Iodine i-123 ioflupane,,,5536.51,7091.71,3
HCPCS,A9585,GADAVIST GADOBUTROL INJ 0.1ML,2.99,1.94,0.48,28.93,72
HCPCS,A9585,GADOBUTROL INJECTION,2.99,1.94,0.26,2.99,78
HCPCS,A9585,Gadobutrol injection,,,0.5,0.64,3
HCPCS,A958500,Gadobutrol injection,,,0.5,0.64,3
HCPCS,A9586,FLORBETAPIR F18,6543.0,4252.95,1.1,6543.0,74
HCPCS,A9586,FLORBETAPIR F18 AMYVID,6178.0,4015.7,129.5,6178.0,89
HCPCS,A9586,Florbetapir f18,,,6103.41,7817.85,3
HCPCS,A958600,Florbetapir f18,,,6103.41,7817.85,3
HCPCS,A9587,GALLIUM GA-68,150.0,97.5,1.1,305.13,78
HCPCS,A9587,Gallium ga-68,,,123.41,158.07,3
HCPCS,A9587,NETSPOT (GA-68 DOTATATE),152.0,98.8,42.26,152.0,80
HCPCS,A958700,Gallium ga-68,,,123.41,158.07,3
HCPCS,A9588,"AXUMIN FLUCICLOVINE F-18, DIAGNOSTIC, 1 MILLICURE",990.0,643.5,129.5,990.0,80
HCPCS,A9588,FLUCICLOVINE F-18,842.0,547.3,1.1,842.0,74
HCPCS,A9588,Fluciclovine f-18,,,1172.88,1502.34,3
HCPCS,A958800,Fluciclovine f-18,,,1172.88,1502.34,3
HCPCS,A9589,Insti hexaminolevulinate hcl,,,24.99,3305.47,19
HCPCS,A958900,Insti hexaminolevulinate hcl,,,2536.09,3248.48,3
HCPCS,A9590,Iodine i-131 iobenguane 1mci,,,129.5,930.53,16
HCPCS,A959000,Iodine i-131 iobenguane 1mci,,,684.36,876.59,3
HCPCS,A9591,FLUOROESTRADIOL F 18 DIAGNOSTIC 1 MCI,6545.5,4254.575,1.1,11557.0,154
HCPCS,A9591,Fluoroestradiol f 18,,,1642.94,2104.44,3
HCPCS,A959100,Fluoroestradiol f 18,,,1642.94,2104.44,3
HCPCS,A9592,COPPER CU-64 DOTATATE DIAGNOSTIC 1 MCI,7993.0,5195.45,1.1,7993.0,74
HCPCS,A9592,"COPPER CU-64, DOTATATE, DIAGNOSTIC, 1 MILLICURIE",2081.0,1352.65,129.5,2081.0,80
HCPCS,A9592,Copper cu 64 dotatate diag,,,2055.9,2633.4,3
HCPCS,A959200,Copper cu 64 dotatate diag,,,2055.9,2633.4,3
HCPCS,A9593,GA-64 PSMA,2031.0,1320.15,129.5,2471.63,82
HCPCS,A9593,Gallium ga-68 psma-11 ucsf,,,1661.51,2128.22,3
HCPCS,A959300,Gallium ga-68 psma-11 ucsf,,,1661.51,2128.22,3
HCPCS,A9594,"Gallium ga-68 psma-11, ucla",,,45.44,2162.68,38
HCPCS,A959400,"Gallium ga-68 psma-11, ucla",,,1626.8,2083.76,3
HCPCS,A9595,F-18 PSMA PYLARIFY,745.5,484.575,1.1,1779.35,156
HCPCS,A9595,"Piflu f-18, dia 1 millicurie",,,1313.76,1682.8,3
HCPCS,A959500,"Piflu f-18, dia 1 millicurie",,,1313.76,1682.8,3
HCPCS,A9596,"GA-68 GOZETOTIDE, DIAGNOSTIC",1880.0,1222.0,129.5,3040.49,82
HCPCS,A9596,Gallium illuccix 1 millicure,,,2206.92,2826.84,3
HCPCS,A959600,Gallium illuccix 1 millicure,,,2206.92,2826.84,3
HCPCS,A9597,"Pet, dx, for tumor id, noc",,,129.5,149.95,8
HCPCS,A9598,"Pet dx for non-tumor id, noc",,,129.5,149.95,8
HCPCS,A9600,Sr89 strontium,,,518.29,11389.0,38
HCPCS,A960000,Sr89 strontium,,,8010.0,10260.0,3
HCPCS,A9601,Flortaucipir inj 1 millicuri,,,46.38,10165.4,38
HCPCS,A960100,Flortaucipir inj 1 millicuri,,,747.6,957.6,3
HCPCS,A9602,Fluorodopa f-18 diag per mci,,,106.94,2693.88,39
HCPCS,A960200,Fluorodopa f-18 diag per mci,,,1065.58,1364.9,3
HCPCS,A9603,"Inj, pafolacianine, 0.1 mg",,,24.99,363.39,13
HCPCS,A960300,"Inj, pafolacianine, 0.1 mg",,,283.7,363.39,3
HCPCS,A9604,Sm 153 lexidronam,,,394.98,47291.99,38
HCPCS,A960400,Sm 153 lexidronam,,,34780.24,44549.97,3
HCPCS,A9606,RADIUM RA223 DICHLORIDE THER,304.5,197.925,1.1,7510.9,163
HCPCS,A9606,Radium ra223 dichloride ther,,,361.02,462.43,3
HCPCS,A960600,Radium ra223 dichloride ther,,,361.02,462.43,3
HCPCS,A9607,"LUTETIUM LU 177 VIPIVOTIDE TETRAXETAN, THERAPEUTIC",486.0,315.9,1.1,21625.09,159
HCPCS,A9607,Lutetium lu 177 vipivotide,,,530.56,679.6,3
HCPCS,A960700,Lutetium lu 177 vipivotide,,,530.56,679.6,3
HCPCS,A9608,"FLOTUFOLASTAT F18, DIAGNOSTIC, 1 MILLICURIE",1329.0,863.85,1.1,1937.61,157
HCPCS,A9608,Flotufolastat f18 diag 1 mci,,,1466.1,1877.92,3
HCPCS,A960800,Flotufolastat f18 diag 1 mci,,,1466.1,1877.92,3
HCPCS,A9609,"F18 fdg, 15 millicuries",,,337.85,391.19,8
HCPCS,A9610,"Xe129 xenon, diagnostic",,,129.5,2845.44,11
HCPCS,A961000,"Xe129 xenon, diagnostic",,,2221.44,2845.44,3
HCPCS,A9611,"Flurpiridaz f18, diag, 1 mci",,,66.25,1368.0,27
HCPCS,A961100,"Flurpiridaz f18, diag, 1 mci",,,1068.0,1368.0,3
HCPCS,A9612,"Inj, fluorescein, 1 mg",,,0.8,28.93,13
HCPCS,A961200,"Inj, fluorescein, 1 mg",,,0.8,1.03,3
HCPCS,A9615,"Inj, pegulicianine, 1 mg",,,4.69,96.81,36
HCPCS,A961500,"Inj, pegulicianine, 1 mg",,,75.58,96.81,3
HCPCS,A9616,Gallium gozellix 1 millicuri,,,129.5,2591.38,27
HCPCS,A961600,Gallium gozellix 1 millicuri,,,2023.09,2591.38,3
HCPCS,A9697,"Inj, magtrace per study dose",,,24.99,2645.94,31
HCPCS,A9698,Non-rad contrast materialnoc,,,24.99,28.93,8
HCPCS,A9699,NOC THERAPEUTIC RADIOPHARM,18025.0,11716.25,0.01,18025.0,80
HCPCS,A9700,ECHOCARDIOGRAPHY CONTRAST,347.2,225.68,1.1,347.2,80
HCPCS,A9700,Echocardiography contrast,,,24.99,28.93,8
HCPCS,A9800,"GALLIUM GA-68 GOZETOTIDE, DIG (LOCAMETZ), 1 MCI",1648.0,1071.2,1.1,2677.97,156
HCPCS,A9800,Gallium locametz 1 millicuri,,,1307.48,1674.75,3
HCPCS,A980000,Gallium locametz 1 millicuri,,,1307.48,1674.75,3
HCPCS,A9900,Supply/accessory/service,,,16.97,2739999.97,9
HCPCS,A9901,DELIVERY/SET UP/DISPENSING,100.0,65.0,0.01,3061000.0,80
HCPCS,A9901,Delivery/set up/dispensing,,,16.97,2739999.97,9
HCPCS,A9999,NOSTRIL RETAINER,250.0,162.5,16.97,250.0,67
HCPCS,ANE120,ELECTIVE COSMETIC ANESTHESIA UNDER AN HOUR,176.0,114.4,1.1,176.0,68
HCPCS,ANE125,ELECTIVE COSMETIC ANESTHESIA HOUR AND ABOVE,87.75,57.04,1.1,87.75,68
HCPCS,B0488,JEJUNAL FEEDING KIT,512.0,332.8,111.62,512.0,59
HCPCS,B4034,Enter feed supkit syr by day,,,9.97,9.97,1
HCPCS,B4035,Enteral feed supp pump per d,,,17.59,17.59,1
HCPCS,B4036,Enteral feed sup kit grav by,,,13.62,13.62,1
HCPCS,B4081,Enteral ng tubing w/ stylet,,,49.98,49.98,1
HCPCS,B4082,Enteral ng tubing w/o stylet,,,35.24,35.24,1
HCPCS,B4082,NASOGASTRIC TUBING,23.92,15.55,1.1,49.41,90
HCPCS,B4083,Enteral stomach tube levine,,,5.21,5.21,1
HCPCS,B4087,"Gastro/jejuno tube, std",,,87.1,87.1,1
HCPCS,B4088,"Gastro/jejuno tube, low-pro",,,100.53,100.53,1
HCPCS,B4100,Food thickener oral,,,1.1,1.1,1
HCPCS,B4102,Ef adult fluids and electro,,,3.84,3.84,1
HCPCS,B4103,Ef ped fluid and electrolyte,,,12.33,12.33,1
HCPCS,B4104,Additive for enteral formula,,,5.48,5.48,1
HCPCS,B4105,Enzyme cartridge enteral nut,,,304.63,304.63,1
HCPCS,B4148,Enteral feed elastomer daily,,,2739849.3,2739849.3,1
HCPCS,B4149,Ef blenderized foods,,,3.26,3.26,1
HCPCS,B4150,Ef complet w/intact nutrient,,,1.23,1.23,1
HCPCS,B4152,Ef calorie dense>/=1.5kcal,,,1.01,1.01,1
HCPCS,B4153,Ef hydrolyzed/amino acids,,,3.92,3.92,1
HCPCS,B4154,Ef spec metabolic noninherit,,,2.14,2.14,1
HCPCS,B4155,Ef incomplete/modular,,,2.3,2.3,1
HCPCS,B4157,Ef special metabolic inherit,,,19.45,19.45,1
HCPCS,B4158,Ef ped complete intact nut,,,1.92,1.92,1
HCPCS,B4159,Ef ped complete soy based,,,4.93,4.93,1
HCPCS,B4160,Ef ped caloric dense>/=0.7kc,,,2.74,2.74,1
HCPCS,B4161,Ef ped hydrolyzed/amino acid,,,7.4,7.4,1
HCPCS,B4162,Ef ped specmetabolic inherit,,,7.12,7.12,1
HCPCS,B4164,Parenteral 50% dextrose solu,,,65.98,65.98,1
HCPCS,B4168,Parenteral sol amino acid 3.,,,96.23,96.23,1
HCPCS,B4172,Parenteral sol amino acid 5.,,,72.61,72.61,1
HCPCS,B4176,Parenteral sol amino acid 7-,,,186.16,186.16,1
HCPCS,B4178,Parenteral sol amino acid >,,,223.39,223.39,1
HCPCS,B4180,Parenteral sol carb > 50%,,,94.72,94.72,1
HCPCS,B4185,Pn soln nos 10 grams lipids,,,43.59,43.59,1
HCPCS,B4187,"Omegaven, 10 grams lipids",,,43.59,43.59,1
HCPCS,B4189,Parenteral sol amino acid &,,,690.1,690.1,1
HCPCS,B4193,Parenteral sol 52-73 gm prot,,,891.68,891.68,1
HCPCS,B4197,Parenteral sol 74-100 gm pro,,,1085.62,1085.62,1
HCPCS,B4199,Parenteral sol > 100gm prote,,,1240.48,1240.48,1
HCPCS,B4216,Parenteral nutrition additiv,,,29.98,29.98,1
HCPCS,B4220,Parenteral supply kit premix,,,31.07,31.07,1
HCPCS,B4222,Parenteral supply kit homemi,,,38.33,38.33,1
HCPCS,B4224,Parenteral administration ki,,,97.05,97.05,1
HCPCS,B5000,Parenteral sol renal-amirosy,,,46.17,46.17,1
HCPCS,B5100,Parenteral solution hepatic,,,18.03,18.03,1
HCPCS,B5200,Parenteral sol hepatic fream,,,16.44,16.44,1
HCPCS,B9002,Enter nutr inf pump any type,,,2050.04,2050.04,1
HCPCS,B9004,Parenteral infus pump portab,,,9795.53,9795.53,1
HCPCS,B9006,Parenteral infus pump statio,,,9795.53,9795.53,1
HCPCS,B9998,Enteral supp not otherwise c,,,2739999.97,2739999.97,1
HCPCS,B9999,Parenteral supp not othrws c,,,2739999.97,2739999.97,1
HCPCS,C1052,"Hemostatic agent, gi, topic",,,200.93,232.66,8
HCPCS,C1062,INTRAVERTEBRAL BODY FRACTURE AUGMENTATION WITH IMPLANT,16475.0,10708.75,200.93,16475.0,76
HCPCS,C1600,"Cath, bladed, vasc prep",,,200.93,2739849.3,9
HCPCS,C1601,"Endo, single, pulmonary",,,200.93,2739849.3,9
HCPCS,C1602,Orth/matrx/bn fill drug-elut,,,200.93,2739849.3,9
HCPCS,C1603,"Ret dev, laser, ivc filter",,,200.93,2739849.3,9
HCPCS,C1604,"Grft, trnsmurl/trnsvens byps",,,200.93,2739849.3,9
HCPCS,C1605,AVEIR DUAL CHAMBER LEADLESS PACEMAKER SYSTEM MFG DR-SYSTEM-AVEIR,61950.0,40267.5,200.93,61950.0,74
HCPCS,C1605,AVEIR LEADLESS DUAL PACEMAKER,61950.0,40267.5,200.93,61950.0,149
HCPCS,C1605,S 275 C1605 ABBOTT AVIER DR LEADLESS,61950.0,40267.5,200.93,61950.0,74
HCPCS,C1606,"Adapter, us to endoscope",,,36.52,42.28,8
HCPCS,C1607,Neurostim integ rechg,,,200.93,232.66,8
HCPCS,C1608,"Prosthesis, dual mob cmc1",,,200.93,232.66,8
HCPCS,C1713,"ADROIT GUIDING CATHETER, IM, SINGLE USE",600.0,390.0,130.8,600.0,75
HCPCS,C1713,BOSTON SCI. TUNNELLING SC-4254,600.0,390.0,130.8,600.0,75
HCPCS,C1713,CERAMENT BONE VOID FILLER 10CC,5448.0,3541.2,200.93,5448.0,76
HCPCS,C1713,CLIK ANCHOR HEXWRENCH SC-4276,150.0,97.5,32.7,232.66,75
HCPCS,C1713,CLIK ANCHOR SC-4316,790.0,513.5,172.22,790.0,75
HCPCS,C1713,"H190005,TETHER VERT BODY SYS",11739.0,7630.35,200.93,11739.0,76
HCPCS,C1713,MEDTRONIC BI WING 97792,248.0,161.2,54.06,248.0,75
HCPCS,C1713,SC-4316 CLIK ANCHOR,790.0,513.5,172.22,790.0,75
HCPCS,C1713,W ANCH SUT FASTAK,790.0,513.5,172.22,790.0,75
HCPCS,C1713,W IMP ANCH MINIRO,737.0,479.05,160.67,737.0,75
HCPCS,C1714,6FR HAWKONE DIRECTIONAL ATHERECTOMY SYST,4313.25,2803.61,200.93,4313.25,67
HCPCS,C1714,AURYON ATHERECTOMY CATHETER,6000.0,3900.0,200.93,6000.0,67
HCPCS,C1714,C1714 ARTHERECTOMY CATH,4043.0,2627.95,200.93,4043.0,67
HCPCS,C1714,CTO RECANALIZATION CATHETER???,305.35,198.48,66.57,305.35,67
HCPCS,C1714,HAWKONE CUTTER DRIVER,139.21,90.49,30.35,232.66,67
HCPCS,C1714,W CATH ATHR TRANSLUM DIREC,1223.0,794.95,200.93,1223.0,67
HCPCS,C1715,W NDL BRACHYTHRPY,174.0,113.1,37.93,232.66,67
HCPCS,C1716,"Brachytx, non-str, gold-198",,,246.67,869.37,29
HCPCS,C1717,BRACHYTX NON-STR HDR IR-192,750.0,487.5,212.1,750.0,186
HCPCS,C1719,"Brachytx, ns, non-hdrir-192",,,309.8,954.67,29
HCPCS,C1721,DR IMPLANTABLE CARDIOVERTER DEFIBRILLATOR,22500.0,14625.0,200.93,22500.0,76
HCPCS,C1721,G110059 ICD FORTIFY ST DR,12850.0,8352.5,200.93,12850.0,69
HCPCS,C1721,G140039 B EVERA XT DR DDMB1D4,14000.0,9100.0,200.93,14000.0,69
HCPCS,C1721,"GALLANT DR ICD, DUAL",22500.0,14625.0,200.93,22500.0,75
HCPCS,C1721,ICD  DUAL CHAMBER TIER II,28500.0,18525.0,200.93,28500.0,75
HCPCS,C1721,ICD DUAL CHAMBER TIER I,26000.0,16900.0,200.93,26000.0,75
HCPCS,C1721,W ICD CURRENT DR 220736,26000.0,16900.0,200.93,26000.0,75
HCPCS,C1722,G110059 ICD FORTIFY ST SR,9500.0,6175.0,200.93,9500.0,69
HCPCS,C1722,G140039 B EVERA XT VR DVMB1D4,11000.0,7150.0,200.93,11000.0,69
HCPCS,C1722,G200319 21-528 MODULARATP NCT04798768 - EMBLEM SICD,21000.0,13650.0,200.93,21000.0,69
HCPCS,C1722,GALLANT VR IMPLANTABLE CARDIOVERTER DEFIBRILLATOR,17250.0,11212.5,200.93,17250.0,74
HCPCS,C1722,ICD SINGLE CHAMBER TIER 0,16980.0,11037.0,200.93,16980.0,75
HCPCS,C1722,ICD SINGLE CHAMBER TIER II,26000.0,16900.0,200.93,26000.0,75
HCPCS,C1722,ICD SINGLE CHAMBER TIER III,36000.0,23400.0,200.93,36000.0,75
HCPCS,C1722,S-ICDR,26000.0,16900.0,200.93,26000.0,75
HCPCS,C1722,SUB-Q ICD IMPLANT TIER 1,3400.0,2210.0,200.93,3400.0,75
HCPCS,C1722,SUB-Q ICD IMPLANT TIER 2,32000.0,20800.0,200.93,32000.0,75
HCPCS,C1722,VARIPULSE BI-DIRECTIONAL CATHETER,12346.0,8024.9,200.93,12346.0,67
HCPCS,C1724,C1724 ATHERECTOMY TIER 2,5123.0,3329.95,200.93,5123.0,67
HCPCS,C1724,C1724 ROTATIONAL ATHERECTOMY CATHETER TIER 1,2355.75,1531.24,200.93,2355.75,67
HCPCS,C1724,CUTTING BALLOON,241.93,157.25,52.74,241.93,67
HCPCS,C1725,28MM X 6CM BALLOON Z MED,998.3,648.9,200.93,998.3,67
HCPCS,C1725,"6.0MM X 20MM BALLOON, 90CM SHAFT, PACIFI",262.5,170.63,57.23,262.5,67
HCPCS,C1725,ACS BALLOON LEVEL I,375.0,243.75,81.75,375.0,67
HCPCS,C1725,ANGIOSCULPT EVO RX PTCA SCORING BALLOON CATHETER WITH HYDROPHILI,1660.0,1079.0,200.93,1660.0,67
HCPCS,C1725,ARMADA 18 PTA CATHETER SZ 2X2 THRU 6X4,127.5,82.88,27.8,232.66,67
HCPCS,C1725,"ATHEROTOME, 6 MM DIA. PERIPHERAL CUTTING BALLOON",1198.5,779.03,200.93,1198.5,67
HCPCS,C1725,ATLAS BALLOON CATHETER,375.37,243.995,80.12,383.24,134
HCPCS,C1725,"ATLAS PTA BALLOON DILATATIONCATHETER, LARGE DIAMETER",470.0,305.5,102.46,470.0,67
HCPCS,C1725,"ATLAS PTA DILATATION CATH, 6.5 FR X 75 CM SHAFT, 14MM BALLON",367.5,238.88,80.12,367.5,67
HCPCS,C1725,B BRAUN BIB BALLOON STENT PLACEMENT CATH 26-30 X 4-5,1328.4,863.46,200.93,1328.4,67
HCPCS,C1725,B BRAUN NUCLEUS X BAL CATH,1313.13,853.53,200.93,1313.13,67
HCPCS,C1725,B-BRAUN MINI GHOST BALLOON,528.0,343.2,115.1,528.0,67
HCPCS,C1725,BALLOON BOSTON EMERGE,192.5,125.13,41.97,232.66,67
HCPCS,C1725,BALLOON OPTA LP,355.7,231.21,77.54,355.7,67
HCPCS,C1725,"BALLOON,SHAFT,STERLING MONORAIL BALLOON DILATATION CATH 135CM 5M",495.0,321.75,107.91,495.0,67
HCPCS,C1725,BARD CONQUEST BALLOON,310.0,201.5,67.58,310.0,67
HCPCS,C1725,BARD; ATLAS BALLOON CATH,897.0,583.05,195.55,897.0,67
HCPCS,C1725,BERMAN ANGIOGRAPHIC BALLOON CATHETER,204.0,132.6,44.47,232.66,67
HCPCS,C1725,BOS SCI MUSTANG OVER THE WIRE PTA BALLOON CATH,270.0,175.5,58.86,270.0,67
HCPCS,C1725,BOS SCIENTFIC BALLON,330.0,214.5,71.94,330.0,67
HCPCS,C1725,BOSTON SCIENTIFIC BALLOON CATH,2551.0,1658.15,200.93,2551.0,67
HCPCS,C1725,BOSTON SCIENTIFIC CUTTING CATH,1160.0,754.0,200.93,1160.0,67
HCPCS,C1725,BOSTON SCIENTIFIC TAKERU PTCA BALLOON CATHETER,229.25,149.01,49.98,232.66,67
HCPCS,C1725,BRAUN TYSHAK BALLOON 10X8,631.88,410.72,137.75,631.88,67
HCPCS,C1725,BRAUN TYSHAK BALLOON 6X3-10X3,631.88,410.72,137.75,631.88,67
HCPCS,C1725,BRAUN TYSHAK II BALLOON 5X2-25,726.77,472.4,158.44,726.77,67
HCPCS,C1725,BRAUN Z-MED II BALLOON 15X3,1154.0,750.1,200.93,1154.0,67
HCPCS,C1725,BRAUN Z-MED II BALLOON 22X4-25,675.0,438.75,147.15,675.0,67
HCPCS,C1725,BRAUN Z-MED II BALLOON 5X2-10X,412.5,268.13,89.93,412.5,67
HCPCS,C1725,C1725 BALLOONS TIER 1,123.0,79.95,26.81,232.66,67
HCPCS,C1725,C1725 BALLOONS TIER 2,220.0,143.0,43.82,239.0,134
HCPCS,C1725,C1725 BALLOONS TIER 4,967.0,628.55,200.93,967.0,67
HCPCS,C1725,C1725 BALLOONS TIER 5,1425.0,926.25,200.93,1425.0,134
HCPCS,C1725,C1725 BALLOONS TIER 6,1620.0,1053.0,200.93,1620.0,67
HCPCS,C1725,C1725 BALLOONS TIER I,192.5,125.13,41.97,232.66,67
HCPCS,C1725,C1725 PTCA CATHETER TIER 0,195.5,127.08,42.62,232.66,67
HCPCS,C1725,C1725 PTCA CATHETER TIER 1,733.05,476.48,159.8,733.05,67
HCPCS,C1725,C1725 PTCA CATHETER TIER 2,1404.71,913.06,200.93,1404.71,67
HCPCS,C1725,"CATH, BALLOON C1725 160",355.37,230.99,77.47,355.37,67
HCPCS,C1725,"CATH, BALLOON C1725 175",474.0,308.1,103.33,474.0,67
HCPCS,C1725,"CATH, BALLOON C1725 180",450.0,292.5,98.1,450.0,67
HCPCS,C1725,"CATH, BALLOON C1725 60",150.0,97.5,32.7,232.66,67
HCPCS,C1725,"CATH, BALLOON C1725 85",213.0,138.45,46.43,232.66,67
HCPCS,C1725,CATHETER ARMADA  BALLOON DILATATION OTW ACCEPTS,158.0,102.7,34.44,232.66,67
HCPCS,C1725,CATHETER R2P METACROSS BALLOON DILATATION RAPID EXCHANGE,520.0,338.0,113.36,520.0,67
HCPCS,C1725,CATHETER TYSHAK II 8FR 18MM STANDARD MICROTHIN LOW PROFILE 100CM,1051.34,683.37,200.93,1051.34,67
HCPCS,C1725,CHARGER OTW PTA BALLOON DILATATION CATHETER,220.0,143.0,47.96,232.66,67
HCPCS,C1725,CONQUEST BALLOON CATHETER,337.5,219.38,73.58,337.5,67
HCPCS,C1725,COOK 6.5 FR. SLIP CATH 125CM,247.0,160.55,53.85,247.0,67
HCPCS,C1725,COOK BALLOON MENCINI DOUBLE,565.0,367.25,123.17,565.0,67
HCPCS,C1725,COOK SLIP-CATH # 280522,137.0,89.05,29.87,232.66,67
HCPCS,C1725,CORDIS BALLOON LEVEL I,760.0,494.0,165.68,760.0,67
HCPCS,C1725,CROSPERIO RX PTA BALLOON DILATATION CATHETER,580.0,377.0,126.44,580.0,67
HCPCS,C1725,DAX MICRO CATHER,1492.5,970.13,200.93,1492.5,67
HCPCS,C1725,DEVICE CATHETER FIXATION TRAPPER EXCHANGE,500.0,325.0,109.0,500.0,67
HCPCS,C1725,EMERGE PTCA DILATATION CATHETER,110.0,71.5,23.98,232.66,67
HCPCS,C1725,EVERCROSS DILATION CATHETER 9MMX40MM,192.5,125.13,41.97,232.66,67
HCPCS,C1725,G230034 ARISE II TRI-LOBE BLLN CATH NCT05800743,600.0,390.0,130.8,600.0,69
HCPCS,C1725,GORE MOLDING & OCCULSION BALLOON 4CM X 90CM,918.0,596.7,200.12,918.0,67
HCPCS,C1725,GUIDANT AGILTRAC BALLOON CATH,147.22,95.69,32.09,232.66,67
HCPCS,C1725,JADE PTA BALLOON DILATATION CATHETER PERCUTANEOUS TRANSLUMINAL A,270.0,175.5,58.86,270.0,67
HCPCS,C1725,MEDITECH SYMMETRY,900.0,585.0,196.2,900.0,67
HCPCS,C1725,"MEDTRONIC ""D"" BALLOON",201.0,130.65,43.82,232.66,67
HCPCS,C1725,MEDTRONIC IN PACT PACLITAXEL PTA BALLOON CATH,1603.8,1042.47,200.93,1603.8,67
HCPCS,C1725,MEDTRONIC NC EUPHORA DILATION CATH 4.0-5.0MMX12MM,161.0,104.65,35.1,232.66,75
HCPCS,C1725,OCCLUSION BAL SSC0407 SRC0410,1816.43,1180.68,200.93,1816.43,67
HCPCS,C1725,OCCLUSION BAL STRYKER SSC0305,1917.34,1246.27,200.93,1917.34,67
HCPCS,C1725,OCCLUSION BALLOON MICRO VEN,1755.0,1140.75,200.93,1755.0,67
HCPCS,C1725,OSCAR PERIPHERAL MULTIFUNCT CATH,1234.25,802.265,200.93,1240.0,201
HCPCS,C1725,OSCAR PERIPHERAL MULTIFUNCTIONAL CATHETER,999.8,649.87,200.93,999.8,67
HCPCS,C1725,PACIFIC PLUS PTA 3.5MM X 20MM X 130MM BALLOON CATH,262.5,170.63,57.23,262.5,67
HCPCS,C1725,"PACIFIC PLUS PTA BALLOON CATH, 3.0MM X 20MM, 90CM SHAFT, 0.018IN",262.5,170.63,57.23,262.5,67
HCPCS,C1725,PALADIN CAROTID PTA BALLOON SYSTEM WITH INTEGRATED EMBOLIC PROTE,2400.0,1560.0,200.93,2400.0,67
HCPCS,C1725,PERIPHERAL IVL CATHETER,4657.5,3027.38,200.93,4657.5,67
HCPCS,C1725,PROWLER MICROCATHETER,585.55,380.61,127.65,585.55,67
HCPCS,C1725,R2P CROSSTELLA RX PTA BALLOON,520.0,338.0,113.36,520.0,67
HCPCS,C1725,"R2P CROSSTELLA RX PTA BALLOON, 200CM, 2MM X 100MM",520.0,338.0,113.36,520.0,67
HCPCS,C1725,"R2P CROSSTELLA RX PTA BALLOON, 200CM, 3MM X 100MM",520.0,338.0,113.36,520.0,67
HCPCS,C1725,"R2P CROSSTELLA RX PTA BALLOON, 200CM, 6MM X 150MM",520.0,338.0,113.36,520.0,67
HCPCS,C1725,R2P METACROSS RX PTA BALLOON DILATATION CATHETER,520.0,338.0,113.36,520.0,67
HCPCS,C1725,"RX PTA BALLOON DILATATION CATHETER 5FR, 3MM X 40MM X 200CM",520.0,338.0,113.36,520.0,67
HCPCS,C1725,SAPPHIRE NC 24 CORONARY DILATATION CATHETER,170.0,110.5,37.06,232.66,134
HCPCS,C1725,SAPPHIRE PRO II BALLOON CORNARY DILATATION CATHETER,170.0,110.5,37.06,232.66,67
HCPCS,C1725,SHOCKWAVE E8 IVL CATHETER,9400.0,6110.0,200.93,9400.0,67
HCPCS,C1725,SHOCKWAVE L6 IVL CATH,6900.0,4485.0,200.93,6900.0,67
HCPCS,C1725,SIZING CATH,227.27,147.73,49.54,232.66,67
HCPCS,C1725,SUBLIME MICROCATHETER,760.0,494.0,165.68,760.0,67
HCPCS,C1725,SUBLIME RADIAL ACCESS PTA BALLOON DILATATION CATHETER,594.0,386.1,129.49,594.0,67
HCPCS,C1725,TELEFLEX RINGER PTCA PERFUSION BALLOON,6200.0,4030.0,200.93,6200.0,67
HCPCS,C1725,TRANSLUM ANGIOPL - CATH,238.0,154.7,51.88,238.0,67
HCPCS,C1725,TRANSLUM ANGIOPL NON-LSR CATH,285.0,185.25,62.13,285.0,67
HCPCS,C1725,TYSHAK II BALLOON DILATATION CATH,1101.8,716.17,200.93,1101.8,67
HCPCS,C1725,"TYSHAK II BALLOON DILATATION CATH, 1.5 ATM, 25MM X 4 CM BALLOON",693.0,450.45,151.07,693.0,67
HCPCS,C1725,US RANGER DILATATION CATHETER BALLOON,3890.0,2528.5,200.93,3890.0,67
HCPCS,C1725,W CATH ANG SURPAS,473.47,307.76,103.22,473.47,67
HCPCS,C1725,XXL BALLOON,300.0,195.0,65.4,300.0,67
HCPCS,C1725,"Z-MED BALLOON CATH, 20MM X 4CM BALLOON",805.5,523.58,175.6,805.5,67
HCPCS,C1725,"Z-MED II BALLOON CATH, 8 ATM 16MM X 4CM BALLOON",802.0,521.3,174.84,802.0,67
HCPCS,C1726,ACLASIA BALLOON DILATOR,661.5,429.98,144.21,661.5,67
HCPCS,C1726,AORTIC DIL CATH TIER I,937.5,609.38,200.93,937.5,67
HCPCS,C1726,ATLAS GOLD OTW DIL 20-24MMX120CM,48.0,31.2,10.46,232.66,67
HCPCS,C1726,C1726 VALVULOPLASTY BALLOON,938.0,609.7,200.93,938.0,67
HCPCS,C1726,"CATH, BALLOON DIL NON-VASC C1726 1200",2400.0,1560.0,200.93,2400.0,67
HCPCS,C1726,COUDE TIP URETHRAL BALLOON,85.68,55.69,18.68,232.66,67
HCPCS,C1726,CRE WIREGUIDED DILATOR,337.5,219.38,73.58,337.5,67
HCPCS,C1726,DIL SRG AMPLTZ TFE ST 30CM 16,1620.0,1053.0,200.93,1620.0,67
HCPCS,C1726,DIL VASC 5FR 20CM HYDRPHLC,22.0,14.3,4.8,232.66,67
HCPCS,C1726,HALO 360 BALLOON,525.0,341.25,114.45,525.0,67
HCPCS,C1726,MALE URETHRAL DILATION BALLOON CATH.,152.33,99.01,33.21,232.66,67
HCPCS,C1726,NON-VAS BALLON DILAT CATH,2307.89,1500.13,200.93,2307.89,67
HCPCS,C1726,TTS BALLOON DILATOR,144.37,93.84,31.47,232.66,67
HCPCS,C1726,W ACHALASIA BALLOON,284.25,184.76,61.97,284.25,67
HCPCS,C1727,"Cath, bal tis dis, non-vas",,,200.93,232.66,8
HCPCS,C1728,3.5 FR B-RAIL CATH,5198.0,3378.7,200.93,5198.0,67
HCPCS,C1728,BRACHYTX SEED ADMIN SET,5197.5,3378.38,200.93,5197.5,67
HCPCS,C1728,W CATHETER MAMMOSITE,56.0,36.4,12.21,232.66,67
HCPCS,C1729,8FR PERICARDIOCENT PROC KIT,258.0,167.7,56.24,258.0,67
HCPCS,C1729,"AMPLATZ ANCHOR PERCUFLEX CATH W/LOCKING MALECOT, 8 FR X 30 CM",133.0,86.45,28.99,232.66,67
HCPCS,C1729,CHAIT TRPDR PED CECOSTOMY CATH SET 10.2FR X 24CM,212.0,137.8,46.22,232.66,67
HCPCS,C1729,CHAIT TRPDR TM PED CECOSTOMY CATH SET (TDCS-100),208.0,135.2,45.34,232.66,67
HCPCS,C1729,COOK GUIDE WIRES.021/80 ST,30.2,19.63,6.58,232.66,67
HCPCS,C1729,FOLEY DRAINAGE CATH,27.0,17.55,5.89,232.66,67
HCPCS,C1729,MEDTRONIC STERILE SLEEVE,19.0,12.35,4.14,232.66,67
HCPCS,C1729,"NAVARRE UNIV DRNG CATH W/NITINOL 6FR, LOCKING PIGTAIL",517.5,336.38,112.82,517.5,67
HCPCS,C1729,"PERICARDIOCENTESIS PROCEDURE KIT, HIGH-FLOW STRAIGHT CATHETER, 6",131.0,85.15,28.56,232.66,67
HCPCS,C1729,PLEURAL DRAINAGE CATHETER,359.0,233.35,78.26,359.0,67
HCPCS,C1729,PLEURX DRAINAGE CATHETER,690.0,448.5,150.42,690.0,67
HCPCS,C1729,REGULAR FLEXIMA NEPHROSTOMY 12F  25MM,328.0,213.2,71.5,328.0,67
HCPCS,C1729,SAFE-T-CENTESIS DRUG-FREE TRAY 6FX16CM BX/10,735.9,478.34,160.43,735.9,67
HCPCS,C1729,"SILICONE MALECOT NEPHROSTOMY CATHETER, 10 FR X 20CM",65.0,42.25,14.17,232.66,67
HCPCS,C1729,W CATH DRNG 10FR/14FR 25CM,102.87,66.87,22.43,232.66,67
HCPCS,C1730,"ADVISOR HD GRID X, SENSOR ENABLED, HIGH DENSITY MAPPING CATHETER",5248.0,3411.2,200.93,5248.0,67
HCPCS,C1730,C1730 EP CATH W/CON TIER 0,243.0,157.95,52.97,243.0,134
HCPCS,C1730,C1730 EP CATH W/CON TIER I,713.0,463.45,155.43,713.0,134
HCPCS,C1730,"CATH, EP, 19 OR FEW ELECT, T34",3400.0,2210.0,200.93,3400.0,67
HCPCS,C1730,CORDIS LASSO CATHETER,1451.25,943.31,200.93,1451.25,67
HCPCS,C1730,DAIG 4F BIPOLAR PACING,70.07,45.55,15.28,232.66,67
HCPCS,C1730,G230249 AVANT GUARD FARADRIVE? STEERABLE SHEATH ? NCT06096337,1300.0,845.0,200.93,1300.0,69
HCPCS,C1730,INQUIRY DECAPOLAR STEERABLE EP CATH,450.0,292.5,98.1,450.0,67
HCPCS,C1730,"LIVEWIRE HEX, OCT, DECA(NEW)",1400.31,910.2,200.93,1400.31,67
HCPCS,C1730,MAPPING CATHETER WITH TRUEREF TECHNOLOGY,2928.0,1903.2,200.93,2928.0,67
HCPCS,C1730,MARINR MC 7FR 2/5/2 EP CATHETER,915.0,594.75,199.47,915.0,67
HCPCS,C1730,NUVISION ICE CATHETER,6400.0,4160.0,200.93,6400.0,67
HCPCS,C1730,QUADRAPOLAR EP CATH,900.0,585.0,196.2,900.0,67
HCPCS,C1730,RPM MAPPING CATHETER,1306.95,849.52,200.93,1306.95,67
HCPCS,C1730,STEEROCATH OCTAPOLAR(NEW),418.5,272.03,91.23,418.5,67
HCPCS,C1730,SUPREME QUAD CRD-2 4FR,278.0,180.7,60.6,278.0,67
HCPCS,C1730,TAP/DEFLECTABLE MAPPING CATH,501.0,325.65,109.22,501.0,67
HCPCS,C1730,W CATH EP 6FR 110CM 2-10-2MM,1665.0,1082.25,200.93,1665.0,67
HCPCS,C1731,C1731 EP CATH WITH ELECTR 3,2099.0,1364.35,200.93,2099.0,134
HCPCS,C1731,W CATH DIAG STEERABLE ORBITER,1238.0,804.7,200.93,1238.0,67
HCPCS,C1732,CARTO NAVIS STAR CATHETER,3375.0,2193.75,200.93,3375.0,67
HCPCS,C1732,G120289 NMARQ PVI SYSTEM NCT01824394,3037.5,1974.38,200.93,3037.5,67
HCPCS,C1732,G190060 FROZEN-AF CRYO-BALLOON CATH MODEL 2315 NCT04133168,4750.0,3087.5,200.93,4750.0,69
HCPCS,C1732,G190060 FROZEN-AF? MAPPING CATHETER MODEL 2317 NCT04133168,900.0,585.0,196.2,900.0,69
HCPCS,C1732,G220208 PULSAR NCT05462145,10000.0,6500.0,200.93,10000.0,69
HCPCS,C1732,INTELLANAV CATHETER G200215 NEWTON AF NCT04580914,3400.0,2210.0,200.93,3400.0,69
HCPCS,C1732,THERMO ABLAT CATH TIER 4,4334.0,2817.1,200.93,4334.0,134
HCPCS,C1732,THERMO ABLAT CATH TIER I,1200.0,780.0,200.93,1200.0,67
HCPCS,C1732,THERMO ABLAT CATH TIER II,2700.0,1755.0,200.93,2700.0,67
HCPCS,C1732,W CATH ABL NAV DS,1554.34,1010.32,200.93,1554.34,67
HCPCS,C1733,C1733 ABLATION CATH TIER I,1275.0,828.75,200.93,1275.0,67
HCPCS,C1733,C1733 ABLATION CATH TIER II,3240.0,2106.0,200.93,3240.0,67
HCPCS,C1733,C1733 ABLATION CATH TIER III,5670.0,3685.5,200.93,5670.0,67
HCPCS,C1733,C1733 EVOLUTION  SHEATH SET,2018.25,1311.86,200.93,2018.25,67
HCPCS,C1733,CELSIUS CARDIAC RADIO-FREQUECY ABLATION SYSTEM CATHETER,1378.0,895.7,200.93,1378.0,67
HCPCS,C1733,FARAWAVE 2.0 CATHETER,16900.0,10985.0,200.93,16900.0,67
HCPCS,C1733,FARAWAVE 2.0 NAV CATHETER,16900.0,10985.0,200.93,16900.0,134
HCPCS,C1733,FARAWAVE ELECTROPHYSIOLOGY ABLATION PFA CATHETER,16900.0,10985.0,200.93,16900.0,67
HCPCS,C1733,"FREEZOR MAX 3, MEDIUM BLUE, CARDIAC CRYOABLATION CATH",3800.0,2470.0,200.93,3800.0,67
HCPCS,C1733,G120067 VICTORY CRYO MLTY SPL,1050.0,682.5,200.93,1050.0,69
HCPCS,C1733,G120067 VICTORY CRYO PVAC GLD,4200.0,2730.0,200.93,4200.0,69
HCPCS,C1733,G120067 VICTORY CRYO PVAC MLTY,1050.0,682.5,200.93,1050.0,69
HCPCS,C1733,"G160219, STOP AF FIRST, NCT 03118518",4200.0,2730.0,200.93,4200.0,69
HCPCS,C1733,G230249 AVANT GUARD FARAWAVE 2.0? NAV PFA CATHETER ? NCT06096337,8250.0,5362.5,200.93,8250.0,69
HCPCS,C1733,G230249 AVANT GUARD FARAWAVE ? PFA CATHETER ? NCT06096337,6450.0,4192.5,200.93,6450.0,69
HCPCS,C1733,G240240 SPHERE-9 VT MAP ABL CATH NCT06703489,11000.0,7150.0,200.93,11000.0,67
HCPCS,C1733,KIT DENALI SNARE 2 SHEATH RETRIEVAL,900.0,585.0,196.2,900.0,67
HCPCS,C1733,MEDTRONIC PULSESELECT PFA LOOP CATHETER,19500.0,12675.0,200.93,19500.0,67
HCPCS,C1733,MEDTRONIC PVAC GOLD CATHETER PULSED AF-PIVOTAL TRIAL IDE G190272,8600.0,5590.0,200.93,8600.0,69
HCPCS,C1733,QDOT MICRO CATHETER,7162.0,4655.3,200.93,7162.0,67
HCPCS,C1733,W CATH ABLATION EZ STEER NAV,60.0,39.0,13.08,232.66,67
HCPCS,C1734,"Orth/devic/drug bn/bn,tis/bn",,,200.93,232.66,8
HCPCS,C1735,SYMPLICITY SPYRAL CATH RDN016,32000.0,20800.0,200.93,32000.0,67
HCPCS,C1736,"RECOR MEDICAL PARADISE RDN CATHETER(S), INTRAVASCULAR FOR RENAL",40000.0,26000.0,200.93,40000.0,67
HCPCS,C1737,Si&pelvis fusn&fixn dev,,,200.93,232.66,8
HCPCS,C1738,Power endo us-guid bx dev,,,200.93,232.66,8
HCPCS,C1739,TUMARK BIOPSY MARKER,165.0,107.25,35.97,232.66,74
HCPCS,C1740,"Lt vent pacing syst, sequen",,,200.93,232.66,8
HCPCS,C1741,Anchor/screw bone absorb,,,200.93,232.66,8
HCPCS,C1742,"Pressure sens syst, cont im",,,200.93,232.66,8
HCPCS,C1743,Scafld endovas resrb drg elu,,,200.93,232.66,8
HCPCS,C1747,ENDOSCOPE SINGLE USE IE DISPOSABLE URINARY TRACT IMAGING ILLUMIN,25.0,16.25,5.45,232.66,67
HCPCS,C1748,"ENDOSCOPE, SINGLE USE, DISPOSABLE",3995.5,2597.08,200.93,3995.5,67
HCPCS,C1749,"Endo, colon, retro imaging",,,200.93,232.66,8
HCPCS,C1750,EQUISTREAM DIALYISIS,930.0,604.5,200.93,930.0,75
HCPCS,C1750,EQUISTREAM LONG-TERM HEMODIALYSIS CATHETER WITH PRELOADED,600.0,390.0,130.8,600.0,75
HCPCS,C1750,GLIDEPATH LONG-TERM HEMODIALYSIS CATHETER WITH PRELOADED STYLET,600.0,390.0,130.8,600.0,75
HCPCS,C1750,HEMOSPLIT DUAL LUMEN CATH 14.5 FR W/AIR GUARD VALVE INTRO (EA),479.0,311.35,104.42,479.0,75
HCPCS,C1750,"QUINTON PERMCATH DUAL LUMEN DIALYSIS CATH KIT W/ GWIRE, OVAL INT",678.0,440.7,147.8,678.0,75
HCPCS,C1750,W CATH 13.5 FR HICKMAN DIALYSIS,639.62,415.75,139.44,639.62,75
HCPCS,C1751,ACCUCATH 20G 2.25IN POWER INJECTIBLE,130.0,84.5,28.34,232.66,74
HCPCS,C1751,ACCUCATH 20G X 2-1/4IN,161.0,104.65,35.1,232.66,74
HCPCS,C1751,"ANGIODYNAMICS PERCEPTOR DT DISP TRANSDUCER, W/SC",19.5,12.68,4.25,232.66,67
HCPCS,C1751,ARROWGUARD BLUE PLUS CATHETER,267.0,173.55,58.21,267.0,67
HCPCS,C1751,"BARD 3FR POWERPICC SV BASIC, SL",244.35,158.83,53.27,244.35,67
HCPCS,C1751,BARD 4 FR POWER PICC DUAL LUMEN,227.5,147.88,49.6,232.66,67
HCPCS,C1751,BARD PICC/SHERLOCK 4FR SINGLE,113.75,73.94,24.8,232.66,67
HCPCS,C1751,BARD PICC/SHERLOCK 5FR DOUBLE,145.0,94.25,31.61,232.66,67
HCPCS,C1751,"BARD POWER PICC SV CATHETIR IR TRAY, SINGLE LUMEN, NITINOL,3FRX7",229.25,149.01,49.98,232.66,67
HCPCS,C1751,BAYLIS GROUNDING PAD,24.0,15.6,5.23,232.66,67
HCPCS,C1751,BIOFLO MAX BARRIER 4F SINGLE,520.0,338.0,113.36,520.0,75
HCPCS,C1751,BIOFLO PICC ON 4F SGL,228.0,148.2,49.7,232.66,75
HCPCS,C1751,BROVIAC/HICKMAN/LEONARD CATH/ 7 FR DUAL LUMEN PED CATH,222.0,144.3,48.4,232.66,67
HCPCS,C1751,CATH ART 7.5FR THRMDIL,54.0,35.1,11.77,232.66,67
HCPCS,C1751,CATH CVP 3-LUMEN 7FR CK-15703,18.05,11.73,3.93,232.66,67
HCPCS,C1751,CATH PWRPICC PROVENA MAX 3FR SL,1054.14,685.19,200.93,1054.14,67
HCPCS,C1751,"CATH,BROVIAC/HICKMAN/LEONARD",5980.0,3887.0,200.93,5980.0,76
HCPCS,C1751,CHLOROGUARD KIT W/PICC,389.82,253.38,84.98,389.82,67
HCPCS,C1751,"CRAGG-MCNAMARA VALV INFUS CATH, 5FR X 135CM, 50CM INFUS,.038IN M",206.5,134.23,45.02,232.66,67
HCPCS,C1751,"CUSTOM ARROW MULTI-LUMEN PRESS INJ CENTRAL VEN CATH KIT, 8.5FR X",213.0,138.45,46.43,232.66,75
HCPCS,C1751,"DISPOSABLE 4F PV LOOP CATHETER, NO LUMEN AND 12 ELECTRODES WITH",2093.0,1360.45,200.93,2093.0,67
HCPCS,C1751,DISPOSABLE 7F PV LOOP CATHETER WITH 0.025 INCH LUMEN AND 12 ELEC,2012.0,1307.8,200.93,2012.0,67
HCPCS,C1751,DOT PROV 4FR DL MAX 3CG,479.5,311.68,104.53,479.5,67
HCPCS,C1751,EKOSONIC MACH 4 BALLOONS,3031.0,1970.15,200.93,3031.0,67
HCPCS,C1751,EKOSONIC MACH 4 ENDOVAS DEVICE,4790.0,3113.5,200.93,4790.0,76
HCPCS,C1751,HICKMAN SINGLE LUMEN CATHETER W/O VITACUFF  4.2 FR,203.0,131.95,44.25,232.66,67
HCPCS,C1751,KIT MAC ARROWG+ARD BLUE ARROW ADVANCER 9FR,272.0,176.8,59.3,272.0,67
HCPCS,C1751,MAX BARRIER 3FR SL SPT,480.06,312.04,104.65,480.06,67
HCPCS,C1751,MIDLINE CATHETER,115.0,74.75,25.07,232.66,67
HCPCS,C1751,MIDLINE INFUSION CATH,1200.0,780.0,200.93,1200.0,67
HCPCS,C1751,MINI STICK OR CHECK-FLO INTRO,113.0,73.45,24.63,232.66,67
HCPCS,C1751,MST BASIC SET 2.6FR DL 50CM (CATH ONLY),294.0,191.1,64.09,294.0,67
HCPCS,C1751,PICC 4FR SINGLE LUMEN 3CG,444.0,288.6,96.79,444.0,67
HCPCS,C1751,PICC 5 FR DOUBLE LUMEN 3CG,533.0,346.45,116.19,533.0,67
HCPCS,C1751,PICC 5 FR TRIPLE LUMEN 3CG,618.0,401.7,134.72,618.0,67
HCPCS,C1751,PICC CATHETER,178.0,115.7,38.8,232.66,67
HCPCS,C1751,POWERGLIDE MIDLINE BASIC KIT,118.0,76.7,25.72,232.66,67
HCPCS,C1751,POWERGLIDE MIDLINE FULL KIT,191.0,124.15,41.64,232.66,67
HCPCS,C1751,"PWRLN PWR INJ CVC, CATH TIP DUAL LUMEN CATH",390.0,253.5,85.02,390.0,67
HCPCS,C1751,"PWRLN PWR INJ CVC, CATH TIP, TRIPLE LUMEN CATH",450.0,292.5,98.1,450.0,67
HCPCS,C1751,SWAN-GANZ 5 LUMEN CATHETER,85.4,55.51,18.62,232.66,67
HCPCS,C1751,VASCU-PICC MAX BARRIER 2.6FR DL 50CM,484.0,314.6,105.51,484.0,67
HCPCS,C1751,W CATH 7FR DUAL F/TRAY V-CUFF,255.57,166.12,55.71,255.57,67
HCPCS,C1752,ANGIODYNAMICS SCHON XL CATHETER,1087.5,706.88,200.93,1087.5,75
HCPCS,C1752,QUINTON PERMACATHETER,152.05,98.83,33.15,232.66,75
HCPCS,C1752,TRAY TRIALYSIS CATH DIALYSIS SHORT TERM,380.0,247.0,82.84,380.0,67
HCPCS,C1753,ACUNAV V10FR 3D ULTSND CATH,4725.0,3071.25,200.93,4725.0,67
HCPCS,C1753,BOS SCI ATLANTIS CORONARY CATH,960.0,624.0,200.93,960.0,67
HCPCS,C1753,C1753 TIER 1 OCT OR IVUS CATHETER,1088.0,707.2,200.93,1088.0,67
HCPCS,C1753,C1753 TIER 2 OCT OR IVUS CATHETER,3240.0,2106.0,200.93,3240.0,67
HCPCS,C1753,OPTICROSS HD CORONARY IMAGING CATHETERS,1406.5,914.23,200.93,1406.5,134
HCPCS,C1753,W CATH ATLANTS SR,1102.21,716.44,200.93,1102.21,67
HCPCS,C1754,"Catheter, intradiscal",,,200.93,232.66,8
HCPCS,C1755,CATH INT THCL 2 PC 878X,1350.0,877.5,200.93,1350.0,67
HCPCS,C1755,CATH INT THCL DIST SPNL KT REV 8598,450.0,292.5,98.1,450.0,67
HCPCS,C1755,CATH INT THCL PROMETRA NO PUMP 11823,1540.0,1001.0,200.93,1540.0,76
HCPCS,C1755,"CATH INT THCL PROMETRA,PUMP 11823",1540.0,1001.0,200.93,1540.0,76
HCPCS,C1755,CATH INT THCL PROX SPNL KT PMP 8596SC,600.0,390.0,130.8,600.0,67
HCPCS,C1755,CATH INT THCL SUTLS PMP CONN 8731SC,967.5,628.88,200.93,967.5,67
HCPCS,C1755,CATH REVISION KIT 11830,1000.0,650.0,200.93,1000.0,75
HCPCS,C1755,PROMETRA INTRATHECAL CATHETER,1540.0,1001.0,200.93,1540.0,76
HCPCS,C1756,"Cath, pacing, transesoph",,,200.93,232.66,8
HCPCS,C1757,10 FR PRONTO EXTRACTION CATH,1192.5,775.13,200.93,1192.5,67
HCPCS,C1757,ANGIOJET ZELANTEDVT THROMBECTOMY SYSTEM 8FR X 105CM,3800.0,2470.0,200.93,3800.0,67
HCPCS,C1757,ARROW TREROTOLA FR BASKET CATH,864.25,561.76,188.41,864.25,67
HCPCS,C1757,C1757 EMBOLECTOMY DEVICE,675.0,438.75,147.15,675.0,67
HCPCS,C1757,C1757 TIER 1 THROMBECTOMY CATH,750.0,487.5,163.5,750.0,67
HCPCS,C1757,C1757 TIER 11 TROMBECTOMY CATH,12150.0,7897.5,200.93,12150.0,67
HCPCS,C1757,C1757 TIER 2 THROMBECTOMY CATH,2336.0,1518.4,200.93,2336.0,67
HCPCS,C1757,C1757 TIER 3 THROMBECTOMY CATH,3800.0,2470.0,200.93,3800.0,67
HCPCS,C1757,CATHETER?CAT6X W/SONIC + LIGHTNING BOLT,15280.0,9932.0,200.93,15280.0,67
HCPCS,C1757,CLEANER VAC THROMBECTOMY SYSTEM,16500.0,10725.0,200.93,16500.0,67
HCPCS,C1757,CLEANER VAC? - 18F OD X 115CM ASPIRATION CATHETER WITH HANDPIECE,16000.0,10400.0,200.93,16000.0,67
HCPCS,C1757,CLEANER15 ROTATIONAL THROMBECTOMY SYSTEM,1992.0,1294.8,200.93,1992.0,67
HCPCS,C1757,CLOTTRIEVER CATHETER,7425.0,4826.25,200.93,7425.0,67
HCPCS,C1757,"CLOTTRIEVER CATHETER, VARIABLE LENGTHTHROMBECTOMY SUCTION CATHET",13000.0,8450.0,200.93,13000.0,67
HCPCS,C1757,EDWARDS ARTERIAL CATH TRUE WAVE 2 LUMEN,220.0,143.0,47.96,232.66,67
HCPCS,C1757,FOGARTY CATHETER,406.54,264.25,88.63,406.54,67
HCPCS,C1757,"G150028 DEFUSE 3-PENUMBRA SYSTEM SEPARATOR FLEX (026,032,041,054",2970.0,1930.5,200.93,2970.0,69
HCPCS,C1757,G150028 DEFUSE 3-SOLITAIRE REVASCULARIZATION DEVICE,8320.05,5408.03,200.93,8320.05,69
HCPCS,C1757,"G190069,  EMBOTRAP II, NCT 04167527",19250.0,12512.5,200.93,19250.0,69
HCPCS,C1757,"G190069, EMBOTRAP III, NCT 04167527",20265.0,13172.25,200.93,20265.0,69
HCPCS,C1757,"G200053, EXCELLENT; EBMBOTRAP II, NCT 03685578",19250.0,12512.5,200.93,19250.0,69
HCPCS,C1757,"G200053, EXCELLENT; EMBOTRAP III, NCT 03685578",20265.0,13172.25,200.93,20265.0,69
HCPCS,C1757,G210308 APEXAV NCT05318092,9000.0,5850.0,200.93,9000.0,69
HCPCS,C1757,INFUSION CATHETER,206.5,134.23,45.02,232.66,67
HCPCS,C1757,JETI? 6F CATHETER KIT,7480.0,4862.0,200.93,7480.0,67
HCPCS,C1757,SOLTR THROMB EMBO EV3 DVC,8320.05,5408.03,200.93,8320.05,67
HCPCS,C1757,THROMBECT/EMBOLECTMY CATH,2180.0,1417.0,200.93,2626.0,201
HCPCS,C1757,THROMBECT/EMBOLECTOMY CATH,2693.0,1750.45,200.93,4035.0,201
HCPCS,C1757,TRIEVER24 THROMBECTOMY CATHETER,13500.0,8775.0,200.93,13500.0,67
HCPCS,C1757,W CATH ANGIO XFEEDER 120CM,420.49,273.32,91.67,420.49,67
HCPCS,C1758,W CATH URET,15.46,10.05,3.37,232.66,67
HCPCS,C1759,ACUNAV ICE CATHETER,2565.0,1667.25,200.93,2565.0,67
HCPCS,C1759,BSW NUVISION,6400.0,4160.0,200.93,6400.0,67
HCPCS,C1759,W CATH ACUNAV ULTRASOUND,2565.0,1667.25,200.93,2565.0,67
HCPCS,C1760,ABBOTT VASCULAR CLOSURE DEVICE,322.5,209.63,70.31,322.5,67
HCPCS,C1760,AMPLATZER DUCT OCCLUDER 9MM,5811.75,3777.64,200.93,5811.75,76
HCPCS,C1760,ANGIO-SEAL VIP VASCULAR CLOSURE 6FR (2 BOXES OF 5),256.5,166.73,55.92,256.5,75
HCPCS,C1760,ANGIOSEAL,350.0,227.5,76.3,350.0,75
HCPCS,C1760,BOSTON SCIENTIFIC EMBOLD FIBERED COILS 10X20,1482.0,963.3,200.93,1482.0,67
HCPCS,C1760,BOSTON SCIENTIFIC EMBOLD FIBERED COILS 12X20,1482.0,963.3,200.93,1482.0,67
HCPCS,C1760,BOSTON SCIENTIFIC EMBOLD FIBERED COILS 12X30,1686.15,1096.0,200.93,1686.15,67
HCPCS,C1760,BOSTON SCIENTIFIC EMBOLD FIBERED COILS 12X50,1686.15,1096.0,200.93,1686.15,67
HCPCS,C1760,BOSTON SCIENTIFIC EMBOLD FIBERED COILS 14X20,1482.0,963.3,200.93,1482.0,67
HCPCS,C1760,BOSTON SCIENTIFIC EMBOLD FIBERED COILS 14X30,1686.15,1096.0,200.93,1686.15,67
HCPCS,C1760,BOSTON SCIENTIFIC EMBOLD FIBERED COILS 14X50,1686.15,1096.0,200.93,1686.15,67
HCPCS,C1760,BOSTON SCIENTIFIC EMBOLD FIBERED COILS 18X50,1686.15,1096.0,200.93,1686.15,67
HCPCS,C1760,BOSTON SCIENTIFIC EMBOLD FIBERED COILS 20X50,1686.15,1096.0,200.93,1686.15,67
HCPCS,C1760,BOSTON SCIENTIFIC EMBOLD FIBERED COILS 22X60,1686.15,1096.0,200.93,1686.15,67
HCPCS,C1760,BOSTON SCIENTIFIC EMBOLD FIBERED COILS 2X4,1332.0,865.8,200.93,1332.0,67
HCPCS,C1760,BOSTON SCIENTIFIC EMBOLD FIBERED COILS 2X6,1332.0,865.8,200.93,1332.0,67
HCPCS,C1760,BOSTON SCIENTIFIC EMBOLD FIBERED COILS 32X60,1686.15,1096.0,200.93,1686.15,67
HCPCS,C1760,BOSTON SCIENTIFIC EMBOLD FIBERED COILS 3X12,1482.0,963.3,200.93,1482.0,67
HCPCS,C1760,BOSTON SCIENTIFIC EMBOLD FIBERED COILS 3X6,1332.0,865.8,200.93,1332.0,67
HCPCS,C1760,BOSTON SCIENTIFIC EMBOLD FIBERED COILS 4X15,1482.0,963.3,200.93,1482.0,67
HCPCS,C1760,BOSTON SCIENTIFIC EMBOLD FIBERED COILS 4X8,1332.0,865.8,200.93,1332.0,67
HCPCS,C1760,BOSTON SCIENTIFIC EMBOLD FIBERED COILS 5X8,1332.0,865.8,200.93,1332.0,67
HCPCS,C1760,BOSTON SCIENTIFIC EMBOLD FIBERED COILS 6X10,1482.0,963.3,200.93,1482.0,67
HCPCS,C1760,BOSTON SCIENTIFIC EMBOLD FIBERED COILS 6X20,1482.0,963.3,200.93,1482.0,67
HCPCS,C1760,CLOSURE DEVICE,262.5,170.63,57.23,262.5,75
HCPCS,C1760,DEVICE VES CLOS MYNX CONTROL VCD 6FR-12FR,350.0,227.5,76.3,350.0,75
HCPCS,C1760,EXOSEAL VASCULAR CLOSURE DEVICE,232.5,151.13,50.69,232.66,75
HCPCS,C1760,G190285 CATALYST?NCT04226547?AMPLATZER AMULET LAA OCCLUDER,12000.0,7800.0,200.93,12000.0,69
HCPCS,C1760,MICRO VASCULAR PLUG MVP-5 US,3390.0,2203.5,200.93,3390.0,76
HCPCS,C1760,MID-BORE VENOUS VASCULAR CLOSURE SYSTEM,321.44,208.94,70.07,321.44,75
HCPCS,C1760,MYNX CLOSURE DEVICE,452.0,293.8,98.54,452.0,74
HCPCS,C1760,MYNX CONTROL WOUND HYDROGEL DRESSING,525.0,341.25,114.45,525.0,74
HCPCS,C1760,PERCLOSE PROSTYLE SUTURE-MEDIATED CLOSURE AND REPAIR SYSTEM,639.9,415.94,139.5,639.9,74
HCPCS,C1760,"PROGLIDE SUTURE-MEDIATED CLOSURE SYSTEM, W/KNOT PUSH & 7 SUT TRI",322.5,209.63,70.31,322.5,75
HCPCS,C1760,STARCLOSE SE VASCULAR CLOSURE SYSTEM 6 FR X 2.0MM  (EA/1),285.0,185.25,62.13,285.0,75
HCPCS,C1760,VASCADE MVP XL VENOUS VASC CLOSURE SYS,225.0,146.25,49.05,232.66,75
HCPCS,C1760,VASCADE VASCULAR CLOSURE SYSTEM DEVICE 5FR,247.5,160.88,53.96,247.5,75
HCPCS,C1760,VASCULAR CLOSURE DEVICE,259.5,168.68,56.57,259.5,75
HCPCS,C1760,VENOUS VASCULAR CLOSURE SYSTEM,450.0,292.5,98.1,450.0,75
HCPCS,C1760,W DEV CLOSR VASC 6/7FR MYNX,1200.0,780.0,200.93,1200.0,75
HCPCS,C1761,CORONARY IVL CATHETER,7050.0,4582.5,200.93,7050.0,67
HCPCS,C1761,SHOCKWAVE C2 IVL CATHETER,7050.0,4582.5,200.93,7050.0,67
HCPCS,C1764,ASSERT-IQ EL+ INSERTABLE CARDIAC MONITOR,10500.0,6825.0,200.93,10500.0,76
HCPCS,C1764,C1764 LOOP RECORDER TIER 2,9990.0,6493.5,200.93,9990.0,152
HCPCS,C1764,MEDTRONIC J SLEEVE,19.0,12.35,4.14,232.66,67
HCPCS,C1764,"MEDTRONIC LINQ II, ACTUAL RECORDER",6270.75,4075.99,200.93,6270.75,67
HCPCS,C1764,"W EVENT RECORDER,CARDIAC IMPLAN",6320.0,4108.0,200.93,6320.0,76
HCPCS,C1765,Adhesion barrier,,,200.93,232.66,8
HCPCS,C1766,AGILIS NXT STEERABLE INTRODUCER 13FR MEDIUM CURL,2600.0,1690.0,200.93,2600.0,67
HCPCS,C1766,AMULET STEERABLE DELIVERY SHEATH,2000.0,1300.0,200.93,2000.0,67
HCPCS,C1766,BARD HALO ONE GUIDING SHEATH,465.0,302.25,101.37,465.0,67
HCPCS,C1766,C1766 BI-DIRECTIONAL INTROD,1782.0,1158.3,200.93,1782.0,134
HCPCS,C1766,C1766 INTRODUCER TIER 2,1200.0,780.0,200.93,1200.0,67
HCPCS,C1766,"COOK 12CM X 12MM MREYE EMBO COIL, 0.038IN MAX(IMWCE-38-12-12)",113.75,73.94,24.8,232.66,67
HCPCS,C1766,"COOK 12FRX13CM, CHECK-FLO INTRO, LG VALVE, INC .038IN STRT 3MM J",71.3,46.35,15.54,232.66,67
HCPCS,C1766,"COOK 5FR X 55CM FLEXOR ANSEL GUIDING SHEATH, MULTIPURPOSE",96.25,62.56,20.98,232.66,67
HCPCS,C1766,"COOK 5FRX45CM, FLEXOR CHECK-FLO INTRODUCER, ANSEL 2",75.25,48.91,16.4,232.66,67
HCPCS,C1766,COOK ROADRUNNER EXCHANGE GUIDEWIRE 0.018X300 CM,171.5,111.48,37.39,232.66,67
HCPCS,C1766,"CORDIS 4FRX100CM INFINITI TL DIAGCATH, SRC, FEMORAL /THRULUMEN",23.0,14.95,5.01,232.66,67
HCPCS,C1766,"CORDIS 4FRX5.5CM, AVANTI SHEATH INTRO, W/ 0.035IN GUIDEWIRE",18.2,11.83,3.97,232.66,67
HCPCS,C1766,DESTINO STEERABLE GUIDING SHEATH 6.5 FR,1498.5,974.03,200.93,1498.5,67
HCPCS,C1766,FARADRIVE ELECTROPHYSIOLOGICAL ABLATION STEERABLE SHEATH,2600.0,1690.0,200.93,2600.0,67
HCPCS,C1766,G190060 FROZEN-AF STEERABLE SHEATH MODEL 2316 NCT04133168,1250.0,812.5,200.93,1250.0,69
HCPCS,C1766,INTELLANAV CATH CABLE G200215 NEWTON AF NCT04580914,490.0,318.5,106.82,490.0,69
HCPCS,C1766,INTRO SHTH 8.5FR 71CM GUID,1664.0,1081.6,200.93,1664.0,67
HCPCS,C1766,MEDTRONIC FLEXCATH CONTOUR STEERABLE SHEATH,4360.0,2834.0,200.93,4360.0,67
HCPCS,C1766,OSCOR DESTINO TWIST STEERABLE GUIDING SHEATH,1425.0,926.25,200.93,1425.0,67
HCPCS,C1766,RAPID INF. DEVICE,476.0,309.4,103.77,476.0,67
HCPCS,C1766,"VERSACROSS RF WIRE, PIGTAIL, D0 SHEATH",3300.0,2145.0,200.93,3300.0,67
HCPCS,C1767,ANS NON-RECHARGEABLE IPG,19316.0,12555.4,200.93,19316.0,76
HCPCS,C1767,"G070235,ACTIVA NEUROSTIM,7426",8545.0,5554.25,200.93,8545.0,69
HCPCS,C1767,G100008 ACTIVA NEUROSTIM 37601,17200.0,11180.0,200.93,17200.0,69
HCPCS,C1767,G240099 ENTERA SYS 37800,10750.0,6987.5,200.93,10750.0,67
HCPCS,C1767,"GENERATOR, NEURO NON-RECHARG",33387.5,21701.875,1.1,51600.0,144
HCPCS,C1767,"GENESIS XP, IPG # 3609",29314.38,19054.35,200.93,29314.38,76
HCPCS,C1767,H990014 NRSTM IMP 2.4INX2.2IN ENTERRA,16900.0,10985.0,200.93,16900.0,69
HCPCS,C1767,KIT INTLS PRGRM EXTRNL 97725,496.0,322.4,108.13,496.0,75
HCPCS,C1767,KIT NRSTM MULTI TRIAL CABLE 355531,496.0,322.4,108.13,496.0,75
HCPCS,C1767,MEDTRONIC NON-RECHARGEABLE IPG,19316.0,12555.4,200.93,19316.0,76
HCPCS,C1767,NRSTM IMP INTELLIS SNSR MRI 97715,23000.0,14950.0,200.93,23000.0,76
HCPCS,C1767,NRSTM IMP PRIME ADV MRI 97702,17000.0,11050.0,200.93,17000.0,76
HCPCS,C1767,ST. JUDE 16 CHANNEL IPG,19980.0,12987.0,200.93,19980.0,76
HCPCS,C1767,W GEN INS/IPG CSTM SYNERGY VEST,19110.0,12421.5,200.93,19110.0,76
HCPCS,C1768,G150224? THORAFLEX HYBRID DEVICE,14000.0,9100.0,200.93,14000.0,69
HCPCS,C1769,.014 GUIDEWIRES,228.0,148.2,49.7,232.66,67
HCPCS,C1769,.035 TIP DEFLECTOR GUIDE WIRE,147.0,95.55,32.05,232.66,67
HCPCS,C1769,0.018IN X 300CM HI-TORQUE COMMAND ST GUIDE,267.88,174.12,58.4,267.88,67
HCPCS,C1769,"5FR X 40CM VSI DE-CLOT MICRO-HV INTRODUCER KIT, NITINOL, SS",78.75,51.19,17.17,232.66,67
HCPCS,C1769,6FR GUIDEZILLA II GUIDE EXTENSION CATH,600.0,390.0,130.8,600.0,67
HCPCS,C1769,"ABBOT ASAHI CONF PRO 12, 014IN/ 180CM GUIDE WIRE",210.0,136.5,45.78,232.66,67
HCPCS,C1769,"ABBOTT, NC TREK, CORONARY DILATION CATH 4.5X15MM",148.75,96.69,32.43,232.66,67
HCPCS,C1769,ABOT GW HI-TORQ BAL HVYWT,131.25,85.31,28.61,232.66,67
HCPCS,C1769,AGILITY 16 STEERABLE GUIDEWIRE,412.5,268.13,89.93,412.5,67
HCPCS,C1769,AMPLATZ SS GUIDEWIRE .035 .038,79.81,51.88,17.4,232.66,67
HCPCS,C1769,AMPLATZ SS WIRE ST,85.63,55.66,18.67,232.66,67
HCPCS,C1769,"ARROW 4FRX40CMX0.018IN MICRO-INTRODUCER, NITINOL PLATINUM, SOFT",37.9,24.64,8.26,232.66,67
HCPCS,C1769,ARROW GUIDEWIRE 6FX24CM,48.0,31.2,10.46,232.66,67
HCPCS,C1769,"ASAHI ASTATO 30 300, 018IN/300CM GUIDE WIRE",247.5,160.88,53.96,247.5,67
HCPCS,C1769,"ASAHI HYDROPHILIC COATED SPRING COIL GUIDE WIRE, 1.5J CE, 0.35IN",80.0,52.0,17.44,232.66,67
HCPCS,C1769,"ASAHI PROWATER PTCA GUIDEWIRE, STRAIGHT, 0.014X300 CM",122.5,79.63,26.71,232.66,67
HCPCS,C1769,ASAHI SILVERWAY,60.0,39.0,13.08,232.66,67
HCPCS,C1769,"ASAHI, GLADIUS, GUIDEWIRE, 014X200CM, PPW14R100S",201.25,130.81,43.87,232.66,67
HCPCS,C1769,B BRAUN MICRO GUIDEWIRE 4F,28.0,18.2,6.1,232.66,67
HCPCS,C1769,"BARD POWER PICC DUAL LUMEN NITINOL GW, 5FR, RADSTIC MICROINTRODU",213.57,138.82,46.56,232.66,67
HCPCS,C1769,"BENTSON CEREBRAL GDWR 0.035"" X 260CM COATED",44.0,28.6,9.59,232.66,67
HCPCS,C1769,"BOSTON SCIENTIFIC FORTE GUIDEWIRE, MOD SUPPORT, FLOPPY, ST TIP,",122.15,79.4,26.63,232.66,67
HCPCS,C1769,BOSTON SCIENTIFIC MAGIC TORQUE GUIDEWIRE,93.19,60.57,20.32,232.66,74
HCPCS,C1769,BOSTON SCIENTIFIC/FORTE 014/185CM MOD SUPPORT GUIDE WIRE,113.75,73.94,24.8,232.66,67
HCPCS,C1769,BOSTON SCIENTIFIC/FORTE 014/300CM MOD SUPPORT GUIDE WIRE,113.75,73.94,24.8,232.66,67
HCPCS,C1769,C1769 EP GUIDEWIRE TIER I,60.0,39.0,13.08,232.66,67
HCPCS,C1769,C1769 EP GUIDEWIRE TIER III,229.5,149.18,50.03,232.66,134
HCPCS,C1769,C1769 WIRES TIER II,292.5,190.13,63.77,292.5,67
HCPCS,C1769,C1769 WIRES TIER III,225.0,146.25,49.05,232.66,67
HCPCS,C1769,CHOICE GUIDEWIRE 014X300CM,667.87,434.12,145.6,667.87,67
HCPCS,C1769,CM WHOLEY J GUIDE WIRE,223.0,144.95,48.61,232.66,67
HCPCS,C1769,CM WHOLEY STRAIGHT GUIDE WIRE,151.76,98.64,33.08,232.66,67
HCPCS,C1769,"COOK AES CURVED .025""X260CM GW",68.95,44.82,15.03,232.66,67
HCPCS,C1769,COOK DEFLECTING WIRE .035/145,86.28,56.08,18.81,232.66,67
HCPCS,C1769,COOK GUID WIRES .021/145 ST,27.62,17.95,6.02,232.66,67
HCPCS,C1769,COOK GUIDE WIRES .018/260 ST,52.52,34.14,11.45,232.66,67
HCPCS,C1769,COOK GUIDE WIRES .018/80 ST,35.02,22.76,7.63,232.66,67
HCPCS,C1769,COOK GUIDE WIRES .021/260 ST,48.14,31.29,10.49,232.66,67
HCPCS,C1769,COOK GUIDE WIRES .025/145 ST,22.1,14.37,4.82,232.66,67
HCPCS,C1769,COOK GUIDE WIRES .025/260 ST,43.78,28.46,9.54,232.66,67
HCPCS,C1769,COOK GUIDE WIRES .032/260 J,43.34,28.17,9.45,232.66,67
HCPCS,C1769,COOK GUIDE WIRES .035/260 J,39.94,25.96,8.71,232.66,67
HCPCS,C1769,COOK GUIDE WIRES .035/260 ST,35.7,23.21,7.78,232.66,67
HCPCS,C1769,COOK GW FOR MULLINS INTRO,94.0,61.1,20.49,232.66,67
HCPCS,C1769,COOK LUNDERQUIST EXTRASTIFF GUIDEWIRE 7.5MM CURVE,177.89,115.63,38.78,232.66,67
HCPCS,C1769,COPE NT .018 60 CM GUIDE WIRE,53.88,35.02,11.75,232.66,67
HCPCS,C1769,DIAMOND OSTEO INTRODUCER,693.0,450.45,151.07,693.0,67
HCPCS,C1769,"FATHOM STEERABLE GUIDEWIRE 0.016""",510.0,331.5,111.18,510.0,67
HCPCS,C1769,FMD PERIPHERAL GUIDEWIRE,470.0,305.5,102.46,470.0,67
HCPCS,C1769,GDWIRE THRUWAY 18X30CM,166.25,108.06,36.24,232.66,67
HCPCS,C1769,GLIDEWIRE CARDIAC/PERIPHERAL VASCULAR GUIDEWIRE,142.0,92.3,30.96,232.66,67
HCPCS,C1769,GLIDEWIRE GOLD,431.83,280.69,94.14,431.83,67
HCPCS,C1769,GLIDEWIRES,61.03,39.67,13.3,232.66,67
HCPCS,C1769,GLIDEWIRES 035 038X260CM,80.08,52.05,17.46,232.66,67
HCPCS,C1769,GUIDANT ACS WIRE,148.75,96.69,32.43,232.66,67
HCPCS,C1769,GUIDE WIRE,106.4,69.16,12.91,1688.0,268
HCPCS,C1769,GUIDE WIRE .035,88.97,57.83,19.4,232.66,67
HCPCS,C1769,GUIDEWIRE .035IN ANGLE HYDROPHILIC VASC STIFF,70.0,45.5,15.26,232.66,67
HCPCS,C1769,GUIDEWIRE 135,270.0,175.5,58.86,270.0,67
HCPCS,C1769,GUIDEWIRE C1769 38,81.49,52.97,17.76,232.66,67
HCPCS,C1769,GUIDEWIRE C1769 40,183.94,119.56,21.8,267.88,134
HCPCS,C1769,GUIDEWIRE C1769 53,133.0,86.45,28.99,232.66,67
HCPCS,C1769,GUIDEWIRE HI-TORQUE BALANCE MIDDLEWEIGHT UNIVERSAL II .014IN STR,177.5,115.38,38.7,232.66,67
HCPCS,C1769,GUIDEWIRE HI-TORQUE SUPRA CORE,140.0,91.0,30.52,232.66,67
HCPCS,C1769,GUIDEWIRE MINAMO,150.0,97.5,32.7,232.66,67
HCPCS,C1769,GUIDEWIRE POWERTURN,142.0,92.3,30.96,232.66,67
HCPCS,C1769,"GUIDEWIRE,APTUS ENDOSTAPL SYS",1485.0,965.25,200.93,1485.0,67
HCPCS,C1769,HI-TORQUE WHISPER MS GUIDE WIRE W/HYDROC,124.25,80.76,27.09,232.66,67
HCPCS,C1769,INFUSSION WIRE .035,402.17,261.41,87.67,402.17,67
HCPCS,C1769,INQWIRE AMPLATZ SHORT TAPER 0.035 X 260CM,87.5,56.88,19.08,232.66,67
HCPCS,C1769,"INQWIRE DIAG G-WIRE 0.025IN X 150CM, FIXED-CORE PTFE COATED, 3MM",16.5,10.73,3.6,232.66,67
HCPCS,C1769,INSTINCT GUIDEWIRE,240.46,156.3,52.42,240.46,67
HCPCS,C1769,J GUIDE WIRE: LONG,131.25,85.31,28.61,232.66,67
HCPCS,C1769,KYPHON EXPRESS BONE DRILL,693.0,450.45,151.07,693.0,67
HCPCS,C1769,KYPHON EXPRESS DIAMOND OSTEO INTRODUCER,600.0,390.0,130.8,600.0,67
HCPCS,C1769,LUBRIGUIDE COATED GUIDEWIRE,85.68,55.69,18.68,232.66,67
HCPCS,C1769,LUNDERQUIST - RING TORQUE,164.0,106.6,35.75,232.66,67
HCPCS,C1769,MAILMAN GUIDEWIRE,258.98,168.34,56.46,258.98,67
HCPCS,C1769,MEDTRONIC/5FRX80CM/NIH CARDIO - MARKER,68.25,44.36,14.88,232.66,67
HCPCS,C1769,MIRAGE GUIDEWIRE .008,517.83,336.59,112.89,517.83,67
HCPCS,C1769,NITREX GUIDE WIRE .018,131.26,85.32,28.61,232.66,67
HCPCS,C1769,NITREX PERIPHERAL VASCULAR GUIDEWIRE,220.0,143.0,47.96,232.66,67
HCPCS,C1769,PLATINUM PLUS LT GUIDEWIRE,86.09,55.96,18.77,232.66,67
HCPCS,C1769,PRECISION VASCULAR SYNCHRO-35,741.0,481.65,161.54,741.0,67
HCPCS,C1769,PRESSURE WIRE GEN-X-GUIDE MOUNTED SEN 0.14X175CM,900.0,585.0,196.2,900.0,67
HCPCS,C1769,PTFE COATED GUIDEWIRE,750.0,487.5,163.5,750.0,67
HCPCS,C1769,"ROADRUNNER PC GUIDEWIRE, FIRM (RPC-35-260)",61.0,39.65,13.3,232.66,67
HCPCS,C1769,ROADRUNNER WIRE GUIDE (RFSPC-35-145),59.0,38.35,12.86,232.66,67
HCPCS,C1769,RUNTHROUGH NS CORONARY GUIDEWIRE,130.0,84.5,28.34,232.66,67
HCPCS,C1769,SOFT ANGLED RADIFOCUS GLIDEWIRE,142.0,92.3,30.96,232.66,67
HCPCS,C1769,"SS GLIDEWIRES 035,038",81.49,52.97,17.76,232.66,67
HCPCS,C1769,STARTER GUIDEWIRE .035IN X 260CM BEN/STR/PTFE/15,41.5,26.98,9.05,232.66,67
HCPCS,C1769,STONE REMOVAL SET (BSM-200),900.0,585.0,196.2,900.0,67
HCPCS,C1769,STRYKER SYNCHRO 2 GUIDEWIRE,751.79,488.66,163.89,751.79,67
HCPCS,C1769,"SYNCHRO-10 MICROFAB NITINOL GUIDEWIRE 0.010IN X 200CM,55CM",709.0,460.85,154.56,709.0,67
HCPCS,C1769,"SYNCHRO-10 MICROFAB NITINOL GUIDEWIRE 0.010IN X 300CM,55CM",838.0,544.7,182.68,838.0,67
HCPCS,C1769,TAD II GUIDEWIRES,249.0,161.85,54.28,249.0,67
HCPCS,C1769,TERUMO GLIDE WIRE GT 0.018 X 180CM STANDARD,253.5,164.78,55.26,253.5,67
HCPCS,C1769,TERUMO GOLD TIP 70 DEGREE,237.11,154.12,51.69,237.11,67
HCPCS,C1769,TERUMO MEDICAL CORP 4FR X 123CM GLIDECATH HYDRO CATH,90.56,58.86,19.74,232.66,67
HCPCS,C1769,TRANSEND EX GUIDEWIRE,620.0,403.0,135.16,620.0,67
HCPCS,C1769,TRANSEND GUIDEWIRE,364.46,236.9,79.45,364.46,67
HCPCS,C1769,TRAXCESS HYDROPHILIC GUIDEWIRE 0.014IN,506.0,328.9,110.31,506.0,67
HCPCS,C1769,V-.018 CONTROL GUIDE WIRE,220.13,143.08,47.99,232.66,67
HCPCS,C1769,VASCULAR SOLUTIONS WIRE 018/40,42.0,27.3,9.16,232.66,67
HCPCS,C1769,VIPERWIRE GUIDEWIRE,300.0,195.0,65.4,300.0,67
HCPCS,C1769,W CLP WR ROTABLDR,20.5,13.33,4.47,232.66,67
HCPCS,C1769,"WALLSTENT GI GUIDEWIRE, SUPER STIFF 0.035IN X 500CM",178.0,115.7,38.8,232.66,67
HCPCS,C1769,WHOLEY .035/260 GW,105.0,68.25,22.89,232.66,67
HCPCS,C1769,"WIRE,GUIDE,PRESSURE,185,STR,VERRATA",1012.5,658.13,200.93,1012.5,67
HCPCS,C1769,X-CELERATOR EXCHANGE GUIDEWIRE,413.33,268.66,90.11,413.33,67
HCPCS,C1770,CONCERTO COIL,1875.0,1218.75,200.93,1875.0,75
HCPCS,C1770,MEDRAD ENDORECTAL IMAGE COIL BPX15-INSRT,258.0,167.7,56.24,258.0,67
HCPCS,C1771,"Rep dev, urinary, w/sling",,,200.93,232.66,8
HCPCS,C1772,PROMETRA PROGRAMMABLE PUMP,17600.0,11440.0,200.93,17600.0,76
HCPCS,C1772,PROMETRA REFILL KIT 11825,43.0,27.95,9.37,232.66,75
HCPCS,C1772,PUMP INT THCL PROMETRA II NO CATH 13827,18000.0,11700.0,200.93,18000.0,76
HCPCS,C1772,"PUMP INT THCL PROMETRA II,CATH 13827",18000.0,11700.0,200.93,18000.0,76
HCPCS,C1772,PUMP INT THCL SNCHR 2 DRG 8637-X0,19800.0,12870.0,200.93,19800.0,76
HCPCS,C1772,SYNCHROMED INF PUMP #8637-20,24075.0,15648.75,200.93,24075.0,76
HCPCS,C1772,SYNCHROMED INF PUMP #8637-40,24075.0,15648.75,200.93,24075.0,76
HCPCS,C1772,W PUMP SYNCH II US MKTJUN,24075.0,15648.75,200.93,24075.0,76
HCPCS,C1773,AMPLATZ GOOSE NECK MICROSNARE KIT 2MM LOOP CATH,885.0,575.25,192.93,885.0,67
HCPCS,C1773,"ARGON VENA CAVA FILTER RETRIEVAL SET, TRIPLE LOOP SNARE",770.0,500.5,167.86,770.0,75
HCPCS,C1773,ATRIEVE? VASCULAR SNARE KIT 6F,490.0,318.5,106.82,490.0,67
HCPCS,C1773,B BRAUN SET MULTI-SNARE RETRIEVAL SNARE CATHETER,553.56,359.81,120.68,553.56,67
HCPCS,C1773,C1773 LEAD LOCKING DEVICE,788.0,512.2,171.78,788.0,134
HCPCS,C1773,C1773 SNARE TIER 1,413.0,268.45,90.03,413.0,67
HCPCS,C1773,C1773 SNARE TIER 3,2558.0,1662.7,200.93,2558.0,67
HCPCS,C1773,C1773 STYLET,771.0,501.15,168.08,771.0,67
HCPCS,C1773,GUNTHER TULIP RETRIEVAL SET,643.0,417.95,140.17,643.0,67
HCPCS,C1773,"HALO? SINGLE LOOP SNARE KIT 4F, 5MM X 20CM",600.0,390.0,130.8,600.0,75
HCPCS,C1773,PROXIMAL DIST 2.7 FR O.D. / 2.4FR X 150CM TREVO PRO 18 MICROCATH,803.0,521.95,175.05,803.0,67
HCPCS,C1773,RET DEV INSERTABLE,2020.0,1313.0,200.93,2020.0,67
HCPCS,C1773,RETRIEVAL CATHETER WITH PEEL AWAY SHEATH,19260.0,12519.0,200.93,19260.0,67
HCPCS,C1773,W DEV RETRIEV INS,683.0,443.95,148.89,683.0,67
HCPCS,C1776,"GORE DRYSEAL FLEX INTRODUCER SHEATH, 22FR X33CM",355.5,231.08,77.5,355.5,67
HCPCS,C1776,"GORE DRYSEAL FLEX INTRODUCER SHEATH, 26 FR X 65 CM",865.5,562.58,188.68,865.5,67
HCPCS,C1776,MEDTRONIC MULLINS INTRO SHEATH 8FR W/HEMO VALVE 59CM- 67CM,148.75,96.69,32.43,232.66,67
HCPCS,C1776,"MERIT 0.038INX260CM INQWIRE AMPLATZ DIAG GWIRE, STRT SHORT TIP",70.0,45.5,15.26,232.66,67
HCPCS,C1776,"MERIT 4F X 65CM, PED-PIG-VSC-2B PERFORMA 0.035",112.0,72.8,24.42,232.66,67
HCPCS,C1776,MERIT 5FR X 11CM PRELUDE IDEAL HYDROPHILIC SHEATH INTRO,91.0,59.15,19.84,232.66,67
HCPCS,C1776,"MERIT 5FX4CM PRELUDE SHORT SHEATH INTRODUCER, GRAY, 0.46MMX40CM",65.9,42.84,14.37,232.66,67
HCPCS,C1776,MERIT 6 FR SHEATH INTRODUCER,98.0,63.7,21.36,232.66,67
HCPCS,C1776,MERIT 6FR X 11CM PRELUDE IDEAL HYDROPHILIC SHEATH INTRO,91.0,59.15,19.84,232.66,67
HCPCS,C1776,MERIT 7FRX13CM CLASSIC SHEATH SPLIT HEMOSTAT INTRODUCER SYSTEM,54.0,35.1,11.77,232.66,67
HCPCS,C1776,MERIT5FR PRELUDE  I DEAL,98.0,63.7,21.36,232.66,67
HCPCS,C1777,ICD LEAD,4600.0,2990.0,200.93,4600.0,75
HCPCS,C1777,LEAD ICD SINGLE COIL LVL 2,5200.0,3380.0,200.93,5200.0,75
HCPCS,C1777,"LEAD, AICD, ENDO SINGLE COIL LVL 7",9261.0,6019.65,200.93,9261.0,75
HCPCS,C1777,"LEAD, AICD, ENDO SINGLE COIL, T69",6900.0,4485.0,200.93,6900.0,75
HCPCS,C1777,PAMIRA ICD LEAD,6900.0,4485.0,200.93,6900.0,74
HCPCS,C1778,1X8 STANDARD LEAD KIT,5975.0,3883.75,200.93,5975.0,76
HCPCS,C1778,"ANS OCTRODE LEADKIT, #3186",5015.0,3259.75,200.93,5015.0,76
HCPCS,C1778,"ANS PERCUT LEAD, 8CHNL #3086",2541.5,1651.98,200.93,2541.5,76
HCPCS,C1778,"ANS QUATTRODE LEADKIT, #3146",3315.0,2154.75,200.93,3315.0,76
HCPCS,C1778,BOSTON SCI 70 CM 8 LEAD KIT,2908.0,1890.2,200.93,2908.0,76
HCPCS,C1778,"G070235,ACTIVA LEAD,3387S-40",2975.0,1933.75,200.93,2975.0,69
HCPCS,C1778,"G070235,ACTIVA LEAD,3389S-40",3075.0,1998.75,200.93,3075.0,69
HCPCS,C1778,G240099 ENTERA LEAD 4531,2625.0,1706.25,200.93,2625.0,67
HCPCS,C1778,H990014 LEAD 4351-35CM,2200.0,1430.0,200.93,2200.0,69
HCPCS,C1778,LEAD KIT PISCES QUAD 33-45CM 3487XX,1750.0,1137.5,200.93,1750.0,76
HCPCS,C1778,LEAD KIT PISCES QUAD PLUS 33-56CM 3888XX,1750.0,1137.5,200.93,1750.0,76
HCPCS,C1778,LEAD NEUROSTIMULATOR C1778 (278),14965.0,9727.25,200.93,14965.0,75
HCPCS,C1778,LEAD NEVRO LEAD1058-XXB,2908.0,1890.2,200.93,2908.0,76
HCPCS,C1778,LEAD NRSTM 45-75CM 3777XX,1800.0,1170.0,200.93,1800.0,76
HCPCS,C1778,LEAD NRSTM MRI 1X8 60-90CM 977A2XX,3158.0,2052.7,200.93,3158.0,76
HCPCS,C1778,LEAD NRSTM MRI 1X8 SC 60-90CM 977Z1XX,3158.0,2052.7,200.93,3158.0,76
HCPCS,C1778,"LEAD, NEUROSTIMULATOR",2145.0,1394.25,1.1,2145.0,68
HCPCS,C1778,"LEAD, WAVEWRITER SPINAL CORD STIMULATOR",2000.0,1300.0,200.93,2000.0,76
HCPCS,C1778,LEAD-OCTAD MEDTRONIC 377730,3980.0,2587.0,200.93,3980.0,76
HCPCS,C1778,MEDTRONIC 1X8 TRIAL LEAD,248.0,161.2,54.06,248.0,75
HCPCS,C1778,MEDTRONIC 52CM UNIPOLAR ENDOCARDIAL SVC LEAD,1275.0,828.75,200.93,1275.0,67
HCPCS,C1778,MEDTRONIC ACCESS KIT 355531,496.0,322.4,108.13,496.0,75
HCPCS,C1778,MEDTRONIC ACCESSORY 3550-24,82.0,53.3,17.88,232.66,75
HCPCS,C1778,MEDTRONIC EXT 37083-60,838.0,544.7,182.68,838.0,75
HCPCS,C1778,MEDTRONIC LEAD KIT 3777-60,2908.0,1890.2,200.93,2908.0,76
HCPCS,C1778,MEDTRONIC LEAD KIT 977A260,3908.0,2540.2,200.93,3908.0,76
HCPCS,C1778,MEDTRONIC LEAD KIT 977A290,3158.0,2052.7,200.93,3158.0,76
HCPCS,C1778,MEDTRONIC LEAD TRIAL 977D260,2502.0,1626.3,200.93,2502.0,76
HCPCS,C1778,MEDTRONIC ON POINT 3987A,3420.0,2223.0,200.93,3420.0,76
HCPCS,C1778,MEDTRONIC SURESCAN 977A160,3158.0,2052.7,200.93,3158.0,76
HCPCS,C1778,NRSTM IMP 30-45CM REV SPNL 355026,582.0,378.3,126.88,582.0,75
HCPCS,C1778,NRSTM IMP 60/75CM PSC ZQD SPNL 355027,700.0,455.0,152.6,700.0,75
HCPCS,C1778,PRECISION LEAD #2108 50CM,3608.0,2345.2,200.93,3608.0,76
HCPCS,C1778,PRECISION LEAD #2108 70CM,3608.0,2345.2,200.93,3608.0,76
HCPCS,C1778,PRECISION LEAD EXT #3108 35CM,1312.0,852.8,200.93,1312.0,75
HCPCS,C1778,PRIMEADVANCED SURESCAN 97702,19800.0,12870.0,200.93,19800.0,76
HCPCS,C1778,PRQ IMPLTJ NEUROSTIMULATOR ELTRD PERIPHERAL NRV,15600.0,10140.0,200.93,15600.0,76
HCPCS,C1778,SC-2218-70 LINEAR LEAD KIT,2908.0,1890.2,200.93,2908.0,76
HCPCS,C1778,SC-2316-50 INFINION LEAD KIT,6400.0,4160.0,200.93,6400.0,76
HCPCS,C1778,SJM IMPLANTABLE NEUROSTIMULATOR,31449.5,20442.18,200.93,31449.5,76
HCPCS,C1778,ST.JUDE LEAD DELIVERY,718.0,466.7,156.52,718.0,75
HCPCS,C1778,W IMP LD NSTIM,5975.0,3883.75,200.93,5975.0,76
HCPCS,C1779,"Lead, pmkr, transvenous vdd",,,200.93,232.66,8
HCPCS,C1780,"Lens, intraocular (new tech)",,,200.93,232.66,8
HCPCS,C1781,MEDTRONIC MESH POUCH,170.0,110.5,37.06,232.66,75
HCPCS,C1782,Morcellator,,,200.93,232.66,8
HCPCS,C1783,"Ocular imp, aqueous drain de",,,200.93,232.66,8
HCPCS,C1784,"Ocular dev, intraop, det ret",,,200.93,232.66,8
HCPCS,C1785,"MEDTRONIC AZURE XT, DR, SURESCAN",5940.0,3861.0,200.93,5940.0,67
HCPCS,C1785,"MERIT, DIAG. ULTRA HIGH FLOW PIGTAIL CATH, 10 SIDE PORTS",22.0,14.3,4.8,232.66,67
HCPCS,C1785,PACEMAKER DUAL CHAMBER TIER 0,5800.0,3770.0,200.93,5800.0,75
HCPCS,C1785,PACEMAKER DUAL CHAMBER TIER I,6174.0,4013.1,200.93,6174.0,75
HCPCS,C1785,PACEMAKER DUAL CHAMBR TIER II,15938.0,10359.7,200.93,15938.0,75
HCPCS,C1785,PACEMAKER DUAL CHMBR TIER III,9354.0,6080.1,200.93,9354.0,75
HCPCS,C1785,PACEMKR AZURE XT DR MRI,8036.0,5223.4,200.93,8036.0,75
HCPCS,C1785,W PACEMAKER ACCENT DR 2110,9354.0,6080.1,200.93,9354.0,75
HCPCS,C1786,ABBOTT AVERI AR LEADLESS PACEMAKER,37950.0,24667.5,200.93,37950.0,75
HCPCS,C1786,AVEIR AR LEADLESS PACER SYSTEM MFG AR-SYSTEM-AVEIR,37950.0,24667.5,200.93,37950.0,74
HCPCS,C1786,AVEIR LEADLESS AR PACEMAKER,37950.0,24667.5,200.93,37950.0,74
HCPCS,C1786,AVEIR LEADLESS VENTRICAL PACEMAKER,24000.0,15600.0,200.93,24000.0,74
HCPCS,C1786,AVEIR VR LEADLESS PACER SYSTEM MFG VR-SYSTEM-AVEIR,24000.0,15600.0,200.93,24000.0,74
HCPCS,C1786,C1786 PM SGL CHAMBER TIER  5,19000.0,12350.0,200.93,19000.0,75
HCPCS,C1786,C1786 PM SGL CHAMBER TIER 4,11000.0,7150.0,200.93,11000.0,75
HCPCS,C1786,C1786 PM SGL CHAMBER TIER III,7200.0,4680.0,200.93,7200.0,75
HCPCS,C1786,G130138 LEADLESS PACEMAKER NCT 04559945,9500.0,6175.0,200.93,9500.0,69
HCPCS,C1786,G200319 21-528 MODULARATP NCT04798768 -  EMPOWER LEADLESS PACEMA,8750.0,5687.5,200.93,8750.0,69
HCPCS,C1786,"LEADLESS PACEMAKER, VENT",16000.0,10400.0,200.93,16000.0,75
HCPCS,C1786,MICRA AV LEADLESS PACEMAKER,22500.0,14625.0,200.93,22500.0,75
HCPCS,C1786,MICRA VR LEADLESS PACEMAKER,17500.0,11375.0,200.93,17500.0,75
HCPCS,C1786,MICRA VR2 TPS MC2VROS US,28230.0,18349.5,200.93,28230.0,76
HCPCS,C1786,PACEMAKER SGL CHAMBER TIER II,6030.0,3919.5,200.93,6030.0,75
HCPCS,C1786,PACEMAKER SGL CHAMBER TIER III,7200.0,4680.0,200.93,7200.0,75
HCPCS,C1786,PRECISE STENT,3900.0,2535.0,200.93,3900.0,76
HCPCS,C1786,S 275 C1786 ABBOTT AVERI AR LEADLESS,37950.0,24667.5,200.93,37950.0,74
HCPCS,C1786,S 275 C1786 ABBOTT AVIER VR LEADLESS,24000.0,15600.0,200.93,24000.0,74
HCPCS,C1786,W PM ACCENT SR,5100.0,3315.0,200.93,5100.0,75
HCPCS,C1787,BOSTON SCI PAT. PROG SC-5500,1260.0,819.0,200.93,1260.0,150
HCPCS,C1787,BS PATIENT PROGRAMMER KIT SC5500-4,1314.0,854.1,200.93,1314.0,75
HCPCS,C1787,EON PATIENT PROGRAMMER 3851,2964.38,1926.85,200.93,2964.38,67
HCPCS,C1787,"G100008 ACTIVA PT PROG,37642",900.0,585.0,196.2,900.0,69
HCPCS,C1787,KIT INTLS PRGRMR 9774X,862.5,560.63,188.03,862.5,67
HCPCS,C1787,MEDTRONICS PT PROG 97740,1260.0,819.0,200.93,1260.0,75
HCPCS,C1787,"PATIENT PROGR, NEUROSTIM",1315.0,854.75,1.1,1315.0,68
HCPCS,C1787,"PATIENT PROGRAMMER, WAVEWRITER SPINAL CORD STIMULATOR",900.0,585.0,196.2,900.0,67
HCPCS,C1787,"PRECISION, PT PRGM KIT#5500",1314.0,854.1,200.93,1314.0,67
HCPCS,C1787,PRGRMR KIT NEVRO PTRC1000,1260.0,819.0,200.93,1260.0,75
HCPCS,C1787,SC-5532-1 REMOTE CONTROL KIT,1600.0,1040.0,200.93,1600.0,76
HCPCS,C1787,SC-5542-1 FREE LINK REMOTE KIT,1260.0,819.0,200.93,1260.0,75
HCPCS,C1787,ST JUDE PATIENT PROGRAMMER,1260.0,819.0,200.93,1260.0,75
HCPCS,C1787,W PROGRAM PT INTERSTIM 3031A,1335.0,867.75,200.93,1335.0,67
HCPCS,C1788,"POWERPORT IMPLANTABLE PORT 8FR, GOSHONG VALVED, MICROINTRODUCER",1372.5,892.13,200.93,1372.5,76
HCPCS,C1788,W CATH PORTACATH,894.45,581.39,194.99,894.45,75
HCPCS,C1789,"Prosthesis, breast, imp",,,200.93,232.66,8
HCPCS,C1813,"Prosthesis, penile, inflatab",,,200.93,232.66,8
HCPCS,C1814,"Retinal tamp, silicone oil",,,200.93,232.66,8
HCPCS,C1815,"Pros, urinary sph, imp",,,200.93,232.66,8
HCPCS,C1816,"PENETRATION 22MM, 18 GA X 16CM",55.4,36.01,12.08,232.66,67
HCPCS,C1817,AMPLATZER MUSCULAR VSD OCCLUDER,26310.0,17101.5,200.93,26310.0,76
HCPCS,C1817,AMPLATZER SEPTAL OCCLUDER,10763.55,6996.31,200.93,10763.55,67
HCPCS,C1817,C1817 STENT TIER 1,11232.0,7300.8,200.93,11232.0,76
HCPCS,C1817,CARDIOSEAL,8941.05,5811.68,200.93,8941.05,76
HCPCS,C1817,DELIV DVC 4FRX60CM-5FRX80CM,1104.0,717.6,200.93,1104.0,75
HCPCS,C1817,GORE CARDIOFORM ASD OCCLUDEER,7175.0,4663.75,200.93,7175.0,69
HCPCS,C1817,GORE CARDIOFORM ASD OCCLUDER,16302.0,10596.3,200.93,16302.0,76
HCPCS,C1817,"GORE, 27MM CARDIOFORM ASD SEPTAL OCCLUDER",10679.85,6941.9,200.93,10679.85,67
HCPCS,C1817,GSX 15MM-30MM SEPTAL OCCLUDER DEVICE,13794.0,8966.1,200.93,13794.0,76
HCPCS,C1817,NIT-OCCLUD PDA DEVICE,3395.0,2206.75,200.93,3395.0,76
HCPCS,C1817,ST JUDE AMP OCCLUDER DEVICE 9-PDA2,8200.0,5330.0,200.93,8200.0,76
HCPCS,C1818,Integrated keratoprosthesis,,,200.93,232.66,8
HCPCS,C1819,Tissue localization-excision,,,200.93,232.66,8
HCPCS,C1820,ANS RECHARGEABLE IPG,24044.0,15628.6,200.93,24044.0,76
HCPCS,C1820,BOSTON NS RECHARGEABLE IPG,27970.0,18180.5,200.93,27970.0,76
HCPCS,C1820,BOSTON SCI. IPG SC-1010C,36346.0,23624.9,200.93,36346.0,76
HCPCS,C1820,BS INTRODUCER SC-4365,180.0,117.0,39.24,232.66,75
HCPCS,C1820,BS PRECISION CHARGING SYS KIT,2300.0,1495.0,200.93,2300.0,76
HCPCS,C1820,BS PRECISION IPG KIT SC-1132,33000.0,21450.0,200.93,33000.0,76
HCPCS,C1820,"EXTERNAL PULSE GENERATOR, 2 PORT HEADER",550.0,357.5,119.9,550.0,75
HCPCS,C1820,"G070235,ACTIVA DBS,37612",24000.0,15600.0,200.93,24000.0,69
HCPCS,C1820,G100008 ACTIVA NEUROSTIM 37612,24000.0,15600.0,200.93,24000.0,69
HCPCS,C1820,"GENERATOR, WAVEWRITER SPINAL CORD STIMULATOR",32600.0,21190.0,200.93,32600.0,76
HCPCS,C1820,MED CHARGING SYSTEM 97754,3200.0,2080.0,200.93,3200.0,76
HCPCS,C1820,MEDTRONIC RECHARGEABLE IPG,26288.0,17087.2,200.93,26288.0,76
HCPCS,C1820,MEDTRONIC ULTRA GENERATOR,24300.0,15795.0,200.93,24300.0,76
HCPCS,C1820,MEDTRONICS GENERATOR 97714,27000.0,17550.0,200.93,27000.0,76
HCPCS,C1820,NRSTM IMP RESTORE SNSR MRI 97714,23000.0,14950.0,200.93,23000.0,76
HCPCS,C1820,NRSTM IMP RESTORE ULTRA MRI 97712,21000.0,13650.0,200.93,21000.0,76
HCPCS,C1820,"PENETRATION 22MM, 18 GUAGE X 20CM",55.32,35.96,12.06,232.66,67
HCPCS,C1820,PRECISION GENERATOR SC#4316,36346.0,23624.9,200.93,36346.0,76
HCPCS,C1820,PRECISION IPG KIT SC1110-02,24300.0,15795.0,200.93,24300.0,76
HCPCS,C1820,PRIMEADVANCED 37702,13365.0,8687.25,200.93,13365.0,76
HCPCS,C1820,RESTORE SENSOR GENERATOR 37714,26600.0,17290.0,200.93,26600.0,76
HCPCS,C1820,SC-1140 IPG KIT,19800.0,12870.0,200.93,19800.0,76
HCPCS,C1820,SJM IPG 16 CHANNEL RECHARGE,25000.0,16250.0,200.93,25000.0,76
HCPCS,C1820,ST JUDE CHARGING SYSTEM 3730,1260.0,819.0,200.93,1260.0,75
HCPCS,C1820,ST JUDE ION MINI GENERATOR,24300.0,15795.0,200.93,24300.0,76
HCPCS,C1820,SURESCAN ULTRA IPG 97712,22000.0,14300.0,200.93,22000.0,76
HCPCS,C1820,W DEVICE IPG RESTRE ULTRA 37712,26600.0,17290.0,200.93,26600.0,76
HCPCS,C1821,Interspinous implant,,,200.93,232.66,8
HCPCS,C1822,CHARGER KIT NEVRO CHGR1000,1485.0,965.25,200.93,1485.0,76
HCPCS,C1822,GNRTR NRSTM IPG KIT NEVRO,25300.0,16445.0,200.93,25300.0,76
HCPCS,C1823,"Gen, neuro, trans sen/stim",,,200.93,232.66,8
HCPCS,C1824,G200042 AIM HIGHER OPTIMIZER SMART MINI SYSTEM NCT05064709,26000.0,16900.0,200.93,26000.0,69
HCPCS,C1825,"Gen, neuro, carot sinus baro",,,200.93,232.66,8
HCPCS,C1826,"Gen, neuro, clo loop, rechg",,,200.93,2739849.3,9
HCPCS,C1827,OPTIMIZER SMART MINI,78000.0,50700.0,200.93,78000.0,75
HCPCS,C1830,POWER BONE MARROW BX NEEDLE,149.0,96.85,1.1,149.0,68
HCPCS,C1830,PWR BN MARROW BX CMP TRAY152MM,193.0,125.45,42.07,232.66,67
HCPCS,C1830,PWR BONE MARROW BX NEEDLE 152 MM,146.0,94.9,31.83,232.66,67
HCPCS,C1830,PWR BONE MARROW BX NEEDLE102MM,258.0,167.7,56.24,258.0,67
HCPCS,C1831,Personalized interbody cage,,,200.93,2739849.3,9
HCPCS,C1832,Auto cell process sys,,,200.93,2739849.3,9
HCPCS,C1833,THE GUARDIAN IMD,20500.0,13325.0,200.93,20500.0,76
HCPCS,C1834,"Pressure sensor system, im",,,200.93,232.66,8
HCPCS,C1839,Iris prosthesis,,,200.93,232.66,8
HCPCS,C1840,Telescopic intraocular lens,,,200.93,232.66,8
HCPCS,C1841,"H110002,B,ARGUS II RETINAL PROS",288116.0,187275.4,200.93,288116.0,76
HCPCS,C1842,"Retinal prosth, add-on",,,200.93,232.66,8
HCPCS,C1849,"Skin substitute, synthetic",,,1101.49,1275.41,8
HCPCS,C1874,ABB XIENCE ALPINE CORO SNT 4.0X18,2241.0,1456.65,200.93,2241.0,76
HCPCS,C1874,AXIOS STENT W/DELIVERY SYSTEM,10000.0,6500.0,200.93,10000.0,76
HCPCS,C1874,B BRAUN BALLOON MOUNTED COVERED STENTS 1.6-3.4,13100.0,8515.0,200.93,13100.0,76
HCPCS,C1874,B BRAUN BALLOON MOUNTED COVERED STENTS 3.9-4.5V,13500.0,8775.0,200.93,13500.0,76
HCPCS,C1874,B-BRAUN 12MM X2.2CM COVERED STENT UNMOUNTED,5350.0,3477.5,200.93,5350.0,76
HCPCS,C1874,BX2 9MMX59MM 7FR 135CM CATH BX2 HEP REDUCED PROFILE,8190.0,5323.5,200.93,8190.0,76
HCPCS,C1874,BX2 HEP REDUCED PROFILE BX2 8MMX39MM 7FR 135CM CATH,8190.0,5323.5,200.93,8190.0,76
HCPCS,C1874,C1874 DRUG ELUT STENT TIER 0,2000.0,1300.0,200.93,2000.0,76
HCPCS,C1874,C1874 DRUG ELUT STENT TIER II,5742.0,3732.3,200.93,5742.0,76
HCPCS,C1874,C1874 DRUG ELUT STENT TIER VI,16200.0,10530.0,200.93,16200.0,76
HCPCS,C1874,CAPITATION TX2 TAA,47000.0,30550.0,200.93,47000.0,76
HCPCS,C1874,CAPITATION ZENITH FLEX AAA,19800.0,12870.0,200.93,19800.0,76
HCPCS,C1874,DRUG ELUTING STENT,7393.0,4805.45,200.93,7393.0,76
HCPCS,C1874,ELUVIA DRUG-ELUTING STENT 7MM X 150MM X 130CM,10497.0,6823.05,200.93,10497.0,75
HCPCS,C1874,"ENDOGRAFT,VIABAHN,VBH071002",5360.0,3484.0,200.93,5360.0,76
HCPCS,C1874,"FLUENCY PS ENDOVAS STNT GFT SYST 10MM X 40MM, 9FR X 117CM, 0.035",2632.5,1711.13,200.93,2632.5,76
HCPCS,C1874,"G100200,TREOVANCE W/NAVITEL",9500.0,6175.0,200.93,9500.0,69
HCPCS,C1874,G120002 BVS/XIENCE STENT,1500.0,975.0,200.93,1500.0,69
HCPCS,C1874,G190185 CGUARD CAROTID STENT SYSTEM,1800.0,1170.0,200.93,1800.0,69
HCPCS,C1874,G200342 B-SAFER 5MMX2.5CM VIABAHN STENT,2755.0,1790.75,200.93,2755.0,67
HCPCS,C1874,G200342 B-SAFER 5MMX29MM VBX VIABAHN STENT,2730.0,1774.5,200.93,2730.0,67
HCPCS,C1874,G200342 BARD COVERA FLARED STENT NCT04747626,2300.0,1495.0,200.93,2300.0,69
HCPCS,C1874,G200342 BARD COVERA STENT  NCT04747626,2225.0,1446.25,200.93,2225.0,69
HCPCS,C1874,GORE VIABAHN VBX BALLOON EXPANDABLE ENDO,8190.0,5323.5,200.93,8190.0,76
HCPCS,C1874,GORE VIABAHN VBX BALLOON EXPANDABLE ENDOPROSTHESIS STENT GRAFT,5460.0,3549.0,200.93,5460.0,152
HCPCS,C1874,ICAST COVERED STENT,3500.0,2275.0,200.93,3500.0,76
HCPCS,C1874,STENT GRAFT HEPARIN COATED,5318.0,3456.7,200.93,5318.0,76
HCPCS,C1874,"STENT, COATED W/DELIVERY",35.0,22.75,7.63,232.66,75
HCPCS,C1874,STRYKER ICAST COVERED STENT,1805.0,1173.25,200.93,1805.0,76
HCPCS,C1874,SYNERGY DRUG ELUDING STENT,2800.0,1820.0,200.93,2800.0,152
HCPCS,C1874,VIATORR TIPS ENDOPROSTHESIS STENT GRAFT,8358.0,5432.7,200.93,8358.0,76
HCPCS,C1874,W STENT AAA BIFUR 22F 36X95MM,3450.04,2242.53,200.93,3450.04,76
HCPCS,C1874,XIENCE DRUG ELUDING STENT,3150.0,2047.5,200.93,3150.0,76
HCPCS,C1874,XIENCE SKYPOINT EVEROLIMUS ELUTING STENT SYSTEM,792.0,514.8,172.66,792.0,75
HCPCS,C1874,XIENCE/BVS PR STENT,2025.0,1316.25,200.93,2025.0,76
HCPCS,C1874,XIENCE/BVS STENT,2025.0,1316.25,200.93,2025.0,76
HCPCS,C1874,ZILVER DRUG ELUTING STENT,3590.0,2333.5,200.93,3590.0,76
HCPCS,C1875,BRAUN COVERED MOUNTED CP STENT 10 ZIG X 5.5 CM,11205.0,7283.25,200.93,11205.0,67
HCPCS,C1875,BRAUN COVERED MOUNTED CP STENT 10 ZIG X 6.0 CM,11542.5,7502.63,200.93,11542.5,67
HCPCS,C1875,BRAUN COVERED MOUNTED CP STENT 8 ZIG X 6.0 CM,9922.5,6449.63,200.93,9922.5,67
HCPCS,C1875,"CAPITATION RELAY PRO TAA, N 2-3",34990.0,22743.5,200.93,34990.0,76
HCPCS,C1875,"CAPITATION RELAY PRO TAA, N 4",45990.0,29893.5,200.93,45990.0,76
HCPCS,C1875,W STENT BRONCHIAL ULTRAFLEX COV,3790.0,2463.5,200.93,3790.0,76
HCPCS,C1876,"10-8MM X 40MM, TAPERED, XACT CAROTID STENT",3950.0,2567.5,200.93,3950.0,76
HCPCS,C1876,3.9CM COVERED CP STENT 8 ZIGS .013IN,4300.0,2795.0,200.93,4300.0,76
HCPCS,C1876,ABBOT HERCULINK RENAL BILIARY STENT 5.0X12X80CM,1540.0,1001.0,200.93,1540.0,76
HCPCS,C1876,"ABBOTT 5CMX18CM, RX HERCULINK ELITE .014 BILIARY STENT SYSTEM",825.0,536.25,179.85,825.0,67
HCPCS,C1876,"ABBOTT/ OMNILINK,7.0MM X 16MM X135CM STENT SYSTEM",1620.0,1053.0,200.93,1620.0,67
HCPCS,C1876,ABBOTT/HERCULINK/EXPANDING BILLARY STENT/5MM X 12MM? 135CM ELITE,825.0,536.25,179.85,825.0,67
HCPCS,C1876,BOS SCI SYNERGY MONORAIL 4.00MMX20MM COR STENT,1485.0,965.25,200.93,1485.0,67
HCPCS,C1876,"BOSTON SCI 3MMX8MM - 4.5MMX28MM, 144CM REBEL BARE METAL STENT SY",1012.5,658.13,200.93,1012.5,67
HCPCS,C1876,BRAUN COVERED CP STENT 1.6 CM,7222.5,4694.63,200.93,7222.5,67
HCPCS,C1876,C1876 CAROTID WALLSTENT,3870.0,2515.5,200.93,3870.0,76
HCPCS,C1876,C1876 STENT TIER 0,1150.0,747.5,200.93,1150.0,75
HCPCS,C1876,C1876 STENT TIER 1,1325.0,861.25,200.93,1325.0,75
HCPCS,C1876,C1876 STENT TIER 3,1790.0,1163.5,200.93,1790.0,76
HCPCS,C1876,C1876 STENT TIER 4,2200.0,1430.0,200.93,2200.0,76
HCPCS,C1876,C1876 STENT TIER 6,3700.0,2405.0,200.93,3700.0,76
HCPCS,C1876,C1876 STENT TIER 7,4990.0,3243.5,200.93,4990.0,76
HCPCS,C1876,CAPITATION OVATION AAA,19000.0,12350.0,200.93,19000.0,76
HCPCS,C1876,CAPITATION RELAY TAA,32000.0,20800.0,200.93,32000.0,76
HCPCS,C1876,CATH BALLOON ATLAS 12/14,1800.0,1170.0,200.93,1800.0,76
HCPCS,C1876,COBALT STENT,1300.0,845.0,200.93,1300.0,75
HCPCS,C1876,"COOK STENT, BILIARY BALLOON",1312.0,852.8,200.93,1312.0,67
HCPCS,C1876,CORDIS PALMAZ BLUE TRANSHEPATIC BILIARY STENT 80CM LENGTH,1260.0,819.0,200.93,1260.0,67
HCPCS,C1876,COVERED CP STENT,11351.64,7378.57,200.93,11351.64,76
HCPCS,C1876,"GIANTURCO Z STENT20CM, 25CM OR 30CM",1492.5,970.13,200.93,1492.5,76
HCPCS,C1876,H020002- ?NF ATLAS STENT 3.0 X 21MM NO TIP,6155.6,4001.14,200.93,6155.6,76
HCPCS,C1876,H020002- ?NF ATLAS STENT 4.0 X 21MM NO TIP,6155.6,4001.14,200.93,6155.6,76
HCPCS,C1876,H020002- NF ATLAS STENT 4.5 X 21MM NO TIP,6155.6,4001.14,200.93,6155.6,76
HCPCS,C1876,H020002- NF ATLAS STENT 4.5 X 30MM NO TIP,6155.6,4001.14,200.93,6155.6,76
HCPCS,C1876,H020002-NF ATLAS STENT 3.0 X 15MM NO TIP,6155.6,4001.14,200.93,6155.6,76
HCPCS,C1876,LVIS JR EXPAND STENT,11890.0,7728.5,200.93,11890.0,76
HCPCS,C1876,"MEDTRONIC 6 F PROT?G? GPS, NITINOL STENT, 9MMX30MMX120CM",900.0,585.0,196.2,900.0,67
HCPCS,C1876,"MEDTRONIC INTRASTENT LD MAX BILIARY STENT, UNMOUNTED,12MMX26MM",937.5,609.38,200.93,937.5,67
HCPCS,C1876,"MEDTRONIC, PACEMAKER ADAPTA DUAL CHAMBER, SMALL",3780.0,2457.0,200.93,3780.0,67
HCPCS,C1876,NEUROFORM ATLAS STENT SYSTEM,12311.2,8002.28,200.93,12311.2,76
HCPCS,C1876,PROTEGE STENT 6-10MMX80CM,1242.0,807.3,200.93,1242.0,67
HCPCS,C1876,R2P MISAGO STENT,2550.0,1657.5,200.93,2550.0,76
HCPCS,C1876,"REBEL CORONARY PLAT CHROMIUM BARE METAL STENT SYS 3MMX8MM, 144 C",750.0,487.5,163.5,750.0,67
HCPCS,C1876,RX ACCULINK CAROTID STENT,4018.0,2611.7,200.93,4018.0,76
HCPCS,C1876,SPUR PERIPHERAL RETRIEVABLE STENT SYSTEM,7990.0,5193.5,200.93,7990.0,67
HCPCS,C1876,STENT ABRE 16MM NITINOL 120MM VENOUS SELF EXPAND,2950.0,1917.5,200.93,2950.0,76
HCPCS,C1876,"STENT, NON-COAT W/DEL C1876 375",1125.0,731.25,200.93,1125.0,75
HCPCS,C1876,"STENT, NON-COAT W/DEL C1876 425",1275.0,828.75,200.93,1275.0,75
HCPCS,C1876,"STENT, NON-COAT W/DEL C1876 550",1650.0,1072.5,200.93,1650.0,76
HCPCS,C1876,"STENT, NON-COAT W/DEL C1876 825",2475.0,1608.75,200.93,2475.0,76
HCPCS,C1876,"STENT, XACT (ALL SIZES)",6023.0,3914.95,200.93,6023.0,75
HCPCS,C1876,SURPASS FLOWDIVERTER <40MM,25200.0,16380.0,200.93,25200.0,76
HCPCS,C1876,SURPASS FLOWDIVERTER >40MM,27600.0,17940.0,200.93,27600.0,76
HCPCS,C1876,W BALLOON ULTRATHIN DIAMOND BS,7996.0,5197.4,200.93,7996.0,76
HCPCS,C1877,"BRAUN COVERED MOUNTED  STENT, 10 ZIG",11002.5,7151.63,200.93,11002.5,67
HCPCS,C1877,"BRAUN COVERED MOUNTED  STENT, 8 ZIG",9720.0,6318.0,200.93,9720.0,67
HCPCS,C1877,"CAPITATION RELAY PRO TAA,M 2-3",34990.0,22743.5,200.93,34990.0,76
HCPCS,C1877,"CAPITATION RELAY PRO TAA,M 4",45990.0,29893.5,200.93,45990.0,76
HCPCS,C1877,"COOK-Z STENT, GIANTURCO-ROSCH TRACHEOBRONCH, 20MM X 5CM  SELF-EX",1493.0,970.45,200.93,1493.0,76
HCPCS,C1877,W STENT BILAIRY ZIMMON,93.48,60.76,20.38,232.66,75
HCPCS,C1878,Matrl for vocal cord,,,1101.49,1275.41,8
HCPCS,C1880,*TULIP VENA CAVA FILTER,1902.0,1236.3,200.93,1902.0,76
HCPCS,C1880,"G140048 IVC FILTER, ALN",725.0,471.25,158.05,725.0,69
HCPCS,C1880,"G140048 IVC FILTER, CRUX",950.0,617.5,200.93,950.0,69
HCPCS,C1880,"G140048 IVC FILTER, DENALI",750.0,487.5,163.5,750.0,69
HCPCS,C1880,"G140048 IVC FILTER, GUNTHER-TULIP",699.0,454.35,152.38,699.0,69
HCPCS,C1880,"G140048 IVC FILTER, OPTEASE",1250.0,812.5,200.93,1250.0,69
HCPCS,C1880,"G140048 IVC FILTER, OPTION",925.0,601.25,200.93,925.0,69
HCPCS,C1880,"G140048 IVC FILTER, TRAPTEASE",991.0,644.15,200.93,991.0,69
HCPCS,C1880,"G140048 IVC FILTER, VENATECH",1474.58,958.48,200.93,1474.58,69
HCPCS,C1880,"GIANT-ROEHM B/N VENA CAVA FT FEM APPRO 11FR X 40CM, 12FR .038IN",1958.0,1272.7,200.93,1958.0,76
HCPCS,C1880,"GIANT-ROEHM B/N VENA CAVA FT JUG APPRO 11FR X 75CM,12FR .038IN M",1958.0,1272.7,200.93,1958.0,76
HCPCS,C1880,GUNTHER TULIP VENA CAVA FILTER SET 65CM,1598.0,1038.7,200.93,1598.0,76
HCPCS,C1880,IVC FIILTER TIER I,1374.0,893.1,200.93,1398.0,151
HCPCS,C1880,W FILTER FEMORAL 65CM,2562.63,1665.71,200.93,2562.63,76
HCPCS,C1881,Dialysis access system,,,200.93,232.66,8
HCPCS,C1882,BI V ICD TIER II,40000.0,26000.0,200.93,40000.0,75
HCPCS,C1882,COBALT XT QUAD CRT-D (W/ PERFORMA LV LEAD),63150.0,41047.5,200.93,63150.0,74
HCPCS,C1882,CRT-D TIER 3,26800.0,17420.0,200.93,26800.0,75
HCPCS,C1882,G120093 SORIN RESPOND CRTD,12300.0,7995.0,200.93,12300.0,69
HCPCS,C1882,HF CARDIAC RESYNCHRONIZATION THERAPY DEFIBRILLATOR,29100.0,18915.0,200.93,29100.0,76
HCPCS,C1882,W DEFIBRILLATOR CONCERTO,31000.0,20150.0,200.93,31000.0,75
HCPCS,C1883,A127 EXTENSION #2342,1621.38,1053.9,200.93,1621.38,76
HCPCS,C1883,ACCESSORY KIT 3550-28,92.0,59.8,20.06,232.66,75
HCPCS,C1883,"ADAPT/EXT, PACING/NEURO LEAD",9450.0,6142.5,200.93,9450.0,75
HCPCS,C1883,ANS LEAD EXTENSION 30 CM #3383,1900.0,1235.0,200.93,1900.0,76
HCPCS,C1883,CARTO REFERENCE PATCH,1425.0,926.25,200.93,1425.0,67
HCPCS,C1883,"G070235,ACTIVA EXTENSION,7482",595.0,386.75,129.71,595.0,69
HCPCS,C1883,"G100008 ACTIVA EXTEN,37086",695.0,451.75,151.51,695.0,69
HCPCS,C1883,KIT EXT NRSTM EXTENSION 37082-X0,1500.0,975.0,200.93,1500.0,76
HCPCS,C1883,KIT ITREL II EXTENSION 7495-51,990.0,643.5,200.93,990.0,75
HCPCS,C1883,KIT ITREL II EXTENT 7495-40,990.0,643.5,200.93,990.0,75
HCPCS,C1883,KIT LD ADPT NVRO 20 CM,1600.0,1040.0,200.93,1600.0,76
HCPCS,C1883,KIT LD EXTN NVRO LEAD2008-XXB,2400.0,1560.0,200.93,2400.0,76
HCPCS,C1883,KIT NRSTM EXTENSION 3708X-X0,800.0,520.0,174.4,800.0,75
HCPCS,C1883,"KIT, ACCESSORY, #3550-16",90.0,58.5,19.62,232.66,75
HCPCS,C1883,"KIT, ITREL II EXT, #7495-25",990.0,643.5,200.93,990.0,75
HCPCS,C1883,"KIT,EXTENSION #3550-09",390.0,253.5,85.02,390.0,75
HCPCS,C1883,"KIT,REVISION #3550-10",580.0,377.0,126.44,580.0,75
HCPCS,C1883,LEAD EXTENDER,512.0,332.8,111.62,512.0,67
HCPCS,C1883,"MEDTRONIC 1X8 EXT 20,40,60CM",383.0,248.95,83.49,383.0,75
HCPCS,C1883,"MEDTRONIC 32CM EPI MYOCARDIAL PACING LEAD, SUTURELESS SCREW IN",637.5,414.38,138.98,637.5,67
HCPCS,C1883,MEDTRONIC ACCESSORY KIT 8590-8,310.0,201.5,67.58,310.0,75
HCPCS,C1883,MEDTRONIC CAPSURE FIX PACING LEAD,607.5,394.88,132.44,607.5,67
HCPCS,C1883,MEDTRONIC EXTENSION KIT 37082-40,5320.0,3458.0,200.93,5320.0,76
HCPCS,C1883,PACEMAKER ADAPTER KIT TIER I,287.0,186.55,62.57,287.0,67
HCPCS,C1883,SC-3138-25 25CM EXT KIT,838.0,544.7,182.68,838.0,75
HCPCS,C1883,SC-3400-30 30CM SPLITTER KIT,2970.0,1930.5,200.93,2970.0,76
HCPCS,C1883,SCS ACESSORY KIT #1701 ANS,690.63,448.91,150.56,690.63,75
HCPCS,C1883,W ADPT 25CM Y UNPLR PIN PLG,496.0,322.4,108.13,496.0,75
HCPCS,C1884,FILTER WIRE (EPD),2943.61,1913.35,200.93,2943.61,67
HCPCS,C1884,W COIL EMBOL AZUR 4/6MM X 20CM,3110.0,2021.5,200.93,3110.0,76
HCPCS,C1884,W EMBLIC PRTCTN RX ACCNT SYS,1755.0,1140.75,200.93,1755.0,67
HCPCS,C1885,AURYON ATHERECTOMY CATHETER EXIMO HYDROPHILIC COATED  4002,5590.0,3633.5,200.93,5590.0,67
HCPCS,C1885,AURYON ATHERECTOMY CATHETER EXIMO HYDROPHILIC COATED 4001,5590.0,3633.5,200.93,5590.0,67
HCPCS,C1885,C1885 TIER 1 LASER CATHETER,3780.0,2457.0,200.93,3780.0,67
HCPCS,C1885,CATHETER EXIMO ATHERECTOMY 2MM - HYDROPHILIC COATED,5590.0,3633.5,200.93,5590.0,67
HCPCS,C1886,AERIN STYLUS,1900.0,1235.0,200.93,1900.0,67
HCPCS,C1886,CATH TACTI SEN EN 8FR D C 115CM ABLA C FORCE,3972.0,2581.8,200.93,3972.0,67
HCPCS,C1887,"2.6FR X 150CM CXI SUPPORT CATHETER, ANGL",247.5,160.88,53.96,247.5,67
HCPCS,C1887,5 FR MEDI-DYNE CATH-DIAGNOSTIC,30.46,19.8,6.64,232.66,67
HCPCS,C1887,6-8 FR CORDIS CATHETER,68.49,44.52,14.93,232.66,67
HCPCS,C1887,6FR SHUTTLE SELECT 90 CM,321.25,208.81,70.03,321.25,67
HCPCS,C1887,"6FR X 100CM ADROIT GUIDING CATHETER, XB 3.5, .072IN ID",74.0,48.1,16.13,232.66,67
HCPCS,C1887,ABBOT/TREK  CORONARY DILATION CATHETER/3.50X15X145CM,148.75,96.69,32.43,232.66,67
HCPCS,C1887,ABBOT/TREK CORONARY DILATION CATHETER/3.0X15X145 CM,148.75,96.69,32.43,232.66,67
HCPCS,C1887,ABBOTT/TREKRX CORONARY DILATION CATH/4.0MM X 15MM,148.75,96.69,32.43,232.66,67
HCPCS,C1887,ACE REPERFUSION CATH & PENUMBRA HI-FLOW ASPIRATION TUBING,3861.0,2509.65,200.93,3861.0,67
HCPCS,C1887,ACE REPERFUSION CATH 5MAX,3334.5,2167.43,200.93,3334.5,67
HCPCS,C1887,"ADROIT GUIDING CATHETER, IM, SINGLE USE",74.0,48.1,16.13,232.66,67
HCPCS,C1887,"ADROIT GUIDING CATHETER, JL 3.5, SINGLE USE",74.0,48.1,16.13,232.66,67
HCPCS,C1887,AGILIS HISPRO SLITTER,70.0,45.5,15.26,232.66,67
HCPCS,C1887,AGILIS? NXT STEERABLE INTRODUCER DUAL-REACH,2600.0,1690.0,200.93,2600.0,67
HCPCS,C1887,ASAHI CROSSWALK STRAIGHT,330.0,214.5,71.94,330.0,67
HCPCS,C1887,BARD DILATION BALLOON VALVULOPLASTY CATHETER,1620.0,1053.0,200.93,1620.0,67
HCPCS,C1887,"BARD DORADO PTA DILATION BALLOON CATHETER, 4MMX2CM, 5FRX80CM",247.5,160.88,53.96,247.5,67
HCPCS,C1887,BARD PTA BALLOON DILATION CATHETER  7 MM X2 CM,247.5,160.88,53.96,247.5,67
HCPCS,C1887,BARD PTA BALLOON DILATION CATHETER 5 MM X4 CM,330.0,214.5,71.94,330.0,67
HCPCS,C1887,BARD PTV DILATION BALLOON,1125.0,731.25,200.93,1125.0,67
HCPCS,C1887,"BARD VIDA BAV BALLOON VALVULOPLASTY CATHETER 22MMX4CM,100CM SHAF",1260.0,819.0,200.93,1260.0,67
HCPCS,C1887,BARD VIDA TRUE FLOW VALVULOPASTY PERFUSION CATHETHER,1958.0,1272.7,200.93,1958.0,67
HCPCS,C1887,BOSTON SCIENTIFIC/PERIPH VASC/FIBER BRAID MICROCATH W/ HYDRO PAS,637.5,414.38,138.98,637.5,67
HCPCS,C1887,"BRAUN BIB DILATION CATHETER,10MMX3.5CM INNER,20MMX4CM OUTER 8 FR",1285.5,835.58,200.93,1285.5,67
HCPCS,C1887,"BRAUN COEFFECIENT PTV DILATION CATH, 11MMX3CM BALL,3.5FR SHAFT X",627.45,407.84,136.78,627.45,67
HCPCS,C1887,"BRAUN TYSHAK II BALLON DILATION CATH, 10MMX4CM BALLOON,5FRX90CM",1026.75,667.39,200.93,1026.75,67
HCPCS,C1887,"BRAUN TYSHAK II BALLON DILATION CATH,8MMX6CM BALLOON,4FRX70CM SH",1155.02,750.76,200.93,1155.02,67
HCPCS,C1887,C1887 DIAG CATH EP TIER 0,15.5,10.08,3.38,232.66,201
HCPCS,C1887,C1887 DIAG CATH EP TIER 4,1493.0,970.45,200.93,1493.0,67
HCPCS,C1887,C1887 DIAG CATH EP TIER 5,2025.0,1316.25,200.93,2025.0,67
HCPCS,C1887,C1887 DIAG CATH EP TIER 6,3240.0,2106.0,200.93,3240.0,67
HCPCS,C1887,C1887 DIAG CATH EP TIER I,276.0,179.4,60.17,276.0,67
HCPCS,C1887,C1887 DIAG CATH EP TIER II,375.0,243.75,81.75,375.0,67
HCPCS,C1887,C1887 DIAG CATH EP TIER III,746.0,484.9,162.63,746.0,201
HCPCS,C1887,C1887 GUIDING CATHETER TIER 1,78.0,50.7,17.0,232.66,67
HCPCS,C1887,C1887 GUIDING CATHETER TIER 2,175.5,114.08,38.26,232.66,67
HCPCS,C1887,C1887 GUIDING CATHETER TIER 4,506.25,329.06,110.36,506.25,67
HCPCS,C1887,CATH GUID .035IN 4.8-3.7FR 90,1313.13,853.53,200.93,1313.13,67
HCPCS,C1887,CATH GUIDE 100CM7FR LAUNCH AL.75 CURVE CORONARY NYLON LARGE LUME,78.0,50.7,17.0,232.66,67
HCPCS,C1887,"CATH, GUIDE C1887 161",322.0,209.3,70.2,322.0,67
HCPCS,C1887,CATHETER ADROIT TRUELUMEN 6FR .072IN AL1 CURVE BLUE YELLOW STAIN,74.0,48.1,16.13,232.66,67
HCPCS,C1887,CATHETER ADROIT TRUELUMEN 6FR .072IN AMPLATZ RIGHT 1 CURVE BLUE,74.0,48.1,16.13,232.66,67
HCPCS,C1887,CATHETER ADROIT TRUELUMEN 6FR .072IN JUDKINS RIGHT 4 CURVE BLUE,74.0,48.1,16.13,232.66,67
HCPCS,C1887,CATHETER BERMAN  ANGIOGRAPHIC 2 LUMEN BALLOON SYRINGE,204.0,132.6,44.47,232.66,67
HCPCS,C1887,CATHETER LAUNCHER,78.0,50.7,17.0,232.66,67
HCPCS,C1887,CATHETER NAVICROSS HYDROPHILIC STAINLESS STEEL 150CM ANGIOGRAPHI,390.0,253.5,85.02,390.0,67
HCPCS,C1887,CATHETER VISTA BRITE TIP TRUELUMEN 7FR .078IN RENAL DOUBLE CURVE,119.4,77.61,26.03,232.66,67
HCPCS,C1887,"CATHETER, GUIDING",1020.0,663.0,200.93,1020.0,67
HCPCS,C1887,CELLO BALLOON GUIDE CATH 8FR X 102CM,1765.8,1147.77,200.93,1765.8,67
HCPCS,C1887,CELLO BALLOON GUIDE CATHETER 8FR X 102CM,1308.0,850.2,200.93,1308.0,67
HCPCS,C1887,CONCENTRIC MERCI MICROCATHETER,1326.0,861.9,200.93,1326.0,67
HCPCS,C1887,COOK .035 ROSEN WIRE,38.24,24.86,8.34,232.66,67
HCPCS,C1887,COOK 4FR JL 1.5 - 4.0,28.0,18.2,6.1,232.66,67
HCPCS,C1887,COOK 7FR GUIDING CATHETER,248.34,161.42,54.14,248.34,67
HCPCS,C1887,COOK PIGTAIL;3-7 FR,41.06,26.69,8.95,232.66,67
HCPCS,C1887,"COOPERSURGICAL 10INX16IN TRANSWARMER, INF TRANS MATTRESS, DISP",50.44,32.79,11.0,232.66,67
HCPCS,C1887,CORDIS 4F IM CATHETER,26.69,17.35,5.82,232.66,67
HCPCS,C1887,"CORDIS 4FRX100CM INF TL DIAG CATH, MULTIPURPOSE, MPA 2, FEM SEL,",15.5,10.08,3.38,232.66,67
HCPCS,C1887,"CORDIS 4FRX100CM INFINITI TL DIAG CATH, AMPLATZ, AR MOD, FEM SEL",15.5,10.08,3.38,232.66,67
HCPCS,C1887,"CORDIS 5FRX100CM INF TL DIAG CATH, AMPLATZ, AR 1 MOD, FEM SEL",15.5,10.08,3.38,232.66,67
HCPCS,C1887,"CORDIS 5FRX100CM INF TL DIAG CATH, JUDKINS L COR, JL 5, FEM SEL,",15.5,10.08,3.38,232.66,67
HCPCS,C1887,"CORDIS 5FRX100CM LVB TIP GUIDING CATH, AMPLATZ COR, AL 2 LBT, .0",74.0,48.1,16.13,232.66,67
HCPCS,C1887,"CORDIS 5FRX100CM LVB TIP GUIDING CATH, AMPLATZ COR, AR 2 LBT, .0",74.0,48.1,16.13,232.66,67
HCPCS,C1887,"CORDIS 5FRX35CM, BRITE TIP INTERVEN SHEATH, 0.035IN MAX GWIRE (E",50.22,32.64,10.95,232.66,67
HCPCS,C1887,"CORDIS 5FRX5.5CM, AVANTI SHEATH INTRO, W/ 0.035IN GUIDEWIRE",18.2,11.83,3.97,232.66,67
HCPCS,C1887,"CORDIS 6FRX100CM INF TL DIAG CATH, INTERNAL MAM, IM, FEM SEL",15.5,10.08,3.38,232.66,67
HCPCS,C1887,"CORDIS 6FRX100CM INF TL DIAG CATH, JUDKINS L COR, JL 5, FEM SEL,",15.5,10.08,3.38,232.66,67
HCPCS,C1887,"CORDIS 6FRX100CM VB TIP GUIDE CATH, AMPLATZ LEFT COR, AL .75, .0",74.0,48.1,16.13,232.66,67
HCPCS,C1887,CORDIS 8MMX2CM SLALOM PTA BALLOON DILATION CATHETER,348.0,226.2,75.86,348.0,67
HCPCS,C1887,"CORDIS 9FR X 98CM VB TIP GUIDING CATH, MULTIPURPOSE, MPA 1, .098",74.0,48.1,16.13,232.66,67
HCPCS,C1887,CORDIS CORONARY GUIDE CATH 6FR,91.88,59.72,20.03,232.66,67
HCPCS,C1887,"CORDIS/SABER PTA BALLOON DILATION CATHETER,5MMX20MM, 4 FR, 150 C",393.75,255.94,85.84,393.75,67
HCPCS,C1887,"CORIDS PWRFLX PICC DUAL LUMEN BALL DIL CATH 5MMX2CM BALL, 5FR,11",192.5,125.13,41.97,232.66,67
HCPCS,C1887,CPS AIM SLITTABLE INNER CATH,342.0,222.3,74.56,342.0,67
HCPCS,C1887,CPS LOCATOR 3D DELIVERY CATHETER AND DILATOR,360.0,234.0,78.48,360.0,67
HCPCS,C1887,CUSTOM AGB MAC 2-L C V ACCESS KIT FOR USE WITH 8 - 8.5 FR. CATHE,121.0,78.65,26.38,232.66,67
HCPCS,C1887,DESTINATION PERIPHERAL GUIDING SHEATH,163.24,106.11,35.59,232.66,67
HCPCS,C1887,ECHELON 14 MICROCATH,969.0,629.85,200.93,969.0,67
HCPCS,C1887,ELEMENT VASCULAR ACCESS SYSTEM,1800.0,1170.0,200.93,1800.0,67
HCPCS,C1887,"EPIC VAS STNT, 12MM X 60MM, 75CM SELF-EXPD, NITINOL, .035IN MAX",1087.5,706.88,200.93,1087.5,67
HCPCS,C1887,EXCEL 14 MICROCATHETER,1131.0,735.15,200.93,1131.0,67
HCPCS,C1887,EXCELSIOR SL-10 PRESHAPED CATH,1246.87,810.47,200.93,1246.87,67
HCPCS,C1887,EXTRACTION GRIP,487.5,316.88,106.28,487.5,67
HCPCS,C1887,FIRMAP PACING CATH,6615.0,4299.75,200.93,6615.0,67
HCPCS,C1887,G120028/S003 3D PENUMBRA,3900.0,2535.0,200.93,3900.0,69
HCPCS,C1887,G210150 ATTAIN COMMAND SUREVALVE GUIDE CATHETER NCT04863664,212.0,137.8,46.22,232.66,69
HCPCS,C1887,G210150 ATTAIN SELECT II SUREVALVE DELIVERY CATHETER SYSTEM NCT0,161.0,104.65,35.1,232.66,69
HCPCS,C1887,G210150 DELIVERY CATHETER (MEDTRONIC) NCT04863664,325.0,211.25,70.85,325.0,69
HCPCS,C1887,G210150 SELECTSITE DEFLECTABLE CATHETER NCT04863664,350.0,227.5,76.3,350.0,69
HCPCS,C1887,GLIDE OR GUIDE CATH,91.0,59.15,19.84,232.66,67
HCPCS,C1887,GLIDE OR GUIDE CATH TIER 1,337.5,219.375,19.84,584.0,268
HCPCS,C1887,GLIDE OR GUIDE CATH TIER 2,743.0,482.95,161.97,743.0,134
HCPCS,C1887,GLIDE OR GUIDE CATH TIER 3,1275.0,828.75,200.93,1275.0,67
HCPCS,C1887,GLIDE OR GUIDE CATH TIER 4,3308.0,2150.2,200.93,3308.0,67
HCPCS,C1887,GLIDE OR GUIDE CATH TIER 5,12622.5,8204.63,200.93,12622.5,67
HCPCS,C1887,GLIDECATH COBRA 2  CATHETER,90.56,58.86,19.74,232.66,67
HCPCS,C1887,GLIDECATH HYDROPHYLIC COATED CATHETER,103.5,67.28,22.56,232.66,67
HCPCS,C1887,GUIDEZILLA GUIDE EXT CATH,750.0,487.5,163.5,750.0,67
HCPCS,C1887,"HALO SINGLE LOOP SNARE KIT 4F, 5MM X 20CM",74.0,48.1,16.13,232.66,67
HCPCS,C1887,"HEADWAY 27 MICROCATH 156CM W/HYDROPHILIC COATIN,6CM STRAIGHT SHA",1406.25,914.06,200.93,1406.25,67
HCPCS,C1887,HEART SYNC PED RADIOTRANS MULTIFUNCT DEFIB ELECTRODES W/ZOLL CON,25.8,16.77,5.62,232.66,67
HCPCS,C1887,"ICU MED THERMOSET, CO-SET, FOR USE WITH IN-LINE PROBE",20.1,13.07,4.38,232.66,67
HCPCS,C1887,INTRACRANIAL CATHETER RFX072-105-08MP,847.88,551.12,184.84,847.88,67
HCPCS,C1887,JUDKINS RT 6FRX100CM DX CATH,34.0,22.1,7.41,232.66,67
HCPCS,C1887,LAUNCHER CATHETER IMA,96.0,62.4,20.93,232.66,67
HCPCS,C1887,LAUNCHER GUIDING CATHETER,78.0,50.7,17.0,232.66,67
HCPCS,C1887,LIGHTNING FLASH CATHETER 115CM HTORQ ASPIRATION TUBING 6F CATHET,19300.0,12545.0,200.93,19300.0,67
HCPCS,C1887,MARATHON MICROCATH,863.0,560.95,188.13,863.0,67
HCPCS,C1887,MEDITECH ST GLIDE CATH,142.0,92.3,30.96,232.66,67
HCPCS,C1887,"MEDTRONIC ACUMEN C315 LEAD DELIVERY GUIDING CATHER, J SHAPED",660.0,429.0,143.88,660.0,67
HCPCS,C1887,MEDTRONIC SELECTSITES STEERABLE DEFLECTING GUIDING CATH FOR 69CM,304.5,197.93,66.38,304.5,67
HCPCS,C1887,"MEDTRONIC WOVEN CORONARY CATH, HI VOL NIH, W/CARDIO MARKER IMAGE",68.25,44.36,14.88,232.66,67
HCPCS,C1887,"MEDTRONIC5FRX100CM LAUNCH GUIDING CATH, AMPLATZ RIGHT 1.0, 0.058",68.25,44.36,14.88,232.66,67
HCPCS,C1887,"MERIT 0.035INX150CM INQWIRE DIAG GWIRE, FIX-CORE HEP COATED, STR",17.2,11.18,3.75,232.66,67
HCPCS,C1887,"MERIT 0.035INX150CM INQWIRE DIAG GWIRE, FIXED-CORE, 3MM J-TIP FI",20.5,13.33,4.47,232.66,67
HCPCS,C1887,"MERIT 0.035INX260CM INQWIRE DIAG GWIRE, FIXED-CORE, 1.5MM J ROSE",40.2,26.13,8.76,232.66,67
HCPCS,C1887,"MERIT 0.035INX260CM INQWIRE DIAG GWIRE, FIXED-CORE, 3MM J-TIP",21.0,13.65,4.58,232.66,67
HCPCS,C1887,"MERIT 3FR X 40CM PERFORMA PED DIAGCATH, PIGTAIL, 4 SIDE PORTS,TE",73.5,47.78,16.02,232.66,67
HCPCS,C1887,"MERIT 48IN 1200 PSI CONTRAST INJ TUBING, POLYURETHANE",11.64,7.57,2.54,232.66,67
HCPCS,C1887,"MERIT 4FR PERFORMA DIAGNOSTIC CATHETER, MULTIPURPOSE BUMPER TIP",46.0,29.9,10.03,232.66,67
HCPCS,C1887,"MERIT 4FRX65CM IMPRESS DIAG PERIPH CATH, STRT FLUSH, 10 SPS",44.0,28.6,9.59,232.66,67
HCPCS,C1887,"MERIT 4FRX65CM SOFTOUCH PED DIAG CATH, 2 BAND PIGTAIL",112.0,72.8,24.42,232.66,67
HCPCS,C1887,"MERIT 4FRX80CM PERFORMA DIAG CATH, PIGTAIL FLUSH, 10 SPS, NON-BR",22.0,14.3,4.8,232.66,67
HCPCS,C1887,"MERIT 4FX10CM MAK, ECHO-ENHANCED 4CM NEEDLE KIT,0.46MMX40CM",50.0,32.5,10.9,232.66,67
HCPCS,C1887,"MERIT 5FRX65CM IMPRESS DIAG PERIPH CATH, STRT FLUSH, 10 SP",50.0,32.5,10.9,232.66,67
HCPCS,C1887,"MERIT 5FRX65CM PERFORMA DIAG CATH,HIGHFLOWPIGTAIL,10 SIDE PORTS",22.0,14.3,4.8,232.66,67
HCPCS,C1887,"MERIT 5FRX90CM IMPRESS DIAG PERIP CATH, STRT FLUSH, 10 SPS, NON-",22.0,14.3,4.8,232.66,67
HCPCS,C1887,"MERIT 5FRX90CM PERFORMA DIAG CATH,HIGH FLOW PIGTAIL, 10 SPS",22.0,14.3,4.8,232.66,67
HCPCS,C1887,"MERIT 6FR PERICARDIOCENTESIS KIT, HIGH-FLOW PIGTAIL CATH",166.16,108.0,36.22,232.66,67
HCPCS,C1887,"MERIT 6FR X 125CM PERFORMA DIAG CATH, A2, 5.8CM TIP, 2 SPS",17.0,11.05,3.71,232.66,67
HCPCS,C1887,"MERIT 6FRX100CM PERFORMA DIAG CATH, JR4.0, 1.9CMTIP, 0.038IN MAX",17.0,11.05,3.71,232.66,67
HCPCS,C1887,"MERIT 6FRX110CM PERFORMA DIAG CATH, STRT CARD PIGTAIL, 8.0CM TIP",126.0,81.9,27.47,232.66,67
HCPCS,C1887,MERIT 7FR /11CM SHEATH INTRODUCER,91.0,59.15,19.84,232.66,67
HCPCS,C1887,MERIT 7FRX13CM PRELUDE SNAP SPLIT HEMOSTAT INTRODUCER SYSTEM,54.0,35.1,11.77,232.66,67
HCPCS,C1887,"MERIT INQWIRE DIAGNOSTIC GUIDEWIRE, FIXED CORE, SUPER STIFF",63.44,41.24,13.83,232.66,67
HCPCS,C1887,MERIT SWIFTNINJA SNCM125,3240.0,2106.0,200.93,3240.0,67
HCPCS,C1887,MICROCATH EXCELSIOR SL-10,1161.37,754.89,200.93,1161.37,67
HCPCS,C1887,MNGS JL1.5 CATH ALL SIZES,218.75,142.19,47.69,232.66,67
HCPCS,C1887,NEURON DEL CATHERTER PENUMBRA,675.0,438.75,147.15,675.0,67
HCPCS,C1887,NEURON DELIVERY CATHETER,1027.5,667.88,200.93,1027.5,67
HCPCS,C1887,"NUMED BIB DILATION CATH,5MMX3CM INNER,10MMX4MM OUTER, 8 FR SHAFT",1285.5,835.58,200.93,1285.5,67
HCPCS,C1887,"PENUMBRA LANTERN DELIVERY MICROCATH, 0.025OMX135CM 45 DEGREE TIP",975.0,633.75,200.93,975.0,67
HCPCS,C1887,PROGREAT MICROCATHETER SYSTEM,760.0,494.0,165.68,760.0,67
HCPCS,C1887,PROMETRA CATH TUNNEL 45.7 CM,180.0,117.0,39.24,232.66,75
HCPCS,C1887,PROWLER 14 MICROCATH STRAIGHT MAX GUIDEWIRE,975.0,633.75,200.93,975.0,67
HCPCS,C1887,"PROWLER 27 MICROCATH, STRAIGHT",1327.5,862.88,200.93,1327.5,67
HCPCS,C1887,"PROWLER SELECT LP ES / PROWLER PLUS 45CM MICROCATH, STRAIGHT",975.0,633.75,200.93,975.0,67
HCPCS,C1887,"PROWLER SELECT PLUS MICROCATH, 5CM, 45 DEG",1053.0,684.45,200.93,1053.0,67
HCPCS,C1887,"PROWLER SELECT PLUS MICROCATH, 5CM, STRAIGHT",907.5,589.88,197.84,907.5,67
HCPCS,C1887,"PROX ?2.3FR / 1.9FR DIS X 150CM, PROWLER 14 MICROCATH, 50CM, 45",1053.0,684.45,200.93,1053.0,67
HCPCS,C1887,"PROX ?2.3FR / 1.9FR DIS X 150CM, PROWLER 14 MICROCATH, 50CM, J C",1053.0,684.45,200.93,1053.0,67
HCPCS,C1887,R2P NAVICROSS CATHETER,830.0,539.5,180.94,830.0,67
HCPCS,C1887,RENEGADE FIBER BRAID MICROCATH W/HYDRO PASS 150/10CM & 130/20CM,637.5,414.38,138.98,637.5,67
HCPCS,C1887,"RENEGADE FIBER BRAIDED MICROCATH W/HYDRO PASS, 150CM 20CM DISTAL",637.5,414.38,138.98,637.5,67
HCPCS,C1887,"RENEGADE HI FLO MICROCATH 135/10 CM, 3FR",588.5,382.53,128.29,588.5,67
HCPCS,C1887,"RENEGADE HI-FLO MICROCATH 150CM X 10CM, STRAIGHT TIP",588.5,382.53,128.29,588.5,67
HCPCS,C1887,"RENEGADE HI-FLO MICROCATHETER, 105/10 CM, 3 FR",588.5,382.53,128.29,588.5,67
HCPCS,C1887,RENEGADE HI-FLOW FATHOM SYSTEM,924.0,600.6,200.93,924.0,67
HCPCS,C1887,RENEGADE HI-FLOW MICROCATHETER,383.15,249.05,83.53,383.15,67
HCPCS,C1887,RENEGADE MICROCATHETER,723.0,469.95,157.61,723.0,67
HCPCS,C1887,"RENEGADE STC 18 MICROCATH W/ RO MARKER, ANGLED 105CM",723.0,469.95,157.61,723.0,67
HCPCS,C1887,"RENEGADE STC 18 MICROCATH W/ RO MARKER, ANGLED 150CM",688.0,447.2,149.98,688.0,67
HCPCS,C1887,"RENEGADE STC 18 MICROCATH W/ RO MARKER, STRAIGHT",693.0,450.45,151.07,693.0,67
HCPCS,C1887,SCIMED DIAGNOSTIC CATH,390.0,253.5,85.02,390.0,67
HCPCS,C1887,SCIMED GUIDE CATH,91.0,59.15,19.84,232.66,67
HCPCS,C1887,SELECTRA VASCULAR GUIDE-CATHETER,426.0,276.9,92.87,426.0,67
HCPCS,C1887,SHUTTLE GUIDING CATHETER,293.15,190.55,63.91,293.15,67
HCPCS,C1887,SOFIA MICROCATHETER,3098.0,2013.7,200.93,3098.0,67
HCPCS,C1887,"SPEX LP SHAPEABLE SUPPORT CATHETER, US",320.0,208.0,69.76,320.0,67
HCPCS,C1887,STRYKER AXS DSTL ACC CATH,3037.5,1974.38,200.93,3037.5,67
HCPCS,C1887,SUBLIME MICROCATHETER,760.0,494.0,165.68,760.0,67
HCPCS,C1887,SWAN GANZ BERMAN,92.0,59.8,20.06,232.66,67
HCPCS,C1887,TELEMARK MICROCATH PERCU SINGLE LUM,780.0,507.0,170.04,780.0,67
HCPCS,C1887,TELEPORT CONTROL MICROCATHETER,1100.0,715.0,200.93,1100.0,67
HCPCS,C1887,TELEPORT MICROCATHETER,1100.0,715.0,200.93,1100.0,67
HCPCS,C1887,TERUMO MICROCATHETER,1231.0,800.15,200.93,1231.0,67
HCPCS,C1887,"TERUMO, CORONARY MICRO GUIDE CATHETER/ 1.8 FR X130 CM",600.0,390.0,130.8,600.0,67
HCPCS,C1887,"TOURGUIDE STEERABLE SHEATH, 6.5F",1150.0,747.5,200.93,1150.0,67
HCPCS,C1887,TRANSIT CATHETER,850.5,552.83,185.41,850.5,67
HCPCS,C1887,VISTA BRITE TIP GUIDING CATHETER,74.0,48.1,16.13,232.66,67
HCPCS,C1887,"VISTA BRITE TIP GUIDING CATHETER, JUDKINS RIGHT CORONARY",74.0,48.1,16.13,232.66,67
HCPCS,C1887,W CATH ANG 135CM CROSSBOSS,1417.5,921.38,200.93,1417.5,67
HCPCS,C1887,W CATH GUID EP FINECROSS,900.0,585.0,196.2,900.0,67
HCPCS,C1887,"WORKING LENGTH REPERFUSION CATH, 3.4FR X 150CM, .032IN MAX G/W",2267.0,1473.55,200.93,2267.0,67
HCPCS,C1888,7FR X 60CM CLOSUREFAST CATHETER,2100.0,1365.0,200.93,2100.0,76
HCPCS,C1888,HIGH FLOW MICROCATHETER,3712.5,2413.13,200.93,3712.5,67
HCPCS,C1889,CAPITATION WATCHMAN,34000.0,22100.0,200.93,34000.0,76
HCPCS,C1889,CATHETER ADROIT TRUELUMEN 6FR .072IN AMPLATZ LEFT .75 CURVE BLUE,64.0,41.6,13.95,232.66,67
HCPCS,C1889,EBR WISE CRT LEADLESS PACEMAKER SYSTEM MFG M7000,146070.0,94945.5,200.93,146070.0,75
HCPCS,C1889,EYELID WEIGHT 0.6 GM,1113.0,723.45,200.93,1113.0,75
HCPCS,C1889,EYELID WEIGHT 0.8 GM,1152.0,748.8,200.93,1152.0,75
HCPCS,C1889,EYELID WEIGHT 1.0 GM,1208.0,785.2,200.93,1208.0,75
HCPCS,C1889,EYELID WEIGHT 1.2 GM,1259.0,818.35,200.93,1259.0,75
HCPCS,C1889,EYELID WEIGHT 1.4 GM,1301.0,845.65,200.93,1301.0,75
HCPCS,C1889,EYELID WEIGHT 1.6 GM,1344.0,873.6,200.93,1344.0,75
HCPCS,C1889,EYELID WEIGHT 1.8 GM,1400.0,910.0,200.93,1400.0,76
HCPCS,C1889,EYELID WEIGHT 2.0 GM,1451.0,943.15,200.93,1451.0,76
HCPCS,C1889,EYELID WEIGHT 2.2 GM,1715.0,1114.75,200.93,1715.0,76
HCPCS,C1889,FARADRIVE STEERABLE SHEATH ADVANTAGE AF NCT05443594 G220079,1400.0,910.0,200.93,1400.0,69
HCPCS,C1889,FARAPOINT PFA POINT CATH ADVANTAGE AF NCT05443594 G220079,10560.0,6864.0,200.93,10560.0,69
HCPCS,C1889,FARASTAR CATH CONNECTION CABLE ADVANTAGE AF NCT05443594 G220079,850.0,552.5,185.3,850.0,69
HCPCS,C1889,FARAWAVE PFA BALLOON CATH ADVANTAGE AF NCT05443594 G220079,6500.0,4225.0,200.93,6500.0,69
HCPCS,C1889,G200097 PARADIGM NCT04489823,10000.0,6500.0,200.93,10000.0,69
HCPCS,C1889,G230249 AVANT GUARD FARASTAR ? CATH CONNECTION CABLE ? NCT060963,200.0,130.0,43.6,232.66,69
HCPCS,C1889,G230249 AVANT GUARD FARASTAR GEN2 ?CATH CONNECTION CABLE ? NCT06,600.0,390.0,130.8,600.0,69
HCPCS,C1889,GUIDEWIRE VASC VC CONN FARADRIVE,1990.0,1293.5,200.93,1990.0,67
HCPCS,C1889,HEMOSPRAY,1977.75,1285.54,200.93,1977.75,67
HCPCS,C1889,ITIND DEVICE,5590.0,3633.5,200.93,5590.0,76
HCPCS,C1889,MEDPOR NOSTRIL RETAINER,250.0,162.5,54.5,250.0,67
HCPCS,C1889,MILD KIT,2835.0,1842.75,200.93,2835.0,76
HCPCS,C1889,RECOR MEDICAL PARADISE ULTRASOUND RDN PRDS-PPP,40000.0,26000.0,200.93,40000.0,76
HCPCS,C1889,SPACEOAR HYDROGEL IMPLANTABLE DEVICE,6530.0,4244.5,200.93,6530.0,76
HCPCS,C1889,THROMBECTOMY EMBOLECTOMY DEVICE EKOS+KIT,13570.0,8820.5,200.93,13570.0,67
HCPCS,C1889,TYRX ANTIBACTERIAL ENVELOPE,1990.0,1293.5,200.93,1990.0,76
HCPCS,C1889,"VERSACROSS CONNECT RF WIRE, PIGTAIL, D0 TRANSSEPTAL DILATOR",1990.0,1293.5,200.93,1990.0,67
HCPCS,C1890,No device w/dev-intensive px,,,10.69,2739849.3,9
HCPCS,C1891,"PUMP,ARROW CONT INFUSION #3000",7889.0,5127.85,200.93,7889.0,76
HCPCS,C1892,2.6M COOLING POINT TUBING,175.0,113.75,38.15,232.66,67
HCPCS,C1892,"ATRIUM MEDICAL EXPRESS DRY-SEAL CHEST DRAIN, SINGLE COLLECTION",57.64,37.47,12.57,232.66,67
HCPCS,C1892,BYRD WORK STATION,1150.5,747.83,200.93,1150.5,67
HCPCS,C1892,"COOK 5 FR X 45 CM, FLEXOR CHECK-FLO INTRODUCER, ANSEL",75.25,48.91,16.4,232.66,67
HCPCS,C1892,"COOK 7FRX63M, CHECK-FLO INTRODUCER, MULLINS, RB TIP, W/O WIRE",80.5,52.33,17.55,232.66,67
HCPCS,C1892,COOK CURVED PEEL AWAY INTRODUC,217.83,141.59,47.49,232.66,67
HCPCS,C1892,DILATOR SHEATH SET,450.0,292.5,98.1,450.0,67
HCPCS,C1892,INTROSYTE INTRODUCER SHEATH 26GAX 1.9CM,46.3,30.1,10.09,232.66,67
HCPCS,C1892,LONG PEEL AWAY INTROD TIER II,202.0,131.3,44.04,232.66,67
HCPCS,C1892,MEDTRONIC RESOLUTE ONYX 4.5X15MM CORONARY STENT SYSTEM,1350.0,877.5,200.93,1350.0,67
HCPCS,C1892,"MERIT SHEATH, PLS-1007 CATHETER",54.0,35.1,11.77,232.66,134
HCPCS,C1892,"MERIT, CONTRAST INJ. TUBING AIRLESS ROTATING ADAPTER",11.64,7.57,2.54,232.66,67
HCPCS,C1892,PEEL-AWAY INTRODUCER SET (PLVW-18.0-38-30),152.0,98.8,33.14,232.66,67
HCPCS,C1892,"REMINGTON MEDICAL, PA-801 CABLE",32.0,20.8,6.98,232.66,67
HCPCS,C1892,SSPC NXT PLUS WITH DELIVERY CATHETER AND DILATOR,700.0,455.0,152.6,700.0,67
HCPCS,C1892,W GINTRO EP IC FC,69.0,44.85,15.04,232.66,67
HCPCS,C1892,WORLEY ADVANCED CSG STANDARD,630.0,409.5,137.34,630.0,67
HCPCS,C1892,WORLEY HEMOSTATIC SAFESHEATH 9FR X 40CM,630.0,409.5,137.34,630.0,67
HCPCS,C1892,WORLEY VEIN SELECTOR STD CURVE,248.0,161.2,54.06,248.0,67
HCPCS,C1893,BALKIN SHEATHS,111.31,72.35,24.27,232.66,67
HCPCS,C1893,BRITE TIP SHEATH,91.0,59.15,19.84,232.66,67
HCPCS,C1893,"BRITE TIP SHEATH 6F,7F,8FX35CM",39.35,25.58,8.58,232.66,67
HCPCS,C1893,"BRITE TIP SHEATH 7F,9FX45CM",101.99,66.29,22.23,232.66,67
HCPCS,C1893,C1893  INTRODUCER/GUIDER 1,270.0,175.5,58.86,270.0,67
HCPCS,C1893,CHECK FLOW SHEATH 30 & 45 CM,95.59,62.13,20.84,232.66,67
HCPCS,C1893,"CHECK-FLO 10 FR, 45CM INTRODUC",199.0,129.35,43.38,232.66,67
HCPCS,C1893,CK FLOW BLUE MULLINS SHEATH,78.22,50.84,17.05,232.66,67
HCPCS,C1893,CORDIS BRITE TIP SHEATH 50CM,63.54,41.3,13.85,232.66,67
HCPCS,C1893,"CORDIS BRT TIP SHEATH 23CM,35C",86.83,56.44,18.93,232.66,67
HCPCS,C1893,CPS DIRECT VASC GUIDE CATH,360.0,234.0,78.48,360.0,67
HCPCS,C1893,INTRODUCER SHEATHS 25CM,25.99,16.89,5.67,232.66,67
HCPCS,C1893,SAFE SHEATH,675.0,438.75,147.15,675.0,67
HCPCS,C1893,SLITTABLE OUTER GUIDE CATHETER,360.0,234.0,78.48,360.0,67
HCPCS,C1893,TRANS-SEPTAL INTRODUCER,375.0,243.75,81.75,375.0,67
HCPCS,C1893,VERSACROSS ACCESS KIT,1850.0,1202.5,200.93,1850.0,67
HCPCS,C1893,W GDNG INTRDCR FAST CTH 60CM,240.0,156.0,52.32,240.0,67
HCPCS,C1894,4FR MICROPUNCTURE,79.0,51.35,17.22,232.66,67
HCPCS,C1894,8.5FR AGILIS INTRODUCER,870.0,565.5,189.66,870.0,67
HCPCS,C1894,"ACCUSTICK II W/RO MARK INTRO SYS, W/0.038 SS J-TIP & 0.018  NITI",138.0,89.7,30.08,232.66,67
HCPCS,C1894,"ARROW 130CMX0.018 VSI GUIDEWIRE, NITINOL MANDREL/PLATINUM SOFT T",75.25,48.91,16.4,232.66,67
HCPCS,C1894,ARROW 35CM SHEATHS,174.13,113.18,37.96,232.66,67
HCPCS,C1894,"ARROW 3FR X 4CM VSI MICRO-HV SHEATH W/HYDROPHILIC COATING, GOLD",85.75,55.74,18.69,232.66,67
HCPCS,C1894,"ARROW 4FR X 40CM VSI MICRO-ACCESS TEARAWAY INTRODUCER KIT, NITIN",74.0,48.1,16.13,232.66,67
HCPCS,C1894,ARROW 4FR X 5.5CM VSI MICRO-HV SHEATH W/HYDROPHILC COATING W/ SS,78.75,51.19,17.17,232.66,67
HCPCS,C1894,ARROW 6FR VSI MICRO DE-CLOT HV INTRODUCER KIT,78.75,51.19,17.17,232.66,67
HCPCS,C1894,ARROW INTRODUCER; 6F X 24 CM,81.2,52.78,17.7,232.66,67
HCPCS,C1894,ARROW PSI KIT 8.5FR 4IN INTRODUCER,194.0,126.1,42.29,232.66,67
HCPCS,C1894,ARROW SHEATH/DILATOR,133.35,86.68,29.07,232.66,67
HCPCS,C1894,ARROWG+ARD BLUE (R) MAC (TM) TWO-LUMEN CENTRAL VENOUS ACCESS KIT,162.92,105.9,35.52,232.66,67
HCPCS,C1894,AVEIR LEADLESS DUAL PM INTRODUCER/SHEATH,6150.0,3997.5,200.93,6150.0,67
HCPCS,C1894,B BRAUN 4F MICRO INTRO SHEATH,28.0,18.2,6.1,232.66,67
HCPCS,C1894,B. BRAUN DVILL MODEL DV 1265 HEMOSTATIS INTRODUCER SET,348.0,226.2,75.86,348.0,67
HCPCS,C1894,"BD INF. 26GA 1.9 FRX50 CM SINGLE LMN, BD FIRST PICC CATHETER ONL",73.5,47.78,16.02,232.66,67
HCPCS,C1894,BRITE TIP,50.22,32.64,10.95,232.66,67
HCPCS,C1894,C1894 SHEATH TIER 2,318.0,206.7,69.32,318.0,134
HCPCS,C1894,C1894 SHEATH TIER 3,975.0,633.75,200.93,975.0,67
HCPCS,C1894,C1894 SHEATH/INTRODUCER TIER 0,52.0,33.8,11.34,232.66,134
HCPCS,C1894,C1894 SHEATH/INTRODUCER TIER 1,111.0,72.15,24.2,232.66,67
HCPCS,C1894,C1894 SHEATH/INTRODUCER TIER 2,167.0,108.55,36.41,232.66,134
HCPCS,C1894,C1894 SHEATH/INTRODUCER TIER 3,255.0,165.75,55.59,255.0,67
HCPCS,C1894,C1894 SHEATH/INTRODUCER TIER 4,332.0,215.8,72.38,332.0,67
HCPCS,C1894,C1894 SHEATH/INTRODUCER TIER 5,621.0,403.65,135.38,621.0,67
HCPCS,C1894,CATH MICRO MAMBA FLEX 135,900.0,585.0,196.2,900.0,67
HCPCS,C1894,CHCKFLO INTRO PERFORM SET,143.5,93.28,31.28,232.66,67
HCPCS,C1894,"CHECK-FLO INTRO 12FR X 30CM, LRG VALVE ASSEMBLY, RB TIP",80.5,52.33,17.55,232.66,75
HCPCS,C1894,"CHECK-FLO INTRO 14FR X 30CM, LRG VALVE ASSEMBLY, RB TIP",98.0,63.7,21.36,232.66,75
HCPCS,C1894,"CHECK-FLO INTRO 16FR X 35CM, LRG VALVE ASSEMBLY, RB TIP",143.5,93.28,31.28,232.66,75
HCPCS,C1894,CHECK-FLO PERFORM INTRO SET (RCFW-12.0-38-45-RB),195.0,126.75,42.51,232.66,75
HCPCS,C1894,CHECK-FLO PERFORM INTRO SET (RCFW-18.0P-38-40-RB),143.5,93.28,31.28,232.66,75
HCPCS,C1894,"CHECK-FLO PERFORM INTRO SET, MULLINS (RCFW-6.0-38-48-RB-MTS)",75.0,48.75,16.35,232.66,75
HCPCS,C1894,CHECK-FLO PERFORMER INTRODUCER,193.64,125.87,42.21,232.66,67
HCPCS,C1894,CHECK-FLO PERFORMER INTRODUCER SET (RCFW-14.0-38-45-RB),257.0,167.05,56.03,257.0,67
HCPCS,C1894,CHECK-FLO PERFORMER INTRODUCER SET (RCFW-16.0P-38-45-RB),143.5,93.28,31.28,232.66,67
HCPCS,C1894,CLOT RETRIEVER SHEATH,2025.0,1316.25,200.93,2025.0,67
HCPCS,C1894,CONVATEC 9CM X 15CM AQUACEL AG SURGICAL COVER DRESSING,53.96,35.07,11.76,232.66,67
HCPCS,C1894,"COOK 10FR/63, 12 OR 14FR/75 MU",151.31,98.35,32.99,232.66,67
HCPCS,C1894,COOK 11/75 MULLINS,131.64,85.57,28.7,232.66,67
HCPCS,C1894,"COOK 14FRX13CM, CHECK-FLO INTRO, LG VALVE, INC.038IN STRT 3MM J",74.0,48.1,16.13,232.66,67
HCPCS,C1894,COOK 16F INTRODUCER SHEATH,331.31,215.35,72.23,331.31,67
HCPCS,C1894,COOK 21GAX7CM ONE-PART PERC ENTRY THINWALL NEEDLE W/BASEPLATE,26.6,17.29,5.8,232.66,67
HCPCS,C1894,"COOK 7FR X 110 CM, FLEXOR TUOHY-BORST SIDEARM INTRODUCER",175.0,113.75,38.15,232.66,67
HCPCS,C1894,COOK 8FR/63 MULLINS,90.37,58.74,19.7,232.66,67
HCPCS,C1894,"COOK CHECK-FLO INTRODUCER SET, MULLINS(RCFW-10.0-38-85-RB-MTS)",152.25,98.96,33.19,232.66,67
HCPCS,C1894,"COOK CHECK-FLO INTRODUCER SET, MULLINS(RCFW-11.0-38-85-RB-MTS)",152.25,98.96,33.19,232.66,67
HCPCS,C1894,COOK CHECK-FLO PERFORMER INTRODUCER SET (RCFW-18.0P-38-85-RB),169.75,110.34,37.01,232.66,67
HCPCS,C1894,COOK FLEXOR SHEATH; 6X30,117.0,76.05,25.51,232.66,67
HCPCS,C1894,COOK INTRODUCER 10.0-38-75-RB,94.0,61.1,20.49,232.66,67
HCPCS,C1894,COOK RAABE SHEATH,80.0,52.0,17.44,232.66,67
HCPCS,C1894,COOK; 10F 30 CM SHEATH,1820.25,1183.16,200.93,1820.25,67
HCPCS,C1894,COOK; 12F 40CM SHEATH,126.44,82.19,27.56,232.66,67
HCPCS,C1894,COOK; 7F/8F 30CM/80CM SHEATH,68.95,44.82,15.03,232.66,67
HCPCS,C1894,"CORDIS 6FRX100CM VB TIP GUIDE CATH, AMPLATZ LEFT COR, AL 1, .070",74.0,48.1,16.13,232.66,67
HCPCS,C1894,CORDIS AVANTI SHEATH,17.0,11.05,3.71,232.66,67
HCPCS,C1894,CVP 7.5 FR INTRODUCER,84.0,54.6,18.31,232.66,67
HCPCS,C1894,CVP 8.5 FR INTRODUCER,47.04,30.58,10.25,232.66,67
HCPCS,C1894,D'VILL LONG LENGTH INTRODUCER SET /12 FR. X 85  CM,328.5,213.53,71.61,328.5,67
HCPCS,C1894,D'VILL LONG LENGTH INTRODUCER SET/ 14 FR. X 85 CM,328.5,213.53,71.61,328.5,67
HCPCS,C1894,DEXTERITY STEERABLE INTRODUCER,2018.0,1311.7,200.93,2018.0,67
HCPCS,C1894,DRYSEAL FLEX INTRODUCER SHEATH,1017.0,661.05,191.84,1154.0,134
HCPCS,C1894,ETHICON SUTURE ETHIBOND XTRA 3-0 SH 30 INCH,9.5,6.18,2.07,232.66,67
HCPCS,C1894,"FAST-CATH 10FR X30CM, 9 FR SNAP LOCK OBTURATOR, 80 CM GUIDEWIRE",80.5,52.33,17.55,232.66,75
HCPCS,C1894,"GALT MED 3FR X 3CM MICROSLIDE INTRO SHEATH SET, .008IN GWIRE",46.3,30.1,10.09,232.66,67
HCPCS,C1894,"GALT MED 4.5FR X 5CM TEARAWAY SHEATH/DILATOR INTRO SET, 0.018IN",32.0,20.8,6.98,232.66,67
HCPCS,C1894,"GALT MED 4FR X 5CM M-A TEARAWAY SHEATH/DILATOR INTRO SET, 0.018I",36.8,23.92,8.02,232.66,67
HCPCS,C1894,"GALT MED 5FR X 5.5CM  MA HEM VALVE INTRO KIT, W/ GUIDE WIRE, SOF",56.0,36.4,12.21,232.66,67
HCPCS,C1894,"GALT MED 5FRX5CMTEARAWAY SHEATH/DILATOR INTRO SET, 0.018IN MAX",32.0,20.8,6.98,232.66,67
HCPCS,C1894,"GALT MED 6FR X 5.5CM M-A HEM VALVE INTRO KIT, W/ GUIDE WIRE, SOF",56.0,36.4,12.21,232.66,67
HCPCS,C1894,GORE DRYSEAL FLEX INTRODUCER/SHEATH DSF 1633,268.5,174.53,58.53,268.5,67
HCPCS,C1894,GORE DRYSEAL FLEX INTRODUCER/SHEATH DSF 1833,322.5,209.63,70.31,322.5,67
HCPCS,C1894,GORE DRYSEAL FLEX INTRODUCER/SHEATH DSF 1883,1272.0,826.8,200.93,1272.0,67
HCPCS,C1894,GORE DRYSEAL FLEX INTRODUCER/SHEATH DSF 2665,865.5,562.58,188.68,865.5,67
HCPCS,C1894,INARI PROTRIEVE SHEATH,5400.0,3510.0,200.93,5400.0,67
HCPCS,C1894,INTRO/SHEATH 22FR X 28CM HYDRO COATING,487.5,316.88,106.28,487.5,67
HCPCS,C1894,INTRO/SHEATH NON-LASER,55.0,35.75,11.99,232.66,67
HCPCS,C1894,INTRODUCER KCFW 4.0-18/3545 RB-ANLO,75.25,48.91,16.4,232.66,67
HCPCS,C1894,KIT 8.5FR 4IN INTRODUCER CUSTOM SHEATH PERCUTANEOUS,182.7,118.76,39.83,232.66,67
HCPCS,C1894,KIT ARTERIAL RADIAL 20G X 8CM SAC CUSTOM,64.0,41.6,13.95,232.66,67
HCPCS,C1894,LOCKING STYLET,79.0,51.35,17.22,232.66,67
HCPCS,C1894,"MERIT 4FRX90CM IMPRESS DIAG PERIPH CATH, STRT FLUSH, 10 SPS",44.0,28.6,9.59,232.66,67
HCPCS,C1894,"MERIT 6.5FR2.1MMX20CM,GREEN,4 HOLES,STRT,RESOLVE NO-LOCK DRAIN C",70.0,45.5,15.26,232.66,67
HCPCS,C1894,NITINOL PLTNM TIP GW (MPIS-501-10.0-SC-NT-SST) INTROD SET,79.0,51.35,17.22,232.66,67
HCPCS,C1894,PERCUTANEOUS SHEATH CK02000,43.87,28.52,9.56,232.66,67
HCPCS,C1894,PINNACLE DESTINATION GUIDING SHEATH,192.0,124.8,41.86,232.66,67
HCPCS,C1894,R2P DESTINATION SLENDER GUIDING SHEATH,568.0,369.2,123.82,568.0,67
HCPCS,C1894,SCIMED ADVANCER,1500.0,975.0,200.93,1500.0,67
HCPCS,C1894,SHEATH SET (VSSW-4.0-18-NPAS-100),185.5,120.58,40.44,232.66,67
HCPCS,C1894,"SHEATH, AVANTI OR PINNACLE",51.0,33.15,11.12,232.66,67
HCPCS,C1894,SUBLIME RADIAL ACCESS GUIDING SHEATH,600.0,390.0,130.8,600.0,67
HCPCS,C1894,"SUPER SHEATH 12FR X 11CM ?, INTRO SHEATH WITHOUT WIRE",15.0,9.75,3.27,232.66,67
HCPCS,C1894,W GDNG SHTH STRGHT CRSS-CUT VLV,179.0,116.35,39.02,232.66,67
HCPCS,C1895,G120093 SORIN RESPOND ATR LEAD,325.0,211.25,70.85,325.0,69
HCPCS,C1895,LEAD ICD TIER I,13250.0,8612.5,200.93,13250.0,75
HCPCS,C1895,LEAD ICD TIER III,8030.0,5219.5,200.93,8030.0,75
HCPCS,C1895,"LEAD,DEFIB(ENDOCARD)DUAL COIL",7550.0,4907.5,200.93,7550.0,75
HCPCS,C1895,"LEADS, ICD",5200.0,3380.0,200.93,5200.0,75
HCPCS,C1896,G210150 NEXT GENERATION ICD LEAD LEADR NCT04863664,4062.0,2640.3,200.93,4062.0,69
HCPCS,C1896,SUB Q ELECTRODE ICD,8000.0,5200.0,200.93,8000.0,75
HCPCS,C1896,SUB Q ELECTRODE ICD TIER 0,1275.0,828.75,200.93,1275.0,74
HCPCS,C1896,SUB Q ELECTRODE ICD TIER I,3200.0,2080.0,200.93,3200.0,75
HCPCS,C1897,AXIUM PATIENT PROGRAMMER,2636.0,1713.4,200.93,2636.0,76
HCPCS,C1897,AXIUM SLIMTIP TRIAL LEAD KIT 50CM,3490.0,2268.5,200.93,3490.0,76
HCPCS,C1897,IMPLANT NEUROSTIM LEAD TEST KIT C1897 (278),824.0,535.6,179.63,824.0,74
HCPCS,C1897,LEAD NRSTM 60CM TRIAL 1X8 977DX60,1200.0,780.0,200.93,1200.0,75
HCPCS,C1897,"LEAD, NEUROSTIM TEST KIT",1095.0,711.75,1.1,1095.0,68
HCPCS,C1897,"LEAD, NEUROSTIM TRIAL KIT",5275.0,3428.75,200.93,5275.0,76
HCPCS,C1897,"LEAD, WAVEWRITER SPINAL CORD STIMULATOR TEST KIT",5000.0,3250.0,200.93,5000.0,76
HCPCS,C1897,MEDTRONIC 1X8 LEAD REV KIT,2502.0,1626.3,200.93,2502.0,76
HCPCS,C1897,MEDTRONIC LEAD KIT 977A275,3158.0,2052.7,200.93,3158.0,76
HCPCS,C1897,NEVRO BLUE PERC LEAD KIT,2908.0,1890.2,200.93,2908.0,76
HCPCS,C1897,SC 2218-50 50CM LEAD KIT,2908.0,1890.2,200.93,2908.0,76
HCPCS,C1897,W IMP LD NSTM TST,824.0,535.6,179.63,824.0,75
HCPCS,C1897,W KT STM INTERSTM,915.0,594.75,199.47,915.0,75
HCPCS,C1898,"BOSTON SCIENTIFIC INGEVITY MRI, 7740, ACTUAL LEAD",510.0,331.5,111.18,510.0,67
HCPCS,C1898,G230050 LEFT VS LEFT RCT ULTIPACE NCT05650658,250.0,162.5,54.5,250.0,69
HCPCS,C1898,G230050 LEFT VS LFT RCT NCT05650658,397.0,258.05,86.55,397.0,69
HCPCS,C1898,LEAD PACEMAKER TIER II,3100.0,2015.0,200.93,3100.0,75
HCPCS,C1898,LEAD PACEMAKER TIER III,5800.0,3770.0,200.93,5800.0,75
HCPCS,C1898,MEDTRONIC 52CM DF-1 UNIPOLAR ENDOCARDIAL SVC CORONARY SINUS LEAD,1275.0,828.75,200.93,1275.0,67
HCPCS,C1898,MEDTRONIC SAFETY CABLE 5587,135.45,88.04,29.53,232.66,67
HCPCS,C1898,"MEDTRONIC SELECT SURE PACEMAKER LEAD, MODEL 3830",675.0,438.75,147.15,675.0,67
HCPCS,C1898,SJM 50 SLIM TIP IMPLANT LEAD,3246.0,2109.9,200.93,3246.0,76
HCPCS,C1898,SJM TRIAL LEAD KIT 60 CM,1452.0,943.8,200.93,1452.0,76
HCPCS,C1898,ULTIPACE PACING LEAD,750.0,487.5,163.5,750.0,75
HCPCS,C1898,W LD FNLINEII STRX EZ4472/4473,858.0,557.7,187.04,858.0,74
HCPCS,C1899,G130222 RELI 4FRT NCT02071173,2600.0,1690.0,200.93,2600.0,69
HCPCS,C1900,ATTAIN STABILITY QUAD MRI SURE SCAN LV LEAD,3940.0,2561.0,200.93,3940.0,76
HCPCS,C1900,G130222 ACUITY LDS NCT02071173,1100.0,715.0,200.93,1100.0,69
HCPCS,C1900,G170020 ATTAIN STABILITY QUAD MRI SURE SCAN LV LEAD,1900.0,1235.0,200.93,1900.0,69
HCPCS,C1900,LEAD LT VENT VENOUS TIER I,4050.0,2632.5,200.93,4050.0,75
HCPCS,C1900,LEAD LT VENT VENOUS TIER III,7760.0,5044.0,200.93,7760.0,75
HCPCS,C1982,"Cath, pressure,valve-occlu",,,200.93,232.66,8
HCPCS,C2596,"Probe, robotic, water-jet",,,200.93,232.66,8
HCPCS,C2613,Lung bx plug w/del sys,,,200.93,232.66,8
HCPCS,C2614,"Probe, perc lumb disc",,,200.93,232.66,8
HCPCS,C2615,"Sealant, pulmonary, liquid",,,1101.49,1275.41,8
HCPCS,C2616,"H980006 BRACHYTX,NON-STR,90 TH",33432.0,21730.8,1030.0,33432.0,94
HCPCS,C2616,YTTRIUM-90,33432.0,21730.8,1030.0,33432.0,94
HCPCS,C2617,STENT URET OPTIMA 788NNN BRD,108.5,70.53,23.65,232.66,75
HCPCS,C2617,"STENT, NON-COR, TEM W/O DEL",3289.0,2137.85,1.1,3289.0,68
HCPCS,C2617,W STENT BIL ADVANIX 2 PGTL CRV,257.59,167.43,56.15,257.59,75
HCPCS,C2618,CAPSULE DELIVERY DEVICE,148.75,96.69,32.43,232.66,67
HCPCS,C2618,CRYOABLATION PROBE,3195.0,2076.75,200.93,3195.0,67
HCPCS,C2618,ICE EDGE 2.4 NEEDLE,2551.5,1658.48,200.93,2551.5,67
HCPCS,C2618,ICE FORCE 2.1 CX HELIUM FREE NDLE,2916.0,1895.4,200.93,2916.0,67
HCPCS,C2618,ICE PEARL 2.1 CX HELIUM FREE NDLE,3200.0,2080.0,200.93,3200.0,67
HCPCS,C2618,ICEFORCE 2.1 CX 90 DEG CRYO NEEDLE,2160.0,1404.0,200.93,2160.0,67
HCPCS,C2618,ICEROD CX 90 DEG CRYO NEEDLE,1823.0,1184.95,200.93,1823.0,67
HCPCS,C2618,ICEROD PLUS 1.5 NEEDLE,2278.8,1481.22,200.93,2278.8,67
HCPCS,C2618,ICESPHERE 1.5 NEEDLE,2278.8,1481.22,200.93,2278.8,67
HCPCS,C2618,W NEEDLE CRYO SEEDNET ICEROD EA,2430.0,1579.5,200.93,2430.0,67
HCPCS,C2619,"Pmkr, dual, non rate-resp",,,200.93,232.66,8
HCPCS,C2620,"Pmkr, single, non rate-resp",,,200.93,232.66,8
HCPCS,C2621,PACEMAKER CONSULTA CRT-P,16000.0,10400.0,200.93,16000.0,75
HCPCS,C2622,S 278 C2622,12337.31,8019.25,200.93,12337.31,76
HCPCS,C2623,DCB 018 IPU06015020P D6.0 L150 UL0200,3080.0,2002.0,200.93,3080.0,67
HCPCS,C2623,DRUG-COATED BALLOON CATHETER,2580.0,1677.0,200.93,2580.0,67
HCPCS,C2623,GORE DRYSEAL FLEX INTRODUCER SHEATH,2790.0,1813.5,200.93,2790.0,67
HCPCS,C2623,IN PACT ADMIRAL DCB BALLOON,1958.0,1272.7,200.93,1958.0,67
HCPCS,C2623,LUTONIX DRUG COATED BALLOON,2092.0,1359.8,200.93,2092.0,67
HCPCS,C2623,PACLITAXEL-COATED PTA BALLOON CATHETER,2590.0,1683.5,200.93,2590.0,67
HCPCS,C2623,"SHOCKWAVE LITHOPLASTY PERIPHERAL BALLOON OTW, 6F",3712.5,2413.13,200.93,3712.5,67
HCPCS,C2623,"SHOCKWAVE LITHOPLASTY PERIPHERAL OTW BALLOON CATHETER, 7F",3712.5,2413.13,200.93,3712.5,67
HCPCS,C2623,US RANGER DILATATION CATHETER BALLOON,5790.0,3763.5,200.93,5790.0,67
HCPCS,C2623,W CATH INPACT ADMIRAL DCB/DEB,2580.0,1677.0,200.93,2580.0,67
HCPCS,C2624,CARDIOMEMS SENSOR/DELIV SYSTEM,35000.0,22750.0,200.93,35000.0,76
HCPCS,C2624,"G170258, GUIDE HF, NCT 03387813",15500.0,10075.0,200.93,15500.0,69
HCPCS,C2625,SPANNER PROSTATIC STENT,1150.0,747.5,200.93,1150.0,75
HCPCS,C2625,STENT PROPEL SINUS IMPLANT,1600.0,1040.0,200.93,1600.0,76
HCPCS,C2625,"STENT, NON-COR, TEMP W/DEL SYST C2625 91",274.0,178.1,54.42,274.0,75
HCPCS,C2625,W STENT URET INLAY OPTIMA,108.5,70.53,23.65,232.66,75
HCPCS,C2626,"Infusion pump, non-prog,temp",,,200.93,232.66,8
HCPCS,C2627,"Cath, suprapubic/cystoscopic",,,200.93,232.66,8
HCPCS,C2628,90CM BRIDGE OCCLUSION BALLOON CATHETER,975.0,633.75,200.93,975.0,67
HCPCS,C2628,ARROW TEMPORARY BALLOON,133.0,86.45,28.99,232.66,67
HCPCS,C2628,C2628 OCCLUSION BALLOON TIER 2,593.0,385.45,129.27,593.0,67
HCPCS,C2628,"CODA BALLOON CATH, 0.035IN GUIDE 9FR X120 CM 32/30 BALLOON",592.5,385.13,129.17,592.5,67
HCPCS,C2628,COOK PARK BLADE SEPTOPLASTY CATHETER 5.7 FRX68.5CM 9.4 MM BLADE,2084.0,1354.6,200.93,2084.0,67
HCPCS,C2628,ENDO CLIPS,225.0,146.25,49.05,232.66,67
HCPCS,C2628,HYPER GLIDE OCC BALLOON,1385.1,900.32,200.93,1385.1,67
HCPCS,C2628,"HYPERGLIDE OCC BALLOON SYST, 4 MM X 30 MM, 4 MM CATH TIP X 150CM",1411.0,917.15,200.93,1411.0,76
HCPCS,C2628,"NONIN PURELIGHT PULSE OXIMETER SENSOR, INFANT",18.0,11.7,3.92,232.66,67
HCPCS,C2628,SCEPTER XC X-TRA COMPLIANT OCCLUSION BALLOON CATH 4.0MM X 11MM,2226.0,1446.9,200.93,2226.0,67
HCPCS,C2628,W BALLOON CATH COOK G31236,1712.13,1112.88,200.93,1712.13,67
HCPCS,C2629,GLIDELIGHT LASER SHEATH,3726.0,2421.9,200.93,3726.0,67
HCPCS,C2629,LASER CATHETER,2565.0,1667.25,200.93,2565.0,67
HCPCS,C2630,C2630 ABLAT CATH TIER I,1418.0,921.7,200.93,1418.0,67
HCPCS,C2630,C2630 ABLAT CATH TIER II,2228.0,1448.2,200.93,2228.0,67
HCPCS,C2630,C2630 ABLAT CATH TIER III,3476.25,2259.56,200.93,3476.25,67
HCPCS,C2630,CHILI COOLED CATHETER,2135.08,1387.8,200.93,2135.08,67
HCPCS,C2630,CRYOABATION STRAIGHT CATH,750.0,487.5,163.5,750.0,67
HCPCS,C2630,G100230 TACTICATH TOCCASTAR,2500.0,1625.0,200.93,2500.0,69
HCPCS,C2630,HALO 360 CATHATER,1688.0,1097.2,200.93,1688.0,67
HCPCS,C2630,HALO 90 CATHETER,1125.0,731.25,200.93,1125.0,67
HCPCS,C2630,MIFI OI ABLATION CATHETER CABLE,630.0,409.5,137.34,630.0,67
HCPCS,C2630,TACTICATH ABLATION CATHETER,2970.0,1930.5,200.93,2970.0,134
HCPCS,C2631,"Rep dev, urinary, w/o sling",,,200.93,232.66,8
HCPCS,C2634,BRACHYTX SRC IODINE 125 3-4MCI,176.0,114.4,49.77,3174.78,93
HCPCS,C2635,"Brachytx, non-str, ha, p-103",,,53.84,358.71,29
HCPCS,C2636,"Brachy linear, non-str,p-103",,,49.05,3174.78,29
HCPCS,C2637,"Brachy,non-str,ytterbium-169",,,309.8,2739849.3,9
HCPCS,C2638,"BRACHYTX, STRANDED, I-125",40.36,26.23,11.41,358.71,93
HCPCS,C2639,W IODINE 1-125 SEEDS NONSTRANDE,11.0,7.15,3.11,358.71,93
HCPCS,C2640,"Brachytx, stranded, p-103",,,64.61,3174.78,29
HCPCS,C2641,"Brachytx, non-stranded,p-103",,,59.71,3174.78,29
HCPCS,C2642,"BRACHYTHERAPY SOURCE, STRANDED, CESIUM-131, PER SOURCE",195.0,126.75,55.15,3174.78,93
HCPCS,C2643,"BRACHYTHERAPY SOURCE, NON-STRANDED, CESIUM-131, PER SOURCE",161.0,104.65,45.53,3174.78,93
HCPCS,C2644,Brachytx cesium-131 chloride,,,2741.85,2739849.3,9
HCPCS,C2645,"Brachytx planar, p-103",,,4.27,358.71,29
HCPCS,C2698,"Brachytx, stranded, nos",,,32.65,358.71,29
HCPCS,C2699,"BRACHYTHERAPY NON-STRANDED RU106, PER SOURCE",1285.0,835.25,31.82,1285.0,93
HCPCS,C5271,Low cost skin substitute app,,,544.87,1701.04,16
HCPCS,C5272,Low cost skin substitute app,,,1469.08,1701.04,8
HCPCS,C5273,Low cost skin substitute app,,,1469.08,1831.43,16
HCPCS,C5274,Low cost skin substitute app,,,1469.08,1701.04,8
HCPCS,C5275,Low cost skin substitute app,,,544.87,1701.04,16
HCPCS,C5276,Low cost skin substitute app,,,1469.08,1701.04,8
HCPCS,C5277,Low cost skin substitute app,,,544.87,1701.04,16
HCPCS,C5278,Low cost skin substitute app,,,1469.08,1701.04,8
HCPCS,C7500,Deb bone 20 cm2 w/drug dev,,,559.63,2739849.3,9
HCPCS,C7501,Perc bx breast lesions stero,,,1031.8,1194.71,8
HCPCS,C7502,Perc bx breast lesions mr,,,1031.8,1194.71,8
HCPCS,C7503,Open exc cerv node(s) w/ id,,,2262.59,2619.84,8
HCPCS,C7504,Perq cvt&ls inj vert bodies,,,3812.17,4414.09,8
HCPCS,C7505,Perq ls&cvt inj vert bodies,,,3812.17,4414.09,8
HCPCS,C7506,Fusion of finger joints,,,1168.27,1352.74,8
HCPCS,C7507,Perq thor&lumb vert aug,,,3812.17,4414.09,8
HCPCS,C7508,Perq lumb&thor vert aug,,,3812.17,4414.09,8
HCPCS,C7509,Dx bronch w/ navigation,,,1114.26,2739849.3,9
HCPCS,C7510,Bronch/lavag w/ navigation,,,1114.26,2739849.3,9
HCPCS,C7511,Bronch/bpsy(s) w/ navigation,,,1114.26,2739849.3,9
HCPCS,C7512,Bronch/bpsy(s) w/ ebus,,,2619.86,2739849.3,9
HCPCS,C7513,Cath/angio dialcir w/aplasty,,,2523.55,2922.01,8
HCPCS,C7514,Cath/angio dial cir w/stents,,,8435.63,9767.57,8
HCPCS,C7515,Cath/angio dial cir w/embol,,,8435.63,9767.57,8
HCPCS,C7516,Cor angio w/ ivus or oct,,,1947.82,2255.37,8
HCPCS,C7517,Cor angio w/ilic/fem angio,,,1947.82,2255.37,8
HCPCS,C7518,Cor/gft angio w/ ivus or oct,,,1947.82,2255.37,8
HCPCS,C7519,Cor/gft angio w/ flow resrv,,,1947.82,2255.37,8
HCPCS,C7520,Cor/gft angio w/ilic/fem ang,,,1947.82,2255.37,8
HCPCS,C7521,R hrt angio w/ ivus or oct,,,1947.82,2255.37,8
HCPCS,C7522,R hrt angio w/flow resrv,,,1947.82,2255.37,8
HCPCS,C7523,L hrt angio w/ ivus or oct,,,1947.82,2255.37,8
HCPCS,C7524,L hrt angio w/flow resrv,,,1947.82,2255.37,8
HCPCS,C7525,L hrt gft ang w/ ivus or oct,,,1947.82,2255.37,8
HCPCS,C7526,L hrt gft ang w/flow resrv,,,1947.82,2255.37,8
HCPCS,C7527,R&l hrt angio w/ ivus or oct,,,1947.82,2255.37,8
HCPCS,C7528,R&l hrt angio w/flow resrv,,,1947.82,2255.37,8
HCPCS,C7529,R&l hrt gft ang w/flow resrv,,,1947.82,2255.37,8
HCPCS,C7530,Cath/aplasty dial cir w/stnt,,,8435.63,9767.57,8
HCPCS,C7531,Angio fem/pop w/ us,,,4672.17,2739849.3,9
HCPCS,C7532,Angio w/ us non-coronary,,,5870.61,6797.55,8
HCPCS,C7533,Ptca w/ plcmt brachytx dev,,,5870.61,2739849.3,9
HCPCS,C7534,Fem/pop revasc w/arthr & us,,,8435.63,2739849.3,9
HCPCS,C7535,Fem/pop revasc w/stent & us,,,8435.63,2739849.3,9
HCPCS,C7537,Insrt atril pm w/l vent lead,,,6303.75,2739849.3,9
HCPCS,C7538,Insrt vent pm w/l vent lead,,,6303.75,2739849.3,9
HCPCS,C7539,Insrt a & v pm w/l vent lead,,,6303.75,2739849.3,9
HCPCS,C7540,Rmv&rplc pm dul w/l vnt lead,,,6303.75,2739849.3,9
HCPCS,C7544,Ercp rmv calc pancreatoscopy,,,2863.07,3315.14,8
HCPCS,C7545,Exch bil cath w/ rmv calculi,,,3471.98,2739849.3,9
HCPCS,C7546,Rep nph/urt cath w/dil stric,,,2117.28,2739849.3,9
HCPCS,C7547,Cnvrt neph cath w/ dil stric,,,2117.28,2739849.3,9
HCPCS,C7548,Exch neph cath w/ dil stric,,,2117.28,2451.59,8
HCPCS,C7549,Chge urtr stent w/ dil stric,,,2117.28,2739849.3,9
HCPCS,C7550,Cysto w/ bx(s) w/ blue light,,,1066.44,4315.0,9
HCPCS,C7551,Exc neuroma w/ implnt nv end,,,3555.79,4117.23,8
HCPCS,C7552,R hrt art/grft ang hrt flow,,,1947.82,2255.37,8
HCPCS,C7553,R&i hrt art/vent ang drg ad,,,1947.82,2255.37,8
HCPCS,C7554,Cystureth blu li cyst fl img,,,1066.44,2739849.3,9
HCPCS,C7555,Rmvl thyrd w/autotran parath,,,4313.71,2739849.3,9
HCPCS,C7556,Bronch lavage w/ebus,,,2619.86,2739849.3,9
HCPCS,C7557,Cor angio/vent w/ffr,,,1947.82,2739849.3,9
HCPCS,C7558,Cor angio/vent w/drug admin,,,1947.82,2739849.3,9
HCPCS,C7560,Ercp remove forgn body&endo,,,2863.07,2739849.3,9
HCPCS,C7561,Dbrd bone w prep&insr rx dev,,,2739849.3,2739849.3,1
HCPCS,C7562,R&l hrt angio w/ffr & 3d map,,,1947.82,2255.37,8
HCPCS,C7563,Trluml ballo angiop all art,,,2523.55,2922.01,8
HCPCS,C7564,Vein mech throm w/intrvas us,,,2523.55,2922.01,8
HCPCS,C7565,Rpr aa hrn < 3 rdc w/ rmvl,,,3392.26,3927.88,8
HCPCS,C7566,Fuse finger joints w/grafts,,,1168.27,1352.74,8
HCPCS,C7567,Bronch/needle bx(s) w/ nav,,,1114.26,1290.2,8
HCPCS,C7568,COR ANGIO W/ FLOW RESRV,27869.0,18114.85,1947.82,27869.0,66
HCPCS,C7568,COR ANGIO W/FLOW RESRV,3045.0,1979.25,1.1,3045.0,68
HCPCS,C7569,PTCA W/ IVUS OR OCT,23726.5,15422.225,1.1,41751.0,134
HCPCS,C7570,COR ANGIO W/ FFR & 3D MAP,23119.0,15027.35,1947.82,23119.0,66
HCPCS,C7570,COR ANGIO W/FFR & 3D MAP,2605.0,1693.25,1.1,2605.0,68
HCPCS,C7571,PCTA W/ COR LITHOTRIP,26736.0,17378.4,1.1,47343.0,134
HCPCS,C7900,"Hopd mntl hlt, 15-29 min",,,24.89,210.73,29
HCPCS,C7901,"Hopd mntl hlt, 30-60 min",,,77.33,232.71,29
HCPCS,C7903,"HOPD MNTL HLT, GRP",89.0,57.85,24.74,152.57,84
HCPCS,C8000,"Suprt dev, a-v fistula, imp",,,200.93,232.66,8
HCPCS,C8001,3d anat seg imaging preop,,,81.63,445.75,29
HCPCS,C8002,"Prep skin cell susp, automtd",,,186.25,7385.52,27
HCPCS,C8003,Imp extar knee shck absrb,,,5335.2,18412.18,27
HCPCS,C8004,"SIM ANGRM W/ PRSR-GEN CATH (ONE-WAY VALVE, INTERMIT OCCLUDING) I",30915.0,20094.75,2523.55,30915.0,76
HCPCS,C8005,Pef bronch ablt 3d nav ebus,,,2619.86,17826.39,20
HCPCS,C8006,Inst pleu-perit shnt w pump,,,2029.97,6737.21,20
HCPCS,C8007,Opn mplnt hpgls ns ary ps gn,,,19174.95,22202.58,8
HCPCS,C8009,Rmv hpgls ns ary and pg,,,2167.75,2510.02,8
HCPCS,C8010,Pc plm pm c ctd emb prtc,,,4672.17,5409.88,8
HCPCS,C8011,Opn mplnt hpgls ns ary rec,,,19174.95,22202.58,8
HCPCS,C8013,Rmv hpls ns ary rec,,,2167.75,2510.02,8
HCPCS,C8900,"Mra w/cont, abd",,,310.77,1863.61,31
HCPCS,C8901,"Mra w/o cont, abd",,,212.58,1165.03,31
HCPCS,C8902,"Mra w/o fol w/cont, abd",,,310.77,1863.61,31
HCPCS,C8903,"Mri w/cont, breast,  uni",,,159.4,903.92,23
HCPCS,C8903,"Mri w/cont, breast, uni",,,386.08,447.04,8
HCPCS,C8905,"Mri w/o fol w/cont, brst, un",,,330.06,1863.61,31
HCPCS,C8906,"Mri w/cont, breast,  bi",,,330.06,1863.61,23
HCPCS,C8906,"Mri w/cont, breast, bi",,,386.08,447.04,8
HCPCS,C8908,"MRI BREAST, BILAT W/WO CONTR",1071.0,696.15,297.74,1071.0,84
HCPCS,C8909,"Mra w/cont, chest",,,310.77,1863.61,31
HCPCS,C8910,"Mra w/o cont, chest",,,212.58,1165.03,31
HCPCS,C8911,"Mra w/o fol w/cont, chest",,,310.77,1863.61,31
HCPCS,C8912,"Mra w/cont, lwr ext",,,310.77,1863.61,31
HCPCS,C8913,"Mra w/o cont, lwr ext",,,212.58,1165.03,31
HCPCS,C8914,"Mra w/o fol w/cont, lwr ext",,,310.77,1863.61,31
HCPCS,C8918,"Mra w/cont, pelvis",,,310.77,1863.61,31
HCPCS,C8919,"Mra w/o cont, pelvis",,,212.58,1165.03,31
HCPCS,C8920,MR ANGIO PELVIS(MRA),6296.0,4092.4,1.1,7088.0,208
HCPCS,C8920,"Mra w/o fol w/cont, pelvis",,,310.77,1863.61,31
HCPCS,C8921,TTE CONGENITAL ANOMALIES W/CONTRAST,4543.0,2952.95,353.35,4543.0,85
HCPCS,C8922,"TTE CONGENITAL ANOMALIES, LIMITED W/CONTRAST",4543.0,2952.95,353.35,4543.0,85
HCPCS,C8923,ECHO 2D W/CONTRAST,4543.0,2952.95,353.35,4543.0,85
HCPCS,C8924,2DTTE W CONTR LTD,2053.0,1334.45,330.06,2053.0,85
HCPCS,C8925,TEE W/CONTRAST 2D,4543.0,2952.95,353.35,4543.0,85
HCPCS,C8926,TEE W/CONTRAST CONGENITAL ANOMALIES,4543.0,2952.95,353.35,4543.0,85
HCPCS,C8927,TEE FOR MONITORING W/CONTRAST,4543.0,2952.95,353.35,4543.0,85
HCPCS,C8928,2D TTE W CONTR STRESS,4543.0,2952.95,353.35,4543.0,85
HCPCS,C8929,"TTE W/DOPPLER, COMPLETE W/CONT",4543.0,2952.95,353.35,4543.0,85
HCPCS,C8930,STRESS ECHO W/CONTRAST,4543.0,2952.95,353.35,4543.0,85
HCPCS,C8931,"Mra, w/dye, spinal canal",,,310.77,1863.61,31
HCPCS,C8932,"Mra, w/o dye, spinal canal",,,212.58,1165.03,31
HCPCS,C8933,"Mra, w/o&w/dye, spinal canal",,,310.77,1863.61,31
HCPCS,C8934,"Mra, w/dye, upper extremity",,,310.77,1863.61,31
HCPCS,C8935,"Mra, w/o dye, upper extr",,,212.58,1165.03,31
HCPCS,C8936,"Mra, w/o&w/dye, upper extr",,,310.77,1863.61,31
HCPCS,C8937,MRI BREAST 3D RENDERING W/INTERP&POSTPROC DIFF WORK STATION,1330.0,864.5,86.82,1330.0,66
HCPCS,C8957,"PROLONGED IV INF, REQ PUMP",1907.0,1239.55,201.23,1907.0,85
HCPCS,C9046,Cocaine hcl nasal (goprelto),,,1.65,11.17,14
HCPCS,C904600,Cocaine hcl nasal (goprelto),,,3.79,4.86,3
HCPCS,C9047,"Injection, caplacizumab-yhdp",,,100.28,16514.52,30
HCPCS,C904700,"Injection, caplacizumab-yhdp",,,1664.46,2132.01,3
HCPCS,C9055,"Inj, brexanolone",,,4806.53,5565.45,8
HCPCS,C9059,"Injection, meloxicam",,,9.64,11.17,8
HCPCS,C9060,Fluoroestradiol f18,,,129.5,149.95,8
HCPCS,C9061,"Injection, teprotumumab-trbw",,,14262.54,16514.52,8
HCPCS,C9062,Daratumumab hyaluronidase,,,4882.66,5653.6,8
HCPCS,C9063,"Injection, eptinezumab-jjmr",,,401.85,465.3,8
HCPCS,C9064,Mitomycin pyelocalyceal inst,,,14262.54,16514.52,8
HCPCS,C9065,Romidepsin non-lyophilized,,,3543.91,4103.47,8
HCPCS,C9066,Sacituzumab govitecan-hziy,,,4806.53,5565.45,8
HCPCS,C9067,Gallium ga-68 dotatoc,,,0.45,149.95,36
HCPCS,C906700,Gallium ga-68 dotatoc,,,16.18,20.73,3
HCPCS,C9068,"Copper cu-64, dotatate, dx",,,129.5,149.95,8
HCPCS,C9069,Belantamab mafodontin-blmf,,,7628.34,8832.81,8
HCPCS,C9070,"Injection, tafasitamab-cxix",,,4882.66,5653.6,8
HCPCS,C9071,"Injection, viltolarsen",,,14262.54,16514.52,8
HCPCS,C9072,"Inj, imm glob asceniv",,,2875.32,3329.32,8
HCPCS,C9073,Brexucabtagene autoleucel ca,,,11170.21,12933.93,8
HCPCS,C9074,"Injection, lumasiran",,,14262.54,16514.52,8
HCPCS,C9075,"Injection, casimersen, 10 mg",,,14262.54,16514.52,8
HCPCS,C9076,Lisocabtagene car pos t,,,11170.21,12933.93,8
HCPCS,C9077,Inj cabotegravir/rilpivirine,,,4882.66,5653.6,8
HCPCS,C9078,"Inj, trilaciclib, 1 mg",,,1401.14,1622.37,8
HCPCS,C9079,"Inj, evinacumab-dgnb, 5 mg",,,4806.53,5565.45,8
HCPCS,C9080,"Inj, melphalan flufen, 1 mg",,,7628.34,8832.81,8
HCPCS,C9081,Idecabtagene car pos t,,,11170.21,12933.93,8
HCPCS,C9082,"Inj dostarlimab-gxly, 100 mg",,,7628.34,8832.81,8
HCPCS,C9083,"Inj, amivantamab-vmjw, 10 mg",,,4806.53,5565.45,8
HCPCS,C9084,"Loncastuximab-lpyl, 0.1 mg",,,14262.54,16514.52,8
HCPCS,C9085,Inj avalglucosid alfa-ngpt,,,18080.41,20935.21,8
HCPCS,C9086,"Inj, anifrolumab-fnia",,,3543.91,4103.47,8
HCPCS,C9087,Inj cyclophosphamd auromedic,,,544.05,629.95,8
HCPCS,C9088,"Instill, bupivac and meloxic",,,0.73,11.17,19
HCPCS,C9089,"Bupivacaine implant, 1 mg",,,0.79,11.17,15
HCPCS,C9090,"Plasminogen, human-tvmh 1 mg",,,32.4,908.28,12
HCPCS,C909000,"Plasminogen, human-tvmh 1 mg",,,64.08,82.08,3
HCPCS,C9091,"Sirolimus, protein-bound,1mg",,,73.28,8832.81,12
HCPCS,C909100,"Sirolimus, protein-bound,1mg",,,144.93,185.64,3
HCPCS,C9092,"Inj., xipere, 1 mg",,,97.9,232.34,11
HCPCS,C909200,"Inj., xipere, 1 mg",,,97.9,125.4,3
HCPCS,C9093,"Inj., susvimo, 0.1 mg",,,86.4,5565.45,12
HCPCS,C909300,"Inj., susvimo, 0.1 mg",,,170.88,218.88,3
HCPCS,C9094,"Inj, sutimlimab-jome, 10 mg",,,4806.53,5565.45,8
HCPCS,C9095,"Inj, tebentafusp-tebn, 1 mcg",,,14262.54,16514.52,8
HCPCS,C9096,"Inj, releuko, 1 mcg",,,200.66,232.34,8
HCPCS,C9097,"Inj, faricimab-svoa, 0.1 mg",,,2875.32,3329.32,8
HCPCS,C9098,Ciltacabtagene car pos t,,,11170.21,12933.93,8
HCPCS,C9101,"Inj, oliceridine 0.1 mg",,,1.23,11.17,25
HCPCS,C910100,"Inj, oliceridine 0.1 mg",,,2.76,3.53,3
HCPCS,C9113,"INJ PANTOPRAZOLE SODIUM, VIA",82.0,53.3,1.1,82.0,68
HCPCS,C9113,"Inj pantoprazole sodium, via",,,9.64,12.45,11
HCPCS,C911300,"Inj pantoprazole sodium, via",,,9.72,12.45,3
HCPCS,C9122,Mometasone furoate (sinuva),,,1401.14,1622.37,8
HCPCS,C9129,Inj clofarabine,,,2739849.3,2739849.3,1
HCPCS,C9132,"Kcentra, per i.u.",,,3543.91,4103.47,8
HCPCS,C9142,"Inj, alymsys, 10 mg",,,77.61,1622.37,9
HCPCS,C9143,Cocaine hcl nasal (numbrino),,,1.65,11.17,14
HCPCS,C914300,Cocaine hcl nasal (numbrino),,,4.79,6.13,3
HCPCS,C9144,"Inj, bupivacaine (posimir)",,,0.5,11.17,24
HCPCS,C914400,"Inj, bupivacaine (posimir)",,,1.03,1.32,3
HCPCS,C9145,"Inj, aponvie, 1 mg",,,0.25,164.23,38
HCPCS,C914500,"Inj, aponvie, 1 mg",,,4.08,5.22,3
HCPCS,C9146,"Inj, elahere, 1 mg",,,18080.41,20935.21,8
HCPCS,C9147,"Inj, tremelimumab-actl, 1 mg",,,4806.53,5565.45,8
HCPCS,C9148,"Inj, teclistamab-cqyv, 0.5mg",,,4882.66,5653.6,8
HCPCS,C9149,"Inj, teplizumab-mzwv, 5 mcg",,,18080.41,20935.21,8
HCPCS,C9150,"Xe129 xenon, diagnostic",,,129.5,2845.44,11
HCPCS,C915000,"Xe129 xenon, diagnostic",,,2221.44,2845.44,3
HCPCS,C9151,"Inj, pegcetacoplan 1 mg",,,4882.66,5653.6,8
HCPCS,C9152,"Inj, abilify asimtufii, 1 mg",,,2875.32,3329.32,8
HCPCS,C9153,"Inj, amisulpride, 1 mg",,,52.18,60.42,8
HCPCS,C9154,Inj buprenorph (brixadi) 1mg,,,52.18,60.42,8
HCPCS,C9155,"Inj epcoritamab-bysp,0.16 mg",,,4882.66,5653.6,8
HCPCS,C9156,"Flotufolastat f18, dia 1 mci",,,129.5,149.95,8
HCPCS,C9157,"Inj, tofersen, 1 mg",,,14262.54,16514.52,8
HCPCS,C9158,"Inj, uzedy, 1 mg",,,1401.14,1622.37,8
HCPCS,C9159,"Inj, balfaxar, per i.u",,,6.73,4103.47,12
HCPCS,C915900,"Inj, balfaxar, per i.u",,,6.73,8.62,3
HCPCS,C9160,Inj daxibotulinumtoxina-lanm,,,8.97,232.34,12
HCPCS,C916000,Inj daxibotulinumtoxina-lanm,,,8.97,11.49,3
HCPCS,C9161,"Inj, aflibercept hd, 1 mg",,,700.88,3329.32,12
HCPCS,C916100,"Inj, aflibercept hd, 1 mg",,,700.88,897.75,3
HCPCS,C9162,"Inj, avacincaptad peg 0.1 mg",,,224.28,3329.32,12
HCPCS,C916200,"Inj, avacincaptad peg 0.1 mg",,,224.28,287.28,3
HCPCS,C9163,Inj talquetamab-tgvs 0.25 mg,,,138.31,5565.45,12
HCPCS,C916300,Inj talquetamab-tgvs 0.25 mg,,,138.31,177.16,3
HCPCS,C9164,"Cantharidin top, applicator",,,401.85,1933.21,12
HCPCS,C916400,"Cantharidin top, applicator",,,1463.16,1874.16,3
HCPCS,C9165,"Inj, elranatamab-bcmm, 1 mg",,,366.79,5565.45,12
HCPCS,C916500,"Inj, elranatamab-bcmm, 1 mg",,,366.79,469.82,3
HCPCS,C9166,"Injection, secukinumab",,,17.43,3329.32,12
HCPCS,C916600,"Injection, secukinumab",,,36.13,46.28,3
HCPCS,C9167,"Inj, adzynma, 10 iu",,,3.38,89.83,12
HCPCS,C916700,"Inj, adzynma, 10 iu",,,70.13,89.83,3
HCPCS,C9168,"Injection, mirikizumab-mrkz",,,32.94,5565.45,12
HCPCS,C916800,"Injection, mirikizumab-mrkz",,,68.3,87.48,3
HCPCS,C9169,"Inj, nogapendekin pmln 1 mcg",,,191.17,5653.6,11
HCPCS,C916900,"Inj, nogapendekin pmln 1 mcg",,,191.17,244.87,3
HCPCS,C9170,"Inj, tarlatamab-dlle, 1 mg",,,3204.0,8832.81,11
HCPCS,C917000,"Inj, tarlatamab-dlle, 1 mg",,,3204.0,4104.0,3
HCPCS,C9171,"Inj, pegulicianine, 1 mg",,,24.99,96.81,11
HCPCS,C917100,"Inj, pegulicianine, 1 mg",,,75.58,96.81,3
HCPCS,C9172,"Inj, beqvez, per tx dose",,,18080.41,20935.21,8
HCPCS,C9173,"Inj, nypozi, 1 mcg",,,0.54,232.34,17
HCPCS,C9174,"Datopotamab deruxtecan, 1 mg",,,14262.54,16514.52,8
HCPCS,C9175,"Inj, treosulfan, 50 mg",,,4806.53,5565.45,8
HCPCS,C9176,NON-HEU TC-99M ADD-ON/DOSE,11.0,7.15,3.06,149.95,76
HCPCS,C9248,"Inj, clevidipine butyrate",,,2.83,164.23,17
HCPCS,C9250,Artiss fibrin sealant,,,17.81,503.13,30
HCPCS,C925000,Artiss fibrin sealant,,,392.79,503.13,3
HCPCS,C9254,"Injection, lacosamide",,,0.43,60.42,13
HCPCS,C925400,"Injection, lacosamide",,,0.43,0.55,3
HCPCS,C9257,BEVACIZUMAB INJECTION 0.25 MG,9.29,6.04,1.82,60.42,93
HCPCS,C9257,Bevacizumab injection,,,4.25,5.45,3
HCPCS,C9257,PR BEVACIZUMAB INJECTION,77.0,50.05,1.1,77.0,68
HCPCS,C925700,Bevacizumab injection,,,4.25,5.45,3
HCPCS,C9285,"Patch, lidocaine/tetracaine",,,36.21,60.42,13
HCPCS,C928500,"Patch, lidocaine/tetracaine",,,36.21,46.38,3
HCPCS,C9290,"Inj, bupivacaine liposome",,,3.03,11.17,11
HCPCS,C929000,"Inj, bupivacaine liposome",,,3.03,3.88,3
HCPCS,C9293,"Injection, glucarpidase",,,56.09,2739849.3,28
HCPCS,C929300,"Injection, glucarpidase",,,923.46,1182.86,3
HCPCS,C9300,"Indigotindisulfonate, 1 mg",,,24.99,28.93,8
HCPCS,C9301,Obecabtagene car pos t,,,11170.21,12933.93,8
HCPCS,C9302,"Inj zanidatamab, 2 mg",,,7628.34,8832.81,8
HCPCS,C9303,"Inj zolbetuximab, 1 mg",,,4806.53,5565.45,8
HCPCS,C9304,"Inj marstacimab, 0.5 mg",,,18080.41,20935.21,8
HCPCS,C9305,"Inj, nipocalimab-aahu, 3 mg",,,7628.34,8832.81,8
HCPCS,C9306,Telisotuzumab vedotin-tllv,,,7628.34,8832.81,8
HCPCS,C9307,Inj linvoseltamab-gcpt 1 mg,,,12.1,8832.81,27
HCPCS,C930700,Inj linvoseltamab-gcpt 1 mg,,,200.78,257.18,3
HCPCS,C9308,"Inj, carboplatin (avyxa)",,,0.64,13.68,19
HCPCS,C930800,"Inj, carboplatin (avyxa)",,,10.68,13.68,3
HCPCS,C9309,Inj onase abepar-brve treat,,,18080.41,20935.21,8
HCPCS,C9352,CONN AXOGUARD 6MM PORCINE 15MM,1889.33,1228.06,411.87,1889.33,76
HCPCS,C9352,"Neuragen nerve guide, per cm",,,2217.17,2839.97,3
HCPCS,C935200,"Neuragen nerve guide, per cm",,,2217.17,2839.97,3
HCPCS,C9353,"Neurawrap nerve protector,cm",,,1101.49,3029.09,13
HCPCS,C935300,"Neurawrap nerve protector,cm",,,2364.82,3029.09,3
HCPCS,C9354,"Veritas collagen matrix, cm2",,,40.58,1275.41,13
HCPCS,C935400,"Veritas collagen matrix, cm2",,,40.58,51.98,3
HCPCS,C9355,"Neuromatrix nerve cuff, cm",,,381.63,1275.41,13
HCPCS,C935500,"Neuromatrix nerve cuff, cm",,,381.63,488.83,3
HCPCS,C9356,"Tenoglide tendon prot, cm2",,,234.64,1275.41,13
HCPCS,C935600,"Tenoglide tendon prot, cm2",,,234.64,300.55,3
HCPCS,C9358,"Surgimend, fetal",,,42.33,1275.41,11
HCPCS,C935800,"Surgimend, fetal",,,42.33,54.22,3
HCPCS,C9359,BONE CUBED CANCELLOUS 15CC,11.5,7.48,2.51,1275.41,75
HCPCS,C9359,BONE STAGRAFT 2CC,259.0,168.35,56.46,1275.41,75
HCPCS,C9359,BONE STAGRAFT 5CC,243.6,158.34,53.1,1275.41,75
HCPCS,C9359,BONE VIVIGEN 10CC,325.0,211.25,70.85,1275.41,75
HCPCS,C9359,BONE VIVIGEN 5CC,360.0,234.0,78.48,1275.41,75
HCPCS,C9359,BONE VIVIGEN FORMABLE 10CC,390.0,253.5,85.02,1275.41,75
HCPCS,C9359,BONE VIVIGEN FORMABLE 5CC,432.0,280.8,94.18,1275.41,75
HCPCS,C9359,FILLER BN VOID 5CC DBX ALGRF,119.84,77.9,26.13,1275.41,75
HCPCS,C9359,FILLER BONE OPTIUM GEL 10CC,80.58,52.38,17.57,1275.41,75
HCPCS,C9359,GRAFT BN SUB W50XL10MM THK7MM COMP BN MTRX,344.0,223.6,74.99,1275.41,75
HCPCS,C9359,GRAFT BONE OPTECURE 10CC,169.5,110.18,36.95,1275.41,75
HCPCS,C9359,GRAFT BONE OPTECURE 2CC,208.5,135.53,45.45,1275.41,75
HCPCS,C9359,GRAFT BONE OPTECURE 5CC,202.2,131.43,44.08,1275.41,75
HCPCS,C9359,"Implnt,bon void filler-putty",,,258.1,330.6,3
HCPCS,C9359,SUB BNGF BBTRAUMA VITOSS FOAM 5CC,497.6,323.44,108.48,1275.41,75
HCPCS,C9359,SUB BNGF VITOSS BBTRAUMA FOAM 2.5CC,530.88,345.07,115.73,1275.41,75
HCPCS,C935900,"Implnt,bon void filler-putty",,,258.1,330.6,3
HCPCS,C9360,"Surgimend, neonatal",,,45.35,1275.41,11
HCPCS,C936000,"Surgimend, neonatal",,,45.35,58.09,3
HCPCS,C9361,Neuromend nerve wrap,,,371.2,1275.41,13
HCPCS,C936100,Neuromend nerve wrap,,,371.2,475.47,3
HCPCS,C9362,"Implnt,bon void filler-strip",,,219.24,280.83,3
HCPCS,C9362,SUB MSTERGRFT CA PHOS COLLAGEN BN GRFT VOID FILLER,60.33,39.21,13.15,1275.41,75
HCPCS,C936200,"Implnt,bon void filler-strip",,,219.24,280.83,3
HCPCS,C9363,Integra meshed bil wound mat,,,117.73,184.57,17
HCPCS,C936300,Integra meshed bil wound mat,,,144.09,184.57,3
HCPCS,C9364,"Porcine implant, permacol",,,38.5,1275.41,13
HCPCS,C936400,"Porcine implant, permacol",,,38.5,49.32,3
HCPCS,C9399,SPINRAZA / NUSINERSEN,168750.0,109687.5,52.18,168750.0,74
HCPCS,C9460,"Injection, cangrelor",,,2.49,840.33,38
HCPCS,C946000,"Injection, cangrelor",,,42.77,54.79,3
HCPCS,C9462,"Injection, delafloxacin",,,0.48,2739849.3,15
HCPCS,C946200,"Injection, delafloxacin",,,1.07,1.37,3
HCPCS,C9482,Sotalol hydrochloride iv,,,3.14,164.23,39
HCPCS,C948200,Sotalol hydrochloride iv,,,51.58,66.07,3
HCPCS,C9488,Conivaptan hcl,,,36.85,840.33,16
HCPCS,C948800,Conivaptan hcl,,,95.19,121.93,3
HCPCS,C9507,Covid-19 convalescent plasma,,,209.08,1342.96,29
HCPCS,C9600,PERC DES W/ ANGIO SINGLE MAJOR,41649.0,27071.85,5870.61,41649.0,84
HCPCS,C9601,PERC DES W/ANGIO ADDTL BRANCH,18602.0,12091.3,2602.0,18602.0,66
HCPCS,C9602,PERC DES/ATHER/ANGIO 1 MAJ ART,44697.0,29053.05,5870.61,44697.0,84
HCPCS,C9603,PERC DES/ ATHER/ANGIO ADDTL BR,14577.0,9475.05,3177.79,14577.0,66
HCPCS,C9604,PERC DES REVASC CABG 1 VSL,42588.0,27682.2,5870.61,42588.0,84
HCPCS,C9605,PERC DES  REVASC CABG ADDTL BR,18602.0,12091.3,4055.24,18602.0,66
HCPCS,C9606,PERC DES REVASC W/AMI 1 VSL,33050.0,21482.5,5870.61,33050.0,66
HCPCS,C9607,PERC DES REVASC CTO SINGLE VSL,51254.0,33315.1,5870.61,51254.0,84
HCPCS,C9608,PERC DES REVASC CTO ADDTL VESSEL,33050.0,21482.5,4132.0,33050.0,66
HCPCS,C9610,AGENT BALLOON CATHETER-DRUG-COATED,16950.0,11017.5,7356.3,9288.6,2
HCPCS,C9610,AGENT DCB,16950.0,11017.5,200.93,16950.0,76
HCPCS,C9610,AGENT DRUG COATED BALLOON,16950.0,11017.5,200.93,16950.0,74
HCPCS,C9725,Place endorectal app,,,792.91,2386.02,29
HCPCS,C9726,Rxt breast appl place/remov,,,1031.8,1194.71,8
HCPCS,C9727,Insert palate implants,,,939.63,3981.36,29
HCPCS,C9728,PLACEMENT OF INTERSTITIAL DEVICE(S) FOR RADIATION,7867.0,5113.55,0.01,12615.0,84
HCPCS,C9733,ICG LYMPHANGIOGRAPHY,2464.0,1601.6,81.99,2464.0,84
HCPCS,C9734,"MRGHIFU, OTHER  THAN UTERINE LEIOMYOMATA",88781.0,57707.65,2029.97,88781.0,77
HCPCS,C9738,Blue light cysto imag agent,,,1066.44,1234.83,8
HCPCS,C9739,CYSTOSCOPY PROSTATIC IMP 1-3,23385.0,15200.25,0.01,23385.0,85
HCPCS,C9740,CYSTOURETHRO W/ADDL IMPLANT,11557.0,7512.05,0.01,15448.24,85
HCPCS,C9745,Nasal endo eustachian tube,,,266.89,309.03,8
HCPCS,C9747,"Ablation, hifu, prostate",,,3284.72,3803.36,8
HCPCS,C9749,Repair nasal stenosis w/imp,,,1558.4,1804.46,8
HCPCS,C9751,"Microwave bronch, 3d, ebus",,,2619.86,10276.37,17
HCPCS,C9752,Intraosseous des lumb/sacrum,,,3812.17,4414.09,8
HCPCS,C9753,Intraosseous destruct add'l,,,9326.79,10799.44,8
HCPCS,C9756,Fluorescence lymph map w/icg,,,86.82,4132.0,9
HCPCS,C9757,Spine device implant surgery,,,9326.79,13361.02,28
HCPCS,C9758,BLIND INTERATRIAL SHUNT IDE,100628.0,65408.2,8413.0,100628.0,84
HCPCS,C9759,Transcath intraop microinf,,,2523.55,2922.01,8
HCPCS,C9760,NON-BLIND INTERATRIAL SHUNT,158128.0,102783.2,8413.0,158128.0,84
HCPCS,C9761,"Cysto, litho, vacuum kidney",,,2117.28,9851.6,28
HCPCS,C9762,Cardiac mri seg dys strain,,,255.48,2444.63,31
HCPCS,C9763,Cardiac mri seg dys stress,,,255.48,2444.63,31
HCPCS,C9764,IVL W/ANGIOPLASTY,65208.0,42385.2,2523.55,65208.0,84
HCPCS,C9764,REVASC ENDOV W/IVL INCL ANGIOPLASTY,65208.0,42385.2,2523.55,65208.0,84
HCPCS,C9765,IVL & STENT W/ANGIOPLASTY,37311.0,24252.15,4672.17,37311.0,84
HCPCS,C9765,REVASC ENDOV W/IVL W/STENT INCL ANGIOPLASTY,37311.0,24252.15,3924.0,37311.0,84
HCPCS,C9766,IVL & ATHERECTOMY W/ANGIOPLASTY,103251.0,67113.15,4672.17,103251.0,84
HCPCS,C9766,REVASC ENDOV W/IVL W/ATHERECTOMY INCL ANGIOPLASTY,103251.0,67113.15,3924.0,103251.0,84
HCPCS,C9767,IVL STENT  ATHERECTOMY W/ANGIOPLASTY,34461.0,22399.65,8050.0,34461.0,84
HCPCS,C9767,REVASC ENDOV W/IVL W/STENT-ATHER INCL ANGIOPLASTY,34461.0,22399.65,7663.0,34461.0,84
HCPCS,C9768,Endo us-guide hep porto grad,,,1500.64,1737.58,8
HCPCS,C9769,Cysto w/temp pros implant,,,3284.72,7992.18,9
HCPCS,C9770,"Vitrec/mech pars, subret inj",,,2885.13,3340.68,8
HCPCS,C9771,Nsl/sins cryo post nasal tis,,,1416.09,1639.68,8
HCPCS,C9772,"REVASC ENDOV, OPEN OR PERC, TIBIAL/PERONEAL ARTERY(IES), W/IVL,",26829.0,17438.85,3924.0,26829.0,252
HCPCS,C9773,"REVASC ENDOV, OPEN OR PERC,  TIBIAL/PERONEAL ARTERY(IES); W/IVL,",46149.0,29996.85,6021.0,46149.0,252
HCPCS,C9774,"REVASC ENDOV, OPEN OR PERC, TIBIAL/PERONEAL ARTERY(IES); W/IVL A",36344.0,23623.6,6021.0,36344.0,252
HCPCS,C9775,"REVASC ENDOV, OPEN OR PERC, TIBIAL/PERONEAL ARTERY(IES); W/IVL A",38839.0,25245.35,6021.0,38839.0,252
HCPCS,C9776,Fluo bile duct imaging w/icg,,,112.68,130.47,8
HCPCS,C9777,Esophag muc integ w/eso egd,,,780.28,9998.15,29
HCPCS,C9778,"Colpopexy, min/inv, ex-perit",,,1469.37,5205.97,28
HCPCS,C9779,Esd endoscopy or colonoscopy,,,1500.64,10364.0,32
HCPCS,C9780,Insert cv cath inf & sup app,,,1624.42,22606.37,29
HCPCS,C9781,Arthro/shoul surg; w/spacer,,,4348.01,34359.11,29
HCPCS,C9782,Blind myocar trpl bon marrow,,,5870.61,47951.37,29
HCPCS,C9783,Blind cor sinus reducer impl,,,5870.61,28720.16,29
HCPCS,C9784,Endo sleeve gastro w/tube,,,4616.0,26873.26,18
HCPCS,C9785,Endo outlet restrict w/tube,,,3156.08,26873.26,30
HCPCS,C9786,Echo cad for hf preserved ef,,,97.71,779.78,10
HCPCS,C9787,Gastric ep mapg simult pt sx,,,299.41,1399.26,10
HCPCS,C9788,Uni breas optoacoustic imag,,,97.71,113.14,8
HCPCS,C9789,INSTILL PHARM RENAL PELVIS,10352.0,6728.8,0.01,10352.0,85
HCPCS,C9790,Kidney histotripsy w/image,,,2117.28,34251.37,10
HCPCS,C9791,Mri hyperpolarized xenon129,,,393.75,6330.67,31
HCPCS,C9792,Blind/nonblind trans atrial,,,8878.22,26716.37,29
HCPCS,C9793,PRE 3D MDL W/CCTA AND/OR MRI,5850.0,3802.5,453.45,5850.0,84
HCPCS,C9794,Complex simulation w/pet-ct,,,771.49,5344.37,10
HCPCS,C9795,Sbrt w/positron emission del,,,989.77,10276.37,10
HCPCS,C9796,Rpr intst excl anrect fist,,,1591.31,2888.59,28
HCPCS,C9797,VASCULAR EMBOLIZATION WITH PRESSURE-GENERATING CATHETER,35000.0,22750.0,5616.0,35000.0,84
HCPCS,C9803,Hopd covid-19 spec collect,,,2.64,25.77,9
HCPCS,C9804,Pump elastomc non-opioid dev,,,200.93,232.66,8
HCPCS,C9806,Pump perist non-opioid dev,,,200.93,232.66,8
HCPCS,C9807,Nerve stim non-opioid dev,,,200.93,232.66,8
HCPCS,C9808,Cryo probe non-opioid dev,,,200.93,232.66,8
HCPCS,C9809,GEN 2 SMART TIP 190,700.0,455.0,1.1,700.0,135
HCPCS,C9810,COLD THERAPY NON-OPIOID DEV,174.0,113.1,1.1,174.0,68
HCPCS,C9810,ICEMAN (COLD THERAPY SYSTEM),174.0,113.1,37.93,232.66,67
HCPCS,C9812,Echgnc nv ndls nonopioid dev,,,200.93,232.66,8
HCPCS,C9813,Prf infs cth nonopioid dev,,,36.52,42.28,8
HCPCS,C9814,Echognc cathr nonopioid dev,,,200.93,232.66,8
HCPCS,C9815,Peristlc pmp nonopioid dev,,,200.93,232.66,8
HCPCS,C9816,Pmp prs reusbl nonopioid dev,,,200.93,232.66,8
HCPCS,C9817,CRYPNM CMPRS NONOPIOID DEV,174.0,113.1,1.1,174.0,68
HCPCS,C9817,SYSTEM CRYO/CUFF IC UNIVERSAL COMPRESSION THERAPY COOLER,174.0,113.1,31.69,174.0,67
HCPCS,C9818,"Suzetrigine, orl, 1mg",,,9.64,11.17,8
HCPCS,C9898,Inpnt stay radiolabeled item,,,10.69,12.38,8
HCPCS,C9899,"Inpt implant pros dev,no cov",,,200.93,2739849.3,9
HCPCS,C9901,Endo defect closure gi tract,,,3155.47,11062.31,27
HCPCS,COSANES1,COSMETIC ANES 1 HOUR 45 MINUTES,1351.0,878.15,1.1,1351.0,68
HCPCS,COSANES1,COSMETIC ANES 2 HOURS,1448.0,941.2,1.1,1448.0,68
HCPCS,COSANES1,COSMETIC ANES 2 HOURS 15 MINUTES,1544.0,1003.6,1.1,1544.0,68
HCPCS,COSANES1,COSMETIC ANES 2 HOURS 30 MINUTES,1641.0,1066.65,1.1,1641.0,68
HCPCS,COSANES1,COSMETIC ANES 2 HOURS 45 MINUTES,1737.0,1129.05,1.1,1737.0,68
HCPCS,COSANES1,COSMETIC ANES 3 HOURS,1834.0,1192.1,1.1,1834.0,68
HCPCS,COSANES1,COSMETIC ANES 3 HOURS 15 MINUTES,1930.0,1254.5,1.1,1930.0,68
HCPCS,COSANES2,COSMETIC ANES 3 HOURS 30 MINUTES,2027.0,1317.55,1.1,2027.0,68
HCPCS,COSANES2,COSMETIC ANES 3 HOURS 45 MINUTES,2123.0,1379.95,1.1,2123.0,68
HCPCS,COSANES2,COSMETIC ANES 4 HOURS,2220.0,1443.0,1.1,2220.0,68
HCPCS,COSANES2,COSMETIC ANES 4 HOURS 15 MINUTES,2316.0,1505.4,1.1,2316.0,68
HCPCS,COSANES2,COSMETIC ANES 4 HOURS 30 MINUTES,2413.0,1568.45,1.1,2413.0,68
HCPCS,COSANES2,COSMETIC ANES 4 HOURS 45 MINUTES,2509.0,1630.85,1.1,2509.0,68
HCPCS,COSANES3,COSMETIC ANES 30 MINUTES,579.0,376.35,1.1,579.0,68
HCPCS,COSANES3,COSMETIC ANES 5 HOURS,2606.0,1693.9,1.1,2606.0,68
HCPCS,COSANES3,COSMETIC ANES 5 HOURS 15 MINUTES,2702.0,1756.3,1.1,2702.0,68
HCPCS,COSANES3,COSMETIC ANES 5 HOURS 30 MINUTES,2799.0,1819.35,1.1,2799.0,68
HCPCS,COSANES3,COSMETIC ANES 5 HOURS 45 MINUTES,2895.0,1881.75,1.1,2895.0,68
HCPCS,COSANES3,COSMETIC ANES 6 HOURS,2992.0,1944.8,1.1,2992.0,68
HCPCS,COSANES3,COSMETIC ANES 6 HOURS 15 MINUTES,3088.0,2007.2,1.1,3088.0,68
HCPCS,COSANES3,COSMETIC ANES 6 HOURS 30 MINUTES,3185.0,2070.25,1.1,3185.0,68
HCPCS,COSANES4,COSMETIC ANES 45 MINUTES,772.0,501.8,1.1,772.0,68
HCPCS,COSANES4,COSMETIC ANES 6 HOURS 45 MINUTES,3281.0,2132.65,1.1,3281.0,68
HCPCS,COSANES4,COSMETIC ANES 7 HOURS,3378.0,2195.7,1.1,3378.0,68
HCPCS,COSANES4,COSMETIC ANES 7 HOURS 15 MINUTES,3474.0,2258.1,1.1,3474.0,68
HCPCS,COSANES4,COSMETIC ANES 7 HOURS 30 MINUTES,3571.0,2321.15,1.1,3571.0,68
HCPCS,COSANES4,COSMETIC ANES 7 HOURS 45 MINUTES,3667.0,2383.55,1.1,3667.0,68
HCPCS,COSANES4,COSMETIC ANES 8 HOURS,3764.0,2446.6,1.1,3764.0,68
HCPCS,COSANES4,COSMETIC ANES 8 HOURS 15 MINUTES,3860.0,2509.0,1.1,3860.0,68
HCPCS,COSANES5,COSMETIC ANES 8 HOURS 30 MINUTES,3957.0,2572.05,1.1,3957.0,68
HCPCS,COSANES5,COSMETIC ANES 8 HOURS 45 MINUTES,4053.0,2634.45,1.1,4053.0,68
HCPCS,COSANES5,COSMETIC ANES 9 HOURS,4150.0,2697.5,1.1,4150.0,68
HCPCS,COSANES5,COSMETIC ANES 9 HOURS 15 MINUTES,4247.0,2760.55,1.1,4247.0,68
HCPCS,COSANES5,COSMETIC ANES 9 HOURS 30 MINUTES,4343.0,2822.95,1.1,4343.0,68
HCPCS,COSANES5,COSMETIC ANES 9 HOURS 45 MINUTES,4440.0,2886.0,1.1,4440.0,68
HCPCS,COSANES6,COSMETIC ANES 1 HOUR,1062.0,690.3,1.1,1062.0,68
HCPCS,COSANES6,COSMETIC ANES 10 HOURS,4536.0,2948.4,1.1,4536.0,68
HCPCS,COSANES7,COSMETIC ANES 1 HOUR 15 MINUTES,1158.0,752.7,1.1,1158.0,68
HCPCS,COSANES9,COSMETIC ANES 1 HOUR 30 MINUTES,1258.0,817.7,1.1,1258.0,68
HCPCS,COSNANES,NON CCF PHYSICIANS COSMETIC CASES,1351.0,878.15,1.1,1351.0,68
HCPCS,D0120,PERIODIC ORAL EVALUATION - ESTABLISHED PATIENT,95.0,61.75,1.1,95.0,86
HCPCS,D0120,Periodic oral evaluation,,,114.68,969.47,28
HCPCS,D0140,LIMITED ORAL EVALUATION - PROBLEM FOCUSED,125.0,81.25,1.1,145.11,86
HCPCS,D0140,Limit oral eval problm focus,,,114.68,969.47,28
HCPCS,D0145,ORAL EVALUATION FOR A PATIENT UNDER THREE YEARS OF AGE AND COUNS,100.0,65.0,1.1,100.0,86
HCPCS,D0145,"Oral evaluation, pt < 3yrs",,,837.27,969.47,8
HCPCS,D0150,COMPREHENSIVE ORAL EVALUATION - NEW OR ESTABLISHED PATIENT,160.0,104.0,1.1,424.99,86
HCPCS,D0150,Comprehensve oral evaluation,,,114.68,969.47,28
HCPCS,D0160,"DETAILED AND EXTENSIVE ORAL EVALUATION - PROBLEM FOCUSED, BY REP",225.0,146.25,1.1,424.99,86
HCPCS,D0160,Extensv oral eval prob focus,,,114.68,969.47,28
HCPCS,D0170,"RE-EVALUATION - LIMITED, PROBLEM FOCUSED (ESTABLISHED PATIENT; N",115.0,74.75,1.1,424.99,86
HCPCS,D0170,"Re-eval,est pt,problem focus",,,114.68,969.47,28
HCPCS,D0171,Re-eval post-op visit,,,114.68,969.47,28
HCPCS,D0180,ANNUAL PERIDONTAL RECALL,160.0,104.0,1.1,286.78,86
HCPCS,D0180,COMPREHENSIVE PERIODONTAL EVALUATION - NEW OR ESTABLISHED PATIEN,160.0,104.0,1.1,286.78,86
HCPCS,D0180,Comp periodontal evaluation,,,114.68,969.47,28
HCPCS,D0190,SCREENING OF A PATIENT,120.0,78.0,1.1,120.0,86
HCPCS,D0190,Screening of a patient,,,837.27,969.47,8
HCPCS,D0191,ASSESSMENT OF A PATIENT,120.0,78.0,1.1,120.0,86
HCPCS,D0191,Assessment of a patient,,,114.68,969.47,28
HCPCS,D0210,INTRAORAL - COMPREHENSIVE OF RADIOGRAPHIC IMAGES,200.0,130.0,1.1,279.87,86
HCPCS,D0210,Intraor comprehensive series,,,29.24,248.31,28
HCPCS,D0220,INTRAORAL - PERIAPICAL FIRST RADIOGRAPHIC IMAGE,50.0,32.5,1.1,51.83,86
HCPCS,D0220,Intraoral periapical first,,,78.83,771.98,28
HCPCS,D0230,INTRAORAL - PERIAPICAL EACH ADDITIONAL RADIOGRAPHIC IMAGE,40.0,26.0,1.1,41.46,86
HCPCS,D0230,Intraoral periapical ea add,,,666.71,771.98,8
HCPCS,D0240,INTRAORAL - OCCLUSAL RADIOGRAPHIC IMAGE,50.0,32.5,1.1,79.47,86
HCPCS,D0240,Intraoral occlusal film,,,78.83,771.98,28
HCPCS,D0250,EXTRA-ORAL ? 2D PROJECTION RADIOGRAPHIC IMAGE CREATED USING A ST,80.0,52.0,1.1,107.11,86
HCPCS,D0250,Extraoral 2d project image,,,78.83,771.98,28
HCPCS,D0251,EXTRA-ORAL POSTERIOR DENTAL RADIOGRAPHIC IMAGE,100.0,65.0,1.1,141.67,86
HCPCS,D0251,Extraoral posterior image,,,78.83,771.98,28
HCPCS,D0270,BITEWING - SINGLE RADIOGRAPHIC IMAGE,45.0,29.25,1.1,55.28,86
HCPCS,D0270,Dental bitewing single image,,,78.83,771.98,28
HCPCS,D0272,BITEWINGS - TWO RADIOGRAPHIC IMAGES,75.0,48.75,1.1,82.92,86
HCPCS,D0272,Dental bitewings two images,,,78.83,771.98,28
HCPCS,D0273,BITEWINGS - THREE RADIOGRAPHIC IMAGES,85.0,55.25,1.1,85.0,86
HCPCS,D0273,Bitewings - three images,,,212.58,771.98,28
HCPCS,D0274,BITEWINGS - FOUR RADIOGRAPHIC IMAGES,100.0,65.0,1.1,117.48,86
HCPCS,D0274,Bitewings four images,,,212.58,771.98,28
HCPCS,D0277,VERTICAL BITEWINGS - 7 TO 8 RADIOGRAPHIC IMAGES,150.0,97.5,1.1,150.0,86
HCPCS,D0277,Vert bitewings 7 to 8 images,,,29.24,248.31,28
HCPCS,D0310,DENTAL SALIOGRAPHY,500.0,325.0,1.1,967.45,86
HCPCS,D0310,Dental saliography,,,29.24,248.31,28
HCPCS,D0320,DENTAL TMJ ARTHROGRAM INCL I,750.0,487.5,1.1,1658.49,86
HCPCS,D0320,Dental tmj arthrogram incl i,,,29.24,248.31,28
HCPCS,D0321,"OTHER TEMPOROMANDIBULAR JOINT RADIOGRAPHIC IMAGES, BY REPORT",250.0,162.5,1.1,1658.49,86
HCPCS,D0321,Other tmj images by report,,,78.83,771.98,28
HCPCS,D0322,Dental tomographic survey,,,71.45,108.8,28
HCPCS,D0322,TOMOGRAPHIC SURVEY,650.0,422.5,1.1,1330.25,86
HCPCS,D0330,PANORAMIC RADIOGRAPHIC IMAGE,175.0,113.75,1.1,228.04,86
HCPCS,D0330,Panoramic image,,,212.58,771.98,28
HCPCS,D0340,"2D CEPHALOMETRIC RADIOGRAPHIC IMAGE ? ACQUISITION, MEASUREMENT A",170.0,110.5,1.1,283.32,86
HCPCS,D0340,2d cephalometric image,,,29.24,90.57,28
HCPCS,D0350,2D ORAL/FACIAL PHOTOGRAPHIC IMAGE OBTAINED INTRA-ORALLY OR EXTRA,100.0,65.0,1.1,283.32,86
HCPCS,D0350,Oral/facial photo images,,,78.83,771.98,28
HCPCS,D0351,3d photographic image,,,666.71,771.98,8
HCPCS,D0364,CONE BEAM CT CAPTURE AND INTERPRETATION WITH LIMITED FIELD OF VI,350.0,227.5,1.1,524.1,86
HCPCS,D0364,Cone beam ct capt & interp,,,71.45,108.8,28
HCPCS,D0365,CONE BEAM CT CAPTURE AND INTERPRETATION WITH FIELD OF VIEW OF ON,400.0,260.0,1.1,524.1,86
HCPCS,D0365,Cone beam ct interprete man,,,71.45,108.8,28
HCPCS,D0366,CONE BEAM CT CAPTURE AND INTERPRETATION WITH FIELD OF VIEW OF ON,400.0,260.0,1.1,524.1,86
HCPCS,D0366,Cone beam ct interprete max,,,71.45,108.8,28
HCPCS,D0367,CONE BEAM CT CAPTURE AND INTERPRETATION WITH FIELD OF VIEW OF BO,400.0,260.0,1.1,524.1,86
HCPCS,D0367,Cone beam ct interp both jaw,,,71.45,108.8,28
HCPCS,D0368,CONE BEAM CT CAPTURE AND INTERPRETATION FOR TMJ SERIES INCLUDING,500.0,325.0,1.1,766.86,86
HCPCS,D0368,Cone beam ct interprete tmj,,,71.45,108.8,28
HCPCS,D0369,MAXILLOFACIAL MRI CAPTURE AND INTERPRETATION,900.0,585.0,1.1,1364.8,86
HCPCS,D0369,Max mri capture & interprete,,,95.38,295.82,28
HCPCS,D0370,MAXILLOFACIAL ULTRASOUND CAPTURE AND INTERPRETATION,650.0,422.5,1.1,650.0,86
HCPCS,D0370,Max ultrasound capt & interp,,,95.38,113.14,28
HCPCS,D0371,SIALOENDOSCOPY CAPTURE AND INTERPRETATION,650.0,422.5,1.1,650.0,86
HCPCS,D0371,Sialoendoscopy capt & interp,,,29.24,90.57,28
HCPCS,D0372,INTRAORAL TOMOSYNTHESIS ? COMPREHENSIVE SERIES OF RADIOGRAPHIC I,250.0,162.5,1.1,338.62,86
HCPCS,D0372,Tomo comp series images,,,666.71,771.98,8
HCPCS,D0373,INTRAORAL TOMOSYNTHESIS ? BITEWING RADIOGRAPHIC IMAGE,50.0,32.5,1.1,65.65,86
HCPCS,D0373,Tomo bitewing image,,,666.71,771.98,8
HCPCS,D0374,INTRAORAL TOMOSYNTHESIS ? PERIAPICAL RADIOGRAPHIC IMAGE,50.0,32.5,1.1,72.56,86
HCPCS,D0374,Tomo periapical image,,,666.71,771.98,8
HCPCS,D0380,CONE BEAM CT IMAGE CAPTURE WITH LIMITED FIELD OF VIEW ? LESS THA,400.0,260.0,1.1,418.41,86
HCPCS,D0380,Cone beam ct capture limited,,,71.45,108.8,28
HCPCS,D0381,CONE BEAM CT IMAGE CAPTURE WITH FIELD OF VIEW OF ONE FULL DENTAL,400.0,260.0,1.1,418.41,86
HCPCS,D0381,Cone beam ct capt mandible,,,71.45,108.8,28
HCPCS,D0382,CONE BEAM CT IMAGE CAPTURE WITH FIELD OF VIEW OF ONE FULL DENTAL,400.0,260.0,1.1,418.41,86
HCPCS,D0382,Cone beam ct capt maxilla,,,71.45,108.8,28
HCPCS,D0383,CONE BEAM CT IMAGE CAPTURE WITH FIELD OF VIEW OF BOTH JAWS; WITH,400.0,260.0,1.1,418.41,86
HCPCS,D0383,Cone beam ct both jaws,,,71.45,108.8,28
HCPCS,D0384,CONE BEAM CT IMAGE CAPTURE FOR TMJ SERIES INCLUDING TWO OR MORE,500.0,325.0,1.1,611.83,86
HCPCS,D0384,Cone beam ct capture tmj,,,71.45,108.8,28
HCPCS,D0385,MAXILLOFACIAL MRI IMAGE CAPTURE,700.0,455.0,1.1,991.0,86
HCPCS,D0385,Max mri image capture,,,95.38,295.82,28
HCPCS,D0386,MAXILLOFACIAL ULTRASOUND IMAGE CAPTURE,360.0,234.0,1.1,360.0,86
HCPCS,D0386,Max ultrasound image capture,,,95.38,113.14,28
HCPCS,D0387,Comp image capture only,,,666.71,771.98,8
HCPCS,D0387,INTRAORAL TOMOSYNTHESIS ? COMPREHENSIVE SERIES OF RADIOGRAPHIC I,100.0,65.0,0.01,122.85,86
HCPCS,D0388,Bitewing image capture only,,,666.71,771.98,8
HCPCS,D0388,INTRAORAL TOMOSYNTHESIS ? BITEWING RADIOGRAPHIC IMAGE ? IMAGE CA,30.0,19.5,0.01,31.0,86
HCPCS,D0389,INTRAORAL TOMOSYNTHESIS ? PERIAPICAL RADIOGRAPHIC IMAGE ? IMAGE,30.0,19.5,0.01,31.0,86
HCPCS,D0389,Periopic image capture only,,,666.71,771.98,8
HCPCS,D0391,INTERPRETATION OF DIAGNOSTIC IMAGE BY A PRACTITIONER NOT ASSOCIA,375.0,243.75,1.1,486.59,86
HCPCS,D0391,Imterprete diagnostic image,,,837.27,969.47,8
HCPCS,D0393,Trtmnt simulation 3d image,,,78.83,969.47,28
HCPCS,D0393,VIRTUAL TREATMENT SIMULATION USING 3D IMAGE VOLUME OR SURFACE SC,400.0,260.0,1.1,623.76,74
HCPCS,D0394,DIGITAL SUBTRACTION OF TWO OR MORE IMAGES OR IMAGE VOLUMES OF TH,400.0,260.0,1.1,400.0,74
HCPCS,D0394,Digital sub 2 or more images,,,78.83,969.47,28
HCPCS,D0395,FUSION OF TWO OR MORE 3D IMAGE VOLUMES OF ONE OR MORE MODALITIES,450.0,292.5,1.1,450.0,74
HCPCS,D0395,Fusion 2 or more 3d images,,,78.83,969.47,28
HCPCS,D0396,3d print of 3d surface scan,,,666.71,771.98,8
HCPCS,D0396,PRINTING OF A 3D DENTAL SURFACE SCAN,100.0,65.0,1.1,190.04,86
HCPCS,D0411,HBA1C IN-OFFICE POINT OF SERVICE TESTING,100.0,65.0,1.1,100.0,74
HCPCS,D0411,Hba1c in office testing,,,11.75,13.61,8
HCPCS,D0412,BLOOD GLUCOSE LEVEL TEST ? IN-OFFICE USING A GLUCOSE METER,100.0,65.0,0.01,100.0,86
HCPCS,D0412,Blood glucose level test,,,11.75,13.61,8
HCPCS,D0414,LABORATORY PROCESSING OF MICROBIAL SPECIMEN TO INCLUDE CULTURE A,250.0,162.5,0.01,250.0,86
HCPCS,D0414,Lab process microbial spec,,,16.64,19.27,8
HCPCS,D0415,COLLECTION OF MICROORGANISMS FOR CULTURE AND SENSITIVITY,270.0,175.5,1.1,270.0,86
HCPCS,D0415,Collection of microorganisms,,,16.64,19.27,8
HCPCS,D0416,VIRAL CULTURE,200.0,130.0,1.1,200.0,86
HCPCS,D0416,Viral culture,,,16.64,19.27,8
HCPCS,D0417,COLLECTION AND PREPERATION OF SALIVA SAMPLE FOR LABORATORY ANALY,275.0,178.75,1.1,275.0,86
HCPCS,D0417,Collect & prep saliva sample,,,2.64,3.06,8
HCPCS,D0418,ANALYSIS OF SALIVA SAMPLE - LABORATORY,200.0,130.0,1.1,200.0,86
HCPCS,D0418,Analysis of saliva sample,,,8.96,10.37,8
HCPCS,D0419,ASSESSMENT OF SALIVARY FLOW BY MEASUREMENT,200.0,130.0,1.1,200.0,74
HCPCS,D0419,Assess of salivary flow,,,837.27,969.47,8
HCPCS,D0422,COLLECTION AND PREPARATION OF GENETIC SAMPLE MATERIAL FOR LABORA,200.0,130.0,1.1,200.0,86
HCPCS,D0422,Collect & prep genetic samp,,,83.94,97.2,8
HCPCS,D0423,GENETIC TEST FOR SUSCEPTIBILITY TO DISEASES ? SPECIMEN ANALYSIS,300.0,195.0,1.1,300.0,80
HCPCS,D0423,Genetic test spec analysis,,,83.94,97.2,8
HCPCS,D0425,CARIES SUSCEPTIBILITY TESTS,125.0,81.25,1.1,125.0,86
HCPCS,D0425,Caries susceptibility test,,,16.64,19.27,8
HCPCS,D0426,"COLLECTION, PREPARATION, AND ANALYSIS OF SALIVA SAMPLE ? POINT-O",200.0,130.0,1.1,200.0,68
HCPCS,D0426,"Coll, analys of saliva",,,2.64,3.06,8
HCPCS,D0431,ADJUNCTIVE PRE-DIAGNOSTIC TEST THAT AIDS IN DETECTION OF MUCOSAL,85.0,55.25,1.1,85.0,86
HCPCS,D0431,Diag tst detect mucos abnorm,,,837.27,969.47,8
HCPCS,D0460,PULP VITALITY TESTS,75.0,48.75,1.1,89.84,86
HCPCS,D0460,Pulp vitality test,,,611.63,1664.63,28
HCPCS,D0461,TESTING FOR CRACKED TOOTH,75.0,48.75,1.1,75.0,68
HCPCS,D0461,Testing for cracked tooth,,,1011.53,1171.25,8
HCPCS,D0470,DIAGNOSTIC CASTS,180.0,117.0,1.1,193.49,86
HCPCS,D0470,Diagnostic casts,,,837.27,969.47,8
HCPCS,D0472,"ACCESSION OF TISSUE, GROSS EXAMINATION, PREPARATION AND TRANSMIS",200.0,130.0,1.1,200.0,86
HCPCS,D0472,"Gross exam, prep & report",,,37.39,43.3,8
HCPCS,D0473,"ACCESSION OF TISSUE, GROSS AND MICROSCOPIC EXAMINATION, PREPARAT",250.0,162.5,1.1,250.0,86
HCPCS,D0473,"Micro exam, prep & report",,,37.39,43.3,8
HCPCS,D0474,"ACCESSION OF TISSUE, GROSS AND MICROSCOPIC EXAMINATION, INCLUDIN",275.0,178.75,1.1,275.0,86
HCPCS,D0474,Micro w exam of surg margins,,,37.39,43.3,8
HCPCS,D0475,DECALCIFICATION PROCEDURE,300.0,195.0,1.1,300.0,86
HCPCS,D0475,Decalcification procedure,,,8.96,10.37,8
HCPCS,D0476,SPECIAL STAINS FOR MICROORGANISMS,375.0,243.75,1.1,375.0,86
HCPCS,D0476,Spec stains for microorganis,,,8.96,10.37,8
HCPCS,D0477,"SPECIAL STAINS, NOT FOR MICROORGANISMS",400.0,260.0,1.1,400.0,86
HCPCS,D0477,Spec stains not for microorg,,,8.96,10.37,8
HCPCS,D0478,IMMUNOHISTOCHEMICAL STAINS,200.0,130.0,1.1,207.31,86
HCPCS,D0478,Immunohistochemical stains,,,8.96,10.37,8
HCPCS,D0479,"TISSUE IN-SITU HYBRIDIZATION, INCLUDING INTERPRETATION",300.0,195.0,1.1,300.0,86
HCPCS,D0479,Tissue in-situ hybridization,,,8.96,10.37,8
HCPCS,D0480,"ACCESSION OF EXFOLIATIVE CYTOLOGIC SMEARS, MICROSCOPIC EXAMINATI",200.0,130.0,1.1,200.0,86
HCPCS,D0480,Cytopath smear prep & report,,,37.39,43.3,8
HCPCS,D0481,Electron microscopy,,,8.96,10.37,8
HCPCS,D0482,DIRECT IMMUNOFLUORESCENCE,150.0,97.5,1.1,150.0,86
HCPCS,D0482,Direct immunofluorescence,,,8.96,10.37,8
HCPCS,D0483,INDIRECT IMMUNOFLUORESCENCE,175.0,113.75,1.1,175.0,86
HCPCS,D0483,Indirect immunofluorescence,,,8.96,10.37,8
HCPCS,D0484,CONSULTATION ON SLIDES PREPARED ELSEWHERE,200.0,130.0,1.1,200.0,86
HCPCS,D0484,Consult slides prep elsewher,,,34.71,40.19,8
HCPCS,D0485,"CONSULTATION, INCLUDING PREPARATION OF SLIDES FROM BIOPSY MATERI",400.0,260.0,1.1,400.0,86
HCPCS,D0485,Consult inc prep of slides,,,34.71,40.19,8
HCPCS,D0486,Access of transep cytol samp,,,37.39,43.3,8
HCPCS,D0486,"LABORATORY ACCESSION OF TRANSEPITHELIAL CYTOLOGIC SAMPLE, MICROS",100.0,65.0,1.1,172.76,86
HCPCS,D0502,"OTHER ORAL PATHOLOGY PROCEDURES, BY REPORT",200.0,130.0,0.01,200.0,86
HCPCS,D0502,Other oral pathology procedu,,,8.96,10.37,8
HCPCS,D0600,"NON-IONIZING DIAGNOSTIC PROCEDURE CAPABLE OF QUANTIFYING, MONITO",100.0,65.0,0.01,100.0,80
HCPCS,D0600,Non-ionizing diag proc,,,611.63,1664.63,28
HCPCS,D0601,"CARIES RISK ASSESSMENT AND DOCUMENTATION, WITH A FINDING OF LOW",100.0,65.0,1.1,100.0,74
HCPCS,D0601,Caries risk assess low risk,,,837.27,969.47,8
HCPCS,D0602,"CARIES RISK ASSESSMENT AND DOCUMENTATION, WITH A FINDING OF MODE",100.0,65.0,1.1,100.0,74
HCPCS,D0602,Caries risk assess mod risk,,,837.27,969.47,8
HCPCS,D0603,"CARIES RISK ASSESSMENT AND DOCUMENTATION, WITH A FINDING OF HIGH",100.0,65.0,1.1,100.0,74
HCPCS,D0603,Caries risk assess high risk,,,837.27,969.47,8
HCPCS,D0604,Antigen test pub hlth pathog,,,16.64,19.27,8
HCPCS,D0605,Antibody test pub hlth path,,,23.08,26.72,8
HCPCS,D0606,Molecular test pub hlth path,,,16.64,19.27,8
HCPCS,D0701,Pano radio image,,,78.83,771.98,28
HCPCS,D0702,2d cephal radio image,,,78.83,771.98,28
HCPCS,D0703,2d oral/facial photo image,,,78.83,771.98,28
HCPCS,D0704,3d photo image capture only,,,666.71,771.98,8
HCPCS,D0705,Extra oral post radio image,,,78.83,771.98,28
HCPCS,D0706,Intraoral occlus radio image,,,78.83,771.98,28
HCPCS,D0707,Intraoral periap radio image,,,78.83,771.98,28
HCPCS,D0708,Intraoral bite radio image,,,78.83,771.98,28
HCPCS,D0709,Intraoral comp image capture,,,78.83,771.98,28
HCPCS,D0801,3D INTRAORAL SURFACE SCAN - DIRECT,200.0,130.0,0.01,244.37,86
HCPCS,D0801,3d intraoral scan direct,,,666.71,771.98,8
HCPCS,D0802,3d dental scan indirect,,,666.71,771.98,8
HCPCS,D0802,DENTAL SURFACE SCAN 3D ? INDIRECT,200.0,130.0,0.01,244.37,86
HCPCS,D0803,3d facial scan direct,,,666.71,771.98,8
HCPCS,D0803,FACIAL SURFACE SCAN 3D ? DIRECT,200.0,130.0,0.01,200.0,86
HCPCS,D0804,3d facial scan indirect,,,666.71,771.98,8
HCPCS,D0804,FACIAL SURFACE SCAN 3D ? INDIRECT,200.0,130.0,0.01,200.0,86
HCPCS,D0999,"UNSPECIFIED DIAGNOSTIC PROCEDURE, BY REPORT",250.0,162.5,0.01,250.0,80
HCPCS,D0999,Unspecified diagnostic proce,,,837.27,969.47,8
HCPCS,D0999.1,"DIAGNOSTIC WAX UP, PER TOOTH",250.0,162.5,1.1,250.0,68
HCPCS,D1110,Dental prophylaxis adult,,,114.68,1171.25,28
HCPCS,D1110,PROPHYLAXIS - ADULT,125.0,81.25,1.1,165.86,86
HCPCS,D1110,PROPHYLAXIS-ADULT PARTIAL MOUTH,75.0,48.75,1.1,165.86,86
HCPCS,D1120,Dental prophylaxis child,,,1011.53,1171.25,8
HCPCS,D1120,PROPHYLAXIS - CHILD,100.0,65.0,1.1,114.02,86
HCPCS,D1206,TOPICAL APPLICATION OF FLUORIDE VARNISH,50.0,32.5,1.1,176.21,86
HCPCS,D1206,Topical fluoride varnish,,,1011.53,1171.25,8
HCPCS,D1208,TOPICAL APPLICATION OF FLUORIDE ? EXCLUDING VARNISH,50.0,32.5,1.1,72.56,86
HCPCS,D1208,Topical app fluorid ex vrnsh,,,1011.53,1171.25,8
HCPCS,D1301,Immunization counseling,,,86.57,100.24,8
HCPCS,D1310,Nutri counsel-control caries,,,1011.53,1171.25,8
HCPCS,D1320,TOBACCO COUNSELING FOR THE CONTROL AND PREVENTION OF ORAL DISEAS,30.0,19.5,1.1,93.29,86
HCPCS,D1320,Tobacco counseling,,,47.12,54.56,8
HCPCS,D1321,Couns for high risk sub use,,,47.12,54.56,8
HCPCS,D1330,Oral hygiene instructions,,,1011.53,1171.25,8
HCPCS,D1351,Dental sealant per tooth,,,1051.41,1217.43,8
HCPCS,D1351,SEALANT - PER TOOTH,75.0,48.75,1.1,103.66,86
HCPCS,D1352,"Prev resin rest, perm tooth",,,1011.53,1171.25,8
HCPCS,D1353,SEALANT REPAIR ? PER TOOTH,75.0,48.75,1.1,107.8,86
HCPCS,D1353,Sealant repair per tooth,,,1051.41,1217.43,8
HCPCS,D1354,INTERIM CARIES ARRESTING MEDICAMENT APPLICATION ? PER TOOTH,125.0,81.25,1.1,167.45,86
HCPCS,D1354,Int caries med app per tooth,,,1011.53,1171.25,8
HCPCS,D1355,Caries med app per tooth,,,1011.53,1171.25,8
HCPCS,D1510,SPACE MAINTAINER - FIXED - UNILATERAL,450.0,292.5,1.1,670.31,86
HCPCS,D1510,Space maintainer fxd unilat,,,611.63,1664.63,28
HCPCS,D1516,"Fixed bilat space maint, max",,,611.63,1664.63,28
HCPCS,D1516,"SPACE MAINTAINER ? FIXED ? BILATERAL, MAXILLARY",500.0,325.0,1.1,1371.71,86
HCPCS,D1517,"Fixed bilat space maint, man",,,611.63,1664.63,28
HCPCS,D1517,"SPACE MAINTAINER ? FIXED ? BILATERAL, MANDIBULAR",550.0,357.5,1.1,1371.71,86
HCPCS,D1520,Remove unilat space maintain,,,611.63,1664.63,28
HCPCS,D1520,SPACE MAINTAINER - REMOVABLE - UNILATERAL,500.0,325.0,1.1,832.7,86
HCPCS,D1526,"Remove bilat space main, max",,,611.63,1664.63,28
HCPCS,D1526,"SPACE MAINTAINER ? REMOVABLE ? BILATERAL, MAXILLARY",600.0,390.0,1.1,1285.32,86
HCPCS,D1527,"Remove bilat space main, man",,,611.63,1664.63,28
HCPCS,D1527,"SPACE MAINTAINER ? REMOVABLE ? BILATERAL, MANDIBULAR",600.0,390.0,1.1,1285.32,86
HCPCS,D1551,RE-CEMENT OR RE-BOND BILATERAL SPACE MAINTAINER - MAXILLARY,150.0,97.5,1.1,179.67,86
HCPCS,D1551,Recement space maint - max,,,611.63,1664.63,28
HCPCS,D1552,RE-CEMENT OR RE-BOND BILATERAL SPACE MAINTAINER - MANDIBULAR,150.0,97.5,1.1,179.67,86
HCPCS,D1552,Recement space maint - man,,,611.63,1664.63,28
HCPCS,D1553,RE-CEMENT OR RE-BOND UNILATERAL SPACE MAINTAINER - PER QUADRANT,160.0,104.0,1.1,160.0,86
HCPCS,D1553,Recement unilat space maint,,,611.63,1664.63,28
HCPCS,D1556,REMOVAL OF FIXED UNILATERAL SPACE MAINTAINER - PER QUADRANT,150.0,97.5,1.1,179.67,86
HCPCS,D1556,Rem fixed unilat space maint,,,1011.53,1171.25,8
HCPCS,D1557,REMOVAL OF FIXED BILATERAL SPACE MAINTAINER - MAXILLARY,165.0,107.25,1.1,179.67,86
HCPCS,D1557,Remove fixed bilat maint max,,,1011.53,1171.25,8
HCPCS,D1558,REMOVAL OF FIXED BILATERAL SPACE MAINTAINER - MANDIBULAR,180.0,117.0,1.1,180.0,86
HCPCS,D1558,Remove fixed bilat man,,,1011.53,1171.25,8
HCPCS,D1575,DISTAL SHOE SPACE MAINTAINER ? FIXED ? UNILATERAL,520.0,338.0,1.1,863.79,86
HCPCS,D1575,"Dist space maint, fixed unil",,,611.63,1664.63,28
HCPCS,D1701,Pfizer vacc admin 1st dose,,,17.08,19.78,8
HCPCS,D1702,Pfizer vacc admin 2nd dose,,,17.08,19.78,8
HCPCS,D1703,Moderna vacc admin 1st dose,,,17.08,19.78,8
HCPCS,D1704,Moderna vacc admin 2nd dose,,,17.08,19.78,8
HCPCS,D1705,Astrazeneca vacc adm 1st dos,,,17.08,19.78,8
HCPCS,D1706,Astrazeneca vacc adm 2nd dos,,,17.08,19.78,8
HCPCS,D1707,Janssen vaccine admin,,,17.08,19.78,8
HCPCS,D1708,Pfizer vacc admin 3rd dose,,,17.08,19.78,8
HCPCS,D1709,Pfizer vaccine admin booster,,,17.08,19.78,8
HCPCS,D1710,Moderna vacc admin 3rd dose,,,17.08,19.78,8
HCPCS,D1711,Moderna vacc admin booster,,,17.08,19.78,8
HCPCS,D1712,Janssen vacc admin booster,,,17.08,19.78,8
HCPCS,D1713,Pfizer vacc adm ped 1st dose,,,17.08,19.78,8
HCPCS,D1714,Pfizer vacc adm ped 2nd dose,,,17.08,19.78,8
HCPCS,D1720,INFLUENZA VACCINE ADMINISTRATION,200.0,130.0,1.1,200.0,68
HCPCS,D1720,Influenza vacc admin,,,17.08,19.78,8
HCPCS,D1781,VACCINE ADMINISTRATION ? HUMAN PAPILLOMAVIRUS ? DOSE 1,200.0,130.0,0.01,200.0,86
HCPCS,D1781,Vac admin human pap dose 1,,,17.08,19.78,8
HCPCS,D1782,VACCINE ADMINISTRATION ? HUMAN PAPILLOMAVIRUS ? DOSE 2,200.0,130.0,0.01,200.0,86
HCPCS,D1782,Vac admin human pap dose 2,,,17.08,19.78,8
HCPCS,D1783,VACCINE ADMINISTRATION ? HUMAN PAPILLOMAVIRUS ? DOSE 3,200.0,130.0,0.01,200.0,86
HCPCS,D1783,Vac admin human pap dose 3,,,17.08,19.78,8
HCPCS,D1999,"UNSPECIFIED PREVENTIVE PROCEDURE, BY REPORT",160.0,104.0,1.1,160.0,68
HCPCS,D1999,Unspecified preventive proc,,,1011.53,1171.25,8
HCPCS,D2140,"AMALGAM - ONE SURFACE, PRIMARY OR PERMANENT",200.0,130.0,1.1,231.49,86
HCPCS,D2140,Amalgam one surface permanen,,,611.63,1664.63,28
HCPCS,D2150,"AMALGAM - TWO SURFACES, PRIMARY OR PERMANENT",280.0,182.0,1.1,300.61,86
HCPCS,D2150,Amalgam two surfaces permane,,,611.63,1664.63,28
HCPCS,D2160,"AMALGAM - THREE SURFACES, PRIMARY OR PERMANENT",350.0,227.5,1.1,362.8,86
HCPCS,D2160,Amalgam three surfaces perma,,,611.63,1664.63,28
HCPCS,D2161,"AMALGAM - FOUR OR MORE SURFACES, PRIMARY OR PERMANENT",400.0,260.0,1.1,442.26,86
HCPCS,D2161,Amalgam 4 or > surfaces perm,,,611.63,1664.63,28
HCPCS,D2330,"RESIN-BASED COMPOSITE - ONE SURFACE, ANTERIOR",260.0,169.0,1.1,276.42,86
HCPCS,D2330,Resin one surface-anterior,,,611.63,1664.63,28
HCPCS,D2331,"RESIN-BASED COMPOSITE - TWO SURFACES, ANTERIOR",300.0,195.0,1.1,352.43,86
HCPCS,D2331,Resin two surfaces-anterior,,,611.63,1664.63,28
HCPCS,D2332,"RESIN-BASED COMPOSITE - THREE SURFACES, ANTERIOR",350.0,227.5,1.1,428.44,86
HCPCS,D2332,Resin three surfaces-anterio,,,611.63,1664.63,28
HCPCS,D2335,RESIN-BASED COMPOSITE - FOUR OR MORE SURFACES (ANTERIOR),450.0,292.5,1.1,507.91,86
HCPCS,D2335,Resin 4/> surf or w incis an,,,611.63,1664.63,28
HCPCS,D2390,Ant resin-based cmpst crown,,,611.63,1664.63,28
HCPCS,D2390,"RESIN-BASED COMPOSITE CROWN, ANTERIOR",700.0,455.0,1.1,700.0,86
HCPCS,D2391,Post 1 srfc resinbased cmpst,,,611.63,1664.63,28
HCPCS,D2391,"RESIN-BASED COMPOSITE - ONE SURFACE, POSTERIOR",275.0,178.75,1.1,310.96,86
HCPCS,D2392,Post 2 srfc resinbased cmpst,,,611.63,1664.63,28
HCPCS,D2392,"RESIN-BASED COMPOSITE - TWO SURFACES, POSTERIOR",350.0,227.5,1.1,428.44,86
HCPCS,D2393,Post 3 srfc resinbased cmpst,,,611.63,1664.63,28
HCPCS,D2393,"RESIN-BASED COMPOSITE - THREE SURFACES, POSTERIOR",425.0,276.25,1.1,532.1,86
HCPCS,D2394,Post >=4srfc resinbase cmpst,,,611.63,1664.63,28
HCPCS,D2394,"RESIN-BASED COMPOSITE - FOUR OR MORE SURFACES, POSTERIOR",500.0,325.0,1.1,532.1,86
HCPCS,D2410,Dental gold foil one surface,,,611.63,1664.63,28
HCPCS,D2420,Dental gold foil two surface,,,611.63,1664.63,28
HCPCS,D2430,Dental gold foil three surfa,,,611.63,1664.63,28
HCPCS,D2510,Dental inlay metalic 1 surf,,,611.63,1664.63,28
HCPCS,D2510,INLAY - METALLIC - ONE SURFACE,1300.0,845.0,1.1,1551.37,86
HCPCS,D2520,Dental inlay metallic 2 surf,,,611.63,1664.63,28
HCPCS,D2520,INLAY - METALLIC - TWO SURFACES,1400.0,910.0,1.1,1758.69,86
HCPCS,D2530,Dental inlay metl 3/more sur,,,611.63,1664.63,28
HCPCS,D2530,INLAY - METALLIC - THREE OR MORE SURFACES,1500.0,975.0,1.1,2028.19,86
HCPCS,D2542,Dental onlay metallic 2 surf,,,611.63,1664.63,28
HCPCS,D2542,ONLAY - METALLIC - TWO SURFACES,2000.0,1300.0,1.1,2073.11,86
HCPCS,D2543,Dental onlay metallic 3 surf,,,611.63,1664.63,28
HCPCS,D2543,ONLAY - METALLIC - THREE SURFACES,2000.0,1300.0,1.1,2080.02,86
HCPCS,D2544,Dental onlay metl 4/more sur,,,611.63,1664.63,28
HCPCS,D2544,ONLAY - METALLIC - FOUR OR MORE SURFACES,2000.0,1300.0,1.1,2162.94,86
HCPCS,D2610,INLAY - PORCELAIN/CERAMIC - ONE SURFACE,2000.0,1300.0,1.1,2000.0,86
HCPCS,D2610,Inlay porcelain/ceramic 1 su,,,611.63,1664.63,28
HCPCS,D2620,INLAY - PORCELAIN/CERAMIC - TWO SURFACES,2000.0,1300.0,1.1,2000.0,86
HCPCS,D2620,Inlay porcelain/ceramic 2 su,,,611.63,1664.63,28
HCPCS,D2630,Dental onlay porc 3/more sur,,,611.63,1664.63,28
HCPCS,D2630,INLAY - PORCELAIN/CERAMIC - THREE OR MORE SURFACES,2000.0,1300.0,1.1,2052.38,86
HCPCS,D2642,Dental onlay porcelin 2 surf,,,611.63,1664.63,28
HCPCS,D2642,ONLAY - PORCELAIN/CERAMIC - TWO SURFACES,2000.0,1300.0,1.1,2000.0,86
HCPCS,D2643,Dental onlay porcelin 3 surf,,,611.63,1664.63,28
HCPCS,D2643,ONLAY - PORCELAIN/CERAMIC - THREE SURFACES,2000.0,1300.0,1.1,2149.12,86
HCPCS,D2644,Dental onlay porc 4/more sur,,,611.63,1664.63,28
HCPCS,D2644,ONLAY - PORCELAIN/CERAMIC - FOUR OR MORE SURFACES,2000.0,1300.0,1.1,2280.42,86
HCPCS,D2650,INLAY - RESIN-BASED COMPOSITE - ONE SURFACE,2000.0,1300.0,1.1,2000.0,86
HCPCS,D2650,Inlay composite/resin one su,,,611.63,1664.63,28
HCPCS,D2651,INLAY - RESIN-BASED COMPOSITE - TWO SURFACES,2000.0,1300.0,1.1,2000.0,86
HCPCS,D2651,Inlay composite/resin two su,,,611.63,1664.63,28
HCPCS,D2652,Dental inlay resin 3/mre sur,,,611.63,1664.63,28
HCPCS,D2652,INLAY - RESIN-BASED COMPOSITE - THREE OR MORE SURFACES,2000.0,1300.0,1.1,2000.0,86
HCPCS,D2662,Dental onlay resin 2 surface,,,611.63,1664.63,28
HCPCS,D2662,ONLAY - RESIN-BASED COMPOSITE - TWO SURFACES,2000.0,1300.0,1.1,2000.0,86
HCPCS,D2663,Dental onlay resin 3 surface,,,611.63,1664.63,28
HCPCS,D2663,ONLAY - RESIN-BASED COMPOSITE - THREE SURFACES,2000.0,1300.0,1.1,2000.0,86
HCPCS,D2664,Dental onlay resin 4/mre sur,,,611.63,1664.63,28
HCPCS,D2664,ONLAY - RESIN-BASED COMPOSITE - FOUR OR MORE SURFACES,2000.0,1300.0,1.1,2055.84,86
HCPCS,D2710,CROWN - RESIN-BASED COMPOSITE (INDIRECT),1400.0,910.0,1.1,1400.0,86
HCPCS,D2710,Crown resin-based indirect,,,611.63,1664.63,28
HCPCS,D2712,CROWN - 3/4CROWN RESIN-BASED COMPOSITE (INDIRECT),1400.0,910.0,1.1,1400.0,86
HCPCS,D2712,Crown 3/4 resin-based compos,,,611.63,1664.63,28
HCPCS,D2720,CROWN - RESIN WITH HIGH NOBLE METAL,1600.0,1040.0,1.1,2280.42,86
HCPCS,D2720,Crown resin w/ high noble me,,,611.63,1664.63,28
HCPCS,D2721,CROWN - RESIN WITH PREDOMINANTLY BASE METAL,1500.0,975.0,1.1,2138.75,86
HCPCS,D2721,Crown resin w/ base metal,,,611.63,1664.63,28
HCPCS,D2722,CROWN - RESIN WITH NOBLE METAL,1600.0,1040.0,1.1,2183.67,86
HCPCS,D2722,Crown resin w/ noble metal,,,611.63,1664.63,28
HCPCS,D2740,CROWN - PORCELAIN/CERAMIC,1600.0,1040.0,1.1,2342.62,86
HCPCS,D2740,Crown porcelain/ceramic,,,611.63,1664.63,28
HCPCS,D2740.5,CEREC CROWN,1600.0,1040.0,1.1,1600.0,68
HCPCS,D2750,CROWN - PORCELAIN FUSED TO HIGH NOBLE METAL,1675.0,1088.75,1.1,2308.07,86
HCPCS,D2750,Crown porcelain w/ h noble m,,,611.63,1664.63,28
HCPCS,D2751,CROWN - PORCELAIN FUSED TO PREDOMINANTLY BASE METAL,1525.0,991.25,1.1,2149.12,86
HCPCS,D2751,Crown porcelain fused base m,,,611.63,1664.63,28
HCPCS,D2752,CROWN - PORCELAIN FUSED TO NOBLE METAL,1650.0,1072.5,1.1,2204.41,86
HCPCS,D2752,Crown porcelain w/ noble met,,,611.63,1664.63,28
HCPCS,D2753,CROWN - PORCELAIN FUSED TO TITANIUM AND TITANIUM ALLOYS,1650.0,1072.5,1.1,2501.56,86
HCPCS,D2753,Crown porc fused to titanium,,,611.63,1664.63,28
HCPCS,D2780,CROWN - 3/4 CAST HIGH NOBLE METAL,1650.0,1072.5,1.1,2073.11,86
HCPCS,D2780,Crown 3/4 cast hi noble met,,,611.63,1664.63,28
HCPCS,D2781,CROWN - 3/4 CAST PREDOMINANTLY BASE METAL,1600.0,1040.0,1.1,2073.11,86
HCPCS,D2781,Crown 3/4 cast base metal,,,611.63,1664.63,28
HCPCS,D2782,CROWN - 3/4 CAST NOBLE METAL,1625.0,1056.25,1.1,2073.11,86
HCPCS,D2782,Crown 3/4 cast noble metal,,,611.63,1664.63,28
HCPCS,D2783,CROWN - 3/4 PORCELAIN/CERAMIC,1625.0,1056.25,1.1,2073.11,86
HCPCS,D2783,Crown 3/4 porcelain/ceramic,,,611.63,1664.63,28
HCPCS,D2790,CROWN - FULL CAST HIGH NOBLE METAL,1750.0,1137.5,1.1,2228.6,86
HCPCS,D2790,Crown full cast high noble m,,,611.63,1664.63,28
HCPCS,D2791,CROWN - FULL CAST PREDOMINANTLY BASE METAL,1625.0,1056.25,1.1,2111.12,86
HCPCS,D2791,Crown full cast base metal,,,611.63,1664.63,28
HCPCS,D2792,CROWN - FULL CAST NOBLE METAL,1675.0,1088.75,1.1,2149.12,86
HCPCS,D2792,Crown full cast noble metal,,,611.63,1664.63,28
HCPCS,D2794,CROWN - TITANIUM,1650.0,1072.5,1.1,2149.12,86
HCPCS,D2794,Crown-titanium,,,611.63,1664.63,28
HCPCS,D2799,Interim crown,,,611.63,1664.63,28
HCPCS,D2799,PROVISIONAL CROWN? FURTHER TREATMENT OR COMPLETION OF DIAGNOSIS,600.0,390.0,1.1,2073.11,86
HCPCS,D2910,"RE-CEMENT OR RE-BOND INLAY, ONLAY, VENEER OR PARTIAL COVERAGE RE",175.0,113.75,1.1,200.4,86
HCPCS,D2910,Recement inlay onlay or part,,,57.69,1664.63,28
HCPCS,D2915,RE-CEMENT OR RE-BOND INDIRECTLY FABRICATED OR PREFABRICATED POST,160.0,104.0,1.1,200.4,86
HCPCS,D2915,Recement cast or prefab post,,,57.69,1664.63,28
HCPCS,D2919,"EVALUATION FOR MODERATE SEDATION, DEEP SEDATION OR GENERAL ANEST",150.0,97.5,1.1,150.0,68
HCPCS,D2920,RE-CEMENT OR RE-BOND CROWN,180.0,117.0,1.1,207.31,86
HCPCS,D2920,Re-cement or re-bond crown,,,57.69,1664.63,28
HCPCS,D2921,"REATTACHMENT OF TOOTH FRAGMENT, INCISAL EDGE OR CUSP",350.0,227.5,1.1,350.0,74
HCPCS,D2921,Reattach tooth fragment,,,57.69,1664.63,28
HCPCS,D2928,Prefab porc/cer crown perm,,,611.63,1664.63,28
HCPCS,D2929,PREFABRICATED PORCELAIN/CERAMIC CROWN ? PRIMARY TOOTH,550.0,357.5,1.1,550.0,86
HCPCS,D2929,Prefab porc/ceram crown pri,,,611.63,1664.63,28
HCPCS,D2930,PREFABRICATED STAINLESS STEEL CROWN - PRIMARY TOOTH,400.0,260.0,1.1,566.65,86
HCPCS,D2930,Prefab stnlss steel crwn pri,,,611.63,1664.63,28
HCPCS,D2931,PREFABRICATED STAINLESS STEEL CROWN - PERMANENT TOOTH,500.0,325.0,1.1,639.21,86
HCPCS,D2931,Prefab stnlss steel crown pe,,,611.63,1664.63,28
HCPCS,D2932,PREFABRICATED RESIN CROWN,510.0,331.5,1.1,694.49,86
HCPCS,D2932,Prefabricated resin crown,,,611.63,1664.63,28
HCPCS,D2933,PREFABRICATED STAINLESS STEEL CROWN WITH RESIN WINDOW,500.0,325.0,1.1,780.87,86
HCPCS,D2933,Prefab stainless steel crown,,,611.63,1664.63,28
HCPCS,D2934,PREFABRICATED ESTHETIC COATED STAINLESS STEEL CROWN - PRIMARY TO,500.0,325.0,1.1,780.87,86
HCPCS,D2934,Prefab steel crown primary,,,611.63,1664.63,28
HCPCS,D2940,PLACEMENT OF INTERIM DIRECT RESTORATION,200.0,130.0,1.1,214.22,86
HCPCS,D2940,Place direct restoration,,,57.69,66.8,8
HCPCS,D2940,Protective restoration,,,611.63,1664.63,20
HCPCS,D2941,INTERIM THERAPEUTIC RESTORATION ? PRIMARY DENTITION,275.0,178.75,1.1,275.0,68
HCPCS,D2941,Int therapeutic restoration,,,57.69,763.85,9
HCPCS,D2949,RESTORATIVE FOUNDATION FOR AN INDIRECT RESTORATION,300.0,195.0,1.1,300.0,74
HCPCS,D2949,Restorative foundation,,,57.69,1664.63,28
HCPCS,D2950,"CORE BUILDUP, INCLUDING ANY PINS WHEN REQUIRED",450.0,292.5,1.1,539.01,86
HCPCS,D2950,Core build-up incl any pins,,,611.63,1664.63,28
HCPCS,D2951,"PIN RETENTION - PER TOOTH, IN ADDITION TO RESTORATION",100.0,65.0,1.1,114.02,86
HCPCS,D2951,Tooth pin retention,,,57.69,1664.63,28
HCPCS,D2952,"POST AND CORE IN ADDITION TO CROWN, INDIRECTLY FABRICATED",600.0,390.0,1.1,822.34,86
HCPCS,D2952,Post and core cast + crown,,,611.63,1664.63,28
HCPCS,D2953,EACH ADDITIONAL INDIRECTLY FABRICATED POST - SAME TOOTH,450.0,292.5,1.1,450.0,86
HCPCS,D2953,Each addtnl cast post,,,1358.5,1573.0,8
HCPCS,D2954,PREFABRICATED POST AND CORE IN ADDITION TO CROWN,450.0,292.5,1.1,680.67,86
HCPCS,D2954,Prefab post/core + crown,,,611.63,1664.63,28
HCPCS,D2955,POST REMOVAL,400.0,260.0,1.1,511.38,86
HCPCS,D2955,Post removal,,,1358.5,1573.0,8
HCPCS,D2956,Indirect rest remov,,,1358.5,1573.0,8
HCPCS,D2956,REMOVAL OF AN INDIRECT RESTORATION ON A NATURAL TOOTH,300.0,195.0,1.1,300.0,86
HCPCS,D2957,EACH ADDITIONAL PREFABRICATED POST - SAME TOOTH,300.0,195.0,1.1,300.0,86
HCPCS,D2957,Each addtnl prefab post,,,611.63,1664.63,28
HCPCS,D2960,LABIAL VENEER (RESIN LAMINATE) - CHAIRSIDE,1000.0,650.0,1.1,1668.85,86
HCPCS,D2960,Labial veneer resin direct,,,611.63,1664.63,28
HCPCS,D2961,LABIAL VENEER (RESIN LAMINATE) - LABORATORY,1500.0,975.0,1.1,1869.26,86
HCPCS,D2961,Labial veneer resin indirect,,,611.63,1664.63,28
HCPCS,D2962,LABIAL VENEER (PORCELAIN LAMINATE) - LABORATORY,1700.0,1105.0,1.1,2031.65,86
HCPCS,D2962,Labial veneer porc indirect,,,611.63,1664.63,28
HCPCS,D2971,ADDITIONAL PROCEDURES TO CONSTRUCT NEW CROWN UNDER EXISTING PART,425.0,276.25,1.1,483.73,86
HCPCS,D2971,Add proc construct new crown,,,611.63,1664.63,28
HCPCS,D2975,COPING,900.0,585.0,1.1,900.0,86
HCPCS,D2975,Coping,,,611.63,1664.63,28
HCPCS,D2976,Band stabilization per tooth,,,1358.5,1573.0,8
HCPCS,D2980,CROWN REPAIR NECESSITATED BY RESTORATIVE MATERIAL FAILURE,400.0,260.0,1.1,570.11,86
HCPCS,D2980,Crown repair,,,611.63,1664.63,28
HCPCS,D2981,INLAY REPAIR NECESSITATED BY RESTORATIVE MATERIAL FAILURE,400.0,260.0,1.1,400.0,80
HCPCS,D2981,Inlay repair,,,611.63,1664.63,28
HCPCS,D2982,ONLAY REPAIR NECESSITATED BY RESTORATIVE MATERIAL FAILURE,400.0,260.0,1.1,400.0,80
HCPCS,D2982,Onlay repair,,,611.63,1664.63,28
HCPCS,D2983,VENEER REPAIR NECESSITATED BY RESTORATIVE MATERIAL FAILURE,430.0,279.5,1.1,430.0,80
HCPCS,D2983,Veneer repair,,,611.63,1664.63,28
HCPCS,D2989,EXCAVATION OF A TOOTH RESULTING IN THE DETERMINATION OF NON-REST,200.0,130.0,1.1,200.0,86
HCPCS,D2989,Excavate tooth non-restorabl,,,57.69,66.8,8
HCPCS,D2990,RESIN INFILTRATION OF INCIPIENT SMOOTH SURFACE LESIONS,50.0,32.5,1.1,214.22,86
HCPCS,D2990,Resin infiltration of lesion,,,57.69,1664.63,28
HCPCS,D2991,APPLICATION OF HYDROXYAPATITE REGENERATION MEDICAMENT ? PER TOOT,200.0,130.0,1.1,246.24,86
HCPCS,D2991,App of hydroxyapatite,,,57.69,66.8,8
HCPCS,D2999,CREST WHITESTRIPS,60.0,39.0,0.01,60.0,80
HCPCS,D2999,CUSTOM WHITENING TRAYS - 1 TRAY,200.0,130.0,0.01,200.0,80
HCPCS,D2999,CUSTOM WHITENING TRAYS - 2 TRAYS,300.0,195.0,0.01,300.0,80
HCPCS,D2999,Dental unspec restorative pr,,,611.63,1664.63,28
HCPCS,D2999,OPALESCENCE 10% 10 DAY NON-CUSTOM,75.0,48.75,0.01,75.0,80
HCPCS,D2999,OPALESCENCE 10% 4 DAY NON-CUSTOM,50.0,32.5,0.01,50.0,80
HCPCS,D2999,OPALESCENCE 15% 10 DAY NON-CUSTOM,75.0,48.75,0.01,75.0,80
HCPCS,D2999,OPALESCENCE 15% 4 DAY NON-CUSTOM,50.0,32.5,0.01,50.0,80
HCPCS,D2999,TOUCH UP KIT 35% - 4 SYRINGES,40.0,26.0,0.01,40.0,80
HCPCS,D2999,"UNSPECIFIED RESTORATIVE PROCEDURE, BY REPORT",400.0,260.0,0.01,400.0,80
HCPCS,D2999.8,IN OFFICE WHITENING,350.0,227.5,1.1,350.0,68
HCPCS,D3110,PULP CAP - DIRECT (EXCLUDING FINAL RESTORATION),125.0,81.25,1.1,141.67,86
HCPCS,D3110,Pulp cap direct,,,611.63,1664.63,28
HCPCS,D3120,PULP CAP - INDIRECT (EXCLUDING FINAL RESTORATION),125.0,81.25,1.1,125.0,86
HCPCS,D3120,Pulp cap indirect,,,611.63,1664.63,28
HCPCS,D3220,THERAPEUTIC PULPOTOMY (EXCLUDING FINAL RESTORATION) - REMOVAL OF,325.0,211.25,1.1,331.7,86
HCPCS,D3220,Therapeutic pulpotomy,,,611.63,1664.63,28
HCPCS,D3221,Gross pulpal debridement,,,611.63,1664.63,28
HCPCS,D3221,"PULPAL DEBRIDEMENT, PRIMARY AND PERMANENT TEETH",350.0,227.5,1.1,350.0,86
HCPCS,D3222,PARTIAL PULPOTOMY FOR APEXOGENESIS - PERMANENT TOOTH WITH INCOMP,425.0,276.25,1.1,425.0,86
HCPCS,D3222,Part pulp for apexogenesis,,,611.63,1664.63,28
HCPCS,D3230,"PULPAL THERAPY (RESORBABLE FILLING) - ANTERIOR, PRIMARY TOOTH (E",400.0,260.0,1.1,604.67,86
HCPCS,D3230,Pulpal therapy anterior prim,,,611.63,1664.63,28
HCPCS,D3240,"PULPAL THERAPY (RESORBABLE FILLING) - POSTERIOR, PRIMARY TOOTH (",430.0,279.5,1.1,430.0,86
HCPCS,D3240,Pulpal therapy posterior pri,,,611.63,1664.63,28
HCPCS,D3310,"ENDODONTIC THERAPY, ANTERIOR TOOTH (EXCLUDING FINAL RESTORATION)",1100.0,715.0,1.1,1402.8,86
HCPCS,D3310,"End thxpy, anterior tooth",,,611.63,1664.63,28
HCPCS,D3320,"ENDODONTIC THERAPY, PREMOLAR TOOTH (EXCLUDING FINAL RESTORATION)",1200.0,780.0,1.1,1710.32,86
HCPCS,D3320,"End thxpy, premolar tooth",,,611.63,1664.63,28
HCPCS,D3330,"ENDODONTIC THERAPY, MOLAR TOOTH (EXCLUDING FINAL RESTORATION)",1500.0,975.0,1.1,2211.32,86
HCPCS,D3330,"End thxpy, molar tooth",,,611.63,1664.63,28
HCPCS,D3331,Non-surg tx root canal obs,,,611.63,1664.63,28
HCPCS,D3331,TREATMENT OF ROOT CANAL OBSTRUCTION; NON-SURGICAL ACCESS,900.0,585.0,1.1,900.0,86
HCPCS,D3332,"INCOMPLETE ENDODONTIC THERAPY; INOPERABLE, UNRESTORABLE OR FRACT",600.0,390.0,1.1,1174.77,86
HCPCS,D3332,Incomplete endodontic tx,,,611.63,1664.63,28
HCPCS,D3333,INTERNAL ROOT REPAIR OF PERFORATION DEFECTS,600.0,390.0,1.1,600.0,86
HCPCS,D3333,Internal root repair,,,611.63,1664.63,28
HCPCS,D3346,RETREATMENT OF PREVIOUS ROOT CANAL THERAPY - ANTERIOR,1300.0,845.0,1.1,1886.52,86
HCPCS,D3346,Retreat root canal anterior,,,611.63,1664.63,28
HCPCS,D3347,RETREATMENT OF PREVIOUS ROOT CANAL THERAPY - PREMOLAR,1400.0,910.0,1.1,2225.14,86
HCPCS,D3347,Retreat root canal premolar,,,611.63,1664.63,28
HCPCS,D3348,RETREATMENT OF PREVIOUS ROOT CANAL THERAPY - MOLAR,1700.0,1105.0,1.1,2674.32,86
HCPCS,D3348,Retreat root canal molar,,,611.63,1664.63,28
HCPCS,D3351,APEXIFICATION/RECALCIFICATION ? INITIAL VISIT (APICAL CLOSURE /,500.0,325.0,1.1,794.69,86
HCPCS,D3351,Apexification/recalc initial,,,611.63,1664.63,28
HCPCS,D3352,APEXIFICATION/RECALCIFICATION ? INTERIM MEDICATION REPLACEMENT,400.0,260.0,1.1,400.0,86
HCPCS,D3352,Apexification/recalc interim,,,611.63,1664.63,28
HCPCS,D3353,APEXIFICATION/RECALCIFICATION - FINAL VISIT (INCLUDES COMPLETED,750.0,487.5,1.1,1171.3,86
HCPCS,D3353,Apexification/recalc final,,,611.63,1664.63,28
HCPCS,D3355,PULPAL REGENERATION - INITIAL VISIT,600.0,390.0,1.1,600.0,74
HCPCS,D3355,Pulpal regeneration initial,,,611.63,1664.63,28
HCPCS,D3356,PULPAL REGENERATION - INTERIM MEDICATION REPLACEMENT,500.0,325.0,1.1,500.0,74
HCPCS,D3356,Pulpal regeneration interim,,,611.63,1664.63,28
HCPCS,D3357,PULPAL REGENERATION - COMPLETION OF TREATMENT,850.0,552.5,1.1,850.0,74
HCPCS,D3357,Pulpal regeneration complete,,,611.63,1664.63,28
HCPCS,D3410,APICOECTOMY - ANTERIOR,1100.0,715.0,1.1,1603.21,86
HCPCS,D3410,Apicoectomy - anterior,,,611.63,1664.63,28
HCPCS,D3421,APICOECTOMY - PREMOLAR (FIRST ROOT),1225.0,796.25,1.1,1751.78,86
HCPCS,D3421,Root surgery premolar,,,611.63,1664.63,28
HCPCS,D3425,APICOECTOMY - MOLAR (FIRST ROOT),1350.0,877.5,1.1,1979.82,86
HCPCS,D3425,Root surgery molar,,,611.63,1664.63,28
HCPCS,D3426,APICOECTOMY (EACH ADDITIONAL ROOT),650.0,422.5,1.1,659.95,86
HCPCS,D3426,Root surgery ea add root,,,1358.5,1573.0,8
HCPCS,D3427,PERIRADICULAR SURGERY WITHOUT APICOECTOMY,500.0,325.0,1.1,500.0,68
HCPCS,D3427,Periradicular surgery,,,1358.5,1573.0,8
HCPCS,D3428,BONE GRAFT IN CONJUNCTION WITH PERIRADICULAR SURGERY ? PER TOOTH,575.0,373.75,1.1,575.0,74
HCPCS,D3428,Bone graft peri per tooth,,,611.63,1664.63,28
HCPCS,D3429,BONE GRAFT IN CONJUNCTION WITH PERIRADICULAR SURGERY ? EACH ADDI,500.0,325.0,1.1,500.0,74
HCPCS,D3429,Bone graft peri each addl,,,1358.5,1573.0,8
HCPCS,D3430,RETROGRADE FILLING - PER ROOT,430.0,279.5,1.1,483.73,86
HCPCS,D3430,Retrograde filling,,,611.63,1664.63,28
HCPCS,D3431,BIOLOGIC MATERIALS TO AID IN SOFT AND OSSEOUS TISSUE REGENERATIO,850.0,552.5,1.1,963.0,74
HCPCS,D3431,Biological materials,,,611.63,1664.63,28
HCPCS,D3432,"GUIDED TISSUE REGENERATION, RESORBABLE BARRIER, PER SITE, IN CON",575.0,373.75,1.1,1178.4,74
HCPCS,D3432,Guided tissue regeneration,,,611.63,1664.63,28
HCPCS,D3450,ROOT AMPUTATION - PER ROOT,600.0,390.0,1.1,984.73,86
HCPCS,D3450,Root amputation,,,611.63,1664.63,28
HCPCS,D3460,ENDODONTIC ENDOSSEOUS IMPLANT,2000.0,1300.0,1.1,4723.23,86
HCPCS,D3460,Endodontic endosseous implan,,,611.63,1664.63,28
HCPCS,D3470,INTENTIONAL REIMPLANTATION (INCLUDING NECESSARY SPLINTING),1100.0,715.0,1.1,1962.55,86
HCPCS,D3470,Intentional replantation,,,611.63,1664.63,28
HCPCS,D3471,SURGICAL REPAIR OF ROOT RESORPTION - ANTERIOR,900.0,585.0,1.1,2048.93,86
HCPCS,D3471,Surg rep root res anterior,,,611.63,1664.63,28
HCPCS,D3472,SURGICAL REPAIR OF ROOT RESORPTION ? PREMOLAR,900.0,585.0,1.1,2366.81,86
HCPCS,D3472,Surg rep root res premolar,,,611.63,1664.63,28
HCPCS,D3473,SURGICAL REPAIR OF ROOT RESORPTION ? MOLAR,1000.0,650.0,1.1,2660.49,86
HCPCS,D3473,Surg rep root res molar,,,611.63,1664.63,28
HCPCS,D3501,SURGICAL EXPOSURE OF ROOT SURFACE W/O APICOECTOMY OR REPAIR OF R,900.0,585.0,1.1,1230.05,86
HCPCS,D3501,Surg exp root surf anterior,,,611.63,1664.63,28
HCPCS,D3502,SURGICAL EXPOSURE OF ROOT SURFACE W/O APICOECTOMY OR REPAIR OF R,900.0,585.0,1.1,1230.05,86
HCPCS,D3502,Surg exp root surf premolar,,,611.63,1664.63,28
HCPCS,D3503,SURGICAL EXPOSURE OF ROOT SURFACE W/O APICOECTOMY OR REPAIR OF R,900.0,585.0,1.1,1230.05,86
HCPCS,D3503,Surg exp root surf molar,,,611.63,1664.63,28
HCPCS,D3910,Isolation- tooth w rubb dam,,,611.63,1664.63,28
HCPCS,D3910,SURGICAL PROCEDURE FOR ISOLATION OF TOOTH WITH RUBBER DAM,300.0,195.0,1.1,300.0,86
HCPCS,D3911,INTRAORIFICE BARRIER,100.0,65.0,1.1,255.68,80
HCPCS,D3911,Intraorifice barrier,,,611.63,1664.63,28
HCPCS,D3920,"HEMISECTION (INCLUDING ANY ROOT REMOVAL), NOT INCLUDING ROOT CAN",700.0,455.0,1.1,767.05,86
HCPCS,D3920,Tooth splitting,,,611.63,1664.63,28
HCPCS,D3921,DECORONATION OR SUBMERGENCE OF AN ERUPTED TOOTH,550.0,357.5,1.1,1005.46,86
HCPCS,D3921,Decor or submerg erupt tooth,,,611.63,1664.63,28
HCPCS,D3950,CANAL PREPARATION AND FITTING OF PREFORMED DOWEL OR POST,350.0,227.5,1.1,350.0,86
HCPCS,D3950,Canal prep/fitting of dowel,,,611.63,1664.63,28
HCPCS,D3999,Endodontic procedure,,,611.63,1664.63,28
HCPCS,D3999,"UNSPECIFIED ENDODONTIC PROCEDURE, BY REPORT",500.0,325.0,0.01,500.0,80
HCPCS,D4210,GINGIVECTOMY OR GINGIVOPLASTY - FOUR OR MORE CONTIGUOUS TEETH OR,1000.0,650.0,1.1,1219.68,86
HCPCS,D4210,Gingivectomy/plasty 4 or mor,,,1358.5,3450.35,28
HCPCS,D4211,GINGIVECTOMY OR GINGIVOPLASTY - ONE TO THREE CONTIGUOUS TEETH OR,600.0,390.0,1.1,600.0,86
HCPCS,D4211,Gingivectomy/plasty 1 to 3,,,1358.5,3450.35,28
HCPCS,D4212,GINGIVECTOMY OR GINGIVOPLASTY TO ALLOW ACCESS FOR RESTORATIVE PR,500.0,325.0,1.1,1219.68,86
HCPCS,D4212,Gingivectomy/plasty rest,,,1358.5,3450.35,28
HCPCS,D4230,ANATOMICAL CROWN EXPOSURE ? FOUR OR MORE CONTIGUOUS TEETH OR TOO,1400.0,910.0,1.1,1641.22,86
HCPCS,D4230,Ana crown exp 4 or> per quad,,,1358.5,3450.35,28
HCPCS,D4231,ANATOMICAL CROWN EXPOSURE ? ONE TO THREE TEETH OR TOOTH BOUNDED,900.0,585.0,1.1,1641.22,86
HCPCS,D4231,Ana crown exp 1-3 per quad,,,1323.06,1614.71,28
HCPCS,D4240,"GINGIVAL FLAP PROCEDURE, INCLUDING ROOT PLANING - FOUR OR MORE C",1100.0,715.0,1.1,1437.35,86
HCPCS,D4240,Gingival flap proc w/ planin,,,1358.5,3450.35,28
HCPCS,D4241,"GINGIVAL FLAP PROCEDURE, INCLUDING ROOT PLANING - ONE TO THREE C",900.0,585.0,1.1,1437.35,86
HCPCS,D4241,Gngvl flap w rootplan 1-3 th,,,1323.06,1614.71,28
HCPCS,D4245,APICALLY POSITIONED FLAP,800.0,520.0,1.1,1382.07,86
HCPCS,D4245,Apically positioned flap,,,1323.06,1614.71,28
HCPCS,D4249,CLINICAL CROWN LENGTHENING ? HARD TISSUE,1200.0,780.0,1.1,1641.22,86
HCPCS,D4249,Crown lengthen hard tissue,,,611.63,1664.63,28
HCPCS,D4260,OSSEOUS SURGERY (INCLUDING ELEVATION OF A FULL THICKNESS FLAP AN,1500.0,975.0,1.1,2321.88,86
HCPCS,D4260,Osseous surgery 4 or more,,,1358.5,6160.68,28
HCPCS,D4261,OSSEOUS SURGERY (INCLUDING ELEVATION OF A FULL THICKNESS FLAP AN,1200.0,780.0,1.1,2321.88,86
HCPCS,D4261,Osseous surg 1 to 3 teeth,,,1358.5,3450.35,28
HCPCS,D4263,BONE REPLACEMENT GRAFT ? RETAINED NATURAL TOOTH ? FIRST SITE IN,575.0,373.75,1.1,1751.78,86
HCPCS,D4263,Bone replce graft first site,,,611.63,1664.63,28
HCPCS,D4264,BONE REPLACEMENT GRAFT ? RETAINED NATURAL TOOTH ? EACH ADDITIONA,450.0,292.5,1.1,1330.25,86
HCPCS,D4264,Bone replce graft each add,,,1358.5,1573.0,8
HCPCS,D4265,BIO MTRLS TO AID SOFT/OS REG,700.0,455.0,1.1,1872.7,86
HCPCS,D4265,Bio mtrls to aid soft/os reg,,,57.69,1664.63,28
HCPCS,D4266,"GUIDED TISSUE REGENERATION, NATURAL TEETH - RESORBABLE BARRIER,",500.0,325.0,1.1,1872.7,86
HCPCS,D4266,"GUIDED TISSUE REGENERATION, NATURAL TEETH, PER SITE",2000.0,1300.0,0.01,2000.0,84
HCPCS,D4267,"GUIDED TISSUE REGENERATION, NATURAL TEETH ? NON-RESORBABLE BARRI",600.0,390.0,1.1,1983.28,86
HCPCS,D4267,Guided tiss regen nonresorb,,,1323.06,1614.71,28
HCPCS,D4268,"SURGICAL REVISION PROCEDURE, PER TOOTH",800.0,520.0,1.1,800.0,86
HCPCS,D4268,Surgical revision procedure,,,611.63,1664.63,28
HCPCS,D4270,PEDICLE SOFT TISSUE GRAFT PROCEDURE,1100.0,715.0,1.1,1717.23,86
HCPCS,D4270,Pedicle soft tissue graft pr,,,1323.06,1614.71,28
HCPCS,D4273,AUTOGENOUS CONNECTIVE TISSUE GRAFT PROCEDURE (INCLUDING DONOR AN,1300.0,845.0,1.1,1883.08,86
HCPCS,D4273,Auto tissue graft 1st tooth,,,1323.06,1614.71,28
HCPCS,D4274,"MESIAL/DISTAL WEDGE PROCEDURE, SINGLE TOOTH (WHEN NOT PERFORMED",700.0,455.0,1.1,700.0,86
HCPCS,D4274,Mesial/distal wedge proc,,,611.63,1664.63,28
HCPCS,D4275,NON-AUTOGENOUS CONNECTIVE TISSUE GRAFT (INCLUDING RECIPIENT SITE,1450.0,942.5,1.1,1765.6,86
HCPCS,D4275,Non-auto graft 1st tooth,,,1323.06,1614.71,28
HCPCS,D4276,"COMBINED CONNECTIVE TISSUE AND DOUBLE PEDICLE GRAFT, PER TOOTH",1300.0,845.0,1.1,1883.08,86
HCPCS,D4276,Con tissue w pedicle graft,,,1323.06,1614.71,28
HCPCS,D4277,FREE SOFT TISSUE GRAFT PROCEDURE (INCLUDING RECIPIENT AND DONOR,1300.0,845.0,1.1,1790.14,86
HCPCS,D4277,Soft tissue graft firsttooth,,,1323.06,1614.71,28
HCPCS,D4278,FREE SOFT TISSUE GRAFT PROCEDURE (INCLUDING RECIPIENT AND DONOR,1000.0,650.0,1.1,1765.6,86
HCPCS,D4278,Soft tissue graft addl tooth,,,1358.5,1573.0,8
HCPCS,D4283,AUTOGENOUS CONNECTIVE TISSUE GRAFT PROCEDURE (INCLUDING DONOR AN,600.0,390.0,1.1,1917.64,86
HCPCS,D4283,Auto tissue graft addl tooth,,,1358.5,1573.0,8
HCPCS,D4285,NON-AUTOGENOUS CONNECTIVE TISSUE GRAFT PROCEDURE (INCLUDING RECI,650.0,422.5,1.1,1917.64,86
HCPCS,D4285,Non-auto graft addl tooth,,,1358.5,1573.0,8
HCPCS,D4286,REMOVAL OF NON-RESORBABLE BARRIER,200.0,130.0,1.1,1803.6,86
HCPCS,D4286,Remove non-resorb barrier,,,1358.5,1573.0,8
HCPCS,D4320,PROVISIONAL SPLINTING - INTRACORONAL,300.0,195.0,1.1,300.0,68
HCPCS,D4320,Provision splnt intracoronal,,,1358.5,1573.0,8
HCPCS,D4321,PROVISIONAL SPLINTING - EXTRACORONAL,300.0,195.0,1.1,300.0,68
HCPCS,D4321,Provisional splint extracoro,,,1358.5,1573.0,8
HCPCS,D4322,SPLINT ? INTRA-CORONAL; NATURAL TEETH OR PROSTHETIC CROWNS,700.0,455.0,1.1,1060.74,86
HCPCS,D4322,Splint intra-coronal,,,611.63,1664.63,28
HCPCS,D4323,SPLINT ? EXTRA-CORONAL; NATURAL TEETH OR PROSTHETIC CROWNS,675.0,438.75,1.1,929.44,86
HCPCS,D4323,Splint extra-coronal,,,611.63,1664.63,28
HCPCS,D4341,PERIODONTAL SCALING AND ROOT PLANING - FOUR OR MORE TEETH PER QU,350.0,227.5,1.1,480.26,86
HCPCS,D4341,Periodontal scaling & root,,,611.63,1664.63,28
HCPCS,D4342,PERIODONTAL SCALING AND ROOT PLANING - ONE TO THREE TEETH PER QU,275.0,178.75,1.1,480.26,86
HCPCS,D4342,Periodontal scaling 1-3teeth,,,611.63,1664.63,28
HCPCS,D4346,SCALING IN PRESENCE OF GENERALIZED MODERATE OR SEVERE GINGIVAL I,250.0,162.5,1.1,536.66,86
HCPCS,D4346,Scaling gingiv inflammation,,,611.63,1664.63,28
HCPCS,D4355,FULL MOUTH DEBRIDEMENT TO ENABLE A COMPREHENSIVE?PERIODONTAL?EVA,230.0,149.5,1.1,317.87,86
HCPCS,D4355,Full mouth debridement,,,611.63,1664.63,28
HCPCS,D4381,LOCAL DELIV ANTIMICRB 1ST SITE,50.0,32.5,1.1,362.8,86
HCPCS,D4381,LOCALIZED DELIVERY OF ANTIMICROBIAL AGENTS VIA A CONTROLLED RELE,85.0,55.25,1.1,362.8,86
HCPCS,D4381,Localized delivery antimicro,,,57.69,1664.63,28
HCPCS,D4910,PERIODONTAL MAINTENANCE,180.0,117.0,1.1,286.78,86
HCPCS,D4910,Periodontal maint procedures,,,611.63,1664.63,28
HCPCS,D4920,UNSCHEDULED DRESSING CHANGE (BY SOMEONE OTHER THAN TREATING DENT,150.0,97.5,1.1,245.33,86
HCPCS,D4920,Unscheduled dressing change,,,57.69,1664.63,28
HCPCS,D4921,GINGIVAL IRRIGATION?WITH A MEDICINAL AGENT?? PER QUADRANT,100.0,65.0,1.1,100.0,74
HCPCS,D4921,Gingival irrigation per quad,,,57.69,138.55,28
HCPCS,D4999,"UNSPECIFIED PERIODONTAL PROCEDURE, BY REPORT",250.0,162.5,0.01,250.0,80
HCPCS,D4999,Unspecified periodontal proc,,,211.91,1573.0,28
HCPCS,D5110,COMPLETE DENTURE - MAXILLARY,3000.0,1950.0,1.1,3000.0,86
HCPCS,D5110,Dentures complete maxillary,,,1358.5,1573.0,8
HCPCS,D5120,COMPLETE DENTURE - MANDIBULAR,3000.0,1950.0,1.1,3000.0,86
HCPCS,D5120,Dentures complete mandible,,,1358.5,1573.0,8
HCPCS,D5130,Dentures immediat maxillary,,,1358.5,1573.0,8
HCPCS,D5130,IMMEDIATE DENTURE - MAXILLARY,3200.0,2080.0,1.1,3200.0,86
HCPCS,D5140,Dentures immediat mandible,,,1358.5,1573.0,8
HCPCS,D5140,IMMEDIATE DENTURE - MANDIBULAR,3200.0,2080.0,1.1,3200.0,86
HCPCS,D5211,Dentures maxill part resin,,,1358.5,1573.0,8
HCPCS,D5211,"MAXILLARY PARTIAL DENTURE ? RESIN BASE (INCLUDING, RETENTIVE/CLA",2100.0,1365.0,1.1,2228.6,86
HCPCS,D5212,Dentures mand part resin,,,1358.5,1573.0,8
HCPCS,D5212,"MANDIBULAR PARTIAL DENTURE ? RESIN BASE (INCLUDING, RETENTIVE/CL",2100.0,1365.0,1.1,2587.93,86
HCPCS,D5213,Dentures maxill part metal,,,1358.5,1573.0,8
HCPCS,D5213,MAXILLARY PARTIAL DENTURE - CAST METAL FRAMEWORK WITH RESIN DENT,3000.0,1950.0,1.1,3000.0,86
HCPCS,D5214,Dentures mandibl part metal,,,1358.5,1573.0,8
HCPCS,D5214,MANDIBULAR PARTIAL DENTURE - CAST METAL FRAMEWORK WITH RESIN DEN,3000.0,1950.0,1.1,3000.0,86
HCPCS,D5221,IMMEDIATE MAXILLARY PARTIAL DENTURE ? RESIN BASE (INCLUDING ANY,2100.0,1365.0,1.1,3282.43,86
HCPCS,D5221,Immed max part denture resin,,,1358.5,1573.0,8
HCPCS,D5222,IMMEDIATE MANDIBULAR PARTIAL DENTURE ? RESIN BASE (INCLUDING ANY,2100.0,1365.0,1.1,3282.43,86
HCPCS,D5222,Immed man part denture resin,,,1358.5,1573.0,8
HCPCS,D5223,IMMEDIATE MAXILLARY PARTIAL DENTURE ? CAST METAL FRAMEWORK WITH,2300.0,1495.0,1.1,4146.22,86
HCPCS,D5223,Immed max part dent metal,,,1358.5,1573.0,8
HCPCS,D5224,IMMEDIATE MANDIBULAR PARTIAL DENTURE ? CAST METAL FRAMEWORK WITH,2300.0,1495.0,1.1,4146.22,86
HCPCS,D5224,Immed mand part dent metal,,,1358.5,1573.0,8
HCPCS,D5225,"MAXILLARY PARTIAL DENTURE - FLEXIBLE BASE (INCLUDING ANY CLASPS,",2100.0,1365.0,1.1,2916.18,86
HCPCS,D5225,Maxillary part denture flex,,,1358.5,1573.0,8
HCPCS,D5226,MANDIBULAR PARTIAL DENTURE - FLEXIBLE BASE (INCLUDING ANY CLASPS,2100.0,1365.0,1.1,2916.18,86
HCPCS,D5226,Mandibular part denture flex,,,1358.5,1573.0,8
HCPCS,D5227,IMMEDIATE MAXILLARY PARTIAL DENTURE - FLEXIBLE BASE (INCLUDING A,2000.0,1300.0,1.1,3064.75,86
HCPCS,D5227,Immed max part denture,,,1358.5,1573.0,8
HCPCS,D5228,IMMEDIATE MANDIBULAR PARTIAL DENTURE - FLEXIBLE BASE (INCLUDING,2000.0,1300.0,1.1,3064.75,86
HCPCS,D5228,Immed mand part denture,,,1358.5,1573.0,8
HCPCS,D5282,REMOVABLE UNILATERAL PARTIAL DENTURE ? ONE PIECE CAST METAL (INC,1500.0,975.0,1.1,1934.9,86
HCPCS,D5282,"Remove unil part denture,max",,,1358.5,1573.0,8
HCPCS,D5283,REMOVABLE UNILATERAL PARTIAL DENTURE ? ONE PIECE CAST METAL (INC,1500.0,975.0,1.1,1934.9,86
HCPCS,D5283,"Remove unil part denture,man",,,1358.5,1573.0,8
HCPCS,D5284,REMOVABLE UNILATERAL PARTIAL DENTURE - 1 PIECE FLEXIBLE BASE (IN,1500.0,975.0,1.1,1820.88,86
HCPCS,D5284,Rem unilat dent flex base,,,1358.5,1573.0,8
HCPCS,D5286,REMOVABLE UNILATERAL PARTIAL DENTURE - 1 PIECE RESIN (INCLUDING,1500.0,975.0,1.1,1820.88,86
HCPCS,D5286,Rem unilat dent 1 pc resin,,,1358.5,1573.0,8
HCPCS,D5410,ADJUST COMPLETE DENTURE - MAXILLARY,135.0,87.75,1.1,145.11,86
HCPCS,D5410,Dentures adjust cmplt maxil,,,57.69,66.8,8
HCPCS,D5411,ADJUST COMPLETE DENTURE - MANDIBULAR,135.0,87.75,1.1,145.11,86
HCPCS,D5411,Dentures adjust cmplt mand,,,57.69,66.8,8
HCPCS,D5421,ADJUST PARTIAL DENTURE - MAXILLARY,135.0,87.75,1.1,145.11,86
HCPCS,D5421,Dentures adjust part maxill,,,57.69,66.8,8
HCPCS,D5422,ADJUST PARTIAL DENTURE - MANDIBULAR,135.0,87.75,1.1,145.11,86
HCPCS,D5422,Dentures adjust part mandbl,,,57.69,66.8,8
HCPCS,D5511,"REPAIR BROKEN COMPLETE DENTURE BASE, MANDIBULAR",325.0,211.25,1.1,435.35,86
HCPCS,D5511,Rep broke comp dent base man,,,1358.5,1573.0,8
HCPCS,D5512,"REPAIR BROKEN COMPLETE DENTURE BASE, MAXILLARY",325.0,211.25,1.1,435.35,86
HCPCS,D5512,Rep broke comp dent base max,,,1358.5,1573.0,8
HCPCS,D5520,RELACE MISSING OR BROKEN TEETH - COMPLETE DENTURE (PER TOOTH),300.0,195.0,1.1,300.0,86
HCPCS,D5520,Replace denture teeth complt,,,1358.5,1573.0,8
HCPCS,D5611,"REPAIR RESIN PARTIAL DENTURE BASE, MANDIBULAR",325.0,211.25,1.1,435.35,86
HCPCS,D5611,Rep resin part dent base man,,,1358.5,1573.0,8
HCPCS,D5612,"REPAIR RESIN PARTIAL DENTURE BASE, MAXILLARY",325.0,211.25,1.1,435.35,86
HCPCS,D5612,Rep resin part dent base max,,,1358.5,1573.0,8
HCPCS,D5621,"REPAIR CAST PARTIAL FRAMEWORK, MANDIBULAR",425.0,276.25,1.1,611.57,86
HCPCS,D5621,Rep cast part frame man,,,1358.5,1573.0,8
HCPCS,D5622,"REPAIR CAST PARTIAL FRAMEWORK, MAXILLARY",425.0,276.25,1.1,611.57,86
HCPCS,D5622,Rep cast part frame max,,,1358.5,1573.0,8
HCPCS,D5630,REPAIR OR REPLACE BROKEN RETENTIVE CLASPING MATERIALS ? PER TOOT,400.0,260.0,1.1,411.16,86
HCPCS,D5630,Rep partial denture clasp,,,1358.5,1573.0,8
HCPCS,D5640,REPLACE MISSING OR BROKEN TEETH - PARTIAL DENTURE (PER TOOTH),300.0,195.0,1.1,300.0,86
HCPCS,D5640,Replace part denture teeth,,,1358.5,1573.0,8
HCPCS,D5650,ADD TOOTH TO EXISTING PARTIAL DENTURE (PER TOOTH),350.0,227.5,1.1,362.8,86
HCPCS,D5650,Add tooth to partial denture,,,1358.5,1573.0,8
HCPCS,D5660,ADD CLASP TO EXISTING PARTIAL DENTURE - PER TOOTH,400.0,260.0,1.1,431.91,86
HCPCS,D5660,Add clasp to partial denture,,,1358.5,1573.0,8
HCPCS,D5670,REPLACE ALL TEETH AND ACRYLIC ON CAST METAL FRAMEWORK (MAXILLARY,1200.0,780.0,1.1,1200.0,86
HCPCS,D5670,Replc tth&acrlc on mtl frmwk,,,1358.5,1573.0,8
HCPCS,D5671,REPLACE ALL TEETH AND ACRYLIC ON CAST METAL FRAMEWORK (MANDIBULA,1200.0,780.0,1.1,1200.0,86
HCPCS,D5671,Replc tth&acrlc mandibular,,,1358.5,1573.0,8
HCPCS,D5710,Dentures rebase cmplt maxil,,,1358.5,1573.0,8
HCPCS,D5710,REBASE COMPLETE MAXILLARY DENTURE,800.0,520.0,1.1,1071.11,86
HCPCS,D5711,Dentures rebase cmplt mand,,,1358.5,1573.0,8
HCPCS,D5711,REBASE COMPLETE MANDIBULAR DENTURE,800.0,520.0,1.1,1022.73,86
HCPCS,D5720,Dentures rebase part maxill,,,1358.5,1573.0,8
HCPCS,D5720,REBASE MAXILLARY PARTIAL DENTURE,800.0,520.0,1.1,1012.36,86
HCPCS,D5721,Dentures rebase part mandbl,,,1358.5,1573.0,8
HCPCS,D5721,REBASE MANDIBULAR PARTIAL DENTURE,800.0,520.0,1.1,1012.36,86
HCPCS,D5725,REBASE HYBRID PROSTHESIS,1100.0,715.0,1.1,1617.03,86
HCPCS,D5725,Rebase hybrid prosthesis,,,1358.5,1573.0,8
HCPCS,D5730,Denture reln cmplt max dir,,,1358.5,1573.0,8
HCPCS,D5730,RELINE COMPLETE MAXILLARY DENTURE (CHAIRSIDE),600.0,390.0,1.1,604.67,86
HCPCS,D5731,Denture reln cmplt mand dir,,,1358.5,1573.0,8
HCPCS,D5731,RELINE COMPLETE MANDIBULAR DENTURE (CHAIRSIDE),600.0,390.0,1.1,604.67,86
HCPCS,D5740,Denture reln part max dir,,,1358.5,1573.0,8
HCPCS,D5740,RELINE MAXILLARY PARTIAL DENTURE (CHAIRSIDE),600.0,390.0,1.1,600.0,86
HCPCS,D5741,Denture reln part mand dir,,,1358.5,1573.0,8
HCPCS,D5741,RELINE MANDIBULAR PARTIAL DENTURE (CHAIRSIDE),600.0,390.0,1.1,600.0,86
HCPCS,D5750,Denture reln cmplt max indir,,,1358.5,1573.0,8
HCPCS,D5750,RELINE COMPLETE MAXILLARY DENTURE (LABORATORY),800.0,520.0,1.1,808.52,86
HCPCS,D5751,Denture reln cmplt mand ind,,,1358.5,1573.0,8
HCPCS,D5751,RELINE COMPLETE MANDIBULAR DENTURE (LABORATORY),800.0,520.0,1.1,808.52,86
HCPCS,D5760,Denture reln part max indir,,,1358.5,1573.0,8
HCPCS,D5760,RELINE MAXILLARY PARTIAL DENTURE (LABORATORY),800.0,520.0,1.1,800.0,86
HCPCS,D5761,Denture reln part mand indir,,,1358.5,1573.0,8
HCPCS,D5761,RELINE MANDIBULAR PARTIAL DENTURE (LABORATORY),800.0,520.0,1.1,800.0,86
HCPCS,D5765,Liner compl/partial rem dent,,,1358.5,1573.0,8
HCPCS,D5765,SOFT LINER FOR COMPLETE OR PARTIAL REMOVABLE DENTURE ? INDIRECT,500.0,325.0,1.1,1098.75,80
HCPCS,D5810,Denture interm cmplt maxill,,,1358.5,1573.0,8
HCPCS,D5810,INTERIM COMPLETE DENTURE (MAXILLARY),1000.0,650.0,1.1,1278.41,86
HCPCS,D5811,Denture interm cmplt mandbl,,,1358.5,1573.0,8
HCPCS,D5811,INTERIM COMPLETE DENTURE (MANDIBULAR),1000.0,650.0,1.1,1371.71,86
HCPCS,D5820,Denture interm part maxill,,,1358.5,1573.0,8
HCPCS,D5820,ESSIX APPLIANCE - MAXILLARY,300.0,195.0,1.1,988.19,86
HCPCS,D5820,INTERIM MAX RPD - COMPLEX,1200.0,780.0,1.1,1200.0,86
HCPCS,D5820,INTERIM PARTIAL DENTURE (MAXILLARY),300.0,195.0,1.1,988.19,86
HCPCS,D5821,Denture interm part mandbl,,,1358.5,1573.0,8
HCPCS,D5821,ESSIX APPLIANCE - MANDIBULAR,300.0,195.0,1.1,1046.92,86
HCPCS,D5821,INTERIM MAND RPD - COMPLEX,1200.0,780.0,1.1,1200.0,86
HCPCS,D5821,INTERIM PARTIAL DENTURE (MANDIBULAR),500.0,325.0,1.1,1046.92,86
HCPCS,D5850,Denture tiss conditn maxill,,,1358.5,1573.0,8
HCPCS,D5850,"TISSUE CONDITIONING, MAXILLARY",200.0,130.0,1.1,241.86,86
HCPCS,D5851,Denture tiss condtin mandbl,,,1358.5,1573.0,8
HCPCS,D5851,"TISSUE CONDITIONING, MANDIBULAR",200.0,130.0,1.1,252.23,86
HCPCS,D5862,"PRECISION ATTACHMENT, BY REPORT",400.0,260.0,1.1,1271.51,86
HCPCS,D5862,Precision attachment,,,1358.5,1573.0,8
HCPCS,D5863,OVERDENTURE - COMPLETE MAXILLARY - NATURAL TOOTH BORNE,3000.0,1950.0,1.1,3000.0,74
HCPCS,D5863,Overdenture complete max,,,1358.5,1573.0,8
HCPCS,D5864,OVERDENTURE ? PARTIAL MAXILLARY - NATURAL TOOTH BORNE,3000.0,1950.0,1.1,3000.0,74
HCPCS,D5864,Overdenture partial max,,,1358.5,1573.0,8
HCPCS,D5865,OVERDENTURE ? COMPLETE MANDIBULAR - NATURAL TOOTH BORNE,3000.0,1950.0,1.1,3000.0,74
HCPCS,D5865,Overdenture complete mandib,,,1358.5,1573.0,8
HCPCS,D5866,OVERDENTURE ? PARTIAL MANDIBULAR - NATURAL TOOTH BORNE,3000.0,1950.0,1.1,3000.0,74
HCPCS,D5866,Overdenture partial mandib,,,1358.5,1573.0,8
HCPCS,D5867,REPLACEMENT OF REPLACEABLE PART OF SEMI-PRECISION OR PRECISION A,500.0,325.0,1.1,500.0,86
HCPCS,D5867,Replacement of precision att,,,1358.5,1573.0,8
HCPCS,D5875,MODIFICATION OF REMOVABLE PROSTHESIS FOLLOWING IMPLANT SURGERY,500.0,325.0,1.1,500.0,86
HCPCS,D5875,Prosthesis modification,,,1358.5,1573.0,8
HCPCS,D5876,ADD METAL SUBSTRUCTURE TO ACRYLIC COMPLETE DENTURE (PER ARCH),1000.0,650.0,0.01,1000.0,86
HCPCS,D5876,Add metal sub to acrylc dent,,,1358.5,1573.0,8
HCPCS,D5877,DUPLICATION OF COMPLETE DENTURE ? MAXILLARY,1200.0,780.0,1.1,1200.0,68
HCPCS,D5877,Dup of complt dent-maxill,,,1358.5,1573.0,8
HCPCS,D5878,DUPLICATION OF COMPLETE DENTURE ? MANDIBULAR,1200.0,780.0,1.1,1200.0,68
HCPCS,D5878,Dup of complt dent-mandib,,,1358.5,1573.0,8
HCPCS,D5899,Removable prosthodontic proc,,,1358.5,1573.0,8
HCPCS,D5899,"UNSPECIFIED REMOVABLE PROSTHODONTIC PROCEDURE, BY REPORT",250.0,162.5,0.01,250.0,80
HCPCS,D5909,MAXILLARY GUIDANCE PROSTHESIS WITH GUIDE FLANGE,7500.0,4875.0,1.1,7500.0,68
HCPCS,D5909,Max guid prothes w/ flange,,,1358.5,1573.0,8
HCPCS,D5911,FACIAL MOULAGE (SECTIONAL),650.0,422.5,1.1,670.31,86
HCPCS,D5911,Facial moulage sectional,,,611.63,1664.63,28
HCPCS,D5912,FACIAL MOULAGE (COMPLETE),700.0,455.0,1.1,700.0,86
HCPCS,D5912,Facial moulage complete,,,611.63,1664.63,28
HCPCS,D5913,NASAL PROSTHESIS,8000.0,5200.0,1.1,14100.61,86
HCPCS,D5913,Nasal prosthesis,,,1358.5,1573.0,8
HCPCS,D5914,AURICULAR PROSTHESIS,9000.0,5850.0,1.1,14100.61,86
HCPCS,D5914,Auricular prosthesis,,,1358.5,1573.0,8
HCPCS,D5915,ORBITAL PROSTHESIS,8500.0,5525.0,1.1,19082.98,86
HCPCS,D5915,Orbital prosthesis,,,1358.5,1573.0,8
HCPCS,D5916,OCULAR PROSTHESIS,6000.0,3900.0,1.1,10632.79,86
HCPCS,D5916,Ocular prosthesis,,,1358.5,1573.0,8
HCPCS,D5919,FACIAL PROSTHESIS,7500.0,4875.0,1.1,7500.0,80
HCPCS,D5919,Facial prosthesis,,,1358.5,1573.0,8
HCPCS,D5922,NASAL SEPTAL PROSTHESIS,4000.0,2600.0,1.1,5182.77,86
HCPCS,D5922,Nasal septal prosthesis,,,1358.5,1573.0,8
HCPCS,D5923,"OCULAR PROSTHESIS, INTERIM",800.0,520.0,1.1,6075.49,86
HCPCS,D5923,Ocular prosthesis interim,,,1358.5,1573.0,8
HCPCS,D5924,CRANIAL PROSTHESIS,2500.0,1625.0,1.1,5182.77,80
HCPCS,D5924,Cranial prosthesis,,,1358.5,1573.0,8
HCPCS,D5925,FACIAL AUGMENTATION IMPLANT PROSTHESIS,2500.0,1625.0,1.1,5182.77,80
HCPCS,D5925,Facial augmentation implant,,,1358.5,1573.0,8
HCPCS,D5926,"NASAL PROSTHESIS, REPLACEMENT",1200.0,780.0,1.1,5182.77,86
HCPCS,D5926,Replacement nasal prosthesis,,,1358.5,1573.0,8
HCPCS,D5927,"AURICULAR PROSTHESIS, REPLACEMENT",1200.0,780.0,1.1,5182.77,86
HCPCS,D5927,Auricular replacement,,,1358.5,1573.0,8
HCPCS,D5928,"ORBITAL PROSTHESIS, REPLACEMENT",1200.0,780.0,1.1,5182.77,86
HCPCS,D5928,Orbital replacement,,,1358.5,1573.0,8
HCPCS,D5929,"FACIAL PROSTHESIS, REPLACEMENT",3000.0,1950.0,1.1,5182.77,80
HCPCS,D5929,Facial replacement,,,1358.5,1573.0,8
HCPCS,D5930,MAXILLARY GUIDANCE PROSTHESIS WITHOUT GUIDE FLANGE,7500.0,4875.0,1.1,7500.0,68
HCPCS,D5930,Max guid prothes w/o flange,,,1358.5,1573.0,8
HCPCS,D5931,"OBTURATOR PROSTHESIS, SURGICAL",5000.0,3250.0,1.1,7591.04,86
HCPCS,D5931,Surgical obturator,,,1358.5,1573.0,8
HCPCS,D5932,"OBTURATOR PROSTHESIS, DEFINITIVE",7000.0,4550.0,1.1,14200.81,86
HCPCS,D5932,Postsurgical obturator,,,1358.5,1573.0,8
HCPCS,D5933,"OBTURATOR PROSTHESIS, MODIFICATION",850.0,552.5,1.1,1138.69,86
HCPCS,D5933,Refitting of obturator,,,1358.5,1573.0,8
HCPCS,D5934,MANDIBULAR GUIDANCE PROSTHESIS WITH GUIDE FLANGE,5000.0,3250.0,1.1,12943.12,86
HCPCS,D5934,Mandibular flange prosthesis,,,1358.5,1573.0,8
HCPCS,D5935,MANDIBULAR GUIDANCE PROSTHESIS WITHOUT GUIDE FLANGE,5000.0,3250.0,1.1,11260.44,86
HCPCS,D5935,Mandibular denture prosth,,,1358.5,1573.0,8
HCPCS,D5936,"OBTURATOR PROSTHESIS, INTERIM",5000.0,3250.0,1.1,12649.44,86
HCPCS,D5936,Temp obturator prosthesis,,,1358.5,1573.0,8
HCPCS,D5937,TRISMUS APPLIANCE (NOT FOR TMD TREATMENT),1000.0,650.0,1.1,1589.39,86
HCPCS,D5937,Trismus appliance,,,1358.5,1573.0,8
HCPCS,D5938,"RESECTION PROSTHESIS, MAXILLARY COMPLETE REMOVABLE",7500.0,4875.0,1.1,7500.0,68
HCPCS,D5938,Resct proth max comp remov,,,1358.5,1573.0,8
HCPCS,D5939,"RESECTION PROSTHESIS, MANDIBULAR COMPLETE REMOVABLE",7500.0,4875.0,1.1,7500.0,68
HCPCS,D5939,Resct proth mand comp remov,,,1358.5,1573.0,8
HCPCS,D5940,"RESECTION PROSTHESIS, MAXILLARY PARTIAL REMOVABLE",7500.0,4875.0,1.1,7500.0,68
HCPCS,D5940,Resct proth max part remov,,,1358.5,1573.0,8
HCPCS,D5941,"RESECTION PROSTHESIS, MANDIBULAR PARTIAL REMOVABLE",7500.0,4875.0,1.1,7500.0,68
HCPCS,D5941,Resct proth mand part remov,,,1358.5,1573.0,8
HCPCS,D5942,Proth max implt sup remv,,,1358.5,1573.0,8
HCPCS,D5942,"RESECTION PROSTHESIS, MAXILLARY IMPLANT/ABUTMENT SUPPORTED REMOV",7500.0,4875.0,1.1,7500.0,68
HCPCS,D5943,Proth mandib implt sup remv,,,1358.5,1573.0,8
HCPCS,D5943,"RESECTION PROSTHESIS, MANDIBULAR IMPLANT/ABUTMENT SUPPORTED REMO",7500.0,4875.0,1.1,7500.0,68
HCPCS,D5944,Max implt sup remv part,,,1358.5,1573.0,8
HCPCS,D5944,"RESECTION PROSTHESIS, MAXILLARY IMPLANT/ABUTMENT SUPPORTED REMOV",7500.0,4875.0,1.1,7500.0,68
HCPCS,D5945,Mand implt sup remv part,,,1358.5,1573.0,8
HCPCS,D5945,"RESECTION PROSTHESIS, MANDIBULAR IMPLANT/ABUTMENT SUPPORTED REMO",7500.0,4875.0,1.1,7500.0,68
HCPCS,D5946,Max implt sup fix,,,1358.5,1573.0,8
HCPCS,D5946,"RESECTION PROSTHESIS, MAXILLARY IMPLANT/ABUTMENT SUPPORTED FIXED",20000.0,13000.0,1.1,20000.0,68
HCPCS,D5947,Mand implt sup fix,,,1358.5,1573.0,8
HCPCS,D5947,"RESECTION PROSTHESIS, MANDIBULAR IMPLANT/ABUTMENT SUPPORTED FIXE",20000.0,13000.0,1.1,20000.0,68
HCPCS,D5948,Max implt sup fix part,,,1358.5,1573.0,8
HCPCS,D5948,"RESECTION PROSTHESIS, MAXILLARY IMPLANT/ABUTMENT SUPPORTED FIXED",15000.0,9750.0,1.1,15000.0,68
HCPCS,D5949,Mand implt sup fix part,,,1358.5,1573.0,8
HCPCS,D5949,"RESECTION PROSTHESIS, MANDIBULAR IMPLANT/ABUTMENT SUPPORTED FIXE",15000.0,9750.0,1.1,15000.0,68
HCPCS,D5951,FEEDING AID,1800.0,1170.0,1.1,2278.21,86
HCPCS,D5951,Feeding aid,,,1358.5,1573.0,8
HCPCS,D5952,Pediatric speech aid,,,1358.5,1573.0,8
HCPCS,D5952,"SPEECH AID PROSTHESIS, PEDIATRIC",4000.0,2600.0,1.1,6709.96,86
HCPCS,D5953,Adult speech aid,,,1358.5,1573.0,8
HCPCS,D5953,"SPEECH AID PROSTHESIS, ADULT",6000.0,3900.0,1.1,12746.17,86
HCPCS,D5954,PALATAL AUGMENTATION PROSTHESIS,5000.0,3250.0,1.1,11809.82,86
HCPCS,D5954,Superimposed prosthesis,,,1358.5,1573.0,8
HCPCS,D5955,"PALATAL LIFT PROSTHESIS, DEFINITIVE",5000.0,3250.0,1.1,10925.28,86
HCPCS,D5955,Palatal lift prosthesis,,,1358.5,1573.0,8
HCPCS,D5958,Intraoral con def inter plt,,,1358.5,1573.0,8
HCPCS,D5958,"PALATAL LIFT PROSTHESIS, INTERIM",3000.0,1950.0,1.1,10365.55,86
HCPCS,D5959,Intraoral con def mod palat,,,1358.5,1573.0,8
HCPCS,D5959,"PALATAL LIFT PROSTHESIS, MODIFICATION",1000.0,650.0,1.1,10365.55,86
HCPCS,D5960,Modify speech aid prosthesis,,,1358.5,1573.0,8
HCPCS,D5960,"SPEECH AID PROSTHESIS, MODIFICATION",250.0,162.5,1.1,10365.55,86
HCPCS,D5982,SURGICAL STENT FOR SOFT TISSUE HEALING,2000.0,1300.0,1.1,2000.0,86
HCPCS,D5982,Surgical stent,,,1358.5,1573.0,8
HCPCS,D5983,RADIATION CARRIER,2000.0,1300.0,1.1,3178.77,86
HCPCS,D5983,Radiation applicator,,,611.63,1664.63,28
HCPCS,D5984,RADIATION SHIELD,2000.0,1300.0,1.1,3178.77,86
HCPCS,D5984,Radiation shield,,,611.63,1664.63,28
HCPCS,D5985,RADIATION CONE LOCATOR,1800.0,1170.0,1.1,3178.77,86
HCPCS,D5985,Radiation cone locator,,,611.63,1664.63,28
HCPCS,D5986,FLUORIDE GEL CARRIER,200.0,130.0,1.1,269.51,86
HCPCS,D5986,Fluoride applicator,,,57.69,66.8,8
HCPCS,D5987,COMMISSURE SPLINT,500.0,325.0,1.1,4771.61,86
HCPCS,D5987,Commissure splint,,,611.63,1664.63,28
HCPCS,D5988,SURGICAL SPLINT,800.0,520.0,1.1,5079.12,86
HCPCS,D5988,Surgical splint,,,611.63,1664.63,28
HCPCS,D5991,VESICULOBULLOUS DISEASE MEDICAMENT CARRIER,350.0,227.5,1.1,350.0,86
HCPCS,D5991,Vesiculobullous disease carr,,,1358.5,1573.0,8
HCPCS,D5992,"ADJUST MAXILLOFACIAL PROSTHETIC APPLIANCE, BY REPORT",250.0,162.5,1.1,325.71,86
HCPCS,D5992,Adjust max prost appliance,,,1358.5,1573.0,8
HCPCS,D5993,MAINTENANCE AND CLEANING OF A MAXILLOFACIAL PROSTHESIS (EXTRA- O,250.0,162.5,1.1,577.28,86
HCPCS,D5993,Main/clean max prosthesis,,,1358.5,1573.0,8
HCPCS,D5994,Peridontal medicament,,,1358.5,1573.0,8
HCPCS,D5995,"Peri medicament w/seal, max",,,1358.5,1573.0,8
HCPCS,D5996,"Peri medicament w/seal, mand",,,1358.5,1573.0,8
HCPCS,D5999,Maxillofacial prosthesis,,,1358.5,1573.0,8
HCPCS,D5999,"UNSPECIFIED MAXILLOFACIAL PROSTHESIS, BY REPORT",2000.0,1300.0,0.01,2000.0,80
HCPCS,D6010,SURGICAL PLACEMENT OF IMPLANT BODY: ENDOSTEAL IMPLANT,2500.0,1625.0,1.1,4412.27,86
HCPCS,D6010,SURGICAL PLACEMENT OF IMPLANT BODY; ENDOSTEAL IMPLANT,2000.0,1300.0,0.01,2000.0,66
HCPCS,D6011,Second stage implant surgery,,,1358.5,1573.0,8
HCPCS,D6012,Endosteal implant,,,1358.5,1573.0,8
HCPCS,D6012,SURGICAL PLACEMENT OF INTERIM IMPLANT BODY FOR TRANSITIONAL PROS,500.0,325.0,1.1,4412.27,86
HCPCS,D6013,SURGICAL PLACEMENT OF MINI IMPLANT,1000.0,650.0,1.1,1543.8,74
HCPCS,D6013,Surgical place mini implant,,,1358.5,1573.0,8
HCPCS,D6040,Odontics eposteal implant,,,1358.5,1573.0,8
HCPCS,D6049,SCALING AND DEBRIDEMENT OF A SINGLE IMPLANT W INFLAMMATION/BLEED,75.0,48.75,1.1,75.0,68
HCPCS,D6049,Scale implt peri-implt inflm,,,57.69,66.8,8
HCPCS,D6050,Odontics transosteal implnt,,,1358.5,1573.0,8
HCPCS,D6050,SURGICAL PLACEMENT: TRANSOSTEAL IMPLANT,7000.0,4550.0,1.1,12590.69,86
HCPCS,D6051,Interim implant abutment,,,1358.5,1573.0,8
HCPCS,D6051,PLACEMENT OF INTERIM IMPLANT ABUTMENT,700.0,455.0,1.1,700.0,86
HCPCS,D6052,SEMI-PRECISION ATTACHMENT ABUTMENT,500.0,325.0,1.1,500.0,68
HCPCS,D6052,Semi precision attach abut,,,1358.5,1573.0,8
HCPCS,D6055,CONNECTING BAR ? IMPLANT SUPPORTED OR ABUTMENT SUPPORTED,4000.0,2600.0,1.1,4000.0,86
HCPCS,D6055,Implant connecting bar,,,1358.5,1573.0,8
HCPCS,D6056,PREFABRICATED ABUTMENT ? INCLUDES MODIFICATION AND PLACEMENT,900.0,585.0,1.1,1036.55,86
HCPCS,D6056,Prefabricated abutment,,,1358.5,1573.0,8
HCPCS,D6057,CUSTOM FABRICATED ABUTMENT ? INCLUDES PLACEMENT,1100.0,715.0,1.1,2936.91,86
HCPCS,D6057,Custom abutment,,,1358.5,1573.0,8
HCPCS,D6058,ABUTMENT SUPPORTED PORCELAIN/CERAMIC CROWN,1800.0,1170.0,1.1,4146.22,86
HCPCS,D6058,Abutment supported crown,,,1358.5,1573.0,8
HCPCS,D6059,ABUTMENT SUPPORTED PORCELAIN FUSED TO METAL CROWN (HIGH NOBLE ME,1800.0,1170.0,1.1,4146.22,86
HCPCS,D6059,Abutment supported mtl crown,,,1358.5,1573.0,8
HCPCS,D6060,ABUTMENT SUPPORTED PORCELAIN FUSED TO METAL CROWN (PREDOMINANTLY,1800.0,1170.0,1.1,4491.74,86
HCPCS,D6060,Abutment supported mtl crown,,,1358.5,1573.0,8
HCPCS,D6061,ABUTMENT SUPPORTED PORCELAIN FUSED TO METAL CROWN (NOBLE METAL),1800.0,1170.0,1.1,4491.74,86
HCPCS,D6061,Abutment supported mtl crown,,,1358.5,1573.0,8
HCPCS,D6062,ABUTMENT SUPPORTED CAST METAL CROWN (HIGH NOBLE METAL),1800.0,1170.0,1.1,3437.91,86
HCPCS,D6062,Abutment supported mtl crown,,,1358.5,1573.0,8
HCPCS,D6063,ABUTMENT SUPPORTED CAST METAL CROWN (PREDOMINANTLY BASE METAL),1800.0,1170.0,1.1,1800.0,86
HCPCS,D6063,Abutment supported mtl crown,,,1358.5,1573.0,8
HCPCS,D6064,ABUTMENT SUPPORTED CAST METAL CROWN (NOBLE METAL),1800.0,1170.0,1.1,1800.0,86
HCPCS,D6064,Abutment supported mtl crown,,,1358.5,1573.0,8
HCPCS,D6065,IMPLANT SUPPORTED PORCELAIN/CERAMIC CROWN,2000.0,1300.0,1.1,3455.19,86
HCPCS,D6065,Implant supported crown,,,1358.5,1573.0,8
HCPCS,D6066,"IMPLANT SUPPORTED PORCELAIN FUSED TO METAL CROWN (TITANIUM, TITA",2000.0,1300.0,1.1,4750.89,86
HCPCS,D6066,Implant supported mtl crown,,,1358.5,1573.0,8
HCPCS,D6067,"IMPLANT SUPPORTED METAL CROWN (TITANIUM, TITANIUM ALLOY, HIGH NO",2000.0,1300.0,1.1,3109.67,86
HCPCS,D6067,Implant supported mtl crown,,,1358.5,1573.0,8
HCPCS,D6068,ABUTMENT SUPPORTED RETAINER FOR PORCELAIN/CERAMIC FPD,1800.0,1170.0,1.1,1800.0,86
HCPCS,D6068,Abutment supported retainer,,,1358.5,1573.0,8
HCPCS,D6069,ABUTMENT SUPPORTED RETAINER FOR PORCELAIN FUSED TO METAL FPD (HI,1800.0,1170.0,1.1,3627.95,86
HCPCS,D6069,Abutment supported retainer,,,1358.5,1573.0,8
HCPCS,D6070,ABUTMENT SUPPORTED RETAINER FOR PORCELAIN FUSED TO METAL FPD (PR,1800.0,1170.0,1.1,2332.25,86
HCPCS,D6070,Abutment supported retainer,,,1358.5,1573.0,8
HCPCS,D6071,ABUTMENT SUPPORTED RETAINER FOR PORCELAIN FUSED TO METAL FPD (NO,1800.0,1170.0,1.1,2515.38,86
HCPCS,D6071,Abutment supported retainer,,,1358.5,1573.0,8
HCPCS,D6072,ABUTMENT SUPPORTED RETAINER FOR CAST METAL FPD (HIGH NOBLE METAL,1800.0,1170.0,1.1,1800.0,86
HCPCS,D6072,Abutment supported retainer,,,1358.5,1573.0,8
HCPCS,D6073,ABUTMENT SUPPORTED RETAINER FOR CAST METAL FPD (PREDOMINANTLY BA,1800.0,1170.0,1.1,1800.0,86
HCPCS,D6073,Abutment supported retainer,,,1358.5,1573.0,8
HCPCS,D6074,ABUTMENT SUPPORTED RETAINER FOR CAST METAL FPD (NOBLE METAL),1800.0,1170.0,1.1,1800.0,86
HCPCS,D6074,Abutment supported retainer,,,1358.5,1573.0,8
HCPCS,D6075,IMPLANT SUPPORTED RETAINER FOR CERAMIC FPD,2000.0,1300.0,1.1,2000.0,86
HCPCS,D6075,Implant supported retainer,,,1358.5,1573.0,8
HCPCS,D6076,IMPLANT SUPPORTED RETAINER FOR PORCELAIN FUSED TO METAL FPD (TIT,2000.0,1300.0,1.1,2000.0,86
HCPCS,D6076,Implant supported retainer,,,1358.5,1573.0,8
HCPCS,D6077,"IMPLANT SUPPORTED RETAINER FOR CAST METAL FPD (TITANIUM, TITANIU",2000.0,1300.0,1.1,2000.0,86
HCPCS,D6077,Implant supported retainer,,,1358.5,1573.0,8
HCPCS,D6080,IMPLANT MAINTENANCE PROCEDURES WHEN A FULL ARCH FIXED HYBRID PRO,400.0,260.0,1.1,400.0,86
HCPCS,D6080,Implant maintenance,,,57.69,66.8,8
HCPCS,D6081,"SCALING/DEBRIDEMENT OF SINGLE IMPLANT IN PRESENCE OF MUCOSITIS,",250.0,162.5,0.01,306.32,86
HCPCS,D6081,"Scale & debride, single imp",,,57.69,66.8,8
HCPCS,D6082,IMPLANT SUPPORTED CROWN - PORCELAIN FUSED TO PREDOMINANTLY BASE,2000.0,1300.0,1.1,3990.74,86
HCPCS,D6082,Imp crown porc to base alloy,,,1358.5,1573.0,8
HCPCS,D6083,IMPLANT SUPPORTED CROWN - PORCELAIN FUSED TO NOBLE ALLOYS,2000.0,1300.0,1.1,3990.74,86
HCPCS,D6083,Imp crown porc to noble allo,,,1358.5,1573.0,8
HCPCS,D6084,IMPLANT SUPPORTED CROWN - PORCELAIN FUSED TO TITANIUM AND TITANI,2000.0,1300.0,1.1,3990.74,86
HCPCS,D6084,Imp crown porc to titanium,,,1358.5,1573.0,8
HCPCS,D6085,Interim implant crown,,,1358.5,1573.0,8
HCPCS,D6085,PROVISIONAL IMPLANT CROWN,700.0,455.0,1.1,700.0,86
HCPCS,D6086,IMPLANT SUPPORTED CROWN - PREDOMINANTLY BASE ALLOYS,2000.0,1300.0,1.1,3507.02,86
HCPCS,D6086,Imp crown base alloys,,,1358.5,1573.0,8
HCPCS,D6087,IMPLANT SUPPORTED CROWN - NOBLE ALLOYS,2000.0,1300.0,1.1,3507.02,86
HCPCS,D6087,Implant crown noble alloys,,,1358.5,1573.0,8
HCPCS,D6088,IMPLANT SUPPORTED CROWN - TITANIUM AND TITANIUM ALLOYS,2000.0,1300.0,1.1,3507.02,86
HCPCS,D6088,Imp crown titanium alloys,,,1358.5,1573.0,8
HCPCS,D6089,ACCESSING AND RETORQUING LOOSE IMPLANT SCREW - PER SCREW,200.0,130.0,1.1,233.04,86
HCPCS,D6089,Access/retorq implant screw,,,57.69,66.8,8
HCPCS,D6090,REPAIR OF IMPLANT/ABUTMENT SUPPORTED PROSTHESIS,1000.0,650.0,1.1,2073.11,86
HCPCS,D6090,Repair implant,,,1358.5,1573.0,8
HCPCS,D6091,PICK UP OF NEW METAL HOUSING,250.0,162.5,1.1,539.36,86
HCPCS,D6091,REPLACEMENT OF SEMI-PRECISION OR PRECISION ATTACHMENT (MALE OR F,500.0,325.0,1.1,539.36,86
HCPCS,D6091,RETENTIVE INSERT CHANGE,100.0,65.0,1.1,539.36,86
HCPCS,D6091,Repl semi/precision attach,,,1358.5,1573.0,8
HCPCS,D6092,RE-CEMENT OR RE-BOND IMPLANT/ABUTMENT SUPPORTED CROWN,250.0,162.5,1.1,250.0,86
HCPCS,D6092,Recement supp crown,,,57.69,66.8,8
HCPCS,D6093,RE-CEMENT OR RE-BOND IMPLANT/ABUTMENT SUPPORTED FIXED PARTIAL DE,250.0,162.5,1.1,250.0,86
HCPCS,D6093,Recement supp part denture,,,57.69,66.8,8
HCPCS,D6094,ABUTMENT SUPPORTED CROWN - (TITANIUM),2000.0,1300.0,1.1,2073.11,86
HCPCS,D6094,Abut support crown titanium,,,1358.5,1573.0,8
HCPCS,D6095,Odontics repr abutment,,,1358.5,1573.0,8
HCPCS,D6095,"REPAIR IMPLANT ABUTMENT, BY REPORT",900.0,585.0,1.1,900.0,68
HCPCS,D6096,REMOVE BROKEN IMPLANT RETAINING SCREW,1000.0,650.0,1.1,1000.0,86
HCPCS,D6096,Remove broken imp ret screw,,,57.69,66.8,8
HCPCS,D6097,ABUTMENT SUPPORTED CROWN - PORCELAIN FUSED TO TITANIUM AND TITAN,2000.0,1300.0,1.1,3911.26,86
HCPCS,D6097,Abut crown porc to titanium,,,1358.5,1573.0,8
HCPCS,D6098,IMPLANT SUPPORTED RETAINER - PORCELAIN FUSED TO PREDOMINANTLY BA,2000.0,1300.0,1.1,3911.26,86
HCPCS,D6098,Imp retain porc to base allo,,,1358.5,1573.0,8
HCPCS,D6099,IMPLANT SUPPORTED RETAINER FOR FPD - PORCELAIN FUSED TO NOBLE AL,2000.0,1300.0,1.1,3990.74,86
HCPCS,D6099,Imp retainer for fpd,,,1358.5,1573.0,8
HCPCS,D6100,"IMPLANT REMOVAL, BY REPORT",900.0,585.0,1.1,1036.55,86
HCPCS,D6100,Surg removal of implant body,,,1358.5,1573.0,8
HCPCS,D6101,DEBRIDEMENT OF A PERI-IMPLANT DEFECT OR DEFECTS SURROUNDING A SI,900.0,585.0,1.1,900.0,86
HCPCS,D6101,Debridement of a periimplant,,,57.69,66.8,8
HCPCS,D6102,DEBRIDEMENT AND OSSEOUS CONTOURING OF A PERI-IMPLANT DEFECT OR D,1100.0,715.0,1.1,2073.11,86
HCPCS,D6102,Debridement & contouring,,,57.69,66.8,8
HCPCS,D6103,BONE GRAFT FOR REPAIR OF PERI-IMPLANT DEFECT ? DOES NOT INCLUDE,575.0,373.75,1.1,2073.11,86
HCPCS,D6103,Bone graft repair perimplant,,,1358.5,1573.0,8
HCPCS,D6104,BONE GRAFT AT TIME OF IMPLANT PLACEMENT,1287.5,836.875,0.01,2073.11,152
HCPCS,D6105,REMOVAL OF IMPLANT BODY NOT REQUIRING BONE REMOVAL OR FLAP ELEVA,350.0,227.5,0.01,350.0,86
HCPCS,D6105,Remove implant body,,,1358.5,1573.0,8
HCPCS,D6106,"GUIDED TISSUE REGENERATION ? RESORBABLE BARRIER, PER IMPLANT",400.0,260.0,1.1,851.76,86
HCPCS,D6106,"GUIDED TISSUE REGENERATION RESORBABLY BARRIER, PER IMPLANT",2000.0,1300.0,0.01,2000.0,66
HCPCS,D6107,"GUIDED TISSUE REGENERATION ? NON-RESORBABLE BARRIER, PER IMPLANT",500.0,325.0,1.1,979.8,86
HCPCS,D6107,Tissue regen non-resorbable,,,57.69,66.8,8
HCPCS,D6110,IMPLANT /ABUTMENT SUPPORTED REMOVABLE DENTURE FOR EDENTULOUS ARC,4000.0,2600.0,1.1,6195.15,86
HCPCS,D6110,Implnt/abut remov dent max,,,1358.5,1573.0,8
HCPCS,D6111,IMPLANT /ABUTMENT SUPPORTED REMOVABLE DENTURE FOR EDENTULOUS ARC,4000.0,2600.0,1.1,6195.15,86
HCPCS,D6111,Implnt/abut remov dent mand,,,1358.5,1573.0,8
HCPCS,D6112,IMPLANT /ABUTMENT SUPPORTED REMOVABLE DENTURE FOR PARTIALLY EDEN,4000.0,2600.0,1.1,6195.15,86
HCPCS,D6112,Imp/abut rem dent part max,,,1358.5,1573.0,8
HCPCS,D6113,IMPLANT /ABUTMENT SUPPORTED REMOVABLE DENTURE FOR PARTIALLY EDEN,4000.0,2600.0,1.1,6195.15,86
HCPCS,D6113,Imp/abut rem dent part mand,,,1358.5,1573.0,8
HCPCS,D6114,IMPLANT /ABUTMENT SUPPORTED FIXED DENTURE FOR EDENTULOUS ARCH ?,20000.0,13000.0,1.1,20000.0,86
HCPCS,D6114,Implnt/abut fixed dent max,,,1358.5,1573.0,8
HCPCS,D6115,IMPLANT /ABUTMENT SUPPORTED FIXED DENTURE FOR EDENTULOUS ARCH ?,20000.0,13000.0,1.1,20000.0,86
HCPCS,D6115,Implnt/abut fixed dent mand,,,1358.5,1573.0,8
HCPCS,D6116,IMPLANT /ABUTMENT SUPPORTED FIXED DENTURE FOR PARTIALLY EDENTULO,9000.0,5850.0,1.1,9000.0,86
HCPCS,D6116,Imp/abut fixed dent part max,,,1358.5,1573.0,8
HCPCS,D6117,IMPLANT /ABUTMENT SUPPORTED FIXED DENTURE FOR PARTIALLY EDENTULO,9000.0,5850.0,1.1,9000.0,86
HCPCS,D6117,Imp/abut fixed dent part man,,,1358.5,1573.0,8
HCPCS,D6118,IMPLANT/ABUTMENT SUPPORTED INTERIM FIXED DENTURE FOR EDENTULOUS,5000.0,3250.0,1.1,5000.0,74
HCPCS,D6118,Imp/abut int fixed dent man,,,1358.5,1573.0,8
HCPCS,D6119,IMPLANT/ABUTMENT SUPPORTED INTERIM FIXED DENTURE FOR EDENTULOUS,5000.0,3250.0,1.1,5000.0,74
HCPCS,D6119,Int/abut int fixed dent max,,,1358.5,1573.0,8
HCPCS,D6120,IMPLANT SUPPORTED RETAINER - PORCELAIN FUSED TO TITANIUM AND TIT,1600.0,1040.0,1.1,3911.26,86
HCPCS,D6120,Imp retain porc to titanium,,,1358.5,1573.0,8
HCPCS,D6121,IMPLANT SUPPORTED RETAINER FOR METAL FPD - PREDOMINANTLY BASE AL,1600.0,1040.0,1.1,3624.49,86
HCPCS,D6121,Retain metal fpd base alloys,,,1358.5,1573.0,8
HCPCS,D6122,IMPLANT SUPPORTED RETAINER FOR METAL FPD - NOBLE ALLOYS,1600.0,1040.0,1.1,3914.72,86
HCPCS,D6122,Retain metal fpd noble alloy,,,1358.5,1573.0,8
HCPCS,D6123,IMPLANT SUPPORTED RETAINER FOR METAL FPD - TITANIUM AND TITANIUM,1600.0,1040.0,1.1,3624.49,86
HCPCS,D6123,Retain metal fpd titanium,,,1358.5,1573.0,8
HCPCS,D6180,IMPLANT MAINTENANCE PROCEDURES WHEN A FULL ARCH FIXED HYBRID PRO,125.0,81.25,1.1,300.61,86
HCPCS,D6180,Implnt maint proced,,,57.69,66.8,8
HCPCS,D6190,SURGICAL INDEX - FULLY GUIDED,1000.0,650.0,1.1,2073.11,86
HCPCS,D6190,SURGICAL INDEX - NON-GUIDED,350.0,227.5,1.1,2073.11,86
HCPCS,D6190,SURGICAL INDEX-FULLY GUIDED,2000.0,1300.0,0.01,2000.0,66
HCPCS,D6191,SEMI-PRECISION ABUTMENT ? PLACEMENT,826.0,536.9,1.1,1129.84,80
HCPCS,D6191,Semi precision abutment,,,1358.5,1573.0,8
HCPCS,D6192,Semi precision attachment,,,1358.5,1573.0,8
HCPCS,D6193,REPLACEMENT OF AN IMPLANT SCREW,150.0,97.5,1.1,632.3,86
HCPCS,D6193,Replace implnt screw,,,57.69,66.8,8
HCPCS,D6194,ABUTMENT SUPPORTED RETAINER CROWN FOR FPD (TITANIUM),1600.0,1040.0,1.1,2073.11,86
HCPCS,D6194,Abut support retainer titani,,,1358.5,1573.0,8
HCPCS,D6195,ABUTMENT SUPPORTED RETAINER - PORCELAIN FUSED TO TITANIUM AND TI,1600.0,1040.0,1.1,3911.26,86
HCPCS,D6195,Abut retain porc to titanium,,,1358.5,1573.0,8
HCPCS,D6196,REMOVAL OF AN INDIRECT RESTORATION ON AN IMPLANT RETAINED ABUTME,100.0,65.0,1.1,100.0,68
HCPCS,D6196,Remv of ind rest on implt,,,1358.5,1573.0,8
HCPCS,D6197,REPLACEMENT OF RESTORATIVE MATERIAL USED TO CLOSE AN ACCESS OPEN,200.0,130.0,0.01,306.32,86
HCPCS,D6197,Replace material prosthesis,,,1358.5,1573.0,8
HCPCS,D6198,REMOVE INTERIM IMPLANT COMPONENT,400.0,260.0,1.1,400.0,86
HCPCS,D6198,Remove interim implant,,,1358.5,1573.0,8
HCPCS,D6199,Implant procedure,,,1358.5,1573.0,8
HCPCS,D6199,RESIDENT IMPLANT PROMO,2200.0,1430.0,1.1,2619.04,80
HCPCS,D6205,Pontic-indirect resin based,,,1358.5,1573.0,8
HCPCS,D6210,PONTIC - CAST HIGH NOBLE METAL,1500.0,975.0,1.1,2176.76,86
HCPCS,D6210,Prosthodont high noble metal,,,1358.5,1573.0,8
HCPCS,D6211,Bridge base metal cast,,,1358.5,1573.0,8
HCPCS,D6211,PONTIC - CAST PREDOMINANTLY BASE METAL,1500.0,975.0,1.1,2038.56,86
HCPCS,D6212,Bridge noble metal cast,,,1358.5,1573.0,8
HCPCS,D6212,PONTIC - CAST NOBLE METAL,1500.0,975.0,1.1,2121.48,86
HCPCS,D6214,PONTIC - TITANIUM,1500.0,975.0,1.1,2121.48,86
HCPCS,D6214,Pontic titanium,,,1358.5,1573.0,8
HCPCS,D6240,Bridge porcelain high noble,,,1358.5,1573.0,8
HCPCS,D6240,PONTIC - PORCELAIN FUSED TO HIGH NOBLE METAL,1500.0,975.0,1.1,2149.12,86
HCPCS,D6241,Bridge porcelain base metal,,,1358.5,1573.0,8
HCPCS,D6241,PONTIC - PORCELAIN FUSED TO PREDOMINANTLY BASE METAL,1500.0,975.0,1.1,1983.28,86
HCPCS,D6242,Bridge porcelain nobel metal,,,1358.5,1573.0,8
HCPCS,D6242,PONTIC - PORCELAIN FUSED TO NOBLE METAL,1500.0,975.0,1.1,2093.84,86
HCPCS,D6243,PONTIC - PORCELAIN FUSED TO TITANIUM AND TITANIUM ALLOYS,1500.0,975.0,1.1,2501.56,86
HCPCS,D6243,Pontic porcelain to titanium,,,1358.5,1573.0,8
HCPCS,D6245,Bridge porcelain/ceramic,,,1358.5,1573.0,8
HCPCS,D6245,PONTIC - PORCELAIN/CERAMIC,1500.0,975.0,1.1,2073.11,86
HCPCS,D6250,Bridge resin w/high noble,,,1358.5,1573.0,8
HCPCS,D6250,PONTIC - RESIN WITH HIGH NOBLE METAL,1500.0,975.0,1.1,2121.48,86
HCPCS,D6251,Bridge resin base metal,,,1358.5,1573.0,8
HCPCS,D6251,PONTIC - RESIN WITH PREDOMINANTLY BASE METAL,1500.0,975.0,1.1,1955.64,86
HCPCS,D6252,Bridge resin w/noble metal,,,1358.5,1573.0,8
HCPCS,D6252,PONTIC - RESIN WITH NOBLE METAL,1500.0,975.0,1.1,2017.83,86
HCPCS,D6253,Interim pontic,,,1358.5,1573.0,8
HCPCS,D6253,PROVISIONAL PONTIC - FURTHER TREATMENT OR COMPLETION OF DIAGNOSI,500.0,325.0,1.1,2017.83,86
HCPCS,D6280,IMPLANT MAINTENANCE PROCEDURES WHEN A FULL ARCH REMOVABLE IMPLAN,250.0,162.5,1.1,250.0,68
HCPCS,D6280,Implt maint procd remv implt,,,57.69,66.8,8
HCPCS,D6545,Dental retainr cast metl,,,1358.5,1573.0,8
HCPCS,D6545,RETAINER - CAST METAL FOR RESIN BONDED FIXED PROSTHESIS,1200.0,780.0,1.1,1200.0,86
HCPCS,D6548,Porcelain/ceramic retainer,,,1358.5,1573.0,8
HCPCS,D6548,RETAINER - PORCELAIN/CERAMIC FOR RESIN BONDED FIXED PROSTHESIS,1300.0,845.0,1.1,1300.0,86
HCPCS,D6549,RETAINER ? FOR RESIN BONDED FIXED PROSTHESIS,1300.0,845.0,1.1,2332.25,86
HCPCS,D6549,Resin retainer,,,1358.5,1573.0,8
HCPCS,D6600,Porcelain/ceramic inlay 2srf,,,1358.5,1573.0,8
HCPCS,D6600,"RETAINER INLAY - PORCELAIN/CERAMIC, TWO SURFACES",1400.0,910.0,1.1,1872.7,86
HCPCS,D6601,Porc/ceram inlay >= 3 surfac,,,1358.5,1573.0,8
HCPCS,D6601,"RETAINER INLAY - PORCELAIN/CERAMIC, THREE OR MORE SURFACES",1500.0,975.0,1.1,2149.12,86
HCPCS,D6602,Cst hgh nble mtl inlay 2 srf,,,1358.5,1573.0,8
HCPCS,D6602,"RETAINER INLAY - CAST HIGH NOBLE METAL, TWO SURFACES",1400.0,910.0,1.1,1872.7,86
HCPCS,D6603,Cst hgh nble mtl inlay >=3sr,,,1358.5,1573.0,8
HCPCS,D6603,"RETAINER INLAY - CAST HIGH NOBLE METAL, THREE OR MORE SURFACES",1500.0,975.0,1.1,2149.12,86
HCPCS,D6604,Cst bse mtl inlay 2 surfaces,,,1358.5,1573.0,8
HCPCS,D6604,"RETAINER INLAY - CAST PREDOMINANTLY BASE METAL, TWO SURFACES",1400.0,910.0,1.1,1872.7,86
HCPCS,D6605,Cst bse mtl inlay >= 3 surfa,,,1358.5,1573.0,8
HCPCS,D6605,"RETAINER INLAY - CAST PREDOMINANTLY BASE METAL, THREE OR MORE SU",1500.0,975.0,1.1,2149.12,86
HCPCS,D6606,Cast noble metal inlay 2 sur,,,1358.5,1573.0,8
HCPCS,D6606,"RETAINER INLAY - CAST NOBLE METAL, TWO SURFACES",1500.0,975.0,1.1,1872.7,86
HCPCS,D6607,Cst noble mtl inlay >=3 surf,,,1358.5,1573.0,8
HCPCS,D6607,"RETAINER INLAY - CAST NOBLE METAL, THREE OR MORE SURFACES",1600.0,1040.0,1.1,2149.12,86
HCPCS,D6608,Onlay porc/crmc 2 surfaces,,,1358.5,1573.0,8
HCPCS,D6608,"RETAINER ONLAY - PORCELAIN/CERAMIC, TWO SURFACES",1500.0,975.0,1.1,2200.95,86
HCPCS,D6609,Onlay porc/crmc >=3 surfaces,,,1358.5,1573.0,8
HCPCS,D6609,"RETAINER ONLAY - PORCELAIN/CERAMIC, THREE OR MORE SURFACES",1600.0,1040.0,1.1,2200.95,86
HCPCS,D6610,Onlay cst hgh nbl mtl 2 srfc,,,1358.5,1573.0,8
HCPCS,D6610,"RETAINER ONLAY - CAST HIGH NOBLE METAL, TWO SURFACES",1600.0,1040.0,1.1,2200.95,86
HCPCS,D6611,Onlay cst hgh nbl mtl >=3srf,,,1358.5,1573.0,8
HCPCS,D6611,"RETAINER ONLAY - CAST HIGH NOBLE METAL, THREE OR MORE SURFACES",1600.0,1040.0,1.1,2200.95,86
HCPCS,D6612,Onlay cst base mtl 2 surface,,,1358.5,1573.0,8
HCPCS,D6612,"RETAINER ONLAY - CAST PREDOMINANTLY BASE METAL, TWO SURFACES",1500.0,975.0,1.1,2200.95,86
HCPCS,D6613,Onlay cst base mtl >=3 surfa,,,1358.5,1573.0,8
HCPCS,D6613,"RETAINER ONLAY - CAST PREDOMINANTLY BASE METAL, THREE OR MORE SU",1600.0,1040.0,1.1,2200.95,86
HCPCS,D6614,Onlay cst nbl mtl 2 surfaces,,,1358.5,1573.0,8
HCPCS,D6614,"RETAINER ONLAY - CAST NOBLE METAL, TWO SURFACES",1500.0,975.0,1.1,2200.95,86
HCPCS,D6615,Onlay cst nbl mtl >=3 surfac,,,1358.5,1573.0,8
HCPCS,D6615,"RETAINER ONLAY - CAST NOBLE METAL, THREE OR MORE SURFACES",1600.0,1040.0,1.1,2200.95,86
HCPCS,D6624,Inlay titanium,,,1358.5,1573.0,8
HCPCS,D6624,RETAINER INLAY - TITANIUM,1500.0,975.0,1.1,1872.7,86
HCPCS,D6634,Onlay titanium,,,1358.5,1573.0,8
HCPCS,D6634,RETAINER ONLAY - TITANIUM,1600.0,1040.0,1.1,2200.95,86
HCPCS,D6710,Crown-indirect resin based,,,1358.5,1573.0,8
HCPCS,D6710,RETAINER CROWN - INDIRECT RESIN BASED COMPOSITE,1500.0,975.0,1.1,2394.44,86
HCPCS,D6720,RETAINER CROWN - RESIN WITH HIGH NOBLE METAL,1600.0,1040.0,1.1,2394.44,86
HCPCS,D6720,Retain crown resin w hi nble,,,1358.5,1573.0,8
HCPCS,D6721,Crown resin w/base metal,,,1358.5,1573.0,8
HCPCS,D6721,RETAINER CROWN - RESIN WITH PREDOMINANTLY BASE METAL,1500.0,975.0,1.1,2270.05,86
HCPCS,D6722,Crown resin w/noble metal,,,1358.5,1573.0,8
HCPCS,D6722,RETAINER CROWN - RESIN WITH NOBLE METAL,1500.0,975.0,1.1,2311.51,86
HCPCS,D6740,Crown porcelain/ceramic,,,1358.5,1573.0,8
HCPCS,D6740,RETAINER CROWN - PORCELAIN/CERAMIC,1600.0,1040.0,1.1,2418.63,86
HCPCS,D6750,Crown porcelain high noble,,,1358.5,1573.0,8
HCPCS,D6750,RETAINER CROWN - PORCELAIN FUSED TO HIGH NOBLE METAL,1600.0,1040.0,1.1,2453.18,86
HCPCS,D6751,Crown porcelain base metal,,,1358.5,1573.0,8
HCPCS,D6751,RETAINER CROWN - PORCELAIN FUSED TO PREDOMINANTLY BASE METAL,1500.0,975.0,1.1,2287.33,86
HCPCS,D6752,Crown porcelain noble metal,,,1358.5,1573.0,8
HCPCS,D6752,RETAINER CROWN - PORCELAIN FUSED TO NOBLE METAL,1600.0,1040.0,1.1,2342.62,86
HCPCS,D6753,RETAINER CROWN - PORCELAIN FUSED TO TITANIUM AND TITANIUM ALLOYS,1600.0,1040.0,1.1,2501.56,86
HCPCS,D6753,Retain crown porc to titaniu,,,1358.5,1573.0,8
HCPCS,D6780,Crown 3/4 high noble metal,,,1358.5,1573.0,8
HCPCS,D6780,RETAINER CROWN - 3/4 CAST HIGH NOBLE METAL,1600.0,1040.0,1.1,2311.51,86
HCPCS,D6781,Crown 3/4 cast based metal,,,1358.5,1573.0,8
HCPCS,D6781,RETAINER CROWN - 3/4 CAST PREDOMINANTLY BASE METAL,1600.0,1040.0,1.1,2314.98,86
HCPCS,D6782,Crown 3/4 cast noble metal,,,1358.5,1573.0,8
HCPCS,D6782,RETAINER CROWN - 3/4 CAST NOBLE METAL,1600.0,1040.0,1.1,2314.98,86
HCPCS,D6783,Crown 3/4 porcelain/ceramic,,,1358.5,1573.0,8
HCPCS,D6783,RETAINER CROWN - 3/4 PORCELAIN/CERAMIC,1600.0,1040.0,1.1,2314.98,86
HCPCS,D6784,RETAINER CROWN 3/4 - TITANIUM AND TITANIUM ALLOYS,1600.0,1040.0,1.1,2501.56,86
HCPCS,D6784,Retainer crown 3/4 titanium,,,1358.5,1573.0,8
HCPCS,D6790,Crown full high noble metal,,,1358.5,1573.0,8
HCPCS,D6790,RETAINER CROWN - FULL CAST HIGH NOBLE METAL,1600.0,1040.0,1.1,2366.81,86
HCPCS,D6791,Crown full base metal cast,,,1358.5,1573.0,8
HCPCS,D6791,RETAINER CROWN - FULL CAST PREDOMINANTLY BASE METAL,1500.0,975.0,1.1,2242.41,86
HCPCS,D6792,Crown full noble metal cast,,,1358.5,1573.0,8
HCPCS,D6792,RETAINER CROWN - FULL CAST NOBLE METAL,1600.0,1040.0,1.1,2325.33,86
HCPCS,D6793,Interim retainer crown,,,1358.5,1573.0,8
HCPCS,D6793,PROVISIONAL RETAINER CROWN,500.0,325.0,1.1,2270.05,86
HCPCS,D6794,Crown titanium,,,1358.5,1573.0,8
HCPCS,D6794,RETAINER CROWN - TITANIUM,1600.0,1040.0,1.1,2270.05,86
HCPCS,D6920,CONNECTOR BAR,1600.0,1040.0,1.1,1600.0,86
HCPCS,D6920,Dental connector bar,,,611.63,1664.63,28
HCPCS,D6930,RE-CEMENT OR RE-BOND FIXED PARTIAL DENTURE,250.0,162.5,1.1,286.78,86
HCPCS,D6930,Recement/bond part denture,,,1358.5,1573.0,8
HCPCS,D6940,STRESS BREAKER,700.0,455.0,1.1,700.0,86
HCPCS,D6940,Stress breaker,,,1358.5,1573.0,8
HCPCS,D6950,PRECISION ATTACHMENT,900.0,585.0,1.1,1271.51,86
HCPCS,D6950,Precision attachment,,,1358.5,1573.0,8
HCPCS,D6980,FIXED PARTIAL DENTURE REPAIR NECESSITATED BY RESTORATIVE MATERIA,500.0,325.0,1.1,677.21,86
HCPCS,D6980,Fixed partial repair,,,1358.5,1573.0,8
HCPCS,D6985,PEDIATRIC PARTIAL DENTURE FX,2000.0,1300.0,1.1,2916.18,86
HCPCS,D6985,Pediatric partial denture fx,,,1358.5,1573.0,8
HCPCS,D6999,Fixed prosthodontic proc,,,1358.5,1573.0,8
HCPCS,D6999,"UNSPECIFIED FIXED PROSTHODONTIC PROCEDURE, BY REPORT",900.0,585.0,0.01,900.0,80
HCPCS,D7111,"EXTRACTION, CORONAL REMNANTS ? PRIMARY TOOTH",175.0,113.75,1.1,290.24,86
HCPCS,D7111,Extraction coronal remnants,,,611.63,1664.63,28
HCPCS,D7140,"EXTRACTION, ERUPTED TOOTH OR EXPOSED ROOT",2000.0,1300.0,0.01,2000.0,84
HCPCS,D7140,"EXTRACTION, ERUPTED TOOTH OR EXPOSED ROOT (ELEVATION AND/OR FORC",300.0,195.0,1.1,300.0,86
HCPCS,D7210,"EXTRACTION, ERUPTED TOOTH REQUIRING REMOVAL OF BONE AND/OR SECTI",400.0,260.0,1.1,463.0,86
HCPCS,D7210,SURGICAL EXTRACTION ERUPTED TOOTH,2000.0,1300.0,0.01,2000.0,84
HCPCS,D7220,IMPCT TOOTH REMOV SOFT TISS TECH,2000.0,1300.0,0.01,2000.0,84
HCPCS,D7220,REMOVAL OF IMPACTED TOOTH - SOFT TISSUE,500.0,325.0,1.1,580.48,86
HCPCS,D7230,IMPCT TOOTH REMOV PART BONY TECH,2000.0,1300.0,0.01,2000.0,84
HCPCS,D7230,REMOVAL OF IMPACTED TOOTH - PARTIALLY BONY,550.0,357.5,1.1,773.96,86
HCPCS,D7240,IMPCT TOOTH REMOV COMP BONY TECH,2000.0,1300.0,0.01,2000.0,84
HCPCS,D7240,REMOVAL OF IMPACTED TOOTH - COMPLETELY BONY,650.0,422.5,1.1,908.72,86
HCPCS,D7241,COMPLICATED FULL BONY EXTRACTION,2000.0,1300.0,0.01,2000.0,84
HCPCS,D7241,"REMOVAL OF IMPACTED TOOTH - COMPLETELY BONY, WITH UNUSUAL SURGIC",750.0,487.5,1.1,1143.67,86
HCPCS,D7250,REMOVAL OF RESIDUAL TOOTH ROOTS (CUTTING PROCEDURE),400.0,260.0,1.1,490.63,86
HCPCS,D7250,REMOVE RESIDUAL ROOT,2000.0,1300.0,0.01,2000.0,84
HCPCS,D7251,"CORONECTOMY ? INTENTIONAL PARTIAL TOOTH REMOVAL, IMPACTED TEETH",600.0,390.0,1.1,770.61,86
HCPCS,D7251,Coronectomy,,,1323.06,1614.71,28
HCPCS,D7252,PARTIAL EXTRACTION FOR IMMEDIATE IMPLANT PLACEMENT,300.0,195.0,1.1,300.0,74
HCPCS,D7252,Part extract for implant,,,1358.5,1573.0,8
HCPCS,D7259,NERVE DISSECTION,500.0,325.0,1.1,500.0,68
HCPCS,D7259,Nerve dissection,,,1358.5,1573.0,8
HCPCS,D7260,OROANTRAL FISTULA CLOSURE,1600.0,1040.0,1.1,4816.53,86
HCPCS,D7260,Oral antral fistula closure,,,611.63,1664.63,28
HCPCS,D7261,PRIMARY CLOSURE OF A SINUS PERFORATION,1100.0,715.0,1.1,4720.48,86
HCPCS,D7261,Primary closure sinus perf,,,611.63,1664.63,28
HCPCS,D7270,TOOTH REIMPLANTATION AND/OR STABILIZATION OF ACCIDENTALLY EVULSE,800.0,520.0,1.1,998.54,86
HCPCS,D7270,Tooth reimplantation,,,611.63,1664.63,28
HCPCS,D7272,TOOTH TRANSPLANTATION (INCLUDES REIMPLANTATION FROM ONE SITE TO,1000.0,650.0,1.1,1420.08,86
HCPCS,D7272,Tooth transplantation,,,611.63,1664.63,28
HCPCS,D7280,EXPOSURE OF AN UNERUPTED TOOTH,650.0,422.5,1.1,1095.3,86
HCPCS,D7280,Exposure of unerupted tooth,,,611.63,1664.63,28
HCPCS,D7282,MOBILIZATION OF ERUPTED OR MALPOSITIONED TOOTH TO AID ERUPTION,600.0,390.0,1.1,925.99,86
HCPCS,D7282,Mobilize erupted/malpos toot,,,1358.5,1573.0,8
HCPCS,D7283,PLACEMENT OF DEVICE TO FACILITATE ERUPTION OF IMPACTED TOOTH,600.0,390.0,1.1,925.99,86
HCPCS,D7283,Place device impacted tooth,,,1358.5,1573.0,8
HCPCS,D7284,EXCISIONAL BIOPSY OF MINOR SALIVARY GLANDS,600.0,390.0,1.1,1143.67,86
HCPCS,D7284,Exc biopsy of saliv glands,,,1358.5,1573.0,8
HCPCS,D7285,Biopsy of oral tissue hard,,,1358.5,1573.0,8
HCPCS,D7285,"INCISIONAL BIOPSY OF ORAL TISSUE-HARD (BONE, TOOTH)",800.0,520.0,1.1,1934.9,86
HCPCS,D7286,Biopsy of oral tissue soft,,,1358.5,1573.0,8
HCPCS,D7286,INCISIONAL BIOPSY OF ORAL TISSUE-SOFT,500.0,325.0,1.1,794.69,86
HCPCS,D7287,EXFOLIATIVE CYTOLOGICAL SAMPLE COLLECTION,300.0,195.0,1.1,300.0,86
HCPCS,D7287,Exfoliative cytolog collect,,,1358.5,1573.0,8
HCPCS,D7288,BRUSH BIOPSY - TRANSEPITHELIAL SAMPLE COLLECTION,300.0,195.0,1.1,1934.9,86
HCPCS,D7288,Brush biopsy,,,1358.5,1573.0,8
HCPCS,D7290,Repositioning of teeth,,,1358.5,1573.0,8
HCPCS,D7290,SURGICAL REPOSITIONING OF TEETH,600.0,390.0,1.1,1339.03,86
HCPCS,D7291,"TRANSSEPTAL FIBEROTOMY/SUPRA CRESTAL FIBEROTOMY, BY REPORT",400.0,260.0,1.1,1036.55,86
HCPCS,D7291,Transseptal fiberotomy,,,611.63,1664.63,28
HCPCS,D7292,PLACEMENT OF TEMPORARY ANCHORAGE DEVICE [SCREW RETAINED PLATE] R,3900.0,2535.0,1.1,8519.64,86
HCPCS,D7292,Screw retained plate,,,1358.5,1573.0,8
HCPCS,D7293,PLACEMENT OF TEMPORARY ANCHORAGE DEVICE REQUIRING FLAP; INCLUDES,250.0,162.5,1.1,9005.98,86
HCPCS,D7293,Temp anchorage dev w flap,,,1358.5,1573.0,8
HCPCS,D7294,PLACEMENT OF TEMPORARY ANCHORAGE DEVICE WITHOUT FLAP; INCLUDES D,250.0,162.5,1.1,5922.81,86
HCPCS,D7294,Temp anchorage dev w/o flap,,,1358.5,1573.0,8
HCPCS,D7295,"Bone harvest,auto graft proc",,,1358.5,1573.0,8
HCPCS,D7295,HARVEST OF BONE FOR USE IN AUTOGENOUS GRAFTING PROCEDURE,1400.0,910.0,1.1,2272.05,86
HCPCS,D7296,"CORTICOTOMY ? ONE TO THREE TEETH OR TOOTH SPACES, PER QUADRANT",1800.0,1170.0,1.1,1948.1,86
HCPCS,D7296,"Corticotomy, 1-3 teeth",,,1358.5,1573.0,8
HCPCS,D7297,"CORTICOTOMY ? FOUR OR MORE TEETH OR TOOTH SPACES, PER QUADRANT",1500.0,975.0,1.1,2028.4,86
HCPCS,D7297,"Corticotomy, 4 or more teeth",,,1358.5,1573.0,8
HCPCS,D7298,"REMOVAL OF TEMPORARY ANCHORAGE DEVICE (SCREW RETAINED PLATE), RE",1000.0,650.0,1.1,1000.0,80
HCPCS,D7298,Remove screw retained plate,,,1358.5,1573.0,8
HCPCS,D7299,"REMOVAL OF TEMPORARY ANCHORAGE DEVICE, REQUIRING FLAP",900.0,585.0,1.1,901.81,80
HCPCS,D7299,Rem anchorage device w/flap,,,1358.5,1573.0,8
HCPCS,D7300,REMOVAL OF TEMPORARY ANCHORAGE DEVICE WITHOUT FLAP,500.0,325.0,1.1,901.81,80
HCPCS,D7300,Rem anchorage dev w/o flap,,,1358.5,1573.0,8
HCPCS,D7310,ALVEOLOPLASTY IN CONJUNCTION WITH EXTRACTIONS - FOUR OR MORE TEE,500.0,325.0,1.1,542.47,86
HCPCS,D7310,Alveoplasty w/ extraction,,,1323.06,1614.71,28
HCPCS,D7311,ALVEOLOPLASTY IN CONJUNCTION WITH EXTRACTIONS - ONE TO THREE TEE,400.0,260.0,1.1,542.47,86
HCPCS,D7311,Alveoloplasty w/extract 1-3,,,1323.06,1614.71,28
HCPCS,D7320,ALVEOLOPLASTY NOT IN CONJUNCTION WITH EXTRACTIONS - FOUR OR MORE,700.0,455.0,1.1,2418.63,86
HCPCS,D7320,Alveoplasty w/o extraction,,,1358.5,1614.71,27
HCPCS,D7321,ALVEOLOPLASTY NOT IN CONJUNCTION WITH EXTRACTIONS - ONE TO THREE,600.0,390.0,1.1,2418.63,86
HCPCS,D7321,Alveoloplasty not w/extracts,,,1358.5,1614.71,27
HCPCS,D7340,VESTIBULOPLASTY - RIDGE EXTENSION (SECONDARY EPITHELIALIZATION),1800.0,1170.0,1.1,4329.35,86
HCPCS,D7340,Vestibuloplasty ridge extens,,,1358.5,6160.68,28
HCPCS,D7350,"VESTIBULOPLASTY - RIDGE EXTENSION (INCLUDING SOFT TISSUE GRAFTS,",3600.0,2340.0,1.1,13533.95,86
HCPCS,D7350,Vestibuloplasty exten graft,,,1358.5,6160.68,28
HCPCS,D7410,EXCISION OF BENIGN LESION UP TO 1.25 CM,600.0,390.0,1.1,3006.01,86
HCPCS,D7410,Rad exc lesion up to 1.25 cm,,,1323.06,1614.71,28
HCPCS,D7411,EXCISION OF BENIGN LESION GREATER THAN 1.25 CM,800.0,520.0,1.1,800.0,86
HCPCS,D7411,Excision benign lesion>1.25c,,,1323.06,1614.71,28
HCPCS,D7412,"EXCISION OF BENIGN LESION, COMPLICATED",1500.0,975.0,1.1,2947.27,86
HCPCS,D7412,Excision benign lesion compl,,,1323.06,1614.71,28
HCPCS,D7413,EXCISION OF MALIGNANT LESION UP TO 1.25 CM,1000.0,650.0,1.1,3044.02,86
HCPCS,D7413,Excision malig lesion<=1.25c,,,1323.06,1614.71,28
HCPCS,D7414,EXCISION OF MALIGNANT LESION GREATER THAN 1.25 CM,1500.0,975.0,1.1,4733.6,86
HCPCS,D7414,Excision malig lesion>1.25cm,,,1323.06,1614.71,28
HCPCS,D7415,"EXCISION OF MALIGNANT LESION, COMPLICATED",1600.0,1040.0,1.1,4733.6,86
HCPCS,D7415,Excision malig les complicat,,,1323.06,1614.71,28
HCPCS,D7440,EXCISION OF MALIGNANT TUMOR - LESION DIAMETER UP TO 1.25 CM,1200.0,780.0,1.1,3044.02,86
HCPCS,D7440,Malig tumor exc to 1.25 cm,,,1358.5,3450.35,28
HCPCS,D7441,EXCISION OF MALIGNANT TUMOR - LESION DIAMETER GREATER THAN 1.25,2100.0,1365.0,1.1,4733.6,86
HCPCS,D7441,Malig tumor > 1.25 cm,,,1358.5,3450.35,28
HCPCS,D7450,REMOVAL OF BENIGN ODONTOGENIC CYST OR TUMOR - LESION DIAMETER UP,900.0,585.0,1.1,1724.13,86
HCPCS,D7450,Rem odontogen cyst to 1.25cm,,,1358.5,3450.35,28
HCPCS,D7451,REMOVAL OF BENIGN ODONTOGENIC CYST OR TUMOR - LESION DIAMETER GR,1500.0,975.0,1.1,2708.86,86
HCPCS,D7451,Rem odontogen cyst > 1.25 cm,,,1358.5,3450.35,28
HCPCS,D7460,REMOVAL OF BENIGN NONODONTOGENIC CYST OR TUMOR - LESION DIAMETER,1000.0,650.0,1.1,1724.13,86
HCPCS,D7460,Rem nonodonto cyst to 1.25cm,,,611.63,1664.63,28
HCPCS,D7461,REMOVAL OF BENIGN NONODONTOGENIC CYST OR TUMOR - LESION DIAMETER,1500.0,975.0,1.1,2777.97,86
HCPCS,D7461,Rem nonodonto cyst > 1.25 cm,,,611.63,1664.63,28
HCPCS,D7465,Lesion destruction,,,1358.5,1573.0,8
HCPCS,D7471,REMOVAL OF LATERAL EXOSTOSIS (MAXILLA OR MANDIBLE),900.0,585.0,1.1,1727.59,86
HCPCS,D7471,Rem exostosis any site,,,1358.5,3450.35,27
HCPCS,D7472,REMOVAL OF TORUS PALATINUS,1300.0,845.0,1.1,1727.59,86
HCPCS,D7472,Removal of torus palatinus,,,611.63,1664.63,28
HCPCS,D7473,REMOVE TORUS MANDIBULARIS,1300.0,845.0,1.1,1727.59,86
HCPCS,D7473,Remove torus mandibularis,,,611.63,1664.63,28
HCPCS,D7485,SURG REDUCT OSSEOUSTUBEROSIT,1100.0,715.0,1.1,2363.34,86
HCPCS,D7485,Surg reduct osseoustuberosit,,,1358.5,6160.68,28
HCPCS,D7490,Maxilla or mandible resectio,,,4527.92,5242.85,8
HCPCS,D7490,RADICAL RESECTION OF MAXILLA OR MANDIBLE,9500.0,6175.0,1.1,24431.61,86
HCPCS,D7509,MARSUPIALIZATION OF ODONTOGENIC CYST,750.0,487.5,1.1,1437.35,86
HCPCS,D7509,Marsupialization odon cyst,,,1358.5,1573.0,8
HCPCS,D7510,I&d absc intraoral soft tiss,,,610.39,1573.0,28
HCPCS,D7510,INCISION AND DRAINAGE OF ABSCESS - INTRAORAL SOFT TISSUE,400.0,260.0,1.1,518.28,86
HCPCS,D7511,INCISION AND DRAINAGE OF ABSCESS - INTRAORAL SOFT TISSUE - COMPL,500.0,325.0,1.1,518.28,86
HCPCS,D7511,Incision/drain abscess intra,,,610.39,1573.0,28
HCPCS,D7520,I&d abscess extraoral,,,57.69,736.94,28
HCPCS,D7520,INCISION AND DRAINAGE OF ABSCESS - EXTRAORAL SOFT TISSUE,800.0,520.0,1.1,2463.55,86
HCPCS,D7521,INCISION AND DRAINAGE OF ABSCESS - EXTRAORAL SOFT TISSUE - COMPL,800.0,520.0,1.1,2463.55,86
HCPCS,D7521,Incision/drain abscess extra,,,610.39,1573.0,28
HCPCS,D7530,"REMOVAL OF FOREIGN BODY FROM MUCOSA, SKIN, OR SUBCUTANEOUS ALVEO",500.0,325.0,1.1,887.98,86
HCPCS,D7530,Removal fb skin/areolar tiss,,,611.63,1664.63,28
HCPCS,D7540,"REMOVAL OF REACTION PRODUCING FOREIGN BODIES, MUSCULOSKELETAL SY",900.0,585.0,1.1,984.73,86
HCPCS,D7540,Removal of fb reaction,,,611.63,1664.63,28
HCPCS,D7550,PARTIAL OSTECTOMY/SEQUESTRECTOMY FOR REMOVAL OF NON-VITAL BONE,500.0,325.0,1.1,615.02,86
HCPCS,D7550,Removal of sloughed off bone,,,611.63,1664.63,28
HCPCS,D7560,MAXILLARY SINUSOTOMY FOR REMOVAL OF TOOTH FRAGMENT OR FOREIGN BO,2000.0,1300.0,1.1,4871.81,86
HCPCS,D7560,Maxillary sinusotomy,,,1358.5,1573.0,8
HCPCS,D7610,Maxilla open reduct simple,,,4527.92,5242.85,8
HCPCS,D7620,Clsd reduct simpl maxilla fx,,,2059.35,2384.51,8
HCPCS,D7630,Open red simpl mandible fx,,,4527.92,5242.85,8
HCPCS,D7640,Clsd red simpl mandible fx,,,2059.35,2384.51,8
HCPCS,D7650,Open red simp malar/zygom fx,,,2059.35,2384.51,8
HCPCS,D7660,Clsd red simp malar/zygom fx,,,295.11,341.7,8
HCPCS,D7670,"ALVEOLUS - CLOSED REDUCTION, MAY INCLUDE STABILIZATION OF TEETH",2000.0,1300.0,1.1,3842.16,86
HCPCS,D7670,Closd rductn splint alveolus,,,295.11,3450.35,28
HCPCS,D7671,Alveolus open reduction,,,295.11,6160.68,28
HCPCS,D7680,Reduct simple facial bone fx,,,4527.92,5242.85,8
HCPCS,D7710,Maxilla open reduct compound,,,4527.92,5242.85,8
HCPCS,D7720,Clsd reduct compd maxilla fx,,,295.11,341.7,8
HCPCS,D7730,Open reduct compd mandble fx,,,4527.92,5242.85,8
HCPCS,D7740,Clsd reduct compd mandble fx,,,4527.92,5242.85,8
HCPCS,D7750,Open red comp malar/zygma fx,,,4527.92,5242.85,8
HCPCS,D7760,Clsd red comp malar/zygma fx,,,295.11,341.7,8
HCPCS,D7770,Open reduc compd alveolus fx,,,295.11,6160.68,28
HCPCS,D7771,Alveolus clsd reduc stblz te,,,295.11,3450.35,28
HCPCS,D7780,Reduct compnd facial bone fx,,,4527.92,5242.85,8
HCPCS,D7810,TMJ OPEN REDUCT-DISLOCATION,6000.0,3900.0,1.1,8665.61,86
HCPCS,D7810,Tmj open reduct-dislocation,,,4527.92,5242.85,8
HCPCS,D7820,CLOSED REDUCTION OF DISLOCATION,900.0,585.0,1.1,1420.08,86
HCPCS,D7820,Closed tmp manipulation,,,1358.5,1573.0,8
HCPCS,D7830,Tmj manipulation under anest,,,824.67,954.88,8
HCPCS,D7840,Removal of tmj condyle,,,4527.92,5242.85,8
HCPCS,D7850,Tmj meniscectomy,,,4527.92,5242.85,8
HCPCS,D7852,Tmj repair of joint disc,,,4527.92,5242.85,8
HCPCS,D7854,Tmj excisn of joint membrane,,,4527.92,5242.85,8
HCPCS,D7856,Tmj cutting of a muscle,,,4527.92,5242.85,8
HCPCS,D7858,Tmj reconstruction,,,4527.92,5242.85,8
HCPCS,D7860,Tmj cutting into joint,,,4527.92,5242.85,8
HCPCS,D7865,Tmj reshaping components,,,4527.92,5242.85,8
HCPCS,D7870,Tmj aspiration joint fluid,,,174.77,202.37,8
HCPCS,D7871,Lysis + lavage w catheters,,,1358.5,1573.0,8
HCPCS,D7872,Tmj diagnostic arthroscopy,,,1358.5,1573.0,8
HCPCS,D7873,Tmj arthroscopy lysis adhesn,,,4527.92,5242.85,8
HCPCS,D7874,Tmj arthroscopy disc reposit,,,2808.13,5242.85,28
HCPCS,D7875,Tmj arthroscopy synovectomy,,,4527.92,5242.85,8
HCPCS,D7876,Tmj arthroscopy discectomy,,,4527.92,5242.85,8
HCPCS,D7877,Tmj arthroscopy debridement,,,4527.92,5242.85,8
HCPCS,D7880,"OCCLUSAL ORTHOTIC DEVICE, BY REPORT",1400.0,910.0,1.1,1506.46,86
HCPCS,D7880,Occlusal orthotic appliance,,,1358.5,1573.0,8
HCPCS,D7881,OCCLUSAL ORTHOTIC DEVICE ADJUSTMENT,250.0,162.5,1.1,518.28,86
HCPCS,D7881,Occ orthotic device adjust,,,57.69,66.8,8
HCPCS,D7899,Tmj unspecified therapy,,,1358.5,1573.0,8
HCPCS,D7899,"UNSPECIFIED TMD THERAPY, BY REPORT",700.0,455.0,0.01,700.0,80
HCPCS,D7910,Dent sutur recent wnd to 5cm,,,1358.5,1573.0,8
HCPCS,D7911,Dental suture wound to 5 cm,,,1358.5,1573.0,8
HCPCS,D7912,Suture complicate wnd > 5 cm,,,1358.5,1573.0,8
HCPCS,D7920,Dental skin graft,,,1358.5,1573.0,8
HCPCS,D7921,COLLECTION AND APPLICATION OF AUTOLOGOUS BLOOD CONCENTRATE PRODU,600.0,390.0,1.1,1420.08,86
HCPCS,D7921,Collect & appl blood product,,,57.69,66.8,8
HCPCS,D7922,PLACEMENT OF INTRA-SOCKET BIOLOGICAL DRESSING TO AID IN HEMOSTAS,150.0,97.5,1.1,324.8,74
HCPCS,D7922,Place intra-socket bio dress,,,57.69,1664.63,28
HCPCS,D7939,INDEXING FOR OSTEOTOMY USING DYNAMIC ROBOTIC ASSISTED OR DYNAMIC,500.0,325.0,1.1,684.13,80
HCPCS,D7939,Indexing for osteotomy,,,29.24,33.86,8
HCPCS,D7940,Reshaping bone orthognathic,,,611.63,5242.85,28
HCPCS,D7941,Bone cutting ramus closed,,,4527.92,5242.85,8
HCPCS,D7943,Cutting ramus open w/graft,,,4527.92,5242.85,8
HCPCS,D7944,BONE CUTTING SEGMENTED,9000.0,5850.0,1.1,16152.99,86
HCPCS,D7944,Bone cutting segmented,,,4527.92,5242.85,8
HCPCS,D7945,Bone cutting body mandible,,,4527.92,5242.85,8
HCPCS,D7946,Reconstruction maxilla total,,,4527.92,5242.85,8
HCPCS,D7947,Reconstruct maxilla segment,,,4527.92,5242.85,8
HCPCS,D7948,Reconstruct midface no graft,,,4527.92,5242.85,8
HCPCS,D7949,Reconstruct midface w/graft,,,4527.92,5242.85,8
HCPCS,D7950,Mandible graft,,,2059.35,6160.68,28
HCPCS,D7950,"OSSEOUS, OSTEOPERIOSTEAL, OR CARTILAGE GRAFT OF THE MANDIBLE OR",3700.0,2405.0,1.1,3700.0,86
HCPCS,D7951,SINUS AUGMENTATION WITH BONE OR BONE SUBSTITUTES VIA A LATERAL O,3900.0,2535.0,1.1,3900.0,86
HCPCS,D7951,Sinus aug w bone or bone sub,,,2059.35,2384.51,8
HCPCS,D7952,SINUS AUGMENTATION VIA A VERTICAL APPROACH,2800.0,1820.0,1.1,2800.0,86
HCPCS,D7952,Sinus augmentation vertical,,,2059.35,2384.51,8
HCPCS,D7953,BONE REPLACEMENT GRAFT FOR RIDGE PRESERVATION,2000.0,1300.0,0.01,2384.51,66
HCPCS,D7953,BONE REPLACEMENT GRAFT FOR RIDGE PRESERVATION - PER SITE,900.0,585.0,1.1,2764.15,86
HCPCS,D7955,REPAIR OF MAXILLOFACIAL SOFT AND/OR HARD TISSUE DEFECT,4000.0,2600.0,1.1,17275.92,86
HCPCS,D7955,Repair maxillofacial defects,,,2059.35,2384.51,8
HCPCS,D7956,"GUIDED TISSUE REGENERATION, EDENTULOUS AREA",2000.0,1300.0,0.01,2000.0,66
HCPCS,D7956,"GUIDED TISSUE REGENERATION, EDENTULOUS AREA ? RESORBABLE BARRIER",400.0,260.0,1.1,1803.6,86
HCPCS,D7957,"GUIDED TISSUE REGENERATION, EDENTULOUS AREA ? NON-RESORBABLE BAR",500.0,325.0,1.1,1803.6,86
HCPCS,D7957,Tiss regen edent nonresorb,,,57.69,66.8,8
HCPCS,D7960,FRENULECTOMY - ALSO KNOWN AS FRENECTOMY OR FRENOTOMY - SEPARATE,250.0,162.5,1.1,1136.75,80
HCPCS,D7960,Frenulectomy/frenectomy,,,1358.5,1573.0,8
HCPCS,D7961,BUCCAL/LABIAL FRENECTOMY (FRENULECTOMY),600.0,390.0,1.1,1057.29,86
HCPCS,D7961,Buccal/labial frenectomy,,,1358.5,1573.0,8
HCPCS,D7962,LINGUAL FRENECTOMY (FRENULECTOMY),600.0,390.0,1.1,1057.29,86
HCPCS,D7962,Lingual frenectomy,,,1358.5,1573.0,8
HCPCS,D7963,Frenuloplasty,,,1358.5,1573.0,8
HCPCS,D7970,EXCISION OF HYPERPLASTIC TISSUE - PER ARCH,700.0,455.0,1.1,1174.77,86
HCPCS,D7970,Excision hyperplastic tissue,,,1358.5,1573.0,8
HCPCS,D7971,EXCISION OF PERICORONAL GINGIVA,400.0,260.0,1.1,400.0,86
HCPCS,D7971,Excision pericoronal gingiva,,,1358.5,1573.0,8
HCPCS,D7972,SURGICAL REDUCTION OF FIBROUS TUBEROSITY,1000.0,650.0,1.1,1000.0,86
HCPCS,D7972,Surg redct fibrous tuberosit,,,1358.5,1573.0,8
HCPCS,D7979,NON ? SURGICAL SIALOLITHOTOMY,850.0,552.5,1.1,850.0,74
HCPCS,D7979,Non-surgical sialolithotomy,,,1358.5,1573.0,8
HCPCS,D7980,Surgical sialolithotomy,,,1358.5,1573.0,8
HCPCS,D7981,Excision of salivary gland,,,1358.5,1573.0,8
HCPCS,D7982,Sialodochoplasty,,,1358.5,1573.0,8
HCPCS,D7983,Closure of salivary fistula,,,1358.5,1573.0,8
HCPCS,D7991,Dental coronoidectomy,,,4527.92,5242.85,8
HCPCS,D7993,Surg place craniofacial impl,,,2059.35,2384.51,8
HCPCS,D7994,Surg place zygomatic impl,,,2059.35,2384.51,8
HCPCS,D7995,Synthetic graft facial bones,,,4527.92,5242.85,8
HCPCS,D7996,Implant mandible for augment,,,2059.35,2384.51,8
HCPCS,D7997,Appliance removal,,,1358.5,1573.0,8
HCPCS,D7998,Intraoral place of fix dev,,,1358.5,1573.0,8
HCPCS,D7999,Oral surgery procedure,,,1358.5,1573.0,8
HCPCS,D7999,"UNSPECIFIED ORAL SURGERY PROCEDURE, BY REPORT",850.0,552.5,0.01,850.0,80
HCPCS,D8010,LIMITED ORTHODONTIC TREATMENT OF THE PRIMARY DENTITION,3500.0,2275.0,1.1,3500.0,86
HCPCS,D8010,Limited dental tx primary,,,1358.5,1573.0,8
HCPCS,D8020,LIMITED ORTHODONTIC TREATMENT OF THE TRANSITIONAL DENTITION,3000.0,1950.0,1.1,4837.26,86
HCPCS,D8020,Limited dental tx transition,,,1358.5,1573.0,8
HCPCS,D8030,Limited dental tx adolescent,,,1358.5,1573.0,8
HCPCS,D8040,Limited dental tx adult,,,1358.5,1573.0,8
HCPCS,D8050,Intercep dental tx primary,,,1358.5,1573.0,8
HCPCS,D8060,Intercep dental tx transitn,,,1358.5,1573.0,8
HCPCS,D8070,Compre dental tx transition,,,1358.5,1573.0,8
HCPCS,D8080,COMPREHENSIVE ORTHODONTIC TREATMENT OF THE ADOLESCENT DENTITION,5500.0,3575.0,1.1,16584.89,86
HCPCS,D8080,Compre dental tx adolescent,,,1358.5,1573.0,8
HCPCS,D8090,COMPREHENSIVE ORTHODONTIC TREATMENT OF THE ADULT DENTITION,6000.0,3900.0,1.1,17275.92,86
HCPCS,D8090,Compre dental tx adult,,,1358.5,1573.0,8
HCPCS,D8090,REFINEMENT ORTHODONTIC TREATMENT OF THE ADULT DENTITION,200.0,130.0,1.1,17275.92,86
HCPCS,D8091,Compre ortho treat w surg,,,2059.35,2384.51,8
HCPCS,D8210,Orthodontic rem appliance tx,,,1358.5,1573.0,8
HCPCS,D8210,REMOVABLE APPLIANCE THERAPY,500.0,325.0,1.1,853.88,86
HCPCS,D8220,Fixed appliance therapy habt,,,1358.5,1573.0,8
HCPCS,D8660,PRE-ORTHODONTIC TREATMENT EXAMINATION TO MONITOR GROWTH AND DEVE,400.0,260.0,1.1,400.0,86
HCPCS,D8660,Preorthodontic tx visit,,,1358.5,1573.0,8
HCPCS,D8670,PERIODIC ORTHODONTIC TREATMENT VISIT,400.0,260.0,1.1,525.19,86
HCPCS,D8670,Periodic orthodontc tx visit,,,1358.5,1573.0,8
HCPCS,D8671,PERIODIC ORTHODONTIC TREATMENT VISIT ASSOCIATED WITH ORTHOGNATHI,100.0,65.0,1.1,691.04,86
HCPCS,D8671,Periodic orth treat w surg,,,1358.5,1573.0,8
HCPCS,D8680,"ORTHODONTIC RETENTION (REMOVAL OF APPLIANCES, CONSTRUCTION AND P",600.0,390.0,1.1,1154.03,86
HCPCS,D8680,ORTHODONTIC RETENTION LOWER,250.0,162.5,1.1,1154.03,86
HCPCS,D8680,ORTHODONTIC RETENTION UPPER,250.0,162.5,1.1,1154.03,86
HCPCS,D8680,Orthodontic retention,,,1358.5,1573.0,8
HCPCS,D8681,REMOVABLE ORTHODONTIC RETAINER ADJUSTMENT,275.0,178.75,1.1,863.79,86
HCPCS,D8681,Removable retainer adjust,,,57.69,66.8,8
HCPCS,D8690,Orthodontic treatment,,,1358.5,1573.0,8
HCPCS,D8695,REMOVAL OF FIXED ORTHODONTIC APPLIANCES FOR REASONS OTHER THAN C,300.0,195.0,1.1,300.0,74
HCPCS,D8695,Remove fixed ortho appliance,,,57.69,66.8,8
HCPCS,D8696,REPAIR OF ORTHODONTIC APPLIANCE - MAXILLARY,250.0,162.5,1.1,518.28,86
HCPCS,D8696,Rep of ortho appliance max,,,57.69,66.8,8
HCPCS,D8697,REPAIR OF ORTHODONTIC APPLIANCE - MANDIBULAR,250.0,162.5,1.1,518.28,86
HCPCS,D8697,Rep of ortho appliance man,,,57.69,66.8,8
HCPCS,D8698,RE-CEMENT OR RE-BOND FIXED RETAINER - MAXILLARY,300.0,195.0,1.1,863.79,86
HCPCS,D8698,Recement fixed retainer max,,,57.69,66.8,8
HCPCS,D8699,RE-CEMENT OR RE-BOND FIXED RETAINER - MANDIBULAR,300.0,195.0,1.1,863.79,86
HCPCS,D8699,Recement fixed retainer man,,,57.69,66.8,8
HCPCS,D8701,"REPAIR OF FIXED RETAINER, INCLUDES REATTACHMENT - MAXILLARY",250.0,162.5,1.1,863.79,86
HCPCS,D8701,Repair fixed retainer max,,,57.69,66.8,8
HCPCS,D8702,"REPAIR OF FIXED RETAINER, INCLUDES REATTACHMENT - MANDIBULAR",250.0,162.5,1.1,863.79,86
HCPCS,D8702,Repair of fixed retainer man,,,57.69,66.8,8
HCPCS,D8703,REPLACEMENT OF LOST OR BROKEN RETAINER - MAXILLARY,200.0,130.0,1.1,863.79,86
HCPCS,D8703,Replace broken retainer max,,,57.69,66.8,8
HCPCS,D8704,REPLACEMENT OF LOST OR BROKEN RETAINER - MANDIBULAR,200.0,130.0,1.1,863.79,86
HCPCS,D8704,Replace broken retainer man,,,57.69,66.8,8
HCPCS,D8999,INVISALIGN UPCHARGES,2200.0,1430.0,0.01,2200.0,80
HCPCS,D8999,ORTHODONTIC RECORDS,300.0,195.0,0.01,300.0,80
HCPCS,D8999,Orthodontic procedure,,,1358.5,1573.0,8
HCPCS,D8999,"UNSPECIFIED ORTHODONTIC PROCEDURE, BY REPORT",600.0,390.0,0.01,600.0,80
HCPCS,D9110,PALLIATIVE TREATMENT OF DENTAL PAIN ??PER VISIT,175.0,113.75,1.1,183.13,86
HCPCS,D9110,Palliative tx dental pain,,,57.69,66.8,8
HCPCS,D9120,FIXED PARTIAL DENTURE SECTIONING,300.0,195.0,1.1,570.11,86
HCPCS,D9120,Fix partial denture section,,,57.69,66.8,8
HCPCS,D9128,"PHOTOBIOMODULATION THERAPY - FIRST 15 MINUTE INCREMENT, OR ANY P",250.0,162.5,1.1,250.0,68
HCPCS,D9128,Photobio therpy-first 15 min,,,57.69,66.8,8
HCPCS,D9129,PHOTOBIOMODULATION THERAPY - EACH SUBSEQUENT 15 MINUTE INCREMENT,75.0,48.75,1.1,75.0,68
HCPCS,D9129,Photobio therpy-sub 15 mins,,,57.69,66.8,8
HCPCS,D9130,TEMPOROMANDIBULAR JOINT DYSFUNCTION ? NON-INVASIVE PHYSICAL THER,300.0,195.0,0.01,300.0,86
HCPCS,D9130,Temporomandibular joint dysf,,,31.09,36.0,8
HCPCS,D9210,Dent anesthesia w/o surgery,,,199.6,231.12,8
HCPCS,D9210,LOCAL ANESTHESIA NOT IN CONJUNCTION WITH OPERATIVE OR SURGICAL P,100.0,65.0,1.1,100.0,86
HCPCS,D9211,Regional block anesthesia,,,199.6,231.12,8
HCPCS,D9212,Trigeminal block anesthesia,,,199.6,231.12,8
HCPCS,D9215,Local anesthesia,,,199.6,231.12,8
HCPCS,D9219,Eval mod/deep sed/gen anest,,,837.27,969.47,8
HCPCS,D9222,ADMINISTRATION OF DEEP SEDATION/GENERAL ANESTHESIA - FIRST 15 MI,350.0,227.5,1.1,494.09,86
HCPCS,D9222,"Deep anest, 1st 15 min",,,199.6,231.12,8
HCPCS,D9223,ADMINISTRATION OF DEEP SEDATION/GENERAL ANESTHESIA ? EACH SUBSEQ,300.0,195.0,1.1,300.0,86
HCPCS,D9223,General anesth ea addl 15 mi,,,199.6,231.12,8
HCPCS,D9224,ADMINISTRATION OF GENERAL ANESTHESIA WITH ADVANCED AIRWAY ? FIRS,500.0,325.0,1.1,500.0,68
HCPCS,D9224,Gen anes adv air-15 min,,,199.6,231.12,8
HCPCS,D9225,ADMINISTRATION OF GENERAL ANESTHESIA WITH ADVANCED AIRWAY ? EACH,250.0,162.5,1.1,250.0,68
HCPCS,D9225,Gen anes adv air-sub 15 min,,,199.6,231.12,8
HCPCS,D9230,Analgesia,,,199.6,231.12,8
HCPCS,D9230,"INHALATION OF NITROUS OXIDE/ANALGESIA, ANXIOLYSIS",100.0,65.0,1.1,100.2,86
HCPCS,D9239,ADMINISTRATION OF MODERATE SEDATION - INTRAENOUS - FIRST 15 MINU,300.0,195.0,1.1,438.81,86
HCPCS,D9239,"Iv mod sedation, 1st 15 min",,,199.6,231.12,8
HCPCS,D9243,ADMINISTRATION OF MODERATE SEDATION - INTRAVENOUS - EACH SUBSEQU,350.0,227.5,1.1,350.0,86
HCPCS,D9243,Iv sedation ea addl 15m,,,199.6,231.12,8
HCPCS,D9244,IN-OFFICE ADMINISTRATION OF MINIMAL SEDATION ? SINGLE DRUG ? ENT,250.0,162.5,1.1,250.0,68
HCPCS,D9244,Office min sed drug enteral,,,199.6,231.12,8
HCPCS,D9245,ADMINISTRATION OF MODERATE SEDATION ? ENTERAL,350.0,227.5,1.1,350.0,68
HCPCS,D9245,Admin mod sedation-enteral,,,199.6,231.12,8
HCPCS,D9246,ADMINISTRATION OF MODERATE SEDATION ? NON-INTRAVENOUS PARENTERAL,350.0,227.5,1.1,350.0,68
HCPCS,D9246,Mod sedation noniv-15 min,,,199.6,231.12,8
HCPCS,D9247,ADMINISTRATION OF MODERATE SEDATION ? NON-INTRAVENOUS PARENTERAL,300.0,195.0,1.1,300.0,68
HCPCS,D9247,Mod sedation noniv-sub15min,,,199.6,231.12,8
HCPCS,D9248,Sedation (non-iv),,,199.6,231.12,8
HCPCS,D9310,CONSULT - DR. KAHN,200.0,130.0,1.1,390.43,86
HCPCS,D9310,CONSULTATION - DIAGNOSTIC SERVICE PROVIDED BY DENTIST OR PHYSICI,200.0,130.0,1.1,390.43,86
HCPCS,D9310,Dental consultation,,,63.76,73.83,8
HCPCS,D9311,CONSULTATION WITH A MEDICAL HEALTH CARE PROFESSIONAL,250.0,162.5,1.1,290.24,86
HCPCS,D9311,Consult w/med hlth care prof,,,63.76,73.83,8
HCPCS,D9410,Dental house call,,,63.76,73.83,8
HCPCS,D9420,HOSPITAL OR AMBULATORY SURGICAL CENTER CALL,400.0,260.0,1.1,708.31,86
HCPCS,D9420,Hospital/asc call,,,63.76,73.83,8
HCPCS,D9430,OFFICE VISIT FOR OBSERVATION (DURING REGULARLY SCHEDULED HOURS),100.0,65.0,1.1,131.3,86
HCPCS,D9430,Office visit during hours,,,57.69,66.8,8
HCPCS,D9440,OFFICE VISIT - AFTER REGULARLY SCHEDULED HOURS,250.0,162.5,1.1,250.0,86
HCPCS,D9440,Office visit after hours,,,57.69,66.8,8
HCPCS,D9450,"CASE PRESENTATION,?SUBSEQUENT TO?DETAILED AND EXTENSIVE TREATMEN",240.0,156.0,1.1,390.43,86
HCPCS,D9450,Case presentation tx plan,,,21.85,25.3,8
HCPCS,D9610,Dent therapeutic drug inject,,,45.54,52.73,8
HCPCS,D9612,Thera par drugs 2 or > admin,,,45.54,52.73,8
HCPCS,D9613,INFILTRATION OF SUSTAINED RELEASE THERAPEUTIC DRUG ? SINGLE OR M,260.0,169.0,0.01,260.0,86
HCPCS,D9613,Infiltration thera drug,,,45.54,52.73,8
HCPCS,D9630,DRUGS OR MEDICAMENTS DISPENSED IN THE OFFICE FOR HOME USE,65.0,42.25,1.1,86.39,86
HCPCS,D9630,Drugs/meds disp for home use,,,57.69,66.8,8
HCPCS,D9910,APPLICATION OF DESENSITIZING MEDICAMENT,75.0,48.75,1.1,82.92,86
HCPCS,D9910,Dent appl desensitizing med,,,57.69,66.8,8
HCPCS,D9911,APPLICATION OF DESENSITIZING RESIN FOR CERVICAL AND/OR ROOT SURF,100.0,65.0,1.1,224.59,86
HCPCS,D9911,Appl desensitizing resin,,,57.69,66.8,8
HCPCS,D9912,PRE-VISIT PATIENT SCREENING,180.0,117.0,1.1,1257.69,86
HCPCS,D9912,Pre-visit patient screening,,,63.76,73.83,8
HCPCS,D9913,Admin of neuromod,,,57.69,66.8,8
HCPCS,D9914,Admin of dermal fill,,,57.69,66.8,8
HCPCS,D9920,Behavior management,,,57.69,66.8,8
HCPCS,D9930,Treatment of complications,,,611.63,1664.63,28
HCPCS,D9932,"CLEANING AND INSPECTION OF REMOVABLE COMPLETE DENTURE, MAXILLARY",125.0,81.25,1.1,224.59,86
HCPCS,D9932,Clean & inspect rem dent max,,,57.69,66.8,8
HCPCS,D9933,"CLEANING AND INSPECTION OF REMOVABLE COMPLETE DENTURE, MANDIBULA",125.0,81.25,1.1,224.59,86
HCPCS,D9933,Clean & inspect rem dent man,,,57.69,66.8,8
HCPCS,D9934,"CLEANING AND INSPECTION OF REMOVABLE PARTIAL DENTURE, MAXILLARY",125.0,81.25,1.1,224.59,86
HCPCS,D9934,Clean rem part denture max,,,57.69,66.8,8
HCPCS,D9935,"CLEANING AND INSPECTION OF REMOVABLE PARTIAL DENTURE, MANDIBULAR",125.0,81.25,1.1,224.59,86
HCPCS,D9935,Clean rem part denture mand,,,57.69,66.8,8
HCPCS,D9936,CLEANING AND INSPECTION OF OCCLUSAL GUARD ? PER APPLIANCE,100.0,65.0,1.1,100.0,68
HCPCS,D9936,Clean occ guard,,,57.69,66.8,8
HCPCS,D9938,FABRICATION OF A CUSTOM REMOVABLE CLEAR PLASTIC TEMPORARY AESTHE,200.0,130.0,1.1,314.43,80
HCPCS,D9938,Fab removable appliance,,,57.69,66.8,8
HCPCS,D9939,PLACEMENT OF A CUSTOM REMOVABLE CLEAR PLASTIC TEMPORARY AESTHETI,200.0,130.0,1.1,200.0,74
HCPCS,D9939,Placemnt removable appliance,,,57.69,66.8,8
HCPCS,D9941,ATHLETIC TRAUMA SPLINT,100.0,65.0,1.1,293.69,86
HCPCS,D9941,FABRICATION OF ATHLETIC MOUTHGUARD,350.0,227.5,1.1,350.0,86
HCPCS,D9941,Fabrication athletic guard,,,57.69,66.8,8
HCPCS,D9942,REPAIR AND/OR RELINE OF OCCLUSAL GUARD,300.0,195.0,1.1,1364.8,86
HCPCS,D9942,Repair/reline occlusal guard,,,57.69,66.8,8
HCPCS,D9943,OCCLUSAL GUARD ADJUSTMENT,175.0,113.75,1.1,324.79,86
HCPCS,D9943,Occlusal guard adjustment,,,57.69,66.8,8
HCPCS,D9944,NIGHTGUARD,1000.0,650.0,1.1,1257.69,86
HCPCS,D9944,OCCLSAL GUARD,850.0,552.5,1.1,1257.69,86
HCPCS,D9944,"OCCLUSAL GUARD ? HARD APPLIANCE, FULL ARCH",1600.0,1040.0,1.1,1600.0,86
HCPCS,D9944,"Occ guard, hard, full arch",,,57.69,1664.63,28
HCPCS,D9945,"OCCLUSAL GUARD ? SOFT APPLIANCE, FULL ARCH",700.0,455.0,1.1,700.0,86
HCPCS,D9945,"Occ guard, soft, full arch",,,611.63,1664.63,28
HCPCS,D9946,MINI COMFORT,300.0,195.0,0.01,315.12,86
HCPCS,D9946,"OCCLUSAL GUARD ? HARD APPLIANCE, PARTIAL ARCH",700.0,455.0,0.01,700.0,86
HCPCS,D9946,"Occ guard, hard, part arch",,,611.63,1664.63,28
HCPCS,D9947,CUSTOM SLEEP APNEA APPLIANCE FABRICATION AND PLACEMENT,4000.0,2600.0,1.1,4000.0,86
HCPCS,D9947,Sleep apnea appliance,,,57.69,66.8,8
HCPCS,D9948,ADJUSTMENT OF CUSTOM SLEEP APNEA APPLIANCE,150.0,97.5,1.1,1257.69,86
HCPCS,D9948,Adjust sleep apnea appliance,,,63.76,73.83,8
HCPCS,D9949,REPAIR OF CUSTOM SLEEP APNEA APPLIANCE,500.0,325.0,1.1,1257.69,80
HCPCS,D9949,Repair sleep apnea appliance,,,63.76,73.83,8
HCPCS,D9950,Occlusion analysis,,,57.69,1664.63,28
HCPCS,D9951,Limited occlusal adjustment,,,57.69,1664.63,28
HCPCS,D9951,OCCLUSAL ADJUSTMENT - LIMITED,250.0,162.5,1.1,250.0,86
HCPCS,D9952,Complete occlusal adjustment,,,611.63,1664.63,28
HCPCS,D9952,OCCLUSAL ADJUSTMENT - COMPLETE,900.0,585.0,1.1,1323.34,86
HCPCS,D9953,RELINE CUSTOM SLEEP APNEA APPLIANCE (INDIRECT),400.0,260.0,0.01,400.0,86
HCPCS,D9953,Reline sleep apnea appliance,,,63.76,73.83,8
HCPCS,D9954,FABRICATION AND DELIVERY OF ORAL APPLIANCE THERAPY (OAT) MORNING,200.0,130.0,1.1,200.0,68
HCPCS,D9954,Fab/del oral appliance thxpy,,,57.69,66.8,8
HCPCS,D9955,ORAL APPLIANCE THERAPY (OAT) TITRATION VISIT,150.0,97.5,1.1,150.0,74
HCPCS,D9955,Oral app thxpy titration vis,,,837.27,969.47,8
HCPCS,D9956,Admin home sleep apnea test,,,1011.53,1171.25,8
HCPCS,D9957,Screening sleep disorders,,,1011.53,1171.25,8
HCPCS,D9959,"UNSPECIFIED SLEEP APNEA SERVICES PROCEDURE, BY REPORT",125.0,81.25,1.1,125.0,68
HCPCS,D9959,Unspec sleep ap proc,,,63.76,73.83,8
HCPCS,D9961,Dup/copy patient's records,,,63.76,73.83,8
HCPCS,D9970,ENAMEL MICROABRASION,250.0,162.5,1.1,250.0,86
HCPCS,D9970,Enamel microabrasion,,,57.69,66.8,8
HCPCS,D9971,ODONTOPLASTY 1 - 2 TEETH; INCLUDES REMOVAL OF ENAMEL PROJECTIONS,200.0,130.0,1.1,200.0,86
HCPCS,D9971,Odontoplasty per tooth,,,57.69,66.8,8
HCPCS,D9972,Extrnl bleaching per arch,,,57.69,66.8,8
HCPCS,D9973,Extrnl bleaching per tooth,,,57.69,66.8,8
HCPCS,D9974,INTERNAL BLEACHING - PER TOOTH,350.0,227.5,1.1,350.0,86
HCPCS,D9974,Intrnl bleaching per tooth,,,57.69,66.8,8
HCPCS,D9975,"EXTERNAL BLEACHING FOR HOME APPLICATION, PER ARCH; INCLUDES MATE",400.0,260.0,1.1,400.0,86
HCPCS,D9975,External bleaching home app,,,57.69,66.8,8
HCPCS,D9985,Sales tax,,,63.76,73.83,8
HCPCS,D9986,MISSED APPOINTMENT,75.0,48.75,1.1,127.85,80
HCPCS,D9986,Missed appointment,,,63.76,73.83,8
HCPCS,D9987,CANCELLED APPOINTMENT,75.0,48.75,1.1,127.85,80
HCPCS,D9987,Cancelled appointment,,,63.76,73.83,8
HCPCS,D9990,CERTIFIED TRANSLATION OR SIGN-LANGUAGE SERVICES ? PER VISIT,125.0,81.25,0.01,125.0,86
HCPCS,D9990,Trans or sign language svcs,,,63.76,73.83,8
HCPCS,D9991,"Case mgmt, appt barriers",,,21.85,25.3,8
HCPCS,D9991,DENTAL CASE MANAGEMENT ? ADDRESSING APPOINTMENT COMPLIANCE BARRI,125.0,81.25,0.01,125.0,86
HCPCS,D9992,"Case mgmt, care coordination",,,21.85,25.3,8
HCPCS,D9992,DENTAL CASE MANAGEMENT ? CARE COORDINATION,172.0,111.8,0.01,172.0,86
HCPCS,D9993,"Case mgmt, interviewing",,,21.85,25.3,8
HCPCS,D9993,DENTAL CASE MANAGEMENT ? MOTIVATIONAL INTERVIEWING,125.0,81.25,0.01,125.0,86
HCPCS,D9994,"Case mgmt, pt education",,,39.1,45.28,8
HCPCS,D9994,DENTAL CASE MANAGEMENT ? PATIENT EDUCATION TO IMPROVE ORAL HEALT,100.0,65.0,0.01,100.0,86
HCPCS,D9995,TELEDENTISTRY ? SYNCHRONOUS; REAL-TIME ENCOUNTER,300.0,195.0,1.1,300.0,74
HCPCS,D9995,Teledentistry real-time,,,57.69,66.8,8
HCPCS,D9996,TELEDENTISTRY ? ASYNCHRONOUS; INFORMATION STORED AND FORWARDED T,175.0,113.75,1.1,175.0,74
HCPCS,D9996,Teledentistry dent review,,,57.69,66.8,8
HCPCS,D9997,DENTAL CASE MANAGEMENT - PATIENTS WITH SPECIAL HEALTH CARE NEEDS,150.0,97.5,1.1,150.0,74
HCPCS,D9997,Dent case mgmt special needs,,,21.85,25.3,8
HCPCS,D9999,Adjunctive procedure,,,57.69,66.8,8
HCPCS,D9999,"UNSPECIFIED ADJUNCTIVE PROCEDURE, BY REPORT",300.0,195.0,0.01,300.0,80
HCPCS,E0100,Cane adjust/fixed with tip,,,11.14,66.99,9
HCPCS,E0105,"CANE, QUAD OR THREE PRONG",28.05,18.23,1.1,192.84,90
HCPCS,E0105,Cane adjust/fixed quad/3 pro,,,31.69,173.31,9
HCPCS,E0110,"CRUTCHES, FOREARM",85.88,55.82,1.1,275.49,90
HCPCS,E0110,Crutch forearm pair,,,31.69,246.57,9
HCPCS,E0111,Crutch forearm each,,,31.69,184.24,9
HCPCS,E0112,Crutch underarm pair wood,,,36.52,124.67,9
HCPCS,E0113,Crutch underarm each wood,,,11.14,67.18,9
HCPCS,E0114,Crutch underarm pair no wood,,,36.52,149.96,9
HCPCS,E0116,Crutch underarm each no wood,,,36.52,88.17,9
HCPCS,E0117,Underarm springassist crutch,,,351.41,756.08,9
HCPCS,E0118,CRUTCH SUBSTITUTE,499.0,324.35,1.1,688.73,80
HCPCS,E0118,Crutch substitute,,,31.69,616.5,9
HCPCS,E0130,"WALKER,ADJUSTABLE FOLDING",82.0,53.3,17.88,82.0,66
HCPCS,E0135,Walker folding adjust/fixed,,,31.69,152.02,9
HCPCS,E0140,Walker w trunk support,,,91.28,1034.84,9
HCPCS,E0141,Rigid wheeled walker adj/fix,,,58.52,156.07,9
HCPCS,E0143,Walker folding wheeled w/o s,,,58.52,156.07,9
HCPCS,E0144,Enclosed walker w rear seat,,,351.41,934.45,9
HCPCS,E0147,Walker variable wheel resist,,,333.06,1327.42,9
HCPCS,E0148,Heavyduty walker no wheels,,,58.52,273.04,9
HCPCS,E0149,HEAVY DUTY WHEELED WALKER,290.0,188.5,1.1,737.79,90
HCPCS,E0149,Heavy duty wheeled walker,,,351.41,407.66,9
HCPCS,E0150,Combo walker-transport chair,,,669.74,775.49,8
HCPCS,E0152,"Walker, battery power wheels",,,31.69,36.7,8
HCPCS,E0153,Forearm crutch platform atta,,,31.69,220.54,9
HCPCS,E0154,Walker platform attachment,,,31.69,160.34,9
HCPCS,E0155,WHEEL ATTACHMENT,15.85,10.3,1.1,88.63,90
HCPCS,E0155,"Walker wheel attachment,pair",,,36.52,68.99,9
HCPCS,E0156,Walker seat attachment,,,11.14,50.96,9
HCPCS,E0157,Walker crutch attachment,,,31.69,195.14,9
HCPCS,E0158,Walker leg extenders set of4,,,36.52,74.03,9
HCPCS,E0159,Brake for wheeled walker,,,11.14,50.69,9
HCPCS,E0160,Sitz type bath or equipment,,,36.52,98.06,9
HCPCS,E0161,Sitz bath/equipment w/faucet,,,36.52,83.3,9
HCPCS,E0162,Sitz bath chair,,,58.52,523.04,9
HCPCS,E0163,"COMMODE CHAIR, STATIONARY",47.55,30.91,1.1,394.75,90
HCPCS,E0163,Commode chair with fixed arm,,,58.52,172.59,9
HCPCS,E0165,Commode chair with detacharm,,,11.14,424.07,9
HCPCS,E0167,Commode chair pail or pan,,,11.14,37.43,9
HCPCS,E0168,Heavyduty/wide commode chair,,,58.52,383.49,9
HCPCS,E0170,Commode chair electric,,,58.52,5675.75,9
HCPCS,E0171,Commode chair non-electric,,,36.52,1064.19,9
HCPCS,E0172,Seat lift mechanism toilet,,,36.52,685.0,9
HCPCS,E0175,Commode chair foot rest,,,31.69,227.26,9
HCPCS,E0181,Press pad alternating w/ pum,,,36.52,524.76,9
HCPCS,E0182,"Replace pump, alt press pad",,,36.52,772.19,9
HCPCS,E0183,Press underlay alter w/pump,,,36.52,524.76,9
HCPCS,E0184,Dry pressure mattress,,,351.41,504.05,9
HCPCS,E0185,Gel pressure mattress pad,,,91.28,539.2,9
HCPCS,E0186,Air pressure mattress,,,11.14,653.93,9
HCPCS,E0187,Water pressure mattress,,,11.14,771.31,9
HCPCS,E0188,Synthetic sheepskin pad,,,36.52,84.23,9
HCPCS,E0189,Lambswool sheepskin pad,,,31.69,158.51,9
HCPCS,E0190,Positioning cushion,,,16.97,78.53,9
HCPCS,E0191,Protector heel or elbow,,,16.97,37.15,9
HCPCS,E0193,Powered air flotation bed,,,1288.13,24645.81,9
HCPCS,E0194,Air fluidized bed,,,31.69,116853.96,9
HCPCS,E0196,Gel pressure mattress,,,36.52,1147.05,9
HCPCS,E0197,Air pressure pad for mattres,,,351.41,638.97,9
HCPCS,E0198,Water pressure pad for mattr,,,351.41,870.0,9
HCPCS,E0199,Dry pressure pad for mattres,,,36.52,94.37,9
HCPCS,E0200,Heat lamp without stand,,,31.69,296.39,9
HCPCS,E0201,Penile contractur devic manu,,,333.06,385.65,8
HCPCS,E0202,Phototherapy light w/ photom,,,31.69,2458.38,9
HCPCS,E0203,Therapeutic lightbox tabletp,,,58.52,387.71,9
HCPCS,E0205,Heat lamp with stand,,,351.41,725.52,9
HCPCS,E0210,Electric heat pad standard,,,36.52,122.09,9
HCPCS,E0215,Electric heat pad moist,,,31.69,264.85,9
HCPCS,E0217,Water circ heat pad w pump,,,333.06,1577.66,9
HCPCS,E0218,Fluid circ cold pad w pump,,,31.69,1781.0,9
HCPCS,E0221,Infrared heating pad system,,,36.52,3474.54,9
HCPCS,E0225,Hydrocollator unit,,,846.64,1235.06,9
HCPCS,E0231,Wound warming device,,,36.52,274.0,9
HCPCS,E0232,Warming card for nwt,,,36.52,274.0,9
HCPCS,E0235,Paraffin bath unit portable,,,11.14,575.67,9
HCPCS,E0236,Pump for water circulating p,,,36.52,1476.18,9
HCPCS,E0239,Hydrocollator unit portable,,,846.64,1429.46,9
HCPCS,E0240,BATH/SHOWER CHAIR,38.5,25.03,1.1,241.86,80
HCPCS,E0240,Bath/shower chair,,,36.52,102.75,9
HCPCS,E0241,"BATH TUB WALL RAIL, EACH",16.7,10.86,1.1,59.85,86
HCPCS,E0241,Bath tub wall rail,,,27.4,42.28,9
HCPCS,E0242,"BATH TUB RAIL, FLOOR BASE",37.0,24.05,1.1,174.48,86
HCPCS,E0242,Bath tub rail floor,,,36.52,156.45,9
HCPCS,E0243,"TOILET RAIL, EACH",35.0,22.75,1.1,107.94,86
HCPCS,E0243,Toilet rail,,,36.52,73.98,9
HCPCS,E0244,RAISED TOILET SEAT,32.0,20.8,1.1,84.3,86
HCPCS,E0244,Toilet seat raised,,,36.52,68.5,9
HCPCS,E0245,Tub stool or bench,,,36.52,130.7,9
HCPCS,E0246,Transfer tub rail attachment,,,36.52,117.82,9
HCPCS,E0247,TRANS BENCH W/WO COMM OPEN,94.95,61.72,1.1,348.97,86
HCPCS,E0247,Trans bench w/wo comm open,,,36.52,164.4,9
HCPCS,E0248,Hdtrans bench w/wo comm open,,,36.52,242.49,9
HCPCS,E0249,Pad water circulating heat u,,,58.52,316.52,9
HCPCS,E0250,Hosp bed fixed ht w/ mattres,,,31.69,2039.79,9
HCPCS,E0251,Hosp bed fixd ht w/o mattres,,,31.69,1979.95,9
HCPCS,E0255,Hospital bed var ht w/ mattr,,,58.52,2064.23,9
HCPCS,E0256,Hospital bed var ht w/o matt,,,31.69,1996.34,9
HCPCS,E0260,Hosp bed semi-electr w/ matt,,,351.41,2064.23,9
HCPCS,E0261,Hosp bed semi-electr w/o mat,,,58.52,2064.23,9
HCPCS,E0265,Hosp bed total electr w/ mat,,,58.52,5004.53,9
HCPCS,E0266,Hosp bed total elec w/o matt,,,58.52,4354.63,9
HCPCS,E0270,Hospital bed institutional t,,,31.69,2874.26,9
HCPCS,E0271,Mattress innerspring,,,351.41,406.89,9
HCPCS,E0272,Mattress foam rubber,,,58.52,457.33,9
HCPCS,E0273,Bed board,,,36.52,79.46,9
HCPCS,E0274,Over-bed table,,,36.52,57.54,9
HCPCS,E0275,Bed pan standard,,,11.14,45.13,9
HCPCS,E0276,Bed pan fracture,,,11.14,40.14,9
HCPCS,E0277,Powered pres-redu air mattrs,,,36.52,6256.02,9
HCPCS,E0280,Bed cradle,,,36.52,102.2,9
HCPCS,E0290,Hosp bed fx ht w/o rails w/m,,,31.69,1957.51,9
HCPCS,E0291,Hosp bed fx ht w/o rail w/o,,,36.52,1498.62,9
HCPCS,E0292,Hosp bed var ht no sr w/matt,,,31.69,2026.83,9
HCPCS,E0293,Hosp bed var ht no sr no mat,,,31.69,1912.05,9
HCPCS,E0294,Hosp bed semi-elect w/ mattr,,,58.52,2064.23,9
HCPCS,E0295,Hosp bed semi-elect w/o matt,,,58.52,2064.23,9
HCPCS,E0296,Hosp bed total elect w/ matt,,,58.52,3904.66,9
HCPCS,E0297,Hosp bed total elect w/o mat,,,58.52,3445.77,9
HCPCS,E0300,Enclosed ped crib hosp grade,,,8700.9,8700.9,1
HCPCS,E0301,"Hd hosp bed, 350-600 lbs",,,351.41,5478.08,9
HCPCS,E0302,Ex hd hosp bed > 600 lbs,,,333.06,15681.65,9
HCPCS,E0303,Hosp bed hvy dty xtra wide,,,351.41,5575.63,9
HCPCS,E0304,Hosp bed xtra hvy dty x wide,,,333.06,16551.96,9
HCPCS,E0305,Rails bed side half length,,,11.14,366.8,9
HCPCS,E0310,Rails bed side full length,,,58.52,355.52,9
HCPCS,E0315,Bed accessory brd/tbl/supprt,,,36.52,198.65,9
HCPCS,E0316,Bed safety enclosure,,,58.52,6715.49,9
HCPCS,E0325,Urinal male jug-type,,,16.97,29.43,9
HCPCS,E0326,Urinal female jug-type,,,11.14,32.2,9
HCPCS,E0328,"Ped hospital bed, manual",,,31.69,20470.27,9
HCPCS,E0329,Ped hospital bed semi/elect,,,416.81,19595.16,9
HCPCS,E0350,Control unit bowel system,,,16.97,68.5,9
HCPCS,E0352,Disposable pack w/bowel syst,,,16.97,68.5,9
HCPCS,E0370,Air elevator for heel,,,16.97,69.05,9
HCPCS,E0371,Nonpower mattress overlay,,,846.64,6256.02,9
HCPCS,E0372,Powered air mattress overlay,,,846.64,6256.02,9
HCPCS,E0373,Nonpowered pressure mattress,,,333.06,6256.02,9
HCPCS,E0424,Stationary compressed gas 02,,,9261.31,9261.31,1
HCPCS,E0425,"COMPRESSED GAS SYSTEM, PURCHASED",472.0,306.8,1.1,2860.9,86
HCPCS,E0425,Gas system stationary compre,,,2192.0,2192.0,1
HCPCS,E0430,Oxygen system gas portable,,,794.6,794.6,1
HCPCS,E0431,Portable gaseous 02,,,2062.56,2062.56,1
HCPCS,E0433,Portable liquid oxygen sys,,,4315.5,4315.5,1
HCPCS,E0434,Portable liquid 02,,,4315.5,4315.5,1
HCPCS,E0435,Oxygen system liquid portabl,,,794.6,794.6,1
HCPCS,E0439,Stationary liquid 02,,,9261.31,9261.31,1
HCPCS,E0440,Oxygen system liquid station,,,2192.0,2192.0,1
HCPCS,E0441,"Stationary o2 contents, gas",,,175.0,175.0,1
HCPCS,E0442,"Stationary o2 contents, liq",,,175.0,175.0,1
HCPCS,E0443,"Portable 02 contents, gas",,,157.11,157.11,1
HCPCS,E0444,"Portable 02 contents, liquid",,,157.11,157.11,1
HCPCS,E0445,Oximeter non-invasive,,,16.97,19.65,8
HCPCS,E0446,"Topical ox deliver sys, nos",,,3699.0,3699.0,1
HCPCS,E0447,"Port o2 cont, liq over 4 lpm",,,235.67,235.67,1
HCPCS,E0455,Oxygen tent excl croup/ped t,,,671.3,671.3,1
HCPCS,E0457,Chest shell,,,333.06,1093.81,9
HCPCS,E0459,Chest wrap,,,31.69,951.14,9
HCPCS,E0462,Rocking bed w/ or w/o side r,,,91.28,11308.91,9
HCPCS,E0465,Home vent invasive interface,,,669.74,775.49,8
HCPCS,E0466,Home vent non-invasive inter,,,669.74,775.49,8
HCPCS,E0467,Home vent multi-function,,,669.74,775.49,8
HCPCS,E0468,Home vent dual fnct incl all,,,669.74,775.49,8
HCPCS,E0469,Lung expans high oscil neb,,,669.74,775.49,8
HCPCS,E0470,Rad w/o backup non-inv intfc,,,351.41,3717.08,9
HCPCS,E0471,Rad w/backup non inv intrfc,,,333.06,9356.58,9
HCPCS,E0472,Rad w backup invasive intrfc,,,333.06,14522.52,9
HCPCS,E0480,Percussor elect/pneum home m,,,36.52,1725.32,9
HCPCS,E0481,Intrpulmnry percuss vent sys,,,11645.0,11645.0,1
HCPCS,E0482,Cough stimulating device,,,846.64,16881.09,9
HCPCS,E0483,Hi freq chest wall oscil sys,,,669.74,41733.76,9
HCPCS,E0484,Non-elec oscillatory pep dvc,,,36.52,138.1,9
HCPCS,E0485,Oral device/appliance prefab,,,846.64,980.32,9
HCPCS,E0486,ORAL DEVICE/APLIAN CUSFAB,4000.0,2600.0,333.06,4000.0,66
HCPCS,E0486,ORAL DEVICE/APPLIANCE CUSFAB,4000.0,2600.0,1.1,4664.5,82
HCPCS,E0487,Electronic spirometer,,,16.97,19.65,8
HCPCS,E0490,Control unit nm hw remote,,,669.74,3514.24,9
HCPCS,E0491,Oral dv nm mouthpc hw remote,,,58.52,276.41,9
HCPCS,E0492,Control unit nm stim w phone,,,669.74,2739849.3,9
HCPCS,E0493,Oral dv/app neuromus mouthpi,,,58.52,2739849.3,9
HCPCS,E0500,Ippb all types,,,58.52,67.76,8
HCPCS,E0530,Electronic posa treatment,,,31.69,1022.49,9
HCPCS,E0550,Humidif extens supple w ippb,,,31.69,1672.96,9
HCPCS,E0555,Humidifier for use w/ regula,,,16.97,19.65,9
HCPCS,E0560,Humidifier supplemental w/ i,,,58.52,552.63,9
HCPCS,E0561,Humidifier nonheated w pap,,,31.69,249.01,9
HCPCS,E0562,Humidifier heated used w pap,,,351.41,441.22,9
HCPCS,E0565,Compressor air power source,,,31.69,1472.72,9
HCPCS,E0570,"NEBULIZER, WITH COMPRESSOR",76.85,49.95,1.1,617.44,90
HCPCS,E0570,Nebulizer with compression,,,31.69,209.72,9
HCPCS,E0572,Aerosol compressor adjust pr,,,36.52,1072.82,9
HCPCS,E0574,Ultrasonic generator w svneb,,,36.52,1580.05,9
HCPCS,E0575,Nebulizer ultrasonic,,,58.52,4034.7,9
HCPCS,E0580,Nebulizer for use w/ regulat,,,58.52,431.93,9
HCPCS,E0585,Nebulizer w/ compressor & he,,,36.52,1046.93,9
HCPCS,E0600,Suction pump portab hom modl,,,36.52,1797.25,9
HCPCS,E0601,Cont airway pressure device,,,58.52,1431.87,9
HCPCS,E0602,AMEDA DUAL HYGIENIKIT PLUS WITH MANUAL ADAPTER,50.0,32.5,10.9,50.0,67
HCPCS,E0602,BREAST PUMP,73.5,47.78,1.1,122.44,90
HCPCS,E0603,ELECTRIC BREAST PUMP,168.0,109.2,1.1,621.93,86
HCPCS,E0603,Electric breast pump,,,351.41,406.89,8
HCPCS,E0604,Hosp grade elec breast pump,,,31.69,685.0,9
HCPCS,E0605,Vaporizer room type,,,36.52,93.6,9
HCPCS,E0606,Drainage board postural,,,11.14,900.78,9
HCPCS,E0607,Blood glucose monitor home,,,31.69,249.81,9
HCPCS,E0610,Pacemaker monitr audible/vis,,,351.41,889.21,9
HCPCS,E0615,Pacemaker monitr digital/vis,,,333.06,1660.0,9
HCPCS,E0616,Cardiac event recorder,,,200.93,232.66,8
HCPCS,E0617,Automatic ext defibrillator,,,91.28,11934.95,9
HCPCS,E0618,Apnea monitor,,,351.41,11005.68,9
HCPCS,E0619,Apnea monitor w recorder,,,846.64,5198.27,9
HCPCS,E0620,Cap bld skin piercing laser,,,1288.13,3431.96,9
HCPCS,E0621,Patient lift sling or seat,,,58.52,278.69,9
HCPCS,E0625,Patient lift bathroom or toi,,,16.97,411.0,9
HCPCS,E0627,"Seat lift mech, electric any",,,91.28,876.14,9
HCPCS,E0629,"Seat lift mech, non-electric",,,91.28,865.81,9
HCPCS,E0630,Patient lift hydraulic,,,58.52,2017.63,9
HCPCS,E0635,Patient lift electric,,,58.52,3926.8,9
HCPCS,E0636,Pt support & positioning sys,,,669.74,33914.93,9
HCPCS,E0637,Combination sit to stand sys,,,91.28,3460.57,9
HCPCS,E0638,Standing frame sys,,,91.28,1403.26,9
HCPCS,E0639,Moveable patient lift system,,,58.52,3901.49,9
HCPCS,E0640,Fixed patient lift system,,,58.52,3901.49,9
HCPCS,E0641,Multi-position stnd fram sys,,,91.28,5480.0,9
HCPCS,E0642,Dynamic standing frame,,,91.28,5480.0,9
HCPCS,E0650,Pneuma compresor non-segment,,,1288.13,2466.33,9
HCPCS,E0651,Pneum compressor segmental,,,1288.13,2918.51,9
HCPCS,E0652,Pneum compres w/cal pressure,,,3989.9,19588.78,9
HCPCS,E0655,Pneumatic appliance half arm,,,58.52,342.99,9
HCPCS,E0656,Segmental pneumatic trunk,,,333.06,2268.5,9
HCPCS,E0657,Segmental pneumatic chest,,,333.06,2130.98,9
HCPCS,E0658,Seg pneum comp 2 arm chest,,,333.06,385.65,8
HCPCS,E0659,Seg pneum comp head neck che,,,333.06,385.65,8
HCPCS,E0660,Pneumatic appliance full leg,,,58.52,507.64,9
HCPCS,E0665,Pneumatic appliance full arm,,,58.52,435.36,9
HCPCS,E0666,Pneumatic appliance half leg,,,58.52,438.84,9
HCPCS,E0667,Seg pneumatic appl full leg,,,91.28,1210.37,9
HCPCS,E0668,SEG PNEUMATIC APPL FULL ARM,108.0,70.2,23.54,980.32,66
HCPCS,E0669,Seg pneumatic appli half leg,,,58.52,650.67,9
HCPCS,E0670,Seg pneum int legs/trunk,,,333.06,4699.59,9
HCPCS,E0671,Pressure pneum appl full leg,,,846.64,1552.84,9
HCPCS,E0672,Pressure pneum appl full arm,,,91.28,1206.5,9
HCPCS,E0673,Pressure pneum appl half leg,,,351.41,1002.54,9
HCPCS,E0675,PNEUMATIC COMPRESSION DEVICE,105.0,68.25,1.1,16863.05,156
HCPCS,E0676,Inter limb compress dev nos,,,1288.13,2329.0,9
HCPCS,E0677,Non pneum seq comp trunk,,,846.64,2268.5,9
HCPCS,E0678,Non pneum seq comp full leg,,,58.52,1270.76,9
HCPCS,E0679,Non pneum seq comp half leg,,,58.52,683.27,9
HCPCS,E0680,Non pneum comp control cal,,,3989.9,20568.25,9
HCPCS,E0681,Non pneu comp control w/o ca,,,1288.13,3064.58,9
HCPCS,E0682,Non pneum compress full arm,,,846.64,1474.45,9
HCPCS,E0683,Non pneu peristalic comp pmp,,,31.69,36.7,8
HCPCS,E0691,Uvl pnl 2 sq ft or less,,,1288.13,3359.43,9
HCPCS,E0692,Uvl sys panel 4 ft,,,669.74,4218.56,9
HCPCS,E0693,Uvl sys panel 6 ft,,,669.74,5200.27,9
HCPCS,E0694,Uvl md cabinet sys 6 ft,,,16552.01,16552.01,1
HCPCS,E0700,Safety equipment,,,16.97,57.54,9
HCPCS,E0705,Transfer device,,,31.69,147.08,9
HCPCS,E0710,Restraints any type,,,11.51,19.65,9
HCPCS,E0711,Ue enclosure restr rom,,,36.52,2739849.3,9
HCPCS,E0715,Intravag pelvic floor kegel,,,669.74,775.49,8
HCPCS,E0716,Supp and acces intravag pelv,,,333.06,385.65,8
HCPCS,E0720,Tens two lead,,,91.28,284.03,9
HCPCS,E0730,Tens four lead,,,91.28,286.99,9
HCPCS,E0731,Conductive garment for tens/,,,91.28,290.0,9
HCPCS,E0732,Ces system,,,91.28,1441.95,9
HCPCS,E0733,Trans elec nerv for trigemin,,,31.69,1441.95,9
HCPCS,E0734,Ext up limb tremor stim wris,,,12349.23,12349.23,1
HCPCS,E0735,Non-invasive vagus nerv stim,,,846.64,1441.95,9
HCPCS,E0739,Rehab sys active assist rt,,,333.06,385.65,8
HCPCS,E0740,Non-implant pelv flr e-stim,,,333.06,2052.73,9
HCPCS,E0743,Ext low ext nerve stimu rls,,,58.52,67.76,8
HCPCS,E0744,Neuromuscular stim for scoli,,,31.69,3071.18,9
HCPCS,E0745,Neuromuscular stim for shock,,,31.69,3514.24,9
HCPCS,E0746,Electromyograph biofeedback,,,91.28,105.69,8
HCPCS,E0747,Elec osteogen stim not spine,,,14640.56,14640.56,1
HCPCS,E0748,Elec osteogen stim spinal,,,14545.76,14545.76,1
HCPCS,E0749,Elec osteogen stim implanted,,,351.41,406.89,8
HCPCS,E0755,Electronic salivary reflex s,,,31.69,753.5,9
HCPCS,E0760,Osteogen ultrasound stimltor,,,12087.24,12087.24,1
HCPCS,E0761,Nontherm electromgntc device,,,52.06,775.49,9
HCPCS,E0762,Trans elec jt stim dev sys,,,669.74,3669.02,9
HCPCS,E0764,Functional neuromuscularstim,,,43442.12,43442.12,1
HCPCS,E0765,Nerve stimulator for tx n&v,,,31.69,314.52,9
HCPCS,E0766,Elec stim cancer treatment,,,31.69,36.7,8
HCPCS,E0767,Intrabuc am rf emf cancer tx,,,669.74,775.49,8
HCPCS,E0769,Electric wound treatment dev,,,669.74,775.49,8
HCPCS,E0770,Functional electric stim nos,,,91.28,22095.36,9
HCPCS,E0776,Iv pole,,,58.52,475.88,9
HCPCS,E0779,Amb infusion pump mechanical,,,11.14,648.17,9
HCPCS,E0780,Mech amb infusion pump <8hrs,,,16.97,38.77,9
HCPCS,E0781,External ambulatory infus pu,,,351.41,8412.92,9
HCPCS,E0784,Ext amb infusn pump insulin,,,846.64,15169.54,9
HCPCS,E0785,Replacement impl pump cathet,,,846.64,980.32,8
HCPCS,E0787,Cgs dose adj insulin inf pmp,,,846.64,11782.0,9
HCPCS,E0791,Parenteral infusion pump sta,,,91.28,9994.4,9
HCPCS,E0830,Ambulatory traction device,,,58.52,67.76,8
HCPCS,E0840,Tract frame attach headboard,,,31.69,273.48,9
HCPCS,E0849,Cervical pneum trac equip,,,333.06,2023.11,9
HCPCS,E0850,Traction stand free standing,,,58.52,392.72,9
HCPCS,E0855,DELUXE HOME TRACTION KIT,631.0,410.15,137.56,631.0,66
HCPCS,E0856,Cervic collar w air bladders,,,58.52,604.17,9
HCPCS,E0860,"TRACTION EQUIPMENT, OVERDOOR",58.0,37.7,1.1,162.23,90
HCPCS,E0860,Tract equip cervical tract,,,36.52,144.07,9
HCPCS,E0870,Tract frame attach footboard,,,58.52,434.87,9
HCPCS,E0880,Trac stand free stand extrem,,,58.52,469.33,9
HCPCS,E0890,Traction frame attach pelvic,,,58.52,382.61,9
HCPCS,E0900,Trac stand free stand pelvic,,,58.52,429.08,9
HCPCS,E0910,Trapeze bar attached to bed,,,11.14,391.55,9
HCPCS,E0911,Hd trapeze bar attach to bed,,,36.52,1423.24,9
HCPCS,E0912,Hd trapeze bar free standing,,,58.52,2800.75,9
HCPCS,E0920,Fracture frame attached to b,,,36.52,1811.93,9
HCPCS,E0930,Fracture frame free standing,,,36.52,1792.95,9
HCPCS,E0935,Cont pas motion exercise dev,,,11.14,23.07,9
HCPCS,E0936,"Cpm device, other than knee",,,11.14,41.32,9
HCPCS,E0940,Trapeze bar free standing,,,36.52,728.73,9
HCPCS,E0941,Gravity assisted traction de,,,36.52,1502.07,9
HCPCS,E0942,Cervical head harness/halter,,,11.14,63.07,9
HCPCS,E0944,Pelvic belt/harness/boot,,,36.52,145.77,9
HCPCS,E0945,Belt/harness extremity,,,36.52,165.69,9
HCPCS,E0946,Fracture frame dual w cross,,,31.69,1974.2,9
HCPCS,E0947,Fracture frame attachmnts pe,,,333.06,1927.21,9
HCPCS,E0948,Fracture frame attachmnts ce,,,333.06,1864.02,9
HCPCS,E0950,Tray,,,58.52,246.55,9
HCPCS,E0951,Loop heel,,,11.14,43.37,9
HCPCS,E0952,"Toe loop/holder, each",,,11.14,51.59,9
HCPCS,E0953,W/c lateral thigh/knee sup,,,58.52,251.89,9
HCPCS,E0954,"Foot box, any type each foot",,,58.52,171.36,9
HCPCS,E0955,Cushioned headrest,,,351.41,495.12,9
HCPCS,E0956,W/c lateral trunk/hip suppor,,,58.52,251.89,9
HCPCS,E0957,W/c medial thigh support,,,58.52,384.12,9
HCPCS,E0958,Whlchr att- conv 1 arm drive,,,36.52,1410.58,9
HCPCS,E0959,Amputee adapter,,,36.52,135.55,9
HCPCS,E0960,W/c shoulder harness/straps,,,31.69,240.68,9
HCPCS,E0961,Wheelchair brake extension,,,36.52,64.69,9
HCPCS,E0966,Wheelchair head rest extensi,,,31.69,232.52,9
HCPCS,E0967,Man wc rim/projection rep ea,,,31.69,233.8,9
HCPCS,E0968,Wheelchair commode seat,,,11.14,703.41,9
HCPCS,E0969,Wheelchair narrowing device,,,58.52,497.72,9
HCPCS,E0970,Wheelchair no. 2 footplates,,,11.14,41.37,9
HCPCS,E0971,Wheelchair anti-tipping devi,,,36.52,96.42,9
HCPCS,E0973,W/ch access det adj armrest,,,58.52,170.43,9
HCPCS,E0974,W/ch access anti-rollback,,,31.69,240.0,9
HCPCS,E0978,"W/c acc,saf belt pelv strap",,,36.52,79.95,9
HCPCS,E0980,Wheelchair safety vest,,,36.52,119.49,9
HCPCS,E0981,"Seat upholstery, replacement",,,36.52,129.14,9
HCPCS,E0982,"Back upholstery, replacement",,,31.69,141.14,9
HCPCS,E0983,Add pwr joystick,,,351.41,9811.15,9
HCPCS,E0984,Add pwr tiller,,,6374.56,6374.56,1
HCPCS,E0985,W/c seat lift mechanism,,,351.41,756.93,9
HCPCS,E0986,Man w/c powr assist syst,,,3989.9,19095.22,9
HCPCS,E0988,Lever-activated wheel drive,,,58.52,11751.09,9
HCPCS,E0990,Wheelchair elevating leg res,,,58.52,227.64,9
HCPCS,E0992,Wheelchair solid seat insert,,,31.69,262.85,9
HCPCS,E0994,Wheelchair arm rest,,,11.14,65.92,9
HCPCS,E0995,"Wc calf rest, pad replacemnt",,,36.52,83.27,9
HCPCS,E1002,Pwr seat tilt,,,12604.41,12604.41,1
HCPCS,E1003,Pwr seat recline,,,14753.26,14753.26,1
HCPCS,E1004,Pwr seat recline mech,,,3989.9,16215.92,9
HCPCS,E1005,Pwr seat recline pwr,,,3989.9,17739.01,9
HCPCS,E1006,Pwr seat combo w/o shear,,,3989.9,21841.61,9
HCPCS,E1007,Pwr seat combo w/shear,,,27148.8,27148.8,1
HCPCS,E1008,Pwr seat combo pwr shear,,,27847.33,27847.33,1
HCPCS,E1009,Add mech leg elevation,,,12330.0,12330.0,1
HCPCS,E1010,Add pwr leg elevation,,,669.74,3784.41,9
HCPCS,E1011,Ped wc modify width adjustm,,,16.97,621.98,9
HCPCS,E1012,Ctr mount pwr elev leg rest,,,3784.41,3784.41,1
HCPCS,E1014,Reclining back add ped w/c,,,91.28,1433.9,9
HCPCS,E1015,Shock absorber for man w/c,,,58.52,402.29,9
HCPCS,E1016,Shock absorber for power w/c,,,58.52,384.09,9
HCPCS,E1017,Hd shck absrbr for hd man wc,,,290.44,406.89,9
HCPCS,E1018,Hd shck absrber for hd powwc,,,290.44,290.44,1
HCPCS,E1020,Residual limb support system,,,351.41,610.77,9
HCPCS,E1022,Wheelchr transport secur,,,36.52,42.28,8
HCPCS,E1023,Wheelchr transit securement,,,36.52,42.28,8
HCPCS,E1028,W/c manual swingaway,,,351.41,445.06,9
HCPCS,E1029,W/c vent tray fixed,,,91.28,1249.77,9
HCPCS,E1030,W/c vent tray gimbaled,,,669.74,3942.64,9
HCPCS,E1031,Rollabout chair with casters,,,31.69,1462.09,9
HCPCS,E1032,Wheelchair joystick drive,,,351.41,406.89,8
HCPCS,E1033,Wheelchair hardware headrest,,,351.41,406.89,8
HCPCS,E1034,Wheelchair trunk hip support,,,351.41,406.89,8
HCPCS,E1035,Patient transfer system <300,,,333.06,19905.09,9
HCPCS,E1036,Patient transfer system >300,,,1288.13,29254.49,9
HCPCS,E1037,"Transport chair, ped size",,,58.52,3757.64,9
HCPCS,E1038,Transport chair pt wt<=300lb,,,11.14,486.49,9
HCPCS,E1039,Transport chair pt wt >300lb,,,36.52,1118.58,9
HCPCS,E1050,Whelchr fxd full length arms,,,58.52,3998.15,9
HCPCS,E1060,Wheelchair detachable arms,,,58.52,4948.44,9
HCPCS,E1070,Wheelchair detachable foot r,,,58.52,3654.94,9
HCPCS,E1083,Hemi-wheelchair fixed arms,,,31.69,3090.75,9
HCPCS,E1084,Hemi-wheelchair detachable a,,,58.52,3850.85,9
HCPCS,E1085,Hemi-wheelchair fixed arms,,,58.52,1076.82,9
HCPCS,E1086,Hemi-wheelchair detachable a,,,58.52,1698.8,9
HCPCS,E1087,Wheelchair lightwt fixed arm,,,58.52,4831.06,9
HCPCS,E1088,Wheelchair lightweight det a,,,58.52,5290.23,9
HCPCS,E1089,Wheelchair lightwt fixed arm,,,351.41,1890.6,9
HCPCS,E1090,Wheelchair lightweight det a,,,351.41,3011.26,9
HCPCS,E1091,Wheelchair Youth,,,2014.72,2014.72,1
HCPCS,E1092,Wheelchair wide w/ leg rests,,,58.52,4392.03,9
HCPCS,E1093,Wheelchair wide w/ foot rest,,,58.52,3908.39,9
HCPCS,E1100,Whchr s-recl fxd arm leg res,,,58.52,3463.61,9
HCPCS,E1110,Wheelchair semi-recl detach,,,58.52,3518.27,9
HCPCS,E1130,Whlchr stand fxd arm ft rest,,,31.69,816.52,9
HCPCS,E1140,Wheelchair standard detach a,,,58.52,1731.68,9
HCPCS,E1150,Wheelchair standard w/ leg r,,,31.69,3202.1,9
HCPCS,E1160,Wheelchair fixed arms,,,31.69,2453.78,9
HCPCS,E1161,Manual adult wc w tiltinspac,,,9287.81,9287.81,1
HCPCS,E1170,Whlchr ampu fxd arm leg rest,,,31.69,2980.57,9
HCPCS,E1171,Wheelchair amputee w/o leg r,,,31.69,2674.46,9
HCPCS,E1172,Wheelchair amputee detach ar,,,58.52,3269.42,9
HCPCS,E1180,Wheelchair amputee w/ foot r,,,58.52,3511.36,9
HCPCS,E1190,Wheelchair amputee w/ leg re,,,58.52,4038.43,9
HCPCS,E1195,Wheelchair amputee heavy dut,,,58.52,4191.49,9
HCPCS,E1200,Wheelchair amputee fixed arm,,,31.69,2903.17,9
HCPCS,E1220,Whlchr special size/constrc,,,5754.0,5754.0,1
HCPCS,E1221,Wheelchair spec size w foot,,,36.52,1865.15,9
HCPCS,E1222,Wheelchair spec size w/ leg,,,31.69,2498.09,9
HCPCS,E1223,Wheelchair spec size w foot,,,31.69,2905.47,9
HCPCS,E1224,Wheelchair spec size w/ leg,,,31.69,3185.69,9
HCPCS,E1225,Manual semi-reclining back,,,36.52,1343.83,9
HCPCS,E1226,Manual fully reclining back,,,333.06,1195.98,9
HCPCS,E1227,Wheelchair spec sz spec ht a,,,351.41,881.84,9
HCPCS,E1228,Wheelchair spec sz spec ht b,,,36.52,1100.16,9
HCPCS,E1229,Pediatric wheelchair nos,,,1288.13,2739999.97,9
HCPCS,E1230,Power operated vehicle,,,8281.4,8281.4,1
HCPCS,E1231,Rigid ped w/c tilt-in-space,,,4027.8,4027.8,1
HCPCS,E1232,Folding ped wc tilt-in-space,,,8395.09,8395.09,1
HCPCS,E1233,Rig ped wc tltnspc w/o seat,,,8697.45,8697.45,1
HCPCS,E1234,Fld ped wc tltnspc w/o seat,,,7572.26,7572.26,1
HCPCS,E1235,Rigid ped wc adjustable,,,669.74,7291.74,9
HCPCS,E1236,Folding ped wc adjustable,,,669.74,6432.97,9
HCPCS,E1237,Rgd ped wc adjstabl w/o seat,,,669.74,6488.79,9
HCPCS,E1238,Fld ped wc adjstabl w/o seat,,,669.74,6432.97,9
HCPCS,E1239,Ped power wheelchair nos,,,2739999.97,2739999.97,1
HCPCS,E1240,Whchr litwt det arm leg rest,,,58.52,4044.49,9
HCPCS,E1250,Wheelchair lightwt fixed arm,,,58.52,1391.92,9
HCPCS,E1260,Wheelchair lightwt foot rest,,,351.41,2156.38,9
HCPCS,E1270,Wheelchair lightweight leg r,,,31.69,3098.8,9
HCPCS,E1280,Whchr h-duty det arm leg res,,,58.52,4714.53,9
HCPCS,E1285,Wheelchair heavy duty fixed,,,58.52,2472.58,9
HCPCS,E1290,Wheelchair hvy duty detach a,,,58.52,2660.54,9
HCPCS,E1295,Wheelchair heavy duty fixed,,,58.52,4410.14,9
HCPCS,E1296,Wheelchair special seat heig,,,333.06,1562.38,9
HCPCS,E1297,Wheelchair special seat dept,,,58.52,332.42,9
HCPCS,E1298,Wheelchair spec seat depth/w,,,846.64,1346.3,9
HCPCS,E1300,Whirlpool portable,,,287.7,287.7,1
HCPCS,E1301,Whirlpool tub walkin portabl,,,2739849.3,2739849.3,1
HCPCS,E1310,Whirlpool non-portable,,,6824.05,6824.05,1
HCPCS,E1352,O2 flow reg pos inspir press,,,2739849.3,2739849.3,1
HCPCS,E1353,Oxygen supplies regulator,,,36.52,42.28,8
HCPCS,E1354,"Wheeled cart, port cyl/conc",,,0.22,0.22,1
HCPCS,E1355,Oxygen supplies stand/rack,,,11.14,12.9,8
HCPCS,E1356,"Batt pack/cart, port conc",,,16.33,16.33,1
HCPCS,E1357,"Battery charger, port conc",,,26.44,26.44,1
HCPCS,E1358,"Dc power adapter, port conc",,,2739849.3,2739849.3,1
HCPCS,E1372,Oxy suppl heater for nebuliz,,,58.52,437.72,9
HCPCS,E1390,Oxygen concentrator,,,9261.31,9261.31,1
HCPCS,E1391,"Oxygen concentrator, dual",,,9261.31,9261.31,1
HCPCS,E1392,Portable oxygen concentrator,,,4315.5,4315.5,1
HCPCS,E1399,Durable medical equipment mi,,,16.97,2739999.97,9
HCPCS,E1500,Centrifuge,,,91.28,822.0,9
HCPCS,E1510,Kidney dialysate delivry sys,,,1288.13,1644.0,9
HCPCS,E1520,Heparin infusion pump,,,351.41,690.48,9
HCPCS,E1530,Replacement air bubble detec,,,36.52,1483.71,9
HCPCS,E1540,Replacement pressure alarm,,,36.52,908.58,9
HCPCS,E1550,Bath conductivity meter,,,36.52,230.16,9
HCPCS,E1560,Replace blood leak detector,,,36.52,959.0,9
HCPCS,E1570,Adjustable chair for esrd pt,,,31.69,43.84,9
HCPCS,E1575,Transducer protect/fld bar,,,2.74,42.28,9
HCPCS,E1580,Unipuncture control system,,,36.52,959.0,9
HCPCS,E1590,Hemodialysis machine,,,2301.6,19595.16,9
HCPCS,E1592,Auto interm peritoneal dialy,,,9590.0,9590.0,1
HCPCS,E1594,Cycler dialysis machine,,,1288.13,6041.7,9
HCPCS,E1600,Deli/install chrg hemo equip,,,36.52,169.33,9
HCPCS,E1610,Reverse osmosis h2o puri sys,,,3386.64,3386.64,1
HCPCS,E1615,Deionizer h2o puri system,,,6850.0,6850.0,1
HCPCS,E1620,Replacement blood pump,,,351.41,959.0,9
HCPCS,E1625,Water softening system,,,91.28,959.0,9
HCPCS,E1629,Tablo for dialysis service,,,16923.09,2739849.3,9
HCPCS,E1630,Reciprocating peritoneal dia,,,6850.0,6850.0,1
HCPCS,E1632,Wearable artificial kidney,,,1288.13,6850.0,9
HCPCS,E1634,Peritoneal dialysis clamp,,,10.14,42.28,9
HCPCS,E1635,Compact travel hemodialyzer,,,1288.13,6850.0,9
HCPCS,E1636,Sorbent cartridges per 10,,,36.52,137.0,9
HCPCS,E1637,"Hemostats for dialysis, each",,,36.52,2739849.3,9
HCPCS,E1639,"Scale, each",,,36.52,342.5,9
HCPCS,E1699,Dialysis equipment noc,,,16.97,2739999.97,9
HCPCS,E1700,Jaw motion rehab system,,,91.28,1150.8,9
HCPCS,E1701,Repl cushions for jaw motion,,,11.14,39.62,9
HCPCS,E1702,Repl measr scales jaw motion,,,11.14,84.34,9
HCPCS,E1800,Adjust elbow ext & flex dev,,,58.52,4808.89,9
HCPCS,E1801,Sps/pass elbow device,,,58.52,5064.37,9
HCPCS,E1802,Adjst forearm pro/sup device,,,91.28,12829.12,9
HCPCS,E1803,Adjust elbow extension dev,,,58.52,67.76,8
HCPCS,E1804,Adjust elbow flexion dev,,,58.52,67.76,8
HCPCS,E1805,Adjust wrist ext & flex dev,,,58.52,4959.95,9
HCPCS,E1806,Sps wrist device,,,58.52,4158.42,9
HCPCS,E1807,Adjust wrist extension dev,,,58.52,67.76,8
HCPCS,E1808,Adjust wrist flexion device,,,58.52,67.76,8
HCPCS,E1810,Adjust knee ext & flex dev,,,58.52,4890.9,9
HCPCS,E1811,Sps/pass knee device,,,58.52,5264.61,9
HCPCS,E1812,Knee ext/flex w act res ctrl,,,31.69,3375.57,9
HCPCS,E1813,Adjust knee extension device,,,58.52,67.76,8
HCPCS,E1814,Adjust knee flexion device,,,58.52,67.76,8
HCPCS,E1815,Adjust ankle ext & flex dev,,,58.52,4959.95,9
HCPCS,E1816,Sps/pass ankle device,,,58.52,5348.34,9
HCPCS,E1818,Sps/pass forearm device,,,58.52,5459.67,9
HCPCS,E1820,Soft interface material,,,31.69,288.3,9
HCPCS,E1821,Replacement interface spsd,,,58.52,393.44,9
HCPCS,E1822,Adjust ankle extension dev,,,58.52,67.76,8
HCPCS,E1823,Adjust ankle flexion device,,,58.52,67.76,8
HCPCS,E1825,Adjust finger ext & flex dev,,,58.52,4959.95,9
HCPCS,E1826,Adjust finger extension dev,,,58.52,67.76,8
HCPCS,E1827,Adjust finger flexion device,,,58.52,67.76,8
HCPCS,E1828,Adjust toe extension device,,,58.52,67.76,8
HCPCS,E1829,Adjust toe flexion device,,,58.52,67.76,8
HCPCS,E1830,Adjust toe ext & flex device,,,58.52,4959.95,9
HCPCS,E1831,Static str toe dev ext/flex,,,31.69,2593.33,9
HCPCS,E1832,Sps finger device,,,31.69,36.7,8
HCPCS,E1840,Adj shoulder ext/flex device,,,846.64,15023.69,9
HCPCS,E1841,Sps/pass shoulder device,,,846.64,17782.16,9
HCPCS,E1902,Aac non-electronic board,,,36.52,10960.0,9
HCPCS,E1905,Vr cbt therapy,,,18586.57,18586.57,1
HCPCS,E2000,Gastric suction pump hme mdl,,,31.69,2034.61,9
HCPCS,E2001,Suct pum ext mgmt sys,,,31.69,1797.25,9
HCPCS,E2100,Bld glucose monitor w voice,,,333.06,2404.57,9
HCPCS,E2101,Bld glucose monitor w lance,,,58.52,704.92,9
HCPCS,E2102,Adju cgm receiver/monitor,,,58.52,627.54,9
HCPCS,E2103,Non-adju cgm receiver/mon,,,58.52,790.33,9
HCPCS,E2104,Glucose monitor w cartridge,,,31.69,36.7,8
HCPCS,E2120,Pulse gen sys tx endolymp fl,,,351.41,11129.66,9
HCPCS,E2201,"Man w/ch acc seat w>=20""<24""",,,91.28,983.91,9
HCPCS,E2202,Seat width 24-27 in,,,846.64,1457.98,9
HCPCS,E2203,Frame depth less than 22 in,,,333.06,1362.6,9
HCPCS,E2204,Frame depth 22 to 25 in,,,1288.13,2431.64,9
HCPCS,E2205,"Manual wc accessory, handrim",,,36.52,113.13,9
HCPCS,E2206,Man wc whl lock comp repl ea,,,36.52,122.86,9
HCPCS,E2207,Crutch and cane holder,,,36.52,149.6,9
HCPCS,E2208,Cylinder tank carrier,,,58.52,249.34,9
HCPCS,E2209,Arm trough each,,,58.52,274.69,9
HCPCS,E2210,Wheelchair bearings,,,16.97,19.65,9
HCPCS,E2211,Pneumatic propulsion tire,,,36.52,107.44,9
HCPCS,E2212,Pneumatic prop tire tube,,,16.97,20.71,9
HCPCS,E2213,Pneumatic prop tire insert,,,36.52,96.28,9
HCPCS,E2214,Pneumatic caster tire each,,,36.52,105.52,9
HCPCS,E2215,Pneumatic caster tire tube,,,16.97,33.24,9
HCPCS,E2216,Foam filled propulsion tire,,,11.14,154.15,9
HCPCS,E2217,Foam filled caster tire each,,,11.14,136.42,9
HCPCS,E2218,Foam propulsion tire each,,,11.14,154.15,9
HCPCS,E2219,Foam caster tire any size ea,,,36.52,136.42,9
HCPCS,E2220,"Solid propuls tire, repl, ea",,,36.52,89.35,9
HCPCS,E2221,"Solid caster tire repl, each",,,36.52,87.95,9
HCPCS,E2222,"Solid caster integ whl, repl",,,11.14,72.75,9
HCPCS,E2224,Propulsion whl excl tire rep,,,58.52,290.99,9
HCPCS,E2225,Caster wheel excludes tire,,,11.14,60.91,9
HCPCS,E2226,Caster fork replacement only,,,36.52,129.88,9
HCPCS,E2227,Gear reduction drive wheel,,,669.74,7343.83,9
HCPCS,E2228,"Mwc acc, wheelchair brake",,,1288.13,3254.16,9
HCPCS,E2230,Manual standing system,,,11.14,2739849.3,9
HCPCS,E2231,Solid seat support base,,,58.52,456.57,9
HCPCS,E2291,Planar back for ped size wc,,,36.52,705.55,9
HCPCS,E2292,Planar seat for ped size wc,,,36.52,493.2,9
HCPCS,E2293,Contour back for ped size wc,,,36.52,875.43,9
HCPCS,E2294,Contour seat for ped size wc,,,36.52,685.0,9
HCPCS,E2295,Ped dynamic seating frame,,,36.52,727.47,9
HCPCS,E2300,Pwr seat elevation sys,,,4795.0,4795.0,1
HCPCS,E2301,Pwr standing,,,1370.0,1370.0,1
HCPCS,E2310,Electro connect btw control,,,669.74,3690.89,9
HCPCS,E2311,Electro connect btw 2 sys,,,7447.98,7447.98,1
HCPCS,E2312,Mini-prop remote joystick,,,7916.05,7916.05,1
HCPCS,E2313,"Pwc harness, expand control",,,91.28,1257.82,9
HCPCS,E2321,Hand interface joystick,,,5014.89,5014.89,1
HCPCS,E2322,Mult mech switches,,,4737.84,4737.84,1
HCPCS,E2323,Special joystick handle,,,31.69,219.94,9
HCPCS,E2324,Chin cup interface,,,36.52,141.19,9
HCPCS,E2325,Sip and puff interface,,,669.74,4528.1,9
HCPCS,E2326,Breath tube kit,,,91.28,1174.97,9
HCPCS,E2327,Head control interface mech,,,8838.42,8838.42,1
HCPCS,E2328,Head/extremity control inter,,,3989.9,16718.52,9
HCPCS,E2329,Head control nonproportional,,,669.74,5975.53,9
HCPCS,E2330,Head control proximity switc,,,11577.9,11577.9,1
HCPCS,E2331,Attendant control,,,2096.1,2096.1,1
HCPCS,E2340,W/c wdth 20-23 in seat frame,,,91.28,1339.72,9
HCPCS,E2341,W/c wdth 24-27 in seat frame,,,333.06,2009.79,9
HCPCS,E2342,W/c dpth 20-21 in seat frame,,,846.64,1674.85,9
HCPCS,E2343,W/c dpth 22-25 in seat frame,,,1288.13,2679.77,9
HCPCS,E2351,Electronic sgd interface,,,333.06,2252.01,9
HCPCS,E2358,Gr 34 nonsealed leadacid,,,333.06,2739849.3,9
HCPCS,E2359,Gr34 sealed leadacid battery,,,333.06,555.43,9
HCPCS,E2360,22nf nonsealed leadacid,,,58.52,376.8,9
HCPCS,E2361,22nf sealed leadacid battery,,,58.52,372.64,9
HCPCS,E2362,Gr24 nonsealed leadacid,,,31.69,343.9,9
HCPCS,E2363,Gr24 sealed leadacid battery,,,58.52,486.98,9
HCPCS,E2364,U1nonsealed leadacid battery,,,58.52,363.05,9
HCPCS,E2365,U1 sealed leadacid battery,,,58.52,248.74,9
HCPCS,E2366,"Battery charger, single mode",,,351.41,517.59,9
HCPCS,E2367,"Battery charger, dual mode",,,846.64,1215.66,9
HCPCS,E2368,Pwr wc drivewheel motor repl,,,333.06,1448.56,9
HCPCS,E2369,Pwr wc drivewheel gear repl,,,846.64,1369.73,9
HCPCS,E2370,Pwr wc dr wh motor/gear comb,,,1288.13,1760.15,9
HCPCS,E2371,Gr27 sealed leadacid battery,,,58.52,460.54,9
HCPCS,E2372,Gr27 non-sealed leadacid,,,206.32,206.32,1
HCPCS,E2373,Hand/chin ctrl spec joystick,,,669.74,2688.84,9
HCPCS,E2374,Hand/chin ctrl std joystick,,,333.06,1700.58,9
HCPCS,E2375,Non-expandable controller,,,1288.13,2281.74,9
HCPCS,E2376,"Expandable controller, repl",,,669.74,4225.16,9
HCPCS,E2377,"Expandable controller, initl",,,333.06,1565.09,9
HCPCS,E2378,Pw actuator replacement,,,333.06,1872.93,9
HCPCS,E2381,Pneum drive wheel tire,,,31.69,206.46,9
HCPCS,E2382,"Tube, pneum wheel drive tire",,,11.14,59.05,9
HCPCS,E2383,"Insert, pneum wheel drive",,,58.52,425.55,9
HCPCS,E2384,Pneumatic caster tire,,,31.69,209.66,9
HCPCS,E2385,"Tube, pneumatic caster tire",,,31.69,141.69,9
HCPCS,E2386,Foam filled drive wheel tire,,,58.52,333.98,9
HCPCS,E2387,Foam filled caster tire,,,31.69,170.02,9
HCPCS,E2388,Foam drive wheel tire,,,31.69,154.18,9
HCPCS,E2389,Foam caster tire,,,36.52,86.17,9
HCPCS,E2390,Solid drive wheel tire,,,36.52,133.41,9
HCPCS,E2391,Solid caster tire,,,11.14,59.32,9
HCPCS,E2392,"Solid caster tire, integrate",,,31.69,146.29,9
HCPCS,E2394,Drive wheel excludes tire,,,31.69,190.9,9
HCPCS,E2395,Caster wheel excludes tire,,,31.69,148.67,9
HCPCS,E2396,Caster fork,,,31.69,164.67,9
HCPCS,E2397,"Pwc acc, lith-based battery",,,846.64,1456.69,9
HCPCS,E2398,Wc dynamic pos back hardware,,,31.69,428.86,9
HCPCS,E2402,Neg press wound therapy pump,,,669.74,22359.47,9
HCPCS,E2500,Sgd digitized pre-rec <=8min,,,846.64,1461.95,9
HCPCS,E2502,Sgd prerec msg >8min <=20min,,,669.74,4470.56,9
HCPCS,E2504,Sgd prerec msg>20min <=40min,,,669.74,5897.33,9
HCPCS,E2506,Sgd prerec msg > 40 min,,,8647.17,8647.17,1
HCPCS,E2508,Sgd spelling phys contact,,,13371.45,13371.45,1
HCPCS,E2510,Sgd w multi methods msg/accs,,,25303.68,25303.68,1
HCPCS,E2511,Sgd sftwre prgrm for pc/pda,,,2192.0,2192.0,1
HCPCS,E2512,"Sgd accessory, mounting sys",,,2536.14,2536.14,1
HCPCS,E2599,Sgd accessory noc,,,2739999.97,2739999.97,1
HCPCS,E2601,Gen w/c cushion wdth < 22 in,,,31.69,123.9,9
HCPCS,E2602,Gen w/c cushion wdth >=22 in,,,58.52,276.49,9
HCPCS,E2603,SKIN PROTECT WC CUS WD <22IN,47.0,30.55,1.1,581.37,90
HCPCS,E2603,Skin protect wc cus wd <22in,,,58.52,333.02,9
HCPCS,E2604,Skin protect wc cus wd>=22in,,,58.52,463.33,9
HCPCS,E2605,Position wc cush wdth <22 in,,,351.41,676.67,9
HCPCS,E2606,Position wc cush wdth>=22 in,,,846.64,1132.09,9
HCPCS,E2607,Skin pro/pos wc cus wd <22in,,,91.28,665.96,9
HCPCS,E2608,Skin pro/pos wc cus wd>=22in,,,91.28,831.73,9
HCPCS,E2609,Custom fabricate w/c cushion,,,669.74,2290.09,9
HCPCS,E2610,Powered w/c cushion,,,1370.0,1370.0,1
HCPCS,E2611,Gen use back cush wdth <22in,,,91.28,472.13,9
HCPCS,E2612,Gen use back cush wdth>=22in,,,846.64,980.32,9
HCPCS,E2613,Position back cush wd <22in,,,846.64,1000.68,9
HCPCS,E2614,Position back cush wd>=22in,,,333.06,1537.41,9
HCPCS,E2615,Pos back post/lat wdth <22in,,,846.64,1124.25,9
HCPCS,E2616,Pos back post/lat wdth>=22in,,,333.06,1564.79,9
HCPCS,E2617,Custom fab w/c back cushion,,,669.74,3279.78,9
HCPCS,E2619,Replace cover w/c seat cush,,,31.69,158.73,9
HCPCS,E2620,Wc planar back cush wd <22in,,,333.06,1221.08,9
HCPCS,E2621,Wc planar back cush wd>=22in,,,333.06,1475.24,9
HCPCS,E2622,Adj skin pro w/c cus wd<22in,,,91.28,1006.95,9
HCPCS,E2623,Adj skin pro wc cus wd>=22in,,,846.64,1273.39,9
HCPCS,E2624,Adj skin pro/pos cus<22in,,,91.28,1023.25,9
HCPCS,E2625,Adj skin pro/pos wc cus>=22,,,846.64,1266.35,9
HCPCS,E2626,Seo mobile arm sup att to wc,,,333.06,2060.23,9
HCPCS,E2627,Arm supp att to wc rancho ty,,,669.74,3006.22,9
HCPCS,E2628,Mobile arm supports reclinin,,,1288.13,2372.68,9
HCPCS,E2629,Friction dampening arm supp,,,669.74,3168.62,9
HCPCS,E2630,Monosuspension arm/hand supp,,,333.06,2090.59,9
HCPCS,E2631,Elevat proximal arm support,,,351.41,839.89,9
HCPCS,E2632,Offset/lat rocker arm w/ela,,,58.52,534.05,9
HCPCS,E2633,Mobile arm support supinator,,,58.52,445.33,9
HCPCS,E3000,Speech volume modulation sys,,,1288.13,6743.96,9
HCPCS,E3200,Gait mod systm rhym auditory,,,669.74,775.49,8
HCPCS,E8000,Posterior gait trainer,,,91.28,4932.0,9
HCPCS,E8001,Upright gait trainer,,,91.28,5480.0,9
HCPCS,E8002,Anterior gait trainer,,,91.28,3151.0,9
HCPCS,ECC,ECC ADOPT-ADDTL CHILD ADM,56.0,36.4,1.1,56.0,68
HCPCS,ECC,ECC ADOPT-BLIND REFER/URG,254.0,165.1,1.1,254.0,68
HCPCS,ECC,ECC ADOPT-GEN INFO ADMIN,128.0,83.2,1.1,128.0,68
HCPCS,ECC,ECC ADOPTION - ADDITIONAL CHILD CLINICAL,69.0,44.85,1.1,69.0,68
HCPCS,ECC,ECC ADOPTION - GENERAL INFORMATION CLINICAL,157.0,102.05,1.1,157.0,68
HCPCS,ECC,ECC ADOPTION - POST ADOPTION CONSULT ADMIN,254.0,165.1,1.1,254.0,68
HCPCS,ECC,ECC ADOPTION - POST ADOPTION CONSULT CLINICAL,311.0,202.15,1.1,311.0,68
HCPCS,ECC,ECC ADOPTION - RECORD REVIEW CLINICAL,157.0,102.05,1.1,157.0,68
HCPCS,ECC,ECC ADOPTION REC RVW ADM,128.0,83.2,1.1,128.0,68
HCPCS,ECC,ECC ADOPTION- BLIND REFERRAL/URGENT REQUEST CLINICAL,311.0,202.15,1.1,311.0,68
HCPCS,ECC,ECC EMBASSY CONSULT CLINICAL,212.0,137.8,1.1,212.0,68
HCPCS,ECC,ECC MYCONSULT EMBSY ADMIN,173.0,112.45,1.1,173.0,68
HCPCS,ECC,ECC MYCONSULT PATHOLOGY REVIEW ADMIN,135.0,87.75,1.1,135.0,68
HCPCS,ECC,ECC MYCONSULT PATHOLOGY REVIEW CLINICAL,165.0,107.25,1.1,165.0,68
HCPCS,ECC,ECC MYCONSULT RADIOLOGY ADMIN,135.0,87.75,1.1,135.0,68
HCPCS,ECC,ECC MYCONSULT RADIOLOGY CLINICAL,165.0,107.25,1.1,165.0,68
HCPCS,ECC,ECC MYCONSULT REC DOM ADM,245.0,159.25,1.1,245.0,68
HCPCS,ECC,ECC MYCONSULT REC INT ADM,325.0,211.25,1.1,325.0,68
HCPCS,ECC,ECC MYCONSULT TRIAGE SECOND OPINION ADMIN,254.0,165.1,1.1,254.0,68
HCPCS,ECC,ECC MYCONSULT TRIAGE SECOND OPINION CLINICAL,311.0,202.15,1.1,311.0,68
HCPCS,ECC,ECC MYCONSULT VIDEO FOLLOW UP ADMIN,68.0,44.2,1.1,68.0,68
HCPCS,ECC,ECC MYCONSULT VIDEO FOLLOW UP CLINICAL,83.0,53.95,1.1,83.0,68
HCPCS,ECC,ECC MYCONSULT VIGILINT CONSULT CLINICAL,1000.0,650.0,1.1,1000.0,68
HCPCS,ECC,ECC PATHOLOGY ADMIN2,81.0,52.65,1.1,81.0,68
HCPCS,ECC,ECC PLASTIC SURG COSMETIC- CONSULT CLINICAL,75.0,48.75,1.1,75.0,68
HCPCS,ECC,ECC PLSTC SURG COSM ADMIN,60.0,39.0,1.1,60.0,68
HCPCS,ECC,ECC PRE-ADOPTION 1 ADMIN,254.0,165.1,1.1,254.0,68
HCPCS,ECC,ECC PRE-ADOPTION CONSULT-1CHILD CLINICAL,311.0,202.15,1.1,311.0,68
HCPCS,ECC,ECC SECOND OPINION ADMIN2,254.0,165.1,1.1,254.0,68
HCPCS,ECC,ECC SECOND OPINION LEVEL 2 CLINICAL,311.0,202.15,1.1,311.0,68
HCPCS,ECC,ECC SECOND OPINION PATH 2 CLINICAL,99.0,64.35,1.1,99.0,68
HCPCS,ECC,JOINT VENTURE DIGITAL SECOND OPINION,500.0,325.0,1.1,500.0,68
HCPCS,ECC,JV MULTIDISCIPLINARY BOARD REVIEW,700.0,455.0,1.1,700.0,68
HCPCS,G0008,ADMIN FLU VACCINE,185.0,120.25,17.08,185.0,84
HCPCS,G0009,Admin pneumococcal vaccine,,,17.08,124.01,29
HCPCS,G0009,MEDICAR PT ADMIN.PNEUMOCCAL VIR,43.0,27.95,1.1,137.75,90
HCPCS,G0010,ADMIN HEPATITIS B VACCINE,185.0,120.25,17.08,185.0,84
HCPCS,G0010,HEPATITIS B ADMINIS,99.0,64.35,1.1,137.75,90
HCPCS,G0011,"Hiv prep counsel, md 15-30m",,,86.57,100.24,8
HCPCS,G0012,Injection of hiv prep drug,,,26.38,74.93,30
HCPCS,G0013,"Hiv prep counsel, clin staff",,,27.62,100.24,28
HCPCS,G0017,Crisis psychotherapy 60m,,,59.78,495.26,9
HCPCS,G0018,Crisis psychotherapy add 30m,,,59.78,248.13,9
HCPCS,G0019,Comm hlth intg svs sdoh 60mn,,,77.33,232.71,21
HCPCS,G0023,Pin service 60m per month,,,77.33,232.71,21
HCPCS,G0027,ABSENCE/PRESENCE SPERM (POC) (POINT OF CARE LAB),45.0,29.25,6.5,45.0,84
HCPCS,G0028,Doc med rsn no scr tob,,,10.69,12.38,8
HCPCS,G0029,No tob scr/cess int,,,10.69,2739849.3,9
HCPCS,G0030,Pt scr tob & cess int,,,10.69,2739849.3,9
HCPCS,G0031,Pall serv during meas,,,10.69,2739849.3,9
HCPCS,G0032,2+ antipsy schiz,,,10.69,2739849.3,9
HCPCS,G0033,2+ benzo seiz,,,10.69,2739849.3,9
HCPCS,G0034,Pall serv during meas,,,10.69,2739849.3,9
HCPCS,G0035,Pt ed pos 23,,,10.69,2739849.3,9
HCPCS,G0036,Pt/ptn decln assess,,,10.69,2739849.3,9
HCPCS,G0037,Pt not able to participate,,,10.69,2739849.3,9
HCPCS,G0038,Clin pt no ref,,,10.69,2739849.3,9
HCPCS,G0039,"Pt no ref, rn spec",,,10.69,2739849.3,9
HCPCS,G0040,Pt phys/occ therapy,,,10.69,2739849.3,9
HCPCS,G0041,Pt/ptn decln referral,,,10.69,2739849.3,9
HCPCS,G0042,Ref to therapy,,,10.69,2739849.3,9
HCPCS,G0043,Pt mech pros ht valv,,,10.69,2739849.3,9
HCPCS,G0044,Pt mitral stenosis,,,10.69,2739849.3,9
HCPCS,G0045,Mrs 90 days post stk,,,10.69,2739849.3,9
HCPCS,G0046,No mrs 90 days post stk,,,10.69,2739849.3,9
HCPCS,G0047,Ped blunt hd traum,,,10.69,2739849.3,9
HCPCS,G0048,Pall serv during meas,,,10.69,2739849.3,9
HCPCS,G0049,Main hemo in-cntr,,,10.69,2739849.3,9
HCPCS,G0050,Pt w/ lmted life expec,,,10.69,2739849.3,9
HCPCS,G0051,Pt hospice mnth,,,10.69,2739849.3,9
HCPCS,G0052,Pt peri dialysis dur mo,,,10.69,2739849.3,9
HCPCS,G0053,Adv rheum pt care mvp,,,10.69,12.38,8
HCPCS,G0054,Strk cr prev pos outcme mvp,,,10.69,12.38,8
HCPCS,G0055,Adv care heart dx mvp,,,10.69,12.38,8
HCPCS,G0056,Opt chronic dx mang mvp,,,10.69,12.38,8
HCPCS,G0057,Best pct pt safety em mvp,,,10.69,12.38,8
HCPCS,G0058,Imprv care le jnt repr mvp,,,10.69,12.38,8
HCPCS,G0059,Pt sfty pos exp w aneth mvp,,,10.69,12.38,8
HCPCS,G0060,Allergy/immunology ss,,,10.69,12.38,8
HCPCS,G0061,Anesthesiology ss,,,10.69,12.38,8
HCPCS,G0062,Audiology ss,,,10.69,12.38,8
HCPCS,G0063,Cardiology ss,,,10.69,12.38,8
HCPCS,G0064,Cert nurse midwife ss,,,10.69,12.38,8
HCPCS,G0065,Chiropractic ss,,,10.69,12.38,8
HCPCS,G0066,Clinical social work ss,,,10.69,12.38,8
HCPCS,G0067,Dentistry ss,,,10.69,2739849.3,9
HCPCS,G0068,Adm iv infusion drug in home,,,478.71,478.71,1
HCPCS,G0069,Adm sq infusion drug in home,,,646.83,646.83,1
HCPCS,G0070,Adm of chemo drug in home,,,804.68,804.68,1
HCPCS,G0071,Comm svcs by rhc/fqhc 5 min,,,10.74,44.47,9
HCPCS,G0076,Care manag h vst new pt 20 m,,,21.85,129.57,9
HCPCS,G0077,Care manag h vst new pt 30 m,,,21.85,192.84,9
HCPCS,G0078,Care manag h vst new pt 45 m,,,21.85,316.58,9
HCPCS,G0079,Care manag h vst new pt 60 m,,,21.85,416.15,9
HCPCS,G0080,Care manag h vst new pt 75 m,,,21.85,543.78,9
HCPCS,G0081,Care man h v ext pt 20 mi,,,21.85,127.05,9
HCPCS,G0082,Care man h v ext pt 30 m,,,21.85,204.6,9
HCPCS,G0083,Care man h v ext pt 45 m,,,21.85,321.13,9
HCPCS,G0084,Care man h v ext pt 60 m,,,21.85,453.83,9
HCPCS,G0085,Care man h v ext pt 75 m,,,21.85,543.78,9
HCPCS,G0086,Care man home care plan 30 m,,,21.85,192.51,9
HCPCS,G0087,Care man home care plan 60 m,,,21.85,270.11,9
HCPCS,G0088,Adm iv drug 1st home visit,,,582.22,582.22,1
HCPCS,G0089,Adm subq drug 1st home visit,,,786.65,786.65,1
HCPCS,G0090,Adm iv chemo 1st home visit,,,978.65,978.65,1
HCPCS,G0101,"CA SCRNING, PELV & BRST EXAM",370.0,240.5,0.01,370.0,87
HCPCS,G0101,"CERV/VAG CANC SCRN,PELV/BREAST EXAM",198.0,128.7,1.1,260.19,144
HCPCS,G0101,SCREEN CERV/VAG & PELV/BREAST,370.0,240.5,31.51,370.0,86
HCPCS,G0102,PROSTATE CA SCREENING; DRE,98.5,64.025,1.1,118.0,196
HCPCS,G0103,Psa screening,,,19.31,74.74,34
HCPCS,G0104,SCREENING SIGMOIDOSCOPY,370.0,240.5,1.1,2666.13,130
HCPCS,G0104,SIGMSCPY FLEX W/WO SPEC,3647.0,2370.55,66.94,4628.0,86
HCPCS,G0105,"COLON, SCRN HIGH RISK",3647.0,2370.55,214.53,5265.0,87
HCPCS,G0105,"COLONOSCOPY, SCREENING, HIGH RISK",1434.0,932.1,1.1,2666.13,130
HCPCS,G0106,Colon ca screen;barium enema,,,142.61,479.66,10
HCPCS,G0108,"DIAB OUTPT TRAINING INDIV, PER SESSN",396.0,257.4,1.1,396.0,140
HCPCS,G0108,DIABETES COUNSELING INDIVIDUAL,177.0,115.05,39.1,177.0,85
HCPCS,G0109,"DIAB TRAIN SERV, GROUP SESSN,INDIVID",110.0,71.5,1.1,110.0,140
HCPCS,G0109,MGMT DIABETES GROUP 30MIN,121.0,78.65,19.66,121.0,85
HCPCS,G0117,GLAUCOMA SCRN HGH RISK DIREC,198.0,128.7,1.1,206.8,128
HCPCS,G0117,Glaucoma scrn hgh risk direc,,,22.7,77.73,29
HCPCS,G0118,Glaucoma scrn hgh risk direc,,,34.79,104.7,29
HCPCS,G0120,Colon ca scrn; barium enema,,,142.61,1003.99,10
HCPCS,G0121,COLONOSCOPY SCRN NOT HIGH RISK,1434.0,932.1,1.1,2666.13,130
HCPCS,G0121,"COLOSCPY, SCRN;  NOT HI RISK",3647.0,2370.55,214.72,5265.0,87
HCPCS,G0122,Colon ca scrn; barium enema,,,56.78,121.74,9
HCPCS,G0123,Screen cerv/vag thin layer,,,15.29,116.83,34
HCPCS,G0124,Screen c/v thin layer by md,,,15.29,61.05,12
HCPCS,G0127,TRIM DYSTROPHIC NAIL ANY NUMBER,238.0,154.7,0.01,238.0,87
HCPCS,G0127,"TRIMMING DYSTROPHIC NAILS,ANY NUMBER",75.0,48.75,1.1,177.54,132
HCPCS,G0128,Corf skilled nursing service,,,23.81,36.0,9
HCPCS,G0129,Php/iop ot service,,,85.08,2739849.3,9
HCPCS,G0130,Single energy x-ray study,,,95.38,551.66,23
HCPCS,G0136,"ADMINISTRATION OF A STANDARDIZED, EVIDENCE-BASED SOCIAL DETERMIN",79.0,51.35,1.1,82.65,128
HCPCS,G0136,Adm of pa/n assess 5-15 m,,,24.89,74.91,21
HCPCS,G0136,Adm of soc dtr assess 5-15 m,,,47.12,54.56,8
HCPCS,G0137,"Inten outpt svs,min 9 pr 7 d",,,105.94,2046.97,9
HCPCS,G0138,Iv cipaglucosidase alfa-atga,,,391.01,662.61,28
HCPCS,G0140,Nav srv peer sup 60 min pr m,,,77.33,232.71,21
HCPCS,G0141,"Scr c/v cyto,autosys and md",,,15.29,61.05,12
HCPCS,G0143,"Scr c/v cyto,thinlayer,rescr",,,15.29,116.83,34
HCPCS,G0144,"Scr c/v cyto,thinlayer,rescr",,,15.29,202.65,34
HCPCS,G0145,"Scr c/v cyto,thinlayer,rescr",,,15.29,202.65,34
HCPCS,G0147,"Scr c/v cyto, automated sys",,,15.29,85.7,34
HCPCS,G0148,"Scr c/v cyto, autosys, rescr",,,15.29,96.22,34
HCPCS,G0151,"Hhcp-serv of pt,ea 15 min",,,205.5,205.5,1
HCPCS,G0152,"Hhcp-serv of ot,ea 15 min",,,2739849.3,2739849.3,1
HCPCS,G0153,"Hhcp-svs of s/l path,ea 15mn",,,28.0,28.0,1
HCPCS,G0155,"Hhcp-svs of csw,ea 15 min",,,258.93,258.93,1
HCPCS,G0156,"Hhcp-svs of aide,ea 15 min",,,6.19,6.19,1
HCPCS,G0157,Hhc pt assistant ea 15,,,2739849.3,2739849.3,1
HCPCS,G0158,Hhc ot assistant ea 15,,,44.31,44.31,1
HCPCS,G0159,Hhc pt maint ea 15 min,,,52.39,52.39,1
HCPCS,G0160,Hhc occup therapy ea 15,,,2739849.3,2739849.3,1
HCPCS,G0161,Hhc slp ea 15 min,,,2739849.3,2739849.3,1
HCPCS,G0162,"Hhc rn e&m plan svs, 15 min",,,246.6,246.6,1
HCPCS,G0166,COUNTERPULSE EXTRNL EA TX,516.0,335.4,86.64,516.0,87
HCPCS,G0168,WOUND CLOSURE BY ADHESIVE,136.0,88.4,1.1,401.5,128
HCPCS,G0168,Wound closure by adhesive,,,39.1,215.66,9
HCPCS,G0175,"Opps service,sched team conf",,,21.85,1156.28,29
HCPCS,G0176,Opps/php/iop; activity thrpy,,,48.61,2739849.3,9
HCPCS,G0177,Opps/php/iop; train & educ,,,48.61,56.29,8
HCPCS,G0179,MD RECERTIFICATION HHA PT,198.0,128.7,1.1,198.0,128
HCPCS,G0179,Md recertification hha pt,,,21.85,106.91,9
HCPCS,G0180,MD CERTIFICATION HHA PATIENT,295.0,191.75,1.1,295.0,128
HCPCS,G0180,Md certification hha patient,,,21.85,137.49,9
HCPCS,G0181,HOME HEALTH CARE SUPERVISION,761.0,494.65,1.1,761.0,128
HCPCS,G0181,Home health care supervision,,,21.85,271.78,9
HCPCS,G0182,Hospice care supervision,,,270.85,270.85,1
HCPCS,G0183,Software meas of cardiac vol,,,82.33,212.67,20
HCPCS,G0186,"Dstry eye lesn,fdr vssl tech",,,402.04,1517.49,29
HCPCS,G0219,Pet img wholbod melano nonco,,,2739849.3,2739849.3,1
HCPCS,G0235,PET NOT OTHERWISE SPECIFIED,8227.0,5347.55,0.01,8870.0,220
HCPCS,G0235,Pet not otherwise specified,,,357.81,1909.17,23
HCPCS,G0237,Therapeutic procd strg endur,,,22.7,77.73,29
HCPCS,G0238,PROC RESP OTHER 1-1 15MIN,98.0,63.7,14.28,98.0,86
HCPCS,G0239,PROC RESP FUNC GROUP,157.0,102.05,18.04,157.0,86
HCPCS,G0239,THERAPEUTIC PROCEDURES GROUP 2/> INDIVIDUALS,157.0,102.05,18.04,157.0,87
HCPCS,G0245,INIT FOOT EXAM PT LOPS,515.0,334.75,0.01,515.0,87
HCPCS,G0245,INITIAL FOOT EXAM PT LOPS,387.0,251.55,1.1,387.0,130
HCPCS,G0246,FOLLOWUP EVAL FOOT PT LOP,515.0,334.75,0.01,515.0,87
HCPCS,G0246,FOLLOWUP EVAL OF FOOT PT LOP,198.0,128.7,1.1,385.69,130
HCPCS,G0247,ROUTINE FOOTCARE PT W LOPS,220.0,143.0,1.1,584.65,130
HCPCS,G0247,ROUTINE FT CARE - PT LOS,795.0,516.75,27.05,795.0,86
HCPCS,G0248,DEMONSTRATE USE HOME INR MON,918.5,597.025,0.01,1322.0,215
HCPCS,G0249,"PROVIDE TEST MATERIAL,EQUIPM",1322.0,859.3,1.1,1322.0,128
HCPCS,G0249,Provide inr test mater/equip,,,63.76,345.1,29
HCPCS,G0250,MD REVIEW INTERPRET OF TEST,79.0,51.35,1.1,79.0,128
HCPCS,G0250,Md inr test revie inter mgmt,,,22.8,73.83,9
HCPCS,G0252,Pet imaging initial dx,,,184.76,184.76,1
HCPCS,G0255,Current percep threshold tst,,,391.75,2739849.3,9
HCPCS,G0257,UNSCHEDULED DIALYS TX,2799.0,1819.35,373.09,2799.0,84
HCPCS,G0257,UNSCHEDULED DIALYSIS ESRD PT,2799.0,1819.35,373.09,2799.0,84
HCPCS,G0259,Inject for sacroiliac joint,,,316.55,366.53,8
HCPCS,G0260,INJ SACROILIAC JOINT ANES,2770.0,1800.5,0.01,4392.0,85
HCPCS,G0260,SIJ INJ - ARTHROGR/ANESTHETIC,2770.0,1800.5,316.55,4628.0,85
HCPCS,G0268,"MEDICARE ONLY, REM IMP EAR WAX",122.0,79.3,0.01,122.0,68
HCPCS,G0268,REMOVAL OF IMPACTED WAX MD,268.0,174.2,1.1,268.0,128
HCPCS,G0269,OCCLUSIVE DEVICE IN VEIN ART,75.0,48.75,1.1,4273.03,80
HCPCS,G0269,PLACEMENT OF OCCLUSIVE DEVICE,838.0,544.7,63.76,4628.0,66
HCPCS,G0269,PLC OCCL DVC ARTERY VEIN,838.0,544.7,63.76,12615.0,66
HCPCS,G0270,MEDICAL NUTRITION THERAPY; REASSESSMENT,198.0,128.7,1.1,198.0,128
HCPCS,G0270,Mnt subs tx for change dx,,,29.84,96.37,36
HCPCS,G0271,GROUP MNT 2 OR MORE 30 MINS,110.0,71.5,1.1,110.0,128
HCPCS,G0271,Group mnt 2 or more 30 mins,,,16.62,96.37,36
HCPCS,G0276,Pild/placebo control clin tr,,,3812.17,18676.74,29
HCPCS,G0277,"Hbot, full body chamber, 30m",,,120.38,362.26,29
HCPCS,G0278,ANGIO ILIAC ARTERY W CATH,6890.0,4478.5,14.91,6890.0,68
HCPCS,G0278,"ILIAC ART ANGIO,CARDIAC CATH",110.0,71.5,1.1,110.0,128
HCPCS,G0279,"TOMOSYNTHESIS, MAMMO",264.0,171.6,1.1,351.0,394
HCPCS,G0279,"Tomosynthesis, mammo",,,51.1,128.95,38
HCPCS,G0281,WND CARE UNATT ELECT STIM 15M,147.0,95.55,14.52,215.66,255
HCPCS,G0282,Elect stim wound care not pd,,,32.8,215.66,9
HCPCS,G0283,ELECTR STIM UNATTEND,145.0,94.25,14.7,145.0,85
HCPCS,G0288,"Recon, cta for surg plan",,,405.62,469.67,8
HCPCS,G0289,"ARTHRO, LOOSE BODY + CHONDRO",651.0,423.15,1.1,651.0,130
HCPCS,G0289,"Arthro, loose body + chondro",,,4348.01,5034.54,8
HCPCS,G0293,"Non-cov surg proc,clin trial",,,34.79,232.28,29
HCPCS,G0294,"Non-cov proc, clinical trial",,,34.79,469.67,29
HCPCS,G0295,Electromagnetic therapy onc,,,186.25,2739849.3,9
HCPCS,G0296,VISIT TO DETERM LDCT ELIG,299.5,194.675,1.1,370.0,228
HCPCS,G0297,Ldct for lung ca screen,,,183.67,212.67,8
HCPCS,G0299,Hhs/hospice of rn ea 15 min,,,36.83,36.83,1
HCPCS,G0300,Hhs/hospice of lpn ea 15 min,,,23.45,23.45,1
HCPCS,G0302,"PREOP SERVICE LVRS, 16 DAYS",2122.0,1379.3,0.01,2122.0,85
HCPCS,G0303,"PREOP SERVICE LVRS, 10-15 DAYS",1246.0,809.9,0.01,1246.0,85
HCPCS,G0304,"PREOP SERVICE LVRS, 1-9 DAYS",2122.0,1379.3,0.01,2122.0,85
HCPCS,G0305,"POSTOP SERVICE LVRS, MIN 6 DAYS",2122.0,1379.3,0.01,2122.0,85
HCPCS,G0306,Cbc/diffwbc w/o platelet,,,7.77,29.95,34
HCPCS,G0307,Cbc without platelet,,,6.47,24.95,34
HCPCS,G0308,180 d implant glucose sensor,,,389.36,450.84,8
HCPCS,G0309,Rem/inser glu sensor dif sit,,,389.36,450.84,8
HCPCS,G0310,5-15 MINS TIME,78.0,50.7,0.01,3060831.65,80
HCPCS,G0310,Immunize counsel 5-15 min,,,86.57,2739849.3,9
HCPCS,G0311,16-30 MINS TIME,78.0,50.7,0.01,3060831.65,80
HCPCS,G0311,Immunize counsel 16-30 mins,,,86.57,2739849.3,9
HCPCS,G0312,"AGES UNDER 21, 5-15 MINS TIME",77.0,50.05,0.01,3060831.65,92
HCPCS,G0312,Immunize couns < 21yr 5-15 m,,,86.57,2739849.3,9
HCPCS,G0313,"AGES UNDER 21, 16-30 MINS TIME",117.0,76.05,0.01,3060831.65,92
HCPCS,G0313,Immunize couns < 21yr 6-30 m,,,86.57,2739849.3,9
HCPCS,G0314,Counsel immune <21 16-30 m,,,86.57,2739849.3,9
HCPCS,G0315,Counsel immune <21  5-15 m,,,2739849.3,2739849.3,1
HCPCS,G0315,Counsel immune <21 5-15 m,,,86.57,100.24,8
HCPCS,G0316,PROLONG INPT EVAL ADD15 M,268.0,174.2,1.1,268.0,140
HCPCS,G0316,Prolong inpt eval add15 m,,,63.76,73.83,8
HCPCS,G0317,PROLONG NURSIN FAC EVAL 15M,244.0,158.6,1.1,244.0,140
HCPCS,G0317,Prolong nursin fac eval 15m,,,63.76,78.86,9
HCPCS,G0318,PROLONG HOME EVAL ADD 15M,244.0,158.6,1.1,244.0,140
HCPCS,G0318,Prolong home eval add 15m,,,63.76,78.17,9
HCPCS,G0320,Two-way audio and video hhs,,,2739849.3,2739849.3,1
HCPCS,G0321,Audio-only hhs,,,2739849.3,2739849.3,1
HCPCS,G0322,Home h physio data collec tr,,,86.64,2739849.3,9
HCPCS,G0323,Care manage beh svs 20mins,,,24.89,74.91,21
HCPCS,G0327,Colon ca scrn;bld-bsd biomrk,,,83.94,2739849.3,11
HCPCS,G0328,Fecal blood scrn immunoassay,,,18.05,49.92,31
HCPCS,G0329,Electromagntic tx for ulcers,,,13.92,215.66,36
HCPCS,G0330,Facility svs dental rehab,,,1358.5,3450.35,28
HCPCS,G0333,Dispense fee initial 30 day,,,63.76,156.18,9
HCPCS,G0337,Hospice evaluation preelecti,,,68.73,180.7,9
HCPCS,G0339,"Robot lin-radsurg com, first",,,4012.14,9088.74,9
HCPCS,G0340,Robt lin-radsurg fractx 2-5,,,4012.14,6678.34,9
HCPCS,G0341,Percutaneous islet celltrans,,,812.3,4020.19,9
HCPCS,G0342,Laparoscopy islet cell trans,,,1983.21,4020.19,9
HCPCS,G0343,LAPAROTOMY ISLET CELL TRANSP,8688.0,5647.2,0.01,12615.0,68
HCPCS,G0372,MD SERVICE REQUIRED FOR PMD,75.0,48.75,1.1,75.0,128
HCPCS,G0372,Md service required for pmd,,,22.71,469.67,9
HCPCS,G0378,CARDIAC - OBS HOSP SVC PER HR  (0-4 HRS),909.0,590.85,198.16,16307.0,70
HCPCS,G0378,CARDIAC - OBS HOSP SVC PER HR (5-12 HRS),241.0,156.65,52.54,16307.0,70
HCPCS,G0378,CARDIAC - OBS SVC PER HR (13-23 HRS),105.0,68.25,22.89,16307.0,70
HCPCS,G0378,OBS HOSP SVC PER HOUR (5-12 HOURS),70.0,45.5,15.26,16307.0,70
HCPCS,G0378,OBS HOSP SVC PER HOUR (OVER 23 HRS),87.0,56.55,18.97,16307.0,70
HCPCS,G0378,OBS SVC PER HOUR (13-23 HOURS),38.0,24.7,8.28,16307.0,70
HCPCS,G0378,OBSERV CARVE OUT 60 MINUTES GRP 1,133.0,86.45,28.99,16307.0,70
HCPCS,G0378,OBSERV CARVE OUT 60 MINUTES GRP 10,133.0,86.45,28.99,16307.0,70
HCPCS,G0378,OBSERV CARVE OUT 60 MINUTES GRP 2,133.0,86.45,28.99,16307.0,70
HCPCS,G0378,OBSERV CARVE OUT 60 MINUTES GRP 3,133.0,86.45,28.99,16307.0,70
HCPCS,G0378,OBSERV CARVE OUT 60 MINUTES GRP 4,133.0,86.45,28.99,16307.0,70
HCPCS,G0378,OBSERV CARVE OUT 60 MINUTES GRP 5,133.0,86.45,28.99,16307.0,70
HCPCS,G0378,OBSERV CARVE OUT 60 MINUTES GRP 6,133.0,86.45,28.99,16307.0,70
HCPCS,G0378,OBSERV CARVE OUT 60 MINUTES GRP 9,133.0,86.45,28.99,16307.0,70
HCPCS,G0378,OBSERV CARVE OUT GRP 7,133.0,86.45,28.99,16307.0,70
HCPCS,G0378,OBSERV CARVE OUT GRP 8,133.0,86.45,28.99,16307.0,70
HCPCS,G0378,OBSERVATION CARVE-OUT PER HR,133.0,86.45,28.99,16307.0,70
HCPCS,G0378,OBSERVATION PER HR-FIRST HOUR,891.0,579.15,168.08,16307.0,140
HCPCS,G0379,DIR ADMIT FOR HOSP OBV CARE,2452.0,1593.8,68.73,16307.0,88
HCPCS,G0380,Lev 1 hosp type b ed visit,,,65.08,195.83,29
HCPCS,G0381,Lev 2 hosp type b ed visit,,,68.73,317.98,29
HCPCS,G0382,Lev 3 hosp type b ed visit,,,68.73,522.19,29
HCPCS,G0383,Lev 4 hosp type b ed visit,,,68.73,769.01,29
HCPCS,G0384,Lev 5 hosp type b ed visit,,,68.73,995.09,29
HCPCS,G0390,Trauma respons w/hosp criti,,,68.73,3574.25,29
HCPCS,G0396,ALCOHOL/SUBS INTERV 15-30MN,286.0,185.9,1.1,286.0,140
HCPCS,G0396,Alcohol/subs interv 15-30mn,,,24.89,110.12,29
HCPCS,G0397,ALCOHOL/SUBS INTERV >30 MIN,572.0,371.8,1.1,572.0,140
HCPCS,G0397,Alcohol/subs interv >30 min,,,118.97,416.23,29
HCPCS,G0398,Home sleep test/type 2 porta,,,86.32,407.79,29
HCPCS,G0399,HOME SLEEP TEST/TYPE 3 PORTA,626.0,406.9,86.32,626.0,85
HCPCS,G0400,Home sleep test/type 4 porta,,,86.32,819.42,29
HCPCS,G0402,INIT PREVENTIVE EXAM NEW,515.0,334.75,0.01,515.0,87
HCPCS,G0402,INITIAL PREVENTIVE EXAM,1144.0,743.6,1.1,1144.0,130
HCPCS,G0403,EKG FOR INITIAL PREVENT EXAM,75.0,48.75,1.1,75.0,130
HCPCS,G0403,Ekg for initial prevent exam,,,23.5,36.72,9
HCPCS,G0404,EKG TRACING FOR INITIAL PREV,188.5,122.525,1.1,279.0,215
HCPCS,G0405,EKG INTERPRET & REPORT PREVE,75.0,48.75,1.1,75.0,128
HCPCS,G0405,Ekg interpret & report preve,,,21.07,27.21,9
HCPCS,G0406,Inpt/tele follow up 15,,,68.73,107.6,9
HCPCS,G0406,TELEHEALTH FOLLOW-UP INPT CONSULTATION 15 MINS,334.0,217.1,1.1,334.0,140
HCPCS,G0407,Inpt/tele follow up 25,,,68.73,187.33,9
HCPCS,G0407,TELEHEALTH FOLLOW-UP INPT CONSULTATION 25 MINS,612.0,397.8,1.1,612.0,142
HCPCS,G0408,Inpt/tele follow up 35,,,68.73,272.96,9
HCPCS,G0408,TELEHEALTH FOLLOW-UP INPT CONSULTATION 35 MINS,880.0,572.0,1.1,880.0,140
HCPCS,G0409,Corf related serv 15 mins ea,,,41.45,58.14,9
HCPCS,G0410,Grp psych php/iop 45-50,,,118.37,152.57,9
HCPCS,G0411,Interactive grp psyc php/iop,,,131.77,2739849.3,9
HCPCS,G0412,OPEN TX ILIAC SPINE UNI/BIL,4598.0,2988.7,1.1,4598.0,128
HCPCS,G0412,Open tx iliac spine uni/bil,,,1899.51,7551.43,21
HCPCS,G0413,PELVIC RING FRACTURE UNI/BIL,6921.0,4498.65,1.1,20863.78,128
HCPCS,G0413,Pelvic ring fracture uni/bil,,,3603.21,18676.74,29
HCPCS,G0414,Pelvic ring fx treat int fix,,,2627.17,7551.43,21
HCPCS,G0415,OPEN TX POST PELVIC FXCTURE,9209.0,5985.85,1.1,9209.0,128
HCPCS,G0415,Open tx post pelvic fxcture,,,3095.56,4172.14,21
HCPCS,G0416,"Prostate biopsy, any mthd",,,68.5,938.4,31
HCPCS,G0416,SAT BIOPSY PROSTATE 1-20 SPC,1440.0,936.0,1.1,2879.0,378
HCPCS,G0420,ED SVC CKD IND PER SESSION,933.0,606.45,1.1,933.0,128
HCPCS,G0420,Ed svc ckd ind per session,,,39.1,283.18,36
HCPCS,G0421,ED SVC CKD GRP PER SESSION,220.0,143.0,1.1,220.0,128
HCPCS,G0421,Ed svc ckd grp per session,,,33.58,70.53,36
HCPCS,G0422,INTENS CARDIAC REHAB W/EXERC,504.0,327.6,69.16,504.0,86
HCPCS,G0422,PR INTENS CARDIAC REHAB W/EXERC,796.0,517.4,1.1,796.0,128
HCPCS,G0423,INTENS CARDIAC REHAB NO EXER,504.0,327.6,69.16,504.0,86
HCPCS,G0423,PR INTENS CARDIAC REHAB NO EXER,796.0,517.4,1.1,796.0,128
HCPCS,G0424,Pulmonary rehab w exer,,,34.33,39.75,8
HCPCS,G0425,Inpt/ed teleconsult30,,,68.73,242.08,9
HCPCS,G0425,PR INPT TELEHEALTH CONSULT 30M,845.0,549.25,1.1,845.0,142
HCPCS,G0426,Inpt/ed teleconsult50,,,68.73,341.29,9
HCPCS,G0426,PR INPT TELEHEALTH CONSULT 50M,1148.0,746.2,1.1,1148.0,142
HCPCS,G0427,Inpt/ed teleconsult70,,,68.73,483.2,9
HCPCS,G0427,PR INPT TELEHEALTH CON 70/>M,1698.0,1103.7,1.1,1698.0,140
HCPCS,G0428,Collagen meniscus implant,,,2483.09,2739849.3,9
HCPCS,G0429,Dermal filler injection(s),,,1060.53,4760.83,29
HCPCS,G0432,EIA HIV-1/HIV-2 SCREEN,135.0,87.75,16.64,135.0,84
HCPCS,G0433,Elisa hiv-1/hiv-2 screen,,,16.64,55.1,34
HCPCS,G0435,Oral hiv-1/hiv-2 screen,,,11.98,36.09,34
HCPCS,G0438,PPPS INITIAL VISIT,203.0,131.95,0.01,242.59,86
HCPCS,G0438,"PPPS, INITIAL VISIT",1040.0,676.0,1.1,1040.0,130
HCPCS,G0439,PPPS SUBSEQ VISIT,189.0,122.85,0.01,190.53,86
HCPCS,G0439,"PPPS, SUBSEQ VISIT",768.0,499.2,1.1,768.0,130
HCPCS,G0442,ANNUAL ALCOHOL SCREEN 15 MIN,206.0,133.9,0.01,206.0,87
HCPCS,G0443,BRIEF ALCOHOL MISUSE COUNSEL,638.0,414.7,0.01,638.0,87
HCPCS,G0444,DEPRESSION SCREEN ANNUAL,99.0,64.35,0.01,119.0,215
HCPCS,G0445,HIGH INTEN BEH COUNS STD 30M,638.0,414.7,0.01,638.0,87
HCPCS,G0446,INTENS BEHAVE THER CARDIO DX,235.0,152.75,0.01,264.0,215
HCPCS,G0447,BEHAVIOR COUNSEL OBESITY 15M,451.0,293.15,0.01,638.0,387
HCPCS,G0448,Place perm pacing cardiovert,,,21832.77,2739849.3,9
HCPCS,G0451,DEVLOPMENT TEST INTERPT&REP,425.0,276.25,16.16,425.0,172
HCPCS,G0451,XM VIRTUAL - SINGLE INDIVIDUAL,425.0,276.25,16.16,425.0,86
HCPCS,G0452,MOLECULAR PATHOLOGY INTERPR,447.0,290.55,1.1,819.0,370
HCPCS,G0452,Molecular pathology interpr,,,4.71,469.67,11
HCPCS,G0453,CONT INTRAOP NEURO MONITOR,264.0,171.6,1.1,264.0,128
HCPCS,G0453,Cont intraop neuro monitor,,,405.62,469.67,8
HCPCS,G0454,MD DOCUMENT VISIT BY NPP,79.0,51.35,1.1,133.94,140
HCPCS,G0454,Md document visit by npp,,,22.8,73.83,9
HCPCS,G0455,FECAL MICROBIOTA PREP INSTILL,590.0,383.5,1.1,2666.13,128
HCPCS,G0455,FMT VIA COLONOSCOPY,3647.0,2370.55,82.08,3647.0,86
HCPCS,G0458,Ldr prostate brachy comp rat,,,405.62,2739849.3,9
HCPCS,G0459,Telehealth inpt pharm mgmt,,,10.58,111.11,9
HCPCS,G0460,Autolog prp not diab ulcer,,,559.63,4760.83,29
HCPCS,G0463,ETN OUTPATINET > 135 MIN,515.0,334.75,0.01,515.0,85
HCPCS,G0463,OFFICE VISIT,515.0,334.75,0.01,515.0,85
HCPCS,G0465,Autolog prp diab wound ulcer,,,557.97,2147.22,29
HCPCS,G0466,Fqhc visit new patient,,,63.76,120.83,9
HCPCS,G0467,"Fqhc visit, estab pt",,,63.76,123.0,9
HCPCS,G0468,"Fqhc visit, ippe or awv",,,63.76,263.86,9
HCPCS,G0469,"Fqhc visit, mh new pt",,,63.76,2739849.3,9
HCPCS,G0470,"Fqhc visit, mh estab pt",,,63.76,218.24,9
HCPCS,G0471,Ven blood coll snf/hha,,,2.64,29.67,29
HCPCS,G0472,HEP SCREEN HIGH RISK/OTHER,234.0,152.1,28.66,234.0,84
HCPCS,G0473,Group behave couns 2-10,,,24.89,152.57,29
HCPCS,G0475,Hiv combination assay,,,23.08,72.55,34
HCPCS,G0476,Hpv combo assay ca screen,,,33.62,105.71,34
HCPCS,G0480,%AMITRIPTYLINE,742.0,482.3,34.82,742.0,84
HCPCS,G0480,%DAAMPC MDA MDMA,742.0,482.3,34.82,742.0,84
HCPCS,G0480,%DAOPIC OPIATE,742.0,482.3,34.82,742.0,84
HCPCS,G0480,%DESIPRAMINE PL,164.0,106.6,34.82,257.48,84
HCPCS,G0480,%IMIPRAMINE PL,147.0,95.55,34.82,257.48,84
HCPCS,G0480,%NORTRIPTYLINE,742.0,482.3,34.82,742.0,84
HCPCS,G0480,%T2BPCR UNLISTED MOLEC,292.0,189.8,34.82,292.0,84
HCPCS,G0480,%TADID AMITRIPTYLINE,742.0,482.3,34.82,742.0,84
HCPCS,G0480,%UQNTPP AMPHET,742.0,482.3,34.82,742.0,84
HCPCS,G0480,%UQNTPP BUPRENORPHINE,742.0,482.3,34.82,742.0,84
HCPCS,G0480,%UQNTPP CANNABINOID NAT,742.0,482.3,34.82,742.0,84
HCPCS,G0480,%UQNTPP COCAINE,742.0,482.3,34.82,742.0,84
HCPCS,G0480,%UQNTPP FENTANYL,742.0,482.3,34.82,742.0,84
HCPCS,G0480,%UQNTPP HEROIN METABOLITE,742.0,482.3,34.82,742.0,84
HCPCS,G0480,%UQNTPP METHADONE,742.0,482.3,34.82,742.0,84
HCPCS,G0480,%UQNTPP OPIATE,742.0,482.3,34.82,742.0,84
HCPCS,G0480,%UQNTPP OPIOIDS 5+,742.0,482.3,34.82,742.0,84
HCPCS,G0480,%UQNTPP OXYCODONE,742.0,482.3,34.82,742.0,84
HCPCS,G0480,%UQNTPP TRAMADOL,742.0,482.3,34.82,742.0,84
HCPCS,G0480,%UTCAQT ANTIDEP CLASS 1-2,742.0,482.3,34.82,742.0,84
HCPCS,G0480,%UTCAQT ANTIDEP NOT SPEC,742.0,482.3,34.82,742.0,84
HCPCS,G0480,%UTCAQT TRICYC & CYC 6+,742.0,482.3,34.82,742.0,84
HCPCS,G0480,*DRUG SCREEN QUAL SNGL,742.0,482.3,34.82,742.0,84
HCPCS,G0480,"6-MAM CONF, UR",742.0,482.3,34.82,742.0,84
HCPCS,G0480,ACYCLOVIR BLOOD,742.0,482.3,34.82,742.0,84
HCPCS,G0480,"ALCOHOL CONF, UR",742.0,482.3,34.82,742.0,84
HCPCS,G0480,ALCOHOLS,742.0,482.3,34.82,742.0,84
HCPCS,G0480,ALKALOID DRUGS (MECDRG),64.4,41.86,18.21,257.48,84
HCPCS,G0480,ALPRAZOLAM,739.0,480.35,34.82,739.0,84
HCPCS,G0480,AMITRIPTYLINE,742.0,482.3,34.82,742.0,84
HCPCS,G0480,AMPCQ METHYLENDIOXY%,742.0,482.3,34.82,742.0,84
HCPCS,G0480,AMPHETAMINE CONF URINE,742.0,482.3,34.82,742.0,84
HCPCS,G0480,"AMPHETAMINE CONF, UR",742.0,482.3,34.82,742.0,168
HCPCS,G0480,AMPHETAMINES (MECDRG),64.4,41.86,18.21,257.48,84
HCPCS,G0480,AMPHETAMINES CONF URINE,739.0,480.35,34.82,739.0,84
HCPCS,G0480,ANALGESICS NON-OPIOID 1 OR 2,742.0,482.3,34.82,742.0,84
HCPCS,G0480,ANTIDEPRESSANT TRICYCLIC 1/2,742.0,482.3,34.82,742.0,84
HCPCS,G0480,ANTIPSYCHOTICS NOS 1-3,742.0,482.3,34.82,742.0,84
HCPCS,G0480,ARIPIPRAZOLE AND METABOLITE,85.0,55.25,24.04,257.48,84
HCPCS,G0480,"BACLOFEN (BACLOF), SKELETAL MUSCLE RELAXANT 1 OR 2",21.0,13.65,5.94,257.48,84
HCPCS,G0480,BARBITUATES CONF BILL,742.0,482.3,34.82,742.0,84
HCPCS,G0480,BARBITURATES,742.0,482.3,34.82,742.0,84
HCPCS,G0480,BARBITURATES (MECDRG),64.4,41.86,18.21,257.48,84
HCPCS,G0480,"BENZO, QUANT, UR",742.0,482.3,34.82,742.0,84
HCPCS,G0480,"BENZO, SER PL, QNT RFLX",742.0,482.3,34.82,742.0,84
HCPCS,G0480,BENZODIAZEPINE CONF BILL,742.0,482.3,34.82,742.0,84
HCPCS,G0480,BENZODIAZEPINES CONF,742.0,482.3,34.82,742.0,84
HCPCS,G0480,BENZODIAZEPINES CONF UR,742.0,482.3,34.82,742.0,84
HCPCS,G0480,BENZODIAZEPINES1-12,742.0,482.3,34.82,742.0,168
HCPCS,G0480,BENZODIAZEPINES1-12 (MECDRG),64.4,41.86,18.21,257.48,84
HCPCS,G0480,BENZTROPINE SERUM,742.0,482.3,34.82,742.0,168
HCPCS,G0480,BRWK ACETAMINOPHEN BL,742.0,482.3,34.82,742.0,84
HCPCS,G0480,BUPRENOR & METAB QNT SER/PL,742.0,482.3,34.82,742.0,84
HCPCS,G0480,BUPRENOR & METAB QNT UR,742.0,482.3,34.82,742.0,84
HCPCS,G0480,BUPRENORPHINE MEC CONF,742.0,482.3,34.82,742.0,84
HCPCS,G0480,CANNABANOIDS,742.0,482.3,34.82,742.0,84
HCPCS,G0480,CANNABINOIDS CONF UR,740.5,481.32500000000005,34.82,742.0,168
HCPCS,G0480,CANNABINOIDS NATURAL,742.0,482.3,34.82,742.0,84
HCPCS,G0480,CARBOXY-THC (MECDRG),64.4,41.86,18.21,257.48,84
HCPCS,G0480,CATHARITIC LAXATIVE UR,742.0,482.3,34.82,742.0,84
HCPCS,G0480,CHROM QUANT,742.0,482.3,34.82,742.0,84
HCPCS,G0480,COCAINE,742.0,482.3,34.82,742.0,84
HCPCS,G0480,COCAINE CONFIRM UR,742.0,482.3,34.82,742.0,84
HCPCS,G0480,"COCAINE METABOLITE, SER OR PL, QNT RFLX",742.0,482.3,34.82,742.0,84
HCPCS,G0480,COLCHICINE LEVEL,742.0,482.3,34.82,742.0,84
HCPCS,G0480,COLUMN CHROM QUANT,157.0,102.05,34.82,257.48,84
HCPCS,G0480,DESIPRAMINE,742.0,482.3,34.82,742.0,84
HCPCS,G0480,DESIPRAMINE PLASMA,153.0,99.45,34.82,257.48,84
HCPCS,G0480,DIGITOXIN,742.0,482.3,34.82,742.0,84
HCPCS,G0480,DIHYDROTESTOSTERONE,742.0,482.3,34.82,742.0,84
HCPCS,G0480,DILTIAZEM,742.0,482.3,34.82,742.0,84
HCPCS,G0480,"DIPHENHYDRAMINE, SERUM/PLASMA",32.0,20.8,9.05,257.48,84
HCPCS,G0480,"DIPHENHYDRAMINE, URINE",742.0,482.3,34.82,742.0,84
HCPCS,G0480,"DIURETIC SURVEY, URINE",740.5,481.32500000000005,34.82,742.0,168
HCPCS,G0480,DOXEPIN/NORDOXEPIN,742.0,482.3,34.82,742.0,168
HCPCS,G0480,DRG BUPRENORPHINE (MECDRG),64.4,41.86,18.21,257.48,84
HCPCS,G0480,DRG COCAINE (MECDRG),64.4,41.86,18.21,257.48,84
HCPCS,G0480,DRG SCRN OXYCODONE,742.0,482.3,34.82,742.0,84
HCPCS,G0480,DRGTOF AMPHETAMINES,742.0,482.3,34.82,742.0,84
HCPCS,G0480,DRGTOF AMPHETAMINES 5 OR MORE,742.0,482.3,34.82,742.0,84
HCPCS,G0480,DRGTOF BENZODIAZEPINES1-12,742.0,482.3,34.82,742.0,84
HCPCS,G0480,DRGTOF DRG SCRN BARBITURATES,238.0,154.7,34.82,257.48,84
HCPCS,G0480,DRGTOF DRG SCRN BUPRENORPHINE,238.0,154.7,34.82,257.48,84
HCPCS,G0480,DRGTOF DRG SCRN COCAINE,238.0,154.7,34.82,257.48,84
HCPCS,G0480,DRGTOF DRG SCRN METHADONE,238.0,154.7,34.82,257.48,84
HCPCS,G0480,DRGTOF DRUG SCRN BENZODIAZ 13 OR MORE,742.0,482.3,34.82,742.0,84
HCPCS,G0480,DRGTOF DRUG SCRN GABAPENTIN NON-BLOOD,742.0,482.3,34.82,742.0,84
HCPCS,G0480,DRGTOF FENTANYL AND METABOLITE,170.0,110.5,34.82,257.48,84
HCPCS,G0480,DRGTOF GABAPENTIN,742.0,482.3,34.82,742.0,84
HCPCS,G0480,DRGTOF METHYLENEDIOXYAMPHETAMINE,173.0,112.45,34.82,257.48,84
HCPCS,G0480,DRGTOF OPIATE CONFIRMATION,742.0,482.3,34.82,742.0,84
HCPCS,G0480,DRGTOF OPIOIDS AND OPIATE ANALOGS,53.0,34.45,14.99,257.48,84
HCPCS,G0480,DRGTOF OPIOIDS AND OPIATE ANALOGS 5 OR MORE,742.0,482.3,34.82,742.0,84
HCPCS,G0480,DRGTOF OPISEC DRG SCRN OXYCODONE,742.0,482.3,34.82,742.0,84
HCPCS,G0480,DRGTOF ORLOPI OPIATES 1 OR MORE,246.0,159.9,34.82,257.48,84
HCPCS,G0480,DRGTOF PHENCYCLIDINE,238.0,154.7,34.82,257.48,84
HCPCS,G0480,DRGTOF PROPOXYPHENE,53.0,34.45,14.99,257.48,84
HCPCS,G0480,DRGTOF TAPENTADOL AND MET,170.0,110.5,34.82,257.48,84
HCPCS,G0480,DRGTOF TRAMADOL,742.0,482.3,34.82,742.0,84
HCPCS,G0480,DRGTOF ZOLPIDEM,742.0,482.3,34.82,742.0,84
HCPCS,G0480,DRUG CONFRM PCP,224.0,145.6,34.82,257.48,84
HCPCS,G0480,DRUG SCREEN AMPHETAMINES 1/2,742.0,482.3,34.82,742.0,84
HCPCS,G0480,"DRUG TEST, DEFINITVE, PER DAY?1-7?DRUG CLASSES",742.0,482.3,34.82,742.0,84
HCPCS,G0480,DTOFMP AMPHETAMINES,53.0,34.45,14.99,257.48,84
HCPCS,G0480,DTOFMP BARBITURATES,53.0,34.45,14.99,257.48,84
HCPCS,G0480,DTOFMP BENZODIAZEPINES,53.0,34.45,14.99,257.48,84
HCPCS,G0480,DTOFMP BUPRENORPHINE,53.0,34.45,14.99,257.48,84
HCPCS,G0480,DTOFMP COCAINE METABOLITE,53.0,34.45,14.99,257.48,84
HCPCS,G0480,DTOFMP FENTANYL,53.0,34.45,14.99,257.48,84
HCPCS,G0480,DTOFMP HEROIN METABOLITE,53.0,34.45,14.99,257.48,84
HCPCS,G0480,DTOFMP HYDROCODONE,53.0,34.45,14.99,257.48,84
HCPCS,G0480,DTOFMP MARIJUANA METAB UMB,742.0,482.3,34.82,742.0,84
HCPCS,G0480,DTOFMP MARIJUANA METABOLITE,53.0,34.45,14.99,257.48,84
HCPCS,G0480,DTOFMP MDMA,53.0,34.45,14.99,257.48,84
HCPCS,G0480,DTOFMP METHADONE,53.0,34.45,14.99,257.48,84
HCPCS,G0480,DTOFMP OPIOIDS,53.0,34.45,14.99,257.48,84
HCPCS,G0480,DTOFMP OPIOIDS AND OPIATE ANALOGS,53.0,34.45,14.99,257.48,84
HCPCS,G0480,DTOFMP OXYCODONE AND METABOLITE,53.0,34.45,14.99,257.48,84
HCPCS,G0480,DTOFMP PHENCYCLIDINE,53.0,34.45,14.99,257.48,84
HCPCS,G0480,DTOFMP PROPOXYPHENE,53.0,34.45,14.99,257.48,84
HCPCS,G0480,DTOFMP SEDATIVE HYPNOTICS,53.0,34.45,14.99,257.48,84
HCPCS,G0480,DTOFMP TAPENTADOL,53.0,34.45,14.99,257.48,84
HCPCS,G0480,ENCAINIDE,742.0,482.3,34.82,742.0,84
HCPCS,G0480,ETHAMBUTOL,742.0,482.3,34.82,742.0,84
HCPCS,G0480,ETHANOL PLASMA,742.0,482.3,34.82,742.0,84
HCPCS,G0480,"FATTY ACID PROFILE,SER PL",157.0,102.05,34.82,257.48,84
HCPCS,G0480,FENTANYL AND METABOLITE (MECDRG),64.4,41.86,18.21,257.48,84
HCPCS,G0480,FENTANYL URINE,740.5,481.32500000000005,34.82,742.0,168
HCPCS,G0480,FLUOXETINE/NORFLUOXETINE,742.0,482.3,34.82,742.0,84
HCPCS,G0480,FLUVOXAMINE,742.0,482.3,34.82,742.0,84
HCPCS,G0480,GABAPENTIN (MECDRG),64.4,41.86,18.21,257.48,84
HCPCS,G0480,GHB CONF RFLX,742.0,482.3,34.82,742.0,84
HCPCS,G0480,GLYBURIDE SERUM,742.0,482.3,34.82,742.0,84
HCPCS,G0480,GOLD SERUM,742.0,482.3,34.82,742.0,84
HCPCS,G0480,HYDROCODONE SER%,742.0,482.3,34.82,742.0,84
HCPCS,G0480,IMIPRAMINE,742.0,482.3,34.82,742.0,84
HCPCS,G0480,ISOPROPANOL,742.0,482.3,34.82,742.0,84
HCPCS,G0480,KETAMINE SERUM,742.0,482.3,34.82,742.0,84
HCPCS,G0480,KETOROLAC SERUM,742.0,482.3,34.82,742.0,84
HCPCS,G0480,LAMOTRIGINE,86.0,55.9,24.32,257.48,84
HCPCS,G0480,LASOSAMIDE,742.0,482.3,34.82,742.0,84
HCPCS,G0480,LEVAMISOLE,742.0,482.3,34.82,742.0,84
HCPCS,G0480,LIBRIUM & METABOLITE,742.0,482.3,34.82,742.0,84
HCPCS,G0480,LORAZEPAM,742.0,482.3,34.82,742.0,84
HCPCS,G0480,LSD CONFIRMATION URINE,742.0,482.3,34.82,742.0,84
HCPCS,G0480,MARIJUANA METAB UMB CRD QUAL,742.0,482.3,34.82,742.0,84
HCPCS,G0480,MELATONIN,295.0,191.75,34.82,295.0,84
HCPCS,G0480,MEPHEDRONE MDPV CONF UR,146.0,94.9,34.82,257.48,84
HCPCS,G0480,MERCAPTOPURINE,742.0,482.3,34.82,742.0,84
HCPCS,G0480,METHADONE,742.0,482.3,34.82,742.0,84
HCPCS,G0480,METHADONE (MECDRG),64.4,41.86,18.21,257.48,84
HCPCS,G0480,"METHADONE CONFIRM, UR",742.0,482.3,34.82,742.0,84
HCPCS,G0480,"METHADONE QNT, UR",742.0,482.3,34.82,742.0,84
HCPCS,G0480,METHAQUALONE GC/MS UR,742.0,482.3,34.82,742.0,84
HCPCS,G0480,METHAZOLAMIDE SER,742.0,482.3,34.82,742.0,84
HCPCS,G0480,METHYLEEDIOXAMPHETAMINE (MECDRG),64.4,41.86,18.21,257.48,84
HCPCS,G0480,METHYLENEDIOXYAMPHET,742.0,482.3,34.82,742.0,84
HCPCS,G0480,METHYLENEDIOXYAMPHETAMINES CONF URINE,739.0,480.35,34.82,739.0,84
HCPCS,G0480,"METHYLONE CONF, UR",146.0,94.9,34.82,257.48,84
HCPCS,G0480,METHYLPHENIDATE (MECDRG),64.4,41.86,18.21,257.48,84
HCPCS,G0480,METHYLPHENIDATE QNT,742.0,482.3,34.82,742.0,84
HCPCS,G0480,"METOPROLOL, SER/PL",32.0,20.8,9.05,257.48,84
HCPCS,G0480,MIDAZOLAM,742.0,482.3,34.82,742.0,84
HCPCS,G0480,MITOTANE,742.0,482.3,34.82,742.0,84
HCPCS,G0480,NICOTINE AND METAB UR,742.0,482.3,34.82,742.0,84
HCPCS,G0480,NICOTINE/COTININE,742.0,482.3,34.82,742.0,84
HCPCS,G0480,NORTRIPTYLINE,742.0,482.3,34.82,742.0,84
HCPCS,G0480,NORTRIPTYLINE PLASMA,742.0,482.3,34.82,742.0,84
HCPCS,G0480,OLANZAPINE,742.0,482.3,34.82,742.0,84
HCPCS,G0480,OPIATE CONFIRMATION (MECDRG),64.4,41.86,18.21,257.48,84
HCPCS,G0480,OPIATE CONFIRMATION UR,742.0,482.3,34.82,742.0,84
HCPCS,G0480,OPIATES 1 OR MORE,742.0,482.3,34.82,742.0,84
HCPCS,G0480,OPIBILL OPIATES,742.0,482.3,34.82,742.0,84
HCPCS,G0480,OPIBILL OXYCODONE,742.0,482.3,34.82,742.0,84
HCPCS,G0480,OPIOIDS AND OPIATE ANALOGS (DRGTOF),742.0,482.3,34.82,742.0,84
HCPCS,G0480,OPIOIDS AND OPIATE ANALOGS (MECDRG),64.4,41.86,18.21,257.48,84
HCPCS,G0480,OPISEC OPIATES 1 OR MORE,742.0,482.3,34.82,742.0,84
HCPCS,G0480,OPISEC OXYCODONE (MEDDRG),64.4,41.86,18.21,257.48,84
HCPCS,G0480,ORLOPI OPIATES 1 OR MORE (MECDRG),64.4,41.86,18.21,257.48,84
HCPCS,G0480,OXYCODONE,742.0,482.3,34.82,742.0,84
HCPCS,G0480,"OXYCODONE CONF, ORAL FLD",742.0,482.3,34.82,742.0,84
HCPCS,G0480,"OXYCODONE CONF/QT, URINE",742.0,482.3,34.82,742.0,84
HCPCS,G0480,PCP CONF BILL,199.0,129.35,34.82,257.48,84
HCPCS,G0480,PCP CONFIRM URINE,739.0,480.35,34.82,739.0,84
HCPCS,G0480,"PCP SER OR PL, QNT RFLX",742.0,482.3,34.82,742.0,84
HCPCS,G0480,PENTOBARBITAL,742.0,482.3,34.82,742.0,84
HCPCS,G0480,PHENCYCLIDINE (MECDRG),64.4,41.86,18.21,257.48,84
HCPCS,G0480,PHENCYCLIDINE (PCP),187.0,121.55,34.82,257.48,84
HCPCS,G0480,"PHENOLPHTHALEIN, STOOL",53.0,34.45,14.99,257.48,84
HCPCS,G0480,PHOSPHATIDYLETHANOL,742.0,482.3,34.82,742.0,84
HCPCS,G0480,PREGABALIN,405.0,263.25,19.23,742.0,168
HCPCS,G0480,PROPA DRUG NOS 1-3,742.0,482.3,34.82,742.0,84
HCPCS,G0480,QUETIAPINE,742.0,482.3,34.82,742.0,84
HCPCS,G0480,RISPERIDONE AND METAB,742.0,482.3,34.82,742.0,84
HCPCS,G0480,SERTRALINE,742.0,482.3,34.82,742.0,84
HCPCS,G0480,SOTAL DRUG NOS 1-3,742.0,482.3,34.82,742.0,84
HCPCS,G0480,STCATH DEF DRUG NOS,742.0,482.3,34.82,742.0,84
HCPCS,G0480,STRYCHNINE SERUM,742.0,482.3,34.82,742.0,84
HCPCS,G0480,SULFONAMIDES,155.0,100.75,34.82,257.48,84
HCPCS,G0480,SULFONYLUREA HYPO URINE,240.0,156.0,34.82,257.48,84
HCPCS,G0480,"SULFONYLUREA HYPOGLY, SER",309.0,200.85,34.82,309.0,84
HCPCS,G0480,"SULFONYLUREA HYPOGLYCEMIA PANEL, QUANTITATIVE, URINE",739.0,480.35,34.82,739.0,84
HCPCS,G0480,SYNTH CANNABINOID METAB,742.0,482.3,34.82,742.0,168
HCPCS,G0480,TAPENTADOL AND MET (MECDRG),64.4,41.86,18.21,257.48,84
HCPCS,G0480,THC CONFIRMATION,742.0,482.3,34.82,742.0,84
HCPCS,G0480,"TORSEMIDE, SER/PL",742.0,482.3,34.82,742.0,84
HCPCS,G0480,"TRAMADOL & METAB, QUANT",740.5,481.32500000000005,34.82,742.0,168
HCPCS,G0480,TRAMADOL (MECDRG),64.4,41.86,18.21,257.48,84
HCPCS,G0480,TRAZODONE,742.0,482.3,34.82,742.0,84
HCPCS,G0480,TRICYCLIC & CYCLICALS 6/MORE,742.0,482.3,34.82,742.0,84
HCPCS,G0480,UQNTOX AMPHETAMINES,78.0,50.7,22.06,257.48,84
HCPCS,G0480,UQNTOX BUPRENORPHINE,78.0,50.7,22.06,257.48,84
HCPCS,G0480,UQNTOX CANNABINOIDS NATURAL,78.0,50.7,22.06,257.48,84
HCPCS,G0480,UQNTOX COCCAINE,78.0,50.7,22.06,257.48,84
HCPCS,G0480,UQNTOX FENTANYL,78.0,50.7,22.06,257.48,84
HCPCS,G0480,UQNTOX HEROINE METABOLITE,78.0,50.7,22.06,257.48,84
HCPCS,G0480,UQNTOX METHADONE,78.0,50.7,22.06,257.48,84
HCPCS,G0480,UQNTOX METHYLENEDIOXYAMPHETAMINES,78.0,50.7,22.06,257.48,84
HCPCS,G0480,UQNTOX OPIATES,78.0,50.7,22.06,257.48,84
HCPCS,G0480,UQNTOX OPIOIDS 5+,78.0,50.7,22.06,257.48,84
HCPCS,G0480,UQNTOX OXYCODONE,78.0,50.7,22.06,257.48,84
HCPCS,G0480,UQNTOX PHENCYCLIDINE,78.0,50.7,22.06,257.48,84
HCPCS,G0480,UQNTOX TRAMADOL,78.0,50.7,22.06,257.48,84
HCPCS,G0480,URDRG 6-MONOACETYLMORPHINE,68.0,44.2,19.23,257.48,84
HCPCS,G0480,URDRG ALKALOIDS NOS,68.0,44.2,19.23,257.48,84
HCPCS,G0480,URDRG AMPHETAMINES,68.0,44.2,19.23,257.48,84
HCPCS,G0480,URDRG ASSAY FOR PHENCYCLIDINE,68.0,44.2,19.23,257.48,84
HCPCS,G0480,URDRG BENZODIAZEPINES,68.0,44.2,19.23,257.48,84
HCPCS,G0480,URDRG BUPRENORPHINE,68.0,44.2,19.23,257.48,84
HCPCS,G0480,URDRG CANNABINOIDS,68.0,44.2,19.23,257.48,84
HCPCS,G0480,URDRG COCAINE,68.0,44.2,19.23,257.48,84
HCPCS,G0480,"URDRG DRUG SCREENING, TAPENTADOL",68.0,44.2,19.23,257.48,84
HCPCS,G0480,URDRG DRUGS NOT OTHERWISE SPECIFIED,68.0,44.2,19.23,257.48,84
HCPCS,G0480,URDRG FENTANYL,68.0,44.2,19.23,257.48,84
HCPCS,G0480,URDRG GABAPENTIN,68.0,44.2,19.23,257.48,84
HCPCS,G0480,URDRG KETAMINE AND NORKETAMINE,68.0,44.2,19.23,257.48,84
HCPCS,G0480,URDRG METHADONE,68.0,44.2,19.23,257.48,84
HCPCS,G0480,URDRG METHYLENEDIOXYAMPHETAMINES,68.0,44.2,19.23,257.48,84
HCPCS,G0480,URDRG OPIATES,68.0,44.2,19.23,257.48,84
HCPCS,G0480,URDRG OPIOIDS,68.0,44.2,19.23,257.48,84
HCPCS,G0480,URDRG OXYCODONE,68.0,44.2,19.23,257.48,84
HCPCS,G0480,URDRG PREGABALIN,68.0,44.2,19.23,257.48,84
HCPCS,G0480,URDRG SKELETAL MUSCLE RELAXANTS,68.0,44.2,19.23,257.48,84
HCPCS,G0480,"URDRG STIMULANTS, SYNTHETIC",68.0,44.2,19.23,257.48,84
HCPCS,G0480,URDRG TRAMADOL,68.0,44.2,19.23,257.48,84
HCPCS,G0480,URDRG ZOLPIDEM,68.0,44.2,19.23,257.48,84
HCPCS,G0480,"VOLATILE SCRN, UR",742.0,482.3,34.82,742.0,84
HCPCS,G0480,ZOLPIDEM (MECDRG),64.4,41.86,18.21,257.48,84
HCPCS,G0481,DRUG TEST DEF 8-14 CLASSES,651.0,423.15,1.1,651.0,88
HCPCS,G0481,"DRUG TEST, DEFINITVE, PER DAY?8-14?DRUG CLASSES",1015.0,659.75,75.43,1015.0,84
HCPCS,G0481,DTOFMP GABAPENTIN,1015.0,659.75,75.43,1015.0,84
HCPCS,G0481,MECDRG AMPHETAMINES 5 OR MORE,1015.0,659.75,75.43,1015.0,84
HCPCS,G0481,MECDRG DRUG SCRN BENZODIAZ 13 OR MORE,1015.0,659.75,75.43,1015.0,84
HCPCS,G0481,MECDRG OPIOIDS AND OPIATE ANALOGS 5 OR MORE,1015.0,659.75,75.43,1015.0,84
HCPCS,G0481,PAIN PANEL QNT UR,1015.0,659.75,75.43,1015.0,84
HCPCS,G0482,DRUG TEST 15-21 CLASSES,1288.0,837.2,75.43,1288.0,84
HCPCS,G0482,"DRUG TEST, DEFINITVE, PER DAY?15-21 DRUG CLASSES",1288.0,837.2,75.43,1288.0,84
HCPCS,G0483,"DRUG TEST, DEFINITVE, PER DAY?22 OR MORE DRUG CLASSES",1600.0,1040.0,75.43,1600.0,84
HCPCS,G0490,"Home visit rn, lpn by rhc/fq",,,2739849.3,2739849.3,1
HCPCS,G0491,Dialysis acu kidney no esrd,,,373.09,2739849.3,9
HCPCS,G0492,Md/oth eval acut kid no esrd,,,373.09,2739849.3,9
HCPCS,G0493,Rn care ea 15 min hh/hospice,,,81.19,81.19,1
HCPCS,G0494,Lpn care ea 15min hh/hospice,,,2739849.3,2739849.3,1
HCPCS,G0495,Rn care train/edu in hh,,,258.93,258.93,1
HCPCS,G0496,Lpn care train/edu in hh,,,2739849.3,2739849.3,1
HCPCS,G0498,CHEMO EXTEND IV INFUS W/PUMP,2091.0,1359.15,293.81,2091.0,84
HCPCS,G0498,CHEMO EXTEND IV INFUSION W/PUMP,1530.0,994.5,1.1,1530.0,78
HCPCS,G0499,Hepb screen high risk indiv,,,28.27,85.17,34
HCPCS,G0500,MOD SEDAT ENDO SERVICE >5 YRS,701.0,455.65,6.92,701.0,68
HCPCS,G0500,MOD SEDAT ENDO SERVICE >5YRS,44.0,28.6,1.1,179.7,130
HCPCS,G0501,Resource-inten svc during ov,,,63.76,73.83,8
HCPCS,G0506,COMP ASSES CARE PLAN CCM SVC,383.0,248.95,1.1,664.19,128
HCPCS,G0508,CRIT CARE TELEHEA CONSULT 60,1760.0,1144.0,1.1,3041.49,128
HCPCS,G0508,Crit care telehea consult 60,,,68.73,535.86,9
HCPCS,G0509,CRIT CARE TELEHEA CONSULT 50,1698.0,1103.7,1.1,2875.08,128
HCPCS,G0509,Crit care telehea consult 50,,,68.73,495.42,9
HCPCS,G0511,Ccm/bhi by rhc/fqhc 20min mo,,,113.3,113.3,1
HCPCS,G0512,Cocm by rhc/fqhc 60 min mo,,,188.79,188.79,1
HCPCS,G0513,"Prolong prev svcs, first 30m",,,63.76,73.83,8
HCPCS,G0514,"Prolong prev svcs, addl 30m",,,63.76,73.83,8
HCPCS,G0516,"Insert drug del implant, >=4",,,168.79,1040.19,29
HCPCS,G0517,Remove drug implant,,,168.79,1040.19,29
HCPCS,G0518,Remove w insert drug implant,,,168.79,1040.19,29
HCPCS,G0519,New pt-cg dyad dem low cmplx,,,21.85,25.3,8
HCPCS,G0520,New pt-cg dyad dem mod cmplx,,,21.85,25.3,8
HCPCS,G0521,New pt-cg dyad dem hig cmplx,,,21.85,25.3,8
HCPCS,G0522,Mgt nw pt dementia low cmplx,,,21.85,25.3,8
HCPCS,G0523,Mgt nw pt dem mod-high cmplx,,,21.85,25.3,8
HCPCS,G0524,Est pt-cg dyad dem low cmplx,,,21.85,25.3,8
HCPCS,G0525,Est pt-cg dyad dem mod cmplx,,,21.85,25.3,8
HCPCS,G0526,Est pt-cg dyad dem hig cmplx,,,21.85,25.3,8
HCPCS,G0527,Mgt est pt dmentia low cmplx,,,21.85,25.3,8
HCPCS,G0528,Mgt est pt dem mod-hi cmplx,,,21.85,25.3,8
HCPCS,G0529,"In home respite care, 4 hr u",,,21.85,25.3,8
HCPCS,G0530,"Adult daycare center, 8 hr u",,,21.85,25.3,8
HCPCS,G0531,"Fclty-based respite, 24 hr u",,,21.85,25.3,8
HCPCS,G0532,Take home supp nasal spray,,,9.64,11.17,8
HCPCS,G0533,Buprenorphone inj weekly,,,38.12,44.14,8
HCPCS,G0534,Coordinated care/or referral,,,38.12,44.14,8
HCPCS,G0535,Pt navigat svs direct/ref,,,38.12,44.14,8
HCPCS,G0536,Peer recover support svs,,,38.12,44.14,8
HCPCS,G0537,RISK ASCVD TST ONCE PR 12 MO,224.5,145.925,1.1,370.0,210
HCPCS,G0538,ASCVD RSK MNG CLIN STF PR MO,224.5,145.925,1.1,370.0,202
HCPCS,G0539,Initial care training 30 m,,,39.1,66.24,33
HCPCS,G0540,Train for caregiver add 15,,,30.26,45.28,33
HCPCS,G0541,No pt prsnt train initial 30,,,27.36,66.24,26
HCPCS,G0542,No pt prsnt train add 15,,,33.04,45.28,14
HCPCS,G0543,Group train w/o patient,,,14.15,51.72,26
HCPCS,G0544,Post d/c phone follow up,,,85.75,105.72,19
HCPCS,G0545,INFECTIOUS DISEASE CONFIRMED/SUSPECTED INHERENT TO INPATIENT OR,392.0,254.8,1.1,392.0,126
HCPCS,G0545,Inherent visit to inpt,,,63.76,73.83,8
HCPCS,G0546,PHONE/INTERNET EHR ASSESS,154.0,100.1,1.1,154.0,126
HCPCS,G0547,PHONE/INTERNET SVS 11-20 M,308.0,200.2,1.1,308.0,126
HCPCS,G0548,PHONE/INTER SVS 21-30 M,462.0,300.3,1.1,462.0,126
HCPCS,G0549,PHONE/INTER FOR TREAT>31 M,616.0,400.4,1.1,616.0,126
HCPCS,G0552,SUPPLY OF DIGITAL DEVICE,381.5,247.975,1.1,515.0,157
HCPCS,G0553,MONTHLY TX FOR DMHT 20MINS,394.0,256.1,1.1,515.0,190
HCPCS,G0554,ADD 20 M OF MONTHLY TX,263.0,170.95,1.1,268.0,173
HCPCS,G0555,Replacment pt electronic sys,,,86.64,1018.61,27
HCPCS,G0556,ADV PRIM CARE MGMT LVL 1,110.0,71.5,1.1,110.0,126
HCPCS,G0556,Adv prim care mgmt lvl 1,,,27.62,38.99,19
HCPCS,G0557,ADV PRIM CARE MGMT LVL 2,339.0,220.35,1.1,339.0,126
HCPCS,G0557,Adv prim care mgmt lvl 2,,,27.62,38.99,19
HCPCS,G0558,ADV PRIM CARE MGMT LVL 3,735.0,477.75,1.1,735.0,126
HCPCS,G0558,Adv prim care mgmt lvl 3,,,85.75,105.72,19
HCPCS,G0559,POST-OP FOLLOW-UP PROVIDED BY A DIFFERENT PRACTICE FROM THE SURG,70.0,45.5,1.1,70.0,126
HCPCS,G0559,Unrelat prac follow up visit,,,63.76,73.83,8
HCPCS,G0560,Safety plan interven,,,41.45,63.41,33
HCPCS,G0561,"Temp tube delivery, unil",,,200.93,232.66,8
HCPCS,G0562,Complex simulation w/pet-ct,,,488.97,1986.82,27
HCPCS,G0563,Sbrt w/positron emission del,,,989.77,3755.01,27
HCPCS,G0564,365 d implant glucose sensor,,,389.36,3254.41,15
HCPCS,G0565,Rem/ins glu snsr 365 dif sit,,,389.36,3254.41,15
HCPCS,G0566,3d bn img algor drvd fr mri,,,86.82,792.09,21
HCPCS,G0567,Screening hep c detect,,,33.62,78.96,21
HCPCS,G0568,"Int psych care mng, 1 cal mo",,,96.11,105.72,12
HCPCS,G0569,"Subs psych care mng, subs mo",,,96.11,105.72,12
HCPCS,G0570,"Care manage serv, pr cal mo",,,35.45,38.99,12
HCPCS,G0571,INTRAOP NERVE CRYOABLATION,598.0,388.7,1.1,598.0,104
HCPCS,G0571,Intraop nerve cryoablation,,,673.41,779.74,8
HCPCS,G0659,Drug test def simple all cl,,,34.82,170.26,34
HCPCS,G0660,Team remote e/m new pt 10 mn,,,68.73,79.59,8
HCPCS,G0661,Team remote e/m new pt 20 mn,,,68.73,79.59,8
HCPCS,G0662,Team remote e/m new pt 30 mn,,,68.73,79.59,8
HCPCS,G0663,Team remote e/m new pt 45 mn,,,68.73,79.59,8
HCPCS,G0664,Team remote e/m new pt 60 mn,,,68.73,79.59,8
HCPCS,G0665,Team remote e/m est pt 10 mn,,,68.73,79.59,8
HCPCS,G0666,Team remote e/m est pt 15 mn,,,68.73,79.59,8
HCPCS,G0667,Team remote e/m est pt 25 mn,,,68.73,79.59,8
HCPCS,G0668,Team remote e/m est pt 40 mn,,,68.73,79.59,8
HCPCS,G0680,Cr art clc art vlv clc w rpt,,,183.67,212.67,8
HCPCS,G0681,App of non-sheet skin sub,,,1469.08,1701.04,8
HCPCS,G0682,App of non-sheet skin sub ad,,,1469.08,1701.04,8
HCPCS,G0683,App of non-sheet skin sub g,,,1469.08,1701.04,8
HCPCS,G0684,App non-sheet skin sb g add,,,1469.08,1701.04,8
HCPCS,G0913,Improve visual funct,,,10.69,2739849.3,9
HCPCS,G0914,Survey not complete,,,10.69,2739849.3,9
HCPCS,G0915,No improve visual funct,,,10.69,2739849.3,9
HCPCS,G0916,Satisfy with care,,,10.69,2739849.3,9
HCPCS,G0917,Care survey not complete,,,10.69,2739849.3,9
HCPCS,G0918,No satisfy with care,,,10.69,2739849.3,9
HCPCS,G1001,Cdsm evicore,,,10.69,2739849.3,9
HCPCS,G1002,Cdsm medcurrent,,,10.69,2739849.3,9
HCPCS,G1003,Cdsm medicalis,,,10.69,2739849.3,9
HCPCS,G1004,Cdsm ndsc,,,0.03,12.38,9
HCPCS,G1005,Cdsm nia,,,10.69,12.38,8
HCPCS,G1006,Cdsm test approp,,,10.69,12.38,8
HCPCS,G1007,Cdsm aim,,,10.69,2739849.3,9
HCPCS,G1008,Cdsm cranberry pk,,,10.69,2739849.3,9
HCPCS,G1009,Cdsm sage health,,,10.69,12.38,8
HCPCS,G1010,Cdsm stanson,,,10.69,2739849.3,9
HCPCS,G1011,Cdsm qualified nos,,,10.69,2739849.3,9
HCPCS,G1012,Cdsm agilemd,,,10.69,2739849.3,9
HCPCS,G1013,Cdsm evidencecare,,,10.69,2739849.3,9
HCPCS,G1014,Cdsm inveniqa,,,10.69,2739849.3,9
HCPCS,G1015,Cdsm reliant,,,10.69,2739849.3,9
HCPCS,G1016,Cdsm speed of care,,,10.69,2739849.3,9
HCPCS,G1017,Cdsm healthhelp,,,10.69,2739849.3,9
HCPCS,G1018,Cdsm infinx,,,10.69,2739849.3,9
HCPCS,G1019,Cdsm logicnets,,,10.69,2739849.3,9
HCPCS,G1020,Cdsm curbside,,,10.69,2739849.3,9
HCPCS,G1021,Cdsm ehealthline,,,10.69,12.38,8
HCPCS,G1022,Cdsm intermountain,,,10.69,2739849.3,9
HCPCS,G1023,Cdsm persivia,,,10.69,2739849.3,9
HCPCS,G1024,Cdsm radrite,,,10.69,2739849.3,9
HCPCS,G1025,Pt mnth 1 mcp prov,,,10.69,2739849.3,9
HCPCS,G1026,Pt hemo > 3mo,,,10.69,2739849.3,9
HCPCS,G1027,Pt hemo < 3mo,,,10.69,2739849.3,9
HCPCS,G1028,Take home supply 8mg per 0.1,,,9.64,349.87,9
HCPCS,G2000,Blinded conv. tx mdd clin tr,,,353.04,1399.26,29
HCPCS,G2001,Post d/c h vst new pt 20 m,,,129.57,129.57,1
HCPCS,G2002,Post-d/c h vst new pt 30 m,,,192.84,192.84,1
HCPCS,G2003,Post-d/c h vst new pt 45 m,,,316.58,316.58,1
HCPCS,G2004,Post-d/c h vst new pt 60 m,,,416.15,416.15,1
HCPCS,G2005,Post-d/c h vst new pt 75 m,,,543.78,543.78,1
HCPCS,G2006,Post-d/c h vst ext pt 20 m,,,127.05,127.05,1
HCPCS,G2007,Post-d/c h vst ext pt 30 m,,,204.6,204.6,1
HCPCS,G2008,Post-d/c h vst ext pt 45 m,,,321.13,321.13,1
HCPCS,G2009,Post-d/c h vst ext pt 60 m,,,453.83,453.83,1
HCPCS,G2010,REMOT IMAGE SUBMIT BY PT,79.0,51.35,1.1,133.94,142
HCPCS,G2010,Remot image submit by pt,,,10.74,23.62,9
HCPCS,G2011,Alcohol/sub misuse assess,,,22.7,77.73,29
HCPCS,G2012,Brief check in by md/qhp,,,10.74,33.26,9
HCPCS,G2013,Post-d/c h vst ext pt 75 m,,,543.78,543.78,1
HCPCS,G2014,Post-d/c care plan overs 30m,,,192.51,192.51,1
HCPCS,G2015,Post-d/c care plan overs 60m,,,270.11,270.11,1
HCPCS,G2020,Hi inten serv for sip model,,,21.85,2739849.3,9
HCPCS,G2021,Hea care pract tx in place,,,10.69,2739849.3,9
HCPCS,G2022,"Benef refuses service, mod",,,10.69,2739849.3,9
HCPCS,G2023,Specimen collect covid-19,,,2.64,49.03,14
HCPCS,G2024,Spec coll snf/lab covid-19,,,2.64,53.22,14
HCPCS,G2025,Dis site tele svcs rhc/fqhc,,,68.73,250.44,9
HCPCS,G2061,Qual nonmd est pt 5-10m,,,68.73,79.59,8
HCPCS,G2062,Qual nonmd est pt 11-20m,,,68.73,79.59,8
HCPCS,G2063,Qual nonmd est pt 21>min,,,68.73,79.59,8
HCPCS,G2067,Med assist tx meth wk,,,38.12,688.45,9
HCPCS,G2068,Med assist tx bupre oral,,,38.12,773.53,9
HCPCS,G2069,Med assist tx inject,,,38.12,5473.62,9
HCPCS,G2070,Med assist tx implant,,,105.94,14837.37,9
HCPCS,G2071,Med tx remove implant,,,38.12,1331.97,9
HCPCS,G2072,Med tx insert/remove imp,,,105.94,15485.9,9
HCPCS,G2073,Med tx naltrexone,,,38.12,4486.91,9
HCPCS,G2074,Med assist tx no drug,,,38.12,545.84,9
HCPCS,G2075,Med tx meds nos,,,38.12,2739849.3,9
HCPCS,G2076,Intake act w/med exam,,,197.35,531.18,9
HCPCS,G2077,Periodic assessment,,,197.35,326.42,9
HCPCS,G2078,Take-home meth,,,9.64,111.55,9
HCPCS,G2079,Take-hom buprenorphine,,,9.64,196.62,9
HCPCS,G2080,Add 30 mins counsel,,,10.58,91.57,9
HCPCS,G2081,Pt 66+ snp or ltc pos > 90d,,,10.69,2739849.3,9
HCPCS,G2082,Visit esketamine 56m or less,,,391.01,3152.37,29
HCPCS,G2083,"Visit esketamine, > 56m",,,391.01,5070.37,29
HCPCS,G2086,Off base opioid tx 70min,,,138.32,416.23,21
HCPCS,G2087,"Off base opioid tx, 60 m",,,138.32,416.23,21
HCPCS,G2089,A1c level 7 to 9%,,,10.69,12.38,8
HCPCS,G2090,Pt 66+ frailty and med dem,,,10.69,2739849.3,9
HCPCS,G2091,Pt 66+ frailty and adv ill,,,10.69,2739849.3,9
HCPCS,G2092,Ace arb arni,,,10.69,2739849.3,9
HCPCS,G2093,Med doc rsn no ace arn arni,,,10.69,2739849.3,9
HCPCS,G2094,Pt rsn no ace arn arni,,,10.69,2739849.3,9
HCPCS,G2095,Sys rsn no ace arn arni,,,10.69,12.38,8
HCPCS,G2096,No rsn ace arb arni,,,10.69,2739849.3,9
HCPCS,G2097,Dx uri 3d after other dx,,,10.69,2739849.3,9
HCPCS,G2098,Pt 66+ frailty and med dem,,,10.69,2739849.3,9
HCPCS,G2099,Pt 66+ frailty and adv ill,,,10.69,2739849.3,9
HCPCS,G2100,Pt 66+ frailty and med dem,,,10.69,2739849.3,9
HCPCS,G2101,Pt 66+ frailty and adv ill,,,10.69,2739849.3,9
HCPCS,G2102,Dil retinal eye exam,,,10.69,12.38,8
HCPCS,G2103,7 stereo photos interpret,,,10.69,12.38,8
HCPCS,G2104,Eye img valid w/7 stereo,,,10.69,12.38,8
HCPCS,G2105,Pt 66+ snp or ltc pos > 90d,,,10.69,2739849.3,9
HCPCS,G2106,Pt 66+ frailty and med dem,,,10.69,2739849.3,9
HCPCS,G2107,Pt 66+ frailty and adv ill,,,10.69,2739849.3,9
HCPCS,G2108,Pt 66+ snp or ltc pos > 90d,,,10.69,12.38,8
HCPCS,G2109,Pt 66+ frailty and med dem,,,10.69,12.38,8
HCPCS,G2110,Pt 66+ frailty and adv ill,,,10.69,12.38,8
HCPCS,G2112,Pred<=5 mg ra glu <6m,,,10.69,2739849.3,9
HCPCS,G2113,"Pred>5 mg >6m, no chg da",,,10.69,2739849.3,9
HCPCS,G2114,Pt 66-80 frailty and med dem,,,10.69,12.38,8
HCPCS,G2115,Pt 66-80 frailty and med dem,,,10.69,2739849.3,9
HCPCS,G2116,Pt 66-80 frailty and adv ill,,,10.69,2739849.3,9
HCPCS,G2117,Pt 66-80 frailty and adv ill,,,10.69,12.38,8
HCPCS,G2118,Pt 81+ frailty,,,10.69,2739849.3,9
HCPCS,G2119,Calc vitd opt,,,10.69,12.38,8
HCPCS,G2120,No calc vitd opt,,,10.69,12.38,8
HCPCS,G2121,Psy dep anx ap and icd asse,,,10.69,2739849.3,9
HCPCS,G2122,Psy/dep/anx/apandicd noasse,,,10.69,2739849.3,9
HCPCS,G2123,Pt 66-80 frailty med dem,,,10.69,12.38,8
HCPCS,G2124,Pt 66-80 frailty adv ill,,,10.69,12.38,8
HCPCS,G2125,Pt 81+ frailty,,,10.69,2739849.3,9
HCPCS,G2126,Pt 66-80 frailty and adv ill,,,10.69,2739849.3,9
HCPCS,G2127,Pt 66-80 frailty and med dem,,,10.69,2739849.3,9
HCPCS,G2128,No aspirin med rsn,,,10.69,2739849.3,9
HCPCS,G2129,No bp outpt,,,10.69,2739849.3,9
HCPCS,G2130,Pt 66+ lt inst > 90,,,10.69,12.38,8
HCPCS,G2131,Pt 81+ frailty,,,10.69,12.38,8
HCPCS,G2132,Pt 66-80 frailty and med dem,,,10.69,12.38,8
HCPCS,G2133,Pt 66-80 frailty and adv ill,,,10.69,12.38,8
HCPCS,G2134,Pt 66+ frailty and med dem,,,10.69,12.38,8
HCPCS,G2135,Pt 66+ frailty and adv ill,,,10.69,12.38,8
HCPCS,G2136,Bk pain vas 6-20wk <= 3,,,10.69,2739849.3,9
HCPCS,G2137,Bk pain vas 6-20wk > 3,,,10.69,2739849.3,9
HCPCS,G2138,Bk pain vas 9-15mo <= 3,,,10.69,2739849.3,9
HCPCS,G2139,Bk pain vas 9-15mo > 3,,,10.69,2739849.3,9
HCPCS,G2140,Leg pain vas 6-20wk <= 3,,,10.69,2739849.3,9
HCPCS,G2141,Leg pain vas 6-20wk > 3,,,10.69,2739849.3,9
HCPCS,G2142,Fs odi 9-15mo postop<= 22,,,10.69,2739849.3,9
HCPCS,G2143,Fs odi 9-15mo > 22,,,10.69,2739849.3,9
HCPCS,G2144,Fs odi 6-20wk postop <= 22,,,10.69,2739849.3,9
HCPCS,G2145,Fsodi 6-20wk >22 or chg 30pt,,,10.69,2739849.3,9
HCPCS,G2146,Leg pain vas 9-15mo <= 3,,,10.69,2739849.3,9
HCPCS,G2147,Leg pain vas 9-15mo > 3,,,10.69,2739849.3,9
HCPCS,G2148,Mpm used,,,10.69,2739849.3,9
HCPCS,G2149,No mpm med rsn,,,10.69,2739849.3,9
HCPCS,G2150,No mpm,,,10.69,2739849.3,9
HCPCS,G2151,Dx degen neuro,,,10.69,2739849.3,9
HCPCS,G2152,Res change sc >=0,,,10.69,2739849.3,9
HCPCS,G2153,Hosp dur meas pd,,,10.69,12.38,8
HCPCS,G2154,Td 9 yrs start end meas,,,10.69,12.38,8
HCPCS,G2155,Hist contraindications,,,10.69,12.38,8
HCPCS,G2156,No prior td or hx contra,,,10.69,12.38,8
HCPCS,G2157,Pneum vacc 12 mo 60+,,,10.69,12.38,8
HCPCS,G2158,Pneum vacc adv rx,,,10.69,12.38,8
HCPCS,G2159,No pneum vacc 12 mo 60+,,,10.69,12.38,8
HCPCS,G2160,Herpzos 50+,,,10.69,12.38,8
HCPCS,G2161,Adv rx zos,,,10.69,12.38,8
HCPCS,G2162,No herpzos 50+,,,10.69,12.38,8
HCPCS,G2163,Infl vacc 07/01 to 06/30,,,10.69,12.38,8
HCPCS,G2164,Adv rx infl vacc,,,10.69,12.38,8
HCPCS,G2165,No infl vacc 07/01 to 06/30,,,10.69,12.38,8
HCPCS,G2166,No pt adm dx no neck fs prom,,,10.69,12.38,8
HCPCS,G2167,Res change sc < 0,,,10.69,2739849.3,9
HCPCS,G2168,Svs by pt in home health,,,2739849.3,2739849.3,1
HCPCS,G2169,Svs by ot in home health,,,2739849.3,2739849.3,1
HCPCS,G2170,Avf by tissue w thermal e,,,3153.41,3651.32,8
HCPCS,G2171,Avf use magnetic/art/ven,,,3153.41,3651.32,8
HCPCS,G2172,Tx for opioid use demo proj,,,38.12,2739849.3,9
HCPCS,G2173,Uri w comorb 12m oth dx,,,10.69,2739849.3,9
HCPCS,G2174,Uri new rx antibiotic 30d,,,10.69,2739849.3,9
HCPCS,G2175,Pt comorb dx 12m of epi,,,10.69,2739849.3,9
HCPCS,G2176,Outpt ed obs w inpt admit,,,10.69,2739849.3,9
HCPCS,G2177,Bronch w rx antibx 30d,,,10.69,2739849.3,9
HCPCS,G2178,Pt not elig low neuro ex,,,10.69,2739849.3,9
HCPCS,G2179,Med doc rsn no low ex,,,10.69,2739849.3,9
HCPCS,G2180,Inelig footwr eval,,,10.69,2739849.3,9
HCPCS,G2181,Bmi not doc medrsn ptref,,,10.69,2739849.3,9
HCPCS,G2182,Pt 1st biolog antirheum,,,10.69,2739849.3,9
HCPCS,G2183,Doc pt unable comm,,,10.69,2739849.3,9
HCPCS,G2184,No caregiver,,,10.69,2739849.3,9
HCPCS,G2185,Caregiver dem trained,,,10.69,2739849.3,9
HCPCS,G2186,Pt ref app rsrcs,,,10.69,2739849.3,9
HCPCS,G2187,Clin ind img hd trauma,,,10.69,2739849.3,9
HCPCS,G2188,Pt 50 yrs w/clin ind hd,,,10.69,2739849.3,9
HCPCS,G2189,Img hd abnml neuro exam,,,10.69,2739849.3,9
HCPCS,G2190,Ind img hd rad neck,,,10.69,2739849.3,9
HCPCS,G2191,Ind img hd pos hd ache,,,10.69,2739849.3,9
HCPCS,G2192,>55 yrs temp hd ache,,,10.69,2739849.3,9
HCPCS,G2193,<6yr new onset hd ache,,,10.69,2739849.3,9
HCPCS,G2194,New hdache ped pt dis,,,10.69,2739849.3,9
HCPCS,G2195,Occip hdache child,,,10.69,2739849.3,9
HCPCS,G2196,Screen unhlthy etoh use,,,10.69,2739849.3,9
HCPCS,G2197,Screen hlthy etoh use,,,10.69,2739849.3,9
HCPCS,G2198,Med rsn no unhlthy etoh,,,10.69,12.38,8
HCPCS,G2199,Not scrn etoh no rsn,,,10.69,2739849.3,9
HCPCS,G2200,Unhlthy etoh rcvd couns,,,10.69,2739849.3,9
HCPCS,G2201,Med rsn no brief couns,,,10.69,12.38,8
HCPCS,G2202,No rsn no brief couns,,,10.69,2739849.3,9
HCPCS,G2203,Med rsn no etoh couns,,,10.69,12.38,8
HCPCS,G2204,Pt 45-85 w/ scope,,,10.69,2739849.3,9
HCPCS,G2205,Preg drng adjv trtmt,,,10.69,2739849.3,9
HCPCS,G2206,Adjv trtmt chemo her2,,,10.69,2739849.3,9
HCPCS,G2207,Rsn no trtmt chem her2,,,10.69,2739849.3,9
HCPCS,G2208,No trtmt chemo and her2,,,10.69,2739849.3,9
HCPCS,G2209,Refused to participate,,,10.69,2739849.3,9
HCPCS,G2210,No neck fs prom no rsn,,,10.69,2739849.3,9
HCPCS,G2211,Complex e/m visit add on,,,42.91,73.83,9
HCPCS,G2211,VISIT CPLX INHERENT E&M ASSOC WITH MED CARE SRVC,145.0,94.25,1.1,145.0,128
HCPCS,G2212,PROLONG OUTPT/OFFICE VIS,268.0,174.2,1.1,268.0,140
HCPCS,G2212,Prolong outpt/office vis,,,63.76,73.83,8
HCPCS,G2213,INITIAT MED ASSIST TX IN ER,572.0,371.8,1.1,572.0,128
HCPCS,G2213,Initiat med assist tx in er,,,10.58,12.25,8
HCPCS,G2214,Init/sub psych care m 1st 30,,,77.33,232.71,21
HCPCS,G2215,Home supply nasal naloxone,,,9.64,151.88,9
HCPCS,G2216,Home supply inject naloxon,,,9.64,30.77,9
HCPCS,G2250,"Remot img sub by pt, non e/m",,,10.74,23.62,36
HCPCS,G2251,"Brief chkin, 5-10, non-e/m",,,10.74,33.26,36
HCPCS,G2252,"Brief chkin by md/qhp, 11-20",,,10.74,64.8,36
HCPCS,G3002,Chronic pain mgmt 30 mins,,,193.42,193.42,1
HCPCS,G3003,Chronic pain mgmt addl 15m,,,67.38,67.38,1
HCPCS,G4000,Dermatology ss,,,10.69,2739849.3,9
HCPCS,G4001,Diagnostic rad ss,,,10.69,2739849.3,9
HCPCS,G4002,Ep cardio ss,,,10.69,2739849.3,9
HCPCS,G4003,Emergency med ss,,,10.69,2739849.3,9
HCPCS,G4004,Endocrinology ss,,,10.69,2739849.3,9
HCPCS,G4005,Family medicine ss,,,10.69,2739849.3,9
HCPCS,G4006,Gastroenterology ss,,,10.69,2739849.3,9
HCPCS,G4007,General surgery ss,,,10.69,2739849.3,9
HCPCS,G4008,Geriatrics ss,,,10.69,2739849.3,9
HCPCS,G4009,Hospitalists ss,,,10.69,2739849.3,9
HCPCS,G4010,Infectious disease ss,,,10.69,2739849.3,9
HCPCS,G4011,Internal medicine ss,,,10.69,2739849.3,9
HCPCS,G4012,Interventional rad ss,,,10.69,2739849.3,9
HCPCS,G4013,Mntal/behav/psych hlth ss,,,10.69,2739849.3,9
HCPCS,G4014,Nephrology ss,,,10.69,2739849.3,9
HCPCS,G4015,Neurology ss,,,10.69,2739849.3,9
HCPCS,G4016,Neurosurgical ss,,,10.69,2739849.3,9
HCPCS,G4017,Nutrition/dietician ss,,,10.69,2739849.3,9
HCPCS,G4018,Ob/gyn ss,,,10.69,2739849.3,9
HCPCS,G4019,Oncology/hema ss,,,10.69,2739849.3,9
HCPCS,G4020,Ophthalmology/optometry ss,,,10.69,2739849.3,9
HCPCS,G4021,Orthopedic surgery ss,,,10.69,2739849.3,9
HCPCS,G4022,Otolaryngology ss,,,10.69,2739849.3,9
HCPCS,G4023,Pathology ss,,,10.69,2739849.3,9
HCPCS,G4024,Pediatrics ss,,,10.69,2739849.3,9
HCPCS,G4025,Physical medicine ss,,,10.69,2739849.3,9
HCPCS,G4026,Phys/occ therapy ss,,,10.69,2739849.3,9
HCPCS,G4027,Plastic surgery ss,,,10.69,2739849.3,9
HCPCS,G4028,Podiatry ss,,,10.69,2739849.3,9
HCPCS,G4029,Preventive medicine ss,,,10.69,2739849.3,9
HCPCS,G4030,Pulmonology ss,,,10.69,2739849.3,9
HCPCS,G4031,Radiation oncology ss,,,10.69,2739849.3,9
HCPCS,G4032,Rheumatology ss,,,10.69,2739849.3,9
HCPCS,G4033,Skilled nursing facility ss,,,10.69,2739849.3,9
HCPCS,G4034,Speech language path ss,,,10.69,2739849.3,9
HCPCS,G4035,Thoracic surgery ss,,,10.69,2739849.3,9
HCPCS,G4036,Urgent care ss,,,10.69,2739849.3,9
HCPCS,G4037,Urology ss,,,10.69,2739849.3,9
HCPCS,G4038,Vascular surgery ss,,,10.69,2739849.3,9
HCPCS,G6001,Echo guidance radiotherapy,,,81.68,107.93,9
HCPCS,G6002,Stereoscopic x-ray guidance,,,53.18,130.47,9
HCPCS,G6003,Radiation treatment delivery,,,136.52,377.71,9
HCPCS,G6004,Radiation treatment delivery,,,136.52,309.89,9
HCPCS,G6005,Radiation treatment delivery,,,136.52,310.69,9
HCPCS,G6006,Radiation treatment delivery,,,136.52,308.25,9
HCPCS,G6007,Radiation treatment delivery,,,136.52,564.08,9
HCPCS,G6008,Radiation treatment delivery,,,136.52,427.69,9
HCPCS,G6009,Radiation treatment delivery,,,136.52,426.86,9
HCPCS,G6010,Radiation treatment delivery,,,136.52,423.6,9
HCPCS,G6011,Radiation treatment delivery,,,136.52,562.55,9
HCPCS,G6012,Radiation treatment delivery,,,136.52,563.37,9
HCPCS,G6013,Radiation treatment delivery,,,136.52,565.81,9
HCPCS,G6014,Radiation treatment delivery,,,136.52,561.73,9
HCPCS,G6015,Radiation tx delivery imrt,,,358.52,873.57,9
HCPCS,G6016,Delivery comp imrt,,,488.97,868.94,9
HCPCS,G6017,Intrafraction track motion,,,10.69,331.38,9
HCPCS,G8395,Lvef>=40% doc normal or mild,,,10.69,2739849.3,9
HCPCS,G8396,Lvef not performed,,,10.69,2739849.3,9
HCPCS,G8397,Dil macula/fundus exam/w doc,,,0.03,12.38,9
HCPCS,G8398,Dil macular/fundus not perfo,,,10.69,12.38,8
HCPCS,G8399,Pt w/dxa results document,,,0.03,12.38,9
HCPCS,G8400,Pt w/dxa no results doc,,,0.03,12.38,9
HCPCS,G8404,Low extemity neur exam docum,,,10.69,2739849.3,9
HCPCS,G8405,Low extemity neur not perfor,,,10.69,2739849.3,9
HCPCS,G8410,Eval on foot documented,,,10.69,2739849.3,9
HCPCS,G8415,Eval on foot not performed,,,10.69,2739849.3,9
HCPCS,G8416,Pt inelig footwear evaluatio,,,10.69,2739849.3,9
HCPCS,G8417,Calc bmi abv up param f/u,,,0.03,12.38,9
HCPCS,G8418,Calc bmi blw low param f/u,,,0.03,12.38,9
HCPCS,G8419,Calc bmi out nrm param nof/u,,,0.03,12.38,9
HCPCS,G8420,Calc bmi norm parameters,,,0.03,12.38,9
HCPCS,G8421,Bmi not calculated,,,0.03,12.38,9
HCPCS,G8422,Pt inelig bmi calculation,,,10.69,12.38,8
HCPCS,G8427,Docrev cur meds by elig clin,,,0.03,12.38,9
HCPCS,G8428,Cur meds not document,,,0.03,12.38,9
HCPCS,G8430,Doc med rsn no medrec,,,0.03,12.38,9
HCPCS,G8431,Pos clin depres scrn f/u doc,,,0.03,12.38,9
HCPCS,G8432,"Dep scr not doc, rng",,,0.03,12.38,9
HCPCS,G8433,Scr for dep not cpt doc rsn,,,0.03,12.38,9
HCPCS,G8442,"Doc pain as nt perf, not elg",,,10.69,12.38,8
HCPCS,G8450,Beta-bloc rx pt w/abn lvef,,,0.03,12.38,9
HCPCS,G8451,Pt w/abn lvef inelig b-bloc,,,10.69,2739849.3,9
HCPCS,G8452,Pt w/abn lvef b-bloc no rx,,,10.69,2739849.3,9
HCPCS,G8465,High risk recurrence pro ca,,,10.69,2739849.3,9
HCPCS,G8473,Ace/arb thxpy rx'd,,,10.69,2739849.3,9
HCPCS,G8474,Ace/arb not rx'd; doc reas,,,10.69,2739849.3,9
HCPCS,G8475,Ace/arb thxpy not rx'd,,,10.69,2739849.3,9
HCPCS,G8476,Bp sys <140 and dias <90,,,10.69,2739849.3,9
HCPCS,G8477,Bp sys>=140 and/or dias >=90,,,10.69,2739849.3,9
HCPCS,G8478,Bp not performed/doc,,,10.69,2739849.3,9
HCPCS,G8482,Flu immunize order/admin,,,0.03,12.38,9
HCPCS,G8483,Flu imm no admin doc rea,,,0.03,12.38,9
HCPCS,G8484,Flu immunize no admin,,,0.03,12.38,9
HCPCS,G8506,Pt rec ace/arb,,,10.69,12.38,8
HCPCS,G8509,Pos pain assess no f/u doc,,,10.69,12.38,8
HCPCS,G8510,"Scr dep neg, no plan reqd",,,0.03,12.38,9
HCPCS,G8511,"Scr dep pos, no plan doc rng",,,10.69,2739849.3,9
HCPCS,G8535,Eld maltreatment not doc,,,10.69,2739849.3,9
HCPCS,G8536,No doc elder mal scrn,,,10.69,2739849.3,9
HCPCS,G8539,DOC FUNCT AND CARE PLAN,692.0,449.8,0.01,692.0,80
HCPCS,G8539,Doc funct and care plan,,,0.03,12.38,9
HCPCS,G8540,Foa not doc as being perf,,,10.69,2739849.3,9
HCPCS,G8541,No doc cur funct assess,,,0.03,12.38,9
HCPCS,G8542,Doc funct no deficiencies,,,0.03,12.38,9
HCPCS,G8543,Cur funct asses; no care pln,,,10.69,2739849.3,9
HCPCS,G8559,Pt ref doc oto eval,,,10.69,2739849.3,9
HCPCS,G8560,Pt hx act drain prev 90 days,,,10.69,2739849.3,9
HCPCS,G8561,Pt inelig for ref oto eval,,,10.69,2739849.3,9
HCPCS,G8562,Pt no hx act drain 90 d,,,10.69,2739849.3,9
HCPCS,G8563,Pt no ref oto reas no spec,,,10.69,2739849.3,9
HCPCS,G8564,Pt ref oto eval,,,10.69,2739849.3,9
HCPCS,G8565,Ver doc hear loss,,,10.69,2739849.3,9
HCPCS,G8566,Pt inelig ref oto eval,,,10.69,2739849.3,9
HCPCS,G8567,Pt no doc hear loss,,,10.69,2739849.3,9
HCPCS,G8568,Pt no ref otolo no spec,,,10.69,2739849.3,9
HCPCS,G8569,Prol intubation req,,,10.69,2739849.3,9
HCPCS,G8570,No prol intub req,,,10.69,2739849.3,9
HCPCS,G8571,Ster wd ifx 30 d postop,,,10.69,12.38,8
HCPCS,G8572,No ster wd ifx,,,10.69,12.38,8
HCPCS,G8573,Stk cabg,,,10.69,12.38,8
HCPCS,G8574,No strk cabg,,,10.69,12.38,8
HCPCS,G8575,Postop ren fail,,,10.69,2739849.3,9
HCPCS,G8576,No postop ren fail,,,10.69,2739849.3,9
HCPCS,G8577,Reop req bld grft oth,,,10.69,2739849.3,9
HCPCS,G8578,No reop req bld grft oth,,,10.69,2739849.3,9
HCPCS,G8598,Asa/antiplat ther used,,,0.03,12.38,9
HCPCS,G8599,No asa/antiplat ther use rng,,,0.03,12.38,9
HCPCS,G8600,Tpa initi w/in 4.5 hr,,,10.69,2739849.3,9
HCPCS,G8601,No elig tpa init w/in 4.5 hr,,,10.69,2739849.3,9
HCPCS,G8602,No tpa init w/in 4.5 hr,,,10.69,2739849.3,9
HCPCS,G8627,Surg proc w/in 30 days,,,10.69,12.38,8
HCPCS,G8628,No surg proc w/in 30 days,,,10.69,12.38,8
HCPCS,G8633,Pharm ther osteo rx,,,10.69,2739849.3,9
HCPCS,G8635,No pharm ther osteo rx,,,10.69,2739849.3,9
HCPCS,G8647,Rafscrs ki scor >= 0,,,10.69,2739849.3,9
HCPCS,G8648,Rafscrs ki scor < 0,,,10.69,2739849.3,9
HCPCS,G8650,Rafs crs ki no scor no rsn,,,10.69,2739849.3,9
HCPCS,G8651,Rafscrs hi scor >=0,,,10.69,2739849.3,9
HCPCS,G8652,Rafscrs hi scor < 0,,,10.69,2739849.3,9
HCPCS,G8654,Rafs crs hi no scor no surv,,,10.69,2739849.3,9
HCPCS,G8655,Rafscrs llfai scor >= 0,,,10.69,2739849.3,9
HCPCS,G8656,Rafscrs llfai scor < 0,,,10.69,2739849.3,9
HCPCS,G8658,Rafscrs llfai no scor + surv,,,10.69,2739849.3,9
HCPCS,G8659,Rafscrs lbi scor >= 0,,,10.69,2739849.3,9
HCPCS,G8660,Rafscrs lbi scor < 0,,,10.69,2739849.3,9
HCPCS,G8661,Rafscrs lbi no scor,,,10.69,2739849.3,9
HCPCS,G8662,Rafs crs lbi no scor no surv,,,10.69,2739849.3,9
HCPCS,G8663,Rafscrs si scor >= 0,,,10.69,2739849.3,9
HCPCS,G8664,Rafscrs si scor < 0,,,10.69,2739849.3,9
HCPCS,G8666,Rafs crs si no scor no surv,,,10.69,2739849.3,9
HCPCS,G8667,Rafscrs ewh scor >= 0,,,10.69,2739849.3,9
HCPCS,G8668,Rafscrs ewh scor < 0,,,10.69,2739849.3,9
HCPCS,G8670,Rafs crs ewh no scor no surv,,,10.69,2739849.3,9
HCPCS,G8671,Rafscrs goi scor >= 0,,,10.69,12.38,8
HCPCS,G8672,Rafscrs goi scor < 0,,,10.69,12.38,8
HCPCS,G8674,"Rafscrs neck, no msr/no foto",,,10.69,12.38,8
HCPCS,G8694,Lvef <=40%,,,10.69,2739849.3,9
HCPCS,G8708,Antibiotic not pres,,,10.69,2739849.3,9
HCPCS,G8709,Uri ep compete diag,,,10.69,2739849.3,9
HCPCS,G8710,Pt pres antibiotic,,,10.69,2739849.3,9
HCPCS,G8711,Pres antibx on/within 3 day,,,0.03,12.38,9
HCPCS,G8712,Not pres antibiotic,,,10.69,2739849.3,9
HCPCS,G8721,"Pt, pn, hist grade doc",,,0.03,12.38,9
HCPCS,G8722,"Med reas pt, pn, not doc",,,10.69,2739849.3,9
HCPCS,G8723,Spec sit not prim tumor,,,10.69,2739849.3,9
HCPCS,G8724,"Pt, pn, hist grade not doc",,,10.69,2739849.3,9
HCPCS,G8730,Pain doc pos and plan,,,10.69,12.38,8
HCPCS,G8731,Pain neg no plan,,,10.69,12.38,8
HCPCS,G8732,No doc of pain,,,10.69,12.38,8
HCPCS,G8733,Doc pos elder mal scrn plan,,,10.69,2739849.3,9
HCPCS,G8734,Doc neg eld req,,,10.69,2739849.3,9
HCPCS,G8735,Eld mal scrn pos no plan,,,10.69,2739849.3,9
HCPCS,G8749,No signs melanoma,,,10.69,2739849.3,9
HCPCS,G8752,Sys bp less 140,,,0.03,12.38,9
HCPCS,G8753,Sys bp > or = 140,,,0.03,12.38,9
HCPCS,G8754,Dias bp less 90,,,0.03,12.38,9
HCPCS,G8755,Dias bp > or = 90,,,0.03,12.38,9
HCPCS,G8756,No bp measure doc,,,0.03,12.38,9
HCPCS,G8783,Bp scrn perf rec interval,,,0.03,12.38,9
HCPCS,G8785,Bp scrn no perf at interval,,,0.03,12.38,9
HCPCS,G8797,Specimen site not esophagus,,,10.69,2739849.3,9
HCPCS,G8798,Specimen site not prostate,,,10.69,2739849.3,9
HCPCS,G8806,Perf ultrsnd to lct preg doc,,,0.03,12.38,9
HCPCS,G8807,No ta tv ultrasnd,,,10.69,2739849.3,9
HCPCS,G8808,"Ultrasound not perf, rng",,,0.03,12.38,9
HCPCS,G8809,Rh-immunoglobulin order,,,10.69,12.38,8
HCPCS,G8810,Doc reas no rh-immuno,,,10.69,12.38,8
HCPCS,G8811,No rh-immunoglobulin order,,,10.69,12.38,8
HCPCS,G8815,Doc reas no statin therapy,,,10.69,2739849.3,9
HCPCS,G8816,Statin med pres at disch,,,10.69,2739849.3,9
HCPCS,G8817,Doc reas no statin med disch,,,10.69,2739849.3,9
HCPCS,G8818,Pt disch to home by day#7,,,10.69,12.38,8
HCPCS,G8825,Pt not disch to home day#7,,,10.69,12.38,8
HCPCS,G8826,Pt disch home day #2 evar,,,10.69,2739849.3,9
HCPCS,G8833,Pt not disch home day#2 evar,,,10.69,2739849.3,9
HCPCS,G8834,Pt disch home day #2 cea,,,10.69,2739849.3,9
HCPCS,G8838,Not disch home by day #2,,,10.69,2739849.3,9
HCPCS,G8839,Sleep apnea assess,,,10.69,2739849.3,9
HCPCS,G8840,Doc reas no sleep apnea,,,10.69,2739849.3,9
HCPCS,G8841,No sleep apnea assess,,,10.69,2739849.3,9
HCPCS,G8842,Ahi rdi rei doc win 2mo,,,10.69,2739849.3,9
HCPCS,G8843,Doc reas no ahi rdi rei,,,10.69,2739849.3,9
HCPCS,G8844,No ahi rdi rei ini dx no rsn,,,10.69,2739849.3,9
HCPCS,G8845,Pos airway press prescribed,,,10.69,2739849.3,9
HCPCS,G8846,Mod or severe osa,,,10.69,2739849.3,9
HCPCS,G8849,Doc reas no pos air press,,,10.69,2739849.3,9
HCPCS,G8850,No pap prescribed,,,10.69,2739849.3,9
HCPCS,G8851,Adhere tx assess at lst ann,,,10.69,2739849.3,9
HCPCS,G8852,Pos air press prescribe,,,10.69,12.38,8
HCPCS,G8854,Reas no adhere therapy,,,10.69,2739849.3,9
HCPCS,G8855,Ther not assessed annually,,,10.69,2739849.3,9
HCPCS,G8856,Ref for oto eval,,,10.69,2739849.3,9
HCPCS,G8857,No elig ref for oto eval,,,0.03,12.38,9
HCPCS,G8858,Not ref for oto eval,,,10.69,2739849.3,9
HCPCS,G8863,No assess bone loss,,,10.69,2739849.3,9
HCPCS,G8864,PNEUMOCOCCAL VACCINE ADMIN,37.0,24.05,0.01,37.0,80
HCPCS,G8864,Pneumococcal vaccine admin,,,0.03,12.38,9
HCPCS,G8865,Doc med reas no pneumococcal,,,10.69,2739849.3,9
HCPCS,G8866,Doc pt reas no pneumococcal,,,10.69,2739849.3,9
HCPCS,G8867,No pneumococcal admin,,,10.69,2739849.3,9
HCPCS,G8869,Doc immune hep b antitnf,,,10.69,2739849.3,9
HCPCS,G8872,Intraop image confirm excise,,,10.69,12.38,8
HCPCS,G8873,Specimen not intraop image,,,10.69,12.38,8
HCPCS,G8874,Tissue not image intraop,,,10.69,12.38,8
HCPCS,G8875,Breast cancer dx min invsive,,,10.69,2739849.3,9
HCPCS,G8876,Doc reas no min inv dx,,,10.69,2739849.3,9
HCPCS,G8877,No brst cncr dx min invasive,,,10.69,2739849.3,9
HCPCS,G8878,Sent lymph node biopsy,,,10.69,2739849.3,9
HCPCS,G8880,Sen lym p node biop not perf,,,10.69,2739849.3,9
HCPCS,G8881,Brst cncr stage > t1n0m0,,,10.69,2739849.3,9
HCPCS,G8882,No sent lymph node biopsy,,,10.69,2739849.3,9
HCPCS,G8883,"Rev, comm, track, doc biopsy",,,10.69,12.38,8
HCPCS,G8884,Doc reas biopsy not review,,,10.69,12.38,8
HCPCS,G8885,"No rev, comm, track biopsy",,,10.69,12.38,8
HCPCS,G8907,Pt doc no events on discharg,,,0.03,12.38,9
HCPCS,G8908,Pt doc w burn prior to d/c,,,10.69,2739849.3,9
HCPCS,G8909,Pt doc no burn prior to d/c,,,10.69,2739849.3,9
HCPCS,G8910,Pt doc to have fall in asc,,,10.69,2739849.3,9
HCPCS,G8911,Pt doc no fall in asc,,,10.69,2739849.3,9
HCPCS,G8912,Pt doc with wrong event,,,10.69,2739849.3,9
HCPCS,G8913,Pt doc no wrong event,,,10.69,2739849.3,9
HCPCS,G8914,Pt trans to hosp post d/c,,,10.69,2739849.3,9
HCPCS,G8915,Pt not trans to hosp at d/c,,,10.69,2739849.3,9
HCPCS,G8916,Pt w iv ab given on time,,,0.03,12.38,9
HCPCS,G8917,Pt w iv ab not given on time,,,10.69,2739849.3,9
HCPCS,G8918,Pt w/o preop order iv ab pro,,,0.03,12.38,9
HCPCS,G8923,Lvef <= 40% or lvsd,,,10.69,2739849.3,9
HCPCS,G8924,Spir res doc fev1/fvc<70%,,,10.69,2739849.3,9
HCPCS,G8925,Spir fev1/fvc>=60% & no copd,,,10.69,12.38,8
HCPCS,G8926,Spiro no perf or doc,,,10.69,12.38,8
HCPCS,G8934,Lvef <=40% or dep lv sys fcn,,,10.69,2739849.3,9
HCPCS,G8935,Rx ace or arb therapy,,,0.03,12.38,9
HCPCS,G8936,Pt not eligible ace/arb,,,10.69,2739849.3,9
HCPCS,G8937,No rx ace/arb therapy,,,10.69,2739849.3,9
HCPCS,G8938,Bmi doc onl fup nt doc,,,10.69,12.38,8
HCPCS,G8939,"Pain as doc positive, no f/u",,,10.69,12.38,8
HCPCS,G8941,Eld maltreatment doc as pos,,,10.69,12.38,8
HCPCS,G8942,Doc fcn/care plan w/30 days,,,0.03,12.38,9
HCPCS,G8944,Ajcc mel cnr stg 0 - iic,,,10.69,2739849.3,9
HCPCS,G8946,Mibm but no dx of breast ca,,,10.69,2739849.3,9
HCPCS,G8950,"Pre-htn or htn doc, f/u indc",,,0.03,12.38,9
HCPCS,G8952,"Pre-htn/htn, no f/u, not gvn",,,0.03,12.38,9
HCPCS,G8955,Most recent assess vol mgmt,,,10.69,2739849.3,9
HCPCS,G8956,Pt rcv hedia outpt dyls fac,,,10.69,2739849.3,9
HCPCS,G8958,Assess vol mgmt not doc,,,10.69,2739849.3,9
HCPCS,G8959,Clin tx mdd comm to tx clin,,,10.69,12.38,8
HCPCS,G8960,Clin tx mdd not comm,,,10.69,12.38,8
HCPCS,G8961,Csit lowrisk surg pts preop,,,10.69,2739849.3,9
HCPCS,G8962,Csit on pt any reas 30 days,,,10.69,2739849.3,9
HCPCS,G8963,Csi per asx pt w/pci 2 yrs,,,10.69,12.38,8
HCPCS,G8964,Csi any other than pci 2 yr,,,10.69,12.38,8
HCPCS,G8965,Csit perf on low chd rsk,,,10.69,2739849.3,9
HCPCS,G8966,Csit perf sx or high chd rsk,,,10.69,2739849.3,9
HCPCS,G8967,Warf or other fda drug presc,,,10.69,2739849.3,9
HCPCS,G8968,Doc med not presb,,,10.69,2739849.3,9
HCPCS,G8969,Doc pt rsn no presc warf/fda,,,10.69,2739849.3,9
HCPCS,G8970,No rsk fac or 1 mod risk te,,,10.69,2739849.3,9
HCPCS,G8973,Mst rcnt hbb < 10g/dl,,,10.69,12.38,8
HCPCS,G8974,Hgb not doc rns not gvn,,,10.69,12.38,8
HCPCS,G8975,"Hgb <10g/dl, med rsn",,,10.69,12.38,8
HCPCS,G8976,Hgb >= 10 g/dl,,,10.69,12.38,8
HCPCS,G9001,"Mccd, initial rate",,,21.85,137.0,9
HCPCS,G9002,"Mccd,maintenance rate",,,21.85,25.3,8
HCPCS,G9003,"Mccd, risk adj hi, initial",,,21.85,2739849.3,9
HCPCS,G9004,"Mccd, risk adj lo, initial",,,21.85,2739849.3,9
HCPCS,G9005,"Mccd, risk adj, maintenance",,,21.85,2739849.3,9
HCPCS,G9006,"Mccd, home monitoring",,,21.85,2739849.3,9
HCPCS,G9007,"Mccd, sch team conf",,,21.85,2739849.3,9
HCPCS,G9008,"Mccd,phys coor-care ovrsght",,,21.85,2739849.3,9
HCPCS,G9009,"Mccd, risk adj, level 3",,,21.85,2739849.3,9
HCPCS,G9010,"Mccd, risk adj, level 4",,,21.85,972.7,9
HCPCS,G9011,"Mccd, risk adj, level 5",,,21.85,2739849.3,9
HCPCS,G9012,Other specified case mgmt,,,21.85,2739849.3,9
HCPCS,G9013,Esrd demo bundle level i,,,357.34,2739849.3,9
HCPCS,G9014,Esrd demo bundle-level ii,,,357.34,2739849.3,9
HCPCS,G9016,Demo-smoking cessation coun,,,47.12,2739849.3,9
HCPCS,G9037,Intrpro req fr rec phys/qhcp,,,50.45,54.49,6
HCPCS,G9038,Co-management services,,,21.85,67.9,14
HCPCS,G9050,ONCOLOGY WORK-UP EVALUATION,24.0,15.6,0.01,24.0,86
HCPCS,G9050,Oncology work-up evaluation,,,10.69,12.38,8
HCPCS,G9051,ONCOLOGY TX DECISION-MGMT,24.0,15.6,0.01,3060831.65,86
HCPCS,G9051,Oncology tx decision-mgmt,,,10.69,2739849.3,9
HCPCS,G9052,ONC SURVEILLANCE FOR DISEASE,24.0,15.6,0.01,3060831.65,86
HCPCS,G9052,Onc surveillance for disease,,,10.69,2739849.3,9
HCPCS,G9053,ONC EXPECTANT MANAGEMENT PT,24.0,15.6,0.01,3060831.65,86
HCPCS,G9053,Onc expectant management pt,,,10.69,2739849.3,9
HCPCS,G9054,ONC SUPERVISION PALLIATIVE,24.0,15.6,0.01,3060831.65,86
HCPCS,G9054,Onc supervision palliative,,,10.69,2739849.3,9
HCPCS,G9055,ONC VISIT UNSPECIFIED NOS,24.0,15.6,0.01,3060831.65,86
HCPCS,G9055,Onc visit unspecified nos,,,10.69,2739849.3,9
HCPCS,G9056,ONC PRAC MGMT ADHERES GUIDE,24.0,15.6,0.01,3060831.65,86
HCPCS,G9056,Onc prac mgmt adheres guide,,,10.69,2739849.3,9
HCPCS,G9057,ONC PRACT MGMT DIFFERS TRIAL,24.0,15.6,0.01,3060831.65,86
HCPCS,G9057,Onc pract mgmt differs trial,,,10.69,2739849.3,9
HCPCS,G9058,ONC PRAC MGMT DISAGREE W/GUI,24.0,15.6,0.01,3060831.65,86
HCPCS,G9058,Onc prac mgmt disagree w/gui,,,10.69,2739849.3,9
HCPCS,G9059,ONC PRAC MGMT PT OPT ALTERNA,24.0,15.6,0.01,3060831.65,86
HCPCS,G9059,Onc prac mgmt pt opt alterna,,,10.69,2739849.3,9
HCPCS,G9060,ONC PRAC MGMT DIF PT COMORB,24.0,15.6,0.01,3060831.65,86
HCPCS,G9060,Onc prac mgmt dif pt comorb,,,10.69,2739849.3,9
HCPCS,G9061,ONC PRAC COND NOADD BY GUIDE,24.0,15.6,0.01,3060831.65,86
HCPCS,G9061,Onc prac cond noadd by guide,,,10.69,2739849.3,9
HCPCS,G9062,ONC PRAC GUIDE DIFFERS NOS,24.0,15.6,0.01,3060831.65,86
HCPCS,G9062,Onc prac guide differs nos,,,10.69,2739849.3,9
HCPCS,G9063,ONC DX NSCLC STGI NO PROGRES,24.0,15.6,0.01,3060831.65,86
HCPCS,G9063,Onc dx nsclc stgi no progres,,,10.69,2739849.3,9
HCPCS,G9064,ONC DX NSCLC STG2 NO PROGRES,24.0,15.6,0.01,3060831.65,86
HCPCS,G9064,Onc dx nsclc stg2 no progres,,,10.69,2739849.3,9
HCPCS,G9065,ONC DX NSCLC STG3A NO PROGRE,24.0,15.6,0.01,3060831.65,86
HCPCS,G9065,Onc dx nsclc stg3a no progre,,,10.69,2739849.3,9
HCPCS,G9066,ONC DX NSCLC STG3B-4 METASTA,24.0,15.6,0.01,3060831.65,86
HCPCS,G9066,Onc dx nsclc stg3b-4 metasta,,,10.69,2739849.3,9
HCPCS,G9067,ONC DX NSCLC DX UNKNOWN NOS,24.0,15.6,0.01,3060831.65,86
HCPCS,G9067,Onc dx nsclc dx unknown nos,,,10.69,2739849.3,9
HCPCS,G9068,ONC DX SCLC/NSCLC LIMITED,24.0,15.6,0.01,3060831.65,86
HCPCS,G9068,Onc dx sclc/nsclc limited,,,10.69,2739849.3,9
HCPCS,G9069,ONC DX SCLC/NSCLC EXT AT DX,24.0,15.6,0.01,3060831.65,86
HCPCS,G9069,Onc dx sclc/nsclc ext at dx,,,10.69,2739849.3,9
HCPCS,G9070,ONC DX SCLC/NSCLC EXT UNKNWN,24.0,15.6,0.01,3060831.65,86
HCPCS,G9070,Onc dx sclc/nsclc ext unknwn,,,10.69,2739849.3,9
HCPCS,G9071,"ONC DX BRST STG1-2B HR,NOPRO",24.0,15.6,0.01,3060831.65,86
HCPCS,G9071,"Onc dx brst stg1-2b hr,nopro",,,10.69,2739849.3,9
HCPCS,G9072,ONC DX BRST STG1-2 NOPROGRES,24.0,15.6,0.01,3060831.65,86
HCPCS,G9072,Onc dx brst stg1-2 noprogres,,,10.69,2739849.3,9
HCPCS,G9073,"ONC DX BRST STG3-HR, NO PRO",24.0,15.6,0.01,3060831.65,86
HCPCS,G9073,"Onc dx brst stg3-hr, no pro",,,10.69,2739849.3,9
HCPCS,G9074,ONC DX BRST STG3-NOPROGRESS,24.0,15.6,0.01,3060831.65,86
HCPCS,G9074,Onc dx brst stg3-noprogress,,,10.69,2739849.3,9
HCPCS,G9075,ONC DX BRST METASTIC/ RECUR,24.0,15.6,0.01,3060831.65,86
HCPCS,G9075,Onc dx brst metastic/ recur,,,10.69,2739849.3,9
HCPCS,G9077,ONC DX PROSTATE T1NO PROGRES,24.0,15.6,0.01,3060831.65,86
HCPCS,G9077,Onc dx prostate t1no progres,,,10.69,2739849.3,9
HCPCS,G9078,ONC DX PROSTATE T2NO PROGRES,24.0,15.6,0.01,3060831.65,86
HCPCS,G9078,Onc dx prostate t2no progres,,,10.69,2739849.3,9
HCPCS,G9079,ONC DX PROSTATE T3B-T4NOPROG,24.0,15.6,0.01,3060831.65,86
HCPCS,G9079,Onc dx prostate t3b-t4noprog,,,10.69,2739849.3,9
HCPCS,G9080,ONC DX PROSTATE W/RISE PSA,24.0,15.6,0.01,3060831.65,86
HCPCS,G9080,Onc dx prostate w/rise psa,,,10.69,2739849.3,9
HCPCS,G9083,ONC DX PROSTATE UNKNOWN NOS,24.0,15.6,0.01,3060831.65,86
HCPCS,G9083,Onc dx prostate unknwn nos,,,10.69,2739849.3,9
HCPCS,G9084,"ONC DX COLON T1-3,N1-2,NO PR",24.0,15.6,0.01,3060831.65,86
HCPCS,G9084,"Onc dx colon t1-3,n1-2,no pr",,,10.69,2739849.3,9
HCPCS,G9085,"ONC DX COLON T4, N0 W/O PROG",24.0,15.6,0.01,3060831.65,86
HCPCS,G9085,"Onc dx colon t4, n0 w/o prog",,,10.69,2739849.3,9
HCPCS,G9086,ONC DX COLON T1-4 NO DX PROG,24.0,15.6,0.01,3060831.65,86
HCPCS,G9086,Onc dx colon t1-4 no dx prog,,,10.69,2739849.3,9
HCPCS,G9087,ONC DX COLON METAS EVID DX,24.0,15.6,0.01,3060831.65,86
HCPCS,G9087,Onc dx colon metas evid dx,,,10.69,2739849.3,9
HCPCS,G9088,ONC DX COLON METAS NOEVID DX,24.0,15.6,0.01,3060831.65,86
HCPCS,G9088,Onc dx colon metas noevid dx,,,10.69,2739849.3,9
HCPCS,G9089,ONC DX COLON EXTENT UNKNOWN,24.0,15.6,0.01,3060831.65,86
HCPCS,G9089,Onc dx colon extent unknown,,,10.69,2739849.3,9
HCPCS,G9090,ONC DX RECTAL T1-2 NO PROGR,24.0,15.6,0.01,3060831.65,86
HCPCS,G9090,Onc dx rectal t1-2 no progr,,,10.69,2739849.3,9
HCPCS,G9091,ONC DX RECTAL T3 N0 NO PROG,24.0,15.6,0.01,3060831.65,86
HCPCS,G9091,Onc dx rectal t3 n0 no prog,,,10.69,2739849.3,9
HCPCS,G9092,"ONC DX RECTAL T1-3,N1-2NOPRG",24.0,15.6,0.01,3060831.65,86
HCPCS,G9092,"Onc dx rectal t1-3,n1-2noprg",,,10.69,2739849.3,9
HCPCS,G9093,"ONC DX RECTAL T4,N,M0 NO PRG",24.0,15.6,0.01,3060831.65,86
HCPCS,G9093,"Onc dx rectal t4,n,m0 no prg",,,10.69,2739849.3,9
HCPCS,G9094,ONC DX RECTAL M1 W/METS PROG,24.0,15.6,0.01,3060831.65,86
HCPCS,G9094,Onc dx rectal m1 w/mets prog,,,10.69,2739849.3,9
HCPCS,G9095,ONC DX RECTAL EXTENT UNKNWN,24.0,15.6,0.01,3060831.65,86
HCPCS,G9095,Onc dx rectal extent unknwn,,,10.69,2739849.3,9
HCPCS,G9096,ONC DX ESOPHAG T1-T3 NOPROG,24.0,15.6,0.01,3060831.65,86
HCPCS,G9096,Onc dx esophag t1-t3 noprog,,,10.69,2739849.3,9
HCPCS,G9097,ONC DX ESOPHAGEAL T4 NO PROG,24.0,15.6,0.01,3060831.65,86
HCPCS,G9097,Onc dx esophageal t4 no prog,,,10.69,2739849.3,9
HCPCS,G9098,ONC DX ESOPHAGEAL METS RECUR,24.0,15.6,0.01,3060831.65,86
HCPCS,G9098,Onc dx esophageal mets recur,,,10.69,2739849.3,9
HCPCS,G9099,ONC DX ESOPHAGEAL UNKNOWN,24.0,15.6,0.01,3060831.65,86
HCPCS,G9099,Onc dx esophageal unknown,,,10.69,2739849.3,9
HCPCS,G9100,ONC DX GASTRIC NO RECURRENCE,24.0,15.6,0.01,3060831.65,86
HCPCS,G9100,Onc dx gastric no recurrence,,,10.69,2739849.3,9
HCPCS,G9101,ONC DX GASTRIC P R1-R2NOPROG,24.0,15.6,0.01,3060831.65,86
HCPCS,G9101,Onc dx gastric p r1-r2noprog,,,10.69,2739849.3,9
HCPCS,G9102,ONC DX GASTRIC UNRESECTABLE,24.0,15.6,0.01,3060831.65,86
HCPCS,G9102,Onc dx gastric unresectable,,,10.69,2739849.3,9
HCPCS,G9103,ONC DX GASTRIC RECURRENT,24.0,15.6,0.01,3060831.65,86
HCPCS,G9103,Onc dx gastric recurrent,,,10.69,2739849.3,9
HCPCS,G9104,ONC DX GASTRIC UNKNOWN NOS,24.0,15.6,0.01,3060831.65,86
HCPCS,G9104,Onc dx gastric unknown nos,,,10.69,2739849.3,9
HCPCS,G9105,ONC DX PANCREATC P R0 RES NO,24.0,15.6,0.01,3060831.65,86
HCPCS,G9105,Onc dx pancreatc p r0 res no,,,10.69,2739849.3,9
HCPCS,G9106,ONC DX PANCREATC P R1/R2 NO,24.0,15.6,0.01,3060831.65,86
HCPCS,G9106,Onc dx pancreatc p r1/r2 no,,,10.69,2739849.3,9
HCPCS,G9107,ONC DX PANCREATIC UNRESECTAB,24.0,15.6,0.01,3060831.65,86
HCPCS,G9107,Onc dx pancreatic unresectab,,,10.69,2739849.3,9
HCPCS,G9108,ONC DX PANCREATIC UNKNWN NOS,24.0,15.6,0.01,3060831.65,86
HCPCS,G9108,Onc dx pancreatic unknwn nos,,,10.69,2739849.3,9
HCPCS,G9109,ONC DX HEAD/NECK T1-T2NO PRG,24.0,15.6,0.01,3060831.65,86
HCPCS,G9109,Onc dx head/neck t1-t2no prg,,,10.69,2739849.3,9
HCPCS,G9110,ONC DX HEAD/NECK T3-4 NOPROG,24.0,15.6,0.01,3060831.65,86
HCPCS,G9110,Onc dx head/neck t3-4 noprog,,,10.69,2739849.3,9
HCPCS,G9111,ONC DX HEAD/NECK M1 METS REC,24.0,15.6,0.01,3060831.65,86
HCPCS,G9111,Onc dx head/neck m1 mets rec,,,10.69,2739849.3,9
HCPCS,G9112,ONC DX HEAD/NECK EXT UNKNOWN,24.0,15.6,0.01,3060831.65,86
HCPCS,G9112,Onc dx head/neck ext unknown,,,10.69,2739849.3,9
HCPCS,G9113,ONC DX OVARIAN STG1A-B NO PR,24.0,15.6,0.01,3060831.65,86
HCPCS,G9113,Onc dx ovarian stg1a-b no pr,,,10.69,2739849.3,9
HCPCS,G9114,ONC DX OVARIAN STG1A-B OR 2,24.0,15.6,0.01,3060831.65,86
HCPCS,G9114,Onc dx ovarian stg1a-b or 2,,,10.69,2739849.3,9
HCPCS,G9115,ONC DX OVARIAN STG3/4 NOPROG,24.0,15.6,0.01,3060831.65,86
HCPCS,G9115,Onc dx ovarian stg3/4 noprog,,,10.69,2739849.3,9
HCPCS,G9116,ONC DX OVARIAN RECURRENCE,24.0,15.6,0.01,3060831.65,86
HCPCS,G9116,Onc dx ovarian recurrence,,,10.69,2739849.3,9
HCPCS,G9117,ONC DX OVARIAN UNKNOWN NOS,24.0,15.6,0.01,3060831.65,86
HCPCS,G9117,Onc dx ovarian unknown nos,,,10.69,2739849.3,9
HCPCS,G9123,ONC DX CML CHRONIC PHASE,24.0,15.6,0.01,3060831.65,86
HCPCS,G9123,Onc dx cml chronic phase,,,10.69,2739849.3,9
HCPCS,G9124,ONC DX CML ACCELER PHASE,24.0,15.6,0.01,3060831.65,86
HCPCS,G9124,Onc dx cml acceler phase,,,10.69,2739849.3,9
HCPCS,G9125,ONC DX CML BLAST PHASE,24.0,15.6,0.01,3060831.65,86
HCPCS,G9125,Onc dx cml blast phase,,,10.69,2739849.3,9
HCPCS,G9126,ONC DX CML REMISSION,24.0,15.6,0.01,3060831.65,86
HCPCS,G9126,Onc dx cml remission,,,10.69,2739849.3,9
HCPCS,G9128,ONC DX MULTI MYELOMA STAGE I,24.0,15.6,0.01,3060831.65,86
HCPCS,G9128,Onc dx multi myeloma stage i,,,10.69,2739849.3,9
HCPCS,G9129,ONC DX MULT MYELOMA STG2 HIG,24.0,15.6,0.01,3060831.65,86
HCPCS,G9129,Onc dx mult myeloma stg2 hig,,,10.69,2739849.3,9
HCPCS,G9130,ONC DX MULTI MYELOMA UNKNOWN,24.0,15.6,0.01,3060831.65,86
HCPCS,G9130,Onc dx multi myeloma unknown,,,10.69,2739849.3,9
HCPCS,G9131,Onc dx brst unknown nos,,,10.69,2739849.3,9
HCPCS,G9132,Onc dx prostate mets no cast,,,10.69,2739849.3,9
HCPCS,G9133,Onc dx prostate clinical met,,,10.69,2739849.3,9
HCPCS,G9134,Onc nhlstg 1-2 no relap no,,,10.69,2739849.3,9
HCPCS,G9135,Onc dx nhl stg 3-4 not relap,,,10.69,2739849.3,9
HCPCS,G9136,Onc dx nhl trans to lg bcell,,,10.69,2739849.3,9
HCPCS,G9137,Onc dx nhl relapse/refractor,,,10.69,2739849.3,9
HCPCS,G9138,Onc dx nhl stg unknown,,,10.69,2739849.3,9
HCPCS,G9139,Onc dx cml dx status unknown,,,10.69,2739849.3,9
HCPCS,G9140,Frontier extended stay demo,,,63.76,2739849.3,9
HCPCS,G9143,Warfarin respon genetic test,,,83.94,445.31,14
HCPCS,G9147,Outpt iv insulin tx any mea,,,391.01,2739849.3,9
HCPCS,G9148,Medical home level 1,,,10.69,2739849.3,9
HCPCS,G9149,Medical home level ii,,,10.69,2739849.3,9
HCPCS,G9150,Medical home level iii,,,10.69,2739849.3,9
HCPCS,G9151,Mapcp demo state,,,10.69,2739849.3,9
HCPCS,G9152,Mapcp demo community,,,10.69,2739849.3,9
HCPCS,G9153,Mapcp demo physician,,,10.69,2739849.3,9
HCPCS,G9156,Evaluation for wheelchair,,,63.76,2739849.3,9
HCPCS,G9157,Transesoph doppl cardiac mon,,,246.76,409.15,9
HCPCS,G9187,Bpci home visit,,,21.85,118.64,9
HCPCS,G9188,Beta not given no reason,,,10.69,2739849.3,9
HCPCS,G9189,Beta pres or already taking,,,10.69,2739849.3,9
HCPCS,G9190,Medical reason for no beta,,,10.69,2739849.3,9
HCPCS,G9191,Pt reason for no beta,,,10.69,2739849.3,9
HCPCS,G9192,System reason for no beta,,,10.69,12.38,8
HCPCS,G9196,Med reason for no ceph,,,10.69,12.38,8
HCPCS,G9197,Order for ceph,,,10.69,12.38,8
HCPCS,G9198,No order for ceph no reason,,,10.69,12.38,8
HCPCS,G9212,Doc of dsm-iv init eval,,,10.69,2739849.3,9
HCPCS,G9213,No doc of dsm-iv,,,10.69,2739849.3,9
HCPCS,G9223,Pjp proph ordered cd4 low,,,10.69,2739849.3,9
HCPCS,G9225,Norsn no foot exam,,,0.03,12.38,9
HCPCS,G9226,3 comp foot exam completed,,,0.03,12.38,9
HCPCS,G9227,"Foa doc, care plan not doc",,,10.69,2739849.3,9
HCPCS,G9228,Gc chl syp documented,,,10.69,2739849.3,9
HCPCS,G9229,Ptrsn no gc chl syp test,,,10.69,12.38,8
HCPCS,G9230,Norsn for gc chl syp test,,,10.69,2739849.3,9
HCPCS,G9231,Doc esrd dia trans preg,,,10.69,2739849.3,9
HCPCS,G9232,Ptrsn no comm comorbid,,,10.69,12.38,8
HCPCS,G9239,Doc rsn hemod & cath acc,,,10.69,12.38,8
HCPCS,G9240,Doc pt w cath maint dia,,,10.69,12.38,8
HCPCS,G9241,Doc pt w out cath maint dia,,,10.69,12.38,8
HCPCS,G9242,Doc viral load >=200,,,10.69,2739849.3,9
HCPCS,G9243,Doc viral load <200,,,10.69,2739849.3,9
HCPCS,G9246,No enc or enc/vir ld 90days,,,10.69,2739849.3,9
HCPCS,G9247,2 enc enc/vir ld 90d,,,10.69,2739849.3,9
HCPCS,G9250,Doc of pain comfort 48hr,,,10.69,12.38,8
HCPCS,G9251,Doc no pain comfort 48hr,,,10.69,12.38,8
HCPCS,G9254,Doc pt dischg >2d,,,10.69,2739849.3,9
HCPCS,G9255,Pt dc home 2nd po day,,,10.69,2739849.3,9
HCPCS,G9256,Doc of pat death after cas,,,10.69,12.38,8
HCPCS,G9257,Doc of pat stroke after cas,,,10.69,12.38,8
HCPCS,G9258,Doc of pat stroke after cea,,,10.69,12.38,8
HCPCS,G9259,Survive/no stroke post cas,,,10.69,12.38,8
HCPCS,G9260,Doc of pat death after cea,,,10.69,12.38,8
HCPCS,G9261,Survive/no stroke post cea,,,10.69,12.38,8
HCPCS,G9262,Doc of death post-aaa repair,,,10.69,12.38,8
HCPCS,G9263,Doc of disch post-aaa repair,,,10.69,12.38,8
HCPCS,G9264,Doc rsn hemod w/cath >=90d,,,10.69,12.38,8
HCPCS,G9265,Doc cath >90d for maint dia,,,10.69,12.38,8
HCPCS,G9266,Norsn pt cath >=90d,,,10.69,12.38,8
HCPCS,G9267,Doc comp or mort w in 30d,,,10.69,12.38,8
HCPCS,G9268,Doc comp or mort w in 90d,,,10.69,12.38,8
HCPCS,G9269,Doc no comp or mort w in 30d,,,10.69,12.38,8
HCPCS,G9270,Doc no comp or mort w in 90d,,,10.69,12.38,8
HCPCS,G9273,Sys<140 and dia<90,,,10.69,2739849.3,9
HCPCS,G9274,Bp out of nrml limits,,,10.69,2739849.3,9
HCPCS,G9275,Doc of non tobacco user,,,10.69,2739849.3,9
HCPCS,G9276,Doc of tobacco user,,,10.69,2739849.3,9
HCPCS,G9277,Doc daily aspirin or contra,,,10.69,2739849.3,9
HCPCS,G9278,Doc no daily aspirin,,,10.69,2739849.3,9
HCPCS,G9279,Pne scrn done doc vac done,,,10.69,2739849.3,9
HCPCS,G9280,Pne not given norsn,,,10.69,2739849.3,9
HCPCS,G9281,Pne scrn done doc not ind,,,10.69,2739849.3,9
HCPCS,G9282,Doc medrsn no histo type,,,10.69,2739849.3,9
HCPCS,G9283,Hist type doc on report,,,10.69,2739849.3,9
HCPCS,G9284,No hist type doc on report,,,10.69,2739849.3,9
HCPCS,G9285,Site not small cell lung ca,,,10.69,2739849.3,9
HCPCS,G9286,Antibio rx w in 10d of sympt,,,10.69,2739849.3,9
HCPCS,G9287,No antibio w in 10d of sympt,,,10.69,2739849.3,9
HCPCS,G9288,Doc medrsn no hist type rpt,,,10.69,2739849.3,9
HCPCS,G9289,Doc type nsm lung ca,,,10.69,2739849.3,9
HCPCS,G9290,No doc type nsm lung ca,,,10.69,2739849.3,9
HCPCS,G9291,Not nsm lung ca,,,10.69,2739849.3,9
HCPCS,G9292,Medrsn no pt category,,,10.69,2739849.3,9
HCPCS,G9293,No pt category on report,,,10.69,2739849.3,9
HCPCS,G9294,Pt cat and thck on report,,,10.69,2739849.3,9
HCPCS,G9295,Non cutaneous loc,,,10.69,2739849.3,9
HCPCS,G9296,Doc share dec prior proc,,,10.69,2739849.3,9
HCPCS,G9297,No doc share dec prior proc,,,10.69,2739849.3,9
HCPCS,G9298,Eval risk vte card 30d prior,,,10.69,2739849.3,9
HCPCS,G9299,No eval risk vte card prior,,,10.69,2739849.3,9
HCPCS,G9300,Doc medrsn no compl antibio,,,10.69,12.38,8
HCPCS,G9301,Doc compl inf antibio,,,10.69,12.38,8
HCPCS,G9302,Norsn incomp inf antibio,,,10.69,12.38,8
HCPCS,G9303,Norsn no pros info op rpt,,,10.69,12.38,8
HCPCS,G9304,Pros info op rpt,,,10.69,12.38,8
HCPCS,G9305,No interv req for leak,,,10.69,2739849.3,9
HCPCS,G9306,Interv req for leak,,,10.69,2739849.3,9
HCPCS,G9307,No ret for surg w in 30d,,,10.69,2739849.3,9
HCPCS,G9308,Unpl ret or w/compl w/in 30d,,,10.69,2739849.3,9
HCPCS,G9309,No unplnd hosp readm in 30d,,,10.69,2739849.3,9
HCPCS,G9310,Unplnd hosp readm in 30d,,,10.69,2739849.3,9
HCPCS,G9311,No surg site infection,,,10.69,2739849.3,9
HCPCS,G9312,Surgical site infection,,,10.69,2739849.3,9
HCPCS,G9313,Amoxic not presc as 1st line,,,10.69,2739849.3,9
HCPCS,G9314,Norsn not first line amox,,,10.69,2739849.3,9
HCPCS,G9315,Amox w/wo clav rx,,,10.69,2739849.3,9
HCPCS,G9316,Doc comm risk calc,,,10.69,2739849.3,9
HCPCS,G9317,No doc comm risk calc,,,10.69,2739849.3,9
HCPCS,G9318,Image std nomenclature,,,10.69,2739849.3,9
HCPCS,G9319,Image not std nomenclature,,,10.69,2739849.3,9
HCPCS,G9321,Prev ct nuc med cnt doc 12mo,,,10.69,2739849.3,9
HCPCS,G9322,No cnt ct nuc med doc 12mo,,,10.69,2739849.3,9
HCPCS,G9326,"Ct done no rad ds index, nrg",,,10.69,12.38,8
HCPCS,G9327,Ct done rad ds index,,,10.69,12.38,8
HCPCS,G9329,Norsn no dicom format doc,,,10.69,12.38,8
HCPCS,G9340,Dicom format doc on rpt,,,10.69,12.38,8
HCPCS,G9341,Srch for ct w in 12 mos,,,10.69,2739849.3,9
HCPCS,G9342,No srch for ct in 12mo norsn,,,10.69,2739849.3,9
HCPCS,G9344,Sysrsn no dicom srch,,,10.69,2739849.3,9
HCPCS,G9345,Follow up pulm nod,,,10.69,2739849.3,9
HCPCS,G9347,No follow up pulm nod norsn,,,10.69,2739849.3,9
HCPCS,G9348,Doc rsn for ord ct scan,,,10.69,12.38,8
HCPCS,G9349,Ct within 28 days,,,10.69,12.38,8
HCPCS,G9350,No doc sinus ct 28d or dx,,,10.69,12.38,8
HCPCS,G9351,Doc >1 sinus ct w 90d dx,,,10.69,2739849.3,9
HCPCS,G9352,Not >1 sinus ct w 90d dx,,,10.69,2739849.3,9
HCPCS,G9353,Medrsn >1 sinus ct w 90d dx,,,10.69,2739849.3,9
HCPCS,G9354,1 or no ct sinus w/in 90d dx,,,10.69,2739849.3,9
HCPCS,G9355,No early ind/delivery,,,10.69,2739849.3,9
HCPCS,G9356,Early ind/delivery,,,10.69,2739849.3,9
HCPCS,G9357,Pp eval/edu perf,,,10.69,2739849.3,9
HCPCS,G9358,Pp eval/edu not perf,,,10.69,2739849.3,9
HCPCS,G9359,Neg mgd pos tb notact,,,10.69,12.38,8
HCPCS,G9360,No doc of neg or man pos tb,,,10.69,12.38,8
HCPCS,G9361,Doc rsn elect c-sec/induct,,,10.69,2739849.3,9
HCPCS,G9364,Sinus caus bac inx,,,10.69,2739849.3,9
HCPCS,G9365,1high risk med ord,,,10.69,12.38,8
HCPCS,G9366,1high risk no ord,,,10.69,12.38,8
HCPCS,G9367,>= 2 same hi-rsk med ord,,,10.69,2739849.3,9
HCPCS,G9368,>= 2 same hi-rsk med not ord,,,10.69,2739849.3,9
HCPCS,G9380,Off assis eol iss,,,10.69,2739849.3,9
HCPCS,G9382,No off assis eol,,,10.69,2739849.3,9
HCPCS,G9383,Recd scrn hcv infec,,,10.69,2739849.3,9
HCPCS,G9384,Doc med rsn no hcv scrn,,,10.69,2739849.3,9
HCPCS,G9385,Doc pt reas not rec hcv srn,,,10.69,2739849.3,9
HCPCS,G9386,Scrn hcv infec not recd,,,10.69,2739849.3,9
HCPCS,G9389,Unpln rup post cap,,,10.69,12.38,8
HCPCS,G9390,No unpln rup post cap,,,10.69,12.38,8
HCPCS,G9393,Ini phq9 >9 remiss <5,,,10.69,2739849.3,9
HCPCS,G9394,"Dx bipol, death, nhres, hosp",,,10.69,2739849.3,9
HCPCS,G9395,Ini phq9 >9 no remiss >=5,,,10.69,2739849.3,9
HCPCS,G9396,Ini phq9 >9 not assess,,,10.69,2739849.3,9
HCPCS,G9399,Doc disc tx choices,,,10.69,12.38,8
HCPCS,G9400,Doc reas no disc tx opt,,,10.69,12.38,8
HCPCS,G9401,No disc tx choices,,,10.69,12.38,8
HCPCS,G9402,Recd f/u w/in 30d disch,,,10.69,2739849.3,9
HCPCS,G9403,Doc reas no 30 day f/u,,,10.69,2739849.3,9
HCPCS,G9404,No 30 day f/u,,,10.69,2739849.3,9
HCPCS,G9405,Recd f/u w/in 7d dc,,,10.69,2739849.3,9
HCPCS,G9406,Doc reas no 7d f/u,,,10.69,2739849.3,9
HCPCS,G9407,No 7d f/u,,,10.69,2739849.3,9
HCPCS,G9408,Card tamp w/in 30d,,,10.69,2739849.3,9
HCPCS,G9409,No card tamp e/in 30d,,,10.69,2739849.3,9
HCPCS,G9410,Admit w/in 180d req remov,,,10.69,2739849.3,9
HCPCS,G9411,No admit w/in 180d req remov,,,10.69,2739849.3,9
HCPCS,G9412,Admit w/in 180d req surg rev,,,10.69,2739849.3,9
HCPCS,G9413,No admit req surg rev,,,10.69,2739849.3,9
HCPCS,G9414,1dose menig vac btwn 10 & 13,,,10.69,2739849.3,9
HCPCS,G9415,No 1dose meni vac btwn 10&13,,,10.69,2739849.3,9
HCPCS,G9416,Pt 1 tdap betw 10-13 yrs,,,10.69,2739849.3,9
HCPCS,G9417,Pt not 1 tdap betw 10-13 yrs,,,10.69,2739849.3,9
HCPCS,G9418,Lungcx bx rpt docs class,,,0.03,12.38,9
HCPCS,G9419,Med reas not incl histo type,,,10.69,2739849.3,9
HCPCS,G9420,Spec site no lung,,,10.69,2739849.3,9
HCPCS,G9421,Lung cx bx rpt no doc class,,,10.69,2739849.3,9
HCPCS,G9422,Rpt doc class histo type,,,10.69,2739849.3,9
HCPCS,G9423,Med reas rpt no histo type,,,10.69,2739849.3,9
HCPCS,G9424,Site no lung or lung cx,,,10.69,2739849.3,9
HCPCS,G9425,Spec rpt no doc class histo,,,10.69,2739849.3,9
HCPCS,G9426,Impr med time edarr pain med,,,10.69,2739849.3,9
HCPCS,G9427,No impro med time pain med,,,10.69,2739849.3,9
HCPCS,G9428,Patho rpt incl pt ctg,,,10.69,2739849.3,9
HCPCS,G9429,Doc med rsn no pt cat,,,10.69,2739849.3,9
HCPCS,G9430,Spec site no cutaneous,,,10.69,2739849.3,9
HCPCS,G9431,Patho rpt no pt ctg,,,10.69,2739849.3,9
HCPCS,G9432,Asth controlled,,,10.69,2739849.3,9
HCPCS,G9434,Asth not controlled,,,10.69,2739849.3,9
HCPCS,G9448,Born 1945-1965,,,10.69,12.38,8
HCPCS,G9449,Hx bld transf b/f 1992,,,10.69,12.38,8
HCPCS,G9450,Hx injec drug use,,,10.69,12.38,8
HCPCS,G9451,1x scrn hcv infect,,,10.69,12.38,8
HCPCS,G9452,Doc med reas no hcv test,,,10.69,2739849.3,9
HCPCS,G9453,Pt reas no hcv infect,,,10.69,12.38,8
HCPCS,G9454,No scr hcv inf 12 mth rp,,,10.69,12.38,8
HCPCS,G9455,"Abd imag w/us, ct or mri",,,10.69,2739849.3,9
HCPCS,G9456,Doc med pt reas no hcc scrn,,,10.69,2739849.3,9
HCPCS,G9457,Pt no abd img no doc rsn,,,10.69,2739849.3,9
HCPCS,G9458,Tob user recd cess interv,,,10.69,2739849.3,9
HCPCS,G9459,Tob non-user,,,0.03,12.38,9
HCPCS,G9460,No tob assess or cess inter,,,10.69,2739849.3,9
HCPCS,G9468,No recd cortico>=10mg/d >60d,,,10.69,2739849.3,9
HCPCS,G9469,Rec cortico>90d or 1rx 900mg,,,10.69,12.38,8
HCPCS,G9470,No rec cortico>60d 1rx 600mg,,,10.69,2739849.3,9
HCPCS,G9471,W/in 2yr dxa not order,,,10.69,2739849.3,9
HCPCS,G9473,Chap services at hospice,,,63.76,2739849.3,9
HCPCS,G9474,Diet counsel at hospice,,,63.76,2739849.3,9
HCPCS,G9475,Other counselor at hospice,,,63.76,2739849.3,9
HCPCS,G9476,Volun service at hospice,,,63.76,2739849.3,9
HCPCS,G9477,Care coord at hospice,,,21.85,2739849.3,9
HCPCS,G9478,Othe therapist at hospice,,,63.76,2739849.3,9
HCPCS,G9479,Pharmacist at hospice,,,63.76,2739849.3,9
HCPCS,G9480,Admission to mccm,,,10.69,2739849.3,9
HCPCS,G9481,Remote e/m new pt 10mins,,,48.64,48.64,1
HCPCS,G9482,Remote e/m new pt 20mins,,,90.86,90.86,1
HCPCS,G9483,Remote e/m new pt 30mins,,,142.23,142.23,1
HCPCS,G9484,Remote e/m new pt 45mins,,,240.27,240.27,1
HCPCS,G9485,Remote e/m new pt 60mins,,,314.99,314.99,1
HCPCS,G9486,Remote e/m est. pt 10mins,,,48.64,48.64,1
HCPCS,G9487,Remote e/m est. pt 15mins,,,96.28,96.28,1
HCPCS,G9488,Remote e/m est. pt 25mins,,,147.55,147.55,1
HCPCS,G9489,Remote e/m est. pt 40mins,,,209.69,209.69,1
HCPCS,G9490,Cmmi mod home visit,,,118.64,118.64,1
HCPCS,G9497,Rec inst no smoke day surg,,,10.69,2739849.3,9
HCPCS,G9498,Abx reg prescribed,,,10.69,2739849.3,9
HCPCS,G9500,Rad expos ind/exp tm doc,,,0.03,12.38,9
HCPCS,G9501,Rad expos ind/exp tm no doc,,,10.69,2739849.3,9
HCPCS,G9502,Med reas no perf foot exam,,,10.69,2739849.3,9
HCPCS,G9503,Pt tk tams hcl,,,10.69,12.38,8
HCPCS,G9504,Doc rsn hep b stat not asses,,,10.69,2739849.3,9
HCPCS,G9505,Abx pres w/in 10 dys of symp,,,10.69,2739849.3,9
HCPCS,G9506,Bio imm resp mod presc,,,10.69,12.38,8
HCPCS,G9507,Doc reas on statin or contra,,,10.69,2739849.3,9
HCPCS,G9508,Doc pt not on statin,,,10.69,2739849.3,9
HCPCS,G9509,Adit mdd dys rem 12 mnths,,,10.69,2739849.3,9
HCPCS,G9510,Remis12m not phq-9 score <5,,,10.69,2739849.3,9
HCPCS,G9511,Idx evt dte phq>9 doc 12 mo,,,10.69,12.38,9
HCPCS,G9512,Indiv pdc > 0.8,,,10.69,2739849.3,9
HCPCS,G9513,Indiv pdc not > 0.8,,,10.69,2739849.3,9
HCPCS,G9514,Req ret or w/in 90d of surg,,,10.69,2739849.3,9
HCPCS,G9515,"No reas, no ret or w/in 90d",,,10.69,2739849.3,9
HCPCS,G9516,Impr vis acuit w/in 90d,,,10.69,2739849.3,9
HCPCS,G9517,No impr vis acuit w/in 90d,,,10.69,2739849.3,9
HCPCS,G9518,Doc active inj drug use,,,10.69,2739849.3,9
HCPCS,G9519,Final ref +/- 1.0 w/in 90d,,,10.69,2739849.3,9
HCPCS,G9520,Refract not +/- 1.0 w/in 90d,,,10.69,2739849.3,9
HCPCS,G9521,Er and ip hosp <2 in 12 mos,,,10.69,2739849.3,9
HCPCS,G9522,Er/ip hosp =/>2 in 12 mos,,,10.69,2739849.3,9
HCPCS,G9523,D/c hemo or perit dialysis,,,10.69,12.38,8
HCPCS,G9524,Refer to hospice,,,10.69,12.38,8
HCPCS,G9525,Doc pt reas no hospice refer,,,10.69,12.38,8
HCPCS,G9526,"No reason, no refer hospice",,,10.69,12.38,8
HCPCS,G9529,Minor blunt trauma w/head ct,,,0.03,12.38,9
HCPCS,G9530,Pt mbht hd ct ord ec prov,,,0.03,12.38,9
HCPCS,G9531,Pt doc,,,10.69,2739849.3,9
HCPCS,G9532,Pt hd ct ord,,,10.69,12.38,8
HCPCS,G9533,Indic for head ct not valid,,,10.69,2739849.3,9
HCPCS,G9537,Img hd clin trial,,,10.69,2739849.3,9
HCPCS,G9539,Intent pot remv time placemt,,,10.69,2739849.3,9
HCPCS,G9540,Pt alive 3 mos post proc,,,10.69,2739849.3,9
HCPCS,G9541,Filter rem 3 mon plmt,,,10.69,2739849.3,9
HCPCS,G9542,Doc reass appr remo filt 3ms,,,10.69,2739849.3,9
HCPCS,G9543,Doc 2x re-assess filt remov,,,10.69,2739849.3,9
HCPCS,G9544,No filt remov w/in 3mos plcm,,,10.69,2739849.3,9
HCPCS,G9547,Cys ren les or adren,,,0.03,12.38,9
HCPCS,G9548,No f/u rec image study,,,10.69,2739849.3,9
HCPCS,G9549,Doc med rsn for f/u imag,,,10.69,2739849.3,9
HCPCS,G9550,Imag rec,,,0.03,12.38,9
HCPCS,G9551,Imag no les,,,0.03,12.38,9
HCPCS,G9552,Inc thyr node <1.0 in rpt,,,0.03,12.38,9
HCPCS,G9553,Prior thyroid dise dx,,,10.69,2739849.3,9
HCPCS,G9554,Ct/cta/mri/a chst foll rec,,,0.03,12.38,9
HCPCS,G9555,Doc med rsn for follup image,,,10.69,2739849.3,9
HCPCS,G9556,Ct/cta/mri/a no follup imag,,,10.69,2739849.3,9
HCPCS,G9557,Ct/cta/mri/a no thyr <1.0cm,,,0.03,12.38,9
HCPCS,G9558,Tx beta-lactam abx therapy,,,10.69,12.38,8
HCPCS,G9559,Doc med reas no abx therapy,,,10.69,12.38,8
HCPCS,G9560,"No beta-lactam abx ther, rng",,,10.69,12.38,8
HCPCS,G9561,Presc opiates >6 wks,,,10.69,12.38,8
HCPCS,G9562,Foll-up eval q3mo opiod tx,,,10.69,12.38,8
HCPCS,G9563,No f/u eval q3mo opiod tx,,,10.69,12.38,8
HCPCS,G9573,Adl pt md or dys rem 6 mon,,,10.69,12.38,8
HCPCS,G9574,Adl pt md dys no rem 6 mon,,,10.69,12.38,8
HCPCS,G9577,Presc opiates >6 wks,,,10.69,12.38,8
HCPCS,G9578,Doc opioid tx 1x during ther,,,10.69,12.38,8
HCPCS,G9579,No doc opioid tx 1x at ther,,,10.69,12.38,8
HCPCS,G9580,Door to punc time <2hrs,,,10.69,2739849.3,9
HCPCS,G9582,"Door to punc time >2hr, nrg",,,10.69,2739849.3,9
HCPCS,G9583,Presc opiates >6 wks,,,10.69,12.38,8
HCPCS,G9584,Eval opioid use instr/pt int,,,10.69,12.38,8
HCPCS,G9585,No eval opi use instr/intv,,,10.69,12.38,8
HCPCS,G9593,Low pecarn ped head trauma,,,10.69,2739849.3,9
HCPCS,G9594,Pt mbht hd ct ord ec prov,,,0.03,12.38,9
HCPCS,G9595,Doc shnt/tum/coag,,,10.69,2739849.3,9
HCPCS,G9596,Ped pt hd ct ord,,,10.69,12.38,8
HCPCS,G9597,No low pecarn ped head traum,,,0.03,12.38,9
HCPCS,G9598,Aor ane 5.5-5.9 cm max diam,,,10.69,2739849.3,9
HCPCS,G9599,Aor ane >=6.0 cm max diam,,,10.69,2739849.3,9
HCPCS,G9600,Symp aaa urgent repair,,,10.69,12.38,8
HCPCS,G9601,Pt dchg home post op day 7,,,10.69,12.38,8
HCPCS,G9602,Pt no dchg home postop day 7,,,10.69,12.38,8
HCPCS,G9603,Pt surv improv bsline tx,,,10.69,2739849.3,9
HCPCS,G9604,Pt surv results not avail,,,10.69,2739849.3,9
HCPCS,G9605,Surv score no improv w/tx,,,10.69,2739849.3,9
HCPCS,G9606,Intraop cyst eval trac inj,,,10.69,2739849.3,9
HCPCS,G9607,Doc med rsn not perf cystosc,,,10.69,2739849.3,9
HCPCS,G9608,Intraop cyst eval not done,,,10.69,2739849.3,9
HCPCS,G9609,Doc order anti-plat,,,10.69,2739849.3,9
HCPCS,G9610,Doc md rsn no antipla,,,10.69,2739849.3,9
HCPCS,G9611,No doc order anti-plat rng,,,10.69,2739849.3,9
HCPCS,G9612,Phodoc 2 mr cec lndmk,,,10.69,12.38,8
HCPCS,G9613,Doc post surg anatomy,,,10.69,12.38,8
HCPCS,G9614,Photodoc < 2 cec lndmk,,,10.69,12.38,8
HCPCS,G9615,Pre-op asst doc,,,10.69,12.38,8
HCPCS,G9616,Doc rsn no preop assmt,,,10.69,12.38,8
HCPCS,G9617,"Pre-op asst not doc, rng",,,10.69,12.38,8
HCPCS,G9618,Doc scr uter mal or us/samp,,,10.69,12.38,8
HCPCS,G9620,No scr utr malig/us/samp rng,,,10.69,12.38,8
HCPCS,G9621,Scr unheal etoh w/counsel,,,10.69,2739849.3,9
HCPCS,G9622,No unheal etoh user,,,0.03,12.38,9
HCPCS,G9623,Doc med rsn no scr etoh use,,,10.69,12.38,8
HCPCS,G9624,Pt not scrn or no counseling,,,10.69,2739849.3,9
HCPCS,G9625,Pt bl srg 30 day pst srg,,,10.69,2739849.3,9
HCPCS,G9626,Med rsn no rpt bladder inj,,,10.69,2739849.3,9
HCPCS,G9627,Pt no bl srg 30 day pst srg,,,10.69,2739849.3,9
HCPCS,G9628,Pt bwli srg 30 day pst srg,,,10.69,2739849.3,9
HCPCS,G9629,Med rsn no rpt bowel inj,,,10.69,2739849.3,9
HCPCS,G9630,Pt no bwli srg 30 day srg,,,10.69,2739849.3,9
HCPCS,G9631,Pt ui srg 30 day pst srg,,,10.69,12.38,8
HCPCS,G9632,Med rsn for no rpt uret inj,,,10.69,12.38,8
HCPCS,G9633,Pt no ui srg 30 day pst srg,,,10.69,12.38,8
HCPCS,G9634,Qual life tool 2x same/impr,,,10.69,12.38,8
HCPCS,G9635,No doc rsn do qual life assm,,,10.69,12.38,8
HCPCS,G9636,No life asst 2x same/decr,,,10.69,12.38,8
HCPCS,G9637,Doc >1 dose reduc tech,,,0.03,12.38,9
HCPCS,G9638,No doc >1 dose reduc tech,,,0.03,12.38,9
HCPCS,G9639,Amp no reqd in48h ieler proc,,,10.69,12.38,8
HCPCS,G9640,Doc plan hybrid/stage proc,,,10.69,12.38,8
HCPCS,G9641,Amp reqd w/in 48h ieler proc,,,10.69,12.38,8
HCPCS,G9642,Current smoker,,,10.69,2739849.3,9
HCPCS,G9643,Elective surgery,,,10.69,2739849.3,9
HCPCS,G9644,No smok b/4 anes day of surg,,,10.69,2739849.3,9
HCPCS,G9645,Had smoke b/4 anes day surg,,,10.69,2739849.3,9
HCPCS,G9646,Pt w/90d mrs 0-2,,,10.69,2739849.3,9
HCPCS,G9647,No mrs score in 90d followup,,,10.69,12.38,8
HCPCS,G9648,Pt w/90d mrs >2,,,10.69,2739849.3,9
HCPCS,G9649,Psor as doc spc bm,,,10.69,2739849.3,9
HCPCS,G9651,Psor as doc no spc bm,,,10.69,2739849.3,9
HCPCS,G9654,Mon anesth care,,,10.69,2739849.3,9
HCPCS,G9655,Toc tool incl key elem,,,10.69,2739849.3,9
HCPCS,G9656,Pt trans from anest to pacu,,,10.69,2739849.3,9
HCPCS,G9658,Toc tool incl elem not used,,,10.69,2739849.3,9
HCPCS,G9659,>=86y scr colo nomed rsn,,,10.69,2739849.3,9
HCPCS,G9660,Doc med rsn colo pt >= 86y,,,10.69,2739849.3,9
HCPCS,G9661,Pt >= 86  w/ hi risk,,,2739849.3,2739849.3,1
HCPCS,G9661,Pt >= 86 w/ hi risk,,,10.69,12.38,8
HCPCS,G9662,Prior dx/active clin ascvd,,,10.69,2739849.3,9
HCPCS,G9663,Fast/dir ldl >= 190 mg/dl,,,10.69,2739849.3,9
HCPCS,G9664,Taking statin or rec'd order,,,0.03,12.38,9
HCPCS,G9665,No statin/no order statin,,,10.69,2739849.3,9
HCPCS,G9666,Fas/dir ldl 70-189mg/dl mst,,,10.69,12.38,8
HCPCS,G9674,Pt w/clin ascvd dx,,,10.69,2739849.3,9
HCPCS,G9675,Pt w/fast/dir lab ldl-c >190,,,10.69,2739849.3,9
HCPCS,G9676,40-75y w/type 1/2 w/ldl-c rs,,,10.69,2739849.3,9
HCPCS,G9678,Oncology care model service,,,10.69,12.38,8
HCPCS,G9679,Acute care pneumonia,,,10.69,2739849.3,9
HCPCS,G9680,Acute care congestive heart,,,10.69,2739849.3,9
HCPCS,G9681,Acute care chronic obstruct,,,10.69,2739849.3,9
HCPCS,G9682,Acute care skin infection,,,10.69,2739849.3,9
HCPCS,G9683,Acute fluid/electro disorder,,,10.69,2739849.3,9
HCPCS,G9684,Acute care urinary tract inf,,,10.69,2739849.3,9
HCPCS,G9685,Acute nursing facility care,,,68.73,485.99,9
HCPCS,G9687,Hospice anytime msmt per,,,10.69,2739849.3,9
HCPCS,G9688,Pt w/hosp anytime msmt per,,,10.69,2739849.3,9
HCPCS,G9689,Inpt elect carotid intervent,,,10.69,2739849.3,9
HCPCS,G9690,Pt in hos,,,10.69,2739849.3,9
HCPCS,G9691,Pt hosp dur msmt period,,,10.69,2739849.3,9
HCPCS,G9692,Hosp recd by pt dur msmt per,,,10.69,2739849.3,9
HCPCS,G9693,Pt use hosp during msmt per,,,10.69,2739849.3,9
HCPCS,G9694,Hosp srv used pt in msmt per,,,10.69,2739849.3,9
HCPCS,G9695,Long act inhal bronchdil pre,,,10.69,2739849.3,9
HCPCS,G9696,Med rsn no presc bronchdil,,,10.69,2739849.3,9
HCPCS,G9697,Pt rsn no presc bronchdil,,,10.69,12.38,8
HCPCS,G9698,Sys rsn no presc bronchdil,,,10.69,2739849.3,9
HCPCS,G9699,Long inhal bronchdil no pres,,,10.69,2739849.3,9
HCPCS,G9700,Pt is w/hosp during msmt per,,,10.69,2739849.3,9
HCPCS,G9701,Child anbx 30 prior dx estab,,,10.69,12.38,8
HCPCS,G9702,Pt use hosp during msmt per,,,10.69,2739849.3,9
HCPCS,G9703,Anbx 30 prior to episode,,,10.69,2739849.3,9
HCPCS,G9704,Ajcc br ca stg i: t1 mic/t1a,,,10.69,2739849.3,9
HCPCS,G9705,Ajcc br ca stg ib,,,10.69,2739849.3,9
HCPCS,G9706,Low recur prost ca,,,10.69,2739849.3,9
HCPCS,G9707,Pt had hosp dur msmt per,,,10.69,2739849.3,9
HCPCS,G9708,Bilat mast/hx bi /unilat mas,,,10.69,2739849.3,9
HCPCS,G9709,Hosp srv used pt in msmt per,,,10.69,2739849.3,9
HCPCS,G9710,Pt prov hosp srv msmt per,,,10.69,2739849.3,9
HCPCS,G9711,Pt hx tot col or colon ca,,,10.69,2739849.3,9
HCPCS,G9712,Doc med rsn presc anbx,,,10.69,2739849.3,9
HCPCS,G9713,Pt use hosp during msmt per,,,10.69,2739849.3,9
HCPCS,G9714,Pt is w/hosp during msmt per,,,10.69,2739849.3,9
HCPCS,G9715,Pt w/hosp anytime msmt per,,,10.69,12.38,8
HCPCS,G9716,Bmi doc onl fup not cmpltd,,,10.69,2739849.3,9
HCPCS,G9717,Doc pt dx bipol,,,0.03,12.38,9
HCPCS,G9718,Hospice anytime msmt per,,,10.69,12.38,8
HCPCS,G9719,Pt not ambul/immob/wc,,,10.69,2739849.3,9
HCPCS,G9720,Hospice anytime msmt per,,,10.69,2739849.3,9
HCPCS,G9721,Pt not ambul/immob/wc,,,10.69,2739849.3,9
HCPCS,G9722,Doc hx renal fail or cr+ >=4,,,10.69,2739849.3,9
HCPCS,G9723,Hosp recd by pt dur msmt per,,,10.69,2739849.3,9
HCPCS,G9724,Pt w/doc use anticoag mst yr,,,10.69,2739849.3,9
HCPCS,G9725,Pt w/hosp anytime msmt per,,,10.69,12.38,8
HCPCS,G9726,Refused to participate,,,10.69,2739849.3,9
HCPCS,G9727,Pt unable cmplt lepf prom,,,10.69,2739849.3,9
HCPCS,G9728,Refused to participate,,,10.69,2739849.3,9
HCPCS,G9729,Pt unbl cmplt lepf prom,,,10.69,2739849.3,9
HCPCS,G9730,Refused to participate,,,10.69,2739849.3,9
HCPCS,G9731,Pt unbl cmplt lepf prom,,,10.69,2739849.3,9
HCPCS,G9732,Refused to participate,,,10.69,2739849.3,9
HCPCS,G9733,Pt unbl cmplt lb fs prom,,,10.69,2739849.3,9
HCPCS,G9734,Refused to participate,,,10.69,2739849.3,9
HCPCS,G9735,Pt unbl cmplt shld fs prom,,,10.69,2739849.3,9
HCPCS,G9736,Refused to participate,,,10.69,2739849.3,9
HCPCS,G9737,Pt unbl cmplt ewh fs prom,,,10.69,2739849.3,9
HCPCS,G9738,Refused to participate,,,10.69,12.38,8
HCPCS,G9739,Pt unbl cmplt go fs prom,,,10.69,12.38,8
HCPCS,G9740,Hosp srv to pt dur msmt per,,,10.69,2739849.3,9
HCPCS,G9741,Pt w/hosp anytime msmt per,,,10.69,2739849.3,9
HCPCS,G9744,Pt not eli d/t act dig htn,,,0.03,12.38,9
HCPCS,G9745,Doc rsn no hbp scrn or f/u,,,10.69,2739849.3,9
HCPCS,G9746,"Mit sten, valve or trans af",,,10.69,2739849.3,9
HCPCS,G9747,Pall dialysis with catheter,,,10.69,12.38,8
HCPCS,G9748,App transpl lvg kidney donor,,,10.69,12.38,8
HCPCS,G9749,Pall dialysis with catheter,,,10.69,12.38,8
HCPCS,G9750,App transpl lvg kidney donor,,,10.69,12.38,8
HCPCS,G9751,Pt died w/in 24 mos rpt time,,,10.69,2739849.3,9
HCPCS,G9752,Urgent surgery,,,10.69,2739849.3,9
HCPCS,G9753,"Doc no dicom, ct other fac",,,10.69,2739849.3,9
HCPCS,G9754,Incid pulm nodule,,,10.69,2739849.3,9
HCPCS,G9755,Doc med rsn no fllw up,,,10.69,2739849.3,9
HCPCS,G9756,Surg proc w/silicone oil,,,10.69,1374.8,9
HCPCS,G9757,Surg proc w/silicone oil,,,10.69,2739849.3,9
HCPCS,G9758,Pt in hos,,,10.69,2739849.3,9
HCPCS,G9759,Hx preop post cap rup,,,10.69,12.38,8
HCPCS,G9760,Pt w/hosp anytime msmt per,,,10.69,2739849.3,9
HCPCS,G9761,Pt w/hosp anytime msmt per,,,10.69,2739849.3,9
HCPCS,G9762,Pt had >= 2-3 hpv vaccines,,,10.69,2739849.3,9
HCPCS,G9763,Pt not have 2-3 hpv vaccines,,,10.69,2739849.3,9
HCPCS,G9764,Pt treatd w/oral syst or bio,,,10.69,2739849.3,9
HCPCS,G9765,Doc pat declined therapy,,,10.69,2739849.3,9
HCPCS,G9766,Cva stroke dx tx transf fac,,,10.69,2739849.3,9
HCPCS,G9767,Hosp new dx cva consid evst,,,10.69,2739849.3,9
HCPCS,G9768,Pt w/hosp anytime msmt per,,,10.69,2739849.3,9
HCPCS,G9769,Bn den 2yr/got ost med/ther,,,10.69,2739849.3,9
HCPCS,G9770,Perip nerve block,,,10.69,2739849.3,9
HCPCS,G9771,"Anes end, 1 temp >35.5(95.9)",,,10.69,2739849.3,9
HCPCS,G9772,Doc med rsn no temp >= 35.5,,,10.69,2739849.3,9
HCPCS,G9773,1 bod temp >=35.5,,,10.69,2739849.3,9
HCPCS,G9774,Pt had hyst,,,10.69,12.38,8
HCPCS,G9775,Recd 2 anti-emet pre/intraop,,,10.69,2739849.3,9
HCPCS,G9776,Doc med rsn no proph antiem,,,10.69,2739849.3,9
HCPCS,G9777,Pt no antiemet pre/intraop,,,10.69,2739849.3,9
HCPCS,G9778,Pts dx w/pregn,,,10.69,12.38,8
HCPCS,G9779,Pts breastfeeding,,,10.69,2739849.3,9
HCPCS,G9780,Pts dx w/rhabdomyolysis,,,10.69,2739849.3,9
HCPCS,G9781,Doc rsn no statin,,,10.69,2739849.3,9
HCPCS,G9782,Hx dx fam/pure hypercholes,,,10.69,2739849.3,9
HCPCS,G9783,"Doc dx dm, fast <70, no stat",,,10.69,12.38,8
HCPCS,G9784,Path/derm prov 2nd biop opin,,,10.69,2739849.3,9
HCPCS,G9785,Path report sent,,,10.69,2739849.3,9
HCPCS,G9786,Path report not sent,,,10.69,2739849.3,9
HCPCS,G9787,Pt alive,,,10.69,2739849.3,9
HCPCS,G9788,Most rct bp </= 130/80,,,10.69,2739849.3,9
HCPCS,G9789,"Record bp ip, er, urg/self",,,10.69,2739849.3,9
HCPCS,G9790,Most rct bp >/= 130/80,,,10.69,2739849.3,9
HCPCS,G9791,Most rct tob stat free,,,10.69,2739849.3,9
HCPCS,G9792,Most rct tob stat not free,,,10.69,2739849.3,9
HCPCS,G9793,Pt on daily asa/antiplat,,,10.69,2739849.3,9
HCPCS,G9794,Doc med rsn no daily aspirin,,,10.69,2739849.3,9
HCPCS,G9795,Pt no daily asa/antiplat,,,10.69,2739849.3,9
HCPCS,G9796,Pt currently on statin,,,10.69,2739849.3,9
HCPCS,G9797,Pt not currently on statin,,,10.69,2739849.3,9
HCPCS,G9798,D/c ami btw 7/1-6/30 meas pd,,,10.69,12.38,8
HCPCS,G9799,Med disp evt indic hx asth,,,10.69,12.38,8
HCPCS,G9800,Pt id intol/alleg beta-block,,,10.69,12.38,8
HCPCS,G9801,Nonacut transf from inpt,,,10.69,12.38,8
HCPCS,G9802,Pt w/hosp anytime msmt per,,,10.69,12.38,8
HCPCS,G9803,Pt presc 135 day trmt,,,10.69,12.38,8
HCPCS,G9804,Pt not presc 135 day trmt,,,10.69,12.38,8
HCPCS,G9805,Pt w/hosp anytime msmt per,,,10.69,2739849.3,9
HCPCS,G9806,Pt recd cerv cyto/hpv,,,10.69,2739849.3,9
HCPCS,G9807,Pt no recd cerv cyto/hpv,,,0.03,12.38,9
HCPCS,G9808,Pt no asthm cont med mst per,,,10.69,12.38,8
HCPCS,G9809,Pt w/hosp anytime msmt per,,,10.69,12.38,8
HCPCS,G9810,Pdc 75% w/asth cont med,,,10.69,12.38,8
HCPCS,G9811,No pdc 75% w/asth cont med,,,10.69,12.38,8
HCPCS,G9812,Pt died during inpt/30d aft,,,10.69,2739849.3,9
HCPCS,G9813,Pt not died w/in 30d of proc,,,10.69,2739849.3,9
HCPCS,G9814,Death during index hosp,,,10.69,12.38,8
HCPCS,G9815,Death not during index hosp,,,10.69,12.38,8
HCPCS,G9816,Death <30 day post discharge,,,10.69,12.38,8
HCPCS,G9817,No death 30-days post-disch,,,10.69,12.38,8
HCPCS,G9818,Doc sex activity,,,10.69,2739849.3,9
HCPCS,G9819,Pt w/hosp anytime msmt per,,,10.69,2739849.3,9
HCPCS,G9820,Doc chlam scr test w/follow,,,10.69,2739849.3,9
HCPCS,G9821,No doc chlam scr ts w/follow,,,10.69,2739849.3,9
HCPCS,G9822,Endo abl proc yr prev ind dt,,,10.69,2739849.3,9
HCPCS,G9823,Endo smpl/hyst bx res doc,,,10.69,2739849.3,9
HCPCS,G9824,Endo smpl/hyst bx res no doc,,,10.69,2739849.3,9
HCPCS,G9825,"Her-2 neg,undoc/unkn",,,10.69,12.38,8
HCPCS,G9826,Transf pract aft init chemo,,,10.69,12.38,8
HCPCS,G9827,Her-2 targ ther no init tx,,,10.69,12.38,8
HCPCS,G9828,Her-2 targ ther dur init tx,,,10.69,12.38,8
HCPCS,G9829,Breast adj chemo admin,,,10.69,12.38,8
HCPCS,G9830,Her-2 pos,,,10.69,2739849.3,9
HCPCS,G9831,Ajcc stg brt ca dx ii or iii,,,10.69,2739849.3,9
HCPCS,G9832,Br ca stg = 1 t stg = t1c,,,10.69,2739849.3,9
HCPCS,G9833,Transf pract aft init chemo,,,10.69,12.38,8
HCPCS,G9834,Pt met dis at dx,,,10.69,12.38,8
HCPCS,G9835,Trastuz given w/in 12 mos dx,,,10.69,12.38,8
HCPCS,G9836,Rsn no trast given doc,,,10.69,12.38,8
HCPCS,G9837,Trastuz not in 12 mos dx,,,10.69,12.38,8
HCPCS,G9838,Pt met dis at dx,,,10.69,2739849.3,9
HCPCS,G9839,Anti-egfr mon anti ther,,,10.69,2739849.3,9
HCPCS,G9840,Gene testing performed,,,10.69,2739849.3,9
HCPCS,G9841,Gene testing not performed,,,10.69,2739849.3,9
HCPCS,G9842,Pt met dis at dx,,,10.69,2739849.3,9
HCPCS,G9843,Kras or nras gene mutation,,,10.69,2739849.3,9
HCPCS,G9844,Pt no recd anti-egfr ther,,,10.69,2739849.3,9
HCPCS,G9845,Pt recd anti-egfr ther,,,10.69,2739849.3,9
HCPCS,G9846,Pt died from cancer,,,10.69,2739849.3,9
HCPCS,G9847,Pt recd chemo last 14d life,,,10.69,2739849.3,9
HCPCS,G9848,Pt no chemo last 14d life,,,10.69,2739849.3,9
HCPCS,G9849,Pt died from cancer,,,10.69,12.38,8
HCPCS,G9850,1/more ed last 30d life,,,10.69,12.38,8
HCPCS,G9851,1/no ed visit last 30d life,,,10.69,12.38,8
HCPCS,G9852,Pt died from cancer,,,10.69,12.38,8
HCPCS,G9853,Icu stay last 30d life,,,10.69,12.38,8
HCPCS,G9854,No icu stay last 30d life,,,10.69,12.38,8
HCPCS,G9855,Pt died from cancer,,,10.69,12.38,8
HCPCS,G9856,Pt no hospice,,,10.69,12.38,8
HCPCS,G9857,Pt admit hospice,,,10.69,12.38,8
HCPCS,G9858,Pt enroll hospice,,,10.69,2739849.3,9
HCPCS,G9859,Pt died from cancer,,,10.69,2739849.3,9
HCPCS,G9860,Pt less 3d hospice,,,10.69,2739849.3,9
HCPCS,G9861,Pt more than 3d hospice,,,10.69,2739849.3,9
HCPCS,G9862,Doc rsn no 10 yr follow,,,10.69,2739849.3,9
HCPCS,G9868,Cmmi asyntelehealth <10min,,,10.69,71.79,9
HCPCS,G9869,Cmmi asyntelehealth 10-20min,,,10.69,96.01,9
HCPCS,G9870,Cmmi asyntelehealth >20min,,,10.69,120.23,9
HCPCS,G9871,"Bhv couns dm prev, onln 60 m",,,86.57,100.24,8
HCPCS,G9873,1 em core session,,,276.9,276.9,1
HCPCS,G9874,4 em core sessions,,,2739849.3,2739849.3,1
HCPCS,G9875,9 em core sessions,,,2739849.3,2739849.3,1
HCPCS,G9876,2 em core ms mo 7-9 no wl,,,205.5,205.5,1
HCPCS,G9877,2 em core ms mo 10-12 no wl,,,2739849.3,2739849.3,1
HCPCS,G9878,2 em core ms mo 7-9 wl,,,2739849.3,2739849.3,1
HCPCS,G9879,2 em core ms mo 10-12 wl,,,2739849.3,2739849.3,1
HCPCS,G9880,Em 5 percent wl,,,397.3,397.3,1
HCPCS,G9881,Em 9 percent wl,,,68.5,68.5,1
HCPCS,G9882,2 em ongoing ms mo 13-15 wl,,,2739849.3,2739849.3,1
HCPCS,G9883,2 em ongoing ms mo 16-18 wl,,,2739849.3,2739849.3,1
HCPCS,G9884,2 em ongoing ms mo 19-21 wl,,,2739849.3,2739849.3,1
HCPCS,G9885,2 em ongoing ms mo 22-24 wl,,,2739849.3,2739849.3,1
HCPCS,G9886,In-person attendance g code,,,68.5,100.24,9
HCPCS,G9887,Distance learning attendance,,,68.5,100.24,9
HCPCS,G9888,5% wl maintnd from bsline wt,,,21.92,21.92,1
HCPCS,G9890,Em bridge payment,,,68.5,68.5,1
HCPCS,G9891,Em session reporting,,,10.69,2739849.3,9
HCPCS,G9892,Doc pt rsn no dil mac exam,,,10.69,2739849.3,9
HCPCS,G9893,No mac exam,,,10.69,2739849.3,9
HCPCS,G9894,Adr dep thrpy prescribed,,,10.69,2739849.3,9
HCPCS,G9895,Doc med rsn no adr dep thrpy,,,10.69,2739849.3,9
HCPCS,G9896,Doc pt rsn no adr dep thrpy,,,10.69,2739849.3,9
HCPCS,G9897,Pt nt prsc adr dep thrpy rng,,,10.69,2739849.3,9
HCPCS,G9898,Pt 66+ snp or ltc pos > 90d,,,10.69,2739849.3,9
HCPCS,G9899,Scrn mam perf rslts doc,,,0.03,12.38,9
HCPCS,G9900,Scrn mam perf rslts not doc,,,0.03,12.38,9
HCPCS,G9901,Pt 66+ snp or ltc pos > 90d,,,10.69,2739849.3,9
HCPCS,G9902,Pt scrn tbco and id as user,,,0.03,12.38,9
HCPCS,G9903,Pt scrn tbco id as non user,,,0.03,12.38,9
HCPCS,G9904,Doc med rsn no tbco scrn,,,10.69,12.38,8
HCPCS,G9905,No pt tbco scrn rng,,,0.03,12.38,9
HCPCS,G9906,Pt recv tbco cess interv,,,0.03,12.38,9
HCPCS,G9907,Doc med rsn no tbco interv,,,10.69,12.38,8
HCPCS,G9908,No pt tbco cess interv rng,,,0.03,12.38,9
HCPCS,G9909,Doc med rsn no tbco interv,,,10.69,12.38,8
HCPCS,G9910,Pt 66+ snp or ltc pos > 90d,,,10.69,2739849.3,9
HCPCS,G9911,Node neg pre/post syst ther,,,10.69,2739849.3,9
HCPCS,G9912,Hbv status assesed and int,,,10.69,2739849.3,9
HCPCS,G9913,No hbv status assesd and int,,,10.69,2739849.3,9
HCPCS,G9914,Pt initiated anti-tnf agent,,,10.69,2739849.3,9
HCPCS,G9915,No documntd hbv results rcd,,,10.69,2739849.3,9
HCPCS,G9916,Funct status past 12 months,,,10.69,2739849.3,9
HCPCS,G9917,Adv dem crgvr limited,,,10.69,2739849.3,9
HCPCS,G9918,"No funct stat perf, rsn nos",,,10.69,2739849.3,9
HCPCS,G9919,Scrn nd pos nd prov of rec,,,10.69,2739849.3,9
HCPCS,G9920,Scrning perf and negative,,,10.69,2739849.3,9
HCPCS,G9921,No or part scrn nd rng or os,,,10.69,2739849.3,9
HCPCS,G9922,Sfty cncrns scrn nd mit recs,,,10.69,2739849.3,9
HCPCS,G9923,Safty cncrns scrn and neg,,,10.69,2739849.3,9
HCPCS,G9924,Doc med rsn no scrn or recs,,,10.69,12.38,8
HCPCS,G9925,No scrn prov rsn nos,,,10.69,2739849.3,9
HCPCS,G9926,Sfty cncrns scrn but no recs,,,10.69,2739849.3,9
HCPCS,G9927,Doc no warf /fda pt trial,,,10.69,12.38,8
HCPCS,G9928,No warf or fda drug presc,,,10.69,2739849.3,9
HCPCS,G9929,Trs/rev af,,,10.69,2739849.3,9
HCPCS,G9930,Com care,,,10.69,2739849.3,9
HCPCS,G9931,No chad or chad scr 0 or 1,,,10.69,2739849.3,9
HCPCS,G9932,Doc pt rsn no tb scrn recrds,,,10.69,12.38,8
HCPCS,G9933,Canc detectd during col scrn,,,10.69,12.38,8
HCPCS,G9934,Doc rsn not detecting cancer,,,10.69,12.38,8
HCPCS,G9935,Canc not detectd during srcn,,,10.69,12.38,8
HCPCS,G9936,Pmh plyp/neo co/rect/jun/ans,,,10.69,12.38,8
HCPCS,G9937,Dig or surv colsco,,,10.69,12.38,8
HCPCS,G9938,Pt 66+ snp or ltc pos > 90d,,,10.69,2739849.3,9
HCPCS,G9939,Same path/derm perf biopsy,,,10.69,2739849.3,9
HCPCS,G9940,Doc reas no statin therapy,,,10.69,2739849.3,9
HCPCS,G9942,Adtl spine proc on same date,,,10.69,12.38,8
HCPCS,G9943,Bk pn nt msr vas scl pre/pst,,,10.69,2739849.3,9
HCPCS,G9945,Pt w/cancer scoliosis,,,10.69,2739849.3,9
HCPCS,G9946,Bk pain no vas,,,10.69,2739849.3,9
HCPCS,G9948,Adtl spine proc on same date,,,10.69,12.38,8
HCPCS,G9949,Leg pain no vas,,,10.69,2739849.3,9
HCPCS,G9954,Pt >2 rsk fac post-op vomit,,,10.69,2739849.3,9
HCPCS,G9955,Inhlnt anesth only for induc,,,10.69,2739849.3,9
HCPCS,G9956,Combo thrpy of >= 2 prophly,,,10.69,2739849.3,9
HCPCS,G9957,Doc med rsn no combo thrpy,,,10.69,2739849.3,9
HCPCS,G9958,No combo prohpyl thrp for pt,,,10.69,2739849.3,9
HCPCS,G9959,Systemic antimicro not presc,,,10.69,2739849.3,9
HCPCS,G9960,Med rsn sys antimi nt rx,,,10.69,2739849.3,9
HCPCS,G9961,Systemic antimicro presc,,,10.69,2739849.3,9
HCPCS,G9962,Embolization doc separatly,,,10.69,2739849.3,9
HCPCS,G9963,Embolization not doc separat,,,10.69,2739849.3,9
HCPCS,G9964,Pt recv >=1 well-chld visit,,,10.69,2739849.3,9
HCPCS,G9965,No well-chld vist recv by pt,,,10.69,2739849.3,9
HCPCS,G9966,"Scrn, inter, report child",,,10.69,12.38,8
HCPCS,G9967,"No scrn, inter, reprt child",,,10.69,12.38,8
HCPCS,G9968,Pt refrd 2 pvdr/spclst in pp,,,10.69,2739849.3,9
HCPCS,G9969,Pvdr rfrd pt rprt rcvd,,,10.69,2739849.3,9
HCPCS,G9970,Pvdr rfrd pt no rprt rcvd,,,10.69,2739849.3,9
HCPCS,G9974,Mac exam perf,,,10.69,2739849.3,9
HCPCS,G9975,Doc med rsn no dil mac exam,,,10.69,2739849.3,9
HCPCS,G9978,Remote e/m new pt 10mins,,,72.34,72.34,1
HCPCS,G9979,Remote e/m new pt 20mins,,,123.55,123.55,1
HCPCS,G9980,Remote e/m new pt 30 mins,,,197.8,197.8,1
HCPCS,G9981,Remote e/m new pt 45mins,,,332.61,332.61,1
HCPCS,G9982,Remote e/m new pt 60mins,,,443.3,443.3,1
HCPCS,G9983,Remote e/m est. pt 10mins,,,72.34,72.34,1
HCPCS,G9984,Remote e/m est. pt  15mins,,,142.07,142.07,1
HCPCS,G9985,Remote e/m est. pt 25mins,,,215.39,215.39,1
HCPCS,G9986,Remote e/m est. pt 40mins,,,313.51,313.51,1
HCPCS,G9987,BPCI ADVANCED IN HOME VISIT,134.0,87.1,1.1,189.0,188
HCPCS,G9988,Pall serv during meas,,,10.69,2739849.3,9
HCPCS,G9989,Med rsn no pneum vax,,,10.69,12.38,8
HCPCS,G9990,No pneum vax admin 19+,,,10.69,2739849.3,9
HCPCS,G9991,Pneum vax admin 19+,,,10.69,2739849.3,9
HCPCS,G9992,Pall serv during meas,,,10.69,2739849.3,9
HCPCS,G9993,Pall serv during meas,,,10.69,2739849.3,9
HCPCS,G9994,Pall serv during meas,,,10.69,2739849.3,9
HCPCS,G9995,Pall serv during meas,,,10.69,12.38,8
HCPCS,G9996,Doc pt pal or hospice,,,10.69,2739849.3,9
HCPCS,G9997,Doc pt preg dur msrmt pd,,,10.69,2739849.3,9
HCPCS,G9998,Doc med rsn <3 colon,,,10.69,2739849.3,9
HCPCS,G9999,Doc sys rsn <3 colon,,,10.69,2739849.3,9
HCPCS,H0001,Alcohol and/or drug assess,,,32.28,228.51,9
HCPCS,H0002,Alcohol and/or drug screenin,,,41.15,228.51,9
HCPCS,H0003,Alcohol and/or drug screenin,,,30.12,2739849.3,9
HCPCS,H0004,Alcohol and/or drug services,,,25.35,110.12,9
HCPCS,H0005,Alcohol and/or drug services,,,1.95,152.57,9
HCPCS,H0006,Alcohol and/or drug services,,,41.45,47.99,9
HCPCS,H0007,Alcohol and/or drug services,,,29.65,69.22,9
HCPCS,H0008,Alcohol and/or drug services,,,272.85,2739849.3,9
HCPCS,H0009,Alcohol and/or drug services,,,272.85,2739849.3,9
HCPCS,H0010,Alcohol and/or drug services,,,272.85,316.03,9
HCPCS,H0011,Alcohol and/or drug services,,,272.85,484.38,9
HCPCS,H0012,Alcohol and/or drug services,,,272.85,2739849.3,9
HCPCS,H0013,Alcohol and/or drug services,,,272.85,2739849.3,9
HCPCS,H0014,Alcohol and/or drug services,,,10.58,927.08,9
HCPCS,H0015,Alcohol and/or drug services,,,21.81,154.07,9
HCPCS,H0016,Alcohol and/or drug services,,,69.76,69.76,1
HCPCS,H0017,Alcohol and/or drug services,,,272.85,2739849.3,9
HCPCS,H0018,Alcohol and/or drug services,,,272.85,2739849.3,9
HCPCS,H0019,Alcohol and/or drug services,,,272.85,2739849.3,9
HCPCS,H0020,Alcohol and/or drug services,,,10.58,59.62,9
HCPCS,H0021,Alcohol and/or drug training,,,2739849.3,2739849.3,1
HCPCS,H0022,Alcohol and/or drug interven,,,95.1,2739849.3,9
HCPCS,H0023,Alcohol and/or drug outreach,,,2739849.3,2739849.3,1
HCPCS,H0024,Alcohol and/or drug preventi,,,2739849.3,2739849.3,1
HCPCS,H0025,Alcohol and/or drug preventi,,,2739849.3,2739849.3,1
HCPCS,H0026,Alcohol and/or drug preventi,,,2739849.3,2739849.3,1
HCPCS,H0027,Alcohol and/or drug preventi,,,2739849.3,2739849.3,1
HCPCS,H0028,Alcohol and/or drug preventi,,,2739849.3,2739849.3,1
HCPCS,H0029,Alcohol and/or drug preventi,,,2739849.3,2739849.3,1
HCPCS,H0030,Alcohol and/or drug hotline,,,2739849.3,2739849.3,1
HCPCS,H0031,Mh health assess by non-md,,,197.35,232.9,9
HCPCS,H0032,MENTAL HEALTH SERVICE PLAN DEVELOPMENT BY NON-PHYSICIAN,692.0,449.8,1.1,692.0,80
HCPCS,H0032,Mh svc plan dev by non-md,,,41.45,191.8,9
HCPCS,H0033,Oral med adm direct observe,,,10.58,40.25,10
HCPCS,H0034,Med trng & support per 15min,,,10.58,37.07,9
HCPCS,H0035,Mh partial hosp tx under 24h,,,149.9,240.44,9
HCPCS,H0036,Comm psy face-face per 15min,,,57.59,57.59,1
HCPCS,H0037,Comm psy sup tx pgm per diem,,,149.9,2739849.3,9
HCPCS,H0038,Self-help/peer svc per 15min,,,2739849.3,2739849.3,1
HCPCS,H0039,Asser com tx face-face/15min,,,2739849.3,2739849.3,1
HCPCS,H0040,Assert comm tx pgm per diem,,,2739849.3,2739849.3,1
HCPCS,H0041,Fos c chld non-ther per diem,,,2739849.3,2739849.3,1
HCPCS,H0042,Fos c chld non-ther per mon,,,2739849.3,2739849.3,1
HCPCS,H0043,"Supported housing, per diem",,,2739849.3,2739849.3,1
HCPCS,H0044,"Supported housing, per month",,,2739849.3,2739849.3,1
HCPCS,H0045,Respite not-in-home per diem,,,2739849.3,2739849.3,1
HCPCS,H0046,"Mental health service, nos",,,95.1,2739999.97,9
HCPCS,H0047,Alcohol/drug abuse svc nos,,,95.1,2739999.97,9
HCPCS,H0048,Spec coll non-blood:a/d test,,,2.64,12.63,9
HCPCS,H0049,ALCOHOL/DRUG SCREENING,118.0,76.7,1.1,118.0,82
HCPCS,H0049,Alcohol/drug screening,,,47.12,71.6,9
HCPCS,H0050,ALCOHOL/DRUG SERVICE 15 MIN,222.0,144.3,1.1,222.0,82
HCPCS,H0050,Alcohol/drug service 15 min,,,61.65,110.12,9
HCPCS,H0052,Mmip mental health and care,,,95.1,110.12,8
HCPCS,H0053,Ht mental health and care,,,95.1,110.12,8
HCPCS,H1000,PRENATAL CARE ATRISK ASSESSM,281.0,182.65,1.1,281.0,98
HCPCS,H1000,PRENATAL RISK ASSESSMENT,90.0,58.5,19.62,148.26,66
HCPCS,H1001,ANTEPARTUM MANAGEMENT,48.0,31.2,1.1,150.23,94
HCPCS,H1001,Antepartum management,,,68.5,79.59,9
HCPCS,H1002,Carecoordination prenatal,,,21.85,27.4,9
HCPCS,H1003,Prenatal at risk education,,,27.4,45.28,9
HCPCS,H1004,Follow up home visit/prental,,,2739849.3,2739849.3,1
HCPCS,H1005,Prenatalcare enhanced srv pk,,,128.04,2739849.3,9
HCPCS,H1010,Nonmed family planning ed,,,31.62,45.28,9
HCPCS,H1011,FAMILY ASSESSMENT,43.0,27.95,1.1,3060831.65,80
HCPCS,H1011,Family assessment,,,197.35,2739849.3,9
HCPCS,H2000,CANS ASSESSMENT,162.5,105.625,1.1,2720889.23,158
HCPCS,H2001,Rehabilitation program 1/2 d,,,89.11,2739849.3,9
HCPCS,H2010,Comprehensive med svc 15 min,,,10.58,48.99,9
HCPCS,H2011,"Crisis interven svc, 15 min",,,59.78,318.09,9
HCPCS,H2012,"Behav hlth day treat, per hr",,,65.49,232.9,9
HCPCS,H2013,"Psych hlth fac svc, per diem",,,2739849.3,2739849.3,1
HCPCS,H2014,"Skills train and dev, 15 min",,,48.61,2739849.3,9
HCPCS,H2015,FUNCTIONAL FAMILY THERAPY FOR JUVENILES (FFT),84.0,54.6,1.1,133.0,138
HCPCS,H2015,INTENSIVE HOME BASED TREATMENT,85.5,55.575,1.1,133.0,138
HCPCS,H2016,"Comp comm supp svc, per diem",,,2739849.3,2739849.3,1
HCPCS,H2017,"Psysoc rehab svc, per 15 min",,,52.66,110.12,9
HCPCS,H2018,"Psysoc rehab svc, per diem",,,149.9,2739849.3,9
HCPCS,H2019,"Ther behav svc, per 15 min",,,42.94,110.12,9
HCPCS,H2020,"Ther behav svc, per diem",,,62.01,173.57,9
HCPCS,H2021,"Com wrap-around sv, 15 min",,,2739849.3,2739849.3,1
HCPCS,H2022,"Com wrap-around sv, per diem",,,2739849.3,2739849.3,1
HCPCS,H2023,"Supported employ, per 15 min",,,2739849.3,2739849.3,1
HCPCS,H2024,"Supported employ, per diem",,,2739849.3,2739849.3,1
HCPCS,H2025,"Supp maint employ, 15 min",,,2739849.3,2739849.3,1
HCPCS,H2026,"Supp maint employ, per diem",,,2739849.3,2739849.3,1
HCPCS,H2027,"Psychoed svc, per 15 min",,,24.66,110.12,9
HCPCS,H2028,"Sex offend tx svc, 15 min",,,95.1,2739849.3,9
HCPCS,H2029,"Sex offend tx svc, per diem",,,149.9,2739849.3,9
HCPCS,H2030,"Mh clubhouse svc, per 15 min",,,2739849.3,2739849.3,1
HCPCS,H2031,"Mh clubhouse svc, per diem",,,2739849.3,2739849.3,1
HCPCS,H2032,"Activity therapy, per 15 min",,,48.61,2739849.3,9
HCPCS,H2033,MULTI SYSTEMIC THERAPY FOR JUVENILES (MST),87.5,56.875,1.1,133.0,146
HCPCS,H2034,"A/d halfway house, per diem",,,272.85,2739849.3,9
HCPCS,H2035,"A/d tx program, per hour",,,95.1,2739849.3,9
HCPCS,H2036,"A/d tx program, per diem",,,149.9,223.69,9
HCPCS,H2037,"Dev delay prev dp ch, 15 min",,,2739849.3,2739849.3,1
HCPCS,H2038,Skill train and dev/diem,,,2739849.3,2739849.3,1
HCPCS,H2040,"Coord specialty care, month",,,2739849.3,2739849.3,1
HCPCS,H2041,Coord special care encounter,,,41.45,2739849.3,9
HCPCS,J0013,"Esketamine, nasal spray",,,31.83,232.34,13
HCPCS,J001300,"Esketamine, nasal spray",,,31.83,40.77,3
HCPCS,J0120,COSM TETRACYCLINE,500.0,325.0,1.1,500.0,68
HCPCS,J0120,Tetracyclin injection,,,29.62,60.42,11
HCPCS,J012000,Tetracyclin injection,,,29.62,37.94,3
HCPCS,J0121,"Inj., omadacycline, 1 mg",,,0.52,465.3,41
HCPCS,J012100,"Inj., omadacycline, 1 mg",,,7.37,9.44,3
HCPCS,J0122,"Inj., eravacycline, 1 mg",,,0.16,164.23,34
HCPCS,J012200,"Inj., eravacycline, 1 mg",,,2.3,2.94,3
HCPCS,J0129,ABATACEPT INJECTION 10 MG,142.17,92.41,34.12,4103.47,93
HCPCS,J0129,Abatacept injection,,,79.69,102.08,3
HCPCS,J012900,Abatacept injection,,,79.69,102.08,3
HCPCS,J0130,Abciximab injection,,,1201.03,3688.63,16
HCPCS,J013000,Abciximab injection,,,2879.72,3688.63,3
HCPCS,J0131,"Inj, acetaminophen (nos)",,,0.1,11.17,18
HCPCS,J013100,"Inj, acetaminophen (nos)",,,0.11,0.14,3
HCPCS,J0132,Acetylcysteine injection,,,0.64,11.17,19
HCPCS,J013200,Acetylcysteine injection,,,0.66,0.84,3
HCPCS,J0133,Acyclovir injection,,,0.03,11.17,19
HCPCS,J013300,Acyclovir injection,,,0.21,0.27,3
HCPCS,J0134,Inj acetaminophen -fresenius,,,0.05,11.17,19
HCPCS,J013400,Inj acetaminophen -fresenius,,,0.11,0.14,3
HCPCS,J0135,Adalimumab injection,,,1347.11,5026.5,14
HCPCS,J013500,Adalimumab injection,,,2601.67,3332.47,3
HCPCS,J0136,"Inj, acetaminophen (b braun)",,,0.05,11.17,19
HCPCS,J013600,"Inj, acetaminophen (b braun)",,,0.09,0.11,3
HCPCS,J0137,"Inj, acetaminophen (hikma)",,,0.07,11.17,19
HCPCS,J013700,"Inj, acetaminophen (hikma)",,,0.09,0.11,3
HCPCS,J0138,Inj acetaminoph 10mg/ibu 3mg,,,0.01,11.17,32
HCPCS,J013800,Inj acetaminoph 10mg/ibu 3mg,,,0.16,0.21,3
HCPCS,J0139,"Inj, adalimumab, 1 mg",,,91.73,232.34,17
HCPCS,J0153,Adenosine inj 1mg,,,0.47,60.42,19
HCPCS,J015300,Adenosine inj 1mg,,,0.94,1.21,3
HCPCS,J0162,Inj epinephrine (fresenius),,,0.8,11.17,16
HCPCS,J016200,Inj epinephrine (fresenius),,,0.82,1.05,3
HCPCS,J0163,Epinephrine in nacl (endo),,,1.54,11.17,16
HCPCS,J016300,Epinephrine in nacl (endo),,,1.57,2.01,3
HCPCS,J0164,Epinephrine in nacl (baxter),,,1.65,11.17,16
HCPCS,J016400,Epinephrine in nacl (baxter),,,1.67,2.14,3
HCPCS,J0165,Inj epinephrine nos 0.1 mg,,,0.76,11.17,16
HCPCS,J016500,Inj epinephrine nos 0.1 mg,,,0.77,0.98,3
HCPCS,J0166,Inj epinephrine (bpi),,,1.94,11.17,16
HCPCS,J016600,Inj epinephrine (bpi),,,1.98,2.53,3
HCPCS,J0167,Inj epinephrine (hospira),,,2.49,11.17,16
HCPCS,J016700,Inj epinephrine (hospira),,,2.53,3.24,3
HCPCS,J0168,Epinephrine (intl med sys),,,5.25,11.17,16
HCPCS,J016800,Epinephrine (intl med sys),,,5.34,6.84,3
HCPCS,J0169,Inj epinephrine (adrenalin),,,2.42,11.17,16
HCPCS,J016900,Inj epinephrine (adrenalin),,,2.46,3.15,3
HCPCS,J0171,Adrenalin epinephrine inject,,,0.79,11.17,12
HCPCS,J0172,"Inj, aducanumab-avwa, 2 mg",,,5.85,5653.6,20
HCPCS,J0173,"Inj, epinephrine (belcher)",,,0.76,11.17,13
HCPCS,J0174,"Inj, lecanemab-irmb, 1 mg",,,784.42,908.28,8
HCPCS,J0174,"Lecanemab-irmb, for iv inj",,,0.17,3.7,32
HCPCS,J017400,"Lecanemab-irmb, for iv inj",,,2.37,3.03,3
HCPCS,J0175,"Inj, donanemab-azbt, 2 mg",,,0.52,908.28,39
HCPCS,J017500,"Inj, donanemab-azbt, 2 mg",,,7.42,9.51,3
HCPCS,J0177,"Inj, aflibercept hd, 1 mg",,,38.37,3329.32,40
HCPCS,J017700,"Inj, aflibercept hd, 1 mg",,,546.44,699.94,3
HCPCS,J0178,AFLIBERCEPT 40MG/ML,3330.5,2164.83,763.9,3330.5,93
HCPCS,J0178,AFLIBERCEPT INJECTION,3330.5,2164.83,1.1,3330.5,78
HCPCS,J0178,Aflibercept injection,,,1359.74,1741.69,3
HCPCS,J017800,Aflibercept injection,,,1359.74,1741.69,3
HCPCS,J0179,"INJECTION, BROLUCIZUMAB-DBLL, 1 MG",1110.17,721.61,1.1,1622.37,167
HCPCS,J0179,"Inj, brolucizumab-dbll, 1 mg",,,628.0,804.41,3
HCPCS,J017900,"Inj, brolucizumab-dbll, 1 mg",,,628.0,804.41,3
HCPCS,J0180,Agalsidase beta injection,,,28.79,8832.81,41
HCPCS,J018000,Agalsidase beta injection,,,409.97,525.13,3
HCPCS,J0184,"Inj, amisulpride, 1 mg",,,1.2,60.42,38
HCPCS,J018400,"Inj, amisulpride, 1 mg",,,20.38,26.11,3
HCPCS,J0185,"Inj., aprepitant, 1 mg",,,0.21,232.34,41
HCPCS,J018500,"Inj., aprepitant, 1 mg",,,3.04,3.9,3
HCPCS,J0190,Inj biperiden lactate/5 mg,,,9.12,60.42,9
HCPCS,J0200,Alatrofloxacin mesylate,,,52.18,2739849.3,9
HCPCS,J0202,"INJECTION, ALEMTUZUMAB",5462.75,3550.79,1.1,7113.76,78
HCPCS,J0202,"Injection, alemtuzumab",,,305.89,16514.52,41
HCPCS,J020200,"Injection, alemtuzumab",,,4355.84,5579.39,3
HCPCS,J0205,Alglucerase injection,,,43.57,2739849.3,12
HCPCS,J0206,Inj allopurinol sodium 1 mg,,,0.55,4103.47,40
HCPCS,J020600,Inj allopurinol sodium 1 mg,,,7.83,10.03,3
HCPCS,J0207,Amifostine,,,27.4,4103.47,17
HCPCS,J020700,Amifostine,,,2288.53,2931.37,3
HCPCS,J0208,"Inj, pedmark, 100 mg",,,12.01,5565.45,38
HCPCS,J020800,"Inj, pedmark, 100 mg",,,195.09,249.89,3
HCPCS,J0209,"Inj, sod thiosulfate (hope)",,,0.11,5565.45,29
HCPCS,J020900,"Inj, sod thiosulfate (hope)",,,1.71,2.19,3
HCPCS,J0210,Methyldopate hcl injection,,,43.2,232.34,17
HCPCS,J021000,Methyldopate hcl injection,,,85.44,109.44,3
HCPCS,J0211,"Inj, nithiodote, 3mg / 125mg",,,0.27,232.34,36
HCPCS,J021100,"Inj, nithiodote, 3mg / 125mg",,,4.18,5.36,3
HCPCS,J0215,Alefacept,,,54.24,2739849.3,11
HCPCS,J0216,"Inj, alfentanil hcl, 500mcg",,,4.57,11.17,15
HCPCS,J021600,"Inj, alfentanil hcl, 500mcg",,,4.57,5.86,3
HCPCS,J0217,Inj velmanase alfa-tycv 1 mg,,,58.15,20935.21,40
HCPCS,J021700,Inj velmanase alfa-tycv 1 mg,,,828.11,1060.72,3
HCPCS,J0218,Inj olipudase alfa-rpcp 1mg,,,49.44,5565.45,40
HCPCS,J021800,Inj olipudase alfa-rpcp 1mg,,,704.03,901.79,3
HCPCS,J0219,Inj aval alfa-nqpt 4mg,,,10.16,20935.21,41
HCPCS,J021900,Inj aval alfa-nqpt 4mg,,,144.71,185.36,3
HCPCS,J0220,Alglucosidase alfa injection,,,148.86,16514.52,16
HCPCS,J022000,Alglucosidase alfa injection,,,416.52,533.52,3
HCPCS,J0221,Lumizyme injection,,,25.92,20935.21,41
HCPCS,J022100,Lumizyme injection,,,369.15,472.85,3
HCPCS,J0222,"Inj., patisiran, 0.1 mg",,,12.5,16514.52,41
HCPCS,J022200,"Inj., patisiran, 0.1 mg",,,177.95,227.93,3
HCPCS,J0223,Inj givosiran 0.5 mg,,,15.09,20935.21,41
HCPCS,J022300,Inj givosiran 0.5 mg,,,214.83,275.17,3
HCPCS,J0224,"Inj. lumasiran, 0.5 mg",,,41.0,16514.52,41
HCPCS,J022400,"Inj. lumasiran, 0.5 mg",,,583.88,747.89,3
HCPCS,J0225,"Inj, vutrisiran, 1 mg",,,626.2,16514.52,41
HCPCS,J022500,"Inj, vutrisiran, 1 mg",,,8917.02,11421.8,3
HCPCS,J0248,"Inj, remdesivir, 1 mg",,,0.86,840.33,41
HCPCS,J024800,"Inj, remdesivir, 1 mg",,,12.28,15.73,3
HCPCS,J0256,ALPHA 1 PROTEINASE INHIBITOR,15.61,10.15,3.75,3329.32,93
HCPCS,J0256,Alpha 1 proteinase inhibitor,,,9.56,12.24,3
HCPCS,J025600,Alpha 1 proteinase inhibitor,,,9.56,12.24,3
HCPCS,J0257,Glassia injection,,,0.71,3329.32,41
HCPCS,J025700,Glassia injection,,,10.13,12.97,3
HCPCS,J0270,ALPROSTADIL 1.25MCG,493.95,321.07,1.01,493.95,75
HCPCS,J0270,"ALPROSTADIL, PER 1.25MCG",493.95,321.07,1.01,493.95,75
HCPCS,J0270,Alprostadil for injection,,,21.95,28.11,3
HCPCS,J027000,Alprostadil for injection,,,21.95,28.11,3
HCPCS,J0275,Alprostadil urethral suppos,,,7.87,2739849.3,15
HCPCS,J027500,Alprostadil urethral suppos,,,87.59,112.2,3
HCPCS,J0278,Amikacin sulfate injection,,,0.86,11.17,19
HCPCS,J027800,Amikacin sulfate injection,,,1.1,1.41,3
HCPCS,J0280,AMINOPHYLLINE 500MG/20ML,7.5,4.88,1.64,23.73,75
HCPCS,J0280,Aminophyllin 250 mg inj,,,18.53,23.73,3
HCPCS,J028000,Aminophyllin 250 mg inj,,,18.53,23.73,3
HCPCS,J0281,Inj aminocaproic acid 1 gram,,,2.79,60.42,16
HCPCS,J028100,Inj aminocaproic acid 1 gram,,,2.83,3.63,3
HCPCS,J0282,Amiodarone hcl,,,0.52,60.42,19
HCPCS,J028200,Amiodarone hcl,,,0.73,0.93,3
HCPCS,J0283,"Inj, amiodarone (nexterone)",,,4.43,2739849.3,19
HCPCS,J028300,"Inj, amiodarone (nexterone)",,,4.5,5.77,3
HCPCS,J0285,Amphotericin b,,,26.14,107.65,19
HCPCS,J028500,Amphotericin b,,,77.06,98.7,3
HCPCS,J0287,Amphotericin b lipid complex,,,10.07,232.34,25
HCPCS,J028700,Amphotericin b lipid complex,,,22.43,28.73,3
HCPCS,J0288,Ampho b cholesteryl sulfate,,,27.4,164.23,11
HCPCS,J0289,Amphotericin b liposome inj,,,2.59,908.28,41
HCPCS,J028900,Amphotericin b liposome inj,,,36.88,47.24,3
HCPCS,J0290,AMPICILLIN 500 MG INJ,10.71,6.96,0.6,10.71,78
HCPCS,J0290,AMPICILLIN SODIUM 500 MG,10.71,6.96,1.03,11.17,75
HCPCS,J0290,Ampicillin 500 mg inj,,,1.05,1.35,3
HCPCS,J029000,Ampicillin 500 mg inj,,,1.05,1.35,3
HCPCS,J0291,"Inj., plazomicin, 5 mg",,,0.44,232.34,41
HCPCS,J029100,"Inj., plazomicin, 5 mg",,,6.25,8.0,3
HCPCS,J0295,Ampicillin sulbactam 1.5 gm,,,2.33,11.17,19
HCPCS,J029500,Ampicillin sulbactam 1.5 gm,,,2.37,3.03,3
HCPCS,J0300,Amobarbital 125 mg inj,,,24.34,501.42,18
HCPCS,J030000,Amobarbital 125 mg inj,,,391.46,501.42,3
HCPCS,J0330,Succinycholine chloride inj,,,1.24,11.17,16
HCPCS,J033000,Succinycholine chloride inj,,,1.82,2.33,3
HCPCS,J0348,Anidulafungin injection,,,0.63,60.42,19
HCPCS,J034800,Anidulafungin injection,,,0.91,1.16,3
HCPCS,J0349,"Inj, rezafungin, 1 mg",,,1.35,60.42,40
HCPCS,J034900,"Inj, rezafungin, 1 mg",,,19.26,24.67,3
HCPCS,J0350,Injection anistreplase 30 u,,,4882.66,2739849.3,9
HCPCS,J0360,"HYDRALAZINE HCL, TO 20 MG",40.0,26.0,7.68,40.0,75
HCPCS,J0360,Hydralazine hcl injection,,,7.81,10.01,3
HCPCS,J036000,Hydralazine hcl injection,,,7.81,10.01,3
HCPCS,J0364,Apomorphine hydrochloride,,,74.15,465.3,16
HCPCS,J036400,Apomorphine hydrochloride,,,74.15,94.98,3
HCPCS,J0365,"Aprotonin, 10,000 kiu",,,5.57,2739849.3,11
HCPCS,J0380,Inj metaraminol bitartrate,,,2.09,2739849.3,11
HCPCS,J0390,Chloroquine injection,,,36.88,60.42,11
HCPCS,J039000,Chloroquine injection,,,36.88,47.24,3
HCPCS,J0391,"Inj, artesunate, 1mg",,,6.48,4103.47,38
HCPCS,J039100,"Inj, artesunate, 1mg",,,104.43,133.77,3
HCPCS,J0395,Arbutamine hcl injection,,,52.18,2739849.3,9
HCPCS,J0400,Aripiprazole injection,,,0.69,60.42,16
HCPCS,J040000,Aripiprazole injection,,,1.53,1.96,3
HCPCS,J0401,"Inj, abilify maintena, 1 mg",,,0.91,3329.32,41
HCPCS,J040100,"Inj, abilify maintena, 1 mg",,,12.96,16.6,3
HCPCS,J0402,"Inj, abilify asimtufii, 1 mg",,,0.75,3329.32,40
HCPCS,J040200,"Inj, abilify asimtufii, 1 mg",,,10.72,13.73,3
HCPCS,J0456,AZITHROMYCIN 500 MG INJ,27.76,18.04,3.58,27.76,75
HCPCS,J0456,Azithromycin,,,3.63,4.65,3
HCPCS,J045600,Azithromycin,,,3.63,4.65,3
HCPCS,J0457,"Injection, aztreonam, 100 mg",,,2.58,60.42,19
HCPCS,J045700,"Injection, aztreonam, 100 mg",,,3.97,5.08,3
HCPCS,J0458,Aztreonam/avibactam 10 mg,,,0.21,5565.45,30
HCPCS,J045800,Aztreonam/avibactam 10 mg,,,2.99,3.83,3
HCPCS,J0461,Atropine sulfate injection,,,0.09,11.17,19
HCPCS,J046100,Atropine sulfate injection,,,0.18,0.23,3
HCPCS,J0462,"Atropine sulf, nte, 0.01 mg",,,0.23,11.17,16
HCPCS,J046200,"Atropine sulf, nte, 0.01 mg",,,0.23,0.3,3
HCPCS,J0463,Inj atr sulf(fres equ).01 mg,,,9.64,11.17,8
HCPCS,J0470,Dimecaprol injection,,,52.18,163.88,18
HCPCS,J047000,Dimecaprol injection,,,114.24,146.33,3
HCPCS,J0475,"BACLOFEN 2,000MCG/ML INTRTHCL SOLUTION",29.0,18.85,6.96,840.33,93
HCPCS,J0475,Baclofen 10 mg injection,,,323.02,413.75,3
HCPCS,J0475,GABLOFEN 1000MCG/ML 20 MG/20ML,442.0,287.3,106.08,840.33,93
HCPCS,J0475,W KIT REFILL LIORESAL INTRATHCL,774.15,503.2,174.58,840.33,93
HCPCS,J047500,Baclofen 10 mg injection,,,323.02,413.75,3
HCPCS,J0476,BACLOFEN 50 MCG FOR TRIAL,263.8,171.47,52.18,263.8,75
HCPCS,J0476,BACLOFEN 50MCG/ML SOLUTION,29.0,18.85,6.32,135.68,75
HCPCS,J0476,Baclofen intrathecal trial,,,105.93,135.68,3
HCPCS,J047600,Baclofen intrathecal trial,,,105.93,135.68,3
HCPCS,J0480,Basiliximab,,,597.63,12264.98,41
HCPCS,J048000,Basiliximab,,,8510.3,10900.84,3
HCPCS,J0485,Belatacept injection,,,0.49,1622.37,41
HCPCS,J048500,Belatacept injection,,,6.92,8.87,3
HCPCS,J0490,BELIMUMAB INJECTION 10 MG,200.46,130.3,48.11,3329.32,93
HCPCS,J0490,Belimumab injection,,,101.74,130.32,3
HCPCS,J049000,Belimumab injection,,,101.74,130.32,3
HCPCS,J0491,Inj anifrolumab-fnia 1mg,,,2.29,4103.47,41
HCPCS,J049100,Inj anifrolumab-fnia 1mg,,,32.65,41.82,3
HCPCS,J0500,Dicyclomine injection,,,19.82,68.42,19
HCPCS,J050000,Dicyclomine injection,,,20.17,25.83,3
HCPCS,J0515,Inj benztropine mesylate,,,19.13,60.42,19
HCPCS,J051500,Inj benztropine mesylate,,,24.6,31.51,3
HCPCS,J0517,"Inj., benralizumab, 1 mg",,,20.5,5653.6,41
HCPCS,J051700,"Inj., benralizumab, 1 mg",,,291.87,373.85,3
HCPCS,J0520,Bethanechol chloride inject,,,9.65,2739849.3,14
HCPCS,J052000,Bethanechol chloride inject,,,10.0,12.81,3
HCPCS,J0525,Inj cefotetan disodium 10 mg,,,0.52,60.42,13
HCPCS,J052500,Inj cefotetan disodium 10 mg,,,0.52,0.66,3
HCPCS,J0558,Peng benzathine/procaine inj,,,2.44,164.23,41
HCPCS,J055800,Peng benzathine/procaine inj,,,34.75,44.51,3
HCPCS,J0561,PENICILLIN G BENZ INJ 100000,15.83,10.29,3.8,164.23,93
HCPCS,J0561,Penicillin g benzathine inj,,,56.91,72.89,3
HCPCS,J056100,Penicillin g benzathine inj,,,56.91,72.89,3
HCPCS,J0565,"Inj, bezlotoxumab, 10 mg",,,4.98,3329.32,41
HCPCS,J056500,"Inj, bezlotoxumab, 10 mg",,,70.9,90.81,3
HCPCS,J0567,"Inj., cerliponase alfa 1 mg",,,15.15,16514.52,30
HCPCS,J056700,"Inj., cerliponase alfa 1 mg",,,250.41,320.75,3
HCPCS,J0570,Buprenorphine implant 74.2mg,,,1311.75,3594.2,14
HCPCS,J057000,Buprenorphine implant 74.2mg,,,2643.3,3385.8,3
HCPCS,J0571,Buprenorphine oral 1mg,,,0.57,60.42,16
HCPCS,J057100,Buprenorphine oral 1mg,,,0.57,0.73,3
HCPCS,J0572,Bupren/nal up to 3mg bupreno,,,8.37,60.42,14
HCPCS,J057200,Bupren/nal up to 3mg bupreno,,,8.37,10.72,3
HCPCS,J0573,Bupren/nal 3.1 to 6mg bupren,,,16.57,60.42,14
HCPCS,J057300,Bupren/nal 3.1 to 6mg bupren,,,16.57,21.23,3
HCPCS,J0574,Bupren/nal 6.1 to 10mg bupre,,,16.57,60.42,14
HCPCS,J057400,Bupren/nal 6.1 to 10mg bupre,,,16.57,21.23,3
HCPCS,J0575,Bupren/nal over 10mg bupreno,,,33.14,60.42,14
HCPCS,J057500,Bupren/nal over 10mg bupreno,,,33.14,42.45,3
HCPCS,J0576,Inj buprenorph (brixadi) 1mg,,,35.18,60.42,9
HCPCS,J0577,"Inj, brixadi, 7 days or less",,,52.18,974.52,40
HCPCS,J057700,"Inj, brixadi, 7 days or less",,,747.69,957.71,3
HCPCS,J0578,"Inj brixadi, more than 7 day",,,52.18,3898.09,40
HCPCS,J057800,"Inj brixadi, more than 7 day",,,2990.77,3830.88,3
HCPCS,J0582,Bivalirudin (endo) 1 mg,,,0.25,164.23,16
HCPCS,J058200,Bivalirudin (endo) 1 mg,,,0.25,0.32,3
HCPCS,J0583,Bivalirudin,,,0.27,164.23,19
HCPCS,J058300,Bivalirudin,,,0.28,0.36,3
HCPCS,J0584,"Injection, burosumab-twza 1m",,,62.25,16514.52,41
HCPCS,J058400,"Injection, burosumab-twza 1m",,,886.48,1135.49,3
HCPCS,J0585,BOTOX PER UNIT,14.0,9.1,1.1,18.37,78
HCPCS,J0585,BOTULINUM TOXIN A PER 1 UNIT,20.85,13.55,1.1,20.85,78
HCPCS,J0585,BOTULINUM TOXIN TYPE A/UNIT,20.85,13.55,5.0,840.33,93
HCPCS,J0585,"Injection,onabotulinumtoxina",,,11.59,14.84,3
HCPCS,J058500,"Injection,onabotulinumtoxina",,,11.59,14.84,3
HCPCS,J0586,ABOBOTULINUMTOXINA,21.97,14.28,1.1,27.55,78
HCPCS,J0586,ABOBOTULINUMTOXINA 5 UNITS,21.97,14.28,5.27,840.33,93
HCPCS,J0586,Abobotulinumtoxina,,,15.66,20.06,3
HCPCS,J0586,DYSPORT 5 UNITS (SP),23.35,15.18,1.1,27.55,78
HCPCS,J058600,Abobotulinumtoxina,,,15.66,20.06,3
HCPCS,J0587,BOTULINUM TOX B INJ PER 100U,40.65,26.42,9.76,840.33,93
HCPCS,J0587,BOTULINUM TOXIN TYPE B,20.9,13.59,1.1,39.79,78
HCPCS,J0587,"Inj, rimabotulinumtoxinb",,,23.66,30.3,3
HCPCS,J058700,"Inj, rimabotulinumtoxinb",,,23.66,30.3,3
HCPCS,J0588,INCOBOTULINUMTOXIN A,15.31,9.95,1.1,15.31,78
HCPCS,J0588,INCOBOTULINUMTOXIN A 1 UNIT,15.31,9.95,3.67,840.33,93
HCPCS,J0588,Incobotulinumtoxin a,,,9.35,11.97,3
HCPCS,J0588,XEOMIN PER UNIT,9.96,6.47,1.1,15.31,78
HCPCS,J058800,Incobotulinumtoxin a,,,9.35,11.97,3
HCPCS,J0589,Inj daxibotulinumtoxina-lanm,,,0.39,232.34,40
HCPCS,J058900,Inj daxibotulinumtoxina-lanm,,,5.54,7.09,3
HCPCS,J0591,"Inj deoxycholic acid, 1 mg",,,32.04,2739849.3,14
HCPCS,J059100,"Inj deoxycholic acid, 1 mg",,,32.04,41.04,3
HCPCS,J0592,Buprenorphine hydrochloride,,,4.26,11.32,19
HCPCS,J059200,Buprenorphine hydrochloride,,,7.49,9.6,3
HCPCS,J0593,"Inj., lanadelumab-flyo, 1 mg",,,10.9,2739849.3,33
HCPCS,J059300,"Inj., lanadelumab-flyo, 1 mg",,,155.2,198.79,3
HCPCS,J0594,Busulfan injection,,,0.11,629.95,41
HCPCS,J059400,Busulfan injection,,,1.58,2.03,3
HCPCS,J0595,Butorphanol tartrate 1 mg,,,3.05,12.63,19
HCPCS,J059500,Butorphanol tartrate 1 mg,,,9.86,12.63,3
HCPCS,J0596,"Injection, ruconest",,,4.6,8832.81,41
HCPCS,J059600,"Injection, ruconest",,,65.47,83.86,3
HCPCS,J0597,"C-1 esterase, berinert",,,9.48,5565.45,41
HCPCS,J059700,"C-1 esterase, berinert",,,135.03,172.96,3
HCPCS,J0598,"C-1 esterase, cinryze",,,8.2,5565.45,41
HCPCS,J059800,"C-1 esterase, cinryze",,,116.82,149.64,3
HCPCS,J0599,"Inj., haegarda 10 units",,,13.89,5653.6,16
HCPCS,J059900,"Inj., haegarda 10 units",,,25.85,33.11,3
HCPCS,J0600,Edetate calcium disodium inj,,,776.21,17679.85,41
HCPCS,J060000,Edetate calcium disodium inj,,,11053.23,14158.07,3
HCPCS,J0601,Sevelamer carbonate 20 mg,,,0.02,60.42,15
HCPCS,J060100,Sevelamer carbonate 20 mg,,,0.02,0.02,3
HCPCS,J0602,Sevelamer carbonate pdr 20mg,,,0.11,60.42,15
HCPCS,J060200,Sevelamer carbonate pdr 20mg,,,0.11,0.14,3
HCPCS,J0603,Sevelamer hydrochloride 20mg,,,0.21,60.42,15
HCPCS,J060300,Sevelamer hydrochloride 20mg,,,0.21,0.27,3
HCPCS,J0604,"Cinacalcet, esrd on dialysis",,,0.04,2739849.3,17
HCPCS,J060400,"Cinacalcet, esrd on dialysis",,,0.04,0.05,3
HCPCS,J0605,Sucroferric oxyhydroxide 5mg,,,0.37,60.42,15
HCPCS,J060500,Sucroferric oxyhydroxide 5mg,,,0.37,0.48,3
HCPCS,J0606,"Inj, etelcalcetide, 0.1 mg",,,0.29,164.23,32
HCPCS,J060600,"Inj, etelcalcetide, 0.1 mg",,,8.81,11.29,3
HCPCS,J0607,Lanthanum carbonate oral 5mg,,,0.09,60.42,15
HCPCS,J060700,Lanthanum carbonate oral 5mg,,,0.09,0.11,3
HCPCS,J0608,Lanthanum carbonate pwdr 5mg,,,0.12,60.42,15
HCPCS,J060800,Lanthanum carbonate pwdr 5mg,,,0.12,0.16,3
HCPCS,J0609,Ferric citrate orl 3 mg iron,,,0.06,60.42,15
HCPCS,J060900,Ferric citrate orl 3 mg iron,,,0.23,0.3,3
HCPCS,J0610,CALCIUM GLUCONATE INJ TO 10 ML,7.5,4.88,1.64,11.17,74
HCPCS,J0611,Calcium glucon (wg critical),,,9.64,11.17,8
HCPCS,J0612,"Inj, calcium gluconate, nos",,,0.05,11.17,19
HCPCS,J061200,"Inj, calcium gluconate, nos",,,0.05,0.07,3
HCPCS,J0613,Calcium glucon (wg critical),,,0.09,11.17,19
HCPCS,J061300,Calcium glucon (wg critical),,,0.16,0.21,3
HCPCS,J0614,"Inj, treosulfan, 50 mg",,,3.9,5565.45,30
HCPCS,J061400,"Inj, treosulfan, 50 mg",,,55.55,71.16,3
HCPCS,J0615,"Calcium acetate, oral, 23 mg",,,0.02,60.42,15
HCPCS,J061500,"Calcium acetate, oral, 23 mg",,,0.04,0.05,3
HCPCS,J0616,Inj metoprolol tartrate 1 mg,,,0.21,11.17,16
HCPCS,J061600,Inj metoprolol tartrate 1 mg,,,0.21,0.27,3
HCPCS,J0618,"Inj, calcium chloride, 2 mg",,,0.05,11.17,13
HCPCS,J061800,"Inj, calcium chloride, 2 mg",,,0.05,0.07,3
HCPCS,J0620,Calcium glycer & lact/10 ml,,,19.24,60.42,15
HCPCS,J062000,Calcium glycer & lact/10 ml,,,27.41,35.11,3
HCPCS,J0630,CALCITONIN SALMON 400 UNITS,245.75,159.74,53.57,3329.32,83
HCPCS,J0630,Calcitonin salmon injection,,,1708.8,2188.8,3
HCPCS,J063000,Calcitonin salmon injection,,,1708.8,2188.8,3
HCPCS,J0636,Inj calcitriol per 0.1 mcg,,,0.73,11.17,16
HCPCS,J063600,Inj calcitriol per 0.1 mcg,,,2.12,2.71,3
HCPCS,J0637,Caspofungin acetate,,,5.53,60.42,19
HCPCS,J063700,Caspofungin acetate,,,6.8,8.71,3
HCPCS,J0638,Canakinumab injection,,,18.47,8832.81,41
HCPCS,J063800,Canakinumab injection,,,262.98,336.85,3
HCPCS,J0640,LEUCOVORIN CALCIUM PER 50 MG,67.75,44.04,6.72,67.75,67
HCPCS,J0640,Leucovorin calcium injection,,,6.84,8.76,3
HCPCS,J064000,Leucovorin calcium injection,,,6.84,8.76,3
HCPCS,J0641,Inj levoleucovorin nos 0.5mg,,,0.05,412.04,20
HCPCS,J064100,Inj levoleucovorin nos 0.5mg,,,0.09,0.11,3
HCPCS,J0642,"Injection, khapzory, 0.5 mg",,,1.37,840.33,20
HCPCS,J064200,"Injection, khapzory, 0.5 mg",,,2.51,3.21,3
HCPCS,J0650,"Inj, levothyroxine nos 10mcg",,,10.47,164.23,18
HCPCS,J065000,"Inj, levothyroxine nos 10mcg",,,10.64,13.63,3
HCPCS,J0651,"Inj, levothyroxine, freskabi",,,0.87,164.23,40
HCPCS,J065100,"Inj, levothyroxine, freskabi",,,12.35,15.82,3
HCPCS,J0652,"Inj, levothyroxine, hikma",,,3.97,164.23,26
HCPCS,J065200,"Inj, levothyroxine, hikma",,,13.69,17.53,3
HCPCS,J0654,"Inj, liothyronine, 1 mcg",,,4.94,164.23,27
HCPCS,J065400,"Inj, liothyronine, 1 mcg",,,94.13,120.57,3
HCPCS,J0665,"Inj, bupivacaine, nos, 0.5mg",,,0.02,11.17,19
HCPCS,J066500,"Inj, bupivacaine, nos, 0.5mg",,,0.02,0.02,3
HCPCS,J0666,"Inj, bupivacaine liposome",,,0.18,11.17,39
HCPCS,J066600,"Inj, bupivacaine liposome",,,2.56,3.28,3
HCPCS,J0668,"Instill, bupivac and meloxic",,,0.1,11.17,27
HCPCS,J066800,"Instill, bupivac and meloxic",,,1.62,2.07,3
HCPCS,J0670,INJ MEPIVACAINE PER 10 ML,9.0,5.85,1.96,11.17,75
HCPCS,J0670,Inj mepivacaine hcl/10 ml,,,6.68,8.55,3
HCPCS,J067000,Inj mepivacaine hcl/10 ml,,,6.68,8.55,3
HCPCS,J0675,"Inj, carboprost, 0.1 mg",,,1.71,82.08,27
HCPCS,J067500,"Inj, carboprost, 0.1 mg",,,64.08,82.08,3
HCPCS,J0681,Inj ceftobipole medocarl 3mg,,,0.14,232.34,27
HCPCS,J068100,Inj ceftobipole medocarl 3mg,,,2.26,2.9,3
HCPCS,J0687,Inj cefazolin (wg crit care),,,1.04,11.17,25
HCPCS,J068700,Inj cefazolin (wg crit care),,,1.57,2.01,3
HCPCS,J0688,"Inj cefazolin sodium, hikma",,,0.98,11.17,25
HCPCS,J068800,"Inj cefazolin sodium, hikma",,,1.57,2.01,3
HCPCS,J0689,"Inj cefazolin sodium, baxter",,,0.75,11.17,20
HCPCS,J068900,"Inj cefazolin sodium, baxter",,,2.26,2.9,3
HCPCS,J0690,ANCEF PER 500 MG,17.0,11.05,1.45,17.0,75
HCPCS,J0690,CEFAZOLIN SODIUM INJECTION,2.4,1.56,0.61,3.06,78
HCPCS,J0690,Cefazolin sodium injection,,,1.48,1.89,3
HCPCS,J069000,Cefazolin sodium injection,,,1.48,1.89,3
HCPCS,J0691,Inj lefamulin 1 mg,,,0.72,232.34,18
HCPCS,J069100,Inj lefamulin 1 mg,,,1.46,1.87,3
HCPCS,J0692,CEFEPIME HCL INJ 500 MG,36.65,23.82,1.52,36.65,75
HCPCS,J0692,Cefepime hcl for injection,,,1.55,1.98,3
HCPCS,J069200,Cefepime hcl for injection,,,1.55,1.98,3
HCPCS,J0693,"Inj., cefiderocol, 5 mg",,,200.66,232.34,8
HCPCS,J0694,Cefoxitin sodium injection,,,4.83,13.92,19
HCPCS,J069400,Cefoxitin sodium injection,,,8.44,10.81,3
HCPCS,J0695,Inj ceftolozane tazobactam,,,1.12,232.34,41
HCPCS,J069500,Inj ceftolozane tazobactam,,,15.93,20.41,3
HCPCS,J0696,CEFTRIAXONE PER 250 MG,6.4,4.16,0.81,11.17,75
HCPCS,J0696,CEFTRIAXONE SODIUM INJECTION,6.4,4.16,0.49,6.4,78
HCPCS,J0696,Ceftriaxone sodium injection,,,0.82,1.05,3
HCPCS,J069600,Ceftriaxone sodium injection,,,0.82,1.05,3
HCPCS,J0697,Sterile cefuroxime injection,,,2.12,11.17,19
HCPCS,J069700,Sterile cefuroxime injection,,,3.65,4.67,3
HCPCS,J0698,"CEFOTAXIME SODIUM, 1 G",19.11,12.42,4.17,26.81,75
HCPCS,J0698,Cefotaxime sodium injection,,,20.93,26.81,3
HCPCS,J069800,Cefotaxime sodium injection,,,20.93,26.81,3
HCPCS,J0699,"Inj, cefiderocol, 10 mg",,,0.3,232.34,41
HCPCS,J069900,"Inj, cefiderocol, 10 mg",,,4.31,5.52,3
HCPCS,J0701,Inj. cefepime hcl (baxter),,,1.81,15.45,20
HCPCS,J070100,Inj. cefepime hcl (baxter),,,10.63,13.61,3
HCPCS,J0702,BETAMETHASONE ACET&SOD PHOSP,12.81,8.33,1.1,21.43,78
HCPCS,J0702,Betamethasone acet&sod phosp,,,12.3,15.75,3
HCPCS,J0702,CELESTONE IM 3MG,12.81,8.33,2.79,16.15,75
HCPCS,J070200,Betamethasone acet&sod phosp,,,12.3,15.75,3
HCPCS,J0703,"Inj, cefepime hcl (b braun)",,,1.81,14.44,20
HCPCS,J070300,"Inj, cefepime hcl (b braun)",,,8.81,11.29,3
HCPCS,J0706,Caffeine citrate injection,,,2.19,11.17,15
HCPCS,J070600,Caffeine citrate injection,,,2.58,3.31,3
HCPCS,J0710,Cephapirin sodium injection,,,3.01,2739849.3,10
HCPCS,J0712,Ceftaroline fosamil inj,,,0.53,232.34,41
HCPCS,J071200,Ceftaroline fosamil inj,,,7.55,9.67,3
HCPCS,J0713,"CEFTAZIDIME, PER 500 MG, INJ",77.26,50.22,2.57,77.26,75
HCPCS,J0713,Inj ceftazidime per 500 mg,,,2.62,3.35,3
HCPCS,J071300,Inj ceftazidime per 500 mg,,,2.62,3.35,3
HCPCS,J0714,Ceftazidime and avibactam,,,13.09,465.3,41
HCPCS,J071400,Ceftazidime and avibactam,,,186.38,238.74,3
HCPCS,J0715,Ceftizoxime sodium / 500 mg,,,6.07,60.42,9
HCPCS,J0716,Centruroides immune f(ab),,,131.42,14353.33,38
HCPCS,J071600,Centruroides immune f(ab),,,11205.67,14353.33,3
HCPCS,J0717,CERTOLIZUMAB PEGOL INJ 1 MG,33.3,21.65,3.86,3329.32,93
HCPCS,J0717,Certolizumab pegol inj 1mg,,,6.89,8.82,3
HCPCS,J071700,Certolizumab pegol inj 1mg,,,6.89,8.82,3
HCPCS,J0720,Chloramphenicol sodium injec,,,6.28,133.11,30
HCPCS,J072000,Chloramphenicol sodium injec,,,103.92,133.11,3
HCPCS,J0725,Chorionic gonadotropin/1000u,,,25.47,63.49,19
HCPCS,J072500,Chorionic gonadotropin/1000u,,,27.41,35.11,3
HCPCS,J0735,Clonidine hydrochloride,,,27.22,60.42,19
HCPCS,J073500,Clonidine hydrochloride,,,30.67,39.28,3
HCPCS,J0736,"Inj, clindamycin phosp 300mg",,,2.27,60.42,19
HCPCS,J073600,"Inj, clindamycin phosp 300mg",,,3.4,4.35,3
HCPCS,J0737,"Inj, clindamycin (baxter)",,,2.21,60.42,19
HCPCS,J073700,"Inj, clindamycin (baxter)",,,4.18,5.36,3
HCPCS,J0738,"Hiv prep, inj, lenacapavir",,,2.02,4103.47,30
HCPCS,J073800,"Hiv prep, inj, lenacapavir",,,28.71,36.78,3
HCPCS,J0739,"Hiv prep, inj, cabotegravir",,,0.89,4103.47,39
HCPCS,J073900,"Hiv prep, inj, cabotegravir",,,12.73,16.3,3
HCPCS,J0740,Cidofovir injection,,,65.56,2111.65,41
HCPCS,J074000,Cidofovir injection,,,933.57,1195.81,3
HCPCS,J0741,"Inj, cabote rilpivir 2mg 3mg",,,3.02,5653.6,41
HCPCS,J074100,"Inj, cabote rilpivir 2mg 3mg",,,43.0,55.08,3
HCPCS,J0742,Inj imip 4 cilas 4 releb 2mg,,,2.4,232.34,27
HCPCS,J074200,Inj imip 4 cilas 4 releb 2mg,,,4.63,5.93,3
HCPCS,J0743,Cilastatin sodium injection,,,7.0,60.42,19
HCPCS,J074300,Cilastatin sodium injection,,,12.64,16.19,3
HCPCS,J0744,Ciprofloxacin iv,,,0.97,11.17,19
HCPCS,J074400,Ciprofloxacin iv,,,3.56,4.56,3
HCPCS,J0745,Inj codeine phosphate /30 mg,,,1.37,11.17,14
HCPCS,J074500,Inj codeine phosphate /30 mg,,,2.71,3.47,3
HCPCS,J0750,"Hiv prep, ftc/tdf 200/300mg",,,0.17,60.42,39
HCPCS,J075000,"Hiv prep, ftc/tdf 200/300mg",,,2.39,3.06,3
HCPCS,J0751,"Hiv prep, ftc/taf 200/25mg",,,8.92,165.49,39
HCPCS,J075100,"Hiv prep, ftc/taf 200/25mg",,,126.97,162.63,3
HCPCS,J0752,"Hiv prep, oral lenacapavir",,,77.89,1445.71,30
HCPCS,J075200,"Hiv prep, oral lenacapavir",,,1109.21,1420.78,3
HCPCS,J0759,"Inj, clevidipine, 1 mg",,,0.36,164.23,27
HCPCS,J075900,"Inj, clevidipine, 1 mg",,,7.53,9.64,3
HCPCS,J0770,Colistimethate sodium inj,,,16.28,60.42,19
HCPCS,J077000,Colistimethate sodium inj,,,21.5,27.54,3
HCPCS,J0775,"Collagenase, clost hist inj",,,134.84,172.71,3
HCPCS,J0775,XIAFLEX INJ 0.01 MG,145.79,94.76,34.99,4103.47,93
HCPCS,J0775,XIAFLEX PER VIAL,10058.88,6538.27,68.97,10058.88,93
HCPCS,J077500,"Collagenase, clost hist inj",,,134.84,172.71,3
HCPCS,J0780,Prochlorperazine injection,,,3.89,11.17,19
HCPCS,J078000,Prochlorperazine injection,,,4.49,5.75,3
HCPCS,J0791,Inj crizanlizumab-tmca 5mg,,,16.2,1622.37,41
HCPCS,J079100,Inj crizanlizumab-tmca 5mg,,,230.67,295.47,3
HCPCS,J0795,Corticorelin ovine triflutal,,,9.05,908.28,12
HCPCS,J0799,"Hiv prep, fda approved, noc",,,52.18,60.42,8
HCPCS,J0800,CORTICOTROPIN INJ UP TO 40 U,396.99,258.04,86.54,9569.16,74
HCPCS,J0800,Corticotropin injection,,,7470.66,9569.16,3
HCPCS,J080000,Corticotropin injection,,,7470.66,9569.16,3
HCPCS,J0801,Inj. acthar gel to 40 units,,,521.57,11221.18,33
HCPCS,J080100,Inj. acthar gel to 40 units,,,7427.1,9513.37,3
HCPCS,J0802,"Inj. (ani), up to 40 units",,,443.97,9176.23,33
HCPCS,J080200,"Inj. (ani), up to 40 units",,,6322.1,8097.97,3
HCPCS,J0834,COSYNTROPIN PER 0.25 MG,90.0,58.5,19.62,90.0,75
HCPCS,J0834,"Inj., cosyntropin, 0.25 mg",,,36.76,47.08,3
HCPCS,J083400,"Inj., cosyntropin, 0.25 mg",,,36.76,47.08,3
HCPCS,J0840,Crotalidae poly immune fab,,,228.32,8832.81,41
HCPCS,J084000,Crotalidae poly immune fab,,,3251.21,4164.47,3
HCPCS,J0841,Inj crotalidae im f(ab')2 eq,,,615.65,11229.36,41
HCPCS,J084100,Inj crotalidae im f(ab')2 eq,,,8766.78,11229.36,3
HCPCS,J0850,Cytomegalovirus imm iv /vial,,,226.04,5653.6,41
HCPCS,J085000,Cytomegalovirus imm iv /vial,,,3218.83,4122.99,3
HCPCS,J0870,"Injection, imetelstat, 1 mg",,,7.29,8832.81,39
HCPCS,J087000,"Injection, imetelstat, 1 mg",,,103.77,132.92,3
HCPCS,J0872,Daptomycin (xellia) unrefrig,,,0.04,60.42,25
HCPCS,J087200,Daptomycin (xellia) unrefrig,,,0.11,0.14,3
HCPCS,J0873,Inj daptomycin (xellia),,,0.04,60.42,25
HCPCS,J087300,Inj daptomycin (xellia),,,0.05,0.07,3
HCPCS,J0874,"Inj, daptomycin (baxter)",,,0.1,2739849.3,18
HCPCS,J087400,"Inj, daptomycin (baxter)",,,0.11,0.14,3
HCPCS,J0875,"Injection, dalbavancin",,,1.95,5653.6,41
HCPCS,J087500,"Injection, dalbavancin",,,27.75,35.55,3
HCPCS,J0877,"Inj, daptomycin (hospira)",,,0.05,60.42,20
HCPCS,J087700,"Inj, daptomycin (hospira)",,,0.11,0.14,3
HCPCS,J0878,Daptomycin injection,,,0.05,0.07,3
HCPCS,J0878,INJ DAPTOMYCIN 1 MG,2.3,1.5,0.05,60.42,75
HCPCS,J087800,Daptomycin injection,,,0.05,0.07,3
HCPCS,J0879,"Difelikefalin, esrd on dialy",,,0.15,465.3,23
HCPCS,J087900,"Difelikefalin, esrd on dialy",,,0.5,0.64,3
HCPCS,J0881,"DARBEPOETIN ALFA, NON-ESRD",26.82,17.43,2.9,840.33,93
HCPCS,J0881,"Darbepoetin alfa, non-esrd",,,5.38,6.89,3
HCPCS,J088100,"Darbepoetin alfa, non-esrd",,,5.38,6.89,3
HCPCS,J0882,"Darbepoetin alfa, esrd use",,,0.38,232.34,41
HCPCS,J088200,"Darbepoetin alfa, esrd use",,,5.38,6.89,3
HCPCS,J0883,Argatroban nonesrd use 1mg,,,0.08,164.23,40
HCPCS,J088300,Argatroban nonesrd use 1mg,,,1.09,1.39,3
HCPCS,J0884,Argatroban esrd dialysis 1mg,,,0.89,164.23,19
HCPCS,J088400,Argatroban esrd dialysis 1mg,,,1.09,1.39,3
HCPCS,J0885,"EPOETIN ALFA, NON-ESRD",45.53,29.59,7.53,232.34,93
HCPCS,J0885,"Epoetin alfa, non-esrd",,,13.78,17.65,3
HCPCS,J088500,"Epoetin alfa, non-esrd",,,13.78,17.65,3
HCPCS,J0887,Epoetin beta esrd use,,,1.44,11.17,20
HCPCS,J088700,Epoetin beta esrd use,,,2.17,2.78,3
HCPCS,J0888,Epoetin beta non esrd,,,1.16,60.42,27
HCPCS,J088800,Epoetin beta non esrd,,,2.17,2.78,3
HCPCS,J0889,Daprodustat oral 1mg esrd,,,200.66,2739849.3,9
HCPCS,J0890,Peginesatide injection,,,17.63,2739849.3,14
HCPCS,J089000,Peginesatide injection,,,23.09,29.57,3
HCPCS,J0891,Argatroban nonesrd (accord),,,0.23,164.23,39
HCPCS,J089100,Argatroban nonesrd (accord),,,8.46,10.83,3
HCPCS,J0892,Argatroban dialysis (accord),,,1.82,164.23,18
HCPCS,J089200,Argatroban dialysis (accord),,,8.46,10.83,3
HCPCS,J0893,"Inj, decitabine (sun pharma)",,,1.36,412.04,20
HCPCS,J089300,"Inj, decitabine (sun pharma)",,,1.39,1.78,3
HCPCS,J0894,DECITABINE INJECTION,164.56,106.96,1.13,412.04,75
HCPCS,J0894,Decitabine injection,,,1.16,1.48,3
HCPCS,J089400,Decitabine injection,,,1.16,1.48,3
HCPCS,J0895,Deferoxamine mesylate inj,,,7.47,60.42,19
HCPCS,J089500,Deferoxamine mesylate inj,,,15.08,19.31,3
HCPCS,J0896,Inj luspatercept-aamt 0.25mg,,,5.35,8832.81,41
HCPCS,J089600,Inj luspatercept-aamt 0.25mg,,,76.13,97.52,3
HCPCS,J0897,DENOSUMAB INJECTION,107.2,69.68,1.1,107.2,78
HCPCS,J0897,Denosumab injection,,,52.44,67.17,3
HCPCS,J0897,INJ DENOSUMAB 1 MG,107.2,69.68,25.19,1559.81,93
HCPCS,J089700,Denosumab injection,,,52.44,67.17,3
HCPCS,J0898,Argatroban nonesrd (auromed),,,1.49,164.23,27
HCPCS,J089800,Argatroban nonesrd (auromed),,,2.58,3.31,3
HCPCS,J0899,"Argatroban dialysis, auromed",,,2.16,164.23,20
HCPCS,J089900,"Argatroban dialysis, auromed",,,2.58,3.31,3
HCPCS,J0901,Vadadustat oral 1mg for esrd,,,0.25,60.42,18
HCPCS,J090100,Vadadustat oral 1mg for esrd,,,0.25,0.32,3
HCPCS,J0911,Inst tauro 1.35mg/hep 100u,,,0.75,232.34,36
HCPCS,J091100,Inst tauro 1.35mg/hep 100u,,,17.8,22.8,3
HCPCS,J0945,Brompheniramine maleate inj,,,0.69,60.42,17
HCPCS,J094500,Brompheniramine maleate inj,,,1.64,2.1,3
HCPCS,J1000,Depo-estradiol cypionate inj,,,24.82,118.15,19
HCPCS,J100000,Depo-estradiol cypionate inj,,,92.24,118.15,3
HCPCS,J1010,"Inj, methylpred acetate 1 mg",,,0.12,11.17,25
HCPCS,J101000,"Inj, methylpred acetate 1 mg",,,0.21,0.27,3
HCPCS,J1020,"DEPO-MEDROL, 20 MG INJ",6.0,3.9,1.31,19.45,74
HCPCS,J1020,Methylprednisolone 20 mg inj,,,15.18,19.45,3
HCPCS,J102000,Methylprednisolone 20 mg inj,,,15.18,19.45,3
HCPCS,J1030,METHLYPREDNISOLONE 40MG,28.26,18.37,6.16,28.26,74
HCPCS,J1030,Methylprednisolone 40 mg inj,,,19.4,24.85,3
HCPCS,J103000,Methylprednisolone 40 mg inj,,,19.4,24.85,3
HCPCS,J1040,"DEPO-MEDROL, 80 MG INJ",22.0,14.3,4.8,42.7,74
HCPCS,J1040,METHYLPREDNISOLONE 80 MG INJ,52.75,34.29,1.1,52.75,72
HCPCS,J1040,Methylprednisolone 80 mg inj,,,33.34,42.7,3
HCPCS,J104000,Methylprednisolone 80 mg inj,,,33.34,42.7,3
HCPCS,J1050,Medroxyprogesterone acetate,,,0.14,60.42,16
HCPCS,J105000,Medroxyprogesterone acetate,,,1.16,1.48,3
HCPCS,J1071,Inj testosterone cypionate,,,0.03,11.17,19
HCPCS,J107100,Inj testosterone cypionate,,,0.05,0.07,3
HCPCS,J1072,"Inj, testosterone, azmiro",,,0.17,11.17,30
HCPCS,J107200,"Inj, testosterone, azmiro",,,2.37,3.03,3
HCPCS,J1073,Testosterone pellet 75 mg,,,9.3,908.28,27
HCPCS,J107300,Testosterone pellet 75 mg,,,224.56,287.64,3
HCPCS,J1094,Inj dexamethasone acetate,,,0.29,60.42,14
HCPCS,J109400,Inj dexamethasone acetate,,,0.61,0.78,3
HCPCS,J1095,"Injection, dexamethasone 9%",,,0.01,840.33,16
HCPCS,J109500,"Injection, dexamethasone 9%",,,2.46,3.15,3
HCPCS,J1096,Dexametha opth insert 0.1 mg,,,12.33,465.3,40
HCPCS,J109600,Dexametha opth insert 0.1 mg,,,175.61,224.94,3
HCPCS,J1097,Phenylep ketorolac opth soln,,,12.19,322.85,37
HCPCS,J109700,Phenylep ketorolac opth soln,,,252.05,322.85,3
HCPCS,J1098,Articaine ophthalmi 8% 0.4ml,,,52.18,60.42,8
HCPCS,J1100,DEXAMETH SOD INJ TO 1MG,1.99,1.29,0.18,11.17,75
HCPCS,J1100,Dexamethasone sodium phos,,,0.2,0.25,3
HCPCS,J110000,Dexamethasone sodium phos,,,0.2,0.25,3
HCPCS,J1105,"Dexmedetomidine film, 1 mcg",,,0.75,60.42,19
HCPCS,J1110,DEHYDROERGOTAMINE INJ  1 MG,94.24,61.26,20.54,130.14,75
HCPCS,J1110,Inj dihydroergotamine mesylt,,,101.6,130.14,3
HCPCS,J111000,Inj dihydroergotamine mesylt,,,101.6,130.14,3
HCPCS,J1120,Acetazolamid sodium injectio,,,23.4,77.05,19
HCPCS,J112000,Acetazolamid sodium injectio,,,45.55,58.35,3
HCPCS,J1130,Inj diclofenac sodium 0.5mg,,,0.45,60.42,13
HCPCS,J113000,Inj diclofenac sodium 0.5mg,,,0.45,0.57,3
HCPCS,J1160,Digoxin injection,,,9.64,25.78,19
HCPCS,J116000,Digoxin injection,,,17.03,21.82,3
HCPCS,J1162,Digoxin immune fab (ovine),,,645.87,13090.19,41
HCPCS,J116200,Digoxin immune fab (ovine),,,9197.24,11780.74,3
HCPCS,J1163,"Inj, diltiazem hcl, 0.5 mg",,,0.05,11.17,16
HCPCS,J116300,"Inj, diltiazem hcl, 0.5 mg",,,0.05,0.07,3
HCPCS,J1164,"Inj dil hyd sod chlo,0.5mg",,,9.64,11.17,8
HCPCS,J1165,Phenytoin sodium injection,,,0.45,11.17,19
HCPCS,J116500,Phenytoin sodium injection,,,1.07,1.37,3
HCPCS,J1170,DILAUDID UP TO 4 MG,28.0,18.2,6.1,28.0,74
HCPCS,J1170,Hydromorphone injection,,,8.15,10.44,3
HCPCS,J117000,Hydromorphone injection,,,8.15,10.44,3
HCPCS,J1171,"Inj, hydromorphone, 0.1 mg",,,0.09,11.17,25
HCPCS,J117100,"Inj, hydromorphone, 0.1 mg",,,0.25,0.32,3
HCPCS,J1180,Dyphylline injection,,,16.89,2739849.3,12
HCPCS,J118000,Dyphylline injection,,,16.89,21.64,3
HCPCS,J1190,Dexrazoxane hcl injection,,,7.25,1380.54,41
HCPCS,J119000,Dexrazoxane hcl injection,,,103.26,132.26,3
HCPCS,J1200,BENADRYL INJECTION TO 50 MG,8.93,5.8,1.25,11.17,75
HCPCS,J1200,DIPHENHYDRAMINE HCL INJECTIO,10.9,7.09,0.66,10.9,78
HCPCS,J1200,Diphenhydramine hcl injectio,,,1.26,1.62,3
HCPCS,J120000,Diphenhydramine hcl injectio,,,1.26,1.62,3
HCPCS,J1201,Inj. cetirizine hcl 0.5mg,,,2.14,60.42,41
HCPCS,J120100,Inj. cetirizine hcl 0.5mg,,,30.42,38.97,3
HCPCS,J1202,Miglustat oral 65 mg,,,72.52,164.23,15
HCPCS,J120200,Miglustat oral 65 mg,,,72.52,92.89,3
HCPCS,J1203,"Inj, cipaglucosidase, 5 mg",,,11.4,16514.52,40
HCPCS,J120300,"Inj, cipaglucosidase, 5 mg",,,162.34,207.94,3
HCPCS,J1205,Chlorothiazide sodium inj,,,43.9,332.5,19
HCPCS,J120500,Chlorothiazide sodium inj,,,103.47,132.54,3
HCPCS,J1212,DMSP 50ML,2047.75,1331.04,491.46,2047.75,93
HCPCS,J1212,Dimethyl sulfoxide 50% 50 ml,,,1333.63,1708.24,3
HCPCS,J121200,Dimethyl sulfoxide 50% 50 ml,,,1333.63,1708.24,3
HCPCS,J1230,Methadone injection,,,9.64,53.9,19
HCPCS,J123000,Methadone injection,,,31.51,40.36,3
HCPCS,J1240,Dimenhydrinate injection,,,1.6,24.52,19
HCPCS,J124000,Dimenhydrinate injection,,,1.64,2.1,3
HCPCS,J1245,Dipyridamole injection,,,3.62,19.17,19
HCPCS,J124500,Dipyridamole injection,,,14.97,19.17,3
HCPCS,J1246,"Inj, dinutuximab, 0.1 mg",,,192.49,2739849.3,4
HCPCS,J124600,"Inj, dinutuximab, 0.1 mg",,,192.49,246.56,3
HCPCS,J1250,DOBUTREX INJ PER 250 MG,29.0,18.85,6.32,29.0,75
HCPCS,J1250,Inj dobutamine hcl/250 mg,,,14.28,18.29,3
HCPCS,J125000,Inj dobutamine hcl/250 mg,,,14.28,18.29,3
HCPCS,J1260,Dolasetron mesylate,,,7.27,16.05,16
HCPCS,J126000,Dolasetron mesylate,,,12.53,16.05,3
HCPCS,J1265,Dopamine injection,,,0.69,11.17,19
HCPCS,J126500,Dopamine injection,,,1.42,1.82,3
HCPCS,J1267,Doripenem injection,,,0.77,164.23,12
HCPCS,J1270,"Injection, doxercalciferol",,,0.32,11.17,19
HCPCS,J127000,"Injection, doxercalciferol",,,0.55,0.71,3
HCPCS,J1271,Inj doxycycline hyclate 1 mg,,,0.18,60.42,16
HCPCS,J127100,Inj doxycycline hyclate 1 mg,,,0.18,0.23,3
HCPCS,J1290,Ecallantide injection,,,72.47,8832.81,41
HCPCS,J129000,Ecallantide injection,,,1031.96,1321.83,3
HCPCS,J1299,"Inj, eculizumab, 2 mg",,,5.63,20935.21,30
HCPCS,J129900,"Inj, eculizumab, 2 mg",,,80.15,102.67,3
HCPCS,J1300,Eculizumab injection,,,224.63,20935.21,23
HCPCS,J130000,Eculizumab injection,,,464.44,594.9,3
HCPCS,J1301,"Injection, edaravone, 1 mg",,,2.18,908.28,41
HCPCS,J130100,"Injection, edaravone, 1 mg",,,31.1,39.83,3
HCPCS,J1302,"Inj, sutimlimab-jome, 10 mg",,,2.38,5565.45,41
HCPCS,J130200,"Inj, sutimlimab-jome, 10 mg",,,33.87,43.39,3
HCPCS,J1303,"Inj., ravulizumab-cwvz 10 mg",,,28.1,20935.21,41
HCPCS,J130300,"Inj., ravulizumab-cwvz 10 mg",,,400.14,512.54,3
HCPCS,J1304,Inj tofersen intrathec 1 mg,,,20.0,16514.52,40
HCPCS,J130400,Inj tofersen intrathec 1 mg,,,284.82,364.82,3
HCPCS,J1305,"Inj, evinacumab-dgnb, 5mg",,,24.65,5565.45,41
HCPCS,J130500,"Inj, evinacumab-dgnb, 5mg",,,350.96,449.55,3
HCPCS,J1306,"Injection, inclisiran, 1 mg",,,1.59,4103.47,40
HCPCS,J130600,"Injection, inclisiran, 1 mg",,,22.59,28.93,3
HCPCS,J1307,"Inj, crovalimab-akkz, 10 mg",,,68.94,16514.52,39
HCPCS,J130700,"Inj, crovalimab-akkz, 10 mg",,,981.69,1257.44,3
HCPCS,J1308,"Inj, famotidine, 0.25 mg",,,0.02,60.42,16
HCPCS,J130800,"Inj, famotidine, 0.25 mg",,,0.02,0.02,3
HCPCS,J1320,Amitriptyline injection,,,4.7,60.42,13
HCPCS,J132000,Amitriptyline injection,,,4.7,6.02,3
HCPCS,J1322,"Elosulfase alfa, injection",,,38.99,8832.81,41
HCPCS,J132200,"Elosulfase alfa, injection",,,555.25,711.22,3
HCPCS,J1323,"Inj, elranatamab-bcmm, 1 mg",,,23.57,5565.45,40
HCPCS,J132300,"Inj, elranatamab-bcmm, 1 mg",,,335.57,429.83,3
HCPCS,J1324,Enfuvirtide injection,,,1.42,2739849.3,17
HCPCS,J132400,Enfuvirtide injection,,,1.42,1.82,3
HCPCS,J1325,Epoprostenol injection,,,16.91,43.73,11
HCPCS,J132500,Epoprostenol injection,,,27.86,35.68,3
HCPCS,J1326,"Inj, zolbetuximab-clzb, 2 mg",,,4.21,5565.45,30
HCPCS,J132600,"Inj, zolbetuximab-clzb, 2 mg",,,59.93,76.77,3
HCPCS,J1327,Eptifibatide injection,,,0.44,412.04,31
HCPCS,J132700,Eptifibatide injection,,,21.36,27.36,3
HCPCS,J1330,Ergonovine maleate injection,,,5.34,60.42,10
HCPCS,J1335,Ertapenem injection,,,16.03,60.42,19
HCPCS,J133500,Ertapenem injection,,,16.3,20.88,3
HCPCS,J1364,Erythro lactobionate /500 mg,,,35.28,221.34,20
HCPCS,J136400,Erythro lactobionate /500 mg,,,35.88,45.96,3
HCPCS,J1370,"Inj, esomeprazole sod, 1 mg",,,0.43,11.17,13
HCPCS,J137000,"Inj, esomeprazole sod, 1 mg",,,0.43,0.55,3
HCPCS,J1380,Estradiol valerate 10 mg inj,,,9.64,25.32,19
HCPCS,J138000,Estradiol valerate 10 mg inj,,,13.26,16.99,3
HCPCS,J1410,Inj estrogen conjugate 25 mg,,,48.97,1019.69,41
HCPCS,J141000,Inj estrogen conjugate 25 mg,,,697.33,893.21,3
HCPCS,J1411,"Inj, hemgenix, per tx dose",,,0.01,10165400.0,33
HCPCS,J1412,Inj roctavian ml 2x10^13vc g,,,0.01,32901.4,36
HCPCS,J141200,Inj roctavian ml 2x10^13vc g,,,25296.92,32402.79,3
HCPCS,J1413,Inj delandistrogene mox rokl,,,0.01,9031040.0,33
HCPCS,J1414,"Inj, beqvez, per tx dose",,,18080.41,7976500.0,17
HCPCS,J1426,"Injection, casimersen, 10 mg",,,20.77,16514.52,32
HCPCS,J142600,"Injection, casimersen, 10 mg",,,341.76,437.76,3
HCPCS,J1427,Inj. viltolarsen,,,58.78,16514.52,18
HCPCS,J142700,Inj. viltolarsen,,,120.47,154.31,3
HCPCS,J1428,"Inj, eteplirsen, 10 mg",,,20.92,16514.52,30
HCPCS,J142800,"Inj, eteplirsen, 10 mg",,,341.76,437.76,3
HCPCS,J1429,Inj golodirsen 10 mg,,,166.21,2739849.3,18
HCPCS,J142900,Inj golodirsen 10 mg,,,341.76,437.76,3
HCPCS,J1430,Ethanolamine oleate 100 mg,,,64.64,1298.57,41
HCPCS,J143000,Ethanolamine oleate 100 mg,,,920.4,1178.94,3
HCPCS,J1434,"Inj, focinvez, 1mg",,,0.33,60.42,39
HCPCS,J143400,"Inj, focinvez, 1mg",,,4.68,6.0,3
HCPCS,J1435,Injection estrone per 1 mg,,,0.36,2739849.3,16
HCPCS,J143500,Injection estrone per 1 mg,,,0.36,0.46,3
HCPCS,J1436,Etidronate disodium inj,,,141.84,2739849.3,12
HCPCS,J143600,Etidronate disodium inj,,,143.9,184.32,3
HCPCS,J1437,Inj. fe derisomaltose 10 mg,,,2.85,840.33,41
HCPCS,J143700,Inj. fe derisomaltose 10 mg,,,40.64,52.05,3
HCPCS,J1438,Etanercept injection,,,784.42,2789.9,25
HCPCS,J143800,Etanercept injection,,,2178.08,2789.9,3
HCPCS,J1439,Inj ferric carboxymaltos 1mg,,,0.14,840.33,41
HCPCS,J143900,Inj ferric carboxymaltos 1mg,,,1.99,2.55,3
HCPCS,J1440,Fecal microbiota jslm 1 ml,,,8.08,5565.45,40
HCPCS,J144000,Fecal microbiota jslm 1 ml,,,115.04,147.36,3
HCPCS,J1442,Inj filgrastim excl biosimil,,,1.78,2.28,3
HCPCS,J1442,NEUPOGEN 480 MCG INJ PER 1 MCG,3.51,2.28,0.84,465.3,93
HCPCS,J144200,Inj filgrastim excl biosimil,,,1.78,2.28,3
HCPCS,J1443,Inj ferric pyrophosphate cit,,,52.18,2739849.3,9
HCPCS,J1444,Fe pyro cit pow 0.1 mg iron,,,0.03,2739849.3,10
HCPCS,J1445,Inj triferic avnu 0.1mg iron,,,0.03,2739849.3,10
HCPCS,J1447,Inj tbo filgrastim 1 microg,,,0.03,465.3,41
HCPCS,J144700,Inj tbo filgrastim 1 microg,,,0.45,0.57,3
HCPCS,J1448,"Injection, trilaciclib, 1mg",,,0.68,1622.37,41
HCPCS,J144800,"Injection, trilaciclib, 1mg",,,9.65,12.36,3
HCPCS,J1449,Inj eflapegrastim-xnst 0.1mg,,,2.94,5653.6,40
HCPCS,J144900,Inj eflapegrastim-xnst 0.1mg,,,41.92,53.69,3
HCPCS,J1450,Fluconazole,,,3.24,11.17,19
HCPCS,J145000,Fluconazole,,,7.97,10.21,3
HCPCS,J1451,"Fomepizole, 15 mg",,,0.8,465.3,38
HCPCS,J145100,"Fomepizole, 15 mg",,,26.98,34.56,3
HCPCS,J1452,Intraocular fomivirsen na,,,725.74,2739849.3,9
HCPCS,J1453,"EMEND-FOSAPREPITANT , 1 MG",4.85,3.15,0.18,60.42,75
HCPCS,J1453,Fosaprepitant injection,,,0.2,0.25,3
HCPCS,J145300,Fosaprepitant injection,,,0.2,0.25,3
HCPCS,J1454,"Inj fosnetupitant, palonoset",,,68.37,1902.05,41
HCPCS,J145400,"Inj fosnetupitant, palonoset",,,973.54,1247.0,3
HCPCS,J1455,Foscarnet sodium injection,,,0.33,232.34,27
HCPCS,J145500,Foscarnet sodium injection,,,11.94,15.3,3
HCPCS,J1456,"Inj, fosaprepitant (teva)",,,0.08,60.42,41
HCPCS,J145600,"Inj, fosaprepitant (teva)",,,1.14,1.46,3
HCPCS,J1457,Gallium nitrate injection,,,2.77,2739849.3,15
HCPCS,J145700,Gallium nitrate injection,,,4.27,5.47,3
HCPCS,J1458,Galsulfase injection,,,64.23,16514.52,34
HCPCS,J145800,Galsulfase injection,,,914.67,1171.6,3
HCPCS,J1459,Inj ivig privigen 500 mg,,,6.29,3329.32,41
HCPCS,J145900,Inj ivig privigen 500 mg,,,89.5,114.64,3
HCPCS,J1460,Gamma globulin 1 cc inj,,,6.24,164.23,41
HCPCS,J146000,Gamma globulin 1 cc inj,,,88.86,113.82,3
HCPCS,J1551,Inj cutaquig 100 mg,,,1.85,4103.47,33
HCPCS,J155100,Inj cutaquig 100 mg,,,26.38,33.79,3
HCPCS,J1552,"Inj, alyglo, 500 mg",,,15.48,3329.32,39
HCPCS,J155200,"Inj, alyglo, 500 mg",,,220.44,282.36,3
HCPCS,J1553,Inj immune glob(yim)100mg,,,7628.34,8832.81,8
HCPCS,J1554,Inj. asceniv,,,61.31,3329.32,41
HCPCS,J155400,Inj. asceniv,,,873.02,1118.25,3
HCPCS,J1555,"Inj cuvitru, 100 mg",,,2.16,3329.32,41
HCPCS,J155500,"Inj cuvitru, 100 mg",,,30.72,39.35,3
HCPCS,J1556,"Inj, imm glob bivigam, 500mg",,,9.96,908.28,34
HCPCS,J155600,"Inj, imm glob bivigam, 500mg",,,141.78,181.6,3
HCPCS,J1557,GAMMAPLEX INJECTION 500 MG,295.55,192.11,55.01,4103.47,93
HCPCS,J1557,Gammaplex injection,,,113.8,145.76,3
HCPCS,J155700,Gammaplex injection,,,113.8,145.76,3
HCPCS,J1558,"Inj. xembify, 100 mg",,,1.88,908.28,41
HCPCS,J155800,"Inj. xembify, 100 mg",,,26.81,34.34,3
HCPCS,J1559,Hizentra injection,,,1.82,908.28,41
HCPCS,J155900,Hizentra injection,,,25.88,33.15,3
HCPCS,J1560,Gamma globulin > 10 cc inj,,,13.07,1389.89,41
HCPCS,J156000,Gamma globulin > 10 cc inj,,,186.05,238.31,3
HCPCS,J1561,Gamunex-c/gammaked,,,87.36,111.9,3
HCPCS,J1561,IMMUNE GLOBULIN LIQUID 500MG,177.62,115.45,42.63,3329.32,93
HCPCS,J156100,Gamunex-c/gammaked,,,87.36,111.9,3
HCPCS,J1562,"Vivaglobin, inj",,,19.48,2739849.3,11
HCPCS,J1566,"Immune globulin, powder",,,9.86,4103.47,41
HCPCS,J156600,"Immune globulin, powder",,,140.42,179.87,3
HCPCS,J1568,Octagam injection,,,5.92,3329.32,41
HCPCS,J156800,Octagam injection,,,84.35,108.05,3
HCPCS,J1569,GAMMAGARD LIQUID INJ 500 MG,210.1,136.57,43.22,4103.47,93
HCPCS,J1569,Gammagard liquid injection,,,84.18,107.82,3
HCPCS,J156900,Gammagard liquid injection,,,84.18,107.82,3
HCPCS,J1570,Ganciclovir sodium injection,,,46.36,123.08,19
HCPCS,J157000,Ganciclovir sodium injection,,,59.67,76.43,3
HCPCS,J1571,Hepagam b im injection,,,8.7,840.33,41
HCPCS,J157100,Hepagam b im injection,,,123.87,158.67,3
HCPCS,J1572,Flebogamma injection,,,11.34,3329.32,39
HCPCS,J157200,Flebogamma injection,,,113.08,144.85,3
HCPCS,J1573,"Hepagam b intravenous, inj",,,8.7,164.23,40
HCPCS,J157300,"Hepagam b intravenous, inj",,,123.87,158.67,3
HCPCS,J1574,"Inj, ganciclovir (exela)",,,9.64,2739849.3,17
HCPCS,J157400,"Inj, ganciclovir (exela)",,,106.8,136.8,3
HCPCS,J1575,Hyqvia 100mg immuneglobulin,,,2.29,4103.47,41
HCPCS,J157500,Hyqvia 100mg immuneglobulin,,,32.63,41.79,3
HCPCS,J1576,"Inj, panzyga, 500 mg",,,8.9,8832.81,40
HCPCS,J157600,"Inj, panzyga, 500 mg",,,126.77,162.38,3
HCPCS,J1580,"GENTAMICIN 80 MG, INJ",7.5,4.88,1.64,11.17,75
HCPCS,J1580,Garamycin gentamicin inj,,,3.86,4.95,3
HCPCS,J158000,Garamycin gentamicin inj,,,3.86,4.95,3
HCPCS,J1595,Injection glatiramer acetate,,,133.5,427.39,25
HCPCS,J159500,Injection glatiramer acetate,,,133.5,171.0,3
HCPCS,J1596,"Inj, glycopyrrolate, 0.1 mg",,,0.51,11.17,25
HCPCS,J159600,"Inj, glycopyrrolate, 0.1 mg",,,0.68,0.87,3
HCPCS,J1597,"Inj glycopyrrolate, glyrx-pf",,,2.23,11.17,18
HCPCS,J159700,"Inj glycopyrrolate, glyrx-pf",,,2.28,2.92,3
HCPCS,J1598,Inj glycopyrrolate fres kabi,,,1.8,11.17,25
HCPCS,J159800,Inj glycopyrrolate fres kabi,,,2.39,3.06,3
HCPCS,J1599,"Ivig non-lyophilized, nos",,,253.37,1622.37,13
HCPCS,J159900,"Ivig non-lyophilized, nos",,,253.37,324.54,3
HCPCS,J1600,Gold sodium thiomaleate inj,,,28.51,2739849.3,16
HCPCS,J160000,Gold sodium thiomaleate inj,,,31.15,39.9,3
HCPCS,J1602,GOLIMUMAB FOR IV USE 1MG,114.65,74.52,11.1,3329.32,93
HCPCS,J1602,Golimumab for iv use 1mg,,,20.7,26.52,3
HCPCS,J160200,Golimumab for iv use 1mg,,,20.7,26.52,3
HCPCS,J1610,Glucagon hydrochloride/1 mg,,,293.45,375.88,3
HCPCS,J1610,INJ GLUCAGON HCL PER 1 MG,618.8,402.22,148.51,618.8,93
HCPCS,J161000,Glucagon hydrochloride/1 mg,,,293.45,375.88,3
HCPCS,J1611,"Inj glucagon hcl, fresenius",,,17.91,339.29,41
HCPCS,J161100,"Inj glucagon hcl, fresenius",,,254.99,326.61,3
HCPCS,J1612,Inj glucagon (gvoke) 0.01 mg,,,0.33,232.34,27
HCPCS,J161200,Inj glucagon (gvoke) 0.01 mg,,,5.38,6.89,3
HCPCS,J1620,Gonadorelin hydroch/ 100 mcg,,,2739849.3,2739849.3,1
HCPCS,J1626,Granisetron hcl injection,,,0.27,0.34,3
HCPCS,J1626,"INJ GRANISETRON HCL, 100 MCG",15.1,9.82,0.26,15.1,75
HCPCS,J162600,Granisetron hcl injection,,,0.27,0.34,3
HCPCS,J1627,"Inj, granisetron, xr, 0.1 mg",,,0.54,60.42,41
HCPCS,J162700,"Inj, granisetron, xr, 0.1 mg",,,7.65,9.8,3
HCPCS,J1628,"Inj., guselkumab, 1 mg",,,9.12,8832.81,40
HCPCS,J162800,"Inj., guselkumab, 1 mg",,,129.83,166.3,3
HCPCS,J1630,Haloperidol injection,,,1.28,11.17,19
HCPCS,J163000,Haloperidol injection,,,1.3,1.66,3
HCPCS,J1631,Haloperidol decanoate inj,,,6.89,60.42,19
HCPCS,J163100,Haloperidol decanoate inj,,,7.01,8.98,3
HCPCS,J1632,"Inj., brexanolone, 1 mg",,,71.6,5565.45,18
HCPCS,J163200,"Inj., brexanolone, 1 mg",,,159.13,203.83,3
HCPCS,J1640,"Hemin, 1 mg",,,4.41,5653.6,41
HCPCS,J164000,"Hemin, 1 mg",,,62.85,80.51,3
HCPCS,J1642,HEPARIN SODIUM PER 10 U,11.0,7.15,0.01,11.0,78
HCPCS,J1642,Inj heparin sodium per 10 u,,,0.01,11.17,19
HCPCS,J164200,Inj heparin sodium per 10 u,,,0.04,0.05,3
HCPCS,J1643,"Inj heparin, pfizer, 1000u",,,0.26,12.55,20
HCPCS,J164300,"Inj heparin, pfizer, 1000u",,,3.74,4.79,3
HCPCS,J1644,HEPARIN 1000UNIT/0.9NS 500ML,8.0,5.2,0.31,11.17,75
HCPCS,J1644,Inj heparin sodium per 1000u,,,0.32,0.41,3
HCPCS,J164400,Inj heparin sodium per 1000u,,,0.32,0.41,3
HCPCS,J1645,Dalteparin sodium,,,12.06,60.42,19
HCPCS,J164500,Dalteparin sodium,,,26.52,33.97,3
HCPCS,J1650,"INJ, LOVENOX, 10 MG",19.2,12.48,0.93,19.2,75
HCPCS,J1650,Inj enoxaparin sodium,,,0.94,1.21,3
HCPCS,J165000,Inj enoxaparin sodium,,,0.94,1.21,3
HCPCS,J1652,FONDAPARINUX  0.5MG INJ,21.58,14.03,1.44,21.58,75
HCPCS,J1652,Fondaparinux sodium,,,1.57,2.01,3
HCPCS,J165200,Fondaparinux sodium,,,1.57,2.01,3
HCPCS,J1655,Tinzaparin sodium injection,,,7.65,60.42,11
HCPCS,J1670,Tetanus immune globulin inj,,,73.57,1585.39,41
HCPCS,J167000,Tetanus immune globulin inj,,,1047.6,1341.87,3
HCPCS,J1675,Histrelin acetate,,,0.69,2739849.3,14
HCPCS,J1700,Hydrocortisone acetate inj,,,1.3,11.17,14
HCPCS,J170000,Hydrocortisone acetate inj,,,2.3,2.94,3
HCPCS,J1710,Hydrocortisone sodium ph inj,,,9.64,11.17,8
HCPCS,J1720,HYDROCORT NA SUCCIN TO 100MG,10.1,6.57,2.2,50.3,75
HCPCS,J1720,HYDROCORTISONE SODIUM SUCC I,31.9,20.74,1.1,55.1,78
HCPCS,J1720,Hydrocortisone sodium succ i,,,39.27,50.3,3
HCPCS,J172000,Hydrocortisone sodium succ i,,,39.27,50.3,3
HCPCS,J1726,"INJECTION, HYDROXYPROGESTERONE CAPROATE (MAKENA), 10MG",115.64,75.17,12.08,164.23,82
HCPCS,J1726,"Makena, 10 mg",,,43.18,55.31,3
HCPCS,J172600,"Makena, 10 mg",,,43.18,55.31,3
HCPCS,J1729,Inj hydroxyprogst capoat nos,,,18.18,164.23,17
HCPCS,J172900,Inj hydroxyprogst capoat nos,,,29.14,37.32,3
HCPCS,J1730,Diazoxide injection,,,52.18,2739849.3,14
HCPCS,J173000,Diazoxide injection,,,230.37,295.08,3
HCPCS,J1736,Inj meloxicam (delova) 1mg,,,9.64,11.17,8
HCPCS,J1737,Inj meloxicam (azurity) 1mg,,,0.13,11.17,27
HCPCS,J173700,Inj meloxicam (azurity) 1mg,,,2.14,2.74,3
HCPCS,J1738,Inj. meloxicam 1 mg,,,3.38,11.17,16
HCPCS,J173800,Inj. meloxicam 1 mg,,,6.69,8.57,3
HCPCS,J1740,IBANDRONATE SODIUM INJ 1 MG,527.32,342.76,23.0,527.32,75
HCPCS,J1740,Ibandronate sodium injection,,,23.39,29.96,3
HCPCS,J174000,Ibandronate sodium injection,,,23.39,29.96,3
HCPCS,J1741,Ibuprofen injection,,,5.57,60.42,18
HCPCS,J174100,Ibuprofen injection,,,5.66,7.25,3
HCPCS,J1742,Ibutilide fumarate injection,,,24.81,833.16,39
HCPCS,J174200,Ibutilide fumarate injection,,,650.45,833.16,3
HCPCS,J1743,Idursulfase injection,,,69.76,16514.52,41
HCPCS,J174300,Idursulfase injection,,,993.42,1272.47,3
HCPCS,J1744,Icatibant injection,,,99.68,5565.45,24
HCPCS,J174400,Icatibant injection,,,99.68,127.68,3
HCPCS,J1745,INFLIXIMAB INJ 10 MG,420.52,273.34,31.67,1622.37,93
HCPCS,J1745,Infliximab not biosimil 10mg,,,57.71,73.92,3
HCPCS,J174500,Infliximab not biosimil 10mg,,,57.71,73.92,3
HCPCS,J1746,"Inj., ibalizumab-uiyk, 10 mg",,,9.69,5565.45,41
HCPCS,J174600,"Inj., ibalizumab-uiyk, 10 mg",,,138.02,176.79,3
HCPCS,J1747,"Inj, spesolimab-sbzo, 1 mg",,,8.22,20935.21,40
HCPCS,J174700,"Inj, spesolimab-sbzo, 1 mg",,,117.0,149.86,3
HCPCS,J1748,"Inj, zymfentra, 10 mg",,,12.47,1622.37,29
HCPCS,J174800,"Inj, zymfentra, 10 mg",,,572.13,732.84,3
HCPCS,J1749,"Inj, iloprost, 0.1 mcg",,,10.0,840.33,18
HCPCS,J174900,"Inj, iloprost, 0.1 mcg",,,10.16,13.02,3
HCPCS,J1750,"INJ IRON DEXTRAN, 50 MG",35.0,22.75,8.4,164.23,93
HCPCS,J1750,Inj iron dextran,,,32.18,41.22,3
HCPCS,J175000,Inj iron dextran,,,32.18,41.22,3
HCPCS,J1756,IRON SUCROSE INJ 1 MG,1.85,1.2,0.4,60.42,75
HCPCS,J1756,Iron sucrose injection,,,0.43,0.55,3
HCPCS,J175600,Iron sucrose injection,,,0.43,0.55,3
HCPCS,J1786,IMUGLUCERASE INJ 400 UNITS,5710.6,3711.89,43.23,8832.81,93
HCPCS,J1786,Imuglucerase injection,,,76.95,98.56,3
HCPCS,J178600,Imuglucerase injection,,,76.95,98.56,3
HCPCS,J1790,Droperidol injection,,,8.86,26.21,19
HCPCS,J179000,Droperidol injection,,,12.78,16.37,3
HCPCS,J1800,Propranolol injection,,,2.97,26.65,16
HCPCS,J180000,Propranolol injection,,,20.81,26.65,3
HCPCS,J1805,"Inj, esmolol hcl, 10mg",,,0.22,60.42,19
HCPCS,J180500,"Inj, esmolol hcl, 10mg",,,0.37,0.48,3
HCPCS,J1806,Inj esmolol hcl wg crit care,,,0.42,60.42,19
HCPCS,J180600,Inj esmolol hcl wg crit care,,,0.73,0.93,3
HCPCS,J1807,"Inj, ethacrynate sod, 1 mg",,,1.61,5653.6,27
HCPCS,J180700,"Inj, ethacrynate sod, 1 mg",,,121.75,155.95,3
HCPCS,J1808,"Inj, folic acid, 0.1 mg",,,0.09,11.17,16
HCPCS,J180800,"Inj, folic acid, 0.1 mg",,,0.09,0.11,3
HCPCS,J1809,"Inj, fosdenopterin, 0.1mg",,,2.16,5565.45,30
HCPCS,J180900,"Inj, fosdenopterin, 0.1mg",,,30.69,39.31,3
HCPCS,J1810,Droperidol/fentanyl inj,,,13.7,60.42,12
HCPCS,J181000,Droperidol/fentanyl inj,,,30.14,38.6,3
HCPCS,J1811,Fiasp for insulin pump use,,,7.41,60.42,26
HCPCS,J181100,Fiasp for insulin pump use,,,14.06,18.01,3
HCPCS,J1812,Inj. insulin (fiasp),,,3.1,11.17,15
HCPCS,J181200,Inj. insulin (fiasp),,,3.1,3.97,3
HCPCS,J1813,Lyumjev for insulin pump use,,,15.68,60.42,19
HCPCS,J181300,Lyumjev for insulin pump use,,,26.88,34.43,3
HCPCS,J1814,Inj. insulin (lyumjev),,,2.94,11.17,15
HCPCS,J181400,Inj. insulin (lyumjev),,,2.94,3.76,3
HCPCS,J1815,INSULIN INJ PER 5 UNITS,104.0,67.6,0.48,104.0,75
HCPCS,J1815,INSULIN INJECTION,5.23,3.4,0.29,5.23,78
HCPCS,J1815,Insulin injection,,,0.48,0.62,3
HCPCS,J181500,Insulin injection,,,0.48,0.62,3
HCPCS,J1817,Insulin for insulin pump use,,,5.12,60.42,19
HCPCS,J181700,Insulin for insulin pump use,,,5.7,7.3,3
HCPCS,J1823,"Inj. inebilizumab-cdon, 1 mg",,,61.94,16514.52,41
HCPCS,J182300,"Inj. inebilizumab-cdon, 1 mg",,,882.08,1129.85,3
HCPCS,J1826,INTERFERON BETA-1A INJ,3523.6,2290.34,768.14,5908.26,83
HCPCS,J1826,Interferon beta-1a inj,,,4612.59,5908.26,3
HCPCS,J182600,Interferon beta-1a inj,,,4612.59,5908.26,3
HCPCS,J1830,Interferon beta-1b / .25 mg,,,141.84,1944.09,17
HCPCS,J183000,Interferon beta-1b / .25 mg,,,1517.75,1944.09,3
HCPCS,J1833,"Injection, isavuconazonium",,,0.13,465.3,38
HCPCS,J183300,"Injection, isavuconazonium",,,2.26,2.9,3
HCPCS,J1834,"Inj, isoniazid, 1 mg",,,0.04,60.42,27
HCPCS,J183400,"Inj, isoniazid, 1 mg",,,0.62,0.8,3
HCPCS,J1835,Itraconazole injection,,,52.18,2739849.3,14
HCPCS,J183500,Itraconazole injection,,,88.75,113.68,3
HCPCS,J1836,"Inj, metronidazole, 10 mg",,,0.03,11.17,19
HCPCS,J183600,"Inj, metronidazole, 10 mg",,,0.05,0.07,3
HCPCS,J1837,"Inj, posaconazole, 1 mg",,,0.04,232.34,30
HCPCS,J183700,"Inj, posaconazole, 1 mg",,,0.62,0.8,3
HCPCS,J1840,Kanamycin sulfate 500 mg inj,,,7.98,60.42,9
HCPCS,J1850,Kanamycin sulfate 75 mg inj,,,1.2,11.17,10
HCPCS,J1885,KETOROLAC TROMETHAMINE INJ,2.85,1.85,0.44,2.85,78
HCPCS,J1885,Ketorolac tromethamine inj,,,0.59,0.75,3
HCPCS,J1885,TORADOL INJ PER 15 MG,55.95,36.37,0.31,55.95,92
HCPCS,J188500,Ketorolac tromethamine inj,,,0.59,0.75,3
HCPCS,J1890,Cephalothin sodium injection,,,19.22,60.42,12
HCPCS,J189000,Cephalothin sodium injection,,,19.22,24.62,3
HCPCS,J1920,"Inj, labetalol hcl, 5mg",,,0.17,11.17,19
HCPCS,J192000,"Inj, labetalol hcl, 5mg",,,0.62,0.8,3
HCPCS,J1921,"Inj labetalol hcl hikma, 5mg",,,1.91,11.17,19
HCPCS,J192100,"Inj labetalol hcl hikma, 5mg",,,1.94,2.49,3
HCPCS,J1930,Lanreotide injection,,,4.42,5565.45,41
HCPCS,J193000,Lanreotide injection,,,62.99,80.69,3
HCPCS,J1931,Laronidase injection,,,4.99,8832.81,41
HCPCS,J193100,Laronidase injection,,,71.11,91.09,3
HCPCS,J1932,"Inj, lanreotide, (cipla) 1mg",,,4.78,5565.45,41
HCPCS,J193200,"Inj, lanreotide, (cipla) 1mg",,,68.03,87.14,3
HCPCS,J1938,"Inj, furosemide, 1 mg",,,0.03,11.17,16
HCPCS,J193800,"Inj, furosemide, 1 mg",,,0.04,0.05,3
HCPCS,J1939,"Inj, bumetanide, 0.5 mg",,,0.62,60.42,25
HCPCS,J193900,"Inj, bumetanide, 0.5 mg",,,0.64,0.82,3
HCPCS,J1940,Furosemide injection,,,0.66,11.17,15
HCPCS,J194000,Furosemide injection,,,1.92,2.46,3
HCPCS,J1941,"INJ, FUROSCIX, 20 MG",882.8,573.82,1.1,3060831.65,74
HCPCS,J1941,"Inj, furoscix, 20 mg",,,52.18,2739849.3,16
HCPCS,J194100,"Inj, furoscix, 20 mg",,,523.64,670.73,3
HCPCS,J1943,"Inj., aristada initio, 1 mg",,,0.41,1622.37,41
HCPCS,J194300,"Inj., aristada initio, 1 mg",,,5.79,7.41,3
HCPCS,J1944,Aripiprazole lauroxil 1 mg,,,0.42,3329.32,41
HCPCS,J194400,Aripiprazole lauroxil 1 mg,,,5.95,7.62,3
HCPCS,J1945,Lepirudin,,,312.27,2739849.3,11
HCPCS,J1950,LEUPROLID ACETATE 11.25 MG,3295.68,2142.19,790.96,4021.62,93
HCPCS,J1950,LEUPROLIDE ACETATE /3.75 MG,1768.0,1149.2,1.1,4790.47,78
HCPCS,J1950,LUPRON DEPOT,3770.0,2450.5,904.8,4021.62,93
HCPCS,J1950,Leuprolide acetate /3.75 mg,,,3139.69,4021.62,3
HCPCS,J195000,Leuprolide acetate /3.75 mg,,,3139.69,4021.62,3
HCPCS,J1951,Inj fensolvi 0.25 mg,,,17.49,1622.37,41
HCPCS,J195100,Inj fensolvi 0.25 mg,,,248.99,318.93,3
HCPCS,J1952,"Leuprolide inj, camcevi, 1mg",,,7.13,2111.65,40
HCPCS,J195200,"Leuprolide inj, camcevi, 1mg",,,101.51,130.03,3
HCPCS,J1953,Levetiracetam injection,,,0.07,11.17,19
HCPCS,J195300,Levetiracetam injection,,,0.07,0.09,3
HCPCS,J1954,Inj leu acet lutr dpt 7.5 mg,,,88.33,2111.65,40
HCPCS,J195400,Inj leu acet lutr dpt 7.5 mg,,,1257.87,1611.21,3
HCPCS,J1955,Inj levocarnitine per 1 gm,,,23.31,96.78,19
HCPCS,J195500,Inj levocarnitine per 1 gm,,,41.42,53.06,3
HCPCS,J1956,"INJ, LEVOFLOXACIN, 250 MG",28.0,18.2,3.78,28.0,75
HCPCS,J1956,Levofloxacin injection,,,3.84,4.92,3
HCPCS,J195600,Levofloxacin injection,,,3.84,4.92,3
HCPCS,J1960,Levorphanol tartrate inj,,,0.8,60.42,13
HCPCS,J196000,Levorphanol tartrate inj,,,0.8,1.03,3
HCPCS,J1961,Inj lenacapavir (hiv tx) 1mg,,,2.79,5565.45,40
HCPCS,J196100,Inj lenacapavir (hiv tx) 1mg,,,39.69,50.84,3
HCPCS,J1980,Hyoscyamine sulfate inj,,,19.48,147.74,17
HCPCS,J198000,Hyoscyamine sulfate inj,,,115.34,147.74,3
HCPCS,J1990,Chlordiazepoxide injection,,,41.1,60.42,16
HCPCS,J199000,Chlordiazepoxide injection,,,46.83,59.99,3
HCPCS,J2001,LIDOCAINE 1% 10ML,42.38,27.55,0.09,42.38,74
HCPCS,J2001,LIDOCAINE HCL INJ FOR IV 10 MG,5.0,3.25,0.09,11.17,74
HCPCS,J2001,Lidocaine injection,,,0.09,0.11,3
HCPCS,J200100,Lidocaine injection,,,0.09,0.11,3
HCPCS,J2002,"Inj, lidocaine in d5w, 1 mg",,,0.01,11.17,17
HCPCS,J200200,"Inj, lidocaine in d5w, 1 mg",,,0.02,0.02,3
HCPCS,J2003,"Inj, lidocaine hcl, 1 mg",,,0.02,11.17,15
HCPCS,J200300,"Inj, lidocaine hcl, 1 mg",,,0.02,0.02,3
HCPCS,J2004,"Inj, lidocaine w epinephrine",,,0.02,11.17,15
HCPCS,J200400,"Inj, lidocaine w epinephrine",,,0.02,0.02,3
HCPCS,J2010,"LINCOMYCIN INJ, TO 300 MG",18.0,11.7,3.92,60.42,75
HCPCS,J2010,Lincomycin injection,,,9.61,12.31,3
HCPCS,J201000,Lincomycin injection,,,9.61,12.31,3
HCPCS,J2020,Linezolid injection,,,4.8,60.42,19
HCPCS,J202000,Linezolid injection,,,4.88,6.25,3
HCPCS,J2021,"Inj, linezolid (hospira)",,,4.34,60.42,20
HCPCS,J202100,"Inj, linezolid (hospira)",,,38.5,49.32,3
HCPCS,J2060,"LORAZEPAM INJ, 2 MG",9.0,5.85,1.96,11.17,75
HCPCS,J2060,Lorazepam injection,,,2.51,3.21,3
HCPCS,J206000,Lorazepam injection,,,2.51,3.21,3
HCPCS,J2062,Loxapine for inhalation 1 mg,,,1.99,2739849.3,30
HCPCS,J206200,Loxapine for inhalation 1 mg,,,32.04,41.04,3
HCPCS,J2150,"MANNITOL INJ, 25% IN 50 ML",6.4,4.16,1.4,11.17,74
HCPCS,J2151,"Inj, mannitol, 250 mg",,,0.11,11.17,16
HCPCS,J215100,"Inj, mannitol, 250 mg",,,0.11,0.14,3
HCPCS,J2170,Mecasermin injection,,,363.07,1005.82,15
HCPCS,J217000,Mecasermin injection,,,785.25,1005.82,3
HCPCS,J2175,"DEMEROL HCL, PER 100MG",10.0,6.5,2.18,18.58,75
HCPCS,J2175,Meperidine hydrochl /100 mg,,,14.51,18.58,3
HCPCS,J217500,Meperidine hydrochl /100 mg,,,14.51,18.58,3
HCPCS,J2180,Meperidine/promethazine inj,,,8.15,21.59,15
HCPCS,J218000,Meperidine/promethazine inj,,,16.86,21.59,3
HCPCS,J2182,"Injection, mepolizumab, 1mg",,,56.76,72.71,3
HCPCS,J2182,MEPOLIZUMAB (NUCALA) PER 1 MG,90.01,58.51,21.6,4103.47,93
HCPCS,J218200,"Injection, mepolizumab, 1mg",,,56.76,72.71,3
HCPCS,J2183,Inj meropenem (wg crit care),,,1.62,11.17,25
HCPCS,J218300,Inj meropenem (wg crit care),,,2.79,3.58,3
HCPCS,J2184,"Inj, meropenem (b. braun)",,,0.75,11.17,20
HCPCS,J218400,"Inj, meropenem (b. braun)",,,3.58,4.58,3
HCPCS,J2185,Meropenem,,,0.67,11.17,19
HCPCS,J218500,Meropenem,,,0.68,0.87,3
HCPCS,J2186,"Inj., meropenem, vaborbactam",,,0.27,232.34,38
HCPCS,J218600,"Inj., meropenem, vaborbactam",,,4.75,6.09,3
HCPCS,J2210,Methylergonovin maleate inj,,,21.08,60.42,19
HCPCS,J221000,Methylergonovin maleate inj,,,38.02,48.7,3
HCPCS,J2212,Methylnaltrexone injection,,,1.15,60.42,17
HCPCS,J221200,Methylnaltrexone injection,,,3.33,4.26,3
HCPCS,J2246,"Inj, micafungin (baxter)",,,0.72,60.42,18
HCPCS,J224600,"Inj, micafungin (baxter)",,,0.73,0.93,3
HCPCS,J2247,"Inj, micafungin (par pharm)",,,0.27,60.42,20
HCPCS,J224700,"Inj, micafungin (par pharm)",,,0.39,0.5,3
HCPCS,J2248,Micafungin sodium injection,,,0.44,60.42,19
HCPCS,J224800,Micafungin sodium injection,,,0.45,0.57,3
HCPCS,J2249,"Inj, remimazolam, 1 mg",,,4.68,11.17,15
HCPCS,J224900,"Inj, remimazolam, 1 mg",,,4.68,6.0,3
HCPCS,J2250,Inj midazolam hydrochloride,,,0.14,11.17,19
HCPCS,J225000,Inj midazolam hydrochloride,,,0.25,0.32,3
HCPCS,J2251,Inj midazolam in 0.9% nacl,,,0.18,11.17,20
HCPCS,J225100,Inj midazolam in 0.9% nacl,,,0.32,0.41,3
HCPCS,J2252,Inj midazolam in 0.8% nacl,,,0.17,11.17,15
HCPCS,J225200,Inj midazolam in 0.8% nacl,,,0.21,0.27,3
HCPCS,J2253,Inj midazolam (seizalam),,,9.64,11.17,8
HCPCS,J2260,Inj milrinone lactate / 5 mg,,,1.66,11.17,19
HCPCS,J226000,Inj milrinone lactate / 5 mg,,,2.4,3.08,3
HCPCS,J2265,Minocycline hydrochloride,,,0.33,60.42,38
HCPCS,J226500,Minocycline hydrochloride,,,5.52,7.07,3
HCPCS,J2267,"Inj, mirikizumab-mrkz, 1 mg",,,5.24,5565.45,39
HCPCS,J226700,"Inj, mirikizumab-mrkz, 1 mg",,,74.62,95.58,3
HCPCS,J2270,"INJ, MORPHINE SULFATE, TO 10MG",2.13,1.38,0.46,11.17,75
HCPCS,J2270,Morphine sulfate injection,,,5.41,6.93,3
HCPCS,J227000,Morphine sulfate injection,,,5.41,6.93,3
HCPCS,J2272,"Inj, morphine (fresenius)",,,3.08,20.36,20
HCPCS,J227200,"Inj, morphine (fresenius)",,,12.05,15.44,3
HCPCS,J2274,IM MORPHINE PRESERVATIVE FREE,28.4,18.46,6.19,60.42,75
HCPCS,J2274,Inj morphine pf epid ithc,,,24.03,30.78,3
HCPCS,J227400,Inj morphine pf epid ithc,,,24.03,30.78,3
HCPCS,J2277,"Inj, motixafortide, 0.25 mg",,,3.31,5565.45,40
HCPCS,J227700,"Inj, motixafortide, 0.25 mg",,,47.13,60.37,3
HCPCS,J2278,ZICONOTIDE 100MCG/ML PRIALT SOLUTION,677.98,440.69,9.04,3329.32,93
HCPCS,J2278,ZICONOTIDE 25MCG/ML PRIALT SOLUTION,169.5,110.18,9.04,3329.32,93
HCPCS,J2278,Ziconotide injection,,,18.81,24.1,3
HCPCS,J227800,Ziconotide injection,,,18.81,24.1,3
HCPCS,J2280,"Inj, moxifloxacin 100 mg",,,9.64,25.84,19
HCPCS,J228000,"Inj, moxifloxacin 100 mg",,,16.3,20.88,3
HCPCS,J2281,Inj moxifloxacin (fres kabi),,,7.49,15.92,20
HCPCS,J228100,Inj moxifloxacin (fres kabi),,,11.82,15.14,3
HCPCS,J2290,"Inj, nafcillin sodium, 20 mg",,,0.11,11.17,18
HCPCS,J229000,"Inj, nafcillin sodium, 20 mg",,,0.11,0.14,3
HCPCS,J2291,"Inj, nafcillin (baxter) 20mg",,,0.26,11.17,16
HCPCS,J229100,"Inj, nafcillin (baxter) 20mg",,,0.27,0.34,3
HCPCS,J2300,Inj nalbuphine hydrochloride,,,2.71,11.17,19
HCPCS,J230000,Inj nalbuphine hydrochloride,,,6.14,7.87,3
HCPCS,J2305,"Inj, nitroglycerin, 5 mg",,,1.44,11.17,19
HCPCS,J230500,"Inj, nitroglycerin, 5 mg",,,2.71,3.47,3
HCPCS,J2310,Inj naloxone hydrochloride,,,12.6,60.42,12
HCPCS,J2311,"Inj, naloxone hcl (zimhi)",,,3.23,60.42,12
HCPCS,J2312,"Inj naloxone hcl nos, 0.01mg",,,0.11,60.42,16
HCPCS,J231200,"Inj naloxone hcl nos, 0.01mg",,,0.12,0.16,3
HCPCS,J2313,"Inj, naloxone (zimhi) 0.01mg",,,0.03,60.42,16
HCPCS,J231300,"Inj, naloxone (zimhi) 0.01mg",,,0.04,0.05,3
HCPCS,J2315,"Naltrexone, depot form",,,0.53,1622.37,41
HCPCS,J231500,"Naltrexone, depot form",,,7.55,9.67,3
HCPCS,J2320,Nandrolone decanoate 50 mg,,,7.57,60.42,15
HCPCS,J232000,Nandrolone decanoate 50 mg,,,7.57,9.69,3
HCPCS,J2323,Natalizumab injection,,,43.63,55.88,3
HCPCS,J2323,TYSABRI 1 MG NATALIZUMAB,74.16,48.2,17.8,5565.45,93
HCPCS,J232300,Natalizumab injection,,,43.63,55.88,3
HCPCS,J2325,Nesiritide injection,,,62.59,908.28,16
HCPCS,J232500,Nesiritide injection,,,150.73,193.07,3
HCPCS,J2326,"Inj, nusinersen, 0.1mg",,,160.77,20935.21,38
HCPCS,J232600,"Inj, nusinersen, 0.1mg",,,2604.12,3335.62,3
HCPCS,J2327,Inj risankizumab-rzaa 1 mg,,,1.87,5565.45,41
HCPCS,J232700,Inj risankizumab-rzaa 1 mg,,,26.58,34.04,3
HCPCS,J2329,"Inj ublituximab-xiiy, 1 mg",,,8.77,16514.52,40
HCPCS,J232900,"Inj ublituximab-xiiy, 1 mg",,,124.92,160.01,3
HCPCS,J2350,INJ OCRELIZUMAB PER 1 MG (OCREVUS),195.0,126.75,46.8,20935.21,93
HCPCS,J2350,"Injection, ocrelizumab, 1 mg",,,105.59,135.25,3
HCPCS,J235000,"Injection, ocrelizumab, 1 mg",,,105.59,135.25,3
HCPCS,J2351,Inj ocrelizumab 1mg hya-ocsq,,,5.88,20935.21,30
HCPCS,J235100,Inj ocrelizumab 1mg hya-ocsq,,,83.75,107.27,3
HCPCS,J2353,OCTREOTIDE DEPOT 1 MG IM INJ,641.65,417.07,154.0,5565.45,93
HCPCS,J2353,"Octreotide injection, depot",,,354.52,454.11,3
HCPCS,J235300,"Octreotide injection, depot",,,354.52,454.11,3
HCPCS,J2354,"Octreotide inj, non-depot",,,0.88,11.17,19
HCPCS,J235400,"Octreotide inj, non-depot",,,1.17,1.5,3
HCPCS,J2355,Oprelvekin injection,,,401.85,1205.94,17
HCPCS,J235500,Oprelvekin injection,,,941.48,1205.94,3
HCPCS,J2356,"Inj tezepelumab-ekko, 1mg",,,2.23,4103.47,40
HCPCS,J235600,"Inj tezepelumab-ekko, 1mg",,,31.72,40.63,3
HCPCS,J2357,INJ OMALIZUMAB 5 MG,151.76,98.64,36.42,3329.32,93
HCPCS,J2357,Omalizumab injection,,,80.99,103.74,3
HCPCS,J235700,Omalizumab injection,,,80.99,103.74,3
HCPCS,J2358,Olanzapine long-acting inj,,,2.92,60.42,27
HCPCS,J235800,Olanzapine long-acting inj,,,5.62,7.2,3
HCPCS,J2359,"Inj. olanzapine, 0.5mg",,,0.96,60.42,19
HCPCS,J235900,"Inj. olanzapine, 0.5mg",,,1.44,1.85,3
HCPCS,J2360,NORFLEX-KEFLEX 60 MG,68.5,44.53,9.64,68.5,75
HCPCS,J2360,ORPHENADRINE INJ TO 60 MG,55.8,36.27,1.1,55.8,78
HCPCS,J2360,Orphenadrine injection,,,11.37,14.57,3
HCPCS,J236000,Orphenadrine injection,,,11.37,14.57,3
HCPCS,J2370,Phenylephrine hcl injection,,,9.64,11.17,8
HCPCS,J2371,Inj phenylephrine hcl 20 mcg,,,0.01,11.17,17
HCPCS,J237100,Inj phenylephrine hcl 20 mcg,,,0.02,0.02,3
HCPCS,J2372,"Inj, biorphen, 20 micrograms",,,0.17,11.17,19
HCPCS,J237200,"Inj, biorphen, 20 micrograms",,,0.28,0.36,3
HCPCS,J2373,"Inj, immphentiv, 20 mcg",,,0.15,11.17,25
HCPCS,J237300,"Inj, immphentiv, 20 mcg",,,0.25,0.32,3
HCPCS,J2400,Chloroprocaine hcl injection,,,31.73,60.42,9
HCPCS,J2401,Chloroprocaine hcl injection,,,0.04,60.42,20
HCPCS,J240100,Chloroprocaine hcl injection,,,0.07,0.09,3
HCPCS,J2402,Chloroprocaine (clorotekal),,,0.09,2739849.3,17
HCPCS,J240200,Chloroprocaine (clorotekal),,,0.66,0.84,3
HCPCS,J2403,"Chloroprocaine opht gel, 1mg",,,0.07,60.42,40
HCPCS,J240300,"Chloroprocaine opht gel, 1mg",,,1.03,1.32,3
HCPCS,J2404,"Inj, nicardipine 0.1 mg",,,0.12,2739849.3,18
HCPCS,J240400,"Inj, nicardipine 0.1 mg",,,0.12,0.16,3
HCPCS,J2405,ONDANSETRON HCL INJECTION,46.25,30.06,0.09,46.25,78
HCPCS,J2405,Ondansetron hcl injection,,,0.16,0.21,3
HCPCS,J2405,ZOFRAN INJ PER 1 MG,1.9,1.24,0.16,11.17,75
HCPCS,J240500,Ondansetron hcl injection,,,0.16,0.21,3
HCPCS,J2406,"Injection, oritavancin 10 mg",,,5.38,3329.32,41
HCPCS,J240600,"Injection, oritavancin 10 mg",,,76.65,98.18,3
HCPCS,J2407,"Injection, oritavancin",,,3.56,3329.32,41
HCPCS,J240700,"Injection, oritavancin",,,50.68,64.91,3
HCPCS,J2410,Oxymorphone hcl injection,,,3.01,2739849.3,17
HCPCS,J241000,Oxymorphone hcl injection,,,6.68,8.55,3
HCPCS,J2425,Palifermin injection,,,4.58,3329.32,41
HCPCS,J242500,Palifermin injection,,,65.2,83.52,3
HCPCS,J2426,"Inj, invega sustenna, 1 mg",,,1.89,1622.37,41
HCPCS,J2426,PR PALIPERIDONE PALMITATE INJ,43.2,28.08,1.1,43.2,78
HCPCS,J242600,"Inj, invega sustenna, 1 mg",,,26.9,34.45,3
HCPCS,J2427,"Inj, invega hafyera/trinza",,,1.62,8832.81,40
HCPCS,J242700,"Inj, invega hafyera/trinza",,,23.12,29.62,3
HCPCS,J2428,"Inj, erzofri, 1 mg",,,1.91,1622.37,30
HCPCS,J242800,"Inj, erzofri, 1 mg",,,27.23,34.88,3
HCPCS,J2430,GNRC PAMIDR DISODIUM PER 30MG,98.2,63.83,19.76,98.2,75
HCPCS,J2430,Pamidronate disodium /30 mg,,,20.1,25.74,3
HCPCS,J243000,Pamidronate disodium /30 mg,,,20.1,25.74,3
HCPCS,J2440,Papaverin hcl injection,,,9.64,102.6,16
HCPCS,J244000,Papaverin hcl injection,,,80.1,102.6,3
HCPCS,J2460,Oxytetracycline injection,,,1.96,60.42,14
HCPCS,J246000,Oxytetracycline injection,,,1.96,2.51,3
HCPCS,J2468,"Inj, palonosetron (posfrea)",,,7.32,135.91,39
HCPCS,J246800,"Inj, palonosetron (posfrea)",,,104.27,133.56,3
HCPCS,J2469,"PALONOSETRON HCL INJ, 25 MCG",136.54,88.75,0.62,136.54,75
HCPCS,J2469,Palonosetron hcl,,,0.62,0.8,3
HCPCS,J246900,Palonosetron hcl,,,0.62,0.8,3
HCPCS,J2470,Inj pantoprazole sodium 40mg,,,4.04,21.03,15
HCPCS,J247000,Inj pantoprazole sodium 40mg,,,4.04,5.18,3
HCPCS,J2471,Inj pantoprazole(hikma) 40mg,,,7.48,16.77,15
HCPCS,J247100,Inj pantoprazole(hikma) 40mg,,,7.48,9.58,3
HCPCS,J2472,"Inj, pantoprazole sodium chl",,,9.64,24.12,15
HCPCS,J247200,"Inj, pantoprazole sodium chl",,,18.83,24.12,3
HCPCS,J2501,Paricalcitol,,,0.83,11.17,19
HCPCS,J250100,Paricalcitol,,,1.73,2.21,3
HCPCS,J2502,"Inj, pasireotide long acting",,,71.88,5565.45,40
HCPCS,J250200,"Inj, pasireotide long acting",,,1023.62,1311.16,3
HCPCS,J2503,Pegaptanib sodium injection,,,815.14,1951.43,12
HCPCS,J2504,"Pegademase bovine, 25 iu",,,332.43,1008.21,12
HCPCS,J2505,"Injection, pegfilgrastim 6mg",,,3543.91,4103.47,8
HCPCS,J2506,Inj pegfilgrast ex bio 0.5mg,,,15.36,4103.47,41
HCPCS,J250600,Inj pegfilgrast ex bio 0.5mg,,,218.66,280.08,3
HCPCS,J2507,PEGLOTICASE INJECTION 1 MG,8362.57,5435.67,2007.02,16514.52,93
HCPCS,J2507,Pegloticase injection,,,6708.48,8592.89,3
HCPCS,J250700,Pegloticase injection,,,6708.48,8592.89,3
HCPCS,J2508,Pegunigalsidase alfa-iwxj,,,28.24,4103.47,40
HCPCS,J250800,Pegunigalsidase alfa-iwxj,,,402.19,515.17,3
HCPCS,J2510,Penicillin g procaine inj,,,33.33,125.72,25
HCPCS,J251000,Penicillin g procaine inj,,,98.15,125.72,3
HCPCS,J2513,Pentastarch 10% solution,,,544.05,2739849.3,9
HCPCS,J2515,Pentobarbital sodium inj,,,4.53,164.23,30
HCPCS,J251500,Pentobarbital sodium inj,,,90.25,115.6,3
HCPCS,J2516,"Inj, pentamidine isethionate",,,0.41,60.42,16
HCPCS,J251600,"Inj, pentamidine isethionate",,,0.43,0.55,3
HCPCS,J2540,PENICILLIN G POTASSIUM INJ,46.8,30.42,0.78,46.8,78
HCPCS,J2540,PENICILLIN G TO 600000 UNITS,65.82,42.78,1.37,65.82,75
HCPCS,J2540,Penicillin g potassium inj,,,1.39,1.78,3
HCPCS,J254000,Penicillin g potassium inj,,,1.39,1.78,3
HCPCS,J2543,Piperacillin/tazobactam,,,1.94,2.49,3
HCPCS,J2543,ZOSYN  1 GM/0.125 GM,37.0,24.05,1.91,37.0,75
HCPCS,J254300,Piperacillin/tazobactam,,,1.94,2.49,3
HCPCS,J2545,PENTAMIDINE ISETHIONTE/300MG,207.0,134.55,1.1,207.0,78
HCPCS,J2545,Pentamidine non-comp unit,,,129.02,256.5,17
HCPCS,J254500,Pentamidine non-comp unit,,,200.25,256.5,3
HCPCS,J2547,"Injection, peramivir",,,0.21,3329.32,38
HCPCS,J254700,"Injection, peramivir",,,3.38,4.33,3
HCPCS,J2550,Promethazine hcl injection,,,2.67,11.17,19
HCPCS,J255000,Promethazine hcl injection,,,7.07,9.05,3
HCPCS,J2560,Phenobarbital sodium inj,,,43.3,86.12,19
HCPCS,J256000,Phenobarbital sodium inj,,,51.76,66.3,3
HCPCS,J2561,"Inj, sezaby, 1 mg",,,0.15,60.42,36
HCPCS,J256100,"Inj, sezaby, 1 mg",,,2.85,3.65,3
HCPCS,J2562,Plerixafor injection,,,3.83,5565.45,41
HCPCS,J256200,Plerixafor injection,,,54.57,69.9,3
HCPCS,J2590,Oxytocin injection,,,2.99,11.17,15
HCPCS,J259000,Oxytocin injection,,,2.99,3.83,3
HCPCS,J2596,Vasopressin (long grove) 1 u,,,3.13,60.42,16
HCPCS,J259600,Vasopressin (long grove) 1 u,,,3.19,4.08,3
HCPCS,J2597,DESMOPRESSIN ACETATE 1MCG,36.01,23.41,5.42,232.34,83
HCPCS,J2597,Inj desmopressin acetate,,,6.07,7.77,3
HCPCS,J259700,Inj desmopressin acetate,,,6.07,7.77,3
HCPCS,J2598,"Inj, vasopressin, 1 unit",,,0.92,60.42,19
HCPCS,J259800,"Inj, vasopressin, 1 unit",,,0.94,1.21,3
HCPCS,J2599,Inj vasopressin (am reg) 1 u,,,0.28,60.42,19
HCPCS,J259900,Inj vasopressin (am reg) 1 u,,,1.53,1.96,3
HCPCS,J2601,"Inj, vasopressin (baxter)",,,0.28,60.42,39
HCPCS,J260100,"Inj, vasopressin (baxter)",,,3.95,5.06,3
HCPCS,J2650,Prednisolone acetate inj,,,0.89,11.17,14
HCPCS,J265000,Prednisolone acetate inj,,,0.89,1.14,3
HCPCS,J2670,Totazoline hcl injection,,,7.35,2739849.3,14
HCPCS,J267000,Totazoline hcl injection,,,7.35,9.42,3
HCPCS,J2675,Inj progesterone per 50 mg,,,1.28,1.64,3
HCPCS,J2675,PROGESTERONE INJ PER 50 MG,8.0,5.2,1.25,11.17,75
HCPCS,J267500,Inj progesterone per 50 mg,,,1.28,1.64,3
HCPCS,J2679,Inj fluphenazine hcl 1.25 mg,,,7.35,60.42,25
HCPCS,J267900,Inj fluphenazine hcl 1.25 mg,,,13.15,16.85,3
HCPCS,J2680,Fluphenazine decanoate 25 mg,,,10.85,60.42,19
HCPCS,J268000,Fluphenazine decanoate 25 mg,,,11.04,14.14,3
HCPCS,J2690,Procainamide hcl injection,,,43.07,785.53,41
HCPCS,J269000,Procainamide hcl injection,,,613.26,785.53,3
HCPCS,J2700,Oxacillin sodium injeciton,,,1.0,11.17,19
HCPCS,J270000,Oxacillin sodium injeciton,,,1.01,1.3,3
HCPCS,J2704,"Inj, propofol, 10 mg",,,0.14,11.17,19
HCPCS,J270400,"Inj, propofol, 10 mg",,,0.16,0.21,3
HCPCS,J2710,Neostigmine methylslfte inj,,,1.5,11.17,16
HCPCS,J271000,Neostigmine methylslfte inj,,,1.5,1.92,3
HCPCS,J2711,Inj neostigmin/glycopyrrolat,,,1.51,11.17,13
HCPCS,J271100,Inj neostigmin/glycopyrrolat,,,1.51,1.94,3
HCPCS,J2720,Inj protamine sulfate/10 mg,,,1.53,11.17,19
HCPCS,J272000,Inj protamine sulfate/10 mg,,,2.79,3.58,3
HCPCS,J2724,Protein c concentrate,,,1.88,4103.47,41
HCPCS,J272400,Protein c concentrate,,,26.72,34.22,3
HCPCS,J2725,Inj protirelin per 250 mcg,,,45.71,2739849.3,14
HCPCS,J272500,Inj protirelin per 250 mcg,,,45.71,58.55,3
HCPCS,J2730,Pralidoxime chloride inj,,,58.88,237.21,16
HCPCS,J273000,Pralidoxime chloride inj,,,185.19,237.21,3
HCPCS,J2760,Phentolaine mesylate inj,,,748.6,958.88,3
HCPCS,J2760,REGITINE INJ TO 5 MG,167.4,108.81,40.18,958.88,93
HCPCS,J276000,Phentolaine mesylate inj,,,748.6,958.88,3
HCPCS,J2765,"METOCLOPRAMIDE HCL,<=10 MG",8.0,5.2,1.74,11.17,75
HCPCS,J2765,Metoclopramide hcl injection,,,1.92,2.46,3
HCPCS,J276500,Metoclopramide hcl injection,,,1.92,2.46,3
HCPCS,J2770,Quinupristin/dalfopristin,,,4.26,1353.48,25
HCPCS,J277000,Quinupristin/dalfopristin,,,995.39,1275.0,3
HCPCS,J2777,"Inj, faricimab-svoa, 0.1mg",,,4.11,3329.32,41
HCPCS,J277700,"Inj, faricimab-svoa, 0.1mg",,,58.56,75.01,3
HCPCS,J2778,LUCENTIS 0.1MG/0.5 MG,1404.2,912.73,65.44,1622.37,93
HCPCS,J2778,RANIBIZUMAB INJECTION,1404.2,912.73,1.1,1404.2,78
HCPCS,J2778,Ranibizumab injection,,,116.48,149.2,3
HCPCS,J277800,Ranibizumab injection,,,116.48,149.2,3
HCPCS,J2779,"Inj, susvimo 0.1 mg",,,9.53,5565.45,40
HCPCS,J277900,"Inj, susvimo 0.1 mg",,,135.67,173.78,3
HCPCS,J2780,Ranitidine hydrochloride inj,,,13.76,17.62,3
HCPCS,J2780,"ZANTAC INJ, 25 MG",3.99,2.59,0.87,17.62,74
HCPCS,J278000,Ranitidine hydrochloride inj,,,13.76,17.62,3
HCPCS,J2781,"Inj, pegcetacoplan, 1mg",,,17.26,3329.32,40
HCPCS,J278100,"Inj, pegcetacoplan, 1mg",,,245.73,314.75,3
HCPCS,J2782,Inj avacincaptad pegol 0.1mg,,,12.87,3329.32,40
HCPCS,J278200,Inj avacincaptad pegol 0.1mg,,,183.2,234.66,3
HCPCS,J2783,Rasburicase,,,47.92,4103.47,41
HCPCS,J278300,Rasburicase,,,682.4,874.08,3
HCPCS,J2785,"LEXISCAN (REGADENOSON) INJ, 0.1 MG.",197.75,128.54,4.69,197.75,75
HCPCS,J2785,REGADENOSON INJ 0.1 MG,109.0,70.85,4.69,149.95,75
HCPCS,J2785,REGADENOSON INJECTION,197.38,128.3,1.1,197.38,78
HCPCS,J2785,Regadenoson injection,,,4.77,6.11,3
HCPCS,J278500,Regadenoson injection,,,4.77,6.11,3
HCPCS,J2786,"Injection, reslizumab, 1mg",,,1.39,3329.32,41
HCPCS,J278600,"Injection, reslizumab, 1mg",,,19.81,25.38,3
HCPCS,J2787,RIBOFLAVIN 5'PHOSPHATE OPTH SOLUTION UPTO 3 ML,3130.0,2034.5,9.64,6238.08,75
HCPCS,J2787,Riboflavin 5'phos opth<=3ml,,,4870.08,6238.08,3
HCPCS,J278700,Riboflavin 5'phos opth<=3ml,,,4870.08,6238.08,3
HCPCS,J2788,Rho d immune globulin 50 mcg,,,25.78,65.21,19
HCPCS,J278800,Rho d immune globulin 50 mcg,,,40.82,52.28,3
HCPCS,J2790,RHO(D) IMMUNE GLOBULIN INJ,425.8,276.77,92.82,425.8,75
HCPCS,J2790,Rho d immune globulin inj,,,143.34,183.61,3
HCPCS,J279000,Rho d immune globulin inj,,,143.34,183.61,3
HCPCS,J2791,"INJECTION, RHO D IMMUNE GLOBULIN (HUMAN), (RHOPHYLAC)",63.79,41.46,8.45,164.23,75
HCPCS,J2791,RHOPHYLAC INJECTION,63.79,41.46,1.1,63.79,78
HCPCS,J2791,Rhophylac injection,,,8.6,11.01,3
HCPCS,J279100,Rhophylac injection,,,8.6,11.01,3
HCPCS,J2792,"Rho(d) immune globulin h, sd",,,4.24,5653.6,41
HCPCS,J279200,"Rho(d) immune globulin h, sd",,,60.36,77.31,3
HCPCS,J2793,Rilonacept injection,,,25.55,2739849.3,17
HCPCS,J279300,Rilonacept injection,,,57.89,74.15,3
HCPCS,J2794,"Inj risperdal consta, 0.5 mg",,,1.4,840.33,41
HCPCS,J279400,"Inj risperdal consta, 0.5 mg",,,19.9,25.49,3
HCPCS,J2795,"ROPIVACAINE HCL INJ, 1 MG",45.16,29.35,0.09,45.16,75
HCPCS,J2795,ROPIVICAINE 0.5 % 10ML,25.85,16.8,0.09,25.85,75
HCPCS,J2795,ROPIVICAINE 1% 10ML,41.32,26.86,0.09,41.32,75
HCPCS,J2795,Ropivacaine hcl injection,,,0.09,0.11,3
HCPCS,J279500,Ropivacaine hcl injection,,,0.09,0.11,3
HCPCS,J2796,"INJ, ROMIPLOSTIM, 10 MCG",186.48,121.21,40.65,1622.37,75
HCPCS,J2796,Romiplostim injection,,,224.01,286.94,3
HCPCS,J279600,Romiplostim injection,,,224.01,286.94,3
HCPCS,J2797,"Inj., rolapitant, 0.5 mg",,,0.96,2739849.3,15
HCPCS,J279700,"Inj., rolapitant, 0.5 mg",,,1.89,2.42,3
HCPCS,J2798,"Inj., perseris, 0.5 mg",,,1.52,840.33,41
HCPCS,J279800,"Inj., perseris, 0.5 mg",,,21.61,27.68,3
HCPCS,J2799,"Inj, uzedy, 1 mg",,,3.13,1622.37,40
HCPCS,J279900,"Inj, uzedy, 1 mg",,,44.57,57.09,3
HCPCS,J2800,Methocarbamol injection,,,8.08,10.35,3
HCPCS,J2800,ROBAXIN UP TO 10 ML,16.0,10.4,3.49,16.0,75
HCPCS,J280000,Methocarbamol injection,,,8.08,10.35,3
HCPCS,J2801,"Inj, rykindo, 0.5 mg",,,1.63,840.33,37
HCPCS,J280100,"Inj, rykindo, 0.5 mg",,,26.26,33.63,3
HCPCS,J2802,"Inj, romiplostim 1 microgram",,,1.38,1622.37,39
HCPCS,J280200,"Inj, romiplostim 1 microgram",,,19.67,25.19,3
HCPCS,J2804,"Inj, rifampin, 1 mg",,,0.27,11.17,16
HCPCS,J280400,"Inj, rifampin, 1 mg",,,0.27,0.34,3
HCPCS,J2805,CCK DOSE,320.0,208.0,69.76,320.0,75
HCPCS,J2805,SINCALIDE INJECTION,320.0,208.0,1.1,407.11,78
HCPCS,J2805,Sincalide injection,,,196.03,251.1,3
HCPCS,J280500,Sincalide injection,,,196.03,251.1,3
HCPCS,J2806,"Inj sincalide, maia, 5 mcg",,,58.37,164.23,11
HCPCS,J280600,"Inj sincalide, maia, 5 mcg",,,58.37,74.76,3
HCPCS,J2810,Inj theophylline per 40 mg,,,0.39,2739849.3,17
HCPCS,J281000,Inj theophylline per 40 mg,,,0.84,1.07,3
HCPCS,J2820,Sargramostim injection,,,7.72,465.3,41
HCPCS,J282000,Sargramostim injection,,,109.92,140.79,3
HCPCS,J2840,Inj sebelipase alfa 1 mg,,,67.51,20935.21,38
HCPCS,J284000,Inj sebelipase alfa 1 mg,,,1090.43,1396.73,3
HCPCS,J2850,Inj secretin synthetic human,,,5.06,840.33,39
HCPCS,J285000,Inj secretin synthetic human,,,88.25,113.04,3
HCPCS,J2860,"Injection, siltuximab",,,21.09,5565.45,41
HCPCS,J286000,"Injection, siltuximab",,,300.25,384.59,3
HCPCS,J2865,Inj sulfameth/trim 5 mg/1 mg,,,0.07,60.42,16
HCPCS,J286500,Inj sulfameth/trim 5 mg/1 mg,,,0.07,0.09,3
HCPCS,J2910,Aurothioglucose injeciton,,,52.18,2739849.3,9
HCPCS,J2916,"FERRLECIT INJ, 12.5 MG",21.33,13.86,3.87,60.42,75
HCPCS,J2916,Na ferric gluconate complex,,,3.93,5.04,3
HCPCS,J291600,Na ferric gluconate complex,,,3.93,5.04,3
HCPCS,J2919,"Inj, methylpred sod succ 5mg",,,0.3,11.17,25
HCPCS,J291900,"Inj, methylpred sod succ 5mg",,,0.46,0.59,3
HCPCS,J2920,Methylprednisolone injection,,,10.25,13.13,3
HCPCS,J2920,"SOLUMEDROL,  40 MG",7.5,4.88,1.64,13.13,74
HCPCS,J292000,Methylprednisolone injection,,,10.25,13.13,3
HCPCS,J2930,Methylprednisolone injection,,,6.35,20.79,13
HCPCS,J293000,Methylprednisolone injection,,,16.23,20.79,3
HCPCS,J2940,Somatrem injection,,,52.18,2739849.3,9
HCPCS,J2941,Somatropin injection,,,48.92,448.13,24
HCPCS,J294100,Somatropin injection,,,332.04,425.31,3
HCPCS,J2950,Promazine hcl injection,,,1.85,11.17,11
HCPCS,J295000,Promazine hcl injection,,,1.85,2.37,3
HCPCS,J2993,Reteplase injection,,,363.07,8265.55,39
HCPCS,J299300,Reteplase injection,,,6452.93,8265.55,3
HCPCS,J2995,Inj streptokinase /250000 iu,,,52.18,2739849.3,11
HCPCS,J2997,Alteplase recombinant,,,167.02,213.93,3
HCPCS,J2997,"TPA INJ, 1 MG",97.72,63.52,23.45,213.93,93
HCPCS,J299700,Alteplase recombinant,,,167.02,213.93,3
HCPCS,J2998,Inj plasminogen tvmh 1mg,,,4.33,908.28,38
HCPCS,J299800,Inj plasminogen tvmh 1mg,,,85.24,109.19,3
HCPCS,J3000,Streptomycin injection,,,34.63,89.1,19
HCPCS,J300000,Streptomycin injection,,,60.31,77.25,3
HCPCS,J3010,Fentanyl citrate injection,,,0.75,11.17,19
HCPCS,J301000,Fentanyl citrate injection,,,2.12,2.71,3
HCPCS,J3030,SUMATRIPTAN SUCCINATE 6 MG,211.0,137.15,46.0,348.15,75
HCPCS,J3030,Sumatriptan succinate / 6 mg,,,79.03,101.23,3
HCPCS,J303000,Sumatriptan succinate / 6 mg,,,79.03,101.23,3
HCPCS,J3031,"Inj., fremanezumab-vfrm 1 mg",,,1.82,465.3,18
HCPCS,J303100,"Inj., fremanezumab-vfrm 1 mg",,,7.17,9.19,3
HCPCS,J3032,Inj. eptinezumab-jjmr 1 mg,,,2.56,1622.37,41
HCPCS,J303200,Inj. eptinezumab-jjmr 1 mg,,,36.49,46.74,3
HCPCS,J3055,Inj talquetamab-tgvs 0.25 mg,,,9.37,5565.45,40
HCPCS,J305500,Inj talquetamab-tgvs 0.25 mg,,,133.36,170.82,3
HCPCS,J3060,"INJ, TALIGLUCERACE ALFA 10 U",107.15,69.65,25.72,16514.52,93
HCPCS,J3060,"Inj, taliglucerase alfa 10 u",,,72.87,93.34,3
HCPCS,J306000,"Inj, taliglucerase alfa 10 u",,,72.87,93.34,3
HCPCS,J3070,Pentazocine injection,,,9.64,279.76,16
HCPCS,J307000,Pentazocine injection,,,218.41,279.76,3
HCPCS,J3090,Inj tedizolid phosphate,,,0.25,465.3,41
HCPCS,J309000,Inj tedizolid phosphate,,,3.49,4.47,3
HCPCS,J3095,Telavancin injection,,,0.92,465.3,41
HCPCS,J309500,Telavancin injection,,,13.12,16.8,3
HCPCS,J3101,Tenecteplase injection,,,23.37,5565.45,41
HCPCS,J310100,Tenecteplase injection,,,332.81,426.29,3
HCPCS,J3105,Terbutaline sulfate inj,,,3.09,21.34,19
HCPCS,J310500,Terbutaline sulfate inj,,,4.4,5.63,3
HCPCS,J3110,Teriparatide injection,,,9.75,4103.47,17
HCPCS,J311000,Teriparatide injection,,,99.13,126.97,3
HCPCS,J3111,INJ ROMOSOZUMAB-AQQG 1 MG,3286.0,2135.9,10.69,3286.0,93
HCPCS,J3111,Inj. romosozumab-aqqg 1 mg,,,21.56,27.61,3
HCPCS,J311100,Inj. romosozumab-aqqg 1 mg,,,21.56,27.61,3
HCPCS,J3121,Inj testostero enanthate 1mg,,,0.05,11.17,19
HCPCS,J312100,Inj testostero enanthate 1mg,,,0.09,0.11,3
HCPCS,J3145,Testosterone undecanoate 1mg,,,0.26,908.28,41
HCPCS,J314500,Testosterone undecanoate 1mg,,,3.68,4.72,3
HCPCS,J3230,Chlorpromazine hcl injection,,,32.4,81.62,19
HCPCS,J323000,Chlorpromazine hcl injection,,,42.31,54.2,3
HCPCS,J3240,THYROTROPIN ALFA 0.9 MG,4871.8,3166.67,1169.23,4871.8,93
HCPCS,J3240,Thyrotropin injection,,,3783.64,4846.46,3
HCPCS,J324000,Thyrotropin injection,,,3783.64,4846.46,3
HCPCS,J3241,Inj. teprotumumab-trbw 10 mg,,,46.16,16514.52,41
HCPCS,J324100,Inj. teprotumumab-trbw 10 mg,,,657.37,842.03,3
HCPCS,J3243,Tigecycline injection,,,0.98,60.42,19
HCPCS,J324300,Tigecycline injection,,,1.0,1.28,3
HCPCS,J3244,Inj. tigecycline (accord),,,0.95,60.42,18
HCPCS,J324400,Inj. tigecycline (accord),,,5.34,6.84,3
HCPCS,J3245,"Inj., tildrakizumab, 1 mg",,,15.47,8832.81,41
HCPCS,J324500,"Inj., tildrakizumab, 1 mg",,,220.35,282.24,3
HCPCS,J3246,Tirofiban hcl,,,4.1,412.04,19
HCPCS,J324600,Tirofiban hcl,,,6.14,7.87,3
HCPCS,J3247,Inj secukinumab intrav 1mg,,,2.26,3329.32,39
HCPCS,J324700,Inj secukinumab intrav 1mg,,,32.16,41.2,3
HCPCS,J3250,TRIMETHOBENZAMIDE HCL,18.35,11.93,4.0,131.33,75
HCPCS,J3250,Trimethobenzamide hcl inj,,,102.53,131.33,3
HCPCS,J325000,Trimethobenzamide hcl inj,,,102.53,131.33,3
HCPCS,J3260,TOBRAMYCIN SULFATE 80MG,7.5,4.88,1.64,11.17,75
HCPCS,J3260,Tobramycin sulfate injection,,,3.68,4.72,3
HCPCS,J326000,Tobramycin sulfate injection,,,3.68,4.72,3
HCPCS,J3262,TOCILIZUMAB INJECTION 1 MG,38.86,25.26,5.6,1622.37,93
HCPCS,J3262,Tocilizumab injection,,,9.99,12.79,3
HCPCS,J326200,Tocilizumab injection,,,9.99,12.79,3
HCPCS,J3263,"Inj, toripalimab-tpzi, 1 mg",,,5.03,5565.45,39
HCPCS,J326300,"Inj, toripalimab-tpzi, 1 mg",,,71.57,91.68,3
HCPCS,J3265,Injection torsemide 10 mg/ml,,,4.71,2739849.3,14
HCPCS,J326500,Injection torsemide 10 mg/ml,,,6.35,8.14,3
HCPCS,J3280,Thiethylperazine maleate inj,,,4.11,2739849.3,12
HCPCS,J3285,Treprostinil injection,,,6.81,840.33,41
HCPCS,J328500,Treprostinil injection,,,96.97,124.21,3
HCPCS,J3290,"Inj, tranexamic acid 5 mg",,,0.05,60.42,13
HCPCS,J329000,"Inj, tranexamic acid 5 mg",,,0.05,0.07,3
HCPCS,J3291,Tranexamic acid in sod chlor,,,0.21,60.42,13
HCPCS,J329100,Tranexamic acid in sod chlor,,,0.21,0.27,3
HCPCS,J3299,Inj xipere 1 mg,,,5.98,232.34,40
HCPCS,J329900,Inj xipere 1 mg,,,85.17,109.1,3
HCPCS,J3300,TRIAMCINOLONE A INJ PRS-FREE,12.92,8.4,1.1,46.78,78
HCPCS,J3300,TRIAMCINOLONE A PRS-FREE 1 MG,12.92,8.4,3.1,164.23,85
HCPCS,J3300,Triamcinolone a inj prs-free,,,43.59,55.84,3
HCPCS,J330000,Triamcinolone a inj prs-free,,,43.59,55.84,3
HCPCS,J3301,KENALOG 10MG,300.0,195.0,0.87,300.0,78
HCPCS,J3301,KENALOG 40 MG /PER 1 CC,43.1,28.02,1.3,43.1,75
HCPCS,J3301,KENALOG 40MG/ML,43.1,28.02,1.3,43.1,75
HCPCS,J3301,KENALOG PER 10MG,40.75,26.49,0.87,40.75,78
HCPCS,J3301,TRIAMCINOLONE ACET INJ 10 MG,43.1,28.02,1.3,43.1,75
HCPCS,J3301,Triamcinolone acet inj nos,,,1.32,1.69,3
HCPCS,J330100,Triamcinolone acet inj nos,,,1.32,1.69,3
HCPCS,J3302,Triamcinolone diacetate inj,,,0.5,11.17,15
HCPCS,J330200,Triamcinolone diacetate inj,,,0.5,0.64,3
HCPCS,J3303,ARISTOSPAN,48.0,31.2,10.46,60.42,75
HCPCS,J3303,Triamcinolone hexacetonl inj,,,17.36,22.23,3
HCPCS,J330300,Triamcinolone hexacetonl inj,,,17.36,22.23,3
HCPCS,J3304,Inj triamcinolone ace xr 1mg,,,2.32,840.33,41
HCPCS,J330400,Inj triamcinolone ace xr 1mg,,,33.07,42.36,3
HCPCS,J3305,Inj trimetrexate glucoronate,,,52.18,2739849.3,9
HCPCS,J3310,Perphenazine injeciton,,,1.36,11.17,9
HCPCS,J3315,Triptorelin pamoate,,,57.9,1380.54,41
HCPCS,J331500,Triptorelin pamoate,,,824.5,1056.1,3
HCPCS,J3316,"Inj., triptorelin xr 3.75 mg",,,470.62,8842.97,40
HCPCS,J331600,"Inj., triptorelin xr 3.75 mg",,,6701.68,8584.18,3
HCPCS,J3320,Spectinomycn di-hcl inj,,,13.05,2739849.3,10
HCPCS,J3350,Urea injection,,,52.18,2739849.3,14
HCPCS,J335000,Urea injection,,,158.21,202.65,3
HCPCS,J3355,"Urofollitropin, 75 iu",,,127.26,232.34,11
HCPCS,J3357,USTEKINUMAB INJECTION 1 MG,612.92,398.4,133.62,8832.81,83
HCPCS,J3357,"Ustekinumab sub cu inj, 1 mg",,,605.38,775.43,3
HCPCS,J335700,"Ustekinumab sub cu inj, 1 mg",,,605.38,775.43,3
HCPCS,J3358,"USTEKINUMAB, IV INJECT, 1 MG",44.32,28.81,10.64,5653.6,93
HCPCS,J3358,"Ustekinumab, iv inject, 1 mg",,,22.23,28.48,3
HCPCS,J335800,"Ustekinumab, iv inject, 1 mg",,,22.23,28.48,3
HCPCS,J3360,DIAZEPAM INJ TO 5 MG,44.85,29.15,9.64,44.85,75
HCPCS,J3360,Diazepam injection,,,11.91,15.25,3
HCPCS,J336000,Diazepam injection,,,11.91,15.25,3
HCPCS,J3364,Urokinase 5000 iu injection,,,9.32,37.89,10
HCPCS,J3365,"Urokinase 250,000 iu inj",,,466.36,2739849.3,10
HCPCS,J3370,Vancomycin hcl injection,,,2.84,11.17,12
HCPCS,J3371,"Inj, vancomycin hcl (mylan)",,,3.35,16.36,13
HCPCS,J3372,"Inj, vancomycin hcl (xellia)",,,3.35,18.03,13
HCPCS,J3373,"Inj, vancomycin hcl, 10 mg",,,0.05,11.17,16
HCPCS,J337300,"Inj, vancomycin hcl, 10 mg",,,0.05,0.07,3
HCPCS,J3374,"Inj, vancomycin (mylan) 10mg",,,0.18,11.17,16
HCPCS,J337400,"Inj, vancomycin (mylan) 10mg",,,0.18,0.23,3
HCPCS,J3375,Inj vancomycin (xellia) 10mg,,,0.23,11.17,16
HCPCS,J337500,Inj vancomycin (xellia) 10mg,,,0.23,0.3,3
HCPCS,J3376,Inj vancomycin (hikma) 10mg,,,0.03,11.17,16
HCPCS,J337600,Inj vancomycin (hikma) 10mg,,,0.04,0.05,3
HCPCS,J3379,"Inj, valproate sod, 5 mg",,,0.08,232.34,16
HCPCS,J337900,"Inj, valproate sod, 5 mg",,,0.09,0.11,3
HCPCS,J3380,Inj vedolizumab iv 1 mg,,,38.04,48.72,3
HCPCS,J3380,VEDOLIZUMAB (ENTYVIO) 1MG,65.05,42.28,15.61,5565.45,93
HCPCS,J338000,Inj vedolizumab iv 1 mg,,,38.04,48.72,3
HCPCS,J3385,VELAGLUCERASE ALFA 100 UNITS,4861.0,3159.65,367.84,8832.81,93
HCPCS,J3385,Velaglucerase alfa,,,687.85,881.06,3
HCPCS,J338500,Velaglucerase alfa,,,687.85,881.06,3
HCPCS,J3387,Inj elivaldogene autotemecel,,,0.01,3498000.0,22
HCPCS,J3389,Topi adm prad zami per treat,,,0.01,3669402.0,22
HCPCS,J3391,"Inj, atidarsagene autotemcel",,,0.01,4955500.0,22
HCPCS,J3392,"Inj, exagamglogene autotem",,,0.01,5013800.0,31
HCPCS,J3393,"Inj, betibeglogene autotemce",,,0.01,6381200.0,31
HCPCS,"J3393,J3490,J359","Inj, betibeglogene autotemce",,,2884000.0,2884000.0,1
HCPCS,J3394,"Inj, lovotibeglogene autotem",,,0.01,6864950.0,31
HCPCS,"J3394,J3490,J359","Inj, lovotibeglogene autotem",,,3399000.0,3399000.0,1
HCPCS,J3396,Verteporfin injection,,,1.45,1622.37,41
HCPCS,J339600,Verteporfin injection,,,20.58,26.36,3
HCPCS,J3397,"Inj., vestronidase alfa-vjbk",,,35.01,2739849.3,31
HCPCS,J339700,"Inj., vestronidase alfa-vjbk",,,580.14,743.1,3
HCPCS,J3398,Inj luxturna 1 billion vec g,,,0.01,16514.52,37
HCPCS,J339800,Inj luxturna 1 billion vec g,,,6505.9,8333.4,3
HCPCS,J3399,Inj onase abepar-xioi treat,,,0.01,6309630.0,34
HCPCS,J3400,Triflupromazine hcl inj,,,52.18,2739849.3,9
HCPCS,J3401,"Vyjuvek 5x10^9pfu/ml, 0.1 ml",,,126.85,16514.52,40
HCPCS,J340100,"Vyjuvek 5x10^9pfu/ml, 0.1 ml",,,1806.33,2313.72,3
HCPCS,J3402,Inj. remestemcel-l-rknd/ td,,,0.01,467872.13,28
HCPCS,J340200,Inj. remestemcel-l-rknd/ td,,,358970.86,459805.37,3
HCPCS,J3403,"Revakinagene, per implant",,,11170.21,604200.0,25
HCPCS,J340300,"Revakinagene, per implant",,,471700.0,604200.0,3
HCPCS,J3404,Inj zopap imad-drba,,,18080.41,20935.21,8
HCPCS,J3410,Hydroxyzine hcl injection,,,9.64,29.64,19
HCPCS,J341000,Hydroxyzine hcl injection,,,23.14,29.64,3
HCPCS,J3411,THIAMINE HCL 100 MG INJ,30.8,20.02,3.16,30.8,75
HCPCS,J3411,Thiamine hcl 100 mg,,,3.22,4.13,3
HCPCS,J341100,Thiamine hcl 100 mg,,,3.22,4.13,3
HCPCS,J3415,Pyridoxine hcl 100 mg,,,9.64,40.63,19
HCPCS,J341500,Pyridoxine hcl 100 mg,,,27.7,35.48,3
HCPCS,J3420,ADMIN VITAMIN B12 INJ,27.25,17.71,0.67,27.25,78
HCPCS,J3420,VITAMIN B-12 INJ TO 1000 MCG,8.0,5.2,1.12,11.17,75
HCPCS,J3420,Vitamin b12 injection,,,1.14,1.46,3
HCPCS,J342000,Vitamin b12 injection,,,1.14,1.46,3
HCPCS,J3424,Inj hydroxocobalamin iv 25mg,,,0.68,2054.28,37
HCPCS,J342400,Inj hydroxocobalamin iv 25mg,,,11.2,14.34,3
HCPCS,J3425,Hydroxocobalamin im 10mcg,,,0.01,11.17,25
HCPCS,J342500,Hydroxocobalamin im 10mcg,,,0.02,0.02,3
HCPCS,J3430,VITAMIN K INJ PER 1 MG,7.5,4.88,1.64,60.42,75
HCPCS,J3430,Vitamin k phytonadione inj,,,5.0,6.41,3
HCPCS,J343000,Vitamin k phytonadione inj,,,5.0,6.41,3
HCPCS,J3465,"Injection, voriconazole",,,1.31,60.42,19
HCPCS,J346500,"Injection, voriconazole",,,1.34,1.71,3
HCPCS,J3470,HYALURONIDASE,2.0,1.3,0.51,60.75,74
HCPCS,J3470,HYALURONIDASE INJECTION,201.88,131.22,1.1,201.88,74
HCPCS,J3470,Hyaluronidase injection,,,55.66,164.23,18
HCPCS,J347000,Hyaluronidase injection,,,56.62,72.53,3
HCPCS,J3471,"Ovine, up to 999 usp units",,,0.49,164.23,19
HCPCS,J347100,"Ovine, up to 999 usp units",,,0.89,1.14,3
HCPCS,J3472,"Ovine, 1000 usp units",,,59.93,465.3,16
HCPCS,J347200,"Ovine, 1000 usp units",,,289.25,370.5,3
HCPCS,J3473,Hyaluronidase recombinant,,,0.37,60.42,19
HCPCS,J347300,Hyaluronidase recombinant,,,0.64,0.82,3
HCPCS,J3475,INJ MAGNESIUM SULFATE/500 MG,7.5,4.88,0.71,11.17,75
HCPCS,J3475,Inj magnesium sulfate,,,0.73,0.93,3
HCPCS,J347500,Inj magnesium sulfate,,,0.73,0.93,3
HCPCS,J3480,INJ POTASSIUM CHLRD PER 2 MEQ,1.06,0.69,0.21,11.17,75
HCPCS,J3480,Inj potassium chloride,,,0.21,0.27,3
HCPCS,J348000,Inj potassium chloride,,,0.21,0.27,3
HCPCS,J3485,Zidovudine,,,0.19,60.42,33
HCPCS,J348500,Zidovudine,,,2.69,3.44,3
HCPCS,J3486,Ziprasidone mesylate,,,12.99,60.42,19
HCPCS,J348600,Ziprasidone mesylate,,,16.29,20.86,3
HCPCS,J3489,RECLAST 1MG,252.2,163.93,8.89,252.2,75
HCPCS,J3489,"RECLAST INJECTION, 1 MG",806.3,524.1,8.89,806.3,75
HCPCS,J3489,"ZOMETA, ZOLEDRONIC ACID 1 MG",252.2,163.93,8.89,252.2,75
HCPCS,J3489,Zoledronic acid 1mg,,,9.04,11.58,3
HCPCS,J348900,Zoledronic acid 1mg,,,9.04,11.58,3
HCPCS,J3490,BELOTERO 1.0CC,600.0,390.0,1.1,600.0,68
HCPCS,J3490,JUVEDERM ULTRA PLUS XC,508.0,330.2,52.18,540750.0,74
HCPCS,J3490,KYBELLA  2CC PER VILE,845.0,549.25,1.1,845.0,68
HCPCS,J3490,OCREVUS 30MG/ML,58501.0,38025.65,52.18,540750.0,74
HCPCS,J3490,PRE-PEN (BENZYPENICILLOYL POLYLYSINE),535.96,348.37,1.1,535.96,68
HCPCS,J3490,RESTYLANE,452.0,293.8,52.18,540750.0,74
HCPCS,J3490,RESTYLANE DEFYNE,1077.0,700.05,52.18,540750.0,74
HCPCS,J3490,RESTYLANE LYFT,696.0,452.4,52.18,540750.0,74
HCPCS,"J3490,J3590",Drugs unclassified injection,,,530450.0,530450.0,1
HCPCS,J3520,Edetate disodium per 150 mg,,,0.01,2739849.3,17
HCPCS,J352000,Edetate disodium per 150 mg,,,2.65,3.4,3
HCPCS,J3530,Nasal vaccine inhalation,,,9.64,11.17,8
HCPCS,J3535,Metered dose inhaler drug,,,3.29,60.42,9
HCPCS,J3570,Laetrile amygdalin vit b17,,,52.18,2739849.3,9
HCPCS,J3590,AVASTIN (BEVACIZUMAB) 1.25 MG,50.0,32.5,1.1,50.0,68
HCPCS,J3590,DAXXIFY,9.0,5.85,1.1,9.0,68
HCPCS,J3590,JUV?DERM SKINVIVE,350.0,227.5,1.1,350.0,68
HCPCS,J3590,JUVADERM ULTRA PLUS,313.31,203.65,52.18,2266000.0,68
HCPCS,J3590,JUVADERM VOLBELLA 0.55CC SYRINGE,400.0,260.0,1.1,400.0,68
HCPCS,J3590,JUVADERM VOLBELLA 1CC SYRINGE,725.0,471.25,1.1,725.0,68
HCPCS,J3590,JUVADERM VOLUMA,800.0,520.0,1.1,800.0,68
HCPCS,J3590,JUVADERM VOLUX XC 1CC,800.0,520.0,1.1,800.0,68
HCPCS,J3590,JUVADERMVOLLURE,700.0,455.0,1.1,700.0,68
HCPCS,J3590,JUVEDERM ULTRA  XC 1CC,600.0,390.0,1.1,600.0,68
HCPCS,J3590,JUVEDERM ULTRA .55 CC,600.0,390.0,1.1,600.0,68
HCPCS,J3590,JUVEDERM ULTRA 1 CC,1200.0,780.0,1.1,1200.0,68
HCPCS,J3590,JUVEDERM ULTRA PLUS,600.0,390.0,1.1,600.0,68
HCPCS,J3590,JUVEDERM ULTRA PLUS .55CC,455.0,295.75,1.1,455.0,68
HCPCS,J3590,JUVEDERM ULTRA XC  .55CC,455.0,295.75,1.1,455.0,68
HCPCS,J3590,JUVEDERM VOLBELLA 0.55CC SYRINGE,600.0,390.0,1.1,600.0,68
HCPCS,J3590,JUVEDERM VOLBELLA 1CC SYRINGE,1200.0,780.0,1.1,1200.0,68
HCPCS,J3590,RENUVA HYDRADTED 1.5 SYRINGE,1125.0,731.25,1.1,1125.0,68
HCPCS,J3590,RENUVA HYDRADTED 3.0 SYRINGE,2250.0,1462.5,1.1,2250.0,68
HCPCS,J3590,RENUVA HYDRATED 1.5,1040.0,676.0,52.18,2266000.0,68
HCPCS,J3590,RENUVA HYDRATED 3.0,2060.0,1339.0,52.18,2266000.0,68
HCPCS,J3590,RESTYLANE  .5 CC,600.0,390.0,1.1,600.0,68
HCPCS,J3590,RESTYLANE  .5CC,400.0,260.0,1.1,400.0,68
HCPCS,J3590,RESTYLANE 1 CC SYRINGE,1200.0,780.0,1.1,1200.0,68
HCPCS,J3590,RESTYLANE 1CC SYRINGE,600.0,390.0,1.1,600.0,68
HCPCS,J3590,RESTYLANE CONTOUR,700.0,455.0,1.1,700.0,68
HCPCS,J3590,RESTYLANE DEFYNE,700.0,455.0,1.1,700.0,68
HCPCS,J3590,RESTYLANE EYELIGHT .5,400.0,260.0,1.1,400.0,68
HCPCS,J3590,RESTYLANE EYELIGHT 1CC,900.0,585.0,1.1,900.0,68
HCPCS,J3590,RESTYLANE GENDER AFFIRMING,800.0,520.0,1.1,800.0,68
HCPCS,J3590,RESTYLANE KYSSE 1CC SYRINGE,700.0,455.0,1.1,700.0,68
HCPCS,J3590,RESTYLANE LYFT,600.0,390.0,1.1,600.0,68
HCPCS,J3590,RESTYLANE REFYNE,700.0,455.0,1.1,700.0,68
HCPCS,J3590,RESTYLANE SILK,600.0,390.0,1.1,600.0,68
HCPCS,J3590,RHA 2 (REVANCE),600.0,390.0,1.1,600.0,68
HCPCS,J3590,RHA 3 (REVANCE),600.0,390.0,1.1,600.0,68
HCPCS,J3590,RHA 4 (REVANCE),600.0,390.0,1.1,600.0,68
HCPCS,J3590,UNCLASSIFIED BIOLOGICS,50.0,32.5,1.1,50.0,68
HCPCS,J3591,Esrd on dialysi drug/bio noc,,,9.64,2739849.3,9
HCPCS,J7030,F NACL .9 1000ML,5.0,3.25,1.09,11.17,75
HCPCS,J7030,NORMAL SALINE 1000 CC,6.0,3.9,1.31,11.17,75
HCPCS,J7030,Normal saline solution infus,,,3.54,4.54,3
HCPCS,J7030,SOL IV 0.9% NACL 1L VIAFLX LF,19.0,12.35,3.48,19.0,75
HCPCS,J703000,Normal saline solution infus,,,3.54,4.54,3
HCPCS,J7040,"INFUSION, NORMAL SALINE 500ML",5.0,3.25,1.09,11.17,75
HCPCS,J7040,NORMAL SALINE SOLUTION INFUS,13.0,8.45,1.1,13.0,78
HCPCS,J7040,Normal saline solution infus,,,2.3,2.94,3
HCPCS,J7040,STRL SALINE SOLN 500 ML=1 UNIT,4.0,2.6,0.87,11.17,75
HCPCS,J704000,Normal saline solution infus,,,2.3,2.94,3
HCPCS,J7042,5% dextrose/normal saline,,,2.33,2.99,3
HCPCS,J7042,D5/0.9NS IV 500ML,16.96,11.02,2.29,16.96,75
HCPCS,J704200,5% dextrose/normal saline,,,2.33,2.99,3
HCPCS,J7050,"NRML SALINE SOLUTION, 250 CC",5.0,3.25,1.09,11.17,75
HCPCS,J7050,Normal saline solution infus,,,1.17,1.5,3
HCPCS,J705000,Normal saline solution infus,,,1.17,1.5,3
HCPCS,J7060,5% dextrose/water,,,3.12,3.99,3
HCPCS,J7060,D5W 500ML,7.5,4.88,1.64,11.17,75
HCPCS,J706000,5% dextrose/water,,,3.12,3.99,3
HCPCS,J7070,D5w infusion,,,5.23,6.7,3
HCPCS,J7070,"INFUSION, D-5-W, 1000 CC",7.5,4.88,1.64,11.17,75
HCPCS,J707000,D5w infusion,,,5.23,6.7,3
HCPCS,J7100,Dextran 40 infusion,,,9.64,182.1,15
HCPCS,J710000,Dextran 40 infusion,,,142.17,182.1,3
HCPCS,J7110,Dextran 75 infusion,,,9.64,33.11,14
HCPCS,J711000,Dextran 75 infusion,,,25.85,33.11,3
HCPCS,J7120,RINGERS LACTATE INFUSION,44.0,28.6,1.1,44.0,78
HCPCS,J7120,Ringers lactate infusion,,,2.58,11.17,19
HCPCS,J712000,Ringers lactate infusion,,,4.24,5.43,3
HCPCS,J7121,5% dextrose in lac ringers,,,9.64,21.84,15
HCPCS,J712100,5% dextrose in lac ringers,,,17.05,21.84,3
HCPCS,J7131,Hypertonic saline sol,,,0.19,11.17,15
HCPCS,J713100,Hypertonic saline sol,,,0.36,0.46,3
HCPCS,J7165,"Inj, human-lans, per i.u",,,0.21,4103.47,37
HCPCS,J716500,"Inj, human-lans, per i.u",,,6.73,8.62,3
HCPCS,J7168,Prothrombin complex kcentra,,,0.26,4103.47,39
HCPCS,J716800,Prothrombin complex kcentra,,,6.37,8.16,3
HCPCS,J7169,"Inj andexxa, 10 mg",,,16.42,16514.52,39
HCPCS,J716900,"Inj andexxa, 10 mg",,,267.0,342.0,3
HCPCS,J7170,"Inj., emicizumab-kxwh 0.5 mg",,,7.06,20935.21,41
HCPCS,J717000,"Inj., emicizumab-kxwh 0.5 mg",,,100.5,128.73,3
HCPCS,J7171,"Inj, adzynma, 10 iu",,,4.44,82.31,39
HCPCS,J717100,"Inj, adzynma, 10 iu",,,63.15,80.89,3
HCPCS,J7172,"Inj marstacim-hncq, 0.5 mg",,,6.31,20935.21,30
HCPCS,J717200,"Inj marstacim-hncq, 0.5 mg",,,89.84,115.07,3
HCPCS,J7173,"Inj. concizumab-mtci, 0.5 mg",,,10.69,3329.32,30
HCPCS,J717300,"Inj. concizumab-mtci, 0.5 mg",,,152.19,194.94,3
HCPCS,J7174,Injection fitusiran 0.04 mg,,,16.58,20935.21,30
HCPCS,J717400,Injection fitusiran 0.04 mg,,,236.06,302.37,3
HCPCS,J7175,"Inj, factor x, (human), 1iu",,,1.24,20935.21,41
HCPCS,J717500,"Inj, factor x, (human), 1iu",,,17.66,22.62,3
HCPCS,J7177,"Inj., fibryga, 1 mg",,,0.15,3329.32,41
HCPCS,J717700,"Inj., fibryga, 1 mg",,,2.19,2.8,3
HCPCS,J7178,Inj human fibrinogen con nos,,,0.19,5565.45,41
HCPCS,J717800,Inj human fibrinogen con nos,,,2.72,3.49,3
HCPCS,J7179,Vonvendi inj 1 iu vwf:rco,,,0.23,5565.45,41
HCPCS,J717900,Vonvendi inj 1 iu vwf:rco,,,3.28,4.2,3
HCPCS,J7180,Factor xiii anti-hem factor,,,1.35,20935.21,41
HCPCS,J718000,Factor xiii anti-hem factor,,,19.15,24.53,3
HCPCS,J7181,Factor xiii recomb a-subunit,,,2.32,16514.52,41
HCPCS,J718100,Factor xiii recomb a-subunit,,,33.04,42.32,3
HCPCS,J7182,Factor viii recomb novoeight,,,0.19,5565.45,41
HCPCS,J718200,Factor viii recomb novoeight,,,2.76,3.53,3
HCPCS,J7183,Wilate injection,,,0.17,5653.6,41
HCPCS,J718300,Wilate injection,,,2.35,3.01,3
HCPCS,J7185,Xyntha inj,,,0.2,4103.47,41
HCPCS,J718500,Xyntha inj,,,2.83,3.63,3
HCPCS,J7186,Antihemophilic viii/vwf comp,,,0.16,5653.6,41
HCPCS,J718600,Antihemophilic viii/vwf comp,,,2.21,2.83,3
HCPCS,J7187,"Humate-p, inj",,,0.19,5653.6,41
HCPCS,J718700,"Humate-p, inj",,,2.65,3.4,3
HCPCS,J7188,Factor viii recomb obizur,,,0.4,5565.45,41
HCPCS,J718800,Factor viii recomb obizur,,,5.75,7.36,3
HCPCS,J7189,Factor viia recomb novoseven,,,0.33,5565.45,41
HCPCS,J718900,Factor viia recomb novoseven,,,4.66,5.97,3
HCPCS,J7190,Factor viii,,,0.14,5653.6,41
HCPCS,J719000,Factor viii,,,1.98,2.53,3
HCPCS,J7191,Factor viii (porcine),,,0.68,2739849.3,26
HCPCS,J719100,Factor viii (porcine),,,3.92,5.02,3
HCPCS,J7192,Factor viii recombinant nos,,,0.2,5565.45,41
HCPCS,J719200,Factor viii recombinant nos,,,2.83,3.63,3
HCPCS,J7193,Factor ix non-recombinant,,,0.17,5565.45,41
HCPCS,J719300,Factor ix non-recombinant,,,2.44,3.12,3
HCPCS,J7194,Factor ix complex,,,0.21,5653.6,41
HCPCS,J719400,Factor ix complex,,,3.03,3.88,3
HCPCS,J7195,Factor ix recombinant nos,,,0.23,5565.45,41
HCPCS,J719500,Factor ix recombinant nos,,,3.26,4.17,3
HCPCS,J7196,Antithrombin recombinant,,,300.11,2739849.3,14
HCPCS,J719600,Antithrombin recombinant,,,300.11,384.41,3
HCPCS,J7197,Antithrombin iii injection,,,0.51,5565.45,41
HCPCS,J719700,Antithrombin iii injection,,,7.21,9.23,3
HCPCS,J7198,Anti-inhibitor,,,0.31,5565.45,41
HCPCS,J719800,Anti-inhibitor,,,4.34,5.56,3
HCPCS,J7199,Hemophilia clot factor noc,,,7.32,232.34,9
HCPCS,J7200,Factor ix recombinan rixubis,,,0.22,5565.45,34
HCPCS,J720000,Factor ix recombinan rixubis,,,3.1,3.97,3
HCPCS,J7201,Factor ix alprolix recomb,,,0.45,5565.45,41
HCPCS,J720100,Factor ix alprolix recomb,,,6.41,8.21,3
HCPCS,J7202,Factor ix idelvion inj,,,0.67,5565.45,41
HCPCS,J720200,Factor ix idelvion inj,,,9.47,12.13,3
HCPCS,J7203,Factor ix recomb gly rebinyn,,,0.57,5565.45,41
HCPCS,J720300,Factor ix recomb gly rebinyn,,,8.1,10.37,3
HCPCS,J7204,Inj recombin esperoct per iu,,,0.28,5565.45,41
HCPCS,J720400,Inj recombin esperoct per iu,,,3.99,5.11,3
HCPCS,J7205,Factor viii fc fusion recomb,,,0.31,5565.45,41
HCPCS,J720500,Factor viii fc fusion recomb,,,4.4,5.63,3
HCPCS,J7207,Factor viii pegylated recomb,,,0.27,5565.45,41
HCPCS,J720700,Factor viii pegylated recomb,,,3.84,4.92,3
HCPCS,J7208,Inj. jivi 1 iu,,,0.33,5565.45,41
HCPCS,J720800,Inj. jivi 1 iu,,,4.72,6.04,3
HCPCS,J7209,Factor viii nuwiq recomb 1iu,,,0.14,5653.6,41
HCPCS,J720900,Factor viii nuwiq recomb 1iu,,,2.01,2.58,3
HCPCS,J7210,"Inj, afstyla, 1 i.u.",,,0.2,5565.45,41
HCPCS,J721000,"Inj, afstyla, 1 i.u.",,,2.81,3.6,3
HCPCS,J7211,"Inj, kovaltry, 1 i.u.",,,0.2,5565.45,41
HCPCS,J721100,"Inj, kovaltry, 1 i.u.",,,2.79,3.58,3
HCPCS,J7212,Factor viia recomb sevenfact,,,0.29,5565.45,34
HCPCS,J721200,Factor viia recomb sevenfact,,,4.18,5.36,3
HCPCS,J7213,"Inj, ixinity, 1 i.u.",,,0.26,5565.45,40
HCPCS,J721300,"Inj, ixinity, 1 i.u.",,,3.68,4.72,3
HCPCS,J7214,Altuviiio per factor viii iu,,,0.58,5653.6,40
HCPCS,J721400,Altuviiio per factor viii iu,,,8.21,10.51,3
HCPCS,J7294,Seg acet and eth estr yearly,,,141.84,2739849.3,17
HCPCS,J729400,Seg acet and eth estr yearly,,,5170.29,6622.62,3
HCPCS,J7295,Eth estr and eton monthly,,,141.84,401.94,17
HCPCS,J729500,Eth estr and eton monthly,,,221.75,284.04,3
HCPCS,J7296,KYLEENA IUD,907.12,589.63,197.75,3323.24,75
HCPCS,J7296,"Kyleena, 19.5 mg",,,2594.46,3323.24,3
HCPCS,J729600,"Kyleena, 19.5 mg",,,2594.46,3323.24,3
HCPCS,J7297,LEVONORGESTREL IU 52MG 3 YR,1500.0,975.0,327.0,2549.22,75
HCPCS,J7297,"Liletta, 52 mg",,,1990.18,2549.22,3
HCPCS,J729700,"Liletta, 52 mg",,,1990.18,2549.22,3
HCPCS,J7298,LEVONORGESTREL IU 52MG,1945.25,1264.41,424.06,3323.24,75
HCPCS,J7298,"Mirena, 52 mg",,,2594.46,3323.24,3
HCPCS,J729800,"Mirena, 52 mg",,,2594.46,3323.24,3
HCPCS,J7299,Intraut copp cont (miudella),,,141.84,3116.3,11
HCPCS,J729900,Intraut copp cont (miudella),,,2432.9,3116.3,3
HCPCS,J7300,Intra copp contra (paragard),,,2431.48,3114.48,3
HCPCS,J7300,W IUD COPPER CONTRACEPTIVE,830.0,539.5,141.84,3114.48,75
HCPCS,J730000,Intra copp contra (paragard),,,2431.48,3114.48,3
HCPCS,J7301,LEVONORGESTREL - SKYLA 13.5MG,1560.8,1014.52,340.25,2767.14,75
HCPCS,J7301,"Skyla, 13.5 mg",,,2160.31,2767.14,3
HCPCS,J730100,"Skyla, 13.5 mg",,,2160.31,2767.14,3
HCPCS,J7303,Contraceptive vaginal ring,,,141.84,164.23,8
HCPCS,J7304,Contraceptive hormone patch,,,41.29,164.23,12
HCPCS,J730400,Contraceptive hormone patch,,,86.97,111.4,3
HCPCS,J7306,Levonorgestrel implant sys,,,200.66,1233.0,16
HCPCS,J730600,Levonorgestrel implant sys,,,903.35,1157.1,3
HCPCS,J7307,ETONOGESTREL IMPLANT SYSTEM,1675.325,1088.96,1.1,3409.95,149
HCPCS,J7307,Etonogestrel implant system,,,2594.46,3323.24,3
HCPCS,J730700,Etonogestrel implant system,,,2594.46,3323.24,3
HCPCS,J7308,AMINOLEVULINIC ACID HCL TOP,290.0,188.5,1.1,1199.91,78
HCPCS,J7308,Aminolevulinic acid hcl top,,,693.9,888.81,3
HCPCS,J7308,LEVULAN KERASTICK/TUBE,1400.0,910.0,336.0,1400.0,93
HCPCS,J730800,Aminolevulinic acid hcl top,,,693.9,888.81,3
HCPCS,J7309,"Methyl aminolevulinate, top",,,222.43,465.3,9
HCPCS,J7310,Ganciclovir long act implant,,,8825.26,2739849.3,12
HCPCS,J7311,"Inj., retisert, 0.01 mg",,,29.64,16514.52,41
HCPCS,J731100,"Inj., retisert, 0.01 mg",,,603.31,772.78,3
HCPCS,J7312,DEXAMETHASONE INTRA IMPLANT 0.1 MG,685.68,445.69,164.56,1622.37,93
HCPCS,J7312,Dexamethasone intra implant,,,364.08,466.35,3
HCPCS,J7312,PR DEXAMETHASONE INTRA IMPLANT,685.69,445.7,1.1,685.69,78
HCPCS,J731200,Dexamethasone intra implant,,,364.08,466.35,3
HCPCS,J7313,"Inj., iluvien, 0.01 mg",,,63.43,8832.81,41
HCPCS,J731300,"Inj., iluvien, 0.01 mg",,,903.24,1156.96,3
HCPCS,J7314,FLUOCINOLONE 0.18 MG INTRAVITRREAL IMPLANT,1112.0,722.8,266.88,5565.45,93
HCPCS,J7314,"Inj., yutiq, 0.01 mg",,,943.2,1208.15,3
HCPCS,J731400,"Inj., yutiq, 0.01 mg",,,943.2,1208.15,3
HCPCS,J7315,Ophthalmic mitomycin,,,141.84,1176.48,13
HCPCS,J731500,Ophthalmic mitomycin,,,918.48,1176.48,3
HCPCS,J7316,"Inj, ocriplasmin, 0.125 mg",,,1086.43,5653.6,14
HCPCS,J731600,"Inj, ocriplasmin, 0.125 mg",,,2109.66,2702.26,3
HCPCS,J7318,"HYALURONAN OR DERIVATIVE, DUROLANE, FOR INTRA-ARTICULAR INJECTIO",58.52,38.04,1.1,58.52,78
HCPCS,J7318,"Inj, durolane 1 mg",,,0.82,840.33,41
HCPCS,J731800,"Inj, durolane 1 mg",,,11.61,14.87,3
HCPCS,J7320,"Genvisc 850, inj, 1mg",,,0.6,232.34,41
HCPCS,J732000,"Genvisc 850, inj, 1mg",,,8.47,10.85,3
HCPCS,J7321,HYALGAN/SUPARTZ INJ PER DOSE,826.4300000000001,537.1800000000001,1.1,830.1,153
HCPCS,J7321,Hyalgan supartz visco-3 dose,,,129.89,166.37,3
HCPCS,J732100,Hyalgan supartz visco-3 dose,,,129.89,166.37,3
HCPCS,J7322,"Hyaluronan, hymo or hymo one",,,2.21,465.3,40
HCPCS,J732200,"Hyaluronan, hymo or hymo one",,,31.4,40.22,3
HCPCS,J7323,EUFLEXXA INJ PER DOSE,234.5,152.43,1.1,388.75,171
HCPCS,J7323,Euflexxa inj per dose,,,187.72,240.45,3
HCPCS,J732300,Euflexxa inj per dose,,,187.72,240.45,3
HCPCS,J7324,ORTHOVISC INJ PER DOSE,1152.9,749.39,1.1,1152.9,171
HCPCS,J7324,Orthovisc inj per dose,,,198.04,253.67,3
HCPCS,J732400,Orthovisc inj per dose,,,198.04,253.67,3
HCPCS,J7325,SYNVISC OR SYNVISC-ONE,102.78,66.81,1.1,102.78,78
HCPCS,J7325,SYNVISC OR SYNVISC-ONE 1 MG,93.4,60.71,7.56,465.3,93
HCPCS,J7325,Synvisc or synvisc-one,,,13.46,17.24,3
HCPCS,J732500,Synvisc or synvisc-one,,,13.46,17.24,3
HCPCS,J7326,GEL-ONE PER DOSE,2999.0,1949.35,1.1,3072.0,171
HCPCS,J7326,Gel-one,,,939.93,1203.95,3
HCPCS,J732600,Gel-one,,,939.93,1203.95,3
HCPCS,J7327,Monovisc inj per dose,,,70.6,1957.37,41
HCPCS,J732700,Monovisc inj per dose,,,1005.29,1287.68,3
HCPCS,J7328,GEL-SYN INJECTION 0.1 MG,7.4,4.81,0.59,7.4,78
HCPCS,J7328,Gelsyn-3 injection 0.1 mg,,,0.08,465.3,33
HCPCS,J732800,Gelsyn-3 injection 0.1 mg,,,1.19,1.53,3
HCPCS,J7329,"Inj, trivisc 1 mg",,,0.45,465.3,40
HCPCS,J732900,"Inj, trivisc 1 mg",,,6.43,8.23,3
HCPCS,J7330,Cultured chondrocytes implnt,,,1101.49,190895.28,16
HCPCS,J733000,Cultured chondrocytes implnt,,,149032.28,190895.28,3
HCPCS,J7331,"Synojoynt, inj., 1 mg",,,5.45,465.3,20
HCPCS,J733100,"Synojoynt, inj., 1 mg",,,5.55,7.11,3
HCPCS,J7332,"Inj., triluron, 1 mg",,,1.27,465.3,41
HCPCS,J733200,"Inj., triluron, 1 mg",,,18.01,23.07,3
HCPCS,J7333,Visco-3 inj dose,,,141.84,164.23,8
HCPCS,J7336,Capsaicin 8% patch,,,6.09,7.8,3
HCPCS,J7336,QUTENZA (CAPSAICIN) 8% PATCH,2154.0,1400.1,3.32,2154.0,93
HCPCS,J733600,Capsaicin 8% patch,,,6.09,7.8,3
HCPCS,J7340,Carbidopa levodopa ent 100ml,,,30.47,624.06,41
HCPCS,J734000,Carbidopa levodopa ent 100ml,,,433.95,555.84,3
HCPCS,J7342,Ciprofloxacin otic susp 6 mg,,,30.02,82.25,18
HCPCS,J734200,Ciprofloxacin otic susp 6 mg,,,60.48,77.47,3
HCPCS,J7345,"Aminolevulinic acid, 10% gel",,,0.22,465.3,41
HCPCS,J734500,"Aminolevulinic acid, 10% gel",,,3.19,4.08,3
HCPCS,J7351,"INJ, BIMATOPROST, INTRACAMERAL IMPLANT, 1 MCG (DURYSTA)",702.1,456.37,1.1,1622.37,167
HCPCS,J7351,Inj bimatoprost itc imp1mcg,,,380.72,487.67,3
HCPCS,J735100,Inj bimatoprost itc imp1mcg,,,380.72,487.67,3
HCPCS,J7352,"Afamelanotide implant, 1 mg",,,367.93,16514.52,38
HCPCS,J735200,"Afamelanotide implant, 1 mg",,,6729.63,8619.97,3
HCPCS,J7353,Anacaulase-bcdb 8.8% gel 1 g,,,7.15,465.3,37
HCPCS,J735300,Anacaulase-bcdb 8.8% gel 1 g,,,122.34,156.7,3
HCPCS,J7354,"Cantharidin top, applicator",,,82.06,1530.26,40
HCPCS,J735400,"Cantharidin top, applicator",,,1168.57,1496.82,3
HCPCS,J7355,Inj travoprost intra impl,,,24.53,1622.37,37
HCPCS,J735500,Inj travoprost intra impl,,,349.29,447.4,3
HCPCS,J7356,Inj foscarb/foslevodopa 5 mg,,,1.23,840.33,16
HCPCS,J735600,Inj foscarb/foslevodopa 5 mg,,,1.25,1.6,3
HCPCS,J7401,Mometasone furoate sinus imp,,,784.42,908.28,8
HCPCS,J7402,Mometasone sinus sinuva,,,1.42,1622.37,41
HCPCS,J740200,Mometasone sinus sinuva,,,20.2,25.88,3
HCPCS,J7500,Azathioprine oral 50mg,,,0.1,12.49,19
HCPCS,J750000,Azathioprine oral 50mg,,,0.11,0.14,3
HCPCS,J7501,Azathioprine parenteral,,,31.69,684.0,39
HCPCS,J750100,Azathioprine parenteral,,,534.0,684.0,3
HCPCS,J7502,Cyclosporine oral 100 mg,,,2.31,11.17,19
HCPCS,J750200,Cyclosporine oral 100 mg,,,3.22,4.13,3
HCPCS,J7503,Tacrol envarsus ex rel oral,,,1.57,60.42,19
HCPCS,J750300,Tacrol envarsus ex rel oral,,,3.33,4.26,3
HCPCS,J7504,Lymphocyte immune globulin,,,663.49,12102.08,41
HCPCS,J750400,Lymphocyte immune globulin,,,9448.12,12102.08,3
HCPCS,J7505,Monoclonal antibodies,,,1347.11,2739849.3,11
HCPCS,J7507,Tacrolimus imme rel oral 1mg,,,0.34,11.17,19
HCPCS,J750700,Tacrolimus imme rel oral 1mg,,,0.36,0.46,3
HCPCS,J7508,Tacrol astagraf ex rel oral,,,0.51,11.17,19
HCPCS,J750800,Tacrol astagraf ex rel oral,,,1.05,1.35,3
HCPCS,J7509,Methylprednisolone oral,,,0.24,11.17,19
HCPCS,J750900,Methylprednisolone oral,,,0.25,0.32,3
HCPCS,J7510,PREDNISONE ORAL PER 5 MG,4.0,2.6,0.87,11.17,75
HCPCS,J7510,Prednisolone oral per 5 mg,,,1.64,2.1,3
HCPCS,J751000,Prednisolone oral per 5 mg,,,1.64,2.1,3
HCPCS,J7511,Antithymocyte globuln rabbit,,,126.22,4103.47,41
HCPCS,J751100,Antithymocyte globuln rabbit,,,1797.36,2302.23,3
HCPCS,J7512,PREDNISONE IR OR DR ORAL 1MG,4.0,2.6,0.01,11.17,75
HCPCS,J7512,PREDNISONE ORAL PER 20 MG,2.0,1.3,0.01,11.17,75
HCPCS,J7512,Prednisone ir or dr oral 1mg,,,0.41,0.52,3
HCPCS,J751200,Prednisone ir or dr oral 1mg,,,0.41,0.52,3
HCPCS,J7513,"Daclizumab, parenteral",,,4.58,3329.32,11
HCPCS,J7514,Mycophenol (myhibbin) 100 mg,,,3.93,11.17,18
HCPCS,J751400,Mycophenol (myhibbin) 100 mg,,,3.99,5.11,3
HCPCS,J7515,Cyclosporine oral 25 mg,,,0.77,11.17,19
HCPCS,J751500,Cyclosporine oral 25 mg,,,0.94,1.21,3
HCPCS,J7516,"Inj, cyclosporine 250mg",,,52.18,170.94,19
HCPCS,J751600,"Inj, cyclosporine 250mg",,,131.15,167.99,3
HCPCS,J7517,Mycophenolate mofetil oral,,,0.26,11.17,19
HCPCS,J751700,Mycophenolate mofetil oral,,,0.27,0.34,3
HCPCS,J7518,Mycophenolic acid,,,0.56,11.17,19
HCPCS,J751800,Mycophenolic acid,,,0.57,0.73,3
HCPCS,J7519,Inj. mycophenolate mofetil,,,0.64,840.33,19
HCPCS,J751900,Inj. mycophenolate mofetil,,,0.66,0.84,3
HCPCS,J7520,"Sirolimus, oral",,,1.7,19.13,19
HCPCS,J752000,"Sirolimus, oral",,,1.73,2.21,3
HCPCS,J7521,Tacrolim granules oral susp,,,2.31,60.42,16
HCPCS,J752100,Tacrolim granules oral susp,,,2.35,3.01,3
HCPCS,J7525,Tacrolimus injection,,,32.81,681.55,41
HCPCS,J752500,Tacrolimus injection,,,467.16,598.39,3
HCPCS,J7527,Oral everolimus,,,2.06,7.54,11
HCPCS,J752700,Oral everolimus,,,2.1,2.69,3
HCPCS,J7528,Mycophen mofetil for susp,,,0.42,11.17,16
HCPCS,J752800,Mycophen mofetil for susp,,,0.43,0.55,3
HCPCS,J7599,Immunosuppressive drug noc,,,52.18,60.42,8
HCPCS,J7601,Ensifentrine inh 3 mg,,,9.64,126.85,18
HCPCS,J760100,Ensifentrine inh 3 mg,,,92.77,118.83,3
HCPCS,J7604,Acetylcysteine comp unit,,,5.48,60.42,9
HCPCS,J7605,Arformoterol non-comp unit,,,1.25,11.17,19
HCPCS,J760500,Arformoterol non-comp unit,,,1.28,1.64,3
HCPCS,J7606,"Formoterol fumarate, inh",,,3.84,11.23,19
HCPCS,J760600,"Formoterol fumarate, inh",,,3.92,5.02,3
HCPCS,J7607,Levalbuterol comp con,,,13.23,60.42,9
HCPCS,J7608,Acetylcysteine non-comp unit,,,6.0,19.29,19
HCPCS,J760800,Acetylcysteine non-comp unit,,,15.06,19.29,3
HCPCS,J7609,Albuterol comp unit,,,1.07,60.42,14
HCPCS,J760900,Albuterol comp unit,,,1.07,1.37,3
HCPCS,J7610,Albuterol comp con,,,2.58,60.42,14
HCPCS,J761000,Albuterol comp con,,,2.58,3.31,3
HCPCS,J7611,Albuterol non-comp con,,,0.25,11.17,19
HCPCS,J761100,Albuterol non-comp con,,,0.46,0.59,3
HCPCS,J7612,Levalbuterol non-comp con,,,0.28,11.17,19
HCPCS,J761200,Levalbuterol non-comp con,,,0.68,0.87,3
HCPCS,J7613,"ALBUTEROL NON-COMP UNIT, 1 MG",2.0,1.3,0.12,11.17,75
HCPCS,J7613,ALBUTEROL UNIT DOSE,6.0,3.9,0.05,6.0,78
HCPCS,J7613,Albuterol non-comp unit,,,0.12,0.16,3
HCPCS,J761300,Albuterol non-comp unit,,,0.12,0.16,3
HCPCS,J7614,LEVALBUTEROL  0.5 MG,13.4,8.71,0.07,13.4,69
HCPCS,J7614,Levalbuterol non-comp unit,,,0.14,0.18,3
HCPCS,J761400,Levalbuterol non-comp unit,,,0.14,0.18,3
HCPCS,J7615,Levalbuterol comp unit,,,0.2,60.42,17
HCPCS,J761500,Levalbuterol comp unit,,,3.01,3.85,3
HCPCS,J7620,ALBUTEROL SULFATE .O83% INH,4.45,2.89,0.13,4.45,78
HCPCS,J7620,"ALBUTEROL, UP TO 2.5 MG",4.4,2.86,0.13,11.17,69
HCPCS,J7620,Albuterol ipratrop non-comp,,,0.36,0.46,3
HCPCS,J762000,Albuterol ipratrop non-comp,,,0.36,0.46,3
HCPCS,J7622,Beclomethasone comp unit,,,0.05,60.42,12
HCPCS,J762200,Beclomethasone comp unit,,,0.05,0.07,3
HCPCS,J7624,Betamethasone comp unit,,,2.15,60.42,12
HCPCS,J762400,Betamethasone comp unit,,,2.15,2.76,3
HCPCS,J7626,Budesonide non-comp unit,,,1.07,11.17,19
HCPCS,J762600,Budesonide non-comp unit,,,1.87,2.39,3
HCPCS,J7627,Budesonide comp unit,,,0.64,60.42,16
HCPCS,J762700,Budesonide comp unit,,,0.64,0.82,3
HCPCS,J7628,Bitolterol mesylate comp con,,,0.46,2739849.3,14
HCPCS,J762800,Bitolterol mesylate comp con,,,0.46,0.59,3
HCPCS,J7629,Bitolterol mesylate comp unt,,,0.5,2739849.3,12
HCPCS,J762900,Bitolterol mesylate comp unt,,,0.5,0.64,3
HCPCS,J7631,Cromolyn sodium noncomp unit,,,0.45,11.17,19
HCPCS,J763100,Cromolyn sodium noncomp unit,,,1.62,2.07,3
HCPCS,J7632,Cromolyn sodium comp unit,,,0.62,2739849.3,13
HCPCS,J7633,Budesonide non-comp con,,,0.05,60.42,14
HCPCS,J763300,Budesonide non-comp con,,,13.9,17.81,3
HCPCS,J7634,Budesonide comp con,,,44.39,60.42,9
HCPCS,J7635,Atropine comp con,,,0.21,2739849.3,12
HCPCS,J763500,Atropine comp con,,,0.21,0.27,3
HCPCS,J7636,Atropine comp unit,,,0.38,60.42,12
HCPCS,J763600,Atropine comp unit,,,1.21,1.55,3
HCPCS,J7637,Dexamethasone comp con,,,0.11,60.42,12
HCPCS,J763700,Dexamethasone comp con,,,0.11,0.14,3
HCPCS,J7638,Dexamethasone comp unit,,,0.21,2739849.3,12
HCPCS,J763800,Dexamethasone comp unit,,,0.21,0.27,3
HCPCS,J7639,Dornase alfa non-comp unit,,,49.61,164.23,19
HCPCS,J763900,Dornase alfa non-comp unit,,,98.18,125.76,3
HCPCS,J7640,Formoterol comp unit,,,3.72,60.42,14
HCPCS,J764000,Formoterol comp unit,,,5.25,6.73,3
HCPCS,J7641,Flunisolide comp unit,,,0.37,2739849.3,16
HCPCS,J764100,Flunisolide comp unit,,,0.37,0.48,3
HCPCS,J7642,Glycopyrrolate comp con,,,2.12,60.42,12
HCPCS,J764200,Glycopyrrolate comp con,,,2.12,2.71,3
HCPCS,J7643,Glycopyrrolate comp unit,,,1.58,2739849.3,14
HCPCS,J764300,Glycopyrrolate comp unit,,,1.58,2.03,3
HCPCS,J7644,IPRATROPIUM BROMIDE NON-COMP,3.7,2.41,0.2,11.17,69
HCPCS,J7644,Ipratropium bromide non-comp,,,0.71,0.91,3
HCPCS,J764400,Ipratropium bromide non-comp,,,0.71,0.91,3
HCPCS,J7645,Ipratropium bromide comp,,,0.11,60.42,14
HCPCS,J764500,Ipratropium bromide comp,,,0.11,0.14,3
HCPCS,J7647,Isoetharine comp con,,,52.18,2739849.3,9
HCPCS,J7648,Isoetharine non-comp con,,,0.32,2739849.3,12
HCPCS,J764800,Isoetharine non-comp con,,,0.32,0.41,3
HCPCS,J7649,Isoetharine non-comp unit,,,0.36,2739849.3,12
HCPCS,J764900,Isoetharine non-comp unit,,,0.36,0.46,3
HCPCS,J7650,Isoetharine comp unit,,,12.33,60.42,9
HCPCS,J7657,Isoproterenol comp con,,,52.18,2739849.3,9
HCPCS,J7658,Isoproterenol non-comp con,,,3.68,2739849.3,12
HCPCS,J765800,Isoproterenol non-comp con,,,3.68,4.72,3
HCPCS,J7659,Isoproterenol non-comp unit,,,3.68,2739849.3,12
HCPCS,J765900,Isoproterenol non-comp unit,,,3.68,4.72,3
HCPCS,J7660,Isoproterenol comp unit,,,52.18,2739849.3,9
HCPCS,J7665,Mannitol for inhaler,,,0.69,17.99,16
HCPCS,J766500,Mannitol for inhaler,,,14.04,17.99,3
HCPCS,J7667,Metaproterenol comp con,,,52.18,2739849.3,9
HCPCS,J7668,Metaproterenol non-comp con,,,0.55,2739849.3,12
HCPCS,J766800,Metaproterenol non-comp con,,,0.55,0.71,3
HCPCS,J7669,Metaproterenol non-comp unit,,,0.77,2739849.3,14
HCPCS,J766900,Metaproterenol non-comp unit,,,0.77,0.98,3
HCPCS,J7670,Metaproterenol comp unit,,,52.18,2739849.3,9
HCPCS,J7674,METHACHOLINE PER 1 MG,5.88,3.82,1.28,60.42,75
HCPCS,J7674,"Methacholine chloride, neb",,,3.38,4.33,3
HCPCS,J767400,"Methacholine chloride, neb",,,3.38,4.33,3
HCPCS,J7676,Pentamidine comp unit dose,,,52.18,2739849.3,9
HCPCS,J7677,Revefenacin inh non-com 1mcg,,,0.2,60.42,19
HCPCS,J767700,Revefenacin inh non-com 1mcg,,,0.36,0.46,3
HCPCS,J7680,Terbutaline sulf comp con,,,0.04,2739849.3,16
HCPCS,J768000,Terbutaline sulf comp con,,,0.04,0.05,3
HCPCS,J7681,Terbutaline sulf comp unit,,,0.04,2739849.3,16
HCPCS,J768100,Terbutaline sulf comp unit,,,0.04,0.05,3
HCPCS,J7682,Tobramycin non-comp unit,,,21.82,60.42,19
HCPCS,J768200,Tobramycin non-comp unit,,,22.2,28.43,3
HCPCS,J7683,Triamcinolone comp con,,,1.0,2739849.3,16
HCPCS,J768300,Triamcinolone comp con,,,1.0,1.28,3
HCPCS,J7684,Triamcinolone comp unit,,,1.0,2739849.3,12
HCPCS,J768400,Triamcinolone comp unit,,,1.0,1.28,3
HCPCS,J7685,Tobramycin comp unit,,,9.45,465.3,13
HCPCS,J7686,"Treprostinil, non-comp unit",,,200.66,2001.08,19
HCPCS,J768600,"Treprostinil, non-comp unit",,,1409.72,1805.71,3
HCPCS,J7699,INO THERAPY PER DAY,4500.0,2925.0,52.18,4500.0,74
HCPCS,J7699,RACEMIC EPINE 2.25% PER VIAL,2.5,1.63,0.55,60.42,68
HCPCS,J7799,Non-inhalation drug for dme,,,52.18,60.42,8
HCPCS,J7999,"Compounded drug, noc",,,52.18,60.42,8
HCPCS,J8490,REGLAN 10 MG TAB,2.0,1.3,0.51,2.0,68
HCPCS,J8498,Antiemetic rectal/supp nos,,,9.64,87.41,9
HCPCS,J8499,ORAL PRESCIP DRUG NON CHEMO NOS,6.5,4.23,1.42,60.42,74
HCPCS,J8499,ORAL PRESCRIP DRUG NON CHEMO,6.5,4.23,1.1,3061000.0,68
HCPCS,J8499,PHARMACY J8499,96.95,63.02,21.14,96.95,74
HCPCS,J8501,Oral aprepitant,,,3.78,60.42,19
HCPCS,J850100,Oral aprepitant,,,4.93,6.32,3
HCPCS,J8502,Inj aprep (aponvie) 1 mg,,,52.18,60.42,8
HCPCS,J8510,Oral busulfan,,,1.27,375.84,37
HCPCS,J851000,Oral busulfan,,,293.42,375.84,3
HCPCS,J8515,"Cabergoline, oral 0.25mg",,,1.95,2739849.3,17
HCPCS,J851500,"Cabergoline, oral 0.25mg",,,3.35,4.29,3
HCPCS,J8520,"Capecitabine, oral, 150 mg",,,0.42,19.13,13
HCPCS,J852000,"Capecitabine, oral, 150 mg",,,1.1,1.41,3
HCPCS,J8521,"Capecitabine, oral, 500 mg",,,0.83,19.13,13
HCPCS,J852100,"Capecitabine, oral, 500 mg",,,2.14,2.74,3
HCPCS,J8522,"Capecitabine, oral, 50 mg",,,0.01,19.13,39
HCPCS,J852200,"Capecitabine, oral, 50 mg",,,0.07,0.09,3
HCPCS,J8530,Cyclophosphamide oral 25 mg,,,1.01,4.15,11
HCPCS,J853000,Cyclophosphamide oral 25 mg,,,3.24,4.15,3
HCPCS,J8540,Oral dexamethasone,,,0.02,11.17,19
HCPCS,J854000,Oral dexamethasone,,,0.02,0.02,3
HCPCS,J8541,"Oral, hemady, 0.25 mg",,,0.78,11.17,15
HCPCS,J854100,"Oral, hemady, 0.25 mg",,,0.78,1.0,3
HCPCS,J8560,Etoposide oral 50 mg,,,10.85,412.04,34
HCPCS,J856000,Etoposide oral 50 mg,,,154.49,197.88,3
HCPCS,J8562,Oral fludarabine phosphate,,,200.66,2739849.3,9
HCPCS,J8565,Gefitinib oral,,,299.49,2739849.3,16
HCPCS,J856500,Gefitinib oral,,,299.49,383.61,3
HCPCS,J8597,Antiemetic drug oral nos,,,9.64,11.17,8
HCPCS,J8600,Melphalan oral 2 mg,,,12.45,2739849.3,9
HCPCS,J860000,Melphalan oral 2 mg,,,19.56,25.06,3
HCPCS,J8610,Methotrexate oral 2.5 mg,,,0.22,19.13,19
HCPCS,J861000,Methotrexate oral 2.5 mg,,,0.27,0.34,3
HCPCS,J8611,Oral methotrexate (jylamvo),,,2.33,43.24,39
HCPCS,J861100,Oral methotrexate (jylamvo),,,33.18,42.5,3
HCPCS,J8612,Oral methotrexate (xatmep),,,2.8,52.04,39
HCPCS,J861200,Oral methotrexate (xatmep),,,39.93,51.14,3
HCPCS,J8650,Nabilone oral,,,16.52,2739849.3,11
HCPCS,J8655,"Oral netupitant, palonosetro",,,47.52,1123.56,41
HCPCS,J865500,"Oral netupitant, palonosetro",,,676.74,866.83,3
HCPCS,J8670,"Rolapitant, oral, 1mg",,,0.25,60.42,41
HCPCS,J867000,"Rolapitant, oral, 1mg",,,3.56,4.56,3
HCPCS,J8700,Temozolomide,,,0.32,19.13,19
HCPCS,J870000,Temozolomide,,,0.96,1.23,3
HCPCS,J8705,Topotecan oral,,,15.64,465.3,34
HCPCS,J870500,Topotecan oral,,,222.66,285.21,3
HCPCS,J8999,Oral prescription drug chemo,,,2739999.97,2739999.97,1
HCPCS,J9000,Doxorubicin hcl injection,,,4.95,6.34,3
HCPCS,J9000,"GNRC DOXORUBICIN HCL,10 MG",73.0,47.45,4.87,73.0,67
HCPCS,J900000,Doxorubicin hcl injection,,,4.95,6.34,3
HCPCS,J9003,Leup inj (camcevi etm) 1 mg,,,1347.11,1559.81,8
HCPCS,J9011,"Datopotamab deruxtecan, 1 mg",,,6.44,16514.52,30
HCPCS,J901100,"Datopotamab deruxtecan, 1 mg",,,91.76,117.53,3
HCPCS,J9015,Aldesleukin injection,,,103.6,16580.16,39
HCPCS,J901500,Aldesleukin injection,,,12944.16,16580.16,3
HCPCS,J9017,"ARSENIC TRIOXIDE,1 MG",227.3,147.75,7.2,629.95,83
HCPCS,J9017,Arsenic trioxide injection,,,13.15,16.85,3
HCPCS,J901700,Arsenic trioxide injection,,,13.15,16.85,3
HCPCS,J9019,Erwinaze injection,,,443.39,16514.52,12
HCPCS,J9020,"Asparaginase, nos",,,67.0,2739849.3,12
HCPCS,J9021,"Inj, aspara, rylaze, 0.1 mg",,,7.02,16514.52,41
HCPCS,J902100,"Inj, aspara, rylaze, 0.1 mg",,,100.0,128.09,3
HCPCS,J9022,"Inj, atezolizumab,10 mg",,,11.74,8832.81,41
HCPCS,J902200,"Inj, atezolizumab,10 mg",,,167.16,214.11,3
HCPCS,J9023,"Injection, avelumab, 10 mg",,,13.12,5565.45,41
HCPCS,J902300,"Injection, avelumab, 10 mg",,,186.88,239.38,3
HCPCS,J9024,Inj atezolizumb 5mg hya-tqjs,,,4.01,8832.81,30
HCPCS,J902400,Inj atezolizumb 5mg hya-tqjs,,,57.14,73.19,3
HCPCS,J9025,"AZACITIDINE INJ, 1MG SDV",27.16,17.65,0.62,412.04,75
HCPCS,J9025,Azacitidine injection,,,0.82,1.05,3
HCPCS,J902500,Azacitidine injection,,,0.82,1.05,3
HCPCS,J9026,"Inj, tarlatamab-dlle, 1 mg",,,195.82,8832.81,39
HCPCS,J902600,"Inj, tarlatamab-dlle, 1 mg",,,2788.53,3571.83,3
HCPCS,J9027,Clofarabine injection,,,1.8,1622.37,41
HCPCS,J902700,Clofarabine injection,,,25.58,32.76,3
HCPCS,J9028,"Inj, nogapendekin pmln, 1mcg",,,11.84,5653.6,39
HCPCS,J902800,"Inj, nogapendekin pmln, 1mcg",,,168.62,215.98,3
HCPCS,J9029,"Instill adstiladrin, tx dose",,,8034.35,169332.0,40
HCPCS,J902900,"Instill adstiladrin, tx dose",,,114409.13,146546.52,3
HCPCS,J9030,BCG LIVE INTRAVESICAL 1MG,711.75,462.64,3.27,711.75,85
HCPCS,J9030,BCG LIVE INTRAVESICAL INSTILLATION 1 MG,711.75,462.64,1.1,711.75,78
HCPCS,J9030,"BCG LIVE INTRAVESICAL INSTILLATION, 1 MG",711.75,462.64,1.1,711.75,78
HCPCS,J9030,Bcg live intravesical 1mg,,,5.84,7.48,3
HCPCS,J903000,Bcg live intravesical 1mg,,,5.84,7.48,3
HCPCS,J9032,"Injection, belinostat, 10mg",,,6.64,5565.45,41
HCPCS,J903200,"Injection, belinostat, 10mg",,,94.54,121.09,3
HCPCS,J9033,"INJ, BENDAMUSTINE HCL, 1MG",98.55,64.06,2.04,4103.47,93
HCPCS,J9033,"Inj, bendamustine hcl, 1mg",,,3.65,4.67,3
HCPCS,J903300,"Inj, bendamustine hcl, 1mg",,,3.65,4.67,3
HCPCS,J9034,"Inj., bendeka 1 mg",,,1.6,4103.47,41
HCPCS,J903400,"Inj., bendeka 1 mg",,,22.84,29.25,3
HCPCS,J9035,Bevacizumab injection,,,131.06,167.88,3
HCPCS,J9035,"INJ BEVACIZUMAB, 10 MG",332.03,215.82,72.7,4103.47,93
HCPCS,J903500,Bevacizumab injection,,,131.06,167.88,3
HCPCS,J9036,Inj. belrapzo/bendamustine,,,1.71,4103.47,41
HCPCS,J903600,Inj. belrapzo/bendamustine,,,24.3,31.12,3
HCPCS,J9037,Inj belantamab mafodot blmf,,,44.79,8832.81,23
HCPCS,J903700,Inj belantamab mafodot blmf,,,94.27,120.75,3
HCPCS,J9038,Inj axatilimab-csfr 0.1 mg,,,6.96,16514.52,30
HCPCS,J903800,Inj axatilimab-csfr 0.1 mg,,,99.06,126.88,3
HCPCS,J9039,"Injection, blinatumomab",,,20.46,5565.45,41
HCPCS,J903900,"Injection, blinatumomab",,,291.35,373.19,3
HCPCS,J9040,Bleomycin sulfate injection,,,40.98,52.49,3
HCPCS,J9040,GNRC BLEOMYCIN SULFT 15 UNITS,174.0,113.1,37.93,174.0,67
HCPCS,J904000,Bleomycin sulfate injection,,,40.98,52.49,3
HCPCS,J9041,"INJ BORTEZOMIB, 0.1 MG",230.27,149.68,2.07,1185.36,76
HCPCS,J9041,"Injection, bortezomib, 0.1mg",,,4.77,6.11,3
HCPCS,J904100,"Injection, bortezomib, 0.1mg",,,4.77,6.11,3
HCPCS,J9042,ADCETRIS/BRENTUXIMAB PER 50MG,501.91,326.24,120.46,8832.81,93
HCPCS,J9042,Brentuximab vedotin inj,,,477.84,612.07,3
HCPCS,J904200,Brentuximab vedotin inj,,,477.84,612.07,3
HCPCS,J9043,CABAZITAXEL INJECTION 1 MG,693.08,450.5,166.34,5565.45,93
HCPCS,J9043,Cabazitaxel injection,,,410.82,526.22,3
HCPCS,J904300,Cabazitaxel injection,,,410.82,526.22,3
HCPCS,J9044,"Inj, bortezomib, nos, 0.1 mg",,,16.25,629.95,9
HCPCS,J9045,"CARBOPLATIN, 50 MG",59.0,38.35,5.13,59.0,67
HCPCS,J9045,Carboplatin injection,,,5.22,6.68,3
HCPCS,J904500,Carboplatin injection,,,5.22,6.68,3
HCPCS,J9046,"Inj, bortezomib, dr. reddy's",,,0.43,629.95,39
HCPCS,J904600,"Inj, bortezomib, dr. reddy's",,,97.83,125.31,3
HCPCS,J9047,INJECTION CARFILZOMIB 1 MG,132.89,86.38,31.89,3329.32,93
HCPCS,J9047,"Injection, carfilzomib, 1 mg",,,98.99,126.79,3
HCPCS,J904700,"Injection, carfilzomib, 1 mg",,,98.99,126.79,3
HCPCS,J9048,"Inj, bortezomib freseniuskab",,,0.87,629.95,39
HCPCS,J904800,"Inj, bortezomib freseniuskab",,,97.83,125.31,3
HCPCS,J9049,"Inj, bortezomib, hospira",,,1.72,629.95,20
HCPCS,J904900,"Inj, bortezomib, hospira",,,2.58,3.31,3
HCPCS,J9050,Carmustine injection,,,29.08,4103.47,41
HCPCS,J905000,Carmustine injection,,,414.06,530.37,3
HCPCS,J9051,"Inj, bortezomib (maia)",,,7.32,2739849.3,14
HCPCS,J905100,"Inj, bortezomib (maia)",,,7.32,9.37,3
HCPCS,J9052,"Inj, carmustine (accord)",,,0.05,4103.47,24
HCPCS,J905200,"Inj, carmustine (accord)",,,523.32,670.32,3
HCPCS,J9054,Inj bortezomib boruzu 0.1 mg,,,3.2,1185.36,30
HCPCS,J905400,Inj bortezomib boruzu 0.1 mg,,,45.62,58.44,3
HCPCS,J9055,Cetuximab injection,,,143.01,183.18,3
HCPCS,J9055,"INJ CETUXIMAB, 10 MG",240.92,156.6,57.82,4103.47,93
HCPCS,J905500,Cetuximab injection,,,143.01,183.18,3
HCPCS,J9056,"Inj, vivimusta, 1 mg",,,4.0,4103.47,40
HCPCS,J905600,"Inj, vivimusta, 1 mg",,,56.94,72.94,3
HCPCS,J9057,"Inj., copanlisib, 1 mg",,,83.98,5653.6,25
HCPCS,J905700,"Inj., copanlisib, 1 mg",,,187.02,239.56,3
HCPCS,J9058,Inj apotex/bendamustine 1 mg,,,24.13,4103.47,13
HCPCS,J905800,Inj apotex/bendamustine 1 mg,,,69.58,89.13,3
HCPCS,J9059,"Inj bendamustine, baxter 1mg",,,24.13,4103.47,13
HCPCS,J905900,"Inj bendamustine, baxter 1mg",,,49.98,64.02,3
HCPCS,J9060,Cisplatin 10 mg injection,,,3.76,4.81,3
HCPCS,J9060,GNRC CISPLATIN PER 10 MG,38.0,24.7,3.7,38.0,75
HCPCS,J906000,Cisplatin 10 mg injection,,,3.76,4.81,3
HCPCS,J9061,"Inj, amivantamab-vmjw",,,2.82,5565.45,41
HCPCS,J906100,"Inj, amivantamab-vmjw",,,40.16,51.44,3
HCPCS,J9063,"Inj, elahere, 1 mg",,,8.9,16514.52,40
HCPCS,J906300,"Inj, elahere, 1 mg",,,126.68,162.27,3
HCPCS,J9064,"Inj, cabazitaxel (sandoz)",,,4806.53,2739849.3,9
HCPCS,J9065,Inj cladribine per 1 mg,,,0.93,629.95,41
HCPCS,J906500,Inj cladribine per 1 mg,,,13.21,16.92,3
HCPCS,J9070,CYCLOPHOSPHAMIDE 100 MG,15.2,9.88,3.31,629.95,74
HCPCS,J9070,Cyclophosphamide 100 mg inj,,,99.36,127.27,3
HCPCS,J907000,Cyclophosphamide 100 mg inj,,,99.36,127.27,3
HCPCS,J9071,Inj cyclophosphamd auromedic,,,0.08,629.95,40
HCPCS,J907100,Inj cyclophosphamd auromedic,,,1.09,1.39,3
HCPCS,J9072,Inj cyclophos frindovyx 5 mg,,,1.12,629.95,33
HCPCS,J907200,Inj cyclophos frindovyx 5 mg,,,16.0,20.5,3
HCPCS,J9073,Inj cyclophos dr reddys 5 mg,,,0.09,629.95,40
HCPCS,J907300,Inj cyclophos dr reddys 5 mg,,,1.25,1.6,3
HCPCS,J9074,"INJ, CYCLOPHOSPHAMD, SANDOZ",15.8,10.27,3.79,629.95,92
HCPCS,J9074,"Inj, cyclophosphamd, sandoz",,,6.84,8.76,3
HCPCS,J907400,"Inj, cyclophosphamd, sandoz",,,6.84,8.76,3
HCPCS,J9075,"Inj, cyclophosphamide, nos",,,0.07,629.95,40
HCPCS,J907500,"Inj, cyclophosphamide, nos",,,1.05,1.35,3
HCPCS,J9076,"Inj, cyclophos (baxter) 5mg",,,0.62,629.95,32
HCPCS,J907600,"Inj, cyclophos (baxter) 5mg",,,8.76,11.22,3
HCPCS,J9098,Cytarabine liposome inj,,,652.08,2739849.3,12
HCPCS,J9100,Cytarabine hcl 100 mg inj,,,1.5,1.92,3
HCPCS,J9100,GENERIC CYTARABINE 100 MG,19.45,12.64,1.46,19.45,75
HCPCS,J910000,Cytarabine hcl 100 mg inj,,,1.5,1.92,3
HCPCS,J9118,Inj. calaspargase pegol-mknl,,,10.26,8832.81,33
HCPCS,J911800,Inj. calaspargase pegol-mknl,,,146.1,187.14,3
HCPCS,J9119,"Inj., cemiplimab-rwlc, 1 mg",,,3.59,5565.45,41
HCPCS,J911900,"Inj., cemiplimab-rwlc, 1 mg",,,51.07,65.41,3
HCPCS,J9120,Dactinomycin injection,,,38.5,1832.79,41
HCPCS,J912000,Dactinomycin injection,,,548.22,702.22,3
HCPCS,J9130,Dacarbazine 100 mg inj,,,7.33,9.39,3
HCPCS,J9130,GNRC DACARBAZINE 100 MG INJ,45.24,29.41,7.22,45.24,67
HCPCS,J913000,Dacarbazine 100 mg inj,,,7.33,9.39,3
HCPCS,J9144,"Daratumumab, hyaluronidase",,,6.88,5653.6,41
HCPCS,J914400,"Daratumumab, hyaluronidase",,,98.01,125.54,3
HCPCS,J9145,"Injection, daratumumab 10 mg",,,8.85,5653.6,41
HCPCS,J914500,"Injection, daratumumab 10 mg",,,126.01,161.4,3
HCPCS,J9150,Daunorubicin injection,,,24.44,629.95,27
HCPCS,J915000,Daunorubicin injection,,,46.87,60.03,3
HCPCS,J9151,Daunorubicin citrate inj,,,18.5,2739849.3,12
HCPCS,J9153,"Inj daunorubicin, cytarabine",,,32.56,8832.81,41
HCPCS,J915300,"Inj daunorubicin, cytarabine",,,463.67,593.92,3
HCPCS,J9155,Degarelix injection,,,0.56,1185.36,41
HCPCS,J915500,Degarelix injection,,,7.92,10.15,3
HCPCS,J9160,Denileukin diftitox inj,,,3317.21,5565.45,11
HCPCS,J916000,Denileukin diftitox inj,,,3317.21,4249.01,3
HCPCS,J9161,Inj denileuk difti-cxdl 1mcg,,,26.53,5565.45,10
HCPCS,J9165,Diethylstilbestrol injection,,,52.18,2739849.3,9
HCPCS,J9171,DOCETAXEL  1 MG,99.6,64.74,1.14,412.04,75
HCPCS,J9171,Docetaxel injection,,,1.16,1.48,3
HCPCS,J917100,Docetaxel injection,,,1.16,1.48,3
HCPCS,J9172,"Docetaxel (docivyx), 1 mg",,,6.22,2739849.3,39
HCPCS,J917200,"Docetaxel (docivyx), 1 mg",,,88.57,113.45,3
HCPCS,J9173,"Inj., durvalumab, 10 mg",,,10.78,4103.47,41
HCPCS,J917300,"Inj., durvalumab, 10 mg",,,153.56,196.7,3
HCPCS,J9174,"Inj, docetaxel (beizray) 1mg",,,5.93,412.04,27
HCPCS,J917400,"Inj, docetaxel (beizray) 1mg",,,95.59,122.44,3
HCPCS,J9175,Elliotts b solution per ml,,,21.79,60.42,15
HCPCS,J917500,Elliotts b solution per ml,,,21.79,27.91,3
HCPCS,J9176,"Injection, elotuzumab, 1mg",,,1.01,5653.6,41
HCPCS,J917600,"Injection, elotuzumab, 1mg",,,14.31,18.33,3
HCPCS,J9177,Inj enfort vedo-ejfv 0.25mg,,,4.59,5565.45,41
HCPCS,J917700,Inj enfort vedo-ejfv 0.25mg,,,65.36,83.72,3
HCPCS,J9178,EPIRUBICIN HCL 2 MG INJ,114.77,74.6,3.45,114.77,67
HCPCS,J9178,"Inj, epirubicin hcl, 2 mg",,,3.51,4.49,3
HCPCS,J917800,"Inj, epirubicin hcl, 2 mg",,,3.51,4.49,3
HCPCS,J9179,Eribulin mesylate injection,,,129.25,165.55,3
HCPCS,J9179,HALAVAN 1MG/2ML,454.16,295.2,72.6,3329.32,93
HCPCS,J917900,Eribulin mesylate injection,,,129.25,165.55,3
HCPCS,J9181,Etoposide injection,,,1.85,2.37,3
HCPCS,J9181,GENERIC ETOPOSIDE 10 MG,2.23,1.45,0.49,19.13,75
HCPCS,J918100,Etoposide injection,,,1.85,2.37,3
HCPCS,J9183,"Gemcit intraves sys, 225 mg",,,18080.41,20935.21,8
HCPCS,J9184,Inj gemcitabin (avyxa) 200mg,,,50.21,1185.36,27
HCPCS,J918400,Inj gemcitabin (avyxa) 200mg,,,833.04,1067.04,3
HCPCS,J9185,"FLUDARABINE PHOSPHATE, 50 MG",1320.05,858.03,134.15,1320.05,75
HCPCS,J9185,Fludarabine phosphate inj,,,144.91,185.61,3
HCPCS,J918500,Fludarabine phosphate inj,,,144.91,185.61,3
HCPCS,J9190,"5-FU, 500 MG",12.31,8.0,2.68,19.13,75
HCPCS,J9190,Fluorouracil injection,,,3.45,4.42,3
HCPCS,J919000,Fluorouracil injection,,,3.45,4.42,3
HCPCS,J9196,Inj gemcitabine hcl (accord),,,4.24,629.95,19
HCPCS,J919600,Inj gemcitabine hcl (accord),,,9.42,12.06,3
HCPCS,J9198,"Inj. infugem, 100 mg",,,26.55,1185.36,23
HCPCS,J919800,"Inj. infugem, 100 mg",,,81.17,103.97,3
HCPCS,J9200,Floxuridine injection,,,101.1,10198.39,33
HCPCS,J920000,Floxuridine injection,,,7573.76,9701.22,3
HCPCS,J9201,"GEMCITABINE HCL , 200 MG",726.35,472.13,6.17,726.35,75
HCPCS,J9201,In gemcitabine hcl nos 200mg,,,6.39,8.19,3
HCPCS,J920100,In gemcitabine hcl nos 200mg,,,6.39,8.19,3
HCPCS,J9202,GOSERLIN ACETATE IMPL PER10.8MG,8727.0,5672.55,599.34,8727.0,93
HCPCS,J9202,GOSERLIN ACETATE IMPL PER3.6MG,2919.0,1897.35,599.34,2919.0,93
HCPCS,J9202,Goserelin acetate implant,,,1383.95,1772.7,3
HCPCS,J920200,Goserelin acetate implant,,,1383.95,1772.7,3
HCPCS,J9203,Gemtuzumab ozogamicin 0.1 mg,,,30.02,5565.45,41
HCPCS,J920300,Gemtuzumab ozogamicin 0.1 mg,,,427.5,547.59,3
HCPCS,J9204,"Inj mogamulizumab-kpkc, 1 mg",,,31.68,8832.81,41
HCPCS,J920400,"Inj mogamulizumab-kpkc, 1 mg",,,451.18,577.91,3
HCPCS,J9205,Inj irinotecan liposome 1 mg,,,8.25,5653.6,41
HCPCS,J920500,Inj irinotecan liposome 1 mg,,,117.41,150.39,3
HCPCS,J9206,"IRINOTECAN, 20 MG",55.73,36.22,3.14,55.73,67
HCPCS,J9206,Irinotecan injection,,,3.19,4.08,3
HCPCS,J920600,Irinotecan injection,,,3.19,4.08,3
HCPCS,J9207,"IXABEPILONE INJECTION, 1 MG",327.42,212.82,78.58,4103.47,93
HCPCS,J9207,Ixabepilone injection,,,249.16,319.15,3
HCPCS,J920700,Ixabepilone injection,,,249.16,319.15,3
HCPCS,J9208,GENERIC IFOSFAMIDE PER 1 GM,293.65,190.87,43.48,293.65,67
HCPCS,J9208,Ifosfamide injection,,,44.22,56.64,3
HCPCS,J920800,Ifosfamide injection,,,44.22,56.64,3
HCPCS,J9209,GENERIC MESNA  200 MG,147.07,95.6,2.98,147.07,67
HCPCS,J9209,Mesna injection,,,3.03,3.88,3
HCPCS,J920900,Mesna injection,,,3.03,3.88,3
HCPCS,J9210,"Inj., emapalumab-lzsg, 1 mg",,,48.02,20935.21,41
HCPCS,J921000,"Inj., emapalumab-lzsg, 1 mg",,,683.75,875.82,3
HCPCS,J9211,Idarubicin hcl injection,,,43.82,412.04,19
HCPCS,J921100,Idarubicin hcl injection,,,71.29,91.31,3
HCPCS,J9212,Interferon alfacon-1 inj,,,9.64,2739849.3,12
HCPCS,J9213,INTERFERON ALFA - 2A INJ,77.0,50.05,16.79,2111.65,75
HCPCS,J9213,Interferon alfa-2a inj,,,90.67,116.14,3
HCPCS,J921300,Interferon alfa-2a inj,,,90.67,116.14,3
HCPCS,J9214,INTERFERON ALFA-2B,115.51,75.08,25.18,1559.81,76
HCPCS,J9214,Interferon alfa-2b inj,,,65.65,84.09,3
HCPCS,J921400,Interferon alfa-2b inj,,,65.65,84.09,3
HCPCS,J9215,Interferon alfa-n3 inj,,,64.33,325.3,9
HCPCS,J921500,Interferon alfa-n3 inj,,,64.33,82.4,3
HCPCS,J9216,Interferon gamma 1-b inj,,,1024.57,23145.6,17
HCPCS,J921600,Interferon gamma 1-b inj,,,18069.81,23145.6,3
HCPCS,J9217,LEUPROLIDE ACETATE 7.5 MG,4491.83,2919.69,170.77,4491.83,93
HCPCS,J9217,LUPRON,1288.0,837.2,1.1,1288.0,78
HCPCS,J9217,Leuprolide acetate suspnsion,,,303.99,389.38,3
HCPCS,J921700,Leuprolide acetate suspnsion,,,303.99,389.38,3
HCPCS,J9218,LUPRON 1 MG,575.0,373.75,11.02,575.0,68
HCPCS,J9218,Leuprolide acetate injeciton,,,107.67,137.92,3
HCPCS,J921800,Leuprolide acetate injeciton,,,107.67,137.92,3
HCPCS,J9219,Leuprolide acetate implant,,,8579.28,10989.19,3
HCPCS,J9219,VIADUR 65MG,11850.0,7702.5,2583.3,11850.0,75
HCPCS,J921900,Leuprolide acetate implant,,,8579.28,10989.19,3
HCPCS,J9220,Indigotindisulfonate sod 1mg,,,1.16,28.93,27
HCPCS,J922000,Indigotindisulfonate sod 1mg,,,21.36,27.36,3
HCPCS,J9223,"Inj. lurbinectedin, 0.1 mg",,,26.35,5653.6,41
HCPCS,J922300,"Inj. lurbinectedin, 0.1 mg",,,375.19,480.58,3
HCPCS,J9225,VANTAS IMPLANT 50 MG,14889.0,9677.85,3245.8,14889.0,76
HCPCS,J9225,Vantas implant,,,10410.56,13334.88,3
HCPCS,J922500,Vantas implant,,,10410.56,13334.88,3
HCPCS,J9226,Supprelin la implant,,,5398.17,122138.08,41
HCPCS,J922600,Supprelin la implant,,,76869.91,98462.58,3
HCPCS,J9227,Inj. isatuximab-irfc 10 mg,,,10.54,5653.6,41
HCPCS,J922700,Inj. isatuximab-irfc 10 mg,,,150.05,192.2,3
HCPCS,J9228,Ipilimumab injection,,,23.36,8832.81,41
HCPCS,J922800,Ipilimumab injection,,,332.7,426.15,3
HCPCS,J9229,Inj inotuzumab ozogam 0.1 mg,,,352.1,16514.52,41
HCPCS,J922900,Inj inotuzumab ozogam 0.1 mg,,,5013.85,6422.24,3
HCPCS,J9230,Mechlorethamine hcl inj,,,272.62,847.36,16
HCPCS,J923000,Mechlorethamine hcl inj,,,661.54,847.36,3
HCPCS,J9245,Inj melpha hydroch nos 50 mg,,,10.87,1622.37,41
HCPCS,J924500,Inj melpha hydroch nos 50 mg,,,154.75,198.22,3
HCPCS,J9246,"Inj., evomela, 1 mg",,,2.33,5565.45,41
HCPCS,J924600,"Inj., evomela, 1 mg",,,33.16,42.48,3
HCPCS,J9247,"Inj, melphalan flufenami 1mg",,,426.9,8832.81,14
HCPCS,J924700,"Inj, melphalan flufenami 1mg",,,1014.6,1299.6,3
HCPCS,J9248,HEPZATO KIT,1660.0,1079.0,398.4,1812.6,93
HCPCS,J9248,Inj melphalan (hepzato) 1 mg,,,1415.1,1812.6,3
HCPCS,J924800,Inj melphalan (hepzato) 1 mg,,,1415.1,1812.6,3
HCPCS,J9249,"Inj, melphalan (apotex) 1 mg",,,8.1,1380.54,27
HCPCS,J924900,"Inj, melphalan (apotex) 1 mg",,,130.53,167.19,3
HCPCS,J9250,"METHOTREXATE SODIUM,  5 MG",2.0,1.3,0.39,19.13,74
HCPCS,J9250,Methotrexate sodium inj,,,0.39,0.5,3
HCPCS,J925000,Methotrexate sodium inj,,,0.39,0.5,3
HCPCS,J9255,"Inj, methotrexate (accord)",,,16.52,2739849.3,9
HCPCS,J9256,"Inj, nipocalimab-aahu, 3 mg",,,4.09,8832.81,30
HCPCS,J925600,"Inj, nipocalimab-aahu, 3 mg",,,58.28,74.65,3
HCPCS,J9258,Paclitaxel (teva),,,2875.32,3329.32,8
HCPCS,J9259,Paclitaxel (american regent),,,15.14,3329.32,13
HCPCS,J925900,Paclitaxel (american regent),,,35.01,44.85,3
HCPCS,J9260,Inj methotrexate sodium 50mg,,,4.59,5.88,3
HCPCS,J9260,"METHOTREXATE SODIUM,  50 MG",10.0,6.5,2.18,19.13,75
HCPCS,J926000,Inj methotrexate sodium 50mg,,,4.59,5.88,3
HCPCS,J9261,Nelarabine injection,,,8.15,5565.45,41
HCPCS,J926100,Nelarabine injection,,,115.98,148.56,3
HCPCS,J9262,"Inj, omacetaxine mep, 0.01mg",,,3.42,1380.54,25
HCPCS,J926200,"Inj, omacetaxine mep, 0.01mg",,,8.12,10.4,3
HCPCS,J9263,Oxaliplatin,,,0.07,60.42,19
HCPCS,J926300,Oxaliplatin,,,0.09,0.11,3
HCPCS,J9264,ABRAXANE 1MG,47.96,31.17,8.18,3329.32,93
HCPCS,J9264,Paclitaxel protein bound,,,14.56,18.65,3
HCPCS,J926400,Paclitaxel protein bound,,,14.56,18.65,3
HCPCS,J9266,Pegaspargase injection,,,3553.01,70641.2,41
HCPCS,J926600,Pegaspargase injection,,,50594.83,64806.86,3
HCPCS,J9267,Paclitaxel injection,,,0.13,0.3,11
HCPCS,J926700,Paclitaxel injection,,,0.18,0.23,3
HCPCS,J9268,Pentostatin injection,,,317.14,6228.43,41
HCPCS,J926800,Pentostatin injection,,,4516.04,5784.59,3
HCPCS,J9269,Inj. tagraxofusp-erzs 10 mcg,,,44.63,20935.21,41
HCPCS,J926900,Inj. tagraxofusp-erzs 10 mcg,,,635.5,814.01,3
HCPCS,J9270,Plicamycin (mithramycin) inj,,,1823.7,2739849.3,9
HCPCS,J9271,Inj pembrolizumab,,,7.47,8832.81,41
HCPCS,J927100,Inj pembrolizumab,,,106.32,136.18,3
HCPCS,J9272,"Inj, dostarlimab-gxly, 10 mg",,,30.93,8832.81,41
HCPCS,J927200,"Inj, dostarlimab-gxly, 10 mg",,,440.44,564.16,3
HCPCS,J9273,"Inj tisotu vedotin-tftv, 1mg",,,24.51,16514.52,41
HCPCS,J927300,"Inj tisotu vedotin-tftv, 1mg",,,349.0,447.04,3
HCPCS,J9274,"Inj, tebentafusp-tebn, 1 mcg",,,27.78,16514.52,41
HCPCS,J927400,"Inj, tebentafusp-tebn, 1 mcg",,,395.53,506.64,3
HCPCS,J9275,"Inj cosibelimab-ipdl, 2 mg",,,2.87,5565.45,27
HCPCS,J927500,"Inj cosibelimab-ipdl, 2 mg",,,46.19,59.17,3
HCPCS,J9276,"Inj zanidatamab-hrii, 2 mg",,,3.13,8832.81,30
HCPCS,J927600,"Inj zanidatamab-hrii, 2 mg",,,44.5,57.0,3
HCPCS,J9277,Inj pem 1 mg bera alfa-pmph,,,7628.34,8832.81,8
HCPCS,J9280,GENERIC MITOMYCIN 5 MG,722.85,469.85,26.1,1185.36,93
HCPCS,J9280,Mitomycin injection,,,46.46,59.51,3
HCPCS,J928000,Mitomycin injection,,,46.46,59.51,3
HCPCS,J9281,Mitomycin instillation,,,40.49,16514.52,41
HCPCS,J928100,Mitomycin instillation,,,576.56,738.51,3
HCPCS,J9282,Mitomycin intravesical inst,,,34.6,16514.52,27
HCPCS,J928200,Mitomycin intravesical inst,,,574.05,735.3,3
HCPCS,J9285,"Inj, olaratumab, 10 mg",,,54.03,5653.6,17
HCPCS,J928500,"Inj, olaratumab, 10 mg",,,104.91,134.38,3
HCPCS,J9286,"Inj glofitamab gxbm, 2.5 mg",,,355.45,7419.73,40
HCPCS,J928600,"Inj glofitamab gxbm, 2.5 mg",,,5061.59,6483.39,3
HCPCS,J9289,Inj nivolumab 2 mg hyaluron,,,3.48,5565.45,30
HCPCS,J928900,Inj nivolumab 2 mg hyaluron,,,49.48,63.38,3
HCPCS,J9292,"Inj, pemetrexed dipotassium",,,10.15,3329.32,32
HCPCS,J929200,"Inj, pemetrexed dipotassium",,,144.59,185.2,3
HCPCS,J9293,Mitoxantrone hydrochl / 5 mg,,,3.86,629.95,41
HCPCS,J929300,Mitoxantrone hydrochl / 5 mg,,,54.97,70.41,3
HCPCS,J9294,"Inj pemetrexed, hospira 10mg",,,0.52,3329.32,40
HCPCS,J929400,"Inj pemetrexed, hospira 10mg",,,7.46,9.55,3
HCPCS,J9295,"Injection, necitumumab, 1 mg",,,0.72,5565.45,41
HCPCS,J929500,"Injection, necitumumab, 1 mg",,,10.2,13.06,3
HCPCS,J9296,Inj pemetrexed (accord) 10mg,,,1.22,3329.32,40
HCPCS,J929600,Inj pemetrexed (accord) 10mg,,,17.34,22.21,3
HCPCS,J9297,Inj pemetrexed (sandoz) 10mg,,,1.42,3329.32,19
HCPCS,J929700,Inj pemetrexed (sandoz) 10mg,,,2.65,3.4,3
HCPCS,J9298,Inj nivol relatlimab 3mg/1mg,,,25.21,20935.21,41
HCPCS,J929800,Inj nivol relatlimab 3mg/1mg,,,358.94,459.76,3
HCPCS,J9299,"Injection, nivolumab",,,59.75,76.54,3
HCPCS,J9299,NIVOLUMAB 100 MG/ 10 ML,26.55,17.26,6.37,5565.45,93
HCPCS,J929900,"Injection, nivolumab",,,59.75,76.54,3
HCPCS,J9301,Obinutuzumab inj,,,10.2,5565.45,41
HCPCS,J930100,Obinutuzumab inj,,,145.3,186.12,3
HCPCS,J9302,ARZERRA 10MG,212.7,138.26,51.05,5565.45,93
HCPCS,J9302,Ofatumumab injection,,,128.87,165.07,3
HCPCS,J930200,Ofatumumab injection,,,128.87,165.07,3
HCPCS,J9303,Panitumumab injection,,,309.13,395.97,3
HCPCS,J9303,VECTIBIX 10 MG,427.4,277.81,102.58,5653.6,93
HCPCS,J930300,Panitumumab injection,,,309.13,395.97,3
HCPCS,J9304,"Inj. pemetrexed, 10 mg",,,4.99,5565.45,41
HCPCS,J930400,"Inj. pemetrexed, 10 mg",,,71.08,91.04,3
HCPCS,J9305,"INJ PEMTREXED, 10 MG",270.6,175.89,3.59,3329.32,93
HCPCS,J9305,Inj. pemetrexed nos 10mg,,,6.39,8.19,3
HCPCS,J930500,Inj. pemetrexed nos 10mg,,,6.39,8.19,3
HCPCS,J9306,INJECTION PERTUZUMAB 1 MG,46.61,30.3,11.19,5653.6,93
HCPCS,J9306,"Injection, pertuzumab, 1 mg",,,30.28,38.78,3
HCPCS,J930600,"Injection, pertuzumab, 1 mg",,,30.28,38.78,3
HCPCS,J9307,Pralatrexate injection,,,49.09,5565.45,41
HCPCS,J930700,Pralatrexate injection,,,699.04,895.4,3
HCPCS,J9308,"Injection, ramucirumab",,,9.45,5565.45,41
HCPCS,J930800,"Injection, ramucirumab",,,134.53,172.32,3
HCPCS,J9309,"Inj, polatuzumab vedotin 1mg",,,17.1,8832.81,41
HCPCS,J930900,"Inj, polatuzumab vedotin 1mg",,,243.45,311.84,3
HCPCS,J9311,"Inj rituximab, hyaluronidase",,,4.61,5653.6,41
HCPCS,J931100,"Inj rituximab, hyaluronidase",,,65.63,84.06,3
HCPCS,J9312,"INJ., RITUXIMAB, 10 MG",465.97,302.88,74.76,5653.6,93
HCPCS,J9312,"Inj., rituximab, 10 mg",,,133.09,170.48,3
HCPCS,J931200,"Inj., rituximab, 10 mg",,,133.09,170.48,3
HCPCS,J9313,"Inj., lumoxiti, 0.01 mg",,,2.92,5565.45,39
HCPCS,J931300,"Inj., lumoxiti, 0.01 mg",,,47.13,60.37,3
HCPCS,J9314,Inj pemetrexed (teva) 10mg,,,1.92,3329.32,40
HCPCS,J931400,Inj pemetrexed (teva) 10mg,,,27.29,34.95,3
HCPCS,J9315,Romidepsin injection,,,4806.53,5565.45,8
HCPCS,J9316,"Pertuzu, trastuzu, 10 mg",,,7.62,5653.6,41
HCPCS,J931600,"Pertuzu, trastuzu, 10 mg",,,108.51,138.99,3
HCPCS,J9317,Sacituzumab govitecan-hziy,,,4.62,1559.81,41
HCPCS,J931700,Sacituzumab govitecan-hziy,,,65.82,84.31,3
HCPCS,J9318,Inj romidepsin non-lyo 0.1mg,,,3.57,5565.45,41
HCPCS,J931800,Inj romidepsin non-lyo 0.1mg,,,50.77,65.03,3
HCPCS,J9319,Inj romidepsin lyophil 0.1mg,,,3.86,5565.45,41
HCPCS,J931900,Inj romidepsin lyophil 0.1mg,,,55.02,70.47,3
HCPCS,J9320,Streptozocin injection,,,362.0,3556.8,18
HCPCS,J932000,Streptozocin injection,,,2776.8,3556.8,3
HCPCS,J9321,Inj epcoritamab-bysp 0.16 mg,,,7.1,5653.6,40
HCPCS,J932100,Inj epcoritamab-bysp 0.16 mg,,,101.12,129.53,3
HCPCS,J9322,Inj pemetrexed (bluepoint),,,1.33,2739849.3,28
HCPCS,J932200,Inj pemetrexed (bluepoint),,,19.46,24.92,3
HCPCS,J9323,Inj pemetrexed ditromethamin,,,0.02,3329.32,40
HCPCS,J932300,Inj pemetrexed ditromethamin,,,0.23,0.3,3
HCPCS,J9324,"Inj, pemrydi rtu, 10 mg",,,9.17,2739849.3,39
HCPCS,J932400,"Inj, pemrydi rtu, 10 mg",,,130.51,167.17,3
HCPCS,J9325,Inj talimogene laherparepvec,,,9.24,5565.45,41
HCPCS,J932500,Inj talimogene laherparepvec,,,131.61,168.58,3
HCPCS,J9326,Telisotuzumab vedotin-tllv,,,18.23,8832.81,30
HCPCS,J932600,Telisotuzumab vedotin-tllv,,,259.65,332.58,3
HCPCS,J9328,Temozolomide injection,,,1.3,3329.32,41
HCPCS,J932800,Temozolomide injection,,,18.51,23.71,3
HCPCS,J9329,"Inj, tislelizumab-jsgr",,,7.3,5653.6,39
HCPCS,J932900,"Inj, tislelizumab-jsgr",,,103.9,133.08,3
HCPCS,J9330,TORISEL 1 MG,505.94,328.86,20.31,1380.54,93
HCPCS,J9330,Temsirolimus injection,,,36.17,46.33,3
HCPCS,J933000,Temsirolimus injection,,,36.17,46.33,3
HCPCS,J9331,Inj sirolimus prot part 1 mg,,,10.89,8832.81,40
HCPCS,J933100,Inj sirolimus prot part 1 mg,,,155.06,198.61,3
HCPCS,J9332,Inj efgartigimod 2mg,,,4.03,8832.81,40
HCPCS,J933200,Inj efgartigimod 2mg,,,57.35,73.46,3
HCPCS,J9333,Inj rozanolixizum-noli 1 mg,,,2.92,8832.81,40
HCPCS,J933300,Inj rozanolixizum-noli 1 mg,,,41.62,53.31,3
HCPCS,J9334,Inj efgart-alfa 2mg hya-qvfc,,,4.27,8832.81,40
HCPCS,J933400,Inj efgart-alfa 2mg hya-qvfc,,,60.73,77.79,3
HCPCS,J9340,Thiotepa injection,,,209.02,1185.36,20
HCPCS,J9341,Inj thiotepa (tepylute) 1 mg,,,67.46,1185.36,16
HCPCS,J934100,Inj thiotepa (tepylute) 1 mg,,,68.62,87.89,3
HCPCS,J9342,Inj thiotepa nos 1 mg,,,1.11,1185.36,30
HCPCS,J934200,Inj thiotepa nos 1 mg,,,15.77,20.2,3
HCPCS,J9345,"Inj, retifanlimab-dlwr, 1 mg",,,3.82,8832.81,40
HCPCS,J934500,"Inj, retifanlimab-dlwr, 1 mg",,,54.34,69.61,3
HCPCS,J9347,"Inj, tremelimumab-actl, 1 mg",,,17.88,5565.45,40
HCPCS,J934700,"Inj, tremelimumab-actl, 1 mg",,,254.58,326.09,3
HCPCS,J9348,"Inj. naxitamab-gqgk, 1 mg",,,85.76,16514.52,41
HCPCS,J934800,"Inj. naxitamab-gqgk, 1 mg",,,1221.22,1564.26,3
HCPCS,J9349,"Inj., tafasitamab-cxix",,,1.78,5653.6,41
HCPCS,J934900,"Inj., tafasitamab-cxix",,,25.35,32.47,3
HCPCS,J9350,"INJ MOSUNETUZUMAB-AXGB, 1 MG",2952.7,1919.26,1.1,20935.21,167
HCPCS,J9350,"Inj mosunetuzumab-axgb, 1 mg",,,1166.58,1494.27,3
HCPCS,J935000,"Inj mosunetuzumab-axgb, 1 mg",,,1166.58,1494.27,3
HCPCS,J9351,TOPOTECAN INJECTION 0.1 MG,134.29,87.29,2.18,134.29,67
HCPCS,J9351,Topotecan injection,,,2.23,2.85,3
HCPCS,J935100,Topotecan injection,,,2.23,2.85,3
HCPCS,J9352,Injection trabectedin 0.1mg,,,48.88,5565.45,41
HCPCS,J935200,Injection trabectedin 0.1mg,,,696.1,891.64,3
HCPCS,J9353,"Inj. margetuximab-cmkb, 5 mg",,,6.72,5653.6,41
HCPCS,J935300,"Inj. margetuximab-cmkb, 5 mg",,,95.68,122.55,3
HCPCS,J9354,INJ ADO-TRASTUZUMAB EMT 1 MG,133.23,86.6,31.98,5653.6,93
HCPCS,J9354,"Inj, ado-trastuzumab emt 1mg",,,75.1,96.19,3
HCPCS,J935400,"Inj, ado-trastuzumab emt 1mg",,,75.1,96.19,3
HCPCS,J9355,Inj trastuzumab excl biosimi,,,130.79,167.53,3
HCPCS,J9355,"TRASTUZUMAB, 10 MG",398.61,259.1,73.48,4103.47,93
HCPCS,J935500,Inj trastuzumab excl biosimi,,,130.79,167.53,3
HCPCS,J9356,"Inj. herceptin hylecta, 10mg",,,7.63,5653.6,41
HCPCS,J935600,"Inj. herceptin hylecta, 10mg",,,108.7,139.24,3
HCPCS,J9357,Valrubicin injection,,,162.92,5653.6,41
HCPCS,J935700,Valrubicin injection,,,2319.95,2971.62,3
HCPCS,J9358,Inj fam-trastu deru-nxki 1mg,,,3.91,4103.47,41
HCPCS,J935800,Inj fam-trastu deru-nxki 1mg,,,55.71,71.36,3
HCPCS,J9359,Inj lon tesirin-lpyl 0.075mg,,,27.65,16514.52,41
HCPCS,J935900,Inj lon tesirin-lpyl 0.075mg,,,393.77,504.38,3
HCPCS,J9360,VINBLASTINE SULFATE 1 MG,12.69,8.25,2.77,12.69,67
HCPCS,J9360,Vinblastine sulfate inj,,,9.22,11.81,3
HCPCS,J936000,Vinblastine sulfate inj,,,9.22,11.81,3
HCPCS,J9361,"Inj, efbemalenograstim alfa-",,,245.64,4103.47,13
HCPCS,J936100,"Inj, efbemalenograstim alfa-",,,245.64,314.64,3
HCPCS,J9370,VINCRISTINE SULFATE 1 MG,42.25,27.46,9.21,42.25,75
HCPCS,J9370,Vincristine sulfate 1 mg inj,,,14.51,18.58,3
HCPCS,J937000,Vincristine sulfate 1 mg inj,,,14.51,18.58,3
HCPCS,J9371,"Inj, vincristine sul lip 1mg",,,3420.78,9410.04,14
HCPCS,J937100,"Inj, vincristine sul lip 1mg",,,7346.43,9410.04,3
HCPCS,J9376,"Inj pozelimab-bbfg, 1 mg",,,11.47,20935.21,29
HCPCS,J937600,"Inj pozelimab-bbfg, 1 mg",,,184.85,236.78,3
HCPCS,J9380,Inj teclistamab cqyv 0.5 mg,,,4.32,5653.6,41
HCPCS,J938000,Inj teclistamab cqyv 0.5 mg,,,61.55,78.84,3
HCPCS,J9381,Inj teplizumab mzwv 5 mcg,,,4.8,20935.21,40
HCPCS,J938100,Inj teplizumab mzwv 5 mcg,,,68.33,87.53,3
HCPCS,J9382,Inj zenocutuzumab-zbco 1 mg,,,4.2,5565.45,30
HCPCS,J938200,Inj zenocutuzumab-zbco 1 mg,,,59.75,76.54,3
HCPCS,J9390,VINORELBINE TARTRATE PER 10MG,190.4,123.76,9.52,190.4,67
HCPCS,J9390,Vinorelbine tartrate inj,,,9.68,12.4,3
HCPCS,J939000,Vinorelbine tartrate inj,,,9.68,12.4,3
HCPCS,J9393,"Inj, fulvestrant (teva)",,,5.21,629.95,39
HCPCS,J939300,"Inj, fulvestrant (teva)",,,42.72,54.72,3
HCPCS,J9394,"Inj, fulvestrant (fresenius)",,,3.39,629.95,41
HCPCS,J939400,"Inj, fulvestrant (fresenius)",,,48.26,61.81,3
HCPCS,J9395,"FULVESTRANT, 25 MG INJ",398.46,259.0,7.51,629.95,83
HCPCS,J9395,"Injection, fulvestrant",,,10.18,13.04,3
HCPCS,J939500,"Injection, fulvestrant",,,10.18,13.04,3
HCPCS,J9400,"Inj, ziv-aflibercept, 1mg",,,0.9,1622.37,41
HCPCS,J940000,"Inj, ziv-aflibercept, 1mg",,,12.85,16.46,3
HCPCS,J9600,Porfimer sodium injection,,,3028.55,63811.73,39
HCPCS,J960000,Porfimer sodium injection,,,49817.93,63811.73,3
HCPCS,J9601,Inj linvoselt-gcpt 1 mg,,,7628.34,8832.81,8
HCPCS,K0001,STANDARD WHEELCHAIR,200.0,130.0,1.1,2042.7,90
HCPCS,K0001,Standard wheelchair,,,31.69,804.68,9
HCPCS,K0002,Stnd hemi (low seat) whlchr,,,31.69,1359.67,9
HCPCS,K0003,Lightweight wheelchair,,,31.69,1182.15,9
HCPCS,K0004,High strength ltwt whlchr,,,58.52,1420.36,9
HCPCS,K0005,Ultralightweight wheelchair,,,669.74,6911.81,9
HCPCS,K0006,Heavy duty wheelchair,,,58.52,2092.15,9
HCPCS,K0007,Extra heavy duty wheelchair,,,58.52,2976.54,9
HCPCS,K0008,Cstm manual wheelchair/base,,,36.52,4384.0,9
HCPCS,K0009,Other manual wheelchair/base,,,11.14,2918.43,9
HCPCS,K0010,Stnd wt frame power whlchr,,,846.64,15696.91,9
HCPCS,K0011,Stnd wt pwr whlchr w control,,,20109.35,20109.35,1
HCPCS,K0012,Ltwt portbl power whlchr,,,91.28,12754.59,9
HCPCS,K0013,Custom power whlchr base,,,31.69,24660.0,9
HCPCS,K0014,Other power whlchr base,,,11.14,15070.82,9
HCPCS,K0015,Detach non-adj ht armrst rep,,,58.52,506.35,9
HCPCS,K0017,Detach adjust armrest base,,,31.69,152.81,9
HCPCS,K0018,Detach adjust armrst upper,,,36.52,86.39,9
HCPCS,K0019,"Arm pad repl, each",,,11.14,43.98,9
HCPCS,K0020,Fixed adjust armrest pair,,,36.52,149.71,9
HCPCS,K0037,Hi mount flip-up footrest ea,,,31.69,131.9,9
HCPCS,K0038,Leg strap each,,,11.14,76.39,9
HCPCS,K0039,Leg strap h style each,,,31.69,164.02,9
HCPCS,K0040,Adjustable angle footplate,,,31.69,169.2,9
HCPCS,K0041,Large size footplate each,,,31.69,156.73,9
HCPCS,K0042,Standard size ftplate rep ea,,,36.52,100.67,9
HCPCS,K0043,Ftrst lowr exten tube rep ea,,,11.14,62.14,9
HCPCS,K0044,Ftrst upr hanger brac rep ea,,,11.14,53.62,9
HCPCS,K0045,Ftrst compl assembly repl ea,,,31.69,177.85,9
HCPCS,K0046,Elev lgrst lwr exten repl ea,,,11.14,62.55,9
HCPCS,K0047,Elev legrst upr hangr rep ea,,,31.69,221.04,9
HCPCS,K0050,Ratchet assembly replacement,,,36.52,102.56,9
HCPCS,K0051,Cam rel asm ft/legrst rep ea,,,31.69,162.24,9
HCPCS,K0052,Swingaway detach ftrest repl,,,31.69,242.79,9
HCPCS,K0053,Elevate footrest articulate,,,58.52,273.07,9
HCPCS,K0056,Seat ht <17 or >=21 ltwt wc,,,31.69,306.74,9
HCPCS,K0065,Spoke protectors,,,36.52,154.56,9
HCPCS,K0069,Rr whl compl sol tire rep ea,,,58.52,312.83,9
HCPCS,K0070,Rr whl compl pne tire rep ea,,,58.52,543.18,9
HCPCS,K0071,Fr cstr comp pne tire rep ea,,,58.52,360.72,9
HCPCS,K0072,Fr cstr semi-pne tire rep ea,,,31.69,221.97,9
HCPCS,K0073,Caster pin lock each,,,36.52,117.19,9
HCPCS,K0077,Fr cstr asmb sol tire rep ea,,,31.69,177.22,9
HCPCS,K0098,"Drive belt for pwc, repl",,,36.52,79.82,9
HCPCS,K0105,Iv hanger,,,58.52,329.95,9
HCPCS,K0108,W/c component-accessory nos,,,36.52,2739999.97,9
HCPCS,K0195,Elevating whlchair leg rests,,,11.14,359.05,9
HCPCS,K0455,Pump uninterrupted infusion,,,351.41,406.89,8
HCPCS,K0462,Temporary replacement eqpmnt,,,16.97,674.86,9
HCPCS,K0552,Sup/ext non-ins inf pump syr,,,8.99,19.65,9
HCPCS,K0553,Ther cgm supply allowance,,,58.52,67.76,8
HCPCS,K0554,Ther cgm receiver/monitor,,,58.52,67.76,8
HCPCS,K0601,Repl batt silver oxide 1.5 v,,,4.08,19.65,9
HCPCS,K0602,Repl batt silver oxide 3 v,,,16.97,22.99,9
HCPCS,K0603,Repl batt alkaline 1.5 v,,,2.06,19.65,9
HCPCS,K0604,Repl batt lithium 3.6 v,,,16.97,22.17,9
HCPCS,K0605,Repl batt lithium 4.5 v,,,11.14,52.96,9
HCPCS,K0606,Aed garment w elec analysis,,,98855.45,98855.45,1
HCPCS,K0607,Repl batt for aed,,,351.41,846.69,9
HCPCS,K0608,Repl garment for aed,,,58.52,503.12,9
HCPCS,K0609,Repl electrode for aed,,,1288.13,3345.9,9
HCPCS,K0669,Seat/back cus no dmepdac ver,,,31.69,1420.69,9
HCPCS,K0672,Removable soft interface le,,,31.69,273.42,9
HCPCS,K0730,Ctrl dose inh drug deliv sys,,,669.74,6767.28,9
HCPCS,K0733,12-24hr sealed lead acid,,,36.52,92.06,9
HCPCS,K0738,Portable gas oxygen system,,,4315.5,4315.5,1
HCPCS,K0739,Repair/svc dme non-oxygen eq,,,16.97,52.09,9
HCPCS,K0740,Repair/svc oxygen equipment,,,2739849.3,2739849.3,1
HCPCS,K0743,Portable home suction pump,,,36.52,2739849.3,9
HCPCS,K0744,Absorp drg <= 16 suc pump,,,36.52,2739849.3,9
HCPCS,K0745,Absorp drg >16<=48 suc pump,,,36.52,2739849.3,9
HCPCS,K0746,Absorp drg >48 suc pump,,,36.52,2739849.3,9
HCPCS,K0800,Pov group 1 std up to 300lbs,,,669.74,2645.47,9
HCPCS,K0801,Pov group 1 hd 301-450 lbs,,,669.74,4802.4,9
HCPCS,K0802,Pov group 1 vhd 451-600 lbs,,,6595.23,6595.23,1
HCPCS,K0806,Pov group 2 std up to 300lbs,,,669.74,4529.93,9
HCPCS,K0807,Pov group 2 hd 301-450 lbs,,,7020.26,7020.26,1
HCPCS,K0808,Pov group 2 vhd 451-600 lbs,,,10852.18,10852.18,1
HCPCS,K0812,Power operated vehicle noc,,,2739849.3,2739849.3,1
HCPCS,K0813,Pwc gp 1 std port seat/back,,,91.28,8905.47,9
HCPCS,K0814,Pwc gp 1 std port cap chair,,,846.64,8841.3,9
HCPCS,K0815,Pwc gp 1 std seat/back,,,846.64,9769.72,9
HCPCS,K0816,Pwc gp 1 std cap chair,,,846.64,9247.53,9
HCPCS,K0820,Pwc gp 2 std port seat/back,,,91.28,9016.22,9
HCPCS,K0821,Pwc gp 2 std port cap chair,,,846.64,9339.59,9
HCPCS,K0822,Pwc gp 2 std seat/back,,,333.06,9863.21,9
HCPCS,K0823,Pwc gp 2 std cap chair,,,333.06,9350.25,9
HCPCS,K0824,Pwc gp 2 hd seat/back,,,333.06,14085.22,9
HCPCS,K0825,Pwc gp 2 hd cap chair,,,333.06,12855.01,9
HCPCS,K0826,Pwc gp 2 vhd seat/back,,,1288.13,26067.35,9
HCPCS,K0827,Pwc gp vhd cap chair,,,333.06,22469.95,9
HCPCS,K0828,Pwc gp 2 xtra hd seat/back,,,1288.13,31907.08,9
HCPCS,K0829,Pwc gp 2 xtra hd cap chair,,,1288.13,30151.81,9
HCPCS,K0830,Pwc gp2 std seat elevate s/b,,,6756.54,6756.54,1
HCPCS,K0831,Pwc gp2 std seat elevate cap,,,6756.54,6756.54,1
HCPCS,K0835,Pwc gp2 std sing pow opt s/b,,,333.06,12221.19,9
HCPCS,K0836,Pwc gp2 std sing pow opt cap,,,333.06,12676.06,9
HCPCS,K0837,Pwc gp 2 hd sing pow opt s/b,,,333.06,15675.32,9
HCPCS,K0838,Pwc gp 2 hd sing pow opt cap,,,333.06,13893.61,9
HCPCS,K0839,Pwc gp2 vhd sing pow opt s/b,,,1288.13,20822.0,9
HCPCS,K0840,Pwc gp2 xhd sing pow opt s/b,,,669.74,31968.35,9
HCPCS,K0841,Pwc gp2 std mult pow opt s/b,,,333.06,13772.2,9
HCPCS,K0842,Pwc gp2 std mult pow opt cap,,,333.06,13752.33,9
HCPCS,K0843,Pwc gp2 hd mult pow opt s/b,,,333.06,16325.82,9
HCPCS,K0848,Pwc gp 3 std seat/back,,,333.06,26819.39,9
HCPCS,K0849,Pwc gp 3 std cap chair,,,333.06,25784.82,9
HCPCS,K0850,Pwc gp 3 hd seat/back,,,1288.13,31108.7,9
HCPCS,K0851,Pwc gp 3 hd cap chair,,,1288.13,29911.59,9
HCPCS,K0852,Pwc gp 3 vhd seat/back,,,1288.13,35944.36,9
HCPCS,K0853,Pwc gp 3 vhd cap chair,,,1288.13,36924.27,9
HCPCS,K0854,Pwc gp 3 xhd seat/back,,,669.74,48916.48,9
HCPCS,K0855,Pwc gp 3 xhd cap chair,,,669.74,46208.65,9
HCPCS,K0856,Pwc gp3 std sing pow opt s/b,,,1288.13,28786.96,9
HCPCS,K0857,Pwc gp3 std sing pow opt cap,,,1288.13,29364.09,9
HCPCS,K0858,Pwc gp3 hd sing pow opt s/b,,,1288.13,35716.5,9
HCPCS,K0859,Pwc gp3 hd sing pow opt cap,,,1288.13,34062.53,9
HCPCS,K0860,Pwc gp3 vhd sing pow opt s/b,,,669.74,51025.6,9
HCPCS,K0861,Pwc gp3 std mult pow opt s/b,,,1288.13,28833.29,9
HCPCS,K0862,Pwc gp3 hd mult pow opt s/b,,,1288.13,35716.5,9
HCPCS,K0863,Pwc gp3 vhd mult pow opt s/b,,,669.74,51025.6,9
HCPCS,K0864,Pwc gp3 xhd mult pow opt s/b,,,669.74,60720.51,9
HCPCS,K0868,Pwc gp 4 std seat/back,,,12040.96,12040.96,1
HCPCS,K0869,Pwc gp 4 std cap chair,,,11050.58,11050.58,1
HCPCS,K0870,Pwc gp 4 hd seat/back,,,13438.19,13438.19,1
HCPCS,K0871,Pwc gp 4 vhd seat/back,,,11496.3,11496.3,1
HCPCS,K0877,Pwc gp4 std sing pow opt s/b,,,13708.14,13708.14,1
HCPCS,K0878,Pwc gp4 std sing pow opt cap,,,13783.16,13783.16,1
HCPCS,K0879,Pwc gp4 hd sing pow opt s/b,,,17615.05,17615.05,1
HCPCS,K0880,Pwc gp4 vhd sing pow opt s/b,,,27768.64,27768.64,1
HCPCS,K0884,Pwc gp4 std mult pow opt s/b,,,12945.54,12945.54,1
HCPCS,K0885,Pwc gp4 std mult pow opt cap,,,17615.05,17615.05,1
HCPCS,K0886,Pwc gp4 hd mult pow s/b,,,27768.64,27768.64,1
HCPCS,K0890,Pwc gp5 ped sing pow opt s/b,,,12283.97,12283.97,1
HCPCS,K0891,Pwc gp5 ped mult pow opt s/b,,,27262.45,27262.45,1
HCPCS,K0898,Power wheelchair noc,,,2739849.3,2739849.3,1
HCPCS,K0899,Pow mobil dev no dmepdac,,,5013.62,5013.62,1
HCPCS,K0900,Cstm dme other than wheelchr,,,16.97,2739849.3,9
HCPCS,K1001,Electronic posa treatment,,,31.69,36.7,8
HCPCS,K1002,Ces system,,,1288.13,1491.52,8
HCPCS,K1004,Lo freq us diathermy device,,,58.52,2739849.3,9
HCPCS,K1005,Disp col sto bag breast milk,,,11.14,12.9,8
HCPCS,K1006,Suct pum ext urine mgmt sys,,,31.69,36.7,8
HCPCS,K1007,Bil hkaf pc s/d micro sensor,,,16923.09,2739849.3,9
HCPCS,K1009,Speech volume modulation sys,,,1288.13,1491.52,8
HCPCS,K1010,Intraurethral drainag device,,,16.97,19.65,8
HCPCS,K1011,Acti intraurethral drainage,,,16.97,19.65,8
HCPCS,K1012,Charger base station intraur,,,16.97,19.65,8
HCPCS,K1013,Enema tube any type repl,,,16.97,19.65,8
HCPCS,K1015,"Foot, adductus position, adj",,,58.52,67.76,8
HCPCS,K1016,Trans elec nerv for trigemin,,,31.69,36.7,8
HCPCS,K1017,Monthly supp use with k1016,,,36.52,42.28,8
HCPCS,K1019,Supp ext up limb tremor stim,,,36.52,42.28,8
HCPCS,K1020,Non-invasive vagus nerv stim,,,846.64,980.32,8
HCPCS,K1021,Exsuff belt incl all sup acc,,,1288.13,1491.52,8
HCPCS,K1022,Endoskel posit rotat unit,,,846.64,980.32,8
HCPCS,K1023,Trans elec nerv periph nerv,,,91.28,105.69,8
HCPCS,K1024,Non pneum comp control cal,,,3989.9,4619.88,8
HCPCS,K1025,Non pneum compress full arm,,,846.64,980.32,8
HCPCS,K1026,Mech allergen parti barrier,,,351.41,406.89,8
HCPCS,K1027,ORAL DEV WITHOUT FIX MECH,3500.0,2275.0,1.1,3060831.65,136
HCPCS,K1028,Control unit nm stim w phone,,,669.74,775.49,8
HCPCS,K1029,Oral dv/app neuromus mouthpi,,,58.52,67.76,8
HCPCS,K1030,Ext recharge bat replacement,,,669.74,2739849.3,9
HCPCS,K1031,Non pneu comp control w/o ca,,,1288.13,1491.52,8
HCPCS,K1032,Non pneum seq comp full leg,,,58.52,67.76,8
HCPCS,K1033,Non pneum seq comp half leg,,,58.52,67.76,8
HCPCS,K1034,Covid test self-admn/collect,,,16.97,27.37,9
HCPCS,K1035,Mol diag reader self-admn,,,31.69,2739849.3,9
HCPCS,K1036,Supplies for ultra diatherm,,,11.14,2739849.3,9
HCPCS,K1037,Docking station for oral dev,,,333.06,385.65,8
HCPCS,L0112,Cranial cervical orthosis,,,669.74,4512.26,9
HCPCS,L0113,Cranial cervical torticollis,,,91.28,919.41,9
HCPCS,L0120,CERVICAL FOAM COLLAR,47.0,30.55,10.25,47.0,74
HCPCS,L0120,"CERVICAL, FLEXIBLE, NON-ADJUSTABLE",52.0,33.8,1.1,104.79,90
HCPCS,L0120,COLLAR ECONOMY X-LONG/NARROW,27.0,17.55,5.89,42.28,74
HCPCS,L0120,"COLLAR, ECONOMY, MEDIUM",9.46,6.15,2.06,42.28,74
HCPCS,L0130,Flex thermoplastic collar mo,,,58.52,492.1,9
HCPCS,L0140,Cervical semi-rigid adjustab,,,31.69,192.98,9
HCPCS,L0150,Cerv semi-rig adj molded chn,,,58.52,345.08,9
HCPCS,L0160,Cerv sr wire occ/man pre ots,,,58.52,503.89,9
HCPCS,L0170,Cervical collar molded to pt,,,333.06,2592.12,9
HCPCS,L0172,C.O. SEMIRIGID THERMAPLASTIC,166.72,108.37,36.34,166.72,74
HCPCS,L0172,SEMI-RIGID CERVICAL COLLAR,249.0,161.85,1.1,561.19,90
HCPCS,L0174,Cerv sr 2pc thor ext pre ots,,,91.28,897.82,9
HCPCS,L0180,Cer post col occ/man sup adj,,,846.64,1454.5,9
HCPCS,L0190,Cerv collar supp adj cerv ba,,,333.06,1715.43,9
HCPCS,L0200,W COLLAR CERV ADJ BAR THRC FRM,726.48,472.21,158.37,726.48,74
HCPCS,L0220,Thor rib belt custom fabrica,,,58.52,416.48,9
HCPCS,L0450,Tlso flex trunk/thor pre ots,,,58.52,319.05,9
HCPCS,L0452,Tlso flex custom fab thoraci,,,351.41,567.18,9
HCPCS,L0454,THORA TLC II LVAD PNEUM LD 5FT,408.24,265.36,89.0,408.24,74
HCPCS,L0455,Tlso flex trnk sj-t9 pre ots,,,91.28,592.31,9
HCPCS,L0456,PREFAB TLSO TO SCAPULAR SPINE,1170.71,760.96,255.21,1170.71,74
HCPCS,L0456,SPIO VEST,348.25,226.36,75.92,775.49,74
HCPCS,L0456,TLSO FLEX PREFAB,319.0,207.35,1.1,3940.95,90
HCPCS,L0457,Tlso flex trnk sj-ss pre ots,,,669.74,1698.53,9
HCPCS,L0458,Tlso 2mod symphis-xipho pre,,,1288.13,2875.3,9
HCPCS,L0460,Tlso 2 shl symphys-stern cst,,,669.74,3236.32,9
HCPCS,L0462,Tlso 3mod sacro-scap pre,,,669.74,4025.39,9
HCPCS,L0464,Tlso 4mod sacro-scap pre,,,669.74,4792.23,9
HCPCS,L0466,Tlso r fram soft ant pre cst,,,846.64,1223.16,9
HCPCS,L0467,Tlso r fram soft pre ots,,,664.29,980.32,9
HCPCS,L0468,Tlso rig fram pelvic pre cst,,,333.06,1532.89,9
HCPCS,L0469,Tlso rig fram pelvic pre ots,,,333.06,846.41,9
HCPCS,L0470,Tlso rigid frame pre subclav,,,333.06,2121.2,9
HCPCS,L0472,TLSO RIGID FRAME HYPEREX PRE,424.0,275.6,1.1,1604.25,90
HCPCS,L0472,W BRACE TLSO TRPLN CTRL HYPRTSN,476.56,309.76,103.89,980.32,74
HCPCS,L0474,TLSO rigid frame pre pelvic,,,884.77,884.77,1
HCPCS,L0480,Tlso rigid plastic custom fa,,,669.74,4869.64,9
HCPCS,L0482,"HEARTMATE POWER BASE UNIT,1240",1985.98,1290.89,432.94,1985.98,75
HCPCS,L0484,Tlso rigid plastic cust fab,,,5874.31,5874.31,1
HCPCS,L0486,W TLSO 2PC PL SHELL W LINER,2415.0,1569.75,526.47,2415.0,67
HCPCS,L0488,Tlso rigid lined pre one pie,,,669.74,3236.32,9
HCPCS,L0490,Tlso rigid plastic pre one,,,91.28,911.95,9
HCPCS,L0491,Tlso 2 piece rigid shell,,,1288.13,2475.97,9
HCPCS,L0492,Tlso 3 piece rigid shell,,,333.06,1612.27,9
HCPCS,L0621,SI STABILIZING BRACE,87.0,56.55,18.97,87.0,74
HCPCS,L0621,SIO FLEX PELVISACRAL PREFAB,101.745,66.13499999999999,1.1,244.49,164
HCPCS,L0622,Sio flex pelvisacral custom,,,351.41,861.7,9
HCPCS,L0623,Sio rig pnl pelv/sac pre ots,,,58.52,301.54,9
HCPCS,L0624,Sio panel custom,,,58.52,630.2,9
HCPCS,L0625,LO FLEXIBL L1-BELOW L5 PRE,33.0,21.45,1.1,143.56,90
HCPCS,L0625,LUMBAR ELASTIC SUPPORT,57.0,37.05,12.43,57.0,74
HCPCS,L0625,LUMBOSACRAL SUPPORT,30.0,19.5,6.54,36.7,74
HCPCS,L0625,W LUMBAR ORTHOSIS CORSET,145.0,94.25,31.61,145.0,74
HCPCS,L0626,LITE BACK,72.0,46.8,15.7,72.0,74
HCPCS,L0626,LO SAG STAYS/PANELS PRE-FAB,79.0,51.35,1.1,308.86,90
HCPCS,L0627,LO SAGITT RIGID PANEL PREFAB,366.16499999999996,238.005,1.1,1628.64,164
HCPCS,L0627,LSO BACK BRACE,655.0,425.75,67.57,980.32,74
HCPCS,L0627,LUMBAR ORTHOSIS (LO),285.0,185.25,62.13,980.32,73
HCPCS,L0627,W BRACE CYBERTECH SPINE FLEX PLUS,180.0,117.0,39.24,980.32,74
HCPCS,L0628,LO FLEX W/O RIGID STAYS PRE,454.0,295.1,1.1,454.0,90
HCPCS,L0628,Lso flex no ri stays pre ots,,,31.69,143.3,9
HCPCS,L0629,Lso flex w/rigid stays cust,,,58.52,616.5,9
HCPCS,L0630,BOG BACK BRACE,413.0,268.45,58.52,413.0,74
HCPCS,L0630,LSO POST RIGID PANEL PRE,454.0,295.1,1.1,641.81,90
HCPCS,L0630,"LSO PREFAB, W/RIGID POST",190.66,123.93,41.56,190.66,74
HCPCS,L0631,W BRACE CYBERTECH PREMIUM PLUS,1207.15,784.65,263.16,1207.15,74
HCPCS,L0632,Lso sag rigid frame cust,,,669.74,890.5,9
HCPCS,L0633,"LSO PREFAB, W/RIG PO/LAT",337.55,219.41,73.59,337.55,74
HCPCS,L0634,Lso flexion control custom,,,333.06,1239.85,9
HCPCS,L0635,Lso sagit rigid panel prefab,,,669.74,3221.47,9
HCPCS,L0636,Lso sagittal rigid panel cus,,,669.74,4371.01,9
HCPCS,L0637,HORIZON 637 LSO LUMBAR BRACE,249.0,161.85,54.28,775.49,74
HCPCS,L0637,LSO SAG-CORONAL PANEL PREFAB,231.0,150.15,1.1,5133.37,90
HCPCS,L0637,LUMBOSACRAL ORTHOSIS W/ CHAIRBACK (LSO) - CUSTOM (L0637),356.0,231.4,77.61,775.49,74
HCPCS,L0637,W BRACE LSO SAG-CORONL PNL PRFB,210.0,136.5,45.78,775.49,74
HCPCS,L0638,Lso sag-coronal panel custom,,,669.74,4252.15,9
HCPCS,L0639,Lso s/c shell/panel prefab,,,669.74,4176.66,9
HCPCS,L0640,LSO S/C SHELL/PANEL CUSTOM,1231.71,800.61,268.51,1231.71,74
HCPCS,L0641,Lo rig pos pnl l1-l5 pre ots,,,133.14,980.32,9
HCPCS,L0642,Lo sag ri an/pos pnl pre ots,,,702.15,980.32,9
HCPCS,L0643,Lso sag ctr rigi pos pre ots,,,58.52,276.63,9
HCPCS,L0648,Lso sag r an/pos pnl pre ots,,,669.74,1753.57,9
HCPCS,L0649,Lso sc r pos/lat pnl pre ots,,,91.28,489.83,9
HCPCS,L0650,Lso sc r ant/pos pnl pre ots,,,669.74,2029.0,9
HCPCS,L0651,Lso sag-co shell pnl pre ots,,,669.74,2029.0,9
HCPCS,L0700,Ctlso a-p-l control molded,,,6418.12,6418.12,1
HCPCS,L0710,Ctlso a-p-l control w/ inter,,,7055.2,7055.2,1
HCPCS,L0810,HALO AMB VEST,3146.25,2045.06,685.88,3146.25,67
HCPCS,L0820,Halo cervical into body jack,,,6778.68,6778.68,1
HCPCS,L0830,Halo cerv into milwaukee typ,,,10372.38,10372.38,1
HCPCS,L0859,Mri compatible system,,,669.74,3672.37,9
HCPCS,L0861,Halo repl liner/interface,,,351.41,694.89,9
HCPCS,L0970,Tlso corset front,,,58.52,344.53,9
HCPCS,L0972,Lso corset front,,,58.52,313.59,9
HCPCS,L0974,Tlso full corset,,,351.41,563.4,9
HCPCS,L0976,Lso full corset,,,58.52,482.02,9
HCPCS,L0978,Axillary crutch extension,,,351.41,606.66,9
HCPCS,L0980,Peroneal straps pair pre ots,,,11.14,55.07,9
HCPCS,L0982,Stocking sup grips 4 pre ots,,,11.14,50.44,9
HCPCS,L0984,"PROTECTIVE BODY SOCK, EACH",79.66,51.78,17.37,79.66,74
HCPCS,L0999,Add to spinal orthosis nos,,,16.97,2739999.97,9
HCPCS,L1000,Ctlso milwauke initial model,,,6537.42,6537.42,1
HCPCS,L1001,Ctlso infant immobilizer,,,58.52,4110.0,9
HCPCS,L1005,Tension based scoliosis orth,,,10318.7,10318.7,1
HCPCS,L1006,Scoliosis orth sag/ cor,,,669.74,775.49,8
HCPCS,L1007,Scoliosis orth s-c custom,,,669.74,775.49,8
HCPCS,L1010,Ctlso axilla sling,,,31.69,269.75,9
HCPCS,L1020,Kyphosis pad,,,31.69,347.4,9
HCPCS,L1025,Kyphosis pad floating,,,58.52,501.2,9
HCPCS,L1030,Lumbar bolster pad,,,31.69,252.44,9
HCPCS,L1040,Lumbar or lumbar rib pad,,,31.69,285.84,9
HCPCS,L1050,Sternal pad,,,31.69,323.48,9
HCPCS,L1060,Thoracic pad,,,58.52,349.16,9
HCPCS,L1070,Trapezius sling,,,58.52,361.68,9
HCPCS,L1080,Outrigger,,,31.69,168.67,9
HCPCS,L1085,Outrigger bil w/ vert extens,,,31.69,564.71,9
HCPCS,L1090,Lumbar sling,,,58.52,324.42,9
HCPCS,L1100,Ring flange plastic/leather,,,58.52,612.25,9
HCPCS,L1110,Ring flange plas/leather mol,,,351.41,1026.54,9
HCPCS,L1120,Covers for upright each,,,36.52,122.62,9
HCPCS,L1200,TLSO CUSTOM SCOLI,2106.44,1369.19,459.2,2106.44,75
HCPCS,L1210,LAT THORAC EXT ADDTN,287.99,187.19,62.78,406.89,74
HCPCS,L1220,Anterior thoracic extension,,,351.41,767.75,9
HCPCS,L1230,Milwaukee type superstructur,,,333.06,2150.74,9
HCPCS,L1240,TLSO LO PROFILE LUMB PAD,107.06,69.59,23.34,107.06,74
HCPCS,L1250,Anterior asis pad,,,31.69,254.98,9
HCPCS,L1260,Anterior thoracic derotation,,,31.69,304.06,9
HCPCS,L1270,Abdominal pad,,,31.69,267.2,9
HCPCS,L1280,Rib gusset (elastic) each,,,31.69,281.7,9
HCPCS,L1290,LAT TROCHANT PAD ADDTN,91.46,59.45,19.94,91.46,74
HCPCS,L1300,SCOLIOSIS BODY JACKET,2028.7,1318.66,442.26,2028.7,75
HCPCS,L1310,Post-operative body jacket,,,669.74,5787.43,9
HCPCS,L1499,DYNAMIC COMPRESSION SYSTEM,3500.0,2275.0,16.97,3500.0,75
HCPCS,L1499,UNLIST PROC FOR SPINAL ORTHO,88.0,57.2,16.97,88.0,74
HCPCS,L1600,Ho flex frejka w/cov pre cst,,,58.52,415.44,9
HCPCS,L1610,Ho frejka cov only pre cst,,,36.52,176.46,9
HCPCS,L1620,HO PAVLIK HARNESS,250.0,162.5,1.1,622.59,164
HCPCS,L1630,Abduct control hip semi-flex,,,58.52,681.08,9
HCPCS,L1640,Pelv band/spread bar thigh c,,,333.06,1526.21,9
HCPCS,L1650,HO ILFELD TYPE,290.28,188.68,63.28,406.89,74
HCPCS,L1652,Ho bi thighcuffs w sprdr bar,,,91.28,1149.24,9
HCPCS,L1653,Ho abduction static ots,,,91.28,105.69,8
HCPCS,L1660,ABDUCTION SPLINT-PEDIATR,160.0,104.0,34.88,160.0,74
HCPCS,L1660,"HIP ORTHOSIS,PLASTIC",176.0,114.4,1.1,716.06,90
HCPCS,L1660,"HO PLASTIC,CUSTOM FITTED",212.71,138.26,46.37,212.71,74
HCPCS,L1680,HO (RANCHO HIP ACTION TYPE),2379.0,1546.35,1.1,4514.28,90
HCPCS,L1680,Pelvic & hip control thigh c,,,669.74,3672.94,9
HCPCS,L1681,Ho bilateral hip abduction,,,6041.81,6041.81,1
HCPCS,L1685,Post-op hip abduct custom fa,,,669.74,3585.73,9
HCPCS,L1686,HO HIP ABDUCTION TYPE,1854.0,1205.1,1.1,3712.87,90
HCPCS,L1686,W ORTHOSIS HIP POSTOP,1103.0,716.95,240.45,1103.0,74
HCPCS,L1690,Combination bilateral ho,,,6234.32,6234.32,1
HCPCS,L1700,Leg perthes orth toronto typ,,,669.74,5015.9,9
HCPCS,L1710,Legg perthes orth newington,,,6387.21,6387.21,1
HCPCS,L1720,Legg perthes orthosis trilat,,,669.74,4755.9,9
HCPCS,L1730,Legg perthes orth scottish r,,,669.74,4015.03,9
HCPCS,L1755,Legg perthes patten bottom t,,,669.74,5772.47,9
HCPCS,L1810,J BRACE WITH HINGES,41.1,26.72,8.96,67.76,74
HCPCS,L1810,KO ELASTIC W/JOINTS,165.0,107.25,1.1,407.92,90
HCPCS,L1810,"LATERAL ""J"" BRACE",92.75,60.29,20.22,92.75,74
HCPCS,L1810,PATELLAR STABILIZING BRACE,175.0,113.75,38.15,175.0,74
HCPCS,L1810,PREFAB ELASTIC KO W JNTS,175.0,113.75,38.15,175.0,74
HCPCS,L1810,REACTION BRACE,50.22,32.64,10.95,67.76,74
HCPCS,L1810,TRU PULL LITE,146.0,94.9,17.21,146.0,74
HCPCS,L1812,DONJOY REACTION KNEE BRACE,84.29,54.79,18.38,84.29,74
HCPCS,L1812,OA REACTION KNEE BRACE,135.0,87.75,10.32,135.0,74
HCPCS,L1820,DELUXE HINGE WRAP AROUND,91.0,59.15,19.84,91.0,74
HCPCS,L1820,ECONOMY HINGED KNEE BRACE,69.0,44.85,15.04,69.0,74
HCPCS,L1820,KO ELAS W/ CONDYLE PADS & JO,295.0,191.75,1.1,563.13,90
HCPCS,L1820,KO W CONDYL PAD & JNTS,167.28,108.73,36.47,167.28,74
HCPCS,L1820,PLAYMAKER KNEE BRACE,324.0,210.6,58.52,324.0,74
HCPCS,L1821,Ko elas w/ condyle pads otf,,,58.52,67.76,8
HCPCS,L1830,"KO IMMOBILIZER, CANVAS LONGITUDE",33.0,21.45,1.1,255.71,90
HCPCS,L1830,PREFAB CANVAS KO IMMOBILIZER,144.5,93.925,29.21,155.0,148
HCPCS,L1831,Knee orth pos locking joint,,,91.28,948.86,9
HCPCS,L1832,"KO ADJUSTABLE KNEE JOINTS,RIGID",161.0,104.65,1.1,2729.31,90
HCPCS,L1832,THROM ADVANCE KNEE,151.0,98.15,32.92,385.65,74
HCPCS,L1832,W BRACE ACL T-ROM KO ADJ JNT,600.0,390.0,130.8,600.0,74
HCPCS,L1833,Ko adj jnt pos r sup pre ots,,,333.06,1320.08,9
HCPCS,L1834,"KO W/O KNEE JOINT, MOLDED",1605.0,1043.25,1.1,2876.06,90
HCPCS,L1834,Ko w/0 joint rigid molded to,,,1288.13,2340.04,9
HCPCS,L1836,Ko rigid w/o joints pre ots,,,58.52,259.12,9
HCPCS,L1840,"KO DEROTATION, CUSTOM FABRICATED",1123.0,729.95,1.1,3726.28,90
HCPCS,L1840,Ko derot ant cruciate custom,,,669.74,3031.81,9
HCPCS,L1843,KO SINGLE UPRIGHT CUSTOM FIT,551.0,358.15,1.1,3555.38,164
HCPCS,L1843,OPAL KNEE BRACE,893.0,580.45,194.67,1491.52,74
HCPCS,L1844,"KNEE ORTHOSIS (KO), SINGLE UPRIGHT CUSTOM FABRICATED",950.0,617.5,207.1,950.0,73
HCPCS,L1844,KO W/ADJ JT ROT CNTRL MOLDED,2070.0,1345.5,1.1,6034.13,90
HCPCS,L1845,KO DONJOY PREFAB,986.01,640.91,214.95,1491.52,74
HCPCS,L1845,"KO DOUBLE UPRIGHT, CUSTOM FITTED",927.0,602.55,1.1,3319.22,90
HCPCS,L1845,OA KNEE BRACE,1451.0,943.15,316.32,1491.52,75
HCPCS,L1845,OTS BRACE - ACL/PCL,1041.52,676.99,227.05,1491.52,74
HCPCS,L1845,"ROM KNEE BRACE, COOL",165.38,107.5,36.05,1491.52,74
HCPCS,L1845,W KO W/ ADJ FLEX/EXT ROTAT CUS,843.0,547.95,183.77,1491.52,74
HCPCS,L1846,CUSTOM ACL/PCL W/PNEUMATIC KNE,1276.0,829.4,278.17,1276.0,74
HCPCS,L1846,"KO DBL UPRIGHT ADJ, CUSTOM FAB",1377.25,895.21,300.24,1377.25,75
HCPCS,L1846,"KO DOUBLE UPRIGHT, MOLDED",1404.0,912.6,1.1,4636.16,90
HCPCS,L1847,Ko dbl upright w/air pre cst,,,333.06,1854.32,9
HCPCS,L1848,Ko dbl upright w/air pre ots,,,333.06,1854.32,9
HCPCS,L1850,KO SWEDISH TYPE,435.0,282.75,1.1,846.66,90
HCPCS,L1850,Ko swedish type pre ots,,,91.28,596.8,9
HCPCS,L1851,Ko single upright prefab ots,,,333.06,1742.39,9
HCPCS,L1852,Ko double upright prefab ots,,,333.06,1662.22,9
HCPCS,L1860,Ko supracondylar socket mold,,,669.74,4020.21,9
HCPCS,L1900,Afo sprng wir drsflx calf bd,,,91.28,919.82,9
HCPCS,L1902,AFO ANKLE GAUNTLET,142.0,92.3,30.96,142.0,74
HCPCS,L1902,AIR SPORT/ANKLE BRACE,163.0,105.95,23.92,163.0,74
HCPCS,L1902,"ASO ANKLE GAUNTLET, CUSTOM FITTED",80.0,52.0,1.1,295.77,90
HCPCS,L1904,"AFO ANKLE GAUNTLET, MOLDED",557.0,362.05,1.1,1788.51,90
HCPCS,L1904,CUSTOM MOLDED ANKLE GAUNTLET,531.32,345.36,115.83,531.32,74
HCPCS,L1906,ACHILLOTRAIN ELASTIC SUPPORT,134.0,87.1,29.21,134.0,74
HCPCS,L1906,AFO AIR CAST,128.185,83.32,27.03,132.37,148
HCPCS,L1906,AFO MULTILIGAMENTUS ANKLE SUPPORT,235.0,152.75,1.1,445.58,90
HCPCS,L1906,BLEDSOE BOOT W/ACHILLES WEDGES,134.0,87.1,29.21,134.0,74
HCPCS,L1907,AFO SUPRAMALLEOLAR CUSTOM,876.0,569.4,1.1,2229.7,90
HCPCS,L1907,"AFO, SUPRAMALLEOLAR W/STRAPS",662.35,430.53,144.39,662.35,74
HCPCS,L1910,Afo sing bar clasp attach sh,,,91.28,904.12,9
HCPCS,L1920,Afo sing upright w/ adjust s,,,91.28,1324.41,9
HCPCS,L1930,AFO PLASTIC,462.0,300.3,1.1,998.24,90
HCPCS,L1930,NIGHT SPLINT,420.0,273.0,91.56,420.0,74
HCPCS,L1930,W PREFAB AFO,296.56,192.76,64.65,406.89,74
HCPCS,L1932,AFO RIG ANT TIB PREFAB TCF/=,917.0,596.05,1.1,3535.79,90
HCPCS,L1932,"AFO,RIGID,ANTERIOR,CRB, PREFAB",1050.4,682.76,228.99,1491.52,74
HCPCS,L1933,Afo rig ant tib tcf/= ots,,,1288.13,1491.52,8
HCPCS,L1940,AFO CUSTOM MADE DFA,573.21,372.59,124.96,573.21,74
HCPCS,L1940,AFO MOLDED TO PATIENT MODEL,515.0,334.75,1.1,1929.62,90
HCPCS,L1945,AFO RIGID ANTERIOR TIBIAL SECTION,1933.0,1256.45,1.1,4447.76,90
HCPCS,L1945,CUSTOM PLASTIC AFO,1321.27,858.83,288.04,1321.27,74
HCPCS,L1950,Afo spiral molded to pt plas,,,1288.13,2479.4,9
HCPCS,L1951,AFO SPIRAL PREFABRICATED,980.0,637.0,1.1,3327.66,90
HCPCS,L1951,PREFAB SPIRAL AFO,988.56,642.56,215.51,1491.52,74
HCPCS,L1952,Afo spiral prefab ots,,,1288.13,1491.52,8
HCPCS,L1960,"AFO POSTERIOR SOLID ANKLE, MOLDED",658.0,427.7,1.1,2456.22,90
HCPCS,L1960,W AFO CUSTOM PLASTIC,992.0,644.8,216.26,992.0,74
HCPCS,L1970,AFO PLASTIC/JOINTS,1045.0,679.25,227.81,1491.52,74
HCPCS,L1970,"AFO WITH ANKLE JOINT, MOLDED",715.0,464.75,1.1,2742.52,90
HCPCS,L1971,"AFO W/ANKLE JOINT, PREFAB",154.0,100.1,1.1,1857.44,90
HCPCS,L1971,ASO ANKLE,140.0,91.0,30.52,385.65,74
HCPCS,L1971,PREFAB AFO W ANKLE JNT,551.76,358.64,120.28,551.76,74
HCPCS,L1980,AFO SINGLE BAR 'BK' ORTHOSIS,717.0,466.05,1.1,1599.88,90
HCPCS,L1980,CUSTOM SGL BAR AFO,652.0,423.8,142.14,980.32,74
HCPCS,L1990,AFO DOUBLE BAR 'BK' ORTHOSIS,721.0,468.65,1.1,1851.67,90
HCPCS,L1990,AFO METAL DBL UPRIGHT,655.0,425.75,142.79,655.0,74
HCPCS,L2000,Kafo sing fre stirr thi/calf,,,669.74,3606.55,9
HCPCS,L2005,Kafo sng/dbl mechanical act,,,13210.83,13210.83,1
HCPCS,L2006,Kaf sng/dbl swg/stn mcpr cus,,,103720.34,103720.34,1
HCPCS,L2010,Kafo sng solid stirrup w/o j,,,669.74,2813.08,9
HCPCS,L2020,Kafo dbl solid stirrup band/,,,669.74,3552.82,9
HCPCS,L2030,Kafo dbl solid stirrup w/o j,,,669.74,3492.13,9
HCPCS,L2034,Kafo pla sin up w/wo k/a cus,,,6549.34,6549.34,1
HCPCS,L2035,Kafo plastic pediatric size,,,58.52,558.55,9
HCPCS,L2036,KAFO PLASTIC 2-JOINTS,2182.28,1418.48,475.74,2182.28,67
HCPCS,L2037,KAFO PLASTIC 1-JOINT,1952.0,1268.8,425.54,1952.0,75
HCPCS,L2038,Kafo w/o joint multi-axis an,,,669.74,4309.94,9
HCPCS,L2040,Hkafo torsion bil rot straps,,,351.41,652.23,9
HCPCS,L2050,Hkafo torsion cable hip pelv,,,333.06,1571.06,9
HCPCS,L2060,Hkafo torsion ball bearing j,,,333.06,1965.07,9
HCPCS,L2070,Hkafo torsion unilat rot str,,,58.52,500.41,9
HCPCS,L2080,Hkafo unilat torsion cable,,,846.64,1203.13,9
HCPCS,L2090,Hkafo unilat torsion ball br,,,846.64,1603.04,9
HCPCS,L2106,Afo tib fx cast plaster mold,,,1288.13,2541.16,9
HCPCS,L2108,"ANKLE, FOOT, ORTHOSIS/IN10",2087.0,1356.55,1.1,4555.35,90
HCPCS,L2108,W BRACE FEMUR FX,1897.0,1233.05,413.55,1897.0,75
HCPCS,L2112,AFO FRACTURE ORTHOSIS SOFT,911.0,592.15,1.1,1999.06,90
HCPCS,L2112,PEDIATRIC FRACTURE WALKER,78.75,51.19,17.17,385.65,74
HCPCS,L2112,PREFAB SOFT CUSTOM FX ORTHOSIS,828.0,538.2,180.5,828.0,74
HCPCS,L2114,AFO FRACTURE ORTHOSIS SEMI-RIGID,2145.0,1394.25,1.1,2503.9,90
HCPCS,L2114,Afo tib fx semi-rigid,,,333.06,2037.24,9
HCPCS,L2116,AFO FRACTURE ORTHOSIS RIGID,84.0,54.6,1.1,3054.0,90
HCPCS,L2116,PREFAB AFO TIBIAL FX ORTHOSIS,1264.0,821.6,275.55,1491.52,74
HCPCS,L2116,PROFILE LOW WALKER,76.8,49.92,16.74,1491.52,74
HCPCS,L2126,Kafo fem fx cast thermoplas,,,669.74,4116.6,9
HCPCS,L2128,KAFO FRACTURE ORTHOSIS,954.0,620.1,1.1,6353.11,90
HCPCS,L2128,Kafo fem fx cast molded to p,,,669.74,5169.09,9
HCPCS,L2132,Kafo femoral fx cast soft,,,1288.13,3137.55,9
HCPCS,L2134,PREFAB SEMI-RIGID KAFO FEM FX,1356.47,881.71,295.71,1356.47,74
HCPCS,L2136,Kafo femoral fx cast rigid,,,669.74,4065.78,9
HCPCS,L2180,ADDN TO FRAC ORTH PLAST SHOE INSRT,229.0,148.85,1.1,525.33,90
HCPCS,L2180,PLASTIC FOOTPLATE,156.05,101.43,34.02,156.05,74
HCPCS,L2182,Drop lock knee,,,58.52,368.39,9
HCPCS,L2184,ADDN TO FRAC ORTH LIMIT MOTN KNEE JT,242.0,157.3,1.1,458.95,90
HCPCS,L2184,INTEGRITY FRX WALKER BRACE,115.0,74.75,25.07,115.0,74
HCPCS,L2186,ADDN TO FRAC ORTH ADJ MOTN KNEE JT,176.0,114.4,1.1,610.4,90
HCPCS,L2186,ADJ MOTION KNEE JNT ADDTN,181.31,117.85,39.53,181.31,74
HCPCS,L2188,Quadrilateral brim,,,91.28,902.8,9
HCPCS,L2190,Waist belt,,,31.69,274.99,9
HCPCS,L2192,Pelvic band & belt thigh fla,,,846.64,1074.85,9
HCPCS,L2200,ADDN TO LOW EXTREM LIMIT ANKLE MOTN,94.0,61.1,1.1,199.09,90
HCPCS,L2200,LIMITED ANKLE MOTION,59.15,38.45,12.89,59.15,66
HCPCS,L2210,P.F. DFA PLANTAR,73.94,48.06,16.12,73.94,74
HCPCS,L2220,DFA PF ASST/RST,95.25,61.91,20.76,95.25,74
HCPCS,L2221,Add lw ext ort ank w micro,,,669.74,775.49,8
HCPCS,L2230,SPLIT STIRRUP AND PLAT,112.61,73.2,24.55,112.61,74
HCPCS,L2232,"Rocker bottom, contact afo",,,58.52,313.18,9
HCPCS,L2240,Round caliper and plate atta,,,31.69,306.96,9
HCPCS,L2250,Foot plate molded stirrup at,,,846.64,1076.87,9
HCPCS,L2260,REINFORCED SOLID STIRRUP,220.64,143.42,48.1,406.89,74
HCPCS,L2265,LONG TONGUE STIRRUP,158.21,102.84,34.49,158.21,74
HCPCS,L2270,W STRAP PAD VARUS/VALGUS T,72.55,47.16,15.82,72.55,74
HCPCS,L2275,ADDN TO LOW EXTREM VARUS/VALGUS CORR,229.0,148.85,1.1,516.49,90
HCPCS,L2275,VARUG/VALGUS PLASTIC CORRECT,153.44,99.74,33.45,153.44,74
HCPCS,L2280,ADDN TO LOW EXTREM MOLD INNER BOOT,601.0,390.65,1.1,2236.89,90
HCPCS,L2280,Molded inner boot,,,333.06,1819.99,9
HCPCS,L2300,Abduction bar jointed adjust,,,91.28,811.64,9
HCPCS,L2310,Abduction bar-straight,,,58.52,370.86,9
HCPCS,L2320,Non-molded lacer,,,351.41,621.93,9
HCPCS,L2330,NONMOLDED LACER CUST ORTHOSIS,432.17,280.91,94.21,980.32,74
HCPCS,L2335,Anterior swing band,,,351.41,906.26,9
HCPCS,L2340,ADDN TO LOW EXTREM PRETIB SHELL,536.0,348.4,1.1,1655.9,90
HCPCS,L2340,PRE TIB SHELL MOLDED,491.91,319.74,107.24,491.91,74
HCPCS,L2350,ADDN TO LOW EXTREM PROSTHETIC TYPE,1081.0,702.65,1.1,3301.36,90
HCPCS,L2350,B.K. SOCKET MOLD PTB AFO,980.72,637.47,213.8,980.72,74
HCPCS,L2360,"ADD, LE, EXTENDED STEEL SHANK",60.72,39.47,13.24,60.72,74
HCPCS,L2360,DACRO SHOE,46.0,29.9,10.03,46.0,74
HCPCS,L2370,Patten bottom,,,351.41,1031.77,9
HCPCS,L2375,Torsion ank & half solid sti,,,58.52,396.7,9
HCPCS,L2380,Torsion straight knee joint,,,58.52,416.07,9
HCPCS,L2385,HEAVY DUTY JOINT STR,172.97,112.43,37.71,172.97,74
HCPCS,L2387,Add le poly knee custom kafo,,,58.52,615.43,9
HCPCS,L2390,Offset knee joint each,,,58.52,329.98,9
HCPCS,L2395,Offset knee joint heavy duty,,,58.52,471.66,9
HCPCS,L2397,SUSPENSION SLEEVE LEXTR ADDTN,143.69,93.4,31.32,143.69,74
HCPCS,L2405,DROP LOCK KNEE JNT,102.64,66.72,22.38,102.64,74
HCPCS,L2415,Knee joint cam lock each joi,,,58.52,391.66,9
HCPCS,L2425,Knee disc/dial lock/adj flex,,,58.52,462.16,9
HCPCS,L2430,RATCHET LOCK KNEE EXTENSION,168.74,109.68,36.79,168.74,74
HCPCS,L2492,Knee lift loop drop lock rin,,,58.52,378.15,9
HCPCS,L2500,Thi/glut/ischia wgt bearing,,,91.28,1008.87,9
HCPCS,L2510,Th/wght bear quad-lat brim m,,,1288.13,2600.18,9
HCPCS,L2520,Th/wght bear quad-lat brim c,,,333.06,1732.91,9
HCPCS,L2525,THIGH WT. BEAR ISCHIAL,1351.56,878.51,294.64,1351.56,74
HCPCS,L2526,Th/wght bear nar m-l brim cu,,,1288.13,2064.78,9
HCPCS,L2530,Thigh/wght bear lacer non-mo,,,351.41,773.17,9
HCPCS,L2540,Thigh/wght bear lacer molded,,,846.64,1463.02,9
HCPCS,L2550,Thigh/wght bear high roll cu,,,91.28,1096.96,9
HCPCS,L2570,Hip clevis type 2 posit jnt,,,333.06,1435.84,9
HCPCS,L2580,Pelvic control pelvic sling,,,333.06,1399.07,9
HCPCS,L2600,Hip clevis/thrust bearing fr,,,351.41,687.63,9
HCPCS,L2610,Hip clevis/thrust bearing lo,,,351.41,759.83,9
HCPCS,L2620,HEAVY DUTY HIP JT,2294.28,1491.28,91.28,2294.28,75
HCPCS,L2622,Hip joint adjustable flexion,,,91.28,1025.88,9
HCPCS,L2624,ADDN TO LO EXTR HIP JT ADJ FLEX/EXTN,528.0,343.2,1.1,1546.09,90
HCPCS,L2624,W A.L. EXT PCC HIP JNT,459.29,298.54,91.28,459.29,74
HCPCS,L2627,Plastic mold recipro hip & c,,,669.74,6890.36,9
HCPCS,L2628,Metal frame recipro hip & ca,,,669.74,5050.48,9
HCPCS,L2630,Pelvic control band & belt u,,,351.41,746.46,9
HCPCS,L2640,Pelvic control band & belt b,,,91.28,1013.03,9
HCPCS,L2650,Pelv & thor control gluteal,,,58.52,446.13,9
HCPCS,L2660,Thoracic control thoracic ba,,,351.41,577.65,9
HCPCS,L2670,Thorac cont paraspinal uprig,,,58.52,514.22,9
HCPCS,L2680,Thorac cont lat support upri,,,58.52,471.72,9
HCPCS,L2750,Plating chrome/nickel pr bar,,,31.69,251.94,9
HCPCS,L2755,NEOPRENE KNEE SUPPORT,153.79,99.96,33.53,153.79,74
HCPCS,L2760,GROWTH EXTENSION BARS,66.87,43.47,14.58,66.87,74
HCPCS,L2768,Ortho sidebar disconnect,,,58.52,420.01,9
HCPCS,L2780,NON-CORSVE FIN PER BAR,74.49,48.42,16.24,74.49,74
HCPCS,L2785,DROP LOCK RETAINER,35.33,22.96,7.7,42.28,74
HCPCS,L2795,ADDN TO LO EXTR ORTHO KNEE CTRL FULL,166.0,107.9,1.1,324.95,90
HCPCS,L2795,DONJOY LATERAL J BRACE,92.75,60.29,20.22,92.75,74
HCPCS,L2795,KNEE CONTROL FULL KNEECAP,96.51,62.73,21.04,96.51,74
HCPCS,L2800,KNEE CAP MEDIAL OR LATERAL P,208.0,135.2,1.1,399.04,90
HCPCS,L2800,VAR/VAL KNEE CAP,101.0,65.65,22.02,101.0,74
HCPCS,L2810,KNEE CONTROL CONDYLAR PAD,96.12,62.48,20.95,96.12,74
HCPCS,L2820,W LINER BRACE,95.58,62.13,20.84,95.58,74
HCPCS,L2830,W LINER INTERFACE AK SOFT,103.4,67.21,22.54,103.4,74
HCPCS,L2840,SOCK TIBIAL FX,50.77,33.0,11.07,50.77,74
HCPCS,L2850,ADDN TO LO EXTR ORTHO FEM SOCK,101.0,65.65,1.1,239.69,90
HCPCS,L2850,SOCK FEMORAL FX,71.2,46.28,15.52,71.2,74
HCPCS,L2861,TORSION MECHANISM KNEE/ANKLE,160.0,104.0,34.88,980.32,74
HCPCS,L2999,AIRHEEL DONJOY,46.0,29.9,10.03,46.0,74
HCPCS,L2999,DONJOY CROSS STRAP BRACE,39.98,25.99,8.72,39.98,74
HCPCS,L2999,MISC LOWER EXTREMITY ORTHOSIS,189.0,122.85,16.97,189.0,74
HCPCS,L2999,PATELLAR TENDON STRAP,27.0,17.55,5.89,27.0,74
HCPCS,L3000,UCBL MOLDED,369.76,240.34,80.61,369.76,74
HCPCS,L3001,"FOOT INS SPENCO MODEL, EA",8.48,5.51,1.85,67.76,74
HCPCS,L3001,FOOT INSERT REMOVABLE SPENCO,153.0,99.45,1.1,524.12,90
HCPCS,L3002,FOOT INSERT REMOVABLE PLASTAZOTE,174.0,113.1,1.1,639.93,90
HCPCS,L3002,PLASTAZOTE INSERT MOLD(ORTHO F,190.1,123.57,41.44,190.1,74
HCPCS,L3003,Foot insert silicone gel eac,,,58.52,561.67,9
HCPCS,L3010,FOOT INSERT REMOVABLE LONG ARCH SPPT,188.0,122.2,1.1,690.35,90
HCPCS,L3010,MOLDED LONG ARCH ORTH,461.0,299.65,58.52,461.0,74
HCPCS,L3020,CUSTOM FOOT ORTHOTIC/ ORTHOTICS METARSAL SUPPORT,120.0,78.0,26.16,406.89,74
HCPCS,L3020,FOOT INSERT REMOVABLE LONG/MT SPPT,171.0,111.15,1.1,786.15,90
HCPCS,L3020,MOLDED LONG ARCH MET,120.0,78.0,26.16,406.89,74
HCPCS,L3030,FOOT INSERT REMOVABLE FORMED TO PT,114.0,74.1,1.1,302.32,90
HCPCS,L3030,SHOE INSERT GRAPHITE,83.04,53.98,18.1,83.04,74
HCPCS,L3031,"HI STRNGTH LTWT FT INSERT,EA",98.0,63.7,21.36,98.0,74
HCPCS,L3040,FOOT ARCH SUPPORT REMV LONG,9.0,5.85,1.1,186.52,90
HCPCS,L3040,PPT MOULDED INSERT EACH,28.0,18.2,6.1,36.7,74
HCPCS,L3040,"PREMOLD LONGIT FOOT ARCH,EA",53.205,34.585,11.12,55.41,148
HCPCS,L3040,UCO SHOE INSERTS,9.0,5.85,1.96,36.7,74
HCPCS,L3050,Foot arch supp premold metat,,,31.69,151.74,9
HCPCS,L3060,Foot arch supp longitud/meta,,,31.69,237.8,9
HCPCS,L3070,Arch suprt att to sho longit,,,36.52,102.5,9
HCPCS,L3080,FOOT ARCH SUPPORT NON-REMV METATAR,35.64,23.17,1.1,125.97,90
HCPCS,L3080,NR METATARSAL ARCH SUPPORT EA,35.64,23.17,7.77,42.28,74
HCPCS,L3090,Arch supp att to shoe long/m,,,36.52,131.22,9
HCPCS,L3100,HALLUS VALGUS NT DYN SPLINT,53.0,34.45,11.55,53.0,74
HCPCS,L3100,HALLUS-VALGUS NIGHT DYNAMIC SPLINT,53.0,34.45,1.1,171.41,90
HCPCS,L3140,DENNIS-BROWNE BAR RT,104.79,68.11,22.84,104.79,74
HCPCS,L3150,DENNIS-BROWNE BAR CP,95.82,62.28,20.89,95.82,74
HCPCS,L3160,Shoe styled positioning dev,,,16.97,131.52,9
HCPCS,L3161,"Foot, adductus position, adj",,,58.52,2739849.3,9
HCPCS,L3170,FOOT PLASTIC HEEL STABILIZER,58.0,37.7,1.1,201.54,238
HCPCS,L3201,Oxford w supinat/pronat inf,,,31.69,76.72,9
HCPCS,L3202,Oxford w/ supinat/pronator c,,,31.69,98.64,9
HCPCS,L3203,JR ORTH SHOE W SUPIN/PRONATOR,59.8,38.87,13.04,59.8,74
HCPCS,L3204,ORTH SHOE INFANT HIGHTOP EACH,46.0,29.9,10.03,46.0,74
HCPCS,L3206,Hightop w/ supp/pronator chi,,,31.69,115.08,9
HCPCS,L3207,Hightop w/ supp/pronator jun,,,31.69,115.08,9
HCPCS,L3208,Surgical boot each infant,,,16.97,32.61,9
HCPCS,L3209,Surgical boot each child,,,16.97,32.61,9
HCPCS,L3211,Surgical boot each junior,,,16.97,32.61,9
HCPCS,L3212,Benesch boot pair infant,,,31.69,57.54,9
HCPCS,L3213,Benesch boot pair child,,,31.69,76.72,9
HCPCS,L3214,Benesch boot pair junior,,,31.69,76.72,9
HCPCS,L3215,Orthopedic ftwear ladies oxf,,,31.69,186.05,9
HCPCS,L3216,"WOMENS DEPTH SHOE, EACH",82.0,53.3,17.88,82.0,74
HCPCS,L3217,Ladies shoes hightop depth i,,,31.69,157.28,9
HCPCS,L3219,Orthopedic mens shoes oxford,,,31.69,203.03,9
HCPCS,L3221,"MENS DEPTH SHOE, EACH",85.0,55.25,18.53,85.0,74
HCPCS,L3222,"MENS HT DEPTH SHOES, EA",87.0,56.55,18.97,87.0,74
HCPCS,L3224,WOMEN'S OXFORD SHOE W BRACE,79.53,51.69,17.34,79.53,74
HCPCS,L3225,MENS SHOE-PART OF BRACE,86.88,56.47,18.94,86.88,74
HCPCS,L3230,CUSTOM DEPTH SHOES,365.0,237.25,31.69,365.0,74
HCPCS,L3250,Custom mold shoe remov prost,,,31.69,573.48,9
HCPCS,L3251,SHOE SILICONE EA,464.0,301.6,1.1,535.68,86
HCPCS,L3251,Shoe molded to pt silicone s,,,58.52,479.5,9
HCPCS,L3252,Shoe molded plastazote cust,,,351.41,406.89,9
HCPCS,L3253,Shoe molded plastazote cust,,,31.69,143.85,9
HCPCS,L3254,Orth foot non-stndard size/w,,,13.7,19.65,9
HCPCS,L3255,Orth foot non-standard size/,,,16.97,38.36,9
HCPCS,L3257,SPLIT SIZE SHOES,91.0,59.15,19.84,91.0,74
HCPCS,L3260,AMBULATORY SURGICAL BOOT EAC,46.0,29.9,1.1,48.82,86
HCPCS,L3260,ORTHOWEDGE SHOE EACH,46.0,29.9,10.03,46.0,67
HCPCS,L3260,SURGICAL BOOT/SHOE EA,19.0,12.35,4.14,19.65,67
HCPCS,L3265,CUSTOM FIT SANDAL,65.0,42.25,14.17,65.0,66
HCPCS,L3300,LIFT FULL FOOT/PER INCH,61.38,39.9,13.38,61.38,74
HCPCS,L3310,LIFT-NEOPRENE/PER INCH,95.82,62.28,20.89,95.82,74
HCPCS,L3320,ACCOMMODATIVE HEEL PAD,68.08,44.25,11.14,68.08,74
HCPCS,L3330,Lifts elevation metal extens,,,333.06,1824.54,9
HCPCS,L3332,FELT HEEL LIFTS,137.0,89.05,2.69,137.0,74
HCPCS,L3332,LIFT-INSIDE/1/2 INCH,85.0,55.25,18.53,85.0,74
HCPCS,L3334,HAPADS HEEL LIFT PER INCH,8.0,5.2,1.74,42.28,74
HCPCS,L3334,"HEEL LIFT, PER INCH",18.0,11.7,3.92,42.28,74
HCPCS,L3334,SHOE LIFT,11.0,7.15,1.1,151.09,90
HCPCS,L3340,Shoe wedge sach,,,31.69,274.77,9
HCPCS,L3350,HEEL WEDGE,22.23,14.45,1.1,90.63,164
HCPCS,L3360,Shoe sole wedge outside sole,,,36.52,114.78,9
HCPCS,L3370,"SOLE WEDGE, BETWEEN SOLE",58.0,37.7,12.64,58.0,74
HCPCS,L3380,Shoe clubfoot wedge,,,31.69,159.91,9
HCPCS,L3390,OUTFLARE WEDGE,58.0,37.7,12.64,58.0,74
HCPCS,L3400,"METATARSAL BAR WEDGE, ROCKER",48.0,31.2,10.46,48.0,74
HCPCS,L3410,Shoe metatarsal bar between,,,58.52,299.29,9
HCPCS,L3420,Full sole/heel wedge btween,,,31.69,176.32,9
HCPCS,L3430,HEEL COUNTER PLASTIC REINFORCED,160.0,104.0,1.1,634.96,90
HCPCS,L3430,"HEEL, COUNTER, PLASTIC REINF",145.0,94.25,31.61,145.0,74
HCPCS,L3440,Heel leather reinforced,,,31.69,246.0,9
HCPCS,L3450,"HEEL, SACH CUSHION TYPE",125.0,81.25,27.25,125.0,74
HCPCS,L3455,Shoe heel new leather standa,,,36.52,131.22,9
HCPCS,L3460,SHOE INSERT,72.33,47.01,15.77,72.33,74
HCPCS,L3465,Shoe heel thomas with wedge,,,31.69,188.73,9
HCPCS,L3470,Shoe heel thomas extend to b,,,31.69,200.87,9
HCPCS,L3480,HEEL PAD AND DEPRESSION FOR SPUR,23.0,14.95,1.1,246.87,90
HCPCS,L3480,"HEEL, PAD AND DEPRESSION SPUR",51.0,33.15,11.12,51.0,74
HCPCS,L3480,"SHOE INSERT, HEALER",15.5,10.08,3.38,36.7,74
HCPCS,L3485,HEEL PAD,46.5,30.225,8.28,55.0,140
HCPCS,L3485,HEEL PAD REMOVABLE FOR SPUR,33.0,21.45,1.1,59.39,86
HCPCS,L3500,Ortho shoe add leather insol,,,36.52,94.26,9
HCPCS,L3510,Orthopedic shoe add rub insl,,,36.52,94.26,9
HCPCS,L3510,SHOE ADDITION INSOLE RUBBER,6.0,3.9,1.1,115.86,90
HCPCS,L3520,O shoe add felt w leath insl,,,36.52,102.5,9
HCPCS,L3530,Ortho shoe add half sole,,,36.52,102.5,9
HCPCS,L3540,FULL SOLE,60.0,39.0,13.08,60.0,74
HCPCS,L3540,SHOE ADDITION SOLE FULL,57.0,37.05,1.1,201.54,90
HCPCS,L3550,O shoe add standard toe tap,,,16.97,28.82,9
HCPCS,L3560,O shoe add horseshoe toe tap,,,11.14,73.73,9
HCPCS,L3560,SHOE ADDITION TOE TAP HORSESHOE,28.0,18.2,1.1,90.63,90
HCPCS,L3570,O shoe add instep extension,,,31.69,274.77,9
HCPCS,L3580,O shoe add instep velcro clo,,,31.69,209.09,9
HCPCS,L3590,O shoe convert to sof counte,,,31.69,172.24,9
HCPCS,L3595,Ortho shoe add march bar,,,36.52,135.22,9
HCPCS,L3600,Trans shoe calip plate exist,,,31.69,246.0,9
HCPCS,L3610,TRANSFER NEW CALIPER PLATE,89.8,58.37,19.58,89.8,74
HCPCS,L3620,TRANS EXIST STIRRUP,143.0,92.95,31.17,143.0,74
HCPCS,L3630,TRANSFER NEW SOLID STIRRUP,118.27,76.88,25.78,118.27,74
HCPCS,L3640,Shoe dennis browne splint bo,,,36.52,139.47,9
HCPCS,L3649,"ORTHOPEDIC SHOE MODIFY, NOS",83.0,53.95,16.97,83.0,66
HCPCS,L3649,UNLISTED PROCEDURE FOR ORTHO SHOES,96.0,62.4,0.01,3061000.0,80
HCPCS,L3650,SHOULDER ORTHOSIS,66.0,42.9,1.1,259.87,90
HCPCS,L3650,SO-PREFAB FIG OF 8 RESTRAINER,18.0,11.7,3.92,36.7,74
HCPCS,L3660,CLAVICLE STRAP,139.0,90.35,30.3,139.0,74
HCPCS,L3660,"SHLDR ORTHOSIS,ABDUC RESTR,CANVAS",153.0,99.45,1.1,372.64,90
HCPCS,L3660,SLING & SWATHE,10.26,6.67,2.24,36.7,74
HCPCS,L3660,SO FIG 8 RESTR CANV WEBBING,33.0,21.45,7.19,36.7,74
HCPCS,L3670,SHLDR ORTHOSIS ACROMIO/CLAVICULAR,105.0,68.25,1.1,409.96,90
HCPCS,L3670,SO ACROMIOCLAVICULAR PREFAB,510.0,331.5,31.69,510.0,74
HCPCS,L3670,SULLY SHOULDER STABILIZER,510.0,331.5,31.69,510.0,74
HCPCS,L3671,So cap design w/o jnts cf,,,1288.13,2643.74,9
HCPCS,L3674,So airplane w/wo joint cf,,,669.74,3468.18,9
HCPCS,L3675,So vest canvas/web pre ots,,,31.69,514.98,9
HCPCS,L3677,So hard plas stabili pre cst,,,31.69,397.3,9
HCPCS,L3678,So hard plas stabili pre ots,,,718.51,1491.52,9
HCPCS,L3702,EO CUSTOM W/O WRIST,317.0,206.05,69.11,406.89,74
HCPCS,L3702,EO W/O JOINTS CF,394.0,256.1,1.1,1041.32,164
HCPCS,L3710,ELBOW ORTHOSIS WITH METAL JOINTS,184.0,119.6,1.1,514.93,90
HCPCS,L3710,EO PREFAB ELASTIC W METAL JOINTS,123.9,80.54,27.01,123.9,74
HCPCS,L3720,Forearm/arm cuffs free motio,,,333.06,2004.8,9
HCPCS,L3730,EO DOUBLE UPRIGHT FLEXION ASSIST,1340.0,871.0,1.1,3268.22,90
HCPCS,L3730,Forearm/arm cuffs ext/flex a,,,1288.13,2659.14,9
HCPCS,L3740,CUSTOM ELBOW HINGE,1440.0,936.0,313.92,1440.0,75
HCPCS,L3740,EO CUSTOM DBL UPRIGHT ADJ LOCK,1444.0,938.6,314.79,1444.0,75
HCPCS,L3740,EO DOUBLE UPRIGHT ADJUSTABLE LOCK,517.0,336.05,1.1,3874.79,90
HCPCS,L3740,W BRACE ELBOW ROM,140.0,91.0,30.52,775.49,74
HCPCS,L3760,EO PREFAB W ADJ LOCK JNTS,548.0,356.2,73.26,980.32,74
HCPCS,L3760,"EO WITHJOINT, PREFABRICATED",119.0,77.35,1.1,1803.51,90
HCPCS,L3761,DONJOY X-ACT ROM ELBOW BRACE,144.15,93.7,31.42,1491.52,74
HCPCS,L3762,EO PREFAB RIGID W/O JOINTS,77.4,50.31,16.87,77.4,74
HCPCS,L3762,RIGID EO WO JOINTS,86.0,55.9,1.1,387.71,90
HCPCS,L3763,EO CUSTOM W/WRIST,267.47,173.86,58.31,385.65,74
HCPCS,L3763,EWHO RIGID W/O JNTS CF,294.0,191.1,1.1,2698.63,90
HCPCS,L3764,Ewho w/joint(s) cf,,,1288.13,2297.85,9
HCPCS,L3765,EWHFO RIGID W/O JNTS CF,453.0,294.45,98.75,775.49,74
HCPCS,L3766,Ewhfo w/joint(s) cf,,,669.74,3983.96,9
HCPCS,L3806,WHFO CUSTOM W/JOINTS,475.0,308.75,103.55,980.32,74
HCPCS,L3806,WHFO W/JOINT(S) CUSTOM FAB,523.0,339.95,1.1,1638.0,90
HCPCS,L3807,BRACE WRIST HW,240.0,156.0,52.32,406.89,74
HCPCS,L3807,EXOS LONG THUMB SPICA,105.0,68.25,22.89,406.89,74
HCPCS,L3807,PREFAB WHFO WO JNTS,267.87,174.12,58.4,406.89,74
HCPCS,L3807,W PREFAB WHFO WO JNTS,267.87,174.12,58.4,406.89,74
HCPCS,L3807,WHFO PREFAB W/O JOINTS,147.0,95.55,32.05,406.89,74
HCPCS,L3807,WHFO STATIC,45.0,29.25,9.81,406.89,74
HCPCS,L3807,WHFO W INFLATABLE AIRCHAMBER,147.0,95.55,1.1,901.69,90
HCPCS,L3808,THUMBGUARD,22.0,14.3,4.8,105.69,74
HCPCS,L3808,WHFO CUSTOM (OT) - A(EXOS),267.0,173.55,58.21,267.0,74
HCPCS,L3808,WHFO CUSTOM RIGID W/OUT JOINTS,363.42,236.22,79.23,363.42,74
HCPCS,L3808,"WHFO, RIGID W/O JOINTS",24.0,15.6,1.1,1284.6,90
HCPCS,L3808,WRIST HAND PLASTIC CAST,141.0,91.65,30.74,141.0,74
HCPCS,L3809,THUMB SPICA,169.0,109.85,1.1,901.69,238
HCPCS,L3891,Torsion mechanism wrist/elbo,,,58.52,231.17,9
HCPCS,L3900,WHFO - CSTM HINGE WRST/FNGR,300.0,195.0,65.4,775.49,74
HCPCS,L3900,WHFO DYNAMIC FLEXOR HINGE,330.0,214.5,1.1,5841.79,90
HCPCS,L3901,Hinge ext/flex wrist finger,,,669.74,6229.14,9
HCPCS,L3904,Whfo electric custom fitted,,,669.74,9903.62,9
HCPCS,L3905,WHO CUSTOM W/NONTORSION JOINTS,310.0,201.5,67.58,1491.52,74
HCPCS,L3905,WHO W/NONTORSION JNT(S) CF,341.0,221.65,1.1,3576.15,90
HCPCS,L3906,WHFO WRIST GAUNTLET,176.0,114.4,1.1,1827.48,90
HCPCS,L3906,WHO CUSTOM W/O JOINTS,443.0,287.95,47.84,980.32,74
HCPCS,L3906,WRIST CUSTOM (OT),72.04,46.83,15.7,980.32,74
HCPCS,L3908,FOREARM SPLINT,30.0,19.5,6.54,36.7,74
HCPCS,L3908,SPLINT WRIST HW,70.0,45.5,15.26,70.0,74
HCPCS,L3908,"SPLINT,WRIST,EXOFORM,LEFT,LG",72.0,46.8,15.7,72.0,74
HCPCS,L3908,"SPLINT,WRIST,EXOFORM,LEFT,MED",72.0,46.8,15.7,72.0,74
HCPCS,L3908,"SPLINT,WRIST,EXOFORM,LEFT,SM",72.0,46.8,15.7,72.0,74
HCPCS,L3908,"SPLINT,WRIST,EXOFORM,RIGHT,LG",72.0,46.8,15.7,72.0,74
HCPCS,L3908,"SPLINT,WRIST,EXOFORM,RIGHT,MED",72.0,46.8,15.7,72.0,74
HCPCS,L3908,"SPLINT,WRIST,EXOFORM,RIGHT,SM",72.0,46.8,15.7,72.0,74
HCPCS,L3908,VIBRATION GLOVE/IMPACT,30.0,19.5,6.54,36.7,74
HCPCS,L3908,WHFO WRIST EXTENSION CONTROL,60.0,39.0,1.1,264.4,90
HCPCS,L3908,WHO PREFAB NON-FX,46.0,29.9,10.03,46.0,74
HCPCS,L3908,WHO PREFAB WRIST W/O JOINTS,83.75,54.44,18.26,83.75,74
HCPCS,L3908,WRIST PREFAB NON FX (OT),30.0,19.5,6.54,36.7,74
HCPCS,L3908,WRIST SPLINT,116.0,75.4,25.29,116.0,74
HCPCS,L3908,WRIST SPLINT LEFT MED,606.31,394.1,31.69,606.31,74
HCPCS,L3908,WRIST SPLINT STANDARD,16.0,10.4,3.49,36.7,74
HCPCS,L3908,WRIST SUPPORT GEL,36.0,23.4,7.85,36.7,74
HCPCS,L3912,HFO FLEXION GLOVE,80.0,52.0,16.97,80.0,74
HCPCS,L3912,WHFO FLEXION GLOVE FINGER CONTROL,88.0,57.2,1.1,379.94,90
HCPCS,L3912,WHFO PREFAB FLEXION GLOVE,88.0,57.2,8.97,88.0,74
HCPCS,L3912,WHFO PREFAB FLEXN GLOVE W ELAS,50.0,32.5,10.9,50.0,74
HCPCS,L3913,HFO CUSTOM W/O JOINTS,200.0,130.0,43.6,406.89,74
HCPCS,L3913,HFO W/O JOINTS CF,193.0,125.45,1.1,976.61,90
HCPCS,L3913,HFO W/O JOINTS CF (EXOS),72.04,46.83,15.7,406.89,74
HCPCS,L3915,Who nontorsion jnts pre cst,,,333.06,1559.66,9
HCPCS,L3916,Who nontorsion jnts pre ots,,,333.06,1559.66,9
HCPCS,L3917,HAND BASED ULNAR/RADIAL BRACE,147.0,95.55,32.05,147.0,74
HCPCS,L3917,PREFAB METACARPL FX ORTHOSIS,137.5,89.375,1.1,380.79,164
HCPCS,L3918,HO PREFAB HAND ORTHOSIS,185.5,120.58,40.44,185.5,74
HCPCS,L3919,HO CUSTOM W/O FINGERS,150.0,97.5,32.7,406.89,74
HCPCS,L3919,HO W/O JOINTS CF,107.5,69.875,1.1,976.61,164
HCPCS,L3921,HFO CUSTOM W/JOINTS,353.0,229.45,76.95,353.0,74
HCPCS,L3921,HFO W/JOINT(S) CF,330.0,214.5,1.1,1158.38,90
HCPCS,L3923,COMFY COOL THUMB SPLINT,47.0,30.55,10.25,47.0,74
HCPCS,L3923,EXOS GUTTER SPLINT,63.0,40.95,13.73,63.0,74
HCPCS,L3923,EXOS SHORT THUMB SPICA,70.0,45.5,15.26,70.0,74
HCPCS,L3923,HAND BASED ULNAR/RADIAL BRACE,147.0,95.55,31.69,147.0,74
HCPCS,L3923,HFO NO JOINTS PREFAB F+Q,47.0,30.55,10.25,47.0,74
HCPCS,L3923,HFO PREFAB W/O JOINTS RIGID,54.0,35.1,11.77,54.0,74
HCPCS,L3923,HFO PREFAB W/O JOINTS SOFT,51.0,33.15,8.97,51.0,74
HCPCS,L3923,HFO W/O JOINTS PF,70.0,45.5,1.1,348.35,90
HCPCS,L3924,SPLINT THUMB NC,93.0,60.45,20.27,93.0,74
HCPCS,L3924,TEEPEE THUMB MS,93.0,60.45,20.27,93.0,74
HCPCS,L3925,FO PIP/DIP WITH JOINT/SPRING,33.0,21.45,1.1,236.88,90
HCPCS,L3925,FO PREFAB SPRING TENSION FINGER,81.0,52.65,7.48,81.0,74
HCPCS,L3925,"OT FO, SAFETY PIN, MODIFIED",59.0,38.35,12.86,59.0,74
HCPCS,L3927,FO PIP/DIP W/O JOINT/SPRING,14.0,9.1,1.1,126.22,90
HCPCS,L3927,FO PREFAB STATIC FINGER,43.0,27.95,8.07,43.0,74
HCPCS,L3927,FO STATIC OVAL,13.0,8.45,2.83,42.28,74
HCPCS,L3929,"HFO NONTORSION JOINT, PREFAB",165.0,107.25,1.1,329.38,90
HCPCS,L3929,HFO PREFAB HINGED W/ JOINTS,97.84,63.6,21.33,97.84,74
HCPCS,L3930,Hfo nontorsion jnts pre ots,,,91.28,268.0,9
HCPCS,L3931,WHFO NONTORSION JOINT PREFAB,33.0,21.45,1.1,751.88,90
HCPCS,L3931,WHFO PREFAB W/ JOINTS,107.0,69.55,23.33,406.89,74
HCPCS,L3933,FO CUSTOM STATIC FINGER,25.0,16.25,5.45,406.89,74
HCPCS,L3933,FO STATIC FINGER CUSTOM,25.0,16.25,5.45,406.89,74
HCPCS,L3933,FO W/O JOINTS CF,183.0,118.95,1.1,769.43,90
HCPCS,L3933,SILICONE PIP TOTAL JOINT SYSTEM,1880.0,1222.0,351.41,1880.0,76
HCPCS,L3935,"FO CUSTOM STATIC-PROGRESSIVE, DYNAMIC",200.0,130.0,43.6,406.89,74
HCPCS,L3935,"FO STATIC-PROGRESSIVE, DYNAMIC CUSTOM",266.0,172.9,57.99,406.89,74
HCPCS,L3956,Add joint upper ext orthosis,,,91.28,164.4,9
HCPCS,L3960,QUADRANT SHOULDER BRACE,993.0,645.45,216.47,1491.52,74
HCPCS,L3960,SEWHO ABDUCTION POSITIONING,1092.0,709.8,1.1,2876.16,90
HCPCS,L3961,Sewho cap design w/o jnts cf,,,669.74,4929.64,9
HCPCS,L3962,SEWHO ABDUCTION POSITIONING,907.0,589.55,1.1,2601.3,90
HCPCS,L3962,Sewho erbs palsey design abd,,,1288.13,2116.49,9
HCPCS,L3967,Sewho airplane w/o jnts cf,,,669.74,5820.17,9
HCPCS,L3971,Sewho cap design w/jnt(s) cf,,,669.74,5524.72,9
HCPCS,L3973,Sewho airplane w/jnt(s) cf,,,669.74,5820.17,9
HCPCS,L3975,Sewhfo cap design w/o jnt cf,,,669.74,4929.64,9
HCPCS,L3976,Sewhfo airplane w/o jnts cf,,,669.74,4929.64,9
HCPCS,L3977,Sewhfo cap desgn w/jnt(s) cf,,,669.74,5524.72,9
HCPCS,L3978,Sewhfo airplane w/jnt(s) cf,,,669.74,5820.17,9
HCPCS,L3980,"UE FX ORTHOSIS, HUMERAL",418.0,271.7,91.12,418.0,74
HCPCS,L3980,UE PREFAB HUMERAL BRACE,438.0,284.7,81.81,438.0,74
HCPCS,L3980,"UPPER LIMB FX ORTHOSIS, HUMERAL",197.0,128.05,1.1,1395.1,90
HCPCS,L3980,W BRACE HUMERUS FX,147.0,95.55,32.05,147.0,74
HCPCS,L3981,Ue fx orth shoul cap forearm,,,91.28,2953.34,9
HCPCS,L3982,EXOS SHORT ARM FX,128.0,83.2,27.9,980.32,74
HCPCS,L3982,EXOS THUMB SPICA FX,140.0,91.0,30.52,980.32,74
HCPCS,L3982,"OT FX ORTHOSIS, RADIUS/ULNAR",30.0,19.5,6.54,980.32,74
HCPCS,L3982,PREFAB SPLNT SHRT ARM FX,240.0,156.0,52.32,980.32,74
HCPCS,L3982,SHRT ARM FX BRACE W/W/OUT BOA,147.0,95.55,32.05,980.32,74
HCPCS,L3982,"UPPER LIMB FX ORTHOSIS, RADIUS/ULNA",264.0,171.6,1.1,1416.56,90
HCPCS,L3982,WHO PREFAB RADIUS/ULNA FX,140.0,91.0,30.52,980.32,74
HCPCS,L3982,WHO RADIUS/ULNA,50.0,32.5,10.9,980.32,74
HCPCS,L3984,CARPAL FX PREFAB (OT),107.065,69.59,14.63,147.0,148
HCPCS,L3984,EXOS WRIST BRACE,98.0,63.7,21.36,105.69,74
HCPCS,L3984,OT FX ORTHOSISWRIST,30.0,19.5,6.54,105.69,74
HCPCS,L3984,PREFAB SPICA FX BRACE,180.0,117.0,39.24,180.0,74
HCPCS,L3984,"UPPER LIMB FX ORTHOSIS, WRIST",108.0,70.2,1.1,1247.87,90
HCPCS,L3984,WHO CARPAL FX FIRM/SOFT,50.0,32.5,10.9,105.69,74
HCPCS,L3995,Sock fracture or equal each,,,36.52,120.45,9
HCPCS,L3999,ELBOW SLEEVE,22.0,14.3,4.8,22.0,74
HCPCS,L3999,UNLISTED PROC UE ORTHOSIS,74.0,48.1,16.13,74.0,74
HCPCS,L3999,UNLISTED UPPER LIMB ORTHOSIS PROCS,119.0,77.35,0.01,3061000.0,80
HCPCS,L3999,WRIST WRAP,8.0,5.2,1.74,19.65,74
HCPCS,L4000,Repl girdle milwaukee orth,,,669.74,4260.18,9
HCPCS,L4002,"REPLACE STRAP, ANY ORTHOSIS",26.5,17.225,1.1,186.72,154
HCPCS,L4010,Replace trilateral socket br,,,1288.13,2589.41,9
HCPCS,L4020,Replace quadlat socket brim,,,1288.13,3110.56,9
HCPCS,L4030,Replace socket brim cust fit,,,333.06,1976.69,9
HCPCS,L4040,Replace molded thigh lacer,,,846.64,1338.63,9
HCPCS,L4045,Replace non-molded thigh lac,,,91.28,988.84,9
HCPCS,L4050,Replace molded calf lacer,,,846.64,1325.75,9
HCPCS,L4055,Replace non-molded calf lace,,,91.28,805.86,9
HCPCS,L4060,Replace high roll cuff,,,91.28,1047.53,9
HCPCS,L4070,Replace prox & dist upright,,,91.28,848.36,9
HCPCS,L4080,Repl met band kafo-afo prox,,,58.52,320.28,9
HCPCS,L4090,Repl met band kafo-afo calf/,,,58.52,272.49,9
HCPCS,L4100,Repl leath cuff kafo prox th,,,58.52,327.4,9
HCPCS,L4110,Repl leath cuff kafo-afo cal,,,31.69,255.64,9
HCPCS,L4130,Replace pretibial shell,,,333.06,1545.25,9
HCPCS,L4205,"REPAIR ORTHO LABOR, PER 15 MIN",27.5,17.88,6.0,27.5,74
HCPCS,L4210,ORTH DEV REPAIR/REPL MINOR P,100.0,65.0,16.97,100.0,74
HCPCS,L4210,"REPAIR OF ORTHOTIC DEVICE, MINOR",110.0,71.5,1.1,110.0,80
HCPCS,L4210,"REPAIR/REPLACE MINOR PARTS, OR",100.0,65.0,16.97,100.0,66
HCPCS,L4350,ACTIVE ANKLE,168.0,109.2,36.62,168.0,74
HCPCS,L4350,AIR CAST ANKLE,42.1,27.37,9.18,67.76,74
HCPCS,L4350,ANKLE BRACE AIR CAST RIGHT,271.58,176.53,58.52,271.58,74
HCPCS,L4350,PNEUMATIC ANKLE CNTRL SPLINT,42.1,27.37,1.1,383.38,90
HCPCS,L4350,PREFAB ANKLE AIRCAST,97.0,63.05,21.15,97.0,74
HCPCS,L4360,AIRCAST PNEUMATIC WALKER,414.0,269.1,78.04,414.0,74
HCPCS,L4360,AIRCAST/WALK SPLINT,304.75,198.09,66.44,304.75,74
HCPCS,L4360,PNEUMATI WALKING BOOT PREFAB,227.0,147.55,49.49,227.0,74
HCPCS,L4360,PNEUMATIC DONJOY XP WALKER,125.0,81.25,27.25,125.0,74
HCPCS,L4360,PNEUMATIC FOAM WALKER,828.0,538.2,91.28,828.0,74
HCPCS,L4360,PNEUMATIC WALKING SPLINT,382.0,248.3,1.1,1025.88,90
HCPCS,L4360,W AIRCAST FP ANKL-FT W/WO JNTS,382.0,248.3,83.28,382.0,74
HCPCS,L4361,Pneuma/vac walk boot pre ots,,,91.28,834.69,9
HCPCS,L4370,Pneum full leg splnt pre ots,,,351.41,758.79,9
HCPCS,L4386,MAXTRAX ANKLE BOOT,51.15,33.25,9.88,67.76,148
HCPCS,L4386,NON-PNEUM WALK BOOT PREFAB,77.0,50.05,1.1,628.25,90
HCPCS,L4386,NON-PNEUMATIC WALKING SPLINT,193.0,125.45,42.07,193.0,74
HCPCS,L4386,NON-PNEUMATIC WEE WALKER,93.1,60.52,20.3,93.1,74
HCPCS,L4387,Non-pneum walk boot pre ots,,,58.52,511.17,9
HCPCS,L4392,Replace afo soft interface,,,11.14,75.84,9
HCPCS,L4394,Replace foot drop spint,,,11.14,55.35,9
HCPCS,L4396,ANKLE CONTRACTURE SPLINT,234.0,152.1,1.1,664.95,90
HCPCS,L4396,DORSIWEDGE NIGHT SPLINT,68.0,44.2,14.82,68.0,74
HCPCS,L4396,W ORTHOSIS ANK/FT STATIC,204.0,132.6,44.47,204.0,74
HCPCS,L4397,EHOB BOOT,300.0,195.0,58.52,300.0,74
HCPCS,L4397,STATIC OR DYNAMI AFO PRE CST,89.25,58.01,19.46,89.25,74
HCPCS,L4398,DORSIWEDGE NIGHT SPLINT,62.2,40.43,13.56,62.2,74
HCPCS,L4398,"FOOT DROP SPLINT,RECUM POSN DEV",102.0,66.3,1.1,306.05,90
HCPCS,L4398,"FOOT DROP SPLINT,RECUMBENT PST",102.0,66.3,22.24,102.0,74
HCPCS,L4631,PTB CROW,2879.55,1871.71,627.74,2879.55,75
HCPCS,L4631,STANDARD CROW,1898.83,1234.24,413.94,1898.83,75
HCPCS,L5000,"PARTIAL FOOT, SHOE INSERT",601.0,390.65,1.1,2275.34,90
HCPCS,L5000,"PARTIAL FOOT,TOE FILLER",676.0,439.4,147.37,676.0,74
HCPCS,L5010,Mold socket ank hgt w/ toe f,,,669.74,5172.71,9
HCPCS,L5020,Tibial tubercle hgt w/ toe f,,,8103.96,8103.96,1
HCPCS,L5050,"SYMES ANKLE SOCKET,SACH FOOT",3231.64,2100.57,704.5,3231.64,67
HCPCS,L5060,Symes met fr leath socket ar,,,10910.79,10910.79,1
HCPCS,L5100,Molded socket shin sach foot,,,8813.18,8813.18,1
HCPCS,L5105,Plast socket jts/thgh lacer,,,12437.33,12437.33,1
HCPCS,L5150,Mold sckt ext knee shin sach,,,13827.33,13827.33,1
HCPCS,L5160,Mold socket bent knee shin s,,,15181.76,15181.76,1
HCPCS,L5200,Kne sing axis fric shin sach,,,11742.0,11742.0,1
HCPCS,L5210,No knee/ankle joints w/ ft b,,,9323.12,9323.12,1
HCPCS,L5220,No knee joint with artic ali,,,10270.04,10270.04,1
HCPCS,L5230,Fem focal defic constant fri,,,15403.49,15403.49,1
HCPCS,L5250,Hip canad sing axi cons fric,,,3989.9,18061.01,9
HCPCS,L5270,Tilt table locking hip sing,,,3989.9,20123.49,9
HCPCS,L5280,Hemipelvect canad sing axis,,,3989.9,19560.81,9
HCPCS,L5301,BK MOLD SOCKET SACH FT ENDO,3159.81,2053.88,688.84,3159.81,67
HCPCS,L5312,"Knee disart, sach ft, endo",,,13635.53,13635.53,1
HCPCS,L5321,AK ENDO SACH,4213.48,2738.76,918.54,4213.48,67
HCPCS,L5331,Hip disart canadian sach ft,,,3989.9,16902.32,9
HCPCS,L5341,Hemipelvectomy canadian sach,,,3989.9,17966.95,9
HCPCS,L5400,Postop dress & 1 cast chg bk,,,669.74,5153.69,9
HCPCS,L5410,Postop dsg bk ea add cast ch,,,333.06,1423.81,9
HCPCS,L5420,Postop dsg & 1 cast chg ak/d,,,669.74,6508.9,9
HCPCS,L5430,Postop dsg ak ea add cast ch,,,333.06,1766.81,9
HCPCS,L5450,"RIGID DRESSING,BK",557.79,362.56,121.6,980.32,74
HCPCS,L5460,Postop app non-wgt bear dsg,,,333.06,2003.73,9
HCPCS,L5500,Init bk ptb plaster direct,,,669.74,4763.52,9
HCPCS,L5505,Init ak ischal plstr direct,,,6700.94,6700.94,1
HCPCS,L5510,Prep bk ptb plaster molded,,,669.74,5688.43,9
HCPCS,L5520,Perp bk ptb thermopls direct,,,669.74,5099.0,9
HCPCS,L5530,Prep bk ptb thermopls molded,,,6702.97,6702.97,1
HCPCS,L5535,Prep bk ptb open end socket,,,6248.6,6248.6,1
HCPCS,L5540,"PREP BK,LAMINATED SOCKET",2416.36,1570.63,526.77,2416.36,67
HCPCS,L5560,Prep ak ischial plast molded,,,7541.03,7541.03,1
HCPCS,L5570,Prep ak ischial direct form,,,7318.84,7318.84,1
HCPCS,L5580,Prep ak ischial thermo mold,,,9083.76,9083.76,1
HCPCS,L5585,Prep ak ischial open end,,,10637.78,10637.78,1
HCPCS,L5590,Prep ak ischial laminated,,,9470.7,9470.7,1
HCPCS,L5595,Hip disartic sach thermopls,,,14800.27,14800.27,1
HCPCS,L5600,Hip disart sach laminat mold,,,3989.9,16844.89,9
HCPCS,L5610,Above knee hydracadence,,,8124.21,8124.21,1
HCPCS,L5611,Ak 4 bar link w/fric swing,,,669.74,5174.44,9
HCPCS,L5613,Ak 4 bar ling w/hydraul swig,,,7870.62,7870.62,1
HCPCS,L5614,4-BAR LINK ABOVE KNEE W/SWING,1990.18,1293.62,433.86,1990.18,75
HCPCS,L5615,Ak 4 bar link hydl swg/stanc,,,18174.26,18174.26,1
HCPCS,L5616,Ak univ multiplex sys frict,,,669.74,4745.73,9
HCPCS,L5617,Ak/bk self-aligning unit ea,,,333.06,1807.36,9
HCPCS,L5618,TEST SOCKET SYMES,394.06,256.14,85.91,394.06,74
HCPCS,L5620,"AD'LX,TEST SOCKET,BK",482.0,313.3,91.28,482.0,74
HCPCS,L5622,Test socket knee disarticula,,,846.64,1290.13,9
HCPCS,L5624,AK TEST SOCKET,470.87,306.07,102.65,980.32,74
HCPCS,L5626,Test socket hip disarticulat,,,333.06,2041.66,9
HCPCS,L5628,Test socket hemipelvectomy,,,333.06,2067.47,9
HCPCS,L5629,"AD'LX,BK ACRYLIC SOCKET",372.65,242.22,81.24,372.65,74
HCPCS,L5630,Syme typ expandabl wall sckt,,,333.06,1773.38,9
HCPCS,L5631,"AD'LX AK/KD,ACRYLIC",515.2,334.88,112.31,515.2,74
HCPCS,L5632,Symes type ptb brim design s,,,351.41,869.73,9
HCPCS,L5634,Symes type poster opening so,,,91.28,1087.67,9
HCPCS,L5636,Symes type medial opening so,,,91.28,831.37,9
HCPCS,L5637,"AD'LX,BK TOTAL CONTACT",451.66,293.58,91.28,451.66,74
HCPCS,L5638,Below knee leather socket,,,333.06,2083.93,9
HCPCS,L5639,Below knee wood socket,,,669.74,3600.74,9
HCPCS,L5640,Knee disarticulat leather so,,,1288.13,2366.78,9
HCPCS,L5642,Above knee leather socket,,,333.06,2193.92,9
HCPCS,L5643,Hip flex inner socket ext fr,,,669.74,6471.0,9
HCPCS,L5644,Above knee wood socket,,,333.06,1896.9,9
HCPCS,L5645,Bk flex inner socket ext fra,,,1288.13,3146.84,9
HCPCS,L5646,Below knee cushion socket,,,333.06,1994.23,9
HCPCS,L5647,BK SUCTION SOCKET,932.74,606.28,203.34,1491.52,74
HCPCS,L5648,Above knee cushion socket,,,1288.13,2356.35,9
HCPCS,L5649,Isch containmt/narrow m-l so,,,7917.53,7917.53,1
HCPCS,L5650,"AD'LX,AK TOTAL CONTACT",572.43,372.08,124.79,572.43,74
HCPCS,L5651,"AD'LX,AK FLEX SOCKET",1848.0,1201.2,402.86,1848.0,75
HCPCS,L5652,SUCTION SUSP AK/KNEE DISART,607.0,394.55,132.33,607.0,74
HCPCS,L5653,Knee disart expand wall sock,,,333.06,2184.71,9
HCPCS,L5654,Socket insert symes,,,91.28,1266.46,9
HCPCS,L5655,"AD'LX,BK SOFT INSERT",333.87,217.02,72.78,333.87,74
HCPCS,L5656,Socket insert knee articulat,,,846.64,1389.15,9
HCPCS,L5658,Socket insert above knee,,,846.64,1466.28,9
HCPCS,L5661,Multi-durometer symes,,,333.06,2103.8,9
HCPCS,L5665,Multi-durometer below knee,,,333.06,1870.35,9
HCPCS,L5666,BELOW KNEE CUFF SUSPENSION,90.41,58.77,19.71,90.41,74
HCPCS,L5668,Bk molded distal cushion,,,58.52,368.89,9
HCPCS,L5670,"AD'LX,BK SUPRACOND SUSP",386.0,250.9,84.15,386.0,74
HCPCS,L5671,"ADDT LOWER EXTREM,W/LOCK MECH",583.26,379.12,127.15,583.26,74
HCPCS,L5672,Bk removable medial brim sus,,,91.28,1153.21,9
HCPCS,L5673,"ADTN TO LE, GEL SOCKET/W/LOCK",926.94,602.51,202.07,1491.52,74
HCPCS,L5676,Bk knee joints single axis p,,,846.64,1163.79,9
HCPCS,L5677,Bk knee joints polycentric p,,,333.06,1782.34,9
HCPCS,L5678,Bk joint covers pair,,,36.52,127.52,9
HCPCS,L5679,"ADTN TO LE, GEL SOCK NOT LOCKI",772.46,502.1,168.4,772.46,74
HCPCS,L5680,Bk thigh lacer non-molded,,,91.28,977.52,9
HCPCS,L5681,"ADTN TO LE, FAB CONG TRAUMATIC",1551.38,1008.4,338.2,1551.38,75
HCPCS,L5682,Bk thigh lacer glut/ischia m,,,1288.13,2008.47,9
HCPCS,L5683,Initial custom socket insert,,,669.74,4249.08,9
HCPCS,L5684,Bk fork strap,,,31.69,154.59,9
HCPCS,L5685,BK HEAVY DUTY SUSP SLEEV,260.8,169.52,56.85,260.8,74
HCPCS,L5686,Bk back check,,,31.69,185.91,9
HCPCS,L5688,"AD'LX, BK, WEB WAIST BELT",72.09,46.86,15.72,72.09,74
HCPCS,L5690,Bk waist belt padded and lin,,,58.52,403.08,9
HCPCS,L5692,Ak pelvic control belt light,,,58.52,426.76,9
HCPCS,L5694,Ak pelvic control belt pad/l,,,351.41,582.63,9
HCPCS,L5695,Ak sleeve susp neoprene/equa,,,58.52,523.75,9
HCPCS,L5696,Ak/knee disartic pelvic join,,,351.41,632.67,9
HCPCS,L5697,Ak/knee disartic pelvic band,,,31.69,300.44,9
HCPCS,L5698,Ak/knee disartic silesian ba,,,58.52,385.41,9
HCPCS,L5699,Shoulder harness,,,351.41,658.72,9
HCPCS,L5700,REPLACEMENT SOCKET BELOW KNEE,3617.61,2351.45,788.64,3617.61,67
HCPCS,L5701,REPLACE SOCKET ABOVE KNEE,4488.0,2917.2,978.38,4488.0,67
HCPCS,L5702,Replace socket hip,,,3989.9,15492.26,9
HCPCS,L5703,Symes ankle w/o (sach) foot,,,8149.39,8149.39,1
HCPCS,L5704,CUSTOM BK COVER,737.62,479.45,160.8,737.62,74
HCPCS,L5705,AK CUSTOM COVER,1352.31,879.0,294.8,1352.31,74
HCPCS,L5706,Custom shape cvr knee disart,,,669.74,3612.64,9
HCPCS,L5707,Custom shape cvr hip disart,,,669.74,4853.69,9
HCPCS,L5710,Kne-shin exo sng axi mnl loc,,,846.64,1155.07,9
HCPCS,L5711,Knee-shin exo mnl lock ultra,,,333.06,1938.55,9
HCPCS,L5712,Knee-shin exo frict swg & st,,,333.06,1383.86,9
HCPCS,L5714,Knee-shin exo variable frict,,,333.06,1408.09,9
HCPCS,L5716,Knee-shin exo mech stance ph,,,1288.13,2784.28,9
HCPCS,L5718,Knee-shin exo frct swg & sta,,,669.74,2977.26,9
HCPCS,L5722,Knee-shin pneum swg frct exo,,,669.74,3620.58,9
HCPCS,L5724,Knee-shin exo fluid swing ph,,,669.74,5580.5,9
HCPCS,L5726,Knee-shin ext jnts fld swg e,,,6643.82,6643.82,1
HCPCS,L5728,Knee-shin fluid swg & stance,,,7785.82,7785.82,1
HCPCS,L5780,Knee-shin pneum/hydra pneum,,,669.74,4286.68,9
HCPCS,L5781,LOWER LIMB PROS VACUUM PUMP,4719.0,3067.35,1028.74,4719.0,67
HCPCS,L5782,Hd low limb pros vacuum pump,,,13625.66,13625.66,1
HCPCS,L5785,Exoskeletal bk ultralt mater,,,333.06,1668.61,9
HCPCS,L5790,Exoskeletal ak ultra-light m,,,1288.13,2408.19,9
HCPCS,L5795,Exoskel hip ultra-light mate,,,669.74,3448.24,9
HCPCS,L5810,Endoskel knee-shin mnl lock,,,333.06,1837.2,9
HCPCS,L5811,Endo knee-shin mnl lck ultra,,,1288.13,2535.35,9
HCPCS,L5812,"AD'ENDO,SAFETY KNEE",696.61,452.8,151.86,696.61,74
HCPCS,L5814,Endo knee-shin hydral swg ph,,,11996.73,11996.73,1
HCPCS,L5816,Endo knee-shin polyc mch sta,,,669.74,2731.29,9
HCPCS,L5818,Endo knee-shin frct swg & st,,,669.74,3084.17,9
HCPCS,L5822,Endo knee-shin pneum swg frc,,,5657.83,5657.83,1
HCPCS,L5824,Endo knee-shin fluid swing p,,,669.74,5348.29,9
HCPCS,L5826,Miniature knee joint,,,10087.75,10087.75,1
HCPCS,L5827,Endo knee shin single axis,,,669.74,775.49,8
HCPCS,L5828,ENDO KNEE-SHIN FLUID SWG/STA,3475.36,2258.98,757.63,3475.36,67
HCPCS,L5830,Endo knee-shin pneum/swg pha,,,6418.12,6418.12,1
HCPCS,L5840,Multi-axial knee/shin system,,,12597.04,12597.04,1
HCPCS,L5845,"ADD,ENDOSKELETAL KNEE-SHIN SYS",2113.92,1374.05,460.83,2113.92,75
HCPCS,L5848,ADD KNEE HYD STANCE EXT,1268.25,824.36,276.48,1268.25,74
HCPCS,L5850,"AD'ENDO,KNEE EXT ASST",150.0,97.5,32.7,150.0,74
HCPCS,L5855,Mech hip extension assist,,,91.28,991.85,9
HCPCS,L5856,"ADD, LE, ENDO, SWING STANCE",28312.43,18403.08,1030.0,28312.43,75
HCPCS,L5857,Elec knee-shin swing only,,,27515.74,27515.74,1
HCPCS,L5858,Stance phase only,,,16923.09,60034.69,9
HCPCS,L5859,Knee-shin pro flex/ext cont,,,669.74,46868.49,9
HCPCS,L5910,"AD'ENDO,BK ALIGN SYS",424.68,276.04,92.58,980.32,74
HCPCS,L5920,"AD'ENDO,AK/HD ALIGN SYS",622.15,404.4,135.63,622.15,74
HCPCS,L5925,ABOVE KNEE MANUAL LOCK,400.0,260.0,87.2,980.32,74
HCPCS,L5926,Endoskel posit rotat unit,,,846.64,2077.0,9
HCPCS,L5930,High activity knee frame,,,10872.73,10872.73,1
HCPCS,L5940,"AD'ENDO,BK ULTRA LIGHT",747.0,485.55,162.85,747.0,74
HCPCS,L5950,"AD'ENDO,AK ULTRA LIGHT",1087.0,706.55,236.97,1491.52,74
HCPCS,L5960,Endo hip ultra-light materia,,,669.74,3736.1,9
HCPCS,L5961,"Endo poly hip, pneu/hyd/rot",,,3989.9,15418.8,9
HCPCS,L5962,PROSTHETIC SKIN,689.23,448.0,150.25,689.23,74
HCPCS,L5964,Above knee flex cover system,,,669.74,3621.05,9
HCPCS,L5966,Hip flexible cover system,,,669.74,4664.55,9
HCPCS,L5968,Multiaxial ankle w dorsiflex,,,11738.32,11738.32,1
HCPCS,L5969,Ak/ft power asst incl motors,,,16923.09,22537.82,9
HCPCS,L5970,Foot external keel sach foot,,,351.41,701.66,9
HCPCS,L5971,"Sach foot, replacement",,,351.41,701.66,9
HCPCS,L5972,FLEXIBLE KEEL FOOT,466.66,303.33,101.73,980.32,74
HCPCS,L5973,Ank-foot sys dors-plant flex,,,16923.09,57029.59,9
HCPCS,L5974,Foot single axis ankle/foot,,,351.41,748.4,9
HCPCS,L5975,Combo ankle/foot prosthesis,,,333.06,1497.55,9
HCPCS,L5976,"LX,ENERGY STORE FOOT",693.15,450.55,151.11,693.15,74
HCPCS,L5978,"LX,MULTI-AXIS FOOT",366.0,237.9,79.79,366.0,74
HCPCS,L5979,MULTI-AXIAL ANKLE/FT PROSTH,2940.55,1911.36,641.04,2940.55,67
HCPCS,L5980,Flex foot system,,,12270.79,12270.79,1
HCPCS,L5981,FLEX-WALK SYS LOW EXT PROSTH,4024.33,2615.81,877.3,4024.33,67
HCPCS,L5982,Exoskeletal axial rotation u,,,333.06,2070.59,9
HCPCS,L5984,ENDOSKELETAL AXIAL ROTATION,758.34,492.92,165.32,758.34,74
HCPCS,L5985,Lwr ext dynamic prosth pylon,,,91.28,912.2,9
HCPCS,L5986,MULTI-AXIAL ROTATION UNIT,914.76,594.59,199.42,1491.52,74
HCPCS,L5987,ALL SHANK FOOT W/VERTICAL LOAD,2708.0,1760.2,590.34,2708.0,67
HCPCS,L5988,Vertical shock reducing pylo,,,6453.03,6453.03,1
HCPCS,L5990,User adjustable heel height,,,669.74,5860.15,9
HCPCS,L5991,Low pros ext osseo connector,,,3989.9,30837.17,9
HCPCS,L5992,Add lw ext foot shell,,,58.52,67.76,8
HCPCS,L5999,Lowr extremity prosthes nos,,,31.69,2739999.97,9
HCPCS,L6000,Part hand thumb rem,,,669.74,5689.61,9
HCPCS,L6010,Part hand little/ring,,,669.74,6331.62,9
HCPCS,L6020,Part hand no fingers,,,669.74,5903.19,9
HCPCS,L6026,Part hand myo exclu term dev,,,14051.13,14051.13,1
HCPCS,L6029,Test interface part handfing,,,351.41,406.89,8
HCPCS,L6030,External frame part handfing,,,333.06,385.65,8
HCPCS,L6031,Rep interface handfng molded,,,1288.13,1491.52,8
HCPCS,L6032,Part handfng ultralite tcf/=,,,333.06,385.65,8
HCPCS,L6033,Part handfing acrylic,,,669.74,775.49,8
HCPCS,L6037,Postop dsg cast chg handfing,,,669.74,775.49,8
HCPCS,L6038,Multiax rotation attachment,,,669.74,775.49,8
HCPCS,L6050,Wrst mld sck flx hng tri pad,,,8029.54,8029.54,1
HCPCS,L6055,Wrst mold sock w/exp interfa,,,10242.15,10242.15,1
HCPCS,L6100,ELB MOLD SOCK FLEX HINGE PAD,2966.76,1928.39,646.75,2966.76,67
HCPCS,L6110,Elbow mold sock suspension t,,,8596.37,8596.37,1
HCPCS,L6120,Elbow mold doub splt soc ste,,,9722.53,9722.53,1
HCPCS,L6130,Elbow stump activated lock h,,,10257.46,10257.46,1
HCPCS,L6200,Elbow mold outsid lock hinge,,,10566.4,10566.4,1
HCPCS,L6205,Elbow molded w/ expand inter,,,14576.14,14576.14,1
HCPCS,L6250,Elbow inter loc elbow forarm,,,10395.48,10395.48,1
HCPCS,L6300,Shlder disart int lock elbow,,,14338.26,14338.26,1
HCPCS,L6310,Shoulder passive restor comp,,,12994.53,12994.53,1
HCPCS,L6320,Shoulder passive restor cap,,,6772.32,6772.32,1
HCPCS,L6350,Thoracic intern lock elbow,,,15710.28,15710.28,1
HCPCS,L6360,Thoracic passive restor comp,,,13639.31,13639.31,1
HCPCS,L6370,Thoracic passive restor cap,,,7909.89,7909.89,1
HCPCS,L6380,Postop dsg cast chg wrst/elb,,,669.74,4574.84,9
HCPCS,L6382,Postop dsg cast chg elb dis/,,,669.74,5446.13,9
HCPCS,L6384,Postop dsg cast chg shlder/t,,,6889.68,6889.68,1
HCPCS,L6386,Postop ea cast chg & realign,,,846.64,1510.26,9
HCPCS,L6388,Postop applicat rigid dsg on,,,333.06,1663.15,9
HCPCS,L6400,Below elbow prosth tiss shap,,,8789.87,8789.87,1
HCPCS,L6450,Elb disart prosth tiss shap,,,11487.92,11487.92,1
HCPCS,L6500,Above elbow prosth tiss shap,,,11280.91,11280.91,1
HCPCS,L6550,Shldr disar prosth tiss shap,,,14611.1,14611.1,1
HCPCS,L6570,Scap thorac prosth tiss shap,,,3989.9,16311.38,9
HCPCS,L6580,Wrist/elbow bowden cable mol,,,669.74,6521.67,9
HCPCS,L6582,Wrist/elbow bowden cbl dir f,,,669.74,5477.31,9
HCPCS,L6584,Elbow fair lead cable molded,,,8110.43,8110.43,1
HCPCS,L6586,Elbow fair lead cable dir fo,,,7226.89,7226.89,1
HCPCS,L6588,Shdr fair lead cable molded,,,11509.75,11509.75,1
HCPCS,L6590,Shdr fair lead cable direct,,,10031.17,10031.17,1
HCPCS,L6600,Polycentric hinge pair,,,351.41,732.68,9
HCPCS,L6605,Single pivot hinge pair,,,351.41,754.13,9
HCPCS,L6610,Flexible metal hinge pair,,,351.41,712.92,9
HCPCS,L6611,"Additional switch, ext power",,,846.64,1329.94,9
HCPCS,L6615,DISCONNECT LOCKING WRIST UNI,252.67,164.24,55.08,406.89,74
HCPCS,L6616,Disconnect insert locking wr,,,31.69,208.32,9
HCPCS,L6620,Flexion/extension wrist unit,,,91.28,1209.79,9
HCPCS,L6621,FLEX/EXT WRIST W/WO FRICTION,3034.15,1972.2,661.44,3034.15,67
HCPCS,L6623,Spring-ass rot wrst w/ latch,,,1288.13,2304.64,9
HCPCS,L6624,Flex/ext/rotation wrist unit,,,12165.33,12165.33,1
HCPCS,L6625,Rotation wrst w/ cable lock,,,333.06,1708.09,9
HCPCS,L6628,Quick disconn hook adapter o,,,333.06,1838.59,9
HCPCS,L6629,LAMINATION COLLAR W/ COUPLIN,218.0,141.7,47.52,218.0,74
HCPCS,L6630,Stainless steel any wrist,,,351.41,922.89,9
HCPCS,L6632,Latex suspension sleeve each,,,31.69,208.65,9
HCPCS,L6635,Lift assist for elbow,,,351.41,667.0,9
HCPCS,L6637,Nudge control elbow lock,,,846.64,1305.88,9
HCPCS,L6638,Elec lock on manual pw elbow,,,8077.99,8077.99,1
HCPCS,L6640,Shoulder abduction joint pai,,,91.28,1087.56,9
HCPCS,L6641,Excursion amplifier pulley t,,,58.52,633.3,9
HCPCS,L6642,Excursion amplifier lever ty,,,351.41,931.13,9
HCPCS,L6645,Shoulder flexion-abduction j,,,91.28,1176.17,9
HCPCS,L6646,Multipo locking shoulder jnt,,,10188.17,10188.17,1
HCPCS,L6647,Shoulder lock actuator,,,333.06,1677.32,9
HCPCS,L6648,Ext pwrd shlder lock/unlock,,,10507.65,10507.65,1
HCPCS,L6650,Shoulder universal joint,,,846.64,1275.69,9
HCPCS,L6655,Standard control cable extra,,,31.69,247.48,9
HCPCS,L6660,HEAVY DUTY CONTROL CABLE,120.9,78.59,26.36,120.9,74
HCPCS,L6665,Teflon or equal cable lining,,,31.69,147.91,9
HCPCS,L6670,Hook to hand cable adapter,,,31.69,154.02,9
HCPCS,L6672,Harness chest/shlder saddle,,,351.41,706.81,9
HCPCS,L6675,HARNESS FIGURE OF 8 SING CON,140.82,91.53,30.7,140.82,74
HCPCS,L6676,Harness figure of 8 dual con,,,58.52,403.52,9
HCPCS,L6677,Ue triple control harness,,,91.28,958.21,9
HCPCS,L6680,TEST SOCK WRIST DISART/BEL E,362.74,235.78,79.08,406.89,74
HCPCS,L6682,Test sock elbw disart/above,,,91.28,1098.41,9
HCPCS,L6684,Test socket shldr disart/tho,,,846.64,1492.62,9
HCPCS,L6686,Suction socket,,,333.06,2214.85,9
HCPCS,L6687,FR TYP SOCKET BE/W,655.0,425.75,142.79,655.0,74
HCPCS,L6688,Frame typ sock above elb/dis,,,333.06,2050.21,9
HCPCS,L6689,Frame typ socket shoulder di,,,1288.13,2443.48,9
HCPCS,L6690,Frame typ sock interscap-tho,,,1288.13,2876.81,9
HCPCS,L6691,Removable insert each,,,846.64,1135.57,9
HCPCS,L6692,Silicon gel insert w/wo lock,,,333.06,2065.93,9
HCPCS,L6693,Lockingelbow forearm cntrbal,,,9170.7,9170.7,1
HCPCS,L6694,Elbow socket ins use w/lock,,,1288.13,2538.88,9
HCPCS,L6695,Elbow socket ins use w/o lck,,,333.06,2115.69,9
HCPCS,L6696,Cus elbo skt in for con/atyp,,,669.74,4249.08,9
HCPCS,L6697,Cus elbo skt in not con/atyp,,,669.74,4249.08,9
HCPCS,L6698,Add up-ex prosthes lock mech,,,333.06,1597.5,9
HCPCS,L6703,"Term dev, passive hand mitt",,,91.28,1129.84,9
HCPCS,L6704,"Term dev, sport/rec/work att",,,333.06,2180.9,9
HCPCS,L6706,TERM DEV MECH HOOK VOL OPEN,494.16,321.2,107.73,980.32,74
HCPCS,L6707,TERM DEV MECH HOOK VOL CLOSE,1748.01,1136.21,381.07,1748.01,75
HCPCS,L6708,Term dev mech hand vol open,,,669.74,3164.81,9
HCPCS,L6709,TERM DEV MECH HAND VOL CLOSE,1706.96,1109.52,372.12,1706.96,75
HCPCS,L6711,"Ped term dev, hook, vol open",,,333.06,2171.72,9
HCPCS,L6712,"Ped term dev, hook, vol clos",,,669.74,3998.67,9
HCPCS,L6713,"Ped term dev, hand, vol open",,,669.74,5046.59,9
HCPCS,L6714,"Ped term dev, hand, vol clos",,,669.74,4274.43,9
HCPCS,L6715,"Term device, multi art digit",,,10198.39,10198.39,1
HCPCS,L6721,"Hook/hand, hvy dty, vol open",,,7597.5,7597.5,1
HCPCS,L6722,"Hook/hand, hvy dty, vol clos",,,6549.48,6549.48,1
HCPCS,L6805,Term dev modifier wrist unit,,,846.64,1238.89,9
HCPCS,L6810,Term dev precision pinch dev,,,351.41,658.61,9
HCPCS,L6880,ELEC HAND IND ART DIGITS,94588.71,61482.66,1030.0,94588.71,75
HCPCS,L6881,TERM DEV AUTO GRASP FEATURE,5423.11,3525.02,1030.0,5423.11,67
HCPCS,L6882,MICROPROCESSOR CONTROL UPLMB,3512.0,2282.8,765.62,3512.0,67
HCPCS,L6883,Replc sockt below e/w disa,,,669.74,6416.81,9
HCPCS,L6884,Replc sockt above elbow disa,,,8779.65,8779.65,1
HCPCS,L6885,Replc sockt shldr dis/interc,,,13639.31,13639.31,1
HCPCS,L6890,PRODUCTION GLOVE,235.56,153.11,51.35,406.89,74
HCPCS,L6895,CUSTOM GLOVE FOR TERM DEVICE,823.2,535.08,179.46,823.2,74
HCPCS,L6900,Hand restorat thumb/1 finger,,,669.74,6264.43,9
HCPCS,L6905,Hand restoration multiple fi,,,669.74,6200.02,9
HCPCS,L6910,Hand restoration no fingers,,,669.74,6095.05,9
HCPCS,L6915,Hand restoration replacmnt g,,,1288.13,2618.81,9
HCPCS,L6920,Wrist disarticul switch ctrl,,,27059.5,27059.5,1
HCPCS,L6925,Wrist disart myoelectronic c,,,28908.59,28908.59,1
HCPCS,L6930,Below elbow switch control,,,26062.11,26062.11,1
HCPCS,L6935,BELOW ELBOW MYOELECTRONIC CT,11759.0,7643.35,1030.0,11759.0,67
HCPCS,L6940,Elbow disarticulation switch,,,33654.71,33654.71,1
HCPCS,L6945,Elbow disart myoelectronic c,,,37546.19,37546.19,1
HCPCS,L6950,Above elbow switch control,,,33592.29,33592.29,1
HCPCS,L6955,Above elbow myoelectronic ct,,,38956.5,38956.5,1
HCPCS,L6960,Shldr disartic switch contro,,,40980.73,40980.73,1
HCPCS,L6965,Shldr disartic myoelectronic,,,16923.09,48548.03,9
HCPCS,L6970,Interscapular-thor switch ct,,,16923.09,51965.31,9
HCPCS,L6975,Interscap-thor myoelectronic,,,16923.09,57278.0,9
HCPCS,L7007,ADULT ELECTRIC HAND,4307.75,2800.04,939.09,4307.75,67
HCPCS,L7008,Pediatric electric hand,,,3989.9,18295.91,9
HCPCS,L7009,Adult electric hook,,,12071.26,12071.26,1
HCPCS,L7040,Prehensile actuator,,,9825.23,9825.23,1
HCPCS,L7045,Pediatric electric hook,,,669.74,5190.98,9
HCPCS,L7170,Electronic elbow hosmer swit,,,19430.57,19430.57,1
HCPCS,L7180,Electronic elbow sequential,,,16923.09,125709.23,9
HCPCS,L7181,Electronic elbo simultaneous,,,16923.09,129429.57,9
HCPCS,L7185,Electron elbow adolescent sw,,,20427.85,20427.85,1
HCPCS,L7186,Electron elbow child switch,,,34342.09,34342.09,1
HCPCS,L7190,Elbow adolescent myoelectron,,,27105.81,27105.81,1
HCPCS,L7191,Elbow child myoelectronic ct,,,36122.43,36122.43,1
HCPCS,L7259,Electronic wrist rotator any,,,13238.31,13238.31,1
HCPCS,L7360,Six volt bat otto bock/eq ea,,,351.41,854.55,9
HCPCS,L7362,Battery chrgr six volt otto,,,91.28,933.55,9
HCPCS,L7364,Twelve volt battery utah/equ,,,846.64,1651.86,9
HCPCS,L7366,Battery chrgr 12 volt utah/e,,,333.06,2271.73,9
HCPCS,L7367,Replacemnt lithium ionbatter,,,846.64,1257.66,9
HCPCS,L7368,Lithium ion battery charger,,,333.06,1630.27,9
HCPCS,L7400,"ADD UE PROST BE/WD, ULTLITE",361.47,234.96,78.8,361.47,74
HCPCS,L7401,Add ue prost a/e ultlite mat,,,91.28,1108.22,9
HCPCS,L7402,Add ue prost s/d ultlite mat,,,846.64,1196.94,9
HCPCS,L7403,ADD UE PROST B/E ACRYLIC,434.33,282.31,91.28,434.33,74
HCPCS,L7404,Add ue prost a/e acrylic,,,333.06,1795.52,9
HCPCS,L7405,Add ue prost s/d acrylic,,,1288.13,2348.07,9
HCPCS,L7499,Upper extremity prosthes nos,,,16.97,2739999.97,9
HCPCS,L7510,PROSTH DEVICE REPL/REPAIR,110.0,71.5,16.97,110.0,74
HCPCS,L7520,REPAIR PROSTH LABOR-15 MIN,27.5,17.88,6.0,27.5,74
HCPCS,L7600,Prosthetic donning sleeve,,,11.14,123.3,9
HCPCS,L7700,Pros soc insert gasket/seal,,,58.52,483.28,9
HCPCS,L7900,VACUUM ERECTION SYSTEM,623.0,404.95,1.1,1741.0,86
HCPCS,L7900,VACUUM ERECTION SYSTEM MANUAL,566.0,367.9,123.39,566.0,74
HCPCS,L7902,"Tension ring, vac erect dev",,,16.97,29.62,9
HCPCS,L8000,"BREAST PROSTHESIS, MASTECTOMY BRA",70.0,45.5,1.1,168.09,90
HCPCS,L8000,Mastectomy bra,,,36.52,136.75,9
HCPCS,L8001,Breast prosthesis bra & form,,,58.52,405.27,9
HCPCS,L8002,Brst prsth bra & bilat form,,,58.52,532.93,9
HCPCS,L8010,Mastectomy sleeve,,,36.52,110.7,9
HCPCS,L8015,Ext breastprosthesis garment,,,31.69,193.61,9
HCPCS,L8020,Mastectomy form,,,351.41,730.32,9
HCPCS,L8030,Breast prosthes w/o adhesive,,,91.28,1129.04,9
HCPCS,L8031,Breast prosthesis w adhesive,,,91.28,1129.04,9
HCPCS,L8032,Reusable nipple prosthesis,,,36.52,126.51,9
HCPCS,L8033,"Nipple prosthesis custom, ea",,,31.69,2739849.3,9
HCPCS,L8035,Custom breast prosthesis,,,11834.31,11834.31,1
HCPCS,L8039,Breast prosthesis nos,,,846.64,2739999.97,9
HCPCS,L8040,Nasal prosthesis,,,8008.31,8008.31,1
HCPCS,L8041,Midfacial prosthesis,,,9651.7,9651.7,1
HCPCS,L8042,Orbital prosthesis,,,10844.59,10844.59,1
HCPCS,L8043,Upper facial prosthesis,,,12145.98,12145.98,1
HCPCS,L8044,Hemi-facial prosthesis,,,13447.32,13447.32,1
HCPCS,L8045,Auricular prosthesis,,,10530.15,10530.15,1
HCPCS,L8046,Partial facial prosthesis,,,8675.77,8675.77,1
HCPCS,L8047,Nasal septal prosthesis,,,669.74,4446.31,9
HCPCS,L8048,Unspec maxillofacial prosth,,,16.97,2739849.3,9
HCPCS,L8049,Repair maxillofacial prosth,,,16.97,49.05,9
HCPCS,L8210,GRAD COMPR STOCK CUSTOM MADE,368.0,239.2,1.1,368.0,68
HCPCS,L8300,Truss single w/ standard pad,,,58.52,270.9,9
HCPCS,L8310,Truss double w/ standard pad,,,58.52,479.94,9
HCPCS,L8320,Truss addition to std pad wa,,,31.69,199.12,9
HCPCS,L8330,Truss add to std pad scrotal,,,31.69,158.54,9
HCPCS,L8400,COMPRESSOGRIP BELOW KNEE,40.0,26.0,8.72,40.0,74
HCPCS,L8400,SHEATH BK,18.46,12.0,4.02,18.46,74
HCPCS,L8410,COMPRESSOGRIP ABOVE KNEE,40.0,26.0,8.72,40.0,74
HCPCS,L8415,Sheath upper limb,,,11.14,68.86,9
HCPCS,L8417,"PROSTH SHEATH/SOCK,INCL GEL",88.0,57.2,11.14,88.0,74
HCPCS,L8420,WOOL SOCK BK,25.0,16.25,5.45,25.0,74
HCPCS,L8430,WOOL SOCK AK,26.47,17.21,5.77,42.28,74
HCPCS,L8435,SOCK WOOL UPPER LIMB,26.47,17.21,5.77,26.47,74
HCPCS,L8440,W SHRINKER PROST BELOW KNEE,54.98,35.74,11.99,54.98,74
HCPCS,L8460,SHRINKER AK,78.16,50.8,17.04,78.16,74
HCPCS,L8465,Shrinker upper limb,,,31.69,197.83,9
HCPCS,L8470,STUMP SOCK SINGLE BELOW KNEE,10.0,6.5,2.18,19.65,74
HCPCS,L8480,Pros sock single ply ak,,,11.14,29.56,9
HCPCS,L8485,Pros sock single ply upper l,,,11.14,39.78,9
HCPCS,L8499,TROUBLESHOOTING DEVICE,87.5,56.88,16.97,87.5,74
HCPCS,L8500,ELECTROLARYNX,550.0,357.5,119.9,1491.52,74
HCPCS,L8501,PROVOX FREEHANDS FLEXIVOICE LIGHT,754.0,490.1,58.52,754.0,74
HCPCS,L8501,TRACHEOSTOMY SPEAKING VALVE,196.0,127.4,1.1,476.82,90
HCPCS,L8501,W VALVE TRACH PASSY MUIR,121.63,79.06,26.52,121.63,74
HCPCS,L8505,"Artificial larynx, accessory",,,38.36,385.65,9
HCPCS,L8507,Trach-esoph voice pros pt in,,,36.52,135.25,9
HCPCS,L8509,"PROVOX 2 VOICE PROSTHESI, 4.5 MM",570.0,370.5,58.52,570.0,74
HCPCS,L8509,PROVOX ACTIVALVE,3015.0,1959.75,58.52,3015.0,75
HCPCS,L8509,TRACH-ESOPH VOICE PROS  IN,419.0,272.35,58.52,419.0,74
HCPCS,L8509,TRACH-ESOPH VOICE PROS MD IN,329.0,213.85,53.63,525.0,222
HCPCS,L8510,Voice amplifier,,,351.41,816.3,9
HCPCS,L8511,"PROVOX PLUG;  REPLACEMENT ONLY, EACH (INCLUDES PROVOX BRUSH)",78.0,50.7,17.0,78.0,74
HCPCS,L8512,Gel cap for trach voice pros,,,7.04,19.65,9
HCPCS,L8513,"BRUSH; REPLACEMENT ONLY,EACH",90.0,58.5,16.97,90.0,74
HCPCS,L8513,LARY BRUSHES,78.75,51.19,16.97,78.75,74
HCPCS,L8514,Repl trach puncture dilator,,,58.52,304.63,9
HCPCS,L8515,Gel cap app device for trach,,,31.69,203.94,9
HCPCS,L8600,Implant breast silicone/eq,,,1288.13,1491.52,8
HCPCS,L8603,COLLAGEN IMPLNT URIN TRCT 2.5CC,770.0,500.5,1.1,1728.46,92
HCPCS,L8603,W IMP COLLAGN A/S,699.9,454.94,152.58,1275.41,75
HCPCS,L8604,Dextranomer/hyaluronic acid,,,1101.49,1275.41,8
HCPCS,L8605,Inj bulking agent anal canal,,,3134.46,4014.92,3
HCPCS,L8605,SOLESTA,1100.0,715.0,239.8,1275.41,75
HCPCS,L860500,Inj bulking agent anal canal,,,3134.46,4014.92,3
HCPCS,L8606,SYNTHETIC IMPLNT URINARY 1ML,436.0,283.4,1.1,815.32,92
HCPCS,L8606,W INJ BULK AGENT COLLAGEN IMP U,529.0,343.85,115.32,1275.41,75
HCPCS,L8606,W INJ BULKING AGENT 1ML MPQ-2.5,711.0,462.15,155.0,1275.41,75
HCPCS,L8607,SILK VOICE INJECTABLE,1350.0,877.5,294.3,1350.0,75
HCPCS,L8608,Arg ii ext com/sup/acc misc,,,16.97,19.65,8
HCPCS,L8610,CORNEAL IMPLANT INTACS,2290.0,1488.5,333.06,2290.0,76
HCPCS,L8612,Aqueous shunt prosthesis,,,333.06,385.65,8
HCPCS,L8613,Ossicular implant,,,91.28,105.69,8
HCPCS,L8614,Cochlear device,,,16923.09,19595.16,8
HCPCS,L8615,Coch implant headset replace,,,846.64,1456.86,9
HCPCS,L8616,Coch implant microphone repl,,,58.52,339.29,9
HCPCS,L8617,Coch implant trans coil repl,,,31.69,296.36,9
HCPCS,L8618,Coch implant tran cable repl,,,36.52,84.72,9
HCPCS,L8619,Coch imp ext proc/contr rplc,,,16923.09,27151.48,9
HCPCS,L8621,L8621- ZINC AIR BATTERY,8.0,5.2,1.74,42.28,67
HCPCS,L8622,Repl alkaline battery,,,1.04,19.65,9
HCPCS,L8623,"Lith ion batt cid,non-earlvl",,,31.69,208.95,9
HCPCS,L8624,"Lith ion batt cid, ear level",,,58.52,520.93,9
HCPCS,L8625,Charger coch impl/aoi battry,,,58.52,610.12,9
HCPCS,L8627,Cid ext speech process repl,,,23045.59,23045.59,1
HCPCS,L8628,Cid ext controller repl,,,669.74,4105.84,9
HCPCS,L8629,Cid transmit coil and cable,,,58.52,578.39,9
HCPCS,L8630,Metacarpophalangeal implant,,,846.64,980.32,8
HCPCS,L8641,Metatarsal joint implant,,,846.64,980.32,8
HCPCS,L8642,Hallux implant,,,91.28,105.69,8
HCPCS,L8658,Interphalangeal joint spacer,,,91.28,105.69,8
HCPCS,L8670,"G000101/S70,GRAFT,TAA,CUSTOM",10000.0,6500.0,333.06,10000.0,69
HCPCS,L8670,"G010002,GREENBERG FENESTRAT",15000.0,9750.0,333.06,15000.0,69
HCPCS,L8670,"G980198/S6,ZENITH CUSTOM",6000.0,3900.0,333.06,6000.0,69
HCPCS,L8678,Ext sply implt neurostim,,,16.97,19.65,8
HCPCS,L8679,NS 100 NEUROSTIMULATOR,9450.0,6142.5,1030.0,9450.0,76
HCPCS,L8680,"ELECTRODE, NEUROSTIMULATOR L8680 (278)",14965.0,9727.25,333.06,14965.0,76
HCPCS,L8681,"G070235,ACTIVA CONTROLLER,7436",660.0,429.0,143.88,775.49,69
HCPCS,L8682,Implt neurostim radiofq rec,,,3989.9,4619.88,8
HCPCS,L8683,Radiofq trsmtr for implt neu,,,3989.9,17407.3,9
HCPCS,L8684,Radiof trsmtr implt scrl neu,,,1288.13,2731.42,9
HCPCS,L8685,Implt nrostm pls gen sng rec,,,20488.95,20488.95,1
HCPCS,L8686,Implt nrostm pls gen sng non,,,13073.61,13073.61,1
HCPCS,L8687,IMPLT NROSTM PLS GEN DUA REC,17550.0,11407.5,1030.0,19595.16,76
HCPCS,L8688,Implt nrostm pls gen dua non,,,17013.98,17013.98,1
HCPCS,L8689,External recharg sys intern,,,669.74,5571.98,9
HCPCS,L8690,"Aud osseo dev, int/ext comp",,,3989.9,4619.88,8
HCPCS,L8691,Aoi snd proc repl excl actua,,,5562.94,5562.94,1
HCPCS,L8692,NON-OSSEOINTEGRATED SND PROC,6000.0,3900.0,1030.0,6000.0,75
HCPCS,L8692,SOFTBAND BA,6000.0,3900.0,1030.0,6000.0,75
HCPCS,L8693,"AUD OSSEO DEV, ABUTMENT",3360.0,2184.0,669.74,3360.0,75
HCPCS,L8694,Aoi transducer/actuator repl,,,3050.58,4619.88,9
HCPCS,L8695,External recharg sys extern,,,11.14,53.87,9
HCPCS,L8696,Ext antenna phren nerve stim,,,91.28,700.07,9
HCPCS,L8698,Misc used with tot art heart,,,16.97,2739849.3,9
HCPCS,L8699,ARMSTRONG MYRINGOTOMY VENT TUBE,29.0,18.85,6.32,29.0,75
HCPCS,L8699,BLUE SILICONE MYRINGOTOMY VENT TUBE,42.0,27.3,9.16,42.0,75
HCPCS,L8699,CI ACOUSTIC COMP KIT,375.0,243.75,16.97,375.0,75
HCPCS,L8699,CI ACOUSTIC SPKR ONLY,300.0,195.0,16.97,300.0,75
HCPCS,L8699,CUSTOM FABRICATED LARYNGEAL KEEL,400.0,260.0,16.97,400.0,75
HCPCS,L8699,PROSTHETIC IMPLANT DEVICE UROLIFT,1900.0,1235.0,16.97,1900.0,76
HCPCS,L8699,"PROSTHETIC IMPLANT,NOS",701.0,455.65,0.01,701.0,80
HCPCS,L8699,REUTER MYRINGOTOMY VENT TUBE,15.0,9.75,3.27,19.65,75
HCPCS,L8699,RICHARDS T TUBE,64.0,41.6,13.95,64.0,74
HCPCS,L8699,TRUMPET TUBE,84.0,54.6,16.97,84.0,74
HCPCS,L8701,Ewh s/d uprt micro sensor,,,411.0,411.0,1
HCPCS,L8702,Ewhf s/d uprt micro sensor,,,411.0,411.0,1
HCPCS,L8720,Ext low ext sens prosthe mec,,,31.69,36.7,8
HCPCS,L8721,Receptor sole l8720 replace,,,31.69,36.7,8
HCPCS,L9900,O&p supply/accessory/service,,,16.97,19.65,8
HCPCS,M0001,Advancing cancer care mvp,,,10.69,2739849.3,9
HCPCS,M0002,Opt care kidney hlth mvp,,,10.69,12.38,8
HCPCS,M0003,Opt care episod neuro mvp,,,10.69,2739849.3,9
HCPCS,M0004,Qual care neurologic cnd mvp,,,10.69,2739849.3,9
HCPCS,M0005,Value in primary care mvp,,,10.69,2739849.3,9
HCPCS,M0010,Eom meos payment,,,2739849.3,2739849.3,1
HCPCS,M0075,Cellular therapy,,,1580.94,2739849.3,9
HCPCS,M0076,PROLOTHERAPY,288.5,187.525,0.01,392.0,213
HCPCS,M0100,Intragastric hypothermia,,,299.41,2739849.3,9
HCPCS,M0201,PNE FLU HEPB COV HOME ADMIN,46.0,29.9,1.1,113.26,74
HCPCS,M0201,Pne flu hepb cov home admin,,,17.08,100.97,29
HCPCS,M0220,Tixagev and cilgav inj,,,45.54,396.7,18
HCPCS,M0221,Tixagev and cilgav inj hm,,,45.54,686.37,18
HCPCS,M0222,Bebtelovimab injection,,,45.54,960.37,17
HCPCS,M0223,Bebtelovimab injection home,,,45.54,1508.37,17
HCPCS,M0224,PEMIVIBART INFUSION (IV INFUSION FOR IMMUNE-COMPROMISED COVID-19,1800.0,1170.0,277.57,1800.0,83
HCPCS,M0233,Iv inf toc hos ad cort ft ds,,,277.57,321.4,8
HCPCS,M0234,Iv inf toc hos ad cort sec,,,277.57,321.4,8
HCPCS,M0235,"Intrav inf, mon anti, fir do",,,277.57,458.89,20
HCPCS,M0236,"Intrav inf, mon anti, sec do",,,277.57,458.89,20
HCPCS,M0237,"Intrav inf, toci, first dose",,,277.57,458.89,20
HCPCS,M0238,"Intrav inf, toci, second dos",,,277.57,458.89,20
HCPCS,M0239,Bamlanivimab-xxxx infusion,,,277.57,346.87,9
HCPCS,M0240,Casiri and imdev repeat,,,277.57,1234.37,17
HCPCS,M0241,Casiri and imdev repeat hm,,,683.36,2056.37,9
HCPCS,M0243,Casirivi and imdevi inj,,,277.57,1234.37,17
HCPCS,M0244,Casirivi and imdevi inj hm,,,683.36,2056.37,9
HCPCS,M0245,Bamlan and etesev infusion,,,277.57,1234.37,17
HCPCS,M0246,Bamlan and etesev infus home,,,683.36,2056.37,9
HCPCS,M0247,Sotrovimab infusion,,,277.57,1234.37,17
HCPCS,M0248,"Sotrovimab inf, home admin",,,683.36,2056.37,9
HCPCS,M0249,ADM TOCILIZU COVID-19 1ST,1081.5,702.975,1.1,1802.0,162
HCPCS,M0250,ADM TOCILIZU COVID-19 2ND,1081.5,702.975,1.1,1802.0,162
HCPCS,M0300,Iv chelationtherapy,,,52.18,169.2,9
HCPCS,M0301,Fabric wrapping of aneurysm,,,2623.14,2739849.3,9
HCPCS,M1003,Tb scr 12 mo pri fst bio dz,,,10.69,2739849.3,9
HCPCS,M1004,Doc med rsn no srn tb,,,10.69,2739849.3,9
HCPCS,M1005,Tb scr no perf,,,10.69,2739849.3,9
HCPCS,M1006,"Dz not ases, no rsn",,,10.69,2739849.3,9
HCPCS,M1007,>=50% total pt outpt ra enct,,,10.69,2739849.3,9
HCPCS,M1008,<50% total pt outpt ra encts,,,10.69,2739849.3,9
HCPCS,M1009,Dc eoc doc med rec,,,10.69,2739849.3,9
HCPCS,M1010,Dc eoc doc med rec,,,10.69,2739849.3,9
HCPCS,M1011,Dc eoc doc med rec,,,10.69,2739849.3,9
HCPCS,M1012,Dc eoc doc med rec,,,10.69,2739849.3,9
HCPCS,M1013,Dc eoc doc med rec,,,10.69,2739849.3,9
HCPCS,M1014,Dc epi care doc medrec,,,10.69,2739849.3,9
HCPCS,M1015,Dc eoc doc med rec,,,10.69,12.38,8
HCPCS,M1016,Pt dx meop or sur steri,,,10.69,2739849.3,9
HCPCS,M1017,Pt admt to palitve serv,,,10.69,12.38,8
HCPCS,M1018,Pt dx hst cr pt sk lg cr scr,,,10.69,2739849.3,9
HCPCS,M1019,Adl pt mj dep ds rs 12 phq<5,,,10.69,2739849.3,9
HCPCS,M1020,Adl pt mj dep ds no rs 12 mo,,,10.69,2739849.3,9
HCPCS,M1021,Pt uc in pp,,,10.69,2739849.3,9
HCPCS,M1022,Pt hospice during perf pd,,,10.69,12.38,8
HCPCS,M1023,Adl pt mj dep ds rs 6 phq<5,,,10.69,12.38,8
HCPCS,M1024,Adl pt mj dep ds no rs 6 mo,,,10.69,12.38,8
HCPCS,M1025,Pt hospice during perf pd,,,10.69,12.38,8
HCPCS,M1026,Pt hospice during perf pd,,,10.69,12.38,8
HCPCS,M1027,Img head (ct or mri) obtnd,,,10.69,2739849.3,9
HCPCS,M1028,Doc of pt prm hda dx and otr,,,10.69,2739849.3,9
HCPCS,M1029,Doc sysm rsn img hd,,,10.69,2739849.3,9
HCPCS,M1031,Pt clin ind img hd,,,10.69,12.38,8
HCPCS,M1032,Adt tkng pharmthry for oud,,,10.69,2739849.3,9
HCPCS,M1033,Pharmthry for oud afr 6.30,,,10.69,12.38,8
HCPCS,M1034,Adt 180 dys pharmthry oud,,,10.69,2739849.3,9
HCPCS,M1035,Adt pd out mat pr 180 dys tx,,,10.69,2739849.3,9
HCPCS,M1036,Adt no 180 dys pharmthry oud,,,10.69,2739849.3,9
HCPCS,M1037,Pt dx lum sp reg cacr,,,10.69,2739849.3,9
HCPCS,M1038,Pt dx lum sp reg fract,,,10.69,2739849.3,9
HCPCS,M1039,Pt dx lum sp reg inf,,,10.69,2739849.3,9
HCPCS,M1040,Pt dx lum idi or cong scol,,,10.69,2739849.3,9
HCPCS,M1041,Pt cr ft inf lm or pt id sl,,,10.69,2739849.3,9
HCPCS,M1043,Fs no odi 9-15mo,,,10.69,2739849.3,9
HCPCS,M1045,Fs oks 9-15mo >= 37 >= 71,,,10.69,2739849.3,9
HCPCS,M1046,Fs oks 9-15mo < 37 < 71,,,10.69,2739849.3,9
HCPCS,M1049,Fs wth scr no odi pre and p,,,10.69,2739849.3,9
HCPCS,M1051,Pt w/cancer scoliosis,,,10.69,2739849.3,9
HCPCS,M1052,Lg pn not meas w/ vas 1yr po,,,10.69,2739849.3,9
HCPCS,M1054,Pt uc in pp,,,10.69,2739849.3,9
HCPCS,M1055,Aspirin used,,,10.69,2739849.3,9
HCPCS,M1056,Presc antico med in pp,,,10.69,2739849.3,9
HCPCS,M1057,"Aspirin not used, no rsn",,,10.69,2739849.3,9
HCPCS,M1058,Pt prm nurs hm res in pp,,,10.69,2739849.3,9
HCPCS,M1059,Pt no prm nurs hm res in pp,,,10.69,2739849.3,9
HCPCS,M1060,Pt died in pp,,,10.69,2739849.3,9
HCPCS,M1061,Pt preg,,,10.69,12.38,8
HCPCS,M1062,Pt imcomprmd,,,10.69,12.38,8
HCPCS,M1063,Pt rec hg dos imsup thpy,,,10.69,12.38,8
HCPCS,M1064,Shing vac doc adm or pv rec,,,10.69,12.38,8
HCPCS,M1065,Shing vac no adm clinc rsn,,,10.69,12.38,8
HCPCS,M1066,Shing vac no doc no rsn,,,10.69,12.38,8
HCPCS,M1067,Hspc pt prv time meam per,,,10.69,2739849.3,9
HCPCS,M1068,Pt not ambulatory,,,10.69,2739849.3,9
HCPCS,M1069,Pt scr ft fall rsk,,,10.69,2739849.3,9
HCPCS,M1070,Pt not scrn fut fall no rsn,,,10.69,2739849.3,9
HCPCS,M1071,Pt had add'l sp pcr perf,,,10.69,12.38,8
HCPCS,M1072,"ROM RAD THERAPY ANAL, PC",11472.0,7456.8,1.1,11472.0,68
HCPCS,M1073,"ROM RAD THERAPY ANAL, TC",67428.0,43828.2,1.1,67428.0,68
HCPCS,M1074,"ROM RAD THERAPY BLADDER, PC",10304.0,6697.6,1.1,10304.0,68
HCPCS,M1075,"ROM RAD THERAPY BLADDER, TC",54154.0,35200.1,1.1,54154.0,68
HCPCS,M1076,"ROM RAD THER BONE METS, PC",5342.0,3472.3,1.1,5342.0,68
HCPCS,M1077,"ROM RAD THER BONE METS, TC",24248.0,15761.2,1.1,24248.0,68
HCPCS,M1078,"ROM RAD THER BRAIN METS, PC",6097.0,3963.05,1.1,6097.0,68
HCPCS,M1079,"ROM RAD THER BRAIN METS, TC",38984.0,25339.6,1.1,38984.0,68
HCPCS,M1080,"ROM RAD THERAPY BREAST, PC",7614.0,4949.1,1.1,7614.0,68
HCPCS,M1081,"ROM RAD THERAPY BREAST, TC",39712.0,25812.8,1.1,39712.0,68
HCPCS,M1082,"ROM RAD THERAPY CERVICAL, PC",11224.0,7295.6,1.1,11224.0,68
HCPCS,M1083,"ROM RAD THERAPY CERVICAL, TC",54252.0,35263.8,1.1,54252.0,68
HCPCS,M1084,"ROM RAD THERAPY CNS, PC",9452.0,6143.8,1.1,9452.0,68
HCPCS,M1085,"ROM RAD THERAPY CNS, TC",59412.0,38617.8,1.1,59412.0,68
HCPCS,M1086,"ROM RAD THER COLORECTAL, PC",9269.0,6024.85,1.1,9269.0,68
HCPCS,M1087,"ROM RAD THER COLORECTAL, TC",48679.0,31641.35,1.1,48679.0,68
HCPCS,M1088,"ROM RAD THER HEAD/NECK, PC",11487.0,7466.55,1.1,11487.0,68
HCPCS,M1089,"ROM RAD THER HEAD/NECK, TC",70144.0,45593.6,1.1,70144.0,68
HCPCS,M1094,"ROM RAD THERAPY LUNG, PC",8246.0,5359.9,1.1,8246.0,68
HCPCS,M1095,"ROM RAD THERAPY LUNG, TC",48030.0,31219.5,1.1,48030.0,68
HCPCS,M1096,"ROM RAD THERAPY LYMPHOMA, PC",6373.0,4142.45,1.1,6373.0,68
HCPCS,M1097,"ROM RAD THERAPY LYMPHOMA, TC",31717.0,20616.05,1.1,31717.0,68
HCPCS,M1098,"ROM RAD THERAPY PANCREAS, PC",9168.0,5959.2,1.1,9168.0,68
HCPCS,M1099,"ROM RAD THERAPY PANCREAS, TC",54386.0,35350.9,1.1,54386.0,68
HCPCS,M1100,"ROM RAD THERAPY PROSTATE, PC",12493.0,8120.45,1.1,12493.0,68
HCPCS,M1101,"ROM RAD THERAPY PROSTATE, TC",81221.0,52793.65,1.1,81221.0,68
HCPCS,M1102,"ROM RAD THERAPY GI, PC",9858.0,6407.7,1.1,9858.0,68
HCPCS,M1103,"ROM RAD THERAPY GI, TC",58634.0,38112.1,1.1,58634.0,68
HCPCS,M1104,"ROM RAD THERAPY UTERUS, PC",10120.0,6578.0,1.1,10120.0,68
HCPCS,M1105,"ROM RAD THERAPY UTERUS, TC",56879.0,36971.35,1.1,56879.0,68
HCPCS,M1106,Start eoc doc med rec,,,10.69,2739849.3,9
HCPCS,M1107,Docu dx degen neuro,,,10.69,2739849.3,9
HCPCS,M1108,Oc ni pt home prog,,,10.69,2739849.3,9
HCPCS,M1109,Oc ni pt dc,,,10.69,2739849.3,9
HCPCS,M1110,Oc not p pt selfdc,,,10.69,2739849.3,9
HCPCS,M1111,Start eoc doc med rec,,,10.69,2739849.3,9
HCPCS,M1112,Docu dx degen neuro,,,10.69,2739849.3,9
HCPCS,M1113,Oc ni pt home prog,,,10.69,2739849.3,9
HCPCS,M1114,Oc ni pt dc,,,10.69,2739849.3,9
HCPCS,M1115,Oc ni pt selfdc,,,10.69,2739849.3,9
HCPCS,M1116,Start eoc doc med rec,,,10.69,2739849.3,9
HCPCS,M1117,Docu dx degen neuro,,,10.69,2739849.3,9
HCPCS,M1118,Oc ni pt home prog,,,10.69,2739849.3,9
HCPCS,M1119,Oc ni pt dc,,,10.69,2739849.3,9
HCPCS,M1120,Oc ni pt selfdc,,,10.69,2739849.3,9
HCPCS,M1121,Start eoc doc med rec,,,10.69,2739849.3,9
HCPCS,M1122,Docu dx degen neuro,,,10.69,2739849.3,9
HCPCS,M1123,Oc ni pt home prog,,,10.69,2739849.3,9
HCPCS,M1124,Oc ni pt dc 1-2 vis,,,10.69,2739849.3,9
HCPCS,M1125,Oc ni pt selfdc 1-2 vis,,,10.69,2739849.3,9
HCPCS,M1126,Start eoc doc med rec,,,10.69,2739849.3,9
HCPCS,M1127,Docu dx degen neuro,,,10.69,2739849.3,9
HCPCS,M1128,Oc ni pt home prog,,,10.69,2739849.3,9
HCPCS,M1129,Oc ni pt dc,,,10.69,2739849.3,9
HCPCS,M1130,Oc ni pt selfdc,,,10.69,2739849.3,9
HCPCS,M1131,Docu dx degen neuro,,,10.69,2739849.3,9
HCPCS,M1132,Oc ni pt home prog,,,10.69,2739849.3,9
HCPCS,M1133,Oc ni pt dc,,,10.69,2739849.3,9
HCPCS,M1134,Oc ni pt selfdc,,,10.69,2739849.3,9
HCPCS,M1135,Start eoc doc med rec,,,10.69,2739849.3,9
HCPCS,M1136,Start eoc doc med rec,,,10.69,12.38,8
HCPCS,M1137,Docu dx degen neuro,,,10.69,12.38,8
HCPCS,M1138,Oc ni pt 1-2 vis,,,10.69,12.38,8
HCPCS,M1139,Oc ni pt self dc 1-2 vis,,,10.69,12.38,8
HCPCS,M1140,Oc ni pt dc 1-2 vis,,,10.69,12.38,8
HCPCS,M1141,Fs no oks,,,10.69,2739849.3,9
HCPCS,M1142,Emerge cases,,,10.69,2739849.3,9
HCPCS,M1143,Ni rehab med chiro,,,10.69,2739849.3,9
HCPCS,M1144,Oc no ind pt 1-2 vis,,,10.69,12.38,8
HCPCS,M1145,"Mfn drug add-on, per dose",,,10.69,12.38,8
HCPCS,M1146,Ongoing care not ind,,,10.69,2739849.3,9
HCPCS,M1147,Care not poss med rsn,,,10.69,2739849.3,9
HCPCS,M1148,Pt self dschg,,,10.69,2739849.3,9
HCPCS,M1149,No neck fs prom incap,,,10.69,2739849.3,9
HCPCS,M1150,Lvef <=40% or mod/sev l vsf,,,10.69,2739849.3,9
HCPCS,M1151,Pt w/ hx trnsplt or lvad,,,10.69,2739849.3,9
HCPCS,M1152,Pt w/ hx trnsplt or lvad,,,10.69,2739849.3,9
HCPCS,M1153,Pt w/ dx osteo doe,,,10.69,2739849.3,9
HCPCS,M1154,Hospc serv dur meas pd,,,10.69,2739849.3,9
HCPCS,M1155,Pt anphx due to pneum,,,10.69,2739849.3,9
HCPCS,M1156,Pt recd actv chemo any time,,,10.69,12.38,8
HCPCS,M1157,Pt recd bone mar trnsplt,,,10.69,12.38,8
HCPCS,M1158,Pt hx immcomp prior/dur pd,,,10.69,12.38,8
HCPCS,M1159,Hospc serv dur meas pd,,,10.69,2739849.3,9
HCPCS,M1160,Pt anphx due to mengb bef 13,,,10.69,2739849.3,9
HCPCS,M1161,Pt anphx due to dtp bef 13,,,10.69,2739849.3,9
HCPCS,M1162,Pt enceph due to dtp bef 13,,,10.69,2739849.3,9
HCPCS,M1163,Pt anphx due to hpv bef 13,,,10.69,2739849.3,9
HCPCS,M1164,Pt w/ dementia any time,,,10.69,2739849.3,9
HCPCS,M1165,Pt use hspc dur meas pd,,,10.69,2739849.3,9
HCPCS,M1166,Path rpt tis spec wle/reexc,,,10.69,2739849.3,9
HCPCS,M1167,Hspc dur meas pd,,,10.69,2739849.3,9
HCPCS,M1168,Pt recd flu vax 7/1-6/30,,,10.69,2739849.3,9
HCPCS,M1169,Doc med rsn no flu vax,,,10.69,2739849.3,9
HCPCS,M1170,Pt w/o flu vax 7/1-6/30,,,10.69,2739849.3,9
HCPCS,M1171,Pt recd 1 td/tdap 9yrs prior,,,10.69,2739849.3,9
HCPCS,M1172,Doc med rsn no td/tdap,,,10.69,2739849.3,9
HCPCS,M1173,Pt no rec td/tdap 9yrs prior,,,10.69,2739849.3,9
HCPCS,M1174,Pt w/ 2 hzv 10/2017 - mp,,,10.69,2739849.3,9
HCPCS,M1175,Doc med rsn no hzv,,,10.69,2739849.3,9
HCPCS,M1176,No 2 hzv 10/2017-meas pd,,,10.69,2739849.3,9
HCPCS,M1177,Pt recd pcv on/aft 19,,,10.69,2739849.3,9
HCPCS,M1178,Doc med rsn no pcv,,,10.69,2739849.3,9
HCPCS,M1179,No pcv recd,,,10.69,2739849.3,9
HCPCS,M1180,Pt imm ckpt inhib therapy,,,10.69,2739849.3,9
HCPCS,M1181,Gr 2 or> dia or gr2 or> col,,,10.69,2739849.3,9
HCPCS,M1182,Not elg pre ex ibd/uc/crohn,,,10.69,2739849.3,9
HCPCS,M1183,Doc imm ckpt inhib hld,,,10.69,2739849.3,9
HCPCS,M1184,Doc med rsn no cst/ist rx,,,10.69,2739849.3,9
HCPCS,M1185,Imm ckpt inhib not hld no rx,,,10.69,2739849.3,9
HCPCS,M1186,Pt w/ rx for hspc/plltv care,,,10.69,2739849.3,9
HCPCS,M1187,Pt w/ esrd,,,10.69,2739849.3,9
HCPCS,M1188,Pt w/ ckd stg 5,,,10.69,2739849.3,9
HCPCS,M1189,Doc khe pef w/efgr/uacr,,,10.69,2739849.3,9
HCPCS,M1190,Doc khe not pef w/efgr/uacr,,,10.69,2739849.3,9
HCPCS,M1191,Hspc svc any time in meas pd,,,10.69,2739849.3,9
HCPCS,M1192,Pt w/ dx sq cell ca of esoph,,,10.69,2739849.3,9
HCPCS,M1193,Rpts w/ imp/con mmr/msi,,,10.69,2739849.3,9
HCPCS,M1194,Med rsn no imp/con mmr/msi,,,10.69,2739849.3,9
HCPCS,M1195,Rpt wo imp/con mmr/msi,,,10.69,2739849.3,9
HCPCS,M1196,Ixv nrs vrs iqa >=4,,,10.69,2739849.3,9
HCPCS,M1197,Isa reduced >=3 fr ixv,,,10.69,2739849.3,9
HCPCS,M1198,Isa not red 3pts /no assess,,,10.69,2739849.3,9
HCPCS,M1199,Pt rec'g rrt,,,10.69,2739849.3,9
HCPCS,M1200,Ace-i/arb rx,,,10.69,2739849.3,9
HCPCS,M1201,Med rsn no ace-i/arb rx,,,10.69,2739849.3,9
HCPCS,M1202,Pt rsn no ace-i/arb rx,,,10.69,2739849.3,9
HCPCS,M1203,No rsn ace-i/arb rx,,,10.69,2739849.3,9
HCPCS,M1204,Ixv nrs vrs iqa >=4,,,10.69,2739849.3,9
HCPCS,M1205,Isa reduced >=3,,,10.69,2739849.3,9
HCPCS,M1206,Isa not red 3pts/no assess,,,10.69,2739849.3,9
HCPCS,M1207,Pt scrn sdoh,,,10.69,2739849.3,9
HCPCS,M1208,Pt no scrn sdoh,,,10.69,2739849.3,9
HCPCS,M1209,>=2 same hi-rsk med w/o diag,,,10.69,2739849.3,9
HCPCS,M1210,>=2 same meds tbl4 not ord,,,10.69,2739849.3,9
HCPCS,M1211,Gsa level>9.0%,,,10.69,2739849.3,9
HCPCS,M1212,Missing gsa not perf,,,10.69,2739849.3,9
HCPCS,M1213,No hx spiro prs spiro>=70%,,,10.69,2739849.3,9
HCPCS,M1214,Spiro results wth obs doc,,,10.69,2739849.3,9
HCPCS,M1215,Med rsn for no doc spiro,,,10.69,2739849.3,9
HCPCS,M1216,No spiro doc no res doc,,,10.69,2739849.3,9
HCPCS,M1217,Sys rsn no doc spiro,,,10.69,2739849.3,9
HCPCS,M1218,Pt copd symptoms,,,10.69,2739849.3,9
HCPCS,M1219,Anphx due to vax,,,10.69,2739849.3,9
HCPCS,M1220,Dre wth interp rtnopthy,,,10.69,2739849.3,9
HCPCS,M1221,Dre w/o rtnopthy,,,10.69,2739849.3,9
HCPCS,M1222,Glaucoma pln of care not doc,,,10.69,2739849.3,9
HCPCS,M1223,Glaucoma plan of care doc,,,10.69,2739849.3,9
HCPCS,M1224,Iop dec <20% from base,,,10.69,2739849.3,9
HCPCS,M1225,Iop dec>=20% from base,,,10.69,2739849.3,9
HCPCS,M1226,Iop not doc,,,10.69,2739849.3,9
HCPCS,M1227,Eb therapy prescribed,,,10.69,2739849.3,9
HCPCS,M1228,Pt + hcv aby +vir w/ rx 3 mo,,,10.69,2739849.3,9
HCPCS,M1229,Pt w/ +hcv +vir ref win 1 mo,,,10.69,2739849.3,9
HCPCS,M1230,Pt hcv rctv aby no f/u tst,,,10.69,2739849.3,9
HCPCS,M1231,Pt hcv tst no reactive res,,,10.69,2739849.3,9
HCPCS,M1232,Pt hcv tst reactive result,,,10.69,2739849.3,9
HCPCS,M1233,Pt no hcv aby or result,,,10.69,2739849.3,9
HCPCS,M1234,Pt hcv rctv aby f/u neg,,,10.69,2739849.3,9
HCPCS,M1235,Doc pt hcv aby rna tst,,,10.69,2739849.3,9
HCPCS,M1236,Baseline mrs > 2,,,10.69,2739849.3,9
HCPCS,M1237,Pt rsn no scrn,,,10.69,2739849.3,9
HCPCS,M1238,Doc 2nd recom hzv 2-6 mo int,,,10.69,2739849.3,9
HCPCS,M1239,Pt no resp heard,,,10.69,2739849.3,9
HCPCS,M1240,Pt no resp best int,,,10.69,2739849.3,9
HCPCS,M1241,Pt no resp seen as person,,,10.69,2739849.3,9
HCPCS,M1242,Pt no resp imprt to me,,,10.69,2739849.3,9
HCPCS,M1243,Pt othr thn true heard,,,10.69,2739849.3,9
HCPCS,M1244,Pt othr thn true best int,,,10.69,2739849.3,9
HCPCS,M1245,Pt othr thn true person,,,10.69,2739849.3,9
HCPCS,M1246,Pt othr thn true imprt to me,,,10.69,2739849.3,9
HCPCS,M1247,Pt resp true best int,,,10.69,2739849.3,9
HCPCS,M1248,Pt resp true seen as person,,,10.69,2739849.3,9
HCPCS,M1249,Pt resp true imprt to me,,,10.69,2739849.3,9
HCPCS,M1250,Pt resp true heard,,,10.69,2739849.3,9
HCPCS,M1251,Pts proxy cmplt hu surv,,,10.69,2739849.3,9
HCPCS,M1252,Pts no cmplt hu survey,,,10.69,2739849.3,9
HCPCS,M1253,Pts hu surv no amb plltv,,,10.69,2739849.3,9
HCPCS,M1254,Pts deceased prior hu surv,,,10.69,2739849.3,9
HCPCS,M1255,"Pts w/ othr rsn vst,+prg tst",,,10.69,2739849.3,9
HCPCS,M1256,Prior history of known cvd,,,10.69,2739849.3,9
HCPCS,M1257,Cvd risk assess not perf,,,10.69,2739849.3,9
HCPCS,M1258,Cvd risk assess perf,,,10.69,2739849.3,9
HCPCS,M1259,Pt stat doc <= 1 yr dialysis,,,10.69,2739849.3,9
HCPCS,M1260,Pt not doc <= 1 yr dialysis,,,10.69,2739849.3,9
HCPCS,M1261,Pts on wtlist bef dialysis,,,10.69,2739849.3,9
HCPCS,M1262,Pts transplt bef dialysis,,,10.69,2739849.3,9
HCPCS,M1263,Pts hosp dialysis dt,,,10.69,2739849.3,9
HCPCS,M1264,Pts 75+ dialysis dt,,,10.69,2739849.3,9
HCPCS,M1265,Cms 2728 completed,,,10.69,2739849.3,9
HCPCS,M1266,Pts admit snf,,,10.69,2739849.3,9
HCPCS,M1267,Pt no act kid transplt wtlst,,,10.69,2739849.3,9
HCPCS,M1268,Pt ac stat kid trnsplt wtlst,,,10.69,2739849.3,9
HCPCS,M1269,Rec'd esrd mcp lst day of mo,,,10.69,2739849.3,9
HCPCS,M1270,Pts no kid transplt wtlst,,,10.69,2739849.3,9
HCPCS,M1271,Pts dem any time/dur mo,,,10.69,2739849.3,9
HCPCS,M1272,Pts kid transplt wtlst,,,10.69,2739849.3,9
HCPCS,M1273,Pts snf 1 yr dialysis,,,10.69,2739849.3,9
HCPCS,M1274,Pts snf exl mo,,,10.69,2739849.3,9
HCPCS,M1275,Pts hosp exl,,,10.69,2739849.3,9
HCPCS,M1276,Calc bmi out nrm param nof/u,,,10.69,2739849.3,9
HCPCS,M1277,Colorectal ca screen doc rev,,,10.69,2739849.3,9
HCPCS,M1278,"Pre-htn or htn doc, f/u indc",,,10.69,2739849.3,9
HCPCS,M1279,"Pre-htn/htn, no f/u, not gvn",,,10.69,2739849.3,9
HCPCS,M1280,Bilat mast/hx bi /unilat mas,,,10.69,2739849.3,9
HCPCS,M1281,Bp scrn no perf at interval,,,10.69,2739849.3,9
HCPCS,M1282,Pt scrn tbco id as non user,,,10.69,2739849.3,9
HCPCS,M1283,Pt scrn tbco and id as user,,,10.69,2739849.3,9
HCPCS,M1284,Pt 66+ snp or ltc pos > 90d,,,10.69,2739849.3,9
HCPCS,M1285,Scrn mam perf rslts not doc,,,10.69,2739849.3,9
HCPCS,M1286,Bmi doc onl fup not cmpltd,,,10.69,2739849.3,9
HCPCS,M1287,Calc bmi blw low param f/u,,,10.69,2739849.3,9
HCPCS,M1288,Doc rsn no hbp scrn or f/u,,,10.69,2739849.3,9
HCPCS,M1289,No pt tbco cess interv rng,,,10.69,2739849.3,9
HCPCS,M1290,Pt not eli d/t act dig htn,,,10.69,2739849.3,9
HCPCS,M1291,Pt 66+ frailty and med dem,,,10.69,2739849.3,9
HCPCS,M1292,Pt 66+ frail inpt adv ill,,,10.69,2739849.3,9
HCPCS,M1293,Calc bmi abv up param f/u,,,10.69,2739849.3,9
HCPCS,M1294,Bp scrn perf rec interval,,,10.69,2739849.3,9
HCPCS,M1295,Pt hx tot col or colon ca,,,10.69,2739849.3,9
HCPCS,M1296,Calc bmi norm parameters,,,10.69,2739849.3,9
HCPCS,M1297,Bmi not doc medrsn ptref,,,10.69,2739849.3,9
HCPCS,M1298,Doc pt preg dur msrmt pd,,,10.69,2739849.3,9
HCPCS,M1299,Flu immunize order/admin,,,10.69,2739849.3,9
HCPCS,M1300,Flu imm no admin doc rea,,,10.69,2739849.3,9
HCPCS,M1301,Pt recv tbco cess interv,,,10.69,2739849.3,9
HCPCS,M1302,Scrn mam perf rslts doc,,,10.69,2739849.3,9
HCPCS,M1303,Hospc serv dur meas pd,,,10.69,2739849.3,9
HCPCS,M1304,No pneum vax admin 19+,,,10.69,2739849.3,9
HCPCS,M1305,Pneum vax admin 19+,,,10.69,2739849.3,9
HCPCS,M1306,Pt anphx due to pneum,,,10.69,2739849.3,9
HCPCS,M1307,Doc pt pal or hospice,,,10.69,2739849.3,9
HCPCS,M1308,Flu immunize no admin,,,10.69,2739849.3,9
HCPCS,M1309,Pall serv during meas,,,10.69,2739849.3,9
HCPCS,M1310,Pt scr tob & cess int,,,10.69,2739849.3,9
HCPCS,M1311,Aphlx to vax bef enc,,,10.69,2739849.3,9
HCPCS,M1312,No pt tbco scrn rng,,,10.69,2739849.3,9
HCPCS,M1313,No tob scr/cess int,,,10.69,2739849.3,9
HCPCS,M1314,Bmi not calculated,,,10.69,2739849.3,9
HCPCS,M1315,Crc no doc no rsn,,,10.69,2739849.3,9
HCPCS,M1316,Tobacco non-user,,,10.69,2739849.3,9
HCPCS,M1317,Pts counsl cpt opt out,,,10.69,2739849.3,9
HCPCS,M1318,Pts no csp doc contact,,,10.69,2739849.3,9
HCPCS,M1319,Pts csp doc contact,,,10.69,2739849.3,9
HCPCS,M1320,Pts scrn + hrsn,,,10.69,2739849.3,9
HCPCS,M1321,"Pts no 7wk inj,no iop,iop>25",,,10.69,2739849.3,9
HCPCS,M1322,"Pts 7wk inj, scrn iop =<25",,,10.69,2739849.3,9
HCPCS,M1323,"Pts 7wk inj, scrn iop >25",,,10.69,2739849.3,9
HCPCS,M1324,Pts intravitreal/pci,,,10.69,2739849.3,9
HCPCS,M1325,Doc med rsn not seen,,,10.69,2739849.3,9
HCPCS,M1326,Pts dx hypotony,,,10.69,2739849.3,9
HCPCS,M1327,Pts no eval ini xm no 8 wks,,,10.69,2739849.3,9
HCPCS,M1328,Pts dx acute vitreous hem,,,10.69,2739849.3,9
HCPCS,M1329,Pts act pvd 2 wks 8 wks,,,10.69,2739849.3,9
HCPCS,M1330,Doc pts rsn no f/u xm,,,10.69,2739849.3,9
HCPCS,M1331,Pts eval ini xm 8 wks,,,10.69,2739849.3,9
HCPCS,M1332,Pts no eval ini xm no 2 wks,,,10.69,2739849.3,9
HCPCS,M1333,Acute vitreous hemorrhage,,,10.69,2739849.3,9
HCPCS,M1334,Pts act pvd 2 wks 2 wks,,,10.69,2739849.3,9
HCPCS,M1335,Doc pts rsn no f/u xm,,,10.69,2739849.3,9
HCPCS,M1336,Pts eval ini xm 2 wks,,,10.69,2739849.3,9
HCPCS,M1337,Acute pvd,,,10.69,2739849.3,9
HCPCS,M1338,Pt f/u 30-180 dys no + imprv,,,10.69,2739849.3,9
HCPCS,M1339,Pts f/u 30-180 dys + improv,,,10.69,2739849.3,9
HCPCS,M1340,Indx whodas 2.0 or sds,,,10.69,2739849.3,9
HCPCS,M1341,Pt no f/u 30-180 dys,,,10.69,2739849.3,9
HCPCS,M1342,Pts died perf per,,,10.69,2739849.3,9
HCPCS,M1343,Pt pam lvl 4 base or srt lin,,,10.69,2739849.3,9
HCPCS,M1344,No bsln/2nd pam score 4-12mo,,,10.69,2739849.3,9
HCPCS,M1345,"Pt bsln pam, 2nd scr 4-12 mo",,,10.69,2739849.3,9
HCPCS,M1346,No pam inc 6 pts 4-12 mo,,,10.69,2739849.3,9
HCPCS,M1347,Pt pam incr 3 pt 4-12 mo,,,10.69,2739849.3,9
HCPCS,M1348,Pam incr 6 pt 4-12 mo,,,10.69,2739849.3,9
HCPCS,M1349,No pam inc 3 pts 4-12 mo,,,10.69,2739849.3,9
HCPCS,M1350,Pt w/ suic saf pln init rev,,,10.69,2739849.3,9
HCPCS,M1351,Pt cmplt suicd saf pln 120dy,,,10.69,2739849.3,9
HCPCS,M1352,"Suicd c-ssrs assessment, equ",,,10.69,2739849.3,9
HCPCS,M1353,Pts no cmplt suicd saf pln,,,10.69,2739849.3,9
HCPCS,M1354,Pt no suicd saf pln 120dy,,,10.69,2739849.3,9
HCPCS,M1355,Suicd based cln eval,,,10.69,2739849.3,9
HCPCS,M1356,Pt died dur meas pd,,,10.69,2739849.3,9
HCPCS,M1357,Pt w/red suic idea 120 days,,,10.69,2739849.3,9
HCPCS,M1358,Pts no <suicd idea 120 dys,,,10.69,2739849.3,9
HCPCS,M1359,"Indx suicd idea, no 0 scr",,,10.69,2739849.3,9
HCPCS,M1360,Suicd c-ssrs assessment,,,10.69,2739849.3,9
HCPCS,M1361,Suicd based cln eval,,,10.69,2739849.3,9
HCPCS,M1362,Pt died dur meas pd,,,10.69,2739849.3,9
HCPCS,M1363,Pts no f/u 120 dys,,,10.69,2739849.3,9
HCPCS,M1364,Ascvd risk >=20pct,,,10.69,2739849.3,9
HCPCS,M1365,Hosp+pall care spec code 17,,,10.69,2739849.3,9
HCPCS,M1366,Focus on women's health mvp,,,10.69,2739849.3,9
HCPCS,M1367,Qual care ent disorder mvp,,,10.69,2739849.3,9
HCPCS,M1368,Prev trt inf d/o hiv/hep mvp,,,10.69,2739849.3,9
HCPCS,M1369,Qualcare mental hlth/sud mvp,,,10.69,2739849.3,9
HCPCS,M1370,Rehab support msk care mvp,,,10.69,2739849.3,9
HCPCS,M1371,Mst rec gsa<7,,,10.69,12.38,8
HCPCS,M1372,Mst rec gsa >=7 and<8,,,10.69,12.38,8
HCPCS,M1373,Mst rec gsa >=8 and <=9,,,10.69,12.38,8
HCPCS,M1374,Ra dx enc 90 days dur per pd,,,10.69,12.38,8
HCPCS,M1375,Ra dx enc 90 days dur per pd,,,10.69,12.38,8
HCPCS,M1376,Ra dx enc 90 days dur per pd,,,10.69,12.38,8
HCPCS,M1377,Fu colscop 10 yr doc w/ disc,,,10.69,12.38,8
HCPCS,M1378,Med rsn no 10 yr fu colscope,,,10.69,12.38,8
HCPCS,M1379,10 yr fu no rec rsn not giv,,,10.69,12.38,8
HCPCS,M1380,2 rx in perf pd any com meds,,,10.69,12.38,8
HCPCS,M1381,Pt sec strk wthin 5 days,,,10.69,12.38,8
HCPCS,M1382,Enc dur perf pd pos 11,,,10.69,12.38,8
HCPCS,M1383,Acute pvd,,,10.69,12.38,8
HCPCS,M1384,Pt died dur perf pd,,,10.69,12.38,8
HCPCS,M1385,Pt rsn not seen 2nd pam,,,10.69,12.38,8
HCPCS,M1386,Exc sx melmn or mlnm is,,,10.69,12.38,8
HCPCS,M1387,Pt died dur perf pd,,,10.69,12.38,8
HCPCS,M1388,Pt doc exm rec melmn,,,10.69,12.38,8
HCPCS,M1390,Pt no doc exm for rec,,,10.69,12.38,8
HCPCS,M1391,All pt dx w/ rec mlnm,,,10.69,12.38,8
HCPCS,M1392,Pt rsn no exm or lst to fu,,,10.69,12.38,8
HCPCS,M1393,Pr no dx rec mlnm,,,10.69,12.38,8
HCPCS,M1394,Stg i-iii br ca,,,10.69,12.38,8
HCPCS,M1395,Init chemo w/def dur ec grp,,,10.69,12.38,8
HCPCS,M1396,Pt ther clin trial,,,10.69,12.38,8
HCPCS,M1397,Pt w/ recur/prog,,,10.69,12.38,8
HCPCS,M1398,Bslne and fu promis doc,,,10.69,12.38,8
HCPCS,M1399,Pt lve prac,,,10.69,12.38,8
HCPCS,M1400,Pt died dur perf pd,,,10.69,12.38,8
HCPCS,M1401,Stg i-iii br ca,,,10.69,12.38,8
HCPCS,M1402,Init chemo w/def dur ec grp,,,10.69,12.38,8
HCPCS,M1403,Bslne and fu promis doc,,,10.69,12.38,8
HCPCS,M1404,Pt ther clin trial,,,10.69,12.38,8
HCPCS,M1405,Pt w/ recur/prog,,,10.69,12.38,8
HCPCS,M1406,Pt lve prac,,,10.69,12.38,8
HCPCS,M1407,Pt died dur perf pd,,,10.69,12.38,8
HCPCS,M1408,Gmln brca bef dx ca,,,10.69,12.38,8
HCPCS,M1409,Recd gmln brca1/brca2 couns,,,10.69,12.38,8
HCPCS,M1410,No gmln brca1/brca2 couns,,,10.69,12.38,8
HCPCS,M1411,1st ln ici no chemo,,,10.69,12.38,8
HCPCS,M1412,Met nsclc w/ egfr alk oth ab,,,10.69,12.38,8
HCPCS,M1413,Pos pdl1 bef init ici tx,,,10.69,12.38,8
HCPCS,M1414,Med rsn no pdl1 bef 1st ther,,,10.69,12.38,8
HCPCS,M1415,No pos pdl1 bef ici ther,,,10.69,12.38,8
HCPCS,M1416,Pt rec hosp,,,10.69,12.38,8
HCPCS,M1417,Pt up to date cov,,,10.69,12.38,8
HCPCS,M1418,Med rsn not up to date cov,,,10.69,12.38,8
HCPCS,M1419,Pt not up to date cov,,,10.69,12.38,8
HCPCS,M1420,Complete ophthalmologic mvp,,,10.69,12.38,8
HCPCS,M1421,Dermatological care mvp,,,10.69,12.38,8
HCPCS,M1422,Gastroenterology care mvp,,,10.69,12.38,8
HCPCS,M1423,Opt care urologic cnd mvp,,,10.69,12.38,8
HCPCS,M1424,Pulmonology care mvp,,,10.69,12.38,8
HCPCS,M1425,Surgical care mvp,,,10.69,12.38,8
HCPCS,M1426,Telehealth enc,,,10.69,12.38,8
HCPCS,M1427,Doc med rsn bone scn,,,10.69,12.38,8
HCPCS,M1428,Bilateral absence of eyes,,,10.69,12.38,8
HCPCS,M1429,"Retinopathy in od, os, ou",,,10.69,12.38,8
HCPCS,M1430,Ret exm ou no retinopthy doc,,,10.69,12.38,8
HCPCS,M1431,Telehealth enc,,,10.69,12.38,8
HCPCS,M1432,Telehealth enc,,,10.69,12.38,8
HCPCS,M1433,Oral chemo wthn 30 days enc,,,10.69,12.38,8
HCPCS,M1434,Orl chemo wthn 30 d post enc,,,10.69,12.38,8
HCPCS,M1435,Oral chemo in perf pd,,,10.69,12.38,8
HCPCS,M1436,Telehealth enc,,,10.69,12.38,8
HCPCS,M1437,Telehealth enc,,,10.69,12.38,8
HCPCS,M1438,Lst knwn well <=210 min,,,10.69,12.38,8
HCPCS,M1439,Sig ocu cond imp surg out,,,10.69,12.38,8
HCPCS,M1440,Telehealth enc,,,10.69,12.38,8
HCPCS,M1441,Init dx slp apn = 1st enc,,,10.69,12.38,8
HCPCS,M1442,Telehealth enc,,,10.69,12.38,8
HCPCS,M1443,Telehealth enc,,,10.69,12.38,8
HCPCS,M1444,Del < 39 weeks gest,,,10.69,12.38,8
HCPCS,M1445,Pp care visit by 12 weeks,,,10.69,12.38,8
HCPCS,M1446,Pt died bef end meas pd,,,10.69,12.38,8
HCPCS,M1447,Pt dx bd bef end meas pd,,,10.69,12.38,8
HCPCS,M1448,Pt dx pd bef end meas pd,,,10.69,12.38,8
HCPCS,M1449,Pt dx scz/pys bef end msr pd,,,10.69,12.38,8
HCPCS,M1450,Pt hos/pal care dur id/pf pd,,,10.69,12.38,8
HCPCS,M1451,Pt dx ppd dur id/pf pd,,,10.69,12.38,8
HCPCS,M1452,Pt dx dementia ever,,,10.69,12.38,8
HCPCS,M1453,Preop vis acu > 20/40,,,10.69,12.38,8
HCPCS,M1454,New cied,,,10.69,12.38,8
HCPCS,M1455,Rep/rev cied,,,10.69,12.38,8
HCPCS,M1456,Pt had htx,,,10.69,12.38,8
HCPCS,M1457,Dx asth dur crnt/prv perf pd,,,10.69,12.38,8
HCPCS,M1458,Pt died bef end meas pd,,,10.69,12.38,8
HCPCS,M1459,Pt hosp/pal care dur perf pd,,,10.69,12.38,8
HCPCS,M1460,"Dx copd, cf, or arf",,,10.69,12.38,8
HCPCS,M1461,Pt dx chron hepc,,,10.69,12.38,8
HCPCS,M1462,Pt clin ind hd image,,,10.69,12.38,8
HCPCS,M1463,2 f/u wthn 180 day rx atmp,,,10.69,12.38,8
HCPCS,M1464,No record of f/u by 180 days,,,10.69,12.38,8
HCPCS,M1465,F/u > 180 days after rx,,,10.69,12.38,8
HCPCS,M1466,Pt disc/lam proc same day,,,10.69,12.38,8
HCPCS,M1467,Pt dx lynch syn,,,10.69,12.38,8
HCPCS,M1468,Hep b vaccine received,,,10.69,12.38,8
HCPCS,M1469,"Hx of hep b, or pos bld test",,,10.69,12.38,8
HCPCS,M1470,Hep b vac not rec'd med rsn,,,10.69,12.38,8
HCPCS,M1471,Ffs hep b not covered,,,10.69,12.38,8
HCPCS,M1472,Hep b vaccine not received,,,10.69,12.38,8
HCPCS,M1473,Pt func cap not allow impr,,,10.69,12.38,8
HCPCS,M1474,Pt dx dementia,,,10.69,12.38,8
HCPCS,M1475,Pt dx huntington,,,10.69,12.38,8
HCPCS,M1476,Pt dx cog imp or ad,,,10.69,12.38,8
HCPCS,M1477,Dx delirium,,,10.69,12.38,8
HCPCS,M1478,Psychoactive sub abuse,,,10.69,12.38,8
HCPCS,M1479,Pt func cap not allow impr,,,10.69,12.38,8
HCPCS,M1480,Pt func cap not allow impr,,,10.69,12.38,8
HCPCS,M1481,Pt in hosp/pal care who died,,,10.69,12.38,8
HCPCS,M1482,Pos quan hep c or qual rna,,,10.69,12.38,8
HCPCS,M1483,Neg quan hep c or qual rna,,,10.69,12.38,8
HCPCS,M1484,No rpt hcv rna perf med rsn,,,10.69,12.38,8
HCPCS,M1485,Neg viro resp hep c/qual rna,,,10.69,12.38,8
HCPCS,M1486,Pt admitted to snf dur eval,,,10.69,12.38,8
HCPCS,M1487,Pt adm to hospice dur eval,,,10.69,12.38,8
HCPCS,M1488,Dx dementia in msr timeframe,,,10.69,12.38,8
HCPCS,M1489,Pt status doc,,,10.69,12.38,8
HCPCS,M1490,Pt status not doc,,,10.69,12.38,8
HCPCS,M1491,Rec'd esrd mcp dur perf pd,,,10.69,12.38,8
HCPCS,M1492,No reported fall,,,10.69,12.38,8
HCPCS,M1493,No fall doc med rsn,,,10.69,12.38,8
HCPCS,M1494,Fall rep since last visit,,,10.69,12.38,8
HCPCS,M1495,"Fall w/ poc, no fall",,,10.69,12.38,8
HCPCS,M1496,No doc of fall or poc,,,10.69,12.38,8
HCPCS,M1497,No doc fall med rsn,,,10.69,12.38,8
HCPCS,M1498,Diagnostic radiology mvp,,,10.69,12.38,8
HCPCS,M1499,Interventional radiology mvp,,,10.69,12.38,8
HCPCS,M1500,Neuropsychology mvp,,,10.69,12.38,8
HCPCS,M1501,Pathology mvp,,,10.69,12.38,8
HCPCS,M1502,Podiatry mvp,,,10.69,12.38,8
HCPCS,M1503,Vascular surgery mvp,,,10.69,12.38,8
HCPCS,OITMIX,OIT MIXING FEE,100.0,65.0,1.1,100.0,68
HCPCS,P2028,Cephalin floculation test,,,4.95,35.08,34
HCPCS,P2029,Congo red blood test,,,4.95,35.08,34
HCPCS,P2031,Hair analysis,,,5.54,26.72,15
HCPCS,P2033,Blood thymol turbidity,,,4.95,35.08,34
HCPCS,P2038,Blood mucoprotein,,,4.95,26.72,34
HCPCS,P3000,CYTOLOGY GYN SCREEN,126.0,81.9,15.29,126.0,83
HCPCS,P3001,Screening pap smear by phys,,,15.29,61.05,12
HCPCS,P7001,Culture bacterial urine,,,16.64,2466002.74,12
HCPCS,P9010,WHOLE BLOOD FOR TRANSFUSION,1553.0,1009.45,1.1,2245.86,86
HCPCS,P9010,WHOLE BLOOD TXFUS PER UNIT,1553.0,1009.45,175.8,1553.0,84
HCPCS,P9011,BLOOD SPLIT UNIT,978.0,635.7,1.1,978.0,86
HCPCS,P9011,SPLIT UNIT,978.0,635.7,131.45,978.0,84
HCPCS,P9012,CRYOPRECIPITATE EA UNIT,439.0,285.35,1.1,439.0,164
HCPCS,P9016,"LEUKOCYTE POOR BLOOD, UNIT",1256.0,816.4,1.1,1256.0,80
HCPCS,P9016,RBC LR EA UNIT,1256.0,816.4,164.64,1256.0,84
HCPCS,P9017,FFP SNGL DONOR WITHIN 8 HR,582.0,378.3,72.81,582.0,84
HCPCS,P9017,ONE DONOR FRESH FROZN PLASMA,582.0,378.3,1.1,582.0,80
HCPCS,P9019,PLATELET CONCENTRATE UNIT,524.0,340.6,1.1,1727.59,80
HCPCS,P9019,"Platelets, each unit",,,49.24,242.09,29
HCPCS,P9020,PLAELET RICH PLASMA UNIT,3846.0,2499.9,1.1,3846.0,80
HCPCS,P9020,PLATELET RICH PLASMA UNIT,3846.0,2499.9,209.08,3846.0,84
HCPCS,P9021,RBC EA UNIT,996.0,647.4,124.3,996.0,84
HCPCS,P9021,RED BLOOD CELLS UNIT,996.0,647.4,1.1,2245.86,80
HCPCS,P9022,RED CELLS WASHED EA UNIT,2738.0,1779.7,341.31,2738.0,84
HCPCS,P9022,WASHED RED BLOOD CELLS UNIT,2738.0,1779.7,1.1,2738.0,80
HCPCS,P9023,"Frozen plasma, pooled, sd",,,1.82,242.09,32
HCPCS,P902300,"Frozen plasma, pooled, sd",,,1.82,2.33,3
HCPCS,P9025,Plasma cryo redu path each,,,123.86,848.47,29
HCPCS,P9026,Cryo fib comp path redu each,,,72.23,559.51,29
HCPCS,P9027,Rbc o2 co2 reduced,,,209.08,521.12,27
HCPCS,P9031,PLATELETS LEUKOCYTES REDUCED,868.0,564.2,1.1,868.0,80
HCPCS,P9031,PLT LR EA UNIT,868.0,564.2,116.59,868.0,84
HCPCS,P9032,PLATELETS IRRADIATED EA UNIT,937.0,609.05,121.43,937.0,84
HCPCS,P9032,"PLATELETS, IRRADIATED",937.0,609.05,1.1,937.0,80
HCPCS,P9033,PLATELETS LEUKORED IRRAD EA UNIT,1417.0,921.05,175.56,1417.0,84
HCPCS,P9033,PLATELETS LEUKOREDUCED IRRAD,1417.0,921.05,1.1,1417.0,80
HCPCS,P9034,"PLATELETS, PHERESIS",2740.0,1781.0,1.1,2740.0,80
HCPCS,P9034,PLTS PHERESIS PER UNIT,2740.0,1781.0,286.1,2740.0,84
HCPCS,P9035,PLATELET PHERES LEUKOREDUCED,3361.0,2184.65,1.1,3361.0,80
HCPCS,P9035,PLT PHERESIS LR EA UNIT,3361.0,2184.65,342.99,3361.0,84
HCPCS,P9036,PLATELET PHERESIS IRRAD EA UNIT,4055.0,2635.75,342.99,4055.0,84
HCPCS,P9036,PLATELET PHERESIS IRRADIATED,4055.0,2635.75,1.1,4055.0,80
HCPCS,P9037,PLATE PHERES LEUKOREDU IRRAD,4662.0,3030.3,1.1,4662.0,80
HCPCS,P9037,PLTS PHERESIS LEUKOR IRR,4662.0,3030.3,342.99,4662.0,84
HCPCS,P9038,RBC IRRADIATED,1030.0,669.5,1.1,1030.0,80
HCPCS,P9038,RBC IRRADIATED EACH UNIT,1030.0,669.5,134.48,1030.0,84
HCPCS,P9039,RBC DEGLYCEROLIZED,4511.0,2932.15,1.1,4511.0,80
HCPCS,P9039,RED CELL FROZ/THAW 1 UNIT,4511.0,2932.15,209.08,4511.0,84
HCPCS,P9040,RBC LEUKOREDUCED IRRADIATED,1765.0,1147.25,1.1,1765.0,80
HCPCS,P9040,RBC LR IRRAD EA UNIT,1765.0,1147.25,209.08,1765.0,84
HCPCS,P9041,"ALBUMIN (HUMAN),5%, 50ML",73.0,47.45,1.1,107.12,86
HCPCS,P9041,"Albumin (human),5%, 50ml",,,1.33,242.09,34
HCPCS,P904100,"Albumin (human),5%, 50ml",,,18.9,24.21,3
HCPCS,P9043,"Plasma protein fract,5%,50ml",,,7.24,242.09,34
HCPCS,P904300,"Plasma protein fract,5%,50ml",,,48.1,61.61,3
HCPCS,P9044,PLASMA CRYOPRECIPITATE REDUCED EA UNIT,1016.0,660.4,62.96,1016.0,84
HCPCS,P9045,ALBUMIN (HUMAN) 5% 250 ML,366.0,237.9,1.1,366.0,86
HCPCS,P9045,"Albumin (human), 5%, 250 ml",,,6.64,397.14,41
HCPCS,P904500,"Albumin (human), 5%, 250 ml",,,94.48,121.02,3
HCPCS,P9046,"Albumin (human), 25%, 20 ml",,,2.65,242.09,41
HCPCS,P904600,"Albumin (human), 25%, 20 ml",,,37.79,48.4,3
HCPCS,P9047,"ALBUMIN (HUMAN), 25%, 50ML",366.0,237.9,1.1,366.0,86
HCPCS,P9047,"Albumin (human), 25%, 50ml",,,94.48,121.02,3
HCPCS,P9047,INF ALBUMIN 25% 50ML,366.0,237.9,53.07,366.0,86
HCPCS,P904700,"Albumin (human), 25%, 50ml",,,94.48,121.02,3
HCPCS,P9048,"Plasmaprotein fract,5%,250ml",,,32.71,279.59,34
HCPCS,P904800,"Plasmaprotein fract,5%,250ml",,,112.98,144.71,3
HCPCS,P9050,GRANUL LEUK 1U TRANSFUSED,6884.0,4474.6,342.99,6884.0,66
HCPCS,P9050,"GRANULOCYTES, PHERESIS UNIT",6884.0,4474.6,1.1,3060831.65,80
HCPCS,P9051,WH BLD OR RBC L/R CMV NEG EA UNIT,1188.0,772.2,140.37,1188.0,84
HCPCS,P9052,"PLATELETS, HLA-M, L/R, UNIT",5365.0,3487.25,1.1,5365.0,80
HCPCS,P9052,PLTS PHERESIS LEUKOR HLA,5365.0,3487.25,342.99,5365.0,84
HCPCS,P9053,PLT PHER IRR L/R CMV NEG EA UNIT,3169.0,2059.85,342.99,3169.0,84
HCPCS,P9054,"Blood, l/r, froz/degly/wash",,,195.96,589.68,29
HCPCS,P9055,"Plt, aph/pher, l/r, cmv-neg",,,210.67,687.22,29
HCPCS,P9056,"Blood, l/r, irradiated",,,78.03,252.05,29
HCPCS,P9057,RED CELL LEUKOREDUCED DEGLYCEROLIZED IRRADIATED,3349.0,2176.85,209.08,3349.0,84
HCPCS,P9058,RBC L/R IRR CMV NEG EA UNIT,1538.0,999.7,206.6,1538.0,84
HCPCS,P9059,CONVALESCENT PLASMA,491.0,319.15,65.9,491.0,84
HCPCS,P9059,FR FRZ PLASMA FRZN 8-24 HOURS EA UNIT,491.0,319.15,65.9,491.0,84
HCPCS,P9060,FR FRZ PLASMA DONOR RETESTED,338.0,219.7,1.1,338.0,80
HCPCS,P9060,FR FRZ PLASMA DONOR RETESTED EA UNIT,338.0,219.7,45.36,338.0,84
HCPCS,P9070,Pathogen reduced plasma pool,,,28.45,242.09,29
HCPCS,P9071,PLASMA SNGL DONOR PATHOGEN REDUCED FRZN EACH UNIT,2018.0,1311.7,209.08,2018.0,84
HCPCS,P9073,PLT PHER PATH-RED EA,4052.0,2633.8,342.99,4052.0,84
HCPCS,P9099,Blood component/product noc,,,28.45,242.09,29
HCPCS,P9100,PATHOGEN TEST FOR PLTS - LVDS PLTS,410.0,266.5,45.47,410.0,84
HCPCS,P9603,One-way allow prorated miles,,,2.64,3.1,9
HCPCS,P9604,One-way allow prorated trip,,,2.64,30.96,9
HCPCS,P9612,CATH COLL SPEC SNGL PATIENT,63.0,40.95,2.64,3443.0,83
HCPCS,P9612,CATHETERIZATION,63.0,40.95,1.1,63.0,90
HCPCS,P9612,STRAIGHT CATH - SPECIMEN COLLECTION,63.0,40.95,2.64,3443.0,83
HCPCS,P9615,Urine specimen collect mult,,,2.64,9.47,11
HCPCS,PKG6699F,FEMTO LASER NO LENS,1900.0,1235.0,1.1,1900.0,68
HCPCS,PKGA270T,TRULIGN,2900.0,1885.0,1.1,2900.0,68
HCPCS,PKGA270V,VIVITY W/FEMTO,3400.0,2210.0,1.1,3400.0,68
HCPCS,PKGA290A,ACTIVEFOCUS TORIC2.5,2900.0,1885.0,1.1,2900.0,68
HCPCS,PKGA2970,ACTIVEFOCUS TORIC2.5 WFEMTO,3400.0,2210.0,1.1,3400.0,68
HCPCS,PKGA2970,RESTOR W/FEMTO,3400.0,2210.0,1.1,3400.0,68
HCPCS,PKGA2970,SYNERGY,2900.0,1885.0,1.1,2900.0,68
HCPCS,PKGA2970,SYNERGY W/FEMTO,3400.0,2210.0,1.1,3400.0,68
HCPCS,PKGA2970,TRULIGN,3400.0,2210.0,1.1,3400.0,68
HCPCS,PKGA9270,CRYSTALENS,2900.0,1885.0,1.1,2900.0,68
HCPCS,PKGA9270,CRYSTALENS W/FEMTO,3400.0,2210.0,1.1,3400.0,68
HCPCS,PKGA9270,PANOPTIX,2900.0,1885.0,1.1,2900.0,68
HCPCS,PKGA9270,PANOPTIX TORIC (INCLUDES CLAREON),2900.0,1885.0,1.1,2900.0,68
HCPCS,PKGA9270,PANOPTIX TORIC W/FEMTO,3400.0,2210.0,1.1,3400.0,68
HCPCS,PKGA9270,PANOPTIX W/FEMTO,2900.0,1885.0,1.1,2900.0,68
HCPCS,PKGA9270,RESTOR,2900.0,1885.0,1.1,2900.0,68
HCPCS,PKGA9270,RESTOR TORIC,2900.0,1885.0,1.1,2900.0,68
HCPCS,PKGA9270,SYMFONY,2900.0,1885.0,1.1,2900.0,68
HCPCS,PKGA9270,SYMFONY TORIC,2900.0,1885.0,1.1,2900.0,68
HCPCS,PKGA9270,SYMFONY TORIC W/FEMTO,3400.0,2210.0,1.1,3400.0,68
HCPCS,PKGA9270,SYMFONY W/FEMTO,3400.0,2210.0,1.1,3400.0,68
HCPCS,PKGA9270,SYNERGY TORIC,2900.0,1885.0,1.1,2900.0,68
HCPCS,PKGA9270,SYNERGY TORIC W/FEMTO,3400.0,2210.0,1.1,3400.0,68
HCPCS,PKGA9270,TORIC W/FEMTO,1900.0,1235.0,1.1,1900.0,68
HCPCS,PKGA9270,TORIC? (INC EYHANCE AND CLAREON TORIC),1400.0,910.0,1.1,1400.0,68
HCPCS,PKGA9270,VIVITY (TORIC)? (INCLUDES CLAREON),2900.0,1885.0,1.1,2900.0,68
HCPCS,PKGFETAL,FETAL INJECTION,1500.0,975.0,1.1,1500.0,68
HCPCS,PKGFETAL,FETAL INJECTION EMP,1312.5,853.13,1.1,1312.5,68
HCPCS,PKGICG,ICG PACKAGE,3434.0,2232.1,1.1,3434.0,68
HCPCS,PKGTERMC,PREGNANCY TERMINATION CONSULT,950.0,617.5,1.1,950.0,68
HCPCS,PKGTERMC,PREGNANCY TERMINATION CONSULT EMP,831.25,540.31,1.1,831.25,68
HCPCS,Q0035,Cardiokymography,,,23.5,104.7,29
HCPCS,Q0081,Infusion ther other than che,,,95.35,321.4,9
HCPCS,Q0083,Chemo by other than infusion,,,45.54,2739849.3,9
HCPCS,Q0084,Chemotherapy by infusion,,,277.57,411.0,9
HCPCS,Q0085,Chemo by both infusion and o,,,277.57,2739849.3,9
HCPCS,Q0091,OBTAINING SCREEN PAP SMEAR,98.0,63.7,15.29,98.0,86
HCPCS,Q0091,PAP SMEAR,130.5,84.825,1.1,163.0,216
HCPCS,Q0092,Set up port xray equipment,,,86.82,100.53,8
HCPCS,Q0111,OIL TEST (SCABIES) (POC) (POINT OF CARE LAB),153.0,99.45,8.96,153.0,84
HCPCS,Q0112,POTASSIUM HYDROXIDE (KOH) PREPS (POC) (POINT OF CARE LAB),40.0,26.0,5.83,40.0,84
HCPCS,Q0113,Pinworm examinations,,,4.27,23.68,31
HCPCS,Q0114,FERN TEST (POINT OF CARE LAB),67.0,43.55,8.96,67.0,84
HCPCS,Q0115,POST-COITAL MUCOUS EXAM,173.0,112.45,1.1,173.0,86
HCPCS,Q0115,Post-coital mucous exam,,,15.29,68.5,31
HCPCS,Q0136,NON ESRD EPOETIN ALPHA INJ,36.0,23.4,1.1,36.0,68
HCPCS,Q0138,"FERUMOXYTOL, NON-ESRD",4.0,2.6,0.33,4.0,78
HCPCS,Q0138,"Ferumoxytol, non-esrd",,,0.05,465.3,41
HCPCS,Q013800,"Ferumoxytol, non-esrd",,,0.64,0.82,3
HCPCS,Q0139,"Ferumoxytol, esrd use",,,0.05,465.3,41
HCPCS,Q013900,"Ferumoxytol, esrd use",,,0.64,0.82,3
HCPCS,Q0144,"AZITHROMYCIN DIHYDRATE,ORAL,1 GRAM",63.0,40.95,1.1,63.0,74
HCPCS,Q0144,"Azithromycin dihydrate, oral",,,47.26,60.53,3
HCPCS,Q0144,ORAL AZITHROMYCIN  1 GM,57.0,37.05,9.64,60.53,75
HCPCS,Q014400,"Azithromycin dihydrate, oral",,,47.26,60.53,3
HCPCS,Q0155,Dronabinol (syndros) 0.1 mg,,,6.92,11.17,15
HCPCS,Q015500,Dronabinol (syndros) 0.1 mg,,,6.92,8.87,3
HCPCS,Q0161,Chlorpromazine hcl 5mg oral,,,0.69,60.42,13
HCPCS,Q016100,Chlorpromazine hcl 5mg oral,,,0.69,0.89,3
HCPCS,Q0162,ONDANSETRON ORAL,13.0,8.45,0.01,13.0,78
HCPCS,Q0162,ONDANSETRON ORAL 1 MG,13.0,8.45,0.02,13.0,75
HCPCS,Q0162,Ondansetron oral,,,0.02,0.02,3
HCPCS,Q016200,Ondansetron oral,,,0.02,0.02,3
HCPCS,Q0163,"DIPHENHYDRAMINE HCL,50MG,ORAL",2.0,1.3,0.03,2.0,74
HCPCS,Q0163,Diphenhydramine hcl 50mg,,,0.04,11.17,16
HCPCS,Q016300,Diphenhydramine hcl 50mg,,,0.04,0.05,3
HCPCS,Q0164,"PROCHLORPERAZINE MALEATE,5MG,ORAL",2.0,1.3,0.27,2.0,78
HCPCS,Q0164,Prochlorperazine maleate 5mg,,,0.44,11.17,16
HCPCS,Q016400,Prochlorperazine maleate 5mg,,,0.73,0.93,3
HCPCS,Q0166,"GRANISETRON HYDROCHLORIDE,1MG,ORAL",136.0,88.4,0.76,136.0,78
HCPCS,Q0166,Granisetron hcl 1 mg oral,,,6.41,8.21,3
HCPCS,Q0166,"KYTRIL, 1MG ORAL",134.0,87.1,6.41,134.0,75
HCPCS,Q016600,Granisetron hcl 1 mg oral,,,6.41,8.21,3
HCPCS,Q0167,"DRONABINOL,2.5MG,ORAL",12.0,7.8,0.52,12.0,78
HCPCS,Q0167,Dronabinol 2.5mg oral,,,0.52,11.17,19
HCPCS,Q016700,Dronabinol 2.5mg oral,,,2.4,3.08,3
HCPCS,Q0169,"PROMETHAZINE HCL,12.5MG,ORAL",2.0,1.3,0.04,2.0,74
HCPCS,Q0169,Promethazine hcl 12.5mg oral,,,0.04,11.17,16
HCPCS,Q016900,Promethazine hcl 12.5mg oral,,,0.18,0.23,3
HCPCS,Q0173,"TRIMETHOBENZAMIDE HCL,250MG,ORAL",2.0,1.3,0.01,3060831.65,74
HCPCS,Q0173,Trimethobenzamide hcl 250mg,,,0.01,2739849.3,17
HCPCS,Q017300,Trimethobenzamide hcl 250mg,,,0.62,0.8,3
HCPCS,Q0174,Thiethylperazine maleate10mg,,,1.4,2739849.3,11
HCPCS,Q0175,"PERPHENZAINE,4MG,ORAL",2.0,1.3,0.51,2.0,74
HCPCS,Q0175,Perphenazine 4mg oral,,,1.0,11.17,16
HCPCS,Q017500,Perphenazine 4mg oral,,,1.0,1.28,3
HCPCS,Q0177,Hydroxyzine pamoate 25mg,,,0.19,11.17,16
HCPCS,Q017700,Hydroxyzine pamoate 25mg,,,0.27,0.34,3
HCPCS,Q0180,"DOLASETRON MESYLATE,100 MG,ORAL",191.0,124.15,1.1,191.0,74
HCPCS,Q0180,Dolasetron mesylate oral,,,9.64,309.11,16
HCPCS,Q018000,Dolasetron mesylate oral,,,128.84,165.03,3
HCPCS,Q0181,Unspecified oral anti-emetic,,,9.64,11.17,8
HCPCS,Q0220,"Tixagev and cilgav, 300mg",,,0.02,2739849.3,12
HCPCS,Q0221,"Tixagev and cilgav, 600mg",,,0.02,2739849.3,11
HCPCS,Q0222,Bebtelovimab 175 mg,,,200.66,6559.56,12
HCPCS,Q0224,"Inj, pemivibart, 4500 mg",,,904.88,16794.48,20
HCPCS,Q022400,"Inj, pemivibart, 4500 mg",,,12885.42,16504.92,3
HCPCS,Q0235,"Inj, monoclon antibody, 1 mg",,,0.61,60.42,15
HCPCS,Q023500,"Inj, monoclon antibody, 1 mg",,,10.47,13.41,3
HCPCS,Q0237,"Inj, tocilizumab-anoh, hospi",,,0.54,3329.32,15
HCPCS,Q023700,"Inj, tocilizumab-anoh, hospi",,,9.22,11.81,3
HCPCS,Q0238,Inj tocilizumab-aazg 1 mg,,,2875.32,3329.32,8
HCPCS,Q0239,Bamlanivimab-xxxx,,,0.01,232.34,9
HCPCS,Q0240,Casirivi and imdevi 600 mg,,,0.02,2739849.3,11
HCPCS,Q0243,Casirivimab and imdevimab,,,0.02,2739849.3,11
HCPCS,Q0244,Casirivi and imdevi 1200 mg,,,0.02,232.34,11
HCPCS,Q0245,Bamlanivimab and etesevima,,,0.02,232.34,11
HCPCS,Q0247,Sotrovimab,,,0.03,5418.0,11
HCPCS,Q0249,Tocilizumab for covid-19,,,0.95,2739849.3,20
HCPCS,Q024900,Tocilizumab for covid-19,,,13.47,17.26,3
HCPCS,Q0477,Pwr module pt cable lvad rpl,,,2506.2,2506.2,1
HCPCS,Q0478,"Power adapter, combo vad",,,58.52,593.59,9
HCPCS,Q0479,HEARTMATE MOBILE POWER UNIT CAT#107754,10800.0,7020.0,1030.0,10800.0,67
HCPCS,Q0479,LVAD MOBILE POWER UNIT CAT#107754,10800.0,7020.0,1030.0,10800.0,67
HCPCS,Q0480,"Driver pneumatic vad, rep",,,16923.09,273999.86,9
HCPCS,Q0481,CERVICAL SEMI-RIGID ADJUSTABLE,70.46,45.8,15.36,19595.16,74
HCPCS,Q0481,HEARTMATE 3 CONTROLLER AND EBB CAT#106531US,7425.0,4826.25,1030.0,19595.16,75
HCPCS,Q0481,"HMII SYSTEM CONTROLLER, 103696",4860.0,3159.0,1030.0,19595.16,75
HCPCS,Q0481,HMII SYSTEM DRIVER,7425.0,4826.25,1030.0,19595.16,75
HCPCS,Q0482,HEARTWARE CONTROLLER,8640.0,5616.0,1030.0,8640.0,67
HCPCS,Q0483,"Monitor elec vad, rep",,,16923.09,60565.32,9
HCPCS,Q0484,HMII DISPLAY MODULE,10530.0,6844.5,1030.0,10530.0,67
HCPCS,Q0485,"Monitor cable elec vad, rep",,,91.28,1135.62,9
HCPCS,Q0486,Mon cable elec/pneum vad rep,,,91.28,945.14,9
HCPCS,Q0487,"Leads any type vad, rep only",,,91.28,1102.6,9
HCPCS,Q0488,"Pwr pack base elec vad, rep",,,16923.09,19595.16,8
HCPCS,Q0489,"Pwr pck base combo vad, rep",,,16923.09,52506.87,9
HCPCS,Q0490,"Emr pwr source elec vad, rep",,,1288.13,2271.21,9
HCPCS,Q0491,Emr pwr source combo vad rep,,,669.74,3570.58,9
HCPCS,Q0492,"Emr pwr cbl elec vad, rep",,,31.69,287.7,9
HCPCS,Q0493,"Emr pwr cbl combo vad, rep",,,351.41,819.07,9
HCPCS,Q0494,"Emr hd pmp elec/combo, rep",,,351.41,693.06,9
HCPCS,Q0495,HEARTMATE UNIVERSAL BATTERY CHARGER CAT#1440,7776.0,5054.4,1030.0,7776.0,67
HCPCS,Q0495,HEARTWARE BATTERY CHARGER CAT#1600US,8235.0,5352.75,1030.0,8235.0,67
HCPCS,Q0495,"LVAD UNIV BATTER CHGR, 1440",9720.0,6318.0,1030.0,9720.0,67
HCPCS,Q0496,"Battery elec/combo vad, rep",,,669.74,4842.87,9
HCPCS,Q0497,HEARTMATE 14 VOLT LI-ION BATTERY CLIPS SET OF 2 CAT#2865,1320.0,858.0,287.76,1320.0,74
HCPCS,Q0497,HMII 14V LI-ION CLIP SET,1485.0,965.25,323.73,1485.0,75
HCPCS,Q0498,"GOGEAR VEST ALL SZ, 1042XX",474.0,308.1,103.33,474.0,74
HCPCS,Q0498,HEARTMATE BATTERY HOLSTER CAT#104234,474.0,308.1,103.33,474.0,74
HCPCS,Q0498,HEARTWARE PATIENT PACK CAT#1475,637.5,414.38,138.98,637.5,74
HCPCS,Q0498,HEARTWARE SHOLDER PACK CAT#2060US,675.0,438.75,147.15,675.0,74
HCPCS,Q0498,HEARTWARE WAIST PACK 2050US,637.5,414.38,138.98,637.5,74
HCPCS,Q0498,"HM SHOWER BAG, 104216/104232",277.5,180.38,60.5,385.65,74
HCPCS,Q0498,HMII VEST MED,675.0,438.75,147.15,675.0,74
HCPCS,Q0499,HEARTMATE GOGEAR CONSOLIDATED BAG L OR R CAT#106449,390.0,253.5,58.52,390.0,74
HCPCS,Q0499,HMII MODULAR BELT LGE,637.5,414.38,58.52,637.5,74
HCPCS,Q0500,"Filters elec/combo vad, rep",,,36.52,98.59,9
HCPCS,Q0501,HEARTMATE SHOWER BAG CAT#104232,675.0,438.75,147.15,675.0,74
HCPCS,Q0501,HEARTWARE SHOWER BAG CAT#2000US,450.0,292.5,98.1,450.0,74
HCPCS,Q0501,HMII SHOWER BAG,450.0,292.5,98.1,450.0,74
HCPCS,Q0502,"Mobility cart pneum vad, rep",,,333.06,2100.35,9
HCPCS,Q0503,Battery pneum vad replacemnt,,,669.74,4200.45,9
HCPCS,Q0504,"Pwr adpt pneum vad, rep veh",,,333.06,2216.58,9
HCPCS,Q0506,HEARTMATE 14 VOLT LI-ION BATTERIES SET OF 4 CAT#2465,2700.0,1755.0,588.6,2700.0,75
HCPCS,Q0506,HEARTMATE STANDALONE BACK-UP BATTERY CAT#106128,750.0,487.5,163.5,1491.52,74
HCPCS,Q0506,HEARTWARE BATTERY CAT#1650DE,1125.0,731.25,245.25,1491.52,74
HCPCS,Q0506,HMII 14V. LI-ION BATTERY EA,1125.0,731.25,245.25,1491.52,74
HCPCS,Q0506,"LVAD BATTERY 14V LI-ION, 2465",750.0,487.5,163.5,1491.52,74
HCPCS,Q0506,"W BTTRY BCKUP,PKT CTRL,HM 106128",600.0,390.0,130.8,1491.52,74
HCPCS,Q0507,Misc sup/acc ext vad,,,16.97,2739999.97,9
HCPCS,Q0508,14V LI-ION PATIENT CABLE,1485.0,965.25,200.93,1485.0,75
HCPCS,Q0508,"BATTERY HOLSTER, 103479/104234",592.5,385.13,129.17,592.5,74
HCPCS,Q0508,"GOGEAR BAG, 106449,1042XX",390.0,253.5,85.02,390.0,74
HCPCS,Q0508,HEARTMATE MODULAR CABLE CAT#10652US,6682.0,4343.3,200.93,6682.0,75
HCPCS,Q0508,HEARTMATE TRAVEL CASE CAT#1260,224.0,145.6,48.83,232.66,74
HCPCS,Q0508,HEARTWARE AC ADAPTER,2430.0,1579.5,200.93,2430.0,75
HCPCS,Q0508,"LVAD ACCESSORY KIT, 106129",238.0,154.7,51.88,238.0,74
HCPCS,Q0508,LVAD DRIVELINE CARE KIT PACK MCS (BIWEEKLY) CAT#03-6487,23.94,15.56,5.22,232.66,74
HCPCS,Q0508,LVAD DRIVELINE CARE KIT PACK MCS (DAILY) CAT#SBA29VACCG,22.84,14.85,4.98,232.66,74
HCPCS,Q0508,"TRAVEL CASE, 1260",224.0,145.6,48.83,232.66,74
HCPCS,Q0509,Mis sup/ac imp vad nopay med,,,200.93,2739999.97,9
HCPCS,Q0510,Dispens fee immunosupressive,,,63.76,137.0,9
HCPCS,Q0511,"Sup fee antiem,antica,immuno",,,16.97,65.76,9
HCPCS,Q0512,Px sup fee anti-can sub pres,,,16.97,43.84,9
HCPCS,Q0513,Disp fee inhal drugs/30 days,,,16.97,90.42,9
HCPCS,Q0514,Disp fee inhal drugs/90 days,,,63.76,180.84,9
HCPCS,Q0515,SERMORELIN ACETATE INJECTION,4.0,2.6,1.02,3060831.65,74
HCPCS,Q0515,Sermorelin acetate injection,,,1.87,2739849.3,17
HCPCS,Q051500,Sermorelin acetate injection,,,3.2,4.1,3
HCPCS,Q0516,Supply fee hiv prep oral 30,,,405.62,469.67,8
HCPCS,Q0517,Supply fee hiv prep oral 60,,,405.62,469.67,8
HCPCS,Q0518,Supply fee hiv prep oral 90,,,405.62,469.67,8
HCPCS,Q0519,Supply fee hiv prep inj 30,,,405.62,469.67,8
HCPCS,Q0520,Supply fee hiv prep inj 60,,,405.62,469.67,8
HCPCS,Q0521,Supply fee hiv prep fda appr,,,405.62,469.67,8
HCPCS,Q1004,Ntiol category 4,,,200.93,2739849.3,9
HCPCS,Q1005,Ntiol category 5,,,200.93,2739849.3,9
HCPCS,Q2004,BLADDER CALCULI IRRIG SOL,72.0,46.8,0.07,449.97,74
HCPCS,Q2004,Bladder calculi irrig sol,,,0.07,402.56,16
HCPCS,Q200400,Bladder calculi irrig sol,,,216.15,276.86,3
HCPCS,Q2009,"FOSPHENYTOIN, 50 MG",8.0,5.2,1.1,15.31,74
HCPCS,Q2009,Fosphenytoin inj pe,,,0.17,60.42,31
HCPCS,Q200900,Fosphenytoin inj pe,,,5.13,6.57,3
HCPCS,Q2017,"Teniposide, 50 mg",,,2875.32,7249.25,11
HCPCS,Q2026,PR RADIESSE INJECTION,1169.0,759.85,1.1,1169.0,68
HCPCS,Q2026,RADIESSE 0.8CC PER EA. SYRINGE,600.0,390.0,1.1,915.24,68
HCPCS,Q2026,RADIESSE 1.5CC EA. SYRINGE,800.0,520.0,1.1,915.24,68
HCPCS,Q2026,RADIESSE INJECTION 0.1 ML,1063.0,690.95,52.18,1063.0,92
HCPCS,Q2028,"Inj, sculptra, 0.5mg",,,1.39,1.78,3
HCPCS,Q2028,SCULPTRA .5MG,800.0,520.0,0.89,800.0,74
HCPCS,Q2028,SCULPTRA 0.5MG INJECTION,588.0,382.2,1.0,1275.41,93
HCPCS,Q202800,"Inj, sculptra, 0.5mg",,,1.39,1.78,3
HCPCS,Q2034,Agriflu vaccine,,,9.99,27.73,9
HCPCS,Q2035,"Afluria vacc, 3 yrs & >, im",,,9.99,53.28,15
HCPCS,Q203500,"Afluria vacc, 3 yrs & >, im",,,34.18,43.78,3
HCPCS,Q2036,"Flulaval vacc, 3 yrs & >, im",,,8.13,53.65,13
HCPCS,Q203600,"Flulaval vacc, 3 yrs & >, im",,,16.07,20.59,3
HCPCS,Q2037,"Fluvirin vacc, 3 yrs & >, im",,,33.14,42.45,3
HCPCS,Q2037,INFLUENZA VACCINE,19.22,12.49,4.19,25.74,74
HCPCS,Q203700,"Fluvirin vacc, 3 yrs & >, im",,,33.14,42.45,3
HCPCS,Q2038,FLU VAC NO PRSV 4 VAL 3 YRS+,54.6,35.49,9.99,106.68,74
HCPCS,Q2038,"Fluzone vacc, 3 yrs & >, im",,,22.57,28.91,3
HCPCS,Q203800,"Fluzone vacc, 3 yrs & >, im",,,22.57,28.91,3
HCPCS,Q2039,"Influenza virus vaccine, nos",,,9.99,53.27,12
HCPCS,Q203900,"Influenza virus vaccine, nos",,,29.53,37.83,3
HCPCS,Q2041,Axicabtagene ciloleucel car+,,,0.01,1231465.6,39
HCPCS,Q204100,Axicabtagene ciloleucel car+,,,947302.19,1213398.31,3
HCPCS,Q2042,Tisagenlecleucel car-pos t,,,0.01,1400338.65,38
HCPCS,Q204200,Tisagenlecleucel car-pos t,,,1008425.71,1291691.36,3
HCPCS,Q2043,SIPULEUCEL-T AUTO CD54+,68158.0,44302.7,1.1,163540.05,78
HCPCS,Q2043,Sipuleucel-t auto cd54+,,,6800.51,146389.05,41
HCPCS,Q204300,Sipuleucel-t auto cd54+,,,96839.32,124041.37,3
HCPCS,Q2049,IMPORTED LIPODOX INJ,2535.0,1647.75,1.1,2535.0,74
HCPCS,Q2049,Imported lipodox inj,,,37.34,5653.6,39
HCPCS,Q204900,Imported lipodox inj,,,1024.57,1312.37,3
HCPCS,Q2050,"DOXORUBICIN HCL, LIPID, 10 MG",2607.0,1694.55,104.0,2607.0,93
HCPCS,Q2050,DOXORUBICIN INJ 10 MG,2862.0,1860.3,1.1,2862.0,78
HCPCS,Q2050,Doxorubicin inj 10mg,,,185.14,237.14,3
HCPCS,Q205000,Doxorubicin inj 10mg,,,185.14,237.14,3
HCPCS,Q2052,"Home ivig, services/supplies",,,16.97,2739849.3,9
HCPCS,Q2053,Brexucabtagene car pos t,,,0.01,1231465.6,39
HCPCS,Q205300,Brexucabtagene car pos t,,,871221.36,1115946.46,3
HCPCS,Q2054,Lisocabtagene mara car pos t,,,0.01,1298358.64,39
HCPCS,Q205400,Lisocabtagene mara car pos t,,,1000718.21,1281818.83,3
HCPCS,Q2055,Idecabtagene vicleucel car,,,0.01,1328051.42,39
HCPCS,Q205500,Idecabtagene vicleucel car,,,993385.48,1272426.34,3
HCPCS,Q2056,Ciltacabtagene car-pos t,,,0.01,1389716.82,39
HCPCS,Q205600,Ciltacabtagene car-pos t,,,1046016.23,1339841.02,3
HCPCS,Q2057,Afamitresgene autoleucel,,,0.01,1787838.4,28
HCPCS,Q205700,Afamitresgene autoleucel,,,1371703.6,1757013.6,3
HCPCS,Q2058,Obecbtge autol up to 400 mil,,,0.01,718200.0,25
HCPCS,Q205800,Obecbtge autol up to 400 mil,,,560700.0,718200.0,3
HCPCS,Q3001,Brachytherapy radioelements,,,73.43,358.71,11
HCPCS,Q3014,TELEHEALTH ORIGINATING SITE FEE (W/ PO MODIFIER),43.0,27.95,0.01,43.0,67
HCPCS,Q3027,INJ BETA INTERFERON IM 1 MCG,169.32,110.06,1.1,1622.37,161
HCPCS,Q3027,Inj beta interferon im 1 mcg,,,153.76,196.95,3
HCPCS,Q302700,Inj beta interferon im 1 mcg,,,153.76,196.95,3
HCPCS,Q3028,Inj beta interferon sq 1 mcg,,,13.54,840.33,16
HCPCS,Q302800,Inj beta interferon sq 1 mcg,,,88.91,113.89,3
HCPCS,Q3031,Collagen skin test,,,63.76,73.83,8
HCPCS,Q4001,Cast sup body cast plaster,,,36.52,163.61,9
HCPCS,Q4002,Cast sup body cast fiberglas,,,36.52,618.17,9
HCPCS,Q4003,CAST SUP SHOULDER CAST PLSTR,171.0,111.15,1.1,171.0,104
HCPCS,Q4003,"CAST SUPPLIES, SHOULDER CAST, 11 YRS +, PLASTER",72.34,47.02,15.77,72.34,67
HCPCS,Q4004,CAST SUP SHOULDER CAST FBRGL,254.0,165.1,1.1,499.85,104
HCPCS,Q4004,"CAST SUPPLIES, SHOULDER CAST, 11 YRS+, FIBERGLASS",250.5,162.83,36.52,250.5,67
HCPCS,Q4005,"CAST SUPPLIES, LONG ARM CAST, 11 YRS +, PLASTER",26.68,17.34,5.82,42.28,67
HCPCS,Q4006,CAST SUP LONG ARM ADULT FBRG,140.0,91.0,1.1,140.0,104
HCPCS,Q4006,"CAST SUPPLIES, LONG ARM CAST, 11 YRS +, FIBERGLASS",26.68,17.34,5.82,26.68,67
HCPCS,Q4007,CAST SUP LONG ARM PED PLSTER,98.0,63.7,1.1,98.0,104
HCPCS,Q4007,"CAST SUPPLIES, LONG ARM CAST, PEDS, PLASTER",13.34,8.67,2.91,13.34,67
HCPCS,Q4008,CAST SUP LONG ARM PED FBRGLS,98.0,63.7,1.1,98.0,104
HCPCS,Q4008,"CAST SUPPLIES, LONG ARM CAST, PEDS, FIBERGLASS",30.0,19.5,6.54,42.28,67
HCPCS,Q4009,CAST SUP SHT ARM ADULT PLSTR,80.0,52.0,1.1,80.0,104
HCPCS,Q4009,"CAST SUPPLIES, SHORT ARM CAST, 11 YRS +, PLASTER",17.82,11.58,3.88,17.82,67
HCPCS,Q4010,CAST SUP SHT ARM ADULT FBRGL,14.0,9.1,1.1,79.96,104
HCPCS,Q4010,"CAST SUPPLIES, SHORT ARM CAST, 11 YRS +, FIBERGLASS",40.08,26.05,8.74,40.08,67
HCPCS,Q4011,CAST SUP SHT ARM PED PLASTER,42.0,27.3,1.1,42.0,104
HCPCS,Q4011,"CAST SUPPLIES, SHORT ARM CAST, PEDS, PLASTER",8.88,5.77,1.94,12.9,67
HCPCS,Q4012,CAST SUP SHT ARM PED FBRGLAS,80.0,52.0,1.1,80.0,104
HCPCS,Q4012,"CAST SUPPLIES, SHORT ARM CAST, PEDS, FIBERGLASS",20.08,13.05,4.38,42.28,67
HCPCS,Q4013,CAST SUP GAUNTLET PLASTER,26.5,17.225,1.1,64.71,171
HCPCS,Q4014,CAST SUP GAUNTLET FIBERGLASS,102.0,66.3,1.1,109.12,104
HCPCS,Q4014,"CAST SUPPLIES, GAUNTLET CAST, 11 YRS +, FIBERGLASS",15.0,9.75,3.27,42.28,67
HCPCS,Q4015,CAST SUP GAUNTLET PED PLSTER,70.0,45.5,1.1,70.0,104
HCPCS,Q4015,"CAST SUPPLIES, GAUNTLET CAST, PEDS, PLASTER",16.24,10.56,3.54,19.65,67
HCPCS,Q4016,CAST SUP GAUNTLET FBRGLS,70.0,45.5,1.1,70.0,104
HCPCS,Q4016,"CAST SUPPLIES, GAUNTLET CAST, PEDS, FIBERGLASS",27.34,17.77,5.96,27.34,67
HCPCS,Q4017,CAST SUP LNG ARM SPLINT PLST,75.0,48.75,1.1,75.0,104
HCPCS,Q4017,"CAST SUPPLIES, LONG ARM SPLINT, 11 YRS +, PLASTER",75.0,48.75,11.14,75.0,67
HCPCS,Q4018,CAST SUP LNG ARM SPLINT FBRG,89.0,57.85,1.1,89.0,104
HCPCS,Q4018,"CAST SUPPLIES, LONG ARM SPLINT, 11 YRS +, FIBERGLASS",29.88,19.42,6.51,29.88,67
HCPCS,Q4019,CAST SUP LNG ARM SPLNT PED P,75.0,48.75,1.1,75.0,104
HCPCS,Q4019,"CAST SUPPLIES, LONG ARM SPLINT, PEDS, PLASTER",9.4,6.11,2.05,19.65,67
HCPCS,Q4020,CAST SUP LNG ARM SPLNT PED F,75.0,48.75,1.1,75.0,104
HCPCS,Q4020,"CAST SUPPLIES, LONG ARM SPLINT, PEDS, FIBERGLASS",14.98,9.74,3.27,14.98,67
HCPCS,Q4020,LONG ARM SPLINT PEDIATRIC 0-10 YEARS,68.0,44.2,11.14,68.0,67
HCPCS,Q4021,CAST SUP SHT ARM SPLINT PLST,44.0,28.6,1.1,44.0,104
HCPCS,Q4021,"CAST SUPPLIES, SHORT ARM SPLINT, 11 YRS +, PLASTER",13.88,9.02,3.03,13.88,67
HCPCS,Q4022,CAST SUP SHT ARM SPLINT FBRG,57.0,37.05,1.1,89.0,171
HCPCS,Q4023,CAST SUP SHT ARM SPLNT PED P,44.0,28.6,1.1,44.0,104
HCPCS,Q4023,"CAST SUPPLIES, SHORT ARM SPLINT, PEDS, PLASTER",6.98,4.54,1.52,19.65,67
HCPCS,Q4024,CAST SUP SHT ARM SPLNT PED F,45.0,29.25,1.1,45.0,104
HCPCS,Q4024,"CAST SUPPLIES, SHORT ARM SPLINT, PEDS, FIBERGLASS",12.54,8.15,2.73,12.9,67
HCPCS,Q4025,Cast sup hip spica plaster,,,36.52,126.23,9
HCPCS,Q4026,Cast sup hip spica fiberglas,,,36.52,394.34,9
HCPCS,Q4027,Cast sup hip spica ped plstr,,,11.14,63.18,9
HCPCS,Q4028,Cast sup hip spica ped fbrgl,,,36.52,197.28,9
HCPCS,Q4029,CAST SUP LONG LEG PLASTER,142.0,92.3,1.1,142.0,104
HCPCS,Q4029,"CAST SUPPLIES, LONG LEG CAST, 11 YRS +, PLASTER",59.5,38.68,12.97,59.5,67
HCPCS,Q4030,CAST SUP LONG LEG FIBERGLASS,194.0,126.1,1.1,312.49,104
HCPCS,Q4030,"CAST SUPPLIES, LONG LEG CAST, 11 YRS +, FIBERGLASS",156.6,101.79,34.14,156.6,67
HCPCS,Q4031,CAST SUP LNG LEG PED PLASTER,116.0,75.4,1.1,116.0,104
HCPCS,Q4031,"CAST SUPPLIES, LONG LEG CAST, PEDS, PLASTER",29.72,19.32,6.48,42.28,67
HCPCS,Q4032,CAST SUP LNG LEG FBRGLS,136.0,88.4,1.1,156.24,104
HCPCS,Q4032,"CAST SUPPLIES, LONG LEG CAST, PEDS, FIBERGLASS",78.3,50.9,17.07,78.3,67
HCPCS,Q4033,"CAST SUPPLIES, LONG LEG CYLINDER CAST, 11 YRS +, PLASTER",55.5,36.08,12.1,55.5,67
HCPCS,Q4034,CAST SUP LNG LEG CYLINDER FB,165.0,107.25,1.1,275.35,104
HCPCS,Q4034,"CAST SUPPLIES, LONG LEG CYLINDER CAST, 11 YRS +, FIBERGLASS",137.98,89.69,30.08,137.98,67
HCPCS,Q4035,CAST SUP LNGLEG CYLNDR PED P,100.0,65.0,1.1,100.0,104
HCPCS,Q4035,"CAST SUPPLIES, LONG LEG CYLINDER CAST, PEDS,PLASTER",27.74,18.03,6.05,42.28,67
HCPCS,Q4036,CAST SUP LNGLEG CYLNDR PED F,118.0,76.7,1.1,137.76,104
HCPCS,Q4036,"CAST SUPPLIES, LONG LEG CYLINDER CAST, PEDS,FIBERGLASS",69.04,44.88,15.05,69.04,67
HCPCS,Q4037,CAST SUP SHRT LEG PLASTER,128.0,83.2,1.1,128.0,104
HCPCS,Q4037,"CAST SUPPLIES SHORT LEG CAST, 11 YRS +, PLASTER",33.82,21.98,7.37,42.28,67
HCPCS,Q4038,CAST SUP SHRT LEG FIBERGLASS,222.0,144.3,1.1,222.0,104
HCPCS,Q4038,"CAST SUPPLIES, SHORT LEG CAST, ADULT (11 YEARS +), FIBERGLASS",84.78,55.11,16.97,84.78,67
HCPCS,Q4039,CAST SUP SHRT LEG PED PLSTER,83.0,53.95,1.1,83.0,104
HCPCS,Q4039,"CAST SUPPLIES, SHORT LEG CAST, PEDS, PLASTER",16.96,11.02,3.7,16.96,67
HCPCS,Q4040,CAST SUP SHRT LEG PED FBRGLS,128.0,83.2,1.1,128.0,104
HCPCS,Q4040,"CAST SUPPLIES, SHORT LEG CAST, PEDS, FIBERGLASS",42.4,27.56,9.24,42.4,67
HCPCS,Q4041,CAST SUP LNG LEG SPLNT PLSTR,88.0,57.2,1.1,88.0,104
HCPCS,Q4041,"CAST SUPPLIES, LONG LEG SPLINT, 11 YRS+, PLASTER",41.16,26.75,8.97,42.28,67
HCPCS,Q4042,CAST SUP LNG LEG SPLNT FBRGL,127.0,82.55,1.1,140.22,104
HCPCS,Q4042,"CAST SUPPLIES, LONG LEG SPLINT, 11 YRS+, FIBERGLASS",70.26,45.67,15.32,70.26,67
HCPCS,Q4043,CAST SUP LNG LEG SPLNT PED P,75.0,48.75,1.1,75.0,104
HCPCS,Q4043,"CAST SUPPLIES, LONG LEG SPLINT, PEDS, PLASTER",20.6,13.39,4.49,20.6,67
HCPCS,Q4044,CAST SUP LNG LEG SPLNT PED F,61.0,39.650000000000006,1.1,70.2,171
HCPCS,Q4045,CAST SUP SHT LEG SPLNT PLSTR,83.0,53.95,1.1,83.0,104
HCPCS,Q4045,"CAST SUPPLIES, SHORT LEG SPLINT, 11 YRS+, PLASTER",23.9,15.54,5.21,23.9,67
HCPCS,Q4046,CAST SUP SHT LEG SPLNT FBRGL,83.0,53.95,1.1,83.0,104
HCPCS,Q4046,CAST SUPPLIES SHORT LEG SPLINT FIBERGLASS,75.0,48.75,16.35,75.0,67
HCPCS,Q4047,CAST SUP SHT LEG SPLNT PED P,95.0,61.75,1.1,95.0,104
HCPCS,Q4047,"CAST SUPPLIES, SHORT LEG SPLINT, PEDS, PLASTER",11.9,7.74,2.59,19.65,67
HCPCS,Q4048,CAST SUP SHT LEG SPLNT FIBERGLASS,80.0,52.0,1.1,80.0,104
HCPCS,Q4048,"CAST SUPPLIES, SHORT LEG SPLINT, PEDS, FIBERGLASS",19.22,12.49,4.19,19.22,67
HCPCS,Q4049,"FINGER SPLINT, STATIC",51.0,33.15,1.1,51.0,92
HCPCS,Q4049,"Finger splint, static",,,7.04,12.9,9
HCPCS,Q4050,CAST SUPPLIES UNLISTED,31.0,20.15,0.01,3061000.0,80
HCPCS,Q4050,Cast supplies unlisted,,,36.52,2739999.97,9
HCPCS,Q4051,SPLINT SUPPLIES MISC,10.0,6.5,0.01,3061000.0,80
HCPCS,Q4051,Splint supplies misc,,,11.14,2739999.97,9
HCPCS,Q4074,Iloprost non-comp unit dose,,,145.33,840.33,19
HCPCS,Q407400,Iloprost non-comp unit dose,,,282.88,362.34,3
HCPCS,Q4080,ILOPROST INHALATION SOLUTION,93.0,60.45,1.1,93.0,68
HCPCS,Q4081,"Epoetin alfa, 100 units esrd",,,0.84,164.23,19
HCPCS,Q408100,"Epoetin alfa, 100 units esrd",,,1.37,1.76,3
HCPCS,Q4082,Drug/bio noc part b drug cap,,,9.64,2739849.3,9
HCPCS,Q4100,"Skin substitute, nos",,,1101.49,1275.41,8
HCPCS,Q4101,APLIGRAF 7.5 CM,77.98,50.69,18.72,183.51,78
HCPCS,Q4101,APLIGRAF DS FLM 7.5CM,340.0,221.0,96.15,340.0,78
HCPCS,Q4101,APLIGRAF SKIN SUB,51.0,33.15,1.1,347.42,110
HCPCS,Q4101,"APLIGRAFT,9978000199",60.22,39.14,14.45,183.51,78
HCPCS,Q4101,Apligraf,,,53.81,68.92,3
HCPCS,Q410100,Apligraf,,,53.81,68.92,3
HCPCS,Q4102,OASIS WND MATRIX 3X3.35=10.5CM SQ PER 1 SQ CM,17.34,11.27,4.16,183.51,78
HCPCS,Q4102,OASIS WND MATRIX 3X7=21CM SQ PER 1 SQ CM,15.14,9.84,3.63,183.51,78
HCPCS,Q4102,OASIS WOUND MATRIX,5.72,3.72,1.37,183.51,78
HCPCS,Q4102,OASIS WOUND MATRIX SKIN SUB,17.0,11.05,1.1,347.42,110
HCPCS,Q4102,"OASIS WOUND MATRIX,8213100015",5.72,3.72,1.37,183.51,78
HCPCS,Q4102,Oasis wound matrix,,,21.15,27.09,3
HCPCS,Q410200,Oasis wound matrix,,,21.15,27.09,3
HCPCS,Q4103,OASIS BURN MATRIX PER 1 SQ CM,5.72,3.72,1.37,183.51,78
HCPCS,Q4103,Oasis burn matrix,,,22.23,28.48,3
HCPCS,Q410300,Oasis burn matrix,,,22.23,28.48,3
HCPCS,Q4104,INTEGRA BMWD PER 1 SQ CM,471.0,306.15,117.73,471.0,78
HCPCS,Q4104,Integra bmwd,,,90.78,116.28,3
HCPCS,Q410400,Integra bmwd,,,90.78,116.28,3
HCPCS,Q4105,Integra drt or omnigraft,,,26.4,129.51,21
HCPCS,Q410500,Integra drt or omnigraft,,,47.95,61.42,3
HCPCS,Q4106,Dermagraft,,,30.32,123.14,4
HCPCS,Q4107,GRAFTJACKET SKIN SUB,191.0,124.15,1.1,347.42,108
HCPCS,Q4107,Graftjacket,,,180.01,230.58,3
HCPCS,Q4107,MATRIX TISS 4X2CM GRAFTJACKET NOW THK1-2MM,257.13,167.13,72.72,1275.41,86
HCPCS,Q410700,Graftjacket,,,180.01,230.58,3
HCPCS,Q4108,DRSG BOVINE COLL GLYCOSAMINOGLYCAN 5X4IN,43.11,28.02,12.19,183.51,78
HCPCS,Q4108,Integra matrix,,,68.6,87.87,3
HCPCS,Q410800,Integra matrix,,,68.6,87.87,3
HCPCS,Q4110,Primatrix,,,41.85,149.13,21
HCPCS,Q411000,Primatrix,,,116.43,149.13,3
HCPCS,Q4111,Gammagraft,,,7.16,129.51,21
HCPCS,Q411100,Gammagraft,,,14.01,17.94,3
HCPCS,Q4112,Cymetra injectable,,,841.78,1988.34,14
HCPCS,Q411200,Cymetra injectable,,,1552.3,1988.34,3
HCPCS,Q4113,Graftjacket xpress,,,841.78,4294.63,8
HCPCS,Q411300,Graftjacket xpress,,,1597.55,2046.3,3
HCPCS,Q4114,Integra flowable wound matri,,,1459.23,6454.22,9
HCPCS,Q411400,Integra flowable wound matri,,,5038.82,6454.22,3
HCPCS,Q4115,ALLOSKIN PER 1 SQ CM,360.0,234.0,27.65,360.0,78
HCPCS,Q4115,Alloskin,,,22.89,29.32,3
HCPCS,Q4115,GRAFT ST TIS FRZN CADVR 5100-001,896.0,582.4,117.73,896.0,78
HCPCS,Q411500,Alloskin,,,22.89,29.32,3
HCPCS,Q4116,Alloderm,,,55.38,70.93,3
HCPCS,Q4116,MATRIX ALLODERM SELECT THK.4-2.4MM THICK LARGE CONTOUR PER CM TI,16.13,10.48,4.56,1275.41,86
HCPCS,Q4116,MATRIX ALLODERM TISS MED 20X16CM,28.11,18.27,7.95,1275.41,86
HCPCS,Q4116,MTRX TISS 20X16CM ALLODERM THK,54.58,35.48,15.44,1275.41,86
HCPCS,Q4116,W GRFT TISSUE ALLODERM PER SQCM,5356.0,3481.4,66.89,5356.0,86
HCPCS,Q411600,Alloderm,,,55.38,70.93,3
HCPCS,Q4117,Hyalomatrix,,,46.33,129.51,20
HCPCS,Q411700,Hyalomatrix,,,51.07,65.41,3
HCPCS,Q4118,GRAFT MATRISTEM MICROMATRIX 100MG PORCINE URINARY BLADDER EXTRAC,2.6,1.69,0.56,2.62,134
HCPCS,Q4118,GRAFT MATRISTEM MICROMATRIX 200MG PORCINE URINARY BLADDER EXTRAC,2.62,1.7,0.57,2.62,67
HCPCS,Q4118,GRAFT MATRISTEM MICROMATRIX 20MG PROCINE URINARY BLADDER EXTRACE,2.7,1.76,0.59,2.7,67
HCPCS,Q4118,GRAFT MATRISTEM MICROMATRIX PORCINE URINAARY BLADDER EXTRACELLUL,2.95,1.92,0.64,2.95,67
HCPCS,Q4118,GRAFT MATRISTEM MICROMATRIX PORCINE URINARY BLADDER EXTRACELLULA,2.5,1.625,0.48,2.62,335
HCPCS,Q4118,GRAFT MATRISTEM MICROMATRIX SOFT TISSUE POWDER MICRONIZED PARTIC,2.09,1.36,0.46,2.09,67
HCPCS,Q4118,Matristem micromatrix,,,6.84,8.76,3
HCPCS,Q411800,Matristem micromatrix,,,6.84,8.76,3
HCPCS,Q4121,PR THERASKIN,101.0,65.65,1.1,347.42,110
HCPCS,Q4121,Theraskin,,,47.79,129.51,21
HCPCS,Q412100,Theraskin,,,93.9,120.27,3
HCPCS,Q4122,"Dermacell, awm, porous sq cm",,,117.73,275.88,19
HCPCS,Q412200,"Dermacell, awm, porous sq cm",,,215.38,275.88,3
HCPCS,Q4123,Alloskin,,,23.04,171.53,21
HCPCS,Q412300,Alloskin,,,127.36,163.13,3
HCPCS,Q4124,OASIS TRI-LAYER WOUND MATRIX,24.0,15.6,1.1,347.42,110
HCPCS,Q4124,OASIS WND MATRIX 5X7 PER 1 SQ CM,18.71,12.16,4.49,183.51,78
HCPCS,Q4124,"OASIS,PORCNE 10X7,8213-0000-09",22.02,14.31,5.28,183.51,78
HCPCS,Q4124,Oasis tri-layer wound matrix,,,4.43,5.68,3
HCPCS,Q412400,Oasis tri-layer wound matrix,,,4.43,5.68,3
HCPCS,Q4125,Arthroflex,,,117.73,129.51,12
HCPCS,Q4126,Memoderm/derma/tranz/integup,,,111.09,214.65,20
HCPCS,Q412600,Memoderm/derma/tranz/integup,,,111.09,142.29,3
HCPCS,Q4127,Talymed,,,117.73,187.66,20
HCPCS,Q412700,Talymed,,,121.91,156.16,3
HCPCS,Q4128,FLEX HD STRUCTURAL 10CMX16CM,24.11,15.67,6.82,183.51,78
HCPCS,Q4128,FLEXHD STRUCTURAL 6CM X 8CM,24.44,15.89,6.91,183.51,78
HCPCS,Q4128,Flexhd/allopatchhd/sq cm,,,53.24,68.19,3
HCPCS,Q412800,Flexhd/allopatchhd/sq cm,,,53.24,68.19,3
HCPCS,Q4130,"G120130,MESH 10X10,NCT01746316",2753.0,1789.45,117.73,2753.0,72
HCPCS,Q4130,"G120130,MESH 10X16,NCT01746316",4404.0,2862.6,117.73,4404.0,72
HCPCS,Q4130,"G120130,MESH 10X20,NCT01746316",5505.0,3578.25,117.73,5505.0,72
HCPCS,Q4130,"G120130,MESH 10X25,NCT01746316",6881.0,4472.65,117.73,6881.0,72
HCPCS,Q4130,"G120130,MESH 12X12,NCT01746316",108.6,70.59,30.71,183.51,72
HCPCS,Q4130,"G120130,MESH 15X25,NCT01746316",10321.0,6708.65,117.73,10321.0,72
HCPCS,Q4130,"G120130,MESH 15X30,NCT01746316",12384.0,8049.6,117.73,12384.0,72
HCPCS,Q4130,"G120130,MESH 16X20,NCT01746316",8807.0,5724.55,117.73,8807.0,72
HCPCS,Q4130,"G120130,MESH 20X20,NCT01746316",11008.0,7155.2,117.73,11008.0,72
HCPCS,Q4130,"G120130,MESH 20X25,NCT01746316",13760.0,8944.0,117.73,13760.0,72
HCPCS,Q4130,"G120130,MESH 20X30,NCT01746316",16510.0,10731.5,117.73,16510.0,72
HCPCS,Q4130,"G120130,MESH 20X40,NCT01746316",22014.0,14309.1,117.73,22014.0,72
HCPCS,Q4130,"G120130,MESH 25X40,NCT01746316",27517.0,17886.05,117.73,27517.0,72
HCPCS,Q4130,"G120130,MESH 30X30,NCT01746316",21224.0,13795.6,117.73,21224.0,72
HCPCS,Q4130,"G120130,MESH 5X16,NCT01746316",2202.0,1431.3,117.73,2202.0,72
HCPCS,Q4130,"G120130,MESH 6X10,NCT01746316",1768.0,1149.2,117.73,1768.0,72
HCPCS,Q4130,"G120130,MESH 6X13,NCT01746316",1541.0,1001.65,117.73,1541.0,72
HCPCS,Q4130,"G120130,MESH 6X16,NCT01746316",2643.0,1717.95,117.73,2643.0,72
HCPCS,Q4130,"G120130,MESH 6X6,NCT01746316",1061.0,689.65,117.73,1061.0,72
HCPCS,Q4130,"G120130,MESH 6X8,NCT01746316",1324.0,860.6,117.73,1324.0,72
HCPCS,Q4130,"G120130,MESH 8X15,NCT01746316",2650.0,1722.5,117.73,2650.0,72
HCPCS,Q4130,"G120130,MESH 8X16,NCT01746316",3524.0,2290.6,117.73,3524.0,72
HCPCS,Q4130,"G120130,MESH 8X8,NCT01746316",1887.0,1226.55,117.73,1887.0,72
HCPCS,Q4130,"G120130,MESH5.5X10,NCT01746316",981.0,637.65,117.73,981.0,72
HCPCS,Q4132,DRSG GRAFIX CORE PER SQ CM,533.33,346.66,117.73,533.33,78
HCPCS,Q4132,"Grafix core, grafixpl core",,,189.93,243.28,3
HCPCS,Q413200,"Grafix core, grafixpl core",,,189.93,243.28,3
HCPCS,Q4133,GRAFIX PL PRIME 1.5X2 CM,557.33,362.26,117.73,557.33,78
HCPCS,Q4133,GRAFIX PL PRIME 16MM DISC,470.25,305.66,117.73,470.25,78
HCPCS,Q4133,GRAFIX PL PRIME 2X3 CM,348.33,226.41,98.51,348.33,78
HCPCS,Q4133,GRAFIX PL PRIME 5X5 CM,223.2,145.08,63.12,223.2,78
HCPCS,Q4133,GRAFIX PRIME 16MM PER SQ CM,136.46,88.7,32.75,298.31,78
HCPCS,Q4133,GRAFIX PRIME 3CM X 4CM,339.0,220.35,81.36,339.0,78
HCPCS,Q4133,GRFT STRAVIX 2CMX2CM,525.0,341.25,117.73,525.0,78
HCPCS,Q4133,GRFT STRAVIX 2CMX4CM,1900.0,1235.0,117.73,1900.0,79
HCPCS,Q4133,Grafix stravix prime pl sqcm,,,246.96,316.33,3
HCPCS,Q4133,STRAVIX PL 3X6 CM,173.08,112.5,48.95,183.51,78
HCPCS,Q413300,Grafix stravix prime pl sqcm,,,246.96,316.33,3
HCPCS,Q4134,Hmatrix,,,117.73,369.54,17
HCPCS,Q413400,Hmatrix,,,288.5,369.54,3
HCPCS,Q4135,Mediskin,,,117.73,129.51,12
HCPCS,Q4136,Ezderm,,,117.73,129.51,12
HCPCS,Q4137,AMNIOEXCEL 2X3,337.0,219.05,80.88,337.0,78
HCPCS,Q4137,AMNIOEXCEL1.5X1.5,614.0,399.1,117.73,614.0,78
HCPCS,Q4137,Amnioexcel biodexcel 1sq cm,,,181.06,231.92,3
HCPCS,Q413700,Amnioexcel biodexcel 1sq cm,,,181.06,231.92,3
HCPCS,Q4138,"Biodfence dryflex, 1cm",,,117.73,223.69,19
HCPCS,Q413800,"Biodfence dryflex, 1cm",,,174.64,223.69,3
HCPCS,Q4139,GRAFT GRAFIX PRIME 2X3CM,308.0,200.2,67.14,1275.41,75
HCPCS,Q4139,GRAFT GRAFIX PRIME PLACENTAL MEMB 4X3CM,236.25,153.56,51.5,1275.41,75
HCPCS,Q4139,GRAFT GRAFIX PRIME PLACENTAL MEMBR 5X5CM,252.0,163.8,54.94,1275.41,75
HCPCS,Q4140,Biodfence 1cm,,,117.73,369.39,19
HCPCS,Q414000,Biodfence 1cm,,,287.68,368.49,3
HCPCS,Q4141,"Alloskin ac, 1 cm",,,81.66,243.89,20
HCPCS,Q414100,"Alloskin ac, 1 cm",,,190.41,243.89,3
HCPCS,Q4142,Xcm biologic tiss matrix 1cm,,,117.73,129.51,12
HCPCS,Q4143,"Repriza, 1cm",,,60.38,1275.41,26
HCPCS,Q414300,"Repriza, 1cm",,,60.38,77.34,3
HCPCS,Q4145,"Epifix, inj, 1mg",,,16.88,68.4,6
HCPCS,Q414500,"Epifix, inj, 1mg",,,53.4,68.4,3
HCPCS,Q4146,"Tensix, 1cm",,,117.73,1275.41,20
HCPCS,Q4147,Architect ecm px fx 1 sq cm,,,101.69,3389.0,20
HCPCS,Q414700,Architect ecm px fx 1 sq cm,,,101.69,130.26,3
HCPCS,Q4148,GRFT NEOX CRYOTEK 1MM 24SQ CM AMNIO UMB CORD,128.96,83.82,36.47,183.51,78
HCPCS,Q4148,Neox neox rt or clarix cord,,,220.36,282.26,3
HCPCS,Q414800,Neox neox rt or clarix cord,,,220.36,282.26,3
HCPCS,Q4149,"Excellagen, 0.1 cc",,,309.72,396.72,7
HCPCS,Q414900,"Excellagen, 0.1 cc",,,309.72,396.72,3
HCPCS,Q4150,Allowrap ds or dry 1 sq cm,,,117.73,1275.41,28
HCPCS,Q415000,Allowrap ds or dry 1 sq cm,,,139.14,178.23,3
HCPCS,Q4151,"Amnioband, guardian 1 sq cm",,,117.73,364.09,21
HCPCS,Q415100,"Amnioband, guardian 1 sq cm",,,240.1,307.55,3
HCPCS,Q4152,ALLOGRFT 2X3CM DERMAPURE,810.0,526.5,117.73,810.0,78
HCPCS,Q4152,ALLOGRFT 4X6CM DERMAPURE,182.92,118.9,51.73,183.51,78
HCPCS,Q4152,ALLOGRFT 7X10CM DERMAPURE,2450.0,1592.5,117.73,2450.0,79
HCPCS,Q4152,Dermapure 1 square cm,,,90.28,115.64,3
HCPCS,Q415200,Dermapure 1 square cm,,,90.28,115.64,3
HCPCS,Q4153,"Dermavest, plurivest sq cm",,,117.73,500.33,20
HCPCS,Q415300,"Dermavest, plurivest sq cm",,,245.52,314.48,3
HCPCS,Q4154,BIOVANCE HUM AMNIO MMBRNE,166.44,108.19,47.07,183.51,78
HCPCS,Q4154,Biovance 1 square cm,,,234.78,300.73,3
HCPCS,Q415400,Biovance 1 square cm,,,234.78,300.73,3
HCPCS,Q4155,Neoxflo or clarixflo 1 mg,,,57.23,87.55,7
HCPCS,Q415500,Neoxflo or clarixflo 1 mg,,,68.35,87.55,3
HCPCS,Q4156,Neox 100 or clarix 100,,,117.27,150.21,19
HCPCS,Q415600,Neox 100 or clarix 100,,,117.27,150.21,3
HCPCS,Q4157,Revitalon 1 square cm,,,117.73,477.8,19
HCPCS,Q415700,Revitalon 1 square cm,,,373.02,477.8,3
HCPCS,Q4158,KERECIS 1.75 X 1.75,796.5,517.73,117.73,796.5,78
HCPCS,Q4158,KERECIS 16 MM,750.0,487.5,117.73,750.0,78
HCPCS,Q4158,KERECIS 3 CM X 3 CM,1574.1,1023.17,117.73,1574.1,79
HCPCS,Q4158,KERECIS 3 X 3.5 CM,1096.5,712.73,117.73,1096.5,78
HCPCS,Q4158,KERECIS 5 CM X 7 CM,1940.63,1261.41,117.73,1940.63,79
HCPCS,Q4158,KERECIS PER SQ CM,275.0,178.75,77.77,275.0,77
HCPCS,Q4158,"Kerecis omega3, per sq cm",,,119.74,153.38,3
HCPCS,Q4158,OMEGA3 SURGICLOSE FISH-SKIN GRFT MESH 2:1 7CM X 10CM,56.39,36.65,15.95,183.51,78
HCPCS,Q4158,OMEGA3 SURGICLOSE WND FISH-SKIN 1000MG 19CM2,55.26,35.92,15.63,183.51,78
HCPCS,Q415800,"Kerecis omega3, per sq cm",,,119.74,153.38,3
HCPCS,Q4159,"AFFINITY, 1.5CM X 1.5CM",1149.99,747.49,117.73,1149.99,78
HCPCS,Q4159,"AFFINITY, 2.5CM X 2.5CM",546.42,355.17,117.73,566.2,78
HCPCS,Q4159,Affinity1 square cm,,,364.83,467.31,3
HCPCS,Q415900,Affinity1 square cm,,,364.83,467.31,3
HCPCS,Q4160,NUSHIELD 1.6 DISC PER SQ CM,296.25,192.56,71.1,296.25,78
HCPCS,Q4160,NUSHIELD 2X3 PER SQ CM,331.25,215.31,79.5,331.25,78
HCPCS,Q4160,NUSHIELD 2X4 PER SQ SM,197.88,128.62,47.49,201.95,78
HCPCS,Q4160,NUSHIELD 3X4 PER SQ CM,229.17,148.96,55.0,229.17,78
HCPCS,Q4160,NUSHIELD 4X4 PER SQ CM,155.86,101.31,37.41,201.95,78
HCPCS,Q4160,NUSHIELD 4X6 PER SQ CM,136.73,88.87,32.82,201.95,78
HCPCS,Q4160,NUSHIELD 6X6 PER SQ CM,121.05,78.68,29.05,201.95,78
HCPCS,Q4160,Nushield 1 square cm,,,4956.2,6348.39,3
HCPCS,Q416000,Nushield 1 square cm,,,4956.2,6348.39,3
HCPCS,Q4161,Bio-connekt per square cm,,,117.73,6260.95,20
HCPCS,Q416100,Bio-connekt per square cm,,,2831.16,3626.43,3
HCPCS,Q4162,"Wndex flw, bioskn flw, 0.5cc",,,3916.0,5518.34,7
HCPCS,Q416200,"Wndex flw, bioskn flw, 0.5cc",,,3916.0,5016.0,3
HCPCS,Q4163,"Woundex, bioskin, per sq cm",,,117.73,462.07,21
HCPCS,Q416300,"Woundex, bioskin, per sq cm",,,324.28,415.37,3
HCPCS,Q4164,"Helicoll, per square cm",,,117.73,3741.32,20
HCPCS,Q416400,"Helicoll, per square cm",,,2920.86,3741.32,3
HCPCS,Q4165,"Keramatrix, kerasorb sq cm",,,94.77,129.51,19
HCPCS,Q416500,"Keramatrix, kerasorb sq cm",,,94.77,121.39,3
HCPCS,Q4166,CYTAL WOUND MATRIX 3 LAYER 10X15 CM,21.32,13.86,6.03,183.51,78
HCPCS,Q4166,"Cytal, per square centimeter",,,35.55,45.53,3
HCPCS,Q4166,GRAFT MATRISTEM PORCINE URNARY BLADDER EXTRACELLULAR MATRIX PER,12.3,8.0,3.48,183.51,78
HCPCS,Q416600,"Cytal, per square centimeter",,,35.55,45.53,3
HCPCS,Q4167,"Truskin, per sq centimeter",,,117.73,275.74,19
HCPCS,Q416700,"Truskin, per sq centimeter",,,215.27,275.74,3
HCPCS,Q4168,"Amnioband, 1 mg",,,30.35,38.87,5
HCPCS,Q416800,"Amnioband, 1 mg",,,30.35,38.87,3
HCPCS,Q4169,"Artacent wound, per sq cm",,,117.73,7384.95,20
HCPCS,Q416900,"Artacent wound, per sq cm",,,3681.88,4716.11,3
HCPCS,Q4170,"Cygnus, per sq cm",,,69.97,1653.63,20
HCPCS,Q417000,"Cygnus, per sq cm",,,69.97,89.63,3
HCPCS,Q4171,"Interfyl, 1 mg",,,21.69,88.92,8
HCPCS,Q417100,"Interfyl, 1 mg",,,69.42,88.92,3
HCPCS,Q4173,Palingen or palingen xplus,,,117.73,2450.01,21
HCPCS,Q417300,Palingen or palingen xplus,,,621.26,795.77,3
HCPCS,Q4174,Palingen or promatrx,,,302.26,3406.32,8
HCPCS,Q417400,Palingen or promatrx,,,2659.32,3406.32,3
HCPCS,Q4175,Miroderm,,,117.73,208.71,20
HCPCS,Q417500,Miroderm,,,162.94,208.71,3
HCPCS,Q4176,"Neopatch or therion, 1 sq cm",,,117.73,433.2,19
HCPCS,Q417600,"Neopatch or therion, 1 sq cm",,,338.2,433.2,3
HCPCS,Q4177,"Floweramnioflo, 0.1 cc",,,320.4,410.4,7
HCPCS,Q417700,"Floweramnioflo, 0.1 cc",,,320.4,410.4,3
HCPCS,Q4178,"Floweramniopatch, per sq cm",,,117.73,237.06,20
HCPCS,Q417800,"Floweramniopatch, per sq cm",,,159.15,203.85,3
HCPCS,Q4179,"Flowerderm, per sq cm",,,117.73,129.51,12
HCPCS,Q4180,"Revita, per sq cm",,,117.73,3586.63,20
HCPCS,Q418000,"Revita, per sq cm",,,1167.89,1495.95,3
HCPCS,Q4181,"Amnio wound, per square cm",,,117.73,350.54,14
HCPCS,Q4182,"Transcyte, per sq centimeter",,,84.02,129.51,17
HCPCS,Q418200,"Transcyte, per sq centimeter",,,84.02,107.62,3
HCPCS,Q4183,"Surgigraft, 1 sq cm",,,117.73,1275.41,27
HCPCS,Q418300,"Surgigraft, 1 sq cm",,,178.0,228.0,3
HCPCS,Q4184,Cellesta or duo per sq cm,,,117.73,1342.33,19
HCPCS,Q418400,Cellesta or duo per sq cm,,,142.47,182.49,3
HCPCS,Q4186,DRSG EPIFIX PER SQ CM,330.77,215.0,79.38,340.41,78
HCPCS,Q4186,"EPIFIX, PER SQ CM",364.0,236.6,1.1,465.27,110
HCPCS,Q4186,Epifix 1 sq cm,,,269.08,344.67,3
HCPCS,Q4186,GRAFT EPIFIX  18MM DISC 2.5CM2,456.67,296.84,117.73,456.67,78
HCPCS,Q4186,GRAFT EPIFIX  2X4CM 8CM2,321.25,208.81,90.85,321.25,78
HCPCS,Q4186,GRAFT EPIFIX 2X2 PER SQ CM,629.94,409.46,117.73,629.94,78
HCPCS,Q4186,GRAFT EPIFIX 2X2CM 4 SQ CM,492.5,320.13,117.73,492.5,78
HCPCS,Q4186,GRAFT EPIFIX 2X3CM 6 SQ CM,381.33,247.86,107.84,381.33,78
HCPCS,Q4186,GRAFT EPIFIX 3.5X3.5CM 8SQ CM,298.5,194.03,84.42,298.5,78
HCPCS,Q4186,GRAFT EPIFIX 3X4CM 12CM2,381.5,247.98,107.89,381.5,78
HCPCS,Q4186,GRAFT EPIFIX 4X4.5CM 10.1SQ CM,258.8,168.22,73.19,258.8,78
HCPCS,Q4186,GRAFT EPIFIX 7X7CM 49 SQ CM,516.05,335.43,112.22,516.05,78
HCPCS,Q4186,GRAFT ST TIS 6X5CM EPIFIX,366.33,238.11,103.6,366.33,78
HCPCS,Q4186,GRAFT ST TIS EPIFIX 14MM AMNIO,299.0,194.35,84.56,299.0,78
HCPCS,Q4186,GRAFT ST TIS EPIFIX 16SQ CM,361.88,235.22,102.34,361.88,78
HCPCS,Q418600,Epifix 1 sq cm,,,269.08,344.67,3
HCPCS,Q4187,"EPICORD, PER SQUARE CM",205.0,133.25,49.2,521.87,78
HCPCS,Q4187,Epicord 1 sq cm,,,436.63,559.28,3
HCPCS,Q418700,Epicord 1 sq cm,,,436.63,559.28,3
HCPCS,Q4188,Amnioarmor 1 sq cm,,,117.73,1111.71,19
HCPCS,Q418800,Amnioarmor 1 sq cm,,,867.91,1111.71,3
HCPCS,Q4189,"Artacent ac, 1 mg",,,44.54,57.05,5
HCPCS,Q418900,"Artacent ac, 1 mg",,,44.54,57.05,3
HCPCS,Q4190,Artacent ac 1 sq cm,,,117.73,1211.41,20
HCPCS,Q419000,Artacent ac 1 sq cm,,,199.93,256.09,3
HCPCS,Q4191,Restorigin 1 sq cm,,,117.73,4211.38,20
HCPCS,Q419100,Restorigin 1 sq cm,,,1166.43,1494.08,3
HCPCS,Q4193,Coll-e-derm 1 sq cm,,,117.73,5033.17,27
HCPCS,Q419300,Coll-e-derm 1 sq cm,,,2479.75,3176.31,3
HCPCS,Q4194,Novachor 1 sq cm,,,117.73,1846.68,19
HCPCS,Q419400,Novachor 1 sq cm,,,1181.26,1513.08,3
HCPCS,Q4195,Puraply 1 sq cm,,,76.01,223.3,20
HCPCS,Q419500,Puraply 1 sq cm,,,174.33,223.3,3
HCPCS,Q4196,DRSG PURAPLY AM PER SQ CM,119.0,77.35,28.56,227.23,78
HCPCS,Q4196,Puraply am 1 sq cm,,,179.83,230.35,3
HCPCS,Q419600,Puraply am 1 sq cm,,,179.83,230.35,3
HCPCS,Q4197,Puraply xt 1 sq cm,,,117.73,336.97,20
HCPCS,Q419700,Puraply xt 1 sq cm,,,125.85,161.2,3
HCPCS,Q4198,Genesis amnio membrane 1sqcm,,,117.73,129.51,12
HCPCS,Q4199,"Cygnus matrix, per sq cm",,,117.73,870.88,20
HCPCS,Q419900,"Cygnus matrix, per sq cm",,,197.85,253.42,3
HCPCS,Q4200,Skin te 1 sq cm,,,117.73,129.51,12
HCPCS,Q4201,Matrion 1 sq cm,,,117.73,285.56,20
HCPCS,Q420100,Matrion 1 sq cm,,,135.44,173.49,3
HCPCS,Q4203,"Derma-gide, 1 sq cm",,,117.73,2400.59,20
HCPCS,Q420300,"Derma-gide, 1 sq cm",,,1874.14,2400.59,3
HCPCS,Q4204,Xwrap 1 sq cm,,,117.73,8418.08,27
HCPCS,Q420400,Xwrap 1 sq cm,,,6572.01,8418.08,3
HCPCS,Q4205,Membrane graft or wrap sq cm,,,117.73,4009.36,20
HCPCS,Q420500,Membrane graft or wrap sq cm,,,2202.36,2821.0,3
HCPCS,Q4206,Fluid flow or fluid gf 1 cc,,,5126.4,6566.4,3
HCPCS,Q420600,Fluid flow or fluid gf 1 cc,,,5126.4,6566.4,3
HCPCS,Q4208,Novafix per sq cm,,,117.73,1094.4,17
HCPCS,Q420800,Novafix per sq cm,,,854.4,1094.4,3
HCPCS,Q4209,Surgraft per sq cm,,,117.73,129.51,12
HCPCS,Q4210,Axolotl graf dualgraf sq cm,,,2323.52,4631.25,4
HCPCS,Q421000,Axolotl graf dualgraf sq cm,,,3615.63,4631.25,3
HCPCS,Q4211,Amnion bio or axobio sq cm,,,117.73,129.51,12
HCPCS,Q4213,"Ascent, 0.5 mg",,,122.71,157.18,7
HCPCS,Q421300,"Ascent, 0.5 mg",,,122.71,157.18,3
HCPCS,Q4214,Cellesta cord per sq cm,,,117.73,129.51,12
HCPCS,Q4216,Artacent cord per sq cm,,,117.73,129.51,12
HCPCS,Q4217,Woundfix biowound plus xplus,,,117.73,2140.35,20
HCPCS,Q421700,Woundfix biowound plus xplus,,,566.04,725.04,3
HCPCS,Q4218,Surgicord per sq cm,,,117.73,342.0,17
HCPCS,Q421800,Surgicord per sq cm,,,267.0,342.0,3
HCPCS,Q4219,Surgigraft dual per sq cm,,,117.73,2736.0,19
HCPCS,Q421900,Surgigraft dual per sq cm,,,2136.0,2736.0,3
HCPCS,Q4220,"Bellacell hd, surederm sq cm",,,117.73,129.51,12
HCPCS,Q4221,Amniowrap2 per sq cm,,,117.73,4647.04,20
HCPCS,Q422100,Amniowrap2 per sq cm,,,3490.58,4471.08,3
HCPCS,Q4222,"Progenamatrix, per sq cm",,,117.73,331.72,20
HCPCS,Q422200,"Progenamatrix, per sq cm",,,258.97,331.72,3
HCPCS,Q4224,Hhf10-p per sq cm,,,1101.49,1275.41,8
HCPCS,Q4225,"Amnio or derma tl, per sq cm",,,117.73,3254.59,27
HCPCS,Q422500,"Amnio or derma tl, per sq cm",,,2540.86,3254.59,3
HCPCS,Q4226,Myown harv prep proc sq cm,,,1058.98,3283.2,6
HCPCS,Q422600,Myown harv prep proc sq cm,,,2563.2,3283.2,3
HCPCS,Q4227,Amniocore per sq cm,,,117.73,2703.45,20
HCPCS,Q422700,Amniocore per sq cm,,,2087.16,2673.44,3
HCPCS,Q4229,Cogenex amnio memb per sq cm,,,117.73,1120.21,20
HCPCS,Q422900,Cogenex amnio memb per sq cm,,,821.22,1051.9,3
HCPCS,Q4231,"Corplex p, per cc",,,1167.93,4074.87,6
HCPCS,Q423100,"Corplex p, per cc",,,1167.93,1496.0,3
HCPCS,Q4232,"Corplex, per sq cm",,,117.73,570.05,20
HCPCS,Q423200,"Corplex, per sq cm",,,194.8,249.52,3
HCPCS,Q4234,"Xcellerate, per sq cm",,,117.73,1723.16,20
HCPCS,Q423400,"Xcellerate, per sq cm",,,986.01,1262.98,3
HCPCS,Q4235,Amniorepair or altiply sq cm,,,117.73,402.94,20
HCPCS,Q423500,Amniorepair or altiply sq cm,,,156.6,200.59,3
HCPCS,Q4236,Carepatch per sq cm,,,117.73,2378.7,20
HCPCS,Q423600,Carepatch per sq cm,,,799.95,1024.65,3
HCPCS,Q4237,"Cryo-cord, per sq cm",,,117.73,1138.59,19
HCPCS,Q423700,"Cryo-cord, per sq cm",,,888.9,1138.59,3
HCPCS,Q4238,"Derm-maxx, per sq cm",,,117.73,4356.6,20
HCPCS,Q423800,"Derm-maxx, per sq cm",,,2585.01,3311.13,3
HCPCS,Q4239,Amnio-maxx or lite per sq cm,,,117.73,5430.28,20
HCPCS,Q423900,Amnio-maxx or lite per sq cm,,,3386.66,4337.97,3
HCPCS,Q4246,"Coretext or protext, per cc",,,6923.0,11012.4,8
HCPCS,Q424600,"Coretext or protext, per cc",,,8597.4,11012.4,3
HCPCS,Q4247,"Amniotext patch, per sq cm",,,117.73,8390.4,20
HCPCS,Q424700,"Amniotext patch, per sq cm",,,6550.4,8390.4,3
HCPCS,Q4248,Dermacyte amn mem allo sq cm,,,117.73,5799.32,20
HCPCS,Q424800,Dermacyte amn mem allo sq cm,,,988.26,1265.86,3
HCPCS,Q4249,"Amniply, per sq cm",,,117.73,5809.64,19
HCPCS,Q424900,"Amniply, per sq cm",,,3506.4,4491.35,3
HCPCS,Q4250,Amnioamp-mp per sq cm,,,117.73,6793.4,19
HCPCS,Q425000,Amnioamp-mp per sq cm,,,5303.62,6793.4,3
HCPCS,Q4251,"Vim, per square centimeter",,,117.73,410.4,19
HCPCS,Q425100,"Vim, per square centimeter",,,320.4,410.4,3
HCPCS,Q4252,"Vendaje, per square centimet",,,94.34,810.99,20
HCPCS,Q425200,"Vendaje, per square centimet",,,94.34,120.84,3
HCPCS,Q4253,Zenith amniotic membrane psc,,,117.73,1289.86,20
HCPCS,Q425300,Zenith amniotic membrane psc,,,134.91,172.8,3
HCPCS,Q4254,Novafix dl per sq cm,,,117.73,877.2,17
HCPCS,Q425400,Novafix dl per sq cm,,,633.47,811.41,3
HCPCS,Q4255,"Reguard, topical use per sq",,,117.73,129.51,12
HCPCS,Q4256,"Mlg complet, per sq cm",,,117.73,2091.58,27
HCPCS,Q425600,"Mlg complet, per sq cm",,,1308.39,1675.91,3
HCPCS,Q4257,"Relese, per sq cm",,,117.73,2086.41,27
HCPCS,Q425700,"Relese, per sq cm",,,1628.86,2086.41,3
HCPCS,Q4258,"Enverse, per sq cm",,,117.73,1275.41,28
HCPCS,Q425800,"Enverse, per sq cm",,,159.76,204.63,3
HCPCS,Q4259,Celera per sq cm,,,117.73,2753.59,27
HCPCS,Q425900,Celera per sq cm,,,1270.03,1626.78,3
HCPCS,Q4260,"Signature apatch, per sq cm",,,117.73,1275.41,20
HCPCS,Q4261,"Tag, per square centimeter",,,117.73,1650.36,27
HCPCS,Q426100,"Tag, per square centimeter",,,1288.44,1650.36,3
HCPCS,Q4262,"Dual layer impax, per sq cm",,,117.73,650.42,19
HCPCS,Q426200,"Dual layer impax, per sq cm",,,176.27,225.79,3
HCPCS,Q4263,"Surgraft tl, per sq cm",,,117.73,4139.98,19
HCPCS,Q426300,"Surgraft tl, per sq cm",,,3232.09,4139.98,3
HCPCS,Q4264,"Cocoon membrane, per sq cm",,,117.73,6965.7,19
HCPCS,Q426400,"Cocoon membrane, per sq cm",,,663.74,850.19,3
HCPCS,Q4265,Neostim tl per sq cm,,,117.73,4546.61,19
HCPCS,Q426500,Neostim tl per sq cm,,,2467.88,3161.11,3
HCPCS,Q4266,Neostim per sq cm,,,117.73,1911.18,19
HCPCS,Q426600,Neostim per sq cm,,,961.73,1231.88,3
HCPCS,Q4267,Neostim dl per sq cm,,,117.73,2396.13,20
HCPCS,Q426700,Neostim dl per sq cm,,,575.31,736.92,3
HCPCS,Q4268,Surgraft ft per sq cm,,,117.73,2825.57,19
HCPCS,Q426800,Surgraft ft per sq cm,,,805.82,1032.18,3
HCPCS,Q4269,Surgraft xt per sq cm,,,117.73,4115.31,19
HCPCS,Q426900,Surgraft xt per sq cm,,,3212.83,4115.31,3
HCPCS,Q4270,Complete sl per sq cm,,,117.73,7569.26,17
HCPCS,Q427000,Complete sl per sq cm,,,5909.33,7569.26,3
HCPCS,Q4271,Complete ft per sq cm,,,117.73,3314.46,19
HCPCS,Q427100,Complete ft per sq cm,,,2031.59,2602.26,3
HCPCS,Q4272,"Esano a, per sq cm",,,117.73,798.0,19
HCPCS,Q427200,"Esano a, per sq cm",,,623.0,798.0,3
HCPCS,Q4273,"Esano aaa, per sq cm",,,117.73,129.51,12
HCPCS,Q4274,"Esano ac, per sq cm",,,117.73,4582.66,19
HCPCS,Q427400,"Esano ac, per sq cm",,,3349.07,4289.82,3
HCPCS,Q4275,"Esano aca, per sq cm",,,117.73,6172.64,19
HCPCS,Q427500,"Esano aca, per sq cm",,,4818.99,6172.64,3
HCPCS,Q4276,"Orion, per sq cm",,,117.73,1040.15,19
HCPCS,Q427600,"Orion, per sq cm",,,483.77,619.66,3
HCPCS,Q4277,"Woundplus e-grat, per sq cm",,,3337.5,4275.0,3
HCPCS,Q427700,"Woundplus e-grat, per sq cm",,,3337.5,4275.0,3
HCPCS,Q4278,"Epieffect, per sq cm",,,117.73,1446.72,20
HCPCS,Q427800,"Epieffect, per sq cm",,,374.78,480.05,3
HCPCS,Q4279,"Vendaje ac, per sq cm",,,117.73,5127.75,19
HCPCS,Q427900,"Vendaje ac, per sq cm",,,3778.44,4839.8,3
HCPCS,Q4280,Xcell amnio matrix per sq cm,,,117.73,5371.34,19
HCPCS,Q428000,Xcell amnio matrix per sq cm,,,4193.41,5371.34,3
HCPCS,Q4281,Barrera slor dl per sq cm,,,117.73,1909.44,19
HCPCS,Q428100,Barrera slor dl per sq cm,,,731.86,937.44,3
HCPCS,Q4282,Cygnus dual per sq cm,,,117.73,2474.99,20
HCPCS,Q428200,Cygnus dual per sq cm,,,599.17,767.47,3
HCPCS,Q4283,"Biovance tri or 3l, sq cm",,,117.73,1419.82,19
HCPCS,Q428300,"Biovance tri or 3l, sq cm",,,811.22,1039.09,3
HCPCS,Q4284,"Dermabind sl, per sq cm",,,117.73,129.51,12
HCPCS,Q4285,Nudyn dl or dl mesh pr sq cm,,,117.73,456.46,19
HCPCS,Q428500,Nudyn dl or dl mesh pr sq cm,,,356.36,456.46,3
HCPCS,Q4286,"Nudyn sl or slw, per sq cm",,,117.73,544.81,19
HCPCS,Q428600,"Nudyn sl or slw, per sq cm",,,381.01,488.03,3
HCPCS,Q4287,"Dermabind dl, per sq cm",,,117.73,129.51,12
HCPCS,Q4288,"Dermabind ch, per sq cm",,,117.73,129.51,12
HCPCS,Q4289,"Revoshield+ amnio, per sq cm",,,117.73,3997.93,19
HCPCS,Q428900,"Revoshield+ amnio, per sq cm",,,2711.03,3472.55,3
HCPCS,Q4290,Membrane wrap hydr per sq cm,,,117.73,4771.75,19
HCPCS,Q429000,Membrane wrap hydr per sq cm,,,3323.28,4256.78,3
HCPCS,Q4291,"Lamellas xt, per sq cm",,,117.73,7961.76,19
HCPCS,Q429100,"Lamellas xt, per sq cm",,,6215.76,7961.76,3
HCPCS,Q4292,"Lamellas, per sq cm",,,117.73,3283.2,19
HCPCS,Q429200,"Lamellas, per sq cm",,,2563.2,3283.2,3
HCPCS,Q4293,"Acesso dl, per sq cm",,,117.73,3613.12,19
HCPCS,Q429300,"Acesso dl, per sq cm",,,2820.77,3613.12,3
HCPCS,Q4294,"Amnio quad-core, per sq cm",,,117.73,7669.49,19
HCPCS,Q429400,"Amnio quad-core, per sq cm",,,5987.58,7669.49,3
HCPCS,Q4295,"Amnio tri-core, per sq cm",,,117.73,6624.43,19
HCPCS,Q429500,"Amnio tri-core, per sq cm",,,5171.7,6624.43,3
HCPCS,Q4296,"Rebound matrix, per sq cm",,,117.73,5809.99,19
HCPCS,Q429600,"Rebound matrix, per sq cm",,,1492.48,1911.71,3
HCPCS,Q4297,"Emerge matrix, per sq cm",,,117.73,3844.54,19
HCPCS,Q429700,"Emerge matrix, per sq cm",,,2318.09,2969.24,3
HCPCS,Q4298,"Amniocore pro, per sq cm",,,117.73,6005.86,19
HCPCS,Q429800,"Amniocore pro, per sq cm",,,4688.79,6005.86,3
HCPCS,Q4299,"Amniocore pro+, per sq cm",,,117.73,7207.63,17
HCPCS,Q429900,"Amniocore pro+, per sq cm",,,5627.01,7207.63,3
HCPCS,Q4300,"Acesso tl, per sq cm",,,117.73,4839.85,19
HCPCS,Q430000,"Acesso tl, per sq cm",,,3778.48,4839.85,3
HCPCS,Q4301,"Activate matrix, per sq cm",,,117.73,4160.1,19
HCPCS,Q430100,"Activate matrix, per sq cm",,,3200.64,4099.69,3
HCPCS,Q4302,"Complete aca, per sq cm",,,117.73,4318.71,19
HCPCS,Q430200,"Complete aca, per sq cm",,,2207.02,2826.97,3
HCPCS,Q4303,"Complete aa, per sq cm",,,117.73,7679.93,19
HCPCS,Q430300,"Complete aa, per sq cm",,,5995.73,7679.93,3
HCPCS,Q4304,"Grafix plus, per sq cm",,,117.73,1977.98,19
HCPCS,Q430400,"Grafix plus, per sq cm",,,796.48,1020.21,3
HCPCS,Q4305,Amer am ac tri-lay per sq cm,,,117.73,129.51,12
HCPCS,Q4306,Americ amnion ac per sq cm,,,117.73,129.51,12
HCPCS,Q4307,"American amnion, per sq cm",,,117.73,129.51,12
HCPCS,Q4308,"Sanopellis, per sq cm",,,117.73,129.51,12
HCPCS,Q4309,"Via matrix, per sq cm",,,117.73,4517.26,19
HCPCS,Q430900,"Via matrix, per sq cm",,,1566.45,2006.47,3
HCPCS,Q4310,"Procenta, per 100 mg",,,2991.94,13543.2,7
HCPCS,Q431000,"Procenta, per 100 mg",,,10573.2,13543.2,3
HCPCS,Q4311,"Acesso, per sq cm",,,117.73,4568.75,14
HCPCS,Q4312,"Acesso ac, per sq cm",,,117.73,5498.81,17
HCPCS,Q431200,"Acesso ac, per sq cm",,,4292.93,5498.81,3
HCPCS,Q4313,"Dermabind fm, per sq cm",,,117.73,7552.55,19
HCPCS,Q431300,"Dermabind fm, per sq cm",,,5896.29,7552.55,3
HCPCS,Q4314,"Reeva, per sq cm",,,117.73,5316.96,17
HCPCS,Q431400,"Reeva, per sq cm",,,4150.96,5316.96,3
HCPCS,Q4315,Regenelink amniotic mem allo,,,117.73,129.51,12
HCPCS,Q4316,"Amchoplast, per sq cm",,,117.73,9639.77,17
HCPCS,Q431600,"Amchoplast, per sq cm",,,7525.79,9639.77,3
HCPCS,Q4317,"Vitograft, per sq cm",,,117.73,10875.6,17
HCPCS,Q431700,"Vitograft, per sq cm",,,8490.6,10875.6,3
HCPCS,Q4318,"E-graft, per sq cm",,,117.73,3645.86,14
HCPCS,Q4319,"Sanograft, per sq cm",,,117.73,6404.52,19
HCPCS,Q431900,"Sanograft, per sq cm",,,5000.02,6404.52,3
HCPCS,Q4320,"Pellograft, per sq cm",,,117.73,1935.84,19
HCPCS,Q432000,"Pellograft, per sq cm",,,317.8,407.07,3
HCPCS,Q4321,"Renograft, per sq cm",,,117.73,8700.48,17
HCPCS,Q432100,"Renograft, per sq cm",,,6792.48,8700.48,3
HCPCS,Q4322,"Caregraft, per sq cm",,,117.73,5075.51,19
HCPCS,Q432200,"Caregraft, per sq cm",,,3249.6,4162.41,3
HCPCS,Q4323,"Alloply, per sq cm",,,117.73,4214.95,19
HCPCS,Q432300,"Alloply, per sq cm",,,2782.41,3563.98,3
HCPCS,Q4324,"Amniotx, per sq cm",,,117.73,4514.4,19
HCPCS,Q432400,"Amniotx, per sq cm",,,3524.4,4514.4,3
HCPCS,Q4325,"Acapatch, per sq cm",,,117.73,6085.92,19
HCPCS,Q432500,"Acapatch, per sq cm",,,3039.9,3893.81,3
HCPCS,Q4326,"Woundplus, per sq cm",,,117.73,4038.62,19
HCPCS,Q432600,"Woundplus, per sq cm",,,1891.64,2423.0,3
HCPCS,Q4327,"Duoamnion, per sq cm",,,117.73,129.51,12
HCPCS,Q4328,"Most, per sq cm",,,117.73,7844.64,19
HCPCS,Q432800,"Most, per sq cm",,,6124.32,7844.64,3
HCPCS,Q4329,"Singlay, per sq cm",,,117.73,129.51,12
HCPCS,Q4330,"Total, per sq cm",,,117.73,129.51,12
HCPCS,Q4331,"Axolotl graft, per sq cm",,,117.73,4367.19,19
HCPCS,Q433100,"Axolotl graft, per sq cm",,,2829.7,3624.56,3
HCPCS,Q4332,"Axolotl dualgraft, per sq cm",,,117.73,4368.69,19
HCPCS,Q433200,"Axolotl dualgraft, per sq cm",,,2992.77,3833.43,3
HCPCS,Q4333,"Ardeograft, per sq cm",,,117.73,2052.0,19
HCPCS,Q433300,"Ardeograft, per sq cm",,,1602.0,2052.0,3
HCPCS,Q4334,"Amnioplast 1, per sq cm",,,117.73,129.51,12
HCPCS,Q4335,"Amnioplast 2, per sq cm",,,117.73,129.51,12
HCPCS,Q4336,"Artecent c, per sq cm",,,117.73,129.51,12
HCPCS,Q4337,"Artecent trident, per sq cm",,,117.73,129.51,12
HCPCS,Q4338,"Artacent velos, per sq cm",,,117.73,129.51,12
HCPCS,Q4339,"Artacent vericlen, per sq cm",,,117.73,6114.39,19
HCPCS,Q433900,"Artacent vericlen, per sq cm",,,3658.51,4686.18,3
HCPCS,Q4340,"Simpligraft, per sq cm",,,117.73,3141.59,17
HCPCS,Q434000,"Simpligraft, per sq cm",,,2452.64,3141.59,3
HCPCS,Q4341,"Simplimax, per sq cm",,,117.73,8034.97,19
HCPCS,Q434100,"Simplimax, per sq cm",,,6272.92,8034.97,3
HCPCS,Q4342,"Theramend, per sq cm",,,117.73,9113.05,19
HCPCS,Q434200,"Theramend, per sq cm",,,4042.72,5178.31,3
HCPCS,Q4343,Dermacyte ac matrx per sq cm,,,117.73,6730.79,19
HCPCS,Q434300,Dermacyte ac matrx per sq cm,,,5254.74,6730.79,3
HCPCS,Q4344,"Tri membrane wrap, per sq cm",,,117.73,8149.61,19
HCPCS,Q434400,"Tri membrane wrap, per sq cm",,,6362.41,8149.61,3
HCPCS,Q4345,Matrix hd allogrft per sq cm,,,117.73,6042.0,17
HCPCS,Q434500,Matrix hd allogrft per sq cm,,,4717.0,6042.0,3
HCPCS,Q4346,Shelter dm matrix per sq cm,,,117.73,9037.76,19
HCPCS,Q434600,Shelter dm matrix per sq cm,,,6521.55,8353.44,3
HCPCS,Q4347,Rampart dl matrix per sq cm,,,117.73,7066.7,17
HCPCS,Q434700,Rampart dl matrix per sq cm,,,5516.99,7066.7,3
HCPCS,Q4348,Sentry sl matrix per sq cm,,,117.73,5035.32,19
HCPCS,Q434800,Sentry sl matrix per sq cm,,,3622.09,4639.53,3
HCPCS,Q4349,Mantle dl matrix per sq cm,,,117.73,9576.0,19
HCPCS,Q434900,Mantle dl matrix per sq cm,,,7476.0,9576.0,3
HCPCS,Q4350,Palisade dm matrix per sq cm,,,117.73,9037.76,19
HCPCS,Q435000,Palisade dm matrix per sq cm,,,6422.4,8226.45,3
HCPCS,Q4351,"Enclose tl matrix, per sq cm",,,117.73,10260.0,19
HCPCS,Q435100,"Enclose tl matrix, per sq cm",,,8010.0,10260.0,3
HCPCS,Q4352,"Overlay sl matrix, per sq cm",,,117.73,5335.2,19
HCPCS,Q435200,"Overlay sl matrix, per sq cm",,,4165.2,5335.2,3
HCPCS,Q4353,Xceed tl matrix per sq cm,,,117.73,9459.36,19
HCPCS,Q435300,Xceed tl matrix per sq cm,,,7384.94,9459.36,3
HCPCS,Q4354,Palingen dl-palingen dl-x,,,117.73,11365.8,17
HCPCS,Q435400,Palingen dl-palingen dl-x,,,8873.3,11365.8,3
HCPCS,Q4355,Abio xpl abio xpl hy p sq cm,,,117.73,6465.44,17
HCPCS,Q435500,Abio xpl abio xpl hy p sq cm,,,5047.58,6465.44,3
HCPCS,Q4356,Abio mem abio hyd per sq cm,,,117.73,6840.0,17
HCPCS,Q435600,Abio mem abio hyd per sq cm,,,5340.0,6840.0,3
HCPCS,Q4357,"Xwrap plus, per sq cm",,,117.73,10875.6,17
HCPCS,Q435700,"Xwrap plus, per sq cm",,,8490.6,10875.6,3
HCPCS,Q4358,"Xwrap dual, per sq cm",,,117.73,13436.82,17
HCPCS,Q435800,"Xwrap dual, per sq cm",,,10490.15,13436.82,3
HCPCS,Q4359,"Choriply, per sq cm",,,117.73,6336.85,17
HCPCS,Q435900,"Choriply, per sq cm",,,4947.19,6336.85,3
HCPCS,Q4360,Amchoplast fd per sq cm,,,117.73,6372.6,17
HCPCS,Q436000,Amchoplast fd per sq cm,,,4975.1,6372.6,3
HCPCS,Q4361,"Epixpress, per sq cm",,,117.73,4833.6,17
HCPCS,Q436100,"Epixpress, per sq cm",,,3773.6,4833.6,3
HCPCS,Q4362,"Cygnus disk, per sq cm",,,117.73,4827.37,14
HCPCS,Q4363,Am bur mem hydro per sq cm,,,117.73,129.51,12
HCPCS,Q4364,Am bur xp mem xpl hy p sq cm,,,117.73,8448.77,17
HCPCS,Q436400,Am bur xp mem xpl hy p sq cm,,,6595.97,8448.77,3
HCPCS,Q4365,Amnio bur dl mem per sq cm,,,117.73,10197.45,14
HCPCS,Q4366,Dl amnio bur x-mem per sq cm,,,117.73,129.51,12
HCPCS,Q4367,"Amniocore sl, per sq cm",,,117.73,1715.45,17
HCPCS,Q436700,"Amniocore sl, per sq cm",,,1339.25,1715.45,3
HCPCS,Q4368,Amchothick per sq cm,,,117.73,10624.8,17
HCPCS,Q436800,Amchothick per sq cm,,,8294.8,10624.8,3
HCPCS,Q4369,Amnioplast 3 per sq cm,,,117.73,129.51,12
HCPCS,Q4370,Aeroguard per sq cm,,,117.73,129.51,12
HCPCS,Q4371,Neoguard per sq cm,,,117.73,129.51,12
HCPCS,Q4372,Amchoplast excl per sq cm,,,117.73,129.51,12
HCPCS,Q4373,Membrane wrp lt per sq cm,,,117.73,7515.79,17
HCPCS,Q437300,Membrane wrp lt per sq cm,,,5867.59,7515.79,3
HCPCS,Q4375,Duograft ac per sq cm,,,117.73,129.51,12
HCPCS,Q4376,Duograft aa per sq cm,,,117.73,129.51,12
HCPCS,Q4377,Trigraft ft per sq cm,,,117.73,129.51,12
HCPCS,Q4378,Renew ft matrix per sq cm,,,117.73,10533.6,17
HCPCS,Q437800,Renew ft matrix per sq cm,,,8223.6,10533.6,3
HCPCS,Q4379,Amniodefend ft per sq cm,,,117.73,7797.6,17
HCPCS,Q437900,Amniodefend ft per sq cm,,,6087.6,7797.6,3
HCPCS,Q4380,Advograft one per sq cm,,,117.73,129.51,12
HCPCS,Q4382,Advograft dual per sq cm,,,117.73,129.51,12
HCPCS,Q4383,Axolotl graft ult per sq cm,,,117.73,129.51,12
HCPCS,Q4384,Axolotl dual ult per sq cm,,,117.73,129.51,12
HCPCS,Q4385,Apollo ft per sq cm,,,117.73,129.51,12
HCPCS,Q4386,Acesso trifaca per sq cm,,,117.73,129.51,12
HCPCS,Q4387,Neothelium ft per sq cm,,,117.73,4322.4,14
HCPCS,Q4388,Neothelium 4l per sq cm,,,117.73,129.51,12
HCPCS,Q4389,Neothelium 4l+ per sq cm,,,117.73,129.51,12
HCPCS,Q4390,Ascendion per sq cm,,,117.73,129.51,12
HCPCS,Q4391,Amnioplast double per sq cm,,,117.73,129.51,12
HCPCS,Q4392,Grafix duo per sq cm,,,117.73,129.51,12
HCPCS,Q4393,Surgraft ac per sq cm,,,117.73,129.51,12
HCPCS,Q4394,Surgraft aca per sq cm,,,117.73,129.51,12
HCPCS,Q4395,Acelagraft per sq cm,,,117.73,129.51,12
HCPCS,Q4396,Natalin per sq cm,,,117.73,7660.8,17
HCPCS,Q439600,Natalin per sq cm,,,5980.8,7660.8,3
HCPCS,Q4397,Summit aaa per sq cm,,,117.73,129.51,12
HCPCS,Q4398,Summit ac per sq cm,,,117.73,129.51,12
HCPCS,Q4399,Summit fx per sq cm,,,117.73,129.51,12
HCPCS,Q4400,Polygon3 per sq cm,,,117.73,129.51,12
HCPCS,Q4401,Absolv3 per sq cm,,,117.73,129.51,12
HCPCS,Q4402,Xwrap 2.0 per sq cm,,,117.73,129.51,12
HCPCS,Q4403,Xwrap dual plus per sq cm,,,117.73,129.51,12
HCPCS,Q4404,Xwrap hydro plus per sq cm,,,117.73,129.51,12
HCPCS,Q4405,Xwrap fenestra plus sq cm,,,117.73,129.51,12
HCPCS,Q4406,Xwrap fenestra per sq cm,,,117.73,129.51,12
HCPCS,Q4407,Xwrap tribus per sq cm,,,117.73,129.51,12
HCPCS,Q4408,Xwrap hydro per sq cm,,,117.73,129.51,12
HCPCS,Q4409,Amniomatrixf3x per sq cm,,,117.73,129.51,12
HCPCS,Q4410,Amchomatrixdl per sq cm,,,117.73,129.51,12
HCPCS,Q4411,Amniomatrixf4x per sq cm,,,117.73,129.51,12
HCPCS,Q4412,Choriofix per sq cm,,,117.73,129.51,12
HCPCS,Q4413,Cygnus solo per sq cm,,,117.73,2083.35,14
HCPCS,Q4414,Simplichor per sq cm,,,117.73,129.51,12
HCPCS,Q4415,Alexiguard st-l per sq cm,,,117.73,129.51,12
HCPCS,Q4416,Alexiguard tl-t per sq cm,,,117.73,129.51,12
HCPCS,Q4417,Alexiguard dl-t per sq cm,,,117.73,129.51,12
HCPCS,Q4420,Nuform per sq cm,,,117.73,129.51,12
HCPCS,Q4431,"Pma skin substitute, nos",,,117.73,129.51,12
HCPCS,Q4432,"510(k) skin subs, nos",,,117.73,129.51,12
HCPCS,Q4433,"361 hct/p skin subs, nos",,,117.73,129.51,12
HCPCS,Q5001,Hospice or home hlth in home,,,0.03,0.03,1
HCPCS,Q5002,Hospice/home hlth in asst lv,,,2739849.3,2739849.3,1
HCPCS,Q5003,Hospice in lt/non-skilled nf,,,63.76,2739849.3,9
HCPCS,Q5004,Hospice in snf,,,63.76,2739849.3,9
HCPCS,Q5005,"Hospice, inpatient hospital",,,63.76,2739849.3,9
HCPCS,Q5006,Hospice in hospice facility,,,63.76,794.05,9
HCPCS,Q5007,Hospice in ltch,,,63.76,2739849.3,9
HCPCS,Q5008,Hospice in inpatient psych,,,63.76,2739849.3,9
HCPCS,Q5009,"Hospice/home hlth, place nos",,,2739849.3,2739849.3,1
HCPCS,Q5010,Hospice home care in hospice,,,2739849.3,2739849.3,1
HCPCS,Q5098,"Inj ustekinumab-srlf, 1 mg",,,18.07,5653.6,13
HCPCS,Q509800,"Inj ustekinumab-srlf, 1 mg",,,18.07,23.14,3
HCPCS,Q5099,"Inj ustekinumab-stba, 1 mg",,,20.74,5653.6,16
HCPCS,Q509900,"Inj ustekinumab-stba, 1 mg",,,21.09,27.02,3
HCPCS,Q5100,"Inj ustekinumab-kfce, 1 mg",,,3.09,5653.6,30
HCPCS,Q510000,"Inj ustekinumab-kfce, 1 mg",,,43.93,56.27,3
HCPCS,Q5101,"Injection, zarxio",,,0.04,232.34,41
HCPCS,Q510100,"Injection, zarxio",,,0.62,0.8,3
HCPCS,Q5103,"Injection, inflectra",,,3.03,1622.37,41
HCPCS,Q510300,"Injection, inflectra",,,57.71,73.92,3
HCPCS,Q5104,"INJECTION, RENFLEXIS",271.0,176.15,27.18,1622.37,93
HCPCS,Q5104,"Injection, renflexis",,,49.4,63.27,3
HCPCS,Q510400,"Injection, renflexis",,,49.4,63.27,3
HCPCS,Q5105,Inj retacrit esrd on dialysi,,,0.75,164.23,27
HCPCS,Q510500,Inj retacrit esrd on dialysi,,,1.35,1.73,3
HCPCS,Q5106,INJ RETACRIT NON_ESRD USE (RETACRIT),39.81,25.88,7.51,465.3,93
HCPCS,Q5106,Inj retacrit non-esrd use,,,13.47,17.26,3
HCPCS,Q510600,Inj retacrit non-esrd use,,,13.47,17.26,3
HCPCS,Q5107,Inj mvasi 10 mg,,,2.98,1622.37,41
HCPCS,Q510700,Inj mvasi 10 mg,,,42.44,54.36,3
HCPCS,Q5108,"Injection, fulphila",,,12.36,3329.32,41
HCPCS,Q510800,"Injection, fulphila",,,175.99,225.42,3
HCPCS,Q5109,"Injection, ixifi, 10 mg",,,401.85,2739849.3,9
HCPCS,Q5110,Nivestym,,,0.04,232.34,41
HCPCS,Q511000,Nivestym,,,0.5,0.64,3
HCPCS,Q5111,"Injection, udenyca 0.5 mg",,,20.25,4103.47,41
HCPCS,Q511100,"Injection, udenyca 0.5 mg",,,288.34,369.34,3
HCPCS,Q5112,Inj ontruzant 10 mg,,,3.41,4103.47,41
HCPCS,Q511200,Inj ontruzant 10 mg,,,48.54,62.18,3
HCPCS,Q5113,Inj herzuma 10 mg,,,6.93,4103.47,41
HCPCS,Q511300,Inj herzuma 10 mg,,,98.67,126.38,3
HCPCS,Q5114,Inj ogivri 10 mg,,,4.71,4103.47,41
HCPCS,Q511400,Inj ogivri 10 mg,,,67.12,85.98,3
HCPCS,Q5115,Inj truxima 10 mg,,,3.77,4103.47,41
HCPCS,Q511500,Inj truxima 10 mg,,,53.67,68.74,3
HCPCS,Q5116,"Inj., trazimera, 10 mg",,,1.03,4103.47,41
HCPCS,Q511600,"Inj., trazimera, 10 mg",,,14.61,18.72,3
HCPCS,Q5117,"Inj., kanjinti, 10 mg",,,6.43,3329.32,41
HCPCS,Q511700,"Inj., kanjinti, 10 mg",,,91.56,117.28,3
HCPCS,Q5118,"Inj., zirabev, 10 mg",,,3.23,1622.37,41
HCPCS,Q511800,"Inj., zirabev, 10 mg",,,45.92,58.82,3
HCPCS,Q5119,"Inj ruxience, 10 mg",,,1.66,4103.47,41
HCPCS,Q511900,"Inj ruxience, 10 mg",,,23.62,30.26,3
HCPCS,Q5120,Inj pegfilgrastim-bmez 0.5mg,,,14.91,4103.47,41
HCPCS,Q512000,Inj pegfilgrastim-bmez 0.5mg,,,212.34,271.98,3
HCPCS,Q5121,"Inj. avsola, 10 mg",,,2.98,840.33,41
HCPCS,Q512100,"Inj. avsola, 10 mg",,,57.71,73.92,3
HCPCS,Q5122,"Inj, nyvepria",,,16.63,5653.6,41
HCPCS,Q512200,"Inj, nyvepria",,,236.83,303.35,3
HCPCS,Q5123,"Inj. riabni, 10 mg",,,2.61,4103.47,41
HCPCS,Q512300,"Inj. riabni, 10 mg",,,37.2,47.65,3
HCPCS,Q5124,"Inj. byooviz, 0.1 mg",,,7.53,1622.37,41
HCPCS,Q512400,"Inj. byooviz, 0.1 mg",,,107.19,137.3,3
HCPCS,Q5125,"Inj, releuko 1 mcg",,,0.04,232.34,41
HCPCS,Q512500,"Inj, releuko 1 mcg",,,0.61,0.78,3
HCPCS,Q5126,Inj alymsys 10 mg,,,4.13,1622.37,41
HCPCS,Q512600,Inj alymsys 10 mg,,,58.76,75.26,3
HCPCS,Q5127,"Inj, stimufend, 0.5 mg",,,18.41,4103.47,40
HCPCS,Q512700,"Inj, stimufend, 0.5 mg",,,262.09,335.71,3
HCPCS,Q5128,"Inj, cimerli, 0.1 mg",,,10.42,908.28,40
HCPCS,Q512800,"Inj, cimerli, 0.1 mg",,,148.35,190.02,3
HCPCS,Q5129,"Inj, vegzelma, 10 mg",,,4.77,1622.37,40
HCPCS,Q512900,"Inj, vegzelma, 10 mg",,,67.92,87.0,3
HCPCS,Q5130,"Inj, fylnetra, 0.5 mg",,,15.9,3329.32,40
HCPCS,Q513000,"Inj, fylnetra, 0.5 mg",,,226.47,290.08,3
HCPCS,Q5131,"Inj, idacio, 20 mg",,,960.13,2739849.3,12
HCPCS,Q513100,"Inj, idacio, 20 mg",,,960.13,1229.83,3
HCPCS,Q5132,"Inj, abrilada, 10 mg",,,784.42,2739849.3,9
HCPCS,Q5133,"Inj, tofidence, 1 mg",,,0.7,908.28,39
HCPCS,Q513300,"Inj, tofidence, 1 mg",,,9.95,12.75,3
HCPCS,Q5134,"Inj, tyruko, 1 mg",,,3.05,5565.45,27
HCPCS,Q513400,"Inj, tyruko, 1 mg",,,50.57,64.77,3
HCPCS,Q5135,"Inj, tyenne, 1 mg",,,0.52,465.3,39
HCPCS,Q513500,"Inj, tyenne, 1 mg",,,7.46,9.55,3
HCPCS,Q5136,"Inj. denosumab-bbdz, 1 mg",,,3.53,1559.81,30
HCPCS,Q513600,"Inj. denosumab-bbdz, 1 mg",,,50.25,64.36,3
HCPCS,Q5137,"Inj, wezlana, sub cu, 1 mg",,,132.17,8832.81,15
HCPCS,Q513700,"Inj, wezlana, sub cu, 1 mg",,,132.17,169.29,3
HCPCS,Q5138,"Inj, wezlana, iv, 1 mg",,,1.46,5653.6,32
HCPCS,Q513800,"Inj, wezlana, iv, 1 mg",,,20.72,26.54,3
HCPCS,Q5139,"Inj, eculizumab-aeeb, 10 mg",,,18080.41,20935.21,8
HCPCS,Q5140,"Inj adalimumab-fkjp, 1 mg",,,87.14,232.34,17
HCPCS,Q5141,"Inj adalimumab-aaty, 1 mg",,,43.57,232.34,17
HCPCS,Q5142,"Inj adalimumab-ryvk, 1 mg",,,13.36,232.34,22
HCPCS,Q514200,"Inj adalimumab-ryvk, 1 mg",,,27.71,35.5,3
HCPCS,Q5143,"Inj adalimumab-adbm, 1 mg",,,22.42,232.34,17
HCPCS,Q5144,"Inj, idacio, 1 mg",,,14.63,232.34,22
HCPCS,Q514400,"Inj, idacio, 1 mg",,,24.01,30.76,3
HCPCS,Q5145,"Inj, abrilada, 1 mg",,,99.63,275.35,17
HCPCS,Q5146,"Inj, hercessi, 10 mg",,,4.64,4103.47,32
HCPCS,Q514600,"Inj, hercessi, 10 mg",,,66.13,84.7,3
HCPCS,Q5147,"Inj, aflibercept-ayyh, 1 mg",,,108.28,3329.32,30
HCPCS,Q514700,"Inj, aflibercept-ayyh, 1 mg",,,1541.84,1974.94,3
HCPCS,Q5148,"Inj, nyposi 1 mcg",,,0.13,232.34,30
HCPCS,Q514800,"Inj, nyposi 1 mcg",,,1.78,2.28,3
HCPCS,Q5149,"Inj, aflibercept-abzv, 1 mg",,,2875.32,3329.32,8
HCPCS,Q5150,"Inj, aflibercept-mrbb, 1 mg",,,2875.32,3329.32,8
HCPCS,Q5151,"Inj, eculizumab-aagh, 2 mg",,,3.96,3329.32,30
HCPCS,Q515100,"Inj, eculizumab-aagh, 2 mg",,,56.37,72.21,3
HCPCS,Q5152,"Inj, eculizumab-aeeb, 2 mg",,,5.29,3329.32,30
HCPCS,Q515200,"Inj, eculizumab-aeeb, 2 mg",,,75.38,96.56,3
HCPCS,Q5153,"Inj, aflibercept-yszy, 1 mg",,,2875.32,3329.32,8
HCPCS,Q5154,"Inj, omlyclo, 5 mg",,,1401.14,1622.37,8
HCPCS,Q5155,"Inj, aflibercept-jbvf, 1 mg",,,1401.14,1622.37,8
HCPCS,Q5156,"Inj, tocilizumab-anoh, 1 mg",,,9.22,1622.37,13
HCPCS,Q515600,"Inj, tocilizumab-anoh, 1 mg",,,9.22,11.81,3
HCPCS,Q5157,"Inj, denosumab-bmwo, 1 mg",,,3.52,1559.81,27
HCPCS,Q515700,"Inj, denosumab-bmwo, 1 mg",,,60.88,77.98,3
HCPCS,Q5158,"Inj, denosumab-bnht, 1 mg",,,3.59,1559.81,27
HCPCS,Q515800,"Inj, denosumab-bnht, 1 mg",,,62.16,79.62,3
HCPCS,Q5159,"Inj, denosumab-dssb, 1 mg",,,34.71,1559.81,13
HCPCS,Q515900,"Inj, denosumab-dssb, 1 mg",,,34.71,44.46,3
HCPCS,Q5160,"Inj, jobevne, 10 mg",,,10.55,4103.47,27
HCPCS,Q516000,"Inj, jobevne, 10 mg",,,170.03,217.79,3
HCPCS,Q5161,"Inj den (auk/bos),biosim 1mg",,,1347.11,1559.81,8
HCPCS,Q5162,"Injection, denosumab-nxxp",,,725.74,840.33,8
HCPCS,Q9001,Chaplain assessment,,,63.76,2739849.3,9
HCPCS,Q9002,Chaplain counsel individu,,,63.76,2739849.3,9
HCPCS,Q9003,Chaplain counsel group,,,63.76,2739849.3,9
HCPCS,Q9004,Va whole health partner serv,,,63.76,2739849.3,9
HCPCS,Q9950,INJ SULF HEXA LIPID MICROSPH,43.0,27.95,9.37,43.0,75
HCPCS,Q9950,Inj sulf hexa lipid microsph,,,32.34,41.43,3
HCPCS,Q9950,LUMASON 25MG VIAL NDC 00270-7099-16,98.0,63.7,19.64,98.0,69
HCPCS,Q995000,Inj sulf hexa lipid microsph,,,32.34,41.43,3
HCPCS,Q9951,"Locm >= 400 mg/ml iodine,1ml",,,24.99,28.93,8
HCPCS,Q9953,"Inj fe-based mr contrast,1ml",,,24.99,133.41,14
HCPCS,Q995300,"Inj fe-based mr contrast,1ml",,,31.2,39.97,3
HCPCS,Q9954,"Oral mr contrast, 100 ml",,,10.92,28.93,12
HCPCS,Q995400,"Oral mr contrast, 100 ml",,,22.37,28.66,3
HCPCS,Q9955,"Inj perflexane lip micros,ml",,,24.99,36.94,13
HCPCS,Q995500,"Inj perflexane lip micros,ml",,,28.84,36.94,3
HCPCS,Q9956,"INJ OCTAFLUOROPROPANE MIC,ML",479.0,311.35,1.1,479.0,78
HCPCS,Q9956,"Inj octafluoropropane mic,ml",,,24.99,93.29,19
HCPCS,Q995600,"Inj octafluoropropane mic,ml",,,71.57,91.68,3
HCPCS,Q9957,"INJ PERFLUTREN LIP MICROS, ML",547.87,356.12,24.99,547.87,75
HCPCS,Q9957,"INJ PERFLUTREN LIP MICROS,ML",382.0,248.3,1.1,382.0,78
HCPCS,Q9957,"Inj perflutren lip micros,ml",,,71.57,91.68,3
HCPCS,Q995700,"Inj perflutren lip micros,ml",,,71.57,91.68,3
HCPCS,Q9958,"CYSTO-CONRAY II, PER ML",2.88,1.87,0.13,28.93,74
HCPCS,Q9958,"Hocm <=149 mg/ml iodine, 1ml",,,0.12,0.16,3
HCPCS,Q995800,"Hocm <=149 mg/ml iodine, 1ml",,,0.12,0.16,3
HCPCS,Q9959,"Hocm 150-199mg/ml iodine,1ml",,,0.2,28.93,11
HCPCS,Q995900,"Hocm 150-199mg/ml iodine,1ml",,,0.2,0.25,3
HCPCS,Q9960,CONTR HOCM 200-249MG 1ML,17.0,11.05,0.21,28.93,68
HCPCS,Q9960,"Hocm 200-249mg/ml iodine,1ml",,,0.32,0.41,3
HCPCS,Q996000,"Hocm 200-249mg/ml iodine,1ml",,,0.32,0.41,3
HCPCS,Q9961,"Hocm 250-299mg/ml iodine,1ml",,,0.46,0.59,3
HCPCS,Q9961,IOTHALAMATE MEGLUMINE INJ USP 60%,36.1,23.47,0.45,36.1,74
HCPCS,Q996100,"Hocm 250-299mg/ml iodine,1ml",,,0.46,0.59,3
HCPCS,Q9962,"Hocm 300-349mg/ml iodine,1ml",,,0.39,28.93,13
HCPCS,Q996200,"Hocm 300-349mg/ml iodine,1ml",,,0.55,0.71,3
HCPCS,Q9963,"Hocm 350-399mg/ml iodine,1ml",,,0.19,28.93,19
HCPCS,Q996300,"Hocm 350-399mg/ml iodine,1ml",,,0.39,0.5,3
HCPCS,Q9964,"Hocm>= 400mg/ml iodine, 1ml",,,0.62,28.93,13
HCPCS,Q996400,"Hocm>= 400mg/ml iodine, 1ml",,,0.69,0.89,3
HCPCS,Q9965,"LOCM 100-199MG/ML IODINE,1ML",14.0,9.1,0.85,14.0,78
HCPCS,Q9965,"Locm 100-199mg/ml iodine,1ml",,,0.85,28.93,19
HCPCS,Q996500,"Locm 100-199mg/ml iodine,1ml",,,1.85,2.37,3
HCPCS,Q9966,CNTRST RAD OMPQ 240 100ML,3.48,2.26,0.7,28.93,72
HCPCS,Q9966,CONTRAST LOCM 200-299,3.48,2.26,0.7,28.93,72
HCPCS,Q9966,"LOCM 200-299MG/ML IODINE,1ML",8.0,5.2,0.36,8.0,78
HCPCS,Q9966,"Locm 200-299mg/ml iodine,1ml",,,0.71,0.91,3
HCPCS,Q9966,OMNIPAQUE 240  50 ML,3.48,2.26,0.7,28.93,72
HCPCS,Q9966,OMNIPAQUE 240 / 20 ML,3.48,2.26,0.7,28.93,72
HCPCS,Q9966,OMNIPAQUE 240 / 200 ML,3.48,2.26,0.7,28.93,72
HCPCS,Q9966,OMNIPAQUE 240 / 50 ML,3.48,2.26,0.7,28.93,72
HCPCS,Q9966,"ULTRAVIST 240, 200-299/ML,1ML",14.42,9.37,0.7,28.93,72
HCPCS,Q996600,"Locm 200-299mg/ml iodine,1ml",,,0.71,0.91,3
HCPCS,Q9967,350MGL/ML PLUSPAK OF 100ML,19.56,12.71,0.12,28.93,66
HCPCS,Q9967,350MGL/ML PLUSPAK OF 50ML,7.72,5.02,0.12,28.93,66
HCPCS,Q9967,CONTR LOCM 300-349 MG/ML,3.48,2.26,0.26,28.93,144
HCPCS,Q9967,CONTR LOCM 300-399 MG 1 ML,3.48,2.26,0.26,28.93,72
HCPCS,Q9967,CONTRAST ULTRAVIST 300 PER,3.48,2.26,0.26,28.93,72
HCPCS,Q9967,"ISOVUE 300, 100 ML, PER ML",3.48,2.26,0.26,28.93,144
HCPCS,Q9967,"ISOVUE 300, 200 ML, PER ML",3.48,2.26,0.26,28.93,72
HCPCS,Q9967,"ISOVUE 300, 50 ML, PER ML",3.48,2.26,0.26,28.93,72
HCPCS,Q9967,"ISOVUE 370, 100 ML, PER ML",3.505,2.275,0.26,28.93,144
HCPCS,Q9967,"ISOVUE 370, 150ML, PER ML",3.3,2.15,0.26,28.93,72
HCPCS,Q9967,LOCM 300-399MG/ML IODINE 1ML,14.0,9.1,0.12,14.0,78
HCPCS,Q9967,"Locm 300-399mg/ml iodine,1ml",,,0.27,0.34,3
HCPCS,Q9967,OMNIPAQUE 300 / 10 ML PER ML,3.48,2.26,0.26,28.93,72
HCPCS,Q9967,OMNIPAQUE 300 / 100 ML,3.48,2.26,0.26,28.93,72
HCPCS,Q9967,OMNIPAQUE 300 / 150 ML,3.48,2.26,0.26,28.93,72
HCPCS,Q9967,OMNIPAQUE 300 / 200 ML,3.48,2.26,0.26,28.93,72
HCPCS,Q9967,OMNIPAQUE 300 / 500 ML,3.48,2.26,0.26,28.93,72
HCPCS,Q9967,OMNIPAQUE 300 150 ML,3.48,2.26,0.26,28.93,72
HCPCS,Q9967,"OMNIPAQUE 300, 50 ML, PER ML",3.48,2.26,0.26,28.93,72
HCPCS,Q9967,"OMNIPAQUE 300, 75ML, PER ML",3.48,2.26,0.26,28.93,72
HCPCS,Q9967,OMNIPAQUE 300MG/ML,3.48,2.26,0.26,28.93,72
HCPCS,Q9967,OMNIPAQUE 350 / 500 ML PER ML,3.48,2.26,0.26,28.93,72
HCPCS,Q9967,"OMNIPAQUE 350, 100 ML, PER ML",3.29,2.1399999999999997,0.26,28.93,144
HCPCS,Q9967,"OMNIPAQUE 350, 150 ML, PER ML",7.970000000000001,5.18,0.26,28.93,144
HCPCS,Q9967,"OMNIPAQUE 350, 200ML, PER ML",2.89,1.88,0.26,28.93,72
HCPCS,Q9967,"OMNIPAQUE 350, 50 ML, PER ML",3.48,2.26,0.26,28.93,144
HCPCS,Q9967,OMNIPAQUE 350MGL/ML PLUSPAK OF 150ML,38.4,24.96,0.12,38.4,66
HCPCS,Q9967,OPTIRAY ?350 -100 ML SYRINGE,2.08,1.35,0.26,28.93,72
HCPCS,Q9967,VISIPAQUE 320 / 100 ML,3.48,2.26,0.26,28.93,72
HCPCS,Q9967,VISIPAQUE 320/150 ML,3.48,2.26,0.26,28.93,72
HCPCS,Q9967,"VISIPAQUE,V-041,PER 1ML",3.48,2.26,0.12,28.93,66
HCPCS,Q996700,"Locm 300-399mg/ml iodine,1ml",,,0.27,0.34,3
HCPCS,Q9968,METHYLENE BLUE PER 1ML,23.27,15.13,5.58,28.93,93
HCPCS,Q9968,Visualization adjunct,,,5.77,7.39,3
HCPCS,Q996800,Visualization adjunct,,,5.77,7.39,3
HCPCS,Q9969,Non-heu tc-99m add-on/dose,,,10.0,28.93,19
HCPCS,Q9982,FLUTEMETAMOL F18 DIAGNOSTIC,8400.0,5460.0,1.1,8400.0,154
HCPCS,Q9982,Flutemetamol f18 diagnostic,,,6835.2,8755.2,3
HCPCS,Q998200,Flutemetamol f18 diagnostic,,,6835.2,8755.2,3
HCPCS,Q9983,Florbetaben f18 diagnostic,,,24.99,9302.4,37
HCPCS,Q998300,Florbetaben f18 diagnostic,,,7262.4,9302.4,3
HCPCS,Q9988,"Platelets, pathogen reduced",,,671.54,671.54,1
HCPCS,Q9991,Buprenorph xr 100 mg or less,,,249.82,5170.68,41
HCPCS,Q999100,Buprenorph xr 100 mg or less,,,3557.38,4556.65,3
HCPCS,Q9992,Buprenorphine xr over 100 mg,,,249.82,5170.68,41
HCPCS,Q999200,Buprenorphine xr over 100 mg,,,3557.38,4556.65,3
HCPCS,Q9996,Ustekinumab- ttwe sub cu inj,,,98.49,8832.81,13
HCPCS,Q999600,Ustekinumab- ttwe sub cu inj,,,98.49,126.15,3
HCPCS,Q9997,Ustekinumab-ttwe iv inj 1 mg,,,1.03,5653.6,30
HCPCS,Q999700,Ustekinumab-ttwe iv inj 1 mg,,,14.72,18.86,3
HCPCS,Q9998,"Inj ustekinumab-aekn, 1 mg",,,5.4,8832.81,30
HCPCS,Q999800,"Inj ustekinumab-aekn, 1 mg",,,76.9,98.5,3
HCPCS,Q9999,Inj ustekinumab-aauz 1 mg,,,4.12,5653.6,30
HCPCS,Q999900,Inj ustekinumab-aauz 1 mg,,,58.67,75.15,3
HCPCS,R0070,Transport portable x-ray,,,86.82,455.61,9
HCPCS,R0075,Transport port x-ray multipl,,,63.76,455.61,9
HCPCS,R0076,Transport portable ekg,,,63.76,187.58,9
HCPCS,S0012,"Butorphanol tartrate, nasal",,,27.09,2739849.3,15
HCPCS,S001200,"Butorphanol tartrate, nasal",,,129.51,165.89,3
HCPCS,S0013,"Esketamine, nasal spray",,,13.19,232.34,10
HCPCS,S0014,"Tacrine hydrochloride, 10 mg",,,2.62,2739849.3,15
HCPCS,S001400,"Tacrine hydrochloride, 10 mg",,,5.2,6.66,3
HCPCS,S0017,"Injection, aminocaproic acid",,,4.71,60.42,12
HCPCS,S001700,"Injection, aminocaproic acid",,,17.39,22.28,3
HCPCS,S0020,BUPIVICAINE 0.5% 10ML,55.7,36.21,12.14,60.42,74
HCPCS,S0021,"Injection, cefoperazone sod",,,17.0,2739849.3,15
HCPCS,S002100,"Injection, cefoperazone sod",,,32.04,41.04,3
HCPCS,S0023,"Injection, cimetidine hydroc",,,0.01,60.42,15
HCPCS,S002300,"Injection, cimetidine hydroc",,,5.11,6.54,3
HCPCS,S0028,FAMOTIDINE 20 MG,11.0,7.15,1.9,60.42,74
HCPCS,S0028,"INJECTION, FAMOTIDINE, 20 MG",12.0,7.8,0.85,12.0,68
HCPCS,S0028,"Injection, famotidine, 20 mg",,,1.9,2.44,3
HCPCS,S002800,"Injection, famotidine, 20 mg",,,1.9,2.44,3
HCPCS,S0030,"Injection, metronidazole",,,1.95,60.42,9
HCPCS,S0032,"Injection, nafcillin sodium",,,25.49,77.6,13
HCPCS,S003200,"Injection, nafcillin sodium",,,28.09,35.98,3
HCPCS,S0034,"Injection, ofloxacin, 400 mg",,,46.99,2739849.3,14
HCPCS,S003400,"Injection, ofloxacin, 400 mg",,,46.99,60.19,3
HCPCS,S0039,"Injection, sulfamethoxazole",,,26.79,206.1,12
HCPCS,S003900,"Injection, sulfamethoxazole",,,26.79,34.31,3
HCPCS,S0040,"Injection, ticarcillin disod",,,14.4,3329.32,15
HCPCS,S004000,"Injection, ticarcillin disod",,,28.48,36.48,3
HCPCS,S0073,"Injection, aztreonam, 500 mg",,,15.66,60.42,9
HCPCS,S0074,"Injection, cefotetan disodiu",,,11.37,60.42,10
HCPCS,S0077,"INJECTION, CLINDAMYCIN PHOSP, 300 MG",21.0,13.65,1.1,21.0,68
HCPCS,S0077,"Injection, clindamycin phosp",,,2.66,60.42,9
HCPCS,S0078,"Injection, fosphenytoin sodi",,,12.96,2739849.3,15
HCPCS,S007800,"Injection, fosphenytoin sodi",,,76.9,98.5,3
HCPCS,S0080,"Injection, pentamidine iseth",,,52.18,3209.01,10
HCPCS,S0081,"Injection, piperacillin sodi",,,1.96,2739849.3,15
HCPCS,S008100,"Injection, piperacillin sodi",,,3.72,4.77,3
HCPCS,S0088,Imatinib 100 mg,,,6.34,2111.65,15
HCPCS,S008800,Imatinib 100 mg,,,6.34,8.12,3
HCPCS,S0090,"Sildenafil citrate, 25 mg",,,0.57,2739849.3,15
HCPCS,S009000,"Sildenafil citrate, 25 mg",,,0.57,0.73,3
HCPCS,S0091,Granisetron 1mg,,,3.77,2739849.3,15
HCPCS,S009100,Granisetron 1mg,,,6.41,8.21,3
HCPCS,S0092,Hydromorphone 250 mg,,,52.18,2739849.3,15
HCPCS,S009200,Hydromorphone 250 mg,,,178.18,228.23,3
HCPCS,S0093,Morphine 500 mg,,,23.23,2739849.3,15
HCPCS,S009300,Morphine 500 mg,,,23.23,29.75,3
HCPCS,S0104,"Zidovudine, oral, 100 mg",,,0.72,2739849.3,15
HCPCS,S010400,"Zidovudine, oral, 100 mg",,,3.24,4.15,3
HCPCS,S0106,Bupropion hcl sr 60 tablets,,,31.24,2739849.3,15
HCPCS,S010600,Bupropion hcl sr 60 tablets,,,31.24,40.01,3
HCPCS,S0108,Mercaptopurine 50 mg,,,3.68,2739849.3,7
HCPCS,S010800,Mercaptopurine 50 mg,,,6.94,8.89,3
HCPCS,S0109,Methadone oral 5mg,,,0.24,2739849.3,15
HCPCS,S010900,Methadone oral 5mg,,,0.59,0.75,3
HCPCS,S0117,Tretinoin topical 5 g,,,2.2,2739849.3,15
HCPCS,S011700,Tretinoin topical 5 g,,,8.81,11.29,3
HCPCS,S0119,Ondansetron 4 mg,,,0.98,11.17,14
HCPCS,S011900,Ondansetron 4 mg,,,0.98,1.25,3
HCPCS,S0122,Inj menotropins 75 iu,,,52.18,690.73,15
HCPCS,S012200,Inj menotropins 75 iu,,,539.25,690.73,3
HCPCS,S0126,Inj follitropin alfa 75 iu,,,124.74,660.77,15
HCPCS,S012600,Inj follitropin alfa 75 iu,,,515.86,660.77,3
HCPCS,S0128,Inj follitropin beta 75 iu,,,52.18,595.08,15
HCPCS,S012800,Inj follitropin beta 75 iu,,,464.58,595.08,3
HCPCS,S0132,Inj ganirelix acetat 250 mcg,,,129.75,513.96,15
HCPCS,S013200,Inj ganirelix acetat 250 mcg,,,401.25,513.96,3
HCPCS,S0136,"Clozapine, 25 mg",,,1.19,60.42,15
HCPCS,S013600,"Clozapine, 25 mg",,,1.58,2.03,3
HCPCS,S0137,"Didanosine, 25 mg",,,1.19,2739849.3,14
HCPCS,S013700,"Didanosine, 25 mg",,,1.19,1.53,3
HCPCS,S0138,"Finasteride, 5 mg",,,0.3,2739849.3,15
HCPCS,S013800,"Finasteride, 5 mg",,,0.32,0.41,3
HCPCS,S0139,"Minoxidil, 10 mg",,,0.98,2739849.3,15
HCPCS,S013900,"Minoxidil, 10 mg",,,0.98,1.25,3
HCPCS,S0140,"Saquinavir, 200 mg",,,2.6,2739849.3,15
HCPCS,S014000,"Saquinavir, 200 mg",,,2.6,3.33,3
HCPCS,S0142,Colistimethate inh sol mg,,,0.2,2739849.3,10
HCPCS,S0145,Peg interferon alfa-2a/180,,,141.84,3046.31,15
HCPCS,S014500,Peg interferon alfa-2a/180,,,2378.26,3046.31,3
HCPCS,S0148,Peg interferon alfa-2b/10,,,200.66,411.59,14
HCPCS,S014800,Peg interferon alfa-2b/10,,,321.33,411.59,3
HCPCS,S0155,Epoprostenol dilutant,,,30.97,232.34,14
HCPCS,S015500,Epoprostenol dilutant,,,30.97,39.67,3
HCPCS,S0156,"Exemestane, 25 mg",,,3.56,2739849.3,7
HCPCS,S015600,"Exemestane, 25 mg",,,3.56,4.56,3
HCPCS,S0157,"Becaplermin gel 1%, 0.5 gm",,,24.35,2739849.3,15
HCPCS,S015700,"Becaplermin gel 1%, 0.5 gm",,,96.81,124.01,3
HCPCS,S0160,Dextroamphetamine,,,0.03,2739849.3,15
HCPCS,S016000,Dextroamphetamine,,,1.48,1.89,3
HCPCS,S0164,Injection pantroprazole,,,1.84,12.45,13
HCPCS,S016400,Injection pantroprazole,,,9.72,12.45,3
HCPCS,S0166,Inj olanzapine 2.5mg,,,7.16,840.33,12
HCPCS,S016600,Inj olanzapine 2.5mg,,,17.27,22.12,3
HCPCS,S0169,Calcitrol,,,0.59,2739849.3,14
HCPCS,S016900,Calcitrol,,,0.59,0.75,3
HCPCS,S0170,Anastrozole 1 mg,,,1.03,2739849.3,7
HCPCS,S017000,Anastrozole 1 mg,,,1.03,1.32,3
HCPCS,S0171,Bumetanide 0.5 mg,,,52.18,60.42,8
HCPCS,S0172,Chlorambucil 2 mg,,,5.01,2739849.3,7
HCPCS,S017200,Chlorambucil 2 mg,,,564.22,722.71,3
HCPCS,S0174,Dolasetron 50 mg,,,9.64,2739849.3,15
HCPCS,S017400,Dolasetron 50 mg,,,63.14,80.87,3
HCPCS,S0175,Flutamide 125 mg,,,1.88,2739849.3,15
HCPCS,S017500,Flutamide 125 mg,,,95.14,121.87,3
HCPCS,S0176,Hydroxyurea 500 mg,,,0.85,2739849.3,7
HCPCS,S017600,Hydroxyurea 500 mg,,,0.85,1.09,3
HCPCS,S0177,Levamisole 50 mg,,,6.75,2739849.3,14
HCPCS,S017700,Levamisole 50 mg,,,11.32,14.5,3
HCPCS,S0178,Lomustine 10 mg,,,14.78,2739849.3,15
HCPCS,S017800,Lomustine 10 mg,,,224.21,287.19,3
HCPCS,S0179,Megestrol 20 mg,,,0.59,2739849.3,7
HCPCS,S017900,Megestrol 20 mg,,,0.59,0.75,3
HCPCS,S0182,"Procarbazine, oral",,,55.95,2739849.3,7
HCPCS,S018200,"Procarbazine, oral",,,377.52,483.57,3
HCPCS,S0183,Prochlorperazine 5 mg,,,0.53,2739849.3,15
HCPCS,S018300,Prochlorperazine 5 mg,,,0.73,0.93,3
HCPCS,S0187,Tamoxifen 10 mg,,,0.41,2739849.3,7
HCPCS,S018700,Tamoxifen 10 mg,,,0.41,0.52,3
HCPCS,S0189,TESTOSTERONE PELLET 75 MG,212.0,137.8,1.1,235.7,72
HCPCS,S0189,Testosterone pellet 75 mg,,,52.18,210.98,10
HCPCS,S0190,"MIFEPRISTONE, ORAL, 200 MG",103.2,67.08,1.1,134.68,74
HCPCS,S0190,"Mifepristone, oral, 200 mg",,,45.0,164.23,15
HCPCS,S019000,"Mifepristone, oral, 200 mg",,,76.54,98.04,3
HCPCS,S0191,"MISOPROSTOL, ORAL, 200 MCG",3.0,1.95,0.76,30.61,74
HCPCS,S0191,"Misoprostol, oral, 200 mcg",,,1.08,60.42,15
HCPCS,S019100,"Misoprostol, oral, 200 mcg",,,2.06,2.64,3
HCPCS,S0194,Vitamin suppl 100 caps,,,9.64,2739849.3,14
HCPCS,S019400,Vitamin suppl 100 caps,,,21.04,26.95,3
HCPCS,S0197,Prenatal vitamins 30 day,,,0.15,11.17,10
HCPCS,S0199,Med abortion inc all ex drug,,,660.34,2370.48,9
HCPCS,S0201,PARTIAL HOSPITALIZATION SERV,532.0,345.8,115.98,532.0,66
HCPCS,S0207,Paramedicintercep nonhospals,,,2739849.3,2739849.3,1
HCPCS,S0208,Paramed intrcept nonvol,,,2739849.3,2739849.3,1
HCPCS,S0209,Wc van mileage per mi,,,10.96,10.96,1
HCPCS,S0215,Nonemerg transp mileage,,,0.82,0.82,1
HCPCS,S0220,Medical conference by physic,,,21.85,2739849.3,9
HCPCS,S0221,"Medical conference, 60 min",,,21.85,2739849.3,9
HCPCS,S0250,Comp geriatr assmt team,,,21.85,2739849.3,9
HCPCS,S0255,Hospice refer visit nonmd,,,63.76,2739849.3,9
HCPCS,S0257,End of life counseling,,,21.85,2739849.3,9
HCPCS,S0260,H&p for surgery,,,139.74,469.67,9
HCPCS,S0265,GENETIC COUNSEL 15 MINS,86.5,56.225,1.1,192.84,146
HCPCS,S0270,Home std case rate 30 days,,,2739849.3,2739849.3,1
HCPCS,S0271,Home hospice case 30 days,,,2739849.3,2739849.3,1
HCPCS,S0272,Home episodic case 30 days,,,2739849.3,2739849.3,1
HCPCS,S0273,Md home visit outside cap,,,21.85,2739849.3,9
HCPCS,S0274,Nurse practr visit outs cap,,,2739849.3,2739849.3,1
HCPCS,S0280,"Medical home, initial plan",,,21.85,25.3,8
HCPCS,S0281,"Medical home, maintenance",,,21.85,25.3,8
HCPCS,S0285,Cnslt before screen colonosc,,,68.73,436.54,9
HCPCS,S0302,Completed epsdt,,,10.69,2739849.3,9
HCPCS,S0310,Hospitalist visit,,,63.76,2739849.3,9
HCPCS,S0311,Comp mgmt care coord adv ill,,,2739849.3,2739849.3,1
HCPCS,S0315,Disease management program,,,21.85,2435555.53,9
HCPCS,S0316,Follow-up/reassessment,,,21.85,2435555.53,9
HCPCS,S0317,Disease mgmt per diem,,,21.85,2435555.53,9
HCPCS,S0320,Rn telephone calls to dmp,,,63.76,2739849.3,9
HCPCS,S0340,Lifestyle mod 1st stage,,,21.85,2435555.53,9
HCPCS,S0341,Lifestyle mod 2 or 3 stage,,,21.85,2739849.3,9
HCPCS,S0342,Lifestyle mod 4th stage,,,86.57,2739849.3,9
HCPCS,S0353,CANCER TREATMENT PLAN INITIAL,463.0,300.95,1.1,982.58,68
HCPCS,S0353,Cancer treatmentplan initial,,,21.85,879.4,9
HCPCS,S0354,CANCER TREATMENT PLAN CHANGE,463.0,300.95,1.1,1224.4,68
HCPCS,S0354,Cancer treatment plan change,,,21.85,1096.9,9
HCPCS,S0390,Rout foot care per visit,,,24.66,55.21,9
HCPCS,S0395,Impression casting ft,,,56.17,121.92,9
HCPCS,S0400,Global eswl kidney,,,2117.28,2739849.3,9
HCPCS,S0500,Dispos cont lens,,,19.18,36.7,9
HCPCS,S0504,Singl prscrp lens,,,36.52,120.56,9
HCPCS,S0506,Bifoc prscp lens,,,36.52,178.1,9
HCPCS,S0508,Trifoc prscrp lens,,,36.52,232.9,9
HCPCS,S0510,Non-prscrp lens,,,27.4,42.28,9
HCPCS,S0512,Daily cont lens,,,2.74,42.28,9
HCPCS,S0514,Color cont lens,,,19.18,42.28,9
HCPCS,S0515,Scleral lens liquid bandage,,,36.52,2739849.3,9
HCPCS,S0516,Safety frames,,,36.52,274.0,9
HCPCS,S0518,Sunglass frames,,,36.52,274.0,9
HCPCS,S0580,Polycarb lens,,,36.52,54.8,9
HCPCS,S0581,Nonstnd lens,,,27.4,42.28,9
HCPCS,S0590,Misc integral lens serv,,,36.52,2739999.97,9
HCPCS,S0592,Comp cont lens eval,,,48.64,186.32,9
HCPCS,S0595,New lenses in pts old frame,,,27.4,42.28,9
HCPCS,S0596,Phakic iol refractive error,,,200.93,2739849.3,9
HCPCS,S0601,Screening proctoscopy,,,57.27,1030.79,9
HCPCS,S0610,Annual gynecological examina,,,68.73,144.12,9
HCPCS,S0610,"GYN EXAM, NEW PT., ANNUAL",373.0,242.45,1.1,373.0,80
HCPCS,S0612,Annual gynecological examina,,,68.73,117.82,9
HCPCS,S0612,"GYN EXAM, EST PT., ANNUAL",303.0,196.95,1.1,303.0,80
HCPCS,S0612,PREVENTIVE VISIT,334.0,217.1,1.1,334.0,80
HCPCS,S0613,Ann breast exam,,,54.8,79.59,9
HCPCS,S0618,Audiometry for hearing aid,,,40.0,65.76,9
HCPCS,S0620,"OPHTHALMOLOGICAL EXAM, NEW PT.",260.5,169.325,1.1,345.0,160
HCPCS,S0620,Routine ophthalmological exa,,,68.73,109.6,9
HCPCS,S0621,"OPHTHALMOLOGICAL EXAM, EST PT.",183.5,119.275,1.1,217.0,160
HCPCS,S0621,Routine ophthalmological exa,,,68.73,123.3,9
HCPCS,S0622,Phys exam for college,,,68.73,2739849.3,9
HCPCS,S0630,Removal of sutures,,,63.76,82.2,9
HCPCS,S0800,LASER IN SITU KERATOMILEUSIS,3529.0,2293.85,1.1,3529.0,80
HCPCS,S0800,LASIK,2154.0,1400.1,0.01,2154.0,67
HCPCS,S0810,PHOTOREFRACTIVE KERATECTOMY,3529.0,2293.85,1.1,3529.0,80
HCPCS,S0810,PHOTOTHERAPEUTIC,2154.0,1400.1,0.01,2154.0,67
HCPCS,S0812,PHOTOTHERAP KERATECT,2920.0,1898.0,1.1,2920.0,80
HCPCS,S0812,PHOTOTHERAPEUTIC KERATECTOMY,3069.0,1994.85,0.01,3984.0,147
HCPCS,S1001,Deluxe item,,,16.97,342.5,9
HCPCS,S1002,Custom item,,,16.97,342.5,9
HCPCS,S1015,Iv tubing extension set,,,16.97,19.65,9
HCPCS,S1016,Non-pvc intravenous administ,,,8.22,19.65,9
HCPCS,S1030,GLUCOSE MONITOR PURCHASE,1850.0,1202.5,403.3,1850.0,67
HCPCS,S1031,Gluc monitor rental,,,846.64,1368.63,9
HCPCS,S1034,Art pancreas system,,,1288.13,2739849.3,9
HCPCS,S1035,Art pancreas inv disp sensor,,,36.52,2739849.3,9
HCPCS,S1036,Art pancreas ext transmitter,,,36.52,2739849.3,9
HCPCS,S1037,Art pancreas ext receiver,,,36.52,2739849.3,9
HCPCS,S1040,CRANIAL REMOLDING ORTHOSIS,3200.0,2080.0,697.6,3200.0,59
HCPCS,S1091,Stent non-coronary propel,,,200.93,2739849.3,15
HCPCS,S109100,Stent non-coronary propel,,,3684.6,4719.6,3
HCPCS,S2053,Transplantation of small int,,,1229.51,2739849.3,9
HCPCS,S2054,Transplantation of multivisc,,,1229.51,2739849.3,9
HCPCS,S2055,Harvesting of donor multivis,,,1229.51,2739849.3,9
HCPCS,S2060,Lobar lung transplantation,,,3135.87,2739849.3,9
HCPCS,S2061,Donor lobectomy (lung),,,3135.87,2739849.3,9
HCPCS,S2065,Simult panc kidn trans,,,1791.93,2739849.3,9
HCPCS,S2066,BREAST GAP FLAP RECONST,21109.0,13720.85,1.1,42854.0,80
HCPCS,S2066,Breast gap flap reconst,,,4882.9,38360.0,9
HCPCS,S2067,"BREAST ""STACKED"" DIEP/GAP",21109.0,13720.85,1.1,22232.04,80
HCPCS,S2067,"Breast ""stacked"" diep/gap",,,4882.9,19900.62,9
HCPCS,S2068,BREAST DIEP FLAP RECONSTRUCT,21109.0,13720.85,1.1,54599.06,80
HCPCS,S2068,Breast diep or siea flap,,,4882.9,48874.04,9
HCPCS,S2070,Cysto laser tx ureteral calc,,,1066.44,2739849.3,9
HCPCS,S2079,Lap esophagomyotomy,,,4773.02,2739849.3,9
HCPCS,S2080,Laup,,,939.63,2739849.3,9
HCPCS,S2083,ADJUSTMENT GASTRIC BAND,72.0,46.8,1.1,356.57,80
HCPCS,S2083,Adjustment gastric band,,,301.4,469.67,9
HCPCS,S2095,Transcath emboliz microspher,,,8435.63,2739849.3,9
HCPCS,S2102,Islet cell tissue transplant,,,3471.98,2739849.3,9
HCPCS,S2103,Adrenal tissue transplant,,,1229.51,2739849.3,9
HCPCS,S2107,Adoptive immunotherapy,,,1580.94,2739849.3,9
HCPCS,S2112,Knee arthroscp harv,,,1831.46,2120.64,9
HCPCS,S2115,Periacetabular osteotomy,,,3067.73,25025.57,9
HCPCS,S2117,"Arthroereisis, subtalar",,,1644.0,2031.98,9
HCPCS,S2118,TOTAL HIP RESURFACING,15305.0,9948.25,1.1,15305.0,80
HCPCS,S2118,Total hip resurfacing,,,3067.73,3552.11,9
HCPCS,S2120,Low density lipoprotein(ldl),,,1580.94,2739849.3,9
HCPCS,S2140,Cord blood harvesting,,,453.96,525.64,9
HCPCS,S2142,Cord blood-derived stem-cell,,,453.96,2739849.3,9
HCPCS,S2150,Bmt harv/transpl 28d pkg,,,1729.41,2739849.3,9
HCPCS,S2152,Solid organ transpl pkg,,,1229.51,2739849.3,9
HCPCS,S2202,Echosclerotherapy,,,239.42,462.56,9
HCPCS,S2205,Minimally invasive direct co,,,14291.15,2739849.3,9
HCPCS,S2206,Minimally invasive direct co,,,14291.15,2739849.3,9
HCPCS,S2207,Minimally invasive direct co,,,14291.15,2739849.3,9
HCPCS,S2208,Minimally invasive direct co,,,14291.15,2739849.3,9
HCPCS,S2209,Minimally invasive direct co,,,14291.15,2739849.3,9
HCPCS,S2225,Myringotomy laser-assist,,,939.63,2739849.3,9
HCPCS,S2230,Implant semi-imp hear,,,1558.4,2739849.3,9
HCPCS,S2235,Implant auditory brain imp,,,9782.47,2739849.3,9
HCPCS,S2260,Induced abortion 17-24 weeks,,,2047.23,2739849.3,9
HCPCS,S2265,Induced abortion 25-28 wks,,,2047.23,2739849.3,9
HCPCS,S2266,Induced abortion 29-31 wks,,,2047.23,2739849.3,9
HCPCS,S2267,Induced abortion 32 or more,,,2047.23,2739849.3,9
HCPCS,S2300,"Arthroscopy, shoulder, surgi",,,1831.46,2739849.3,9
HCPCS,S2325,HIP CORE DECOMPRESSION,2516.0,1635.4,1.1,2696.74,80
HCPCS,S2325,Hip core decompression,,,68.73,2414.71,9
HCPCS,S2340,Chemodenervation of abductor,,,1416.09,2739849.3,9
HCPCS,S2341,Chemodenerv adduct vocal,,,1416.09,2739849.3,9
HCPCS,S2342,Nasal endoscop po debrid,,,266.89,4229.49,9
HCPCS,S2348,Decompress disc rf lumbar,,,3812.17,2739849.3,9
HCPCS,S2350,"Diskectomy, anterior, with d",,,2157.75,4414.09,9
HCPCS,S2351,"Diskectomy, anterior, with d",,,2157.75,4414.09,9
HCPCS,S2400,Fetal surg congen hernia,,,2362.56,2739849.3,9
HCPCS,S2401,Fetal surg urin trac obstr,,,2362.56,2739849.3,9
HCPCS,S2402,Fetal surg cong cyst malf,,,2362.56,2739849.3,9
HCPCS,S2403,Fetal surg pulmon sequest,,,2362.56,2739849.3,9
HCPCS,S2404,FETAL SURG MYELOMENINGO,18821.5,12233.975,1.1,3060831.65,146
HCPCS,S2405,Fetal surg sacrococ teratoma,,,2362.56,2739849.3,9
HCPCS,S2409,Fetal surg noc,,,2362.56,2739999.97,9
HCPCS,S2411,FETOSCOP LASER THER TTTS,4457.0,2897.05,1.1,13150.06,82
HCPCS,S2411,Fetoscop laser ther ttts,,,257.14,11771.45,9
HCPCS,S2900,ROBOTIC SURGICAL SYSTEM,526.0,341.9,0.01,765.25,80
HCPCS,S2900,Robotic surgical system,,,405.62,685.0,9
HCPCS,S3000,Bilat dil retinal exam,,,68.73,82.67,9
HCPCS,S3005,Eval self-assess depression,,,10.69,2435555.53,9
HCPCS,S3600,Stat lab,,,33.56,2739849.3,9
HCPCS,S3601,Stat lab home/nf,,,33.56,2739849.3,9
HCPCS,S3620,Newborn metabolic screening,,,19.67,171.59,10
HCPCS,S3630,Eosinophil blood count,,,8.48,2739849.3,9
HCPCS,S3645,Hiv-1 antibody testing of or,,,23.08,2739849.3,9
HCPCS,S3650,"Saliva test, hormone level;",,,18.15,2739849.3,9
HCPCS,S3652,"Saliva test, hormone level;",,,18.15,2739849.3,9
HCPCS,S3655,Antisperm antibodies test,,,23.08,2739849.3,9
HCPCS,S3708,Gastrointestinal fat absorpt,,,18.15,2739849.3,9
HCPCS,S3722,Dose optimization auc - 5fu,,,18.31,2739849.3,9
HCPCS,S3800,Genetic testing als,,,83.94,2739849.3,9
HCPCS,S3840,Dna analysis ret-oncogene,,,83.94,2739849.3,9
HCPCS,S3841,Gene test retinoblastoma,,,83.94,2739849.3,9
HCPCS,S3842,Gene test hippel-lindau,,,83.94,2739849.3,9
HCPCS,S3844,Dna analysis deafness,,,83.94,2739849.3,9
HCPCS,S3845,Gene test alpha-thalassemia,,,83.94,2739849.3,9
HCPCS,S3846,Gene test beta-thalassemia,,,83.94,2739849.3,9
HCPCS,S3849,Gene test niemann-pick,,,83.94,2739849.3,9
HCPCS,S3850,Gene test sickle cell,,,83.94,2739849.3,9
HCPCS,S3852,Dna analysis apoe alzheimer,,,83.94,2739849.3,9
HCPCS,S3853,Gene test myo musclr dyst,,,83.94,2739849.3,9
HCPCS,S3854,Gene profile panel breast,,,83.94,2739849.3,9
HCPCS,S3861,Genetic test brugada,,,83.94,2739849.3,9
HCPCS,S3865,Comp genet test hyp cardiomy,,,83.94,2739849.3,9
HCPCS,S3866,Spec gene test hyp cardiomy,,,83.94,2739849.3,9
HCPCS,S3870,Cgh test developmental delay,,,109.69,2739849.3,9
HCPCS,S3900,Surface emg,,,24.66,453.61,9
HCPCS,S3902,Ballistocardiogram,,,23.5,2739849.3,9
HCPCS,S3904,Masters two step,,,86.64,2739849.3,9
HCPCS,S4005,Interim labor facility globa,,,63.76,2739849.3,9
HCPCS,S4011,Ivf package,,,151.26,17926.64,9
HCPCS,S4013,Compl gift case rate,,,151.26,2739849.3,9
HCPCS,S4014,Compl zift case rate,,,151.26,2739849.3,9
HCPCS,S4015,Complete ivf nos case rate,,,151.26,24660.0,9
HCPCS,S4016,Frozen ivf case rate,,,151.26,12458.73,9
HCPCS,S4017,Ivf canc a stim case rate,,,151.26,2739849.3,9
HCPCS,S4018,F emb trns canc case rate,,,151.26,2739849.3,9
HCPCS,S4020,Ivf canc b4 aspir case rate,,,151.26,2739849.3,9
HCPCS,S4021,Ivf canc aftr aspr case rate,,,151.26,15665.59,9
HCPCS,S4022,Asst oocyte fert case rate,,,151.26,8588.34,9
HCPCS,S4023,Incompl donor egg case rate,,,151.26,2739849.3,9
HCPCS,S4024,Air polymer foam per study,,,24.99,2544.48,13
HCPCS,S402400,Air polymer foam per study,,,1986.48,2544.48,3
HCPCS,S4025,Donor serv ivf case rate,,,151.26,2739849.3,9
HCPCS,S4026,Procure donor sperm,,,24.85,2739849.3,9
HCPCS,S4027,Store prev froz embryos,,,24.85,2739849.3,9
HCPCS,S4028,Microsurg epi sperm asp,,,151.26,2457.37,9
HCPCS,S4030,Sperm procure init visit,,,151.26,2739849.3,9
HCPCS,S4031,Sperm procure subs visit,,,151.26,2739849.3,9
HCPCS,S4035,Stimulated iui case rate,,,151.26,6595.4,9
HCPCS,S4037,Cryo embryo transf case rate,,,151.26,2739849.3,9
HCPCS,S4040,Monit store cryo embryo 30 d,,,24.85,123.3,9
HCPCS,S4042,Ovulation mgmt per cycle,,,21.85,2739849.3,9
HCPCS,S4981,Insert levonorgestrel ius,,,68.6,2156.38,9
HCPCS,S4988,Penile contractur devic manu,,,333.06,385.65,8
HCPCS,S4989,Contracept iud,,,702.34,1994.17,10
HCPCS,S4990,Nicotine patch legend,,,4.49,2739849.3,12
HCPCS,S499000,Nicotine patch legend,,,4.49,5.75,3
HCPCS,S4991,Nicotine patch nonlegend,,,4.25,2739849.3,12
HCPCS,S499100,Nicotine patch nonlegend,,,4.25,5.45,3
HCPCS,S4993,Contraceptive pills for bc,,,2.46,60.42,12
HCPCS,S499300,Contraceptive pills for bc,,,2.46,3.15,3
HCPCS,S4995,Smoking cessation gum,,,0.75,2739849.3,12
HCPCS,S499500,Smoking cessation gum,,,0.75,0.96,3
HCPCS,S5000,"Prescription drug, generic",,,16.97,2435555.53,9
HCPCS,S5001,"Prescription drug,brand name",,,16.97,2435555.53,9
HCPCS,S5010,5% dextrose and 0.45% saline,,,16.97,30.55,14
HCPCS,S501000,5% dextrose and 0.45% saline,,,18.51,23.71,3
HCPCS,S5012,5% dextrose with potassium,,,10.15,52.88,14
HCPCS,S501200,5% dextrose with potassium,,,10.15,13.0,3
HCPCS,S5013,5%dextrose/0.45%saline1000ml,,,6.03,19.65,9
HCPCS,S5014,D5w/0.45ns w kcl and mgs04,,,16.97,2739849.3,9
HCPCS,S5035,Hit routine device maint,,,16.97,2739849.3,9
HCPCS,S5036,Hit device repair,,,16.97,283.56,9
HCPCS,S5100,Adult daycare services 15min,,,63.76,2739849.3,9
HCPCS,S5101,Adult day care per half day,,,63.76,2739849.3,9
HCPCS,S5102,Adult day care per diem,,,63.76,2739849.3,9
HCPCS,S5105,Centerbased day care perdiem,,,63.76,2739849.3,9
HCPCS,S5108,Homecare train pt 15 min,,,2739849.3,2739849.3,1
HCPCS,S5109,Homecare train pt session,,,240.44,240.44,1
HCPCS,S5110,FAMILY HOMECARE TRAINING 15M,692.0,449.8,1.1,3060831.65,80
HCPCS,S5110,Family homecare training 15m,,,2739849.3,2739849.3,1
HCPCS,S5111,Family homecare train/sessio,,,2739849.3,2739849.3,1
HCPCS,S5115,Nonfamily homecare train/15m,,,2739849.3,2739849.3,1
HCPCS,S5116,Nonfamily hc train/session,,,2739849.3,2739849.3,1
HCPCS,S5120,Chore services per 15 min,,,2739849.3,2739849.3,1
HCPCS,S5121,Chore services per diem,,,2739849.3,2739849.3,1
HCPCS,S5125,Attendant care service /15m,,,2739849.3,2739849.3,1
HCPCS,S5126,Attendant care service /diem,,,2739849.3,2739849.3,1
HCPCS,S5130,Homaker service nos per 15m,,,2739849.3,2739849.3,1
HCPCS,S5131,Homemaker service nos /diem,,,2739849.3,2739849.3,1
HCPCS,S5135,Adult companioncare per 15m,,,63.76,2739849.3,9
HCPCS,S5136,Adult companioncare per diem,,,63.76,2739849.3,9
HCPCS,S5140,Adult foster care per diem,,,63.76,2739849.3,9
HCPCS,S5141,Adult foster care per month,,,63.76,2739849.3,9
HCPCS,S5145,Child fostercare th per diem,,,63.76,2739849.3,9
HCPCS,S5146,Ther fostercare child /month,,,63.76,2739849.3,9
HCPCS,S5150,BEHAVIORAL HEALTH RESPITE 15 MIN - 3HR,10.0,6.5,1.1,3060831.65,80
HCPCS,S5150,Unskilled respite care /15m,,,63.76,2739849.3,9
HCPCS,S5151,BEHAVIORAL HEALTH RESPITE PER DIEM 3+HOURS,106.0,68.9,1.1,3060831.65,80
HCPCS,S5151,Unskilled respitecare /diem,,,63.76,2739849.3,9
HCPCS,S5160,Emer response sys instal&tst,,,36.52,2739849.3,9
HCPCS,S5161,Emer rspns sys serv permonth,,,36.52,2739849.3,9
HCPCS,S5162,Emer rspns system purchase,,,36.52,822.0,9
HCPCS,S5165,Home modifications per serv,,,2739849.3,2739849.3,1
HCPCS,S5170,Homedelivered prepared meal,,,2739849.3,2739849.3,1
HCPCS,S5175,"Laundry serv,ext,prof,/order",,,2739849.3,2739849.3,1
HCPCS,S5180,Hh respiratory thrpy in eval,,,2739849.3,2739849.3,1
HCPCS,S5181,Hh respiratory thrpy nos/day,,,2739849.3,2739849.3,1
HCPCS,S5185,Med reminder serv per month,,,63.76,2739849.3,9
HCPCS,S5190,Wellness assessment by nonph,,,405.62,2435555.53,9
HCPCS,S5199,Personal care item nos each,,,16.97,2739999.97,9
HCPCS,S5497,Hit cath care noc,,,19.18,19.18,1
HCPCS,S5498,Hit simple cath care,,,19.18,19.18,1
HCPCS,S5501,Hit complex cath care,,,27.4,27.4,1
HCPCS,S5502,Hit interim cath care,,,137.0,137.0,1
HCPCS,S5517,Hit declotting kit,,,137.0,137.0,1
HCPCS,S5518,Hit cath repair kit,,,137.0,137.0,1
HCPCS,S5520,Hit picc insert kit,,,205.5,205.5,1
HCPCS,S5521,Hit midline cath insert kit,,,205.5,205.5,1
HCPCS,S5522,Hit picc insert no supp,,,349.35,349.35,1
HCPCS,S5523,Hip midline cath insert kit,,,349.35,349.35,1
HCPCS,S5550,Insulin rapid 5 u,,,0.5,2739849.3,7
HCPCS,S555000,Insulin rapid 5 u,,,0.5,0.64,3
HCPCS,S5551,Insulin most rapid 5 u,,,0.77,3.97,7
HCPCS,S555100,Insulin most rapid 5 u,,,0.77,0.98,3
HCPCS,S5552,Insulin intermed 5 u,,,0.49,2739849.3,7
HCPCS,S555200,Insulin intermed 5 u,,,0.5,0.64,3
HCPCS,S5553,Insulin long acting 5 u,,,0.9,2739849.3,7
HCPCS,S555300,Insulin long acting 5 u,,,1.25,1.6,3
HCPCS,S5560,Insulin reuse pen 1.5 ml,,,2739849.3,2739849.3,1
HCPCS,S5561,Insulin reuse pen 3 ml,,,91.49,2739849.3,6
HCPCS,S556100,Insulin reuse pen 3 ml,,,91.49,117.19,3
HCPCS,S5565,Insulin cartridge 150 u,,,2739849.3,2739849.3,1
HCPCS,S5566,Insulin cartridge 300 u,,,57.41,2739849.3,6
HCPCS,S556600,Insulin cartridge 300 u,,,57.41,73.53,3
HCPCS,S5570,Insulin dispos pen 1.5 ml,,,213.6,2739849.3,6
HCPCS,S557000,Insulin dispos pen 1.5 ml,,,213.6,273.6,3
HCPCS,S5571,Insulin dispos pen 3 ml,,,67.96,2739849.3,6
HCPCS,S557100,Insulin dispos pen 3 ml,,,67.96,87.05,3
HCPCS,S8030,Tantalum ring application,,,381.15,2739849.3,9
HCPCS,S8035,Magnetic source imaging,,,255.48,2739849.3,9
HCPCS,S8037,Mrcp,,,310.77,2137.25,9
HCPCS,S8040,Topographic brain mapping,,,695.79,2739849.3,9
HCPCS,S8042,Mri low field,,,255.48,2739849.3,9
HCPCS,S8055,Us guidance fetal reduct,,,93.21,2739849.3,9
HCPCS,S8080,Scintimammography,,,311.35,2739849.3,9
HCPCS,S8085,Fluorine-18 fluorodeoxygluco,,,355.93,355.93,1
HCPCS,S8092,Electron beam computed tomog,,,71.45,2739849.3,9
HCPCS,S8096,Portable peak flow meter,,,11.14,71.79,9
HCPCS,S8097,Asthma kit,,,11.14,2739849.3,9
HCPCS,S8100,Spacer without mask,,,6.85,42.28,10
HCPCS,S8101,Spacer with mask,,,16.97,99.46,10
HCPCS,S8110,Peak expiratory flow rate (p,,,13.7,75.24,9
HCPCS,S8120,O2 contents gas cubic ft,,,8.22,8.22,1
HCPCS,S8121,O2 contents liquid lb,,,3.01,3.01,1
HCPCS,S8130,Interferential stim 2 chan,,,91.28,2739849.3,9
HCPCS,S8131,Interferential stim 4 chan,,,91.28,2739849.3,9
HCPCS,S8185,Flutter device,,,16.97,231.53,9
HCPCS,S8186,Swivel adaptor,,,16.97,68.77,9
HCPCS,S8189,Trach supply noc,,,36.52,2739999.97,9
HCPCS,S8210,Mucus trap,,,6.17,19.65,9
HCPCS,S8265,Haberman feeder,,,11.14,125.38,9
HCPCS,S8270,Enuresis alarm,,,36.52,356.06,9
HCPCS,S8301,Infect control supplies nos,,,12.33,19.65,9
HCPCS,S8415,Supplies for home delivery,,,16.97,2739849.3,9
HCPCS,S8420,Custom gradient sleev/glov,,,11.14,445.25,9
HCPCS,S8421,Ready gradient sleev/glov,,,11.14,197.28,9
HCPCS,S8422,Custom grad sleeve med,,,11.14,445.25,9
HCPCS,S8423,Custom grad sleeve heavy,,,11.14,445.25,9
HCPCS,S8424,READY GRADIENT SLEEVE,90.0,58.5,1.1,498.94,80
HCPCS,S8424,Ready gradient sleeve,,,11.14,445.25,9
HCPCS,S8425,Custom grad glove med,,,11.14,445.25,9
HCPCS,S8426,Custom grad glove heavy,,,11.14,445.25,9
HCPCS,S8427,Ready gradient glove,,,11.14,445.25,9
HCPCS,S8428,GAUNTLET W/THMB STB 23-36 MMHG,39.9,25.94,8.7,39.9,67
HCPCS,S8428,READY GRADIENT GAUNTLET,52.0,33.8,1.1,330.59,80
HCPCS,S8429,Gradient pressure wrap,,,11.14,61.65,9
HCPCS,S8430,Padding for comprssn bdg,,,16.97,36.09,9
HCPCS,S8431,Compression bandage,,,16.97,21.92,9
HCPCS,S8450,Splint digit,,,16.97,24.66,9
HCPCS,S8451,Splint wrist or ankle,,,11.14,54.8,9
HCPCS,S8452,Splint elbow,,,16.97,104.81,9
HCPCS,S8460,Camisole post-mast,,,36.52,341.62,9
HCPCS,S8490,100 insulin syringes,,,16.97,2739849.3,13
HCPCS,S849000,100 insulin syringes,,,69.78,89.38,3
HCPCS,S8930,Auricular electrostimulation,,,391.75,2739849.3,9
HCPCS,S8940,Hippotherapy per session,,,31.09,2739849.3,9
HCPCS,S8948,LOW-LEVEL LASER TRMT 15 MIN,72.0,46.8,1.1,72.0,80
HCPCS,S8948,Low-level laser trmt 15 min,,,31.09,36.0,9
HCPCS,S8950,"Complex lymphedema therapy,",,,31.09,36.0,9
HCPCS,S8990,Pt or manip for maint,,,31.09,53.43,9
HCPCS,S8999,Resuscitation bag,,,11.14,104.37,9
HCPCS,S9001,Home uterine monitor with or,,,5480.0,5480.0,1
HCPCS,S9002,Intra-vag motion sens biofk,,,669.74,775.49,8
HCPCS,S9007,Ultrafiltration monitor,,,58.52,5480.0,9
HCPCS,S9024,Paranasal sinus ultrasound,,,97.71,2739849.3,9
HCPCS,S9025,Omnicardiogram/cardiointegra,,,23.5,2739849.3,9
HCPCS,S9034,Eswl for gallstones,,,1363.63,2739849.3,9
HCPCS,S9055,Procuren or other growth fac,,,559.63,2739849.3,9
HCPCS,S9056,Coma stimulation per diem,,,405.62,2739849.3,9
HCPCS,S9061,Medical supplies and equipme,,,246.6,246.6,1
HCPCS,S9083,Urgent care center global,,,95.9,469.67,9
HCPCS,S9088,Services provided in urgent,,,117.82,469.67,9
HCPCS,S9090,Vertebral axial decompressio,,,31.09,123.3,9
HCPCS,S9097,Home visit wound care,,,2739849.3,2739849.3,1
HCPCS,S9098,Home phototherapy visit,,,2739849.3,2739849.3,1
HCPCS,S9110,Telemonitoring/home per mnth,,,2739849.3,2739849.3,1
HCPCS,S9117,Back school visit,,,63.76,2739849.3,9
HCPCS,S9122,Home health aide or certifie,,,45.26,45.26,1
HCPCS,S9123,Nursing care in home rn,,,109.6,109.6,1
HCPCS,S9124,"Nursing care, in the home; b",,,82.2,82.2,1
HCPCS,S9125,"Respite care, in the home, p",,,43.26,43.26,1
HCPCS,S9126,"Hospice care, in the home, p",,,205.5,205.5,1
HCPCS,S9127,"Social work visit, in the ho",,,2739849.3,2739849.3,1
HCPCS,S9128,"Speech therapy, in the home,",,,2739849.3,2739849.3,1
HCPCS,S9129,"Occupational therapy, in the",,,2739849.3,2739849.3,1
HCPCS,S9131,Pt in the home per diem,,,274.0,274.0,1
HCPCS,S9140,"Diabetic management program,",,,39.1,2435555.53,9
HCPCS,S9141,"Diabetic management program,",,,39.1,616.5,9
HCPCS,S9145,Insulin pump initiation,,,39.1,68.5,9
HCPCS,S9150,Evaluation by ocularist,,,63.76,2739849.3,9
HCPCS,S9152,"Speech therapy, re-eval",,,70.74,81.91,9
HCPCS,S9208,Home mgmt preterm labor,,,164.4,164.4,1
HCPCS,S9209,Home mgmt pprom,,,164.4,164.4,1
HCPCS,S9211,Home mgmt gest hypertension,,,101.38,101.38,1
HCPCS,S9212,Hm postpar hyper per diem,,,101.38,101.38,1
HCPCS,S9213,Hm preeclamp per diem,,,342.5,342.5,1
HCPCS,S9214,Hm gest dm per diem,,,274.0,274.0,1
HCPCS,S9325,Hit pain mgmt per diem,,,260.3,260.3,1
HCPCS,S9326,Hit cont pain per diem,,,260.3,260.3,1
HCPCS,S9327,Hit int pain per diem,,,260.3,260.3,1
HCPCS,S9328,Hit pain imp pump diem,,,260.3,260.3,1
HCPCS,S9329,Hit chemo per diem,,,260.3,260.3,1
HCPCS,S9330,Hit cont chem diem,,,260.3,260.3,1
HCPCS,S9331,Hit intermit chemo diem,,,260.3,260.3,1
HCPCS,S9335,Ht hemodialysis diem,,,260.3,432.0,9
HCPCS,S9336,Hit cont anticoag diem,,,191.8,191.8,1
HCPCS,S9338,Hit immunotherapy diem,,,274.0,274.0,1
HCPCS,S9339,Hit periton dialysis diem,,,260.3,432.0,9
HCPCS,S9340,Hit enteral per diem,,,9.04,9.04,1
HCPCS,S9341,Hit enteral grav diem,,,27.4,27.4,1
HCPCS,S9342,Hit enteral pump diem,,,43.84,43.84,1
HCPCS,S9343,Hit enteral bolus nurs,,,54.8,54.8,1
HCPCS,S9345,Hit anti-hemophil diem,,,54.8,54.8,1
HCPCS,S9346,Hit alpha-1-proteinas diem,,,260.3,260.3,1
HCPCS,S9347,Hit longterm infusion diem,,,164.4,164.4,1
HCPCS,S9348,Hit sympathomim diem,,,164.4,164.4,1
HCPCS,S9349,Hit tocolysis diem,,,548.0,548.0,1
HCPCS,S9351,Hit cont antiemetic diem,,,191.8,191.8,1
HCPCS,S9353,Hit cont insulin diem,,,548.0,548.0,1
HCPCS,S9355,Hit chelation diem,,,156.18,156.18,1
HCPCS,S9357,Hit enzyme replace diem,,,123.3,123.3,1
HCPCS,S9359,Hit anti-tnf per diem,,,191.8,191.8,1
HCPCS,S9361,Hit diuretic infus diem,,,219.2,219.2,1
HCPCS,S9363,Hit anti-spasmotic diem,,,219.2,219.2,1
HCPCS,S9364,Hit tpn total diem,,,438.4,438.4,1
HCPCS,S9365,Hit tpn 1 liter diem,,,438.4,438.4,1
HCPCS,S9366,Hit tpn 2 liter diem,,,438.4,438.4,1
HCPCS,S9367,Hit tpn 3 liter diem,,,548.0,548.0,1
HCPCS,S9368,Hit tpn over 3l diem,,,548.0,548.0,1
HCPCS,S9370,Ht inj antiemetic diem,,,20.55,25.3,9
HCPCS,S9372,Ht inj anticoag diem,,,21.85,123.3,9
HCPCS,S9373,Hit hydra total diem,,,137.0,137.0,1
HCPCS,S9374,Hit hydra 1 liter diem,,,137.0,137.0,1
HCPCS,S9375,Hit hydra 2 liter diem,,,137.0,137.0,1
HCPCS,S9376,Hit hydra 3 liter diem,,,137.0,137.0,1
HCPCS,S9377,Hit hydra over 3l diem,,,137.0,137.0,1
HCPCS,S9379,Hit noc per diem,,,219.2,219.2,1
HCPCS,S9381,Hit high risk/escort,,,63.76,2739849.3,9
HCPCS,S9401,Anticoag clinic per session,,,68.73,2739849.3,9
HCPCS,S9430,Pharmacy comp/disp serv,,,41.1,469.67,9
HCPCS,S9432,Med food non inborn err meta,,,2739849.3,2739849.3,1
HCPCS,S9433,Medical food oral 100% nutr,,,2739849.3,2739849.3,1
HCPCS,S9434,Mod solid food suppl,,,2739849.3,2739849.3,1
HCPCS,S9435,Medical foods for inborn err,,,2739849.3,2739849.3,1
HCPCS,S9436,CHILDBIRTH CLASS,152.0,98.8,33.14,152.0,66
HCPCS,S9437,Childbirth refresher class,,,39.1,2739849.3,9
HCPCS,S9438,Cesarean birth class,,,39.1,2739849.3,9
HCPCS,S9439,Vbac class,,,39.1,2739849.3,9
HCPCS,S9441,Asthma education,,,39.1,2435555.53,9
HCPCS,S9442,Birthing class,,,39.1,2739849.3,9
HCPCS,S9443,Lactation class,,,39.1,75.46,9
HCPCS,S9444,PARENTING CLASS,38.0,24.7,8.28,45.28,66
HCPCS,S9445,Pt education noc individ,,,39.1,2435555.53,9
HCPCS,S9446,Pt education noc group,,,44.67,186.32,9
HCPCS,S9447,INFANT SAFETY CLASS,38.0,24.7,8.28,45.28,66
HCPCS,S9449,Weight mgmt class,,,39.1,45.28,9
HCPCS,S9451,Exercise class,,,0.03,45.28,9
HCPCS,S9452,PRENATAL CLINIC GROUP,37.0,24.05,8.07,51.72,66
HCPCS,S9453,Smoking cessation class,,,47.12,2739849.3,9
HCPCS,S9454,Stress mgmt class,,,39.1,418.07,9
HCPCS,S9455,"Diabetic management program,",,,44.67,126.04,9
HCPCS,S9460,"Diabetic management program,",,,63.76,904.2,9
HCPCS,S9465,"Diabetic management program,",,,44.11,96.37,9
HCPCS,S9470,"Nutritional counseling, diet",,,44.11,96.37,9
HCPCS,S9472,Cardiac rehabilitation progr,,,69.16,2435555.53,9
HCPCS,S9473,Pulmonary rehabilitation pro,,,34.33,2435555.53,9
HCPCS,S9474,Enterostomal therapy by a re,,,405.62,2739849.3,9
HCPCS,S9475,Ambulatory setting substance,,,149.9,2739849.3,9
HCPCS,S9476,Vestibular rehab per diem,,,70.74,2739849.3,9
HCPCS,S9480,Intensive outpatient psychia,,,113.96,154.07,9
HCPCS,S9482,MRSS STABILIZATION SERVICE,84.0,54.6,1.1,3060831.65,146
HCPCS,S9484,CRISIS MOBILE RESPONSE FU,136.5,88.725,1.1,348.95,146
HCPCS,S9485,CRISIS MOBILE RESPONSE,305.0,198.25,1.1,3060831.65,146
HCPCS,S9490,Hit corticosteroid/diem,,,260.3,260.3,1
HCPCS,S9494,Hit antibiotic total diem,,,260.3,260.3,1
HCPCS,S9497,Hit antibiotic q3h diem,,,260.3,260.3,1
HCPCS,S9500,Hit antibiotic q24h diem,,,260.3,260.3,1
HCPCS,S9501,Hit antibiotic q12h diem,,,260.3,260.3,1
HCPCS,S9502,Hit antibiotic q8h diem,,,260.3,260.3,1
HCPCS,S9503,Hit antibiotic q6h diem,,,260.3,260.3,1
HCPCS,S9504,Hit antibiotic q4h diem,,,260.3,260.3,1
HCPCS,S9529,Venipuncture home/snf,,,2.64,7.4,9
HCPCS,S9537,Ht hem horm inj diem,,,19.18,25.3,9
HCPCS,S9538,Hit blood products diem,,,453.96,548.0,9
HCPCS,S9542,Ht inj noc per diem,,,20.55,20.55,1
HCPCS,S9558,Ht inj growth horm diem,,,21.85,95.9,9
HCPCS,S9559,Hit inj interferon diem,,,21.85,95.9,9
HCPCS,S9560,Ht inj hormone diem,,,21.85,328.8,9
HCPCS,S9562,Ht inj palivizumab/ab diem,,,21.85,120.56,9
HCPCS,S9563,Ht inj immuno diem,,,2739849.3,2739849.3,1
HCPCS,S9590,Ht irrigation diem,,,205.5,205.5,1
HCPCS,S9810,Ht pharm per hour,,,328.8,328.8,1
HCPCS,S9900,Christian sci pract visit,,,63.76,2739849.3,9
HCPCS,S9901,Christian sci nurse visit,,,63.76,2739849.3,9
HCPCS,S9960,Air ambulanc nonemerg fixed,,,7792.53,7792.53,1
HCPCS,S9961,Air ambulan nonemerg rotary,,,9060.0,9060.0,1
HCPCS,S9970,Health club membership yr,,,10.69,2739849.3,9
HCPCS,S9975,Transplant related per diem,,,191.8,191.8,1
HCPCS,S9976,Lodging per diem,,,2739849.3,2739849.3,1
HCPCS,S9977,Meals per diem,,,2739849.3,2739849.3,1
HCPCS,S9981,Med record copy admin,,,63.76,274.0,9
HCPCS,S9982,Med record copy per page,,,63.76,2739849.3,9
HCPCS,S9986,Not medically necessary svc,,,63.76,2733.15,9
HCPCS,S9988,Serv part of phase i trial,,,63.76,2739849.3,9
HCPCS,S9989,Services outside us,,,63.76,2739849.3,9
HCPCS,S9990,Services provided as part of,,,63.76,2739849.3,9
HCPCS,S9991,Services provided as part of,,,63.76,2739849.3,9
HCPCS,S9992,Transportation costs to and,,,2739849.3,2739849.3,1
HCPCS,S9994,Lodging costs (e.g. hotel ch,,,2739849.3,2739849.3,1
HCPCS,S9996,Meals for clinical trial par,,,2739849.3,2739849.3,1
HCPCS,S9999,Sales tax,,,51.76,73.83,9
HCPCS,T1000,Private duty/independent nsg,,,98.64,98.64,1
HCPCS,T1001,Nursing assessment/evaluatn,,,2739849.3,2739849.3,1
HCPCS,T1002,Rn services up to 15 minutes,,,2739849.3,2739849.3,1
HCPCS,T1003,Lpn/lvn services up to 15min,,,43.16,43.16,1
HCPCS,T1004,Nsg aide service up to 15min,,,2739849.3,2739849.3,1
HCPCS,T1005,Respite care service 15 min,,,2739849.3,2739849.3,1
HCPCS,T1006,Family/couple counseling,,,158.8,2739849.3,9
HCPCS,T1007,Treatment plan development,,,41.45,2739849.3,9
HCPCS,T1009,Child sitting services,,,2739849.3,2739849.3,1
HCPCS,T1010,Meals when receive services,,,2739849.3,2739849.3,1
HCPCS,T1012,Alcohol/substance abuse skil,,,48.61,2739849.3,9
HCPCS,T1013,Sign lang/oral interpreter,,,63.76,2739849.3,9
HCPCS,T1014,"Telehealth transmit, per min",,,405.62,2739849.3,9
HCPCS,T1015,Clinic service,,,46.36,79.59,9
HCPCS,T1016,Case management,,,21.85,2739849.3,9
HCPCS,T1017,Targeted case management,,,21.85,2739849.3,9
HCPCS,T1018,School-based iep ser bundled,,,2739849.3,2739849.3,1
HCPCS,T1019,Personal care ser per 15 min,,,2739849.3,2739849.3,1
HCPCS,T1020,Personal care ser per diem,,,2739849.3,2739849.3,1
HCPCS,T1021,Hh aide or cn aide per visit,,,2739849.3,2739849.3,1
HCPCS,T1022,Contracted services per day,,,2739849.3,2739849.3,1
HCPCS,T1023,Program intake assessment,,,47.12,2739849.3,9
HCPCS,T1024,Team evaluation & management,,,21.85,2739849.3,9
HCPCS,T1025,"Ped compr care pkg, per diem",,,41.45,2739849.3,9
HCPCS,T1026,"Ped compr care pkg, per hour",,,41.45,2739849.3,9
HCPCS,T1027,Family training & counseling,,,2739849.3,2739849.3,1
HCPCS,T1028,Home environment assessment,,,2739849.3,2739849.3,1
HCPCS,T1029,Dwelling lead investigation,,,2739849.3,2739849.3,1
HCPCS,T1030,Rn home care per diem,,,2739849.3,2739849.3,1
HCPCS,T1031,Lpn home care per diem,,,2739849.3,2739849.3,1
HCPCS,T1032,Sv doula brth wrk per 15 min,,,63.76,2739849.3,9
HCPCS,T1033,Sv doula brth wrk per diem,,,63.76,2739849.3,9
HCPCS,T1040,Comm bh clinic svc per diem,,,149.9,2739849.3,9
HCPCS,T1041,Comm bh clinic svc per month,,,2739849.3,2739849.3,1
HCPCS,T1502,Medication admin visit,,,45.54,2739849.3,9
HCPCS,T1503,ADMINISTRATION OF MEDICATION OTHER THAN ORAL AND/OR INJECTABLE,94.0,61.1,19.31,94.0,67
HCPCS,T1505,"Elec med comp dev, noc",,,16.97,2739849.3,9
HCPCS,T1999,Noc retail items andsupplies,,,16.97,2739849.3,9
HCPCS,T2001,N-et; patient attend/escort,,,2739849.3,2739849.3,1
HCPCS,T2002,N-et; per diem,,,2739849.3,2739849.3,1
HCPCS,T2003,N-et; encounter/trip,,,2739849.3,2739849.3,1
HCPCS,T2004,N-et; commerc carrier pass,,,2739849.3,2739849.3,1
HCPCS,T2005,N-et; stretcher van,,,2739849.3,2739849.3,1
HCPCS,T2007,Non-emer transport wait time,,,2739849.3,2739849.3,1
HCPCS,T2010,Pasrr level i,,,2739849.3,2739849.3,1
HCPCS,T2011,Pasrr level ii,,,2739849.3,2739849.3,1
HCPCS,T2012,"Habil ed waiver, per diem",,,2739849.3,2739849.3,1
HCPCS,T2013,Habil ed waiver per hour,,,2739849.3,2739849.3,1
HCPCS,T2014,"Habil prevoc waiver, per d",,,2739849.3,2739849.3,1
HCPCS,T2015,Habil prevoc waiver per hr,,,2739849.3,2739849.3,1
HCPCS,T2016,Habil res waiver per diem,,,2739849.3,2739849.3,1
HCPCS,T2017,Habil res waiver 15 min,,,2739849.3,2739849.3,1
HCPCS,T2018,Habil sup empl waiver/diem,,,2739849.3,2739849.3,1
HCPCS,T2019,Habil sup empl waiver 15min,,,2739849.3,2739849.3,1
HCPCS,T2020,Day habil waiver per diem,,,2739849.3,2739849.3,1
HCPCS,T2021,Day habil waiver per 15 min,,,2739849.3,2739849.3,1
HCPCS,T2022,MOD CARE COOR FULL MONTH,274.0,178.1,1.1,3060831.65,138
HCPCS,T2023,MOD CARE COOR PARTIAL MONTH,170.5,110.82499999999999,1.1,3060831.65,138
HCPCS,T2024,Serv asmnt/care plan waiver,,,2739849.3,2739849.3,1
HCPCS,T2025,"Waiver service, nos",,,2739849.3,2739849.3,1
HCPCS,T2026,Special childcare waiver/d,,,2739849.3,2739849.3,1
HCPCS,T2027,Spec childcare waiver 15 min,,,2739849.3,2739849.3,1
HCPCS,T2028,"Special supply, nos waiver",,,16.97,2739849.3,9
HCPCS,T2029,"Special med equip, noswaiver",,,16.97,2739849.3,9
HCPCS,T2030,Assist living waiver/month,,,2739849.3,2739849.3,1
HCPCS,T2031,Assist living waiver/diem,,,2739849.3,2739849.3,1
HCPCS,T2032,"Res care, nos waiver/month",,,2739849.3,2739849.3,1
HCPCS,T2033,"Res, nos waiver per diem",,,2739849.3,2739849.3,1
HCPCS,T2034,Crisis interven waiver/diem,,,2739849.3,2739849.3,1
HCPCS,T2035,Utility services waiver,,,16.97,2739849.3,9
HCPCS,T2036,Camp overnite waiver/session,,,2739849.3,2739849.3,1
HCPCS,T2037,Camp day waiver/session,,,2739849.3,2739849.3,1
HCPCS,T2038,Comm trans waiver/service,,,2739849.3,2739849.3,1
HCPCS,T2039,Vehicle mod waiver/service,,,2739849.3,2739849.3,1
HCPCS,T2040,Financial mgt waiver/15min,,,2739849.3,2739849.3,1
HCPCS,T2041,Support broker waiver/15 min,,,2739849.3,2739849.3,1
HCPCS,T2042,Hospice routine home care,,,2739849.3,2739849.3,1
HCPCS,T2043,Hospice continuous home care,,,2739849.3,2739849.3,1
HCPCS,T2044,Hospice respite care,,,2739849.3,2739849.3,1
HCPCS,T2045,Hospice general care,,,2739849.3,2739849.3,1
HCPCS,T2046,"Hospice long term care, r&b",,,2739849.3,2739849.3,1
HCPCS,T2047,Hab prevo waiver per 15,,,2739849.3,2739849.3,1
HCPCS,T2048,"Bh ltc res r&b, per diem",,,272.85,2739849.3,9
HCPCS,T2049,"N-et; stretcher van, mileage",,,2739849.3,2739849.3,1
HCPCS,T2050,Financial mgt waiver/diem,,,2739849.3,2739849.3,1
HCPCS,T2051,Support broker waiver/diem,,,2739849.3,2739849.3,1
HCPCS,T2101,BREAST MILK PROC/STORE/DIST,42.0,27.3,9.16,42.0,58
HCPCS,T4521,Adult size brief/diaper sm,,,16.97,2739849.3,9
HCPCS,T4522,Adult size brief/diaper med,,,16.97,2739849.3,9
HCPCS,T4523,Adult size brief/diaper lg,,,16.97,2739849.3,9
HCPCS,T4524,Adult size brief/diaper xl,,,1.86,19.65,9
HCPCS,T4525,Adult size pull-on sm,,,0.74,19.65,9
HCPCS,T4526,Adult size pull-on med,,,16.97,2739849.3,9
HCPCS,T4527,Adult size pull-on lg,,,16.97,2739849.3,9
HCPCS,T4528,Adult size pull-on xl,,,16.97,2739849.3,9
HCPCS,T4529,Ped size brief/diaper sm/med,,,16.97,2739849.3,9
HCPCS,T4530,Ped size brief/diaper lg,,,1.75,19.65,9
HCPCS,T4531,Ped size pull-on sm/med,,,16.97,2739849.3,9
HCPCS,T4532,Ped size pull-on lg,,,1.75,19.65,9
HCPCS,T4533,Youth size brief/diaper,,,1.81,19.65,9
HCPCS,T4534,Youth size pull-on,,,1.84,19.65,9
HCPCS,T4535,Disposable liner/shield/pad,,,16.97,2739849.3,9
HCPCS,T4536,Reusable pull-on any size,,,16.97,2739849.3,9
HCPCS,T4537,Reusable underpad bed size,,,16.97,2739849.3,9
HCPCS,T4538,Diaper serv reusable diaper,,,16.97,2739849.3,9
HCPCS,T4539,Reuse diaper/brief any size,,,16.97,2739849.3,9
HCPCS,T4540,Reusable underpad chair size,,,16.97,2739849.3,9
HCPCS,T4541,Large disposable underpad,,,0.33,19.65,9
HCPCS,T4542,Small disposable underpad,,,16.97,2739849.3,9
HCPCS,T4543,Adult disp brief/diap abv xl,,,16.97,2739849.3,9
HCPCS,T4544,Adlt disp und/pull on abv xl,,,16.97,2739849.3,9
HCPCS,T4545,Incon disposable penile wrap,,,16.97,2739849.3,9
HCPCS,T5001,Position seat spec orth need,,,16.97,2739849.3,9
HCPCS,T5999,"Supply, nos",,,16.97,2739999.97,9
HCPCS,U0001,COVID19,248.0,161.2,1.1,248.0,86
HCPCS,U0001,COVID19 INHOUSE,248.0,161.2,14.37,248.0,85
HCPCS,U0001,COVID19 SENDOUT,248.0,161.2,14.37,248.0,85
HCPCS,U0002,COVID19,354.0,230.1,1.1,354.0,86
HCPCS,U0002,COVID19 INHOUSE,354.0,230.1,16.64,354.0,85
HCPCS,U0002,COVID19 SENDOUT,354.0,230.1,16.64,354.0,85
HCPCS,U0003,Cov-19 amp prb hgh thruput,,,20.52,84.03,19
HCPCS,U0004,Cov-19 test non-cdc hgh thru,,,20.52,84.03,19
HCPCS,U0005,Infec agen detec ampli probe,,,10.0,28.01,19
HCPCS,V2020,Vision svcs frames purchases,,,31.69,241.59,9
HCPCS,V2025,Eyeglasses delux frames,,,36.52,274.0,9
HCPCS,V2100,Lens spher single plano 4.00,,,36.52,149.3,9
HCPCS,V2101,Single visn sphere 4.12-7.00,,,36.52,143.47,9
HCPCS,V2102,Singl visn sphere 7.12-20.00,,,31.69,248.05,9
HCPCS,V2103,Spherocylindr 4.00d/12-2.00d,,,36.52,125.68,9
HCPCS,V2104,Spherocylindr 4.00d/2.12-4d,,,36.52,129.57,9
HCPCS,V2105,Spherocylinder 4.00d/4.25-6d,,,36.52,154.13,9
HCPCS,V2106,Spherocylinder 4.00d/>6.00d,,,31.69,170.7,9
HCPCS,V2107,Spherocylinder 4.25d/12-2d,,,31.69,152.02,9
HCPCS,V2108,Spherocylinder 4.25d/2.12-4d,,,31.69,152.43,9
HCPCS,V2109,Spherocylinder 4.25d/4.25-6d,,,31.69,212.3,9
HCPCS,V2110,Spherocylinder 4.25d/over 6d,,,31.69,171.47,9
HCPCS,V2111,Spherocylindr 7.25d/.25-2.25,,,31.69,207.8,9
HCPCS,V2112,Spherocylindr 7.25d/2.25-4d,,,31.69,234.74,9
HCPCS,V2113,Spherocylindr 7.25d/4.25-6d,,,31.69,237.39,9
HCPCS,V2114,Spherocylinder over 12.00d,,,31.69,281.26,9
HCPCS,V2115,Lens lenticular bifocal,,,31.69,283.48,9
HCPCS,V2118,Lens aniseikonic single,,,31.69,308.47,9
HCPCS,V2121,"Lenticular lens, single",,,31.69,278.16,9
HCPCS,V2199,Lens single vision not oth c,,,16.97,2739999.97,9
HCPCS,V2200,Lens spher bifoc plano 4.00d,,,31.69,168.15,9
HCPCS,V2201,Lens sphere bifocal 4.12-7.0,,,31.69,180.16,9
HCPCS,V2202,Lens sphere bifocal 7.12-20.,,,31.69,223.34,9
HCPCS,V2203,Lens sphcyl bifocal 4.00d/.1,,,31.69,173.17,9
HCPCS,V2204,Lens sphcy bifocal 4.00d/2.1,,,31.69,178.18,9
HCPCS,V2205,Lens sphcy bifocal 4.00d/4.2,,,31.69,197.55,9
HCPCS,V2206,Lens sphcy bifocal 4.00d/ove,,,31.69,231.89,9
HCPCS,V2207,Lens sphcy bifocal 4.25-7d/.,,,31.69,195.99,9
HCPCS,V2208,Lens sphcy bifocal 4.25-7/2.,,,31.69,192.59,9
HCPCS,V2209,Lens sphcy bifocal 4.25-7/4.,,,31.69,226.1,9
HCPCS,V2210,Lens sphcy bifocal 4.25-7/ov,,,31.69,243.64,9
HCPCS,V2211,Lens sphcy bifo 7.25-12/.25-,,,31.69,237.17,9
HCPCS,V2212,Lens sphcyl bifo 7.25-12/2.2,,,31.69,248.27,9
HCPCS,V2213,Lens sphcyl bifo 7.25-12/4.2,,,31.69,261.04,9
HCPCS,V2214,Lens sphcyl bifocal over 12.,,,58.52,272.82,9
HCPCS,V2215,Lens lenticular bifocal,,,58.52,340.64,9
HCPCS,V2218,Lens aniseikonic bifocal,,,58.52,347.13,9
HCPCS,V2219,Lens bifocal seg width over,,,31.69,160.13,9
HCPCS,V2220,Lens bifocal add over 3.25d,,,36.52,142.23,9
HCPCS,V2221,"Lenticular lens, bifocal",,,58.52,283.67,9
HCPCS,V2299,Lens bifocal speciality,,,16.97,172.62,9
HCPCS,V2300,Lens sphere trifocal 4.00d,,,31.69,229.86,9
HCPCS,V2301,Lens sphere trifocal 4.12-7.,,,31.69,281.92,9
HCPCS,V2302,LENS SPHERE TRIFOCAL 7.12-20,101.0,65.65,1.1,323.68,90
HCPCS,V2302,Lens sphere trifocal 7.12-20,,,31.69,263.37,9
HCPCS,V2303,Lens sphcy trifocal 4.0/.12-,,,31.69,221.26,9
HCPCS,V2304,Lens sphcy trifocal 4.0/2.25,,,31.69,223.83,9
HCPCS,V2305,Lens sphcy trifocal 4.0/4.25,,,31.69,250.05,9
HCPCS,V2306,Lens sphcyl trifocal 4.00/>6,,,31.69,257.48,9
HCPCS,V2307,LENS SPHCY TRIFOCAL 4.25-7/.,187.0,121.55,1.1,301.29,90
HCPCS,V2307,Lens sphcy trifocal 4.25-7/.,,,31.69,245.15,9
HCPCS,V2308,Lens sphc trifocal 4.25-7/2.,,,31.69,267.4,9
HCPCS,V2309,LENS SPHC TRIFOCAL 4.25-7/4.,187.0,121.55,1.1,343.93,90
HCPCS,V2309,Lens sphc trifocal 4.25-7/4.,,,58.52,279.84,9
HCPCS,V2310,LENS SPHC TRIFOCAL 4.25-7/>6,187.0,121.55,1.1,359.24,90
HCPCS,V2310,Lens sphc trifocal 4.25-7/>6,,,58.52,292.28,9
HCPCS,V2311,LENS SPHC TRIFO 7.25-12/.25-,187.0,121.55,1.1,414.79,90
HCPCS,V2311,Lens sphc trifo 7.25-12/.25-,,,58.52,337.49,9
HCPCS,V2312,Lens sphc trifo 7.25-12/2.25,,,58.52,309.35,9
HCPCS,V2313,Lens sphc trifo 7.25-12/4.25,,,58.52,337.68,9
HCPCS,V2314,Lens sphcyl trifocal over 12,,,58.52,345.19,9
HCPCS,V2315,Lens lenticular trifocal,,,58.52,383.19,9
HCPCS,V2318,Lens aniseikonic trifocal,,,58.52,471.09,9
HCPCS,V2319,Lens trifocal seg width > 28,,,31.69,212.68,9
HCPCS,V2320,LENS TRIFOCAL ADD OVER 3.25D,24.0,15.6,1.1,275.73,90
HCPCS,V2320,Lens trifocal add over 3.25d,,,31.69,224.32,9
HCPCS,V2321,"Lenticular lens, trifocal",,,58.52,377.71,9
HCPCS,V2399,Lens trifocal speciality,,,16.97,232.9,9
HCPCS,V2410,LENS VARIAB ASPHERICITY SING,48.0,31.2,1.1,405.88,90
HCPCS,V2410,Lens variab asphericity sing,,,58.52,330.22,9
HCPCS,V2430,LENS VARIABLE ASPHERICITY BI,48.0,31.2,1.1,429.62,90
HCPCS,V2430,Lens variable asphericity bi,,,58.52,349.54,9
HCPCS,V2499,VARIABLE ASPHERICITY LENS,48.0,31.2,0.01,260.19,80
HCPCS,V2499,Variable asphericity lens,,,16.97,232.9,9
HCPCS,V2500,Contact lens pmma spherical,,,31.69,295.48,9
HCPCS,V2501,Cntct lens pmma-toric/prism,,,58.52,419.33,9
HCPCS,V2502,Contact lens pmma bifocal,,,58.52,568.17,9
HCPCS,V2503,Cntct lens pmma color vision,,,58.52,548.77,9
HCPCS,V2510,RGP KERATOCONUS/SINGLE LENS,225.0,146.25,1.1,484.28,163
HCPCS,V2510,RGP POST GRAFT/SINGLE LENS,225.0,146.25,1.1,484.28,163
HCPCS,V2510,RGP SPHERE/SINGLE LENS,100.0,65.0,1.1,484.28,163
HCPCS,V2511,RGP TORIC/SINGLE LENS,165.0,107.25,1.1,717.78,163
HCPCS,V2512,RGP MULTIFOCAL/SINGLE LENS,225.0,146.25,1.1,826.21,163
HCPCS,V2513,Contact lens extended wear,,,58.52,677.22,9
HCPCS,V2520,ACUVUE 2,57.0,37.05,1.1,482.55,163
HCPCS,V2520,ACUVUE OASYS 1-DAY MAX 90 PK,151.0,98.15,1.1,482.55,163
HCPCS,V2520,ALDEN HP SPHERE - 3 PACK,76.0,49.4,1.1,482.55,163
HCPCS,V2520,ALDEN HP SPHERE - SINGLE PACK,76.0,49.4,1.1,482.55,163
HCPCS,V2520,AVAIRA VITALITY 6 PK,50.0,32.5,1.1,482.55,163
HCPCS,V2520,BIOCOLORS PROSTHETIC,730.0,474.5,1.1,730.0,163
HCPCS,V2520,BIOCOLORS SPHERE,250.0,162.5,1.1,482.55,163
HCPCS,V2520,BIOFINITY XR,66.0,42.9,1.1,482.55,163
HCPCS,V2520,BIOMEDICS 55,30.0,19.5,1.1,482.55,90
HCPCS,V2520,BIOMEDICS 55 PREMIER,64.0,41.6,1.1,482.55,163
HCPCS,V2520,BIOTRUE ONE DAY 90 PK,93.0,60.45,1.1,482.55,163
HCPCS,V2520,CLARITI 1 DAY 90PK,90.0,58.5,1.1,482.55,163
HCPCS,V2520,CLEARSIGHT 1DAY 90PK,69.0,44.85,1.1,482.55,90
HCPCS,V2520,CONTACT LENS HYDROPHILIC,36.0,23.4,1.1,482.55,90
HCPCS,V2520,DAILES ACP 90PK,100.0,65.0,1.1,482.55,163
HCPCS,V2520,DAILIES COLORS 30 PK,51.0,33.15,1.1,482.55,163
HCPCS,V2520,DAILIES COLORS 90 PK,115.0,74.75,1.1,482.55,163
HCPCS,V2520,FRESHLOOK COLORS/CB,97.0,63.05,1.1,482.55,90
HCPCS,V2520,"INTELLIWAVE  (3-PK, ONLY NON-WRNTD.)",138.0,89.7,1.1,482.55,163
HCPCS,V2520,"INTELLIWAVE  (SINGLE, WRNTD.)",100.0,65.0,1.1,482.55,163
HCPCS,V2520,MISIGHT 1 DAY 180 X 2 (6 MONTH),555.0,360.75,1.1,555.0,163
HCPCS,V2520,MISIGHT 1 DAY 90 PK,165.0,107.25,1.1,482.55,163
HCPCS,V2520,MY DAY 90 PK,120.0,78.0,1.1,482.55,163
HCPCS,V2520,NATURALVUE?SPHERE,60.0,39.0,13.08,67.76,73
HCPCS,V2520,NATURALVUE?SPHERE?????????????????,60.0,39.0,1.1,482.55,90
HCPCS,V2520,PROCLEAR MONTHLY,77.0,50.05,1.1,482.55,90
HCPCS,V2520,SOFLENS DAILY FOR ASTIG. 30 PK,35.0,22.75,1.1,482.55,90
HCPCS,V2520,SOFTLENS DAILY 90 PK,100.0,65.0,1.1,482.55,163
HCPCS,V2521,1 DAY ACUVUE MOIST ASTIG 30 PK,67.0,43.55,1.1,955.6,163
HCPCS,V2521,1 DAY ACUVUE MOIST ASTIG 90 PK,147.0,95.55,1.1,955.6,163
HCPCS,V2521,1 DAY ACUVUE OASYS ASTIG 30 PK,70.0,45.5,1.1,955.6,163
HCPCS,V2521,1- DAY AV MOIST ASTIG 720PK,600.0,390.0,1.1,955.6,90
HCPCS,V2521,1-DAY ACUVUE OASYS ASTIG 90 PK,167.0,108.55,1.1,955.6,163
HCPCS,V2521,ACUVUE OASYS 1-DAY MAX ASTIG 30 PK,59.0,38.35,1.1,955.6,163
HCPCS,V2521,ACUVUE OASYS 1-DAY MAX ASTIG MULTIFOCAL 30PK,70.0,45.5,1.1,955.6,163
HCPCS,V2521,ACUVUE OASYS ASTIGMATISM,60.0,39.0,1.1,955.6,163
HCPCS,V2521,ACUVUE OAYSS FOR ASTIG (ANNUAL 6 PK X4),140.0,91.0,1.1,955.6,90
HCPCS,V2521,ACUVUE VITA  ASTIG. 6 PK,89.0,57.85,1.1,955.6,163
HCPCS,V2521,AIR OPTIX AQUA FOR ASTIG.,96.0,62.4,1.1,955.6,90
HCPCS,V2521,AIR OPTIX HYDRAGYLDE FOR ASTIG.,96.0,62.4,20.93,406.89,73
HCPCS,V2521,ALDEN HP TORIC - 3 PACK,140.0,91.0,1.1,955.6,163
HCPCS,V2521,ALDEN HP TORIC - SINGLE PACK,140.0,91.0,1.1,955.6,163
HCPCS,V2521,AVAIRA TORIC,35.0,22.75,1.1,955.6,90
HCPCS,V2521,AVAIRA VITALITY TORIC 6 PK,60.0,39.0,1.1,955.6,163
HCPCS,V2521,BIOCOLORS TORIC,310.0,201.5,1.1,955.6,163
HCPCS,V2521,BIOFINITY,66.0,42.9,1.1,955.6,163
HCPCS,V2521,BIOFINITY TORIC,90.0,58.5,1.1,955.6,163
HCPCS,V2521,BIOFINITY TORIC XR,167.0,108.55,1.1,955.6,163
HCPCS,V2521,BIOMEDICS TORIC,75.0,48.75,1.1,955.6,163
HCPCS,V2521,BIOTRUE ONE DAY FOR ASTIGMATISM (30 PK),48.0,31.2,10.46,406.89,73
HCPCS,V2521,CLARITI 1 DAY TORIC 30PK,59.0,38.35,1.1,955.6,163
HCPCS,V2521,CLARITI 1 DAY TORIC 90 PK,128.0,83.2,1.1,955.6,163
HCPCS,V2521,CLEARSIGHT 1DAY TORIC30PK,35.0,22.75,1.1,955.6,90
HCPCS,V2521,CNTCT LENS HYDROPHILIC TORIC,35.0,22.75,1.1,955.6,90
HCPCS,V2521,DAILIES ACP TORIC  90 PK,136.0,88.4,1.1,955.6,163
HCPCS,V2521,DAILIES ACP TORIC 30 PACK,53.0,34.45,1.1,955.6,163
HCPCS,V2521,DAILIES TOTAL 1 FOR ASTIG 30 PK,64.0,41.599999999999994,1.1,955.6,253
HCPCS,V2521,DAILIES TOTAL 1 FOR ASTIG 90 PK,161.5,104.975,1.1,955.6,253
HCPCS,V2521,HYDRASOFT TORIC/THIN SIN.,110.0,71.5,1.1,955.6,90
HCPCS,V2521,HYDRASOFT TORIC/THIN3 PK,110.0,71.5,1.1,955.6,90
HCPCS,V2521,INFUSE FOR ASTIG 90PK,165.0,107.25,1.1,955.6,163
HCPCS,V2521,"INTELLIWAVE  TORIC (SINGLE, WRNTD.)",160.0,104.0,1.1,955.6,163
HCPCS,V2521,"INTELLIWAVE TORIC  (3-PK, ONLY NON-WRNTD.)",192.0,124.8,1.1,955.6,163
HCPCS,V2521,MY DAY TORIC 90 PK,163.0,105.95,1.1,955.6,163
HCPCS,V2521,PRECISION 1 ONE DAY ASTIG 30 PK,59.5,38.675,1.1,955.6,236
HCPCS,V2521,PRECISION 1 ONE DAY ASTIG 90 PK,128.0,83.2,1.1,955.6,236
HCPCS,V2521,PRECISION 7 FOR ASTIG 12PK,76.0,49.4,1.1,955.6,236
HCPCS,V2521,PRECISION 7 FOR ASTIG 27PK,126.0,81.9,1.1,955.6,163
HCPCS,V2521,PROCLEAR TORIC,113.0,73.45,1.1,955.6,163
HCPCS,V2521,PROCLEAR TORIC XR 6PK.,200.0,130.0,1.1,955.6,163
HCPCS,V2521,PUREVISION 2 FOR ASTIG. 6 PK,67.0,43.55,1.1,955.6,90
HCPCS,V2521,PUREVISION TORIC,65.0,42.25,1.1,955.6,90
HCPCS,V2521,SOFTLENS - 6 PK,76.0,49.4,1.1,955.6,163
HCPCS,V2521,TOTAL 30 TORIC 6 PK,92.0,59.8,1.1,955.6,163
HCPCS,V2521,ULTRA FOR ASTIGMATISM,90.0,58.5,1.1,955.6,163
HCPCS,V2521,VERTEX TORIC,50.0,32.5,1.1,955.6,90
HCPCS,V2521,VERTEX TORIC XR,90.0,58.5,1.1,955.6,90
HCPCS,V2521A,BIOTRUE ONE DAY FOR ASTIGMATISM (30 PK),48.0,31.2,1.1,48.0,68
HCPCS,V2522,1 DAY ACUVUE M.F. 90 PK,139.0,90.35,1.1,699.32,163
HCPCS,V2522,1 DAY ACUVUE MOIST  MF 30 PK,89.0,57.85,1.1,699.32,163
HCPCS,V2522,1 DAY ACUVUE MOIST MF 90 PK,165.0,107.25,1.1,699.32,163
HCPCS,V2522,1 DAY ACVUE M.F. 30PK,75.0,48.75,1.1,699.32,90
HCPCS,V2522,ACUVUE OASYS 1-DAY MAX  MULTIFOCAL 30 PK,87.0,56.55,1.1,699.32,163
HCPCS,V2522,ACUVUE OASYS 1-DAY MAX  MULTIFOCAL 90 PK,195.0,126.75,1.1,699.32,163
HCPCS,V2522,ACUVUE OASYS FOR PRESB.,60.0,39.0,1.1,699.32,90
HCPCS,V2522,ACUVUE OASYS MULTIFOCAL,65.0,42.25,1.1,699.32,163
HCPCS,V2522,AIR OPTIX AQUA MULTIFOCAL,147.0,95.55,1.1,699.32,90
HCPCS,V2522,AIR OPTIX HYDRAGYLDE MULTIFOCAL,147.0,95.55,32.05,406.89,73
HCPCS,V2522,BIOFINITY MULTIFOCAL,122.0,79.3,1.1,699.32,163
HCPCS,V2522,BIOFINITY TORIC MF 6 PK,177.0,115.05,1.1,699.32,163
HCPCS,V2522,BIOTRUE ONE DAY FOR ASTIGMATISM (90 PK),127.0,82.55,1.1,699.32,163
HCPCS,V2522,BIOTRUE ONEDAY FOR PRESBYOPIA (90 PK),149.0,96.85,1.1,699.32,163
HCPCS,V2522,BIOTRUE ONEDAY FOR PRESBYOPIA 30 PK,58.0,37.7,1.1,699.32,163
HCPCS,V2522,CLARITI 1 DAY MF 3 ADD 30 PK,69.0,44.85,1.1,699.32,163
HCPCS,V2522,CLARITI 1 DAY MF 3 ADD 90 PK,150.0,97.5,1.1,699.32,163
HCPCS,V2522,CLARITI 1 DAY MF 30PK,60.0,39.0,1.1,699.32,163
HCPCS,V2522,CLARITI 1 DAY MF 90PK,134.0,87.1,1.1,699.32,163
HCPCS,V2522,CVUE ADV.MULTIFOCAL 6PK,225.0,146.25,1.1,699.32,163
HCPCS,V2522,DAILIES ACP MULTIF 30 PK,64.0,41.6,1.1,699.32,163
HCPCS,V2522,DAILIES ACP MULTIF 90PK,157.0,102.05,1.1,699.32,163
HCPCS,V2522,DAILIES TOTAL 1 MULTIFOCAL 30 PACK,75.0,48.75,1.1,699.32,163
HCPCS,V2522,DAILIES TOTAL 1 MULTIFOCAL 90 PACK,197.0,128.05,1.1,699.32,163
HCPCS,V2522,INFUSE MF 90PK,187.0,121.55,1.1,699.32,163
HCPCS,V2522,"INTELLIWAVE  MF TORIC (3-PK, ONLY NON WTD)",300.0,195.0,1.1,699.32,163
HCPCS,V2522,"INTELLIWAVE  MF TORIC (SINGLE, WRNTD.)",230.0,149.5,1.1,699.32,163
HCPCS,V2522,"INTELLIWAVE  MULTI (3-PK, ONLY NON-WRNTD.)",240.0,156.0,1.1,699.32,163
HCPCS,V2522,"INTELLIWAVE MULTI (SINGLE, WRNTD.)",210.0,136.5,1.1,699.32,163
HCPCS,V2522,MISIGHT CONTACT LENS,475.0,308.75,1.1,699.32,163
HCPCS,V2522,MY DAY MF 90 PK,182.0,118.3,1.1,699.32,163
HCPCS,V2522,MY DAY MULTI 90 PK,125.0,81.25,1.1,699.32,90
HCPCS,V2522,NATURALVUE? MULTI,100.0,65.0,21.8,406.89,73
HCPCS,V2522,NATURALVUE? MULTI???????????????????,100.0,65.0,1.1,699.32,90
HCPCS,V2522,PROCLEAR 1 DAY MF,137.0,89.05,1.1,699.32,90
HCPCS,V2522,PROCLEAR 1 DAY MF 30PK,35.0,22.75,1.1,699.32,90
HCPCS,V2522,PROCLEAR 1 DAY MF 90 PK,158.0,102.7,1.1,699.32,163
HCPCS,V2522,PROCLEAR MF XR 6PK,205.0,133.25,1.1,699.32,163
HCPCS,V2522,PROCLEAR MULTIFOCAL 6PK,130.0,84.5,1.1,699.32,163
HCPCS,V2522,PROCLEAR MULTIFOCAL TORIC,240.0,156.0,1.1,699.32,163
HCPCS,V2522,PUREVISION 2 MULTIFOCAL,81.0,52.65,1.1,699.32,90
HCPCS,V2522,PUREVISION MULTIFOCAL,65.0,42.25,1.1,699.32,90
HCPCS,V2522,SOFLENS MULTIFOCAL,116.0,75.4,1.1,699.32,163
HCPCS,V2522,TOTAL 30 MF 6 PK,129.0,83.85,1.1,699.32,163
HCPCS,V2522,TOTAL 30 MF TORIC 6 PK,163.0,105.95,1.1,699.32,163
HCPCS,V2522,ULTRA MF FOR ASTIGMATISM,185.0,120.25,1.1,699.32,163
HCPCS,V2523,1-DAY ACUVUE DEFINE 30 PK,59.0,38.35,1.1,734.23,163
HCPCS,V2523,1-DAY ACUVUE MOIST 30PK,54.0,35.1,1.1,734.23,163
HCPCS,V2523,1-DAY ACUVUE MOIST 720 PK,460.0,299.0,1.1,734.23,90
HCPCS,V2523,1-DAY ACUVUE MOIST 90 PK,100.0,65.0,1.1,734.23,163
HCPCS,V2523,1-DAY ACUVUE OASYS 90 PK,133.0,86.45,1.1,734.23,163
HCPCS,V2523,1-DAY ACUVUE TRUE E.90 PK,135.0,87.75,1.1,734.23,90
HCPCS,V2523,1-DAY ACUVUE TRUE EYE 720,610.0,396.5,1.1,734.23,90
HCPCS,V2523,ACUVUE BANDAGE PLANO 6PK,48.0,31.2,1.1,734.23,163
HCPCS,V2523,ACUVUE OASYS 1-DAY MAX 30 PK,70.0,45.5,1.1,734.23,163
HCPCS,V2523,ACUVUE OASYS 12 PK,109.0,70.85,1.1,734.23,163
HCPCS,V2523,ACUVUE OASYS 24 PK,173.0,112.45,1.1,734.23,163
HCPCS,V2523,ACUVUE OASYS 54 PK,218.0,141.7,1.1,734.23,90
HCPCS,V2523,ACUVUE VITA 12 PK,142.0,92.3,1.1,734.23,163
HCPCS,V2523,ACUVUE VITA 6 PK,89.0,57.85,1.1,734.23,163
HCPCS,V2523,AIR OPTIX AQUA,50.0,32.5,1.1,734.23,90
HCPCS,V2523,AIR OPTIX AQUA N& DAY,137.0,89.05,1.1,734.23,163
HCPCS,V2523,AIR OPTIX COLORS,163.0,105.95,1.1,734.23,163
HCPCS,V2523,AIR OPTIX PLUS HYDRAGYIDE,77.0,50.05,1.1,734.23,90
HCPCS,V2523,AIR OPTIX PLUS HYDRAGYLDE,77.0,50.05,16.79,77.0,73
HCPCS,V2523,AVAIRA,30.0,19.5,1.1,734.23,90
HCPCS,V2523,BIOFINITY ENERGYS,71.0,46.15,1.1,734.23,163
HCPCS,V2523,BIOTRUE ONE DAY 30PK,38.0,24.7,1.1,734.23,163
HCPCS,V2523,CLARITI 1 DAY 180 PK,152.0,98.8,1.1,734.23,163
HCPCS,V2523,CLARITI 1 DAY 30 PK,43.0,27.95,1.1,734.23,163
HCPCS,V2523,DAILIES ACP 30 PK,40.0,26.0,1.1,734.23,163
HCPCS,V2523,DAILIES TOTAL 1  30 PK,59.0,38.35,1.1,734.23,163
HCPCS,V2523,DAILIES TOTAL 1  90 PK,154.0,100.1,1.1,734.23,163
HCPCS,V2523,DAILIES TOTAL 1 30PK,53.0,34.45,1.1,734.23,90
HCPCS,V2523,DAY -1  ACUVUE TRUE EYE 30 PK,64.0,41.6,1.1,734.23,90
HCPCS,V2523,FLEXLENS SPH.CUSTOM 4PK,165.0,107.25,1.1,734.23,163
HCPCS,V2523,FLEXLENS SPH.SILICONE 3PK,120.0,78.0,1.1,734.23,163
HCPCS,V2523,INFUSE 90 PK,137.0,89.05,1.1,734.23,163
HCPCS,V2523,MI SIGHT 1-DAY 180 PK,329.0,213.85,1.1,734.23,163
HCPCS,V2523,MY DAY 180 PK,212.0,137.8,1.1,734.23,163
HCPCS,V2523,MY DAY ENERGYS 90 PK,140.0,91.0,1.1,734.23,163
HCPCS,V2523,PRECISION 1 30 PK,48.0,31.2,1.1,734.23,163
HCPCS,V2523,PRECISION 1 90 PK,103.0,66.95,1.1,734.23,163
HCPCS,V2523,PRECISION 7 12 PK,61.0,39.65,1.1,734.23,163
HCPCS,V2523,PRECISION 7 27 PK,101.0,65.65,1.1,734.23,163
HCPCS,V2523,PROCLEAR 1 DAY 90 PK,113.0,73.45,1.1,734.23,163
HCPCS,V2523,PROCLEAR SPHERE,91.0,59.15,1.1,734.23,163
HCPCS,V2523,PUREVISION 2,50.0,32.5,1.1,734.23,90
HCPCS,V2523,PUREVISION 2 HD 6 PK,67.0,43.55,1.1,734.23,90
HCPCS,V2523,SILSOFT,225.0,146.25,1.1,734.23,163
HCPCS,V2523,TOTAL 30  SPHERE 6 PK,76.0,49.4,1.1,734.23,163
HCPCS,V2523,TOTAL 30 6 PK,73.0,47.45,1.1,734.23,90
HCPCS,V2523,ULTRA,73.0,47.45,1.1,734.23,163
HCPCS,V2523,ULTRA FOR PRESBYOPIA,124.0,80.6,1.1,734.23,163
HCPCS,V2524,Cntct lens hydrophil photoch,,,58.52,449.88,9
HCPCS,V2525,"Cl, hydrophilic, dual focus",,,58.52,2739849.3,9
HCPCS,V2526,Cntct lens blue violet,,,351.41,2739849.3,9
HCPCS,V2530,Contact lens gas impermeable,,,351.41,955.05,9
HCPCS,V2531,RGP ORTHO-K WARRANTED/SINGLE,300.0,195.0,1.1,2149.61,163
HCPCS,V2531,"SCLERAL LENS,WRNTD/SINGLE LENS",550.0,357.5,1.1,2149.61,163
HCPCS,V2531,"SCLERAL, SPECIALTY, 1 LENS",700.0,455.0,1.1,2149.61,163
HCPCS,V2531,SYNERGES SCLERAL VS,475.0,308.75,1.1,2149.61,163
HCPCS,V2531,SYNERGEYES  U.H (SINGLE),350.0,227.5,1.1,2149.61,163
HCPCS,V2531,SYNERGEYES A (SINGLE),300.0,195.0,1.1,2149.61,163
HCPCS,V2531,SYNERGEYES A/ANNUAL,450.0,292.5,1.1,2149.61,163
HCPCS,V2531,SYNERGEYES CLEARCONE SINGLE,450.0,292.5,1.1,2149.61,163
HCPCS,V2531,SYNERGEYES CLEARCONE/ANNUAL,600.0,390.0,1.1,2149.61,163
HCPCS,V2531,SYNERGEYES DUE. EXT. PAR,380.0,247.0,1.1,2149.61,163
HCPCS,V2531,SYNERGEYES DUE. PROG (.ANNUAL),340.0,221.0,1.1,2149.61,163
HCPCS,V2531,SYNERGEYES DUE. PROG. SINGLE,200.0,130.0,1.1,2149.61,163
HCPCS,V2531,SYNERGEYES DUETTE (ANNUAL),300.0,195.0,1.1,2149.61,163
HCPCS,V2531,SYNERGEYES DUETTE M.F (ANNUAL),340.0,221.0,1.1,2149.61,163
HCPCS,V2531,SYNERGEYES DUETTE M.F SINGLE,180.0,117.0,1.1,2149.61,163
HCPCS,V2531,SYNERGEYES DUETTE/SINGLE,165.0,107.25,1.1,2149.61,163
HCPCS,V2531,SYNERGEYES ID MULTIFOCAL EDOF*/ANNUAL,350.0,227.5,1.1,2149.61,163
HCPCS,V2531,SYNERGEYES ID MULTIFOCAL EDOF*/SINGLE,225.0,146.25,1.1,2149.61,163
HCPCS,V2531,SYNERGEYES ID/ANNUAL,310.0,201.5,1.1,2149.61,163
HCPCS,V2531,SYNERGEYES ID/SINGLE,180.0,117.0,1.1,2149.61,163
HCPCS,V2531,SYNERGEYES KC (ANNUAL),600.0,390.0,1.1,2149.61,163
HCPCS,V2531,SYNERGEYES KC/SINGLE,450.0,292.5,1.1,2149.61,163
HCPCS,V2531,SYNERGEYES PS (ANNUAL),600.0,390.0,1.1,2149.61,163
HCPCS,V2531,SYNERGEYES PS/SINGLE,375.0,243.75,1.1,2149.61,163
HCPCS,V2531,SYNERGEYES U.H/ANNUAL,600.0,390.0,1.1,2149.61,163
HCPCS,V2531,ULTRAHEALTH FC / SINGLE,430.0,279.5,1.1,2149.61,163
HCPCS,V2531,ULTRAHEALTH FC /ANNUAL/PER EYE,600.0,390.0,1.1,2149.61,163
HCPCS,V2599,COLOR MATCHING SERVICE,1000.0,650.0,0.01,1000.0,153
HCPCS,V2599,CUSTOM COLOR,400.0,260.0,0.01,400.0,153
HCPCS,V2600,Hand held low vision aids,,,16.97,54.8,9
HCPCS,V2610,Single lens spectacle mount,,,16.97,95.9,9
HCPCS,V2615,Telescop/othr compound lens,,,200.93,274.0,9
HCPCS,V2623,PROSTHETIC CONTACT LENS,515.0,334.75,1.1,3722.11,90
HCPCS,V2623,Plastic eye prosth custom,,,669.74,3028.41,9
HCPCS,V2624,POLISHING ARTIFICAL EYE,99.0,64.35,1.1,240.31,90
HCPCS,V2624,POLISHING/RESURFACING OCULAR PROSTHESIS,99.0,64.35,1.1,240.31,163
HCPCS,V2625,Enlargemnt of eye prosthesis,,,846.64,1548.4,9
HCPCS,V2626,Reduction of eye prosthesis,,,351.41,640.75,9
HCPCS,V2627,Scleral cover shell,,,669.74,4593.56,9
HCPCS,V2628,Fabrication & fitting,,,91.28,977.11,9
HCPCS,V2629,Prosthetic eye other type,,,200.93,1370.0,9
HCPCS,V2630,Anter chamber intraocul lens,,,200.93,232.66,8
HCPCS,V2631,Iris support intraoclr lens,,,200.93,232.66,8
HCPCS,V2632,Post chmbr intraocular lens,,,200.93,232.66,8
HCPCS,V2700,BALANCE LENS,37.0,24.05,1.1,177.01,90
HCPCS,V2700,Balance lens,,,31.69,144.01,9
HCPCS,V2702,Deluxe lens feature,,,27.4,36.7,9
HCPCS,V2710,Glass/plastic slab off prism,,,31.69,236.08,9
HCPCS,V2715,Prism lens/es,,,11.14,46.28,9
HCPCS,V2718,FRESNEL PRISM PRESS,35.0,22.75,1.1,122.86,90
HCPCS,V2718,FRESNEL PRISM PRESS-ON LENS,60.0,39.0,1.1,122.86,163
HCPCS,V2718,PRESS ON FRESNELL PRISM,60.0,39.0,13.08,60.0,74
HCPCS,V2730,Special base curve,,,11.14,83.68,9
HCPCS,V2744,Tint photochromatic lens/es,,,11.14,57.27,9
HCPCS,V2745,"Tint, any color/solid/grad",,,11.14,32.96,9
HCPCS,V2750,Anti-reflective coating,,,11.14,64.28,9
HCPCS,V2755,Uv lens/es,,,11.14,53.81,9
HCPCS,V2756,Eye glass case,,,2.74,19.65,9
HCPCS,V2760,Scratch resistant coating,,,11.14,53.05,9
HCPCS,V2761,MIRROR COATING,41.0,26.65,1.1,42.09,86
HCPCS,V2761,Mirror coating,,,16.97,27.4,9
HCPCS,V2762,"Polarization, any lens",,,31.69,192.54,9
HCPCS,V2770,Occluder lens/es,,,11.14,62.69,9
HCPCS,V2780,Oversize lens/es,,,11.14,40.25,9
HCPCS,V2781,Progressive lens per lens,,,58.52,95.9,9
HCPCS,V2782,"Lens, 1.54-1.65 p/1.60-1.79g",,,31.69,207.94,9
HCPCS,V2783,"Lens, >= 1.66 p/>=1.80 g",,,31.69,234.52,9
HCPCS,V2784,Lens polycarb or equal,,,31.69,152.48,9
HCPCS,V2785,CORNEAL TISSUE,9660.0,6279.0,1842.39,9660.0,66
HCPCS,V2785,CORNEAL TISSUE DSAEK/DMEK,9660.0,6279.0,1842.39,9660.0,66
HCPCS,V2785,PRE-CUT CORNEA FOR DMEK,9660.0,6279.0,1842.39,9660.0,66
HCPCS,V2785,PRE-CUT CORNEA FOR DSAEK,9660.0,6279.0,1842.39,9660.0,66
HCPCS,V2786,Occupational multifocal lens,,,16.97,178.1,9
HCPCS,V2787,ASTIGMATISM-CORRECT FUNCTION,648.0,421.2,1.1,648.0,80
HCPCS,V2787,LENS IOL ACRYSOF SA6AT,555.0,360.75,120.99,555.0,74
HCPCS,V2787,TORIC LENS,555.0,360.75,120.99,555.0,74
HCPCS,V2788,CRYSTAL LENS,995.0,646.75,200.93,995.0,74
HCPCS,V2788,LENS IOL RESTOR SV25TX,995.0,646.75,200.93,995.0,148
HCPCS,V2788,LENS IOL SYMFONY ZXR00,995.0,646.75,200.93,995.0,74
HCPCS,V2788,LENS SYMFONY TORIC ZX225,2350.0,1527.5,200.93,2350.0,75
HCPCS,V2788,PANOPTIX IOL TFAT00,995.0,646.75,200.93,995.0,74
HCPCS,V2788,PANOPTIX TORIC IOL TFATX0,995.0,646.75,200.93,995.0,74
HCPCS,V2788,PRESBYOPIA-CORRECT FUNCTION,2625.0,1706.25,1.1,2754.9,80
HCPCS,V2788,RESTOR LENS,995.0,646.75,200.93,995.0,74
HCPCS,V2788,VIVITY DAT,995.0,646.75,200.93,995.0,74
HCPCS,V2790,Amniotic membrane,,,1101.49,1275.41,8
HCPCS,V2797,Vis item/svc in other code,,,36.52,2739999.97,9
HCPCS,V2799,Misc vision item or service,,,36.52,2739999.97,9
HCPCS,V5008,Hearing screening,,,40.0,205.5,9
HCPCS,V5010,Assessment for hearing aid,,,40.0,274.0,9
HCPCS,V5011,Hearing aid fitting/checking,,,40.0,232.9,9
HCPCS,V5014,HEARING AID REPAIR/MODIFYING,332.0,215.8,1.1,612.2,86
HCPCS,V5014,Hearing aid repair/modifying,,,40.0,548.0,9
HCPCS,V5020,Conformity evaluation,,,40.0,205.5,9
HCPCS,V5030,Body-worn hearing aid air,,,333.06,2603.0,9
HCPCS,V5040,Body-worn hearing aid bone,,,333.06,2603.0,9
HCPCS,V5050,Hearing aid monaural in ear,,,333.06,2603.0,9
HCPCS,V5060,Behind ear hearing aid,,,333.06,2603.0,9
HCPCS,V5070,Glasses air conduction,,,91.28,2603.0,9
HCPCS,V5080,Glasses bone conduction,,,91.28,2603.0,9
HCPCS,V5090,Hearing aid dispensing fee,,,40.0,1233.0,9
HCPCS,V5095,Implant mid ear hearing pros,,,91.28,2739849.3,9
HCPCS,V5100,Body-worn bilat hearing aid,,,846.64,4589.5,9
HCPCS,V5110,Hearing aid dispensing fee,,,40.0,1849.5,9
HCPCS,V5120,Body-worn binaur hearing aid,,,1288.13,4589.5,9
HCPCS,V5130,In ear binaural hearing aid,,,1288.13,4589.5,9
HCPCS,V5140,Behind ear binaur hearing ai,,,1288.13,4589.5,9
HCPCS,V5150,Glasses binaural hearing aid,,,1288.13,4589.5,9
HCPCS,V5160,"DISPENSING FEE, BINAURAL",429.0,278.85,1.1,2066.18,152
HCPCS,V5171,"HEARING AID, CONTRALATERAL ROUTING DEVICE, MONAURAL, IN THE EAR",1700.0,1105.0,130.8,2800.0,268
HCPCS,V5172,"HEARING AID, CONTRALAT ROUTING DEVICE, MONAURAL, IN THE CANAL (I",1700.0,1105.0,130.8,2800.0,268
HCPCS,V5181,"HEARING AID, CONTRALAT ROUTING DEVICE, MONAURAL, BEHIND THE EAR",2100.0,1365.0,283.4,2800.0,201
HCPCS,V5190,Hearing aid monaural glasses,,,91.28,2603.0,9
HCPCS,V5200,CROS HEARING AID DISPENS FEE,351.0,228.15,1.1,1377.45,86
HCPCS,V5200,"DISPENSING FEE, CONTRALATERAL, MONAURAL",300.0,195.0,40.0,300.0,66
HCPCS,V5211,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, ITE/ITE TIE",2800.0,1820.0,333.06,3900.0,268
HCPCS,V5212,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, ITE/ITC TIE",2800.0,1820.0,333.06,3900.0,268
HCPCS,V5213,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, ITE/BTE TIE",2800.0,1820.0,333.06,3900.0,268
HCPCS,V5214,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, ITC/ITC TIE",2800.0,1820.0,333.06,3900.0,268
HCPCS,V5215,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, ITC/BTE TIE",2800.0,1820.0,333.06,3900.0,268
HCPCS,V5221,"HEARING AID, CONTRALATERAL ROUTING SYSTEM, BINAURAL, BTE/BTE TIE",2800.0,1820.0,333.06,3900.0,268
HCPCS,V5230,Hearing aid binaural glasses,,,91.28,4589.5,9
HCPCS,V5240,DISPENSING FEE BICROS,325.0,211.25,1.1,2066.18,86
HCPCS,V5240,"DISPENSING FEE, CONTRALATERAL ROUTING SYSTEM, BINAURAL",300.0,195.0,40.0,300.0,66
HCPCS,V5241,"DISPENSING FEE, MONAURAL",325.0,211.25,1.1,1377.45,80
HCPCS,V5241,"DISPENSING FEE, MONAURAL HEARING AID, ANY TYPE",300.0,195.0,40.0,300.0,66
HCPCS,V5242,"Hearing aid, monaural, cic",,,669.74,2603.0,9
HCPCS,V5243,"Hearing aid, monaural, itc",,,669.74,2603.0,9
HCPCS,V5244,"Hearing aid, prog, mon, cic",,,669.74,2603.0,9
HCPCS,V5245,"Hearing aid, prog, mon, itc",,,669.74,2603.0,9
HCPCS,V5246,"Hearing aid, prog, mon, ite",,,1288.13,2603.0,9
HCPCS,V5247,"Hearing aid, prog, mon, bte",,,1288.13,2603.0,9
HCPCS,V5248,"Hearing aid, binaural, cic",,,669.74,4589.5,9
HCPCS,V5249,"Hearing aid, binaural, itc",,,669.74,4589.5,9
HCPCS,V5250,"Hearing aid, prog, bin, cic",,,669.74,4589.5,9
HCPCS,V5251,"Hearing aid, prog, bin, itc",,,669.74,4589.5,9
HCPCS,V5252,"Hearing aid, prog, bin, ite",,,669.74,4589.5,9
HCPCS,V5253,"Hearing aid, prog, bin, bte",,,669.74,4589.5,9
HCPCS,V5254,"HEARING AID, DIGITAL, MONAURAL, CIC TIER 1",600.0,390.0,130.8,775.49,67
HCPCS,V5254,"HEARING AID, DIGITAL, MONAURAL, CIC TIER 2",1300.0,845.0,283.4,1300.0,67
HCPCS,V5254,"HEARING AID, DIGITAL, MONAURAL, CIC TIER 3",2100.0,1365.0,457.8,2100.0,67
HCPCS,V5254,"HEARING AID, DIGITAL, MONAURAL, CIC TIER 4",2800.0,1820.0,610.4,2800.0,67
HCPCS,V5254,"HEARING ID, DIGIT, MON, CIC",643.0,417.95,1.1,4146.22,86
HCPCS,V5255,"HEARING AID, DIGIT, MON, ITC",643.0,417.95,1.1,4146.22,86
HCPCS,V5255,"HEARING AID, DIGITAL, MONAURAL, ITC TIER 1",600.0,390.0,130.8,775.49,67
HCPCS,V5255,"HEARING AID, DIGITAL, MONAURAL, ITC TIER 2",1300.0,845.0,283.4,1300.0,67
HCPCS,V5255,"HEARING AID, DIGITAL, MONAURAL, ITC TIER 3",2100.0,1365.0,457.8,2100.0,67
HCPCS,V5255,"HEARING AID, DIGITAL, MONAURAL, ITC TIER 4",2800.0,1820.0,610.4,2800.0,67
HCPCS,V5256,"HEARING AID, DIGIT, MON, ITE",694.0,451.1,1.1,4146.22,86
HCPCS,V5256,"HEARING AID, DIGITAL, MONAURAL, ITE TIER 1",600.0,390.0,130.8,1491.52,67
HCPCS,V5256,"HEARING AID, DIGITAL, MONAURAL, ITE TIER 2",1300.0,845.0,283.4,1491.52,67
HCPCS,V5256,"HEARING AID, DIGITAL, MONAURAL, ITE TIER 3",2100.0,1365.0,457.8,2100.0,67
HCPCS,V5256,"HEARING AID, DIGITAL, MONAURAL, ITE TIER 4",2800.0,1820.0,610.4,2800.0,67
HCPCS,V5257,"HEARING AID, DIGIT, MON, BTE",643.0,417.95,1.1,3673.2,86
HCPCS,V5257,"HEARING AID, DIGITAL, MONAURAL, BTE TIER 1",600.0,390.0,130.8,1491.52,67
HCPCS,V5257,"HEARING AID, DIGITAL, MONAURAL, BTE TIER 2",1300.0,845.0,283.4,1491.52,67
HCPCS,V5257,"HEARING AID, DIGITAL, MONAURAL, BTE TIER 3",2100.0,1365.0,457.8,2100.0,67
HCPCS,V5257,"HEARING AID, DIGITAL, MONAURAL, BTE TIER 4",2800.0,1820.0,610.4,2800.0,67
HCPCS,V5258,"HEARING AID, DIGITAL, BINAURAL, CIC TIER 1",1200.0,780.0,261.6,1200.0,67
HCPCS,V5258,"HEARING AID, DIGITAL, BINAURAL, CIC TIER 2",2600.0,1690.0,566.8,2600.0,67
HCPCS,V5258,"HEARING AID, DIGITAL, BINAURAL, CIC TIER 3",4200.0,2730.0,669.74,4200.0,67
HCPCS,V5258,"HEARING AID, DIGITAL, BINAURAL, CIC TIER 4",5600.0,3640.0,669.74,5600.0,67
HCPCS,V5259,"HEARING AID, DIGITAL, BINAURAL, ITC TIER 1",1200.0,780.0,261.6,1200.0,67
HCPCS,V5259,"HEARING AID, DIGITAL, BINAURAL, ITC TIER 2",2600.0,1690.0,566.8,2600.0,67
HCPCS,V5259,"HEARING AID, DIGITAL, BINAURAL, ITC TIER 3",4200.0,2730.0,669.74,4200.0,67
HCPCS,V5259,"HEARING AID, DIGITAL, BINAURAL, ITC TIER 4",5600.0,3640.0,669.74,5600.0,67
HCPCS,V5260,"HEARING AID, DIGITAL, BINAURAL, ITE TIER 1",1200.0,780.0,261.6,1200.0,67
HCPCS,V5260,"HEARING AID, DIGITAL, BINAURAL, ITE TIER 2",2600.0,1690.0,566.8,2600.0,67
HCPCS,V5260,"HEARING AID, DIGITAL, BINAURAL, ITE TIER 3",4200.0,2730.0,669.74,4200.0,67
HCPCS,V5260,"HEARING AID, DIGITAL, BINAURAL, ITE TIER 4",5600.0,3640.0,669.74,5600.0,67
HCPCS,V5261,"HEARING AID, DIGIT, BIN, BTE",1867.0,1213.55,1.1,6910.37,86
HCPCS,V5261,"HEARING AID, DIGITAL, BINAURAL, BTE TIER 1",1200.0,780.0,261.6,1200.0,67
HCPCS,V5261,"HEARING AID, DIGITAL, BINAURAL, BTE TIER 2",2600.0,1690.0,566.8,2600.0,67
HCPCS,V5261,"HEARING AID, DIGITAL, BINAURAL, BTE TIER 3",4200.0,2730.0,669.74,4200.0,67
HCPCS,V5261,"HEARING AID, DIGITAL, BINAURAL, BTE TIER 4",5600.0,3640.0,669.74,5600.0,67
HCPCS,V5262,"Hearing aid, disp, monaural",,,31.69,219.2,9
HCPCS,V5263,"Hearing aid, disp, binaural",,,58.52,438.4,9
HCPCS,V5264,EAR MOLD/INSERT,92.0,59.8,1.1,169.3,80
HCPCS,V5264,Ear mold/insert,,,36.52,137.0,9
HCPCS,V5265,"EAR MOLD/INSERT, DISP",541.0,351.65,1.1,541.0,80
HCPCS,V5265,PEDIATRIC EAR MOLD FOR CORRECTION,275.0,178.75,36.52,275.0,67
HCPCS,V5266,Battery for hearing device,,,15.62,19.65,9
HCPCS,V5267,Hearing aid sup/access/dev,,,11.14,32.88,9
HCPCS,V5268,Ald telephone amplifier,,,36.52,274.0,9
HCPCS,V5269,"Alerting device, any type",,,58.52,274.0,9
HCPCS,V5270,"Ald, tv amplifier, any type",,,31.69,274.0,9
HCPCS,V5271,"Ald, tv caption decoder",,,31.69,274.0,9
HCPCS,V5272,Tdd,,,36.52,274.0,9
HCPCS,V5273,Ald for cochlear implant,,,91.28,274.0,9
HCPCS,V5274,Ald unspecified,,,31.69,274.0,9
HCPCS,V5275,Ear impression,,,11.14,95.9,9
HCPCS,V5281,"HEARING AID, CONTRALAT ROUTING DEVICE, MONAURAL, BEHIND THE EAR",600.0,390.0,130.8,1491.52,67
HCPCS,V5282,Ald fm/dm system binaural,,,1288.13,2739849.3,9
HCPCS,V5283,"Ald neck, loop ind receiver",,,58.52,2739849.3,9
HCPCS,V5284,Ald fm/dm ear level receiver,,,91.28,2739849.3,9
HCPCS,V5285,Ald fm/dm aud input receiver,,,58.52,2739849.3,9
HCPCS,V5286,Ald blu tooth fm/dm receiver,,,31.69,2739849.3,9
HCPCS,V5287,"Ald fm/dm receiver, nos",,,58.52,2739849.3,9
HCPCS,V5288,Ald fm/dm transmitter ald,,,1288.13,2739849.3,9
HCPCS,V5289,Ald fm/dm adapt/boot couplin,,,36.52,2739849.3,9
HCPCS,V5290,Ald transmitter microphone,,,846.64,2739849.3,9
HCPCS,V5298,Hearing aid noc,,,58.52,3288.0,9
HCPCS,V5299,CI ACOUSTIC RECEIVER,100.0,65.0,21.8,100.0,67
HCPCS,V5299,FM SYSTEM FITTING FEE,100.0,65.0,21.8,100.0,67
HCPCS,V5299,"HEARING AID, OTHER:",55.0,35.75,0.01,3061000.0,80
HCPCS,V5336,Repair communication device,,,91.28,109.6,9
HCPCS,V5362,SPEECH SCREENING,155.0,100.75,1.1,155.0,80
HCPCS,V5362,Speech screening,,,31.09,38.91,9
HCPCS,V5363,Language screening,,,31.09,38.91,9
HCPCS,V5364,Dysphagia screening,,,31.09,38.91,9
HCPCS,V7218,FRESNEL PRISM PRESS-ON LENS,60.0,39.0,1.1,60.0,68
HCPCS,W0702,WC/WH INITIAL PER 15 MIN,106.0,68.9,23.11,106.0,116
HCPCS,W0703,WC/WH EA ADDITIONAL PER 15 MIN,100.0,65.0,21.8,100.0,116
HCPCS,W0710,OT COMBINED WORK CONDITIONING PER 15 MIN,207.0,134.55,45.13,207.0,58
HCPCS,W0710,OT WK CNDITIONNG PER 15 MIN,242.0,157.3,52.76,242.0,58
HCPCS,W0710,OT/PT WK CNDITIONNG PER 15 MIN,203.0,131.95,1.1,203.0,68
HCPCS,W0710,PT COMBINED WORK CONDITIONING PER 15 MIN,207.0,134.55,45.13,207.0,58
HCPCS,W0710,PT WK CNDITIONNG PER 15 MIN,242.0,157.3,52.76,242.0,58
HCPCS,a9591,"FLUOROESTRADIOL F 18, DIAGNOSTIC, 1 MCI",1534.0,997.1,41.39,1534.0,80
HCPCS,a9699,LUTETIUM LU 177 THERAPEAUTIC,99145.0,64444.25,21613.61,99145.0,58
HCPCS,c1874,"G140178, RESOLUTE ONYX, NCT 03647475",675.0,438.75,147.15,675.0,69
HCPCS,v2788,LENS SYMFONY TORIC ZXT,995.0,646.75,200.93,995.0,74
MS-DRG,001,HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC,,,9000.0,818381.95,25
MS-DRG,001-A,Craniotomy Age> 17,,,36400.0,36400.0,1
MS-DRG,001-A,Heart - Adult,,,361500.0,446380.0,4
MS-DRG,001-A,Heart - Adult & Pediatric,,,295292.0,295292.0,1
MS-DRG,001-B,Deep Brain Stimulation Unilateral,,,45300.0,45300.0,1
MS-DRG,001-C,Deep Brain Stimulation Bilateral,,,69100.0,69100.0,1
MS-DRG,001-P,Heart - Pediatric,,,363339.0,535426.0,3
MS-DRG,002,HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC,,,9000.0,345352.0,25
MS-DRG,002-A,Heart - Adult,,,361500.0,446380.0,4
MS-DRG,002-A,Heart - Adult & Pediatric,,,295292.0,295292.0,1
MS-DRG,002-P,Heart - Pediatric,,,363339.0,535426.0,5
MS-DRG,003,"ECMO OR TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITH MAJOR O.R. PROCEDURES",,,18150.0,619839.52,23
MS-DRG,003-P,Heart - Pediatric,,,444900.0,444900.0,2
MS-DRG,004,"TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITHOUT MAJOR O.R. PROCEDURES",,,18150.0,404502.43,23
MS-DRG,005,LIVER TRANSPLANT WITH MCC OR INTESTINAL TRANSPLANT,,,7000.0,520404.0,25
MS-DRG,005-A,Liver/Intestinal - Adult,,,603170.0,603170.0,1
MS-DRG,005-C,Liver - Cadaveric,,,139000.0,486600.0,2
MS-DRG,005-CP,Liver - Cadaveric Pediactric,,,471700.0,471700.0,1
MS-DRG,005-DA,Liver (Deceased Donor) - Adult,,,397360.0,486600.0,3
MS-DRG,005-DP,Liver (Deceased Donor) - Pediatric,,,385169.0,385169.0,1
MS-DRG,005-DP,Liver (Deceased Donor) -Pediatric,,,471700.0,471700.0,2
MS-DRG,005-I,Intestinal - Adult,,,563700.0,563700.0,2
MS-DRG,005-L,Liver - Live,,,139000.0,561500.0,2
MS-DRG,005-LA,Liver (Live Donor) - Adult,,,458602.0,561500.0,3
MS-DRG,005-LP,Liver (Live Donor) - Pediatric,,,457752.0,560500.0,3
MS-DRG,005-LP,Liver - Live Pediatric,,,560500.0,560500.0,1
MS-DRG,005-P,Liver/Intestinal - Pediatric,,,696055.0,696055.0,1
MS-DRG,006,LIVER TRANSPLANT WITHOUT MCC,,,7000.0,428236.0,25
MS-DRG,006-C,Liver - Cadaveric,,,139000.0,486600.0,2
MS-DRG,006-CP,Liver - Cadaveric Pediatric,,,471700.0,471700.0,1
MS-DRG,006-DA,Liver (Deceased Donor) - Adult,,,358735.0,486600.0,4
MS-DRG,006-DP,Liver (Deceased Donor) - Pediatric,,,385169.0,385169.0,1
MS-DRG,006-DP,Liver (Deceased Donor) -Pediatric,,,471700.0,471700.0,2
MS-DRG,006-L,Liver - Live,,,139000.0,561500.0,2
MS-DRG,006-LA,Liver (Live Donor) - Adult,,,374196.0,561500.0,4
MS-DRG,006-LP,Liver (Live Donor) - Pediatric,,,457752.0,560500.0,3
MS-DRG,006-LP,Liver - Live Pediatric,,,560500.0,560500.0,1
MS-DRG,006-P,Liver (Live & Deceased Donor) - Pediatric,,,449447.0,449447.0,1
MS-DRG,007,LUNG TRANSPLANT,,,115678.46,115678.46,14
MS-DRG,007,Lung transplant,,,9000.0,408897.0,11
MS-DRG,007-D,Lung (Double) - Adult,,,354264.0,479141.0,4
MS-DRG,007-L,Lung Transplant,,,433900.0,433900.0,1
MS-DRG,007-S,Lung (Single) - Adult,,,349729.0,451839.0,4
MS-DRG,008,Kidney/Pancreas - Adult,,,274261.0,292000.0,3
MS-DRG,008,SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT,,,50671.35,50671.35,14
MS-DRG,008,Simultaneous pancreas/kidney transplant,,,8000.0,234842.0,11
MS-DRG,008-KP,Kidney Pancreas,,,292000.0,292000.0,1
MS-DRG,010,PANCREAS TRANSPLANT,,,64575.28,64575.28,14
MS-DRG,010,Pancreas,,,186135.0,186135.0,1
MS-DRG,010,Pancreas - Adult,,,228000.0,235615.0,3
MS-DRG,010,Pancreas transplant,,,18150.0,234842.0,10
MS-DRG,010 -P,Pancreas,,,228000.0,228000.0,1
MS-DRG,011,"TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH MCC",,,49339.46,49339.46,14
MS-DRG,011,"Tracheostomy for face,mouth & neck diagnoses w MCC",,,18150.0,159276.08,9
MS-DRG,012,"TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH CC",,,38382.52,38382.52,14
MS-DRG,012,"Tracheostomy for face,mouth & neck diagnoses w CC",,,17927.0,123119.85,9
MS-DRG,013,"TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITHOUT CC/MCC",,,26575.11,26575.11,14
MS-DRG,013,"Tracheostomy for face,mouth & neck diagnoses w/o CC/MCC",,,18150.0,84157.21,9
MS-DRG,014,ALLOGENEIC BONE MARROW TRANSPLANT,,,5000.0,350958.73,24
MS-DRG,014-R,Allogeneic Related BMT ? Adult & Pediatric,,,428000.0,428000.0,2
MS-DRG,014-RA,Allogeneic Related BMT - Adult,,,366514.0,366514.0,1
MS-DRG,014-RA,Allogeneic Related BMT ? Adult,,,349444.0,349444.0,1
MS-DRG,014-RP,Allogeneic Related BMT - Pediatric,,,440327.0,440327.0,1
MS-DRG,014-RP,Allogeneic Related BMT ? Pediatric,,,394880.0,394880.0,1
MS-DRG,014-U,Allogeneic Unrelated,,,481200.0,481200.0,1
MS-DRG,014-U,Allogeneic Unrelated BMT ? Adult & Pediatric,,,481200.0,481200.0,2
MS-DRG,014-UA,Allogeneic Unrelated BMT - Adult,,,430092.0,430092.0,1
MS-DRG,014-UA,Allogeneic Unrelated BMT ? Adult,,,392967.0,392967.0,1
MS-DRG,014-UP,Allogeneic Unrelated BMT - Pediatric,,,540638.0,540638.0,1
MS-DRG,014-UP,Allogeneic Unrelated BMT ? Pediatric,,,444062.0,444062.0,1
MS-DRG,016,AUTOLOGOUS BONE MARROW TRANSPLANT WITH CC/MCC,,,5000.0,173165.03,24
MS-DRG,016,Autologous BMT - Adult & Pediatric,,,240500.0,240500.0,2
MS-DRG,016-A,Autologous BMT - Adult,,,196483.0,205695.0,2
MS-DRG,016-P,Autologous BMT - Pediatric,,,222030.0,247521.0,2
MS-DRG,017,AUTOLOGOUS BONE MARROW TRANSPLANT WITHOUT CC/MCC,,,5000.0,158639.46,24
MS-DRG,017,Autologous BMT - Adult & Pediatric,,,240500.0,240500.0,2
MS-DRG,017-A,Autologous BMT - Adult,,,196483.0,205695.0,2
MS-DRG,017-P,Autologous BMT - Pediatric,,,222030.0,247521.0,2
MS-DRG,018,CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES,,,383231.0,383231.0,14
MS-DRG,018,CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL IMMUNOTHERAPY,,,18150.0,1261067.31,9
MS-DRG,019,Kidney/Pancreas - Adult,,,274261.0,292000.0,3
MS-DRG,019,SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT WITH HEMODIALYSIS,,,8000.0,234842.0,25
MS-DRG,020,INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH MCC,,,17927.0,289300.0,25
MS-DRG,021,INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH CC,,,17927.0,160500.0,25
MS-DRG,022,INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITHOUT CC/MCC,,,17927.0,61133.18,21
MS-DRG,023,CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITH MCC OR ANTINEOPLASTIC IMPLANT OR EPILEPSY WITH NEUROSTIMULATOR,,,51783.77,51783.77,14
MS-DRG,023,CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITH MCC OR CHEMOTHERAPY IMPLANT OR EPILEPSY WITH NEUROSTIMULATOR,,,18708.0,139200.0,11
MS-DRG,024,CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITHOUT MCC,,,17927.0,94700.0,25
MS-DRG,025,CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC,,,20763.0,135700.0,25
MS-DRG,026,CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH CC,,,20763.0,87500.0,25
MS-DRG,027,CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITHOUT CC/MCC,,,20763.0,77400.0,25
MS-DRG,028,SPINAL PROCEDURES WITH MCC,,,17927.0,115599.69,25
MS-DRG,029,SPINAL PROCEDURES WITH CC OR SPINAL NEUROSTIMULATORS,,,20763.0,76922.0,25
MS-DRG,030,SPINAL PROCEDURES WITHOUT CC/MCC,,,17927.0,59300.0,25
MS-DRG,031,VENTRICULAR SHUNT PROCEDURES WITH MCC,,,17927.0,86204.82,25
MS-DRG,032,VENTRICULAR SHUNT PROCEDURES WITH CC,,,17927.0,49590.0,25
MS-DRG,033,VENTRICULAR SHUNT PROCEDURES WITHOUT CC/MCC,,,15788.09,50400.0,25
MS-DRG,034,CAROTID ARTERY STENT PROCEDURES WITH MCC,,,17927.0,75400.0,25
MS-DRG,035,CAROTID ARTERY STENT PROCEDURES WITH CC,,,17927.0,59600.0,25
MS-DRG,036,CAROTID ARTERY STENT PROCEDURES WITHOUT CC/MCC,,,17927.0,48200.0,25
MS-DRG,037,EXTRACRANIAL PROCEDURES WITH MCC,,,17927.0,92700.0,25
MS-DRG,038,EXTRACRANIAL PROCEDURES WITH CC,,,15431.44,54900.0,25
MS-DRG,039,EXTRACRANIAL PROCEDURES WITHOUT CC/MCC,,,11474.69,43400.0,25
MS-DRG,040,"PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH MCC",,,17927.0,74289.49,25
MS-DRG,041,"PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH CC OR PERIPHERAL NEUROSTIMULATOR",,,17927.0,51191.0,25
MS-DRG,042,"PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITHOUT CC/MCC",,,16361.55,52200.0,25
MS-DRG,052,SPINAL DISORDERS AND INJURIES WITH CC/MCC,,,17101.4,34374.0,21
MS-DRG,053,SPINAL DISORDERS AND INJURIES WITHOUT CC/MCC,,,9737.48,24200.0,21
MS-DRG,054,NERVOUS SYSTEM NEOPLASMS WITH MCC,,,14584.51,32000.0,25
MS-DRG,055,NERVOUS SYSTEM NEOPLASMS WITHOUT MCC,,,10095.01,25700.0,25
MS-DRG,056,DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC,,,21630.73,44696.44,25
MS-DRG,057,DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC,,,12537.55,24288.0,25
MS-DRG,058,MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH MCC,,,16200.49,32890.78,21
MS-DRG,059,MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH CC,,,12053.47,34500.0,25
MS-DRG,060,MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITHOUT CC/MCC,,,9211.8,24200.0,25
MS-DRG,061,"ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH MCC",,,24200.0,53046.6,21
MS-DRG,062,"ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH CC",,,16622.62,40920.0,21
MS-DRG,063,"ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITHOUT CC/MCC",,,13495.1,34194.0,21
MS-DRG,064,INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC,,,17927.0,56900.0,25
MS-DRG,065,INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS,,,10012.7,35300.0,25
MS-DRG,066,INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC,,,7128.55,24200.0,25
MS-DRG,067,PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITH MCC,,,14069.45,28257.79,21
MS-DRG,068,PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITHOUT MCC,,,8721.52,25600.0,25
MS-DRG,069,TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC,,,8140.97,24200.0,25
MS-DRG,070,OTHER CEREBROVASCULAR DISORDERS WITH MCC,,,15804.9,64800.0,25
MS-DRG,071,OTHER CEREBROVASCULAR DISORDERS WITH CC,,,10151.65,24200.0,25
MS-DRG,072,OTHER CEREBROVASCULAR DISORDERS WITHOUT CC/MCC,,,7763.97,25700.0,25
MS-DRG,073,CRANIAL AND PERIPHERAL NERVE DISORDERS WITH MCC,,,15269.49,52600.0,25
MS-DRG,074,CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC,,,10194.13,24200.0,25
MS-DRG,075,VIRAL MENINGITIS WITH CC/MCC,,,18041.25,36892.7,25
MS-DRG,076,VIRAL MENINGITIS WITHOUT CC/MCC,,,8374.61,24200.0,25
MS-DRG,080,NONTRAUMATIC STUPOR AND COMA WITH MCC,,,17089.89,34824.4,21
MS-DRG,081,NONTRAUMATIC STUPOR AND COMA WITHOUT MCC,,,8997.63,24200.0,25
MS-DRG,082,TRAUMATIC STUPOR AND COMA >1 HOUR WITH MCC,,,21298.86,43974.94,21
MS-DRG,083,TRAUMATIC STUPOR AND COMA >1 HOUR WITH CC,,,13424.3,27800.0,21
MS-DRG,084,TRAUMATIC STUPOR AND COMA >1 HOUR WITHOUT CC/MCC,,,9530.39,24200.0,21
MS-DRG,085,TRAUMATIC STUPOR AND COMA <1 HOUR WITH MCC,,,21177.62,43711.36,21
MS-DRG,086,TRAUMATIC STUPOR AND COMA <1 HOUR WITH CC,,,12600.39,24757.0,25
MS-DRG,087,TRAUMATIC STUPOR AND COMA <1 HOUR WITHOUT CC/MCC,,,9166.66,24200.0,25
MS-DRG,088,CONCUSSION WITH MCC,,,13034.91,26008.63,21
MS-DRG,089,CONCUSSION WITH CC,,,10794.14,24200.0,21
MS-DRG,090,CONCUSSION WITHOUT CC/MCC,,,8356.91,24200.0,21
MS-DRG,091,OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC,,,16613.77,43200.0,25
MS-DRG,092,OTHER DISORDERS OF NERVOUS SYSTEM WITH CC,,,10125.1,24200.0,25
MS-DRG,093,OTHER DISORDERS OF NERVOUS SYSTEM WITHOUT CC/MCC,,,8118.85,24200.0,25
MS-DRG,094,BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH MCC,,,24200.0,82500.0,25
MS-DRG,095,BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH CC,,,23897.16,57400.0,25
MS-DRG,096,BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITHOUT CC/MCC,,,23897.16,63500.0,25
MS-DRG,097,NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH MCC,,,24200.0,69491.03,21
MS-DRG,098,NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH CC,,,21381.16,50100.0,25
MS-DRG,099,NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITHOUT CC/MCC,,,13128.72,26212.58,21
MS-DRG,1,HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITH MCC,,,243086.57,273985.5,9
MS-DRG,10,NeNous System Neoplasms with cc,,,10700.0,10700.0,1
MS-DRG,10,PANCREAS TRANSPLANT,,,64575.28,240800.0,12
MS-DRG,100,SEIZURES W MCC,,,61700.0,61700.0,1
MS-DRG,100,SEIZURES WITH MCC,,,17871.83,56877.0,35
MS-DRG,100,Seizures w/MCC,,,47285.0,52959.0,2
MS-DRG,101,SEIZURES W/O MCC,,,30800.0,30800.0,1
MS-DRG,101,SEIZURES WITHOUT MCC,,,8723.21,33500.0,35
MS-DRG,101,Seizures w/o MCC,,,23210.0,25995.0,2
MS-DRG,102,HEADACHES W MCC,,,41200.0,41200.0,1
MS-DRG,102,HEADACHES WITH MCC,,,10768.66,24200.0,35
MS-DRG,102,Headaches w/MCC,,,31006.0,34727.0,2
MS-DRG,103,HEADACHES W/O MCC,,,28700.0,28700.0,1
MS-DRG,103,HEADACHES WITHOUT MCC,,,8108.19,24200.0,35
MS-DRG,103,Headaches w/o MCC,,,11029.0,12352.0,2
MS-DRG,11,"TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH MCC",,,47208.32,54273.41,9
MS-DRG,113,ORBITAL PROCEDURES W CC/MCC,,,55300.0,55300.0,1
MS-DRG,113,ORBITAL PROCEDURES WITH CC/MCC,,,18150.0,68659.17,32
MS-DRG,114,ORBITAL PROCEDURES W/O CC/MCC,,,31500.0,31500.0,1
MS-DRG,114,ORBITAL PROCEDURES WITHOUT CC/MCC,,,10963.05,39511.66,32
MS-DRG,115,EXTRAOCULAR PROCEDURES EXCEPT ORBIT,,,13964.14,36300.0,24
MS-DRG,115,Extraocular procedures except orbit,,,18150.0,44823.68,9
MS-DRG,116,INTRAOCULAR PROCEDURES W CC/MCC,,,41600.0,41600.0,1
MS-DRG,116,INTRAOCULAR PROCEDURES WITH CC/MCC,,,15147.71,52801.94,32
MS-DRG,117,INTRAOCULAR PROCEDURES W/O CC/MCC,,,22600.0,22600.0,1
MS-DRG,117,INTRAOCULAR PROCEDURES WITHOUT CC/MCC,,,10072.79,31682.33,32
MS-DRG,12,"TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITH CC",,,36093.38,42220.77,9
MS-DRG,121,ACUTE MAJOR EYE INFECTIONS W CC/MCC,,,25900.0,25900.0,1
MS-DRG,121,ACUTE MAJOR EYE INFECTIONS WITH CC/MCC,,,10800.48,33971.85,32
MS-DRG,122,ACUTE MAJOR EYE INFECTIONS W/O CC/MCC,,,15800.0,15800.0,1
MS-DRG,122,ACUTE MAJOR EYE INFECTIONS WITHOUT CC/MCC,,,6629.59,22947.72,32
MS-DRG,123,NEUROLOGICAL EYE DISORDERS,,,7703.92,17800.0,24
MS-DRG,123,Neurological eye disorders,,,11612.44,23321.52,9
MS-DRG,124,OTHER DISORDERS OF THE EYE W MCC,,,30000.0,30000.0,1
MS-DRG,124,OTHER DISORDERS OF THE EYE WITH MCC OR THROMBOLYTIC AGENT,,,12010.72,38638.49,32
MS-DRG,124-A,Circulatory Disorders W/Cath. and Complex DX,,,10300.0,10300.0,1
MS-DRG,124-B,Circulatory Disorders W/Cath and Complex DX,,,19300.0,19300.0,1
MS-DRG,125,OTHER DISORDERS OF THE EYE W/O MCC,,,18600.0,18600.0,1
MS-DRG,125,OTHER DISORDERS OF THE EYE WITHOUT MCC,,,7866.63,22422.06,32
MS-DRG,125-A,Circulatory Disorders W/Cath. W/O Complex DX,,,7800.0,7800.0,1
MS-DRG,125-B,Circulatory Disorders W/Cath. W/O Complex DX,,,12900.0,12900.0,1
MS-DRG,13,"TRACHEOSTOMY FOR FACE, MOUTH AND NECK DIAGNOSES OR LARYNGECTOMY WITHOUT CC/MCC",,,23589.29,29232.62,9
MS-DRG,135,SINUS & MASTOID PROCEDURES W CC/MCC,,,71800.0,71800.0,1
MS-DRG,135,SINUS AND MASTOID PROCEDURES WITH CC/MCC,,,18150.0,63370.51,32
MS-DRG,136,SINUS & MASTOID PROCEDURES W/O CC/MCC,,,39400.0,39400.0,1
MS-DRG,136,SINUS AND MASTOID PROCEDURES WITHOUT CC/MCC,,,9209.19,29649.81,32
MS-DRG,137,MOUTH PROCEDURES W CC/MCC,,,50500.0,50500.0,1
MS-DRG,137,MOUTH PROCEDURES WITH CC/MCC,,,12825.29,43605.92,32
MS-DRG,138,Cardiac Arrhythmia and Conduction Disorders wt Cath,,,9200.0,9200.0,1
MS-DRG,138,MOUTH PROCEDURES W/O CC/MCC,,,30100.0,30100.0,1
MS-DRG,138,MOUTH PROCEDURES WITHOUT CC/MCC,,,7792.52,25879.7,32
MS-DRG,139,Cardiac Arrhythmia and Conduction Disorders W/0  Gath,,,5700.0,5700.0,1
MS-DRG,139,SALIVARY GLAND PROCEDURES,,,12007.45,36600.0,24
MS-DRG,139,Salivary gland procedures,,,17968.31,36086.15,9
MS-DRG,14,ALLOGENEIC BONE MARROW TRANSPLANT,,,107427.79,254000.0,12
MS-DRG,14,Specific Cerebrovascular Disorders,,,12900.0,12900.0,1
MS-DRG,140,MAJOR HEAD AND NECK PROCEDURES WITH MCC,,,18150.0,124559.56,32
MS-DRG,141,MAJOR HEAD AND NECK PROCEDURES WITH CC,,,18150.0,63694.66,32
MS-DRG,142,MAJOR HEAD AND NECK PROCEDURES WITHOUT CC/MCC,,,14320.24,46619.67,32
MS-DRG,143,"OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH MCC",,,18150.0,109411.96,32
MS-DRG,144,"OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITH CC",,,15905.51,50605.88,32
MS-DRG,145,"OTHER EAR, NOSE, MOUTH AND THROAT O.R. PROCEDURES WITHOUT CC/MCC",,,10986.28,35110.77,32
MS-DRG,146,"EAR, NOSE, MOUTH & THROAT MALIGNANCY W MCC",,,37800.0,37800.0,1
MS-DRG,146,"EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH MCC",,,18150.0,61834.43,32
MS-DRG,146,Rectal Resection W/CC,,,30500.0,30500.0,1
MS-DRG,147,"EAR, NOSE, MOUTH & THROAT MALIGNANCY W CC",,,24100.0,24100.0,1
MS-DRG,147,"EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITH CC",,,11502.37,37131.61,32
MS-DRG,147,Rectal Resection WIO CC,,,22600.0,22600.0,1
MS-DRG,148,"EAR, NOSE, MOUTH & THROAT MALIGNANCY W/O CC/MCC",,,16700.0,16700.0,1
MS-DRG,148,"EAR, NOSE, MOUTH AND THROAT MALIGNANCY WITHOUT CC/MCC",,,7682.42,23277.71,32
MS-DRG,148,Major Small/Large Bowel W/CC,,,34800.0,34800.0,1
MS-DRG,149,DYSEQUILIBRIUM,,,7224.81,12600.0,24
MS-DRG,149,Dysequilibrium,,,10929.02,21948.97,9
MS-DRG,149,Pelvic Pouch,,,31200.0,31200.0,1
MS-DRG,150,EPISTAXIS W MCC,,,24600.0,24600.0,1
MS-DRG,150,EPISTAXIS WITH MCC,,,12684.23,38883.79,32
MS-DRG,151,EPISTAXIS W/O MCC,,,13100.0,13100.0,1
MS-DRG,151,EPISTAXIS WITHOUT MCC,,,7315.13,21435.0,32
MS-DRG,152,OTITIS MEDIA & URI W MCC,,,18600.0,18600.0,1
MS-DRG,152,OTITIS MEDIA AND URI WITH MCC,,,10556.2,34523.79,32
MS-DRG,153,OTITIS MEDIA & URI W/O MCC,,,12900.0,12900.0,1
MS-DRG,153,OTITIS MEDIA AND URI WITHOUT MCC,,,6916.88,21557.65,32
MS-DRG,154,"OTHER EAR, NOSE, MOUTH & THROAT DIAGNOSES W MCC",,,26100.0,26100.0,1
MS-DRG,154,"OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH MCC",,,14783.87,45658.89,32
MS-DRG,155,"OTHER EAR, NOSE, MOUTH & THROAT DIAGNOSES W CC",,,16400.0,16400.0,1
MS-DRG,155,"OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITH CC",,,8825.56,26764.55,32
MS-DRG,156,"OTHER EAR, NOSE, MOUTH & THROAT DIAGNOSES W/O CC/MCC",,,12100.0,12100.0,1
MS-DRG,156,"OTHER EAR, NOSE, MOUTH AND THROAT DIAGNOSES WITHOUT CC/MCC",,,6578.84,20182.19,32
MS-DRG,157,Anal and Stomal Procedures  W/CC,,,12400.0,12400.0,1
MS-DRG,157,DENTAL & ORAL DISEASES W MCC,,,28400.0,28400.0,1
MS-DRG,157,DENTAL AND ORAL DISEASES WITH MCC,,,14880.21,50135.71,32
MS-DRG,158,Anal and Stomal Procedures W/0 cc,,,7000.0,7000.0,1
MS-DRG,158,DENTAL & ORAL DISEASES W CC,,,15500.0,15500.0,1
MS-DRG,158,DENTAL AND ORAL DISEASES WITH CC,,,8885.78,26568.89,32
MS-DRG,159,DENTAL & ORAL DISEASES W/O CC/MCC,,,11300.0,11300.0,1
MS-DRG,159,DENTAL AND ORAL DISEASES WITHOUT CC/MCC,,,6468.74,20690.33,32
MS-DRG,16,AUTOLOGOUS BONE MARROW TRANSPLANT WITH CC/MCC,,,52713.32,58903.26,9
MS-DRG,163,MAJOR CHEST PROCEDURES W MCC,,,107100.0,107100.0,1
MS-DRG,163,MAJOR CHEST PROCEDURES WITH MCC,,,17927.0,130882.01,37
MS-DRG,164,MAJOR CHEST PROCEDURES W CC,,,55100.0,55100.0,1
MS-DRG,164,MAJOR CHEST PROCEDURES WITH CC,,,17927.0,78100.0,37
MS-DRG,165,MAJOR CHEST PROCEDURES W/O CC/MCC,,,38200.0,38200.0,1
MS-DRG,165,MAJOR CHEST PROCEDURES WITHOUT CC/MCC,,,16828.46,57400.0,37
MS-DRG,166,OTHER RESP SYSTEM O.R. PROCEDURES W MCC,,,75900.0,75900.0,1
MS-DRG,166,OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH MCC,,,17927.0,109152.05,37
MS-DRG,167,OTHER RESP SYSTEM O.R. PROCEDURES W CC,,,41800.0,41800.0,1
MS-DRG,167,OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITH CC,,,16511.92,52664.69,37
MS-DRG,168,OTHER RESP SYSTEM O.R. PROCEDURES W/O CC/MCC,,,28500.0,28500.0,1
MS-DRG,168,OTHER RESPIRATORY SYSTEM O.R. PROCEDURES WITHOUT CC/MCC,,,12440.8,39902.98,37
MS-DRG,17,AUTOLOGOUS BONE MARROW TRANSPLANT WITHOUT CC/MCC,,,49146.53,54061.18,9
MS-DRG,173,ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS WITH PRINCIPAL DIAGNOSIS PULMONARY EMBOLISM,,,27189.9,30153.53,23
MS-DRG,173,Ultrasound Accelerated and other Thrombolysis with Principal Diagnosis Pulmonary Embolism,,,18150.0,86919.81,9
MS-DRG,175,PULMONARY EMBOLISM W MCC,,,37300.0,37300.0,1
MS-DRG,175,PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE,,,12915.61,40113.24,37
MS-DRG,176,PULMONARY EMBOLISM W/O MCC,,,23100.0,23100.0,1
MS-DRG,176,PULMONARY EMBOLISM WITHOUT MCC,,,7801.12,25000.0,37
MS-DRG,177,RESPIRATORY INFECTIONS & INFLAMMATIONS W MCC,,,47200.0,47200.0,1
MS-DRG,177,RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC,,,14699.57,54966.0,37
MS-DRG,178,RESPIRATORY INFECTIONS & INFLAMMATIONS W CC,,,33500.0,33500.0,1
MS-DRG,178,RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC,,,9328.76,28900.0,37
MS-DRG,179,RESPIRATORY INFECTIONS & INFLAMMATIONS W/O CC/MCC,,,23600.0,23600.0,1
MS-DRG,179,RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT CC/MCC,,,7415.77,22048.27,37
MS-DRG,18,CHIMERIC ANTIGEN RECEPTOR (CAR) T-CELL AND OTHER IMMUNOTHERAPIES,,,325184.19,421554.1,8
MS-DRG,180,RESPIRATORY NEOPLASMS W MCC,,,42900.0,42900.0,1
MS-DRG,180,RESPIRATORY NEOPLASMS WITH MCC,,,15828.96,51572.5,37
MS-DRG,181,RESPIRATORY NEOPLASMS W CC,,,29400.0,29400.0,1
MS-DRG,181,RESPIRATORY NEOPLASMS WITH CC,,,10345.46,31276.41,37
MS-DRG,182,RESPIRATORY NEOPLASMS W/O CC/MCC,,,20600.0,20600.0,1
MS-DRG,182,RESPIRATORY NEOPLASMS WITHOUT CC/MCC,,,7742.73,31800.0,37
MS-DRG,183,MAJOR CHEST TRAUMA W MCC,,,37800.0,37800.0,1
MS-DRG,183,MAJOR CHEST TRAUMA WITH MCC,,,14448.41,44677.67,32
MS-DRG,184,MAJOR CHEST TRAUMA W CC,,,24900.0,24900.0,1
MS-DRG,184,MAJOR CHEST TRAUMA WITH CC,,,9982.47,31074.91,32
MS-DRG,185,MAJOR CHEST TRAUMA W/O CC/MCC,,,18400.0,18400.0,1
MS-DRG,185,MAJOR CHEST TRAUMA WITHOUT CC/MCC,,,7484.58,22968.16,32
MS-DRG,186,PLEURAL EFFUSION W MCC,,,39200.0,39200.0,1
MS-DRG,186,PLEURAL EFFUSION WITH MCC,,,14385.62,45512.88,37
MS-DRG,187,PLEURAL EFFUSION W CC,,,26600.0,26600.0,1
MS-DRG,187,PLEURAL EFFUSION WITH CC,,,9431.11,28884.69,37
MS-DRG,188,PLEURAL EFFUSION W/O CC/MCC,,,19400.0,19400.0,1
MS-DRG,188,PLEURAL EFFUSION WITHOUT CC/MCC,,,7110.41,20944.39,32
MS-DRG,189,PULMONARY EDEMA & RESPIRATORY FAILURE,,,30600.0,30600.0,1
MS-DRG,189,PULMONARY EDEMA AND RESPIRATORY FAILURE,,,11438.72,41000.0,37
MS-DRG,19,SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT WITH HEMODIALYSIS,,,64211.55,70632.71,9
MS-DRG,190,CHRONIC OBSTRUCTIVE PULMONARY DISEASE W MCC,,,29100.0,29100.0,1
MS-DRG,190,CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC,,,10454.7,32348.16,37
MS-DRG,191,CHRONIC OBSTRUCTIVE PULMONARY DISEASE W CC,,,23300.0,23300.0,1
MS-DRG,191,CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC,,,8184.75,24618.13,37
MS-DRG,191,Major Pancreas Shunt and Liver,,,46700.0,46700.0,1
MS-DRG,192,CHRONIC OBSTRUCTIVE PULMONARY DISEASE W/O CC/MCC,,,18400.0,18400.0,1
MS-DRG,192,CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITHOUT CC/MCC,,,6362.08,18748.33,37
MS-DRG,193,SIMPLE PNEUMONIA & PLEURISY W MCC,,,35100.0,35100.0,1
MS-DRG,193,SIMPLE PNEUMONIA AND PLEURISY WITH MCC,,,12129.43,38384.42,37
MS-DRG,194,SIMPLE PNEUMONIA & PLEURISY W CC,,,24000.0,24000.0,1
MS-DRG,194,SIMPLE PNEUMONIA AND PLEURISY WITH CC,,,7848.43,23534.7,37
MS-DRG,195,SIMPLE PNEUMONIA & PLEURISY W/O CC/MCC,,,17800.0,17800.0,1
MS-DRG,195,SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC,,,6151.34,18354.09,37
MS-DRG,196,INTERSTITIAL LUNG DISEASE W MCC,,,41100.0,41100.0,1
MS-DRG,196,INTERSTITIAL LUNG DISEASE WITH MCC,,,17001.35,55111.9,37
MS-DRG,197,INTERSTITIAL LUNG DISEASE W CC,,,26800.0,26800.0,1
MS-DRG,197,INTERSTITIAL LUNG DISEASE WITH CC,,,9310.69,27716.57,37
MS-DRG,198,INTERSTITIAL LUNG DISEASE W/O CC/MCC,,,20500.0,20500.0,1
MS-DRG,198,INTERSTITIAL LUNG DISEASE WITHOUT CC/MCC,,,6819.68,20915.19,37
MS-DRG,199,PNEUMOTHORAX W MCC,,,45700.0,45700.0,1
MS-DRG,199,PNEUMOTHORAX WITH MCC,,,15979.48,51517.01,32
MS-DRG,2,HEART TRANSPLANT OR IMPLANT OF HEART ASSIST SYSTEM WITHOUT MCC,,,95581.79,111491.53,9
MS-DRG,20,INTRACRANIAL VASCULAR PROCEDURES W PDX HEMORRHAGE W MCC,,,215500.0,215500.0,1
MS-DRG,20,INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH MCC,,,70133.21,175900.0,10
MS-DRG,20,"Intracranial Vascular Procedure w/PDX Hemorrhage
w/MCC",,,282396.0,282396.0,1
MS-DRG,20,Intracranial Vascular Procedure w/PDX Hemorrhage w/MCC,,,252139.0,252139.0,1
MS-DRG,200,PNEUMOTHORAX W CC,,,26500.0,26500.0,1
MS-DRG,200,PNEUMOTHORAX WITH CC,,,10321.38,32102.86,37
MS-DRG,201,PNEUMOTHORAX W/O CC/MCC,,,18700.0,18700.0,1
MS-DRG,201,PNEUMOTHORAX WITHOUT CC/MCC,,,6619.26,20883.07,37
MS-DRG,202,BRONCHITIS & ASTHMA W CC/MCC,,,22600.0,22600.0,1
MS-DRG,202,BRONCHITIS AND ASTHMA WITH CC/MCC,,,9110.28,28361.95,37
MS-DRG,203,BRONCHITIS & ASTHMA W/O CC/MCC,,,17100.0,17100.0,1
MS-DRG,203,BRONCHITIS AND ASTHMA WITHOUT CC/MCC,,,5800.0,19566.01,37
MS-DRG,204,RESPIRATORY SIGNS & SYMPTOMS,,,18800.0,18800.0,1
MS-DRG,204,RESPIRATORY SIGNS AND SYMPTOMS,,,7771.01,23578.5,37
MS-DRG,205,OTHER RESPIRATORY SYSTEM DIAGNOSES W MCC,,,37100.0,37100.0,1
MS-DRG,205,OTHER RESPIRATORY SYSTEM DIAGNOSES WITH MCC,,,17000.0,53470.69,37
MS-DRG,206,OTHER RESPIRATORY SYSTEM DIAGNOSES W/O MCC,,,21000.0,21000.0,1
MS-DRG,206,OTHER RESPIRATORY SYSTEM DIAGNOSES WITHOUT MCC,,,8586.44,27482.94,37
MS-DRG,207,RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT >96 HOURS,,,135000.0,135000.0,1
MS-DRG,207,RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT >96 HOURS,,,18150.0,187912.54,37
MS-DRG,208,RESPIRATORY SYSTEM DIAGNOSIS W VENTILATOR SUPPORT <=96 HOURS,,,58400.0,58400.0,1
MS-DRG,208,RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS,,,17927.0,80270.29,37
MS-DRG,209,COMPLEX AORTIC ARCH PROCEDURES,,,18150.0,267972.59,26
MS-DRG,21,INTRACRANIAL VASCULAR PROCEDURES W PDX HEMORRHAGE W CC,,,161800.0,161800.0,1
MS-DRG,21,INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITH CC,,,47920.83,97600.0,10
MS-DRG,21,"Intracranial Vascular Procedures w/PDX Hemorrhage
w/CC",,,225857.0,225857.0,1
MS-DRG,21,Intracranial Vascular Procedures w/PDX Hemorrhage w/CC,,,201658.0,201658.0,1
MS-DRG,212,CONCOMITANT AORTIC AND MITRAL VALVE PROCEDURES,,,97305.39,107035.93,22
MS-DRG,212,CONCOMITANT AORTIC AND MITRAL VALVE?PROCEDURES,,,94499.72,94499.72,1
MS-DRG,212,Concomitant Aortic and Mitral Valve Procedures,,,18138.0,317556.34,9
MS-DRG,213,ENDOVASCULAR ABDOMINAL AORTA WITH ILIAC BRANCH PROCEDURES,,,18150.0,101200.46,26
MS-DRG,215,OTHER HEART ASSIST SYSTEM IMPLANT,,,89189.23,455400.0,24
MS-DRG,215,Other heart assist system implant,,,24200.0,345352.0,10
MS-DRG,216,CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W CARD CATH W MCC,,,208500.0,208500.0,1
MS-DRG,216,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH MCC,,,18138.0,283600.0,35
MS-DRG,216,Cardiac Valve ..w/Card Cath w/MCC,,,267716.0,299842.0,2
MS-DRG,217,CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W CARD CATH W CC,,,138200.0,138200.0,1
MS-DRG,217,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITH CC,,,18138.0,223200.0,35
MS-DRG,217,Cardiac Valve…w/Card Cath w/CC,,,204547.0,229093.0,2
MS-DRG,218,CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W CARD CATH W/O CC/MCC,,,119400.0,119400.0,1
MS-DRG,218,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITH CARDIAC CATHETERIZATION WITHOUT CC/MCC,,,19029.0,138613.9,30
MS-DRG,218,Cardiac Valve w/Card Cath w/o CC/MCC,,,193636.0,216872.0,2
MS-DRG,219,CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W/O CARD CATH W MCC,,,174100.0,174100.0,1
MS-DRG,219,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH MCC,,,18138.0,227461.0,35
MS-DRG,219,Cardiac Valve w/o Card Cath w/MCC,,,144813.0,162191.0,2
MS-DRG,22,INTRACRANIAL VASCULAR PROCEDURES W PDX HEMORRHAGE W/O CC/MCC,,,102400.0,102400.0,1
MS-DRG,22,INTRACRANIAL VASCULAR PROCEDURES WITH PRINCIPAL DIAGNOSIS HEMORRHAGE WITHOUT CC/MCC,,,29191.11,32110.22,9
MS-DRG,22,"Intracranial Vascular Procedures w/PDX Hemorrhage w/o
CC/MCC",,,153254.0,153254.0,1
MS-DRG,22,Intracranial Vascular Procedures w/PDX Hemorrhage w/o CC/MCC,,,136834.0,136834.0,1
MS-DRG,220,CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W/O CARD CATH W CC,,,116500.0,116500.0,1
MS-DRG,220,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITH CC,,,18138.0,206686.0,35
MS-DRG,220,Cardiac Valve w/o Card Cath w/CC,,,190044.0,212849.0,2
MS-DRG,221,CARDIAC VALVE & OTH MAJ CARDIOTHORACIC PROC W/O CARD CATH W/O CC/MCC,,,102100.0,102100.0,1
MS-DRG,221,CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION WITHOUT CC/MCC,,,18138.0,179384.0,35
MS-DRG,221,Cardiac Valve w/o Card Cath w/o CC/MCC,,,160302.0,179538.0,2
MS-DRG,228,OTHER CARDIOTHORACIC PROCEDURES W MCC,,,151000.0,151000.0,1
MS-DRG,228,OTHER CARDIOTHORACIC PROCEDURES WITH MCC,,,17144.0,185200.0,35
MS-DRG,228,Other Cardio Procedures w/MCC,,,144706.0,162071.0,2
MS-DRG,229,OTHER CARDIOTHORACIC PROCEDURES W/O MCC,,,97700.0,97700.0,1
MS-DRG,229,OTHER CARDIOTHORACIC PROCEDURES WITHOUT MCC,,,17144.0,143800.0,35
MS-DRG,229,Other Cardio Procedures w/CC,,,149133.0,167029.0,2
MS-DRG,23,CRANIO W MAJOR DEV IMPL/ACUTE COMPLEX CNS PDX W MCC OR CHEMO IMPLANT,,,119400.0,119400.0,1
MS-DRG,23,CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITH MCC OR ANTINEOPLASTIC IMPLANT OR EPILEPSY WITH NEUROSTIMULATOR,,,51783.77,56962.15,8
MS-DRG,23,CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITH MCC OR CHEMOTHERAPY IMPLANT OR EPILEPSY WITH NEUROSTIMULATOR,,,49867.92,84700.0,2
MS-DRG,23,"Cranio w/Major Dev IMPL/Acute Complex CNS PDX
w/MCC",,,178158.0,178158.0,1
MS-DRG,23,Cranio w/Major Dev IMPL/Acute Complex CNS PDX w/MCC,,,159070.0,159070.0,1
MS-DRG,231,CORONARY BYPASS W PTCA W MCC,,,228000.0,228000.0,1
MS-DRG,231,CORONARY BYPASS WITH PTCA WITH MCC,,,19029.0,177710.72,30
MS-DRG,231,Coronary Bypass w/MCC,,,249867.0,279851.0,2
MS-DRG,232,CORONARY BYPASS W PTCA W/O MCC,,,166400.0,166400.0,1
MS-DRG,232,CORONARY BYPASS WITH PTCA WITHOUT MCC,,,19029.0,127805.67,30
MS-DRG,232,Coronary Bypass w/o MCC,,,207124.0,231979.0,2
MS-DRG,233,CORONARY BYPASS W CARDIAC CATH W MCC,,,162400.0,162400.0,1
MS-DRG,233,CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITH MCC,,,68028.41,132100.0,24
MS-DRG,233,CORONARY BYPASS WITH CARDIAC CATHETERIZATION WITH MCC,,,19029.0,217200.0,11
MS-DRG,233,Coronary Bypass w/MCC,,,242863.0,272007.0,2
MS-DRG,234,CORONARY BYPASS W CARDIAC CATH W/O MCC,,,106100.0,106100.0,1
MS-DRG,234,CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITHOUT MCC,,,46557.18,96200.0,24
MS-DRG,234,CORONARY BYPASS WITH CARDIAC CATHETERIZATION WITHOUT MCC,,,19029.0,175008.0,11
MS-DRG,234,Coronary bypass w/cardiac cath w/o MCC,,,175457.0,196512.0,2
MS-DRG,235,CORONARY BYPASS W/O CARDIAC CATH W MCC,,,128500.0,128500.0,1
MS-DRG,235,CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITH MCC,,,19029.0,168400.0,35
MS-DRG,235,Coronary Bypass w/o Card Cath w/MCC,,,209573.0,234722.0,2
MS-DRG,236,CORONARY BYPASS W/O CARDIAC CATH W/O MCC,,,83500.0,83500.0,1
MS-DRG,236,CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC,,,19029.0,130900.0,35
MS-DRG,236,Coronary bypass w/o cardiac cath w/o MCC,,,136911.0,153340.0,2
MS-DRG,239,AMPUTATION FOR CIRC SYS DISORDERS EXC UPPER LIMB & TOE W MCC,,,106800.0,106800.0,1
MS-DRG,239,AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH MCC,,,24200.0,159900.0,35
MS-DRG,239,Amputation upper limb & toe w/MCC,,,167417.0,187507.0,2
MS-DRG,24,CRANIO W MAJOR DEV IMPL/ACUTE COMPLEX CNS PDX W/O MCC,,,89000.0,89000.0,1
MS-DRG,24,CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITHOUT MCC,,,33495.71,57600.0,10
MS-DRG,24,Cranio w/Major Dev IMPL/Acute w/o MCC,,,107142.0,119999.0,2
MS-DRG,240,AMPUTATION FOR CIRC SYS DISORDERS EXC UPPER LIMB & TOE W CC,,,76700.0,76700.0,1
MS-DRG,240,AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITH CC,,,24200.0,77600.0,35
MS-DRG,240,Amputation upper limb & toe w/CC,,,69790.0,78165.0,2
MS-DRG,241,AMPUTATION FOR CIRC SYS DISORDERS EXC UPPER LIMB & TOE W/O CC/MCC,,,40800.0,40800.0,1
MS-DRG,241,AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS EXCEPT UPPER LIMB AND TOE WITHOUT CC/MCC,,,13323.42,53900.0,35
MS-DRG,241,Amputation upper limb & toe w/o CC/MCC,,,53726.0,60173.0,2
MS-DRG,242,PERMANENT CARDIAC PACEMAKER IMPLANT W MCC,,,82500.0,82500.0,1
MS-DRG,242,PERMANENT CARDIAC PACEMAKER IMPLANT WITH MCC,,,17144.0,119200.0,35
MS-DRG,242,Permanent Card Implant w/MCC,,,135234.0,151462.0,2
MS-DRG,243,PERMANENT CARDIAC PACEMAKER IMPLANT W CC,,,58700.0,58700.0,1
MS-DRG,243,PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC,,,19029.0,83675.0,35
MS-DRG,243,Permanent Card Implant w/CC,,,94970.0,106366.0,2
MS-DRG,244,PERMANENT CARDIAC PACEMAKER IMPLANT W/O CC/MCC,,,47500.0,47500.0,1
MS-DRG,244,PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT CC/MCC,,,16318.39,67964.0,35
MS-DRG,244,Permanent Card Implant w/o CC/MCC,,,74747.0,83717.0,2
MS-DRG,245,AICD GENERATOR PROCEDURES,,,41448.09,103300.0,25
MS-DRG,245,AICD Generator Procedures,,,154173.0,172674.0,2
MS-DRG,245,AICD generator procedures,,,19029.0,151688.0,11
MS-DRG,25,CRANIOTOMY & ENDOVASCULAR INTRACRANIAL PROCEDURES W MCC,,,94100.0,94100.0,1
MS-DRG,25,CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC,,,39263.92,82500.0,10
MS-DRG,25,"Craniotomy & Endovascular Intracranial Procedures
w/MCC",,,156323.0,156323.0,1
MS-DRG,25,Craniotomy & Endovascular Intracranial Procedures w/MCC,,,139574.0,139574.0,1
MS-DRG,250,PERC CARDIOVASC PROC W/O CORONARY ARTERY STENT W MCC,,,65900.0,65900.0,1
MS-DRG,250,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITH MCC,,,17144.0,114400.0,35
MS-DRG,250,Perc Cardio Proc w/o Coronary Stent w/MCC,,,108680.0,121722.0,2
MS-DRG,251,PERC CARDIOVASC PROC W/O CORONARY ARTERY STENT W/O MCC,,,43500.0,43500.0,1
MS-DRG,251,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITHOUT INTRALUMINAL DEVICE WITHOUT MCC,,,14235.95,67627.0,35
MS-DRG,251,Perc Cardio Proc w/o Coronary Stent w/o MCC,,,69718.0,78084.0,2
MS-DRG,252,OTHER VASCULAR PROCEDURES W MCC,,,69200.0,69200.0,1
MS-DRG,252,OTHER VASCULAR PROCEDURES WITH MCC,,,18708.0,96400.0,35
MS-DRG,252,Other Vascular procedures w/MCC,,,109535.0,122679.0,2
MS-DRG,253,OTHER VASCULAR PROCEDURES W CC,,,55300.0,55300.0,1
MS-DRG,253,OTHER VASCULAR PROCEDURES WITH CC,,,18708.0,84003.0,35
MS-DRG,253,Other Vascular procedures w/CC,,,89659.0,100418.0,2
MS-DRG,254,OTHER VASCULAR PROCEDURES W/O CC/MCC,,,37300.0,37300.0,1
MS-DRG,254,OTHER VASCULAR PROCEDURES WITHOUT CC/MCC,,,15842.72,56434.0,35
MS-DRG,254,Other Vascular procedures w/o CC/MCC,,,60195.0,67418.0,2
MS-DRG,255,UPPER LIMB & TOE AMPUTATION FOR CIRC SYSTEM DISORDERS W MCC,,,76500.0,76500.0,1
MS-DRG,255,UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH MCC,,,23301.14,51897.98,30
MS-DRG,255,Upper Limb & Toe Sys Disorders w/MCC,,,88362.0,98965.0,2
MS-DRG,256,UPPER LIMB & TOE AMPUTATION FOR CIRC SYSTEM DISORDERS W CC,,,35100.0,35100.0,1
MS-DRG,256,UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITH CC,,,15363.61,32667.6,35
MS-DRG,256,Upper Limb & Toe Sys Disorders w/CC,,,39292.0,44007.0,2
MS-DRG,257,Mastectomy With TramFlap Breast Reconstruction,,,35400.0,35400.0,1
MS-DRG,257,UPPER LIMB & TOE AMPUTATION FOR CIRC SYSTEM DISORDERS W/O CC/MCC,,,32000.0,32000.0,1
MS-DRG,257,UPPER LIMB AND TOE AMPUTATION FOR CIRCULATORY SYSTEM DISORDERS WITHOUT CC/MCC,,,8466.88,24200.0,30
MS-DRG,257,Upper Limb & Toe Sys Disorders w/o CC/MCC,,,34556.0,38703.0,2
MS-DRG,258,CARDIAC PACEMAKER DEVICE REPLACEMENT W MCC,,,85900.0,85900.0,1
MS-DRG,258,CARDIAC PACEMAKER DEVICE REPLACEMENT WITH MCC,,,24200.0,60454.0,30
MS-DRG,258,Cardiac Pacemaker Replacement w/MCC,,,97652.0,109370.0,2
MS-DRG,258,Mastectomy with Microsurgery Breast Reconstruclion,,,35400.0,35400.0,1
MS-DRG,259,CARDIAC PACEMAKER DEVICE REPLACEMENT W/O MCC,,,56400.0,56400.0,1
MS-DRG,259,CARDIAC PACEMAKER DEVICE REPLACEMENT WITHOUT MCC,,,15914.11,63237.0,35
MS-DRG,259,Cardiac Pacemaker Replacement w/o MCC,,,67374.0,75459.0,2
MS-DRG,259,Mastectomy With TramFlap Breast Reconstruction,,,35400.0,35400.0,1
MS-DRG,26,CRANIOTOMY & ENDOVASCULAR INTRACRANIAL PROCEDURES W CC,,,66000.0,66000.0,1
MS-DRG,26,CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH CC,,,27103.89,53300.0,10
MS-DRG,26,Craniotomy & Endovascular intracranial Procedures w/CC,,,89760.0,100531.0,2
MS-DRG,260,Axillary Lymph Node Removal With or Without Partial Mastectomy,,,35400.0,35400.0,1
MS-DRG,260,CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT W MCC,,,106400.0,106400.0,1
MS-DRG,260,CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH MCC,,,24200.0,100800.0,35
MS-DRG,260,Cardiac Pacemaker Revision w/MCC,,,132733.0,148661.0,2
MS-DRG,261,CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT W CC,,,55300.0,55300.0,1
MS-DRG,261,CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITH CC,,,17117.47,62216.0,35
MS-DRG,261,Cardiac Pacemaker Revision w/CC,,,60772.0,68065.0,2
MS-DRG,261,Simple Complete Mastectomy,,,35400.0,35400.0,1
MS-DRG,262,CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT W/O CC/MCC,,,45200.0,45200.0,1
MS-DRG,262,CARDIAC PACEMAKER REVISION EXCEPT DEVICE REPLACEMENT WITHOUT CC/MCC,,,13850.6,50882.0,35
MS-DRG,262,"Cardiac Pacemaker except devise replacement w/o
CC/MCC",,,50102.0,50102.0,1
MS-DRG,262,Cardiac Pacemaker except devise replacement w/o CC/MCC,,,44734.0,44734.0,1
MS-DRG,263,VEIN LIGATION & STRIPPING,,,58000.0,58000.0,1
MS-DRG,263,VEIN LIGATION AND STRIPPING,,,23865.4,58824.38,30
MS-DRG,263,Vein ligation & stripping,,,69187.0,77489.0,2
MS-DRG,264,OTHER CIRCULATORY SYSTEM O.R. PROCEDURES,,,30635.4,60000.0,25
MS-DRG,264,Other circulatory system O.R. procedures,,,24200.0,64273.14,11
MS-DRG,264,Other circulatory system OR procedures,,,96673.0,108274.0,2
MS-DRG,265,AICD LEAD PROCEDURES,,,31478.64,90800.0,24
MS-DRG,265,AICD Lead procedures,,,88406.0,99015.0,2
MS-DRG,265,AICD lead procedures,,,19029.0,102016.0,7
MS-DRG,265,Modified Radical Mastectomy,,,35400.0,35400.0,1
MS-DRG,266,ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITH MCC,,,52325.39,60837.57,23
MS-DRG,266,ENDOVASCULAR CARDIAC VALVE REPLACEMENT W MCC,,,19029.0,173600.0,12
MS-DRG,266,Endovascular Cardiac Valve Replacement w/MCC,,,266711.0,298716.0,2
MS-DRG,266,Mastectomy With TramFlap Breast Reconstruction,,,35400.0,35400.0,1
MS-DRG,267,ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITHOUT MCC,,,41262.92,47524.28,23
MS-DRG,267,ENDOVASCULAR CARDIAC VALVE REPLACEMENT W/O MCC,,,19029.0,159600.0,12
MS-DRG,267,Endovascular Cardiac Valve Replacement w/o MCC,,,200263.0,224295.0,2
MS-DRG,268,AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON W MCC,,,182400.0,182400.0,1
MS-DRG,268,AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITH MCC,,,19029.0,345352.0,31
MS-DRG,268,"Aortic and Heart Assist Procedures exc pulsation balloon
w/MCC",,,246904.0,246904.0,1
MS-DRG,268,Aortic and Heart Assist Procedures exc pulsation balloon w/MCC,,,220450.0,220450.0,1
MS-DRG,269,AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON W/O MCC,,,103800.0,103800.0,1
MS-DRG,269,AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITHOUT MCC,,,19029.0,345352.0,31
MS-DRG,269,"Aortic and Heart Assist Procedures exc pulsation balloon
w/o MCC",,,153477.0,153477.0,1
MS-DRG,269,Aortic and Heart Assist Procedures exc pulsation balloon w/o MCC,,,137033.0,137033.0,1
MS-DRG,27,CRANIOTOMY & ENDOVASCULAR INTRACRANIAL PROCEDURES W/O CC/MCC,,,52700.0,52700.0,1
MS-DRG,27,CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITHOUT CC/MCC,,,22022.08,47100.0,10
MS-DRG,27,"Craniotomy & Endovascular intracranial procedures w/o
CC/MCC",,,73575.0,73575.0,1
MS-DRG,27,Craniotomy & Endovascular intracranial procedures w/o CC/MCC,,,65692.0,65692.0,1
MS-DRG,270,OTHER MAJOR CARDIOVASCULAR PROCEDURES W MCC,,,137300.0,137300.0,1
MS-DRG,270,OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH MCC,,,19029.0,168175.0,30
MS-DRG,270,Other Major Cardiovascular Procedures w/MCC,,,166194.0,186137.0,2
MS-DRG,271,OTHER MAJOR CARDIOVASCULAR PROCEDURES W CC,,,83500.0,83500.0,1
MS-DRG,271,OTHER MAJOR CARDIOVASCULAR PROCEDURES WITH CC,,,19029.0,99351.0,30
MS-DRG,271,Other Major Cardiovascular Procedures w/CC,,,110306.0,123543.0,2
MS-DRG,272,OTHER MAJOR CARDIOVASCULAR PROCEDURES W/O CC/MCC,,,59500.0,59500.0,1
MS-DRG,272,OTHER MAJOR CARDIOVASCULAR PROCEDURES WITHOUT CC/MCC,,,19029.0,73451.0,30
MS-DRG,272,Other Major Cardiovascular Procedures w/o CC/MCC,,,79005.0,88486.0,2
MS-DRG,273,PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITH MCC,,,34429.84,41339.77,23
MS-DRG,273,PERCUTANEOUS INTRACARDIAC PROCEDURES W MCC,,,19029.0,114513.0,8
MS-DRG,273,Percutaneous Intracardiac Procedures w/MCC,,,125019.0,140021.0,2
MS-DRG,274,PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITHOUT MCC,,,27640.62,33222.9,23
MS-DRG,274,PERCUTANEOUS INTRACARDIAC PROCEDURES W/O MCC,,,19029.0,80387.0,8
MS-DRG,274,Percutaneous Intracardiac Procedures w/o MCC,,,85216.0,95442.0,2
MS-DRG,275,CARDIAC DEFIBRILLATOR IMPLANT WITH CARDIAC CATHETERIZATION AND MCC,,,18150.0,155657.0,30
MS-DRG,275,Cardiac defib implant w/MCC with & w/o shock,,,248677.0,278518.0,2
MS-DRG,276,CARDIAC DEFIBRILLATOR IMPLANT WITH MCC,,,54076.67,54076.67,1
MS-DRG,276,CARDIAC DEFIBRILLATOR IMPLANT WITH MCC OR CAROTID SINUS NEUROSTIMULATOR,,,18150.0,115566.98,29
MS-DRG,276,Cardiac defib implant w/o Card Cath w/MCC,,,231349.0,259111.0,2
MS-DRG,277,CARDIAC DEFIBRILLATOR IMPLANT WITHOUT MCC,,,40808.76,46139.02,23
MS-DRG,277,Cardiac Defibrillator Implant without MCC,,,18150.0,149409.0,7
MS-DRG,277,Cardiac defib implant w/o Card Cath w/o MCC,,,125253.0,140283.0,2
MS-DRG,278,Other Vascular procedures w/MCC,,,109535.0,122679.0,2
MS-DRG,278,ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITH MCC,,,43831.35,55364.67,23
MS-DRG,278,Ultrasound Accelerated and Other Thrombolysis of Peripheral Vascular Structures with MCC,,,18150.0,107093.69,7
MS-DRG,279,Other Vascular procedures with or w/o CC/MCC,,,106340.0,119101.0,2
MS-DRG,279,ULTRASOUND ACCELERATED AND OTHER THROMBOLYSIS OF PERIPHERAL VASCULAR STRUCTURES WITHOUT MCC,,,28357.99,36286.45,23
MS-DRG,279,Ultrasound Accelerated and Other Thrombolysis of Peripheral Vascular Structures without MCC,,,18150.0,77390.0,7
MS-DRG,28,SPINAL PROCEDURES W MCC,,,123100.0,123100.0,1
MS-DRG,28,SPINAL PROCEDURES WITH MCC,,,53088.35,65700.0,10
MS-DRG,28,Spinal procedures w/MCC,,,133462.0,149477.0,2
MS-DRG,280,"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE W MCC",,,49400.0,49400.0,1
MS-DRG,280,"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC",,,14913.75,59200.0,35
MS-DRG,280,Acute Myocardial Infarction alive w/MCC,,,39553.0,44299.0,2
MS-DRG,281,"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE W CC",,,29900.0,29900.0,1
MS-DRG,281,"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC",,,8724.07,40000.0,35
MS-DRG,281,Acute Myocardial Infarction alive w/CC,,,39726.0,44493.0,2
MS-DRG,282,"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE W/O CC/MCC",,,21400.0,21400.0,1
MS-DRG,282,"ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC",,,7032.14,30200.0,35
MS-DRG,282,Acute Myocardial Infarction w/o CC/MCC,,,28037.0,31401.0,2
MS-DRG,283,"ACUTE MYOCARDIAL INFARCTION, EXPIRED W MCC",,,47800.0,47800.0,1
MS-DRG,283,"ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH MCC",,,17614.64,60200.0,35
MS-DRG,283,Acute Myocardial Infarction expired w/MCC,,,63564.0,71192.0,2
MS-DRG,284,"ACUTE MYOCARDIAL INFARCTION, EXPIRED W CC",,,24700.0,24700.0,1
MS-DRG,284,"ACUTE MYOCARDIAL INFARCTION, EXPIRED WITH CC",,,7168.9,24200.0,30
MS-DRG,284,Acute Myocardial Infarction expired w/CC,,,29146.0,32644.0,2
MS-DRG,285,"ACUTE MYOCARDIAL INFARCTION, EXPIRED W/O CC/MCC",,,17100.0,17100.0,1
MS-DRG,285,"ACUTE MYOCARDIAL INFARCTION, EXPIRED WITHOUT CC/MCC",,,5624.06,24200.0,30
MS-DRG,285,Acute Myocardial Infarction expired w/o CC/MCC,,,19398.0,21726.0,2
MS-DRG,286,"CIRCULATORY DISORDERS EXCEPT AMI, W CARD CATH W MCC",,,59500.0,59500.0,1
MS-DRG,286,"CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC",,,17927.0,73600.0,35
MS-DRG,286,Circulatory Disorders except AMI w/Card Cath w/MCC,,,74719.0,83685.0,2
MS-DRG,287,"CIRCULATORY DISORDERS EXCEPT AMI, W CARD CATH W/O MCC",,,30700.0,30700.0,1
MS-DRG,287,"CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC",,,10168.27,41322.0,35
MS-DRG,287,"Circulatory disorders except AMI, w/cardiac cath w/o
MCC",,,43469.0,43469.0,1
MS-DRG,287,"Circulatory disorders except AMI, w/cardiac cath w/o MCC",,,38812.0,38812.0,1
MS-DRG,288,ACUTE & SUBACUTE ENDOCARDITIS W MCC,,,79100.0,79100.0,1
MS-DRG,288,ACUTE AND SUBACUTE ENDOCARDITIS WITH MCC,,,1136.0,78100.0,36
MS-DRG,288,Acute & Sub Acute Endocarditis w/MCC,,,102308.0,114585.0,2
MS-DRG,289,ACUTE & SUBACUTE ENDOCARDITIS W CC,,,51100.0,51100.0,1
MS-DRG,289,ACUTE AND SUBACUTE ENDOCARDITIS WITH CC,,,1136.0,32840.76,31
MS-DRG,289,Acute & Sub Acute Endocarditis w/CC,,,65761.0,73652.0,2
MS-DRG,29,SPINAL PROCEDURES W CC OR SPINAL NEUROSTIMULATORS,,,70800.0,70800.0,1
MS-DRG,29,SPINAL PROCEDURES WITH CC OR SPINAL NEUROSTIMULATORS,,,29668.01,42500.0,10
MS-DRG,29,Spinal procedures w/CC or Spinal Neurostimulators,,,88915.0,99585.0,2
MS-DRG,290,ACUTE & SUBACUTE ENDOCARDITIS W/O CC/MCC,,,41400.0,41400.0,1
MS-DRG,290,ACUTE AND SUBACUTE ENDOCARDITIS WITHOUT CC/MCC,,,1136.0,24200.0,31
MS-DRG,290,Acute & Sub Acute Endocarditis w/o CC/MCC,,,43824.0,49083.0,2
MS-DRG,290,Thyroid Procedures,,,13400.0,13400.0,1
MS-DRG,291,HEART FAILURE & SHOCK W MCC,,,42600.0,42600.0,1
MS-DRG,291,HEART FAILURE AND SHOCK WITH MCC,,,12018.47,45393.0,35
MS-DRG,291,Heart Failure & Shock w/MCC,,,54994.0,61593.0,2
MS-DRG,292,HEART FAILURE & SHOCK W CC,,,28100.0,28100.0,1
MS-DRG,292,HEART FAILURE AND SHOCK WITH CC,,,8202.81,26700.0,35
MS-DRG,292,Heart Failure & Shock w/CC,,,36365.0,40729.0,2
MS-DRG,293,HEART FAILURE & SHOCK W/O CC/MCC,,,19100.0,19100.0,1
MS-DRG,293,HEART FAILURE AND SHOCK WITHOUT CC/MCC,,,5514.82,24200.0,35
MS-DRG,293,Heart failure & shock w/o CC/MCC,,,24465.0,27401.0,2
MS-DRG,296,"CARDIAC ARREST, UNEXPLAINED W MCC",,,45000.0,45000.0,1
MS-DRG,296,"CARDIAC ARREST, UNEXPLAINED WITH MCC",,,14887.95,30050.96,30
MS-DRG,296,Cardiac Arrest unexplained w/MCC,,,46672.0,52273.0,2
MS-DRG,297,"CARDIAC ARREST, UNEXPLAINED W CC",,,19400.0,19400.0,1
MS-DRG,297,"CARDIAC ARREST, UNEXPLAINED WITH CC",,,6682.52,24200.0,30
MS-DRG,297,Cardiac Arrest unexplained w/CC,,,23395.0,26202.0,2
MS-DRG,298,"CARDIAC ARREST, UNEXPLAINED W/O CC/MCC",,,14500.0,14500.0,1
MS-DRG,298,"CARDIAC ARREST, UNEXPLAINED WITHOUT CC/MCC",,,4594.46,24200.0,30
MS-DRG,298,Cardiac Arrest unexplained w/o CC/MCC,,,16566.0,18554.0,2
MS-DRG,299,PERIPHERAL VASCULAR DISORDERS W MCC,,,38700.0,38700.0,1
MS-DRG,299,PERIPHERAL VASCULAR DISORDERS WITH MCC,,,14709.03,36100.0,35
MS-DRG,299,Peripheral vascular disorders w/MCC,,,51414.0,57584.0,2
MS-DRG,3,Craniotomy Age 0-17,,,41100.0,41100.0,1
MS-DRG,3,"ECMO OR TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITH MAJOR O.R. PROCEDURES",,,185140.41,207801.64,9
MS-DRG,30,SPINAL PROCEDURES W/O CC/MCC,,,42200.0,42200.0,1
MS-DRG,30,SPINAL PROCEDURES WITHOUT CC/MCC,,,19937.06,36100.0,10
MS-DRG,30,Spinal procedures w/o CC/MCC,,,54221.0,60728.0,2
MS-DRG,300,PERIPHERAL VASCULAR DISORDERS W CC,,,27400.0,27400.0,1
MS-DRG,300,PERIPHERAL VASCULAR DISORDERS WITH CC,,,10003.98,24200.0,35
MS-DRG,300,Peripheral vascular disorders w/CC,,,35081.0,39291.0,2
MS-DRG,301,PERIPHERAL VASCULAR DISORDERS W/O CC/MCC,,,18900.0,18900.0,1
MS-DRG,301,PERIPHERAL VASCULAR DISORDERS WITHOUT CC/MCC,,,6931.5,24200.0,35
MS-DRG,301,Peripheral vascular disorders w/o CC/MCC,,,24205.0,27110.0,2
MS-DRG,302,ATHEROSCLEROSIS W MCC,,,34100.0,34100.0,1
MS-DRG,302,ATHEROSCLEROSIS WITH MCC,,,10801.34,24200.0,30
MS-DRG,302,Atherosclerosis w/MCC,,,36759.0,41170.0,2
MS-DRG,303,ATHEROSCLEROSIS W/O MCC,,,17200.0,17200.0,1
MS-DRG,303,ATHEROSCLEROSIS WITHOUT MCC,,,6578.84,24200.0,35
MS-DRG,303,Atherosclerosis w/o MCC,,,20923.0,23434.0,2
MS-DRG,303,Kidney Ureter Major Bladder Procedures For Neoplasm,,,39400.0,39400.0,1
MS-DRG,304,HYPERTENSION W MCC,,,33300.0,33300.0,1
MS-DRG,304,HYPERTENSION WITH MCC,,,10900.26,24200.0,30
MS-DRG,304,Hypertension w/MCC,,,38066.0,42634.0,2
MS-DRG,304,Kidney Ureter Major Bladder Procedures for Non-Neoplasm With cc,,,27100.0,27100.0,1
MS-DRG,305,HYPERTENSION W/O MCC,,,17500.0,17500.0,1
MS-DRG,305,HYPERTENSION WITHOUT MCC,,,7252.34,24200.0,35
MS-DRG,305,Hypertension w/o MCC,,,22425.0,25116.0,2
MS-DRG,305,Kidney Ureter Major Bladder Procedures For Non-Neoplasm W/0 cc,,,16700.0,16700.0,1
MS-DRG,306,CARDIAC CONGENITAL & VALVULAR DISORDERS W MCC,,,38700.0,38700.0,1
MS-DRG,306,CARDIAC CONGENITAL AND VALVULAR DISORDERS WITH MCC,,,13675.13,47500.0,35
MS-DRG,306,Cardiac Congenital & Valvular w/MCC,,,47556.0,53263.0,2
MS-DRG,307,CARDIAC CONGENITAL & VALVULAR DISORDERS W/O MCC,,,22500.0,22500.0,1
MS-DRG,307,CARDIAC CONGENITAL AND VALVULAR DISORDERS WITHOUT MCC,,,8763.63,25870.0,35
MS-DRG,307,Cardiac Congenital & Valvular w/o MCC,,,28414.0,31824.0,2
MS-DRG,308,CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W MCC,,,34100.0,34100.0,1
MS-DRG,308,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC,,,11167.77,27600.0,35
MS-DRG,308,Cardiac Arrhythmia & Conduction w/MCC,,,29874.0,33459.0,2
MS-DRG,309,CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W CC,,,22400.0,22400.0,1
MS-DRG,309,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC,,,7154.28,24646.0,35
MS-DRG,309,Cardiac Arrhythmia & Conduction w/CC,,,29347.0,32869.0,2
MS-DRG,31,VENTRICULAR SHUNT PROCEDURES W MCC,,,90400.0,90400.0,1
MS-DRG,31,VENTRICULAR SHUNT PROCEDURES WITH MCC,,,36840.86,48400.0,10
MS-DRG,31,Ventricular Shunt procedure w/MCC,,,129511.0,145052.0,2
MS-DRG,310,CARDIAC ARRHYTHMIA & CONDUCTION DISORDERS W/O CC/MCC,,,15700.0,15700.0,1
MS-DRG,310,CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC,,,5607.72,24200.0,35
MS-DRG,310,Cardiac arrhythmia & conduction disorders w/o CC/MCC,,,20082.0,22492.0,2
MS-DRG,311,ANGINA PECTORIS,,,6801.62,16000.0,25
MS-DRG,311,Angina Pectoris,,,18870.0,21134.0,2
MS-DRG,311,Angina pectoris,,,10206.33,24200.0,11
MS-DRG,312,SYNCOPE & COLLAPSE,,,20500.0,20500.0,1
MS-DRG,312,SYNCOPE AND COLLAPSE,,,8289.69,24200.0,35
MS-DRG,312,Syncope & Collapse,,,26599.0,29791.0,2
MS-DRG,313,CHEST PAIN,,,6931.5,17100.0,25
MS-DRG,313,Chest pain,,,10469.52,24200.0,13
MS-DRG,314,OTHER CIRCULATORY SYSTEM DIAGNOSES W MCC,,,53500.0,53500.0,1
MS-DRG,314,OTHER CIRCULATORY SYSTEM DIAGNOSES WITH MCC,,,17927.0,43600.0,35
MS-DRG,314,Other circulatory system diagnoses w/MCC,,,29954.0,33548.0,2
MS-DRG,315,OTHER CIRCULATORY SYSTEM DIAGNOSES W CC,,,27100.0,27100.0,1
MS-DRG,315,OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC,,,9072.43,27400.0,35
MS-DRG,315,Other circulatory system diagnoses w/CC,,,34526.0,38669.0,2
MS-DRG,316,OTHER CIRCULATORY SYSTEM DIAGNOSES W/O CC/MCC,,,18000.0,18000.0,1
MS-DRG,316,OTHER CIRCULATORY SYSTEM DIAGNOSES WITHOUT CC/MCC,,,6667.43,24200.0,35
MS-DRG,316,Other circulatory system diagnoses w/o CC/MCC,,,4902.0,5490.0,2
MS-DRG,317,CONCOMITANT LEFT ATRIAL APPENDAGE CLOSURE AND CARDIAC ABLATION,,,18150.0,121547.2,30
MS-DRG,317,"Concomitant Left Atrial Appendage Closer and Cardiac
Ablation",,,202235.0,202235.0,1
MS-DRG,317,Concomitant Left Atrial Appendage Closer and Cardiac Ablation,,,180567.0,180567.0,1
MS-DRG,318,PERCUTANEOUS CORONARY ATHERECTOMY WITHOUT INTRALUMINAL DEVICE,,,18150.0,42952.87,26
MS-DRG,319,OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITH MCC,,,24200.0,94082.39,30
MS-DRG,319,Other Endovascular Cardiac Valve Procedures with MCC,,,124020.0,138902.0,2
MS-DRG,32,VENTRICULAR SHUNT PROCEDURES W CC,,,45500.0,45500.0,1
MS-DRG,32,VENTRICULAR SHUNT PROCEDURES WITH CC,,,19164.64,28600.0,10
MS-DRG,32,Ventricular Shunt procedure w/CC,,,61796.0,69212.0,2
MS-DRG,320,OTHER ENDOVASCULAR CARDIAC VALVE PROCEDURES WITHOUT MCC,,,20706.04,50706.13,30
MS-DRG,320,"Other Endovascular Cardia Valve Procedures without
MCC",,,79524.0,79524.0,1
MS-DRG,320,Other Endovascular Cardia Valve Procedures without MCC,,,71004.0,71004.0,1
MS-DRG,321,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITH MCC OR 4+ ARTERIES/INTRALUMINAL DEVICES,,,25150.29,27665.32,23
MS-DRG,321,"Per cardiovascular procedure w/drug or non-drug-eluting
stent w/MCC or 4+ vessels/stents",,,119642.0,119642.0,1
MS-DRG,321,Per cardiovascular procedure w/drug or non-drug-eluting stent w/MCC or 4+ vessels/stents,,,106823.0,106823.0,1
MS-DRG,321,Percutaneous Cardiovascular Procedures with Intraluminal Device with MMC or 4+ Arteries/Intraluminal Devices,,,18150.0,56889.0,7
MS-DRG,322,PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITHOUT MCC,,,16357.09,18341.35,23
MS-DRG,322,"Per cardiovasc procedure w/drug or non-drug-eluting stent
w/o MCC",,,75177.0,75177.0,1
MS-DRG,322,Per cardiovasc procedure w/drug or non-drug-eluting stent w/o MCC,,,67122.0,67122.0,1
MS-DRG,322,Percutaneous Cardiovascular Procedures with Intraluminal Device without MCC,,,18150.0,74855.0,7
MS-DRG,323,CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITH MCC,,,37432.64,43305.22,23
MS-DRG,323,Coronary Intravascular Lithotripsy with Intraluminal Device with MCC,,,18150.0,126373.06,9
MS-DRG,324,CORONARY INTRAVASCULAR LITHOTRIPSY WITH INTRALUMINAL DEVICE WITHOUT MCC,,,28278.0,31853.23,23
MS-DRG,324,Coronary Intravascular Lithotripsy with Intraluminal Device without MCC,,,18150.0,92018.65,9
MS-DRG,325,CORONARY INTRAVASCULAR LITHOTRIPSY WITHOUT INTRALUMINAL DEVICE,,,25413.68,32431.48,23
MS-DRG,325,Coronary Intravascular Lithotripsy without Intraluminal Device,,,18150.0,93753.31,9
MS-DRG,326,"STOMACH, ESOPHAGEAL & DUODENAL PROC W MCC",,,142300.0,142300.0,1
MS-DRG,326,"STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH MCC",,,17927.0,145647.04,37
MS-DRG,327,"STOMACH, ESOPHAGEAL & DUODENAL PROC W CC",,,68700.0,68700.0,1
MS-DRG,327,"STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH CC",,,17927.0,74300.0,37
MS-DRG,328,"STOMACH, ESOPHAGEAL & DUODENAL PROC W/O CC/MCC",,,40700.0,40700.0,1
MS-DRG,328,"STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITHOUT CC/MCC",,,14501.74,46791.97,37
MS-DRG,329,MAJOR SMALL & LARGE BOWEL PROCEDURES W MCC,,,131600.0,131600.0,1
MS-DRG,329,MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC,,,17927.0,134231.59,37
MS-DRG,33,VENTRICULAR SHUNT PROCEDURES W/O CC/MCC,,,35400.0,35400.0,1
MS-DRG,33,VENTRICULAR SHUNT PROCEDURES WITHOUT CC/MCC,,,14518.94,30600.0,10
MS-DRG,33,Ventricular Shunt procedures w/o CC/MCC,,,43674.0,48915.0,2
MS-DRG,330,MAJOR SMALL & LARGE BOWEL PROCEDURES W CC,,,67400.0,67400.0,1
MS-DRG,330,MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC,,,17927.0,70005.43,37
MS-DRG,331,MAJOR SMALL & LARGE BOWEL PROCEDURES W/O CC/MCC,,,44100.0,44100.0,1
MS-DRG,331,MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC,,,14996.33,49145.73,37
MS-DRG,332,RECTAL RESECTION W MCC,,,126700.0,126700.0,1
MS-DRG,332,RECTAL RESECTION WITH MCC,,,22000.0,105735.3,32
MS-DRG,333,RECTAL RESECTION W CC,,,66100.0,66100.0,1
MS-DRG,333,RECTAL RESECTION WITH CC,,,19076.05,68399.27,37
MS-DRG,334,Prostatectomy,,,22200.0,22200.0,1
MS-DRG,334,RECTAL RESECTION W/O CC/MCC,,,42400.0,42400.0,1
MS-DRG,334,RECTAL RESECTION WITHOUT CC/MCC,,,15061.7,51500.0,37
MS-DRG,335,PERITONEAL ADHESIOLYSIS W MCC,,,108700.0,108700.0,1
MS-DRG,335,PERITONEAL ADHESIOLYSIS WITH MCC,,,22000.0,104280.99,37
MS-DRG,336,PERITONEAL ADHESIOLYSIS W CC,,,62100.0,62100.0,1
MS-DRG,336,PERITONEAL ADHESIOLYSIS WITH CC,,,17927.0,61580.37,37
MS-DRG,337,PERITONEAL ADHESIOLYSIS W/O CC/MCC,,,43100.0,43100.0,1
MS-DRG,337,PERITONEAL ADHESIOLYSIS WITHOUT CC/MCC,,,13999.41,44826.61,37
MS-DRG,34,CAROTID ARTERY STENT PROCEDURE W MCC,,,85500.0,85500.0,1
MS-DRG,34,CAROTID ARTERY STENT PROCEDURES WITH MCC,,,34244.04,46000.0,10
MS-DRG,34,Cartoid Arter Stent Procedure w/MCC,,,112118.0,125572.0,2
MS-DRG,344,MINOR SMALL & LARGE BOWEL PROCEDURES W MCC,,,83900.0,83900.0,1
MS-DRG,344,MINOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC,,,22000.0,75425.51,37
MS-DRG,345,MINOR SMALL & LARGE BOWEL PROCEDURES W CC,,,44000.0,44000.0,1
MS-DRG,345,MINOR SMALL AND LARGE BOWEL PROCEDURES WITH CC,,,13600.29,43941.75,37
MS-DRG,346,MINOR SMALL & LARGE BOWEL PROCEDURES W/O CC/MCC,,,32700.0,32700.0,1
MS-DRG,346,MINOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC,,,11506.67,34640.6,37
MS-DRG,347,ANAL & STOMAL PROCEDURES W MCC,,,65900.0,65900.0,1
MS-DRG,347,ANAL AND STOMAL PROCEDURES WITH MCC,,,21153.33,67038.41,32
MS-DRG,348,ANAL & STOMAL PROCEDURES W CC,,,38400.0,38400.0,1
MS-DRG,348,ANAL AND STOMAL PROCEDURES WITH CC,,,11623.65,38220.89,37
MS-DRG,349,ANAL & STOMAL PROCEDURES W/O CC/MCC,,,25300.0,25300.0,1
MS-DRG,349,ANAL AND STOMAL PROCEDURES WITHOUT CC/MCC,,,8372.26,25424.13,37
MS-DRG,35,CAROTID ARTERY STENT PROCEDURE W CC,,,51900.0,51900.0,1
MS-DRG,35,CAROTID ARTERY STENT PROCEDURES WITH CC,,,20361.98,36300.0,10
MS-DRG,35,Cartoid Artery Stent Procedure w/CC,,,60634.0,67910.0,2
MS-DRG,350,INGUINAL & FEMORAL HERNIA PROCEDURES W MCC,,,64400.0,64400.0,1
MS-DRG,350,INGUINAL AND FEMORAL HERNIA PROCEDURES WITH MCC,,,21599.75,72770.96,32
MS-DRG,351,INGUINAL & FEMORAL HERNIA PROCEDURES W CC,,,37200.0,37200.0,1
MS-DRG,351,INGUINAL AND FEMORAL HERNIA PROCEDURES WITH CC,,,13736.2,44519.97,37
MS-DRG,352,INGUINAL & FEMORAL HERNIA PROCEDURES W/O CC/MCC,,,26500.0,26500.0,1
MS-DRG,352,INGUINAL AND FEMORAL HERNIA PROCEDURES WITHOUT CC/MCC,,,10279.23,34103.26,37
MS-DRG,353,HERNIA PROCEDURES EXCEPT INGUINAL & FEMORAL W MCC,,,76200.0,76200.0,1
MS-DRG,353,HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH MCC,,,22000.0,84747.11,32
MS-DRG,354,HERNIA PROCEDURES EXCEPT INGUINAL & FEMORAL W CC,,,44400.0,44400.0,1
MS-DRG,354,HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH CC,,,15427.26,49131.13,37
MS-DRG,354,Uterine and Adnexa Procedures for Nonovarian/Adnexal Malignancy W/ cc,,,17600.0,17600.0,1
MS-DRG,355,HERNIA PROCEDURES EXCEPT INGUINAL & FEMORAL W/O CC/MCC,,,33700.0,33700.0,1
MS-DRG,355,HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITHOUT CC/MCC,,,12262.75,39278.04,37
MS-DRG,355,Uterine and Adnexa Procedures for Nonovarian/Adnexal Malignancy W/0 cc,,,13600.0,13600.0,1
MS-DRG,356,OTHER DIGESTIVE SYSTEM O.R. PROCEDURES W MCC,,,102100.0,102100.0,1
MS-DRG,356,OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH MCC,,,17927.0,128282.94,37
MS-DRG,356,Uterine and Adnexa Procedures for Nonmalignancy W/ CC,,,16400.0,16400.0,1
MS-DRG,357,OTHER DIGESTIVE SYSTEM O.R. PROCEDURES W CC,,,55000.0,55000.0,1
MS-DRG,357,OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITH CC,,,20165.87,67911.58,37
MS-DRG,357,Uterine and Adnexa Procedures for Ovarian or Adnexal Malicmancv,,,22800.0,22800.0,1
MS-DRG,358,OTHER DIGESTIVE SYSTEM O.R. PROCEDURES W/O CC/MCC,,,35900.0,35900.0,1
MS-DRG,358,OTHER DIGESTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC,,,12451.12,40822.87,37
MS-DRG,359,PERCUTANEOUS CORONARY ATHERECTOMY WITH INTRALUMINAL DEVICE WITH MCC,,,18150.0,60976.69,26
MS-DRG,36,CAROTID ARTERY STENT PROCEDURE W/O CC/MCC,,,38800.0,38800.0,1
MS-DRG,36,CAROTID ARTERY STENT PROCEDURES WITHOUT CC/MCC,,,16562.67,29400.0,10
MS-DRG,36,Cartoid Artery Stent Procedure  w/o MCC,,,50442.0,56495.0,2
MS-DRG,36,Complex Retinal Procedures,,,13700.0,13700.0,1
MS-DRG,360,PERCUTANEOUS CORONARY ATHERECTOMY WITH INTRALUMINAL DEVICE WITHOUT MCC,,,18150.0,42812.78,26
MS-DRG,368,MAJOR ESOPHAGEAL DISORDERS W MCC,,,51700.0,51700.0,1
MS-DRG,368,MAJOR ESOPHAGEAL DISORDERS WITH MCC,,,15159.75,46488.26,32
MS-DRG,369,MAJOR ESOPHAGEAL DISORDERS W CC,,,29100.0,29100.0,1
MS-DRG,369,MAJOR ESOPHAGEAL DISORDERS WITH CC,,,9548.1,29208.84,32
MS-DRG,37,EXTRACRANIAL PROCEDURES W MCC,,,68400.0,68400.0,1
MS-DRG,37,EXTRACRANIAL PROCEDURES WITH MCC,,,29360.08,56400.0,10
MS-DRG,37,Extracranial Procedures w/MCC,,,87208.0,97673.0,2
MS-DRG,37,Simple Orbital Procedures excludes,,,9800.0,9800.0,1
MS-DRG,370,MAJOR ESOPHAGEAL DISORDERS W/O CC/MCC,,,20600.0,20600.0,1
MS-DRG,370,MAJOR ESOPHAGEAL DISORDERS WITHOUT CC/MCC,,,6799.04,22000.0,32
MS-DRG,371,MAJOR GASTROINTESTINAL DISORDERS & PERITONEAL INFECTIONS W MCC,,,48100.0,48100.0,1
MS-DRG,371,MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH MCC,,,15830.68,51779.84,37
MS-DRG,372,MAJOR GASTROINTESTINAL DISORDERS & PERITONEAL INFECTIONS W CC,,,29900.0,29900.0,1
MS-DRG,372,MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC,,,9648.73,29816.26,37
MS-DRG,373,MAJOR GASTROINTESTINAL DISORDERS & PERITONEAL INFECTIONS W/O CC/MCC,,,21100.0,21100.0,1
MS-DRG,373,MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITHOUT CC/MCC,,,7034.72,22000.0,37
MS-DRG,374,DIGESTIVE MALIGNANCY W MCC,,,56000.0,56000.0,1
MS-DRG,374,DIGESTIVE MALIGNANCY WITH MCC,,,18956.49,62456.46,37
MS-DRG,375,DIGESTIVE MALIGNANCY W CC,,,33700.0,33700.0,1
MS-DRG,375,DIGESTIVE MALIGNANCY WITH CC,,,11363.89,35323.95,37
MS-DRG,376,DIGESTIVE MALIGNANCY W/O CC/MCC,,,23400.0,23400.0,1
MS-DRG,376,DIGESTIVE MALIGNANCY WITHOUT CC/MCC,,,8390.33,26992.33,37
MS-DRG,377,G.I. HEMORRHAGE W MCC,,,48700.0,48700.0,1
MS-DRG,377,GASTROINTESTINAL HEMORRHAGE WITH MCC,,,16434.51,53383.08,37
MS-DRG,378,G.I. HEMORRHAGE W CC,,,27200.0,27200.0,1
MS-DRG,378,GASTROINTESTINAL HEMORRHAGE WITH CC,,,9275.43,28639.38,37
MS-DRG,379,G.I. HEMORRHAGE W/O CC/MCC,,,18100.0,18100.0,1
MS-DRG,379,GASTROINTESTINAL HEMORRHAGE WITHOUT CC/MCC,,,6271.76,22000.0,37
MS-DRG,38,EXTRACRANIAL PROCEDURES W CC,,,35000.0,35000.0,1
MS-DRG,38,EXTRACRANIAL PROCEDURES WITH CC,,,14654.84,33400.0,10
MS-DRG,38,Extracranial Procedures w/CC,,,45421.0,50872.0,2
MS-DRG,380,COMPLICATED PEPTIC ULCER W MCC,,,55500.0,55500.0,1
MS-DRG,380,COMPLICATED PEPTIC ULCER WITH MCC,,,17347.13,57302.13,32
MS-DRG,381,COMPLICATED PEPTIC ULCER W CC,,,29500.0,29500.0,1
MS-DRG,381,COMPLICATED PEPTIC ULCER WITH CC,,,10163.11,31641.45,32
MS-DRG,382,COMPLICATED PEPTIC ULCER W/O CC/MCC,,,21100.0,21100.0,1
MS-DRG,382,COMPLICATED PEPTIC ULCER WITHOUT CC/MCC,,,7240.3,23379.92,37
MS-DRG,383,UNCOMPLICATED PEPTIC ULCER W MCC,,,36400.0,36400.0,1
MS-DRG,383,UNCOMPLICATED PEPTIC ULCER WITH MCC,,,11669.24,40320.58,32
MS-DRG,384,UNCOMPLICATED PEPTIC ULCER W/O MCC,,,23800.0,23800.0,1
MS-DRG,384,UNCOMPLICATED PEPTIC ULCER WITHOUT MCC,,,8275.06,24962.72,32
MS-DRG,385,INFLAMMATORY BOWEL DISEASE W MCC,,,44800.0,44800.0,1
MS-DRG,385,INFLAMMATORY BOWEL DISEASE WITH MCC,,,14770.97,46207.91,37
MS-DRG,386,INFLAMMATORY BOWEL DISEASE W CC,,,26600.0,26600.0,1
MS-DRG,386,INFLAMMATORY BOWEL DISEASE WITH CC,,,9332.2,28510.89,37
MS-DRG,387,INFLAMMATORY BOWEL DISEASE W/O CC/MCC,,,20400.0,20400.0,1
MS-DRG,387,INFLAMMATORY BOWEL DISEASE WITHOUT CC/MCC,,,6560.77,22000.0,37
MS-DRG,388,G.I. OBSTRUCTION W MCC,,,42600.0,42600.0,1
MS-DRG,388,GASTROINTESTINAL OBSTRUCTION WITH MCC,,,13438.58,43126.99,37
MS-DRG,389,G.I. OBSTRUCTION W CC,,,23600.0,23600.0,1
MS-DRG,389,GASTROINTESTINAL OBSTRUCTION WITH CC,,,7690.16,23064.53,37
MS-DRG,39,EXTRACRANIAL PROCEDURES W/O CC/MCC,,,24000.0,24000.0,1
MS-DRG,39,EXTRACRANIAL PROCEDURES WITHOUT CC/MCC,,,10585.44,26300.0,10
MS-DRG,39,Extracranial Procedures w/o CC/MCC,,,31235.0,34983.0,2
MS-DRG,39,Intermediate Retinal Procedures,,,11900.0,11900.0,1
MS-DRG,390,G.I. OBSTRUCTION W/O CC/MCC,,,16500.0,16500.0,1
MS-DRG,390,GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC,,,5501.92,22000.0,37
MS-DRG,391,"ESOPHAGITIS, GASTROENT & MISC DIGEST DISORDERS W MCC",,,32900.0,32900.0,1
MS-DRG,391,"ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC",,,11843.85,37038.16,37
MS-DRG,392,"ESOPHAGITIS, GASTROENT & MISC DIGEST DISORDERS W/O MCC",,,20400.0,20400.0,1
MS-DRG,392,"ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC",,,7506.94,22766.66,37
MS-DRG,393,OTHER DIGESTIVE SYSTEM DIAGNOSES W MCC,,,45900.0,45900.0,1
MS-DRG,393,OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC,,,15039.33,46704.36,37
MS-DRG,394,OTHER DIGESTIVE SYSTEM DIAGNOSES W CC,,,25700.0,25700.0,1
MS-DRG,394,OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC,,,8891.8,27325.25,37
MS-DRG,395,OTHER DIGESTIVE SYSTEM DIAGNOSES W/O CC/MCC,,,18100.0,18100.0,1
MS-DRG,395,OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC,,,6269.18,22000.0,37
MS-DRG,397,APPENDIX PROCEDURES WITH MCC,,,22108.1,24492.75,23
MS-DRG,397,Appendix Procedures with MCC,,,18150.0,69938.26,9
MS-DRG,398,APPENDIX PROCEDURES WITH CC,,,13811.03,15913.49,23
MS-DRG,398,Appendix Procedures without MCC/CC,,,18150.0,44201.66,9
MS-DRG,399,APPENDIX PROCEDURES WITHOUT CC/MCC,,,10461.58,33428.67,32
MS-DRG,4,Spinal Procedures,,,28700.0,28700.0,1
MS-DRG,4,"TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NECK WITHOUT MAJOR O.R. PROCEDURES",,,122335.24,136019.29,9
MS-DRG,40,PERIPH/CRANIAL NERVE & OTHER NERV SYST PROC W MCC,,,82400.0,82400.0,1
MS-DRG,40,"PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH MCC",,,33241.1,43800.0,10
MS-DRG,40,"Periph/Cranial Nerve & Other Nerve Sys Procedures
w/MCC",,,131564.0,131564.0,1
MS-DRG,40,Periph/Cranial Nerve & Other Nerve Sys Procedures w/MCC,,,117468.0,117468.0,1
MS-DRG,402,SINGLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL,,,18150.0,172700.0,34
MS-DRG,402,"Single Level Combined Anterior and Posterior Spinal
Fusion Except Cervical",,,131080.0,146810.0,2
MS-DRG,405,"PANCREAS, LIVER & SHUNT PROCEDURES W MCC",,,106500.0,106500.0,1
MS-DRG,405,"PANCREAS, LIVER AND SHUNT PROCEDURES WITH MCC",,,17927.0,159755.01,37
MS-DRG,406,"PANCREAS, LIVER & SHUNT PROCEDURES W CC",,,54400.0,54400.0,1
MS-DRG,406,"PANCREAS, LIVER AND SHUNT PROCEDURES WITH CC",,,18150.0,84694.54,37
MS-DRG,407,"PANCREAS, LIVER & SHUNT PROCEDURES W/O CC/MCC",,,39300.0,39300.0,1
MS-DRG,407,"PANCREAS, LIVER AND SHUNT PROCEDURES WITHOUT CC/MCC",,,18150.0,64818.98,37
MS-DRG,408,BILIARY TRACT PROC EXCEPT ONLY CHOLECYST W OR W/O C.D.E. W MCC,,,76100.0,76100.0,1
MS-DRG,408,BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH MCC,,,18150.0,104126.22,32
MS-DRG,409,BILIARY TRACT PROC EXCEPT ONLY CHOLECYST W OR W/O C.D.E. W CC,,,43200.0,43200.0,1
MS-DRG,409,BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITH CC,,,18150.0,70100.0,37
MS-DRG,41,PERIPH/CRANIAL NERVE & OTHER NERV SYST PROC W CC OR PERIPH NEUROSTIM,,,47200.0,47200.0,1
MS-DRG,41,"PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITH CC OR PERIPHERAL NEUROSTIMULATOR",,,20219.2,30500.0,10
MS-DRG,41,"Periph/Cranial Nerve & Other Sys Procedures w/CC or
Periph Neurostimulator",,,72554.0,72554.0,1
MS-DRG,41,Periph/Cranial Nerve & Other Sys Procedures w/CC or Periph Neurostimulator,,,64780.0,64780.0,1
MS-DRG,410,BILIARY TRACT PROC EXCEPT ONLY CHOLECYST W OR W/O C.D.E. W/O CC/MCC,,,32500.0,32500.0,1
MS-DRG,410,BILIARY TRACT PROCEDURES EXCEPT ONLY CHOLECYSTECTOMY WITH OR WITHOUT C.D.E. WITHOUT CC/MCC,,,14137.03,46365.6,32
MS-DRG,411,CHOLECYSTECTOMY W C.D.E. W MCC,,,69700.0,69700.0,1
MS-DRG,411,CHOLECYSTECTOMY WITH C.D.E. WITH MCC,,,18150.0,96466.27,32
MS-DRG,412,CHOLECYSTECTOMY W C.D.E. W CC,,,46500.0,46500.0,1
MS-DRG,412,CHOLECYSTECTOMY WITH C.D.E. WITH CC,,,18150.0,61399.31,32
MS-DRG,413,CHOLECYSTECTOMY W C.D.E. W/O CC/MCC,,,35000.0,35000.0,1
MS-DRG,413,CHOLECYSTECTOMY WITH C.D.E. WITHOUT CC/MCC,,,15095.24,48491.58,32
MS-DRG,414,CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O C.D.E. W MCC,,,68600.0,68600.0,1
MS-DRG,414,CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH MCC,,,18150.0,104038.61,32
MS-DRG,415,CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O C.D.E. W CC,,,39500.0,39500.0,1
MS-DRG,415,CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITH CC,,,17809.9,60353.84,32
MS-DRG,416,CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE W/O C.D.E. W/O CC/MCC,,,25900.0,25900.0,1
MS-DRG,416,CHOLECYSTECTOMY EXCEPT BY LAPAROSCOPE WITHOUT C.D.E. WITHOUT CC/MCC,,,12581.01,39812.45,32
MS-DRG,417,LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W MCC,,,46800.0,46800.0,1
MS-DRG,417,LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH MCC,,,18150.0,69690.04,37
MS-DRG,418,LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W CC,,,32400.0,32400.0,1
MS-DRG,418,LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC,,,15059.98,49399.79,37
MS-DRG,419,LAPAROSCOPIC CHOLECYSTECTOMY W/O C.D.E. W/O CC/MCC,,,24700.0,24700.0,1
MS-DRG,419,LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CC/MCC,,,12128.57,39885.46,37
MS-DRG,42,Intermediate Retinal Procedures,,,11900.0,11900.0,1
MS-DRG,42,PERIPH/CRANIAL NERVE & OTHER NERV SYST PROC W/O CC/MCC,,,42100.0,42100.0,1
MS-DRG,42,"PERIPHERAL, CRANIAL NERVE AND OTHER NERVOUS SYSTEM PROCEDURES WITHOUT CC/MCC",,,15913.25,31700.0,10
MS-DRG,42,"Periph/Cranial Nerve & Other Nerve Sys Procedures w/o
CC/MCC",,,60355.0,60355.0,1
MS-DRG,42,Periph/Cranial Nerve & Other Nerve Sys Procedures w/o CC/MCC,,,53888.0,53888.0,1
MS-DRG,420,HEPATOBILIARY DIAGNOSTIC PROCEDURES W MCC,,,67900.0,67900.0,1
MS-DRG,420,HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH MCC,,,18150.0,99497.54,32
MS-DRG,421,HEPATOBILIARY DIAGNOSTIC PROCEDURES W CC,,,32900.0,32900.0,1
MS-DRG,421,HEPATOBILIARY DIAGNOSTIC PROCEDURES WITH CC,,,14881.07,50740.21,32
MS-DRG,422,HEPATOBILIARY DIAGNOSTIC PROCEDURES W/O CC/MCC,,,27900.0,27900.0,1
MS-DRG,422,HEPATOBILIARY DIAGNOSTIC PROCEDURES WITHOUT CC/MCC,,,13434.28,40869.6,32
MS-DRG,423,OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES W MCC,,,87700.0,87700.0,1
MS-DRG,423,OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH MCC,,,18150.0,121280.06,37
MS-DRG,424,OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES W CC,,,46000.0,46000.0,1
MS-DRG,424,OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITH CC,,,18150.0,63893.24,32
MS-DRG,425,OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES W/O CC/MCC,,,29800.0,29800.0,1
MS-DRG,425,OTHER HEPATOBILIARY OR PANCREAS O.R. PROCEDURES WITHOUT CC/MCC,,,14091.44,43813.26,32
MS-DRG,426,MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE,,,18150.0,212047.89,30
MS-DRG,426,"Multiple Level Combined Anterior and Posterior Spinal
Fusion Except Cervical with MCC",,,393099.0,393099.0,1
MS-DRG,426,Multiple Level Combined Anterior and Posterior Spinal Fusion Except Cervical with MCC,,,350981.0,350981.0,1
MS-DRG,427,MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITH CC,,,18150.0,269394.0,34
MS-DRG,427,"Multiple Level Combined Anterior and Posterior Spinal
Fusion Except Cervical with CC",,,266535.0,266535.0,1
MS-DRG,427,Multiple Level Combined Anterior and Posterior Spinal Fusion Except Cervical with CC,,,237978.0,237978.0,1
MS-DRG,428,MULTIPLE LEVEL COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION EXCEPT CERVICAL WITHOUT CC/MCC,,,18150.0,203786.0,34
MS-DRG,428,"Multiple Level Combined Anterior and Posterior Spinal
Fusion Except Cervical without CC/MCC",,,206546.0,206546.0,1
MS-DRG,428,Multiple Level Combined Anterior and Posterior Spinal Fusion Except Cervical without CC/MCC,,,184416.0,184416.0,1
MS-DRG,429,COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITH MCC,,,18150.0,173344.7,30
MS-DRG,429,"Combined Anterior and Posterior Cervical Spinal with
MCC",,,312988.0,312988.0,1
MS-DRG,429,Combined Anterior and Posterior Cervical Spinal with MCC,,,279454.0,279454.0,1
MS-DRG,430,COMBINED ANTERIOR AND POSTERIOR CERVICAL SPINAL FUSION WITHOUT MCC,,,18150.0,228300.0,34
MS-DRG,430,"Combined Anterior and Posterior Cervical Spinal without
MCC",,,205285.0,205285.0,1
MS-DRG,430,Combined Anterior and Posterior Cervical Spinal without MCC,,,183290.0,183290.0,1
MS-DRG,432,CIRRHOSIS & ALCOHOLIC HEPATITIS W MCC,,,39700.0,39700.0,1
MS-DRG,432,CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH MCC,,,17646.47,57477.34,37
MS-DRG,433,CIRRHOSIS & ALCOHOLIC HEPATITIS W CC,,,21400.0,21400.0,1
MS-DRG,433,CIRRHOSIS AND ALCOHOLIC HEPATITIS WITH CC,,,9997.1,30844.21,37
MS-DRG,434,CIRRHOSIS & ALCOHOLIC HEPATITIS W/O CC/MCC,,,14200.0,14200.0,1
MS-DRG,434,CIRRHOSIS AND ALCOHOLIC HEPATITIS WITHOUT CC/MCC,,,4700.0,20807.14,37
MS-DRG,435,MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS W MCC,,,40200.0,40200.0,1
MS-DRG,435,MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC,,,16489.56,53637.15,37
MS-DRG,436,MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS W CC,,,26500.0,26500.0,1
MS-DRG,436,MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH CC,,,10495.13,33031.51,37
MS-DRG,437,MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS W/O CC/MCC,,,21500.0,21500.0,1
MS-DRG,437,MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITHOUT CC/MCC,,,6100.0,24918.92,37
MS-DRG,438,DISORDERS OF PANCREAS EXCEPT MALIGNANCY W MCC,,,38400.0,38400.0,1
MS-DRG,438,DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH MCC,,,15105.57,47606.73,37
MS-DRG,439,DISORDERS OF PANCREAS EXCEPT MALIGNANCY W CC,,,20100.0,20100.0,1
MS-DRG,439,DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC,,,8194.21,24565.56,37
MS-DRG,440,DISORDERS OF PANCREAS EXCEPT MALIGNANCY W/O CC/MCC,,,14600.0,14600.0,1
MS-DRG,440,DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITHOUT CC/MCC,,,6085.97,18150.0,37
MS-DRG,441,"DISORDERS OF LIVER EXCEPT MALIG,CIRR,ALC HEPA W MCC",,,43800.0,43800.0,1
MS-DRG,441,"DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH MCC",,,16954.49,71872.0,37
MS-DRG,442,"DISORDERS OF LIVER EXCEPT MALIG,CIRR,ALC HEPA W CC",,,21100.0,21100.0,1
MS-DRG,442,"DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH CC",,,9105.98,28189.66,37
MS-DRG,443,"DISORDERS OF LIVER EXCEPT MALIG,CIRR,ALC HEPA W/O CC/MCC",,,15400.0,15400.0,1
MS-DRG,443,"DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITHOUT CC/MCC",,,6839.46,20433.34,37
MS-DRG,444,DISORDERS OF THE BILIARY TRACT W MCC,,,37100.0,37100.0,1
MS-DRG,444,DISORDERS OF THE BILIARY TRACT WITH MCC,,,15283.62,48795.29,37
MS-DRG,445,DISORDERS OF THE BILIARY TRACT W CC,,,23900.0,23900.0,1
MS-DRG,445,DISORDERS OF THE BILIARY TRACT WITH CC,,,10123.54,31959.76,37
MS-DRG,446,DISORDERS OF THE BILIARY TRACT W/O CC/MCC,,,17800.0,17800.0,1
MS-DRG,446,DISORDERS OF THE BILIARY TRACT WITHOUT CC/MCC,,,7653.17,24159.64,37
MS-DRG,447,MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE,,,18150.0,140258.0,30
MS-DRG,447,Multiple Level Spinal Fusion Except Cervical with MCC,,,224643.0,251600.0,2
MS-DRG,448,MULTIPLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC,,,18150.0,132220.0,34
MS-DRG,448,"Multiple Level Spinal Fusion Except Cervical without
MCC",,,153238.0,153238.0,1
MS-DRG,448,Multiple Level Spinal Fusion Except Cervical without MCC,,,136820.0,136820.0,1
MS-DRG,450,SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITH MCC OR CUSTOM-MADE ANATOMICALLY DESIGNED INTERBODY FUSION DEVICE,,,18150.0,140258.0,30
MS-DRG,450,"Single Level Spinal Fusion Except Cervical w/MCC of
Custom-made anatomically designed interbody fusion device",,,172556.0,172556.0,1
MS-DRG,450,"Single Level Spinal Fusion Except Cervical w/MCC of Custom-made anatomically designed interbody fusion
device",,,193263.0,193263.0,1
MS-DRG,451,SINGLE LEVEL SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC,,,18150.0,108180.0,34
MS-DRG,451,Single Level Spinal Fusion Except Cervical w/o MCC,,,103397.0,115805.0,2
MS-DRG,456,SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR EXT FUS W MCC,,,221800.0,221800.0,1
MS-DRG,456,"SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH MCC",,,17927.0,212600.0,35
MS-DRG,456,Spinal fusion w/spinal curve fusion w/MCC,,,214017.0,239699.0,2
MS-DRG,457,SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR EXT FUS W CC,,,157700.0,157700.0,1
MS-DRG,457,"SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITH CC",,,20763.0,186607.0,35
MS-DRG,457,Spinal fusion w/spinal curve fusion w/CC,,,196182.0,219724.0,2
MS-DRG,458,SPINAL FUS EXC CERV W SPINAL CURV/MALIG/INFEC OR EXT FUS W/O CC/MCC,,,119400.0,119400.0,1
MS-DRG,458,"SPINAL FUSION EXCEPT CERVICAL WITH SPINAL CURVATURE, MALIGNANCY, INFECTION OR EXTENSIVE FUSIONS WITHOUT CC/MCC",,,20763.0,145800.0,35
MS-DRG,458,Spinal fusion w/spinal curve fusion w/o CC/MCC,,,153085.0,171455.0,2
MS-DRG,461,BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITH MCC,,,49949.21,71000.0,24
MS-DRG,461,BILATERAL OR MULTIPLE MAJOR JOINT PROCS OF LOWER EXTREMITY W MCC,,,114800.0,114800.0,1
MS-DRG,461,Bilateral or multiple lower extremity w/MCC,,,149992.0,167991.0,2
MS-DRG,461,Bilateral or multiple major joint procs of lower extremity w MCC,,,17927.0,116800.0,11
MS-DRG,462,BILATERAL OR MULTIPLE MAJOR JOINT PROCEDURES OF LOWER EXTREMITY WITHOUT MCC,,,24612.22,51800.0,24
MS-DRG,462,BILATERAL OR MULTIPLE MAJOR JOINT PROCS OF LOWER EXTREMITY W/O MCC,,,73300.0,73300.0,1
MS-DRG,462,Bilateral or multiple major joint procedures,,,103166.0,115546.0,2
MS-DRG,462,Bilateral or multiple major joint procs of lower extremity w/o MCC,,,17927.0,85200.0,11
MS-DRG,463,"WND DEBRID & SKN GRFT EXC HAND, FOR MUSCULO-CONN TISS DIS W MCC",,,120400.0,120400.0,1
MS-DRG,463,WND Debrid & Skin graft tissue w/MCC,,,166443.0,186416.0,2
MS-DRG,463,WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH MCC,,,23100.0,188200.0,35
MS-DRG,464,"WND DEBRID & SKN GRFT EXC HAND, FOR MUSCULO-CONN TISS DIS W CC",,,68200.0,68200.0,1
MS-DRG,464,WND Debrid & Skin graft tissue w/CC,,,89900.0,100688.0,2
MS-DRG,464,WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITH CC,,,23100.0,105500.0,35
MS-DRG,465,"WND DEBRID & SKN GRFT EXC HAND, FOR MUSCULO-CONN TISS DIS W/O CC/MCC",,,45700.0,45700.0,1
MS-DRG,465,WND Debrid & Skin graft w/o CC/MCC,,,57481.0,64379.0,2
MS-DRG,465,WOUND DEBRIDEMENT AND SKIN GRAFT EXCEPT HAND FOR MUSCULOSKELETAL AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC,,,15728.32,67300.0,35
MS-DRG,466,REVISION OF HIP OR KNEE REPLACEMENT W MCC,,,112400.0,112400.0,1
MS-DRG,466,REVISION OF HIP OR KNEE REPLACEMENT WITH MCC,,,17927.0,120500.0,35
MS-DRG,466,Revision of hip or knee replacement w/MCC,,,138922.0,155593.0,2
MS-DRG,467,REVISION OF HIP OR KNEE REPLACEMENT W CC,,,77000.0,77000.0,1
MS-DRG,467,REVISION OF HIP OR KNEE REPLACEMENT WITH CC,,,18708.0,90700.0,35
MS-DRG,467,Revision of hip or knee replacement w/CC,,,93825.0,105084.0,2
MS-DRG,468,REVISION OF HIP OR KNEE REPLACEMENT W/O CC/MCC,,,62500.0,62500.0,1
MS-DRG,468,REVISION OF HIP OR KNEE REPLACEMENT WITHOUT CC/MCC,,,18708.0,75200.0,35
MS-DRG,468,Revision of hip or knee w/o CC/MCC,,,79707.0,89272.0,2
MS-DRG,469,MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITH MCC OR TOTAL ANKLE REPLACEMENT,,,27914.97,57900.0,24
MS-DRG,469,MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W MCC,,,73500.0,73500.0,1
MS-DRG,469,"Major joint replacement or reattachment of lower extremity
w/MCC",,,93897.0,93897.0,1
MS-DRG,469,Major joint replacement or reattachment of lower extremity w MCC,,,17927.0,95100.0,12
MS-DRG,469,Major joint replacement or reattachment of lower extremity w/MCC,,,83837.0,83837.0,1
MS-DRG,470,MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC,,,17013.39,36800.0,24
MS-DRG,470,MAJOR JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY W/O MCC,,,46100.0,46100.0,1
MS-DRG,470,"Major Joint replacement or reattachment of lower extremity
w/o MCC",,,71744.0,71744.0,1
MS-DRG,470,Major Joint replacement or reattachment of lower extremity w/o MCC,,,64057.0,64057.0,1
MS-DRG,470,Major joint replacement or reattachment of lower extremity w/o MCC,,,17927.0,60600.0,12
MS-DRG,471,CERVICAL SPINAL FUSION W MCC,,,107700.0,107700.0,1
MS-DRG,471,CERVICAL SPINAL FUSION WITH MCC,,,17927.0,125500.0,35
MS-DRG,471,Cervical spinal fusion w/MCC,,,136138.0,152475.0,2
MS-DRG,471A,Bilateral Total Hip Replacement  Proc. of Lower Extremitv,,,43800.0,43800.0,1
MS-DRG,471B,Bilateral Total Knee Replacement Proc. of Low Extr,,,36700.0,36700.0,1
MS-DRG,472,CERVICAL SPINAL FUSION W CC,,,64400.0,64400.0,1
MS-DRG,472,CERVICAL SPINAL FUSION WITH CC,,,17927.0,102300.0,35
MS-DRG,472,Cervical spinal fusion w/CC,,,85727.0,96014.0,2
MS-DRG,473,CERVICAL SPINAL FUSION W/O CC/MCC,,,51400.0,51400.0,1
MS-DRG,473,CERVICAL SPINAL FUSION WITHOUT CC/MCC,,,17927.0,83000.0,35
MS-DRG,473,Cervical spinal fusion w/o CC/MCC,,,64977.0,72774.0,2
MS-DRG,474,AMPUTATION FOR MUSCULOSKELETAL SYS & CONN TISSUE DIS W MCC,,,83800.0,83800.0,1
MS-DRG,474,AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH MCC,,,23100.0,82595.4,30
MS-DRG,474,Amputation for Muscular Sys Tissue Dis w/MCC,,,109069.0,122157.0,2
MS-DRG,475,AMPUTATION FOR MUSCULOSKELETAL SYS & CONN TISSUE DIS W CC,,,46400.0,46400.0,1
MS-DRG,475,AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITH CC,,,19351.3,57400.0,35
MS-DRG,475,Amputation for Muscular Sys Tissue Dis w/CC,,,23192.0,25975.0,2
MS-DRG,476,AMPUTATION FOR MUSCULOSKELETAL SYS & CONN TISSUE DIS W/O CC/MCC,,,24100.0,24100.0,1
MS-DRG,476,AMPUTATION FOR MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC,,,10799.62,23272.0,30
MS-DRG,476,Amputation for Muscular Sys Tissue Dis w/o CC/MCC,,,31098.0,34830.0,2
MS-DRG,477,BIOPSIES OF MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W MCC,,,68000.0,68000.0,1
MS-DRG,477,BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC,,,23100.0,66466.5,30
MS-DRG,477,Biopsies of Muscular Tissue w/MCC,,,39653.0,44411.0,2
MS-DRG,478,BIOPSIES OF MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W CC,,,50100.0,50100.0,1
MS-DRG,478,BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC,,,20910.76,60800.0,35
MS-DRG,478,Biopsies of Muscular Tissue w/CC,,,69286.0,77600.0,2
MS-DRG,479,BIOPSIES OF MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W/O CC/MCC,,,39100.0,39100.0,1
MS-DRG,479,BIOPSIES OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC,,,16069.8,42700.0,35
MS-DRG,479,Biopsies of Muscular Tissue w/o CC/MCC,,,51735.0,57943.0,2
MS-DRG,480,HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT W MCC,,,67200.0,67200.0,1
MS-DRG,480,HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC,,,23100.0,85900.0,35
MS-DRG,480,Hip & femur procedures except major joint w/MCC,,,92838.0,103979.0,2
MS-DRG,481,HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT W CC,,,44800.0,44800.0,1
MS-DRG,481,HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC,,,17927.0,67000.0,35
MS-DRG,481,Hip & femur procedures except major joint w/CC,,,59140.0,66237.0,2
MS-DRG,482,HIP & FEMUR PROCEDURES EXCEPT MAJOR JOINT W/O CC/MCC,,,36600.0,36600.0,1
MS-DRG,482,HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC,,,14440.67,47500.0,35
MS-DRG,482,Hip & femur procedures except major joint w/o CC/MCC,,,47878.0,53623.0,2
MS-DRG,483,MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES,,,22713.65,37800.0,24
MS-DRG,483,MAJOR JOINT/LIMB REATTACHMENT PROCEDURE OF UPPER EXTREMITIES,,,17927.0,62100.0,12
MS-DRG,483,"Major joint & limb reattachment upper extremity
w/CC/MCC",,,86679.0,86679.0,1
MS-DRG,483,Major joint & limb reattachment upper extremity w/CC/MCC,,,77392.0,77392.0,1
MS-DRG,485,KNEE PROCEDURES W PDX OF INFECTION W MCC,,,68200.0,68200.0,1
MS-DRG,485,KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH MCC,,,17927.0,140400.0,35
MS-DRG,485,Knee procedures w/PDX of Infection w/MCC,,,93499.0,104719.0,2
MS-DRG,486,KNEE PROCEDURES W PDX OF INFECTION W CC,,,46100.0,46100.0,1
MS-DRG,486,KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITH CC,,,17927.0,77200.0,35
MS-DRG,486,Knee procedures w/PDX of Infection w/ CC,,,63616.0,71250.0,2
MS-DRG,487,KNEE PROCEDURES W PDX OF INFECTION W/O CC/MCC,,,34500.0,34500.0,1
MS-DRG,487,KNEE PROCEDURES WITH PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC,,,14387.34,33305.0,30
MS-DRG,487,Knee procedures w/PDX of Infection w/o CC/MCC,,,45440.0,50893.0,2
MS-DRG,488,KNEE PROCEDURES W/O PDX OF INFECTION W CC/MCC,,,39200.0,39200.0,1
MS-DRG,488,KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITH CC/MCC,,,16726.16,45100.0,34
MS-DRG,488,Knee procedures w/o pdx of infection w/CC/MCC,,,51559.0,57746.0,2
MS-DRG,489,KNEE PROCEDURES W/O PDX OF INFECTION W/O CC/MCC,,,28800.0,28800.0,1
MS-DRG,489,KNEE PROCEDURES WITHOUT PRINCIPAL DIAGNOSIS OF INFECTION WITHOUT CC/MCC,,,10955.21,40900.0,34
MS-DRG,489,Knee procedures w/o PDX of Infection w/o CC/MCC,,,35249.0,39479.0,2
MS-DRG,492,"LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR W MCC",,,71900.0,71900.0,1
MS-DRG,492,"LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH MCC",,,17927.0,70641.58,30
MS-DRG,492,"Lower extremity & humerous procedure except hip, foot,
femur w/MCC",,,106279.0,106279.0,1
MS-DRG,492,"Lower extremity & humerous procedure except hip, foot, femur w/MCC",,,94892.0,94892.0,1
MS-DRG,493,"LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR W CC",,,47800.0,47800.0,1
MS-DRG,493,"LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC",,,17927.0,50500.0,34
MS-DRG,493,"Lower extremity & hemur procedure except hip, foot,
femur w/CC",,,66117.0,66117.0,1
MS-DRG,493,"Lower extremity & hemur procedure except hip, foot, femur w/CC",,,59033.0,59033.0,1
MS-DRG,494,"LOWER EXTREM & HUMER PROC EXCEPT HIP,FOOT,FEMUR W/O CC/MCC",,,36600.0,36600.0,1
MS-DRG,494,"LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT CC/MCC",,,17012.53,37500.0,34
MS-DRG,494,"Lower extremity & humer procedure except hip, foot,
femur w/o CC/MCC",,,55559.0,55559.0,1
MS-DRG,494,"Lower extremity & humer procedure except hip, foot, femur w/o CC/MCC",,,49606.0,49606.0,1
MS-DRG,495,LOCAL EXCISION & REMOVAL INT FIX DEVICES EXC HIP & FEMUR W MCC,,,68800.0,68800.0,1
MS-DRG,495,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH MCC,,,23100.0,98000.0,34
MS-DRG,495,"Local excision & removal int fix devices hip & femur
w/MCC",,,102644.0,102644.0,1
MS-DRG,495,Local excision & removal int fix devices hip & femur w/MCC,,,91646.0,91646.0,1
MS-DRG,496,LOCAL EXCISION & REMOVAL INT FIX DEVICES EXC HIP & FEMUR W CC,,,40100.0,40100.0,1
MS-DRG,496,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITH CC,,,17035.91,64200.0,34
MS-DRG,496,"Local excision & removal int fix devices hip & femur
w/CC",,,55832.0,55832.0,1
MS-DRG,496,Local excision & removal int fix devices hip & femur w/CC,,,49850.0,49850.0,1
MS-DRG,497,LOCAL EXCISION & REMOVAL INT FIX DEVICES EXC HIP & FEMUR W/O CC/MCC,,,28400.0,28400.0,1
MS-DRG,497,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES EXCEPT HIP AND FEMUR WITHOUT CC/MCC,,,11764.97,44600.0,34
MS-DRG,497,"Local excision & removal int fix devices hip & femur w/o
CC/MCC",,,38358.0,38358.0,1
MS-DRG,497,Local excision & removal int fix devices hip & femur w/o CC/MCC,,,34248.0,34248.0,1
MS-DRG,498,LOCAL EXCISION & REMOVAL INT FIX DEVICES OF HIP & FEMUR W CC/MCC,,,52900.0,52900.0,1
MS-DRG,498,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITH CC/MCC,,,22513.23,58043.23,30
MS-DRG,498,"Local excision & removal int fix devices hip & femur
w/CC/MCC",,,72947.0,72947.0,1
MS-DRG,498,Local excision & removal int fix devices hip & femur w/CC/MCC,,,65131.0,65131.0,1
MS-DRG,499,LOCAL EXCISION & REMOVAL INT FIX DEVICES OF HIP & FEMUR W/O CC/MCC,,,25400.0,25400.0,1
MS-DRG,499,LOCAL EXCISION AND REMOVAL OF INTERNAL FIXATION DEVICES OF HIP AND FEMUR WITHOUT CC/MCC,,,10779.84,36625.03,30
MS-DRG,499,"Local excision & removal int fix devices hip & femur w/o
CC/MCC",,,34605.0,34605.0,1
MS-DRG,499,Local excision & removal int fix devices hip & femur w/o CC/MCC,,,30897.0,30897.0,1
MS-DRG,5,Carotid Endarterectomy,,,27200.0,27200.0,1
MS-DRG,5,LIVER TRANSPLANT WITH MCC OR INTESTINAL TRANSPLANT,,,92317.64,101549.4,9
MS-DRG,500,SOFT TISSUE PROCEDURES W MCC,,,69800.0,69800.0,1
MS-DRG,500,SOFT TISSUE PROCEDURES WITH MCC,,,23100.0,60890.75,34
MS-DRG,500,Soft tissue procedures w/MCC,,,73757.0,82608.0,2
MS-DRG,501,Knee Procedures W/CC/Excludina,,,30000.0,30000.0,1
MS-DRG,501,SOFT TISSUE PROCEDURES W CC,,,36600.0,36600.0,1
MS-DRG,501,SOFT TISSUE PROCEDURES WITH CC,,,16146.36,51600.0,34
MS-DRG,501,Soft tissue procedures w/CC,,,48732.0,54580.0,2
MS-DRG,502,Anterior Cruciate Ligament Repair/Augmentation or Reconstruction,,,30000.0,30000.0,1
MS-DRG,502,SOFT TISSUE PROCEDURES W/O CC/MCC,,,26900.0,26900.0,1
MS-DRG,502,SOFT TISSUE PROCEDURES WITHOUT CC/MCC,,,12813.25,38100.0,34
MS-DRG,502,Soft tissue procedure,,,32621.0,36536.0,2
MS-DRG,503,Anterior Cruciate Ligament Repair/Augmentation or Reconstruction,,,30000.0,30000.0,1
MS-DRG,503,FOOT PROCEDURES W MCC,,,54000.0,54000.0,1
MS-DRG,503,FOOT PROCEDURES WITH MCC,,,23100.0,53700.76,30
MS-DRG,503,Foot procedures w/MCC,,,70334.0,78774.0,2
MS-DRG,504,FOOT PROCEDURES W CC,,,35100.0,35100.0,1
MS-DRG,504,FOOT PROCEDURES WITH CC,,,15890.89,33978.32,30
MS-DRG,504,Foot procedures w/CC,,,47817.0,53555.0,2
MS-DRG,505,FOOT PROCEDURES W/O CC/MCC,,,29300.0,29300.0,1
MS-DRG,505,FOOT PROCEDURES WITHOUT CC/MCC,,,15890.89,34400.0,34
MS-DRG,505,Foot procedures w/o CC/MCC,,,35090.0,39301.0,2
MS-DRG,506,MAJOR THUMB OR JOINT PROCEDURES,,,13011.9,29500.0,24
MS-DRG,506,Major Thumb or joint procedures,,,39749.0,44519.0,2
MS-DRG,506,Major thumb or joint procedures,,,20846.49,28517.0,7
MS-DRG,507,MAJOR SHOULDER OR ELBOW JOINT PROCEDURES W CC/MCC,,,43700.0,43700.0,1
MS-DRG,507,MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITH CC/MCC,,,17058.03,42185.0,30
MS-DRG,507,Major Shoulder or elbow joint procedures w/CC/MCC,,,57133.0,63989.0,2
MS-DRG,508,MAJOR SHOULDER OR ELBOW JOINT PROCEDURES W/O CC/MCC,,,37800.0,37800.0,1
MS-DRG,508,MAJOR SHOULDER OR ELBOW JOINT PROCEDURES WITHOUT CC/MCC,,,11896.32,36407.0,30
MS-DRG,508,Major Shoulder or elbow joint procedures w/o CC/MCC,,,36901.0,41329.0,2
MS-DRG,510,"SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH MCC",,,25379.27,30582.84,23
MS-DRG,510,"SHOULDER,ELBOW OR FOREARM PROC,EXC MAJOR JOINT PROC W MCC",,,54800.0,54800.0,1
MS-DRG,510,"Shoulder, elbow or forearm procedure w/MCC",,,70205.0,78630.0,2
MS-DRG,510,"Shoulder,elbow or forearm proc,exc major joint proc w MCC",,,23100.0,58114.42,7
MS-DRG,511,"SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITH CC",,,17664.53,21421.43,23
MS-DRG,511,"SHOULDER,ELBOW OR FOREARM PROC,EXC MAJOR JOINT PROC W CC",,,39200.0,39200.0,1
MS-DRG,511,"Shoulder, elbow or forearm procedure w/CC",,,46538.0,52123.0,2
MS-DRG,511,"Shoulder,elbow or forearm proc,exc major joint proc w CC",,,23100.0,37875.0,7
MS-DRG,512,"SHOULDER, ELBOW OR FOREARM PROCEDURES, EXCEPT MAJOR JOINT PROCEDURES WITHOUT CC/MCC",,,14624.74,20900.0,24
MS-DRG,512,"SHOULDER,ELBOW OR FOREARM PROC,EXC MAJOR JOINT PROC W/O CC/MCC",,,31900.0,31900.0,1
MS-DRG,512,"Shoulder, elbow or forearm procedure w/o CC/MCC",,,34244.0,38353.0,2
MS-DRG,512,"Shoulder,elbow or forearm proc,exc major joint proc w/o CC/MCC",,,23100.0,34500.0,11
MS-DRG,513,"HAND OR WRIST PROC, EXCEPT MAJOR THUMB OR JOINT PROC W CC/MCC",,,33500.0,33500.0,1
MS-DRG,513,"HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITH CC/MCC",,,13745.66,32425.0,30
MS-DRG,513,"Hand or wrist procedure except major thumb/joint
w/CC/MCC",,,45914.0,45914.0,1
MS-DRG,513,Hand or wrist procedure except major thumb/joint w/CC/MCC,,,40995.0,40995.0,1
MS-DRG,514,Cardiac Defibrillator Implant w/ Gath,,,81100.0,81100.0,1
MS-DRG,514,"HAND OR WRIST PROC, EXCEPT MAJOR THUMB OR JOINT PROC W/O CC/MCC",,,21700.0,21700.0,1
MS-DRG,514,"HAND OR WRIST PROCEDURES, EXCEPT MAJOR THUMB OR JOINT PROCEDURES WITHOUT CC/MCC",,,9565.3,23100.0,30
MS-DRG,514,"Hand or wrist procedure except major thumb/joint w/o
CC/MCC",,,29634.0,29634.0,1
MS-DRG,514,Hand or wrist procedure except major thumb/joint w/o CC/MCC,,,26459.0,26459.0,1
MS-DRG,515,Cardiac Defibrillator Implant w/o Cath,,,64500.0,64500.0,1
MS-DRG,515,OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W MCC,,,70100.0,70100.0,1
MS-DRG,515,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH MCC,,,23100.0,97000.0,35
MS-DRG,515,Other Muscul Sys & Conn tissue procedure w/MCC,,,100371.0,112416.0,2
MS-DRG,516,Cardiovascular Procedure w/ AMI,,,22900.0,22900.0,1
MS-DRG,516,OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W CC,,,46400.0,46400.0,1
MS-DRG,516,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC,,,18098.91,54500.0,35
MS-DRG,516,Other Muscul Sys & tissue procedure w/o CC/MCC,,,60362.0,67605.0,2
MS-DRG,517,OTHER MUSCULOSKELET SYS & CONN TISS O.R. PROC W/O CC/MCC,,,40100.0,40100.0,1
MS-DRG,517,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITHOUT CC/MCC,,,13634.7,49400.0,35
MS-DRG,517,"Other musculoskeletal sys & connective tissue or procedure
w/o CC/MCC",,,53986.0,53986.0,1
MS-DRG,517,Other musculoskeletal sys & connective tissue or procedure w/o CC/MCC,,,48202.0,48202.0,1
MS-DRG,517C,Cardiovascular Procedure w/ Stent w/oAMI,,,16600.0,16600.0,1
MS-DRG,518,BACK & NECK PROC EXC SPINAL FUSION W MCC OR DISC DEVICE/NEUROSTIM,,,64700.0,64700.0,1
MS-DRG,518,BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH MCC OR DISC DEVICE OR NEUROSTIMULATOR,,,23100.0,109140.37,32
MS-DRG,518,Cardiovascular Procedure w/o Stent w/o AMI,,,15600.0,15600.0,1
MS-DRG,519,BACK & NECK PROC EXC SPINAL FUSION W CC,,,38400.0,38400.0,1
MS-DRG,519,BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH CC,,,17756.57,58411.84,32
MS-DRG,519,Cervical Spinal Fusion w/CC,,,37400.0,37400.0,1
MS-DRG,52,SPINAL DISORDERS & INJURIES W CC/MCC,,,61300.0,61300.0,1
MS-DRG,52,SPINAL DISORDERS AND INJURIES WITH CC/MCC,,,17101.4,18811.54,9
MS-DRG,52,Spinal Disorders & Injuries w/CC/MCC,,,45263.0,50695.0,2
MS-DRG,520,BACK & NECK PROC EXC SPINAL FUSION W/O CC/MCC,,,27600.0,27600.0,1
MS-DRG,520,BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITHOUT CC/MCC,,,10743.0,43626.36,32
MS-DRG,520,Cervical Spinal Fusion without CC,,,28600.0,28600.0,1
MS-DRG,521,HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC,,,17927.0,83818.45,32
MS-DRG,522,HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC,,,17927.0,61843.19,32
MS-DRG,53,SPINAL DISORDERS & INJURIES W/O CC/MCC,,,33300.0,33300.0,1
MS-DRG,53,SPINAL DISORDERS AND INJURIES WITHOUT CC/MCC,,,8720.63,10711.23,9
MS-DRG,53,Spinal Disorders & Injuries w/o CC/MCC,,,27470.0,30766.0,2
MS-DRG,533,FRACTURES OF FEMUR W MCC,,,38400.0,38400.0,1
MS-DRG,533,FRACTURES OF FEMUR WITH MCC,,,13911.67,30162.55,30
MS-DRG,533,Fractures of femur w/MCC,,,45016.0,50418.0,2
MS-DRG,534,FRACTURES OF FEMUR W/O MCC,,,21400.0,21400.0,1
MS-DRG,534,FRACTURES OF FEMUR WITHOUT MCC,,,7796.82,23100.0,35
MS-DRG,534,Fractures of femur w/o MCC,,,22519.0,25221.0,2
MS-DRG,535,FRACTURES OF HIP & PELVIS W MCC,,,33500.0,33500.0,1
MS-DRG,535,FRACTURES OF HIP AND PELVIS WITH MCC,,,12234.36,24665.68,30
MS-DRG,535,Fractures of hip & pelvis w/MCC,,,39101.0,43793.0,2
MS-DRG,536,FRACTURES OF HIP & PELVIS W/O MCC,,,20400.0,20400.0,1
MS-DRG,536,FRACTURES OF HIP AND PELVIS WITHOUT MCC,,,7770.15,23100.0,30
MS-DRG,536,Fractures of hip & pelvis w/o MCC,,,21847.0,24469.0,2
MS-DRG,537,"SPRAINS, STRAINS, & DISLOCATIONS OF HIP, PELVIS & THIGH W CC/MCC",,,25900.0,25900.0,1
MS-DRG,537,"SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITH CC/MCC",,,8699.98,23100.0,30
MS-DRG,537,"Sprains, strains & dislocations of hip, pelvis & thigh
w/CC/MCC",,,29576.0,29576.0,1
MS-DRG,537,"Sprains, strains & dislocations of hip, pelvis & thigh w/CC/MCC",,,26407.0,26407.0,1
MS-DRG,538,"SPRAINS, STRAINS, & DISLOCATIONS OF HIP, PELVIS & THIGH W/O CC/MCC",,,19800.0,19800.0,1
MS-DRG,538,"SPRAINS, STRAINS, AND DISLOCATIONS OF HIP, PELVIS AND THIGH WITHOUT CC/MCC",,,6571.09,23100.0,30
MS-DRG,538,"Sprains, strains & dislocations of hip, pelvis & thigh w/o
CC/MCC",,,21930.0,21930.0,1
MS-DRG,538,"Sprains, strains & dislocations of hip, pelvis & thigh w/o CC/MCC",,,19580.0,19580.0,1
MS-DRG,539,OSTEOMYELITIS W MCC,,,54500.0,54500.0,1
MS-DRG,539,OSTEOMYELITIS WITH MCC,,,18190.95,63600.0,35
MS-DRG,539,Osteomyelitis w/MCC,,,61091.0,68422.0,2
MS-DRG,54,NERVOUS SYSTEM NEOPLASMS W MCC,,,51500.0,51500.0,1
MS-DRG,54,NERVOUS SYSTEM NEOPLASMS WITH MCC,,,13689.75,19400.0,10
MS-DRG,54,Nervous System Neoplasm w/MCC,,,42400.0,47488.0,2
MS-DRG,540,OSTEOMYELITIS W CC,,,37100.0,37100.0,1
MS-DRG,540,OSTEOMYELITIS WITH CC,,,11926.43,24940.81,35
MS-DRG,540,Osteomyelitis w/CC,,,27264.0,30536.0,2
MS-DRG,541,OSTEOMYELITIS W/O CC/MCC,,,27200.0,27200.0,1
MS-DRG,541,OSTEOMYELITIS WITHOUT CC/MCC,,,8040.08,23100.0,30
MS-DRG,541,Osteomyelitis w/o CC/MCC,,,29869.0,33453.0,2
MS-DRG,542,PATHOLOGICAL FRACTURES & MUSCULOSKELET & CONN TISS MALIG W MCC,,,52000.0,52000.0,1
MS-DRG,542,PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH MCC,,,16704.93,43500.0,35
MS-DRG,542,Pathological Fractures & Muscul Malig w/MCC,,,62041.0,69486.0,2
MS-DRG,543,PATHOLOGICAL FRACTURES & MUSCULOSKELET & CONN TISS MALIG W CC,,,31100.0,31100.0,1
MS-DRG,543,PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH CC,,,9920.54,35600.0,35
MS-DRG,543,Pathological Fractures & Muscul Malig w/CC,,,17992.0,20151.0,2
MS-DRG,544,PATHOLOGICAL FRACTURES & MUSCULOSKELET & CONN TISS MALIG W/O CC/MCC,,,21800.0,21800.0,1
MS-DRG,544,PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITHOUT CC/MCC,,,7295.35,23800.0,35
MS-DRG,544,Pathological Fractures & Muscul Malig w/o CC/MCC,,,24496.0,27436.0,2
MS-DRG,545,CONNECTIVE TISSUE DISORDERS W MCC,,,69000.0,69000.0,1
MS-DRG,545,CONNECTIVE TISSUE DISORDERS WITH MCC,,,22530.44,52500.0,35
MS-DRG,545,Connective tissue disorders w/MCC,,,75770.0,84862.0,2
MS-DRG,546,CONNECTIVE TISSUE DISORDERS W CC,,,32000.0,32000.0,1
MS-DRG,546,CONNECTIVE TISSUE DISORDERS WITH CC,,,10753.18,31800.0,35
MS-DRG,546,Connective tissue disorders w/CC,,,35973.0,40290.0,2
MS-DRG,547,CONNECTIVE TISSUE DISORDERS W/O CC/MCC,,,22500.0,22500.0,1
MS-DRG,547,CONNECTIVE TISSUE DISORDERS WITHOUT CC/MCC,,,7213.63,23100.0,35
MS-DRG,547,Connective tissue disorders w/o CC/MCC,,,23176.0,25957.0,2
MS-DRG,548,SEPTIC ARTHRITIS W MCC,,,52100.0,52100.0,1
MS-DRG,548,SEPTIC ARTHRITIS WITH MCC,,,18123.85,37150.52,30
MS-DRG,548,Septic Arthritis w/MCC,,,53394.0,59801.0,2
MS-DRG,549,SEPTIC ARTHRITIS W CC,,,32500.0,32500.0,1
MS-DRG,549,SEPTIC ARTHRITIS WITH CC,,,11160.89,23226.53,30
MS-DRG,549,Septic Arthritis w/CC,,,35717.0,40003.0,2
MS-DRG,55,NERVOUS SYSTEM NEOPLASMS W/O MCC,,,39700.0,39700.0,1
MS-DRG,55,NERVOUS SYSTEM NEOPLASMS WITHOUT MCC,,,10095.01,15600.0,10
MS-DRG,55,Nervous System Neoplasm w/o MCC,,,31846.0,35668.0,2
MS-DRG,550,SEPTIC ARTHRITIS W/O CC/MCC,,,24600.0,24600.0,1
MS-DRG,550,SEPTIC ARTHRITIS WITHOUT CC/MCC,,,8210.55,23100.0,30
MS-DRG,550,Septic Arthritis w/o CC/MCC,,,23610.0,26443.0,2
MS-DRG,551,MEDICAL BACK PROBLEMS W MCC,,,43900.0,43900.0,1
MS-DRG,551,MEDICAL BACK PROBLEMS WITH MCC,,,15472.85,32248.16,35
MS-DRG,551,Medical back problems w/MCC,,,49970.0,55966.0,2
MS-DRG,552,MEDICAL BACK PROBLEMS W/O MCC,,,24600.0,24600.0,1
MS-DRG,552,MEDICAL BACK PROBLEMS WITHOUT MCC,,,9085.33,23100.0,35
MS-DRG,552,Medical back problems w/o MCC,,,26087.0,29217.0,2
MS-DRG,553,BONE DISEASES & ARTHROPATHIES W MCC,,,33900.0,33900.0,1
MS-DRG,553,BONE DISEASES AND ARTHROPATHIES WITH MCC,,,12028.79,24940.81,35
MS-DRG,553,Bone diseases & Arthropathies w/MCC,,,36954.0,41388.0,2
MS-DRG,554,BONE DISEASES & ARTHROPATHIES W/O MCC,,,20500.0,20500.0,1
MS-DRG,554,BONE DISEASES AND ARTHROPATHIES WITHOUT MCC,,,7300.0,23100.0,35
MS-DRG,554,Bone diseases & Arthropathies w/o MCC,,,10328.0,11567.0,2
MS-DRG,555,SIGNS & SYMPTOMS OF MUSCULOSKELETAL SYSTEM & CONN TISSUE W MCC,,,35700.0,35700.0,1
MS-DRG,555,SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC,,,12378.01,25431.43,30
MS-DRG,555,Signs & Symptoms of Muscul Tissue w/MCC,,,37753.0,42283.0,2
MS-DRG,556,SIGNS & SYMPTOMS OF MUSCULOSKELETAL SYSTEM & CONN TISSUE W/O MCC,,,21000.0,21000.0,1
MS-DRG,556,SIGNS AND SYMPTOMS OF MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT MCC,,,7818.32,23100.0,35
MS-DRG,556,Signs & Symptoms of Muscul Tissue w/o MCC,,,21519.0,24101.0,2
MS-DRG,557,"TENDONITIS, MYOSITIS & BURSITIS W MCC",,,38600.0,38600.0,1
MS-DRG,557,"TENDONITIS, MYOSITIS AND BURSITIS WITH MCC",,,14124.99,30400.0,35
MS-DRG,557,"Tendonitis, Myositis & Bursitis w/MCC",,,47731.0,53459.0,2
MS-DRG,558,"TENDONITIS, MYOSITIS & BURSITIS W/O MCC",,,23600.0,23600.0,1
MS-DRG,558,"TENDONITIS, MYOSITIS AND BURSITIS WITHOUT MCC",,,7600.0,23100.0,35
MS-DRG,558,"Tendonitis, Myositis & Bursitis w/o MCC",,,26273.0,29426.0,2
MS-DRG,559,"AFTERCARE, MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W MCC",,,52500.0,52500.0,1
MS-DRG,559,"AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH MCC",,,16762.23,35880.68,30
MS-DRG,559,"Aftercare, Muscul Sys & Connective tissue w/MCC",,,57297.0,64173.0,2
MS-DRG,56,DEGENERATIVE NERVOUS SYSTEM DISORDERS W MCC,,,71700.0,71700.0,1
MS-DRG,56,DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC,,,21630.73,25100.0,10
MS-DRG,56,Degen Nervous System Disorder w/MCC,,,52219.0,58485.0,2
MS-DRG,560,"AFTERCARE, MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W CC",,,30100.0,30100.0,1
MS-DRG,560,"AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITH CC",,,10589.75,23100.0,30
MS-DRG,560,"Aftercare, Muscul Sys & Connective tissue w/CC",,,31490.0,35269.0,2
MS-DRG,561,"AFTERCARE, MUSCULOSKELETAL SYSTEM & CONNECTIVE TISSUE W/O CC/MCC",,,20800.0,20800.0,1
MS-DRG,561,"AFTERCARE, MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE WITHOUT CC/MCC",,,7827.78,23100.0,35
MS-DRG,561,"Aftercare, Muscul Sys & Connective tissue w/o CC/MCC",,,18694.0,20937.0,2
MS-DRG,562,"FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITH MCC",,,13383.53,15049.05,23
MS-DRG,562,"FX, SPRN, STRN & DISL EXCEPT FEMUR, HIP, PELVIS & THIGH W MCC",,,37200.0,37200.0,1
MS-DRG,562,"FX, sprain, strain & disl except femur, hip, pelvis & thigh
w/MCC",,,47898.0,47898.0,1
MS-DRG,562,"FX, sprain, strain & disl except femur, hip, pelvis & thigh w/MCC",,,42766.0,42766.0,1
MS-DRG,562,"Fx, sprn, strn & disl except femur, hip, pelvis & thigh w MCC",,,20718.02,27413.15,7
MS-DRG,563,"FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITHOUT MCC",,,6600.0,9896.43,24
MS-DRG,563,"FX, SPRN, STRN & DISL EXCEPT FEMUR, HIP, PELVIS & THIGH W/O MCC",,,22400.0,22400.0,1
MS-DRG,563,"FX, sprain, strain & disl except femur, hip, pelvis & thigh
w/o MCC",,,25554.0,25554.0,1
MS-DRG,563,"FX, sprain, strain & disl except femur, hip, pelvis & thigh w/o MCC",,,22816.0,22816.0,1
MS-DRG,563,"Fx, sprn, strn & disl except femur, hip, pelvis & thigh w/o MCC",,,10900.0,23100.0,11
MS-DRG,564,OTHER MUSCULOSKELETAL SYS & CONNECTIVE TISSUE DIAGNOSES W MCC,,,44700.0,44700.0,1
MS-DRG,564,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH MCC,,,14292.72,29698.86,30
MS-DRG,564,Other Muscul sys & connective tissue diagnoses w/MCC,,,44202.0,49506.0,2
MS-DRG,565,OTHER MUSCULOSKELETAL SYS & CONNECTIVE TISSUE DIAGNOSES W CC,,,27200.0,27200.0,1
MS-DRG,565,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITH CC,,,9566.16,23100.0,35
MS-DRG,565,Other Muscul sys & connective tissue diagnoses w/CC,,,28697.0,32141.0,2
MS-DRG,566,OTHER MUSCULOSKELETAL SYS & CONNECTIVE TISSUE DIAGNOSES W/O CC/MCC,,,20400.0,20400.0,1
MS-DRG,566,OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE DIAGNOSES WITHOUT CC/MCC,,,6100.0,23100.0,35
MS-DRG,566,"Other Muscul sys & connective tissue diagnoses w/o
CC/MCC",,,23236.0,23236.0,1
MS-DRG,566,Other Muscul sys & connective tissue diagnoses w/o CC/MCC,,,20746.0,20746.0,1
MS-DRG,57,DEGENERATIVE NERVOUS SYSTEM DISORDERS W/O MCC,,,43300.0,43300.0,1
MS-DRG,57,DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC,,,9000.0,13791.31,10
MS-DRG,57,Degen Nervous System Disorders w/o MCC,,,29400.0,32928.0,2
MS-DRG,570,SKIN DEBRIDEMENT W MCC,,,96100.0,96100.0,1
MS-DRG,570,SKIN DEBRIDEMENT WITH MCC,,,18150.0,85888.94,32
MS-DRG,571,SKIN DEBRIDEMENT W CC,,,58400.0,58400.0,1
MS-DRG,571,SKIN DEBRIDEMENT WITH CC,,,15196.74,49338.47,32
MS-DRG,572,SKIN DEBRIDEMENT W/O CC/MCC,,,42600.0,42600.0,1
MS-DRG,572,SKIN DEBRIDEMENT WITHOUT CC/MCC,,,10621.57,33475.4,32
MS-DRG,573,SKIN GRAFT FOR SKIN ULCER OR CELLULITIS W MCC,,,149400.0,149400.0,1
MS-DRG,573,SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH MCC,,,18150.0,191320.53,32
MS-DRG,574,SKIN GRAFT FOR SKIN ULCER OR CELLULITIS W CC,,,115800.0,115800.0,1
MS-DRG,574,SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITH CC,,,18150.0,101375.29,32
MS-DRG,575,SKIN GRAFT FOR SKIN ULCER OR CELLULITIS W/O CC/MCC,,,59900.0,59900.0,1
MS-DRG,575,SKIN GRAFT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC,,,16974.84,52477.79,32
MS-DRG,576,SKIN GRAFT EXC FOR SKIN ULCER OR CELLULITIS W MCC,,,175100.0,175100.0,1
MS-DRG,576,SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH MCC,,,18150.0,143129.74,32
MS-DRG,577,SKIN GRAFT EXC FOR SKIN ULCER OR CELLULITIS W CC,,,92700.0,92700.0,1
MS-DRG,577,SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITH CC,,,18150.0,77408.39,32
MS-DRG,578,SKIN GRAFT EXC FOR SKIN ULCER OR CELLULITIS W/O CC/MCC,,,56100.0,56100.0,1
MS-DRG,578,SKIN GRAFT EXCEPT FOR SKIN ULCER OR CELLULITIS WITHOUT CC/MCC,,,15288.07,46911.7,32
MS-DRG,579,"OTHER SKIN, SUBCUT TISS & BREAST PROC W MCC",,,110300.0,110300.0,1
MS-DRG,579,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH MCC",,,18150.0,94573.92,32
MS-DRG,58,MULTIPLE SCLEROSIS & CEREBELLAR ATAXIA W MCC,,,65200.0,65200.0,1
MS-DRG,58,MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH MCC,,,16200.49,17820.54,9
MS-DRG,58,Multiple Schlerosis & Cerebellar w/MCC,,,50027.0,56030.0,2
MS-DRG,580,"OTHER SKIN, SUBCUT TISS & BREAST PROC W CC",,,66800.0,66800.0,1
MS-DRG,580,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITH CC",,,16045.72,50462.78,32
MS-DRG,581,"OTHER SKIN, SUBCUT TISS & BREAST PROC W/O CC/MCC",,,51400.0,51400.0,1
MS-DRG,581,"OTHER SKIN, SUBCUTANEOUS TISSUE AND BREAST PROCEDURES WITHOUT CC/MCC",,,13174.52,42142.85,32
MS-DRG,582,MASTECTOMY FOR MALIGNANCY W CC/MCC,,,60700.0,60700.0,1
MS-DRG,582,MASTECTOMY FOR MALIGNANCY WITH CC/MCC,,,15858.2,56262.5,32
MS-DRG,583,MASTECTOMY FOR MALIGNANCY W/O CC/MCC,,,53300.0,53300.0,1
MS-DRG,583,MASTECTOMY FOR MALIGNANCY WITHOUT CC/MCC,,,14924.93,50357.65,32
MS-DRG,584,"BREAST BIOPSY, LOCAL EXCISION & OTHER BREAST PROCEDURES W CC/MCC",,,72700.0,72700.0,1
MS-DRG,584,"BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITH CC/MCC",,,18150.0,62514.86,32
MS-DRG,585,"BREAST BIOPSY, LOCAL EXCISION & OTHER BREAST PROCEDURES W/O CC/MCC",,,64300.0,64300.0,1
MS-DRG,585,"BREAST BIOPSY, LOCAL EXCISION AND OTHER BREAST PROCEDURES WITHOUT CC/MCC",,,17870.11,56335.51,32
MS-DRG,59,MULTIPLE SCLEROSIS & CEREBELLAR ATAXIA W CC,,,40600.0,40600.0,1
MS-DRG,59,MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITH CC,,,11320.02,20900.0,10
MS-DRG,59,Multiple Schlerosis & Cerebellar w/CC,,,30634.0,34310.0,2
MS-DRG,592,SKIN ULCERS W MCC,,,28200.0,28200.0,1
MS-DRG,592,SKIN ULCERS WITH MCC,,,18150.0,56516.57,32
MS-DRG,593,SKIN ULCERS W CC,,,20000.0,20000.0,1
MS-DRG,593,SKIN ULCERS WITH CC,,,11312.28,34643.52,32
MS-DRG,594,SKIN ULCERS W/O CC/MCC,,,14700.0,14700.0,1
MS-DRG,594,SKIN ULCERS WITHOUT CC/MCC,,,8095.29,25313.16,32
MS-DRG,595,MAJOR SKIN DISORDERS W MCC,,,40400.0,40400.0,1
MS-DRG,595,MAJOR SKIN DISORDERS WITH MCC,,,18150.0,61930.8,32
MS-DRG,596,MAJOR SKIN DISORDERS W/O MCC,,,19300.0,19300.0,1
MS-DRG,596,MAJOR SKIN DISORDERS WITHOUT MCC,,,10094.3,31612.25,32
MS-DRG,597,MALIGNANT BREAST DISORDERS W MCC,,,35200.0,35200.0,1
MS-DRG,597,MALIGNANT BREAST DISORDERS WITH MCC,,,15825.26,48684.32,32
MS-DRG,598,MALIGNANT BREAST DISORDERS W CC,,,23900.0,23900.0,1
MS-DRG,598,MALIGNANT BREAST DISORDERS WITH CC,,,10075.37,33037.35,32
MS-DRG,599,MALIGNANT BREAST DISORDERS W/O CC/MCC,,,14200.0,14200.0,1
MS-DRG,599,MALIGNANT BREAST DISORDERS WITHOUT CC/MCC,,,7880.79,22468.79,32
MS-DRG,6,LIVER TRANSPLANT WITHOUT MCC,,,42108.28,46319.11,9
MS-DRG,60,MULTIPLE SCLEROSIS & CEREBELLAR ATAXIA W/O CC/MCC,,,31400.0,31400.0,1
MS-DRG,60,MULTIPLE SCLEROSIS AND CEREBELLAR ATAXIA WITHOUT CC/MCC,,,8471.18,12800.0,10
MS-DRG,60,Multiple Schlerosis & Cerebellar w/o CC/MCC,,,23708.0,26553.0,2
MS-DRG,600,NON-MALIGNANT BREAST DISORDERS W CC/MCC,,,20100.0,20100.0,1
MS-DRG,600,NON-MALIGNANT BREAST DISORDERS WITH CC/MCC,,,9023.4,30417.84,32
MS-DRG,601,NON-MALIGNANT BREAST DISORDERS W/O CC/MCC,,,13300.0,13300.0,1
MS-DRG,601,NON-MALIGNANT BREAST DISORDERS WITHOUT CC/MCC,,,5951.78,18150.0,32
MS-DRG,602,CELLULITIS W MCC,,,29100.0,29100.0,1
MS-DRG,602,CELLULITIS WITH MCC,,,13432.56,41506.22,32
MS-DRG,603,CELLULITIS W/O MCC,,,16800.0,16800.0,1
MS-DRG,603,CELLULITIS WITHOUT MCC,,,8371.4,25432.89,32
MS-DRG,604,"TRAUMA TO THE SKIN, SUBCUT TISS & BREAST W MCC",,,27100.0,27100.0,1
MS-DRG,604,"TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITH MCC",,,13574.49,42989.74,32
MS-DRG,605,"TRAUMA TO THE SKIN, SUBCUT TISS & BREAST W/O MCC",,,16200.0,16200.0,1
MS-DRG,605,"TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITHOUT MCC",,,8740.41,26749.95,32
MS-DRG,606,MINOR SKIN DISORDERS W MCC,,,28100.0,28100.0,1
MS-DRG,606,MINOR SKIN DISORDERS WITH MCC,,,14463.27,44189.98,32
MS-DRG,607,MINOR SKIN DISORDERS W/O MCC,,,15400.0,15400.0,1
MS-DRG,607,MINOR SKIN DISORDERS WITHOUT MCC,,,8228.62,26469.6,32
MS-DRG,61,ACUTE ISCHEMIC STROKE W USE OF THROMBOLYTIC AGENT W MCC,,,105900.0,105900.0,1
MS-DRG,61,Acute Ischemic Stroke ..Agent w/MCC,,,87066.0,97514.0,2
MS-DRG,61,"ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH MCC",,,24048.61,28018.69,9
MS-DRG,614,ADRENAL & PITUITARY PROCEDURES W CC/MCC,,,63700.0,63700.0,1
MS-DRG,614,ADRENAL AND PITUITARY PROCEDURES WITH CC/MCC,,,17927.0,64007.14,32
MS-DRG,615,ADRENAL & PITUITARY PROCEDURES W/O CC/MCC,,,37500.0,37500.0,1
MS-DRG,615,ADRENAL AND PITUITARY PROCEDURES WITHOUT CC/MCC,,,13121.19,40863.76,32
MS-DRG,616,"AMPUTAT OF LOWER LIMB FOR ENDOCRINE,NUTRIT,& METABOL DIS W MCC",,,107800.0,107800.0,1
MS-DRG,616,"AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC",,,20350.0,101842.54,32
MS-DRG,617,"AMPUTAT OF LOWER LIMB FOR ENDOCRINE,NUTRIT,& METABOL DIS W CC",,,53200.0,53200.0,1
MS-DRG,617,"AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC",,,17409.93,54618.37,32
MS-DRG,618,"AMPUTAT OF LOWER LIMB FOR ENDOCRINE,NUTRIT,& METABOL DIS W/O CC/MCC",,,32900.0,32900.0,1
MS-DRG,618,"AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CC/MCC",,,11504.95,41418.61,32
MS-DRG,619,O.R. PROCEDURES FOR OBESITY W MCC,,,81800.0,81800.0,1
MS-DRG,619,O.R. PROCEDURES FOR OBESITY WITH MCC,,,19029.0,97600.0,37
MS-DRG,62,ACUTE ISCHEMIC STROKE W USE OF THROMBOLYTIC AGENT W CC,,,73000.0,73000.0,1
MS-DRG,62,Acute Ischemic Stroke…Agent w/CC,,,59376.0,66501.0,2
MS-DRG,62,"ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITH CC",,,16113.67,18284.88,9
MS-DRG,620,O.R. PROCEDURES FOR OBESITY W CC,,,47300.0,47300.0,1
MS-DRG,620,O.R. PROCEDURES FOR OBESITY WITH CC,,,14531.84,68400.0,37
MS-DRG,621,O.R. PROCEDURES FOR OBESITY W/O CC/MCC,,,41100.0,41100.0,1
MS-DRG,621,O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC,,,13368.91,56100.0,37
MS-DRG,622,"SKIN GRAFTS & WOUND DEBRID FOR ENDOC, NUTRIT & METAB DIS W MCC",,,97600.0,97600.0,1
MS-DRG,622,"SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH MCC",,,20350.0,103939.32,32
MS-DRG,623,"SKIN GRAFTS & WOUND DEBRID FOR ENDOC, NUTRIT & METAB DIS W CC",,,50100.0,50100.0,1
MS-DRG,623,"SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC",,,16947.41,52387.26,32
MS-DRG,624,"SKIN GRAFTS & WOUND DEBRID FOR ENDOC, NUTRIT & METAB DIS W/O CC/MCC",,,28500.0,28500.0,1
MS-DRG,624,"SKIN GRAFTS AND WOUND DEBRIDEMENT FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITHOUT CC/MCC",,,9423.37,36559.24,32
MS-DRG,625,"THYROID, PARATHYROID & THYROGLOSSAL PROCEDURES W MCC",,,70900.0,70900.0,1
MS-DRG,625,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH MCC",,,20350.0,88195.98,32
MS-DRG,626,"THYROID, PARATHYROID & THYROGLOSSAL PROCEDURES W CC",,,39800.0,39800.0,1
MS-DRG,626,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITH CC",,,13777.48,43786.98,32
MS-DRG,627,"THYROID, PARATHYROID & THYROGLOSSAL PROCEDURES W/O CC/MCC",,,27100.0,27100.0,1
MS-DRG,627,"THYROID, PARATHYROID AND THYROGLOSSAL PROCEDURES WITHOUT CC/MCC",,,11692.47,38790.34,32
MS-DRG,628,"OTHER ENDOCRINE, NUTRIT & METAB O.R. PROC W MCC",,,88700.0,88700.0,1
MS-DRG,628,"OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH MCC",,,20350.0,108833.74,32
MS-DRG,629,"OTHER ENDOCRINE, NUTRIT & METAB O.R. PROC W CC",,,57500.0,57500.0,1
MS-DRG,629,"OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITH CC",,,20140.92,63627.5,32
MS-DRG,63,ACUTE ISCHEMIC STROKE W USE OF THROMBOLYTIC AGENT W/O CC/MCC,,,61100.0,61100.0,1
MS-DRG,63,Acute Ischemic Stroke…Agent w/o CC/MCC,,,46665.0,52265.0,2
MS-DRG,63,"ISCHEMIC STROKE, PRECEREBRAL OCCLUSION OR TRANSIENT ISCHEMIA WITH THROMBOLYTIC AGENT WITHOUT CC/MCC",,,12878.62,14844.61,9
MS-DRG,630,"OTHER ENDOCRINE, NUTRIT & METAB O.R. PROC W/O CC/MCC",,,39900.0,39900.0,1
MS-DRG,630,"OTHER ENDOCRINE, NUTRITIONAL AND METABOLIC O.R. PROCEDURES WITHOUT CC/MCC",,,12848.52,42621.78,32
MS-DRG,637,DIABETES W MCC,,,30500.0,30500.0,1
MS-DRG,637,DIABETES WITH MCC,,,13321.6,41955.95,32
MS-DRG,638,DIABETES W CC,,,18800.0,18800.0,1
MS-DRG,638,DIABETES WITH CC,,,8684.5,26171.73,32
MS-DRG,639,DIABETES W/O CC/MCC,,,13400.0,13400.0,1
MS-DRG,639,DIABETES WITHOUT CC/MCC,,,6184.88,20350.0,32
MS-DRG,64,INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W MCC,,,67800.0,67800.0,1
MS-DRG,64,INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC,,,17905.38,34600.0,10
MS-DRG,64,Intracranial Hemorrhage or cerebral infarction w/MCC,,,55953.0,62667.0,2
MS-DRG,640,"MISC DISORDERS OF NUTRITION,METABOLISM,FLUIDS/ELECTROLYTES W MCC",,,25700.0,25700.0,1
MS-DRG,640,"MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC",,,12218.02,14180.71,23
MS-DRG,640,Nutritional & misc metabolic disorders w MCC,,,19420.96,39003.53,9
MS-DRG,641,"MISC DISORDERS OF NUTRITION,METABOLISM,FLUIDS/ELECTROLYTES W/O MCC",,,16100.0,16100.0,1
MS-DRG,641,"MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC",,,7516.41,8754.54,23
MS-DRG,641,Nutritional & misc metabolic disorders w/o MCC,,,12023.97,22725.77,9
MS-DRG,642,INBORN AND OTHER DISORDERS OF METABOLISM,,,11470.55,27200.0,24
MS-DRG,642,Inborn errors of metabolism,,,20350.0,41529.59,9
MS-DRG,643,ENDOCRINE DISORDERS W MCC,,,35300.0,35300.0,1
MS-DRG,643,ENDOCRINE DISORDERS WITH MCC,,,15050.52,48071.06,32
MS-DRG,644,ENDOCRINE DISORDERS W CC,,,22500.0,22500.0,1
MS-DRG,644,ENDOCRINE DISORDERS WITH CC,,,9684.0,29933.08,32
MS-DRG,645,ENDOCRINE DISORDERS W/O CC/MCC,,,16400.0,16400.0,1
MS-DRG,645,ENDOCRINE DISORDERS WITHOUT CC/MCC,,,7493.18,22436.66,32
MS-DRG,65,INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W CC OR TPA IN 24 HRS,,,40400.0,40400.0,1
MS-DRG,65,INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS,,,9542.07,21500.0,10
MS-DRG,65,Intracranial Hemorrhage or cerebral infraction w/CC,,,34454.0,38588.0,2
MS-DRG,650,KIDNEY TRANSPLANT WITH HEMODIALYSIS WITH MCC,,,6500.0,160243.0,34
MS-DRG,650-A,Kidney (Deceased & Live Donor) - Adult,,,158573.0,158573.0,1
MS-DRG,650-A,Kidney - Adult,,,161100.0,161100.0,1
MS-DRG,650-C,KIDNEY TRANSPLANT WITH HEMODIALYSIS WITH MCC - Cadaveric,,,185100.0,185100.0,3
MS-DRG,650-C,Kidney - Cadaveric,,,175300.0,175300.0,1
MS-DRG,650-D,Kidney (Deceased) - Adult & Pediatric,,,175300.0,175300.0,2
MS-DRG,650-DA,Kidney (Deceased ) - Adult,,,143039.0,143039.0,1
MS-DRG,650-DP,Kidney (Deceased) - Pediatric,,,166486.0,166486.0,1
MS-DRG,650-L,Kidney ( Live Donor) - Adult & Pediatric,,,161100.0,161100.0,2
MS-DRG,650-LA,Kidney ( Live Donor) - Adult,,,131556.0,131556.0,1
MS-DRG,650-LD,KIDNEY TRANSPLANT WITH HEMODIALYSIS WITH MCC - Live Donor,,,170100.0,170100.0,3
MS-DRG,650-LP,Kidney ( Live Donor) - Pediatric,,,153120.0,153120.0,1
MS-DRG,650-P,Kidney (Deceased & Live Donor) - Pediatric,,,175870.0,175870.0,1
MS-DRG,651,KIDNEY TRANSPLANT WITH HEMODIALYSIS WITHOUT MCC,,,6500.0,160243.0,34
MS-DRG,651-A,Kidney (Deceased & Live Donor) - Adult,,,158573.0,158573.0,1
MS-DRG,651-A,Kidney - Adult,,,161100.0,161100.0,1
MS-DRG,651-C,KIDNEY TRANSPLANT WITH HEMODIALYSIS WITHOUT MCC - Cadaveric,,,185100.0,185100.0,3
MS-DRG,651-C,Kidney - Cadaveric,,,175300.0,175300.0,1
MS-DRG,651-D,Kidney (Deceased) - Adult & Pediatric,,,175300.0,175300.0,2
MS-DRG,651-DA,Kidney (Deceased ) - Adult,,,143039.0,143039.0,1
MS-DRG,651-DP,Kidney (Deceased) - Pediatric,,,166486.0,166486.0,1
MS-DRG,651-L,Kidney ( Live Donor) - Adult & Pediatric,,,161100.0,161100.0,2
MS-DRG,651-LA,Kidney ( Live Donor) - Adult,,,131556.0,131556.0,1
MS-DRG,651-LD,KIDNEY TRANSPLANT WITH HEMODIALYSIS WITHOUT MCC - Live Donor,,,170100.0,170100.0,3
MS-DRG,651-LP,Kidney (Live Donor) - Pediatric,,,153120.0,153120.0,1
MS-DRG,651-P,Kidney (Deceased & Live Donor) - Pediatric,,,175870.0,175870.0,1
MS-DRG,652,KIDNEY TRANSPLANT,,,27213.99,32617.41,23
MS-DRG,652,Kidney transplant,,,6500.0,160243.0,11
MS-DRG,652-A,Kidney (Deceased & Live Donor) - Adult,,,158573.0,158573.0,1
MS-DRG,652-A,Kidney - Adult,,,161100.0,161100.0,1
MS-DRG,652-C,KIDNEY TRANSPLANT - Cadaveric,,,185100.0,185100.0,3
MS-DRG,652-C,Kidney - Cadaveric,,,175300.0,175300.0,1
MS-DRG,652-D,Kidney (Deceased) - Adult & Pediatric,,,175300.0,175300.0,2
MS-DRG,652-DA,Kidney (Deceased ) - Adult,,,143039.0,143039.0,1
MS-DRG,652-DP,Kidney (Deceased) - Pediatric,,,166486.0,166486.0,1
MS-DRG,652-L,Kidney (Live Donor) - Adult & Pediatric,,,161100.0,161100.0,2
MS-DRG,652-LA,Kidney ( Live Donor) - Adult,,,131556.0,131556.0,1
MS-DRG,652-LD,KIDNEY TRANSPLANT - Live Donor,,,170100.0,170100.0,3
MS-DRG,652-LP,Kidney (Live Donor) - Pediatric,,,153120.0,153120.0,1
MS-DRG,652-P,Kidney (Deceased & Live Donor) - Pediatric,,,175870.0,175870.0,1
MS-DRG,653,MAJOR BLADDER PROCEDURES W MCC,,,178400.0,178400.0,1
MS-DRG,653,MAJOR BLADDER PROCEDURES WITH MCC,,,20350.0,151750.47,37
MS-DRG,654,MAJOR BLADDER PROCEDURES W CC,,,95500.0,95500.0,1
MS-DRG,654,MAJOR BLADDER PROCEDURES WITH CC,,,17927.0,115500.0,37
MS-DRG,655,MAJOR BLADDER PROCEDURES W/O CC/MCC,,,67100.0,67100.0,1
MS-DRG,655,MAJOR BLADDER PROCEDURES WITHOUT CC/MCC,,,18663.17,92000.0,37
MS-DRG,656,KIDNEY & URETER PROCEDURES FOR NEOPLASM W MCC,,,106800.0,106800.0,1
MS-DRG,656,KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH MCC,,,17927.0,103500.0,37
MS-DRG,657,KIDNEY & URETER PROCEDURES FOR NEOPLASM W CC,,,62500.0,62500.0,1
MS-DRG,657,KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITH CC,,,16519.66,68300.0,37
MS-DRG,658,KIDNEY & URETER PROCEDURES FOR NEOPLASM W/O CC/MCC,,,47500.0,47500.0,1
MS-DRG,658,KIDNEY AND URETER PROCEDURES FOR NEOPLASM WITHOUT CC/MCC,,,13731.9,59500.0,37
MS-DRG,659,KIDNEY & URETER PROCEDURES FOR NON-NEOPLASM W MCC,,,104000.0,104000.0,1
MS-DRG,659,KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC,,,20350.0,74201.9,37
MS-DRG,66,INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION W/O CC/MCC,,,28800.0,28800.0,1
MS-DRG,66,INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC,,,6715.6,14600.0,10
MS-DRG,66,"Intracranial hemorrhage or cerebral infarction w/o
CC/MCC",,,27672.0,27672.0,1
MS-DRG,66,Intracranial hemorrhage or cerebral infarction w/o CC/MCC,,,24707.0,24707.0,1
MS-DRG,660,KIDNEY & URETER PROCEDURES FOR NON-NEOPLASM W CC,,,58500.0,58500.0,1
MS-DRG,660,KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC,,,12321.24,51200.0,37
MS-DRG,661,KIDNEY & URETER PROCEDURES FOR NON-NEOPLASM W/O CC/MCC,,,44100.0,44100.0,1
MS-DRG,661,KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC,,,9625.51,50400.0,37
MS-DRG,662,MINOR BLADDER PROCEDURES W MCC,,,89700.0,89700.0,1
MS-DRG,662,MINOR BLADDER PROCEDURES WITH MCC,,,20350.0,89404.98,32
MS-DRG,663,MINOR BLADDER PROCEDURES W CC,,,46700.0,46700.0,1
MS-DRG,663,MINOR BLADDER PROCEDURES WITH CC,,,13933.17,50900.0,37
MS-DRG,664,MINOR BLADDER PROCEDURES W/O CC/MCC,,,37600.0,37600.0,1
MS-DRG,664,MINOR BLADDER PROCEDURES WITHOUT CC/MCC,,,10083.11,38900.0,37
MS-DRG,665,PROSTATECTOMY W MCC,,,95100.0,95100.0,1
MS-DRG,665,PROSTATECTOMY WITH MCC,,,20350.0,91148.4,32
MS-DRG,666,PROSTATECTOMY W CC,,,54500.0,54500.0,1
MS-DRG,666,PROSTATECTOMY WITH CC,,,14964.5,51084.81,32
MS-DRG,667,PROSTATECTOMY W/O CC/MCC,,,31100.0,31100.0,1
MS-DRG,667,PROSTATECTOMY WITHOUT CC/MCC,,,9635.83,32304.36,32
MS-DRG,668,TRANSURETHRAL PROCEDURES W MCC,,,76100.0,76100.0,1
MS-DRG,668,TRANSURETHRAL PROCEDURES WITH MCC,,,20350.0,85272.76,32
MS-DRG,669,TRANSURETHRAL PROCEDURES W CC,,,40500.0,40500.0,1
MS-DRG,669,TRANSURETHRAL PROCEDURES WITH CC,,,14106.06,45323.06,37
MS-DRG,67,NONSPECIFIC CVA & PRECEREBRAL OCCLUSION W/O INFARCT W MCC,,,51800.0,51800.0,1
MS-DRG,67,NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITH MCC,,,13309.56,13309.56,1
MS-DRG,67,Nonspecific CVA & Precerebral w/o Infarction w/MCC,,,45779.0,51272.0,2
MS-DRG,67,PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITH MCC,,,14069.45,15476.4,8
MS-DRG,670,TRANSURETHRAL PROCEDURES W/O CC/MCC,,,29900.0,29900.0,1
MS-DRG,670,TRANSURETHRAL PROCEDURES WITHOUT CC/MCC,,,9015.66,29500.0,37
MS-DRG,671,URETHRAL PROCEDURES W CC/MCC,,,48500.0,48500.0,1
MS-DRG,671,URETHRAL PROCEDURES WITH CC/MCC,,,15621.66,52419.39,37
MS-DRG,672,URETHRAL PROCEDURES W/O CC/MCC,,,30400.0,30400.0,1
MS-DRG,672,URETHRAL PROCEDURES WITHOUT CC/MCC,,,10208.7,46000.0,37
MS-DRG,673,OTHER KIDNEY & URINARY TRACT PROCEDURES W MCC,,,103700.0,103700.0,1
MS-DRG,673,OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC,,,20350.0,122699.32,37
MS-DRG,674,OTHER KIDNEY & URINARY TRACT PROCEDURES W CC,,,69900.0,69900.0,1
MS-DRG,674,OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH CC,,,20350.0,68294.14,37
MS-DRG,675,OTHER KIDNEY & URINARY TRACT PROCEDURES W/O CC/MCC,,,48000.0,48000.0,1
MS-DRG,675,OTHER KIDNEY AND URINARY TRACT PROCEDURES WITHOUT CC/MCC,,,14259.17,47933.8,37
MS-DRG,68,NONSPECIFIC CVA & PRECEREBRAL OCCLUSION W/O INFARCT W/O MCC,,,33500.0,33500.0,1
MS-DRG,68,NONSPECIFIC CVA AND PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITHOUT MCC,,,8377.42,15500.0,2
MS-DRG,68,Nonspecific CVA & Precerebral w/o Infarctiion w/o MCC,,,27028.0,30271.0,2
MS-DRG,68,PRECEREBRAL OCCLUSION WITHOUT INFARCTION WITHOUT MCC,,,8721.52,9593.67,8
MS-DRG,682,RENAL FAILURE W MCC,,,42400.0,42400.0,1
MS-DRG,682,RENAL FAILURE WITH MCC,,,13713.83,43249.64,37
MS-DRG,683,RENAL FAILURE W CC,,,25900.0,25900.0,1
MS-DRG,683,RENAL FAILURE WITH CC,,,8441.07,25575.99,37
MS-DRG,684,RENAL FAILURE W/O CC/MCC,,,17500.0,17500.0,1
MS-DRG,684,RENAL FAILURE WITHOUT CC/MCC,,,6019.73,20350.0,37
MS-DRG,686,KIDNEY & URINARY TRACT NEOPLASMS W MCC,,,47300.0,47300.0,1
MS-DRG,686,KIDNEY AND URINARY TRACT NEOPLASMS WITH MCC,,,17015.11,52673.45,37
MS-DRG,687,KIDNEY & URINARY TRACT NEOPLASMS W CC,,,30000.0,30000.0,1
MS-DRG,687,KIDNEY AND URINARY TRACT NEOPLASMS WITH CC,,,9850.01,30598.9,37
MS-DRG,688,KIDNEY & URINARY TRACT NEOPLASMS W/O CC/MCC,,,19500.0,19500.0,1
MS-DRG,688,KIDNEY AND URINARY TRACT NEOPLASMS WITHOUT CC/MCC,,,7024.4,23079.13,37
MS-DRG,689,KIDNEY & URINARY TRACT INFECTIONS W MCC,,,30100.0,30100.0,1
MS-DRG,689,KIDNEY AND URINARY TRACT INFECTIONS WITH MCC,,,10861.55,33884.24,37
MS-DRG,69,TRANSIENT ISCHEMIA,,,28500.0,28500.0,1
MS-DRG,69,TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC,,,7677.26,9300.0,10
MS-DRG,69,Transient ischemia,,,22622.0,25337.0,2
MS-DRG,690,KIDNEY & URINARY TRACT INFECTIONS W/O MCC,,,22000.0,22000.0,1
MS-DRG,690,KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC,,,7698.76,23639.83,37
MS-DRG,693,URINARY STONES W/O ESW LITHOTRIPSY W MCC,,,37500.0,37500.0,1
MS-DRG,693,URINARY STONES WITH MCC,,,10500.0,39263.43,37
MS-DRG,694,URINARY STONES W/O ESW LITHOTRIPSY W/O MCC,,,20800.0,20800.0,1
MS-DRG,694,URINARY STONES WITHOUT MCC,,,7516.41,22827.99,37
MS-DRG,695,KIDNEY & URINARY TRACT SIGNS & SYMPTOMS W MCC,,,34400.0,34400.0,1
MS-DRG,695,KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITH MCC,,,10495.99,33402.39,32
MS-DRG,696,KIDNEY & URINARY TRACT SIGNS & SYMPTOMS W/O MCC,,,19700.0,19700.0,1
MS-DRG,696,KIDNEY AND URINARY TRACT SIGNS AND SYMPTOMS WITHOUT MCC,,,6745.71,20350.0,37
MS-DRG,697,URETHRAL STRICTURE,,,9412.19,24000.0,24
MS-DRG,697,Urethral stricture,,,15672.29,31474.99,9
MS-DRG,698,OTHER KIDNEY & URINARY TRACT DIAGNOSES W MCC,,,44200.0,44200.0,1
MS-DRG,698,OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC,,,15253.51,48313.44,37
MS-DRG,699,OTHER KIDNEY & URINARY TRACT DIAGNOSES W CC,,,29300.0,29300.0,1
MS-DRG,699,OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC,,,9567.88,29641.05,37
MS-DRG,7,LUNG TRANSPLANT,,,113207.26,127246.31,9
MS-DRG,7,Vagal NeNe Stimulation,,,26000.0,26000.0,1
MS-DRG,70,NONSPECIFIC CEREBROVASCULAR DISORDERS W MCC,,,63000.0,63000.0,1
MS-DRG,70,NONSPECIFIC CEREBROVASCULAR DISORDERS WITH MCC,,,15751.54,39400.0,2
MS-DRG,70,Nonspecific Cerebrovascular w/MCC,,,51799.0,58015.0,2
MS-DRG,70,OTHER CEREBROVASCULAR DISORDERS WITH MCC,,,15804.9,17385.39,8
MS-DRG,700,OTHER KIDNEY & URINARY TRACT DIAGNOSES W/O CC/MCC,,,21000.0,21000.0,1
MS-DRG,700,OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITHOUT CC/MCC,,,6766.35,20350.0,37
MS-DRG,707,MAJOR MALE PELVIC PROCEDURES W CC/MCC,,,59300.0,59300.0,1
MS-DRG,707,MAJOR MALE PELVIC PROCEDURES WITH CC/MCC,,,17487.34,58414.76,32
MS-DRG,708,MAJOR MALE PELVIC PROCEDURES W/O CC/MCC,,,44100.0,44100.0,1
MS-DRG,708,MAJOR MALE PELVIC PROCEDURES WITHOUT CC/MCC,,,10766.0,44803.24,32
MS-DRG,709,PENIS PROCEDURES W CC/MCC,,,71300.0,71300.0,1
MS-DRG,709,PENIS PROCEDURES WITH CC/MCC,,,18150.0,67958.3,32
MS-DRG,71,NONSPECIFIC CEREBROVASCULAR DISORDERS W CC,,,38000.0,38000.0,1
MS-DRG,71,NONSPECIFIC CEREBROVASCULAR DISORDERS WITH CC,,,9860.33,14700.0,2
MS-DRG,71,Nonspecific Cerebrovascular w/o CC/MCC,,,30899.0,34607.0,2
MS-DRG,71,OTHER CEREBROVASCULAR DISORDERS WITH CC,,,10151.65,11166.82,8
MS-DRG,710,PENIS PROCEDURES W/O CC/MCC,,,48000.0,48000.0,1
MS-DRG,710,PENIS PROCEDURES WITHOUT CC/MCC,,,13472.09,40919.24,32
MS-DRG,711,TESTES PROCEDURES W CC/MCC,,,69500.0,69500.0,1
MS-DRG,711,TESTES PROCEDURES WITH CC/MCC,,,17229.29,60853.21,32
MS-DRG,712,TESTES PROCEDURES W/O CC/MCC,,,35100.0,35100.0,1
MS-DRG,712,TESTES PROCEDURES WITHOUT CC/MCC,,,9995.38,32114.54,32
MS-DRG,713,TRANSURETHRAL PROSTATECTOMY W CC/MCC,,,52400.0,52400.0,1
MS-DRG,713,TRANSURETHRAL PROSTATECTOMY WITH CC/MCC,,,13233.01,43903.79,32
MS-DRG,714,TRANSURETHRAL PROSTATECTOMY W/O CC/MCC,,,27600.0,27600.0,1
MS-DRG,714,TRANSURETHRAL PROSTATECTOMY WITHOUT CC/MCC,,,8878.03,30879.25,32
MS-DRG,715,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROC FOR MALIGNANCY W CC/MCC,,,67800.0,67800.0,1
MS-DRG,715,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITH CC/MCC,,,18150.0,65335.87,32
MS-DRG,716,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROC FOR MALIGNANCY W/O CC/MCC,,,39700.0,39700.0,1
MS-DRG,716,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES FOR MALIGNANCY WITHOUT CC/MCC,,,13003.34,42957.61,32
MS-DRG,717,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROC EXC MALIGNANCY W CC/MCC,,,53900.0,53900.0,1
MS-DRG,717,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITH CC/MCC,,,16755.35,55208.27,32
MS-DRG,718,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROC EXC MALIGNANCY W/O CC/MCC,,,34100.0,34100.0,1
MS-DRG,718,OTHER MALE REPRODUCTIVE SYSTEM O.R. PROCEDURES EXCEPT MALIGNANCY WITHOUT CC/MCC,,,11391.41,39222.55,32
MS-DRG,72,NONSPECIFIC CEREBROVASCULAR DISORDERS W/O CC/MCC,,,28500.0,28500.0,1
MS-DRG,72,NONSPECIFIC CEREBROVASCULAR DISORDERS WITHOUT CC/MCC,,,7248.04,15600.0,2
MS-DRG,72,Nonspecific Cerebrovascular w/o CC/MCC,,,22796.0,25532.0,2
MS-DRG,72,OTHER CEREBROVASCULAR DISORDERS WITHOUT CC/MCC,,,7763.97,8540.37,8
MS-DRG,722,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM W MCC",,,23200.0,23200.0,1
MS-DRG,722,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH MCC",,,15666.39,52848.67,32
MS-DRG,723,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM W CC",,,14800.0,14800.0,1
MS-DRG,723,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITH CC",,,10453.84,33370.27,32
MS-DRG,724,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM W/O CC/MCC",,,10100.0,10100.0,1
MS-DRG,724,"MALIGNANCY, MALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC",,,6874.56,19148.41,32
MS-DRG,725,BENIGN PROSTATIC HYPERTROPHY W MCC,,,18100.0,18100.0,1
MS-DRG,725,BENIGN PROSTATIC HYPERTROPHY WITH MCC,,,11427.79,34173.35,32
MS-DRG,726,BENIGN PROSTATIC HYPERTROPHY W/O MCC,,,9900.0,9900.0,1
MS-DRG,726,BENIGN PROSTATIC HYPERTROPHY WITHOUT MCC,,,7198.15,21084.57,32
MS-DRG,727,INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM W MCC,,,18900.0,18900.0,1
MS-DRG,727,INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITH MCC,,,13434.28,43305.13,32
MS-DRG,728,INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM W/O MCC,,,11100.0,11100.0,1
MS-DRG,728,INFLAMMATION OF THE MALE REPRODUCTIVE SYSTEM WITHOUT MCC,,,7823.48,23689.47,32
MS-DRG,729,OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES W CC/MCC,,,14700.0,14700.0,1
MS-DRG,729,OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITH CC/MCC,,,10264.61,30917.22,32
MS-DRG,73,CRANIAL & PERIPHERAL NERVE DISORDERS W MCC,,,51100.0,51100.0,1
MS-DRG,73,CRANIAL AND PERIPHERAL NERVE DISORDERS WITH MCC,,,14089.72,32000.0,10
MS-DRG,73,Cranial & Peripheral w/MCC,,,38936.0,43608.0,2
MS-DRG,730,OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES W/O CC/MCC,,,9100.0,9100.0,1
MS-DRG,730,OTHER MALE REPRODUCTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC,,,6015.43,19624.42,32
MS-DRG,734,"PELVIC EVISCERATION, RAD HYSTERECTOMY & RAD VULVECTOMY W CC/MCC",,,86600.0,86600.0,1
MS-DRG,734,"PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITH CC/MCC",,,18150.0,62202.39,32
MS-DRG,735,"PELVIC EVISCERATION, RAD HYSTERECTOMY & RAD VULVECTOMY W/O CC/MCC",,,39500.0,39500.0,1
MS-DRG,735,"PELVIC EVISCERATION, RADICAL HYSTERECTOMY AND RADICAL VULVECTOMY WITHOUT CC/MCC",,,11236.58,39292.64,32
MS-DRG,736,UTERINE & ADNEXA PROC FOR OVARIAN OR ADNEXAL MALIGNANCY W MCC,,,133000.0,133000.0,1
MS-DRG,736,UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH MCC,,,18150.0,104386.12,32
MS-DRG,737,UTERINE & ADNEXA PROC FOR OVARIAN OR ADNEXAL MALIGNANCY W CC,,,62200.0,62200.0,1
MS-DRG,737,UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITH CC,,,17984.51,60175.7,32
MS-DRG,738,UTERINE & ADNEXA PROC FOR OVARIAN OR ADNEXAL MALIGNANCY W/O CC/MCC,,,44500.0,44500.0,1
MS-DRG,738,UTERINE AND ADNEXA PROCEDURES FOR OVARIAN OR ADNEXAL MALIGNANCY WITHOUT CC/MCC,,,13842.86,42884.61,32
MS-DRG,739,UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH MCC,,,32778.82,36056.7,23
MS-DRG,739,"UTERINE,ADNEXA PROC FOR NON-OVARIAN/ADNEXAL MALIG W MCC",,,111600.0,111600.0,1
MS-DRG,739,"Uterine,adnexa proc for non-ovarian/adnexal malig w MCC",,,18150.0,104628.51,9
MS-DRG,74,CRANIAL & PERIPHERAL NERVE DISORDERS W/O MCC,,,35500.0,35500.0,1
MS-DRG,74,CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC,,,9761.41,11213.54,10
MS-DRG,74,Cranial & Peripheral w/o MCC,,,26842.0,30063.0,2
MS-DRG,740,UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITH CC,,,16435.37,18794.99,23
MS-DRG,740,"UTERINE,ADNEXA PROC FOR NON-OVARIAN/ADNEXAL MALIG W CC",,,54400.0,54400.0,1
MS-DRG,740,"Uterine,adnexa proc for non-ovarian/adnexal malig w CC",,,18150.0,52845.75,9
MS-DRG,741,UTERINE AND ADNEXA PROCEDURES FOR NON-OVARIAN AND NON-ADNEXAL MALIGNANCY WITHOUT CC/MCC,,,12610.25,15061.7,23
MS-DRG,741,"UTERINE,ADNEXA PROC FOR NON-OVARIAN/ADNEXAL MALIG W/O CC/MCC",,,39400.0,39400.0,1
MS-DRG,741,"Uterine,adnexa proc for non-ovarian/adnexal malig w/o CC/MCC",,,18150.0,41646.4,9
MS-DRG,742,UTERINE & ADNEXA PROC FOR NON-MALIGNANCY W CC/MCC,,,51300.0,51300.0,1
MS-DRG,742,UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITH CC/MCC,,,16507.62,53581.66,32
MS-DRG,743,UTERINE & ADNEXA PROC FOR NON-MALIGNANCY W/O CC/MCC,,,32500.0,32500.0,1
MS-DRG,743,UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC,,,11105.84,36232.16,32
MS-DRG,744,"D&C, CONIZATION, LAPAROSCOPY & TUBAL INTERRUPTION W CC/MCC",,,53300.0,53300.0,1
MS-DRG,744,"D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITH CC/MCC",,,17602.6,59839.87,32
MS-DRG,745,"D&C, CONIZATION, LAPAROSCOPY & TUBAL INTERRUPTION W/O CC/MCC",,,33800.0,33800.0,1
MS-DRG,745,"D&C, CONIZATION, LAPAROSCOPY AND TUBAL INTERRUPTION WITHOUT CC/MCC",,,9610.03,33218.41,32
MS-DRG,746,"VAGINA, CERVIX & VULVA PROCEDURES W CC/MCC",,,47100.0,47100.0,1
MS-DRG,746,"VAGINA, CERVIX AND VULVA PROCEDURES WITH CC/MCC",,,15199.32,50728.53,32
MS-DRG,747,"VAGINA, CERVIX & VULVA PROCEDURES W/O CC/MCC",,,29800.0,29800.0,1
MS-DRG,747,"VAGINA, CERVIX AND VULVA PROCEDURES WITHOUT CC/MCC",,,8679.92,25105.82,32
MS-DRG,748,FEMALE REPRODUCTIVE SYSTEM RECONSTRUCTIVE PROCEDURES,,,12513.05,38000.0,24
MS-DRG,748,Female reproductive system reconstructive procedures,,,18150.0,40513.32,9
MS-DRG,749,OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES W CC/MCC,,,87800.0,87800.0,1
MS-DRG,749,OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITH CC/MCC,,,18150.0,74981.62,32
MS-DRG,75,Major Chest Procedures,,,32300.0,32300.0,1
MS-DRG,75,VIRAL MENINGITIS W CC/MCC,,,65700.0,65700.0,1
MS-DRG,75,VIRAL MENINGITIS WITH CC/MCC,,,15610.48,20100.0,10
MS-DRG,75,Viral meningitis w/CC/MCC,,,53483.0,59901.0,2
MS-DRG,750,OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES W/O CC/MCC,,,41400.0,41400.0,1
MS-DRG,750,OTHER FEMALE REPRODUCTIVE SYSTEM O.R. PROCEDURES WITHOUT CC/MCC,,,11886.86,43097.79,32
MS-DRG,754,"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM W MCC",,,41900.0,41900.0,1
MS-DRG,754,"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH MCC",,,16357.95,53783.17,32
MS-DRG,755,"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM W CC",,,24600.0,24600.0,1
MS-DRG,755,"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITH CC",,,10343.74,31767.02,32
MS-DRG,756,"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM W/O CC/MCC",,,14600.0,14600.0,1
MS-DRG,756,"MALIGNANCY, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC",,,9009.64,28049.48,32
MS-DRG,757,"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM W MCC",,,31500.0,31500.0,1
MS-DRG,757,"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH MCC",,,12968.94,41815.78,32
MS-DRG,758,"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM W CC",,,22900.0,22900.0,1
MS-DRG,758,"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITH CC",,,9562.72,28589.74,32
MS-DRG,759,"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM W/O CC/MCC",,,15400.0,15400.0,1
MS-DRG,759,"INFECTIONS, FEMALE REPRODUCTIVE SYSTEM WITHOUT CC/MCC",,,6300.15,19379.11,32
MS-DRG,76,VIRAL MENINGITIS W/O CC/MCC,,,37200.0,37200.0,1
MS-DRG,76,VIRAL MENINGITIS WITHOUT CC/MCC,,,6800.0,9212.07,10
MS-DRG,76,Viral meningitis w/o CC/MCC,,,27171.0,30432.0,2
MS-DRG,760,MENSTRUAL & OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS W CC/MCC,,,19300.0,19300.0,1
MS-DRG,760,MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITH CC/MCC,,,9272.85,29422.02,32
MS-DRG,761,MENSTRUAL & OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS W/O CC/MCC,,,12100.0,12100.0,1
MS-DRG,761,MENSTRUAL AND OTHER FEMALE REPRODUCTIVE SYSTEM DISORDERS WITHOUT CC/MCC,,,6120.56,18150.0,32
MS-DRG,768,VAGINAL DELIVERY W O.R. PROC EXCEPT STERIL &/OR D&C,,,36300.0,36300.0,1
MS-DRG,768,VAGINAL DELIVERY WITH O.R. PROCEDURES EXCEPT STERILIZATION AND/OR D&C,,,6141.0,11610.72,32
MS-DRG,769,POSTPARTUM & POST ABORTION DIAGNOSES W O.R. PROCEDURE,,,58800.0,58800.0,1
MS-DRG,769,POSTPARTUM AND POST ABORTION DIAGNOSES WITH O.R. PROCEDURES,,,12747.02,49347.23,32
MS-DRG,770,"ABORTION W D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY",,,27800.0,27800.0,1
MS-DRG,770,"ABORTION WITH D&C, ASPIRATION CURETTAGE OR HYSTEROTOMY",,,9945.45,29281.85,32
MS-DRG,776,POSTPARTUM & POST ABORTION DIAGNOSES W/O O.R. PROCEDURE,,,22100.0,22100.0,1
MS-DRG,776,POSTPARTUM AND POST ABORTION DIAGNOSES WITHOUT O.R. PROCEDURES,,,6865.71,19119.2,32
MS-DRG,779,ABORTION W/O D&C,,,19700.0,19700.0,1
MS-DRG,779,ABORTION WITHOUT D&C,,,8517.09,24568.48,32
MS-DRG,783,CESAREAN SECTION W STERILIZATION W MCC,,,48100.0,48100.0,1
MS-DRG,783,CESAREAN SECTION WITH STERILIZATION WITH MCC,,,9672.0,25078.79,32
MS-DRG,784,CESAREAN SECTION W STERILIZATION W CC,,,30300.0,30300.0,1
MS-DRG,784,CESAREAN SECTION WITH STERILIZATION WITH CC,,,9672.0,16775.0,32
MS-DRG,785,CESAREAN SECTION W STERILIZATION W/O CC/MCC,,,23400.0,23400.0,1
MS-DRG,785,CESAREAN SECTION WITH STERILIZATION WITHOUT CC/MCC,,,8308.61,16775.0,32
MS-DRG,786,CESAREAN SECTION W/O STERILIZATION W MCC,,,42900.0,42900.0,1
MS-DRG,786,CESAREAN SECTION WITHOUT STERILIZATION WITH MCC,,,9672.0,17236.45,32
MS-DRG,787,CESAREAN SECTION W/O STERILIZATION W CC,,,29800.0,29800.0,1
MS-DRG,787,CESAREAN SECTION WITHOUT STERILIZATION WITH CC,,,9672.0,16775.0,32
MS-DRG,788,CESAREAN SECTION W/O STERILIZATION W/O CC/MCC,,,24900.0,24900.0,1
MS-DRG,788,CESAREAN SECTION WITHOUT STERILIZATION WITHOUT CC/MCC,,,8576.98,16775.0,32
MS-DRG,789,"NEONATES, DIED OR TRANSFERRED TO ANOTHER ACUTE CARE FACILITY",,,16300.32,26600.0,24
MS-DRG,789,"Neonates, died or transferred to another acute care facility",,,2417.0,52629.65,10
MS-DRG,790,"EXTREME IMMATURITY OR RESPIRATORY DISTRESS SYNDROME, NEONATE",,,51929.72,87800.0,24
MS-DRG,790,"Extreme immaturity or respiratory distress syndrome, neonate",,,4371.0,173568.03,10
MS-DRG,791,PREMATURITY W MAJOR PROBLEMS,,,59900.0,59900.0,1
MS-DRG,791,PREMATURITY WITH MAJOR PROBLEMS,,,4371.0,118534.98,33
MS-DRG,792,PREMATURITY W/O MAJOR PROBLEMS,,,36100.0,36100.0,1
MS-DRG,792,PREMATURITY WITHOUT MAJOR PROBLEMS,,,2417.0,71523.99,33
MS-DRG,793,FULL TERM NEONATE W MAJOR PROBLEMS,,,61700.0,61700.0,1
MS-DRG,793,FULL TERM NEONATE WITH MAJOR PROBLEMS,,,4371.0,121764.83,33
MS-DRG,794,NEONATE W OTHER SIGNIFICANT PROBLEMS,,,21800.0,21800.0,1
MS-DRG,794,NEONATE WITH OTHER SIGNIFICANT PROBLEMS,,,2417.0,43100.71,33
MS-DRG,795,NORMAL NEWBORN,,,2513.74,3123.93,24
MS-DRG,795,Normal newborn,,,597.0,18150.0,10
MS-DRG,796,VAGINAL DELIVERY W STERILIZATION/D&C W MCC,,,40100.0,40100.0,1
MS-DRG,796,VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH MCC,,,6141.0,12539.42,32
MS-DRG,797,VAGINAL DELIVERY W STERILIZATION/D&C W CC,,,23200.0,23200.0,1
MS-DRG,797,VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITH CC,,,6141.0,10917.6,32
MS-DRG,798,VAGINAL DELIVERY W STERILIZATION/D&C WO CC/MCC,,,23200.0,23200.0,1
MS-DRG,798,VAGINAL DELIVERY WITH STERILIZATION AND/OR D&C WITHOUT CC/MCC,,,6141.0,10496.09,32
MS-DRG,799,SPLENECTOMY W MCC,,,82300.0,82300.0,1
MS-DRG,799,SPLENIC PROCEDURES WITH MCC,,,18150.0,132257.47,32
MS-DRG,8,SIMULTANEOUS PANCREAS AND KIDNEY TRANSPLANT,,,47597.11,308400.0,12
MS-DRG,8,Vagal NeNe Stimulation,,,26000.0,26000.0,1
MS-DRG,80,NONTRAUMATIC STUPOR & COMA W MCC,,,48600.0,48600.0,1
MS-DRG,80,NONTRAUMATIC STUPOR AND COMA WITH MCC,,,17089.89,18798.88,9
MS-DRG,80,Nontraumatic Stupor w/MCC,,,38317.0,42915.0,2
MS-DRG,800,SPLENECTOMY W CC,,,45900.0,45900.0,1
MS-DRG,800,SPLENIC PROCEDURES WITH CC,,,18150.0,82042.91,32
MS-DRG,801,SPLENECTOMY W/O CC/MCC,,,26900.0,26900.0,1
MS-DRG,801,SPLENIC PROCEDURES WITHOUT CC/MCC,,,14916.33,55745.61,32
MS-DRG,802,OTHER O.R. PROC OF THE BLOOD & BLOOD FORMING ORGANS W MCC,,,51100.0,51100.0,1
MS-DRG,802,OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH MCC,,,18150.0,116347.67,32
MS-DRG,803,OTHER O.R. PROC OF THE BLOOD & BLOOD FORMING ORGANS W CC,,,28700.0,28700.0,1
MS-DRG,803,OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITH CC,,,16105.93,54285.46,32
MS-DRG,804,OTHER O.R. PROC OF THE BLOOD & BLOOD FORMING ORGANS W/O CC/MCC,,,19900.0,19900.0,1
MS-DRG,804,OTHER O.R. PROCEDURES OF THE BLOOD AND BLOOD FORMING ORGANS WITHOUT CC/MCC,,,10305.03,39599.27,32
MS-DRG,805,VAGINAL DELIVERY W/O STERILIZATION/D&C W MCC,,,30600.0,30600.0,1
MS-DRG,805,VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH MCC,,,6141.0,11684.71,32
MS-DRG,806,VAGINAL DELIVERY W/O STERILIZATION/D&C W CC,,,21100.0,21100.0,1
MS-DRG,806,VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITH CC,,,6141.0,10160.0,32
MS-DRG,807,VAGINAL DELIVERY W/O STERILIZATION/D&C W/O CC/MCC,,,18200.0,18200.0,1
MS-DRG,807,VAGINAL DELIVERY WITHOUT STERILIZATION OR D&C WITHOUT CC/MCC,,,6141.0,10160.0,32
MS-DRG,808,MAJOR HEMATOL/IMMUN DIAG EXC SICKLE CELL CRISIS & COAGUL W MCC,,,71800.0,71800.0,1
MS-DRG,808,MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH MCC,,,18150.0,64477.3,32
MS-DRG,809,MAJOR HEMATOL/IMMUN DIAG EXC SICKLE CELL CRISIS & COAGUL W CC,,,39800.0,39800.0,1
MS-DRG,809,MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITH CC,,,11448.18,36968.08,32
MS-DRG,81,NONTRAUMATIC STUPOR & COMA W/O MCC,,,29700.0,29700.0,1
MS-DRG,81,NONTRAUMATIC STUPOR AND COMA WITHOUT MCC,,,8577.84,10900.0,10
MS-DRG,81,Nontraumatic Stupor w/o MCC,,,8937.0,10009.0,2
MS-DRG,810,MAJOR HEMATOL/IMMUN DIAG EXC SICKLE CELL CRISIS & COAGUL W/O CC/MCC,,,31000.0,31000.0,1
MS-DRG,810,MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATION DISORDERS WITHOUT CC/MCC,,,8982.11,30563.86,32
MS-DRG,811,RED BLOOD CELL DISORDERS W MCC,,,44100.0,44100.0,1
MS-DRG,811,RED BLOOD CELL DISORDERS WITH MCC,,,12896.68,41009.77,32
MS-DRG,812,RED BLOOD CELL DISORDERS W/O MCC,,,28500.0,28500.0,1
MS-DRG,812,RED BLOOD CELL DISORDERS WITHOUT MCC,,,8733.53,26814.19,32
MS-DRG,813,COAGULATION DISORDERS,,,14110.37,63500.0,24
MS-DRG,813,Coagulation disorders,,,18150.0,44543.34,9
MS-DRG,814,RETICULOENDOTHELIAL & IMMUNITY DISORDERS W MCC,,,56200.0,56200.0,1
MS-DRG,814,RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH MCC,,,18150.0,62106.02,32
MS-DRG,815,RETICULOENDOTHELIAL & IMMUNITY DISORDERS W CC,,,31900.0,31900.0,1
MS-DRG,815,RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITH CC,,,9535.19,29611.84,32
MS-DRG,816,RETICULOENDOTHELIAL & IMMUNITY DISORDERS W/O CC/MCC,,,24200.0,24200.0,1
MS-DRG,816,RETICULOENDOTHELIAL AND IMMUNITY DISORDERS WITHOUT CC/MCC,,,6467.02,18456.3,32
MS-DRG,817,OTHER ANTEPARTUM DIAGNOSES W O.R. PROCEDURE W MCC,,,76700.0,76700.0,1
MS-DRG,817,OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH MCC,,,18150.0,66629.56,32
MS-DRG,818,OTHER ANTEPARTUM DIAGNOSES W O.R. PROCEDURE W CC,,,41100.0,41100.0,1
MS-DRG,818,OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITH CC,,,11330.44,33852.12,32
MS-DRG,819,OTHER ANTEPARTUM DIAGNOSES W O.R. PROCEDURE W/O CC/MCC,,,20600.0,20600.0,1
MS-DRG,819,OTHER ANTEPARTUM DIAGNOSES WITH O.R. PROCEDURES WITHOUT CC/MCC,,,7818.32,25111.66,32
MS-DRG,82,Respiratory Neoplasms,,,9600.0,9600.0,1
MS-DRG,82,"TRAUMATIC STUPOR & COMA, COMA >1 HR W MCC",,,77700.0,77700.0,1
MS-DRG,82,TRAUMATIC STUPOR AND COMA >1 HOUR WITH MCC,,,20752.49,23428.75,9
MS-DRG,82,Traumatic Stupor & Coma w/MCC,,,58459.0,65474.0,2
MS-DRG,820,LYMPHOMA & LEUKEMIA W MAJOR O.R. PROCEDURE W MCC,,,123400.0,123400.0,1
MS-DRG,820,LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH MCC,,,20350.0,207900.0,37
MS-DRG,821,LYMPHOMA & LEUKEMIA W MAJOR O.R. PROCEDURE W CC,,,48700.0,48700.0,1
MS-DRG,821,LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITH CC,,,19997.28,65373.84,37
MS-DRG,822,LYMPHOMA & LEUKEMIA W MAJOR O.R. PROCEDURE W/O CC/MCC,,,25300.0,25300.0,1
MS-DRG,822,LYMPHOMA AND LEUKEMIA WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC,,,10632.75,53000.0,37
MS-DRG,823,LYMPHOMA & NON-ACUTE LEUKEMIA W OTHER O.R. PROC W MCC,,,92500.0,92500.0,1
MS-DRG,823,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH MCC,,,20350.0,133889.91,37
MS-DRG,824,LYMPHOMA & NON-ACUTE LEUKEMIA W OTHER O.R. PROC W CC,,,47200.0,47200.0,1
MS-DRG,824,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITH CC,,,19713.42,72800.0,37
MS-DRG,825,LYMPHOMA & NON-ACUTE LEUKEMIA W OTHER O.R. PROC W/O CC/MCC,,,28400.0,28400.0,1
MS-DRG,825,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH OTHER PROCEDURES WITHOUT CC/MCC,,,11381.95,45700.0,37
MS-DRG,826,MYELOPROLIF DISORD OR POORLY DIFF NEOPL W MAJ O.R. PROC W MCC,,,101700.0,101700.0,1
MS-DRG,826,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH MCC,,,20350.0,136605.79,32
MS-DRG,827,MYELOPROLIF DISORD OR POORLY DIFF NEOPL W MAJ O.R. PROC W CC,,,49100.0,49100.0,1
MS-DRG,827,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITH CC,,,20350.0,98600.0,37
MS-DRG,828,MYELOPROLIF DISORD OR POORLY DIFF NEOPL W MAJ O.R. PROC W/O CC/MCC,,,30700.0,30700.0,1
MS-DRG,828,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH MAJOR O.R. PROCEDURES WITHOUT CC/MCC,,,14582.59,49756.07,32
MS-DRG,829,MYELOPROLIF DISORD OR POORLY DIFF NEOPL W OTHER O.R. PROC W CC/MCC,,,70000.0,70000.0,1
MS-DRG,829,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURES WITH CC/MCC,,,20350.0,104500.0,37
MS-DRG,83,"TRAUMATIC STUPOR & COMA, COMA >1 HR W CC",,,49500.0,49500.0,1
MS-DRG,83,TRAUMATIC STUPOR AND COMA >1 HOUR WITH CC,,,12754.76,14766.73,9
MS-DRG,83,Traumatic Stupor & Coma w/CC,,,40874.0,45779.0,2
MS-DRG,830,MYELOPROLIF DISORD OR POORLY DIFF NEOPL W OTHER O.R. PROC W/O CC/MCC,,,31400.0,31400.0,1
MS-DRG,830,MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASMS WITH OTHER PROCEDURES WITHOUT CC/MCC,,,13374.93,43950.52,32
MS-DRG,831,OTHER ANTEPARTUM DIAGNOSES W/O O.R. PROCEDURE W MCC,,,31100.0,31100.0,1
MS-DRG,831,OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH MCC,,,10695.54,35116.61,32
MS-DRG,832,OTHER ANTEPARTUM DIAGNOSES W/O O.R. PROCEDURE W CC,,,21700.0,21700.0,1
MS-DRG,832,OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITH CC,,,7223.95,21072.88,32
MS-DRG,833,OTHER ANTEPARTUM DIAGNOSES W/O O.R. PROCEDURE W/O CC/MCC,,,11700.0,11700.0,1
MS-DRG,833,OTHER ANTEPARTUM DIAGNOSES WITHOUT O.R. PROCEDURES WITHOUT CC/MCC,,,5266.24,18150.0,32
MS-DRG,834,ACUTE LEUKEMIA W/O MAJOR O.R. PROCEDURE W MCC,,,116100.0,116100.0,1
MS-DRG,834,ACUTE LEUKEMIA WITH MCC,,,49656.28,54621.91,22
MS-DRG,834,ACUTE LEUKEMIA WITHOUT MAJOR O.R. PROCEDURES WITH MCC,,,17927.0,160321.55,15
MS-DRG,835,ACUTE LEUKEMIA W/O MAJOR O.R. PROCEDURE W CC,,,46500.0,46500.0,1
MS-DRG,835,ACUTE LEUKEMIA WITH CC,,,19530.67,21483.74,22
MS-DRG,835,ACUTE LEUKEMIA WITHOUT MAJOR O.R. PROCEDURES WITH CC,,,19167.22,106100.0,15
MS-DRG,836,ACUTE LEUKEMIA W/O MAJOR O.R. PROCEDURE W/O CC/MCC,,,24900.0,24900.0,1
MS-DRG,836,ACUTE LEUKEMIA WITHOUT CC/MCC,,,11864.08,13050.49,22
MS-DRG,836,ACUTE LEUKEMIA WITHOUT MAJOR O.R. PROCEDURES WITHOUT CC/MCC,,,11725.15,35613.06,15
MS-DRG,837,CHEMO W ACUTE LEUKEMIA AS SDX OR W HIGH DOSE CHEMO AGENT W MCC,,,123800.0,123800.0,1
MS-DRG,837,CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS OR WITH HIGH DOSE CHEMOTHERAPY AGENT WITH MCC,,,17927.0,171600.0,37
MS-DRG,838,CHEMO W ACUTE LEUKEMIA AS SDX W CC OR HIGH DOSE CHEMO AGENT,,,54100.0,54100.0,1
MS-DRG,838,CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC OR HIGH DOSE CHEMOTHERAPY AGENT,,,17927.0,71900.0,37
MS-DRG,839,CHEMO W ACUTE LEUKEMIA AS SDX W/O CC/MCC,,,27900.0,27900.0,1
MS-DRG,839,CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC,,,12582.73,42166.21,37
MS-DRG,84,"TRAUMATIC STUPOR & COMA, COMA >1 HR W/O CC/MCC",,,35800.0,35800.0,1
MS-DRG,84,TRAUMATIC STUPOR AND COMA >1 HOUR WITHOUT CC/MCC,,,9019.1,10483.43,9
MS-DRG,84,Traumaic Stupor & Coma w/o CC/MCC,,,26410.0,29579.0,2
MS-DRG,840,LYMPHOMA & NON-ACUTE LEUKEMIA W MCC,,,64400.0,64400.0,1
MS-DRG,840,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH MCC,,,17927.0,94468.78,37
MS-DRG,841,LYMPHOMA & NON-ACUTE LEUKEMIA W CC,,,35000.0,35000.0,1
MS-DRG,841,LYMPHOMA AND NON-ACUTE LEUKEMIA WITH CC,,,14282.4,47641.77,37
MS-DRG,842,LYMPHOMA & NON-ACUTE LEUKEMIA W/O CC/MCC,,,23400.0,23400.0,1
MS-DRG,842,LYMPHOMA AND NON-ACUTE LEUKEMIA WITHOUT CC/MCC,,,9843.13,29506.71,37
MS-DRG,843,OTHER MYELOPROLIF DIS OR POORLY DIFF NEOPL DIAG W MCC,,,37200.0,37200.0,1
MS-DRG,843,OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH MCC,,,17080.49,58254.14,32
MS-DRG,844,OTHER MYELOPROLIF DIS OR POORLY DIFF NEOPL DIAG W CC,,,24400.0,24400.0,1
MS-DRG,844,OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITH CC,,,11075.73,35551.73,37
MS-DRG,845,OTHER MYELOPROLIF DIS OR POORLY DIFF NEOPL DIAG W/O CC/MCC,,,17600.0,17600.0,1
MS-DRG,845,OTHER MYELOPROLIFERATIVE DISORDERS OR POORLY DIFFERENTIATED NEOPLASTIC DIAGNOSES WITHOUT CC/MCC,,,7992.93,24869.27,32
MS-DRG,846,CHEMOTHERAPY W/O ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS W MCC,,,50800.0,50800.0,1
MS-DRG,846,CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH MCC,,,13900.0,75708.78,37
MS-DRG,847,CHEMOTHERAPY W/O ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS W CC,,,25800.0,25800.0,1
MS-DRG,847,CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC,,,11725.15,38203.36,37
MS-DRG,848,CHEMOTHERAPY W/O ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS W/O CC/MCC,,,18800.0,18800.0,1
MS-DRG,848,CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITHOUT CC/MCC,,,7838.97,24805.03,37
MS-DRG,849,RADIOTHERAPY,,,18100.0,36100.0,25
MS-DRG,849,Radiotherapy,,,20350.0,79125.53,13
MS-DRG,85,"TRAUMATIC STUPOR & COMA, COMA <1 HR W MCC",,,77500.0,77500.0,1
MS-DRG,85,TRAUMATIC STUPOR AND COMA <1 HOUR WITH MCC,,,20286.29,23295.38,9
MS-DRG,85,Traumatic Stupor & Coma w/MCC,,,61914.0,69344.0,2
MS-DRG,850,ACUTE LEUKEMIA WITH OTHER PROCEDURES,,,18150.0,252883.38,32
MS-DRG,853,INFECTIOUS & PARASITIC DISEASES W O.R. PROCEDURE W MCC,,,115000.0,115000.0,1
MS-DRG,853,INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC,,,17927.0,144221.94,37
MS-DRG,854,INFECTIOUS & PARASITIC DISEASES W O.R. PROCEDURE W CC,,,53200.0,53200.0,1
MS-DRG,854,INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC,,,17981.93,58350.51,32
MS-DRG,855,INFECTIOUS & PARASITIC DISEASES W O.R. PROCEDURE W/O CC/MCC,,,35200.0,35200.0,1
MS-DRG,855,INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITHOUT CC/MCC,,,14321.67,43722.73,32
MS-DRG,856,POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS W O.R. PROC W MCC,,,104400.0,104400.0,1
MS-DRG,856,POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH MCC,,,17927.0,132835.69,37
MS-DRG,857,POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS W O.R. PROC W CC,,,46800.0,46800.0,1
MS-DRG,857,POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH CC,,,18150.0,62538.22,37
MS-DRG,858,POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS W O.R. PROC W/O CC/MCC,,,32700.0,32700.0,1
MS-DRG,858,POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITHOUT CC/MCC,,,11877.4,40676.86,37
MS-DRG,86,"TRAUMATIC STUPOR & COMA, COMA <1 HR W CC",,,44100.0,44100.0,1
MS-DRG,86,TRAUMATIC STUPOR AND COMA <1 HOUR WITH CC,,,12076.96,14300.0,10
MS-DRG,86,Traumatic Stupor & Coma w/CC,,,36062.0,40389.0,2
MS-DRG,862,POSTOPERATIVE & POST-TRAUMATIC INFECTIONS W MCC,,,45700.0,45700.0,1
MS-DRG,862,POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITH MCC,,,16610.84,53257.51,37
MS-DRG,863,POSTOPERATIVE & POST-TRAUMATIC INFECTIONS W/O MCC,,,24900.0,24900.0,1
MS-DRG,863,POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITHOUT MCC,,,9395.85,29141.67,37
MS-DRG,864,FEVER,,,21100.0,21100.0,1
MS-DRG,864,FEVER AND INFLAMMATORY CONDITIONS,,,8519.35,25923.5,37
MS-DRG,865,VIRAL ILLNESS W MCC,,,33400.0,33400.0,1
MS-DRG,865,VIRAL ILLNESS WITH MCC,,,13490.19,43754.85,32
MS-DRG,866,VIRAL ILLNESS W/O MCC,,,19300.0,19300.0,1
MS-DRG,866,VIRAL ILLNESS WITHOUT MCC,,,7700.0,25394.93,37
MS-DRG,867,OTHER INFECTIOUS & PARASITIC DISEASES DIAGNOSES W MCC,,,66600.0,66600.0,1
MS-DRG,867,OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH MCC,,,18150.0,61127.72,37
MS-DRG,868,OTHER INFECTIOUS & PARASITIC DISEASES DIAGNOSES W CC,,,26600.0,26600.0,1
MS-DRG,868,OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITH CC,,,9827.65,37600.0,37
MS-DRG,869,OTHER INFECTIOUS & PARASITIC DISEASES DIAGNOSES W/O CC/MCC,,,16700.0,16700.0,1
MS-DRG,869,OTHER INFECTIOUS AND PARASITIC DISEASES DIAGNOSES WITHOUT CC/MCC,,,6984.83,21309.43,32
MS-DRG,87,"TRAUMATIC STUPOR & COMA, COMA <1 HR W/O CC/MCC",,,31200.0,31200.0,1
MS-DRG,87,TRAUMATIC STUPOR AND COMA <1 HOUR WITHOUT CC/MCC,,,6800.0,10083.33,10
MS-DRG,87,Traumatic Stupor & Coma w/o CC/MCC,,,23098.0,25870.0,2
MS-DRG,870,SEPTICEMIA OR SEVERE SEPSIS W MV >96 HOURS,,,148400.0,148400.0,1
MS-DRG,870,SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS,,,17927.0,201845.3,37
MS-DRG,871,SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W MCC,,,44400.0,44400.0,1
MS-DRG,871,SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC,,,17672.27,56726.83,37
MS-DRG,872,SEPTICEMIA OR SEVERE SEPSIS W/O MV >96 HOURS W/O MCC,,,25900.0,25900.0,1
MS-DRG,872,SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC,,,9663.36,29883.43,37
MS-DRG,876,O.R. PROCEDURE W PRINCIPAL DIAGNOSES OF MENTAL ILLNESS,,,59100.0,59100.0,1
MS-DRG,876,O.R. PROCEDURES WITH PRINCIPAL DIAGNOSIS OF MENTAL ILLNESS,,,1243.0,112866.67,33
MS-DRG,88,CONCUSSION W MCC,,,57400.0,57400.0,1
MS-DRG,88,CONCUSSION WITH MCC,,,12929.37,14338.4,9
MS-DRG,88,Concussion w/MCC,,,47641.0,53358.0,2
MS-DRG,880,ACUTE ADJUSTMENT REACTION & PSYCHOSOCIAL DYSFUNCTION,,,21700.0,21700.0,1
MS-DRG,880,ACUTE ADJUSTMENT REACTION AND PSYCHOSOCIAL DYSFUNCTION,,,1637.0,28040.72,32
MS-DRG,881,DEPRESSIVE NEUROSES,,,8657.83,19500.0,24
MS-DRG,881,Depressive neuroses,,,1637.0,27477.1,9
MS-DRG,882,NEUROSES EXCEPT DEPRESSIVE,,,9069.85,21300.0,24
MS-DRG,882,Neuroses except depressive,,,1637.0,31358.18,9
MS-DRG,883,DISORDERS OF PERSONALITY & IMPULSE CONTROL,,,37600.0,37600.0,1
MS-DRG,883,DISORDERS OF PERSONALITY AND IMPULSE CONTROL,,,1637.0,57421.86,32
MS-DRG,884,ORGANIC DISTURBANCES & INTELLECTUAL DISABILITY,,,34400.0,34400.0,1
MS-DRG,884,ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY,,,1637.0,46984.71,32
MS-DRG,885,PSYCHOSES,,,12919.91,32100.0,24
MS-DRG,885,Psychoses,,,1637.0,40790.75,9
MS-DRG,886,BEHAVIORAL & DEVELOPMENTAL DISORDERS,,,24500.0,24500.0,1
MS-DRG,886,BEHAVIORAL AND DEVELOPMENTAL DISORDERS,,,1243.0,60604.99,33
MS-DRG,887,OTHER MENTAL DISORDER DIAGNOSES,,,10549.0,29500.0,24
MS-DRG,887,Other mental disorder diagnoses,,,1243.0,31273.49,10
MS-DRG,89,CONCUSSION W CC,,,39300.0,39300.0,1
MS-DRG,89,CONCUSSION WITH CC,,,10016.88,11873.55,9
MS-DRG,89,Concussion w/CC,,,29730.0,33298.0,2
MS-DRG,894,"ALCOHOL, DRUG ABUSE OR DEPENDENCE, LEFT AMA",,,6163.38,7184.31,23
MS-DRG,894,"ALCOHOL/DRUG ABUSE OR DEPENDENCE, LEFT AMA",,,12000.0,12000.0,1
MS-DRG,894,"Alcohol/drug abuse or dependence, left AMA",,,1243.0,18150.0,10
MS-DRG,895,"ALCOHOL, DRUG ABUSE OR DEPENDENCE WITH REHABILITATION THERAPY",,,13599.53,14959.48,22
MS-DRG,895,ALCOHOL/DRUG ABUSE OR DEPENDENCE W REHABILITATION THERAPY,,,32200.0,32200.0,1
MS-DRG,895,Alcohol/drug abuse or dependence w rehabilitation therapy,,,1243.0,41339.77,10
MS-DRG,896,"ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITH MCC",,,16515.54,18167.09,22
MS-DRG,896,ALCOHOL/DRUG ABUSE OR DEPENDENCE W/O REHABILITATION THERAPY W MCC,,,40000.0,40000.0,1
MS-DRG,896,Alcohol/drug abuse or dependence w/o rehabilitation therapy w MCC,,,1243.0,50962.16,10
MS-DRG,897,"ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC",,,8884.35,9772.79,22
MS-DRG,897,ALCOHOL/DRUG ABUSE OR DEPENDENCE W/O REHABILITATION THERAPY W/O MCC,,,18600.0,18600.0,1
MS-DRG,897,Alcohol/drug abuse or dependence w/o rehabilitation therapy w/o MCC,,,1243.0,25780.41,10
MS-DRG,90,CONCUSSION W/O CC/MCC,,,29500.0,29500.0,1
MS-DRG,90,CONCUSSION WITHOUT CC/MCC,,,8169.27,9192.6,9
MS-DRG,90,Concussion w/o CC/MCC,,,21920.0,24550.0,2
MS-DRG,901,WOUND DEBRIDEMENTS FOR INJURIES W MCC,,,77400.0,77400.0,1
MS-DRG,901,WOUND DEBRIDEMENTS FOR INJURIES WITH MCC,,,18150.0,122553.31,32
MS-DRG,902,WOUND DEBRIDEMENTS FOR INJURIES W CC,,,33900.0,33900.0,1
MS-DRG,902,WOUND DEBRIDEMENTS FOR INJURIES WITH CC,,,17117.47,55909.14,32
MS-DRG,903,WOUND DEBRIDEMENTS FOR INJURIES W/O CC/MCC,,,19900.0,19900.0,1
MS-DRG,903,WOUND DEBRIDEMENTS FOR INJURIES WITHOUT CC/MCC,,,11281.31,34155.83,32
MS-DRG,904,SKIN GRAFTS FOR INJURIES W CC/MCC,,,58400.0,58400.0,1
MS-DRG,904,SKIN GRAFTS FOR INJURIES WITH CC/MCC,,,18150.0,107265.54,32
MS-DRG,905,SKIN GRAFTS FOR INJURIES W/O CC/MCC,,,24700.0,24700.0,1
MS-DRG,905,SKIN GRAFTS FOR INJURIES WITHOUT CC/MCC,,,14199.55,43319.73,32
MS-DRG,906,HAND PROCEDURES FOR INJURIES,,,18455.42,26900.0,24
MS-DRG,906,Hand procedures for injuries,,,18150.0,57363.45,9
MS-DRG,907,OTHER O.R. PROCEDURES FOR INJURIES W MCC,,,69200.0,69200.0,1
MS-DRG,907,OTHER O.R. PROCEDURES FOR INJURIES WITH MCC,,,18150.0,112119.08,32
MS-DRG,908,OTHER O.R. PROCEDURES FOR INJURIES W CC,,,36800.0,36800.0,1
MS-DRG,908,OTHER O.R. PROCEDURES FOR INJURIES WITH CC,,,18145.36,58265.83,32
MS-DRG,909,OTHER O.R. PROCEDURES FOR INJURIES W/O CC/MCC,,,23500.0,23500.0,1
MS-DRG,909,OTHER O.R. PROCEDURES FOR INJURIES WITHOUT CC/MCC,,,11704.51,38334.78,32
MS-DRG,91,OTHER DISORDERS OF NERVOUS SYSTEM W MCC,,,61100.0,61100.0,1
MS-DRG,91,OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC,,,16474.94,26200.0,10
MS-DRG,91,Other disorders of nervous system w/MCC,,,50363.0,56407.0,2
MS-DRG,913,TRAUMATIC INJURY W MCC,,,30800.0,30800.0,1
MS-DRG,913,TRAUMATIC INJURY WITH MCC,,,14715.06,47735.22,32
MS-DRG,914,TRAUMATIC INJURY W/O MCC,,,18800.0,18800.0,1
MS-DRG,914,TRAUMATIC INJURY WITHOUT MCC,,,8677.62,25859.26,32
MS-DRG,915,ALLERGIC REACTIONS W MCC,,,39500.0,39500.0,1
MS-DRG,915,ALLERGIC REACTIONS WITH MCC,,,15743.8,49107.76,32
MS-DRG,916,ALLERGIC REACTIONS W/O MCC,,,14700.0,14700.0,1
MS-DRG,916,ALLERGIC REACTIONS WITHOUT MCC,,,6507.44,19457.96,32
MS-DRG,917,POISONING & TOXIC EFFECTS OF DRUGS W MCC,,,35300.0,35300.0,1
MS-DRG,917,POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC,,,14899.13,45801.99,32
MS-DRG,918,POISONING & TOXIC EFFECTS OF DRUGS W/O MCC,,,17600.0,17600.0,1
MS-DRG,918,POISONING AND TOXIC EFFECTS OF DRUGS WITHOUT MCC,,,8404.09,25029.89,32
MS-DRG,919,COMPLICATIONS OF TREATMENT W MCC,,,43800.0,43800.0,1
MS-DRG,919,COMPLICATIONS OF TREATMENT WITH MCC,,,16480.96,53464.85,32
MS-DRG,92,OTHER DISORDERS OF NERVOUS SYSTEM W CC,,,35500.0,35500.0,1
MS-DRG,92,OTHER DISORDERS OF NERVOUS SYSTEM WITH CC,,,9901.62,12600.0,10
MS-DRG,92,Other disorders of nervous system w/CC,,,27983.0,31341.0,2
MS-DRG,920,COMPLICATIONS OF TREATMENT W CC,,,24800.0,24800.0,1
MS-DRG,920,COMPLICATIONS OF TREATMENT WITH CC,,,9533.47,29270.17,32
MS-DRG,921,COMPLICATIONS OF TREATMENT W/O CC/MCC,,,17200.0,17200.0,1
MS-DRG,921,COMPLICATIONS OF TREATMENT WITHOUT CC/MCC,,,6710.44,20103.35,32
MS-DRG,922,"OTHER INJURY, POISONING & TOXIC EFFECT DIAG W MCC",,,35700.0,35700.0,1
MS-DRG,922,"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITH MCC",,,15326.63,51087.73,32
MS-DRG,923,"OTHER INJURY, POISONING & TOXIC EFFECT DIAG W/O MCC",,,20200.0,20200.0,1
MS-DRG,923,"OTHER INJURY, POISONING AND TOXIC EFFECT DIAGNOSES WITHOUT MCC",,,9567.88,29719.89,32
MS-DRG,927,EXTENSIVE BURNS OR FULL THICKNESS BURNS W MV >96 HRS W SKIN GRAFT,,,375600.0,375600.0,1
MS-DRG,927,EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITH SKIN GRAFT,,,18150.0,623498.65,32
MS-DRG,928,FULL THICKNESS BURN W SKIN GRAFT OR INHAL INJ W CC/MCC,,,135100.0,135100.0,1
MS-DRG,928,FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITH CC/MCC,,,18150.0,209464.36,32
MS-DRG,929,FULL THICKNESS BURN W SKIN GRAFT OR INHAL INJ W/O CC/MCC,,,66600.0,66600.0,1
MS-DRG,929,FULL THICKNESS BURN WITH SKIN GRAFT OR INHALATION INJURY WITHOUT CC/MCC,,,18150.0,94057.02,32
MS-DRG,93,OTHER DISORDERS OF NERVOUS SYSTEM W/O CC/MCC,,,27400.0,27400.0,1
MS-DRG,93,OTHER DISORDERS OF NERVOUS SYSTEM WITHOUT CC/MCC,,,7584.36,9000.0,10
MS-DRG,93,Other disorders of nervous system w/o CC/MCC,,,21072.0,23601.0,2
MS-DRG,933,EXTENSIVE BURNS OR FULL THICKNESS BURNS W MV >96 HRS W/O SKIN GRAFT,,,46400.0,46400.0,1
MS-DRG,933,EXTENSIVE BURNS OR FULL THICKNESS BURNS WITH MV >96 HOURS WITHOUT SKIN GRAFT,,,18150.0,113722.32,32
MS-DRG,934,FULL THICKNESS BURN W/O SKIN GRFT OR INHAL INJ,,,24600.0,24600.0,1
MS-DRG,934,FULL THICKNESS BURN WITHOUT SKIN GRAFT OR INHALATION INJURY,,,18150.0,64556.15,32
MS-DRG,935,NON-EXTENSIVE BURNS,,,19302.34,24600.0,24
MS-DRG,935,Non-extensive burns,,,18150.0,60158.18,9
MS-DRG,939,O.R. PROC W DIAGNOSES OF OTHER CONTACT W HEALTH SERVICES W MCC,,,64600.0,64600.0,1
MS-DRG,939,O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH MCC,,,18150.0,105963.09,32
MS-DRG,94,BACTERIAL & TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM W MCC,,,134700.0,134700.0,1
MS-DRG,94,BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH MCC,,,32179.67,50200.0,10
MS-DRG,94,Bacterial & Tuberculous w/MCC,,,108286.0,121280.0,2
MS-DRG,940,O.R. PROC W DIAGNOSES OF OTHER CONTACT W HEALTH SERVICES W CC,,,38600.0,38600.0,1
MS-DRG,940,O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITH CC,,,18150.0,68244.49,32
MS-DRG,941,O.R. PROC W DIAGNOSES OF OTHER CONTACT W HEALTH SERVICES W/O CC/MCC,,,28000.0,28000.0,1
MS-DRG,941,O.R. PROCEDURES WITH DIAGNOSES OF OTHER CONTACT WITH HEALTH SERVICES WITHOUT CC/MCC,,,17605.18,59214.92,32
MS-DRG,945,REHABILITATION W CC/MCC,,,30700.0,30700.0,1
MS-DRG,945,REHABILITATION WITH CC/MCC,,,1949.0,45223.77,32
MS-DRG,946,REHABILITATION W/O CC/MCC,,,26500.0,26500.0,1
MS-DRG,946,REHABILITATION WITHOUT CC/MCC,,,1949.0,33490.0,32
MS-DRG,947,SIGNS & SYMPTOMS W MCC,,,28600.0,28600.0,1
MS-DRG,947,SIGNS AND SYMPTOMS WITH MCC,,,11858.48,37070.29,32
MS-DRG,948,SIGNS & SYMPTOMS W/O MCC,,,18800.0,18800.0,1
MS-DRG,948,SIGNS AND SYMPTOMS WITHOUT MCC,,,7629.09,23377.0,32
MS-DRG,949,AFTERCARE W CC/MCC,,,23800.0,23800.0,1
MS-DRG,949,AFTERCARE WITH CC/MCC,,,10076.23,34742.81,32
MS-DRG,95,BACTERIAL & TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM W CC,,,92000.0,92000.0,1
MS-DRG,95,BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITH CC,,,21414.81,34900.0,10
MS-DRG,95,Bacterial & Tuberculous w/CC,,,74793.0,83768.0,2
MS-DRG,950,AFTERCARE W/O CC/MCC,,,14200.0,14200.0,1
MS-DRG,950,AFTERCARE WITHOUT CC/MCC,,,5836.52,18330.72,32
MS-DRG,951,OTHER FACTORS INFLUENCING HEALTH STATUS,,,5672.23,23300.0,24
MS-DRG,951,Other factors influencing health status,,,8084.8,18150.0,9
MS-DRG,955,CRANIOTOMY FOR MULTIPLE SIGNIFICANT TRAUMA,,,59529.2,142500.0,24
MS-DRG,955,Craniotomy for multiple significant trauma,,,18150.0,196568.31,9
MS-DRG,956,"LIMB REATTACHMENT, HIP & FEMUR PROC FOR MULTIPLE SIGNIFICANT TRAUMA",,,99200.0,99200.0,1
MS-DRG,956,"LIMB REATTACHMENT, HIP AND FEMUR PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA",,,18150.0,109890.89,32
MS-DRG,957,OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA W MCC,,,179200.0,179200.0,1
MS-DRG,957,OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH MCC,,,18150.0,222523.94,32
MS-DRG,958,OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA W CC,,,100400.0,100400.0,1
MS-DRG,958,OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITH CC,,,18150.0,123058.52,32
MS-DRG,959,OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA W/O CC/MCC,,,65800.0,65800.0,1
MS-DRG,959,OTHER O.R. PROCEDURES FOR MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC,,,18150.0,85976.55,32
MS-DRG,96,BACTERIAL & TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM W/O CC/MCC,,,82800.0,82800.0,1
MS-DRG,96,BACTERIAL AND TUBERCULOUS INFECTIONS OF NERVOUS SYSTEM WITHOUT CC/MCC,,,21414.81,38600.0,10
MS-DRG,96,Bacterial & Tuberculous w/o CC/MCC,,,61220.0,68566.0,2
MS-DRG,963,OTHER MULTIPLE SIGNIFICANT TRAUMA W MCC,,,51300.0,51300.0,1
MS-DRG,963,OTHER MULTIPLE SIGNIFICANT TRAUMA WITH MCC,,,18150.0,79835.16,32
MS-DRG,964,OTHER MULTIPLE SIGNIFICANT TRAUMA W CC,,,28100.0,28100.0,1
MS-DRG,964,OTHER MULTIPLE SIGNIFICANT TRAUMA WITH CC,,,13698.35,44756.52,32
MS-DRG,965,OTHER MULTIPLE SIGNIFICANT TRAUMA W/O CC/MCC,,,19200.0,19200.0,1
MS-DRG,965,OTHER MULTIPLE SIGNIFICANT TRAUMA WITHOUT CC/MCC,,,8644.93,27465.42,32
MS-DRG,969,HIV W EXTENSIVE O.R. PROCEDURE W MCC,,,152700.0,152700.0,1
MS-DRG,969,HIV WITH EXTENSIVE O.R. PROCEDURES WITH MCC,,,18150.0,178760.32,32
MS-DRG,97,NON-BACTERIAL INFECT OF NERVOUS SYS EXC VIRAL MENINGITIS W MCC,,,120100.0,120100.0,1
MS-DRG,97,NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH MCC,,,31628.31,36339.02,9
MS-DRG,97,Non Bacterial Infect of Nervous System w/MCC,,,102398.0,114686.0,2
MS-DRG,970,HIV W EXTENSIVE O.R. PROCEDURE W/O MCC,,,62800.0,62800.0,1
MS-DRG,970,HIV WITH EXTENSIVE O.R. PROCEDURES WITHOUT MCC,,,18150.0,77019.99,32
MS-DRG,974,HIV W MAJOR RELATED CONDITION W MCC,,,73300.0,73300.0,1
MS-DRG,974,HIV WITH MAJOR RELATED CONDITION WITH MCC,,,18150.0,84279.86,32
MS-DRG,975,HIV W MAJOR RELATED CONDITION W CC,,,35000.0,35000.0,1
MS-DRG,975,HIV WITH MAJOR RELATED CONDITION WITH CC,,,12532.24,37817.89,32
MS-DRG,976,HIV W MAJOR RELATED CONDITION W/O CC/MCC,,,24100.0,24100.0,1
MS-DRG,976,HIV WITH MAJOR RELATED CONDITION WITHOUT CC/MCC,,,9060.47,26361.55,32
MS-DRG,977,HIV W OR W/O OTHER RELATED CONDITION,,,34100.0,34100.0,1
MS-DRG,977,HIV WITH OR WITHOUT OTHER RELATED CONDITION,,,12556.14,37896.73,32
MS-DRG,98,NON-BACTERIAL INFECT OF NERVOUS SYS EXC VIRAL MENINGITIS W CC,,,70100.0,70100.0,1
MS-DRG,98,NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITH CC,,,19454.52,30500.0,10
MS-DRG,98,Non Bacterial infect of Nervous System w/CC,,,55934.0,62646.0,2
MS-DRG,981,EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC,,,17927.0,137014.64,32
MS-DRG,982,EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC,,,18150.0,71795.58,32
MS-DRG,983,EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC,,,15144.27,50053.94,32
MS-DRG,987,NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC,,,18150.0,100119.57,32
MS-DRG,988,NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC,,,15555.43,47998.05,32
MS-DRG,989,NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITHOUT CC/MCC,,,10734.25,35020.24,32
MS-DRG,99,NON-BACTERIAL INFECT OF NERVOUS SYS EXC VIRAL MENINGITIS W/O CC/MCC,,,49300.0,49300.0,1
MS-DRG,99,NON-BACTERIAL INFECTION OF NERVOUS SYSTEM EXCEPT VIRAL MENINGITIS WITHOUT CC/MCC,,,12779.7,14441.59,9
MS-DRG,99,NonBacterial Infect of Nervous System w/o CC/MCC,,,37743.0,42272.0,2